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Sample records for pure medical treatment

  1. Acceptability of Musa Balbisiana (Saba Banana Puree in Two Treatments in Making Ice Cream

    Directory of Open Access Journals (Sweden)

    Mario A. De Castro Jr.

    2016-11-01

    Full Text Available Musa Balbisiana or Saba is a variety of banana fruit that is nutritious and readily available in the market the whole year round. This experimental study aimed to determine the acceptability of the ice cream made from Saba banana puree in two treatments (treatment 1- cooked puree and treatment 2- uncooked puree. Data gathered were described and analyzed using a special Analysis of Variance. The sensory characteristics of the ice cream in two treatments were compared with one another based on the 9-point hedonic scale utilized by trained panelist in the education sector in secondary, tertiary and graduate school level that specialized in food related discipline such as Food Technology, Food Service Management, Technology and Livelihood Education- Food Trades and Hotel and Restaurant Management. Results indicated that in treatment 1( cooked puree the taste and texture of the ice cream were liked extremely however its color was rated liked very much, while in treatment 2 (uncooked puree the texture and color were rated liked moderately while its taste was rated liked very much. A comparison of the sensory characteristics between the two treatments revealed that there is a significant difference in terms of taste, texture and color and overall acceptability of the Saba banana ice cream. It is then recommended that in preparing Saba banana puree using treatment 1 (cooking method, the fruit should be subjected in numerous sieving process using a fine mesh siever or sifter to produce good quality puree texture.

  2. Irradiation in combination of heat treatment of mango puree

    International Nuclear Information System (INIS)

    Noomhorm, A.; Apintanapong, M.

    1996-01-01

    The effect of irradiation with heat combination treatment on the shelf life and quality of mango puree was studied. Thermal inactivation of polyphenol oxidase enzyme at 80 degree C and 15 min. was used as a measure of adequacy of pre-heat treatment. Irradiation of mango puree after heat treatment at dosage of 0, 2, 4, 6 and 8 kGy showed no change in mc, pH, acidity, and TSS but during storage, growth of microorganisms brought changes in these values. Irradiation in combination with low temperature (5 degree C) reduced discoloration and darkening rate during storage. Irradiation dose from 0 to 8 kGy resulted in log linear reductions in microorganism levels but at 6 and 8 kGy, there was no growth of microorganisms. Products irradiated at 8 kGy showed no microorganism growth at both temperatures

  3. Effect of Heat Treatment on the Lycopene Content of Tomato Puree ...

    African Journals Online (AJOL)

    Effect of Heat Treatment on the Lycopene Content of Tomato Puree. MI Mohammed, DI Malami. Abstract. Lycopene is a powerful antioxidant. Epidemiological studies have associated its consumption with numerous health benefits. In this study the effects of heating on lycopene were investigated by exposing tomato ...

  4. Safety in wastewater treatment: the pure oxygen system

    International Nuclear Information System (INIS)

    Giagnoni, L.

    1998-01-01

    Though the active sludge process represent, nowadays, the main reference system referring to installations for wastewater treatments, nevertheless systems that exploit the pure oxygen properties constitute an alternative method to the traditional cycle. The following essay is divided into two parts: the first one deals with the fundamental concepts related to the active sludge process and to the alternative system proposed, mentioned before, and includes a short account of the functional characteristics and a brief comparison with traditional methods; the second part represents the head corpus of the work and deals with the problems related to the safety with particular reference to the risk of an explosion meanwhile the process. Moreover, it's drawn attention to the fundamental role of security systems that, nowadays, get frequently used in such kind of installations. On this subject, furthermore, it's pointed out the great importance of the whole preliminary treatments in the planning phase, with particular reference to the processes used for stripping [it

  5. Sixth form pure mathematics

    CERN Document Server

    Plumpton, C

    1968-01-01

    Sixth Form Pure Mathematics, Volume 1, Second Edition, is the first of a series of volumes on Pure Mathematics and Theoretical Mechanics for Sixth Form students whose aim is entrance into British and Commonwealth Universities or Technical Colleges. A knowledge of Pure Mathematics up to G.C.E. O-level is assumed and the subject is developed by a concentric treatment in which each new topic is used to illustrate ideas already treated. The major topics of Algebra, Calculus, Coordinate Geometry, and Trigonometry are developed together. This volume covers most of the Pure Mathematics required for t

  6. Pure oxygen for the urban water waste treatment; Oxigeno puro para tratamiento de aguas residuales urbanas

    Energy Technology Data Exchange (ETDEWEB)

    Estevez Pastor, F.S.; Ferrer Gaztambide, J. [EDAR La China (Spain)

    1995-11-01

    The pilot plant for waste water treatment in La China (Spain) is described. This plant used pure oxygen for the waste water treatment. The best depuration, the flexibility to experiment the fluctuations of flow and change are studied. (Author)

  7. A randomised controlled trial of face to face versus pure online self-help cognitive behavioural treatment for perfectionism.

    Science.gov (United States)

    Egan, Sarah J; van Noort, Emily; Chee, Abby; Kane, Robert T; Hoiles, Kimberley J; Shafran, Roz; Wade, Tracey D

    2014-12-01

    Previous research has shown cognitive-behavioural treatment (CBT) to be effective in reducing perfectionism. The present study investigated the efficacy of two formats of CBT for perfectionism (CBT-P), face-to-face and pure online self-help, in reducing perfectionism and associated psychological symptoms. Participants were randomly allocated to face-to-face CBT-P (n = 18), pure online self-help CBT-P (n = 16), or a waitlist control period (n = 18). There was no significant change for the waitlist group on any of the outcome measures at the end of treatment. Both the face-to-face and pure online self-help groups reported significant reductions at the end of treatment for the perfectionism variables which were maintained at the 6-month follow-up. The face-to-face group also reported significant reductions over this time in depression, anxiety, and stress, and a significant pre-post increase in self-esteem, all of which were maintained at the 6-month follow-up. In contrast, the pure online self-help group showed no significant changes on these outcomes. The face-to-face group was statistically superior to the pure online self-help group at follow-up on the perfectionism measures, concern over mistakes and personal standards. The results show promising evidence for CBT for perfectionism, especially when offered face to face, where sustained benefit across a broad range of outcomes can be expected. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  8. Bone metastases only pure seminoma, evolution and treatment. Literature review and report of a clinical case

    International Nuclear Information System (INIS)

    Vázquez, A.; Cuello, M.; Terzieff, V.; Viola, A.

    2004-01-01

    The only bone metastases in pure seminoma is a biological entity extremely rare. We report a case studied since 2000, treatment and outcome. Case report: 35. Orquiectomizado in September 2000 AP: pure seminoma in the presence of a neoplastic nodule in the spermatic cord.Adjuvant lumboaorticas, left iliac and inguinal chains Rt., 3060 cGy in 3.2 sem. until December 2000 Normal tumor markers throughout the period. In Oct. 2001 TAC control morfoestructural altered posterior the sixth left costal arch. AP: puncture under TAC. Malignant germ cell tumor compatible with pure seminoma. C.O. single lesion. MDT is performed based on PEB for 4 cycles and additional RT obtaining a complete response with reduction bone lesion, asymptomatic until November 2002, again at the level falls costal, VIP x 3 New relapse dorsal paravertebral June 2003, Gemcitabine and Rt paclitaxel, dose intensification transplant. Keeps score high. Poor prognosis. Discussion: In the literature we found no reports of bone lesions only secondary to a pure seminoma. They are described in the context of a frame overall spread in advanced patients and in more than three or four including accompanying synchronous nodal, liver and lung damage. Subsequent developments mark the disease resistance to treatments performed. The three lines are Qt prior to transplantation have shown that best results for the treatment of disease. We discuss the time introduction thereof to obtain a durable complete response. If the marker not normalized but not displayed clinical or paraclinical disease prognosis is bad in the short term

  9. Medical marijuana users in substance abuse treatment

    Directory of Open Access Journals (Sweden)

    Swartz Ronald

    2010-03-01

    Full Text Available Abstract Background The rise of authorized marijuana use in the U.S. means that many individuals are using cannabis as they concurrently engage in other forms of treatment, such as substance abuse counseling and psychotherapy. Clinical and legal decisions may be influenced by findings that suggest marijuana use during treatment serves as an obstacle to treatment success, compromises treatment integrity, or increases the prevalence or severity of relapse. In this paper, the author reviews the relationship between authorized marijuana use and substance abuse treatment utilizing data from a preliminary pilot study that, for the first time, uses a systematic methodology to collect data examining possible effects on treatment. Methods Data from the California Outcomes Measurement System (CalOMS were compared for medical (authorized marijuana users and non-marijuana users who were admitted to a public substance abuse treatment program in California. Behavioral and social treatment outcomes recorded by clinical staff at discharge and reported to the California Department of Alcohol and Drug Programs were assessed for both groups, which included a sample of 18 reported medical marijuana users. Results While the findings described here are preliminary and very limited due to the small sample size, the study demonstrates that questions about the relationship between medical marijuana use and involvement in drug treatment can be systematically evaluated. In this small sample, cannabis use did not seem to compromise substance abuse treatment amongst the medical marijuana using group, who (based on these preliminary data fared equal to or better than non-medical marijuana users in several important outcome categories (e.g., treatment completion, criminal justice involvement, medical concerns. Conclusions This exploratory study suggests that medical marijuana is consistent with participation in other forms of drug treatment and may not adversely affect

  10. Adding Group Psychotherapy to Medication Treatment in Dysthymia

    Science.gov (United States)

    Hellerstein, David J.; Little, Suzanne A. S.; Samstag, Lisa Wallner; Batchelder, Sarai; Muran, J. Christopher; Fedak, Michael; Kreditor, David; Rosenthal, Richard N.; Winston, Arnold

    2001-01-01

    Patients with dysthymia have been shown to respond to treatment with antidepressant medications, and to some degree to psychotherapy. Even patients successfully treated with medication often have residual symptoms and impaired psychosocial functioning. The authors describe a prospective randomized 36-week study of dysthymic patients, comparing continued treatment with antidepressant medication (fluoxetine) alone and medication with the addition of group therapy treatment. After an 8-week trial of fluoxetine, medication-responsive subjects were randomly assigned to receive either continued medication only or medication plus 16 sessions of manualized group psychotherapy. Results provide preliminary evidence that group therapy may provide additional benefit to medication-responding dysthymic patients, particularly in interpersonal and psychosocial functioning. PMID:11264333

  11. Planning of emergency medical treatment in nuclear power plant

    International Nuclear Information System (INIS)

    Kusama, Tomoko

    1989-01-01

    Medical staffs and health physicists have shown deep concerning at the emergency plans of nuclear power plants after the TMI nuclear accident. The most important and basic countermeasure for accidents was preparing appropriate and concrete organization and plans for treatment. We have planed emergency medical treatment for radiation workers in a nuclear power plant institute. The emergency medical treatment at institute consisted of two stages, that is on-site emergency treatment at facility medical service. In first step of planning in each stage, we selected and treatment at facility medical service. In first step of planning in each stage, we selected and analyzed all possible accidents in the institute and discussed on practical treatments for some possible accidents. The manuals of concrete procedure of emergency treatment for some accidents were prepared following discussion and facilities and equipment for medical treatment and decontamination were provided. All workers in the institute had periodical training and drilling of on-site emergency treatment and mastered technique of first aid. Decontamination and operation rooms were provided in the facillity medical service. The main functions at the facility medical service have been carried out by industrial nurses. Industrial nurses have been in close co-operation with radiation safety officers and medical doctors in regional hospital. (author)

  12. Information in medical treatment courses

    DEFF Research Database (Denmark)

    Møller, Marianne; Hollnagel, Erik; Andersen, Stig Ejdrup

    Background Unintended events and suboptimal treatment with medicines are major burdens for patients and health systems all over the world. Information processes have important roles for establishing safe and effective treatment courses. The platform for this Ph.d. study is learning from situations...... to the quality of medical treatment courses. Methods Systems theory, cybernetics (steering, timing and feedback) and a classic communication model are applied as theoretical frames. Two groups of patients and their information providers are studied using qualitative methods. The data analysis focuses...... that goes well (Safety-II) while having a broad understanding of quality. Objectives The overall purpose is to investigate how information is used as a steering tool for quality in medical treatment courses. In this first part of the study, the role of information on medicine is analyzed in relation...

  13. [Apatite-forming ability of pure titanium implant after micro-arc oxidation treatment].

    Science.gov (United States)

    Tian, Zhihui; Zhang, Yu; Wang, Lichao; Nan, Kaihui

    2013-10-01

    To investigate the apatite forming ability of pure titanium implant after micro-arc oxidation treatment in simulated body fluid (SBF) and obtain implants with calcium phosphate (Ca-P) layers. The implants were immersed in (SBF) after micro-arc oxidation treatment for different time lengths, and their apatite forming ability and the morphology and constituents of the Ca-P layers formed on the sample surface were analyzed using X-ray diffraction, scanning electron microscopy, X-ray photoelectron spectroscopy, and energy dispersive electron probe. After immersion in SBF, large quantities of Ca-P layers were induced on the surface of the samples. The Ca-P layers were composed of octacalcium phosphate and carbonated hydroxyapatite, and the crystals showed a plate-like morphology with an oriented growth. The implants with micro-arc oxidation treatment show good apatite forming ability on the surface with rich calcium and phosphorus elements. The formed layers are composed of bone-like apatite including octacalcium phosphate and carbonated hydroxyapatite.

  14. Effect of heat treatment on bend stress relaxation of pure tungsten

    International Nuclear Information System (INIS)

    Sasaki, Kenta; Nogami, Shuhei; Fukuda, Makoto; Katakai, Yasuyuki; Hasegawa, Akira

    2013-01-01

    Highlights: • Bend stress relaxation test was performed on the pure tungsten after heat treatment for stress relief. • The BSR ratio of the heat treated specimen was larger than that of the as-received specimen at this temperature region. • Small reduction in the BSR ratio was observed at the temperatures of 500–800 °C. • The BSR ratio of the heat treated specimen decreased significantly at the temperatures of 900–1000 °C. • The BSR ratio decreased significantly in a short time below 0.1 h, and then decreased slowly. -- Abstract: Bend stress relaxation (BSR) tests at temperatures of 500, 600, 800, 900 and 1000 °C for 0.1, 0.5 and 1 h in vacuum were performed on the pure tungsten after heat treatment for stress relief at 900 °C for 1 h. The degree of stress relaxation increased with test temperature. The BSR ratio of the heat treated specimen was larger than that of the as-received specimen at this temperature region. Small reduction in the BSR ratio was observed at the temperatures of 500, 600 and 800 °C. The BSR ratio of the heat treated specimen decreased significantly at the temperatures of 900 and 1000 °C and it was close to that of the as-received specimen. The BSR ratio of the heat treated specimen and the as-received specimen exhibited similar trend of time-evolution. The stress was exponentially relaxed with increasing test time. The BSR ratio decreased significantly in a short time below 0.1 h, and then decreased slowly. Higher activation energy of stress relaxation evaluated by cross-cut method was obtained for the higher temperature

  15. Medical Treatment for Uterine Myomas

    Directory of Open Access Journals (Sweden)

    Ming-Hui Cheng

    2008-03-01

    Full Text Available Uterine myomas are the most common benign tumors in the female reproductive tract. Most women with myomas are asymptomatic. Therefore, expectant observation and follow-up are often recommended for these myoma patients. However, myomas may cause menstrual symptoms, pelvic pain, pressure complaints, subfer-tility or pregnancy-related complications, with resultant requests for a definitive treatment. The management of myomas has become multidisciplinary in the past 20 years. Basically, the choice of treatment depends on the patient's age, the reason for treatment, the issue of fertility preservation, and the patient's preference. The treatment spectrum includes an expectant management, medical therapy, surgical intervention, uterine artery embolization or ablative techniques. Medical therapy is an option for women with symptomatic myomas who prefer non-surgical treatment, consider fertility preservation, or expect a less aggressive operation after shrinkage of the uterine volume. This review will summarize the recent well-documented drugs for the management of uterine myomas.

  16. Medical Treatment of Gastroenteropancreatic Neuroendocrine Tumors

    Directory of Open Access Journals (Sweden)

    Thomas Gress

    2012-02-01

    Full Text Available Treatment of the clinically and prognostically heterogeneous neuroendocrine neoplasms (NEN should be based on a multidisciplinary approach, including surgical, interventional, medical and nuclear medicine-based therapeutic options. Medical therapies include somatostatin analogues, interferon-a, mTOR inhibitors, multikinase inhibitors and systemic chemotherapy. For the selection of the appropriate medical treatment the hormonal activity, primary tumor localization, tumor grading and growth behaviour as well as the extent of the disease must be considered. Somatostatin analogues are mainly indicated in hormonally active tumors for symptomatic relief, but antiproliferative effects have also been demonstrated, especially in well-differentiated intestinal NET. The efficacy of everolimus and sunitinib in patients with pancreatic neuroendocrine tumors (pNET has been demonstrated in large placebo-controlled clinical trials. pNETs are also chemosensitive. Streptozocin-based chemotherapeutic regimens are regarded as current standard of care. Temozolomide in combination with capecitabine is an alternative that has shown promising results that need to be confirmed in larger trials. Currently, no comparative studies and no molecular markers are established that predict the response to medical treatment. Therefore the choice of treatment for each pNET patient is based on individual parameters taking into account the patient’s preference, expected side effects and established response criteria such as proliferation rate and tumor load. Platin-based chemotherapy is still the standard treatment for poorly differentiated neuroendocrine carcinomas. Clearly, there is an unmet need for new systemic treatment options in patients with extrapancreatic neuroendocrine tumors.

  17. [Major breakthroughs in the medical treatment

    DEFF Research Database (Denmark)

    Kirk, O.; Gerstoft, J.; Lundgren, J.D.

    2009-01-01

    The introduction of antiretroviral combination therapy for patients with HIV infection is described as an example of a breakthrough within the field of medical treatment. The background for the breakthrough and the phases thereof are described and for comparison, the circumstances of major breakt...... breakthroughs within other medical specialities are mentioned Udgivelsesdato: 2009/3/2......The introduction of antiretroviral combination therapy for patients with HIV infection is described as an example of a breakthrough within the field of medical treatment. The background for the breakthrough and the phases thereof are described and for comparison, the circumstances of major...

  18. Forensic investigation of medical treatment related deaths.

    Science.gov (United States)

    Ibrahim, Joseph E; Ranson, David L; O'Brien, Adam; Charles, Amanda; Young, Carmel

    2009-04-01

    Patients suffer preventable harm from their medical treatment. The traditional approaches to investigating medical treatment related deaths are the 'hospital mortality audit' and legal or coroners investigation. The aim is to describe how the patient safety movement in the late 1990s is changing traditional approaches to the investigation. The prevention of medical treatment related death involves an investigation as one of five major stages. These are Stage I Preparedness; Stage II Recognition and reporting; Stage III Investigation and analysis; Stage IV Findings and recommendations; and Stage V Response. The influence of the patient safety approach is considered at each stage with a particular focus on Stage I. It is at this stage that the concepts of clinical governance, culture and systems of care have a major influence on the nature of an investigation. The genesis of the modern forensic investigation into medical treatment related deaths in Victoria, Australia is described. The formation of the Clinical Liaison Service incorporates concepts from the patient safety approach with clinical staff to transform the traditional Coroner's investigation. Benefits of a modern forensic investigation include improving appropriateness of cases proceeding to investigation and a focus on prevention. Achieving a reduction in medical treatment related death requires substantial shifts towards an approach consistent with the patient safety.

  19. 28 CFR 549.43 - Involuntary psychiatric treatment and medication.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Involuntary psychiatric treatment and... INSTITUTIONAL MANAGEMENT MEDICAL SERVICES Administrative Safeguards for Psychiatric Treatment and Medication § 549.43 Involuntary psychiatric treatment and medication. Title 18 U.S.C. 4241-4247 and federal court...

  20. Emergency medical treatment and 'do not resuscitate' orders: When ...

    African Journals Online (AJOL)

    Whether there is a conflict between these two requirements is answered by considering: (i) the meaning of emergency medical treatment; (ii) the relationship between emergency medical treatment and DNR orders; (iii) the meaning of futile medical treatment; (iv) the relationship between DNR orders and euthanasia; and (v) ...

  1. Bayero Journal of Pure and Applied Sciences: Submissions

    African Journals Online (AJOL)

    Bayero Journal of Pure and Applied Sciences (BAJOPAS) is an international journal that publishes original research and critical reviews in broad areas of ... Technology, Mathematical Sciences, Microbiology, Physics and Medical Sciences.

  2. Bayero Journal of Pure and Applied Sciences

    African Journals Online (AJOL)

    The Journal's scope is wide in that it reported findings in the areas of pure and ... Physics, Medical Sciences and Zoology form part of the contents of the Journal. Scientists in the academia, research institutes and industries are therefore ...

  3. Influence of homogenization treatment on physicochemical properties and enzymatic hydrolysis rate of pure cellulose fibers.

    Science.gov (United States)

    Jacquet, N; Vanderghem, C; Danthine, S; Blecker, C; Paquot, M

    2013-02-01

    The aim of this study is to compare the effect of different homogenization treatments on the physicochemical properties and the hydrolysis rate of a pure bleached cellulose. Results obtained show that homogenization treatments improve the enzymatic hydrolysis rate of the cellulose fibers by 25 to 100 %, depending of the homogenization treatment applied. Characterization of the samples showed also that homogenization had an impact on some physicochemical properties of the cellulose. For moderate treatment intensities (pressure below 500 b and degree of homogenization below 25), an increase of water retention values (WRV) that correlated to the increase of the hydrolysis rate was highlighted. Result also showed that the overall crystallinity of the cellulose properties appeared not to be impacted by the homogenization treatment. For higher treatment intensities, homogenized cellulose samples developed a stable tridimentional network that contributes to decrease cellulase mobility and slowdown the hydrolysis process.

  4. Surface modification of TA2 pure titanium by low energy high current pulsed electron beam treatments

    International Nuclear Information System (INIS)

    Gao Yukui

    2011-01-01

    Surface integrity changes of TA2 pure titanium including surface topography, microstructure and nanohardness distribution along surface layer were investigated by different techniques of low energy high current pulsed electron beam treatments (LEHCPEBTs). The surface topography was characterized by SEM. Moreover, the TEM observation and X-ray diffraction analysis were performed to reveal the surface modification mechanism of TA2 pure titanium by LEHCPEBTs. The surface roughness was modified by electron beam treatment and the polishing mechanism was analyzed by studying the cross section microstructure of electron beam treated specimens by SEM and TEM. The results show that the surface finish obtains good polishing quality and there is no phase transformation but the dislocations by LEHCPEBT. Furthermore, the nanohardness in the surface modified layer is improved. The remelt and fine-grain microstructure of surface layer caused by LEHCPEBTs are the main polishing mechanism and the reason of modification of surface topography and the increment in nanohardness is mainly due to the dislocations and fine grains in the modified layer induced by LEHCPEBT.

  5. Alcoholism treatment and medical care costs from Project MATCH.

    Science.gov (United States)

    Holder, H D; Cisler, R A; Longabaugh, R; Stout, R L; Treno, A J; Zweben, A

    2000-07-01

    This paper examines the costs of medical care prior to and following initiation of alcoholism treatment as part of a study of patient matching to treatment modality. Longitudinal study with pre- and post-treatment initiation. The total medical care costs for inpatient and outpatient treatment for patients participating over a span of 3 years post-treatment. Three treatment sites at two of the nine Project MATCH locations (Milwaukee, WI and Providence, RI). Two hundred and seventy-nine patients. Patients were randomly assigned to one of three treatment modalities: a 12-session cognitive behavioral therapy (CBT), a four-session motivational enhancement therapy (MET) or a 12-session Twelve-Step facilitation (TSF) treatment over 12 weeks. Total medical care costs declined from pre- to post-treatment overall and for each modality. Matching effects independent of clinical prognosis showed that MET has potential for medical-care cost-savings. However, patients with poor prognostic characteristics (alcohol dependence, psychiatric severity and/or social network support for drinking) have better cost-savings potential with CBT and/or TSF. Matching variables have significant importance in increasing the potential for medical-care cost-reductions following alcoholism treatment.

  6. Diagnosis and treatment of thymoma associated with pure red cell aplasia: three cases report

    International Nuclear Information System (INIS)

    Wang Wencai; Xu Wuyin

    2000-01-01

    Objective: To discuss how to diagnose and treat thymoma associated with pure red cell aplasia (PRCA). Methods: Three patients of thymoma associated with PRCA were treated with thymothymectomy, and the local radiotherapy was conducted after operation for avoiding the thymoma reproduction. Determining of their peripheral blood hemoglobin was used to evaluate the postoperation result in PRCA. If PRCA can not be relieved, oral prednisone and cyclosporin A were given. Results: One patient with PRCA was cured, the second patient remained in remission by treatment with prednisone and CsA, and the third patient was in progress. Conclusion: The treatment by means of 'thymothymectomy-local radiotherapy-use of prednisone and CsA', is effective for thymoma associated with PRCA

  7. The Comparison of Double J Stent Insertion and Conservative Treatment Alone in Severe Pure Gestational Hydronephrosis: A Case Controlled Clinical Study

    Science.gov (United States)

    Çeçen, Kürşat; Ülker, Kahraman

    2014-01-01

    Objective. Management options of gestational hydronephrosis are based on the coexisting stone disease, pyelonephritis, and renal disease. However, the management option and its consequences in the absence of a coexisting disease state are not clear. In this study we aimed to compare the effectiveness of conservative treatment and double J insertion in symptomatic pure gestational hydronephrosis. Material and Methods. The data of the women with severe pure gestational hydronephrosis over a nine-year period was collected retrospectively. The included women were grouped into two according to receiving double J stent insertion or conservative treatments. Results. Double J insertion and conservative treatment groups included 24 and 29 women, respectively. Hydronephrosis was demonstrated on the right, left, or both kidneys in 37 (70%), 13 (24%), and 3 (6%) women, respectively. None of the participants gave birth prior to the 37th week. The demographics, initial pain scores, the severity of the hydronephrosis during first admission, and pain scores one week after the interventions did not differ significantly between groups (P > 0.05). Similarly, the rates of complications, postpartum pain scores, and permanent hydronephrosis did not differ between groups (P > 0.05). Conclusion. Double J insertion in symptomatic pure gestational hydronephrosis adds no benefit to conservative treatment. PMID:24574939

  8. The Comparison of Double J Stent Insertion and Conservative Treatment Alone in Severe Pure Gestational Hydronephrosis: A Case Controlled Clinical Study

    Directory of Open Access Journals (Sweden)

    Kürşat Çeçen

    2014-01-01

    Full Text Available Objective. Management options of gestational hydronephrosis are based on the coexisting stone disease, pyelonephritis, and renal disease. However, the management option and its consequences in the absence of a coexisting disease state are not clear. In this study we aimed to compare the effectiveness of conservative treatment and double J insertion in symptomatic pure gestational hydronephrosis. Material and Methods. The data of the women with severe pure gestational hydronephrosis over a nine-year period was collected retrospectively. The included women were grouped into two according to receiving double J stent insertion or conservative treatments. Results. Double J insertion and conservative treatment groups included 24 and 29 women, respectively. Hydronephrosis was demonstrated on the right, left, or both kidneys in 37 (70%, 13 (24%, and 3 (6% women, respectively. None of the participants gave birth prior to the 37th week. The demographics, initial pain scores, the severity of the hydronephrosis during first admission, and pain scores one week after the interventions did not differ significantly between groups (P>0.05. Similarly, the rates of complications, postpartum pain scores, and permanent hydronephrosis did not differ between groups (P>0.05. Conclusion. Double J insertion in symptomatic pure gestational hydronephrosis adds no benefit to conservative treatment.

  9. Nanobots The Future Of Medical Treatments

    Directory of Open Access Journals (Sweden)

    Somanna M B

    2015-08-01

    Full Text Available Abstract Nanobots will help bridge the technological gaps between physics chemistry and biology on the nano-scale. This will lead to many innovative approaches which will result in new methods and products for both technological and medical-pharmaceutical applications. In this report the following questions are addressed How a nanobot works and how nanobots can contribute to medical technology. Advancement in technology is essential for the treatment of many problems such as implants related to bones and membranes. Furthermore nanobots are good candidates for these complex treatments with their size being very small. Nanobots are also considered and some are already in use as drug delivery systems and contrast agents. It is argued that coated nanobots functionalized with target molecules are interacting with external devices offering real prospective for medical applications.

  10. Potential of different mechanical and thermal treatments to control off-flavour generation in broccoli puree.

    Science.gov (United States)

    Koutidou, Maria; Grauwet, Tara; Van Loey, Ann; Acharya, Parag

    2017-02-15

    The aim of this study was scientifically investigate the impact of the sequence of different thermo-mechanical treatments on the volatile profile of differently processed broccoli puree, and to investigate if any relationship persists between detected off-flavour changes and microstructural changes as a function of selected process conditions. Comparison of the headspace GC-MS fingerprinting of the differently processed broccoli purees revealed that an adequate combination of processing steps allows to reduce the level of off-flavour volatiles. Moreover, applying mechanical processing before or after the thermal processing at 90°C determines the pattern of broccoli tissue disruption, resulting into different microstructures and various enzymatic reactions inducing volatile generation. These results may aid the identification of optimal process conditions generating a reduced level of off-flavour in processed broccoli. In this way, broccoli can be incorporated as a food ingredient into mixed food products with limited implications on sensorial consumer acceptance. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Effect of pectinase treatment on extraction of antioxidant phenols from pomace, for the production of puree-enriched cloudy apple juices.

    Science.gov (United States)

    Oszmiański, Jan; Wojdyło, Aneta; Kolniak, Joanna

    2011-07-15

    Effects of pomace maceration on yield, turbidity, cloud stability, composition of phenolics, antioxidant activity and colour properties were studied, to evaluate the potential applicability of enzyme preparations in puree-enriched cloudy apple juice production. The yield of mixed juice and puree from pomace obtained in the enzymatic processing of apple ranged from 92.3% to 95.3%, significantly higher than the yield from the control without enzymatic pomace treatment (81.8%). Higher turbidity was obtained upon pomace treatment with Pectinex XXL and Pectinex Ultra SPL enzymes. The total content of phenolic compounds in apple pomace was higher than in raw juices (1520mg/kg and 441mg/L, respectively). The total polyphenol yields were higher in juices treated with Pectinex AFP L-4, Pectinex Yield Mash and Pectinex XXL, as compared to the control treatment. During 6months of storage, a significant change was observed in the content of polyphenols, especially in procyanidin fractions. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  12. Osteoporosis Treatment: Medications Can Help

    Science.gov (United States)

    ... help Osteoporosis treatment may involve medication along with lifestyle change. Get answers to some of the most common ... 2017. Khan M, et al. Drug-related adverse events of osteoporosis therapy. ... and management of osteoporosis. European Journal of Rheumatology. 2017;4: ...

  13. Refusal of Emergency Medical Treatment: Case Studies and Ethical Foundations.

    Science.gov (United States)

    Marco, Catherine A; Brenner, Jay M; Kraus, Chadd K; McGrath, Norine A; Derse, Arthur R

    2017-11-01

    Informed consent is an important component of emergency medical treatment. Most emergency department patients can provide informed consent for treatment upon arrival. Informed consent should also be obtained for emergency medical interventions that may entail significant risk. A related concept to informed consent is informed refusal of treatment. Patients may refuse emergency medical treatment during their evaluation and treatment. This article addresses important considerations for patients who refuse treatment, including case studies and discussion of definitions, epidemiology, assessment of decisional capacity, information delivery, medicolegal considerations, and alternative care plans. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  14. Combined Medical Treatment Of Chronic Pancreatitis

    Directory of Open Access Journals (Sweden)

    Umnova Larisa

    2015-04-01

    Full Text Available The aim of the study was to determine the most effective medical treatment of patients with chronic pancreatitis, by using either pancreatin alone or in combination with proton pump inhibitor (PPI or PPI and non-steroidal anti-inflammatory drug (NSAID. Patients with chronic pancreatitis, who did not require a surgical treatment, received medical treatment for a one–month period: 20 patients received pancreatin monotherapy; 48 patients were given a combination of pancreatin and PPI; 38 patients were treated with a combination of pancreatin, PPI and NSAID (PNP therapy group. In comparison with other groups, patients in the PNP therapy group showed improvement in body mass index, abdominal pain, bowel movements, chronic pancreatitis severity, as well as their quality of life assessment (p < 0.05. The combination of pancreatin, PPI and NSAID was the most effective among those applied in chronic pancreatitis patient treatment. A one–month long course of this therapy was safe and did not cause any significant adverse effects. The combination of pancreatin, PPI and NSAID for treatment of chronic pancreatitis can be recommended, as it is based on pathogenesis of the disease, effective, safe and economically advantageous.

  15. Current Medications for the Treatment of Attention-Deficit/Hyperactivity Disorder

    Science.gov (United States)

    Vaughan, Brigette S.; Roberts, Holly J.; Needelman, Howard

    2009-01-01

    Attention-Deficit/Hyperactivity Disorder (ADHD) is common among children. Fortunately, ADHD is highly treatable with medication. The purpose of this article is to serve as a primer on medication treatment for ADHD for school psychologists. The article discusses the available stimulant and nonstimulant medication for the treatment of ADHD.…

  16. Medical high-resolution image sharing and electronic whiteboard system: A pure-web-based system for accessing and discussing lossless original images in telemedicine.

    Science.gov (United States)

    Qiao, Liang; Li, Ying; Chen, Xin; Yang, Sheng; Gao, Peng; Liu, Hongjun; Feng, Zhengquan; Nian, Yongjian; Qiu, Mingguo

    2015-09-01

    There are various medical image sharing and electronic whiteboard systems available for diagnosis and discussion purposes. However, most of these systems ask clients to install special software tools or web plug-ins to support whiteboard discussion, special medical image format, and customized decoding algorithm of data transmission of HRIs (high-resolution images). This limits the accessibility of the software running on different devices and operating systems. In this paper, we propose a solution based on pure web pages for medical HRIs lossless sharing and e-whiteboard discussion, and have set up a medical HRI sharing and e-whiteboard system, which has four-layered design: (1) HRIs access layer: we improved an tile-pyramid model named unbalanced ratio pyramid structure (URPS), to rapidly share lossless HRIs and to adapt to the reading habits of users; (2) format conversion layer: we designed a format conversion engine (FCE) on server side to real time convert and cache DICOM tiles which clients requesting with window-level parameters, to make browsers compatible and keep response efficiency to server-client; (3) business logic layer: we built a XML behavior relationship storage structure to store and share users' behavior, to keep real time co-browsing and discussion between clients; (4) web-user-interface layer: AJAX technology and Raphael toolkit were used to combine HTML and JavaScript to build client RIA (rich Internet application), to meet clients' desktop-like interaction on any pure webpage. This system can be used to quickly browse lossless HRIs, and support discussing and co-browsing smoothly on any web browser in a diversified network environment. The proposal methods can provide a way to share HRIs safely, and may be used in the field of regional health, telemedicine and remote education at a low cost. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Selection of medical treatment in stable angina pectoris

    DEFF Research Database (Denmark)

    Ardissino, D; Savonitto, S; Egstrup, K

    1995-01-01

    pectoris. BACKGROUND: The characteristics of anginal symptoms and the results of exercise testing are considered of great importance for selecting medical treatment in patients with chronic stable angina pectoris. However, little information is available on how this first evaluation may be used to select....... CONCLUSIONS: The results of a baseline exercise test, but not the characteristics of anginal symptoms, may offer useful information for selecting medical treatment in stable angina pectoris....

  18. Rational noncompliance with prescribed medical treatment.

    Science.gov (United States)

    Stewart, Douglas O; DeMarco, Joseph P

    2010-09-01

    Despite the attention that patient noncompliance has received from medical researchers, patient noncompliance remains poorly understood and difficult to alter. With a better theory of patient noncompliance, both greater success in achieving compliance and greater respect for patient decision making are likely. The theory presented, which uses a microeconomic approach, bridges a gap in the extant literature that has so far ignored the contributions of this classic perspective on decision making involving the tradeoff of costs and benefits. The model also generates a surprising conclusion: that patients are typically acting rationally when they refuse to comply with certain treatments. However, compliance is predicted to rise with increased benefits and reduced costs. The prediction that noncompliance is rational is especially true in chronic conditions at the point that treatment begins to move closer to the medically ideal treatment level. Although the details of this theory have not been tested empirically, it is well supported by existing prospective and retrospective studies.

  19. Oriental Medical Treatment of Lumbar Spinal Stenosis

    Directory of Open Access Journals (Sweden)

    Hae-Yeon Lee

    2003-12-01

    Full Text Available Lumbar spinal stenosis results from the progressive combined narrowing of the central spinal canal, the neurorecesses, and the neuroforaminal canals. In the absence of prior surgery, tumor, or infection, the spinal canal may become narrowed by bulging or protrusion of the intervertebral disc annulus, herniation of the nucleus pulposis posteriorly, thickening of the posterior longitudinal ligament, hypertrophy of the ligamentum flavum, epidural fat deposition, spondylosis of the intervertebral disc margins, or a combination of two or more of the above factors. Patients with spinal stenosis become symptomatic when pain, motor weakness, paresthesia, or other neurologic compromise causes distress. In one case, we administrated oriental medical treatment with acupuncture treatment and herb-medicine. Oriental medical treatment showed desirable effect on lumbar spinal stenosis.

  20. Pure water syndrome: Bacteriological quality of Sachet- packed ...

    African Journals Online (AJOL)

    Pure water syndrome: Bacteriological quality of Sachet- packed drinking water ... of fecal contamination and inadequate water treatment or no treatment at all. ... of hygiene criteria were present in the range of 98 and 106 cfu/100ml of water ...

  1. Improving quality of an innovative pea puree by high hydrostatic pressure.

    Science.gov (United States)

    Klug, Tâmmila Venzke; Martínez-Sánchez, Ascensión; Gómez, Perla A; Collado, Elena; Aguayo, Encarna; Artés, Francisco; Artés-Hernández, Francisco

    2017-10-01

    The food industry is continuously innovating to fulfill consumer demand for new, healthy, ready-to-eat products. Pea purees could satisfy this trend by increasing the intake of legumes, which are an important source of nutrients. Moreover, sensorial properties like viscosity could be improved by high hydrostatic pressure (HHP). In this study the effect of a boiling treatment (10 min) followed by HHP at 550 kPa (0, 5 or 10 min) on the rheological properties, associated with enzymatic activity and particle size, as well as on the microbial and sensory quality of a pea-based puree stored for 36 days at 5 °C, has been assessed. The particle size of pea puree decreased after all processing treatments, but increased during storage in HHP-treated samples. Conversely, boiling treatment showed an increase in polygalacturonase activity at the end of the storage period, with a decrease in particle size, viscosity and stability. However, 5 min of 550 kPa HHP showed the highest mean particle size, mean surface diameter and viscosity regarding the remaining treatments. The microbial load remained low during storage. HHP treatment can be used by the food industry to improve the rheological properties, viscosity and stability of pea purees. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  2. Gastroesophageal Reflux Disease: Medical or Surgical Treatment?

    Directory of Open Access Journals (Sweden)

    Theodore Liakakos

    2009-01-01

    Full Text Available Background. Gastroesophageal reflux disease is a common condition with increasing prevalence worldwide. The disease encompasses a broad spectrum of clinical symptoms and disorders from simple heartburn without esophagitis to erosive esophagitis with severe complications, such as esophageal strictures and intestinal metaplasia. Diagnosis is based mainly on ambulatory esophageal pH testing and endoscopy. There has been a long-standing debate about the best treatment approach for this troublesome disease. Methods and Results. Medical treatment with PPIs has an excellent efficacy in reversing the symptoms of GERD, but they should be taken for life, and long-term side effects do exist. However, patients who desire a permanent cure and have severe complications or cannot tolerate long-term treatment with PPIs are candidates for surgical treatment. Laparoscopic antireflux surgery achieves a significant symptom control, increased patient satisfaction, and complete withdrawal of antireflux medications, in the majority of patients. Conclusion. Surgical treatment should be reserved mainly for young patients seeking permanent results. However, the choice of the treatment schedule should be individualized for every patient. It is up to the patient, the physician and the surgeon to decide the best treatment option for individual cases.

  3. Contemporary Management of Struvite Stones Using Combined Endourologic and Medical Treatment: Predictors of Unfavorable Clinical Outcome.

    Science.gov (United States)

    Iqbal, Muhammad Waqas; Youssef, Ramy F; Neisius, Andreas; Kuntz, Nicholas; Hanna, Jonathan; Ferrandino, Michael N; Preminger, Glenn M; Lipkin, Michael E

    2016-07-01

    Struvite stones have been associated with significant morbidity and mortality, yet there has not been a report on the medical management of struvite stones in almost 20 years. We report on the contemporary outcomes of the surgical and medical management of struvite stones in a contemporary series. A retrospective review of patients who were treated with percutaneous nephrolithotomy (PCNL) for struvite stones at Duke University Medical Center between January 2005 and September 2012 identified a total of 75 patients. Of these, 43 patients had adequate follow-up and were included in this analysis. Stone activity, defined as either stone recurrence or stone-related events, and predictors of activity were evaluated after combined surgical and medical treatment. The study included 43 patients with either pure (35%) or mixed (65%) struvite stones with a median age of 55±15 years (range 21-89 years). The stone-free rate after PCNL was 42%. Stone recurrence occurred in 23% of patients. Postoperatively, 30% of patients had a stone-related event, while 60% of residual stones remained stable with no growth after a median follow-up of 22 months (range 6-67 mos). Kidney function remained stable during follow-up. Independent predictors of stone activity included the presence of residual stones >0.4 cm(2), preoperative large stone burden (>10 cm(2)), and the presence of medical comorbidities (P<0.05). Struvite stones can be managed safely with PCNL followed by medical therapy. The majority of patients with residual fragments demonstrated no evidence of stone growth on medical therapy. With careful follow-up and medical management, kidney function can be maintained and stone morbidity can be minimized. Initial large stone burden, residual stones after surgery, and associated medical comorbidities may have deleterious effect on stone recurrence or residual stone-related events.

  4. Medical versus surgical treatment for refractory or recurrent peptic ulcer.

    Science.gov (United States)

    Gurusamy, Kurinchi Selvan; Pallari, Elena

    2016-03-29

    Refractory peptic ulcers are ulcers in the stomach or duodenum that do not heal after eight to 12 weeks of medical treatment or those that are associated with complications despite medical treatment. Recurrent peptic ulcers are peptic ulcers that recur after healing of the ulcer. Given the number of deaths due to peptic ulcer-related complications and the long-term complications of medical treatment (increased incidence of fracture), it is unclear whether medical or surgical intervention is the better treatment option in people with recurrent or refractory peptic ulcers. To assess the benefits and harms of medical versus surgical treatment for people with recurrent or refractory peptic ulcer. We searched the specialised register of the Cochrane Upper GI and Pancreatic Diseases group, the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded, and trials registers until September 2015 to identify randomised trials and non-randomised studies, using search strategies. We also searched the references of included studies to identify further studies. We considered randomised controlled trials and non-randomised studies comparing medical treatment with surgical treatment in people with refractory or recurrent peptic ulcer, irrespective of language, blinding, or publication status for inclusion in the review. Two review authors independently identified trials and extracted data. We planned to calculate the risk ratio, mean difference, standardised mean difference, or hazard ratio with 95% confidence intervals using both fixed-effect and random-effects models with Review Manager 5 based on intention-to-treat analysis. We included only one non-randomised study published 30 years ago in the review. This study included 77 participants who had gastric ulcer and in whom medical therapy (histamine H2 receptor blockers, antacids, and diet) had failed after an average duration of treatment of 29 months. The

  5. Use of combined treatments involving gamma irradiation for the sterilization of a carrot puree intended to immunocompromised patients

    International Nuclear Information System (INIS)

    Gharbi Yahyaoui, Asma

    2010-01-01

    In this study, we were interested to the application of a series of combined physical treatments (blanching, vacuum packaging and irradiation) on carrot puree. The results showed that with sub-lethal dose of 3 kGy in combination with moderate heat treatment and moderate pressure vacuum we can achieve an undetectable level of bacteria while preserving the antioxidant activity and the phenolic content. The combination of mild irradiation doses with other physical or biological preservation methods can be used to provide more dietary variety for immunocompromised patients and other groups since it ensures stable sterile foods.

  6. The mixed message behind "Medication-Assisted Treatment" for substance use disorder.

    Science.gov (United States)

    Robinson, Sean M; Adinoff, Bryon

    2018-01-01

    The gap between treatment utilization and treatment need for substance use disorders (SUDs) remains a significant concern in our field. While the growing call to bridge this gap often takes the form of more treatment services and/or better integration of existing services, this perspective proposes that more effective labels for and transparent descriptions of existing services would also have a meaningful impact. Adopting the perspective of a consumer-based health-care model (wherein treatments and services are products and patients are consumers) allows us to consider how labels like Addiction-focused Medical Management, Medication-Assisted Treatment, Medication-Assisted Therapy, and others may actually be contributing to the underutilization problem rather than alleviating it. In this perspective, "Medication-Assisted Therapy" for opioid-use disorder (OUD) is singled out and discussed as inherently confusing, providing the message that pharmacotherapy for this disorder is a secondary treatment to other services which are generally regarded, in practice, as ancillary. That this mixed message is occurring amidst a nationwide "opioid epidemic" is a potential cause for concern and may actually serve to reinforce the longstanding, documented stigma against OUD pharmacotherapy. We recommend that referring to pharmacotherapy for SUD as simply "medication," as we do for other chronic medical disorders, will bring both clarity and precision to this effective treatment approach.

  7. Testing for clinical inertia in medication treatment of bipolar disorder.

    Science.gov (United States)

    Hodgkin, Dominic; Merrick, Elizabeth L; O'Brien, Peggy L; McGuire, Thomas G; Lee, Sue; Deckersbach, Thilo; Nierenberg, Andrew A

    2016-11-15

    Clinical inertia has been defined as lack of change in medication treatment at visits where a medication adjustment appears to be indicated. This paper seeks to identify the extent of clinical inertia in medication treatment of bipolar disorder. A second goal is to identify patient characteristics that predict this treatment pattern. Data describe 23,406 visits made by 1815 patients treated for bipolar disorder during the STEP-BD practical clinical trial. Visits were classified in terms of whether a medication adjustment appears to be indicated, and also whether or not one occurred. Multivariable regression analyses were conducted to find which patient characteristics were predictive of whether adjustment occurred. 36% of visits showed at least 1 indication for adjustment. The most common indications were non-response to medication, side effects, and start of a new illness episode. Among visits with an indication for adjustment, no adjustment occurred 19% of the time, which may be suggestive of clinical inertia. In multivariable models, presence of any indication for medication adjustment was a predictor of receiving one (OR=1.125, 95% CI =1.015, 1.246), although not as strong as clinical status measures. The associations observed are not necessarily causal, given the study design. The data also lack information about physician-patient communication. Many patients remained on the same medication regimen despite indications of side effects or non-response to treatment. Although lack of adjustment does not necessarily reflect clinical inertia in all cases, the reasons for this treatment pattern merit further examination. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. MEDICAL vs. MEDICAL AND SURGICAL TREATMENT FOR BRUCELLA ENDOCARDITIS: A REVIEW OF THE LITERATURE

    Science.gov (United States)

    Keshtkar-Jahromi, Maryam; Razavi, Seyed-Mostafa; Gholamin, Sharareh; Keshtkar-Jahromi, Marzieh; Hossain, Mian; Sajadi, Mohammad

    2012-01-01

    This review was undertaken to determine the role of surgery in the treatment of brucella endocarditis. All English and French articles reporting brucella endocarditis (1966–2011) in Pubmed, Google and Scopus were reviewed. 308 cases were identified and Linear and Logistic regression was performed. Surgery improved outcomes by decreasing mortality from 32.7% in the medical treatment only group to 6.7% in the combined surgical and medical treatment group (p<.001). This association was still significant while controlling for other contributing factors. In the absence of a controlled trial, we recommend the utmost vigilance and consideration of surgical management in treating such patients. PMID:23102495

  9. The economic burden of overseas medical treatment: a cross sectional study of Maldivian medical travelers.

    Science.gov (United States)

    Suzana, Mariyam; Mills, Anne; Tangcharoensathien, Viroj; Chongsuvivatwong, Virasakdi

    2015-09-26

    Access to tertiary care is a problem common to many small states, especially island ones. Although medical treatment overseas (MTO) may result in cost savings to high income countries, it can be a relatively high cost for low and middle income source countries. The purpose of this study was to estimate the costs of overseas medical treatment incurred by the households of medical travelers from Maldives and assess the burden of medical treatment overseas on the government and on households. A survey was conducted of inbound Maldivian medical travelers who traveled during the period June - December 2013. Participants were stratified by the source of funds used for treatment abroad. Three hundred and forty four government-subsidized and 471 privately funded Maldivians were interviewed. Self-reported data on the utilization and expenses incurred during the last visit abroad, including both expenses covered by the government and borne by the household, were collected using a researcher administered structured questionnaire. The median per capita total cost of a medical travel episode amounted to $1,470. Forty eight percent of the cost was spent on travel. Twenty six percent was spent on direct medical costs, which were markedly higher among patients subsidized by the government than self-funded patients (p = economic burden to the Maldives in terms of lost consumer spending in the local economy and catastrophic health spending by households. Geographical inequality in access to public funds for MTO and the disproportionate travel cost borne by travelers from rural areas need to be addressed in the existing Universal Health Care programme to minimize the burden of MTO. Increased investment to create more capacity in the domestic health infrastructure either through government, private or by foreign direct investment can help divert the outflow on MTO.

  10. The limits of parental responsibility regarding medical treatment decisions.

    Science.gov (United States)

    Woolley, Sarah L

    2011-11-01

    Parental responsibility (PR) was a concept introduced by the Children Act (CA) 1989 which aimed to replace the outdated notion of parental rights and duties which regarded children as parental possessions. Section 3(1) CA 1989 defines PR as 'all the rights, duties, powers, responsibilities and authority which by law a parent of a child has in relation to the child'. In exercising PR, individuals may make medical treatment decisions on children's behalf. Medical decision-making is one area of law where both children and the state can intercede and limit parental decision-making. Competent children can consent to treatment and the state can interfere if parental decisions are not seemingly in the child's 'best interests'. This article examines the concept, and limitations, of PR in relation to medical treatment decision-making.

  11. Medication-Assisted Treatment For Opioid Addiction in Opioid Treatment Programs. Treatment Improvement Protocol (TIP) Series 43

    Science.gov (United States)

    Tinkler, Emily; Vallejos Bartlett, Catalina; Brooks, Margaret; Gilbert, Johnatnan Max; Henderson, Randi; Shuman, Deborah, J.

    2005-01-01

    TIP 43 provides best-practice guidelines for medication-assisted treatment of opioid addiction in opioid treatment programs (OTPs). The primary intended audience for this volume is substance abuse treatment providers and administrators who work in OTPs. Recommendations in the TIP are based on both an analysis of current research and determinations…

  12. Endoscopic Endonasal Surgery for Purely Intrathird Ventricle Craniopharyngioma.

    Science.gov (United States)

    Nishioka, Hiroshi; Fukuhara, Noriaki; Yamaguchi-Okada, Mitsuo; Yamada, Shozo

    2016-07-01

    Extended endoscopic transsphenoidal surgery (EETS) is a safe and effective treatment for many suprasellar craniopharyngiomas, including those with third-ventricle involvement. Craniopharyngioma entirely within the third ventricle (purely intraventricular type), however, is generally regarded unsuitable for treatment with EETS. Three patients underwent total removal of a purely intraventricular craniopharyngioma with inferior extension via EETS by direct incision of the bulging, stretched ventricular floor and fine dissection from the ventricular wall. In 2 patients with an anteriorly displaced chiasm, the space between the chiasm and pituitary stalk created a wide corridor to the ventricle, whereas in the third case, in which the infrachiasmal space was somewhat narrowed, partial sacrifice of the pituitary gland was necessary to obtain sufficient space. Despite preservation of the stalk in 2 patients, hypopituitarism and diabetes insipidus developed after surgery. There was no other complication including obesity. Selected patients with purely intraventricular craniopharyngioma can be treated effectively and safely with EETS. Those with inferior extension in the interpeduncular fossa and anterior displacement of the chiasm may be suitable candidates. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Treatment of Binge Eating Disorder in Racially and Ethnically Diverse Obese Patients in Primary Care: Randomized Placebo-Controlled Clinical Trial of Self-Help and Medication

    Science.gov (United States)

    Grilo, Carlos M.; Masheb, Robin M.; White, Marney A.; Gueorguieva, Ralitza; Barnes, Rachel D.; Walsh, B. Timothy; McKenzie, Katherine C.; Genao, Inginia; Garcia, Rina

    2014-01-01

    Objective The objective was to determine whether treatments with demonstrated efficacy for binge eating disorder (BED) in specialist treatment centers can be delivered effectively in primary care settings to racially/ethnically diverse obese patients with BED. This study compared the effectiveness of self-help cognitive-behavioral therapy (shCBT) and an anti-obesity medication (sibutramine), alone and in combination, and it is only the second placebo-controlled trial of any medication for BED to evaluate longer-term effects after treatment discontinuation. Method 104 obese patients with BED (73% female, 55% non-white) were randomly assigned to one of four 16-week treatments (balanced 2-by-2 factorial design): sibutramine (N=26), placebo (N=27), shCBT+sibutramine (N=26), or shCBT+placebo (N=25). Medications were administered in double-blind fashion. Independent assessments were performed monthly throughout treatment, post-treatment, and at 6- and 12-month follow-ups (16 months after randomization). Results Mixed-models analyses revealed significant time and medication-by-time interaction effects for percent weight loss, with sibutramine but not placebo associated with significant change over time. Percent weight loss differed significantly between sibutramine and placebo by the third month of treatment and at post-treatment. After the medication was discontinued at post-treatment, weight re-gain occurred in sibutramine groups and percent weight loss no longer differed among the four treatments at 6- and 12-month follow-ups. For binge-eating, mixed-models revealed significant time and shCBT-by-time interaction effects: shCBT had significantly lower binge-eating frequency at 6-month follow-up but the treatments did not differ significantly at any other time point. Demographic factors did not significantly predict or moderate clinical outcomes. Discussion Our findings suggest that pure self-help CBT and sibutramine did not show long-term effectiveness relative to

  14. Treatment of binge eating disorder in racially and ethnically diverse obese patients in primary care: randomized placebo-controlled clinical trial of self-help and medication.

    Science.gov (United States)

    Grilo, Carlos M; Masheb, Robin M; White, Marney A; Gueorguieva, Ralitza; Barnes, Rachel D; Walsh, B Timothy; McKenzie, Katherine C; Genao, Inginia; Garcia, Rina

    2014-07-01

    The objective was to determine whether treatments with demonstrated efficacy for binge eating disorder (BED) in specialist treatment centers can be delivered effectively in primary care settings to racially/ethnically diverse obese patients with BED. This study compared the effectiveness of self-help cognitive-behavioral therapy (shCBT) and an anti-obesity medication (sibutramine), alone and in combination, and it is only the second placebo-controlled trial of any medication for BED to evaluate longer-term effects after treatment discontinuation. 104 obese patients with BED (73% female, 55% non-white) were randomly assigned to one of four 16-week treatments (balanced 2-by-2 factorial design): sibutramine (N = 26), placebo (N = 27), shCBT + sibutramine (N = 26), or shCBT + placebo (N = 25). Medications were administered in double-blind fashion. Independent assessments were performed monthly throughout treatment, post-treatment, and at 6- and 12-month follow-ups (16 months after randomization). Mixed-models analyses revealed significant time and medication-by-time interaction effects for percent weight loss, with sibutramine but not placebo associated with significant change over time. Percent weight loss differed significantly between sibutramine and placebo by the third month of treatment and at post-treatment. After the medication was discontinued at post-treatment, weight re-gain occurred in sibutramine groups and percent weight loss no longer differed among the four treatments at 6- and 12-month follow-ups. For binge-eating, mixed-models revealed significant time and shCBT-by-time interaction effects: shCBT had significantly lower binge-eating frequency at 6-month follow-up but the treatments did not differ significantly at any other time point. Demographic factors did not significantly predict or moderate clinical outcomes. Our findings suggest that pure self-help CBT and sibutramine did not show long-term effectiveness relative to placebo for treating BED in

  15. Medical Marijuana Use among Adolescents in Substance Abuse Treatment

    Science.gov (United States)

    Salomonsen-Sautel, Stacy; Sakai, Joseph T.; Thurstone, Christian; Corley, Robin; Hopfer, Christian

    2012-01-01

    Objective: To assess the prevalence and frequency of medical marijuana diversion and use among adolescents in substance abuse treatment and to identify factors related to their medical marijuana use. Method: This study calculated the prevalence and frequency of diverted medical marijuana use among adolescents (n = 164), ages 14-18 years (mean age…

  16. Wireless local network architecture for Naval medical treatment facilities

    OpenAIRE

    Deason, Russell C.

    2004-01-01

    Approved for public release; distribution is unlimited In today's Navy Medicine, an approach towards wireless networks is coming into view. The idea of developing and deploying workable Wireless Local Area Networks (WLAN) throughout Naval hospitals is but just a few years down the road. Currently Naval Medical Treatment Facilities (MTF) are using wired Local Area Networks (LANs) throughout the infrastructure of each facility. Civilian hospitals and other medical treatment facilities have b...

  17. [Development of performance evaluation and management system on advanced schistosomiasis medical treatment].

    Science.gov (United States)

    Zhou, Xiao-Rong; Huang, Shui-Sheng; Gong, Xin-Guo; Cen, Li-Ping; Zhang, Cong; Zhu, Hong; Yang, Jun-Jing; Chen, Li

    2012-04-01

    To construct a performance evaluation and management system on advanced schistosomiasis medical treatment, and analyze and evaluate the work of the advanced schistosomiasis medical treatment over the years. By applying the database management technique and C++ programming technique, we inputted the information of the advanced schistosomiasis cases into the system, and comprehensively evaluated the work of the advanced schistosomiasis medical treatment through the cost-effect analysis, cost-effectiveness analysis, and cost-benefit analysis. We made a set of software formula about cost-effect analysis, cost-effectiveness analysis, and cost-benefit analysis. This system had many features such as clear building, easy to operate, friendly surface, convenient information input and information search. It could benefit the performance evaluation of the province's advanced schistosomiasis medical treatment work. This system can satisfy the current needs of advanced schistosomiasis medical treatment work and can be easy to be widely used.

  18. Pure endoscopic transsphenoidal surgery for treatment of acromegaly: results of 67 cases treated in a pituitary center.

    Science.gov (United States)

    Gondim, Jackson A; Almeida, João Paulo; de Albuquerque, Lucas Alverne F; Gomes, Erika; Schops, Michele; Ferraz, Tania

    2010-10-01

    Acromegaly is a chronic disease related to the excess of growth hormone (GH) and insulin-like growth factor–I secretion, usually by pituitary adenomas. Traditional treatment of acromegaly consists of surgery, drug therapy, and eventually radiotherapy. The introduction of endoscopy as an additional tool for surgical treatment of pituitary adenomas and, therefore, acromegaly represents an important advance of pituitary surgery in the recent years. The aim of this retrospective study is to evaluate the results of pure transsphenoidal endoscopic surgery in a series of patients with acromegaly who were operated on by a pituitary specialist surgeon. The authors discuss the advantages, outcome, complications, and factors related to the success of the endoscopic approach in cases of GHsecreting adenomas. The authors retrospectively analyzed data from cases involving patients with GH-secreting adenomas who underwent pure transsphenoidal endoscopic surgery at the Department of Neurosurgery of the General Hospital in Fortaleza, Brazil, between 2000 and 2009. Tumors were classified according to size as micro- or macroadenomas, and tumor extension was analyzed based on suprasellar/parasellar extension and sella floor destruction. All patients were followed up for at least 1 year. The criteria of disease control were GH levels transsphenoidal surgery for treatment of acromegaly. Disease control was obtained in 50 cases (74.6%). The rate of treatment success was higher in patients with microadenomas (disease control achieved in 12 [85.7%] of 14 cases) than in those with larger lesions. Suprasellar/parasellar extension and high levels of sella floor erosion were associated with lower rates of disease control (p = 0.01 and p = 0.02, respectively). Complications related to the endoscopic surgery included epistaxis (6.0%), transitory diabetes insipidus (4.5%), and 1 case of seizure (1.5%). Endoscopic transsphenoidal surgery represents an effective option for treatment of patients

  19. Plasma treatment: A Novel Medical Application

    International Nuclear Information System (INIS)

    Boonyawan, Dheerawan

    2015-01-01

    Cold atmospheric plasma (CAP) for the medical treatment is a new field in plasma application, called plasma medicine. CAP contrains mix of excited atoms and molecules, UV photons, charged particles as well as reactive oxygen species (ROS) and reactive nitrogen species (RNS). Typical species in air CAPs are O 3 , OH, N x , and HNO x . Two cold atomospheric plasma devices were utiized (either in an indirect or a direct way) for the treatment of physiologically healthy volunterrs, The results show that CAP is effective againts chronic wound infections and/ or for skin treatment in clinical trials. The current developments in this field have fuelled the hope that CAP could be, and interesting new therapeutic apptoach in the treatment of cancer.

  20. An update on the medical treatment of Graves' hyperthyroidism.

    Science.gov (United States)

    Marinò, Michele; Latrofa, Francesco; Menconi, Francesca; Chiovato, Luca; Vitti, Paolo

    2014-11-01

    Medical treatment of Graves' hyperthyroidism is based on the use of thionamides; namely, methimazole and propylthiouracil. In the past, methimazole was preferred by European endocrinologists, whereas propylthiouracil was the first choice for the majority of their North American colleagues. However, because of the recent definition of a better side-effect profile, methimazole is nowadays the first choice world while. Although thionamides are quite effective for the short-term control of Graves' hyperthyroidism, a relatively high proportion of patients relapses after thionamide withdrawal. Other possible medical treatments, include iodine and compounds containing iodine, perchlorate, lithium (as an adjuvant in patients undergoing radioiodine therapy), β-adrenergic antagonists, glucocorticoids, and some new molecules still under investigation. Management of Graves' hyperthyroidism using thionamides as well as the other available medical treatments is here reviewed in detail, with a special mention of situations such as pregnancy and lactation, as well as neonatal and fetal thyrotoxicosis.

  1. Morphine as first medication for treatment of cancer pain

    Directory of Open Access Journals (Sweden)

    Beatriz C. Nunes

    2014-07-01

    Full Text Available BACKGROUND AND OBJECTIVES: the medications used according to the recommendation of the World Health Organization do not promote pain relief in a number of patients with cancer pain. The aim of this study was to evaluate the use of morphine as first medication for the treatment of moderate cancer pain in patients with advanced and/or metastatic disease, as an option to the recommendations of the World Health Organization analgesic ladder. METHOD: sixty patients without opioid therapy, with >18 years of age, were randomized into two groups. G1 patients received medication according to the analgesic ladder and started treatment with non-opioids in the first, weak opioids in the second, and strong opioids in the third step; G2 patients received morphine as first analgesic medication. The efficacy and tolerability of initial use of morphine were evaluated every two weeks for three months. RESULTS: the groups were similar with respect to demographic data. There was no significant difference between the groups regarding pain intensity, quality of life, physical capacity, satisfaction with treatment, need for complementation and dose of morphine. In G1 there was a higher incidence of nausea (p = 0.0088, drowsiness (p = 0.0005, constipation (p = 0.0071 and dizziness (p = 0.0376 in the second visit and drowsiness (p = 0.05 in the third. CONCLUSIONS: the use of morphine as first medication for pain treatment did not promote better analgesic effect than the ladder recommended by World Health Organization, with higher incidence of adverse effects.

  2. Multi-sample nonparametric treatments comparison in medical ...

    African Journals Online (AJOL)

    Multi-sample nonparametric treatments comparison in medical follow-up study with unequal observation processes through simulation and bladder tumour case study. P. L. Tan, N.A. Ibrahim, M.B. Adam, J. Arasan ...

  3. Tribological Properties of Surface-Textured and Plasma-Nitrided Pure Titanium Under Oil Lubrication Condition

    Science.gov (United States)

    Zhang, Baosen; Dong, Qiangsheng; Ba, Zhixin; Wang, Zhangzhong; Shi, Hancheng; Xue, Yanting

    2018-01-01

    Plasma nitriding was conducted as post-treatment for surface texture on pure titanium to obtain a continuous nitriding layer. Supersonic fine particles bombarding (SFPB) was carried out to prepare surface texture. The surface morphologies and chemical composition were analyzed using scanning electron microscope and energy disperse spectroscopy. The microstructures of modified layers were characterized by transmission electron microscope. The tribological properties of surface-textured and duplex-treated pure titanium under oil lubrication condition were systematically investigated in the ball-on-plate reciprocating mode. The effects of applied load and sliding velocity on the tribological behavior were analyzed. The results show that after duplex treatments, the grains size in modified layer becomes slightly larger, and hardness is obviously improved. Wear resistance of duplex-treated pure titanium is significantly improved referenced to untreated and surface-textured pure titanium, which is 3.22 times as much as untreated pure titanium and 2.15 times of that for surface-textured pure titanium, respectively.

  4. Parity and the medicalization of addiction treatment.

    Science.gov (United States)

    Roy, Ken; Miller, Michael

    2010-06-01

    Parity, the idea that insurance coverage for the treatment of addiction should be on a par with insurance coverage for the treatment of other medical illnesses, is not a new idea, but the path to achieving "real parity" has been a long, hard and complex journey. Action by Congress to pass major parity legislation in 2008 was a huge step forward, but does not mean that parity has been achieved. Parity has required a paradigm shift in the understanding of addiction as a biological illness: many developments of science and policy changes by professional organizations and governmental entities have contributed to that paradigm shift. Access to adequate treatment for patients must acknowledge the paradigm shift reflected in parity as it has evolved to the current point: that this biological illness is widespread, that it is important that it be treated effectively, that appropriate third party payment for physician-provided or physician-supervised addiction treatment is critical for addiction medicine to become a part of the mainstream of our nation's healthcare delivery system, and that medical specialty care provides the most effective and cost effective benefit to patients and therefore to our society.

  5. The effect of postoperative medical treatment on left ventricular mass regression after aortic valve replacement.

    Science.gov (United States)

    Helder, Meghana R K; Ugur, Murat; Bavaria, Joseph E; Kshettry, Vibhu R; Groh, Mark A; Petracek, Michael R; Jones, Kent W; Suri, Rakesh M; Schaff, Hartzell V

    2015-03-01

    The study objective was to analyze factors associated with left ventricular mass regression in patients undergoing aortic valve replacement with a newer bioprosthesis, the Trifecta valve pericardial bioprosthesis (St Jude Medical Inc, St Paul, Minn). A total of 444 patients underwent aortic valve replacement with the Trifecta bioprosthesis from 2007 to 2009 at 6 US institutions. The clinical and echocardiographic data of 200 of these patients who had left ventricular hypertrophy and follow-up studies 1 year postoperatively were reviewed and compared to analyze factors affecting left ventricular mass regression. Mean (standard deviation) age of the 200 study patients was 73 (9) years, 66% were men, and 92% had pure or predominant aortic valve stenosis. Complete left ventricular mass regression was observed in 102 patients (51%) by 1 year postoperatively. In univariate analysis, male sex, implantation of larger valves, larger left ventricular end-diastolic volume, and beta-blocker or calcium-channel blocker treatment at dismissal were significantly associated with complete mass regression. In the multivariate model, odds ratios (95% confidence intervals) indicated that male sex (3.38 [1.39-8.26]) and beta-blocker or calcium-channel blocker treatment at dismissal (3.41 [1.40-8.34]) were associated with increased probability of complete left ventricular mass regression. Patients with higher preoperative systolic blood pressure were less likely to have complete left ventricular mass regression (0.98 [0.97-0.99]). Among patients with left ventricular hypertrophy, postoperative treatment with beta-blockers or calcium-channel blockers may enhance mass regression. This highlights the need for close medical follow-up after operation. Labeled valve size was not predictive of left ventricular mass regression. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  6. Liability for damage caused by medical X-ray treatment

    International Nuclear Information System (INIS)

    1977-01-01

    A case of liability for damage caused by X-ray medical treatment was recently brought before the courts in Norway. Following a mistake by the physician handling the X-ray apparatus the plaintiff had received an overdose of radiation on her nose and a lengthy and expensive plastic surgery treatment had been required to repair the damage. The local court of Aalesund ruled in April 1975 that the physician concerned had committed a fault but could not be accused of gross negligence or gross fault in view of Norwegian case law on medical liability. Therefore the plaintiff obtained compensation for her medical expenses but was refused compensation for non-material damage (disfigurement and pretium doloris). (NEA) [fr

  7. Follow-up Medical Care After Cancer Treatment

    Science.gov (United States)

    ... Data Conducting Clinical Trials Statistical Tools and Data Terminology Resources NCI Data Catalog Cryo-EM NCI's Role ... Questions to Ask About Cancer Research Follow-Up Medical Care Once you’re done with cancer treatment, ...

  8. Medical treatment of Cushing disease: new targets, new hope.

    Science.gov (United States)

    Fleseriu, Maria

    2015-03-01

    This article provides an update on current medical therapies for the treatment of Cushing disease. This information will be of value in determining patients' suitability for certain medical treatments. An approach of combining drugs from the same or different classes could potentially increase the number of patients in whom Cushing can be controlled while minimizing adverse effects, although larger studies are needed. Successful clinical management of patients with Cushing disease remains a challenge. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Medical Treatment of Uterine Leiomyoma

    Science.gov (United States)

    Sabry, Mohamed; Al-Hendy, Ayman

    2012-01-01

    Uterine leiomyomas (also called myomata or fibroids) are the most common gynecologic tumors in the United States. The prevalence of leiomyomas is at least 3 to 4 times higher among African American women than in white women. Pathologically, uterine leiomyomas are benign tumors that arise in any part of the uterus under the influence of local growth factors and sex hormones, such as estrogen and progesterone. These common tumors cause significant morbidity for women and they are considered to be the most common indication for hysterectomy in the world; they are also associated with a substantial economic impact on health care systems that amounts to approximately $2.2 billion/year in the United States alone. Uterine myomas cause several reproductive problems such as heavy or abnormal uterine bleeding, pelvic pressure, infertility, and several obstetrical complications including miscarriage and preterm labor. Surgery has traditionally been the gold standard for the treatment of uterine leiomyomas and has typically consisted of either hysterectomy or myomectomy. In recent years, a few clinical trials have evaluated the efficacy of orally administered medications for the management of leiomyoma-related symptoms. In the present review, we will discuss these promising medical treatments in further detail. PMID:22378865

  10. Laser treatment of medical skin disease in women.

    Science.gov (United States)

    LaRosa, C; Chiaravalloti, A; Jinna, S; Berger, W; Finch, J

    2017-09-01

    Laser treatment is a relatively new and increasingly popular modality for the treatment of many dermatologic conditions. A number of conditions that predominantly occur in women and that have a paucity of effective treatments include rosacea, connective tissue disease, melasma, nevus of Ota, lichen sclerosus (LS), notalgia paresthetica and macular amyloidosis, and syringomas. Laser therapy is an important option for the treatment of patients with these conditions. This article will review the body of literature that exists for the laser treatment of women with these medical conditions.

  11. Rehabilitation of pure alexia

    DEFF Research Database (Denmark)

    Starrfelt, Randi; Ólafsdóttir, Rannveig Rós; Arendt, Ida-Marie

    2013-01-01

    that pure alexia was an easy target for rehabilitation efforts. We review the literature on rehabilitation of pure alexia from 1990 to the present, and find that patients differ widely on several dimensions like alexia severity, and associated deficits. Many patients reported to have pure alexia......-designed and controlled studies of rehabilitation of pure alexia....

  12. Medical treatment of radiation injuries-Current US status

    Energy Technology Data Exchange (ETDEWEB)

    Jarrett, D.G. [OSA - CBD and CDP, 3050 Defense Pentagon, Room 3C257, Washington, DC 20301-3050 (United States)], E-mail: david.jarrett@us.army.mil; Sedlak, R.G.; Dickerson, W.E. [Uniformed Services University, Armed Forces Radiobiology Research Institute, 8901 Wisconsin Avenue, Bethesda, MD 20889-5603 (United States); Reeves, G.I. [Northrop Grumman IT, 8211 Terminal Road, Lorton, VA 22079-1421 (United States)

    2007-07-15

    A nuclear incident or major release of radioactive materials likely would result in vast numbers of patients, many of whom would require novel therapy. Fortunately, the numbers of radiation victims in the United States (USA) have been limited to date. If a mass-casualty situation occurs, there will be a need to perform rapid, accurate dose estimates and to provide appropriate medications and other treatment to ameliorate radiation injury. The medical management of radiation injury is complex. Radiation injury may include acute radiation sickness (ARS) from external and/or internal radiation exposure, internal organ damage from incorporated radioactive isotopes, and cutaneous injury. Human and animal data have shown that optimal medical care may nearly double the survivable dose of ionizing radiation. Current treatment strategies for radiation injuries are discussed with concentration on the medical management of the hematopoietic syndrome. In addition, priority areas for continuing and future research into both acute deterministic injuries and also long-term stochastic sequelae of radiation exposure have been identified. There are several near-term novel therapies that appear to offer excellent prognosis for radiation casualties, and these are also described.

  13. Laser treatment of medical skin disease in women

    Directory of Open Access Journals (Sweden)

    C. LaRosa, MD

    2017-09-01

    Full Text Available Laser treatment is a relatively new and increasingly popular modality for the treatment of many dermatologic conditions. A number of conditions that predominantly occur in women and that have a paucity of effective treatments include rosacea, connective tissue disease, melasma, nevus of Ota, lichen sclerosus (LS, notalgia paresthetica and macular amyloidosis, and syringomas. Laser therapy is an important option for the treatment of patients with these conditions. This article will review the body of literature that exists for the laser treatment of women with these medical conditions.

  14. Medical aspects of the treatment of irradiated persons

    International Nuclear Information System (INIS)

    Carpaij, W.J.M.

    1976-01-01

    The possibilities of a medical assistance of patients after a nuclear accident and also the specific demands that supposes such an assistance, are discussed. On the basis of literary subjects, prevention as well as diagnostic and treatment are examined. It appears that such a medical assistance program cannot be drafted in detail beforehand, but must be fixed on the basis of the accidental situation. (author)

  15. Medical tourism: A snapshot of evidence on treatment abroad.

    Science.gov (United States)

    Lunt, Neil; Horsfall, Daniel; Hanefeld, Johanna

    2016-06-01

    The scoping review focuses on medical tourism, whereby consumers elect to travel across borders or to overseas destinations to receive their treatment. Such treatments include: cosmetic and dental surgery; cardio, orthopaedic and bariatric surgery; IVF; and organ and tissue transplantation. The review assesses the emerging focus of research evidence post-2010. The narrative review traverses discussion on medical tourism definitions and flows, consumer choice, clinical quality and outcomes, and health systems implications. Attention is drawn to gaps in the research evidence. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Trends in Medication Treatment for ADHD

    Science.gov (United States)

    Castle, Lon; Aubert, Ronald E.; Verbrugge, Robert R.; Khalid, Mona; Epstein, Robert S.

    2007-01-01

    Objective: This study examines demographic trends in the use of medications to treat ADHD in adult and pediatric populations. Method: Using pharmacy claims data for a large population of commercially insured Americans, the study measures ADHD treatment prevalence and drug use from 2000 to 2005. Results: In 2005, 4.4% of children (ages 0 to 19) and…

  17. Reference data for the medical treatment by 'Yayoi'

    International Nuclear Information System (INIS)

    1976-12-01

    ''Yayoi'' is the nickname for the fast neutron reactor of the University of Tokyo and reached to the critical range in April, 1970 for the first time. It is an air cooled type fast reactor for condensed uranium installed in Tokai Village, Ibaraki Prefecture with thermal powers of 2 Kw (steady working), 200 Kw (unsteady working) or 1 Gw (reactive pulse working). There were submitted to explain about summaries of irradiation equipment and medical irradiation field, and technical capacity of irradiation treatment by ''Yayoi''. Additional data were also prepared explaining the purpose of medical treatment, expected dose, counterplans for security, minimization of general exposed dose radiation control and in emergency cases. (Kobatake, H.)

  18. Improving Public Health Through Access to and Utilization of Medication Assisted Treatment

    Directory of Open Access Journals (Sweden)

    Thomas F. Kresina

    2011-10-01

    Full Text Available Providing access to and utilization of medication assisted treatment (MAT for the treatment of opioid abuse and dependence provides an important opportunity to improve public health. Access to health services comprising MAT in the community is fundamental to achieve broad service coverage. The type and placement of the health services comprising MAT and integration with primary medical care including human immunodeficiency virus (HIV prevention, care and treatment services are optimal for addressing both substance abuse and co-occurring infectious diseases. As an HIV prevention intervention, integrated (same medical record for HIV services and MAT services MAT with HIV prevention, care and treatment programs provides the best “one stop shopping” approach for health service utilization. Alternatively, MAT, medical and HIV services can be separately managed but co-located to allow convenient utilization of primary care, MAT and HIV services. A third approach is coordinated care and treatment, where primary care, MAT and HIV services are provided at distinct locations and case managers, peer facilitators, or others promote direct service utilization at the various locations. Developing a continuum of care for patients with opioid dependence throughout the stages MAT enhances the public health and Recovery from opioid dependence. As a stigmatized and medical disenfranchised population with multiple medical, psychological and social needs, people who inject drugs and are opioid dependent have difficulty accessing services and navigating medical systems of coordinated care. MAT programs that offer comprehensive services and medical care options can best contribute to improving the health of these individuals thereby enhancing the health of the community.

  19. Practical questions of organization of medical aid and treatment in specialized medical care facilities to the people exposed to radiation

    International Nuclear Information System (INIS)

    Baranov, A.E.; Bad'in, V.I.; Gasteva, G.N.

    1995-01-01

    Basing on the accident at the Chernobyl Nuclear Power Plant, the paper studied practical questions of organization of medical aid and treatment in specialized medical establishments prepared well in advance, and in temporary arranged specialized medical institutions. The requirements to such medical treatment establishments are studied herein: the aims and structure of the admission department; the measures of decontamination and emergency medical aid in case of acute intake of certain radionuclides; control of radioactive contamination of human organism of the injured persons and dosimetry of medical personnel; minimum degree of clinical examinations; schemes of therapy of various forms of acute radiation disease with combined effects. The authors indicated a list of the necessary drug preparations for treatment of patients with acute radiation disease of 3-4 degree of severity and the regulations of autopsy and taking samples for biophysical investigations of persons who died from radiation disease. 5 tabs

  20. A long-acting calcium antagonist over one year did not improve BMIPP myocardial scintigraphic imagings in patients with pure coronary spastic angina

    International Nuclear Information System (INIS)

    Sueda, Shozo; Oshita, Akira; Izoe, Yousuke; Kohno, Hiroaki; Fukuda, Hiroshi; Ochi, Takaaki; Uraoka, Tadao

    2007-01-01

    Calcium antagonists (Ca) have been effective in reducing angina attacks in patients with variant angina. However, there are no reports regarding the effectiveness of Ca on myocardial fatty acid metabolic images in patients with pure coronary spastic angina (CSA). This study sought to examine the correlation between myocardial fatty acid metabolic images and the medical treatment of Ca in patients with pure CSA. This study included 35 consecutive patients (28 men, mean age of 66±10 years) with angiographically confirmed coronary spasm and no fixed stenosis. Long-acting Ca was administered to all 35 patients. Isosorbide dinitrate/nicorandil/another Ca/beta-blocker were administered when chest pain was not controlled. Using an iodinated fatty acid analogue, 15-(p-[iodine-123]iodophenyl)-3-(R,S)methylpentadecanoic acid (BMIPP), myocardial scintigraphies with intravenous adenosine triphosphate infusion were performed before cardiac catheterization and 12 mo after medical therapy. According to the medical control states, these 35 patients were classified into 3 groups; response (disappearance of angina attacks, 12 pts, 60±11 years), partial response (angina attacks <4/mo, 12 pts, 67±10 years), and no response to therapy (angina attacks ≥4/mo, 11 pts, 71±6 years). Reduced BMIPP uptake was observed in 24 (69%) of 35 patients before the treatment. Reduced BMIPP uptake was also found in 18 patients (51%) after 12 mo. Normal BMIPP uptake after 12 mo therapy was observed in about half (response: 42%, partial response: 58%, no response: 45%) of patients among the 3 groups. There was no difference regarding the value of washout rate (WOR) (response; 10±7 (before), 14±8% (12 mo)), partial response; 11±7, 10±5%, no response; 13±9, 14±8%) among the 3 groups. The defect scores of BMIPP in the three groups were not different during at least one year medical therapy. No difference regarding the distribution of other medical therapies (angiotensin converting enzyme

  1. [Classical medications in the treatment of inflammatory bowel diseases].

    Science.gov (United States)

    Duvnjak, Marko; Bilić, Ante; Barsić, Neven; Tomasić, Vedran; Stojsavljević, Sanja

    2013-04-01

    The treatment of inflammatory bowel diseases is complex and requires individual approach to every single patient. Traditionally, the approach is based on introduction of so called "classical" medication into the treatment regimen, from ones less potent and with fewer side effects to the ones more toxic but also therapeutically more effective. Aminosalicylates were the first choice of treatment for a long time. However, the role of aminosalicylates is becoming more and more diminished, although they are still the drug of choice in the treatment of mild to moderate ulcerative colitis. Corticosteroids are the therapy of choice in treatment of active IBD for achieving remission in moderate to severe disease. Azathioprine and 6- mercaptopurine belong to a group of thiopurines with an immunomodulatory effect which, in Crohn's disease as well as in ulcerative colitis, primarily have a role in a steroid dependant or steroid refractory type of disease and in maintenance of remission. Lately, early introduction of these medications is proposed to enhance the number of patients that remain in remission. Methotrexate is used for the therapy of active and relapsing Crohn's disease and represents an alternative in patients who do not tolerate or do not respond to azathioprine or 6-mercaptopurine therapy. Cyclosporine is used in treating steroid refractory ulcerative colitis and in some patients can postpone the need for colectomy. Antibiotics do not have a proven effect on the course of inflammatory bowel diseases and their primary role is to treat septic complications. Classic medications today represent a standard in the management of inflammatory bowel diseases, and the combination of the previously mentioned drugs often has a more potent effect on the course of the disease than any medication on its own and their combination is still an object of investigations and clinical studies.

  2. Euthanasia is not medical treatment.

    Science.gov (United States)

    Boudreau, J Donald; Somerville, Margaret A

    2013-01-01

    The public assumes that if euthanasia and assisted suicide were to be legalized they would be carried out by physicians. In furthering critical analysis, we supplement the discourse in the ethics and palliative care literature with that from medical education and evolving jurisprudence. Both proponents and opponents agree that the values of respect for human life and for individuals' autonomy are relevant to the debate. Advocates of euthanasia and assisted suicide give priority to the right to personal autonomy and avoid discussions of harmful impacts of these practices on medicine, law and society. Opponents give priority to respect for life and identify such harmful effects. These both require euthanasia to remain legally prohibited. Proposals are emerging that if society legalizes euthanasia it should not be mandated to physicians. The impact of characterizing euthanasia as 'medical treatment' on physicians' professional identity and on the institutions of medicine and law should be examined in jurisdictions where assisted suicide and euthanasia have been de-criminalized.

  3. Effectiveness of medical treatment for Cushing's syndrome: a systematic review and meta-analysis.

    Science.gov (United States)

    Broersen, Leonie H A; Jha, Meghna; Biermasz, Nienke R; Pereira, Alberto M; Dekkers, Olaf M

    2018-05-31

    To systematically review the effectiveness of medical treatment for Cushing's syndrome in clinical practice, regarding cortisol secretion, clinical symptom improvement, and quality of life. To assess the occurrence of side effects of these medical therapies. Eight electronic databases were searched in March 2017 to identify potentially relevant articles. Randomized controlled trials and cohort studies assessing the effectiveness of medical treatment in patients with Cushing's syndrome, were eligible. Pooled proportions were reported including 95% confidence intervals. We included 35 articles with in total 1520 patients in this meta-analysis. Most included patients had Cushing's disease. Pooled reported percentage of patients with normalization of cortisol ranged from 35.7% for cabergoline to 81.8% for mitotane in Cushing's disease. Patients using medication monotherapy showed a lower percentage of cortisol normalization compared to use of multiple medical agents (49.4 vs. 65.7%); this was even higher for patients with concurrent or previous radiotherapy (83.6%). Mild side effects were reported in 39.9%, and severe side effects were seen in 15.2% of patients after medical treatment. No meta-analyses were performed for clinical symptom improvement or quality of life due to lack of sufficient data. This meta-analysis shows that medication induces cortisol normalization effectively in a large percentage of patients. Medical treatment for Cushing's disease patients is thus a reasonable option in case of a contraindication for surgery, a recurrence, or in patients choosing not to have surgery. When experiencing side effects or no treatment effect, an alternate medical therapy or combination therapy can be considered.

  4. Color Spectrum Properties of Pure and Non-Pure LATEX in Discriminating Rubber Clone Series

    International Nuclear Information System (INIS)

    Noor Aishah Khairuzzaman; Hadzli Hashim; Nina Korlina Madzhi; Noor Ezan Abdullah; Faridatul Aima Ismail; Ahmad Faiz Sampian; Azhana Fatnin Che Will

    2015-01-01

    A study of color spectrum properties for pure and non-pure latex in discriminating rubber clone series has been presented in this paper. There were five types of clones from the same series being used as samples in this study named RRIM2002, RRIM2007, RRIM2008, RRIM2014, and RRIM3001. The main objective is to identify the significant color spectrum (RGB) from pure and non-pure latex that can discriminate rubber clone series. The significant information of color spectrum properties for pure and non-pure latex is determined by using spectrometer and Statistical Package for the Social Science (SPSS). Visible light spectrum (VIS) is used as a radiation light of the spectrometer to emit light to the surface of the latex sample. By using SPSS software, the further numerical analysis of color spectrum properties is being conducted. As the conclusion, blue color spectrum for non-pure is able to discriminate for all rubber clone series whereas only certain color spectrum can differentiate several clone series for pure latex. (author)

  5. [Conservative treatment of cervical radiculopathy with 5% lidocaine medicated plaster].

    Science.gov (United States)

    Mattozzi, I

    2015-02-01

    Cervical radiculopathy is a mixed pain syndrome characterized by neuropathic, skeletal and myofascial pain. This condition is frequently found in developed countries and is a significant source of disability and a reason for frequent medical consultation. In our Pain Therapy Centre, cervical radiculopathy is initially treated with bi-weekly cycles of mesotherapy coupled, at least 15 days later, with physiotherapy to reach the complete mobilization of cervical spine. Cervical radiculopathy is a localized neuro-pathic pain and in agreement with international guidelines, we checked if patients treated topically with 5% lidocaine medicated plaster may benefit in improving pain management and in reducing the time necessary to start physiotherapy. A retrospective study was carried out on 60 patients, of which 30 were treated with mesotherapy and 30 were treated with 5% lidocaine medicated plaster. Data for a total of 30 days observation were collected from the patient medical records. In particular, besides medical history, intensity of pain, intensity of allodynia and pain were considered. For all analyzed parameters, both treatments were effective, but patients treated with 5% lidocaine medicated plaster showed faster control of the painful symptoms, an essential condition for an earlier rehabilitative treatment.

  6. The role of combination medical therapy in the treatment of acromegaly.

    Science.gov (United States)

    Lim, Dawn Shao Ting; Fleseriu, Maria

    2017-02-01

    Uncontrolled acromegaly results in approximately 2-fold excess mortality. Pituitary surgery is first-line therapy, and medical treatment is indicated for persistent disease. While cabergoline and pegvisomant are used in select patients, somatostatin receptor ligands (SRLs) remain the cornerstone of medical treatment. Management of patients poorly responsive to SRLs is therefore, challenging. The purpose of this review is to highlight the options for combination medical therapy in the treatment of acromegaly, with an emphasis on efficacy and safety. All original articles/abstracts detailing combination medical therapy in acromegaly were identified from a PubMed search. Studies reviewed included retrospective and open-label prospective studies. While the combination of SRL and cabergoline was generally well tolerated, a lower baseline insulin-like growth factor-1 (IGF-1) level was the best predictor of efficacy; this combination may be most effective in patients with mildly elevated IGF-1. SRL-pegvisomant combination normalized IGF-1 in the majority of patients; continued efficacy despite individual drug dosing reduction was also reported. The risk of significant liver enzyme elevation was, however, higher than that reported with SRL monotherapy; close monitoring is recommended. Data on pegvisomant-cabergoline combination is limited, but this may be an option in the setting of SRL intolerance. Reports on temozolomide used in combination with other medical therapies in patients with aggressive GH-secreting tumors are also summarized. While more prospective, randomized controlled trials on long-term efficacy and safety are needed, combination medical therapy remains a treatment strategy that should be considered for acromegaly patients poorly responsive to SRLs.

  7. TVT-O for the treatment of pure urodynamic stress incontinence: efficacy, adverse effects, and prognostic factors at 5-year follow-up.

    Science.gov (United States)

    Serati, Maurizio; Bauer, Ricarda; Cornu, Jean Nicolas; Cattoni, Elena; Braga, Andrea; Siesto, Gabriele; Lizée, Daphné; Haab, François; Torella, Marco; Salvatore, Stefano

    2013-05-01

    Inside-out tension-free vaginal transobturator tape (TVT-O) is currently one of the most effective and popular procedures for the surgical treatment of female stress urinary incontinence (SUI), but data reporting long-term outcomes are scarce. To evaluate the efficacy and safety of TVT-O 5-yr implantation for management of pure SUI in women. A prospective observational study was conducted in four tertiary reference centers. Consecutive women presenting with urodynamically proven, pure SUI treated by TVT-O were included. Patients with mixed incontinence and/or anatomic evidence of pelvic organ prolapse were excluded. TVT-O implantation without any associated procedure. Data regarding subjective outcomes (International Consultation on Incontinence-Short Form [ICIQ-SF], Patient Global Impression of Improvement, patient satisfaction scores), objective cure (stress test) rates, and adverse events were collected during follow-up. Multivariable analyses were performed to investigate outcomes. Of the 191 women included, 21 (11.0%) had previously undergone a failed anti-incontinence surgical procedure. Six (3.1%) patients were lost to follow-up. The 5-yr subjective and objective cure rates were 90.3% and 90.8%, respectively. De novo overactive bladder (OAB) was reported by 24.3% of patients at 5-yr follow-up. Median ICIQ-SF score significantly improved from 17 (interquartile range [IQR]:16-17) preoperatively to 0 (IQR: 0-2) (pTVT-O implantation is a highly effective option for the treatment of women with pure SUI, showing a very high cure rate and a low incidence of complications after 5-yr follow-up. Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  8. Influence of medical treatment, smoking and disease activity on pregnancy outcomes in Crohn's disease

    DEFF Research Database (Denmark)

    Julsgaard, Mette; Nørgaard, Mette; Hvas, Christian Lodberg

    2014-01-01

    of low birth weight. Mean birth weight in children of smokers in medical treatment was significantly reduced by 274 g compared with children of non-smokers who received medical treatment.In children of women without medical treatment, this difference was 126 g between smokers and non-smokers. Women...... in medical treatment did not have an increased risk of preterm delivery (POR 0.71; 95% confidence interval (CI) 0.18–2.79), congenital malformations (POR 0.60; 0.10–3.76) or cesarean section (POR 1.40; 0.63–3.08). Conclusion. In CD, smoking was negatively associated with child birth weight. This association...

  9. The Effects of Medical Treatment of Attention Deficit Hyperactivity Disorder (ADHD) on Children’s Academic Achievement

    DEFF Research Database (Denmark)

    Keilow, Maria; Holm, Anders; Fallesen, Peter

    2015-01-01

    We use Danish register data to estimate the effect of medical treatment of ADHD on children’s academic achievement. Using a sample of 7,523 children who undergo medical treatment, we exploit plausibly exogenous variation in medical nonresponse to estimate the effect of medical treatment on school...

  10. 7 CFR 110.5 - Availability of records to facilitate medical treatment.

    Science.gov (United States)

    2010-01-01

    ... pesticide required to be maintained under § 110.3 is necessary to provide medical treatment or first aid to... care professional, to be a medical emergency, the record information of the restricted use pesticide, relating to the medical emergency, shall be provided immediately. (b)(1) The attending licensed health care...

  11. Analysis of Initial Baseline Clinical Parameters and Treatment Strategy Associated with Medication Failure in the Treatment of Benign Prostatic Hyperplasia in Korea

    Directory of Open Access Journals (Sweden)

    Hoon Choi

    2010-12-01

    Full Text Available Purpose To analyze the baseline clinical factors and medication treatment strategy used in cases with medication treatment failure of benign prostatic hyperplasia (BPH. Methods From January 2006 to December 2009, 677 BPH patients with at least 3 months of treatment with medication were enrolled. We analyzed clinical factors by medication failure (n=161 versus maintenance (n=516, by prostate size (less than 30 g, n=231; 30 to 50 g, n=244; greater than 50 g, n=202, and by prostate-specific antigen (PSA levels (less than 1.4 ng/mL, n=324; more than 1.4 ng/mL, n=353. Results Age, combination medication rate, PSA, and prostate volume were statistically different between the medication treatment failure and maintenance groups. By prostate size, the PSA and medication failure rates were relatively higher and the medication period was shorter in patients with a prostate size of more than 30 g. The combination medication rate was higher in patients with a prostate size of more than 50 g. The medication failure rate and prostate volume were higher in patients with a PSA level of more than 1.4 ng/mL. However, the combination treatment rate was not significantly different in patients with a PSA level lower than 1.4 ng/mL. Suggestive cutoffs for combination medication are a prostate volume of 34 g and PSA level of 1.9 ng/mL. Conclusions The clinical factors associated with medication failure were age, treatment type, and prostate volume. Combination therapy should be considered more in Korea in patients with a PSA level higher than 1.4 ng/mL and a prostate volume of between 30 and 50 g to prevent medication failure.

  12. Current and future medical treatments for patients with acromegaly.

    Science.gov (United States)

    Maffezzoni, Filippo; Formenti, Anna Maria; Mazziotti, Gherardo; Frara, Stefano; Giustina, Andrea

    2016-08-01

    Acromegaly is a relatively rare condition of growth hormone (GH) excess associated with significant morbidity and, when left untreated, high mortality. Therapy for acromegaly is targeted at decreasing GH and insulin-like growth hormone 1 levels, ameliorating patients' symptoms and decreasing any local compressive effects of the pituitary adenoma. The therapeutic options for acromegaly include surgery, medical therapies (such as dopamine agonists, somatostatin receptor ligands and the GH receptor antagonist pegvisomant) and radiotherapy. However, despite all these treatments option, approximately 50% of patients are not adequately controlled. In this paper, the authors discuss: 1) efficacy and safety of current medical therapy 2) the efficacy and safety of the new multireceptor-targeted somatostatin ligand pasireotide 3) medical treatments currently under clinical investigation (oral octreotide, ITF2984, ATL1103), and 4) preliminary data on the use of new injectable and transdermal/transmucosal formulations of octreotide. This expert opinion supports the need for new therapeutic agents and modalities for patients with acromegaly.

  13. The effect of medical treatment of attention deficit hyperactivity disorder (ADHD) on foster care caseloads

    DEFF Research Database (Denmark)

    Fallesen, Peter; Wildeman, Christopher

    2015-01-01

    = 157,938) in the period from 1998 to 2010 to show that increasing medical treatment of attention deficit hyperactivity disorder (ADHD) accounts for a substantial share of the decrease in foster care caseloads. According to our estimates, the decline in foster care caseloads during this period would...... have been 45% smaller absent increases in medical treatment of ADHD. These findings are especially provocative in light of recent research showing ambiguous effects of medical treatment of ADHD. Future research should be attentive to how medical treatment aimed at addressing children’s acute behavioral...

  14. Medical treatment of concussion.

    Science.gov (United States)

    Wright, Justin M

    2014-08-01

    A concussion is a brain injury, a change in function induced by traumatic forces. The incidence of concussion is increasing, likely due to increased awareness and improvement in recognition. Speech and language pathology professionals working in schools may encounter patients who have suffered concussions. At the root of concussion pathophysiology is altered metabolism and an acquired energy deficit. The mainstay of treatment for concussion is cognitive and physical rest, allowing for normalization of the metabolism and correction of the energy deficit. Once recovered, the student may need accommodations to successfully return to school without added difficulty and should follow a return to play protocol to return to athletics safely. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  15. Treatments of medical complications of anorexia nervosa and bulimia nervosa.

    Science.gov (United States)

    Mehler, Philip S; Krantz, Mori J; Sachs, Katherine V

    2015-01-01

    Inherent to anorexia nervosa and bulimia nervosa are a plethora of medical complications which correlate with the severity of weight loss or the frequency and mode of purging. Yet, the encouraging fact is that most of these medical complications are treatable and reversible with definitive care and cessation of the eating-disordered behaviours. Herein, these treatments are described for both the medical complications of anorexia nervosa and those which are a result of bulimia nervosa.

  16. Non-critical pure spinor superstrings

    International Nuclear Information System (INIS)

    Adam, Ido; Grassi, Pietro Antonio; Mazzucato, Luca; Oz, Yaron; Yankielowicz, Shimon

    2007-01-01

    We construct non-critical pure spinor superstrings in two, four and six dimensions. We find explicitly the map between the RNS variables and the pure spinor ones in the linear dilaton background. The RNS variables map onto a patch of the pure spinor space and the holomorphic top form on the pure spinor space is an essential ingredient of the mapping. A basic feature of the map is the requirement of doubling the superspace, which we analyze in detail. We study the structure of the non-critical pure spinor space, which is different from the ten-dimensional one, and its quantum anomalies. We compute the pure spinor lowest lying BRST cohomology and find an agreement with the RNS spectra. The analysis is generalized to curved backgrounds and we construct as an example the non-critical pure spinor type IIA superstring on AdS 4 with RR 4-form flux

  17. Allopathic, complementary, and alternative medical treatment utilization for pain among methadone-maintained patients.

    Science.gov (United States)

    Barry, Declan T; Beitel, Mark; Cutter, Christopher J; Garnet, Brian; Joshi, Dipa; Schottenfeld, Richard S; Rounsaville, Bruce J

    2009-01-01

    We surveyed 150 methadone maintenance treatment program (MMTP) patients about pain, pain treatment utilization, perceived efficacy of prior pain treatment, and interest in pursuing pain treatment at the MMTP. Respondents with chronic severe pain (CSP) (ie, pain lasting at least six months with moderate to severe pain intensity or significant pain interference) and "some pain" (ie, pain reported in the previous week but not CSP) endorsed similar rates of past-week and lifetime allopathic or standard medical (with the exception of lifetime medical use of non-opiate medication) and complementary and alternative medicine (CAM) utilization for pain reduction. Prior pain treatments were perceived to be less effective by CSP than SP patients but both groups had equivalent high rates of interest in pain treatment associated with the MMTP. These findings may have implications for resource and program planning in MMTPs.

  18. Assessment of Evidence Base from Medical Debriefs Data on Space Motion Sickness Incidence and Treatment

    Science.gov (United States)

    Younker, D.R.; Daniels, V.R.; Boyd, J.L.; Putcha, L.

    2008-01-01

    An objective of this data compilation and analysis project is to examine incidence and treatment efficacy of common patho-physiological disturbances during spaceflight. Analysis of medical debriefs data indicated that astronauts used medications to alleviate symptoms of four major ailments for which astronauts received treatment for sleep disturbances, space motion sickness (SMS), pain (headache, back pain) and sinus congestion. In the present data compilation and analysis project on SMS treatment during space missions, subject demographics (gender, age, first-time or repeat flyer), incidence and severity of SMS symptoms and subjective treatment efficacy from 317 crewmember debrief records were examined from STS-1 through STS-89. Preliminary analysis of data revealed that 50% of crew members reported SMS symptoms on at least one flight and 22% never experienced it. In addition, there were 387 medication dosing episodes reported, and promethazine was the most commonly used medication. Results of analysis of symptom check lists, medication use/efficacy and gender and flight record differences in incidence and treatment efficacy will be presented. Evidence gaps for treatment efficacy along with medication use trend analysis will be identified.

  19. Antihypertensive medication classes used among medicare beneficiaries initiating treatment in 2007-2010.

    Science.gov (United States)

    Kent, Shia T; Shimbo, Daichi; Huang, Lei; Diaz, Keith M; Kilgore, Meredith L; Oparil, Suzanne; Muntner, Paul

    2014-01-01

    After the 2003 publication of the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) guidelines, there was a 5-10% increase in patients initiating antihypertensive medication with a thiazide-type diuretic, but most patients still did not initiate treatment with this class. There are few contemporary published data on antihypertensive medication classes filled by patients initiating treatment. We used the 5% random Medicare sample to study the initiation of antihypertensive medication between 2007 and 2010. Initiation was defined by the first antihypertensive medication fill preceded by 365 days with no antihypertensive medication fills. We restricted our analysis to beneficiaries ≥ 65 years who had two or more outpatient visits with a hypertension diagnosis and full Medicare fee-for-service coverage for the 365 days prior to initiation of antihypertensive medication. Between 2007 and 2010, 32,142 beneficiaries in the 5% Medicare sample initiated antihypertensive medication. Initiation with a thiazide-type diuretic decreased from 19.2% in 2007 to 17.9% in 2010. No other changes in medication classes initiated occurred over this period. Among those initiating antihypertensive medication in 2010, 31.3% filled angiotensin-converting enzyme inhibitors (ACE-Is), 26.9% filled beta blockers, 17.2% filled calcium channel blockers, and 14.4% filled angiotensin receptor blockers (ARBs). Initiation with >1 antihypertensive medication class decreased from 25.6% in 2007 to 24.1% in 2010. Patients initiated >1 antihypertensive medication class most commonly with a thiazide-type diuretic and either an ACE-I or ARB. These results suggest that JNC 7 had a limited long-term impact on the choice of antihypertensive medication class and provide baseline data prior to the publication of the 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults from the Panel Members Appointed to

  20. [Medical treatment support to tuberculous patients--from the standpoint of community support].

    Science.gov (United States)

    2001-11-01

    A symposium with "Medical Treatment Support to Tuberculous Patients--From the standpoint of community support" as its theme was held at the 76th Annual Meeting of the Japanese Society for Tuberculosis (April 20, 2001). "Once, It is infected with tuberculosis, one have to complete medication with a sensitive antituberculosis drug by observing the prescribed dose and duration for successful treatment". For this to be promoted community, it is necessary that (1) to manage patient's medication by medical facilities, (2) to support patient's medication by health center and (3) to support patient's living by welfare offices. Not that each facilities takes such responsibilities alone, but various community must fulfill them continuously in liaison with one another. On what measures should be taken to that end, reports based on practical examples from Nagoya City, Yokohama City and Kanagawa Prefecture have been compiled as follows. 1. It was in-office liaison by conference that supported the DOTS activities of health nurses. 2. It is cooperating, without health, medical treatment, and welfare going out, as follows. (1) A system for hospitals and clinics to carry out DOTS treatment consistently has been kept in good condition. (2) For a patient to take a drug in front of a nurse has become common, causing the patients to be motivated. (3) Assignment of MSW and nurses in charge of DOTS sent from hospitals has make it possible to offer or exchange information smoothly among those concerned. (4) A system for many persons concerned to support patients timely has been kept in good condition. This resulted in an increase in the cure rate of tuberculosis in the areas which have day laborers' lodgings. 3. By DOTS for in-patients, the number of self-discharges has decreased by 1/3, and the treatment completion rate was 94%. 4. In promotion of DOTS for the patients who have health problems other than tuberculosis, the role MSW plays is great. 5. As conditions for supporting DOTS

  1. Luxation radio carpienne ouverte pure: à propos d'un cas | El Alaoui ...

    African Journals Online (AJOL)

    ... the dislocation (C, D). The patient underwent wrist immobilization for 6 weeks, followed by a pin ablation (E) then sessions of reeducation. After a backward movement of 18 months, the evolution was good, with a normal mobility of the wrist. Keywords: Dislocation, pure, radio carpal. Pan African Medical Journal 2016; 23 ...

  2. Impact of medical treatment on lung diffusion capacity in elderly patients with heart failure. Baseline characteristics and 1-year follow up after medical treatment

    DEFF Research Database (Denmark)

    Petersen, Claus Leth; Kjaer, Andreas

    2005-01-01

    treatment (baseline) and after 1 year of treatment with diuretics and ACE-inhibitors/angiotensin-II receptor antagonists. Age- and gender-matched healthy volunteers were included as control group. RESULTS: (mean+/-S.E.M.): K(CO) at baseline was 0.95+/-0.06 and 1.25+/-0.04 mmol/min x kPa/l in HF patients......AIM: The aim of this investigation was (1) to study the effect of untreated chronic heart failure (CHF) on alveolar membrane diffusion capacity (transfer coefficient, K(CO)) in elderly patients and (2) to study the impact of the standard regime of medical treatment with diuretics and ACE......-inhibitor/angiotensin-II receptor antagonists on K(CO) in these patients. METHODS: Non-medicated patients (except for diuretics) with symptoms of heart failure (NYHA II-III) and echocardiographically estimated left ventricular ejection fraction (LVEF)

  3. Perceived discrimination, socioeconomic disadvantage and refraining from seeking medical treatment in Sweden.

    Science.gov (United States)

    Wamala, Sarah; Merlo, Juan; Boström, Gunnel; Hogstedt, Christer

    2007-05-01

    To analyse the association between perceived discrimination and refraining from seeking required medical treatment and the contribution of socioeconomic disadvantage. Data from the Swedish National Survey of Public Health 2004 were used for analysis. Respondents were asked whether they had refrained from seeking required medical treatment during the past 3 months. Perceived discrimination was based on whether respondents reported that they had been treated in a way that made them feel humiliated (due to ethnicity/race, religion, gender, sexual orientation, age or disability). The Socioeconomic Disadvantage Index (SDI) was developed to measure economic deprivation (social welfare beneficiary, being unemployed, financial crisis and lack of cash reserves). Swedish population-based survey of 14,736 men and 17,115 women. Both perceived discrimination and socioeconomic disadvantage were independently associated with refraining from seeking medical treatment. Experiences of frequent discrimination even without any socioeconomic disadvantage were associated with three to nine-fold increased odds for refraining from seeking medical treatment. A combination of both frequent discrimination and severe SDI was associated with a multiplicative effect on refraining from seeking medical treatment, but this effect was statistically more conclusive among women (OR = 11.6, 95% CI 8.1 to 16.6; Synergy Index (SI) = 2.0 (95% CI 1.2 to 3.2)) than among men (OR = 12, 95% CI 7.7 to 18.7; SI = 1.6 (95% CI 1.3 to 2.1)). The goal of equitable access to healthcare services cannot be achieved without public health strategies that confront and tackle discrimination in society and specifically in the healthcare setting.

  4. Treatment of Post-Traumatic Stress Disorder Nightmares at a Veterans Affairs Medical Center

    Science.gov (United States)

    Detweiler, Mark B.; Pagadala, Bhuvaneshwar; Candelario, Joseph; Boyle, Jennifer S.; Detweiler, Jonna G.; Lutgens, Brian W.

    2016-01-01

    The effectiveness of medications for PTSD in general has been well studied, but the effectiveness of medicatio.ns prescribed specifically for post-traumatic stress disorder (PTSD) nightmares is less well known. This retrospective chart review examined the efficacy of various medications used in actual treatment of PTSD nightmares at one Veteran Affairs Hospital. Records at the Salem, VA Veterans Affairs Medical Center (VAMC) were examined from 2009 to 2013 to check for the efficacy of actual treatments used in comparis.on with treatments suggested in three main review articles. The final sample consisted of 327 patients and 478 separate medication trials involving 21 individual medications plus 13 different medication combinations. The three most frequently utilized medications were prazosin (107 trials), risperidone (81 trials), and quetiapine (72 trials). Five medications had 20 or more trials with successful results (partial to full nightmare cessation) in >50% of trials: risperidone (77%, 1.0–6.0 mg), clonidine (63%, 0.1–2.0 mg), quetiapine (50%, 12.5–800.0 mg), mirtazapine (50%; 7.5–30.0 mg), and terazosin (64%, 50.0–300.0 mg). Notably, olanzapine (2.5–10.0) was successful (full remission) in all five prescription trials in five separate patients. Based on the clinical results, the use of risperidone, clonidine, terazosin, and olanzapine warrants additional investigation in clinically controlled trials as medications prescribed specifically for PTSD nightmares. PMID:27999253

  5. On the ethics of withholding and withdrawing medical treatment.

    Science.gov (United States)

    Reichlin, Massimo

    2014-01-01

    A general rationale is presented for withholding and withdrawing medical treatment in end-of-life situations, and an argument is offered for the moral irrelevance of the distinction, both in the context of pharmaceutical treatments, such as chemotherapy in cancer, and in the context of life-sustaining treatments, such as the artificial ventilator in lateral amyotrophic sclerosis. It is argued that this practice is not equivalent to sanctioning voluntary active euthanasia and that it is not likely to favour it.

  6. Chemical treatment of radioactive liquid wastes from medical applications

    International Nuclear Information System (INIS)

    Castillo A, J.

    1995-01-01

    This work is a study about the treatment of the most important radioactive liquid wastes from medical usages, generated in medical institutions with nuclear medicine services. The radionuclides take in account are 32 P, 35 S, 125 I. The treatments developed and improved were specific chemical precipitations for each one of the radionuclides. This work involve to precipitate the radionuclide from the liquid waste, making a chemical compound insoluble in the aqueous phase, for this process the radionuclide stay in the precipitate, lifting the aqueous phase with a very low activity than the begin. The 32 P precipitated in form of Ca 3 32 P O 4 and Ca 2 H 32 P O 4 with a value for Decontamination Factor (DF) at the end of the treatment of 32. The 35 S was precipitated in form of Ba 35 SO 4 with a DF of 26. The 125 I was precipitated in Cu 125 I to obtain a DF of 24. The results of the treatments are between the limits given for the International Atomic Energy Agency and the 10 Code of Federal Regulation 20, for the safety release at the environment. (Author)

  7. Parent perspectives on the decision to initiate medication treatment of attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Coletti, Daniel J; Pappadopulos, Elizabeth; Katsiotas, Nikki J; Berest, Alison; Jensen, Peter S; Kafantaris, Vivian

    2012-06-01

    Despite substantial evidence supporting the efficacy of stimulant medication for children with attention-deficit/hyperactivity disorder (ADHD), adherence to stimulant treatment is often suboptimal. Applying social/cognitive theories to understanding and assessing parent attitudes toward initiating medication may provide insight into factors influencing parent decisions to follow ADHD treatment recommendations. This report describes results from formative research that used focus groups to obtain parent input to guide development of a provider-delivered intervention to improve adherence to stimulants. Participants were caregivers of children with ADHD who were given a stimulant treatment recommendation. Focus groups were recorded and transcribed verbatim. Data were analyzed by inductive, grounded theory methods as well as a deductive analytic strategy using an adapted version of the Unified Theory of Behavior Change to organize and understand parent accounts. Five groups were conducted with 27 parents (mean child age=9.35 years; standard deviation [SD]=2.00), mean time since diagnosis=3.33 years (SD=2.47). Most parents (81.5%) had pursued stimulant treatment. Inductive analysis revealed 17 attitudes facilitating adherence and 25 barriers. Facilitators included parent beliefs that medication treatment resulted in multiple functional gains and that treatment was imperative for their children's safety. Barriers included fears of personality changes and medication side effects. Complex patterns of parent adherence to medication regimens were also identified, as well as preferences for psychiatrists who were diagnostically expert, gave psychoeducation using multiple modalities, and used a chronic illness metaphor to explain ADHD. Theory-based analyses revealed conflicting expectancies about treatment risks and benefits, significant family pressures to avoid medication, guilt and concern that their children required medication, and distorted ideas about treatment risks

  8. Assault in medical law: revisiting the boundaries of informed consent to medical treatment in South Africa.

    Science.gov (United States)

    Wilson, Maria C I

    2009-05-01

    This article focuses on assault as a cause of action in medical law, with particular emphasis on the requirements for informed consent, both under common law and under the National Health Act 2003 (Sth Africa). In particular, the test for consent, adopted in Castell v De Greef 1994 (4) SA 408 (C), is analysed in detail. It is noted that the wording of this test for informed consent mirrors the wording of the test for negligence laid down in the Australian case of Rogers v Whitaker (1992) 175 CLR 479. Further, the relationship between the delictual elements of wrongfulness and fault in assault is discussed. It is argued that in South African law a valid consent to medical treatment requires knowledge not only of the general nature of medical treatment but also of the consequences of the treatment and, in determining which consequences should be disclosed to a patient, the constitutional rights to equality and self-determination support the application of a subjective patient-centred test for informed consent. However, it is also proposed that the broad right of a patient to information is reined in at the fault element of assault, so that a limited requirement of consciousness of wrongfulness on the part of the defendant negates liability for delictual assault.

  9. Experimental Treatment for Duchenne Muscular Dystrophy Gets Boost from Existing Medication

    Science.gov (United States)

    ... Boost from Existing Medication Spotlight on Research Experimental Treatment for Duchenne Muscular Dystrophy Gets Boost from Existing Medication By Colleen Labbe, M.S. | March 1, 2013 A mouse hanging on a wire during a test of muscle strength. Mice with a mutant dystrophin gene, which ...

  10. [Limitation of medical treatment and ethics in chronic recurrent Clivus chordoma].

    Science.gov (United States)

    Egger, Alexandra; Müller-Busch, H Christof

    2008-01-01

    In this paper ethical questions concerning the limitation and termination of medical treatment of comatose patients will be discussed on the basis of a case study. The team is confronted with extremely high communicative and ethical demands, since every person engaged in the treatment and care of the patient should take part in this decision making process. The final responsibility regarding the medical decisions, however, lies with the doctor in charge. In such cases advance directives or living wills are important and should be taken into consideration.

  11. Antihypertensive medication classes used among medicare beneficiaries initiating treatment in 2007-2010.

    Directory of Open Access Journals (Sweden)

    Shia T Kent

    Full Text Available After the 2003 publication of the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7 guidelines, there was a 5-10% increase in patients initiating antihypertensive medication with a thiazide-type diuretic, but most patients still did not initiate treatment with this class. There are few contemporary published data on antihypertensive medication classes filled by patients initiating treatment.We used the 5% random Medicare sample to study the initiation of antihypertensive medication between 2007 and 2010. Initiation was defined by the first antihypertensive medication fill preceded by 365 days with no antihypertensive medication fills. We restricted our analysis to beneficiaries ≥ 65 years who had two or more outpatient visits with a hypertension diagnosis and full Medicare fee-for-service coverage for the 365 days prior to initiation of antihypertensive medication. Between 2007 and 2010, 32,142 beneficiaries in the 5% Medicare sample initiated antihypertensive medication. Initiation with a thiazide-type diuretic decreased from 19.2% in 2007 to 17.9% in 2010. No other changes in medication classes initiated occurred over this period. Among those initiating antihypertensive medication in 2010, 31.3% filled angiotensin-converting enzyme inhibitors (ACE-Is, 26.9% filled beta blockers, 17.2% filled calcium channel blockers, and 14.4% filled angiotensin receptor blockers (ARBs. Initiation with >1 antihypertensive medication class decreased from 25.6% in 2007 to 24.1% in 2010. Patients initiated >1 antihypertensive medication class most commonly with a thiazide-type diuretic and either an ACE-I or ARB.These results suggest that JNC 7 had a limited long-term impact on the choice of antihypertensive medication class and provide baseline data prior to the publication of the 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults from the Panel

  12. Adherence to medical treatment in relation to pregnancy, birth outcome & breastfeeding behavior among women with Crohn's disease.

    Science.gov (United States)

    Julsgaard, Mette

    2016-07-01

    Crohn's disease (CD) is common among women of fertile age, and it often requires maintenance medical treatment. Adherence to medical treatment among women with CD prior to, during, and after pregnancy has, however, never been examined. Although CD women have increased risk of adverse pregnancy outcomes, little is known about predictors for these outcomes in women with CD. In addition, the impact of breastfeeding on disease activity remains controversial. The aims of this PhD thesis were to determine adherence to treatment and to investigate predictors for and prevalence rates of non-adherence to maintenance medical treatment among women with CD prior to, during, and after pregnancy; to assess pregnancy outcomes among women with CD, taking medical treatment, smoking status, and disease activity into account; to assess breastfeeding rates and the impact of breastfeeding on the risk of relapse. We conducted a population-based prevalence study including 154 women with CD who had given birth within a six-year period. We combined questionnaire data, data from medical records, and medical register data. Among 105 (80%) respondents, more than half reported taking medication with an overall high adherence rate of 69.8%. Counselling, previous pregnancy, and planned pregnancy seemed to decrease the likelihood of non-adherence, whereas smoking seemed to predict non-adherence prior to pregnancy, although our sample size prevented any firm conclusions. During pregnancy, the vast majority (95%) of CD women were in remission. The children's birth weight did not differ in relation to maternal medical treatment, but mean birth weight in children of smokers in medical treatment was 274 g lower than that of children of non-smokers in medical treatment. In our relatively small study CD women in medical treatment were not at increased risk of adverse pregnancy outcomes compared with untreated women with CD. In total, 87.6% of CD women were breastfeeding, and rates did not vary by

  13. Factors Associated With Medication-Overuse Headache in Patients Seeking Treatment for Primary Headache.

    Science.gov (United States)

    Peck, Kelly R; Roland, Malcolm M; Smitherman, Todd A

    2018-03-09

    Although risk factors for medication-overuse headache have been identified within the general population, most studies have neglected clinical samples. The present study examined the relative and combined associations of these factors with medication-overuse headache in a sample of US adults seeking treatment for primary headache disorders. Treatment-seeking headache patients provided data on demographics, headache variables, psychiatric variables, use of headache medications, and use of other prescription medications and substances. A classification tree selection strategy was utilized within this cross-sectional study to differentiate between those with and without medication-overuse headache, and a final multivariable model assessed their combined utility. Forty-three of 164 participants (26.2%) met diagnostic criteria for medication-overuse headache. Relative to non-medication-overuse headache participants, participants with medication-overuse headache reported greater headache-related disability (odds ratio = 1.09, 95% confidence interval = 1.01-1.18), escape and avoidance responses indicative of fear of pain (odds ratio = 1.07, 95% confidence interval = 1.00-1.15), and use of combination medications for headache (odds ratio = 3.10, 95% confidence interval = 1.51-6.36). The final multivariable model differentiated well between the 2 groups (area under the receiver operating characteristic curve = .78; 95% confidence interval = .71-.86). Items that assess headache-related disability, use of combination medications, and fear of pain help identify patients who are currently overusing acute headache medications and may serve as indicators of treatment progress. Future studies should apply similar analytic approaches longitudinally to identify headache sufferers at risk for medication-overuse headache prior to headache progression. © 2018 American Headache Society.

  14. [Cirurgia Taurina--emergency medical treatment of bullfighters in Spain].

    Science.gov (United States)

    Lehmann, V; Lehmann, J

    2003-08-01

    A considerable risk of life-threatening injury is inherent to bullfighting. Thus, a unique form of emergency treatment has evolved over recent decades of organized bull-fighting. Today bullfight arenas in larger cities are equipped with emergency facilities including fully furnished operating rooms. During a fiesta these facilities are run by a medical team consisting of three surgeons, one intensive care specialist, and one anesthesiologist with their supporting medical personnel. In smaller arenas or villages immediate care units consist of emergency vehicles, and a mobile container equipped with a fully functional operating room. Of all toreros the matadores including the novilleros are most often injured in 56 % of cases. This rate decreases for banderillos (30 %), and for picadores (14 %). Parts of the body that are most frequently affected are thighs, and the inguinal region (54 %). Head and neck injuries are seen in 19 %, and 12 % of cases present with open abdominal wounds including liver or gastrointestinal tract traumas. 10 % of injuries affect the thorax, and 4 % the pelvic floor. The particular form of organised medical treatment for bullfighters in Spain has only developed since the nineteen-thirties. In 1972 a scientific society for bullfight surgery was founded in Spain by specialized surgeons, and immediate care specialists holding a first convention that year. The society is continuously striving to improve technical and logistical aspects of immediate medical care for injured bullfighters.

  15. The effect of ultrasound on particle size, color, viscosity and polyphenol oxidase activity of diluted avocado puree.

    Science.gov (United States)

    Bi, Xiufang; Hemar, Yacine; Balaban, Murat O; Liao, Xiaojun

    2015-11-01

    The effect of ultrasound treatment on particle size, color, viscosity, polyphenol oxidase (PPO) activity and microstructure in diluted avocado puree was investigated. The treatments were carried out at 20 kHz (375 W/cm(2)) for 0-10 min. The surface mean diameter (D[3,2]) was reduced to 13.44 μm from an original value of 52.31 μm by ultrasound after 1 min. A higher L(∗) value, ΔE value and lower a(∗) value was observed in ultrasound treated samples. The avocado puree dilution followed pseudoplastic flow behavior, and the viscosity of diluted avocado puree (at 100 s(-1)) after ultrasound treatment for 1 min was 6.0 and 74.4 times higher than the control samples for dilution levels of 1:2 and 1:9, respectively. PPO activity greatly increased under all treatment conditions. A maximum increase of 25.1%, 36.9% and 187.8% in PPO activity was found in samples with dilution ratios of 1:2, 1:5 and 1:9, respectively. The increase in viscosity and measured PPO activity might be related to the decrease in particle size. The microscopy images further confirmed that ultrasound treatment induced disruption of avocado puree structure. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Revascularisation versus medical treatment in patients with stable coronary artery disease

    DEFF Research Database (Denmark)

    Windecker, Stephan; Stortecky, Stefan; Stefanini, Giulio G

    2014-01-01

    OBJECTIVE: To investigate whether revascularisation improves prognosis compared with medical treatment among patients with stable coronary artery disease. DESIGN: Bayesian network meta-analyses to combine direct within trial comparisons between treatments with indirect evidence from other trials ...

  17. Only for "purely scientific" institutions: the Medical Library Association's Exchange, 1898-1950s.

    Science.gov (United States)

    Connor, Jennifer J

    2011-04-01

    Centralized exchanges of scientific materials existed by the late nineteenth century, but they did not include medical publications. North American medical leaders therefore formed an association of institutions to run their own exchange: the Medical Library Association (MLA). After providing background to the exchange concept and the importance of institutional members for MLA, this article examines archival MLA correspondence to consider the role of its Exchange in the association's professional development before the 1950s. MLA's membership policy admitted only libraries open to the medical profession with a large number of volumes. But the correspondence of the MLA Executive Committee reveals that the committee constantly adjusted the definition of library membership: personal, public, sectarian, commercial, allied science, and the then-termed "colored" medical school libraries all were denied membership. Study of these decisions, using commercial and sectarian libraries as a focus, uncovers the primary justification for membership exclusions: a goal of operating a scientific exchange. Also, it shows that in this way, MLA shadowed policies and actions of the American Medical Association. Finally, the study suggests that the medical profession enforced its policies of exclusion through MLA, despite a proclaimed altruistic sharing of medical literature.

  18. Mixtures of maximally entangled pure states

    Energy Technology Data Exchange (ETDEWEB)

    Flores, M.M., E-mail: mflores@nip.up.edu.ph; Galapon, E.A., E-mail: eric.galapon@gmail.com

    2016-09-15

    We study the conditions when mixtures of maximally entangled pure states remain entangled. We found that the resulting mixed state remains entangled when the number of entangled pure states to be mixed is less than or equal to the dimension of the pure states. For the latter case of mixing a number of pure states equal to their dimension, we found that the mixed state is entangled provided that the entangled pure states to be mixed are not equally weighted. We also found that one can restrict the set of pure states that one can mix from in order to ensure that the resulting mixed state is genuinely entangled. Also, we demonstrate how these results could be applied as a way to detect entanglement in mixtures of the entangled pure states with noise.

  19. Reevaluating response and failure of medical treatment of endometriosis: a systematic review.

    Science.gov (United States)

    Becker, Christian M; Gattrell, William T; Gude, Kerstin; Singh, Sukhbir S

    2017-07-01

    To assess patient response rates to medical therapies used to treat endometriosis-associated pain. A systematic review with the use of Medline and Embase. Not applicable. Women receiving medical therapy to treat endometriosis. None. The proportions of patients who: experienced no reduction in endometriosis-associated pain symptoms; had pain symptoms remaining at the end of the treatment period; had pain recurrence after treatment cessation; experienced an increase or no change in disease score during the study; were satisfied with treatment; and discontinued therapy owing to adverse events or lack of efficacy. The change in pain symptom severity experienced during and after treatment, as measured on the visual analog scale, was also assessed. In total, 58 articles describing 125 treatment arms met the inclusion criteria. Data for the response of endometriosis-associated pain symptoms to treatment were presented in only 29 articles. The median proportions of women with no reduction in pain were 11%-19%; at the end of treatment, 5%-59% had pain remaining; and after follow-up, 17%-34% had experienced recurrence of pain symptoms after treatment cessation. After median study durations of 2-24 months, the median discontinuation rates due to adverse events or lack of efficacy were 5%-16%. Few studies of medical therapies for endometriosis report outcomes that are relevant to patients, and many women gain only limited or intermittent benefit from treatment. Copyright © 2017. Published by Elsevier Inc.

  20. Semi-empirical model to determine pure β--emitters in closed waste packages using Bremsstrahlung radiation

    International Nuclear Information System (INIS)

    Takacs, S.; Hermanne, A.

    2001-01-01

    Medical establishments and research laboratories use many different type of radionuclides for diagnostic, therapeutic and research purposes. As a final by product large amount of medical waste are produced. This waste represents both biological and radiation hazards, therefore it requires special treatments in both point of view. Biomedical waste is usually best managed on site by decay storage, with minimal transport risk and ALARA (as low as reasonably achieved) exposure levels. The nuclear medical waste has characteristics fundamentally different from the nuclear fuel cycle waste. In medical practice radioactive material is used both in sealed and unsealed form, but major part of the medical waste is produced by using unsealed isotopes of relatively short half-life in most cases less than 100 days and of low specific activity. There are gamma-emitter, position-emitter and pure beta-knitter among these isotopes. The positron-emitter isotopes have usually less than 2 hours half-life; therefore they do not contribute too much to the volume of the radioactive waste since they decay rapidly. Among the γ- and pure β - - emitters there are isotopes with half-life from seconds to several hundred days. Waste containing isotopes with longer half-life contributes mainly to that large volume of waste produced regularly at biomedical sites. On site decay storage requires accurate determination of activity levels. Since quantitative estimation of isotope activity can be difficult where waste packages contain a mixed combination of β - -γ-emitters, segregation at the time of waste production is essential. Accurate identification and quantitative measurement of γ-emitter isotopes is possible with a large volume, reverse electrode, high purity germanium detector even those cases when the isotope emits only low energy gamma photons. However, there is problem with the pure β - emitting isotopes to measure. In biological health care and pharmaceutical research a range of

  1. Use of medical foods and nutritional approaches in the treatment of Alzheimer's disease.

    Science.gov (United States)

    Thaipisuttikul, Papan; Galvin, James E

    2012-03-01

    Alzheimer's disease, the most common cause of dementia, has a high global economic impact. To date, there is no curative treatment; therefore, many efforts are directed not only at novel potential disease-modifying treatments and interventions, but also to develop alternative symptomatic and supportive treatments. Examples of these efforts include the medical foods. There are three medical foods that claim to offer symptomatic benefits: Axona(®), Souvenaid(®) and CerefolinNAC(®). Axona supplies ketone bodies as alternative energy source to neurons. Souvenaid provides precursors thought to enhance synaptic function. CerefolinNAC addresses the role of oxidative stress related to memory loss. The current scientific evidence on these medical foods is reviewed in this article. Furthermore, we also review the concept and evidence supporting use of the Mediterranean diet, a possible alternative to medical foods that, if implemented correctly, may have lower costs, fewer side effects and stronger epidemiological health outcomes.

  2. BRUCELLA ENDOCARDITIS IN IRANIAN PATIENTS: COMBINED MEDICAL AND SURGICAL TREATMENT

    Directory of Open Access Journals (Sweden)

    Ebrahim Nematipour

    1995-06-01

    Full Text Available Brucella endocarditis is a Tare but serious complication ofbrucellosis and is the main cause of death reuuedto thisdisease: Itis not rare in the endemic areas and aaualiy accounts for up to 8~lO% ofendocarditis infections: We report seven adult cases of brucella endocarditis in lmam-Khorneini Hospual: Contrary to previous independent reports, female patients were not rare in this study and accountedfor three out ofseven. Four patients were cared for by combined medical and surgical treatment and were recovered Three of the patients that did not receive the combined theraPl could not he saved This report confirms the necessity of prompt combined medical and surgical treatment ofbrucella endocarditis.

  3. Content and Formation Cause of VOCs in Medical Waste Non-incineration Treatment Project

    Science.gov (United States)

    Dengchao, Jin; Hongjun, Teng; Zhenbo, Bao; Yang, Li

    2018-02-01

    When medical waste is treated by non-incineration technology, volatile organic compounds in the waste will be volatile out and form odor pollution. This paper studied VOCs productions in medical waste steam treatment project, microwave treatment project and chemical dinifection project. Sampling and analysis were carried out on the waste gas from treatment equipment and the gas in treatment workshop. The contents of nine VOCs were determined. It was found that the VOCs content in the exhaust gas at the outlet of steam treatment unit was much higher than that of microwave and chemical treatment unit, while the content of VOCs in the chemical treatment workshop was higher than that in the steam and microwave treatment workshop. The formation causes of VOCs were also analyzed and discussed in this paper.

  4. Effect of Heat Treatment on the Microstructure and Wear Properties of Al-Zn-Mg-Cu/In-Situ Al-9Si-SiCp/Pure Al Composite by Powder Metallurgy

    Science.gov (United States)

    Yu, Byung Chul; Bae, Ki-Chang; Jung, Je Ki; Kim, Yong-Hwan; Park, Yong Ho

    2018-03-01

    This study examined the effects of heat treatment on the microstructure and wear properties of Al-Zn-Mg-Cu/in-situ Al-9Si-SiCp/pure Al composites. Pure Al powder was used to increase densification but it resulted in heterogeneous precipitation as well as differences in hardness among the grains. Heat treatment was conducted to solve this problem. The heat treatment process consisted of three stages: solution treatment, quenching, and aging treatment. After the solution treatment, the main dissolved phases were η'(Mg4Zn7), η(MgZn2), and Al2Cu phase. An aging treatment was conducted over the temperature range, 100-240 °C, for various times. The GP zone and η'(Mg4Zn7) phase precipitated at a low aging temperature of 100-160 °C, whereas the η(MgZn2) phase precipitated at a high aging temperature of 200-240 °C. The hardness of the sample aged at 100-160 °C was higher than that aged at 200-240 °C. The wear test was conducted under various linear speeds with a load of 100 N. The aged composite showed a lower wear rate than that of the as-sintered composite under all conditions. As the linear speed was increased to 1.0 m/s, the predominant wear behavior changed from abrasive to adhesive wear in all composites.

  5. Effect of Heat Treatment on the Microstructure and Wear Properties of Al-Zn-Mg-Cu/In-Situ Al-9Si-SiCp/Pure Al Composite by Powder Metallurgy

    Science.gov (United States)

    Yu, Byung Chul; Bae, Ki-Chang; Jung, Je Ki; Kim, Yong-Hwan; Park, Yong Ho

    2018-05-01

    This study examined the effects of heat treatment on the microstructure and wear properties of Al-Zn-Mg-Cu/in-situ Al-9Si-SiCp/pure Al composites. Pure Al powder was used to increase densification but it resulted in heterogeneous precipitation as well as differences in hardness among the grains. Heat treatment was conducted to solve this problem. The heat treatment process consisted of three stages: solution treatment, quenching, and aging treatment. After the solution treatment, the main dissolved phases were η'(Mg4Zn7), η(MgZn2), and Al2Cu phase. An aging treatment was conducted over the temperature range, 100-240 °C, for various times. The GP zone and η'(Mg4Zn7) phase precipitated at a low aging temperature of 100-160 °C, whereas the η(MgZn2) phase precipitated at a high aging temperature of 200-240 °C. The hardness of the sample aged at 100-160 °C was higher than that aged at 200-240 °C. The wear test was conducted under various linear speeds with a load of 100 N. The aged composite showed a lower wear rate than that of the as-sintered composite under all conditions. As the linear speed was increased to 1.0 m/s, the predominant wear behavior changed from abrasive to adhesive wear in all composites.

  6. The microbiology and the efficacy of antibiotic-based medical treatment of chronic rhinosinusitis in Singapore.

    Science.gov (United States)

    Chin, C W D; Yeak, C L S; Wang, D Y

    2010-12-01

    Medical therapy including appropriate antibiotic treatment is advocated for the management of chronic rhinosinusitis (CRS), with sinus surgery reserved for treatment failures. This study investigates the microbiology of CRS and their response to culture-directed antibiotic treatment. Sinus aspirates of mucopus from 172 consecutive CRS patients, with (n=89) and without (n=83) previous antibiotic treatment, were obtained for bacterial culture at their first visit. Medical treatment which included initial empirical and subsequent culture-directed antibiotics was instituted. Endoscopic sinus surgery (FESS) was performed for patients with persistent CRS and/or complications of CRS. A follow-up of 12 months was scheduled for all patients. One hundred and twenty (69.8%) patients were treated successfully by with antibiotic-based medical therapy. Thirty-eight patients (22.1%) did not respond to medical treatment and eventually underwent FESS. The incidence of CRS with nasal polyps (CRSwNP) was higher in FESS group (n=13, 34.2%) than patients with medical treatment only (n=9, 6.7%). Staphylococcus aureus was the most common pathogen (n=43, 25%) and amongst patients with no prior antibiotic treatment, the incidence was higher in patients with CRSwNP (n=8, 53 %) than CRS without NP (CRSwoNP) (n=20, 27%). The rate of sensitivity of the cultured microbes to amoxicillin with clavulanate and cephalosporins was 78% and 70%, respectively. The microbiology of CRS in Singapore is described. Staphylococcus aureus appears to be the most common bacterial isolates in both CRS with and without nasal polyps. Medical treatment with CRS using culture-directed antibiotics is effective in the majority of patients, especially in patients without nasal polyps.

  7. Effect of high hydrostatic pressure processing on the background microbial loads and quality of cantaloupe puree.

    Science.gov (United States)

    Mukhopadhyay, Sudarsan; Sokorai, Kimberly; Ukuku, Dike; Fan, Xuetong; Juneja, Vijay

    2017-01-01

    The objective of this study was to investigate and evaluate the effects of high hydrostatic pressure (HHP) applied to cantaloupe puree (CP) on microbial loads and product quality during storage for 10days at 4°C. Freshly prepared, double sealed and double bagged CP (ca. 5g) was pressure treated at 300, 400 and 500MPa at 8°C and 15°C for 5min. Microflora populations, soluble solid content, pH, color, antioxidant activity, appearance and aroma were measured at 1, 6, and 10d of storage. Results showed that high pressure treatment of 300MPa (8°C and 15°C) resulted in reduction of total aerobic plate count from 3.3 to 1.8logCFU/g. The treatment reduced the populations of native aerobic plate count to non-detectable levels (detection limit 1logCFU/g) at 400MPa and 500MPa pressures at 15°C. Pressure treatment completely inactivated mold and yeast in puree below the limits of detection at day 1 and no regrowth was observed during 10days of storage at 4°C while mold and yeast in untreated puree survived during the storage. High pressure treatment did not show any adverse impact on physical properties as soluble solid content (SSC, 11.2°Brix) and acidity (pH, 6.9). The instrumental color parameters (L*, a*, b*) were affected due to HHP treatment creating a slightly lighter product, compared to control, as indicated by higher L.* and lower a* values. However the change was not detected by the sensory panel while evaluating appearance scores. Pressure treatment did not affect the antioxidant capacity of puree product compared to control. Visual appearance and sniffing aroma test by panel revealed no adverse changes in the sensory parameters as a result of HHP treatment. HHP method described in this study appears to be a promising way to inactivate spoilage microorganisms in the cantaloupe puree and maintain quality. This study provides a viable option for preservation and marketing this product. Published by Elsevier Ltd.

  8. Medications for addiction treatment: an opportunity for prescribing clinicians to facilitate remission from alcohol and opioid use disorders.

    Science.gov (United States)

    Park, Tae Woo; Friedmann, Peter D

    2014-10-01

    Substance use disorders are a leading cause of morbidity and mortality in the United States. Medications for the treatment of substance use disorders are effective yet underutilized. This article reviews recent literature examining medications used for the treatment of alcohol and opioid use disorders. The neurobehavioral rationale for medication treatment and the most common ways medications work in the treatment of substance use disorders are discussed. Finally, the medications and the evidence behind their effectiveness are briefly reviewed. Physicians and other prescribing clinicians should take an active role in facilitating remission and recovery from substance use disorders by prescribing these effective medications with brief medical management counseling.

  9. Validation of an abbreviated Treatment Satisfaction Questionnaire for Medication (TSQM-9 among patients on antihypertensive medications

    Directory of Open Access Journals (Sweden)

    Desrosiers Marie-Pierre

    2009-04-01

    Full Text Available Abstract Background The 14-item Treatment Satisfaction Questionnaire for Medication (TSQM Version 1.4 is a reliable and valid instrument to assess patients' satisfaction with medication, providing scores on four scales – side effects, effectiveness, convenience and global satisfaction. In naturalistic studies, administering the TSQM with the side effects domain could provoke the physician to assess the presence or absence of adverse events in a way that is clinically atypical, carrying the potential to interfere with routine medical care. As a result, an abbreviated 9-item TSQM (TSQM-9, derived from the TSQM Version 1.4 but without the five items of the side effects domain was created. In this study, an interactive voice response system (IVRS-administered TSQM-9 was psychometrically evaluated among patients taking antihypertensive medication. Methods A total of 3,387 subjects were invited to participate in the study from an online panel who self-reported taking a prescribed antihypertensive medication. The subjects were asked to complete the IVRS-administered TSQM-9 at the start of the study, along with the modified Morisky scale, and again within 7 to 14 days. Standard psychometric analyses were conducted; including Cronbach's alpha, intraclass correlation coefficients, structural equation modeling, Spearman correlation coefficients and analysis of covariance (ANCOVA. Results A total of 396 subjects completed all the study procedures. Approximately 50% subjects were male with a good racial/ethnic mix: 58.3% white, 18.9% black, 17.7% Hispanic and 5.1% either Asian or other. There was evidence of construct validity of the TSQM-9 based on the structural equation modeling findings of the observed data fitting the Decisional Balance Model of Treatment Satisfaction even without the side effects domain. TSQM-9 domains had high internal consistency as evident from Cronbach's alpha values of 0.84 and greater. TSQM-9 domains also demonstrated good test

  10. Reliability and validity of the Treatment Satisfaction Questionnaire for Medication among Portuguese-speaking Brazilian patients with hypertension.

    Science.gov (United States)

    Sauer Liberato, Ana Carolina; Cunha Matheus Rodrigues, Roberta; Kim, MyoungJin; Mallory, Caroline

    2016-07-01

    This study examined the reliability and validity of the Brazilian Portuguese version of the Treatment Satisfaction Questionnaire for Medication (version 1.4) among patients with hypertension. Understanding the patient experience with treatment satisfaction will contribute to improved medication adherence and control of hypertension. Hypertension is a serious problem in Brazil that is associated with chronic illness controlled, in part, by consistent adherence to medications. Patient satisfaction with medication treatment is associated with adherence to medication. The Treatment Satisfaction Questionnaire for Medication (version 1.4) is a promising instrument for measuring medication; however, to date there has been no report of the reliability and validity of the instrument with Portuguese-speaking adults with hypertension in Brazil. Cross-sectional descriptive exploratory study. A convenience sample of 300 patients with hypertension in an outpatient setting in the southeast region of São Paulo state in Brazil completed the Treatment Satisfaction Questionnaire for Medication (version 1.4). The instrument, comprised of four subscales, was evaluated for reliability using correlation analyses and internal consistency. Confirmatory factor analysis was used to determine factorial validity. Correlational analyses, internal consistency (Cronbach's alpha) and hierarchical confirmatory factor analysis demonstrate adequate support for the four-factor dimensionality, reliability and factorial validity of the Treatment Satisfaction Questionnaire for Medication (version 1.4). This study provides modest evidence for internal consistency and factorial validity of the Treatment Satisfaction Questionnaire for Medication (version 1.4) in Portuguese-speaking adult Brazilians with hypertension. Future testing should focus on extending reliability testing, discriminant validity and potential translation and literacy issues in this population. Within known limitations, clinicians will

  11. Revascularisation versus medical treatment in patients with stable coronary artery disease: network meta-analysis

    Science.gov (United States)

    Stortecky, Stefan; Stefanini, Giulio G; daCosta, Bruno R; Rutjes, Anne Wilhelmina; Di Nisio, Marcello; Siletta, Maria G; Maione, Ausilia; Alfonso, Fernando; Clemmensen, Peter M; Collet, Jean-Philippe; Cremer, Jochen; Falk, Volkmar; Filippatos, Gerasimos; Hamm, Christian; Head, Stuart; Kappetein, Arie Pieter; Kastrati, Adnan; Knuuti, Juhani; Landmesser, Ulf; Laufer, Günther; Neumann, Franz-Joseph; Richter, Dimitri; Schauerte, Patrick; Sousa Uva, Miguel; Taggart, David P; Torracca, Lucia; Valgimigli, Marco; Wijns, William; Witkowski, Adam; Kolh, Philippe; Juni, Peter

    2014-01-01

    Objective To investigate whether revascularisation improves prognosis compared with medical treatment among patients with stable coronary artery disease. Design Bayesian network meta-analyses to combine direct within trial comparisons between treatments with indirect evidence from other trials while maintaining randomisation. Eligibility criteria for selecting studies A strategy of initial medical treatment compared with revascularisation by coronary artery bypass grafting or Food and Drug Administration approved techniques for percutaneous revascularization: balloon angioplasty, bare metal stent, early generation paclitaxel eluting stent, sirolimus eluting stent, and zotarolimus eluting (Endeavor) stent, and new generation everolimus eluting stent, and zotarolimus eluting (Resolute) stent among patients with stable coronary artery disease. Data sources Medline and Embase from 1980 to 2013 for randomised trials comparing medical treatment with revascularisation. Main outcome measure All cause mortality. Results 100 trials in 93 553 patients with 262 090 patient years of follow-up were included. Coronary artery bypass grafting was associated with a survival benefit (rate ratio 0.80, 95% credibility interval 0.70 to 0.91) compared with medical treatment. New generation drug eluting stents (everolimus: 0.75, 0.59 to 0.96; zotarolimus (Resolute): 0.65, 0.42 to 1.00) but not balloon angioplasty (0.85, 0.68 to 1.04), bare metal stents (0.92, 0.79 to 1.05), or early generation drug eluting stents (paclitaxel: 0.92, 0.75 to 1.12; sirolimus: 0.91, 0.75 to 1.10; zotarolimus (Endeavor): 0.88, 0.69 to 1.10) were associated with improved survival compared with medical treatment. Coronary artery bypass grafting reduced the risk of myocardial infarction compared with medical treatment (0.79, 0.63 to 0.99), and everolimus eluting stents showed a trend towards a reduced risk of myocardial infarction (0.75, 0.55 to 1.01). The risk of subsequent revascularisation was noticeably

  12. Medical Cannabis and the Treatment of Obstructive Sleep Apnea: An American Academy of Sleep Medicine Position Statement.

    Science.gov (United States)

    Ramar, Kannan; Rosen, Ilene M; Kirsch, Douglas B; Chervin, Ronald D; Carden, Kelly A; Aurora, R Nisha; Kristo, David A; Malhotra, Raman K; Martin, Jennifer L; Olson, Eric J; Rosen, Carol L; Rowley, James A

    2018-03-30

    The diagnosis and effective treatment of obstructive sleep apnea (OSA) in adults is an urgent health priority. Positive airway pressure (PAP) therapy remains the most effective treatment for OSA, although other treatment options continue to be explored. Limited evidence citing small pilot or proof of concept studies suggest that the synthetic medical cannabis extract dronabinol may improve respiratory stability and provide benefit to treat OSA. However, side effects such as somnolence related to treatment were reported in most patients, and the long-term effects on other sleep quality measures, tolerability, and safety are still unknown. Dronabinol is not approved by the United States Food and Drug Administration (FDA) for treatment of OSA, and medical cannabis and synthetic extracts other than dronabinol have not been studied in patients with OSA. The composition of cannabinoids within medical cannabis varies significantly and is not regulated. Synthetic medical cannabis may have differential effects, with variable efficacy and side effects in the treatment of OSA. Therefore, it is the position of the American Academy of Sleep Medicine (AASM) that medical cannabis and/or its synthetic extracts should not be used for the treatment of OSA due to unreliable delivery methods and insufficient evidence of effectiveness, tolerability, and safety. OSA should be excluded from the list of chronic medical conditions for state medical cannabis programs, and patients with OSA should discuss their treatment options with a licensed medical provider at an accredited sleep facility. Further research is needed to understand the functionality of medical cannabis extracts before recommending them as a treatment for OSA. Copyright © 2018 American Academy of Sleep Medicine. All rights reserved.

  13. Medical and welfare device session. Toward medical treatment and welfare of tomorrow; Iryo fukushi kiki session. Ashita no iryo fukushi ni mukete

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-09-01

    This paper is the material distributed in the medical and welfare device session held under the auspices of NEDO in September 2000. Diversification of needs in the medical and welfare areas and handling of age advancement are the growing issue. NEDO is putting efforts toward enhancement of quality of life (QOL) and realization of the nation with great life by providing high-quality and high-efficiency medical and welfare services. The NEDO's efforts cover the areas of treating adult diseases such as cancers and cardiac diseases whose seriousness is growing, early diagnoses of diseases, medical treatment with low invasion, elderly people helping, reduction of helpers' burden, reduction of handicaps to elderly people and mentally and physically handicapped persons, and assistance to participation in the society. To achieve these goals, NEDO is implementing the following four projects: research and development of medical and welfare device technologies, researches of medical science and engineering collaboration type, and promotion of developing welfare techno-systems and practical application of welfare appliances. Developments are being made toward practical application of medical and welfare devices with excellent safety and convenience, of low cost and high performance. The session gave the keynote addresses related to medical treatment and prevention of brain diseases; brain, the universe and MRI (the world of mind as seen in images), and high-tech medical treatments to protect brain (challenge to brain that starts now). (NEDO)

  14. Pediatric Depression: When Does Parental Refusal for Treatment Constitute Medical Neglect?

    Science.gov (United States)

    Shapiro, Michael

    2018-06-01

    Depression is a common disorder in youth, and 10% to 15% of individuals have a lifetime prevalence by 18 years of age. Youth who receive treatment typically have a positive outcome, but many remain undiagnosed and untreated. 1 There is a dearth of literature on parental refusal to consent to treatment for pediatric depression and the circumstances under which such refusal could be considered medical neglect. In general, it appears that mental health diagnoses are rarely reported in cases of medical neglect. 2 . Copyright © 2018 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  15. Meditate don't medicate: How medical imaging evidence supports the role of meditation in the treatment of depression

    International Nuclear Information System (INIS)

    Annells, S.; Kho, K.; Bridge, P.

    2016-01-01

    Introduction: Depression is a debilitating psychiatric disorder that affects a large proportion of the population. The current treatment for depression involves anti-depressant medication which is associated with side effects and a heightened risk of relapse. Methods: A systematic literature review was performed to determine the value of medical imaging studies in measuring the impact of meditation on depression. Results: Medical imaging studies have successfully demonstrated that meditation may counteract or prevent the physiological cause of depression by decreasing amygdala activity and increasing grey matter volume and activity of the hippocampus, prefrontal cortex and other brain regions associated with attention and emotional self-regulation. Recent advances in functional imaging have enabled visualisation of neural plasticity within the brain. This has shown that for meditators, practice-induced alterations could be due to micro-anatomical processes that may represent an increased functional capacity within the brain regions activated. These changes within brain physiology in association with the skills gained during meditation such as self-regulation, mental processing of negative information and relaxation techniques could potentially lead to a permanent cure for depression and thus prevent relapse. Conclusions: The results of this review suggest that medical imaging has a valuable role to play in evidencing the physiological changes within the brain caused by meditation that counteract those that cause depression. These studies indicate that meditation is a viable alternative to medication for clinical treatment of patients with depression. More rigorous longitudinal imaging studies are proposed to enhance understanding of the neural pathways and mechanisms of meditation. - Highlights: • Medical imaging demonstrates physiological changes that counteract those that cause depression. • Meditation is an alternative to medication for clinical treatment of

  16. Mental Health of Prisoners: Identifying Barriers to Mental Health Treatment and Medication Continuity

    Science.gov (United States)

    Connell, Nadine M.

    2014-01-01

    Objectives. We assessed mental health screening and medication continuity in a nationally representative sample of US prisoners. Methods. We obtained data from 18 185 prisoners interviewed in the 2004 Survey of Inmates in State and Federal Correctional Facilities. We conducted survey logistic regressions with Stata version 13. Results. About 26% of the inmates were diagnosed with a mental health condition at some point during their lifetime, and a very small proportion (18%) were taking medication for their condition(s) on admission to prison. In prison, more than 50% of those who were medicated for mental health conditions at admission did not receive pharmacotherapy in prison. Inmates with schizophrenia were most likely to receive pharmacotherapy compared with those presenting with less overt conditions (e.g., depression). This lack of treatment continuity is partially attributable to screening procedures that do not result in treatment by a medical professional in prison. Conclusions. A substantial portion of the prison population is not receiving treatment for mental health conditions. This treatment discontinuity has the potential to affect both recidivism and health care costs on release from prison. PMID:25322306

  17. Analysis of medical institutions with various organizational forms of rehabilitation treatment and outpatient departments

    Directory of Open Access Journals (Sweden)

    Shapovalenko T.V.

    2013-12-01

    Full Text Available The study aimed organization of the analysis of activity of two medical institutions rendering services in rehabilitation and recovery treatment to adult population, having various organizational forms. Material and Methods. For five years there had been studied practical experience of rendering medical care on recovery treatment and rehabilitation to adult population on the basis of medico-statistical processing of reporting documentation of the Medicine Recovery Center and the rehabilitation, Ministry of Health of Russia functioning on the basis of the "Medical and Rehabilitation Center" — large versatile medical center and the interdistrict center of recovery treatment on the basis of city policlinic of St. Petersburg. Results. As a result it had been established an advisability of rendering this type of specialized medical care by medical institutions with different organizational forms. Conclusion. The interdistrict centers of rehabilitation functioning as a part of city policlinics, are undoubtedly necessary, as the closest medical setting for patients' homes, however such functions as diagnostics of a functional condition of an organism and an objective assessment of a state of health of patients with use of screening techniques; inspection of the organized collectives and groups of the population for the purpose of identification of groups of risk, establishment of extent of influence of environmental factors on a state of health, active supervision over persons with factors of the increased risk of diseases and correction of the revealed functional violations, etc. can be performed only in the centers organized on the basis of modern versatile treatment-and-prophylactic establishments, equipped with the modern diagnostic devices, allowing to supplement traditional methods of drug therapy with new effective techniques of treatment.

  18. Some aspects of anelastic and microplastic creep of pure Al and two Al-alloys

    Energy Technology Data Exchange (ETDEWEB)

    Sgobba, S. (Lab. de Metallurgie Mecanique, Dept. des Materiaux, Ecole Polytechnique Federale de Lausanne (Switzerland)); Kuenzi, H.U. (Lab. de Metallurgie Mecanique, Dept. des Materiaux, Ecole Polytechnique Federale de Lausanne (Switzerland)); Ilschner, B. (Lab. de Metallurgie Mecanique, Dept. des Materiaux, Ecole Polytechnique Federale de Lausanne (Switzerland))

    1993-11-01

    Anelastic creep of pure Al, commercial Al-Cu and a binary Al-Cu alloy has been measured at room temperature by means of a high resolution laser interferometer. The irreversible component of the deformation was also quantified from measurements of the anelastic creep recovery. The dependence of the deformation-time curves on thermal treatment and cold work is analyzed. The mechanisms responsible for the room temperature anelastic creep are discussed. Materials loaded below their elastic limit can present either a pure anelastic behavior (commercial Al-Cu) or additional viscoelastic creep (pure Al, high purity Al-Cu). For commercial Al-Cu, the presence of an irreversible deformation appears to be mainly related to the state of the surface. A viscoelastic after effect has been measured for this alloy after a Cu-electroplating treatment. As a typical result for room temperature creep, the irreversible deformation depends logarithmically on load time. (orig.).

  19. Some aspects of anelastic and microplastic creep of pure Al and two Al-alloys

    International Nuclear Information System (INIS)

    Sgobba, S.; Kuenzi, H.U.; Ilschner, B.

    1993-01-01

    Anelastic creep of pure Al, commercial Al-Cu and a binary Al-Cu alloy has been measured at room temperature by means of a high resolution laser interferometer. The irreversible component of the deformation was also quantified from measurements of the anelastic creep recovery. The dependence of the deformation-time curves on thermal treatment and cold work is analyzed. The mechanisms responsible for the room temperature anelastic creep are discussed. Materials loaded below their elastic limit can present either a pure anelastic behavior (commercial Al-Cu) or additional viscoelastic creep (pure Al, high purity Al-Cu). For commercial Al-Cu, the presence of an irreversible deformation appears to be mainly related to the state of the surface. A viscoelastic after effect has been measured for this alloy after a Cu-electroplating treatment. As a typical result for room temperature creep, the irreversible deformation depends logarithmically on load time. (orig.)

  20. Perceptions of the state policy environment and adoption of medications in the treatment of substance use disorders.

    Science.gov (United States)

    Knudsen, Hannah K; Abraham, Amanda J

    2012-01-01

    Despite growing interest in the use of evidence-based treatment practices for treating substance use disorders, adoption of medications by treatment programs remains modest. Drawing on resource dependence and institutional theory, this study examined the relationships between adoption of medications by treatment programs and their perceptions about the state policy environment. Data were collected through mailed surveys and telephone interviews with 250 administrators of publicly funded substance abuse treatment programs in the United States between 2009 and 2010. Multiple imputation and multivariate logistic regression were used to estimate the associations between perceptions of the state policy environment and the odds of adopting at least one medication for the treatment of substance use disorders. A total of 91 (37%) programs reported having prescribed any medication for treatment of a substance use disorder. Programs were significantly more likely to have adopted at least one medication if they perceived greater support for medications by the Single State Agency. The odds of adoption were significantly greater if the program was aware that at least one medication was included on their state's Medicaid formulary and that state-contract funding permitted the purchase of medications. States may play significant roles in promoting the adoption of medications, but adequate dissemination of information about state policies and priorities may be vital to further adoption. Future research should continue to study the relationships between the adoption of medications for treating substance use disorders and the evolving policy environment.

  1. Telepsychiatrists' Medication Treatment Strategies in the Children's Attention-Deficit/Hyperactivity Disorder Telemental Health Treatment Study

    Science.gov (United States)

    Tse, Yuet Juhn; Fesinmeyer, Megan D.; Garcia, Jessica; Myers, Kathleen

    2016-01-01

    Abstract Objective: The purpose of this study was to examine the prescribing strategies that telepsychiatrists used to provide pharmacologic treatment in the Children's Attention-Deficit/Hyperactivity Disorder (ADHD) Telemental Health Treatment Study (CATTS). Methods: CATTS was a randomized controlled trial that demonstrated the superiority of a telehealth service delivery model for the treatment of ADHD with combined pharmacotherapy and behavior training (n=111), compared with management in primary care augmented with a telepsychiatry consultation (n=112). A diagnosis of ADHD was established with the Computerized Diagnostic Interview Schedule for Children (CDISC), and comorbidity for oppositional defiant disorder (ODD) and anxiety disorders (AD) was established using the CDISC and the Child Behavior Checklist. Telepsychiatrists used the Texas Children's Medication Algorithm Project (TCMAP) for ADHD to guide pharmacotherapy and the treat-to-target model to encourage their assertive medication management to a predetermined goal of 50% reduction in ADHD-related symptoms. We assessed whether telepsychiatrists' decision making about making medication changes was associated with baseline ADHD symptom severity, comorbidity, and attainment of the treat-to-target goal. Results: Telepsychiatrists showed high fidelity (91%) to their chosen algorithms in medication management. At the end of the trial, the CATTS intervention showed 46.0% attainment of the treat-to-target goal compared with 13.6% for the augmented primary care condition, and significantly greater attainment of the goal by comorbidity status for the ADHD with one and ADHD with two comorbidities groups. Telepsychiatrists' were more likely to decide to make medication adjustments for youth with higher baseline ADHD severity and the presence of disorders comorbid with ADHD. Multiple mixed methods regression analyses controlling for baseline ADHD severity and comorbidity status indicated that the telepsychiatrists

  2. Autonomy, religious values, and refusal of lifesaving medical treatment.

    OpenAIRE

    Wreen, M J

    1991-01-01

    The principal question of this paper is: Why are religious values special in refusal of lifesaving medical treatment? This question is approached through a critical examination of a common kind of refusal of treatment case, one involving a rational adult. The central value cited in defence of honouring such a patient's refusal is autonomy. Once autonomy is isolated from other justificatory factors, however, possible cases can be imagined which cast doubt on the great valuational weight assign...

  3. Satisfaction with medication in coronary disease treatment: psychometrics of the Treatment Satisfaction Questionnaire for Medication.

    Science.gov (United States)

    Liberato, Ana Carolina Sauer; Rodrigues, Roberta Cunha Matheus; São-João, Thaís Moreira; Alexandre, Neusa Maria Costa; Gallani, Maria Cecília Bueno Jayme

    2016-06-07

    to psychometrically test the Brazilian version of the Treatment Satisfaction Questionnaire for Medication - TSQM (version 1.4), regarding ceiling and floor effect, practicability, acceptability, reliability and validity. participants with coronary heart disease (n=190) were recruited from an outpatient cardiology clinic at a university hospital in Southeastern Brazil and interviewed to evaluate their satisfaction with medication using the TSQM (version 1.4) and adherence using the Morisky Self-Reported Measure of Medication Adherence Scale and proportion of adherence. The Ceiling and Floor effect were analyzed considering the 15% worst and best possible TSQM scores; Practicability was assessed by time spent during TSQM interviews; Acceptability by proportion of unanswered items and participants who answered all items; Reliability through the Cronbach's alpha coefficient and Validity through the convergent construct validity between the TSQM and the adherence measures. TSQM was easily applied. Ceiling effect was found in the side effects domain and floor effect in the side effects and global satisfaction domains. Evidence of reliability was close to satisfied in all domains. The convergent construct validity was partially supported. the Brazilian TSQM presents evidence of acceptability and practicability, although its validity was weakly supported and adequate internal consistency was observed for one domain. realizar o teste psicométrico da versão brasileira do Treatment Satisfaction Questionnaire for Medication - TSQM (versão 1.4) [Questionário Satisfação com Tratamento Medicamentoso] com relação aos efeitos de teto e chão, praticidade, aceitabilidade, confiabilidade e validade. os participantes com doença cardíaca coronária (n=190) foram recrutados num ambulatório de cardiologia de um hospital universitário no sudeste do Brasil e entrevistados para avaliar satisfação em relação ao tratamento medicamentoso através da TSQM (versão 1.4) e ades

  4. Mental health law: compulsory treatment in a general medical setting.

    Science.gov (United States)

    Linford, Steven

    2005-10-01

    Compulsory treatment of severe mental disorder can seem complicated even to psychiatrists. This article attempts to explain the current legal framework as it applies in common clinical situations in a general medical context.

  5. The suggestion of common cause of disease, characteristics of human body, and medical treatment

    Directory of Open Access Journals (Sweden)

    Byung-Jun Cho

    2011-06-01

    Full Text Available Objectives & Methods: This suggestion was attempted to be elevated the recognition of common characteristics in disease. So, we performed to analyze the correlation of common cause of disease, characteristics of human body, and medical treatment. And the results are as follows. Results: 1. The cause of disease is consist of genetic factor, aging, habit, food of not good in health, weather, environment, deficit of the physical activity, stress and so on. 2. Generally, human has common and individual weakness. Individual weakness is appeared similar to the occurrence of volcano and lapse. 3. The correlation of disease and medical treatments is possible to explain using the quotation of the law of motion made by Isaac Newton, the great physicist. 4. When the process of the medical treatment was not progressed, the prognosis is determined by the correlation of the homeostasis(H' in human body and the homeostasis(H of disease. 5. The prognosis of disease is determined by the relationship between the energy of disease(F and medical treatment(F'. 6. The exact diagnosis is possible to predict the treatment sequence, and the facts that homeostasis in human body and disease, relationship between the energy of disease(F and medical treatment(F', action and reaction are important to determine the prognosis. 7. The careful observation of improving response and worsening action of disease becomes available for exact prognosis. Conclusion: The above described contents may be useful in clinical studies, and the concrete clinical reports about this will be made afterward.

  6. Perspectives on the Pure-Tone Audiogram.

    Science.gov (United States)

    Musiek, Frank E; Shinn, Jennifer; Chermak, Gail D; Bamiou, Doris-Eva

    The pure-tone audiogram, though fundamental to audiology, presents limitations, especially in the case of central auditory involvement. Advances in auditory neuroscience underscore the considerably larger role of the central auditory nervous system (CANS) in hearing and related disorders. Given the availability of behavioral audiological tests and electrophysiological procedures that can provide better insights as to the function of the various components of the auditory system, this perspective piece reviews the limitations of the pure-tone audiogram and notes some of the advantages of other tests and procedures used in tandem with the pure-tone threshold measurement. To review and synthesize the literature regarding the utility and limitations of the pure-tone audiogram in determining dysfunction of peripheral sensory and neural systems, as well as the CANS, and to identify other tests and procedures that can supplement pure-tone thresholds and provide enhanced diagnostic insight, especially regarding problems of the central auditory system. A systematic review and synthesis of the literature. The authors independently searched and reviewed literature (journal articles, book chapters) pertaining to the limitations of the pure-tone audiogram. The pure-tone audiogram provides information as to hearing sensitivity across a selected frequency range. Normal or near-normal pure-tone thresholds sometimes are observed despite cochlear damage. There are a surprising number of patients with acoustic neuromas who have essentially normal pure-tone thresholds. In cases of central deafness, depressed pure-tone thresholds may not accurately reflect the status of the peripheral auditory system. Listening difficulties are seen in the presence of normal pure-tone thresholds. Suprathreshold procedures and a variety of other tests can provide information regarding other and often more central functions of the auditory system. The audiogram is a primary tool for determining type

  7. 75 FR 80762 - Medicare Program; Emergency Medical Treatment and Labor Act: Applicability to Hospital and...

    Science.gov (United States)

    2010-12-23

    ... [CMS-1350-ANPRM] RIN 0938-AQ51 Medicare Program; Emergency Medical Treatment and Labor Act... Emergency Medical Treatment and Labor Act (EMTALA). Specifically, this document serves as a request for... available to persons without Federal government identification, commenters are encouraged to leave their...

  8. 77 FR 5213 - Medicare Program; Emergency Medical Treatment and Labor Act (EMTALA): Applicability to Hospital...

    Science.gov (United States)

    2012-02-02

    ... [CMS-1350-NC] RIN 0938-AQ51 Medicare Program; Emergency Medical Treatment and Labor Act (EMTALA... the applicability of the Emergency Medical Treatment and Labor Act (EMTALA) to hospital inpatients... available to persons without Federal government identification, commenters are encouraged to leave their...

  9. Update on the medical treatment of juvenile idiopathic arthritis.

    Science.gov (United States)

    Hashkes, Philip J; Laxer, Ronald M

    2006-12-01

    Many exciting developments in the treatment of juvenile idiopathic arthritis (JIA) have emerged recently, including new tools to assess the results of clinical trials (eg, the definition of remission and a radiologic scoring tool). New controlled studies examined the equivalence of meloxicam to naproxen, the efficacy of leflunomide but the superiority of methotrexate, and the use of infliximab in polyarthritis JIA. Initial studies have shown the potential of anti-interleukin (IL)-1 and anti-IL-6 receptor antibody therapy for systemic JIA. Corticosteroid-sparing medications including the use of "biologic modifiers" for JIA-associated uveitis have been described. Evidence-based guidelines for the main subtypes of JIA have been published. However, good evidence on the treatment of several disease subtypes is still lacking. Studies of new medications and the use of combination therapy, including aggressive induction therapy early in the disease course, are necessary to continue improving the outcome of JIA patients.

  10. Generalized pure Lovelock gravity

    Science.gov (United States)

    Concha, Patrick; Rodríguez, Evelyn

    2017-11-01

    We present a generalization of the n-dimensional (pure) Lovelock Gravity theory based on an enlarged Lorentz symmetry. In particular, we propose an alternative way to introduce a cosmological term. Interestingly, we show that the usual pure Lovelock gravity is recovered in a matter-free configuration. The five and six-dimensional cases are explicitly studied.

  11. About the elaboration of pure uranium dicarbide

    International Nuclear Information System (INIS)

    Besson, J.; Blum, P.; Guinet, Ph.; Spitz, J.

    1963-01-01

    In order to develop methods for the elaboration of as pure as possible uranium dicarbide, the authors report the study of different elaboration processes based on the reaction between uranium and carbon, or between uranium and hydrocarbon, or between uranium oxide and carbon. They finally choose a method which comprises an arc-induced fusion of a mixture of uranium dioxide and carbon. The fusion process is described. The influence of thermal treatments is discussed as well as the graphite electrode carburization

  12. Organization of medical aid and treatment of victims of mass ionizing radiation injuries

    International Nuclear Information System (INIS)

    Gus'kova, A.K.; Burenin, P.I.; Barabanova, A.V.

    1987-01-01

    General organization points on medical aid and treatment of mass ionizing radiation injuries in population are presented. Characteristic of losses and structure of injuries induced by a nuclear explosion are given. Destructions in a town caused by a nuclear explosion and medical aid conditions for patients are analysed. Main information about structure of medical surveillance of civil defence and criteria of medical classification and evacuation of the injured are presented

  13. Treatment Sequencing for Childhood ADHD: A Multiple-Randomization Study of Adaptive Medication and Behavioral Interventions.

    Science.gov (United States)

    Pelham, William E; Fabiano, Gregory A; Waxmonsky, James G; Greiner, Andrew R; Gnagy, Elizabeth M; Pelham, William E; Coxe, Stefany; Verley, Jessica; Bhatia, Ira; Hart, Katie; Karch, Kathryn; Konijnendijk, Evelien; Tresco, Katy; Nahum-Shani, Inbal; Murphy, Susan A

    2016-01-01

    Behavioral and pharmacological treatments for children with attention deficit/hyperactivity disorder (ADHD) were evaluated to address whether endpoint outcomes are better depending on which treatment is initiated first and, in case of insufficient response to initial treatment, whether increasing dose of initial treatment or adding the other treatment modality is superior. Children with ADHD (ages 5-12, N = 146, 76% male) were treated for 1 school year. Children were randomized to initiate treatment with low doses of either (a) behavioral parent training (8 group sessions) and brief teacher consultation to establish a Daily Report Card or (b) extended-release methylphenidate (equivalent to .15 mg/kg/dose bid). After 8 weeks or at later monthly intervals as necessary, insufficient responders were rerandomized to secondary interventions that either increased the dose/intensity of the initial treatment or added the other treatment modality, with adaptive adjustments monthly as needed to these secondary treatments. The group beginning with behavioral treatment displayed significantly lower rates of observed classroom rule violations (the primary outcome) at study endpoint and tended to have fewer out-of-class disciplinary events. Further, adding medication secondary to initial behavior modification resulted in better outcomes on the primary outcomes and parent/teacher ratings of oppositional behavior than adding behavior modification to initial medication. Normalization rates on teacher and parent ratings were generally high. Parents who began treatment with behavioral parent training had substantially better attendance than those assigned to receive training following medication. Beginning treatment with behavioral intervention produced better outcomes overall than beginning treatment with medication.

  14. Generalized pure Lovelock gravity

    Directory of Open Access Journals (Sweden)

    Patrick Concha

    2017-11-01

    Full Text Available We present a generalization of the n-dimensional (pure Lovelock Gravity theory based on an enlarged Lorentz symmetry. In particular, we propose an alternative way to introduce a cosmological term. Interestingly, we show that the usual pure Lovelock gravity is recovered in a matter-free configuration. The five and six-dimensional cases are explicitly studied.

  15. Withdrawing and withholding medical treatment: a comparative study between the Malaysian, English and Islamic law.

    Science.gov (United States)

    Kassim, Puteri Nemie Jahn; Adeniyi, Omipidan Bashiru

    2010-09-01

    The permissibility and lawfulness of withdrawing and withholding medical treatment has attracted considerable debates and criticisms, as the legal issues are drawn into entering the slippery slope of euthanasia. Proponents of "sanctity of life" views that withdrawing and withholding medical treatment with knowledge that death would result is still within the sphere of euthanasia, whereas proponents of "quality of life" argue that it is not, as death is not intended. Their arguments maintain that for patients who are totally dependant on machines to ensure the work of some bodily functions, living may amount to little more than survival as dying is prolonged. Furthermore, the prolonging of life of the dying patient has profound implications on patients themselves, their relatives, dependants and medical providers. Thus, withdrawing and withholding medical treatment would not only respect a patient's right to self-determination, by allowing them to die in their underlying condition, but will ensure that medical providers are able to concentrate on more worthwhile treatments. This paper discusses the intractable difficulties with the moral distinction between withholding and withdrawing treatment and euthanasia, as well as makes a comparative study between the present state of law in Malaysia and England on this issue. The paper further highlights the differences between civil law and Islamic law in this controversial area.

  16. Biosorpsi Tanaman Puring (Codiaeum variegatum Terhadap Emisi Timbal (Pb Pada Kendaraan Bermotor

    Directory of Open Access Journals (Sweden)

    Nur Amalia P

    2014-07-01

    Full Text Available Enhancement the motorized vehicle number will be potential for air pollution in the big cities. One of the pollutant which is resulted from burning process fuel is timbale (Pb metal. Alternative effort that is used to decrease the higher timbale (Pb metal pollutantmaterial is with manner biosorption use puring plant (codiaeumvariegatum.The aim of this research is to know the puring plantability in absorbs Pb metal. The treatment methodis used to sprinkling plant and without sprinkling and than directly exposure to plant with period 3,6 and 9 days. The result of research  that puring leaves ability can absorb Pb concentration metal between (1 until 1,5 ppm or 0,304 mg/Kg at nine days of period exposure, it order can be considered as biosorption agent Pb metal pollution.

  17. Depth concentrations of deuterium ions implanted into some pure metals and alloys

    International Nuclear Information System (INIS)

    Didyk, A.Yu.; Wisniewski, R.; Kitowski, K.; Wilczynska, T.; Hofman, A.; Kulikauskas, V.; Shiryaev, A.A.; Zubavichyus, Ya.V.

    2011-01-01

    Pure metals (Cu, Ti, Zr, V, Pd) and diluted Pd alloys (Pd-Ag, Pd-Pt, Pd-Ru, Pd-Rh) were implanted by 25-keV deuterium ions at fluences in the range (1.2-2.3) x 10 22 D + /m 2 . The post-treatment depth distributions of deuterium ions were measured 10 days and three months after the implantation by using Elastic Recoil Detection Analysis (ERDA) and Rutherford Backscattering (RBS). Comparison of the obtained results allowed us to make conclusions about relative stability of deuterium and hydrogen gases in pure metals and diluted Pd alloys. Very high diffusion rates of implanted deuterium ions from V and Pd pure metals and Pd alloys were observed. Small-angle X-ray scattering revealed formation of nanosized defects in implanted corundum and titanium

  18. A Rare Prostatic Diagnosis of an Old Man: A Pure Prostatic Leiomyoma

    Directory of Open Access Journals (Sweden)

    W. M. van Ulden-Bleumink

    2013-01-01

    Full Text Available A pure leiomyoma of the prostate is a rare benign tumor. An 82-year-old man was referred to our urology department with gross hematuria and complete urinary retention. Examination revealed a benign prostatic hyperplasia. Transrectal ultrasound showed a prostate of 125 mL. Serum PSA was 1.9 µg/L. A simple retropubic prostatectomy was performed. Histopathological examination showed a pure leiomyoma of the prostate, without the presence of glandular prostate tissue. The diagnosis, characteristics, and treatment of this tumor are described.

  19. Medication Assisted Treatment for the 21st Century: Community Education Kit.

    Science.gov (United States)

    Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Substance Abuse Treatment.

    The need to support the success of individuals in methadone-assisted recovery, and the recent availability of new pharmacologic treatment options for opioid dependence, calls for an information tool that underscores the evidence-based benefits of medication assisted treatment for opioid dependence. The U.S. Department of Health and Human Services'…

  20. Musical notation reading in pure alexia

    DEFF Research Database (Denmark)

    Starrfelt, Randi; Wong, Yetta K.

    2017-01-01

    Pure alexia (PA) is an acquired reading disorder following lesions to left ventral temporo-occipital cortex. Patients with PA read slowly but correctly, and show an abnormal effect of word length on RTs. However, it is unclear how pure alexia may affect musical notation reading. We report a pure...

  1. Health locus of control: Its relationship with medication adherence and medication wastage.

    Science.gov (United States)

    West, Lorna Marie; Borg Theuma, Ruth; Cordina, Maria

    2017-12-09

    Non-adherence is a significant factor contributing to medication wastage. Whilst there is some evidence on the influence of patients' health locus of control in relation to adherence, there has been little inquiry into its relationship with mediation wastage. To determine the relationship between medication adherence and health locus of control as well as medication wastage and health locus of control in patients with chronic conditions. Outpatients having a diagnosis of asthma, cardiovascular conditions, or diabetes participated in a cross-sectional study employing a self-administered questionnaire. The questionnaire determined presence of unused medication (wastage), adherence using 'Tool for Adherence Behaviour Screening' (TABS), and health locus of control using 'Multidimensional Health Locus of Control' (MHLC) scale Form C. Logistic regression was performed to ascertain the effects of MHLC and demographics in relation to adherence and wastage. MHLC beliefs were divided into 8 types of health locus of control. One-Way ANOVA was used to assess differences between conditions and belief types. P-values ≤ .05 were considered significant. There were 330 patients recruited (58% male; age, mean±(SD): 61 ± 15 years; 110 asthma, 110 cardiovascular, 110 diabetes). In terms of health locus of control, females had higher 'doctors' beliefs (p = .054) and significantly lower 'other people' beliefs (p = control. 'Yea-sayers' had the least presence of unused medication, followed by 'pure internal' believers. 'Pure powerful others external' had the highest presence of unused medication. Healthcare professionals should take into account patients' health locus of control beliefs whilst conducting an intervention with patients; this can impact positively medication adherence and minimisation of medication wastage. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Use of medical foods and nutritional approaches in the treatment of Alzheimer’s disease

    Science.gov (United States)

    Thaipisuttikul, Papan; Galvin, James E

    2012-01-01

    SUMMARY Alzheimer’s disease, the most common cause of dementia, has a high global economic impact. To date, there is no curative treatment; therefore, many efforts are directed not only at novel potential disease-modifying treatments and interventions, but also to develop alternative symptomatic and supportive treatments. Examples of these efforts include the medical foods. There are three medical foods that claim to offer symptomatic benefits: Axona®, Souvenaid® and CerefolinNAC®. Axona supplies ketone bodies as alternative energy source to neurons. Souvenaid provides precursors thought to enhance synaptic function. CerefolinNAC addresses the role of oxidative stress related to memory loss. The current scientific evidence on these medical foods is reviewed in this article. Furthermore, we also review the concept and evidence supporting use of the Mediterranean diet, a possible alternative to medical foods that, if implemented correctly, may have lower costs, fewer side effects and stronger epidemiological health outcomes. PMID:23362453

  3. South-South medical tourism and the quest for health in Southern Africa.

    Science.gov (United States)

    Crush, Jonathan; Chikanda, Abel

    2015-01-01

    Intra-regional South-South medical tourism is a vastly understudied subject despite its significance in many parts of the Global South. This paper takes issue with the conventional notion of South Africa purely as a high-end "surgeon and safari" destination for medical tourists from the Global North. It argues that South-South movement to South Africa for medical treatment is far more significant, numerically and financially, than North-South movement. The general lack of access to medical diagnosis and treatment in SADC countries has led to a growing temporary movement of people across borders to seek help at South African institutions in border towns and in the major cities. These movements are both formal (institutional) and informal (individual) in nature. In some cases, patients go to South Africa for procedures that are not offered in their own countries. In others, patients are referred by doctors and hospitals to South African facilities. But the majority of the movement is motivated by lack of access to basic healthcare at home. The high demand and large informal flow of patients from countries neighbouring South Africa has prompted the South African government to try and formalise arrangements for medical travel to its public hospitals and clinics through inter-country agreements in order to recover the cost of treating non-residents. The danger, for 'disenfranchised' medical tourists who fall outside these agreements, is that medical xenophobia in South Africa may lead to increasing exclusion and denial of treatment. Medical tourism in this region and South-South medical tourism in general are areas that require much additional research. Copyright © 2014. Published by Elsevier Ltd.

  4. [Regional analysis of drug treatment prevalence and medication of diabetes mellitus in Germany].

    Science.gov (United States)

    Willert, T; Walker, J; Schramm, W

    2012-11-01

    Diabetes mellitus is a widespread chronic disease. Diabetes prevalence was already analyzed in multiple complex studies. The goal of this analysis was the determination of the regional drug treatment prevalence and medication of diabetes mellitus in Germany. Simultaneously, we examined and validated the applicability of prescription data of the German statutory health insurance (SHI) as the basis for reliable and comparable prevalence estimations. For the analysis, we used anonymized data from a prescription database as well as the member statistics of the German federal Ministry of Health. By using defined prescription profiles with anti-diabetic medication, we determined the diabetic patients and treatment schemes per Association of SHI Physicians. Subsequently, we calculated and described the drug treatment prevalence and medication. A differentiation between type 1 and type 2 diabetes was not possible. The total prevalence of drug-treated patients in Germany was 7.77%. The regional values ranged from 6.40% in Schleswig-Holstein until 11.37% in Saxony-Anhalt. The highest numbers of drug treatment prevalence were found in the East of Germany. Insulin treatment was frequent in Hamburg, but rare in Bavaria. Insulin combined with oral anti-diabetic medication was mainly dispensed in Saxony-Anhalt and Brandenburg, least in Hamburg. A treatment with one or more oral anti-diabetics was most common in Bavaria and Bremen, lowest in Rhineland-Palatinate and Mecklenburg-West Pomerania. We developed an easy to use evaluation algorithm for prescription data to estimate the drug treatment prevalence of a chronic disease. The estimated prevalence confirms the increasing trend reported from other studies and appears to be plausible in comparison. More research is required to validate and enhance the method. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Medical treatment for heavy menstrual bleeding

    Directory of Open Access Journals (Sweden)

    Yi-Jen Chen

    2015-10-01

    Full Text Available Heavy menstrual bleeding, or menorrhagia, is subjectively defined as a “complaint of a large amount of bleeding during menstrual cycles that occurs over several consecutive cycles” and is objectively defined as menstrual blood loss of more than 80 mL per cycle that is associated with an anemia status (defined as a hemoglobin level of <10 g/dL. During their reproductive age, more than 30% of women will complain of or experience a heavy amount of bleeding, which leads to a debilitating health outcome, including significantly reduced health-related quality of life, and a considerable economic burden on the health care system. Although surgical treatment might be the most important definite treatment, especially hysterectomy for those women who have finished bearing children, the uterus is still regarded as the regulator and controller of important physiological functions, a sexual organ, a source of energy and vitality, and a maintainer of youth and attractiveness. This has resulted in a modern trend in which women may reconsider the possibility of organ preservation. For women who wish to retain the uterus, medical treatment may be one of the best alternatives. In this review, recent trends in the management of women with heavy menstrual bleeding are discussed.

  6. Improved operating efficiency due to the use of pure oxygen in biological treatment plants for industrial effluents; Mejora de la eficiencia en la operacion de plantas depuradoras biologicas de efluentes industriales mediante la utilizacion de oxigeno puro

    Energy Technology Data Exchange (ETDEWEB)

    Cabeza, R.; Bargallo, J.; Crespi, M.

    2005-07-01

    The use of pure oxygen in biological waste water treatment plants offers a number of advantages due to its physicochemical properties in relation to Henry's Law Flick's Law. Pure oxygen is employed in addition to, or instead of, the existing oxygenation system for treating waste in plants in industrial sectors such as foods, chemicals, paper-making, textiles and others. Its main application is in heavy load treatments and when there are problems of space for siting or enlarging the plant, as it combines well with membrane bioreactor (MBR) and sequence batch reactor (SBR) treatments, as has been shown in several plants in operation. (Author) 4 refs.

  7. [Orthodontic treatment of patients medicated with bisphosphonates-a clinical case report].

    Science.gov (United States)

    Krieger, Elena; d'Hoedt, Bernd; Scheller, Herbert; Jacobs, Collin; Walter, Christian; Wehrbein, Heinrich

    2013-01-01

    Bisphosphonates (BP) are an established medication, e.g., for the prevention/therapy of osteoporosis. The effects of the changed bone metabolism for orthodontic treatments are unknown. A 66-year-old woman underwent a total oral rehabilitation. The therapy included (1) tooth extractions, (2) periodontal treatment, (3) insertion of dental implants, (4) provisional implant restorations, (5) orthodontic treatment, and (6) definite implant restorations. The orthodontic tooth movements were in- and retrusion of the upper frontal teeth, intrusion of the lower front teeth, using the dental implants as skeletal anchorage. After implant insertion and one month before beginning the orthodontic treatment, osteoporosis was diagnosed in this patient and, without notification to our facility, BP treatment was initiated by her general practitioner (alendronate oral, 70 mg/week), with an overall duration of intake of 7 months. After 13 months, the orthodontic treatment was successfully accomplished; however enlarged periodontal gaps, sclerotic bone areas, and mild apical root resorptions of the upper frontal teeth were found in this patient. Currently, there are no recommendations for orthodontic patients undergoing BP therapy. Orthodontic tooth movement in this low-risk patient with a short duration of intake and a low-dose BP medication was possible. Because of the reduced bone metabolism and the higher amount of side effects, the treatment should be performed with extremely light forces and frequent monitoring.

  8. A comparative trial of psychotherapy and pharmacotherapy for "pure" dysthymic patients.

    Science.gov (United States)

    Markowitz, John C; Kocsis, James H; Bleiberg, Kathryn L; Christos, Paul J; Sacks, Michael

    2005-12-01

    Psychotherapy of "pure" dysthymic disorder remains understudied. This article reports outcomes of an acute randomized trial of 94 subjects treated for 16 weeks with either interpersonal psychotherapy (IPT), brief supportive psychotherapy (BSP), sertraline, or sertraline plus IPT. Recruited by clinical referral and advertising, subjects met DSM-IV criteria for early onset dysthymic disorder, with no episode of major depression in the prior six months. They were randomly assigned to one of four 16-week treatments, with options for crossover or continuation treatment. Results were analyzed from the intention-to-treat sample by ANCOVA, controlling for baseline depressive severity. Subjects improved in all conditions over time, with the cells including sertraline pharmacotherapy showing superiority over psychotherapy alone for response and remission. Response rates were 58% for sertraline alone, 57% for combined treatment, 35% for IPT, and 31% for BSP. The study was underpowered and may have employed too "active" a control condition. Follow-up data were unobtainable. In this acute trial for "pure" dysthymic disorder, sertraline with or without IPT showed advantages relative to IPT and BSP. Methodological difficulties may have limited differential outcome findings. This study bolsters a small but growing literature on the treatment of dysthymic disorder, suggesting that pharmacotherapy may acutely benefit patients more than psychotherapy.

  9. Depression, patient characteristics, and attachment style: correlates and mediators of medication treatment adherence in a racially diverse primary care sample.

    Science.gov (United States)

    Hooper, Lisa M; Tomek, Sara; Roter, Debra; Carson, Kathryn A; Mugoya, George; Cooper, Lisa A

    2016-03-01

    The depth and breadth of problems related to depressive symptomatology and optimal treatment outcomes, including medication treatment adherence, have long been documented in the literature. Missing are clear explanations as to what factors and patient characteristics may account for lack of medication treatment adherence. The two objectives of the current study were to examine the predictive strength of depression, patient characteristics, and patient attachment style regarding medication treatment adherence and to consider the extent to which attachment styles mediate the relation between depression and medication treatment adherence. Participants in the present study were 237 racially diverse American primary care patients with a diagnosis of hypertension who were participants in a clinical trial. Depression, patient characteristics, attachment style, and medication treatment adherence were assessed. Partly consistent with our four hypotheses, the following results were found: (a) Black American, younger, never married, and poorer patients had lower medication treatment adherence (b) depression was significantly associated with lower self-reported medication adherence; (c) insecure-dismissing attachment style was related to lower medication adherence; and (d) insecure-dismissing attachment style mediates the relation between depression and medication treatment adherence by exacerbating the negative association. Physicians and other primary care providers should consider how depressive symptomatology, patient characteristics, and attachment style may inform the treatment plans they put forward and the extent to which patients may adhere to those treatment plans.

  10. Life science, agriculture and forestry and fishery and health and medical treatment

    International Nuclear Information System (INIS)

    1999-11-01

    This book gives descriptions of future technology in Korea, by field : Life science, agriculture and forestry and fishery and health and medical treatment. It indicates the purpose of survey, survey system survey outline, characteristic of this survey, how to read the prediction of survey result, the result of survey with the tasks of survey object, field on important survey and development period of realizable prediction, obstacle of realization, propel ways for survey and development, policy tasks, important future technology chronological table, characteristic of respondent, the result of survey : Life science, agriculture and forestry and fishery and health and medical treatment.

  11. Frontier of Advanced Accelerator Applications and Medical Treatments Using Nuclear Techniques. Abstract

    International Nuclear Information System (INIS)

    2015-01-01

    To address the challenges of research-based practice, developing advanced accelerator applications, and medical treatments using nuclear tecniqoes, researchers from Rajamakala University of Technology Lanna, Office of Atoms for Peace, and Chiang Mai University have joined in hosting this conference. Nuclear medicine, amedical specialty, diagnoses and treats diseases in a safe and painless way. Nuclear techniques can determine medical information that may otherwise be unavailable, require surgery, or necessitate more expensive and invasive diagnostic tests. Advance in nuclear techniques also offer the potential to detect abnormalities at earlier stages, leasding to earlier treatment and a more successful prognosis.

  12. Towards Realization of Intelligent Medical Treatment at Nanoscale by Artificial Microscopic Swarm Control Systems

    Directory of Open Access Journals (Sweden)

    Alireza Rowhanimanesh

    2017-07-01

    Full Text Available Background: In this paper, the novel concept of artificial microscopic swarm control systems is proposed as a promising approach towards realization of intelligent medical treatment at nanoscale. In this new paradigm, treatment is done autonomously at nanoscale within the patient’s body by the proposed swarm control systems.Methods: From control engineering perspective, medical treatment can be considered as a control problem, in which the ultimate goal is to find the best feasible way to change the state of diseased tissue from unhealthy to healthy in presence of uncertainty. Although a living tissue is a huge swarm of microscopic cells, nearly all of the common treatment methods are based on macroscopic centralized control paradigm. Inspired by natural microscopic swarm control systems such as nervous, endocrine and immune systems that work based on swarm control paradigm, medical treatment needs a paradigm shift from macroscopic centralized control to microscopic swarm control. An artificial microscopic swarm control system consists of a huge number of very simple autonomous microscopic agents that exploit swarm intelligence to realize sense, control (computing and actuation at nanoscale in local, distributed and decentralized manner. This control system can be designed based on mathematical analysis and computer simulation.Results: The proposed approach is used for treatment of atherosclerosis and cancer based on mathematical analysis and in-silico study.Conclusion: The notion of artificial microscopic swarm control systems opens new doors towards realization of autonomous and intelligent medical treatment at nanoscale within the patient’s body.

  13. Pure culture response of ectomycorrhizal fungi to imposed water stress

    Science.gov (United States)

    Mark D. Coleman; Caroline S. Bledsoe; William Lopushinsky

    1989-01-01

    The ability of ectomycorrhizal fungal isolates to tolerate imposed water stress in pure culture was examined in 55 isolates of 18 species. Water potential treatments, adjusted with polyethylene glycol, were applied to Petri dish units. These units allowed colony diameter measurements of fungi grown on liquid media. Delayed growth initiation and inhibition of growth...

  14. Medical treatment of second-trimester fetal miscarriage; A retrospective analysis

    OpenAIRE

    Niinimaki, Maarit; Mentula, Maarit; Jahangiri, Reetta; Mannisto, Jaana; Haverinen, Annina; Heikinheimo, Oskari

    2017-01-01

    Abstract Objectives: Research on the treatment of second-trimester miscarriages is scarce. We studied the outcomes, and the factors associated with adverse events and need for hospital resources in the medical treatment of second-trimester miscarriage. Materials and methods: In these retrospective analyses we studied women treated for spontaneous fetal miscarriage with misoprostol-only (n = 24) or mifepristone and misoprostol (n = 177) in duration of gestation 12+1–21+6. Primary outcome...

  15. Pure homology of algebraic varieties

    OpenAIRE

    Weber, Andrzej

    2003-01-01

    We show that for a complete complex algebraic variety the pure component of homology coincides with the image of intersection homology. Therefore pure homology is topologically invariant. To obtain slightly more general results we introduce "image homology" for noncomplete varieties.

  16. The rights of the dying: the refusal of medical treatments in Argentine courts

    Directory of Open Access Journals (Sweden)

    Juan Pedro Alonso

    2016-10-01

    Full Text Available This paper addresses the judicialization of end of life medical decision-making, as part of the advance of the justice system in the regulation of medical practice and the rise of recognition of patient autonomy. The article analyzes, from a sociological standpoint, legal decisions regarding treatment refusal at the end of life produced by the Argentine courts between 1975 and 2015. Based on a qualitative design, 38 sentences collected from jurisprudential databases using key terms were analyzed. First, judicialized cases during the period are described; these are characterized by a high proportion of claims presented by health institutions, a pro-treatment bias in the legal actions requested, and a high percentage of unnecessary litigation in the absence of conflicts or in situations that do not require court intervention. Second, legal and extralegal factors affecting the justiciability of decisions to refuse or withdraw medical treatments, such as changes in the law and processes of politicization of claims, are analyzed.

  17. The transition to medication adoption in publicly funded substance use disorder treatment programs: organizational structure, culture, and resources.

    Science.gov (United States)

    Knudsen, Hannah K; Roman, Paul M

    2014-05-01

    Medications for the treatment of substance use disorders (SUDs) are not widely available in publicly funded SUD treatment programs. Few studies have drawn on longitudinal data to examine the organizational characteristics associated with programs transitioning from not delivering any pharmacotherapy to adopting at least one SUD medication. Using two waves of panel longitudinal data collected over a 5-year period, we measured the transition to medication adoption in a cohort of 190 publicly funded treatment organizations that offered no SUD medications at baseline. Independent variables included organizational characteristics, medical resources, funding, treatment culture, and detailing activities by pharmaceutical companies. Of 190 programs not offering SUD pharmacotherapy at baseline, 22.6% transitioned to offering at least one SUD medication at follow-up approximately 5 years later. Multivariate logistic regression results indicated that the employment of at least one physician at baseline, having a greater proportion of Medicaid clients, and pharmaceutical detailing were positively associated with medication adoption. Adoption of pharmacotherapy was more likely in programs that had greater medical resources, Medicaid funding, and contact with pharmaceutical companies. Given the potential expansion of Medicaid under the Affordable Care Act, patients served by publicly funded programs may gain greater access to such treatments, but research is needed to document health reform's impact on this sector of the treatment system.

  18. Effect of nonthermal plasma treatment on surface chemistry of commercially-pure titanium and shear bond strength to autopolymerizing acrylic resin

    Energy Technology Data Exchange (ETDEWEB)

    Vechiato-Filho, Aljomar José, E-mail: aljomarvechiatoflo@gmail.com [Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Univ. Estadual Paulista — UNESP, Aracatuba, Sao Paulo (Brazil); Silva Vieira Marques, Isabella da [Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sao Paulo (Brazil); Santos, Daniela Micheline dos [Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Univ. Estadual Paulista — UNESP, Aracatuba, Sao Paulo (Brazil); Oliveira Matos, Adaias [Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sao Paulo (Brazil); Rangel, Elidiane Cipriano; Cruz, Nilson Cristino da [Laboratory of Technological Plasmas (LaPTec), Engineering College, Univ. Estadual Paulista — UNESP, Sorocaba, Sao Paulo (Brazil); Barão, Valentim Adelino Ricardo [Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sao Paulo (Brazil)

    2016-03-01

    The effect of nonthermal plasma on the surface characteristics of commercially pure titanium (cp-Ti), and on the shear bond strength between an autopolymerizing acrylic resin and cp-Ti was investigated. A total of 96 discs of cp-Ti were distributed into four groups (n = 24): Po (no surface treatment), SB (sandblasting), Po + NTP and SB + NTP (methane plasma). Surface characterization was performed through surface energy, surface roughness, scanning microscopy, energy dispersive spectroscopy, and X-ray diffraction tests. Shear bond strength test was conducted immediately and after thermocycling. Surface treatment affected the surface energy and roughness of cp-Ti discs (P < .001). SEM–EDS showed the presence of the carbide thin film. XRD spectra revealed no crystalline phase changes. The SB + NTP group showed the highest bond strength values (6.76 ± 0.70 MPa). Thermocycling reduced the bond strength of the acrylic resin/cp-Ti interface (P < .05), except for Po group. NTP is an effective treatment option for improving the shear bond strength between both materials. - Highlights: • We tested the bond strength between two widely used materials in dentistry (acrylic and titanium). • We performed an innovative surface treatment with nonthermal plasma. • Increasing adhesion will avoid complications of full-arch implant-retained prostheses.

  19. Effective medical treatment of opiate addiction. National Consensus Development Panel on Effective Medical Treatment of Opiate Addiction.

    Science.gov (United States)

    1998-12-09

    release at the conference and was updated with the panel's final revisions. Opiate dependence is a brain-related medical disorder that can be effectively treated with significant benefits for the patient and society, and society must make a commitment to offer effective treatment for opiate dependence to all who need it. All persons dependent on opiates should have access to methadone hydrochloride maintenance therapy under legal supervision, and the US Office of National Drug Control Policy and the US Department of Justice should take the necessary steps to implement this recommendation. There is a need for improved training for physicians and other health care professionals. Training to determine diagnosis and treatment of opiate dependence should also be improved in medical schools. The unnecessary regulations of methadone maintenance therapy and other long-acting opiate agonist treatment programs should be reduced, and coverage for these programs should be a required benefit in public and private insurance programs.

  20. Analysis of pure maple syrup consumers

    Science.gov (United States)

    Paul E. Sendak

    1974-01-01

    Virtually all of the pure maple syrup productim in the United States is in the northern states of Maine, Massachusetts, Michigan, New Hampshire, New York, Ohio, Pennsylvania, Vermont, and Wisconsin. Pure maple syrup users living in the maple production area and users living in other areas of the United States were asked a series of questions about their use of pure...

  1. Retrospective analysis of first-line treatment for follicular lymphoma based on outcomes and medical economics.

    Science.gov (United States)

    Muneishi, Manaka; Nakamura, Ayaka; Tachibana, Katsumi; Suemitsu, Junko; Hasebe, Shinji; Takeuchi, Kazuto; Yakushijin, Yoshihiro

    2018-04-01

    Follicular lymphoma (FL) is the most common type of non-Hodgkin lymphoma (NHL), with indolent progression. Several treatment options are selected, based not only on disease status, quality of life (QOL), and age of patient, but also on recent increasing medical costs. We retrospectively analysed the first-line treatment of FL with regard to treatment outcomes and medical economics, and discuss the appropriate strategies for FL. Data on a total of 69 newly-diagnosed patients with FL was retrospectively collected from 2001 to 2015. The median age of the patients was 60 years and the median follow-up was 58 months. A total of 25 cases with FL were treated with R monotherapy, and 28 cases were treated with R-CHOP as first-line treatment. The factors affecting the decision of physicians to use R or R-CHOP treatment were serum level of lactate dehydrogenase (LDH) and disease stage. The first-line treatment-associated survival did not show any statistical differences between R and R-CHOP. The average hospitalization and average of all medical costs during the first-line treatment were 4.1 days (R) versus 55.7 days (R-CHOP), and JPY 1,707,693 (USD 15,324) (R) versus JPY 2,136,117 (USD 19,170) (R-CHOP), respectively. R monotherapy for patients whose diseases show low tumor burden and who are not candidates for local treatment has benefits as a first-line treatment compared to R-CHOP, based on the patients' QOL and medical economics.

  2. The Outcome of Surgery versus Medical Management in the Treatment of Vesicoureteral Reflux

    Directory of Open Access Journals (Sweden)

    Caleb P. Nelson

    2008-01-01

    Full Text Available Evaluation of the relative merits of medical versus surgical management of vesicoureteral reflux (VUR has been limited by the few prospective studies comparing these strategies. Among those trials that have been reported, the only consistent positive finding has been that incidence of febrile UTI is lower among children undergoing surgical treatment in comparison with medical treatment. Studies have not found significant differences in overall incidence of UTI, or in rates of new renal scarring or progression of existing scarring. It is likely that there is a subset of children with VUR who do benefit from aggressive treatment of their VUR, but we are not yet able to fully determine which children these are. It is hoped that future research will further clarify which treatments are useful in which children.

  3. Informed consent to medical treatment--the Israeli experience.

    Science.gov (United States)

    Weil, Z

    1998-01-01

    The ideological foundation of the doctrine of "informed consent" is rooted in the concept of personal freedom and freedom of choice. The concept of individual autonomy is represented by the "reasonable patient" standard which requires the disclosure of all information which a reasonable person in the position of the patient would need in order to make a rational decision regarding a proposed medical treatment. This attitude, however, conflicts with the traditional paternalism which is reflected in the "reasonable physician" standard, that is that a doctor must disclose that medical information which a rational doctor would relate to a patient in order to receive his consent. The enactment of the Patients' Rights Law in Israel in 1996 was an essential turning point in Israeli medical law. Section 13 of the new law explicitly establishes the requirement of informed consent and the details which a doctor must relate to a patient in order to reach the said agreement. Nevertheless, the law does not state the standard according to which it should be assessed whether the disclosure was proper. In a recent decision (C.A. 434/94 Shai Berman et al. v. Mor--the Institute for Medical Information, Ltd.) the Israeli Supreme Court took a step forward and determined that the duty to inform a patient will be judged by recognised criteria of negligence as they apply to the merits of each case.

  4. Pure red cell aplasia in a simultaneous pancreas-kidney transplantation patient: inside the erythroblast

    Directory of Open Access Journals (Sweden)

    Francesca Labbadia

    2012-09-01

    Full Text Available A case of pure red cell aplasia in a simultaneous kidney-pancreas transplant recipient on immunosuppressive therapy is reported here. The patient presented with anemia unresponsive to erythropoietin treatment. Bone marrow cytomorphology was highly suggestive of parvovirus pure red cell aplasia, which was confirmed with serology and polymerase chain reaction positive for parvovirus B19 DNA in peripheral blood. After the administration of intravenous immunoglobulin the anemia improved with a rising number of the reticulocytes.

  5. Guidelines for the medical treatment of idiopathic pulmonary fibrosis.

    Science.gov (United States)

    Xaubet, Antoni; Molina-Molina, María; Acosta, Orlando; Bollo, Elena; Castillo, Diego; Fernández-Fabrellas, Estrella; Rodríguez-Portal, José Antonio; Valenzuela, Claudia; Ancochea, Julio

    2017-05-01

    Idiopathic pulmonary fibrosis is defined as chronic fibrosing interstitial pneumonia limited to the lung, with poor prognosis. The incidence has been rising in recent years probably due to improved diagnostic methods and increased life expectancy. In 2013, the SEPAR guidelines for the diagnosis and treatment for idiopathic pulmonary fibrosis were published. Since then, clinical trials and meta-analyses have shown strong scientific evidence for the use of pirfenidone and nintedanib in the treatment of idiopathic pulmonary fibrosis. In 2015, the international consensus of 2011 was updated and new therapeutic recommendations were established, prompting us to update our recommendation for the medical treatment of idiopathic pulmonary fibrosis accordingly. Diagnostic aspects and non-pharmacological treatment will not be discussed as no relevant developments have emerged since the 2013 guidelines. Copyright © 2017 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. [Problem areas and examples of best practice in intersectoral medication treatment--a literature review].

    Science.gov (United States)

    Mehrmann, Lena; Ollenschläger, Günter

    2014-01-01

    Transitions between the outpatient and inpatient sector are a critical phase in medication treatment. This article provides an overview of published problem areas and examples of best practice in the intersectoral medication treatment. Data with regard to related problem areas and examples of best practice was collected in August 2011 by a systematic literature research. The relevant literature was identified using the following databases and search engines: MEDLINE, The Cochrane Library, EMBASE, Google, and Google Scholar. Additionally, a hand search was done on the websites of SpringerLink and Thieme Connect. The initial search yielded a total of 4,409 records which were further selected in two screening steps and analysed according to their relevance. Of the remaining 63 records, 3 exclusively described problem areas, 11 of them examples of best practice, and 49 provided information on both problem areas and examples of best practice with regard to intersectoral medication treatment. Among other things, problem areas include varying legal regulations in inpatient and outpatient medication treatment, drug therapy interruptions after hospital discharge, or deficits in communication and continuity of care. Examples of best practice are projects, programmes, initiatives, recommendations, and points to consider with respect to medication reconciliation, pharmaceutical support, or transitions of care. Problem areas as well as examples of best practice are mainly focused on the transition from inpatient to outpatient care. Copyright © 2013. Published by Elsevier GmbH.

  7. Depot-medication compliance for patients with psychotic disorders: the importance of illness insight and treatment motivation.

    Science.gov (United States)

    Noordraven, Ernst L; Wierdsma, André I; Blanken, Peter; Bloemendaal, Anthony Ft; Mulder, Cornelis L

    2016-01-01

    Noncompliance is a major problem for patients with a psychotic disorder. Two important risk factors for noncompliance that have a severe negative impact on treatment outcomes are impaired illness insight and lack of motivation. Our cross-sectional study explored how they are related to each other and their compliance with depot medication. Interviews were conducted in 169 outpatients with a psychotic disorder taking depot medication. Four patient groups were defined based on low or high illness insight and on low or high motivation. The associations between depot-medication compliance, motivation, and insight were illustrated using generalized linear models. Generalized linear model showed a significant interaction effect between motivation and insight. Patients with poor insight and high motivation for treatment were more compliant (94%) (95% confidence interval [CI]: 1.821, 3.489) with their depot medication than patients with poor insight and low motivation (61%) (95% CI: 0.288, 0.615). Patients with both insight and high motivation for treatment were less compliant (73%) (95% CI: 0.719, 1.315) than those with poor insight and high motivation. Motivation for treatment was more strongly associated with depot-medication compliance than with illness insight. Being motivated to take medication, whether to get better or for other reasons, may be a more important factor than having illness insight in terms of improving depot-medication compliance. Possible implications for clinical practice are discussed.

  8. Free to become martyrs? The right to refuse medical treatment on religious grounds in a comparative perspective

    Directory of Open Access Journals (Sweden)

    Vincenzo Pacillo

    2016-09-01

     ABSTRACT: This study focuses on the right of patients to refuse medical treatments on religious grounds and on the (supposed right to the parents to refuse medical treatments on behalf of their children, emphasizing the links and connections between the freedom of religion, the right to self-determination and the right to refuse medical treatment based on religious motivations. After a comparison between the norms devoted to rule the exercise of these rights in the English (and Welsh and Italian legal systems, the article suggests that the approach of medical staff towards a Refusal of Medical Treatment on Religious Grounds ought to start an intercultural process. This process ought to be a cross-cultural dialogue devoted not only to translate medical language in a language which can be fully understood by the patient, but also to create a reciprocal comprehension between the (mainstream ethnocultural communication codes and instances of the staff and the (nondominant ethnocultural (and religious communication codes and instances of the patient (or of his/her parents.

  9. Urodynamic study in women with pure stress urinary incontinence.

    Science.gov (United States)

    Valdevenito, J P; Águila, F; Naser, M; Manríquez, V; Wenzel, C; Díaz, J P

    2015-03-01

    To describe the results of urodynamic study in women with pure stress urinary incontinence symptoms, including the characteristics of the overactive detrusor. No other clinical assessments were taken into account. A retrospective study in women with urinary incontinence consecutively evaluated by urodynamic study. From a total of 710 women, only 108 (15%) with pure stress urinary incontinence symptoms were selected. Women with prior urinary incontinence surgery, pelvic organ prolapse (stage ≥iii), pelvic radiotherapy, using medication active on the lower urinary tract and neurological diseases were excluded. Infusion rate was 70 ml/min. Detrusor overactivity was induced only by cough. A standardized cough stress test with progressive cough intensity was carried out. Reference urodynamic values for stress incontinent women are described. Urodynamic stress incontinence was observed in 79 women (73.1%), detrusor overactivity in 4 (3.7%) and mixed urodynamic diagnosis in 15 (13.8%). Test was inconclusive in 10 patients (9.2%). Two women had detrusor overactivity incontinence (1.9%). One patient had detrusor overactivity induced by cough without urodynamic stress incontinence (0.9%). There was an association between detrusor overactivity and nocturia ≥2 (P=.002; odds ratio: 3.74; 95% confidence interval: 1.22-11.39). One woman had a bladder outlet obstruction (0.9%). In women with pure stress urinary incontinence, without knowing the outcome of other clinical assessments, urodynamic study can provide useful information to define the proper therapy. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Mixed states vs. pure mania in the french sample of the EMBLEM study: results at baseline and 24 months – European mania in bipolar longitudinal evaluation of medication

    Directory of Open Access Journals (Sweden)

    Azorin Jean-Michel

    2009-06-01

    Full Text Available Abstract Background To describe the clinical course and treatment patterns over 24 months of patients experiencing an acute manic/mixed episode within the standard course of care. Methods EMBLEM was a 2-year European prospective, observational study on outcomes of patients experiencing a manic/mixed episode. Adults with bipolar disorder were enrolled within the standard course of care as in/outpatients if they initiated or changed oral medication for treatment of acute mania. After completing 12 weeks of acute phase, patients were assessed every 3–6 months during the maintenance phase. We present the 24 month results, with subgroup analysis for mixed states (MS and pure mania (PM. These subgroup analyses are driven by the high proportion of antidepressants prescribed in this cohort. Results In France, 771 patients were eligible for the maintenance phase. 69% of patients completed the follow up over 24 months. The mean age was 45.5 years (sd = 13.6 with 57% of women. 504 (66% patients were experiencing a PM and 262 (34% a MS at baseline. The main significant differences in MS vs. PM at baseline were: a higher rate of women, and in the previous 12 months, a higher frequency of episodes (manic/mixed and depressive, more suicide attempts, more rapid cycling, fewer social activities and more work impairment. Over the 24 months of follow-up the MS group had a significantly lower recovery than PM (36% vs. 46%, p = 0.006. Overall, 42% of all patients were started on monotherapy and 58% on combination therapy; of those 35% and 30% respectively remained on their initial medication throughout the 24 months. At baseline, 36% were treated with an antidepressant, this proportion remains high throughout the follow-up period, with a significantly higher rate for MS vs. PM at 24 months (55% vs. 27%, p Conclusion In this large sample, MS occur frequently (34%, they are more severe at baseline and have a worse functional prognosis than PM. Although

  11. Automated extraction of genomic DNA from medically important yeast species and filamentous fungi by using the MagNA Pure LC system.

    Science.gov (United States)

    Loeffler, Juergen; Schmidt, Kathrin; Hebart, Holger; Schumacher, Ulrike; Einsele, Hermann

    2002-06-01

    A fully automated assay was established for the extraction of DNA from clinically important fungi by using the MagNA Pure LC instrument. The test was evaluated by DNA isolation from 23 species of yeast and filamentous fungi and by extractions (n = 28) of serially diluted Aspergillus fumigatus conidia (10(5) to 0 CFU/ml). Additionally, DNA from 67 clinical specimens was extracted and compared to the manual protocol. The detection limit of the MagNA Pure LC assay of 10 CFU corresponded to the sensitivity when DNA was extracted manually; in 9 of 28 runs, we could achieve a higher sensitivity of 1 CFU/ml blood, which was found to be significant (p DNA from all fungal species analyzed could be extracted and amplified by real-time PCR. Negative controls from all MagNA Pure isolations remained negative. Sixty-three clinical samples showed identical results by both methods, whereas in 4 of 67 samples, discordant results were obtained. Thus, the MagNA Pure LC technique offers a fast protocol for automated DNA isolation from numerous fungi, revealing high sensitivity and purity.

  12. [Informed consent and parental refusal to medical treatment in childhood. The threshold of medical and social tolerance. Part I].

    Science.gov (United States)

    Guadarrama-Orozco, Jessica H; Garduño Espinosa, Juan; Vargas López, Guillermo; Viesca Treviño, Carlos

    Informed consent is a right of all individuals and no one can force anyone to receive treatment against their wishes. The right to accept or refuse treatment persists in individuals who are incompetent from a legal point of view; this is exercised on their behalf by a third party. Children are considered incompetent to make medical decisions about their own health and their parents or legal guardians are empowered to make those decisions. However, parental authority is not absolute and there are situations where their decisions are not the best, sometimes leading to jeopardizing the well-being and even the lives of their children, forcing the state to intervene on behalf of the best interests of the child. This is the reason why it is necessary to ask the following questions: is it really the child's best interest that moves us to legally intervene when a parent refuses to accept the proposed medical treatment or is the damage done to make this decision? What kind of parental decisions are those that should not be tolerated? After a review of the theme, we conclude that if the decision of the parents regarding a medical decision is considered to be made with maleficence that is harmful to the child, it is justified that the State intervenes. Finally, we exposed four criteria that can be used in making decisions in complex cases where parents refuse treatment for their children. Copyright © 2015. Publicado por Masson Doyma México S.A.

  13. 30 CFR 50.20-3 - Criteria-Differences between medical treatment and first aid.

    Science.gov (United States)

    2010-07-01

    ... and first aid. 50.20-3 Section 50.20-3 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION... first aid. (a) Medical treatment includes, but is not limited to, the suturing of any wound, treatment... treatment. Tetanus and flu shots are considered preventative in nature. First aid includes any one-time...

  14. Fundamentals of the Pure Spinor Formalism

    CERN Document Server

    Hoogeveen, Joost

    2010-01-01

    This thesis presents recent developments within the pure spinor formalism, which has simplified amplitude computations in perturbative string theory, especially when spacetime fermions are involved. Firstly the worldsheet action of both the minimal and the non-minimal pure spinor formalism is derived from first principles, i.e. from an action with two dimensional diffeomorphism and Weyl invariance. Secondly the decoupling of unphysical states in the minimal pure spinor formalism is proved

  15. Marion duPont Scott Equine Medical Center uses innovative lameness treatment

    OpenAIRE

    Lee, Kate

    2009-01-01

    Virginia Tech's Marion duPont Scott Equine Medical Center is now offering an equine lameness therapy that prevents further degeneration of the affected joint and offers a longer-lasting benefit than traditional steroid treatment.

  16. Nordic veterinarians' threshold for medical treatment of dairy cows, influence on disease recording and medicine use

    DEFF Research Database (Denmark)

    Espetvedt, Mari N.; Rintakoski, Simo; Wolff, Cecilia

    2013-01-01

    these thresholds may increase the understanding of prudent use of antibiotics. The primary objective of this study was to investigate whether Nordic veterinarians, on a between country-level, vary in their intention to start medical treatment of a dairy cow with mild clinical mastitis, on the same day as making......National databases for dairy cows in the four Nordic countries, Denmark, Finland, Norway and Sweden, have been found to capture varying proportions of disease events on farm. A variation in the thresholds of veterinarians to initiate medical treatment may be a reason for this. Studying...... countries the specific attitude belief of highest influence was that starting treatment the same day as diagnosing a case of mild clinical mastitis gives the best result, compared to delaying treatment. The varying intentions of veterinarians to initiate medical treatment are likely to influence centrally...

  17. Refusal of medical treatment in the pediatric emergency service: analysis of reasons and aspects.

    Science.gov (United States)

    Gündüz, Ramiz Coşkun; Halil, Halit; Gürsoy, Cüneyt; Çifci, Atilla; Özgün, Seher; Kodaman, Tuğba; Sönmez, Mehtap

    2014-01-01

    Refusal of treatment for acutely ill children is still an important problem in the emergency service. When families refuse medical treatment for their acutely ill children, healthcare professionals may attempt to provide information and negotiate with the family concerning treatment refusal and its possible adverse outcomes, and request consent for refusal of medical treatment. There is insufficient data about refusal of treatment in our country. The purpose of this study was to analyze the causes of treatment refusal in the pediatric emergency service. We collected data recorded on informed consent forms. During a 2-year-study period, 215 patients refused treatment recommended by acute health care professionals. The majorty of patients were in the 0-2 year age group. Hospitalization was the type of treatment most commonly refused; restrictions regarding family members staying with their children during hospitalization and admission to another hospital were the major reasons for refusal of treatment. Clarifying the reasons for treatment refusal may help us to overcome deficiencies, improve conditions, resolve problems and build confidence between healthcare providers and service users, increasing users' satisfaction in the future.

  18. Measurement of contamination by radioisotopes for medical examination and treatment in medical organizations

    International Nuclear Information System (INIS)

    Hamada, Masahiko

    1975-01-01

    For safety control of radioactive contamination by medical examination and treatment in medical organizations, establishment of a Health and Physics Department is desired. It is necessary to dispose of radiopharmaceuticals according to the classification of safety and to separate the use of non-sealed nuclides from the radiotherapy room. In relation to radioactive air pollution, attention should be paid to the sampling test of hood, management of 133 Xe using room, and air pollution in the disposal storage room and patient urine storage room. Concerning the disposal of liquid waste, it is most important to devise entirely different method of disposal according to the level differences in the amount of diagnostic use and the therapeutic dose. The method of use is most important also for the decision of the size of storage tank. For sampling and monitoring it is advisable to use up to the 10th rank nuclide for safety counting in consideration of physicochemical conditions. (Chiba, N.)

  19. Levonorgestrel-releasing intrauterine system vs. usual medical treatment for menorrhagia: an economic evaluation alongside a randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Sabina Sanghera

    Full Text Available OBJECTIVE: To undertake an economic evaluation alongside the largest randomised controlled trial comparing Levonorgestrel-releasing intrauterine device ('LNG-IUS' and usual medical treatment for women with menorrhagia in primary care; and compare the cost-effectiveness findings using two alternative measures of quality of life. METHODS: 571 women with menorrhagia from 63 UK centres were randomised between February 2005 and July 2009. Women were randomised to having a LNG-IUS fitted, or usual medical treatment, after discussing with their general practitioner their contraceptive needs or desire to avoid hormonal treatment. The treatment was specified prior to randomisation. For the economic evaluation we developed a state transition (Markov model with a 24 month follow-up. The model structure was informed by the trial women's pathway and clinical experts. The economic evaluation adopted a UK National Health Service perspective and was based on an outcome of incremental cost per Quality Adjusted Life Year (QALY estimated using both EQ-5D and SF-6D. RESULTS: Using EQ-5D, LNG-IUS was the most cost-effective treatment for menorrhagia. LNG-IUS costs £100 more than usual medical treatment but generated 0.07 more QALYs. The incremental cost-effectiveness ratio for LNG-IUS compared to usual medical treatment was £1600 per additional QALY. Using SF-6D, usual medical treatment was the most cost-effective treatment. Usual medical treatment was both less costly (£100 and generated 0.002 more QALYs. CONCLUSION: Impact on quality of life is the primary indicator of treatment success in menorrhagia. However, the most cost-effective treatment differs depending on the quality of life measure used to estimate the QALY. Under UK guidelines LNG-IUS would be the recommended treatment for menorrhagia. This study demonstrates that the appropriate valuation of outcomes in menorrhagia is crucial.

  20. Stigma associated with medication treatment for young adults with opioid use disorder: a case series.

    Science.gov (United States)

    Hadland, Scott E; Park, Tae Woo; Bagley, Sarah M

    2018-05-07

    Opioid-related overdose deaths have risen sharply among young adults. Despite this increase, access to evidence-based medication for opioid agonist treatment (OAT) for youth remains low. Among older adults, barriers to OAT include the paucity of buprenorphine-waivered prescribers and low rates of prescribing among waivered physicians. We have increasingly found in our clinical practice significant stigma related to using OAT to treat addiction for young adults. In this series, we describe three cases of young adults who faced significant stigma related to their treatment. The first case is a young male with a history of significant trauma and a severe opioid use disorder. He started buprenorphine and has found a job, stayed abstinent, and began a healthy relationship. At each step in his recovery, he has faced resistance to taking medication from other treatment providers, directors of sober houses, and his parents. The second case is a young woman who presented to a substance use treatment program after a relapse. She was unable to restart buprenorphine despite our calling to ask that it be restarted. Ultimately, she left against medical advice and was stabilized as an outpatient on buprenorphine. The final case is a young woman who stopped buprenorphine after being told she was "not sober" while attending 12-step group but restarted after conversations with her clinical team. In each case, the patient has continued their medication treatment and are stable. Opioid-related deaths continue to rise among all age groups, including young adults. Stigma related to medication treatment can be a substantial barrier for many young adult patients but there are concrete steps that providers and communities can take to address this stigma.

  1. Comparative in vitro biocompatibility of nickel-titanium, pure nickel, pure titanium, and stainless steel: genotoxicity and atomic absorption evaluation.

    Science.gov (United States)

    Assad, M; Lemieux, N; Rivard, C H; Yahia, L H

    1999-01-01

    The genotoxicity level of nickel-titanium (NiTi) was compared to that of its pure constituents, pure nickel (Ni) and pure titanium (Ti) powders, and also to 316L stainless steel (316L SS) as clinical reference material. In order to do so, a dynamic in vitro semiphysiological extraction was performed with all metals using agitation and ISO requirements. Peripheral blood lymphocytes were then cultured in the presence of all material extracts, and their comparative genotoxicity levels were assessed using electron microscopy-in situ end-labeling (EM-ISEL) coupled to immunogold staining. Cellular chromatin exposition to pure Ni and 316L SS demonstrated a significantly stronger gold binding than exposition to NiTi, pure Ti, or the untreated control. In parallel, graphite furnace atomic absorption spectrophotometry (AAS) was also performed on all extraction media. The release of Ni atoms took the following decreasing distribution for the different resulting semiphysiological solutions: pure Ni, 316L SS, NiTi, Ti, and controls. Ti elements were detected after elution of pure titanium only. Both pure titanium and nickel-titanium specimens obtained a relative in vitro biocompatibility. Therefore, this quantitative in vitro study provides optimistic results for the eventual use of nickel-titanium alloys as surgical implant materials.

  2. Study of sterilization-treatment in pure and N- doped carbon thin films synthesized by inductively coupled plasma assisted pulsed-DC magnetron sputtering

    Energy Technology Data Exchange (ETDEWEB)

    Javid, Amjed [Center for Advanced Plasma Surface Technology (CAPST), NU-SKKU Joint Institute for Plasma Nano-Materials (IPNM), Advanced Materials Science and Engineering, Sungkyunkwan University, Suwon 440-746 (Korea, Republic of); Department of Textile Processing, National Textile University, Faisalabad 37610 (Pakistan); Kumar, Manish, E-mail: manishk@skku.edu [Center for Advanced Plasma Surface Technology (CAPST), NU-SKKU Joint Institute for Plasma Nano-Materials (IPNM), Advanced Materials Science and Engineering, Sungkyunkwan University, Suwon 440-746 (Korea, Republic of); Han, Jeon Geon, E-mail: hanjg@skku.edu [Center for Advanced Plasma Surface Technology (CAPST), NU-SKKU Joint Institute for Plasma Nano-Materials (IPNM), Advanced Materials Science and Engineering, Sungkyunkwan University, Suwon 440-746 (Korea, Republic of)

    2017-01-15

    Highlights: • Pure and N-doped nanocrystallie carbon films are synthesized by ICP assisted pulsed DC plasma process. • ICP power induces the increase in average graphitic crystallite size from 4.86 nm to 6.42 nm. • Beneficial role of ICP source assistance to achieve high sputtering throughput (deposition rate ∼55 nm/min). • Post-sterilization electron-transport study shows N-doped carbon films having promising stability. - Abstract: Electrically-conductive nanocrystalline carbon films, having non-toxic and non-immunogenic characteristics, are promising candidates for reusable medical devices. Here, the pure and N- doped nanocrystalline carbon films are deposited by the assistance of inductively coupled plasma (ICP) in an unbalanced facing target pulsed-DC magnetron sputtering process. Through the optical emission spectroscopy study, the role of ICP assistance and N-doping on the reactive components/radicals during the synthesis is presented. The N-doping enhances the three fold bonding configurations by increasing the ionization and energies of the plasma species. Whereas, the ICP addition increases the plasma density to control the deposition rate and film structure. As a result, sputtering-throughput (deposition rate: 31–55 nm/min), electrical resistivity (4–72 Ωcm) and water contact angle (45.12°–54°) are significantly tailored. Electric transport study across the surface microchannel confirms the superiority of N-doped carbon films for sterilization stability over the undoped carbon films.

  3. Concurrence classes for general pure multipartite states

    International Nuclear Information System (INIS)

    Heydari, Hoshang

    2005-01-01

    We propose concurrence classes for general pure multipartite states based on an orthogonal complement of a positive operator-valued measure on quantum phase. In particular, we construct W m class, GHZ m , and GHZ m-1 class concurrences for general pure m-partite states. We give explicit expressions for W 3 and GHZ 3 class concurrences for general pure three-partite states and for W 4 , GHZ 4 and GHZ 3 class concurrences for general pure four-partite states

  4. State-Targeted Funding and Technical Assistance to Increase Access to Medication Treatment for Opioid Use Disorder.

    Science.gov (United States)

    Abraham, Amanda J; Andrews, Christina M; Grogan, Colleen M; Pollack, Harold A; D'Aunno, Thomas; Humphreys, Keith; Friedmann, Peter D

    2018-04-01

    As the United States grapples with an opioid epidemic, expanding access to effective treatment for opioid use disorder is a major public health priority. Identifying effective policy tools that can be used to expand access to care is critically important. This article examines the relationship between state-targeted funding and technical assistance and adoption of three medications for treating opioid use disorder: oral naltrexone, injectable naltrexone, and buprenorphine. This study draws from the 2013-2014 wave of the National Drug Abuse Treatment System Survey, a nationally representative, longitudinal study of substance use disorder treatment programs. The sample includes data from 695 treatment programs (85.5% response rate) and representatives from single-state agencies in 49 states and Washington, D.C. (98% response rate). Logistic regression was used to examine the relationships of single-state agency targeted funding and technical assistance to availability of opioid use disorder medications among treatment programs. State-targeted funding was associated with increased program-level adoption of oral naltrexone (adjusted odds ratio [AOR]=3.14, 95% confidence interval [CI]=1.49-6.60, p=.004) and buprenorphine (AOR=2.47, 95% CI=1.31-4.67, p=.006). Buprenorphine adoption was also correlated with state technical assistance to support medication provision (AOR=1.18, 95% CI=1.00-1.39, p=.049). State-targeted funding for medications may be a viable policy lever for increasing access to opioid use disorder medications. Given the historically low rates of opioid use disorder medication adoption in treatment programs, single-state agency targeted funding is a potentially important tool to reduce mortality and morbidity associated with opioid disorders and misuse.

  5. Medical tourism.

    Science.gov (United States)

    Leggat, Peter

    2015-01-01

    Medical tourism is a burgeoning industry in our region. It involves patients travelling outside of their home country for medical treatment. This article provides an outline of the current research around medical tourism, especially its impact on Australians. Patients are increasingly seeking a variety of medical treatments abroad, particularly those involving cosmetic surgery and dental treatment, often in countries in South-East Asia. Adverse events may occur during medical treatment abroad, which raises medico-legal and insurance issues, as well as concerns regarding follow-up of patients. General practitioners need to be prepared to offer advice, including travel health advice, to patients seeking medical treatment abroad.

  6. Quality of life in purely ocular myasthenia in Japan

    Science.gov (United States)

    2014-01-01

    Background Since there has been no conclusive evidence regarding the treatment of ocular myasthenia, treatment guidelines were recently issued by the European Federation of Neurological Societies/European Neurological Society (EFNS/ENS). However, the therapeutic outcomes concerning the quality-of-life (QOL) of patients with ocular myasthenia are not yet fully understood. Methods We investigated the therapeutic outcomes of patients with purely ocular myasthenia in a multicenter cross-sectional survey in Japan. To evaluate the severity of ocular symptoms, we used the ocular-quantitative MG (QMG) score advocated by Myasthenia Gravis Foundation of America. We used the Japanese translated version of the MG-QOL15, a self-appraised scoring system. Results Of 607 myasthenia gravis (MG) patients with an observation-duration of illness ≥ 2 years, the cases of 123 patients (20%) were limited to ocular muscles (purely ocular myasthenia). During the entire clinical course, 81 patients experienced both ptosis and diplopia, 36 had ptosis alone, and six had diplopia alone. Acetyl-cholinesterase inhibitors and prednisolone were used in 98 and 52 patients, respectively. Treatment improved ocular symptoms, with the mean reduction in ocular-QMG score of 2.3 ± 1.8 points. However, 47 patients (38%) failed to gain minimal manifestation or a better status. Patients with unfavorable outcomes also self-reported severe QOL impairment. Multivariate analyses showed that the pretreatment ocular-QMG score was associated with unfavorable outcomes, but not associated with the patient’s QOL. Conclusion A treatment strategy designed in accord with a patient's ocular presentation must be considered in order to improve ocular symptoms and the patient's QOL. PMID:24996227

  7. Poor adherence to medication as assessed by the Morisky Medication Adherence Scale-8 and low satisfaction with treatment in 237 psoriasis patients.

    Science.gov (United States)

    Saeki, Hidehisa; Imafuku, Shinichi; Abe, Masatoshi; Shintani, Yoichi; Onozuka, Daisuke; Hagihara, Akihito; Katoh, Norito; Murota, Hiroyuki; Takeuchi, Satoshi; Sugaya, Makoto; Tanioka, Miki; Kaneko, Sakae; Masuda, Koji; Hiragun, Takaaki; Inomata, Naoko; Kitami, Yuki; Tsunemi, Yuichiro; Abe, Shinya; Kobayashi, Miwa; Morisky, Donald E; Furue, Masutaka

    2015-04-01

    Previously we assessed the medication adherence for oral and topical remedies by a translated Japanese version of the Morisky Medication Adherence Scale-8 (MMAS-8) together with socioeconomic backgrounds in 3096 Japanese dermatological patients, and found the medication adherence, especially to topical drugs, was poor in these patients. In order to elucidate the disease-specific sociomedical factors, we further sub-analyzed the medication adherence in 237 psoriasis patients and compared it with that in other dermatological diseases such as atopic dermatitis, urticaria or tinea. This study was conducted among patients registered in monitoring system and 3096 eligible patients were enrolled. Our web-based questionnaire included the following items such as age, sex, annual income, main health-care institution, experience of effectiveness by oral or topical medication, overall satisfaction with treatment, and MMAS-8 for oral or topical medication. Mean adherence score by MMAS-8 was 5.2 for oral and 4.3 for topical medication. More patients with psoriasis used a university hospital and fewer used a private clinic compared with those with the other skin disease patients. Experience of drug effectiveness by oral medication and overall satisfaction with treatment was lower in psoriasis patients than in other patients. In oral medication, significantly better adherence was observed in those of higher age and with higher annual income. The adherence to medication, especially to topical drugs, was poor in 237 psoriasis patients. We speculated that some severe psoriasis patients were not sufficiently treated systemically and were resistant to topical therapy, leading to poor adherence. © 2015 Japanese Dermatological Association.

  8. Organizational fidelity to a medication management evidence-based practice in the treatment of schizophrenia.

    Science.gov (United States)

    El-Mallakh, Peggy; Howard, Patricia B; Rayens, Mary Kay; Roque, Autumn P; Adkins, Sarah

    2013-11-01

    Organizational support is essential for successful implementation of evidence-based practice (EBP) in clinical settings. This 3-year study used a mixed qualitative and quantitative design to implement a medication management EBP in the treatment of schizophrenia in six community mental health clinics in a south-central state of the United States. Findings from organizational fidelity assessments indicate that support for EBP implementation was moderate. Organizational support was highest for prescriber access to relevant patient information at each medication visit, scheduling flexibility for patients' urgent problems, and availability of medication guidelines. Organizational support was lowest for medication availability and identification of treatment refractory patients. Findings suggest that leadership is essential to support successful implementation. Nurse educators can incorporate implementation research and leadership training into graduate nursing programs to facilitate successful EBP implementation in practice settings. Copyright 2013, SLACK Incorporated.

  9. Matching of treatment-resistant heroin-dependent patients to medical prescription of heroin or oral methadone treatment: results from two randomized controlled trials

    NARCIS (Netherlands)

    Blanken, Peter; Hendriks, Vincent M.; Koeter, Maarten W. J.; van Ree, Jan M.; van den Brink, Wim

    2005-01-01

    AIMS: To investigate which baseline patient characteristics of treatment-resistant heroin addicts differentially predicted treatment response to medical heroin prescription compared to standard methadone maintenance treatment. DESIGN: Two open-label randomized controlled trials; pooled data.

  10. Revascularisation versus medical treatment in patients with stable coronary artery disease

    DEFF Research Database (Denmark)

    Windecker, Stephan; Stortecky, Stefan; Stefanini, Giulio G

    2014-01-01

    while maintaining randomisation. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: A strategy of initial medical treatment compared with revascularisation by coronary artery bypass grafting or Food and Drug Administration approved techniques for percutaneous revascularization: balloon angioplasty, bare metal...

  11. Right of a patient to refuse medical treatment: justification for judicial ...

    African Journals Online (AJOL)

    Nnamdi Azikiwe University Journal of International Law and Jurisprudence ... This paper discusses the right of a patient to refuse medical treatment and juxtaposes ... This is achieved by an expository review of relevant case law and scholarly ...

  12. Specialized medical sections for the treatment of radiation injuries from accidents in nuclear power plants

    International Nuclear Information System (INIS)

    Deanovic, Z.; Boranic, M.; Vitale, B.

    1980-01-01

    Presented is the organization of the final, highly specialized treatment (diagnostic and therapeutic) of persons that have been severely injured in a radiation or nuclear accident. In this organizational scheme, the leading idea was to group and establish suitable medical sections for the acceptance, diagnosic work-up, and treatment of radiation casualties, around a strong medical center in which the different specialists would be available

  13. Polarized ensembles of random pure states

    Science.gov (United States)

    Deelan Cunden, Fabio; Facchi, Paolo; Florio, Giuseppe

    2013-08-01

    A new family of polarized ensembles of random pure states is presented. These ensembles are obtained by linear superposition of two random pure states with suitable distributions, and are quite manageable. We will use the obtained results for two purposes: on the one hand we will be able to derive an efficient strategy for sampling states from isopurity manifolds. On the other, we will characterize the deviation of a pure quantum state from separability under the influence of noise.

  14. Testing the efficacy of pure versus guided mirror exposure in women with bulimia nervosa: A combination of neuroendocrine and psychological indices.

    Science.gov (United States)

    Díaz-Ferrer, Sandra; Rodríguez-Ruiz, Sonia; Ortega-Roldán, Blanca; Moreno-Domínguez, Silvia; Fernández-Santaella, M Carmen

    2015-09-01

    Body exposure improves body image problems in women with eating disorders. However it has almost always been combined with other interventions. Thus, the efficacy of body exposure alone (i.e., pure exposure) remains largely unclear. We aimed to compare the efficacy of two body exposure techniques through psychological and neuroendocrine indices recorded within and between successive sessions. Twenty-nine women with high body dissatisfaction and diagnosis of bulimia nervosa were randomly assigned to one of two treatment groups: Pure Exposure (n = 14) or Guided Exposure (n = 15). Participants received 6 exposure sessions. After each session, changes in thoughts (positive/negative) and body satisfaction were assessed. Also, we assessed the body discomfort experienced by participants within and between sessions. Finally, the changes in salivary cortisol levels within and between the initial and final treatment sessions were measured. Both groups showed a reduction in negative thoughts and a progressive increase in positive thoughts throughout the treatment. However, the increase in body satisfaction and the reduction in subjective discomfort within the sessions were greater in the pure exposure group. The cortisol levels during the initial and final treatment sessions decreased in both groups. Methodological limitations are reported. These results suggest that pure and guided exposures are effective interventions for improving thoughts and neuroendocrine responses, although pure exposure increased more body satisfaction feelings in bulimic women. Subjective discomfort also showed different patterns of change within and along sessions for each treatment. Reasons for these results are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Do stressful life events predict medical treatment outcome in first episode of depression?

    DEFF Research Database (Denmark)

    Bock, Camilla; Bukh, Jens Drachmann; Vinberg, Maj

    2009-01-01

    BACKGROUND: It is unclear whether medical treatment outcome in first episode depression differ for patients with and without stressful life events prior to onset of depression. METHODS: Patients discharged with a diagnosis of a single depressive episode from a psychiatric in- or outpatient hospital......-II) and the interview of recent life events (IRLE). Medical treatment history was assessed in detail using standardised procedures (TRAQ). Remission was defined as a score or= 4 on TRAQ following (1) first trial of antidepressant treatment (2) two adequate trials of antidepressant treatment. RESULTS: A total of 399...... patients participated in the interview and among these 301 patients obtained a SCAN diagnosis of a single depressive episode. A total of 62.8% of the 301 patients experienced at least one moderate to severe stressful life event in a 6 months period prior to symptom onset. The presence of a stressful life...

  16. Antimicrobial activity of pure platelet-rich plasma against microorganisms isolated from oral cavity

    OpenAIRE

    Drago, Lorenzo; Bortolin, Monica; Vassena, Christian; Taschieri, Silvio; Del Fabbro, Massimo

    2013-01-01

    Background Autologous platelet concentrates (PCs) have been extensively used in a variety of medical fields to promote soft and hard tissue regeneration. The significance behind their use lies in the abundance of growth factors in platelets ?-granules that promotes wound healing. In addition, antibacterial properties of PCs against various bacteria have been recently pointed out. In this study, the antimicrobial effect of pure platelet-rich plasma (P-PRP) was evaluated against oral cavity mic...

  17. Reflections on Remaining Obstacles in a Primary-Care Oriented Pure PBL Curriculum after Twelve Years of Implementation

    Science.gov (United States)

    D'Ottavio, Alberto Enrique; Bassan, Norberto David

    2014-01-01

    A pioneer primary-care oriented pure PBL curriculum, based on constructivism and adult learning theories combined with Morin's complex thinking, was implemented in our medical school since 2002. Regardless of warnings opportunely made because the basic requirements for its successful implementation could not be fully fulfilled in practice, the…

  18. The Relationship Between Treatment Adherence and Non-picked Up Medications in Community Pharmacies

    Directory of Open Access Journals (Sweden)

    Vu Phan Hoang Nguyen

    2016-10-01

    Full Text Available Medication adherence is one of the major factors that determine an outcome of a treatment. Despite the effort of healthcare providers to improve the adherence rate, it still remains a serious issue in our health care system today. Many patients do not take their medications as directed or just simply do not want to fill or refill their prescriptions. A small survey performed by pharmacy students at Temple School of Pharmacy showed that there is a significant number of patients did not pick up their medications. Cardiovascular medications are the most common non-picked up drugs. There are various reasons that patients use to justify for this non-adherence behavior. However, they are unaware that their actions create a tremendous negative effect not only on the treatment itself but also on the entire health care system. The consequences include expensive therapies, inaccurate research data, and poor treatment outcomes. Many solutions have been utilized to solve this problem, but it is still the major problem for healthcare providers to keep in mind when planning a drug regimen. Although many people believed that pharmacists are responsible for solving this problem, it should be a multidisciplinary effort of all healthcare providers to improve the medication adherence. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received, employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties.   Type: Student Project

  19. Organization of medical aid and treatment of individuals affected in radiation accidents

    International Nuclear Information System (INIS)

    Mikhajlov, M.G.; Andreev, E.A.; Bliznakov, V.

    1979-01-01

    The emergency programme of the medical service for radiation accidents constitutes part of the whole emergency programme of the establishment whose production process is derectly connected with the utilization of ionizing radiation sources. The chief of the establishment health centre also heads the operative radiation accident group. When a radiation accident occurs the medical personnel, according to a previously developed plan, reports at the Health centre. The medical aid is based on the principle of step treatment and evacuation of the affected persons, according to the prescriptions. The first step of the medical evacuation is the health centre; the second - the District hospital, where a team of specialists is formed, all of them previously well trained in the recognition and treatment of radiation sickness. The third step is the specialized clinic for radiation injuries. Persons, who have received irradiation dose of up to 100 rad, or are in a shock state, or have incorporated radioactive substances, are temporarily hospitalized at the health centre. The assistance rended to them consists of: control of shock, asphyxia and bleeding, primary surgical treatment of wounds in cases of complex injuries, deactivation under dosimetric control, attempt for accelerated removal of the radioactive substances, etc. At the District hospital and the specialized clinic the therapeutic measures are conformed to the pathogenetic mechanism and severity of clinical symptoms, and their dynamics. Their aim is first of all to block the earlier radiation effects, to prevent and to treat the haemorrhagic phenomena and infectious complications, to restore the activity of the blood organs, etc. (A.B.)

  20. Buprenorphine implants in medical treatment of opioid addiction.

    Science.gov (United States)

    Chavoustie, Steven; Frost, Michael; Snyder, Ole; Owen, Joel; Darwish, Mona; Dammerman, Ryan; Sanjurjo, Victoria

    2017-08-01

    Opioid use disorder is a chronic, relapsing disease that encompasses use of both prescription opioids and heroin and is associated with a high annual rate of overdose deaths. Medical treatment has proven more successful than placebo treatment or psychosocial intervention, and the partial µ-opioid receptor agonist and κ-opioid receptor antagonist buprenorphine is similar in efficacy to methadone while offering lower risk of respiratory depression. However, frequent dosing requirements and potential for misuse and drug diversion contribute to significant complications with treatment adherence for available formulations. Areas covered: This review describes the development of and preliminary data from clinical trials of an implantable buprenorphine formulation. Efficacy and safety data from comparative studies with other administrations of buprenorphine, including tablets and sublingual film, will be described. Key premises of the Risk Evaluation and Mitigation Strategy program for safely administering buprenorphine implants, which all prescribing physicians must complete, are also discussed. Expert commentary: Long-acting implantable drug formulations that offer consistent drug delivery and lower risk of misuse, diversion, or accidental pediatric exposure over traditional formulations represent a promising development for the effective treatment of opioid use disorder.

  1. Use of medications and resources for treatment of nausea, vomiting, or constipation in hospitalized patients treated with analgesics.

    Science.gov (United States)

    Suh, Dong-Churl; Kim, Myoung S; Chow, Wing; Jang, Eun-Jin

    2011-01-01

    Hospitalized patients often experience adverse events of the gastrointestinal tract due to analgesic treatment. The objectives of this study were to estimate use of medications for treatment of nausea, vomiting, or constipation (NVC medications) after initiation of analgesic treatment, and to compare differences in length of stay and treatment costs between patients who received NVC medications and those who did not. This retrospective cohort study used the Premier Perspective data from January 1, 2005 to December 31, 2007 and stratified inpatients into 4 groups based on the first analgesic agent they were given. Patients were observed for 14 days after the first analgesic use until a regimen change, first use of NVC medication, or hospital discharge, whichever occurred first. Data were analyzed using a Cox proportional hazards model and a generalized linear model. This study found that 239,183 (55.1%) of 434,304 patients received NVC medications after analgesic administration. Compared with oral nonopioid analgesics, the risk of using NVC medication was 4.8 times higher for injectable opioid analgesics after controlling for confounders. Patients who received NVC medications were hospitalized 0.26 days longer (P hospital resources.

  2. [Analysis of medical cost of atlantoaxial disorders in patients receiving innovated treatment technologies].

    Science.gov (United States)

    Wu, Yunxia; Liu, Zhongjun

    2016-01-19

    To explore the effects of innovated technologies and products on improving outcomes and decreasing medical costs by analyzing a total and subtotal medical costs of patients with atlantoaxial disorders. The medical costs of 1 489 patients with atlantoaxial disorders from Peking University Third Hospital from 2005 to 2014, who received innovated technologies and products treatment were retrospectively analyzed and compared.Descriptive analysis and ANOVA were used for statistical analysis, and SPSS 19.0 was used to analyze data. From 2005 to 2014, under the situation of a general increase in medical cost by 327%, the total medical costs were stable for patients who used innovated technologies and products for treatment, fluctuating from 20 851 in 2005 to 20 878 in 2014; however, the cases of operation increased year by year, from 88 in 2005 to 163 in 2014; the average length of stay decreased from 21 in 2005 to 10 in 2014; the total cases of transfusion were 22 from 2005 to 2014; the safety, stability and feasibility of the innovated technologies and products were illustrated through the decrease of average length of stay, the reduction of bleeding and the significance of outcomes. It is illustrated that the innovated technologies and products not only decrease patients' suffering and medical costs but also are safe, stable and feasible.

  3. Polarized ensembles of random pure states

    International Nuclear Information System (INIS)

    Cunden, Fabio Deelan; Facchi, Paolo; Florio, Giuseppe

    2013-01-01

    A new family of polarized ensembles of random pure states is presented. These ensembles are obtained by linear superposition of two random pure states with suitable distributions, and are quite manageable. We will use the obtained results for two purposes: on the one hand we will be able to derive an efficient strategy for sampling states from isopurity manifolds. On the other, we will characterize the deviation of a pure quantum state from separability under the influence of noise. (paper)

  4. [Αnti-Inflammatory medication as adjunctive antidepressive treatment].

    Science.gov (United States)

    Boufidou, F; Nikolaou, C

    2016-01-01

    Mounting data of evidence that have emerged during the last twenty years, point towards the existence of an inflammatory mechanism underlying the pathophysiology of depressive disorder. These data have inspired a number of clinical studies characterized by the administration of inflammatory response altering medication in addition to conventional medication in depressive disorder patients. The drugs were either Non Steroid Anti-inflammatory Drugs (NSAIDs) or Tumor Necrosis Factor-alpha (TNFa) inhibitors and were selected among those that are already in use for various diseases related to the immune system. The choice of these specific immunomodulatory agents for the co-administration with conventional antidepressive medication was based on a number of laboratory data and clinical evidence. A total of seven relevant clinical trials have been conducted, all of them with promising results that have been published between 2006 and 2013. However, only four out of them were eligibly designed regarding the homogeneity of the study groups, randomization, double-blinding and placebo controlling. These three studies showed clinical advantages of the adjunctive medication as estimated by significant drops in Hamilton scores. Of interest are the findings of the most recent and largest clinical trial of the TNF-a antagonist infliximab which show that treatment with anti-inflammatory agents may be beneficial only in depressive patients with raised levels of baseline inflammatory markers. A limitation of the studies was that, since no guidelines currently exist for anti-inflammatory agents and depression, adjunctive medication could have been under or overdosed. Other limitations were the follow-up period that was rather small and the number of the participants that was also small. Recently, a lot of progress has been made in identifying therapeutic targets along metabolic pathways in the brain relevant to depression, which could be manipulated by immune mediators. In fact

  5. The use of antipsychotic medication in child and adolescent psychiatric treatment in Denmark. A cross-sectional survey

    DEFF Research Database (Denmark)

    Deurell, Maria; Weischer, Merete; Pagsberg, Anne Katrine

    2008-01-01

    for patients in antipsychotic treatment were: schizophrenia, schizotypal disorder, autism spectrum disorders and personality disorders. Monotherapy was used in 87% of cases. Sixty-four per cent of patients treated with antipsychotics, received a second-generation antipsychotic as the main treatment. All 244......The number of children and adolescents with psychiatric disorders being treated with antipsychotic medication is increasing significantly; however, only a limited evidence-base is available on this topic, especially when children are concerned. This study reports and discusses the use...... patients received one or more additional treatment modalities other than medication. Antipsychotic medication has a definite role in the treatment of children and adolescents with psychiatric disorders. Second-generation antipsychotics used as monotherapy prevail....

  6. Treatment outcome of alcohol use disorder outpatients with or without medically assisted detoxification

    NARCIS (Netherlands)

    Merkx, Maarten J. M.; Schippers, Gerard M.; Koeter, Maarten W. J.; de Wildt, Wencke A. J. M.; Vedel, Ellen; Goudriaan, Anna E.; van den Brink, Wim

    2014-01-01

    Little is known about the incremental effects of medically assisted detoxification on outpatient treatment for alcohol use disorders. The objective of this study was to compare drinking outcomes in a psychosocial treatment program between two groups of heavy drinking patients who had an alcohol use

  7. Manual therapy intervention in the treatment of patients with carpal tunnel syndrome: median nerve mobilization versus medical treatment

    Directory of Open Access Journals (Sweden)

    Faten I Mohamed

    2016-01-01

    Conclusion CTS improves after median nerve mobilization, which is better than conventional medical treatment. It provides support for the use of manual therapy in conservative management of CTS with satisfactory Results .

  8. Medical cost of Lassa fever treatment in Irrua Specialist Teaching ...

    African Journals Online (AJOL)

    This cross-sectional study sought to estimate the direct medical cost of Lassa fever treatment on patients in South-South Nigeria. All the 73 confirmed Lassa fever cases admitted in the isolation ward of the Institute Of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital (ISTH) Irrua, in Edo State, Nigeria, ...

  9. Diagnosis and treatment of cancer in medical textbooks of ancient Iran.

    Science.gov (United States)

    Tabatabaei, Seyed Mahmoud; Ali Tabatabaei, Seyed Mohammad

    2014-01-01

    Research shows that ancient Iranians were among the pioneers of medical science, and are therefore admired and praised by non-Iranian scholars for their efforts and accomplishments in this field. Investigations of medical and historical texts indicate that between the 10(th) and the 18(th) century A.D., ancient Iran experienced a golden age of medicine. Great physicians such as Rhazes, al-Ahwazi, Avicenna and others reviewed the medical textbooks of civilizations such as Greece and India, Theories were scientifically criticized, superstitious beliefs were discarded, valuable innovations were added to pre-existing knowledge and the ultimate achievements were compiled as precious textbooks. Alhawi by Rhazes, Cannon by Avicenna, and Kamil al-Sina'ah by al-Ahwazi are among the works that were treasured by domestic and foreign scientists alike, as well as future generations who continued to appreciate them for centuries. The above-mentioned textbooks discuss diseases and conditions related to neurosurgery, ophthalmology, ear, nose and throat, gastroenterology, urology, skeletomuscular system and other specialties, as well as cancer and similar subjects. One of the richest texts on the description, diagnosis, differential diagnosis, and prognosis of cancer and therapeutic approaches is Alhawi by Mohammad ibn Zakarya al Razi (Rhazes). This article presents a brief summary of Rhazes' views about the definition of cancer, types, signs and symptoms, prevalence, complications, medical care, treatment and even surgical indications and contraindications. Moreover, his opinions are compared against the views of other physicians and theories of modern medicine. It is also recommended to review the medical heritage of Iran and evaluate the proposed treatments based on modern methodologies and scientific approaches.

  10. Only for “purely scientific” institutions: the Medical Library Association's Exchange, 1898–1950s

    Science.gov (United States)

    Connor, Jennifer J

    2011-01-01

    Objective: Centralized exchanges of scientific materials existed by the late nineteenth century, but they did not include medical publications. North American medical leaders therefore formed an association of institutions to run their own exchange: the Medical Library Association (MLA). After providing background to the exchange concept and the importance of institutional members for MLA, this article examines archival MLA correspondence to consider the role of its Exchange in the association's professional development before the 1950s. Results: MLA's membership policy admitted only libraries open to the medical profession with a large number of volumes. But the correspondence of the MLA Executive Committee reveals that the committee constantly adjusted the definition of library membership: personal, public, sectarian, commercial, allied science, and the then-termed “colored” medical school libraries all were denied membership. Conclusion: Study of these decisions, using commercial and sectarian libraries as a focus, uncovers the primary justification for membership exclusions: a goal of operating a scientific exchange. Also, it shows that in this way, MLA shadowed policies and actions of the American Medical Association. Finally, the study suggests that the medical profession enforced its policies of exclusion through MLA, despite a proclaimed altruistic sharing of medical literature. PMID:21464849

  11. Discussion of feasibility to carry out intensity modulated radiation therapy in conventional medical electron linear accelerator treatment rooms

    International Nuclear Information System (INIS)

    Yang Haiyou; Liu Liping; Liang Yueqin; Zhang Liang; Yu Shui

    2010-01-01

    Objective: To investigate the feasibility about the shielding effect of conventional medical electron linear accelerator treatment in the existing rooms to carry out intensity modulated radiation therapy (IMRT). Methods: The estimation model given in NCRP REPORT No. 151- S tructural Shielding Design and Evaluation for Megavoltage X-and Gamma-Ray Radiotherapy Facilities i s adopted by linking instances, which presents the calculation methods on radiation level at the ambience of megavoltage medical electron linear accelerator treatment room. Results: The radiation level, as well as the additional annual effect dose of occupational and public at the ambience of accelerator treatment room, in crease to a certain extent, when conventional medical electron linear accelerator treatment room; are used to carry out IMRT. Conclusion: It is necessary to make environmental impact assessment for conventional medical electron linear accelerator treatment rooms, which will be used to execute IMRT. (authors)

  12. Tensor modes in pure natural inflation

    Science.gov (United States)

    Nomura, Yasunori; Yamazaki, Masahito

    2018-05-01

    We study tensor modes in pure natural inflation [1], a recently-proposed inflationary model in which an axionic inflaton couples to pure Yang-Mills gauge fields. We find that the tensor-to-scalar ratio r is naturally bounded from below. This bound originates from the finiteness of the number of metastable branches of vacua in pure Yang-Mills theories. Details of the model can be probed by future cosmic microwave background experiments and improved lattice gauge theory calculations of the θ-angle dependence of the vacuum energy.

  13. Method of producing vegetable puree

    DEFF Research Database (Denmark)

    2004-01-01

    A process for producing a vegetable puree, comprising the sequential steps of: a)crushing, chopping or slicing the vegetable into pieces of 1 to 30 mm; b) blanching the vegetable pieces at a temperature of 60 to 90°C; c) contacted the blanched vegetable pieces with a macerating enzyme activity; d......) blending the macerated vegetable pieces and obtaining a puree....

  14. Effects of deep cryogenic treatment on the microstructure and mechanical properties of commercial pure zirconium

    Energy Technology Data Exchange (ETDEWEB)

    Yuan, Chao; Wang, Yunpeng; Sang, Deli; Li, Yijun; Jing, Lei; Fu, Ruidong, E-mail: rdfu@ysu.edu.cn; Zhang, Xiangyi

    2015-01-15

    Highlights: • The microstructure and mechanical properties of DCT-treated Zr were investigated. • DCT induced a change in grain orientation and improved internal stress. • Changes in grain orientation and internal stress increased dislocation density. • Hardness in basal planes was significantly larger than that in prism planes. • Strength levels were high and good ductility could still be achieved after DCT. - Abstract: The effects of deep cryogenic treatment (DCT) on the microstructure and mechanical properties of commercial pure zirconium were investigated. Experimental results indicated that DCT induced a change in grain orientation and improved internal stress, which in turn increased dislocation density that led to improved hardness. Hardness in basal planes was found to be significantly larger than that in prism planes. Moreover, strength was enhanced in DCT-treated zirconium and the ductility was comparable to that of as-annealed zirconium. This phenomenon was due to the increase in dislocation density and the good ductility resulting from the motion of pre-existing dislocations and specific dislocation configurations. DCT led to the transformation of tensile fracture mode from mixed-rupture characteristics of quasi-cleavage and dimples to quasi-cleavage, thereby increasing compatible deformation capabilities. The possible mechanisms underlying microstructural modification, tensile strength, and hardness improvement were discussed.

  15. Effects of deep cryogenic treatment on the microstructure and mechanical properties of commercial pure zirconium

    International Nuclear Information System (INIS)

    Yuan, Chao; Wang, Yunpeng; Sang, Deli; Li, Yijun; Jing, Lei; Fu, Ruidong; Zhang, Xiangyi

    2015-01-01

    Highlights: • The microstructure and mechanical properties of DCT-treated Zr were investigated. • DCT induced a change in grain orientation and improved internal stress. • Changes in grain orientation and internal stress increased dislocation density. • Hardness in basal planes was significantly larger than that in prism planes. • Strength levels were high and good ductility could still be achieved after DCT. - Abstract: The effects of deep cryogenic treatment (DCT) on the microstructure and mechanical properties of commercial pure zirconium were investigated. Experimental results indicated that DCT induced a change in grain orientation and improved internal stress, which in turn increased dislocation density that led to improved hardness. Hardness in basal planes was found to be significantly larger than that in prism planes. Moreover, strength was enhanced in DCT-treated zirconium and the ductility was comparable to that of as-annealed zirconium. This phenomenon was due to the increase in dislocation density and the good ductility resulting from the motion of pre-existing dislocations and specific dislocation configurations. DCT led to the transformation of tensile fracture mode from mixed-rupture characteristics of quasi-cleavage and dimples to quasi-cleavage, thereby increasing compatible deformation capabilities. The possible mechanisms underlying microstructural modification, tensile strength, and hardness improvement were discussed

  16. Successful medical treatment of glans ischemia after voluntary buprenorphine injection.

    Science.gov (United States)

    Brecheteau, François; Grison, Pierre; Abraham, Pierre; Lebdai, Souhil; Kemgang, Steve; Souday, Vincent; Nedelcu, Cosmina; Culty, Thibaut; Larré, Stéphane; Azzouzi, Abdel Rahmene; Bigot, Pierre

    2013-11-01

    The diverted use of synthetic opioid buprenorphine by drug addicts can be responsible for serious ischemic and infectious complications, particularly in the case of intravenous injection. We present a case of serious glans ischemia after buprenorphine injection directly into the deep dorsal vein of the penis. Analysis using new medical imaging techniques and treatments is detailed below. A 26-year-old male drug addict presented with glans pain 4 days after self-injection of buprenorphine into the deep dorsal vein of the penis. The patient was apyretic and presented a urethral discharge. His glans was blue without discoloration on digital pressure. Additionally, his biologic and serologic tests were normal while bacteriology showed the presence of Enterobacter cloacae urethritis. After 48 hours of intravenous antibiotic treatment without improvement, a specific medical treatment using enoxaparin and ilomedin was initiated, with the assumption that there was an ischemic complication. Laser speckle contrast imaging allowed confirmation of the presence of distal penis ischemia and provided an accurate mapping of the ischemic zone. A 28-day treatment combining antibiotics, subcutaneous heparin at curative dose, antiplatelet drug, ilomedin, and hyperbaric oxygen therapy resulted in clinical improvement of the lesions with no functional complications. To date, no consensus exists on the proper diagnostic and treatment approach to severe glans ischemia due to buprenorphine injection into the deep dorsal vein of the penis. The results of laser speckle contrast imaging were of real interest during the process of diagnosis. In addition, the combination of ilomedin with hyperbaric oxygen therapy and anticoagulant and antiplatelet drugs appeared to be an effective therapy. © 2013 International Society for Sexual Medicine.

  17. Treatment Patterns Associated with ACR-Recommended Medications in the Management of Fibromyalgia in the United States.

    Science.gov (United States)

    Liu, Yifei; Qian, Chunlin; Yang, Mei

    2016-03-01

    Fibromyalgia (FM) affects up to 6% of U.S. adults, resulting in a significant burden on the health care system and poor quality of life for patients. Duloxetine, pregabalin, and milnacipran are approved for management of FM; however, consensus is lacking regarding optimal therapy. Patients with FM taking approved medications often do not experience meaningful symptom relief, and many experience intolerable adverse events. To assess treatment patterns associated with available and commonly used medications for the management of FM using U.S. health insurance claims. This retrospective analysis used the MarketScan claims database to identify adults with a first diagnosis of FM (ICD-9-CM code 729.1) between 2009 and 2011 with continuous health plan enrollment for 12 months pre- and post-index. Medications of interest were pregabalin, gabapentin, duloxetine, milnacipran, cyclobenzaprine, and tramadol. These are 6 of the 8 medications recommended by the American College of Rheumatology (ACR) for treating FM; the other 2 (amitriptyline and venlafaxine) were only included in some initial assessments. The Charlson Comorbidity Index (CCI) was used to assess overall comorbidity burden. Endpoints included proportion of patients treated within 1 year after first diagnosis; initial treatment pattern; adherence over the first-year follow-up period for the medications of interest; and discontinuation, switching, and combination therapy patterns among pain medications of interest at different time points. Proportion of days covered (PDC; defined as number of days in the period when the patient had drug supply divided by the number of days in the period) was used to define adherence, which was categorized as low (PDC time to discontinuation (defined as the first drug supply gap ≥ 90 days) was estimated using Kaplan-Meier analysis. Overall, 240,144 patients met the inclusion criteria. Patients were predominantly women (68%), had preferred provider organization insurance coverage

  18. Proposal of a model for multidisciplinary treatment program of chronic migraine with medication overuse: preliminary study.

    Science.gov (United States)

    Grazzi, L; Prunesti, A; Bussone, G

    2015-05-01

    The treatment of patients with chronic migraine associated with medication overuse is challenging in clinical practice; different strategies of treatment have been recently developed, multidisciplinary treatment approaches have been developed in academic headache centers. Education and support of patients are necessary to improve patients' adherence to pharmacological treatments as well as to non-pharmacological therapies. This study reports a clinical experience conducted at our Headache center with a group of female patients, suffering from chronic migraine complicated by medication overuse, treated by a multidisciplinary approach and followed for a period of 1 year after withdrawal. Results confirm the efficacy of a multifaceted treatment to manage this problematic category of patients.

  19. Perceived Relapse Risk and Desire for Medication Assisted Treatment among Persons Seeking Inpatient Opiate Detoxification

    Science.gov (United States)

    Bailey, Genie L; Herman, Debra S.; Stein, Michael D.

    2016-01-01

    Most patients with opioid addiction do not receive medication at the time of discharge from brief inpatient detoxification programs despite the high risk of relapse and the availability of three FDA-approved medications. We surveyed 164 inpatient opioid detoxification patients to assess desire for pharmacotherapy following detoxification program discharge. Participants were predominantly male (71.3%) and 80% had detoxed in the past. Reporting on their most recent previous inpatient detoxification, 27% had relapsed the day they were discharged, 65% within a month of discharge, and 90% within a year of discharge. 63% reported they wanted medication-assisted treatment (MAT) after discharge from the current admission. The odds of desiring a treatment medication increased by a factor of 1.02 for every 1% increase in perceived relapse risk (p detox abstinence. PMID:23786852

  20. Medical complications of anorexia nervosa and their treatments: an update on some critical aspects.

    Science.gov (United States)

    Brown, Carrie; Mehler, Philip S

    2015-12-01

    Anorexia nervosa has the highest mortality rate of any psychiatric disorder. Many of the deaths are attributable to medical complications which arise as the malnutrition and weight loss worsens. Every body system may be adversely affected by anorexia nervosa. Yet, remarkably, most of the medical complications of anorexia nervosa are treatable and reversible with optimal medical care, as part of a multidisciplinary team who are often involved in the care of these patients. Herein, we will describe the medical complications of anorexia nervosa and their treatments.

  1. ActionScript Developer's Guide to PureMVC

    CERN Document Server

    Hall, Cliff

    2011-01-01

    Gain hands-on experience with PureMVC, the popular open source framework for developing maintainable applications with a Model-View-Controller architecture. In this concise guide, PureMVC creator Cliff Hall teaches the fundamentals of PureMVC development by walking you through the construction of a complete non-trivial Adobe AIR application. Through clear explanations and numerous ActionScript code examples, you'll learn best practices for using the framework's classes in your day-to-day work. Discover how PureMVC enables you to focus on the purpose and scope of your application, while the f

  2. Application countermeasures of non-incineration technologies for medical waste treatment in China.

    Science.gov (United States)

    Chen, Yang; Ding, Qiong; Yang, Xiaoling; Peng, Zhengyou; Xu, Diandou; Feng, Qinzhong

    2013-12-01

    By the end of 2012, there were 272 modern, high-standard, centralized medical waste disposal facilities operating in various cities in China. Among these facilities nearly 50% are non-incineration treatment facilities, including the technologies of high temperature steam, chemical disinfection and microwave. Each of the non-incineration technologies has its advantages and disadvantages, and any single technology cannot offer a panacea because of the complexity of medical waste disposal. Although non-incineration treatment of medical waste can avoid the release of polychlorinated dibenzo-p-dioxins/dibenzofurans, it is still necessary to decide how to best meet the local waste management needs while minimizing the impact on the environment and public health. There is still a long way to go to establish the sustainable application and management mode of non-incineration technologies. Based on the analysis of typical non-incineration process, pollutant release, and the current tendency for technology application and development at home and abroad, this article recommends the application countermeasures of non-incineration technologies as the best available techniques and best environmental practices in China.

  3. Hypnosis in Spain (1888-1905): from spectacle to medical treatment of mediumship.

    Science.gov (United States)

    Graus, Andrea

    2014-12-01

    Towards the end of the nineteenth century, some Spanish physicians sought to legitimize hypnotherapy within medicine. At the same time, hypnotism was being popularized among the Spanish population through stage hypnosis shows. In order to extend the use of medical hypnotherapy, some physicians made efforts to demarcate the therapeutic use of hypnotic suggestion from its application for recreational purposes, as performed by stage hypnotists. However, in the eyes of some physicians, the first public session to legitimize hypnotherapy turned out to be a complete failure due to its similarities with a stage hypnosis performance. Apart from exploring this kind of hitherto little-known historical cases, we explore the role of spiritists in legitimizing medical hypnosis. At a time when Spanish citizens were still reluctant to accept hypnotherapy, the spiritists sponsored a charitable clinic where treatment using hypnosis was offered. We conclude that the clinic was effective in promoting the use of hypnotherapy, both among physicians as clinical practice, and as a medical treatment for patients from the less privileged classes of Spanish society. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. The effect of medical treatments on stroke risk in asymptomatic carotid stenosis.

    Science.gov (United States)

    King, Alice; Shipley, Martin; Markus, Hugh

    2013-02-01

    Recent evidence suggests current best medical treatment may be sufficient to prevent stroke in patients with asymptomatic carotid stenosis. If this is the case, then it is important to determine risk reduction provided by treatments. Using Asymptomatic Carotid Emboli Study (ACES) prospective data, the effect of current treatment and risk factors on future stroke and transient ischemic attack risk were determined. Four-hundred seventy-seven patients with asymptomatic carotid stenosis were followed-up every 6 months for 2 years. Changes in risk factors and stroke prevention therapies were reviewed at each visit. Using time-dependent Cox regression, the relationship between current treatment over time was determined and presented as hazard ratios and 95% confidence intervals for risk of stroke, transient ischemic attack, and cardiovascular death end points. On multivariate analysis, antiplatelets (P=0.001) and lower mean blood pressure (P=0.002) were independent predictors of reduced risk of ipsilateral stroke and transient ischemic attack. Antiplatelets (Pstroke or cardiovascular death. Antiplatelet therapy and blood pressure control are the most important factors in reducing short-term stroke and cardiovascular risk in patients with asymptomatic carotid stenosis. More prospective data are required for medical treatments in asymptomatic carotid stenosis in particular for current statin usage.

  5. Osteopathic manipulative treatment for self-reported fatigue, stress, and depression in first-year osteopathic medical students.

    Science.gov (United States)

    Wiegand, Sarah; Bianchi, William; Quinn, Thomas A; Best, Mark; Fotopoulos, Thomas

    2015-02-01

    During medical education, many students experience psychological distress, including symptoms such as fatigue, stress, and depression. To evaluate the effect of osteopathic manipulative treatment (OMT) on self-perceived fatigue, stress, and depression in first-year osteopathic medical students. This randomized controlled pilot study with repeated measures was conducted at the Lake Erie College of Osteopathic Medicine-Bradenton in Florida during the fall 2012 semester. First-year osteopathic medical students voluntarily enrolled in the study and were randomly assigned to directed OMT (D-OMT), nondirected OMT (ND-OMT), or control groups. The D-OMT and ND-OMT groups received treatment by osteopathic physicians weekly for 4 weeks. The control group received no treatment. All groups completed the Epworth Sleepiness Scale (ESS), the Self-Perceived Stress Scale (SPSS), and the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire 9 (PHQ-9) depression scale before treatment (pretest), after 2 treatments (midtest), and after 4 treatments (posttest). All participants self-reported as white and single, with both sexes equally represented, and had an mean age of 24 years. Analysis of ESS scores revealed a statistically significant decrease in the D-OMT group from pretest and posttest scores and a statistically significant increase in the ND-OMT group from pretest to midtest but not from pretest to posttest scores. No statistically significant differences were noted in the control group scores on this measure. No statistically significant differences were seen in the SPSS or PHQ-9 scores from pretest to midtest or pretest to posttest in any of the 3 groups. The D-OMT regimen used in the current study produced a statistically significant decrease in self-perceived fatigue in first-year osteopathic medical students. Osteopathic manipulative treatment represents a potential modality to reduce self-perceived distress in medical students. Further research is

  6. Medical and surgical treatment of idiopathic granulomatous lobular mastitis: a benign inflammatory disease mimicking invasive carcinoma.

    Science.gov (United States)

    Gurleyik, Gunay; Aktekin, Ali; Aker, Fugen; Karagulle, Hikmet; Saglamc, Abdullah

    2012-03-01

    Idiopathic granulomatous lobular mastitis (IGLM) is a rare chronic inflammatory disease of the breast with obscure etiology that mimics invasive carcinoma both clinically and radiologically. The treatment of IGLM remains controversial. The aim of proper management is to use a combination of medical and surgical treatment of this benign condition to achieve a good cosmetic result and low recurrence rate. A retrospective analysis of 19 patients with IGLM is performed based on the findings of clinical, radiological, and pathological examinations. The results of two treatments are presented: medical treatment with oral corticosteroids, and consecutive surgical excision after a follow-up period of 20 months (range, 6-75 months). The majority of patients treated in this paper were young (mean, 34 years) parous women with a history of hormonal medication use. The main clinical finding is large, irregular, and painful mass. Hypoechoic lobulated, irregular tubular or oval shaped masses had been imaged by ultrasound. Mammographic findings were an ill-defined mass, enlarged axillary lymph nodes, asymmetric density, and architectural distortion. Diagnoses of IGLM had been established by cytological or histological examination. Symptoms subside and inflammatory changes regressed with medical treatment. The remaining lesions were excised by consecutive breast conserving surgery. The disease recurred in one patient during the follow-up period. IGLM is an inflammatory breast disease found in young women who present with a large painful irregular mass, which mimics carcinoma, as a physical change. Breast imaging modalities are not helpful to differentiate IGLM from invasive cancer. The correct diagnosis is established by cytological or histological examination. Medical treatment with corticosteroids provides significant regression of the inflammatory disease, allowing more conservative surgery. Consecutive surgical excision of the remaining lesions with good cosmetic results

  7. Assessing Need for Medication-Assisted Treatment for Opiate-Dependent Prison Inmates

    Science.gov (United States)

    Albizu-García, Carmen E.; Caraballo, José Noel; Caraballo-Correa, Glorimar; Hernández-Viver, Adriana; Román-Badenas, Luis

    2012-01-01

    Individuals with a history of heroin dependence are overrepresented in American correctional facilities and 75% of inmates with a drug use disorder do not receive treatment during incarceration or after release. Medication-assisted treatment (MAT) with opiate agonists, such as methadone or buprenorphine, constitute standard of care; to guide planning for an expansion of drug treatment services in correctional facilities, a needs assessment was conducted at the Department of Correction and Rehabilitation (DCR) of Puerto Rico (PR). We report on the research process, the findings that informed our recommendations for the PCR to expand MAT for eligible inmates, and lessons learned. PMID:22263714

  8. Medical Negligence : An Overview

    Directory of Open Access Journals (Sweden)

    Bratin Kumar Dey

    2017-04-01

    Full Text Available Medical professionals are treated as next to God. They provide humanitarian services and gives solace to individuals suffering from various diseases and disorders. Due to their great service to humanity, the doctors and medical professionals are treated with reverence and since the ancient times the medical profession has been considered as a noble profession. However with the passage of time, there has been a change in the doctor - patient relationship. During the last few decades a number of incidents have come to light in which the patients have suffered due to the error and inadvertent conduct of doctors. Due to the increasing conflicts and legal disputes between the doctors and patients, most of the legal systems have developed various rules and principles to deal with such inadvertent behavior of doctors. This has led to the development of a new branch of jurisprudence, i.e. medical negligence. Hence, any negligence on part of the medical professional would be treated as either a tort of negligence or a deficiency in service under Consumer Protection Act, 1986. As the profession involves the idea of an occupation requiring purely intellectual skills or of manual skills controlled by the intellectual skill of the operator, it is distinctively different from an occupation, which is substantially production or sale or arrangement for the production or sale of commodities. Medicine is a highly complex domain. It is difficult for consumer laws to review medical negligence cases with flawless technical clarity and accuracy. Thus medical negligence is not purely a matter of consideration for judiciary but also the technical inputs of specialized experts in the field have substantial weightage while deciding the case of medical negligence against doctors. The present paper is devoted to introvert inspection of negligence in medical profession in the light of existing laws with more emphasis on the interpretation of consumer protection law by

  9. Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities.

    Science.gov (United States)

    Jakobsen, Gunn Signe; Småstuen, Milada Cvancarova; Sandbu, Rune; Nordstrand, Njord; Hofsø, Dag; Lindberg, Morten; Hertel, Jens Kristoffer; Hjelmesæth, Jøran

    2018-01-16

    The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain. To compare changes in obesity-related comorbidities in patients with severe obesity (body mass index ≥40 or ≥35 and at least 1 comorbidity) undergoing bariatric surgery or specialized medical treatment. Cohort study with baseline data of exposures from November 2005 through July 2010 and follow-up data from 2006 until death or through December 2015 at a tertiary care outpatient center, Vestfold Hospital Trust, Norway. Consecutive treatment-seeking adult patients (n = 2109) with severe obesity assessed (221 patients excluded and 1888 patients included). Bariatric surgery (n = 932, 92% gastric bypass) or specialized medical treatment (n = 956) including individual or group-based lifestyle intervention programs. Primary outcomes included remission and new onset of hypertension based on drugs dispensed according to the Norwegian Prescription Database. Prespecified secondary outcomes included changes in comorbidities. Adverse events included complications retrieved from the Norwegian Patient Registry and a local laboratory database. Among 1888 patients included in the study, the mean (SD) age was 43.5 (12.3) years (1249 women [66%]; mean [SD] baseline BMI, 44.2 [6.1]; 100% completed follow-up at a median of 6.5 years [range, 0.2-10.1]). Surgically treated patients had a greater likelihood of remission and lesser likelihood for new onset of hypertension (remission: absolute risk [AR], 31.9% vs 12.4%); risk difference [RD], 19.5% [95% CI, 15.8%-23.2%], relative risk [RR], 2.1 [95% CI, 2.0-2.2]; new onset: AR, 3.5% vs 12.2%, RD, 8.7% [95% CI, 6.7%-10.7%], RR, 0.4 [95% CI, 0.3-0.5]; greater likelihood of diabetes remission: AR, 57.5% vs 14.8%; RD, 42.7% [95% CI, 35.8%-49.7%], RR, 3.9 [95% CI, 2.8-5.4]; greater risk of new-onset depression: AR, 8.9% vs 6.5%; RD, 2.4% [95% CI, 1.3%-3.5%], RR, 1.5 [95% CI, 1.4-1.7]; and

  10. Usefulness of Pure Laparoscopic Hepatectomy for Hepatocellular Carcinoma in a Severely Cirrhotic Patient

    Directory of Open Access Journals (Sweden)

    Isamu Hosokawa

    2013-07-01

    Full Text Available The number of patients undergoing laparoscopic hepatectomy has rapidly increased in recent years, and indications for this procedure are gradually expanding. Pure laparoscopic hepatectomy is reportedly useful in cases with severe liver cirrhosis. A 55-year-old woman under observation for liver cirrhosis was found to have hepatocellular carcinoma in liver segment III and was referred to our hospital for surgery. The tumor was located in the edge of liver segment III, where percutaneous ablation therapy was unsuitable. Since her hepatic functional reserve was poor, pure laparoscopic partial hepatectomy was performed. The postoperative course was favorable, with no ascites retention, edema or weight gain. The greatest advantage of pure laparoscopic hepatectomy for hepatocellular carcinoma with concomitant liver cirrhosis is that postoperative ascites retention is minimal, meaning that there is little risk of water-electrolyte imbalance associated with ascites retention or hypoproteinemia. This is believed to be because the abdominal incision is small and mobilization of the liver is minimized, reducing the destruction of the routes of collateral lymph flow and blood flow generated in patients with liver cirrhosis. Pure laparoscopic hepatectomy may be a treatment choice for patients with hepatocellular carcinoma and concomitant severe liver cirrhosis.

  11. Are medical treatments for individuals and groups like single-play and multiple-play gambles?

    Directory of Open Access Journals (Sweden)

    Michael L. DeKay

    2006-11-01

    Full Text Available People are often more likely to accept risky monetary gambles with positive expected values when the gambles will be played more than once. We investigated whether this distinction between single-play and multiple-play gambles extends to medical treatments for individual patients and groups of patients. Resident physicians and medical students (extit{n} = 69 and undergraduates (extit{n} = 99 ranked 9 different flu shots and a no-flu-shot option in 1 of 4 combinations of perspective (individual patient vs. group of 1000 patients and uncertainty frame (probability vs. frequency. The rank of the no-flu-shot option (a measure of preference for treatment vs. no treatment was not significantly related to perspective or participant population. The main effect of uncertainty frame and the interaction between perspective and uncertainty frame approached significance (0.1 {extgreater} extit{p} {extgreater} 0.05, with the no-flu-shot option faring particularly poorly (treatment faring particularly well when decisions about many patients were based on frequency information. Undergraduate participants believed that the no-flu-shot option would be less attractive (treatment would be more attractive in decisions about many patients, but these intuitions were inconsistent with the actual ranks. These results and those of other studies suggest that medical treatments for individuals and groups are not analogous to single-play and multiple-play monetary gambles, perhaps because many people are unwilling to aggregate treatment outcomes over patients in the same way that they would compute net gains or losses over monetary gambles.

  12. [Therapy of fatigue in multiple sclerosis : A treatment algorithm].

    Science.gov (United States)

    Veauthier, C; Paul, F

    2016-12-01

    Fatigue is one of the most frequent symptoms of multiple sclerosis (MS) and one of the main reasons for underemployment and early retirement. The mechanisms of MS-related fatigue are unknown but comorbid disorders play a major role. Anemia, diabetes, side effects of medication and depression should be ruled out. Moreover, excessive daytime sleepiness (EDS) should be differentiated from fatigue. No approved medicinal therapy of MS fatigue is currently available. Presentation of current treatment strategies with a particular focus on secondary fatigue due to sleep disorders. A review of the literature was carried out. All MS patients suffering from fatigue should be questioned with respect to EDS and if necessary sleep medical investigations should be carried out; however, pure fatigue without accompanying EDS can also be caused by a sleep disorder. Medications, particularly freely available antihistamines, can also increase fatigue. Furthermore, anemia, iron deficits, diabetes and hypothyroidism should be excluded. Self-assessment questionnaires show an overlap between depression and fatigue. Several studies have shown that cognitive behavioral therapy and various psychotherapeutic measures, such as vertigo training, progressive exercise training and individualized physiotherapy as well as fatigue management interventions can lead to a significant improvement of MS-related fatigue. There is currently no medication which is suitable for treatment of fatigue, with the exception of fampridine for the treatment of motor functions and motor fatigue.

  13. Treatment outcomes of overweight children and parents in the medical home

    Science.gov (United States)

    Background Experience treating young obese children in the Patient Center Medical Home (PCMH) is lacking. We have shown in the PCMH that after 6 months concurrent treatment of overweight children and their overweight parents (Intervention) results in lower % Over Body Mass Index (%OBMI) compared to ...

  14. Microstructure, mechanical behaviour and fracture of pure tungsten wire after different heat treatments

    DEFF Research Database (Denmark)

    Zhao, P.; Riesch, J.; Höschen, T.

    2017-01-01

    Plastic deformation of tungsten wire is an effective source of toughening tungsten fibre-reinforced tungsten composites (Wf/W) and other tungsten fibre-reinforced composites. To provide a reference for optimization of those composites, unconstrained pure tungsten wire is studied after various hea...... a rather different microstructure. As-fabricated wire and wire recrystallized at 1273 K for 3 h show fine grains with a high aspect ratio and a substantial plastic deformability: a clearly defined tensile strength, high plastic work, similar necking shape, and the characteristic knife...

  15. Telephone-administered psychotherapy in combination with antidepressant medication for the acute treatment of major depressive disorder.

    Science.gov (United States)

    Corruble, Emmanuelle; Swartz, Holly A; Bottai, Thierry; Vaiva, Guillaume; Bayle, Frank; Llorca, Pierre-Michel; Courtet, Philippe; Frank, Ellen; Gorwood, Philip

    2016-01-15

    Telephone-administered psychotherapies (T-P) provided as an adjunct to antidepressant medication may improve response rates in major depressive disorder (MDD). The goal of this study was to compare telephone-administered social rhythm therapy (T-SRT) and telephone-administered intensive clinical management (T-ICM) as adjuncts to antidepressant medication for MDD. A secondary goal was to compare T-P with Treatment as Usual (TAU) as adjunctive treatment to medication for MDD. 221 adult out-patients with MDD, currently depressed, were randomly assigned to 8 sessions of weekly T-SRT (n=110) or T-ICM (n=111), administered as an adjunct to agomelatine. Both psychotherapies were administered entirely by telephone, by trained psychologists who were blind to other aspects of treatment. The 221 patients were a posteriori matched with 221 depressed outpatients receiving TAU (controls). The primary outcome measure was the percentage of responders at 8 weeks post-treatment. No significant differences were found between T-SRT and T-ICM. But T-P was associated with higher response rates (65.4% vs 54.8%, p=0.02) and a trend toward higher remission rates (33.2% vs 25.1%; p=0.06) compared to TAU. Short term study. This study is the first assessing the short-term effects of an add-on, brief, telephone-administered psychotherapy in depressed patients treated with antidepressant medication. Eight sessions of weekly telephone-delivered psychotherapy as an adjunct to antidepressant medication resulted in improved response rates relative to medication alone. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Is psychotropic medication use related to organisational and treatment culture in residential care.

    Science.gov (United States)

    Peri, Kathryn; Kerse, Ngaire; Moyes, Simon; Scahill, Shane; Chen, Charlotte; Hong, Jae Beom; Hughes, Carmel M

    2015-01-01

    The purpose of this paper is to establish the relationship between organisational culture and psychotropic medication use in residential care. Cross-sectional analyses of staff and resident's record survey in residential aged care facilities in Auckland, New Zealand (NZ). The competing values framework categorised organisational culture as clan, hierarchical, market driven or adhocracy and was completed by all staff. The treatment culture tool categorised facilities as having resident centred or traditional culture and was completed by registered nursing staff and general practitioners (GP). Functional and behavioural characteristics of residents were established by staff report and health characteristics and medications used were ascertained from the health record. Multiple regression was used to test for associations between measures of culture with psychotropic medication use (anxiolytics, sedatives, major tranquillisers). In total 199 staff, 27 GP and 527 residents participated from 14 facilities. On average 8.5 medications per resident were prescribed and 42 per cent of residents received psychotropic medication. Having a diagnosis of anxiety or depression (odds ratio (OR) 3.18, 95 per cent confidence interval (CI) 1.71, 5.91), followed by persistent wandering (OR 2.53, 95 per cent CI 1.59, 4.01) and being in a dementia unit (OR 2.45, 95 per cent CI 1.17, 5.12) were most strongly associated with psychotropic use. Controlling for resident- and facility-level factors, health care assistants' assignation of hierarchical organisational culture type was independently associated with psychotropic medication use, (OR 1.29, CI 1.08, 1.53) and a higher treatment culture score from the GP was associated with lower use of psychotropic medication (OR 0.95, CI 0.92, 0.98). Psychotropic medication use remains prevalent in residential care facilities in NZ. Interventions aimed at changing organisational culture towards a less hierarchical and more resident-centred culture

  17. The enforcement regulation for the law for radiation and x-ray technicians engaging in medical treatment

    International Nuclear Information System (INIS)

    1978-01-01

    These provisions are established on the basis of and to enforce the ''Law for radiation and X-ray technicians engaging in medical treatment''. Applications for the license of radiation and X-ray technicians engaging in medical treatment shall be filed, attached with a copy or an abstract of the census register of the applicant and a medical certificate by a doctor of whether the applicant is an insane, a deaf, a dumb or a blind person or a person caught by an infectious disease or not. In the register of such technicians, the number and the date of registration, the names of the prefectures where the technicians are legally domiciled, their names and the date of birth, the year and month of passing the examination, the matters concerning withdrawal of the license or suspension of the practice must be written. The date and the place of the examination for such technicians shall be published beforehand on the official gazette. The examinations for such radiation and X-ray technicians are made on the subjects, such as physics, electrical engineering, chemistry, elementary medical science, radiology, photographing technique, medical treatment technique and control technique. (Okada, K.)

  18. Medically supervised water-only fasting in the treatment of borderline hypertension.

    Science.gov (United States)

    Goldhamer, Alan C; Lisle, Douglas J; Sultana, Peter; Anderson, Scott V; Parpia, Banoo; Hughes, Barry; Campbell, T Colin

    2002-10-01

    Hypertension-related diseases are the leading causes of morbidity and mortality in industrially developed societies. Surprisingly, 68% of all mortality attributed to high blood pressure (BP) occurs with systolic BP between 120 and 140 mm Hg and diastolic BP below 90 mm Hg. Dietary and lifestyle modifications are effective in the treatment of borderline hypertension. One such lifestyle intervention is the use of medically supervised water-only fasting as a safe and effective means of normalizing BP and initiating health-promoting behavioral changes. Sixty-eight (68) consecutive patients with borderline hypertension with systolic BP in excess of 119 mm Hg and diastolic BP less than 91 mm Hg were treated in an inpatient setting under medical supervision. The treatment program consisted of a short prefasting period (approximately 1-2 days on average) during which food consumption was limited to fruits and vegetables followed by medically supervised water-only fasting (approximately 13.6 days on average). Fasting was followed by a refeeding period (approximately 6.0 days on average). The refeeding program consisted of a low-fat, low-sodium, plant-based, vegan diet. Approximately 82% of the subjects achieved BP at or below 120/80 mm Hg by the end of the treatment program. The mean BP reduction was 20/7 mm Hg, with the greatest decrease being observed for subjects with the highest baseline BP. A linear regression of BP decrease against baseline BP showed that the estimated BP below which no further decrease would be expected was 96.0/67.0 mm Hg at the end of the fast and 99.2/67.3 mm Hg at the end of refeeding. These levels are in agreement with other estimates of the BP below which stroke events are eliminated, thus suggesting that these levels could be regarded as the "ideal" BP values. Medically supervised water-only fasting appears to be a safe and effective means of normalizing BP and may assist in motivating health-promoting diet and lifestyle changes.

  19. Pure robotic retrocaval ureter repair

    Directory of Open Access Journals (Sweden)

    Ashok k. Hemal

    2008-12-01

    Full Text Available PURPOSE: To demonstrate the feasibility of pure robotic retrocaval ureter repair. MATERIALS AND METHODS: A 33 year old female presented with right loin pain and obstruction on intravenous urography with the classical "fish-hook" appearance. She was counseled on the various methods of repair and elected to have a robot assisted repair. The following steps are performed during a pure robotic retrocaval ureter repair. The patient is placed in a modified flank position, pneumoperitoneum created and ports inserted. The colon is mobilized to expose the retroperitoneal structures: inferior vena cava, right gonadal vein, right ureter, and duodenum. The renal pelvis and ureter are mobilized and the renal pelvis transected. The ureter is transposed anterior to the inferior vena cava and a pyelopyelostomy is performed over a JJ stent. RESULTS: This patient was discharged on postoperative day 3. The catheter and drain tube were removed on day 1. Her JJ stent was removed at 6 weeks postoperatively. The postoperative intravenous urography at 3 months confirmed normal drainage of contrast medium. CONCLUSION: Pure robotic retrocaval ureter is a feasible procedure; however, there does not appear to be any great advantage over pure laparoscopy, apart from the ergonomic ease for the surgeon as well the simpler intracorporeal suturing.

  20. Medication regularity of pulmonary fibrosis treatment by contemporary traditional Chinese medicine experts based on data mining.

    Science.gov (United States)

    Zhang, Suxian; Wu, Hao; Liu, Jie; Gu, Huihui; Li, Xiujuan; Zhang, Tiansong

    2018-03-01

    Treatment of pulmonary fibrosis by traditional Chinese medicine (TCM) has accumulated important experience. Our interest is in exploring the medication regularity of contemporary Chinese medical specialists treating pulmonary fibrosis. Through literature search, medical records from TCM experts who treat pulmonary fibrosis, which were published in Chinese and English medical journals, were selected for this study. As the object of study, a database was established after analysing the records. After data cleaning, the rules of medicine in the treatment of pulmonary fibrosis in medical records of TCM were explored by using data mining technologies such as frequency analysis, association rule analysis, and link analysis. A total of 124 medical records from 60 doctors were selected in this study; 263 types of medicinals were used a total of 5,455 times; the herbs that were used more than 30 times can be grouped into 53 species and were used a total of 3,681 times. Using main medicinals cluster analysis, medicinals were divided into qi-tonifying, yin-tonifying, blood-activating, phlegm-resolving, cough-suppressing, panting-calming, and ten other major medicinal categories. According to the set conditions, a total of 62 drug compatibility rules have been obtained, involving mainly qi-tonifying, yin-tonifying, blood-activating, phlegm-resolving, qi-descending, and panting-calming medicinals, as well as other medicinals used in combination. The results of data mining are consistent with clinical practice and it is feasible to explore the medical rules applicable to the treatment of pulmonary fibrosis in medical records of TCM by data mining.

  1. Can Kinesiological Activities Change "Pure" Motor Development in Preschool Children during One School Year?

    Science.gov (United States)

    Krneta, Željko; Casals, Cristina; Bala, Gustav; Madić, Dejan; Pavlović, Slobodan; Drid, Patrik

    2015-07-01

    The purpose of this study was to evaluate the effects of an additional, organized, and more intensive kinesiological treatment on "pure" motor abilities in preschool children. In the present study an experimental treatment was carried out on a sample of 37 preschool boys by applying kinesiological activities. The 60 minute treatment was applied over a period of one school year (9 months), twice a week. A control group of 31 boys were trained according to the regular program for preschool institutions. Treatment effects were assessed by 8 motor ability tests and 5 anthropometric measures. The significant differences between the groups, which were observed after the final measurement and compared to the initial one, proved that the kinesiological treatment had a positive impact on the general development of "pure" motor abilities. The most significant effect of experimental kinesiological treatment was the improvement in whole body force, flexibility and coordination of preschool boys. These findings, obtained only in one school year, point to the importance of physical exercise and the application of additional kinesiological activities with various modalities, to improve motor development, even morphological growth and development in preschool children. The effects of the perennial application of kinesiological activities, under the supervision of kinesiological professionals, could be beneficial and could form the basis for a better biological and motor development in older age.

  2. Characterizing commercial pureed foods: sensory, nutritional, and textural analysis.

    Science.gov (United States)

    Ettinger, Laurel; Keller, Heather H; Duizer, Lisa M

    2014-01-01

    Dysphagia (swallowing impairment) is a common consequence of stroke and degenerative diseases such as Parkinson's and Alzheimer's. Limited research is available on pureed foods, specifically the qualities of commercial products. Because research has linked pureed foods, specifically in-house pureed products, to malnutrition due to inferior sensory and nutritional qualities, commercial purees also need to be investigated. Proprietary research on sensory attributes of commercial foods is available; however direct comparisons of commercial pureed foods have never been reported. Descriptive sensory analysis as well as nutritional and texture analysis of commercially pureed prepared products was performed using a trained descriptive analysis panel. The pureed foods tested included four brands of carrots, of turkey, and two of bread. Each commercial puree was analyzed for fat (Soxhlet), protein (Dumas), carbohydrate (proximate analysis), fiber (total fiber), and sodium content (Quantab titrator strips). The purees were also texturally compared with a line spread test and a back extrusion test. Differences were found in the purees for sensory attributes as well as nutritional and textural properties. Findings suggest that implementation of standards is required to reduce variability between products, specifically regarding the textural components of the products. This would ensure all commercial products available in Canada meet standards established as being considered safe for swallowing.

  3. Vacuum evaporation of pure metals

    OpenAIRE

    Safarian, Jafar; Engh, Thorvald Abel

    2013-01-01

    Theories on the evaporation of pure substances are reviewed and applied to study vacuum evaporation of pure metals. It is shown that there is good agreement between different theories for weak evaporation, whereas there are differences under intensive evaporation conditions. For weak evaporation, the evaporation coefficient in Hertz-Knudsen equation is 1.66. Vapor velocity as a function of the pressure is calculated applying several theories. If a condensing surface is less than one collision...

  4. Metal release behavior of surface oxidized stainless steels into flowing high temperature pure water

    International Nuclear Information System (INIS)

    Fujiwara, Kazuo; Tomari, Haruo; Nakayama, Takenori; Shimogori, Kazutoshi; Ishigure, Kenkichi; Matsuura, Chihiro; Fujita, Norihiko; Ono, Shoichi.

    1987-01-01

    In order to clarify the effect of oxidation treatment of Type 304 SS on the inhibition of metal release into high temperature pure water, metal release rate of individual alloying element into flowing deionized water containing 50 ppb dissolved oxygen was measured as the function of exposure time on representative specimens oxidized in air and steam. The behavior of metal release was also discussed in relation to the structure of surface films. Among the alloying elements the amount of Fe ion, Cr ion and Fe crud in high temperature pure water tended to saturate with the exposure time and that of Ni ion and Co ion tended to increase monotonously with the exposure time for all specimens tested. And the treatment of steam-oxidation was the most effective to decrease the metal release of alloying elements and the treatment by air-oxidation also decreased the metal release. These tendencies were confirmed to correlate well with the structure of the surface films as it was in the results in the static autoclave test. (author)

  5. 12-Step participation reduces medical use costs among adolescents with a history of alcohol and other drug treatment.

    Science.gov (United States)

    Mundt, Marlon P; Parthasarathy, Sujaya; Chi, Felicia W; Sterling, Stacy; Campbell, Cynthia I

    2012-11-01

    Adolescents who attend 12-step groups following alcohol and other drug (AOD) treatment are more likely to remain abstinent and to avoid relapse post-treatment. We examined whether 12-step attendance is also associated with a corresponding reduction in health care use and costs. We used difference-in-difference analysis to compare changes in seven-year follow-up health care use and costs by changes in 12-step participation. Four Kaiser Permanente Northern California AOD treatment programs enrolled 403 adolescents, 13-18-years old, into a longitudinal cohort study upon AOD treatment entry. Participants self-reported 12-step meeting attendance at six-month, one-year, three-year, and five-year follow-up. Outcomes included counts of hospital inpatient days, emergency room (ER) visits, primary care visits, psychiatric visits, AOD treatment costs and total medical care costs. Each additional 12-step meeting attended was associated with an incremental medical cost reduction of 4.7% during seven-year follow-up. The medical cost offset was largely due to reductions in hospital inpatient days, psychiatric visits, and AOD treatment costs. We estimate total medical use cost savings at $145 per year (in 2010 U.S. dollars) per additional 12-step meeting attended. The findings suggest that 12-step participation conveys medical cost offsets for youth who undergo AOD treatment. Reduced costs may be related to improved AOD outcomes due to 12-step participation, improved general health due to changes in social network following 12-step participation, or better compliance to both AOD treatment and 12-step meetings. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  6. [Aripiprazole - a medical treatment alternative for Tourette Syndrome in childhood and adolescence].

    Science.gov (United States)

    Frölich, Jan; Starck, Martina; Banaschewski, Tobias; Lehmkuhl, Gerd

    2010-07-01

    We report a case-series of seven patients with a medical history of at least two years of tic disorder treated with the partial dopamine agonist aripiprazole to illustrate its efficacy as a treatment alternative for motor and vocal tics in children and adolescents. A case series of five patients with Tourette Syndrome (TS) and two with chronic motor tic disorder (age range 8; 7-18; 1 year), the majority of whom had been refractory to treatment with other neuroleptics or had ceased treatment due to intolerable side effects, were treated for eight weeks with aripiprazole. Before and after treatment, parents rated the severity of motor and vocal tic symptoms on the Yale Tourette Syndrome Checklist. Within eight weeks mean motor tic symptoms decreased by 66% and mean vocal tic symptoms decreased by 26%. Mean effective dosage was 14.3 mg/day (min. 5 mg, max. 30 mg). Symptoms of comorbid ADHD or Obsessive Compulsive Disorder were not significantly influenced. During medication only mild side effects were observed, e.g., abdominal pain, fatigue and increased emotional sensitivity. No patient dropped out of treatment due to side effects. Aripiprazole may be an effective pharmacologic treatment alternative for individuals with chronic motor tic disorder and TS. It induces quick, significant and sustained effects with few generally mild and transient side effects, if anything. Its effectiveness, especially relative to comorbidities, should be verified in double-blind, placebo-controlled studies.

  7. Pure natural inflation

    Science.gov (United States)

    Nomura, Yasunori; Watari, Taizan; Yamazaki, Masahito

    2018-01-01

    We point out that a simple inflationary model in which the axionic inflaton couples to a pure Yang-Mills theory may give the scalar spectral index (ns) and tensor-to-scalar ratio (r) in complete agreement with the current observational data.

  8. Automated Extraction of Genomic DNA from Medically Important Yeast Species and Filamentous Fungi by Using the MagNA Pure LC System

    OpenAIRE

    Loeffler, Juergen; Schmidt, Kathrin; Hebart, Holger; Schumacher, Ulrike; Einsele, Hermann

    2002-01-01

    A fully automated assay was established for the extraction of DNA from clinically important fungi by using the MagNA Pure LC instrument. The test was evaluated by DNA isolation from 23 species of yeast and filamentous fungi and by extractions (n = 28) of serially diluted Aspergillus fumigatus conidia (105 to 0 CFU/ml). Additionally, DNA from 67 clinical specimens was extracted and compared to the manual protocol. The detection limit of the MagNA Pure LC assay of 10 CFU corresponded to the sen...

  9. The medical consequences of nuclear weapons

    International Nuclear Information System (INIS)

    Humphrey, J.; Hartog, M.; Middleton, H.

    1982-01-01

    A pamphlet has been produced by the Medical Campaign Against Nuclear Weapons (MCANW) and by the Medical Association for the Prevention of War (MAPW) to bring the catastrophic effects that the use of nuclear weapons would entail to the attention of the general public, politicians and members of the medical profession. It describes the medical consequences of the effects of blast, heat and ionizing radiation from nuclear weapons, including details from the Hiroshima and Nagasaki atomic bombings. The medical consequences of a nuclear attack including consideration of the casualties, care of the injured, psychological effects and the outcome are also discussed. It is concluded that if for none other than purely medical reasons, nuclear warfare must never be allowed to happen. (UK)

  10. Randomised controlled trial of counseling sessions, antidepressant medication, and combined treatment for major depression in primary care setting

    International Nuclear Information System (INIS)

    Mossa, Samir Y.; Al-Sayed, H.; Malik, Mariam A.; Al-Hageri, S.; Al-Shaar, I.

    2006-01-01

    The study was made to determine whether counseling sessions using Egan's model combined with antidepressant medication is more effective than either treatment alone in the management of major depression in primary care. Patient aged 18 years and above with major depression on the research diagnostic criteria - a score of 13 or more on the 17 items. Hamilton rating scale for depression and a minimum duration of 4 weeks. Counseling sessions based on Egan's Model by research family physician or antidepressant medication or combination of both was performed. Hamilton rating scale for depression, Beck depression inventory, clinical interview schedule, and modified social adjustment schedule were used and assessed at 6 , 12 and 52 weeks. Patients in all groups showed a clear improvement after 12 weeks. The combination of counseling sessions and antidepressant medication is more effective than either treatment alone. Counseling sessions used by a trained family physician is an effective treatment for depressive disorders in primary care. The combination of this treatment with antidepressant medication is more effective than either treatment alone. (author)

  11. Conformal pure radiation with parallel rays

    International Nuclear Information System (INIS)

    Leistner, Thomas; Paweł Nurowski

    2012-01-01

    We define pure radiation metrics with parallel rays to be n-dimensional pseudo-Riemannian metrics that admit a parallel null line bundle K and whose Ricci tensor vanishes on vectors that are orthogonal to K. We give necessary conditions in terms of the Weyl, Cotton and Bach tensors for a pseudo-Riemannian metric to be conformal to a pure radiation metric with parallel rays. Then, we derive conditions in terms of the tractor calculus that are equivalent to the existence of a pure radiation metric with parallel rays in a conformal class. We also give analogous results for n-dimensional pseudo-Riemannian pp-waves. (paper)

  12. Evaluation of treatment effects in obese children with co-morbid medical or psychiatric conditions

    Science.gov (United States)

    The need for effective treatments for pediatric overweight is well known. We evaluated the applicability of an evidence-based treatment in an applied clinic setting that includes children with severe obesity and comorbid medical or psychiatric conditions. Forty-eight overweight children and their fa...

  13. Concordance of self-reported and medical chart information on cancer diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Shu Xiao Ou

    2011-05-01

    Full Text Available Abstract Background Self-reported information is an important tool for collecting clinical information for epidemiologic studies and in clinical settings where electronic medical records are not employed and shared. Methods Using data collected from the Shanghai Breast Cancer Survival Study (SBCSS, a population-based, prospective cohort study of 5,042 women diagnosed with breast cancer in Shanghai, China, we compared the concordance of patient questionnaire responses to a survey administered approximately 6 months after cancer diagnosis with medical chart information obtained from the diagnostic hospitals for several disease and treatment-related variables. Results Of 5,042 SBCSS participants, medical chart information was available for 4,948 women (98.1%. Concordance between patient self-reported and medical chart information was high for the majority of disease-related variables, including: diagnosing hospital (agreement: 98.7%, kappa: 0.99, type of surgery conducted (94.0%, 0.53, ER/PR status (94.5%, 0.91, and tumor position (98.2%, 0.97, as well as for important calendar dates, such as date of diagnosis, surgery, and first chemotherapy treatment. The 10 most commonly used chemotherapeutic drugs were all reported with agreement rates of at least 82%, with associated kappa values that ranged from 0.41 for calcium folinate to 0.76 for vinorelbine. Conclusions Our study found high validity for patient self-reported information for a variety of disease and treatment-related variables, suggesting the utility of self-reports as an important source of clinical information for both epidemiological research and patient care.

  14. Pure spinor partition function and the massive superstring spectrum

    International Nuclear Information System (INIS)

    Aisaka, Yuri; Arroyo, E. Aldo; Berkovits, Nathan; Nekrasov, Nikita

    2008-01-01

    We explicitly compute up to the fifth mass-level the partition function of ten-dimensional pure spinor worldsheet variables including the spin dependence. After adding the contribution from the (x μ , θ α , p α ) matter variables, we reproduce the massive superstring spectrum. Even though pure spinor variables are bosonic, the pure spinor partition function contains fermionic states which first appear at the second mass-level. These fermionic states come from functions which are not globally defined in pure spinor space, and are related to the b ghost in the pure spinor formalism. This result clarifies the proper definition of the Hilbert space for pure spinor variables.

  15. Possibilities for Hospital Treatment of Industrial Accident Victims in Military Medical Academy

    International Nuclear Information System (INIS)

    Todorovic, V.; Jevtic, M.; Jovanovic, D.; Jovic-Stosic, J.

    2007-01-01

    Possibility of mass injuries in traffic, industrial accidents or terrorist attack is every day reality. Management of victims may need complex measures including activities on the site, transportation, and hospital care. Preparedness for hospital treatment of mass trauma or poisoning is among the main duties of Military Medical Academy (MMA). It is medical institution of tertiary level with the capacity of 1214 beds in 13 surgical clinics, 12 internal medicine clinics, 2 neuropsychiatry clinics, poison control centre and organ transplantation centre. National Poison Control Centre is the only specialized institution for treatment of adult's acute poisonings in the country. Centre includes: 1. Clinic of Toxicology and Clinical Pharmacology with Intensive Care Unit and Toxicology Information Department; 2. Institute of Experimental Toxicology and Pharmacology; 3. Mobile Toxicological - Chemical Squad. Being a part of MMA, Centre benefits from all advantages of central type hospital, including possibilities for contemporary diagnostic and therapeutic procedures of different specialities, and other necessary medical and logistic support. Except hospital organization and preparedness for admission of mass injuries victims, one of strategic goals of MMA is functional integration in civilian health care system including more detailed planning for collaboration in case of chemical accidents.(author)

  16. Testing effects in mixed- versus pure-list designs.

    Science.gov (United States)

    Rowland, Christopher A; Littrell-Baez, Megan K; Sensenig, Amanda E; DeLosh, Edward L

    2014-08-01

    In the present study, we investigated the role of list composition in the testing effect. Across three experiments, participants learned items through study and initial testing or study and restudy. List composition was manipulated, such that tested and restudied items appeared either intermixed in the same lists (mixed lists) or in separate lists (pure lists). In Experiment 1, half of the participants received mixed lists and half received pure lists. In Experiment 2, all participants were given both mixed and pure lists. Experiment 3 followed Erlebacher's (Psychological Bulletin, 84, 212-219, 1977) method, such that mixed lists, pure tested lists, and pure restudied lists were given to independent groups. Across all three experiments, the final recall results revealed significant testing effects for both mixed and pure lists, with no reliable difference in the magnitude of the testing advantage across list designs. This finding suggests that the testing effect is not subject to a key boundary condition-list design-that impacts other memory phenomena, including the generation effect.

  17. Hydrobalneological methods in modern medical treatment

    Directory of Open Access Journals (Sweden)

    Włodzisław Kuliński

    2015-03-01

    Full Text Available Introduction: Therapeutic methods combining balneology and hydrotherapy have been used in treatment and prevention for a long time. Their influence on the skin, based on mechanical, thermal, and hydrostatic stimuli, results in a reaction of the internal organs as well as the whole body. The most important effects of such procedures are changes within the cardiovascular system. Aim of the research: The use of hydrobalneological methods in modern medical treatment. Material and methods : The analysis focused on the influence of water jets at alternating temperatures in the treatment of functional cardiovascular disturbances with the use of non-invasive methods of autonomic nervous system function work-up based on the analysis of heart rate variability. The effect of the jets on heart rate and blood pressure was observed in 50 patients with first-degree hypertension, which was accompanied by radioelectrocardiographic (RECG assessment of the influence of underwater massage and carbonic acid baths on the cardiovascular system in patients undergoing these procedures due to Da Costa’s syndrome. Results : Water jets at alternating temperatures successfully modulate the tension within the autonomic nervous system and stimulate its parasympathetic part. Underwater massage is a gentle procedure and does not cause significant changes in heart rate and RECG tracing. Carbonic acid baths decrease autonomic nervous system excitability. Conclusions: The study results show a possibility of regulating autonomic nervous system function with the use of selected balneological and hydrotherapeutic methods, and thus influencing the functional level of the human body which is most appropriate for the requirements created by the internal and external environment of the body.

  18. Unemployment risk among individuals undergoing medical treatment for chronic diseases.

    Science.gov (United States)

    Nakaya, N; Nakamura, T; Tsuchiya, N; Tsuji, I; Hozawa, A; Tomita, H

    2016-03-01

    Chronic diseases increase the risk of unemployment even in non-disaster settings; therefore, in post-disaster settings, special attention needs to be paid to the employment status of those suffering from chronic diseases. To examine the association between chronic disease and the risk of unemployment in a disaster area. This cross-sectional study was conducted in Shichigahama Town, Miyagi, north-eastern Japan, where had been severely inundated by the 2011 tsunami. Logistic regression analyses were used to evaluate the association between undergoing medical treatment for a combination of chronic diseases (stroke, cancer, myocardial infarction and angina) and unemployment risk. Confounders such as psychological distress and levels of daily life activity were considered. Among the 2588 individuals studied, there was a statistically significant association between undergoing medical treatment for chronic disease and the risk of unemployment [odds ratio (OR) = 1.7, 95% confidence interval (CI) 1.02-2.7, P unemployment risk was observed only in participants with a higher degree of psychological distress and/or poorer levels of daily life activity. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. Surrogate motherhood as a medical treatment procedure for women's infertility.

    Science.gov (United States)

    Jovic, Olga S

    2011-03-01

    The content of this work is conceived on the research of the consequences of surrogate motherhood as a process of assisted procreation, which represent a way of parenthood in cases when it is not possible to realize parenthood through a natural way. Surrogate motherhood is a process in which a woman (surrogate mother) agrees to carry a pregnancy with the intent to give the child to the couple with whom she has made a contract on surrogate maternity after the birth. This process of conception and birth makes the determination of the child's origin on its mother's side hard to determine, because of the distinction of the genetic and gestation phases of the two women. The concept of surrogate motherhood is to appear in two forms, depending on the existence or the non-existence of the genetic link between the surrogate mother and the child she gives birth to. There are gestation (full) and genetic (partial) surrogates each with different modalities and legal and ethical implications. In Serbia, Infertility Treatment and the Bio-medically Assisted Procreation Act from 2009 explicitly forbids surrogate motherhood, despite the fact that an infertile couple decides to use it, as a rule, after having tried all other treatment procedures, in cases when there is a diagnosis but the conventional treatment applied has not produced the desired results. Given the fact that no one has the right to ignore the sufferings of people who cannot procreate naturally, the medical practice and legal science in our country plead for a formulation of a legal framework in which to apply surrogate motherhood as an infertility treatment, under particular conditions.

  20. 78 FR 56719 - Challenging Regulatory and Reimbursement Paradigms for Medical Devices in the Treatment of...

    Science.gov (United States)

    2013-09-13

    ...] Challenging Regulatory and Reimbursement Paradigms for Medical Devices in the Treatment of Metabolic Diseases... announcing a public workshop entitled ``Changing Regulatory and Reimbursement Paradigms for Medical Devices... registration information on the AGA Web site. If you need special accommodations due to a disability, please...

  1. Tractable Quantification of Entanglement for Multipartite Pure States

    International Nuclear Information System (INIS)

    Nian-Quan, Jiang; Yu-Jian, Wang; Yi-Zhuang, Zheng; Gen-Chang, Cai

    2008-01-01

    We present kth-order entanglement measure and global kth-order entanglement measure for multipartite pure states, and extend Bennett's measure of partial entropy for bipartite pure states to a multipartite case. These measures are computable and can effectively classify and quantify the entanglement of multipartite pure states. (general)

  2. Infection prevention and control in deployed military medical treatment facilities.

    Science.gov (United States)

    Hospenthal, Duane R; Green, Andrew D; Crouch, Helen K; English, Judith F; Pool, Jane; Yun, Heather C; Murray, Clinton K

    2011-08-01

    Infections have complicated the care of combat casualties throughout history and were at one time considered part of the natural history of combat trauma. Personnel who survived to reach medical care were expected to develop and possibly succumb to infections during their care in military hospitals. Initial care of war wounds continues to focus on rapid surgical care with debridement and irrigation, aimed at preventing local infection and sepsis with bacteria from the environment (e.g., clostridial gangrene) or the casualty's own flora. Over the past 150 years, with the revelation that pathogens can be spread from patient to patient and from healthcare providers to patients (including via unwashed hands of healthcare workers, the hospital environment and fomites), a focus on infection prevention and control aimed at decreasing transmission of pathogens and prevention of these infections has developed. Infections associated with combat-related injuries in the recent operations in Iraq and Afghanistan have predominantly been secondary to multidrug-resistant pathogens, likely acquired within the military healthcare system. These healthcare-associated infections seem to originate throughout the system, from deployed medical treatment facilities through the chain of care outside of the combat zone. Emphasis on infection prevention and control, including hand hygiene, isolation, cohorting, and antibiotic control measures, in deployed medical treatment facilities is essential to reducing these healthcare-associated infections. This review was produced to support the Guidelines for the Prevention of Infections Associated With Combat-Related Injuries: 2011 Update contained in this supplement of Journal of Trauma.

  3. The medical and surgical treatment in secondary and tertiary hyperparathyroidism. Review.

    Science.gov (United States)

    Cocchiara, G; Fazzotta, S; Palumbo, V D; Damiano, G; Cajozzo, M; Maione, C; Buscemi, S; Spinelli, G; Ficarella, S; Maffongelli, A; Caternicchia, F; Ignazio Lo Monte, A; Buscemi, G

    2017-01-01

    Hyperparathyroidism is an alteration of the pathophysiological parathyroid hormone (PTH) secretion due or an independent and abnormal release (primary or tertiary hyperparathyroidism) by the parathyroid or an alteration of calcium homeostasis that stimulates the excessive production of parathyroid hormone (secondary hyperparathyroidism). There is not a standard, clinical or surgical, treatment for hyperparathyroidism. We review current diagnostic and therapeutic methods. In secondary hyperparathyroidism (2HPT) there is a progressive hyperplasia of the parathyroid glands and an increased production of parathyroid hormone. Several causes are proposed: chronic renal insufficiency, vitamin D deficiency, malabsorption syndrome. The tertiary hyperparathyroidism (3HPT) is considered a state of excessive autonomous secretion of PTH due to long-standing 2HPT and it's usually the result of a lack of suppression in the production of PTH. The pathophysiological implications are both skeletal and extraskeletal: it damages the cardiovascular system, nervous system, immune, hematopoietic and endocrine system. The introduction of new drugs has improved the survival of these patients, allowing the inhibition of the synthesis of PTH. Indication for surgical treatment is unresponsive medical therapy. There are no large prospective studies that comparing the medical and surgical treatment. The choice is not unique and we have to consider the singolar case and the clinical condition of the patient.

  4. Impact of a Student Pharmacist Driven Medication Reconciliation and Antidepressant Treatment History Project at a Depression Clinic: A Pilot Study

    Science.gov (United States)

    Tang, Stella S.; Jaward, Leanna; Ward, Kristen; Parikh, Sagar V.; Bostwick, Jolene R.

    2017-01-01

    Objectives To improve treatment of patients with depression, a new pilot service project involving student pharmacists who would conduct medication reconciliation and review of antidepressant treatment history was created and evaluated. Experimental design A prospective study conducted at the University of Michigan Depression Center. Principal observations From an initial sample of 78 referrals, 41 subjects were reached by phone, with 34 completing medication reconciliation and antidepressant treatment history. Of the 34 patients, 25 (73.5%) had at least one discrepancy identified in their medication list, resulting in 164 medication changes in the electronic medical record (EMR). A total of 105 past antidepressant trials were documented in the 34 individuals, with 34 (32.4%) trials found to be inadequate. Thirteen (38.2%) patients reported failure to respond to two different antidepressants from different classes. All 34 patients participated well in the phone calls and were willing to consult a pharmacist at their upcoming clinic visit. Conclusions A student pharmacist pilot was feasible, identified many discrepancies in the medication record, and identified important medication treatment history in patients with depression in advance of the clinic visit. The project provides support for a specialized role for student pharmacists and demonstrates that interprofessional care can contribute to improved treatment of depression. PMID:28626270

  5. Medical treatment methods, medical indication claims and patentability: A quest into the rationale of the exclusion and patentability in the context of the future of personalised medicine

    NARCIS (Netherlands)

    Bostyn, S.J.R.

    2016-01-01

    This contribution discusses the thorny issue of the rationale of the exclusion from patentability of medical treatment methods and the patentability of medical indications. This quest is the consequence of our earlier findings that medical indication patents present a real life risk for many players

  6. Gate-Driven Pure Spin Current in Graphene

    Science.gov (United States)

    Lin, Xiaoyang; Su, Li; Si, Zhizhong; Zhang, Youguang; Bournel, Arnaud; Zhang, Yue; Klein, Jacques-Olivier; Fert, Albert; Zhao, Weisheng

    2017-09-01

    The manipulation of spin current is a promising solution for low-power devices beyond CMOS. However, conventional methods, such as spin-transfer torque or spin-orbit torque for magnetic tunnel junctions, suffer from large power consumption due to frequent spin-charge conversions. An important challenge is, thus, to realize long-distance transport of pure spin current, together with efficient manipulation. Here, the mechanism of gate-driven pure spin current in graphene is presented. Such a mechanism relies on the electrical gating of carrier-density-dependent conductivity and spin-diffusion length in graphene. The gate-driven feature is adopted to realize the pure spin-current demultiplexing operation, which enables gate-controllable distribution of the pure spin current into graphene branches. Compared with the Elliott-Yafet spin-relaxation mechanism, the D'yakonov-Perel spin-relaxation mechanism results in more appreciable demultiplexing performance. The feature of the pure spin-current demultiplexing operation will allow a number of logic functions to be cascaded without spin-charge conversions and open a route for future ultra-low-power devices.

  7. A Systematic Review on the Use of Psychosocial Interventions in Conjunction With Medications for the Treatment of Opioid Addiction.

    Science.gov (United States)

    Dugosh, Karen; Abraham, Amanda; Seymour, Brittany; McLoyd, Keli; Chalk, Mady; Festinger, David

    2016-01-01

    Opioid use and overdose rates have risen to epidemic levels in the United States during the past decade. Fortunately, there are effective medications (ie, methadone, buprenorphine, and oral and injectable naltrexone) available for the treatment of opioid addiction. Each of these medications is approved for use in conjunction with psychosocial treatment; however, there is a dearth of empirical research on the optimal psychosocial interventions to use with these medications. In this systematic review, we outline and discuss the findings of 3 prominent prior reviews and 27 recent publications of empirical studies on this topic. The most widely studied psychosocial interventions examined in conjunction with medications for opioid addiction were contingency management and cognitive behavioral therapy, with the majority focusing on methadone treatment. The results generally support the efficacy of providing psychosocial interventions in combination with medications to treat opioid addictions, although the incremental utility varied across studies, outcomes, medications, and interventions. The review highlights significant gaps in the literature and provides areas for future research. Given the enormity of the current opioid problem in the United States, it is critical to gain a better understanding of the most effective ways to deliver psychosocial treatments in conjunction with these medications to improve the health and well-being of individuals suffering from opioid addiction.

  8. Pure natural inflation

    Directory of Open Access Journals (Sweden)

    Yasunori Nomura

    2018-01-01

    Full Text Available We point out that a simple inflationary model in which the axionic inflaton couples to a pure Yang–Mills theory may give the scalar spectral index (ns and tensor-to-scalar ratio (r in complete agreement with the current observational data.

  9. Effectiveness of medication / auricular therapy / phyto-therapy combination in the treatment of hypertensive patients

    Directory of Open Access Journals (Sweden)

    José Ramón Martínez Pérez

    2015-10-01

    Full Text Available Background: hypertension is one of the main cardiovascular risk factors, so its control improves the life expectancy of patients.Objective: to assess the effects of a treatment combining medication with auricular therapy and phyto-therapy in hypertensive patients assisted at the health area of ”Romárico Oro” Polyclinic, in Puerto Padre, Las Tunas province.Methods: an intervention study was carried out in 68 hypertensive patients of the health area of “Romárico Oro” Polyclinic in Puerto Padre from April, 2013 to April, 2014. The patients were distributed at random into two equal groups; the first received medication combined with auricular therapy and phyto-therapy, while the second one received only medication. The statistical analysis was done by means of Statistic system, t-student and Chi-Square tests were used and p< or =0.05 was considered as level of statistical significance.Results: by the end of the intervention, 73, 53% of the patients of the group with the combination of drug treatment and auricular therapy and phyto-therapy were controlled. In this group, the diastolic filling pressure diminished to 2, 2 mm Hg and the systolic gradient to 3, 66 mm, regarding the group treated only with drugs. Only one patient, representing the 2, 94% showed adverse reaction to the natural and traditional treatment.Conclusions: the combination of medication with auricular therapy and phyto-therapy proved to be effective, corroborated by a significant decrease of quantity of crisis, diastolic and systolic filling pressure values and increase of number of patients with their disease controlled; the report of only one complication shows the innocuousness of the auricular therapy and phyto-therapy treatment.

  10. The medical treatment of the plutonium-contaminated wound

    International Nuclear Information System (INIS)

    Liu Yanling

    1988-01-01

    Some experiences in medical treatment of plutonium-contaminated wound gained through the animal experiments and clinical practices were described. For the treatment of plutonium-contaminated wound, much attention should be devoted to the early emergency measure at accident site. In some case when the surgical interference is needed, radioactivity in local wound and in regional lympho-nodes of wound, firstly, must be determined and the contaminated area must be demonstrated before operation. Selecting a proper approach for anaesthesia is one of the critical factors for successfulness of operation. The operation should be performed under the coordination of monitoring workers. During operation, the rules for decontamination should be followed to avoid recontamination. In addition to conventional administration of chelating agents, the local application of such agents during and after operation is a better supplementary therapeutic procedure for some cases when the residual amount of plutonium in wound is less and any other surgical procedures will not be performed further

  11. Quality of medical service, patient satisfaction and loyalty with a focus on interpersonal-based medical service encounters and treatment effectiveness: a cross-sectional multicenter study of complementary and alternative medicine (CAM) hospitals.

    Science.gov (United States)

    Kim, Chang Eun; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Kim, Me-Riong; Choi, Areum; Park, Ki Byung; Lee, Ho-Joo; Ha, In-Hyuk

    2017-03-28

    Treatment effectiveness holds considerable importance in the association between service quality and satisfaction in medical service studies. While complementary and alternative medicine (CAM) use grows more prominent, comprehensive evaluations of the quality of medical service at CAM-oriented hospitals are scarce. This study assesses the quality of medical services provided at a CAM-oriented hospital of Korean medicine using the service encounter system approach and analyzes the influence of treatment effectiveness on patient loyalty. A survey study using one-on-one interviews was conducted using a cross-sectional design in outpatients visiting one of fifteen Korean medicine facilities located throughout Korea. A total of 880 surveys were completed from June to July, 2014, and 728 surveys were included in the final analysis after excluding incomplete or incorrect questionnaires. The reliability and validity of the surveys was confirmed using Cronbach's alpha coefficient and confirmatory factor analysis, and a structural equation modeling analysis was performed to verify causality and association between factors (quality of medical service, treatment effectiveness, patient satisfaction, and intent to revisit). The measured factors of physician performance and quality of service procedures had a positive effect on treatment effectiveness. The impression of the facilities and environment directly impacted satisfaction rates for interpersonal-based medical service encounters, while treatment effectiveness positively affected satisfaction regarding quality of medical service. However, treatment effectiveness had a more significant effect on satisfaction compared to facilities and environment, and it indirectly affected satisfaction and directly influenced intent to revisit. Treatment effectiveness and satisfaction both positively influenced intent to revisit. The importance of treatment effectiveness should be recognized when examining quality of medical services, and

  12. Pure chiral optical fibres.

    Science.gov (United States)

    Poladian, L; Straton, M; Docherty, A; Argyros, A

    2011-01-17

    We investigate the properties of optical fibres made from chiral materials, in which a contrast in optical activity forms the waveguide, rather than a contrast in the refractive index; we refer to such structures as pure chiral fibres. We present a mathematical formulation for solving the modes of circularly symmetric examples of such fibres and examine the guidance and polarisation properties of pure chiral step-index, Bragg and photonic crystal fibre designs. Their behaviour is shown to differ for left- and right-hand circular polarisation, allowing circular polarisations to be isolated and/or guided by different mechanisms, as well as differing from equivalent non-chiral fibres. The strength of optical activity required in each case is quantified.

  13. Attitudes toward euthanasia, assisted suicide and termination of life-sustaining treatment of Puerto Rican medical students, medical residents, and faculty.

    Science.gov (United States)

    Ramirez Rivera, J; Rodríguez, R; Otero Igaravidez, Y

    2000-01-01

    To elicit the opinion of Puerto Rican medical students, residents and internal medicine faculty as to the appropriateness of euthanasia and physician-assisted suicide and end-of-life management. Survey using a 16-item questionnaire answered within a two-month period in the fall of 1996. Rounds or faculty meetings at teaching hospitals located in the north, south and southwest of the island of Puerto Rico. There were 424 participants. The questionnaires of 279 medical students, 75 medical residents, and 35 internal medicine faculty members were analyzed. Thirty-five questionnaires, which were incomplete or answered by non-Puerto Rican participants, were excluded. Frequency of support of active euthanasia, physician-assisted suicide, withholding or withdrawing life-sustaining treatment with informed consent was determined. Whether it was ethical to prescribe full doses of drugs needed to alleviate pain even if it would hasten death, or agree to limit or restrict resources for the terminally ill was also determined. Forty per cent of the students, 33% of the residents, and 20% of the faculty supported euthanasia. If physician-assisted suicide were legalized, 50 per cent of the students, 43 per cent of the residents and 45 percent of the faculty would not be opposed to it. Sixty-eight per cent of the students, 67 per cent of the residents and 88 per cent of the faculty would support withholding or withdrawing life-sustaining treatment for dying patients with informed consent. Seventy-nine per cent of residents, 80 per cent of the faculty but only 54 per cent of medical students would prescribe full doses of drugs needed to alleviate pain in dying patients even if they would hasten death. Thirty-six per cent of the residents and faculty would agree to limit the use of medical resources for the terminally ill but only sixteen per cent of medical students would do so. The acceptance of euthanasia was inversely proportional to the clinical experience of the respondents: 40

  14. Medical and surgical treatment of primary divergent strabismus.

    Science.gov (United States)

    Noguera, H; Castiella Acha, J C; Anguiano Jimenez, M

    2014-11-01

    To evaluate the long-term effectiveness of different therapies applied in the past 30 years, both medical and surgical, and results, with the ultimate aim of determining which are the most appropriate criteria to indicate when and how to perform medical and surgical treatment in these patients. A retrospective randomized study was conducted on 198 patients with primary divergent strabismus first seen in our clinic (IOC) in the last 36 years (1976-2012), with a mean follow-up of 8.38 years. Demographic and clinical characteristics, as well as the various treatments performed, and motor and sensory outcome were collected. They were finally divided into 3 groups of 70, 71 and 56 patients, respectively, according to their first visit, in order to compare the therapies applied. Half (50%) of our patients debuted before 2 years of age (P50=24 months), and 26.3% had optimal binocular vision at the beginning of the study. Medical treatment was used as exclusive therapy in 29.3% of cases (occlusion therapy, applying negative lenses, botulinum toxin), and 70.7% required surgery (61.2% by double retro-insertion of lateral rectus, and 38.8% monolateral retro-resection). There was a recurrence in 26.7% of patients, and 40 re-interventions were performed (70% due to recurrence of divergent strabismus, 12.5% due to surgical over-correction, and 17.5% for other reasons). In the end, 61.1% of patients had perfect binocular vision (TNO=60"), and the proportion was higher in patients who showed proper control of their strabismus at the beginning (P=.003). However, no differences were found in the other variables studied. When the patients were divided into 3 groups (which are demographically comparable), an increased number of patients in Group 3 were found to be treated using negative lenses and botulinum toxin (P<.001 and P=.003). This group was found to have had a higher proportion of bilateral surgery (P=.032), seeking greater immediate postoperative over-correction, thus

  15. Guidelines for adults on self-medication for the treatment of acute diarrhoea

    NARCIS (Netherlands)

    Wingate, D.; Phillips, S. F.; Lewis, S. J.; Malagelada, J. R.; Speelman, P.; Steffen, R.; Tytgat, G. N.

    2001-01-01

    Acute uncomplicated diarrhoea is commonly treated by self-medication. Guidelines for treatment exist, but are inconsistent, sometimes contradictory, and often owe more to dogma than evidence. An ad hoc multidisciplinary group has reviewed the literature to determine best practice. In general it is

  16. Medications (for IBS)

    Medline Plus

    Full Text Available ... IBS Global Treatments IBS Diet Low FODMAP Diet Complementary or Alternative Treatments Medications Psychological Treatments Online Studies ... IBS Global Treatments IBS Diet Low FODMAP Diet Complementary or Alternative Treatments Medications Psychological Treatments Online Studies ...

  17. Medications (for IBS)

    Medline Plus

    Full Text Available ... Treatments IBS Diet Low FODMAP Diet Complementary or Alternative Treatments Medications Psychological Treatments Online Studies News You ... Treatments IBS Diet Low FODMAP Diet Complementary or Alternative Treatments Medications Psychological Treatments Online Studies News You ...

  18. 20 CFR 725.704 - Notification of right to medical benefits; authorization of treatment.

    Science.gov (United States)

    2010-04-01

    ... Vocational Rehabilitation § 725.704 Notification of right to medical benefits; authorization of treatment. (a... is desirable or necessary in the best interest of the miner. The miner may change physicians or...

  19. Assessing the effect of treatment duration on the association between anti-diabetic medication and cancer risk.

    Directory of Open Access Journals (Sweden)

    Anna But

    Full Text Available Most studies that have evaluated the association between anti-diabetic medication and cancer risk have suffered from methodological drawbacks. To avoid time-related biases, we evaluated the effect of treatment duration on the cancer risk among naive users of anti-diabetic medication as compared to non-users. In addition, we addressed the influence of common risk factors such as smoking and BMI. The study population comprised 23,394 participants of FINRISK surveys. Data on cancer and anti-diabetic medication were linked with the study cohorts. We applied Lexis tabulation to the data and analyzed split records by using Poisson regression. Changes in cancer incidence in relation to treatment duration were examined by modeling the rate ratio (RR. After a median follow-up of 9 years, 53 cancer cases among users of anti-diabetic medication and 1,028 among non-users were diagnosed. No significant difference in cancer risk between users and non-users was observed after adjustment. The RR for all medication regardless of its duration was 1.01 [95% CI 0.75-1.33], and 1.37 [0.94-1.94] for period of 1-4 years. The results were similar for metformin, sulfonylurea, and insulin. This study demonstrates that evaluation of the variation in cancer risk in relation to treatment duration is of particular importance for enhancing the accuracy of conclusions on the link between exposure to anti-diabetic medication and cancer risk.

  20. Assessing the effect of treatment duration on the association between anti-diabetic medication and cancer risk.

    Science.gov (United States)

    But, Anna; Wang, Haining; Männistö, Satu; Pukkala, Eero; Haukka, Jari

    2014-01-01

    Most studies that have evaluated the association between anti-diabetic medication and cancer risk have suffered from methodological drawbacks. To avoid time-related biases, we evaluated the effect of treatment duration on the cancer risk among naive users of anti-diabetic medication as compared to non-users. In addition, we addressed the influence of common risk factors such as smoking and BMI. The study population comprised 23,394 participants of FINRISK surveys. Data on cancer and anti-diabetic medication were linked with the study cohorts. We applied Lexis tabulation to the data and analyzed split records by using Poisson regression. Changes in cancer incidence in relation to treatment duration were examined by modeling the rate ratio (RR). After a median follow-up of 9 years, 53 cancer cases among users of anti-diabetic medication and 1,028 among non-users were diagnosed. No significant difference in cancer risk between users and non-users was observed after adjustment. The RR for all medication regardless of its duration was 1.01 [95% CI 0.75-1.33], and 1.37 [0.94-1.94] for period of 1-4 years. The results were similar for metformin, sulfonylurea, and insulin. This study demonstrates that evaluation of the variation in cancer risk in relation to treatment duration is of particular importance for enhancing the accuracy of conclusions on the link between exposure to anti-diabetic medication and cancer risk.

  1. Current neurotrauma treatment practice in secondary medical service centers

    International Nuclear Information System (INIS)

    Suehiro, Eiichi; Yoshino, Hiroko; Koizumi, Hiroyasu; Yoneda, Hiroshi; Suzuki, Michiyasu

    2011-01-01

    Despite neurotrauma treatment practices comprising a significant amount of neurosurgical work for secondary medical service centers, little attention has been placed on neurotrauma cases and evaluation of current neurotrauma treatment practices is limited. Therefore we investigated current neurotrauma practices in our hospital located in a Japanese suburban city. We analyzed 439 patients with traumatic brain injury (TBI) admitted to our hospital between April 2004 and October 2010. Patients were divided into three groups based on the Glasgow Coma Scale (GCS) score on admission: mild TBI (GCS 14-15) in 252 patients (57.4%), moderate TBI (GCS 9-13) in 116 patients (26.4%), and severe TBI (GCS 3-8) in 71 patients (16.2%). Age, gender, alcohol consumption, cause of injury, cranial CT findings, neurosurgical procedure, length of hospital stay, and clinical outcome were analyzed. The average age of the patients was 59.2 years old. Male patients comprised 65%. Alcohol consumption was reported in 81 cases (18.5%), most of them with moderate TBI. Fall (208 cases, 47.4%) was the most frequent cause of injury, followed by traffic accident (115 cases, 26.2%) and high fall (73 cases, 16.6%). Acute subdural hematoma (174 cases, 39.6%) was most frequently seen in cranial CT findings on admission, which significantly increased with severity. A neurosurgical procedure was performed for 70 cases (15.9%), of which 15 (6.0%) were mild TBI and 18 (15.5%) were moderate TBI. The average hospital stay was 20.8 days, which significantly increased with severity. The overall rate of favorable outcome was 82.7%, and mortality was 8.2%; outcome deteriorated with severity. Some mild and moderate TBI cases had deteriorated and required surgery or resulted in death. These findings suggest that cautious treatment is necessary even in mild to moderate TBI cases which are often encountered in secondary medical service centers. (author)

  2. Early hemodynamic assessment and treatment of elderly patients in the medical ICU.

    Science.gov (United States)

    Voga, Gorazd; Gabršček-Parežnik, Lucija

    2016-12-01

    The aim of this retrospective study was to analyze differences in the initial hemodynamic assessment and its impact on the treatment in patients aged 80 years or older compared to younger patients during the first 6 h after admission to the medical intensive care unit (ICU). We analyzed 615 consecutive patients admitted to the medical ICU of which 124 (20%) were aged 80 years or more. The older group had a significantly higher acute physiology and chronic health evaluation (APACHE II) score, an overall mortality in the ICU and a presence of pre-existing cardiac disease. Both groups did not differ in the presence of shock and shock types on admission. In 57% of older and in 56% of younger patients, transthoracic echocardiography was performed with a higher therapeutic impact in the older patients. Transesophageal echocardiography was performed in 3% of the patients in both groups for specific diagnostic problems. Early reassessment with transthoracic echocardiography was necessary in 5% of the older and in 6% of the younger patients and resulted in a change of the treatment in one third of the patients. Continuous invasive hemodynamic monitoring was used in 11% of the older and in 10% of the younger patients and resulted in a therapeutic change in 71% of the older and in 64% of the younger patients. Patients aged 80 years or older represent 20% of all admissions to the medical ICU. Once admitted the older patients were similarly hemodynamically assessed as the younger ones with a similar impact on the treatment.

  3. The practice and effect of combined duty of administrative management, medical treatment and nursing

    Directory of Open Access Journals (Sweden)

    Min HU

    2014-09-01

    Full Text Available Objective: To explore the effect of combined duty mode on discovery and control of medical nursing hidden trouble. Method: In order to make sure that patients are in the first place, we should take the mode of combined duty of administrative management, medical treatment and nursing. Results:The incidence of nursing errors and defects reduced, and patients’ satisfaction improved. the differences were statistically significant (P<0.01 or P<0.05.Results: Combined duty can the reduce medical nursing defects, improve the efficiency of quality health care services and the management efficiency.

  4. Perceived treatment effectiveness, medication compliance, and complementary and alternative medicine use among veterans with bipolar disorder.

    Science.gov (United States)

    Jarman, Christopher N; Perron, Brian E; Kilbourne, Amy M; Teh, Carrie Farmer

    2010-03-01

    Recent research shows a high rate of complementary and alternative medicine (CAM) use among persons with mental disorders, although correlates and patterns of CAM use are relatively unknown. This study tested whether CAM use is associated with perceived effectiveness of conventional treatment (i.e., psychotropic medication and psychotherapy) and medication compliance among persons with bipolar disorder. Patients with bipolar disorder (n = 435) were included as part of a naturalistic cohort study. Measures of CAM utilization, medication compliance, and perceptions of the effectiveness of psychotropic medications and psychotherapy were based on previously established questionnaires. Associations were tested using bivariate and multivariate analyses. Bivariate analyses showed that patients who did not perceive psychotherapy as effective at improving social, family, or job functioning reported greater CAM use. However, medication compliance was not significantly associated with use of CAM. Patients who used oral (e.g., herbal therapies) or cognitive (e.g., meditation) CAM were more likely to report that their medications were not effective at relieving manic or depressive symptoms. Users of cognitive CAM were more likely to report that their medications did not help with social, job, or family functioning, and that they did not prevent recurrences of manic or depressive episodes. None of the bivariate associations remained significant in multivariate analyses. Prior research has suggested that persons who are dissatisfied with treatment for medical conditions are more likely to use CAM therapies. However, the results of this study do not show CAM therapies to be associated with perceived effectiveness of treatments for mental health problems among this sample of persons with serious mental illnesses. This suggests that motivations for CAM use may vary by population and condition. Because few correlates of CAM use among persons with serious mental illnesses are known

  5. Medication assisted treatment in US drug courts: results from a nationwide survey of availability, barriers and attitudes.

    Science.gov (United States)

    Matusow, Harlan; Dickman, Samuel L; Rich, Josiah D; Fong, Chunki; Dumont, Dora M; Hardin, Carolyn; Marlowe, Douglas; Rosenblum, Andrew

    2013-01-01

    Drug treatment courts are an increasingly important tool in reducing the census of those incarcerated for non-violent drug offenses; medication assisted treatment (MAT) is proven to be an effective treatment for opioid addiction. However, little is known about the availability of and barriers to MAT provision for opioid-addicted people under drug court jurisdiction. Using an online survey, we assessed availability, barriers, and need for MAT (especially agonist medication) for opioid addiction in drug courts. Ninety-eight percent reported opioid-addicted participants, and 47% offered agonist medication (56% for all MAT including naltrexone). Barriers included cost and court policy. Responses revealed significant uncertainty, especially among non-MAT providing courts. Political, judicial and administrative opposition appear to affect MAT's inconsistent use and availability in drug court settings. These data suggest that a substantial, targeted educational initiative is needed to increase awareness of the treatment and criminal justice benefits of MAT in the drug courts. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Treatment with at Homeopathic Complex Medication Modulates Mononuclear Bone Marrow Cell Differentiation

    Directory of Open Access Journals (Sweden)

    Beatriz Cesar

    2011-01-01

    Full Text Available A homeopathic complex medication (HCM, with immunomodulatory properties, is recommended for patients with depressed immune systems. Previous studies demonstrated that the medication induces an increase in leukocyte number. The bone marrow microenvironment is composed of growth factors, stromal cells, an extracellular matrix and progenitor cells that differentiate into mature blood cells. Mice were our biological model used in this research. We now report in vivo immunophenotyping of total bone marrow cells and ex vivo effects of the medication on mononuclear cell differentiation at different times. Cells were examined by light microscopy and cytokine levels were measured in vitro. After in vivo treatment with HCM, a pool of cells from the new marrow microenvironment was analyzed by flow cytometry to detect any trend in cell alteration. The results showed decreases, mainly, in CD11b and TER-119 markers compared with controls. Mononuclear cells were used to analyze the effects of ex vivo HCM treatment and the number of cells showing ring nuclei, niche cells and activated macrophages increased in culture, even in the absence of macrophage colony-stimulating factor. Cytokines favoring stromal cell survival and differentiation in culture were induced in vitro. Thus, we observe that HCM is immunomodulatory, either alone or in association with other products.

  7. On the importance of PURE - Public Understanding of Renewable Energy

    Energy Technology Data Exchange (ETDEWEB)

    Broman, Lars; Kandpal, Tara C.

    2013-09-15

    Public understanding of science (PUS) is a central concept among science communicators. Public understanding of renewable energy (PURE) is proposed as an important sub-concept of PUS. The aim of this paper is to interest and invite renewable energy scientists to join a PURE research project. Four separate important questions for a PURE research project can be identified: (A) Is PURE important? (B) Which issues of PURE are the most important ones, according to renewable energy scientists? (C) What understanding of renewable energy has the general public today, worldwide? (D) How to achieve PURE?.

  8. Bi-orderings on pure braided Thompson's groups

    OpenAIRE

    Burillo, Jose; Gonzalez-Meneses, Juan

    2006-01-01

    In this paper it is proved that the pure braided Thompson’s group BF admits a bi-order, analog to the bi-order of the pure braid groups. Ministerio de Educación y Ciencia Fondo Europeo de Desarrollo Regional

  9. Comparison of patients undergoing switching versus augmentation of antipsychotic medications during treatment for schizophrenia

    Directory of Open Access Journals (Sweden)

    Ascher-Svanum H

    2012-03-01

    Full Text Available Haya Ascher-Svanum, Alan JM Brnabic, Anthony H Lawson, Bruce J Kinon, Virginia L Stauffer, Peter D Feldman, Katarina KelinLilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, Indiana, USAAbstract: It is often difficult to determine whether a patient may best benefit by augmenting their current medication or switching them to another. This post-hoc analysis compares patients’ clinical and functional profiles at the time their antipsychotic medications were either switched or augmented. Adult outpatients receiving oral antipsychotic treatment for schizophrenia were assessed during a 12-month international observational study. Clinical and functional measures were assessed at the time of first treatment switch/augmentation (0–14 days prior and compared between Switched and Augmented patient groups. Due to low numbers of patients providing such data, interpretations are based on effect sizes. Data at the time of change were available for 87 patients: 53 Switched and 34 Augmented. Inadequate response was the primary reason for treatment change in both groups, whereas lack of adherence was more prevalent in the Switched group (26.4% vs 8.8%. Changes in clinical severity from study initiation to medication change were similar, as indicated by Clinical Global Impressions–Severity scores. However, physical and mental component scores of the 12-item Short-Form Health Survey improved in the Augmented group, but worsened in the Switched group. These findings suggest that the patient’s worsening or lack of meaningful improvement prompts clinicians to switch antipsychotic medications, whereas when patients show some improvement, clinicians may be more likely to try bolstering the improvements through augmentation. Current findings are consistent with physicians’ stated reasons for switching versus augmenting antipsychotics in the treatment of schizophrenia. Confirmation of these findings requires further research

  10. Music as a complementary therapy in medical treatment

    Directory of Open Access Journals (Sweden)

    Samuel Halim

    2002-12-01

    Full Text Available Music can act not only as a source of enjoyable sound that gives pleasant feeling, but also a source of healing. Music as a therapy has developed, supported by many researches conducted by experts in music, education and medicine. The impact of music therapy can be observed in many case studies, showing the positive effects of music to the betterment of human’s neuro-behavior, emotional and physical states. Some reasons to use music as a therapy are: toget audioanalgesic response, to focus attention, to reinforce learning, to enhance interpersonal relationships, and to promote mind-body health in the medical staff. The use of music to help patients with non-infectious diseases such as Alzheimer disease, autism, cancer, headache, heart disease and stroke are described along with experiments and case studies on these diseases. However controversies around music therapy occurred. Therefore, more experiments need to be taken in order to clear the controversies and to use music as a therapy in the present and future medical treatment. (Med J Indones 2002; 11: 250-7.Keywords: therapeutic effect, music therapy, Alzheimer, autism, cancer, stroke

  11. Treatment Related Thoughts Based on Health Belief Model and Medication Nonadherence in Patients who Prescribed Anxiolytics and Antidepressants

    Directory of Open Access Journals (Sweden)

    Meltem Meric

    2010-10-01

    Full Text Available AIM: The purpose of this study was to evaluate the relationship between treatment adherence and treatment related thoughts based on health belief model in patients who currently take medication due to depression and anxiety disorder. METHOD: The present study was performed at the Psychiatry Department of a teaching hospital. The sample of the study consisted from 112 individuals who take medications due to depression and anxiety disorder. Personal information form and an inquiry form including treatment related thoughts based on health belief model were used to collect data. Chi- Square and Percentages were used for statistical analysis. RESULTS: Of the patients, 58.9% were diagnosed as depression and 41.1% anxiety disorder. 60.7% stated that they had a non-adherence experience in the past. Of these non-adherent patients, 29.5% stopped to take the medication with the idea “I can do it without medication” and 14.3% stopped the medication because of the side effects. Gender, age, marital status and education level were not related to the non-adherence. Only two treatment related thoughts based on health belief concepts were significantly related to the non adherence experience. These thoughts were “If I do not take the medications properly the problems may be permanent” and “If I do not take the medications properly my illness may get worse”. Most of the patients marked “agree” options of the items under the perceived severity, self-efficacy, benefits, susceptibility and health motivation subheads. CONCLUSION: The results of this study showed that the thoughts and perceptions based on health belief concepts helps to identify and express the thoughts related to treatment adherence. These concepts can be used to describe and classify the thoughts about the treatments of patients. However, prospective and qualitative studies may be useful to clarify the influence of the health beliefs on treatment adherence. [TAF Prev Med Bull 2010; 9

  12. Isotopically pure single crystal epitaxial diamond films and their preparation

    International Nuclear Information System (INIS)

    Banholzer, W.F.; Anthony, T.R.; Williams, D.M.

    1992-01-01

    The present invention is directed to the production of single crystal diamond consisting of isotopically pure carbon-12 or carbon-13. In the present invention, isotopically pure single crystal diamond is grown on a single crystal substrate directly from isotopically pure carbon-12 or carbon-13. One method for forming isotopically pure single crystal diamond comprises the steps of placing in a reaction chamber a single substrate heated to an elevated diamond forming temperature. Another method for forming isotopically pure single crystal diamond comprises diffusing isotopically pure carbon-12 or carbon-13 through a metallic catalyst under high pressure to a region containing a single crystal substrate to form an isotopically pure single crystal diamond layer on said single crystal substrate

  13. PSYCHE Pure Shift NMR Spectroscopy.

    Science.gov (United States)

    Foroozandeh, Mohammadali; Morris, Gareth; Nilsson, Mathias

    2018-03-13

    Broadband homodecoupling techniques in NMR, also known as "pure shift" methods, aim to enhance spectral resolution by suppressing the effects of homonuclear coupling interactions to turn multiplet signals into singlets. Such techniques typically work by selecting a subset of "active" nuclear spins to observe, and selectively inverting the remaining, "passive", spins to reverse the effects of coupling. Pure Shift Yielded by Chirp Excitation (PSYCHE) is one such method; it is relatively recent, but has already been successfully implemented in a range of different NMR experiments. Paradoxically, PSYCHE is one of the trickiest of pure shift NMR techniques to understand but one of the easiest to use. Here we offer some insights into theoretical and practical aspects of the method, and into the effects and importance of the experimental parameters. Some recent improvements that enhance the spectral purity of PSYCHE spectra will be presented, and some experimental frameworks including examples in 1D and 2D NMR spectroscopy, for the implementation of PSYCHE will be introduced. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  14. Texture and Microtexture of Pure (6N and Commercially Pure Aluminum after Deformation by Extrusion with Forward-Backward Rotating Die (Kobo

    Directory of Open Access Journals (Sweden)

    Bieda M.

    2016-03-01

    Full Text Available Pure aluminium (6N and commercially pure aluminium (99.7 was deformed by KOBO method. Microstructure and texture of both materials after deformation was analyzed by means of scanning and transmission electron microscopy. Advanced methods of crystallographic orientations measurements like Electron Backscatter Diffraction - EBSD (SEM and microdiffraction (TEM was used. Grain size distribution and misorientation between grains in cross and longitudinal sections of the samples were analyzed. Differences in size and homogeneity of the grains were observed in both materials. Pure aluminium was characterized by larger grain size in both sections of extruded material. Whereas commercially pure aluminium reveals smaller grain size and more homogeneous and stable microstructure.

  15. CLINICAL EVIDENCE OF THE EFFECTIVENESS OF VIFERON® MEDICATIONS IN THE TREATMENT OF ARVI AND INFLUENZA IN ADULTS

    Directory of Open Access Journals (Sweden)

    V. V. Malinovskaya

    2014-01-01

    Full Text Available The paper presents a comparative analysis of the results of clinical laboratory trials carried out on the basis of 10 different medical and preventive treatment facilities drawing on the principles and methodology of evidence-based medicine, which confirmed the certainty of clinical effectiveness of Viferon® medications in the treatment of acute respiratory viral infections (ARVI and influenza in adults. The algorithm included an assessment of antiviral, immunomodulatory, anti-inflammatory, anti-oxidant actions of the medication under the conditions of concurrent, unmasked, randomized, placebo-controlled, clinical immunological studies and a retrospective analysis in keeping with the “Guidelines for Good Clinical Practice”. Thereby, it was shown that the use of Viferon® medications (suppositories, gel in the treatment of adults with influenza and ARVI, whether with viral or viral-bacterial etiology, contributes to a statistically significant reduction in duration of principal clinical symptoms and the disease as a whole, as well as a decrease of immune and interferon system imbalance and a faster elimination of viral antigens. On the basis of the proven antiviral therapeutic effectiveness and immunomodulatory action, safety and high tolerability, easy-to-administer form in the  outpatient settings, Viferon® has been recommended as a disease-modifying agent in the treatment of influenza and ARVI in adults.

  16. Treatment of asymptomatic UTI in older delirious medical in-patients: A prospective cohort study.

    Science.gov (United States)

    Dasgupta, Monidipa; Brymer, Chris; Elsayed, Sameer

    2017-09-01

    Despite clinical practice guidelines, asymptomatic bacteriuria (ASB) in older people is frequently treated. A common reason for treating ASB is a change in mental status. To determine how often asymptomatic UTI is treated in older medically ill delirious individuals and its association with functional recovery. Consecutive older medical in-patients were screened for delirium, and followed in hospital. Treatment for asymptomatic UTI was defined as documented treatment for a possible urinary tract infection with antibiotics, without concurrent infectious or urinary symptoms. The primary outcome was functional recovery at discharge or 3 months post-discharge. Poor functional recovery was defined by any one of death, new permanent long-term institutionalization or decreased ability to perform activities of daily living. The study sample comprised 343 delirious in-patients, of which 237 (69%) had poor functional recovery. Ninety two (27%) delirious in-patients were treated for asymptomatic UTI. Treatment for asymptomatic UTI was associated with poor functional recovery compared to other delirious in-patients (RR 1.30, 95% CI: 1.14-1.48 overall). Similar results were seen when the analysis was restricted to only bacteriuric delirious individuals. Seven (7.5%) individuals treated for asymptomatic UTI developed Clostridium difficile infection compared to eight (3.2%) in the remainder of the delirious cohort (OR 2.45, 95% CI: 0.86-6.96). These results suggest that treatment of asymptomatic UTI in older medical in-patients with delirium is common, and of questionable benefit. Further research is needed to establish guidelines to minimize over-treatment of UTI in older delirious in-patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. The role of sleep quality and quantity in moderating the effectiveness of medication in the treatment of children with ADHD.

    Science.gov (United States)

    Morash-Conway, Jessica; Gendron, Melissa; Corkum, Penny

    2017-03-01

    The current study examined: (1) whether long-acting stimulant medication is effective in improving performance on measures of memory, attention, and academic productivity; and (2) whether sleep impacts the relationship between medication and performance. Participants were 21 newly diagnosed, medication-naïve children (mean age = 9.1 years) with ADHD, who participated in a 4-week blinded placebo-controlled randomized trial of long-acting MPH. Participants underwent assessments of sleep (i.e., polysomnography) and of cognitive performance. Long-acting stimulant medication was found to be an effective treatment for enhancing alerting attention, executive attention, working memory, and academic productivity, but resulted in poorer sleep. Moreover, sleep duration was found to impact the treatment response to medication, in that longer sleep duration at baseline was related to improved executive attention. These results underscore the importance of evaluating and monitoring sleep when prescribing stimulant medication as a treatment for ADHD in children.

  18. Application of NCRP REPORT No.151 for evaluating the radiation level at the ambience of megavoltage medical electron linear accelerator treatment room

    International Nuclear Information System (INIS)

    Yang Haiyou; Yu Shui

    2011-01-01

    Objective: The estimation model,on radiation level at the ambience of medical electron linear accelerator treatment rooms, is derived on the basis of NCRP REPORT No.151, which presents the calculation model of shielding design about barrier thicknesses of megavoltage medical electron linear accelerator treatment rooms. Methods: The estimation model comes from NCRP REPORT No.151- S tructural Shielding Design and Evaluation for Megavoltage X-and Gamma-Ray Radiotherapy Facilities , which presents the calculation model of shielding design about megavoltage medical electron linear accelerator treatment rooms, and the dose rate at isocenter replaces the workload, and the occupancy factor and the use factor are forsaken, then the converse deduction is done according to barrier thicknesses of shielding materials. Ultimately, the estimation model, on radiation level at the ambience of medical electron linear accelerator treatment rooms, is derived. Results: It can be regarded as a systematic estimation model for calculating the radiation level at the ambience of medical electron linear accelerator treatment room. Conclusion: The estimation model has certain practical value to evaluate the radiation level at the ambience of medical electron linear accelerator treatment room. (authors)

  19. Medical prescription of heroin to treatment resistant heroin addicts: two randomised controlled trials

    NARCIS (Netherlands)

    van den Brink, Wim; Hendriks, Vincent M.; Blanken, Peter; Koeter, Maarten W. J.; van Zwieten, Barbara J.; van Ree, Jan M.

    2003-01-01

    OBJECTIVE: To determine whether supervised medical prescription of heroin can successfully treat addicts who do not sufficiently benefit from methadone maintenance treatment. DESIGN: Two open label randomised controlled trials. SETTING: Methadone maintenance programmes in six cities in the

  20. Lectures on the theory of pure motives

    CERN Document Server

    Murre, Jacob P; A, Chris

    2013-01-01

    The theory of motives was created by Grothendieck in the 1960s as he searched for a universal cohomology theory for algebraic varieties. The theory of pure motives is well established as far as the construction is concerned. Pure motives are expected to have a number of additional properties predicted by Grothendieck's standard conjectures, but these conjectures remain wide open. The theory for mixed motives is still incomplete. This book deals primarily with the theory of pure motives. The exposition begins with the fundamentals: Grothendieck's construction of the category of pure motives and examples. Next, the standard conjectures and the famous theorem of Jannsen on the category of the numerical motives are discussed. Following this, the important theory of finite dimensionality is covered. The concept of Chow-K�nneth decomposition is introduced, with discussion of the known results and the related conjectures, in particular the conjectures of Bloch-Beilinson type. We finish with a chapter on relative m...

  1. Medications (for IBS)

    Medline Plus

    Full Text Available ... Treating IBS Pain IBS Global Treatments IBS Diet Low FODMAP Diet Complementary or Alternative Treatments Medications Psychological ... Treating IBS Pain IBS Global Treatments IBS Diet Low FODMAP Diet Complementary or Alternative Treatments Medications Psychological ...

  2. Medications (for IBS)

    Medline Plus

    Full Text Available ... Treatments Medications Psychological Treatments Online Studies News You Can Use Living With IBS Relationships and IBS Pregnancy ... Treatments Medications Psychological Treatments Online Studies News You Can Use Living With IBS Relationships and IBS Pregnancy ...

  3. Medications (for IBS)

    Medline Plus

    Full Text Available ... Diet Complementary or Alternative Treatments Medications Psychological Treatments Online Studies News You Can Use Living With IBS ... Diet Complementary or Alternative Treatments Medications Psychological Treatments Online Studies News You Can Use Living With IBS ...

  4. The effect of financial incentives on patients' motivation for treatment: results of "Money for Medication," a randomised controlled trial.

    Science.gov (United States)

    Noordraven, Ernst L; Wierdsma, André I; Blanken, Peter; Bloemendaal, Anthony F T; Mulder, Cornelis L

    2018-05-24

    Offering financial incentives is an effective intervention for improving adherence in patients taking antipsychotic depot medication. We assessed whether patients' motivation for treatment might be reduced after receiving financial rewards. This study was part of Money for Medication, a multicentre, open-label, randomised controlled trial, which demonstrated the positive effects of financial incentives on antipsychotic depot compliance. Three mental healthcare institutions in Dutch secondary psychiatric care services participated. Eligible patients were aged 18-65 years, had been diagnosed with schizophrenia or another psychotic disorder, had been prescribed antipsychotic depot medication or had an indication to start using depot medication, and were participating in outpatient treatment. For 12 months, patients were randomly assigned either to treatment as usual (control group) or to treatment as usual plus a financial reward for each depot of medication received (€30 per month if fully compliant; intervention group). They were followed up for 6 months, during which time no monetary rewards were offered for taking antipsychotic medication. To assess treatment motivation after 0, 12 and 18 months, interviews were conducted using a supplement to the Health of the Nation Outcome Scales (HoNOS) and the Treatment Entry Questionnaire (TEQ). Patients were randomly assigned to the intervention (n = 84) or the control group (n = 85). After 12 months, HoNOS motivation scores were available for 131 patients (78%). Ninety-one percent of the patients had no or mild motivational problems for overall treatment; over time, there were no significant differences between the intervention and control groups. TEQ data was available for a subgroup of patients (n = 61), and showed no significant differences over time between the intervention and control groups for external motivation (β = 0.37 95% CI: -2.49 - 3.23, p = 0.799); introjected motivation (

  5. Feasibility of purely endoscopic intramedullary fixation of mandibular condyle fractures.

    Science.gov (United States)

    Frake, Paul C; Goodman, Joseph F; Joshi, Arjun S

    2015-01-01

    The investigators of this study hypothesized that fractures of the mandibular condyle can be repaired using short-segment intramedullary implants and purely endoscopic surgical technique, using a basic science, human cadaver model in an academic center. Endoscopic instrumentation was used through a transoral mucosal incision to place intramedullary implants of 2 cm in length into osteotomized mandibular condyles. The surgical maneuvers that required to insert these implants, including condyle positioning, reaming, implant insertion, and seating of the mandibular ramus, are described herein. Primary outcome was considered as successful completion of the procedure. Ten cadaveric mandibular condyles were successfully repaired with rigid intramedullary internal fixation without the use of external incisions. Both insertion of a peg-type implant and screwing a threaded implant into the condylar head were possible. The inferior portion of the implant remained exposed, and the ramus of the mandible was manipulated into position on the implant using retraction at the sigmoid notch. The results of this study suggest that purely endoscopic repair of fractures of the mandibular condyle is possible by using short-segment intramedullary titanium implants and a transoral endoscopic approach without the need for facial incisions or punctures. The biomechanical advantages of these intramedullary implants, including improved strength and resistance to mechanical failure compared with miniplates, have been recently established. The combination of improved implant design and purely endoscopic technique may allow for improved fixation and reduced surgical- and implant-related morbidity in the treatment of condylar fractures.

  6. Adolescent substance use in the multimodal treatment study of attention-deficit/hyperactivity disorder (ADHD) (MTA) as a function of childhood ADHD, random assignment to childhood treatments, and subsequent medication.

    Science.gov (United States)

    Molina, Brooke S G; Hinshaw, Stephen P; Eugene Arnold, L; Swanson, James M; Pelham, William E; Hechtman, Lily; Hoza, Betsy; Epstein, Jeffery N; Wigal, Timothy; Abikoff, Howard B; Greenhill, Laurence L; Jensen, Peter S; Wells, Karen C; Vitiello, Benedetto; Gibbons, Robert D; Howard, Andrea; Houck, Patricia R; Hur, Kwan; Lu, Bo; Marcus, Sue

    2013-03-01

    To determine long-term effects on substance use and substance use disorder (SUD), up to 8 years after childhood enrollment, of the randomly assigned 14-month treatments in the multisite Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (MTA; n = 436); to test whether medication at follow-up, cumulative psychostimulant treatment over time, or both relate to substance use/SUD; and to compare substance use/SUD in the ADHD sample to the non-ADHD childhood classmate comparison group (n = 261). Mixed-effects regression models with planned contrasts were used for all tests except the important cumulative stimulant treatment question, for which propensity score matching analysis was used. The originally randomized treatment groups did not differ significantly on substance use/SUD by the 8-year follow-up or earlier (mean age = 17 years). Neither medication at follow-up (mostly stimulants) nor cumulative stimulant treatment was associated with adolescent substance use/SUD. Substance use at all time points, including use of two or more substances and SUD, were each greater in the ADHD than in the non-ADHD samples, regardless of sex. Medication for ADHD did not protect from, or contribute to, visible risk of substance use or SUD by adolescence, whether analyzed as randomized treatment assignment in childhood, as medication at follow-up, or as cumulative stimulant treatment over an 8-year follow-up from childhood. These results suggest the need to identify alternative or adjunctive adolescent-focused approaches to substance abuse prevention and treatment for boys and girls with ADHD, especially given their increased risk for use and abuse of multiple substances that is not improved with stimulant medication. Clinical trial registration information-Multimodal Treatment Study of Children With Attention Deficit and Hyperactivity Disorder (MTA); http://clinical trials.gov/; NCT00000388. Copyright © 2013 American Academy of Child and Adolescent

  7. Pharmacological Treatments of Alzheimer’s Disease: Current Medication,

    Directory of Open Access Journals (Sweden)

    Arash Mowla

    2010-12-01

    Full Text Available Background: Alzheimer’s disease (AD that is identified by progressive cognitive deficit and behavioral disturbances (BD are the most common form of dementia. As the population is aging, patients with AD are becoming a serious burden for societies. In this study, current medication for cognitive deficit and behavioral disturbances are reviewed. Also the new treatment strategies for cognitive dysfunction and behavioral disturbances are surveyed. Methods: The method employed in this researh was a systematic bibliographic review, in which only the double-blind placebo-controlled studies or the clinically detailed enough open-labeled studies using validated scales were retained. Results: The efficacy of cholinesterase inhibitors (Tacrine, Rivastigmine, Donapezil and Galantamine has been demonstrated in several double blind placebo controlled clinical trials. They have shown a mild efficacy in mild to moderate AD. Memantine, a NMDA antagonist is the only drug that has demonstrated mild efficacy in moderate to severe AD in controlled clinical trial. Clinical trials surveying the efficacy of active and passive immunization against B amyloid protoin has halted due to serious adverse events. Studies of inducing neurogenesis in brain of AD patients are preliminary. Antipsychotics have shown efficacy for controlling BD of AD patients but they are associated with adverse events. Except for carbamazepine, there is not enough evidence for other anticanvulsants to be effective for behavioral disturbances of AD patients. A controlled clinical trial and some open studies have shown the efficacy of citalopram for BD. Further studies are needed to confirm the efficacy of other medications like trazadon, buspiron and beta blockers for BD. Conclusion: Cholinesterase inhibitors have demonstrated disappointing results. Memantine is only mildly effective for cognitive deficit. To date, no amyloid-modifying therapy has yet been successful in phase 3 clinical trials

  8. The adverse influence of spina bifida occulta on the medical treatment outcome of primary monosymptomatic nocturnal enuresis

    Directory of Open Access Journals (Sweden)

    Basri Cakiroglu

    2014-12-01

    Full Text Available Objective: Previous reports have suggested that the incidence of spina bifida occulta (SBO in patients with primary monosymptomatic nocturnal enuresis (PMNE is higher than the general population. The purpose of this study was to investigate the effect of spina bifida occulta on the medical treatment outcome of PMNE. Material and Methods: Between January 2008 and December 2011, a total of 223 children (151 boys and 72 girls, aged 6-16 years; mean age: 10.1 ± 3.04 years with PMNE were reviewed retrospectively. All of the children underwent physical examination, urine analysis, urinary tract ultrasonography and kidney ureter bladder (KUB scout film. All patients were initially treated with a timed voiding program and were given desmopressin acetate when necessary. Results: Spina bifida occulta was detected in 75 children (33.6%. Spina bifida occulta affected L4 in 2 children, L5 in 6 children, L4-L5 in 3 children, S1 in 52 children, S2 in 7 children and S1-S2 in 2 children. Treatment was successful in 79% of the children without SBO, and in only 48% of the children with SBO. Medical treatment success rates differed significantly between the study groups. Conclusion: The presence of spina bifida occulta significantly affects the response to medical treatment in patients with PMNE. Thus, verifying spina bifida occulta status in PMNE can facilitate prognostic predictions about the response to medical treatment.

  9. Treatment Outcomes From a Specialist Model for Treating Tobacco Use Disorder in a Medical Center.

    Science.gov (United States)

    Burke, Michael V; Ebbert, Jon O; Schroeder, Darrell R; McFadden, David D; Hays, J Taylor

    2015-11-01

    Cigarette smoking causes premature mortality and multiple morbidity; stop smoking improves health. Higher rates of smoking cessation can be achieved through more intensive treatment, consisting of medication and extended counseling of patients, but there are challenges to integrating these interventions into healthcare delivery systems. A care model using a master-level counselor trained as a tobacco treatment specialist (TTS) to deliver behavioral intervention, teamed with a supervising physician/prescriber, affords an opportunity to integrate more intensive tobacco dependence treatment into hospitals, clinics, and other medical systems. This article analyzes treatment outcomes and predictors of abstinence for cigarette smokers being treated using the TTS-physician team in a large outpatient clinic over a 7-year period.This is an observational study of a large cohort of cigarette smokers treated for tobacco dependence at a medical center. Patients referred by the primary healthcare team for a TTS consult received a standard assessment and personalized treatment planning guided by a workbook. Medication and behavioral plans were developed collaboratively with each patient. Six months after the initial assessment, a telephone call was made to ascertain a 7-day period of self-reported abstinence. The univariate association of each baseline patient characteristic with self-reported tobacco abstinence at 6 months was evaluated using the chi-squared test. In addition, a multiple logistic regression analysis was performed with self-reported tobacco abstinence as the dependent variable and all baseline characteristics included as explanatory variables.Over a period of 7 years (2005-2011), 6824 cigarette smokers who provided general research authorization were seen for treatment. The 6-month self-reported abstinence rate was 28.1% (95% confidence interval: 27.7-30.1). The patients most likely to report abstinence were less dependent, more motivated to quit, and did not

  10. Pure energy solutions - pure tomorrows

    International Nuclear Information System (INIS)

    Allison, J.

    2006-01-01

    HTC is an energy technology company whose mandate is to deliver 'Carbon Clear Solutions' to address the pending challenges the energy sector is facing in meeting the environmental impact of Greenhouse Gas emissions, and energy security. HTC will speak on its comprehensive suite of technologies including hydrogen production, CO 2 capture and CO 2 sequestration. HTC has patented technologies that produce H 2 from a broad variety of feedstocks such as Natural gas, Diesel, Gasoline, Bio-fuels i.e. ethanol, methanol and Coal Gasification. HTC Hydrogen reformation systems are unique in their method of delivering pure Hydrogen. Dry Reformation Reactor - New catalyst system designed to eliminate contamination problems (i.e. coking) while at the same time operate at a low temperature. Water Gas Shift Reactor - Plus - improved and redesigned catalyst that improves operating temperature and hydrogen production efficiency. Two stage catalyst reactor that provides near balance of the endothermic and exothermic reaction temperatures for efficient energy balance

  11. Pure γ-families

    International Nuclear Information System (INIS)

    Dunaevskii, A.M.

    1977-01-01

    The subject of this work are pure gamma families consisting of the gamma quanta produced in the early stages of cosmic cascades. The criteria of selecting these families from the all measured families are presented. The characteristics of these families are given and some conclusions about the mechanism of the nuclear-electromagnetic cascades are extracted. (S.B.)

  12. Pharmacoeconomic efficacy of complex medical and climatic treatment of atopic asthma in Teberda resort

    Directory of Open Access Journals (Sweden)

    Erkenova Z.T.

    2010-09-01

    Full Text Available 120 patients with atopic asthma have been divided into two groups: the control group (60 patients - has been treated with budesonide and formoterol combination (Cymbicort Turbuhaler in individual doses; the main group (60 patients additionally has being taken a course of climatic therapy in Teberda resort for 21 days. Common pharmacoeconomic analysis has been carried out with study of «expenses-efficiency» balance. Statistic results have been processed with Statistica 6,0 program. Complex of medical and climatic treatment of atopic asthma in Teberda resort promoted twice reduction of Cymbicort Turbuhaler dosage in 63,33% of patients while holding asthma control. Main group patients significantly rarely asked for stationary, out-patient or emergency aid; so it helped to reduce yearly expenses for 1 patient treatment to 51, 69%. Complex medical and climatic treatment of atopic asthma in Teberda resort allows to reduce pharmacoeconomic expenses significantly and to improve disease course

  13. Subpopulation Treatment Effect Pattern Plot (STEPP) analysis of Ki67 assay according to histology: prognostic relevance for resected early stage 'pure' and 'mixed' lobular breast cancer.

    Science.gov (United States)

    Carbognin, Luisa; Sperduti, Isabella; Brunelli, Matteo; Marcolini, Lisa; Nortilli, Rolando; Pilotto, Sara; Zampiva, Ilaria; Merler, Sara; Fiorio, Elena; Filippi, Elisa; Manfrin, Erminia; Pellini, Francesca; Bonetti, Franco; Pollini, Giovanni Paolo; Tortora, Giampaolo; Bria, Emilio

    2016-03-22

    The aim of this analysis was to investigate the potential impact of Ki67 assay in a series of patients affected by early stage invasive lobular carcinoma (ILC) undergone surgery. Clinical-pathological data were correlated with disease-free and overall survival (DFS/OS). The maximally selected Log-Rank statistics analysis was applied to the Ki67 continuous variable to estimate appropriate cut-offs. The Subpopulation Treatment Effect Pattern Plot (STEPP) analysis was performed to assess the interaction between 'pure' or 'mixed' histology ILC and Ki67. At a median follow-up of 67 months, 10-years DFS and OS of 405 patients were 67.8 and 79.8%, respectively. Standardized Log-Rank statistics identified 2 optimal cut-offs (6 and 21%); 10-years DFS and OS were 75.1, 66.5, and 30.2% (p = 0.01) and 84.3, 76.4 and 59% (p = 0.003), for patients with a Ki67 21%, respectively. Ki67 and lymph-node status were independent predictor for longer DFS and OS at the multivariate analysis, with radiotherapy (for DFS) and age (for OS). Ki67 highly replicated at the internal cross-validation analysis (DFS 85%, OS 100%). The STEPP analysis showed that DFS rate decreases as Ki67 increases and those patients with 'pure' ILC performed worse than 'mixed' histology. Despite the retrospective and exploratory nature of the study, Ki67 was able to significantly discriminate the prognosis of patients with ILC, and the effect was more pronounced for patients with 'pure' ILC.

  14. Pure spinor integration from the collating formula

    International Nuclear Information System (INIS)

    Grassi, P.A.; Sommovigo, L.

    2011-01-01

    We use the technique developed by Becchi and Imbimbo to construct a well-defined BRST-invariant path integral formulation of pure spinor amplitudes. The space of pure spinors can be viewed from the algebraic geometry point of view as a collection of open sets where the constraints can be solved and a set of free and independent variables can be defined. On the intersections of those open sets, the functional measure jumps and one has to add boundary terms to construct a well-defined path integral. The result is the definition of the pure spinor integration measure constructed in terms of differential forms on each single patch.

  15. Feasibility study of gamma-ray medical radiography

    International Nuclear Information System (INIS)

    Alyassin, Abdalmajeid M.; Maqsoud, Hamza A.; Mashat, Ahmad M.; Al-Mohr, Al-Sayed; Abdulwajid, Subhan

    2013-01-01

    This research explores the feasibility of using gamma-ray radiography in medical imaging. We will show that gamma-ray medical radiography has the potential to provide alternative diagnostic medical information to X-ray radiography. Approximately one Ci Am-241 radioactive source which emits mono-energetic 59.5 keV gamma rays was used. Several factors that influence the feasibility of this study were tested. They were the radiation source uniformity, image uniformity, and image quality parameters such as contrast, noise, and spatial resolution. In addition, several gamma-ray and X-ray images were acquired using humanoid phantoms. These images were recorded on computed radiography image receptors and displayed on a standard monitor. Visual assessments of these images were then conducted. The Am-241 radioactive source provided relatively uniform radiation exposure and images. Image noise and image contrast were mainly dependent on the exposure time and source size, whereas spatial resolution was dependent on source size and magnification factor. The gamma-ray humanoid phantom images were of lower quality than the X-ray images mainly due to the low radioactivity used and not enough exposure time. Nevertheless, the gamma-ray images displayed most of the main structures contained in the humanoid phantoms. Higher exposure rates and thus lower exposure times were estimated for different pure Am-241 source sizes that are hypothesized to provide high quality images similar to X-ray images. For instance, a 10 mm source size of pure Am-241 with 7 s exposure time should produce images similar in contrast and noise to X-ray images. This research paves the way for the production and usage of a highly radioactive Am-241 source with the potential to lead to the feasibility of acceptable quality medical gamma-ray radiography. - Highlights: ► Characterized the performance of gamma-ray radiography. ► Displayed medical images of humanoid phantoms using gamma radiography. ► Am-241

  16. WHO'S IN CHARGE? THE RELATIONSHIP BETWEEN MEDICAL LAW, MEDICAL ETHICS, AND MEDICAL MORALITY?

    Science.gov (United States)

    Foster, Charles; Miola, José

    2015-01-01

    Medical law inevitably involves decision-making, but the types of decisions that need to be made vary in nature, from those that are purely technical to others that contain an inherent ethical content. In this paper we identify the different types of decisions that need to be made, and explore whether the law, the medical profession, or the individual doctor is best placed to make them. We also argue that the law has failed in its duty to create a coherent foundation from which such decision-making might properly be regulated, and this has resulted in a haphazard legal framework that contains no consistency. We continue by examining various medico-legal topics in relation to these issues before ending by considering the risk of demoralisation. © The Author 2015. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Recognition and treatment of depression: a comparison of Australian and Chinese medical students.

    Science.gov (United States)

    Rong, Ye; Luscombe, Georgina M; Davenport, Tracey A; Huang, Yueqin; Glozier, Nick; Hickie, Ian B

    2009-08-01

    Depression is a major public health problem in both China and Australia. To improve services, we need to ensure health professionals have an appropriate understanding of depression and its treatments. This study compares the level of awareness of depression between Chinese and Australian medical students. The International Depression Literacy Survey assessing the public health impact, recognition and treatment of depression was completed by pre-psychiatric training medical students in China (n = 220) and Australia (n = 177). Chinese students were far less likely to consider mental health conditions and depression as major public health problems (P Depression symptom recognition was similar with four of the top five symptoms of depression the same in both groups of students. Chinese students were more likely to consider some psychological symptoms such as "thinking life is not worth living", but less likely to consider somatic features such as "sleep disturbance" as typical for people with depression. Chinese students were more likely to claim that they would seek help from mental health professionals if experiencing depression whilst Australian students were more likely to seek help from a general or family doctor. Chinese medical students recognise depression similarly to Australian students but do not consider it a major public health problem. These results challenge the stereotype that depression is characterised by somatic symptoms in China. Increasing awareness of the public health impact of depression should be incorporated into the medical curriculum in China.

  18. Development of X-ray protective clothes for medical treatments

    International Nuclear Information System (INIS)

    Nagai, M.; Koike, K.; Fujinuma, T.; Aso, T.; Konba, T.

    1991-01-01

    As various medical treatments using X-ray irradiation are getting more important in modern medicine, effective, excellent X-ray protective clothes have been required. Elastomeric or PVC sheets containing powdery lead are usually employed as conventional X-ray protective clothes. In this case, enhancement of X-ray shielding efficiency increases the weight because the efficiency depends on the amount of lead incorporated. Such heavy clothes give significant fatigue and inconvenience during long term use. Consequently, lightweight and comfortable X-ray protective clothes have been eagerly desired in the medical field. The authors have improved these defects in the conventional clothes by means of elastomeric blending technologies and successfully developed new, lightweight and comfortable X-ray shielding clothes. The new clothes consist of lead-containing rubber sheet in which lead is homogeneously incorporated and lightweight PVC laminated with fabrics. They achieved favorable sense of touch, comfortable wearing and long-term durability. Furthermore, the clothes satisfy all requirements including X-ray shielding efficiency defined in JIS specifications. This article introduces the development of the new clothes and their properties in detail. (author)

  19. Application of Irradiation. Application to polymer processing, exhaust gas treatment, sterilization of medical instruments and food

    Energy Technology Data Exchange (ETDEWEB)

    Sawai, Takeshi; Sawai, Teruko

    2000-03-01

    Many fields such as industry, agriculture, medical treatment and environment use radiation. This report explained some examples of irradiation applications. Radiation source is {sup 60}Co {gamma}-ray. Polymer industry use radiation for radiation curing (thermally stable polymer), tire, expanded polymer, radiation induced graft copolymerization and electron beam curing. On environmental conservation, radiation is used for elimination of NOx and SOx in exhaust combustion gas. In the medical treatment, radiation is applied to sterilization of medical instruments, that occupied about 50% volume, and blood for transfusion, which is only one method to prevent GVHD after transfusion. On agriculture, irradiation to spice, dry vegetable, frozen kitchen, potato and garlic are carried out in 30 countries. However, potato is only a kind food in Japan. Radiation breeding and pest control are put in practice. (S.Y.)

  20. Pure and Pseudo-pure Fluid Thermophysical Property Evaluation and the Open-Source Thermophysical Property Library CoolProp

    DEFF Research Database (Denmark)

    Bell, Ian H.; Wronski, Jorrit; Quoilin, Sylvain

    2014-01-01

    property correlations described here have been implemented into CoolProp, an open-source thermophysical property library. This library is written in C++, with wrappers available for the majority of programming languages and platforms of technical interest. As of publication, 110 pure and pseudo-pure fluids...... are included in the library, as well as properties of 40 incompressible fluids and humid air. The source code for the CoolProp library is included as an electronic annex....

  1. Nigeria Journal of Pure and Applied Physics

    African Journals Online (AJOL)

    Nigeria Journal of Pure and Applied Physics publishes papers of the highest quality and significance in specific areas of physics, pure and applied, as listed below. The journal content reflects core physics disciplines, but is also open to a broad range of topics whose central theme falls within the bounds of physics.

  2. Refurbishment of JMTR pure water facility

    International Nuclear Information System (INIS)

    Asano, Norikazu; Hanakawa, Hiroki; Kusunoki, Hidehiko; Satou, Shinichi

    2012-05-01

    In the refurbishment of JMTR, facilities were classified into which (1) were all updated, (2) were partly updated, and (3) were continuance used by the considerations of the maintenance history, the change parts availability and the latest technology. The JMTR pure water facility was classified into all updated facility based on the consideration. The Update construction was conducted in between FY2007 and FY2008. The refurbishment of JMTR pure water facility is summarized in this report. (author)

  3. Parent and medical professional willingness to enroll children in a hypothetical pediatric optic neuritis treatment trial

    Directory of Open Access Journals (Sweden)

    Amy eWaldman

    2011-11-01

    Full Text Available The Optic Neuritis Treatment Trial and subsequent studies have had a tremendous impact on the treatment and prognosis of optic neuritis and multiple sclerosis in adults. The results of these studies have been extrapolated to children; however, pediatric data are sparse. Using the method of prospective preference assessment, the willingness of parents and medical professionals to enroll children in a hypothetical Pediatric Optic Neuritis Treatment Trial was assessed using a mock consent form and questionnaire. A 3-arm trial was proposed: 1 intravenous corticosteroids, 2 high-dose oral corticosteroids, and 3 an oral placebo. The forms were completed by 198 parents and 49 physicians. After reviewing the hypothetical scenario, trial design, risks and benefits, and alternatives to the study, 21% of parents would enroll their children in the trial whereas 98% of medical professionals would enroll their patients. With medical professional recommendation, 43% of parents would enroll their children. The manner in which this hypothetical trial was presented to parents, specifically with respect to the recommendation of their child’s health care team, influenced a parent’s willingness to participate.

  4. Surgical treatment for medically refractory focal epilepsy in a patient with fragile X syndrome.

    Science.gov (United States)

    Kenmuir, Cynthia; Richardson, Mark; Ghearing, Gena

    2015-10-01

    Medication resistant temporal lobe epilepsy occurs in a small population of patients with fragile X syndrome. We present the case of a 24-year-old man with medically refractory temporal lobe epilepsy and fragile X syndrome who underwent left anterior temporal lobectomy resulting in cessation of seizures. Our patient was diagnosed with fragile X syndrome with a fully mutated, fully methylated FMR1 gene resulting in 572 CGG repeats. He developed seizures initially controlled with Depakote monotherapy, but progressed to become medically refractive to combination treatment with Depakote, lamotrigine and zonisamide. Prolonged video EEG monitoring revealed interictal left temporal sharp waves and slowing as well as subclinical and clinical seizures, each with left temporal onset. 3T MRI was consistent with left mesial temporal sclerosis. After discussing the case in our multidisciplinary surgical epilepsy conference, he was referred for presurgical evaluation including neuropsychological testing and Wada testing. He underwent an asleep left anterior temporal lobectomy, sparing the superior temporal gyrus. Pathology showed neuronal loss and gliosis in the hippocampus and amygdala. Twelve months after surgery, the patient has not experienced a seizure. He is described by his parents as less perseverative and less restless. We have presented the case of a 24 year-old-man with fragile X syndrome who underwent successful left anterior temporal lobectomy for the treatment of medically refractory epilepsy who is now seizure free without further functional impairment. This case report demonstrates the feasibility of surgical treatment for a patient with comorbid fragile X syndrome and mesial temporal sclerosis. Copyright © 2015 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  5. Archives: Bayero Journal of Pure and Applied Sciences

    African Journals Online (AJOL)

    Items 1 - 20 of 20 ... Archives: Bayero Journal of Pure and Applied Sciences. Journal Home > Archives: Bayero Journal of Pure and Applied Sciences. Log in or Register to get access to full text downloads.

  6. Archives: Nigeria Journal of Pure and Applied Physics

    African Journals Online (AJOL)

    Items 1 - 6 of 6 ... Archives: Nigeria Journal of Pure and Applied Physics. Journal Home > Archives: Nigeria Journal of Pure and Applied Physics. Log in or Register to get access to full text downloads.

  7. Adopting evidence-based medically assisted treatments in substance abuse treatment organizations: roles of leadership socialization and funding streams.

    Science.gov (United States)

    Blum, Terry C; Davis, Carolyn D; Roman, Paul M

    2014-01-01

    This paper examines the organizational adoption of medically assisted treatments (MAT) for substance use disorders (SUDs) in a representative sample of 555 US for-profit and not-for-profit treatment centers. The study examines organizational adoption of these treatments in an institutionally contested environment that traditionally has valued behavioral treatment, using sociological and resource dependence frameworks. The findings indicate that socialization of leadership, measured by formal clinical education, is related to the adoption of MAT. Funding patterns also affect innovation adoption, with greater adoption associated with higher proportions of earned income from third party fees for services, and less adoption associated with funding from criminal justice sources. These findings may generalize to other social mission-oriented organizations where innovation adoption may be linked to private and public benefit values inherent in the type of socialization of leadership and different patterns of funding support.

  8. Thermomechanical characterization of pure polycrystalline tantalum

    International Nuclear Information System (INIS)

    Rittel, D.; Bhattacharyya, A.; Poon, B.; Zhao, J.; Ravichandran, G.

    2007-01-01

    The thermomechanical behavior of pure polycrystalline tantalum has been characterized over a wide range of strain rates, using the recently developed shear compression specimen [D. Rittel, S. Lee, G. Ravichandran, Experimental Mechanics 42 (2002) 58-64]. Dynamic experiments were carried out using a split Hopkinson pressure bar, and the specimen's temperature was monitored throughout the tests using an infrared radiometer. The results of the mechanical tests confirm previous results on pure Ta. Specifically, in addition to its significant strain rate sensitivity, it was observed that pure Ta exhibits very little strain hardening at high strain rates. The measured temperature rise in the specimen's gauge was compared to theoretical predictions which assume a total conversion of the mechanical energy into heat (β = 1) [G.I. Taylor, H. Quinney, Proceedings of the Royal Society of London, vol. A, 1934, pp. 307-326], and an excellent agreement was obtained. This result confirms the previous result of Kapoor and Nemat-Nasser [R. Kapoor, S. Nemat-Nasser, Mech. Mater. 27 (1998) 1-12], while a different experimental approach was adopted here. The assumption that β = 1 is found to be justified in this specific case by the lack of dynamic strain hardening of pure Ta. However, this assumption should be limited to non-hardening materials, to reflect the fact that strain hardening implies that part of the mechanical energy is stored into the material's microstructure

  9. Pure squamous cell carcinoma of the breast presenting as a pyogenic abscess: a case report.

    Science.gov (United States)

    Nair, Vimoj J; Kaushal, Vivek; Atri, Rajeev

    2007-08-01

    The field of oncology is studded with fascinating case reports of rarities, and management of breast cancer by the oncologist has, at times, resulted in the surfacing of such instances of rarities. Pure squamous cell carcinoma (SCC) of the breast is such an example of a rare and generally aggressive malignancy constituting breast cancers. To the best of our knowledge, until 2006, only 5 patients of primary SCC of the breast, which presented clinically as breast abscess, have been reported in medical literature. We report the sixth worldwide case of pure primary SCC of the breast presenting as an abscess. In this report, we highlight the fact that a benign lesion like breast abscess can harbor such a rare malignancy. Clinicians should be aware of that fact, and adequate investigations should be done to rule out that possibility. Extensive literature review has been done to discuss the clinical and radiologic features as well as management of this rare lesion.

  10. Radiological emergency response in a medical waste treatment unit

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Fabio F.; Boni-Mitake, Malvina; Vianna, Estanislau B.; Nicolau, Jose R.A.; Rodrigues, Demerval L. [Instituto de Pesquisas Energeticas e Nucleares (IPEN), Sao Paulo, SP (Brazil)

    2000-07-01

    Radioactive materials are largely used in medicine, research and industry. The amount of radioactive material employed in each application varies from negligible to large and it can be in sealed or non-sealed form. A medical waste treatment unit that deals only with A-type medical waste (ABNT-NBR 12808), which does not include radioactive waste, detected abnormal radiation levels in a collecting truck and the IPEN-CNEN/SP Nuclear and Radiological Emergency Response Team was called. The presence of radioactive material inside the truck was confirmed; however, its origin and nature were not possible to be determined because the truck had collected medical waste in several facilities. So, an operation in order to segregate and identify that material was carried out. During the operation, a second collecting truck presenting abnormal radiation levels arrived to the unit and the same procedure was carried out on that truck. In both situations, the contaminated objects found were infantile diapers. The radioactive waste was transported to IPEN-CNEN/SP to be managed. Samples of the radioactive materials were submitted to gamma spectrometry and the radionuclide was identified as Iodine-131. Since that attendance, similar occurrences have been frequent. These events suggest that it is necessary a better control of the radioactive waste at the generating facilities and there should be basic radioprotection orientations to the discharging patients that were submitted to nuclear medicine procedures. (author)

  11. Radiological emergency response in a medical waste treatment unit

    International Nuclear Information System (INIS)

    Suzuki, Fabio F.; Boni-Mitake, Malvina; Vianna, Estanislau B.; Nicolau, Jose R.A.; Rodrigues, Demerval L.

    2000-01-01

    Radioactive materials are largely used in medicine, research and industry. The amount of radioactive material employed in each application varies from negligible to large and it can be in sealed or non-sealed form. A medical waste treatment unit that deals only with A-type medical waste (ABNT-NBR 12808), which does not include radioactive waste, detected abnormal radiation levels in a collecting truck and the IPEN-CNEN/SP Nuclear and Radiological Emergency Response Team was called. The presence of radioactive material inside the truck was confirmed; however, its origin and nature were not possible to be determined because the truck had collected medical waste in several facilities. So, an operation in order to segregate and identify that material was carried out. During the operation, a second collecting truck presenting abnormal radiation levels arrived to the unit and the same procedure was carried out on that truck. In both situations, the contaminated objects found were infantile diapers. The radioactive waste was transported to IPEN-CNEN/SP to be managed. Samples of the radioactive materials were submitted to gamma spectrometry and the radionuclide was identified as Iodine-131. Since that attendance, similar occurrences have been frequent. These events suggest that it is necessary a better control of the radioactive waste at the generating facilities and there should be basic radioprotection orientations to the discharging patients that were submitted to nuclear medicine procedures. (author)

  12. Pure transvaginal excision of mesh erosion involving the bladder.

    Science.gov (United States)

    Firoozi, Farzeen; Goldman, Howard B

    2013-06-01

    We present a pure transvaginal approach to the removal of eroded mesh involving the bladder secondary to placement of transvaginal mesh for management of pelvic organ prolapse (POP) using a mesh kit. Although technically challenging, we demonstrate the feasibility of a purely transvaginal approach, avoiding a potentially more morbid transabdominal approach. The video presents the surgical technique of pure transvaginal excision of mesh erosion involving the bladder after mesh placement using a prolapse kit was performed. This video shows that purely transvaginal removal of mesh erosion involving the bladder can be done safely and is feasible.

  13. Tata Laksana Kasus Perempuan dengan Pure Gonadal Dysgenesis 46, XY (Sindrom Swyer

    Directory of Open Access Journals (Sweden)

    Kanadi Sumapradja

    2016-06-01

    Full Text Available Disorders of sex development (DSD adalah kelainan medis yang dikaitkan dengan ketidakcocokan antara kromosom, gonad dan fenotip. Sindrom Swyer adalah kelainan berupa disgenesis gonad 46,XY dan diikuti dengan tidak terjadinya pelepasan anti-mullerian hormone (AMH dari gonad yang mengalami disgenesis sehingga mengakibatkan berkembangnya duktus muller menjadi uterus. Keadaan tersebut mengakibatkan pasien mengeluh amenorea primer dan organ seks sekunder tidak berkembang. Orientasi gender umumnya adalah sebagai perempuan, karena kurangnya paparan hormon androgen terhadap otak. Tatalaksana kasus Disorders of sex development (DSD sangat mementingkan pasien (patient-centered sehingga tatalaksana medikamentosa maupun pembedahan harus berdasarkan pemahaman pasien terhadap orientasi gendernya. Pada makalah ini dilaporkan kasus sindrom swyer pada seorang perempuan usia 29 tahun dengan keluhan amenorea primer. Hasil analisis kromosom 46,XY (20 metafase dengan hormon follicle stimulating hormone (FSH 31.5miu/ml, luteinizing hormone (LH 10.8miu/ml, estradiol (E2 <5pg/ml, testosteron total (T <0.0025ng/ml. Tatalaksana medikamentosa adalah memberikan terapi hormon estrogen untuk membantu proses feminisasi. Karena risiko tinggi terjadinya tumor pada kasus disgenesis gonad intra-abdomen dengan kromosom Y, maka direncanakan tindakan gonadektomi. Kata kunci: Tatalaksana, Sindrom Swyer, pure gonadal dysgenesis Case Management of Pure Gonadal Dysgenesis 46, XY (Sindrom Swyer Abstract Disorders of sex development (DSD are medical conditions in which the development of chromosomal, gonadal or anatomic sex varies from normal and may be incongruent with each other. Swyer syndrome is a condition caused by pure gonadal dysgenesis 46,XY, which followed by inadequate anti-mullerian (AMH production results in maintenance and further development of mullerian duct into uterus. Therefore, many patients who suffer from this condition initially come with chief complaint of primary

  14. Treatment of prehypertension: lifestyle and/or medication

    Directory of Open Access Journals (Sweden)

    Collier SR

    2012-11-01

    Full Text Available Scott R Collier,1 Michael Landram21Vascular Biology and Autonomic Studies Laboratory, Appalachian State University, Boone, NC, USA; 2Università degli Studi di Roma “Foro Italico”, Rome, ItalyAbstract: Prehypertension is a warning to individuals with resting blood pressures between 120/80 mmHg and 139/89 mmHg of an insidious progression of blood pressure towards hypertensive levels (≥140/90 mmHg. Prehypertension is associated with increased cardiovascular risk and end organ damage compared with individuals who are normotensive. This review primarily focuses on internal and external factors associated with the prevalence of prehypertension. Elucidating all of the factors associated with a rise in resting blood pressure and comparing the effects of medication versus lifestyle changes may aid the clinician in developing a preventive and/or treatment strategy for each individual.Keywords: sex differences, blood pressure, lifestyle changes

  15. The enforcement regulation for the law for radiation technicians engaging in medical treatment

    International Nuclear Information System (INIS)

    1985-01-01

    The ordinance is set up under the provisions of the law concerning radiation and x-ray technicians engaging in medical treatment, to enforce it. An application for the license of such a technician shall be filed according to the form prescribed, attached with a copy or an abstract of the census register of the applicant and a medical certificate of a doctor concerning whether the applicant is an insane, deaf or blind person, or a case of epidemic. The membership registration of such a technician shall include the number and date of the registration, the prefecture of his legal domicile, name birth date and sex distinction, the year and month of his success in the examination for such technicains, the items concerning the cancellation of the license or the suspension of the business, etc. The subjects of the examination for such technicians are physics, radiological physics, electrical engineering, chemistry, general basic medical science, radiological biology, photographing technology, treatment technics and others. An application for the examination for such technicians shall be filed to the Minister of Health and Welfare, attached with a personal history, a study certificate or a diploma of graduation, a photograph of the applicant and other specified documents. (Kubozono, M.)

  16. Creep mechanisms and constitutive relations in pure metals

    International Nuclear Information System (INIS)

    Nix, W.D.

    1979-01-01

    The mechanisms of creep of pure metals is briefly reviewed and divided into two parts: steady state flow mechanisms, and non-steady state flow mechanisms and constitutive relations. Creep by diffusional flow is now reasonably well understood, with theory and experiment in good agreement. The closely related phenomenon of Harper--Dorn creep can also be understood in terms of diffusion between dislocations. Power law creep involves the climb of edge disloctions controlled by lattice self diffusion. Theoretical treatments of this process invariably give a power law exponent of 3. This natural creep law is compared with the data for FCC and BCC metals. It is suggested that diffusion controlled climb is the controlling process in BCC metals at very high temperatures. Stacking fault energy effects may preclude the possibility that creep is controlled entirely by lattice self diffusion in some FCC metals. The subject of power law breakdown is presented as a natural consequence of the transition to low temperature flow phenomena. The role of core diffusion in this transition is briefly discussed. The mechanisms are presented by which pure metals creep at elevated temperatures. While most of this review deals with the mechanisms of steady state flow, some discussion is devoted to creep flow under non-steady state conditions. This topic is discussed in connection with the development of constitutive equations for describing plastic flow in metals

  17. Comparison of hydrogen storage properties of pure Mg and milled ...

    Indian Academy of Sciences (India)

    Administrator

    increase the hydriding and dehydriding rates, pure Mg was ground under hydrogen atmosphere (reactive .... Hydrogen storage properties of pure Mg and milled pure Mg. 833. Figure 3. ... elongated and flat shapes via collisions with the steel.

  18. [Drugs for young Mozart. Medical treatment of Wolfgang as a child by his father Leopold Mozart].

    Science.gov (United States)

    Bankl, H C; Reiter, C; Bankl, H

    2001-12-17

    Leopold Mozart (1719-1787), father of Wolfgang Amadé, had profound medical knowledge and was a passionate medical dilettante. As long as the young Mozart lived with his father and travelled on his concert tours with him, Leopold cared for his son in medical matters. Doctors were only consulted occasionally. In the extensive correspondence of Mozart's father drugs and treatments used for Wolfgang Amadé are reported in detail. This represents a reliable description of the pharmacological therapies of the late 18th century. The mentioned drugs are, as far as possible, viewed from todays medical perspective.

  19. Low-Temperature Blanching as a Tool to Modulate the Structure of Pectin in Blueberry Purees.

    Science.gov (United States)

    Chevalier, Laura M; Rioux, Laurie-Eve; Angers, Paul; Turgeon, Sylvie L

    2017-09-01

    Blueberry composition was characterized for 6 cultivars. It contains a good amount of dietary fiber (10% to 20%) and pectin (4% to 7%) whose degree of methylation (DM) is sensitive to food processing. A low temperature blanching (LTB: 60 °C/1 h) was applied on blueberry purees to decrease pectin DM, in order to modulate puree properties and functionalities (that is, viscosity and stability), and to enhance pectin affinity toward other components within food matrices. Fiber content, viscosity, pectin solubility, DM, and monosaccharide composition were determined for both pasteurized, and LTB+pasteurized blueberry purees. The results showed that neither the amount of fiber, nor the viscosity were affected by LTB, indicating that this treatment did not result in any significant pectin depolymerization and degradation. LTB caused a decrease both in pectin DM from 58-67% to 45-47% and in the amount of water-soluble pectin fraction, the latter remaining the major fraction of total pectin at 52% to 57%. A LTB is a simple and mild process to produce blueberry purees with mostly soluble and low-methylated pectin in order to extend functionality and opportunities for interactions with other food ingredients. © 2017 Institute of Food Technologists®.

  20. Factors associated with having a medical marijuana card among Veterans with recent substance use in VA outpatient treatment.

    Science.gov (United States)

    Davis, Alan K; Bonar, Erin E; Ilgen, Mark A; Walton, Maureen A; Perron, Brian E; Chermack, Stephen T

    2016-12-01

    Psychiatric symptoms, somatic problems, and co-occurring substance use have been associated with medical marijuana consumption among civilian patients with substance use disorders. It is possible that these factors may impact Veterans' ability to engage in or adhere to mental health and substance use disorder treatment. Therefore, we examined whether psychiatric functioning, substance use, and somatic problems were associated with medical marijuana use among Veterans receiving substance use disorder and/or mental health treatment. Participants (n=841) completed screening measures for a randomized controlled trial and 67 (8%) reported that they had a current medical marijuana card. Most of these participants (78%) reported using marijuana to treat severe/chronic pain. Significant bivariate differences revealed that, compared to participants without a medical marijuana card, those with a card were more likely to be in a middle income bracket, unemployed, and they had a significantly higher number of recent days of marijuana use, synthetic marijuana use, and using sedatives prescribed to them. Additionally, a significantly higher proportion of participants with a medical marijuana card scored above the clinical cutoff for posttraumatic stress disorder (PTSD) symptoms, had significantly higher severity of sleep-related problems, and reported a higher level of pain. These findings highlight the co-occurrence of substance use, PTSD symptoms, sleep-related problems, and chronic pain among Veterans who use medical marijuana. Future research should investigate the inter-relationships among medical marijuana use and other clinical issues (e.g., PTSD symptoms, sleep, pain) over time, and potential implications of medical marijuana use on treatment engagement and response. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Method for the recovery of uranium from a concentrate using pure phosphoric acid

    International Nuclear Information System (INIS)

    1980-01-01

    Procedure for the recovery of an uranium bearing concentrate and pure phosphoric acid from a wet process phosphoric acid from the treatment fluid with a precipitation means in conjunction with an organic diluent, the thus formed precipitate to separate and from the remaining mixture of phosphoric acid and diluent the phosphoric acid to extract, characterised in that one applies an inorganic fluorine compound. (G.C.)

  2. 42 CFR 412.105 - Special treatment: Hospitals that incur indirect costs for graduate medical education programs.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Special treatment: Hospitals that incur indirect costs for graduate medical education programs. 412.105 Section 412.105 Public Health CENTERS FOR... SYSTEMS FOR INPATIENT HOSPITAL SERVICES Special Treatment of Certain Facilities Under the Prospective...

  3. Early medical rehabilitation after neurosurgical treatment of malignant brain tumours in Slovenia.

    Science.gov (United States)

    Kos, Natasa; Kos, Boris; Benedicic, Mitja

    2016-06-01

    The number of patients with malignant brain tumours is on the rise, but due to the novel treatment methods the survival rates are higher. Despite increased survival the consequences of tumour properties and treatment can have a significant negative effect on the patients' quality of life. Providing timely and appropriate rehabilitation interventions is an important aspect of patient treatment and should be started immediately after surgery. The most important goal of rehabilitation is to prevent complications that could have a negative effect on the patients' ability to function. By using individually tailored early rehabilitation it is often possible to achieve the patients' independence in mobility as well as in performing daily tasks before leaving the hospital. A more precise evaluation of the patients' functional state after completing additional oncologic therapy should be performed to stratify the patients who should be directed to complex rehabilitation treatment. The chances of a good functional outcome in patients with malignant brain tumours could be increased with good early medical rehabilitation treatment.

  4. A double-blind, randomized study comparing pure chromated glycerin with chromated glycerin with 1% lidocaine and epinephrine for sclerotherapy of telangiectasias and reticular veins.

    Science.gov (United States)

    Kern, Philippe; Ramelet, Albert-Adrien; Wutschert, Robert; Mazzolai, Lucia

    2011-11-01

    Chromated glycerin (CG) is an effective, although painful, sclerosing agent for telangiectasias and reticular leg veins treatment. To determine pain level and relative efficacy of pure or one-third lidocaine-epinephrine 1% mixed chromated glycerin in a prospective randomized double-blind trial. Patients presenting with telangiectasias and reticular leg veins on the lateral aspect of the thigh (C(1A) or (S) E(P) A(S) P(N1) ) were randomized to receive pure CG or CG mixed with one-third lidocaine-epinephrine 1% (CGX) treatment. Lower limb photographs were taken before and after treatment and analyzed by blinded expert reviewers for efficacy assessment (visual vein disappearance). Patients' pain and satisfaction were assessed using visual analogue scales. Data from 102 of 110 randomized patients could be evaluated. Patient pain scores were significantly higher when pure CG was used than with CGX (psclerotherapy pain without affecting efficacy when treating telangiectasias and reticular leg veins. © 2011 by the American Society for Dermatologic Surgery, Inc.

  5. [Medical abortion provided by telemedicine to women in Latin America: complications and their treatment].

    Science.gov (United States)

    Larrea, Sara; Palència, Laia; Perez, Glòria

    2015-01-01

    To analyze reported complications and their treatment after a medical abortion with mifepristone and misoprostol provided by a telemedicine service to women living in Latin America. Observational study based on the registry of consultations in a telemedicine service. A total of 872 women who used the service in 2010 and 2011 participated in the study. The dependent variables were overall complications, hemorrhage, incomplete abortion, overall treatments, surgical evacuation, and antibiotics. Independent variables were age, area of residence, socioeconomic deprivation, previous children, pregnancies and abortions, and week of pregnancy. We fitted Poisson regression models with robust variance to estimate incidence ratios and 95% confidence intervals (95%CI). Complications were reported by 14.6% of the participants: 6.2% reported hemorrhage and 6.8% incomplete abortion. Nearly one-fifth (19.0%) received postabortion treatment: 10.9% had a surgical evacuation and 9.3% took antibiotics. Socioeconomic deprivation increased the risk of complications by 64% (95%CI: 15%-132%), and, among these, the risk of incomplete abortion by 82% (95%CI: 8%-206%) and the risk of surgical intervention by 62% (95%CI: 7%-144%). Previous pregnancies increased the risk of complications and, specifically, the risk of hemorrhage by 2.29 times (95%CI: 1.33-3.95%). Women with a pregnancy of 12 or more weeks had a 2.45 times higher risk of receiving medical treatment and a 2.94 times higher risk of taking antibiotics compared with women with pregnancies of 7 or less weeks. Medical abortion provided by telemedicine seems to be a safe and effective alternative in contexts where it is legally restricted. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  6. Withholding and withdrawing life-sustaining treatment: criminal responsibility for established medical practice?

    Science.gov (United States)

    White, Ben; Willmott, Lindy; Allen, John

    2010-05-01

    The law recognises the right of a competent adult to refuse medical treatment even if this will lead to death. Guardianship and other legislation also facilitates the making of decisions to withhold or withdraw life-sustaining treatment in certain circumstances. Despite this apparent endorsement that such decisions can be lawful, doubts have been raised in Queensland about whether decisions to withhold or withdraw life-sustaining treatment would contravene the criminal law, and particularly the duty imposed by the Criminal Code (Qld) to provide the "necessaries of life". This article considers this tension in the law and examines various arguments that might allow for such decisions to be made lawfully. It ultimately concludes, however, that criminal responsibility may still arise and so reform is needed.

  7. Pure Science and Applied Science

    Directory of Open Access Journals (Sweden)

    Robert J. Aumann

    2011-01-01

    Full Text Available (Excerpt The name of my talk is Pure Science and Applied Science, and the idea I would like to sell to you today is that there is no such thing as “pure” or “applied” science. In other words, there is such a thing as science, but there is no difference between pure and applied science. Science is one entity and cannot be separated into different categories. In order to back that up, I would like to tell you a little story. As an undergraduate, I studied mathematics at City College in New York. At that time, what was called Pure Mathematics was in vogue, and the more prominent mathematicians were a little contemptuous of any kind of application. A very famous, prominent mathematician in the first half of the previous century by the name of G. H. Hardy, who was in a branch of mathematics called number theory, said that the only thing he regretted was that he unwittingly did some important work in mathematical genetics that eventually turned out to have some application. … Such was the atmosphere in the late ’40s of the previous century and, being a young man and impressionable, I was swept up in this atmosphere.

  8. [What Psychiatrists Should Know about the Medical Documentation They Issue: Admission for Medical Care and Protection, Medical Treatment for Persons with Disabilities, Mental Health Disability Certification, etc].

    Science.gov (United States)

    Yamasaki, Masao

    2015-01-01

    Psychiatrists issue a wide variety of documentation, among which are torms such as Registration of Admission for Medical Care and Protection, Periodic Report of Condition, Certification of Medical Treatment for Persons with Disabilities, and Mental Health Disability Certification, which are required under laws such as the Act on Mental Health and Welfare for the Mentally Disabled. These documents are important in that they are related to protecting the human rights of people with mental disorders, as well as securing appropriate medical and welfare services for them. However, in the course of reviewing and evaluating documentation at our Mental Health and Welfare Center, we encounter forms which are incomplete, or which contain inappropriate content. In order to protect the human rights of people with mental disorders, and to ensure the provision of appropriate medical and welfare services for them, I call on psychiatrists to issue carefully written and appropriate documentation. In this talk I will focus primarily on what psychiatrists should know when filling in forms in the course of their day-to-day clinical work.

  9. Pure Androgen-Secreting Adrenal Adenoma Associated with Resistant Hypertension

    Directory of Open Access Journals (Sweden)

    René Rodríguez-Gutiérrez

    2013-01-01

    Full Text Available Pure androgen-secreting adrenal adenoma is very rare, and its diagnosis remains a clinical challenge. Its association with resistant hypertension is uncommon and not well understood. We present an 18-year-old female with a 10-year history of hirsutism that was accidentally diagnosed with an adrenal mass during the evaluation of a hypertensive crisis. She had a long-standing history of hirsutism, clitorimegaly, deepening of the voice, and primary amenorrhea. She was phenotypically and socially a male. FSH, LH, prolactin, estradiol, 17-hydroxyprogesterone, and progesterone were normal. Total testosterone and DHEA-S were elevated. Cushing syndrome, primary aldosteronism, pheochromocytoma, and nonclassic congenital adrenal hyperplasia were ruled out. She underwent adrenalectomy and pathology reported an adenoma. At 2-month followup, hirsutism and virilizing symptoms clearly improved and blood pressure normalized without antihypertensive medications, current literature of this unusual illness and it association with hypertension is presented and discussed.

  10. Synthesis of pure iron magnetic nanoparticles in large quantity

    International Nuclear Information System (INIS)

    Tiwary, C S; Kashyap, S; Chattopadhyay, K; Biswas, K

    2013-01-01

    Free nanoparticles of iron (Fe) and their colloids with high saturation magnetization are in demand for medical and microfluidic applications. However, the oxide layer that forms during processing has made such synthesis a formidable challenge. Lowering the synthesis temperature decreases rate of oxidation and hence provides a new way of producing pure metallic nanoparticles prone to oxidation in bulk amount (large quantity). In this paper we have proposed a methodology that is designed with the knowledge of thermodynamic imperatives of oxidation to obtain almost oxygen-free iron nanoparticles, with or without any organic capping by controlled milling at low temperatures in a specially designed high-energy ball mill with the possibility of bulk production. The particles can be ultrasonicated to produce colloids and can be bio-capped to produce transparent solution. The magnetic properties of these nanoparticles confirm their superiority for possible biomedical and other applications. (paper)

  11. Medical education and law: withholding/withdrawing treatment from adults without capacity.

    Science.gov (United States)

    Parker, M; Willmott, L; White, B; Williams, G; Cartwright, C

    2015-06-01

    Law is increasingly involved in clinical practice, particularly at the end of life, but undergraduate and postgraduate education in this area remains unsystematic. We hypothesised that attitudes to and knowledge of the law governing withholding/withdrawing life-sustaining treatment from adults without capacity (the WWLST law) would vary and demonstrate deficiencies among medical specialists. We investigated perspectives, knowledge and training of medical specialists in the three largest (populations and medical workforces) Australian states, concerning the WWLST law. Following expert legal review, specialist focus groups, pre-testing and piloting in each state, seven specialties involved with end-of-life care were surveyed, with a variety of statistical analyses applied to the responses. Respondents supported the need to know and follow the law. There were mixed views about its helpfulness in medical decision-making. Over half the respondents conceded poor knowledge of the law; this was mirrored by critical gaps in knowledge that varied by specialty. There were relatively low but increasing rates of education from the undergraduate to continuing professional development (CPD) stages. Mean knowledge score did not vary significantly according to undergraduate or immediate postgraduate training, but CPD training, particularly if recent, resulted in greater knowledge. Case-based workshops were the preferred CPD instruction method. Teaching of current and evolving law should be strengthened across all stages of medical education. This should improve understanding of the role of law, ameliorate ambivalence towards the law and contribute to more informed deliberation about end-of-life issues with patients and families. © 2015 Royal Australasian College of Physicians.

  12. Treatment errors resulting from use of lasers and IPL by medical laypersons: results of a nationwide survey.

    Science.gov (United States)

    Hammes, Stefan; Karsai, Syrus; Metelmann, Hans-Robert; Pohl, Laura; Kaiser, Kathrine; Park, Bo-Hyun; Raulin, Christian

    2013-02-01

    The demand for hair and tattoo removal with laser and IPL technology (intense pulsed light technology) is continually increasing. Nowadays these treatments are often carried out by medical laypersons without medical supervision in franchise companies, wellness facilities, cosmetic institutes and hair or tattoo studios. This is the first survey is to document and discuss this issue and its effects on public health. Fifty patients affected by treatment errors caused by medical laypersons with laser and IPL applications were evaluated in this retrospective study. We used a standardized questionnaire with accompanying photographic documentation. Among the reports there were some missing or no longer traceable parameters, which is why 7 cases could not be evaluated. The following complications occurred, with possible multiple answers: 81.4% pigmentation changes, 25.6% scars, 14% textural changes and 4.6% incorrect information. The sources of error (multiple answers possible) were the following: 62.8% excessively high energy, 39.5% wrong device for the indication, 20.9% treatment of patients with darker skin or marked tanning, 7% no cooling, and 4.6% incorrect information. The causes of malpractice suggest insufficient training, inadequate diagnostic abilities, and promising unrealistic results. Direct supervision by a medical specialist, comprehensive experience in laser therapy, and compliance with quality guidelines are prerequisites for safe laser and IPL treatments. Legal measures to make such changes mandatory are urgently needed. © The Authors | Journal compilation © Blackwell Verlag GmbH, Berlin.

  13. Medical capsule robots: A renaissance for diagnostics, drug delivery and surgical treatment.

    Science.gov (United States)

    Mapara, Sanyat S; Patravale, Vandana B

    2017-09-10

    The advancements in electronics and the progress in nanotechnology have resulted in path breaking development that will transform the way diagnosis and treatment are carried out currently. This development is Medical Capsule Robots, which has emerged from the science fiction idea of robots travelling inside the body to diagnose and cure disorders. The first marketed capsule robot was a capsule endoscope developed to capture images of the gastrointestinal tract. Today, varieties of capsule endoscopes are available in the market. They are slightly larger than regular oral capsules, made up of a biocompatible case and have electronic circuitry and mechanisms to capture and transmit images. In addition, robots with diagnostic features such as in vivo body temperature detection and pH monitoring have also been launched in the market. However, a multi-functional unit that will diagnose and cure diseases inside the body has not yet been realized. A remote controlled capsule that will undertake drug delivery and surgical treatment has not been successfully launched in the market. High cost, inadequate power supply, lack of control over drug release, limited space for drug storage on the capsule, inadequate safety and no mechanisms for active locomotion and anchoring have prevented their entry in the market. The capsule robots can revolutionize the current way of diagnosis and treatment. This paper discusses in detail the applications of medical capsule robots in diagnostics, drug delivery and surgical treatment. In diagnostics, detailed analysis has been presented on wireless capsule endoscopes, issues associated with the marketed versions and their corresponding solutions in literature. Moreover, an assessment has been made of the existing state of remote controlled capsules for targeted drug delivery and surgical treatment and their future impact is predicted. Besides the need for multi-functional capsule robots and the areas for further research have also been

  14. Microstructure and crystallographic texture of pure titanium parts generated by laser additive manufacturing

    Science.gov (United States)

    Arias-González, Felipe; del Val, Jesús; Comesaña, Rafael; Penide, Joaquín; Lusquiños, Fernando; Quintero, Félix; Riveiro, Antonio; Boutinguiza, Mohamed; Gil, Francisco Javier; Pou, Juan

    2018-01-01

    In this paper, the microstructure and crystallographic texture of pure Ti thin walls generated by Additive Manufacturing based on Laser Cladding (AMLC) are analyzed in depth. From the results obtained, it is possible to better understand the AMLC process of pure titanium. The microstructure observed in the samples consists of large elongated columnar prior β grains which have grown epitaxially from the substrate to the top, in parallel to the building direction. Within the prior β grains, α-Ti lamellae and lamellar colonies are the result of cooling from above the β-transus temperature. This transformation follows the Burgers relationship and the result is a basket-weave microstructure with a strong crystallographic texture. Finally, a thermal treatment is proposed to transform the microstructure of the as-deposited samples into an equiaxed microstructure of α-Ti grains.

  15. Access database application in medical treatment management platform

    International Nuclear Information System (INIS)

    Wu Qingming

    2014-01-01

    For timely, accurate and flexible access to medical expenses data, we applied Microsoft Access 2003 database management software, and we finished the establishment of a management platform for medical expenses. By developing management platform for medical expenses, overall hospital costs for medical expenses can be controlled to achieve a real-time monitoring of medical expenses. Using the Access database management platform for medical expenses not only changes the management model, but also promotes a sound management system for medical expenses. (authors)

  16. Repeated dose studies with pure Epigallocatechin-3-gallate demonstrated dose and route dependant hepatotoxicity with associated dyslipidemia.

    Science.gov (United States)

    Ramachandran, Balaji; Jayavelu, Subramani; Murhekar, Kanchan; Rajkumar, Thangarajan

    2016-01-01

    EGCG (Epigallocatechin-3-gallate) is the major active principle catechin found in green tea. Skepticism regarding the safety of consuming EGCG is gaining attention, despite the fact that it is widely being touted for its potential health benefits, including anti-cancer properties. The lack of scientific data on safe dose levels of pure EGCG is of concern, while EGCG has been commonly studied as a component of GTE (Green tea extract) and not as a single active constituent. This study has been carried out to estimate the maximum tolerated non-toxic dose of pure EGCG and to identify the treatment related risk factors. In a fourteen day consecutive treatment, two different administration modalities were compared, offering an improved [i.p (intraperitoneal)] and limited [p.o (oral)] bioavailability. A trend of dose and route dependant hepatotoxicity was observed particularly with i.p treatment and EGCG increased serum lipid profile in parallel to hepatotoxicity. Fourteen day tolerable dose of EGCG was established as 21.1 mg/kg for i.p and 67.8 mg/kg for p.o. We also observed that, EGCG induced effects by both treatment routes are reversible, subsequent to an observation period for further fourteen days after cessation of treatment. It was demonstrated that the severity of EGCG induced toxicity appears to be a function of dose, route of administration and period of treatment.

  17. AdS pure spinor superstring in constant backgrounds

    International Nuclear Information System (INIS)

    Chandia, Osvaldo; Bevilaqua, L. Ibiapina; Vallilo, Brenno Carlini

    2014-01-01

    In this paper we study the pure spinor formulation of the superstring in AdS_5×S"5 around point particle solutions of the classical equations of motion. As a particular example we quantize the pure spinor string in the BMN background

  18. Graph Theory to Pure Mathematics: Some Illustrative Examples

    Indian Academy of Sciences (India)

    Graph Theory to Pure Mathematics: Some. Illustrative Examples v Yegnanarayanan is a. Professor of Mathematics at MNM Jain Engineering. College, Chennai. His research interests include graph theory and its applications to both pure maths and theoretical computer science. Keywords. Graph theory, matching theory,.

  19. Self-controlled Study of Onychomycosis Treated with Long-pulsed Nd:YAG 1064-nm Laser Combined with Itraconazole

    Directory of Open Access Journals (Sweden)

    Yan Li

    2016-01-01

    Conclusions: For patients with mild or moderate onychomycosis, we recommended a pure medication treatment or combination treatment with medication and laser. For those patients with severe onychomycosis, we recommended a combination of medication and laser therapy.

  20. Tonsillectomy efficacy in children with PFAPA syndrome is comparable to the standard medical treatment: a long-term observational study.

    Science.gov (United States)

    Vigo, Giulia; Martini, Giorgia; Zoppi, Silvia; Vittadello, Fabio; Zulian, Francesco

    2014-01-01

    Tonsillectomy has recently been suggested as an effective treatment for PFAPA syndrome but little is known about its long-term efficacy. We compared the clinical features and the long-term outcome of a large cohort of patients with PFAPA syndrome treated with tonsillectomy or with standard medical treatment. We conducted a retrospective study on patients with PFAPA syndrome followed at a tertiary care centre from January 1993 to August 2010. Clinical characteristics and laboratory parameters were evaluated at onset and during the follow-up. Disease outcomes of patients who underwent tonsillectomy and of those treated with medical therapy (NSAIDs, prednisone) were compared. Clinical remission on medication (CRM) was considered the persistence of fever attacks which were well controlled by medical therapy, clinical remission (CR) was defined as the absence of fever attacks, without any treatment, for more than 12 months. 275 patients with PFAPA syndrome, 59.6% males, aged 27.9 months at onset and followed for mean 54.5 months, entered the study. CR was reported in 59.6% of the patients and was significantly less frequent in those with positive family history for PFAPA (46.4% vs. 66.1%, p=0.003). 27/41 patients (65.9%), responded to tonsillectomy and this result was comparable with that observed in those treated with medical therapy (59.1%, p=0.51). Disease duration, age at remission or presence of associated symptoms were not significantly different in both groups. No predictors of tonsillectomy failure were found. In a large cohort of patients with PFAPA syndrome, tonsillectomy efficacy was comparable to the standard medical treatment.

  1. Rapid hardening induced by electric pulse annealing in nanostructured pure aluminum

    DEFF Research Database (Denmark)

    Zeng, Wei; Shen, Yao; Zhang, Ning

    2012-01-01

    Nanostructured pure aluminum was fabricated by heavy cold-rolling and then subjected to recovery annealing either by applying electric pulse annealing or by traditional air furnace annealing. Both annealing treatments resulted in an increase in yield strength due to the occurrence of a “dislocation...... source-limited hardening” mechanism. However, the hardening kinetics was substantially faster for the electric pulse annealed material. Detailed microstructural characterization suggested that the rapid hardening during electric pulse annealing is related to an enhanced rate of recovery of dislocation...

  2. Expander graphs in pure and applied mathematics

    OpenAIRE

    Lubotzky, Alexander

    2012-01-01

    Expander graphs are highly connected sparse finite graphs. They play an important role in computer science as basic building blocks for network constructions, error correcting codes, algorithms and more. In recent years they have started to play an increasing role also in pure mathematics: number theory, group theory, geometry and more. This expository article describes their constructions and various applications in pure and applied mathematics.

  3. Air contamination analysis during emergency medical treatment

    International Nuclear Information System (INIS)

    Yamada, Y.; Fukutsu, K.; Yuuki, M.; Akashi, M.

    2009-01-01

    After radiological emergencies, patients contaminated with radioactivity are taken to radiation emergency hospitals for treatment. Numerical simulations using the computer software 'Flow Designer R were made in order to evaluate indoor air contamination caused by the breathing out of contaminated air. The National Inst. of Radiological Sciences facility was used for the numerical evaluation. Results indicate that the dispersion of contaminated air depends on the characteristics of the contaminants, and that the dispersion range was limited and localised. Only medical staff standing in a special position near the patient was exposed to almost un-diluted contaminated air. Highly contaminated air was evacuated with a local exhaust pump system. Room air quality was monitored using a continuous air sampling system, but it was found that the sampling point was not representative for the purpose of radiation protection. From the air-flow analysis, some problems that affect radiological safety were revealed and valuable information and measures for preventing secondary contamination were determined. (authors)

  4. Pure odd-order oscillators with constant excitation

    Science.gov (United States)

    Cveticanin, L.

    2011-02-01

    In this paper the excited vibrations of a truly nonlinear oscillator are analyzed. The excitation is assumed to be constant and the nonlinearity is pure (without a linear term). The mathematical model is a second-order nonhomogeneous differential equation with strong nonlinear term. Using the first integral, the exact value of period of vibration i.e., angular frequency of oscillator described with a pure nonlinear differential equation with constant excitation is analytically obtained. The closed form solution has the form of gamma function. The period of vibration depends on the value of excitation and of the order and coefficient of the nonlinear term. For the case of pure odd-order-oscillators the approximate solution of differential equation is obtained in the form of trigonometric function. The solution is based on the exact value of period of vibration. For the case when additional small perturbation of the pure oscillator acts, the so called 'Cveticanin's averaging method' for a truly nonlinear oscillator is applied. Two special cases are considered: one, when the additional term is a function of distance, and the second, when damping acts. To prove the correctness of the method the obtained results are compared with those for the linear oscillator. Example of pure cubic oscillator with constant excitation and linear damping is widely discussed. Comparing the analytically obtained results with exact numerical ones it is concluded that they are in a good agreement. The investigations reported in the paper are of special interest for those who are dealing with the problem of vibration reduction in the oscillator with constant excitation and pure nonlinear restoring force the examples of which can be found in various scientific and engineering systems. For example, such mechanical systems are seats in vehicles, supports for machines, cutting machines with periodical motion of the cutting tools, presses, etc. The examples can be find in electronics

  5. Use of magnets in medical treatment

    Energy Technology Data Exchange (ETDEWEB)

    Aliev, A.

    1983-01-01

    In the Soviet Union magnetic fields were first applied successfully for medical purposes in the treatment of various diseases in the forties. Clinical-experimental research has established that a constant magnetic field and a low-frequency alternating magnetic field posses analgesic, antiedematous and antifebril action, decrease dystrophic processes, and increase blood circulation. An alternating magnetic field at a frequency of 50 cycles per second has a rhythm close to that of muscle nerve currents in the normal bodily state. Thus, in applying a 50-cycle magnetic field to organs and tissues as a specific stimulus we normalize the frequency of the current. By normalizing the electrical state of the tissues it is possible to normalize the general state of the organism as well. It is assumed that the magnetic field, like a tape-recorder heat, erases the pathological recording which has distorted or replaced the normal information characteristic of the cells. The range of magnetotherapy's therapeutic action is very broad: it includes cardiovascular diseases, hypertension, skin diseases, obliterating endarteritis, disturbances of peripheral blood circulation, diseases of the digestive organs, diseases of the musculoskeletal apparatus, osteochondrosis, radiculitis, and many others.

  6. AdS pure spinor superstring in constant backgrounds

    Energy Technology Data Exchange (ETDEWEB)

    Chandia, Osvaldo [Departamento de Ciencias, Facultad de Artes Liberales, Universidad Adolfo Ibáñez,Facultad de Ingeniería y Ciencias, Universidad Adolfo Ibáñez,Diagonal Las Torres 2640, Peñalolén, Santiago (Chile); Bevilaqua, L. Ibiapina [Escola de Ciências e Tecnologia, Universidade Federal do Rio Grande do Norte,Caixa Postal 1524, 59072-970, Natal, RN (Brazil); Vallilo, Brenno Carlini [Facultad de Ciencias Exactas, Departamento de Ciencias Físicas, Universidad Andres Bello,Republica 220, Santiago (Chile)

    2014-06-05

    In this paper we study the pure spinor formulation of the superstring in AdS{sub 5}×S{sup 5} around point particle solutions of the classical equations of motion. As a particular example we quantize the pure spinor string in the BMN background.

  7. Female Sexual Dysfunction-Medical and Psychological Treatments, Committee 14.

    Science.gov (United States)

    Kingsberg, Sheryl A; Althof, Stanley; Simon, James A; Bradford, Andrea; Bitzer, Johannes; Carvalho, Joana; Flynn, Kathryn E; Nappi, Rossella E; Reese, Jennifer B; Rezaee, Roya L; Schover, Leslie; Shifrin, Jan L

    2017-12-01

    Since the millennium we have witnessed significant strides in the science and treatment of female sexual dysfunction (FSD). This forward progress has included (i) the development of new theoretical models to describe healthy and dysfunctional sexual responses in women; (ii) alternative classification strategies of female sexual disorders; (iii) major advances in brain, hormonal, psychological, and interpersonal research focusing on etiologic factors and treatment approaches; (iv) strong and effective public advocacy for FSD; and (v) greater educational awareness of the impact of FSD on the woman and her partner. To review the literature and describe the best practices for assessing and treating women with hypoactive sexual desire disorder, female sexual arousal disorder, and female orgasmic disorders. The committee undertook a comprehensive review of the literature and discussion among themselves to determine the best assessment and treatment methods. Using a biopsychosocial lens, the committee presents recommendations (with levels of evidence) for assessment and treatment of hypoactive sexual desire disorder, female sexual arousal disorder, and female orgasmic disorders. The numerous significant strides in FSD that have occurred since the previous International Consultation of Sexual Medicine publications are reviewed in this article. Although evidence supports an integrated biopsychosocial approach to assessment and treatment of these disorders, the biological and psychological factors are artificially separated for review purposes. We recognize that best outcomes are achieved when all relevant factors are identified and addressed by the clinician and patient working together in concert (the sum is greater than the whole of its parts). Kingsberg SA, Althof S, Simon JA, et al. Female Sexual Dysfunction-Medical and Psychological Treatments, Committee 14. J Sex Med 2017;14:1463-1491. Copyright © 2017 International Society for Sexual Medicine. Published by

  8. Similarities and differences between learning abilities, "pure" learning disabilities, "pure" ADHD and comorbid ADHD with learning disabilities.

    Science.gov (United States)

    Mangina, Constantine A; Beuzeron-Mangina, Helen

    2009-08-01

    This research pursues the crucial question of the differentiation of preadolescents with "Pure" ADHD, comorbid ADHD with learning disabilities, "Pure" learning disabilities and age-matched normal controls. For this purpose, Topographic Mapping of Event-Related Brain Potentials (ERPs) to a Memory Workload Paradigm with visually presented words, Bilateral Electrodermal Activity during cognitive workload and Mangina-Test performance were used. The analysis of Topographic distribution of amplitudes revealed that normal preadolescents were significantly different from "Pure" ADHD (Plearning disabilities (Plearning disabilities (Plearning disabilities have shown a marked reduction of prefrontal and frontal negativities (N450). As for the "Pure" Learning Disabled preadolescents, very small positivities (P450) in prefrontal and frontal regions were obtained as compared to the other pathological groups. Bilateral Electrodermal Activity during cognitive workload revealed a significant main effect for groups (P<0.00001), Left versus Right (P=0.0029) and sessions (P=0.0136). A significant main effect for the Mangina-Test performance which separated the four groups was found (P<0.000001). Overall, these data support the existence of clear differences and similarities between the pathological preadolescent groups as opposed to age-matched normal controls. The psychophysiological differentiation of these groups, provides distinct biological markers which integrate central, autonomic and neuropsychometric variables by targeting the key features of these pathologies for diagnosis and intervention strategies and by providing knowledge for the understanding of normal neurocognitive processes and functions.

  9. Corrosion of pure magnesium under thin electrolyte layers

    International Nuclear Information System (INIS)

    Zhang Tao; Chen Chongmu; Shao Yawei; Meng Guozhe; Wang Fuhui; Li Xiaogang; Dong Chaofang

    2008-01-01

    The corrosion behavior of pure magnesium was investigated by means of cathodic polarization curve, electrochemical impedance spectroscopy (EIS) and electrochemical noise (EN) under aerated and deaerated thin electrolyte layers (TEL) with various thicknesses. Based on shot noise theory and stochastic theory, the EN results were quantitatively analyzed by using the Weibull and Gumbel distribution function, respectively. The results show that the cathodic process of pure magnesium under thin electrolyte layer was dominated by hydrogen reduction. With the decreasing of thin electrolyte layer thickness, cathodic process was retarded slightly while the anodic process was inhibited significantly, which indicated that both the cathodic and anodic process were inhibited in the presence of oxygen. The absence of oxygen decreased the corrosion resistance of pure magnesium in case of thin electrolyte layer. The corrosion was more localized under thin electrolyte layer than that in bulk solution. The results also demonstrate that there exist two kinds of effects for thin electrolyte layer on the corrosion behavior of pure magnesium: (1) the rate of pit initiation was evidently retarded compared to that in bulk solution; (2) the probability of pit growth oppositely increased. The corrosion model of pure magnesium under thin electrolyte layer was suggested in the paper

  10. Engineering arbitrary pure and mixed quantum states

    International Nuclear Information System (INIS)

    Pechen, Alexander

    2011-01-01

    Controlled manipulation by atomic- and molecular-scale quantum systems has attracted a lot of research attention in recent years. A fundamental problem is to provide deterministic methods for controlled engineering of arbitrary quantum states. This work proposes a deterministic method for engineering arbitrary pure and mixed states of a wide class of quantum systems. The method exploits a special combination of incoherent and coherent controls (incoherent and coherent radiation) and has two properties which are specifically important for manipulating by quantum systems: it realizes the strongest possible degree of their state control, complete density matrix controllability, meaning the ability to steer arbitrary pure and mixed initial states into any desired pure or mixed final state, and it is all-to-one, such that each particular control transfers all initial system states into one target state.

  11. Complementary and Alternative Medicine use: Influence of Patients’ Satisfaction with Medical Treatment among Breast Cancer Patients at Uganda Cancer Institute

    Directory of Open Access Journals (Sweden)

    Frank Kiwanuka

    2018-02-01

    Full Text Available Introduction: Use of Complementary and alternative medicine (CAM is high among cancer patients especially breast cancer patients. This study sought to evaluate Complementary and alternative medicine use in breast cancer patients and how its use is influencedby patient’s satisfaction with conventional medical treatment among breast cancer patients attending Uganda Cancer Institute. Patients and Methods: A cross-sectional study design was used in this study. Participants who were diagnosed histologically with breast cancer at Uganda Cancer Institute took part in the study. A questionnaire was developed and used to interview the participants and medical records of the respondents were also reviewed. Results: A total of 235 participants completed the study. The prevalence of CAM use was 77%. CAM therapies used included herbal medicines, prayer for health, vitamins/minerals, native healers, Chinese medicines, massage, yoga, Ayurvedic medicine, Acupuncture, reflexolog, Support group attendance, meditation, Magnetic and Bio-fieldmanipulation. Satisfaction with medical treatment was significantlyassociated with CAM use. Patients who are not satisfiedwith medical treatment were more likely to use CAM. Conclusion: There is a high number of breast cancer patients using CAM, various categories of therapies are being used and patients’ satisfaction with medical treatment triggers off a patients decision to use CAM therapies.

  12. Opportunity for Collaboration Between Radiation Injury Treatment Network Centers and Medical Toxicology Specialists.

    Science.gov (United States)

    Davlantes, Elizabeth; Shartar, Samuel; Venero, Jennifer; Steck, Alaina; Langston, Amelia; Kazzi, Ziad N

    2017-08-01

    The Radiation Injury Treatment Network (RITN) comprises >50 centers across the United States that are poised to care for victims of a radiation emergency. The network is organized around bone marrow transplant centers because these facilities excel in both radiation medicine and the care of patients with severe bone marrow depression. A radiation emergency may cause not only irradiation from an external source but also internal contamination with radioactive material. Because medical toxicologists are trained in radiation injury management and have expertise in the management of internal contamination, RITN centers may benefit from partnerships with medical toxicology resources, which may be located at academic medical centers, hospital inpatient clinical services, outpatient clinics, or poison control centers. We determined the locations of existing RITN centers and assessed their proximity to various medical toxicology resources, including medical toxicology fellowship programs, inpatient toxicology services, outpatient toxicology clinics, and poison control centers. Data were derived from publicly available Internet sources in March 2015. The majority of RITN centers do not have a medical toxicology fellowship, an inpatient toxicology service, or an outpatient toxicology clinic within the same institution. Fifty-seven percent of RITN centers have at least one of these resources located in the same city, however, and 73% of centers have at least one of these resources or a poison control center within the same city. Ninety-five percent of RITN centers have at least one medical toxicology resource within the state. Most RITN centers are located in the same city as at least one medical toxicology resource. Establishing relationships between RITN centers and medical toxicologists needs to be explored further.

  13. A New Trend in the Management of Pediatric Deep Neck Abscess: Achievement of the Medical Treatment Alone.

    Science.gov (United States)

    Çetin, Aslı Çakır; Olgun, Yüksel; Özses, Arif; Erdağ, Taner Kemal

    2017-06-01

    Albeit the traditional opinion that advocates a routine surgical drainage for the treatment of an abscess, the case series presenting high success rates of the medical therapy alone is increasing in deep neck abscesses of childhood. This research focuses on children whose deep neck abscess fully disappeared after only medical treatment. In a retrospective study, we evaluated medical records of 12 pediatric (<18 years old) cases diagnosed with deep neck abscess or abscess containing suppurative lymphadenitis and treated with only medical therapy between 2010 and 2015 for age, gender, treatment modality, parameters related to antimicrobial agents, location of the infection, etiology, symptoms, duration of hospital stay, characteristics of the radiological and biochemical examination findings, and complications. The mean age of 10 male and two female children was 5.9 years (range, 1-17 years). Baseline and the last control's mean values of white blood cell (WBC), C-reactive protein, and erythrocyte sedimentation rate were 18,050/μL, 99.8 mg/L, 73.1 mm/h, and 8,166/μL, 34.1 mg/L, 35.3 mm/h, respectively. Contrast-enhanced neck computed tomography demonstrated an abscess in seven cases and an abscess containing suppurative lymphadenitis in five cases. The largest diameter of the abscess was 41 mm. All cases were given broad-spectrum empirical antibiotherapy (penicillin+metronidazole, ceftriaxone+metronidazole, or clindamycin). No medical treatment failure was experienced. Independent of age and abscess size, if the baseline WBC is ≤25.200/μL, if only two or less than two cervical compartments are involved, if there are no complications in the admission, and if the etiological reason is not a previous history of trauma, surgery, foreign body, and malignancy, pediatric deep neck abscess can be treated successfully with parenteral empirical wide-spectrum antibiotherapy.

  14. The influence of patients' preference/attitude towards psychotherapy and antidepressant medication on the treatment of major depressive disorder.

    Science.gov (United States)

    Moradveisi, Latif; Huibers, Marcus; Renner, Fritz; Arntz, Arnoud

    2014-03-01

    Preferences and attitudes patients hold towards treatment are important, as these can influence treatment outcome. In depression research, the influence of patients' preference/attitudes on outcome and dropout has mainly been studied for antidepressant medication, and less for psychological treatments. We investigated the effects of patients' preference and attitudes towards psychological treatment and antidepressant medication on treatment outcome and dropout, and tested specificity of effects. Data are based on a randomized trial testing the effectiveness of behavioural activation (BA) vs antidepressant medication (ADM) for major depression (MDD) in Iran. Patients with MDD (N = 100) were randomized to BA (N = 50) or ADM (N = 50). Patients' preference/attitudes towards psychotherapy and ADM were assessed at baseline and associated with dropout and treatment outcome using logistic regression and multilevel analysis. High scores on psychotherapy preference/attitude and low scores on ADM preference/attitude predicted dropout from ADM, while no association between dropout and preference/attitude was found in BA. Psychotherapy preference/attitude moderated the differential effect of BA and ADM on one outcome measure, but the association disappeared after one year. Because in Iran most patients have only access to ADM, offering a psychological treatment for depression could attract especially those patients that prefer this newly available treatment. Patients' preferences and attitudes towards depression treatments influence dropout from ADM, and moderate the short-term difference in effectiveness between BA and ADM. The fact that dropout from BA was not affected by preference/attitude speaks for its acceptability among patients. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Anti-corrosion layer prepared by plasma electrolytic carbonitriding on pure aluminum

    International Nuclear Information System (INIS)

    Wu, Jie; Zhang, Yifan; Liu, Run; Wang, Bin; Hua, Ming; Xue, Wenbin

    2015-01-01

    Highlights: • PEC/N can be applied to low melting point metal. • The spectroscopic characterization of plasma discharge is investigated. • Electron concentration and electron temperature are evaluated for PEC/N. • Phase composition of the carbonitrided layer is determined. • PEC/N improves the corrosion resistance of aluminum greatly. - Abstract: In this paper, plasma electrolytic carbonitriding (PEC/N) method was applied to pure aluminum for the first time. The spectroscopic characterization of plasma discharge during PEC/N process was analyzed and the electron temperature was calculated in terms of optical emission spectroscopy. The results showed the discharge plasma was in local thermal equilibrium (LTE) state. Electron concentration and electron temperature were about 6 × 10 21 m −3 and 4000 K, respectively. The carbonitrided layer contained Al 4 C 3 , AlN and Al 7 C 3 N 3 phases. After PEC/N treatment, the corrosion resistance of pure aluminum was significantly improved, which was related to the formation of nitride phases. This work expands the application of plasma electrolysis technology on the surface modification of low melting point metal

  16. [Study of the Application of Mobile Medical Technology in Construction of Grading Diagnosis and Treatment System].

    Science.gov (United States)

    Zhu, Wenwu; Shen, Yihong; Zhen, Hui; Yang, Xiaohe; Hu, Kai

    2018-02-08

    The combination of mobile medical technology and the grading diagnosis and treatment system (GDTS) can stimulate the allocation of medical resources, reduce medical cost and improve public health significantly. Firstly we summarize development features of mobile medical technology in foreign and domestic market, then we study the application model of mobile medical application in GDTS with field research data and analyzes its advantage and shortage. Finally, we propose four measures for further developing mobile medical application in the GDTS:the government departments should formulate policies and industry standards of products as soon as possible to meet requirement of market; service providers should take the hospitals as core role to achieve mutual benefit and win-win situation; take the daily monitoring of chronic diseases as an entry point to build profitable business model; enhance publicity to promote public health awareness.

  17. Complex windmill transformation producing new purely magnetic fluids

    International Nuclear Information System (INIS)

    Lozanovski, C; Wylleman, L

    2011-01-01

    Minimal complex windmill transformations of G 2 IB(ii) spacetimes (admitting a two-dimensional Abelian group of motions of the so-called Wainwright B(ii) class) are defined and the compatibility with a purely magnetic Weyl tensor is investigated. It is shown that the transformed spacetimes cannot be perfect fluids or purely magnetic Einstein spaces. We then determine which purely magnetic perfect fluids (PMpfs) can be windmill-transformed into purely magnetic anisotropic fluids (PMafs). Assuming separation of variables, complete integration produces two, algebraically general, G 2 I-B(ii) PMpfs: a solution with zero 4-acceleration vector and spatial energy-density gradient, previously found by the authors, and a new solution in terms of Kummer's functions, where these vectors are aligned and non-zero. The associated windmill PMafs are rotating but non-expanding. Finally, an attempt to relate the spacetimes to each other by a simple procedure leads to a G 2 I-B(ii) one-parameter PMaf generalization of the previously found metric.

  18. Purely leptonic currents

    International Nuclear Information System (INIS)

    Gourdin, M.

    1976-01-01

    In most gauge theories weak neutral currents appear as a natural consequence of the models, but the specific properties are not predicted in a general way. In purely leptonic interactions the structure of these currents can be tested without making assumptions about the weak couplings of the hadrons. The influence of neutral currents appearing in the process e + e - → μ + μ - can be measured using the polarization of the outgoing myons. (BJ) [de

  19. Language as Pure Potential

    Science.gov (United States)

    Park, Joseph Sung-Yul

    2016-01-01

    Language occupies a crucial position in neoliberalism, due to the reimagination of language as commodified skill. This paper studies the role of language ideology in this transformation by identifying a particular ideology that facilitates this process, namely the ideology which views language as pure potential. Neoliberalism treats language as a…

  20. Dahlbeck and Pure Ontology

    Science.gov (United States)

    Mackenzie, Jim

    2016-01-01

    This article responds to Johan Dahlbeck's "Towards a pure ontology: Children's bodies and morality" ["Educational Philosophy and Theory," vol. 46 (1), 2014, pp. 8-23 (EJ1026561)]. His arguments from Nietzsche and Spinoza do not carry the weight he supposes, and the conclusions he draws from them about pedagogy would be…

  1. Relationship between oxide film structures and corrosion resistance of SUS 304 L stainless steel in high temperature pure water

    International Nuclear Information System (INIS)

    Yamanaka, Kazuo; Matsuda, Yasushi.

    1990-01-01

    The effect of various oxidation conditions on metal release of SUS304L stainless steels in deaerated pure water at 488 K was investigated. The behavior of metal release was also discussed in relation to the surface films which were formed by various oxidation treatments. The results obtained are as follows: (1) The oxidation treatment in high purity argon gas at high temperatures for short time such as 1273 K - 2 min (120S) was effective to decrease the metal dissolution, and the oxide films primarily consisted of spinel type double oxide layer containing high concentration of Mn and Cr. (2) The oxidation treatments in non-deaerated pure water at 561 K for 24∼336 h (86.4∼1209.6 ks) were furthermore effective to decrease the metal dissolution. (3) It may be concluded that the key factors controlling the metal release are thickness, structure and compactness together with compositions of surface oxide films. (author)

  2. Chapter 12. Pure Tap Water Hydraulic Systems and Applications

    DEFF Research Database (Denmark)

    Conrad, Finn; Adelstorp, Anders

    1997-01-01

    Presentation of developed a modern pure tap water hydraulic components (Nessie), systems and industrial applications.......Presentation of developed a modern pure tap water hydraulic components (Nessie), systems and industrial applications....

  3. Effects of previous growth hormone excess and current medical treatment for acromegaly on cognition

    NARCIS (Netherlands)

    Brummelman, Pauline; Koerts, Janneke; Dullaart, Robin P. F.; van den Berg, Gerrit; Tucha, Oliver; Wolffenbuttel, Bruce H. R.; van Beek, Andre P.

    2012-01-01

    Background In untreated acromegaly patients, decreased cognitive functioning is reported to be associated with the degree of growth hormone (GH) and IGF-1 excess. Whether previous GH excess or current medical treatment for acromegaly specifically affects cognition remains unclear. The aim of this

  4. Pure Red Cell Aplasia and Hypogammaglobulinemia in a Patient with Thymoma

    Directory of Open Access Journals (Sweden)

    Chen-Sung Lin

    2009-01-01

    Full Text Available Both pure red cell aplasia (PRCA and hypogammaglobulinemia are rarer conditions than myasthenia gravis (MG in thymoma patients. Several articles have discussed the relation between PRCA and thymoma or hypogammaglobulinemia and thymoma, and their proper treatments. Instances of both PRCA and hypogammaglobulinemia in a thymoma patient are few and reported sporadically in the literature. We discuss a 46-year-old woman with thymoma and simultaneous PRCA and hypogammaglobulinemia who achieved complete remission from PRCA after perioperative steroid administration and extended thymectomy, and review the literature.

  5. Hospital admission and mortality rates in anorexia nervosa: experience from an integrated medical-psychiatric outpatient treatment.

    Science.gov (United States)

    De Filippo, E; Signorini, A; Bracale, R; Pasanisi, F; Contaldo, F

    2000-12-01

    To evaluate the effectiveness of an integrated medical-psychiatric treatment of major eating disorders. Historical cohort study. Outpatient Unit for Protein Energy Malnutrition of the Department of Clinical and Experimental Medicine, "Federico II" University of Naples, time of study: January 1994 to December 1997 PARTICIPANTS: 147 female patients with restrictive or bulimic anorexia nervosa (mean age 19.8 +/- 13.7, BMI 14.7 +/- 2.1 Kg/m2) consecutively attending the outpatient unit between January 1994 and December 1997. Hospitalization and mortality rates were evaluated up to Jan 1999 with a minimum follow-up of 18 months. There were 23 admissions to the Clinical Nutrition ward for 19 patients (i.e. 12.9%) mostly due to severe protein energy malnutrition, and 2 deaths, only 1 strictly related to anorexia (mortality rate 0.7%). Integrated outpatient medical-psychiatric treatment for major eating disorders is an effective and inexpensive procedure that reduces mortality and admissions due to medical complications in the medium term.

  6. Production of pure metals

    Science.gov (United States)

    Philipp, W. H.; Marsik, S. J.; May, C. E. (Inventor)

    1974-01-01

    A process for depositing elements by irradiating liquids is reported. Ultra pure elements are precipitated from aqueous solutions or suspensions of compounds. A solution of a salt of a metal to be prepared is irradiated, and the insoluble reaction product settles out. Some chemical compounds may also be prepared in this manner.

  7. Entropy balance in pure interactions of open quantum systems

    International Nuclear Information System (INIS)

    Urigu, R.

    1989-01-01

    Processes are considered in which a statistical ensemble w of quantum systems is split into ensembles, or channels (w i ), conditional to the occurrence, with respective probabilities (p i w ), of associated macroscopic effects. These processes are described here by a family of operations T i : w → p i w w iT , which remarkably generalize the usual state reductions of the nondestructive measurements. In a previous work it was proved that the microscopic entropy of the given open system decreases or at most remains constant if all the T i are pure operations, i.e., they transform pure states into pure states; it is proved here that the increase in entropy of the external world, computed as S Tm (w) = - Σ i p i w lg p i w , is sufficient to compensate for such an entropy decrease whenever the T i are all pure operations of the first kind, whereas whenever some T i is pure of the second kind (or nonpure, too), the total entropy, computed as above, may decrease

  8. Role of medical thoracoscopy in the treatment of tuberculous pleural effusion

    Science.gov (United States)

    Gao, Xusheng; Zhu, Huaiyang; Ding, Caihong

    2016-01-01

    Background Fibrous tuberculous pleural effusion (TPE) represents common disease in tuberculous clinic. Medical thoracoscopy has been used to treat pleural empyema and shown promising outcomes, but data of its use in multiloculated and organized TPE remains limited to know. Methods The study was performed on 430 cases with TPE. The cases were divided into free-flowing, multiloculated effusion and organized effusion group. Each group was subdivided into two or three types of therapeutic approaches: ultrasound guided pigtail catheter, large-bore tube chest drainage and medical thoracoscopy. Patients with multiloculated or organized effusions received streptokinase, introduced into the pleural cavity via chest tubes. The successful effectiveness of the study was defined as duration of chest drainage, time from treatment to discharge days and no further managements. Results Patients with organized effusion were older than those with free-flowing effusion and incidence of organized effusion combined with pulmonary tuberculosis (PTB) was higher than those of multiloculated effusion and free-flowing effusion respectively. Positive tuberculosis of pleural fluid culture was higher in organized effusion than that in free-flowing effusion. Sputum positive for acid-fast bacillus (AFB) in organized effusion was higher than that in multiloculated effusion and free-flowing effusion. Medical thoracoscopy showed significant efficacy in the group of multiloculated effusion and organized effusion but free-flowing effusion. No chronic morbidity and mortality related to complications was observed. Conclusions Medical thoracoscopy was a safe and successful method in treating multiloculated and organized TPE. PMID:26904212

  9. Relationships between self-reported unfair treatment and prescription medication use, illicit drug use, and alcohol dependence among Filipino Americans.

    Science.gov (United States)

    Gee, Gilbert C; Delva, Jorge; Takeuchi, David T

    2007-05-01

    We examined associations between self-reported unfair treatment and prescription medication use, illicit drug use, and alcohol dependence. We used data from the Filipino American Community Epidemiological Survey, a cross-sectional investigation involving 2217 Filipino Americans interviewed in 1998-1999. Multinomial logistic and negative binomial regression analyses were used in assessing associations between unfair treatment and the substance use categories. Reports of unfair treatment were associated with prescription drug use, illicit drug use, and alcohol dependence after control for age, gender, location of residence, employment status, educational level, ethnic identity level, nativity, language spoken, marital status, and several health conditions. Unfair treatment may contribute to illness and subsequent use of prescription medications. Furthermore, some individuals may use illicit drugs and alcohol to cope with the stress associated with such treatment. Addressing the antecedents of unfair treatment may be a potential intervention route.

  10. Nigeria Journal of Pure and Applied Physics: Journal Sponsorship

    African Journals Online (AJOL)

    Nigeria Journal of Pure and Applied Physics: Journal Sponsorship. Journal Home > About the Journal > Nigeria Journal of Pure and Applied Physics: Journal Sponsorship. Log in or Register to get access to full text downloads.

  11. Nigeria Journal of Pure and Applied Physics: Site Map

    African Journals Online (AJOL)

    Nigeria Journal of Pure and Applied Physics: Site Map. Journal Home > About the Journal > Nigeria Journal of Pure and Applied Physics: Site Map. Log in or Register to get access to full text downloads.

  12. Study on patient-induced radioactivity during proton treatment in hengjian proton medical facility.

    Science.gov (United States)

    Wu, Qingbiao; Wang, Qingbin; Liang, Tianjiao; Zhang, Gang; Ma, Yinglin; Chen, Yu; Ye, Rong; Liu, Qiongyao; Wang, Yufei; Wang, Huaibao

    2016-09-01

    At present, increasingly more proton medical facilities have been established globally for better curative effect and less side effect in tumor treatment. Compared with electron and photon, proton delivers more energy and dose at its end of range (Bragg peak), and has less lateral scattering for its much larger mass. However, proton is much easier to produce neutron and induced radioactivity, which makes radiation protection for proton accelerators more difficult than for electron accelerators. This study focuses on the problem of patient-induced radioactivity during proton treatment, which has been ignored for years. However, we confirmed it is a vital factor for radiation protection to both patient escort and positioning technician, by FLUKA's simulation and activation formula calculation of Hengjian Proton Medical Facility (HJPMF), whose energy ranges from 130 to 230MeV. Furthermore, new formulas for calculating the activity buildup process of periodic irradiation were derived and used to study the relationship between saturation degree and half-life of nuclides. Finally, suggestions are put forward to lessen the radiation hazard from patient-induced radioactivity. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Results from a global survey of contact lens-wearer satisfaction with OPTI-FREE® PureMoist® Multi-Purpose Disinfecting Solution

    Directory of Open Access Journals (Sweden)

    Lemp J

    2013-11-01

    Full Text Available Jessie Lemp, Jami R Kern Global Medical Affairs, Alcon Laboratories, Inc, Fort Worth, Texas, USA Purpose: The objective of the study reported here was to obtain information on acceptance and satisfaction with OPTI-FREE® PureMoist® Multi-Purpose Disinfecting Solution (MPDS from contact lens wearers globally. Methods: Eligible contact lens wearers provided baseline demographic and lens-wear-regimen information, and advised their ocular dryness/discomfort level and current lens-wear experience. Volunteers received OPTI-FREE PureMoist MPDS and a survey consisting of ten statements about the trial solution. Volunteers were instructed to use the solution daily and to complete the survey after 2 weeks of use. Descriptive statistical analysis was conducted on data from the entire group, from the subset of respondents reporting ocular dryness and/or discomfort at trial initiation (symptomatic subgroup, and from each geographic region. Results: Volunteers from nine countries returned 10,610 surveys, in which 50% of respondents classified themselves as having ocular dryness/discomfort. Lens comfort and visual performance responses from the total population and the symptomatic subgroup were significantly more positive after 2 weeks of OPTI-FREE PureMoist use than at baseline, irrespective of the habitual lens-care solution. In the USA, Southeast Asia, and Europe, 14% to 20% more respondents reported that their contact lenses provided all-day comfort after 2 weeks of OPTI-FREE PureMoist use compared with baseline (P<0.0001. Australia reported 31% more patients with all-day comfort after OPTI-FREE PureMoist use (P<0.0001. Approximately four out of five respondents from both populations reported their intent to continue using OPTI-FREE PureMoist. Globally, 39% of all respondents and 58% of symptomatic respondents experienced reduced end-of-day dryness with their contact lenses after use of OPTI-FREE PureMoist (P<0.0001. Conclusion: Results from this large

  14. Repeated dose studies with pure Epigallocatechin-3-gallate demonstrated dose and route dependant hepatotoxicity with associated dyslipidemia

    Directory of Open Access Journals (Sweden)

    Balaji Ramachandran

    Full Text Available EGCG (Epigallocatechin-3-gallate is the major active principle catechin found in green tea. Skepticism regarding the safety of consuming EGCG is gaining attention, despite the fact that it is widely being touted for its potential health benefits, including anti-cancer properties. The lack of scientific data on safe dose levels of pure EGCG is of concern, while EGCG has been commonly studied as a component of GTE (Green tea extract and not as a single active constituent. This study has been carried out to estimate the maximum tolerated non-toxic dose of pure EGCG and to identify the treatment related risk factors. In a fourteen day consecutive treatment, two different administration modalities were compared, offering an improved [i.p (intraperitoneal] and limited [p.o (oral] bioavailability. A trend of dose and route dependant hepatotoxicity was observed particularly with i.p treatment and EGCG increased serum lipid profile in parallel to hepatotoxicity. Fourteen day tolerable dose of EGCG was established as 21.1 mg/kg for i.p and 67.8 mg/kg for p.o. We also observed that, EGCG induced effects by both treatment routes are reversible, subsequent to an observation period for further fourteen days after cessation of treatment. It was demonstrated that the severity of EGCG induced toxicity appears to be a function of dose, route of administration and period of treatment. Keywords: EGCG, Green tea, Serum lipids, Dose dependant toxicity, Route dependant toxicity, Liver toxicity, Dyslipidemia

  15. [Medical treatment of chronic venous disease: evolution or involution?].

    Science.gov (United States)

    Agus, G B

    2011-06-01

    Chronic venous disease (CVD) is an important clinical condition with substantial epidemiological implications and socio-economic repercussions. In the Western world the consequences of its high prevalence, the costs of diagnosis and therapy, the significant loss of working hours and the repercussions on patients'quality of life are well known. Pharmacotherapy for CVD has greatly developed over the last 40 years and largely used in the symptomatic treatment of CVD together with compression therapy and to make patients more comfortable. The clinical efficacy on the symptoms (feeling of heaviness, pain, paresthesia, heat and burning sensations, night cramps, etc.) has long been confirmed by Level III, IV and V evidence, but there are now Level I and II trials on specific drugs. For the bioflavonoids double-blind, randomised trials have used micronized purified flavonoid fraction; rutosides; escin; anthocyanosides; and synthetic calcium dobesilate. It was therefore surprising some recent difficulties in the use of this important treatment in health national system in Italy. In this up-date we use the method on evidence-based medicine from the medical literature. We have started a governance and economic analysis of the problem in Italy. Particular consideration was given to the evidence set out in review, meta-analysis, guidelines and Consensus Statements in this field. The evidence for pharmacological agents in the treatment of CVD suggests today a wide use in all CEAP classes.

  16. Brazilian dentists' attitudes about medical emergencies during dental treatment.

    Science.gov (United States)

    Arsati, Franco; Montalli, Victor Angelo; Flório, Flavia Martão; Ramacciato, Juliana Cama; da Cunha, Fernanda Lopes; Cecanho, Rodrigo; de Andrade, Eduardo Dias; Motta, Rogério Heládio Lopes

    2010-06-01

    The main objective of this study was to evaluate the prevalence of emergencies in dental practices and the prepared-ness and the training experience in cardiopulmonary resuscitation (CPR) of Brazilian dentists in dealing with emergencies. The volunteer participants in the study were 498 Brazilian dentists who were present at the 27th International Congress of Dentistry in São Paulo. The most prevalent emergency was presyncope (reported by 54.20 percent of respondents), followed by orthostatic hypotension (44.37 percent), moderate allergic reactions (16.86 percent), hypertensive crisis (15.06 percent), asthma (15.06 percent), syncope (12.65 percent), angina (6.82 percent), convulsion (6.22 percent), hypoglycemia (5.62 percent), hyperventilation crisis (5.22 percent), choking (2.20 percent), and cerebrovascular accident (0.8 percent). Anaphylaxis, myocardial infarction, and cardiac arrest were the rarest emergencies, reported by only 0.4, 0.2, and 0.2 percent of dentists, respectively. Only 41 percent of the dentists judged themselves capable to diagnose the cause of an emergency during a dental visit. The majority responded that they would be capable of performing initial treatment of presyncope, syncope, orthostatic hypotension, convulsion, and choking. However, most of them felt unable to treat anaphylaxis, myocardial infarction, or cardiac arrest. Further, the majority felt unable to perform CPR or undertake an intravenous injection. It was concluded that the most prevalent medical emergencies in dental practice of Brazilian dentists are presyncope and orthostatic hypotension. The occurrence of life-threatening medical emergencies like anaphylaxis, myocardial infarction, cardiac arrest, and cerebrovascular accident is rare. Brazilian dentists are not fully prepared to manage medical emergencies and have insufficient experience training in CPR.

  17. 40 years of medical mycology at JAC.

    Science.gov (United States)

    Ostrosky-Zeichner, Luis

    2016-12-01

    In the past 40 years, medical mycology has gone from a curiosity in the basements of medical schools to a mainstream branch of clinical microbiology and infectious diseases. Long gone are the days of carefully curated collections of organisms identified purely based on morphology and skill, the lack of therapeutic interventions beyond amphotericin B and the occasional strange case in the ward of a diabetic patient with mucormycosis. We highlight advances in medical mycology as reflected in the past 40 years of JAC. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  18. Effect of gamma irradiation and storage time on microbial growth and physicochemical characteristics of pumpkin (Cucurbita Moschata Duchesne ex Poiret) puree.

    Science.gov (United States)

    Gliemmo, María F; Latorre, María E; Narvaiz, Patricia; Campos, Carmen A; Gerschenson, Lía N

    2014-01-01

    The effect of gamma irradiation (0-2 kGy) and storage time (0-28 days) on microbial growth and physicochemical characteristics of a packed pumpkin puree was studied. For that purpose, a factorial design was applied. The puree contained potassium sorbate, glucose and vanillin was stored at 25°C . Gamma irradiation diminished and storage time increased microbial growth. A synergistic effect between both variables on microbial growth was observed. Storage time decreased pH and color of purees. Sorbate content decreased with storage time and gamma irradiation. Mathematical models of microbial growth generated by the factorial design allowed estimating that a puree absorbing 1.63 kGy would have a shelf-life of 4 days. In order to improve this time, some changes in the applied hurdles were assayed. These included a thermal treatment before irradiation, a reduction of irradiation dose to 0.75 kGy and a decrease in storage temperature at 20°C . As a result, the shelf-life of purees increased to 28 days.

  19. Winter forage quality of oats (avena sativa), barley (hordeum vulgare) and vetch (vicia sativa) in pure stand and cereal legume mixture

    International Nuclear Information System (INIS)

    Ullah, Z.

    2015-01-01

    A field study was carried out for two consecutive years in subtropical rainfed conditions of Rawalpindi, Pakistan to evaluate the forage quality of oats, barley and vetch grown in pure stands and cereal-legume mixtures. Treatments comprised oats pure stand, oats in oats-vetch mixture, barley pure stand, barley in barley-vetch mixture, vetch pure stand, vetch in oats-vetch mixture and vetch in barley-vetch mixture. Forage yield and quality of oats and barley were improved in oats-vetch and barley-vetch mixtures than their respective pure stands. The higher values of crude protein (CP) and lower values of neutral detergent fiber (NDF) and acid detergent fiber (ADF) reflected quality forage. CP for oats in oats-vetch -1 -1 mixture and barley in barley-vetch mixture was 175 g kg and 170 g kg, -1 respectively. NDF and ADF for oats in oats-vetch mixture were 494 g kg /sup -1/ and 341 g kg, respectively; while these values for barley in barley-vetch -1 -1 mixture were 340 g kg and 176 g kg, respectively. (author)

  20. Medications (for IBS)

    Medline Plus

    Full Text Available ... Medications Psychological Treatments Online Studies Living With IBS Relationships and IBS Pregnancy and IBS Travel and IBS ... Medications Psychological Treatments Online Studies Living With IBS Relationships and IBS Pregnancy and IBS Travel and IBS ...

  1. Minors' rights to refuse medical treatment requested by their parents: remaining issues.

    Science.gov (United States)

    Griswold, D P; Griswold, D B

    2000-08-01

    Nurse practitioners are regularly faced with ethical and legal dilemmas when providing care to minors. Laws may not provide clear direction; there may even be conflicting precedents regarding the status of minors, particularly with regard to the juvenile justice system. This article reviews the status of minors' rights with regard to refusing or consenting to medical tests or treatments. Three cases from one author's (DPG) practice illustrate the issues involved.

  2. Predictors of aortic growth in uncomplicated type B aortic dissection from the Acute Dissection Stent Grafting or Best Medical Treatment (ADSORB) database

    DEFF Research Database (Denmark)

    Kamman, Arnoud V; Brunkwall, Jan; Verhoeven, Eric L

    2017-01-01

    BACKGROUND: The high-risk patient cohort of uncomplicated type B aortic dissections (uTBADs) needs to be clarified. We compared uTBAD patients treated with best medical treatment (BMT), with and without aortic growth, from the Acute Dissection Stent Grafting or Best Medical Treatment (ADSORB) tri...

  3. Black hole attractors and pure spinors

    International Nuclear Information System (INIS)

    Hsu, Jonathan P.; Maloney, Alexander; Tomasiello, Alessandro

    2006-01-01

    We construct black hole attractor solutions for a wide class of N = 2 compactifications. The analysis is carried out in ten dimensions and makes crucial use of pure spinor techniques. This formalism can accommodate non-Kaehler manifolds as well as compactifications with flux, in addition to the usual Calabi-Yau case. At the attractor point, the charges fix the moduli according to Σf k = Im(CΦ), where Φ is a pure spinor of odd (even) chirality in IIB (A). For IIB on a Calabi-Yau, Φ = Ω and the equation reduces to the usual one. Methods in generalized complex geometry can be used to study solutions to the attractor equation

  4. Black Hole Attractors and Pure Spinors

    International Nuclear Information System (INIS)

    Hsu, Jonathan P.; Maloney, Alexander; Tomasiello, Alessandro

    2006-01-01

    We construct black hole attractor solutions for a wide class of N = 2 compactifications. The analysis is carried out in ten dimensions and makes crucial use of pure spinor techniques. This formalism can accommodate non-Kaehler manifolds as well as compactifications with flux, in addition to the usual Calabi-Yau case. At the attractor point, the charges fix the moduli according to Σf k = Im(CΦ), where Φ is a pure spinor of odd (even) chirality in IIB (A). For IIB on a Calabi-Yau, Φ = (Omega) and the equation reduces to the usual one. Methods in generalized complex geometry can be used to study solutions to the attractor equation

  5. Fungal keratitis secondary to Scedosporium apiospermum infection and successful treatment with surgical and medical intervention.

    Science.gov (United States)

    Kepez Yildiz, Burcin; Hasanreisoglu, Murat; Aktas, Zeynep; Aksu, Gulsah; Kocak, Burcak Comert; Akata, Fikret

    2014-04-01

    To report a rare case of severe fungal keratitis caused by Scedosporium apiospermum, which was treated with a penetrating tectonic keratoplasty and aggressive medical treatment. A 62-year-old woman with a history of soil contamination of the right eye while planting vegetables presented with a severe corneal abscess and ocular pain. The patient received medical treatment and underwent tectonic keratoplasty. Both corneal scrapings and the corneal button were evaluated microscopically. The samples were sent for aerobic and anaerobic bacterial and fungal cultures. Microbiological examinations showed S. apiospermum. The isolate was sensitive to amphoterycine B, caspofungin, voriconazole, and resistant to fluconazole. No clinical improvement was achieved with topical voriconazole, vancomycin, ceftazidime, and systemic voriconazole. A penetrating tectonic keratoplasty and lensectomy with continuation of anti-fungal therapy achieved satisfactory results. A fungal etiology should be suspected in a progressive and untreatable corneal abscess. Microbiological investigation is very important in early diagnosis. Despite early diagnosis and aggressive treatment, in selected cases removing the infected tissue surgically is vital in preserving the ocular globe and vision.

  6. Medications (for IBS)

    Medline Plus

    Full Text Available ... Agents Antidiarrheal Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best ... Agents Antidiarrheal Agents Antidepressant Medications Newer IBS Medications ... Psychological Treatments Understanding Stress Cognitive Behavioral ...

  7. Pure Air`s Bailly scrubber: A four-year retrospective

    Energy Technology Data Exchange (ETDEWEB)

    Manavi, G.B.; Vymazal, D.C. [Pure Air, Allentown, PA (United States); Sarkus, T.A. [Dept. of Energy, Pittsburgh, PA (United States)

    1997-12-31

    Pure Air`s Advanced Flue Gas Desulfurization (AFGD) Clean Coal Project has completed four highly successful years of operation at NIPSCO`s Bailly Station. As part of their program, Pure Air has concluded a six-part study of system performance. This paper summarizes the results of the demonstration program, including AFGD performance on coals ranging from 2.0--2.4% sulfur. The paper highlights novel aspects of the Bailly facility, including pulverized limestone injection, air rotary sparger for oxidation, wastewater evaporation system and the production of PowerChip{reg_sign} gypsum. Operations and maintenance which have led to the facility`s notable 99.47% availability record are also discussed. A project company, Pure Air on the Lake Limited Partnership, owns the AFGD facility. Pure Air was the turn key contractor and Air Products and Chemicals, Inc. is the operator of the AFGD system.

  8. Post-cold war United Nations peacekeeping operations: a review of the case for a hybrid level 2+ medical treatment facility.

    Science.gov (United States)

    Johnson, Ralph Jay

    2015-01-01

    Post-Cold War, UN peacekeeping operations (UN PKOs) have become larger, more mobile, multi-faceted and conducted over vast areas of remote, rugged, and harsh geography. They have been increasingly involved in dangerous areas with ill-defined boundaries, simmering internecine armed conflict, and disregard on the part of some local parties for peacekeepers' security and role. Yet progressively there have been expectations of financial restraint and austerity. Additionally, UN PKOs have become more "robust," that is, engaged in preemptive, assertive operations. A statistically positive and significant relationship exists between missions' size, complexity, remoteness, and aggressive tenor and a higher probability of trauma or death, especially as a result of hostile actions or disease. Therefore, in the interest of "force protection" and optimizing operations, a key component of UN PKOs is health care and medical treatment. The expectation is that UN PKO medical support must conform to the general intent and structure of current UN PKOs to become more streamlined, portable, mobile, compartmentalized, and specialized, but also more varied and complex to address the medical aspects of these missions cost-efficiently. This article contends that establishing a hybrid level 2-a level 2 with level 3 modules and components (i.e., level 2+)-is a viable course of action when considering trends in the medical aspects of Post-Cold War UN PKOs. A level 2 medical treatment facility has the potential to provide needed forward mobile medical treatment, especially trauma care, for extended, complex, large-scale, and comprehensive UN PKOs. This is particularly the case for missions that include humanitarian outreach, preventive medicine, and psychiatry. The level 2 treatment facility is flexible enough to expand into a hybrid level 2+ with augmentation of modules based on changes in mission requirements and variation in medical aspects.

  9. Medications (for IBS)

    Medline Plus

    Full Text Available ... Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best used in ... Agents Antidepressant Medications Newer IBS Medications Probiotics and ... Treatments Understanding Stress Cognitive Behavioral Therapy Relaxation ...

  10. Short- and long-term subjective medical treatment outcome of trauma surgery patients: the importance of physician empathy

    Directory of Open Access Journals (Sweden)

    Steinhausen S

    2014-09-01

    Full Text Available Simone Steinhausen,1 Oliver Ommen,2 Sunya-Lee Antoine,1 Thorsten Koehler,3 Holger Pfaff,4 Edmund Neugebauer11Institute for Research in Operative Medicine (IFOM, Witten/Herdecke University, Campus Cologne-Merheim, Germany; 2Federal Centre for Health Education (BZgA, Cologne, Germany; 3Institute for Applied Social Sciences (infas, Bonn, Germany; 4Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR, Faculty of Human Science and Faculty of Medicine, University of Cologne, Germany Purpose: To investigate accident casualties’ long-term subjective evaluation of treatment outcome 6 weeks and 12 months after discharge and its relation to the experienced surgeon’s empathy during hospital treatment after trauma in consideration of patient-, injury-, and health-related factors. The long-term results are compared to the 6-week follow-up outcomes.Patients and methods: Two hundred and seventeen surgery patients were surveyed at 6 weeks, and 206 patients at 12 months after discharge from the trauma surgical general ward. The subjective evaluation of medical treatment outcome was measured 6 weeks and 12 months after discharge with the respective scale from the Cologne Patient Questionnaire. Physician Empathy was assessed with the Consultation and Relational Empathy Measure. The correlation between physician empathy and control variables with the subjective evaluation of medical treatment outcome 12 months after discharge was identified by means of logistic regression analysis under control of sociodemographic and injury-related factors.Results: One hundred and thirty-six patients were included within the logistic regression analysis at the 12-month follow-up. Compared to the 6-week follow-up, the level of subjective evaluation of medical treatment outcome was slightly lower and the association with physician empathy was weaker. Compared to patients who rated the empathy of their surgeon lower than 31 points, patients

  11. Shunting arc plasma source for pure carbon ion beam

    Energy Technology Data Exchange (ETDEWEB)

    Koguchi, H.; Sakakita, H.; Kiyama, S.; Shimada, T.; Sato, Y.; Hirano, Y. [Energy Technology Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), 1-1-1 Umezono, Tsukuba, Ibaraki 305-8568 (Japan)

    2012-02-15

    A plasma source is developed using a coaxial shunting arc plasma gun to extract a pure carbon ion beam. The pure carbon ion beam is a new type of deposition system for diamond and other carbon materials. Our plasma device generates pure carbon plasma from solid-state carbon material without using a hydrocarbon gas such as methane gas, and the plasma does not contain any hydrogen. The ion saturation current of the discharge measured by a double probe is about 0.2 mA/mm{sup 2} at the peak of the pulse.

  12. Shunting arc plasma source for pure carbon ion beam.

    Science.gov (United States)

    Koguchi, H; Sakakita, H; Kiyama, S; Shimada, T; Sato, Y; Hirano, Y

    2012-02-01

    A plasma source is developed using a coaxial shunting arc plasma gun to extract a pure carbon ion beam. The pure carbon ion beam is a new type of deposition system for diamond and other carbon materials. Our plasma device generates pure carbon plasma from solid-state carbon material without using a hydrocarbon gas such as methane gas, and the plasma does not contain any hydrogen. The ion saturation current of the discharge measured by a double probe is about 0.2 mA∕mm(2) at the peak of the pulse.

  13. Corrosion of pure OFHC-copper in simulated repository conditions

    International Nuclear Information System (INIS)

    Aaltonen, P.

    1990-04-01

    The research program 'Corrosion of pure OFHC-copper in simulated repository conditions' was planned to provide an experimental evaluation with respect to the theoretical calculations and forecasts made for the corrosion behaviour of pure copper in bentonite groundwater environments at temperatures between 20-80 deg C. The aim of this study in the first place is to evaluate the effects of groundwater composition, bentonite and temperature on the equilibrium and possible corrosion reactions between pure copper and the simulated repository environment. The progress report includes the results obtained after 36 months exposure time

  14. Impact of symptomatic hypoglycemia on medication adherence, patient satisfaction with treatment, and glycemic control in patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Walz L

    2014-04-01

    Full Text Available Lotta Walz,1,3 Billie Pettersson,2,3 Ulf Rosenqvist,4 Anna Deleskog,3,5 Gunilla Journath,6 Per Wändell7 1Department of Oncology-Pathology, Karolinska Institutet, Stockholm, 2Center for Medical Technology Assessment, Linköping University, Linköping, 3Merck Sharp and Dohme (Sweden AB, Sollentuna, 4Department of Internal Medicine, Motala Hospital, Motala, 5Department of Molecular Medicine and Surgery, 6Department of Medicine, Karolinska Institutet, Stockholm, 7Department of Neurobiology, Care Sciences and Society, Centre for Family Medicine, Karolinska Institutet, Huddinge, Sweden Background: The purpose of this study was to evaluate the impact of symptomatic hypoglycemia on medication adherence, satisfaction with treatment, and glycemic control in patients with type 2 diabetes based on the treatment goals stated in the Swedish national guidelines. Methods: This cross-sectional, multicenter study was carried out between January and August 2009 in 430 consecutive primary health care patients on stable doses of metformin and sulfonylureas for at least 6 months. The patients completed questionnaires covering their experiences of low blood glucose and adherence, as well as barriers to and satisfaction with drug treatment (using the Treatment Satisfaction Questionnaire for Medication. Physicians collected the data from medical records. Results: Patients who experienced moderate or worse symptoms of hypoglycemia reported poorer adherence to medication (46% versus 67%; P<0.01 and were more likely to perceive barriers such as “bothered by medication side effects” (36% versus 14%; P<0.001 compared with patients with no or mild symptoms. Patients with moderate or worse symptoms of hypoglycemia were less satisfied with their treatment than those with no or mild symptoms as determined by the Treatment Satisfaction Questionnaire for Medication-Global satisfaction (67.0 versus 71.2; P<0.05. Overall, achievement of target glycated hemoglobin

  15. The effect of some medical treatments of Thalassemia on the red blood cells

    International Nuclear Information System (INIS)

    Zhang Xiufang; Shen Linming; Bao Hongxia; Din Xiaolan; Wang Rongxin; Huang Youwen; Liu Yuanyuan; Gao Naifei

    1992-01-01

    The Moessbauer spectroscopy (MS) and circular dichroism (CD) measurements have been used to investigate the effect of some medical treatments on the red blood cells (RBCs) of the patients with HbH disease and β-thalassemia (Thal.) major, respectively. The results indicate that both splenectomy and treatment with myleran are effective to alleviate the symptoms of anemia for some patients, but both of them are different in the effect on the RBCs of the patients. On the basis of the results, a hypothesis on the course of denaturation in hemoglobin (Hb) of the patients is proposed. (orig.)

  16. Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system

    DEFF Research Database (Denmark)

    Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra

    2014-01-01

    were abstracted from medical records. Flow diagrams were drawn for different standard treatment cycles and direct costs at each stage in the flow charts were measured and valued by a bottomup procedure. Indirect costs were distributed to each treatment cycle on the basis of number of visits as basis...

  17. The law for radiation and x-ray technicians engaging in medical treatment

    International Nuclear Information System (INIS)

    1977-01-01

    The Law aims to define the qulifications of radiation and x-ray technicians engaging in medical treatment and to regulate so that the works are carried out properly for helping popularization and improvement of medicine and public hygiene. Persons who wish to be radiation or x-ray technicians engaging in medical treatment are required to pass the examinations for such technicians and obtain the licenes of the Minister of Health and Welfare for the former technicians and the license of a prefectural governor for the latter technicians. Mentally disordered, deaf, dumb or blind persons are excluded from licensees. Registration of such technicians, delivery of the license certificates and other related matters are provided for. The examinations are held concerning the knowledges and skills necessary for such technicians and carried out by the Minister of Health and Welfare. Persons except doctors, dentists and such technicians are prohibited to engage in the practices to apply radiation to human bodies. Restrictions on the intensity of radiation applied and the places of work are defined concerning such practices. Penal servitude of less than a year and fines less than yen 10,000 or yen 5,000 are imposed upon the violation of such prohibitions or restrictions. (Okada, K.)

  18. New Combined Medical Treatment With Etilefrine and Octreotide for Chylothorax After Esophagectomy

    Science.gov (United States)

    Ohkura, Yu; Ueno, Masaki; Iizuka, Toshiro; Haruta, Shusuke; Tanaka, Tsuyoshi; Udagawa, Harushi

    2015-01-01

    Abstract Postoperative chylothorax is a rare but well-known complication of general thoracic surgery. Medical treatment of chylothorax was reported in the past, but there is still considerable controversy on the appropriate management strategies. Two patients with esophageal cancer underwent esophagectomy, 2-field lymph node dissection, and resection of thoracic duct together with ileocolic reconstruction via the retrosternal route at our hospital. Chylothorax developed on the 32nd postoperative day (POD) in 1 patient and the 12th POD in the other, manifesting as a change in the character of thoracic drainage to turbid white. Both were immediately started on octreotide (300 μg/ day) and etilefrine (120 mg/day). When the amount of pleural effusion decreased to Picibanil (OK432). Thereafter, the patients gradually made satisfactory progress and resumed oral food intake, and the thoracotomy tubes were eventually removed. They have remained recurrence-free at the time of writing. In this report, we demonstrated the clinical efficacy of etilefrine for the management of postesophagectomy chylothorax. New medical treatment options for this condition are now broad and the usefulness of combined therapy consisting of a sclerosing agent, etilefrine, and octreotide is underscored, regardless of the status of the thoracic duct. PMID:26656358

  19. Pure Electric and Pure Magnetic Resonances in Near-Infrared Metal Double-Triangle Metamaterial Arrays

    International Nuclear Information System (INIS)

    Cao Zhi-Shen; Pan Jian; Chen Zhuo; Zhan Peng; Min Nai-Ben; Wang Zhen-Lin

    2011-01-01

    We experimentally and numerically investigate the optical properties of metamaterial arrays composed of double partially-overlapped metallic nanotriangles fabricated by an angle-resolved nanosphere lithography. We demonstrate that each double-triangle can be viewed as an artificial magnetic element analogous to the conventional metal split-ring-resonator. It is shown that under normal-incidence conditions, individual double-triangle can exhibit a strong local magnetic resonance, but the collective response of the metamaterial arrays is purely electric because magnetic resonances of the two double-triangles in a unit cell having opposite openings are out of phase. For oblique incidences the metamaterial arrays are shown to support a pure magnetic response at the same frequency band. Therefore, switchable electric and magnetic resonances are achieved in double-triangle arrays. Moreover, both the electric and magnetic resonances are shown to allow for a tunability over a large spectral range down to near-infrared. (condensed matter: electronic structure, electrical, magnetic, and optical properties)

  20. Medical Tourism: The Trend toward Outsourcing Medical Procedures to Foreign Countries

    Science.gov (United States)

    York, Diane

    2008-01-01

    The rising costs of medical treatment in the United States are fueling a movement to outsource medical treatment. Estimates of the number of Americans traveling overseas for treatment range from 50,000 to 500,000. Charges for common procedures such as heart bypass can be $11,000 in Thailand compared to $130,000 in the United States. Knee…

  1. Treatment planning of electroporation-based medical interventions: electrochemotherapy, gene electrotransfer and irreversible electroporation

    International Nuclear Information System (INIS)

    Zupanic, Anze; Kos, Bor; Miklavcic, Damijan

    2012-01-01

    In recent years, cancer electrochemotherapy (ECT), gene electrotransfer for gene therapy and DNA vaccination (GET) and tissue ablation with irreversible electroporation (IRE) have all entered clinical practice. We present a method for a personalized treatment planning procedure for ECT, GET and IRE, based on medical image analysis, numerical modelling of electroporation and optimization with the genetic algorithm, and several visualization tools for treatment plan assessment. Each treatment plan provides the attending physician with optimal positions of electrodes in the body and electric pulse parameters for optimal electroporation of the target tissues. For the studied case of a deep-seated tumour, the optimal treatment plans for ECT and IRE require at least two electrodes to be inserted into the target tissue, thus lowering the necessary voltage for electroporation and limiting damage to the surrounding healthy tissue. In GET, it is necessary to place the electrodes outside the target tissue to prevent damage to target cells intended to express the transfected genes. The presented treatment planning procedure is a valuable tool for clinical and experimental use and evaluation of electroporation-based treatments. (paper)

  2. Superposing pure quantum states with partial prior information

    Science.gov (United States)

    Dogra, Shruti; Thomas, George; Ghosh, Sibasish; Suter, Dieter

    2018-05-01

    The principle of superposition is an intriguing feature of quantum mechanics, which is regularly exploited in many different circumstances. A recent work [M. Oszmaniec et al., Phys. Rev. Lett. 116, 110403 (2016), 10.1103/PhysRevLett.116.110403] shows that the fundamentals of quantum mechanics restrict the process of superimposing two unknown pure states, even though it is possible to superimpose two quantum states with partial prior knowledge. The prior knowledge imposes geometrical constraints on the choice of input states. We discuss an experimentally feasible protocol to superimpose multiple pure states of a d -dimensional quantum system and carry out an explicit experimental realization for two single-qubit pure states with partial prior information on a two-qubit NMR quantum information processor.

  3. Medications (for IBS)

    Medline Plus

    Full Text Available ... Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best used in ... Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Psychological Treatments Understanding Stress Cognitive Behavioral Therapy Relaxation ...

  4. "Now We Are Going on a Journey": Meaning-Making with a Healthcare Game during Toddlers' Medical Treatment

    Science.gov (United States)

    Høiseth, Marikken; Hopperstad, Marit Holm

    2016-01-01

    This study explores how toddlers and caregivers make meaning with an interactive healthcare game on a tablet during medical treatment. The data material consists of video recordings of six nebuliser treatments of two children. Using a social semiotic perspective and a multimodal analysis, the study identifies how children and caregivers make…

  5. Minimal covariant observables identifying all pure states

    Energy Technology Data Exchange (ETDEWEB)

    Carmeli, Claudio, E-mail: claudio.carmeli@gmail.com [D.I.M.E., Università di Genova, Via Cadorna 2, I-17100 Savona (Italy); I.N.F.N., Sezione di Genova, Via Dodecaneso 33, I-16146 Genova (Italy); Heinosaari, Teiko, E-mail: teiko.heinosaari@utu.fi [Turku Centre for Quantum Physics, Department of Physics and Astronomy, University of Turku (Finland); Toigo, Alessandro, E-mail: alessandro.toigo@polimi.it [Dipartimento di Matematica, Politecnico di Milano, Piazza Leonardo da Vinci 32, I-20133 Milano (Italy); I.N.F.N., Sezione di Milano, Via Celoria 16, I-20133 Milano (Italy)

    2013-09-02

    It has been recently shown by Heinosaari, Mazzarella and Wolf (2013) [1] that an observable that identifies all pure states of a d-dimensional quantum system has minimally 4d−4 outcomes or slightly less (the exact number depending on d). However, no simple construction of this type of minimal observable is known. We investigate covariant observables that identify all pure states and have minimal number of outcomes. It is shown that the existence of this kind of observables depends on the dimension of the Hilbert space.

  6. Critical opalescence in the pure Coulomb system

    Science.gov (United States)

    Bobrov, V. B.; Trigger, S. A.

    2011-04-01

    Based on the dielectric formalism and quantum field theory methods, the phenomenon of critical opalescence is explained for light scattering in pure matter as a two-component electron-nuclear system with Coulomb interaction. A similar phenomenon is shown to occur in the case of neutron scattering in pure substances as well. The obtained results are valid for quantum case and arbitrary strong Coulomb interaction. Thus, the relations between structure factors derived for the electron-nuclear system are the exact result of the quantum statistical mechanics.

  7. Anti-corrosion layer prepared by plasma electrolytic carbonitriding on pure aluminum

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Jie; Zhang, Yifan; Liu, Run; Wang, Bin; Hua, Ming [Key Laboratory for Beam Technology and Materials Modification of Ministry of Education, College of Nuclear Science and Technology, Beijing Normal University, Beijing 100875 (China); Beijing Radiation Center, Beijing 100875 (China); Xue, Wenbin, E-mail: xuewb@bnu.edu.cn [Key Laboratory for Beam Technology and Materials Modification of Ministry of Education, College of Nuclear Science and Technology, Beijing Normal University, Beijing 100875 (China); Beijing Radiation Center, Beijing 100875 (China)

    2015-08-30

    Highlights: • PEC/N can be applied to low melting point metal. • The spectroscopic characterization of plasma discharge is investigated. • Electron concentration and electron temperature are evaluated for PEC/N. • Phase composition of the carbonitrided layer is determined. • PEC/N improves the corrosion resistance of aluminum greatly. - Abstract: In this paper, plasma electrolytic carbonitriding (PEC/N) method was applied to pure aluminum for the first time. The spectroscopic characterization of plasma discharge during PEC/N process was analyzed and the electron temperature was calculated in terms of optical emission spectroscopy. The results showed the discharge plasma was in local thermal equilibrium (LTE) state. Electron concentration and electron temperature were about 6 × 10{sup 21} m{sup −3} and 4000 K, respectively. The carbonitrided layer contained Al{sub 4}C{sub 3}, AlN and Al{sub 7}C{sub 3}N{sub 3} phases. After PEC/N treatment, the corrosion resistance of pure aluminum was significantly improved, which was related to the formation of nitride phases. This work expands the application of plasma electrolysis technology on the surface modification of low melting point metal.

  8. Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system: results from a 5-year follow-up cohort study.

    Science.gov (United States)

    Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra; Ziebe, Søren; Mikkelsen Englund, Anne L; Hald, Finn; Boivin, Jacky; Schmidt, Lone

    2014-01-01

    To examine the costs to the public health care system of couples in medically assisted reproduction. Longitudinal cohort study of infertile couples initiating medically assisted reproduction treatment. Specialized public fertility clinics in Denmark. Seven hundred and thirty-nine couples having no child at study entry and with data on kind of treatment and live birth (yes/no) for each treatment attempt at the specialized public fertility clinic. Treatment data for medically assisted reproduction attempts conducted at the public fertility clinics were abstracted from medical records. Flow diagrams were drawn for different standard treatment cycles and direct costs at each stage in the flow charts were measured and valued by a bottom-up procedure. Indirect costs were distributed to each treatment cycle on the basis of number of visits as basis. Costs were adjusted to 2012 prices using a constructed medical price index. Live birth, costs. Total costs per live birth in 2012 prices were estimated to 10,755€. Costs per treated couple - irrespective of whether the treatment was terminated by a live birth or not - were estimated at 6607€. Costs per live birth of women <35 years at treatment initiation were 9338€ and 15,040€ for women ≥35 years. The public costs for live births after conception with medically assisted reproduction treatment are relatively modest. The results can be generalized to public fertility treatment in Denmark and to other public treatment settings with similar limitations in numbers of public treatment cycles offered. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

  9. Parental perception of treatment and medical care in children with craniosynostosis.

    Science.gov (United States)

    Kluba, S; Rohleder, S; Wolff, M; Haas-Lude, K; Schuhmann, M U; Will, B E; Reinert, S; Krimmel, M

    2016-11-01

    Surgery for craniosynostosis implies a relevant strain on the child and the parents. The development of the child's self-perception and self-confidence is mainly influenced by parental attitudes. The outcomes of 46 patients were analysed, taking into consideration parental perceptions. Parents were asked to indicate their satisfaction with the medical care and treatment provided using a questionnaire. Aesthetics were evaluated by the parents and doctors using a score (1=perfect, 5=deficient). Major surgical complications (2.2%) were reported only in the case of complex synostosis. Reoperation was necessary in 2.9% of isolated cases and 45.5% of complex cases. In general, parents were satisfied with the medical (1.3) and nursing (1.6) inpatient care. Aesthetic assessments differed between parents and surgeons, although not significantly (P=0.27). The surgeons perceived the results to be better than the parents, especially for complex synostosis (1.3 vs. 2.7). Alopecia and persistent asymmetry led to a worse perception of aesthetics. Persistent bone defects did not influence parental satisfaction. All participating parents would opt for surgery again. Surgery led to satisfactory results with a low risk of severe complications. Nevertheless, the outcomes and limits of the surgical procedure must be communicated effectively to parents, especially in complex cases, to avoid a mismatch in expectations. It would be desirable to implement structured interviews with parents during regular treatment management. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  10. In vitro corrosion, cytotoxicity and hemocompatibility of bulk nanocrystalline pure iron

    International Nuclear Information System (INIS)

    Nie, F L; Zheng, Y F; Wei, S C; Hu, C; Yang, G

    2010-01-01

    Bulk nanocrystalline pure iron rods were fabricated by the equal channel angular pressure (ECAP) technique up to eight passes. The microstructure and grain size distribution, natural immersion and electrochemical corrosion in simulated body fluid, cellular responses and hemocompatibility were investigated in this study. The results indicate that nanocrystalline pure iron after severe plastic deformation (SPD) would sustain durable span duration and exhibit much stronger corrosion resistance than that of the microcrystalline pure iron. The interaction of different cell lines reveals that the nanocrystalline pure iron stimulates better proliferation of fibroblast cells and preferable promotion of endothelialization, while inhibits effectively the viability of vascular smooth muscle cells (VSMCs). The burst of red cells and adhesion of the platelets were also substantially suppressed on contact with the nanocrystalline pure iron in blood circulation. A clear size-dependent behavior from the grain nature deduced by the gradual refinement microstructures was given and well-behaved in vitro biocompatibility of nanocrystalline pure iron was concluded.

  11. Multi-Institutional Survey of Medical Treatment for Late-Onset Hypogonadism in Japan.

    Science.gov (United States)

    Taniguchi, Hisanori; Matsuda, Tadashi

    2017-03-01

    The adequate criteria for late-onset hypogonadism (LOH) diagnosis, including serum testosterone levels, type (total or free testosterone) and duration of androgen replacement therapy, and evaluations of treatment effectiveness remain controversial. To evaluate the current status of medical treatment for LOH in Japan, the first nationwide survey were performed. A total of 35 questionnaires answered by urologists in high-volume facilities were analyzed. The median numbers of patients with hypogonadism-related symptoms per month were 10. Aging Male Symptom Score, International Index of Erectile Function, and International Prostate Symptom Score questionnaires were widely used for questionnaires. The diagnostic criteria for LOH varied. Among the patients who presented with hypogonadism-related symptoms, the mean proportion of patients undergoing treatment for LOH was 62.3%. In Japan, LOH was treated not only with testosterone enanthate injections or testosterone ointment but also with Kampo medicine. In many facilities, LOH treatment effectiveness was assessed after a 3-month period. Efficacy was assessed in different ways. Treatment effectiveness rate ranged from 30% to 80%. The duration of LOH treatment was not fixed and was established individually by both the patient and treating physician. This study showed that the real clinical practices for LOH are very diverse, and a general consensus is needed.

  12. THE EFFECTIVENESS OF THE IMPLEMENTATION OF TECHNOLOGY SUBSTITUTING INPATIENT TREATMENT DURING THE MEDICAL CARE PROVISION TO WOMEN WITH BENIGN GYNECOLOGICAL NEOPLASMS

    Directory of Open Access Journals (Sweden)

    A. A. Lobganidze

    2017-01-01

    Full Text Available Relevance. Over the last decades, such technology substituting inpatient treatment as outpatient treatment has been actively discussed and used in practice. Despite this fact, many problems of outpatient treatment have not been solved in full, no effective leverages contributing to creating economic incentives for increasing the volume and range of medical services in day hospitals have been found in the mandatory medical insurance system.Objective. Based on an in-depth analysis of medical care provision to women with benign gynaecological neoplasms, to offer measures for improvement of medical care in outpatient facilities, particularly by using technologies substituting inpatient treatment, and to evaluate their effectiveness.Materials and methods. A comprehensive retrospective evaluation of outpatient and inpatient medical care was conducted in St. Petersburg over the period from 2008 to 2015. The information contained in the database of billed and paid invoices of the obligatory medical insurance system of St. Petersburg was studied. For the total period of eight years, the data on medical care provision to 81 622 women suffering from benign tumors of the female reproductive organs, particularly in day hospitals, were obtained. In the period 2015–2016, medical care provision to patients with benign neoplasms of the gynecological sphere was thoroughly analyzed. In 18 women’s health departments and 19 in-patient facilities in all districts of the city, all cases of treatment of patients in the basic women’s health departments and in-patient facilities were analyzed by experts. By Taking into account the obtained results, an organizational experiment on introducing substituting technologies followed by evaluating the effectiveness of their use was developed and implemented on the basis of the medical institutions in one of the districts of St. Petersburg.Results. The activeness of outpatient facilities for treatment of women with benign

  13. Analyzing medical costs with time-dependent treatment: The nested g-formula.

    Science.gov (United States)

    Spieker, Andrew; Roy, Jason; Mitra, Nandita

    2018-04-16

    As medical expenses continue to rise, methods to properly analyze cost outcomes are becoming of increasing relevance when seeking to compare average costs across treatments. Inverse probability weighted regression models have been developed to address the challenge of cost censoring in order to identify intent-to-treat effects (i.e., to compare mean costs between groups on the basis of their initial treatment assignment, irrespective of any subsequent changes to their treatment status). In this paper, we describe a nested g-computation procedure that can be used to compare mean costs between two or more time-varying treatment regimes. We highlight the relative advantages and limitations of this approach when compared with existing regression-based models. We illustrate the utility of this approach as a means to inform public policy by applying it to a simulated data example motivated by costs associated with cancer treatments. Simulations confirm that inference regarding intent-to-treat effects versus the joint causal effects estimated by the nested g-formula can lead to markedly different conclusions regarding differential costs. Therefore, it is essential to prespecify the desired target of inference when choosing between these two frameworks. The nested g-formula should be considered as a useful, complementary tool to existing methods when analyzing cost outcomes. Copyright © 2018 John Wiley & Sons, Ltd.

  14. Compact objects in pure Lovelock theory

    Science.gov (United States)

    Dadhich, Naresh; Hansraj, Sudan; Chilambwe, Brian

    For static fluid interiors of compact objects in pure Lovelock gravity (involving only one Nth order term in the equation), we establish similarity in solutions for the critical odd and even d = 2N + 1, 2N + 2 dimensions. It turns out that in critical odd d = 2N + 1 dimensions, there cannot exist any bound distribution with a finite radius, while in critical even d = 2N + 2 dimensions, all solutions have similar behavior. For exhibition of similarity, we would compare star solutions for N = 1, 2 in d = 4 Einstein and d = 6 in Gauss-Bonnet theory, respectively. We also obtain the pure Lovelock analogue of the Finch-Skea model.

  15. Primary anterior vaginal wall pure ammonium acid urate stone. Case report

    Directory of Open Access Journals (Sweden)

    Sherif M. Khattab

    2013-06-01

    Full Text Available Vaginal stones are extremely rare and are classified as primary and secondary. A 45 year-old female presented with an unexplained dyspareunia and vaginal discomfort for 2 years unresponsive to traditional treatment. Vaginal examination revealed no prolapse or vaginal fistula. Digital examination revealed multiple small rounded firm to hard or tender masses varying in size from 0.5 to 1.5 cm anterior to the vagina. Patient was treated with midline anterior vaginal wall incision with the extraction of eight smooth surfaced stones with uneventful postoperative course. Stone analysis revealed that they were composed of pure ammonium acid urate (AU. We recommend that for any patient with unexplained dyspareunia or vaginal discomfort that has proved to be unresponsive to traditional treatment, the possibility of anterior vaginal wall stones should be kept in mind.

  16. Thermal behaviour of pure and binary Fe(NO3)3.9H2O and (NH4)6Mo7O24.4H2O systems

    International Nuclear Information System (INIS)

    Shaheen, W.M.

    2007-01-01

    Thermal behaviour of pure ferric nitrate, ammonium molybdate and their mixtures in different ratios were investigated by means of thermal analysis (TG, DTG and DTA) techniques. Relative thermal analysis (RTA) graphical treatment of derivatographic curves of the components in the pure and binary system has been carried out as well. A series of Fe 2 O 3 -MoO 3 systems were prepared from pure and binary salts by heating at 350, 550, 750 and 1000 deg. C. The X-ray diffraction (XRD) analysis was used to characterize the phases produced from thermal treatment of investigated solids. The results revealed that pure ferric nitrate decomposed to Fe 2 O 3 at 250, while pure ammonium molybdate decomposed into MoO 3 and 340 deg. C and then melted at 790 deg. C. For the binary components, crystalline ferric or molybdenum oxides were detected beside ferric molybdate Fe 2 (MoO 4 ) 3 phase starting from 350 deg. C. Fe 2 (MoO 4 ) 3 phase was formed as a result of solid-solid interactions between the produced oxides. The thermal stability of the formed compound was significantly affected by the composition of the mixture and treatment temperature. The presence of two-component solids in the binary systems affected the thermal decomposition of their individual salt and affected their physical and chemical behaviour. The catalytic activity of the obtained pure and mixed oxides was measured using the decomposition of hydrogen peroxide reaction as a model reaction at 20-50 deg. C. It was found that the mixed oxide solids had catalytic activity higher than single oxides thermally treated at 350 and 550 deg. C. This is attributed to the increase in the concentration of active sites via creation of new ion pairs in case of binary systems. The rise in calcination temperature up to 750 and 1000 deg. C brought about drastic decrease in the activity of all solids because of changing catalyst composition and/or sintering process. The activation energies of H 2 O 2 decomposition were determined

  17. On pure spinor formalism for quantum superstring and spinor moving frame

    International Nuclear Information System (INIS)

    Bandos, Igor A

    2013-01-01

    The D = 10 pure spinor constraint can be solved in terms of spinor moving frame variables v -α q and eight-component complex null vector Λ + q , Λ + q Λ + q =0, which can be related to the κ-symmetry ghost. Using this and similar solutions for the conjugate pure spinor and other elements of the non-minimal pure spinor formalism, we present a (hopefully useful) reformulation of the measure of the pure spinor path integral for superstring in terms of products of Cartan forms corresponding to the coset of 10D Lorentz group and to the coset of complex orthogonal group SO(8, C). Our study suggests a possible complete reformulation of the pure spinor superstring in terms of new irreducible set of variable. (paper)

  18. Cohomology in the Pure Spinor Formalism for the Superstring

    International Nuclear Information System (INIS)

    Berkovits, Nathan

    2000-01-01

    A manifestly super-Poincare covariant formalism for the superstring has recently been constructed using a pure spinor variable. Unlike the covariant Green-Schwarz formalism, this new formalism is easily quantized with a BRST operator and tree-level scattering amplitudes have been evaluated in a manifestly covariant manner. In this paper, the cohomology of the BRST operator in the pure spinor formalism is shown to give the usual light-cone Green-Schwarz spectrum. Although the BRST operator does not directly involve the Virasoro constraint, this constraint emerges after expressing the pure spinor variable in terms of SO(8) variables. (author)

  19. Current approaches to treatments for schizophrenia spectrum disorders, part I: an overview and medical treatments

    Directory of Open Access Journals (Sweden)

    Chien WT

    2013-09-01

    Full Text Available Wai Tong Chien, Annie LK Yip School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong Abstract: During the last three decades, an increasing understanding of the etiology, psychopathology, and clinical manifestations of schizophrenia spectrum disorders, in addition to the introduction of second-generation antipsychotics, has optimized the potential for recovery from the illness. Continued development of various models of psychosocial intervention promotes the goal of schizophrenia treatment from one of symptom control and social adaptation to an optimal restoration of functioning and/or recovery. However, it is still questionable whether these new treatment approaches can address the patients' needs for treatment and services and contribute to better patient outcomes. This article provides an overview of different treatment approaches currently used in schizophrenia spectrum disorders to address complex health problems and a wide range of abnormalities and impairments resulting from the illness. There are different treatment strategies and targets for patients at different stages of the illness, ranging from prophylactic antipsychotics and cognitive–behavioral therapy in the premorbid stage to various psychosocial interventions in addition to antipsychotics for relapse prevention and rehabilitation in the later stages of the illness. The use of antipsychotics alone as the main treatment modality may be limited not only in being unable to tackle the frequently occurring negative symptoms and cognitive impairments but also in producing a wide variety of adverse effects to the body or organ functioning. Because of varied pharmacokinetics and treatment responsiveness across agents, the medication regimen should be determined on an individual basis to ensure an optimal effect in its long-term use. This review also highlights that the recent practice guidelines and standards have

  20. Development of the medical apparatus for Doppler-controlled treatment of hemorrhoids using laser coagulation

    Directory of Open Access Journals (Sweden)

    Nikolay A. Gryaznov

    2017-12-01

    Full Text Available In the article authors present the concept of the surgical manipulator delivering laser radiation to the target area. For the implementation of Doppler-controlled treatment of hemorrhoids by laser coagulation, an important circumstance is the necessity to realize by means of the dopplerograph the possibility of controlling the efficiency of coagulation of the pathological vessel immediately after the impact, which will create the prerequisites for the formation of a program cycle with the inclusion of control elements by feedback. In this regard, the structure of the laser medical apparatus is developed, which allows determining the location, size and flow of arterial and venous vessels, performing laser coagulation of pathologically damaged sites under constant Doppler control. The developed adaptive power management system includes several functional units for the processing of the data from ultrasound scanner and the Doppler. Medical apparatus for minimally invasive treatment of hemorrhoids based on the laser coagulator and ultrasound Doppler will allow performing surgeries in automated and half-automated modes. The suggested medical apparatus helps to determine pathological vessels, choose the required radiation mode and provides vessel obliteration. Successful realization of constructive combination of real-time diagnostics and surgical manipulation with a laser can result in a unique minimally invasive solution to treat hemorrhoids that currently doesn’t have analogues.

  1. Implication of ultrasound bladder parameters on treatment response in patients with benign prostatic hyperplasia under medical management

    Directory of Open Access Journals (Sweden)

    Rajeev Thekumpadam Puthenveetil

    2015-10-01

    Conclusion: Ultrasound bladder parameters are useful tools for measuring the treatment response in BPH patients. Our study shows that RI and DWT significantly correlate with the treatment response in BPH patients. More importantly, pretreatment values of increased IPP and PUA determines the non-improvement of symptoms in BPH patients. Our study suggests the importance of transabdominal ultrasonography (KUB–P with Doppler for evaluating treatment responses to medical management.

  2. Hydroxyapatite coatings produced on commercially pure titanium by micro-arc oxidation

    Energy Technology Data Exchange (ETDEWEB)

    Huang Yong [College of Materials Science and Engineering, South China University of Technology, Guangzhou 510641 (China); Wang Yingjun [College of Materials Science and Engineering, South China University of Technology, Guangzhou 510641 (China); Ning Chengyun [College of Materials Science and Engineering, South China University of Technology, Guangzhou 510641 (China); Nan Kaihui [College of Materials Science and Engineering, South China University of Technology, Guangzhou 510641 (China); Han Yong [State Key Laboratory for Mechanical Behavior of Materials, Xi' an Jiaotong University, Xi' an 710049 (China)

    2007-09-15

    A porous hydroxyapatite (HA) coating on commercially pure titanium was prepared by micro-arc oxidation (MAO) in electrolytic solution containing calcium acetate and {beta}-glycerol phosphate disodium salt pentahydrate ({beta}-GP). The thickness, phase, composition morphology and biocompatibility of the oxide coating were characterized by x-ray diffraction (XRD), electron probe microanalysis (EPMA), scanning electron microscopy (SEM) with an energy dispersive x-ray spectrometer (EDS) and cell culture. The thickness of the MAO film was about 20 {mu}m, and the coating was porous and uneven without any apparent interface to the titanium substrates. The result of XRD showed that the porous coating was made up of HA film. The favorable osteoblast cell affinity gives HA film good biocompatibility. HA coatings are expected to have significant uses for medical applications such as dental implants and artificial bone joints.

  3. Hydroxyapatite coatings produced on commercially pure titanium by micro-arc oxidation.

    Science.gov (United States)

    Huang, Yong; Wang, Yingjun; Ning, Chengyun; Nan, Kaihui; Han, Yong

    2007-09-01

    A porous hydroxyapatite (HA) coating on commercially pure titanium was prepared by micro-arc oxidation (MAO) in electrolytic solution containing calcium acetate and beta-glycerol phosphate disodium salt pentahydrate (beta-GP). The thickness, phase, composition morphology and biocompatibility of the oxide coating were characterized by x-ray diffraction (XRD), electron probe microanalysis (EPMA), scanning electron microscopy (SEM) with an energy dispersive x-ray spectrometer (EDS) and cell culture. The thickness of the MAO film was about 20 microm, and the coating was porous and uneven without any apparent interface to the titanium substrates. The result of XRD showed that the porous coating was made up of HA film. The favorable osteoblast cell affinity gives HA film good biocompatibility. HA coatings are expected to have significant uses for medical applications such as dental implants and artificial bone joints.

  4. Hydroxyapatite coatings produced on commercially pure titanium by micro-arc oxidation

    International Nuclear Information System (INIS)

    Huang Yong; Wang Yingjun; Ning Chengyun; Nan Kaihui; Han Yong

    2007-01-01

    A porous hydroxyapatite (HA) coating on commercially pure titanium was prepared by micro-arc oxidation (MAO) in electrolytic solution containing calcium acetate and β-glycerol phosphate disodium salt pentahydrate (β-GP). The thickness, phase, composition morphology and biocompatibility of the oxide coating were characterized by x-ray diffraction (XRD), electron probe microanalysis (EPMA), scanning electron microscopy (SEM) with an energy dispersive x-ray spectrometer (EDS) and cell culture. The thickness of the MAO film was about 20 μm, and the coating was porous and uneven without any apparent interface to the titanium substrates. The result of XRD showed that the porous coating was made up of HA film. The favorable osteoblast cell affinity gives HA film good biocompatibility. HA coatings are expected to have significant uses for medical applications such as dental implants and artificial bone joints

  5. First-line nitrosourea-based chemotherapy in symptomatic non-resectable supratentorial pure low-grade astrocytomas.

    Science.gov (United States)

    Frenay, M P; Fontaine, D; Vandenbos, F; Lebrun, C

    2005-09-01

    At the present time, there are no proven beneficial effects of chemotherapy (CT) for the treatment of pure low-grade astrocytomas. Brain radiotherapy (RT) still remains the standard treatment in order to reduce or delay tumor progression or symptoms, despite possible long-term neurologic complications. We report 10 patients, with histologically proven pure low-grade fibrillary astrocytomas, to which we administered a first-line nitrosourea-based CT. All patients were symptomatic with pharmaco-resistant epilepsy or neurologic symptoms, and had been rejected for neurosurgical resection. All patients with epilepsy had a clinical improvement with reduction in seizure frequency and 60% became seizure-free. CT was well tolerated; all patients developed myelosuppression with 40% of grade III/IV hematotoxicity. Seven were alive at the time of writing with a mean follow-up of 6.5 years (3.5-12) from first recorded symptoms. The three deceased patients died 7.5, 7.5, and 8.5 years from first symptoms. These results demonstrate that some patients with symptomatic non-resectable fibrillary low-grade astrocytomas can be treated with up-front CT to improve their neurologic status. This report suggests that benefits of CT on symptoms, survival, and quality of life should be prospectively compared with RT.

  6. Properties and distribution of pure GA-sequences of mammalian genomes.

    Directory of Open Access Journals (Sweden)

    Guenter Albrecht-Buehler

    Full Text Available The article describes DNA sequences of mammalian genomes that are longer than 50 bases, but consist exclusively of G's and A's ('pure GA-sequences'. Although their frequency of incidence should be 10(-16 or smaller, the chromosomes of human, chimpanzee, dog, cat, rat, and mouse contained many tens of thousands of them ubiquitously located along the chromosomes with a species-dependent density, reaching sizes of up to 1300 [b]. With the exception of a small number of poly-A-, poly-G-, poly-GA-, and poly-GAAA-sequences (combined <0.5%, all pure GA-sequences of the mammals tested were unique individuals, contained several repeated short GA-containing motifs, and shared a common hexa-nucleotide spectrum. At most 2% of the human GA-sequences were transcribed into mRNAs; all others were not coding for proteins. Although this could have made them less subject to natural selection, they contained many [corrected] times fewer point mutations than one should expect from the genome at large. As to the presence of other sequences with similarly restricted base contents, there were approximately as many pure TC-sequences as pure GA-sequences, but many fewer pure AC-, TA, and TG-sequences. There were practically no pure GC-sequences. The functions of pure GA-sequences are not known. Supported by a number of observations related to heat shock phenomena, the article speculates that they serve as genomic sign posts which may help guide polymerases and transcription factors to their proper targets, and/or as spatial linkers that help generate the 3-dimensional organization of chromatin.

  7. New Insights into Medical Treatment of Acromegaly

    NARCIS (Netherlands)

    S.J.C.M.M. Neggers (Bas)

    2011-01-01

    textabstractGiants and Acromegalics fascinated people, since ancient times. Historical artifacts, paintings, illustrations, photographs or articles have documented many. The earliest medical reports date back to 1516. In 1864 Verga was the first to describe an acromegalic in medical literature

  8. Posterior magnetic effect on the pure and doped Fe-Ni alloy under neutron irradiation

    International Nuclear Information System (INIS)

    Ferreira, Iris

    1974-01-01

    Polycrystalline specimens of unirradiated and neutron irradiated Fe-Ni alloys have been studied in the temperature range RT - 500 deg C. The study was carried out in pure (50-50) as well as in Si, A1, Cr and Mo doped samples. Initial magnetic permeability was measured in unirradiated (virgin)and in neutron irradiated samples, during isochronal and linear thermal treatments. The main results are: a magnetic After Effect (MAE) is detected in the temperature range 370 deg C - Tc, where Tc is the Curie Temperature. In this range an activation energy of 3.2 ± 0.2 eV was determined for the Cr doped Fe-Ni alloy (impurity content: 0.1%); measurements made in the irradiated samples, during a linear temperature treatment, show the existence of several MAE zones in the temperature range RT - Tc. The isochronal annealing experiments show that these MAE zones are accompanied by a decrease in the room temperature value of the magnetic permeability, for zones between RT and a certain temperature T 1 . Above this range there is a steep increase in the room temperature permeability. Activation energies were determined for pure and Mo-doped (0.1%) samples for the first MAE zone (50 deg C - 120 deg C). The values obtained 1.25 - 0.08 eV and 1.42 ± 0.09 eV, respectively; the impurity - doped samples show a different behaviour relative to the pure ones: samples with low impurity content (0.1% and 0.5% of Si, Al or Mo) present an enhancement in the amplitude and also an overlapping of the diffusion stages. On the other hand, samples with higher impurity content (2 and 4% of Mo) show a decrease in these amplitudes. (author)

  9. Modern Palliative Radiation Treatment: Do Complexity and Workload Contribute to Medical Errors?

    Energy Technology Data Exchange (ETDEWEB)

    D' Souza, Neil, E-mail: neil.dsouza@sunnybrook.ca [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Holden, Lori [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Robson, Sheila [Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Mah, Kathy; Di Prospero, Lisa; Wong, C. Shun; Chow, Edward; Spayne, Jacqueline [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada)

    2012-09-01

    Purpose: To examine whether treatment workload and complexity associated with palliative radiation therapy contribute to medical errors. Methods and Materials: In the setting of a large academic health sciences center, patient scheduling and record and verification systems were used to identify patients starting radiation therapy. All records of radiation treatment courses delivered during a 3-month period were retrieved and divided into radical and palliative intent. 'Same day consultation, planning and treatment' was used as a proxy for workload and 'previous treatment' and 'multiple sites' as surrogates for complexity. In addition, all planning and treatment discrepancies (errors and 'near-misses') recorded during the same time frame were reviewed and analyzed. Results: There were 365 new patients treated with 485 courses of palliative radiation therapy. Of those patients, 128 (35%) were same-day consultation, simulation, and treatment patients; 166 (45%) patients had previous treatment; and 94 (26%) patients had treatment to multiple sites. Four near-misses and 4 errors occurred during the audit period, giving an error per course rate of 0.82%. In comparison, there were 10 near-misses and 5 errors associated with 1100 courses of radical treatment during the audit period. This translated into an error rate of 0.45% per course. An association was found between workload and complexity and increased palliative therapy error rates. Conclusions: Increased complexity and workload may have an impact on palliative radiation treatment discrepancies. This information may help guide the necessary recommendations for process improvement for patients who require palliative radiation therapy.

  10. The effect of pure state structure on nonequilibrium dynamics

    International Nuclear Information System (INIS)

    Newman, C M; Stein, D L

    2008-01-01

    Motivated by short-range Ising spin glasses, we review some rigorous results and their consequences for the relation between the number/nature of equilibrium pure states and nonequilibrium dynamics. Two of the consequences for spin glass dynamics following an instantaneous deep quench to a temperature with broken spin flip symmetry are: (1) almost all initial configurations lie on the boundary between the basins of attraction of multiple pure states; (2) unless there are uncountably many pure states with almost all pairs having zero overlap, there can be no equilibration to a pure state as time t → ∞. We discuss the relevance of these results to the difficulty of equilibration of spin glasses. We also review some results concerning the 'nature versus nurture' problem of whether the large-t behavior of both ferromagnets and spin glasses following a deep quench is determined more by the initial configuration (nature) or by the dynamics realization (nurture)

  11. Still Struggling: Characteristics of Youth with OCD Who Are Partial Responders to Medication Treatment

    Science.gov (United States)

    Freeman, J.; Sapyta, J.; Garcia, A.; Fitzgerald, D.; Khanna, M.; Choate-Summers, M.; Moore, P.; Chrisman, A.; Haff, N.; Naeem, A.; March, J.; Franklin, M.

    2011-01-01

    The primary aim of this paper is to examine the characteristics of a large sample of youth with OCD who are partial responders (i.e., still have clinically significant symptoms) to serotonin reuptake inhibitor (SRI) medication. The sample will be described with regard to: demographics, treatment history, OCD symptoms/severity, family history and…

  12. Medical education and cognitive continuum theory: an alternative perspective on medical problem solving and clinical reasoning.

    Science.gov (United States)

    Custers, Eugène J F M

    2013-08-01

    Recently, human reasoning, problem solving, and decision making have been viewed as products of two separate systems: "System 1," the unconscious, intuitive, or nonanalytic system, and "System 2," the conscious, analytic, or reflective system. This view has penetrated the medical education literature, yet the idea of two independent dichotomous cognitive systems is not entirely without problems.This article outlines the difficulties of this "two-system view" and presents an alternative, developed by K.R. Hammond and colleagues, called cognitive continuum theory (CCT). CCT is featured by three key assumptions. First, human reasoning, problem solving, and decision making can be arranged on a cognitive continuum, with pure intuition at one end, pure analysis at the other, and a large middle ground called "quasirationality." Second, the nature and requirements of the cognitive task, as perceived by the person performing the task, determine to a large extent whether a task will be approached more intuitively or more analytically. Third, for optimal task performance, this approach needs to match the cognitive properties and requirements of the task. Finally, the author makes a case that CCT is better able than a two-system view to describe medical problem solving and clinical reasoning and that it provides clear clues for how to organize training in clinical reasoning.

  13. Physicochemical state of the nanotopographic surface of commercially pure titanium following anodization-hydrothermal treatment reveals significantly improved hydrophilicity and surface energy profiles.

    Science.gov (United States)

    Takebe, Jun; Ito, Shigeki; Miura, Shingo; Miyata, Kyohei; Ishibashi, Kanji

    2012-01-01

    A method of coating commercially pure titanium (cpTi) implants with a highly crystalline, thin hydroxyapatite (HA) layer using discharge anodic oxidation followed by hydrothermal treatment (Spark discharged Anodic oxidation treatment ; SA-treated cpTi) has been reported for use in clinical dentistry. We hypothesized that a thin HA layer with high crystallinity and nanostructured anodic titanium oxide film on such SA-treated cpTi implant surfaces might be a crucial function of their surface-specific potential energy. To test this, we analyzed anodic oxide (AO) cpTi and SA-treated cpTi disks by SEM and AFM. Contact angles and surface free energy of each disk surface was measured using FAMAS software. High-magnification SEM and AFM revealed the nanotopographic structure of the anodic titanium oxide film on SA-treated cpTi; however, this was not observed on the AO cpTi surface. The contact angle and surface free energy measurements were also significantly different between AO cpTi and SA-treated cpTi surfaces (Tukey's, P<0.05). These data indicated that the change of physicochemical properties of an anodic titanium oxide film with HA crystals on an SA-treated cpTi surface may play a key role in the phenomenon of osteoconduction during the process of osseointegration. Copyright © 2011 Elsevier B.V. All rights reserved.

  14. Visual processing in pure alexia

    DEFF Research Database (Denmark)

    Starrfelt, Randi; Habekost, Thomas; Gerlach, Christian

    2010-01-01

    affected. His visual apprehension span was markedly reduced for letters and digits. His reduced visual processing capacity was also evident when reporting letters from words. In an object decision task with fragmented pictures, NN's performance was abnormal. Thus, even in a pure alexic patient with intact...

  15. Breast abscess as the initial manifestation of primary pure squamous cell carcinoma: a rare presentation and literature review.

    Science.gov (United States)

    Salemis, Nikolaos S

    2011-01-01

    Primary squamous cell carcinoma of the breast is a very rare tumor accounting for less than 0.4% of all breast cancers. Fewer than 100 cases have been reported in the literature so far. The diagnosis requires strict pathologic criteria to be fulfilled. Due to the rarity of this tumor the optimal treatment and prognosis are both unclear. Breast abscess as the initial presentation of a primary squamous cell breast carcinoma is an extremely rare clinical entity. In this study, we describe a case of a 61-year-old postmenopausal woman who presented with typical manifestations of a breast abscess and was diagnosed with a pure primary squamous cell breast carcinoma. Diagnostic evaluation and management of the patient are discussed along with a review of the literature. Despite its rarity, the possibility of a primary pure squamous cell breast carcinoma should always be considered in the differential diagnosis in postmenopausal patients presenting with manifestations of a breast abscess, especially in those who respond poorly to the initial treatment. Physicians should be aware of this rare malignancy in order to avoid delays in diagnosis and treatment.

  16. Microstructural study of metal-metal composites elaborated by interdiffusion between pure nickel and devitrified Fe-Ni-Mo-B glasses

    International Nuclear Information System (INIS)

    Ratovondrahona, E.; Bouquet, G.; Portier, R.

    1993-01-01

    It is well known that amorphous metallic alloys are able to give rise to microcrystallized structures when submitted to the effect of temperature, i.e. when devitrification takes place. These microstructures are particularly interesting for various applications. Materials produced from devitrified amorphous phase generally exhibit good mechanical properties, but are accompanied by some brittleness. In order to avoid this disadvantage, the authors tried to elaborate a composite material resulting from diffusion heat treatments carried out on alternate stackings of amorphous alloys and pure metal sheets. The idea is that by choosing discerning metallic glass and an appropriate diffusion heat treatment temperature, it might be possible to obtain mechanically hard phases, such as metallic borides, and disperse these compounds in the pure metallic matrix to be reinforced. Here, the authors only present the microstructural results of this study, although some preliminary mechanical tests have been preformed

  17. Electron Acoustic Waves in Pure Ion Plasmas

    Science.gov (United States)

    Anderegg, F.; Driscoll, C. F.; Dubin, D. H. E.; O'Neil, T. M.

    2009-11-01

    Electron Acoustic Waves (EAW) are the low frequency branch of electrostatic plasma waves. These waves exist in neutralized plasmas, pure electron plasmas and in pure ion plasmasfootnotetextF. Anderegg et al., PRL 102, 095001 (2009) and PoP 16, 055705 (2009). (where the name is deceptive). Here, we observe standing mθ= 0 mz= 1 EAWs in a pure ion plasma column. At small amplitude, the EAWs have a phase velocity vph ˜1.4 v, and the frequencies are in close agreement with theory. At moderate amplitudes, waves can be excited over a broad range of frequencies, with observed phase velocities in the range of 1.4 v vph diagnostic shows that particles slower than vph oscillate in phase with the wave, while particles moving faster than vph oscillate 180^o out of phase with the wave. From a fluid perspective, this gives an unusual negative dynamical compressibility. That is, the wave pressure oscillations are 180^o out of phase from the density oscillations, almost fully canceling the electrostatic restoring force, giving the low and malleable frequency.

  18. Laser-induced generation of pure tensile stresses

    International Nuclear Information System (INIS)

    Niemz, M.H.; Lin, C.P.; Pitsillides, C.; Cui, J.; Doukas, A.G.; Deutsch, T.F.

    1997-01-01

    While short compressive stresses can readily be produced by laser ablation, the generation of pure tensile stresses is more difficult. We demonstrate that a 90 degree prism made of polyethylene can serve to produce short and pure tensile stresses. A compressive wave is generated by ablating a thin layer of strongly absorbing ink on one surface of the prism with a Q-switched frequency-doubled Nd:YAG laser. The compressive wave driven into the prism is reflected as a tensile wave by the polyethylene-air interface at its long surface. The low acoustic impedance of polyethylene makes it ideal for coupling tensile stresses into liquids. In water, tensile stresses up to -200bars with a rise time of the order of 20 ns and a duration of 100 ns are achieved. The tensile strength of water is determined for pure tensile stresses lasting for 100 ns only. The technique has potential application in studying the initiation of cavitation in liquids and in comparing the effect of compressive and tensile stress transients on biological media. copyright 1997 American Institute of Physics

  19. Pure spinor formalism as an N = 2 topological string

    International Nuclear Information System (INIS)

    Berkovits, Nathan

    2005-01-01

    Following suggestions of Nekrasov and Siegel, a non-minimal set of fields are added to the pure spinor formalism for the superstring. Twisted c-circumflex = 3 N = 2 generators are then constructed where the pure spinor BRST operator is the fermionic spin-one generator, and the formalism is interpreted as a critical topological string. Three applications of this topological string theory include the super-Poincare covariant computation of multiloop superstring amplitudes without picture-changing operators, the construction of a cubic open superstring field theory without contact-term problems, and a new four-dimensional version of the pure spinor formalism which computes F-terms in the spacetime action

  20. A Comparison of Stent Implant versus Medical Treatment for Severe Symptomatic Intracranial Stenosis: A Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Rezao Mohammadian

    2012-11-01

    Full Text Available Background: Atherosclerotic stenosis of the major intracranial arteries is the most common cause of ischemic stroke. There are limited treatments for severe intracranial stenosis, and stent placement versus medical treatment remains controversial. The aim of this study was to compare functional outcomes of these two modalities in patients with severe symptomatic intracranial stenosis. Methods: At a single center, between 2008 and 2011, patients with angiographically demonstrated severe (70–90% symptomatic intracranial atherosclerosis were divided into two groups: group A, which received only medical treatment, and group B, which underwent endovascular stent implant treatment. The severity and location of the stenosis was determined by digital subtraction angiography and the Warfarin-Aspirin Symptomatic Intracranial Disease (WASID trial criteria in all patients. The exclusion criteria were: specific causes other than atherosclerosis, such as artery dissection, fibromuscular dysplasia, vasculitis, radiation and intracranial hemorrhage, focal neurological deficit that did not correlate to internal carotid artery or middle cerebral artery stenosis. All procedures were done under light anesthesia. Technical success was defined as the reduction of stenosis to Results: Overall, 63 patients (29 in group A and 34 in group B were evaluated and followed for a mean period of 15.22 months (range 6–25. The technical success rate was 97% in a total of 34 stents in 34 patients. There was no difference between the early (within 30 days adverse event rates of the two groups. The median follow-up duration for the stent implant patients was 15 months (range 6–25, and for the medically treated cohort it was 14 months (range 8–25. The re-stenosis rate was 5.8% and the total number of late (>30 days adverse events, including stroke, myocardial infarction and death, was 1 (2.9% and 6 (20.7% in the stent implant and medical groups, respectively (p = 0.042. The

  1. Predictors and Moderators of Response to Cognitive Behavioral Therapy and Medication for the Treatment of Binge Eating Disorder

    Science.gov (United States)

    Grilo, Carlos M.; Masheb, Robin M.; Crosby, Ross D.

    2012-01-01

    Objective: To examine predictors and moderators of response to cognitive behavioral therapy (CBT) and medication treatments for binge-eating disorder (BED). Method: 108 BED patients in a randomized double-blind placebo-controlled trial testing CBT and fluoxetine treatments were assessed prior, throughout, and posttreatment. Demographic factors,…

  2. Pure soliton solutions of some nonlinear partial differential equations

    International Nuclear Information System (INIS)

    Fuchssteiner, B.

    1977-01-01

    A general approach is given to obtain the system of ordinary differential equations which determines the pure soliton solutions for the class of generalized Korteweg-de Vries equations. This approach also leads to a system of ordinary differential equations for the pure soliton solutions of the sine-Gordon equation. (orig.) [de

  3. Pure Surface Texture Mapping Technology and it's Application for Mirror Image

    Directory of Open Access Journals (Sweden)

    Wei Feng Wang

    2013-02-01

    Full Text Available Based on the study of pure surface texture mapping technology, pure texture surface rendering method is proposed. The method is combined pure surface texture rendering and view mirror, real-time rendering has an index of refraction, reflection, and the flow of water ripple effect. Through the experimental verification of the validity of the algorithm.

  4. Differences in behavioral health disorders and unmet treatment needs between medical marijuana users and recreational marijuana users: Results from a national adult sample.

    Science.gov (United States)

    Park, Ji-Yeun; Wu, Li-Tzy

    2017-11-01

    Available data suggest that medical marijuana users may have more mental health problems than recreational marijuana users. There is limited information about differences in behavioral health disorders and unmet treatment needs between medical and recreational marijuana users. We compared past-year prevalence of behavioral health disorders and unmet treatment needs across three marijuana subgroups (recreational use only, medical use only, and both). Sex-stratified logistic regression was performed to determine their associations with marijuana use status. We analyzed data from adults (≥18 years) who used marijuana in the past year (N=15,440) from 2013 to 2014 National Surveys on Drug Use and Health. Among 15,440 past-year marijuana users, 90.2% used recreational marijuana only, 6.2% used medical marijuana only, and 3.6% used both. Both users had the highest prevalence of behavioral health disorders and unmet treatment needs overall, with no significant sex differences. In the sex-specific logistic regression analysis, medical only users and both users showed somewhat different patterns of associations (reference group=recreational only users). Medical only users had decreased odds of alcohol or drug use disorders, and unmet need for alcohol or drug treatment among males and females. Additionally, female medical only users had decreased odds of opioid use disorder. Both users had increased odds of major depressive episode, hallucinogen use disorder, and unmet need for mental health services among males, and cocaine use disorder among females. Different approaches tailored to individuals' sex and motives for marijuana use is needed for the prevention and treatment of behavioral health problems. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Benzodiazepines and antipsychotic medications for treatment of acute cocaine toxicity in animal models--a systematic review and meta-analysis.

    Science.gov (United States)

    Heard, Kennon; Cleveland, Nathan R; Krier, Shay

    2011-11-01

    There are no controlled human studies to determine the efficacy of benzodiazepines or antipsychotic medications for prevention or treatment of acute cocaine toxicity. The only available controlled data are from animal models and these studies have reported inconsistent benefits. The objective of this study was to quantify the reported efficacy of benzodiazepines and antipsychotic medication for the prevention of mortality due to cocaine poisoning. We conducted a systematic review to identify English language articles describing experiments that compared a benzodiazepine or antipsychotic medication to placebo for the prevention of acute cocaine toxicity in an animal model. We then used these articles in a meta-analysis with a random-effects model to quantify the absolute risk reduction observed in these experiments. We found 10 articles evaluating antipsychotic medications and 15 articles evaluating benzodiazepines. Antipsychotic medications reduced the risk of death by 27% (95% CI, 15.2%-38.7%) compared to placebo and benzodiazepines reduced the risk of death by 52% (42.8%-60.7%) compared to placebo. Both treatments showed evidence of a dose-response effect, and no experiment found a statistically significant increase in risk of death. We conclude that both benzodiazepines and antipsychotic medications are effective for the prevention of lethality from cocaine toxicity in animal models.

  6. Nigeria Journal of Pure and Applied Physics: About this journal

    African Journals Online (AJOL)

    Nigeria Journal of Pure and Applied Physics: About this journal. Journal Home > Nigeria Journal of Pure and Applied Physics: About this journal. Log in or Register to get access to full text downloads.

  7. Medications (for IBS)

    Medline Plus

    Full Text Available ... Agents Antidiarrheal Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best ... Agents Antidiarrheal Agents Antidepressant Medications Newer IBS ... Antibiotics Psychological Treatments Understanding Stress Cognitive Behavioral ...

  8. Treatment Effect in Earlier Trials of Patients With Chronic Medical Conditions: A Meta-Epidemiologic Study.

    Science.gov (United States)

    Alahdab, Fares; Farah, Wigdan; Almasri, Jehad; Barrionuevo, Patricia; Zaiem, Feras; Benkhadra, Raed; Asi, Noor; Alsawas, Mouaz; Pang, Yifan; Ahmed, Ahmed T; Rajjo, Tamim; Kanwar, Amrit; Benkhadra, Khalid; Razouki, Zayd; Murad, M Hassan; Wang, Zhen

    2018-03-01

    To determine whether the early trials in chronic medical conditions demonstrate an effect size that is larger than that in subsequent trials. We identified randomized controlled trials (RCTs) evaluating a drug or device in patients with chronic medical conditions through meta-analyses (MAs) published between January 1, 2007, and June 23, 2015, in the 10 general medical journals with highest impact factor. We estimated the prevalence of having the largest effect size or heterogeneity in the first 2 published trials. We evaluated the association of the exaggerated early effect with several a priori hypothesized explanatory variables. We included 70 MAs that had included a total of 930 trials (average of 13 [range, 5-48] RCTs per MA) with average follow-up of 24 (range, 1-168) months. The prevalence of the exaggerated early effect (ie, proportion of MAs with largest effect or heterogeneity in the first 2 trials) was 37%. These early trials had an effect size that was on average 2.67 times larger than the overall pooled effect size (ratio of relative effects, 2.67; 95% CI, 2.12-3.37). The presence of exaggerated effect was not significantly associated with trial size; number of events; length of follow-up; intervention duration; number of study sites; inpatient versus outpatient setting; funding source; stopping a trial early; adequacy of random sequence generation, allocation concealment, or blinding; loss to follow-up or the test for publication bias. Trials evaluating treatments of chronic medical conditions published early in the chain of evidence commonly demonstrate an exaggerated treatment effect compared with subsequent trials. At the present time, this phenomenon remains unpredictable. Considering the increasing morbidity and mortality of chronic medical conditions, decision makers should act on early evidence with caution. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  9. The effects of acupoint-catgut embedment combined with medical treatment on the BODE index scores of chronic obstructive pulmonary disease (COPD) patients

    Science.gov (United States)

    Giri, P. B. S. W.; Srilestari, A.; Abdurrohim, K.; Yunus, F.

    2017-08-01

    Chronic Obstructive Pulmonary Disease (COPD) is now the fourth leading cause of death in the world. As COPD medications are associated with high mortality levels, continuous research into the improvement of treatment modalities is being conducted. This study aimed to identify the effects of acupoint-catgut embedment combined with medical treatment on the Body mass index, airflow Obstruction, Dyspnea and Exercise capacity (BODE) index scores of COPD patients. A single-blind randomized controlled trial was conducted on 48 patients; participants were allocated into either the acupoint-catgut embedment with medication group (case group) or the sham acupuncture with medication group (control group). Acupoint-catgut embedment was conducted at the BL13 Feishu, BL43 Gaohuangshu, BL20 Pishu, BL23 Shenshu, and ST40 Fenglong points two times at an interval of 15 days. The BODE index, a primary outcome indicator, was assessed on Day 1 and Day 30. The results showed statistically and clinically significant differences between the two groups—in fact, BODE index scores were reduced by 1.83 points in the case group (p = 0.000). Ultimately, BODE index scores were lower in the intervention group than in the control group, thus indicating a statistically significant and clinically important improvement of COPD-related symptoms. According to these results, acupoint-catgut embedment combined with medical treatment is concluded to be more effective than medical treatment alone in reducing BODE index scores.

  10. Pure type systems with subtyping

    NARCIS (Netherlands)

    Zwanenburg, J.; Girard, J.-Y.

    1999-01-01

    We extend the framework of Pure Type Systems with subtyping, as found in F = ¿ . This leads to a concise description of many existing systems with subtyping, and also to some new interesting systems. We develop the meta-theory for this framework, including Subject Reduction and Minimal Typing. The

  11. How Low Can You Go: Spatial Frequency Sensitivity in Pure Alexia

    DEFF Research Database (Denmark)

    Starrfelt, Randi; Nielsen, S.; Habekost, T.

    Objective: Pure alexia is a seemingly selective deficit in reading, follow- ing focal lesions to the posterior left hemisphere. The hallmark feature of pure alexia is a word length effect in single word reading, where reaction times may increase with hundreds of milliseconds per additional letter...... in a word. Other language functions, including writing, are intact. It has been suggested that pure alexia is caused by a general deficit in visual processing, one that affects reading disproportionally compared to other visual stimuli. The most concrete hypothesis to date suggests that pure alexia...... is caused by a lack of sensitivity to particular spatial frequencies (e.g., Fiset et al., 2006), and that this results in the characteristic word length effect, as well as effects of letter confusability on reading times. Participants and Methods: We have tested this hypothesis in a patient with pure alexia...

  12. American Society of Addiction Medicine (ASAM) National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use.

    Science.gov (United States)

    Kampman, Kyle; Jarvis, Margaret

    2015-01-01

    The Centers for Disease Control have recently described opioid use and resultant deaths as an epidemic. At this point in time, treating this disease well with medication requires skill and time that are not generally available to primary care doctors in most practice models. Suboptimal treatment has likely contributed to expansion of the epidemic and concerns for unethical practices. At the same time, access to competent treatment is profoundly restricted because few physicians are willing and able to provide it. This "Practice Guideline" was developed to assist in the evaluation and treatment of opioid use disorder, and in the hope that, using this tool, more physicians will be able to provide effective treatment. Although there are existing guidelines for the treatment of opioid use disorder, none have included all of the medications used at present for its treatment. Moreover, few of the existing guidelines address the needs of special populations such as pregnant women, individuals with co-occurring psychiatric disorders, individuals with pain, adolescents, or individuals involved in the criminal justice system. This Practice Guideline was developed using the RAND Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Method (RAM) - a process that combines scientific evidence and clinical knowledge to determine the appropriateness of a set of clinical procedures. The RAM is a deliberate approach encompassing review of existing guidelines, literature reviews, appropriateness ratings, necessity reviews, and document development. For this project, American Society of Addiction Medicine selected an independent committee to oversee guideline development and to assist in writing. American Society of Addiction Medicine's Quality Improvement Council oversaw the selection process for the independent development committee. Recommendations included in the guideline encompass a broad range of topics, starting with the initial evaluation of the

  13. Research on the Applicable Method of Valuation of Pure Electric Used vehicles

    Science.gov (United States)

    Cai, yun; Tan, zhengping; Wang, yidong; Mao, pan

    2018-03-01

    With the rapid growth in the ownership of pure electric vehicles, the research on the valuation of used electric vehicles has become the key to the development of the pure electric used vehicle market. The paper analyzed the application of the three value assessment methods, current market price method, capitalized earning method and replacement cost method, in pure electric used vehicles, and draws a conclusion that the replacement cost method is more suitable for pure electric used car. At the same time, the article also conducted a parametric correction exploration research, aiming at the characteristics of pure electric vehicles and replacement cost of the constituent factors. Through the analysis of the applicability parameters of physical devaluation, functional devaluation and economic devaluation, the revised replacement cost method can be used for the valuation of purely used electric vehicles for private use.

  14. Quasinormal modes in pure de Sitter spacetimes

    International Nuclear Information System (INIS)

    Du Daping; Wang Bin; Su Ruheng

    2004-01-01

    We have studied scalar perturbations as well as fermion perturbations in pure de Sitter spacetimes. For scalar perturbations we have shown that well-defined quasinormal modes in d-dimensions can exist provided that the mass of scalar field m>(d-1/2l). The quasinormal modes of fermion perturbations in three and four dimensional cases have also been investigated. We found that different from other dimensional cases, in the three dimensional pure de Sitter spacetime there is no quasinormal mode for the s-wave. This interesting difference caused by the spacial dimensions is true for both scalar and fermion perturbations

  15. Catatonia in the medically ill: Etiology, diagnosis, and treatment. The Academy of Consultation-Liaison Psychiatry Evidence-Based Medicine Subcommittee Monograph.

    Science.gov (United States)

    Denysenko, Lex; Sica, Nicole; Penders, Thomas M; Philbrick, Kemuel L; Walker, Audrey; Shaffer, Scott; Zimbrean, Paula; Freudenreich, Oliver; Rex, Nicole; Carroll, Brendan T; Francis, Andrew

    2018-05-01

    Catatonia in medically ill patients is rare but often unrecognized. This monograph summarizes current knowledge on the diagnosis, epidemiology, etiology, and management of catatonia occurring in the medical setting. PubMed searches were used to identify relevant articles from 1962 to present. More than 3,000 articles were obtained and reviewed for relevance, including references of articles identified by the initial search. Several areas were identified as important, including: (1) catatonia and delirium; (2) malignant catatonia; (3) pediatric catatonia; (4) catatonia associated with another medical condition (CAMC); (5) drug exposure and withdrawal syndromes associated with catatonia; and (6) treatment of catatonia in the medical setting. Catatonia in the medically ill appears to have numerous etiologies, although etiology does not seem to modify the general treatment approach of prompt administration of lorazepam. Delirium and catatonia are commonly comorbid in the medical setting and should not be viewed as mutually exclusive. Electroconvulsive therapy should be offered to patients who do not respond to benzodiazepines or have malignant features. Removing offending agents and treating the underlying medical condition is paramount when treating CAMC. Memantine or amantadine may be helpful adjunctive agents. There is not enough evidence to support the use of antipsychotics or stimulants in treating CAMC.

  16. Individual differences in aversion to ambiguity regarding medical tests and treatments: association with cancer screening cognitions.

    Science.gov (United States)

    Han, Paul K J; Williams, Andrew E; Haskins, Amy; Gutheil, Caitlin; Lucas, F Lee; Klein, William M P; Mazor, Kathleen M

    2014-12-01

    Aversion to "ambiguity"-uncertainty about the reliability, credibility, or adequacy of information-about medical tests and treatments is an important psychological response that varies among individuals, but little is known about its nature and extent. The purpose of this study was to examine how individual-level ambiguity aversion relates to important health cognitions related to different cancer screening tests. A survey of 1,074 adults, ages 40 to 70 years, was conducted in four integrated U.S. healthcare systems. The Ambiguity Aversion in Medicine (AA-Med) scale, a measure of individual differences in aversion to ambiguity (AA) about medical tests and treatments, was administered along with measures of several cancer screening-related cognitions: perceived benefits and harms of colonoscopy, mammography, and PSA screening, and ambivalence and future intentions regarding these tests. Multivariable analyses were conducted to assess the associations between AA-Med scores and cancer screening cognitions. Individual-level AA as assessed by the AA-Med scale was significantly associated (P ambiguity. Individual-level AA constitutes a measurable, wide-ranging cognitive bias against medical intervention, and more research is needed to elucidate its mechanisms and effects. ©2014 American Association for Cancer Research.

  17. Nigeria Journal of Pure and Applied Physics: Editorial Policies

    African Journals Online (AJOL)

    Focus and Scope. Nigeria Journal of Pure and Applied Physics publishes papers of the highest quality and significance in specific areas of physics, pure and applied, as listed below. The journal content reflects core physics disciplines, but is also open to a broad range of topics whose central theme falls within the bounds ...

  18. Understanding kidney transplant patients' treatment choices: The interaction of emotion with medical and social influences on risk preferences.

    Science.gov (United States)

    Harrington, Jean; Morgan, Myfanwy

    2016-04-01

    Following renal transplantation patients experience on-going immunosuppressant medication to reduce the risk of graft rejection. Over the long term the side effects of immunosuppressive drugs may affect graft survival and significantly increase risks of cancers, stroke and cardiovascular disease. To reduce these risks research is underway to develop a biomarker test to identify those patients who are likely to be 'tolerant' to their graft and therefore able to reduce immunosuppression. Biomarker tests may however incorrectly identify some patients as tolerant, thus jeopardising their graft. Following a quantitative assessment of risk preferences we undertook a qualitative study to investigate the range of influences that shaped the substantial variations found in the level of risk transplant recipients were hypothetically willing to take. In-depth interviews were carried out in the United Kingdom between May 2013 and July 2014 with 24 transplant recipients all of whom had stable kidney graft function. These interviews identified a range of factors that patients take into account when making risk assessments, including familial views, trust and the ritual of 'gift exchange' that permeates the social space of kidney transplantation. Our data support the notion that emotion is not part of a linear process, preceding and separate to reason, but is intertwined with personal understanding and perception of risk and involves a complex interplay between different influences on decision-making. Our data also support Lupton's view that risk judgements are shared and collective rather than located within the individual and suggests that patient choice rather than involving a purely rational weighing of medical benefit is often based on influences that may not accord with the framework nor intention of medical professionals and medical research. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. The Grass Might Be Greener: Medical Marijuana Patients Exhibit Altered Brain Activity and Improved Executive Function after 3 Months of Treatment

    Directory of Open Access Journals (Sweden)

    Staci A. Gruber

    2018-01-01

    Full Text Available The vast majority of states have enacted full or partial medical marijuana (MMJ programs, causing the number of patients seeking certification for MMJ use to increase dramatically in recent years. Despite increased use of MMJ across the nation, no studies thus far have examined the specific impact of MMJ on cognitive function and related brain activation. In the present study, MMJ patients seeking treatment for a variety of documented medical conditions were assessed prior to initiating MMJ treatment and after 3 months of treatment as part of a larger longitudinal study. In order to examine the effect of MMJ treatment on task-related brain activation, MMJ patients completed the Multi-Source Interference Test (MSIT while undergoing functional magnetic resonance imaging (fMRI. We also collected data regarding conventional medication use, clinical state, and health-related measures at each visit. Following 3 months of treatment, MMJ patients demonstrated improved task performance accompanied by changes in brain activation patterns within the cingulate cortex and frontal regions. Interestingly, after MMJ treatment, brain activation patterns appeared more similar to those exhibited by healthy controls from previous studies than at pre-treatment, suggestive of a potential normalization of brain function relative to baseline. These findings suggest that MMJ use may result in different effects relative to recreational marijuana (MJ use, as recreational consumers have been shown to exhibit decrements in task performance accompanied by altered brain activation. Moreover, patients in the current study also reported improvements in clinical state and health-related measures as well as notable decreases in prescription medication use, particularly opioids and benzodiapezines after 3 months of treatment. Further research is needed to clarify the specific neurobiologic impact, clinical efficacy, and unique effects of MMJ for a range of indications and how it

  20. The Grass Might Be Greener: Medical Marijuana Patients Exhibit Altered Brain Activity and Improved Executive Function after 3 Months of Treatment.

    Science.gov (United States)

    Gruber, Staci A; Sagar, Kelly A; Dahlgren, Mary K; Gonenc, Atilla; Smith, Rosemary T; Lambros, Ashley M; Cabrera, Korine B; Lukas, Scott E

    2017-01-01

    The vast majority of states have enacted full or partial medical marijuana (MMJ) programs, causing the number of patients seeking certification for MMJ use to increase dramatically in recent years. Despite increased use of MMJ across the nation, no studies thus far have examined the specific impact of MMJ on cognitive function and related brain activation. In the present study, MMJ patients seeking treatment for a variety of documented medical conditions were assessed prior to initiating MMJ treatment and after 3 months of treatment as part of a larger longitudinal study. In order to examine the effect of MMJ treatment on task-related brain activation, MMJ patients completed the Multi-Source Interference Test (MSIT) while undergoing functional magnetic resonance imaging (fMRI). We also collected data regarding conventional medication use, clinical state, and health-related measures at each visit. Following 3 months of treatment, MMJ patients demonstrated improved task performance accompanied by changes in brain activation patterns within the cingulate cortex and frontal regions. Interestingly, after MMJ treatment, brain activation patterns appeared more similar to those exhibited by healthy controls from previous studies than at pre-treatment, suggestive of a potential normalization of brain function relative to baseline. These findings suggest that MMJ use may result in different effects relative to recreational marijuana (MJ) use, as recreational consumers have been shown to exhibit decrements in task performance accompanied by altered brain activation. Moreover, patients in the current study also reported improvements in clinical state and health-related measures as well as notable decreases in prescription medication use, particularly opioids and benzodiapezines after 3 months of treatment. Further research is needed to clarify the specific neurobiologic impact, clinical efficacy, and unique effects of MMJ for a range of indications and how it compares to