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Sample records for selective mutism treated

  1. Selective Mutism: Treating the Silent Child

    Science.gov (United States)

    Shott, Elizabeth F.; Warren, Mary Ellen

    2011-01-01

    Infant mental health specialists are increasingly expected to treat complex mental health disorders in very young children. Selective mutism is an anxiety disorder which can lead to functional impairment across home, preschool, and community settings. The authors share their experiences with Keylah, a preschooler with significant social anxiety…

  2. Selective mutism.

    Science.gov (United States)

    Hua, Alexandra; Major, Nili

    2016-02-01

    Selective mutism is a disorder in which an individual fails to speak in certain social situations though speaks normally in other settings. Most commonly, this disorder initially manifests when children fail to speak in school. Selective mutism results in significant social and academic impairment in those affected by it. This review will summarize the current understanding of selective mutism with regard to diagnosis, epidemiology, cause, prognosis, and treatment. Studies over the past 20 years have consistently demonstrated a strong relationship between selective mutism and anxiety, most notably social phobia. These findings have led to the recent reclassification of selective mutism as an anxiety disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. In addition to anxiety, several other factors have been implicated in the development of selective mutism, including communication delays and immigration/bilingualism, adding to the complexity of the disorder. In the past few years, several randomized studies have supported the efficacy of psychosocial interventions based on a graduated exposure to situations requiring verbal communication. Less data are available regarding the use of pharmacologic treatment, though there are some studies that suggest a potential benefit. Selective mutism is a disorder that typically emerges in early childhood and is currently conceptualized as an anxiety disorder. The development of selective mutism appears to result from the interplay of a variety of genetic, temperamental, environmental, and developmental factors. Although little has been published about selective mutism in the general pediatric literature, pediatric clinicians are in a position to play an important role in the early diagnosis and treatment of this debilitating condition.

  3. [Selective mutism].

    Science.gov (United States)

    Ytzhak, A; Doron, Y; Lahat, E; Livne, A

    2012-10-01

    Selective mutism is an uncommon disorder in young children, in which they selectively don't speak in certain social situations, while being capable of speaking easily in other social situations. Many etiologies were proposed for selective mutism including psychodynamic, behavioral and familial etc. A developmental etiology that includes insights from all the above is gaining support. Accordingly, mild language impairment in a child with an anxiety trait may be at the root of developing selective mutism. The behavior will be reinforced by an avoidant pattern in the family. Early treatment and followup for children with selective mutism is important. The treatment includes non-pharmacological therapy (psychodynamic, behavioral and familial) and pharmacologic therapy--mainly selective serotonin reuptake inhibitors (SSRI).

  4. Selective mutism

    OpenAIRE

    VENCLÍKOVÁ, Jana

    2014-01-01

    The thesis deals with the elective mutism in a child of pre-school age. In the theoretical part describes the problems of mutism, i.e. elective definition, etiology and clinical presentation. Further possibilities of differential diagnosis and intersectoral cooperation in diagnosis and therapy of elective mutism. Part of the therapy are also options for reeducation in children. The empirical part of the Bachelor thesis is focused on the case study of a boy with diagnosed elective mutism. On t...

  5. Silent suffering: understanding and treating children with selective mutism.

    Science.gov (United States)

    Manassis, Katharina

    2009-02-01

    Children with selective mutism (SM) restrict speech in some social environments, often resulting in substantial academic and social impairment. Although SM is considered rare, one or more children with SM can be found in most elementary schools. Assessment is performed to confirm the diagnosis, rule out psychological and medical factors that may account for the mutism, ascertain comorbid and exacerbating conditions needing treatment, and develop an intervention plan. Interventions are often multidisciplinary and focus on decreasing anxiety, increasing social speech and ameliorating SM-related impairment. Research is limited, but symptomatic improvement has been demonstrated with behavioral interventions and multimodal treatments that include school and family participation, as well as behavioral methods. Selective serotonin-reuptake inhibitors, especially fluoxetine, have also been found to be efficacious and merit consideration in severe cases. Persistence of some SM or anxiety symptoms despite treatment is common. Further development of treatments targeting specific etiological factors, comparative treatment studies and determination of optimal involvement of families and schools in treatment are needed to improve outcomes for children with SM.

  6. Treating Youths with Selective Mutism with an Alternating Design of Exposure-Based Practice and Contingency Management

    Science.gov (United States)

    Vecchio, Jennifer; Kearney, Christopher A.

    2009-01-01

    Selective mutism is a severe childhood disorder involving failure to speak in public situations in which speaking is expected. The present study examined 9 youths with selective mutism treated with child-focused, exposure-based practices and parent-focused contingency management via an alternating treatments design. Broadband measures of…

  7. Examination of a Social Problem-Solving Intervention to Treat Selective Mutism

    NARCIS (Netherlands)

    O'Reilly, M.F.; McNally, D.; Sigafoos, J.; Lancioni, G.E.; Green, V.A.; Edrisinha, C.; Machalicek, W.A.; Sorrells, A.; Didden, H.C.M.

    2008-01-01

    The authors examined the use of a social problem-solving intervention to treat selective mutism with 2 sisters in an elementary school setting. Both girls were taught to answer teacher questions in front of their classroom peers during regular classroom instruction. Each girl received individualized

  8. Examination of a Social Problem-Solving Intervention to Treat Selective Mutism

    Science.gov (United States)

    O'Reilly, Mark; McNally, Deirdre; Sigafoos, Jeff; Lancioni, Giulio E.; Green, Vanessa; Edrisinha, Chaturi; Machalicek, Wendy; Sorrells, Audrey; Lang, Russell; Didden, Robert

    2008-01-01

    The authors examined the use of a social problem-solving intervention to treat selective mutism with 2 sisters in an elementary school setting. Both girls were taught to answer teacher questions in front of their classroom peers during regular classroom instruction. Each girl received individualized instruction from a therapist and was taught to…

  9. Treating Selective Mutism Using Modular CBT for Child Anxiety: A Case Study

    Science.gov (United States)

    Reuther, Erin T.; Davis, Thompson E., III; Moree, Brittany N.; Matson, Johnny L.

    2011-01-01

    Selective mutism is a rare, debilitating condition usually seen in children. Unfortunately, there is little research examining effective treatments for this disorder, and designing an evidence-based treatment plan can be difficult. This case study presents the evidence-based treatment of an 8-year-old Caucasian boy with selective mutism using an…

  10. [Treatment of selective mutism].

    Science.gov (United States)

    Melfsen, Siebke; Warnke, Andreas

    2007-11-01

    Selective mutism is a communication disorder of childhood in which the child does not speak in specific social situations despite the ability to speak in other situations. A literature review was completed in order to provide practical guidelines for the assessment and treatment of children with selective mutism. There are many different behavioral approaches in the treatment of this disorder, e.g. contingency management, shaping, stimulus fading, escape-avoidance, self-modeling, learning theory approaches. A clearer diagnostic understanding of the disorder as part of anxiety or oppositional disorders needs to be realized prior to generalize an effective treatment for this disorder.

  11. Selective Mutism: Phenomenological Characteristics.

    Science.gov (United States)

    Ford, Mary Ann; Sladeczek, Ingrid E.; Carlson, John; Kratochwill, Thomas R.

    1998-01-01

    To explore factors related to selective mutism (SM), a survey of persons (N=153, including 135 children) with SM was undertaken. Three theoretical assumptions are supported: (1) variant talking behaviors prior to identification of SM; (2) link between SM and social anxiety; (3) potential link between temperament and SM. (EMK)

  12. When to Intervene in Selective Mutism: The Multimodal Treatment of a Case of Persistent Selective Mutism.

    Science.gov (United States)

    Powell, Shawn; Dalley, Mahlono

    1995-01-01

    An identification and treatment model differentiating transient mutism from persistent selective mutism is proposed. The case study of a six-year-old girl is presented, who was treated with a multimodal approach combining behavioral techniques with play therapy and family involvement. At posttreatment and follow-up, she was talking in a manner…

  13. Behavioral Intervention to Treat Selective Mutism across Multiple Social Situations and Community Settings

    Science.gov (United States)

    Lang, Russell; Regester, April; Mulloy, Austin; Rispoli, Mandy; Botout, Amanda

    2011-01-01

    We evaluated a behavioral intervention for a 9-year-old girl with selective mutism. The intervention consisted of role play and video self-modeling. The frequency of spoken initiations, responses to questions, and communication breakdowns was measured during three social situations (i.e., ordering in a restaurant, meeting new adults, and playing…

  14. Selective Mutism in Elementary Students

    Science.gov (United States)

    Hahn, Jennifer Joy

    2008-01-01

    Selective mutism is defined as "the consistent failure to speak in specific social situations despite the ability to speak in other settings" (American Psychiatric Association, 1994 as cited in Zelenko & Shaw, 2000). For many years, selective mutism was considered to be a very rare disorder amongst individuals, and little attention…

  15. A Selective Mutism Arising from First Language Attrition, Successfully Treated with Paroxetine-CBT Combination Treatment.

    Science.gov (United States)

    Serra, Agostino; Di Mauro, Paola; Andaloro, Claudio; Maiolino, Luigi; Pavone, Piero; Cocuzza, Salvatore

    2015-10-01

    After immersion in a foreign language, speakers often have difficulty retrieving native-language words and may experience a decrease in its proficiency, this phenomenon, in the non-pathological form, is known as first language attrition. Self-perception of this low native-language proficiency and apprehension occurring when speaking is expected and, may sometimes lead these people to a state of social anxiety and, in extreme forms, can involve the withholding of speech as a primitive tool for self-protection, linking them to selective mutism. We report an unusual case of selective mutism arising from first language attrition in an Italian girl after attending a two-year "German language school", who successfully responded to a paroxetine-cognitive behavioral treatment (CBT) combination treatment.

  16. Phenomenology and treatment of selective mutism.

    Science.gov (United States)

    Kumpulainen, Kirsti

    2002-01-01

    Selective mutism is a multidimensional childhood disorder in which, according to the most recent studies, biologically mediated temperament and anxiety components seem to play a major role. Several psychotherapy methods have been reported in case studies to be useful, but the disorder is commonly seen to be resistant to change, particularly in cases of long duration. Currently, behaviour modification and other cognitive methods, together with cooperation with the family and the school personnel, are recommended in the treatment of selective mutism. Selective serotonin reuptake inhibitors and selective monoamine oxidase inhibitors have also been reported to be helpful when treating children with selective mutism. At the moment, pharmacotherapy cannot be recommended as the treatment of first choice but if other methods of treatment are not helpful, medication can be included in the treatment scheme. Comprehensive evaluation and treatment of possible primary and comorbid problems that require treatment are also essential.

  17. Contemporary views on selective mutism

    Directory of Open Access Journals (Sweden)

    Dimoski Sanja

    2016-01-01

    Full Text Available The aim of this paper is to review contemporary literature on selective mutism (SM, available in our language. The paper includes a contemporary definition of the disorder, previous studies of selective mutism, theories about its origin, and treatment. SM is a disorder that occurs in childhood, when a child's speech is selectively lacking in certain social situations. School is the context in which the disorder is typically manifested, which is why SM is often diagnosed only after children start school. The paper gives a historical account of changes in views on this disorder. Modern conceptions emphasize selective inability of children to spontaneously and successfully express themselves verbally. In researching SM, case studies on children who have selective mutism are most commonly published. Etiological factors are not precisely defined, and different conceptions give their interpretations depending on various theoretical frameworks. Some studies consistently indicate a relation between SM and social anxiety, and some with opposing behavior and delays in language development. Based on theoretical explanations of SM, psychological interventions (behavioral and cognitive-behavioral, psychodynamic and projective techniques, counseling and family therapy are created. Modern treatment of selective mutism includes an eclectic approach and emphasizes the role of teachers and school in general. Future studies should deepen the knowledge about selective mutism, specify the methodological procedure and stimulate the individualized treatment of children with SM.

  18. Selective Serotonin Reuptake Inhibitors for Treatment of Selective Mutism

    Directory of Open Access Journals (Sweden)

    Mazlum Çöpür

    2012-03-01

    Full Text Available Some authors suggest that selective mutism should be considered as a variant of social phobia or a disorder in the obsessive-compulsive spectrum. Recent studies indicate that pharmacological treatments may be effective in the treatment of selective mutism. In this article, four cases who were treated with citalopram and escitalopram are presented. The results indicate that the drugs were well tolerated, and the level of social and verbal interactions improved significantly. These findings have shown that citalopram and escitalopram can be considered in medication of selective mutism; nevertheless, it is essential that research be done with more cases than previous ones, in order to prove their accuracy

  19. Selective Mutism: Causes and Interventions.

    Science.gov (United States)

    Hultquist, Alan M.

    1995-01-01

    This article reviews the literature regarding the diagnostic criteria, causes, assessment, and treatment of selective mutism in school-age children. The most successful treatments have included various forms or combinations of behavior modification, though these may not address the underlying problem. (Author/DB)

  20. Selective mutism and abnormal electroencephalography (EEG) tracings.

    Science.gov (United States)

    Politi, Keren; Kivity, Sara; Goldberg-Stern, Hadassa; Halevi, Ayelet; Shuper, Avinoam

    2011-11-01

    Epileptic discharges are not considered a part of the clinical picture of selective mutism, and electroencephalography is generally not recommended in its work-up. This report describes 6 children with selective mutism who were found to have a history of epilepsy and abnormal interictal or subclinical electroencephalography recordings. Two of them had benign epilepsy of childhood with centro-temporal spikes. The mutism was not related in time to the presence of active seizures. While seizures could be controlled in all children by medications, the mutism resolved only in 1. Although the discharges could be coincidental, they might represent a co-morbidity of selective mutism or even play a role in its pathogenesis. Selective mutism should be listed among the psychiatric disorders that may be associated with electroencephalographic abnormalities. It can probably be regarded as a symptom of a more complicated organic brain disorder.

  1. Selective mutism: a review of etiology, comorbidities, and treatment.

    Science.gov (United States)

    Wong, Priscilla

    2010-03-01

    Selective mutism is a rare and multidimensional childhood disorder that typically affects children entering school age. It is characterized by the persistent failure to speak in select social settings despite possessing the ability to speak and speak comfortably in more familiar settings. Many theories attempt to explain the etiology of selective mutism.Comorbidities and treatment. Selective mutism can present a variety of comorbidities including enuresis, encopresis, obsessive-compulsive disorder, depression, premorbid speech and language abnormalities, developmental delay, and Asperger's disorders. The specific manifestations and severity of these comorbidities vary based on the individual. Given the multidimensional manifestations of selective mutism, treatment options are similarly diverse. They include individual behavioral therapy, family therapy, and psychotherapy with antidepressants and anti-anxiety medications.Future directions. While studies have helped to elucidate the phenomenology of selective mutism, limitations and gaps in knowledge still persist. In particular, the literature on selective mutism consists primarily of small sample populations and case reports. Future research aims to develop an increasingly integrated, multidimensional framework for evaluating and treating children with selective mutism.

  2. Selective Mutism Questionnaire: Measurement Structure and Validity

    Science.gov (United States)

    Letamendi, Andrea M.; Chavira, Denise A.; Hitchcock, Carla A.; Roesch, Scott C.; Shipon-Blum, Elisa; Stein, Murray B.

    2008-01-01

    The psychometric properties of the Selective Mutism Questionnaire (SMQ) are evaluated using a clinical sample of children with selective mutism (SM). The study shows that SMQ is useful in determining the severity of a child's nonspeaking behaviors, the scope of these behaviors and necessary follow up assessment.

  3. Social phobia and selective mutism.

    Science.gov (United States)

    Keeton, Courtney P; Crosby Budinger, Meghan

    2012-07-01

    Social phobia (SOP) and selective mutism (SM) are related anxiety disorders characterized by distress and dysfunction in social situations. SOP typically onsets in adolescence and affects about 8% of the general population, whereas SM onsets before age 5 and is prevalent in up to 2% of youth. Prognosis includes a chronic course that confers risk for other disorders or ongoing social disability, but more favorable outcomes may be associated with young age and low symptom severity. SOP treatments are relatively more established, whereas dissemination of promising and innovative SM-treatment strategies is needed.

  4. Augmented Self-Modeling as an Intervention for Selective Mutism

    Science.gov (United States)

    Kehle, Thomas J.; Bray, Melissa A.; Byer-Alcorace, Gabriel F.; Theodore, Lea A.; Kovac, Lisa M.

    2012-01-01

    Selective mutism is a rare disorder that is difficult to treat. It is often associated with oppositional defiant behavior, particularly in the home setting, social phobia, and, at times, autism spectrum disorder characteristics. The augmented self-modeling treatment has been relatively successful in promoting rapid diminishment of selective mutism…

  5. Female monozygotic twins with selective mutism--a case report.

    Science.gov (United States)

    Sharkey, L; Mc Nicholas, F

    2006-04-01

    Selective mutism is a rare social anxiety disorder characterized by a total lack of speech in certain specific situations despite the ability to speak in others. Both genetic and psychosocial factors are thought to be involved in its presentation, persistence, and response to treatment. This case report describes a case of young female monozygotic twins who presented with selective mutism and their treatment spanning a 2-year period. It highlights the strong genetic association along with environmental factors such as social isolation and consequences of maternal social phobia, all contributing to treatment resistance, despite an intensive multimodal biopsychosocial approach. General issues related to the difficulties in treating monozygotic twins are also addressed.

  6. Multimethod Behavioral Treatment of Long-Term Selective Mutism.

    Science.gov (United States)

    Watson, T. Steuart; Kramer, Jack J.

    1992-01-01

    Conducted single-subject, experimental research to examine efficacy of treating severe, long-term selective mutism in nine-year-old male using shaping, multiple reinforcers, natural consequences, stimulus fading, and mild aversives. Implemented different treatment regimens in home and school environments. Home intervention resulted in increase in…

  7. Selective Mutism in Elementary School: Multidisciplinary Interventions.

    Science.gov (United States)

    Giddan, Jane J.; And Others

    1997-01-01

    Presents the symptoms of selective mutism and historical background for treatment. It provides a case study which illustrates successful multidisciplinary treatment outcomes for a child who was selectively mute. Issues relevant to speech-language pathologists working with elementary school children are discussed and treatment guidelines provided.…

  8. Selective Mutism: Definition, Issues, and Treatment.

    Science.gov (United States)

    Brigham, Frederick J.; Cole, Jane E.

    This paper reviews definitions and issues in selective mutism in children and summarizes results of interventions conducted and published since 1982. Definitions and diagnostic criteria of the American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (1994)" and the World Health Organization's…

  9. Elective Mutism Associated with Selective Inactivity.

    Science.gov (United States)

    Hill, Linda; Scull, John

    1985-01-01

    Effective treatment procedures for a nine-year-old boy with elective mutism and selective inactivity included increasing the frequency of situations in which he could already speak and decreasing the frequency of those in which he seldom spoke (specifically coercive situations). (CL)

  10. Silent Suffering: Children with Selective Mutism

    Science.gov (United States)

    Camposano, Lisa

    2011-01-01

    Despite increasing awareness, the childhood disorder of selective mutism is under-researched and commonly misdiagnosed. The purpose of this article is to highlight current issues related to this disorder as well as describe various treatment approaches including behavioral, cognitive-behavioral, psychodynamic, family, and pharmacological…

  11. Mutism: elective or selective, and acquired.

    Science.gov (United States)

    Gordon, N

    2001-03-01

    When a child does not speak, this may be because there is no wish to do so (elective or selective mutism), or the result of lesions in the brain, particularly in the posterior fossa. The characteristics of the former children are described, especially their shyness; and it is emphasized that mild forms are quite common and a definitive diagnosis should only be made if the condition is significantly affecting the child and family. In the case of mutism due to organic causes, the commonest of these is trauma to the cerebellum. Operations on the cerebellum to remove tumours can be followed by mutism, often after an interval of a few days, and it may last for several months or longer, to be followed by dysarthria. Other rarer causes are discussed, and also the differential diagnosis. The so-called posterior fossa syndrome consists of mutism combined with ataxia, cranial nerve palsies, bulbar palsies, hemiparesis, cognitive impairment and emotional lability, but the post-operative symptoms are often dominated by the lack of speech. The most accepted cause for the condition is vascular spasm with involvement of the dentate nucleus and the dentatorubrothalamic tracts to the brain-stem, and subsequently to the cortex. Diaschisis may be involved in causing the loss of higher cerebral functions, and possibly, complicating hydrocephalus. The treatment of elective mutism is reviewed, either using a psychotherapeutic approach or a variety of drugs, or both. These may well be ineffective, and it must be remembered that the condition often resolves on its own. The former treatment must concentrate on the training of social skills and activities of daily life and must be targeted to both the child, the family, and the school. Also, all kinds of punishment and insistence on speech must be discouraged. The drug, which seems to be most effective, is fluoxetine. Discovering more about the causes of mutism due to organic causes may well depend on studies using such techniques as

  12. Selective Mutism: A Review of Etiology, Comorbidities, and Treatment

    OpenAIRE

    Wong, Priscilla

    2010-01-01

    Selective mutism is a rare and multidimensional childhood disorder that typically affects children entering school age. It is characterized by the persistent failure to speak in select social settings despite possessing the ability to speak and speak comfortably in more familiar settings. Many theories attempt to explain the etiology of selective mutism.

  13. Behavior Observations for Linking Assessment to Treatment for Selective Mutism

    Science.gov (United States)

    Shriver, Mark D.; Segool, Natasha; Gortmaker, Valerie

    2011-01-01

    Selective mutism is a childhood disorder that most school psychologists and educational providers will come across at least once in their careers. Selective mutism is associated with significant impairment in educational settings where speaking is necessary for academic and social skill development. Effective treatments for selective mutism…

  14. Treatment of Selective Mutism: A Best-Evidence Synthesis.

    Science.gov (United States)

    Stone, Beth Pionek; Kratochwill, Thomas R.; Sladezcek, Ingrid; Serlin, Ronald C.

    2002-01-01

    Presents systematic analysis of the major treatment approaches used for selective mutism. Based on nonparametric statistical tests of effect sizes, major findings include the following: treatment of selective mutism is more effective than no treatment; behaviorally oriented treatment approaches are more effective than no treatment; and no…

  15. The Development and Psychometric Properties of the Selective Mutism Questionnaire

    Science.gov (United States)

    Bergman, R. Lindsey; Keller, Melody L.; Piacentini, John; Bergman, Andrea J.

    2008-01-01

    Research on selective mutism (SM) has been limited by the absence of standardized, psychometrically sound assessment measures. The purpose of our investigation was to present two studies that examined the factor structure and initial reliability and validity of the Selective Mutism Questionnaire (SMQ), a 17-item parent report measure of failure to…

  16. A Controlled Single-Case Treatment of Severe Long-Term Selective Mutism in a Child with Mental Retardation

    Science.gov (United States)

    Facon, Bruno; Sahiri, Safia; Riviere, Vinca

    2008-01-01

    The aim of the present study was to demonstrate the efficacy of combining two operant learning procedures--shaping and fading--for treating selective mutism. The participant was a 12-year-old boy with mental retardation presenting a severe long-term selective mutism. The treatment was aimed at increasing the loudness of his vocalizations in an…

  17. Pediatric selective mutism therapy: a randomized controlled trial.

    Science.gov (United States)

    Esposito, Maria; Gimigliano, Francesca; Barillari, Maria R; Precenzano, Francesco; Ruberto, Maria; Sepe, Joseph; Barillari, Umberto; Gimigliano, Raffaele; Militerni, Roberto; Messina, Giovanni; Carotenuto, Marco

    2017-10-01

    Selective mutism (SM) is a rare disease in children coded by DSM-5 as an anxiety disorder. Despite the disabling nature of the disease, there is still no specific treatment. The aims of this study were to verify the efficacy of six-month standard psychomotor treatment and the positive changes in lifestyle, in a population of children affected by SM. Randomized controlled trial registered in the European Clinical Trials Registry (EuDract 2015-001161-36). University third level Centre (Child and Adolescent Neuropsychiatry Clinic). Study population was composed by 67 children in group A (psychomotricity treatment) (35 M, mean age 7.84±1.15) and 71 children in group B (behavioral and educational counseling) (37 M, mean age 7.75±1.36). Psychomotor treatment was administered by trained child therapists in residential settings three times per week. Each child was treated for the whole period by the same therapist and all the therapists shared the same protocol. The standard psychomotor session length is of 45 minutes. At T0 and after 6 months (T1) of treatments, patients underwent a behavioral and SM severity assessment. To verify the effects of the psychomotor management, the Child Behavior Checklist questionnaire (CBCL) and Selective Mutism Questionnaire (SMQ) were administered to the parents. After 6 months of psychomotor treatment SM children showed a significant reduction among CBCL scores such as in social relations, anxious/depressed, social problems and total problems (Pselective mutism, even if further studies are needed. The present study identifies in psychomotricity a safe and efficacy therapy for pediatric selective mutism.

  18. Unable to Speak: Selective Mutism in Youth.

    Science.gov (United States)

    Smith-Schrandt, Heather L; Ellington, Erin

    2018-02-01

    It is important for psychiatric nurses to be familiar with the clinical presentation and recommended treatment for selective mutism (SM), as it is a childhood anxiety disorder that is not commonly studied. This article provides a brief overview of its diagnostic criteria, prevalence, assessment, and history. Special attention is given to misconceptions regarding the disorder and differentiation of trauma and oppositional disorders. Two vignettes illustrate varied presentations of SM, with and without comorbid social phobia. Empirically supported behavioral and psychopharmacological treatment is outlined, and considerations for nursing are provided. [Journal of Psychosocial Nursing and Mental Health Services, 56(2), 14-18.]. Copyright 2018, SLACK Incorporated.

  19. Two sets of twins with selective mutism: neuropsychological findings.

    Science.gov (United States)

    Gray, Robert M; Jordan, Catherine M; Ziegler, Richard S; Livingston, Ronald B

    2002-03-01

    Neuropsychological data are reviewed from two sets of dizygotic twins presenting with selective mutism characterized by situation specific anxiety, extreme passive behavior, lack of responsivity, lack of peer interaction, and a chronic course of selective mutism. Both sets of twins had a history of prematurity and delayed speech development. One set of twins presented with normal intelligence and normal receptive language skills but with expressive language and oral motor sequencing difficulties. The second set of twins presented with Verbal IQ deficits and significant receptive and expressive language deficits. A summary of current conceptualizations regarding etiology and treatment of selective mutism is provided.

  20. Selective Mutism and Social Anxiety Disorder: All in the Family?

    Science.gov (United States)

    Chavira, Denise A.; Shipon-Blum, Elisa; Hitchcock, Carla; Cohan, Sharon; Stein, Murray B.

    2007-01-01

    The relationship between a history of lifetime psychiatric disorders of parents with selective mutism (SM) in their children is examined. The results support earlier findings of a familial relationship between generalized social phobia and SM.

  1. Treatment of selective mutism: focus on selective serotonin reuptake inhibitors.

    Science.gov (United States)

    Kaakeh, Yaman; Stumpf, Janice L

    2008-02-01

    Abstract Selective mutism is a pediatric psychiatric disorder that occurs when a child consistently fails to speak in specific situations in which speaking is expected, such as at school and social gatherings, but speaks appropriately in other settings. Selective mutism often is diagnosed when a child starts school and does not talk to teachers or peers, but talks to family members at home; the condition is frequently accompanied by anxiety and shyness. Although the underlying etiology of the condition remains unclear, psychotherapy is the preferred initial treatment, with the support of parents and teachers. If the child does not respond to psychotherapy, addition of pharmacologic treatment should be considered, depending on the severity of symptoms and presence of other illnesses. Although data are limited to case reports and trials with small patient populations and short follow-up periods, some patients with selective mutism respond to therapy with selective serotonin reuptake inhibitors (SSRIs). Fluoxetine is the most studied SSRI as treatment for the condition, although further investigation is required to determine the optimal dosage and duration of therapy.

  2. Selective mutism: more than social anxiety?

    Science.gov (United States)

    Yeganeh, Robin; Beidel, Deborah C; Turner, Samuel M

    2006-01-01

    This study investigated the relationship between selective mutism (SM), social phobia (SP), oppositionality, and parenting styles. Twenty-one children with SP, 21 children with SM and SP, and 21 normal children ages 7-15, and the mother of each child, participated in an assessment of psychopathological factors potentially related to SM. Children with SM did not endorse higher levels of social anxiety than did children with SP, although clinicians gave higher severity ratings to those who had both disorders. In addition, although a dimensional measure of oppositionality (Eyberg Child Behavior Inventory) did not reveal group differences, there were significantly more diagnoses of oppositional defiant disorder among children with SM (29%) in comparison to children with SP alone (5%). With respect to parenting styles, there were no significant differences among parents of children with SM and the other groups, except that children with SP reported significantly less warmth/acceptance from parents than normal children. These data replicate previous findings that children with SM do not report greater social anxiety than other children with a SP diagnosis. Furthermore, they suggest that oppositional behaviors may be part of the clinical presentation of a subset of children with SM.

  3. Too Anxious to Speak? The Implications of Current Research into Selective Mutism for Educational Psychology Practice

    Science.gov (United States)

    Cleave, Hayley

    2009-01-01

    Selective Mutism is a low incidence disorder but has considerable impact on the school system when it occurs. Over the last decade several research articles have been published which have challenged the understanding of the aetiology of Selective Mutism. Current perceptions about the aetiology of Selective Mutism are considered in order to inform…

  4. Comparing interventions for selective mutism: a pilot study.

    Science.gov (United States)

    Manassis, Katharina; Tannock, Rosemary

    2008-10-01

    To examine the outcome within 6 to 8 months of medical and nonmedical intervention for children with severe selective mutism (SM). Children with SM (n = 17) and their mothers, seen in a previous study, attended follow-up appointments with a clinician. Obtained by maternal report were: treatment received, current diagnosis (based on semi-structured interview), speech in various environments, and global improvement. An independent clinician also rated global functioning. The diagnosis of SM persisted in 16 children, but significant symptomatic improvement was evident in the sample. All children had received school consultations. Children who had been treated with selective serotonin reuptake inhibitors (SSRI) (n = 10) showed greater global improvement, improvement in functioning, and improvement in speech outside the family than children who were unmedicated (n = 7). No differences were evident for children receiving and not receiving additional nonmedical intervention. The findings suggest the potential benefit of SSRI treatment in severe SM, but randomized comparative treatment studies are indicated.

  5. Narrative Skills in Children with Selective Mutism: An Exploratory Study

    Science.gov (United States)

    McInnes, Alison; Fung, Daniel; Manassis, Katharina; Fiksenbaum, Lisa; Tannock, Rosemary

    2004-01-01

    Selective mutism (SM) is a rare and complex disorder associated with anxiety symptoms and speech-language deficits; however, the nature of these language deficits has not been studied systematically. A novel cross-disciplinary assessment protocol was used to assess anxiety and nonverbal cognitive, receptive language, and expressive narrative…

  6. Functional Assessment-Based Intervention for Selective Mutism

    Science.gov (United States)

    Kern, Lee; Starosta, Kristin M.; Bambara, Linda M.; Cook, Clayton R.; Gresham, Frank R.

    2007-01-01

    The process of functional assessment has emerged as an essential component for intervention development. Applications across divergent types of problem behavior, however, remain limited. This study evaluated the applicability of this promising approach to students with selective mutism. Two middle school students served as participants. The…

  7. Language and Academic Abilities in Children with Selective Mutism

    Science.gov (United States)

    Nowakowski, Matilda E.; Cunningham, Charles E.; McHolm, Angela E.; Evans, Mary Ann; Edison, Shannon; St. Pierre, Jeff; Boyle, Michael H.; Schmidt, Louis A.

    2009-01-01

    We examined receptive language and academic abilities in children with selective mutism (SM; n = 30; M age = 8.8 years), anxiety disorders (n = 46; M age = 9.3 years), and community controls (n = 27; M age = 7.8 years). Receptive language and academic abilities were assessed using standardized tests completed in the laboratory. We found a…

  8. Assessment and Treatment of Selective Mutism with English Language Learners

    Science.gov (United States)

    Mayworm, Ashley M.; Dowdy, Erin; Knights, Kezia; Rebelez, Jennica

    2015-01-01

    Selective mutism (SM) is a type of anxiety disorder that involves the persistent failure to speak in contexts where speech is typically expected (e.g., school), despite speaking in other contexts (e.g., home). Research on the etiology and treatment of SM is limited, as it is a rare disorder and few clinical trials evaluating SM interventions have…

  9. Selective Mutism: Practice and Intervention Strategies for Children

    Science.gov (United States)

    Hung, Shu-Lan; Spencer, Michael S.; Dronamraju, Rani

    2012-01-01

    The onset of selective mutism (SM) is usually between the ages of three and five years, when the children first go to preschool. However, these children are most commonly referred for treatment between the ages of six and 11, when they are entering the elementary school system. Early detection and early intervention is suggested for effective SM…

  10. Differential Diagnosis of Selective Mutism in Bilingual Children

    Science.gov (United States)

    Toppelberg, Claudio O.; Tabors, Patton; Coggins, Alissa; Lum, Kirk; Burger, Claudia

    2005-01-01

    Early diagnosis of selective mutism (SM) is an important concern. SM prevalence is higher than initially thought and at least three times higher in immigrant language minority children. Although the DSM-IV precludes diagnosing SM in immigrant children with limited language proficiency (as children acquiring a second language may normally undergo a…

  11. Ericksonian hypnotherapy for selective mutism: A single-case study.

    Science.gov (United States)

    Cavarra, Mauro; Brizio, Adelina; Gava, Nicoletta

    2017-01-16

    Children affected by selective mutism don't speak in contexts that are unfamiliar to them or in which speaking is expected or required (e.g. school, kindergarten…). Such disorder interferes with the child's normal activities, may have invalidating consequences in the long run if left untreated, is associated to anxious conditions and is considered hard to treat. Contemporary research is still in need of methodologically rigorous outcome studies and the results described in the small number of published randomized controlled trials and retrospective studies indicate cognitive-behavioral interventions lasting 20-24 sessions as the best therapeutic option. This case study, involving a 7-year-old girl, aims at providing preliminary evidence on the effectiveness of Ericksonian hypnosis in the treatment of this condition. A brief review of current evidence is provided. The case was treated by a licensed hypnotherapist, specialized in family therapy, in 5 sessions during the course of 3 months. After 3 months the symptoms of the client were resolved and the diagnosis was no longer applicable. Other improvements regarded her mood, social skills and school performance.  Conclusions: Ericksonian Hypnotherapy lead to the remission of the disorder and to the improvement of the general well being of the client in 5 sessions, a much briefer time span compared to what is reported in current literature. This paper represents the first step in the elaboration of replicable and reliable intervention principles.

  12. Selective mutism: an update and suggestions for future research.

    Science.gov (United States)

    Scott, Samantha; Beidel, Deborah C

    2011-08-01

    Speculation continues regarding the accurate classification of selective mutism and potential etiologic factors. Current research has shed some light on several factors that may predispose some children to this disorder, but conclusions are difficult to draw due to reliance on subjective measures, few comparison groups, and/or limited theoretical grounding. This article provides an update on recent efforts to elucidate the etiologic pathways of selective mutism and on the current debate regarding its strong overlap with anxiety disorders, most notably social phobia. An additional attempt is made to examine findings based on a developmental perspective that accounts for multiple pathways, context, and the developmental stage of the child. Emotion regulation theory is offered as a potential factor in why some children may be more vulnerable to the etiologic factors described. Suggestions for future research are offered based on this integration of information.

  13. Anxiety and oppositional behavior profiles among youth with selective mutism.

    Science.gov (United States)

    Diliberto, Rachele A; Kearney, Christopher A

    2016-01-01

    Selective mutism (SM) is a debilitating condition in which a child does not speak in social situations where speech is expected. The clinical conceptualization of SM has been debated historically, with evidence pointing partly to anxious and oppositional behavior profiles. Behavioral characteristics were examined in a clinical sample of 57 youth formally diagnosed with selective mutism. Parents rated children across internalizing and externalizing behaviors on the Child Behavior Checklist. Eighteen highly rated items were subjected to exploratory and then confirmatory factor analysis. Anxiety and oppositional behavior factors were derived. The anxious behavior profile was associated with social anxiety disorder symptoms, social problems, and aggressive behaviors but not oppositional defiant disorder symptoms. The oppositional behavior profile was associated with aggressive behaviors, oppositional defiant disorder symptoms, social problems, and inversely to social anxiety disorder symptoms. Results are consistent with emerging research regarding subgroups of children with SM. Behavior profiles are discussed as well with respect to assessment and treatment implications. Readers will learn about the nature of children with selective mutism as well as behaviors that differentiate anxious and oppositional behavior profiles. Items that comprise anxious and oppositional behavior profiles are presented. These item profiles may have ramifications for assessment and treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. The Selective Mutism Questionnaire: Measurement Structure and Validity

    Science.gov (United States)

    Letamendi, Andrea M.; Chavira, Denise A.; Hitchcock, Carla A.; Roesch, Scott C.; Shipon-Blum, Elisa; Stein, Murray B.; Roesch, Scott C.

    2010-01-01

    Objective To evaluate the factor structure, reliability, and validity of the 17-item Selective Mutism Questionnaire. Method Diagnostic interviews were administered via telephone to 102 parents of children identified with selective mutism (SM) and 43 parents of children without SM from varying U.S. geographic regions. Children were between the ages of 3 and 11 inclusive and comprised 58% girls and 42% boys. SM diagnoses were determined using the Anxiety Disorders Interview Schedule for Children - Parent Version (ADIS-C/P); SM severity was assessed using the 17-item Selective Mutism Questionnaire (SMQ); and behavioral and affective symptoms were assessed using the Child Behavior Checklist (CBCL). An exploratory factor analysis (EFA) was conducted to investigate the dimensionality of the SMQ and a modified parallel analysis procedure was used to confirm EFA results. Internal consistency, construct validity, and incremental validity were also examined. Results The EFA yielded a 13-item solution consisting of three factors: a) Social Situations Outside of School, b) School Situations, and c) Home and Family Situations. Internal consistency of SMQ factors and total scale ranged from moderate to high. Convergent and incremental validity were also well supported. Conclusions Measure structure findings are consistent with the 3-factor solution found in a previous psychometric evaluation of the SMQ. Results also suggest that the SMQ provides useful and unique information in the prediction of SM phenomenon beyond other child anxiety measures. PMID:18698268

  15. Social phobia, anxiety, oppositional behavior, social skills, and self-concept in children with specific selective mutism, generalized selective mutism, and community controls.

    Science.gov (United States)

    Cunningham, Charles E; McHolm, Angela E; Boyle, Michael H

    2006-08-01

    We compared social phobia, anxiety, oppositional behavior, social skills, and self-concept in three groups: (1) 28 children with specific mutism (who did not speak to teachers but were more likely to speak to parents and peers at home and school); (2) 30 children with generalized mutism (whose speaking was restricted primarily to their homes); and (3) 52 community controls. Children with generalized mutism evidenced higher anxiety at school, and more separation anxiety, OCD, and depressive symptoms at home. Parents and teachers reported that the social phobia and anxiety scores of children in both the specific and generalized mutism subgroups were higher than controls. Children in both the specific and generalized mutism groups evidenced greater deficits in verbal and nonverbal social skills at home and school than controls. Teachers and parents did not report differences in nonverbal measures of social cooperation and conflict resolution and we found no evidence that selective mutism was linked to an increase in externalizing problems such as oppositional behavior or ADHD. Although children with specific mutism speak in a wider range of situations and appear less anxious to their teachers than children with generalized mutism, significant socially phobic behavior and social skills deficits are present in both groups.

  16. [Outpatient treatment of selective mutism: long-standing selective mutism in a 17-year-old male].

    Science.gov (United States)

    Herdener-Pinnekamp, Katharina; Gundelfinger, Ronnie; Steinhausen, Hans-Christoph

    2010-01-01

    The present case report describes the successful treatment of a 17 year old male adolescent suffering for 10 years from selective mutism. Following a summary review of recent publications on therapy approaches, the report describes the treatment concept in the present case, including detailed assessment of co-morbid disorders, motivation for change, behaviour therapy with supporting drug intervention, and intensive co-operation with parents and other caretakers.

  17. Including Children with Selective Mutism in Mainstream Schools and Kindergartens: Problems and Possibilities

    Science.gov (United States)

    Omdal, Heidi

    2008-01-01

    There is little research on inclusion of children with selective mutism in school/kindergarten. Moreover, few studies have tried to understand selectively mute children's interactions in the natural surroundings of their home and school/kindergarten. Five children meeting the DSM-IV criteria for selective mutism were video-observed in social…

  18. The use of medication in selective mutism: a systematic review.

    Science.gov (United States)

    Manassis, Katharina; Oerbeck, Beate; Overgaard, Kristin Romvig

    2016-06-01

    Despite limited evidence, selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs) are used to reduce symptoms of selective mutism (SM) in children unresponsive to psychosocial interventions. We review existing evidence for the efficacy of these medications, limitations of the literature, and resulting treatment considerations. Bibliographic searches were conducted in Medline, Embase, PsycInfo, Web of Science and Cochrane up to June 2015. Two reviewers independently sought studies of children with SM as primary psychiatric diagnosis, which reported response to medication treatment. Abstracts were limited to those reporting original data. Two reviewers independently assessed the ten papers reporting on >2 subjects regarding study design, key results, and limitations. Heterogeneity of designs mandated a descriptive summary. Symptomatic improvement was found for 66/79 children treated with SSRIs and 4/4 children treated with phenelzine. Only 3/10 studies had unmedicated comparison groups and only two were double-blinded. This review may be affected by publication bias, missed studies, and variability of outcome measures in included studies. Although there is some evidence for symptomatic improvement in SM with medication, especially SSRIs, it is limited by small numbers, lack of comparative trials, lack of consistent measures, and lack of consistent reporting on tolerability. The clinician must weigh this paucity of evidence against the highly debilitating nature of SM, and its adverse effects on the development of those children whose progress with psychosocial interventions is limited or very slow. Studies of optimal dosage and timing of medications in relation to psychosocial treatments are also needed.

  19. Augmented Self-Modeling as a Treatment for Children with Selective Mutism.

    Science.gov (United States)

    Kehle, Thomas J.; Madaus, Melissa R.; Baratta, Victoria S.; Bray, Melissa A.

    1998-01-01

    Describes the treatment of three children experiencing selective mutism. The procedure utilized incorporated self-modeling, mystery motivators, self-reinforcement, stimulus fading, spacing, and antidepressant medication. All three children evidenced a complete cessation of selective mutism and maintained their treatment gains at follow-up.…

  20. Selective Mutism: A Three-Tiered Approach to Prevention and Intervention

    Science.gov (United States)

    Busse, R. T.; Downey, Jenna

    2011-01-01

    Selective mutism is a rare anxiety disorder that prevents a child from speaking at school or other community settings, and can be detrimental to a child's social development. School psychologists can play an important role in the prevention and treatment of selective mutism. As an advocate for students, school psychologists can work with teachers,…

  1. An Assessment Protocol for Selective Mutism: Analogue Assessment Using Parents as Facilitators.

    Science.gov (United States)

    Schill, Melissa T.; And Others

    1996-01-01

    Assesses protocol for conducting a functional analysis of maintaining variables for children with selective mutism. A parent was trained in and later applied various behavior strategies designed to increase speech in an eight-year-old girl with selective mutism. Parent and child ratings of treatment were positive. Presents implications for future…

  2. The Sounds of Silence: Language, Cognition, and Anxiety in Selective Mutism

    Science.gov (United States)

    Manassis, Katharina; Tannock, Rosemary; Garland, E. Jane; Minde, Klaus; McInnes, Alison; Clark, Sandra

    2007-01-01

    Objectives: To determine whether oral language, working memory, and social anxiety differentiate children with selective mutism (SM), children with anxiety disorders (ANX), and normal controls (NCs) and explore predictors of mutism severity. Method: Children ages 6 to 10 years with SM (n = 44) were compared with children with ANX (n = 28) and NCs…

  3. Reduced auditory efferent activity in childhood selective mutism.

    Science.gov (United States)

    Bar-Haim, Yair; Henkin, Yael; Ari-Even-Roth, Daphne; Tetin-Schneider, Simona; Hildesheimer, Minka; Muchnik, Chava

    2004-06-01

    Selective mutism is a psychiatric disorder of childhood characterized by consistent inability to speak in specific situations despite the ability to speak normally in others. The objective of this study was to test whether reduced auditory efferent activity, which may have direct bearings on speaking behavior, is compromised in selectively mute children. Participants were 16 children with selective mutism and 16 normally developing control children matched for age and gender. All children were tested for pure-tone audiometry, speech reception thresholds, speech discrimination, middle-ear acoustic reflex thresholds and decay function, transient evoked otoacoustic emission, suppression of transient evoked otoacoustic emission, and auditory brainstem response. Compared with control children, selectively mute children displayed specific deficiencies in auditory efferent activity. These aberrations in efferent activity appear along with normal pure-tone and speech audiometry and normal brainstem transmission as indicated by auditory brainstem response latencies. The diminished auditory efferent activity detected in some children with SM may result in desensitization of their auditory pathways by self-vocalization and in reduced control of masking and distortion of incoming speech sounds. These children may gradually learn to restrict vocalization to the minimal amount possible in contexts that require complex auditory processing.

  4. Children with autism spectrum disorders and selective mutism

    Directory of Open Access Journals (Sweden)

    Steffenburg H

    2018-05-01

    Full Text Available Hanna Steffenburg, Suzanne Steffenburg, Christopher Gillberg, Eva Billstedt Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden Background: It has been suggested that autism spectrum disorder (ASD might be a “comorbid” condition in selective mutism (SM. Methods: In this retrospective study, we examined medical records of children with SM diagnosis (n=97 at a medical center specializing in assessment of ASD. Results: Mean age for onset of SM symptoms was 4.5 years and mean age at SM diagnosis was 8.8 years. SM was more common among girls (boy:girl ratio=2.7:1. We found that 63% of the study group had an ASD (no gender difference. The SM group with combined ASD had later onset of symptoms, higher age at diagnosis, more often a history of speech delay, and a higher proportion of borderline IQ or intellectual disability.Conclusion: The results highlight the risk of overlap between ASD and SM. Keywords: selective mutism, autism spectrum disorders, Asperger syndrome, autistic disorder

  5. Selective mutism and temperament: the silence and behavioral inhibition to the unfamiliar.

    Science.gov (United States)

    Gensthaler, Angelika; Khalaf, Sally; Ligges, Marc; Kaess, Michael; Freitag, Christine M; Schwenck, Christina

    2016-10-01

    Behavioral inhibition (BI) is a suspected precursor of selective mutism. However, investigations on early behavioral inhibition of children with selective mutism are lacking. Children aged 3-18 with lifetime selective mutism (n = 109), social phobia (n = 61), internalizing behavior (n = 46) and healthy controls (n = 118) were assessed using the parent-rated Retrospective Infant Behavioral Inhibition (RIBI) questionnaire. Analyses showed that children with lifetime selective mutism and social phobia were more inhibited as infants and toddlers than children of the internalizing and healthy control groups, who displayed similar low levels of behavioral inhibition. Moreover, behavioral inhibition was higher in infants with lifetime selective mutism than in participants with social phobia according to the Total BI score (p = 0.012) and the Shyness subscale (p selective mutism. Results yield first evidence of the recently hypothesized temperamental origin of selective mutism. Children at risk should be screened for this debilitating child psychiatric condition.

  6. Group therapy for selective mutism - a parents' and children's treatment group.

    Science.gov (United States)

    Sharkey, Louise; Mc Nicholas, Fiona; Barry, Edwina; Begley, Maire; Ahern, Sinead

    2008-12-01

    To evaluate the feasibility and effectiveness of group therapy for children with selective mutism and their parents. Five children (mean age 6.1 years) with a diagnosis of selective mutism were administered group therapy over an 8-week period. Parents simultaneously attended a second group, aimed at providing education and advice on managing selective mutism in everyday situations, and in the school environment. At post-treatment, all children increased their level of confident speaking in school, clinic and community settings. Parents indicated a reduction in their own anxiety levels, from pre- to post-treatment on self-rating scales. Findings support the feasibility and effectiveness of group therapy for children with selective mutism and their parents.

  7. Comorbidity and Family Factors Associated with Selective Mutism

    Directory of Open Access Journals (Sweden)

    Brian A. Buzzella

    2011-01-01

    Full Text Available Recent findings suggest that Selective Mutism (SM is best conceptualized as a childhood anxiety disorder and that oppositional behavior may or may not be a significant part of the clinical picture. Twenty-nine mothers of children with SM and 28 mothers of children who did not meet diagnostic criteria for any Axis I disorder (a community comparison group completed parental self-report questionnaires and clinician-rated interviews assessing anxiety and oppositional behavior, parental psychopathology, and family factors with hypothesized relationships with childhood anxiety. Findings suggested that children with SM experienced more anxiety than those in the community comparison group, with significantly higher levels of social anxiety, rumination, and physical symptoms reported. Mothers of children with SM reported greater monitoring of their children's activities, but they did not significantly differ from community comparison group mothers on reports of other parenting behaviors. Such findings may have important implications for guiding family involvement in psychosocial interventions.

  8. Clinical distinctions between selective mutism and social phobia: an investigation of childhood psychopathology.

    Science.gov (United States)

    Yeganeh, Robin; Beidel, Deborah C; Turner, Samuel M; Pina, Armando A; Silverman, Wendy K

    2003-09-01

    To investigate the hypothesis that children with selective mutism are more socially anxious than children with social anxiety disorder but who are not selectively mute. Twenty-three children with comorbid selective mutism and social phobia and 23 age-matched controls with social phobia alone and their parents participated in a comprehensive assessment of social anxiety and related aspects of psychopathology. The results do not uniformly support previous suggestions that children with selective mutism refuse speech because they are "frozen with fear." Although clinician and observer ratings for children with selective mutism revealed higher ratings of social distress than for children with social phobia alone, self-report data do not support this conclusion. Furthermore, although there were no group differences on measures of trait anxiety, general fears, or scores on the Child Behavior Checklist broadband Internalizing or Externalizing scales, children with selective mutism scored higher than children with social phobia alone on the Child Behavior Checklist Delinquency subscale, suggesting the presence of a broader clinical syndrome. It remains unclear whether children with selective mutism have extreme levels of social anxiety. Potential areas that might shed further light on this interesting disorder are discussed.

  9. The outcome of children with selective mutism following cognitive behavioral intervention: a follow-up study.

    Science.gov (United States)

    Lang, Claudia; Nir, Ziv; Gothelf, Ayelet; Domachevsky, Shoshi; Ginton, Lee; Kushnir, Jonathan; Gothelf, Doron

    2016-04-01

    Selective mutism (SM) is a relatively rare childhood disorder and is underdiagnosed and undertreated. The purpose of the retrospective naturalistic study was to examine the long-term outcome of children with SM who were treated with specifically designed modular cognitive behavioral therapy (MCBT). Parents of 36 children who met diagnostic criteria of SM that received MCBT treatment were invited for a follow-up evaluation. Parents were interviewed using structured scales and completed questionnaires regarding the child, including the Selective Mutism Questionnaire (SMQ). Twenty-four subjects were identified and evaluated. Their mean age ± SD of onset of SM symptoms, beginning of treatment, and age at follow-up were 3.4 ± 1.4, 6.4 ± 3.1, and 9.3 ± 3.4 years, respectively. There was robust improvement from beginning of treatment to follow-up evaluation in SM, social anxiety disorder, and specific phobia symptoms. The recovery rate from SM was 84.2 %. SM-focused MCBT is feasible in children and possibly effective in inducing long-term reduction of SM and comorbid anxiety symptoms. • There are limited empirical data on selective mutism (SM) treatment outcome and specifically on cognitive-behavioral therapy, with the majority of studies being uncontrolled case reports of 1 to 2 cases each. • There is also limited data on the long-term outcome of children with SM following treatment. What is New: • Modular cognitive behavioral treatment is a feasible and possibly effective treatment for SM. Intervention at a younger age is more effective comparing to an older age. • Treatment for SM also decreases the rate of psychiatric comorbidities, including separation anxiety disorder and specific phobia.

  10. Mutism as the presenting symptom: three case reports and selective review of literature.

    Science.gov (United States)

    Aggarwal, Ashish; Sharma, Dinesh Dutt; Kumar, Ramesh; Sharma, Ravi C

    2010-01-01

    Mutism, defined as an inability or unwillingness to speak, resulting in an absence or marked paucity of verbal output, is a common clinical symptom seen in psychiatric as well as neurology outpatient department. It rarely presents as an isolated disability and often occurs in association with other disturbances in behavior, thought processes, affect, or level of consciousness. It is often a focus of clinical attention, both for the physician and the relatives. Mutism occurs in a number of conditions, both functional and organic, and a proper diagnosis is important for the management. We hereby present three cases, who presented with mutism as the presenting symptom and the differential diagnosis and management issues related to these cases are discussed. The authors also selectively reviewed the literature on mutism, including psychiatric, neurologic, toxic-metabolic, and drug-induced causes.

  11. Selective Mutism: The Fraternal Twin of Childhood Social Phobia.

    Science.gov (United States)

    Gensthaler, Angelika; Maichrowitz, Verena; Kaess, Michael; Ligges, Marc; Freitag, Christine M; Schwenck, Christina

    Selective mutism (SM) is an anxiety disorder with a close link to childhood social phobia (SP). Our studies compare behavioral problem profiles in children and adolescents with SM and SP and control groups and assess the comorbidity patterns of SM and SP. Participants aged 3-18 years with SM (n = 95), SP (n = 74) and internalizing disorders (INT, n = 46) and a typically developing control group (CG, n = 119) were assessed with the Child Behavior Checklist (CBCL); adolescents were additionally assessed with the Youth Self-Report (YSR). Comorbidity was assessed in SM and SP participants with a diagnostic interview. SP was detected in 94% of children with SM. SM participants showed different behavioral and psychiatric symptoms than SP: they were more frequently affected by lifetime separation anxiety disorder (SM: 45%, SP: 26%) and oppositional defiant disorder (SM: 22%, SP: 5%), and less by generalized anxiety disorder (SM: 6%, SP: 20%) and major depression (SM: 12%, SP: 26%). Adolescents with SM showed high rates of agoraphobia (SM 27%; SP 10%) and more social problems (YSR), and were more withdrawn (CBCL, YSR) than those with SP alone. Specific behavioral problems of SM and SP compared to INT and CG were observed. SM and SP represent separate but closely related disorders, distinct from other INT and CG, with specific patterns of lifetime comorbidities. © 2016 S. Karger AG, Basel.

  12. Selective mutism: are primary care physicians missing the silence?

    Science.gov (United States)

    Schwartz, Richard H; Freedy, Alicia S; Sheridan, Michael J

    2006-01-01

    To survey parents of children with selective mutism (SM) in regard to (1) the role of the primary care physician in the diagnosis of SM; (2) the social and school consequences of SM; and (3) their opinion of the effectiveness of different treatment modalities, a 39-item written survey was mailed to 27 parents with at least one child diagnosed with SM on the basis of diagnostic and statistical manual IV-text revision (DSM IV-TR) criteria. Twenty-seven parents (100%), with a total of 33 children with SM, completed the survey. There were 24 girls and 9 boys. The mean age when parents had strong concerns about symptoms of SM was 3.8 years, but diagnosis did not occur until nearly a year later. Twenty-three (69.7%) of the children with SM were never diagnosed accurately or referred by their primary care physicians. SM caused important school/social problems for 17 (51.5%) of the children. Speech therapy was provided for 36.4% of children and was thought to have been helpful for 30% of them. Behavior modification was the treatment for 45.5% of children and perceived to be helpful for 66.7% of them. Selective serotonin re-uptake inhibitor pharmacotherapy was prescribed for 17 (51.5%) of the children and believed to be effective for 11 (65%) of them. Primary care physicians in this study rarely diagnosed accurately or referred children with SM in a timely fashion, even though symptoms of the condition were generally very apparent and parents had expressed concern. Behavioral modification, pharmacotherapy with SSRIs, and early intervention are viable treatment options. Early diagnosis is key to preventing long-term effects of this condition.

  13. Abnormalities in auditory efferent activities in children with selective mutism.

    Science.gov (United States)

    Muchnik, Chava; Ari-Even Roth, Daphne; Hildesheimer, Minka; Arie, Miri; Bar-Haim, Yair; Henkin, Yael

    2013-01-01

    Two efferent feedback pathways to the auditory periphery may play a role in monitoring self-vocalization: the middle-ear acoustic reflex (MEAR) and the medial olivocochlear bundle (MOCB) reflex. Since most studies regarding the role of auditory efferent activity during self-vocalization were conducted in animals, human data are scarce. The working premise of the current study was that selective mutism (SM), a rare psychiatric disorder characterized by consistent failure to speak in specific social situations despite the ability to speak normally in other situations, may serve as a human model for studying the potential involvement of auditory efferent activity during self-vocalization. For this purpose, auditory efferent function was assessed in a group of 31 children with SM and compared to that of a group of 31 normally developing control children (mean age 8.9 and 8.8 years, respectively). All children exhibited normal hearing thresholds and type A tympanograms. MEAR and MOCB functions were evaluated by means of acoustic reflex thresholds and decay functions and the suppression of transient-evoked otoacoustic emissions, respectively. Auditory afferent function was tested by means of auditory brainstem responses (ABR). Results indicated a significantly higher proportion of children with abnormal MEAR and MOCB function in the SM group (58.6 and 38%, respectively) compared to controls (9.7 and 8%, respectively). The prevalence of abnormal MEAR and/or MOCB function was significantly higher in the SM group (71%) compared to controls (16%). Intact afferent function manifested in normal absolute and interpeak latencies of ABR components in all children. The finding of aberrant efferent auditory function in a large proportion of children with SM provides further support for the notion that MEAR and MOCB may play a significant role in the process of self-vocalization. © 2013 S. Karger AG, Basel.

  14. Assessing Spoken Language Competence in Children with Selective Mutism: Using Parents as Test Presenters

    Science.gov (United States)

    Klein, Evelyn R.; Armstrong, Sharon Lee; Shipon-Blum, Elisa

    2013-01-01

    Children with selective mutism (SM) display a failure to speak in select situations despite speaking when comfortable. The purpose of this study was to obtain valid assessments of receptive and expressive language in 33 children (ages 5 to 12) with SM. Because some children with SM will speak to parents but not a professional, another purpose was…

  15. Assessment and Treatment of Selective Mutism: Recommendations and a Case Study.

    Science.gov (United States)

    Sheridan, Susan M.; And Others

    1995-01-01

    Presents results of stimulus fading procedure used to treat a six-year-old girl with elective mutism. Presents assessment protocol that features procedures that can be used to render a diagnosis and assist in treatment planning. Results suggest stimulus fading of new persons into the school setting was effective in producing speech. (JBJ)

  16. Selective mutism: a consensus based care pathway of good practice.

    Science.gov (United States)

    Keen, D V; Fonseca, S; Wintgens, A

    2008-10-01

    Selective mutism (SM) now acknowledged as an anxiety condition, tends to be a poorly understood, highly complex and vastly under-recognised clinical entity. Children with SM are a vulnerable group as the condition is not the remit of any one professional group. This inevitably leads to delay in formal diagnosis and management. There is a lack of systematic research on which to base guidelines for management. To develop, agree and validate key principles underlying the management of SM through a consensus process involving international experts, in order to create a local care pathway. A local multi-agency consultation process developed 11 statements, which were felt to be the key principles underpinning a potential care pathway for managing SM. Thirteen recognised experts from North America, Europe and Australia participated in a modified Delphi process involving two rounds using a Likert-scale and free commentary. Both quantitative and qualitative analyses were used in the validation or revision of the statements at each stage. Response rates were 100% for Round 1 and 84.6% for Round 2. Despite the differing professional backgrounds and service contexts, by successive revision and/or revalidation of statements, it was possible to arrive at a consensus about key principles relating to early recognition, assessment and intervention. The agreed key principles are presented together with the resulting local care pathway. Through a Delphi process, agreement was reached by a multidisciplinary group of professionals, on key principles that underpin the timely identification, assessment and management of children with SM. These include the potential for staff in school/preschool settings to identify SM and that intervention programmes should generally be based in these settings. Children with SM should receive assessment for possible coexisting disorders, whether developmental, emotional or behavioural and additional specific intervention given for these. Agreement was

  17. Evaluation of Children with Selective Mutism and Social Phobia: A Comparison of Psychological and Psychophysiological Arousal

    Science.gov (United States)

    Young, Brennan J.; Bunnell, Brian E.; Beidel, Deborah C.

    2012-01-01

    Although children with social phobia (SP) and selective mutism (SM) present similarly in a clinical setting, it remains unclear whether children with SM are unable to speak due to overwhelming anxiety, or whether withholding speech functions as an avoidance mechanism. A total of 35 children (ages 5-12 years) with either SM (n = 10), SP (n = 11),…

  18. Blindness and Selective Mutism: One Student's Response to Voice-Output Devices

    Science.gov (United States)

    Holley, Mary; Johnson, Ashli; Herzberg, Tina

    2014-01-01

    This case study was designed to measure the response of one student with blindness and selective mutism to the intervention of voice-output devices across two years and two different teachers in two instructional settings. Before the introduction of the voice output devices, the student did not choose to communicate using spoken language or…

  19. The Silent Minority: Supporting Students with Selective Mutism Using Systemic Perspectives

    Science.gov (United States)

    Lawrence, Zena

    2017-01-01

    Selective Mutism (SM) is an under-researched area of child development. While the incidence rate is low, the impact of this difficulty can be pervasive and can present as a significant risk for student mental health and wellbeing. The following article presents a case study focusing on parent-student intervention for a preadolescent male, using an…

  20. The Current State of Empirical Support for the Pharmacological Treatment of Selective Mutism

    Science.gov (United States)

    Carlson, John S.; Mitchell, Angela D.; Segool, Natasha

    2008-01-01

    This article reviews the current state of evidence for the psychopharmacological treatment of children diagnosed with selective mutism within the context of its link to social anxiety disorder. An increased focus on potential medication treatment for this disorder has resulted from significant monetary and resource limitations in typical practice,…

  1. The Teachers' Role in the Assessment of Selective Mutism and Anxiety Disorders

    Science.gov (United States)

    Martinez, Yvonne J.; Tannock, Rosemary; Manassis, Katharina; Garland, E. Jane; Clark, Sandra; McInnes, Alison

    2015-01-01

    Selective mutism (SM) is a childhood disorder characterized by failure to speak in social situations, despite there being an expectation to speak and the capacity to do so. There has been a focus on elucidating the differences between SM and anxiety disorder (ANX) in the recent literature. Although children with SM exhibit more symptoms at school…

  2. Behavioral and Emotional Adjustment, Family Functioning, Academic Performance, and Social Relationships in Children with Selective Mutism

    Science.gov (United States)

    Cunningham, Charles E.; McHolm, Angela; Boyle, Michael H.; Patel, Sejal

    2004-01-01

    This study addressed four questions which parents of children with selective mutism (SM) frequently ask: (1) Is SM associated with anxiety or oppositional behavior? (2) Is SM associated with parenting and family dysfunction? (3) Will my child fail at school? and (4) Will my child make friends or be teased and bullied? In comparison to a sample of…

  3. Selective Mutism: A Team Approach to Assessment and Treatment in the School Setting

    Science.gov (United States)

    Ponzurick, Joan M.

    2012-01-01

    The school nurse plays a pivotal role in the assessment and treatment of selective mutism (SM), a rare disorder found in elementary school children. Due to anxiety, children with SM do not speak in uncomfortable situations, primarily the school setting. Diagnosis of SM is often missed in the formative years because the child does speak at home.…

  4. Refining the Classification of Children with Selective Mutism: A Latent Profile Analysis

    Science.gov (United States)

    Cohan, Sharon L.; Chavira, Denise A.; Shipon-Blum, Elisa; Hitchcock, Carla; Roesch, Scott C.; Stein, Murray B.

    2008-01-01

    The goal of this study was to develop an empirically derived classification system for selective mutism (SM) using parent-report measures of social anxiety, behavior problems, and communication delays. The sample consisted of parents of 130 children (ages 5-12) with SM. Results from latent profile analysis supported a 3-class solution made up of…

  5. A Long-Term Outcome Study of Selective Mutism in Childhood

    Science.gov (United States)

    Steinhausen, Hans-Christoph; Wachter, Miriam; Laimbock, Karin; Metzke, Christa Winkler

    2006-01-01

    Objective: Controlled study of the long-term outcome of selective mutism (SM) in childhood. Method: A sample of 33 young adults with SM in childhood and two age- and gender-matched comparison groups were studied. The latter comprised 26 young adults with anxiety disorders in childhood (ANX) and 30 young adults with no psychiatric disorders during…

  6. Selective Mutism in Immigrant Children: Cultural Considerations for Assessment and Intervention

    Science.gov (United States)

    Thomson, Becky

    2017-01-01

    Selective mutism (SM) is a childhood anxiety disorder characterized by the persistent failure to speak in situations where speech is typically expected (e.g., school), despite speaking in other situations (e.g., home; American Psychiatric Association [APA], 2013). Immigrant children are more likely to be diagnosed with SM than the general…

  7. P50 Suppression in Children with Selective Mutism: A Preliminary Report

    Science.gov (United States)

    Henkin, Yael; Feinholz, Maya; Arie, Miri; Bar-Haim, Yair

    2010-01-01

    Evidence suggests that children with selective mutism (SM) display significant aberrations in auditory efferent activity at the brainstem level that may underlie inefficient auditory processing during vocalization, and lead to speech avoidance. The objective of the present study was to explore auditory filtering processes at the cortical level in…

  8. Meeting Educators Where They Are: Professional Development to Address Selective Mutism

    Science.gov (United States)

    Harwood, Debra; Bork, Po-Ling

    2011-01-01

    Children with selective mutism (SM) present unique challenges for teachers. Typically, children with SM have such an immense anxiety associated with being seen or heard speaking they fail to speak inside the classroom and particularly with teachers. This article reports on the effectiveness of a small-scale exploratory study involving 22…

  9. The Importance of a Team Approach in Working Effectively with Selective Mutism: A Case Study

    Science.gov (United States)

    Borger, Gary W.; Bartley, Dana L.; Armstrong, Norma; Kaatz, Debra; Benson, Dave

    2007-01-01

    Selective Mutism (SM) in children and adolescents is characterized by a persistent failure to speak in certain social situations including at school or with friends despite the ability to speak and comprehend language. Not due to a specific communication disorder, SM is actually a pervasive psychological problem that lies along the continuum of…

  10. Treatment of Selective Mutism: Applications in the Clinic and School through Conjoint Consultation

    Science.gov (United States)

    Mitchell, Angela D.; Kratochwill, Thomas R.

    2013-01-01

    The purpose of this study was to evaluate the effectiveness of a psychosocial approach to the treatment of Selective Mutism (SM). Four children with SM along with their parents and teachers participated in the study. A comprehensive assessment was completed; manualized treatment was implemented through a conjoint behavioral consultation approach,…

  11. Case Report: Evaluation strategies and cognitive intervention: the case of a monovular twin child affected by selective mutism.

    Science.gov (United States)

    Capobianco, Micaela; Cerniglia, Luca

    2018-01-01

    The present work describes the assessment process, evaluation strategies, and cognitive intervention on a 9 years old child with selective mutism (SM), a monovular twin of a child also affected by mutism. Currently, the cognitive behavioral multimodal treatment seems the most effective therapeutic approach for children diagnosed with selective mutism (Capobianco & Cerniglia, 2018). The illustrated case confirms the role of biological factors involved in mutacic disorder but also highlights the importance of environmental influences in the maintenance of the disorder with respect to relational and contextual dynamics (e.g. complicity between sisters, family relationships). The article discusses furthermore the importance of an early diagnosis as a predictor of positive treatment outcomes.

  12. [Multilingualism and child psychiatry: on differential diagnoses of language disorder, specific learning disorder, and selective mutism].

    Science.gov (United States)

    Tamiya, Satoshi

    2014-01-01

    Multilingualism poses unique psychiatric problems, especially in the field of child psychiatry. The author discusses several linguistic and transcultural issues in relation to Language Disorder, Specific Learning Disorder and Selective Mutism. Linguistic characteristics of multiple language development, including so-called profile effects and code-switching, need to be understood for differential diagnosis. It is also emphasized that Language Disorder in a bilingual person is not different or worse than that in a monolingual person. Second language proficiency, cultural background and transfer from the first language all need to be considered in an evaluation for Specific Learning Disorder. Selective Mutism has to be differentiated from the silent period observed in the normal successive bilingual development. The author concludes the review by remarking on some caveats around methods of language evaluation in a multilingual person.

  13. Selective mutism and anxiety: a review of the current conceptualization of the disorder.

    Science.gov (United States)

    Sharp, William G; Sherman, Colleen; Gross, Alan M

    2007-01-01

    Selective mutism (SM) is a rare and interesting condition that has been associated with a wide variety of childhood psychiatric conditions. Historically viewed as more of an oddity than a distinct diagnostic entity, early conceptualizations of the condition were based largely on case studies that tended to link SM with oppositional behavior. More recently, controlled studies have enhanced our understanding of SM. This review summarizes the current conceptualization of SM, highlighting evidence supporting the notion that SM is an anxiety-related condition.

  14. Integrated Behavior Therapy for Selective Mutism: a randomized controlled pilot study.

    Science.gov (United States)

    Bergman, R Lindsey; Gonzalez, Araceli; Piacentini, John; Keller, Melody L

    2013-10-01

    To evaluate the feasibility, acceptability, and preliminary efficacy of a novel behavioral intervention for reducing symptoms of selective mutism and increasing functional speech. A total of 21 children ages 4 to 8 with primary selective mutism were randomized to 24 weeks of Integrated Behavior Therapy for Selective Mutism (IBTSM) or a 12-week Waitlist control. Clinical outcomes were assessed using blind independent evaluators, parent-, and teacher-report, and an objective behavioral measure. Treatment recipients completed a three-month follow-up to assess durability of treatment gains. Data indicated increased functional speaking behavior post-treatment as rated by parents and teachers, with a high rate of treatment responders as rated by blind independent evaluators (75%). Conversely, children in the Waitlist comparison group did not experience significant improvements in speaking behaviors. Children who received IBTSM also demonstrated significant improvements in number of words spoken at school compared to baseline, however, significant group differences did not emerge. Treatment recipients also experienced significant reductions in social anxiety per parent, but not teacher, report. Clinical gains were maintained over 3 month follow-up. IBTSM appears to be a promising new intervention that is efficacious in increasing functional speaking behaviors, feasible, and acceptable to parents and teachers. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Sluggish vagal brake reactivity to physical exercise challenge in children with selective mutism.

    Science.gov (United States)

    Heilman, Keri J; Connolly, Sucheta D; Padilla, Wendy O; Wrzosek, Marika I; Graczyk, Patricia A; Porges, Stephen W

    2012-02-01

    Cardiovascular response patterns to laboratory-based social and physical exercise challenges were evaluated in 69 children and adolescents, 20 with selective mutism (SM), to identify possible neurophysiological mechanisms that may mediate the behavioral features of SM. Results suggest that SM is associated with a dampened response of the vagal brake to physical exercise that is manifested as reduced reactivity in heart rate and respiration. Polyvagal theory proposes that the regulation of the vagal brake is a neurophysiological component of an integrated social engagement system that includes the neural regulation of the laryngeal and pharyngeal muscles. Within this theoretical framework, sluggish vagal brake reactivity may parallel an inability to recruit efficiently the structures involved in speech. Thus, the findings suggest that dampened autonomic reactivity during mobilization behaviors may be a biomarker of SM that can be assessed independent of the social stimuli that elicit mutism.

  16. Treatment of selective mutism based on cognitive behavioural therapy, psychopharmacology and combination therapy - a systematic review.

    Science.gov (United States)

    Østergaard, Kasper Rud

    2018-02-15

    Selective mutism (SM) is a debilitating childhood anxiety disorder characterized by a persistent lack of speech in certain social settings and is considered hard to treat. Cognitive behavioral therapy (CBT) and pharmacological treatments are the best described treatments in the literature. To test whether there is evidence on treatment based on CBT, medication or a combination of these. Systematic and critical review of the literature on CBT and/or pharmacological treatments of SM. Literature was sought on PubMed, Embase and Psycinfo in March 2017. Of the included studies, six examined CBT, seven pharmacologic treatment and two a combination of these. Using CBT 53/60 children improved symptomatically whilst respectively 55/67 and 6/7 improved using pharmacologic- and combination-treatment. Pharmacologic treatment and especially CBT showed promising results supported by some degree of evidence, which combination treatment lacks. Yet small numbers, few RCTs, heterogeneous study designs, lack of consistent measures, short treatment and follow-up periods, generally limits the evidence. This needs focus in future research.

  17. Selective mutism: follow-up study 1 year after end of treatment.

    Science.gov (United States)

    Oerbeck, Beate; Stein, Murray B; Pripp, Are H; Kristensen, Hanne

    2015-07-01

    Cognitive behavioral therapy (CBT) is generally considered the recommended approach for selective mutism (SM). Prospective follow-up studies of treated SM and predictors of outcome are scarce. We have developed a CBT home and school-based intervention for children with SM previously found to increase speech in a pilot efficacy study and in a randomized controlled treatment study. In the present report we provide outcome data 1 year after having completed the 6-month course of CBT for 24 children with SM, aged 3-9 years (mean age 6.5 years, 16 girls). Primary outcome measures were the teacher rated School Speech Questionnaire (SSQ) and diagnostic status. At follow-up, no significant decline was found on the SSQ scores. Age and severity of SM had a significant effect upon outcome, as measured by the SSQ. Eight children still fulfilled diagnostic criteria for SM, four were in remission, and 12 children were without diagnosis. Younger children improved more, as 78% of the children aged 3-5 years did not have SM, compared with 33% of children aged 6-9 years. Treatment gain was upheld at follow-up. Greater improvement in the younger children highlights the importance of an early intervention.

  18. Can Adults Who Have Recovered from Selective Mutism in Childhood and Adolescence Tell Us Anything about the Nature of the Condition and/or Recovery from It?

    Science.gov (United States)

    Omdal, Heidi

    2007-01-01

    The literature on selective mutism provides little information on the child's own perspective. Six adults who had been selectively mute were interviewed about their childhood and adolescence. Data analysis led to identification of five themes, each of which has potentially important implications for teachers. (1) Origins of selective mutism: all…

  19. A case of selective mutism in an 8-year-old girl with thalassaemia major after bone marrow transplantation.

    Science.gov (United States)

    Plener, P L; Gatz, S A; Schuetz, C; Ludolph, A G; Kölch, M

    2012-01-01

    Selective mutism is rare with a prevalence below 1% in the general population, but a higher prevalence in populations at risk (children with speech retardation, migration). Evidence for treatment strategies is hardly available. This case report provides information on the treatment of selective mutism in an 8-year-old girl with preexisting thalassaemia major. As medications she received penicillin prophylaxis (500000 IE/d) and deferasirox (Exjade; 20-25mg/kg/d), an iron chelator. The preexisting somatic disease and treatment complicated the treatment, as there are no data about pharmacological combination therapy. Psychotherapy in day treatment, supported by the use of the SSRI fluoxetine (10 mg), led to a decrease in the selective mutism score from 33 to 12 points, GAF improved by 21 points. Mean levels of fluoxetine plus norfluoxetine were 287.8 ng/ml without significant level fluctuations. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Significance of cultural beliefs in presentation of psychiatric illness: a case report of selective mutism in a man from Nepal.

    Science.gov (United States)

    Babikian, Sarkis; Emerson, Lyndal; Wynn, Gary H

    2007-11-01

    A 22-year-old active duty E1 Nepalese male who recently emigrated from Nepal suddenly exhibited strange behaviors and mutism during Advanced Individual Training. After receiving care from a hospital near his unit, he was transferred to Walter Reed Army Medical Center Inpatient Psychiatry for further evaluation and treatment. Although he was admitted with a diagnosis of psychosis not otherwise specified (NOS), after consideration of cultural factors and by ruling out concurrent thought disorder, a diagnosis of selective mutism was made. To our knowledge this is the first reported case of selective mutism in a soldier. This case serves as a reminder of the need for cultural awareness during psychological evaluation, diagnosis, and treatment of patients.

  1. An auditory-neuroscience perspective on the development of selective mutism

    Directory of Open Access Journals (Sweden)

    Yael Henkin

    2015-04-01

    Full Text Available Selective mutism (SM is a relatively rare psychiatric disorder of childhood characterized by consistent inability to speak in specific social situations despite the ability to speak normally in others. SM typically involves severe impairments in social and academic functioning. Common complications include school failure, social difficulties in the peer group, and aggravated intra-familial relationships. Although SM has been described in the medical and psychological literatures for many years, the potential underlying neural basis of the disorder has only recently been explored. Here we explore the potential role of specific auditory neural mechanisms in the psychopathology of SM and discuss possible implications for treatment.

  2. When silence is not golden: an integrated approach to selective mutism.

    Science.gov (United States)

    McInnes, Alison; Manassis, Katharina

    2005-08-01

    Selective mutism (SM) is a rare disorder that is associated with both anxiety and communication impairments. Preliminary evidence suggests that educational attainment and development of social skills and self-esteem may be affected by SM in a significant proportion of cases. There is a critical need for cross-disciplinary research from the fields of speech-language pathology, psychiatry, and clinical psychology to develop protocols for assessing language and cognitive functioning in children with SM and developing interventions that address psychiatric, communicative, and social aspects of this disorder.

  3. Ties of silence--Family lived experience of selective mutism in identical twins.

    Science.gov (United States)

    Albrigtsen, Vårin; Eskeland, Benedicte; Mæhle, Magne

    2016-04-01

    This article is based on an in-depth interview with a pair of twins diagnosed with selective mutism and their parents 2 years after recovery. Selective mutism (SM) is a rare disorder, and identical twins sharing the condition are extremely rare. The twins developed SM simultaneously during their first year of school. The treatment and follow-up they received for several years are briefly described in this article. The interview explored the children's and their parents' narratives about the origin of the condition, the challenges it entailed in their daily lives, and what they found helpful in the treatment they were offered. In the interview, the children conveyed experiences that even the parents were unaware of and revealed examples of daily life-traumas for which they were unable to obtain support and help. The whole family was trapped in the silence. The twins and their parents emphasized different aspects in terms of what they believed were helpful. The implications of these findings for our understanding and treatment of children with SM are discussed, as well as the potential of service user involvement in child and adolescent mental health research. © The Author(s) 2015.

  4. Joint Attention in Parent-Child Dyads Involving Children with Selective Mutism: A Comparison between Anxious and Typically Developing Children

    Science.gov (United States)

    Nowakowski, Matilda E.; Tasker, Susan L.; Cunningham, Charles E.; McHolm, Angela E.; Edison, Shannon; St. Pierre, Jeff; Boyle, Michael H.; Schmidt, Louis A.

    2011-01-01

    Although joint attention processes are known to play an important role in adaptive social behavior in typical development, we know little about these processes in clinical child populations. We compared early school age children with selective mutism (SM; n = 19) versus mixed anxiety (MA; n = 18) and community controls (CC; n = 26) on joint…

  5. A Phenomenological Case Study of the Elementary to Secondary Transition for One Female Student Diagnosed with Selective Mutism

    Science.gov (United States)

    Nashman-Smith, Mona

    2017-01-01

    Selective mutism (SM) is considered a communication and anxiety disorder that afflicts about 1% of students. The rarity of SM and the isolated cases of this condition has rendered the elementary to secondary school experience for a student with SM difficult to study. Utilizing a qualitative approach, this phenomenological case study examined the…

  6. Practitioner Review: Psychosocial Interventions for Children with Selective Mutism--A Critical Evaluation of the Literature from 1990-2005

    Science.gov (United States)

    Cohan, Sharon L.; Chavira, Denise A.; Stein, Murray B.

    2006-01-01

    Background: There have been several reports of successful psychosocial interventions for children with selective mutism (SM), a disorder in which a child consistently fails to speak in one or more social settings (e.g., school) despite speaking normally in other settings (e.g., home). The present literature review was undertaken in order to…

  7. Suffering in silence: why a developmental psychopathology perspective on selective mutism is needed.

    Science.gov (United States)

    Cohan, Sharon L; Price, Joseph M; Stein, Murray B

    2006-08-01

    A developmental psychopathology perspective is offered in an effort to organize the existing literature regarding the etiology of selective mutism (SM), a relatively rare disorder in which a child consistently fails to speak in 1 or more social settings (e.g., school) despite speaking normally in other settings (e.g., home). Following a brief description of the history, prevalence, and course of the disorder, multiple pathways to the development of SM are discussed, with a focus on the various genetic, temperamental, psychological, and social/environmental systems that may be important in conceptualizing this unusual childhood disorder. The authors propose that SM develops due to a series of complex interactions among the various systems reviewed (e.g., a strong genetic loading for anxiety interacts with an existing communication disorder, resulting in heightened sensitivity to verbal interactions and mutism in some settings). Suggestions are provided for future longitudinal, twin/adoption, molecular genetic, and neuroimaging studies that would be particularly helpful in testing the pathways perspective on SM.

  8. Reduced auditory processing capacity during vocalization in children with Selective Mutism.

    Science.gov (United States)

    Arie, Miri; Henkin, Yael; Lamy, Dominique; Tetin-Schneider, Simona; Apter, Alan; Sadeh, Avi; Bar-Haim, Yair

    2007-02-01

    Because abnormal Auditory Efferent Activity (AEA) is associated with auditory distortions during vocalization, we tested whether auditory processing is impaired during vocalization in children with Selective Mutism (SM). Participants were children with SM and abnormal AEA, children with SM and normal AEA, and normally speaking controls, who had to detect aurally presented target words embedded within word lists under two conditions: silence (single task), and while vocalizing (dual task). To ascertain specificity of auditory-vocal deficit, effects of concurrent vocalizing were also examined during a visual task. Children with SM and abnormal AEA showed impaired auditory processing during vocalization relative to children with SM and normal AEA, and relative to control children. This impairment is specific to the auditory modality and does not reflect difficulties in dual task per se. The data extends previous findings suggesting that deficient auditory processing is involved in speech selectivity in SM.

  9. An auditory-neuroscience perspective on the development of selective mutism.

    Science.gov (United States)

    Henkin, Yael; Bar-Haim, Yair

    2015-04-01

    Selective mutism (SM) is a relatively rare psychiatric disorder of childhood characterized by consistent inability to speak in specific social situations despite the ability to speak normally in others. SM typically involves severe impairments in social and academic functioning. Common complications include school failure, social difficulties in the peer group, and aggravated intra-familial relationships. Although SM has been described in the medical and psychological literatures for many years, the potential underlying neural basis of the disorder has only recently been explored. Here we explore the potential role of specific auditory neural mechanisms in the psychopathology of SM and discuss possible implications for treatment. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. A Vietnamese man with selective mutism: the relevance of multiple interacting 'cultures' in clinical psychiatry.

    Science.gov (United States)

    Hollifield, Michael; Geppert, Cynthia; Johnson, Yuam; Fryer, Carol

    2003-09-01

    Multiple cultural variables have effects on the psychobiology and behavioral manifestations of illness, as do patient and physician perceptions of illness. The interaction among these variables is at the heart of clinical psychiatry. This case of a Vietnamese man with selective mutism underscores the relevance of the 'cultures' of medicine, psychiatry, and war and trauma on the manifestations of illness and illness perceptions by patient and physician. The discussion focuses on how these cultures interact and play a crucial role in formulating diagnosis and treatment planning. Suggestions are given for shifts in medical education that will encourage relevant cultural paradigms to make their way into educational and clinical systems, which in turn should improve cultural competence in clinical psychiatry.

  11. Attention in selective mutism--an exploratory case-control study.

    Science.gov (United States)

    Oerbeck, Beate; Kristensen, Hanne

    2008-01-01

    The aim of the study was to explore the association between selective mutism (SM) and attention. In SM social anxiety seems central but language impairment and motor problems are also reported. Attention problems have been described in parental behavioral ratings, while neuropsychological studies are lacking. A neuropsychological test (the Trail Making Test) and parental ratings of attention- and anxiety problems were administered to a clinical sample of 23 children with SM (aged 7-16 years, 12 boys and 11 girls) and 46 non-referred matched controls. The SM group differed from controls on the Trail Making Test, but the group difference disappeared, when controlling for motor function and IQ. Parental ratings of attention problems were not significantly associated with the neuropsychological attention measure. Neuropsychological studies of attention controlled for IQ and motor function are needed as well as tests that measure different aspects of attention.

  12. Social Communication Anxiety Treatment (S-CAT) for children and families with selective mutism: A pilot study.

    Science.gov (United States)

    Klein, Evelyn R; Armstrong, Sharon Lee; Skira, Kathryn; Gordon, Janice

    2017-01-01

    This research assessed the feasibility of Social Communication Anxiety Treatment (S-CAT) developed by Elisa Shipon-Blum, a brief multimodal approach, to increase social communication in 40 children aged 5-12 years with selective mutism (SM). SM is a disorder in which children consistently fail to speak in specific situations although they have the ability to do so. Key features of this approach are the SM-Social Communication Comfort Scale (SCCS), transfer of control (ToC), a nonchalant therapeutic style, and cognitive-behavioral strategies over a brief time frame. Following 9 weeks of treatment, children showed significant gains in speaking frequency on all 17 items from the Selective Mutism Questionnaire (SMQ), a standardized measure of SM severity. Children also showed decreased levels of anxiety and withdrawal as reported by parents on the Child Behavior Checklist (CBCL). SM initial symptom severity and family therapy compliance, but not duration of SM, contributed to treatment outcomes.

  13. Treatment of selective mutism: a 5-year follow-up study.

    Science.gov (United States)

    Oerbeck, Beate; Overgaard, Kristin Romvig; Stein, Murray B; Pripp, Are Hugo; Kristensen, Hanne

    2018-01-22

    Selective mutism (SM) has been defined as an anxiety disorder in the diagnostic and statistical manual of mental disorders (DSM-5). Cognitive behavioral therapy (CBT) is the recommended approach for SM, but prospective long-term outcome studies are lacking. Reports from the children themselves, and the use of more global quality of life measures, are also missing in the literature. We have developed a school-based CBT intervention previously found to increase speech in a pilot efficacy study and a randomized controlled treatment study. Continued progress was found in our 1-year follow-up studies, where older age and more severe SM had a significant negative effect upon outcome. In the present study, we provide 5-year outcome data for 30 of these 32 children with SM who completed the same CBT for mean 21 weeks (sd 5, range 8-24) at mean age 6 years (10 boys). Mean age at the 5-year follow-up was 11 years (range 8-14). Outcome measures were diagnostic status, the teacher- and parent-rated selective mutism questionnaires, and child rated quality of life and speaking behavior. At the 5-year follow-up, 21 children were in full remission, five were in partial remission and four fulfilled diagnostic criteria for SM. Seven children (23%) fulfilled criteria for social phobia, and separation anxiety disorder, specific phobia and/or enuresis nocturna were found in a total of five children (17%). Older age and severity at baseline and familial SM were significant negative predictors of outcome. Treatment gains were maintained on the teacher- and parent questionnaires. The children rated their overall quality of life as good. Although most of them talked outside of home, 50% still experienced it as somewhat challenging. These results point to the long-term effectiveness of CBT for SM, but also highlight the need to develop more effective interventions for the subset of children with persistent symptoms.Clinical trials registration NCT01002196.

  14. Selective mutism. A school-based cross-sectional study from Turkey.

    Science.gov (United States)

    Karakaya, I; Sişmanlar, S G; Oç, O Y; Memik, N C; Coşkun, A; Ağaoğlu, B; Yavuz, C I

    2008-03-01

    The aim of this study is to examine the prevalence of selective mutism (SM) in Kocaeli, Turkey. Kindergarten, first, second and third grade students of all public/private schools within the city were included in the study. "SM screening forms" prepared on basis of DSM-IV were submitted to classroom teachers in all these schools asking whether they had any students meeting such symptoms. About 84.51% of the schools returned forms covering 64,103 children. Five hundred and twenty six of these children were thought to have symptoms of SM by their teachers. After their DSM-IV based clinical evaluation by a child and adolescent psychiatrist, only 21 children were diagnosed as SM. Among the SM group, three were in the kindergarten, 15 were in the first grade and three were in the second grade. Twelve of the children were male and nine were female (male: female ratio is 1.3:1). In this cross-sectional study, 0.83% of children were reported to have SM symptoms by their teachers. After the clinical evaluation of these children, the prevalence rate of SM was found to be 0.033%.

  15. Selective mutism: a review and integration of the last 15 years.

    Science.gov (United States)

    Viana, Andres G; Beidel, Deborah C; Rabian, Brian

    2009-02-01

    Selective mutism (SM) is a rare childhood disorder characterized by a lack of speech in one or more settings in which speaking is socially expected. A comprehensive and uniform theory about the etiology, assessment, and treatment of SM does not exist. Historically, varying definitions and criteria have been applied to children with SM, therefore making comparisons between studies somewhat difficult. Accumulating findings on the phenomenology of SM point to a complex and multidetermined etiology. Developmental psychopathology represents a useful heuristic for conceptualization of SM and serves as an integrative framework for organizing the sometimes disparate findings that permeate the SM literature. The purpose of this review is to summarize the literature on SM, including phenomenology, assessment, and treatment, with the main goals of clarifying its clinical presentation, offering a theoretical understanding of SM from a developmental psychopathology perspective, and highlighting both research and practice gaps that may exist. Recommendations for future research are made with the goal of expanding the current knowledge base on the etiology of SM.

  16. Parental adjustment, parenting attitudes and emotional and behavioral problems in children with selective mutism.

    Science.gov (United States)

    Alyanak, Behiye; Kılınçaslan, Ayşe; Harmancı, Halime Sözen; Demirkaya, Sevcan Karakoç; Yurtbay, Tülin; Vehid, Hayriye Ertem

    2013-01-01

    The present study investigated emotional and behavioral problems in children with selective mutism (SM) along with the psychological adjustment and parenting attitudes of their mothers and fathers. Participants included 26 children with SM (mean age = 8.11 ± 2.11 years), 32 healthy controls (mean age = 8.18 ± 2.55 years) and the parents of all children. Children with SM displayed higher problem scores than controls in a variety of emotional and behavioral parameters. They predominantly displayed internalizing problems, whereas aggressive and delinquent behavior was described among a subsample of the children. Significant differences existed between the SM and control groups only in paternal psychopathology, which included anxiety and depression. They did not differ with respect to maternal psychological distress or mother or father reported parental attitudes. Another important result of the present study was that the severity of emotional and behavioral problems of children with SM was correlated with maternal psychopathology but not paternal psychopathology. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Children's and parent's psychological profiles in selective mutism and generalized anxiety disorder: a clinical study.

    Science.gov (United States)

    Capozzi, Flavia; Manti, Filippo; Di Trani, Michela; Romani, Maria; Vigliante, Miriam; Sogos, Carla

    2017-10-28

    Selective mutism (SM) is classified in DSM-5 as an anxiety disorder. The aim of the study was to investigate the psychological features of children with SM and their parental psychological profiles, compared to generalized anxiety disorder (GAD) children and their parents. The parents of 26 preschool children with SM and 32 with children with GAD filled out the child behavior check list for 1½-5 years (CBCL1½-5) and the symptom checklist-90-revised (SCL-90-R). Information about the children and their parents' histories was collected through clinical interviews. Children with SM scored higher than children with GAD on the CBCL1½-5 withdrawn scale and lower on the attention problems, aggressive behavior, and externalizing problems scales. Mothers of children with SM scored higher on the SCL-90-R obsessive-compulsive subscale and Global Severity Index than mothers of children with GAD, while fathers of children with SM scored higher on the SCL-90-R Phobic Anxiety subscale and on the Global Severity Index than fathers of children with GAD. Parents of children with SM displayed a greater presence of stressful life events than parents of children with GAD. Data appeared to confirm that SM and GAD share a common anxious core, though some differences in the children's psychological profiles and the parents' history and personality emerged. Future research should focus on the role of external factors, such as parent-child relationship, in the development of SM.

  18. Identifying Treatment Response of Sertraline in a Teenager with Selective Mutism using Electrophysiological Neuroimaging.

    Science.gov (United States)

    Eugene, Andy R; Masiak, Jolanta

    2016-06-01

    Selective Mutism is described as the inability to verbally express oneself in anxiety provoking social situations and may result in awkward social interactions in school-aged children. In this case-report we present the baseline electrophysiological neuroimaging results and after treatment with Sertraline for 6-weeks. A 20-channel EEG event-related potential recording was acquired during an internal voice task at baseline prior to the initiation of 50mg of Sertraline and then repeated 6-weeks after treatment with Sertraline. EEG signals were processed for movement, eye-blink, and muscle artifacts and ERP signal averaging was completed. ERPs were analyzed using Standard Low Resolution Brain Electromagnetic Tomography (sLORETA). At baseline, Sertraline increased the neuronal activation in the middle temporal gyrus and the anterior cingulate gyrus from baseline in the patient following 6-weeks of treatment. Our findings suggest that electrophysiological neuroimaging may provide a creative approach for personalizing medicine by providing insight to the pharmacodynamics of antidepressants.

  19. Prevalence and description of selective mutism in immigrant and native families: a controlled study.

    Science.gov (United States)

    Elizur, Yoel; Perednik, Ruth

    2003-12-01

    To assess the incidence of selective mutism (SM) in West Jerusalem's state preschools and evaluate social anxiety/phobia disposition (SAP), social competence (SC), markers of neurodevelopmental delay/disorder (NDD), mothers' psychological adjustment, and marital conflict in immigrant and native children with SM and their matched controls. Mothers of 9 immigrant and 10 native children with SM and their matched controls completed questionnaires evaluating themselves, their marriages, and their children. A response rate of 30% (19/64) was obtained. The general prevalence of SM was 0.76%, while the rate among immigrants was 2.2%. Except for mothers' adjustment, all immigrant/native group effects were significant. There were significant interactions between the SM/control and immigrant/native groups for SAP, NDD, and SC. Immigrant children with SM had higher SAP and SC scores and lower NDD scores than native children with SM. This study distinguished between homogenous (socially anxious) and comorbid children with SM. In this sample, the disorder appeared to be associated with a combination of a specific diathesis (SAP) with intrinsic (NDD) and/or environmental (family immigration) vulnerabilities. Marital discord appeared to be a general risk factor for SM.

  20. Case Report: Evaluation strategies and cognitive intervention: the case of a monovular twin child affected by selective mutism [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Micaela Capobianco

    2018-02-01

    Full Text Available The present work describes the assessment process, evaluation strategies, and cognitive intervention on a 9 years old child with selective mutism (SM, a monovular twin of a child also affected by mutism. Currently, the cognitive behavioral multimodal treatment seems the most effective therapeutic approach for children diagnosed with selective mutism (Capobianco & Cerniglia, 2018. The illustrated case confirms the role of biological factors involved in mutacic disorder but also highlights the importance of environmental influences in the maintenance of the disorder with respect to relational and contextual dynamics (e.g. complicity between sisters, family relationships. The article discusses furthermore the importance of an early diagnosis as a predictor of positive treatment outcomes.

  1. Latent Class Symptom Profiles of Selective Mutism: Identification and Linkage to Temperamental and Social Constructs.

    Science.gov (United States)

    Diliberto, Rachele; Kearney, Christopher A

    2017-11-21

    Selective mutism (SM) is a stable, debilitating psychiatric disorder in which a child fails to speak in most public situations. Considerable debate exists as to the typology of this population, with empirically-based studies pointing to possible dimensions of anxiety, oppositionality, and communication problems, among other aspects. Little work has juxtaposed identified symptom profiles with key temperamental and social constructs often implicated in SM. The present study examined a large, diverse, non-clinical, international sample of children aged 6-10 years with SM to empirically identify symptom profiles and to link these profiles to key aspects of temperament (i.e., emotionality, shyness, sociability, activity) and social functioning (i.e., social problems, social competence). Exploratory and confirmatory factor analysis revealed anxiety/distress, oppositionality, and inattention domains. In addition, latent class analysis revealed nuanced profiles labeled as (1) moderately anxious, oppositional, and inattentive, (2) highly anxious, and moderately oppositional and inattentive, and (3) mildly to moderately anxious, and mildly oppositional and inattentive. Class 2 was the most impaired group and was associated with greater emotionality, shyness, and social problems. Class 3 was the least impaired group and was associated with better sociability and social competence and activity. Class 1 was largely between the other classes, demonstrating less shyness and social problems than Class 2. The results help confirm previous findings of anxiety and oppositional profiles among children with SM but that nuanced classes may indicate subtle variations in impairment. The results have implications not only for subtyping this population but also for refining assessment and case conceptualization strategies and pursuing personalized and perhaps less lengthy treatment.

  2. Comparison of behavioral profiles for anxiety-related comorbidities including ADHD and selective mutism in children.

    Science.gov (United States)

    Levin-Decanini, Tal; Connolly, Sucheta D; Simpson, David; Suarez, Liza; Jacob, Suma

    2013-09-01

    Elucidating differences in social-behavioral profiles of children with comorbid presentations, utilizing caregiver as well as teacher reports, will refine our understanding of how contextual symptoms vary across anxiety-related disorders. In our pediatric anxiety clinic, the most frequent diagnoses and comorbidities were mixed anxiety (MA; ≥ 1 anxiety disorder; N = 155), anxiety with comorbid attention-deficit hyperactivity disorder (MA/ADHD, N = 47) and selective mutism (SM, N = 48). Behavioral measures (CPRS, CTRS) were analyzed using multiple one-way multivariate analyses of covariance tests. Differences between the three diagnostic groups were examined using completed parent and teacher reports (N = 135, 46, and 48 for MA, MA/ADHD, and SM groups, respectively). Comparisons across the MA, MA/ADHD, and SM groups indicate a significant multivariate main effect of group for caregiver and teacher responses (P < 0.01). Caregivers reported that children with SM are similar in profile to those with MA, and both groups were significantly different from the MA/ADHD group. Teachers reported that children with SM had more problems with social behaviors than with the MA or MA/ADHD groups. Further comparison indicates a significant main effect of group (P < 0.001), such that children with SM have the greatest differences in behavior observed by teachers versus caregivers. Clinical profiles between MA/ADHD, MA, and SM groups varied, illustrating the importance of multi-rater assessment scales to capture subtle distinctions and to inform treatment planning given that comorbidities occur frequently in children who present with anxiety. © 2013 Wiley Periodicals, Inc.

  3. Playing with Gladys: A case study integrating drama therapy with behavioural interventions for the treatment of selective mutism.

    Science.gov (United States)

    Oon, Phei Phei

    2010-04-01

    This case study examines an integrative approach combining drama therapy and the behavioural skill "shaping", as offered to Gladys, a 5-year-old girl diagnosed with selective mutism. This study found that shaping, when implemented in the context of play, with play as the primary reinforcer, elicited from Gladys vocalization and eventually speech within a very short time. Her vocalizations allowed her to enter dramatic play, which in turn propelled spontaneous speech. This article looks at how the three elements of dramatherapy - the playspace, role-playing and dramatic projection - brought about therapeutic changes for Gladys. Aside from spontaneous speech, Gladys also developed positive self-esteem and a heightened sense of spontaneity. Subsequently, these two qualities helped her generalize her speech to new settings on her own. Gladys's newly harnessed spontaneity further helped her become more sociable and resilient.This study advances the possibility of integrating a behavioural skill with drama therapy for the therapeutic benefits of a child with an anxiety-related condition like selective mutism.

  4. Children Who are Anxious in Silence: A Review on Selective Mutism, the New Anxiety Disorder in DSM-5.

    Science.gov (United States)

    Muris, Peter; Ollendick, Thomas H

    2015-06-01

    Selective mutism (SM) is a relatively rare childhood disorder characterized by a consistent failure to speak in specific settings (e.g., school, social situations) despite speaking normally in other settings (e.g., at home). The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists SM among the anxiety disorders. This makes sense as the current review of the literature confirms that anxiety is a prominent symptom in many children suffering from this condition. Further, research on the etiology and treatment of SM also corroborates the conceptualization of SM as an anxiety disorder. At the same time, critical points can be raised regarding the classification of SM as an anxiety disorder. We explore a number of such issues in this review. Recommendations for dealing with this diagnostic conundrum are made for psychologists, psychiatrists, and other mental health workers who face children with SM in clinical practice, and directions for future research are highlighted.

  5. An Examination of Fluoxetine for the Treatment of Selective Mutism Using a Nonconcurrent Multiple-Baseline Single-Case Design Across 5 Cases.

    Science.gov (United States)

    Barterian, Justin A; Sanchez, Joel M; Magen, Jed; Siroky, Allison K; Mash, Brittany L; Carlson, John S

    2018-01-01

    This study examined the utility of fluoxetine in the treatment of 5 children, aged 5 to 14 years, diagnosed with selective mutism who also demonstrated symptoms of social anxiety. A nonconcurrent, randomized, multiple-baseline, single-case design with a single-blind placebo-controlled procedure was used. Parents and the study psychiatrist completed multiple methods of assessment including Direct Behavior Ratings and questionnaires. Treatment outcomes were evaluated by calculating effect sizes for each participant as an individual and for the participants as a group. Information regarding adverse effects with an emphasis on behavioral disinhibition and ratings of parental acceptance of the intervention was gathered. All 5 children experienced improvement in social anxiety, responsive speech, and spontaneous speech with medium to large effect sizes; however, children still met criteria for selective mutism at the end of the study. Adverse events were minimal, with only 2 children experiencing brief occurrences of minor behavioral disinhibition. Parents found the treatment highly acceptable.

  6. Behavioral and Socio-Emotional Functioning in Children with Selective Mutism: A Comparison with Anxious and Typically Developing Children across Multiple Informants

    Science.gov (United States)

    Carbone, Diana; Schmidt, Louis A.; Cunningham, Charles C.; McHolm, Angela E.; Edison, Shannon; St. Pierre, Jeff; Boyle, Michael H.

    2010-01-01

    We examined differences among 158 children, 44 with selective mutism (SM; M = 8.2 years, SD = 3.4 years), 65 with mixed anxiety (MA; M = 8.9 years, SD = 3.2 years), and 49 community controls (M = 7.7 years, SD = 2.6 years) on primary caregiver, teacher, and child reports of behavioral and socio-emotional functioning. Children with SM were rated…

  7. Selective mutism due to a dog bite trauma in a 4-year-old girl: a case report

    Directory of Open Access Journals (Sweden)

    Anyfantakis Dimitrios

    2009-11-01

    Full Text Available Abstract Introduction A child experiencing an event of threatening or catastrophic nature may experience considerable post-traumatic psychological distress. Dog bites present an important public health problem and are a frequent cause of physical trauma in children. Physicians who manage paediatric trauma may not be vigilant of the high risk of psychological stress in children exposed to a physical injury. Case presentation A 4-year-old white girl of Greek origin, with a dog-bite related trauma was admitted to the University Hospital of Crete, Greece, for surgical repair and intravenous antibiotic therapy due to extensive lesions. Exposure to the traumatic event triggered the onset of an unusual psychological response, selective mutism and acute post-traumatic stress disorder. Conclusion There is limited literature discussing the psychological effect of dog bites in children. Parents and physicians involved in pediatric physical trauma need to be more familiar with post-traumatic behavioral reactions. Awareness of the potential development of such reactions may result in early detection and effective management of children at risk.

  8. Selective mutism due to a dog bite trauma in a 4-year-old girl: a case report

    Science.gov (United States)

    2009-01-01

    Introduction A child experiencing an event of threatening or catastrophic nature may experience considerable post-traumatic psychological distress. Dog bites present an important public health problem and are a frequent cause of physical trauma in children. Physicians who manage paediatric trauma may not be vigilant of the high risk of psychological stress in children exposed to a physical injury. Case presentation A 4-year-old white girl of Greek origin, with a dog-bite related trauma was admitted to the University Hospital of Crete, Greece, for surgical repair and intravenous antibiotic therapy due to extensive lesions. Exposure to the traumatic event triggered the onset of an unusual psychological response, selective mutism and acute post-traumatic stress disorder. Conclusion There is limited literature discussing the psychological effect of dog bites in children. Parents and physicians involved in pediatric physical trauma need to be more familiar with post-traumatic behavioral reactions. Awareness of the potential development of such reactions may result in early detection and effective management of children at risk. PMID:19946578

  9. Selective mutism: a home-and kindergarten-based intervention for children 3-5 years: a pilot study.

    Science.gov (United States)

    Oerbeck, Beate; Johansen, Jorunn; Lundahl, Kathe; Kristensen, Hanne

    2012-07-01

    The aim was to examine the outcome of a multimodal treatment for selective mutism (SM). Seven children, aged three-five years, who were referred for SM were included. The treatment started at home and was continued at kindergarten for a maximum of six months, with predefined treatment goals in terms of speaking levels, from I ("Speaks to the therapist in a separate room with a parent present") through to VI ("Speaks in all kindergarten settings without the therapist present"). The outcome measures were the teacher-reported School Speech Questionnaire (SSQ) and the treatment goal obtained (I-VI) six months after the onset of treatment, and the SSQ and Clinical Global Impression Scale (CGI) at one-year follow-up. Six children spoke in all kindergarten settings (VI) after a mean of 14 weeks treatment. One child, with more extensive neuro-developmental delay, spoke in some settings only (V). The mean SSQ score was 0.59 (SD = 0.51) at baseline compared with 2.68 (SD = 0.35) at the six-month evaluation and 2.26 (SD = 0.93) at one-year follow-up. The mean CGI score at baseline was 4.43 (SD = 0.79) compared with 1.14 (SD = 0.38) at follow-up. Home- and kindergarten-based treatment appears to be promising.

  10. Practitioner review: Psychosocial interventions for children with selective mutism: a critical evaluation of the literature from 1990-2005.

    Science.gov (United States)

    Cohan, Sharon L; Chavira, Denise A; Stein, Murray B

    2006-11-01

    There have been several reports of successful psychosocial interventions for children with selective mutism (SM), a disorder in which a child consistently fails to speak in one or more social settings (e.g., school) despite speaking normally in other settings (e.g., home). The present literature review was undertaken in order to provide an up-to-date summary and critique of the SM treatment literature published in the past fifteen years. PubMed, PsycINFO, and Web of Science databases were searched to identify SM treatment studies published in peer-reviewed journals between 1990 and 2005. A total of 23 studies were included in the present review. Of these, ten used a behavioral/cognitive behavioral approach, one used a behavioral language training approach, one used a family systems approach, five used a psychodynamic approach, and six used multimodal approaches to SM treatment. Although much of this literature is limited by methodological weaknesses, the existing research provides support for the use of behavioral and cognitive-behavioral interventions. Multimodal treatments also appear promising, but the essential components of these interventions have yet to be established. An outline of a cognitive-behavioral treatment package for a typical SM child is provided and the review concludes with suggestions for future research.

  11. Is selective mutism associated with deficits in memory span and visual memory?: An exploratory case-control study.

    Science.gov (United States)

    Kristensen, Hanne; Oerbeck, Beate

    2006-01-01

    Our main aim in this study was to explore the association between selective mutism (SM) and aspects of nonverbal cognition such as visual memory span and visual memory. Auditory-verbal memory span was also examined. The etiology of SM is unclear, and it probably represents a heterogeneous condition. SM is associated with language impairment, but nonspecific neurodevelopmental factors, including motor problems, are also reported in SM without language impairment. Furthermore, SM is described in Asperger's syndrome. Studies on nonverbal cognition in SM thus merit further investigation. Neuropsychological tests were administered to a clinical sample of 32 children and adolescents with SM (ages 6-17 years, 14 boys and 18 girls) and 62 nonreferred controls matched for age, gender, and socioeconomic status. We used independent t-tests to compare groups with regard to auditory-verbal memory span, visual memory span, and visual memory (Benton Visual Retention Test), and employed linear regression analysis to study the impact of SM on visual memory, controlling for IQ and measures of language and motor function. The SM group differed from controls on auditory-verbal memory span but not on visual memory span. Controlled for IQ, language, and motor function, the SM group did not differ from controls on visual memory. Motor function was the strongest predictor of visual memory performance. SM does not appear to be associated with deficits in visual memory span or visual memory. The reduced auditory-verbal memory span supports the association between SM and language impairment. More comprehensive neuropsychological studies are needed.

  12. Application of a web-based cognitive-behavioural therapy programme for the treatment of selective mutism in Singapore: a case series study.

    Science.gov (United States)

    Ooi, Yoon Phaik; Raja, Malini; Sung, Sharon Cohan; Fung, Daniel S S; Koh, Jessie B K

    2012-07-01

    Selective mutism (SM) is characterised by limited or a lack of speech in selected social settings. Recent reviews suggest that cognitive-behavioural therapy (CBT) is an effective and promising treatment approach for SM. However, there is still a lack of studies documenting the applicability of CBT for SM in diverse populations. The goal of the present study was to examine the use of a web-based CBT programme ('Meeky Mouse') among Singaporean children diagnosed with SM. Five children with SM (one boy and four girls aged 6-11 years) participated in the 14-week 'Meeky Mouse' programme, in addition to being prescribed with an unchanged dosage of fluoxetine 10-20 mg daily. The progress made by the children throughout the course of the programme was documented by the therapist. Post treatment, four out of the five children demonstrated improvements in the frequency of speech during therapy sessions at home, in school and at other social situations. Findings from the present study provide support for the use of a web-based CBT programme in improving speech and decreasing the severity of SM among affected children.

  13. Children of Few Words: Relations Among Selective Mutism, Behavioral Inhibition, and (Social) Anxiety Symptoms in 3- to 6-Year-Olds.

    Science.gov (United States)

    Muris, Peter; Hendriks, Eline; Bot, Suili

    2016-02-01

    Children with selective mutism (SM) fail to speak in specific public situations (e.g., school), despite speaking normally in other situations (e.g., at home). The current study explored the phenomenon of SM in a sample of 57 non-clinical children aged 3-6 years. Children performed two speech tasks to assess their absolute amount of spoken words, while their parents completed questionnaires for measuring children's levels of SM, social anxiety and non-social anxiety symptoms as well as the temperament characteristic of behavioral inhibition. The results indicated that high levels of parent-reported SM were primarily associated with high levels of social anxiety symptoms. The number of spoken words was negatively related to behavioral inhibition: children with a more inhibited temperament used fewer words during the speech tasks. Future research is necessary to test whether the temperament characteristic of behavioral inhibition prompts children to speak less in novel social situations, and whether it is mainly social anxiety that turns this taciturnity into the psychopathology of SM.

  14. Die terapeutiese gebruik van die scenotoets met verwysing na selektiewe mutisme

    Directory of Open Access Journals (Sweden)

    Adre Nieuwoudt

    2002-11-01

    Full Text Available There is a paucity of applied research and available literature about selective mutism. Opsomming Daar is min toegepaste navorsing en beskikbare literatuur oor selektiewe mutisme. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

  15. A common genetic variant in the neurexin superfamily member CNTNAP2 is associated with increased risk for selective mutism and social anxiety-related traits.

    Science.gov (United States)

    Stein, Murray B; Yang, Bao-Zhu; Chavira, Denise A; Hitchcock, Carla A; Sung, Sharon C; Shipon-Blum, Elisa; Gelernter, Joel

    2011-05-01

    Selective mutism (SM), considered an early-onset variant of social anxiety disorder, shares features of impaired social interaction and communication with autism spectrum disorders (ASDs) suggesting a possible shared pathophysiology. We examined association of a susceptibility gene, contactin-associated protein-like 2 (CNTNAP2), for ASDs and specific language impairment with SM and social anxiety-related traits. Sample 1 subjects were 99 nuclear families including 106 children with SM. Sample 2 subjects were young adults who completed measures of social interactional anxiety (n = 1028) and childhood behavioral inhibition (n = 920). Five single nucleotide polymorphisms in CNTNAP2 (including rs7794745 and rs2710102, previously associated with ASDs) were genotyped. Analyses revealed nominal significance (p = .018) for association of SM with rs2710102, which, with rs6944808, was part of a common haplotype associated with SM (permutation p = .022). Adjusting for sex and ancestral proportion, each copy of the rs2710102*a risk allele in the young adults was associated with increased odds of being >1 SD above the mean on the Social Interactional Anxiety Scale (odds ratio = 1.33, p = .015) and Retrospective Self-Report of Inhibition (odds ratio = 1.40, p = .010). Although association was found with rs2710102, the risk allele (a) for the traits studied here is the nonrisk allele for ASD and specific language impairment. These findings suggest a partially shared etiology between ASDs and SM and raise questions about which aspects of these syndromes are potentially influenced by CNTNAP2 and mechanism(s) by which these influences may be conveyed. Copyright © 2011 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  16. Overcoming Mutism in Adults with Learning Disabilities: A Case Study.

    Science.gov (United States)

    Bell, Dorothy M.; Espie, Colin A.

    2003-01-01

    A woman with Down syndrome, who had shown selective mutism for more than 14 years, successfully participated in a program designed to reinforce communication and gradually increase the number of words spoken to one person and then to others. Nonaversive behavior methods were used and response initiative procedures were developed. (Contains…

  17. Goiter and deaf mutism.

    Science.gov (United States)

    Thieme, E T

    1975-08-01

    The occurrence of deaf-mutism and goiter unassocaited with creatinism or mental retardation in euthyroid patients is known as Pendred's Syndrome. It is considered due to a single mutant recessive gene responsible for both the goiter and deafness. The penetrance is high, the intenseness of expressivity may vary within the same family and only one generation is affected. The extremely atypical hyperplasia seen in such goiters has been considered malignant. In 1956 the author reported a family in which 4 of 6 sibilings demonstrated Pendred's Syndrome. Three of the 4 had undergone thyroidectomy, two were considered to have carcinoma. Nineteen years later the family is again reported. The fourth sibling has recently undergone thyroidectomy. This thyroid demonstrated the same atypical hyperplasia as seen in the elder two siblings. The 19 year followup of this family has shown no evidence of recurrence or metastases, indicating that the atypical hyperplasia is probably not malignant. Pendred's Syndrome is described and certain suggestions are made for the counseling of the parents and the treatment and counseling of those children so afflicted.

  18. Characteristics of Acupoint Selection in Treating Apoplexy

    Institute of Scientific and Technical Information of China (English)

    ZHAO Chao-rong; ZHANG Yan; GU Hong; ZHOU Yun; XIAO Yuan-chun

    2003-01-01

    Objective: To explore the characteristics of acupoint selection in the treatment of apoplexy. Method:This paper reviews and analyzes the ancient and current medical literature, and then summarizes the characteris -tics of acupoint selection in treating apoplexy. Results:Four characteristics are presented: the acupoints on the head are mostly used; the acupoints are principally selected according to the course of nerves; the acupoints of the yang meridians are usually selected; the special acupoints and empirical acupoints are often combined.Conclusion: Above principles may be adopted in the selection of acupoints to treat apoplexy.

  19. Cerebellar mutism: review of the literature

    DEFF Research Database (Denmark)

    Gudrunardottir, Thora; Sehested, Astrid; Juhler, Marianne

    2011-01-01

    Cerebellar mutism is a common complication of posterior fossa surgery in children. This article reviews current status with respect to incidence, anatomical substrate, pathophysiology, risk factors, surgical considerations, treatment options, prognosis and prevention....

  20. Cerebellar mutism--report of four cases.

    Science.gov (United States)

    Ozimek, A; Richter, S; Hein-Kropp, C; Schoch, B; Gorissen, B; Kaiser, O; Gizewski, E; Ziegler, W; Timmann, D

    2004-08-01

    The aim of the present study was to investigate the manifestations of mutism after surgery in children with cerebellar tumors. Speech impairment following cerebellar mutism in children was investigated based on standardized acoustic speech parameters and perceptual criteria. Mutistic and non-mutistic children after cerebellar surgery as well as orthopedic controls were tested pre-and postoperatively. Speech impairment was compared with the localization of cerebellar lesions (i. e. affected lobules and nuclei). Whereas both control groups showed no abnormalities in speech and behavior, the mutistic group could be divided into children with dysarthria in post mutistic phase and children with mainly behavioral disturbances. In the mutistic children involvement of dentate and fastigial nuclei tended to be more frequent and extended than in the nonmutistic cerebellar children. Cerebellar mutism is a complex phenomenon of at least two types. Dysarthric symptoms during resolution of mutism support the anarthria hypothesis, while mainly behavioral changes suggest an explanation independent from speech motor control.

  1. Cerebellar mutism: review of the literature

    DEFF Research Database (Denmark)

    Gudrunardottir, Thora; Sehested, Astrid; Juhler, Marianne

    2011-01-01

    Cerebellar mutism is a common complication of posterior fossa surgery in children. This article reviews current status with respect to incidence, anatomical substrate, pathophysiology, risk factors, surgical considerations, treatment options, prognosis and prevention.......Cerebellar mutism is a common complication of posterior fossa surgery in children. This article reviews current status with respect to incidence, anatomical substrate, pathophysiology, risk factors, surgical considerations, treatment options, prognosis and prevention....

  2. Sex selection: treating different cases differently.

    Science.gov (United States)

    Dickens, B M; Serour, G I; Cook, R J; Qiu, R-Z

    2005-08-01

    This paper contrasts ethical approaches to sex selection in countries where discrimination against women is pervasive, resulting in selection against girl children, and in countries where there is less general discrimination and couples do not prefer children of either sex. National sex ratio imbalances where discrimination against women is common have resulted in laws and policies, such as in India and China, to deter and prevent sex selection. Birth ratios of children can be affected by techniques of prenatal sex determination and abortion, preconception sex selection and discarding disfavored embryos, and prefertilization sperm sorting, when disfavored sperm remain unused. Incentives for son preference are reviewed, and laws and policies to prevent sex selection are explained. The elimination of social, economic and other discrimination against women is urged to redress sex selection against girl children. Where there is no general selection against girl children, sex selection can be allowed to assist families that want children of both sexes.

  3. [Selective embolization to treat obstetric hemorrhage].

    Science.gov (United States)

    Ferrer Puchol, M D; Lanciego, C; Esteban, E; Ciampi, J J; Edo, M A; Ferragud, S

    2014-01-01

    To describe cases of obstetric hemorrhage that have called for selective intra-arterial embolization and the different embolization techniques used. To assess the clinical outcomes and postprocedural fertility. We studied 27 women with obstetric hemorrhage. In 24 patients, embolization was performed by catheterizing both uterine arteries and in 2 patients only one uterine artery was catheterized (pseudoaneurysm). The materials used for embolization consisted of Spongostan in 17/27, particles in 9/27, and coils in 1/27. Clinical follow-up included an analysis of early and late complications and of postprocedural fertility. Hemorrhage was classified as primary (25/27) or secondary (2/27). The cause of bleeding was vaginal delivery (20), cesarean sections (5), abortion (1), and cervical ectopic pregnancy (1). The initial technical success rate was 100% and the clinical success rate was 92.6% (25 of the 27 patients). Bleeding ceased and the outcome was satisfactory in 25 patients. During clinical follow-up ranging from one to seven years, 23 patients had normal menstruation and 6 patients completed 7 full-term pregnancies. Intra-arterial embolization for obstetric hemorrhage leads to good outcomes and few complications and it preserves fertility. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

  4. Optimizing antibiotic selection in treating COPD exacerbations

    Directory of Open Access Journals (Sweden)

    Attiya Siddiqi

    2008-03-01

    Full Text Available Attiya Siddiqi, Sanjay SethiDivision of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Veterans Affairs Western New York Health Care System and University of Buffalo, State University of New York, Buffalo, New York, USAAbstract: Our understanding of the etiology, pathogenesis and consequences of acute exacerbations of chronic obstructive pulmonary disease (COPD has increased substantially in the last decade. Several new lines of evidence demonstrate that bacterial isolation from sputum during acute exacerbation in many instances reflects a cause-effect relationship. Placebo-controlled antibiotic trials in exacerbations of COPD demonstrate significant clinical benefits of antibiotic treatment in moderate and severe episodes. However, in the multitude of antibiotic comparison trials, the choice of antibiotics does not appear to affect the clinical outcome, which can be explained by several methodological limitations of these trials. Recently, comparison trials with nontraditional end-points have shown differences among antibiotics in the treatment of exacerbations of COPD. Observational studies that have examined clinical outcome of exacerbations have repeatedly demonstrated certain clinical characteristics to be associated with treatment failure or early relapse. Optimal antibiotic selection for exacerbations has therefore incorporated quantifying the risk for a poor outcome of the exacerbation and choosing antibiotics differently for low risk and high risk patients, reserving the broader spectrum drugs for the high risk patients. Though improved outcomes in exacerbations with antibiotic choice based on such risk stratification has not yet been demonstrated in prospective controlled trials, this approach takes into account concerns of disease heterogeneity, antibiotic resistance and judicious antibiotic use in exacerbations.Keywords: COPD, exacerbation, bronchitis, antibiotics

  5. Transient mutism and pathologic laughter in the course of cerebellitis.

    Science.gov (United States)

    Dimova, Petia S; Bojinova, Veneta S; Milanov, Ivan G

    2009-07-01

    The phenomenon of cerebellar mutism with subsequent dysarthria is most commonly described as a part of posterior fossa syndrome after surgery for neoplasms in childhood. Pathologic laughter, on the other hand, is observed primarily in various neurologic diseases in adults. In the present case, a child manifested transient mutism and pathologic laughter during a severe cerebellitis. Headache, vertigo, and impaired consciousness developed during an acute respiratory infection. Thereafter, severe ataxia, mutism, and involuntary laughter became the main clinical features, as well as pyramidal signs. Magnetic resonance imaging revealed cerebellar swelling and T(2) hyperintensity. During steroid treatment, a gradual vanishing of the pathologic laughter and improvement of the motor and speech functions occurred. Recovery was slow and incomplete, and follow-up magnetic resonance imaging showed cerebellar atrophy. This case confirms that mutism is a rare, but possible, manifestation in acute parainfectious cerebellitis and provides a novel example of pathologic laughter during this disease in childhood.

  6. Increasing Verbal Behavior of a Student Who Is Selectively Mute

    Science.gov (United States)

    Beare, Paul; Torgerson, Colleen; Creviston, Cindy

    2008-01-01

    "Selective mutism" is the term used to describe a disorder in which a person speaks only in restricted stimulus situations. Examination of single-subject research concerning selective mutism reveals the most popular and successful interventions to instate speech involve a combination of behavior modification procedures. The present research…

  7. Super selective uterine arterio-embolization in treating uterine myoma

    International Nuclear Information System (INIS)

    Gu Yaqin; Wang Jiangu; Shang Jinyun; Zhang Jian; Zhang Rulan; Tan Yuedi; Zhao Zehua; Xu Chongsen

    2001-01-01

    Objective: To study the clinical efficacy of super selective uterine arterio-embolization in treating uterine myoma. Methods: From February to August 2000, 28 cases of uterine myomas were under-gone bilateral arterio-embolization of tumor feeding vessels. Results: The successful rate of embolization catheterization reached 100%. B-mode ultrasound examination revealed the following during 1-6 months after the procedure, with an average shrinkage of 25% in volume for all cases in the first month follow up, complete disappearance of tumor in 8 cases and with an average shrinkage of 68% volumetrically for the other 20 cases, together with conspicuous decrease in volume of menstruation. Conclusions: Interventional treatment for uterine myoma is definite effective especially in submucosal uterine myoma

  8. [Selective neck dissection for treating recurrent branchial anomalies].

    Science.gov (United States)

    Chen, Liangsi; Song, Xinhan; Zhang, Siyi; Han, Zhijuan; Luo, Xiaoning; Chen, Shaohua; Zhan, Jiandong

    2011-01-01

    To evaluate the role of selective neck dissection in the treatment of recurrent branchial anomalies. The clinical data of 18 patients with recurrent branchial anomalies were retrospectively analyzed. In accordance with the embryologic and anatomic features of branchial anomalies, different types of selective neck dissection were applied. With dissection and protection of important vessels, nerves and other structures, enbloc resection principles were applied to extirpate branchial lesions, scarrings and inflammatory granuloma during the operation. Of all 18 patients, 16 cases were healed with primary healing, 2 cases with local incision infection were healed after dressing changes. A temporary facial nerve paralysis occurred in 1 case with recurrent first branchial cleft fistula postoperatively, and completely recovered 2 months after operation. A postoperative temporary vocal cord paralysis occurred in 1 case with recurrent fourth branchial cleft fistula, and totally recuperated 1 month after operation. No recurrences were found in all 18 cases with a follow-up period of 12-78 months (average 35 months). Selective neck dissection is a safe and effective surgical procedure for the radical treatment of recurrent branchial anomalies.

  9. Fluorodeoxyglucose positron emission tomography/computed tomography findings in a patient with cerebellar mutism after operation in posterior fossa

    Directory of Open Access Journals (Sweden)

    Gonca Kara Gedik

    2017-03-01

    Full Text Available Cerebellar mutism is a transient period of speechlessness that evolves after posterior fossa surgery in children. Although direct cerebellar and brain stem injury and supratentorial dysfunction have been implicated in the mediation of mutism, the pathophysiological mechanisms involved in the evolution of this kind of mutism remain unclear. Magnetic resonance imaging revealed dentatothalamocortical tract injuries and single photon emission computed tomography showed cerebellar and cerebral hypoperfusion in patients with cerebellar mutism. However, findings with 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT in this group of patients have not been documented previously. In this clinical case, we report a patient who experienced cerebellar mutism after undergoing a posterior fossa surgery. Right cerebellar and left frontal lobe hypometabolism was shown using FDG PET/CT. The FDG metabolism of both the cerebellum and the frontal lobe returned to normal levels after the resolution of the mutism symptoms.

  10. Selective Serotonin Reuptake Inhibitors in Human Pregnancy: To Treat or Not to Treat?

    Directory of Open Access Journals (Sweden)

    Orna Diav-Citrin

    2012-01-01

    Full Text Available Selective serotonin reuptake inhibitors (SSRIs are increasingly prescribed during pregnancy. The purpose of the present paper is to summarize and evaluate the current evidence for the risk/benefit analysis of SSRI use in human pregnancy. The literature has been inconsistent. Although most studies have not shown an increase in the overall risk of major malformations, several studies have suggested that SSRIs may be associated with a small increased risk for cardiovascular malformations. Others have noted associations between SSRIs and specific types of rare major malformations. In some studies, there appears to be a small increased risk for miscarriages, which may be associated with the underlying maternal condition. Neonatal effects have been described in up to 30% of neonates exposed to SSRIs late in pregnancy. Persistent pulmonary hypertension of the newborn has also been described with an absolute risk of <1%. The risk associated with treatment discontinuation, for example, higher frequency of relapse and increased risk of preterm delivery, should also be considered. The overall benefit of treatment seems to outweigh the potential risks.

  11. Interviews with Selectively Mute Children

    Science.gov (United States)

    Omdal, Heidi; Galloway, David

    2007-01-01

    The assessment of selective mutism usually takes place in a clinic, where the child often refuses to speak to the therapist. The challenge when trying to understand the child's own perspective is to find a medium for communication. Three selectively mute children were interviewed using Raven's Controlled Projection for Children (RCPC). The…

  12. Intervention with the Selectively Mute Child.

    Science.gov (United States)

    Porjes, Michelle D.

    1992-01-01

    Defines selective mutism as describing children who actively choose to speak to few people in selected environments, noting it is most commonly used to describe nonverbal behavior in school setting. Reviews literature from psychoanalytic and learning theory approaches. Presents intervention strategies used with two selectively mute first graders.…

  13. [Mutism and acute behavioral disorders revealing MELAS syndrome].

    Science.gov (United States)

    Coomans, H; Barroso, B; Bertandeau, E; Bonnan, M; Dakar, A; Demasles, S; Garraud, S; Krim, E; Martin-Négrier, M-L

    2011-11-01

    MELAS syndrome (mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes) is a rare genetic mitochondrial disease which can cause cerebral (cerebrovascular accident, migraine, mental deterioration..), sensorial (bilateral symmetrical deafness) and peripheral (muscular involvement, neuropathy) disorders potentially associated with diabetes, renal or cardiac disorders, or growth retardation. Eighty percent of the patients have the 3243 A>G mutation in the leucine RNA transfer gene. Clinical manifestations leading to discovery of the mutation can be extremely varied, affecting patients of different age groups. We report the case of a 49-year-old man who presented acute fits of confusion followed by mutism and praxic disorders. History taking revealed recently diagnosed type 2 diabetes, axonal neuropathy, and bilateral symmetrical deafness requiring hearing aids. The initial MRI showed FLAIR sequences with bi-parietal abnormalities, no signs of recent stroke on the DW/B10000 sequences, and basal ganglia calcifications. Blood tests and morphological findings ruled out a vascular origin. Search for lactic acidosis remained constantly negative in blood samples despite positive cerebrospinal fluid samples (N×3). The 3243 A>G mitochondrial DNA mutation was identified. The neuropsychological evaluation revealed a serious dysexecutive syndrome with a major impact on the patient's self sufficiency. Neurocognitive disorders are not common in MELAS syndrome. Brain MRI results and the presence of extra-neurological signs can be helpful for diagnosis. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  14. Cerebellar Mutism Syndrome and Other Complications After Surgery in the Posterior Fossa in Adults

    DEFF Research Database (Denmark)

    Wibroe, Morten; Rochat, Per; Juhler, Marianne

    2018-01-01

    BACKGROUND: Cerebellar mutism syndrome (CMS) is rarely described in adults; however, data on self-assessed linguistic complications after posterior fossa surgery do not exist. METHODS: Through a prospective single-center study, data on 59 tumor operations in the posterior fossa were collected pre...

  15. Discussion of indication for selecting ectopic pregnancy treated by trans-uterine artery embolization

    International Nuclear Information System (INIS)

    Xu Wenjian; Ni Caifang; Tan Xiaomei

    2007-01-01

    Objective: To discuss the selection of indication for using uterine artery perfusion and embolization in tubal pregnancy. Methods: Fifty one cases of tubal pregnancy were treated by superselective trans-uterine artery (TUA) catheterization with perfusing Methorexate (MTX) and then embolized the uterine arteries by gelfoam. The comparisons among serum β-HCG concentration, abdominal bleeding and the size of the ectopic mass could state the importance of the indication selection preproceduralty. Results: Forty eight of the 51 cases were cured by this method, when the ectopic mass size ≥5 cm, the cure rate was low, 33.33% (P<0.01), although the serum β-HCG concentration was ≤10 000 mIU/ml with no abdominal hemorrhage; otherwise, with mass size ≤5 cm, without consideration of the serum β-HCG concentration and abdominal bleeding, the cure rate was 97.92%. Conclusion: The technique of trans-uterine artery MTX perfusion and embolization selection of close clinical could result in satisfactory treatment for tubal pregnancy. Careful selection of indication, close clinical observation and neady for any emergency should always be on alert. (authors)

  16. Fracture behaviour of a magnesium–aluminium alloy treated by selective laser surface melting treatment

    International Nuclear Information System (INIS)

    Taltavull, C.; López, A.J.; Torres, B.; Rams, J.

    2014-01-01

    Highlights: • β-Mg 17 Al 12 presents fragile fracture behavior decreasing the ductility of AZ91D. • SLSM treatment only modifies the β-Mg 17 Al 12 phase whilst α-Mg remains unaltered. • In-situ SEM bending test allows to observe and data record of the crack propagation. • Eutectic microestructure of modified β-phase presents ductile fracture behaviour. • Fracture toughness of laser treated specimen is 40% greater than as-received alloy. - Abstract: Fracture behaviour of AZ91D magnesium alloy is dominated by the brittle fracture of the β-Mg 17 Al 12 phase so its modification is required to improve the toughness of this alloy. The novel laser treatment named as Selective Laser Surface Melting (SLSM) is characterized by the microstructural modification of the β-Mg 17 Al 12 phase without altering the α-Mg matrix. We have studied the effect of the selected microstructural modification induced by the laser treatment in the fracture behaviour of the alloy has been studied using in situ Scanning Electron Microscopy bending test. This test configuration allows the in situ observation of the crack progression and the record of the load–displacement curve. It has been observed that the microstructural modification introduced by SLSM causes an increase of 40% of the fracture toughness of the treated specimen. This phenomenon can be related with the transition from brittle to ductile fracture behaviour of the laser modified β-phase

  17. Clomazone selectivity in cotton seeds treated with dietholate and zinc acetate

    Directory of Open Access Journals (Sweden)

    Miriam Hiroko Inoue

    2014-12-01

    Full Text Available The objective of this study objective was to evaluate the selectivity of pre-emergence applications the herbicide clomazone cotton seeds treated with dietholate and zinc acetate. The 4 x 2 factorial arrangement was adopted (4 seed treatment methods and 2 clomazone dosages, distributed in a randomized block design with 4 repetitions. In treatments where dietholate and zinc acetate were applied, rates of 0.4 kg ha-1 and 8 ml per kg of seeds were used respectively. The clomazone rates used refer to 0.8 and 1.0 kg ha- 1. The cotton cultivar used was the Fiber Max 966 LL. Independent of treatment, all seeds were treated with tiametoxam insecticide and fludioxonil + metalaxyl-M fungicide at rates of 2.24 and 0.08 + 0.03 g per kg of seed, respectively, to control pests early and limit losses caused by pathogens in germination and seedling emergence. Dietholate and zinc acetate treatment had greater initial effect on cotton plants at 21, 30 and 45 days after application. In phytointoxication symptoms were observed for treatment with dietholate and zinc acetate during the evaluation periods. Seeds treated with dietholate, dietholate and zinc acetate or zinc acetate alone provided a higher number of bolls and seed cotton production compared to the control.

  18. Microorganism selection and performance in bioslurry reactors treating PAH-contaminated soil.

    Science.gov (United States)

    Cassidy, D P; Hudak, A J

    2002-09-01

    A continuous-flow reactor (CSTR) and a soil slurry-sequencing batch reactor (SS-SBR) were operated in 81 vessels for 200 days to treat a soil contaminated with polycyclic aromatic hydrocarbons (PAH). Filtered slurry samples were used to quantify bulk biosurfactant concentrations and PAH emulsification. Concentrations of Corynebacterium aquaticum, Flavobacterium mizutaii, Mycobacterium gastri, Pseudomonas aeruginosa, and Pseudomonas putida were determined using fatty acid methyl ester (FAME) analysis. The CSTR and SS-SBR selected microbial consortia with markedly different surfactant-producing and PAH-degrading abilities. Biosurfactant levels in the SS-SBR reached 4 times the critical micelle concentration (CMC) that resulted in considerable emulsification of PAH. In contrast, CSTR operation resulted in nomeasurable biosurfactant production. Total PAH removal efficiency was 93% in the SS-SBR, compared with only 66% in the CSTR, and stripping of PAH was 3 times less in the SS-SBR. Reversing the mode of operation on day 100 caused a complete reversal in microbial consortia and in reactor performance by day 140. These results show that bioslurry reactor operation can be manipulated to control overall reactor performance.

  19. Afraid To Be Heard: The Selectively Mute Child.

    Science.gov (United States)

    Longo, Sharon L.

    2001-01-01

    Presents facts about selective mutism, an anxiety disorder believed to be caused by low levels of serotonin in the brain, discussing its effects on school children, explaining how to get the necessary help (e.g., talking to health professionals and becoming educated about the disorder), and noting what parents can do (e.g., help raise the child's…

  20. Alkali-treated titanium selectively regulating biological behaviors of bacteria, cancer cells and mesenchymal stem cells.

    Science.gov (United States)

    Li, Jinhua; Wang, Guifang; Wang, Donghui; Wu, Qianju; Jiang, Xinquan; Liu, Xuanyong

    2014-12-15

    Many attentions have been paid to the beneficial effect of alkali-treated titanium to bioactivity and osteogenic activity, but few to the other biological effect. In this work, hierarchical micro/nanopore films were prepared on titanium surface by acid etching and alkali treatment and their biological effects on bacteria, cancer cells and mesenchymal stem cells were investigated. Gram-positive Staphylococcus aureus, Gram-negative Escherichia coli, and human cholangiocarcinoma cell line RBE were used to investigate whether alkali-treated titanium can influence behaviors of bacteria and cancer cells. Responses of bone marrow mesenchymal stem cells (BMMSCs) to alkali-treated titanium were also subsequently investigated. The alkali-treated titanium can potently reduce bacterial adhesion, inhibit RBE and BMMSCs proliferation, while can better promote BMMSCs osteogenesis and angiogenesis than acid-etched titanium. The bacteriostatic ability of the alkali-treated titanium is proposed to result from the joint effect of micro/nanotopography and local pH increase at bacterium/material interface due to the hydrolysis of alkali (earth) metal titanate salts. The inhibitory action of cell proliferation is thought to be the effect of local pH increase at cell/material interface which causes the alkalosis of cells. This alkalosis model reported in this work will help to understand the biologic behaviors of various cells on alkali-treated titanium surface and design the intended biomedical applications. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Comparative storage studies of selected varieties of potatoes treated with CIPC and gamma radiation

    International Nuclear Information System (INIS)

    Islam, M.S.; Karim, A.; Hossain, M.M.; Hossain, A.

    1990-01-01

    Three varieties of potatoes (Diamant, Kufri sinduri and Lal pakri) were treated with 8 Krad of gamma radiation and CIPC at the rate of 2 gm/kg of potatoes and were stored at 4 deg C, 15 deg. C and ambient temperature. The control, irradiated and CIPC treated potatoes at ambient temperature spoiled within 2 months of storage. Control potatoes stored at 15 deg. C lost their market value due to sprouting and shrinkage after 6 months of storage. Irradiated potatoes stored at 15 deg. C lost weight at a slower rate than CIPC treated samples stored at the same temperature and control potatoes stored at 4 deg. C. All the potatoes in control samples sprouted within 3 months of storage at 15 deg. C whereas no sprouting was recorded in any variety of potatoes treated with radiation or CIPC and stored at 15 deg. C for 6 months. After 6 months of storage reducing sugar content was much lower in the irradiated or CIPC treated potatoes than the control potatoes stored at 4 deg. C. The irradiated tubers stored at 15 deg. C and control tubers stored at 4 deg. C retained excellent physical appearance and market quality at the end of 6 months storage though irradiated potatoes were more attractive

  2. Silent at school--elective mutism and abuse.

    Science.gov (United States)

    MacGregor, R; Pullar, A; Cundall, D

    1994-01-01

    A retrospective case-control study of electively mute children from one city is reported. Eight of 18 children selectively mute in school had suffered definite or probable abuse compared with only one control with a speech or language problem, and no classroom controls. The implications for management are discussed. PMID:8048829

  3. Testing the Effects of Peer Socialization versus Selection on Alcohol and Marijuana Use among Treated Adolescents

    Science.gov (United States)

    Becker, Sara J.; Curry, John F.

    2014-01-01

    This study examined the relative influence of peer socialization and selection on alcohol and marijuana use among 106 adolescents who received a brief intervention. Adolescents were recruited between 2003 and 2007 and followed for 12 months as part of a SAMHSA-funded study. Cross-lagged panel models using four assessment points examined the longitudinal relationship between adolescent substance use and peer substance involvement separately for alcohol and marijuana. Consistent with community studies, there was evidence of both peer socialization and peer selection for alcohol use, and only evidence of peer selection for marijuana use. Implications for research and intervention are discussed. PMID:23965039

  4. Selection of fusion levels in idiopathic adolescent scoliosis treated by Harrington-DDT instrumentation

    DEFF Research Database (Denmark)

    Andersen, G R; Andersen, M O; Christensen, S B

    1995-01-01

    Clinical records and radiographs of 106 patients treated by Harrington-dorsal transverse traction (DDT) instrumentation for idiopathic adolescent thoracolumbar scoliosis were reviewed. Our strategy was to fuse from one vertebra above the measured curve to two vertebrae below the curve, but to avoid...

  5. Selective passive adsorption of nitrate with surfactant treated porous electrode and electrostatic regeneration

    Science.gov (United States)

    Oyarzun, Diego I.; Hemmatifar, Ali; Palko, James W.; Stadermann, Michael; Santiago, Juan G.; Stanford microfluidics lab Team; Lawrence Livermore National Lab Team

    2017-11-01

    Nitrate is an important pollutant in drinking water worldwide, and a number of methods exist for the removal of nitrate from water including ion exchange and reverse osmosis. However, these approaches suffer from a variety of disadvantages including the need for a regenerating brine supply and disposal of used brine for ion exchange and low water recovery ratio for reverse osmosis. We are researching and developing a form of capacitive deionization (CDI) for energy efficient desalination and selective removal of ionic toxins from water. In CDI an electrode is used to electrostatically trap ions in a pair of porous electrodes. Here, we demonstrate the use of high surface area activated carbon electrodes functionalized with ion exchange moieties for adsorption of nitrate from aqueous solution. Unlike a traditional ion exchanger, the functionalized surfaces can be repeatedly regenerated by the application of an electrostatic potential which displaces the bound NO3- while leaving an excess of electronic charge on the electrode. Trimethylammonium has an intrinsic selectivity, we are using this moiety to selectively remove nitrate over chloride. We performed adsorption/desorption cycles under several desorption voltages and ratios of concentrations.

  6. CONCENTRATION OF SELECTED ELEMENTS IN RAW AND ULTRA HEAT TREATED COW MILK

    Directory of Open Access Journals (Sweden)

    Lukáčová Anetta

    2012-10-01

    Full Text Available The potential presence of toxic metals in food is being recognized as a priority by standards organizations and constitutes an analytical challenge. The toxic metal content of milk and dairy products is due to several factors: environmental conditions, the manufacturing process and the possible contamination during several steps of the manufacturing processes. The aim of this study was to evaluate samples of raw milk with fat contents 3.8% obtained at randomly from animal farms in around Nitra, western Slovakia region and ultra – heat treated cow milk (UHT with fat contents 1.5% commercially available from local market in Nitra. Samples of milk were analysed for metal contents using atomic absorption spectrophotometry (AAS. UHT milk showed higher levels of cadmium, nickel and iron. Higher levels of zinc, copper were detected in raw milk. Significant differences in the concentration of copper between raw and UHT cow milk were found.

  7. Chronic catatonia with obsessive compulsive disorder symptoms treated with lorazepam, memantine, aripiprazole, fluvoxamine and neurosurgery

    OpenAIRE

    Mukai, Yuki; Two, Aimee; Jean-Baptiste, Michel

    2011-01-01

    Catatonia is a syndrome with protean manifestations and multiple aetiologies. In this report, the authors describe the case of a young woman who presented for care after a 13-year period of catatonia-like symptoms, including mutism, refusal to eat and persistent neck flexion. Medical management included placement of a percutaneous endoscopic gastric tube for nutritional support. A thorough medical investigation later revealed the presence of a cervical spine haemangioma that was treated surgi...

  8. Selective retention of oils in aqueous mixtures using palygorskite treated with waterproof materials

    International Nuclear Information System (INIS)

    Matesanz, J.M.; Aisa, C.; Aragues, J.L.; Ovelleiro, J.L.

    1994-01-01

    An oil-selective absorbent has been developed from clay materials that is easy to manufacture and use, and provides good results in different working conditions, compared to conventional water treatment methods. The absorbent can be used in fixed beds in a column or spread directly onto an oil spill. The absorbent is a palygorskite (attapulgite) coated with a silicone. The silicone coating reduces the water absorption capacity of the palygorskite to near zero, but affects oil absorption capacity very little. The Westinghouse method was used to evaluate the absorption capacity of the silicone-coated palygorskite. The results indicate that the material could be a good choice for reducing the organic matter content of drinking water. 4 refs., 2 figs., 2 tabs

  9. Comparison between Exclusive and Selective Drug-Eluting Stent Strategies in Treating Patients with Multivessel Coronary Artery Disease.

    Science.gov (United States)

    Tung, Ying-Chang; Hsiao, Ping-Gune; Hsu, Lung-An; Kuo, Chi-Tai; Chang, Chi-Jen

    2014-05-01

    The expanded usage of drug-eluting stents (DES) in treating patients with multivessel coronary artery disease (CAD) may sometimes be limited in real-world practice due to cost concerns. We compared the clinical outcomes of exclusive and selective DES use in treating patients with multivessel CAD. From November 2004 to December 2011, 110 patients with multivessel CAD who received four or more stents were enrolled into this study, and divided into two groups according to the DES strategy employed: exclusive DES (n = 52), or selective DES (n = 58). In the selective DES group, DES was reserved for complex lesions only, such that the incidence and predictors of clinical events were assessed. At a mean follow-up of 41.4 ± 26.5 months, there were no significant differences between the two strategies in terms of baseline characteristics, all-cause mortality (exclusive vs. selective: 1.9% vs. 6.9%, p = 0.21), cardiac death (1.9% vs. 1.7%, p = 0.94) and nonfatal myocardial infarction (3.8% vs. 5.2%, p = 0.74). Despite the presence of more ostial lesions in the exclusive DES group, there was a trend such that major adverse cardiac events (MACE) and target lesion revascularization (TLR) rates were higher in the selective DES group (MACE: 17.3% vs. 31%, p = 0.16; TLR: 11.5% vs. 24.1%, p = 0.08). The higher MACE rate in the selective DES group was mainly driven by a higher target vessel revascularization (TVR) rate (15.4% vs. 29.3%, p = 0.08). In the exclusive DES group, SYNTAX score was an independent predictor of MACE [Haxard ratio (HR): 1.09, 95% confidence internal (CI): 1.02-1.16, p = 0.01] and TVR (HR 1.08, 95% CI 1.01-1.15, p = 0.04). Compared to the exclusive DES strategy, the selective DES strategy with reservation of DES for complex lesions is associated with numerically higher, but not statistically significant, rates of MACE and all-cause mortality in this small group of patients with multivessel CAD receiving four or more stents. Bare metal stent; Drug

  10. Material selection for a constructed wetroof receiving pre-treated high strength domestic wastewater.

    Science.gov (United States)

    Zapater-Pereyra, M; van Dien, F; van Bruggen, J J A; Lens, P N L

    2013-01-01

    A constructed wetroof (CWR) is defined in this study as the combination of a green roof and a constructed wetland: a shallow wastewater treatment system placed on the roof of a building. The foremost challenge of such CWRs, and the main aim of this investigation, is the selection of an appropriate matrix capable of assuring the required hydraulic retention time, the long-term stability and the roof load-bearing capacity. Six substrata were subjected to water dynamics and destructive tests in two testing-tables. Among all the materials tested, the substratum configuration composed of sand, light expanded clay aggregates, biodegradable polylactic acid beads together with stabilization plates and a turf mat is capable of retaining the water for approximately 3.8 days and of providing stability (stabilization plates) and an immediate protection (turf mat) to the system. Based on those results, a full-scale CWR was built, which did not show any physical deterioration after 1 year of operation. Preliminary wastewater treatment results on the full-scale CWR suggest that it can highly remove main wastewater pollutants (e.g. chemical oxygen demand, PO4(3-)-P and NH4(+)-N). The results of these tests and practical design considerations of the CWR are discussed in this paper.

  11. Disorders of working memory and selected cognitive processes inpatients treated for paranoid schizophrenia

    Directory of Open Access Journals (Sweden)

    Damian Giętkowski

    2012-03-01

    Full Text Available Already since the times of Baddeley and Hitch the dorsolateral part of the frontal lobe was regarded as the function‑ al centre of the working memory. Working memory disorders are, on the other hand, one of the basic and consoli‑ dated disorders in the course of paranoid schizophrenia. The concept of neurodevelopmental schizophrenia com‑ bines these elements and associates the illness with the changes occurring in the brain in the prenatal period. The efficiency of the working memory system, which acts as a buffer manipulating with the possessed and inflowing information, influences the quality of other cognitive processes, such as long‑term memory, short‑term memory, con‑ centration and thinking. A study was performed on two groups: one experimental consisting of 31 people suffering from paranoid schizophrenia and one control group of 31 healthy people. In both groups a replica of Wisconsin Card Sorting Task was used in order to measure the efficiency of the working memory and selected tests from WAIS‑R (PL: the Polish adaptation of Wechsler Adult Intelligence Scale to assess the functioning of concentration, memory and thinking. The results of the study showed that in the experimental group the efficiency of the working memory is very low and that the illness affects the performance of concentration, memory and thinking. Moreover the tests proved that the working memory disorder increases with time.

  12. Selective synthesis of double helices of carbon nanotube bundles grown on treated metallic substrates

    Energy Technology Data Exchange (ETDEWEB)

    Cervantes-Sodi, Felipe; Iniguez-Rabago, Agustin; Rosas-Melendez, Samuel; Ballesteros-Villarreal, Monica [Departamento de Fisica y Matematicas, Universidad Iberoamericana, Prolongacion Paseo de la Reforma 880, Lomas de Santa Fe (Mexico); Vilatela, Juan J. [IMDEA Materials Institute, E.T.S. de Ingenieros de Caminos, Madrid (Spain); Reyes-Gutierrez, Lucio G.; Jimenez-Rodriguez, Jose A. [Ingenieria Industrial, Grupo JUMEX, Ecatepec de Morelos, Estado de Mexico (Mexico); Palacios, Eduardo [Lab. de Microscopia Electronica de Ultra Alta Resolucion, Instituto Mexicano del Petroleo, San Bartolo Atepehuacan (Mexico); Terrones, Mauricio [Department of Physics, Department of Materials Science and Engineering and Materials Research Institute, Pennsylvania State University, University Park, PA (United States); Research Center for Exotic Nanocarbons (JST), Shinshu University, Nagano (Japan)

    2012-12-15

    Double-helix microstructures consisting of two parallel strands of hundreds of multi-walled carbon nanotubes (MWCNTs) have been synthesized by chemical vapour deposition of ferrocene/toluene vapours on metal substrates. Growth of coiled carbon nanostructures with site selectivity is achieved by varying the duration of thermochemical pretreatment to deposit a layer of SiO{sub x} on the metallic substrate. Production of multibranched structures of MWCNTs converging in SiO{sub x} microstructure is also reported. In the abstract figure, panel (a) shows a coloured micrograph of a typical double-helix coiled microstructure of MWCNTs grown on SiO{sub x} covered steel substrate. Green and blue show each of the two individual strands of MWCNTs. Panel (b) is an amplification of a SiO{sub x} microparticle (white) on the tip of the double-stranded coil (green and blue). The microparticle guides the collective growth of hundreds of MWCNTs to form the coiled structure. (Copyright copyright 2012 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  13. Evaluation of Selected Atherosclerosis Risk Factors in Women with Subclinical Hypothyroidism Treated with L-Thyroxine.

    Science.gov (United States)

    Adamarczuk-Janczyszyn, Maria; Zdrojowy-Wełna, Aleksandra; Rogala, Natalia; Zatońska, Katarzyna; Bednarek-Tupikowska, Grażyna

    2016-01-01

    Subclinical hypothyroidism (SCH) is a common endocrine disorder, probably increasing cardiovascular (CV) risk. However, the relation between SCH and atherosclerosis risk factors remains unclear. The aim of the study was to evaluate selected atherosclerosis risk factors in women with SCH in comparison to a group of healthy women and women with overt hypothyroidism, as well as to investigate the influence of L-thyroxine replacement on those risk factors. The study group consisted of 187 obese women aged between 50 and 70 years: 100 women with SCH, 45 women with overt hypothyroidism and 42 women with TSH level in reference ranges. Anthropometric parameters were evaluated. Laboratory tests included thyroid hormones concentrations, lipid profile with apolipoproteins, CRP, homocysteine. Atherosclerotic indexes were calculated: LDL C/HDL C ratio, apoA1/apoB ratio and Castelli risk index. Women with hypothyroidism were given L-thyroxine treatment and after 6 months in euthyroidism the evaluation was repeated. Total cholesterol, LDL-cholesterol and triglycerides concentrations as well as LDL-C/HDL-C ratio and Castelli index were higher in SCH than in controls and decreased after L-thyroxin substitution. All of the calculated atherosclerosis indexes showed significant positive correlations with TSH concentration in SCH group. Also in this group the systolic and diastolic blood pressure decreased significantly after treatment. Dyslipidemia in obese SCH women is not severe, but if untreated for many years, it may lead to atherosclerosis. Substitution therapy improves the lipid profile, changing the relations between protective and proatherogenic fractions of serum lipids, and optimises blood pressure.

  14. Clinical characteristics of patient selection and imaging predictors of outcome in solid tumors treated with checkpoint-inhibitors

    International Nuclear Information System (INIS)

    Rossi, Sabrina; Toschi, Luca; Castello, Angelo; Grizzi, Fabio; Mansi, Luigi; Lopci, Egesta

    2017-01-01

    The rapidly evolving knowledge on tumor immunology and the continuous implementation of immunotherapy in cancer have recently led to the FDA and EMA approval of several checkpoint inhibitors as immunotherapic agents in clinical practice. Anti-CTLA-4, anti-PD-1, and anti-PDL-1 antibodies are becoming standard of care in advanced melanoma, as well as in relapsed or metastatic lung and kidney cancer, demonstrating higher and longer response compared to standard chemotherapy. These encouraging results have fostered the evaluation of these antibodies either alone or in combination with other therapies in several dozen clinical trials for the treatment of multiple tumor types. However, not all patients respond to immune checkpoint inhibitors, hence, specific biomarkers are necessary to guide and monitor therapy. The utility of PD-L1 expression as a biomarker has varied in different clinical trials, but, to date, no consensus has been reached on whether PD-L1 expression is an ideal marker for response and patient selection; approximately 20-25% of patients will respond to immunotherapy with checkpoint inhibitors despite a negative PD-L1 staining. On the other hand, major issues concern the evaluation of objective response in patients treated with immunotherapy. Pure morphological criteria as commonly used in solid tumors (i.e. RECIST) are not sufficient because change in size is not an early and reliable marker of tumor response to biological therapies. Thus, the scientific community has required a continuous adaptation of immune-related response criteria (irRC) to overcome the problem. In this context, metabolic information and antibody-based imaging with positron emission tomography (PET) have been investigated, providing a powerful approach for an optimal stratification of patients at staging and during the evaluation of the response to therapy. In the present review we provide an overview on the clinical characteristics of patient selection when using imaging

  15. Clinical characteristics of patient selection and imaging predictors of outcome in solid tumors treated with checkpoint-inhibitors

    Energy Technology Data Exchange (ETDEWEB)

    Rossi, Sabrina; Toschi, Luca [Humanitas Clinical and Research Hospital, Medical Oncology, Rozzano (Italy); Castello, Angelo [Humanitas Clinical and Research Hospital, Nuclear Medicine, Rozzano (Italy); Grizzi, Fabio [Humanitas Clinical and Research Hospital, Immunology and Inflammation, Rozzano (Italy); Mansi, Luigi [Seconda Universita di Napoli, Nuclear Medicine, Naples (Italy); Lopci, Egesta [Humanitas Clinical and Research Hospital, Nuclear Medicine, Rozzano (Italy); Humanitas Cancer Center, Humanitas Clinical and Research Hospital, Nuclear Medicine, Rozzano, MI (Italy)

    2017-12-15

    The rapidly evolving knowledge on tumor immunology and the continuous implementation of immunotherapy in cancer have recently led to the FDA and EMA approval of several checkpoint inhibitors as immunotherapic agents in clinical practice. Anti-CTLA-4, anti-PD-1, and anti-PDL-1 antibodies are becoming standard of care in advanced melanoma, as well as in relapsed or metastatic lung and kidney cancer, demonstrating higher and longer response compared to standard chemotherapy. These encouraging results have fostered the evaluation of these antibodies either alone or in combination with other therapies in several dozen clinical trials for the treatment of multiple tumor types. However, not all patients respond to immune checkpoint inhibitors, hence, specific biomarkers are necessary to guide and monitor therapy. The utility of PD-L1 expression as a biomarker has varied in different clinical trials, but, to date, no consensus has been reached on whether PD-L1 expression is an ideal marker for response and patient selection; approximately 20-25% of patients will respond to immunotherapy with checkpoint inhibitors despite a negative PD-L1 staining. On the other hand, major issues concern the evaluation of objective response in patients treated with immunotherapy. Pure morphological criteria as commonly used in solid tumors (i.e. RECIST) are not sufficient because change in size is not an early and reliable marker of tumor response to biological therapies. Thus, the scientific community has required a continuous adaptation of immune-related response criteria (irRC) to overcome the problem. In this context, metabolic information and antibody-based imaging with positron emission tomography (PET) have been investigated, providing a powerful approach for an optimal stratification of patients at staging and during the evaluation of the response to therapy. In the present review we provide an overview on the clinical characteristics of patient selection when using imaging

  16. Functioning in patients with major depression treated with duloxetine or a selective serotonin reuptake inhibitor in East Asia

    Directory of Open Access Journals (Sweden)

    Novick D

    2016-02-01

    Full Text Available Diego Novick,1 William Montgomery,2 Josep Maria Haro,3 Maria Victoria Moneta,3 Gang Zhu,4 Li Yue,5 Jihyung Hong,6 Héctor Dueñas,7 Roberto Brugnoli8 1Eli Lilly and Company, Windlesham, Surrey, UK; 2Eli Lilly Australia Pty Ltd, West Ryde, NSW, Australia; 3Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain; 4Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, 5Lilly Suzhou Pharmaceutical Company, Ltd, Shanghai, People’s Republic of China; 6Department of Healthcare Management, Gachon University, Seongnam, South Korea; 7Eli Lilly de Mexico, Mexico City, Mexico; 8School of Medicine, Sapienza University of Rome, Rome, ItalyPurpose: To assess and compare the levels of functioning in patients with major depressive disorder treated with either duloxetine with a daily dose of ≤60 mg or a selective serotonin reuptake inhibitor (SSRI as monotherapy for up to 6 months in a naturalistic setting in East Asia. In addition, this study examined the impact of painful physical symptoms (PPS on the effects of these treatments.Patients and methods: Data for this post hoc analysis were taken from a 6-month prospective observational study involving 1,549 patients with major depressive disorder without sexual dysfunction. The present analysis focused on a subgroup of patients from East Asia (n=587. Functioning was measured using the Sheehan Disability Scale (SDS. Depression severity was assessed using the 16-item Quick Inventory of Depressive Symptomatology-Self Report. PPS were rated using the modified Somatic Symptom Inventory. A mixed model with repeated measures was fitted to compare the levels of functioning between duloxetine-treated (n=227 and SSRI-treated (n=225 patients, adjusting for baseline patient characteristics.Results: The mean SDS total score was similar between the two treatment cohorts (15.46 [standard deviation =6.11] in the duloxetine

  17. Effectiveness of 308-nm Excimer Laser Therapy in Treating Alopecia Areata, Determined by Examining the Treated Sides of Selected Alopecic Patches.

    Science.gov (United States)

    Byun, Ji Won; Moon, Jong Hyuk; Bang, Chan Yl; Shin, Jeonghyun; Choi, Gwang Seong

    2015-01-01

    Some studies have reported the use of 308-nm excimer laser therapy for treating alopecia areata (AA); however, the effectiveness of this therapy on a theoretical basis has not yet been comparatively analyzed. To determine the therapeutic effect of excimer laser therapy on AA. One alopecic patch was divided into control and treated sides in 10 patients with AA. Then, 308-nm excimer laser therapy was administered twice a week for 12 weeks. Photograph and phototrichogram analyses were performed. Photographic assessments by both dermatologists and individuals of the general population showed objective improvements after excimer laser therapy. On the treated side, the hair count and hair diameter had statistically increased after treatment. However, only the hair diameter was found to be significantly high in the treated half when it was compared with the control side. The 308-nm excimer laser has a therapeutic effect on AA, which is proven by photograph and phototrichogram analysis by a side-by-side comparison. © 2015 S. Karger AG, Basel.

  18. Renal artery denervation for treating resistant hypertension : definition of the disease, patient selection and description of the procedure.

    Science.gov (United States)

    Volpe, Massimo; Rosei, Enrico Agabiti; Ambrosioni, Ettore; Cottone, Santina; Cuspidi, Cesare; Borghi, Claudio; De Luca, Nicola; Fallo, Francesco; Ferri, Claudio; Mancia, Giuseppe; Morganti, Alberto; Muiesan, Maria Lorenza; Sarzani, Riccardo; Sechi, Leonardo; Tocci, Giuliano; Virdis, Agostino

    2012-12-01

    Arterial hypertension is responsible for a significant burden of cardiovascular morbidity and mortality, worldwide. Although several rational and integrated pharmacological strategies are available, the control of high blood pressure still remains largely unsatisfactory. Failure to achieve effective blood pressure control in treated hypertensive patients may have a substantial impact on individual global cardiovascular risk, since it significantly increases the risk of developing hypertension-related macrovascular and microvascular complications. Arterial hypertension is arbitrarily defined as 'resistant' or 'refractory' when the recommended blood pressure goals (clinic blood pressure below 140/90 mmHg or below 130/80 mmHg in patients with type 2 diabetes mellitus or nephropathy) are not achieved in the presence of a therapeutic strategy that includes lifestyle changes and at least three classes of antihypertensive drugs, including a diuretic, at adequate doses. Recently, an innovative non-pharmacological option has become available for treating resistant hypertension. Sympathetic denervation of renal arteries is a minimally invasive procedure that is performed via percutaneous access from the femoral artery. It consists of radiofrequency ablation of the afferent and efferent nerves of the renal sympathetic nervous system, with consequent isolation of renal parenchymal and juxtaglomerular structures from abnormal stimulation of the efferent adrenergic system. The present position paper of the Italian Society of Hypertension (SIIA) offers a diagnostic and therapeutic approach for the proper identification and effective clinical management of patients with resistant hypertension, who are candidates for renal artery denervation. These indications may have important implications not only from a clinical point of view, but also from an economic point of view, since a proper identification of patients with true resistant hypertension and an accurate selection of patients

  19. Thiourea-treated graphene aerogel as a highly selective gas sensor for sensing of trace level of ammonia

    Energy Technology Data Exchange (ETDEWEB)

    Alizadeh, Taher, E-mail: talizadeh@ut.ac.ir [Department of Analytical Chemistry, Faculty of Chemistry, University College of Science, University of Tehran, P.O. Box 14155-6455, Tehran (Iran, Islamic Republic of); Ahmadian, Farzaneh [Department of Applied Chemistry, Faculty of Science, University of Mohaghegh Ardabili, Daneshgah Street, P.B179, 56199-11367 Ardabil (Iran, Islamic Republic of)

    2015-10-15

    As a result of this study, a new and simple method was proposed for the fabrication of an ultra sensitive, robust and reversible ammonia gas sensor. The sensing mechanism was based upon the change in electrical resistance of a graphene aerogel as a result of sensor exposing to ammonia. Three-dimensional graphene hydrogel was first synthesized via hydrothermal method in the absence or presence of various amounts of thiourea. The obtained material was heated to obtain aerogel and then it was used as ammonia gas sensor. The materials obtained were characterized using different techniques such as Fourier transform infrared spectroscopy (FT-IR), thermal gravimetric analysis (TGA), X-ray diffraction (XRD) and scanning electron microscopy (SEM). The thiourea-treated graphene aerogel was more porous (389 m{sup 2} g{sup −1}) and thermally unstable and exhibited higher sensitivity, shorter response time and better selectivity toward ammonia gas, compared to the aerogel produced in the absence of thiourea. Thiourea amount, involved in the hydrogel synthesis step, was found to be highly effective factor in the sensing properties of finally obtained aerogel. The sensor response time to ammonia was short (100 s) and completely reversible (recovery time of about 500 s) in ambient temperature. The sensor response to ammonia was linear between 0.02 and 85 ppm and its detection limit was found to be 10 ppb (3S/N). - Highlights: • An ammonia gas sensor with ppb level determination capability was proposed. • A new procedure has been introduced for gas sensor fabrication by graphene hydrogel. • Thiourea-treated graphene aerogel was used as excellent ammonia gas sensor.

  20. Risk factors for development of postoperative cerebellar mutism syndrome in children after medulloblastoma surgery.

    Science.gov (United States)

    Pols, San Y C V; van Veelen, Marie Lise C; Aarsen, Femke K; Gonzalez Candel, Antonia; Catsman-Berrevoets, Coriene E

    2017-07-01

    OBJECTIVE Postoperative cerebellar mutism syndrome (pCMS) occurs in 7%-50% of children after cerebellar tumor surgery. Typical features include a latent onset of 1-2 days after surgery, transient mutism, emotional lability, and a wide variety of motor and neurobehavioral abnormalities. Sequelae of this syndrome usually persist long term. The principal causal factor is bilateral surgical damage (regardless of tumor location) to any component of the proximal efferent cerebellar pathway, which leads to temporary dysfunction of cerebral cortical regions as a result of diaschisis. Tumor type, cerebellar midline location, and brainstem involvement are risk factors for pCMS that have been identified repeatedly, but they do not explain its latent onset. Ambiguous or negative results for other factors, such as hydrocephalus, postoperative meningitis, length of vermian incision, and tumor size, have been reached. The aim of this study was to identify perioperative clinical, radiological, and laboratory factors that also increase risk for the development of pCMS. The focus was on factors that might explain the delayed onset of pCMS and thus might provide a time window for taking precautionary measures to prevent pCMS or reduce its severity. The study was focused specifically on children who had undergone surgery for medulloblastoma. METHODS In this single-center retrospective cohort study, the authors included 71 children with medulloblastoma, 28 of whom developed pCMS after primary resection. Clinical and laboratory data were collected prospectively and analyzed systematically. Variables were included for univariate and multivariate analysis. RESULTS Univariate regression analysis revealed 7 variables that had a significant influence on pCMS onset, namely, tumor size, maximum tumor diameter > 5 cm, tumor infiltration or compression of the brainstem, significantly larger decreases in hemoglobin (p = 0.010) and hematocrit (p = 0.003) in the pCMS group after surgery than in the

  1. Mutismo cerebelar transitório: relato de dois casos Transitory cerebellar mutism: report of two cases

    Directory of Open Access Journals (Sweden)

    JOSÉ ALBERTO GONÇALVES DA SILVA

    1999-12-01

    Full Text Available Relatamos dois casos de mutismo observados após ressecção de tumores do cerebelo em duas crianças do sexo feminino, tratando-se, no primeiro caso de meduloblastoma, e no segundo, de astrocitoma juvenil. Em ambas havia lesão pré-operatória de nervos bulbares. A fisiopatogenia do mutismo envolve fatores anatômicos, vasculares e emocionais. As características essenciais do mutismo cerebelar são discutidas com base em revisão da literatura.We present two cases of mutism observed after resection of tumors of the cerebellum, in two children of the feminine sex, being in the first case of medulloblastoma and in the second of juvenile astrocytoma. In both patients there was pre-operative lesion of low cranial nerves. The pathophysiology of the mutism involves anatomical, vascular and emotional factors, being its essential characteristics discussed with base in revision of the literature.

  2. Die terapeutiese gebruik van die scenotoets met verwysing na ...

    African Journals Online (AJOL)

    There is a paucity of applied research and available literature about selective mutism. The main aim of this study is to illustrate that the 'Scenotest', developed by Gerhild von Staabs (1991: 1), can be used as a therapeutic technique in treating children with selective mutism. A further aim is to supplement existing literature ...

  3. Event-related potential correlates of selective processing in early- and continuously-treated children with phenylketonuria : Effects of concurrent phenylalanine level and dietary control

    NARCIS (Netherlands)

    de Sonneville, Leo M. J.; Huijbregts, Stephan C. J.; van Spronsen, Francjan J.; Verkerk, Paul H.; Sergeant, Joseph A.; Licht, Robert

    2010-01-01

    This Study focused on important characteristics of attentional (selective) processing in children with early-treated phenylketonuria (PKU). Seven to 14-year-old children with PKU were allocated to high phenylalanine (Phe) and low Phe groups and compared with control children on amplitudes and

  4. Event-related potential correlates of selective processing in early- and continuously-treated children with phenylketonuria: Effects of concurrent phenylalanine level and dietary control

    NARCIS (Netherlands)

    Sonneville, L.M.J. de; Huijbregts, S.C.J.; Spronsen, F.J. van; Verkerk, P.H.; Sergeant, J.A.; Licht, R.

    2009-01-01

    This study focused on important characteristics of attentional (selective) processing in children with early-treated phenylketonuria (PKU). Seven to 14-year-old children with PKU were allocated to high phenylalanine (Phe) and low Phe groups and compared with control children on amplitudes and

  5. Exercise tolerance and selected motor skills in young females with idiopathic scoliosis treated with different physiotherapeutic methods.

    Science.gov (United States)

    Fabian, Krzysztof Marek; Rożek-Piechura, Krystyna

    2014-01-01

    Scoliosis is a disorder that leads to dysfunction of a number of systems in the body, especially in young females. Physical capacity is one of the most important elements of good health as well as ofbiological development. Adolescence is a time when physical capacity develops intensively, and the condition of the respiratory system is one of many factors that have an impact on the level of physical capacity. This paper aims to evaluate a short-term application of two methods of physiotherapy and their influence on the level of exercise tolerance in young females suffering from idiopathic scoliosis. The study involved a group of 49 young females aged 14-15 years diagnosed with (2040°) thoracic and lumbar scoliosis who were in-patients at the rehabilitation ward of the Regional Paediatric Rehabilitation Hospital in Jastrzębie Zdrój. The group was divided into two subgroups depending on the method of rehabilitation employed: the first subgroup received asymmetric breathing exercise therapy by Dobosiewicz and the second subgroup practised symmetric remedial exercises. Cobb's angle, the degree of skeletal maturity, i.e. the Risser sign and the degree trunk rotation of the apex of the curvature by means of Raimondi's coefficient were determined once in an x-ray image. Basic somatic features, maximal voluntary ventilation (MVV parameter), selected motor skills and exercise tolerance were assessed on two occasions (before beginning and after completion of the rehabilitation treatment). 1. Young females suffering from (20-40°) thoracic and lumbar scoliosis demonstrate respiratory dysfunction, as shown by decreased maximal voluntary ventilation (MVV) in the two subgroups in the present study. Exercises according to Dobosiewicz's method brought about a significantly higher degree of improvement in this parameter. 2. The physiotherapeutic regimen administered to the young girls with scoliosis significantly improved their strength motor skills and exercise tolerance. A

  6. Mutism and auditory agnosia due to bilateral insular damage--role of the insula in human communication.

    Science.gov (United States)

    Habib, M; Daquin, G; Milandre, L; Royere, M L; Rey, M; Lanteri, A; Salamon, G; Khalil, R

    1995-03-01

    We report a case of transient mutism and persistent auditory agnosia due to two successive ischemic infarcts mainly involving the insular cortex on both hemispheres. During the 'mutic' period, which lasted about 1 month, the patient did not respond to any auditory stimuli and made no effort to communicate. On follow-up examinations, language competences had re-appeared almost intact, but a massive auditory agnosia for non-verbal sounds was observed. From close inspection of lesion site, as determined with brain resonance imaging, and from a study of auditory evoked potentials, it is concluded that bilateral insular damage was crucial to both expressive and receptive components of the syndrome. The role of the insula in verbal and non-verbal communication is discussed in the light of anatomical descriptions of the pattern of connectivity of the insular cortex.

  7. Outcomes in 24 selected patients with stage IVB cervical cancer and excellent performance status treated with radiotherapy and chemotherapy

    International Nuclear Information System (INIS)

    Zighelboim, Israel; Taylor, Nicholas P.; Powell, Matthew A.; Gibb, Randall K.; Rader, Janet S.; Mutch, David G.; Grigsby, Perry W.

    2006-01-01

    We sought to review outcomes in patients with stage IVB carcinoma of the cervix treated with irradiation in combination with chemotherapy. We report outcomes of 24 consecutive patients with good performance status treated from 1998 to 2005. Most of these patients underwent concurrent irradiation with platinum-based chemotherapy. Some patients received subsequent systemic chemotherapy. All patients underwent external beam radiotherapy; 7 patients (29%) had additional high-dose-rate and 12 (50%) low-dose-rate brachytherapy. Two patients (8%) received an intensity modulated radiation therapy (IMRT) boost instead of brachytherapy. The mean dose to point A was variable (73.9±19.2 Gy). Twenty patients (83%) received radio-sensitizing platinum-based chemotherapy, and the remaining had radiotherapy alone. Seven patients (29%) had further combination chemotherapy. Therapy was well tolerated. The overall survival was 44% at 36 months and 22% at 5 years. Patients with stage IVB cervical cancer have mostly been treated with palliative intent. With the advent of concurrent chemoradiation, we have treated many of these cases with aggressive combination therapy. In this series, the use of radiotherapy and multiagent chemotherapy in patients with stage IVB cervical carcinoma and good performance status was well tolerated and resulted in higher survival rates than previously reported. (author)

  8. An early examination of access to select orphan drugs treating rare diseases in health insurance exchange plans.

    Science.gov (United States)

    Robinson, Sandy W; Brantley, Kelly; Liow, Christine; Teagarden, J Russell

    2014-10-01

    Patients with rare diseases often face significant health care access challenges, particularly since the number of available treatment options for rare diseases is limited. The implementation of health insurance exchanges promises improved access to health care. However, when purchasing a plan, patients with rare diseases need to consider multiple factors, such as insurance premium, access to providers, coverage of a specific medication or treatment, tier placement of drug, and out-of-pocket costs.  To provide an early snapshot of the exchange plan landscape from the perspective of patients with select rare diseases by evaluating the degree of access to medications in a subset of exchange plans based on coverage, tier placement, associated cost sharing, and utilization management (UM) applied.  The selection of drugs for this analysis began by identifying rare diseases with FDA-approved treatment options using the National Institutes of Health Office of Rare Diseases' webpage and further identification of a subset of drugs based on select criteria to ensure a varied sample, including the characteristics and prevalence of the condition. The medications were categorized based on whether alternative therapies have FDA approval for the same indication and whether there are comparators based on class or therapeutic area. The list was narrowed to 11 medications across 7 diseases, and the analysis was based on how these drugs are listed in exchange plan outpatient pharmacy benefit formularies. This analysis focused on 84 plans in 15 states with the highest expected exchange enrollment and included a variety of plan types to ensure that variability in the marketplace was represented. To best approximate plans that will have the greatest enrollment, the analysis focused on silver and bronze plan formularies because consumers in this market are expected to be sensitive to premiums. Data on drug coverage, tier placement, cost, and UM were collected from these plans

  9. Clinic Predictive Factors for Insufficient Myocardial Reperfusion in ST-Segment Elevation Myocardial Infarction Patients Treated with Selective Aspiration Thrombectomy during Primary Percutaneous Coronary Intervention

    Directory of Open Access Journals (Sweden)

    Jinfan Tian

    2016-01-01

    Full Text Available Background. Insufficient data are available on the potential benefit of selective aspiration and clinical predictors for no-reflow in STEMI patients undergoing primary percutaneous coronary intervention (PPCI adjunct with aspiration thrombectomy. Objective. The aim of our study was to investigate clinical predictors for insufficient reperfusion in patients with high thrombus burden treated with PPCI and manual aspiration thrombectomy. Methods. From January 2011 till December 2015, 277 STEMI patients undergoing manual aspiration thrombectomy and PPCI were selected and 202 patients with a Thrombolysis in Myocardial Infarction (TIMI thrombus grade 4~5 were eventually involved in our study. According to a cTFC value, patients were divided into Group I (cTFC > 40, namely, insufficient reperfusion group; Group II (cTFC ≤ 40, namely, sufficient reperfusion group. Results. Univariate analysis showed that hypertension, multivessel disease, time from symptom to PCI (≧4.8 hours, and postaspiration cTFC > 40 were negative predictors for insufficient reperfusion. After multivariate adjustment, age ≧ 60 years, hypertension, time from symptom to PCI (≧4.8 hours, and postaspiration cTFC > 40 were independently associated with insufficient reperfusion in STEMI patients treated with manual aspiration thrombectomy. Upfront intracoronary GP IIb/IIIa inhibitor (Tirofiban was positively associated with improved myocardial reperfusion. Conclusion. Fully identifying risk factors will help to improve the effectiveness of selective thrombus aspiration.

  10. The search for new antimalarial drugs from plants used to treat fever and malaria or plants ramdomly selected: a review

    Directory of Open Access Journals (Sweden)

    Krettli Antoniana U

    2001-01-01

    Full Text Available In this review we discuss the ongoing situation of human malaria in the Brazilian Amazon, where it is endemic causing over 610,000 new acute cases yearly, a number which is on the increase. This is partly a result of drug resistant parasites and new antimalarial drugs are urgently needed. The approaches we have used in the search of new drugs during decades are now reviewed and include ethnopharmocology, plants randomly selected, extracts or isolated substances from plants shown to be active against the blood stage parasites in our previous studies. Emphasis is given on the medicinal plant Bidens pilosa, proven to be active against the parasite blood stages in tests using freshly prepared plant extracts. The anti-sporozoite activity of one plant used in the Brazilian endemic area to prevent malaria is also described, the so called "Indian beer" (Ampelozizyphus amazonicus, Rhamnaceae. Freshly prepared extracts from the roots of this plant were totally inactive against blood stage parasites, but active against sporozoites of Plasmodium gallinaceum or the primary exoerythrocytic stages reducing tissue parasitism in inoculated chickens. This result will be of practical importance if confirmed in mammalian malaria. Problems and perspectives in the search for antimalarial drugs are discussed as well as the toxicological and clinical trials to validate some of the active plants for public health use in Brazil.

  11. Patterning Method for Silver Nanoparticle Electrodes in Fully Solution-Processed Organic Thin-Film Transistors Using Selectively Treated Hydrophilic and Hydrophobic Surfaces

    Science.gov (United States)

    Fukuda, Kenjiro; Takeda, Yasunori; Kobayashi, Yu; Shimizu, Masahiro; Sekine, Tomohito; Kumaki, Daisuke; Kurihara, Masato; Sakamoto, Masatomi; Tokito, Shizuo

    2013-05-01

    Fully solution-processed organic thin-film transistor (OTFT) devices have been fabricated with simple patterning process at a relatively low process temperature of 100 °C. In the patterning process, a hydrophobic amorphous fluoropolymer material, which was used as the gate dielectric layer and the underlying base layer, was treated with an oxygen plasma to selectively change its surface wetting properties from hydrophobic to hydrophilic. Silver source and drain electrodes were successfully formed in the treated areas with highly uniform line widths and without residues between the electrodes. Nonuniformities in the thickness of the silver electrodes originating from the “coffee-ring” effect were suppressed by optimizing the blend of solvents used with the silver nanoparticles, such that the printed electrodes are appropriate for bottom-gate OTFT devices. A fully solution-processed OTFT device using a polymer semiconductor material (PB16TTT) exhibited good electrical performance with no hysteresis in its transfer characteristics and with good linearity in its output characteristics. A relatively high carrier mobility of 0.14 cm2 V-1 s-1 and an on/off ratio of 1×105 were obtained with the fabricated TFT device.

  12. Selective splenic targeting of In-114m by heat-treated red blood cells for the treatment of lymphoid cell malignancy

    International Nuclear Information System (INIS)

    Sharma, H.L.; Jackson, N.C.; Jackson, H.; Smith, A.M.; Shukla, S.K.

    1998-01-01

    Spleen targeted In-114m, using labelled autologous lymphocytes, has produced a significant antitumour effect in patients with chronic lymphocytic leukaemia and Non-Hodgkins lymphoma (Sharma et al, Anti-Cancer Research 17, 1815-1822,1997). Heat treated red blood cells could be used as alternative vectors for splenic targeting of In-114m, making the technique easier, more universally applicable and furthermore, may reduce the myelosuppression seen with labelled lymphocytes. Red blood cells from HO3T rats were labelled with In-114m-oxine, incubated at 49.5 deg. C for 15 minutes and their distribution investigated in the spleen, liver and blood or recipient animals. The splenic uptake in the spleen at 24h was 64.08%, remained unchanged at 7 days, cleared slowly after that, clearly demonstrating the specificity of HTRBC to target In-114m to the spleen. The depletion of peripheral blood lymphocytes was measured in two groups of HO3T rats following the administration of 1.6 and 3.2 MBq of In-114m-HTRBC respectively. Compared to the controls, ∼ 70% of lymphocytes were depleted in the treated animals within one week and remained unchanged for 6 weeks. Using a rat T-cell lymphocytic leukaemia model, with resemblance to the clinical disease, an anti-leukaemic effect of his method of treatment, was monitored. An average life span of the treated group (1.85 MBq of In-114m-HTRBC) was 17.1 days, compared to the 13.5 days for the untreated group. These results are similar to the ones reported by targeting In-114m with labelled lymphocytes. In summary, the project has shown that In-114m-HTRBC can be used to deposit the radioactivity, selectively in the spleen, which in turn, depletes the peripheral blood lymphocytes and produces an anti-leukaemic effect in terms of enhanced life span. The bone marrow toxicity from In-114m therapy is under investigation and a pharmacokinetic study in selected cancer patients is planned following which, a clinical trial will be considered. (author)

  13. Cerebellar mutism syndrome in children with brain tumours of the posterior fossa

    DEFF Research Database (Denmark)

    Wibroe, Morten; Cappelen, Johan; Castor, Charlotte

    2017-01-01

    and four Dutch centres will join with a total annual accrual of 130 patients. Three other major European centres are invited to join from 2016/17. Follow-up will run for 12 months after inclusion of the last patient. All patients are treated according to local practice. Clinical data are collected through...

  14. The streptomycin-treated mouse intestine selects Escherichia coli envZ missense mutants that interact with dense and diverse intestinal microbiota.

    Science.gov (United States)

    Leatham-Jensen, Mary P; Frimodt-Møller, Jakob; Adediran, Jimmy; Mokszycki, Matthew E; Banner, Megan E; Caughron, Joyce E; Krogfelt, Karen A; Conway, Tyrrell; Cohen, Paul S

    2012-05-01

    Previously, we reported that the streptomycin-treated mouse intestine selected nonmotile Escherichia coli MG1655 flhDC deletion mutants of E. coli MG1655 with improved colonizing ability that grow 15% faster in vitro in mouse cecal mucus and 15 to 30% faster on sugars present in mucus (M. P. Leatham et al., Infect. Immun. 73:8039-8049, 2005). Here, we report that the 10 to 20% remaining motile E. coli MG1655 are envZ missense mutants that are also better colonizers of the mouse intestine than E. coli MG1655. One of the flhDC mutants, E. coli MG1655 ΔflhD, and one of the envZ missense mutants, E. coli MG1655 mot-1, were studied further. E. coli MG1655 mot-1 is more resistant to bile salts and colicin V than E. coli MG1655 ΔflhD and grows ca. 15% slower in vitro in mouse cecal mucus and on several sugars present in mucus compared to E. coli MG1655 ΔflhD but grows 30% faster on galactose. Moreover, E. coli MG1655 mot-1 and E. coli MG1655 ΔflhD appear to colonize equally well in one intestinal niche, but E. coli MG1655 mot-1 appears to use galactose to colonize a second, smaller intestinal niche either not colonized or colonized poorly by E. coli MG1655 ΔflhD. Evidence is also presented that E. coli MG1655 is a minority member of mixed bacterial biofilms in the mucus layer of the streptomycin-treated mouse intestine. We offer a hypothesis, which we call the "Restaurant" hypothesis, that explains how nutrient acquisition in different biofilms comprised of different anaerobes can account for our results.

  15. Distinguishing HIV-1 drug resistance, accessory, and viral fitness mutations using conditional selection pressure analysis of treated versus untreated patient samples

    Directory of Open Access Journals (Sweden)

    Lee Christopher

    2006-05-01

    Full Text Available Abstract Background HIV can evolve drug resistance rapidly in response to new drug treatments, often through a combination of multiple mutations 123. It would be useful to develop automated analyses of HIV sequence polymorphism that are able to predict drug resistance mutations, and to distinguish different types of functional roles among such mutations, for example, those that directly cause drug resistance, versus those that play an accessory role. Detecting functional interactions between mutations is essential for this classification. We have adapted a well-known measure of evolutionary selection pressure (Ka/Ks and developed a conditional Ka/Ks approach to detect important interactions. Results We have applied this analysis to four independent HIV protease sequencing datasets: 50,000 clinical samples sequenced by Specialty Laboratories, Inc.; 1800 samples from patients treated with protease inhibitors; 2600 samples from untreated patients; 400 samples from untreated African patients. We have identified 428 mutation interactions in Specialty dataset with statistical significance and we were able to distinguish primary vs. accessory mutations for many well-studied examples. Amino acid interactions identified by conditional Ka/Ks matched 80 of 92 pair wise interactions found by a completely independent study of HIV protease (p-value for this match is significant: 10-70. Furthermore, Ka/Ks selection pressure results were highly reproducible among these independent datasets, both qualitatively and quantitatively, suggesting that they are detecting real drug-resistance and viral fitness mutations in the wild HIV-1 population. Conclusion Conditional Ka/Ks analysis can detect mutation interactions and distinguish primary vs. accessory mutations in HIV-1. Ka/Ks analysis of treated vs. untreated patient data can distinguish drug-resistance vs. viral fitness mutations. Verification of these results would require longitudinal studies. The result

  16. Crystal structure and nanotopographical features on the surface of heat-treated and anodized porous titanium biomaterials produced using selective laser melting

    Energy Technology Data Exchange (ETDEWEB)

    Amin Yavari, S., E-mail: s.aminyavari@tudelft.nl [Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, 2628 CD Delft (Netherlands); FT Innovations BV, Braamsluiper 1, 5831 PW Boxmeer (Netherlands); Wauthle, R. [KU Leuven, Department of Mechanical Engineering, Section Production Engineering, Machine Design and Automation (PMA), Celestijnenlaan 300B, 3001 Leuven (Belgium); LayerWise NV, Kapeldreef 60, Leuven (Belgium); Böttger, A.J. [Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, 2628 CD Delft (Netherlands); Schrooten, J. [Department of Metallurgy and Materials Engineering, KU Leuven, Kasteelpark Arenberg 44 PB 2450, 3001 Heverlee (Belgium); Weinans, H. [Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, 2628 CD Delft (Netherlands); Department of Orthopedics and Department of Rheumatology, UMC Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands); Zadpoor, A.A. [Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, 2628 CD Delft (Netherlands)

    2014-01-30

    Porous titanium biomaterials manufactured using additive manufacturing techniques such as selective laser melting are considered promising materials for orthopedic applications where the biomaterial needs to mimic the properties of bone. Despite their appropriate mechanical properties and the ample pore space they provide for bone ingrowth and osseointegration, porous titanium structures have an intrinsically bioinert surface and need to be subjected to surface bio-functionalizing procedures to enhance their in vivo performance. In this study, we used a specific anodizing process to build a hierarchical oxide layer on the surface of porous titanium structures made by selective laser melting of Ti6Al4V ELI powder. The hierarchical structure included both nanotopographical features (nanotubes) and micro-features (micropits). After anodizing, the biomaterial was heat treated in Argon at different temperatures ranging between 400 and 600 °C for either 1 or 2 h to improve its bioactivity. The effects of applied heat treatment on the crystal structure of TiO{sub 2} nanotubes and the nanotopographical features of the surface were studied using scanning electron microscopy and X-ray diffraction. It was shown that the transition from the initial crystal structure, i.e. anatase, to rutile occurs between 500 and 600 °C and that after 2 h of heat treatment at 600 °C the crystal structure is predominantly rutile. The nanotopographical features of the surface were found to be largely unchanged for heat treatments carried out at 500 °C or below, whereas they were partially or largely disrupted after heat treatment at 600 °C. The possible implications of these findings for the bioactivity of porous titanium structures are discussed.

  17. Skin-targeted inhibition of PPAR β/δ by selective antagonists to treat PPAR β/δ-mediated psoriasis-like skin disease in vivo.

    Directory of Open Access Journals (Sweden)

    Katrin Hack

    Full Text Available We have previously shown that peroxisome proliferator activating receptor ß/δ (PPAR β/δ is overexpressed in psoriasis. PPAR β/δ is not present in adult epidermis of mice. Targeted expression of PPAR β/δ and activation by a selective synthetic agonist is sufficient to induce an inflammatory skin disease resembling psoriasis. Several signalling pathways dysregulated in psoriasis are replicated in this model, suggesting that PPAR β/δ activation contributes to psoriasis pathogenesis. Thus, inhibition of PPAR β/δ might harbour therapeutical potential. Since PPAR β/δ has pleiotropic functions in metabolism, skin-targeted inhibition offer the potential of reducing systemic adverse effects. Here, we report that three selective PPAR β/δ antagonists, GSK0660, compound 3 h, and GSK3787 can be formulated for topical application to the skin and that their skin concentration can be accurately quantified using ultra-high performance liquid chromatography (UPLC/mass spectrometry. These antagonists show efficacy in our transgenic mouse model in reducing psoriasis-like changes triggered by activation of PPAR β/δ. PPAR β/δ antagonists GSK0660 and compound 3 do not exhibit systemic drug accumulation after prolonged application to the skin, nor do they induce inflammatory or irritant changes. Significantly, the irreversible PPAR β/δ antagonist (GSK3787 retains efficacy when applied topically only three times per week which could be of practical clinical usefulness. Our data suggest that topical inhibition of PPAR β/δ to treat psoriasis may warrant further exploration.

  18. Irradiation of the tumor bed alone after lumpectomy in selected patients with early stage breast cancer treated with breast conserving therapy

    International Nuclear Information System (INIS)

    Vicini, F.; Chen, P; Benitez, P.; Johnson, P.; Gustafson, G.; Horwitz, E.; McCarthy, K.; Lacerna, M.; Goldstein, Neil; Martinez, A.

    1997-01-01

    Purpose: We present the initial findings of our in-house protocol treating the tumor bed alone after lumpectomy with low dose rate (LDR) interstitial brachytherapy in selected patients with early stage breast cancer treated with breast conserving therapy (BCT). Materials and Methods: Since 1/1/93, 50 women with early stage breast cancer were entered into a protocol of tumor bed irradiation alone using an interstitial LDR implant. Patients were eligible if their tumor was an infiltrating ductal carcinoma ≤ 3 cm in maximum diameter, pathologic margins were clear by at least 2 mm, the tumor did not contain an extensive intraductal component, the axilla was surgically staged with ≤ 3 nodes involved with cancer, and a postoperative mammogram was performed. Implants were positioned using a template guide delivering 50 Gy over 96 hours to the lumpectomy bed plus a 1-2 cm margin. Local control, cosmetic outcome, and complications were assessed. Results: Patients ranged in age from 40 to 84 years (median 65). The median tumor size was 10 mm (range, 1-25). Seventeen patients (34%) had well differentiated tumors, 22 (4%) had moderately differentiated tumors, and in 11 (22%) the tumor was poorly differentiated. Forty-five patients (90%) were node negative while 5 (10%) had 1-3 positive nodes. A total of 23 (46%) patients were placed on tamoxifen and 3 (6%) received adjuvant systemic chemotherapy. No patient was lost to follow-up. The median follow-up is 40 months (range 29-50). No patient has experienced a local, regional, or distant failure. One patient died from colorectal carcinoma with no evidence of recurrent breast cancer. Good-to-excellent cosmetic results have been observed in all 50 patients (median cosmetic follow-up 36 months). No patient has experienced significant sequelae related to their implant. Conclusions: Early results with treatment of the tumor bed alone with a LDR interstitial implant appear promising. Long-term follow-up of these patients will be

  19. Normal Bone Microstructure and Density But Worse Physical Function in Older Women Treated with Selective Serotonin Reuptake Inhibitors, a Cross-Sectional Population-Based Study.

    Science.gov (United States)

    Larsson, Berit; Mellström, Dan; Johansson, Lisa; Nilsson, Anna G; Lorentzon, Mattias; Sundh, Daniel

    2018-05-05

    Depression in the elderly is today often treated with selective serotonin reuptake inhibitors (SSRIs) because of their favorable adverse effect profile. However, treatment with SSRIs is associated with increased risk of fractures. Whether this increased risk depends on reduced bone strength or increased fall risk due to reduced physical function is not certain. The aim was therefore to investigate if treatment with SSRIs is associated with impaired bone microstructure, bone density, or physical function in older women. From an ongoing population-based study, 1057 women (77.7 ± 1.5 years) were included. Validated questionnaires were used to assess information regarding medical history, medications, smoking, mental and physical health, and physical activity. Physical function was measured using clinically used tests: timed up and go, walking speed, grip strength, chair stand test, and one leg standing. Bone mineral density (BMD) was measured at the hip and spine with dual-energy X-ray absorptiometry (Hologic Discovery A). Bone geometry and microstructure were measured at the ultradistal and distal (14%) site of radius and tibia using high-resolution peripheral quantitative computed tomography (HR-pQCT; XtremeCT). Treatment with SSRIs was associated with higher BMD at the femoral neck, total hip, and lumbar spine, whereas no associations were found for any HR-pQCT-derived measurements. The use of SSRIs was associated with lower grip strength, walking speed, and fewer chair stand rises. These associations were valid also after adjustments for known risk factors for falls. Treatment with SSRIs was, independently of covariates, associated with worse physical function without any signs of inferior bone geometry and microstructure.

  20. Effects of Nigella sativa L. and Urtica dioica L. on selected mineral status and hematological values in CCl4-treated rats.

    Science.gov (United States)

    Meral, Ismail; Kanter, Mehmet

    2003-01-01

    This study was designed to investigate the effects of Nigella sativa L. (NS), known as black seed, or/and Urtica dioica L. (UD), known as stinging nettle root, treatments on serum Na, K, Cl, and Ca levels and some hematological values of CCl4-treated rats. Sixty healthy male Sprague-Dawley rats, weighing 250-300 g, were randomly allotted into 1 of 4 experimental groups: A (CCl4-only treated), B (CCl4+UD treated), C (CCl4+NS treated), and D (CCl4+UD+NS treated), each containing 15 animals. All groups received CCl4 (0.8 mL/kg of body weight, subcutaneously, twice a week for 90 d starting d 1). In addition, B, C, and D groups also received the daily ip injection of 0.2 mL/kg NS and/or 2 mL/kg UD oils for 45 d starting d 46. Group A, on the other hand, received only 2 mL/kg normal saline solution for 45 d starting d 46. Blood samples for the biochemical analysis were taken by cardiac puncture from five randomly chosen rats in each treatment group at the beginning, d 45, and d 90 of the experiment. The CCl4 treatment for 45 d significantly (p0.05) the serum Na and Cl levels. NS or UD treatments (alone or combination) for 45 d starting d 46 significantly (p<0.05) decreased the elevated serum K and Ca levels and also increased (p<0.05) the reduced RBC, WBC, PCV, and Hb levels. It is concluded that NS and/or UD treatments might ameliorate the CCl4-induced disturbances of anemia, some minerals, and body's defense mechanism in CCl4-treated rats.

  1. The impact of different proportions of a treated effluent on the biotransformation of selected micro-contaminants in river water microcosms.

    Science.gov (United States)

    Nödler, Karsten; Tsakiri, Maria; Licha, Tobias

    2014-10-10

    Attenuation of micro-contaminants is a very complex field in environmental science and evidence suggests that biodegradation rates of micro-contaminants in the aqueous environment depend on the water matrix. The focus of the study presented here is the systematic comparison of biotransformation rates of caffeine, carbamazepine, metoprolol, paracetamol and valsartan in river water microcosms spiked with different proportions of treated effluent (0%, 0.1%, 1%, and 10%). Biotransformation was identified as the dominating attenuation process by the evolution of biotransformation products such as atenolol acid and valsartan acid. Significantly decreasing biotransformation rates of metoprolol were observed at treated effluent proportions ≥ 0.1% whereas significantly increasing biotransformation rates of caffeine and valsartan were observed in the presence of 10% treated effluent. Potential reasons for the observations are discussed and the addition of adapted microorganisms via the treated effluent was suggested as the most probable reason. The impact of additional phosphorus on the biodegradation rates was tested and the experiments revealed that phosphorus-limitation was not responsible.

  2. Tricky Treats

    Centers for Disease Control (CDC) Podcasts

    The Eagle Books are a series of four books that are brought to life by wise animal characters - Mr. Eagle, Miss Rabbit, and Coyote - who engage Rain That Dances and his young friends in the joy of physical activity, eating healthy foods, and learning from their elders about health and diabetes prevention. Tricky Treats shows children the difference between healthy snacks and sweet treats.

  3. Selecting Treatments and Monitoring Outcomes: The Circle of Evidence-Based Practice and Client-Centered Care in Treating a Preschool Child Who Stutters

    Science.gov (United States)

    Ratner, Nan Bernstein

    2018-01-01

    Purpose: The purpose of the present clinical forum is to compare how 2 clinicians might select among therapy options for a preschool-aged child who presents with stuttering close to onset. Method: I discuss approaches to full evaluation of the child's profile, advisement of evidence-based practice options open to the family, the need for…

  4. Role of ceftazidime dose regimen on the selection of resistant Enterobacter cloacae in the intestinal flora of rats treated for an experimental pulmonary infection

    NARCIS (Netherlands)

    W.H.F. Goessens (Wil); J.W. Mouton (Johan); M.T. ten Kate (Marian); A.J. Bijl; A. Ott (Alewijn); I.A.J.M. Bakker-Woudenberg (Irma)

    2007-01-01

    textabstractObjectives: The effect of ceftazidime dosing increments and frequency of dosing on the selection of ceftazidime-resistant Enterobacter cloacae in the intestine was studied in rats, during treatment of a pulmonary infection caused by Klebsiella pneumoniae. Methods: Rats with pulmonary

  5. Selection and persistence of CTX-M-producing Escherichia coli in the intestinal flora of pigs treated with amoxicillin, ceftiofur, or cefquinome

    DEFF Research Database (Denmark)

    Cavaco, Lina; Abatih, E.; Aarestrup, Frank Møller

    2008-01-01

    Extended-spectrum beta-lactamases (ESBLs), mainly of the CTX-M family, have been associated with Escherichia coli strains of animal origin in Europe. An in vivo experiment was performed to study the effects of veterinary beta-lactam drugs on the selection and persistence of ESBL-producing E. coli...

  6. Directional selection at the pfmdr1, pfcrt, pfubp1, and pfap2mu loci of Plasmodium falciparum in Kenyan children treated with ACT.

    Science.gov (United States)

    Henriques, Gisela; Hallett, Rachel L; Beshir, Khalid B; Gadalla, Nahla B; Johnson, Rachel E; Burrow, Rebekah; van Schalkwyk, Donelly A; Sawa, Patrick; Omar, Sabah A; Clark, Taane G; Bousema, Teun; Sutherland, Colin J

    2014-12-15

    The efficacy of artemisinin-based combination therapy (ACT) for Plasmodium falciparum malaria may be threatened by parasites with reduced responsiveness to artemisinins. Among 298 ACT-treated children from Mbita, Kenya, submicroscopic persistence of P. falciparum on day 3 posttreatment was associated with subsequent microscopically detected parasitemia at days 28 or 42. DNA sequences of resistance-associated parasite loci pfcrt, pfmdr1, pfubp1, and pfap2mu were determined in the Mbita cohort before treatment, on days 2 and 3 after initiation of treatment, and on the day of treatment failure. Parasites surviving ACT on day 2 or day 3 posttreatment were significantly more likely than the baseline population to carry the wild-type haplotypes of pfcrt (CVMNK at codons 72-76; P < .001) and pfmdr1 (NFD at codons 86, 184, 1246; P < .001). In contrast, variant alleles of the novel candidate resistance genes pfap2mu (S160N/T; P = .006) and pfubp-1 (E1528D; P < .001) were significantly more prevalent posttreatment. No genetic similarities were found to artemisinin-tolerant parasites recently described in Cambodia. Among treated children in western Kenya, certain P. falciparum genotypes defined at pfcrt, pfmdr1, pfap2mu, and pfubp1 more often survive ACT at the submicroscopic level, and contribute to onward transmission and subsequent patent recrudescence. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

  7. Selection of an early biomarker for vascular normalization using dynamic contrast-enhanced ultrasonography to predict outcomes of metastatic patients treated with bevacizumab.

    Science.gov (United States)

    Lassau, N; Coiffier, B; Kind, M; Vilgrain, V; Lacroix, J; Cuinet, M; Taieb, S; Aziza, R; Sarran, A; Labbe-Devilliers, C; Gallix, B; Lucidarme, O; Ptak, Y; Rocher, L; Caquot, L M; Chagnon, S; Marion, D; Luciani, A; Feutray, S; Uzan-Augui, J; Benatsou, B; Bonastre, J; Koscielny, S

    2016-10-01

    Dynamic contrast-enhanced ultrasonography (DCE-US) has been used for evaluation of tumor response to antiangiogenic treatments. The objective of this study was to assess the link between DCE-US data obtained during the first week of treatment and subsequent tumor progression. Patients treated with antiangiogenic therapies were included in a multicentric prospective study from 2007 to 2010. DCE-US examinations were available at baseline and at day 7. For each examination, a 3 min perfusion curve was recorded just after injection of a contrast agent. Each perfusion curve was modeled with seven parameters. We analyzed the correlation between criteria measured up to day 7 on freedom from progression (FFP). The impact was assessed globally, according to tumor localization and to type of treatment. The median follow-up was 20 months. The mean transit time (MTT) evaluated at day 7 was the only criterion significantly associated with FFP (P = 0.002). The cut-off point maximizing the difference between FFP curves was 12 s. Patients with at least a 12 s MTT had a better FFP. The results according to tumor type were significantly heterogeneous: the impact of MTT on FFP was more marked for breast cancer (P = 0.004) and for colon cancer (P = 0.025) than for other tumor types. Similarly, the differences in FFP according to MTT at day 7 were marked (P = 0.004) in patients receiving bevacizumab. The MTT evaluated with DCE-US at day 7 is significantly correlated to FFP of patients treated with bevacizumab. This criterion might be linked to vascular normalization. 2007-A00399-44. © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  8. Comparative efficacy of selective serotonin reuptake inhibitors (SSRI) in treating major depressive disorder: a protocol for network meta-analysis of randomised controlled trials.

    Science.gov (United States)

    Jia, Yongliang; Zhu, Hongmei; Leung, Siu-Wai

    2016-06-07

    There have been inconsistent findings from randomised controlled trials (RCTs) and systematic reviews on the efficacies of selective serotonin reuptake inhibitors (SSRIs) as the first-line treatment of major depressive disorder (MDD). Besides inconsistencies among randomised controlled trials (RCTs), their risks of bias and evidence grading have seldom been evaluated in meta-analysis. This study aims to compare the efficacy of SSRIs by conducting a Bayesian network meta-analysis, which will be the most comprehensive evaluation of evidence to resolve the inconsistency among previous studies. SSRIs including citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline and vilazodone have been selected. Systematic database searching and screening will be conducted for the RCTs on drug treatment of patients with MDD according to pre-specified search strategies and selection criteria. PubMed, the Cochrane Library, EMBASE, ScienceDirect, the US Food and Drug Administration Website, ClinicalTrial.gov and WHO Clinical Trials will be searched. Outcome data including Hamilton Depression Rating Scale (HDRS), Montgomery-Åsberg Depression Rating Scale (MADRS) and Clinical Global Impression (CGI) from eligible RCTs will be extracted. The outcomes will be analysed as ORs and mean differences under a random-effects model. A Bayesian network meta-analysis will be conducted with WinBUGS software, to compare the efficacies of SSRIs. Subgroup and sensitivity analysis will be performed to explain the study heterogeneity and evaluate the robustness of the results. Meta-regression analysis will be conducted to determine the possible factors affecting the efficacy outcomes. The Cochrane risk of bias assessment tool will be used to assess the RCT quality, and the Grading of Recommendation, Assessment, Development and Evaluation will be used to assess the strength of evidence from the meta-analysis. No ethical approval is required because this study includes neither

  9. In vivo study on selection of ESBL-producing Escherichia coli in the intestinal tract of pigs treated with extended-spectrum cephalosporins

    DEFF Research Database (Denmark)

    Concalves Cavaco, Lina Maria; Aarestrup, Frank; Abatih Nji, Emmanuel

    2007-01-01

    treatment at day 4, 8, 15, 22 and 25. Total coliforms and cefotaxime-resistant coliforms were counted on MacConckey agar plates without and with 2mg/L cefotaxime, respectively. Selected cefotaxime-resistant colonies were identified as E. coli by biochemical testing and the presence of the gene was confirmed...... by PCR. Surprisingly, all but one of the pigs carried cephalosporin resistant coliforms carrying blaCTX-M genes in the faeces prior to inoculation. Following treatment both relative and total numbers of cefotaxime-resistant E. coli were significantly higher in the two groups treated with cephalosporins...

  10. Tricky Treats

    Centers for Disease Control (CDC) Podcasts

    2008-08-04

    The Eagle Books are a series of four books that are brought to life by wise animal characters - Mr. Eagle, Miss Rabbit, and Coyote - who engage Rain That Dances and his young friends in the joy of physical activity, eating healthy foods, and learning from their elders about health and diabetes prevention. Tricky Treats shows children the difference between healthy snacks and sweet treats.  Created: 8/4/2008 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 8/5/2008.

  11. Cas9/sgRNA selective targeting of the P23H Rhodopsin mutant allele for treating retinitis pigmentosa by intravitreal AAV9.PHP.B-based delivery.

    Science.gov (United States)

    Giannelli, Serena G; Luoni, Mirko; Castoldi, Valerio; Massimino, Luca; Cabassi, Tommaso; Angeloni, Debora; Demontis, Gian Carlo; Leocani, Letizia; Andreazzoli, Massimiliano; Broccoli, Vania

    2018-03-01

    P23H is the most common mutation in the RHODOPSIN (RHO) gene leading to a dominant form of retinitis pigmentosa (RP), a rod photoreceptor degeneration that invariably causes vision loss. Specific disruption of the disease P23H RHO mutant while preserving the wild-type (WT) functional allele would be an invaluable therapy for this disease. However, various technologies tested in the past failed to achieve effective changes and consequently therapeutic benefits. We validated a CRISPR/Cas9 strategy to specifically inactivate the P23H RHO mutant, while preserving the WT allele in vitro. We, then, translated this approach in vivo by delivering the CRISPR/Cas9 components in murine Rho+/P23H mutant retinae. Targeted retinae presented a high rate of cleavage in the P23H but not WT Rho allele. This gene manipulation was sufficient to slow photoreceptor degeneration and improve retinal functions. To improve the translational potential of our approach, we tested intravitreal delivery of this system by means of adeno-associated viruses (AAVs). To this purpose, the employment of the AAV9-PHP.B resulted the most effective in disrupting the P23H Rho mutant. Finally, this approach was translated successfully in human cells engineered with the homozygous P23H RHO gene mutation. Overall, this is a significant proof-of-concept that gene allele specific targeting by CRISPR/Cas9 technology is specific and efficient and represents an unprecedented tool for treating RP and more broadly dominant genetic human disorders affecting the eye, as well as other tissues.

  12. Autoimmune Thyroid Diseases in Patients Treated with Alemtuzumab for Multiple Sclerosis: An Example of Selective Anti-TSH-Receptor Immune Response

    Directory of Open Access Journals (Sweden)

    Mario Rotondi

    2017-09-01

    Full Text Available Alemtuzumab, a humanized anti-CD52 monoclonal antibody, is approved for the treatment of active relapsing-remitting multiple sclerosis (MS. Alemtuzumab induces a rapid and prolonged depletion of lymphocytes from the circulation, which results in a profound immuno-suppression status followed by an immune reconstitution phase. Secondary to reconstitution autoimmune diseases represent the most common side effect of Alemtuzumab treatment. Among them, Graves’ disease (GD is the most frequent one with an estimated prevalence ranging from 16.7 to 41.0% of MS patients receiving Alemtuzumab. Thyrotropin (TSH receptor (R-reactive B cells are typically observed in GD and eventually present this autoantigen to T-cells, which, in turn, secrete several pro-inflammatory cytokines and chemokines. Given that reconstitution autoimmunity is more frequently characterized by autoantibody-mediated diseases rather than by destructive Th1-mediated disorders, it is not surprising that GD is the most commonly reported side effect of Alemtuzumab treatment in patients with MS. On the other hand, immune reconstitution GD was not observed in a large series of patients with rheumatoid arthritis treated with Alemtuzumab. This negative finding supports the view that patients with MS are intrinsically more at risk for developing Alemtuzumab-related thyroid dysfunctions and in particular of GD. From a clinical point of view, Alemtuzumab-induced GD is characterized by a surprisingly high rate of remission, both spontaneous and after antithyroid drugs, as well as by a spontaneous shift to hypothyroidism, which is supposed to result from a change from stimulating to blocking TSH-receptor antibodies. These immune and clinical peculiarities support the concept that antithyroid drugs should be the first-line treatment in Alemtuzumab-induced Graves’ hyperthyroidism.

  13. Selective decontamination of the digestive tract in critically ill patients treated in intensive care units: a mixed-methods feasibility study (the SuDDICU study).

    Science.gov (United States)

    Francis, Jill J; Duncan, Eilidh M; Prior, Maria E; Maclennan, Graeme S; Dombrowski, Stephan; Bellingan, Geoff U; Campbell, Marion K; Eccles, Martin P; Rose, Louise; Rowan, Kathryn M; Shulman, Rob; Peter R Wilson, A; Cuthbertson, Brian H

    2014-04-01

    Hospital-acquired infections (HAIs) are a major cause of morbidity and mortality. Critically ill patients in intensive care units (ICUs) are particularly susceptible to these infections. One intervention that has gained much attention in reducing HAIs is selective decontamination of the digestive tract (SDD). SDD involves the application of topical non-absorbable antibiotics to the oropharynx and stomach and a short course of intravenous (i.v.) antibiotics. SDD may reduce infections and improve mortality, but has not been widely adopted in the UK or internationally. Hence, there is a need to identify the reasons for low uptake and whether or not further clinical research is needed before wider implementation would be considered appropriate. The project objectives were to (1) identify and describe the SDD intervention, (2) identify views about the evidence base, (3) identify acceptability of further research and (4) identify feasibility of further randomised controlled trials (RCTs). A four-stage approach involving (1) case studies of two ICUs in which SDD is delivered including observations, interviews and documentary analysis, (2) a three-round Delphi study for in-depth investigation of clinicians' views, including semi-structured interviews and two iterations of questionnaires with structured feedback, (3) a nationwide online survey of consultants in intensive care medicine and clinical microbiology and (4) semistructured interviews with international clinical triallists to identify the feasibility of further research. Case studies were set in two UK ICUs. Other stages of this research were conducted by telephone and online with NHS staff working in ICUs. (1) Staff involved in SDD adoption or delivery in two UK ICUs, (2) ICU experts (intensive care consultants, clinical microbiologists, hospital pharmacists and ICU clinical leads), (3) all intensive care consultants and clinical microbiologists in the UK with responsibility for patients in ICUs were invited and

  14. Expression of selected genes of dendritic and Treg cells in blood and skin of morphea patients treated with UVA1 phototherapy

    Science.gov (United States)

    Osmola-Mańkowska, Agnieszka J.; Kowalczyk, Michał J.; Żaba, Ryszard W.; Adamski, Zygmunt; Dańczak-Pazdrowska, Aleksandra

    2018-01-01

    Introduction Morphea is a chronic autoimmune disease characterized by fibrosis of the skin. Dendritic cells (DC) and regulatory T cells (Tregs) play a significant role in development of autoimmune and tolerance mechanisms. The aim of the study was to establish the expression of selected genes of plasmacytoid and myeloid DC, Treg cells, and the microenvironment of cytokines (interleukin-17A (IL-17A), transforming growth factor β (TGF-β)) in blood and skin of morphea patients. In addition, the effect of UVA1 phototherapy on expression of the aforementioned genes was evaluated. Material and methods The study was performed on 15 blood and 10 skin samples from patients with morphea. The evaluation included expression of CLEC4C (C-type lectin domain family 4, member C receptor), Lymphocyte antigen 75 (LY75), Forkhead box p3 (foxp3) transcription factor, IL-17A and TGF-β genes in peripheral blood mononuclear cells (PBMC) and in skin samples both before and after UVA1 phototherapy using real-time polymerase chain reaction. Results The study revealed lower expression of CLEC4C before (p = 0.010) and after (p = 0.009) phototherapy and lower expression of IL-17A before (p = 0.038) phototherapy in PBMC of patients with morphea vs. the control group. Expression of CLEC4C in PBMC correlated negatively (rho = –0.90; p = 0.001) with activity of disease after phototherapy. No significant differences were found between expression of analysed genes before and after UVA1 therapy in PBMC and skin of morphea patients. Conclusions The results do not confirm the involvement of analysed subsets of DC and Tregs in UVA1 phototherapy in morphea, but point to CLEC4C as a possible biomarker associated with the disease activity. PMID:29593811

  15. Effect of cytomegalovirus co-infection on normalization of selected T-cell subsets in children with perinatally acquired HIV infection treated with combination antiretroviral therapy.

    Science.gov (United States)

    Kapetanovic, Suad; Aaron, Lisa; Montepiedra, Grace; Anthony, Patricia; Thuvamontolrat, Kasalyn; Pahwa, Savita; Burchett, Sandra; Weinberg, Adriana; Kovacs, Andrea

    2015-01-01

    We examined the effect of cytomegalovirus (CMV) co-infection and viremia on reconstitution of selected CD4+ and CD8+ T-cell subsets in perinatally HIV-infected (PHIV+) children ≥ 1-year old who participated in a partially randomized, open-label, 96-week combination antiretroviral therapy (cART)-algorithm study. Participants were categorized as CMV-naïve, CMV-positive (CMV+) viremic, and CMV+ aviremic, based on blood, urine, or throat culture, CMV IgG and DNA polymerase chain reaction measured at baseline. At weeks 0, 12, 20 and 40, T-cell subsets including naïve (CD62L+CD45RA+; CD95-CD28+), activated (CD38+HLA-DR+) and terminally differentiated (CD62L-CD45RA+; CD95+CD28-) CD4+ and CD8+ T-cells were measured by flow cytometry. Of the 107 participants included in the analysis, 14% were CMV+ viremic; 49% CMV+ aviremic; 37% CMV-naïve. In longitudinal adjusted models, compared with CMV+ status, baseline CMV-naïve status was significantly associated with faster recovery of CD8+CD62L+CD45RA+% and CD8+CD95-CD28+% and faster decrease of CD8+CD95+CD28-%, independent of HIV VL response to treatment, cART regimen and baseline CD4%. Surprisingly, CMV status did not have a significant impact on longitudinal trends in CD8+CD38+HLA-DR+%. CMV status did not have a significant impact on any CD4+ T-cell subsets. In this cohort of PHIV+ children, the normalization of naïve and terminally differentiated CD8+ T-cell subsets in response to cART was detrimentally affected by the presence of CMV co-infection. These findings may have implications for adjunctive treatment strategies targeting CMV co-infection in PHIV+ children, especially those that are now adults or reaching young adulthood and may have accelerated immunologic aging, increased opportunistic infections and aging diseases of the immune system.

  16. Effect of cytomegalovirus co-infection on normalization of selected T-cell subsets in children with perinatally acquired HIV infection treated with combination antiretroviral therapy.

    Directory of Open Access Journals (Sweden)

    Suad Kapetanovic

    Full Text Available We examined the effect of cytomegalovirus (CMV co-infection and viremia on reconstitution of selected CD4+ and CD8+ T-cell subsets in perinatally HIV-infected (PHIV+ children ≥ 1-year old who participated in a partially randomized, open-label, 96-week combination antiretroviral therapy (cART-algorithm study.Participants were categorized as CMV-naïve, CMV-positive (CMV+ viremic, and CMV+ aviremic, based on blood, urine, or throat culture, CMV IgG and DNA polymerase chain reaction measured at baseline. At weeks 0, 12, 20 and 40, T-cell subsets including naïve (CD62L+CD45RA+; CD95-CD28+, activated (CD38+HLA-DR+ and terminally differentiated (CD62L-CD45RA+; CD95+CD28- CD4+ and CD8+ T-cells were measured by flow cytometry.Of the 107 participants included in the analysis, 14% were CMV+ viremic; 49% CMV+ aviremic; 37% CMV-naïve. In longitudinal adjusted models, compared with CMV+ status, baseline CMV-naïve status was significantly associated with faster recovery of CD8+CD62L+CD45RA+% and CD8+CD95-CD28+% and faster decrease of CD8+CD95+CD28-%, independent of HIV VL response to treatment, cART regimen and baseline CD4%. Surprisingly, CMV status did not have a significant impact on longitudinal trends in CD8+CD38+HLA-DR+%. CMV status did not have a significant impact on any CD4+ T-cell subsets.In this cohort of PHIV+ children, the normalization of naïve and terminally differentiated CD8+ T-cell subsets in response to cART was detrimentally affected by the presence of CMV co-infection. These findings may have implications for adjunctive treatment strategies targeting CMV co-infection in PHIV+ children, especially those that are now adults or reaching young adulthood and may have accelerated immunologic aging, increased opportunistic infections and aging diseases of the immune system.

  17. Stereo-selectivity and regio-selectivity in the metabolism of 7,8-dihydrobenzo[a]pyrene by cytochrome P450, epoxide hydrolase and hepatic microsomes from 3-methylcholanthrene-treated rats.

    Science.gov (United States)

    Adams, J D; Yagi, H; Levin, W; Jerina, D M

    1995-03-30

    The active site of cytochrome P450 1A1 has been probed with the substrate 7,8-dihydrobenzo[a]pyrene using a purified, reconstituted system composed of cytochrome P450 1A1, NADPH-cytochrome c reductase and lipid in the presence or absence of epoxide hydrolase. The turnover of the substrate was found to be 38 nmol/nmol of cytochrome P450/min. The metabolic products that were identified are: a phenolic 7,8-dihydrobenzo[a]pyrene (20-29%); 9,10-epoxy-7,8,9,10-tetrahydrobenzo[a]pyrene (17-28%); benzo[a]pyrene (12-19%); 7-hydroxy-7,8-dihydrobenzo[a]pyrene (13-16%); 8-hydroxy-7,8-dihydrobenzo[a]pyrene (7-15%); 3-hydroxybenzo[a]pyrene (7-15%); 4,5-epoxy-4,5,7,8-tetrahydrobenzo[a]pyrene (0-4%); and a triol of 7,8,9,10-tetrahydrobenzo[a]pyrene (0-4%). 9,10-Epoxy-7,8,9,10-tetrahydrobenzo[a]pyrene undergoes rapid hydrolysis to cis- and trans-9,10-dihydroxy-dihydroxy-7,8,9,10-tetrahydrobenzo[a]pyrene (2:1) by benzylic attack of water at C-10. Approximately 71% of the trans diols are derived from (+)-(9S,10R)-epoxy-7,8,9,10-tetrahydrobenzo[a]pyrene, indicating that cytochrome P450 1A1 has more than a 2:1 preference for selective epoxidation of an enantiotopic face of 7,8-dihydrobenzo[a]pyrene. This stereo-selectivity agrees with the postulated stereo-selectivity predicted by a previously described active site model for cytochrome P450 1A1. Epoxide hydrolase in pure form or in hepatic microsomes catalyzes the hydrolysis of 9,10-epoxy-7,8,9,10-tetrahydrobenzo[a]pyrene, which is inhibited by 1,1,1-trichloropropane 2,3-oxide. The (+)-(9S,10R)-isomer of the epoxide is slightly preferred as a substrate over its enantiomer and is cleaved by benzylic and nonbenzylic attack. Only benzylic attack was found with (-)-(9R,10S)-9,10-epoxy-7,8,9,10-tetrahydrobenzo[a]pyrene.

  18. A randomised controlled trial of cognitive behaviour therapy in adolescents with major depression treated by selective serotonin reuptake inhibitors. The ADAPT trial.

    Science.gov (United States)

    Goodyer, I M; Dubicka, B; Wilkinson, P; Kelvin, R; Roberts, C; Byford, S; Breen, S; Ford, C; Barrett, B; Leech, A; Rothwell, J; White, L; Harrington, R

    2008-05-01

    To determine if, in the short term, depressed adolescents attending routine NHS Child and Adolescent Mental Health Services (CAMHS), and receiving ongoing active clinical care, treatment with selective serotonin reuptake inhibitors (SSRIs) plus cognitive behaviour therapy (CBT) compared with SSRI alone, results in better healthcare outcomes. A pragmatic randomised controlled trial (RCT) was conducted on depressed adolescents attending CAMHS who had not responded to a psychosocial brief initial intervention (BII) prior to randomisation. Six English CAMHS participated in the study. A total of 208 patients aged between 11 and 17 years were recruited and randomised. All participants received active routine clinical care in a CAMHS outpatient setting and an SSRI and half were offered CBT. The duration of the trial was a 12-week treatment phase, followed by a 16-week maintenance phase. Follow-up assessments were at 6, 12 and 28 weeks. The primary outcome measure was the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA). Secondary outcome measures were self-report depressive symptoms, interviewer-rated depressive signs and symptoms, interviewer-rated psychosocial impairment and clinical global impression of response to treatment. Information on resource use was collected in interview at baseline and at the 12- and 28-week follow-up assessments using the Child and Adolescent Service Use Schedule (CA-SUS). Of the 208 patients randomised, 200 (96%) completed the trial to the primary end-point at 12 weeks. By the 28-week follow-up, 174 (84%) participants were re-evaluated. Overall, 193 (93%) participants had been assessed at one or more time points. Clinical characteristics indicated that the trial was conducted on a severely depressed group. There was significant recovery at all time points in both arms. The findings demonstrated no difference in treatment effectiveness for SSRI + CBT over SSRI only for the primary or secondary outcome measures at

  19. N-acetylaspartate (NAA) levels in selected areas of the brain in patients with chronic schizophrenia treated with typical and atypical neuroleptics: a proton magnetic resonance spectroscopy (1H MRS) study.

    Science.gov (United States)

    Szulc, Agata; Galińska, Beata; Tarasów, Eugeniusz; Kubas, Bozena; Dzienis, Wojciech; Konarzewska, Beata; Poplawska, Regina; Tomczak, Anna A; Czernikiewicz, Andrzej; Walecki, Jerzy

    2007-05-01

    NAA, marker of neurons integrity and viability, is one of the most important brain metabolites visible in 1H MRS. In most studies of schizophrenia, the decrease of NAA level was observed in the temporal, frontal lobes and in the thalamus. This finding was observed more often among chronic patients, what suggests the influence of disease duration or the effect of neuroleptic treatment. The aim of the present study was the comparison of NAA levels in brain of schizophrenic patients taking typical and atypical neuroleptics. We analyzed the NAA levels in selected brain areas in 58 schizophrenic patients and 21 healthy controls. 10 patients were treated with typical neuroleptics, 10 patients with clozapine, 17 received olanzapine and 21 - risperidone. 1H MRS was performed on a 1,5 MR scanner with PRESS sequence. Voxels of 2x2x2 cm were localized in the left frontal, left temporal lobe and left thalamus. There were no differences in NAA levels between patients on typical and atypical medications analyzed together and separately (olanzapine, clozapine and risperidone groups). We also did not find any differences between patients taking selected atypical neuroleptics and controls. The NAA level in the thalamus in the group of patients receiving typical antipsychotics was the lowest among all groups and differed significantly from healthy controls. The results of our study suggest that atypical neuroleptics may have favorable effect on NAA concentration in brain of schizophrenic patients. Decrease in NAA level in patients taking typical medication may be caused by the progression of the disease or by the direct action of these drugs.

  20. A prospective evaluation of treatment with Selective Internal Radiation Therapy (SIR-spheres) in patients with unresectable liver metastases from colorectal cancer previously treated with 5-FU based chemotherapy

    International Nuclear Information System (INIS)

    Lim, L; Gibbs, P; Yip, D; Shapiro, JD; Dowling, R; Smith, D; Little, A; Bailey, W; Liechtenstein, M

    2005-01-01

    To prospectively evaluate the efficacy and safety of selective internal radiation (SIR) spheres in patients with inoperable liver metastases from colorectal cancer who have failed 5FU based chemotherapy. Patients were prospectively enrolled at three Australian centres. All patients had previously received 5-FU based chemotherapy for metastatic colorectal cancer. Patients were ECOG 0–2 and had liver dominant or liver only disease. Concurrent 5-FU was given at investigator discretion. Thirty patients were treated between January 2002 and March 2004. As of July 2004 the median follow-up is 18.3 months. Median patient age was 61.7 years (range 36 – 77). Twenty-nine patients are evaluable for toxicity and response. There were 10 partial responses (33%), with the median duration of response being 8.3 months (range 2–18) and median time to progression of 5.3 mths. Response rates were lower (21%) and progression free survival shorter (3.9 mths) in patients that had received all standard chemotherapy options (n = 14). No responses were seen in patients with a poor performance status (n = 3) or extrahepatic disease (n = 6). Overall treatment related toxicity was acceptable, however significant late toxicity included 4 cases of gastric ulceration. In patients with metastatic colorectal cancer that have previously received treatment with 5-FU based chemotherapy, treatment with SIR-spheres has demonstrated encouraging activity. Further studies are required to better define the subsets of patients most likely to respond

  1. Development of a method based on on-line reversed phase liquid chromatography and gas chromatography coupled by means of an adsorption-desorption interface for the analysis of selected chiral volatile compounds in methyl jasmonate treated strawberries.

    Science.gov (United States)

    de la Peña Moreno, Fernando; Blanch, Gracia Patricia; Flores, Gema; Ruiz Del Castillo, Maria Luisa

    2010-02-12

    A method based on the use of the through oven transfer adsorption-desorption (TOTAD) interface in on-line coupling between reversed phase liquid chromatography and gas chromatography (RPLC-GC) for the determination of chiral volatile compounds was developed. In particular, the method was applied to the study of the influence of methyl jasmonate (MJ) treatment on the production and enantiomeric composition of selected aroma compounds in strawberry. The compounds studied were ethyl 2-methylbutanoate, linalool and 4-hydroxy-2,5-dimethyl-3(2H)-furanone (i.e. furaneol), which were examined on days 3, 6 and 9 after treatment. The method developed resulted in relative standard deviations (RSDs) of 21.6%, 8.1% and 9.8% and limits of detection (LD) of 0.04, 0.07 and 0.02mg/l for ethyl 2-methylbutanoate, linalool and furaneol, respectively. The application of the RPLC-TOTAD-GC method allowed higher levels of ethyl 2-methylbutanoate, linalool and furaneol to be detected, particularly after 9 days of treatment. Besides, MJ demonstrated to affect the enantiomeric distribution of ethyl 2-methylbutanoate. On the contrary, the enantiomeric composition of linalool and furaneol kept constant in both control and MJ-treated strawberries throughout the study. These results are discussed. Copyright 2009 Elsevier B.V. All rights reserved.

  2. Cost-effectiveness analysis for joint pain treatment in patients with osteoarthritis treated at the Instituto Mexicano del Seguro Social (IMSS: Comparison of nonsteroidal anti-inflammatory drugs (NSAIDs vs. cyclooxygenase-2 selective inhibitors

    Directory of Open Access Journals (Sweden)

    Mejía-Aranguré Juan

    2008-11-01

    Full Text Available Abstract Background Osteoarthritis (OA is one of the main causes of disability worldwide, especially in persons >55 years of age. Currently, controversy remains about the best therapeutic alternative for this disease when evaluated from a cost-effectiveness viewpoint. For Social Security Institutions in developing countries, it is very important to assess what drugs may decrease the subsequent use of medical care resources, considering their adverse events that are known to have a significant increase in medical care costs of patients with OA. Three treatment alternatives were compared: celecoxib (200 mg twice daily, non-selective NSAIDs (naproxen, 500 mg twice daily; diclofenac, 100 mg twice daily; and piroxicam, 20 mg/day and acetaminophen, 1000 mg twice daily. The aim of this study was to identify the most cost-effective first-choice pharmacological treatment for the control of joint pain secondary to OA in patients treated at the Instituto Mexicano del Seguro Social (IMSS. Methods A cost-effectiveness assessment was carried out. A systematic review of the literature was performed to obtain transition probabilities. In order to evaluate analysis robustness, one-way and probabilistic sensitivity analyses were conducted. Estimations were done for a 6-month period. Results Treatment demonstrating the best cost-effectiveness results [lowest cost-effectiveness ratio $17.5 pesos/patient ($1.75 USD] was celecoxib. According to the one-way sensitivity analysis, celecoxib would need to markedly decrease its effectiveness in order for it to not be the optimal treatment option. In the probabilistic analysis, both in the construction of the acceptability curves and in the estimation of net economic benefits, the most cost-effective option was celecoxib. Conclusion From a Mexican institutional perspective and probably in other Social Security Institutions in similar developing countries, the most cost-effective option for treatment of knee and/or hip OA

  3. Greenland shark (Somniosus microcephalus) feeding behavior on static fishing gear, effect of SMART (Selective Magnetic and Repellent-Treated) hook deterrent technology, and factors influencing entanglement in bottom longlines

    Science.gov (United States)

    Sullivan, Rennie; Hedges, Kevin J.

    2018-01-01

    The Greenland Shark (Somniosus microcephalus) is the most common bycatch in the Greenland halibut (Reinhardtius hippoglossoides) bottom longline fishery in Cumberland Sound, Canada. Historically, this inshore fishery has been prosecuted through the ice during winter but winter storms and unpredictable landfast ice conditions since the mid-1990s have led to interest in developing a summer fishery during the ice-free season. However, bycatch of Greenland shark was found to increase substantially with 570 sharks captured during an experimental Greenland halibut summer fishery (i.e., mean of 6.3 sharks per 1,000 hooks set) and mortality was reported to be about 50% due in part to fishers killing sharks that were severely entangled in longline gear. This study investigated whether the SMART (Selective Magnetic and Repellent-Treated) hook technology is a practical deterrent to Greenland shark predation and subsequent bycatch on bottom longlines. Greenland shark feeding behavior, feeding kinematics, and variables affecting entanglement/disentanglement and release are also described. The SMART hook failed to deter Greenland shark predation, i.e., all sharks were captured on SMART hooks, some with more than one SMART hook in their jaw. Moreover, recently captured Greenland sharks did not exhibit a behavioral response to SMART hooks. In situ observations of Greenland shark feeding show that this species uses a powerful inertial suction mode of feeding and was able to draw bait into the mouth from a distance of 25–35 cm. This method of feeding is suggested to negate the potential deterrent effects of electropositive metal and magnetic alloy substitutions to the SMART hook technology. The number of hooks entangled by a Greenland shark and time to disentangle and live-release a shark was found to increase with body length.

  4. Greenland shark (Somniosus microcephalus) feeding behavior on static fishing gear, effect of SMART (Selective Magnetic and Repellent-Treated) hook deterrent technology, and factors influencing entanglement in bottom longlines.

    Science.gov (United States)

    Grant, Scott M; Sullivan, Rennie; Hedges, Kevin J

    2018-01-01

    The Greenland Shark ( Somniosus microcephalus ) is the most common bycatch in the Greenland halibut ( Reinhardtius hippoglossoides ) bottom longline fishery in Cumberland Sound, Canada. Historically, this inshore fishery has been prosecuted through the ice during winter but winter storms and unpredictable landfast ice conditions since the mid-1990s have led to interest in developing a summer fishery during the ice-free season. However, bycatch of Greenland shark was found to increase substantially with 570 sharks captured during an experimental Greenland halibut summer fishery (i.e., mean of 6.3 sharks per 1,000 hooks set) and mortality was reported to be about 50% due in part to fishers killing sharks that were severely entangled in longline gear. This study investigated whether the SMART (Selective Magnetic and Repellent-Treated) hook technology is a practical deterrent to Greenland shark predation and subsequent bycatch on bottom longlines. Greenland shark feeding behavior, feeding kinematics, and variables affecting entanglement/disentanglement and release are also described. The SMART hook failed to deter Greenland shark predation, i.e., all sharks were captured on SMART hooks, some with more than one SMART hook in their jaw. Moreover, recently captured Greenland sharks did not exhibit a behavioral response to SMART hooks. In situ observations of Greenland shark feeding show that this species uses a powerful inertial suction mode of feeding and was able to draw bait into the mouth from a distance of 25-35 cm. This method of feeding is suggested to negate the potential deterrent effects of electropositive metal and magnetic alloy substitutions to the SMART hook technology. The number of hooks entangled by a Greenland shark and time to disentangle and live-release a shark was found to increase with body length.

  5. Selektívny mutizmus ako úzkostná porucha? Stručný prehľad o etiológii selektívneho mutizmu

    OpenAIRE

    Gabriela Majerechová

    2015-01-01

    Selective mutism is a disorder in which a child fluently speaks in well-known situations but is mute in less known situations. Despite overall etiology research, causes of mutism are still unrevealed. The paper summarizes various research studies which focused on links between selective mutism and anxiety disorders, particularly social phobia. In spite of some empirical evidence, it is still impossible to state that the selective mutism is an anxiety disorder.

  6. Seletividade de herbicidas aplicados em pré-emergência na cultura de cana-de-açúcar tratada com nematicidas Selectivity of pre-emergence herbicides to sugarcane treated with nematicides

    Directory of Open Access Journals (Sweden)

    E. Negrisoli

    2004-12-01

    Full Text Available O objetivo do trabalho foi estudar a seletividade de herbicidas para a cultura da cana-de-açúcar quando aplicado em culturas tratadas com nematicidas. O experimento foi instalado em área pertencente à Usina São José, município de Borebi-SP, ano agrícola de 2000/01. A variedade de cana-de-açúcar utilizada foi a RB855113. Utilizou-se o delineamento experimental de blocos ao acaso em parcelas subdivididas, com quatro repetições. Cada parcela correspondeu a 27 linhas de 10,0 m, espaçadas em 1,0 m, sendo dividida em três subparcelas. As parcelas corresponderam aos tratamentos com os herbicidas, e as subparcelas, à aplicação ou não dos nematicidas carbofuran (2,10 kg ha-1 e terbufós 2,25 kg ha��. Os herbicidas testados foram: tebuthiuron (1,12 kg ha-1, ametryne (1,75 kg ha¹, sulfentrazone (0,8 kg ha-1, metribuzin (1,92 kg ha-1, isoxaflutole (0,0525 kg ha¹, clomazone (1,25 kg ha¹, oxyfluorfen (0,36 kg ha-1 e azafenidin+hexazinone (0,1575 + 0,2025 kg ha-1, sendo todos aplicados em pré-emergência, além de uma parcela como testemunha. Os resultados obtidos evidenciaram que os herbicidas oxyfluorfen e azafenidin+hexazinone causaram os maiores níveis de fitotoxicidade na cana-de-açúcar, independentemente do uso dos nematicidas carbofuran e terbufós. Os herbicidas tebuthiuron, ametryne, sulfentrazone, metribuzin, isoxaflutole, clomazone, oxyfluorfen e azafenidin+hexazinone, aplicados em doses representativas das comercialmente utilizadas, mostraram-se seletivos à cana-de-açúcar, não afetando seu crescimento, sua produtividade e suas características tecnológicas. Os nematicidas não interferiram nos níveis de intoxicação provocados pelos herbicidas utilizados na cultura.The objective of this work was to study the selectivity of herbicides to sugarcane when applied in crops treated with nematicides. The experiment was carried out in Borebi, São Paulo-Brazil, during the growing season 2000/2001. The sugar cane variety

  7. Seletividade de herbicidas aplicados em pré-emergência da cultura da cana-de-açúcar (RB 867515 tratada com nematicidas Selectivity of herbicides applied on pre-emergence of nematicide-treated sugarcane crop (RB 867515

    Directory of Open Access Journals (Sweden)

    J.F. Barela

    2006-06-01

    areas previously treated with nematicides on the planting furrow. The experiment was carried out in a commercial sugarcane area in Piracicaba (SP, from April 2003 to July 2004. The treatments resulted from the combination of nine herbicide factors and four nematicide factors. The herbicides used in the experiment were: sulfentrazone, tebuthiuron, metribuzin, ametrina, diuron, clomazone, pendimethalin and diuron+hexazinone, besides a hand-weeded check. The nematicides used were: carbofuran, terbufos, aldicarb and a check without nematicide. Phytotoxicity of the different combinations at 15, 30, 60 and 90 days after sprouting, yield (t ha-1 and qualitative technological parameters were evaluated. It was observed that the initial selectivity of the herbicides was reduced as a function of the interaction between the different classes used. Phytotoxic symptoms were acute, with the most serious cases originating from the association of nematicides with clomazone, pendimethalin and tebuthiuron. However, phytotoxic damages did not reflect a significant yield or qualitative losses, a fact that may have influenced injury recovery capacity, as presented by the RB 867515 variety, due to high nematode infestations or high experimental variability.

  8. Asymptomatic Bacteriuria: To Treat or Not To Treat. Pro Treatment.

    Science.gov (United States)

    Köves, Béla

    2018-06-14

    Asymptomatic bacteriuria (ABU) should be treated only in pregnant women and before urological procedures that breach the mucosa. In all other clinical settings, treatment of ABU is not beneficial and only contributes to antibiotic-associated morbidity and the selection of antibiotic resistance; therefore, screening and treatment are not recommended. Copyright © 2018 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  9. Treating schizophrenia during menopause.

    Science.gov (United States)

    Brzezinski, Amnon; Brzezinski-Sinai, Noa A; Seeman, Mary V

    2017-05-01

    The aim of this review is to examine three questions: What are the risks and benefits of treating women with schizophrenia with hormone therapy (HT) at menopause? Should the antipsychotic regimen be changed at menopause? Do early- and late-onset women with schizophrenia respond differently to HT at menopause? MEDLINE databases for the years 1990 to 2016 were searched using the following interactive terms: schizophrenia, gender, menopause, estrogen, and hormones. The selected articles (62 out of 800 abstracts) were chosen on the basis of their applicability to the objectives of this targeted narrative review. HT during the perimenopause in women with schizophrenia ameliorates psychotic and cognitive symptoms, and may also help affective symptoms. Vasomotor, genitourinary, and sleep symptoms are also reduced. Depending on the woman's age and personal risk factors and antipsychotic side effects, the risk of breast cancer and cardiovascular disease may be increased. Antipsychotic types and doses may need to be adjusted at menopause, as may be the mode of administration. Both HT and changes in antipsychotic management should be considered for women with schizophrenia at menopause. The question about differences in response between early- and late-onset women cannot yet be answered.

  10. Treated Effluent Disposal Facility

    Data.gov (United States)

    Federal Laboratory Consortium — Treated non-hazardous and non-radioactive liquid wastes are collected and then disposed of through the systems at the Treated Effluent Disposal Facility (TEDF). More...

  11. The selective A-type K+ current blocker Tx3-1 isolated from the Phoneutria nigriventer venom enhances memory of naïve and Aβ(25-35)-treated mice.

    Science.gov (United States)

    Gomes, Guilherme M; Dalmolin, Gerusa D; Cordeiro, Marta do Nascimento; Gomez, Marcus V; Ferreira, Juliano; Rubin, Maribel A

    2013-12-15

    Potassium channels regulate many neuronal functions, including neuronal excitability and synaptic plasticity, contributing, by these means, to mnemonic processes. In particular, A-type K(+) currents (IA) play a key role in hippocampal synaptic plasticity. Therefore, we evaluated the effect of the peptidic toxin Tx3-1, a selective blocker of IA currents, extracted from the venom of the spider Phoneutria nigriventer, on memory of mice. Administration of Tx3-1 (i.c.v., 300 pmol/site) enhanced both short- and long-term memory consolidation of mice tested in the novel object recognition task. In comparison, 4-aminopyridine (4-AP; i.c.v., 30-300 pmol/site), a non-selective K(+) channel blocker did not alter long-term memory and caused toxic side effects such as circling, freezing and tonic-clonic seizures. Moreover, Tx3-1 (i.c.v., 10-100 pmol/site) restored memory of Aβ25-35-injected mice, and exhibited a higher potency to improve memory of Aβ25-35-injected mice when compared to control group. These results show the effect of the selective blocker of IA currents Tx3-1 in both short- and long-term memory retention and in memory impairment caused by Aβ25-35, reinforcing the role of IA in physiological and pathological memory processes. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Significance of ERBB2 overexpression in therapeutic resistance and cancer-specific survival in muscle-invasive bladder cancer patients treated with chemoradiation-based selective bladder-sparing approach.

    Science.gov (United States)

    Inoue, Masaharu; Koga, Fumitaka; Yoshida, Soichiro; Tamura, Tomoki; Fujii, Yasuhisa; Ito, Eisaku; Kihara, Kazunori

    2014-10-01

    To investigate the associations of ERBB 2 overexpression with chemoradiation therapy (CRT) resistance and cancer-specific survival (CSS) in muscle-invasive bladder cancer (MIBC) patients treated with the CRT-based bladder-sparing protocol. From 1997 to 2012, 201 patients with cT2-4aN0M0 bladder cancer were treated with CRT (40 Gy with concurrent cisplatin) following transurethral resection of bladder tumor (TURBT). Basically, patients with tumors that showed good CRT response and were amenable to segmental resection underwent partial cystectomy (PC) with pelvic lymph node dissection for bladder preservation; otherwise, radical cystectomy (RC) was recommended. Included in this study were 119 patients in whom TURBT specimens were available for immunohistochemical analysis of ERBB 2 expression. Following CRT, 30 and 65 patients underwent PC or RC, respectively; the remaining 24 patients did not undergo cystectomy. Tumors were defined as CRT-resistant when patients did not achieve complete response after CRT. Associations of ERBB 2 overexpression with CRT resistance and CSS were evaluated. CRT resistance was observed clinically in 56% (67 of 119 patients) and pathologically (in cystectomy specimens) in 55% (52 of 95 patients). ERBB 2 overexpression was observed in 45 patients (38%). On multivariate analysis, ERBB 2 overexpression was an independent predictor for CRT resistance clinically (odds ratio, 3.6; P=.002) and pathologically (odds ratio, 2.9; P=.031). ERBB 2 overexpression was associated with shorter CSS (5-year CSS rates, 56% vs 87% for the ERBB 2 overexpression group vs the others; P=.001). ERBB 2 overexpression was also an independent risk factor for bladder cancer death at all time points of our bladder-sparing protocol (pre-CRT, post-CRT, and post-cystectomy). ERBB 2 overexpression appears relevant to CRT resistance and unfavorable CSS in MIBC patients treated with the CRT-based bladder-sparing protocol. ERBB 2-targeting treatment may improve the outcomes

  13. Significance of ERBB2 Overexpression in Therapeutic Resistance and Cancer-Specific Survival in Muscle-Invasive Bladder Cancer Patients Treated With Chemoradiation-Based Selective Bladder-Sparing Approach

    International Nuclear Information System (INIS)

    Inoue, Masaharu; Koga, Fumitaka; Yoshida, Soichiro; Tamura, Tomoki; Fujii, Yasuhisa; Ito, Eisaku; Kihara, Kazunori

    2014-01-01

    Purpose: To investigate the associations of ERBB 2 overexpression with chemoradiation therapy (CRT) resistance and cancer-specific survival (CSS) in muscle-invasive bladder cancer (MIBC) patients treated with the CRT-based bladder-sparing protocol. Methods and Materials: From 1997 to 2012, 201 patients with cT2-4aN0M0 bladder cancer were treated with CRT (40 Gy with concurrent cisplatin) following transurethral resection of bladder tumor (TURBT). Basically, patients with tumors that showed good CRT response and were amenable to segmental resection underwent partial cystectomy (PC) with pelvic lymph node dissection for bladder preservation; otherwise, radical cystectomy (RC) was recommended. Included in this study were 119 patients in whom TURBT specimens were available for immunohistochemical analysis of ERBB 2 expression. Following CRT, 30 and 65 patients underwent PC or RC, respectively; the remaining 24 patients did not undergo cystectomy. Tumors were defined as CRT-resistant when patients did not achieve complete response after CRT. Associations of ERBB 2 overexpression with CRT resistance and CSS were evaluated. Results: CRT resistance was observed clinically in 56% (67 of 119 patients) and pathologically (in cystectomy specimens) in 55% (52 of 95 patients). ERBB 2 overexpression was observed in 45 patients (38%). On multivariate analysis, ERBB 2 overexpression was an independent predictor for CRT resistance clinically (odds ratio, 3.6; P=.002) and pathologically (odds ratio, 2.9; P=.031). ERBB 2 overexpression was associated with shorter CSS (5-year CSS rates, 56% vs 87% for the ERBB 2 overexpression group vs the others; P=.001). ERBB 2 overexpression was also an independent risk factor for bladder cancer death at all time points of our bladder-sparing protocol (pre-CRT, post-CRT, and post-cystectomy). Conclusions: ERBB 2 overexpression appears relevant to CRT resistance and unfavorable CSS in MIBC patients treated with the CRT-based bladder

  14. [Urinary tract infections in pregnancy: when to treat, how to treat, and what to treat with].

    Science.gov (United States)

    Kladenský, J

    2012-04-01

    Urinary tract infections (UTI) in pregnant women are a relatively frequent occurrence and the spectrum of these infections ranges from lower urinary tract disease (asymptomatic bacteriuria, acute cystitis) to upper urinary tract disease (acute pyelonephritis). Anatomical and functional changes in the urinary tract in pregnancy result in significantly higher susceptibility to progression of the infection from asymptomatic bacteriuria to the stage of acute pyelonephritis. Untreated asymptomatic bacteriuria in pregnancy leads, in as much as 40%, to the development of acute pyelonephritis with all the subsequent negative effects not only for the woman herself, but particularly for the fetus. Bacteriuria in pregnancy accounts for a significantly higher number of newborns with a low birth weight, low gestational age and higher neonatal mortality rate. Therefore, it is necessary to perform screening for bacteriuria in pregnant women and, when the finding is positive, to treat this bacteriuria. The selection of an appropriate antimicrobial agent to treat urinary tract infection in pregnancy is limited by the safety of a given drug not only for the woman, but particularly for the fetus. The article provides an overview of medications that can be safely used throughout the pregnancy or only in certain stages of pregnancy. The selection of an appropriate antibiotic should always be preceded by the result of urine culture. The article presents the principles and rules for treating asymptomatic bacteriuria, acute cystitis and acute pyelonephritis in pregnant women.

  15. [Selective cervical dorsal root cutting off part of the vertebral lateral mass fixation combined with exercise therapy for treating spastic cerebral paralysis of the upper limbs caused by cerebral palsy].

    Science.gov (United States)

    Zhang, Peng; Hu, Wei; Cao, Xu; Xu, Shi-gang; Li, De-kui; Xu, Lin

    2009-10-01

    To explore the feasibility and the result for the surgical treatment of spastic cerebral paralysis of the upper limbs in patients who underwent the selective cervical dorsal root cutting off part of the vertebral lateral mass fixation combined with exercise therapy. From March 2004 to April 2008, 27 patients included 19 boys and 8 girls, aging 13-21 years with an average of 15 years underwent selective cervical dorsal root cutting off part of the vertebral lateral mass fixation with exercise therapy. The AXIS 8 holes titanium plate was inserted into the lateral mass of spinous process through guidance of the nerve stimulator, choosed fasciculus of low-threshold nerve dorsal root and cut off its 1.5 cm. After two weeks, training exercise therapy was done in patients. Training will include lying position, turning body, sitting position, crawling, kneeling and standing position, walking and so on. Spastic Bobath inhibiting abnormal pattern was done in the whole process of training. The muscular tension, motor function (GMFM), functional independence (WeeFIM) were observed after treatment. All patients were followed up from 4 to 16 months with an average of 6 months. Muscular tension score were respectively 3.30 +/- 0.47 and 1.25 +/- 0.44 before and after treatment;GMFM score were respectively 107.82 +/- 55.17 and 131.28 +/- 46.45; WeeFIM score were respectively 57.61 +/- 25.51 and 87.91 +/- 22.39. There was significant improvement before and after treatment (P cerebral paralysis of the upper limbs is safe and effective method, which can decrease muscular tension and improve motor function, which deserves more wide use.

  16. Comparative study of the displacement of the selected clips in the cavity measured by orthogonal kilovoltage X-ray film in conditions of free breath and active breathing control for patients treated by external-beam partial breast irradiation

    International Nuclear Information System (INIS)

    Li Jianbin; Han Lei; Zhang Yingjie; Xu Min; Fan Tingyong; Shao Qing; Gong Guanzhong

    2010-01-01

    Objective: To compare the displacements of the clips in the cavity measured with orthogonal kilovoltage (KV) X-my plain film in conditions of moderate deep inspiration breathing hold (mDIBH) and free breath (FB), and compare the margins from clinical target volume (CTV) to planning target volume (PTV) based on the displacements. Methods: Before radiotherapy, 2 and 5 sets of orthogonal KV plain film were respectively collected in mDIBH and FB group, then the automatic registration of the reconstructed KV plain film and DRR derived from the planning CT images was finished. In conditions of mDIBH and FB, the displacements of the selected clip at the same location in the different directions and of the different selected clips in the same direction were compared. The margins in three dimensional directions were calculated and compared in conditions of mDIBH and FB. Results: In FB hold group, the difference of displacement in left-right (LR), cranial-caudal (CC) and anterior-posterior (AP) directions were statistically significant between the clips at the cranial and caudal border of the cavity (9.7 mm and 10.6 nun (Z = -2.12, P =0.037) ,7.3 mm and 8.3 mm (Z = -2.31 ,P=0.041) ,15.5 mm and 16.1 nun (Z = -2.32,P = 0.041)), but not statistically significant for the clips at the bottom and lateral P=0.814),15.7 mm and 16.5 mm (Z=-0.26, P=0.856)). The corresponding differences in the different directions were statistically significant (5.0 mm and 7.8 mm(Z = -2.31, P =0.036), 5.0 mm and 9. 3 nun (Z= -2.21, P=0.021), 7.8 mm and 9.3 mm (Z= -2.11, P=0.041)). In FB group, the differences of the displacements of the four selected clips were statistically significant in CC and AP directions (7.3 mm and 8.4 mm (Z= -2.45, P=0.021), 15.5 mm and 16.5 mm (Z= -2.41, P= 0.043)), but not in LF direction (10.6 nun and 10.6 mm (Z= -0.24, P=0.815)). In mDIBH group, the displacements in LF direction were statistically significant (4.4 mm and 5.4 mm (Z = -2.31, P = O. 031)), but not in CC and

  17. Legislation on treating animals in human care

    OpenAIRE

    Konečná, Petra

    2016-01-01

    1 Abstract This Master's thesis entitled Legislation on treating animals in human care compares Czech and Australian legislation in selected aspects of three categories of animals in human care - farm animals, companion animals and animals used for scientific and other research purposes. The thesis is composed of 5 main chapters. The first chapter describes sources of law regarding treating animals in human care from the perspectives of international law, European Union law, federal Czech law...

  18. Selective retina therapy (SRT)

    International Nuclear Information System (INIS)

    Brinkmann, R.; Birngruber, R.

    2007-01-01

    Selective Retina Therapy (SRT) is a new and very gentle laser method developed at the Medical Laser Center Luebeck. It is currently investigated clinically in order to treat retinal disorders associated with a decreased function of the retinal pigment epithelium (RPE). SRT is designed to selectively effect the RPE while sparing the neural retina and the photoreceptors as well as the choroid. Aim of the therapy is the rejuvenation of the RPE in the treated areas, which should ideally lead to a long term metabolic increase at the chorio-retinal junction. In contrast to conventional laser photocoagulation, which is associated with a complete thermal necrosis of the treated site, SRT completely retains full vision. This paper reviews the methods and mechanisms behind selective RPE effects and reports the first clinical results. An online dosimetry technique to visualize the ophthalmoscopically invisible effects is introduced. (orig.)

  19. Dandruff: How to Treat

    Medline Plus

    Full Text Available ... NP/PA laws Action center Public and patients SPOT Skin Cancer™ Community programs & events Learn about skin cancer ... and scalp problems Dandruff: How to treat public SPOT Skin Cancer™ Diseases and treatments Acne and rosacea Bumps ...

  20. Dandruff: How to Treat

    Medline Plus

    Full Text Available ... NP/PA laws Action center Public and patients SPOT Skin Cancer™ Community programs & events Learn about skin ... and scalp problems Dandruff: How to treat public SPOT Skin Cancer™ Diseases and treatments Acne and rosacea ...

  1. Dandruff: How to Treat

    Medline Plus

    Full Text Available ... hair, and nail care Skin care Hair care / hair loss Injured skin Nail care Anti-aging skin care ... scalp problems Alopecia areata Dandruff: How to treat Hair loss Scalp psoriasis Itchy skin Painful skin / joints Rashes ...

  2. Dandruff: How to Treat

    Medline Plus

    Full Text Available ... hair, and nail care Skin care Hair care / hair loss Injured skin Nail care Anti-aging skin care ... sweaty skin Eczema / dermatitis Hair and scalp problems Alopecia areata Dandruff: How to treat Hair loss Scalp ...

  3. Dandruff: How to Treat

    Medline Plus

    Full Text Available ... the causes, which appear to be complex. The most effective way to treat and control dandruff is ... when outdoors and seeking shade whenever possible. For most people, dandruff does not require medical attention. However, ...

  4. Dandruff: How to Treat

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    Full Text Available ... Meet our partners Español Donate Diseases and treatments Acne and rosacea Bumps and growths Color problems Contagious ... treat public SPOT Skin Cancer™ Diseases and treatments Acne and rosacea Bumps and growths Color problems Contagious ...

  5. Dandruff: How to Treat

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    Full Text Available ... C. Fox Award and Lectureship Grants from outside organizations Health Volunteers Overseas Grant Honorary International Society Meeting ... complex. The most effective way to treat and control dandruff is to use dandruff shampoo and scalp ...

  6. Dandruff: How to Treat

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    Full Text Available ... Rotation PICMED Grant Professionalism Award Resident-Fellow QI Project Award Resident International Grant Resident Scholarship to Legislative ... are still studying the causes, which appear to be complex. The most effective way to treat and ...

  7. Dandruff: How to Treat

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    Full Text Available ... treat and control dandruff is to use dandruff shampoo and scalp treatments. Follow these tips from dermatologists ... best results: Follow the instructions on the dandruff shampoo bottle: There are many different dandruff shampoos, and ...

  8. Dandruff: How to Treat

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    Full Text Available ... Skin Knowledge lesson plans and activities Video library Find a dermatologist Why see a board-certified dermatologist? ... hair, and nail care Kids’ zone Video library Find a dermatologist Dandruff: How to treat Dandruff is ...

  9. Dandruff: How to Treat

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    Full Text Available ... World Dialogues in Dermatology JAAD Mohs AUC MyDermPath+ Psoriasis Patient education resources Practice Management Center Coding and ... areata Dandruff: How to treat Hair loss Scalp psoriasis Itchy skin Painful skin / joints Rashes Scaly skin ...

  10. Dandruff: How to Treat

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    Full Text Available ... and patients Diseases and treatments Hair and scalp problems Dandruff: How to treat public SPOT Skin Cancer™ Diseases and treatments Acne and rosacea Bumps and growths Color problems Contagious skin diseases Cosmetic treatments Dry / sweaty skin ...

  11. Dandruff: How to Treat

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    Full Text Available ... skin, hair, and nails Skin dictionary Camp Discovery Good Skin Knowledge lesson plans and ... Dandruff: How to treat Dandruff is a common scalp condition in which small pieces of dry ...

  12. Dandruff: How to Treat

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    Full Text Available ... Hair and scalp problems Dandruff: How to treat public SPOT Skin Cancer™ Diseases and treatments Acne and ... Member resources Practice Tools Education Meetings & events Advocacy Public & patients Academy resources for: Dermatologists in the US ...

  13. Dandruff: How to Treat

    Medline Plus

    Full Text Available ... Mohs AUC MyDermPath+ Psoriasis Patient education resources Practice Management Center Coding and reimbursement Coding MACRA Fee schedule ... complex. The most effective way to treat and control dandruff is to use dandruff shampoo and scalp ...

  14. Electrolyte Concentrates Treat Dehydration

    Science.gov (United States)

    2009-01-01

    Wellness Brands Inc. of Boulder, Colorado, exclusively licensed a unique electrolyte concentrate formula developed by Ames Research Center to treat and prevent dehydration in astronauts returning to Earth. Marketed as The Right Stuff, the company's NASA-derived formula is an ideal measure for athletes looking to combat dehydration and boost performance. Wellness Brands also plans to expand with products that make use of the formula's effective hydration properties to help treat conditions including heat stroke, altitude sickness, jet lag, and disease.

  15. Intention-to-treat

    OpenAIRE

    Molenberghs, Geert

    2005-01-01

    The randomized clinical trial paradigm is sketched, as well as the foundations on which its validity is based. Issues that jeopardize this validity, such as patient noncompliance and early withdrawal, are discussed. Intention to treat, being an important historical answer to this problem, is introduced, together with a set of criticisms and an indication of alternative approaches. as-treated analysis;clinical trial;incomplete data;last observation carried forward;randomization

  16. Treating chancroid with enoxacin.

    Science.gov (United States)

    Naamara, W; Kunimoto, D Y; D'Costa, L J; Ndinya-Achola, J O; Nsanze, H; Ronald, A R; Plummer, F A

    1988-01-01

    Increasing resistance of Haemophilus ducreyi to antimicrobials necessitates further trials of new antimicrobial agents for treating chancroid. Enoxacin has excellent in vitro activity against H ducreyi, and a randomised clinical trial of three doses of enoxacin 400 mg at intervals of 12 hours compared with a single dose of trimethoprim/sulphametrole (TMP/SMT) 640/3200 mg was therefore conducted. Of 169 men enrolled in the study, 86 received enoxacin and 83 received TMP/SMT. Ulcers were improved or cured in 65/73 men treated with enoxacin and 57/70 men treated with TMP/SMT. This difference was not significant. At 72 hours after treatment, H ducreyi was eradicated from ulcers of 72/77 men treated with enoxacin and of 67/74 of those treated with TMP/SMT. Patients with buboes responded equally well to both treatments. Of 100 H ducreyi strains tested, all were susceptible to both 0.25 mg/l enoxacin and the combination of 0.25 mg/l TMP and 5 mg/l SMT. Although most men treated with either regimen were cured, neither regimen appeared to be the optimum treatment for chancroid. This study shows the efficacy of enoxacin for a soft tissue infection caused by Gram negative organisms. PMID:3044978

  17. Acupuncture for treating fibromyalgia

    Science.gov (United States)

    Deare, John C; Zheng, Zhen; Xue, Charlie CL; Liu, Jian Ping; Shang, Jingsheng; Scott, Sean W; Littlejohn, Geoff

    2014-01-01

    Background One in five fibromyalgia sufferers use acupuncture treatment within two years of diagnosis. Objectives To examine the benefits and safety of acupuncture treatment for fibromyalgia. Search methods We searched CENTRAL, PubMed, EMBASE, CINAHL, National Research Register, HSR Project and Current Contents, as well as the Chinese databases VIP and Wangfang to January 2012 with no language restrictions. Selection criteria Randomised and quasi-randomised studies evaluating any type of invasive acupuncture for fibromyalgia diagnosed according to the American College of Rheumatology (ACR) criteria, and reporting any main outcome: pain, physical function, fatigue, sleep, total well-being, stiffness and adverse events. Data collection and analysis Two author pairs selected trials, extracted data and assessed risk of bias. Treatment effects were reported as standardised mean differences (SMD) and 95%confidence intervals (CI) for continuous outcomes using different measurement tools (pain, physical function, fatigue, sleep, total well-being and stiffness) and risk ratio (RR) and 95% CI for dichotomous outcomes (adverse events).We pooled data using the random-effects model. Main results Nine trials (395 participants) were included. All studies except one were at low risk of selection bias; five were at risk of selective reporting bias (favouring either treatment group); two were subject to attrition bias (favouring acupuncture); three were subject to performance bias (favouring acupuncture) and one to detection bias (favouring acupuncture). Three studies utilised electro-acupuncture (EA) with the remainder using manual acupuncture (MA) without electrical stimulation. All studies used ’formula acupuncture’ except for one, which used trigger points. Low quality evidence from one study (13 participants) showed EA improved symptoms with no adverse events at one month following treatment. Mean pain in the non-treatment control group was 70 points on a 100 point scale

  18. Process for treating biomass

    Science.gov (United States)

    Campbell, Timothy J.; Teymouri, Farzaneh

    2018-04-10

    This invention is directed to a process for treating biomass. The biomass is treated with a biomass swelling agent within the vessel to swell or rupture at least a portion of the biomass. A portion of the swelling agent is removed from a first end of the vessel following the treatment. Then steam is introduced into a second end of the vessel different from the first end to further remove swelling agent from the vessel in such a manner that the swelling agent exits the vessel at a relatively low water content.

  19. Bioremediation of treated wood with fungi

    Science.gov (United States)

    Barbara L. Illman; Vina W. Yang

    2006-01-01

    The authors have developed technologies for fungal bioremediation of waste wood treated with oilborne or metal-based preservatives. The technologies are based on specially formulated inoculum of wood-decay fungi, obtained through strain selection to obtain preservative-tolerant fungi. This waste management approach provides a product with reduced wood volume and the...

  20. Dandruff: How to Treat

    Medline Plus

    Full Text Available ... see a board-certified dermatologist? Home Public and patients Diseases and treatments Hair and scalp problems Dandruff: How to treat ... can properly diagnose your condition and recommend a treatment plan that best meets your needs. FIND A FREE SPOTme® SKIN CANCER SCREENING ... & patients Academy resources for: Dermatologists in the US and ...

  1. Dandruff: How to Treat

    Medline Plus

    Full Text Available ... which appear to be complex. The most effective way to treat and control dandruff is to use dandruff shampoo and scalp treatments. Follow these tips from dermatologists to get the best results: Follow the instructions on the dandruff shampoo ...

  2. Treat upgrade fuel fabrication

    International Nuclear Information System (INIS)

    Davidson, K.V.; Schell, D.H.

    1979-01-01

    An extrusion and thermal treatment process was developed to produce graphite fuel rods containing a dispersion of enriched UO 2 . These rods will be used in an upgraded version of the Transient Reactor Test Facility (TREAT). The improved fuel provides a higher graphite matrix density, better fuel dispersion and higher thermal capabilities than the existing fuel

  3. Dandruff: How to Treat

    Medline Plus

    Full Text Available ... problems Dandruff: How to treat public SPOT Skin Cancer™ Diseases and treatments Acne and rosacea Bumps and growths Color problems ... can properly diagnose your condition and recommend a treatment plan that best meets your needs. FIND A FREE SPOTme® ... FIND A DERMATOLOGIST Advanced Search Explore the ...

  4. Treating hydrocarbon oils

    Energy Technology Data Exchange (ETDEWEB)

    Knottenbelt, H W

    1910-04-13

    An improved process of treating petroleum and shale oils is disclosed consisting in separating by distillation fractions suitable after treatment as a substitute for turpentine and for illuminating purposes respectively such treatment consisting in separating any tar bodies that may be present and subjecting the fractions to the action of a solution of ammonia carrying litmus, substantially as and for the purpose set forth.

  5. Inkjet Printing of Functional Materials on Selectively Plasma Treated Surfaces

    NARCIS (Netherlands)

    ir Martijn van Dongen; ir Renee Verkuijlen; Dr Jan Bernards

    2011-01-01

    In manufacturing of organic electronics, inkjet printing as an alternative technique for depositing materials is becoming increasingly important. Aside to the ink formulations challenges, improving the resolution of the printed patterns is a major goal. In this study we will discuss a newly

  6. Process of treating tars

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, C; Hempel, H; Weissenburger, H

    1955-05-05

    A process is described for treating tars or tar oils, especially carbonization tars, characterized in that the tars or tar oils are mixed with benzene or light oils which contain no aromatic material or only slight amounts, or with gas oil in such amounts that the asphalt precipitates, and after separation of the precipitated material the mixture is treated with caustic solution for separation of the phenols, and after separation of the phenolate liquor the mixture is subjected to heating for removal of the dilution medium, then the remaining oil can be used as heating oil or it is submitted to distillation for the purpose of recovering a fuel suitable for diesel motors, while the phenolate liquor is worked up into phenols.

  7. Treating mine water

    Energy Technology Data Exchange (ETDEWEB)

    Matlak, E S; Kochegarova, L V; Zaslavskaya, I Yu

    1980-10-01

    Taking into account the negative influence of mine waters with suspended matter on the natural environment on the surface, the maximum treatment of mine water underground, is proposed. It is noted that full treatment of mine water, using conventional filtration methods, would be rather expensive, but a limited treatment of mine water is possible. Such treated mine water can be used in dust suppression and fire fighting systems. Mine water treated underground should be free of any odor, with pH level ranging from 6 to 9.5, with suspended matter content not exceeding 50 mg/l and coli-titre not less than 300 cm$SUP$3. It is suggested that water treatment to produce water characterized by these parameters is possible and economical. Recommendations on construction of underground sedimentation tanks and channels, and a hydraulic system of cleaning sedimentation tanks are proposed. The settling would be stored underground in abandoned workings. (2 refs.) (In Russian)

  8. Method of treating depression

    Science.gov (United States)

    Henn, Fritz [East Patchogue, NY

    2012-01-24

    Methods for treatment of depression-related mood disorders in mammals, particularly humans are disclosed. The methods of the invention include administration of compounds capable of enhancing glutamate transporter activity in the brain of mammals suffering from depression. ATP-sensitive K.sup.+ channel openers and .beta.-lactam antibiotics are used to enhance glutamate transport and to treat depression-related mood disorders and depressive symptoms.

  9. Gas treating absorption theory and practice

    CERN Document Server

    Eimer, Dag

    2014-01-01

    Gas Treating: Absorption Theory and Practice provides an introduction to the treatment of natural gas, synthesis gas and flue gas, addressing why it is necessary and the challenges involved.  The book concentrates in particular on the absorption-desorption process and mass transfer coupled with chemical reaction. Following a general introduction to gas treatment, the chemistry of CO2, H2S and amine systems is described, and selected topics from physical chemistry with relevance to gas treating are presented. Thereafter the absorption process is discussed in detail, column hardware is explain

  10. Treating oil shale

    Energy Technology Data Exchange (ETDEWEB)

    Dolbear, S H

    1921-01-04

    Oil shale is treated for the separation of the valuable organic compounds, with a view to economy in subsequent destructive distillation, by grinding to powder, mixing with water to form a pulp, adding a small quantity of an oil liquid and aerating the mixture to form a froth containing the organic compounds. If the powdered shale contains sufficient free oil, the addition of oil to the pulp may be dispensed with. In some cases an electrolyte such as sulfuric acid may be added to the pulp.

  11. Eumycetoma Treated With Ketoconazole

    Directory of Open Access Journals (Sweden)

    Mittal Radha Rani

    1997-01-01

    Full Text Available A 43 year old female had progressive indolent, firm, tender, nodular swellings with multiple sinuses discharging pus containing black granules on left foot and ankle since 3 years. Smear of granule showed dark brown irregular mass with hyphae towards the periphery. Superimposed E. coli infection was treated with cefadroxyl 500 mg B.D Histopathologically marked acanthosis of epidermis , dense collection of mononuclear PMNL’s, plasma cells around granules of maduramycosis were seen. X-ray foor showed osteolytic lesions and culture was negative. Satisfactory and progressive improvement occurred after 7 weeks of therapy with ketoconozole 200 mg.

  12. Young Children Treat Robots as Informants.

    Science.gov (United States)

    Breazeal, Cynthia; Harris, Paul L; DeSteno, David; Kory Westlund, Jacqueline M; Dickens, Leah; Jeong, Sooyeon

    2016-04-01

    Children ranging from 3 to 5 years were introduced to two anthropomorphic robots that provided them with information about unfamiliar animals. Children treated the robots as interlocutors. They supplied information to the robots and retained what the robots told them. Children also treated the robots as informants from whom they could seek information. Consistent with studies of children's early sensitivity to an interlocutor's non-verbal signals, children were especially attentive and receptive to whichever robot displayed the greater non-verbal contingency. Such selective information seeking is consistent with recent findings showing that although young children learn from others, they are selective with respect to the informants that they question or endorse. Copyright © 2016 Cognitive Science Society, Inc.

  13. Treating hydrocarbon oils

    Energy Technology Data Exchange (ETDEWEB)

    Scott, R; MacIvor, W

    1869-09-01

    The treatment of hydrocarbon oils, such as coal or shale oils, paraffin oils, and petroleum, either in the crude or more or less refined state has the object of reducing the specific gravity and otherwise improving the qualities of such oils. The oil to be treated is put into any ordinary still and distilled. The vapor escaping during the distillation is passed through one or more heating vessels or chambers and exposed to the heat necessary to produce the change. The heating vessels or chambers may be made of metal, clay, or any other material adapted to endure heat, and they may be made of any desired form, or they may be constituted of a coil of metal pipes or a series of tubes such as are used for heating air for blast furnaces.

  14. Transient mutism after anterior transcallosal approach | Naama ...

    African Journals Online (AJOL)

    African Journal of Neurological Sciences. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 34, No 1 (2015) >. Log in or Register to get access to full text downloads.

  15. Monoclonal antibodies for treating cancer

    International Nuclear Information System (INIS)

    Dillman, R.O.

    1989-01-01

    The purpose of this study is to assess the current status of in-vivo use of monoclonal antibodies for treating cancer. Publications appearing between 1980 and 1988 were identified by computer searches using MEDLINE and CANCERLIT, by reviewing the table of contents of recently published journals, and by searching bibliographies of identified books and articles. More than 700 articles, including peer-reviewed articles and book chapters, were identified and selected for analysis. The literature was reviewed and 235 articles were selected as relevant and representative of the current issues and future applications for in-vivo monoclonal antibodies for cancer therapy and of the toxicity and efficacy which has been associated with clinical trials. Approaches include using antibody alone (interacting with complement or effector cells or binding directly with certain cell receptors) and immunoconjugates (antibody coupled to radioisotopes, drugs, toxins, or other biologicals). Most experience has been with murine antibodies. Trials of antibody alone and radiolabeled antibodies have confirmed the feasibility of this approach and the in-vivo trafficking of antibodies to tumor cells. However, tumor cell heterogeneity, lack of cytotoxicity, and the development of human antimouse antibodies have limited clinical efficacy. Although the immunoconjugates are very promising, heterogeneity and the antimouse immune response have hampered this approach as has the additional challenge of chemically or genetically coupling antibody to cytotoxic agents. As a therapeutic modality, monoclonal antibodies are still promising but their general use will be delayed for several years. New approaches using human antibodies and reducing the human antiglobulin response should facilitate treatment. 235 references

  16. Drugs for treating giardiasis.

    Science.gov (United States)

    Granados, Carlos E; Reveiz, Ludovic; Uribe, Luis G; Criollo, Claudia P

    2012-12-12

    Giardiasis infection may be asymptomatic, or can cause diarrhoea (sometimes severe), weight loss, malabsorption, and, in children, failure to thrive. It is usually treated with metronidazole given three times daily for five to 10 days. To evaluate the relative effectiveness of alternative antibiotic regimens for treating adults or children with symptomatic giardiasis. We searched the Cochrane Infectious Disease Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 6 2012); MEDLINE, EMBASE, LILACS and the International Clinical Trials Registry Platform Search Portal (3 July 2012). We included randomized controlled trials (RCT) comparing metronidazole administered for five to 10 days with any of the following drugs: metronidazole (single dose), tinidazole, albendazole, mebendazole, and nitazoxanide. The primary outcomes were parasitological and clinical cure. Two authors independently assessed studies for inclusion, performed the risk of bias assessment, and extracted data. We summarized data using risk ratios and mean differences and we presented the results in forest plots and performed meta-analyses where possible. We assessed heterogeneity using the Chi(2) test, I(2) statistic and visual inspection; and we explored this by using subgroup analyses.We assessed the quality of evidence by using the GRADE approach. We included 19 trials, involving 1817 participants, of which 1441 were children. Studies were generally small, with poor methods reporting. . Most reported parasitological outcomes rather than clinical improvement.Ten trials, from India, Mexico, Peru, Iran, Cuba, and Turkey, compared albendazole (400 mg once daily for five to 10 days) with metronidazole (250 mg to 500 mg three times daily for five to 10 days). This once-daily regimen of albendazole is probably equivalent to metronidazole at achieving parasitological cure (RR 0.99, 95% CI 0.95 to 1.03; 932 participants, 10 trials; moderate quality evidence), and

  17. Site selection

    CERN Multimedia

    CERN PhotoLab

    1968-01-01

    To help resolve the problem of site selection for the proposed 300 GeV machine, the Council selected "three wise men" (left to right, J H Bannier of the Netherlands, A Chavanne of Switzerland and L K Boggild of Denmark).

  18. Benchmark selection

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Tvede, Mich

    2002-01-01

    Within a production theoretic framework, this paper considers an axiomatic approach to benchmark selection. It is shown that two simple and weak axioms; efficiency and comprehensive monotonicity characterize a natural family of benchmarks which typically becomes unique. Further axioms are added...... in order to obtain a unique selection...

  19. Chemical oxidizers treat wastewater

    International Nuclear Information System (INIS)

    Stephenson, F.A.

    1992-01-01

    Based on the inherent benefits of these original oxidation systems, a second generation of advanced oxidation processes (AOPs) has emerged. These processes combine key features of the first generation technologies with more sophisticated advances in UV technology, such as the new pulsed plasma xenon flash lamp that emits high-energy, high-intensity UV light. Second generation systems can be equipped with a transmittance controller to prevent lamp fouling or scaling. The coupling of the first generation's technology with the new UV sources provides the rapid destruction of chlorinated and nonchlorinated hydrocarbons and humic acids from contaminated water. It also is effective in the treatment of organic laden gases from soil vapor extraction systems. AOPs may promote the oxidation (and subsequent removal) of heavy metals in water, though few data are available to verify the claim. The success of AOPs, including ozonation with UV light, hydrogen peroxide with UV light and advanced photolysis, is linked with their creation of hydroxyl-free radicals (OH·) that are effective in eliminating contaminants such as formaldehyde, chlorinated hydrocarbons and chlorinated solvents. Hydroxyl free-radicals are consumed in microsecond reactions and exhibit little substrate selectivity with the exception of halogenated alkanes such as chloroform. They can act as chain carriers. Given their power, hydroxyl free-radicals react with virtually all organic solutes more quickly (especially in water) than any other oxidants, except fluorine. There are projects that have found the combination of some AOPs to be the most efficient organic destruction techniques for the job. For example, one project successfully remediated groundwater contaminated with gasoline and Number 2 diesel through successive treatments of ozone and hydrogen peroxide with ultraviolet light, followed by granular activated carbon. 5 refs., 2 tabs

  20. 关节对应取穴法配合运动针刺治疗急性踝关节扭伤疗效分析%Analysis of the Efficacy of Joint-corresponding Point Selection plus Exercise Acupuncture in Treating Acute Ankle Sprain

    Institute of Scientific and Technical Information of China (English)

    裴春勤; 魏瑛

    2017-01-01

    目的 观察关节对应取穴法配合运动针刺治疗急性踝关节扭伤的临床疗效.方法 选取70例急性踝关节扭伤的患者,随机分为两组,每组35例.治疗组采用关节对应取穴配合运动针刺法治疗,对照组采用弹力绷带固定,两组均配合冰敷、制动抬高等辅助措施.7d为1个疗程,共治疗2个疗程.观察并记录治疗前后两组患者疼痛、压痛、肿胀、活动范围评分变化,并比较疗效.结果 治疗组愈显率为88.6%,对照组愈显率为54.3%,治疗组明显优于对照组(P<0.01).治疗后两组关节疼痛、压痛、肿胀、活动范围评分减少(P<0.01);治疗后治疗组关节压痛、活动范围评分低于对照组(P<0.05).结论 应用关节对应取穴法配合运动针刺治疗急性踝关节扭伤临床疗效明显.%Objective To investigate the clinical efficacy of joint-corresponding point selection plus exercise acupuncture in treating acute ankle sprain.Method Enrolled 70 patients with acute ankle sprain were randomly allocated to two groups.The treatment group received joint-corresponding point selection plus exercise acupuncture and the control group,elastic bandage fixation.Both groups were given ice compress,mobilizationand elevation as auxiliary measures.Treatment was provided seven days as one coursefor a total of two courses.The pain, tenderness, swelling andrange of activitieswere scored in the two groups of patients before and after treatment.Thetherapeutic effects were compared.Result The total efficacy rate was 88.6% in the treatment groupand54.3% in the control group.The therapeutic effect was significantly better in the treatment group than in the control group (P<0.01). Joint pain, tenderness, swelling and activity scores decreased in the two groups after treatment (P<0.01). Joint tenderness and activity scores were lower in the treatment group than in the control group after treatment (P<0.01).Conclusion Joint-corresponding point selection plus exercise

  1. Process of treating surfaces of metals

    International Nuclear Information System (INIS)

    Kimura, T.; Murao, A.; Kuwahara, T.

    1975-01-01

    Both higher corrosion resistance and paint adherence are given to films formed on the surfaces of metals by treating the surfaces with aqueous solutions of one or more materials selected from the group consisting of water soluble vinyl monomer or water soluble high polymer and then irradiating with ionizing radioactive rays on the nearly dried surface film. When a water soluble inorganic compound is mixed with the above mentioned aqueous solution, the film properties are greatly improved. The inorganic ionic material should contain a cation from the group consisting of Ca, Mg, Zn, Cr, Al, Fe, and Ni. Electron beams may be used. (U.S.)

  2. Upgrading of TREAT experimental capabilities

    International Nuclear Information System (INIS)

    Dickerman, C.E.; Rose, D.; Bhattacharyya, S.K.

    1982-01-01

    The TREAT facility at the Argonne National Laboratory site in the Idaho National Engineering Laboratory is being upgraded to provide capabilities for fast-reactor-safety transient experiments not possible at any other experimental facility. Principal TREAT Upgrade (TU) goal is provision for 37-pin size experiments on energetics of core-disruptive accidents (CDA) in fast breeder reactor cores with moderate sodium void coefficients. this goal requires a significant enhancement of the capabilities of the TREAT facility, specifically including reactor control, hardened neutron spectrum incident on the test sample, and enlarged building. The upgraded facility will retain the capability for small-size experiments of the types currently being performed in TREAT. Reactor building and crane upgrading have been completed. TU schedules call for the components of the upgraded reactor system to be finished in 1984, including upgraded TREAT fuel and control system, and expanded coverage by the hodoscope fuel-motion diagnostics system

  3. Antimicrobial drugs for treating cholera

    Science.gov (United States)

    Leibovici-Weissman, Ya'ara; Neuberger, Ami; Bitterman, Roni; Sinclair, David; Salam, Mohammed Abdus; Paul, Mical

    2014-01-01

    Background Cholera is an acute watery diarrhoea caused by infection with the bacterium Vibrio cholerae, which if severe can cause rapid dehydration and death. Effective management requires early diagnosis and rehydration using oral rehydration salts or intravenous fluids. In this review, we evaluate the additional benefits of treating cholera with antimicrobial drugs. Objectives To quantify the benefit of antimicrobial treatment for patients with cholera, and determine whether there are differences between classes of antimicrobials or dosing schedules. Search methods We searched the Cochrane Infectious Disease Group Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; African Index Medicus; LILACS; Science Citation Index; metaRegister of Controlled Trials; WHO International Clinical Trials Registry Platform; conference proceedings; and reference lists to March 2014. Selection criteria Randomized and quasi-randomized controlled clinical trials in adults and children with cholera that compared: 1) any antimicrobial treatment with placebo or no treatment; 2) different antimicrobials head-to-head; or 3) different dosing schedules or different durations of treatment with the same antimicrobial. Data collection and analysis Two reviewers independently applied inclusion and exclusion criteria, and extracted data from included trials. Diarrhoea duration and stool volume were defined as primary outcomes. We calculated mean difference (MD) or ratio of means (ROM) for continuous outcomes, with 95% confidence intervals (CI), and pooled data using a random-effects meta-analysis. The quality of evidence was assessed using the GRADE approach. Main results Thirty-nine trials were included in this review with 4623 participants. Antimicrobials versus placebo or no treatment Overall, antimicrobial therapy shortened the mean duration of diarrhoea by about a day and a half compared to placebo or no treatment (MD -36.77 hours, 95% CI -43

  4. Selective oxidation

    International Nuclear Information System (INIS)

    Cortes Henao, Luis F.; Castro F, Carlos A.

    2000-01-01

    It is presented a revision and discussion about the characteristics and factors that relate activity and selectivity in the catalytic and not catalytic partial oxidation of methane and the effect of variables as the temperature, pressure and others in the methane conversion to methanol. It thinks about the zeolites use modified for the catalytic oxidation of natural gas

  5. Selective gossip

    NARCIS (Netherlands)

    Üstebay, D.; Castro, R.M.; Rabbat, M.

    2009-01-01

    Motivated by applications in compression and distributed transform coding, we propose a new gossip algorithm called Selective Gossip to efficiently compute sparse approximations of network data. We consider running parallel gossip algorithms on the elements of a vector of transform coefficients.

  6. Inspection methods and their selection

    International Nuclear Information System (INIS)

    Maier, H.J.

    1980-01-01

    First those nondestructive testing methods, which are used in quality assurance, are to be treated, e.g. - ultrasonics - radiography - magnetic particle testing - dye penetrant testing - eddy currents, and their capabilities and limitations are shown. Second the selection of optimal testing methods under the aspect of defect recognition in different materials and components are shown. (orig./RW)

  7. Treat mine water using passive methods

    International Nuclear Information System (INIS)

    Kleinmann, R.L.P.; Hedin, R.S.

    1993-01-01

    Passive treatment represents an alternative to conventional chemical treatment of coal mine drainage. When successful, passive systems require less investment, less maintenance and usually are less expensive than conventional chemical treatment systems. As a result, during the last seven years, more than 500 passive systems have been constructed in the United States to treat coal mine drainage. Some exist as an alternative to conventional treatment; others serve as an inexpensive pretreatment step than can decrease subsequent chemical requirements. Sulfide minerals present in rock disturbed during mining can oxidize to form an acidic metal-laden solution, commonly known as acid mine drainage (AMD). Alkalinity present in the rock may partially or completely neutralize AMD, but if either acidity or excessive metal contaminants remain, the water must be treated before it can be discharged legally. The principal regulated contaminant metals of coal mine drainage are iron and manganese. Metal mine drainage often contains more toxic metals, such as cadmium, nickel, copper and zinc. Chemical treatment of AMD is estimated to cost America's mining industry more than $1 million a day. Three principal passive technologies are used in the treatment of coal mine drainage: Aerobic wetlands, wetlands constructed with an organic substrate and anoxic limestone drains (ALDS). The selection of the technology or combination of technologies to be used depends on the quality of the water being treated

  8. Selective impairment of verb processing associated with pathological changes in Brodmann areas 44 and 45 in the motor neurone disease-dementia-aphasia syndrome.

    Science.gov (United States)

    Bak, T H; O'Donovan, D G; Xuereb, J H; Boniface, S; Hodges, J R

    2001-01-01

    We report six patients with clinically diagnosed and electrophysiologically confirmed motor neurone disease (MND), in whom communication problems were an early and dominant feature. All patients developed a progressive non-fluent aphasia culminating in some cases in complete mutism. In five cases, formal testing revealed deficits in syntactic comprehension. Comprehension and production of verbs were consistently more affected those that of nouns and this effect remained stable upon subsequent testing, despite overall deterioration. The classical signs of MND, including wasting, fasciculations and severe bulbar symptoms, occurred over the following 6-12 months. The behavioural symptoms ranged from mild anosognosia to personality change implicating frontal-lobe dementia. In three cases, post-mortem examination has confirmed the clinical diagnosis of MND-dementia. In addition to the typical involvement of motor and premotor cortex, particularly pronounced pathological changes were observed in the Brodmann areas 44 (Broca's area) and 45. The finding of a selective impairment of verb/action processing in association with the dementia/aphasia syndrome of MND suggests that the neural substrate underlying verb representation is strongly connected to anterior cortical motor systems.

  9. Evaluating and Treating Transverse Myelitis

    Science.gov (United States)

    ... myelitis (TM). Neurologists from the American Academy of Neurology are doctors who identify and treat diseases of ... an educational service of the American Academy of Neurology. It is based on an assessment of current ...

  10. Treating Cushing's Disease in Dogs

    Science.gov (United States)

    ... For Consumers Consumer Updates Treating Cushing's Disease in Dogs Share Tweet Linkedin Pin it More sharing options ... FDA Consumer Health Information Your 9-year old dog has been drinking a lot more lately and ...

  11. How to Treat Gestational Diabetes

    Science.gov (United States)

    ... A Listen En Español How to Treat Gestational Diabetes Be sure to see the latest Diabetes Forecast ... and a healthy start for your baby. Gestational Diabetes – Looking Ahead Gestational diabetes usually goes away after ...

  12. Best Medications to Treat Fibromyalgia

    Science.gov (United States)

    ... open('/content/cro/en/health/prescription-drugs/best-buy-drugs/Evaluating_Prescription_Drugs_Used_to_Treat_Fibromyalgia.print. ... price, we have chosen three Consumer Reports Best Buy Drugs as initial options to consider if you and ...

  13. Treating and Preventing Sports Hernias

    Science.gov (United States)

    ... Close ‹ Back to Healthy Living Treating and Preventing Sports Hernias If you play ice hockey, tennis or ... for the most commonly misdiagnosed groin pain—a sports hernia. A sports hernia often results from overuse ...

  14. Treating Obesity As a Disease

    Science.gov (United States)

    ... Obesity, And What You Can Do Understanding the American Obesity Epidemic Stress Management How Does Stress Affect You? ... Keeping the Weight Off • Obesity - Introduction - Understanding the American Obesity Epidemic - Treating Obesity as a Disease - Childhood Obesity ...

  15. Treating P.A.D.

    Science.gov (United States)

    ... Issue Past Issues Special Section Treating P.A.D. Past Issues / Summer 2008 Table of Contents For ... Illustration courtesy of NHLBI Treatment for P.A.D. is designed to reduce a patient's symptoms, prevent ...

  16. Ricardian selection

    OpenAIRE

    Finicelli, Andrea; Pagano, Patrizio; Sbracia, Massimo

    2009-01-01

    We analyze the foundations of the relationship between trade and total factor productivity (TFP) in the Ricardian model. Under general assumptions about the autarky distributions of industry productivities, trade openness raises TFP. This is due to the selection effect of international competition � driven by comparative advantages � which makes "some" high- and "many" low-productivity industries exit the market. We derive a model-based measure of this effect that requires only production...

  17. System of treating flue gas

    International Nuclear Information System (INIS)

    Ziegler, D.L.

    1975-01-01

    A system is described for treating or cleaning incinerator flue gas containing acid gases and radioactive and fissionable contaminants. Flue gas and a quench solution are fed into a venturi and then tangentially into the lower portion of a receptacle for restricting volumetric content of the solution. The upper portion of the receptacle contains a scrub bed to further treat or clean the flue gas

  18. Cryotherapy usage to treat plantar warts

    International Nuclear Information System (INIS)

    Miranda Diaz, BelkisTamara

    2010-01-01

    Treating dermatosis with liquid nitrogen as cryogen (substance generating cold) allows cellular destruction in more than 5 mm depth, making it indispensable to use it treating cutaneous cancers; besides that, it is cheap, easy to conserve and manage, and it is not considered flammable or toxic. Its applying retains the growth factor inside the injury, the collagen is not damaged as it is in burning by hot, there is not almost injury contraction, the perineurium is not altered, and when the tissue necrosis takes place, it retains tissue necrosis factor, helping to increase the necrosis of tissues. Taking into account the high incidence of dermatosis that can be treated with cryogen, in our consultation; we decided to generalize this treatment at the Provincial Interior Ministry Clinic. Plantar warts represent a big percent, limiting our patients in developing their working activities. This cutaneous viral disease is favored by the patients' systemic immunodepressions, hyperhidrosis and podalic disturbances. We selected the patients assisting to our extern al consultation with plantar wart clinical diagnosis in the period from September 2006 to September 2007. They signed an act of informed consent where the possible side effects are explained. Liquid nitrogen was applied with cotton applicators once a week after mechanical reduction. We made a clinical evolving evaluation fortnightly during the treatment, according to the elements and clinical characteristics referred by the patient, and proved by the physical examination carried out by the main investigator, because of the likelihood of short and long time side effects. This investigation demonstrated that cryotherapy is efficacious in treating plantar warts, since all the patients were healed in a short time period, most of them without side effects

  19. Selective Europeanization

    DEFF Research Database (Denmark)

    Hoch Jovanovic, Tamara; Lynggaard, Kennet

    2014-01-01

    and rules. The article examines the reasons for both resistance and selectiveness to Europeanization of the Danish minority policy through a “path dependency” perspective accentuating decision makers’ reluctance to deviate from existing institutional commitments, even in subsequently significantly altered...... political contexts at the European level. We further show how the “translation” of international norms to a domestic context has worked to reinforce the original institutional setup, dating back to the mid-1950s. The translation of European-level minority policy developed in the 1990s and 2000s works most...

  20. Selective Reproduction

    DEFF Research Database (Denmark)

    Svendsen, Mette N.

    2015-01-01

    This article employs a multi-species perspective in investigating how life's worth is negotiated in the field of neonatology in Denmark. It does so by comparing decision-making processes about human infants in the Danish neonatal intensive care unit with those associated with piglets who serve as...... as expectations within linear or predictive time frames are key markers in both sites. Exploring selective reproductive processes across human infants and research piglets can help us uncover aspects of the cultural production of viability that we would not otherwise see or acknowledge....

  1. EDITORIAL: Nanotechnological selection Nanotechnological selection

    Science.gov (United States)

    Demming, Anna

    2013-01-01

    At the nanoscale measures can move from a mass-scale analogue calibration to counters of discrete units. The shift redefines the possible levels of control that can be achieved in a system if adequate selectivity can be imposed. As an example as ionic substances pass through nanoscale pores, the quantity of ions is low enough that the pore can contain either negative or positive ions. Yet precise control over this selectivity still raises difficulties. In this issue researchers address the challenge of how to regulate the ionic selectivity of negative and positive charges with the use of an external charge. The approach may be useful for controlling the behaviour, properties and chemical composition of liquids and has possible technical applications for nanofluidic field effect transistors [1]. Selectivity is a critical advantage in the administration of drugs. Nanoparticles functionalized with targeting moieties can allow delivery of anti-cancer drugs to tumour cells, whilst avoiding healthy cells and hence reducing some of the debilitating side effects of cancer treatments [2]. Researchers in Belarus and the US developed a new theranostic approach—combining therapy and diagnosis—to support the evident benefits of cellular selectivity that can be achieved when nanoparticles are applied in medicine [3]. Their process uses nanobubbles of photothermal vapour, referred to as plasmonic nanobubbles, generated by plasmonic excitations in gold nanoparticles conjugated to diagnosis-specific antibodies. The intracellular plasmonic nanobubbles are controlled by laser fluence so that the response can be tuned in individual living cells. Lower fluence allows non-invasive high-sensitive imaging for diagnosis and higher fluence can disrupt the cellular membrane for treatments. The selective response of carbon nanotubes to different gases has leant them to be used within various different types of sensors, as summarized in a review by researchers at the University of

  2. Pharmacotherapeutic approaches for treating psoriasis in difficult-to-treat areas.

    Science.gov (United States)

    Kivelevitch, Dario; Frieder, Jillian; Watson, Ian; Paek, So Yeon; Menter, M Alan

    2018-04-01

    Despite great therapeutic advancements in psoriasis, four notable difficult-to-treat areas including the scalp, nails, intertriginous (including genitals), and palmoplantar regions, pose a challenge to both physicians and patients. Localized disease of these specific body regions inflicts a significant burden on patients' quality of life and requires an adequate selection of treatments. Areas covered: This manuscript discusses appropriate therapies and important treatment considerations for these difficult-to-treat areas based on the available clinical data from the literature. Expert opinion: Clinical trials assessing therapies for the difficult-to-treat areas have been inadequate. With the first biological clinical trial for genital psoriasis pending publication, it is with hope that other biological agents will be evaluated for region-specific psoriasis. A greater understanding of the genetic and immunologic aspects of regional psoriasis, as well as identification of unique biomarkers, will further guide management decisions. For example, the recent discovery of the IL-36 receptor gene for generalized pustular psoriasis may prove valuable for other forms of psoriasis. Ultimately, identification of the most beneficial treatments for each psoriasis subtype and difficult-to-treat area will provide patients with maximal quality of life.

  3. Do Surgeons Treat Their Patients Like They Would Treat Themselves?

    NARCIS (Netherlands)

    Janssen, Stein J.; Teunis, Teun; Guitton, Thierry G.; Ring, David; Spoor, Andy B.; Chauhan, Aakash; Shafritz, Adam B.; Wasterlain, Amy; Terrono, Andrew L.; Neviaser, Andrew S.; Schmidt, Andrew; Nelson, Andy; Miller, Anna N.; Kristan, Anze; Apard, Thomas; Berner, Arne; Ilyas, Asif; Jubel, Axel; Jost, Bernhard; Babis, George; Watkins, Barry; Kreis, Barbara; Nolan, Betsy M.; Crist, Brett D.; Cross, Brian J.; Wills, Brian P. D.; Barreto, Camilo Jose Romero; Ekholm, Carl; Swigart, Carrie; Spath, Catherine; Zalavras, Charalampos; Cassidy, Charles; Garnavos, Christos; Moreno-Serrano, Constanza L.; Rodner, Craig; Klostermann, Cyrus; Osei, Daniel A.; Rikli, Daniel A.; Haverkamp, Daniel; Polatsch, Daniel; Drosdowech, Darren; Edelstein, David M.; Eygendaal, Denise; Verbeek, Diederik O. F.; Doornberg, Job N.; van den Bekerom, Michel P. J.; Schep, Niels; Kloen, Peter; Haverlag, Robert; Schepers, Tim

    2015-01-01

    There is substantial unexplained geographical and surgeon-to-surgeon variation in rates of surgery. One would expect surgeons to treat patients and themselves similarly based on best evidence and accounting for patient preferences. (1) Are surgeons more likely to recommend surgery when choosing for

  4. Effect of water treated and urea treated neem ( Azadirachta indica ...

    African Journals Online (AJOL)

    In a study to evaluate the carcass haematological and biochemical characteristics of broiler birds fed graded levels of water and urea-treated neem kernel cake (NKC), 300 day-old broilers (Cobb, 500) were randomly assigned to five dietary treatments for 56 days. Water and feed were fed adlibitum. The diets were ...

  5. Trick or Treat and Telescopes

    Science.gov (United States)

    Buratti, Bonnie J.; Meinke, Bonnie K.; Schmude, Richard W.

    2017-10-01

    Based on an activity that DPS member Richard Schmude Jr. has been doing for years, with over 5000 children reached, DPS initiated in 2016 a pilot program entitled “Trick-or-Treat and Telescopes.” DPS encouraged its members to put out their telescopes during trick-or-treat time on Halloween, in their own lawns or in a neighbor’s lawn with better viewing (or more traffic). The program will be continued in 2017. This year should offer good viewing with a waxing gibbous moon and Saturn visible. The program was also advertised though the Night Sky Network, a consortium of astronomy clubs. The following website gives advice and connections to resources.https://dps.aas.org/education/trick-or-treat-and-telescopes acknowledged.

  6. Selected writings

    CERN Document Server

    Galilei, Galileo

    2012-01-01

    'Philosophy is written in this great book which is continually open before our eyes - I mean the universe...' Galileo's astronomical discoveries changed the way we look at the world, and our place in the universe. Threatened by the Inquisition for daring to contradict the literal truth of the Bible, Galileo ignited a scientific revolution when he asserted that the Earth moves. This generous selection from his writings contains all the essential texts for a reader to appreciate his lasting significance. Mark Davie's new translation renders Galileo's vigorous Italian prose into clear modern English, while William R. Shea's version of the Latin Sidereal Message makes accessible the book that created a sensation in 1610 with its account of Galileo's observations using the newly invented telescope. All Galileo's contributions to the debate on science and religion are included, as well as key documents from his trial before the Inquisition in 1633. A lively introduction and clear notes give an overview of Galileo's...

  7. Site selection

    International Nuclear Information System (INIS)

    Olsen, C.W.

    1983-07-01

    The conditions and criteria for selecting a site for a nuclear weapons test at the Nevada Test Site are summarized. Factors considered are: (1) scheduling of drill rigs, (2) scheduling of site preparation (dirt work, auger hole, surface casing, cementing), (3) schedule of event (when are drill hole data needed), (4) depth range of proposed W.P., (5) geologic structure (faults, Pz contact, etc.), (6) stratigraphy (alluvium, location of Grouse Canyon Tuff, etc.), (7) material properties (particularly montmorillonite and CO 2 content), (8) water table depth, (9) potential drilling problems (caving), (10) adjacent collapse craters and chimneys, (11) adjacent expended but uncollapsed sites, (12) adjacent post-shot or other small diameter holes, (13) adjacent stockpile emplacement holes, (14) adjacent planned events (including LANL), (15) projected needs of Test Program for various DOB's and operational separations, and (16) optimal use of NTS real estate

  8. Prefrontal dysfunction in early and continuously treated phenylketonuria

    NARCIS (Netherlands)

    Stemerdink, NBA; Kalverboer, AF; van der Meere, JJ; de Jong, LW; Slijper, FME; Verkerk, PH; van Spronsen, FJ

    1999-01-01

    In this study, we tested the hypothesis that patients with early and continuously treated phenylketonuria (PKU) are selectively impaired in cognitive functions dependent on the prefrontal cortex (PFC) over a wide age range. Thirty-six patients with PKU between 8 and 20 years of age and 36 controls

  9. Ammonia treated Mo/AC catalysts for CO hydrogenation with ...

    Indian Academy of Sciences (India)

    SHARIF F ZAMAN

    the influence of acid treated AC as a support with K-Ni-. Mo active ... K-Ni-Mo/AC catalyst was more selective to oxygenates. (>40% ... mineral impurities (K, Si, Sn and Fe) <1%. ...... edge technical support with thanks Science and Technology.

  10. Quality Control Of Selected Pesticides With GC

    Energy Technology Data Exchange (ETDEWEB)

    Karasali, H. [Benaki Phytopathological Institute Laboratory of Physical and Chemical Analysis of Pesticides, Ekalis (Greece)

    2009-07-15

    The practical quality control of selected pesticides with GC is treated. Detailed descriptions are given on materials and methods used, including sample preparation and GC operating conditions. The systematic validation of multi methods is described, comprising performance characteristics in routine analysis, like selectivity, specificity etc. This is illustrated by chromatograms, calibration curves and tables derived from real laboratory data. (author)

  11. Treating rheumatoid arthritis to target

    DEFF Research Database (Denmark)

    Smolen, Josef S; Breedveld, Ferdinand C; Burmester, Gerd R

    2016-01-01

    BACKGROUND: Reaching the therapeutic target of remission or low-disease activity has improved outcomes in patients with rheumatoid arthritis (RA) significantly. The treat-to-target recommendations, formulated in 2010, have provided a basis for implementation of a strategic approach towards this t...

  12. Method for treating radioactive liquids

    International Nuclear Information System (INIS)

    Komrow, R.R.; Pritchard, J.F.

    1980-01-01

    A process for treating and handling radioactive liquids and rendering such liquids safe for handling is disclosed. Transportation and disposal, the process comprises adding thereto a small amount of a water-insoluble alkali salt of an aqueous alkali saponified gelatinized-starch-polyacrylonitrile graft polymer, to form a solid, semi-solid or gel product

  13. Articles Treated with Biocidal Products

    OpenAIRE

    Söyleriz, Yüksel

    2015-01-01

    In this study, articles treated with biocidal products have been assessed in the scope of Directive 98/8/EC Concerning the Placing of Biocidal Products on the Market and of Regulation (EU) No 528/2012 concerning the Making Available on the Market and Use of Biocidal Products.

  14. Selected papers

    CERN Document Server

    Elgot, Calvin C

    1982-01-01

    Cal Elgot was a very serious and thoughtful researcher, who with great determi­ nation attempted to find basic explanations for certain mathematical phenomena­ as the selection of papers in this volume well illustrate. His approach was, for the most part, rather finitist and constructivist, and he was inevitably drawn to studies of the process of computation. It seems to me that his early work on decision problems relating automata and logic, starting with his thesis under Roger Lyndon and continuing with joint work with Biichi, Wright, Copi, Rutledge, Mezei, and then later with Rabin, set the stage for his attack on the theory of computation through the abstract treatment of the notion of a machine. This is also apparent in his joint work with A. Robinson reproduced here and in his joint papers with John Shepherdson. Of course in the light of subsequent work on decision problems by Biichi, Rabin, Shelah, and many, many others, the subject has been placed on a completely different plane from what it was whe...

  15. Selective solvent extraction of oils

    Energy Technology Data Exchange (ETDEWEB)

    1938-04-09

    In the selective solvent extraction of naphthenic base oils, the solvent used consists of the extract obtained by treating a paraffinic base oil with a selective solvent. The extract, or partially spent solvent is less selective than the solvent itself. Selective solvents specified for the extraction of the paraffinic base oil are phenol, sulphur dioxide, cresylic acid, nitrobenzene, B:B/sup 1/-dichlorethyl ether, furfural, nitroaniline and benzaldehyde. Oils treated are Coastal lubricating oils, or naphthenic oils from the cracking, or destructive hydrogenation of coal, tar, lignite, peat, shale, bitumen, or petroleum. The extraction may be effected by a batch or counter-current method, and in the presence of (1) liquefied propane, or butane, or naphtha, or (2) agents which modify the solvent power such as, water, ammonia, acetonitrile, glycerine, glycol, caustic soda or potash. Treatment (2) may form a post-treatment effected on the extract phase. In counter-current treatment in a tower some pure selective solvent may be introduced near the raffinate outlet to wash out any extract therefrom.

  16. Selective arterial thrombolysis with urokinase

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jae Hyung; Park, Kil Sun; Chung, Jin Wook; Han, Joon Koo; Kim, Sang Joon [Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Dae Young [Choong Buk University College of Medicine, Jeonju (Korea, Republic of)

    1991-07-15

    Seven patients with thrombotic occlusions of the peripheral arteries or grafts were treated with urokinase by direct intraarterial selective infusion. During the infusion, simultaneous heparin infusion was used to reduce the frequency of thrombus formation on the infusion catheter or recurrent thrombosis. In 4 patients in whom a complete thrombolysis occurred, urokinase was infused by a high-dose transthrombus bolus technique followed by continuous infusion. There other patients, in whom thrombolysis was partially accomplished and then surgical thrombectomy was performed, were treated only by continuous urokinase infusion. Small hematomas developed at the infusion catheter entry site in 2 patients, but transfusion or operation was not required. Other significant complications were not found. Our results suggest that selective arterial infusion of urokinase with a transthrombus bolus technique can accomplish a complete arterial thrombolysis without any significant complications.

  17. Selective arterial thrombolysis with urokinase

    International Nuclear Information System (INIS)

    Park, Jae Hyung; Park, Kil Sun; Chung, Jin Wook; Han, Joon Koo; Kim, Sang Joon; Kim, Dae Young

    1991-01-01

    Seven patients with thrombotic occlusions of the peripheral arteries or grafts were treated with urokinase by direct intraarterial selective infusion. During the infusion, simultaneous heparin infusion was used to reduce the frequency of thrombus formation on the infusion catheter or recurrent thrombosis. In 4 patients in whom a complete thrombolysis occurred, urokinase was infused by a high-dose transthrombus bolus technique followed by continuous infusion. There other patients, in whom thrombolysis was partially accomplished and then surgical thrombectomy was performed, were treated only by continuous urokinase infusion. Small hematomas developed at the infusion catheter entry site in 2 patients, but transfusion or operation was not required. Other significant complications were not found. Our results suggest that selective arterial infusion of urokinase with a transthrombus bolus technique can accomplish a complete arterial thrombolysis without any significant complications

  18. Apparatus for treating bituminous shale

    Energy Technology Data Exchange (ETDEWEB)

    1942-11-24

    A method is given of transforming finely crushed bituminous shale, for instance of maximum particle size of about 5 mm, into balls, nodules, or similar shapes, in which the shale to be treated is passed in the form of lumps through a rotary drum. The finely crushed shale with a higher content of moisture is brought into contact with finely crushed shale of a lower content of moisture, and thereby serves as kernel material during the formation of the nodules or similar shapes.

  19. Plexiform Neurofibroma Treated with Pharmacopuncture

    Directory of Open Access Journals (Sweden)

    Chungsan Lim

    2014-09-01

    Full Text Available Objectives: The purpose of this study is to report a case of a plexiform neurofibroma (PNF in the pelvic region treated with sweet bee venom (SBV and mountain ginseng pharmacopuncture (MGP. Methods: A 16-year-old girl was diagnosed as having PNFs, neurofibromatosis type 1, 10 years ago and she had surgery three times to remove the benign tumors, but the growth of the PNFs continued. She has been treated in our clinic with SBV and MGP two times per month from March 2010 to April 2014. SBV was injected intra-subcutaneously at the borders of the PNFs in the pelvic region, and MGP was administrated intravenously each treatment time. Results: The growths of the PNFs occurred rapidly and continued steadily before treatment. Since March 2010, she has been treated in our clinic, and the growths of the PNFs have almost stopped; further-more, the discomfort of hip joint pain has been reduced, and her general condition has improved. Conclusion: We cautiously conclude that SBV and MGP treatment has some effects that suppress the growth and the spread of the PNFs in this patient.

  20. Treat to target in gout.

    Science.gov (United States)

    Perez-Ruiz, Fernando; Moreno-Lledó, Aitana; Urionagüena, Irati; Dickson, Alastair J

    2018-01-01

    The treat-to-target (T2T) approach has been successfully implemented in a number of diseases. T2T has been proposed for rheumatic diseases such as RA, spondyloarthritis, lupus, and recently for gout. The level of evidence for such approaches differs from one condition to the other (moderate to high for hyperlipidaemia, for example). Practice is based on the best available evidence at any time, and in absence of good evidence for T2T in gout, some suggest a conservative only-treat-symptoms approach. Evidence suggests that not treating gout to target in the long term is overall associated with worsening outcomes, such as flares, tophi and structural damage, which is associated to loss of quality of life and mortality. Different targets have been proposed for hyperuricaemia in gout; lower than 6 mg/dl (0.36 mmol/l) for all patients, at least gout. © The Author 2018. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. TREAT neutron-radiography facility

    International Nuclear Information System (INIS)

    Harrison, L.J.

    1981-01-01

    The TREAT reactor was built as a transient irradiation test reactor. By taking advantage of built-in system features, it was possible to add a neutron-radiography facility. This facility has been used over the years to radiograph a wide variety and large number of preirradiated fuel pins in many different configurations. Eight different specimen handling casks weighing up to 54.4 t (60 T) can be accommodated. Thermal, epithermal, and track-etch radiographs have been taken. Neutron-radiography service can be provided for specimens from other reactor facilities, and the capacity for storing preirradiated specimens also exists

  2. Treating rheumatoid arthritis to target

    DEFF Research Database (Denmark)

    Smolen, Josef S; Aletaha, Daniel; Bijlsma, Johannes W J

    2010-01-01

    BACKGROUND: Aiming at therapeutic targets has reduced the risk of organ failure in many diseases such as diabetes or hypertension. Such targets have not been defined for rheumatoid arthritis (RA). OBJECTIVE: /st> To develop recommendations for achieving optimal therapeutic outcomes in RA. METHODS....... Levels of evidence, strength of recommendations and levels of agreement were derived. RESULTS: The treat-to-target activity resulted in 10 recommendations. The treatment aim was defined as remission with low disease activity being an alternative goal in patients with long-standing disease. Regular follow...

  3. Process of treating carbonaceous substances

    Energy Technology Data Exchange (ETDEWEB)

    1938-12-16

    A process is described of removing halogens or halogen compounds (or both) from the products which form when carbonaceous substances are treated thermally in the presence of halogens or halogen compounds, consisting of passing the reaction products at the same temperature with a substance able to fix halogens or acid halides through an apparatus included between the receiver and the heat exchanger, which contains, in a relatively restricted space, internal elements obliquely disposed in relation to the direction of the flow, stretched in this direction and constituted preferably of helicoidal passages.

  4. Treating Intraradicular Pockets of molars

    Directory of Open Access Journals (Sweden)

    H. Lotfizade

    1987-10-01

    Full Text Available It appears that until bone graft has not achieved 100% success, intraradicular diseases remain controversial and therefore, different treatment plans are suggested for them. Treating intraradicular diseases depend on many factors: maxillary molars are more prone to bone loss and have worse prognosis. To assess prognosis more carefully these factors should be considered: 1 bone loss: its apical depth, local or generalized 2 bone condition: buccal, lingual, mesial and distal aspects 3 tooth mobility: grades 2 and 3 have not good prognosis. Crown root ratio is also important. 4 the angle of divergence of roots: the more the roots are divergent, the better the prognosis would be. 5adjacent teeth health 6tooth position in jaws 7 age and general health of the patients 8 oral hygiene In general, teeth with 2 roots can be treated more effectively than 3 root ones. Maxillary first premolars are exceptions that do not respond to the treatments positively. We should look forward to the future investigations and findings.

  5. Treating leachate by Fenton oxidation

    Directory of Open Access Journals (Sweden)

    Roger Iván Méndez Novelo

    2010-01-01

    Full Text Available Leachates are formed from liquids, mainly rainwater, percolating through solid wastes during stabilisation. Their composition is variable and highly toxic; leachate treatment is therefore a complex task. Leachates represent a high risk to health due to the Yucatan Peninsula’s highly permeable soil. The results are presented from applying the Fenton process to treating leachate from the sanitary Merida landfill, Yucatan, Mexico. The Fenton process consists of treating the contaminant load with an H2O2 and FeSO4 combination in acidic conditions. Optimal reaction time, pH value, Fenton reagent dose, post treatment coagulation – flocculation doses and increased biodegradability index were all determined. Optimal oxidation conditions and doses were 202+ minute contact time, 4 pH, 600 mg/L H2O2 concentration and 1,000 mg/L Fe. Average organic matter removal rate, measured as CODS and TOC, were 78% and 87% respectively. The biodegradability index increased from 0.07 to 0.11 during the Fenton process and up to 0.13 when the Fenton process was followed by coagulation-flocculation.

  6. Quantum leap for treating wastewaters

    International Nuclear Information System (INIS)

    Wallace, Paula

    2012-01-01

    Full text: For many Australian food manufacturers there is increasing pressure from government agencies to reach higher standards of wastewater treatment for environmental discharge. In fact, throughout the western wolrd industrual water users are facing a similar challenge. One of the big problems is ageing pipe networks, particularly sewage pipes. Also, industrial wastewaters with high sugar-nutrient loads can cause serious damage to pipelines. This is because fermentation occurs within the wastewater, eroding and degrading the pipes, causing numerous cracks and fractures. This in turn leads to water ingress, which puts a strain on treatment plants because of the higher volume of water, especially in wet weather. Food manufacturing produces large volumes of mostly biodegradable liquid and solid waste. Wastewaters released from food manufacturing can be 'muddy', with high concentrations of suspended solids, fats, oils and grease (FOGs), and, usually, nutrients such as nitrogen. The issue for many food manufacturers is that existing wastewater treatment systems are unable to reduce the nutrient load in the biological treatment stage to a level allowing acceptable discharge. In addition, most rely on large tanks housing bacteria that are submerged in water and aerated. Aeration is energy-hungry and can create a 'sludge-cake' on top of the water, which is difficult to treat. Most existing technologies also use filters, but they foul easily and require ongoing maintenance. According to BioGill chief executive John West, the BioGill technology is groundbreaking and radically different from conventional bioreactors because the 'gills' are not submerged. Instead, the gills, composed of Nano-Ceramic Membrane sheets arranged vertically in pairs, are suspended in the air, above ground, with wastewater travelling down between them. “Fungi and bacteria, known as biomass, grow on the membranes in direct contact with the air, eating nutrients much faster than other systems

  7. Materials selection for cutting tools

    International Nuclear Information System (INIS)

    Burkhis, Adel M.

    2008-01-01

    The selection of proper tool steel for a given application is a difficult task. So; the most important selection factors in choosing cutting tool materials are based on their tool material requirements, cutting tool design and service conditions which is mainly considered as functional requirements. The processability requirements concerns in heat treat ability of the material tool. The classification of these tool materials were discussed with their properties requirement and percent of alloying element which is added to give best properties with a little increase in cost that highly appear in comparison of the selection. The cutting tool materials were evaluated based on two cases; The first was in case of rough surface; the high speed steels is the best material and the other was the ceramic material is the highest performance in cutting of soft or high rate of metal removal. (author)

  8. Pilot Project to Optimize Superfund-financed Pump and Treat Systems: Summary Report and Lessons Learned

    Science.gov (United States)

    This report summarizes Phase II (site optimization) of the Nationwide Fund-lead Pump and Treat Optimization Project. This phase included conducting Remediation System Evaluations (RSEs) at each of the 20 sites selected in Phase I.

  9. Method for treating a nuclear process off-gas stream

    Science.gov (United States)

    Pence, Dallas T.; Chou, Chun-Chao

    1984-01-01

    Disclosed is a method for selectively removing and recovering the noble gas and other gaseous components typically emitted during nuclear process operations. The method is adaptable and useful for treating dissolver off-gas effluents released during reprocessing of spent nuclear fuels whereby to permit radioactive contaminant recovery prior to releasing the remaining off-gases to the atmosphere. Briefly, the method sequentially comprises treating the off-gas stream to preliminarily remove NO.sub.x, hydrogen and carbon-containing organic compounds, and semivolatile fission product metal oxide components therefrom; adsorbing iodine components on silver-exchanged mordenite; removing water vapor carried by said stream by means of a molecular sieve; selectively removing the carbon dioxide components of said off-gas stream by means of a molecular sieve; selectively removing xenon in gas phase by passing said stream through a molecular sieve comprising silver-exchanged mordenite; selectively separating krypton from oxygen by means of a molecular sieve comprising silver-exchanged mordenite; selectively separating krypton from the bulk nitrogen stream using a molecular sieve comprising silver-exchanged mordenite cooled to about -140.degree. to -160.degree. C.; concentrating the desorbed krypton upon a molecular sieve comprising silver-exchange mordenite cooled to about -140.degree. to -160.degree. C.; and further cryogenically concentrating, and the recovering for storage, the desorbed krypton.

  10. Method for treating a nuclear process off-gas stream

    International Nuclear Information System (INIS)

    Pence, D.T.; Chou, C.C.

    1984-01-01

    Disclosed is a method for selectively removing and recovering the noble gas and other gaseous components typically emitted during nuclear process operations. The method is adaptable and useful for treating dissolver off-gas effluents released during reprocessing of spent nuclear fuels whereby to permit radioactive contaminant recovery prior to releasing the remaining off-gases to the atmosphere. Briefly, the method sequentially comprises treating the off-gas stream to preliminarily remove NO /SUB x/ , hydrogen and carbon-containing organic compounds, and semivolatile fission product metal oxide components therefrom; adsorbing iodine components on silver-exchanged mordenite; removing water vapor carried by said stream by means of a molecular sieve; selectively removing the carbon dioxide components of said off-gas stream by means of a molecular sieve; selectively removing xenon in gas phase by passing said stream through a molecular sieve comprising silver-exchanged mordenite; selectively separating krypton from oxygen by means of a molecular sieve comprising silver-exchanged mordenite; selectively separating krypton from the bulk nitrogen stream using a molecular sieve comprising silver-exchanged mordenite cooled to about -140 0 to -160 0 C.; concentrating the desorbed krypton upon a molecular sieve comprising silver-exchange mordenite cooled to about -140 0 to -160 0 C.; and further cryogenically concentrating, and the recovering for storage, the desorbed krypton

  11. In vitro antimycobacterial and cytotoxic data on medicinal plants used to treat tuberculosis

    Directory of Open Access Journals (Sweden)

    Joseph M. Nguta

    2016-06-01

    Full Text Available This article contains data on in vitro antimycobacterial activity and cytotoxicity of hydroethanolic crude extracts from five selected medicinal plant species traditionally used to treat tuberculosis in Ghanaian ethnomedicine, see “Medicinal plants used to treat TB in Ghana” [1]. The interpretation and discussion of these data and further extensive insights into drug discovery against tuberculosis from natural products of plant biodiversity can be found in “Antimycobacterial and cytotoxic activity of selected medicinal plant extracts” [2].

  12. National Environmental Policy Act Hazards Assessment for the TREAT Alternative

    Energy Technology Data Exchange (ETDEWEB)

    Christensen, Boyd D. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Schafer, Annette L. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-02-01

    This document provides an assessment of hazards as required by the National Environmental Policy Act for the alternative of restarting the reactor at the Transient Reactor Test (TREAT) facility by the Resumption of Transient Testing Program. Potential hazards have been identified and screening level calculations have been conducted to provide estimates of unmitigated dose consequences that could be incurred through this alternative. Consequences considered include those related to use of the TREAT Reactor, experiment assembly handling, and combined events involving both the reactor and experiments. In addition, potential safety structures, systems, and components for processes associated with operating TREAT and onsite handling of nuclear fuels and experiments are listed. If this alternative is selected, a safety basis will be prepared in accordance with 10 CFR 830, “Nuclear Safety Management,” Subpart B, “Safety Basis Requirements.”

  13. National Environmental Policy Act Hazards Assessment for the TREAT Alternative

    Energy Technology Data Exchange (ETDEWEB)

    Boyd D. Christensen; Annette L. Schafer

    2013-11-01

    This document provides an assessment of hazards as required by the National Environmental Policy Act for the alternative of restarting the reactor at the Transient Reactor Test (TREAT) facility by the Resumption of Transient Testing Program. Potential hazards have been identified and screening level calculations have been conducted to provide estimates of unmitigated dose consequences that could be incurred through this alternative. Consequences considered include those related to use of the TREAT Reactor, experiment assembly handling, and combined events involving both the reactor and experiments. In addition, potential safety structures, systems, and components for processes associated with operating TREAT and onsite handling of nuclear fuels and experiments are listed. If this alternative is selected, a safety basis will be prepared in accordance with 10 CFR 830, “Nuclear Safety Management,” Subpart B, “Safety Basis Requirements.”

  14. Tool for treating subterranean wells

    International Nuclear Information System (INIS)

    Muller, L.; Randermann, E.

    1991-01-01

    This paper describes a system for treating subterranean wells. It comprises: elongated treatment tool having inflatable packers, a support tube connected to one end of the tool operable to lower tool from a well head into a well and to supply liquid to tool, the tool providing valve means operable in response changes in tension ins aid tube and without rotating the tube sequentially: (a) inflate the packers to isolate one portion of the from the remaining portions thereof and to lock the against movement along the well; (b) inject treatment fluid supplied to the tool through support tube into the one portion of the well and (c) deflate the packers permitting further movement of tool along the well

  15. Treating malnutrition in the community.

    Science.gov (United States)

    Dera, Merceline; Woodham, Diane

    2016-11-02

    Malnutrition is a clinical and public health problem. It has adverse effects on the physical and psycho-social wellbeing of individuals by predisposing to disease, negatively affecting its outcome and reducing the likelihood of independence. An estimated 3 million people in the UK are affected by malnutrition, most of whom live in the community ( BAPEN, 2011 ). Despite the scale of this problem, it remains under-detected, under-treated, underresourced and often overlooked by those involved in the care of at risks individuals such as the elderly. In most cases malnutrition is a treatable condition that can be managed by optimising food intake and using oral nutritional supplements (ONS) where necessary. The main focus of this article is on the dangers of malnutrition for older people in the community and the use of ONS in the treatment and management of malnutrition.

  16. Orgasmic headache treated with nimodipine.

    Science.gov (United States)

    Lee, Jea Whan; Ha, Yeon Soo; Park, Seung Chol; Seo, Ill Young; Lee, Hak Seung

    2013-07-01

    Orgasmic headache (OH) is a sudden and severe headache that occurs at the time of or shortly after an orgasm. AIM.: We present the case of typical primary headache associated with sexual activity, especially during an orgasmic period. A 34-year-old man complained of sudden and severe headache during sexual activity, or orgasmic period, for 2 months. The headache developed abruptly with an orgasm and then decreased shortly over a period of 4 ≈ 8 hours. Magnetic resonance angiography revealed severe spasm of the M1 segment of both the middle cerebral arteries. He was treated with oral nimodipine (30 mg every 8 hours), which alleviated the headache and prevented its recurrence. We postulated a pathophysiological relationship between OH and migraine, especially with respect to vasoconstriction, and believe that in such cases, nimodipine may be an effective therapy. © 2013 International Society for Sexual Medicine.

  17. Process for treating hydrocarbons, etc

    Energy Technology Data Exchange (ETDEWEB)

    1933-09-15

    A process is described for treating simultaneously bituminous substances and hydrocarbon oils for the production of low-boiling hydrocarbons and volatilization of the bituminous substances, characterized by the fact that it consists of heating a current of charge constituted by a mixture of the bituminous substances and hydrocarbon oils, to a high temperature, passing the heated current into a zone of extended reaction where the vapors are separated from the liquid or solid residue to favor transformation of the liquid hydrocarbons and volatilization of the bituminous substances, owing to the utilization of a heating agent carried to a high temperature being brought in contact with the heated charge in order to communicate its heat to the charge, while this later presents itself as relatively fine pellet or in the condition of distinct particles, particularly separated from one another.

  18. Glycerine Treated Nanofibrillated Cellulose Composites

    Directory of Open Access Journals (Sweden)

    Esra Erbas Kiziltas

    2016-01-01

    Full Text Available Glycerine treated nanofibrillated cellulose (GNFC was prepared by mixing aqueous nanofibrillated cellulose (NFC suspensions with glycerine. Styrene maleic anhydride (SMA copolymer composites with different loadings of GNFC were prepared by melt compounding followed by injection molding. The incorporation of GNFC increased tensile and flexural modulus of elasticity of the composites. Thermogravimetric analysis showed that as GNFC loading increased, the thermal stability of the composites decreased marginally. The incorporation of GNFC into the SMA copolymer matrix resulted in higher elastic modulus (G′ and shear viscosities than the neat SMA copolymer, especially at low frequencies. The orientation of rigid GNFC particles in the composites induced a strong shear thinning behavior with an increase in GNFC loading. The decrease in the slope of elastic modulus with increasing GNFC loading suggested that the microstructural changes of the polymer matrix can be attributed to the incorporation of GNFC. Scanning electron microscopy (SEM images of fracture surfaces show areas of GNFC agglomerates in the SMA matrix.

  19. Process for treating oil shale

    Energy Technology Data Exchange (ETDEWEB)

    1920-08-22

    A process for treating oil shale is characterized in that the shale is first finely ground, then heated in the presence of steam in a high-pressure retort at 1 to 50 atmospheres pressure at a temperature of 200/sup 0/ to 450/sup 0/C and then with large amounts of water with or without materials forming emulsions with water or with oil. Solution medium suitable for bitumen or paraffin is beaten up in a rapid hammer mill until all or most all of the oil or bitumen is emulsified. The emulsion is separated by filter-pressing and centrifuging from the solid shale residue and the oil or bitumen is again separated from the emulsion medium by heating, acidulating, standing, or centrifuging, and then in known ways is further separated, refined, and worked up.

  20. To treat or not to treat: should psychologists treat tobacco use disorder?

    Science.gov (United States)

    Bodie, Linda P

    2014-08-01

    The author presented this Presidential Address for Divison 18, Psychologists in Public Service, at the 2012 American Psychological Association Convention in Orlando, Florida. The address challenges public service psychologists to reduce the tobacco disease burden through their roles as researchers, leaders, educators, and practitioners and explains why treating tobacco use disorder is important and relevant for psychologists. The address discusses the prevalence and the resulting mortality and morbidity rates of tobacco use disorder, which call for effective evidence-based interventions that can be integrated by psychologists into other ongoing treatments. Treatment of the underserved populations, including those with serious mental illness and/or substance use disorders, presents many barriers. In addition, education and training for tobacco use disorder in undergraduate and graduate clinical psychology programs present further barriers for psychology trainees. However, progress is being made because of the numerous resources and psychology leaders who are advocates for tobacco use disorder treatment and research. Challenges for the future include increasing awareness of the importance of treatment for tobacco use disorder, finding innovative ways to increase access to comprehensive evidence-based treatment, and acknowledging that psychologists can make a difference in reducing the tobacco use disorder disease burden. Psychologists have an ethical and professional responsibility to treat tobacco use disorder.

  1. Treating gout in kidney transplant recipients.

    Science.gov (United States)

    Baroletti, Steven; Bencivenga, Gina Ann; Gabardi, Steven

    2004-06-01

    To review the etiology, treatment, and preventive strategies of hyperuricemia and gout in kidney transplant recipients. Primary literature was obtained via Medline (1966-June 2003). Studies evaluating treatment and prevention of hyperuricemia and gout in kidney transplantation were considered for evaluation. English-language studies were selected for inclusion. Approximately 14,000 kidney transplantations were performed in the United States in 2003, and of those transplant recipients, nearly 13% will experience a new onset of gout. The prevalence of hyperuricemia is even greater. There are several mechanisms by which hyperuricemia and gout develop in kidney transplant recipients. Medication-induced hyperuricemia and renal dysfunction are 2 of the more common mechanisms. Prophylactic and treatment options include allopurinol, colchicine, corticosteroids, and, if absolutely necessary, nonsteroidal antiinflammatory drugs. It is generally recommended to decide whether the risks of prophylactic therapy and treatment outweigh the benefits. Often, the risk of adverse events associated with agents to treat these ailments tends to outweigh the benefits; therefore, treatment is usually reserved for symptomatic episodes of acute gout. Practitioners must also decide if changes in immunosuppressive regimens may be of benefit on a patient-by-patient basis.

  2. Treating gynaecological disorders with traditional Chinese medicine ...

    African Journals Online (AJOL)

    Traditional Chinese Medicine (TCM) has significant advantages in treating gynaecological disorders. The paper has provided a brief introduction on the current progress of treating some gynaecological disorders including endometriosis, infertility, dysmenorrhea, abnormal uterine bleeding, premenstrual syndrome, ...

  3. Heart failure in patients treated with bisphosphonates

    DEFF Research Database (Denmark)

    Grove, E L; Abrahamsen, B; Vestergaard, P

    2013-01-01

    The aim of this study was to investigate the occurrence of heart failure in patients treated with bisphosphonates.......The aim of this study was to investigate the occurrence of heart failure in patients treated with bisphosphonates....

  4. How Are Genetic Conditions Treated or Managed?

    Science.gov (United States)

    ... mtDNA Resources Help Me Understand Genetics Share: Email Facebook Twitter Home Help Me Understand Genetics Genetic Consultation How are genetic conditions treated or managed? How are genetic conditions treated or managed? Many ...

  5. Vagus Nerve Stimulation for Treating Epilepsy

    Science.gov (United States)

    ... and their FAMILIES VAGUS NERVE STIMULATION FOR TREATING EPILEPSY This information sheet is provided to help you ... how vagus nerve stimulation (VNS) may help treat epilepsy. The American Academy of Neurology (AAN) is the ...

  6. Method of treating waste water

    Science.gov (United States)

    Deininger, J. Paul; Chatfield, Linda K.

    1991-01-01

    A process of treating water to remove transuranic elements contained therein by adjusting the pH of a transuranic element-containing water source to within the range of about 6.5 to about 14.0, admixing the water source with an alkali or alkaline earth ferrate in an amount sufficient to form a precipitate within the water source, the amount of ferrate effective to reduce the transuranic element concentration in the water source, permitting the precipitate in the admixture to separate and thereby yield a supernatant liquid having a reduced transuranic element concentration, and separating the supernatant liquid having the reduced transuranic element concentration from the admixture is provided. Additionally, a water soluble salt, e.g., a zirconium salt, can be added with the alkali or alkaline earth ferrate in the process to provide greater removal efficiencies. A composition of matter including an alkali or alkaline earth ferrate and a water soluble salt, e.g., a zirconium salt, is also provided.

  7. Treating water-reactive wastes

    International Nuclear Information System (INIS)

    Lussiez, G.W.

    1993-01-01

    Some compounds and elements, such as lithium hydride, magnesium, sodium, and calcium react violently with water to generate much heat and produce hydrogen. The hydrogen can ignite or even form an explosive mixture with air. Other metals may react rapidly only if they are finely divided. Some of the waste produced at Los Alamos National Laboratory includes these metals that are contaminated with radioactivity. By far the greatest volume of water-reactive waste is lithium hydride contaminated with depleted uranium. Reactivity of the water-reactive wastes is neutralized with an atmosphere of humid nitrogen, which prevents the formation of an explosive mixture of hydrogen and air. When we adjust the temperature of the nitrogen and the humidifier, the nitrogen can be more or less humid, and the rate of reaction can be adjusted and controlled. Los Alamos has investigated the rates of reaction of lithium hydride as a function of the temperature and humidity, and, as anticipated, they in with in temperature and humidity. Los Alamos will investigate other variables. For example, the nitrogen flow will be optimized to conserve nitrogen and yet keep the reaction rates high. Reaction rates will be determined for various forms of lithium waste, from small chips to powder. Bench work will lead to the design of a skid-mounted process for treating wastes. Other water-reactive wastes will also be investigated

  8. Physical exercise in treating obesity

    Directory of Open Access Journals (Sweden)

    Victor Keihan Rodrigues Matsudo

    2006-03-01

    Full Text Available Undoubtedly, no regular practice of physical exercise is one of thefactors that determine the global epidemics of weight excess andobesity in all age groups. Taking up physical activities regularlysince the initial stages of life (childhood, during adolescence andmaintaining them in adulthood – from young adults to over 50 yearsof age - is essential to assure an appropriate control of weight andbody fat. The general recommendation of physical exercise for goodhealth is to practice at least 30 minutes of moderate activities, atleast five days a week, and preferably every day. When the purposeis to lose and control weight in overweighed and obese individuals,the minimum practice should last 60 minutes/day, preferably 90minutes/day, at least five days/week, in a continuous or accumulatedmanner. Physical exercise is associated with several physical,psychological and social benefits that justify it inclusion as a crucialstrategy to prevent and treat overweight and obesity in any agegroup. Apart from moderate aerobic physical exercise, such aswalking, cycling, swimming, or more vigorous activities, such asjogging or running, resistance exercises and changes in lifestyle areessential, together with re-education of eating habits, to fight theepidemics of overweight and obesity. Besides the effect of weightcontrol, reduced body fat, prevention of weight gain and maintenanceof lean mass, physical exercise is related to a better lipid profile andreduced risk of associated diseases, such as diabetes, hypertension,metabolic syndrome, cardiovascular diseases and, consequently,lower risk of death.

  9. 'Treat to Target' - Lessons Learnt.

    Science.gov (United States)

    Kurti, Zsuzsanna; Vegh, Zsuzsanna; Golovics, Petra Anna; Lakatos, Peter Laszlo

    2016-01-01

    Therapeutic management in inflammatory bowel diseases (IBD) has significantly changed in the last decades with the advent of biological therapy resulting in new treatment targets other than clinical symptoms. Patient stratification in the early stage of the disease is an important step to identify patients with poor prognosis, who might benefit from early aggressive treatment to avoid complications in the later disease course. Recent randomized and hypothesis driven (e.g., Randomized Evaluation of an Algorithm for Crohn's Treatment, Post-Operative Crohn's Endoscopic Recurrence) clinical trials conducted in the biological era underscore the need of objective disease monitoring including assessment of biomarkers (e.g., C-reactive protein and calprotectin), mucosal healing and, for biologically treated patients, therapeutic drug monitoring beside clinical symptom assessment in both Crohn's disease and ulcerative colitis. Assessing the treatment efficacy objectively has become an important element of patient monitoring besides clinical symptom assessment. Further clinical studies are needed to assess whether implementation of new therapeutic algorithms based on these targets and tight monitoring in clinical practice have the potential to further improve long-term disease outcomes in IBD. © 2016 S. Karger AG, Basel.

  10. Social Selection and Religiously Selective Faith Schools

    Science.gov (United States)

    Pettinger, Paul

    2014-01-01

    This article reviews recent research looking at the socio-economic profile of pupils at faith schools and the contribution religiously selective admission arrangements make. It finds that selection by faith leads to greater social segregation and is open to manipulation. It urges that such selection should end, making the state-funded school…

  11. Selective laser trabeculoplasty

    Directory of Open Access Journals (Sweden)

    Jing-Ming Shi

    2012-12-01

    Full Text Available The introduction of selective laser trabeculoplasty (SLT provided a new choice for the reduction of intraocular pressure (IOP in eyes with open angle glaucoma (OAG and ocular hypertension (OHT. SLT was demonstrated equally as effective as topical medical therapy and argon laser trabeculoplasty (ALT to lower IOP. It is a potentially repeatable procedure because of the lack of coagulation damage to the trabecular meshwork (TM and also effect in patients with previously failed ALT. SLT can be used to treat patients with OAG, pseudoexfoliation glaucoma, pigmentary glaucoma, normal-tension glaucoma, OHT, juvenile glaucoma, pseudophakic and aphakic glaucoma. Furthermore, SLT can be considered as a primary treatment option in patients who cannot tolerate or are noncompliant with medications, while not interfering with the success of future surgery. Its safety profiles include mild and transient inflammation, ocular pain and a small risk of moderate IOP elevations after the procedure. SLT is a safe and effective means of IOP reduction in eyes with OAG and OHT.

  12. Antimicrobial drugs for treating cholera.

    Science.gov (United States)

    Leibovici-Weissman, Ya'ara; Neuberger, Ami; Bitterman, Roni; Sinclair, David; Salam, Mohammed Abdus; Paul, Mical

    2014-06-19

    Cholera is an acute watery diarrhoea caused by infection with the bacterium Vibrio cholerae, which if severe can cause rapid dehydration and death. Effective management requires early diagnosis and rehydration using oral rehydration salts or intravenous fluids. In this review, we evaluate the additional benefits of treating cholera with antimicrobial drugs. To quantify the benefit of antimicrobial treatment for patients with cholera, and determine whether there are differences between classes of antimicrobials or dosing schedules. We searched the Cochrane Infectious Disease Group Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; African Index Medicus; LILACS; Science Citation Index; metaRegister of Controlled Trials; WHO International Clinical Trials Registry Platform; conference proceedings; and reference lists to March 2014. Randomized and quasi-randomized controlled clinical trials in adults and children with cholera that compared: 1) any antimicrobial treatment with placebo or no treatment; 2) different antimicrobials head-to-head; or 3) different dosing schedules or different durations of treatment with the same antimicrobial. Two reviewers independently applied inclusion and exclusion criteria, and extracted data from included trials. Diarrhoea duration and stool volume were defined as primary outcomes. We calculated mean difference (MD) or ratio of means (ROM) for continuous outcomes, with 95% confidence intervals (CI), and pooled data using a random-effects meta-analysis. The quality of evidence was assessed using the GRADE approach. Thirty-nine trials were included in this review with 4623 participants. Antimicrobials versus placebo or no treatment Overall, antimicrobial therapy shortened the mean duration of diarrhoea by about a day and a half compared to placebo or no treatment (MD -36.77 hours, 95% CI -43.51 to -30.03, 19 trials, 1013 participants, moderate quality evidence). Antimicrobial therapy also

  13. Interventions for treating schistosomiasis mansoni.

    Science.gov (United States)

    Saconato, H; Atallah, A

    2000-01-01

    Schistosomiasis is a parasite that is carried by freshwater snails. The intestinal form infects the intestine, liver and spleen and can be fatal. The objective of this review was to assess the effects of oxamniquine or praziquantel for treating Schistosomiasis mansoni We searched the Cochrane Infectious Diseases Group trials register, the Cochrane Controlled Trials Register, Medline, Lilacs and reference lists of articles. The Revista da Sociedade Brasileira de Medicina Tropical and Brazilian Tropical Medicine Congress abstracts were handsearched Randomised and quasi-randomised trials comparing oxamniquine and/or praziquantel to placebo for the treatment of Schistosomiasis mansoni. Two reviewers independently assessed trial quality and extracted data. Thirteen trials met the inclusion criteria. Praziquantel and oxamniquine were effective in curing Schistosoma mansoni infection when compared to placebo. In Africa, praziquantel 40 mg/Kg is more effective than oxamniquine 15 mg/Kg in individuals older than 14 years (OR 3.54, 95%CI 1.70, 7.38), but no difference was found when compared with oxamniquine 30 mg/Kg (OR 0.29, 95%CI 0.08, 1.01). In Brazil, praziquantel was equally effective when compared with oxamniquine in individuals older than 14 years (OR 1.70, 95%CI 0.83, 3.49). Both drugs appear safe. There was no difference in reinfection rate between zinc supplementation and placebo (OR 0.82, 95%CI 0.47, 1.41). IPraziquantel and oxamniquine both appear to be effective for the treatment of Schistosomiasis mansoni, although lower doses of oxamniquine (less than 30 milligrams per kilogram) may not be as effective.

  14. Hypertensive thalamic hematoma treated by CT stereotactic evacuation (with two cases reports)

    International Nuclear Information System (INIS)

    Wang Hongsheng; Zhu Fengqing

    2002-01-01

    Objective: To investigate new surgical method to treat hypertensive thalamic hematoma. Methods: Two medial-degree coma patients with hypertensive thalamic hematoma were treated by CT stereotactic evacuation. Results: One week after operation the two patients regained consciousness. The function of paraplegic appendage restored partly, and one patient could take care of himself. Conclusion: CT stereotactic evacuation to treat hypertensive thalamic hematoma has the advantages of small trauma, little complication and good clinical results. The authors suggest that it be selected firstly in treating hypertensive thalamic hematoma

  15. Pancreatic Stones: Treat or Ignore?

    Directory of Open Access Journals (Sweden)

    DA Howell

    1999-01-01

    Full Text Available Painful, chronic pancreatitis is of complex etiology, but increasing clinical experience suggests that removal of pancreatic duct stones in many cases significantly improves patients’ symptoms. The development and refinement of therapeutic endoscopic retrograde choledochopancreatography have permitted improved access to the pancreatic duct, which makes the development of new techniques of stone fragmentation and fragment removal a much more successful nonsurgical intervention. A major step forward has been the understanding of the safety and efficacy of pancreatic sphincterotomy, which is necessary for the removal of these difficult stones. The recognition that extracorporeal shock wave lithotripsy can be delivered safely with good efficacy has revolutionized the nonsurgical management of pancreatic duct stones. Nevertheless, advanced and sophisticated therapeutic endoscopy is necessary to achieve clearance of the duct, which can generally be accomplished in the majority of selected patients. State-of-the-art treatments are described, and some new approaches using pancreatoscopy and electrohydrolic lithotripsy are discussed. Newly recognized long term complications are reviewed. Finally, it must be recognized that chronic pancreatitis is an ongoing disease that does not have a simple treatment or cure, and frequently represents a process of remissions and relapses requiring interventions and problem solving.

  16. Report on the achievements in the Sunshine Project in fiscal 1993 on development of a jet flow bed gasification electric power plant. Investigative research on a technology to treat coals used for coal gasification (investigation for coal type selection); 1993 nendo funryusho gas ka hatsuden plant kaihatsu seika hokokusho. Sekitan gas kayotan no shori gijutsu ni kansuru chosa kenkyu (tanshu sentei chosa)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1984-03-01

    This paper describes the achievements in the Sunshine Project in fiscal 1993 in the investigation for coal type selection. The investigation is purposed to elucidate the status of existence and resources of coals as the raw material for coal gasification and liquefaction, the coal quality features, and the gasification and liquefaction characteristics. The results will be used as the fundamental materials for technological development. Discussions will also be given on the coal applicability to the composite gasification power generation system in which liquefied residue generated in the process are mixed with the supplied coal. Coal quality analysis and a liquefaction test under the standard condition were completed on 389 test samples composed of 136 kinds of coals produced in Canada, Australia, the U.S.A., China and Indonesia. Coal types were enumerated according to the oil yield. A gasification test was performed on the specific gravity separated coals of Chinese coals to discuss the effect of change in the ash amount on the gasification characteristics. A partial coal combustion test revealed that fuel ratio, oxygen partial pressure, and oxygen molar fraction parameters affect the combustion characteristics. The micro-gravity field is effective in discussing the combustion characteristics of particulate groups of dust coal. A coal oxidizing test was performed, wherein oxidizing characteristics and spontaneous ignition performance were estimated successfully from temperature rise of heat stored in coal. The coal type matrix data were prepared. (NEDO)

  17. Anabolic steroids for treating pressure ulcers.

    Science.gov (United States)

    Naing, Cho; Whittaker, Maxine A

    2017-06-20

    Pressure ulcers, also known as bed sores, pressure sores or decubitus ulcers develop as a result of a localised injury to the skin or underlying tissue, or both. The ulcers usually arise over a bony prominence, and are recognised as a common medical problem affecting people confined to a bed or wheelchair for long periods of time. Anabolic steroids are used as off-label drugs (drugs which are used without regulatory approval) and have been used as adjuvants to usual treatment with dressings, debridement, nutritional supplements, systemic antibiotics and antiseptics, which are considered to be supportive in healing of pressure ulcers. Anabolic steroids are considered because of their ability to stimulate protein synthesis and build muscle mass. Comprehensive evidence is required to facilitate decision making, regarding the benefits and harms of using anabolic steroids. To assess the effects of anabolic steroids for treating pressure ulcers. In March 2017 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. Published or unpublished randomised controlled trials (RCTs) comparing the effects of anabolic steroids with alternative treatments or different types of anabolic steroids in the treatment of pressure ulcers. Two review authors independently carried out study selection, data extraction and risk of bias assessment. The review contains only one trial with a total of 212 participants, all with spinal cord injury and open pressure ulcers classed as stage III and IV. The participants were

  18. Corticosteroids for treating hypotension in preterm infants.

    Science.gov (United States)

    Ibrahim, Hafis; Sinha, Ian P; Subhedar, Nimish V

    2011-12-07

    Systemic hypotension is a relatively common complication of preterm birth and is associated with periventricular haemorrhage, periventricular white matter injury and adverse neurodevelopmental outcome. Corticosteroid treatment has been used as an alternative or an adjunct to conventional treatment with volume expansion and vasopressor/inotropic therapy. To determine the effectiveness and safety of corticosteroids used either as primary treatment of hypotension or for the treatment of refractory hypotension in preterm infants. Randomized or quasi-randomised controlled trials were identified by searching the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2011), MEDLINE (1996 to Jan 2011), EMBASE (1974 to Jan 2011), CINAHL (1981 to 2011), reference lists of published papers and abstracts from the Pediatric Academic Societies and the European Society for Pediatric Research meetings published in Pediatric Research (1995 to 2011). We included all randomised or quasi-randomised controlled trials investigating the effect of corticosteroid therapy in the treatment of hypotension in preterm infants (babies with hypotension resistant to inotropes/pressors and volume therapy. We included studies comparing oral/intravenous corticosteroids with placebo, other drugs used for providing cardiovascular support or no therapy in this review. Methodological quality of eligible studies was assessed according to the methods used for minimising selection bias, performance bias, attrition bias and detection bias. Studies that evaluated corticosteroids (1) as primary treatment for hypotension or (2) for refractory hypotension unresponsive to prior use of inotropes/pressors and volume therapy, were analysed using separate comparisons. Data were analysed using the standard methods of the Neonatal Review Group using Rev Man 5.1.2. Treatment effect was analysed using relative risk, risk reduction, number needed to treat for categorical outcomes and

  19. Oil concentrations below a demulsifier treated slick

    International Nuclear Information System (INIS)

    Lunel, T.; Lewis, A.

    1993-01-01

    During field trials in the North Sea in 1992, three 20-tonne slicks of a relatively weak 30% water-in-oil emulsion were released. Two of the slicks were treated with demulsifier from spray aircraft and one of the treated slicks was sprayed with dispersant seven hours later. The experiment used flow-through fluorometry to determine oil concentrations below the control and demulsifier-treated slick. Remote sensing imagery was used to determine the area of the surface slicks. Emulsion formation was slowed down in the two demulsifier-treated slicks relative to the control slick. The demulsifier-treated slicks resulted in maximum oil concentrations in water some five times higher than the control slick and spread over a volume 10-20 times as large. The control slick was therefore more persistent on the sea surface than either of the treated slicks. 5 refs., 5 figs., 5 tabs

  20. Influence of the size of MoS{sub 2} particles supported on alumina on the activity and the selectivity of hydro-treating reactions; Influence de la taille des particules de MoS{sub 2} supportees sur alumine sur l`activite et la selectivite des reactions d`hydrotraitement

    Energy Technology Data Exchange (ETDEWEB)

    Da Silva, P.

    1998-01-14

    The influence of the size of molybdenum disulfide particles supported on alumina on hydro-desulfurization and hydrogenation reactions has been studied. Different methods have been used to modify the length and the stacking of MoS{sub 2} slabs. MoS{sub 2} slab length measured from Electron Microscopy is increased from 20 to 40 angstroms by increasing loading from 4 to 22 % pds in Mo. These catalysts have been tested and characterised by different techniques. Increasing the sulfiding temperature also leads to an increase in MoS{sub 2} slab length. Bulk MoS{sub 2} and MoS{sub 2}/Al{sub 2}O{sub 3} showing high MoS{sub 2} slab stacking have been prepared from ammonium tetra-thio-molybdate salt. Sulfide phase characterisation results and an hexagonal MoS{sub 2} slab model have been used to estimate a number of edge and corner Mo ions. Catalysts have been characterised by Temperature Programmed Reduction and by CO adsorption at low temperatures (infra-red). Edge and corner Mo ions site densities determined by these techniques are linearly correlated with the number of sites calculated from the hexagonal MoS{sub 2} slab model and the characterisation results. Catalysts have been tested at 350 deg. C, under a total pressure of 4,5 MPa for dibenzo-thiophene hydro-desulfurization and 1-methyl naphthalene hydrogenation in the presence of nitrogen compounds. Linear correlations have been obtained between the catalytic activity and the number of edge and corner Mo sites estimated from different techniques. These results obtained from independent techniques clearly show the essential part played by edge and corner sites on catalytic activity. MoS{sub 2} slab length has no influence on the selectivity hydrogenation/hydro-desulfurization of tested catalysts. On the other side, the increase o stacking of MoS{sub 2} slab un-favours the hydrogenation reaction when compared to the hydro-desulfurization reaction. (author) 169 refs.

  1. Early Uncomplicated Appendicitis-Who Can We Treat Nonoperatively?

    Science.gov (United States)

    Horattas, Mark C; Horattas, Ileana K; Vasiliou, Elya M

    2018-02-01

    This study evaluated nonoperative treatment for mild appendicitis and reviewed selection criteria to be used in introducing this option into clinical practice. A retrospective review of 73 consecutive cases of appendicitis treated by a single surgeon from 2011 to 2013 was completed. Patients who were diagnosed with mild appendicitis meeting the criteria of an APPENDICITIS scoring algorithm proposed in this manuscript were considered for nonoperative management. An additional 17 patients with mild appendicitis were offered and successfully treated nonoperatively between 2014 and 2016 and reviewed. Of these original 73 patients, 37 had moderate to severe appendicitis and directly underwent appendectomy. The remaining patients were diagnosed with mild appendicitis and considered eligible for nonoperative management. Of these, 14 patients were offered nonoperative therapy. Thirteen responded successfully; one patient responded partially, but later opted for surgery. In 2014, this scoring system and preliminary results were shared with the other surgeons in our department. Nonoperative management was then selectively adopted by a few of the surgeons from 2014 to 2016 with another 17 patients (APPENDICITIS score of 0 or 1) being offered and successfully managed nonoperatively. Patients with mild or early appendicitis can be successfully managed nonoperatively. A proposed APPENDICITIS scoring system may provide a helpful mnemonic for successfully selecting patients for this option.

  2. Management Matters. Selection Policies

    Science.gov (United States)

    Pappas, Marjorie L.

    2003-01-01

    One of the most important policy documents for a school library media center is the selection policy or the collection development policy. A well-developed selection policy provides a rationale for the selection decisions made by the school library media specialist. A selection policy represents the criteria against which a challenged book is…

  3. Performance review: neutron hodoscope at TREAT

    International Nuclear Information System (INIS)

    Stanford, G.S.; DeVolpi, A.; Fink, C.L.; Regis, J.P.; Rhodes, E.A.; Stewart, R.R.

    1976-01-01

    The current fuel-motion-detection capabilities of the neutron hodoscopes at TREAT are outlined and discussed, including such topics as spatial and fuel-density resolution, dynamic range, and corrections for detector dead time and supralinearity. Capabilities and analytical techniques are illustrated with examples from several of the power-transient experiments that have been run in the TREAT reactor

  4. FLAMMABILITY OF HERBICIDE-TREATED GUAVA FOLIAGE

    Science.gov (United States)

    Guava leaves treated with herbicide were found to be less flammable than untreated green leaves or dead leaves . Differences in flammability were...determined by small-scale laboratory fires, differential thermal analysis, and thermogravimetric analysis. The herbicide-treated leaves had a higher ash

  5. Distribution pattern of surgically treated symptomatic prolapsed ...

    African Journals Online (AJOL)

    Background: The pattern of distribution of surgically treated symptomatic prolapsed lumbar and sacral intervertebral discs has been published, though scantily, especially in males. We decided to look at our own series, compare and contrast ours with some of those published. Materials and Methods: We treated 88 locations ...

  6. Process for treating oil-chalk

    Energy Technology Data Exchange (ETDEWEB)

    1925-10-20

    A process for treating oil-chalk or similar oil-containing minerals is characterized in that the material is treated in a stream of air diluted with indifferent gases at a temperature of about 150/sup 0/ to 160/sup 0/C.

  7. Erlotinib in previously treated non-small-cell lung cancer

    International Nuclear Information System (INIS)

    Smrdel, U.; Kovac, V.

    2006-01-01

    Background. Erlotinib is a novel biological anti-tumour agent in the treatment of advanced non small cell lung cancer. It represents the molecularly-targeted therapy which has been studied extensively. Case report. We present a case of a patient who suffered from advanced non-small-cell lung cancer. After the progress of disease following a prior chemotherapy he was treated with erlotinib with remarkable effect which was shown at chest x ray and symptoms were quite reduced. Conclusions. In selected patients with advanced non-small-cell lung cancer Erlotinib improves survival and symptom control as it results in presented case. (author)

  8. Method for treating a nuclear process off-gas stream

    International Nuclear Information System (INIS)

    Pence, D.T.; Chou, C.-C.

    1981-01-01

    A method is described for selectively removing and recovering the noble gas and other gaseous components typically emitted during nuclear process operations. The method is useful for treating dissolver off-gas effluents released during reprocessing of spent nuclear fuels to permit radioactive contaminant recovery prior to releasing the remaining off-gases to the atmosphere. The method involves a sequence of adsorption and desorption steps which are specified. Particular reference is made to the separation of xenon and krypton from the off-gas stream, and to the use of silver-exchanged mordenite as the adsorbent. (U.K.)

  9. Radiation exposure estimation from patient treated by I-131

    International Nuclear Information System (INIS)

    Lahfi, Y.; Anjak, O.

    2012-09-01

    Radioactive iodine is the main radiopharmaceutical substance in the nuclear medicine field which used in diagnosis and treatment of patients suffering from thyroid cancer; thus it can be considered as the main source of the public and patient relative exposure. In this study, 192 patients were selected randomly and their radiation dose rate was measured at different levels of the patient's body (thyroid, knee, bladder) after one, twenty four and forty eight hours from availing the prescript quantity of the I-131. The collected data may serve in estimating the worker and public exposure related to the patient treated by I-131. (authors)

  10. Cancer-treating composition containing inductively-heatable particles

    International Nuclear Information System (INIS)

    Gordon, R.T.

    1978-01-01

    A cancer-treating composition including minute particles suspended in an aqueous solution in dosage form is described. This makes it possible to introduce into the interior of the cells of living tissue minute particles, with magnetic properties, which are inductively heated when subjected to a high frequency alternating electromagnetic field. Incorporating specific radioisotopes or tumor-specific antibodies bound to the particles increases selectivity and affinity of cancer cells for the particles. The particles may be used to deliver a chemotherapeutic agent primarily to the interior of the cancer cells by encapsulating the chemotherapeutic agent within the particles for release when the high frequency alternating electromagnetic field is applied. (author)

  11. [Outcome of eating disorder patients treated in tertiary care].

    Science.gov (United States)

    Suokas, Jaana; Gissler, Mika; Haukka, Jari; Linna, Milla; Raevuori, Anu; Suvisaari, Jaana

    2015-01-01

    We assessed the outcome of eating disorder patients treated in a specialized treatment setting. Register-based follow-up study of adults (n = 2 450, 95% women, age range 18-62 years). For each patient four background-matched controls were selected. The hazard ratio for all-cause mortality was 6.51 in anorexia, 2.97 in bulimia and 1.77 in BED. Autoimmune diseases were more common in patients than in controls. Bulimia and BED were associated with increased type 2 diabetes risk. Pregnancy and childbirth rates were lower among patients than among controls. Eating disorders are associated with multiple health problems and increased mortality risk.

  12. Hybrid options for treating cardiac disease.

    Science.gov (United States)

    Umakanthan, Ramanan; Leacche, Marzia; Zhao, David X; Gallion, Anna H; Mishra, Prabodh C; Byrne, John G

    2011-01-01

    The options for treating heart disease have greatly expanded during the course of the last 2 1/2 decades with the advent of hybrid technology. The hybrid option for treating cardiac disease implies using the technology of both interventional cardiology and cardiac surgery to treat cardiac disease. This rapidly developing technology has given rise to new and creative techniques to treat cardiac disease involving coronary artery disease, coronary artery disease and cardiac valve disease, and atrial fibrillation. It has also led to the establishment of new procedural suites called hybrid operating rooms that facilitate the integration of technologies of interventional cardiology catheterization laboratories with those of cardiac surgery operating rooms. The development of hybrid options for treating cardiac disease has also greatly augmented teamwork and collaboration between interventional cardiologists and cardiac surgeons. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Topical herbal therapies for treating osteoarthritis.

    Science.gov (United States)

    Cameron, Melainie; Chrubasik, Sigrun

    2013-05-31

    Before extraction and synthetic chemistry were invented, musculoskeletal complaints were treated with preparations from medicinal plants. They were either administered orally or topically. In contrast to the oral medicinal plant products, topicals act in part as counterirritants or are toxic when given orally. To update the previous Cochrane review of herbal therapy for osteoarthritis from 2000 by evaluating the evidence on effectiveness for topical medicinal plant products. Databases for mainstream and complementary medicine were searched using terms to include all forms of arthritis combined with medicinal plant products. We searched electronic databases (Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, AMED, CINAHL, ISI Web of Science, World Health Organization Clinical Trials Registry Platform) to February 2013, unrestricted by language. We also searched the reference lists from retrieved trials. Randomised controlled trials of herbal interventions used topically, compared with inert (placebo) or active controls, in people with osteoarthritis were included. Two review authors independently selected trials for inclusion, assessed the risk of bias of included studies and extracted data. Seven studies (six different medicinal plant interventions; 785 participants) were included. Single studies (five studies) and non-comparable studies (two studies) precluded pooling of results.Moderate evidence from a single study of 174 people with hand osteoarthritis indicated that treatment with Arnica extract gel probably results in similar benefits as treatment with ibuprofen (non-steroidal anti-inflammatory drug) with a similar number of adverse events. Mean pain in the ibuprofen group was 44.2 points on a 100 point scale; treatment with Arnica gel reduced the pain by 4 points after three weeks: mean difference (MD) -3.8 points (95% confidence intervals (CI) -10.1 to 2.5), absolute reduction 4% (10% reduction to 3% increase). Hand function was 7

  14. Officer Selection (la Selection des officiers)

    National Research Council Canada - National Science Library

    2000-01-01

    .... The theme of this workshop, officer selection, is an issue of central importance to the military forces of all countries, since it determines which individuals, with what characteristics, will...

  15. Foam dressings for treating pressure ulcers.

    Science.gov (United States)

    Walker, Rachel M; Gillespie, Brigid M; Thalib, Lukman; Higgins, Niall S; Whitty, Jennifer A

    2017-10-12

    Pressure ulcers, also known as pressure injuries and bed sores, are localised areas of injury to the skin or underlying tissues, or both. Dressings made from a variety of materials, including foam, are used to treat pressure ulcers. An evidence-based overview of dressings for pressure ulcers is needed to enable informed decision-making on dressing use. This review is part of a suite of Cochrane Reviews investigating the use of dressings in the treatment of pressure ulcers. Each review will focus on a particular dressing type. To assess the clinical and cost effectiveness of foam wound dressings for healing pressure ulcers in people with an existing pressure ulcer in any care setting. In February 2017 we searched: the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations); Ovid Embase; EBSCO CINAHL Plus and the NHS Economic Evaluation Database (NHS EED). We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. Published or unpublished randomised controlled trials (RCTs) and cluster-RCTs, that compared the clinical and cost effectiveness of foam wound dressings for healing pressure ulcers (Category/Stage II or above). Two review authors independently performed study selection, risk of bias and data extraction. A third reviewer resolved discrepancies between the review authors. We included nine trials with a total of 483 participants, all of whom were adults (59 years or older) with an existing pressure ulcer Category/Stage II or above. All trials had two arms, which compared foam dressings with other dressings for treating pressure ulcers.The certainty of evidence ranged from low to very low due

  16. Consensus paper on post-operative pediatric cerebellar mutism syndrome

    DEFF Research Database (Denmark)

    Gudrunardottir, Thora; Morgan, Angela T; Lux, Andrew L

    2016-01-01

    -operative pediatric CMS" was formed, preliminary recommendations for diagnostic and follow-up procedures were created, two working groups on a new scoring scale and risk prediction and prevention were established, and areas were identified where further information is needed. DISCUSSION: The consensus process...... to provide a more solid foundation for future clinical and research work. It is thought as a consensus for moving forward and hopefully paves the way to developing a standard approach to this challenging problem with the advent of better scoring methods and ultimate goal of reducing the risk of CMS....

  17. Predictors for perioperative blood transfusion in elderly patients with extra capsular hip fractures treated with cephalo-medullary nailing

    Directory of Open Access Journals (Sweden)

    M. Ali Fazal

    2018-02-01

    Conclusion: Patient age, ASA grade, preoperative haemoglobin and length of nail are reliable predictors for perioperative blood transfusion in extra capsular hip fractures in elderly patients treated with cephalo-medullary nailing and reinforce a selective transfusion policy.

  18. TREAT - Teachers redesigning educational activities with technology

    DEFF Research Database (Denmark)

    Nielsen, Tobias Alsted; Andersen, Mathias Elmose; Alsholm, Anne-Mette

    undervisningssituationer på Aarhus Universitet BSS. TREAT kan anvendes som en selvstændig ressource af den enkelte underviser, eller som en integreret del af Educational IT/blended learning kurser. TREAT tager afsæt i Dee Finks “Integrated Course Design” (2005), som belyser hvordan undervisere kan sammensætte et...... ressourcen i forbindelse med CUL’s blended learning kurser har været positive. Vi oplever derudover en national såvel som international interesse for ressourcen. treat.au.dk Referencer: Biggs, J. & C. Tang (2007): Teaching for Quality Learning at University. Open University Press, McGraw- Hill Education...

  19. Removal of nitrate from water by adsorption onto zinc chloride treated activated carbon

    DEFF Research Database (Denmark)

    Bhatnagar, A.; Ji, M.; Choi, Y.H.

    2008-01-01

    Adsorption study with untreated and zinc chloride (ZnCl2) treated coconut granular activated carbon (GAC) for nitrate removal from water has been carried out. Untreated coconut GAC was treated with ZnCl2 and carbonized. The optimal conditions were selected by studying the influence of process...... variables such as chemical ratio and activation temperature. Experimental results reveal that chemical weight ratio of 200% and temperature of 500 degrees C was found to be optimum for the maximum removal of nitrate from water. Both untreated and ZnCl2 treated coconut GACs were characterized by scanning...... capacity of untreated and ZnCl2 treated coconut GACs were found 1.7 and 10.2 mg/g, respectively. The adsorption of nitrate on ZnCl2 treated coconut GAC was studied as a function of contact time, initial concentration of nitrate anion, temperature, and pH by batch mode adsorption experiments. The kinetic...

  20. Influence of different adhesive systems on bond strength of carbon fiber posts used to restore endodontically treated teeth

    OpenAIRE

    Silva, Lorena dos Santos; Reis, Kátia Rodrigues; Ambrosano, Glaucia Maria Bovi; Chuí, Fabíola Mendonça da Silva; Sena, Neylla Teixeira; Carvalhal, Cintia Iara Oda; Oliveira, Jonas Alves de

    2013-01-01

    The aim of this study was to evaluate the influence of three adhesive systems on resinous bonding of carbon fiber posts on roots of endodontically treated bovine incisors. Thirty bovine lower incisors with similar dimensions were selected for this study. The roots were endodontically treated and subsequently prepared for post cementation. The posts were treated with adhesive systems Scotchbond MultiPurpose Plus – 3M chemical cure (Group I), light cure (Group II) and dual cure (Group III). Car...

  1. Characterization of a Laser Surface-Treated Martensitic Stainless Steel

    Directory of Open Access Journals (Sweden)

    S.R. Al-Sayed

    2017-05-01

    Full Text Available Laser surface treatment was carried out on AISI 416 machinable martensitic stainless steel containing 0.225 wt.% sulfur. Nd:YAG laser with a 2.2-KW continuous wave was used. The aim was to compare the physical and chemical properties achieved by this type of selective surface treatment with those achieved by the conventional treatment. Laser power of different values (700 and 1000 W with four corresponding different laser scanning speeds (0.5, 1, 2, and 3 m•min−1 was adopted to reach the optimum conditions for impact toughness, wear, and corrosion resistance for laser heat treated (LHT samples. The 0 °C impact energy of LHT samples indicated higher values compared to the conventionally heat treated (CHT samples. This was accompanied by the formation of a hard surface layer and a soft interior base metal. Microhardness was studied to determine the variation of hardness values with respect to the depth under the treated surface. The wear resistance at the surface was enhanced considerably. Microstructure examination was characterized using optical and scanning electron microscopes. The corrosion behavior of the LHT samples was also studied and its correlation with the microstructures was determined. The corrosion data was obtained in 3.5% NaCl solution at room temperature by means of a potentiodynamic polarization technique.

  2. Characterization of a Laser Surface-Treated Martensitic Stainless Steel.

    Science.gov (United States)

    Al-Sayed, S R; Hussein, A A; Nofal, A A; Hassab Elnaby, S I; Elgazzar, H

    2017-05-29

    Laser surface treatment was carried out on AISI 416 machinable martensitic stainless steel containing 0.225 wt.% sulfur. Nd:YAG laser with a 2.2-KW continuous wave was used. The aim was to compare the physical and chemical properties achieved by this type of selective surface treatment with those achieved by the conventional treatment. Laser power of different values (700 and 1000 W) with four corresponding different laser scanning speeds (0.5, 1, 2, and 3 m•min-1) was adopted to reach the optimum conditions for impact toughness, wear, and corrosion resistance for laser heat treated (LHT) samples. The 0 °C impact energy of LHT samples indicated higher values compared to the conventionally heat treated (CHT) samples. This was accompanied by the formation of a hard surface layer and a soft interior base metal. Microhardness was studied to determine the variation of hardness values with respect to the depth under the treated surface. The wear resistance at the surface was enhanced considerably. Microstructure examination was characterized using optical and scanning electron microscopes. The corrosion behavior of the LHT samples was also studied and its correlation with the microstructures was determined. The corrosion data was obtained in 3.5% NaCl solution at room temperature by means of a potentiodynamic polarization technique.

  3. Economic Selection Theory

    DEFF Research Database (Denmark)

    Knudsen, Thorbjørn

    2003-01-01

    principles of variation, continuity and selection, it is argued that economic selection theory should mimic the causal structure of neo-Darwinian theory. Two of the most influential explanations of economic evolution, Alchian's and Nelson and Winter's, are used to illustrate how this could be achieved.......The present article provides a minimal description of the causal structure of economic selection theory and outlines how the internal selection dynamics of business organisations can be reconciled with selection in competitive markets. In addition to generic similarity in terms of the Darwinian...

  4. Selective Reproductive Technologies

    DEFF Research Database (Denmark)

    Gammeltoft, Tine; Wahlberg, Ayo

    2014-01-01

    From a historical perspective, selective reproduction is nothing new. Infanticide, abandonment, and selective neglect of children have a long history, and the widespread deployment of sterilization and forced abortion in the twentieth century has been well documented. Yet in recent decades select......, discussing how selective reproduction engages with issues of long-standing theoretical concern in anthropology, such as politics, kinship, gender, religion, globalization, and inequality....... (ARTs), what we term selective reproductive technologies (SRTs) are of a more specific nature: Rather than aiming to overcome infertility, they are used to prevent or allow the birth of certain kinds of children. This review highlights anthropological research into SRTs in different parts of the world...

  5. IT Project Selection

    DEFF Research Database (Denmark)

    Pedersen, Keld

    2016-01-01

    for initiation. Most of the research on project selection is normative, suggesting new methods, but available empirical studies indicate that many methods are seldom used in practice. This paper addresses the issue by providing increased understanding of IT project selection practice, thereby facilitating...... the development of methods that better fit current practice. The study is based on naturalistic decision-making theory and interviews with experienced project portfolio managers who, when selecting projects, primarily rely on political skills, experience and personal networks rather than on formal IT project......-selection methods, and these findings point to new areas for developing new methodological support for IT project selection....

  6. Prosthodontic Approach to Treat Obstructive Sleep Apnea ...

    African Journals Online (AJOL)

    Prosthodontic Approach to Treat Obstructive Sleep Apnea. ... Annals of Medical and Health Sciences Research ... disordered breathing represents a continuum, ranging from simple snoring sans sleepiness, upper‑airway resistance syndrome, obstructive sleep apnea (OSA) syndrome, to hypercapnic respiratory failure.

  7. How Is Diabetes Treated in Children?

    Science.gov (United States)

    ... Consumers Home For Consumers Consumer Updates How Is Diabetes Treated in Children? Share Tweet Linkedin Pin it ... as diabetes gets worse over time. Type 2 Diabetes Type 2 diabetes is most often diagnosed in ...

  8. Therapies for Treating Diabetic Nerve Pain

    Science.gov (United States)

    ... pain. There is moderate evidence that the drugs oxcarbazepine, lamotrigine, and lacosamide likely do not help treat ... at first, opioids can have less of an effect over time. There is moderate evidence that the ...

  9. Avulsion Fracture: How Is It Treated?

    Science.gov (United States)

    ... way to treat an avulsion fracture in a young athlete? Answers from Edward R. Laskowski, M.D. ... Clinic does not endorse any of the third party products and services advertised. Advertising and sponsorship policy ...

  10. Hemifacial atrophy treated with autologous fat transplantation

    Directory of Open Access Journals (Sweden)

    Gandhi Vijay

    2005-01-01

    Full Text Available A 23-year-old male developed right hemifacial atrophy following marphea profunda. Facial asymmetry due to residual atrophy was treated with autologous fat harvested from buttocks with marked cosmetic improvement.

  11. Physics design of the upgraded TREAT reactor

    International Nuclear Information System (INIS)

    Bhattacharyya, S.K.; Lell, R.M.; Liaw, J.R.; Ulrich, A.J.; Wade, D.C.; Yang, S.T.

    1980-01-01

    With the deferral of the Safety Test Facility (STF), the TREAT Upgrade (TU) reactor has assumed a lead role in the US LMFBR safety test program for the foreseeable future. The functional requirements on TU require a significant enhancement of the capability of the current TREAT reactor. A design of the TU reactor has been developed that modifies the central 11 x 11 fuel assembly array of the TREAT reactor such as to provide the increased source of hard spectrum neutrons necessary to meet the functional requirements. A safety consequence of the increased demands on TU is that the self limiting operation capability of TREAT has proved unattainable, and reliance on a safety grade Plant Protection System is necessary to ensure that no clad damage occurs under postulated low-probability reactivity accidents. With that constraint, the physics design of TU provides a means of meeting the functional requirements with a high degree of confidence

  12. Evaluation of asphalt treated permeable base.

    Science.gov (United States)

    2013-12-01

    III : Tec : hnical : Report Documentation Page : 1. Report No. : 2. Government Accession : No. : 3. Recipient's Catalog No : . : 201 : 3 : - : 09 : - : - : - : - : - : - : 4. Title and Subtitle : 5. Report Date : Evaluation of Asphalt Treated Permeab...

  13. Branding to treat jaundice in India.

    Science.gov (United States)

    John, Selva Inita; Balekuduru, Ainash; Zachariah, Uday; Eapen, C E; Chandy, George

    2009-01-01

    Jaundice is regarded as a mysterious disease rather than a symptom of disease in several parts of India. We describe 8 cases that underwent branding to treat jaundice and subsequently presented to our centre. The causes for jaundice in these patients included a variety of benign and malignant disorders. Our report suggests that despite being literate, strong cultural beliefs lead people to seek potentially harmful procedures like branding to treat jaundice in parts of India.

  14. Outcome of Endodontically Treated Cracked Teeth

    Science.gov (United States)

    2016-06-01

    directed by: CAPT Te!Ty Webb, D.D.S., M.S. A " cracked tooth" is defined as a thin surface enamel and dentin disruption of unknown depth, and is often...OUTCOME OF ENDODONTICALL Y TREATED CRACKED TEETH by David Michael Dow II, D.D.S. Lieutenant Commander, Dental Corps United States Navy A thesis...copyrighted material in the thesis manuscript titled: "Outcome ofEndodontically Treated Cracked Teeth" is appropriately acknowledged and, beyond

  15. Selective transcervical tubal recanalisation using DSA

    International Nuclear Information System (INIS)

    Kelekis, D.; Fezoulidis, I.; Petsas, T.; Tsapalira, A.; Kelekis, N.

    1991-01-01

    The results of selective transcervical tubal recanalisation by means of a catheter in 20 patients with tubal occlusions are reported and discussed. The advantages of tubal recanalisation under DSA are stressed. In 18 (90%) of the 20 patients treated, it was possible to recanalise at least one tube. Nine of these 18 women (50%) became pregnant during the period of observation, averaging 12 months. Selective transcervical recanalisation of obstructive tubes is a rapid, reliable, cheap and hardly invasive treatment of sterility, when compared with laparoscopy or laparotomy. In the majority of patients it makes surgery unnecessary. (orig.) [de

  16. Selective uterine artery embolization: its application in treating symptomatic uterine leiomyomas

    International Nuclear Information System (INIS)

    Zhang Guofu; Han Zhigang; Hu Pei'an; Wang Shijia; Tian Xiaomei; Zhou Yan; He Beiyi; Wang Jing

    2010-01-01

    Objective: To discuss the feasibility and safety of uterine artery embolization(UAE) for the treatment of symptomatic uterine leiomyomas. Methods: During the period of Jan. 2005-June 2009, UAE was performed in 85 patients with uterine leiomyomas in the authors' hospital. The main symptoms included hypermenorrhea, delayed menstruation and pelvic pressure symptoms. The bilateral uterine arteries were embolized with polyvinyl alcohol particles (diameter 500-710 μm) and Gelfoam. The technical success rate and the clinical results were observed. The patients were followed up for 6-36 months. Results: The technical success rate of bilateral uterine artery embolization was 100%. No serious complications occurred. During the follow-up period, menses returned to regular cycle in all patients and the hemoglobin concentration rose up to normal level in patients with anemia. The sizes of uterine leiomyomas were decreased by 57.5% after 6 months of the procedure. Conclusion: UAE is an effective and less-invasive treatment for symptomatic uterine leiomyomas with reliable results and fewer complications. This technique can greatly avoid unnecessary uterectomy and, thus, preserve the fertility of the female patients.(authors)

  17. Selective inhibition of B lymphocytes in TBTC-treated human bone marrow long-term culture.

    NARCIS (Netherlands)

    Carfi', M.; Bowe, G.; Pieters, R.; Gribaldo, L.

    2010-01-01

    Tributyltin chloride (TBTC) is well known for its immunotoxic effect, in particular towards immature thymocytes. TBTC is also known to induce adipocyte differentiation in primary human bone marrow cultures, which is reflected in the decrease in a number of adipocyte-derived cytokines, chemokines and

  18. Screening selected Vietnamese plants used to treat diabetes for PTP1B inhibitory activity

    DEFF Research Database (Denmark)

    Trinh, Thi Dieu Binh; Staerk, D; Jäger, A K

    2016-01-01

    -scale HPLC, and this showed that ethyl acetate and butanol extracts of R. mucronata and K. candel contained high levels of tannins, and were therefore not investigated further. Ethyl acetate extracts of N. mirabilis, P. amarus, P. urinaria, L. octavalvis, E. hirta, S. cumini, F. racemosa, P. ducle, C...

  19. The Use of Predatory Bacteria to Control Select Pathogens and Treat Respiratory Infections

    Science.gov (United States)

    2015-04-13

    V. et al. The development of a multiplex real-time PCR to quantify Fusarium DNA of trichothecene and fumonisin producing strains in maize ...AND ADDRESS (ES) U.S. Army Research Office P.O. Box 12211 Research Triangle Park, NC 27709-2211 Predatory bacteria, Bdellovibrio bacteriovorus...of Papers published in peer-reviewed journals : Number of Papers published in non peer-reviewed journals : Final Report: The Use of Predatory Bacteria

  20. Selecting Effective Treatments: A Comprehensive, Systematic Guide to Treating Mental Disorders. Revised Edition.

    Science.gov (United States)

    Seligman, Linda

    This book presents an overview of the major types of mental disorders, accompanied by treatment models that are structured, comprehensive, grounded in research, and likely to be effective. Chapter topics are: (1) "Introduction to Effective Treatment Planning"; (2) "Mental Disorders in Infants, Children, and Adolescents"; (3) "Situationally…

  1. ADVANCED TOOLS FOR ASSESSING SELECTED PRESCRIPTION AND ILLICIT DRUGS IN TREATED SEWAGE EFFLUENTS AND SOURCE WATERS

    Science.gov (United States)

    The purpose of this poster is to present the application and assessment of advanced technologies in a real-world environment - wastewater effluent and source waters - for detecting six drugs (azithromycin, fluoxetine, omeprazole, levothyroxine, methamphetamine, and methylenedioxy...

  2. Selective sparing of goblet cells and paneth cells in the intestine of methotrexate-treated rats

    NARCIS (Netherlands)

    M. Verburg (Melissa); I.B. Renes (Ingrid); H.P. Meijer; J.A. Taminiau; H.A. Büller (Hans); A.W.C. Einerhand (Sandra); J. Dekker (Jan)

    2000-01-01

    textabstractProliferation, differentiation, and cell death were studied in small intestinal and colonic epithelia of rats after treatment with methotrexate. Days 1-2 after treatment were characterized by decreased proliferation, increased apoptosis, and decreased numbers and depths

  3. [Selected aspects of quality of life of patients treated for neoplasms of oral cavity].

    Science.gov (United States)

    Fraczak, Piotr

    2008-01-01

    Neoplasms of oral cavity make up 2.4% of all neoplasms in male and 1.1% in female population of Poland. Treatment of neoplasms in this area is mainly surgical and leads to a smaller or larger disability with a disorder of basic physiological functions such as breathing, swallowing and speech. It leads as well to the creation of psychological symptoms such as anxiety, depression. Lack of available data in Polish literature as well as in foreign literature on the subject of psychological state and quality of life of those patients, convinced me to start research in this area. The research was conducted on a group of 131 patients aged 44-82 years. The patients were divided into three groups: group I consisted of patients after surgical procedures in the face area, group II of patients with serious prognosis (leukaemia) and group III of healthy patients. All patients were subject to survey, which consisted of 2 parts. First part contained 7 questions and related to patient's knowledge as to prognosis for further life (this part pertained patients from group I and II). Second part of the questionnaire was a shortened version of a depression scale based on 15 traits and short version based on 4 traits. It was adopted, that this is a good research tool in case of depression, since it is directed exclusively on diagnosis of depression symptoms. Short research technique facilitates the patient to answer questions asked. The results were interpreted according to depression rating scale. The research indicated that amongst patients after surgical procedures; over 50% of women and almost 40% of man showed intensified growth of depression. This percentage was significantly lower in the group of patients with serious prognosis. In the healthy group, all of the women and over 80% of men had no depression. Education statistically had no significant influence on the depression level. It can be ascertained that surgical procedures in the facial area and oral cavity have influence and generate patient's depression. Therefore, the care over those patients should be multispecialistic.

  4. Under treated Breast Cancer in the Elderly

    International Nuclear Information System (INIS)

    Malik, M.K.; Tartter, P.I.; Belfer, R.

    2013-01-01

    The effect of under treatment with adjuvant hormonal therapy, chemotherapy, or radiation was studied in elderly women with breast cancer. A prospectively maintained database was used to identify women undergoing potentially curative surgery between 1978 and 2012. The presentation, pathologic findings, treatment, and outcomes of 382 women over 70 were compared to the findings in 2065 younger patients. Subsequently, conventionally treated and under treated elderly patients were identified and their characteristics and outcomes were compared. Both young and old patients presented most frequently with mammographic findings, but older patients presented more frequently with mammographic masses while younger patients presented more frequently with mammographic calcifications. Cancers of older patients were significantly more favorable than cancers in younger patients: smaller, with more infiltrating lobular, fewer ductal carcinoma in situ, and more frequently estrogen receptor positive and fewer were poorly differentiated. Elderly patients had less axillary sampling, fewer mastectomies, less adjuvant radiation therapy, and more hormonal therapy. Fifty-one percent of the 382 elderly patients were under treated by conventional criteria. Under treated patients were more frequently in situ, better differentiated, smaller, and more often estrogen receptor positive. Forty-four percent of the under treated patients died during followup without disease recurrence. Despite under treatment, local and distant disease-free survival was comparable to patients who were not under treated.

  5. Potent and selective mediators of cholesterol efflux

    Energy Technology Data Exchange (ETDEWEB)

    Bielicki, John K; Johansson, Jan

    2015-03-24

    The present invention provides a family of non-naturally occurring polypeptides having cholesterol efflux activity that parallels that of full-length apolipoproteins (e.g., Apo AI and Apo E), and having high selectivity for ABAC1 that parallels that of full-length apolipoproteins. The invention also provides compositions comprising such polypeptides, methods of identifying, screening and synthesizing such polypeptides, and methods of treating, preventing or diagnosing diseases and disorders associated with dyslipidemia, hypercholesterolemia and inflammation.

  6. Multi-Physics Simulation of TREAT Kinetics using MAMMOTH

    Energy Technology Data Exchange (ETDEWEB)

    DeHart, Mark; Gleicher, Frederick; Ortensi, Javier; Alberti, Anthony; Palmer, Todd

    2015-11-01

    With the advent of next generation reactor systems and new fuel designs, the U.S. Department of Energy (DOE) has identified the need for the resumption of transient testing of nuclear fuels. DOE has decided that the Transient Reactor Test Facility (TREAT) at Idaho National Laboratory (INL) is best suited for future testing. TREAT is a thermal neutron spectrum nuclear test facility that is designed to test nuclear fuels in transient scenarios. These specific fuels transient tests range from simple temperature transients to full fuel melt accidents. The current TREAT core is driven by highly enriched uranium (HEU) dispersed in a graphite matrix (1:10000 U-235/C atom ratio). At the center of the core, fuel is removed allowing for the insertion of an experimental test vehicle. TREAT’s design provides experimental flexibility and inherent safety during neutron pulsing. This safety stems from the graphite in the driver fuel having a strong negative temperature coefficient of reactivity resulting from a thermal Maxwellian shift with increased leakage, as well as graphite acting as a temperature sink. Air cooling is available, but is generally used post-transient for heat removal. DOE and INL have expressed a desire to develop a simulation capability that will accurately model the experiments before they are irradiated at the facility, with an emphasis on effective and safe operation while minimizing experimental time and cost. At INL, the Multi-physics Object Oriented Simulation Environment (MOOSE) has been selected as the model development framework for this work. This paper describes the results of preliminary simulations of a TREAT fuel element under transient conditions using the MOOSE-based MAMMOTH reactor physics tool.

  7. Stem cell transplantation for treating Duchenne muscular dystrophy

    Science.gov (United States)

    Yang, Xiaofeng

    2012-01-01

    OBJECTIVE: To identify global research trends in stem cell transplantation for treating Duchenne muscular dystrophy using a bibliometric analysis of Web of Science. DATA RETRIEVAL: We performed a bibliometric analysis of studies on stem cell transplantation for treating Duchenne muscular dystrophy from 2002 to 2011 retrieved from Web of Science. SELECTION CRITERIA: Inclusion criteria: (a) peer-reviewed published articles on stem cell transplantation for treating Duchenne muscular dystrophy indexed in Web of Science; (b) original research articles, reviews, meeting abstracts, proceedings papers, book chapters, editorial material, and news items; and (c) publication between 2002 and 2011. Exclusion criteria: (a) articles that required manual searching or telephone access; (b) documents that were not published in the public domain; and (c) corrected papers. MAIN OUTCOME MEASURES: (1) Annual publication output; (2) distribution according to subject areas; (3) distribution according to journals; (4) distribution according to country; (5) distribution according to institution; (6) distribution according to institution in China; (7) distribution according to institution that cooperated with Chinese institutions; (8) top-cited articles from 2002 to 2006; (9) top-cited articles from 2007 to 2011. RESULTS: A total of 318 publications on stem cell transplantation for treating Duchenne muscular dystrophy were retrieved from Web of Science from 2002 to 2011, of which almost half derived from American authors and institutes. The number of publications has gradually increased over the past 10 years. Most papers appeared in journals with a focus on gene and molecular research, such as Molecular Therapy, Neuromuscular Disorders, and PLoS One. The 10 most-cited papers from 2002 to 2006 were mostly about different kinds of stem cell transplantation for muscle regeneration, while the 10 most-cited papers from 2007 to 2011 were mostly about new techniques of stem cell transplantation

  8. Assessment of candidate sites for disposal of treated effluents at the Hanford Site, Washington

    International Nuclear Information System (INIS)

    Davis, J.D.

    1992-01-01

    A rigidly defined evaluation process was used to recommend a preferred location to dispose of treated effluents from facilities in the 200 Areas of the US Department of Energy's Hanford Site in Washington State. First, siting constraints were defined based on functional design considerations and siting guidelines. Then, criteria for selecting a preferred site from among several candidates were identified and their relative importance defined. Finally, the weighted criteria were applied and a site was selected for detailed characterization by subsurface investigations

  9. Restaurant Selection in Dublin

    OpenAIRE

    Cullen, Frank

    2012-01-01

    The primary objective of this research was to investigate the selection process used by consumers when choosing a restaurant to dine. This study examined literature on consumer behaviour, restaurant selection, and decision-making, underpinning the contention that service quality is linked to the consumer’s selection of a restaurant. It supports the utility theories that consumers buy bundles of attributes that simultaneously combined represent a certain level of service quality at a certain p...

  10. Compressors selection and sizing

    CERN Document Server

    Brown, Royce N

    2005-01-01

    This practical reference provides in-depth information required to understand and properly estimate compressor capabilities and to select the proper designs. Engineers and students will gain a thorough understanding of compression principles, equipment, applications, selection, sizing, installation, and maintenance. The many examples clearly illustrate key aspects to help readers understand the ""real world"" of compressor technology.Compressors: Selection and Sizing, third edition is completely updated with new API standards. Additions requested by readers include a new section on di

  11. Cryogenic Selective Surfaces

    Data.gov (United States)

    National Aeronautics and Space Administration — Selective surfaces have wavelength dependent emissivity/absorption. These surfaces can be designed to reflect solar radiation, while maximizing infrared emittance,...

  12. Recruiter Selection Model

    National Research Council Canada - National Science Library

    Halstead, John B

    2006-01-01

    .... The research uses a combination of statistical learning, feature selection methods, and multivariate statistics to determine the better prediction function approximation with features obtained...

  13. Asbestos: selected cancers

    National Research Council Canada - National Science Library

    Institute of Medicine; Board on Population Health and Public Health Practice; Institute of Medicine; National Academy of Sciences

    2006-01-01

    ...: Selected Health Effects. This committee was charged with addressing whether asbestos exposure is causally related to adverse health consequences in addition to asbestosis, mesothelioma, and lung cancer. Asbestos...

  14. Oral zinc for treating diarrhoea in children

    Science.gov (United States)

    Lazzerini, Marzia; Wanzira, Humphrey

    2016-01-01

    Background In developing countries, diarrhoea causes around 500,000 child deaths annually. Zinc supplementation during acute diarrhoea is currently recommended by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF). Objectives To evaluate oral zinc supplementation for treating children with acute or persistent diarrhoea. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL (the Cochrane Library 2016, Issue 5), MEDLINE, Embase, LILACS, CINAHL, mRCT, and reference lists up to 30 September 2016. We also contacted researchers. Selection criteria Randomized controlled trials (RCTs) that compared oral zinc supplementation with placebo in children aged one month to five years with acute or persistent diarrhoea, including dysentery. Data collection and analysis Both review authors assessed trial eligibility and risk of bias, extracted and analysed data, and drafted the review. The primary outcomes were diarrhoea duration and severity. We summarized dichotomous outcomes using risk ratios (RR) and continuous outcomes using mean differences (MD) with 95% confidence intervals (CI). Where appropriate, we combined data in meta-analyses (using either a fixed-effect or random-effects model) and assessed heterogeneity. We assessed the certainty of the evidence using the GRADE approach. Main results Thirty-three trials that included 10,841 children met our inclusion criteria. Most included trials were conducted in Asian countries that were at high risk of zinc deficiency. Acute diarrhoea There is currently not enough evidence from well-conducted RCTs to be able to say whether zinc supplementation during acute diarrhoea reduces death or number of children hospitalized (very low certainty evidence). In children older than six months of age, zinc supplementation may shorten the average duration of diarrhoea by around half a day (MD −11.46 hours, 95% CI −19.72 to −3.19; 2581 children, 9 trials, low

  15. Topical phenytoin for treating pressure ulcers.

    Science.gov (United States)

    Hao, Xiang Yong; Li, Hong Ling; Su, He; Cai, Hui; Guo, Tian Kang; Liu, Ruifeng; Jiang, Lei; Shen, Yan Fei

    2017-02-22

    Pressure ulcers are common in clinical practice and pose a significant health problem worldwide. Apart from causing suffering to patients, they also result in longer hospital stays and increase the cost of health care. A variety of methods are used for treating pressure ulcers, including pressure relief, patient repositioning, biophysical strategies, nutritional supplementation, debridement, topical negative pressure, and local treatments including dressings, ointments and creams such as bacitracin, silver sulphadiazine, neomycin, and phenytoin. Phenytoin is a drug more commonly used in the treatment of epilepsy, but may play an important role in accelerating ulcer healing. To assess the effects of topical phenytoin on the rate of healing of pressure ulcers of any grade, in any care setting. In September 2016, we searched the following electronic databases to identify relevant randomized clinical trials: the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL; the Cochrane Library); Ovid MEDLINE; Ovid Embase; and EBSCO CINAHL Plus. We handsearched conference proceedings from the European Pressure Ulcer Advisory Panel, European Wound Management Association and the Tissue Viability Society for all available years. We searched the references of the retrieved trials to identify further relevant trials. We also searched clinical trials registries to identify ongoing and unpublished studies. There were no restrictions with respect to language, date of publication or study setting. We included all randomized controlled trials (RCTs) addressing the effects (both benefits and harms) of topical phenytoin on the healing of pressure ulcers of any grade compared with placebo or alternative treatments or no therapy, irrespective of blinding, language, and publication status. Two review authors independently selected studies, extracted information on participants, interventions, methods and results and assessed risk of bias using

  16. [Sexual offences--selected cases].

    Science.gov (United States)

    Łabecka, Marzena; Jarzabek-Bielecka, Grazyna; Lorkiewicz-Muszyńska, Dorota

    2013-04-01

    Expert testimony on violence victims also includes victims of sexual assault. The role of an expert is to classify the injuries by their severity as defined in art. 157 156 or 217 of the Criminal Code pertaining to crimes against health and life. Also, the role of an expert opinion is to determine whether the injuries identified during the exam occurred at the time and under the circumstances stated in medical history. The examination of sexual assault victims is conducted by two experts: a gynecologist and a forensic physician. Most examinations are performed at different times and various medical centers. The conclusions are presented in an official report. Regardless of victim age, all sexual crimes are investigated ex officio by the Police Department and the Prosecutor's Office. Further legal classification of criminal offenses is the task of an appropriate legal body and the offenses are codified in accordance with the provisions of chapter XXV of the Criminal Code, articles 197 - 205. In controversial cases, i.e. when two different expert opinions appear on the same case, or if, according to the law enforcement, a medical opinion is insufficient for some reason, an appropriate expert or team of experts is appointed to resolve the problem. To present selected cases of sexual violence victims treated at the Department of Gynecology and assessed at the Department of Forensic Medicine with reference to the challenges regarding qualification of the sustained injuries and clinical diagnoses. Research material included selected forensic opinions developed for law enforcement offices that involved victims of sexual violence. The expert opinions were prepared either on the basis of submitted evidence, or both, submitted evidence and examination of the victim at the Department of Forensic Medicine. Moreover the article presents a case of a patient examined and treated at the Department of Gynecology in Poznan. Based on the selected cases, the authors conclude that a

  17. Pump and treat may be the solution

    International Nuclear Information System (INIS)

    Hoffman, A. H.; Truax, S. K.; Conrad, D.

    1997-01-01

    A case history of a 'pump and treat' system, designed to remediate chlorinated solvents and petroleum hydrocarbons in soil and groundwater resulting from historic leaking of six underground storage tanks, was described. The objective of this paper was two-fold: (1) to call into question the findings of some earlier studies which claimed that 'pump and treat' will not work to remediate impacted groundwater in a timely or cost-effective manner, and (2) to demonstrate that under certain circumstances, at some sites, groundwater 'pump and treat' may be the most appropriate, lowest cost remediation alternative. The paper also demonstrates the applicability of horizontal wells and methods to use soil venting in the saturated zone as opposed to its traditional use in the vadose zone. Details of the design parameters, system characteristics and operation are provided. 2 refs., 2 tabs

  18. Treated Wastewater Reuse on Potato (Solanum Tuberosum)

    DEFF Research Database (Denmark)

    Battilani, A; Plauborg, Finn; Andersen, Mathias Neumann

    2014-01-01

    A field experiment was carried out in Northern Italy (Po Valley), within the frame of the EU project SAFIR, to asses the impact of treated wastewater reuse on potato yield, quality and hygiene. The potato crop was drip irrigated and fertigated. Wastewater produced by small communities (≤2000 EI......) was treated by Membrane Bio Reactor (MBR) technology and gravel filter (FTS) during three cropping seasons. Treated wastewater, soil and tubers were analysed for the faecal indicator bacterium E. coli and heavy metals contents. Potato total yield was similar for tap and reused water, while the marketable...... production has been found higher with the latter. The tuber dry matter content as well as reducing sugars were not affected by reused water. Total sugars content was higher with MBR and FTS water. Water use efficiency (WUE) was significantly higher with reused water. Compared to tap water, crop gross margin...

  19. Current developments in TREAT hodoscope technology

    International Nuclear Information System (INIS)

    De Volpi, A.

    1975-01-01

    The development of fuel motion monitoring is traced from its inception through present operation and into future programs. After noting the role of fuel motion studies in terms of safety assurance for the LMFBR, the history of in-pile fuel monitoring is reviewed. The operational record of the present TREAT fast neutron hodoscope is summarized with attention to various performance features. Development plans for the TREAT hodoscope are described in some detail. Application of the hodoscope has been considered for eight safety facilities other than TREAT. In addition, there is a possible role for fuel monitoring techniques to be extended to real-time ex-vessel core surveillance in operating reactors. Certain intrinsic strengths of the hodoscope technique for material monitoring are identified. The pattern of development may be characterized as an adaptation of several technologies to fit available requirements and resources

  20. Uterine arterial embolization to treat uterine leiomyoma

    International Nuclear Information System (INIS)

    Wang Huali; Han Lu; Wang Feng

    2002-01-01

    Objective: To assess the clinical effects of uterine arterial embolization on uterine leiomyoma. Methods: The authors treated 21 patients with uterine leiomyoma by Seldinger's uterine arterial embolization. The 4.0 F Cobra catheter was laced into the double uterine arteries with Polyvinyl Alcohol Foam (PVA) particles as the embolization. At 3 and 6 months postoperatively, the authors investigated the effects of the embolization. Results: After uterine arterial embolization, the volume of uterine leiomyoma decreased and menorrhagia was under controlled. The symptoms of anemia and oppression were relieved. The physiologic functions of ovary and uterus were preserved completely. Conclusions: Uterine arterial embolization is an effective and less invasive way to treat uterine leiomyoma

  1. Nanofluids with plasma treated diamond nanoparticles

    International Nuclear Information System (INIS)

    Yu Qingsong; Kim, Young Jo; Ma Hongbin

    2008-01-01

    In this study, diamond nanoparticles were plasma treated by glow discharges of methane and oxygen with an aim of improving their dispersion characteristics in a base fluid of water and enhancing the thermal conductivity of the resulting nanofluids. It was found that, after plasma treatment, stable nanofluids with improved thermal conductivity were obtained without using any stabilizing agents. With <0.15 vol % addition of plasma treated nanoparticles into water, a 20% increase in thermal conductivity was achieved and a 5%-10% increase in both fluid density and viscosity was observed

  2. Severe iron intoxication treated with exchange transfusion

    DEFF Research Database (Denmark)

    Carlsson, M; Cortes, D; Jepsen, S

    2009-01-01

    An 18-month-old previous healthy girl who had ingested 442 mg elemental iron/kg was admitted to a paediatric intensive care unit. The child was treated with gastric lavage, whole bowel irrigation and intravenous deferoxamine. After 2 h of standard therapy serum iron had risen threefold to 1362 µg....../dl (244 µmol/l). The child was treated with exchange transfusion (ET; 52 ml/kg) and serum iron fell to 134 µg/dl (24 µmol/l). The patient made an uncomplicated recovery. ET should be considered in severe iron poisoning when standard therapy is inadequate....

  3. Severe iron intoxication treated with exchange transfusion

    DEFF Research Database (Denmark)

    Carlsson, Marcella; Cortes, Dina; Jepsen, Søren

    2008-01-01

    An 18-month-old previous healthy girl who had ingested 442 mg elemental iron/kg was admitted to a paediatric intensive care unit. The child was treated with gastric lavage, whole bowel irrigation and intravenous deferoxamine. After 2 h of standard therapy serum iron had risen threefold to 1362 mi...... microg/dl (244 micromol/l). The child was treated with exchange transfusion (ET; 52 ml/kg) and serum iron fell to 134 microg/dl (24 micromol/l). The patient made an uncomplicated recovery. ET should be considered in severe iron poisoning when standard therapy is inadequate....

  4. Treating infidelity in same-sex couples.

    Science.gov (United States)

    Martell, Christopher R; Prince, Stacey E

    2005-11-01

    Psychotherapy with same-sex couples does not differ markedly from standard couple therapies; this is also true for treating couples facing infidelity. However, same-sex couples often design their relationships differently, without tradition and formal marital contracts to prescribe behavior. Based on clinical experience and the empirical research, this article addresses the differing norms involved in affirmatively treating infidelity in gay and lesbian couples within the framework of integrative behavioral couple therapy (IBCT). Two cases illustrate the process and outcome of IBCT with same-sex couples.

  5. Somatic symptom disorder treated with electroconvulsive therapy.

    Science.gov (United States)

    Borisovskaya, Anna; Augsburger, Jay Alan

    2017-05-01

    Somatic symptom disorder (SSD) is a challenging condition to treat with chronic pain, a common and disabling symptom. We present a patient who received electroconvulsive therapy (ECT) for SSD with significant improvement in pain and gastrointestinal symptoms. We also present a brief literature review of similar cases treated with ECT. Preliminary evidence suggests that ECT should be considered for treatment of SSD comorbid with major depressive disorder, when standard treatments fail. Further research is needed to clarify whether ECT can be used for SSD without associated depression.

  6. Treating agent for urea containing radioactive materials

    International Nuclear Information System (INIS)

    Ogawa, Hiroshi; Maki, Kentaro.

    1973-01-01

    Object: To add a coagulant into urea containing radioactive material to precipitate and remove the radioactive material in the urea. Structure: Iodosalt is added into urea and next, a mixed reagent in which silver ion or silver acetic ion and iron hydroxide precipitation or ferrite ion coexist is added therein. The urea is treated to have a sufficient alkaline, after which it is introduced into a basket type centrifuge formed with a filter layer in combination of an upper glass fiber layer and a lower active carbon layer. The treating agent can uniformly remove radioactive ion and radioactive chelate within urea containing inorganic salt and various metabolites. (Nakamura, S.)

  7. Intracellular Protein Delivery for Treating Breast Cancer

    Science.gov (United States)

    2014-08-01

    machinery. In stark contrast, hen HeLa cells were treated with S S Rho—APO NC, strong ed fluorescence of rhodamine was present in the nuclei, esulting...limit (>2500mm3) within 12 days. n sharp contrast, tumor growth was significantly delayed hen treated with S S APO NC (Fig. 4a). Fixed tumor tis- ues...estimation of that each nano molecules throu l groups. ting ligands g” of cycloocty ed nanocapsule targeting ligand ing hormone (L eu -Arg-Pro-NH that

  8. Women: A Select Bibliography.

    Science.gov (United States)

    Kusnerz, Peggy A., Comp.; Pollack, Ann M., Comp.

    This select bibliography lists books, monographs, journals and newsletters which relate to feminism, women's studies, and other perspectives on women. Selections are organized by topic: general, bibliographies, art and literature, biography/autobiography, economics, education, family and marriage, history, politics and sex roles. Also included is…

  9. Sexual selection in Fungi

    NARCIS (Netherlands)

    Nieuwenhuis, B.P.S.

    2012-01-01

    Sexual selection is an important factor that drives evolution, in which fitness is increased, not by increasing survival or viability, but by acquiring more or better mates. Sexual selection favours traits that increase the ability of an individual to obtain more matings than other individuals

  10. Selection and training

    NARCIS (Netherlands)

    Sgobba, T.; Landon, L.B.; Marciacq, J.B.; Groen, E.L.; Tikhonov, N.; Torchia, F.

    2018-01-01

    Selection and training represent two means of ensuring flight crew members are qualified and prepared to perform safely and effectively in space. The first part of the chapter looks at astronaut selection beginning with the evolutionary changes in the US and Russian programs. A discussion of the

  11. Kin Selection - Mutation Balance

    DEFF Research Database (Denmark)

    Dyken, J. David Van; Linksvayer, Timothy Arnold; Wade, Michael J.

    2011-01-01

    selection-mutation balance, which provides an evolutionary null hypothesis for the statics and dynamics of cheating. When social interactions have linear fitness effects and Hamilton´s rule is satisfied, selection is never strong enough to eliminate recurrent cheater mutants from a population, but cheater...

  12. A Selective CPS Transformation

    DEFF Research Database (Denmark)

    Nielsen, Lasse Riechstein

    2001-01-01

    characterize this involvement as a control effect and we present a selective CPS transformation that makes functions and expressions continuation-passing if they have a control effect, and that leaves the rest of the program in direct style. We formalize this selective CPS transformation with an operational...

  13. Microbial pathogens in source and treated waters from drinking water treatment plants in the US

    Science.gov (United States)

    An occurrence survey was conducted on selected pathogens in source and treated drinking water collected from 25 drinking water treatment plants (DWTPs) in the United States. Water samples were analyzed for the protozoa Giardia and Cryptosporidium (EPA Method 1623); the fungi Asp...

  14. A coil placement technique to treat intracranial aneurysm with incorporated artery

    Directory of Open Access Journals (Sweden)

    Chao-Bao Luo

    2018-03-01

    Conclusion: This technique is effective and safe in managing intracranial aneurysms with IAs. Although aneurysmal recurrence may occur in some aneurysms because of insufficient coiling, this technique is simpler to perform and requires less skill than other techniques. It can be an alternative option for treating some selected intracranial aneurysms with IAs.

  15. Green Supplier Selection Criteria

    DEFF Research Database (Denmark)

    Nielsen, Izabela Ewa; Banaeian, Narges; Golinska, Paulina

    2014-01-01

    Green supplier selection (GSS) criteria arise from an organization inclination to respond to any existing trends in environmental issues related to business management and processes, so GSS is integrating environmental thinking into conventional supplier selection. This research is designed...... to determine prevalent general and environmental supplier selection criteria and develop a framework which can help decision makers to determine and prioritize suitable green supplier selection criteria (general and environmental). In this research we considered several parameters (evaluation objectives......) to establish suitable criteria for GSS such as their production type, requirements, policy and objectives instead of applying common criteria. At first a comprehensive and deep review on prevalent and green supplier selection literatures performed. Then several evaluation objectives defined to assess the green...

  16. Phenotypic selection in natural populations: what limits directional selection?

    Science.gov (United States)

    Kingsolver, Joel G; Diamond, Sarah E

    2011-03-01

    Studies of phenotypic selection document directional selection in many natural populations. What factors reduce total directional selection and the cumulative evolutionary responses to selection? We combine two data sets for phenotypic selection, representing more than 4,600 distinct estimates of selection from 143 studies, to evaluate the potential roles of fitness trade-offs, indirect (correlated) selection, temporally varying selection, and stabilizing selection for reducing net directional selection and cumulative responses to selection. We detected little evidence that trade-offs among different fitness components reduced total directional selection in most study systems. Comparisons of selection gradients and selection differentials suggest that correlated selection frequently reduced total selection on size but not on other types of traits. The direction of selection on a trait often changes over time in many temporally replicated studies, but these fluctuations have limited impact in reducing cumulative directional selection in most study systems. Analyses of quadratic selection gradients indicated stabilizing selection on body size in at least some studies but provided little evidence that stabilizing selection is more common than disruptive selection for most traits or study systems. Our analyses provide little evidence that fitness trade-offs, correlated selection, or stabilizing selection strongly constrains the directional selection reported for most quantitative traits.

  17. Selective scattering in a zigzag graphene nanoribbon

    International Nuclear Information System (INIS)

    Nakabayashi, Jun; Kurihara, Susumu

    2009-01-01

    Electric transport of a zigzag graphene nanoribbon through a step-like potential or a potential barrier is studied by using the recursive Green's function method. The results for a step-like potential show that scattering processes in a zigzag graphene nanoribbon obey a following selection rule: when the number of zigzag chains N is even, electrons in the band m are only scattered into the bands m+2n, where n is an integer. According to this selection rule, a step-like potential blocks the current when the potential height exceeds the incident energy as long as only the low-energy region is treated. Then, replacing a step-like potential with a potential barrier, we also show that it can play the role of a b and-selective filter .

  18. Gynecology: select topics.

    Science.gov (United States)

    Sidani, Mohamad; Campbell, James

    2002-06-01

    Menopause, premenstrual syndrome, dysmenorrhea, female fertility, and mastalgia are common problems not easily treated by conventional medicine. Women often seek alternative therapies to help address these conditions. Some evidence points to the efficacy of black cohosh, exercise, and possibly Kava and St. John's wort, in the treatment of menopausal symptoms. Clinical trials indicate that symptoms of premenstrual syndrome may be alleviated with calcium, magnesium, vitamin E. Thiamine, omega-3 fatty acids, the Japanese herbal concoction, TSS, and calcium have proved useful in treating women with dysmenorrhea. Symptoms of mastalgia may be attenuated by evening primrose oil, chaste tree and flaxseed oil may be helpful.

  19. Preliminary report on the Pinex at TREAT

    International Nuclear Information System (INIS)

    Berzins, G.J.; Han, K.S.; Roach, W.H.

    1976-01-01

    The neutron image of a GETR fuel pin was observed in a pinhole experiment (Pinex) performed at TREAT. The signal amplitude, recorded with intensified television cameras, compared well with expectations. The results carry favorable implications for continued development of nonredundant pinhole array techniques, as well as for refinement of single pinhole experiments, as diagnostic tools for the LMFBR safety program

  20. Method of treating oil-bearing shale

    Energy Technology Data Exchange (ETDEWEB)

    Freeman, N H

    1926-04-14

    The process is given for treating shale or other oil-bearing mineral which consists of the application of dry heat to render the oil soluble and subjects the product of the heat treatment to an operation to extract the soluble oils.

  1. Ruptured hepatoblastoma treated with primary surgical resection

    African Journals Online (AJOL)

    The remaining part of the left lobe of the liver, including segment IV ... lung, and brain metastasis, and was treated with comfort measures only ... tumor was noted on the right side of the liter. ... invasive and can control the bleeding to allow for a complete workup and ... Our two cases presented here add to the growing body.

  2. Early-Treated Phenylketonuria: Neuropsychologic Consequences.

    Science.gov (United States)

    Brunner, Robert L.; And Others

    1983-01-01

    The neuropsychologic performance of 27 children (about 6 to 13 years old) with early-treated phenylketonuria (PKU) was evaluated and correlated with their serum phenylalanine concentrations at several ages. (Author/SEW) Journal Availability: The Journal of Pediatrics; The C. V. Mosby Company, 11830 Westline Industrial Drive, St. Louis, MO 63141.

  3. Treating shale oil to obtain sulfonates

    Energy Technology Data Exchange (ETDEWEB)

    Schaeffer, H

    1921-01-21

    The process shows as its principal characteristics: (1) treating the oil with chlorsulfonic acid at a temperature of about 100/sup 0/C; (2) the transformation of the sulfonic acid obtained into salts; (3) as new industrial products, the sulfonates obtained and their industrial application as disinfectants for hides and wood.

  4. Cutaneous streptococcal abscess treated by photodynamic therapy ...

    African Journals Online (AJOL)

    Its action can alter fundamental structures for the survival of microorganisms without any development of microbial resistance. Materials and Methods: Young sheep presenting with abscess in the left forelimb caused by Streptococcus spp. was previously treated with antibiotics. There was no clinical improvement with the ...

  5. Restoration of the endodontically treated posterior tooth

    Directory of Open Access Journals (Sweden)

    Andrea Polesel

    2014-06-01

    Results and conclusions: Direct adhesive restorations, indirect bonded restorations and traditional full crown are three therapeutic options for the single posterior endodontically treated teeth. The amount of remaining sound tooth structure is the most significant factor influencing the therapeutic approach. The clinician's operative skill is a determining aspect for long-term success of adhesive inlays.

  6. Statistical process control for residential treated wood

    Science.gov (United States)

    Patricia K. Lebow; Timothy M. Young; Stan Lebow

    2017-01-01

    This paper is the first stage of a study that attempts to improve the process of manufacturing treated lumber through the use of statistical process control (SPC). Analysis of industrial and auditing agency data sets revealed there are differences between the industry and agency probability density functions (pdf) for normalized retention data. Resampling of batches of...

  7. Characterization of asphalt treated base course material

    Science.gov (United States)

    2010-06-01

    Asphalt-treated bases are often used in new pavements; the materials are available and low-cost, but there is little data on how these materials perform in cold regions. : This study investigated four ATB types (hot asphalt, emulsion, foamed asphalt,...

  8. Treating a case of Savant syndrome

    OpenAIRE

    Busuttil, Joseph

    1994-01-01

    Memory and artistic prodigies among the population at large are uncommon; among the mentally retarded, they are rarer still. This article describes the treatment of such a case, technically known as the Savant Syndrome, seen by occupational therapists at Mount Carmel Psychiatric Hospital and treated over a period of 18 years.

  9. Serum testosterone concentration in chloroquine- treated rats ...

    African Journals Online (AJOL)

    ONOS

    2010-07-05

    Jul 5, 2010 ... The effects of ascorbic acid (vitamin C) and alpha-tocopherol (vitamin E) were studied on serum testosterone ... chloroquine are probably mediated via the generation of free radicals. ... Effects of ascorbic acid and alpha-tocopherol on serum testosterone concentration in chloroquine-treated rats. Groups.

  10. TREAT (TREe-based Association Test)

    Science.gov (United States)

    TREAT is an R package for detecting complex joint effects in case-control studies. The test statistic is derived from a tree-structure model by recursive partitioning the data. Ultra-fast algorithm is designed to evaluate the significance of association between candidate gene and disease outcome

  11. Interventions for treating obesity in children

    NARCIS (Netherlands)

    Oude Luttikhuis, Hiltje; Baur, Louise; Jansen, Hanneke; Shrewsbury, Vanessa A.; O'Malley, Claire; Stolk, Ronald P.; Summerbell, Carolyn D.

    2009-01-01

    Background Child and adolescent obesity is increasingly prevalent, and can be associated with significant short- and long-term health consequences. Objectives To assess the efficacy of lifestyle, drug and surgical interventions for treating obesity in childhood. Search strategy We searched CENTRAL

  12. Tuberculosis Facts - TB Can Be Treated

    Science.gov (United States)

    Tuberculosis (TB) Facts TB Can Be Treated What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one ... Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination Page 1 of 2 TB Facts: TB ...

  13. Device and method for treating cells

    NARCIS (Netherlands)

    2010-01-01

    The present invention relates to a device for treating biological cells in an object, the device comprising: - a single winding coil element; - an electrical generator connected to the single winding coil element, the single winding being configured to be positioned essentially around the object;

  14. Finishability of CCA pressure-treated wood

    Science.gov (United States)

    Alan Ross; Richard Carlson; William Feist; Steven Bussjaeger

    2000-01-01

    Thus, a need arose for the development of surface finishes for CCA-treated wood that could address the special requirements of this substrate and provide protection against the ravages of water, sunlight, mildew, and other aspects of weathering and wear. Initially, this need was not addressed, most wood preserving companies had little expertise in surface finishes and...

  15. Method of treating radioactive waste material

    International Nuclear Information System (INIS)

    Allison, W.

    1980-01-01

    A method of treating radioactive waste material, particularly a radioactive sludge, is described comprising separating solid material from liquid material, compressing the solid material and encapsulating the solid material in a hardenable composition such as cement, bitumen or a synthetic resin. The separation and compaction stages are conveniently effected in a tube press. (author)

  16. The diagnosis and treatment of tubal pregnancy with selective salpingography

    International Nuclear Information System (INIS)

    Li Qunying

    2000-01-01

    Objective: To study feasibility of diagnosing and treating tubal pregnancy with selective salpingography. methods: 13 women diagnosed clinically as ectopic pregnancy without abdominal bleeding were studied and confirmed as tubal pregnancy with selective salpingography, MTX was then injected through fallopian tube. Urine hCG, blood β-hCG and US were studied during follow-up. Results: 12 cases tubal pregnancy were confirmed as well as 1 case of intra-uterine pregnancy. X-ray showed a localized dilation of fallopian tube, half-loop, ring-like or irregular shaped filling defect. In one case, cluster of grapes appearance of contrast medium could be seen at the umbrella end of fallopian tube. Of the 12 cases of tubal pregnancy, 10 were successfully treated, the successful rate was 83%. Conclusion: Selective salpingography is a simple safe and effective method of diagnosing and treating tubal pregnancy

  17. Selective retina therapy (SRT); Selektive Retina-Therapie (SRT)

    Energy Technology Data Exchange (ETDEWEB)

    Brinkmann, R.; Birngruber, R. [Luebeck Univ. (Germany). Inst. fuer Biomedizinische Optik; Medizinisches Laserzentrum Luebeck GmbH, Luebeck (Germany)

    2007-07-01

    Selective Retina Therapy (SRT) is a new and very gentle laser method developed at the Medical Laser Center Luebeck. It is currently investigated clinically in order to treat retinal disorders associated with a decreased function of the retinal pigment epithelium (RPE). SRT is designed to selectively effect the RPE while sparing the neural retina and the photoreceptors as well as the choroid. Aim of the therapy is the rejuvenation of the RPE in the treated areas, which should ideally lead to a long term metabolic increase at the chorio-retinal junction. In contrast to conventional laser photocoagulation, which is associated with a complete thermal necrosis of the treated site, SRT completely retains full vision. This paper reviews the methods and mechanisms behind selective RPE effects and reports the first clinical results. An online dosimetry technique to visualize the ophthalmoscopically invisible effects is introduced. (orig.)

  18. Increased systolic ambulatory blood pressure and microalbuminuria in treated and non-treated hypertensive smokers

    DEFF Research Database (Denmark)

    Sørensen, Kaspar; Kristensen, Kjeld S; Bang, Lia E

    2004-01-01

    The primary aim of the present study was to evaluate the impact of smoking status on both clinic and ambulatory blood pressure (BP) and heart rate (HR) by using 24-h ambulatory BP monitoring in treated and non-treated hypertensive smokers and non-smokers. A secondary aim was to evaluate...

  19. Simulation of selected genealogies.

    Science.gov (United States)

    Slade, P F

    2000-02-01

    Algorithms for generating genealogies with selection conditional on the sample configuration of n genes in one-locus, two-allele haploid and diploid models are presented. Enhanced integro-recursions using the ancestral selection graph, introduced by S. M. Krone and C. Neuhauser (1997, Theor. Popul. Biol. 51, 210-237), which is the non-neutral analogue of the coalescent, enables accessible simulation of the embedded genealogy. A Monte Carlo simulation scheme based on that of R. C. Griffiths and S. Tavaré (1996, Math. Comput. Modelling 23, 141-158), is adopted to consider the estimation of ancestral times under selection. Simulations show that selection alters the expected depth of the conditional ancestral trees, depending on a mutation-selection balance. As a consequence, branch lengths are shown to be an ineffective criterion for detecting the presence of selection. Several examples are given which quantify the effects of selection on the conditional expected time to the most recent common ancestor. Copyright 2000 Academic Press.

  20. Range Selection and Median

    DEFF Research Database (Denmark)

    Jørgensen, Allan Grønlund; Larsen, Kasper Green

    2011-01-01

    and several natural special cases thereof. The rst special case is known as range median, which arises when k is xed to b(j 􀀀 i + 1)=2c. The second case, denoted prex selection, arises when i is xed to 0. Finally, we also consider the bounded rank prex selection problem and the xed rank range......Range selection is the problem of preprocessing an input array A of n unique integers, such that given a query (i; j; k), one can report the k'th smallest integer in the subarray A[i];A[i+1]; : : : ;A[j]. In this paper we consider static data structures in the word-RAM for range selection...... selection problem. In the former, data structures must support prex selection queries under the assumption that k for some value n given at construction time, while in the latter, data structures must support range selection queries where k is xed beforehand for all queries. We prove cell probe lower bounds...

  1. Textural properties of chicken breast treated by different means

    Directory of Open Access Journals (Sweden)

    Jozef Čurlej

    2013-12-01

    Full Text Available The aim of the study was to compare textural atributes of cooked chicken breast samples subjected to different storage or preparation conditions (raw meat after cooking, raw meat after freezing/subsequent thawing, after storage under modified – controlled conditions using instrumental analysis. For this purpose, samples were subjected to texture testing by the use of Warner-Bratzler probe, to find changes in muscle hardness by determination of firmness and work of shear. As expected, various values of mentioned atributes were obtained for tested samples treated by three different ways. For statistical evaluation of the results, macro function of Exponent software and paired T test were used, statistically significant differences were taken at p <0.05. In conclussion, different forces were needed for cutting of tested samples, subjected to selected storage conditions, prior to cooking.

  2. Treating Hypotension in Preterm Neonates With Vasoactive Medications

    Directory of Open Access Journals (Sweden)

    Chloe Joynt

    2018-04-01

    Full Text Available Preterm neonates often have hypotension which may be due to various etiologies. While it is controversial to define hypotension in preterm neonates, various vasoactive medications are commonly used to provide the cardiovascular support to improve the blood pressure, cardiac output, or to treat shock. However, the literature on the systemic and regional hemodynamic effects of these antihypotensive medications in neonates is deficient and incomplete, and cautious translation of findings from other clinical populations and animal studies is required. Based on a literature search on published reports, meta-analytic reviews, and selected abstracts, this review discusses the current available information on pharmacologic actions, clinical effects, and side effects of commonly used antihypotensive medications including dopamine, dobutamine, epinephrine, norepinephrine, vasopressin, and milrinone in preterm neonates.

  3. Directly observed therapy for treating tuberculosis

    Science.gov (United States)

    Karumbi, Jamlick; Garner, Paul

    2015-01-01

    Background Tuberculosis (TB) requires at least six months of treatment. If treatment is incomplete, patients may not be cured and drug resistance may develop. Directly Observed Therapy (DOT) is a specific strategy, endorsed by the World Health Organization, to improve adherence by requiring health workers, community volunteers or family members to observe and record patients taking each dose. Objectives To evaluate DOT compared to self-administered therapy in people on treatment for active TB or on prophylaxis to prevent active disease. We also compared the effects of different forms of DOT. Search methods We searched the following databases up to 13 January 2015: the Cochrane Infectious Diseases Group Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library; MEDLINE; EMBASE; LILACS and mRCT. We also checked article reference lists and contacted relevant researchers and organizations. Selection criteria Randomized controlled trials (RCTs) and quasi-RCTs comparing DOT with routine self-administration of treatment or prophylaxis at home. Data collection and analysis Two review authors independently assessed risk of bias of each included trial and extracted data. We compared interventions using risk ratios (RR) with 95% confidence intervals (CI). We used a random-effects model if meta-analysis was appropriate but heterogeneity present (I2 statistic = 50%). We assessed the quality of the evidence using the GRADE approach. Main results Eleven trials including 5662 participants met the inclusion criteria. DOT was performed by a range of people (nurses, community health workers, family members or former TB patients) in a variety of settings (clinic, the patient's home or the home of a community volunteer). DOT versus self-administered Six trials from South Africa, Thailand, Taiwan, Pakistan and Australia compared DOT with self-administered therapy for treatment. Trials included DOT at home by family members

  4. Trend of Pharmacopuncture Therapy for Treating Cervical Disease in Korea

    Directory of Open Access Journals (Sweden)

    Seok-Hee Kim

    2014-12-01

    Full Text Available Objectives: The purpose of this study is to analyze trends in domestic studies on pharmacopuncture therapy for treating cervical disease. Methods: This study was carried out on original copies and abstracts of theses listed in databases or published until July 2014. The search was made on the Oriental medicine Advanced Searching Integrated System (OASIS the National Digital Science Library (NDSL, and the Korean traditional knowledge portal. Search words were ‘pain on cervical spine’, ‘cervical pain’, ‘ruptured cervical disk’, ‘cervical disc disorder’, ‘stiffness of the neck’, ‘cervical disk’, ‘whiplash injury’, ‘cervicalgia’, ‘posterior cervical pain’, ‘neck disability’, ‘Herniated Nucleus Pulposus (HNP’, and ‘Herniated Intervertebral Disc (HIVD’. Results: Twenty-five clinical theses related to pharmacopuncture were selected and were analyzed by year according to the type of pharmacopuncture used, the academic journal in which the publication appeared, and the effect of pharmacopuncture therapy. Conclusion: The significant conclusions are as follows: (1 Pharmacopunctures used for cervical pain were Bee venom pharmacopuncture, Carthami-flos pharmacopuncture, Scolopendra pharmacopuncture, Ouhyul pharmacopuncturen, Hwangryun pharmacopuncture, Corpus pharmacopuncture, Soyeom pharmacopuncture, Hwangryunhaedoktang pharmacopuncture, Shinbaro phamacopuncture. (2 Randomized controlled trials showed that pharmacopuncture therapy combined with other methods was more effective. (3 In the past, studies oriented toward Bee venom pharmacopuncture were actively pursued, but the number of studies on various other types of pharmacopuncture gradually began to increase. (4 For treating a patient with cervical pain, the type of pharmacopuncture to be used should be selected based on the cause of the disease and the patient’s condition.

  5. Medicinal plants used to treat TB in Ghana.

    Science.gov (United States)

    Nguta, Joseph Mwanzia; Appiah-Opong, Regina; Nyarko, Alexander K; Yeboah-Manu, Dorothy; Addo, Phyllis G A

    2015-06-01

    The current study was designed to document medicinal plant species that are traditionally used to treat tuberculosis (TB) by Ghanaian communities. The medicinal plants used against TB or its signs and symptoms were selected using library and online published data searches. A guided questionnaire interview was also conducted with a botanist involved in plant collection at the Centre for Scientific Research into Plant Medicine (CSRPM) at Mampong. Data obtained were entered in Excel and summarized into means and frequencies using SPSS 12.0.1 for windows, and expressed as tables and bar graphs. A total of 15 medicinal plant species distributed between 13 genera and 13 families were documented. The following medicinal plant species were found to be used against TB in Greater Accra and Eastern parts of Ghana: Azadirachta indica A. Juss. Stem bark (Meliaceae), Hygrophila auriculata Heine, whole plant (Acanthaceae), Chenopodium ambrosioides L. leaves (Amaranthaceae), Coix lacryma-jobi L. glumes (Poaceae), Solanum torvum Sw. unripe fruits (Solanaceae), Solanum torvum Sw. leaves (Solanaceae), Bidens pilosa L. whole plant (Asteraceae), Phyllanthus fraternus G.L. Webster leaves (Phyllanthaceae), Dissotis rotundifolia (Sm.) Triana, leaves (Melastomataceae), Cymbopogon giganteus Chiov. Leaves (Poaceae), Cyperus articulatus L. roots (Cyperaceae), Allium sativum L. bulb (Amaryllidaceae), Zingiber officinale Roscoe, rhizomes (Zingiberaceae), Allium cepa L. bulbs (Amaryllidaceae), Allium cepa L. leaves (Amaryllidaceae), Aloe vera var. barbadensis aqueous extract from leaves (Xanthorrhoeaceae), Aloe vera var. barbadensis organic extract from leaves (Xanthorrhoeaceae), Cocos nucifera Linn, water (Arecaceae) and Cocos nucifera Linn. Husk (Arecaceae). The collected plant species could be a source of a new class of drugs against TB. Bioactivity guided fractionation is recommended to identify lead compounds for antimycobacterial activity. The current paper documents for the first time

  6. Animal Toxins as Therapeutic Tools to Treat Neurodegenerative Diseases

    Science.gov (United States)

    de Souza, Jessica M.; Goncalves, Bruno D. C.; Gomez, Marcus V.; Vieira, Luciene B.; Ribeiro, Fabiola M.

    2018-01-01

    Neurodegenerative diseases affect millions of individuals worldwide. So far, no disease-modifying drug is available to treat patients, making the search for effective drugs an urgent need. Neurodegeneration is triggered by the activation of several cellular processes, including oxidative stress, mitochondrial impairment, neuroinflammation, aging, aggregate formation, glutamatergic excitotoxicity, and apoptosis. Therefore, many research groups aim to identify drugs that may inhibit one or more of these events leading to neuronal cell death. Venoms are fruitful natural sources of new molecules, which have been relentlessly enhanced by evolution through natural selection. Several studies indicate that venom components can exhibit selectivity and affinity for a wide variety of targets in mammalian systems. For instance, an expressive number of natural peptides identified in venoms from animals, such as snakes, scorpions, bees, and spiders, were shown to lessen inflammation, regulate glutamate release, modify neurotransmitter levels, block ion channel activation, decrease the number of protein aggregates, and increase the levels of neuroprotective factors. Thus, these venom components hold potential as therapeutic tools to slow or even halt neurodegeneration. However, there are many technological issues to overcome, as venom peptides are hard to obtain and characterize and the amount obtained from natural sources is insufficient to perform all the necessary experiments and tests. Fortunately, technological improvements regarding heterologous protein expression, as well as peptide chemical synthesis will help to provide enough quantities and allow chemical and pharmacological enhancements of these natural occurring compounds. Thus, the main focus of this review is to highlight the most promising studies evaluating animal toxins as therapeutic tools to treat a wide variety of neurodegenerative conditions, including Alzheimer’s disease, Parkinson’s disease, brain

  7. Fluoxetine-treated male wrasses exhibit low AVT expression.

    Science.gov (United States)

    Semsar, Katharine; Perreault, Heidi A N; Godwin, John

    2004-12-17

    In many species, increasing serotonergic activity can reduce aggression and reverse dominance relationships. These effects may in part be mediated through interactions with the arginine vasotocin/vasopressin (AVT/AVP) system. We tested this hypothesis in a territorial coral reef fish, the bluehead wrasse (Thalassoma bifasciatum), by experimentally enhancing serotonergic neurotransmission, using the selective serotonin re-uptake inhibitor (SSRI) fluoxetine. Terminal phase (TP) males received 2 weeks of nightly intraperitoneal fluoxetine injections (6 microg/g body weight) and were then tested for their aggressive response to an intruder and killed to examine AVT phenotype in the preoptic area of the hypothalamus (POA), an area important to social behavior in fishes. Our previously published study demonstrated that fluoxetine-treated males are less aggressive [H.A.N. Perreault, K. Semsar, J. Godwin, Fluoxetine treatment decreases territorial aggression in a coral reef fish, Physiol. and Behav. 79 (2003) 719-724.]. Here, further study of these same fluoxetine-treated males shows approximately twofold lower AVT mRNA expression relative to saline-treated controls in all regions of the POA (all p0.4). This study experimentally supports the hypothesis that behavioral effects of SSRIs may be mediated in part through interactions with the AVT/AVP system. These results parallel findings from rodents and humans and are consistent with an indirect neurosteroidogenic rather than a solely direct serotonergic mechanism for SSRI effects on the AVT/AVP system. Furthermore, they suggest that SSRI effects on neuroendocrine function may be best modeled in animals with sensitive stress responses such as those found in nondomesticated animals.

  8. Raptor Acupuncture for Treating Chronic Degenerative Joint Disease.

    Science.gov (United States)

    Choi, Keum Hwa; Buhl, Gail; Ponder, Julia

    2016-12-01

    A permanently captive 21-year-old male bald eagle was diagnosed with chronic degenerative joint disease in the right stifle with severe lameness (Grade 5) based on radiography. Clinical signs included decreased movement, vocalization, non weight-bearing on the affected limb, inappetence, depression, and pododermatitis on the left foot (bumblefoot, Grade 3). The eagle was treated with anti-inflammatory or analgesic drugs including carprofen and celecoxib. As there was no observed clinical improvement with any of the treatments, acupuncture treatment was provided. The eagle was treated with dry needle acupuncture once per week for 2 months and biweekly for another 2 months. The Traditional Eastern Medicine diagnosis of this eagle was Bony Bi syndrome. The selected acupuncture points were ST 36, LI 4, BL 40, BL 60, GB 34, and Ba Feng (Table 3). The lameness score improved from Grade 5 to Grade 1 after 4 months of acupuncture treatment. The observed pododermatitis improved from Grade 3 to Grade 0. Symptoms including inappetence and vocalizations were significantly reduced over the 4 month period. There was no significant improvement in the radiographic signs. In conclusion, acupuncture may be a potential medical option for permanently captive raptors having musculoskeletal conditions, such as degenerative joint disease. Copyright © 2016. Published by Elsevier B.V.

  9. Monoclonal antibodies specific to heat-treated porcine blood.

    Science.gov (United States)

    Raja Nhari, Raja Mohd Hafidz; Hamid, Muhajir; Rasli, Nurmunirah Mohamad; Omar, Abdul Rahman; El Sheikha, Aly Farag; Mustafa, Shuhaimi

    2016-05-01

    Porcine blood is potentially being utilized in food as a binder, gelling agent, emulsifier or colorant. However, for certain communities, the usage of animal blood in food is strictly prohibited owing to religious concerns and health reasons. This study reports the development of monoclonal antibodies (MAbs) against heat-treated soluble proteins (HSPs) of autoclaved porcine blood; characterization of MAbs against blood, non-blood and plasma from different animal species using qualitative indirect non-competitive enzyme-linked immunosorbent assay (ELISA); and immunoblotting of antigenic components in HSPs of porcine blood. Fifteen MAbs are specific to heat-treated and raw porcine blood and not cross-reacted with other animal blood and non-blood proteins (meat and non-meat). Twelve MAbs are specific to porcine plasma, while three MAbs specific to porcine plasma are cross-reacted with chicken plasma. Immunoblotting revealed antigenic protein bands (∼60, ∼85-100 and ∼250 kDa) in porcine blood and plasma recognized by the MAbs. Selection of MAbs that recognized 60 kDa HSPs of porcine blood and plasma as novel monoclonal antibodies would be useful for detection of porcine plasma in processed food using the immunoassay method. © 2015 Society of Chemical Industry. © 2015 Society of Chemical Industry.

  10. Raptor Acupuncture for Treating Chronic Degenerative Joint Disease

    Directory of Open Access Journals (Sweden)

    Keum Hwa Choi

    2016-12-01

    Full Text Available A permanently captive 21-year-old male bald eagle was diagnosed with chronic degenerative joint disease in the right stifle with severe lameness (Grade 5 based on radiography. Clinical signs included decreased movement, vocalization, non weight-bearing on the affected limb, inappetence, depression, and pododermatitis on the left foot (bumblefoot, Grade 3. The eagle was treated with anti-inflammatory or analgesic drugs including carprofen and celecoxib. As there was no observed clinical improvement with any of the treatments, acupuncture treatment was provided. The eagle was treated with dry needle acupuncture once per week for 2 months and biweekly for another 2 months. The Traditional Eastern Medicine diagnosis of this eagle was Bony Bi syndrome. The selected acupuncture points were ST 36, LI 4, BL 40, BL 60, GB 34, and Ba Feng (Table 3. The lameness score improved from Grade 5 to Grade 1 after 4 months of acupuncture treatment. The observed pododermatitis improved from Grade 3 to Grade 0. Symptoms including inappetence and vocalizations were significantly reduced over the 4 month period. There was no significant improvement in the radiographic signs. In conclusion, acupuncture may be a potential medical option for permanently captive raptors having musculoskeletal conditions, such as degenerative joint disease.

  11. Selection of Celebrity Endorsers

    DEFF Research Database (Denmark)

    Hollensen, Svend; Schimmelpfennig, Christian

    2013-01-01

    several candidates by means of subtle evaluation procedures. Design/methodology/approach – A case study research has been carried out among companies experienced in celebrity endorsements to learn more about the endorser selection process in practise. Based on these cases theory is inductively developed......Purpose - This research aims at shedding some light on the various avenues marketers can undertake until finally an endorsement contract is signed. The focus of the study lies on verifying the generally held assumption that endorser selection is usually taken care of by creative agencies, vetting....... Findings – Our research suggests that generally held assumption that endorsers being selected and thoroughly vetted by a creative agency may not be universally valid. A normative model to illustrate the continuum of the selection process in practise is suggested and the two polar case studies (Swiss brand...

  12. Feature Selection by Reordering

    Czech Academy of Sciences Publication Activity Database

    Jiřina, Marcel; Jiřina jr., M.

    2005-01-01

    Roč. 2, č. 1 (2005), s. 155-161 ISSN 1738-6438 Institutional research plan: CEZ:AV0Z10300504 Keywords : feature selection * data reduction * ordering of features Subject RIV: BA - General Mathematics

  13. Selective information sampling

    Directory of Open Access Journals (Sweden)

    Peter A. F. Fraser-Mackenzie

    2009-06-01

    Full Text Available This study investigates the amount and valence of information selected during single item evaluation. One hundred and thirty-five participants evaluated a cell phone by reading hypothetical customers reports. Some participants were first asked to provide a preliminary rating based on a picture of the phone and some technical specifications. The participants who were given the customer reports only after they made a preliminary rating exhibited valence bias in their selection of customers reports. In contrast, the participants that did not make an initial rating sought subsequent information in a more balanced, albeit still selective, manner. The preliminary raters used the least amount of information in their final decision, resulting in faster decision times. The study appears to support the notion that selective exposure is utilized in order to develop cognitive coherence.

  14. Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE)

    DEFF Research Database (Denmark)

    Peyrin-Biroulet, L; Sandborn, W; Sands, B E

    2015-01-01

    OBJECTIVES: The Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) program was initiated by the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD). It examined potential treatment targets for inflammatory bowel disease (IBD) to be used for a "treat-t...... target. CONCLUSIONS: Evidence- and consensus-based recommendations for selecting the goals for treat-to-target strategies in patients with IBD are made available. Prospective studies are needed to determine how these targets will change disease course and patients' quality of life....

  15. Pump-and-treat is not the only solution to aquifer remediation

    International Nuclear Information System (INIS)

    Odermatt, J.R.

    1994-01-01

    The Environmental Protection Agency (EPA) recently surveyed remediation technologies used at petroleum-contaminated sites in 22 states. About 96 percent of underground storage tank (UST) corrective action sites used some form of pump-and-treat technology to remediate contaminated groundwater. However, using only pump-and-treat technology is not a cost-effective approach to aquifer remediation. Pump-and-treat may be more appropriate for containing plumes or for use in initial emergency response actions at sites and massive NAPL releases to groundwater. As of 1990, 68 percent of Superfund records of decision selected pump-and-treat as the final remedy for aquifer remediation. However, of 13 sites where the remedial alternative objective was to restore the aquifer to health-based levels, only one pump-and-treat method has succeeded. Except in cases where human health and the environment are threatened, long-term active technologies, such as pump-and-treat, may not be warranted. Groundwater monitoring and possible wellhead treatment may be perceived as time-consuming processes; however, at many sites, this long-term approach may be far less costly and just as effective as other long-term strategies based on exclusive use of pump-and-treat technology

  16. HARMONIC DRIVE SELECTION

    Directory of Open Access Journals (Sweden)

    Piotr FOLĘGA

    2014-03-01

    Full Text Available The variety of types and sizes currently in production harmonic drive is a problem in their rational choice. Properly selected harmonic drive must meet certain requirements during operation, and achieve the anticipated service life. The paper discusses the problems associated with the selection of the harmonic drive. It also presents the algorithm correct choice of harmonic drive. The main objective of this study was to develop a computer program that allows the correct choice of harmonic drive by developed algorithm.

  17. Spectrally selective glazings

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-08-01

    Spectrally selective glazing is window glass that permits some portions of the solar spectrum to enter a building while blocking others. This high-performance glazing admits as much daylight as possible while preventing transmission of as much solar heat as possible. By controlling solar heat gains in summer, preventing loss of interior heat in winter, and allowing occupants to reduce electric lighting use by making maximum use of daylight, spectrally selective glazing significantly reduces building energy consumption and peak demand. Because new spectrally selective glazings can have a virtually clear appearance, they admit more daylight and permit much brighter, more open views to the outside while still providing the solar control of the dark, reflective energy-efficient glass of the past. This Federal Technology Alert provides detailed information and procedures for Federal energy managers to consider spectrally selective glazings. The principle of spectrally selective glazings is explained. Benefits related to energy efficiency and other architectural criteria are delineated. Guidelines are provided for appropriate application of spectrally selective glazing, and step-by-step instructions are given for estimating energy savings. Case studies are also presented to illustrate actual costs and energy savings. Current manufacturers, technology users, and references for further reading are included for users who have questions not fully addressed here.

  18. Selection in artistic gymnastics

    Directory of Open Access Journals (Sweden)

    Maria Olaru

    2009-06-01

    Full Text Available This study envisages the analysis of the specific aspects of the selection process in artistic gymnastics, focusing particularly onthe selection of Romania’s recent years. In our opinion, the shift to a cone of darkness of the artistic gymnastics, an extremelypopular sport in our country 20 years ago, is also based on and the orientation of children to other fields – unfortunately manyof them outside sports and physical activities in general. In the present study, we shall present the stages of the artisticgymnastics, as its importance in the subsequent performances has been proven a long time ago. The plethora of qualities andskills which are necessary to select a child for gymnastics and those that this sport develops when performed as a spare timeactivity. The case studied in this endeavour is the one of the main centers for gymnast recruitment in Romania; the attentionpaid by the trainers to the selection for this sport makes the data regarding the number of children involved to increase oncemore. This is a satisfactory fact as it is a well-known fact that a wide range primary selection sets a serious basis for thesecondary selection, and the third, respectively, envisaging the future performance and concurrently ensures the involvementof more children in a physical activity that will prepare them, both physically and mentally for a healthy life.

  19. Infantile acne treated with oral isotretinoin

    DEFF Research Database (Denmark)

    Miller, Iben Marie; Echeverría, Begoña; Torrelo, Antonio

    2013-01-01

    In contrast to adolescent acne, infantile acne (IA) is a rare condition with only a limited body of available literature. In this descriptive, retrospective study, we reviewed six cases from 2002 to 2010 treated with oral isotretinoin. The average age of onset was 6.16 months (range 0-21 mos......). Consistent with the previous, limited literature, we found predominantly boys are affected, a predilection for the cheeks, and a polymorphic inflammatory morphology. Two patients had a family history of acne. All cases were successfully and safely treated with oral isotretinoin. The suggested treatment...... of childhood acne is similar to that of adolescents (graded according to the severity of the skin disease and risk of scarring). Oral isotretinoin appears to be an effective and safe treatment for severe IA....

  20. Bioengineering Strategies to Treat Female Infertility.

    Science.gov (United States)

    Kuo, Che-Ying; Baker, Hannah; Fries, Melissa H; Yoo, James J; Kim, Peter C W; Fisher, John P

    2017-06-01

    Bioengineering strategies have demonstrated enormous potential to treat female infertility as a result of chemotherapy, uterine injuries, fallopian tube occlusion, massive intrauterine adhesions, congenital uterine malformations, and hysterectomy. These strategies can be classified into two broad categories as follows: (i) Transplantation of fresh or cryopreserved organs into the host and (ii) tissue engineering approaches that utilize a combination of cells, growth factors, and biomaterials that leverages the body's inherent ability to regenerate/repair reproductive organs. While whole organ transplant has demonstrated success, the source of the organ and the immunogenic effects of allografts remain challenging. Even though tissue engineering strategies can avoid these issues, their feasibilities of creating whole organ constructs are yet to be demonstrated. In this article we summarize the recent advancements in the applications of bioengineering to treat female infertility.

  1. Treating infidelity: clinical and ethical directions.

    Science.gov (United States)

    Snyder, Douglas K; Doss, Brian D

    2005-11-01

    This article addresses clinical and ethical directions in treating clients coping with infidelity. Developing competence in this domain requires familiarity with empirical research regarding infidelity, individual and cultural differences involving non-monogamy, and assessment and intervention skills related to treating infidelity. Practical directions will entail distinguishing among responsibilities to individual partners versus their relationship and managing related potential conflicts of interest with other involved parties. Confidentiality assumes increased complexity when confronting undisclosed infidelity in couple therapy and when a client engaging in high-risk behaviors for contracting STDs or testing seropositive for HIV has not informed his or her partner(s). Finally, we discuss therapists' need to concretely articulate their values that influence treatment of infidelity.

  2. Life Expectancy in Patients Treated for Osteoporosis

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Osmond, Clive; Cooper, Cyrus

    2015-01-01

    Osteoporosis is a chronic disease, carrying an elevated risk of fractures, morbidity, and death. Long-term treatment may be required, but the long-term risks with osteoporosis drugs remain incompletely understood. The competing risk of death may be a barrier to treating the oldest, yet this may...... not be rational if the risk of death is reduced by treatment. It is difficult to devise goal-directed long-term strategies for managing osteoporosis without firm information about residual life expectancy in treated patients. We conducted an observational study in Danish national registries tracking prescriptions...... for osteoporosis drugs, comorbid conditions, and deaths. We included 58,637 patients and 225,084 age- and sex-matched control subjects. Information on deaths until the end of 2013 was retrieved, providing a follow-up period of 10 to 17 years. In men younger than 80 years and women younger than 60 years...

  3. Ceramic onlay for endodontically treated mandibular molar

    Directory of Open Access Journals (Sweden)

    Roopadevi Garlapati

    2014-01-01

    Full Text Available Restoration of endodontically treated teeth is important for the success of endodontic treatment. In full coverage restorations, maximum amount of tooth structure is compromised, so as to conserve the amount of tooth structure partial coverage restorations, can be preferred. This case report is on fabrication of a conservative tooth colored restoration for an endodontically treated posterior tooth. A 22-year-old male patient presented with pain in the mandibular left first molar. After endodontic treatment, composite material was used as postendodontic restoration. The tooth was then prepared to receive a ceramic onlay and bonded with self-adhesive universal resin cement. Ceramic onlay restoration was periodically examined up to 2 years.

  4. Treating Lead Toxicity: Possibilities beyond Synthetic Chelation

    Directory of Open Access Journals (Sweden)

    Shambhavi Tannir

    2013-01-01

    Full Text Available Lead, a ubiquitous metal, is one of the most abundant elements present on earth. Its easy availability and cost effectiveness made it an extremely popular component in the industrial revolution. However, its hazardous health effects were not considered at the time. Over the last few decades, with the adverse effects of lead coming to the forefront, nations across the world have started to recognize and treat lead toxicity. The most reliable and used method until now has been chelation therapy. Recent research has suggested the use of natural products and sources to treat lead poisoning with minimal or no side effects. This review has tried to summarize a few of the natural products/sources being investigated by various groups.

  5. Dr. Shi Hanzhang's Experience in Treating Andropathy

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ Dr. Shi Hanzhang (施汉章) of Dongzhimen Hospital affiliated to Beijing University of Traditional Chinese Medicine is experienced in both teaching and clinical practice, especially in treating andropathy, such as sexual disorder, infertility, and hyperplasia of the prostate. The author has the honour to follow him for study and really learned a lot from him. A brief introduction to Dr. Shi's way of thinking in treatment is as follows.

  6. Nociceptive Effects of Locally Treated Metoprolol

    Directory of Open Access Journals (Sweden)

    Nursima Cukadar

    2015-06-01

    Results: Metoprolol, an antagonist, significantly decreased the thermal latency and mechanical thresholds with dose and time dependent manner. However, dobutamine, an agonist, enhanced the latency and thresholds dose and time dependent. Conclusions: This results suggest that in contrast to dobutamine, locally treated metoprolol may cause hyperalgesic and allodynic actions. In addition, our results can demonstrate that peripheral beta-adrenergic receptors can play important roles in nociceptive process. [Cukurova Med J 2015; 40(2.000: 258-266

  7. [Ultraminipercutaneous nephrolithotripsy in treating kidney stones].

    Science.gov (United States)

    Martov, A G; Dutov, S V; Andronov, A S

    2016-04-01

    Percutaneous nephrolithotripsy (PNL) is the recommended method of surgical treatment of kidney stones of size greater than 2 cm. Trends in the development of modern urology have been steadily toward less traumatic method to treat nephrolithiasis - minimally invasive PNL. The present work aimed to explore of the possibilities of one of the modern variants of minimally invasive PNL - ultra-mini-PNL in treating nephrolithiasis. The study included 60 patients (mean age 45.6+/-7.2 years) with isolated kidney calculus, up to 2.0 cm or several stones with a total size of up to 2.5 cm. All patients were found to have 77 kidney stones, six of which had a size of 10 mm, 51 had a size of 11-15 mm and 20 had a size of 16-20 mm. 45% of patients had isolated renal pelvic stones and 28.3% had stones in the renal pelvis and lower calyx. All patients underwent ultra-mini-PNL using nephroscope size 7.5 Ch and tube size 12 Fr. The average duration of surgery from the moment of the puncture of the pyelocaliceal system to installing the nephrostomy tube was 65.4 minutes. Complete clearance of stones after single-stage ultra-mini-PNL was observed in 80% of cases. Nephrostomy tube was removed on days 2-3. The average postoperative hospital stay was 5.1 days. The most common complication was postoperative exacerbation of pyelonephritis (13.3% of patients), successfully treated with conservative measures. There were no cases of postoperative bleeding, accompanied by anemia and needed a blood transfusion. Considering high effectiveness and low rate of complications of ultra-mini-PNL, it can be successfully used in treating nephrolithiasis among a wide group of patients.

  8. Novel Therapeutic Approaches Toward Treating Prostate Cancer

    Science.gov (United States)

    2013-05-01

    Kinases, Prostate Cancer, AKT inhibition, Mouse, Prostate Stem Cells 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES...Bearss 0, Wierda WG, Gandhi V (2009) Pim kinase inhibitor, 5GI-1776, induces apoptosis in CLL lymphocytes. Blood 114:4150--4157. 27. Grey R, et aL...PIM1 expression predict outcome in mantle cell lymphoma treated with high dose therapy, stem eel! transplantation and rituximab: a Cancer and Leukemia

  9. Instrument response during overpower transients at TREAT

    International Nuclear Information System (INIS)

    Meek, C.C.; Bauer, T.H.; Hill, D.J.; Froehle, P.H.; Klickman, A.E.; Tylka, J.P.; Doerner, R.C.; Wright, A.E.

    1982-01-01

    A program to empirically analyze data residuals or noise to determine instrument response that occurs during in-pile transient tests is out-lined. As an example, thermocouple response in the Mark III loop during a severe overpower transient in TREAT is studied both in frequency space and in real-time. Time intervals studied included both constant power and burst portions of the power transient. Thermocouple time constants were computed. Benefits and limitations of the method are discussed

  10. Intracellular Protein Delivery for treating Breast Cancer

    Science.gov (United States)

    2013-06-01

    concentration increases, but not as dramatic as cytoplamic fractions possible due to slower nuclear transport than cellular internalization. The nucleus...polymers, dendrimers , and hydrogels for drug delivery. Pharmaceutical research 29, 902-921. Wilson, J.M. (2005). Gendicine: the first commercial gene...sequences were not ccessible to the transport machinery. In stark contrast, hen HeLa cells were treated with S S Rho—APO NC, strong ed fluorescence of

  11. [Arsenical keratosis treated by dermatome shaving].

    Science.gov (United States)

    Kjerkegaard, Ulrik Knap; Heje, Jens Martin; Vestergaard, Christian; Stausbøl-Grøn, Birgitte; Stolle, Lars Bjørn

    2014-05-05

    Cutaneous malignancy in association with arsenic exposure is a rare but well-documented phenomenon. Signs of chronic arsenic exposure are very rare in Denmark today. However, arsenic was used in the medical treatment of psoriasis vulgaris up till the 1980's and several patients suffer from this arsenic treatment today. This case report shows that arsenical keratosis can be treated by dermatome shaving, a superficial destructive therapy.

  12. Analysis of the TREAT LEU Conceptual Design

    Energy Technology Data Exchange (ETDEWEB)

    Connaway, H. M. [Argonne National Lab. (ANL), Argonne, IL (United States); Kontogeorgakos, D. C. [Argonne National Lab. (ANL), Argonne, IL (United States); Papadias, D. D. [Argonne National Lab. (ANL), Argonne, IL (United States); Brunett, A. J. [Argonne National Lab. (ANL), Argonne, IL (United States); Mo, K. [Argonne National Lab. (ANL), Argonne, IL (United States); Strons, P. S. [Argonne National Lab. (ANL), Argonne, IL (United States); Fei, T. [Argonne National Lab. (ANL), Argonne, IL (United States); Wright, A. E. [Argonne National Lab. (ANL), Argonne, IL (United States)

    2016-03-01

    Analyses were performed to evaluate the performance of the low enriched uranium (LEU) conceptual design fuel for the conversion of the Transient Reactor Test Facility (TREAT) from its current highly enriched uranium (HEU) fuel. TREAT is an experimental nuclear reactor designed to produce high neutron flux transients for the testing of reactor fuels and other materials. TREAT is currently in non-operational standby, but is being restarted under the U.S. Department of Energy’s Resumption of Transient Testing Program. The conversion of TREAT is being pursued in keeping with the mission of the Department of Energy National Nuclear Security Administration’s Material Management and Minimization (M3) Reactor Conversion Program. The focus of this study was to demonstrate that the converted LEU core is capable of maintaining the performance of the existing HEU core, while continuing to operate safely. Neutronic and thermal hydraulic simulations have been performed to evaluate the performance of the LEU conceptual-design core under both steady-state and transient conditions, for both normal operation and reactivity insertion accident scenarios. In addition, ancillary safety analyses which were performed for previous LEU design concepts have been reviewed and updated as-needed, in order to evaluate if the converted LEU core will function safely with all existing facility systems. Simulations were also performed to evaluate the detailed behavior of the UO2-graphite fuel, to support future fuel manufacturing decisions regarding particle size specifications. The results of these analyses will be used in conjunction with work being performed at Idaho National Laboratory and Los Alamos National Laboratory, in order to develop the Conceptual Design Report project deliverable.

  13. Sexual Issues in Treating Trauma Survivors.

    Science.gov (United States)

    Zoldbrod, Aline P

    The effect of interpersonal trauma on sexuality can be profound. The field of sexual trauma is complex empirically and clinically, with contradictory theories and conflicting data. Research definitions and treatment protocols for child sexual abuse are very imprecise. There are no firm, empirically proven guidelines for treating men and women who have been sexually abused as children or adolescents. Overt sexual abuse (OSA) in children and adolescents is defined here as molestation, rape, or incest. Research has shown that OSA may, but does not necessarily, lead to sexual dysfunction in adulthood. The effects of OSA are worsened by concurrent types of family of origin abuse, such as emotional abuse or physical abuse. One factor that seems related to the varying impact of OSA on adult sexuality is the patients' family of origin experience with nonsexual Milestones of Sexual Development. Without positive experiences with touch, trust and empathy, the ability to relax and be soothed, and power, the effects of OSA are potentiated and complicated. Sexuality is embodied, so experiences with touch are particularly important when working with OSA. A three-color Body Map technique which assesses stored associations to touch is provided. The concept of developmental sexual trauma (DST) is introduced as a way to label traumagenic family events which potentiate OSA or negatively effect sex but which are not explicitly sexual in origin. Strategies to assess and treat OSA are reviewed. Body Maps are recommended to assess and treat sexual trauma.

  14. Anxiety in Patients Treated with Hemodialysis.

    Science.gov (United States)

    Cohen, Scott D; Cukor, Daniel; Kimmel, Paul L

    2016-12-07

    Anxiety is a common yet frequently overlooked psychiatric symptom in patients with ESRD treated with hemodialysis (HD). Anxiety is characterized by disruptive feelings of uncertainty, dread, and fearfulness. A variety of common medical complaints may be manifestations of an anxiety disorder, including palpitations, tremors, indigestion, numbness/tingling, nervousness, shortness of breath, diaphoresis, and fear. It is essential for the clinician to rule out specific medical conditions, including cardiovascular, pulmonary, and neurologic diseases, before ascribing these symptoms to an anxiety disorder. In addition, there is considerable overlap between the symptoms of anxiety and those of depression and uremia. This psychiatric condition has a significant adverse impact on patients' perception of quality of life. Little is known regarding the prevalence and impact of anxiety disorders in patients with ESRD treated with HD; however, many of the seemingly irrational behaviors of patients, or behaviors which place them in conflict with staff and physicians, such as behavioral noncompliance, may be the expression of an underlying anxiety disorder. In this review, we present three clinical vignettes, highlighting the impact of anxiety disorders in patients with ESRD treated with HD. Copyright © 2016 by the American Society of Nephrology.

  15. Municipal Treated Wastewater Irrigation: Microbiological Risk Evaluation

    Directory of Open Access Journals (Sweden)

    Antonio Lonigro

    2008-06-01

    Full Text Available Municipal wastewater for irrigation, though treated, can contain substances and pathogens toxic for humans and animals. Pathogens, although not harmful from an agronomical aspect, undoubtedly represent a major concern with regards to sanitary and hygienic profile. In fact, vegetable crops irrigated with treated wastewater exalt the risk of infection since these products can also be eaten raw, as well as transformed or cooked. Practically, the evaluation of the microbiological risk is important to verify if the microbial limits imposed by law for treated municipal wastewater for irrigation, are valid, thus justifying the treatments costs, or if they are too low and, therefore, they don’ t justify them. Different probabilistic models have been studied to assess the microbiological risk; among these, the Beta-Poisson model resulted the most reliable. Thus, the Dipartimento di Scienze delle Produzioni Vegetali of the University of Bari, which has been carrying out researches on irrigation with municipal filtered wastewater for several years, considered interesting to verify if the microbial limits imposed by the italian law n.185/03 are too severe, estimating the biological risk by the probabilistic Beta-Poisson model. Results of field trials on vegetable crops irrigated by municipal filtered wastewater, processed by the Beta-Poisson model, show that the probability to get infection and/or illness is extremely low, and that the actual italian microbial limits are excessively restrictive.

  16. Fertility in patients treated for testicular cancer.

    Science.gov (United States)

    Matos, Erika; Skrbinc, Breda; Zakotnik, Branko

    2010-09-01

    Testicular cancer affects men mostly in their reproductive age with a cure rate over 90% and fertility is one of the main concerns of survivors. To further elucidate the question of fertility after treatment for testicular cancer, we performed a survey in patients treated in our institution. We sent a questionnaire to patients treated for testicular cancer at our institute from 1976 to 2002 (n = 490) of whom 297 (60.6%) responded. We considered the patients to have conserved fertility if they had children after treatment without assisted reproductive technologies. Before treatment 119/297 (40.1%) of patients and after treatment 150/297 (50.5%) of patients tried to have children (p = 0.019). Of 119 patients who tried to have children before treatment for testicular cancer 98 (82.4%) succeeded and 74/150 (49.3%) were successful after treatment (p years. The post-treatment fatherhood in patients treated with surgery only (orchidectomy +/- retroperitoneal lymphnode dissection-RPLND) was 59%, in those with additional radiotherapy 68%, and chemotherapy 50% (p = 0.233). Fertility rate in patients where a non nerve sparing RPLND was performed was only 37%, 62% in patients with nerve sapring RPLND, and 77% in patients where RPLND was not performed (p Fertility rate after treatment for testicular cancer is reduced. From our data, the most important treatment modality that influences fertility is non nerve sparing RPLND that should be avoided whenever possible in order improve the quality of life our patients.

  17. Effectiveness testing of spill-treating agents

    International Nuclear Information System (INIS)

    Fingas, M.F.; Stoodley, R.; Laroche, N.

    1990-01-01

    Laboratory effectiveness tests are described for four classes of spill-treating agents: solidifiers, demulsifying agents, surface-washing agents and dispersants. Many treating agents in these four categories have been tested for effectiveness and the results are presented. Solidifiers or gelling agents solidify oil, requiring a large amount of agent to solidify oil-ranging between 16% by weight, to over 200%. Emulsion breakers prevent or reverse the formation of water-in-oil emulsions. A newly-developed effectiveness test shows that only one product is highly effective; however, many products will work, but require large amounts of spill-treating agent. Surfactant--containing materials are of two types, surface-washing agents and dispersants. Testing has shown that an agent that is a good dispersant is conversely a poor surface-washing agent, and vice versa. Tests of surface-washing agents show that only a few agents have effectiveness of 25-40%, where this effectiveness is the percentage of heavy oil removed from a test surface. Results using the 'swirling flask' test for dispersant effectiveness are reported. Heavy oils show effectiveness values of about 1%, medium crudes of about 10%, light crude oils of about 30% and very light oils of about 90%. (author)

  18. Surface resistivity measurement of plasma treated polymers

    International Nuclear Information System (INIS)

    Simon, D.; Pigram, P.J.; Liesegang, J.

    2000-01-01

    Full text: Resistivity of insulators is an important property of materials used within the integrated circuit and packaging industries. The measurement of electrical resistivity of insulator materials in the surface region in this work is interpreted through observations of surface charge decay. A self-field driven and diffusion charge transport theory is used to model the process and resistivity values obtained computationally. Data for the charge decay of surface charged samples are collected by suspending them inside a coaxial cylinder connected to an electrometer. Samples used have been low density polyethylene LDPE sheet, both pristine and surface treated. Some samples have been treated by air plasma at low vacuum pressures for different periods of time; others have been washed in ethyl acetate and then plasma treated before the resistivity measurement. The sets of resistivity measurements form the various treatments are compared below. X-ray photoelectron spectroscopy (XPS) has also been used to investigate and account for the observed variations in surface resistivity

  19. Meaning identification and meaning selection for general language monolingual dictionaries

    DEFF Research Database (Denmark)

    Bergenholtz, Henning; Agerbo, Heidi

    2014-01-01

    The traditional way for lexicographers to deal with polysemy in dictionaries is by applying the terms lumping and splitting. We will not follow this tradition. Instead, we argue that the identification and selection of meaning items (= polysems) should be treated in the same way as the identifica......The traditional way for lexicographers to deal with polysemy in dictionaries is by applying the terms lumping and splitting. We will not follow this tradition. Instead, we argue that the identification and selection of meaning items (= polysems) should be treated in the same way...... to references in the world (in this contribution called things), followed by a formulation of the identified meaning items which can be used for reception situations. Not always – as in the case of lemma selection – will all the identified meaning items be included in the dictionary. The selection of identified...... meaning items will depend on the genuine purpose of the dictionary....

  20. Treating autoimmune disorders with venom-derived peptides.

    Science.gov (United States)

    Shen, Bingzheng; Cao, Zhijian; Li, Wenxin; Sabatier, Jean-Marc; Wu, Yingliang

    2017-09-01

    The effective treatment of autoimmune diseases remains a challenge. Voltage-gated potassium Kv1.3 channels, which are expressed in lymphocytes, are a new therapeutic target for treating autoimmune disease. Consequently, Kv1.3 channel-inhibiting venom-derived peptides are a prospective resource for new drug discovery and clinical application. Area covered: Preclinical and clinical studies have produced a wealth of information on Kv1.3 channel-inhibiting venom-derived peptides, especially from venomous scorpions and sea anemones. This review highlights the advances in screening and design of these peptides with diverse structures and potencies. It focuses on representative strategies for improving peptide selectivity and discusses the preclinical research on those venom-derived peptides as well as their clinical developmental status. Expert opinion: Encouraging results indicate that peptides isolated from the venom of venomous animals are a large resource for discovering immunomodulators that act on Kv1.3 channels. Since the structural diversity of venom-derived peptides determines the variety of their pharmacological activities, the design and optimization of venom-peptides for improved Kv1.3 channel-specificity has been advanced through some representative strategies, such as peptide chemical modification, amino acid residue truncation and binding interface modulation. These advances should further accelerate research, development and the future clinical application of venom-derived peptides selectively targeting Kv1.3 channels.