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Sample records for ra patient population

  1. Are RA patients from a non-endemic HCV population screened for HCV? A cross-sectional analysis of three different settings.

    Science.gov (United States)

    Skinner-Taylor, Cassandra Michelle; Erhard-Ramírez, Alejandro; Garza-Elizondo, Mario Alberto; Esquivel-Valerio, Jorge Antonio; Abud-Mendoza, Carlos; Martínez-Martínez, Marco Ulises; Vega-Morales, David; Arana-Guajardo, Ana

    In Mexico, other risk factors are associated with hepatitis C virus (HCV): prior heroin users, living alone, widower, and northern region residence. Rheumatoid arthritis (RA) patients are considered immunosuppressed and HCV testing is recommended before treatment. The aim of the study was to describe the characteristics of HCV testing in RA patients in three different medical care settings in a non-endemic area. A retrospective observational study was performed using medical records from 960 RA patients describing the indications for HCV testing. The test was performed in 28.6% and the HCV overall frequency was 0.36%. Population characteristics were not associated with an increased risk of HCV infection; therefore, anti-HCV positivity was low. The main reason for testing was before starting biological agents. Due to the low pre-test probability, testing for HCV infection should be personalized; i.e., according to disease prevalence in a particular geographical location and the individual risk factors. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  2. From patients with arthralgia, pre-RA and recently diagnosed RA: What is the current status of understanding RA pathogenesis?

    NARCIS (Netherlands)

    M. Molendijk (Marlieke); J.M.W. Hazes (Mieke); E.W. Lubberts (Erik)

    2018-01-01

    textabstractIt is believed that therapy for rheumatoid arthritis (RA) is the most effective and beneficial within a short time frame around RA diagnosis. This insight has caused a shift from research in patients with established RA to patients at risk of developing RA and recently diagnosed

  3. THE IMMUNOLOGICAL CHARACTERISTIC OF RA PATIENTS WITH ANAEMIA

    Directory of Open Access Journals (Sweden)

    A. E. Sizikov

    2014-07-01

    Full Text Available Abstract. The aim of the investigation was to study the immunological characteristics of RA patients with anaemia. Clinical and laboratory data including the percentage of the main lymphocyte subclasses, phagocyte and DTH-effector activity, serum concentration of immunoglobulins, the percentage of cells producing IFNγ and/or IL-4 and percent of monocytes producing TNF. We revealed some significant clinical, laboratory and immunological differences between RA patients and healthy donors and between patients with and without anaemia. Our data demonstrate RA anemic patients to have more severe disorders than patients without anaemia. We also revealed some significant immunological differences between RA patients and healthy donors and between patients with and without anaemia, including percent of cells producing IFNγ and/or IL-4. Our data permit to conclude that RA patients have many different immunological disturbances, more severe in anaemic patients.

  4. Productivity loss due to absenteeism and presenteeism by different instruments in patients with RA and subjects without RA

    NARCIS (Netherlands)

    Braakman-Jansen, Louise Marie Antoinette; Kuper, Ina H.; van de Laar, Mart A F J; Taal, Erik

    2012-01-01

    Objectives. To explore the impact of at-work productivity loss on the total productivity cost by different instruments in patients recently diagnosed with RA and controls without RA. Methods. Cross-sectional data were collected from outpatients with RA between December 2007 and February 2008. The

  5. Pulmonary cryptococcosis in rheumatoid arthritis (RA) patients: Comparison of imaging characteristics among RA, acquired immunodeficiency syndrome, and immunocompetent patients

    International Nuclear Information System (INIS)

    Yanagawa, Noriyo; Sakai, Fumikazu; Takemura, Tamiko; Ishikawa, Satoru; Takaki, Yasunobu; Hishima, Tsunekazu; Kamata, Noriko

    2013-01-01

    Purpose: The imaging characteristics of cryptococcosis in rheumatoid arthritis (RA) patients were analyzed by comparing them with those of acquired immunodeficiency syndrome (AIDS) and immunocompetent patients, and the imaging findings were correlated with pathological findings. Methods: Two radiologists retrospectively compared the computed tomographic (CT) findings of 35 episodes of pulmonary cryptococcosis in 31 patients with 3 kinds of underlying states (10 RA, 12 AIDS, 13 immunocompetent), focusing on the nature, number, and distribution of lesions. The pathological findings of 18 patients (8 RA, 2 AIDS, 8 immunocompetent) were analyzed by two pathologists, and then correlated with imaging findings. Results: The frequencies of consolidation and ground glass attenuation (GGA) were significantly higher, and the frequency of peripheral distribution was significantly lower in the RA group than in the immunocompetent group. Peripheral distribution was less common and generalized distribution was more frequent in the RA group than in the AIDS group. The pathological findings of the AIDS and immunocompetent groups reflected their immune status: There was lack of a granuloma reaction in the AIDS group, and a complete granuloma reaction in the immunocompetent group, while the findings of the RA group varied, including a complete granuloma reaction, a loose granuloma reaction and a hyper-immune reaction. Cases with the last two pathologic findings were symptomatic and showed generalized or central distribution on CT. Conclusion: Cryptococcosis in the RA group showed characteristic radiological and pathological findings compared with the other 2 groups

  6. Pulmonary cryptococcosis in rheumatoid arthritis (RA) patients: Comparison of imaging characteristics among RA, acquired immunodeficiency syndrome, and immunocompetent patients

    Energy Technology Data Exchange (ETDEWEB)

    Yanagawa, Noriyo, E-mail: noriyo_yana@ybb.ne.jp [Departments of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-8-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677 (Japan); Sakai, Fumikazu [Department of Diagnostic Radiology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama 350-1298 (Japan); Takemura, Tamiko [Department of Pathology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935 (Japan); Ishikawa, Satoru [Department of Respiratory Medicine, National Hospital Organization Chiba-East-Hospital, 673 Nitona-cho, Chuo-ku, Chiba-shi, Chiba 260-8712 (Japan); Takaki, Yasunobu [Departments of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-8-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677 (Japan); Hishima, Tsunekazu [Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-8-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677 (Japan); Kamata, Noriko [Departments of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-8-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677 (Japan)

    2013-11-01

    Purpose: The imaging characteristics of cryptococcosis in rheumatoid arthritis (RA) patients were analyzed by comparing them with those of acquired immunodeficiency syndrome (AIDS) and immunocompetent patients, and the imaging findings were correlated with pathological findings. Methods: Two radiologists retrospectively compared the computed tomographic (CT) findings of 35 episodes of pulmonary cryptococcosis in 31 patients with 3 kinds of underlying states (10 RA, 12 AIDS, 13 immunocompetent), focusing on the nature, number, and distribution of lesions. The pathological findings of 18 patients (8 RA, 2 AIDS, 8 immunocompetent) were analyzed by two pathologists, and then correlated with imaging findings. Results: The frequencies of consolidation and ground glass attenuation (GGA) were significantly higher, and the frequency of peripheral distribution was significantly lower in the RA group than in the immunocompetent group. Peripheral distribution was less common and generalized distribution was more frequent in the RA group than in the AIDS group. The pathological findings of the AIDS and immunocompetent groups reflected their immune status: There was lack of a granuloma reaction in the AIDS group, and a complete granuloma reaction in the immunocompetent group, while the findings of the RA group varied, including a complete granuloma reaction, a loose granuloma reaction and a hyper-immune reaction. Cases with the last two pathologic findings were symptomatic and showed generalized or central distribution on CT. Conclusion: Cryptococcosis in the RA group showed characteristic radiological and pathological findings compared with the other 2 groups.

  7. Tooth breakage in patients injected with 224Ra

    International Nuclear Information System (INIS)

    Sonnabend, E.; Spiess, H.; Mays, C.W.

    1986-01-01

    Tooth breakage has been common among the 224 Ra patients, especially those injected as teenagers. The fracture of 1 or more teeth was reported by 26% (8/31) of boys and 23% (7/30) of girls injected with 224 Ra at 16-20 years of age. Combining results from all age groups, the incidence of tooth fractures increased significantly with dose (P=0.01). Unlike the normal loss of permanent teeth by periodontal disease, in which the entire tooth is lost, the tooth loss following 224 Ra injection was primarily from tooth resorption near the gum line causing the tooth crowns to break off easily. Eventually the tooth roots may either become incorporated into the jawbone or are resorbed and replaced with bone. These tooth fractures resembled those observed in the U.S. radium dial painters and in dogs injected with bone-seeking α-emitters. (orig.)

  8. PADI4 Haplotypes in Association with RA Mexican Patients, a New Prospect for Antigen Modulation

    Directory of Open Access Journals (Sweden)

    Maria Guadalupe Zavala-Cerna

    2013-01-01

    Full Text Available Peptidyl arginine deiminase IV (PAD 4 is the responsible enzyme for a posttranslational modification called citrullination, originating the antigenic determinant recognized by anti-cyclic citrullinated peptide antibodies (ACPA. Four SNPs (single nucleotide polymorphisms have been described in PADI4 gene to form a susceptibility haplotype for rheumatoid arthritis (RA; nevertheless, results in association studies appear contradictory in different populations. The aim of the study was to analyze if the presence of three SNPs in PADI4 gene susceptibility haplotype (GTG is associated with ACPA positivity in patients with RA. This was a cross-sectional study that included 86 RA patients and 98 healthy controls. Polymorphisms PADI4_89, PADI4_90, and PADI4_92 in the PADI4 gene were genotyped. The susceptibility haplotype (GTG was more frequent in RA patients; interestingly, we found a new haplotype associated with RA with a higher frequency (GTC. There were no associations between polymorphisms and high scores in Spanish HAQ-DI and DAS-28, but we did find an association between RARBIS index and PADI4_89, PADI4_90 polymorphisms. We could not confirm an association between susceptibility haplotype presence and ACPA positivity. Further evidence about proteomic expression of this gene will determine its participation in antigenic generation and autoimmunity.

  9. [The usefullness of hyaluronate injection in patients with RA].

    Science.gov (United States)

    Saito, Seiji

    2003-06-01

    In this seminar, we reported the usefulness of hyaluronate injection in clinical application with patients of RA. In basic research areas, however, the mechanisms responsible for the reported beneficial clinical effects of these treatments remain unclear. There is accumulating experimental evidence to show that the receptors of HA, eg, CD-44, accelerate the inflammation of joint. Administration high molecular weight HA may modulate CD-44 sensitive macromolecular in joint inflammation in part to reduce the activity of proteinases such as MMP-9.

  10. Epidemiological studies of German patients injected with Ra-224

    International Nuclear Information System (INIS)

    Mays, C.W.; Spiess, H.

    1983-01-01

    The health of 898 patients who received repeated injections of short-lived 224 Ra after World War II, mainly for the treatment of tuberculosis and ankylosing spondylitis has been followed. As of 1980, 53 of these patients had developed bone sarcoma vs only 0.2 cases expected naturally. Two patients with bone sarcoma subsequently developed an additional bone sarcoma. No new bone sarcomas have been reported since the end of 1974. For the patients in each category, the tumor rate at every year after 224 Ra injection was calculated by dividing the yearly number of bone sarcomas by the number of patients whose follow-up extended to that year. This corrected for the effects of death and incomplete follow-up. The yearly tumor rates were then summed to obtain the cumulative tumor rate. Dividing by the average skeletal dose in rads yielded the cumulative risk. The cumulative tumor risk was about 200 bone sarcomas/10 6 person rad of average skeletal dose and, with the dosimetric assumptions used, was not statistically different for (a) juveniles vs adults, (b) males vs females, or (c) TB patients vs spondylitic patients

  11. Factors associated with absenteeism, presenteeism and activity impairment in patients in the first years of RA.

    Science.gov (United States)

    Bansback, Nick; Zhang, Wei; Walsh, David; Kiely, Patrick; Williams, Richard; Guh, Daphne; Anis, Aslam; Young, Adam

    2012-02-01

    To understand the impact of the early years of RA on all aspects of work productivity, and determine how this is related to clinical markers. Previous research on work productivity has examined predominantly early retirement and absenteeism. The impact of reduced work performance (presenteeism) and activity impairment is less well understood in early RA populations. Working patients enrolled in an RA inception cohort were recruited into a nested study. A questionnaire incorporating the Work Productivity and Activity Impairment (WPAI) instrument was administered with a number of clinical outcomes, including the Multidimensional Health Assessment Questionnaire (MD-HAQ) and scales for pain, fatigue and patient assessment of disease patient global assessment (PtGA). Analysis included 150 RA patients, with the mean age at onset being 48 years (s.d. 10 years) and disease duration from symptom onset being 49 months. Patients had relatively mild disease: MD-HAQ (0.6), pain (3.6), PtGA (3.6) and fatigue (4.6). Of the 92% patients working for pay, 19% reported missing work (absenteeism) in the past week due to their health, accounting for 46% of their working time. Even while at work, ∼25% of actual hours was lost due to poor health, while outside work 33% of patients' regular daily activities were prevented. In multivariate analyses, disease severity was associated with the presence of absenteeism, presenteeism and activity impairment. Patients able to self-schedule their work had lower presenteeism and activity impairment. Productivity loss is common in patients in the first years of RA who are in paid work and was associated with work characteristics and adverse clinical outcomes.

  12. Impact of socioeconomic gradients within and between countries on health of patients with rheumatoid arthritis (RA): Lessons from QUEST RA

    NARCIS (Netherlands)

    Putrik, Polina; Sokka, Tuulikki; Ramiro, Sofia; Boonen, Annelies

    2012-01-01

    In this chapter, we discuss challenges in collecting data on outcomes of patients who receive usual rheumatology care. We present results of the multinational Quantitative Monitoring of Patients with Rheumatoid Arthritis (QUEST RA) study which is a successful example of quantitative clinical

  13. 226Ra intake in the population from Bucharest during the past ten years

    International Nuclear Information System (INIS)

    Toader, M.; Vasilache, R.A.; Tomulescu, V.

    1998-01-01

    During 1986-1996 the content of several radionuclides, including 226 Ra, in the basic foodstuffs and in drinking water was determined. Based on these data and on the data concerning the constituents of the diet in Romania, the 226 Ra intake by the population of Bucharest was estimated for the last ten years, and the doses due to this intake were calculated. The results are presented in graphs and tables, and some general conclusions are drawn. (A.K.)

  14. 224Ra: Risk to bone and haematopoietic tissue in ankylosing spondylitis patients

    International Nuclear Information System (INIS)

    Wick, R.R.; Goessner, W.; Chmelevsky, D.

    1986-01-01

    This follow-up study includes 1501 adult patients, who received repeated intraveneous injections of 224 Ra as a treatment for ankylosing spondylitis (a.sp), and a control group of 1557 a.sp. patients not treated with radioactive drugs or X-rays. The average total injected activity for the patients of the exposure group was 4.8 μCi of 224 Ra per kg body weight; the resulting average skeletal dose of α-rays has been 0.65 Gy. The mean duration of the 224 Ra treatment was 12 weeks with the mode at 10 weeks. At present, the mean follow-up time in the group of exposed patients is 16 years, and three cases of malignant skeletal tumours have been observed in patients with α-doses to the skeleton below 0.9 Gy (the lowest skeletal dose found to be associated with a bone tumour in the high dose group followed by Spiess and Mays). Based on general population statistics the expected number of bone tumours (ICD 170) was 0.4-0.7 . A recent risk estimate from data of Spiess and Mays suggests 5.8 radiation induced bone tumours for the present follow-up time. It is, furthermore, notable that 2 of the 3 observed skeletal tumours are tumours of the bone marrow; in the high dose group of Spiess and Mays there has been only 1 bone marrow tumour among 55 bone tumours. No malignant bone tumours have occurred, until now, in the control group. In the 224 Ra-group and the control group there have been 6 and 5 leukaemias, respectively,. Among the 6 leukaemias in the 224 R group 3 were chronic myeloid leukaemias while among the 5 leukaemias in the control group there was no chronic myeloid leukaemia. (orig.)

  15. Serum progranulin irrelated with Breg cell levels, but elevated in RA patients, reflecting high disease activity.

    Science.gov (United States)

    Chen, Jiaxi; Li, Shuang; Shi, Jianfeng; Zhang, Lili; Li, Jun; Chen, Shiyong; Wu, Chunlong; Shen, Bo

    2016-03-01

    Soluble progranulin (PGRN) is known to directly regulate regulatory T cells; however, whether PGRN levels are elevated in patients with rheumatoid arthritis and affect the regulatory subsets of B cells remain unknown. In this study, a total of 80 RA patients and 60 healthy controls were studied. Serum progranulin levels were determined using enzyme-linked immune-sorbent assay. A receiver operating characteristic (ROC) curve was used to evaluate the feasibility of serum PGRN as a biomarker for distinguishing patients with RA. CD19(+)CD5(+)GrB(+) B cells were analyzed by flow cytometry in peripheral blood mononuclear cells (PBMCs). Serum progranulin levels in RA patients (median, 59.4 ng/mL) and in RA patients DAS28 > 5.1 (median, 71.98 ng/mL) were much higher than those in normal controls (median, 46.3 ng/mL; P progranulin levels was 0.705 for RA versus normal controls and the area under the ROC curve for progranulin levels in RA patients DAS28 > 5.1 was 0.977 versus normal controls (P progranulin and DAS28, CRP, ESR were all positively correlated in RA patients (P 0.05). Our findings indicated that induction of PGRN expression may play a role in RA immune reaction and PGRN levels could be a useful biomarker in RA inflammatory response, but irrelated with Breg cell levels.

  16. Specificities of anti-neutrophil autoantibodies in patients with rheumatoid arthritis (RA)

    DEFF Research Database (Denmark)

    Brimnes, J; Halberg, P; Jacobsen, Søren

    1997-01-01

    The objective of this study was to characterize antigens recognized by neutrophil-specific autoantibodies from patients with RA. Sera from 62 RA patients were screened by indirect immunofluorescence (IIF). Positive sera were further tested by ELISAs for antibodies against various granule proteins...

  17. Clinical characteristics of RA patients with secondary SS and association with joint damage

    OpenAIRE

    Brown, Lindsay E.; Frits, Michelle L.; Iannaccone, Christine K.; Weinblatt, Michael E.; Shadick, Nancy A.; Liao, Katherine P.

    2014-01-01

    Objectives. Secondary SS (sSS) is a common extra-articular manifestation of RA. There are conflicting data regarding the association of sSS with worse joint damage. This study aims to characterize sSS patients in an RA cohort and study the association between sSS and joint damage.

  18. Opium addiction increases interleukin 1 receptor antagonist (IL-1Ra) in the coronary artery disease patients.

    Science.gov (United States)

    Saadat, Habibollah; Ziai, Seyed Ali; Ghanemnia, Maryam; Namazi, Mohammad Hasan; Safi, Morteza; Vakili, Hosein; Dabbagh, Ali; Gholami, Omid

    2012-01-01

    There is evidence that opium addiction has immunosuppressant effects. Coronary artery disease (CAD) is a condition resulted from atherosclerosis which is dependent on the immune response. To evaluate plasma levels of interleukin-6 and interleukin-1Ra in 30 patients with three-vessel coronary artery disease, ejection fraction of more than 35% and to evaluate their changes after prognostic treadmill test in 15 opium addicted and 15 non-addicted patients. The participants underwent prognostic treadmill test and plasma levels of interleukin-6 (IL-6) and interleukin-1Ra (IL-1Ra) were evaluated with ELISA method before, just after and 4 hours after the test. IL-1Ra (2183 pg/ml) tended to decrease over time in the opium addicted group (1372 pg/ml after prognostic treadmill test and 1034 pg/ml 4 hours after that), although such decrease did not reach the statistical significance. IL-1Ra levels were significantly higher in opium addicted than in non addicted patients. Opium addiction had no significant effect on IL-6 changes. Consumption of opium in CAD patients is associated with higher IL-1Ra levels.

  19. Opium addiction increases interleukin 1 receptor antagonist (IL-1Ra in the coronary artery disease patients.

    Directory of Open Access Journals (Sweden)

    Habibollah Saadat

    Full Text Available BACKGROUND: There is evidence that opium addiction has immunosuppressant effects. Coronary artery disease (CAD is a condition resulted from atherosclerosis which is dependent on the immune response. PURPOSE: To evaluate plasma levels of interleukin-6 and interleukin-1Ra in 30 patients with three-vessel coronary artery disease, ejection fraction of more than 35% and to evaluate their changes after prognostic treadmill test in 15 opium addicted and 15 non-addicted patients. METHODS: The participants underwent prognostic treadmill test and plasma levels of interleukin-6 (IL-6 and interleukin-1Ra (IL-1Ra were evaluated with ELISA method before, just after and 4 hours after the test. RESULTS: IL-1Ra (2183 pg/ml tended to decrease over time in the opium addicted group (1372 pg/ml after prognostic treadmill test and 1034 pg/ml 4 hours after that, although such decrease did not reach the statistical significance. IL-1Ra levels were significantly higher in opium addicted than in non addicted patients. Opium addiction had no significant effect on IL-6 changes. CONCLUSION: Consumption of opium in CAD patients is associated with higher IL-1Ra levels.

  20. Long-term clinical investigation of patients with ankylosing spondylitis treated with /sup 224/Ra

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, E [Universitatsklinik Friedrichsheim, Frankfurt, West Germany; Ruckbeil, C; Wick, R R

    1983-01-01

    Between 1952 and 1980 about 250 patients with ankylosing spondylitis were treated with /sup 224/Ra at the Orthopaedic University Hospital of Frankfurt/M. In 1970, 119 of them were examined and X-rayed as was another group of 40 patients in 1980. The results of those examined could be compared with a group of 40 patients treated without /sup 224/Ra. Patients with /sup 224/Ra demonstrated a long-lasting period of subjective improvement after the treatment, with reduced consumption of antirheumatoid and analgesic drugs, on the average. Blood examinations show inflammatory activities. Nevertheless, the ankylosing spondylitis proceeded. In the final stages of the disease, neither the clinical aspects nor the X-rays showed any specific changes. We observed no case of malignant bone tumor. Of the 169 examined patients, 22 had a total of 32 children after the treatment with /sup 224/Ra. Among these was a set of twins with cerebral palsy and diabetes insipidus renalis. In conclusion, /sup 224/Ra in ankylosing spondylitis is a recommended treatment without higher risk compared to the common therapy with drugs.

  1. Incidence of tumours of the skeleton in 224Ra-treated ankylosing spondylitis patients

    International Nuclear Information System (INIS)

    Wick, R.R.; Goessner, W.

    1983-01-01

    We are following 1426 ankylosing spondylitis (a.sp.) patients treated with 224 Ra and 1556 control patients with a.sp. not treated with any form of ionizing radiation. The average follow-up time of the exposure group is 16 years and the average α-dose to the skeleton is 65 rad, resulting from intravenous injection of 4.8μCi/kg 224 Ra on average within a medium injection span of 12 weeks. Injections normally have been performed once a week, and in some cases also half-weekly with a correspondingly shorter injection span. Since 1970 three cases of malignant tumours in the skeleton have been observed in the exposure group in patients with skeletal α-doses below 90 rad compared with 0.6 expected. (No bone tumour has occurred in the control group.) Two of the three cases observed were tumours of the bone marrow. The incidence of leukaemias in both exposure and control groups is discussed with respect to phenylbutazone treatment and α-radiation from 224 Ra. An effect of 224 Ra on the bone marrow not yet detected in the Spiess series of patients treated with higher amounts of 224 Ra cannot be excluded. (author)

  2. Fatigue as experienced by patients with rheumatoid arthritis (RA): a qualitative study.

    NARCIS (Netherlands)

    Repping-Wuts, J.W.J.; Uitterhoeve, R.J.; Riel, P.L.C.M. van; Achterberg, T. van

    2008-01-01

    OBJECTIVE: Interest in fatigue research has grown since the finding that fatigue is, besides pain, the symptom most frequently reported by patients with rheumatoid arthritis (RA). The aim of this study was to explore the experience of fatigue from the patients' perspective. METHODS: Twenty-nine

  3. IgG4 Production Against Adalimumab During Long Term Treatment of RA Patients

    NARCIS (Netherlands)

    van Schouwenburg, Pauline A.; Krieckaert, Charlotte L.; Nurmohamed, Michael; Hart, Margreet; Rispens, Theo; Aarden, Lucien; Wouters, Diana; Wolbink, Gerrit Jan

    2012-01-01

    A substantial part of rheumatoid arthritis (RA) patients is chronically treated with adalimumab. Some of these patients produce antibodies against adalimumab, which correlate with lower serum drug levels and reduced clinical response. Long term exposure to antigens may result in antigen specific

  4. Activity concentration and population dose from 226Ra due to consumption of dietary components

    International Nuclear Information System (INIS)

    Wagh, S.S.; Patra, A.K.; Ravi, P.M.; Sarkar, P.K.

    2012-01-01

    226 Ra (T 1/2 = 1620 years, α-energy 4.78 MeV, 4.59 MeV, γ-energy 186 keV), a product of natural uranium decay series, is abundantly observed in natural environment. Radium, along with its homologue calcium, an essential element in the plant system, is absorbed from the soil by plants and gets redistributed. within different parts of the plants. Because of the long half-life of 226 Ra, it gets accumulated in the human body for along time. The hazard due to ingestion of 226 Ra dissolved in water is reported to be about 40 times higher than that of 90 Sr. This paper deals with the concentration of 226 Ra in different dietary components and ingestion dose from 226 Ra due to consumption of dietary components. Internal radiation exposure to non-human biota due to 226 Ra is also discussed

  5. Radiation exposure of relatives of patients treated with Ra-223 dichloride

    International Nuclear Information System (INIS)

    Wanke, C.; Szermerski, B.; Solle, A.; Geworski, L.; Kranert, W.T.; Andreeff, M.; TU Dresden

    2015-01-01

    Since November 2013, a radiopharmaceutical containing Ra-223 dichloride as active substance is approved in the European Union for patients with castration resistant prostate cancer with symptomatic bone metastases and no known visceral metastases. Ra-223 (T 1/2 = 11.43 d) decays via a chain of 4 alpha and 2 beta decays. This therapy is presently the only application of an alpha emitter in clinical routine therapy. To show that the exposure of relatives and caregivers of patients treated with Ra-223 dichloride in an outpatient setting does not exceed a value of 1 mSv, the multicenter study ''RAPSODY'' was conducted. As Ra-223 and most of its progeny emit alpha particles, the internal exposure had to be evaluated in particular. Within this study, measurements of the radiation emitted from the patient were performed using standard dose-rate meters. Wipe-tests were taken in the patients' homes to identify significant contaminations and evaluated by liquid scintillation counting. Samples of saliva and sweat were taken and measured using gamma spectrometry. Ra-223 disintegrates to the noble gas Rn-219 and was measured in the exhaled breath from the patients using conventional Radon Monitors. Furthermore, a computational fluid dynamics simulation (CFD) was performed to assess the radioactivity in the air, which could be inhaled by persons close to the patient. Conclusions: The potential exposure of relatives and caregivers by external irradiation and incorporation of radioactivity exhaled or excreted by the patient with saliva or sweat is well below 1 mSv. No objections are seen regarding outpatient treatment. This paper summarizes contents of a poster presented at the Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging.

  6. Flexor hallucis longus tendon rupture in RA-patients is associated with MTP 1 damage and pes planus

    NARCIS (Netherlands)

    Baan, H.; Baan, Henriette; Drossaers-Bakker, K.W.; Dubbeldam, Rosemary; Dubbeldam, Rosemary; Buurke, Jaap J.; Nene, A.V.; van de Laar, Mart A F J

    2007-01-01

    Background: To assess the prevalence of and relation between rupture or tenosynovitis of the Flexor Hallucis Longus (FHL) tendon and range of motion, deformities and joint damage of the forefoot in RA patients with foot complaints. Methods: Thirty RA patients with painful feet were analysed, their

  7. 226 Ra in food

    International Nuclear Information System (INIS)

    Toader, M.

    1993-01-01

    Between 1986 and 1992 the author has evaluated natural levels of 226 Ra in some foods representing the major components of the diet in Bucharest population. The estimated daily intake by an adult was 72.5 mBq 226 Ra/day or 65.9 mBq 226 Ra/g.Ca. (Author)

  8. RA Reactor; Reaktor RA

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1989-07-01

    This chapter includes the following: General description of the RA reactor, organization of work, responsibilities of leadership and operators team, regulations concerning operation and behaviour in the reactor building, regulations for performing experiments, regulations and instructions for inserting samples into experimental channels. [Serbo-Croat] Ovo (prvo) poglavlje sadrzi sledece: Opis reaktora RA; semu organizacije rada i rukovodjenja; prava i duznosti direktora i rukovodioca pogona reaktora, propise o rezimu rada i kretanja u zgradi reaktora, propise o izvodjenju eksperimenata, propise o unosenju uzoraka u eksperimentalne kanale reaktora.

  9. RA Reactor; Reaktor RA

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1978-02-15

    In addition to basic characteristics of the RA reactor, organizational scheme and financial incentives, this document covers describes the state of the reactor components after 18 years of operation, problems concerned with obtaining the licence for operation with 80% fuel, problems of spent fuel storage in the storage pool of the reactor building and the need for renewal of reactor equipment, first of all instrumentation. [Serbo-Croat] Pored osnovnih karakeristika reaktora RA, organizacije rada i finansijskih pokazatelja, razmatra se stanje opreme reaktora nakon 18 godina rada, pitanja dozvole za rad sa 80% obogacenim gorivom, problem skladistenja isluzenog goriva u bazenu zgrade reaktora i potreba za obnavljanjem komponenti opreme, pre svega elektronske.

  10. Stages of change, barriers, benefits, and preferences for exercise in RA patients: a cross-sectional study.

    Science.gov (United States)

    Henchoz, Y; Zufferey, P; So, A

    2013-01-01

    To determine the distribution of exercise stages of change in a rheumatoid arthritis (RA) cohort, and to examine patients' perceptions of exercise benefits, barriers, and their preferences for exercise. One hundred and twenty RA patients who attended the Rheumatology Unit of a University Hospital were asked to participate in the study. Those who agreed were administered a questionnaire to determine their exercise stage of change, their perceived benefits and barriers to exercise, and their preferences for various features of exercise. Eighty-nine (74%) patients were finally included in the analyses. Their mean age was 58.4 years, mean RA duration 10.1 years, and mean disease activity score 2.8. The distribution of exercise stages of change was as follows: precontemplation (n = 30, 34%), contemplation (n = 11, 13%), preparation (n = 5, 6%), action (n = 2, 2%), and maintenance (n = 39, 45%). Compared to patients in the maintenance stage of change, precontemplators exhibited different demographic and functional characteristics and reported less exercise benefits and more barriers to exercise. Most participants preferred exercising alone (40%), at home (29%), at a moderate intensity (64%), with advice provided by a rheumatologist (34%) or a specialist in exercise and RA (34%). Walking was by far the preferred type of exercise, in both the summer (86%) and the winter (51%). Our cohort of patients with RA was essentially distributed across the precontemplation and maintenance exercise stages of change. These subgroups of patients exhibit psychological and functional differences that make their needs different in terms of exercise counselling.

  11. RAPID3 scores and hand outcome measurements in RA patients: a preliminary study.

    Science.gov (United States)

    Qorolli, Merita; Hundozi-Hysenaj, Hajrije; Rexhepi, Sylejman; Rehxepi, Blerta; Grazio, Simeon

    2017-06-01

    The Routine Assessment of Patient Index Data 3 (RAPID3) is a patient-reported disease activity measure used to assess physical function, pain, and global health in patients with rheumatoid arthritis (RA) without formal joint counts. Since hand involvement and its decreased function are hallmarks of RA, the aim of our study was to investigate the performance of RAPID3 scores with regard to hand function and to confirm previous findings that the RAPID3 score as a disease activity measure is strongly correlated with the DAS28 score. Sixty-eight consecutive patients with RA (85% female), aged 18-75 years, were included in the study and were recruited during their outpatient visit. Apart from demographic and clinical data, the obtained parameters of interest included RAPID3 scores and assessments of the function of the hand, namely, the signal of functional impairment (SOFI)-hand, grip strength, and pulp-to-palm distance, as well the Health Assessment Questionnaire- Disability Index (HAQ-DI) and DAS28 scores. Pearson's correlation coefficient, Student's t test and linear regression were used in the statistical analysis of the results. The significance was set to p < 0.05. A positive correlation was found between RAPID3 scores and HAQ-DI scores, SOFI-hand scores, and pulp-to-palm distance, and negative correlation was observed between RAPID3 scores and grip strength. The order regarding the strength of correlations between RAPID3 scores and other variables (from the strongest to the weakest) was as follows: HAQ-DI, grip strength, SOFI-hand and pulp-to-palm distance. The hand assessment variables had stronger correlations with RAPID3 scores than with DAS28 scores. Our preliminary study showed that RAPID3 scores were strongly correlated with measurements of the functional ability of the hand, demonstrating that RAPID3 can be used as a measure of disease activity in clinical practice and to characterize hand function. Further studies are needed to confirm this result.

  12. Automated radiofrequency-based US measurement of common carotid intima-media thickness in RA patients treated with synthetic vs synthetic and biologic DMARDs.

    Science.gov (United States)

    Naredo, Esperanza; Möller, Ingrid; Corrales, Alfonso; Bong, David A; Cobo-Ibáñez, Tatiana; Corominas, Hector; Garcia-Vivar, Ma Luz; Macarrón, Pilar; Navio, Teresa; Richi, Patricia; Iagnocco, Annamaria; Garrido, Jesús; Martínez-Hernández, David

    2013-02-01

    To compare the carotid intima-media thickness (IMT) assessed with automated radiofrequency-based US in RA patients treated with synthetic vs synthetic and biologic DMARDs and controls. Ninety-four RA patients and 94 sex- and age-matched controls were prospectively recruited at seven centres. Cardiovascular (CV) risk factors and co-morbidities, RA characteristics and therapy were recorded. Common carotid artery (CCA)-IMT was assessed in RA patients and controls with automated radiofrequency-based US by the same investigator at each centre. Forty-five (47.9%) RA patients had been treated with synthetic DMARDs and 49 (52.1%) with synthetic and biologic DMARDs. There were no significant differences between the RA patients and controls in demographics, CV co-morbidities and CV disease. There were significantly more smokers among RA patients treated with synthetic and biologic DMARDs (P = 0.036). Disease duration and duration of CS and synthetic DMARD therapy was significantly longer in RA patients treated with synthetic and biologic DMARDs (P radiofrequency-based measurement of CCA-IMT can discriminate between RA patients treated with synthetic DMARDs vs RA patients treated with synthetic and biologic DMARDs.

  13. The provisional ACR/EULAR definition of remission in RA: a comment on the patient global assessment criterion

    NARCIS (Netherlands)

    Vermeer, M.; Kuper, Hillechina H.; van der Bijl, Arie E.; Baan, H.; Posthumus, Marcel D.; Brus, Herman L.M.; van Riel, Piet L.C.M.; van de Laar, Mart A F J

    2012-01-01

    Objectives. The provisional ACR/European League Against Rheumatism (EULAR) definition of remission in RA requires a score of ≤1 on the patient global assessment (PGA, 0–10 scale). We explored the relation between the PGA criterion and the patient's clinical disease state in an observational dataset.

  14. Changes in hand bone mineral density and the association with the level of disease activity in patients with RA

    NARCIS (Netherlands)

    Dirven, L.; Guler-Yuksel, M.; de Beus, W.M.; Ronday, H.K.; Speyer, I.; Huizinga, T.W.; Dijkmans, B.A.C.; Allaart, C.F.; Lems, W.F.

    2011-01-01

    Objective. To determine if metacarpal bone mineral density (mBMD) gain occurs in patients with rheumatoid arthritis (RA). If mBMD loss is driven by inflammation, we expect to find mBMD gain in patients who are in remission. Methods. mBMD was measured by digital X-ray radiogrammetry in consecutive

  15. The provisional ACR/EULAR definition of remission in RA : a comment on the patient global assessment criterion

    NARCIS (Netherlands)

    Vermeer, Marloes; Kuper, Hillechiena H.; van der Bijl, Arie E.; Baan, Henriette; Posthumus, Marcel D.; Brus, Herman L. M.; van Riel, Piet L. C. M.; van de Laar, Mart A. F. J.

    Objectives. The provisional ACR/European League Against Rheumatism (EULAR) definition of remission in RA requires a score of 41 on the patient global assessment (PGA, 0-10 scale). We explored the relation between the PGA criterion and the patient's clinical disease state in an observational dataset.

  16. Ottawa Panel Evidence-Based Clinical Practice Guidelines for Patient Education in the Management of Rheumatoid Arthritis (RA)

    Science.gov (United States)

    Brosseau, Lucie; Wells, George A.; Tugwell, Peter; Egan, Mary; Dubouloz, Claire-Jehanne; Welch, Vivian A.; Trafford, Laura; Sredic, Danjiel; Pohran, Kathryn; Smoljanic, Jovana; Vukosavljevic, Ivan; De Angelis, Gino; Loew, Laurianne; McEwan, Jessica; Bell, Mary; Finestone, Hillel M.; Lineker, Sydney; King, Judy; Jelly, Wilma; Casimiro, Lynn; Haines-Wangda, Angela; Russell-Doreleyers, Marion; Laferriere, Lucie; Lambert, Kim

    2012-01-01

    Background and purpose: The objective of this article is to create guidelines for education interventions in the management of patients ([greater than] 18 years old) with rheumatoid arthritis (RA). Methods: The Ottawa Methods Group identified and synthesized evidence from comparative controlled trials using Cochrane Collaboration methods. The…

  17. Value of body mass index in the diagnosis of obesity according to DEXA in well-controlled RA patients.

    Science.gov (United States)

    Tello-Winniczuk, Nina; Vega-Morales, David; García-Hernandez, Pedro A; Esquivel-Valerio, Jorge A; Garza-Elizondo, Mario A; Arana-Guajardo, Ana C

    Rheumatoid arthritis (RA) has an indirect effect on body composition. Body mass index (BMI) is not a valid predictor of body fat in RA patients. To evaluate the accuracy of BMI in identifying obesity diagnosed according to dual energy X-ray absorptiometry (DXA) in well-controlled RA patients. An observational, cross-sectional, descriptive, analytical study. We used 3 different cutoffs for obesity as determined by DXA: >35% total fat, >40% total fat, and >35% central fat mass (central obesity). One hundred one patients were included. We found that 35% total fat corresponded to a BMI of 24kg/m 2 , with a sensitivity of 90% and specificity of 75% (area under the curve [AUC] 0.917); 40% total fat to a BMI of 25kg/m 2 , with a sensitivity of 86% and specificity of 39% (AUC 0.822); and 35% central fat mass to a BMI of 22kg/m 2 , with a sensitivity of 97% and specificity of 84% (AUC 0.951). Obesity according to DXA was underdiagnosed when the classic BMI cutoffs were used in well-controlled RA patients. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  18. Manlighet i kris? Några anmärkningar om mansporträtt i tre populärlitterära romaner

    OpenAIRE

    Szymoniak, Katarzyna

    2010-01-01

    I artikeln konfronteras Susan Faludis och Thomas Johanssons teori om manlighetskris med mansporträtt i tre svenska populärlitterära romaner. Teorin om manlighetskris uppstod i samband med feminism. Enligt forskarna visar sig manlighetskrisen i mäns oförmåga att ingå nära relationer, ensamhet och rädsla att inte leva upp till mansidealet. Tre svenska populärromaner Pappadagar i Råttans år av Daniel Möllberg (2007), Vi som aldrig sa hora av Ronnie Sandahl (2007) and Vi har redan sagt hej då av ...

  19. The dose exposure of the environmental population by natural and released Ra-226 from an uranium mine prospect

    International Nuclear Information System (INIS)

    Schuettelkopf, H.; Kiefer, H.

    1980-08-01

    The concentration of natural Ra-226 in the environment of Baden-Baden was determined in samples of drinking water, surface water, sediments, soil, fish, milk and other food. The results partly are higher than normal caused by a local uranium deposit. Ra-226 releases with waste water from an uranium mine prospect are measured. The Ra-226 concentrations in creeks and sediments partly caused by this waste water were determined. Ra-226 concentrations in soil and plant samples collected on uranium ore dumps were partly much higher than in the environment. (orig.) [de

  20. How comparable are rates of malignancies in patients with rheumatoid arthritis across the world? A comparison of cancer rates, and means to optimise their comparability, in five RA registries.

    Science.gov (United States)

    Askling, Johan; Berglind, Niklas; Franzen, Stefan; Frisell, Thomas; Garwood, Christopher; Greenberg, Jeffrey D; Ho, Meilien; Holmqvist, Marie; Horne, Laura; Inoue, Eisuke; Michaud, Kaleb; Nyberg, Fredrik; Pappas, Dimitrios A; Reed, George; Tanaka, Eiichi; Tran, Trung N; Verstappen, Suzanne M M; Yamanaka, Hisashi; Wesby-van Swaay, Eveline; Symmons, Deborah

    2016-10-01

    The overall incidence of cancer in patients with rheumatoid arthritis (RA) is modestly elevated. The extent to which cancer rates in RA vary across clinical cohorts and patient subsets, as defined by disease activity or treatment is less known but critical for understanding the safety of existing and new antirheumatic therapies. We investigated comparability of, and means to harmonise, malignancy rates in five RA registries from four continents. Participating RA registries were Consortium of Rheumatology Researchers of North America (CORRONA) (USA), Swedish Rheumatology Quality of Care Register (SRR) (Sweden), Norfolk Arthritis Register (NOAR) (UK), CORRONA International (several countries) and Institute of Rheumatology, Rheumatoid Arthritis (IORRA) (Japan). Within each registry, we analysed a main cohort of all patients with RA from January 2000 to last available data, and sensitivity analyses of sub-cohorts defined by disease activity, treatment change, prior comorbidities and restricted by calendar time or follow-up, respectively. Malignancy rates with 95% CIs were estimated, and standardised for age and sex, based on the distributions from a typical RA clinical trial programme population (fostamatinib). There was a high consistency in rates for overall malignancy excluding non-melanoma skin cancer (NMSC), for malignant lymphomas, but not for all skin cancers, across registries, in particular following age/sex standardisation. Standardised rates of overall malignancy excluding NMSC varied from 0.56 to 0.87 per 100 person-years. Within each registry, rates were generally consistent across sensitivity analyses, which differed little from the main analysis. In real-world RA populations, rates of both overall malignancy and of lymphomas are consistent. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. Patient refusal for regional anesthesia in elderly orthopedic population: A cross-sectional survey at a tertiary care hospital.

    Science.gov (United States)

    Salam, Asma Abdus; Afshan, Gauhar

    2016-01-01

    Improvements in pain management techniques in the last decade have had a major impact on the practice of orthopedic surgeries, for example, total hip arthroplasty and total knee arthroplasty. Although there are a number of treatment options for postoperative pain, a gold standard has not been established. In our institution, both general anesthesia and regional anesthesia (RA), are being offered to the elderly orthopedic population but RA is not frequently accepted by elderly population. The objective of this study was to determine the frequency of various reasons for refusal of RA in elderly patients undergoing orthopedic surgeries. A prospective study conducted over a period of 1 year, had 549 patients with ages above 60 years who underwent different types of elective orthopedic procedures 182 patients who refused RA were interviewed according to a structured questionnaire designed to assess the reasons of refusal. Most common reason for the refusal of RA was surgeon's choice (38.5%), whereas 20.3% of the patients were unaware about the RA. There was a significant association between female gender and refusing RA due to backache (17.2%) and fear of being awake during the operation (24.1%) respectively. This survey showed that the main reasons among elderly female population were the fear of remaining awake and backache. However, overall it was the surgeon's choice which made patients refuse RA, and the anesthesiologists were the main source of information.

  2. Flexor Hallucis Longus tendon rupture in RA-patients is associated with MTP 1 damage and pes planus

    Directory of Open Access Journals (Sweden)

    Buurke Jaap J

    2007-11-01

    Full Text Available Abstract Background To assess the prevalence of and relation between rupture or tenosynovitis of the Flexor Hallucis Longus (FHL tendon and range of motion, deformities and joint damage of the forefoot in RA patients with foot complaints. Methods Thirty RA patients with painful feet were analysed, their feet were examined clinically for the presence of pes planus and range of motion (ROM, radiographs were scored looking for the presence of forefoot damage, and ultrasound examination was performed, examining the presence of tenosyovitis or rupture of the FHL at the level of the medial malleolus. The correlation between the presence or absence of the FHL and ROM, forefoot damage and pes planus was calculated. Results In 11/60(18% of the feet, a rupture of the FHL was found. This was associated with a limited motion of the MTP1-joint, measured on the JAM (χ2 = 10.4, p = 0.034, a higher prevalence of pes planus (χ2 = 5.77, p = 0.016 and a higher prevalence of erosions proximal at the MTP-1 joint (χ2 = 12.3, p = 0.016, and joint space narrowing of the MTP1 joint (χ2 = 12.7, p = 0.013. Conclusion Rupture of the flexor hallucis longus tendon in RA-patients is associated with limited range of hallux motion, more erosions and joint space narrowing of the MTP-1-joint, as well as with pes planus.

  3. Can baseline ultrasound results help to predict failure to achieve DAS28 remission after 1 year of tight control treatment in early RA patients?

    Science.gov (United States)

    Ten Cate, D F; Jacobs, J W G; Swen, W A A; Hazes, J M W; de Jager, M H; Basoski, N M; Haagsma, C J; Luime, J J; Gerards, A H

    2018-01-30

    At present, there are no prognostic parameters unequivocally predicting treatment failure in early rheumatoid arthritis (RA) patients. We investigated whether baseline ultrasonography (US) findings of joints, when added to baseline clinical, laboratory, and radiographical data, could improve prediction of failure to achieve Disease Activity Score assessing 28 joints (DAS28) remission (baseline. Clinical, laboratory, and radiographical parameters were recorded. Primary analysis was the prediction by logistic regression of the absence of DAS28 remission 12 months after diagnosis and start of therapy. Of 194 patients included, 174 were used for the analysis, with complete data available for 159. In a multivariate model with baseline DAS28 (odds ratio (OR) 1.6, 95% confidence interval (CI) 1.2-2.2), the presence of rheumatoid factor (OR 2.3, 95% CI 1.1-5.1), and type of monitoring strategy (OR 0.2, 95% CI 0.05-0.85), the addition of baseline US results for joints (OR 0.96, 95% CI 0.89-1.04) did not significantly improve the prediction of failure to achieve DAS28 remission (likelihood ratio test, 1.04; p = 0.31). In an early RA population, adding baseline ultrasonography of the hands, wrists, and feet to commonly available baseline characteristics did not improve prediction of failure to achieve DAS28 remission at 12 months. Clinicaltrials.gov, NCT01752309 . Registered on 19 December 2012.

  4. RA Reactor

    International Nuclear Information System (INIS)

    1989-01-01

    This chapter includes the following: General description of the RA reactor, organization of work, responsibilities of leadership and operators team, regulations concerning operation and behaviour in the reactor building, regulations for performing experiments, regulations and instructions for inserting samples into experimental channels [sr

  5. RA Reactor

    International Nuclear Information System (INIS)

    1978-02-01

    In addition to basic characteristics of the RA reactor, organizational scheme and financial incentives, this document covers describes the state of the reactor components after 18 years of operation, problems concerned with obtaining the licence for operation with 80% fuel, problems of spent fuel storage in the storage pool of the reactor building and the need for renewal of reactor equipment, first of all instrumentation [sr

  6. Prevalence of Periodontitis in Patients with Established Rheumatoid Arthritis: A Swedish Population Based Case-Control Study

    Science.gov (United States)

    Eriksson, Kaja; Nise, Lena; Kats, Anna; Luttropp, Elin; Catrina, Anca Irinel; Askling, Johan; Jansson, Leif; Alfredsson, Lars; Klareskog, Lars; Lundberg, Karin; Yucel-Lindberg, Tülay

    2016-01-01

    Introduction The possible hypothesis of a link between periodontitis and rheumatoid arthritis (RA), specifically anti-citrullinated protein antibody (ACPA) positive RA, prompted us to investigate the prevalence of periodontitis in the Swedish Epidemiological Investigation of RA (EIRA), a well-characterised population-based RA case-control cohort. Methods Periodontal status of 2,740 RA cases and 3,942 matched controls was retrieved through linking EIRA with the National Dental Health Registry (DHR), where dental diagnostic- and treatment codes on the adult Swedish population have been registered. Dental records from 100 cases and controls were reviewed to validate the periodontal diagnostic codes in DHR. Results The reviewed dental records confirmed 90% of the periodontitis diagnoses in DHR among RA cases, and 88% among controls. We found the positive predictive value of periodontitis diagnoses in the DHR to be 89% (95% CI 78 to 95%) with a sensitivity of 77% (95% CI: 65 to 86%). In total, 86% of EIRA participants were identified in DHR. The risk for periodontitis increased by age and current smoking status in both cases as well as controls. No significant differences in prevalence of periodontal disease in terms of gingivitis, periodontitis, peri-implantitis or increased risk for periodontitis or peri-implantitis were observed between RA cases and controls. In addition, there was no difference on the basis of seropositivity, ACPA or rheumatoid factor (RF), among patients with RA. Conclusions Our data verify that smoking and ageing are risk factors for periodontitis, both in RA and controls. We found no evidence of an increased prevalence of periodontitis in patients with established RA compared to healthy controls, and no differences based on ACPA or RF status among RA subjects. PMID:27203435

  7. Factors that influence fatigue status in patients with severe rheumatoid arthritis (RA) and good disease outcome following 6 months of TNF inhibitor therapy: a comparative analysis.

    LENUS (Irish Health Repository)

    Minnock, Patricia

    2015-11-01

    The objective of the present study is to determine the factors associated with persistent fatigue in patients with severe rheumatoid arthritis (RA) and good disease response to 6 months of tumour necrosis factor inhibitor therapy. Eligible patients with either persistent (PF) or no fatigue (NF) were compared. Using validated questionnaires and bivariate analysis, this cross-sectional survey explored if clinical characteristics, pain, self-efficacy, sleep and mood\\/depression differed between groups. Patients with PF (PF; NF) (n = 28; 28) reported significantly more overall pain (11.3 ± 9.4 (0-33); 6.9 ± 8.9 (0-33)), more recent and current pain intensity (41.4 ± 26.6 (0-80) 24.4 ± 26.6 (0-100) and depression (11.8 ± 7.5 (1-35); 8.2 ± 6.6 (0-26)), than the NF group. There was no significant difference between groups in self-efficacy and both groups experienced poor sleep quality (Pittsburgh Sleep Quality Index >5). Despite having good disease response, the PF group had significantly higher rheumatoid factor incidence, disease activity score-28, early morning stiffness duration and lower incidence of ever-failing disease-modifying anti-rheumatic drugs than the NF group. These findings enhance the fatigue literature in patients with RA prescribed tumour necrosis factor (TNF) inhibition therapy, identifying the potentially modifiable factors of pain and depression, previously demonstrated to be strongly associated with fatigue in non-biologic populations. In addition, this study highlights the association between persistent fatigue and an on-going state of low disease activity. This infers that more judicious disease management could minimise the symptom burden of pain and depression and consequentially fatigue.

  8. Nocturnal blood pressure dipping is similar in rheumatoid arthritis patients as compared to a normal population.

    Science.gov (United States)

    Turgay Yildirim, O; Gonullu, E; Aydin, F; Aksit, E; Huseyinoglu Aydin, A; Dagtekin, E

    2018-04-12

    Rheumatoid arthritis (RA) is a systemic autoimmune inflammatory disorder which further doubles the risk of developing cardiovascular disease. Some studies suggest that in RA patients, the prevalence of hypertension increases due to prednisolone use, clinical status, genetic factors, and physical inactivity. On the other hand, dipper and non-dipper status in RA patients compared to non-RA subjects has not been investigated to our knowledge. Purpose of the study is to investigate whether non-dipper status is more deteriorated in RA patients. Sixty-five RA patients and 61 age-sex-matched control patients were evaluated in this cross-sectional study. Patients were classified according to 24-h ambulatory blood pressure monitoring results. Patients with previous hypertension diagnosis, coronary artery disease, and abnormal kidney function were excluded. Mean age of the study sample was 53.7 ± 12.3 years and 40.5% were male. There was no significant difference between groups in terms of basic demographic characteristics. Leukocyte counts (p = 0.001), neutrophil counts (p = 0.001), and red cell distribution width (p = 0.000) were significantly higher in the RA group. ABPM results indicate no significant difference between RA patients and the control group in terms of daytime systolic and diastolic blood pressure, nighttime systolic and diastolic blood pressure, and average systolic and diastolic blood pressure results (p > 0.05). There was no statistical difference regarding the non-dipper status of patient groups (p = 0.412). Nocturnal blood pressure dipping was significantly similar between groups (p = 0.980). In conclusion, RA patients have similar values in terms of nocturnal blood pressure dipping and hypertension diagnosis as compared to normal population.

  9. Age and sex dependencies of anxiety and depression in cardiologic patients compared with the general population

    OpenAIRE

    Hinz, A; Kittel, J; Karoff, M; Schwarz, R

    2004-01-01

    Objective: The aim of this study was to test age and sex effects on anxiety and depression using the Hospital Anxiety and Depression Scale HADS. Method: Sample 1 consisted of 2037 subjects of the German general population, and sample 2 comprised 2696 cardiologic patients. Results: In the group of the general population we observed a linear increase of depression and (to a lower extent) of anxiety with age. In contrast to that, the patients reached their anxiety and depression maxima in the ra...

  10. Are Janus Kinase Inhibitors Superior over Classic Biologic Agents in RA Patients?

    Directory of Open Access Journals (Sweden)

    Przemyslaw J. Kotyla

    2018-01-01

    Full Text Available The Janus Kinases (JAKs are a family of intracellular tyrosine kinases that provide transmission signals from cytokine, interferons, and many hormones receptors to the nucleus resulting in synthesis of many biologically active compounds and changing cell metabolism and function. That was theoretical background to synthetize the JAK inhibitors (Jakinibs. In recent years a substantial battery of evidence has been collected indicating the potential role of Jakinibs to interact with the specific elements of the immune system, therefore changing the inflammatory response. JAK kinase blockade offers a unique opportunity to block most of the key cytokines enabling the deep interaction into immune system functioning. Following discovery first Jakinibs were intensively studied in various forms of autoimmune diseases, including rheumatoid arthritis, and finally two Jakinibs tofacitinib and Baricitinib have been approved for the treatment of rheumatoid arthritis. Some clinical data indicated that under special circumstances Jakinibs may be even superior to biologics in the treatment of RA; however this suggestion should be verified in large clinical and observational studies.

  11. A non-synonymous single-nucleotide polymorphism in the gene encoding Toll-like Receptor 3 (TLR3) is associated with sero-negative Rheumatoid Arthritis (RA) in a Danish population

    DEFF Research Database (Denmark)

    Laska, Magdalena Janina; Hansen, Bettina; Troldborg, Anne

    2014-01-01

    BACKGROUND: It has been suggested that polymorphisms in Toll-like Receptors (TLRs) are associated with Rheumatoid Arthritis (RA), but the implicated alleles have differed between studies. The aim of this investigation was to explore whether polymorphisms of TLR genes are associated with RA...... according to IgM rheumatoid factor (RF) and anti-cyclic citrinullated peptide (CCP) status suggested a significant association of sero-negative RA with the rs3775291 A allele and disease activity in this subset. CONCLUSION: These observations on a RA population of Danish ancestry suggest that variations...... in the TLR3 locus may be implicated in the pathogenesis of sero-negative RA. Since this TLR3 SNP has previously been associated with systemic lupus erythematous (SLE), the present findings support the notion that TLR3 genetic variants may represent a common risk factor in different chronic inflammatory...

  12. Risk of leukaemia following intravenous treatment with {sup 224}Ra - results of a long term follow-up study of ankylosing spondylitis patients; Leukaemierisiko nach intravenoeser {sup 224}Ra-Behandlung - Ergebnisse einer Langzeitstudie an Bechterew-Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Wick, R.R. [GSF - Forschungszentrum fuer Umwelt und Gesundheit Neuherberg GmbH, Oberschleissheim (Germany). Inst. fuer Strahlenbiologie; Chmelevsky, D. [GSF - Forschungszentrum fuer Umwelt und Gesundheit Neuherberg GmbH, Oberschleissheim (Germany). Inst. fuer Strahlenschutz; Goessner, W. [GSF - Forschungszentrum fuer Umwelt und Gesundheit Neuherberg GmbH, Oberschleissheim (Germany). Inst. fuer Pathologie

    1993-12-31

    In an epidemiological study of the somatic late effects risk following incorporation of a short lived {alpha}-emitter, 1473 ankylosing spondylitis patients treated with repeated intravenous injections of {sup 224}Ra in the years 1948 - 75, have been observed in the GSF. The usual therapeutic plan consisted of a total of 10 - 12 injections of 1.036 MBq (28 {mu}Ci) of {sup 224}Ra each, given at weekly intervals; this would result in an cumulative {alpha}-dose of 0.56 - 0.67 Gy to the marrow-free skeleton of a 70-kg-man (standard man). These patients have been followed together with a control group of ankylosing spondylitis patients not treated with radioactive drugs and/or X-rays. Until May 1993 (mean follow-up time 19.9 yr), 595 patients of the exposure group and 722 patients of the control group have died, causes of death have been ascertained for 578, resp. 668 patients. Among others we observed in the exposure group 10 cases of leukaemia (vs. 2.7 - 2.8 cases expected, p < 0.001) and 6 cases of leukaemia in the control group (vs. 3.3 - 3.5 exp., p = 0.14). Subclassification of the leukaemias shows a clear preference for chronic myeloid leukaemia (CML) in the exposure group (4 cases obs. vs. 0.8 cases exp., p = 0.009), whereas in the control group the observed cases of CML are within the range of expectancy. Similar observations have not been made in another group of patients, now observed by Spiess and co-workers, who have been treated at a higher dose/dose rate range. This increased incidence of leukaemias in our exposure group is in one line with results from animal experiments with bone seeking {alpha}-emitters given at low dose rates. The induction of myeloid leukaemia has been demonstrated in mice down to dose rates of only a few mGy/day also for {sup 239}Pu, an {alpha}-emitter which like {sup 224}Ra deposits preferentially on the bone surface. (orig.) [Deutsch] Im Rahmen einer epidemiologischen Studie zum somatischen Strahlenspaetschadenrisiko nach

  13. A unique drug distribution process for radium Ra 223 dichloride injection and its implication for product quality, patient privacy, and delineation of professional responsibilities.

    Science.gov (United States)

    Dansereau, Raymond N

    2014-11-01

    On May 15, 2013, Bayer Healthcare Pharmaceuticals announced that it had received marketing approval for the therapeutic radioactive medication radium Ra 223 dichloride injection (Xofigo; Ra 223). The product acquisition and distribution process for hospital-based nuclear pharmacies and nuclear medicine services is unlike any other. The product is distributed as a low-risk compounded sterile preparation through a single compounding nuclear pharmacy located in Denver, Colorado, pursuant to a prescription. This model for drug distribution and delivery to the user institution has implications for product quality, patient privacy, and delineation of professional responsibilities. © The Author(s) 2014.

  14. Risk of leukaemia following intravenous treatment with 224Ra - results of a long term follow-up study of ankylosing spondylitis patients

    International Nuclear Information System (INIS)

    Wick, R.R.; Chmelevsky, D.; Goessner, W.

    1993-01-01

    In an epidemiological study of the somatic late effects risk following incorporation of a short lived α-emitter, 1473 ankylosing spondylitis patients treated with repeated intravenous injections of 224 Ra in the years 1948 - 75, have been observed in the GSF. The usual therapeutic plan consisted of a total of 10 - 12 injections of 1.036 MBq (28 μCi) of 224 Ra each, given at weekly intervals; this would result in an cumulative α-dose of 0.56 - 0.67 Gy to the marrow-free skeleton of a 70-kg-man (standard man). These patients have been followed together with a control group of ankylosing spondylitis patients not treated with radioactive drugs and/or X-rays. Until May 1993 (mean follow-up time 19.9 yr), 595 patients of the exposure group and 722 patients of the control group have died, causes of death have been ascertained for 578, resp. 668 patients. Among others we observed in the exposure group 10 cases of leukaemia (vs. 2.7 - 2.8 cases expected, p 239 Pu, an α-emitter which like 224 Ra deposits preferentially on the bone surface. (orig.) [de

  15. [The reentrant binomial model of nuclear anomalies growth in rhabdomyosarcoma RA-23 cell populations under increasing doze of rare ionizing radiation].

    Science.gov (United States)

    Alekseeva, N P; Alekseev, A O; Vakhtin, Iu B; Kravtsov, V Iu; Kuzovatov, S N; Skorikova, T I

    2008-01-01

    Distributions of nuclear morphology anomalies in transplantable rabdomiosarcoma RA-23 cell populations were investigated under effect of ionizing radiation from 0 to 45 Gy. Internuclear bridges, nuclear protrusions and dumbbell-shaped nuclei were accepted for morphological anomalies. Empirical distributions of the number of anomalies per 100 nuclei were used. The adequate model of reentrant binomial distribution has been found. The sum of binomial random variables with binomial number of summands has such distribution. Averages of these random variables were named, accordingly, internal and external average reentrant components. Their maximum likelihood estimations were received. Statistical properties of these estimations were investigated by means of statistical modeling. It has been received that at equally significant correlation between the radiation dose and the average of nuclear anomalies in cell populations after two-three cellular cycles from the moment of irradiation in vivo the irradiation doze significantly correlates with internal average reentrant component, and in remote descendants of cell transplants irradiated in vitro - with external one.

  16. Effect of bedside shielding on air-kerma rates around gynecologic intracavitary brachytherapy patients containing 226Ra or 137Cs

    International Nuclear Information System (INIS)

    Papin, P.J.; Ramsey, M.J.; LaFontaine, R.L.; LePage, R.P.

    1990-01-01

    An anthropomorphic phantom was implanted with 226Ra or 137Cs gynecologic intracavitary brachytherapy sources. Air-kerma rate measurements were taken at 10-cm increments along a horizontal plane from the side of the bed at 50 cm, 87 cm, and 136 cm heights above the floor. Five portable lead shields were placed at the head, at the foot and along one side of the bed and readings were taken again at the corresponding heights above, below and behind the shields. The readings were normalized to 100-mg Ra equivalence, and air-kerma rate curves were drawn allowing for the comparison of 226Ra and 137Cs with and without lead shields. The data demonstrated that the air-kerma rates for 137Cs were reduced more than those for 226Ra with the use of the portable lead shields. There was four times the transmission with 226Ra than with 137Cs. The optimal placement was with the lateral bedside shields proximal to the head and foot closest to the bed, with the middle shield overlapping in back. The shields at the head and foot should extend out and overlap the bedside shields. The level of the sources should be positioned near the bottom of the shields. This information will provide the medical health physicist with an estimate of air-kerma rates for both 226Ra and 137Cs with and without shielding for evaluating personnel exposures as well as the effectiveness of current shielding in relation to radiation protection requirements in adjacent rooms or hallways

  17. Distribution of 226Ra and 228Ra in drinking water and dose assessment

    International Nuclear Information System (INIS)

    Ajay Kumar; Sugandhi, S.; Usha, N.; Rupali, K.; Gurg, R.P.

    2002-01-01

    The radioactivity concentrations of 226 Ra and 228 Ra have been analysed in 123 drinking water samples received from different regions of India. The maximum concentrations of 226 Ra and 228 Ra in drinking water are 8 mBq/l and 11.5 mBq/l respectively. The higher doses due to intake of 228 Ra through drinking water suggests that 228 Ra should also be measured in the assessment of ingestion dose to the population. The estimated committed effective doses range from 0.082 to 2.45 μSv/year and from 1.53 to 8.81 μSv/year for the ingestion of 226 Ra and 228 Ra respectively. (author)

  18. Joint positions matter for ultrasound examination of RA patients-increased power Doppler signal in neutral versus flat position of hands.

    Science.gov (United States)

    Husic, Rusmir; Lackner, Angelika; Stradner, Martin H; Hermann, Josef; Dejaco, Christian

    2017-08-01

    Position of joints might influence the result of US examination in patients with RA. The purpose of this work was to compare grey-scale (GS) and power Doppler (PWD) findings obtained in neutral vs flat position of hands. A cross-sectional study of 42 RA patients with active disease. Two dimensional and 3D sonography of wrists and MCP joints were conducted in two different joint positions: neutral position, which is a slight flexion of the fingers with relaxed extensor muscles; and flat position, where all palm and volar sides of fingers touch the Table. Two dimensional GS synovitis (GSS) and PWD signals were scored semi-quantitatively (0-3). For 3D sonography, the percentage of PWD voxels within a region of interest was calculated. GSS was not quantified using 3D sonography. Compared with neutral position, 2D PWD signals disappeared in 28.3% of joints upon flattening. The median global 2D PWD score (sum of all PWD scores of an individual patient) decreased from 8 to 3 ( P < 0.001), and the global 3D PWD voxel score from 3.8 to 0.9 ( P < 0.001). The reduction of PWD scores was similar in all joints (2D: minus 50%, 3D: minus 66.4-80.1%). Inter- and intrareader agreement of PWD results was good (intraclass correlation coefficient: 0.75-0.82). In RA, a neutral position of the hands is linked to a higher sensitivity of 2D and 3D sonography in detecting PWD signals at wrists and MCP joints, compared with a flat position. Standardization of the scanning procedure is essential for obtaining comparable US results in RA patients in trials and clinical routines. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  19. Power of national economy, disease control and employment status in patients with RA-an analytical multi-site ecological study.

    Science.gov (United States)

    Pieringer, Herwig; Puchner, Rudolf; Pohanka, Erich; Danninger, Kathrin

    2016-02-01

    In rheumatology, sufficient disease control is a central part of the treatment concept. However, modern treatment strategies are associated with a substantial economic burden for health care systems. Ecological studies offer the unique opportunity to analyse differences between groups as well as group level effects. In the present analytical multi-site ecological study, we investigated whether more powerful national economies as measured by the gross domestic product per capita (GDPpc) are associated with better disease control in RA patients as measured by the disease activity score 28 (DAS28). We used aggregated data on RA patients from the recently published COMORA study as well as the World Health Organization database. There was a strong negative correlation between DAS28 and GDPpc (r = -0.815; p = 0.0002). Adjustment for sex, smoking status, disease duration or current employment status did not significantly change this association. There was a strong, negative correlation between DAS28 and age (r = -0.870; p < 0.001) and a strong, positive correlation between GDPpc and age (r = 0.737; p = 0.002). Adjustment for age reduced the regression coefficient (DAS28/GDPpc) to -0.000018 (p = 0.054). There was a negative correlation between DAS28 and current employment status (r = -0.642; p = 0.008) and a positive correlation between GDPpc and employment status (r = 0.722; p = 0.002). In conclusion, there is evidence of an association between disease control and GDPpc. This association is alleviated after adjustment for age. Of note, in countries with higher GDPpc, a higher proportion of RA patients are currently employed. This is true despite the fact that RA patients in countries with higher GDPpc are also older.

  20. Association of the TYMS 3G/3G genotype with poor response and GGH 354GG genotype with the bone marrow toxicity of the methotrexate in RA patients.

    Science.gov (United States)

    Jekic, Biljana; Lukovic, Ljiljana; Bunjevacki, Vera; Milic, Vera; Novakovic, Ivana; Damnjanovic, Tatjana; Milasin, Jelena; Popovic, Branka; Maksimovic, Nela; Damjanov, Nemanja; Radunovic, Goran; Kovacevic, Ljiljana; Krajinovic, Maja

    2013-03-01

    Gamma-glutamyl hydrolase (GGH), cyclin D1 (CCND1) and thymidylate synthase (TS) genes encode enzymes that are involved in methotrexate (MTX) action. In a group of 184 RA patients treated with MTX, we have investigated whether selected polymorphisms in these genes modulate MTX efficacy and/or have impact on adverse drug effects (ADEs). The efficacy of the MTX therapy has been estimated using the disease activity score in 28 joints (DAS28-ESR) based on EULAR criteria and relative DAS28 values (rDAS28). All adverse drug events were recorded. Patients were genotyped for selected polymorphisms of the GGH (-354 G > T and 452 C > T), CCND1 (870 A > G) and TYMS (variable number of tandem repeats, VNTR, and G to C substitution of triple repeat, 3R allele) gene. Association studies have been performed between obtained genotypes and the efficacy and toxicity of MTX. According to the EULAR response criteria, 146 RA patients (79.3 %) were classified as responders (good/moderate response) and 38 (20.7 %) as non-responders (poor response). Higher frequency of the TYMS 3 G/3 G genotype has been found among non-responders as compared to individuals with remaining genotypes (p = 0.02). ADEs were recorded in 53 patients. Among those patients eight experienced bone marrow toxicity, all of them carried GGH -354GG genotype (p = 0.003). No other significant association were observed. The 3 G/3 G genotype of the TYMS gene may indicate predisposition of poor response to MTX and GG genotype of GGH -354 T > G polymorphism may have high predictive value for myelosuppression in RA patients.

  1. Factors associated with influenza and pneumococcal vaccine uptake among rheumatoid arthritis patients in Denmark invited to participate in a pneumococcal vaccine trial (Immunovax_RA)

    DEFF Research Database (Denmark)

    Nguyen, MTT; Lindegaard, H.; Hendricks, O.

    2017-01-01

    the survey during scheduled follow-up visits. The questionnaire included questions concerning previous influenza and pneumococcal vaccine uptake, attitudes about vaccination, and socio-demographic factors. Factors associated with recalled vaccine uptake were assessed by multivariate logistic regression....... Results: A total of 192 RA patients completed the survey, 134 (70%) of whom were women and 90 (47%) were aged ≥ 65 years. Sixty-seven patients (35%) received conventional disease-modifying anti-rheumatic drugs (cDMARDs) and 125 (65%) combination therapy with biological disease-modifying anti...

  2. HLA-DRB1 shared epitope alleles in patients with rheumatoid arthritis: relation to autoantibodies and disease severity in a south Indian population.

    Science.gov (United States)

    Konda Mohan, Vasanth; Ganesan, Nalini; Gopalakrishnan, Rajasekhar; Venkatesan, Vettriselvi

    2017-10-01

    To investigate the presence of the 'shared epitope' (SE) in the HLA-DRB1 alleles in patients with RA and to ascertain the frequency of the HLA-DRB1 alleles with autoantibodies (anti-cyclic citrullinated peptide [anti-CCP] rheumatoid factor [RF]) and disease severity. A total of 200 RA patients and 200 apparently healthy subjects participated in the study. HLA-DRB1 were genotyped using polymerase chain reaction with sequence-specific primer (PCR-SSP). Anti-CCP and RF in serum were determined by in vitro quantitative enzyme-linked immunosorbent assay (ELISA) method. Erythrocyte sedimentation rate (ESR) was measured by Westergren method. Disease activity was assessed by using the disease activity score-28 (DAS-28). Chi-square test and Student's t-test were used in the statistical analysis. A significant increase in the frequency of HLA-DRB1*01, *04, *10 and *14 were identified in RA patients and showed a strong association with the disease susceptibility. While the frequencies of HLA-DRB1*03, *07, *11 and *13 were significantly lower in RA patients than in controls. The other HLA-DRB1 alleles *08, *09, *12, *15 and *16 showed no significant difference. The frequency of anti-CCP and RF antibodies did not showed significant difference in SE-positive patients compared with SE-negative patients. DAS-28 values of RA patients showed no significant difference between SE-positive and SE-negative groups. Our results indicate that HLA-DRB1*01, *04, *10 and *14 alleles are related with RA, while HLA-DRB1*03, *07, *11 and *13 protect against RA in our population. On the other hand, we failed to provide evidence for the association of the autoantibodies and DAS-28 with SE-positive RA patients. © 2016 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

  3. Patients receiving anti-TNF therapies experience clinically important improvements in RA-related fatigue: results from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis.

    Science.gov (United States)

    Druce, Katie L; Jones, Gareth T; Macfarlane, Gary J; Basu, Neil

    2015-06-01

    Pro-inflammatory cytokines such as TNF-α are important in the pathogenesis of fatigue in conditions such as RA. This study aimed to determine whether fatigue improved in a cohort of RA patients with clinically relevant fatigue commencing anti-TNF-α therapy and, if so, to identify predictors of improvement. Participants recruited to a long-term observational cohort study (the British Society for Rheumatology Biologics Register for RA) provided information on fatigue using the 36-item Short Form Health Survey (SF-36) vitality subscale. The prevalence of severe baseline fatigue (SF-36 vitality ≤12.5) was calculated and improvements, considered as (i) absolute values and (ii) improvement from severe to non-severe fatigue (SF-36 vitality >12.5), were examined 6 months subsequently. A comprehensive set of putative predictors of fatigue improvement were evaluated using multivariable logistic regression. In 6835 participants the prevalence of severe baseline fatigue was 38.8%. Of those with severe fatigue, 70% reported clinically relevant improvement and 66% moved to the non-severe fatigue category (i.e. improvers). The mean change for improvers was three times the minimum clinically important difference for improvement (33.0 U). Independent baseline predictors of improvement were female sex [odds ratio (OR) 1.3 (95% CI 1.1, 1.7)], not being unemployed due to ill health [OR 1.5 (95% CI 1.2, 1.7)], low disability [OR 1.2 (95% CI 1.001, 1.5)], seropositivity [OR 1.2 (95% CI 0.98, 1.4)], not using steroids [OR 1.2 (95% CI 1.03, 1.5)], no history of hypertension [OR 1.4 (95% CI 1.1, 1.6)] or depression [OR 1.3 (95% CI 1.1, 1.5)] and good mental health [SF-36 mental health subscale >35; OR 1.4 (95% CI 1.2, 1.7)]. Fatigued RA patients reported substantial improvement in their fatigue after commencing anti-TNF-α therapy. Further, a number of clinical and psychosocial baseline factors identified those most likely to improve, supporting future stratified approaches to RA

  4. Impact of a magnetic resonance imaging-guided treat-to-target strategy on disease activity and progression in patients with rheumatoid arthritis (the IMAGINE-RA trial)

    DEFF Research Database (Denmark)

    Møller-Bisgaard, Signe; Hørslev-Petersen, Kim; Ejbjerg, Bo Jannik

    2015-01-01

    /absence of BME may therefore be clinically beneficial. We present the design of a randomized controlled trial (RCT) aiming to evaluate whether an MRI-guided treatment strategy compared to a conventional treatment strategy in anti-CCP-positive erosive RA is better to prevent progression of erosive joint damage...... swollen joints and treatment with synthetic disease-modifying antirheumatic drugs (DMARDs) will be included. Patients will be randomized to either a treatment strategy based on conventional laboratory and clinical examinations (control group) or a treatment strategy based on conventional laboratory...

  5. Diferenciação genética entre populações de Pseudoplatystoma corruscans (Agassiz, 1829 (Osteichthyes, Pimelodidae isoladas pelos saltos de Guaíra do rio Paraná Genetic differentiation among populations of Pseudoplatystoma corruscans (Agassiz, 1829 (Osteichthyes, Pimelodidae isolated by the Guaíra Falls in the Paraná River

    Directory of Open Access Journals (Sweden)

    Sônia Maria Alves Pinto Prioli

    2002-05-01

    Full Text Available Os saltos de Guaíra, também denominados Sete Quedas, constituíam até 1982 uma barreira para a dispersão de peixes migradores. Este trabalho teve por objetivo verificar se populações de Pseudoplatystoma corruscans (Osteichthyes, Pimelodidae eram isoladas pelos saltos de Guaíra. Amostras provenientes da planície de inundação do alto rio Paraná (PL, do reservatório Itaipu (IT e de jusante de Yacyretá (YA, foram comparadas por RAPD. O FST de Lynch foi significativo entre PL e IT (0,090 e PL e YA (0,112. O fluxo gênico estimado (Nm variou de 2,0 entre PL e YA a 8,1 entre IT e YA, e a distância genética de Nei de D = 0,0638 entre PL e YA a D = 0,0174 entre IT e YA. Estes resultados indicam existência de diferenciação genética e que, possivelmente, Sete Quedas isolavam reprodutivamente as populações. Sugerem, também, a possibilidade de áreas diferentes de desova, impedindo parcialmente a homogeneização genética das populações IT e PL.Until 1982, the Guaíra Falls, also named the Seven Falls, constituted a barrier to the dispersion of migratory fish in the Paraná River. The objective of this work was to verify if populations of Pseudoplatystoma corruscans (Osteichthyes, Pimelodidae were isolated by the Guaíra Falls. Samples from the Upper Paraná River floodplain (PL, the Itaipu reservoir (IT, and downstream Yacyretá reservoir (YA were compared by RAPD markers. Lynch's FST was significant between PL and IT (0.090, and PL and YA (0.112. Estimated gene flow (Nm varied from 2.0 between PL and YA to 8.1 between IT and YA. Nei's genetic distance varied from D = 0.0638 between PL and YA to D = 0.0174 between IT and YA. These results indicate the existence of genetic differentiation and that, possibly, the Guaíra Falls isolated the populations reproductively. They also suggest the possibility of different spawning areas, partially avoiding the genetic homogenization of the IT and PL populations.

  6. IL-1Ra (recombinant human IL-1 receptor antagonist in the treatment of rheumatoid arthritis: the efficacy

    Directory of Open Access Journals (Sweden)

    L. Cozzi

    2011-09-01

    Full Text Available Interleukin 1 receptor antagonist (IL-1Ra is a naturally occurring IL-1 inhibitor, acting as a “receptor antagonist”, which blocks IL-1 mediated signal transduction. In 1990 IL-1Ra was cloned and later on, a large numbers of studies led to disclosure of the crucial importance of the imbalance between IL-1 and IL-1Ra in the pathogenesis of rheumatoid arthritis (RA. In 1991, almost 8 years after the initial isolation of IL-1, recombinant IL-1Ra (IL-1ra, Kineret was introduced in clinical trials involving patients with RA. Between 2001 and 2002 IL-1ra was approved by the US Food and Drug Administration and by the European Agency for the Evaluation of the Medicinal Products and in 2003 it was registered in Italy, too. In RA recombinant IL-1ra has been evaluated in 5 randomized, placebo-controlled clinical trials involving more than 2900 patients. Two of the trials involved the use of IL-1ra as monotherapy versus placebo and two trials in combination with methotrexate (MTX; the last trial explored the use of a fixed 100 mg/day IL-1ra dosage in a RA patient population including a wide array of co-morbid conditions as well as concomitant medications. The studies confirmed both the efficacy and the safety of IL-1ra in patients with active and severe RA. 43% of patients receiving 150 mg/day IL-1ra achieved a 20% response according to the American College of Rheumatology criteria (ACR20, compared to 27% in the placebo group. In the MTX combination therapy study, 42% of the patients receiving 1 mg/Kg/day of IL-1ra achieved an ACR20, 24% an ACR50 and 10% an ACR70. In each study, significant improvements in the Health Assessment Questionnaire scores (HAQ were observed. There were rapid gains in the number of days at work or domestic activity in the treated patients, and the increases in productivity were dose related. At early 24 weeks, there was significant reduction of both the score for progression of joint space narrowing (JSN and the Total modified

  7. 224Ra and 226Ra experimentally induced dental changes in rats

    International Nuclear Information System (INIS)

    Reichart, P.A.; Althoff, J.; Eckhardt, W.; Rippel, W.

    1979-01-01

    Sprague-Dawley rats received intragastrically a single dose of 226 Ra or 224 Ra once weekly for 21 weeks. During this period the animals of both groups were thus exposed to comparable doses. After 12 weeks, a shortening of the maxillary incisors was observed, and this progressed during the course of the 55-week experiment. Radiologically, a loss of pulpal transparency and an apical irregular opacity in the maxillary incisors were demonstrable. Histologically, dysplastic changes of the maxillary incisors and multiple resorptions at the cemento-enamel junction of the molars were seen. The observed alterations were more pronounced in the 226 Ra group than in the 224 Ra treated group. The experimentally induced resorptions were comparable to those observed in patients who had incorporated 224 Ra or 226 Ra. Clinical, radiological, histological, γspecrometrical, and autoradiographical findings, as well as dose-estimations, are described. (author)

  8. Ingestion dose from 238U, 232Th, 226Ra, 40K and 137CS in cereals, pulses and drinking water to adult population in a high background radiation area, Odisha (India)

    International Nuclear Information System (INIS)

    Lenka, P.; Sahoo, S. K.; Mohapatra, S.; Patra, A. C.; Dubey, J. S.; Vidyasagar, D.; Tripathi, R. M.; Puranik, V. D.

    2013-01-01

    A natural high background radiation area is located in Chhatrapur, Odisha in the eastern part of India. The inhabitants of this area are exposed to external radiation levels higher than the global average background values, due to the presence of uranium, thorium and its decay products in the monazite sands bearing placer deposits in its beaches. The concentrations of 232 Th, 238 U, 226 Ra, 40 K and 137 Cs were determined in cereals (rice and wheat), pulses and drinking water consumed by the population residing around this region and the corresponding annual ingestion dose was calculated. The annual ingestion doses from cereals, pulses and drinking water varied in the range of 109.4-936.8, 10.2-307.5 and 0.5-2.8 μSv y -1 , respectively. The estimated total annual average effective dose due to the ingestion of these radionuclides in cereals, pulses and drinking water was 530 μSv y -1 . The ingestion dose from cereals was the highest mainly due to a high consumption rate. The highest contribution of dose was found to be from 226 Ra for cereals and drinking water and 40 K was the major dose contributor from the intake of pulses. The contribution of man-made radionuclide 137 Cs to the total dose was found to be minimum. 226 Ra was found to be the largest contributor to ingestion dose from all sources. (authors)

  9. 226Ra, 228Ra and 228Ra/226Ra in surface marine sediment of Malaysia

    International Nuclear Information System (INIS)

    Mei-Wo Yii; Zal Uyun Wan-Mahmood

    2013-01-01

    Surface sediment samples were collected at the West (east coast and west coast of Peninsular Malaysia) and East (Sabah and Sarawak) Malaysia in several expeditions within August 2003 until June 2008 for determining the level of natural radium isotopes. Activity concentrations of 226 Ra and 228 Ra in surface marine sediment at 176 sampling stations were measured. The activity concentrations of both radionuclides in Malaysia (East and West Malaysia) display varied with the range from 9 to 158 Bq/kg dry wt. and 13 to 104 Bq/kg dry wt., respectively. Meanwhile, the ratio distributions of 228 Ra/ 226 Ra were ranged from 0.62 to 3.75. This indicated that the ratios were slightly high at west coast of Peninsular Malaysia compared to other regions (east coast of Peninsular Malaysia, Sabah and Sarawak). The variation of activity concentrations of 226 Ra and 228 Ra and its ratios were also supported by the statistical analyses of one-way ANOVA and t test at 95 % confidence level, whereby there were proved that the measured values were different between the regions. These different were strictly related to their half-life, potential input sources (included their parents, 238 U and 232 Th), parent's characteristic, the geological setting/formation of the study area, environment origin and behavior. (author)

  10. Socioeconomic and employment status of patients with rheumatoid arthritis in Korea.

    Science.gov (United States)

    Kwon, Jeong-Mi; Rhee, Jinnie; Ku, Hyemin; Lee, Eui-Kyung

    2012-01-01

    This study investigates the prevalence of rheumatoid arthritis (RA) by gender and socio-economic characteristics. It also explores the differences in the employment status between RA patients and the general population without RA in Korea. We analyzed data from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) conducted from 2007 to 2009. Prevalence rates were estimated for female and male patients with RA in terms of age, residence, education, income level, and occupation type. The female respondents aged 45 to 64 were divided into the RA population and the non-RA population in order to compare the employment status between the two groups. The annual physician-diagnosed RA prevalence rate was 1.45%. The prevalence rate was 2.27% for women and 0.62% for men. Individuals with RA had a significantly lower employment rate than individuals without RA (41.7 vs. 68.1%). The main reason for non-employment among RA patients was health-related problems (47.1%). There was statistically significant difference in employment type among the two groups. The experience rates for sick leave and sick-in-bed due to RA were 1.7 and 3.9%, respectively. Middle- and old-aged women accounted for the majority of the Korean RA population, which had a significant lower employment rate compared to the population without RA for both sexes. RA resulted in considerable productivity loss in Korea.

  11. Measuring the radium quartet (228Ra, 226Ra, 224Ra, 223Ra) in seawater samples using gamma spectrometry

    International Nuclear Information System (INIS)

    Beek, P. van; Souhaut, M.; Reyss, J.-L.

    2010-01-01

    Radium isotopes are widely used in marine studies (eg. to trace water masses, to quantify mixing processes or to study submarine groundwater discharge). While 228 Ra and 226 Ra are usually measured using gamma spectrometry, short-lived Ra isotopes ( 224 Ra and 223 Ra) are usually measured using a Radium Delayed Coincidence Counter (RaDeCC). Here we show that the four radium isotopes can be analyzed using gamma spectrometry. We report 226 Ra, 228 Ra, 224 Ra, 223 Ra activities measured using low-background gamma spectrometry in standard samples, in water samples collected in the vicinity of our laboratory (La Palme and Vaccares lagoons, France) but also in seawater samples collected in the plume of the Amazon river, off French Guyana (AMANDES project). The 223 Ra and 224 Ra activities determined in these samples using gamma spectrometry were compared to the activities determined using RaDeCC. Activities determined using the two techniques are in good agreement. Uncertainties associated with the 224 Ra activities are similar for the two techniques. RaDeCC is more sensitive for the detection of low 223 Ra activities. Gamma spectrometry thus constitutes an alternate method for the determination of short-lived Ra isotopes.

  12. Calibration of the PROMIS Physical Function Item Bank in Dutch Patients with Rheumatoid Arthritis

    NARCIS (Netherlands)

    Oude Voshaar, M.A.H.; ten Klooster, P.M.; Glas, C.A.W.; Vonkeman, H.E.; Taal, E; Krishnan, E.; Moens, H.J.B.; Boers, M.; Terwee, C.B.; van Riel, P.L.C.M.; van de Laar, M.A.F.J.

    2014-01-01

    Objective: To calibrate the Dutch-Flemish version of the PROMIS physical function (PF) item bank in patients with rheumatoid arthritis (RA) and to evaluate cross-cultural measurement equivalence with US general population and RA data. Methods: Data were collected from RA patients enrolled in the

  13. Does a family history of RA influence the clinical presentation and treatment response in RA?

    Science.gov (United States)

    Frisell, Thomas; Saevarsdottir, Saedis; Askling, Johan

    2016-06-01

    To assess whether family history of rheumatoid arthritis (RA), among the strongest risk factors for developing RA, also carries information on the clinical presentation and treatment response. The prospective Swedish Rheumatology register was linked to family history of RA, defined as diagnosed RA in any first-degree relative, ascertained through the Swedish Multi-Generation and Patient registers. Clinical presentation was examined among patients with early RA 2000-2011 (symptom onset clinical characteristics, drug survival, European League Against Rheumatism (EULAR) response and change in disease activity at 3 and 6 months was estimated using linear and generalised logistic regression models. Correlation in relatives' response measures was also assessed. Patients with early RA with family history of RA were more often rheumatoid factor positive, but with no other clinically meaningful differences in their clinical presentation. Family history of RA did not predict response to MTX or TNFi, with the possible exception of no versus good EULAR response to TNFi at 6 months (OR=1.4, 95% CI 1.1 to 1.7). Having a relative who discontinued TNFi within a year increased the odds of doing the same (OR=3.7, 95% CI 1.8 to 7.5), although we found no significant familial correlations in change in disease activity measures. Family history of RA did not modify the clinical presentation of RA or predict response to standard treatment with MTX or TNFi. Treatment response, particularly drug survival, may itself be familial. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  14. The association of fatigue, comorbidity burden, disease activity, disability and gross domestic product in patients with rheumatiod arthritis. Results from 34 countries participating in the Quest-RA programme

    NARCIS (Netherlands)

    Grøn, K.L.; Ørnbjerg, L.M.; Hetland, M.L.; Aslam, F.; Khan, N.A.; Jacobs, J.W.G.; Henrohn, D.; Rasker, Johannes J.; Kauppi, M.J.; Lang, H.C.; Mota, L.M.H.; Aggarwal, A.; Yamanaka, H.; Badsha, H.; Gossec, L.; Cutolo, M.; Ferraccioli, G.; Gremese, E.; Bong Lee, E.; Inanc, N.; Direskeneli, H.; Taylor, Peter; Huisman, Marieke; Alten, R.; Pohl, C.; Oyoo, O.; Stropuviene, S.; Drosos, A.A.; Kerzberg, E.; Ancuta, C.; Mofti, A.; Bergman, M.; Detert, J.; Selim, Z.I.; Abda, E.A.; Rexhepi, B.; Sokka, T.

    2014-01-01

    OBJECTIVES: The aim is to assess the prevalence of comorbidities and to further analyse to which degree fatigue can be explained by comorbidity burden, disease activity, disability and gross domestic product (GDP) in patients with rheumatoid arthritis (RA).METHODS: Nine thousands eight hundred

  15. The association of fatigue, comorbidity burden, disease activity, disability and gross domestic product in patients with rheumatoid arthritis. Results from 34 countries participating in the Quest-RA program

    DEFF Research Database (Denmark)

    Grøn, Kathrine Lederballe; Ornbjerg, Lykke Midtbøll; Hetland, Merete Lund

    2014-01-01

    OBJECTIVES: The aim is to assess the prevalence of comorbidities and to further analyse to which degree fatigue can be explained by comorbidity burden, disease activity, disability and gross domestic product (GDP) in patients with rheumatoid arthritis (RA). METHODS: Nine thousands eight hundred...

  16. Determination of 226Ra and 228Ra in gypsum

    International Nuclear Information System (INIS)

    Godoy, J.M.

    1989-01-01

    The content of 226 Ra and 228 Ra in different samples of phosphogypsum and three samples of gypsite were determined by gamma spectroscopy. For 226 Ra the 295, 352 and 609 KeV lines and for 228 Ra the 911 and 969 KeV lines were used. The specific activities values ranged from 0.36 to 22.8 pCi/g for 226 Ra and 0.90 to 10.3 pCi/g for 228 Ra. The contribution of a sypsum roof-covering to the 222 Rn concentration in a room was estimated, based on the highest value reported. (author) [pt

  17. Evaluation of Real-World Experience with Tofacitinib Compared with Adalimumab, Etanercept, and Abatacept in RA Patients with 1 Previous Biologic DMARD: Data from a U.S. Administrative Claims Database.

    Science.gov (United States)

    Harnett, James; Gerber, Robert; Gruben, David; Koenig, Andrew S; Chen, Connie

    2016-12-01

    Real-world data comparing tofacitinib with biologic disease-modifying antirheumatic drugs (bDMARDs) are limited. To compare characteristics, treatment patterns, and costs of patients with rheumatoid arthritis (RA) receiving tofacitinib versus the most common bDMARDs (adalimumab [ADA], etanercept [ETN], and abatacept [ABA]) following a single bDMARD in a U.S. administrative claims database. This study was a retrospective cohort analysis of patients aged ≥ 18 years with an RA diagnosis (ICD-9-CM codes 714.0x-714.4x; 714.81) and 1 previous bDMARD filling ≥ 1 tofacitinib or bDMARD claim in the Truven MarketScan Commercial and Medicare Supplemental claims databases (November 1, 2012-October 31, 2014). Monotherapy was defined as absence of conventional synthetic DMARDs within 90 days post-index. Persistence was evaluated using a 60-day gap. Adherence was assessed using proportion of days covered (PDC). RA-related total, pharmacy, and medical costs were evaluated in the 12-month pre- and post-index periods. Treatment patterns and costs were adjusted using linear models including a common set of clinically relevant variables of interest (e.g., previous RA treatments), which were assessed separately using t-tests and chi-squared tests. Overall, 392 patients initiated tofacitinib; 178 patients initiated ADA; 118 patients initiated ETN; and 191 patients initiated ABA. Tofacitinib patients were older versus ADA patients (P = 0.0153) and had a lower proportion of Medicare supplemental patients versus ABA patients (P = 0.0095). Twelve-month pre-index bDMARD use was greater in tofacitinib patients (77.6%) versus bDMARD cohorts (47.6%-59.6%). Tofacitinib patients had greater 12-month pre-index RA-related total costs versus bDMARD cohorts (all P 0.10) proportion of patients were persistent with tofacitinib (42.6%) versus ADA (37.6%), ETN (42.4%), and ABA (43.5%). Mean PDC was 0.55 for tofacitinib versus 0.57 (ADA), 0.59 (ETN), and 0.44 (ABA; P = 0.0003). Adjusted analyses

  18. Decrease in sick leave among patients with rheumatoid arthritis in the first 12 months after start of treatment with tumour necrosis factor antagonists: a population-based controlled cohort study.

    Science.gov (United States)

    Olofsson, Tor; Englund, Martin; Saxne, Tore; Jöud, Anna; Jacobsson, Lennart T H; Geborek, Pierre; Allaire, Saralynn; Petersson, Ingemar F

    2010-12-01

    To investigate the effect of tumour necrosis factor (TNF) antagonist treatment of patients with rheumatoid arthritis (RA) on sick leave (SL) and disability pension (DP) in a population-based setting in southern Sweden. All patients with RA in the South Swedish Arthritis Treatment Group register living in the county of Skåne (population 1.2 million), who started their first treatment with a TNF antagonist between January 2004 and December 2007 and were 18-58 years at treatment start (n = 365), were identified. For each patient with RA, four matched reference subjects from the general population were randomly selected. Data were linked to the Swedish Social Insurance Agency register and the point prevalence of SL and DP as well as days of SL and DP per month were calculated from 360 days before until 360 days after treatment start. At treatment start 38.6% of the patients with RA were registered for SL. During the first 6 months this share dropped to 28.5% (decrease by 26.2%, ptreatment year. Comparing patients with RA to the reference group the relative risk of being on SL was 6.6 (95% CI 5.2 to 8.5) at initiation of anti-TNF treatment and 5.2 (95% CI 4.0 to 6.8) 1 year after that. The corresponding figures for DP were 3.4 (95% CI 2.7 to 4.2) and 3.2 (95% CI 2.7 to 3.9). There was a marked decline in SL during the first 6 months of TNF antagonist treatment in patients with RA in southern Sweden, maintained throughout the first year, which was not offset by a corresponding increase in DP.

  19. Analysis of the cell infiltrate and expression of matrix metalloproteinases and granzyme B in paired synovial biopsy specimens from the cartilage-pannus junction in patients with RA

    NARCIS (Netherlands)

    Smeets, T. J.; Kraan, M. C.; Galjaard, S.; Youssef, P. P.; Smith, M. D.; Tak, P. P.

    2001-01-01

    Examination of synovial tissue (ST) obtained at surgery because of end stage destructive rheumatoid arthritis (RA) showed that macrophages and fibroblasts are the major cell types at the cartilage-pannus junction (CPJ). This study aimed at defining the cell infiltrate and mediators of joint

  20. Sedentary behaviour in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Thomsen, Tanja; Beyer, Nina; Aadahl, Mette

    2015-01-01

    BACKGROUND: Despite increasing interest in investigating sedentary behaviour (SB) in the general population and in patients with rheumatoid arthritis (RA), there is little documentation of the subjective experiences of SB in patients with RA. This study aimed to examine how patients with RA...... modification of physical activity level causing increase in SB, especially during periods of disease flare. Prioritizing and planning of SB also functioned as part of self-management strategies. 3) It has nothing to do with my arthritis; for some patients, SB was not related to RA, but simply reflected a way...

  1. Cardiovascular safety of biologic therapies for the treatment of RA.

    Science.gov (United States)

    Greenberg, Jeffrey D; Furer, Victoria; Farkouh, Michael E

    2011-11-15

    Cardiovascular disease represents a major source of extra-articular comorbidity in patients with rheumatoid arthritis (RA). A combination of traditional cardiovascular risk factors and RA-related factors accounts for the excess risk in RA. Among RA-related factors, chronic systemic inflammation has been implicated in the pathogenesis and progression of atherosclerosis. A growing body of evidence--mainly derived from observational databases and registries--suggests that specific RA therapies, including methotrexate and anti-TNF biologic agents, can reduce the risk of future cardiovascular events in patients with RA. The cardiovascular profile of other biologic therapies for the treatment of RA has not been adequately studied, including of investigational drugs that improve systemic inflammation but alter traditional cardiovascular risk factors. In the absence of large clinical trials adequately powered to detect differences in cardiovascular events between biologic drugs in RA, deriving firm conclusions on cardiovascular safety is challenging. Nevertheless, observational research using large registries has emerged as a promising approach to study the cardiovascular risk of emerging RA biologic therapies.

  2. Estuarine geochemistry of 224Ra, 226Ra, and 222Rn

    International Nuclear Information System (INIS)

    Elsinger, R.J.

    1982-01-01

    Desorption from river borne sediments is the most likely source of the excess 226 Ra. Laboratory mixing experiments on Pee Dee River sediments show an increase in 226 Ra desorption with increasing salinities with maximum desorption occurring at or above 20 0 /oo salinity. Desorption and diffusion are the sources for 226 Ra in the estuarine systems. In Winyah Bay the 228 Ra/ 226 Ra activity ratio does not change significantly with salinity, averaging around 1.4, indicating desorption as the major source of 228 Ra. In the Yangtze River the 228 Ra/ 226 Ra activity ratio is constant (approx.1.90) until increasing linearly above 16 0 /oo. A diffusive flux from regeneration by 232 Th decay in shelf sediments is the source of the increase. In Delaware Bay 228 Ra increases faster than 226 Ra in the less than or equal to22 0 /oo water, indicating a source in addition to desorption. The increase can be balanced by a 0.33 dpm/cm 2 -year flux over the upper part of the Bay where fine grained sediments predominate. 224 Ra behavior is controlled by its 3.64 day half-life. In Winyah Bay a flux of around 0.4 dpm/cm 2 -day is necessary to support the standing crop of non-desorbed 224 Ra in the water column. In Delaware Bay the nearly constant 224 Ra in concentration over the 2.5 0 /oo to 12 0 /oo salinity range are maintained by regeneration from 228 Th in the turbidity maximum zones and diffusion from bottom sediments. Water leaving on ebb tide from a salt marsh on Delaware Bay had increases in all three radium isotopes ( 224 Ra > 228 Ra > 226 Ra) compared to water coming in on the flood tide. Excess 222 Rn concentrations in a fresh water section of the Pee Dee River show a decreasing downstream gradient. Using these gradients to determine evasion rates, stagnant film thicknesses range from 21μ to 62μ

  3. IL-1Ra: its role in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    M. Cutolo

    2011-09-01

    Full Text Available Interleukin-1 (IL-1 is one of the pivotal cytokines in initiating and driving the processes of rheumatoid arthritis (RA, and the body’s natural response, IL-1 receptor antagonist (IL-1Ra, has been shown conclusively to block its effects. IL-1 mediate several clinical symptoms of the inflammatory reaction (i.e. fever, pain, sleep disturbances. IL-1 is considered a key mediator in RA joint damage because of its greater capacity (greater than TNF of increasing matrix degradation by inducing the production of MMPs and PGE2 in synovial cells, as well by its role as mediator of bone and cartilage destruction. In addition, IL-1 decreases the repair process by suppressing matrix synthesis and shows a strong synergism with TNF in inducing many inflammatory genes at both local and systemic level. The induced endogenous production of IL-1Ra, in presence of the RA synovitis, is too low to contrast the high affinity of IL-1 for the cell receptors. Therefore, IL-1Ra presence should result in very effective prevention of IL-1 signal transduction particularly in the inflammatory site. In laboratory and animal studies inhibition of IL-1 by either antibodies to IL-1 or IL-1Ra proved beneficial to the outcome. IL-1Ra is a member of the IL-1 superfamily. The effects of different DMARDs on IL-1Ra levels in RA patients support the important role that selected anticytokine treatments might exert in the pathophysiology of the disease. However, since anti TNFα therapy it is not effective in all RA patients, nor does it fully control the arthritic process in affected joints of good responders and complete TNF suppression should be avoided, the combined treatment with intermediate doses of TNF and IL-1 blockers, reaching synergistic suppression of arthritis, seems warranted in RA.

  4. Effects of interleukin-1 receptor antagonist (IL-1Ra) gene 86 bp VNTR polymorphism on recurrent pregnancy loss: a case-control study.

    Science.gov (United States)

    Hajizadeh, Yasamin Sayed; Emami, Elina; Nottagh, Marina; Amini, Zahra; Maroufi, Nazila Fathi; Azimian, Saba Haj; Isazadeh, Alireza

    2017-05-26

    Objective Recurrent pregnancy loss (RPL) is a heterogeneous disease which is defined as two or more consecutive fetal losses during early pregnancy. Interleukin-1 receptor antagonist (IL-1Ra) is a anti-inflammatory cytokine, which inhibits IL-1 activity by binding to its receptors. The aim of this study was to investigate the association between RPL and IL-1Ra intron 2 polymorphism (86 bp VNTR) in Iranian women. Materials and methods In this case control study, genetic polymorphism was studied in 140 RPL patients and 140 healthy women as controls. Genomic DNA was extracted from the blood samples and polymorphism analysis was performed using the polymerase chain reaction (PCR) method. Finally, the data obtained were analyzed by statistical software. Results We found an increased frequency of the IL-1Ra 1/1 genotype in the case group compared to the control group. Whereas, the frequency of IL-1Ra genotype 1/2 was higher in control group than in the case group. However, we did not observe an association between IL-1Ra 86 bp VNTR polymorphism in intron 2 and RPL patients (p > 0.05). Conclusion IL-1Ra VNTR polymorphism may not be a genetic factor for RPL. However, investigation of IL-1Ra polymorphism was recommended in other populations and patients with recurrent pregnancy loss.

  5. Growth retardation in children injected with 224Ra

    International Nuclear Information System (INIS)

    Spiess, H.; Mays, C.W.; Spiess-Paulus, E.

    1986-01-01

    We have obtained the adult heights of 133 patients formerly injected with 224 Ra as juveniles. 224 Ra induced growth retardation was greatest in children injected at young ages and increased with dose. The growth retardation was well represented as a 2% decrease in potential growth post irradiation per 100 rads of calculated average skeletal dose. (orig.)

  6. TARGETED INFORMATION ON METHOTREXATE AND LIFTING ALCOHOL RESTRICTIONS IN PATIENTS WITH RA AND PSA IS SAFE AND REDUCES PATIENTS' NEGATIVE BELIEFS

    DEFF Research Database (Denmark)

    Larsen, Janni Lisander; Nordin, Henrik

    Background Research regarding potential interaction between use of Methotrexate (MTX) and alcohol consumption is sparse (1-2, 5). Nevertheless patients traditionally are advised against alcohol intake while on MTX for safety reasons. Furthermore MTX generally is perceived by doctors and patients ...

  7. Mental health, fatigue and function are associated with increased risk of disease flare following TNF inhibitor tapering in patients with rheumatoid arthritis: an exploratory analysis of data from the Optimizing TNF Tapering in RA (OPTTIRA) trial.

    Science.gov (United States)

    Bechman, Katie; Sin, Fang En; Ibrahim, Fowzia; Norton, Sam; Matcham, Faith; Scott, David Lloyd; Cope, Andrew; Galloway, James

    2018-01-01

    Tapering of anti-tumour necrosis factor (TNF) therapy appears feasible, safe and effective in selected patients with rheumatoid arthritis (RA). Depression is highly prevalent in RA and may impact on flare incidence through various mechanisms. This study aims to investigate if psychological states predict flare in patients' dose tapering their anti-TNF therapy. This study is a post-hoc analysis of the Optimizing TNF Tapering in RA trial, a multicentre, randomised, open-label study investigating anti-TNF tapering in RA patients with sustained low disease activity. Patient-reported outcomes (Health Assessment Questionnaire, EuroQol 5-dimension scale, Functional Assessment of Chronic Illness Therapy fatigue scale (FACIT-F), 36-Item Short Form Survey (SF-36)) were collected at baseline. The primary outcome was flare, defined as an increase in 28-joint count Disease Activity Score (DAS28) ≥0.6 and ≥1 swollen joint. Discrete-time survival models were used to identify patient-reported outcomes that predict flare. Ninety-seven patients were randomised to taper their anti-TNF dose by either 33% or 66%. Forty-one patients flared. Higher baseline DAS28 score was associated with flare (adjusted HR 1.96 (95% CI 1.18 to 3.24), p=0.01). Disability (SF-36 physical component score), fatigue (FACIT-F) and mental health (SF-36 mental health subscale (MH)) predicted flare in unadjusted models. In multivariate analyses, only SF-36 MH remained a statistically significant predictor of flare (adjusted HR per 10 units 0.74 (95% CI 0.60 to 0.93), p=0.01). Baseline DAS28 and mental health status are independently associated with flare in patients who taper their anti-TNF therapy. Fatigue and function also associate with flare but the effect disappears when adjusting for confounders. Given these findings, mental health and functional status should be considered in anti-TNF tapering decisions in order to optimise the likelihood of success. EudraCT Number: 2010-020738-24; ISRCTN: 28955701

  8. Population pharmacokinetics of vancomycin in Jordanian patients

    African Journals Online (AJOL)

    predictors of vancomycin clearance include: weight, serum creatinine, chronic renal ... (http://www.budapestopenaccessinitiative.org/read), which permit ... reproduction in any medium, provided the original work is properly credited. ... fluid balance; and albumin levels]); (3) .... vancomycin half-life is prolonged in patients with.

  9. 226Ra, 228Ra, 223Ra, and 224Ra in coastal waters with application to coastal dynamics and groundwater input

    International Nuclear Information System (INIS)

    Moore, W.S.

    1997-01-01

    Four radium isotopes offer promise in unraveling the complex dynamics of coastal ocean circulation and groundwater input. Each isotope is produced by decay of a thorium parent bound to sediment. The activities of these thorium isotopes and the sediment-water distribution coefficient for radium provide an estimate of the source function of each Ra isotope to the water. In salt marshes that receive little surface water input, Ra activities which exceed coastal ocean values must originate within the marsh. In North Inlet, South Carolina, the activities of 226 Ra exported from the marsh far exceed the activities generated within the marsh. To supply the exported activities, substantial groundwater input is required. In the coastal region itself, 226 Ra activities exceed the amount that can be supplied from rivers. Here also, substantial groundwater input is required. Within the coastal ocean, 223 Ra and 224 Ra may be used to determine mixing rates with offshore waters. Shore-perpendicular profiles of 223 Ra and 224 Ra show consistent trends which may be modeled as eddy diffusion coefficients of 350-540 m 2 s -1 . These coefficients allow an assessment of cross-shelf transport and provide further insight on the importance of groundwater to coastal regions. (author)

  10. Incidence and time trends of Herpes zoster in rheumatoid arthritis: a population-based cohort study

    Science.gov (United States)

    Veetil, Bharath Manu Akkara; Myasoedova, Elena; Matteson, Eric L.; Gabriel, Sherine E.; Green, Abigail B.; Crowson, Cynthia S.

    2012-01-01

    Objective To determine the incidence, time trends, risk factors and severity of herpes zoster (HZ) in a population-based incidence cohort of patients with rheumatoid arthritis (RA) compared to a group of individuals without RA from the same population. Methods All residents of Olmsted County, MN who first fulfilled 1987 American College of Rheumatology criteria for RA between 1/1/1980 and 12/31/2007 and a cohort of similar residents without RA were assembled and followed by retrospective chart review until death, migration, or 12/31/2008. Results There was no difference in the presence of HZ prior to RA incidence/index date between the cohorts (p=0.85). During follow-up 84 patients with RA (rate: 12.1 per 1000 person-years) and 44 subjects without RA (rate: 5.4 per 1000 person-years) developed HZ. Patients with RA were more likely to develop HZ than those without RA (hazard ratio: 2.4; 95% confidence interval: 1.7, 3.5). Patients diagnosed with RA in 1995–2007 had a higher likelihood of developing HZ than those diagnosed in 1980–1994. Erosive disease, previous joint surgery, use of hydroxychloroquine and corticosteroids were significantly associated with the development of HZ in RA, while the use of methotrexate or biologic agents was not. Complications of HZ occurred at a similar rate in both cohorts. Conclusion The incidence of HZ is increased in RA and has risen in recent years. The increasing incidence of HZ in more recent years is also noted in the general population. RA disease severity is associated with development of HZ. PMID:23281295

  11. Causes of death in rheumatoid arthritis: How do they compare to the general population?

    Science.gov (United States)

    Widdifield, Jessica; Paterson, J Michael; Huang, Anjie; Bernatsky, Sasha

    2018-03-07

    To compare mortality rates, underlying causes of death, excess mortality and years of potential life lost (YPLL) among rheumatoid arthritis (RA) patients relative to the general population. We studied an inception cohort of 87,114 Ontario RA patients and 348,456 age/sex/area-matched general population comparators over 2000 to 2013. All-cause, cause-specific, and excess mortality rates, mortality rate ratios (MRRs), and YPLL were estimated. A total of 11,778 (14% of) RA patients and 32,472 (9% of) comparators died during 508,385 and 1,769,365 person-years (PY) of follow-up, respectively, for corresponding mortality rates of 232 (95% CI 228, 236) and 184 (95% CI 182, 186) per 10,000 PYs. Leading causes of death in both groups were diseases of the circulatory system, cancer, and respiratory conditions. Increased mortality for all-cause and specific causes was observed in RA relative to the general population. MRRs were elevated for most causes of death. Age-specific mortality ratios illustrated a high excess mortality among RA patients under 45 years of age for respiratory disease and circulatory disease. RA patients lost 7,436 potential years of life per 10,000 persons, compared with 4,083 YPLL among those without RA. Mortality rates were increased in RA patients relative to the general population across most causes of death. The potential life years lost (before the age of 75) among RA patients was roughly double that among those without RA, reflecting higher rate ratios for most causes of death and RA patients dying at earlier ages. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  12. RA reactor operation and maintenance; Pogon i odrzavanje reaktora RA

    Energy Technology Data Exchange (ETDEWEB)

    Zecevic, V [Institute of Nuclear Sciences Boris Kidric, Reaktor RA, Vinca, Beograd (Serbia and Montenegro)

    1963-02-15

    This volume includes the final report on RA reactor operation and utilization of the experimental facilities in 1962, detailed analysis of the system for heavy water distillation and calibration of the system for measuring the activity of the air.

  13. RA reactor operation and maintenance

    International Nuclear Information System (INIS)

    Zecevic, V.

    1963-02-01

    This volume includes the final report on RA reactor operation and utilization of the experimental facilities in 1962, detailed analysis of the system for heavy water distillation and calibration of the system for measuring the activity of the air

  14. Automated measurement of 224Ra and 226Ra in water

    International Nuclear Information System (INIS)

    Dimova, N.; Burnett, W.C.; Horwitz, E.P.; Lane-Smith, D.

    2007-01-01

    We present a new simple approach for automated, non-destructive measurement of the alpha-emitting radium isotopes ( 223 Ra, 224 Ra, and 226 Ra) in water based on the emanation of their respective radon daughters ( 219 Rn, 220 Rn, and 222 Rn). The method combines the high adsorption uptake of MnO 2 Resin for radium (K d =2.4x10 4 ml/g) over a wide pH range with the simplicity of the activity registration using a commercial radon-in-air analyzer (RAD7, DURRIDGE Company, Inc). Radium is first adsorbed onto the MnO 2 Resin by passing a water sample through the resin packed in a gas-tight glass cartridge. The same cartridge is then connected to the radon analyzer via a simple tubing system to circulate air through the resin and a drying system. The efficiency of the proposed system is determined by running standards prepared in the same manner. Our results indicate that the efficiency for 226 Ra is >22% if both 218 Po and 214 Po counts are collected. This is comparable with typical efficiencies for alpha spectrometry but with much less sample preparation. We estimate that an MDA of 0.8 pCi/L for 226 Ra may be obtained with this new approach using a 1 L water sample and less than 4 h of counting

  15. Measuring the radium quartet ({sup 228}Ra, {sup 226}Ra, {sup 224}Ra, {sup 223}Ra) in seawater samples using gamma spectrometry

    Energy Technology Data Exchange (ETDEWEB)

    Beek, P. van, E-mail: vanbeek@legos.obs-mip.f [LEGOS, Laboratoire d' Etudes en Geophysique et Oceanographie Spatiales (CNRS/CNES/IRD/UPS), Observatoire Midi Pyrenees, 14 Avenue Edouard Belin, 31400 Toulouse (France); Souhaut, M. [LEGOS, Laboratoire d' Etudes en Geophysique et Oceanographie Spatiales (CNRS/CNES/IRD/UPS), Observatoire Midi Pyrenees, 14 Avenue Edouard Belin, 31400 Toulouse (France); Reyss, J.-L. [LSCE, Laboratoire des Sciences du Climat et de l' Environnement (CNRS/CEA/UVSQ), Avenue de la Terrasse, 91198 Gif-sur-Yvette (France)

    2010-07-15

    Radium isotopes are widely used in marine studies (eg. to trace water masses, to quantify mixing processes or to study submarine groundwater discharge). While {sup 228}Ra and {sup 226}Ra are usually measured using gamma spectrometry, short-lived Ra isotopes ({sup 224}Ra and {sup 223}Ra) are usually measured using a Radium Delayed Coincidence Counter (RaDeCC). Here we show that the four radium isotopes can be analyzed using gamma spectrometry. We report {sup 226}Ra, {sup 228}Ra, {sup 224}Ra, {sup 223}Ra activities measured using low-background gamma spectrometry in standard samples, in water samples collected in the vicinity of our laboratory (La Palme and Vaccares lagoons, France) but also in seawater samples collected in the plume of the Amazon river, off French Guyana (AMANDES project). The {sup 223}Ra and {sup 224}Ra activities determined in these samples using gamma spectrometry were compared to the activities determined using RaDeCC. Activities determined using the two techniques are in good agreement. Uncertainties associated with the {sup 224}Ra activities are similar for the two techniques. RaDeCC is more sensitive for the detection of low {sup 223}Ra activities. Gamma spectrometry thus constitutes an alternate method for the determination of short-lived Ra isotopes.

  16. Interleukin-4 (IL4 and Interleukin-4 receptor (IL4RA polymorphisms in asthma: a case control study

    Directory of Open Access Journals (Sweden)

    Lorente Félix

    2005-11-01

    Full Text Available Abstract Background IL4/IL4RA pathway plays an important role in atopy and asthma. Different polymorphisms in IL4 and IL4RA genes have been described. Particularly, -33C>TIL4 and 576Q>RIL4RA SNPs have been independently associated to atopy and asthma. The purpose of this study was to analyse these polymorphisms in a population of patients with a well-characterized asthma phenotype. Methods A total of 212 unrelated Caucasian individuals, 133 patients with asthma and 79 healthy subjects without symptoms or history of asthma or atopy and with negative skin prick tests were recruited. Lung function was measured by spirometry and asthma was specialist physician-diagnosed according to the ATS (American Thoracic Society criteria and classified following the GINA (Global Initiative for Asthma guidelines. Skin prick tests were performed according to EAACI recommendations. -33C>TIL4 was studied with TaqMan assay and 576Q>RIL4RA by PCR-RFLP technique. Hardy-Weinberg equilibrium was analysed in all groups. Dichotomous variables were analysed using χ2, Fisher exact test, Monte Carlo simulation test and odds ratio test. To model the effects of multiple covariates logistic regression was used. Results No statistically significant differences between the group of patients with asthma and the controls were found when the allele and genotype distribution of -33C>TIL4 and 576Q>RIL4RA polymorphisms were compared. However, the T allele of the -33C>TIL4 SNP was more frequent in patients with persistent asthma. Multivariate analysis adjusted for age and sex confirmed that carriers of allele T had an increased risk of persistent asthma (OR:2.77, 95%CI:1.18–6.49; p = 0.019. Analysis of combination of polymorphisms showed that patients carrying both the T allele of -33C>TIL4 and the A allele of 576Q>RIL4RA had an increased risk of asthma. This association was particularly observed in persistent asthma [Fisher's p value = 0.0021, Monte Carlo p value (after 104

  17. Avaliação da expressão de interleucina 1 beta (IL-1β e antagonista do receptor de interleucina 1 (IL-1Ra em pacientes com hanseníase Evaluation of the expression of interleukin 1 beta(IL-1β and interleukin 1 receptor antagonist (IL-1Ra in leprosy patients

    Directory of Open Access Journals (Sweden)

    Rosane Dias Costa

    2008-01-01

    Full Text Available A hanseníase é uma doença infectocontagiosa espectral que acompanha-se por uma série de eventos imunológicos desencadeados pela resposta do hospedeiro frente ao agente etiológico, o Mycobacterium leprae. Evidências sugerem que a indução e manutenção da resposta imune/inflamatória na hanseníase estão vinculadas a interações de múltiplas células e fatores solúveis, particularmente através da ação de citocinas. Nesse estudo, foram mensurados níveis de IL-1β e IL-1Ra de 37 casos novos de hanseníase acompanhados ao longo do tratamento e 30 controles sadios pelo teste ELISA. A coleta de sangue periférico foi realizada em quatro tempos para os casos de hanseníase (pré-tratamento com PQT, 2ª dose, 6ª dose e pós-PQT e em único momento para os controles. Na comparação dos níveis das moléculas de casos no pré-PQT e controles, houve diferença estatisticamente significativa somente para IL-1β. Nossos resultados sugerem a participação dessa citocina no processo imune/inflamatório.Leprosy is an infectious and contagious spectral disease accompanied by a series of immunological events triggered by the host's response to the etiologic agent, Mycobacterium leprae. Evidence suggests that the induction and maintenance of the immune/inflammatory response in leprosy are linked to multiple cell interactions and soluble factors, mainly through the action of cytokines. The ELISA test was used to measure the levels of IL-1β and IL-1Ra in 37 new leprosy patients followed-up during treatment and 30 healthy controls. Peripheral blood was collected four times during the treatment of leprosy patients (MDT pretreatment, 2nd dose, 6th dose and post-MDT, and only once from the controls. The comparison of molecular levels in pre-MDT patients and controls showed a statistically significant difference for IL-1β. The results suggest the participation of this cytokine in the genesis of the immune/inflammatory process.

  18. Regulations for RA reactor operation; Propisi nuklearnog reaktora 'RA'

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1980-09-15

    Regulations for RA reactor operation are written in accordance with the legal regulations defined by the Law about radiation protection and related legal acts, as well as technical standards according to the IAEA recommendations. The contents of this book include: fundamental data about the reactor; legal regulations for reactor operation; organizational scheme for reactor operation; general and detailed instructions for operation, behaviour in the reactor building, performing experiments; operating rules for operation under steady state and accidental conditions. [Serbo-Croat] Propisi o radu nuklearnog reaktora RA pisani su tako da svi zakonski propisi definisani 'Zakonom o zastiti od jonizujuceg zracenja' i pratecim propisima (devet pravilnika) kao i tehnicke norme prema preporukama MAAE budu postovani u punoj meri pri radu reaktora. Sadrzaj ove knjige obuhvata: osnovne podatke o reaktoru; zakonske propise; organizaciju rada reaktora RA; opste propise o rezimu rada, kretanju u zgradi reaktora, izvodjenju eksperimenata; pogonske propise za rad u normalnom rezimu i u slucaju udesa.

  19. Radiosensitivity and thermoresistance of rat RA-2 rhabdomyosarcoma cells

    International Nuclear Information System (INIS)

    Fedorova, E.V.; Trusova, V.D.; Vakhtin, Yu.B.

    1990-01-01

    The data obtained show that clonogenic RA-2T cells are 2-3 times more thermoresistant than clonogenic cells of the original thermosensitive RA-2T strain as estimated by D 0 value upon heating up to 43-45 deg C. After X-irradiation of rat rhabdomyosarcoma, a decrease in the capacity of forming pulmonary colonies is more pronounced in cells of the thermosensitive RA-2 strain cells than in those of the thermoresistant strain RA-2T (D 0 =1.6 Gy and D 0 =2.4 Gy, respectively). In all appearance, within one and the same tumor cell population, the hereditarily thermoresistant cells are more radioresistant than the thermosensitive ones

  20. The association of fatigue, comorbidity burden, disease activity, disability and gross domestic product in patients with rheumatoid arthritis. Results from 34 countries participating in the Quest-RA program.

    Science.gov (United States)

    Grøn, Kathrine Lederballe; Ornbjerg, Lykke Midtbøll; Hetland, Merete Lund; Aslam, Fawad; Khan, Nasim A; Jacobs, Johannes W G; Henrohn, Dan; Rasker, J J; Kauppi, Markku J; Lang, Hui-Chu; Mota, Licia M H; Aggarwal, Amita; Yamanaka, Hisahi; Badsha, Humeira; Gossec, Laure; Cutolo, Maurizio; Ferraccioli, Gianfranco; Gremese, Elisa; Bong Lee, Eun; Inanc, Nevsun; Direskeneli, Haner; Taylor, Peter; Huisman, Margriet; Alten, Rieke; Pohl, Christoph; Oyoo, Omondi; Stropuviene, Sigita; Drosos, Alexandrosos A; Kerzberg, Eduardo; Ancuta, Codorina; Mofti, Ayman; Bergman, Martin; Detert, Jaqueline; Selim, Zaraa I; Abda, Essam A; Rexhepi, Blerta; Sokka, Tuulikki

    2014-01-01

    The aim is to assess the prevalence of comorbidities and to further analyse to which degree fatigue can be explained by comorbidity burden, disease activity, disability and gross domestic product (GDP) in patients with rheumatoid arthritis (RA). Nine thousands eight hundred seventy-four patients from 34 countries, 16 with high GDP (>24.000 US dollars [USD] per capita) and 18 low-GDP countries (6.6) compared with 23.0% in high-GDP countries (p<0.001). In univariate analysis, fatigue increased with increasing number of comorbidities, disease activity and disability in both high- and low-GDP countries. In multivariate analysis of all countries, these 3 variables explained 29.4% of the variability, whereas GDP was not significant. Fatigue is a widespread problem associated with high comorbidity burden, disease activity and disability regardless of GDP.

  1. A study of a reduction of patient's radiation exposure by using the new ortho screen film system. 3. A study of Kodak InSight EF/RA imaging system

    International Nuclear Information System (INIS)

    Yagi, Hiroshi; Imura, Hiroyoshi; Amano, Masafumi; Kuroda, Tokue; Nishitani, Hiromu.

    1995-01-01

    The developing temperature dependency of Kodak InSight EF/RA Image System (IEF system) was evaluated by measuring characteristic curve, resolution properties and noise RMS. Furthermore, the possibility of the reduction of the patient's exposure without decrease in image quality was evaluated. The physical imaging properties of screen/film systems were affected by the developing temperature. Except the gross fog, other imaging properties of IEF system on developing temperature was small. Especially it was confirmed that the developing temperature dependency of granularity of IEF system was less than those of the other new ortho screen film systems (Konica ES-C medical x-ray film of EX system and Fuji UR-1 medical x-ray film of AD system). Therefore, there is the possibility of the reduction of the patient's exposure by using the higher developing temperature than the traditional situation after due consideration of increasing the gross fog. (author)

  2. [The character of the morphological changes of the mucous membrane of the large intestine and the genetic polymorphism of IL-1RA, IL-1B, IL-4 TNFA in patient with irritable bowel syndrome].

    Science.gov (United States)

    Sarsenbaeva, A S; Ivanova, E L; Burmistrova, A L; Drozdov, I V

    2013-01-01

    The aim of this study was to evaluate the presence or absence of a relationship between the variants of the course of IBS and their association with genetic polymorphisms of genes and intergenic interaction of cytokines. The sample consisted of 81 patients, the diagnosis was verified according to the criteria of the Rome III, were isolated psychopathological, morphological complications, extra-intestinal symptoms. Polymorphism genotyping IL-1Ra, IL-b, IL-4, TNFa performed by PCR. Statistical treatment are a non-parametric analysis of multiple comparisons, hierarchical log-linear analysis. It is found out the relation between the clinical variants with morphological changes of the mucous membrane of the large intestine, the association between gender characteristics of patients with IBS is established and with genetic polymorphisms of cytokines.

  3. A population study on rheumatoid arthritis in Lesotho, southern Africa.

    Science.gov (United States)

    Moolenburgh, J D; Valkenburg, H A; Fourie, P B

    1986-01-01

    Motivated by the results of a hospital study on rheumatoid arthritis (RA) in Lesotho (southern Africa) a survey of inflammatory polyarthritis (IP) and RA was undertaken in a sample of the rural population of that country. Contrary to expectations the prevalence of IP grades 2-4 (definite disease) was low (0.4%) and equal in both sexes, while probable and definite RA combined (American Rheumatism Association (ARA) criteria) occurred in 1.8% of both males and females. RA was slightly more severe than in other rural African Negro studies but less so when compared with the disease condition of the patients observed in the hospital study. Rheumatoid factor and particularly that directed against heterologous antigen occurred in 41% of the RA patients and in 16% of the controls. Two thirds of the definite cases and 29% of the combined probable and definite group showed radiological abnormalities. PMID:3740998

  4. Determination of long-lived natural Ra isotopes, 226Ra, in mineral and spring waters from Caxambu (MG) and Aguas de Lindoia (SP) spas

    International Nuclear Information System (INIS)

    Negrao, Sergio Garcia

    2012-01-01

    Caxambu, except for Viotti Spring, Dom Pedro Spring and Dona Leopoldina Spring. In Aguas de Lindoia and Lindoia, the highest committed effective doses estimated were 8.4 10-3 mSv y-1 for the intake of 226 Ra (bottled mineral water Sao Jorge) and 2.6 10-2 mSv y-1 for 226 Ra (Santa Filomena spring - station 2). Both values are below the limit recommended by World Health Organization. The maximum committed effective doses per year obtained in this work were 7.4 10-1 mSv y-1 for 226 Ra (Venancio Spring) and 2.2 mSv y-1 for 228 Ra (Ernestina Guedes Spring). Considering the case of '2 26 Ra intake via mineral water, the dose obtained represents less than 31 % of the average effective dose attributable annually from natural background radiation. However, in the case of 228 Ra the annual committed effective dose limit recommended by ICRP (considering all sources of radiation exposure for the world population) was exceeded not only in Ernestina Guedes Spring, but also in Beleza Spring. (author)

  5. Moyamoya vasculopathy - Patient demographics and characteristics in the Finnish population.

    Science.gov (United States)

    Saarela, Marika; Mustanoja, Satu; Pekkola, Johanna; Tyni, Tiina; Hernesniemi, Juha; Kivipelto, Leena; Tatlisumak, Turgut

    2017-01-01

    Background and purpose Moyamoya vasculopathy, a rare steno-occlusive progressive cerebrovascular disorder, has not been thoroughly studied in Caucasian populations. We established a registry of Finnish patients treated at the Helsinki University Hospital, to collect and report demographic and clinical data. Methods We collected data both retrospectively and prospectively from all the patients with a moyamoya vasculopathy referred to our hospital between January 1987 and December 2014. All patients underwent a neurological outpatient clinic visit. Results We diagnosed 61 patients (50 females, 10 children) with moyamoya vasculopathy. The mean age at the disease-onset was 31.5 ± 17.9 years. The two most common presenting symptoms were ischemic stroke (n = 31) and hemorrhage (n = 8). Forty-four percent underwent revascularization surgery, and 70% were prescribed antithrombotic treatment. Conclusions The results support in part the Western phenotype of the disease considering the later presentation and larger female predominance compared to the Asian moyamoya vasculopathy reports. However, the proportion of ischemic strokes and hemorrhagic strokes is closer to Japanese population than German population. The absence of familial cases points to a different genetic profile in the Finnish patients.

  6. Diabetic vitrectomy in a large type 1 diabetes patient population

    DEFF Research Database (Denmark)

    Ostri, Christoffer; la Cour, Morten; Lund-Andersen, Henrik

    2014-01-01

    1996 and 2010. Surgical history was obtained from The Danish National Patient Register. RESULTS: The population consisted of 3980 patients with type 1 diabetes. Median follow-up was 10.0 years. In total, 106 patients underwent diabetic vitrectomy in the observation period. Surgery indications were...... nonclearing vitreous haemorrhage (43%) or tractional retinal detachment (57%). The cumulative incidence rates of diabetic vitrectomy were 1.6% after 5 years and 2.9% after 10 years. When excluding patients with no or mild diabetic retinopathy, the corresponding rates were higher; 3.7% and 6.4%, respectively...... (p diabetic vitrectomy increased in patients experiencing glycosylated haemoglobin A1c > 75 mmol/mol in the observation period (p

  7. Employment among patients with multiple sclerosis-a population study.

    Directory of Open Access Journals (Sweden)

    Hanne Marie Bøe Lunde

    Full Text Available To investigate demographic and clinical factors associated with employment in MS.The study included 213 (89.9% of all MS patients in Sogn and Fjordane County, Western Norway at December 31st 2010. The patients underwent clinical evaluation, structured interviews and completed self-reported questionnaires. Demographic and clinical factors were compared between patients being employed versus patients being unemployed and according to disease course of MS. Logistic regression analysis was used to identify factors independently associated with current employment.After a mean disease duration of almost 19 years, 45% of the population was currently full-time or part- time employed. Patients with relapsing -remitting MS (RRMS had higher employment rate than patients with secondary (SPMS and primary progressive (PPMS. Higher educated MS patients with lower age at onset, shorter disease duration, less severe disability and less fatigue were most likely to be employed.Nearly half of all MS patients were still employed after almost two decades of having MS. Lower age at onset, shorter disease duration, higher education, less fatigue and less disability were independently associated with current employment. These key clinical and demographic factors are important to understand the reasons to work ability in MS. The findings highlight the need for environmental adjustments at the workplace to accommodate individual 's needs in order to improve working ability among MS patients.

  8. Employment among patients with multiple sclerosis-a population study.

    Science.gov (United States)

    Bøe Lunde, Hanne Marie; Telstad, Wenche; Grytten, Nina; Kyte, Lars; Aarseth, Jan; Myhr, Kjell-Morten; Bø, Lars

    2014-01-01

    To investigate demographic and clinical factors associated with employment in MS. The study included 213 (89.9%) of all MS patients in Sogn and Fjordane County, Western Norway at December 31st 2010. The patients underwent clinical evaluation, structured interviews and completed self-reported questionnaires. Demographic and clinical factors were compared between patients being employed versus patients being unemployed and according to disease course of MS. Logistic regression analysis was used to identify factors independently associated with current employment. After a mean disease duration of almost 19 years, 45% of the population was currently full-time or part- time employed. Patients with relapsing -remitting MS (RRMS) had higher employment rate than patients with secondary (SPMS) and primary progressive (PPMS). Higher educated MS patients with lower age at onset, shorter disease duration, less severe disability and less fatigue were most likely to be employed. Nearly half of all MS patients were still employed after almost two decades of having MS. Lower age at onset, shorter disease duration, higher education, less fatigue and less disability were independently associated with current employment. These key clinical and demographic factors are important to understand the reasons to work ability in MS. The findings highlight the need for environmental adjustments at the workplace to accommodate individual 's needs in order to improve working ability among MS patients.

  9. Doses from 222Rn, 226Ra, and 228Ra in groundwater from Guarani aquifer, South America.

    Science.gov (United States)

    Bonotto, D M

    2004-01-01

    Groundwater samples were analysed for 222Rn, 226Ra, and 228Ra in Guarani aquifer spreading around 1 million km2 within four countries in South America, and it was found that their activity concentrations are lognormally distributed. Population-weighted average activity concentration for these radionuclides allowed to estimate a value either slightly higher (0.13 mSv/year) than 0.1 mSv for the total effective dose or two times higher (0.21 mSv/year) than this limit, depending on the choice of the dose conversion factor. Such calculation adds useful information for the appropriate management of this transboundary aquifer that is socially and economically very important to about 15 million inhabitants living in Brazil, Argentina, Uruguay and Paraguay.

  10. Doses from 222Rn, 226Ra, and 228Ra in groundwater from Guarani aquifer, South America

    International Nuclear Information System (INIS)

    Bonotto, D.M.

    2004-01-01

    Groundwater samples were analysed for 222 Rn, 226 Ra, and 228 Ra in Guarani aquifer spreading around 1 million km 2 within four countries in South America, and it was found that their activity concentrations are lognormally distributed. Population-weighted average activity concentration for these radionuclides allowed to estimate a value either slightly higher (0.13 mSv/year) than 0.1 mSv for the total effective dose or two times higher (0.21 mSv/year) than this limit, depending on the choice of the dose conversion factor. Such calculation adds useful information for the appropriate management of this transboundary aquifer that is socially and economically very important to about 15 million inhabitants living in Brazil, Argentina, Uruguay and Paraguay

  11. Gene polymorphisms and febrile neutropenia in acute leukemia--no association with IL-4, CCR-5, IL-1RA, but the MBL-2, ACE, and TLR-4 are associated with the disease in Turkish patients: a preliminary study.

    Science.gov (United States)

    Pehlivan, Mustafa; Sahin, Handan Haydaroğlu; Ozdilli, Kurşat; Onay, Hüseyin; Ozcan, Ali; Ozkinay, Ferda; Pehlivan, Sacide

    2014-07-01

    The aim of this study was to investigate the mannose-binding lectin 2 (MBL-2), interleukin (IL)-4, Toll-like receptor 4 (TLR-4), angiotensin converting enzyme (ACE), chemokine receptor 5 (CCR-5), and IL-1 receptor antagonist (RA) gene polymorphisms (GPs) in acute leukemias (ALs) and to evaluate their roles in febrile neutropenia (FN) resulting from chemotherapy. The study included 60 AL patients hospitalized between the period of July 2001 and August 2006. Polymorphisms for the genes ACE(I/D), CCR-5, IL-1RA, MBL-2, TLR-4, and IL-4 were typed by polymerase chain reaction (PCR) and/or PCR-restriction fragment length polymerase. Genotype frequencies for these genes were compared in the patient and control groups. The relationships between the genotypes and the body distribution of infections, pathogens, the duration of neutropenia, and febrile episodes in AL patients were evaluated. No significant differences in either the genotype distribution or the allelic frequencies of TLR-4, IL-4, CCR-5, IL-1RN GPs were observed between patients and healthy controls. The AB/BB genotype (53.3%) in the MBL-2 gene was found to be significantly higher in the AL patients compared with control groups. There were correlations between the presence of MBL-2, TLR-4, and ACE polymorphisms and clinical parameters due to FN. Overall, bacteremia was more common in MBL BB and ACE DD. Gram-positive bacteremia was more common in ACE for ID versus DD genotype. Gram-negative bacteremia was more common for both the MBL-2 AB/BB genotype and TLR-4 AG genotype. Median durations of febrile episodes were significantly shorter in ACE DD and MBL AB/BB. Although TLR-4, ACE, and MBL-2 GPs have been extensively investigated in different clinical pictures, this is the first study to evaluate the role of these polymorphisms in the genetic etiopathogenesis of FN in patients with ALs. As a conclusion, TLR-4, ACE, and MBL-2 genes might play roles in the genetic etiopathogenesis of FN in patients with ALs.

  12. Influence of Cigarette Smoking on Rheumatoid Arthritis Risk in the Han Chinese Population

    Directory of Open Access Journals (Sweden)

    Jian Yin

    2017-06-01

    Full Text Available ObjectivesCigarette smoking has been shown in European populations to be associated with rheumatoid arthritis (RA susceptibility. This study aims to examine the association of smoking with RA in the Han Chinese population.Methods718 Han Chinese RA patients and 404 healthy controls were studied. The associations of cigarette smoking (current, former or ever vs. never smokers, and pack-years of exposure with RA, anti-cyclic citrullinated peptide antibody (ACPA positive RA, IgM rheumatoid factor (RF positive RA, and baseline radiographic erosions (modified van der Heijde–Sharp scores were assessed. The interaction between smoking and the HLA-DRB1 shared epitope (SE in RA was also examined.ResultsIn this study, 11 (1.53% cases and 6 (1.49% controls were former smokers (p = 0.95, while 95 (13.23% cases and 48 (11.88% controls were current smokers (p = 0.52. Trends toward associations between smoking status (ever vs. never with RA-overall (p = 0.15, OR = 1.44, ACPA-positive RA (p = 0.24, OR = 1.37, RF-positive RA (p = 0.14, OR = 1.46, or the presence of radiographic erosions (p = 0.66, OR = 1.28 were observed although individually here were not statistically significant. There was no evidence of statistical interaction between smoking status (ever vs. never and SE for all RA, ACPA-positive RA, ACPA-negative RA, RF-positive RA, RF-negative RA (p = 0.37, 0.50, 0.24, 0.26, and 0.81 respectively, and the 95% CI for the attributable proportion for all interactions included 0.ConclusionThis is the first study to examine the association of cigarette smoking with RA in the Han Chinese population. This study shows a trend toward an interaction between smoking and SE carriage influencing the risk of RA, though findings were not statistically significant. It is possible that in the presence of universal exposure to heavy air pollution the effect of smoking on RA risk may be obscured.

  13. Population pharmacokinetics of ticagrelor in patients with acute coronary syndromes.

    Science.gov (United States)

    Li, Jianguo; Tang, Weifeng; Storey, Robert F; Husted, Steen; Teng, Renli

    2016-09-01

    Ticagrelor is an orally administered antiplatelet agent used to reduce thrombotic events in patients with acute coronary syndromes. Data from two studies in patients with acute coronary syndromes with large amounts of pharmacokinetic (PK) data (phase IIb DISPERSE-2 study (n = 609)); phase III PLATO PK substudy (n = 6,381)), along with non-linear mixed effects modeling software, were used to develop population PK models for ticagrelor and its metabolite, AR-C124910XX, and to evaluate the impact of demographic and clinical factors on the PK of ticagrelor and AR-C124910XX. 32 covariates relating to disease history, biomarkers, clinical chemistry, and concomitant medications were assessed. A one-compartment model with population mean PK parameters of firstorder absorption rate constant (0.67/h), apparent systemic clearance (14 L/h), and apparent volume of distribution (221 L) was shown to best describe the PK profile of ticagrelor. Patients co-administered moderate CYP3A inducers or inhibitors increased (by 110%, 95% confidence interval (CI), 52 - 192%) or decreased (by 64%, 95% CI, 39 - 73%) apparent ticagrelor clearance, respectively, while habitual smoking decreased apparent ticagrelor clearance by 22% (95% CI, 19 - 25%). Ticagrelor bioavailability was 21% (95% CI, 19 - 22%) lower at treatment initiation (visit 1) versus subsequent visits. Compared with Caucasian patients, ticagrelor bioavailability was 39% (95% CI, 33 - 46%) higher in Asian patients and 18% (95% CI, 6 - 28%) lower in Black patients. In the current analyses, the population PK models developed for ticagrelor and AR-C124910XX described the data obtained in the DISPERSE-2 and PLATO studies well, and were consistent with previous phase I PK studies.

  14. [The management of asymptomatic bacteriuria in different patient population].

    Science.gov (United States)

    Ivanov, M-L; Malinverni, R

    2008-11-12

    Who should be screened for asymptomatic bacteriuria (AB) and who should be treated? This review updates some aspects of the management of AB in different patient populations. A systematic screening for AB is recommended for pregnant women because of a significant risk of complications. In these cases as well as before any uro-gynecologic surgical procedure treatment of AB is strongly recommended. The management of AB in immunosuppressed or transplanted patients is more controversial. In other populations treating AB is not recommended and the outcome seems to be worse in case of treatment due to possible side effects and selection of resistant organisms. Recent studies have shown a considerable gap between clinical practice and recommendations.

  15. Chemical dosimetry at the RA reactor; Hemijska dozimetrija reaktora RA

    Energy Technology Data Exchange (ETDEWEB)

    Gal, O [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1961-12-15

    This report presents the results of measurements of absorbed doses axial and radial distribution in the vertical experimental channels of the RA reactor. Measurements were done in channels VK-5, VK-7, VK-9 and GF-36. Results were compared to the results of calorimetry measurements and measured neutron flux values performed by other laboratories. Fricke and oxalate dosemeters were used in addition to the cobalt indicators.

  16. Radium isotope (223Ra, 224Ra, 226Ra and 228Ra) distribution near Brazil's largest port, Paranaguá Bay, Brazil

    International Nuclear Information System (INIS)

    Dias, Thais H.; Oliveira, Joselene de; Sanders, Christian J.; Carvalho, Franciane; Sanders, Luciana M.; Machado, Eunice C.; Sá, Fabian

    2016-01-01

    This work investigates the 223 Ra, 224 Ra, 226 Ra and 228 Ra isotope distribution in river, estuarine waters and sediments of the Paranaguá Estuarine Complex (PEC). The stratification of the Ra isotopes along water columns indicate differing natural sources. In sediments, the radium isotope activities was inversely proportional to the particle size. The highest concentrations of 223 Ra, 224 Ra, 226 Ra and 228 Ra in the water column were found in the bottom more saline waters and towards the inner of the estuary. These relatively high concentrations towards the bottom of the estuary may be attributed to the influence of tidally driven groundwater source and desorption from particles at the maximum turbidity zone. The apparent river water ages from the radium isotope ratios, 223 Ra/ 224 Ra and 223 Ra/ 228 Ra, indicate that the principal rivers that flow into the estuary have residence times from between 6 and 11 days. - Highlights: • Radium isotope concentrations were evaluated along a large estuarine system. • The radioactivity level in river, estuary and sediments was within a normal range. • Spatial distributions of site specific radionuclides have differing activities and sources.

  17. Efficacy and Safety of Fingolimod in an Unselected Patient Population.

    Directory of Open Access Journals (Sweden)

    Maria Rasenack

    Full Text Available Fingolimod is a first in class oral compound approved for the treatment of relapsing-remitting multiple sclerosis (RR-MS. The aim of this study was to evaluate clinical and neuroradiological responses to fingolimod as well as the safety and tolerability in RR-MS patients in clinical practice. In addition, a panel of pro-inflammatory serum cytokines was explored as potential biomarker for treatment response.We conducted a retrospective, non-randomized, open-label, observational study in 105 patients with RR-MS and measured cytokines in longitudinal serum samples.Compared to the year before fingolimod start the annualized relapse rate was reduced by 44%. Also, the percentage of patients with a worsening of the EDSS decreased. Accordingly, the fraction of patients with no evidence of disease activity (no relapse, stable EDSS, no new active lesions in MRI increased from 11% to 38%. The efficacy and safety were comparable between highly active patients or patients with relevant comorbidities and our general patient population.The efficacy in reducing relapses was comparable to that observed in the phase III trials. In our cohort fingolimod was safe and efficacious irrespective of comorbidities and previous treatment.

  18. RA Reactor applications, Annex A

    International Nuclear Information System (INIS)

    Cupac, S.; Vukadin, Z.

    2000-01-01

    Full text: In 2000 Ra reactor was not operated. New instrumentation is not complete, without it, it is not possible to think about reactor start-up. Since 1985, when reactor operation was forbidden, there are 480 fuel elements left in 48 fuel channels in the reactor core. Heavy water was removed from the reactor core because of the repair of the heavy water pumps in 1986. The old instrumentation was removed. Eleven years after being left to its own destiny, it would be difficult to imagine that anybody would think of reactor restart without examining the state of reactor vessel and other vital reactor components. Maintaining the reactor under existing conditions without final decision about restart or permanent shutdown is destructive for this nuclear facility. The existing state that pertains for more than 10 years would have only one result, destruction of the RA reactor [sr

  19. RA Reactor applications, Annex A

    International Nuclear Information System (INIS)

    Cupac, S.; Vukadin, Z.

    1998-01-01

    Full text: In 1998 Ra reactor was not operated. New instrumentation is not complete, without it, it is not possible to think about reactor start-up. Since 1985, when reactor operation was forbidden, there are 480 fuel elements left in 48 fuel channels in the reactor core. Heavy water was removed from the reactor core because of the repair of the heavy water pumps in 1986. The old instrumentation was removed. Eleven years after being left to its own destiny, it would be difficult to imagine that anybody would think of reactor restart without examining the state of reactor vessel and other vital reactor components. Maintaining the reactor under existing conditions without final decision about restart or permanent shutdown is destructive for this nuclear facility. The existing state that pertains for more than 10 years would have only one result, destruction of the RA reactor [sr

  20. RA Reactor applications, Annex A

    International Nuclear Information System (INIS)

    Cupac, S.; Vukadin, Z.

    1996-01-01

    Full text: In 2000 Ra reactor was not operated. New instrumentation is not complete, without it, it is not possible to think about reactor start-up. Since 1985, when reactor operation was forbidden, there are 480 fuel elements left in 48 fuel channels in the reactor core. Heavy water was removed from the reactor core because of the repair of the heavy water pumps in 1986. The old instrumentation was removed. Eleven years after being left to its own destiny, it would be difficult to imagine that anybody would think of reactor restart without examining the state of reactor vessel and other vital reactor components. Maintaining the reactor under existing conditions without final decision about restart or permanent shutdown is destructive for this nuclear facility. The existing state that pertains for more than 10 years would have only one result, destruction of the RA reactor [sr

  1. 228Ra in monazite processing

    International Nuclear Information System (INIS)

    Paul, A.C.; Pillai, K.C.

    1979-01-01

    The treatment of monazite, adopted by the Indian Rare Earths plant is based on alkali digestion by caustic soda and acid leaching by hydrochloric acid. The paper deals with the distribution of 228 Ra, the daughter product of 232 Th in the effluents and outlines the treatment procedures adopted to reduce its levels. The activity gets distributed into the soluble and insoluble fractions in the effluent depending on its acidic/alkaline nature. The scheme for further deactivation of the effluent was based on lime treatment. It is observed that more than 95% removal of Ra is achievable by the treatment. The procedures leading to the proposed final treatment and disposal of effluent are schematically represented. Some environmental data are presented to show the impact of effluent releases in river, water and sediments. (B.G.W.)

  2. Lightcurve of NEA 1993 RA

    Science.gov (United States)

    Vaduvescu, Ovidiu; Aznar Macias, Amadeo

    2018-01-01

    The near-Earth asteroid (NEA) 1993 RA was observed with the 2.5-m Isaac Newton Telescope (INT) in full Moon conditions for 8h total during three successive nights (2017 Oct 3-6). The composite lightcurve could be fit by a 3-order period P = 5.64 ± 0.01 h with amplitude of 0.13 mag; other solutions are possible.

  3. Regulations for RA reactor operation

    International Nuclear Information System (INIS)

    1980-09-01

    Regulations for RA reactor operation are written in accordance with the legal regulations defined by the Law about radiation protection and related legal acts, as well as technical standards according to the IAEA recommendations. The contents of this book include: fundamental data about the reactor; legal regulations for reactor operation; organizational scheme for reactor operation; general and detailed instructions for operation, behaviour in the reactor building, performing experiments; operating rules for operation under steady state and accidental conditions [sr

  4. Gender differences in Latin-American patients with rheumatoid arthritis.

    Science.gov (United States)

    Barragán-Martínez, Carolina; Amaya-Amaya, Jenny; Pineda-Tamayo, Ricardo; Mantilla, Rubén D; Castellanos-de la Hoz, Juan; Bernal-Macías, Santiago; Rojas-Villarraga, Adriana; Anaya, Juan-Manuel

    2012-12-01

    Data on the effect of gender in rheumatoid arthritis (RA) in non-Caucasian populations is scarce. Latin America and the Caribbean (LAC) is a large population with unique characteristics, including high admixture. Our aim was to examine the effect of gender in patients with RA in LAC. This was a 2-phase study. First we conducted a cross-sectional and analytical study in which 1128 consecutive Colombian patients with RA were assessed. Second, a systematic review of the literature was done to evaluate the effect of gender in LAC patients with RA. Our results show a high prevalence of RA in LAC women with a ratio of 5.2 women per man. Colombian women with RA are more at risk of having an early age at onset and developing polyautoimmunity and abdominal obesity, and they perform more household duties than their male counterparts. However, male gender was associated with the presence of extra-articular manifestations. Of a total of 641 potentially relevant articles, 38 were considered for final analysis, in which several factors and outcomes related to gender were identified. RA in LAC women is not only more common but presents with some clinical characteristics that differ from RA presentation in men. Some of those characteristics could explain the high rates of disability and worse prognosis observed in women with RA in LAC. Copyright © 2012 Elsevier HS Journals, Inc. All rights reserved.

  5. RA research nuclear reactor - Annual report 1985; Istrazivacki nuklearni reaktor RA - Izvestaj za 1985. godinu

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1985-12-01

    Research reactor RA Annual report for year 1985 is divided into two main parts to cover: (1) operation and maintenance and (2) activities related to radiation protection. [Serbo-Croat] Godisnji izvestaj po projektu 'Istrazivacki nuklearni reaktor RA' za 1985 godinu sastoji se od dva dela: prvi deo obuhvata pogon i odzavanje reaktora RA, a drugi poslove zastite od zracenja na reaktoru RA.

  6. RA Research reactor, Annual report 1986; Istrazivacki nuklearni reaktor RA - Izvestaj za 1986. godinu

    Energy Technology Data Exchange (ETDEWEB)

    Sotic, O [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1986-12-01

    Research reactor RA Annual report for year 1985 is divided into two main parts to cover: (1) operation and maintenance and (2) activities related to radiation protection. [Serbo-Croat] Godisnji izvestaj po projektu 'Istrazivacki nuklearni reaktor RA' za 1986 godinu sastoji se od dva dela: prvi deo obuhvata pogon i odzavanje reaktora RA, a drugi poslove zastite od zracenja na reaktoru RA.

  7. Risk of Incident Liver Disease in Patients with Psoriasis, Psoriatic Arthritis, and Rheumatoid Arthritis: A Population-Based Study.

    Science.gov (United States)

    Ogdie, Alexis; Grewal, Sungat K; Noe, Megan H; Shin, Daniel B; Takeshita, Junko; Chiesa Fuxench, Zelma C; Carr, Rotonya M; Gelfand, Joel M

    2018-04-01

    Relatively little is known about the risk for incident liver disease in psoriasis (PsO), psoriatic arthritis (PsA), and rheumatoid arthritis (RA). We performed a cohort study among patients with PsO, PsA, or RA and matched controls in The Health Improvement Network from 1994 to 2014. Outcomes of interest were any liver disease, nonalcoholic fatty liver disease, and cirrhosis (any etiology). Among patients with PsO (N = 197,130), PsA (N = 12,308), RA (N = 54,251), and matched controls (N = 1,279,754), the adjusted hazard ratios for any liver disease were elevated among patients with PsO (without systemic therapy [ST] 1.37; with ST 1.97), PsA (without ST 1.38; with ST 1.67), and RA without an ST (1.49) but not elevated in patients with RA prescribed an ST (0.96). Incident nonalcoholic fatty liver disease was highest in patients with PsO prescribed an ST (2.23) and PsA with an ST (2.11). The risk of cirrhosis was highest among patients with PsO with an ST (2.62) and PsA without an ST (3.15). Additionally, the prevalence of liver disease and cirrhosis increased in a stepwise fashion with increasing body surface area affected by PsO (P for trend <0.001). More so than RA, PsO and PsA are associated with liver disease, particularly nonalcoholic fatty liver disease and cirrhosis, and this was true even among patients without ST exposure. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  8. Post-stroke infection: a role for IL-1ra?

    Science.gov (United States)

    Tanzi, Pat; Cain, Kevin; Kalil, Angela; Zierath, Dannielle; Savos, Anna; Gee, J Michael; Shibata, Dean; Hadwin, Jessica; Carter, Kelly; Becker, Kyra

    2011-04-01

    Infection is common following stroke and is independently associated with worse outcome. Clinical studies suggest that infections occur more frequently in those individuals with stroke-induced immunologic dysfunction. This study sought to explore the contribution of immunomodulatory cytokines and hormones to lymphocyte function and infection risk. Patients (N = 112) were enrolled as soon as possible after the onset of ischemic stroke. Blood was drawn to assess plasma cortisol, IL-10, IL-1ra, lymphocyte numbers, and lymphocyte function at 72 h after stroke onset; infections were censored through 21 days after stroke onset. Infection occurred in 25% of patients. Stroke severity was the most important predictor of infection risk. Increased plasma cortisol, IL-10, and IL-1ra, as well as decreased lymphocyte numbers, at 72 h after stroke onset were associated with risk of subsequent infection. After controlling for stroke severity, only IL-1ra was independently associated with infection risk, and the degree of risk was consistent throughout the post-stroke period. Infection, but not IL-1ra itself, was associated with worse outcome at 3 months. In this study cohort, increased plasma IL-1ra was independently associated with the risk of post-stroke infection. Further studies are needed to validate this finding, which could have important implications for stroke therapy.

  9. Prevalences of rheumatoid arthritis in Roman Catholic nuns and the general female population in Brittany, France: a pilot study.

    Science.gov (United States)

    Ollivier, Y; Saraux, A; Le Goff, P

    2004-01-01

    To evaluate the influence of lifestyle factors on the prevalence of rheumatoid arthritis (RA) by comparing Roman Catholic nuns and the general female population. RA prevalence in the general population was evaluated using a standardized telephone survey in 1857 homes taken at random. Individuals who reported an inflammatory joint disease were contacted by a rheumatologist of our unit, missing data were collected from the general practitioner or rheumatologist with the patient's permission, and if necessary a physical examination was done by a rheumatologist. The 9 largest Roman Catholic nun communities in Brittany were screened using the same standardized questionnaire administered face-to-face; nuns who reported an inflammatory joint disease were interviewed and examined by rheumatologists. In both populations, RA was diagnosed when (1) the rheumatologist of our unit who interviewed the patient considered the RA classification criteria positive and (2) the rheumatologist who examined the patient gave a diagnosis of RA independently from RA classification criteria. Data were available for 1706 adult females in the general population and 721 nuns. Of the 20 nuns who reported RA or polyarthritis, 11 received a diagnosis of RA (prevalence 1.52%). The prevalences adjustedfor the French population after 40 years were 1.66% (95% confidence interval, 0.84-2.44) and 1.33 (0.27-2.40) among the nuns and the general female population, respectively. Although our nun population was too small for definite conclusions, we found no evidence of a difference in RA prevalence among nuns and the general female population in Brittany.

  10. Measurements of neutron flux in the RA reactor; Merenje karakteristika neutronskog fluksa u reaktoru RA

    Energy Technology Data Exchange (ETDEWEB)

    Raisic, N [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1961-12-15

    This report includes the following separate parts: Thermal neutron flux in the experimental channels od RA reactor; Epithermal neutron flux in the experimental channels od RA reactor; Fast neutron flux in the experimental channels od RA reactor; Thermal neutron flux in the thermal column and biological experimental channel; Neutronic measurements in the RA reactor cell; Temperature reactivity coefficient of the RA reactor; design of the device for measuring the activity of wire. [Serbo-Croat] Ovaj izvestaj sadrzi sledece referate: Fluks termalnih neutrona u eksperimentalnim kanalima reaktora RA; Fluks epitermalnih neutrona u eksperimentalnim kanalima reaktora RA; Fluks brzih neutrona u eksperimentalnim kanalima reaktora RA; Fluks termalnih neurona u termalnoj koloni i bioloskom eksperimentalnom kanalu; Neutronska merenja u elementarnoj celiji reaktora RA; Temperaturni koeficijent reaktivnosti reaktora RA; Projekat uredjaja za merenje radioaktivnosti zice.

  11. Radon emanometric technique for 226Ra estimation

    International Nuclear Information System (INIS)

    Mandakini Maharana; Sengupta, D.; Eappen, K.P.

    2010-01-01

    Studies on natural background radiation show that the major contribution of radiation dose received by population is through inhalation pathway vis-a-vis contribution from radon ( 222 Rn) gas. The immediate parent of radon being radium ( 226 Ra), it is imperative that radium content is measured in the various matrices that are present in the environment. Among the various methods available for the measurement of radium, gamma spectrometry and radiochemical method are the two extensively used measurement methods. In comparison with these two methods, the radon emanometric technique, described here, is a simple and convenient method. The paper gives details of sample processing, radon bubbler, Lucas cell and the methodology used in the emanometric method. Comparison of emanometric method with gamma spectrometry has also undertaken and the results for a few soil samples are given. The results show a fairly good agreement among the two methods. (author)

  12. RA reactor building and installations; Zgrada 'RA' i instalacije

    Energy Technology Data Exchange (ETDEWEB)

    Badrljica, R; Sanovic, V; Skoric, M [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1985-08-15

    RA reactor building is made of reinforced concrete and bricks. It is closed facility with a limited number of controlled openings, doors and windows. The site of the building is 100 m above the sea level, 20 m above the mean Danube level and 8 m above the level of the neighbouring stream Mlaka. The building consists of three parts: central prismatic part, annex - surrounding the central part and the sanitary corridor. The biggest space is the reactor hall. In addition to the detailed description and drawings of the reactor building this documents includes design specifications of: electrical installation, water supply system, sewage system, ventilation and heating, gas and compressed air systems. A separate chapter is devoted to fire protection. Zgrada reaktora RA izgradjena je od armiranog betona i opeke, kao zatvoreni objekat ogranicenog broja kontolisanih otvora, sa ogranicenim brojem vrata i prozora. Plato na kojem je zgrada izgradjena nalazi se na 100 m nadmorske visine, na 20 m iznad srednjeg vodostaja Dunava i 8 m iznad nivoa obliznjeg potoka Mlaka. Zgrada se sastoji iz tri dela: sredisnjeg prizmaticnog dela, aneksa - prstenastog okvira sredisnog dela i sanitarnog propusnika. Pojedinacno najveci prostor zauzima reaktorska hala. Pored detaljnog opisa i plana zgrade, ovaj dokument sadrzi projekat elektricne instalacije, projekat vodovoda i kanalizacije, ventilacije i grejanja, instalacije gasa i komprimovanog vazduha. Posebno poglavlje posveceno je protivpozarnoj zastiti.

  13. Patient and population exposure from clinic nuclear medicine in China

    International Nuclear Information System (INIS)

    Zhang Liangan; Chang Hexin; Zhang Wenyi; Sun Kai

    1993-01-01

    In the work, a method of epidemiological stratified sampling was adopted. The sampling covers 200 hospitals throughout 24 provinces. The patient doses were estimated by MIRD method. The survey data were statistic analysis by a computer, and main results of the annual frequencies, patient dose and collective dose were reported. The annual frequency of clinic nuclear medicine in China was 0.62 cases per 1000 inhabitant. The highest frequency was found in thyroid uptake procedure, it is 0.26 cases per 1000 population. The patient dose per examination is changed with various radiopharmaceuticals administered mainly. In nuclear medical examination, the highest effective dose per examination was found in the procedure of thyroid scintigraphy, it is about 93.8 mGy lexam with 131 I, and this is 312 times as that with 99m Tc. In hyperthyroidism, the patient dose is very high, the effective dose is 2.6 Gy lexam, the thyroid dose is 86.0 Gy lexam. (5 tabs.)

  14. Patient engagement with research: European population register study.

    Science.gov (United States)

    McKevitt, Christopher; Fudge, Nina; Crichton, Siobhan; Bejot, Yannick; Daubail, Benoît; Di Carlo, Antonio; Fearon, Patricia; Kolominsky-Rabas, Peter; Sheldenkar, Anita; Newbound, Sophie; Wolfe, Charles D A

    2015-12-01

    Lay involvement in implementation of research evidence into practice may include using research findings to guide individual care, as well as involvement in research processes and policy development. Little is known about the conditions required for such involvement. To assess stroke survivors' research awareness, use of research evidence in their own care and readiness to be involved in research processes. Cross sectional survey of stroke survivors participating in population-based stroke registers in six European centres. The response rate was 74% (481/647). Reasons for participation in register research included responding to clinician request (56%) and to 'give something back' (19%); however, 20% were unaware that they were participating in a stroke register. Research awareness was generally low: 57% did not know the purpose of the register they had been recruited to; 73% reported not having received results from the register they took part in; 60% did not know about any research on stroke care. Few participants (7.6%) used research evidence during their consultations with a doctor. The 34% of participants who were interested in being involved in research were younger, more highly educated and already research aware. Across Europe, stroke survivors already participating in research appear ill informed about stroke research. Researchers, healthcare professionals and patient associations need to improve how research results are communicated to patient populations and research participants, and to raise awareness of the relationship between research evidence and increased quality of care. © 2014 John Wiley & Sons Ltd.

  15. The collaborative edge: patient empowerment for vulnerable populations.

    Science.gov (United States)

    Safran, Charles

    2003-03-01

    The problems with access to care and the special needs for educational outreach for disadvantage or vulnerable populations of patients require innovation. This paper describes Baby CareLink use of information technology to support communication, consultation, and collaboration among colleagues as well as with patients, their families, and community resources. In response to the educational, emotional and communication needs of parents of premature infants and the clinicians who care for the infants and support the families, we developed Baby CareLink, a secure collaborative environment. Baby CareLink provides a nurturing environment where parents, even though remote from the Neonatal Intensive Care Unit, can actively participate in decisions surrounding their baby's care. In a southeastern hospital serving a mostly Medicaid population in a rural setting, more than 300 parents have used Baby CareLink more than 11000 times during the past year. Despite the common wisdom that Medicaid families do not have access to the Internet, approximately 85% of the parents access Baby CareLink from home, at work, from the library or other public access point. The median use of Baby CareLinks from outside the hospital by parents is 17 separate sessions. In a city hospital in the midwestern US which exclusively serves a Medicaid population, experience has been equally encouraging. More than 70 parents have initiated more than 600 secure sessions with Baby CareLink. In contrast to the rural hospital, only 35% of sessions have been initiated outside the hospital. Experience with Baby CareLink suggests that families from all walks of life will use and benefit from collaborative tools that keep them informed and involved in the care of their children. The most significant barrier to wider deployment is bandwidth limitations into the homes of most families. The care of premature infants is a great example of an area where medical knowledge and ability has grown dramatically, and where

  16. VELoCiRaPTORS.

    Science.gov (United States)

    Lundgren, J.; Esham, B.; Padalino, S. J.; Sangster, T. C.; Glebov, V.

    2007-11-01

    The Venting and Exhausting of Low Level Air Contaminants in the Rapid Pneumatic Transport of Radioactive Samples (VELoCiRaPTORS) system is constructed to transport radioactive materials quickly and safely at the NIF. A radioactive sample will be placed inside a carrier that is transported via an airflow system produced by controlled differential pressure. Midway through the transportation process, the carrier will be stopped and vented by a powered exhaust blower which will remove radioactive gases within the transport carrier. A Geiger counter will monitor the activity of the exhaust gas to ensure that it is below acceptable levels. If the radiation level is sufficient, the carrier will pass through the remainder of the system, pneumatically braking at the counting station. The complete design will run manually or automatically with control software. Tests were performed using an inactive carrier to determine possible transportation problems. The system underwent many consecutive trials without failure. VELoCiRaPTORS is a prototype of a system that could be installed at both the Laboratory for Laser Energetics at the University of Rochester and the National Ignition Facility at LLNL.

  17. Irritable Bowel Syndrome in a Population of African Patients

    Directory of Open Access Journals (Sweden)

    Sylvester Chuks Nwokediuko

    2012-01-01

    Full Text Available Background. Functional dyspepsia is the prototype functional gastrointestinal disorder. This study was designed to determine its prevalence, subtypes, and risk factors associated with the subtypes. Method. Patients with upper gastrointestinal symptoms who presented for endoscopy were administered a questionnaire containing the functional dyspepsia and irritable bowel syndrome modules of the Rome III diagnostic criteria. Results. Of 192 patients who had functional dyspepsia, epigastric pain syndrome, postprandial distress syndrome, and combination of the two subtypes accounted for 79.2%, 62.5%, and 50%, respectively. Multivariate analysis of the risk factors showed that independent predictors of postprandial distress syndrome were alcohol and irritable bowel syndrome while irritable bowel syndrome was independent predictor of epigastric pain syndrome. Alcohol, smoking, and use of nonsteroidal anti-inflammatory drugs were independent predictors of cooccurrence of postprandial distress syndrome and epigastric pain syndrome. Conclusion. Functional dyspepsia accounts for 62.5% of dyspepsia in a population of black African patients. Regarding symptomatology, epigastric pain syndrome, postprandial distress syndrome, and combination of the two subtypes account for 79.2%, 62.5%, and 50%, respectively. Risk factors for functional dyspepsia are irritable bowel syndrome, alcohol, smoking, and use of nonsteroidal anti-inflammatory drugs.

  18. Cost of tumor necrosis factor blockers per patient with rheumatoid arthritis in a multistate Medicaid population

    Directory of Open Access Journals (Sweden)

    Bonafede M

    2014-09-01

    Full Text Available Machaon Bonafede,1 George J Joseph,2 Neel Shah,2 Nicole Princic,1 David J Harrison2 1Truven Health Analytics, Cambridge, MA, 2Amgen Inc., Thousand Oaks, CA, USA Background: The purpose of this study was to estimate the annual cost per treated patient for the tumor necrosis factor (TNF blockers, etanercept, adalimumab, and infliximab in rheumatoid arthritis (RA patients covered by Medicaid. Methods: The MarketScan Medicaid Multistate Database was used to identify adult RA patients who used etanercept, adalimumab, or infliximab (index agents from 2007 to 2011. The index date was the first claim preceded by 180 days and followed by 360 days of continuous enrollment. Patients with other conditions for which these agents are approved by the US Food and Drug Administration were excluded. “Continuing” patients had one or more pre-index claim for their index biologic, and "new" patients did not. Cost per treated patient was calculated in the 360 day post-index period for each index agent as the total index drug and administration cost to the payer and the costs of switched-to agents divided by the number of patients who received the index agent. Results: A total of 1,085 patients met the study criteria. Forty-eight percent received etanercept (n=521; 37% received adalimumab (n=405; and 15% received infliximab (n=159. Patient characteristics were similar across groups (mean age 47.4 years, 83% female. The annual cost per treated patient was lowest for etanercept ($18,466, followed by adalimumab ($20,983 and infliximab ($26,516. For all agents, annual costs were lower for new patients ($17,996 for etanercept, $18,992 for adalimumab, and $24,756 for infliximab than for continuing patients ($19,004 for etanercept, $24,438 for adalimumab, and $28,127 for infliximab. Conclusion: Etanercept had lower costs per treated patient than adalimumab or infliximab in both new and continuing Medicaid enrollees with RA. Keywords: cost, tumor necrosis factor

  19. Long-Term Dietary Changes after Diagnosis of Rheumatoid Arthritis in Swedish Women: Data from a Population-Based Cohort

    Directory of Open Access Journals (Sweden)

    Cecilia Lourdudoss

    2018-01-01

    Full Text Available Objective. To investigate long-term dietary changes after rheumatoid arthritis (RA diagnosis in Swedish women, compared to women without RA. Methods. This study included 21,602 women from the Swedish Mammography Cohort (SMC, who completed dietary questionnaires in 1997 and 2009. Between 1997 and 2009, 191 women were diagnosed with RA. Dietary changes after RA diagnosis were analyzed based on intake of 82 food items. Statistical analysis included linear mixed models. Results. Women with RA, compared to women without RA, had significantly lower intake (mean servings per week of animal products such as black pudding, egg, kidney, and liver paste (2.94±2.73 versus 2.45±1.82, p=0.010 and dairy products (35.14±20.02 versus 28.42±16.10, p=0.040 in 1997 and of cereals and grains (31.01±15.54 versus 28.00±14.98, p=0.009 in 2009. However, multivariable adjusted changes in dietary intake from 1997 to 2009 did not show any significant difference in intake. Nevertheless, women without RA increased their intake of whole wheat bread, wheat/oat bran, and rice more than women with RA. Conclusion. Women who had been diagnosed with RA had similar dietary patterns over time as the general population; these women did not remarkably change their diet over time due to their disease. Dietary recommendations for RA patients are needed.

  20. Population Dynamics of Patients with Bacterial Resistance in Hospital Environment

    Directory of Open Access Journals (Sweden)

    Leilei Qu

    2016-01-01

    Full Text Available During the past decades, the increase of antibiotic resistance has become a major concern worldwide. The researchers found that superbugs with new type of resistance genes (NDM-1 have two aspects of transmission characteristics; the first is that the antibiotic resistance genes can horizontally transfer among bacteria, and the other is that the superbugs can spread between humans through direct contact. Based on these two transmission mechanisms, we study the dynamics of population in hospital environment where superbugs exist. In this paper, we build three mathematic models to illustrate the dynamics of patients with bacterial resistance in hospital environment. The models are analyzed using stability theory of differential equations. Positive equilibrium points of the system are investigated and their stability analysis is carried out. Moreover, the numerical simulation of the proposed model is also performed which supports the theoretical findings.

  1. Clinical research in small genomically stratified patient populations.

    Science.gov (United States)

    Martin-Liberal, J; Rodon, J

    2017-07-01

    The paradigm of early drug development in cancer is shifting from 'histology-oriented' to 'molecularly oriented' clinical trials. This change can be attributed to the vast amount of tumour biology knowledge generated by large international research initiatives such as The Cancer Genome Atlas (TCGA) and the use of next generation sequencing (NGS) techniques developed in recent years. However, targeting infrequent molecular alterations entails a series of special challenges. The optimal molecular profiling method, the lack of standardised biological thresholds, inter- and intra-tumor heterogeneity, availability of enough tumour material, correct clinical trials design, attrition rate, logistics or costs are only some of the issues that need to be taken into consideration in clinical research in small genomically stratified patient populations. This article examines the most relevant challenges inherent to clinical research in these populations. Moreover, perspectives from the Academia point of view are reviewed as well as initiatives to be taken in forthcoming years. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Fully automated joint space width measurement and digital X-ray radiogrammetry in early RA

    NARCIS (Netherlands)

    Platten, Michael; Kisten, Yogan; Kälvesten, Johan; Arnaud, Laurent; Forslind, Kristina; van Vollenhoven, Ronald

    2017-01-01

    To study fully automated digital joint space width (JSW) and bone mineral density (BMD) in relation to a conventional radiographic scoring method in early rheumatoid arthritis (eRA). Radiographs scored by the modified Sharp van der Heijde score (SHS) in patients with eRA were acquired from the

  3. Research nuclear reactor RA - Annual Report 1989

    International Nuclear Information System (INIS)

    Sotic, O.

    1989-12-01

    Annual report concerning the project 'RA research nuclear reactor' for 1989, financed by the Serbian ministry of science is divided into two parts. First part is concerned with RA reactor operation and maintenance, which is the task of the Division for reactor engineering of the Institute for multidisciplinary studies and RA reactor engineering. Second part deals with radiation protection activities at the RA reactor which is the responsibility of the Institute for radiation protection. Scientific council of the Institute for multidisciplinary studies and RA reactor engineering has stated that this report describes adequately the activity and tasks fulfilled at the RA reactor in 1989. The scope and the quality of the work done were considered successful both concerning the maintenance and reconstruction, as well as radiation protection activities [sr

  4. RA Research nuclear reactor - Annual report 1987

    International Nuclear Information System (INIS)

    1987-12-01

    Annual report concerning the project 'RA research nuclear reactor' for 1987, financed by the Serbian ministry of science is divided into two parts. First part is concerned with RA reactor operation and maintenance, which is the task of the Division for reactor engineering of the Institute for multidisciplinary studies and RA reactor engineering. Second part deals with radiation protection activities at the RA reactor which is the responsibility of the Institute for radiation protection. Scientific council of the Institute for multidisciplinary studies and RA reactor engineering has stated that this report describes adequately the activity and tasks fulfilled at the RA reactor in 1989. The scope and the quality of the work done were considered successful both concerning the maintenance and reconstruction, as well as radiation protection activities [sr

  5. RA Research reactor, Annual report 1988

    International Nuclear Information System (INIS)

    Sotic, O.

    1988-12-01

    Annual report concerning the project 'RA research nuclear reactor' for 1989, financed by the Serbian ministry of science is divided into two parts. First part is concerned with RA reactor operation and maintenance, which is the task of the Division for reactor engineering of the Institute for multidisciplinary studies and RA reactor engineering. Second part deals with radiation protection activities at the RA reactor which is the responsibility of the Institute for radiation protection. Scientific council of the Institute for multidisciplinary studies and RA reactor engineering has stated that this report describes adequately the activity and tasks fulfilled at the RA reactor in 1989. The scope and the quality of the work done were considered successful both concerning the maintenance and reconstruction, as well as radiation protection activities [sr

  6. Sedentary behaviour in patients with rheumatoid arthritis: A qualitative study

    Directory of Open Access Journals (Sweden)

    Tanja Thomsen

    2015-10-01

    Full Text Available Background: Despite increasing interest in investigating sedentary behaviour (SB in the general population and in patients with rheumatoid arthritis (RA, there is little documentation of the subjective experiences of SB in patients with RA. This study aimed to examine how patients with RA describe their daily SB. Methods: Fifteen patients with RA (10 women and 5 men from 23 to 73 years of age and with a disease duration ranging from 4 to 27 years were interviewed following a semi-structured interview guide. Data were analysed using the content analysis method described by Graneheim. Results: SB appeared in three categories covering: 1 A constant battle between good and bad days; SB could be a consequence of RA in terms of days with pronounced pain and fatigue resulting in many hours of SB. 2 Adaptation to everyday life; living with the unpredictability of RA included constant modification of physical activity level causing increase in SB, especially during periods of disease flare. Prioritizing and planning of SB also functioned as part of self-management strategies. 3 It has nothing to do with my arthritis; for some patients, SB was not related to RA, but simply reflected a way of living independent of the disease. Conclusions: SB is perceived, motivated, and performed differently in patients with RA. An individually tailored approach may be essential in understanding and encouraging patients’ motivation towards sustainable change in SB and activity patterns.

  7. LCA versus RA - an introduction

    DEFF Research Database (Denmark)

    Olsen, Stig Irving

    2000-01-01

    Risk Assessment (RA) of chemicals is an environmental management tool used to assess the risk of specific chemicals, which are harmful to man or the environment under certain circumstances of use or in certain environmental recipients. Life Cycle Assessment (LCA) or environmental assessment...... of Industrial Products) developed in Denmark (Wenzel et al., 1997), respectively. The interactions between the two tools can be viewed from two different angles: 1. As a general reflection of how the tools supplement each other in the total environmental effort. 2. As an assessment of coincidences...... on Principles and Methods for Hazard and Risk Assessment)focuses on an assessment of the toxicological and ecotoxicological risks, the focus of this article's comparison of assessment principles, data requirements etc. will be on the assessment of toxicity and ecotoxicity in EDIP's impact assessment methodology...

  8. RA radiological characterization database application

    International Nuclear Information System (INIS)

    Steljic, M.M; Ljubenov, V.Lj. . E-mail address of corresponding author: milijanas@vin.bg.ac.yu; Steljic, M.M.)

    2005-01-01

    Radiological characterization of the RA research reactor is one of the main activities in the first two years of the reactor decommissioning project. The raw characterization data from direct measurements or laboratory analyses (defined within the existing sampling and measurement programme) have to be interpreted, organized and summarized in order to prepare the final characterization survey report. This report should be made so that the radiological condition of the entire site is completely and accurately shown with the radiological condition of the components clearly depicted. This paper presents an electronic database application, designed as a serviceable and efficient tool for characterization data storage, review and analysis, as well as for the reports generation. Relational database model was designed and the application is made by using Microsoft Access 2002 (SP1), a 32-bit RDBMS for the desktop and client/server database applications that run under Windows XP. (author)

  9. Optimum RA reactor fuelling scheme

    International Nuclear Information System (INIS)

    Strugar, P.; Nikolic, V.

    1965-10-01

    Ideal reactor refueling scheme can be achieved only by continuous fuel elements movement in the core, which is not possible, and thus approximations are applied. One of the possible approximations is discontinuous movement of fuel elements groups in radial direction. This enables higher burnup especially if axial exchange is possible. Analysis of refueling schemes in the RA reactor core and schemes with mixing the fresh and used fuel elements show that 30% higher burnup can be achieved by applying mixing, and even 40% if reactivity due to decrease in experimental space is taken into account. Up to now, mean burnup of 4400 MWd/t has been achieved, and the proposed fueling scheme with reduction of experimental space could achieve mean burnup of 6300 MWd/t which means about 25 Mwd/t per fuel channel [sr

  10. RA Reactor applications, Annex A

    International Nuclear Information System (INIS)

    Martinc, R.; Cupac, S.; Stanic, A.

    1990-01-01

    RA reactor was not operated during the past five years due to the renewal and reconstruction of the reactor systems, which in underway. In the period from 1986-1990, reactor was operated only 144 MWh in 1986, for the need of testing the reactor systems and possibility of irradiating 125 I. Reactor will not be operated in 1991 because of the exchange of complete instrumentation which is planned to be finished by the end of 1991. It is expected to start operation in May 1992. That is why this annex includes the plan of reactor operation for period of nine months starting from from the moment of start-up. It is planned to operate the reactor at 0.02 MW power first three months, to increase the power gradually and reach 3.5 MW after 8 months of operation. It is foreseen to operate the reactor at 4.7 MW from the tenth month on [sr

  11. Population Pharmacokinetics of Cladribine in Patients with Multiple Sclerosis.

    Science.gov (United States)

    Savic, Radojka M; Novakovic, Ana M; Ekblom, Marianne; Munafo, Alain; Karlsson, Mats O

    2017-10-01

    The aims of this study were to characterize the concentration-time course of cladribine (CdA) and its main metabolite 2-chloroadenine (CAde), estimate interindividual variability in pharmacokinetics (PK), and identify covariates explaining variability in the PK of CdA. This population PK analysis was based on the combined dataset from four clinical studies in patients with multiple sclerosis (MS): three phase I studies, including one food and one drug-drug interaction study, and one phase III clinical study. Plasma and urine concentration data of CdA and CAde were modeled simultaneously. The analysis comprised a total of 2619 CdA and CAde plasma and urine concentration observations from 173 patients with MS who received an intravenous infusion or oral tablet doses of CdA as a single agent or in combination with interferon (IFN) β-1a. CdA PK data were best described by a three-compartment model, while a one-compartment model best described the PK of CAde. CdA renal clearance (CL R ) was correlated with creatinine clearance (CL CR ), predicting a decrease in the total clearance of 19%, 30% and 40% for patients with mild (CL CR  = 65 ml/min), moderate (CL CR  = 40 ml/min) and severe (CL CR  = 20 ml/min) renal impairment, respectively. Food decreased the extent of CdA absorption by 11.2% and caused an absorption delay. Coadministration with IFNβ-1a was found to increase non-CL R (CL NR ) by 21%, resulting in an increase of 11% in total clearance. Both CdA and CAde displayed linear PK after intravenous and oral administration of CdA, with CdA renal function depending on CL CR . Trial registration number for study 25643: NCT00213135.

  12. Factor structure of the arthritis body experience scale (ABES) in a U.S. population of people with osteoarthritis (OA), rheumatoid arthritis (RA), fibromyalgia (FM) and other rheumatic conditions.

    Science.gov (United States)

    Boyington, J E A; Devellis, R; Shreffler, J; Schoster, B; Callahan, L F

    2008-01-01

    To examine the psychometric properties of the Arthritis Body Experience Scale (ABES) in a US sample of people with osteoarthritis, rheumatoid arthritis, fibromyalgia and other rheumatic conditions. The ABES, with the scoring direction modified, was phone-administered to 937 individuals who self-identified as having one or more arthritis conditions based on a validated, US, national survey assessment tool. Descriptive statistics of demographic variables and factor analysis of scale items were conducted. Scale dimensionality was assessed using principal component analysis (PCA) with oblique rotation. Criteria for assessing factors were eigenvalues > 1, visual assessment of scree plot, and structure and pattern matrices. The predominantly female (74.2%) and Caucasian (79.9%) sample had a mean age of 61.0 ± 13.1 years, and a mean BMI of 30.2 ± 7.1. Major arthritis conditions reported were rheumatoid arthritis, osteoarthritis and fibromyalgia. A three-factor structure with cronbach alpha values of .84, .85 and .53 was elicited, and accounted for 72% of the variance. Compared to the two-factor structure evidenced by the original ABES scale in a sample of UK adults, the data from this sample evidenced a three-factor structure with higher variance. The third factor's cronbach alpha of .53 was low and could be improved by the addition of salient questions derived from further qualitative interviews with patients with arthritis and other rheumatic conditions and from current literature findings. The observed psychometrics indicate the scale usefully assesses body image in populations with arthritis and related conditions. However, further testing and refinement is needed to determine its utility in clinical and other settings.

  13. Ra-226 collective dosimetry for surface waters in the uranium mining region of Pocos de Caldas

    International Nuclear Information System (INIS)

    Paschoa, A.S.; Sigaud, G.M.; Montenegro, E.C.; Baptista, G.B.

    1980-01-01

    Graphs of the collective dose equivalent for the whole body, bone, gastro-intestinal tract (lower large intestine), kidneys, and liver, via the pathways of drinking water and ingestion of food grown in irrigated fields are presented as a function of the 226 Ra concentrations in the surface waters of the Pocos de Caldas region. The collective dose equivalent calculated from the 226 Ra concentrations measured in the baseline studies are compared with those collective dose equivalent estimated from the projected higher 226 Ra concentrations in the river waters. The 226 Ra concentrations in river waters of the region are expected to be enhanced due to 226 Ra releases from uranium mining and milling operations. The dose equivalent commitment for the exposed population for the referred pathways is also estimated for the contribution of the mine during its predicted time of operation. The assumptions for the dose calculations are presented and the results obtained are discussed. (H.K.)

  14. Observation of unexpectedly small E1 moments in sup 224 Ra

    Energy Technology Data Exchange (ETDEWEB)

    Poynter, R.J.; Butler, P.A.; Clarkson, N.; Hoare, T.H.; Jones, G.D.; White, C.A. (Liverpool Univ. (UK). Oliver Lodge Lab.); Cline, D. (Rochester Univ., NY (USA). Nuclear Structure Research Lab.); Connell, K.A.; Cunningham, R.A.; Simpson, J. (Science and Engineering Research Council, Daresbury (UK). Daresbury Lab.); Goettig, L. (Warsaw Univ. (Poland). Inst. Fizyki Doswiadczalnej); Hughes, J.R.; Jarvis, N.S.; Mullins, S.M.; Wadsworth, R.; Watson, D.L. (York Univ. (UK). Dept. of Physics); Juutinen, S. (Jyvaeskylae Univ. (Finland). Dept. of Physics); Pass, C.N. (Oxford Univ. (UK). Dept. of Nuclear Physics)

    1989-12-14

    The {alpha}-decay of {sup 228}Th and the reaction {sup 226}Ra({sup 58}Ni, {sup 60}Ni){sup 224}Ra have been employed to populate states in {sup 224}Ra up to I{sup {pi}}=12{sup +}. Values of the intrinsic electric dipole moment vertical strokeQ{sub 1}vertical stroke have been deduced from the observed B(E1)/B(E2) branching ratios. These values are < or approx.0.1 e fm for spins up to I{sup {pi}}=9{sup -}, and are thus smaller than those in {sup 218,220}Ra or {sup 226}Ra. The behaviour of Q{sub 1} suggests that shell effects are important in this mass region, although theoretical calculations which include these effects do not reproduce the observed pattern. (orig.).

  15. Determination of ''226Ra by Alpha Spectrometry by Using ''225Ra as Yield Tracer

    International Nuclear Information System (INIS)

    Crespo, M. T.; Oller, O.

    1999-01-01

    A method for the determination of low-level ''226 Ra in environmental and geological samples by alpha spectrometry is described. The method is based on the use of ''225 Ra from ''229 Th as yield tracer and has been developed to analyze U, Th and Ra in the same sample. (Author) 12 refs

  16. Phosphoproteome and Transcriptome of RA-Responsive and RA-Resistant Breast Cancer Cell Lines.

    Directory of Open Access Journals (Sweden)

    Marilyn Carrier

    Full Text Available Retinoic acid (RA, the main active vitamin A metabolite, controls multiple biological processes such as cell proliferation and differentiation through genomic programs and kinase cascades activation. Due to these properties, RA has proven anti-cancer capacity. Several breast cancer cells respond to the antiproliferative effects of RA, while others are RA-resistant. However, the overall signaling and transcriptional pathways that are altered in such cells have not been elucidated. Here, in a large-scale analysis of the phosphoproteins and in a genome-wide analysis of the RA-regulated genes, we compared two human breast cancer cell lines, a RA-responsive one, the MCF7 cell line, and a RA-resistant one, the BT474 cell line, which depicts several alterations of the "kinome". Using high-resolution nano-LC-LTQ-Orbitrap mass spectrometry associated to phosphopeptide enrichment, we found that several proteins involved in signaling and in transcription, are differentially phosphorylated before and after RA addition. The paradigm of these proteins is the RA receptor α (RARα, which was phosphorylated in MCF7 cells but not in BT474 cells after RA addition. The panel of the RA-regulated genes was also different. Overall our results indicate that RA resistance might correlate with the deregulation of the phosphoproteome with consequences on gene expression.

  17. Operators retraining in RA-1

    International Nuclear Information System (INIS)

    Pereira, R; Daoud, A

    2012-01-01

    The nuclear activity in Argentina has its foundational milestone in the creation of the Comision Nacional de EnergIa Atomica in 1950. Achievements since then, linked to the area of nuclear reactors and nuclear fuel materials, fuel cycle facilities and the applications of nuclear technology in medicine, industry, agriculture, food preservation, environmental studies and many others, have relied on personnel trained in this specific technology in both professional and technical level. This training has been done in most cases in the exclusive scope of CNEA. Eventually CNEA has been linked with the University to ensure that personnel training concerned to work done in the nuclear field had guarantees of formality and excellence. The creation of the Instituto de Tecnologia Nuclear Dan Beninson that, under an agreement with the Universidad Nacional de General San Martin, has set up an enabling environment for the training of professionals and university technicians to serve with the multiple and growing use of this technology. On the other hand the Institute has been issuing, along with its careers, specialized courses that, in some cases, have been requested by CNEA's nuclear installations and companies related to the nuclear sector. In particular, the Specialization in Nuclear Reactors and its Fuel Cycle (ERCC) and the Courses of Introduction to Nuclear Technology-Complementary training for Installations Personnel Class I (CI-CC), this last, recognized by the ARN as a requirement for applying to the individual licensing examination, providing work experience in the RA-1 reactor among which we can find commissioning, control rods calibration by various methods and calculations of reactivity. With this practical framework developed in the RA-1 and the academic support provided by the Instituto de Tecnologia Nuclear Dan Beninson it was developed a training program for nuclear reactors operators. Let us stress that this research reactor has been forming generations

  18. The population genetics of Pseudomonas aeruginosa isolates from different patient populations exhibits high-level host specificity.

    Directory of Open Access Journals (Sweden)

    Rosa van Mansfeld

    Full Text Available OBJECTIVE: To determine whether highly prevalent P. aeruginosa sequence types (ST in Dutch cystic fibrosis (CF patients are specifically linked to CF patients we investigated the population structure of P. aeruginosa from different clinical backgrounds. We first selected the optimal genotyping method by comparing pulsed-field gel electrophoresis (PFGE, multilocus sequence typing (MLST and multilocus variable number tandem-repeat analysis (MLVA. METHODS: Selected P. aeruginosa isolates (n = 60 were genotyped with PFGE, MLST and MLVA to determine the diversity index (DI and congruence (adjusted Rand and Wallace coefficients. Subsequently, isolates from patients admitted to two different ICUs (n = 205, from CF patients (n = 100 and from non-ICU, non-CF patients (n = 58, of which 19 were community acquired were genotyped with MLVA to determine distribution of genotypes and genetic diversity. RESULTS: Congruence between the typing methods was >79% and DIs were similar and all >0.963. Based on costs, ease, speed and possibilities to compare results between labs an adapted MLVA scheme called MLVA9-Utrecht was selected as the preferred typing method. In 363 clinical isolates 252 different MLVA types (MTs were identified, indicating a highly diverse population (DI  = 0.995; CI  = 0.993-0.997. DI levels were similarly high in the diverse clinical sources (all >0.981 and only eight genotypes were shared. MTs were highly specific (>80% for the different patient populations, even for similar patient groups (ICU patients in two distinct geographic regions, with only three of 142 ICU genotypes detected in both ICUs. The two major CF clones were unique to CF patients. CONCLUSION: The population structure of P. aeruginosa isolates is highly diverse and population specific without evidence for a core lineage in which major CF, hospital or community clones co-cluster. The two genotypes highly prevalent among Dutch CF patients appeared unique to CF patients

  19. Population pharmacokinetics and pharmacodynamics of cysteamine in nephropathic cystinosis patients

    Directory of Open Access Journals (Sweden)

    Bouazza Naïm

    2011-12-01

    Full Text Available Abstract Background Nephropathic cystinosis is an autosomal recessive disorder resulting in an impaired transport of cystine trough the lysosomal membrane causing an accumulation of free cystine in lysosomes. The only specific treatment for nephropathic cystinosis is cysteamine bitartrate. This study was aimed to describe the relationship between cysteamine plasma concentrations and white blood cell cystine levels, and to simulate an optimized administration scheme to improve the management of patients with cystinosis. Methods Cysteamine and cystine concentrations were measured in 69 nephropathic cystinosis patients. A total of 250 cysteamine plasma concentrations and 243 intracellular cystine concentrations were used to perform a population pharmacokinetic and pharmacodynamic analysis. An optimized administration scheme was simulated in order to maintain cystine levels below 1 nmol half-cystine/mg of protein and to investigate the possibility of administrating the treatment less than 4 times a day (QID, recommended. The current dosing recommendations are 1.3 g/m2/day for less than 50 kg BW and 2 g/day thereafter; the maximum dose should not exceed 1.95 g/m2/day. Results Cysteamine concentrations were satisfactorily described by a one-compartment model. Parameter estimates were standardized for a mean standard bodyweight using an allometric model. WBC cystine levels were adequately described by an indirect response model where the first-order removal rate constant is stimulated by the cysteamine concentrations. Conclusions According to simulations, in order to increase the percentage of patient with cystine levels below 1 nmol half-cystine/mg of protein, the current dosages could be changed as follows: 80 mg/kg/day (QID from 10 to 17 kg, 70 mg/kg/day (QID from 17 to 25 kg, 60 mg/kg/day (QID from 25 to 40 kg and 50 mg/kg/day (QID from 40 to 70 kg (these dosages remain under the maximum recommended dose. However an 8-hourly daily treatment (TID

  20. Replication study of STAT4 rs7574865 G/T polymorphism and risk of rheumatoid arthritis in a Chinese population.

    Science.gov (United States)

    Shen, Li; Liu, Ruiping; Zhang, Hui; Huang, Yong; Sun, Rongbin; Tang, Peifu

    2013-09-10

    Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are common systemic autoimmune diseases with genetic and environmental predisposing factors. Signal transducer and activator of transcription 4 (STAT4) transmits signals induced by interleukin-12, interleukin-23 and interferon-γ, which are key cytokines and play important roles in the development of autoimmune diseases. Previous studies confirmed the STAT4 rs7574865 G/T locus to be associated with RA. Thus we conducted a replication study to investigate STAT4 rs7574865 G/T polymorphism and RA/AS susceptibility in a Chinese population. We studied STAT4 rs7574865 G/T gene polymorphism in 520 patients with RA, 100 AS patients and 520 controls in a Chinese population. Genotyping was done using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). When the STAT4 rs7574865 GG homozygote genotype was used as the reference group, the GT or GT/TT genotypes were associated with the risk for RA. After stratification analyses, a significantly increased risk for RA associated with the STAT4 rs7574865 GT genotype was evident among the rheumatoid factor (RF)-positive patients, patients with higher erythrocyte sedimentation rate (ESR) level and patients with higher RA disease activity score (DAS28) compared with the STAT4 rs7574865 GG genotype. A significantly increased risk for RA associated with the STAT4 rs7574865 TT genotype was evident among older patients and RF-negative patients compared with the STAT4 rs7574865 GG genotype. STAT4 rs7574865 G/T was not associated with susceptibility to AS. This replication study confirmed that STAT4 rs7574865 G/T polymorphism was associated with the risk of RA. STAT4 polymorphisms are associated with rheumatoid arthritis risk. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. Determination of 226Ra and 228Ra in surface seawater around Sagami bay and its vicinity

    International Nuclear Information System (INIS)

    Nakano-Ohta, T.; Kubota, T.; Mahara, Y.; Yoshikawa, M.; Sato, J.

    2006-01-01

    Activity ratios of 228 Ra/ 226 Ra in surface seawaters were observed at 5 ports of Izu-Oshima, Ajiro port of Sagami bay and Umizuri park of Tokyo bay. The 228 Ra/ 226 Ra activity ratio in surface seawaters were from 0.2 to 0.7 for Izu-Oshima, from 0.2 to 0.7 for Ajiro port and from 0.6 to 0.8 for Tokyo bay. The activity ratio in surface seawaters of Izu-Oshima and Atami of Sagami bay showed lower in spring and highly in autumn, while narrow variation pattern was observed in Umizuri park of Tokyo bay. The observed variation patterns of 228 Ra/ 226 Ra in surface seawaters at Izu-oshima, Ajiro park and Umizuri park may be reflected by difference of contribution from amount of seawater far off coast with low 228 Ra concentration. (author)

  2. Preparation of 227Ac/223Ra by neutron irradiation of 226Ra

    International Nuclear Information System (INIS)

    Ekaterina Kukleva; Jan Kozempel; Martin Vlk; Petra Micolova; Dusan Vopalka

    2015-01-01

    Radium-223 is a prospective alpha-emitter for targeted radionuclide therapy. Although 223 Ra is formed naturally by the decay of 235 U, for practical reasons its preparation involves neutron irradiation of 226 Ra. The β - decay of the 227 Ra (T ½ = 43 min) produced via 226 Ra(n,γ) 227 Ra reaction leads to 227 Ac, a mother nuclide of 227 Th and subsequently 223 Ra. Radium target material is generally available in multigram quantities from historical stock. The main aim of this study was to experimentally as well as theoretically evaluate and verify the available literature data on production of 227 Ac/ 223 Ra. According to the data obtained from the γ-spectra, the approximate yield values were determined and effective cross section value for the 227 Ac production was calculated to 14 ± 4 b. (author)

  3. Patterns of Mortality in Patients Treated with Dental Implants: A Comparison of Patient Age Groups and Corresponding Reference Populations.

    Science.gov (United States)

    Jemt, Torsten; Kowar, Jan; Nilsson, Mats; Stenport, Victoria

    2015-01-01

    Little is known about the relationship between implant patient mortality compared to reference populations. The aim of this study was to report the mortality pattern in patients treated with dental implants up to a 15-year period, and to compare this to mortality in reference populations with regard to age at surgery, sex, and degree of tooth loss. Patient cumulative survival rate (CSR) was calculated for a total of 4,231 treated implant patients from a single clinic. Information was based on surgical registers in the clinic and the National Population Register in Sweden. Patients were arranged into age groups of 10 years, and CSR was compared to that of the reference population of comparable age and reported in relation to age at surgery, sex, and type of jaw/dentition. A similar, consistent, general relationship between CSR of different age groups of implant patients and reference populations could be observed for all parameters studied. Completely edentulous patients presented higher mortality than partially edentulous patients (P age groups showed mortality similar to or higher than reference populations, while older patient age groups showed increasingly lower mortality than comparable reference populations for edentulous and partially edentulous patients (P age groups of patients compared to reference populations was observed, indicating higher patient mortality in younger age groups and lower in older groups. The reported pattern is not assumed to be related to implant treatment per se, but is assumed to reflect the variation in general health of a selected subgroup of treated implant patients compared to the reference population in different age groups.

  4. Radiation protection at reactors RA and RB

    International Nuclear Information System (INIS)

    Ninkovic, M.

    2003-02-01

    Radiation protection activities at the RA and RB reactors are imposed by the existing legal regulations and international recommendations in this field. This annual report contains five parts which cover the following topics: Radiation safety, dosimetry control and technical radiation protection at reactors RA and RB; Handling of radioactive waste, actions and decontamination; Control of the environment (surroundings of RA and RB reactors) and meteorological measurements; Control of internal contamination and internal exposure; Health control od personnel exposed to radiation. Personnel as well as financial data are part of this report

  5. Lack of association of variants previously associated with anti-TNF medication response in rheumatoid arthritis patients: results from a homogeneous Greek population.

    Directory of Open Access Journals (Sweden)

    Maria I Zervou

    Full Text Available Treatment strategies blocking tumor necrosis factor (anti-TNF have proven very successful in patients with rheumatoid arthritis (RA, showing beneficial effects in approximately 50-60% of the patients. However, a significant subset of patients does not respond to anti-TNF agents, for reasons that are still unknown. The aim of this study was to validate five single nucleotide polymorphisms (SNPs of PTPRC, CD226, AFF3, MyD88 and CHUK gene loci that have previously been reported to predict anti-TNF outcome. In addition, two markers of RA susceptibility, namely TRAF1/C5 and STAT4 were assessed, in a cohort of anti-TNF-treated RA patients, from the homogeneous Greek island of Crete, Greece. The RA patient cohort consisted of 183 patients treated with either of 3 anti-TNF biologic agents (infliximab, adalimumab and etanercept from the Clinic of Rheumatology of the University Hospital of Crete. The SNPs were genotyped by TaqMan assays or following the Restriction Fragments Length Polymorphisms (RFLPs approach. Disease activity score in 28 joints (DAS28 at baseline and after 6 months were available for all patients and analysis of good versus poor response at 6 months was performed for each SNP. None of the 7 genetic markers correlated with treatment response. We conclude that the gene polymorphisms under investigation are not strongly predictive of anti-TNF response in RA patients from Greece.

  6. Lack of association of variants previously associated with anti-TNF medication response in rheumatoid arthritis patients: results from a homogeneous Greek population.

    Science.gov (United States)

    Zervou, Maria I; Myrthianou, Efsevia; Flouri, Irene; Plant, Darren; Chlouverakis, Gregory; Castro-Giner, Francesc; Rapsomaniki, Panayiota; Barton, Anne; Boumpas, Dimitrios T; Sidiropoulos, Prodromos; Goulielmos, George N

    2013-01-01

    Treatment strategies blocking tumor necrosis factor (anti-TNF) have proven very successful in patients with rheumatoid arthritis (RA), showing beneficial effects in approximately 50-60% of the patients. However, a significant subset of patients does not respond to anti-TNF agents, for reasons that are still unknown. The aim of this study was to validate five single nucleotide polymorphisms (SNPs) of PTPRC, CD226, AFF3, MyD88 and CHUK gene loci that have previously been reported to predict anti-TNF outcome. In addition, two markers of RA susceptibility, namely TRAF1/C5 and STAT4 were assessed, in a cohort of anti-TNF-treated RA patients, from the homogeneous Greek island of Crete, Greece. The RA patient cohort consisted of 183 patients treated with either of 3 anti-TNF biologic agents (infliximab, adalimumab and etanercept) from the Clinic of Rheumatology of the University Hospital of Crete. The SNPs were genotyped by TaqMan assays or following the Restriction Fragments Length Polymorphisms (RFLPs) approach. Disease activity score in 28 joints (DAS28) at baseline and after 6 months were available for all patients and analysis of good versus poor response at 6 months was performed for each SNP. None of the 7 genetic markers correlated with treatment response. We conclude that the gene polymorphisms under investigation are not strongly predictive of anti-TNF response in RA patients from Greece.

  7. The biological effects of 224Ra injected into dogs

    International Nuclear Information System (INIS)

    Muggenburg, B.A.; Lloyd, R.D.; Hahn, F.F.; Griffith, W.C.; Boecker, B.B.

    1994-01-01

    The purpose of this study was to investigate the toxicity of injected 224 Ra in the dog. Radium-224 is a short-lived isotope of radium with a half-life of 3.62 d. When administered parenterally, it deposits on bone surfaces; because of its short half-life, most of its energy is deposited on bone surfaces, in a manner similar to plutonium. The experimental design included a comparison to the exposed human population. Instead of using a single injection of 224 Ra, groups were included in which dogs were injected once, 10 times, or 50 times. This design provided groups that could be compared to the multiple injections often used in people for the treatment of ankylosing spondylitis

  8. SF Treg cells transcribing high levels of Bcl-2 and microRNA-21 demonstrate limited apoptosis in RA

    NARCIS (Netherlands)

    van der Geest, Kornelis S. M.; Smigielska, Katarzyna; Park, Ji-Ah; Abdulahad, Wayel H.; Kim, Hye-Won; Kroesen, Bart-Jan; van den Berg, Anke; Boots, Annemieke M. H.; Lee, Eun-Bong; Brouwer, Elisabeth

    Objective. The aim of this study was to investigate the turnover of Treg cells in the SF of RA patients. Methods. Treg cells were enumerated in peripheral blood and SF of RA patients and analysed by flow cytometry for expression of the proliferation marker Ki-67 and binding of the apoptosis marker

  9. Reproduction of the RA reactor fuel element fabrication; Reprodukcija izrade gorivnog elementa za reaktor RA

    Energy Technology Data Exchange (ETDEWEB)

    Novakovic, M [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1961-12-15

    This document includes the following nine reports: Final report on task 08/12 - testing the Ra reactor fuel element; design concept for fabrication of RA reactor fuel element; investigation of the microstructure of the Ra reactor fuel element; Final report on task 08/13 producing binary alloys with Al, Mo, Zr, Nb and B additions; fabrication of U-Al alloy; final report on tasks 08/14 and 08/16; final report on task 08/32 diffusion bond between the fuel and the cladding of the Ra reactor fuel element; Final report on task 08/33, fabrication of the RA reactor fuel element cladding; and final report on task 08/36, diffusion of solid state metals. Ovaj rad sadrzi devet priloga: 1. Zavrsni izvestaj o podzadatku 08/12, ispitivanje elementa goriva reaktora RA; 2. Koncepcija izrade gorivnog elementa reaktora RA; 3. Ispitivanje mikrostrukture gorivnog elementa reaktora RA; 4. Zavrsni izvestaj o podzadatku 08/13, dobijanje binarnih legura urana sa legirajucim komponentama Al, Mo, Zr, Nb i B; 5. Dobijanje legure U-Al; 6. Zavrsni izvestaj o podzadacima 08/14 i 08/16; 7. Zavrsni izvestaj o podzadatku 08/32, difuziona veza goriva i kosuljice gorivnog elementa reaktora RA; 8. Zavrsni izvestaj o podzadatku 08/33, izrada kosuljice gorivnog elementa reaktora RA; 9. Zavrsni izvestaj o podzadatku 08/36, difuzija kod metala u cvrstom stanju.

  10. Gene-Based Genome-Wide Association Analysis in European and Asian Populations Identified Novel Genes for Rheumatoid Arthritis.

    Directory of Open Access Journals (Sweden)

    Hong Zhu

    Full Text Available Rheumatoid arthritis (RA is a complex autoimmune disease. Using a gene-based association research strategy, the present study aims to detect unknown susceptibility to RA and to address the ethnic differences in genetic susceptibility to RA between European and Asian populations.Gene-based association analyses were performed with KGG 2.5 by using publicly available large RA datasets (14,361 RA cases and 43,923 controls of European subjects, 4,873 RA cases and 17,642 controls of Asian Subjects. For the newly identified RA-associated genes, gene set enrichment analyses and protein-protein interactions analyses were carried out with DAVID and STRING version 10.0, respectively. Differential expression verification was conducted using 4 GEO datasets. The expression levels of three selected 'highly verified' genes were measured by ELISA among our in-house RA cases and controls.A total of 221 RA-associated genes were newly identified by gene-based association study, including 71'overlapped', 76 'European-specific' and 74 'Asian-specific' genes. Among them, 105 genes had significant differential expressions between RA patients and health controls at least in one dataset, especially for 20 genes including 11 'overlapped' (ABCF1, FLOT1, HLA-F, IER3, TUBB, ZKSCAN4, BTN3A3, HSP90AB1, CUTA, BRD2, HLA-DMA, 5 'European-specific' (PHTF1, RPS18, BAK1, TNFRSF14, SUOX and 4 'Asian-specific' (RNASET2, HFE, BTN2A2, MAPK13 genes whose differential expressions were significant at least in three datasets. The protein expressions of two selected genes FLOT1 (P value = 1.70E-02 and HLA-DMA (P value = 4.70E-02 in plasma were significantly different in our in-house samples.Our study identified 221 novel RA-associated genes and especially highlighted the importance of 20 candidate genes on RA. The results addressed ethnic genetic background differences for RA susceptibility between European and Asian populations and detected a long list of overlapped or ethnic specific RA

  11. Employment among patients with multiple sclerosis - A population study

    OpenAIRE

    Lunde, Hanne Marie; Telstad, Wenche; Torkildsen, Nina Agnethe Grytten; Kyte, Lars; Aarseth, Jan; Myhr, Kjell-Morten; Bø, Lars

    2014-01-01

    OBJECTIVE: To investigate demographic and clinical factors associated with employment in MS. METHODS: The study included 213 (89.9%) of all MS patients in Sogn and Fjordane County, Western Norway at December 31st 2010. The patients underwent clinical evaluation, structured interviews and completed self-reported questionnaires. Demographic and clinical factors were compared between patients being employed versus patients being unemployed and according to disease course of MS. Logist...

  12. The decay scheme of 229Ra

    International Nuclear Information System (INIS)

    Yang, W.F.; Yuan, S.G.; Fang, K.M.; Shen, S.F.; Mou, W.T.; Zhang, X.Q.; Li, Z.Q.

    1997-01-01

    By bombarding the natural thorium targets with 14 MeV neutrons, 229 Ra was produced through the reaction 232 Th(n,α) 229 Ra. The radium activities were separated from the irradiated targets by coprecipitation with the BaCl 2 . A total of 18 new weak γ rays with energies of 14.5, 15.6, 18.8, 21.8, 22.5, 44.0, 47.5, 55.0, 63.0, 69.6, 93.6, 94.1, 98.5, 102.2, 104.5, 106.1, 161.1, and 171.5 keV which could be assigned to the decay of 229 Ra were observed in the isolated radium fractions employing high resolution HPGe detectors and γ(X)-γ coincidence methods. A decay scheme of 229 Ra based on these observations is proposed. (orig.). With 2 figs

  13. Understanding Rheumatoid Arthritis (RA): Treatment and Causes

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Understanding Rheumatoid Arthritis (RA) Treatment and Causes Past Issues / Summer 2014 Table of Contents How Is Rheumatoid Arthritis Treated? Doctors have many ways to treat this ...

  14. RA Construction KC, LLC Information Sheet

    Science.gov (United States)

    RA Construction KC, LLC (the Company) is located in Gladstone, Missouri. The settlement involves renovation activities conducted at a property constructed prior to 1978, located in Kansas City, Missouri.

  15. Doses from {sup 222}Rn, {sup 226}Ra, and {sup 228}Ra in groundwater from Guarani aquifer, South America

    Energy Technology Data Exchange (ETDEWEB)

    Bonotto, D.M. E-mail: dbonotto@rc.unesp.br

    2004-07-01

    Groundwater samples were analysed for {sup 222}Rn, {sup 226}Ra, and {sup 228}Ra in Guarani aquifer spreading around 1 million km{sup 2} within four countries in South America, and it was found that their activity concentrations are lognormally distributed. Population-weighted average activity concentration for these radionuclides allowed to estimate a value either slightly higher (0.13 mSv/year) than 0.1 mSv for the total effective dose or two times higher (0.21 mSv/year) than this limit, depending on the choice of the dose conversion factor. Such calculation adds useful information for the appropriate management of this transboundary aquifer that is socially and economically very important to about 15 million inhabitants living in Brazil, Argentina, Uruguay and Paraguay.

  16. RA Research nuclear reactor Part 1, RA Reactor operation and maintenance in 1987; Istrazivacki nuklearni reaktor RA Deo 1 - Pogon i odrzavanje nuklearnog reaktora RA u 1987. godini

    Energy Technology Data Exchange (ETDEWEB)

    Sotic, O; Martinc, R; Cupac, S; Sulem, B; Badrljica, R; Majstorovic, D; Sanovic, V [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1987-12-15

    RA research reacto was not operated due to the prohibition issued in 1984 by the Government of Serbia. Three major tasks were finished in order to fulfill the licensing regulations about safety of nuclear facilities which is the condition for obtaining permanent operation licence. These projects involved construction of the emergency cooling system, reconstruction of the existing special ventilation system, and renewal of the system for electric power supply of the reactor systems. Renewal of the RA reactor instrumentation system was initiated. Design project was done by the Russian Atomenergoeksport, and is foreseen to be completed by the end of 1988. The RA reactor safety report was finished in 1987. This annual report includes 8 annexes concerning reactor operation, activities of services and financial issues, and three special annexes: report on testing the emergency cooling system, report on renewal of the RA reactor and design specifications for reactor renewal and reconstruction. [Serbo-Croat] Reaktor RA nije radio usled zabrane Izvsnog veca Skupstine Srbije od 27. avgusta 1984. U cilju povecanja pouzdanosti rada reaktora a da bi se udovoljilo zakonskim propisima sto je uslov za dobijanje stalne dozvole za rad realizovana su tri velika zahvata na reaktoru RA. Ovi zahvati obuhvatili su izgradnju sistema za hladjenje jezgra reaktora u slucaju nuzde, rekonstukciju postojeceg sistema specijalne ventilacije i rekonstrukciju sistema napajanja elektricnom energijom neophodnih potrosaca reaktora RA. Zapoceti su radovi na modernizaciji intrumentacije reaktora RA, projekat je izradjen u sovjetskoj organizaciji Atomenergoeksport, a trebalo bi da se realizuje do kraja 1989. godine. U cilju povecanja prostora za skladistenje ozracenog nuklearnog goriva i njegovog efikasnijeg koriscenja, izradjen je su projekti za rekonstrukciju postojecih uredjaja za rukovanje gorivom, povecanje smestajnog kapaciteta i preciscavanje vode u bazenima za odlezavanje. Realizaija ovih

  17. Determination of sup 226 Ra and sup 228 Ra in gypsum

    Energy Technology Data Exchange (ETDEWEB)

    Godoy, J M [Instituto de Radioprotecao e Dosimetria, Rio de Janeiro, RJ (Brazil)

    1989-01-01

    The content of {sup 226}Ra and {sup 228}Ra in different samples of phosphogypsum and three samples of gypsite were determined by gamma spectroscopy. For {sup 226}Ra the 295, 352 and 609 KeV lines and for {sup 228}Ra the 911 and 969 KeV lines were used. The specific activities values ranged from 0.36 to 22.8 pCi/g for {sup 226}Ra and 0.90 to 10.3 pCi/g for {sup 228}Ra. The contribution of a sypsum roof-covering to the {sup 222}Rn concentration in a room was estimated, based on the highest value reported. (author).

  18. Distribution and flux of 226Ra and 228Ra in the Amazon River estuary

    International Nuclear Information System (INIS)

    Key, R.M.; Sarmiento, J.L.; Stallard, R.F.; Moore, W.S.

    1985-01-01

    Measurements of 226 Ra and 228 Ra in the Amazon River estuary show that desorption from riverborne suspended particulate matter in the estuary increases the riverine flux of both isotopes to the ocean by a factor of approximately 5 over the flux attributable to radium dissolved in the river water alone. The total Amazon flux supplies approximately 0.20% of the 226 Ra and approximately 2.6% of the 228 Ra standing crops in the near-surface Atlantic (0-200 m). Diffusive flux from estuarine and shelf sediments and desorption from resuspended sediments in the region of the estuary approximately double the estuarine 226 Ra concentration and quadruple the estuarine 228 Ra concentration above that caused by the dissolved and desorbed river components alone

  19. Implanted Cardiac Defibrillator Care in Radiation Oncology Patient Population

    International Nuclear Information System (INIS)

    Gelblum, Daphna Y.; Amols, Howard

    2009-01-01

    Purpose: To review the experience of a large cancer center with radiotherapy (RT) patients bearing implantable cardiac defibrillators (ICDs) to propose some preliminary care guidelines as we learn more about the devices and their interaction with the therapeutic radiation environment. Methods and Materials: We collected data on patients with implanted ICDs treated with RT during a 2.5-year period at any of the five Memorial Sloan-Kettering clinical campuses. Information regarding the model, location, and dose detected from the device, as well as the treatment fields, fraction size, and treatment energy was collected. During this time, a new management policy for these patients had been implemented requiring treatment with low-energy beams (6 MV) and close surveillance of the patients in partnership with their electrophysiologist, as they received RT. Results: During the study period, 33 patients were treated with an ICD in place. One patient experienced a default of the device to its initial factory setting that was detected by the patient hearing an auditory signal from the device. This patient had initially been treated with a 15-MV beam. After this episode, his treatment was replanned to be completed with 6-MV photons, and he experienced no further events. Conclusion: Patients with ICDs and other implanted computer-controlled devices will be encountered more frequently in the RT department, and proper management is important. We present a policy for the safe treatment of these patients in the radiation oncology environment.

  20. Brief history of /sup 224/Ra usage in radiotherapy and radiobiology

    Energy Technology Data Exchange (ETDEWEB)

    Schales, F [Gesellschaft fuer Strahlen- und Umweltforschung m.b.H., Neuherberg (Germany, F.R.)

    1978-07-01

    Attempts were made a short time after its discovery to introduce /sup 224/Ra in therapy. Besides its external application in dermatology the treatment of rheumatic diseases seemed to be promising. From 1944-1952 about 2000 patients, most of them with tuberculosis or ankylosing spondylitis were treated in a German hospital with repeated intravenous injections of Peteosthor, a combination containing /sup 224/Ra with traces of platinum and eosin, totalling about 4000 ..mu..Ci/sup 224/Ra. Different lesions were observed which were suspected to be due to irradiation. The treatment has nevertheless continued. A group of 1500 additional patients, exclusively adults, has received rather low amounts (250-300 ..mu..Ci) of /sup 224/Ra and are now under study. Based on linear hypothetical dose-effect relationships in this group an osteosarcoma incidence of 3-5 per 1000 patients could be expected during the first 20 years following average skeletal doses of 56 rad. In experiments started in 1965 in Neuherberg, Germany, the acute and late effects of /sup 224/Ra and /sup 227/Th in rats and mice are investigated. Similar experiments are under way in Czechoslovakia. In Salt Lake City, Utah, in connection with studies on boneseeking radioisotopes using dogs, a pilot study on /sup 224/Ra was started in 1963. Together with studies of Ra and Th toxicity a mock dial paint containing /sup 224/Ra and /sup 234/Th was developed. As /sup 224/Ra is a /sup 232/Th decay product, it might play a certain role in the Thorotrast problem.

  1. RA Research reactor, Annual report 1988; Istrazivacki nuklearni reaktor RA - Izvestaj za 1988. godinu

    Energy Technology Data Exchange (ETDEWEB)

    Sotic, O [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1988-12-15

    Annual report concerning the project 'RA research nuclear reactor' for 1989, financed by the Serbian ministry of science is divided into two parts. First part is concerned with RA reactor operation and maintenance, which is the task of the Division for reactor engineering of the Institute for multidisciplinary studies and RA reactor engineering. Second part deals with radiation protection activities at the RA reactor which is the responsibility of the Institute for radiation protection. Scientific council of the Institute for multidisciplinary studies and RA reactor engineering has stated that this report describes adequately the activity and tasks fulfilled at the RA reactor in 1989. The scope and the quality of the work done were considered successful both concerning the maintenance and reconstruction, as well as radiation protection activities. [Serbo-Croat] Godisnji izvestaj po projektu 'Istrazivacki nuklearni reaktor RA' za 1989. godinu, koji finansira republicka zajednica za nauku SR Srbije po ugovoru br. 3705/1 sastoji se iz dva dela. Prvi deo obuhvata pogon i odrzavanje nuklearnog reaktora RA, sto predstavlja obavezu Odeljenja za reaktorski inzenjering u sastavu OOUR Instituta za multidisciplinarna istrazivanja i inzenjering RA. Drugi deo obuhvata poslove zastite od zracenja na reaktoru RA, sto predstavlja obavezu OOUR Instituta za zastitu od zracenja 'Zastita'. Naucno vece Instituta za multidisciplinarna istrazivanja i inzenjering RA ocenilo je da sadrzina ovog izvestaja odgovara izvrsenim poslovima na reaktoru RA u 1989. godini. Pozitivno se ocenjuje obim i kvalitet izvrsenih radova kako u pogledu odrzavanja i rekonstrukcije reaktora, tako i u pogledu poslova zastite od zracenja izvrsenih kod njega.

  2. Research nuclear reactor RA - Annual Report 1989; Istrazivacki nuklearni reaktor RA - Izvestaj za 1989. godinu

    Energy Technology Data Exchange (ETDEWEB)

    Sotic, O [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1989-12-15

    Annual report concerning the project 'RA research nuclear reactor' for 1989, financed by the Serbian ministry of science is divided into two parts. First part is concerned with RA reactor operation and maintenance, which is the task of the Division for reactor engineering of the Institute for multidisciplinary studies and RA reactor engineering. Second part deals with radiation protection activities at the RA reactor which is the responsibility of the Institute for radiation protection. Scientific council of the Institute for multidisciplinary studies and RA reactor engineering has stated that this report describes adequately the activity and tasks fulfilled at the RA reactor in 1989. The scope and the quality of the work done were considered successful both concerning the maintenance and reconstruction, as well as radiation protection activities. [Serbo-Croat] Godisnji izvestaj po projektu 'Istrazivacki nuklearni reaktor RA' za 1989. godinu, koji finansira republicka zajednica za nauku SR Srbije po ugovoru br. 3705/1 sastoji se iz dva dela. Prvi deo obuhvata pogon i odrzavanje nuklearnog reaktora RA, sto predstavlja obavezu Odeljenja za reaktorski inzenjering u sastavu OOUR Instituta za multidisciplinarna istrazivanja i inzenjering RA. Drugi deo obuhvata poslove zastite od zracenja na reaktoru RA, sto predstavlja obavezu OOUR Instituta za zastitu od zracenja 'Zastita'. Naucno vece Instituta za multidisciplinarna istrazivanja i inzenjering RA ocenilo je da sadrzina ovog izvestaja odgovara izvrsenim poslovima na reaktoru RA u 1989. godini. Pozitivno se ocenjuje obim i kvalitet izvrsenih radova kako u pogledu odrzavanja i rekonstrukcije reaktora, tako i u pogledu poslova zastite od zracenja izvrsenih kod njega.

  3. Radiochemical determination and separation or total radium, 226Ra and 224Ra

    International Nuclear Information System (INIS)

    Suarez, J. A.; Gonzalez, J. A.; Pablo, M. A. de

    1987-01-01

    Radiochemical purification and separation of radium has been carried out and the determination of total radium solubilized in aqueous samples has been studied assuming that all the alpha emitters of the sample have their origin in the 226Ra and elements of its desintegration chain. Also, the activities of 22Ra and 226 Ra have been evaluated separately doing a measurement after the chemical separation of the radium and another one 10 days after. (Author) 9 refs

  4. Ba(Ra)SO4 species flotation for decontamination of Ra(II) residual solution

    International Nuclear Information System (INIS)

    Stoica, Ligia; Catuneanu, Rodica; Filip, Gheorghe

    1993-01-01

    The paper presents the results of the research performed on Ra(II) separation from complex composition solutions in a HCO 3 - /CO 3 2- buffer system by Ba(Ra)SO 4 precipitation followed by flotation. The collector selection was done by electrokinetic potential determinations. The optimum concentrations of precipitation-flocculation reagents were established on the basis of the experimental data obtained for synthetic solutions having the same Ra(II) activity, namely 20 pCi/l. (authors)

  5. Association of STAT4 with rheumatoid arthritis: a replication study in three European populations.

    Science.gov (United States)

    Orozco, Gisela; Alizadeh, Behrooz Z; Delgado-Vega, Angélica M; González-Gay, Miguel A; Balsa, Alejandro; Pascual-Salcedo, Dora; Fernández-Gutierrez, Benjamín; González-Escribano, María F; Petersson, Ingemar F; van Riel, Piet L C M; Barrera, Pilar; Coenen, Marieke J H; Radstake, Timothy R D J; van Leeuwen, Miek A; Wijmenga, Cisca; Koeleman, Bobby P C; Alarcón-Riquelme, Marta; Martín, Javier

    2008-07-01

    This study was undertaken to investigate the previously reported association of the STAT4 polymorphism rs7574865 with rheumatoid arthritis (RA) in 3 different European populations from Spain, Sweden, and The Netherlands, comprising a total of 2,072 patients and 2,474 controls. Three different cohorts were included in the study: 923 RA patients and 1,296 healthy controls from Spain, 273 RA patients and 285 healthy controls from Sweden, and 876 RA patients and 893 healthy controls from The Netherlands. DNA from patients and controls was obtained from peripheral blood. Samples were genotyped for the STAT4 single-nucleotide polymorphism rs7574865 using a TaqMan 5'-allele discrimination assay. The chi-square test was performed to compare allele and genotype distributions. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. We observed a significantly increased frequency of the minor T allele in RA patients compared with healthy controls in the Spanish population (24.8% versus 20.8%; P = 0.001, OR 1.26 [95% CI 1.09-1.45]). This association was confirmed in both the Swedish population (P = 0.03, OR 1.35 [95% CI 1.03-1.77]) and the Dutch population (P = 0.03, OR 1.45 [95% CI 1.21-1.73]). The overall P value for all 3 populations was 9.79 x 10(-6) (OR 1.25 [95% CI 1.13-1.37]). No association between rs7574865 and the presence of rheumatoid factor or anti-cyclic citrullinated peptide autoantibodies was observed. A meta-analysis of all published STAT4 associations revealed an OR of 1.25 (95% CI 1.19-1.33) (P = 1 x 10(-5)). Our findings indicate an association between the STAT4 polymorphism rs7574865 and RA in 3 different populations, from Spain, Sweden, and The Netherlands, thereby confirming previous data.

  6. IL-1ra anti-inflammatory cytokine polymorphism is associated with risk of gastric cancer and chronic gastritis in a Brazilian population, but the TNF-β pro-inflammatory cytokine is not.

    Science.gov (United States)

    Oliveira, J Garcia; Duarte, M Cristina; Silva, A Elizabete

    2012-07-01

    Genetic polymorphisms in genes that codify inflammatory cytokines have been associated with gastric carcinogenesis. This study evaluated polymorphisms IL-1RN VNTR and TNFB+252A/G in a population from Southeast Brazil with regard to the risk of chronic gastritis and gastric cancer and the presence of an association of gastric lesions with risk factors such as gender, age, smoking, drinking and Helicobacter pylori infection. In this case-control study, polymorphism at IL-1RN VNTR was investigated using the allele-specific polymerase chain reaction method, while the polymerase chain reaction-restriction fragment length polymorphism technique was used to identify the TNFB+252A/G genotype in 675 Brazilian individuals [229 with chronic gastritis (CG), 200 with gastric cancer (GC) and 246 healthy individuals as controls (C)]. Multiple logistic regression analysis (log-additive, dominant, and recessive models) have not showed association of the genotype frequencies for the SNP TNFB + 252A/G with risk of CG or GC. However, as for IL-1RN VNTR it was observed significant differences in all three analysis models, with higher values of OR in recessive model, both in the GC group (OR = 3.04, 95% CI = 1.41-6.56, p cancer and precancerous lesions in the Southeast Brazilian population, reinforcing the importance of host genetic factors in the susceptibility to gastric cancer and the participation of cytokines in both the inflammation and the carcinogenic process.

  7. Timing is everything: Reiterative Wnt, BMP and RA signaling regulate developmental competence during endoderm organogenesis.

    Science.gov (United States)

    Rankin, Scott A; McCracken, Kyle W; Luedeke, David M; Han, Lu; Wells, James M; Shannon, John M; Zorn, Aaron M

    2018-02-01

    A small number of signaling pathways are used repeatedly during organogenesis, and they can have drastically different effects on the same population of cells depending on the embryonic stage. How cellular competence changes over developmental time is not well understood. Here we used Xenopus, mouse, and human pluripotent stem cells to investigate how the temporal sequence of Wnt, BMP, and retinoic acid (RA) signals regulates endoderm developmental competence and organ induction, focusing on respiratory fate. While Nkx2-1+ lung fate is not induced until late somitogenesis stages, here we show that lung competence is restricted by the gastrula stage as a result of Wnt and BMP-dependent anterior-posterior (A-P) patterning. These early Wnt and BMP signals make posterior endoderm refractory to subsequent RA/Wnt/BMP-dependent lung induction. We further mapped how RA modulates the response to Wnt and BMP in a temporal specific manner. In the gastrula RA promotes posterior identity, however in early somite stages of development RA regulates respiratory versus pharyngeal potential in anterior endoderm and midgut versus hindgut potential in posterior endoderm. Together our data suggest a dynamic and conserved response of vertebrate endoderm during organogenesis, wherein early Wnt/BMP/RA impacts how cells respond to later Wnt/BMP/RA signals, illustrating how reiterative combinatorial signaling can regulate both developmental competence and subsequent fate specification. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Determination of 226Ra and 224Ra in drinking waters by liquid scintillation counting

    International Nuclear Information System (INIS)

    Manjon, G.; Vioque, I.; Moreno, H.; Garcia-Tenorio, R.; Garcia-Leon, M.

    1997-01-01

    A method for the determination of Ra-isotopes in water samples has been developed. Ra is coprecipitated with Ba as sulphate. The precipitate is then dissolved with EDTA and counted with a liquid scintillation system after mixing with a scintillation cocktail. The study of the temporal evolution of the separated activity gives the isotopic composition of the sample, i.e. the 224 Ra and 226 Ra contribution to the total activity. The method has been applied to some Spanish drinking waters. (author)

  9. Greek rheumatoid arthritis patients have elevated levels of antibodies against antigens from Proteus mirabilis.

    Science.gov (United States)

    Christopoulos, Georgios; Christopoulou, V; Routsias, J G; Babionitakis, A; Antoniadis, C; Vaiopoulos, G

    2017-03-01

    Patients with rheumatoid arthritis (RA) from different ethnic groups present elevated levels of antibodies against Proteus mirabilis. This finding implicates P. mirabilis in the development of RA. The aim of this study was to investigate the importance of P. mirabilis in the etiopathogenesis of RA in Greek RA patients. In this study, 63 patients with RA and 38 healthy controls were included. Class-specific antibodies IgM, IgG, and IgA against three human cross-reactive and non-cross-reactive synthetic peptides from P. mirabilis-hemolysin (HpmB), urease C (UreC), and urease F (UreF)-were performed in all subjects, using the ELISA method. RA patients had elevated levels of IgM, IgG, and IgA antibodies against HpmB and UreC Proteus peptide which are significantly different compared to healthy controls: p = 0.005, p Proteus peptide-which are non-cross-reactive with human tissue antigens-were observed and their significant difference compared to healthy controls (p = 0.007, p mirabilis antigenic epitopes, such as in North European populations, albeit Greek RA patients presenting the cross-reaction antigen in a low percentage. These results indicate that P. mirabilis through the molecular mimicry mechanism leads to inflammation and damage of the joints in RA.

  10. Communication Adaptations for a Diverse International Patient Population.

    Science.gov (United States)

    Ghosh, Aditya; Joshi, Shashank; Ghosh, Amit K

    2017-11-01

    We live in an age of hyper connectivity, people from around the world are looking outside their own national borders to receive medical care. As more people are learning about the quality that the elite Indian hospitals provide at a competitive, and often more affordable, price compared to other institutions around the world, they are becoming increasingly interested in receiving their medical care in Indian hospitals. It is for this exact reason that it is very important to learn the importance of communicating effectively with people from a diverse background. Over the next decade, the number of international patients that Indian hospitals will provide care for is set to dramatically increase. In this new age of medicine in India, it is imperative that doctors are adequately equipped with the communication skills to appropriately connect with patients coming from very different cultural backgrounds. The interaction with an international patient can be tremendously deepened through effective communication that adheres to the cultural beliefs of the patient. In this article, we detail how to effectively communicate with people from different backgrounds. We explore how to speak with patients and connect on a deeper level and respect the cultural differences that exist. We will also discuss how to avoid offending your patients or miscommunicating your plans to them. Overall, improved awareness of cultural differences will ensure higher patient satisfaction as well as an improved doctor patient interaction. © Journal of the Association of Physicians of India 2011.

  11. Investigations of excretion rates of the radionuclides {sup 230}Th, {sup 226}Ra, {sup 210}Pb and {sup 210}Po of persons of the general population and of workers in selected regions in Germany

    Energy Technology Data Exchange (ETDEWEB)

    Schaefer, I. [Nuclear Engineering and Analytics Rossendorf Inc. D-01328 Dresden (Germany); Seitz, G. [Institution for statutory accident insurance and prevention in the precision engineering and electrical industry, D-50941 Koeln (Germany); Hartmann, M. [Federal Office for Radiation Protection, D-10318 Berlin (Germany)

    2006-07-01

    According to ICRP 60 and European-Directive 96/29, Naturally Occurring Radioactive Materials (NORM) and Technical Enriched Naturally Occurring Radioactive Materials (TENORM) have to take the radiation protection of the general population as well as of workers into account. The German radiation protection regulations stress that particularly. In connection with these regulations, various measurement programs have been and still are performed to investigate the relevant exposure paths. One of these programs is the determination of the intake of natural occurring radionuclides of the uranium decay series in individuals of the public, in exposed regions and houses and also at NORM workplaces by excretion analysis. Excretion analysis surveillance is one of the common tools for internal dosimetry. Sources of primordial radionuclides could be the ingestion of foodstuff and water and the incorporation of (mostly airborne) pollution on work places. The main focus in this report is set upon the excretion rate in faeces and urine. A cohort of about 100 persons was selected in five regions in Germany. One of these regions we chose to be the reference area. It is situated in the northern part of Germany with low background radiation. The other regions are in the south-west and south-east mountain areas. Workers were selected from drinking water providers, natural gas providers, balneologic facilities and exhibition mines and museum pits. In the same region also persons of public were recruited for the study. The paper presents selected data of the above mentioned nuclides in urine and faeces samples which were collected during 2002 to 2005. The results are grouped due the parameters like regions and working fields and are discussed in detail. These are 15 mBq/d in urine and 70 mBq/d in faeces and are not as different for the different nuclides as one may expect. (authors)

  12. Investigations of excretion rates of the radionuclides 230Th, 226Ra, 210Pb and 210Po of persons of the general population and of workers in selected regions in Germany

    International Nuclear Information System (INIS)

    Schaefer, I.; Seitz, G.; Hartmann, M.

    2006-01-01

    According to ICRP 60 and European-Directive 96/29, Naturally Occurring Radioactive Materials (NORM) and Technical Enriched Naturally Occurring Radioactive Materials (TENORM) have to take the radiation protection of the general population as well as of workers into account. The German radiation protection regulations stress that particularly. In connection with these regulations, various measurement programs have been and still are performed to investigate the relevant exposure paths. One of these programs is the determination of the intake of natural occurring radionuclides of the uranium decay series in individuals of the public, in exposed regions and houses and also at NORM workplaces by excretion analysis. Excretion analysis surveillance is one of the common tools for internal dosimetry. Sources of primordial radionuclides could be the ingestion of foodstuff and water and the incorporation of (mostly airborne) pollution on work places. The main focus in this report is set upon the excretion rate in faeces and urine. A cohort of about 100 persons was selected in five regions in Germany. One of these regions we chose to be the reference area. It is situated in the northern part of Germany with low background radiation. The other regions are in the south-west and south-east mountain areas. Workers were selected from drinking water providers, natural gas providers, balneologic facilities and exhibition mines and museum pits. In the same region also persons of public were recruited for the study. The paper presents selected data of the above mentioned nuclides in urine and faeces samples which were collected during 2002 to 2005. The results are grouped due the parameters like regions and working fields and are discussed in detail. These are 15 mBq/d in urine and 70 mBq/d in faeces and are not as different for the different nuclides as one may expect. (authors)

  13. Assessment of 226Ra, 228Ra and 40K contents in the Egyptian bottled natural water

    International Nuclear Information System (INIS)

    El-Afifi, E.M.; Hilal, M.A.; Khalifa, S.M.; Aly, H.F.

    2004-01-01

    The activity concentrations of 2 26Ra, 2 28Ra and 4 0 and k in different brands of the bottled egyptian natural water of different origins obtained from four regions, have been analyzed nondestructively by gamma- ray spectrometry. The study covers nine brands of natural water commonly used mainly for drinking in egypt. The results showed, concentrations up to 184, 156 and 1700 mBq I - 1 for 2 26Ra, 2 28Ra and 4 0K, respectively, in one brand of the natural water from water from Siwa oasis. Whereas, lower activity concentrations of 2 26Ra and 2 28Ra were found in one brand of these natural waters from El sadat region. The activity concentration of 4 0K was found to be in the background range in the brands from El sadat, kafr El arbein and beilbeis regions. The committed effective doses reached 1.9 x 10 - 2 m Sy Y - 1 for ingestion of 2 26Ra and 2 28Ra for one liter per day, respectively, which are lower than the standard permissible limit by the WHO and IAEA. However, it is recommended to moderate drinking of bottled natural water to avoid the accumulation effect of radioactive nuclides especially radium

  14. Techniques for precise mapping of 226Ra and 228Ra in the ocean

    International Nuclear Information System (INIS)

    Moore, W.S.; Key, R.M.; Sarmiento, J.L.

    1985-01-01

    Improvements in the analyses of 226 Ra and 228 Ra in seawater made possible by better extraction and processing techniques reduce significantly the errors associated with these measurements. These improvements and the extensive sampling for Ra isotopes conducted on the TTO North Atlantic Study should enable us to use the distribution of 228 Ra to study mixing processes on a 3-15 year time scale in both the upper and deep North Atlantic. The 228 Ra profiles already analyzed show a closer resemblance to GEOSECS tritium data than to TTO tritium data in the upper ocean. This is because the transient tracer tritium was responding on a 10-year time scale during GEOSECS and a 20-year time scale during TTO. The steady state tracer 228 Ra should always respond on a time scale of 8 years. Thus the 228 Ra data obtained on TTO should provide a means to extend the features of the GEOSECS tritium field to the regions of the TTO study. The 226 Ra data are of high enough quality to identify features associated with different water masses. Changes in the positions of the deep-water masses since the GEOSECS cruise are revealed by the 226 Radata

  15. Use of nuclear recoil for separating 228Ra, 224Ra, and 233Pa from colloidal thorium

    International Nuclear Information System (INIS)

    Beydon, J.; Gratot, I.

    1968-01-01

    By using α-recoil it is possible to separate by dialysis the α disintegration products (224 Ra; 228 Ra) of thorium from colloidal thorium hydroxide.The use of n, γ recoil allows the separation of 233 Pa produced by the neutron irradiation of thorium, on condition that the colloidal thorium hydroxide is irradiated in the presence of a dispersing. (author) [fr

  16. Study of the specific concentrations of {sup 40}K, {sup 224}Ra, {sup 226}Ra and {sup 228}Ra in some seasonings marketed in Rio de Janeiro City

    Energy Technology Data Exchange (ETDEWEB)

    Garcêz, Ricardo W.D.; Lopes, José M.; Silva, Leandro B.; Silva, Ademir X. da [Coordenacao de Pos-Graduacao e Pesquisa de Engenharia (PEN/COPPE/UFRJ), Rio de Janeiro, RJ (Brazil). Programa de Engenharia Nuclear; Lima, Marco A.F., E-mail: rgarcez@nuclear.ufrj.br [Universidade Federal Fluminense (UFF), Niterói, RJ (Brazil). Instituto de Biologia

    2017-07-01

    The seasoning are vegetables substances used in foods to enhance their flavor, aroma and color. This work presents an investigation of the activity concentration of Naturally Occurring Radioactive Materials (NORMs) in 28 samples of seasoning utilized by brazilian population. The seasoning samples were measured using gamma spectroscopy technique with a high-purity germanium (HPGe) detector, a non-destructive nuclear method and with the LabSOCS software for the calculation of the efficiency curve. The analysis shows that the activity concentration of {sup 40}K was measured in all samples and ranges from 21.0 Bq/kg to 1288 Bq/kg. The highest concentration activity of {sup 40}K was measured to 'cheiro verde', a local seasoning made of chives (Allium Schoenoprasum) and parsley (Petroselinum Crispum), while annatto, made with the fruit of Bixa Orelhana, had the lowest activity concentration. Brazil nut (Bertholletia Excelsa) presented the highest concentrations for {sup 226}Ra and {sup 228}Ra with 24 Bq/kg and 25.7 Bq/kg, respectively and black pepper (Piper Nigrum) presented the highest concentration for {sup 224}Ra with 33.9 Bq/kg. The highest effective dose for members of the public due to ingestion was 23.5 μSv/y due to Brazil nut and the lowest effective dose was found for annatto: 0.13 μSv/y. The syrian seasoning sample present specific concentration of 6.1±1.1 Bq/kg for {sup 137}Cs and 0.08 μSv/y of effective dose. The values found in this work do not represent a risk to human health. (author)

  17. Study of the specific concentrations of 40K, 224Ra, 226Ra and 228Ra in some seasonings marketed in Rio de Janeiro City

    International Nuclear Information System (INIS)

    Garcêz, Ricardo W.D.; Lopes, José M.; Silva, Leandro B.; Silva, Ademir X. da; Lima, Marco A.F.

    2017-01-01

    The seasoning are vegetables substances used in foods to enhance their flavor, aroma and color. This work presents an investigation of the activity concentration of Naturally Occurring Radioactive Materials (NORMs) in 28 samples of seasoning utilized by brazilian population. The seasoning samples were measured using gamma spectroscopy technique with a high-purity germanium (HPGe) detector, a non-destructive nuclear method and with the LabSOCS software for the calculation of the efficiency curve. The analysis shows that the activity concentration of 40 K was measured in all samples and ranges from 21.0 Bq/kg to 1288 Bq/kg. The highest concentration activity of 40 K was measured to 'cheiro verde', a local seasoning made of chives (Allium Schoenoprasum) and parsley (Petroselinum Crispum), while annatto, made with the fruit of Bixa Orelhana, had the lowest activity concentration. Brazil nut (Bertholletia Excelsa) presented the highest concentrations for 226 Ra and 228 Ra with 24 Bq/kg and 25.7 Bq/kg, respectively and black pepper (Piper Nigrum) presented the highest concentration for 224 Ra with 33.9 Bq/kg. The highest effective dose for members of the public due to ingestion was 23.5 μSv/y due to Brazil nut and the lowest effective dose was found for annatto: 0.13 μSv/y. The syrian seasoning sample present specific concentration of 6.1±1.1 Bq/kg for 137 Cs and 0.08 μSv/y of effective dose. The values found in this work do not represent a risk to human health. (author)

  18. Typhoid fever in a South African in-patient population

    NARCIS (Netherlands)

    Khan, Mohammad Enayet Hossain

    2004-01-01

    In conclusion, the data presented herein show that no single clinical or paraclinical parameter is reliable in arriving at a correct clinical diagnosis of typhoid fever and that bacteriologic confirmation is necessary for the diagnosis of typhoid fever. Patients ’ age and sex influence the clinical

  19. Intraocular surgery in a large diabetes patient population

    DEFF Research Database (Denmark)

    Ostri, Christoffer

    2014-01-01

    The prevalence of diabetes is on the increase in developed countries. Accordingly, the prevention and treatment of vision-threatening diabetic eye complications is assuming greater importance. The overall aim of this thesis is to analyse risk factors for intraocular surgery in a large diabetes po...... surgery, which can be used for preventive purposes, surgical decision-making and patient counselling....

  20. Trends in the first decade of 21st century healthcare utilisation in a rheumatoid arthritis cohort compared with the general population.

    Science.gov (United States)

    Hagel, Sofia; Petersson, Ingemar F; Bremander, Ann; Lindqvist, Elisabet; Bergknut, Charlotte; Englund, Martin

    2013-07-01

    To study 21st century trends in healthcare utilisation by patients with rheumatoid arthritis (RA) compared with the general population. Observational cohort study. Using Swedish healthcare register data, we identified 3977 Region Skåne residents (mean age in 2001, 62.7 years; 73% women) presenting with RA (International Classification of Diseases-10 codes M05 or M06) in 1998-2001. We randomly sampled two referents from the general population per RA patient matched for age, sex and area of residence. We calculated the year 2001-2010 trends for the annual ratio (RA cohort/referents) of the mean number of hospitalisations and outpatient clinic visits. By the end of the 10-year period, 62% of patients and 74% of referents were still alive and resident in the region. From 2001 to 2010, the ratio (RA cohort/referents) of the mean number of hospitalisations for men and women decreased by 27% (p=0.01) and 28% (p=0.004), respectively. The corresponding decrease was 29% (p=0.005) and 16% (p=0.004) for outpatient physician care, 34% (p=0.009) and 18% (p=0.01) for nurse visits, and 34% (p=0.01) and 28% (p=0.004) for physiotherapy. The absolute reduction in number of hospitalisations was from an annual mean of 0.79 to 0.69 in male patients and from 0.71 to 0.59 in female patients. The corresponding annual mean number of consultations in outpatient physician care by male and female RA patients changed from 9.2 to 7.7 and from 9.9 to 8.7, respectively. During the first decade of the 21st century, coinciding with increasing use of earlier and more active RA treatment including biological treatment, overall inpatient and outpatient healthcare utilisation by a cohort of patients with RA decreased relative to the general population.

  1. A new determination method of 226Ra, 224Ra, and 228Th in water

    International Nuclear Information System (INIS)

    Horiuchi, Kimiko; Murakami, Yukio.

    1981-01-01

    A new method for the determination of 226 Ra, 224 Ra and 228 Th in water samples is described. It consists of extraction of 222 Rn and 220 Rn into a scintillator-toluene solution in equilibrium with 226 Ra and 224 Ra and the application of integral counting techniques with a liquid scintillation counter. One liter water sample, weakly acidified with hydrochloric acid, is transferred to a glass bottle, and vigorously bubbled with a stream of nitrogen to expel any radon or thoron in the water sample. Twenty five ml of the scintillator-toluene solution is added to the bottle (time is recorded). The bottle is stoppered with a Teflon stopper and kept at an upside-down position for a given period of time (usually 4 -- 16 days) to allow radon and thoron in partial equilibrium with their parent nuclides. Then, the sample system is vigorously shaken for 2 m and the organic layer is gently transferred to a counting vial through a specially devised transferring tube which is connected to the bottle. The initial counting time is set at 4 h after the separation of organic layer. The measurements are repeated 3 times each immediately and after 106 h from the initial counting time. From these results, the integral counting rates of radon and thoron at the initial counting time are easily obtained. The activities of 226 Ra, 224 Ra and 228 Th in the water sample are calculated from these integral counting rates by the proposed formulas. Some data on the 226 Ra and 224 Ra contents of mineral springs are presented. The lowest detection limits for 226 Ra and 224 Ra were 1.10 x 10 -12 and 1.47 x 10 -9 Ci, respectively. The present method is rapid, easy and accurate and eliminates a time-consuming sealing of the sample in Curie bottle and tedious procedure to transfer the sample gas through a vacuum system to the detector. (author)

  2. Research nuclear reactor RA, Annual Report 2001

    International Nuclear Information System (INIS)

    Sotic, O.

    2002-01-01

    During 2001, activities at the RA research nuclear reactor in were performed according to the Contract about financing of the RA reactor for the period January-December 2001, signed by the Ministry of Science, technology and development of the Republic of Serbia. RA reactor was not operated since shutdown in August 1984. Although, the most of the planned reconstruction activities were finished until 1991, the most important, which was concerned with exchange of the reactor instrumentation, financed by the IAEA, was interrupted due to international sanctions imposed on the country. Since 1992, all the renewal and reconstruction activities were ceased. Continuous aging and degradation of the equipment and facilities demand decision making about the future status of the Ra reactor. Until this decision is made it is an obligation to maintain control and maintenance of ventilation system, power supply, internal transportation system, spent fuel storage, hot cells, electronic fuel surveillance system, and part of the stationary dosimetry system. In 2001, apart from the mentioned activities, actions were undertaken related to maintenance of the reactor building and installations. The most important tasks fulfilled were: protection of the roof of the ventilation system building, purchase and installing the fire protection system and twelve new battery cells in the reactor building. There were no actions concerned with improvement of the conditions for intermediate spent fuel storage. With the support of IAEA, actions were initiated for possible transport of the spent fuel tu Russia. At the end of 2001, preparations were started for possible future decommissioning of the RA reactor. After, renewal of the membership of our country in the IAEA, the Government of Yugoslavia has declared its attitude about the intention of RA reactor decommissioning at the General Conference in September 2001 [sr

  3. Measurements of neutron flux in the RA reactor

    International Nuclear Information System (INIS)

    Raisic, N.

    1961-12-01

    This report includes the following separate parts: Thermal neutron flux in the experimental channels od RA reactor; Epithermal neutron flux in the experimental channels od RA reactor; Fast neutron flux in the experimental channels od RA reactor; Thermal neutron flux in the thermal column and biological experimental channel; Neutronic measurements in the RA reactor cell; Temperature reactivity coefficient of the RA reactor; design of the device for measuring the activity of wire [sr

  4. Evaluation of clinical and cytogenetic parameters in rheumatoid arthritis patients for effective diagnosis.

    Science.gov (United States)

    Chandirasekar, R; Kumar, B Lakshman; Jayakumar, R; Uthayakumar, V; Jacob, Raichel; Sasikala, K

    2015-01-15

    Rheumatoid arthritis is the commonest inflammatory joint disease, affecting nearly 1% of the adult population worldwide. Early and accurate diagnosis and prognosis of rheumatoid arthritis (RA) have become increasingly important. In the present study, we aimed to elucidate the relationships between hematological, biochemical, immunological and cytogenetic parameters in rheumatoid arthritis patients and healthy normal controls. The study group comprised of 126 RA patients and equal number of healthy normal control subjects. The blood was collected and analyzed for biochemical, immunological, enzymatic and cytogenetic parameters. Results of the present study indicated that 20% of RA patient's hematological, 31% of biochemical and 70% immunological parameters had a significant difference from the controls and reference range. The RF and anti-CCP antibody levels were also positive in 70% of RA patients. A significant increase in minor chromosomal abnormalities was also observed in patients as compared to controls. The knowledge about autoimmune diseases is very low among the South Indian population. The present study has thus helped in understanding the RA disease in a better way based on a pattern of various clinical markers of the disease condition which might help in planning therapeutic intervention strategies and create awareness about the disease management among RA patients of the population studied. Copyright © 2014. Published by Elsevier B.V.

  5. RA-0 reactor. New neutronic calculations

    International Nuclear Information System (INIS)

    Rumis, D.; Leszczynski, F.

    1990-01-01

    An updating of the neutronic calculations performed at the RA-0 reactor, located at the Natural, Physical and Exact Sciences Faculty of Cordoba National University, are herein described. The techniques used for the calculation of a reactor like the RA-0 allows prediction in detail of the flux behaviour in the core's interior and in the reflector, which will be helpful for experiments design. In particular, the use of WIMSD4 code to make calculations on the reactor implies a novelty in the possible applications of this code to solve the problems that arise in practice. (Author) [es

  6. ICMPv6 RA Flooding Vulnerability Research

    Directory of Open Access Journals (Sweden)

    Linas Jočys

    2016-06-01

    Full Text Available ICMPv6 is the newest version of internet control message protocol, whose main purpose is to send error message indicating packet processing failure. It is know that ICMPv6 is technologically vulnerable. One of those vulnerabilities is the ICMPv6 RA flooding vulnerability, which can lead to systems in Local Area Network slow down or full stop. This paper will discuss Windows (XP, 7, 8.1 and Linux Ubuntu 14 operating systems resistance to RA flooding attack research and countermeasures to minimize this vulnerability.

  7. Utilitarian prioritization of radiation oncology patients based on maximization of population tumour control

    Science.gov (United States)

    Ebert, M. A.; Li, W.; Jennings, L.; Kearvell, R.; Bydder, S.

    2013-06-01

    An objective method for establishing patient prioritization in the context of a radiotherapy waiting list is investigated. This is based on a utilitarian objective, being the greatest probability of local tumour control in the population of patients. A numerical simulation is developed and a clinical patient case-mix is used to determine the influence of the characteristics of the patient population on resulting optimal patient scheduling. With the utilitarian objective, large gains in tumour control probability (TCP) can be achieved for individuals or cohorts by prioritizing patients for that fraction of the patient population with relatively small sacrifices in TCP for a smaller fraction of the population. For a waiting list in steady state with five patients per day commencing treatment and leaving the list (and so with five patients per day entering the list), and a mean wait time of 35 days and a maximum of 90 days, optimized wait times ranged from a mean of one day for patients with tumour types with short effective doubling times to a mean of 66.9 days for prostate cancer patients. It is found that, when seeking the optimal daily order of patients on the waiting list in a constrained simulation, the relative rather than absolute value of TCP is the determinant of the resulting optimal waiting times. An increase in the mean waiting time mostly influences (increases) the optimal waiting times of patients with fast-growing tumours. The proportional representation of groups (separated by tumour type) in the patient population has an influence on the resulting distribution of optimal waiting times for patients in those groups, though has only a minor influence on the optimal mean waiting time for each group.

  8. Utilitarian prioritization of radiation oncology patients based on maximization of population tumour control

    International Nuclear Information System (INIS)

    Ebert, M A; Li, W; Kearvell, R; Bydder, S; Jennings, L

    2013-01-01

    An objective method for establishing patient prioritization in the context of a radiotherapy waiting list is investigated. This is based on a utilitarian objective, being the greatest probability of local tumour control in the population of patients. A numerical simulation is developed and a clinical patient case-mix is used to determine the influence of the characteristics of the patient population on resulting optimal patient scheduling. With the utilitarian objective, large gains in tumour control probability (TCP) can be achieved for individuals or cohorts by prioritizing patients for that fraction of the patient population with relatively small sacrifices in TCP for a smaller fraction of the population. For a waiting list in steady state with five patients per day commencing treatment and leaving the list (and so with five patients per day entering the list), and a mean wait time of 35 days and a maximum of 90 days, optimized wait times ranged from a mean of one day for patients with tumour types with short effective doubling times to a mean of 66.9 days for prostate cancer patients. It is found that, when seeking the optimal daily order of patients on the waiting list in a constrained simulation, the relative rather than absolute value of TCP is the determinant of the resulting optimal waiting times. An increase in the mean waiting time mostly influences (increases) the optimal waiting times of patients with fast-growing tumours. The proportional representation of groups (separated by tumour type) in the patient population has an influence on the resulting distribution of optimal waiting times for patients in those groups, though has only a minor influence on the optimal mean waiting time for each group. (paper)

  9. Study of the specific activity concentrations of 40K, {sup 226}Ra, {sup 228}Ra and {sup 232}Th in vegetables and their respective covering tissues (peels)

    Energy Technology Data Exchange (ETDEWEB)

    Lopes, J.M.; Garcêz, R.W.D., E-mail: marqueslopez@yahoo.com.br [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil). Programa de Engenharia Nuclear; Silva, A.X. [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil). Escola Politécnica

    2017-07-01

    This work presents an analysis of specific concentrations of {sup 40}K, {sup 226}Ra, {sup 228}Ra and {sup 232}Th in some vegetables that are part of the diet of the population of the state of Rio de Janeiro. Furthermore, was analyzed the concentrations of radionuclides in the same coating tissue that compose the vegetables. It can notice an increase of the specific concentration of {sup 40}K in the peels of vegetables that have little or no contact with the ground. Among the samples examined, only the pumpkin showed measurable amount of {sup 137}Cs both saves and in the skin. (author)

  10. Study of the specific activity concentrations of 40K, 226Ra, 228Ra and 232Th in vegetables and their respective covering tissues (peels)

    International Nuclear Information System (INIS)

    Lopes, J.M.; Garcêz, R.W.D.; Silva, A.X.

    2017-01-01

    This work presents an analysis of specific concentrations of 40 K, 226 Ra, 228 Ra and 232 Th in some vegetables that are part of the diet of the population of the state of Rio de Janeiro. Furthermore, was analyzed the concentrations of radionuclides in the same coating tissue that compose the vegetables. It can notice an increase of the specific concentration of 40 K in the peels of vegetables that have little or no contact with the ground. Among the samples examined, only the pumpkin showed measurable amount of 137 Cs both saves and in the skin. (author)

  11. Population pharmacokinetics of amikacin in neonatal intensive care unit patients

    Directory of Open Access Journals (Sweden)

    Paulo Caceres Guido

    2017-02-01

    Full Text Available Background Amikacin treatment requires close monitoring of blood concentrations to increase the probability that levels achieved are both effective and safe. Aims We described population pharmacokinetics parameters of amikacin in newborns from a Neonatal Intensive Care Unit with suspected or documented sepsis. Methods A nonlinear mixed-effect model approach was used to analyse the data. Results Twenty seven neonates were enrolled. Final parameter estimates were: Ke(h-1=0.232x(CR Exp-0.85; V(mL/kg=497. Conclusion Weight and serum creatinine are associated with neonatal amikacin volume of distribution and elimination constant rate, respectively. The presence of sepsis may decrease amikacin elimination, although this observation should be further explored. These results could help to individualize amikacin dosage for neonates.

  12. Determination of 226 Ra and 228 Ra in mineral spring waters of the Aguas da Prata region

    International Nuclear Information System (INIS)

    Oliveira, J. de.

    1993-01-01

    Concentration levels of 226 Ra and 228 Ra have been analysed in most of the mineral spring waters available in the Aguas da Prata region. The 226 Ra and 228 Ra were determined by coprecipitation with barium sulphate. The 226 Ra was determined by gross alpha counting of the Ba(Ra)SO 4 precipitate. The determination of 228 Ra was done by measuring the gross beta activity of the same precipitate. Both measurements were carried out in a low background gas flow proportional counter. Dose calculations were performed in order to evaluate the relative importance of such radionuclides to the radiation exposure due to the ingestion of these waters. Based upon measured concentrations, committed effective doses up to 5.5 x 10 -1 mSv/y and 1.0 x 10 -2 mSv/y were observed for 226 Ra and 228 Ra, respectively. These results show that 226 Ra is the main contributor to radiation exposure. (author)

  13. Optimising radiation outcomes, scheduling patient waiting lists for maximum population tumour control

    International Nuclear Information System (INIS)

    Ebert, M.A.; Jennings, L.; Kearvell, R.; Bydder, S.

    2011-01-01

    Full text: Delays in the commencement of radiotherapy, possibly due to resource constraints, are known to impact on control-related outcomes. We sought an objective solution for patient prioritisation based on tumour control probability (TCP). With a utilitarian objective for maximising TCP in a population of M patients, with patient i waiting a time between diagnosis and treatment of Ti and a mean wait time of TMean, the optimisation problem is as shown. A linear-quadratic/Poissonian model for cell survival/TCP was considered including cell doubling during the wait time. Solutions to several distributions of patient population characteristics were examined together with the expected change in TCP for the population and individuals. An analytical solution to the optimisation problem was found which gives the optimal wait time for each patient as a function of the distribution of radiobiological characteristics in the population. This solution does not allow a negativity constraint on an individual's optimised waiting time so a waiting list simulation was developed to enforce that. Optimal wait time distributions were calculated for situations where patients are allocated distinct diagnostic groups (sharing radiobiological parameters) and for a (log-normal) distribution of doubling times in the population. In order to meet the utilitarian objective, the optimal solutions require patients with rapid cell doubling times to be accelerated up the waiting list at the expense of those with slowly proliferating tumours. The net population benefit however is comparable to or greater then the expected benefit from beam intensity modulation or dose escalation.

  14. Polycystic kidney disease among 4,436 intracranial aneurysm patients from a defined population.

    Science.gov (United States)

    Nurmonen, Heidi J; Huttunen, Terhi; Huttunen, Jukka; Kurki, Mitja I; Helin, Katariina; Koivisto, Timo; von Und Zu Fraunberg, Mikael; Jääskeläinen, Juha E; Lindgren, Antti E

    2017-10-31

    To define the association of autosomal dominant polycystic kidney disease (ADPKD) with the characteristics of aneurysmal subarachnoid hemorrhage (aSAH) and unruptured intracranial aneurysm (IA) disease. We fused data from the Kuopio Intracranial Aneurysm database (n = 4,436 IA patients) and Finnish nationwide registries into a population-based series of 53 IA patients with ADPKD to compare the aneurysm- and patient-specific characteristics of IA disease in ADPKD and in the general IA population, and to identify risks for de novo IA formation. In total, there were 33 patients with ADPKD with aSAH and 20 patients with ADPKD with unruptured IAs. The median size of ruptured IAs in ADPKD was significantly smaller than in the general population (6.00 vs 8.00 mm) and the proportion of small ruptured IAs was significantly higher (31% vs 18%). Median age at aSAH was 42.8 years, 10 years younger than in the general IA population. Multiple IAs were present in 45% of patients with ADPKD compared to 28% in the general IA population. Cumulative risk of de novo IA formation was 1.3% per patient-year (vs 0.2% in the general IA population). Hazard for de novo aneurysm formation was significantly elevated in patients with ADPKD (Cox regression hazard ratio 7.7, 95% confidence interval 2.8-20; p IAs in patients with ADPKD and risk for de novo IAs is higher than in the general Eastern Finnish population. ADPKD should be considered as an indicator for long-term angiographic follow-up in patients with diagnosed IAs. © 2017 American Academy of Neurology.

  15. Demographics of implant placement and complications of a patient subgroup in a dental hospital population.

    LENUS (Irish Health Repository)

    Brennan, Maire

    2011-03-14

    Little has been reported about the demographics of implant placement in the Irish population and the complications that occur. This is important in terms of service planning and providing patient information.

  16. Demographics of implant placement and complications of a patient subgroup in a dental hospital population.

    LENUS (Irish Health Repository)

    Brennan, Maire

    2010-05-01

    Little has been reported about the demographics of implant placement in the Irish population and the complications that occur. This is important in terms of service planning and providing patient information.

  17. Fine structures in 14C emission of 223Ra and 224Ra

    International Nuclear Information System (INIS)

    Hourani, E.; Rosier, L.; Berrier-Ronsin, G.; Elayi, A.; Mueller, A.C.; Rappenecker, G.; Rotbard, G.; Renou, G.; Liebe, A.; Stab, L.

    1991-01-01

    The measurement of the energy spectrum of 14 C nuclei emitted in the spontaneous radioactivity from 223 Ra and 224 Ra has been carried out, using thin and intense sources (480 MBq for 223 Ra and 3550 MBq for 224 Ra). The sources were obtained by implanting mass-separated beams from ISOLDE (CERN) into Al and vitreous C catchers. The measurement was performed with the supraconducting solenoidal spectrometer SOLENO installed at Orsay. The discovery, of a fine structure in the energy spectrum of 14 C emission from 223 Ra, which is analogous to the one known for α emission, is confirmed. Only 13% of the branching ratio in 14 C decay leads to the ground state of the residual nucleus, while 8l% to the first excited state. For 14 C emission of 224 Ra, a lower limit of 2 for the hindrance factor has been measured for the transition to the first excited state in the residual nucleus. Also, a precise identification in Z with a E·ΔE telescope has been performed for the radiation from the 223 Ra source. (author) 22 refs., 11 figs., 1 tab

  18. Bladder cancer in cancer patients: population-based estimates from a large Swedish study

    OpenAIRE

    Bermejo, J Lorenzo; Sundquist, J; Hemminki, K

    2009-01-01

    Background: This study quantified the risk of urinary bladder neoplasms in cancer patients taking into account the age at first diagnosis, the gender of the patients and the lead time between diagnoses. Methods: We used standardised incidence ratios (SIRs) to compare the incidence of bladder tumours in 967?767 cancer patients with the incidence rate in the general Swedish population. A total of 3324 male and 1560 female patients developed bladder tumours at least 1 year after first cancer dia...

  19. Some Chronic Rhinosinusitis Patients Have Significantly Elevated Populations of Seven Fungi in their Sinuses

    Science.gov (United States)

    Abstract: Objectives/Hypothesis: To measure the populations of 36 fungi in the homes and sinuses of chronic rhinosinusitis (CRS) and non-CRS patients. Study Design: Single-blind cross-sectional study. Methods: Populations of 36 fungi were measured in sinus samples and in the home...

  20. Disparities in rheumatoid arthritis disease activity according to gross domestic product in 25 countries in the QUEST-RA database

    DEFF Research Database (Denmark)

    Sokka, T; Kautiainen, H; Pincus, T

    2009-01-01

    OBJECTIVE: To analyse associations between the clinical status of patients with rheumatoid arthritis (RA) and the gross domestic product (GDP) of their resident country. METHODS: The Quantitative Standard Monitoring of Patients with Rheumatoid Arthritis (QUEST-RA) cohort includes clinical....... CONCLUSIONS: The clinical status of patients with RA was correlated significantly with GDP among 25 mostly European countries according to all disease measures, associated only modestly with the current use of antirheumatic medications. The burden of arthritis appears substantially greater in "low GDP" than...

  1. Developing a Construct to Evaluate Flares in Rheumatoid Arthritis: A Conceptual Report of the OMERACT RA Flare Definition Working Group

    DEFF Research Database (Denmark)

    Alten, Rieke; Choy, Ernest H; Christensen, Robin

    2011-01-01

    Rheumatoid arthritis (RA) patients and healthcare professionals (HCP) recognize that episodic worsening disease activity, often described as a "flare," is a common feature of RA that can contribute to impaired function and disability. However, there is no standard definition to enable measurement...... of its intensity and impact. The conceptual framework of the Outcome Measures in Rheumatology Clinical Trials (OMERACT) RA Flare Definition Working Group includes an anchoring statement, developed at OMERACT 9 in 2008: "flare in RA" is defined as worsening of signs and symptoms of sufficient intensity....... The conceptual framework of flare takes into account validated approaches to measurement in RA: (1) various disease activity indices (e.g., Disease Activity Score, Clinical Disease Activity Index, Simplified Disease Activity Index); (2) use of patient-reported outcomes (PRO); and (3) characterization...

  2. RA research reactor - properties and experimental capabilities

    International Nuclear Information System (INIS)

    Milosevic, M.; Martinc, R.

    1978-01-01

    The brief survey of the Reactor RA exploitation experience, as well as the reactor equipment state, after 18 years of operation is presented. The results of efforts spent on reactor characteristics improvement in order to ensure safe and reliable reactor operation for next 15-20 years, are described [sr

  3. Waste Management During RA Reactor Decommissioning

    International Nuclear Information System (INIS)

    Markovic, M.; Avramovic, I.

    2008-01-01

    The objective of radioactive waste management during the RA reactor decommissioning is to deal with radioactive waste in a manner that protects human health and the environment now and in the future. The estimation of waste quantities to be expected during decommissioning is a very important step in the initial planning. (author)

  4. Chôra : Creation and Pathology

    DEFF Research Database (Denmark)

    Isar, Nicoletta

    2009-01-01

    Plato's dialogue the Timaeus describes not only the making of the cosmos (order), but also the condition of what is not order, neither for the human body nor for the universe. What is disorder in cosmogonic terms it is disease for the human body. Timaeus applies to the concept chôra in discussing...

  5. Regulations and instructions for RA reactor operation

    International Nuclear Information System (INIS)

    1989-01-01

    This regulatory guide consists of following 4 chapters: Description of the RA reactor, organization scheme, regulations for performing experiments; Regulations for staff on duty; Instructions for operating the vacuum systems, heavy water and helium systems; and evacuation in case of accident [sr

  6. Status of RA3 conversion studies

    International Nuclear Information System (INIS)

    Testoni, J.

    1983-01-01

    Studies carried out at CNEA in Argentina for the conversion of the RA3 3.5 MW reactor to LEU fuel dealt with neutronic, thermal hydraulic, safety analysis, as well as fuel manufacture. Some of the results for the neutronic studies are reported

  7. Views on life and death of physicians, nurses, cancer patients and general population in Japan.

    Science.gov (United States)

    Sekiya, Noriyasu; Kuroda, Yujiro; Nakajima, Kasumi; Iwamitsu, Yumi; Kanai, Yoshiaki; Miyashita, Mitsunori; Kotani, Midori; Kitazawa, Yutaka; Yamashita, Hideomi; Nakagawa, Keiichi

    2017-01-01

    This study aimed to investigate views on life and death among physicians, nurses, cancer patients, and the general population in Japan and examine factors affecting these views. We targeted 3,140 physicians, 470 nurses, 450 cancer patients, and 3,000 individuals from the general population. We used the Death Attitudes Inventory (DAI) to measure attitudes toward life and death. The collection rates were 35% (1,093/3,140), 78% (366/470), 69% (310/450), and 39% (1,180/3,000) for physicians, nurses, patients, and the general population, respectively. We found that age, sex, social role (i.e., physician, nurse, cancer patient, and general population) were significantly correlated with DAI subscales. Compared with general population, attitudes toward death of physicians, nurses and cancer patients differed significantly even after adjusted their age and sex. Our study is the first to analyze differences in views on life and death among physicians, nurses, cancer patients, and the general population in Japan.

  8. Association of E26 Transformation Specific Sequence 1 Variants with Rheumatoid Arthritis in Chinese Han Population.

    Directory of Open Access Journals (Sweden)

    Lin Chen

    Full Text Available E26 transformation specific sequence 1 (ETS-1 belongs to the ETS family of transcription factors that regulate the expression of various immune-related genes. Increasing evidence indicates that ETS-1 could contribute to the pathogenesis of autoimmune disease. Recent research has provided evidence that ETS-1 might correlate with rheumatoid arthritis (RA, but it's not clearly defined. In this study, we aimed to identify whether polymorphisms of ETS-1 play a role in Rheumatoid arthritis (RA susceptibility and development in Chinese Han population.Four single nucleotide polymorphisms (SNPs within ETS-1 were selected based on HapMap data and previous associated studies. Whole blood and serum samples were obtained from 158 patients with RA and 192 healthy subjects. Genotyping was performed with polymerase chain reaction-high resolution melting (PCR-HRM assay and the data was analyzed using SPSS17.0.A significantly positive correlation was observed between the SNP rs73013527 of ETS-1 and RA susceptibility, DAS28 and CRP (P<0.001, P = 0.001, and P = 0.028, respectively. Carriers of the haplotype CCT or TCT for rs4937333, rs11221332 and rs73013527 were associated with decreased risk of RA as compared to controls. No statistical significant difference was observed in the distribution of rs10893872, rs4937333 and rs11221332 genotypes between RA patients and controls.Our data further supports that ETS-1 has a relevant role in the pathogenesis and development of RA. Allele T of rs73013527 plays a protective role in occurrence of RA but a risk factor in the high disease activity. Rs10893872, rs11221332 and rs4937333 are not associated with RA susceptibility and clinical features.

  9. Incidence of call stone in liver cirrhosis patients: comparison with genera population

    International Nuclear Information System (INIS)

    Kim, Chul Jjoong; Park, Cheol Min; Park, Seung Chul; Chung, Kyoo Byung; Suh, Won Hyuck

    1994-01-01

    We investigated the incidence of gallstone detected by ultrasound in cirrhotic patients, and it was compared with that of the general population. One hundred and seventy seven patients with proven or suspected liver cirrhosis were evaluated sonographic ally to determine the presence of gallstone. We classified 177 cirrhotic patients into A,B, and C by Child classification and investigated the incidence of gallstone for each class. The control group was 363 general population with age distribution and sex-ratio similar to cirrhotic patients.Gallstone was visualized by ultrasound in 32(18.1%) of 177 cirrhotic patients. The incidence of gallstone was 13.1% in Child A, 21.0% in child B, and 20.0% in Child C cirrhotic patients. Overall incidence of gallstone was 3.9% in 363 general population. In summary, the incidence of gallstone was significantly higher in cirrhosis patients than in general population(p<0.01). The patients with moderate and severe cirrhosis showed higher incidence of gallstone than the patients with mild cirrhosis(20.5% vs 13.1%)

  10. Research nuclear reactor RA - Annual Report 1991

    International Nuclear Information System (INIS)

    Sotic, O.

    1992-01-01

    Activities related to revitalisation of the RA reactor stared in 1986, were continued in 1991. A number of interventions on the reactor components were finished that are supposed to enable continuous and reliable operation. The last, and at the same time largest action, related to exchange of complete reactor instrumentation is underway, but it is behind the schedule in 1991 because the delivery of components from USSR is late. Production of this instruments is financed by the IAEA according to the contract signed in December 1988 with Russian Atomenergoexport. According to this contract, it has been planned that the RA reactor instrumentation should be delivered to the Vinca Institute by the end of 1990. Only 56% of the instrumentation was delivered until September 1991. Since then any delivery of components to Yugoslavia was stopped because of the temporary embargo imposed by the IAEA. In 1991 most of the existing RA reactor instrumentation was dismantled, only the part needed for basic measurements when reactor is not operated, was maintained. Construction of some support elements is almost finished by the local staff. The Institute has undertaken this activity in order to speed up the ending of the project. If all the planned instrumentation would not arrive until the end of March 1992, it would not be possible to start the RA reactor testing operation in the first part of 1993, as previously planned. In 1991, 53 staff members took part in the activities during 1991, which is considered sufficient for maintenance and repair conditions. Research reactor RA Annual report for year 1991 is divided into two main parts to cover: (1) operation and maintenance and (2) activities related to radiation protection [sr

  11. Research nuclear reactor RA - Annual Report 1994

    International Nuclear Information System (INIS)

    Sotic, O.

    1994-12-01

    Activities related to revitalisation of the RA reactor stared in 1986, were continued in 1991. A number of interventions on the reactor components were finished that are supposed to enable continuous and reliable operation. The last, and at the same time largest action, related to exchange of complete reactor instrumentation is underway, but it is behind the schedule in 1991 because the delivery of components from USSR is late. Production of this instruments is financed by the IAEA according to the contract signed in December 1988 with Russian Atomenergoexport. According to this contract, it has been planned that the RA reactor instrumentation should be delivered to the Vinca Institute by the end of 1990. Only 56% of the instrumentation was delivered until September 1991. Since then any delivery of components to Yugoslavia was stopped because of the temporary embargo imposed by the IAEA. In 1991 most of the existing RA reactor instrumentation was dismantled, only the part needed for basic measurements when reactor is not operated, was maintained. Activities related to improvement of Russian project were continued in 1994. Control and maintenance of the reactor components was done regularly and efficiently. Extensive repair of the secondary coolant loop is almost finished and will be completed in the first part of 1995 according to existing legal procedures and IAEA recommendations. Fuel inspection by the IAEA safeguards inspectors was done on a monthly basis. There have been on the average 47 employees at the RA reactor which is considered sufficient for maintenance and repair conditions. Research reactor RA Annual report for year 1991 is divided into two main parts to cover: (1) operation and maintenance and (2) activities related to radiation protection [sr

  12. A Promoter Region Polymorphism in PDCD-1 Gene Is Associated with Risk of Rheumatoid Arthritis in the Han Chinese Population of Southeastern China

    Directory of Open Access Journals (Sweden)

    CuiPing Liu

    2014-01-01

    Full Text Available Objective. Programmed cell death 1 (PD-1 induces negative signals to T cells during interaction with its ligands and is therefore a candidate gene in the development of autoimmune diseases such as rheumatoid arthritis (RA. Herein, we investigate the association of PDCD-1 polymorphisms with the risk of RA among Chinese patients and healthy controls. Methods. Using the PCR-direct sequencing analysis, 4 PDCD-1 SNPs (rs36084323, rs11568821, rs2227982, and rs2227981 were genotyped in 320 RA patients and 309 matched healthy controls. Expression of PD-1 was determined in peripheral blood lymphocytes by flow cytometry and quantitative real-time reverse transcriptase polymerase chain reaction. Results. We observed that the GG genotype of rs36084323 was associated with a increased risk for developing RA (OR 1.70, 95% 1.11–2.61, P=0.049. Patients carrying G/G genotype displayed an increased mRNA level of PD-1 (P=0.04 compared with A/A genotype and healthy controls. Meanwhile, patients homozygous for rs36084323 had induced basal PD-1 expression on activated CD4+ T cells. Conclusion. The PDCD-1 polymorphism rs36084323 was significantly associated with RA risk in Han Chinese population. This SNP, which effectively influenced the expression of PD-1, may be a biomarker of early diagnosis of RA and a suitable indicator of utilizing PD-1 inhibitor for treatment of RA.

  13. Therapy palliative with 223Ra without special radiation protection measures?

    International Nuclear Information System (INIS)

    Just, Guenther; Petzold, Juergen

    2015-01-01

    For nearly 2 years now as a therapy of the castration resistant prostata carcinoma a nuclide therapy with 223 Ra-Dichloride (trade-mark Xofigo) is applied. Xofigo is applied by a medical specialist for nuclear medicine altogether 6 times in a monthly distance. The activity used in each case is according to the body weight (50 kBq/kg BW). This therapy is licensed by the supervisory authorities of the German federal countries as an ambulant therapy. Special radiation protection measures are only required when exceeding a given number of 17 patients per year as incorparation measurements.

  14. Association of STAT4 with rheumatoid arthritis - A replication study in three European populations : a replication study in three European populations

    NARCIS (Netherlands)

    Orozco, Gisela; Alizadeh, Behrooz Z.; Delgado-Vega, Angelica M.; Gonzalez-Gay, Miguel A.; Balsa, Alejandro; Pascual-Salcedo, Dora; Fernandez-Gutierrez, Benjamin; Gonzalez-Escribano, Maria F.; Petersson, Ingemar F.; van Riel, Piet L. C. M.; Barrera, Pilar; Coenen, Marieke J. H.; Radstake, Timothy R. D. J.; van Leeuwen, Miek A.; Wijmenga, Cisca; Koeleman, Bobby P. C.; Alarcon-Riquelme, Marta; Martin, Javier

    Objective. This study was undertaken to investigate the previously reported association of the STAT4 polymorphism rs7574865 with rheumatoid arthritis (RA) in 3 different European populations from Spain, Sweden, and The Netherlands, comprising a total of 2,072 patients and 2,474 controls. Methods.

  15. RA Research nuclear reactor Part 1, RA Reactor operation and maintenance in 1987

    International Nuclear Information System (INIS)

    Sotic, O.; Martinc, R.; Cupac, S.; Sulem, B.; Badrljica, R.; Majstorovic, D.; Sanovic, V.

    1987-01-01

    RA research reacto was not operated due to the prohibition issued in 1984 by the Government of Serbia. Three major tasks were finished in order to fulfill the licensing regulations about safety of nuclear facilities which is the condition for obtaining permanent operation licence. These projects involved construction of the emergency cooling system, reconstruction of the existing special ventilation system, and renewal of the system for electric power supply of the reactor systems. Renewal of the RA reactor instrumentation system was initiated. Design project was done by the Russian Atomenergoeksport, and is foreseen to be completed by the end of 1988. The RA reactor safety report was finished in 1987. This annual report includes 8 annexes concerning reactor operation, activities of services and financial issues, and three special annexes: report on testing the emergency cooling system, report on renewal of the RA reactor and design specifications for reactor renewal and reconstruction [sr

  16. Measurements of neutron flux in the RA reactor; Merenje karakteristika neutronskog fluksa u reaktoru RA

    Energy Technology Data Exchange (ETDEWEB)

    Raisic, N [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1961-12-15

    This report includes results of the following measurements performed at the RA reactor: thermal neutron flux in the experimental channels, epithermal and fast neutron flux, neutron flux in the biological shield, neutron flux distribution in the reactor cell.

  17. Behavior of 226Ra in the aquatic environment of the uranium mine region of Pocos de Caldas, MG, Brazil

    International Nuclear Information System (INIS)

    Silva Amaral, E.C. da.

    1979-08-01

    A sampling and analytical program for 238 U, 226 Ra and 210 Pb was started, at first, in the uranium mine region, at Pocos de Caldas, MG, Brazil. Afterwards, the interaction was studied between 226 Ra and local river sediments and waters. Peliminary studies were also done on the mobility of 226 Ra retained on solid matter or soil, induced by local waters. Above normal concentrations of 238 U, 226 Ra and 210 Pb were found in local waters, sediments and plants collected on the imediate vicinity of the mine. 226 Ra distribution coefficients are on the order of 10 3 for the different samples assayed. It was concluded that, in the future, 226 Ra discharged into liquid environment should be only temporarily retained by sediments. Its transport by surface waters should be predominantly in the soluble form. 226 Ra should become the critical radionuclide in terms of internal radiation dose on the local population, due to its ingestion with water. 226 Ra retained on solid supports is mobilized by local waters and its solubilization is dependent on the volume of water passed through. (M.A.) [pt

  18. Increased risk of chronic liver disease in patients with bipolar disorder: A population-based study.

    Science.gov (United States)

    Hsu, Jer-Hwa; Chien, I-Chia; Lin, Ching-Heng

    2016-01-01

    This study aimed to investigate the prevalence and incidence of chronic liver disease in patients with bipolar disorder. We used a random sample of 766,427 subjects aged ≥18 years from the National Health Research Institute database in the year 2005. Subjects with at least one primary diagnosis of bipolar disorder in 2005 were identified. Patients with a primary or secondary diagnosis of chronic liver disease were also defined. We compared the prevalence and associated factors of chronic liver disease between patients with bipolar disorder and the general population in 2005. We also compared the incidence of chronic liver disease in patients with bipolar disorder and the general population from 2006 to 2010. The prevalence of chronic liver disease in patients with bipolar disorder (13.9%) was 2.68 times higher than that of the general population (5.8%) in 2005. The average annual incidence of chronic liver disease in patients with bipolar disorder from 2006 to 2010 was also higher than that of the general population (2.95% vs. 1.73%; risk ratio: 1.71; 95% confidence interval: 1.46-2.01). Patients with bipolar disorder had a significantly higher prevalence and incidence of chronic liver disease than those in the general population, and younger patients with bipolar disorder have a much higher prevalence and incidence than those in the general population. Male sex, second-generation antipsychotic or antidepressant use, and hyperlipidemia were associated factors for chronic liver disease in patients with bipolar disorder. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. 228Ra and 226Ra measurement on a BaSO4 co-precipitation source

    International Nuclear Information System (INIS)

    Medley, Peter; Martin, Paul; Bollhöfer, Andreas; Parry, David

    2015-01-01

    One of the most commonly-used methods for determination of 226 Ra, particularly in water samples, utilises co-precipitation of Ra with BaSO 4 , followed by microfiltration to produce a source for alpha counting. This paper describes two extensions to BaSO 4 co-precipitation methods which enable determination of 228 Ra using the same source. The adaptations presented here do not introduce any contaminants that will affect the separation of radium or alpha counting for 226 Ra, and can be used for re-analysis of already existing sources prepared by BaSO 4 co-precipitation. The first adaptation uses detection of 228 Ac on the source by gamma spectrometry. The detection efficiency is high, allowing analysis of water samples at sufficiently low activity to be suitable in testing for compliance with drinking water quality standards. As 228 Ac grows in quickly, taking less than 2 days to reach equilibrium with the 228 Ra parent, this can also be useful in radiological emergency response situations. The second adaptation incorporates a method for the digestion of BaSO 4 sources, allowing separation of thorium and subsequent determination of 228 Th activity. Although ingrowth periods for 228 Th can be lengthy, very low detection limits for 228 Ra can be achieved with this technique. - Highlights: • We developed two methods for 228 Ra measurement on Ba(Ra)SO 4 co-precipitation sources. • Measurement by gamma spectrometry using the daughter 228 Ac is rapid. • Detection limits are suitable for assessment of drinking water quality. • The second approach uses alpha spectrometry on a separated Th fraction. • This is more sensitive than gamma spectrometry after an ingrowth period greater than about 1 month

  20. Radiation protection at the RA Reactor in 1998, RA reactor annual report, Part -2

    International Nuclear Information System (INIS)

    Ninkovic, M.; Pavlovic, R.; Mandic, M.; Pavlovic, S.; Grsic, Z.

    1998-01-01

    Radiation protection tasks which enable safe operation of the RA reactor, and are defined according the the legal regulations and IAEA safety recommendations are sorted into four categories in this report: (1) Control of the working environment, dosimetry at the RA reactor; (2) Radioactivity control in the vicinity of the reactor and meteorology measurements; (3) Collecting and treatment of fluid effluents; and (4) radioactive wastes, decontamination and actions. Each of the category is described as a separate annex of this report [sr

  1. RA Research nuclear reactor, Part II: radiation protection at the RA reactor in 1987

    International Nuclear Information System (INIS)

    Ninkovic, M.; Ajdacic, N.; Zaric, M.; Vukovic, Z.

    1987-01-01

    Radiation protection tasks which enable safe operation of the RA reactor, and are defined according the the legal regulations and IAEA safety recommendations are sorted into four categories in this report: (1) Control of the working environment, dosimetry at the RA reactor and radiation protection; (2) Radioactivity control in the vicinity of the reactor and meteorology measurements; (3) Decontamination and relevant actions, collecting and treatment of fluid effluents; and and solid radioactive wastes [sr

  2. Radiation protection at the RA Reactor in 1988, Part -2, RA reactor annual report

    International Nuclear Information System (INIS)

    Ninkovic, M.; Ajdacic, N.; Zaric, M.; Vukovic, Z.

    1988-01-01

    Radiation protection tasks which enable safe operation of the RA reactor, and are defined according the the legal regulations and IAEA safety recommendations are sorted into four categories in this report: (1) Control of the working environment, dosimetry at the RA reactor and radiation protection; (2) Radioactivity control in the vicinity of the reactor and meteorology measurements; (3) Decontamination and relevant actions, collecting and treatment of fluid effluents; and and solid radioactive wastes [sr

  3. Serum 25-hydroxyvitamin D in a West African population of tuberculosis patients and unmatched healthy controls

    DEFF Research Database (Denmark)

    Wejse, Christian; Olesen, Rikke; Rabna, Paulo

    2007-01-01

    BACKGROUND: Little is known regarding vitamin D deficiency (VDD) in African populations and in tuberculosis (TB) patients. VDD has been shown to be associated with TB. OBJECTIVE: We aimed to compare the degree of vitamin D insufficiency (VDI) and VDD in TB patients and healthy adult controls...... in a West African population. DESIGN: An unmatched case-control study was performed at a Demographic Surveillance Site in Guinea-Bissau. Serum 25-hydroxyvitamin D(3) [25(OH)D(3)] concentrations were measured in 362 TB patients and in 494 controls. RESULTS: Hypovitaminosis D [25(OH)D(3) Udgivelsesdato: 2007...

  4. COPD, Body Mass, Fat Free Body Mass and prognosis in Patients from a Random Population Sample

    DEFF Research Database (Denmark)

    Vestbo, Jørgen; Prescott, E; Almdal, Thomas Peter

    2006-01-01

    distribution of low FFMI and its association with prognosis in a population-based cohort of patients with COPD. METHODS: We used data on 1,898 patients with COPD identified in a population-based epidemiologic study in Copenhagen. FFM was measured using bioelectrical impedance analysis. Patients were followed...... mortality and 2.4 (1.4-4.0) for COPD-related mortality. FFMI was also a predictor of overall mortality when analyses were restricted to subjects with normal BMI. CONCLUSIONS: FFMI provides information in addition to BMI and assessment of FFM should be considered in the routine assessment of COPD....

  5. Simultaneous determination of Ra-226, Ra-228 and Pb-210 using a successive coprecipitations techniques

    International Nuclear Information System (INIS)

    Vilhena Schayer Sabino, C. de; Kastner, S.M.S.; Amaral, A.M.

    1990-01-01

    Several techniques for determination of Ra-226, Ra228 and Pb-210. were developed and used in routine at CDTN in the laboratories of radiochemistry. The matrixes were: water and industrial wastes. Some problems of these techniques were the time spent for analyses and chemical separations, interferents, among others. Now-a-days the method in routine developed here is the one of successive coprecipitations, followed α and β countings of the Ra-226 and Ra-228 daughters. This method is based on coprecipitation, purification of barium radium sulfate with EDTA in acetic solution. Lead is dissolved, radium remains precipitated and suffers a new purification and the time for growing of their daughters is waited to be performed the simultaneous α and β countings for Ra-226 and Ra-228 determination. Pb-210 is analyzed in the floating of the first purification with a carrier of bismuth, and the time for Bi-210 growing is waited. Then it is precipitated as hydroxid, purified as phosphate and the β counting of Bi-210 is done. (author) [pt

  6. 226Ra, 228Ra and 40K in scales formed in boilers of industrial installations

    International Nuclear Information System (INIS)

    Poggi, Claudia M. Braga; Farias, Emerson Emiliano G. de; Hazin, Clovis A.; Gazineu, Maria Helena P.; Universidade Catolica de Pernambuco

    2011-01-01

    Many industrial processes involve the production of steam in boilers, which is sent through pipes to machines and other equipment used in different sectors of the installations. The water commonly used in these processes is groundwater, which generally has high concentrations of calcium and magnesium salts, that can co-precipitate with naturally occurring radioactive elements such as 226 Ra and 228 Ra creating radioactive scales, which are deposited in pipes, thus decreasing the efficiency of steam production. In addition, 40 K that is present in all soils and rocks with a concentration of about 0.012% of natural potassium can also be concentrated in these scales. No data was found in literature relating to radionuclides present in the scales formed on boilers in general. In this context, the purpose of this work was to determine concentrations of 226 Ra, 228 Ra and 40 K, in scales generated inside boilers from different industries in the cities of Caruaru, Paulista and Goiana, Pernambuco. Determination of the radionuclides concentration was performed by gamma spectrometry with an HPGe detector, calculating their specific activities. Activity concentrations of 226 Ra were in the range of -1 and 228 Ra activity concentrations varied from 1 . Activity concentrations of 40 K were in the range of -1 . All these activity concentrations were lower than the limits established by the Brazilian Nuclear Energy Commission of for this type of matrix. (author)

  7. Mortality Rates in Patients With Chronic Hepatitis C and Cirrhosis Compared With the General Population

    DEFF Research Database (Denmark)

    Hallager, Sofie; Brehm Christensen, Peer; Ladelund, Steen

    2017-01-01

    Background: Knowledge about mortality rates (MRs) in patients with chronic hepatitis C (CHC) with cirrhosis is limited. This study aimed to estimate all-cause MRs among patients with CHC with or without cirrhosis in Denmark compared with the general population. Methods: Patients registered...... in the Danish Database for Hepatitis B and C with CHC and a liver fibrosis assessment were eligible for inclusion. Liver fibrosis was assessed by means of liver biopsy, transient elastography, and clinical cirrhosis. Up to 20 sex- and age-matched individuals per patient were identified in the general population....... Data were extracted from nationwide registries. Results: A total of 3410 patients with CHC (1014 with cirrhosis), and 67 315 matched individuals were included. Adjusted MR ratios (MRRs) between patients with or without cirrhosis and their comparison cohorts were 5.64 (95% confidence interval [CI], 4...

  8. Risk Factors for Venous Thromboembolism in Hospitalized Patients in the Chinese Population

    Directory of Open Access Journals (Sweden)

    Wang Chunling

    2018-04-01

    Full Text Available Venous thromboembolism (VTE refers to the formation of a blood clot inside veins and has a high risk of inducing medical accidents. An effective risk assessment model will help screen high risk populations and prevent the occurrence of VTE. In this study, 287 VTE cases were collected and analyzed for risk factors in a Chinese population. The risks of VTE were evaluated using the Caprini and Padua models. Our results indicated that the Caprini model was more effective in evaluating VTE risk among hospitalized patients than the Padua model. As well, the Caprini model was more relevant in VTE risk assessment among surgery patients compared with internal medicine patients, while the Padua model showed no significant differences. In our studies, the most frequent risk factors included obesity, medical patients currently at bed rest, and severe lung disease. Our studies provide clinical support on selecting the suitable risk assessment model of VTE in the Chinese population.

  9. A study on applying Ra needle interstitial brachytherapy for oral cancer

    International Nuclear Information System (INIS)

    Yoshida, Shunichi; Komiya, Yoshiaki; Uchida, Ikuhiro; Tashiro, Kazuyoshi

    1999-01-01

    To investigate applicability of Ra needle interstitial brachytherapy, 93 cases of oral squamous carcinoma were examined. The patients underwent Ra needle interstitial brachytherapy as thorough therapy in our hospital. The criteria of applying Ra needle interstitial brachytherapy was diameter of within 5 cm and depth within 2 cm of tumor size. Ra needle interstitial brachytherapy was applied to 82 cases of tongue, 10 cases of oral floor and one case of lower lip carcinomas. The local control rate was 92.5%, and secondary neck metastasis was 32.3% in all cases applied Ra needle interstitial brachytherapy. The results were not bad compared with surgical treatment. However, the 5-year cumulative survival rate was 64.9%, which was not good enough at the result to obtain a good local control rate and secondary neck metastasis rate. The result was relative to low treatment result of local recurrence cases with Ra needle interstitial brachytherapy. To improve the result, it is important to distinguish local recurrence from radioinduced ulcer, and to start early secondary treatment. The cases in which cervical lymph node metastasis was found as the first examination underwent neck dessection after Ra needle interstitial brachytherapy. The 5-year cumulative survival rate was 83.3% in N1 cases and 40.6% in N2 cases, and the result of N2 cases was poorer than N1 cases with a significant difference. The results indicate that a needle having a diameter of within 5 cm, depth of within 2 cm and less than N1 can be applied during Ra needle interstitial brachytherapy for complete cure of cancer. (author)

  10. Increased migraine risk in osteoporosis patients: a nationwide population-based study

    OpenAIRE

    Wu, Chieh-Hsin; Zhang, Zi-Hao; Wu, Ming-Kung; Wang, Chiu-Huan; Lu, Ying-Yi; Lin, Chih-Lung

    2016-01-01

    Background Osteoporosis and migraine are both important public health problems and may have overlapping pathophysiological mechanisms. The aim of this study was to use a Taiwanese population-based dataset to assess migraine risk in osteoporosis patients. Methods The Taiwan National Health Insurance Research Database was used to analyse data for 40,672 patients aged ?20?years who had been diagnosed with osteoporosis during 1996?2010. An additional 40,672 age-matched patients without osteoporos...

  11. Intravenous injection of Ra-224 as a treatment in Morbus Paget

    International Nuclear Information System (INIS)

    Koch, W.

    1976-01-01

    Between 1956 and 1973, 21 patients with histologically verified Morbus Paget were treated at the author's hospital with low dosage 224 Ra. In none of these patients an immediate or late impairment of the hematogenic or parenchymal organs was observed. (MG) [de

  12. Autoimmune and immunogenetic profile of patients with optic neuritis in a population-based cohort

    DEFF Research Database (Denmark)

    Soelberg, K.; Nilsson, A. C.; Nielsen, C.

    2018-01-01

    Background: Optic neuritis (ON) is an inflammatory optic neuropathy, where the genetic and autoimmune dependency remains poorly characterized. Objective: To investigate autoimmune and immunogenetic aspects of ON. Method: In a prospective population-based cohort 51 patients with ON were included...... antibodies. Coexisting neural autoantibodies were detected in two patients and in 12 patients other systemic autoantibodies were found. Four (8%) had other autoimmune disorders. A family history of autoimmunity was observed in 12 (24%) and of demyelinating disease in six patients (12%). In MS-ON patients...

  13. Identification of high risk patients with hypertrophic cardiomyopathy in a northern Greek population

    Directory of Open Access Journals (Sweden)

    Karvounis Charalambos

    2009-07-01

    Full Text Available Abstract Background The percentage of hypertrophic cardiomyopathy (HCM patients who are in high risk for Sudden Death (SD constitutes only a minority of all HCM population but the incidence of SD in this subset is high (at least 5% annually. The identification of this small but important proportion of high risk HCM patients has been the clue in the clinical evaluation of these patients. Methods Our study cohort consisted from 123 patients with HCM who are currently followed up in our Institution. Five clinical risk factors were assessed: a family history of premature SD, unexplained syncope, Non Sustained Ventricular Tachycardia (NSVT on 24-h ECG monitoring, Abnormal Blood Pressure Response (ABPR during upright exercise testing and Maximum left ventricular Wall Thickness (MWT ≥30 mm. The purpose of our study was the identification of high risk HCM patients coming from Northern Greece. Results Fifteen patients (12.2% of the whole cohort had MWT ≥ 30 mm, 30 patients (24.4% had an ABPR to exercise, 17 patients (13.8% had episodes of NSVT in 24-h Holter monitoring, 17 patients (13.8% suffered from syncope, and 8 patients (6.5% had a positive family history of premature SD. Data analysis revealed that 74 patients (60.1% had none risk factor. Twenty four patients (19.5% had 1 risk factor, 17 patients (13.8% had 2 risk factors, 4 patients (3.25% had 3 risk factors, and 4 patients (3.25% had 4 risk factors, while none patient had 5 risk factors. Twenty five patients (20.3% had 2 or more risk factors. Conclusion This study for the first time confirms that, although a 60% of patients with HCM coming from a regional Greek population are in low risk for SD, a substantial proportion (almost 20% carries a high risk for SD justifying prophylactic therapy with amiodaron or ICD implantation.

  14. Depression in Cardiovascular Patients in Middle Eastern Populations: A Literature Review.

    Science.gov (United States)

    Donnelly, Tam Truong; Al Suwaidi, Jassim Mohd; Al-Qahtani, Awad; Asaad, Nidal; Qader, Najlaa Abdul; Singh, Rajvir; Fung, Tak Shing; Mueed, Irem; Sharara, Shima; El Banna, Noha; Omar, Sarah

    2015-08-01

    Cardiovascular disease (CVD) is increasing in Middle Eastern countries. Depression is associated with increased morbidity and mortality rates among cardiovascular (CV) patients. Early detection of and intervention for depression among CV patients can reduce morbidity and mortality and save health care costs. Public information on mental health care needs of Arab CV patients living in Middle East regions is scattered and limited. This literature review surveyed and summarized research studies to learn what is known about the relationship between depression and CVD in Middle Eastern populations. The information will raise awareness among health care professionals and policy makers regarding the clinical significance of depression in Arab CV patients. It might contribute to development of culturally appropriate and effective mental health care services. Multiple databases were searched and 60 articles were assessed, including studies that investigated depression in Arab CV patient populations, physiological mechanisms of depression-CVD comorbidity, and intervention strategies that affect CV risk in depressed Arab patients. We discuss the extent to which this issue has been explored in Arab populations living in Middle East regions and Arab populations living abroad. We recommend that more comprehensive and in-depth research studies be conducted with Arab cardiac patients to enable implementation of culturally appropriate and effective mental health care interventions.

  15. Factors affecting {sup 223}Ra therapy: clinical experience after 532 cycles from a single institution

    Energy Technology Data Exchange (ETDEWEB)

    Etchebehere, Elba C. [The University of Texas MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Campinas State University (Unicamp), Department of Nuclear Medicine, Campinas (Brazil); Milton, Denai R. [The University of Texas MD Anderson Cancer Center, Department of Biostatistics, Houston, TX (United States); Araujo, John C. [The University of Texas MD Anderson Cancer Center, Department of Genitourinary Medical Oncology, Houston, TX (United States); Swanston, Nancy M.; Macapinlac, Homer A.; Rohren, Eric M. [The University of Texas MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States)

    2016-01-15

    The aim of this study was to identify baseline features that predict outcome in {sup 223}Ra therapy. We retrospectively reviewed 110 patients with metastatic castration-resistant prostate cancer treated with {sup 223}Ra. End points were overall survival (OS), progression-free survival (PFS), bone event-free survival (BeFS), and bone marrow failure (BMF). The following parameters were evaluated prior to the first {sup 223}Ra cycle: serum levels of hemoglobin (Hb), prostate-specific antigen (PSA), alkaline phosphatase (ALP), Eastern Cooperative Oncology Group (ECOG) status, pain score, use of chemotherapy, and external beam radiation therapy (EBRT). During/after {sup 223}Ra we evaluated: the total number of radium cycles (Ra{sub Tot}), the PSA doubling time (PSA{sub DT}), and the use of chemotherapy, EBRT, abiraterone, and enzalutamide. A significant reduction of ALP (p < 0.001) and pain score (p = 0.041) occurred throughout the {sup 223} Ra cycles. The risk of progression was associated with declining ECOG status [hazard ratio (HR) = 3.79; p < 0.001] and decrease in PSA{sub DT} (HR = 8.22; p < 0.001). Ra{sub Tot}, ALP, initial ECOG status, initial pain score, and use of abiraterone were associated with OS (p ≤ 0.008), PFS (p ≤ 0.003), and BeFS (p ≤ 0.020). Ra{sub Tot}, ALP, initial ECOG status, and initial pain score were significantly associated with BMF (p ≤ 0.001) as well as Hb (p < 0.001) and EBRT (p = 0.009). On multivariable analysis, only Ra{sub Tot} and abiraterone remained significantly associated with OS (p < 0.001; p = 0.033, respectively), PFS (p < 0.001; p = 0.041, respectively), and BeFS (p < 0.001; p = 0.019, respectively). Additionally, Ra{sub Tot} (p = 0.027) and EBRT (p = 0.013) remained significantly associated with BMF. Concomitant use of abiraterone and {sup 223}Ra seems to have a beneficial effect, while the EBRT may increase the risk of BMF. (orig.)

  16. Preparation of 227Ac by neutron irradiation of 226Ra

    International Nuclear Information System (INIS)

    Kukleva, E.; Kozempel, J.; Vlk, M.; Micolova, P.; Vopalka, D.

    2015-01-01

    Radium-223 is prospective alpha-emitting therapeutic radionuclide for targeted radionuclide therapy. Although 223 Ra is formed naturally by the decay of 235 U, for practical reasons its preparation involves neutron irradiation of 226 Ra. The α-decay of the 227 Ra (T 12 = 43 min.) produced via 226 Ra(n,γ) 227 Ra reaction leads to 227 Ac, a mother nuclide of 227 Th and 223 Ra subsequently. Irradiation target radium material is generally available in multi-gram quantities from historical stock. Main aim of this study was to experimentally and theoretically evaluate and verify available literature data on production of 223 Ra. According to data obtained from γ-spectra, the approximate yield values were determined and effective cross-section for the 223 Ra production was calculated. (authors)

  17. Skeletal dosimetry of injected 226RA in young adult beagles

    International Nuclear Information System (INIS)

    Lloyd, R.D.; Mays, C.W.; Atherton, D.R.

    1986-01-01

    Revised equations are presented for the skeletal dose to young adult beagles from 226 Ra injection. For 0.1 kg of skel/kg body and given 1 μCi 226 Ra/kg with 210 Pb/ 226 Ra = 0.05, the average skeletal dose in rad at 6 yr is 226 Ra = 1200, 222 Rn -> 214 Po = 1050, injected 210 Pb = 56 and 210 Pb from Rn decay in bone = 22. For a Pb/Ra ratio = 0.4, dose from injected 210 Pb is about 20% of that from 226 Ra -> 214 Po. A similar but not numerically indentical relationship obtains for ingested 226 Ra, so the dose from 210 Pb should be included in any study of 226 Ra effects. (orig.)

  18. Insurance problems among inflammatory bowel disease patients: results of a Dutch population based study.

    Science.gov (United States)

    Russel, M G V M; Ryan, B M; Dagnelie, P C; de Rooij, M; Sijbrandij, J; Feleus, A; Hesselink, M; Muris, J W; Stockbrugger, R

    2003-03-01

    The majority of patients with inflammatory bowel disease (IBD) have a normal life expectancy and therefore should not be weighted when applying for life assurance. There is scant literature on this topic. In this study our aim was to document and compare the incidence of difficulties in application for life and medical insurance in a population based cohort of IBD patients and matched population controls. A population based case control study of 1126 IBD patients and 1723 controls. Based on a detailed questionnaire, the frequency and type of difficulties encountered when applying for life and medical insurance in matched IBD and control populations were appraised. In comparison with controls, IBD patients had an 87-fold increased risk of encountering difficulties when applying for life assurance (odds ratio (OR) 87 (95% confidence interval (CI) 31-246)), with a heavily weighted premium being the most common problem. Patients of high educational status, with continuous disease activity, and who smoked had the highest odds of encountering such problems. Medical insurance difficulties were fivefold more common in IBD patients compared with controls (OR 5.4 (95% CI 2.3-13)) although no specific disease or patient characteristics were identified as associated with such difficulties. This is the first detailed case control study that has investigated insurance difficulties among IBD patients. Acquiring life and medical insurance constituted a major problem for IBD patients in this study. These results are likely to be more widely representative given that most insurance companies use international guidelines for risk assessment. In view of the recent advances in therapy and promising survival data on IBD patients, evidence based guidelines for risk assessment of IBD patients by insurance companies should be drawn up to prevent possible discriminatory practices.

  19. 226Ra and 228Ra in ground water of the Cambrian-Ordovician Aquifer System in northern Illinois

    International Nuclear Information System (INIS)

    Gilkeson, R.H.; Holtzman, R.B.

    1982-01-01

    Over a large region of Illinois, ground water of the Cambrian-Ordovician Aquifer System exceeds the US EPA drinking water standard of 5 pCi/L for the combined concentration of 226 Ra and 228 Ra. 226 Ra concentrations range from 226 Ra is the geochemistry of uranium in the ground-water flow system, while the 228 Ra activity in ground water which ranges from 232 Th-bearing minerals in the aquifer strata. The comparison of recent analyses to historical data gathered over the last 20 years indicates that, with few exceptions, 226 Ra and 228 Ra activities in ground water have remained constant. The combined concentrations of the two nuclides in ground water of the aquifer system ranged from 226 Ra concentrations were high (greater than or equal to 10 pCi/L), those of 228 Ra were low (less than or equal to 2 pCi/L), but, with few exceptions, in regions where 228 Ra concentrations were high, those of 226 Ra were also high. The range of values raises questions concerning the validity of the US EPA regulation which requires analysis for 228 Ra only when the concentration of 226 Ra exceeds 3.0 pCi/L

  20. Medical resource use and expenditure in patients with chronic heart failure: a population-based analysis of 88 195 patients.

    Science.gov (United States)

    Farré, Nuria; Vela, Emili; Clèries, Montse; Bustins, Montse; Cainzos-Achirica, Miguel; Enjuanes, Cristina; Moliner, Pedro; Ruiz, Sonia; Verdú-Rotellar, Jose Maria; Comín-Colet, Josep

    2016-09-01

    Heart failure (HF) is one of the diseases with greater healthcare expenditure. However, little is known about the cost of HF at a population level. Hence, our aim was to study the population-level distribution and predictors of healthcare expenditure in patients with HF. This was a population-based longitudinal study including all prevalent HF cases in Catalonia (Spain) on 31 December 2012 (n = 88 195). We evaluated 1-year healthcare resource use and expenditure using the Health Department (CatSalut) surveillance system that collects detailed information on healthcare usage for the entire population. Mean age was 77.4 (12) years; 55% were women. One-year mortality rate was 14%. All-cause emergency department visits and unplanned hospitalizations were required at least once in 53.4% and 30.8% of patients, respectively. During 2013, a total of €536.2 million were spent in the care of HF patients (7.1% of the total healthcare budget). The main source of expenditure was hospitalization (39% of the total) whereas outpatient care represented 20% of the total expenditure. In the general population, outpatient care and hospitalization were the main expenses. In multivariate analysis, younger age, higher presence of co-morbidities, and a recent HF or all-cause hospitalization were independently associated with higher healthcare expenditure. In Catalonia, a large portion of the annual healthcare budget is devoted to HF patients. Unplanned hospitalization represents the main source of healthcare-related expenditure. The knowledge of how expenditure is distributed in a non-selected HF population might allow health providers to plan the distribution of resources in patients with HF. © 2016 The Authors. European Journal of Heart Failure © 2016 European Society of Cardiology.

  1. Association of STAT4 with rheumatoid arthritis: a replication study in three European populations.

    NARCIS (Netherlands)

    Orozco, G.; Alizadeh, B.Z.; Delgado-Vega, A.M.; Gonzalez-Gay, M.A.; Balsa, A.; Pascual-Salcedo, D.; Fernandez-Gutierrez, B.; Gonzalez-Escribano, M.F.; Petersson, I.F.; Riel, P.L.C.M. van; Barrera, P.; Coenen, M.J.H.; Radstake, T.R.D.J.; Leeuwen, M.A. van; Wijmenga, C.; Koeleman, B.P.; Alarcon-Riquelme, M.E.; Martin, J.

    2008-01-01

    OBJECTIVE: This study was undertaken to investigate the previously reported association of the STAT4 polymorphism rs7574865 with rheumatoid arthritis (RA) in 3 different European populations from Spain, Sweden, and The Netherlands, comprising a total of 2,072 patients and 2,474 controls. METHODS:

  2. Patient loyalty in a mature IDS market: is population health management worth it?

    Science.gov (United States)

    Carlin, Caroline S

    2014-06-01

    To understand patient loyalty to providers over time, informing effective population health management. Patient care-seeking patterns over a 6-year timeframe in Minnesota, where care systems have a significant portion of their revenue generated by shared-saving contracts with public and private payers. Weibull duration and probit models were used to examine patterns of patient attribution to a care system and the continuity of patient affiliation with a care system. Clustering of errors within family unit was used to account for within-family correlation in unobserved characteristics that affect patient loyalty. The payer provided data from health plan administrative files, matched to U.S. Census-based characteristics of the patient's neighborhood. Patients were retrospectively attributed to health care systems based on patterns of primary care. I find significant patient loyalty, with past loyalty a very strong predictor of future relationship. Relationships were shorter when the patient's health status was complex and when the patient's care system was smaller. Population health management can be beneficial to the care system making this investment, particularly for patients exhibiting prior continuity in care system choice. The results suggest that co-located primary and specialty services are important in maintaining primary care loyalty. © Health Research and Educational Trust.

  3. The prevalence of tenosynovitis of the interosseous tendons of the hand in patients with rheumatoid arthritis.

    OpenAIRE

    Rowbotham, EL; Freeston, JE; Emery, P; Grainger, AJ

    2015-01-01

    AIM: The aim of this study was to establish the prevalence of tenosynovitis affecting the interosseous tendons of the hand in a rheumatoid arthritis (RA) population and to assess for association with metacarpophalangeal (MCP) joint synovitis, flexor tendon tenosynovitis or ulnar drift. METHODS: Forty-four patients with RA underwent hand MRI along with 20 normal controls. Coronal 3D T1 VIBE sequences pre- and post-contrast were performed and reconstructed. The presence of interosseous tendon t...

  4. The risk of being depressed is significantly higher in cancer patients than in the general population

    DEFF Research Database (Denmark)

    Hartung, T J; Brähler, E; Faller, H

    2017-01-01

    BACKGROUND: Depression is a common co-morbidity of cancer that has a detrimental effect on quality of life, treatment adherence and potentially survival. We conducted an epidemiological multi-center study including a population-based random comparison sample and estimated the prevalence...... of depressive symptoms by cancer site, thereby identifying cancer patients with the highest prevalence of depression. PATIENTS AND METHODS: We included 4020 adult cancer inpatients and outpatients from five distinct regions across Germany in a proportional stratified random sample based on the nationwide cancer......% participated (51% women, mean age = 58 years). We estimated that one in four cancer patients (24%) is depressed (PHQ-9 ≥ 10). The odds of being depressed among cancer patients were more than five times higher than in the general population (OR, 5.4; 95% CI, 4.6-6.2). Patients with pancreatic (M = 8.0, SD = 5...

  5. Who are medical marijuana patients? Population characteristics from nine California assessment clinics.

    Science.gov (United States)

    Reinarman, Craig; Nunberg, Helen; Lanthier, Fran; Heddleston, Tom

    2011-01-01

    Marijuana is a currently illegal psychoactive drug that many physicians believe has substantial therapeutic uses. The medical literature contains a growing number of studies on cannabinoids as well as case studies and anecdotal reports suggesting therapeutic potential. Fifteen states have passed medical marijuana laws, but little is known about the growing population of patients who use marijuana medicinally. This article reports on a sample of 1,746 patients from a network of nine medical marijuana evaluation clinics in California. Patients completed a standardized medical history form; evaluating physicians completed standardized evaluation forms. From this data we describe patient characteristics, self-reported presenting symptoms, physician evaluations, other treatments tried, other drug use, and medical marijuana use practices. Pain, insomnia, and anxiety were the most common conditions for which evaluating physicians recommended medical marijuana. Shifts in the medical marijuana patient population over time, the need for further research, and the issue of diversion are discussed.

  6. Determination of 226Ra by alpha spectrometry of liquid scintillation

    International Nuclear Information System (INIS)

    Nobrega, A.W.; Sachett, I.A.; Hespanhol, E.C.B.

    1987-01-01

    The determination of 226 Ra in environmental samples using alpha spectrometry in liquid scintilation is studied. The Radon 1-2 emanation method and 226 Ra separation process of other radionuclides alpha emissors are analyzed. The use of 226 Ra coprecipitation with barium sulphate is evaluated. (M.J.C.) [pt

  7. Work ability in rheumatoid arthritis patients

    DEFF Research Database (Denmark)

    Hansen, Sofie M; Hetland, Merete Lund; Pedersen, Jacob

    2017-01-01

    Objectives: The aim was to study work ability in patients with RA compared with the general population by investigating the rates and risks of long-term sickness absence, unemployment and disability pension, and the chance of returning to work and the changes in these risks over time (1994-2011)....

  8. Cardiovascular risk profiles in a hospital-based population of patients with psoriatic arthritis and ankylosing spondylitis

    DEFF Research Database (Denmark)

    Nissen, Christoffer B; Hørslev-Petersen, Kim; Primdahl, Jette

    2017-01-01

    The objective of the study was to investigate the frequency of traditional risk factors for the cardiovascular (CV) disease, to calculate the Systematic COronary Risk Evaluation (SCORE) for CV-related mortality in Danish patients with psoriatic arthritis (PsA) and ankylosing spondylitis (AS......), and to compare with results from patients with rheumatoid arthritis (RA) from the same settlement. All PsA and AS patients aged 18-85 years from one outpatient clinic were invited. A rheumatology nurse conducted 30-min screening consultation, preceded by a lipid and glucose profile. High SCORE risk led...... to recommendation of follow-up by general practitioners. Multiple and logistic regression analyses, adjusted for age and gender, were performed, to compare risk factors and risk SCOREs. Participants were 116 AS (29.3% female) and 170 PsA (54.7% female). AS had opposed PsA patients' lower 10-year risk SCOREs of CV...

  9. Population Pharmacokinetics of Tenofovir in Human Immunodeficiency Virus-Infected Patients Taking Highly Active Antiretroviral Therapy

    OpenAIRE

    Jullien, Vincent; Tréluyer, Jean-Marc; Rey, Elisabeth; Jaffray, Patrick; Krivine, Anne; Moachon, Laurence; Lillo-Le Louet, Agnès; Lescoat, Anne; Dupin, Nicolas; Salmon, Dominique; Pons, Gérard; Urien, Saïk

    2005-01-01

    The influence of renal function on tenofovir pharmacokinetics was investigated in 193 human immunodeficiency virus (HIV)-infected patients by the use of a population approach performed with the nonlinear mixed effects modeling program NONMEM. Tenofovir pharmacokinetics was well described by a two-compartment open model in which the absorption and the distribution rate constants are equal. Typical population estimates of apparent central distribution volume (Vc/F), peripheral distribution volu...

  10. Frequency of opioid use in a population of cancer patients during the trajectory of the disease

    DEFF Research Database (Denmark)

    Jarlbæk, Lene; Gilså Hansen, Dorte; Bruera, E

    2010-01-01

    AIMS: Bearing in mind that Denmark has one of the world's highest legal uses of strong opioids per capita, the aim of the present study was to describe the frequency of opioid use in a complete, population-based cohort of cancer patients at different time points during the trajectory of the disease......, and to analyse the influence of different factors on opioid use close to death. MATERIALS AND METHODS: All incident cancer patients registered in 1997-1998 (n=4006) from a population of 470,000 were followed individually from diagnosis to death (non-survivors) or for 5 years (survivors). The use of opioids...... was obtained from a prescription database covering the whole population. RESULTS: Among the 43% cancer patients who survived for 5 years, 12% used opioids at diagnosis, 38% during follow-up and 10% after 5 years. For the non-survivors, 80% used opioids sometime during follow-up. At diagnosis, use related...

  11. Multi-Wavelength Observations of Asteroid 2100 Ra-Shalom: Visible, Infrared, and Thermal Spectroscopy Results

    Science.gov (United States)

    Clark, Beth Ellen; Shepard, M.; Bus, S. J.; Vilas, F.; Rivkin, A. S.; Lim, L.; Lederer, S.; Jarvis, K.; Shah, S.; McConnochie, T.

    2004-01-01

    The August 2003 apparition of asteroid 2100 Ra-Shalom brought together a collaboration of observers with the goal of obtaining rotationally resolved multiwavelength spectra at each of 5 facilities: infrared spectra at the NASA Infrared Telescope Facility (Clark and Shepard), radar images at Arecibo (Shepard and Clark), thermal infrared spectra at Palomar (Lim, McConnochie and Bell), visible spectra at McDonald Observatory (Vilas, Lederer and Jarvis), and visible lightcurves at Ondrojev Observatory (Pravec). The radar data was to be used to develop a high spatial resolution physical model to be used in conjunction with spectral data to investigate compositional and textural properties on the near surface of Ra Shalom as a function of rotation phase. This was the first coordinated multi-wavelength investigation of any Aten asteroid. There are many reasons to study near-Earth asteroid (NEA) 2100 Ra-Shalom: 1) It has a controversial classification (is it a C- or K-type object)? 2) There would be interesting dynamical ramifications if Ra-Shalom is a K-type because most K-types come from the Eos family and there are no known dynamical pathways from Eos to the Aten population. 3) The best available spectra obtained previously may indicate a heterogeneous surface (most asteroids appear to be fairly homogeneous). 4) Ra-Shalom thermal observations obtained previously indicated a lack of regolith, minimizing the worry of space weathering effects in the spectra. 5) Radar observations obtained previously hinted at interesting surface structures. 6) Ra-Shalom is one of the largest Aten objects. And 7) Ra-Shalom is on a short list of proposed NEAs for spacecraft encounters and possible sample returns. Preliminary results from the visible, infrared, and thermal spectroscopy measurements will be presented here.

  12. Research nuclear reactor RA - Annual Report 1997; Istrazivacki nuklearni reaktor RA - Izvestaj za 1997. godinu

    Energy Technology Data Exchange (ETDEWEB)

    Sotic, O [Vinca Institute of Nuclear Sciences, Beograd (Serbia and Montenegro)

    1997-12-01

    RA reactor is not in operation since 1984, activities related to revitalisation of the RA reactor started in 1986. The planned actions related to renewal of the reactor components were finished except for the most important action, related to exchange of complete reactor instrumentation which was delayed. Only 80% of the instrumentation was delivered until September 1991. Since then any delivery of components to Yugoslavia was stopped because of the sanctions imposed to our country. The existing RA reactor instrumentation was dismantled. Control and maintenance of the reactor components was done regularly and efficiently. Fuel inspection by the IAEA safeguards inspectors was done on a monthly basis. There have been on the average 42 employees at the RA reactor which is considered sufficient for maintenance and repair conditions. The problem of financing the reactor activities and maintenance remains unsolved. Research reactor RA Annual report for year 1997 is divided into two main parts to cover: (1) operation and maintenance and (2) activities related to radiation protection. [Serbo-Croat] Reaktor RA nije u pogonu od 1984, aktivnosti na revitalizaciji, rekostrukciji i modernizaciji reaktorski sistema zapocete su 1986. godine. Okoncan je niz zahvata na opremi postrojenja kojima ce se u narednom periodu omoguciti kontinualan i pouzdan rad ovog reaktora. Poslednji, i ujedno najveci zahvat, koji se odnosi na zamenu celokupne instrumentacije kasni zbog zastoja u isporuci opreme koja se izradjuje u Sovjetskom savezu. Do septembra 1991. godine isporuceno svega 80% od predvidjene kolicine. Od tada je svaka isporuka obustavljena, a razlog je privremena zabrana na sve isporuke opreme za Jugoslaviju usled sankcija uvedenih od strane organizacije Ujedinjenih nacija. Demontirana je postojeca instrumentacija. Kontrola i odrzavanje celopkupne opreme postrojenja, kao i remontni radovi izvrsavani su redovno i efikasno. Kontrola goriva od strane safeguard inspektora MAAE obavljana

  13. Orthopedic Surgery among Patients with Rheumatoid Arthritis: A Population-based study to Identify Risk factors, Sex differences, and Time trends.

    Science.gov (United States)

    Richter, Michael; Crowson, Cynthia S; Matteson, Eric L; Makol, Ashima

    2017-12-20

    To identify risk factors for large joint (LJS) versus small joint surgery (SJS) in rheumatoid arthritis (RA) and evaluate trends in surgery rates over time. A retrospective medical record review was performed of all orthopedic surgeries following first fulfillment of 1987 ACR criteria for adult-onset RA among residents of Olmsted County, Minnesota, USA in 1980-2013. Risk factors were examined using Cox models adjusted for age, sex and calendar year of RA incidence. Trends in incidence of joint surgeries were examined using Poisson regression models. A total of 1077 patients with RA (mean age 56 years, 69% female, 66% seropositive) were followed for a median of 10.7 years during which 112 (90 women) underwent at least one SJS and 204 (141 women) underwent at least one LJS. Risk factors included advanced age, rheumatoid factor and anti-CCP antibody positivity for both SJS and LJS, and BMI≥30 kg/m 2 for LJS. Risk factors for SJS and LJS at any time during follow-up included the presence of radiographic erosions, large joint swelling, and methotrexate use. SJS rates decreased by calendar year of incidence (hazard ratio 0.53; p=0.001), with significant decline in SJS after 1995. The cumulative incidence of SJS was higher in women than men (p=0.008). In recent years, there has been a significant decline in rates of SJS but not LJS in patients with RA. The incidence of SJS is higher among women. Traditional RA risk factors are strong predictors for SJS and LJS. Increasing age and obesity are predictive of LJS. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  14. Frequency of BRAF V600E Mutation in the Mexican Population of Patients With Metastatic Melanoma

    Directory of Open Access Journals (Sweden)

    Erika Ruiz-Garcia

    2017-06-01

    Full Text Available Purpose: The BRAF V600E mutation has been described in melanomas occurring in the Caucasian, European, and Asian populations. However, in the Mexican population, the status and clinical significance of BRAF mutation has not been researched on a large scale. Methods: Consecutive BRAF-tested Mexican patients with metastatic melanoma (n = 127 were analyzed for mutations in exon 15 of the BRAF gene in genomic DNA by real-time polymerase chain reaction technology for amplification and detection. The results were correlated with the clinical-pathologic features and the prognosis of the patients. Results: The frequency of somatic mutation V600E within the BRAF gene was 54.6% (43 of 127 patients. Nodular melanoma was the most prevalent subtype in our population, with BRAF mutations in 37.2% (16 of 55 patients. In contrast, superficial spread had a frequency of 18.6% BRAF mutation (eight of 24. Other clinicopathologic features were assessed to correlate with the mutation status. Conclusion: This study searched for the most prevalent BRAF V600E mutation type in melanoma in a heterogeneous population from Mexico. Nodular melanoma was found to be the most prevalent in metastatic presentation and the presence of BRAF V600E mutation, perhaps related to the mixed ancestry; in the north, ancestry is predominantly European and in the south, it is predominantly Asian. The outcomes of the mutation correlations were similar to those found in other populations.

  15. Suicidal ideation and attempts in patients with stroke: a population-based study.

    Science.gov (United States)

    Chung, Jae Ho; Kim, Jung Bin; Kim, Ji Hyun

    2016-10-01

    Stroke is known to be associated with an increase in the risk for suicide. However, there are very few population-based studies investigating the risk of suicidal ideation and attempts in patients with stroke. The purpose of this study was to compare the risk of suicidal ideation and attempts between patients with stroke and population without stroke using nationwide survey data. Individual-level data were obtained from 228,735 participants (4560 with stroke and 224,175 without stroke) of the 2013 Korean Community Health Survey. Demographic characteristics, socioeconomic status, physical health status, and mental health status were compared between patients with stroke and population without stroke. Multivariable logistic regression was performed to investigate the independent effects of the stroke on suicidal ideation and attempts. Stroke patients had more depressive mood (12.6 %) than population without stroke (5.7 %, p suicidal ideation (24.4 %) and attempts (1.3 %) than population without stroke (9.8 and 0.4 %, respectively; both p suicidal ideation (OR 1.65, 95 % CI 1.52-1.79) and suicidal attempts (OR 1.64, 95 % CI 1.21-2.22), adjusting for demographics, socioeconomic factors, and physical health and mental health factors. We found that stroke increased the risk for suicidal ideation and attempts, independent of other factors that are known to be associated with suicidality, suggesting that stroke per se may be an independent risk factor for suicidality.

  16. Analysis of the genetic ancestry of patients with oral clefts from South American admixed populations.

    Science.gov (United States)

    Vieira-Machado, Camilla D; de Carvalho, Flavia M; Santana da Silva, Luiz C; Dos Santos, Sidney E; Martins, Claudia; Poletta, Fernando A; Mereb, Juan C; Vieira, Alexandre R; Castilla, Eduardo E; Orioli, Iêda M

    2016-08-01

    Increased susceptibility to cleft lip, with or without cleft palate (CL±P) has been observed in South America, as related to Amerindian ancestry, using epidemiological data, uniparental markers, and blood groups. In this study, it was evaluated whether this increased risk remains when Amerindian ancestry is estimated using autosomal markers and considered in the predictive model. Ancestry was estimated through genotyping 62 insertion and deletion (INDEL) markers in sample sets of patients with CL±P, patients with cleft palate (CP), and controls, from Patagonia in southern Argentina and Belém in northern Brazil. The Amerindian ancestry in patients from Patagonia with CL±P was greater than in controls although it did not reach statistical significance. The European ancestry in patients with CL±P from Belém and in patients with CP from Belém and Patagonia was higher than in controls and statistically significant for patients with CP who were from Belém. This high contribution of European genetic ancestry among patients with CP who were from Belém has not been previously observed in American populations. Our results do not corroborate the currently accepted risks for CL±P and CP estimated by epidemiological studies in the North American populations and probably reflect the higher admixture found in South American ethnic groups when compared with the same ethnic groups from the North American populations. © 2016 Eur J Oral Sci.

  17. Marital status, treatment, and survival in patients with glioblastoma multiforme: a population based study.

    Science.gov (United States)

    Chang, Susan M; Barker, Fred G

    2005-11-01

    Social factors influence cancer treatment choices, potentially affecting patient survival. In the current study, the authors studied the interrelations between marital status, treatment received, and survival in patients with glioblastoma multiforme (GM), using population-based data. The data source was the Surveillance, Epidemiology, and End Results (SEER) Public Use Database, 1988-2001, 2004 release, all registries. Multivariate logistic, ordinal, and Cox regression analyses adjusted for demographic and clinical variables were used. Of 10,987 patients with GM, 67% were married, 31% were unmarried, and 2% were of unknown marital status. Tumors were slightly larger at the time of diagnosis in unmarried patients (49% of unmarried patients had tumors larger than 45 mm vs. 45% of married patients; P = 0.004, multivariate analysis). Unmarried patients were less likely to undergo surgical resection (vs. biopsy; 75% of unmarried patients vs. 78% of married patients) and were less likely to receive postoperative radiation therapy (RT) (70% of unmarried patients vs. 79% of married patients). On multivariate analysis, the odds ratio (OR) for resection (vs. biopsy) in unmarried patients was 0.88 (95% confidence interval [95% CI], 0.79-0.98; P = 0.02), and the OR for RT in unmarried patients was 0.69 (95% CI, 0.62-0.77; P Unmarried patients more often refused both surgical resection and RT. Unmarried patients who underwent surgical resection and RT were found to have a shorter survival than similarly treated married patients (hazard ratio for unmarried patients, 1.10; P = 0.003). Unmarried patients with GM presented with larger tumors, were less likely to undergo both surgical resection and postoperative RT, and had a shorter survival after diagnosis when compared with married patients, even after adjustment for treatment and other prognostic factors. (c) 2005 American Cancer Society.

  18. Measurement of "2"2"6Ra and "2"2"8Ra in Brazilian and Israeli Phosphates

    International Nuclear Information System (INIS)

    Ferreira, W.; Canella Avelar, A.; Menezes, M.

    2014-01-01

    Since the 1970s, the IAEA recognizes that phosphoric acid presents an alternate source of uranium, but given the status of both phosphate and uranium markets the potential of recovering uranium from phosphoric acid still marginal. New technologies for the recovery of uranium from phosphoric acid, national and global interests and environment barriers could shape this market in the medium and long-term scenarios. On the other hand, the use of phosphates is the major source of phosphorus in agriculture and livestock. Beyond phosphorus and calcium, phosphate is also source of some hazardous elements, such: arsenic, cadmium, thorium and uranium, including a variety of radioisotopes as well. This radioactivity is sure to be released in the environment, contributing to the background. The risk is not recognized for some of the players in this market, mainly workers who apply phosphate fertilizers in the farmland, in some cases manipulating phosphates with their bare hands, and without any respiratory protection equipment (RPE) as well. This paper deals with the radioactivity from "2"2"6Ra and "2"2"8Ra in four phosphates often used in Brazilian agriculture. Three Brazilian and an Israeli phosphate were analysed and compared with international criteria. The specific activities of "2"2"6Ra (from the uranium decay series) and "2"2"8Ra (from the thorium decay series) were taken into consideration to ensure an adequate risk assessment. Specific activities were determined by high-resolution gamma spectroscopy with germanium detector and Genie® software from Canberra in the Centre of Nuclear Technology Development (CDTN/CNEN). The concentration of "2"2"6Ra was measured using the 186.2 keV energy peak, the concentration of "2"2"8Ra through "2"2"8Ac. The system was calibrated using a set of standard materials from IAEA. The measured samples were crushed and sieved to a grain (98% at least) size as small as 75 μm. Stable mass was achieved grinding, drying at 105°C and mixing

  19. Long-Term Outcomes in Puerto Ricans with Rheumatoid Arthritis (RA) Receiving Early Treatment with Disease-Modifying Anti-Rheumatic Drugs using the American College of Rheumatology Definition of Early RA.

    Science.gov (United States)

    Varela-Rosario, Noemí; Arroyo-Ávila, Mariangelí; Fred-Jiménez, Ruth M; Díaz-Correa, Leyda M; Pérez-Ríos, Naydi; Rodríguez, Noelia; Ríos, Grissel; Vilá, Luis M

    2017-01-01

    Early treatment of rheumatoid arthritis (RA) results in better long-term outcomes. However, the optimal therapeutic window has not been clearly established. To determine the clinical outcome of Puerto Ricans with RA receiving early treatment with conventional and/or biologic disease-modifying anti-rheumatic drugs (DMARDs) based on the American College of Rheumatology (ACR) definition of early RA. A cross-sectional study was performed in a cohort of Puerto Ricans with RA. Demographic features, clinical manifestations, disease activity, functional status, and pharmacotherapy were determined. Early treatment was defined as the initiation of DMARDs (conventional and/or biologic) in less than 6 months from the onset of symptoms attributable to RA. Patients who received early (disease duration was 14.9 years and 337 (87.0%) patients were women. One hundred and twenty one (31.3%) patients received early treatment. In the multivariate analysis adjusted for age and sex, early treatment was associated with better functional status, lower probability of joint deformities, intra-articular injections and joint replacement surgeries, and lower scores in the physician's assessments of global health, functional impairment and physical damage of patients. Using the ACR definition of early RA, this group of patients treated with DMARDs within 6 months of disease had better long-term outcomes with less physical damage and functional impairment.

  20. Celiac Disease Autoimmunity in Patients with Autoimmune Diabetes and Thyroid Disease among Chinese Population.

    Directory of Open Access Journals (Sweden)

    Zhiyuan Zhao

    Full Text Available The prevalence of celiac disease autoimmunity or tissue transglutaminase autoantibodies (TGA amongst patients with type 1 diabetes (T1D and autoimmune thyroid disease (AITD in the Chinese population remains unknown. This study examined the rate of celiac disease autoimmunity amongst patients with T1D and AITD in the Chinese population. The study included 178 patients with type 1 diabetes and 119 with AITD where 36 had both T1D and AITD, classified as autoimmune polyglandular syndrome type 3 variant (APS3v. The study also included 145 patients with type 2 diabetes (T2D, 97 patients with non-autoimmune thyroid disease (NAITD, and 102 healthy controls. Serum islet autoantibodies, thyroid autoantibodies and TGA were measured by radioimmunoassay. TGA positivity was found in 22% of patients with either type 1 diabetes or AITD, much higher than that in patients with T2D (3.4%; p< 0.0001 or NAITD (3.1%; P < 0.0001 or healthy controls (1%; p<0.0001. The patients with APS3v having both T1D and AITD were 36% positive for TGA, significantly higher than patients with T1D alone (p = 0.040 or with AITD alone (p = 0.017. T1D and AITD were found to have a 20% and 30% frequency of overlap respectively at diagnosis. In conclusion, TGA positivity was high in the Chinese population having existing T1D and/or AITD, and even higher when both diseases were present. Routine TGA screening in patients with T1D or AITD will be important to early identify celiac disease autoimmunity for better clinical care of patients.

  1. Chromosome breakage in lymphocytes from humans with body burdens of 226Ra

    International Nuclear Information System (INIS)

    Hoegerman, S.F.; Cummins, H.T.; Bronec, J.F.

    1976-01-01

    Peripheral lymphocytes from 10 controls and 40 patients with body burdens of 226 Ra ranging from below the limit of detection to 8.6 μCi were scored for unstable chromosome aberrations. The patient population was divided into four groups: a group with body burdens below the limit of detection (less than 0.003 μCi, 12 patients); a low-burden group (0.003 to 0.099 μCi, 13 patients); a moderate-burden group (0.1 to 0.99 μCi, 11 patients); and a high-burden group (greater than 1.0 μCi, 4 patients). In none of these groups was the frequency of cells with unstable aberrations significantly elevated above that in the controls. The rate of occurrence of dicentric and ring chromosomes was above the control frequency in only the two patients with the highest burdens (3.55 and 8.6 μCi). Our results are consistent with the expectation derived from a recent calculation of alpha dose delivered to blood by bone-deposited radium and its decay products. Marshall and Hoegerman have estimated that the blood dose for an individual with a radium burden of 1.0 μCi is 0.09 +- 0.03 rad/year. The value is compared with the dose estimate used by Boyd et al. in their study of British radium-dial painters, and the relevance of the blood dose to the lymphocyte dose is discussed

  2. Patient satisfaction with community pharmacy: comparing urban and suburban chain-pharmacy populations.

    Science.gov (United States)

    Malewski, David F; Ream, Aimrie; Gaither, Caroline A

    2015-01-01

    Patient satisfaction with pharmaceutical care can be a strong predictor of medication and other health-related outcomes. Less understood is the role that location of pharmacies in urban or suburban environments plays in patient satisfaction with pharmacy and pharmacist services. The purpose of this study was to serve as a pilot examining urban and suburban community pharmacy populations for similarities and differences in patient satisfaction. Community pharmacy patients were asked to self-administer a 30-question patient satisfaction survey. Fifteen questions addressed their relationship with the pharmacist, 10 questions addressed satisfaction and accessibility of the pharmacy, and five questions addressed financial concerns. Five urban and five suburban pharmacies agreed to participate. Data analysis included descriptive statistics and chi-square analysis. Most patients reported high levels of satisfaction. Satisfaction with pharmacist relationship and service was 70% or higher with no significant differences between locations. There were significant differences between the urban and suburban patients regarding accessibility of pharmacy services, customer service and some patient/pharmacist trust issues. The significant differences between patient satisfaction in the suburban and urban populations warrant a larger study with more community pharmacies in other urban, suburban and rural locations to better understand and validate study findings. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Patients undergoing radical prostatectomy have a better survival than the background population

    DEFF Research Database (Denmark)

    Andreas Røder, Martin; Brasso, Klaus; Drimer Berg, Kasper

    2013-01-01

    underwent radical prostatectomy. Patients were followed prospectively per protocol. No patients were lost to follow-up. Overall and cause-specific survival were described using Kaplan-Meier plots. Standardized relative survival and mortality ratio were calculated based on expected survival in the age......INTRODUCTION: The objective of this study was to investigate standardised relative survival and mortality ratio for patients undergoing radical prostatectomy for localized prostate cancer at our institution. MATERIAL AND METHODS: Between 1995 and 2010, a total of 1,350 consecutive patients......-matched Danish population using the methods and macros described by Dickmann. The country-specific population mortality rates used for calculation of the expected survival were based on data from The Human Mortality Database. RESULTS: The median follow-up was 3.4 years (range: 0-14.3 years). A total of 59 (4...

  4. Increased risk of benign prostate hyperplasia in sleep apnea patients: a nationwide population-based study.

    Directory of Open Access Journals (Sweden)

    Ping-Song Chou

    Full Text Available BACKGROUND: Sleep apnea (SA is a common sleep disorder characterized by chronic intermittent hypoxia (IH. Chronic IH induces systemic inflammatory processes, which can cause tissue damage and contribute to prostatic enlargement. The purpose of this study was to evaluate the association between benign prostate hyperplasia (BPH and SA in a Taiwanese population. METHODS: The study population was identified from Taiwan's National Health Insurance Research Database (NHIRD and contained 202 SA patients and 1010 control patients. The study cohort consisted of men aged ≥ 30 years who were newly diagnosed with SA between January 1997 and December 2005. Each patient was monitored for 5 years from the index date for the development of BPH. A Cox regression analysis was used to calculate the hazard ratios (HRs for BPH in the SA and control patients. RESULTS: During the 5-year follow-up, 18 SA patients (8.9% and 32 non-SA control patients (3.2% developed BPH. The adjusted HR for BPH was 2.35-fold higher in the patients with SA than in the control patients (95% confidence interval (CI 1.28-4.29, P<.01. We further divided the SA patients into 4 age groups. After adjusting for potential confounding factors, the highest adjusted HR for BPH in the SA patients compared with the control patients was 5.59 (95% CI = 2.19-14.31, P<.001 in the patients aged between 51 and 65 years. CONCLUSION: Our study results indicate that patients with SA are associated with increased longitudinal risk of BPH development, and that the effects of SA on BPH development are age-dependent.

  5. Migration of 226 Ra, 228 Ra, 210 Pb, U and Th from phosphogypsum

    International Nuclear Information System (INIS)

    Silva, Nivaldo Carlos da; Cipriani, Moacir; Taddei, Maria Helena T.

    2002-01-01

    The physico-chemical availability of radioactive elements ( 210 Pb, 226 Ra, 228 Ra, Th and U) in Brazilian phosphogypsum was investigated in a large scale leaching experiment carried out in lysimeters, using phosphogypsum samples (approximately 1.2 tons) from two phosphoric acid industries. Lysimeters were built using cylindrical concrete containers with 0.9 m inner diameter and 2 m depth. The bottom of the lysimeter was filled with a 10 cm layer of gravel covered with geomembrane sheet. Under this layer a pipe was designed to drain the percolated water. Three lysimeters were filled with phosphogypsum from each industry and a mixture of both. As percolated water comes exclusively from the rain, sample was collected daily when available. Samples were then pooled weekly, carefully prepared and submitted to radiochemical analysis. Radiochemical characterization of phosphogypsum and percolated water was performed by radiochemical separation followed by gross alpha and beta counting ( 226 Ra, 228 Ra and 210 Pb) and UV-Vis spectrophotometry with Arsenazo III (U and Th). This experiment was carried out from 12/01/1999 to 01/22/2001, with a precipitation of 2,732 mm. It was observed that approximately 40% (534 L) of the rain fall percolated through the lysimeter 1. The analysis of 22 samples of percolated water from lysimeter 1 showed mean radionuclides activities of 70±30 mBqL -1 , 70±50 mBqL -1 , 100±60 mBqL -1 and 110±55 mBqL -1 for U, 226 Ra, 228 Ra and 210 Pb, respectively. Thorium activities were below detection limit. (author)

  6. Estomatitis subprótesis en pacientes mayores de 15 años pertenecientes al Policlínico "Raúl Sánchez" Denture-induced stomatitis in patients older than 15 years old. "Raul Sanchez" outpatient clinic

    Directory of Open Access Journals (Sweden)

    Ania Mercedes Silva Contreras

    2012-10-01

    Full Text Available Introducción: la estomatitis subprótesis es una de las alteraciones que con más frecuencia se diagnostica dentro de las patologías bucales, y se define como una alteración de tipo inflamatoria, que puede degenerar en una lesión hiperplásica si no se trata oportunamente. Objetivo: caracterizar el comportamiento de la estomatitis subprótesis en esa población. Material y método: se realizó un estudio observacional, descriptivo y transversal en la población de 15 años y más portadores de prótesis dental parcial o total del Policlínico "Raúl Sánchez" en el municipio Pinar del Río, durante el período comprendido desde febrero del 2008 a febrero del 2010. La muestra quedó constituida por 232 pacientes seleccionados mediante un muestreo por conglomerado trietápico. Para el análisis estadístico de los datos se emplearon medidas de resúmenes para variables cualitativas (porcentaje puntuales y por intervalos de confianza y se implementó, en los casos necesarios, la prueba no paramétrica ji cuadrado con el propósito de determinar se existe correlación entre algunas de las variables. Y se obtuvo un nivel de significación de pIntroduction: denture-induced stomatitis is one of the most frequent alterations diagnosed among the oral-cavity pathologies; it is defined as an inflammatory-type state that can lead to a hyperplastic lesion if it is not properly treated. Objective: to characterize the behavior of denture-induced stomatitis in this population. Material and method: an observational, descriptive and cross-sectional study was conducted in partial and total denture-wearing patients older than 15 years old belonging to "Raul Sanchez" outpatient clinic in Pinar del Rio during February 2008 to February 2010. The sample was comprised of 232 patients chosen by means of three-state conglomeration. To the statistical analysis of data, measures to sum up the qualitative variables (punctual percentage and confidence interval were used

  7. Impact of 5-HT(3) RA selection within triple antiemetic regimens on uncontrolled highly emetogenic chemotherapy-induced nausea/vomiting.

    Science.gov (United States)

    Schwartzberg, Lee; Jackson, James; Jain, Gagan; Balu, Sanjeev; Buchner, Deborah

    2011-08-01

    It is recommended that patients initiate triple antiemetic therapy with one of the 5-hydroxytryptamine receptor antagonists (5-HT(3) RAs), aprepitant (or its intravenous prodrug fosaprepitant) and dexamethasone prior to the start of highly emetogenic chemotherapy (HEC). However, the impact of 5-HT(3) RA selection within triple antiemetic regimens on the risk of uncontrolled chemotherapy-induced nausea and vomiting (CINV) with HEC has not been well studied. To assess the likelihood of an uncontrolled CINV event following antiemetic prophylaxis with the 5-HT(3) RA palonosetron + aprepitant/fosaprepitant + dexamethasone (palonosetron cohort) versus any of the other 5-HT(3) RAs + aprepitant/fosaprepitant + dexamethasone (other 5-HT(3) RA cohort) among single-day HEC cycles. Single-day HEC cycles (a gap of at least 5 days between two administrations) among patients with a cancer diagnosis and receiving antiemetic prophylaxis with the aforementioned regimens between 1/1/2006 and 6/30/2010 were identified from the IMS LifeLink claims database. Uncontrolled CINV events were identified through ICD-9-CM codes (nausea and vomiting), Current Procedural Terminology codes (hydration), rescue medications and/or use of antiemetic therapy from days 2-5 following HEC administration. Risks for an uncontrolled CINV event among all patients, and within breast cancer and multiple cancer subpopulations, were analyzed at cycle level using logistic multivariate regression models. A total of 8018 cycles for the palonosetron cohort and 1926 cycles for the other 5-HT(3) RA cohort (3574 and 978 patients, respectively) were analyzed. Single-day HEC cycles received by the palonosetron cohort had a significantly lower unadjusted risk of an uncontrolled CINV event (17.5 vs 20.7% for the other 5-HT(3) RA cohort; p = 0.0010), with a 17% lower adjusted risk for palonosetron-administered cycles (odds ratio: 0.83; 95% CI: 0.73-0.94; p = 0.0042). Results in the breast cancer and multiple cancer

  8. Quality of life among prostate cancer patients: A prospective longitudinal population-based study

    International Nuclear Information System (INIS)

    Schaake, Wouter; Groot, Martijn de; Krijnen, Wim P.; Langendijk, Johannes A.; Bergh, Alfons C.M. van den

    2013-01-01

    Purpose: To investigate the course of quality of life (QoL) among prostate cancer patients treated with external beam radiotherapy and to compare the results with QoL of a normal age-matched reference population. Patients and methods: The study population was composed of 227 prostate cancer patients, treated with radiotherapy. The EORTC QLQ-C30 was used to assess QoL before radiotherapy and six months, one year, two years and three years after completion of radiotherapy. Mixed model analyses were used to investigate longitudinal changes in QoL. QoL of prostate cancer patients was compared to that of a normative cohort using a multivariate analysis of covariance. Results: A significant decline in QoL was observed after radiotherapy (p < 0.001). The addition of hormonal therapy to radiotherapy was associated with a lower level of role functioning. Patients with coronary heart disease and or chronic obstructive pulmonary disease or asthma had a significantly worse course in QoL. Although statistically significant, all differences were classified as small or trivial. Conclusion: Prostate cancer patients experience a small worsening of QoL as compared with baseline and as compared with a normal reference population. As co-morbidity modulates patients’ post-treatment QoL, a proper assessment of co-morbidity should be included in future longitudinal analyses on QoL

  9. Instructions for RA reactor decontamination - Annex 10; Prilog 10 - Uputstvo za dekontaminaciju Reaktora RA

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1963-12-15

    Instructions for RA reactor decontamination includes: action plan for decontamination of the heavy water system by 7% water solution of H{sub 3}PO{sub 4} + 2% CrO{sub 3} acid; description of the preparatory work including calculation of the pipes volume and installation of special pipes; detailed instructions for decontamination procedure. [Serbo-Croat] Uputstvo za dekontaminaciju Reaktora RA sadrzi: plan operacija za dekontaminaciju sistema teske vode 7% vodenim rastvorom kiseline H{sub 3}PO{sub 4} + 2% CrO{sub 3}; opis pripremnih radova ukljucujuci proracun zapremine covovoda i montiranje posebnih cevovoda; detaljno uputstvo za izvodjenje operacija pri dekontaminaciji.

  10. Radiation protection at the RA Reactor in 1993, RA research reactor, Part

    International Nuclear Information System (INIS)

    Ninkovic, M.; Pavlovic, R.; Mandic, M.; Sipka, V.; Grsic, Z.

    1993-01-01

    Radiation protection tasks which enable safe operation of the RA reactor, and are defined according the the legal regulations and IAEA safety recommendations are sorted into four categories in this report: (1) Control of the working environment, dosimetry and radiation protection at the RA reactor; (2) decontamination, collecting and treatment of fluid effluents and solid wastes; (3) Radioactivity control in the vicinity of the reactor and (4)meteorology measurements; (3). Each of the category is described as a separate annex of this report [sr

  11. Development of a scale to assess cancer stigma in the non-patient population.

    Science.gov (United States)

    Marlow, Laura A V; Wardle, Jane

    2014-04-23

    Illness-related stigma has attracted considerable research interest, but few studies have specifically examined stigmatisation of cancer in the non-patient population. The present study developed and validated a Cancer Stigma Scale (CASS) for use in the general population. An item pool was developed on the basis of previous research into illness-related stigma in the general population and patients with cancer. Two studies were carried out. The first study used Exploratory factor analysis to explore the structure of items in a sample of 462 postgraduate students recruited through a London university. The second study used Confirmatory factor analysis to confirm the structure among 238 adults recruited through an online market research panel. Internal reliability, test-retest reliability and construct validity were also assessed. Exploratory factor analysis suggested six subscales, representing: Awkwardness, Severity, Avoidance, Policy Opposition, Personal Responsibility and Financial Discrimination. Confirmatory factor analysis confirmed this structure with a 25-item scale. All subscales showed adequate to good internal and test-retest reliability in both samples. Construct validity was also good, with mean scores for each subscale varying in the expected directions by age, gender, experience of cancer, awareness of lifestyle risk factors for cancer, and social desirability. Means for the subscales were consistent across the two samples. These findings highlight the complexity of cancer stigma and provide the Cancer Stigma Scale (CASS) which can be used to compare populations, types of cancer and evaluate the effects of interventions designed to reduce cancer stigma in non-patient populations.

  12. INTERLEUKIN 28 RECEPTOR GENE ALPHA IL28RA AND PSORIASIS: ASSOCIATION WITH DISEASE SEVERITY AND AGE AT ONSET

    Directory of Open Access Journals (Sweden)

    E. S. Galimova

    2015-01-01

    Full Text Available Molecular basis still remains unclear for psoriasis, a chronic inflammatory skin disease. It biological features are presented by abnormal differentiation of epidermal keratinocytes, overgrowth and dilation of blood vessels, and leukocyte infiltration of dermal and epidermal skin layers. These events appear to be driven, mainly, by various cytokines and chemokines released by activated T cell populations. The aim of this replication study was to determine, whether the rs4649203 SNP of IL28RA gene is associated with susceptibility to psoriasis. A total of 341 patients with psoriasis and 407 matched healthy controls were enrolled to carry out a case control study. Genotyping was performed using a Real-Time PCR assay. Our preliminary data suggest that the polymorphism located in IL28RA gene, known to be related to inflammatory and immunity processes, showed an association with patients’ age at onset and the disease severity. The results of this study are promising, with respect to development of a personalized approach to psoriasis treatment.

  13. Ra-226 bioaccumulation and growth indices in fish.

    Science.gov (United States)

    Shi, Xiaopei; Smith, Richard; Seymour, Colin; Mothersill, Carmel

    2017-06-01

    To determine the accumulated activity of Ra-226 in fathead minnows fed with environmentally relevant levels of Ra-226 for 5 months in water at 20 °C, and to evaluate the influence of this level of Ra-226 on the growth of fathead minnows. Fathead minnows were fed with fish food containing 10-10,000 mBq/g Ra-226 for 5 months. At the end of the experiment, the fish were sacrificed, flash frozen in liquid nitrogen and kept at -20 °C. Longitudinal sections of 40 μm thickness were cut at the middle of the fish body using a cryostat. The activity of Ra-226 in each section was determined using autoradiography with a nuclear track detector CR-39. According to the weight and the width of the fish, the activity of Ra-226 in the whole fish body could be estimated. In addition, the length and the weight of the fish were measured and the condition factor was calculated to evaluate the growth and fitness of the fish. There is a positive but non-linear relationship between the accumulated activity of Ra-226 in fish body and the concentration of Ra-226 in fish food. The highest activity of Ra-226 accumulated in fish body was found from fish fed with 10,000 mBq/g Ra-226 food. This was calculated as 256.4 ± 49.1 mBq/g, p fish fed with food containing lower concentration of Ra-226 (up to 1000 mBq/g), the bioaccumulation of Ra-226 in the body saturated. The Ra-226 concentration factor (CF) for fish was inversely proportional to the Ra-226 activity in food, and the highest CF value was 2.489, obtained from the lowest dietary Ra-226 activity (10 mBq/g). In addition, condition factors (K) of fish in all Ra-226-treated groups were significantly lower than those of the controls. The results show that the bioaccumulation of Ra-226 in fish is not simply related to the dietary Ra-226 activity, and has a saturation value when the dietary activity is low. In addition, the environmental level of Ra-226 in the fish food has a small adverse effect on the growth and fitness of fathead

  14. Are Indian patients with juvenile-onset ankylosing spondylitis taller than reference population ?

    Directory of Open Access Journals (Sweden)

    Pulukool Sandhya

    2015-01-01

    Full Text Available Background & objectives: Paucity of growth retardation has been observed by us in patients with juvenile-onset ankylosing spondylitis (JAS in a tertiary care health centre in south India. We, therefore, undertook this pilot study to assess and compare anthropometry of patients with JAS who were 15 yr and older with that of adult onset ankylosing spondylitis (AAS and matching Indian reference population. Methods: Consecutive male patients (December 2009- October 2012 with JAS and AAS fulfilling Modified New York Criteria were selected after applying inclusion and exclusion criteria. Demography and anthropometry were noted. Height of both patient groups as well as their parents and siblings were compared with that of the reference population. Mid-parental height and delta height were derived. Those with delta height of >8.5 cm were compared with the remaining. Multivariate logistic regression was done for variables that were found to be significant by chi-square in bivariate analysis. Similar analysis was done for BMI also. Results: There was no significant difference in anthropometric variables between JAS and AAS groups. Twenty eight of the 30 (93.33% JAS patients were taller as compared to the reference population. Twenty six (86.67% AAS patients were taller than the reference population. The mean heights of JAS (170.67 ± 6.94 cm and AAS (168.2 ± 5.94 cm patients were significantly higher than the reference value of 163.11 cm; both p0 <0.001. Logistic regression revealed that tallness in JAS was associated positively with hypermobility (OR=23.46,95%CI 1.2-447.2, p0 =0.036. No significant association was detected for height in AAS and for BMI in both JAS and AAS groups. Interpretation & conclusions: No growth retardation was seen in patients with JAS in our study. Majority of patients with JAS and AAS were taller than reference population. The difference between mean height of JAS and AAS was not significant. Larger studies involving different

  15. Population pharmacokinetic (PK) analysis of laromustine, an emerging alkylating agent, in cancer patients.

    Science.gov (United States)

    Nassar, Ala F; Wisnewski, Adam V; King, Ivan

    2017-05-01

    1. Alkylating agents are capable of introducing an alkyl group into nucleophilic sites on DNA or RNA through covalent bond. Laromustine is an active member of a relatively new class of sulfonylhydrazine prodrugs under development as antineoplastic alkylating agents, and displays significant single-agent activity. 2. This is the first report of the population pharmacokinetic analysis of laromustine, 106 patients, 66 with hematologic malignancies and 40 with solid tumors, participated in five clinical trials worldwide. Of these, 104 patients were included in the final NONMEM analysis. 3. The population estimates for total clearance (CL) and volume of distribution of the central compartment (V 1 ) were 96.3 L/h and 45.9 L, associated with high inter-patient variability of 52.9% and 79.8% and inter-occasion variability of 26.7% and 49.3%, respectively. The population estimates for Q and V 2 were 73.2 L/h and 29.9 L, and inter-patient variability in V 2 was 63.1%, respectively. 4. The estimate of V ss (75.8 L) exceeds total body water, indicating that laromustine is distributed to tissues. The half-life is short, less than 1 h, reflecting rapid clearance. Population PK analysis showed laromustine pharmacokinetics to be independent of dose and organ function with no effect on subsequent dosing cycles.

  16. [Vitamin B12 levels in the patient population attending an urban health centre in Madrid].

    Science.gov (United States)

    Camarero-Shelly, M

    2018-04-01

    Vitamin B 12 levels are usually measured in Primary Care when the patients have symptoms or risk factors associated with its deficiency, mostly in the elderly. However, no evidence has been found to support the recommendation of screening in the general population. The aim of this study is to assess the relevance of having extended the screening of vitamin B 12 deficiency to a younger population, after observing an increase in the prescription of this injected vitamin in a population under 65 years, by analysing the vitamin B 12 values obtained. A descriptive, retrospective, observational study was conducted on a sample consisting of 5,531 patients from Barajas Health Primary Centre, Madrid, between 2008 and 2012, and on whom a blood test was performed for any reason, with values of vitamin B 12 . A deficiency was found in 9.1% (SD 2.3) of the patients, of whom 49.4% were less than 65 years. The deficiencies were associated (P<.001, 95% CI) with age, dementia, changes in blood red cell counts, memory, and with the taking of metformin and proton pump inhibitors (P=.007). The prevalence of vitamin B 12 deficiency in our served population is similar in patients older and younger than 65 years. The extended screening was relevant. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Distribution and determinants of health and work status in a comprehensive population of injury patients

    NARCIS (Netherlands)

    Meerding, Willem Jan; Looman, Caspar W. N.; Essink-Bot, Marie-Louise; Toet, Hidde; Mulder, Saakje; van Beeck, Ed F.

    2004-01-01

    BACKGROUND: Insight into the distribution and determinants of both short- and long-term disability can be used to prioritize the development of prevention policies and to improve trauma care. We report on a large follow-up study in a comprehensive population of injury patients. METHODS: We fielded a

  18. Perception of the etiology of illness: causal attributions in a heart patient population.

    Science.gov (United States)

    Koslowsky, M; Croog, S H; La Voie, L

    1978-10-01

    This study examined perceived causes of myocardial infarction in a patient population of 345 men previously free from significant medical problems. Investigation of their perceptions following the life-threatening illness crisis indicated that stress and tension factors were the causes most commonly cited. Possible social and psychological correlates are analyzed using an attribution theory framework, and their implications are discussed.

  19. Do Class III patients have a different growth spurt than the general population?

    Science.gov (United States)

    Lee, Yun-Sik; Lee, Shin-Jae; An, Hongseok; Donatelli, Richard E; Kim, Soo-Hwan

    2012-11-01

    Understanding the timing and length of the growth spurt of Class III prognathic patients is fundamental to the strategy of interceptive orthopedic orthodontics as well as to the timing of orthognathic surgery. Consequently, this study was undertaken to determine whether there are any significant differences in the stature growth pattern of Class III subjects compared with non-Class III subjects and the general population. Twelve-year longitudinal stature growth data were collected for 402 randomly selected adolescents in the general population, 55 Class III mandibular prognathic patients, and 37 non-Class III patients. The growth data were analyzed by using the traditional linear interpolation method and nonlinear growth functions. The 6 stature growth parameters were measured: age at takeoff, stature at takeoff, velocity at takeoff, age at peak height velocity, stature at peak height velocity, and velocity at peak height velocity. Comparisons in the stature growth parameters and 15 cephalometric variables among the general population, Class III subjects, and non-Class III subjects were made with multivariate analysis. Patients with Class III prognathism did not have different growth parameters compared with Class II subjects or the general population. This study does not allow meaningful conclusions with regard to the relationship of mandibular size and stature growth pattern. The application of nonlinear growth curves vs the traditional linear interpolation method was also discussed. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  20. Methods of Suicide among Cancer Patients: A Nationwide Population-Based Study

    Science.gov (United States)

    Chung, Kuo-Hsuan; Lin, Herng-Ching

    2010-01-01

    A 3-year nationwide population-based data set was used to explore methods of suicide (violent vs. nonviolent) and possible contributing factors among cancer patients in Taiwan. A total of 1,065 cancer inpatients who committed suicide were included as our study sample. The regression shows that those who had genitourinary cancer were 0.55 times (p…

  1. A Population-Based Cohort Study on Peripheral Arterial Disease in Patients with Schizophrenia.

    Directory of Open Access Journals (Sweden)

    Wen-Yu Hsu

    Full Text Available Peripheral arterial disease (PAD is considered the leading cause of atherosclerotic cardiovascular morbidity. Several risk factors of PAD have been observed in patients with schizophrenia. Therefore, we hypothesize that the incidence of PAD is higher in the schizophrenia population than in the general population.The patients in this population-based cohort study were selected from the Taiwanese National Health Insurance Research Database on the basis of the claims data from 2000 to 2011. We compared the incidence of PAD between schizophrenia and nonschizophrenia cohorts. Cox proportional hazard regression models were employed for analyzing the risk of PAD after adjustment for sex, age, and comorbidities.The adjusted hazard ratio (HR for PAD in the schizophrenia cohort was 1.26-fold higher than that in the nonschizophrenia cohort. Furthermore, patients with schizophrenia using atypical antipsychotics exhibited a high adjusted HR for PAD.Compared with the general population, the risk of PAD is higher among patients with schizophrenia. Early diagnosis and intervention can mitigate complications resulting from cardiovascular diseases and lower mortality.

  2. Mortality among patients with cleared hepatitis C virus infection compared to the general population

    DEFF Research Database (Denmark)

    Omland, Lars Haukali; Christensen, Peer Brehm; Krarup, Henrik Bygum

    2011-01-01

    The increased mortality in HCV-infected individuals partly stems from viral damage to the liver and partly from risk-taking behaviours. We examined mortality in patients who cleared their HCV-infection, comparing it to that of the general population. We also addressed the question whether prognosis...

  3. Safety of Tofacitinib in the Treatment of Rheumatoid Arthritis in Latin America Compared With the Rest of the World Population.

    Science.gov (United States)

    Castañeda, Oswaldo M; Romero, Felix J; Salinas, Ariel; Citera, Gustavo; Mysler, Eduardo; Rillo, Oscar; Radominski, Sebastiao C; Cardiel, Mario H; Jaller, Juan J; Alvarez-Moreno, Carlos; Ponce de Leon, Dario; Castelli, Graciela; García, Erika G; Kwok, Kenneth; Rojo, Ricardo

    2017-06-01

    Rheumatoid arthritis (RA) is a chronic, autoimmune disease characterized by joint destruction. Tofacitinib is an oral Janus kinase inhibitor for the treatment of RA. This post hoc analysis assessed the safety of tofacitinib in Latin American (LA) patients with RA versus the Rest of World (RoW) population. Data were pooled from 14 clinical studies of tofacitinib: six Phase 2, six Phase 3 and two long-term extension studies. Incidence rates (IRs; patients with events/100 patient-years of treatment exposure) were calculated for safety events of special interest combined across tofacitinib doses. 95% confidence intervals (CI) for IRs were calculated using the maximum likelihood method. Descriptive comparisons were made between LA and RoW (excluding LA) populations. This analysis included data from 984 LA patients and 4687 RoW patients. IRs for safety events of special interest were generally similar between LA and RoW populations, with overlapping 95% CIs. IRs for discontinuation due to adverse events, serious infections, tuberculosis, all herpes zoster (HZ), serious HZ, malignancies (excluding non-melanoma skin cancer) and major adverse cardiovascular events were numerically lower for LA versus RoW patients; IR for mortality was numerically higher. No lymphoma was reported in the LA population versus eight cases in the RoW population. Exposure (extent and length) was lower in the LA population (2148.33 patient-years [mean = 2.18 years]) versus RoW (10515.68 patient-years [mean = 2.24 years]). This analysis of pooled data from clinical studies of tofacitinib in patients with RA demonstrates that tofacitinib has a consistent safety profile across LA and RoW patient populations.

  4. Research nuclear reactor RA - Annual Report 1991; Istrazivacki nuklearni reaktor RA - Izvestaj za 1991. godinu

    Energy Technology Data Exchange (ETDEWEB)

    Sotic, O [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1992-01-01

    Activities related to revitalisation of the RA reactor stared in 1986, were continued in 1991. A number of interventions on the reactor components were finished that are supposed to enable continuous and reliable operation. The last, and at the same time largest action, related to exchange of complete reactor instrumentation is underway, but it is behind the schedule in 1991 because the delivery of components from USSR is late. Production of this instruments is financed by the IAEA according to the contract signed in December 1988 with Russian Atomenergoexport. According to this contract, it has been planned that the RA reactor instrumentation should be delivered to the Vinca Institute by the end of 1990. Only 56% of the instrumentation was delivered until September 1991. Since then any delivery of components to Yugoslavia was stopped because of the temporary embargo imposed by the IAEA. In 1991 most of the existing RA reactor instrumentation was dismantled, only the part needed for basic measurements when reactor is not operated, was maintained. Construction of some support elements is almost finished by the local staff. The Institute has undertaken this activity in order to speed up the ending of the project. If all the planned instrumentation would not arrive until the end of March 1992, it would not be possible to start the RA reactor testing operation in the first part of 1993, as previously planned. In 1991, 53 staff members took part in the activities during 1991, which is considered sufficient for maintenance and repair conditions. Research reactor RA Annual report for year 1991 is divided into two main parts to cover: (1) operation and maintenance and (2) activities related to radiation protection. [Serbo-Croat] U 1991. godini nastavljeni su poslovi na revitalizaciji reaktora RA, zapocetoj 1986. godine. Okoncan je niz zahvata na opremi postrojenja kojima ce se u narednom periodu omoguciti kontinualan i pouzdan rad ovog reaktora. Poslednji, i ujedno najveci

  5. Translocator protein as an imaging marker of macrophage and stromal activation in RA pannus.

    Science.gov (United States)

    Narayan, Nehal; Owen, David; Mandhair, Harpreet; Smyth, Erica; Carlucci, Francesco; Saleem, Azeem; Gunn, Roger; Rabiner, Eugenii Ilan A; Wells, Lisa; Dakin, Stephanie; Sabokbar, Afsie; Taylor, Peter

    2018-01-04

    Positron Emission Tomography (PET) radioligands targeted to Translocator protein (TSPO), offer a highly sensitive and specific means of imaging joint inflammation in rheumatoid arthritis (RA). Through high expression of TSPO on activated macrophages, TSPO PET has been widely reported in several studies of RA as a means of imaging synovial macrophages in vivo. However, this premise does not take into account the ubiquitous expression of TSPO. This study aimed to investigate TSPO expression in major cellular constituents of RA pannus; monocytes, macrophages, fibroblast-like synoviocytes (FLS) and CD4+ T lymphocytes, to more accurately interpret TSPO PET signal from RA synovium. Methods: 3 RA patients and 3 healthy volunteers underwent PET both knees using the TSPO radioligand 11 C-PBR28. Through synovial tissue 3H-PBR28 autoradiography and immunostaining of 6 RA patients and 6 healthy volunteers, cellular expression of TSPO in synovial tissue was evaluated. TSPO mRNA expression and 3H-PBR28 radioligand binding was assessed using in vitro monocytes, macrophages, FLS and CD4+ T-lymphocytes. Results: 11 C-PBR28 PET signal was significantly higher in RA compared to healthy joints (average SUV 0.82± 0.12 compared to 0.03± 0.004 respectively, p<0.01). Further, 3H-PBR28 specific binding in synovial tissue was approximately 10-fold higher in RA compared to healthy controls. Immunofluorescence revealed TSPO expression on macrophages, FLS and CD4+ T cells. In vitro study demonstrated highest TSPO mRNA expression and 3H-PBR28 specific binding, in activated FLS, non-activated and activated 'M2' reparative macrophages, with least TSPO expression in activated and non-activated CD4+ T lymphocytes. Conclusion: This study is the first evaluation of cellular TSPO expression in synovium, finding highest TSPO expression and PBR28 binding on activated synovial FLS and M2 phenotype macrophages. TSPO targeted PET may therefore have unique sensitivity to detect FLS and macrophage

  6. Ra-226 concentrations in the Lower Weser region in the vicinity of a pollution source

    International Nuclear Information System (INIS)

    Lauer, R.

    1981-01-01

    Near Nordenham at the lower Weser Ra-containing waste water is discharged from a fertilizer factory. The measurements are restricted to Ra-analysis and the Ra in fish, sediment, and river water samples (Ra-226). (DG) [de

  7. CCR6(+) Th cell populations distinguish ACPA positive from ACPA negative rheumatoid arthritis.

    Science.gov (United States)

    Paulissen, Sandra M J; van Hamburg, Jan Piet; Davelaar, Nadine; Vroman, Heleen; Hazes, Johanna M W; de Jong, Pascal H P; Lubberts, Erik

    2015-11-30

    Patients with rheumatoid arthritis (RA) can be separated into two major subpopulations based on the absence or presence of serum anti-citrullinated protein antibodies (ACPAs). The more severe disease course in ACPA(+) RA and differences in treatment outcome between these subpopulations suggest that ACPA(+) and ACPA(-) RA are different disease subsets. The identification of T-helper (Th) cells specifically recognizing citrullinated peptides, combined with the strong association between HLA-DRB1 and ACPA positivity, point toward a pathogenic role of Th cells in ACPA(+) RA. In this context we recently identified a potential pathogenic role for CCR6(+) Th cells in RA. Therefore, we examined whether Th cell population distributions differ by ACPA status. We performed a nested matched case-control study including 27 ACPA(+) and 27 ACPA(-) treatment-naive early RA patients matched for disease activity score in 44 joints, presence of rheumatoid factor, sex, age, duration of complaints and presence of erosions. CD4(+)CD45RO(+) (memory) Th cell distribution profiles from these patients were generated based on differential chemokine receptor expression and related with disease duration. ACPA status was not related to differences in total CD4(+) T cell or memory Th cell proportions. However, ACPA(+) patients had significantly higher proportions of Th cells expressing the chemokine receptors CCR6 and CXCR3. Similar proportions of CCR4(+) and CCR10(+) Th cells were found. Within the CCR6(+) cell population, four Th subpopulations were distinguished based on differential chemokine receptor expression: Th17 (CCR4(+)CCR10(-)), Th17.1 (CXCR3(+)), Th22 (CCR4(+)CCR10(+)) and CCR4/CXCR3 double-positive (DP) cells. In particular, higher proportions of Th22 (p = 0.02), Th17.1 (p = 0.03) and CCR4/CXCR3 DP (p = 0.01) cells were present in ACPA(+) patients. In contrast, ACPA status was not associated with differences in Th1 (CCR6(-)CXCR3(+); p = 0.90), Th2 (CCR6(-)CCR4(+); p = 0.27) and T

  8. Patient Populations, Clinical Associations, and System Efficiency in Healthcare Delivery System

    Science.gov (United States)

    Liu, Yazhuo

    The efforts to improve health care delivery usually involve studies and analysis of patient populations and healthcare systems. In this dissertation, I present the research conducted in the following areas: identifying patient groups, improving treatments for specific conditions by using statistical as well as data mining techniques, and developing new operation research models to increase system efficiency from the health institutes' perspective. The results provide better understanding of high risk patient groups, more accuracy in detecting disease' correlations and practical scheduling tools that consider uncertain operation durations and real-life constraints.

  9. Pharmacokinetics of Antibiotics in Sub-Saharan African Patient Populations: A Systematic Review.

    Science.gov (United States)

    Bos, Jeannet C; van Hest, Reinier M; Prins, Jan M

    2017-08-01

    In sub-Saharan Africa (SSA), severe febrile illness accounts for a large majority of medical admissions. SSA patients may also suffer from cachexia and organ dysfunction resulting from tuberculosis, hepatitis B, and hypertension. It is hard to tell how these conditions influence the pharmacokinetics (PK) of antibiotics in this population. The aim of this systematic review was to summarize antibiotic PK data of SSA adult patient populations to clarify whether inappropriate drug concentrations that may also lead to antimicrobial resistance are likely to occur. An electronic search was conducted in Ovid MEDLINE, Embase, and the African Index Medicus collecting studies from 1946 to May 2016. Reviewers independently selected studies reporting outcome data on volume of distribution (V), clearance, and half-life. Relevant information was abstracted and quality assessed. Twelve studies were selected, addressing 6 antibiotic classes. There were 6 studies on fluoroquinolones and 1 on β-lactam antibiotics. Nine out of 12 originated from South Africa and 6 of those dealt with intensive care unit (ICU) populations. The quality of most studies was low. Studies on amikacin, teicoplanin, and ertapenem (n = 4) displayed a pattern of a large V with low drug concentrations. Fluoroquinolone PK changes were less prominent and more diverse whereas the probability of pharmacodynamic target attainment was low for the treatment of tuberculosis in South Africa. Interindividual variability of V was high for 10/12 studies. Antibiotic PK data of SSA adult patient populations are scarce, but disease-induced inappropriate drug concentrations do occur. Data from non-ICU, severely ill patients, and β-lactam data are particularly lacking, whereas β-lactam antibiotics are commonly used, and typically vulnerable to disease-induced PK changes. Studies investigating the PK and pharmacodynamics of β-lactam antibiotics in severely ill, adult SSA patient populations are needed to improve local

  10. Design of fuel element for RA10

    International Nuclear Information System (INIS)

    Estevez, Esteban A.; Markiewicz, Mario; Gerding, Roberto

    2012-01-01

    The RA-10 reactor is an open pool multipurpose reactor. It is intended for radioisotopes production, fuel irradiation and use of neutron beam experiments. The nominal configuration core consists of 19 fuel elements (FE) and 6 in-core irradiation positions. With regard to the FE, although both conceptual design and manufacturing technology are similar to the already developed and qualified by CNEA (MTR fuel flat plate), the conditions imposed by the new reactor on FE's are more demanding that previous supplies. Here it should be mentioned the magnitude of the hydrodynamic forces acting on the FE caused by coolant flow through the core (upward) and mainly by the high coolant velocity between fuel plates (greater than 5 times than those currently in operation). Moreover, the high power density results in higher heat flux in fuel plates and greater temperature gradient. As a result of these increased demands present during irradiation, and in order to maintain a high level of reliability, it is necessary carry out some modifications in the mechanical design of the FE (with respect to the so-called ECBE design or s tandard ) . Design verification is performed through analytical and code calculations, and hydrodynamic tests on a full-scale prototype. This article describes the design of the FE for RA 10 reactor, with special emphasis on those aspects that represent innovations in the traditional design (ECBE). It also presents the functional requirements, design criteria and design limits established according to the reactor operational states (author)

  11. High-Speed RaPToRS

    Science.gov (United States)

    Henchen, Robert; Esham, Benjamin; Becker, William; Pogozelski, Edward; Padalino, Stephen; Sangster, Thomas; Glebov, Vladimir

    2008-11-01

    The High-Speed Rapid Pneumatic Transport of Radioactive Samples (HS-RaPToRS) system, designed to quickly and safely move radioactive materials, was assembled and tested at the Mercury facility of the Naval Research Laboratory (NRL) in Washington D.C. A sample, which is placed inside a four-inch-diameter carrier, is activated before being transported through a PVC tube via airflow. The carrier travels from the reaction chamber to the end station where it pneumatically brakes prior to the gate. A magnetic latch releases the gate when the carrier arrives and comes to rest. The airflow, optical carrier-monitoring devices, and end gate are controlled manually or automatically with LabView software. The installation and testing of the RaPToRS system at NRL was successfully completed with transport times of less than 3 seconds. The speed of the carrier averaged 16 m/s. Prospective facilities for similar systems include the Laboratory for Laser Energetics and the National Ignition Facility.

  12. Population Pharmacokinetics of Meropenem in Plasma and Subcutis in Patients on Extracorporeal Membrane Oxygenation Treatment

    DEFF Research Database (Denmark)

    Hanberg, Pelle; Öbrink-Hansen, Kristina; Thorsted, Anders

    2018-01-01

    The objectives of this study were to describe meropenem pharmacokinetics (PK) in plasma and/or subcutaneous adipose tissue (SCT) in critically ill patients receiving ECMO treatment, and to develop a population PK model to simulate alternative dosing regimens and modes of administration. We...... conducted a prospective observational study. Ten patients on ECMO treatment received meropenem (1 or 2 g) intravenously over 5 min every 8 hours. Serial SCT concentrations were determined using microdialysis and compared with plasma concentrations. A population PK model of SCT and plasma data was developed...... infusion would be needed for 100%fT>MIC and 100%fT>4xMIC to be obtained. Meropenem plasma and SCT concentrations were associated with estimated creatinine-clearance (eCLCr). Simulations showed that in patients with increased eCLCr, dose increment or continuous infusion may be needed to obtain therapeutic...

  13. Alpha-particle doses to human organs and tissues from internally-deposited 226Ra and 228Ra

    International Nuclear Information System (INIS)

    Keane, A.T.; Schlenker, R.A.

    1981-01-01

    Estimation of radiation doses to the soft tissues from internally-deposited 226 Ra and 228 Ra is relevant to an investigation of soft-tissue malignancies in radium-exposed persons being conducted at the Center for Human Radiobiology. Alpha-particle doses in a 50-year period following a single injection of 226 Ra or 228 Ra are presented for 31 soft tissues and organs of the adult human. The dose estimates were derived from the ICRP alkaline earth model fitted to data on retention of 226 Ra in soft tissues and bone, combined with reported ratios of 226 Ra to Ca in soft tissue and bone at natural levels and the distribution of Ca in the tissues of Reference Man (ICRP23). The median of the 31 organ and tissue doses from the α-particles of 226 Ra itself is 0.08 rad per injected μCi. An additional average dose of 0.01 rad per μCi 226 Ra daughter products produced in soft tissue or transferred from bone to soft tissue. Soft-tissue doses from α-particles of the 228 Ra decay series are about six times those from 226 Ra α-particles for equal injected activities of 228 Ra and 226 Ra, with the assumption that 228 Ra daughter products do not transfer from the organ in which they are produced. The 50-year dose to the red marrow of bone from α-particles originating in bone is 0.55 rad per μCi 226 Ra injected and 1.0 rad per μCi 228 Ra injected. For ingestion by dial painters of luminous compound containg 226 Ra or 228 Ra with a daughter-to-parent activity ratio of 0.5, the dose to the mucosal alyer of the lower large intestine from α-particles originating in the gut contents is about 0.1 rad per μCi systemic intake of 226 Ra or 228 Ra

  14. Soft-tissue effects following /sup 224/Ra injections into humans

    Energy Technology Data Exchange (ETDEWEB)

    Spiess, H; Gerspach, A [Muenchen Univ. (Germany, F.R.). Kinderklinik; Mays, C W

    1978-07-01

    Following the Second World War, repeated intravenous injections of /sup 224/Ra were given to German children and adults for the intended treatment of tuberculosis, ankylosing spondylitis and a few other diseases. We have ascertained the health status of 204 juveniles and 612 adults for whom both dosage and injection span are known. /sup 224/Ra is known as a skeletal-seeker, and has induced malignant bone sarcomas, benign exostoses, tooth breakage, and growth retardation. But because of its short 3.62-day half-life, /sup 224/Ra also decays to an appreciable extent in soft tissues, as do the injected atoms of its decay products. Evidence is presented suggesting that some, but certainly not all, of the observed cases of soft-tissue neoplasms, kidney diseases, liver cirrhosis, and cataracts may be related to the /sup 224/Ra therapy. Of particular interest are the 8 cases of cataracts reported at 14-46 years of age (33 yr average) among the 204 patients injected with /sup 224/Ra as juveniles. Due to the rarity of naturally-occurring cataracts at young ages, perhaps all of these 8 cases can be regarded as induced.

  15. Application of a prediction model for the progression of rheumatoid arthritis in patients with undifferentiated arthritis.

    Science.gov (United States)

    Arana-Guajardo, Ana; Pérez-Barbosa, Lorena; Vega-Morales, David; Riega-Torres, Janett; Esquivel-Valerio, Jorge; Garza-Elizondo, Mario

    2014-01-01

    Different prediction rules have been applied to patients with undifferentiated arthritis (UA) to identify those that progress to rheumatoid arthritis (RA). The Leiden Prediction Rule (LPR) has proven useful in different UA cohorts. To apply the LPR to a cohort of patients with UA of northeastern Mexico. We included 47 patients with UA, LPR was applied at baseline. They were evaluated and then classified after one year of follow-up into two groups: those who progressed to RA (according to ACR 1987) and those who did not. 43% of the AI patients developed RA. In the RA group, 56% of patients obtained a score ≤ 6 and only 15% ≥ 8. 70% who did not progress to RA had a score between 6 and ≤ 8. There was no difference in median score of LPR between groups, p=0.940. Most patients who progressed to RA scored less than 6 points in the LPR. Unlike what was observed in other cohorts, the model in our population did not allow us to predict the progression of the disease. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  16. The patient perspective: utilizing focus groups to inform care coordination for high-risk medicaid populations.

    Science.gov (United States)

    Sheff, Alex; Park, Elyse R; Neagle, Mary; Oreskovic, Nicolas M

    2017-07-25

    Care coordination programs for high-risk, high-cost patients are a critical component of population health management. These programs aim to improve outcomes and reduce costs and have proliferated over the last decade. Some programs, originally designed for Medicare patients, are now transitioning to also serve Medicaid populations. However, there are still gaps in the understanding of what barriers to care Medicaid patients experience, and what supports will be most effective for providing them care coordination. We conducted two focus groups (n = 13) and thematic analyses to assess the outcomes drivers and programmatic preferences of Medicaid patients enrolled in a high-risk care coordination program at a major academic medical center in Boston, MA. Two focus groups identified areas where care coordination efforts were having a positive impact, as well as areas of unmet needs among the Medicaid population. Six themes emerged from the focus groups that clustered in three groupings: In the first group (1) enrollment in an existing medical care coordination programs, and (2) provider communication largely presented as positive accounts of assistance, and good relationships with providers, though participants also pointed to areas where these efforts fell short. In the second group (3) trauma histories, (4) mental health challenges, and (5) executive function difficulties all presented challenges faced by high-risk Medicaid patients that would likely require redress through additional programmatic supports. Finally, in the third group, (6) peer-to-peer support tendencies among patients suggested an untapped resource for care coordination programs. Programs aimed at high-risk Medicaid patients will want to consider programmatic adjustments to attend to patient needs in five areas: (1) provider connection/care coordination, (2) trauma, (3) mental health, (4) executive function/paperwork and coaching support, and (5) peer-to-peer support.

  17. Measurement of 226Ra, 228Ra, 137CS and 40K in edible parts of two types of leafy vegetables cultivated in Tehran province-Iran and resultant annual ingestion radiation dose

    International Nuclear Information System (INIS)

    Changizi, V.; Jafarpoor, Z.; Naseri, M.

    2010-01-01

    The sources of radioactivity in the environment have natural; terrestrial and extraterrestrial. and anthropogenic origins. Plants may get radioactive nuclides in two ways: (i) by the deposition of radioactive fallout, (ii) by absorption from the soil. Materials and Methods: The Concentrations of the natural radionuclides ( 226 Ra, 228 Ra, 40 K) and the artificial radionuclide ( 137 CS) in leek and parsley in Tehran province-Iran were determined using high-purity Ge detectors. Also the effective dose due to the ingestion of such vegetables by the population of Tehran province was studied. Results: The average value of radionuclide concentrations in parsley samples were measured 177.69 ± 12.47 mBq kg -1 fresh for 226 Ra; 349.62 ± 28.42 mBq kg -1 fresh for 228 Ra; 187364.6 mBq kg 1 fresh for 40 K. The average value of radionuclide concentrations in leek samples were measured 94.31 ± 6.46 mBq kg -1 fresh for 226 Ra; 207.47 ± 19.46 mBq kg -1 fresh for 228 Ra; 174555 ± 1704.21 mBq kg -1 fresh for 40 K. The concentrations of 137 Cs in most of Parsley and Leek samples were below the minimum detectable activity. Conclusion: The Average 226 Ra and 228 Ra activities in 29 leek and parsley samples were about 2.63 and 6.78 times the reference values, respectively. The annual effective dose resulting from the studied radionuclides for the adult population in Tehran province were found to be safe in comparison with normal background areas.

  18. IoT devices and applications based on LoRa/LoRaWAN

    CSIR Research Space (South Africa)

    Khutsoane, Oratile C

    2017-10-01

    Full Text Available such as smart water management systems. However, they require high energy-efficient sensor nodes that are able to communicate across long distance. This motivates the development of many Low-Power Wide Area Networks (LPWAN) technologies, such as LoRa, to fulfill...

  19. Research nuclear reactor RA - Annual report 1992; Istrazivacki nuklearni reaktor RA - Izvestaj za 1992. godinu

    Energy Technology Data Exchange (ETDEWEB)

    Sotic, O [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1992-12-01

    Research reactor RA Annual report for year 1992 is divided into two main parts to cover: (1) operation and maintenance and (2) activities related to radiation protection. First part includes 8 annexes describing reactor operation, activities of services for maintenance of reactor components and instrumentation, financial report and staffing. Second annex B is a paper by Z. Vukadin 'Recurrence formulas for evaluating expansion series of depletion functions' published in 'Kerntechnik' 56, (1991) No.6 (INIS record no. 23024136. Second part of the report is devoted to radiation protection issues and contains 4 annexes with data about radiation control of the working environment and reactor environment, description of decontamination activities, collection of radioactive wastes, and meteorology data. [Serbo-Croat] Godisnji izvestaj o radu nuklearnog reaktora RA za 1992. godinu sastoji se od dva dela: prvi deo obuhvata pogon i odzavanje reaktora RA, a drugi poslove zastite od zracenja na reaktoru RA. Prvi deo sadrzi 8 priloga, koji opisuju rad reaktora i poslove sluzbi za odrzavanje opreme i komponenti, finansijski izvestaj, kadrovsku strukturu osoblja reaktora. Drugi prilog (B) je rad Z. Vukadina 'Recurrence formulas for evaluating expansion series of depletion functions' objavljen u casopisu Kerntechnik, 1991. Drugi deo izvestaja o poslovima zastite od zracenja sadrzi 4 priloga sa podacima radijacione kontrole radne sredine i okoline reaktora, opis poslova dekontaminacije i sakupljanja radioaktivnih materija, kao i meteoroloske podatke.

  20. RA-0 reactor. New neutronic calculations; Reactor RA-0. Nuevos calculos neutronicos

    Energy Technology Data Exchange (ETDEWEB)

    Rumis, D; Leszczynski, F

    1991-12-31

    An updating of the neutronic calculations performed at the RA-0 reactor, located at the Natural, Physical and Exact Sciences Faculty of Cordoba National University, are herein described. The techniques used for the calculation of a reactor like the RA-0 allows prediction in detail of the flux behaviour in the core`s interior and in the reflector, which will be helpful for experiments design. In particular, the use of WIMSD4 code to make calculations on the reactor implies a novelty in the possible applications of this code to solve the problems that arise in practice. (Author). [Espanol] En este trabajo se actualizan los calculos neutronicos realizados para el reactor RA-0, instalado en la Facultad de Ciencias Exactas, Fisicas y Naturales de la Universidad Nacional de Cordoba. Se describen los calculos realizados hasta la fecha y los resultados obtenidos. Las tecnicas incorporadas al calculo de un reactor como el RA-0 permiten predecir en detalle el comportamiento del flujo en el interior del nucleo y en el reflector, lo que sera una importante ayuda en el diseno de experimentos. En particular, el empleo del codigo WIMSD4 para calculos del reactor completo constituye una novedad en las posibles aplicaciones de ese codigo para resolver problemas que se presentan en la practica. (Autor).

  1. Marital status and survival in patients with rectal cancer: A population-based STROBE cohort study.

    Science.gov (United States)

    Li, Zhuyue; Wang, Kang; Zhang, Xuemei; Wen, Jin

    2018-05-01

    To examine the impact of marital status on overall survival (OS) and rectal cancer-specific survival (RCSS) for aged patients.We used the Surveillance, Epidemiology and End Results database to identify aged patients (>65 years) with early stage rectal cancer (RC) (T1-T4, N0, M0) in the United States from 2004 to 2010. Propensity score matching was conducted to avoid potential confounding factors with ratio at 1:1. We used Kaplan-Meier to compare OS and RCSS between the married patients and the unmarried, respectively. We used cox proportion hazard regressions to obtain hazard rates for OS, and proportional subdistribution hazard model was performed to calculate hazard rates for RCSS.Totally, 5196 patients were included. The married (2598 [50%]) aged patients had better crude 5-year overall survival rate (64.2% vs 57.3%, P vs 75.9%, P unmarried (2598 (50%)), respectively. In multivariate analyses, married patients had significantly lower overall death than unmarried patients (HR = 0.77, 95% CI = 0.71-0.83, P married patients had no cancer-specific survival benefit versus the unmarried aged patients (HR = 0.92, 95% CI = 0.81-1.04, P = .17).Among old population, married patients with early stage RC had better OS than the unmarried, while current evidence showed that marital status might have no protective effect on cancer-specific survival.

  2. Trauma patients who present in a delayed fashion: a unique and challenging population.

    Science.gov (United States)

    Kao, Mary J; Nunez, Hector; Monaghan, Sean F; Heffernan, Daithi S; Adams, Charles A; Lueckel, Stephanie N; Stephen, Andrew H

    2017-02-01

    A proportion of trauma patients present for evaluation in a delayed fashion after injury, likely due to a variety of medical and nonmedical reasons. There has been little investigation into the characteristics and outcomes of trauma patients who present delayed. We hypothesize that trauma patients who present in a delayed fashion are a unique population at risk of increased trauma-related complications. This was a retrospective review from 2010-2015 at a Level I trauma center. Patients were termed delayed if they presented >24 hours after injury. Patients admitted within 24 hours of their injury were the comparison group. Charts were reviewed for demographics, mechanism, comorbidities, complications and outcomes. A subgroup analysis was done on patients who suffered falls. During the 5-y period, 11,705 patients were admitted. A total of 588 patients (5%) presented >24 h after their injury. Patients in the delayed group were older (65 versus 55 y, P fashion have unique characteristics and are more likely to suffer negative outcomes including substance withdrawal. Future goals will include exploring strategies for early intervention, such as automatic withdrawal monitoring and social work referral for all patients who present in a delayed fashion. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. The genetics of rheumatoid arthritis: risk and protection in different stages of the evolution of RA

    Science.gov (United States)

    Yarwood, Annie; Huizinga, Tom W. J.

    2016-01-01

    There is now a general consensus that RA has a spectrum of disease stages that can begin many years before the onset of clinical symptoms. It is widely thought that understanding the complex interplay between genetics and environment, and their role in pathogenesis, is essential in gaining further insight into the mechanisms that drive disease development and progression. More than 100 genetic susceptibility loci have now been identified for RA through studies that have focused on patients with established RA compared with healthy controls. Studying the early preclinical phases of disease will provide valuable insights into the biological events that precede disease and could potentially identify biomarkers to predict disease onset and future therapeutic targets. In this review we will cover recent advances in the knowledge of genetic and environmental risk factors and speculate on how these factors may influence the transition from one stage of disease to another. PMID:25239882

  4. Increased risk of dialysis and end-stage renal disease among HIV patients in Denmark compared with the background population

    DEFF Research Database (Denmark)

    Rasch, Magnus G; Helleberg, Marie; Feldt-Rasmussen, Bo

    2014-01-01

    BACKGROUND: HIV patients have increased risk of impaired renal function. We aimed to estimate the incidence of any renal replacement therapy (aRRT) and start of chronic renal replacement therapy (cRRT) among HIV patients compared with population controls. METHODS: In a nationwide, population......-based cohort study we analysed incidence rates (IR), incidence rate ratios (IRR) and risk factors for aRRT and cRRT among HIV patients compared with an age- and gender-matched population control cohort using Poisson regression. RESULTS: We identified 5300 HIV patients and 53 000 population controls. The IRs...

  5. Identifying elements of patient-centered care in underserved populations: a qualitative study of patient perspectives.

    Directory of Open Access Journals (Sweden)

    Sheela Raja

    Full Text Available Patient-centered care is an important goal in the delivery of healthcare. However, many patients do not engage in preventive medical care. In this pilot study, we conducted twenty in depth, semi-structured qualitative interviews at the University of Illinois at Chicago Health Sciences campus in a four month time frame. Many patients were underserved and underinsured, and we wanted to understand their experiences in the healthcare system. Using content analysis, several themes emerged from the interview data. Participants discussed the need for empathy and rapport with their providers. They identified provider behaviors that fostered a positive clinical relationship, including step-by step explanations of procedures, attention to body language and clinic atmosphere, and appropriate time management. Participants identified cost as the most common barrier to engaging in preventive care and discussed children and social support as motivating factors. A long-term relationship with a provider was an important motivator for preventive care, suggesting that the therapeutic alliance was essential to many patients. Conversely, many participants discussed a sense of dehumanization in the healthcare system, reporting that their life circumstances were overlooked, or that they were judged based on insurance status or ethnicity. We discuss implications for provider training and healthcare delivery, including the importance of patient-centered medical homes.

  6. Research nuclear reactor RA - Annual Report 1996; Istrazivacki nuklearni reaktor RA - Izvestaj za 1996. godinu

    Energy Technology Data Exchange (ETDEWEB)

    Sotic, O [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1996-12-01

    Activities related to revitalisation of the RA reactor started in 1986, were continued in 1996. All the planned actions related to renewal of the reactor components were finished. The last, and at the same time most important action, related to exchange of complete reactor instrumentation is underway, delayed. The delivery of components from USSR is late. Production of this instruments is financed by the IAEA according to the contract signed in December 1988 with Russian Atomenergoexport. According to this contract, it has been planned that the RA reactor instrumentation should be delivered to the Vinca Institute by the end of 1990. Only 80% of the instrumentation was delivered until September 1991. Since then any delivery of components to Yugoslavia was stopped because of the temporary embargo imposed by the IAEA. The existing RA reactor instrumentation was dismantled. Control and maintenance of the reactor components was done regularly and efficiently. Fuel inspection by the IAEA safeguards inspectors was done on a monthly basis. There have been on the average 43 employees at the RA reactor which is considered sufficient for maintenance and repair conditions. The problem of financing the reactor activities and maintenance remains unsolved. Research reactor RA Annual report for year 1996 is divided into two main parts to cover: (1) operation and maintenance and (2) activities related to radiation protection. [Serbo-Croat] U toku 1996. godine nastavljeni su poslovi na revitalizaciji reaktora RA, zapocetoj 1986. godine. Okoncan je niz zahvata na opremi postrojenja kojima ce se u narednom periodu omoguciti kontinualan i pouzdan rad ovog reaktora. Poslednji, i ujedno najveci zahvat, koji se odnosi na zamenu celokupne instrumentacije kasni zbog zastoja u isporuci opreme koja se izradjuje u Sovjetskom savezu. Izradu ove opreme finansira Medjunarodna agencija za atomsku energiju kroz ugovor sklopljen decembra 1988. godine sa moskovskom firmom Atomenergoexport. Prema tom

  7. Malignancy in scleroderma patients from south west England: a population-based cohort study.

    LENUS (Irish Health Repository)

    Siau, Keith

    2010-01-08

    The pathophysiological relationship between scleroderma and malignancy remains poorly understood. Although some previous studies have demonstrated an increased malignancy risk in patients with scleroderma, others have been inconclusive. We aimed to determine if patients with scleroderma had an increased risk of malignancy compared to an age- and sex-matched local South West England population, and if there were any important differences between scleroderma patients with and without malignancy. Methods of this study are as follows. Notes were obtained on all local scleroderma patients (n = 68) locally, and those diagnosed with malignancy verified by contacting each patient\\'s general practitioner. Expected malignancy figures were obtained from age- and sex-stratified regional prevalence data provided by the South West Cancer Intelligence Service registry. Among the patients, 22.1% with scleroderma were identified with concurrent malignancy. Affected sites were of the breast (n = 5), haematological system (n = 5), skin (n = 4), and unknown primary (n = 1). Overall, malignancy risk was found to be increased in scleroderma (RR = 3.15, 95% CI 1.77-5.20, p = 0.01). In particular, this risk was the highest for haematological malignancies (RR = 18.5, 95% CI 6-43, p = 0.03), especially for non-Hodgkin\\'s lymphoma (RR = 25.8, 95% CI 5-75, p = 0.10). The majority of patients (86.7%) developed malignancy after the onset of scleroderma (mean = 6.9 years). Age of >70 and patients with limited scleroderma were significant risk factors for a patient with scleroderma to have a concurrent malignancy; however, no increased risk was found in patients with any particular pattern of organ involvement, cytotoxic usage or serology. To conclude, in this small patient cohort, we have found that scleroderma is associated with an increased risk of malignancy. This risk is statistically significant in patients with limited scleroderma. Patients who are elderly and those with limited disease

  8. Profile of circulating levels of IL-1Ra, CXCL10/IP-10, CCL4/MIP-1β and CCL2/MCP-1 in dengue fever and parvovirosis

    Directory of Open Access Journals (Sweden)

    Luzia Maria de-Oliveira-Pinto

    2012-02-01

    Full Text Available Dengue virus (DENV and parvovirus B19 (B19V infections are acute exanthematic febrile illnesses that are not easily differentiated on clinical grounds and affect the paediatric population. Patients with these acute exanthematic diseases were studied. Fever was more frequent in DENV than in B19V-infected patients. Arthritis/arthralgias with DENV infection were shown to be significantly more frequent in adults than in children. The circulating levels of interleukin (IL-1 receptor antagonist (Ra, CXCL10/inducible protein-10 (IP-10, CCL4/macrophage inflammatory protein-1 beta and CCL2/monocyte chemotactic protein-1 (MCP-1 were determined by multiplex immunoassay in serum samples obtained from B19V (37 and DENV-infected (36 patients and from healthy individuals (7. Forward stepwise logistic regression analysis revealed that circulating CXCL10/IP-10 tends to be associated with DENV infection and that IL-1Ra was significantly associated with DENV infection. Similar analysis showed that circulating CCL2/MCP-1 tends to be associated with B19V infection. In dengue fever, increased circulating IL-1Ra may exert antipyretic actions in an effort to counteract the already increased concentrations of IL-1β, while CXCL10/IP-10 was confirmed as a strong pro-inflammatory marker. Recruitment of monocytes/macrophages and upregulation of the humoral immune response by CCL2/MCP-1 by B19V may be involved in the persistence of the infection. Children with B19V or DENV infections had levels of these cytokines similar to those of adult patients.

  9. Population pharmacokinetics of proguanil in patients with acute P. falciparum malaria after combined therapy with atovaquone.

    Science.gov (United States)

    Hussein, Z; Eaves, C J; Hutchinson, D B; Canfield, C J

    1996-11-01

    1. The pharmacokinetics of proguanil were evaluated in patients with acute P. falciparum malaria receiving concomitantly proguanil hydrochloride and atovaquone. The population consisted of 203 Blacks, 112 Orientals and 55 Malays; 274 males and 96 females. Of the 370 patients, 114 and 256 patients were classified as 'poor' and 'extensive' metabolizers of proguanil, respectively. Body weight and age ranged between 11-110 kg and 3-65 years, respectively. 2. A one compartment model with first-order absorption and elimination was fitted to proguanil plasma concentration-time profiles, using non-linear mixed effect modelling (NONMEM). 3. Oral clearance (CLo) showed a 0.785 power relationship with body weight and was 13% higher in Orientals than Blacks and Malays and 17% lower in 'poor' than 'extensive' metabolizers. According to the mean weight of each population, the final population estimates of CLo in Blacks, Orientals and Malays who are 'extensive' metabolizers were 54.0, 61.5 and 64.3 l h-1, respectively. Age, gender and dose had no significant effects on CLo. 4. Apparent volume of distribution (V/F) showed a 0.88 power relationship with body weight. The final population estimates were 562 and 1629 l in children ( 15 years, respectively, who had a mean body weight of 22.6 and 54.8 kg, respectively. The effect of other covariates on V/F was not examined. 5. The final magnitudes of interpatient variability in CLo and V/F were relatively low at 22.5 and 17.0%, respectively. 6. Population pharmacokinetic parameter estimates in Black, Oriental and Malay patients with acute P. falciparum malaria are in good agreement with results of pharmacokinetic studies in healthy Caucasian volunteers. In view of the 30-50% residual variability in proguanil plasma concentrations, the slight effects of Orientals and 'poor' metabolizers on CLo are unlikely to be clinically significant. Hence, dose recommendation will be solely based on body weight.

  10. Association of MiRNA-146a, MiRNA-499, IRAK1 and PADI4 Polymorphisms with Rheumatoid Arthritis in Egyptian Population

    Directory of Open Access Journals (Sweden)

    Olfat Gamil Shaker

    2018-05-01

    Full Text Available Background/Aims: Rheumatoid arthritis (RA is a systemic autoimmune disease affecting up to 1% of the population worldwide. The aim of the present study was to investigate whether miRNA-146a rs2910164, miRNA-499 rs3746444, IRAK1 rs3027898 and PADI4 rs1748033 polymorphisms are associated with susceptibility to RA in Egyptians and whether they influence disease severity and activity. Methods: The study was performed on 104 unrelated RA patients and 112 healthy subjects. RA patients were further subdivided into active and inactive RA groups. Polymorphisms were genotyped by using real-time polymerase chain reaction with TaqMan allelic discrimination assay. Results: Significant differences in the frequency of miRNA-146a rs2910164, miRNA-499 rs3746444, IRAK1 rs3027898 and PADI4 rs1748033 alleles and genotypes were observed between RA patients and controls. Only CA and AA genotypes of IRAK1 rs3027898 shows a significant difference between active and inactive subgroups. MiRNA-146a rs2910164 and IRAK1 rs3027898 polymorphisms were a risk factor for predisposition to RA in codominant and dominant tested inheritance models, while, the miRNA-499 rs3746444 and PADI4 rs1748033 polymorphisms were a risk factor in codominant and recessive one. CG and GG genotypes of miRNA-146a rs2910164 were associated with positive erosions. CA genotype of IRAK1 rs3027898 was associated with low disease activity and negative erosions, while, the AA genotype was associated with high disease activity. CC genotype of PADI4 rs1748033 was associated with negative rheumatoid factor. Conclusion: The 4 studied SNPs were likely to play an important role in the susceptibility to RA and can influence disease severity and activity in Egyptian population.

  11. Comparison of various risk indicators among patients with chronic and aggressive periodontitis in davangere population

    Science.gov (United States)

    Vandana, Kharidhi Laxman; Nadkarni, Rahul Dilip; Guddada, Kaveri

    2015-01-01

    Background: The aim of the present study was to compare various risk indicators of chronic periodontitis (CP) and aggressive periodontitis (AP) among patients of Davangere population. Materials and Methods: Totally, 89 CP and 90 AP patients were selected from outpatient Department of Periodontics, College of Dental Sciences, Davangere. Various clinical parameters proven to be risk indicators were determined for each patient such as age, gender, occupation, oral hygiene habits, personal habits, income, level of education, place of residence, frequency of dental visits, various oral hygiene indices, gingival status, wasting diseases, malocclusion, laboratory investigations, and the results were subjected to statistical analysis. Results: This study demonstrated that AP is manifested early in life in susceptible individuals. Proven risk indicators for AP and CP in the present study population included young age, place of residence, income and education levels, frequency of dental visits. Patients with AP had better oral hygiene habits and oral hygiene index results than patients with CP. Paan chewing and smoking could be considered as risk factors, both in CP and AP cases. The similar association of plaque scores but higher bleeding tendency in AP patients supported the fact of higher susceptibility of AP patients to periodontal breakdown. Malocclusion being present in the majority of cases could also be put forth as a risk factor for AP and CP. Conclusion: This study identifies the different risk indicators for CP and AP and demonstrates the need for constructing nationwide oral health promotion programs to improve the level of oral health awareness and standards in Indian population. PMID:26392693

  12. Population pharmacokinetics of tamsulosin hydrochloride in paediatric patients with neuropathic and non-neuropathic bladder

    Science.gov (United States)

    Tsuda, Yasuhiro; Tatami, Shinji; Yamamura, Norio; Tadayasu, Yusuke; Sarashina, Akiko; Liesenfeld, Karl-Heinz; Staab, Alexander; Schäfer, Hans-Günter; Ieiri, Ichiro; Higuchi, Shun

    2010-01-01

    AIMS The main objective of this study was to characterize the population pharmacokinetics of tamsulosin hydrochloride (HCl) in paediatric patients with neuropathic and non-neuropathic bladder. A secondary objective was to compare the pharmacokinetics in paediatric patients and adults. METHODS Tamsulosin HCl plasma concentrations in 1082 plasma samples from 189 paediatric patients (age range 2–16 years) were analyzed with NONMEM, applying a one compartment model with first-order absorption. Based on the principles of allometry, body weight was incorporated in the base model, along with fixed allometric exponents. Covariate analysis was performed by means of a stepwise forward inclusion and backward elimination procedure. Simulations based on the final model were used to compare the pharmacokinetics with those in adults. RESULTS Beside the priori-implemented body weight, only α1-acid glycoprotein had an effect on both apparent clearance and apparent volume of distribution. No other investigated covariates, including gender, age, race, patient population and concomitant therapy with anti-cholinergics, significantly affected the pharmacokinetics of tamsulosin HCl (P tamsulosin HCl in paediatric patients was established and it described the data well. There was no major difference in the pharmacokinetics of tamsulosin HCl between paediatric patients (age range 2–16 years) and adults when the effect of body weight was taken into consideration. PMID:20642551

  13. Risk of Periodontal Disease in Patients With Asthma: A Nationwide Population-Based Retrospective Cohort Study.

    Science.gov (United States)

    Shen, Te-Chun; Chang, Pei-Ying; Lin, Cheng-Li; Wei, Chang-Ching; Tu, Chih-Yen; Hsia, Te-Chun; Shih, Chuen-Ming; Hsu, Wu-Huei; Sung, Fung-Chang; Kao, Chia-Hung

    2017-08-01

    Studies have reported an association between asthma and oral diseases, including periodontal diseases. The aim of this retrospective study is to investigate risk of periodontal diseases for patients with asthma. Using the claims data of National Health Insurance of Taiwan and patients without a history of periodontal diseases, 19,206 asthmatic patients, who were newly diagnosed from 2000 through 2010, were identified. For each case, four comparison individuals without history of asthma and periodontal disease were randomly selected from the general population and frequency matched (categorical matched) by sex, age, and year of diagnosis (n = 76,824). Both cohorts were followed to the end of 2011 to monitor occurrence of periodontal diseases. Adjusted hazard ratios (aHRs) of periodontal disease were estimated using Cox proportional hazards regression analysis. Overall incidence of periodontal diseases was 1.18-fold greater in the asthma cohort than in the comparison cohort (P periodontal diseases compared with those with a mean of less than one visit. Patients with at least three admissions annually also had a similar aHR (51.8) for periodontal disease. In addition, asthmatic patients on inhaled corticosteroid (ICS) therapy had greater aHRs than non-users (aHR = 1.12; 95% CI = 1.03 to 1.23). In the studied population, asthmatic patients are at an elevated risk of developing periodontal diseases. The risk is much greater for those with emergency medical demands or hospital admissions and those on ICS treatment.

  14. Safety of iobitridol in the general population and at-risk patients

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, Thomas J. [University Hospital Frankfurt, Johann Wolfgang Goethe-University, Department of Radiology, Frankfurt (Germany); J. W. Goethe University of Frankfurt, Institute of Diagnostic and Interventional Radiology, Frankfurt (Germany); Honold, Elmar [Guerbet GmbH, Sulzbach (Germany); Wolf, Michael [Michael Wolf Information Systems, Puettlingen (Germany); Mohajeri, H.; Hammerstingl, R. [University Hospital Frankfurt, Johann Wolfgang Goethe-University, Department of Radiology, Frankfurt (Germany)

    2006-06-15

    The purpose of this study was to review the rate of adverse events after contrast medium administration in the general population and at-risk patients (renal impairment, heart failure (NYHA III or IV), hypotension or hypertension, coronary artery disease, previous reaction to contrast media, asthma and/or allergies, dehydration, diabetes mellitus, poor general condition) under daily practice conditions in a post-marketing surveillance study. Two hundred and ten radiologists conducted various X-ray examinations in 52,057 patients. To document the safety of iobitridol in routine use, all patients undergoing X-ray examinations were included. Exclusion criteria were contraindications listed in the locally approved summary of product characteristics. The adverse event rate was 0.96% (at-risk patients 1.39%); the rate of serious adverse events 0.044% in all patients (at-risk patients 0.057%). Adverse events occurred more often in women than in men (P<0.001). In patients who had previously reacted to a contrast medium, adverse events were reported in 3.43% with mild to moderate symptoms. In 47.76% of these patients, a premedication was administered. There was no difference in the frequency of adverse events and serious adverse events whether premedicated or not (P=0.311 and P=0.295, respectively). Iobitridol was well-tolerated in 99.04% of cases (at-risk patients 98.61%). (orig.)

  15. Risk of Clostridium difficile Infection in Patients With Celiac Disease: A Population-Based Study.

    Science.gov (United States)

    Lebwohl, Benjamin; Nobel, Yael R; Green, Peter H R; Blaser, Martin J; Ludvigsson, Jonas F

    2017-12-01

    Patients with celiac disease are at increased risk for infections such as tuberculosis, influenza, and pneumococcal pneumonia. However, little is known about the incidence of Clostridium difficile infection (CDI) in patients with celiac disease. We identified patients with celiac disease based on intestinal biopsies submitted to all pathology departments in Sweden over a 39-year period (from July 1969 through February 2008). We compared risk of CDI (based on stratified Cox proportional hazards models) among patients with celiac disease vs. without celiac disease (controls) matched by age, sex, and calendar period. We identified 28,339 patients with celiac disease and 141,588 controls; neither group had a history of CDI. The incidence of CDI was 56/100,000 person-years among patients with celiac disease and 26/100,000 person-years among controls, yielding an overall hazard ratio (HR) of 2.01 (95% confidence interval (CI), 1.64-2.47; Pceliac disease (HR, 5.20; 95% CI, 2.81-9.62; Pceliac disease and controls. In a large population-based cohort study, patients with celiac disease had significantly higher incidence of CDI than controls. This finding is consistent with prior findings of higher rates of other infections in patients with celiac disease, and suggests the possibility of altered gut immunity and/or microbial composition in patients with celiac disease.

  16. Behavior and distribution of 226Ra and 228Ra in the east coast of Peninsular Malaysia marine environment

    International Nuclear Information System (INIS)

    Nurrul Assyikeen Mohd Jaffary; Zal Uyun Wan Mahmood; Zaharudin Ahmad; Yii, Mei Wo; Kamarozaman Ishak

    2010-01-01

    The present distributions of 226 Ra, 228 Ra and activity ratios of 228 Ra/ 226 Ra covering the east coast of Peninsular Malaysia were studied. Sediment core samples were collected at 10 identified stations with the thickness of water column between 14 - 72 m depth during the cruise conducted in 2008. Activity concentrations of 226 Ra and 228 Ra in sediment cores of the studied area were in the range of 18.95 ±4.25 Bq/ kg to 46.48 ± 6.41 Bq/ kg dry wt. and 35.50 ± 7.50 Bq/ kg to 77.10 ±11.37 Bq/ kg dry wt., respectively. Meanwhile, the calculated activity ratios of 228 Ra/ 226 Ra were varied mostly 1.48 to 2.24. The finding showed that there has relationships between 226 Ra, 228 Ra and oceanographic parameters which are can be attributed for better understanding of its transport processes and behavior in the east coast of Peninsular Malaysia marine environment. (author)

  17. Association between insurance status and patient safety in the lumbar spine fusion population.

    Science.gov (United States)

    Tanenbaum, Joseph E; Alentado, Vincent J; Miller, Jacob A; Lubelski, Daniel; Benzel, Edward C; Mroz, Thomas E

    2017-03-01

    Lumbar fusion is a common and costly procedure in the United States. Reimbursement for surgical procedures is increasingly tied to care quality and patient safety as part of value-based reimbursement programs. The incidence of adverse quality events among lumbar fusion patients is unknown using the definition of care quality (patient safety indicators [PSI]) used by the Centers for Medicare and Medicaid Services (CMS). The association between insurance status and the incidence of PSI is similarly unknown in lumbar fusion patients. This study sought to determine the incidence of PSI in patients undergoing inpatient lumbar fusion and to quantify the association between primary payer status and PSI in this population. A retrospective cohort study was carried out. The sample comprised all adult patients aged 18 years and older who were included in the Nationwide Inpatient Sample (NIS) that underwent lumbar fusion from 1998 to 2011. The incidence of one or more PSI, a validated and widely used metric of inpatient health-care quality and patient safety, was the primary outcome variable. The NIS data were examined for all cases of inpatient lumbar fusion from 1998 to 2011. The incidence of adverse patient safety events (PSI) was determined using publicly available lists of the International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes. Logistic regression models were used to determine the association between primary payer status (Medicaid and self-pay relative to private insurance) and the incidence of PSI. A total of 539,172 adult lumbar fusion procedures were recorded in the NIS from 1998 to 2011. Patients were excluded from the secondary analysis if "other" or "missing" was listed for primary insurance status. The national incidence of PSI was calculated to be 2,445 per 100,000 patient years of observation, or approximately 2.5%. In a secondary analysis, after adjusting for patient demographics and hospital characteristics, Medicaid

  18. Why patients visit their doctors: assessing the most prevalent conditions in a defined American population.

    Science.gov (United States)

    St Sauver, Jennifer L; Warner, David O; Yawn, Barbara P; Jacobson, Debra J; McGree, Michaela E; Pankratz, Joshua J; Melton, L Joseph; Roger, Véronique L; Ebbert, Jon O; Rocca, Walter A

    2013-01-01

    To describe the prevalence of nonacute conditions among patients seeking health care in a defined US population, emphasizing age, sex, and ethnic differences. The Rochester Epidemiology Project (REP) medical records linkage system was used to identify all residents of Olmsted County, Minnesota, on April 1, 2009, who had consented to review of their medical records for research (142,377 patients). We then electronically extracted all International Classification of Diseases, Ninth Revision codes noted in the records of these patients by any health care institution between January 1, 2005, and December 31, 2009. We grouped International Classification of Diseases, Ninth Revision codes into clinical classification codes and then into 47 broader disease groups associated with health-related quality of life. Age- and sex-specific prevalence was estimated by dividing the number of individuals within each group by the corresponding age- and sex-specific population. Patients within a group who had multiple codes were counted only once. We included a total of 142,377 patients, 75,512 (53%) of whom were female. Skin disorders (42.7%), osteoarthritis and joint disorders (33.6%), back problems (23.9%), disorders of lipid metabolism (22.4%), and upper respiratory tract disease (22.1%, excluding asthma) were the most prevalent disease groups in this population. Ten of the 15 most prevalent disease groups were more common in women in almost all age groups, whereas disorders of lipid metabolism, hypertension, and diabetes were more common in men. Additionally, the prevalence of 7 of the 10 most common groups increased with advancing age. Prevalence also varied across ethnic groups (whites, blacks, and Asians). Our findings suggest areas for focused research that may lead to better health care delivery and improved population health. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  19. Real world heart failure epidemiology and outcome: A population-based analysis of 88,195 patients.

    Science.gov (United States)

    Farré, Núria; Vela, Emili; Clèries, Montse; Bustins, Montse; Cainzos-Achirica, Miguel; Enjuanes, Cristina; Moliner, Pedro; Ruiz, Sonia; Verdú-Rotellar, José María; Comín-Colet, Josep

    2017-01-01

    Heart failure (HF) is frequent and its prevalence is increasing. We aimed to evaluate the epidemiologic features of HF patients, the 1-year follow-up outcomes and the independent predictors of those outcomes at a population level. Population-based longitudinal study including all prevalent HF cases in Catalonia (Spain) on December 31st, 2012. Patients were divided in 3 groups: patients without a previous HF hospitalization, patients with a remote (>1 year) HF hospitalization and patients with a recent (population studied. Some comorbidity, an all-cause hospitalization or emergency department visit the previous year were associated with a worse outcome.

  20. Dendritic cell populations in patients with self-reported food hypersensitivity

    Directory of Open Access Journals (Sweden)

    Lied GA

    2011-05-01

    Full Text Available Gülen A Lied1,3,4,*, Petra Vogelsang2,*, Arnold Berstad1,4, Silke Appel2 1Institute of Medicine, 2Broegelmann Research Laboratory, The Gade Institute, University of Bergen, Norway; 3Division of Gastroenterology, Department of Medicine; 4Section of Clinical Allergology, Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway *These authors contributed equally to this workAbstract: Self-reported hypersensitivity to food is a common condition and many of these patients have indications of intestinal immune activation. Dendritic cells (DCs are recognized as the most potent antigen-presenting cells involved in both initiating immune responses and maintaining tolerance. The aims of this study were to evaluate the DC populations with their phenotype and T cell stimulatory capacity in patients with food hypersensitivity and to study its relationship with atopic disease. Blood samples from 10 patients with self-reported food hypersensitivity, divided into atopic and nonatopic subgroups, and 10 gender- and age-matched healthy controls were analyzed by flow cytometry using the Miltenyi Blood Dendritic cells kit. Monocyte-derived DCs (moDCs were evaluated concerning their phenotype and T cell stimulatory capacity. DC populations and cell surface markers were not significantly different between patients and healthy controls, but moDCs from atopic patients expressed significantly more CD38 compared to moDCs from nonatopic patients. Moreover, lipopolysaccharide stimulated moDCs from atopic patients produced significantly more interleukin-10 compared to nonatopic patients. CD38 expression was correlated to total serum immunoglobulin E levels. These findings support the notion of immune activation in some patients with self-reported food hypersensitivity. They need to be confirmed in a larger cohort.Keywords: food hypersensitivity, atopy, dendritic cells, CD38

  1. Dosimetry of {sup 223}Ra-chloride: dose to normal organs and tissues

    Energy Technology Data Exchange (ETDEWEB)

    Lassmann, Michael [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Nosske, Dietmar [Federal Office for Radiation Protection (BfS), Department of Radiation and Health, Oberschleissheim (Germany)

    2013-02-15

    {sup 223}Ra-Chloride (also called Alpharadin {sup registered}) targets bone metastases with short range alpha particles. In recent years several clinical trials have been carried out showing, in particular, the safety and efficacy of palliation of painful bone metastases in patients with castration-resistant prostate cancer using {sup 223}Ra-chloride. The purpose of this work was to provide a comprehensive dosimetric calculation of organ doses after intravenous administration of {sup 223}Ra-chloride according to the present International Commission on Radiological Protection (ICRP) model for radium. Absorbed doses were calculated for 25 organs or tissues. Bone endosteum and red bone marrow show the highest dose coefficients followed by liver, colon and intestines. After a treatment schedule of six intravenous injections with 0.05 MBq/kg of {sup 223}Ra-chloride each, corresponding to 21 MBq for a 70 kg patient, the absorbed alpha dose to the bone endosteal cells is about 16 Gy and the corresponding absorbed dose to the red bone marrow is approximately 1.5 Gy. The comprehensive list of dose coefficients presented in this work will assist in comparing and evaluating organ doses from various therapy modalities used in nuclear medicine and will provide a base for further development of patient-specific dosimetry. (orig.)

  2. Evaluation of a practical expert defined approach to patient population segmentation: a case study in Singapore

    Directory of Open Access Journals (Sweden)

    Lian Leng Low

    2017-11-01

    Full Text Available Abstract Background Segmenting the population into groups that are relatively homogeneous in healthcare characteristics or needs is crucial to facilitate integrated care and resource planning. We aimed to evaluate the feasibility of segmenting the population into discrete, non-overlapping groups using a practical expert and literature driven approach. We hypothesized that this approach is feasible utilizing the electronic health record (EHR in SingHealth. Methods In addition to well-defined segments of “Mostly healthy”, “Serious acute illness but curable” and “End of life” segments that are also present in the Ministry of Health Singapore framework, patients with chronic diseases were segmented into “Stable chronic disease”, “Complex chronic diseases without frequent hospital admissions”, and “Complex chronic diseases with frequent hospital admissions”. Using the electronic health record (EHR, we applied this framework to all adult patients who had a healthcare encounter in the Singapore Health Services Regional Health System in 2012. ICD-9, 10 and polyclinic codes were used to define chronic diseases with a comprehensive look-back period of 5 years. Outcomes (hospital admissions, emergency attendances, specialist outpatient clinic attendances and mortality were analyzed for years 2012 to 2015. Results Eight hundred twenty five thousand eight hundred seventy four patients were included in this study with the majority being healthy without chronic diseases. The most common chronic disease was hypertension. Patients with “complex chronic disease” with frequent hospital admissions segment represented 0.6% of the eligible population, but accounted for the highest hospital admissions (4.33 ± 2.12 admissions; p < 0.001 and emergency attendances (ED (3.21 ± 3.16 ED visits; p < 0.001 per patient, and a high mortality rate (16%. Patients with metastatic disease accounted for the highest specialist outpatient

  3. Research nuclear reactor RA - Annual Report 1994; Istrazivacki nuklearni reaktor RA - Izvestaj za 1994. godinu

    Energy Technology Data Exchange (ETDEWEB)

    Sotic, O [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1994-12-01

    Activities related to revitalisation of the RA reactor stared in 1986, were continued in 1991. A number of interventions on the reactor components were finished that are supposed to enable continuous and reliable operation. The last, and at the same time largest action, related to exchange of complete reactor instrumentation is underway, but it is behind the schedule in 1991 because the delivery of components from USSR is late. Production of this instruments is financed by the IAEA according to the contract signed in December 1988 with Russian Atomenergoexport. According to this contract, it has been planned that the RA reactor instrumentation should be delivered to the Vinca Institute by the end of 1990. Only 56% of the instrumentation was delivered until September 1991. Since then any delivery of components to Yugoslavia was stopped because of the temporary embargo imposed by the IAEA. In 1991 most of the existing RA reactor instrumentation was dismantled, only the part needed for basic measurements when reactor is not operated, was maintained. Activities related to improvement of Russian project were continued in 1994. Control and maintenance of the reactor components was done regularly and efficiently. Extensive repair of the secondary coolant loop is almost finished and will be completed in the first part of 1995 according to existing legal procedures and IAEA recommendations. Fuel inspection by the IAEA safeguards inspectors was done on a monthly basis. There have been on the average 47 employees at the RA reactor which is considered sufficient for maintenance and repair conditions. Research reactor RA Annual report for year 1991 is divided into two main parts to cover: (1) operation and maintenance and (2) activities related to radiation protection. [Serbo-Croat] U 1994. godini nastavljeni su poslovi na revitalizaciji reaktora RA, zapocetoj 1986. godine. Okoncan je niz zahvata na opremi postrojenja kojima ce se u narednom periodu omoguciti kontinualan i

  4. Research nuclear reactor RA - Annual report 1992

    International Nuclear Information System (INIS)

    Sotic, O.

    1992-12-01

    Research reactor RA Annual report for year 1992 is divided into two main parts to cover: (1) operation and maintenance and (2) activities related to radiation protection. First part includes 8 annexes describing reactor operation, activities of services for maintenance of reactor components and instrumentation, financial report and staffing. Second annex B is a paper by Z. Vukadin 'Recurrence formulas for evaluating expansion series of depletion functions' published in 'Kerntechnik' 56, (1991) No.6 (INIS record no. 23024136. Second part of the report is devoted to radiation protection issues and contains 4 annexes with data about radiation control of the working environment and reactor environment, description of decontamination activities, collection of radioactive wastes, and meteorology data [sr

  5. RA research reactor - potentials and prospective

    International Nuclear Information System (INIS)

    Sotic, O.

    1984-01-01

    Since December 1959, the RA reactor was operated successfully, except for a few shorter periods needed for maintenance and a four longer shutdown periods caused by decrease in the heavy water quality. Accordingly, reconstruction of some reactor systems was started at the beginning of this decad, as well as increase of its experimental potential which would enable its efficient reliable operation in the future period. Reconstruction is concerned with emergency core cooling system, special ventilation system, and modernization of the reactor instrumentation. Improvement of the experimental potential is related to modifications of the neutron scattering instruments. Development of methods for isotope production is described as well. Design of the reactor experimental loop with external cooling system will be of significant importance in improvement of reactor potential in the future

  6. Measurements of multipolarities in 225Ra

    International Nuclear Information System (INIS)

    Andersen, E.; Nyboe, K.; Thorsteinsen, T.F.; Gietz, H.; Kaffrell, N.; Mattsson, S.; Nyman, G.

    1989-01-01

    Multipolarities of 45 transitions in 225 Ra have been established by investigating the radiations associated with the β - decay of 225 Fr. The study includes β - , e - and γ-singles spectra, e - γ- and γγ-coincidence measurements. The conversion electrons were measured with a mini-orange electron spectrometer, and the γ-spectra with Ge detectors. The multipolarities obtained from the measured conversion coefficients support the assignments of spin-parity doublets thus giving evidence for a stable octupole deformation of this nucleus. The negative parity of the 394.2 keV level established in the present work indicates that this level is a candidate for the parity-doublet partner of the 5/2 + state at 236.3 keV. (orig.)

  7. RaPToRS Sample Delivery System

    Science.gov (United States)

    Henchen, Robert; Shibata, Kye; Krieger, Michael; Pogozelski, Edward; Padalino, Stephen; Glebov, Vladimir; Sangster, Craig

    2010-11-01

    At various labs (NIF, LLE, NRL), activated material samples are used to measure reaction properties. The Rapid Pneumatic Transport of Radioactive Samples (RaPToRS) system quickly and safely moves these radioactive samples through a closed PVC tube via airflow. The carrier travels from the reaction chamber to the control and analysis station, pneumatically braking at the outlet. A reversible multiplexer routes samples from various locations near the shot chamber to the analysis station. Also, the multiplexer allows users to remotely load unactivated samples without manually approaching the reaction chamber. All elements of the system (pneumatic drivers, flow control valves, optical position sensors, multiplexers, Geiger counters, and release gates at the analysis station) can be controlled manually or automatically using a custom LabVIEW interface. A prototype is currently operating at NRL in Washington DC. Prospective facilities for Raptors systems include LLE and NIF.

  8. Automated classification of eligibility criteria in clinical trials to facilitate patient-trial matching for specific patient populations.

    Science.gov (United States)

    Zhang, Kevin; Demner-Fushman, Dina

    2017-07-01

    To develop automated classification methods for eligibility criteria in ClinicalTrials.gov to facilitate patient-trial matching for specific populations such as persons living with HIV or pregnant women. We annotated 891 interventional cancer trials from ClinicalTrials.gov based on their eligibility for human immunodeficiency virus (HIV)-positive patients using their eligibility criteria. These annotations were used to develop classifiers based on regular expressions and machine learning (ML). After evaluating classification of cancer trials for eligibility of HIV-positive patients, we sought to evaluate the generalizability of our approach to more general diseases and conditions. We annotated the eligibility criteria for 1570 of the most recent interventional trials from ClinicalTrials.gov for HIV-positive and pregnancy eligibility, and the classifiers were retrained and reevaluated using these data. On the cancer-HIV dataset, the baseline regex model, the bag-of-words ML classifier, and the ML classifier with named entity recognition (NER) achieved macro-averaged F2 scores of 0.77, 0.87, and 0.87, respectively; the addition of NER did not result in a significant performance improvement. On the general dataset, ML + NER achieved macro-averaged F2 scores of 0.91 and 0.85 for HIV and pregnancy, respectively. The eligibility status of specific patient populations, such as persons living with HIV and pregnant women, for clinical trials is of interest to both patients and clinicians. We show that it is feasible to develop a high-performing, automated trial classification system for eligibility status that can be integrated into consumer-facing search engines as well as patient-trial matching systems. Published by Oxford University Press on behalf of the American Medical Informatics Association 2017. This work is written by US Government employees and is in the public domain in the US.

  9. Disassembling and modification of RA-3

    International Nuclear Information System (INIS)

    Tarizzo, R.D.

    1990-01-01

    The objective of this paper is to describe the partial disassembling and modification of RA-3, called the Modernization Project. It comprises all the technical and administrative steps directly related with this task. The improvement of RA-3 is a result of the lack of 90% enriched uranium obliging a change over to 20% enriched uranium. This brought about design modifications both in fuel elements and the reactor. The presentation of documents for the licensing authority as well as are detailed separately. The modernization project was divided in 25 tasks: 1) changing fuel element support table, 2) changing heat exchanger, 3) repairing of cooling towers, 4) repairing of primary circuit valves, 5) repairing of irradiation channels, 6) construction of a new sampler, 7) changing tangential channel, 8) cleaning and disassembling of reactor (inside), 9) changing continuous demineralizer (ion exchange column), 10) detection of failure in fuel elements, 11) modification of nuclear instrumentation, 12) modification of conventional instrumentation, 13) modification of electrical system, 14) changing telemanipulators, 15) construction of mechanism bridge, 16) changing a primary circuit valve when the heat exchanger is changed too, 17) painting ground floor, hall floor, and pump room floor with epoxy resin levelling, 18) installation of fire alarm system, 19) radioactive liquid discharge, 20) modification of secondary circuit (This task involves: a) installation of a third secondary pump, b) extension of this piping, c) installation of two 12 inch valves to the present cooling towers pools independent, d) installation of filtering system), 21) optimization hot water bed, 22) changing detector support table, 23) removal, decontamination and reinstallation of shielding, 25) changing pneumatic system

  10. Long-term oxygen therapy in COPD patients: population-based cohort study on mortality.

    Science.gov (United States)

    Pavlov, Nikolay; Haynes, Alan Gary; Stucki, Armin; Jüni, Peter; Ott, Sebastian Robert

    2018-01-01

    Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death worldwide and is associated with a growing and substantial socioeconomic burden. Long-term oxygen therapy (LTOT), recommended by current treatment guidelines for COPD patients with severe chronic hypoxemia, has shown to reduce mortality in this population. The aim of our study was to assess the standardized mortality ratios of incident and prevalent LTOT users and to identify predictors of mortality. We conducted a 2-year follow-up population-based cohort study comprising all COPD patients receiving LTOT in the canton of Bern, Switzerland. Comparing age- and sex-adjusted standardized mortality ratios, we examined associations between all-cause mortality and patient characteristics at baseline. To avoid immortal time bias, data for incident (receiving LTOT <6 months) and prevalent users were analyzed separately. At baseline, 475 patients (20% incident users, n=93) were receiving LTOT because of COPD (48/100,000 inhabitants). Mortality of incident and prevalent LTOT users was 41% versus 27%, respectively, p <0.007, and standardized mortality ratios were 8.02 (95% CI: 5.64-11.41) versus 5.90 (95% CI: 4.79-7.25), respectively. Type 2 respiratory failure was associated with higher standardized mortality ratios among incident LTOT users (60.57, 95% CI: 11.82-310.45, p =0.038). Two-year mortality rate of COPD patients on incident LTOT was somewhat lower in our study than in older cohorts but remained high compared to the general population, especially in younger patients receiving LTOT <6 months. Type 2 respiratory failure was associated with mortality.

  11. Analysis of immune cell populations in atrial myocardium of patients with atrial fibrillation or sinus rhythm.

    Directory of Open Access Journals (Sweden)

    Natalia Smorodinova

    Full Text Available Atrial fibrillation (AF is the most common arrhythmia and despite obvious clinical importance remains its pathogenesis only partially explained. A relation between inflammation and AF has been suggested by findings of increased inflammatory markers in AF patients.The goal of this study was to characterize morphologically and functionally CD45-positive inflammatory cell populations in atrial myocardium of patients with AF as compared to sinus rhythm (SR.We examined 46 subjects (19 with AF, and 27 in SR undergoing coronary bypass or valve surgery. Peroperative bioptic samples of the left and the right atrial tissue were examined using immunohistochemistry.The number of CD3+ T-lymphocytes and CD68-KP1+ cells were elevated in the left atrial myocardium of patients with AF compared to those in SR. Immune cell infiltration of LA was related to the rhythm, but not to age, body size, LA size, mitral regurgitation grade, type of surgery, systemic markers of inflammation or presence of diabetes or hypertension. Most of CD68-KP1+ cells corresponded to dendritic cell population based on their morphology and immunoreactivity for DC-SIGN. The numbers of mast cells and CD20+ B-lymphocytes did not differ between AF and SR patients. No foci of inflammation were detected in any sample.An immunohistochemical analysis of samples from patients undergoing open heart surgery showed moderate and site-specific increase of inflammatory cells in the atrial myocardium of patients with AF compared to those in SR, with prevailing population of monocyte-macrophage lineage. These cells and their cytokine products may play a role in atrial remodeling and AF persistence.

  12. Combined Population Dynamics and Entropy Modelling Supports Patient Stratification in Chronic Myeloid Leukemia

    Science.gov (United States)

    Brehme, Marc; Koschmieder, Steffen; Montazeri, Maryam; Copland, Mhairi; Oehler, Vivian G.; Radich, Jerald P.; Brümmendorf, Tim H.; Schuppert, Andreas

    2016-04-01

    Modelling the parameters of multistep carcinogenesis is key for a better understanding of cancer progression, biomarker identification and the design of individualized therapies. Using chronic myeloid leukemia (CML) as a paradigm for hierarchical disease evolution we show that combined population dynamic modelling and CML patient biopsy genomic analysis enables patient stratification at unprecedented resolution. Linking CD34+ similarity as a disease progression marker to patient-derived gene expression entropy separated established CML progression stages and uncovered additional heterogeneity within disease stages. Importantly, our patient data informed model enables quantitative approximation of individual patients’ disease history within chronic phase (CP) and significantly separates “early” from “late” CP. Our findings provide a novel rationale for personalized and genome-informed disease progression risk assessment that is independent and complementary to conventional measures of CML disease burden and prognosis.

  13. Morbidity and medicine prescriptions in a nationwide Danish population of patients diagnosed with polycystic ovary syndrome

    DEFF Research Database (Denmark)

    Glintborg, Dorte; Hass Rubin, Katrine; Nybo, Mads

    2015-01-01

    OBJECTIVE: The prevalence of type 2 diabetes is increased in polycystic ovary syndrome (PCOS), but the prevalence of other diseases is not clarified. We aimed to investigate morbidity and medicine prescriptions in PCOS. DESIGN: A National Register-based study. METHODS: Patients with PCOS (PCOS...... Denmark and an embedded cohort; PCOS Odense University Hospital (OUH)) and one control population. Premenopausal women with PCOS underwent clinical and biochemical examination (PCOS OUH, n=1217). PCOS Denmark (n=19 199) included women with PCOS in the Danish National Patient Register. Three age......-matched controls were included per patient (n=57 483). MAIN OUTCOME MEASURES: Diagnosis codes and filled prescriptions. RESULTS: The mean (range) age of the PCOS Denmark group and controls was 30.6 (12-60) years. Patients in PCOS Denmark had higher Charlson index, higher prevalence of diabetes, dyslipidemia...

  14. Influence of relativistic effects on hydrolysis of Ra2+

    International Nuclear Information System (INIS)

    Zielinska, B.; Bilewicz, A.

    2005-01-01

    Using 224 Ra radiotracer the first hydrolysis constant (pK 1h ) of Ra 2+ cations has been determined. The pK 1h value of Ra 2+ was compared with the pK 1h values of other Group 2 cations. It has been shown that the electrostatic hydrolysis model based on assumption that pK 1h is a linear function of reciprocal ionic radii (1/r i ) does not describe well the hydrolysis of Group 2 metal cations. The reason of higher Ra 2+ hydrolysis as expected is the influence of relativistic effects on bonding 7s and 7p 1/2 orbitals. (author)

  15. Research on background neutron of 226Ra γ source

    International Nuclear Information System (INIS)

    Ji Changsong

    1996-01-01

    This work studies the background neutron emission of 226 Ra γ source: the mechanism of resulting in background neutron is studied; a thesis that the (α, n) type reaction on Radium carriers Cl or Br is the main source of creating background neutron emission of 226 Ra γ source has been proposed and certificated; a proposal of substitution of Cl carrier by Br in radium source produced in China in order to reduce background neutron emission is put forward. A result to reduce the background neutron from 96.4 neutrons/4πsmgRa to 6.1 neutrons/4πsmgRa is obtained

  16. Modeling the Energy Performance of LoRaWAN

    OpenAIRE

    Casals, Lluís; Mir, Bernat; Vidal, Rafael; Gomez, Carles

    2017-01-01

    LoRaWAN is a flagship Low-Power Wide Area Network (LPWAN) technology that has highly attracted much attention from the community in recent years. Many LoRaWAN end-devices, such as sensors or actuators, are expected not to be powered by the electricity grid; therefore, it is crucial to investigate the energy consumption of LoRaWAN. However, published works have only focused on this topic to a limited extent. In this paper, we present analytical models that allow the characterization of LoRaWAN...

  17. RA Reactor operation and maintenance (I-IX), Part IV, Task 3.08/04, Refurbishment of the RA reactor; Pogon i odrzavanje reaktora RA (I-IX), IV Deo, Zadatak 3.08/04 Remont reaktora RA

    Energy Technology Data Exchange (ETDEWEB)

    Zecevic, V [Institute of Nuclear Sciences Boris Kidric, Reaktor RA, Vinca, Beograd (Serbia and Montenegro)

    1963-12-15

    This volume contains reports describing maintenance and repair work of the RA reactor instrumentation, equipment of the reactor dosimetry control system, and equipment for regulation and control systems.

  18. Population Pharmacokinetics and Pharmacodynamics of Meropenem in Nonobese, Obese, and Morbidly Obese Patients.

    Science.gov (United States)

    Chung, Eun Kyoung; Cheatham, S Christian; Fleming, Megan R; Healy, Daniel P; Kays, Michael B

    2017-03-01

    The study objective was to evaluate meropenem population pharmacokinetics and pharmacodynamics in nonobese, obese, and morbidly obese patients. Forty adult patients-11 nonobese (body mass index [BMI] calculate probability of target attainment (PTA) for 5 dosing regimens, infused over 0.5 and 3 hours, using fT>MIC of 40%, 54%, and 100% of the dosing interval. A 2-compartment linear-elimination model best described the serum concentration-time data, and creatinine clearance was significantly associated with systemic clearance. Pharmacokinetic parameters were not significantly different among patient groups. In patients with creatinine clearances ≥50 mL/min, all simulated dosing regimens achieved >90% PTA at 40% fT>MIC in all patient groups at MICs ≤2 mg/L. Only 500 mg q8h, infused over 0.5 hour, did not achieve >90% PTA at 54% fT>MIC in nonobese and morbidly obese patients. At 100% fT>MIC, 1 g q6h and 2 g q8h, infused over 3 hours, reliably achieved >90% PTA in all patient groups. Meropenem pharmacokinetics are comparable among nonobese, obese, and morbidly obese patients. Standard dosing regimens provide adequate pharmacodynamic exposures for susceptible pathogens at 40% and 54% fT>MIC, but prolonged infusions of larger doses are needed for adequate exposures at 100% fT>MIC. Dosage adjustments based solely on body weight are unnecessary. © 2016, The American College of Clinical Pharmacology.

  19. Evidence of dietary calcium and vitamin D inadequacies in a population of dental patients.

    Science.gov (United States)

    Pehowich, Daniel J; Pehowich, Enid D

    2016-12-01

    To determine the dietary calcium and vitamin D intake of a cohort of dental patients identified as being at risk of inadequacy based on a 24-hour food recall. A retrospective chart analysis was carried out on 5-day food record and nutrient analyses of 670 dental patients aged 18 to 82 years obtained over a 10-year period. All patients had scored poorly on a 24-hour food recall survey during their initial examination. The overall mean and median calcium and vitamin D intakes of the patients were significantly lower than the current estimated needs for the general population. Although calcium intake did not change over the 10-year period, vitamin D consumption decreased. The greatest dietary intake inadequacies for both calcium and vitamin D were seen in both male and female patients over age 50 years. A 24-Hour Food Recall Questionnaire may be an effective means for the oral health professional to screen patients for calcium and vitamin D and other nutrient inadequacies. Screening for potential dietary inadequacies of calcium and vitamin D may identify patients potentially at risk for poor bone health. Our results indicate that the dental health professional can obtain evidence necessary to change patient dietary behavior and thus contribute to successful treatment outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Increased risk of ischemic stroke in cervical cancer patients: a nationwide population-based study

    International Nuclear Information System (INIS)

    Tsai, Shiang-Jiun; Su, Yu-Chieh; Hung, Shih-Kai; Huang, Yung-Sung; Tung, Chien-Hsueh; Lee, Ching-Chih; Lee, Moon-Sing; Chiou, Wen-Yen; Lin, Hon-Yi; Hsu, Feng-Chun; Tsai, Chih-Hsin

    2013-01-01

    Increased risk of ischemic stroke has been validated for several cancers, but limited study evaluated this risk in cervical cancer patients. Our study aimed to evaluate the risk of ischemic stroke in cervical cancer patients. The study analyzed data from the 2003 to 2008 National Health Insurance Research Database (NHIRD) provided by the National Health Research Institutes in Taiwan. Totally, 893 cervical cancer patients after radiotherapy and 1786 appendectomy patients were eligible. The Kaplan-Meier method and the Cox proportional hazards model were used to assess the risk of ischemic stroke. The 5-year cumulative risk of ischemic stroke was significantly higher for the cervical cancer group than for the control group (7.8% vs 5.1%; p <0.005). The risk of stroke was higher in younger (age <51 years) than in older (age ≥51 years) cervical cancer patients (HR = 2.73, p = 0.04; HR = 1.37, p = 0.07) and in patients with more than two comorbid risk factors (5 years cumulative stroke rate of two comorbidities: 15% compared to no comorbidities: 4%). These study demonstrated cervical cancer patients had a higher risk of ischemic stroke than the general population, especially in younger patients. Strategies to reduce this risk should be assessed

  1. Long-term survival among Hodgkin's lymphoma patients with gastrointestinal cancer: a population-based study

    Science.gov (United States)

    Youn, P.; Li, H.; Milano, M. T.; Stovall, M.; Constine, L. S.; Travis, L. B.

    2013-01-01

    Background The increased risk of gastrointestinal (GI) cancers after Hodgkin's lymphoma (HL) is well established. However, no large population-based study has described the actuarial survival after subsequent GI cancers in HL survivors (HL-GI). Patients and methods For 209 patients with HL-GI cancers (105 colon, 35 stomach, 30 pancreas, 21 rectum, and 18 esophagus) and 484 165 patients with first primary GI cancers (GI-1), actuarial survival was compared, accounting for age, gender, race, GI cancer stage, radiation for HL, and other variables. Results Though survival of HL patients who developed localized stage colon cancer was similar to that of the GI-1 group, overall survival (OS) of HL patients with regional or distant stage colon cancer was reduced [hazard ratio, (HR) = 1.46, P = 0.01]. The HL survivors with regional or distant stage colon cancer in the transverse segment had an especially high risk of mortality (HR: 2.7, P = 0.001 for OS). For localized stomach cancer, OS was inferior among HL survivors (HR = 3.46, P = 0.006). Conclusions The HL patients who develop GI cancer experience significantly reduced survival compared with patients with a first primary GI cancer. Further research is needed to explain the inferior survival of HL patients and to define selection criteria for cancer screening in HL survivors. PMID:22855552

  2. Development of a scale to assess cancer stigma in the non-patient population

    Science.gov (United States)

    2014-01-01

    Background Illness-related stigma has attracted considerable research interest, but few studies have specifically examined stigmatisation of cancer in the non-patient population. The present study developed and validated a Cancer Stigma Scale (CASS) for use in the general population. Methods An item pool was developed on the basis of previous research into illness-related stigma in the general population and patients with cancer. Two studies were carried out. The first study used Exploratory factor analysis to explore the structure of items in a sample of 462 postgraduate students recruited through a London university. The second study used Confirmatory factor analysis to confirm the structure among 238 adults recruited through an online market research panel. Internal reliability, test-retest reliability and construct validity were also assessed. Results Exploratory factor analysis suggested six subscales, representing: Awkwardness, Severity, Avoidance, Policy Opposition, Personal Responsibility and Financial Discrimination. Confirmatory factor analysis confirmed this structure with a 25-item scale. All subscales showed adequate to good internal and test-retest reliability in both samples. Construct validity was also good, with mean scores for each subscale varying in the expected directions by age, gender, experience of cancer, awareness of lifestyle risk factors for cancer, and social desirability. Means for the subscales were consistent across the two samples. Conclusions These findings highlight the complexity of cancer stigma and provide the Cancer Stigma Scale (CASS) which can be used to compare populations, types of cancer and evaluate the effects of interventions designed to reduce cancer stigma in non-patient populations. PMID:24758482

  3. Cataract surgery in a population-based cohort of patients with type 1 diabetes

    DEFF Research Database (Denmark)

    Grauslund, Jakob; Green, Anders; Sjølie, Anne K

    2011-01-01

    .05-3.40) were the only statistically significant predictors of cataract surgery. Duration of diabetes, gender, glycaemic regulation, proteinuria, smoking, blood pressure and level of retinopathy were not associated with cataract surgery. Conclusion: Type 1 diabetes is associated with a high long-term incidence......ABSTRACT. Purpose: To estimate the long-term cumulative incidence of cataract surgery and associated risk factors in a 25-year follow-up of a population-based cohort of patients with type 1 diabetes. Methods: Based on insulin prescriptions, a population-based cohort of 727 patients with type 1...... of surgery were 59.3 and 42 years, respectively. Cataract surgery in the cohort took place approximately 20 years earlier compared to non-diabetic persons. In a multivariate regression analysis, baseline age [hazard ratio (HR) 1.89 per 10 years, 95% CI 1.46-2.27] and maculopathy (HR 1.89, 95% CI 1...

  4. Molecular epidemiology and dynamics of Pseudomonas aeruginosa populations in lungs of cystic fibrosis patients

    DEFF Research Database (Denmark)

    Jelsbak, Lars; Johansen, Helle Krogh; Frost, Anne Louise Viborg

    2007-01-01

    The ability to establish lifelong persistent infections is a fundamental aspect of the interactions between many pathogenic microorganisms and their mammalian hosts. One example is chronic lung infections by the opportunistic pathogen Pseudomonas aeruginosa in cystic fibrosis (CF) patients....... This infection process is associated with extensive genetic adaptation and microevolution of the infecting bacteria. Through investigations of P. aeruginosa populations and infection dynamics in a group of CF patients followed at the Danish CF Clinic in Copenhagen, we have identified two distinct and dominant...

  5. Smaller than expected cognitive deficits in schizophrenia patients from the population-representative ABC catchment cohort.

    Science.gov (United States)

    Lennertz, Leonhard; An der Heiden, Wolfram; Kronacher, Regina; Schulze-Rauschenbach, Svenja; Maier, Wolfgang; Häfner, Heinz; Wagner, Michael

    2016-08-01

    Most neuropsychological studies on schizophrenia suffer from sample selection bias, with male and chronic patients being overrepresented. This probably leads to an overestimation of cognitive impairments. The present study aimed to provide a less biased estimate of cognitive functions in schizophrenia using a population-representative catchment area sample. Schizophrenia patients (N = 89) from the prospective Mannheim ABC cohort were assessed 14 years after disease onset and first diagnosis, using a comprehensive neuropsychological test battery. A healthy control group (N = 90) was carefully matched according to age, gender, and geographic region (city, rural surrounds). The present sample was representative for the initial ABC cohort. In the comprehensive neuropsychological assessment, the schizophrenia patients were only moderately impaired as compared to the healthy control group (d = 0.56 for a general cognitive index, d = 0.42 for verbal memory, d = 0.61 for executive functions, d = 0.69 for attention). Only 33 % of the schizophrenia patients scored one standard deviation unit below the healthy control group in the general cognitive index. Neuropsychological performance did not correlate with measures of the clinical course including age at onset, number of hospital admissions, and time in paid work. Thus, in this population-representative sample of schizophrenia patients, neuropsychological deficits were less pronounced than expected from meta-analyses. In agreement with other epidemiological studies, this suggests a less devastating picture of cognition in schizophrenia.

  6. Differences Between Patients that Made an Impulsive or Premeditated Suicide Attempt in a Mexican Population.

    Science.gov (United States)

    Reyes-Tovilla, Jorge E; Hernández Yánez, Homero Daniel; Peralta-Jiménez, Yesenia; Ramón-Frías, Teresa; Juárez-Rojop, Isela; Pool-García, Sherezada; Velázquez-Sánchez, Martha Patricia; López-Narvóez, Lilia; Fresán, Ana; Tovilla-Zárate, Carlos Alfonso

    2015-01-01

    We performed a study to identify differences between patients with impulsive suicide attempt and those with premeditated suicide attempt in a Mexican population. We studied 144 patients who recently attempted suicide. Impulsive and premeditated suicide attempts were evaluated with the Suicide Intent Scale. These data were divided according to the type of attempt. Subsequently, the characteristics between the two groups were compared. The rate of patients that made an impulsive attempt was 61.8% and only 9.7% of the patients carried out a premeditated suicide attempt. More years of schooling/education and less severity of the attempt were observed in patients that carried out an impulsive suicide attempt (p suicide attempt. Our findings demonstrate that there are clinical differences among the individuals who carried out an impulsive suicide attempt from those who premeditated an attempt in a Mexican population. As a result, when planning interventions and prevention efforts it may be helpful to consider these clinical differences and demographic characteristics. © 2015 The Author(s).

  7. Environmental factors in a population-based inception cohort of inflammatory bowel disease patients in Europe

    DEFF Research Database (Denmark)

    Burisch, J; Pedersen, Natalia; Cukovic-Cavka, S

    2014-01-01

    BACKGROUND AND AIMS: The incidence of inflammatory bowel disease (IBD) is increasing in Eastern Europe possibly due to changes in environmental factors towards a more "westernised" standard of living. The aim of this study was to investigate differences in exposure to environmental factors prior ...... and Western European patients differed in environmental factors prior to diagnosis. Eastern European patients exhibited higher occurrences of suspected risk factors for IBD included in the Western lifestyle.......BACKGROUND AND AIMS: The incidence of inflammatory bowel disease (IBD) is increasing in Eastern Europe possibly due to changes in environmental factors towards a more "westernised" standard of living. The aim of this study was to investigate differences in exposure to environmental factors prior...... to diagnosis in Eastern and Western European IBD patients. METHODS: The EpiCom cohort is a population-based, prospective inception cohort of 1560 unselected IBD patients from 31 European countries covering a background population of 10.1 million. At the time of diagnosis patients were asked to complete an 87...

  8. Hand hygiene compliance in patients under contact precautions and in the general hospital population.

    Science.gov (United States)

    Almaguer-Leyva, Martín; Mendoza-Flores, Lidia; Medina-Torres, Ana Gabriela; Salinas-Caballero, Ana Gabriela; Vidaña-Amaro, Jose Antonio; Garza-Gonzalez, Elvira; Camacho-Ortiz, Adrián

    2013-11-01

    Hand hygiene (HH) is the single most important intervention for preventing hospital-acquired infections. Contact precautions are a series of actions that infection control units take to reduce the transmission of nosocomial pathogens. We conducted an observational study of HH compliance. Observations were stratified as opportunities in patients under contact precautions and in the general hospital population. Trained infection control personnel performed all direct evaluations. A total of 3,270 opportunities were recorded. HH compliance was statistically higher in patients on contact precautions than in the overall population (70.3% vs 60.4%; P = .0001). Critical care areas had higher HH compliance when patients were isolated by contact precautions. Medical wards were statistically lower in HH when patients were under contact precautions. Respiratory technicians had the highest HH compliance in both overall performance and in patients under contact precautions. Medical students had a lower HH compliance in both evaluations (P Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  9. Predictors of suicide in the patient population admitted to a locked-door psychiatric acute ward.

    Directory of Open Access Journals (Sweden)

    Roar Fosse

    Full Text Available No prior study appears to have focused on predictors of suicide in the general patient population admitted to psychiatric acute wards. We used a case-control design to investigate the association between suicide risk factors assessed systematically at admission to a locked-door psychiatric acute ward in Norway and subsequent death by suicide.From 2008 to 2013, patients were routinely assessed for suicide risk upon admission to the acute ward with a 17-item check list based on recommendations from the Norwegian Directorate of Health and Social Affairs. Among 1976 patients admitted to the ward, 40 patients, 22 men and 18 women, completed suicide within December 2014.Compared to a matched control group (n = 120, after correction for multiple tests, suicide completers scored significantly higher on two items on the check list: presence of suicidal thoughts and wishing to be dead. An additional four items were significant in non-corrected tests: previous suicide attempts, continuity of suicidal thoughts, having a suicide plan, and feelings of hopelessness, indifference, and/or aggression. A brief scale based on these six items was the only variable associated with suicide in multivariate regression analysis, but its predictive value was poor.Suicide specific ideations may be the most central risk markers for suicide in the general patient population admitted to psychiatric acute wards. However, a low predictive value may question the utility of assessing suicide risk.

  10. National Incidence of Patient Safety Indicators in the Total Hip Arthroplasty Population.

    Science.gov (United States)

    Tanenbaum, Joseph E; Knapik, Derrick M; Wera, Glenn D; Fitzgerald, Steven J

    2017-09-01

    The Centers for Medicare & Medicaid Services use the incidence of patient safety indicators (PSIs) to determine health care value and hospital reimbursement. The national incidence of PSI has not been quantified in the total hip arthroplasty (THA) population, and it is unknown if patient insurance status is associated with PSI incidence after THA. All patients in the Nationwide Inpatient Sample (NIS) who underwent THA in 2013 were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification codes. The incidence of PSI was determined using the International Classification of Diseases, Ninth Revision, diagnosis code algorithms published by the Centers for Medicare & Medicaid Services and the Agency for Healthcare Research and Quality. The association of insurance status and the incidence of PSI during the inpatient episode was determined by comparing privately insured and Medicare patients with Medicaid/self-pay patients using a logistic regression model that controlled for patient demographics, patient comorbidities, and hospital characteristics. In 2013, the NIS included 68,644 hospitalizations with primary THA performed during the inpatient episode. During this period, 429 surgically relevant PSI were recorded in the NIS. The estimated national incidence rate of PSI after primary THA was 0.63%. In our secondary analysis, the privately insured cohort had significantly lower odds of experiencing one or more PSIs relative to the Medicaid/self-pay cohort (odds ratio, 0.47; 95% confidence interval, 0.29-0.76). The national incidence of PSI among THA patients is relatively low. However, primary insurance status is associated with the incidence of one or more PSIs after THA. As value-based payment becomes more widely adopted in the United States, quality benchmarks and penalty thresholds need to account for these differences in risk-adjustment models to promote and maintain access to care in the underinsured population. Copyright

  11. Social Role Participation in Patients With Ankylosing Spondylitis: A Cross-Sectional Comparison With Population Controls.

    Science.gov (United States)

    van Genderen, Simon; Plasqui, Guy; Landewé, Robert; Lacaille, Diane; Arends, Suzanne; van Gaalen, Floris; van der Heijde, Désirée; Heuft, Liesbeth; Luime, Jolanda; Spoorenberg, Anneke; Gignac, Monique; Boonen, Annelies

    2016-12-01

    Participation in social roles for persons with chronic disease is important for their quality of life, but interpretation of the data on participation is difficult in the absence of a benchmark. This study aimed to compare social role participation in patients with ankylosing spondylitis (AS) to population controls using the Social Role Participation Questionnaire (SRPQ). There were 246 AS patients and 510 population controls who completed the SRPQ, which assesses participation in 11 roles (with scores ranging 1-5) across 4 dimensions (importance, satisfaction with performance, satisfaction with time, and physical difficulty), and additionally ranked their 3 most important roles. The ranking of role importance, the SRPQ dimension scores, and the gap between importance and satisfaction with performance of roles were compared between patients and controls. Patients (62% male; mean ± SD age 51 ± 12 years) and controls (70% male; mean ± SD 42 ± 15 years) ranked intimate relationships, relationships with children/stepchildren/grandchildren, and employment as the most important roles. Compared to controls, patients gave higher scores on the SRPQ to importance (3.75 versus 3.43), but reported lower satisfaction with performance (3.19 versus 3.58) and greater physical difficulty (3.87 versus 4.67) (P ≤ 0.05 for all). The largest differences in gaps between importance and satisfaction with performance for patients compared to controls were seen in the physical leisure, hobbies, and traveling and vacation categories, in which patients assigned higher importance but reported especially low satisfaction. As society places increasing emphasis on individual responsibility to participate fully in social roles, the current data suggest that health care providers should pay more attention to participation restrictions experienced by patients with AS. © 2016, American College of Rheumatology.

  12. Patient and population protection in X-ray examinations -a general roentgenological and health problem

    International Nuclear Information System (INIS)

    Khadzhidekov, G.; Dermendzhiev, Kh.

    1975-01-01

    Population exposure in excess of that due to natural radiation background is known to result primarily (to 70-90%) from medical X-rays given in mass screening. Protection of the population is a problem of great concern in present-day radiology and is approached by balancing benefits of diagnostic X-rays against risks presented by the probability of overexposing the patient. An evaluation on such a basis necessitates detailed and accurate information on patient radiation exposure and takes into account factors leading to a population hazard by making assessments in terms of so-called genetically significant doses. Gonad doses have to be carefully analysed, implying a need for studies of various types of X-ray procedures, precautionary measures taken, etc. An important issue in the choice and adoption of an appropriate method for large-scale gonad dose assessments in routine practice. To obtain an estimate of radiation hazard from medical roentgenology in terms of genetically significant doses and identify measures necessary to limit exposure risks, collaborative efforts are needed involving participation of roentgenologists and hygienists, and use of dosimetric, organizational-methodological, and statistical techniques. These efforts should lead to an abrupt reduction in radiation burden to the population from diagnostic X-rays. (author)

  13. Concentration of natural radionuclides (40K, 228Ra and 226Ra) in vegetables and fruits collected around Kudankulam, South India

    International Nuclear Information System (INIS)

    Mahiban Ross, E.; Feroz Khan, M.; Lenin Raj, Y.; Godwin Wesley, S.; Kumar, M.; Sundar Rajan, P.

    2007-01-01

    Baseline activity concentration of the natural radio nuclides 40 K, 228 Ra and 226 Ra in vegetables and fruits was determined around Kudankulam. In many of the samples, 228 Ra and 226 Ra was below minimum detection limit. 40 K was found to be more in leafy vegetables followed by pods, tubers and fleshy fruits. The highest accumulator among the matrices was the leafy vegetables with the geometric mean of 189.47 Bq.kg -1 fresh for vegetables and fruits with the geometric mean of 128.95 Bq.kg -1 fresh. 228 Ra activity in vegetables and fruits ranged from 0.074 to 1.153 and 0.074 to 0.131 Bq.kg -l fresh respectively. 226 Ra in vegetables and fruits ranged from BDL to 0.07 and BDL-.044 Bq.kg -l fresh respectively. 40 K in vegetables and fruits followed a log normal distribution. (author)

  14. Patient safety is not enough: targeting quality improvements to optimize the health of the population.

    Science.gov (United States)

    Woolf, Steven H

    2004-01-06

    Ensuring patient safety is essential for better health care, but preoccupation with niches of medicine, such as patient safety, can inadvertently compromise outcomes if it distracts from other problems that pose a greater threat to health. The greatest benefit for the population comes from a comprehensive view of population needs and making improvements in proportion with their potential effect on public health; anything less subjects an excess of people to morbidity and death. Patient safety, in context, is a subset of health problems affecting Americans. Safety is a subcategory of medical errors, which also includes mistakes in health promotion and chronic disease management that cost lives but do not affect "safety." These errors are a subset of lapses in quality, which result not only from errors but also from systemic problems, such as lack of access, inequity, and flawed system designs. Lapses in quality are a subset of deficient caring, which encompasses gaps in therapeutics, respect, and compassion that are undetected by normative quality indicators. These larger problems arguably cost hundreds of thousands more lives than do lapses in safety, and the system redesigns to correct them should receive proportionately greater emphasis. Ensuring such rational prioritization requires policy and medical leaders to eschew parochialism and take a global perspective in gauging health problems. The public's well-being requires policymakers to view the system as a whole and consider the potential effect on overall population health when prioritizing care improvements and system redesigns.

  15. Assessment of the performance of the American Urological Association symptom score in 2 distinct patient populations.

    Science.gov (United States)

    Johnson, Timothy V; Schoenberg, Evan D; Abbasi, Ammara; Ehrlich, Samantha S; Kleris, Renee; Owen-Smith, Ashli; Gunderson, Kristin; Master, Viraj A

    2009-01-01

    Recent research suggests that low education and illiteracy may drive misunderstanding of the American Urological Association Symptom Score, a key tool in the American Urological Association benign prostatic hyperplasia guidelines. It is unclear whether misunderstanding is confined to patients of low socioeconomic status. Therefore, we reevaluated the prevalence and impact of this misunderstanding in a county vs university hospital population. This prospective study involved 407 patients from a county hospital and a university hospital who completed the American Urological Association Symptom Score as self-administered and then as interviewer administered. Responses were compared by calculating correlation coefficients and weighted kappa statistics to assess patient understanding of the American Urological Association Symptom Score. Multivariate logistic regression analyses were used to examine the association between patient characteristics and poor understanding of the American Urological Association Symptom Score. Of the patients 72% understood all 7 American Urological Association Symptom Score questions. Of the measured demographic variables only education level significantly affected this understanding. Compared to patients with more than 12 years of education county hospital patients with less than 9 years of education were 57.06 times more likely to misunderstand the American Urological Association Symptom Score (95% CI 14.32-329.34) while university hospital patients with less than 9 years of education were 38.27 times more likely to misunderstand the American Urological Association Symptom Score (95% CI 1.69-867.83). Of county hospital patients 31% and of university hospital patients 21% significantly misrepresented their symptom severity according to current guidelines. Patients with low education regardless of location are more likely to misunderstand the American Urological Association Symptom Score, misrepresent their symptoms and, therefore, receive

  16. The potential of {sup 223}Ra and {sup 18}F-fluoride imaging to predict bone lesion response to treatment with {sup 223}Ra-dichloride in castration-resistant prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Murray, Iain; Chittenden, Sarah J.; Denis-Bacelar, Ana M.; Flux, Glenn D. [Royal Marsden NHS Foundation Trust, Joint Department of Physics, Sutton, Surrey (United Kingdom); The Institute of Cancer Research, London (United Kingdom); Hindorf, Cecilia [Royal Marsden NHS Foundation Trust, Joint Department of Physics, Sutton, Surrey (United Kingdom); The Institute of Cancer Research, London (United Kingdom); Skaane University Hospital, Department of Radiation Physics, Lund (Sweden); Parker, Christopher C. [Royal Marsden NHS Foundation Trust, Department of Urology, Sutton (United Kingdom); Chua, Sue [Royal Marsden NHS Foundation Trust, Department of Nuclear Medicine, Sutton (United Kingdom)

    2017-10-15

    The aims of this study were to calculate bone lesion absorbed doses resulting from a weight-based administration of {sup 223}Ra-dichloride, to assess the relationship between those doses and corresponding {sup 18}F-fluoride uptake and to assess the potential of quantitative {sup 18}F-fluoride imaging to predict response to treatment. Five patients received two intravenous injections of {sup 223}Ra-dichloride, 6 weeks apart, at 110 kBq/kg whole-body weight. The biodistribution of {sup 223}Ra in metastatic lesions as a function of time after administration as well as associated lesion dosimetry were determined from serial {sup 223}Ra scans. PET/CT imaging using {sup 18}F-fluoride was performed prior to the first treatment (baseline), and at week 6 immediately before the second treatment and at week 12 after baseline. Absorbed doses to metastatic bone lesions ranged from 0.6 Gy to 44.1 Gy. For individual patients, there was an average factor difference of 5.3 (range 2.5-11.0) between the maximum and minimum lesion dose. A relationship between lesion-absorbed doses and serial changes in {sup 18}F-fluoride uptake was demonstrated (r{sup 2} = 0.52). A log-linear relationship was demonstrated (r{sup 2} = 0.77) between baseline measurements of {sup 18}F-fluoride uptake prior to {sup 223}Ra-dichloride therapy and changes in uptake 12 weeks after the first cycle of therapy. Correlations were also observed between both {sup 223}Ra and {sup 18}F-fluoride uptake in lesions (r = 0.75) as well as between {sup 223}Ra absorbed dose and {sup 18}F-fluoride uptake (r = 0.96). There is both inter-patient and intra-patient heterogeneity of absorbed dose estimates to metastatic lesions. A relationship between {sup 223}Ra lesion absorbed dose and subsequent lesion response was observed. Analysis of this small group of patients suggests that baseline uptake of {sup 18}F-fluoride in bone metastases is significantly correlated with corresponding uptake of {sup 223}Ra, the associated {sup 223

  17. Incremental healthcare resource utilization and costs in US patients with Cushing's disease compared with diabetes mellitus and population controls.

    Science.gov (United States)

    Broder, Michael S; Neary, Maureen P; Chang, Eunice; Ludlam, William H

    2015-12-01

    Resource utilization and costs in Cushing's disease (CD) patients have not been studied extensively. We compared CD patients with diabetes mellitus (DM) patients and population-based controls to characterize differences in utilization and costs. Using 2008-2012 MarketScan® database, we identified three patient groups: (1) CD patients; (2) DM patients; and (3) population-based control patients without CD. DM and control patients were matched to CD patients by age, gender, region, and review year in a 2:1 ratio. Outcomes included annual healthcare resource utilization and costs. There were 1852 CD patients, 3704 DM patients and 3704 controls. Mean age was 42.9 years; 78.2 % were female. CD patients were hospitalized more frequently (19.3 %) than DM patients (11.0 %, p < .001) or controls (5.6 %, p < .001). CD patients visited the ED more frequently (25.4 %) than DM patients (21.1 %, p < .001) or controls (14.3 %, p < .001). CD patients had more office visits than DM patients (19.1 vs. 10.7, p < .001) or controls (7.1, p < .001). CD patients on average filled more prescriptions than DM patients (51.7 vs. 42.7, p < .001) or controls (20.5, p < .001). Mean total healthcare costs for CD patients were $26,269 versus $12,282 for DM patients (p < .001) and $5869 for controls (p < .001). CD patients had significantly higher annual rates of healthcare resource utilization compared to matched DM patients and population controls without CD. CD patient costs were double DM costs and quadruple control costs. This study puts into context the additional burdens of CD over DM, a common, chronic endocrine condition affecting multiple organ systems, and population controls.

  18. Association between use of disease-modifying antirheumatic drugs and diabetes in patients with ankylosing spondylitis, rheumatoid arthritis, or psoriasis/psoriatic arthritis: a nationwide, population-based cohort study of 84,989 patients

    Directory of Open Access Journals (Sweden)

    Chen HH

    2017-05-01

    Full Text Available Hsin-Hua Chen,1–7 Der-Yuan Chen,1–6 Chi-Chen Lin,1,2 Yi-Ming Chen,1–4 Kuo-Lung Lai,3,4 Ching-Heng Lin1 1Department of Medical Research, Taichung Veterans General Hospital, 2Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, Chung-Hsing University, Taichung, 3School of Medicine, National Yang-Ming University, Taipei, 4Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, 5School of Medicine, Chung-Shan Medical University, 6Department of Medical Education, Taichung Veterans General Hospital, Taichung, 7Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan Purpose: The aim of this study is to investigate the association between the use of disease-modifying antirheumatic drugs (DMARDs and diabetes mellitus (DM in patients with ankylosing spondylitis (AS, rheumatoid arthritis (RA, or psoriasis/psoriatic arthritis (PS/PSA.Patients and methods: This retrospective cohort study used a nationwide, population-based administrative database to enroll 84,989 cases with AS, RA, or PS/PSA who initiated treatment with anti-tumor necrosis factor (anti-TNF drugs or nonbiologic DMARDs. Multivariable analysis was used to estimate the effect of different therapies on the risk of DM.Results: The incidence rates of DM per 1,000 person-years were 8.3 for users of anti-TNF drugs, 13.3 for users of cyclosporine (CSA, 8.4 for users of hydroxychloroquine (HCQ, and 8.1 for users of other nonbiologic DMARDs. Compared with the users of nonbiologic DMARDs, the multivariate-adjusted hazard ratios (aHRs for DM were significantly lower for those who used anti-TNF drugs with HCQ (aHR: 0.49, 95% confidence interval [CI]: 0.36–0.66 and those who used HCQ alone (aHR: 0.70, 95% CI: 0.63–0.78, but not for those who used anti-TNFs without HCQ (aHR: 1.23, 95% CI: 0.94–1.60 or CSA (aHR: 1.14, 95% CI: 0.77–1

  19. RA Research nuclear reactor - Annual report 1987; Istrazivacki nuklearni reaktor RA - Izvestaj o radu za 1987. godinu

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1987-12-15

    Annual report concerning the project 'RA research nuclear reactor' for 1987, financed by the Serbian ministry of science is divided into two parts. First part is concerned with RA reactor operation and maintenance, which is the task of the Division for reactor engineering of the Institute for multidisciplinary studies and RA reactor engineering. Second part deals with radiation protection activities at the RA reactor which is the responsibility of the Institute for radiation protection. Scientific council of the Institute for multidisciplinary studies and RA reactor engineering has stated that this report describes adequately the activity and tasks fulfilled at the RA reactor in 1989. The scope and the quality of the work done were considered successful both concerning the maintenance and reconstruction, as well as radiation protection activities. [Serbo-Croat] Godisnji izvestaj po projektu 'Istrazivacki nuklearni reaktor RA' za 1987. godinu, koji finansira republicka zajednica za nauku SR Srbije po ugovoru br. 3509/1 sastoji se iz dva dela. Prvi deo obuhvata pogon i odrzavanje nuklearnog reaktora RA, sto predstavlja obavezu Odeljenja za reaktorski inzenjering u sastavu OOUR Instituta za multidisciplinarna istrazivanja i inzenjering RA. Drugi deo obuhvata poslove zastite od zracenja na reaktoru RA, sto predstavlja obavezu OOUR Instituta za zastitu od zracenja 'Zastita'. Naucno vece Instituta za multidisciplinarna istrazivanja i inzenjjring RA ocenilo je da sadrzina ovog izvestaja odgovara izvrsenim poslovima na reaktoru RA u 1989. godini. Pozitivno se ocenjuje obim i kvalitet izvrsenih radova kako u pogledu odrzavanja i rekonstrukcije reaktora, tako i u pogledu poslova zastite od zracenja izvrsenih kod njega.

  20. Transfer of 226Ra, 228Ra, 210Pb and 210Po in aquatic organisms and food chain

    International Nuclear Information System (INIS)

    Yang Xiaotong; Weng Detong; Chen Wenyin; Chen Xiuyun; Chen Jixi; Zhao Shimin

    1998-01-01

    Objective: To find out the transfer regularities of 226 Ra, 228 Ra, 210 Pb and 210 Po, which are natural radionuclides in the aquatic organisms and food chain. Methods: Large amount of breed of representative aquatic products and their living waters and sediments were collected and treated according to routine experimental procedures. The contents of 226 Ra, 228 Ra, 210 Pb and 210 Po were detected in each sample. Measured data were analyzed statistically and pairwise comparisons were made to determine the differences between groups. Results: 226 Ra, 228 Ra and 210 Pb were mainly deposited in the bones (or shells), their concentration factors (CF) ranged from 10 2 to 10 3 ; the CF ranged only from 10 0 to 10 2 in the flesh. 210 Po was mainly deposited in the soft tissues, CF ranged from 10 2 to 10 4 ; especially in the stomachs and intestines of fishes, the value reached 10 4 . The cooking process did not impinge significantly on the transfer of 226 Ra, 228 Ra and 210 Pb in the food chain (P>0.05), but did significantly influence the transfer of 210 Po, especially in the freshwater fishes and shrimps. Paired comparison test of the activities between raw flesh and cooked flesh showed very significant difference (P 226 Ra, 228 Ra, 210 Pb and 210 Po. Even though the bones (or shells) of aquatic organisms contained relatively higher levels of 226 Ra, 228 Ra and 210 Pb, the cooking process does not significantly increase the radioactive contents in the foodstuffs. However, the cooking process does significantly influence the transfer of 210 Po. It does significantly increase the content of 210 Po in foodstuffs

  1. Raça, cor e etnia em estudos epidemiológicos sobre populações brasileiras: revisão sistemática na base PubMed Race, color and ethnicity in epidemiologic studies carried out with Brazilian populations: systematic review on the PubMed database

    Directory of Open Access Journals (Sweden)

    Juliana Fernandes Kabad

    2012-01-01

    Full Text Available O objetivo foi analisar o uso das variáveis raça, cor e etnia em estudos epidemiológicos sobre populações brasileiras. Trata-se de revisão sistemática, conduzida na base PubMed,entre janeiro de 2000 e julho de 2010. Para o conjunto dos trabalhos revisados, aplicou-se ficha com questões sobre seus objetivos e a relevância da classificação étnico-racial em suas análises, características sócio-demográficas e aspectos da identificação étnico-racial das populações investigadas, bem como o seguimento de recomendações quanto ao uso das classificações de raça, cor e etnia. Dos 1.174 artigos identificados, 151 foram elegíveis para a revisão. Maiores proporções de cada um dos seguintes aspectos foram observadas nos artigos em que a identificação étnico-racial ocupou papel central em suas análises - destes, 18% justificaram o emprego das categorias; 16% consideraram a classificação étnico-racial como fluida e relativa ao contexto da produção dos dados; 65% descreveram o método da classificação étnico-racial; 17% entenderam esta classificação como medida de variabilidade genética; 26% interpretaram a variável como fator de risco para o desfecho em questão; 47% consideraram fatores socioeconômicos na interpretação das desigualdades étnico-raciais; e 27% incluíram tais fatores no ajuste de modelos estatísticos. Apenas dois estudos explicitaram o conceito, que embasou o uso da variável étnico-racial. Uma proporção expressiva dos estudos epidemiológicos analisados não segue os critérios mínimos que vêm sendo sugeridos quanto ao uso de variáveis relacionadas à classificação étnico-racial, de modo que este aspecto deve ser aperfeiçoado nas pesquisas em Saúde Coletiva.This paper aims to analyze the use of the variables race, color and ethnicity in epidemiologic studies, carried out with Brazilian populations. This is a systematic review, conducted in the PubMed bibliographic database, on papers

  2. A structural equation model of patient-healthcare provider relationships and HIV-infected patient outcomes in Chinese populations.

    Science.gov (United States)

    Chen, Wei-Ti; Shiu, Chengshi; Yang, Joyce P; Chuang, Peing; Zhang, Lin; Bao, Meijuan; Lu, Hongzhou

    2018-03-01

    Obtaining maximum antiretroviral therapy (ART) adherence is critical for maintaining a high CD4 count and strong immune function in PLWHA. Key factors for achieving optimum adherence include good medication self-efficacy, decreased medication-taking difficulties, and positive patient-healthcare provider (HCP) relationships. Limited studies have analyzed the correlation of these factors and ART adherence in Chinese population. In this paper, structural equation modeling was performed to assess the proposed model of relations between patient-HCP relationships and adherence. Audio Computer-Assisted Self-Interview (ACASI) software was used to collect data on ART adherence and patient variables among 227 PLWHA in Shanghai and Taipei. Participants completed a one-time 60-minute ACASI survey that consisted of standardized measures to assess demographics, recent CD4 counts, self-efficacy, patient-HCP relationship, adherence, and medication-taking difficulties. The data shown the relationship between patient-HCP relationships and adherence was significantly consistent with mediation by medication self-efficacy. However, patient-HCP interaction did not directly influence medication-taking difficulties, and medication-taking difficulties did not significantly affect CD4 counts. Furthermore, patient-HCP interactions did not directly impact CD4 counts; rather, the relation was consistent with mediation (by either better medication self-efficacy or better adherence) or by improved adherence alone. Future interventions should be designed to enhance self-management and provide better patient-HCP communication. This improved communication will enhance medication self-efficacy and decrease medication-taking difficulties. This in turn will improve medication adherence and immune function among PLWHA.

  3. Separation of Ra/Ca by ion exchange; Separacion de Ra/Ca por intercambio ionico

    Energy Technology Data Exchange (ETDEWEB)

    Iturbe, J L; Jimenez R, M; Flores M, J

    1991-04-15

    The radium and the calcium belong to the same group in the periodic classification and as consequence both they present very similar chemical properties, that makes difficult its separation. Both elements are also frequently associate in the nature, the calcium is very abundant, the radium is not it and for that reason it is indispensable its separation to analyze to this last one. The alpha spectroscopy is very appropriate to analyze to the {sup 226} Ra, however to achieve a good resolution of the spectra, the samples should contain small quantities of calcium. The purposes of this work were to know the chromatographic behavior of the alkaline-earthy cations: calcium, barium and radium and to apply these knowledge to the separation of the {sup 226} Ra and its analysis by means of alpha spectroscopy. (Author)

  4. RA Research reactor, Part 1, Operation and maintenance of the RA nuclear reactor for 1986

    International Nuclear Information System (INIS)

    Sotic, O.; Martinc, R.; Cupac, S.; Sulem, B.; Badrljica, R.; Majstorovic, D.; Sanovic, V.

    1986-01-01

    In order to enable future reliable operation of the RA reactor, according to new licensing regulations, three major tasks started in 1984 were fulfilled: building of the new emergency system, reconstruction of the existing ventilation system, and reconstruction of the power supply system. Simultaneously in 1985/1986 renewal of the instrumentation and reconstruction of the system for handling and storage of the spent fuel in the reactor building have started. Design projects for these tasks are almost finished and the reconstruction of both systems is expected to be finished until 1988 and mid 1989 respectively. RA reactor Safety report was finished according to the recommendations of the IAEA. Investments in 1986 were used for 8000 kg of heavy water, maintenance of reactor systems and supply of new components, reconstruction of reactor systems. This report includes 8 annexes concerning reactor operation, activities of services and financial issues [sr

  5. Patient and population doses of x-ray diagnostics in Finland

    Energy Technology Data Exchange (ETDEWEB)

    Rannikko, S; Karila, K T.K.; Toivonen, M

    1997-09-01

    Periodic surveys of patient and population doses are important because of the large contribution of x-ray diagnostics to the artificial population dose. Measured entrance surface doses and dose-area products are the main quantities used for monitoring patient doses in hospitals, and most population dose studies have been derived from these quantities and from the frequences of x-ray examinations. This study is based on the radiation, exposure geometry, and patient parameters recorded by experienced radiographers and postgraduated students. The software used in the work (ODS-60 of Rados Technology) suits the determination of effective and organ doses from such detailed data using a human-like patient phantom which can be adapted for sex and size. The program, together with the very detailed input data, made it possible to determine organ equivalent and effective doses for complicated dynamic x-ray examinations and interventions in more detail than in previous studies. Collective organ and effective doses were derived for 50 examination types. The annual collective dose from diagnostic x-ray examinations in 1994 was 0.5 mSv per capita in Finland. The five groups of examinations or examinations that had greatest contributions to the collective dose were CT, barium enema: double contrast, lumbar spine, carotid angiography, and intestinal transit. Together they represented for about 60 % of the total dose. The highest dose-area products (about 2000 Gy cm{sup 2}) were obtained from certain angiographic and interventional examinations. A literature survey showed that Finland patient doses are at the same average level as in other countries of a high standard of health care. (orig.). 125 refs.

  6. Patient and population doses of x-ray diagnostics in Finland

    International Nuclear Information System (INIS)

    Rannikko, S.; Karila, K.T.K.; Toivonen, M.

    1997-09-01

    Periodic surveys of patient and population doses are important because of the large contribution of x-ray diagnostics to the artificial population dose. Measured entrance surface doses and dose-area products are the main quantities used for monitoring patient doses in hospitals, and most population dose studies have been derived from these quantities and from the frequences of x-ray examinations. This study is based on the radiation, exposure geometry, and patient parameters recorded by experienced radiographers and postgraduated students. The software used in the work (ODS-60 of Rados Technology) suits the determination of effective and organ doses from such detailed data using a human-like patient phantom which can be adapted for sex and size. The program, together with the very detailed input data, made it possible to determine organ equivalent and effective doses for complicated dynamic x-ray examinations and interventions in more detail than in previous studies. Collective organ and effective doses were derived for 50 examination types. The annual collective dose from diagnostic x-ray examinations in 1994 was 0.5 mSv per capita in Finland. The five groups of examinations or examinations that had greatest contributions to the collective dose were CT, barium enema: double contrast, lumbar spine, carotid angiography, and intestinal transit. Together they represented for about 60 % of the total dose. The highest dose-area products (about 2000 Gy cm 2 ) were obtained from certain angiographic and interventional examinations. A literature survey showed that Finland patient doses are at the same average level as in other countries of a high standard of health care. (orig.)

  7. Diagrams about RA reactor operation, Annex 7; Prilog 7 - Rad reaktora RA po godinama - dijagrami

    Energy Technology Data Exchange (ETDEWEB)

    Martinc, R [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1976-01-15

    This Annex 7 includes diagrams about RA reactor operation (MWh) from 1960-1975; mean values of reactor power per day and month in 1975, and percent of utilisation of experimental space during 1975. [Serbo-Croat] Ovaj prilog sadrzi dijagrame o radu reaktora (MWh) po godinama (1960-1975); srednje vrednosti dnevne snage reaktora u 1975. godini; rad reakrora (MWh) po mesecima u 1975; procenat iskoriscenja eksperimentalnog prostora u 1975. godini.

  8. RA Reactor operation and maintenance (I-IX), Part IV, Task 3.08/04, Refurbishment of the RA reactor

    International Nuclear Information System (INIS)

    Zecevic, V.

    1963-12-01

    This volume contains reports describing maintenance and repair work of the RA reactor instrumentation, equipment of the reactor dosimetry control system, and equipment for regulation and control systems

  9. Patients' diets and preferences in a pediatric population with inflammatory bowel disease.

    Science.gov (United States)

    Green, T J; Issenman, R M; Jacobson, K

    1998-01-01

    To determine the dietary practices of the pediatric inflammatory bowel disease population at the Children's Hospital of the Hamilton Health Sciences Corporation and the reported effectiveness of those diets. A questionnaire mailed to 153 pediatric patients was returned by 125 patients (76 Crohn's disease [CD] and 49 ulcerative colitis [UC] patients)--an 82% response rate. The median age of respondents was 13 years, and 62% were male. Ninety per cent and 71% of CD and UC patients, respectively, had changed their diets since diagnosis. Caloric supplements (eg, BOOST [Mead Johnson Nutritionals]), sole source nutrition, low fibre and lactose-free diets were used by more than 15% of CD patients, whereas lactose-free, nonspicy, low acid, additive-free, caloric supplement and low fibre diets were used by more than 15% of UC patients. A diet supplement was more commonly used in CD patients (P juice. A benefit was reported for 103 of 141 reported diets, with the most commonly alleviated symptoms being abdominal pain, diarrhea and flatulence. Many children with inflammatory bowel disease have altered their diets to manage their disease and have attributed symptomatic relief to these diets.

  10. Plasma and erythrocyte membrane phospholipids and fatty acids in Italian general population and hemodialysis patients.

    Science.gov (United States)

    Dessì, Mariarita; Noce, Annalisa; Bertucci, Pierfrancesco; Noce, Gianluca; Rizza, Stefano; De Stefano, Alessandro; Manca di Villahermosa, Simone; Bernardini, Sergio; De Lorenzo, Antonino; Di Daniele, Nicola

    2014-03-21

    Dyslipidemia and abnormal phospholipid metabolism are frequent in uremic patients and increase their risk of cardiovascular disease (CVD): ω-3 polyunsaturated fatty acids (PUFAs) may reduce this risk in the general population. In this study we compared the plasma and erythrocyte cell membrane composition of PUFAs in a group of Caucasian hemodialysis (HD) patients and in a control group of healthy subjects and evaluated the erythrocyte/cell membrane fatty acid ratio as a marker of the dietary intake of phospholipids. The relationship between ω-3 and ω-6 fatty acids and the possible differences in PUFAs concentrations were also investigated. After obtaining a fully informed consent, a total of ninety-nine HD patients and 160 non uremic control subjects from "Tor Vergata" University Hospital were enrolled into the study. None of them took antioxidant drugs or dietary supplements for at least 90 days prior to the observation. Blood samples were analysed by gas-chromatographic coupled to a mass spectrometric detector.The daily intake of total calories, proteins, lipids and carbohydrates is significantly lower in HD patients than in controls (p HD patients (p HD patients, due to the removal of nutrients during the dialysis and to persistent malnutrition. A dietary treatment addressed to increase plasma ω-3 PUFAs and to optimize ω-6/ω-3 ratio may exert a protective action and reduce the risk of CVD in HD patient.

  11. Evaluating screening colonoscopy quality in an uninsured urban population following patient navigation

    Directory of Open Access Journals (Sweden)

    Keith Naylor

    2017-03-01

    Full Text Available Patient navigation (PN increases screening colonoscopy completion in minority and uninsured populations. However, colonoscopy quality is under-reported in the setting of PN and quality indicators have often failed to meet benchmark standards. This study investigated screening colonoscopy quality indicators after year-one of a PN initiative targeting the medically uninsured. This was a retrospective analysis of 296 outpatient screening colonoscopies. Patients were 45 to 75 years of age with no history of bowel cancer, inflammatory bowel disease, or colorectal surgery. The screening colonoscopy quality indicators: adenoma detection rate (ADR, cecal intubation rate (CIR, and bowel preparation quality were compared in 89 uninsured Federally Qualified Health Center (FQHC patients who received PN and 207 University Hospital patients who received usual care. The FQHC PN and University Hospital cohorts were similar in female sex (69% vs. 70%; p = 0.861 and African American race (61% vs. 61%; p = 0.920. The FQHC PN cohort was younger (57 years vs. 60 years; p < 0.001. There was no difference in ADR (33% vs. 32%; p = 0.971 or CIR (96% vs. 95%; p = 0.900 comparing the FQHC PN and University Hospital cohorts. The FQHC PN patients had a greater likelihood of an optimal bowel preparation on multivariate logistic regression (odds ratio 4.17; 95% confidence interval 1.07 to 16.20. Uninsured FQHC patients who received PN were observed to have intra-procedure quality indicators that exceeded bench-mark standards for high-quality screening colonoscopy and were equivalent to those observed in an insured University Hospital patient population.

  12. Risk of Nongenitourinary Cancers in Patients With Spinal Cord Injury: A Population-based Cohort Study.

    Science.gov (United States)

    Kao, Chia-Hong; Sun, Li-Min; Chen, Yueh-Sheng; Lin, Cheng-Li; Liang, Ji-An; Kao, Chia-Hung; Weng, Ming-Wei

    2016-01-01

    Little information is available regarding the risk of nongenitourinary (GU) cancers in patients with spinal cord injury (SCI). The authors conducted a nationwide population-based study to investigate whether a higher risk of non-GU cancer is seen among patients with SCI.Data retrieved from the National Health Insurance Research Database of Taiwan were used in this study. A total of 41,900 patients diagnosed with SCI between 2000 and 2011 were identified from the National Health Insurance Research Database and comprised the SCI cohort. Each of these patients was randomly frequency matched with 4 people from the general population (without SCI) according to age, sex, comorbidities, and index year. Cox proportional hazards regression analysis was used to calculate adjusted hazard ratios and 95% confidence intervals and determine how SCI affected non-GU cancer risk.No significant difference in overall non-GU cancer risk was observed between the SCI and control groups. The patients with SCI exhibited a significantly higher risk of developing esophageal, liver, and hematologic malignancies compared with those without SCI. By contrast, the SCI cohort had a significantly lower risk of colorectal cancer compared with the non-SCI cohort (adjusted hazard ratio = 0.80, 95% confidence interval = 0.69-0.93). Additional stratified analyses by sex, age, and follow-up duration revealed various correlations between SCI and non-GU cancer risk.The patients with SCI exhibited higher risk of esophageal, liver, and hematologic malignancies but a lower risk of colorectal cancer compared with those without SCI. The diverse patterns of cancer risk among the patients with SCI may be related to the complications of chronic SCI.

  13. Morbidity and medicine prescriptions in a nationwide Danish population of patients diagnosed with polycystic ovary syndrome.

    Science.gov (United States)

    Glintborg, Dorte; Hass Rubin, Katrine; Nybo, Mads; Abrahamsen, Bo; Andersen, Marianne

    2015-05-01

    The prevalence of type 2 diabetes is increased in polycystic ovary syndrome (PCOS), but the prevalence of other diseases is not clarified. We aimed to investigate morbidity and medicine prescriptions in PCOS. A National Register-based study. Patients with PCOS (PCOS Denmark and an embedded cohort; PCOS Odense University Hospital (OUH)) and one control population. Premenopausal women with PCOS underwent clinical and biochemical examination (PCOS OUH, n=1217). PCOS Denmark (n=19 199) included women with PCOS in the Danish National Patient Register. Three age-matched controls were included per patient (n=57 483). Diagnosis codes and filled prescriptions. The mean (range) age of the PCOS Denmark group and controls was 30.6 (12-60) years. Patients in PCOS Denmark had higher Charlson index, higher prevalence of diabetes, dyslipidemia, and hypertension than controls. PCOS was associated with a two times increased risk of stroke and thrombosis, whereas the risk of other cardiovascular diseases was not increased. Thyroid disease, asthma, migraine, and depression were more prevalent in PCOS Denmark vs controls, whereas fractures were rarer. Infertility was increased in patients compared with controls, but the mean number of births was higher in PCOS. Medicine prescriptions within all diagnosis areas were significantly higher in PCOS patients than in controls.In PCOS OUH, polycystic ovaries (PCO) and irregular menses were associated with a more adverse metabolic risk profile, but individual Rotterdam criteria were not associated with cardiometabolic diagnoses. Cardiometabolic and psychiatric morbidity were significantly increased in a Danish population with PCOS. Medical diseases are frequent also in young patients with PCOS. © 2015 European Society of Endocrinology.

  14. Rheumatoid factor testing in Spanish primary care: A population-based cohort study including 4.8 million subjects and almost half a million measurements.

    Science.gov (United States)

    Morsley, Klara; Miller, Anne; Luqmani, Raashid; Fina-Aviles, Francesc; Javaid, Muhammad Kassim; Edwards, Christopher J; Pinedo-Villanueva, Rafael; Medina, Manuel; Calero, Sebastian; Cooper, Cyrus; Arden, Nigel; Prieto-Alhambra, Daniel

    2018-02-26

    Rheumatoid factor (RF) testing is used in primary care in the diagnosis of rheumatoid arthritis (RA); however a positive RF may occur without RA. Incorrect use of RF testing may lead to increased costs and delayed diagnoses. The aim was to assess the performance of RF as a test for RA and to estimate the costs associated with its use in a primary care setting. A retrospective cohort study using the Information System for the Development of Research in Primary Care database (contains primary care records and laboratory results of >80% of the Catalonian population, Spain). Participants were patients ≥18 years with ≥1 RF test performed between 01/01/2006 and 31/12/2011, without a pre-existing diagnosis of RA. Outcome measures were an incident diagnosis of RA within 1 year of testing, and the cost of testing per case of RA. 495,434/4,796,498 (10.3%) patients were tested at least once. 107,362 (21.7%) of those tested were sero-positive of which 2768 (2.6%) were diagnosed with RA within 1 year as were 1141/388,072 (0.3%) sero-negative participants. The sensitivity of RF was 70.8% (95% CI 69.4-72.2), specificity 78.7% (78.6-78.8), and positive and negative predictive values 2.6% (2.5-2.7) and 99.7% (99.6-99.7) respectively. Approximately €3,963,472 was spent, with a cost of €1432 per true positive case. Although 10% of patients were tested for RF, most did not have RA. Limiting testing to patients with a higher pre-test probability would significantly reduce the cost of testing. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  15. Determination of the four natural Ra isotopes in thermal waters by gamma-ray spectrometry

    International Nuclear Information System (INIS)

    Condomines, M.; Rihs, S.; Lloret, E.; Seidel, J.L.

    2010-01-01

    Our method for the simultaneous determination of the four natural Ra isotopes ( 226 Ra, 228 Ra, 224 Ra and 223 Ra) in thermal waters involves a separation of Ra on a selective filter (3 M EMPORE TM Radium Rad disk), and a single counting using a broad-energy HPGe detector (BE Ge manufactured by CANBERRA TM ). The calculation of 223 Ra and 228 Ra activities requires interference and cascade summing corrections. The 226 Ra activities in CO 2 -rich thermal waters of the Lodeve Basin (South of France) range from 530 to 2240 mBq/l. The low ( 228 Ra/ 226 Ra) activity ratios (0.19-0.29) suggest that Ra is mostly derived from the aquifer carbonates. The short-lived 224 Ra and 223 Ra are probably added to the water through recoil or desorption processes from Th-enriched coatings on the fracture walls.

  16. Determination of 226Ra and 224Ra in sediments samples by liquid scintillation counting

    International Nuclear Information System (INIS)

    Villa, M.; Moreno, H.P.; Manjon, G.

    2005-01-01

    An experimental procedure has been developed for a rapid determination of the activity concentration of 226 Ra and 224 Ra in sediments by liquid scintillation counting. The importance of the method lies in its application to the measurement of sediments where the Ra-isotopes activity concentration has been increased due to an anthropomorphic enhancement based on releases of naturally occurring radioactive material (NORM). A sample pre-treatment, including a digestion with aqua regia and a precipitation of hydroxides, was applied to samples before the radium extraction, which was made by co-precipitation with barium. Measurements were done in a low background scintillation spectrometer Quantulus 1220, which can separate and detect simultaneously α and β particles. Additionally, some improvements are suggested for a better α and β interference correction of the results. The obtaining of radiochemical yields is also improved using 133 Ba as tracer, which decays by emission of conversion electrons and γ-rays; the wide range of radiochemical yields obtained confirms the need of this analyses. The procedure has been applied to the measurement of riverbed sediments from an estuary in the south-west of Spain, affected in the past by direct and indirect phosphogypsum discharges

  17. RA Research nuclear reactor, Part I - RA nuclear reactor operation, maintenance and utilization in 1983

    International Nuclear Information System (INIS)

    Sotic, O.; Martinc, R.; Kozomara-Maic, S.; Cupac, S.; Raickovic, N.; Radivojevic, J.; Badrljica, R.; Majstorovic, D.; Sanovic, V.

    1983-12-01

    After regular shutdown in November 1982, inspection of the fuel elements from the RA reactor core which was done from December 1982 - February 1983 has shown that there are deposits of aluminium oxides on the surface of the fuel cladding. After restart The RA reactor was operated at power levels from 1.8 - 2 MW, with 80% enriched uranium dioxide fuel elements. It was found that there was no corrosion of the fuel element cladding and that it was not possible to find the cause of surface deposition on the cladding surfaces without further operation. It was decided to purify the heavy water permanently during operation and to increase the heavy water flow by operating two pumps. This procedure was adopted in order to decrease the possibility of corrosion. The Safety committee of the Institute has approved this procedure for operating the RA reactor in 1983. The core was made of 80% enriched fuel, critical experiments were done until June 1983, and after that the operation was continued at power levels up to 2 MW [sr

  18. Risk of developing depressive disorders following rheumatoid arthritis: a nationwide population-based study.

    Directory of Open Access Journals (Sweden)

    Shu-Li Wang

    Full Text Available BACKGROUND & AIMS: To evaluate the risk of depressive disorders among rheumatoid arthritis (RA by using the Taiwan National Health Insurance Research Database (NHIRD. METHODS: We conducted a retrospective study of a matched cohort of 18 285 participants (3 657 RA patients and 14 628 control patients who were selected from the NHIRD. Patients were observed for a maximum of 10 years to determine the rates of newly diagnosed depressive disorders, and Cox regression was used to identify the risk factors associated with depressive disorders in RA patients. RESULTS: During the 10-year follow-up period, 205 (11.2 per 1000 person-years RA patients and 384 (5.1 per 1000 person-years control patients were diagnosed with depressive disorders. In RA patients, most depressive disorders (n = 163, 80% developed with five years of being diagnosed with RA. The incidence risk ratio of depressive disorders between RA patients and control patients was 2.20 (95% confidence interval [CI], 1.84-2.61, P<.001. After adjusting for age, sex, and comorbidities, RA patients were 2.06 times more likely to develop depressive disorders (95% CI, 1.73-2.44, P<.001 compared with the control patients. Hyperthyroidism (HR = 1.67 was an independent risk factor for depressive disorders in patients with RA. CONCLUSIONS: The likelihood of developing depressive disorders is greater among RA patients than among patients without RA. Symptoms of depression should be sought in patients with RA.

  19. Neuropathy-specific alterations in a Mexican population of diabetic patients.

    Science.gov (United States)

    Carbajal-Ramírez, Angélica; García-Macedo, Rebeca; Díaz-García, Carlos Manlio; Sanchez-Soto, Carmen; Padrón, Araceli Méndez; de la Peña, Jorge Escobedo; Cruz, Miguel; Hiriart, Marcia

    2017-08-25

    Neuropathy is one of the major complications of type 2 diabetes mellitus. Our first aim was to determine the clinical characteristics of a population of diabetic patients with different types of neuropathy. Our next goal was to characterize the cytokine profile (IL-6 and IL-10), nerve growth factor (NGF) and circulating cell-adhesion molecules in these patients. Finally, we aimed to compare the renal function among the groups of neuropathic patients. In a cross-sectional study, we included 217 diabetic patients classified in three groups: sensory polyneuropathy with hypoesthesia (DS h P) or hyperesthesia (DS H P), and motor neuropathy (DMN). Two control groups were included: one of 26 diabetic non-neuropathic patients (DNN), and the other of 375 non-diabetic (ND) healthy subjects. The participants were attending to the Mexican Institute of Social Security. The circulating levels of NGF were significantly lower in diabetic patients, compared to healthy subjects. The range of IL-6 and IL-10 levels in neuropathic patients was higher than the control groups; however, several samples yielded null measurements. Neuropathic patients also showed increased circulating levels of the adhesion molecules ICAM, VCAM, and E-Selectin, compared to the ND group. Moreover, neuropathic patients showed reduced glomerular filtration rates compared to healthy subjects (82-103 ml/min per 1.73 m 2 , data as range from 25th-75th percentiles), especially in the group with DMN (45-76 ml/min per 1.73 m 2 ). Some particular alterations in neuropathic patients included -but were not limited to- changes in circulating NGF, cell adhesion molecules, inflammation, and the worsening of the renal function. This study supports the need for further clinical surveillance and interventions considering a neuropathy-related basis.

  20. Intake of 226Ra, 210Pb and 210Po with food in Poland

    International Nuclear Information System (INIS)

    Pietrzak-Flis, Z.; Chrzanowski, E.; Dembinska, S.

    1997-01-01

    Intake with food and water of 226 Ra, 210 Pb and 210 Po was determined for an adult population in regions of central, northern and northeastern Poland. The content of radionuclides was determined in the daily diet and, in the central region, also in foodstuffs and drinking water. The annual intake with foodstuffs was estimated on the basis of their average annual consumption. The 226 Ra intake in northeastern Poland was approximately 17% higher than the overall average, correlating well with the higher concentration of this radionuclide in the soil. The 210 Po/ 210 Pb ratio was close to unity in the continental regions, whereas at the Baltic Sea coast it was approximately 1.5. The latter value can be ascribed to a larger consumption of fish for which the 210 Po/ 210 Pb ratio was found to be approximately 10. In central Poland the largest intake of 226 Ra was with flour and vegetables (contribution approx. 60%), the largest intake of 210 Pb was with flour and meat (approx. 50%) and the largest intake of 210 Po was with fish (approx. 34%). From the intake and dose coefficient, annual effective doses were calculated. The dose from 210 Pb and 210 Po was approx. 54 μSv year -1 , and the dose from 226 Ra was approx. 4 μSv year -1

  1. "Community vital signs": incorporating geocoded social determinants into electronic records to promote patient and population health.

    Science.gov (United States)

    Bazemore, Andrew W; Cottrell, Erika K; Gold, Rachel; Hughes, Lauren S; Phillips, Robert L; Angier, Heather; Burdick, Timothy E; Carrozza, Mark A; DeVoe, Jennifer E

    2016-03-01

    Social determinants of health significantly impact morbidity and mortality; however, physicians lack ready access to this information in patient care and population management. Just as traditional vital signs give providers a biometric assessment of any patient, "community vital signs" (Community VS) can provide an aggregated overview of the social and environmental factors impacting patient health. Knowing Community VS could inform clinical recommendations for individual patients, facilitate referrals to community services, and expand understanding of factors impacting treatment adherence and health outcomes. This information could also help care teams target disease prevention initiatives and other health improvement efforts for clinic panels and populations. Given the proliferation of big data, geospatial technologies, and democratization of data, the time has come to integrate Community VS into the electronic health record (EHR). Here, the authors describe (i) historical precedent for this concept, (ii) opportunities to expand upon these historical foundations, and (iii) a novel approach to EHR integration. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Clinical validity of a population database definition of remission in patients with major depression.

    Science.gov (United States)

    Sicras-Mainar, Antoni; Blanca-Tamayo, Milagrosa; Gutiérrez-Nicuesa, Laura; Salvatella-Pasant, Jordi; Navarro-Artieda, Ruth

    2010-02-11

    Major depression (MD) is one of the most frequent diagnoses in Primary Care. It is a disabling illness that increases the use of health resources. To describe the concordance between remission according to clinical assessment and remission obtained from the computerized prescription databases of patients with MD in a Spanish population. multicenter cross-sectional. The population under study was comprised of people from six primary care facilities, who had a MD episode between January 2003 and March 2007. A specialist in psychiatry assessed a random sample of patient histories and determined whether a certain patient was in remission according to clinical criteria (ICPC-2). Regarding the databases, patients were considered in remission when they did not need further prescriptions of AD for at least 6 months after completing treatment for a new episode. Validity indicators (sensitivity [S], specificity [Sp]) and clinical utility (positive and negative probability ratio [PPR] and [NPR]) were calculated. The concordance index was established using Cohen's kappa coefficient. Significance level was p Reliability analysis: Cronbach's alpha: 90.6% (CI was 95%: 85.6 - 95.6%). Results show an acceptable level of concordance between remission obtained from the computerized databases and clinical criteria. The major discrepancies were found in diagnostic accuracy.

  3. Cognitive profile of patients with burning mouth syndrome in the Japanese population.

    Science.gov (United States)

    Matsuoka, Hirofumi; Himachi, Mika; Furukawa, Hirokazu; Kobayashi, Shiho; Shoki, Harumi; Motoya, Ryo; Saito, Masato; Abiko, Yoshihiro; Sakano, Yuji

    2010-07-01

    The present study investigated which cognitive characteristics, including cancer phobia, self-efficacy, pain-related catastrophizing, and anxiety sensitivity, affect burning mouth syndrome (BMS) symptoms in the Japanese population. A total of 46 BMS patients (44 women and 2 men; mean age, 59.98 +/- 9.57 years; range, 30-79 years) completed a battery of questionnaires, including measures of pain severity, oral-related quality of life (QOL), stress-response, pain-related catastrophizing, self-efficacy, anxiety sensitivity, and tongue cancer phobia. The Pain Catastrophizing Scale (PCS), General Self-Efficacy Scale (GSES), and Anxiety Sensitivity Index (ASI) scores in the BMS patients were compared with the scores of Japanese healthy participants (PCS, n = 449; GSES, n = 278; ASI, n = 9603) reported in previous studies. Catastrophizing and anxiety sensitivity were significantly higher in the BMS patients than in the healthy subjects (P disability, social disability, and handicap. Cancer phobia was significantly correlated with psychological disability and handicap. Since catastrophizing showed a higher correlation with BMS symptoms than cancer phobia, catastrophizing might be a more significant cognitive factor affecting symptoms than cancer phobia in BMS patients in the Japanese population.

  4. Gender, body mass index and rheumatoid arthritis disease activity: results from the QUEST-RA Study.

    Science.gov (United States)

    Jawaheer, D; Olsen, J; Lahiff, M; Forsberg, S; Lähteenmäki, J; da Silveira, I G; Rocha, F A; Magalhães Laurindo, I M; Henrique da Mota, L M; Drosos, A A; Murphy, E; Sheehy, C; Quirke, E; Cutolo, M; Rexhepi, S; Dadoniene, J; Verstappen, S M M; Sokka, T

    2010-01-01

    To investigate whether body mass index (BMI), as a proxy for body fat, influences rheumatoid arthritis (RA) disease activity in a gender-specific manner. Consecutive patients with RA were enrolled from 25 countries into the QUEST-RA program between 2005 and 2008. Clinical and demographic data were collected by treating rheumatologists and by patient self-report. Distributions of Disease Activity Scores (DAS28), BMI, age, and disease duration were assessed for each country and for the entire dataset; mean values between genders were compared using Student's t-tests. An association between BMI and DAS28 was investigated using linear regression, adjusting for age, disease duration and country. A total of 5,161 RA patients (4,082 women and 1,079 men) were included in the analyses. Overall, women were younger, had longer disease duration, and higher DAS28 scores than men, but BMI was similar between genders. The mean DAS28 scores increased with increasing BMI from normal to overweight and obese, among women, whereas the opposite trend was observed among men. Regression results showed BMI (continuous or categorical) to be associated with DAS28. Compared to the normal BMI range, being obese was associated with a larger difference in mean DAS28 (0.23, 95% CI: 0.11, 0.34) than being overweight (0.12, 95% CI: 0.03, 0.21); being underweight was not associated with disease activity. These associations were more pronounced among women, and were not explained by any single component of the DAS28. BMI appears to be associated with RA disease activity in women, but not in men.

  5. RAPIDARC (RA) in the uterine cervical cancer; dosimetric gain vs 3D-Crt

    International Nuclear Information System (INIS)

    Ramirez, J.; Garcia, B.; Quispe, K.; Gonzales, A.; Marquina, J.

    2014-08-01

    This work aims to quantitatively assess RAPIDARC (RA) treatments versus three dimensional-Conformal Radiation Therapy with field to field technique (3D-Crt-Fin F). 11 patients with cervical cancer treated at our institution radically or adjuvant clinical stages I-III B were evaluated. The prescribed dose was 50 Gy (2 Gy / Fr). The RA plans consisted of two isocentric complete arcs and conformational plans of 4 isocentric fields (previous, subsequent, right side and left side) with 3D-Crt-Fin F technique; both cases carried out ??in the Eclipse version 10 planner with calculation algorithm analytical anisotropic algorithm (AAA) and volumetric optimization software (for VMAT plans). Homogeneity indices (Hi), conformity indices (CI) Sigma indices (S-Index), monitor units (MU) and the time required for each treatment were compared. The mean age was 52 years (32-65) of the 11 patients 9 were clinical stages I-II B. The Hi varied from 0.052 for RA to 0.163 for 3D-Crt-Fin F (p = 0.009), and the CI between 1.005 and 1.35 (p = 0.26), the S-index from 1.2 to 3.7 (p = 0.001) and the H-index of 1.08 to 1.15 (p = 0.24). All dose limits in risk organs were met with a significant difference in the RA plans versus 3D-Crt-Fin F. In patients with cervical cancer the treatment plans quality with the indices aforementioned seems to be better with the RA technique, being observed a significant reduction of radiation to surrounding organs. (author)

  6. Association Study for 26 Candidate Loci in Idiopathic Pulmonary Fibrosis Patients from Four European Populations

    Directory of Open Access Journals (Sweden)

    Amit Kishore

    2016-07-01

    Full Text Available Idiopathic pulmonary fibrosis (IPF affects lung parenchyma with progressing fibrosis. In this study, we aimed to replicate MUC5B rs35705950 variants and determine new plausible candidate variants for IPF among four different European populations. We genotyped 26 IPF candidate loci in 165 IPF patients from four European countries: Czech Republic (n = 41, Germany (n = 33, Greece (n = 40, France (n = 51 and performed association study comparing observed variant distribution with this obtained in a genetically similar Czech healthy control population (n = 96 described in our earlier data report. A highly significant association for a promoter variant (rs35705950 of mucin encoding MUC5B gene was observed in all IPF populations, individually and combined [OR (95% CI; p-value as 5.23 (8.94-3.06; 1.80x10-11. Another non-coding variant, rs7934606 in MUC2 was significant among German patients [2.85 (5.05-1.60; 4.03x10-4] and combined European IPF cases [2.18 (3.16-1.50; 3.73x10-5]. The network analysis for these variants indicated gene-gene and gene-phenotype interactions in IPF and lung biology. With replication of MUC5B rs35705950 previously reported in U.S. populations of European descent and indicating other plausible polymorphic variants relevant for IPF, we provide additional reference information for future extended functional and population studies aimed, ideally with inclusion of clinical parameters, at identification of IPF genetic markers.

  7. Invasive Candidiasis in Various Patient Populations: Incorporating Non-Culture Diagnostic Tests into Rational Management Strategies

    Science.gov (United States)

    Clancy, Cornelius J.; Shields, Ryan K.; Nguyen, M. Hong

    2016-01-01

    Mortality rates due to invasive candidiasis remain unacceptably high, in part because the poor sensitivity and slow turn-around time of cultures delay the initiation of antifungal treatment. β-d-glucan (Fungitell) and polymerase chain reaction (PCR)-based (T2Candida) assays are FDA-approved adjuncts to cultures for diagnosing invasive candidiasis, but their clinical roles are unclear. We propose a Bayesian framework for interpreting non-culture test results and developing rational patient management strategies, which considers test performance and types of invasive candidiasis that are most common in various patient populations. β-d-glucan sensitivity/specificity for candidemia and intra-abdominal candidiasis is ~80%/80% and ~60%/75%, respectively. In settings with 1%–10% likelihood of candidemia, anticipated β-d-glucan positive and negative predictive values are ~4%–31% and ≥97%, respectively. Corresponding values in settings with 3%–30% likelihood of intra-abdominal candidiasis are ~7%–51% and ~78%–98%. β-d-glucan is predicted to be useful in guiding antifungal treatment for wide ranges of populations at-risk for candidemia (incidence ~5%–40%) or intra-abdominal candidiasis (~7%–20%). Validated PCR-based assays should broaden windows to include populations at lower-risk for candidemia (incidence ≥~2%) and higher-risk for intra-abdominal candidiasis (up to ~40%). In the management of individual patients, non-culture tests may also have value outside of these windows. The proposals we put forth are not definitive treatment guidelines, but rather represent starting points for clinical trial design and debate by the infectious diseases community. The principles presented here will be applicable to other assays as they enter the clinic, and to existing assays as more data become available from different populations. PMID:29376927

  8. Coronary artery disease and hypertension in a non-selected spinal cord injury patient population.

    Science.gov (United States)

    Aidinoff, E; Bluvshtein, V; Bierman, U; Gelernter, I; Front, L; Catz, A

    2017-03-01

    Retrospective observational comparative study. The objectives of this study were to assess the atherosclerosis diseases and risk factors prevalence after spinal cored injury (SCI). Loewenstein Rehabilitation Hospital, Israel. Data of 154 traumatic and non-traumatic SCI patients were retrospectively collected. Coronary artery disease (CAD), myocardial infarction (MI), hypertension (HT) and risk factors for atherosclerotic diseases were examined after SCI for prevalence and effects, and compared with published corresponding data of the general population. CAD, MI and HT were found in 11.7, 6.7 and 29.2% of 120 patients, aged 53.4±11.1 years, 83.3% males, who survived until the end of the follow-up. Corresponding values for the general population, adjusted for age, gender and years of education, are 8.5, 6.6 and 24.9% in Israel, and 10.2% for CAD and 40.3% for HT, in US. Body mass index>30 increased the odds of acquiring CAD (P=0.016). Hypercholesterolemia and older age at injury increased the hazard for HT (P=0.044; P=0.019, respectively). A steady partner decreased the risk of CAD (P=0.029). HT was more prevalent at T 4 -T 6 than above T 4 (52 vs 23.3%, P=0.02). Patients with SCI below T 6 had a higher rate of diabetes mellitus, hypercholesterolemia, and past smoking, and fewer years of education than those with SCI above T 7 (P=0.016; P=0.032; P=0.034; P=0.014, respectively). The prevalence of CAD, HT and some of their risk factors after SCI is generally, but not consistently and not statistically significant, slightly higher than in the corresponding general population. The challenge is to reduce the prevalence of atherosclerotic morbidity after SCI below that in the general population.

  9. Invasive Candidiasis in Various Patient Populations: Incorporating Non-Culture Diagnostic Tests into Rational Management Strategies

    Directory of Open Access Journals (Sweden)

    Cornelius J. Clancy

    2016-02-01

    Full Text Available Mortality rates due to invasive candidiasis remain unacceptably high, in part because the poor sensitivity and slow turn-around time of cultures delay the initiation of antifungal treatment. β-d-glucan (Fungitell and polymerase chain reaction (PCR-based (T2Candida assays are FDA-approved adjuncts to cultures for diagnosing invasive candidiasis, but their clinical roles are unclear. We propose a Bayesian framework for interpreting non-culture test results and developing rational patient management strategies, which considers test performance and types of invasive candidiasis that are most common in various patient populations. β-d-glucan sensitivity/specificity for candidemia and intra-abdominal candidiasis is ~80%/80% and ~60%/75%, respectively. In settings with 1%–10% likelihood of candidemia, anticipated β-d-glucan positive and negative predictive values are ~4%–31% and ≥97%, respectively. Corresponding values in settings with 3%–30% likelihood of intra-abdominal candidiasis are ~7%–51% and ~78%–98%. β-d-glucan is predicted to be useful in guiding antifungal treatment for wide ranges of populations at-risk for candidemia (incidence ~5%–40% or intra-abdominal candidiasis (~7%–20%. Validated PCR-based assays should broaden windows to include populations at lower-risk for candidemia (incidence ≥~2% and higher-risk for intra-abdominal candidiasis (up to ~40%. In the management of individual patients, non-culture tests may also have value outside of these windows. The proposals we put forth are not definitive treatment guidelines, but rather represent starting points for clinical trial design and debate by the infectious diseases community. The principles presented here will be applicable to other assays as they enter the clinic, and to existing assays as more data become available from different populations.

  10. Measurements at the RA Reactor related to the VISA-2 project - Part 1, Start-up of the RA reactor and measurement of new RA reactor core parameters

    International Nuclear Information System (INIS)

    Markovic, H.

    1962-07-01

    The objective of the measurements was determining the neutron flux in the RA reactor core. Since the number of fuel channels is increased from 56 to 68 within the VISA-2 project, it was necessary to attain criticality of the RA reactor and measure the neutron flux properties. The 'program of RA reactor start-up' has been prepared separately and it is included in this report. Measurements were divided in two phases. First phase was measuring of the neutron flux after the criticality was achieved but at zero power. During phase two measurements were repeated at several power levels, at equilibrium xenon poisoning. This report includes experimental data of flux distributions and absolute values of the thermal and fast neutron flux in the RA reactor experimental channels and values of cadmium ratio for determining the neutron epithermal flux. Data related to calibration of regulatory rods for cold un poisoned core are included [sr

  11. Mental functioning in patients with rheumatoid arthritis over an eleven years follow-up period: the role of comorbidity

    NARCIS (Netherlands)

    Hoek, van den J.; Roorda, L.D.; Boshuizen, H.C.; Bos, van den G.A.; Hees, van J.; Rupp, I.; Tijhuis, G.; Dekker, J.

    2012-01-01

    Background Mental functioning is reported as an important outcome measure in patients with Rheumatoid Arthritis (RA). Patients show lower mental functioning scores than the general population (1). A factor that has great impact on the overall health outcomes is comorbidity (2). Both somatic and

  12. RA Research reactor, Annual report 1971

    International Nuclear Information System (INIS)

    Milosevic, D. et al.

    1971-12-01

    During 1971, the RA Reactor was operated at nominal power of 6.5 MW for 190 days, and 50 days at lower power levels. Total production mounted to 31606 MWh which is 5.3% higher than planned, and the highest annual level since the reactor started operation. Reactor was used for irradiation and experiments according to the demand of 425 users, of which 370 from the Institute and 55 external users. This report contains detailed data about reactor power and experiments performed in 1971. Discrepancies from the action plan, meaning higher production was achieved in June and December due to special demand of the users. Total number of interruptions was lower than during all the previous years, and were caused mainly due to power cuts during reactor operation. There was no longer interruption caused by failures of the equipment. There was only on scram shutdown during this year caused by a false signal of the reactor control instrumentation. Shorter interruptions resulted from breaking of connectors in the technical water pipe system caused by soil sliding near the pumping station on the Danube. Total personnel exposure dose was lower than during previous years. There was no accident nor any event that could be called accidental. Decontamination od surfaces was less than during previous years. It was concluded that the successful operation in 1971 resulted from efficient work during past years. But, some of the activities were interrupted due to undefined policy concerned with operation of the RA reactor and financial issues. This involves study of the possibility to use highly enriched fuel that would increase the useful neutron flux and the reactor compatibility with similar reactors for the future ten years. Another project that has been interrupted is construction of the emergency core cooling system which is important for the reactor safety. Financial problems have influenced not only the reactor operation but the number of employees, which could cause negative

  13. 226Ra determination in phosphogypsum by alpha-particle spectrometry

    International Nuclear Information System (INIS)

    Aguado, J.L.; Bolivar, J.P.; Garcia-Tenorio, R.

    1999-01-01

    A radiochemical method for 226 Ra determination by alpha-particle spectrometry in environmental samples has been developed in our laboratory. The method has been validated by measurements in samples with known concentrations of this radionuclide and it has been applied in studies related to 226 Ra behaviour in phosphogypsum (the main by-product of producing phosphoric acid from phosphate rocks). (author)

  14. Rheumatoid Arthritis (RA) associated interstitial lung disease (ILD).

    LENUS (Irish Health Repository)

    O'Dwyer, David N

    2013-10-01

    Rheumatoid Arthritis (RA) is the most common Connective Tissue Disease (CTD) and represents an increasing burden on global health resources. Interstitial lung disease (ILD) has been recognised as a complication of RA but its potential for mortality and morbidity has arguably been under appreciated for decades. New studies have underscored a significant lifetime risk of ILD development in RA. Contemporary work has identified an increased risk of mortality associated with the Usual Interstitial Pneumonia (UIP) pattern which shares similarity with the most devastating of the interstitial pulmonary diseases, namely Idiopathic Pulmonary Fibrosis (IPF). In this paper, we discuss recent studies highlighting the associated increase in mortality in RA-UIP. We explore associations between radiological and histopathological features of RA-ILD and the prognostic implications of same. We emphasise the need for translational research in this area given the growing burden of RA-ILD. We highlight the importance of the respiratory physician as a key stakeholder in the multidisciplinary management of this disorder. RA-ILD focused research offers the opportunity to identify early asymptomatic disease and define the natural history of this extra articular manifestation. This may provide a unique opportunity to define key regulatory fibrotic events driving progressive disease. We also discuss some of the more challenging and novel aspects of therapy for RA-ILD.

  15. 226Ra concentrations in some Illinois well waters

    International Nuclear Information System (INIS)

    Holtzman, R.B.; Gilkeson, R.H.

    1982-01-01

    226 Ra concentrations are reported for the waters from deep wells in 43 communities in Illinois. The concentrations range from 0.08 to 20.6 pCi/L. The effectiveness of additives (nitric acid or EDTA) in keeping the 226 Ra in solution in the samples is discussed

  16. RA Reactor operation and maintenance (I-IX), Part I

    International Nuclear Information System (INIS)

    Zecevic, V.

    1963-12-01

    The report on RA reactor operation and maintenance for year 1963 is divided in six tasks. This volume contains the introductory report, and three tasks of the final report, namely reactor exploitation, reactivity changes of the RA reactor before repair, planning of refuelling

  17. The study of 226Ra concentration in Teheran's pasteurized milk

    International Nuclear Information System (INIS)

    Khademi, B.; Sekhavat, A.; Movahed Shari'atpanahi, J.

    1975-01-01

    A study of 226 88 Ra concentration in pasteurized milk distributed in Tehran during 1970-72 was accomplished. The Ash resulting from the milk was 4.5 to 5.5 gr., which might be due to poor nourishment of the animals. These results are compared with the Ra concentration in France and Puerto Rico

  18. Anti-citrullinated protein antibodies are associated with neutrophil extracellular traps in the sputum in relatives of rheumatoid arthritis patients

    Science.gov (United States)

    Demoruelle, M. Kristen; Harrall, Kylie K.; Ho, Linh; Purmalek, Monica M.; Seto, Nickie L.; Rothfuss, Heather M.; Weisman, Michael H.; Solomon, Joshua J.; Fischer, Aryeh; Okamoto, Yuko; Kelmenson, Lindsay B.; Parish, Mark C.; Feser, Marie; Fleischer, Chelsie; Anderson, Courtney; Mahler, Michael; Norris, Jill M.; Kaplan, Mariana J.; Cherrington, Brian D.; Holers, V. Michael; Deane, Kevin D.

    2017-01-01

    Objectives Studies suggest that rheumatoid arthritis (RA)-related autoimmunity is initiated at a mucosal site. However, the factors associated with the mucosal generation of this autoimmunity are unknown, especially in individuals who are at-risk for future RA. Therefore, we tested anti-cyclic citrullinated peptide (anti-CCP) antibodies in the sputum of RA-free first-degree relatives (FDRs) of RA patients and patients with classifiable RA. Methods We evaluated induced sputum and serum from 67 FDRs and 20 RA subjects for anti-CCP-IgA and anti-CCP-IgG, with cut-off levels for positivity determined in a control population. Sputum was also evaluated for cell counts, neutrophil extracellular traps (NETs) using sandwich ELISAs for protein/nucleic acid complexes, and total citrulline. Results Sputum anti-CCP-IgA and/or anti-CCP-IgG was positive in 17/67 (25%) FDRs and 14/20 (70%) RA subjects, including a portion of FDRs who were serum anti-CCP negative. In FDRs, elevations of sputum anti-CCP-IgA and anti-CCP-IgG were associated with elevated sputum cell counts and levels of NET complexes. Anti-CCP-IgA was associated with ever-smoking and elevated sputum citrulline levels. Conclusions Anti-CCP is elevated in the sputum of FDRs, including seronegative FDRs, suggesting the lung may be one site of anti-CCP generation in this population. The association of anti-CCP with elevated cell counts and NET levels in FDRs supports a hypothesis that local airway inflammation and NET formation may drive anti-CCP production in the lung and may promote the early stages of RA development. Longitudinal studies are needed to follow the evolution of these processes relative to the development of systemic autoimmunity and articular RA. PMID:28182854

  19. Assessing the impact of heart failure specialist services on patient populations

    Directory of Open Access Journals (Sweden)

    Lyratzopoulos Georgios

    2004-05-01

    Full Text Available Abstract Background The assessment of the impact of healthcare interventions may help commissioners of healthcare services to make optimal decisions. This can be particularly the case if the impact assessment relates to specific patient populations and uses timely local data. We examined the potential impact on readmissions and mortality of specialist heart failure services capable of delivering treatments such as b-blockers and Nurse-Led Educational Intervention (N-LEI. Methods Statistical modelling of prevented or postponed events among previously hospitalised patients, using estimates of: treatment uptake and contraindications (based on local audit data; treatment effectiveness and intolerance (based on literature; and annual number of hospitalization per patient and annual risk of death (based on routine data. Results Optimal treatment uptake among eligible but untreated patients would over one year prevent or postpone 11% of all expected readmissions and 18% of all expected deaths for spironolactone, 13% of all expected readmisisons and 22% of all expected deaths for b-blockers (carvedilol and 20% of all expected readmissions and an uncertain number of deaths for N-LEI. Optimal combined treatment uptake for all three interventions during one year among all eligible but untreated patients would prevent or postpone 37% of all expected readmissions and a minimum of 36% of all expected deaths. Conclusion In a population of previously hospitalised patients with low previous uptake of b-blockers and no uptake of N-LEI, optimal combined uptake of interventions through specialist heart failure services can potentially help prevent or postpone approximately four times as many readmissions and a minimum of twice as many deaths compared with simply optimising uptake of spironolactone (not necessarily requiring specialist services. Examination of the impact of different heart failure interventions can inform rational planning of relevant healthcare

  20. Clinical validity of a population database definition of remission in patients with major depression

    Directory of Open Access Journals (Sweden)

    Salvatella-Pasant Jordi

    2010-02-01

    Full Text Available Abstract Background Major depression (MD is one of the most frequent diagnoses in Primary Care. It is a disabling illness that increases the use of health resources. Aim: To describe the concordance between remission according to clinical assessment and remission obtained from the computerized prescription databases of patients with MD in a Spanish population. Methods Design: multicenter cross-sectional. The population under study was comprised of people from six primary care facilities, who had a MD episode between January 2003 and March 2007. A specialist in psychiatry assessed a random sample of patient histories and determined whether a certain patient was in remission according to clinical criteria (ICPC-2. Regarding the databases, patients were considered in remission when they did not need further prescriptions of AD for at least 6 months after completing treatment for a new episode. Validity indicators (sensitivity [S], specificity [Sp] and clinical utility (positive and negative probability ratio [PPR] and [NPR] were calculated. The concordance index was established using Cohen's kappa coefficient. Significance level was p Results 133 patient histories were reviewed. The kappa coefficient was 82.8% (confidence intervals [CI] were 95%: 73.1 - 92.6, PPR 9.8% and NPR 0.1%. Allocation discrepancies between both criteria were found in 11 patients. S was 92.5% (CI was 95%: 88.0 - 96.9% and Sp was 90.6% (CI was 95%: 85.6 - 95.6%, p Conclusions Results show an acceptable level of concordance between remission obtained from the computerized databases and clinical criteria. The major discrepancies were found in diagnostic accuracy.

  1. Assessing the impact of heart failure specialist services on patient populations.

    Science.gov (United States)

    Lyratzopoulos, Georgios; Cook, Gary A; McElduff, Patrick; Havely, Daniel; Edwards, Richard; Heller, Richard F

    2004-05-24

    The assessment of the impact of healthcare interventions may help commissioners of healthcare services to make optimal decisions. This can be particularly the case if the impact assessment relates to specific patient populations and uses timely local data. We examined the potential impact on readmissions and mortality of specialist heart failure services capable of delivering treatments such as b-blockers and Nurse-Led Educational Intervention (N-LEI). Statistical modelling of prevented or postponed events among previously hospitalised patients, using estimates of: treatment uptake and contraindications (based on local audit data); treatment effectiveness and intolerance (based on literature); and annual number of hospitalization per patient and annual risk of death (based on routine data). Optimal treatment uptake among eligible but untreated patients would over one year prevent or postpone 11% of all expected readmissions and 18% of all expected deaths for spironolactone, 13% of all expected readmisisons and 22% of all expected deaths for b-blockers (carvedilol) and 20% of all expected readmissions and an uncertain number of deaths for N-LEI. Optimal combined treatment uptake for all three interventions during one year among all eligible but untreated patients would prevent or postpone 37% of all expected readmissions and a minimum of 36% of all expected deaths. In a population of previously hospitalised patients with low previous uptake of b-blockers and no uptake of N-LEI, optimal combined uptake of interventions through specialist heart failure services can potentially help prevent or postpone approximately four times as many readmissions and a minimum of twice as many deaths compared with simply optimising uptake of spironolactone (not necessarily requiring specialist services). Examination of the impact of different heart failure interventions can inform rational planning of relevant healthcare services.

  2. Cardiovascular events in patients with atherothrombotic disease: a population-based longitudinal study in Taiwan.

    Directory of Open Access Journals (Sweden)

    Wen-Hsien Lee

    Full Text Available BACKGROUND: Atherothrombotic diseases including cerebrovascular disease (CVD, coronary artery disease (CAD, and peripheral arterial disease (PAD, contribute to the major causes of death in the world. Although several studies showed the association between polyvascular disease and poor cardiovascular (CV outcomes in Asian population, there was no large-scale study to validate this relationship in this population. METHODS AND RESULTS: This retrospective cohort study included patients with a diagnosis of CVD, CAD, or PAD from the database contained in the Taiwan National Health Insurance Bureau during 2001-2004. A total of 19954 patients were enrolled in this study. The atherothrombotic disease score was defined according to the number of atherothrombotic disease. The study endpoints included acute coronary syndrome (ACS, all strokes, vascular procedures, in hospital mortality, and so on. The event rate of ischemic stroke (18.2% was higher than that of acute myocardial infarction (5.7% in our patients (P = 0.0006. In the multivariate Cox regression analyses, the adjusted hazard ratios (HRs of each increment of atherothrombotic disease score in predicting ACS, all strokes, vascular procedures, and in hospital mortality were 1.41, 1.66, 1.30, and 1.14, respectively (P≦0.0169. CONCLUSIONS: This large population-based longitudinal study in patients with atherothrombotic disease demonstrated the risk of subsequent ischemic stroke was higher than that of subsequent AMI. In addition, the subsequent adverse CV events including ACS, all stroke, vascular procedures, and in hospital mortality were progressively increased as the increase of atherothrombotic disease score.

  3. Postoperative adverse outcomes in intellectually disabled surgical patients: a nationwide population-based study.

    Directory of Open Access Journals (Sweden)

    Jui-An Lin

    Full Text Available BACKGROUND: Intellectually disabled patients have various comorbidities, but their risks of adverse surgical outcomes have not been examined. This study assesses pre-existing comorbidities, adjusted risks of postoperative major morbidities and mortality in intellectually disabled surgical patients. METHODS: A nationwide population-based study was conducted in patients who underwent inpatient major surgery in Taiwan between 2004 and 2007. Four controls for each patient were randomly selected from the National Health Insurance Research Database. Preoperative major comorbidities, postoperative major complications and 30-day in-hospital mortality were compared between patients with and without intellectual disability. Use of medical services also was analyzed. Adjusted odds ratios using multivariate logistic regression analyses with 95% confidence intervals were applied to verify intellectual disability's impact. RESULTS: Controls were compared with 3983 surgical patients with intellectual disability. Risks for postoperative major complications were increased in patients with intellectual disability, including acute renal failure (odds ratio 3.81, 95% confidence interval 2.28 to 6.37, pneumonia (odds ratio 2.01, 1.61 to 2.49, postoperative bleeding (odds ratio 1.35, 1.09 to 1.68 and septicemia (odds ratio 2.43, 1.85 to 3.21 without significant differences in overall mortality. Disability severity was positively correlated with postoperative septicemia risk. Medical service use was also significantly higher in surgical patients with intellectual disability. CONCLUSION: Intellectual disability significantly increases the risk of overall major complications after major surgery. Our findings show a need for integrated and revised protocols for postoperative management to improve care for intellectually disabled surgical patients.

  4. Female schizophrenia patients and risk of breast cancer: A population-based cohort study.

    Science.gov (United States)

    Wu Chou, Ana Isabel; Wang, Yu-Chiao; Lin, Cheng-Li; Kao, Chia-Hung

    2017-10-01

    Breast cancer is the most common type of cancer in women. This population-based cohort study aimed to examine the association between breast cancer in female schizophrenia patients and its association with the use of antipsychotics drugs. All study subjects were selected from the Taiwan Insurance Claims Data (1998-2008). We compared the risk for breast cancer between female schizophrenia patients receiving antipsychotics (n=29,641) with female patients without any serious mental illnesses nor receiving antipsychotic drugs (n=59,282). We also compared between patients on 1) first-generation antipsychotics (FGAs) alone; 2) combination of first and second generation antipsychotics (SGAs); and 3) SGAs alone. We then stratified those on SGAs into two subgroups according to their prolactin-elevating properties: risperidone (RIS), paliperidone (PAL) or amisulpride (AMI) and all other SGAs. After adjusting for confounding factors, the risk of breast cancer in female schizophrenia patients was 1.94 higher than the non-schizophrenia cohort (aHR: 1.94, 95% CI: 1.43-2.63). Schizophrenia patients receiving a combination of FGAs and SGAs had a slightly higher risk of breast cancer than non-schizophrenic patients (aHR: 2.17, 95% CI: 1.56-3.01). Patients on RIS, PAL, and AMI had a 1.96-fold risk of breast cancer compared to the non-schizophrenic cohort (95% CI: 1.36-2.82). This study raises awareness among both clinicians and patients about the importance of breast cancer screening and the promotion of healthy lifestyle choices. Due to the nature of our database, confounding factors - such as parity, obesity, hormone therapy, and smoking - could not be controlled for. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Increased active von Willebrand factor during disease development in the aging diabetic patient population.

    Science.gov (United States)

    Chen, Shuang Feng; Xia, Zuo Li; Han, Ji Ju; Wang, Yi Ting; Wang, Ji Yue; Pan, Shao Dong; Wu, Ya Ping; Zhang, Bin; Li, Guang Yao; Du, Jing Wei; Gao, Hen Qiang; de Groot, Philip G; de Laat, Bas; Hollestelle, Martine J

    2013-02-01

    Type 2 diabetes is known to cause endothelial activation resulting in the secretion of von Willebrand factor (VWF). We have shown that levels of VWF in a glycoprotein Ib-binding conformation are increased in specific clinical settings. The aim of the current study is to investigate whether active VWF levels increase during aging and the development of diabetes within the population of patients suffering from type 2 diabetes. Patients and controls were divided into two groups based on age: older and younger than 60 years of age. VWF antigen, VWF propeptide, VWF activation factor and total active VWF were measured. Patients older than 60 years of age had increased levels of total active VWF, VWF activation factor and VWF propeptide compared to younger patients and controls. All measured VWF parameters were associated with age in diabetic patients. Total active VWF and VWF propeptide correlated with the period of being diagnosed with diabetes. Regression analyses showed that especially the VWF activation factor was strongly associated with diabetes in patients older than 60 years of age. In conclusion, we found that the conformation of VWF could be involved in the disease process of diabetes and that the VWF in a glycoprotein Ib-binding conformation could play a role as risk marker during the development of diabetes in combination with an increase in age. Our study shows that the active quality of VWF was more important than the quantity.

  6. Unilateral hemimandibular hyperactivity: Clinical features of a population of 128 patients.

    Science.gov (United States)

    Vernucci, Roberto Antonio; Mazzoli, Valentina; Galluccio, Gabriella; Silvestri, Alessandro; Barbato, Ersilia

    2018-07-01

    Facial asymmetries due to unilateral condylar hyperactivity are often a challenge both for maxillo-facial surgeons and for orthodontists; the current literature shows different opinions about aetiology, classification, treatment approach and timing. We made a retrospective study on patients suffering from unilateral condylar hyperactivity between 1997 and 2015 in our Department; clinical features and treatment options were grouped and compared with literature. The descriptive analysis investigated variables like sex, age, side and direction of the asymmetry, condylar activity and type of intervention. The population was composed of 128 patients. The hemimandibular hyperactivity occurs equally in both sexes around the second decade, although the range of the first consultation goes from 7 to 49 y.o. The vertical hyperdevelopment group is almost equal to the horizontal. All the patients with horizontal hyperactivity showed negative scintigraphy and were treated with pre-surgical orthodontics and orthognathic surgery; patients with vertical hyperactivity and positive scintigraphy were treated with condylectomy and post-surgical orthodontics. In our group of patients, direction of the hyperactivity and results of the scintigraphy lead to treatment choice and timing. Further studies are necessary to explain why, in our group, all the patients with horizontal involvement are negative to scintigraphy. Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  7. Risk of thyroid cancer in patients with thyroiditis: a population-based cohort study.

    Science.gov (United States)

    Liu, Chien-Liang; Cheng, Shih-Ping; Lin, Hui-Wen; Lai, Yuen-Liang

    2014-03-01

    The causative relationship between autoimmune thyroiditis and thyroid cancer remains a controversial issue. The aim of this population-based study was to investigate the risk of thyroid cancer in patients with thyroiditis. From the Longitudinal Health Insurance Database 2005 (LHID2005) of Taiwan, we identified adult patients newly diagnosed with thyroiditis between 2004 and 2009 (n = 1,654). The comparison cohort (n = 8,270) included five randomly selected age- and sex-matched controls for each patient in the study cohort. All patients were followed up from the date of cohort entry until they developed thyroid cancer or to the end of 2010. Multivariate Cox regression was used to assess the risk of developing thyroid cancer. A total of 1,000 bootstrap replicates were created for internal validation. A total of 35 patients developed thyroid cancer during the study period, of whom 24 were from the thyroiditis cohort and 11 were from the comparison cohort (incidence 353 and 22 per 100,000 person-years, respectively). After adjusting for potential confounding factors, the hazard ratio (HR) for thyroid cancer in patients with thyroiditis was 13.24 (95 % CI 6.40-27.39). Excluding cancers occurring within 1 year of follow-up, the HR remained significantly increased (6.64; 95 % CI 2.35-18.75). Hypothyroidism was not an independent factor associated with the occurrence of thyroid cancer. We found an increased risk for the development of thyroid cancer after a diagnosis of thyroiditis, independent of comorbidities.

  8. Welfare costs in patients with rheumatoid arthritis and their partners compared with matched controls

    DEFF Research Database (Denmark)

    Løppenthin, Katrine; Esbensen, Bente Appel; Østergaard, Mikkel

    2017-01-01

    collected from population-based registers in the period from 1998 to 2009. A total of 25,547 Danish patients with a diagnosis of RA and 15,660 of their partners were identified and compared with 101,755 randomly selected age- and gender-matched controls and 62,681 control partners. The direct and indirect...... costs were calculated for patients and their partners and compared to matched controls. These included inpatient and outpatient treatment, medication, income from employment and social transfer payments. Patients with RA had statistically significantly more inpatient and outpatient costs than control...... subjects, i.e., treatment (€346 vs. €211), hospitalization (€1261 vs. €778), and medication use (€654 vs. €393). The costs associated with the patients were present 11 years before diagnosis of RA (€1592) compared with control subjects (€1172). Furthermore, income from employment was lower for patients...

  9. Reproduction of the RA reactor fuel element fabrication

    International Nuclear Information System (INIS)

    Novakovic, M.

    1961-12-01

    This document includes the following nine reports: Final report on task 08/12 - testing the Ra reactor fuel element; design concept for fabrication of RA reactor fuel element; investigation of the microstructure of the Ra reactor fuel element; Final report on task 08/13 producing binary alloys with Al, Mo, Zr, Nb and B additions; fabrication of U-Al alloy; final report on tasks 08/14 and 08/16; final report on task 08/32 diffusion bond between the fuel and the cladding of the Ra reactor fuel element; Final report on task 08/33, fabrication of the RA reactor fuel element cladding; and final report on task 08/36, diffusion of solid state metals [sr

  10. Recovery of Ra-223 from natural thorium irradiated by protons

    Energy Technology Data Exchange (ETDEWEB)

    Vasiliev, Aleksandr N.; Ostapenko, Valentina S. [Lomonosov Moscow State Univ. (Russian Federation); Russian Academy of Sciences, Moscow-Troitsk (Russian Federation). Inst. for Nuclear Research; Lapshina, Elena V.; Ermolaev, Stanislav V.; Zhuikov, Boris L. [Russian Academy of Sciences, Moscow-Troitsk (Russian Federation). Inst. for Nuclear Research; Danilov, Sergey S. [Lomonosov Moscow State Univ. (Russian Federation); Kalmykov, Stepan N. [Lomonosov Moscow State Univ. (Russian Federation); National Research Center ' Kurchatov Institute' (NRC ' Kurchatov Institute' ), Moscow (Russian Federation)

    2016-11-01

    Irradiation of natural thorium with medium-energy protons is considered to be a prospective approach to large-scale production of {sup 225}Ac and {sup 223}Ra. In addition to the earlier-developed method of {sup 225}Ac isolation, the present work focuses on the simultaneous recovery of {sup 223}Ra from the same thorium target. Radiochemical procedure is based on liquid-liquid extraction, cation exchange and extraction chromatography. The procedure provides separation of radium from spallation and fission products generated in the thorium target. High chemical yield (85-90%) and radionuclide purity of {sup 223}Ra (> 99.8% except {sup 224}Ra and {sup 225}Ra isotopes) have been achieved.

  11. Clinical predictors of mortality following rotational atherectomy and stent implantation in high‐risk patients: A single center experience

    Science.gov (United States)

    Édes, István F.; Ruzsa, Zoltán; Szabó, György; Nardai, Sándor; Becker, Dávid; Benke, Kálmán; Szilveszter, Bálint

    2015-01-01

    Objectives Our aim was to assess the procedural success and determine the clinical predictors of postprocedure mortality, following rotational atherectomy (RA) and stenting in high‐risk patients. Background RA is mainly used to facilitate stenting in complex lesions. Outcomes involving RA and stenting have been investigated, yet high‐risk patients have not been adequately described. Methods Data of 218 consecutive patients who underwent RA were evaluated in a prospective register. Primary endpoints were the angiographic success and long‐term mortality. Secondary endpoints were procedural success, consumption of the angioplasty equipment, and periprocedural major adverse cardiac events. The impact of the relevant angiographic and clinical characteristics on long‐term mortality was analyzed using uni‐ and multivariate Cox regression analysis. Results Mean age of the patients was 70 ± 8.2 years, diabetes was present in 44%, and chronic renal failure in 29%. Prior myocardial infarction and three‐vessel disease amounted to 42.2% and 32.6%, respectively. Altogether, 52.8% of patients underwent RA after a failed, non‐RA intervention attempt, and 30.7% of cases presented as acute coronary syndromes. Angiographic success was 100%, and all patients received stents after RA. Periprocedural major adverse cardiac events occurred in five (2.3%) patients. Postprocedural death was investigated, with a mean follow‐up of 36 months. Mortality amounted to 37.2%. Multivariate analysis revealed that left ventricular ejection fraction < 50%, glomerular filtration rate < 60 ml/min, cardiogenic shock, and diabetes were the only independent mortality predictors. Conclusions We have found that RA and stenting is feasible and viable in an elderly high‐risk population, with exceptional procedural success and acceptable long‐term results. © 2015 Wiley Periodicals, Inc. PMID:26032270

  12. Long-term oxygen therapy in COPD patients: population-based cohort study on mortality

    Directory of Open Access Journals (Sweden)

    Pavlov N

    2018-03-01

    Full Text Available Nikolay Pavlov,1 Alan Gary Haynes,2,3 Armin Stucki,4 Peter Jüni,5 Sebastian Robert Ott1 1Department of Pulmonary Medicine, University Hospital (Inselspital, University of Bern, Bern, Switzerland; 2CTU Bern, University of Bern, Bern, Switzerland; 3Institute of Social and Preventive Medicine (ISPM, University of Bern, Bern, Switzerland; 4Department of Internal Medicine, Spital Thun, Thun, Switzerland; 5Applied Health Research Centre, Li Ka Shing Knowledge Institute of St Michael’s Hospital, Department of Medicine, University of Toronto, Toronto, ON, Canada Purpose: Chronic obstructive pulmonary disease (COPD is the fourth leading cause of death worldwide and is associated with a growing and substantial socioeconomic burden. Long-term oxygen therapy (LTOT, recommended by current treatment guidelines for COPD patients with severe chronic hypoxemia, has shown to reduce mortality in this population. The aim of our study was to assess the standardized mortality ratios of incident and prevalent LTOT users and to identify predictors of mortality. Patients and methods: We conducted a 2-year follow-up population-based cohort study comprising all COPD patients receiving LTOT in the canton of Bern, Switzerland. Comparing age- and sex-adjusted standardized mortality ratios, we examined associations between all-cause mortality and patient characteristics at baseline. To avoid immortal time bias, data for incident (receiving LTOT <6 months and prevalent users were analyzed separately. Results: At baseline, 475 patients (20% incident users, n=93 were receiving LTOT because of COPD (48/100,000 inhabitants. Mortality of incident and prevalent LTOT users was 41% versus 27%, respectively, p<0.007, and standardized mortality ratios were 8.02 (95% CI: 5.64–11.41 versus 5.90 (95% CI: 4.79–7.25, respectively. Type 2 respiratory failure was associated with higher standardized mortality ratios among incident LTOT users (60.57, 95% CI: 11.82–310.45, p=0

  13. Population specific biomarkers of human aging: a big data study using South Korean, Canadian and Eastern European patient populations.

    Science.gov (United States)

    Mamoshina, Polina; Kochetov, Kirill; Putin, Evgeny; Cortese, Franco; Aliper, Alexander; Lee, Won-Suk; Ahn, Sung-Min; Uhn, Lee; Skjodt, Neil; Kovalchuk, Olga; Scheibye-Knudsen, Morten; Zhavoronkov, Alex

    2018-01-11

    Accurate and physiologically meaningful biomarkers for human aging are key to assessing anti-aging therapies. Given ethnic differences in health, diet, lifestyle, behaviour, environmental exposures and even average rate of biological aging, it stands to reason that aging clocks trained on datasets obtained from specific ethnic populations are more likely to account for these potential confounding factors, resulting in an enhanced capacity to predict chronological age and quantify biological age. Here we present a deep learning-based hematological aging clock modeled using the large combined dataset of Canadian, South Korean and Eastern European population blood samples that show increased predictive accuracy in individual populations compared to population-specific hematologic aging clocks. The performance of models was also evaluated on publicly-available samples of the American population from the National Health and Nutrition Examination Survey (NHANES). In addition, we explored the association between age predicted by both population-specific and combined hematological clocks and all-cause mortality. Overall, this study suggests a) the population-specificity of aging patterns and b) hematologic clocks predicts all-cause mortality. Proposed models added to the freely available Aging.AI system allowing improved ability to assess human aging. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America.

  14. Changing Trends in Opioid Use Among Patients With Rheumatoid Arthritis in the United States.

    Science.gov (United States)

    Curtis, Jeffrey R; Xie, Fenglong; Smith, Christian; Saag, Kenneth G; Chen, Lang; Beukelman, Timothy; Mannion, Melissa; Yun, Huifeng; Kertesz, Stefan

    2017-09-01

    Opioid prescribing recently has come under intense scrutiny. However, longitudinal patterns of prescription opioid receipt in a population-based cohort of patients with chronic pain, such as those with rheumatoid arthritis (RA), have not been well characterized. The aim of this study was to examine both trends over time and variability in individual physician prescribing of short-term and long-term use of opioids. We identified a cohort of RA patients based on 2006-2014 Medicare data and evaluated longitudinal time trends in "regular" use of opioids. A separate analysis conducted in 2014 assessed rheumatologist-specific variability in regular use of opioid prescriptions in patients with RA. We identified 97,859 RA patients meeting the eligibility criteria. The mean age of the patients was 67 years, 80% were female, 82% were white, and 12% were African American. The most commonly used opioids were those that combined acetaminophen with hydrocodone or propoxyphene. Regular opioid prescribing increased slowly but peaked in 2010 before propoxyphene was withdrawn from the market. Following the withdrawal of propoxyphene, receipt of hydrocodone and tramadol increased commensurately, and overall opioid use declined only slightly. Factors associated with regular use of opioids included younger age, female sex, African American race, back pain, fibromyalgia, anxiety, and depression. Variability between US rheumatologists (n = 4,024) in prescribing the regular use of opioids for their RA patients was high; in the average rheumatologist's practice, 40% of RA patients used prescription opioids regularly. In almost half of the patients, at least some opioid prescriptions were written by a rheumatologist, and 14% received opioids that were co-prescribed concurrently by more than 1 physician. In the US, opioid use in older patients with RA peaked in 2010 and is now declining slightly. Withdrawal of propoxyphene from the US market in 2010 had minimal effect on overall opioid

  15. Smartphone application for rheumatoid arthritis self-management: cross-sectional study revealed the usefulness, willingness to use and patients' needs.

    Science.gov (United States)

    Azevedo, Rita; Bernardes, Miguel; Fonseca, João; Lima, Aurea

    2015-10-01

    Patient-centered smartphone applications have potential to support rheumatoid arthritis (RA) self-management but remain almost unexplored in literature. Therefore, this study evaluated the usefulness of a smartphone application to support RA self-management, the willingness of RA patients to use and pay for it and the features the application should have. In this cross-sectional study, a questionnaire was developed to collect information on population, device ownership, usefulness and willingness to use and pay for a RA self-management application and application features. Descriptive statistics, Chi-square, Fisher's exact test, t test or Mann-Whitney's test and multivariate analysis were used. One hundred RA patients answered the questionnaire. Patients' mean age was 57 ± 11.9 years, most were females (91 %), with multiple drug regimens and a 40 % treatment non-compliance rate. Most patients believed that could have a more active role in self-management (94 %) and reported it would be useful to develop a RA self-management application (86 %). Patients willing to use an application (83 %) were younger, with a possible more active role in self-management, with access to a smartphone, and using short message service, electronic mail and Internet. Multivariate analysis confirmed these results, except the associations regarding access to a smartphone and use of electronic mail and Internet. Fifty-eight patients (82 %) were willing to pay for a RA self-management application and the most requested feature for it was information in a simple format. This study suggested the usefulness and patients' willingness to use and pay for a RA self-management application and provided insight on patients' needs.

  16. Patients taking medications for bipolar disorder are more prone to metabolic syndrome than Korea's general population.

    Science.gov (United States)

    Lee, Nam Young; Kim, Se Hyun; Cho, Belong; Lee, Yeon Ji; Chang, Jae Seung; Kang, Ung Gu; Kim, Yong Sik; Ahn, Yong Min

    2010-10-01

    Despite growing concerns about the co-morbidity of metabolic syndrome (MetS) and bipolar disorder, few studies have been conducted on this topic in Asian populations. This study examined Korean patients with bipolar disorder to assess its co-morbidity with MetS and to compare the prevalence of MetS in patients with medication for bipolar disorder with that of healthy patients. We used cross-sectional data from the medical records of patients with bipolar disorder who presented to the psychiatric clinic in Seoul National University Hospital between June 2007 and June 2008. The control group, matched for age and gender, was randomly drawn from visitors to the Health Promotion Center at the same hospital during the same period. We compared the prevalence of MetS between these two groups with independent sample t-tests and chi-squared tests. We also calculated the indirectly standardized prevalence ratio (ISPR) with a standardization that used the Fourth Korean National Health and Nutrition Examination Survey (KNHNES, 2007). The prevalence of MetS in patients who took medication for bipolar disorder (N=152) was 27.0%, 25.0% and 25.7%, based on the definitions of the American Heart Association and the National Heart, Lung and Blood Institute's adaptation of the Adult Treatment Panel III (AHA), the National Cholesterol Education Program for Adult Treatment Panel III (ATPIII) and the International Diabetes Federation (IDF), respectively. The present study determined that the prevalence of MetS was significantly higher in patients with bipolar disorder than in the control group; the odds ratios (OR) (95% CI) were 2.44 (1.35-4.40), 2.48 (1.34-4.59) and 2.57 (1.40-4.74), based on the definition of the AHA, ATPIII and IDF, respectively. The ISPR (95% CI) was 1.48 (1.02-1.93), 1.54 (1.05-2.03) and 1.98 (1.36-2.60), respectively. Patients with medications for bipolar disorder showed a significantly higher prevalence of increased waist circumference, elevated triglycerides, and

  17. Significance of determination of serum cytidine deaminase (CD) levels for diagnosis of active rheumatoid arthritis (RA)

    International Nuclear Information System (INIS)

    Xiao Chuangqing; Jang Xiaogong; He Yunnan

    2005-01-01

    Objective: To determine the clinical value of measurement of serum cytidine deaminase (CD) levels in patients with active rheumatoid arthritis (RA). Methods: Serum levels of CD were detected with spectrophotometry, in 33 patients with active RA and 60 controls. The erythrocyte sedimentation rate (ESR) and CRP content were also determined in both groups. Results: The ser- um CD contents in patients with active RA(14.80 ± 2.11U/ml) were significantly higher than those in controls(4.86±1.86 U/ml,P<0.01). The CRP contents (51.46 ± 20.43mg/L) and ESR readings(85.03 ± 27.6mm/h) in the patients were also significantly higher than those in the controls(3.40 ± 2.21mg/L and 13.04 ± 4.89mm/h respectively, all P<0.01). In the patients, the serum CD contents were linearly positively correlated with the ESR contents and CRP readings (r=0.6324 and 0.8013 respectively, P <0.01). Conclusion: Serum CD is an early biochemical marker for diagnosis of active rheumatoid arthritis and is also of prognostic value. (authors)

  18. Population Pharmacokinetics of Hydroxychloroquine in Japanese Patients With Cutaneous or Systemic Lupus Erythematosus.

    Science.gov (United States)

    Morita, Shigemichi; Takahashi, Toshiya; Yoshida, Yasushi; Yokota, Naohisa

    2016-04-01

    Hydroxychloroquine (HCQ) is an effective treatment for patients with cutaneous lupus erythematosus (CLE) or systemic lupus erythematosus (SLE) and has been used for these patients in more than 70 nations. However, in Japan, HCQ has not been approved for CLE or SLE. To establish an appropriate therapeutic regimen and to clarify the pharmacokinetics (PK) of HCQ in Japanese patients with CLE with or without SLE (CLE/SLE), a population pharmacokinetic (PopPK) analysis was performed. In a clinical study of Japanese patients with a diagnosis of CLE irrespective of the presence of SLE, blood and plasma drug concentration-time data receiving multiple oral doses of HCQ sulfate (200-400 mg daily) were analyzed using nonlinear mixed-effects model software. The blood and plasma concentrations of HCQ were analyzed using a high-performance liquid chromatography tandem mass spectrometry method. Model evaluation and validation were performed using goodness-of-fit (GOF) plots, visual predictive check, and a bootstrap. The PopPKs of HCQ in the blood and plasma of 90 Japanese patients with CLE/SLE were well described by a 1-compartment model with first-order absorption and absorption lag time. Body weight was a significant (P < 0.001) covariate of oral clearance of HCQ. The final model was assessed using GOF plots, a bootstrap, and visual predictive check, and this model was appropriate. Simulations based on the final model suggested that the recommended daily doses of HCQ sulfate (200-400 mg) based on the ideal body weight in Japanese patients with CLE/SLE were in the similar concentration ranges. The PopPK models derived from both blood and plasma HCQ concentrations of Japanese patients with CLE/SLE were developed and validated. Based on this study, the dosage regimens of HCQ sulfate for Japanese patients with CLE/SLE should be calculated using the individual ideal body weight.

  19. Clinical manifestations in uveitis patients with and without rheumatic disease in a Chinese population in Taiwan.

    Science.gov (United States)

    Tseng, Shi-Ting; Yao, Tsung-Chieh; Huang, Jing-Long; Yeh, Kuo-Wei; Hwang, Yih-Shiou

    2017-12-01

    Uveitis can be a local eye disease or a manifestation of systemic rheumatologic disorders. However, the differences of clinical manifestations between uveitis patients with or without systemic rheumatologic disease have been seldom described in literature. We investigated the clinical features and complications of rheumatic disease-related uveitis, and compared the characteristics in patients with and without rheumatic disease in a Chinese population in Taiwan. A retrospective review was performed for all patients who had been diagnosed with uveitis between January 2009 and June 2014 at the Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan. A total of 823 uveitis patients were enrolled in the study, including 123 patients with rheumatic diseases. The most frequent rheumatic diseases included ankylosing spondylitis (5.8%), followed by Behçet's disease (2.8%), sarcoidosis (1.4%), psoriasis (1.1%), and juvenile idiopathic arthritis (1.1%). Compared with patients without rheumatic disease, those with rheumatic disease-related uveitis had a lower mean age at onset (35.1 ± 15.8 years vs. 44.0 ± 17.5 years), a longer follow-up period (27.1 ± 25.3 months vs. 22.2 ± 23.0 months), a higher incidence of anterior uveitis (69.0% vs. 46.3%), less frequent posterior uveitis (4.9% vs. 21.4%), a higher incidence of recurrence (26.8% vs. 14.1%), more frequent bilateral involvement (53.7% vs. 38.8%), and more frequent posterior synechiae (17.2% vs. 9.4%). The disease course and clinical manifestations of rheumatic disease-related uveitis were different from those unrelated. Patients with rheumatic disease-related uveitis had a higher recurrent rate and more frequent posterior synechiae than patients without rheumatic diseases. Copyright © 2015. Published by Elsevier B.V.

  20. Screening for Fabry's disease in young patients with ischemic stroke in a Chinese population.

    Science.gov (United States)

    Song, Xiaowei; Xue, Sufang; Zhao, Jingyan; Wu, Jian

    2017-04-01

    Fabry disease is an X-linked lysosomal storage disorder frequently associated with cerebrovascular disease. Data regarding Fabry disease and ischemic stroke has been lacking in China. In this study, we investigated the prevalence of Fabry disease and the distribution of the alpha-galactosidase A (α-GalA) gene - GLA mutations in young stroke patients in the Chinese population and its association with stroke subtypes. A total of 357 ischemic stroke patients admitted to Xuanwu Hospital of Capital Medical University, aged 18-55 years old, including 293 patients with cerebral infarction and 64 patients with transient ischemic attack, were enrolled in this study. Mutations in the GLA gene were screened by Sanger sequencing. Enzyme levels were measured to further confirm the disease in patients with the gene mutation. The mutation frequency was compared among different stroke subtypes and further compared with the control group individually. No pathogenic mutations in the coding regions of the GLA gene were identified in this group of patients and thus no Fabry disease was found in our study. However, the frequency of an intronic polymorphism c.-10C>T was significantly different among different Trial of Org 10172 in Acute Stroke Treatment subtypes (p T polymorphism in patients with stroke due to other causes and undetermined causes was much higher than that in the control group (OR = 3.18, 95% CI: 1.29-7.83, p stroke patients. In addition, our results suggested that the c.-10C>T polymorphism may be a risk factor for ischemic stroke of other and undetermined causes. Further study is required to confirm our findings.

  1. Cancer risk in patients with alopecia areata: a nationwide population-based matched cohort study.

    Science.gov (United States)

    Chen, Chih-Chiang; Chang, Yun-Ting; Liu, Han-Nan; Chen, Yi-Ju

    2018-05-01

    Alopecia areata (AA) is an organ-specific autoimmune disorder. Defective immune system related disorders are prone to increase the risk of cancer formation. However, the association among AA and variety of cancer types had never been studied. A nationwide population-based matched cohort study was conducted to evaluate the cancer risk in patients with AA. Records from Taiwan National Health Insurance Research Database were analyzed. Cases of AA from 1997 to 2013 and cancers registered in the catastrophic illness profile from the same time period were collected. The standard incidence ratio (SIR) of each cancer was calculated. In total, 2099 cancers among 162,499 patients with AA and without prior cancers were identified. The overall cancer risks in AA patients were slightly decreased, especially among male subjects (SIR: 0.89). Refer to individual cancer, the cancer risk of nonmelanoma skin cancer (NMSC) (SIR: 0.59), upper GI cancer (SIR: 0.70), liver cancer (SIR: 0.82), uterine, and cervix cancer (SIR: 0.84) were significantly lower in patients with AA. In contrast, AA patients were inclined to have lymphoma, breast cancer, kidney, and urinary bladder cancer with the SIR of 1.55, 2.93, and 2.95, respectively. Age stratified analyses revealed female AA patients younger than 50 years old have even higher risk of breast cancer (SIR: 3.37). Further sensitivity analysis showed similar results after excluding major autoimmune disorders. Cancer risk in AA patients is organ specific, and it is not associated with the underlying autoimmune disorders in patients with AA. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  2. Female fertility preservation in the pediatric and adolescent cancer patient population.

    Science.gov (United States)

    Algarroba, Gabriela N; Sanfilippo, Joseph S; Valli-Pulaski, Hanna

    2018-04-01

    The 5-year survival rate for childhood cancer is over 80%, thereby increasing the number of young women facing infertility in the future because of the gonadotoxic effects of chemotherapy and radiation. The gonadotoxic effects of childhood cancer treatment vary by the radiation regimen and the chemotherapeutic drugs utilized. Although the American Society of Clinical Oncology guidelines recommend fertility preservation for all patients, there are several barriers and ethical considerations to fertility preservation in the pediatric and adolescent female population. Additionally, the fertility preservation methods for pre- and postpubertal females differ, with only experimental methods available for prepubertal females. We will review the risk of chemotherapy and radiation on female fertility, the approach to fertility preservation in the pediatric and adolescent female population, methods of fertility preservation for both pre- and postpubertal females, barriers to fertility preservation, cost, and psychological and ethical considerations. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. Symptom patterns in dissociative identity disorder patients and the general population.

    Science.gov (United States)

    Ross, Colin A; Ness, Laura

    2010-01-01

    The authors used the Dissociative Disorders Interview Schedule to compare structured interview symptom patterns in a general population sample (N= 502) and a sample of patients with clinical diagnoses of dissociative identity disorder (N= 303). Based on the Trauma Model, the authors predicted that the patterns would be similar in the 2 samples and that symptom scores would be higher in participants reporting childhood sexual abuse in both samples. They predicted that symptom scores would be higher among women with dissociative identity disorder reporting sexual abuse than among women in the general population reporting sexual abuse, with the clinical sample reporting more severe abuse. These predictions were supported by the data. The authors conclude that symptom patterns in dissociative identity disorder are typical of the normal human response to severe, chronic childhood trauma and have ecological validity for the human race in general.

  4. Appendicectomies in Albanians in Greece: outcomes in a highly mobile immigrant patient population

    Science.gov (United States)

    2001-01-01

    Background Albanian immigrants in Greece comprise a highly mobile population with unknown health care profile. We aimed to assess whether these immigrants were more or less likely to undergo laparotomy for suspected appendicitis with negative findings (negative appendicectomy), by performing a controlled study with individual (1:4) matching. We used data from 6 hospitals in the Greek prefecture of Epirus that is bordering Albania. Results Among a total of 2027 non-incidental appendicectomies for suspected appendicitis performed in 1994-1999, 30 patients with Albanian names were matched (for age, sex, time of operation and hospital) to 120 patients with Greek names. The odds for a negative appendicectomy were 3.4-fold higher (95% confidence interval [CI], 1.24-9.31, p = 0.02) in Albanian immigrants than in matched Greek-name subjects. The difference was most prominent in men (odds ratio 20.0, 95% CI, 1.41-285, p = 0.02) while it was not formally significant in women (odds ratio 1.56, 95% CI, 0.44-5.48). The odds for perforation were 1.25-fold higher in Albanian-name immigrants than in Greek-name patients (95% CI 0.44- 3.57). Conclusions Albanian immigrants in Greece are at high risk for negative appendicectomies. Socioeconomic, cultural and language parameters underlying health care inequalities in highly mobile immigrant populations need better study. PMID:11472640

  5. Related B cell clones populate the meninges and parenchyma of patients with multiple sclerosis.

    Science.gov (United States)

    Lovato, Laura; Willis, Simon N; Rodig, Scott J; Caron, Tyler; Almendinger, Stefany E; Howell, Owain W; Reynolds, Richard; O'Connor, Kevin C; Hafler, David A

    2011-02-01

    In the central nervous system of patients with multiple sclerosis, B cell aggregates populate the meninges, raising the central question as to whether these structures relate to the B cell infiltrates found in parenchymal lesions or instead, represent a separate central nervous system immune compartment. We characterized the repertoires derived from meningeal B cell aggregates and the corresponding parenchymal infiltrates from brain tissue derived primarily from patients with progressive multiple sclerosis. The majority of expanded antigen-experienced B cell clones derived from meningeal aggregates were also present in the parenchyma. We extended this investigation to include 20 grey matter specimens containing meninges, 26 inflammatory plaques, 19 areas of normal appearing white matter and cerebral spinal fluid. Analysis of 1833 B cell receptor heavy chain variable region sequences demonstrated that antigen-experienced clones were consistently shared among these distinct compartments. This study establishes a relationship between extraparenchymal lymphoid tissue and parenchymal infiltrates and defines the arrangement of B cell clones that populate the central nervous system of patients with multiple sclerosis.

  6. 226Ra and 228Ra in scale and sludge samples and their correlation with the chemical composition.

    Science.gov (United States)

    Godoy, José Marcus; da Cruz, Rosana Petinatti

    2003-01-01

    In order to contribute to a future waste management policy related to the presence of technologically enhanced natural occurring radioactive material (TENORM) in the Brazilian petroleum industry, the present work presents the chemical composition and the (226)Ra and (228)Ra content of sludge and scales generated during the offshore E and P petroleum activities in the Campos Basin, the primary offshore oil production region in Brazil. The (226)Ra and (228)Ra content on 36 sludge and scales samples were determined by gamma-spectrometry. Based on X-ray diffractometry results, a chemical analysis schema for these samples was developed. The results have shown that scales are 75% barium and strontium sulfates, with a mean (226)Ra and (228)Ra content of 106 kBq kg(-1) and 78 kBq kg(-1), respectively. On the other hand, sludge samples have a much more complex chemical composition than the scales. The (226)Ra and (228)Ra content in sludge also varies much more than the content observed in the scales samples and ranged from 0.36 to 367 kBq kg(-1) and 0.25 to 343 kBq kg(-1), respectively.

  7. RA Reactor operation and maintenance (I-IX), Part I; Pogon i odrzavanje reaktora RA (I-IX), I Deo

    Energy Technology Data Exchange (ETDEWEB)

    Zecevic, V [Institute of Nuclear Sciences Boris Kidric, Reaktor RA, Vinca, Beograd (Serbia and Montenegro)

    1963-12-15

    The report on RA reactor operation and maintenance for year 1963 is divided in six tasks. This volume contains the introductory report, and three tasks of the final report, namely reactor exploitation, reactivity changes of the RA reactor before repair, planning of refuelling.

  8. RA Reactor operation and maintenance (I-IX), part VII, Task 3.08/04, Refurbishment of the RA reactor

    International Nuclear Information System (INIS)

    Zecevic, V.

    1963-12-01

    This volume covers the following reports concerned with the maintenance and repair work of the RA reactor: repair of the technical water system; maintenance of the transportation equipment; vacuuming and drying during refurbishment; repair and decontamination of the distillation device; and the report on participation of the operational dosimetry division in the RA reactor refurbishment activities

  9. Preliminary Investigations Showing Venous Thromboembolism Recurrence in Patients with Residual Venous Obstruction in Singaporean Population.

    Science.gov (United States)

    Sule, Ashish Anil; Er, Chaozer; Chong, Claudia Y X; Chin, Han Xin; Chin, Tay Jam

    2017-12-01

    This study aims to determine the association of residual venous obstruction (RVO) with recurrent venous thromboembolism (VTE). A retrospective cohort study was conducted determining if RVO on ultrasonography is associated with recurrent VTE in a Singaporean population. The subjects were identified from the Vascular Diagnostic Laboratory patients' record of Tan Tock Seng Hospital (TTSH), Singapore between 2008 and 2013. All the patients included had RVO after 3 months of anticoagulation. Data such as age, gender, race, thrombus location, etiology, history of malignancy, thrombophilia screen, treatment duration, and follow-up were recorded for analysis. Statistical analysis was performed using Stata/SE 13.1 (StataCorp LLC). The study was approved by the National Healthcare Group Domain Specific Review Board (DSRB), Singapore. Out of the 34 patients who had RVO, 6 (17.6%) developed VTE recurrence. Patients were treated with anticoagulation for a mean time of 24.5 months. The mean follow-up time for VTE recurrence was 25.4 months. Out of the six patients who had VTE recurrence, one had common iliac vein involvement, four had superficial femoral vein and common femoral vein involvement, zero had popliteal vein involvement, and one had calf veins involvement. There was a significant association between thrombophilia ( p  = 0.0195) and malignancy ( p  = 0.020) at inclusion with the risk of recurrent VTE. The presence of RVO after 3 months of anticoagulation is likely to increase the risk of VTE recurrence. Larger studies with RVO are needed to evaluate if there is an increased risk of VTE recurrence in the Asian population.

  10. SU-F-J-08: Quantitative SPECT Imaging of Ra-223 in a Phantom

    Energy Technology Data Exchange (ETDEWEB)

    Yue, J; Hobbs, R; Sgouros, G; Frey, E [Johns Hopkins University Baltimore, MD (United States)

    2016-06-15

    Purpose: Ra-223 therapy of prostate cancer bone metastases is being used to treat patients routinely. However, the absorbed dose distribution at the macroscopic and microscopic scales remains elusive, due to the inability to image the small activities injected. Accurate activity quantification through imaging is essential to calculate the absorbed dose in organs and sub-units in radiopharmaceutical therapy, enabling personalized absorbed dose-based treatment planning methodologies and more effective and optimal treatments. Methods: A 22 cm diameter by 20 cm long cylindrical phantom, containing a 3.52 cm diameter sphere, was used. A total of 2.01 MBq of Ra-223 was placed in the phantom with 177.6 kBq in the sphere. Images were acquired on a dual-head Siemens Symbia T16 gamma camera using three 20% full-width energy windows and centered at 84, 154, and 269 keV (120 projections, 360° rotation, 45 s per view). We have implemented reconstruction of Ra-223 SPECT projections using OS-EM (up to 20 iterations of 10 subsets) with compensation for attenuation using CT-based attenuation maps, collimator-detector response (CDR) (including septal penetration, scatter and Pb x-ray modeling), and scatter in the patient using the effective source scatter estimation (ESSE) method. The CDR functions and scatter kernels required for ESSE were computed using the SIMIND MC simulation code. All Ra-223 photon emissions as well as gamma rays from the daughters Rn-219 and Bi-211 were modeled. Results: The sensitivity of the camera in the three combined windows was 107.3 cps/MBq. The visual quality of the SPECT images was reasonably good and the activity in the sphere was 27% smaller than the true activity. This underestimation is likely due to partial volume effect. Conclusion: Absolute quantitative Ra-223 SPECT imaging is achievable with careful attention to compensate for image degrading factors and system calibration.

  11. Women, men, and rheumatoid arthritis: analyses of disease activity, disease characteristics, and treatments in the QUEST-RA study.

    Science.gov (United States)

    Sokka, Tuulikki; Toloza, Sergio; Cutolo, Maurizio; Kautiainen, Hannu; Makinen, Heidi; Gogus, Feride; Skakic, Vlado; Badsha, Humeira; Peets, Tõnu; Baranauskaite, Asta; Géher, Pál; Ujfalussy, Ilona; Skopouli, Fotini N; Mavrommati, Maria; Alten, Rieke; Pohl, Christof; Sibilia, Jean; Stancati, Andrea; Salaffi, Fausto; Romanowski, Wojciech; Zarowny-Wierzbinska, Danuta; Henrohn, Dan; Bresnihan, Barry; Minnock, Patricia; Knudsen, Lene Surland; Jacobs, Johannes Wg; Calvo-Alen, Jaime; Lazovskis, Juris; Pinheiro, Geraldo da Rocha Castelar; Karateev, Dmitry; Andersone, Daina; Rexhepi, Sylejman; Yazici, Yusuf; Pincus, Theodore

    2009-01-01

    Gender as a predictor of outcomes of rheumatoid arthritis (RA) has evoked considerable interest over the decades. Historically, there is no consensus whether RA is worse in females or males. Recent reports suggest that females are less likely than males to achieve remission. Therefore, we aimed to study possible associations of gender and disease activity, disease characteristics, and treatments of RA in a large multinational cross-sectional cohort of patients with RA called Quantitative Standard Monitoring of Patients with RA (QUEST-RA). The cohort includes clinical and questionnaire data from patients who were seen in usual care, including 6,004 patients at 70 sites in 25 countries as of April 2008. Gender differences were analyzed for American College of Rheumatology Core Data Set measures of disease activity, DAS28 (disease activity score using 28 joint counts), fatigue, the presence of rheumatoid factor, nodules and erosions, and the current use of prednisone, methotrexate, and biologic agents. Women had poorer scores than men in all Core Data Set measures. The mean values for females and males were swollen joint count-28 (SJC28) of 4.5 versus 3.8, tender joint count-28 of 6.9 versus 5.4, erythrocyte sedimentation rate of 30 versus 26, Health Assessment Questionnaire of 1.1 versus 0.8, visual analog scales for physician global estimate of 3.0 versus 2.5, pain of 4.3 versus 3.6, patient global status of 4.2 versus 3.7, DAS28 of 4.3 versus 3.8, and fatigue of 4.6 versus 3.7 (P < 0.001). However, effect sizes were small-medium and smallest (0.13) for SJC28. Among patients who had no or minimal disease activity (0 to 1) on SJC28, women had statistically significantly higher mean values compared with men in all other disease activity measures (P < 0.001) and met DAS28 remission less often than men. Rheumatoid factor was equally prevalent among genders. Men had nodules more often than women. Women had erosions more often than men, but the statistical significance

  12. Asymmetric hearing loss in a random population of patients with mild to moderate sensorineural hearing loss.

    Science.gov (United States)

    Segal, Nili; Shkolnik, Mark; Kochba, Anat; Segal, Avichai; Kraus, Mordechai

    2007-01-01

    We evaluated the correlation of asymmetric hearing loss, in a random population of patients with mild to moderate sensorineural hearing loss, to several clinical factors such as age, sex, handedness, and noise exposure. We randomly selected, from 8 hearing institutes in Israel, 429 patients with sensorineural hearing loss of at least 30 dB at one frequency and a speech reception threshold not exceeding 30 dB. Patients with middle ear disease or retrocochlear disorders were excluded. The results of audiometric examinations were compared binaurally and in relation to the selected factors. The left ear's hearing threshold level was significantly higher than that of the right ear at all frequencies except 1.0 kHz (p < .05). One hundred fifty patients (35%) had asymmetric hearing loss (more than 10 dB difference between ears). In most of the patients (85%) the binaural difference in hearing threshold level, at any frequency, was less than 20 dB. Age, handedness, and sex were not found to be correlated to asymmetric hearing loss. Noise exposure was found to be correlated to asymmetric hearing loss.

  13. Population pharmacodynamic model of bicarbonate response to acetazolamide in mechanically ventilated chronic obstructive pulmonary disease patients

    Science.gov (United States)

    2011-01-01

    Introduction Acetazolamide is commonly given to chronic obstructive pulmonary disease (COPD) patients with metabolic alkalosis. Little is known of the pharmacodynamics of acetazolamide in the critically ill. We undertook the pharmacodynamic modeling of bicarbonate response to acetazolamide in COPD patients under mechanical ventilation. Methods This observational, retrospective study included 68 invasively ventilated COPD patients who received one or multiple doses of 250 or 500 mg of acetazolamide during the weaning period. Among the 68 investigated patients, 207 time-serum bicarbonate observations were available for analysis. Population pharmacodynamics was modeled using a nonlinear mixedeffect model. The main covariates of interest were baseline demographic data, Simplified Acute Physiology Score II (SAPS II) at ICU admission, cause of respiratory failure, co-prescription of drugs interfering with the acid-base equilibrium, and serum concentrations of protein, creatinin, potassium and chloride. The effect of acetazolamide on serum bicarbonate levels at different doses and in different clinical conditions was subsequently simulated in silico. Results The main covariates interacting with acetazolamide pharmacodynamics were SAPS II at ICU admission (P = 0.01), serum chloride (P 500 mg twice daily is required to reduce serum bicarbonate concentrations > 5 mmol/L in the presence of high serum chloride levels or coadministration of systemic corticosteroids or furosemide. Conclusions This study identified several covariates that influenced acetazolamide pharmacodynamics and could allow a better individualization of acetazolamide dosing when treating COPD patients with metabolic alkalosis. PMID:21917139

  14. Population pharmacodynamic modeling and simulation of the respiratory effect of acetazolamide in decompensated COPD patients.

    Directory of Open Access Journals (Sweden)

    Nicholas Heming

    Full Text Available Chronic obstructive pulmonary disease (COPD patients may develop metabolic alkalosis during weaning from mechanical ventilation. Acetazolamide is one of the treatments used to reverse metabolic alkalosis.619 time-respiratory (minute ventilation, tidal volume and respiratory rate and 207 time-PaCO2 observations were obtained from 68 invasively ventilated COPD patients. We modeled respiratory responses to acetazolamide in mechanically ventilated COPD patients and then simulated the effect of increased amounts of the drug.The effect of acetazolamide on minute ventilation and PaCO2 levels was analyzed using a nonlinear mixed effect model. The effect of different ventilatory modes was assessed on the model. Only slightly increased minute ventilation without decreased PaCO2 levels were observed in response to 250 to 500 mg of acetazolamide administered twice daily. Simulations indicated that higher acetazolamide dosage (>1000 mg daily was required to significantly increase minute ventilation (P0.75 L min(-1 in 60% of the population. The model also predicts that 45% of patients would have a decrease of PaCO2>5 mmHg with doses of 1000 mg per day.Simulations suggest that COPD patients might benefit from the respiratory stimulant effect after the administration of higher doses of acetazolamide.

  15. Inappropriate prescribing in an acutely ill population of elderly patients as determined by Beers' Criteria.

    LENUS (Irish Health Repository)

    Gallagher, Paul F

    2012-02-03

    INTRODUCTION: Adverse drug events (ADEs) are associated with inappropriate prescribing (IP) and result in increased morbidity, mortality and resource utilisation. We used Beers\\' Criteria to determine the three-month prevalence of IP in a non-selected community-dwelling population of acutely ill older people requiring hospitalisation. METHODS: A prospective, observational study of 597 consecutive acute admissions was performed. Diagnoses and concurrent medications were recorded before hospital physician intervention, and Beers\\' Criteria applied. RESULTS: Mean patient age (SD) was 77 (7) years. Median number of medications was 5, range 0-13. IP occurred in 32% of patients (n = 191), with 24%, 6% and 2% taking 1, 2 and 3 inappropriate medications respectively. Patients taking >5 medications were 3.3 times more likely to receive an inappropriate medication than those taking < or =5 medications (OR 3.34: 95%, CI 2.37-4.79; P<0.001). Forty-nine per cent of patients with inappropriate prescriptions were admitted with adverse effects of the inappropriate medications. Sixteen per cent of all admissions were associated with such adverse effects. CONCLUSION: IP is highly prevalent in acutely ill older patients and is associated with polypharmacy and hospitalisation. However, Beers\\' Criteria cannot be used as a gold standard as they do not comprehensively address all aspects of IP in older people.

  16. Evidence of recombination in Hepatitis C Virus populations infecting a hemophiliac patient

    Directory of Open Access Journals (Sweden)

    Cristina Juan

    2009-11-01

    Full Text Available Abstract Background/Aim Hepatitis C virus (HCV infection is an important cause of morbidity and mortality in patients affected by hereditary bleeding disorders. HCV, as others RNA virus, exploit all possible mechanisms of genetic variation to ensure their survival, such as recombination and mutation. In order to gain insight into the genetic variability of HCV virus strains circulating in hemophiliac patients, we have performed a phylogenetic analysis of HCV strains isolated from 10 patients with this kind of pathology. Methods Putative recombinant sequence was identified with the use of GARD program. Statistical support for the presence of a recombination event was done by the use of LARD program. Results A new intragenotypic recombinant strain (1b/1a was detected in 1 out of the 10 hemophiliac patient studied. The recombination event was located at position 387 of the HCV genome (relative to strain AF009606, sub-type 1a corresponding to the core gene region. Conclusion Although recombination may not appear to be common among natural populations of HCV it should be considered as a possible mechanism for generating genetic diversity in hemophiliacs patients.

  17. Bridging the gap between goal intentions and actions: a systematic review in patient populations.

    Science.gov (United States)

    Kersten, Paula; McCambridge, Alana; M Kayes, Nicola; Theadom, Alice; McPherson, Kathryn M

    2015-01-01

    To evaluate the evidence for the effectiveness of if-then implementation intentions (if-then plans) in adult patient populations. Outcomes of interest included adherence, goal pursuit and physical health outcomes. Keywords were used to search electronic databases without date or language restrictions (up to 30 April 2014). Studies were included if they (1) concerned a patient population; (2) used if-then plans as a sole intervention or as part of treatment, therapy or rehabilitation; (3) if they were randomised controlled trials. The PEDro scale was used to evaluate study quality. Guidance as set out by the Cochrane Collaboration was used. Two reviewers independently extracted data, discrepancies were discussed and if required referred to a third reviewer. In total, 18 of the 2141 articles were identified as potentially relevant and four studies of people with epilepsy, chronic back pain, stroke and obesity met the inclusion criteria. People who form if-then plans achieved better outcomes on epilepsy and stroke medication adherence and physical capacity than controls. Of the four studies that used an if-then plan, only one (people with epilepsy) looked at the intervention as a stand-alone strategy. Further research needs to explore if this simple approach improves rehabilitation outcomes and is a helpful and feasible strategy for people experiencing disabilities. Implications for Rehabilitation Steps involved in achieving goals, such as doing exercises or completing other goal related tasks, can be compromised for people with chronic health conditions particularly resulting from difficulties in self-regulating behaviour. If-then plans are implementation intention tools aimed at supporting people to deal more effectively with self-regulatory problems that might undermine goal striving and goal attainment, and have been found to be effective in health promotion and health behaviour change. This systematic literature review identified four studies completed with

  18. The stigma of mental illness in Southern Ghana: attitudes of the urban population and patients' views.

    Science.gov (United States)

    Barke, Antonia; Nyarko, Seth; Klecha, Dorothee

    2011-11-01

    Stigma is a frequent accompaniment of mental illness leading to a number of detrimental consequences. Most research into the stigma connected to mental illness was conducted in the developed world. So far, few data exist on countries in sub-Saharan Africa and no data have been published on population attitudes towards mental illness in Ghana. Even less is known about the stigma actually perceived by the mentally ill persons themselves. A convenience sample of 403 participants (210 men, mean age 32.4±12.3 years) from urban regions in Accra, Cape Coast and Pantang filled in the Community Attitudes towards the Mentally Ill (CAMI) questionnaire. In addition, 105 patients (75 men, mean age 35.9±11.0 years) of Ghana's three psychiatric hospitals (Accra Psychiatry Hospital, Ankaful Hospital, Pantang Hospital) answered the Perceived Stigma and Discrimination Scale. High levels of stigma prevailed in the population as shown by high proportions of assent to items expressing authoritarian and socially restrictive views, coexisting with agreement with more benevolent attitudes. A higher level of education was associated with more positive attitudes on all subscales (Authoritarianism, Social Restrictiveness, Benevolence and Acceptance of Community Based Mental Health Services). The patients reported a high degree of experienced stigma with secrecy concerning the illness as a widespread coping strategy. Perceived stigma was not associated with sex or age. The extent of stigmatising attitudes within the urban population of Southern Ghana is in line with the scant research in other countries in sub-Saharan Africa and mirrored by the experienced stigma reported by the patients. These results have to be seen in the context of the extreme scarcity of resources within the Ghanaian psychiatric system. Anti-stigma efforts should include interventions for mentally ill persons themselves and not exclusively focus on public attitudes.

  19. Population pharmacokinetics of intravenous Erwinia asparaginase in pediatric acute lymphoblastic leukemia patients.

    Science.gov (United States)

    Sassen, Sebastiaan D T; Mathôt, Ron A A; Pieters, Rob; Kloos, Robin Q H; de Haas, Valérie; Kaspers, Gertjan J L; van den Bos, Cor; Tissing, Wim J E; Te Loo, Maroeska; Bierings, Marc B; Kollen, Wouter J W; Zwaan, Christian M; van der Sluis, Inge M

    2017-03-01

    Erwinia asparaginase is an important component in the treatment of pediatric acute lymphoblastic leukemia. A large variability in serum concentrations has been observed after intravenous Erwinia asparaginase. Currently, Dutch Childhood Oncology Group protocols dose alterations are based on trough concentrations to ensure adequate asparaginase activity (≥100 IU/L). The aim of this study was to describe the population pharmacokinetics of intravenous Erwinia asparaginase to quantify and gather insight into inter-individual and inter-occasion variability. The starting dose was evaluated on the basis of the derived population pharmacokinetic parameters. In a multicenter prospective observational study, a total of 714 blood samples were collected from 51 children (age 1-17 years) with acute lymphoblastic leukemia. The starting dose was 20,000 IU/m 2 three times a week and adjusted according to trough levels from week three onwards. A population pharmacokinetic model was developed using NONMEM ® A 2-compartment linear model with allometric scaling best described the data. Inter-individual and inter-occasion variability of clearance were 33% and 13%, respectively. Clearance in the first month of treatment was 14% higher ( P <0.01). Monte Carlo simulations with our pharmacokinetic model demonstrated that patients with a low weight might require higher doses to achieve similar concentrations compared to patients with high weight. The current starting dose of 20,000 IU/m 2 might result in inadequate concentrations, especially for smaller, lower weight patients, hence dose adjustments based on individual clearance are recommended. The protocols were approved by the institutional review boards. (Registered at NTR 3379 Dutch Trial Register; www.trialregister.nl). Copyright© Ferrata Storti Foundation.

  20. Preparation and labelling hydroxyapatite with 223Ra and 99mTc

    International Nuclear Information System (INIS)

    Malkova, E.; Micolova, P.; Vlk, M.; Kozempel, J.; Rabyk, M.

    2015-01-01

    The aim of this study was the preparation, studies and investigation of novel nanoparticles suitable for targeted delivery of 223 Ra and 99 mTc. Preliminary experiments were focused on the synthesis of hydroxyapatite nanoparticles (HANPs) and their affinity to 223 Ra and 99m Tc. Technetium-99m ( 99 mTc, T 1 /2 = 6.0 h) is the most commonly used medical radionuclide for diagnostic procedures. Radium-223 is the first -emitting radionuclide approved for targeted radionuclide therapy. The physical half-life of 223 Ra of 11.4 days is providing sufficient time for the synthesis, distribution and administration of the radiopharmaceutical to patients. HANPs labelling yields with 223 Ra were 95 - 100 % and with 99m Tc were 93 - 94 % depending on the reaction conditions. HANPs were studied on FT-IR (Fourier transform infrared spectroscopy), XRPD (X-Ray Powder Diffraction), DLS (Dynamic Light Scattering), and the sizes of nanoparticles were studied at temperatures 80, 120 and 200 grad C. (authors)

  1. Radiological impact of diagnostic nuclear medicine technology on the Quebec population (patients and workers) in 1989

    International Nuclear Information System (INIS)

    Renaud, L.; Blanchette, J.

    1992-01-01

    Using the results of a six month survey on the doses received by non-monitored hospital workers from diagnostic nuclear medicine patients (DNMP) in three hospitals and published statistics on Quebec's workers and hospitals, an evaluation of the radiological impact of DNMP has been calculated on the Quebec's population. In 1989, diagnostic nuclear medicine gave an average of 6.4 mSv/act or a total of 2,800 sv-man. The diagnostic nuclear medicine technologists' community received 0.4 Sv-man and the non-monitored hospital workers 1.7 Sv-man from the DNMP in the same year. (author)

  2. Does the applied polytrauma definition notably influence outcome and patient population? - a retrospective analysis.

    Science.gov (United States)

    Frenzel, Stephan; Krenn, Philipp; Heinz, Thomas; Negrin, Lukas Leopold

    2017-08-31

    Although the term "polytrauma" has been in use for decades, no generally accepted definition exists. The aim of this study was to demonstrate that different polytrauma definitions applied to a specific patient population result in diverse subgroups of individuals, who in turn present a varying outcome. All patients (≥18 years) treated at our level I trauma center within a time period of three years were classified according to 11 selected polytrauma definitions and included in our study, if they were rated "polytraumatized" by at least one of these definitions. All patients, who met the criteria of a certain definition, were combined to the relevant definition-positive group, thus resulting in 11 patient subgroups. Their demographic data (number of patients, mean patient age, mean Injury Severity Score value, median number of ventilator days, median length of stay at the intensive care unit and at the hospital, mortality rate and odds ratio) were statistically compared. Three hundred seventy-five patients (73% male) with a mean age of 47 years met the inclusion criteria and were allocated to the relevant subgroups; their patient number varied from 55 to 346 and their mean Injury Severity Score value ranged from 4 to 75. Not surprisingly, all examined parameters were subject to variations. Whereas most definition-positive groups showed a mortality rate of about 21% to 30%, 18% of the individuals, who met the criteria according to Blacker, and 40% of the polytrauma victims according to Schalamon died. The Pape 1-, Schalamon-, and Berlin-positive groups presented a significant odds ratio with regard to mortality that considerably exceeded 1. A polytrauma definition can only be a reliable tool in classifying trauma victims if it provides a significant odds ratio with regard to mortality that considerably exceeds 1 and if it succeeds in capturing patients with multiple severe injuries and a higher mortality rate without reducing the number of polytraumatized

  3. Retrospective analysis of spinal trauma in patients with ankylosing spondylitis: a descriptive study in Indian population.

    Science.gov (United States)

    Mahajan, R; Chhabra, H S; Srivastava, A; Venkatesh, R; Kanagaraju, V; Kaul, R; Tandon, V; Nanda, A; Sangondimath, G; Patel, N

    2015-05-01

    This study aims to understand the demographics, mode of trauma, hospital stay, complications, neurological improvement, mortality and expenditure incurred by Indian patients with spinal trauma and ankylosing spondylitis (AS). Retrospective analysis of the patient data admitted to a tertiary referral hospital from 2008 to 2013 with the diagnosis of AS and spinal trauma was carried out. The variables studied were demographics, mode of trauma, neurological status, neurological improvement, involved vertebral level, duration of hospital stay, comorbid factors, expenditure and complications during the stay. Forty-six patients with diagnosis of AS with spine trauma were admitted over the last 5 years with a total of 52 fractures. All were male patients; 58.6% had injury because of trivial trauma and 78.2% patients presented with neurological injury. C5 C6, C6 C7, C7 D1 and D12 were the most common injured level. Fractures through intervertebral disc were most common in cervical spine. Of the patients, 52.7% had shown neurological improvement of at least grade 1(AIS). Mean expenditure of patient admitted with spinal cord injury (SCI) with AS is 7957 USD (United States dollar), which is around five times the per capita income in India (as per year 2013). Males with AS are much more prone to spinal fractures than females and its incidence may be higher than previously reported. Domestic falls are the most common mechanism of spinal trauma in this population. High velocity injuries are associated with complete SCI. The study reinforces the need for development of subsidized spinal care services for SCI management.

  4. Quality of life in patients with hereditary hemorrhagic telangiectasia in Norway: a population based study.

    Science.gov (United States)

    Geirdal, Amy Østertun; Dheyauldeen, Sinan; Bachmann-Harildstad, Gregor; Heimdal, Ketil

    2012-06-01

    Hereditary hemorrhagic telangiectasia (HHT) is a rare, autosomal dominant disease characterized by the presence of recurrent epistaxis and small characteristic malformations of the peripheral blood vessels near the surface of the skin or mucosal linings. Arteriovenous malformations (AVM) of the lung, liver, and CNS are also known clinical findings. The purpose of this study was to examine quality of life (QoL) in patients with HHT in Norway. Sixty-six affected patients (39 women and 27 men) were included. QoL on overall-, health-related (HR-QoL), and disease-specific levels were measured with Cantril's Ladder (CL), Short Form 36 (SF-36), and a Symptom-specific QoL question in HHT patients (SFB-HHT-Q), respectively. Comparisons were made between patients and an age and gender adjusted normative sample from the Norwegian population (N = 990). Overall, the results reflected that several HHT disease-related variables were associated with reduced QoL on all three levels; overall QoL (CL), HR-QoL (SF36) as well as disease-specific QoL (SFB-HHT-Q), while demographic variables impacted HR-QoL in HHT patients. Compared to the normative sample, all subscales of SF36, but bodily pain, were significantly poorer in the HHT patients. HHT disease variables had the strongest association with QoL compared to demographic variables. The results substantiate that disease severity is associated with poorer QoL in this patients. Pain contributed independently to all levels of QoL. Copyright © 2012 Wiley Periodicals, Inc.

  5. 226Ra and 228Ra activities associated with agricultural drainage ponds and wetland ponds in the Kankakee Watershed, Illinois-Indiana, USA

    International Nuclear Information System (INIS)

    Sidle, W.C.; Shanklin, D.; Lee, P.Y.; Roose, D.L.

    2001-01-01

    Background radioactivity is elevated in many agricultural drainage ponds and also constructed wetland ponds in the Kankakee watershed. During 1995-1999, gross-α and -β activities were measured up to 455 and 1650 mBq L -1 , respectively. 226 Ra and 228 Ra averaged 139 and 192 mBq L -1 in controlled drainage ponds compared to 53 and 58 mBq L -1 for 226 Ra and 228 Ra, respectively, in native wetland ponds. Analyses of applied ammonium phosphate fertilizers near both native and controlled ponds indicate comparable 226 Ra/ 228 Ra and 228 Ra/ 232 Th activity ratios with only the surface waters in the controlled ponds. For example, 226 Ra/ 228 Ra activity ratios in controlled ponds ranged from 0.79 to 0.91 and group with a local fertilizer batch containing FL phosphate compounds with 226 Ra/ 228 Ra activity ratios of 0.83-1.04. Local soils of the Kankakee watershed have 226 Ra/ 228 Ra activity ratios of 0.54-0.70. Calculated Ra fluxes of waters, in drainage ditches associated with these controlled ponds, for 226 Ra ranged from 0.77 to 9.00 mBq cm -2 d -1 and for 228 Ra ranged from 1.22 to 8.43 mBq cm -2 d -1 . Ra activity gradients were measured beneath these controlled ponds both in agricultural landscapes and in constructed wetlands, all being associated with drainage ditches. Ra had infiltrated to the local water table but was below regulatory maximum contaminant limits. Still, measurable Ra activity was measured downgradient of even the constructed wetlands in the Kankakee watershed, suggesting that the attenuation of Ra was low. However, no Ra excess was observed in the riparian zone or the Kankakee River downgradient of the native wetland ponds

  6. RA reactor exploitation, task 3.08/01; Zadatak 3.08/01 - Eksploatacija reaktora RA

    Energy Technology Data Exchange (ETDEWEB)

    Zecevic, V [Institute of Nuclear Sciences Boris Kidric, Reaktor RA, Vinca, Beograd (Serbia and Montenegro)

    1963-12-15

    During 1963 the RA reactor was operated for 1852 hours at mean power of 5.7 MW (total power production was 10716 MWh). Reactor was used for irradiation according to the demand of 356 users, and 15 experiments. The reason for decreased operation in comparison with the previous year was repair of all the reactor equipment and decontamination of the heavy water system. This report contains detailed data about reactor power, reactivity changes and fuel burnup. Mean monthly usage of the reactor experimental channels as well as samples which were irradiated are part of this report.

  7. RA research reactor - properties and experimental capabilities; Istrazivacki reaktor RA - Tehnicke karakteristike i eksploatacione mogucnosti

    Energy Technology Data Exchange (ETDEWEB)

    Milosevic, M; Martinc, R [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1978-05-15

    The brief survey of the Reactor RA exploitation experience, as well as the reactor equipment state, after 18 years of operation is presented. The results of efforts spent on reactor characteristics improvement in order to ensure safe and reliable reactor operation for next 15-20 years, are described. Prikazani su fragmenti iz eksploatacije reaktora kao i stanje opreme, posle 18 godina rada. Na kraju je dat prikaz sta je preduzeto i sta se preduzima da se poboljsaju karakteristike i poveca sigurnost i bezbednost rada za sledecih 15-20 godina.

  8. Measurement of neutrons in the RA reactor cell; Merenje neutrona u elementarnoj celiji reaktora RA

    Energy Technology Data Exchange (ETDEWEB)

    Raisic, N; Bosevski, T [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1961-12-15

    A special experimental device was constructed for measuring the neutron flux distribution in the RA reactor cell. This device simulated the reactor cell in order to avoid disturbance in the reactor core. It was made of an aluminium cylindrical vessel having outer diameter same as the vertical experimental channel and contained three fuel slugs. Hole was made in through the center of the fuel slugs and a copper wire was placed in the hole for measuring the thermal neutron flux distribution. It was placed in the experimental channel VK-5 in the location of highest neutron flux. Handling of samples for irradiation was quite simple.

  9. HIV-infected mental health patients: characteristics and comparison with HIV-infected patients from the general population and non-infected mental health patients

    Directory of Open Access Journals (Sweden)

    Schadé Annemiek

    2013-01-01

    Full Text Available Abstract Objectives HIV-infected patients are at increased risk of developing mental health symptoms, which negatively influence the treatment of the HIV-infection. Mental health problems in HIV-infected patients may affect public health. Psychopathology, including depression and substance abuse, can increase hazardous sexual behaviour and, with it, the chance of spreading HIV. Therefore, it is important to develop an optimal treatment plan for HIV-infected patients with mental health problems. The majority of HIV-infected patients in the Netherlands (almost 60% are homosexual men. The main objectives of this study were to describe the clinical and demographic characteristics of patients with HIV who seek treatment for their mental health symptoms in the Netherlands. Secondly, we tested whether HIV infected and non-infected homosexual patients with a lifetime depressive disorder differed on several mental health symptoms. Methods We compared a cohort of 196 patients who visited the outpatient clinic for HIV and Mental Health with HIV-infected patients in the general population in Amsterdam (ATHENA-study and with non-HIV infected mental health patients (NESDA-study. DSM-IV diagnoses were determined, and several self-report questionnaires were used to assess mental health symptoms. Results Depressive disorders were the most commonly occurring diagnoses in the cohort and frequent drug use was common. HIV-infected homosexual men with a depressive disorder showed no difference in depressive symptoms or sleep disturbance, compared with non-infected depressive men. However, HIV-positive patients did express more symptoms like fear, anger and guilt. Although they showed significantly more suicidal ideation, suicide attempts were not more prevalent among HIV-infected patients. Finally, the HIV-infected depressive patients displayed a considerably higher level of drug use than the HIV-negative group. Conclusion Habitual drug use is a risk factor for

  10. Seasonal variations in 228Ra/226Ra ratio within coastal waters of the Sea of Japan: implications for water circulation patterns in coastal areas

    International Nuclear Information System (INIS)

    Inoue, M.; Tanaka, K.; Watanabe, S.; Kofuji, H.; Yamamoto, M.; Komura, K.

    2006-01-01

    In this study, low-background γ-spectrometry was used to determine the 228 Ra/ 226 Ra ratio of 131 coastal water samples from various environments around Honshu Island, Japan (mainly around Noto Peninsula) at 1-3 month intervals from April 2003 until September 2005. Spatial variation in 228 Ra/ 226 Ra ratios was also assessed by analyzing 34 coastal water samples from five areas within the Sea of Japan during May and June 2004. The 228 Ra/ 226 Ra ratio of coastal water from all sites around Noto Peninsula shows seasonal variation, with minimum values during summer ( 228 Ra/ 226 Ra = 0.7) and maximum values during autumn-winter ( 228 Ra/ 226 Ra = 1.7-2). This seasonal variation is similar to that recorded for coastal water between Tsushima Strait and Noto Peninsula. The measured lateral variation in 228 Ra/ 226 Ra ratios within coastal water between Tsushima Strait and Noto Peninsula is only minor (0.5-0.7; May-June 2004). Coastal waters from two other sites (Pacific shore and Tsugaru Strait, north Honshu) show no clear seasonal variation in 228 Ra/ 226 Ra ratio. These measured variations in 228 Ra/ 226 Ra ratio, especially the temporal variations, have important implications for seasonal changes in patterns of coastal water circulation within the Sea of Japan