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Sample records for southern surgical association

  1. American Pediatric Surgical Association

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    American Pediatric Surgical Association Search for: Login Resources + For Members For Professionals For Training Program Directors For Media For ... Surgical Outcomes Surveys & Results Publications Continuing Education + ExPERT Pediatric Surgery NaT Annual Meeting CME MOC Requirements Residents / ...

  2. Magnitude and factors associated with post-cesarean surgical site ...

    African Journals Online (AJOL)

    Magnitude and factors associated with post-cesarean surgical site infection at Hawassa University Teaching and referral hospital, southern Ethiopia: a ... the hospital. Thus, it should be averted by implementing infection prevention techniques.

  3. Problems associated with basic oral surgical techniques

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    Kapatkin, A.S.; Marretta, S.M.; Schloss, A.J.

    1990-01-01

    The veterinarian must be able to diagnose several types of dental problems. History, physical examination, clinical pathology, and radiography are important in making an accurate diagnosis. Basic oral surgery includes various extraction techniques and management of their associated complications. Knowledge of dental anatomy and proper surgical technique can make an extraction curative rather than a frustrating procedure with multiple complications

  4. Surgical Site Infections and Associated Operative Characteristics.

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    Waltz, Paul K; Zuckerbraun, Brian S

    Surgical site infection (SSI) contributes significantly to surgical morbidity. Patient factors and operative factors contribute to the risk of development of SSI. This review focuses on understanding operative characteristics that are associated with an increased risk of SSI. Much attention has been given to protocol care to reduce SSI, such as hair removal, skin preparation, and pre-operative antibiotic agents. Even with this, the appropriate antibiotic and re-dosing regimens often remain a challenge. Other operative factors such as blood loss/transfusion, emergency/urgent cases, duration of the operation, type of anesthesia, and resident involvement are also potentially modifiable to reduce the risk of SSI. Data are reviewed to highlight the increased risk associated with such factors. Strategies to reduce risk, such as operative care bundles, have significant promise to reduce the incidence of SSI for any given procedure.

  5. Clinical Performance of Emergency Surgical Officers in Southern ...

    African Journals Online (AJOL)

    GB

    The proportion of cesarean and instrumental deliveries over the total deliveries were 13% and 0.7%, respectively. Explorative laparotomies and appendectomies were the majority of the non-obstetric emergency operations. Interviewed staff in the respective hospitals stated that ESOs' clinical decision making, surgical skill ...

  6. Complications associated with malnutrition in elective surgical ...

    African Journals Online (AJOL)

    Purpose: To identify the level of malnutrition and complications observed in Malaysia. Methods: A prospective, observational study was conducted with the objectives of identifying the degree of malnutrition, complications and the need for nutritional support in elective surgical patients. Collection of data was performed in ...

  7. Association of Safety Culture with Surgical Site Infection Outcomes.

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    Fan, Caleb J; Pawlik, Timothy M; Daniels, Tania; Vernon, Nora; Banks, Katie; Westby, Peggy; Wick, Elizabeth C; Sexton, J Bryan; Makary, Martin A

    2016-02-01

    Hospital workplace culture may have an impact on surgical outcomes; however, this association has not been established. We designed a study to evaluate the association between safety culture and surgical site infection (SSI). Using the Hospital Survey on Patient Safety Culture and National Healthcare Safety Network definitions, we measured 12 dimensions of safety culture and colon SSI rates, respectively, in the surgical units of Minnesota community hospitals. A Pearson's r correlation was calculated for each of 12 dimensions of surgical unit safety culture and SSI rate and then adjusted for surgical volume and American Society of Anesthesiologists (ASA) classification. Seven hospitals participated in the study, with a mean survey response rate of 43%. The SSI rates ranged from 0% to 30%, and surgical unit safety culture scores ranged from 16 to 92 on a scale of 0 to 100. Ten dimensions of surgical unit safety culture were associated with colon SSI rates: teamwork across units (r = -0.96; 95% CI [-0.76, -0.99]), organizational learning (r = -0.95; 95% CI [-0.71, -0.99]), feedback and communication about error (r = -0.92; 95% CI [-0.56, -0.99]), overall perceptions of safety (r = -0.90; 95% CI [-0.45, -0.99]), management support for patient safety (r = -0.90; 95% CI [-0.44, -0.98]), teamwork within units (r = -0.88; 95% CI [-0.38, -0.98]), communication openness (r = -0.85; 95% CI [-0.26, -0.98]), supervisor/manager expectations and actions promoting safety (r = -0.85; 95% CI [-0.25, -0.98]), non-punitive response to error (r = -0.78; 95% CI [-0.07, -0.97]), and frequency of events reported (r = -0.76; 95% CI [-0.01, -0.96]). After adjusting for surgical volume and ASA classification, 9 of 12 dimensions of surgical unit safety culture were significantly associated with lower colon SSI rates. These data suggest an important role for positive safety and teamwork culture and engaged hospital management in producing high-quality surgical

  8. Barriers for students pursuing a surgical career and where the Surgical Interest Association can intervene.

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    Dolan-Evans, Elliot; Rogers, Gary D

    2014-06-01

    There are some concerns that medical student interest in surgery is suffering. The aims of this project were to investigate the proportion of medical students interested in surgery from years 1 to 4, explore influential attitudinal and demographic factors, and establish baseline data to study the future effects of the Surgical Interest Association. Students were surveyed through an audience response system in year orientation sessions. For a majority of the analyses, respondents were dichotomized based on expressing an interest in surgery or not. There were no significant differences in the interest students had for a surgical career between medical student year levels in a cross-sectional analysis. However, available longitudinal data demonstrated a significant decrease in surgical interest from first years in 2012 to second years in 2013. Lifestyle, working hours and training length concerns had minimal effects as career influences on students interested in surgery, whereas academic interest and career opportunities were motivating factors in choosing this career. The results suggested no difference between levels of interest from first to final year students in surgery as a career, though only 22% of final year students were interested in surgery. This study also suggested that promoting the academic and scientific side of surgery, along with career opportunities available, may be an important avenue to encourage students into surgery. Future research will investigate the changing interests of students in surgery longitudinally throughout the medical school and to analyse the effects of the Surgical Interest Association. © 2014 Royal Australasian College of Surgeons.

  9. Surgical Management of Compound Odontoma Associated with Unerupted Tooth

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    Andrea Pacifici

    2015-01-01

    Full Text Available Odontomas represent the most common type of odontogenic benign jaws tumors among patients younger than 20 years of age. These tumors are composed of enamel, dentine, cementum, and pulp tissue. According to the World Health Organization classification, two distinct types of odontomas are acknowledged: complex and compound odontoma. In complex odontomas, all dental tissues are formed, but appeared without an organized structure. In compound odontomas, all dental tissues are arranged in numerous tooth-like structures known as denticles. Compound odontomas are often associated with impacted adjacent permanent teeth and their surgical removal represents the best therapeutic option. A case of a 20-year-old male patient with a compound odontoma-associated of impacted maxillary canine is presented. A minimally invasive surgical technique is adopted to remove the least amount of bone tissue as far as possible.

  10. Surgical Management of Multiple Valve Endocarditis Associated with Dialysis Catheter

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    R. Zea-Vera

    2016-01-01

    Full Text Available Endocarditis associated with dialysis catheter is a disease that must be suspected in every patient with hemodialysis who develops fever. Multiple valve disease is a severe complication of endocarditis that needs to be managed in a different way. There is very limited data for treatment and every case must be considered individually. We present a patient with this complication and describe the medical treatment and surgical management. We report the case of a 15-year-old patient with acute renal failure that develops trivalvular endocarditis after the hemodialysis catheter was placed, with multiple positive blood culture for Staphylococcus aureus. Transesophageal echocardiography was done and aortic and tricuspid valvular vegetations and mitral insufficiency were reported. Patient was successfully treated by surgery on the three valves, including aortic valve replacement. There is limited data about the appropriate treatment for multiple valvular endocarditis; it is important to consider this complication in the setting of hemodialysis patients that develop endocarditis and, despite the appropriate treatment, have a torpid evolution. In countries where endovenous drug abuse is uncommon, right sided endocarditis is commonly associated with vascular catheters. Aggressive surgical management should be the treatment of choice in these kinds of patients.

  11. Ventilator-associated pneumonia in surgical emergency intensive care unit.

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    Ertugrul, Bulent M; Yildirim, Ayse; Ay, Pinar; Oncu, Serkan; Cagatay, Atahan; Cakar, Nahit; Ertekin, Cemalettin; Ozsut, Halit; Eraksoy, Haluk; Calangu, Semra

    2006-01-01

    To investigate the incidence, risk factors and the etiology of ventilator-associated pneumonia (VAP) in surgical emergency intensive care unit (ICU) patients. We conducted this prospective cohort study in the surgical emergency ICU of Istanbul Medical Faculty between December 1999 and May 2001. We included 100 mechanically ventilated patients in this study. We diagnosed VAP according to the current diagnostic criteria. We identified the etiology of VAP cases by both quantitative cultures of endotracheal aspiration and blood cultures. To analyze the predisposing factors for the development of VAP, we recorded the following variables: age, gender, acute physiology and chronic health evaluation (APACHE) II score, Glasgow coma scale (GCS), sequential organ failure assessment (SOFA) score, serum albumin level, duration of mechanical ventilation (MV) prior to the development of VAP, and underlying diseases. We determined the VAP incidence rate as 28%. We found the APACHE II score and the duration of MV to be statistically significant variables for the development of VAP. There were no significant differences regarding age, gender, GCS, SOFA score, albumin level, or underlying diseases for the development of VAP. The isolated bacteria among VAP cases were as follows: Staphylococcus aureus (n=12, 43%), Acinetobacter spp. (n=6, 21%), coagulase-negative Staphylococci (n=4, 15%), Pseudomonas aeruginosa (n=3, 10.7%) and Klebsiella pneumoniae (n=3, 10.7%). Ventilator-associated pneumonia is a common infection, and certain interventions might affect the incidence of VAP. The ICU clinicians should be aware of the risk factors for VAP, which could prove useful in identifying patients at high risk for VAP, and modifying patient care to minimize the risk of VAP.

  12. Prospective hospital-based survey of attitudes of Southern women toward surgical treatment of breast cancer.

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    Wei, J P; Sherry, R M; Baisden, B L; Peckel, J; Lala, G

    1995-07-01

    Breast-conserving surgery is equivalent to total mastectomy in the treatment of breast cancer. The Southern part of the United States has a low rate of breast conservation. We surveyed 300 women: 100 hospital personnel, 100 cancer clinic patients, and 100 non-cancer clinic patients. The women were asked about their attitudes toward breast cancer, surgery preferences, and factors that might influence their decisions. One hundred eighty-nine chose mastectomy as the best operation, 106 women chose lumpectomy, and five women were undecided. There was no difference in mean age, racial distribution, education level, income level, percentage of women who considered themselves Southern women, concerns about breast cancer, recent mammograms, previous breast surgery, previous breast cancer treatment, or acquaintances with breast cancer between the mastectomy and the lumpectomy groups. Women interested in saving the breast were more likely to pick lumpectomy (35 vs. 84%, p = 0.001). A fear of cancer recurrence played a role in the decision (88 vs. 40%, p = 0.001). Fear of radiation therapy (76 vs. 57%, p = 0.002) and of the side effects (80 vs. 63%, p = 0.005) was a significant factor. The choice of surgery for breast cancer is an individual process between a woman and her surgeon. Attitudes and fears regarding cancer recurrence and radiation therapy may make women select mastectomy over lumpectomy.

  13. Prevalence of ischemic heart disease and associated factors in patients with rheumatoid arthritis in Southern Brazil

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    Rafael Kmiliauskis Santos Gomes

    Full Text Available Abstract Objective: To estimate the prevalence of ischemic heart disease and associated factors in patients with rheumatoid arthritis. Methods: A cross-sectional study using the American College of Rheumatology diagnostic criteria in order to select patients seen at primary or secondary health care units in Blumenau, Santa Catarina, Southern Brazil, in 2014. The presence of ischemic heart disease was defined as an acute myocardial infarction with percutaneous coronary intervention or coronary artery bypass graft surgery that has occurred after diagnosis. Fischer's exact test, Wald's linear trend test, and multivariate logistic regression analysis were used to test the associations. Results: Among 296 patients (83.1% female with a mean age of 56.6 years and a mean rheumatoid arthritis duration of 11.3 years, 13 reported having acute myocardial infarction requiring a percutaneous or surgical reperfusion procedure, a prevalence of 4.4% (95% CI 2.0-6.7. Diabetes Mellitus (odds ratio [OR] 4.9 [95% CI 1.6-13.8] and disease duration >10 years (OR 8.2 [95% CI 1.8-39.7] were the only factors associated with an ischemic disease that remained in the final model, after the multivariate analysis. Conclusion: The prevalence of acute myocardial infarction was similar to that observed in other studies. Among the traditional risk factors, Diabetes Mellitus, and among the factors related to rheumatoid arthritis, disease duration, were the variables associated with comorbidity.

  14. Necrophagous diptera associated with wild animal carcasses in southern Brazil

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    Ândrio Z. da Silva

    2014-12-01

    Full Text Available Necrophagous Diptera associated with wild animal carcasses in southern Brazil. The aim of this study was to acquire a better knowledge concerning the diversity of necrophagous Diptera that develop on wild animal carcasses. For this purpose, the decomposition of six wild animal carcasses was observed in order to collect and identify the main species of necrophagous flies associated with the decomposition process. The carcasses were found on highways near the cities of Pelotas and Capão do Leão in the initial stage of decomposition, with no significant injuries or prior larval activity. Four wild animal models were represented in this study: two specimens of Didelphis albiventris Lund, 1840; two Tupinambis merianae Linnaeus, 1758; one Nothura maculosa Temminck, 1815; and one Cerdocyon thous Linnaeus, 1766. A total of 16,242 flies from 14 species were reared in the laboratory, where Muscidae presented the greatest diversity of necrophagous species. Overall, (i carcasses with larger biomass developed a higher abundance of flies and (ii the necrophagous community was dominated by Calliphoridae, two patterns that were predicted from published literature; and (iii the highest diversity was observed on the smaller carcasses exposed to the lowest temperatures, a pattern that may have been caused by the absence of the generalist predator Chrysomya albiceps (Wiedemann, 1819. (iv An UPGMA analysis revealed a similar pattern of clusters of fly communities, where the same species were structuring the groupings.

  15. One stage surgical treatment for scoliosis associated with intraspinal abnormalities

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    Kai WANG

    2017-09-01

    Full Text Available Objective To evaluate the effectiveness and safety of one stage surgical treatment for scoliosis and coexisting intraspinal abnormalities. Methods The data of 6 patients who underwent one stage surgical treatment for scoliosis and coexisting intraspinal abnormalities from October 2016 to January 2017 were retrospectively analyzed. Treatment for intraspinal abnormalities, posterior correction, osteotomy and internal fixation were performed simultaneously. The clinical and radiologic presentations, operative details, complications and postoperative outcomes were evaluated. Results The success rate was 100%. The operating time was (470.83 ± 136.20 min and intraoperative bleeding amount was 1350 (625, 2150 ml. Total fusion segments were 11.00 ± 2.76. Both Cobb angle of scoliosis [postoperation (19.60 ± 5.94° vs. preoperation (59.40 ± 14.31°, P = 0.007] and kyphosis [postoperation (25.80 ± 10.87° vs. preoperation (62.40 ± 21.04°, P = 0.005] were improved after operation. Tethered cords were released and epidermoid cyst, ganglioglioma and lipoma were excised. Syringomyelia was left untreated. No neurological functional defect or worsening was found. Muscle strength of all patients was improved. Muscular tone of 4 patients and difficulty in urination of 5 patients were also improved. The mean hospital stay was (8.83 ± 3.31 d. No severe complications, such as infection, cerebrospinal fluid (CSF leakage, failed internal fixation, fractured pedicle screws or rods occurred after operation. None of the patients died, or experienced deterioration of neurological function, delayed infection, pseudoarthrosis, or loss correction during the (7.50 ± 1.22 months follow - up. Conclusions The one stage surgical treatment for scoliosis and intraspinal abnormalities seems to be a safe and effective approach. Neurological functional defect can be improved after operation. Osteotomy can improve correction result. DOI: 10.3969/j.issn.1672-6731.2017.09.011

  16. Gynecomastia associated with herniated nipples: an optimal surgical approach.

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    Jaiswal, Rohit; Pu, Lee L Q

    2012-04-01

    Gynecomastia is a common disorder observed in male plastic surgery patients. Treatment options may include observation, surgical excision, or liposuction techniques. Congenital herniated nipple is a more rare condition, especially in male patients. We present the case of a 12-year-old boy with bilateral gynecomastia and herniated nipple-areolar complexes. A staged repair was undertaken in this patient with grade 2 gynecomastia. The first operation was ultrasonic liposuction bilaterally, yielding 200 mL of aspirate from the left and 400 mL on the right, to correct the gynecomastia. The second procedure, performed 6 months later, was a bilateral periareolar mastopexy to repair the herniated nipple-areolar complexes. The result of the first procedure was flattened and symmetrical breast tissue bilaterally, essentially a correction of the gynecomastia. The herniated nipples were still present, however. Bilateral periareolar mastopexies were then performed with resulting reduction of the herniations. There were no complications with either procedure, and a good cosmetic result was achieved. A staged surgical approach was successful in correcting both conditions with an excellent aesthetic result and the advantage of decreased risk for nipple complications.

  17. Analysis of diplopia associated with thyroid-associated ophthalmopathy requiring surgical treatment

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    Funaki, Chika; Yamazaki, Sei; Maeda, Toshine; Inoue, Yoichi [Olympia Eye Hospital, Tokyo (Japan)

    2003-03-01

    The purpose of this study was to analyze diplopia associated with thyroid-associated ophthalmopathy requiring surgical treatment. Five hundred patients operated upon for diplopia by a single surgeon were included in this study. Stretching of extraocular muscles was evaluated by orbital magnetic resonance imaging (MRI) or computed tomography (CT). Ocular motility was evaluated in 9 positions of gaze using the Hess chart and field of fixation and duction test. Surgical treatment for diplopia was placement of an adjustable suture. Two hundred-twenty-four patients were male (mean age 53.9 years) and 276 patients were female (mean age 52.1 years). Three hundred-seventy patients (70%) had unilateral ocular motility dysfunction and 130 patients had bilateral dysfunction. In patients with unilateral dysfunction, the frequency of each direction of gaze dysfunction was as follows: upward gaze, 63.2%; outward, 6.8%; downward, 16.5%; inward, 0.8%; and complex, 12.7%. In patients with bilateral dysfunction, the frequency of each direction of gaze dysfunction was as follows: 11.5%, 41.5%, 5.4%, 0%, and 41.5% respectively. The majority of patients in this study had unilateral ocular motility. The most frequent direction of gaze restriction was upward in those with unilateral diplopia and outward and complex in those with bilateral diplopia. Stretching of the lateral or medial rectus muscle alone occurred very rarely in this population. (author)

  18. Interest in international surgical volunteerism: results of a survey of members of the American Pediatric Surgical Association.

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    Butler, Marilyn W; Krishnaswami, Sanjay; Rothstein, David H; Cusick, Robert A

    2011-12-01

    This study assesses interest in international volunteer work by members of the American Pediatric Surgical Association (APSA) and attempts to identify demographics, motivations, obstacles, and institutional issues of the respondents. An online survey service was used to send a 25-question survey to all APSA members with email addresses in November 2009. An answer to all questions was not required. Written comments were encouraged. The survey was sent to 807 members of whom 316 responded, for a response rate of 39%. International work had been done previously by 48% of respondents, whereas 95% stated that they were interested or perhaps interested in doing so. Most (83%) were interested in operating with local surgeons to teach them how to perform procedures. Altruism was the chief motivation in 75% of respondents. Primary obstacles to doing international work were family obligations and lack of time, although 37% stated that a lack of information about volunteer opportunities was an issue. A significant number of respondents (48%) stated that their institution had no established international collaborations. This study suggests that there is interest in international volunteerism among many members of APSA. Understanding the issues surrounding surgical volunteerism may facilitate humanitarian involvement among pediatric surgeons. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. Age is not associated with increased surgical complications in patients after laparoscopic sleeve gastrectomy.

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    Jędrzejewski, Emil; Liszka, Maciej; Maciejewski, Marcin; Kowalewski, Piotr K; Walędziak, Maciej; Paśnik, Krzysztof; Janik, Michał R

    2018-03-01

    Age is considered as a risk factor in bariatric surgery. The observation was made on the basis of results from studies where patients underwent different type of surgery, but laparoscopic sleeve gastrectomy (LSG) was not among them. It is necessary to reevaluate the association of age with adverse events in the group of patients after LSG. To investigate the association of age with surgery-related adverse events in patients after LSG. Retrospective analysis of medical data was performed. The study involved 345 patients who underwent LSG in our institution between January 2013 and December 2014. The patients were subdivided by age into four groups according to quartiles. In 30-day follow-up adverse events were evaluated. We considered the presence of the following events as the endpoint of our study: death, medical events and surgical events. In general, we observed adverse events in 36 (10.4%) patients. The mortality rate in our study was 0.59%. Nineteen events were surgical and 18 medical. In 1 patient a surgical event was associated with a medical event. Bleeding was the most common surgical event and was observed in 17 (4.9%) cases. Age was not associated with surgical events (OR = 1.032, 95% CI: 0.991-1.075, p = 0.33) or medical events (OR = 0.997, 95% CI: 0.956-1.039, p = 0.89). The LSG is a safe bariatric procedure with low mortality. Bleeding is the most frequent surgical complication. Our findings suggest that age is not associated with increased risk of surgical or medical adverse events after LSG.

  20. Acute posterior cruciate ligament injuries: effect of location, severity, and associated injuries on surgical management.

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    Anderson, Mark A; Simeone, F Joseph; Palmer, William E; Chang, Connie Y

    2018-06-01

    To correlate MRI findings of patients with posterior cruciate ligament (PCL) injury and surgical management. A retrospective search yielded 79 acute PCL injuries (36 ± 16 years old, 21 F, 58 M). Two independent readers graded PCL tear location (proximal, middle, or distal third) and severity (low-grade or high-grade partial/complete) and evaluated injury of other knee structures. When available, operative reports were examined and the performed surgical procedure was compared with injury grade, location, and presence of associated injuries. The most commonly injured knee structures in acute PCL tears were posterolateral corner (58/79, 73%) and anterior cruciate ligament (ACL) (48/79, 61%). Of the 64 patients with treatment information, 31/64 (48%) were managed surgically: 12/31 (39%) had PCL reconstruction, 13/31 (42%) had ACL reconstruction, 10/31 (32%) had posterolateral corner reconstruction, 9/31 (29%) had LCL reconstruction, 8/31 (26%) had meniscectomy, and 8/31 (26%) had fixation of a fracture. Proximal third PCL tear and multiligamentous injury were more commonly associated with surgical management (P < 0.05). Posterolateral and posteromedial corner, ACL, collateral ligament, meniscus, patellar retinaculum, and gastrocnemius muscle injury, and fracture were more likely to result in surgical management (P < 0.05). Patients with high-grade partial/complete PCL tear were more likely to have PCL reconstruction as a portion of surgical management (P < 0.05). Location of PCL tear and presence of other knee injuries were associated with surgical management while high-grade/complete PCL tear grade was associated with PCL reconstruction. MRI reporting of PCL tear location, severity, and of other knee structure injuries is important for guiding clinical management.

  1. What Factors are Associated With a Surgical Site Infection After Operative Treatment of an Elbow Fracture?

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    Claessen, Femke M A P; Braun, Yvonne; van Leeuwen, Wouter F; Dyer, George S; van den Bekerom, Michel P J; Ring, David

    2016-02-01

    Surgical site infections are one of the more common major complications of elbow fracture surgery and can contribute to other adverse outcomes, prolonged hospital stays, and increased healthcare costs. We asked: (1) What are the factors associated with a surgical site infection after elbow fracture surgery? (2) When taking the subset of closed elbow fractures only, what are the factors associated with a surgical site infection? (3) What are the common organisms isolated from an elbow infection after open treatment? One thousand three hundred twenty adult patients underwent surgery for an elbow fracture between January 2002 and July 2014 and were included in our study. Forty-eight of 1320 patients (4%) had a surgical site infection develop. Thirty-four of 1113 patients with a closed fracture (3%) had a surgical site infection develop. For all elbow fractures, use of plate and screw fixation (adjusted odds ratio [OR]= 2.2; 95% CI, 1.0-4.5; p = 0.041) and use of external fixation before surgery (adjusted OR = 4.7; 95% CI, 1.1-21; p = 0.035) were associated with higher infection rates. When subset analysis was performed for closed fractures, only smoking (adjusted OR = 2.2; 95% CI, 1.1-4.5; p = 0.023) was associated with higher infection rates. Staphylococcus aureus was the most common bacteria cultured (59%). The only modifiable risk factor for a surgical site infection after open reduction and internal fixation was cigarette smoking. Plate fixation and temporary external fixation are likely surrogates for more complex injuries, therefore no recommendations should be inferred from this association. Surgeons should counsel patients who smoke. Level IV, prognostic study.

  2. Factors associated with a primary surgical approach for sinonasal squamous cell carcinoma.

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    Cracchiolo, Jennifer R; Patel, Krupa; Migliacci, Jocelyn C; Morris, Luc T; Ganly, Ian; Roman, Benjamin R; McBride, Sean M; Tabar, Viviane S; Cohen, Marc A

    2018-03-01

    Primary surgery is the preferred treatment of T1-T4a sinonasal squamous cell carcinoma (SNSCC). Patients with SNSCC in the National Cancer Data Base (NCDB) were analyzed. Factors that contributed to selecting primary surgical treatment were examined. Overall survival (OS) in surgical patients was analyzed. Four-thousand seven hundred and seventy patients with SNSCC were included. In T1-T4a tumors, lymph node metastases, maxillary sinus location, and treatment at high-volume centers were associated with selecting primary surgery. When primary surgery was utilized, tumor factors and positive margin guided worse OS. Adjuvant therapy improved OS in positive margin resection and advanced T stage cases. Tumor and non-tumor factors are associated with selecting surgery for the treatment of SNSCC. When surgery is selected, tumor factors drive OS. Negative margin resection should be the goal of a primary surgical approach. When a positive margin resection ensues, adjuvant therapy may improve OS. © 2017 Wiley Periodicals, Inc.

  3. Spectrum of peripheral neuropathies associated with surgical interventions; A neurophysiological assessment.

    LENUS (Irish Health Repository)

    Saidha, Shiv

    2010-01-01

    We hypothesized that a wide range of surgical procedures may be complicated by neuropathies, not just in close proximity but also remote from procedural sites. The aim of this study was to classify post-operative neuropathies and the procedures associated with them.

  4. Fluid Overload and Cumulative Thoracostomy Output Are Associated With Surgical Site Infection After Pediatric Cardiothoracic Surgery.

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    Sochet, Anthony A; Nyhan, Aoibhinn; Spaeder, Michael C; Cartron, Alexander M; Song, Xiaoyan; Klugman, Darren; Brown, Anna T

    2017-08-01

    To determine the impact of cumulative, postoperative thoracostomy output, amount of bolus IV fluids and peak fluid overload on the incidence and odds of developing a deep surgical site infection following pediatric cardiothoracic surgery. A single-center, nested, retrospective, matched case-control study. A 26-bed cardiac ICU in a 303-bed tertiary care pediatric hospital. Cases with deep surgical site infection following cardiothoracic surgery were identified retrospectively from January 2010 through December 2013 and individually matched to controls at a ratio of 1:2 by age, gender, Risk Adjustment for Congenital Heart Surgery score, Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery category, primary cardiac diagnosis, and procedure. None. Twelve cases with deep surgical site infection were identified and matched to 24 controls without detectable differences in perioperative clinical characteristics. Deep surgical site infection cases had larger thoracostomy output and bolus IV fluid volumes at 6, 24, and 48 hours postoperatively compared with controls. For every 1 mL/kg of thoracostomy output, the odds of developing a deep surgical site infection increase by 13%. By receiver operative characteristic curve analysis, a cutoff of 49 mL/kg of thoracostomy output at 48 hours best discriminates the development of deep surgical site infection (sensitivity 83%, specificity 83%). Peak fluid overload was greater in cases than matched controls (12.5% vs 6%; p operative characteristic curve analysis, a threshold value of 10% peak fluid overload was observed to identify deep surgical site infection (sensitivity 67%, specificity 79%). Conditional logistic regression of peak fluid overload greater than 10% on the development of deep surgical site infection yielded an odds ratio of 9.4 (95% CI, 2-46.2). Increased postoperative peak fluid overload and cumulative thoracostomy output were associated with deep surgical site infection after pediatric

  5. Clinical and Surgical Factors Associated With Increased Epilepsy Risk in Children With Hydrocephalus.

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    Tully, Hannah M; Kukull, Walter A; Mueller, Beth A

    2016-06-01

    Children with hydrocephalus are at risk for epilepsy both due to their underlying condition and as a consequence of surgical treatment; however, the relative contributions of these factors remain unknown. The authors sought to characterize epilepsy among children with infancy-onset hydrocephalus and to examine the risks of epilepsy associated with hydrocephalus subtype and with factors related to surgical treatment. We conducted a longitudinal cohort study of all children with infancy-onset hydrocephalus treated at a major regional children's hospital during 2002 to 2012, with follow-up to ascertain risk factors and epilepsy outcome through April 2015. Poisson regression was used to calculate adjusted risk ratios and 95% confidence intervals for associations. Among 379 children with hydrocephalus, 86 (23%) developed epilepsy (mean onset age = 2.7 years), almost one fifth of whom had a history of infantile spasms. Relative to spina bifida-associated hydrocephalus, children with other major hydrocephalus subtypes had fourfold higher risks of developing epilepsy. Among children who underwent surgery, surgical infection doubled the risk of epilepsy (risk ratio = 2.0, 95% confidence interval = 1.4 to 3.0). Epilepsy was associated with surgical failure for intracranial reasons but not extracranial reasons (risk ratio = 1.7, 95% confidence interval = 1.1 to 2.7; risk ratio = 1.1, 95% confidence interval = 0.7 to 1.9, respectively). Epilepsy is common among children with hydrocephalus. Compared with children with spina bifida-associated hydrocephalus, children with other major hydrocephalus subtypes have a markedly increased risk of epilepsy. Surgical infection doubles the risk of epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Detected peritoneal fluid in small bowel obstruction is associated with the need for surgical intervention.

    LENUS (Irish Health Repository)

    O'Daly, Brendan J

    2009-06-01

    BACKGROUND: Predicting the clinical course in adhesional small bowel obstruction is difficult. There are no validated clinical or radiologic features that allow early identification of patients likely to require surgical intervention. METHODS: We conducted a retrospective review of 100 patients consecutively admitted to a tertiary level teaching hospital over a 3-year period (2002-2004) who had acute adhesional small bowel obstruction and underwent computed tomography (CT). The primary outcomes that we assessed were conservative management or the need for surgical intervention. We investigated time to physiologic gastrointestinal function recovery as a secondary outcome. We examined independent predictors of surgical intervention in a bivariate analysis using a stepwise logistic regression analysis. RESULTS: Of the 100 patients investigated, we excluded 12. Of the 88 remaining patients, 58 (66%) were managed conservatively and 30 (34%) underwent surgery. Peritoneal fluid detected on a CT scan (n = 37) was associated more frequently with surgery than conservative management (46% v. 29%, p = 0.046, chi(2)). Logistical regression identified peritoneal fluid detected on a CT scan as an independent predictor of surgical intervention (odds ratio 3.0, 95% confidence interval 1.15-7.84). CONCLUSION: The presence of peritoneal fluid on a CT scan in patients with adhesional small bowel obstruction is an independent predictor of surgical intervention and should alert the clinician that the patient is 3 times more likely to require surgery.

  7. Analysis of cellulase and polyphenol oxidase production by southern pine beetle associated fungi

    Science.gov (United States)

    Abduvali Valiev; Zumrut B. Ogel; Dier D. Klepzig

    2009-01-01

    In this study, the production of extracellular enzymes by fungi associated with southern pine beetle was investigated for the first time. Cellulase and polyphenol oxidase production were analyzed for three beetle associated fungi. Only the mutualistic symbiont Entomocorticium sp. A was found to produce cellulases and polyphenol oxidase....

  8. Effects of available water on growth and competition of southern pine beetle associated fungi

    Science.gov (United States)

    Kier D. Klepzig; J. Flores-Otero; R.W. Hofstetter; M.P. Ayers

    2004-01-01

    Competitive interactions among bark beetle associated fungi are potentially influenced by abiotic factors. Water potential, in particular, undergoes marked changes over the course of beetle colonization of tree hosts. To investigate the impact of water potential on competition among three southern pine beetle associated fungi, Ophiostoma minus,

  9. National surgical mortality audit may be associated with reduced mortality after emergency admission.

    Science.gov (United States)

    Kiermeier, Andreas; Babidge, Wendy J; McCulloch, Glenn A J; Maddern, Guy J; Watters, David A; Aitken, R James

    2017-10-01

    The Western Australian Audit of Surgical Mortality was established in 2002. A 10-year analysis suggested it was the primary driver in the subsequent fall in surgeon-related mortality. Between 2004 and 2010 the Royal Australasian College of Surgeons established mortality audits in other states. The aim of this study was to examine national data from the Australian Institute of Health and Welfare (AIHW) to determine if a similar fall in mortality was observed across Australia. The AIHW collects procedure and outcome data for all surgical admissions. AIHW data from 2005/2006 to 2012/2013 was used to assess changes in surgical mortality. Over the 8 years surgical admissions increased by 23%, while mortality fell by 18% and the mortality per admission fell by 33% (P audit was associated with a sharp decline in perioperative mortality. In the absence of any influences from other changes in clinical governance or new quality programmes it is probable it had a causal effect. The reduced mortality was most evident in high-risk patients. This study adds to the evidence that national audits are associated with improved outcomes. © 2017 Royal Australasian College of Surgeons.

  10. Is anemia associated with cognitive impairment and delirium among older acute surgical patients?

    Science.gov (United States)

    Myint, Phyo Kyaw; Owen, Stephanie; McCarthy, Kathryn; Pearce, Lyndsay; Moug, Susan J; Stechman, Michael J; Hewitt, Jonathan; Carter, Ben

    2018-03-01

    The determinants of cognitive impairment and delirium during acute illness are poorly understood, despite being common among older people. Anemia is common in older people, and there is ongoing debate regarding the association between anemia, cognitive impairment and delirium, primarily in non-surgical patients. Using data from the Older Persons Surgical Outcomes Collaboration 2013 and 2014 audit cycles, we examined the association between anemia and cognitive outcomes in patients aged ≥65 years admitted to five UK acute surgical units. On admission, the Confusion Assessment Method was carried out to detect delirium. Cognition was assessed using the Montreal Cognitive Assessment, and two levels of impairment were defined as Montreal Cognitive Assessment cognitive impairment or delirium. The adjusted odds ratios of cognitive impairment were 0.95 (95% CI 0.56-1.61) and 1.00 (95% CI 0.61-1.64) for the Montreal Cognitive Assessment cognitive outcomes among older people in this acute surgical setting. Considering the retrospective nature of the study and possible lack of power, findings should be taken with caution. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 The Authors Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.

  11. Prevalence of graduated compression stocking-associated pressure injuries in surgical intensive care units.

    Science.gov (United States)

    Hobson, Deborah B; Chang, Tracy Y; Aboagye, Jonathan K; Lau, Brandyn D; Shihab, Hasan M; Fisher, Betsy; Young, Samantha; Sujeta, Nancy; Shaffer, Dauryne L; Popoola, Victor O; Kraus, Peggy S; Knorr, Gina; Farrow, Norma E; Streiff, Michael B; Haut, Elliott R

    2017-08-01

    This study aimed to determine the prevalence of static graduated compression stocking (sGCS)-associated pressure injury among patients in surgical intensive care units (ICUs). We retrospectively reviewed data from wound care rounds between April 2011 and June 2012 at 3 surgical ICUs at an urban, tertiary care hospital. Patients with sGCS-associated pressure injury were identified and descriptive analysis was performed on their demographic, perioperative, and postoperative characteristics. We examined 1787 individual patients during 2391 patient encounters. A total of 129 (7.2%) of patients developed pressure injuries. Forty patients (2.2%) developed sGCS-associated pressure injury. Static GCS-associated pressure injury accounted for 31% (40/129) of all pressure injuries and 74% (40/54) of all medical device-related pressure injury. Eighteen (45%) and 6 (15%) developed stage 1 and 2 pressure injury, respectively, and 16 (40%) developed deep tissue injuries. The mean age of our patients was 64.7 years, about half (47.5%) were male, and their mean Acute Physiology and Chronic Health Evaluation II score was 18.8. Many had comorbid conditions, including obesity (44.5%) and diabetes (42.5%), and required mechanical ventilation (45%). Pressure injuries are a notable complication of sGCS in surgical ICU patients. Appropriate measures are required to help avoid this potentially preventable harm. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Improved compliance with the World Health Organization Surgical Safety Checklist is associated with reduced surgical specimen labelling errors.

    Science.gov (United States)

    Martis, Walston R; Hannam, Jacqueline A; Lee, Tracey; Merry, Alan F; Mitchell, Simon J

    2016-09-09

    A new approach to administering the surgical safety checklist (SSC) at our institution using wall-mounted charts for each SSC domain coupled with migrated leadership among operating room (OR) sub-teams, led to improved compliance with the Sign Out domain. Since surgical specimens are reviewed at Sign Out, we aimed to quantify any related change in surgical specimen labelling errors. Prospectively maintained error logs for surgical specimens sent to pathology were examined for the six months before and after introduction of the new SSC administration paradigm. We recorded errors made in the labelling or completion of the specimen pot and on the specimen laboratory request form. Total error rates were calculated from the number of errors divided by total number of specimens. Rates from the two periods were compared using a chi square test. There were 19 errors in 4,760 specimens (rate 3.99/1,000) and eight errors in 5,065 specimens (rate 1.58/1,000) before and after the change in SSC administration paradigm (P=0.0225). Improved compliance with administering the Sign Out domain of the SSC can reduce surgical specimen errors. This finding provides further evidence that OR teams should optimise compliance with the SSC.

  13. The American Association for Thoracic Surgery 2016 ethics forum: Working virtues in surgical practice.

    Science.gov (United States)

    Churchill, Larry R

    2017-05-01

    Moral virtues are the complement to ethical principles. They constitute the elements of character that drive habits and daily routines. Certain virtues are especially important in surgery, shaping surgical practice even when no big decisions are at hand. Eight virtues are described and the work they do is explored: trustworthiness, equanimity, empathy, advocacy, compassion, courage, humility, and hope. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  14. Visual recovery after surgical repair of chronic macular detachment associated with peripheral retinoschisis

    OpenAIRE

    Vaidehi S. Dedania; Devon H. Ghodasra; Mark W. Johnson

    2018-01-01

    Purpose: To report 2 cases of chronic macular detachment associated with peripheral retinoschisis in which surgical repair resulted in significant visual recovery. Observations: A 44-year-old man and 60-year-old woman were evaluated for chronic macular detachment, with a duration of 5 years and 6 months, respectively. In each case, optical coherence tomography was used to establish a diagnosis of full-thickness macular detachment resulting from peripheral retinoschisis and to confirm or ident...

  15. Surgical treatment of complications associated with the Angio-Seal vascular closure device.

    Science.gov (United States)

    Cikirikcioglu, Mustafa; Cherian, Sanjay; Keil, Vera; Manzano, Norman; Gemayel, Gino; Theologou, Thomas; Kalangos, Afksendiyos

    2011-05-01

    Vascular closure devices are used to provide quick hemostasis and early ambulation after percutaneous interventions. The Angio-Seal (AS) vascular closure device forms a mechanical seal by closing the puncture site located between a bioabsorbable anchor within the lumen and a collagen sponge on the adventitia. Although morbidities associated with AS are reportedly infrequent, even the slightest inaccuracy in device implantation may result in displacement of these device components, leading to sudden and severe complications. We report the surgical treatment of complications associated with the use of AS in four patients, including acute limb ischemia, pseudoaneurysm formation, significant hemorrhage, and hypovolemic shock. A common factor in all these cases was that the components of the AS device were displaced from their original site of implantation, stressing the importance of proper device placement. All patients underwent successful surgical vascular repair. Our report highlights the need for exercising extreme care during device implantation, and also the requirement for vigilant inspection for any associated vascular complications commencing immediately after device implantation. It is vital that these device components are actively looked for and removed during surgical exploration so as to prevent future complications. Copyright © 2011. Published by Elsevier Inc.

  16. Overweight and factors associated in civil servants from Southern Brazil

    Directory of Open Access Journals (Sweden)

    Eliane Cristina de Andrade Gonçalves

    2016-07-01

    Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2016v18n3p277   This study aimed to estimate the prevalence of overweight and investigate its association with sociodemographic factors, physical activity level, hypercholesterolemia, and diabetes in civil servants of a university in the state of Paraná, Brazil. The research was conducted with 339 civil servants aged above 18 years. Overweight was analyzed by self-reported body mass index. Physical activity level was evaluated using a questionnaire. Sociodemographic data (sex, age, economic status, educational level, marital status, and working hours and information on the chronic diseases of interest (hypercholesterolemia and diabetes were obtained from self-report. The association between overweight and the other variables was investigated using binary logistic regression. The prevalence of overweight was 50.6%. The groups most susceptible to overweight were: male civil servants (OR: 2.04; CI: 1.30-3.22, those less than 12 years of education (OR: 2.46; CI: 1.43-4.23, who were insufficiently active (OR: 1.64; CI: 1.03-2.60, and those with hypercholesterolemia (OR: 2.28; CI: 1.32-3.96. This study concluded that more than a half of the sample was overweight and that this condition was associated with male sex, educational level below 12 years, insufficient physical activity, and hypercholesterolemia.

  17. Surgical informed consent in obstetric and gynecologic surgeries: experience from a comprehensive teaching hospital in Southern Ethiopia.

    Science.gov (United States)

    Teshome, Million; Wolde, Zenebe; Gedefaw, Abel; Tariku, Mequanent; Asefa, Anteneh

    2018-05-24

    Surgical Informed Consent (SIC) has long been recognized as an important component of modern medicine. The ultimate goals of SIC are to improve clients' understanding of the intended procedure, increase client satisfaction, maintain trust between clients and health providers, and ultimately minimize litigation issues related to surgical procedures. The purpose of the current study is to assess the comprehensiveness of the SIC process for women undergoing obstetric and gynecologic surgeries. A hospital-based cross-sectional study was undertaken at Hawassa University Comprehensive Specialized Hospital (HUCSH) in November and December, 2016. A total of 230 women who underwent obstetric and/or gynecologic surgeries were interviewed immediately after their hospital discharge to assess their experience of the SIC process. Thirteen components of SIC were used based on international recommendations, including the Royal College of Surgeon's standards of informed consent practices for surgical procedures. Descriptive summaries are presented in tables and figures. Forty percent of respondents were aged between 25 and 29 years. Nearly a quarter (22.6%) had no formal education. More than half (54.3%) of respondents had undergone an emergency surgical procedure. Only 18.4% of respondents reported that the surgeon performing the operation had offered SIC, while 36.6% of respondents could not recall who had offered SIC. All except one respondent provided written consent to undergo a surgical procedure. However, 8.3% of respondents received SIC service while already on the operation table for their procedure. Only 73.9% of respondents were informed about the availability (or lack thereof) of alternative treatment options. Additionally, a majority of respondents were not informed about the type of anesthesia to be used (88.3%) and related complications (87.4%). Only 54.2% of respondents reported that they had been offered at least six of the 13 SIC components used by the

  18. The Factors Associated with Outcomes in Surgically Managed Ruptured Cerebral Aneurysm.

    Science.gov (United States)

    Chee, Lai Chuang; Siregar, Johari Adnan; Ghani, Abdul Rahman Izani; Idris, Zamzuri; Rahman Mohd, Noor Azman A

    2018-02-01

    . The mean GCS of the patients subjected to surgical clipping was 13, with the majority falling into the good clinical grade (78.1%). The mean timing of the surgery after SAH was 5.3 days and this was further categorised into early (day one to day three, 45.3%), intermediate (day four to day ten, 56.2%), and late (after day ten, 9.5%). The total favourable outcome achieved at discharge was 59.0% as compared to 41.0% of the unfavourable outcome, with an overall mortality rate of 10.5%. At the six-month post surgery review ( n = 94), the patients with a favourable outcome constituted 71.3% as compared to 28.7% with an unfavourable outcome. The mortality, six months post surgery was 3.2%. On a univariate analysis of early surgical clipping, patients with a better GCS and good clinical grade had a significantly better outcome at discharge. Based on the univariate study, six months post surgery, the timing of the surgery and the clinical grade remained significant predictors of the outcome. On the basis of the multivariate analysis, male patients of younger age, with a good clinical grade, were associated with favourable outcomes, both at discharge and six months post surgery. In this study, we concluded that younger male patients with a good clinical grade were associated with a favourable outcome both at discharge and six months post surgery. We did not find the timing of the surgery, size of the aneurysm or duration of surgery to be associated with a patient's surgical outcome. Increasing age was not associated with the surgical outcome in a longer term of patient's follow up.

  19. Skull reconstruction after resection of bone tumors in a single surgical time by the association of the techniques of rapid prototyping and surgical navigation.

    Science.gov (United States)

    Anchieta, M V M; Salles, F A; Cassaro, B D; Quaresma, M M; Santos, B F O

    2016-10-01

    Presentation of a new cranioplasty technique employing a combination of two technologies: rapid prototyping and surgical navigation. This technique allows the reconstruction of the skull cap after the resection of a bone tumor in a single surgical time. The neurosurgeon plans the craniotomy previously on the EximiusMed software, compatible with the Eximius Surgical Navigator, both from the company Artis Tecnologia (Brazil). The navigator imports the planning and guides the surgeon during the craniotomy. The simulation of the bone fault allows the virtual reconstruction of the skull cap and the production of a personalized modelling mold using the Magics-Materialise (Belgium)-software. The mold and a replica of the bone fault are made by rapid prototyping by the company Artis Tecnologia (Brazil) and shipped under sterile conditions to the surgical center. The PMMA prosthesis is produced during the surgical act with the help of a hand press. The total time necessary for the planning and production of the modelling mold is four days. The precision of the mold is submillimetric and accurately reproduces the virtual reconstruction of the prosthesis. The production of the prosthesis during surgery takes until twenty minutes depending on the type of PMMA used. The modelling mold avoids contraction and dissipates the heat generated by the material's exothermic reaction in the polymerization phase. The craniectomy is performed with precision over the drawing made with the help of the Eximius Surgical Navigator, according to the planned measurements. The replica of the bone fault serves to evaluate the adaptation of the prosthesis as a support for the perforations and the placement of screws and fixation plates, as per the surgeon's discretion. This technique allows the adequate oncologic treatment associated with a satisfactory aesthetic result, with precision, in a single surgical time, reducing time and costs.

  20. Factors associated with simulator-assessed laparoscopic surgical skills of veterinary students.

    Science.gov (United States)

    Kilkenny, Jessica J; Singh, Ameet; Kerr, Carolyn L; Khosa, Deep K; Fransson, Boel A

    2017-06-01

    OBJECTIVE To determine whether simulator-assessed laparoscopic skills of veterinary students were associated with training level and prior experience performing nonlaparoscopic veterinary surgery and other activities requiring hand-eye coordination and manual dexterity. DESIGN Experiment. SAMPLE 145 students without any prior laparoscopic surgical or fundamentals of laparoscopic surgery (FLS) simulator experience in years 1 (n = 39), 2 (34), 3 (39), and 4 (33) at a veterinary college. PROCEDURES A questionnaire was used to collect data from participants regarding experience performing veterinary surgery, playing video games, and participating in other activities. Participants performed a peg transfer, pattern cutting, and ligature loop-placement task on an FLS simulator, and FLS scores were assigned by an observer. Scores were compared among academic years, and correlations between amounts of veterinary surgical experience and FLS scores were assessed. A general linear model was used to identify predictors of FLS scores. RESULTS Participants were predominantly female (75%), right-hand dominant (92%), and between 20 and 29 years of age (98%). No significant differences were identified among academic years in FLS scores for individual tasks or total FLS score. Scores were not significantly associated with prior surgical or video game experience. Participants reporting no handicraft experience had significantly lower total FLS scores and FLS scores for task 2 than did participants reporting a lot of handicraft experience. CONCLUSIONS AND CLINICAL RELEVANCE Prior veterinary surgical and video game experience had no influence on FLS scores in this group of veterinary students, suggesting that proficiency of veterinary students in FLS may require specific training.

  1. Burnout is Associated With Emotional Intelligence but not Traditional Job Performance Measurements in Surgical Residents.

    Science.gov (United States)

    Cofer, Kevin D; Hollis, Robert H; Goss, Lauren; Morris, Melanie S; Porterfield, John R; Chu, Daniel I

    2018-02-23

    To evaluate whether burnout was associated with emotional intelligence and job performance in surgical residents. General surgery residents at a single institution were surveyed using the Maslach Burnout Inventory (MBI) and trait EI questionnaire (TEIQ-SF). Burnout was defined as scoring in 2 of the 3 following domains; Emotional Exhaustion (high), Depersonalization (high), and Personal Accomplishment (low). Job performance was evaluated using faculty evaluations of clinical competency-based surgical milestones and standardized test scores including the American Board of Surgery In-Training Exam (ABSITE) and the United States Medical Licensing Examination (USMLE) Step 3. USMLE Step 1 and USMLE Step 2, which were taken prior to residency training, were included to examine possible associations of burnout with USMLE examinations. Statistical comparison was made using Pearson correlation and simple linear regression adjusting for PGY level. This study was conducted at the University of Alabama at Birmingham (UAB) general surgery residency program. All current and incoming general surgery residents at UAB were invited to participate in this study. Forty residents participated in the survey (response rate 77%). Ten residents, evenly distributed from incoming residents to PGY-4, had burnout (25%). Mean global EI was lower in residents with burnout versus those without burnout (3.71 vs 3.9, p = 0.02). Of the 4 facets of EI, mean self-control values were lower in residents with burnout versus those without burnout (3.3 vs 4.06, p burnout was associated with global EI, with the strongest correlation being with personal accomplishment (r = 0.64; p burnout did not have significantly different mean scores for USMLE Step 1 (229 vs 237, p = 0.12), Step 2 (248 vs 251, p = 0.56), Step 3 (223 vs 222, p = 0.97), or ABSITE percentile (44.6 vs 58, p = 0.33) compared to residents without burnout. Personal accomplishment was associated with ABSITE percentile scores (r = 0.35; p = 0

  2. Identifying the Infection Control Areas Requiring Modifications in Thoracic Surgery Units: Results of a Two-Year Surveillance of Surgical Site Infections in Hospitals in Southern Poland.

    Science.gov (United States)

    Dubiel, Grzegorz; Rogoziński, Paweł; Żaloudik, Elżbieta; Bruliński, Krzysztof; Różańska, Anna; Wójkowska-Mach, Jadwiga

    2017-10-01

    Surgical site infection (SSI) is considered to be a priority in infection control. The objective of this study is the analysis of results of active targeted surveillance conducted over a two-year period in the Department of Thoracic Surgery at the Pulmonology and Thoracic Surgery Center in Bystra, in southern Poland. The retrospective analysis was carried out on the basis of results of active monitoring of SSI in the 45-bed Department of Thoracic Surgery at the Pulmonology and Thoracic Surgery Center in Bystra between April 1, 2014 and April 30, 2016. Surgical site infections were identified based on the definitions of the European Centre for Disease Prevention and Control (ECDC) taking into account the time of symptom onset, specifically, whether the symptoms occurred within 30 d after the surgical procedure. Detection of SSI relied on daily inspection of incisions by a trained nurse, analysis of medical and nursing entries in the computer system, and analysis of all results of microbiologic tests taken in the unit and in the operating room. In the study period, data were collected regarding 1,387 treatment procedures meeting the registration criteria. Forty cases of SSI were detected yielding an incidence rate of 3%. Most cases (55%) were found in the course of hospitalization and 45% were detected after the patient's discharge. The SSIs were classified as follows: superficial, 37.5%; deep infections, 7.5%; and organ/space infection, 55%. Among patients who were diagnosed with SSI, most were male (77.5%). For patients with an American Society of Anesthesiologists (ASA) score I-II the incidence rate was 2%; ASA score III or more, 3.7%. The incidence rate varied from 0.3% in clean surgical site to 6.5% in clean-contaminated site. The study validated the usefulness of targeted surveillance in monitoring SSIs in patients hospitalized in thoracic surgery departments. Surgical site infection surveillance identified areas of care requiring modifications, namely

  3. Blue-stain Fungi Associated with Roots of Southern Pine Trees Attacked by the Southern Pine Beetle, Dendroctonus frontalis

    Science.gov (United States)

    William J. Otrosina; Nolan J. Hess; Stanley J. Zarnoch; Thelma J. Perry; John P. Jones

    1997-01-01

    Forty paired plots were established from eastern Texas to Alabama to study root-infecting, blue-stain fungi in southern pine stands undergoing southern pine beetle (SPB) attack. Woody roots were sampled in plots undergoing recent or current attack by the SPB. Comparisons were made between occurrence of Lcptogrqhiumspp. and related fungi and data on various...

  4. American College of Surgeons/Association for Surgical Education medical student simulation-based surgical skills curriculum needs assessment.

    Science.gov (United States)

    Glass, Charity C; Acton, Robert D; Blair, Patrice G; Campbell, Andre R; Deutsch, Ellen S; Jones, Daniel B; Liscum, Kathleen R; Sachdeva, Ajit K; Scott, Daniel J; Yang, Stephen C

    2014-02-01

    Simulation can enhance learning effectiveness, efficiency, and patient safety and is engaging for learners. A survey was conducted of surgical clerkship directors nationally and medical students at 5 medical schools to rank and stratify simulation-based educational topics. Students applying to surgery were compared with others using Wilcoxon's rank-sum tests. Seventy-three of 163 clerkship directors (45%) and 231 of 872 students (26.5%) completed the survey. Of students, 28.6% were applying for surgical residency training. Clerkship directors and students generally agreed on the importance and timing of specific educational topics. Clerkship directors tended to rank basic skills, such as examination skills, higher than medical students. Students ranked procedural skills, such as lumbar puncture, more highly than clerkship directors. Surgery clerkship directors and 4th-year medical students agree substantially about the content of a simulation-based curriculum, although 4th-year medical students recommended that some topics be taught earlier than the clerkship directors recommended. Students planning to apply to surgical residencies did not differ significantly in their scoring from students pursuing nonsurgical specialties. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Correlation between smoking habit and surgical outcomes on viral-associated hepatocellular carcinomas.

    Science.gov (United States)

    Kai, Keita; Komukai, Sho; Koga, Hiroki; Yamaji, Koutaro; Ide, Takao; Kawaguchi, Atsushi; Aishima, Shinichi; Noshiro, Hirokazu

    2018-01-07

    To investigate the association between smoking habits and surgical outcomes in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) (B-HCC) and hepatitis C virus (HCV)-related HCC (C-HCC) and clarify the clinicopathological features associated with smoking status in B-HCC and C-HCC patients. We retrospectively examined the cases of the 341 consecutive patients with viral-associated HCC (C-HCC, n = 273; B-HCC, n = 68) who underwent curative surgery for their primary lesion. We categorized smoking status at the time of surgery into never, ex- and current smoker. We analyzed the B-HCC and C-HCC groups' clinicopathological features and surgical outcomes, i.e ., disease-free survival (DFS), overall survival (OS), and disease-specific survival (DSS). Univariate and multivariate analyses were performed using a Cox proportional hazards regression model. We also performed subset analyses in both patient groups comparing the current smokers to the other patients. The multivariate analysis in the C-HCC group revealed that current-smoker status was significantly correlated with both OS ( P = 0.0039) and DSS ( P = 0.0416). In the B-HCC patients, no significant correlation was observed between current-smoker status and DFS, OS, or DSS in the univariate or multivariate analyses. The subset analyses comparing the current smokers to the other patients in both the C-HCC and B-HCC groups revealed that the current smokers developed HCC at significantly younger ages than the other patients irrespective of viral infection status. A smoking habit is significantly correlated with the overall and disease-specific survivals of patients with C-HCC. In contrast, the B-HCC patients showed a weak association between smoking status and surgical outcomes.

  6. Victorian Audit of Surgical Mortality is associated with improved clinical outcomes.

    Science.gov (United States)

    Beiles, C Barry; Retegan, Claudia; Maddern, Guy J

    2015-11-01

    Improved outcomes are desirable results of clinical audit. The aim of this study was to use data from the Victorian Audit of Surgical Mortality (VASM) and the Victorian Admitted Episodes Dataset (VAED) to highlight specific areas of clinical improvement and reduction in mortality over the duration of the audit process. This study used retrospective, observational data from VASM and VAED. VASM data were reported by participating public and private health services, the Coroner and self-reporting surgeons across Victoria. Aggregated VAED data were supplied by the Victorian Department of Health. Assessment of outcomes was performed using chi-squared trend analysis over successive annual audit periods. Because initial collection of data was incomplete in the recruitment phase, statistical analysis was confined to the last 3-year period, 2010-2013. A 20% reduction in surgical mortality over the past 5 years has been identified from the VAED data. Progressive increase in both surgeon and hospital participation, significant reduction in both errors in management as perceived by assessors and increased direct consultant involvement in cases returned to theatre have been documented. The benefits of VASM are reflected in the association with a reduction of mortality and adverse clinical outcomes, which have clinical and financial benefits. It is a purely educational exercise and continued participation in this audit will ensure the highest standards of surgical care in Australia. This also highlights the valuable collaboration between the Victorian Department of Health and the RACS. © 2014 Royal Australasian College of Surgeons.

  7. Unilateral severe chronic periodontitis associated with ipsilateral surgical resection of cranial nerves V, VI, and VII.

    Science.gov (United States)

    Zavarella, Matthew M; Leblebicioglu, Binnaz; Claman, Lewis J; Tatakis, Dimitris N

    2006-01-01

    The central and peripheral nervous systems participate in several local physiological and pathological processes. There is experimental evidence that the inflammatory, local immune, and wound healing responses of a tissue can be modulated by its innervation. The aim of this clinical report is to present a case of unilateral severe periodontitis associated with ipsilateral surgical resection of the fifth, sixth, and seventh cranial nerves and to discuss the possible contribution of the nervous system to periodontal pathogenesis. A 39-year-old female patient with a history of a cerebrovascular accident caused by a right pontine arteriovenous malformation and destruction of the right fifth, sixth, and seventh cranial nerves was diagnosed with severe chronic periodontitis affecting only the right maxillary and mandibular quadrants. The patient's oral hygiene was similar for right and left sides of the mouth. Percentages of tooth surfaces carrying dental plaque were 41% and 36% for right and left sides, respectively. Non-surgical and surgical periodontal therapy was performed, and the patient was placed on a regular periodontal maintenance schedule. Healing following initial periodontal therapy and osseous periodontal surgery occurred without complications. Follow-up clinical findings at 1 year revealed stable periodontal health. This case report suggests that periodontal innervation may contribute to the regulation of local processes involved in periodontitis pathogenesis. It also suggests that periodontal therapy can be performed successfully at sites and in patients affected by paralysis.

  8. Out-of-office hours' elective surgical intensive care admissions and their associated complications.

    Science.gov (United States)

    Morgan, David J R; Ho, Kwok Ming; Ong, Yang Jian; Kolybaba, Marlene L

    2017-11-01

    The 'weekend' effect is a controversial theory that links reduced staffing levels, staffing seniority and supportive services at hospitals during 'out-of-office hours' time periods with worsening patient outcomes. It is uncertain whether admitting elective surgery patients to intensive care units (ICU) during 'out-of-office hours' time periods mitigates this affect through higher staffing ratios and seniority. Over a 3-year period in Western Australia's largest private hospital, this retrospective nested-cohort study compared all elective surgical patients admitted to the ICU based on whether their admission occurred 'in-office hours' (Monday-Friday 08.00-18.00 hours) or 'out-of-office hours' (all other times). The main outcomes were surgical complications using the Dindo-Clavien classification and length-of-stay data. Of the total 4363 ICU admissions, 3584 ICU admissions were planned following elective surgery resulting in 2515 (70.2%) in-office hours and 1069 (29.8%) out-of-office hours elective ICU surgical admissions. Out-of-office hours ICU admissions following elective surgery were associated with an increased risk of infection (P = 0.029), blood transfusion (P = 0.020), total parental nutrition (P office hours ICU admissions were also associated with an increased hospital length-of-stay, with (1.74 days longer, P office hours ICU admissions following elective surgery is common and associated with serious post-operative complications culminating in significantly longer hospital length-of-stays and greater transfers with important patient and health economic implications. © 2017 Royal Australasian College of Surgeons.

  9. Computed tomographic assessment of the surgical risks associated with fibrocavernous pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Wu, Ming-Ho; Chang, Jia-Ming; Haung, Tsung-Mao; Cheng, Li-Li; Tseng, Yau-Lin; Lin, Mu-Yen; Lai, Wu-Wei

    2004-01-01

    We evaluated the surgical risks associated with fibrocavernous pulmonary tuberculosis by retrospectively examining chest computed tomography (CT) scans. We reviewed the records of 40 patients who underwent pulmonary resection for fibrocavernous pulmonary tuberculosis, for whom preoperative CT scans were available. The disease was categorized as class I, defined as a cavity within one lobe without remarkable pleural thickness, in 21 patients; class II, defined as a cavity extending beyond one lobe or within one lobe with remarkable pleural thickness, in 10 patients; and class III, defined as bilateral cavities, in 9 patients. Four of the nine patients with bilateral cavities underwent bilateral pulmonary resection and five underwent unilateral pulmonary resection. The study parameters were intraoperative blood loss, operative time, hospital stay, major operative morbidity, and hospital death. Intraoperative blood loss and operative time were significantly greater and hospital stay was significantly longer in patients with advanced disease (P=0.046, P=0.000, and P=0.143, respectively). Major surgical morbidity mainly occurred in association with advanced disease (P=0.028) at the following incidences: class I, 5%; class II, 30%; class III, 44.4%. Two hospital deaths occurred, both following bilateral pulmonary resection for class III disease, accounting for an overall 5% mortality rate. The surgical risks associated with fibrocavernous pulmonary tuberculosis were well correlated with anatomic involvement, according to the extent of cavitation and the severity of pleural thickness, as depicted by CT. Staged pulmonary resection or the combination of one-sided resection with other modalities is recommended for the treatment of bilateral cavities. (author)

  10. Hospital costs associated with surgical site infections in general and vascular surgery patients.

    Science.gov (United States)

    Boltz, Melissa M; Hollenbeak, Christopher S; Julian, Kathleen G; Ortenzi, Gail; Dillon, Peter W

    2011-11-01

    Although much has been written about excess cost and duration of stay (DOS) associated with surgical site infections (SSIs) after cardiothoracic surgery, less has been reported after vascular and general surgery. We used data from the National Surgical Quality Improvement Program (NSQIP) to estimate the total cost and DOS associated with SSIs in patients undergoing general and vascular surgery. Using standard NSQIP practices, data were collected on patients undergoing general and vascular surgery at a single academic center between 2007 and 2009 and were merged with fully loaded operating costs obtained from the hospital accounting database. Logistic regression was used to determine which patient and preoperative variables influenced the occurrence of SSIs. After adjusting for patient characteristics, costs and DOS were fit to linear regression models to determine the effect of SSIs. Of the 2,250 general and vascular surgery patients sampled, SSIs were observed in 186 inpatients. Predisposing factors of SSIs were male sex, insulin-dependent diabetes, steroid use, wound classification, and operative time (P surgery. Although the excess costs and DOS associated with SSIs after general and vascular surgery are somewhat less, they still represent substantial financial and opportunity costs to hospitals and suggest, along with the implications for patient care, a continuing need for cost-effective quality improvement and programs of infection prevention. Copyright © 2011 Mosby, Inc. All rights reserved.

  11. Factors associated with local public health agency participation in obesity prevention in southern States.

    Science.gov (United States)

    Hatala, Jeffrey J; Fields, Tina T

    2015-05-01

    Obesity rates in the southern US states are higher than in other states. Historically, large-scale community-based interventions in the United States have not proven successful. With local public health agencies (LPHAs) tasked with prevention, their role in obesity prevention is important, yet little research exists regarding what predicts the participation of LPHAs. Cross-sectional data from the 2008 National Association of City and County Health Officials profile study and two public health conceptual frameworks were used to assess structural and environmental predictors of LPHA participation in obesity prevention. The predictors were compared between southern and nonsouthern states. Univariate and weighted logistic regressions were performed. Analysis revealed that more LPHAs in southern states were engaged in nearly all of the 10 essential public health functions related to obesity prevention compared with nonsouthern states. Presence of community-based organizations and staffing levels were the only significant variables in two of the six logistic regression models. This study provides insights into the success rates of the obesity prevention efforts of LPHAs in southern and nonsouthern states. Future research is needed to understand why and how certain structural elements and any additional factors influence LPHA participation in obesity prevention.

  12. Association between Pre-Operative Cefazolin Dose and Surgical Site Infection in Obese Patients.

    Science.gov (United States)

    Peppard, William J; Eberle, David G; Kugler, Nathan W; Mabrey, Danielle M; Weigelt, John A

    A fixed dose of cefazolin results in serum concentrations that decrease as body mass increases. Current national guidelines suggest a pre-operative cefazolin dose of two grams may be insufficient for patients ≥120 kg; thus a three gram dose is recommended. These recommendations, however, are based on pharmacokinetic rather than outcome data. We evaluate the efficacy of pre-operative cefazolin two gram and three gram doses as measured by the rate of surgical site infection (SSI). We conducted a retrospective review of adult patients ≥100 kg who were prescribed cefazolin as surgical prophylaxis between September 1, 2012 and May 31, 2013 at an academic medical center. Patients were excluded if cefazolin was prescribed but not administered, had a known infection at the site of surgery, or inappropriately received cefazolin prophylaxis based on surgical indication. The SSIs were identified by documentation of SSI in the medical record or findings consistent with the standard Centers for Disease Control and Prevention definition. Inpatient and outpatient records up to 90 days post-operative were reviewed for delayed SSI. Four hundred eighty-three surgical cases were identified in which pre-operative cefazolin was prescribed. Forty-seven patients were excluded leaving a total of 436 patients for final analysis: 152 in the cefazolin two gram group and 284 in the three gram group. Baseline demographics were similar between groups with a mean follow-up duration of 77 days for both groups. Unadjusted SSI rates were 7.2% and 7.4% (odds ratio [OR] 0.98, p = 0.95), for the two gram and three gram groups, respectively. When differences in follow-up between groups were considered and logistic regression was adjusted with propensity score, there remained no difference in SSI rates (OR 0.87, 95% confidence interval 0.36-2.06, p = 0.77). In otherwise similar obese surgical patients weighing ≥100 kg, the administration of a pre-operative cefazolin two gram dose is

  13. Driving a Fishery along the Bumpy Ride of Today's Globalisation: The Case of the Australian Southern Rock Lobster Association

    NARCIS (Netherlands)

    Dentoni, D.; Lu, J.; English, F.; McBride, R.

    2012-01-01

    The case of the Australian Southern Rock Lobster Association describes real issues faced by the Market Development Manager of a collective agri-food organization (SRL) representing all the southern rock lobster fishermen in Victoria, South Australia and Tasmania. The case deals with recent

  14. Association between fundus autofluorescence and visual outcome in surgically closed macular holes.

    Science.gov (United States)

    Lee, Young Seob; Yu, Seung-Young; Cho, Nam Suk; Kim, Moo Sang; Kim, Young Gyun; Kim, Eung Suk; Kwak, Hyung Woo

    2013-06-01

    To investigate the association between fundus autofluorescence (FAF) and visual acuity, recovery of foveal microstructure, and FAF in surgically closed macular holes. Twenty-six eyes with surgically closed macular hole were classified into two groups based on foveal FAF: normal autofluorescence (NAF) or increased autofluorescence (IAF). The association between foveal FAF and visual acuity was analyzed. In addition, we examined the relationship between recovery of the foveal microstructure assessed by spectral domain optical coherence tomography and FAF after macular hole surgery. At 1 month and 6 months after surgery, there were 9 NAF eyes and 17 IAF eyes. There were no differences between NAF and IAF eyes at 1 month and 6 months after surgery. Preoperative best-corrected visual acuity (logarithm of the minimum angle of resolution) did not differ between groups. Best-corrected visual acuity was significantly higher in the NAF group than in the IAF group at 1 month postoperatively (0.59 ± 0.34 vs. 0.91 ± 0.36, P = 0.044) and tended to be higher at 6 months (0.37 ± 0.38 vs. 0.69 ± 0.53, P = 0.126). Restoration of photoreceptor external limiting membrane differed significantly in 8 NAF eyes (89%) and 4 IAF eyes (24%) at postoperation 1 month (P = 0.001). After 6 months, external limiting membrane was restored in all 9 NAF eyes (100%) and in only 11 IAF eyes (65%) (P = 0.042). Fundus autofluorescence findings observed in surgically closed macular holes correlated with visual improvement and photoreceptor status. Eyes with visual improvement had restoration of normal foveal autofluorescence and retinal microstructure, whereas eyes with persistent foveal hyperautofluorescence did not achieve complete restoration of the retinal microstructure, and visual improvement was not as significant.

  15. Association between socioeconomic status, surgical treatment and mortality in patients with colorectal cancer.

    Science.gov (United States)

    Dik, V K; Aarts, M J; Van Grevenstein, W M U; Koopman, M; Van Oijen, M G H; Lemmens, V E; Siersema, P D

    2014-08-01

    High socioeconomic status is associated with better survival in colorectal cancer (CRC). This study investigated whether socioeconomic status is associated with differences in surgical treatment and mortality in patients with CRC. Patients diagnosed with stage I-III CRC between 2005 and 2010 in the Eindhoven Cancer Registry area in the Netherlands were included. Socioeconomic status was determined at a neighbourhood level by combining the mean household income and the mean value of the housing. Some 4422 patients with colonic cancer and 2314 with rectal cancer were included. Patients with colonic cancer and high socioeconomic status were operated on with laparotomy (70·7 versus 77·6 per cent; P = 0·017), had laparoscopy converted to laparotomy (15·7 versus 29·5 per cent; P = 0·008) and developed anastomotic leakage or abscess (9·6 versus 12·6 per cent; P = 0·049) less frequently than patients with low socioeconomic status. These differences remained significant after adjustment for patient and tumour characteristics. In rectal cancer, patients with high socioeconomic status were more likely to undergo resection (96·3 versus 93·7 per cent; P = 0·083), but this was not significant in multivariable analysis (odds ratio (OR) 1·44, 95 per cent confidence interval 0·84 to 2·46). The difference in 30-day postoperative mortality in patients with colonic cancer and high and low socioeconomic status (3·6 versus 6·8 per cent; P socioeconomic status have more favourable surgical treatment characteristics than patients with low socioeconomic status. The lower 30-day postoperative mortality found in patients with colonic cancer and high socioeconomic status is largely explained by patient and surgical factors. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

  16. Magnetic resonance imaging findings associated with surgically proven rotator interval lesions

    Energy Technology Data Exchange (ETDEWEB)

    Vinson, Emily N.; Major, Nancy M. [Duke University Medical Center, Department of Radiology, P.O. Box 3808, Durham, NC (United States); Higgins, Laurence D. [Brigham and Women' s Hospital, Department of Orthopedic Surgery, Boston, MA (United States)

    2007-05-15

    To identify shoulder magnetic resonance imaging (MRI) findings associated with surgically proven rotator interval abnormalities. The preoperative MRI examinations of five patients with surgically proven rotator interval (RI) lesions requiring closure were retrospectively evaluated by three musculoskeletal-trained radiologists in consensus. We assessed the structures in the RI, including the coracohumeral ligament, superior glenohumeral ligament, fat tissue, biceps tendon, and capsule for variations in size and signal alteration. In addition, we noted associated findings of rotator cuff and labral pathology. Three of three of the MR arthrogram studies demonstrated extension of gadolinium to the cortex of the undersurface of the coracoid process compared with the control images, seen best on the sagittal oblique images. Four of five of the studies demonstrated subjective thickening of the coracohumeral ligament, and three of five of the studies demonstrated subjective thickening of the superior glenohumeral ligament. Five of five of the studies demonstrated a labral tear. The MRI arthrogram finding of gadolinium extending to the cortex of the undersurface of the coracoid process was noted on the studies of those patients with rotator interval lesions at surgery in this series. Noting this finding - especially in the presence of a labral tear and/or thickening of the coracohumeral ligament or superior glenohumeral ligament - may be helpful in the preoperative diagnosis of rotator interval lesions. (orig.)

  17. Morbidity associated with 30-day surgical site infection following nonshunt pediatric neurosurgery

    Science.gov (United States)

    Sherrod, Brandon A.; Rocque, Brandon G.

    2017-01-01

    Objective Morbidity associated with surgical site infection (SSI) following nonshunt pediatric neurosurgical procedures is poorly understood. The purpose of this study was to analyze acute morbidity and mortality associated with SSI after nonshunt pediatric neurosurgery using a nationwide cohort. Methods The authors reviewed data from the American College of Surgeons National Surgical Quality Improvement Program Pediatric (NSQIP-P) 2012–2014 database, including all neurosurgical procedures performed on pediatric patients. Procedures were categorized by Current Procedural Terminology (CPT) codes. CSF shunts were excluded. Deep and superficial SSIs occurring within 30 days of an index procedure were identified. Deep SSIs included deep wound infections, intracranial abscesses, meningitis, osteomyelitis, and ventriculitis. The following outcomes occurring within 30 days of an index procedure were analyzed, along with postoperative time to complication development: sepsis, wound disruption, length of postoperative stay, readmission, reoperation, and death. Results A total of 251 procedures associated with a 30-day SSI were identified (2.7% of 9296 procedures). Superficial SSIs were more common than deep SSIs (57.4% versus 42.6%). Deep SSIs occurred more frequently after epilepsy or intracranial tumor procedures. Superficial SSIs occurred more frequently after skin lesion, spine, Chiari decompression, craniofacial, and myelomeningocele closure procedures. The mean (± SD) postoperative length of stay for patients with any SSI was 9.6 ± 14.8 days (median 4 days). Post-SSI outcomes significantly associated with previous SSI included wound disruption (12.4%), sepsis (15.5%), readmission (36.7%), and reoperation (43.4%) (p neurosurgery. Rates of SSI-associated complications are significantly lower in patients with superficial infection than in those with deep infection. There were no cases of SSI-related mortality within 30 days of the index procedure. PMID:28186474

  18. A comparative qualitative study of misconceptions associated with contraceptive use in southern and northern Ghana

    Directory of Open Access Journals (Sweden)

    Philip Baba Adongo

    2014-09-01

    Full Text Available Evidence from Ghana consistently shows that unmet need for contraception is pervasive with many possible causes, yet how these may differ by cultural zone remains poorly understood. This qualitative study was designed to elicit information on the nature and form of misconceptions associated with contraceptive use among northern and southern Ghanaians. Twenty-two focus group discussions (FGDs with married community members were carried out. Community Health Officers, Community Health Volunteers, and Health Care Managers were also interviewed using a semi-structured interview guide. Focus group discussions and in-depth interviews were recorded digitally, transcribed verbatim, and analyzed using QSR Nvivo 10 to compare contraceptive misconceptions in northern and southern Ghana. Results indicate that misconceptions associated with the use of contraceptives were widespread but similar in both settings. Contraceptives were perceived to predispose women to both primary and secondary infertility, uterine fibroids, and cancers. As regular menstrual flow was believed to prevent uterine fibroids, contraceptive use-related amenorrhea was thought to render acceptors vulnerable to uterine fibroids as well as cervical and breast cancers. Contraceptive acceptors were stigmatized and ridiculed as promiscuous. Among northern respondents, condom use was generally perceived to inhibit erection and therefore capable of inducing male impotence, while in southern Ghana, condom use was believed to reduce sensation and sexual gratification. The study indicates that misconceptions associated with contraceptive use are widespread in both regions. Moreover, despite profound social and contextual differences that distinguish northern and southern Ghanaians, prevailing fears and misconceptions are shared by respondents from both settings. Findings attest to the need for improved communication to provide accurate information for dispelling these misconceptions.

  19. Reduction in Surgical Wound Infection Rates Associated with Reporting Data to Surgeons

    Directory of Open Access Journals (Sweden)

    GD Taylor

    1994-01-01

    Full Text Available Several studies have shown that wound infection (surgical site infection [ ssi ] rates fall when surgeons are provided with data on their performance. Since 1987, the authors have been performing concurrent surveillance of surgical patients and confidentially reporting surgeon-specific ssi rates to individual surgeons and their clinical directors, and providing surgeons with the mean rates of their peers. The program has been gradually refined and expanded. Data are now collected on wound infection risk and report risk adjusted rates compared with the mean for hospitals in the United States National Nosocomial Infections Surveillance (nnis data bank. Since inception through to December 1993, ssi rates have fallen 68% in clean contaminated general surgery cases (relative risk [rr] 0.36, 95% ci 0.2 to 0.6, P=0.0001, 64% in clean plastic surgery cases (rr 0.35, 95% ci 0.06 to 1.8, 72% in caesarean section cases (rr 0.23, 95% ci 0.03 to 1.96 and 42% in clean cardiovascular surgery cases (rr 0.59, 95% ci 0.34 to 1.0. In clean orthopedic surgery the ssi rate remained stable from 1987 through 1992. In 1993 a marked increase was experienced. Reasons for this are being explored. Overall there was a 32% decrease in ssi rate between the index year and 1993 or, in percentage terms, 2.8% to 1.9% (rr 0.65, 95% ci 0.51 to 0.86, P=0.002. ssi surveillance should become standard in Canadian hospitals interested in improving the quality of surgical care and reducing the clinical impact and cost associated with nosocomial infection.

  20. Characterization of Campylocarpon pseudofasciculare associated with black foot of grapevine in southern Brazil

    Directory of Open Access Journals (Sweden)

    Ricardo Feliciano dos SANTOS

    2015-01-01

    Full Text Available The incidence and severity of black foot has been recently increasing in nurseries and vineyards of southern Brazil. The goal of the present study was to characterize Campylocarpon isolates associated with black foot of grapevines (Vitis spp. using multi-gene DNA analysis (internal transcribed spacers [ITS rDNA], β-tubulin and histone H3 and morphological characteristics, and to test the pathogenicity of the isolates in grapevine (Vitis labrusca cv. Bordô. The three DNA regions analyzed indicated that all the isolates belonged to Campylocarpon pseudofasciculare. Their morphology was similar to descriptions published for the species. Isolates exhibited umber- to chestnut-coloured colonies and macroconidia (38.0 × 7.0 μm predominantly with three septa. All the isolates inoculated in V. labrusca cv. Bordô caused typical symptoms of black foot. This is the first report of Campylocarpon pseudofasciculare in southern Brazil.

  1. Factors associated with dental fluorosis in school children in southern Brazil: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Marina Sousa Azevedo

    2014-05-01

    Full Text Available This cross-sectional study assessed risk factors for dental fluorosis (DF among 8- to 12-year-old children in southern Brazil. Children attending 20 schools were randomly selected (n = 1,196. They were interviewed and their parents answered a questionnaire that was sent home. Prevalence of DF was 8.53% (modified Dean’s criteria, and the prevalence of severe DF was 0.17%. The results of multiple logistic regression analyses indicated that DF was associated with a higher frequency of tooth brushing and with initial use of fluoride toothpaste at the emergence of the first tooth. DF does not constitute a public health problem in southern Brazil.

  2. Surgical site infections in women and their association with clinical conditions

    Directory of Open Access Journals (Sweden)

    Maria Zélia de Araújo Madeira

    2014-07-01

    Full Text Available Introduction Surgical site infections (SSIs can affect body tissues, cavities, or organs manipulated in surgery and constitute 14% to 16% of all infections. This study aimed to determine the incidence of SSIs in women following their discharge from a gynecology outpatient clinic, to survey different types of SSIs among women, and to verify the association of SSIs with comorbidities and clinical conditions. Methods Data were collected via analytical observation with a cross-sectional design, and the study was conducted in 1,026 women who underwent gynecological surgery in a teaching hospital in the municipality of Teresina, in the northeast Brazilian State of Piauí, from June 2011 to March 2013. Results The incidence of SSIs after discharge was 5.8% among the women in the outpatient clinic. The most prevalent surgery among the patients was hysterectomy, while the most prevalent type of SSI was superficial incisional. Comorbidities in women with SSIs included cancer, diabetes mellitus, and hypertension. Conclusions Surveillance of SSIs during the post-discharge period is critical for infection prevention and control. It is worth reflecting on the planning of surgical procedures for patients who have risk factors for the development of SSIs.

  3. The medical antigravity suit for management of surgically uncontrollable bleeding associated with abdominal pregnancy.

    Science.gov (United States)

    Sandberg, E C; Pelligra, R

    1983-07-01

    Three patients with abdominal pregnancy have been treated at Stanford University Hospital in recent years. Common to each was surgically uncontrolled hemorrhage for which circumferential pneumatic compression (supplied by a medical antigravity suit) was used to stop the bleeding. In each patient, the hemostatic effect of treatment was dramatic. In published accounts of the use of the garment in other severely hemorrhaging patients, the effects have been similarly dramatic and equally successful. These observations lead to a compelling consideration in regard to optimum management of patients with abdominal pregnancy. If our experience is confirmed by others, optimum management in abdominal pregnancy hereafter should regularly and routinely include removal of the placenta at the primary operation. This approach would anticipate use of the medical antigravity suit to provide hemostasis if surgically uncontrollable bleeding is encountered. Theoretically, the complications and long-term morbidity associated with retention of the placenta would be eliminated by this means while the previous disadvantage of placental removal, the potential for exsanguinating hemorrhage, would be circumvented.

  4. Surgical treatment of limbic epilepsy associated with extrahippocampal lesions: the problem of dual pathology.

    Science.gov (United States)

    Lévesque, M F; Nakasato, N; Vinters, H V; Babb, T L

    1991-09-01

    The authors present their review of 178 patients who underwent en bloc temporal lobectomies as surgical treatment for intractable epilepsy. Hippocampal cell density was quantitatively analyzed and the histology of the anterior temporal lobe was reviewed. Fifty-four patients (30.3%) had evidence of extrahippocampal lesions in addition to neuronal cell loss within the hippocampus (the dual pathology group). The pattern of cell loss was analyzed in the remaining 124 cases (69.7%) with no extrahippocampal pathology, and compared with that of the dual pathology group and a control group of four nonepileptic patients. Hippocampal cell loss was found in almost all epileptic patients compared to the control group. Severe cell loss greater than 30% of control values was found in 88.7% of patients without extrahippocampal lesions, but in only 51.8% of patients with dual pathology. The difference between these two groups was statistically significant (p less than 0.001). In the dual pathology group, lesions of different pathology had a significant relationship with the degree of hippocampal cell loss: all 12 patients with glioma had mild cell loss, whereas all 13 patients with heterotopia were associated with severe cell loss. Severity of hippocampal cell loss was also analyzed in relation to seizure history: a prior severe head injury was associated with severe cell loss. Other factors such as seizure duration, secondary generalization, or family history of seizures were not associated with hippocampal damage. Dual pathology may produce a combination of neocortical and temporolimbic epilepsies that warrants a precise definition of the true epileptogenic area prior to surgical treatment.

  5. Spectrum of peripheral neuropathies associated with surgical interventions; A neurophysiological assessment

    LENUS (Irish Health Repository)

    Saidha, Shiv

    2010-04-19

    Abstract Background We hypothesized that a wide range of surgical procedures may be complicated by neuropathies, not just in close proximity but also remote from procedural sites. The aim of this study was to classify post-operative neuropathies and the procedures associated with them. Methods We retrospectively identified 66 patients diagnosed with post-procedure neuropathies between January 2005 and June 2008. We reviewed their referral cards and medical records for patient demographics, information on procedures, symptoms, as well as clinical and neurophysiological findings. Results Thirty patients (45.4%) had neuropathies remote from procedural sites and 36 patients (54.5%) had neuropathies in close proximity to procedural sites. Half of the remote neuropathies (15\\/30) developed following relatively short procedures. In 27% of cases (8\\/30) remote neuropathies were bilateral. Seven patients developed neuropathies remote from operative sites following hip arthroplasties (7\\/30: 23.3%), making hip arthroplasty the most common procedure associated with remote neuropathies. Sciatic neuropathies due to hip arthroplasty (12\\/36, 33.3%) accounted for the majority of neuropathies occurring in close proximity to operative sites. Five medial cutaneous nerve of forearm neuropathies occurred following arterio-venous fistula (AVF) formation. Conclusions An array of surgical procedures may be complicated by neuropathy. Almost half of post-procedure neuropathies occur remote from the site of procedure, emphasizing the need to try to prevent not just local, but also remote neuropathies. Mechanical factors and patient positioning should be considered in the prevention of post-operative neuropathies. There is a possible association between AVF formation and medial cutaneous nerve of forearm neuropathy, which requires further study for validation.

  6. Multiple intracranial aneurysms and moyamoya disease associated with microcephalic osteodysplastic primordial dwarfism type II: surgical considerations.

    Science.gov (United States)

    Waldron, James S; Hetts, Steven W; Armstrong-Wells, Jennifer; Dowd, Christopher F; Fullerton, Heather J; Gupta, Nalin; Lawton, Michael T

    2009-11-01

    Microcephalic osteodysplastic primordial dwarfism type II (MOPD II) is a rare genetic syndrome characterized by extremely small stature and microcephaly, and is associated in 25% of patients with intracranial aneurysms and moyamoya disease. Although aneurysmal subarachnoid hemorrhage and stroke are leading causes of morbidity and death in these patients, MOPD II is rarely examined in the neurosurgical literature. The authors report their experience with 3 patients who presented with MOPD II, which includes a patient with 8 aneurysms (the most aneurysms reported in the literature), and the first report of a patient with both moyamoya disease and multiple aneurysms. The poor natural history of these lesions indicates aggressive microsurgical and/or endovascular therapy. Microsurgery, whether for aneurysm clip placement or extracranial-intracranial bypass, is challenging due to tight surgical corridors and diminutive arteries in these patients, but is technically feasible and strongly indicated when multiple aneurysms must be treated or cerebral revascularization is needed.

  7. Early surgical treatment of middle cerebral artery aneurysms associated with intracerebral haematoma.

    Science.gov (United States)

    Prat, Ricardo; Galeano, Inmaculada

    2007-06-01

    Patients with haematoma secondary to middle cerebral artery aneurysm often require urgent surgical treatment consisting of evacuation of the haematoma and aneurysmal clipping. . We present our experience over 5 years with 12 patients who underwent surgery before the first 8h of bleeding. Surgery included craniotomy, evacuation of the haematoma, and aneurysmal clipping. Preoperative angiography was performed in all cases. All patients had a score of 4 or 5 on the scale of the World Federation of Neurological Surgeons. Five of the patients were evolving well after 1 year. Clinical status upon admission, temporal lobe versus sylvian location of the haematoma, right-hemisphere involvement, and a midline deviation of less than 2 cm, were all most frequently associated with a good prognosis. In our experience, and in the literature available to us, early surgery in patients with haematoma secondary to middle cerebral artery aneurysm offers acceptable results in patients with World Federation of Neurological Surgeons scores of 4 or 5.

  8. Secular trends in mortality associated with new therapeutic strategies in surgical critical illness.

    Science.gov (United States)

    Hartl, Wolfgang H; Wolf, Hilde; Schneider, Christian P; Küchenhoff, Helmut; Jauch, Karl-Walter

    2007-10-01

    Since 1999 randomized controlled trials have shown that new therapeutic strategies, such as strict glycemic control, increased use of noninvasive ventilation and of lung-protective ventilation, and early goal-oriented shock therapy, may reduce mortality in selected groups of critically ill patients. Whether these benefits can be translated to a surgical clinical setting is unclear. We wanted to evaluate longitudinally the successive routine implementation of new therapeutic measures and its effect on postsurgical patients admitted to the intensive care unit. We performed a retrospective analysis on data collected prospectively from March 1, 1993 through February 28, 2005. A cohort of 1,802 consecutive cases requiring intensive care therapy for more than 4 days was analyzed. A significant decrease in mortality was observed in the last years of the study. With adjustment for relevant covariates, treatment after the implementation of new therapeutic strategies was identified as an independent factor linked with a reduced risk of death (odds ratio [OR] .518; 95% confidence interval [CI] .337-.796), whereas older age (OR 1.030; 95% CI 1.015-1.045), a high severity score on admission (OR 1.155; 95% CI 1.113-1.198) or during intensive care unit stay (OR 1.187; 95% CI 1.145-1.231), a high number of failing organs (OR 1.918; 95% CI 1.635-2.250), and peritonitis (OR 3.277; 95% CI 2.046-5.246) were independently associated with death. Implementing of a variety of new therapeutic measures into routine care of critically ill surgical patients was associated with improved survival after 2001.

  9. Synoptic aspects of the central Chile rainfall variability associated with the southern oscillation

    International Nuclear Information System (INIS)

    Rutllant, J.; Fuenzalida, H.

    1988-07-01

    Central Chile winter rainfall patterns show a positive anomaly during the developing stage of warm events associated to the negative phase of the Southern Oscillation. On the other hand, cold events during the positive phase of the Southern Oscillation, correspond quite closely to dry conditions. However, several dry years seem to precede or follow warm events without being necessarily classified as cold events. A synoptic characterization of major winter storms during the development of the most recent warm events in 1972, 1982 and 1987, is presented. Dry winter months during cold-event years are described in terms of average 500 hPa contour anomaly fields. Significant departures from this general behavior, as storms not associated to warm events and extended dry periods during otherwise wet winters, are also analyzed. It is found that major winter storms occurring during the developing phase of warm events are related to hemispheric types of blocking and anomaly patterns where sonal wavenumber 4 and a particular phase of wavenumber 3 dominate. The blockings, located in the Bellingshausen sea area, split the westerly flow diverting the storm tracks towards central Chile. Cold years, often immediately preceding or following a warm event, bring dry conditions in the study area due to a well developed subtropical anticyclonic belt and predominantly sonal westerly flow. Superimposed on these general conditions, anomaly contour patterns in southern South America reveal opposite signs with respect to those associated to warm events. Heavy winter storms not coinciding with warm events show local types of blocking in the Antartic peninsula area, with meridionally or slightly NE-SW oriented troughs and ridges. Extended dry spells and rainfall episodes during warm-event winters seem to be connected with alternating subtropical anomalies moving east with an intraseasonal time scale, superimposed on the aforementioned anomaly pattern at high latitudes. 21 refs, 17 figs, 1 tab

  10. Circulating serovars of Leptospira in cart horses of central and southern Ethiopia and associated risk factors.

    Science.gov (United States)

    Tsegay, K; Potts, A D; Aklilu, N; Lötter, C; Gummow, B

    2016-03-01

    Little work has been done on diseases of horses in Ethiopia or tropical regions of the world. Yet, Ethiopia has the largest horse population in Africa and their horses play a pivotal role in their economy as traction animals. A serological and questionnaire survey was therefore conducted to determine the circulating serovars of Leptospira and their association with potential risk factors in the cart horse population of Central and Southern Ethiopia. A total of 184 out of 418 cart horses from 13 districts had antibody titres of 1:100 or greater to at least one of 16 serovars of Leptospira species in Central and Southern Ethiopian horses. A significantly higher seropositivity (62.1%) was noted in horses from the highland agroecology followed by midland (44.4%) and lowland (39.8%). Serovar Bratislava (34.5%) was the predominant serovar followed by serovars Djasiman (9.8%), Topaz (5.98%) and Pomona (5.3%). Age and location proved to be associated with seropositive horses with older horses being more commonly affected and the districts of Ziway (Batu) (Apparent Prevalence (AP)=65.5%), Shashemene (AP=48.3%) and Sebeta (AP=41.4%) having the highest prevalence. Multivariable logistic regression found risk factors significantly associated with Leptospira seropositive horses were drinking river water (OR=2.8) and horses 7-12 years old (OR=5) and risk factors specifically associated with serovar Bratislava seropositive horses were drinking river water (OR=2.5), horses ≥13 years (OR=3.5) and the presence of dogs in adjacent neighbouring properties (OR=0.3). Dogs had a protective effect against seropositivity to serovars Bratislava and Djasiman, which may be due to their ability to control rodents. The high seroprevalence confirm that leptospirosis is endemic among horses of Central and Southern Ethiopia. The predominance of serovar Bratislava supports the idea that serovar Bratislava may be adapted to and maintained by the horse population of Central and Southern Ethiopia

  11. Minor Postoperative Increases of Creatinine Are Associated with Higher Mortality and Longer Hospital Length of Stay in Surgical Patients

    Science.gov (United States)

    Kork, Felix; Balzer, Felix; Spies, Claudia D.; Wernecke, Klaus-Dieter; Ginde, Adit A.; Jankowski, Joachim; Eltzschig, Holger K.

    2015-01-01

    Background Surgical patients frequently experience postoperative increases in creatinine levels. The authors hypothesized that even small increases in postoperative creatinine levels are associated with adverse outcomes. Methods The authors examined the association of postoperative changes from preoperative baseline creatinine with all-cause in-hospital mortality and hospital length of stay (HLOS) in a retrospective analysis of surgical patients at a single tertiary care center between January 2006 and June 2012. Results The data of 39,369 surgical patients (noncardiac surgery n = 37,345; cardiac surgery n = 2,024) were analyzed. Acute kidney injury (AKI)—by definition of the Kidney Disease: Improving Global Outcome group—was associated with a five-fold higher mortality (odds ratio [OR], 4.8; 95% CI, 4.1 to 5.7; P creatinine, exposure to radiocontrast agent, type of surgery, and surgical AKI risk factors. Importantly, even minor creatinine increases (Δcreatinine 25 to 49% above baseline but creatinine increases had a five-fold risk of death (OR, 5.4; 95% CI, 1.5 to 20.3; P creatinine levels are associated with adverse outcomes. These results emphasize the importance to find effective therapeutic approaches to prevent or treat even mild forms of postoperative kidney dysfunction to improve surgical outcomes. PMID:26492475

  12. Prevalence of sun exposure and its associated factors in southern Brazil: a population-based study.

    Science.gov (United States)

    Duquia, Rodrigo Pereira; Menezes, Ana Maria Baptista; Almeida, Hiram Larangeira de; Reichert, Felipe Fossati; Santos, Iná da Silva dos; Haack, Ricardo Lanzetta; Horta, Bernardo Lessa

    2013-01-01

    Sunlight exposure is responsible for a large number of dermatological diseases. We estimated the prevalence of sunlight exposure and its associated factors in adults from southern Brazil in a cross-sectional, population-based study. We investigated a representative sample of individuals aged ≥ 20 years (n=3,136). Sunlight exposure and its associated factors were evaluated in two distinct situations: at leisure time and at work. The time period investigated ranged from December 2004 to March 2005, comprising 120 days of the highest ultraviolet index in the urban area of the city of Pelotas, in southern Brazil. The participants were asked about sunlight exposure for at least 20 minutes between 10 A.M. and 4 P.M. The analysis was stratified by sex, and sunlight exposure was grouped into five categories. Among the 3,136 participants, prevalence of sunlight exposure at the beach was 32.8% (95% CI, 30.3 - 35.2) and 26.3% (95% CI, 24.2 28.3) among men and women, respectively. The prevalence at work was 39.8% (95% CI, 37.2 - 42.4) among men and 10.5% (95% CI, 9.1 - 12.0) among women. Age was inversely associated with sunlight exposure. Family income and achieved schooling were positively associated with sunlight exposure at leisure time and inversely associated with sunglight exposure at work. Self-reported skin color was not associated. Knowledge of any friend or relative who has been affected by skin cancer was positively associated with sunlight exposure among men at work. Despite the media campaigns on the harmful effects of excessive sunlight exposure, we found a high prevalence of sunlight exposure during a period of high ultraviolet index.

  13. Prevalence of sun exposure and its associated factors in southern Brazil: a population-based study*

    Science.gov (United States)

    Duquia, Rodrigo Pereira; Menezes, Ana Maria Baptista; de Almeida, Hiram Larangeira; Reichert, Felipe Fossati; dos Santos, Iná da Silva; Haack, Ricardo Lanzetta; Horta, Bernardo Lessa

    2013-01-01

    BACKGROUND Sunlight exposure is responsible for a large number of dermatological diseases. OBJECTIVE We estimated the prevalence of sunlight exposure and its associated factors in adults from southern Brazil in a cross-sectional, population-based study. METHODS We investigated a representative sample of individuals aged ≥ 20 years (n=3,136). Sunlight exposure and its associated factors were evaluated in two distinct situations: at leisure time and at work. The time period investigated ranged from December 2004 to March 2005, comprising 120 days of the highest ultraviolet index in the urban area of the city of Pelotas, in southern Brazil. The participants were asked about sunlight exposure for at least 20 minutes between 10 A.M. and 4 P.M. The analysis was stratified by sex, and sunlight exposure was grouped into five categories. RESULTS Among the 3,136 participants, prevalence of sunlight exposure at the beach was 32.8% (95% CI, 30.3 - 35.2) and 26.3% (95% CI, 24.2 28.3) among men and women, respectively. The prevalence at work was 39.8% (95% CI, 37.2 - 42.4) among men and 10.5% (95% CI, 9.1 - 12.0) among women. Age was inversely associated with sunlight exposure. Family income and achieved schooling were positively associated with sunlight exposure at leisure time and inversely associated with sunglight exposure at work. Self-reported skin color was not associated. Knowledge of any friend or relative who has been affected by skin cancer was positively associated with sunlight exposure among men at work. CONCLUSION Despite the media campaigns on the harmful effects of excessive sunlight exposure, we found a high prevalence of sunlight exposure during a period of high ultraviolet index. PMID:24068126

  14. Smoking behaviour and associated factors of illicit cigarette consumption in a border province of southern Thailand.

    Science.gov (United States)

    Ketchoo, Chittawet; Sangthong, Rassamee; Chongsuvivatwong, Virasakdi; Geater, Alan; McNeil, Edward

    2013-07-01

    Illicit cigarette consumption has increased worldwide. It is important to understand this problem thoroughly. To investigate behaviours and factors associated with illicit cigarette consumption in southern Thailand. A survey and qualitative study were conducted in a border province in southern Thailand next to Malaysia. A modified snowballing technique was used to recruit 300 illicit and 150 non-illicit cigarette smokers. A questionnaire was used to interview subjects. Illicit cigarette packs were obtained in order to identify their characteristics. Bivariate and multivariate logistic regression was used for data analysis. Smoking of illicit cigarettes has become accepted in the communities. They were available in supermarkets and vendor shops. Friends and other illicit smokers known by illicit cigarette smokers were an important source of information for access to illicit cigarette products. The main factors associated with smoking illicit cigarettes, compared with smoking non-illicit cigarettes, were younger age, higher education and higher average monthly expenditure on cigarettes (most illicit smokers smoked illicit cigarettes (average price per packet = 33 THB (US$1.1), while most non-illicit smokers smoked hand-rolled cigarettes (average price per packet = 7 THB (US$0.2)) and knowledge of other illicit cigarette smokers. The low price of illicit cigarettes was the main reason for their use. Selling strategies included sale of singles, sale in shops and direct sale through social networking. Illicit cigarette consumption has become more acceptable especially among young adult smokers. Age and extent of social networks are important factors associated with smoking illicit cigarettes.

  15. Diagnostic evaluation and aggressive surgical approach in bleeding pseudoaneurysms associated with pancreatic pseudocysts

    International Nuclear Information System (INIS)

    Pitkaeranta, P.; Haapiainen, R.; Kivisaari, L.; Schroeder, T.

    1991-01-01

    Hemorrhage is an uncommon but serious complication of pancreatic pseudocysts. When gastrointestinal bleeding or intra-abdominal hemorrhage is associated with a pancreatic pseudocysts and the usual sources of bleeding are not detected by endoscopy, the rupture of a pseudoaneurysm inside the pseudocyst should be suspected. The article present 13 cases, 11 associated with chronic and 2 with late complications after acute necrotizing pancreatitis. On the basis of sonographic findings, bleeding site was suspected in 8 of 11 patients. Computed tomography (CT) was performed on 10, and bleeding was suspected in 8. The pseudoaneurysm itself was detected by CT in one and by ultrasonography in none. Visceral angiography was performed on five patients, and the pseudoaneurysm was evident in all. External drainage with arterial ligation was done as a primary operation in five patients; four of them later underwent pancreatic resection because of rebleeding. In eight cases pancreatic resection was the initial operation; none of these patients continued to bleed or needed reoperation because of the same pseudoaneurysm. There were no intraoperative deaths, but one patient died postoperatively. Aggressive diagnostic evaluation and surgical approach are associated with a reduction in mortality and morbidity in this serious complication of pancreatic pseudocysts. 28 refs., 2 figs., 1 tab

  16. Rapid restoration of bone mass after surgical management of hyperthyroidism: A prospective case control study in Southern India.

    Science.gov (United States)

    Karunakaran, Poongkodi; Maharajan, Chandrasekaran; Mohamed, Kamaludeen N; Rachamadugu, Suresh V

    2016-03-01

    The rate and the extent of bone remineralization at cancellous versus cortical sites after treatment of hyperthyroidism is unclear. Few studies have examined the effect of operative management of hyperthyroidism on recovery of bone mass. To evaluate prospectively the bone mineral density (BMD), bone mineral content (BMC), and bone areal size at the spine, hip, and forearm before and after total thyroidectomy. A prospective case control observational study from August 2011 to July 2014 in a single center. This study evaluated 40 overt hyperthyroid patients and 31 age-matched euthyroid controls who were operative candidates. Bone indices were measured at baseline and 6-month postoperatively using dual energy x-ray absorptiometry. Serum levels of alkaline phosphatase and 25-hydroxy vitamin D3 (25OHD) were assessed. Baseline BMD of hyperthyroid subjects at the spine, hip, and forearm were less than euthyroid controls (P = .001) with concomitant increases in serum alkaline phosphatase (mean ± SD, 143 ± 72 vs 72 ± 23 IU/L control; P hyperthyroid patients, posttreatment BMD expressed as g/cm(2) were 0.97 ± 0.12 (vs pretreatment 0.91 ± 0.14; P = .001) at the spine, 0.87 ± 0.12 (vs pretreatment 0.80 ± 0.13; P = .001) at the hip, and 0.67 ± 0.09 (vs pretreatment 0.64 ± 0.11; P = .191) at the forearm. The percent change in BMD was greatest at spine (8.3%) followed by the hip (7.6%) and forearm (3.0%). Operative management with total thyroidectomy improved the bone loss associated with hyperthyroidism as early as 6 months postoperatively at the hip and spine despite concomitant vitamin D deficiency. Delayed recovery of bone indices at the forearm, a cortical bone, requires further long-term evaluation. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Association of leprosy with HLA-DR2 in a Southern Brazilian population

    Directory of Open Access Journals (Sweden)

    Visentainer J.E.L.

    1997-01-01

    Full Text Available The association between HLA specificities and leprosy was investigated in a Southern Brazilian population. One hundred and twenty-one patients and 147 controls were typed for HLA-A, B, Cw, DR and DQ. Patients were subdivided into the following subgroups, according to clinical, histological and immunological criteria: lepromatous (N = 55, tuberculoid (N = 32, dimorphous (N = 20, and indeterminate (N = 14. The frequencies of HLA specificities were compared between the total group of patients and controls, and between the same controls and each subgroup of patients. After correction of the probabilities, deviations were not significant, except for the DR2 specificity, which presented a frequency of 44.2% in the total group of patients and 56.3% in the subgroup of individuals with the tuberculoid form of the disease, compared to 23.3% in the controls. Stratified analysis showed that the increased DR2 frequency in the total group of patients was due to the subgroups with the tuberculoid and dimorphous forms. The relative risk of tuberculoid leprosy for DR2-positive individuals was 4.2, and the etiologic fraction of DR2 was 0.429. In conclusion, a positive association of the DR2 specificity with the tuberculoid form of leprosy, but not with the lepromatous, dimorphous, or indeterminate forms, was demonstrated in this Southern Brazilian population

  18. Outbreak of hepatitis C virus infection associated with narcotics diversion by an hepatitis C virus-infected surgical technician.

    Science.gov (United States)

    Warner, Amy E; Schaefer, Melissa K; Patel, Priti R; Drobeniuc, Jan; Xia, Guoliang; Lin, Yulin; Khudyakov, Yury; Vonderwahl, Candace W; Miller, Lisa; Thompson, Nicola D

    2015-01-01

    Drug diversion by health care personnel poses a risk for serious patient harm. Public health identified 2 patients diagnosed with acute hepatitis C virus (HCV) infection who shared a common link with a hospital. Further investigation implicated a drug-diverting, HCV-infected surgical technician who was subsequently employed at an ambulatory surgical center. Patients at the 2 facilities were offered testing for HCV infection if they were potentially exposed. Serum from the surgical technician and patients testing positive for HCV but without evidence of infection before their surgical procedure was further tested to determine HCV genotype and quasi-species sequences. Parenteral medication handling practices at the 2 facilities were evaluated. The 2 facilities notified 5970 patients of their possible exposure to HCV, 88% of whom were tested and had results reported to the state public health departments. Eighteen patients had HCV highly related to the surgical technician's virus. The surgical technician gained unauthorized access to fentanyl owing to limitations in procedures for securing controlled substances. Public health surveillance identified an outbreak of HCV infection due to an infected health care provider engaged in diversion of injectable narcotics. The investigation highlights the value of public health surveillance in identifying HCV outbreaks and uncovering a method of drug diversion and its impacts on patients. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

  19. Medical and Surgical Treatment in Pediatric Orbital Myositis Associated with Coxsackie Virus

    Directory of Open Access Journals (Sweden)

    Pedro Gil

    2015-01-01

    Full Text Available Purpose. To report a case of orbital myositis associated with Coxsackie virus and its medical and surgical approach. Methods. Complete ophthalmological examination and imaging and analytical investigation were performed. Results. A 6-year-old male presented with subacute painless binocular horizontal diplopia. Examination revealed bilateral best-corrected visual acuity (BCVA of 20/20 and right eye 45-prism-dioptre (PD esotropia in near and distance fixations, with no motility restrictions. Serologic screening was positive for Coxsackie virus acute infection and computerized tomography (CT suggested right eye medial rectus orbital myositis. An oral corticosteroid 1.0 mg/kg/day regimen was started. A new CT after two months showed symmetrical lesions in both medial rectus muscles. Corticosteroids were increased to 1.5 mg/kg/day. After imagiological resolution on the 4th month, alternating 45 PD esotropia persisted. Bilateral 7 mm medial rectus recession was performed after 1 year without spontaneous recovery. At 1-year follow-up, the patient is orthophoric with 200′′ stereopsis and bilateral 20/20 BCVA. Conclusions. To our knowledge, this is the first reported case of orbital myositis associated with Coxsackie virus. This is also the first reported case of isolated strabismus surgery after orbital myositis in pediatric age, highlighting the favourable aesthetic and functional outcomes even in cases of late ocular motility disorders.

  20. A trial of surgical treatment in a dog suffering from severe cholecystitis associated with biliary calculus

    International Nuclear Information System (INIS)

    Uno, T.; Okamoto, K.; Onaka, C.; Fujita, K.; Yamamura, H.; Sakai, T.

    2009-01-01

    A miniature dachshund, 5 years and 3 months of age, with a history of cholecystitis associated with biliary calculus that had developed one year previously, presented with anorexia and vomiting. A series of examinations, including CT imaging by drip infusion cholangiography (DIC-CT), revealed that no bile was flowing into the gallbladder. Thickening of the gallbladder wall and a biliary calculus occupying the lumen of the gallbladder with a laminated internal structure were also found. Based on the results of a detailed examination, the gallbladder was extracted. E. coli and Enterococcus sp. were isolated by microbiological tests inside the gallbladder and around its outer wall. The findings of drug susceptibility tests indicated that the E. coli could be a substrate-specific, broad spectrum, beta-lactamase-producing bacterium. In this case, administration of faropenem sodium was initiated before the surgery and the postoperative course was good. DIC-CT imaging can properly visualize the biliary duct system, and an explanation that relied on these images was useful for the dog's owner. It was thought that surgical treatment should actively be considered to prevent a relapse of cholecystitis in cases involving cholecystitis associated with biliary calculi

  1. Macular detachment associated with an optic pit: optical coherence tomography patterns and surgical outcomes.

    Science.gov (United States)

    Skaat, Alon; Moroz, Iris; Moisseiev, Joseph

    2013-01-01

    To describe the different optical coherence tomography (OCT) patterns in macular detachment associated with an optic disc pit and their long-term evolution following vitrectomy.
 The data of 5 patients (9-43 years of age) with unilateral macular detachment associated with an optic disc pit, who had at least 1 year of follow-up, were compiled. Pars plana vitrectomy combined with gas tamponade was performed as the primary procedure in all patients. The OCT scans, best-corrected visual acuity (BCVA), and anatomic outcomes were documented.
 Two main OCT patterns were identified: a multilayer schisis pattern and a serous detachment pattern. Patients with multilayer schisis pattern were older and demonstrated worse mean preoperative (20/160) and postoperative (20/50) BCVA compared to serous detachment pattern patients (20/30 and 20/20, respectively). An average of 2.3 procedures per patient was needed in the multilayer schisis pattern compared to just one procedure in the serous detachment pattern. In 3 patients, additional pneumatic retinopexy was performed with full resolution of the subretinal fluid achieved.
 Two distinct OCT patterns were observed in eyes with macular detachments with an optic pit, with different clinical features and prognoses. Excellent final visual acuity was obtained in all eyes, including those that required several surgical procedures.

  2. Surgical treatment of hallux valgus associated with flexible flatfoot during growing age.

    Science.gov (United States)

    Faldini, Cesare; Nanni, Matteo; Traina, Francesco; Fabbri, Daniele; Borghi, Raffaele; Giannini, Sandro

    2016-04-01

    During growth, hallux valgus could present associated with flatfoot. Considering the current disagreement about correction of hallux valgus during growth and the lack of reports about simultaneous correction of hallux valgus associated with flexible flatfoot, we present simultaneous treatment of both deformities during growth combining subtalar arthroeresis and SERI first metatarsal osteotomy, reporting results at an average five-year follow-up. Thirty-two children (64 feet, age range 8-12 years) affected by hallux valgus associated with flexible flatfoot underwent surgical treatment combining SERI first metatarsal osteotomy and subtalar arthroereisis with bioabsorbable endorthotic implant. Clinical evaluation was summarized with AOFAS score, and standard standing radiographs were performed. AOFAS score ranged from 86 ± 2 to 98 ± 2 (hindfoot) and from 80 ± 4 to 98 ± 2 (forefoot). HVA ranged from 21° ± 2 to 5° ± 2, IMA from 14° ± 2 to 7° ± 2, DMAA from 18° ± 2 to 2° ± 2, and Meary's angle from 162° ± 11 to 175° ± 4. Complications included one case of delayed wound healing, inflammatory skin reaction around the outlet of the percutaneous Kirschner wire in two cases, displacement of the endorthotic implant in one case, and a second surgery to replace the implant. SERI osteotomy and subtalar arthroereisis resulted in an effective, technically simple and easily combined approach, with a high rate of good results and low rate of complications at mid-term follow-up. These techniques performed simultaneously represent a viable option in case of hallux valgus associated with flexible flatfoot during growth. Nevertheless, considering the limitations of this study, we believe that a larger case series and a longer follow-up should be desirable.

  3. Association of Postoperative Readmissions With Surgical Quality Using a Delphi Consensus Process to Identify Relevant Diagnosis Codes.

    Science.gov (United States)

    Mull, Hillary J; Graham, Laura A; Morris, Melanie S; Rosen, Amy K; Richman, Joshua S; Whittle, Jeffery; Burns, Edith; Wagner, Todd H; Copeland, Laurel A; Wahl, Tyler; Jones, Caroline; Hollis, Robert H; Itani, Kamal M F; Hawn, Mary T

    2018-04-18

    Postoperative readmission data are used to measure hospital performance, yet the extent to which these readmissions reflect surgical quality is unknown. To establish expert consensus on whether reasons for postoperative readmission are associated with the quality of surgery in the index admission. In a modified Delphi process, a panel of 14 experts in medical and surgical readmissions comprising physicians and nonphysicians from Veterans Affairs (VA) and private-sector institutions reviewed 30-day postoperative readmissions from fiscal years 2008 through 2014 associated with inpatient surgical procedures performed at a VA medical center between October 1, 2007, and September 30, 2014. The consensus process was conducted from January through May 2017. Reasons for readmission were grouped into categories based on International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes. Panelists were given the proportion of readmissions coded by each reason and median (interquartile range) days to readmission. They answered the question, "Does the readmission reason reflect possible surgical quality of care problems in the index admission?" on a scale of 1 (never related) to 5 (directly related) in 3 rounds of consensus building. The consensus process was completed in May 2017 and data were analyzed in June 2017. Consensus on proportion of ICD-9-coded readmission reasons that reflected quality of surgical procedure. In 3 Delphi rounds, the 14 panelists achieved consensus on 50 reasons for readmission; 12 panelists also completed group telephone calls between rounds 1 and 2. Readmissions with diagnoses of infection, sepsis, pneumonia, hemorrhage/hematoma, anemia, ostomy complications, acute renal failure, fluid/electrolyte disorders, or venous thromboembolism were considered associated with surgical quality and accounted for 25 521 of 39 664 readmissions (64% of readmissions; 7.5% of 340 858 index surgical procedures). The proportion of readmissions

  4. Financial Contribution of Residents When Billing as "Junior Associates" in the "Surgical Firm".

    Science.gov (United States)

    Stoller, Jeremy; Pratt, Sarah; Stanek, Stephen; Zelenock, Gerald; Nazzal, Munier

    2016-01-01

    There is an increasing number of proposals to change the way Graduate Medical Education is funded. This study attempts to estimate the potential financial contribution of surgical residents using an alternative funding mechanism similar to that used by law firms, which would allow surgery departments to bill for resident activity as "junior associates." Following 24 residents over a period of 12 weeks, we were able to estimate the annual revenue that they generated from operating room procedures, independent consultations, patient management, and minor procedures using Medicare reimbursement rates. The appropriate first assistant modifier was used to calculate the operating room procedure fees, but full price was used to calculate the revenue for minor procedures, patient management, and consultations done independently. We adjusted for vacation time and academic activities. Including postgraduate year 1 residents, the estimated yearly revenue generated per resident in first assistant operative services was $33,305.67. For minor procedures, patient management, and independent consultations, the estimated yearly revenue per resident was $37,350.66. The total estimated financial contribution per resident per year was $70,656.33. Excluding postgraduate year 1 residents, as most states require completion of the intern year before full licensure, the estimated yearly revenue generated per resident in first assistant operative services was $38,914.56. For minor procedures, patient management, and independent consultations, the estimated yearly revenue per resident was $55,957.33. The total estimated financial contribution per resident per year was $94,871.89. Residents provide a significant service to hospitals. If resident activity was compensated at the level of supervised "junior associates" of a surgery department, more than 75% of the direct educational costs of training could be offset. Furthermore, we believe this value is underestimated. Given the foreseeable

  5. The association of health and income in the elderly: experience from a southern state of Brazil.

    Directory of Open Access Journals (Sweden)

    Gerda G Fillenbaum

    Full Text Available In high income, developed countries, health status tends to improve as income increases, but primarily through the 50(th-66(th percentile of income. It is unclear whether the same limitation holds in middle income countries, and for both general assessments of health and specific conditions.Data were obtained from Brazil, a middle income country. In-person interviews with a representative sample of community residents age ≥ 60 (N=6963, in the southern state of Rio Grande do Sul, obtained information on demographic characteristics including household income and number of persons supported, general health status (self-rated health, functional status, depression, and seven physician-diagnosed, self-reported health conditions. Analyses used household income (adjusted for number supported and economies of scale together with higher order income terms, and controlled for demographics and comorbidities, to ascertain nonlinearity between income and general and specific health measures.In fully controlled analyses income was associated with general measures of health (linearly with self-rated health, nonlinearly with functional status. For specific health measures there was a consistent linear association with depression, pulmonary disorders, renal disorders, and sensory impairment. For musculoskeletal, cardiovascular (negative association, and gastrointestinal disorders this association no longer held when comorbidities were controlled. There was no association with diabetes.Contrary to findings in high income countries, the association of household-size-adjusted income with health was generally linear, sometimes negative, and sometimes absent when comorbidities were controlled.

  6. Association between promoter -1607 polymorphism of MMP1 and Lumbar Disc Disease in Southern Chinese

    Directory of Open Access Journals (Sweden)

    Leong John CY

    2008-04-01

    Full Text Available Abstract Background Matrix metalloproteinases (MMPs are involved in the degradation of the extracellular matrix of the intervertebral disc. A SNP for guanine insertion/deletion (G/D, the -1607 promoter polymorphism, of the MMP1 gene was found significantly affecting promoter activity and corresponding transcription level. Hence it is a good candidate for genetic studies in DDD. Methods Southern Chinese volunteers between 18 and 55 years were recruited from the population. DDD in the lumbar spine was defined by MRI using Schneiderman's classification. Genomic DNA was isolated from the leukocytes and genotyping was performed using the Sequenom® platform. Association and Hardy-Weinberg equilibrium checking were assessed by Chi-square test and Mann-Whitney U test. Results Our results showed substantial evidence of association between -1607 promoter polymorphism of MMP1 and DDD in the Southern Chinese subjects. D allelic was significantly associated with DDD (p value = 0.027, odds ratio = 1.41 with 95% CI = 1.04–1.90 while Genotypic association on the presence of D allele was also significantly associated with DDD (p value = 0.046, odds ratio = 1.50 with 95% CI = 1.01–2.24. Further age stratification showed significant genotypic as well as allelic association in the group of over 40 years (genotypic: p value = 0.035, odds ratio = 1.617 with 95% CI = 1.033–2.529; allelic: p value = 0.033, odds ratio = 1.445 with 95% CI = 1.029–2.029. Disc bulge, annular tears and the Schmorl's nodes were not associated with the D allele. Conclusion We demonstrated that individuals with the presence of D allele for the -1607 promoter polymorphism of MMP1 are about 1.5 times more susceptible to develop DDD when compared with those having G allele only. Further association was identified in individuals over 40 years of age. Disc bulge, annular tear as well as Schmorl's nodes were not associated with this polymorphism.

  7. Body mass index is not associated with reoperation rates in patients with a surgically treated perforated peptic ulcer

    DEFF Research Database (Denmark)

    Duch, Patricia; Møller, Morten Hylander

    2015-01-01

    INTRODUCTION: The aim of the present nationwide Danish cohort study was to examine the association between body mass index (BMI) and reoperation in patients who are sur-gically treated for perforated peptic ulcer (PPU). METHODS: This was a nationwide cohort study of all Danish patients who were...

  8. Aesthetic Surgical Procedures in Men: Major Complications and Associated Risk Factors.

    Science.gov (United States)

    Kaoutzanis, Christodoulos; Winocour, Julian; Yeslev, Max; Gupta, Varun; Asokan, Ishan; Roostaeian, Jason; Grotting, James C; Higdon, K Kye

    2018-03-14

    The number of men undergoing cosmetic surgery is increasing in North America. To determine the incidence and risk factors of major complications in males undergoing cosmetic surgery, compare the complication profiles between men and women, and identify specific procedures that are associated with higher risk of complications in males. A prospective cohort of patients undergoing cosmetic surgery between 2008 and 2013 was identified from the CosmetAssure database. Gender specific procedures were excluded. Primary outcome was occurrence of a major complication in males requiring emergency room visit, hospital admission, or reoperation within 30 days of the index operation. Univariate and multivariate analysis evaluated potential risk factors for major complications including age, body mass index (BMI), smoking, diabetes, type of surgical facility, type of procedure, and combined procedures. Of the 129,007 patients, 54,927 underwent gender nonspecific procedures, of which 5801 (10.6%) were males. Women showed a higher mean age (46.4 ± 14.1 vs 45.2 ± 16.7 years, P procedures (RR 3.47), and combined procedures (RR 2.56). Aesthetic surgery in men is safe with low major complication rates. Modifiable predictors of complications included BMI and combined procedures.

  9. Surgical management of gingival overgrowth associated with Cowden sydrome: a case report and current understanding.

    Science.gov (United States)

    Feitosa, Daniela da Silva; Santamaria, Mauro Pedrine; Casati, Márcio Zaffalon; Sallum, Enilson Antonio; Nociti Júnior, Francisco Humberto; de Toledo, Sérgio

    2011-05-01

    Cowden syndrome, also known as multiple hamartoma syndrome, is a rare autosomal dominant disorder characterized by multiple hamartomas and a high risk of development of malignancy. Oral findings, such as papillomatous lesions and fibromas, are common features; however, a periodontal phenotype has not been reported previously. Therefore, this report presents a case of gingival overgrowth associated with Cowden syndrome, its successful surgical management, and the 12-month follow-up results. Additionally, we discuss the implications for clinicians. A 23-year-old woman was referred to the Department of Periodontics, Piracicaba Dental School, presenting with generalized gingival overgrowth. A detailed dental and medical history and clinical examination confirmed the systemic diagnosis of Cowden syndrome. Histology, radiographs, and clinical data document the entire clinical approach and follow-up. Clinically, there were minor signs of recurrence of gingival overgrowth in a 12-month period after gingivectomy; however, papular lesions reappeared in keratinized gingiva immediately after healing. No signs of bone loss related to the systemic condition were observed radiographically. Histologically, a dense connective tissue with a moderate chronic inflammatory infiltrate and epithelial acanthosis, which is characteristic of gingival hyperplasia, were demonstrated. Gingival overgrowth may occur as an oral phenotype related to Cowden syndrome and can be successfully treated by means of external bevel gingivectomy, followed by regular maintenance therapy, contributing to the patient's well-being, both functionally and esthetically.

  10. Associations Among Cardiometabolic Abnormalities, Obesity, and Sociobehavioral Factors in a Southern Nevada Adult Population.

    Science.gov (United States)

    Feng, Jing; Johnson, Michael D; Iser, Joseph P

    Cardiometabolic abnormalities underlie many health risks associated with obesity. We determined the relationship between cardiometabolic abnormalities, sociodemographic characteristics, and modifiable risk factors among adults in Southern Nevada. We included 2415 participants older than 20 years from the Behavioral Risk Factor Surveillance System surveys conducted in 2011, 2013, and 2015 in Southern Nevada. Cardiometabolic abnormalities were assessed on the combined basis of blood pressure, cholesterol, and diabetes status. Logistic regression stratified by body mass index status was used to examine cardiometabolic abnormalities in different body mass index classes. Odds ratio estimates for cardiometabolic abnormalities after accounting for sociodemographic and health behavior characteristics. Cardiometabolic abnormalities followed a socioeconomic gradient, although adjustment for lifestyle variables attenuated the associative link. Non-Hispanic black (vs white) race did not elevate cardiometabolic abnormalities risk among nonobese adults, yet conferred a multivariable-adjusted odds ratio of 2.18 (95% confidence interval [CI], 1.03-4.61) among obese adults. By comparison, odds of cardiometabolic abnormalities among nonobese adults were 2.42 (95% CI, 0.99-5.92) times higher for Hispanics and 2.83 (95% CI, 1.23-6.55) times higher for other or multiracial minorities. Among obese adults, male gender (odds ratio: 1.84; 95% CI, 1.03-3.27) and former (odds ratio: 2.09; 95% CI, 1.14-3.85) smoker status were associated with cardiometabolic abnormalities independent of other covariates. The present data support intervention strategies tailored to reinforce and promote positive health behaviors among disadvantaged groups. There were variable patterns of ethnic group disparities in clustered cardiometabolic abnormalities across body mass index classes. Targeted prevention approaches incorporating an explicit health equity perspective may help mitigate observed differences.

  11. Mio-Pliocene aridity in the south-central Andes associated with Southern Hemisphere cold periods.

    Science.gov (United States)

    Amidon, William H; Fisher, G Burch; Burbank, Douglas W; Ciccioli, Patricia L; Alonso, Ricardo N; Gorin, Andrew L; Silverhart, Perri H; Kylander-Clark, Andrew R C; Christoffersen, Michael S

    2017-06-20

    Although Earth's climate history is best known through marine records, the corresponding continental climatic conditions drive the evolution of terrestrial life. Continental conditions during the latest Miocene are of particular interest because global faunal turnover is roughly synchronous with a period of global glaciation from ∼6.2-5.5 Ma and with the Messinian Salinity Crisis from ∼6.0-5.3 Ma. Despite the climatic and ecological significance of this period, the continental climatic conditions associated with it remain unclear. We address this question using erosion rates of ancient watersheds to constrain Mio-Pliocene climatic conditions in the south-central Andes near 30° S. Our results show two slowdowns in erosion rate, one from ∼6.1-5.2 Ma and another from 3.6 to 3.3 Ma, which we attribute to periods of continental aridity. This view is supported by synchrony with other regional proxies for aridity and with the timing of glacial ‟cold" periods as recorded by marine proxies, such as the M2 isotope excursion. We thus conclude that aridity in the south-central Andes is associated with cold periods at high southern latitudes, perhaps due to a northward migration of the Southern Hemisphere westerlies, which disrupted the South American Low Level Jet that delivers moisture to southeastern South America. Colder glacial periods, and possibly associated reductions in atmospheric CO 2 , thus seem to be an important driver of Mio-Pliocene ecological transitions in the central Andes. Finally, this study demonstrates that paleo-erosion rates can be a powerful proxy for ancient continental climates that lie beyond the reach of most lacustrine and glacial archives.

  12. Association of a miRNA-137 Polymorphism with Schizophrenia in a Southern Chinese Han Population

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    Guoda Ma

    2014-01-01

    Full Text Available Both genome wide association study (GWAS and biochemical studies of Caucasian populations indicate a robust association between the miR-137 genetic variant rs1625579 and schizophrenia, but inconsistent results have been reported. To assay the association between this variant and schizophrenia, we genotyped 611 schizophrenic patients from Southern Chinese Han population for the risk single nucleotide polymorphism (SNP rs1625579 using the SNaPshot technique and compared the clinical profiles of different genotypes. Additionally, a meta-analysis was performed using the combined sample groups from five case-control publications and the present study. Both the genotype and allele distributions of the rs1625579 SNP were significantly different between patients and controls (P=0.036 and 0.026, SNP. TT genotype carriers showed slightly lower Brief Assessment of Cognition in Schizophrenia- (BACS- derived working memory performance than G carriers (15.58 ± 9.56 versus 19.71 ± 8.18, P=0.045. In the meta-analysis, we observed a significant association between rs1625579 and schizophrenia under different genetic models (all P<0.05. The results of our study and meta-analysis provide convincing evidence that rs1625579 is significantly associated with schizophrenia. Furthermore, the miR-137 polymorphism influences the working memory performance of schizophrenic patients in a Chinese Han population.

  13. Ex vivo repair of renal artery aneurysm associated with surgical treatment of abdominal aortic aneurysm

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    Kostić Dušan M.

    2004-01-01

    Full Text Available INTRODUCTION Renal artery aneurysms is relatively uncommon with reported incidence ranges from 0.3% to 1%. However, considering all visceral artery aneurysms the percentage of renal artery aneurysms is relatively high between 15-25%. The distal forms of renal artery aneurysms sometimes require "ex vivo" reconstruction and kidney autotransplantation. CASE REPORT A 75-year-old male presented with the right abdominal and back pain. He suffered from a long history of arterial hypertension and chronic renal failure over the last few months (urea blood = 19.8 mmol/l; creatinine = 198 mmol/l. Duplex ultrasonography showed abdominal aortic aneurysm. Subsequent translumbarangiography revealed juxtarenal abdominal aortic aneurysm associated with distal right renal artery aneurysm. The operation was performed under combined thoracic epidural analgesia and general anesthesia using transperitoneal approach. After the laparotomy, the ascending colon was mobilized and reflected medially followed by Kocher maneuver. The result was visualization of the anterior aspect of the right kidney, the collecting system, ureter as well as the right renal vein and artery with large saccular aneurysm located distally. After mobilization of the renal vessels and careful dissection of the ureter, the kidney was explanted. The operation was continued by two surgical teams. The first team performed abdominal aortic aneurysm resection and reconstruction with bifurcated Dacron graft. The second team performed ex vivo reparation of renal artery aneurysm. All time during the explantation, the kidney was perfused by Collins' solution. The saccular right renal artery aneurysm 4 cm in diameter was located at the kidney hilus at the first bifurcation. Three branches originated from the aneurysm. The aneurysm was resected completely. The longest and widest of three branches arising from the aneurysmal sac was end-to-end anastomized with 6 mm PTFE graft. After this intervention, one of

  14. Surgical correction of ectopic penis and scrotum associated with bilateral orchidopexy.

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    Sobral, Daniel Santos Rocha; Silva, Helder Damásio da; Damázio, Eulálio

    2017-01-01

    Ectopic penis is usually associated with penoscrotal transposition, and it is rarely observed in isolation. We report a surgical approach for an extremely rare case. A 10-year-old male patient with bilateral cryptorchidism and ectopic penis and scrotum in perineal area, with no penoscrotal transposition, representing an association not yet described in literature. A previous orchiopexy failed due to ectopic scrotum. By means of an inverted Y incision, the penis was mobilized and a perineal skin flap in form of a testicular sac was prepared. Finally orchiopexy was performed. The surgery was essential to treat cryptorchidism and to improve the self-image of the patient. RESUMO O pênis ectópico geralmente ocorre associado à transposição peno-escrotal, sendo raro isoladamente. Relatamos uma abordagem cirúrgica para um caso extremamente raro. Tratava-se de paciente do sexo masculino, 10 anos, com criptorquidia bilateral e pênis e escroto ectópicos, na região perineal, sem transposição peno-escrotal, representando uma associação ainda não descrita na literatura. Orquidopexia prévia sem sucesso, devido à ectopia do escroto. Por meio de uma incisão em Y invertido, mobilizou-se o pênis e preparou-se um retalho da pele perineal em forma de bolsa testicular. Por fim, realizou-se a orquidopexia. A cirurgia foi fundamental para tratar a criptorquidia e promover ganho na autoimagem do paciente.

  15. The Effect of an Orthopaedic Surgical Procedure in the National Basketball Association.

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    Minhas, Shobhit V; Kester, Benjamin S; Larkin, Kevin E; Hsu, Wellington K

    2016-04-01

    Professional basketball players have a high incidence of injuries requiring surgical intervention. However, no studies in the current literature have compared postoperative performance outcomes among common injuries to determine high- and low-risk procedures to these athletes' careers. To compare return-to-play (RTP) rates and performance-based outcomes after different orthopaedic procedures in National Basketball Association (NBA) players and to determine which surgeries are associated with the worst postoperative change in performance. Cohort study; Level of evidence, 3. Athletes in the NBA undergoing anterior cruciate ligament reconstruction, Achilles tendon repair, lumbar discectomy, microfracture, meniscus surgery, hand/wrist or foot fracture fixation, and shoulder stabilization were identified through team injury reports and archives on public record. The RTP rate, games played per season, and player efficiency rating (PER) were determined before and after surgery. Statistical analysis was used to compare the change between pre- and postsurgical performance among the different injuries. A total of 348 players were included. The RTP rates were highest in patients with hand/wrist fractures (98.1%; mean age, 27.0 years) and lowest for those with Achilles tears (70.8%; mean age, 28.4 years) (P = .005). Age ≥30 years (odds ratio [OR], 3.85; 95% CI, 1.24-11.91) and body mass index ≥27 kg/m(2) (OR, 3.46; 95% CI, 1.05-11.40) were predictors of not returning to play. Players undergoing Achilles tendon repair and arthroscopic knee surgery had a significantly greater decline in postoperative performance outcomes at the 1- and 3-year time points and had shorter career lengths compared with the other procedures. NBA players undergoing Achilles tendon rupture repair or arthroscopic knee surgery had significantly worse performance postoperatively compared with other orthopaedic procedures. © 2016 The Author(s).

  16. A large Venous-Arterial PCO2 Is Associated with Poor Outcomes in Surgical Patients

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    João M. Silva

    2011-01-01

    Full Text Available Background. This study evaluated whether large venous-arterial CO2 gap (PCO2 gap preoperatively is associated to poor outcome. Method. Prospective study which included adult high-risk surgical patients. The patients were pooled into two groups: wide [P(v-aCO2] versus narrow [P(v-aCO2]. In order to determine the best value to discriminate hospital mortality, it was applied a ROC (receiver operating characteristic curve for the [P(v-aCO2] values collected preoperatively, and the most accurate value was chosen as cut-off to define the groups. Results. The study included 66 patients. The [P(v-aCO2] value preoperatively that best discriminated hospital mortality was 5.0 mmHg, area=0.73. Preoperative patients with [P(v-aCO2] more than 5.0 mmHg presented a higher hospital mortality (36.4% versus 4.5% P=0.004, higher prevalence of circulatory shock (56.8% versus 22.7% P=0.01 and acute renal failure postoperatively (27.3% versus 4.5% P=0.02, and longer hospital length of stays 20.0 (14.0–30.0 versus 13.5 (9.0–25.0 days P=0.01. Conclusions. The PCO2 gap values more than 5.0 mmHg preoperatively were associated with worse postoperatively outcome.

  17. Peritendinous calcinosis of calcaneus tendon associated with dermatomyositis: correlation between conventional radiograph, ultrasound, magnetic resonance imaging and gross surgical pathology

    International Nuclear Information System (INIS)

    Rosa, Ana Claudia Ferreira; Gomide, Lidyane Marques de Paula; Lemes, Marcella Stival

    2006-01-01

    Interstitial calcinosis is an uncommon condition in which there is either localized or widely disseminated deposition of calcium in the skin, subcutaneous tissues, muscles, and tendons. Calcinosis is often associated with collagen diseases, scleroderma and dermatomyositis. The authors report a case of interstitial calcinosis associated with dermatomyositis studied with conventional radiograph, ultrasound and magnetic resonance imaging, and correlate the imaging findings with the results of surgical pathology gross examination. (author)

  18. Effects of uranium development on erosion and associated sedimentation in southern San Juan Basin, New Mexico

    Science.gov (United States)

    Cooley, Maurice E.

    1979-01-01

    A reconnaissance was made of some of the effects of uranium development on erosion and associated sedimentation in the southern San Juan Basin, where uranium development is concentrated. In general, the effects of exploration on erosion are minor, although erosion may be accelerated by the building of access roads, by activities at the drilling sites, and by close concentration of drilling sites. Areas where the greatest effects on erosion and sedimentation from mining and milling operations have occurred are: (1) in the immediate vicinity of mines and mills, (2) near waste piles, and (3) in stream channels where modifications, such as changes in depth have been caused by discharge of excess mine and mill water. Collapse of tailings piles could result in localized but excessive erosion and sedimentation.

  19. Association of the germline TP53 R337H mutation with breast cancer in southern Brazil

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    Srivastava Kumar

    2008-12-01

    Full Text Available Abstract Background The germline TP53-R337H mutation is strongly associated with pediatric adrenocortical tumors (ACT in southern Brazil; it has low penetrance and limited tissue specificity in most families and therefore is not associated with Li-Fraumeni syndrome. However, other tumor types, mainly breast cancer, have been observed in carriers of several unrelated kindreds, raising the possibility that the R337H mutation may also contribute to breast tumorigenesis in a genetic background-specific context. Methods We conducted a case-control study to determine the prevalence of the R337H mutation by sequencing TP53 exon 10 in 123 women with breast cancer and 223 age- and sex-matched control subjects from southern Brazil. Fisher's test was used to compare the prevalence of the R337H. Results The R337H mutation was found in three patients but in none of the controls (p = 0.0442. Among the carriers, two had familial history of cancer meeting the Li-Fraumeni-like criteria. Remarkably, tumors in each of these three cases underwent loss of heterozygosity by eliminating the mutant TP53 allele rather than the wild-type allele. Polymorphisms were identified within the TP53 (R72P and Ins16 and MDM2 (SNP309 genes that may further diminish TP53 tumor suppressor activity. Conclusion These results demonstrate that the R337H mutation can significantly increase the risk of breast cancer in carriers, which likely depends on additional cooperating genetic factors. These findings are also important for understanding how low-penetrant mutant TP53 alleles can differentially influence tumor susceptibility.

  20. Association of the germline TP53 R337H mutation with breast cancer in southern Brazil

    International Nuclear Information System (INIS)

    Assumpção, Juliana G; Zeferino, Luiz Carlos; Dufloth, Rozany M; Brandalise, Silvia Regina; Yunes, José Andres; Seidinger, Ana Luíza; Mastellaro, Maria José; Ribeiro, Raul C; Zambetti, Gerard P; Ganti, Ramapriya; Srivastava, Kumar; Shurtleff, Sheila; Pei, Deqing

    2008-01-01

    The germline TP53-R337H mutation is strongly associated with pediatric adrenocortical tumors (ACT) in southern Brazil; it has low penetrance and limited tissue specificity in most families and therefore is not associated with Li-Fraumeni syndrome. However, other tumor types, mainly breast cancer, have been observed in carriers of several unrelated kindreds, raising the possibility that the R337H mutation may also contribute to breast tumorigenesis in a genetic background-specific context. We conducted a case-control study to determine the prevalence of the R337H mutation by sequencing TP53 exon 10 in 123 women with breast cancer and 223 age- and sex-matched control subjects from southern Brazil. Fisher's test was used to compare the prevalence of the R337H. The R337H mutation was found in three patients but in none of the controls (p = 0.0442). Among the carriers, two had familial history of cancer meeting the Li-Fraumeni-like criteria. Remarkably, tumors in each of these three cases underwent loss of heterozygosity by eliminating the mutant TP53 allele rather than the wild-type allele. Polymorphisms were identified within the TP53 (R72P and Ins16) and MDM2 (SNP309) genes that may further diminish TP53 tumor suppressor activity. These results demonstrate that the R337H mutation can significantly increase the risk of breast cancer in carriers, which likely depends on additional cooperating genetic factors. These findings are also important for understanding how low-penetrant mutant TP53 alleles can differentially influence tumor susceptibility

  1. Factors associated with perioperative mortality in dogs with surgically managed gastric dilatation-volvulus: 137 cases (1988-1993).

    Science.gov (United States)

    Brourman, J D; Schertel, E R; Allen, D A; Birchard, S J; DeHoff, W D

    1996-06-01

    To evaluate factors associated with perioperative mortality in dogs with gastric dilatation-volvulus and to determine the influence of treatment differences between university and private specialty practices on outcome. Retrospective analysis of medical records. 137 dogs with gastric dilatation-volvulus. Signalment; frequency of preoperative and postoperative treatments and complications; intraoperative findings; surgical technique; and hematologic, serum biochemical, and electrocardiographic results were recorded, evaluated for association with mortality, and compared between institutions. Mortality did not differ between institutions, and overall mortality was 18% (24/137). Surgical techniques differed between institutions, but were not associated with mortality. Gastric necrosis was associated with significantly higher mortality (46%; 13/28). When partial gastrectomy or splenectomy was performed, mortality (35 and 32% or 8/23 and 10/31, respectively) was significantly increased. Splenectomy was performed in 11 of 23 dogs requiring partial gastrectomy, and when both procedures were performed, mortality (55%; 6/11) was significantly increased. Preoperative cardiac arrhythmias were associated with significantly higher mortality (38%; 6/16). Mortality in dogs > 10 years old was not significantly greater than that in younger dogs. Patient management differences between practices did not seem to influence survival in dogs with surgically managed gastric dilatation-volvulus. Signalment, including age, did not influence mortality. Gastric necrosis, gastric resection, splenectomy, and preoperative cardiac arrhythmias were associated with mortality > 30%.

  2. Association Between Ibuprofen Use and Severity of Surgically Managed Posttonsillectomy Hemorrhage.

    Science.gov (United States)

    Mudd, Pamela A; Thottathil, Princy; Giordano, Terri; Wetmore, Ralph F; Elden, Lisa; Jawad, Abbas F; Ahumada, Luis; Gálvez, Jorge A

    2017-07-01

    Ibuprofen used in postoperative management of pain after tonsillectomy has not been shown to increase the overall risk for posttonsillectomy hemorrhage (PTH). The severity of bleeding is difficult to quantify but may be a more important outcome to measure. To evaluate the association between ibuprofen use and severity of PTH using transfusion events as a marker of severity. This retrospective cohort study identified 8868 patients who underwent tonsillectomy from January 20, 2011, through June 30, 2014, at the tertiary academic Children's Hospital of Philadelphia. Of these patients, 6710 met the inclusion criteria. Data were collected using electronic database acquisition and query. Multivariate analysis was performed to identify independent prognostic factors for PTH and receipt of transfusion. Of the 6710 patients who met criteria for analysis (3454 male [51.5%] and 3256 female [48.5%]; median age, 5.4 years [interquartile range, 3.7-8.2 years]), 222 (3.3%) presented with PTH that required surgical control (sPTH). A total of 15 of the 8868 patients required transfusion for an overall risk for transfusion after tonsillectomy of 0.2%. Fifteen of 222 patients undergoing sPTH (6.8%) received transfusions. No significant independent increased risk for sPTH was associated with use of ibuprofen (adjusted odds ratio [OR], 0.90; 95% CI, 0.68-1.19). A significant independent association was found in the risk for sPTH in patients 12 years or older (adjusted OR, 2.74; 95% CI, 1.99-3.76) and in patients with a history of recurrent tonsillitis (adjusted OR, 1.52; 95% CI, 1.12-2.06). When using transfusion rates as a surrogate for severity of sPTH, transfusion increased by more than 3-fold among ibuprofen users compared with nonusers (adjusted OR, 3.16; 95% CI, 1.01-9.91), and the upper limit of the 95% CI suggests the difference could be nearly 10 times greater. The risk for sPTH is not increased with use of postoperative ibuprofen but is increased in patients 12 years or older

  3. [A surgical case of mesial temporal lobe epilepsy associated with hippocampal sclerosis and traumatic neocortical lesion].

    Science.gov (United States)

    Kitazawa, Yu; Jin, Kazutaka; Iwasaki, Masaki; Suzuki, Hiroyoshi; Tanaka, Fumiaki; Nakasato, Nobukazu

    2017-11-25

    A 26-year-old right-handed woman, with a history of left temporal lobe contusion caused by a fall at the age of 9 months, started to have complex partial seizures with oral automatism at the age of 7 years. The seizures occurred once or twice a month despite combination therapy with several antiepileptic agents. Her history and imaging studies suggested the diagnosis of epilepsy arising from traumatic neocortical temporal lesion. Comprehensive assessment including long-term video EEG monitoring, MRI, FDG-PET, MEG, and neuropsychological evaluation was performed at the age of 26 years. The diagnosis was left mesial temporal lobe epilepsy associated with hippocampal atrophy and traumatic temporal cortical lesion. The patient was readmitted for surgical treatment at the age of 27 years. Intracranial EEG monitoring showed that ictal discharges started in the left hippocampus and spread to the traumatic lesion in the left posterior superior temporal gyrus 10 seconds after the onset. This case could not be classified as dual pathology exactly, because the traumatic left temporal cortical lesion did not show independent epileptogenicity. However, the traumatic lesion was highly likely to be the source of the epileptogenicity, and she had right hemispheric dominance for language and functional deterioration in the whole temporal cortex. Therefore, left amygdalo-hippocampectomy and left temporal lobectomy including the traumatic lesion were performed according to the diagnosis of dual pathology. Subsequently, she remained seizure-free for 3 years. Comprehensive assessment of seizure semiology, neurophysiology, neuroradiology, and neuropsychology is important to determine the optimum therapeutic strategies for drug-resistant epilepsy.

  4. Multiple interacting factors influence adherence, and outcomes associated with surgical safety checklists: a qualitative study.

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    Anna R Gagliardi

    Full Text Available The surgical safety checklist (SSC is meant to enhance patient safety but studies of its impact conflict. This study explored factors that influenced SSC adherence to suggest how its impact could be optimized.Participants were recruited purposively by profession, region, hospital type and time using the SSC. They were asked to describe how the SSC was adopted, associated challenges, perceived impact, and suggestions for improving its use. Grounded theory and thematic analysis were used to collect and analyse data. Findings were interpreted using an implementation fidelity conceptual framework.Fifty-one participants were interviewed (29 nurses, 13 surgeons, 9 anaesthetists; 18 small, 14 large and 19 teaching hospitals; 8 regions; 31 had used the SC for ≤12 months, 20 for 13+ months. The SSC was inconsistently reviewed, and often inaccurately documented as complete. Adherence was influenced by multiple issues. Extensive modification to accommodate existing practice patterns eliminated essential interaction at key time points to discuss patient management. Staff were often absent or not paying attention. They did not feel it was relevant to their work given limited evidence of its effectiveness, and because they were not engaged in its implementation. Organizations provided little support for implementation, training, monitoring and feedback, which are needed to overcome these, and other individual and team factors that challenged SSC adherence. Responses were similar across participants with different characteristics.Multiple processes and factors influenced SSC adherence. This may explain why, in studies evaluating SSC impact, outcomes were variable. Recommendations included continuing education, time for pilot-testing, and engaging all staff in SSC review. Others may use the implementation fidelity framework to plan SSC implementation or evaluate SSC adherence. Further research is needed to establish which SSC components can be modified

  5. Higher clinical performance during a surgical clerkship is independently associated with matriculation of medical students into general surgery.

    Science.gov (United States)

    Daly, Shaun C; Deal, Rebecca A; Rinewalt, Daniel E; Francescatti, Amanda B; Luu, Minh B; Millikan, Keith W; Anderson, Mary C; Myers, Jonathan A

    2014-04-01

    The purpose of our study was to determine the predictive impact of individual academic measures for the matriculation of senior medical students into a general surgery residency. Academic records were evaluated for third-year medical students (n = 781) at a single institution between 2004 and 2011. Cohorts were defined by student matriculation into either a general surgery residency program (n = 58) or a non-general surgery residency program (n = 723). Multivariate logistic regression was performed to evaluate independently significant academic measures. Clinical evaluation raw scores were predictive of general surgery matriculation (P = .014). In addition, multivariate modeling showed lower United States Medical Licensing Examination Step 1 scores to be independently associated with matriculation into general surgery (P = .007). Superior clinical aptitude is independently associated with general surgical matriculation. This is in contrast to the negative correlation United States Medical Licensing Examination Step 1 scores have on general surgery matriculation. Recognizing this, surgical clerkship directors can offer opportunities for continued surgical education to students showing high clinical aptitude, increasing their likelihood of surgical matriculation. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Perceptions of Employment and Use of Part-Time Faculty among Chief Instructional Officers at Southern Association of Colleges and Schools-Accredited Public Associate's Colleges

    Science.gov (United States)

    Speer, Charlotte Nix

    2013-01-01

    Based on Yackee's (2000) study of the perceptions of chief instructional officers (CIOs) at community colleges accredited by North Central Association of Colleges and Schools (NCA), this study identified, described, and compared the perceptions of CIOs at institutions accredited by Southern Association of Colleges and Schools Commission on…

  7. Association of the FOXO3A locus with extreme longevity in a southern Italian centenarian study.

    Science.gov (United States)

    Anselmi, Chiara Viviani; Malovini, Alberto; Roncarati, Roberta; Novelli, Valeria; Villa, Francesco; Condorelli, Gianluigi; Bellazzi, Riccardo; Puca, Annibale Alessandro

    2009-04-01

    A number of potential candidate genes in a variety of biological pathways have been associated with longevity in model organisms. Many of these genes have human homologs and thus have the potential to provide insights into human longevity. Recently, several studies suggested that FOXO3A functions as a key bridge for various signaling pathways that influence aging and longevity. Interestingly, Willcox and colleagues identified several variants that displayed significant genotype-gender interaction in male human longevity. In particular, a nested case-control study was performed in an ethnic Japanese population in Hawaii, and five candidate longevity genes were chosen based on links to the insulin-insulin-like growth factor-1 (IGF-1) signaling pathway. In the Willcox study, the investigated genetic variations (rs2802292, rs2764264, and rs13217795) within the FOXO3A gene were significantly associated with longevity in male centenarians. We validated the association of FOXO3A polymorphisms with extreme longevity in males from the Southern Italian Centenarian Study. Particularly, rs2802288, a proxy of rs2802292, showed the best allelic association--minor allele frequency (MAF) = 0.49; p = 0.003; odds ratio (OR) = 1.51; 95% confidence interval (CI), 1.15-1.98). Furthermore, we undertook a meta-analysis to explore the significance of rs2802292 association with longevity by combining the association results of the current study and the findings coming from the Willcox et al. investigation. Our data point to a key role of FOXO3A in human longevity and confirm the feasibility of the identification of such genes with centenarian-controls studies. Moreover, we hypothesize the susceptibility to the longevity phenotype may well be the result of complex interactions involving genes and environmental factors but also gender.

  8. Association between dietary patterns and mental disorders in pregnant women in Southern Brazil

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    Jéssica T.A. Paskulin

    2017-03-01

    Full Text Available Objective: To evaluate the association between dietary patterns and mental disorders among pregnant women in southern Brazil. Methods: Cross-sectional study with 712 pregnant women recruited from the Study of Food Intake and Eating Behaviors in Pregnancy (ECCAGe. Food intake assessment was performed using the Food Frequency Questionnaire. Dietary patterns were identified by cluster analysis. The Primary Care Evaluation of Mental Disorders (PRIME-MD was used to evaluate participants’ mental health. Poisson regression models with robust variance were fitted to estimate prevalence ratios (PR. Results: In the adjusted models, there was a high prevalence of major depressive disorder among women with low fruit intake (43%, PR 1.43, 95%CI 1.04-1.95 and high sweets and sugars intake (91%, PR 1.91, 95%CI 1.19-3.07. Women with a common-Brazilian dietary pattern had higher prevalence of major depressive disorder compared to those with a varied consumption pattern (PR 1.43, 95%CI 1.01-2.02. Low intake of beans was significantly associated with generalized anxiety disorder (PR 1.40, 95%CI 1.01-1.93. Conclusions: Low consumption of fruits and beans and intake of the common-Brazilian dietary pattern during pregnancy were associated with higher prevalence of mental disorders. These results reinforce the importance of an adequate dietary intake to ensure better mental health in pregnancy.

  9. Induced abortion and associated factors in health facilities of Guraghe zone, southern Ethiopia.

    Science.gov (United States)

    Tesfaye, Gezahegn; Hambisa, Mitiku Teshome; Semahegn, Agumasie

    2014-01-01

    Unsafe abortion is one of the major medical and public health problems in developing countries including Ethiopia. However, there is a lack of up-to-date and reliable information on induced abortion distribution and its determinant factors in the country. This study was intended to assess induced abortion and associated factors in health facilities of Guraghe zone, Southern Ethiopia. Institution based cross-sectional study was conducted in eight health facilities in Guraghe zone. Client exit interview was conducted on 400 patients using a structured questionnaire. Bivariate and multivariate logistic regression analysis was performed to identify factors associated with induced abortion. Out of 400 women, 75.5% responded that the current pregnancy that ended in abortion is unwanted. However, only 12.3% of the respondents have admitted interference to the current pregnancy. Having more than four pregnancies (AOR = 4.28, CI: (1.24-14.71)), age of 30-34 years (AOR = 0.15, CI: (0.04-0.55)), primary education (AOR = 0.26, CI: (0.13-0.88)), and wanted pregnancy (AOR = 0.44, CI: (0.14-0.65)) were found to have association with induced abortion. The study revealed high level of induced abortion which is underpinned by high magnitude of unwanted pregnancy. There is requirement for widespread expansion of increased access to high quality family planning service and post-abortion care.

  10. No association of GSTM1 null polymorphism with endometriosis in women from central and southern Iran

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    Razieh Dehghani Firouzabadi

    2012-01-01

    Full Text Available Background: Endometriosis is one of the most common gynecologic disorders. It is a complex trait and both genetic and environmental factors have been implicated in its pathogenesis. There is growing evidence indicating that exposure to environmental contaminants is a risk factor for endometriosis. Glutathione-S-Transferase M1 (GSTM1 is one of the genes involved in detoxification of endogenous and exogenous compounds. Objective: Several studies have indicated an association between GSTM1 null mutation and endometriosis. In this study, the possible association between the GSTM1 gene null genotype and susceptibility to endometriosis in woman from central and southern Iran was investigated.Materials and Methods: One hundred and one unrelated premenopausal women with endometriosis and 142 unrelated healthy premenopausal women without endometriosis were enrolled in the study. Genomic DNA was extracted from Peripheral blood in all subjects. GSTM1 null genotyping was performed by polymerase chain reaction (PCR.Results: There was no significant difference between frequencies of GSTM1 null genotype in case and control groups (50.5% Vs. 52.1%, p=0.804. Furthermore, this genotype was not associated with severity of endometriosis in our sample (p=0.77. Conclusion: further studies involving gene-environment and gene-gene interactions, particularly combination of GSTM1 and other GST gene family polymorphisms are needed.

  11. Surgical management of fibrotic encapsulation of the fluocinolone acetonide implant in CAPN5-associated proliferative vitreoretinopathy.

    Science.gov (United States)

    Tlucek, Paul S; Folk, James C; Sobol, Warren M; Mahajan, Vinit B

    2013-01-01

    To review fibrosis of fluocinolone acetonide (FA) implants in subjects with CAPN5 autosomal dominant neovascular inflammatory vitreoretinopathy (ADNIV). A retrospective case series was assembled from ADNIV patients in which there was fibrotic encapsulation of a fluocinolone acetonide implant. CAPN5 genotypes and surgical repair techniques were reviewed. Two eyes of two ADNIV patients developed a fibrotic capsule over the fluocinolone acetonide implant. Both patients had Stage IV disease. Patient A had a c.731T > C mutation in the CAPN5 gene and patient B had a c.728G > T mutation. The fibrotic membrane was surgically excised and the implant function was restored. The exuberant fibrotic response in later stages of ADNIV may be resistant to local immunosuppression with steroids. Surgical excision of fibrotic membranes over FA implants can reestablish local steroid delivery in cases of severe proliferative vitreoretinopathy.

  12. Assessment of surgical portosystemic shunts and associated complications: The diagnostic and therapeutic role of radiologists

    Energy Technology Data Exchange (ETDEWEB)

    Taslakian, Bedros, E-mail: btaslakian@gmail.com [Department of Radiology, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Faraj, Walid, E-mail: wf07@aub.edu.lb [Department of General Surgery, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Khalife, Mohammad, E-mail: mk12@aub.edu.lb [Department of General Surgery, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Al-Kutoubi, Aghiad, E-mail: mk00@aub.edu.lb [Department of Radiology, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); El-Merhi, Fadi, E-mail: fe19@aub.edu.lb [Department of Radiology, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Saade, Charbel, E-mail: cs39@aub.edu.lb [Department of Radiology, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Hallal, Ali, E-mail: ah05@aub.edu.lb [Department of General Surgery, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Haydar, Ali, E-mail: ah24@aub.edu.lb [Department of Radiology, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon)

    2015-08-15

    Highlights: • Portal hypertension is the pathological increase in portal venous pressure. • Surgical portosystemic shunting is an accepted methods to decrease portal venous pressure. • Surgical portosystemic shunts are divided into selective and nonselective. • Shunt thrombosis is a serious complication, resulting in shunt dysfunction. • Imaging is essential in the assessment of the shunt function and anatomy. - Abstract: Surgical portosystemic shunting, the formation of a vascular connection between the portal and systemic venous circulation, has been used as a treatment to reduce portal venous pressure. Although the use of portosystemic shunt surgery in the management of portal hypertension has declined during the past decade in favour of alternative therapies, and subsequently surgeons and radiologists became less familiar with the procedure, it remains a well-established treatment. Knowledge of different types of surgical portosystemic shunts, their pathophysiology and complications will help radiologists improve communication with surgeons and enhance their understanding of the diagnostic and therapeutic role of radiology in the assessment and management of these shunts. Optimal assessment of the shunt is essential to determine its patency and allow timely intervention. Both non-invasive and invasive imaging modalities complement each other in the evaluation of surgical portosystemic shunts. Interventional radiology plays an important role in the management of complications, such as shunt thrombosis and stenosis. This article describes the various types of surgical portosystemic shunts, explains the anatomy and pathophysiology of these shunts, illustrates the pearls and pitfalls of different imaging modalities in the assessment of these shunts and demonstrates the role of radiologists in the interventional management of complications.

  13. Assessment of surgical portosystemic shunts and associated complications: The diagnostic and therapeutic role of radiologists

    International Nuclear Information System (INIS)

    Taslakian, Bedros; Faraj, Walid; Khalife, Mohammad; Al-Kutoubi, Aghiad; El-Merhi, Fadi; Saade, Charbel; Hallal, Ali; Haydar, Ali

    2015-01-01

    Highlights: • Portal hypertension is the pathological increase in portal venous pressure. • Surgical portosystemic shunting is an accepted methods to decrease portal venous pressure. • Surgical portosystemic shunts are divided into selective and nonselective. • Shunt thrombosis is a serious complication, resulting in shunt dysfunction. • Imaging is essential in the assessment of the shunt function and anatomy. - Abstract: Surgical portosystemic shunting, the formation of a vascular connection between the portal and systemic venous circulation, has been used as a treatment to reduce portal venous pressure. Although the use of portosystemic shunt surgery in the management of portal hypertension has declined during the past decade in favour of alternative therapies, and subsequently surgeons and radiologists became less familiar with the procedure, it remains a well-established treatment. Knowledge of different types of surgical portosystemic shunts, their pathophysiology and complications will help radiologists improve communication with surgeons and enhance their understanding of the diagnostic and therapeutic role of radiology in the assessment and management of these shunts. Optimal assessment of the shunt is essential to determine its patency and allow timely intervention. Both non-invasive and invasive imaging modalities complement each other in the evaluation of surgical portosystemic shunts. Interventional radiology plays an important role in the management of complications, such as shunt thrombosis and stenosis. This article describes the various types of surgical portosystemic shunts, explains the anatomy and pathophysiology of these shunts, illustrates the pearls and pitfalls of different imaging modalities in the assessment of these shunts and demonstrates the role of radiologists in the interventional management of complications

  14. Factors Associated with Mortality among Patients on TB Treatment in the Southern Region of Zimbabwe, 2013

    Science.gov (United States)

    Sandy, Charles; Masuka, Nyasha; Hazangwe, Patrick; Choto, Regis C.; Mutasa-Apollo, Tsitsi; Nkomo, Brilliant; Sibanda, Edwin; Mugurungi, Owen; Siziba, Nicholas

    2017-01-01

    Background. In 2013, the tuberculosis (TB) mortality rate was highest in southern Zimbabwe at 16%. We therefore sought to determine factors associated with mortality among registered TB patients in this region. Methodology. This was a retrospective record review of registered patients receiving anti-TB treatment in 2013. Results. Of 1,971 registered TB patients, 1,653 (84%) were new cases compared with 314 (16%) retreatment cases. There were 1,538 (78%) TB/human immunodeficiency virus (HIV) coinfected patients, of whom 1,399 (91%) were on antiretroviral therapy (ART) with median pre-ART CD4 count of 133 cells/uL (IQR, 46–282). Overall, 428 (22%) TB patients died. Factors associated with increased mortality included being ≥65 years old [adjusted relative risk (ARR) = 2.48 (95% CI 1.35–4.55)], a retreatment TB case [ARR = 1.34 (95% CI, 1.10–1.63)], and being HIV-positive [ARR = 1.87 (95% CI, 1.44–2.42)] whilst ART initiation was protective [ARR = 0.25 (95% CI, 0.22–0.29)]. Cumulative mortality rates were 10%, 14%, and 21% at one, two, and six months, respectively, after starting TB treatment. Conclusion. There was high mortality especially in the first two months of anti-TB treatment, with risk factors being recurrent TB and being HIV-infected, despite a high uptake of ART. PMID:28352474

  15. Factors Associated with Mortality among Patients on TB Treatment in the Southern Region of Zimbabwe, 2013

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    Kudakwashe C. Takarinda

    2017-01-01

    Full Text Available Background. In 2013, the tuberculosis (TB mortality rate was highest in southern Zimbabwe at 16%. We therefore sought to determine factors associated with mortality among registered TB patients in this region. Methodology. This was a retrospective record review of registered patients receiving anti-TB treatment in 2013. Results. Of 1,971 registered TB patients, 1,653 (84% were new cases compared with 314 (16% retreatment cases. There were 1,538 (78% TB/human immunodeficiency virus (HIV coinfected patients, of whom 1,399 (91% were on antiretroviral therapy (ART with median pre-ART CD4 count of 133 cells/uL (IQR, 46–282. Overall, 428 (22% TB patients died. Factors associated with increased mortality included being ≥65 years old [adjusted relative risk (ARR = 2.48 (95% CI 1.35–4.55], a retreatment TB case [ARR = 1.34 (95% CI, 1.10–1.63], and being HIV-positive [ARR = 1.87 (95% CI, 1.44–2.42] whilst ART initiation was protective [ARR = 0.25 (95% CI, 0.22–0.29]. Cumulative mortality rates were 10%, 14%, and 21% at one, two, and six months, respectively, after starting TB treatment. Conclusion. There was high mortality especially in the first two months of anti-TB treatment, with risk factors being recurrent TB and being HIV-infected, despite a high uptake of ART.

  16. Head Lice Infestation (Pediculosis and Associated Factors among Primary School Girls in Sirik County, Southern Iran

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    Alireza Sanei-Dehkordi

    2017-12-01

    Full Text Available Background Head lice infestation (pediculosis is a serious health problem that can cause a high level of anxiety and psychological frustration, especially in developing countries.Socio-demographic factors are important determinants of the occurrence of head lice infestation. This study aimed to determine the head lice infestations and the factors affecting the rate of infestationin primary school girls.   Materials and Methods In this cross-sectional study, a total of 358 school girls from two urban and three rural primary school girls in Sirik County, Southern Iran, were randomly selected. For the diagnosis of head lice infestation, students were examined carefully by visual inspection of the scalp and hair for the presence of lice. Self-administered questionnaire was used to collect data on socio-demographic and associated factors of head lice infestation. SPSS version 21.0 was used to analyze the data. Results The prevalence of head lice infestation among primary school girls was 56.15%. There were significant associations between head lice infestation and age (p

  17. Neonatal hypothermia and associated risk factors among newborns of southern Nepal

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    LeClerq Steven C

    2010-07-01

    Full Text Available Abstract Background Neonatal hypothermia is associated with an increased mortality risk for 28 days. There are few community-based data on specific risk factors for neonatal hypothermia. Estimates of association between neonatal hypothermia in the community and risk factors are needed to guide the design of interventions to reduce exposure. Methods A cohort of 23,240 babies in rural southern Nepal was visited at home by field workers who measured axillary temperatures for 28 days (213,316 temperature measurements. The cumulative incidence of hypothermia (defined as Results Ten percent of the babies (n = 2342 were observed with temperatures of 2500 g. Risk varied inversely along the entire weight spectrum: for every 100 g decrement hypothermia risk increased by 7.4%, 13.5% and 31.3%% for babies between 3000 g and 2500 g, 2500 g and 2000 g and Conclusions In addition to season in which the babies were born, weight is an important risk factor for hypothermia. Smaller babies are at higher relative risk of hypothermia during the warm period and do not receive the protective seasonal benefit apparent among larger babies. The need for year-round thermal care, early breastfeeding and maternal thermal care should be emphasized. Further work is needed to quantify the benefits of other simple neonatal thermal care practices.

  18. Factors associated with recurrence of alcohol-related traffic violations in southern Brazil.

    Science.gov (United States)

    Schmitz, Aurinez R; Goldim, José R; Guimarães, Luciano S P; Lopes, Fernanda M; Kessler, Felix; Sousa, Tanara; Gonçalves, Veralice M; Pechansky, Flavio

    2014-09-01

    To analyze variables associated with recurrence of blood alcohol content (BAC)-related traffic violations among drivers in southern Brazil. This cross-sectional study included 12,204 driving-under-the-influence (DUI) offenders according to data provided by the Rio Grande do Sul state Transportation Department. Sociodemographic characteristics, license duration, license category, and psychological assessment results were analyzed. Drivers convicted of DUI more than once in 2009/2010 were considered recidivists. Variables were evaluated using descriptive statistical analysis and Poisson regression, adjusted by sex, age, and education level. A total of 538 (4.41%) drivers were considered recidivists. The following variables showed the strongest associations with recidivism: being aged 41-50 years (prevalence ratio [PR] = 3.41), being licensed for ≥ 12 years (PR = 1.86), being licensed for motorcycles, cars and trucks (PR = 1.36), having a license with psychological restrictions (PR = 1.33), and driving a truck or a similar vehicle at the moment of notification (PR = 1.08). In the age group with the highest risk for recurrence, drivers showed a higher probability of having a diagnosis of alcohol dependence and other psychiatric comorbidities that hinder the control of alcohol use. Psychological assessments seem to be important in predicting repeat offenses, especially when limited aptitudes are suspected, and should therefore be better investigated.

  19. Association of genetic and phenotypic variability with geography and climate in three southern California oaks.

    Science.gov (United States)

    Riordan, Erin C; Gugger, Paul F; Ortego, Joaquín; Smith, Carrie; Gaddis, Keith; Thompson, Pam; Sork, Victoria L

    2016-01-01

    Geography and climate shape the distribution of organisms, their genotypes, and their phenotypes. To understand historical and future evolutionary and ecological responses to climate, we compared the association of geography and climate of three oak species (Quercus engelmannii, Quercus berberidifolia, and Quercus cornelius-mulleri) in an environmentally heterogeneous region of southern California at three organizational levels: regional species distributions, genetic variation, and phenotypic variation. We identified climatic variables influencing regional distribution patterns using species distribution models (SDMs), and then tested whether those individual variables are important in shaping genetic (microsatellite) and phenotypic (leaf morphology) variation. We estimated the relative contributions of geography and climate using multivariate redundancy analyses (RDA) with variance partitioning. The modeled distribution of each species was influenced by climate differently. Our analysis of genetic variation using RDA identified small but significant associations between genetic variation with climate and geography in Q. engelmannii and Q. cornelius-mulleri, but not in Q. berberidifolia, and climate explained more of the variation. Our analysis of phenotypic variation in Q. engelmannii indicated that climate had more impact than geography, but not in Q. berberidifolia. Throughout our analyses, we did not find a consistent pattern in effects of individual climatic variables. Our comparative analysis illustrates that climate influences tree response at all organizational levels, but the important climate factors vary depending on the level and on the species. Because of these species-specific and level-specific responses, today's sympatric species are unlikely to have similar distributions in the future. © 2016 Botanical Society of America.

  20. Metabolic differentiation of early Lyme disease from southern tick-associated rash illness (STARI).

    Science.gov (United States)

    Molins, Claudia R; Ashton, Laura V; Wormser, Gary P; Andre, Barbara G; Hess, Ann M; Delorey, Mark J; Pilgard, Mark A; Johnson, Barbara J; Webb, Kristofor; Islam, M Nurul; Pegalajar-Jurado, Adoracion; Molla, Irida; Jewett, Mollie W; Belisle, John T

    2017-08-16

    Lyme disease, the most commonly reported vector-borne disease in the United States, results from infection with Borrelia burgdorferi. Early clinical diagnosis of this disease is largely based on the presence of an erythematous skin lesion for individuals in high-risk regions. This, however, can be confused with other illnesses including southern tick-associated rash illness (STARI), an illness that lacks a defined etiological agent or laboratory diagnostic test, and is coprevalent with Lyme disease in portions of the eastern United States. By applying an unbiased metabolomics approach with sera retrospectively obtained from well-characterized patients, we defined biochemical and diagnostic differences between early Lyme disease and STARI. Specifically, a metabolic biosignature consisting of 261 molecular features (MFs) revealed that altered N -acyl ethanolamine and primary fatty acid amide metabolism discriminated early Lyme disease from STARI. Development of classification models with the 261-MF biosignature and testing against validation samples differentiated early Lyme disease from STARI with an accuracy of 85 to 98%. These findings revealed metabolic dissimilarity between early Lyme disease and STARI, and provide a powerful and new approach to inform patient management by objectively distinguishing early Lyme disease from an illness with nearly identical symptoms. Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

  1. Prevalence and predictors associated with intestinal infections by protozoa and helminths in southern Brazil.

    Science.gov (United States)

    Casavechia, Maria Teresinha Gomes; Lonardoni, Maria Valdrinez Campana; Venazzi, Eneide Aparecida Sabaini; Campanerut-Sá, Paula Aline Zanetti; da Costa Benalia, Hugo Rafael; Mattiello, Matheus Felipe; Menechini, Pedro Victor Lazaretti; Dos Santos, Carlos Aparecido; Teixeira, Jorge Juarez Vieira

    2016-06-01

    Approximately 2 billion people are infected with soil-transmitted helminths worldwide, mainly in tropical and subtropical areas. This research aimed to investigate the prevalence and predictors associated with parasitic infections in primary health care. A cross-sectional study was performed with a large random sample to identify the prevalence and predictors associated with parasitic infections in primary health care in Marialva, southern Brazil, from April 2011 to September 2013. Stool samples from 775 individuals were analyzed for the presence of protozoan cysts, helminth eggs, and larvae. The overall prevalence of intestinal parasites was 13.94 %, and the prevalence of protozoa and helminths was 15.1 and 2.9 %, respectively. The predictor variables that were associated with intestinal parasites were male gender odds ratio (OR) 1.60, 95 % confidence interval (CI 1.10-2.40) and the absence of a kitchen garden (OR 2.28, 95 % CI, 1.08-4.85). Positive associations were found between Giardia duodenalis and individuals aged ≤18 with high risk (OR 19.0, 95 % CI 2.16-167.52), between Endolimax nana and the absence of a kitchen garden (p < 0.01), and between Trichuris trichiura and the presence of a kitchen garden (p = 0.014). Polyparasitism was present in 27.27 % of infected individuals. Our findings confirmed a relatively low prevalence in primary care, compared to international standards, despite the rare publications in the area. As variables, male gender and the absence of a kitchen garden stood out as important predictors. It is highly relevant that the health conditions of the population comply with consistent standards.

  2. Factors associated with caries: a survey of students from southern Brazil

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    Tássia Silvana Borges

    Full Text Available Abstract Objective: To describe the factors associated with dental caries among students from Santa Cruz do Sul, Rio Grande do Sul, Brazil. Methods: A cross-sectional study was conducted in a random sample of 623 students of both genders, aged 10-17 years old. Tooth decay was performed using the index of the World Health Organization (1997, DMFT (permanent dentition that expresses the sum of decayed, missing and filled teeth per person. The maternal educational level was rated using criteria of the Brazilian Association of Market Research Companies. The remaining variables were obtained by a structured questionnaire. Poisson regression analysis was used to test the association between variables using robust models and a subsequently adjusted model. Data were expressed as prevalence ratio (PR. Results: Multivariate analysis identified the following factors related to the experience of dental caries: residence in rural municipalities (PR: 1.15; 95%CI: 1.0-1.3, attending a city school (PR: 3.30; 95%CI: 1.1-9.4 or a state school (PR: 3.40; 95%CI: 1.1-9.6; and having an illiterate mother or a mother that only attended up to the 4th year of school (PR: 1.67; 95%CI: 1.1-2.4 or high school (PR: 1.54; 95%CI: 1.1-2.2. Conclusions: The presence of caries in students in southern Brazil was associated with residence in rural areas, mother with little education and attendance to a public school.

  3. [Fruit flies (Diptera: Tephritidae) and their parasitoids (Hymenoptera: Braconidae) associated to host plants in the southern region of Bahia State].

    Science.gov (United States)

    Bittencourt, M A L; da Silva, A C M; Silva, V E S; Bomfim, Z V; Guimarães, J A; de Souza Filho, M F; Araujo, E L

    2011-01-01

    The association among Anastrepha species, braconid parasitoids and host fruits in southern Bahia is recorded. Doryctobracon areolatus (Szépligeti) was associated with A. serpentina (Wied.) in Pouteria caimito, A. bahiensis Lima in Helicostylis tomentosa, A. sororcula Zucchi in Eugenia uniflora, and A. obliqua (Macquart) in Spondias purpurea. Anatrepha obliqua was unique in fruits of Averrhoa carambola, but associated with D. areolatus, Asobara anastrephae (Muesebeck) and Utetes anastrephae (Viereck). In Achras sapota, A. serpentina was associated with A. anastrephae and D. areolatus, while in Psidium guajava, A. fraterculus (Wied.) and A. sororcula were associated with D. areolatus and U. anastrephae.

  4. Surgical Management and Long-Term Seizure Outcome After Surgery for Temporal Lobe Epilepsy Associated with Cerebral Cavernous Malformations.

    Science.gov (United States)

    Yang, Peng-Fan; Pei, Jia-Sheng; Jia, Yan-Zeng; Lin, Qiao; Xiao, Hui; Zhang, Ting-Ting; Zhong, Zhong-Hui

    2018-02-01

    Operative strategies for cerebral cavernous malformation (CCM)-associated temporal lobe epilepsy and timing of surgical intervention continue to be debated. This study aimed to establish an algorithm to evaluate the efficacy of surgical intervention strategies, to maximize positive surgical outcomes and minimize postsurgical neurologic deficits. 47 patients having undergone operation for CCM-associated temporal lobe epilepsy were retrospectively reviewed. They had received a diagnostic series for seizure localization, including long-term video electroencephalography (vEEG), high-resolution magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET-CT). In patients with mesial temporal lobe CCMs, the involved structures (amygdala, hippocampus, or parahippocampal gyrus) were resected in addition to the lesions. Patients with neocortical epileptogenic CCM underwent extended lesionectomy guided by intraoperative electrocorticography; further performance of amygdalohippocampectomy depended on the extent of hippocampal epileptogenicity. The study cohort contained 28 patients with drug-resistant epilepsy (DRE), 12 with chronic epilepsy (CE), and 7 with sporadic seizure (SS). Normal temporal lobe metabolism was seen in 7/7 patients of the SS group. Hypometabolism was found in all patients with chronic disease except for those with posterior inferior and middle temporal gyrus cavernous malformations (CMs). Of the 31 patients with superficial neocortical CCM, 7 had normal PET without hippocampal sclerosis, 14 had ipsilateral temporal lobe hypometabolism without hippocampal sclerosis, and 10 had obvious hippocampal sclerosis and hypometabolism. Seizure freedom in DRE, CE, and SS was 82.1%, 75%, and 100%, respectively. A significant difference was found between lesion laterality and postoperative seizure control; the rate was lower in left-sided cases because of less aggressive resection. Our study demonstrates that the data from the

  5. Risk Factors Associated with Discordant Ki-67 Levels between Preoperative Biopsy and Postoperative Surgical Specimens in Breast Cancers.

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    Hyung Sun Kim

    Full Text Available The Ki-67 labelling index is significant for the management of breast cancer. However, the concordance of Ki-67 expression between preoperative biopsy and postoperative surgical specimens has not been well evaluated. This study aimed to find the correlation in Ki-67 expression between biopsy and surgical specimens and to determine the clinicopathological risk factors associated with discordant values.Ki-67 levels were immunohistochemically measured using paired biopsy and surgical specimens in 310 breast cancer patients between 2008 and 2013. ΔKi-67 was calculated by postoperative Ki-67 minus preoperative levels. The outliers of ΔKi-67 were defined as [lower quartile of ΔKi-67-1.5 × interquartile range (IQR] or (upper quartile + 1.5 × IQR and were evaluated according to clinicopathological parameters by logistic regression analysis.The median preoperative and postoperative Ki-67 levels were 10 (IQR, 15 and 10 (IQR, 25, respectively. Correlation of Ki-67 levels between the two specimens indicated a moderately positive relationship (coefficient = 0.676. Of 310 patients, 44 (14.2% showed outliers of ΔKi-67 (range, ≤-20 or ≥28. A significant association with poor prognostic factors was found among these patients. Multivariate analysis determined that significant risk factors for outliers of ΔKi-67 were tumor size >1 cm, negative progesterone receptor (PR expression, grade III cancer, and age ≤35 years. Among 171 patients with luminal human epidermal growth factor receptor 2-negative tumors, breast cancer subtype according to preoperative or postoperative Ki-67 levels discordantly changed in 46 (26.9% patients and a significant proportion of patients with discordant cases had ≥1 risk factor.Ki-67 expression showed a substantial concordance between biopsy and surgical specimens. Extremely discordant Ki-67 levels may be associated with aggressive tumor biology. In patients with luminal subtype disease, clinical application of Ki-67

  6. Exploring Associations between Problematic Internet Use, Depressive Symptoms and Sleep Disturbance among Southern Chinese Adolescents.

    Science.gov (United States)

    Tan, Yafei; Chen, Ying; Lu, Yaogui; Li, Liping

    2016-03-14

    The primary aim of this study was to examine associations between problematic Internet use, depression and sleep disturbance, and explore whether there were differential effects of problematic Internet use and depression on sleep disturbance. A total of 1772 adolescents who participated in the Shantou Adolescent Mental Health Survey were recruited in 2012 in Shantou, China. The Chinese version of the Internet Addiction Test (IAT) was used to evaluate the prevalence and severity of Internet addiction. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI), a 10-item version of the Center for Epidemiologic Studies Depression Scale (CESD-10), and other socio-demographic measures were also completed. Multiple regression analysis was used to test the mediating effect of problematic Internet use and depression on sleep disturbance. Among the participants, 17.2% of adolescents met the criteria for problematic Internet use, 40.0% were also classified as suffering from sleep disturbance, and 54.4% of students had depressive symptoms. Problematic Internet use was significantly associated with depressive symptoms and sleep disturbance. The correlation between depressive symptoms and sleep disturbance was highly significant. Both problematic Internet use (β = 0.014; Sobel test Z = 12.7, p Internet use. There is a high prevalence of problematic Internet use, depression and sleep disturbance among high school students in southern China, and problematic Internet use and depressive symptoms are strongly associated with sleep disturbance. This study provides evidence that problematic Internet use and depression have partially mediating effects on sleep disturbance. These results are important for clinicians and policy makers with useful information for prevention and intervention efforts.

  7. Exploring Associations between Problematic Internet Use, Depressive Symptoms and Sleep Disturbance among Southern Chinese Adolescents

    Directory of Open Access Journals (Sweden)

    Yafei Tan

    2016-03-01

    Full Text Available The primary aim of this study was to examine associations between problematic Internet use, depression and sleep disturbance, and explore whether there were differential effects of problematic Internet use and depression on sleep disturbance. A total of 1772 adolescents who participated in the Shantou Adolescent Mental Health Survey were recruited in 2012 in Shantou, China. The Chinese version of the Internet Addiction Test (IAT was used to evaluate the prevalence and severity of Internet addiction. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI, a 10-item version of the Center for Epidemiologic Studies Depression Scale (CESD-10, and other socio-demographic measures were also completed. Multiple regression analysis was used to test the mediating effect of problematic Internet use and depression on sleep disturbance. Among the participants, 17.2% of adolescents met the criteria for problematic Internet use, 40.0% were also classified as suffering from sleep disturbance, and 54.4% of students had depressive symptoms. Problematic Internet use was significantly associated with depressive symptoms and sleep disturbance. The correlation between depressive symptoms and sleep disturbance was highly significant. Both problematic Internet use (β = 0.014; Sobel test Z = 12.7, p < 0.001 and depression (β = 0.232; Sobel test Z = 3.39, p < 0.001 had partially mediating effects on sleep disturbance and depression was of greater importance for sleep disturbance than problematic Internet use. There is a high prevalence of problematic Internet use, depression and sleep disturbance among high school students in southern China, and problematic Internet use and depressive symptoms are strongly associated with sleep disturbance. This study provides evidence that problematic Internet use and depression have partially mediating effects on sleep disturbance. These results are important for clinicians and policy makers with useful information for

  8. Engagement and role of surgical trainees in global surgery: Consensus statement and recommendations from the Association of Surgeons in Training.

    Science.gov (United States)

    Mohan, Helen M; Fitzgerald, Edward; Gokani, Vimal; Sutton, Paul; Harries, Rhiannon; Bethune, Robert; McDermott, Frank D

    2018-04-01

    There is a wide chasm in access to essential and emergency surgery between high and low/middle income countries (LMICs). Surgeons worldwide are integral to solutions needed to address this imbalance. Involving surgical trainees, who represent the future of surgery, is vital to this endeavour. The Association of Surgeons in Training (ASiT) is an independent charity that support surgical trainees of all ten surgical specialties in the UK and Ireland. ASiT convened a consensus meeting at the ASiT conference in Liverpool 2016 to discuss trainee engagement with global surgery, including potential barriers and solutions. A face-to-face consensus meeting reviewed the engagement of, and roles for, surgical trainees in global surgery at the ASiT Conference (Liverpool, England), March 2016. Participants self-identified based on experience and interest in the field, and included trainees (residents and students) and consultants (attending grade). Following expert review, seven pre-determined core areas were presented for review and debate. Extensive discussion was facilitated by a consultant and a senior surgical trainee, with expertise in global surgery. The draft derived from these initial discussions was circulated to all those who had participated, and an iterative process of revision was undertaken until a final consensus and recommendations were reached. There is increasing interest from trainee surgeons to work in LMICs. There are however, ethical considerations, and it is important that trainees working in LMICs undertake work appropriate to their training stage and competencies. Visiting surgeons must consider the requirements of the hosting centres rather than just their own objectives. If appropriately organised, both short and long-term visits, can enable development of transferable clinical, organisational, research and education skills. A central repository of information on global surgery would be useful to trainees, to complement existing resources. Challenges

  9. The Media Protest of Neighbouring Associations, Promoter of Citizen Democratic Culture during Transition in Southern Spain

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    Sandra Méndez-Muros

    2018-02-01

    Full Text Available In the current context of placing value on the neighbouring movement within the Spanish democratic Transition, we set out to confirm that the press actively participates in the growing conjunction of neighbouring issues with political content and contributes to the idea that this movement becomes a parameter of the democratic culture for the citizen during Transition. Since the conflict is newsworthy, we conduct a micro-social study of the neighbouring protest in the newspaper El Correo de Andalucía, published in the southern Spanish city of Seville. Through analysis of content, we study the informative flow and the repertoire of protest following a typology that distinguishes four formats (demonstrations, strikes, speeches and associations divided into two levels of conflict. The analysis sample consists of 33 texts published between November 1975 (Franco’s death and the accession to the throne of Juan Carlos I and June 1977 (the first democratic general elections. The main conclusion reveals that the newspaper becomes a platform that gives visibility to the neighbouring movement, normalising behaviours and procedure rules through the protest.

  10. Southern Association of Colleges and Schools Accreditation:Impact on Elementary Student Performance

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    Darlene Y. Bruner

    2004-07-01

    Full Text Available Currently, 848 Georgia public elementary schools that house third- and fifth-grades in the same building use the Southern Association of Colleges and Schools (SACS accreditation as a school improvement model. The purpose of this investigation was to determine whether elementary schools that are SACS accredited increased their levels of academic achievement at a higher rate over a five-year period than elementary schools that were not SACS accredited as measured by the Iowa Test of Basic Skills (ITBS. Independent variables included accreditation status, socioeconomic status (SES of schools, and baseline scores of academic achievement. Dependent variables included mathematics and reading achievement scores. There was a statistically significant difference found when examining the SES of schools and baseline scores of the elementary schools. SACS accredited elementary schools had higher SES and higher baseline scores in third- and fifth grade mathematics and reading. However, the multiple regression model indicated no statistically significant differences in gain scores between SACS accredited and non-SACS accredited elementary schools in third- and fifth-grade mathematics and reading achievement during the five year period examined in this study.

  11. Habitat associations of migrating and overwintering grassland birds in Southern Texas

    Science.gov (United States)

    Igl, Lawrence D.; Ballard, Bart M.

    1999-01-01

    We report on the habitat associations of 21 species of grassland birds overwintering in or migrating through southern Texas, during 1991-1992 and 1992-1993. Ninety percent of our grassland bird observations were made during winter and spring, and only 10% occurred during fall. Grassland species made up a high proportion of the total bird densities in grassland and shrub-grassland habitats, but much lower proportions in the habitats with more woody vegetation. Fewer grassland species were observed in grassland and woodland than in brushland, parkland, and shrub-grassland habitats. Grassland birds generally were found in higher densities in habitats that had woody canopy coverage of < 30%; densities of grassland birds were highest in shrub-grassland habitat and lowest in woodland habitat. Species that are grassland specialists on their breeding grounds tended to be more habitat specific during the nonbreeding season compared to shrub-grassland specialists, which were more general in their nonbreeding-habitat usage. Nonetheless, our data demonstrate that grassland birds occur in a variety of habitats during the nonbreeding season and seem to occupy a broader range of habitats than previously described.

  12. Physical inactivity and associated factors among women from a municipality in southern Brazil.

    Science.gov (United States)

    Marcellino, Cristiano; Henn, Ruth Liane; Olinto, Maria Teresa; Bressan, Ana Weigert; Paniz, Vera Maria; Pattussi, Marcos Pascoal

    2014-05-01

    Physical inactivity is one of the most important modifiable risk factors that is raising the global burden of chronic diseases. This is a cross-sectional, population-based study of 790 women aged 20 years or older living in the urban area of a municipality in Southern Brazil. The level of physical activity was measured using the International Physical Activity Questionnaire, short form. Inactivity was defined as fewer than 150 min/wk-1 spent in moderate or vigorous physical activities. Prevalence ratios were calculated by robust Poisson regression. The prevalence of physical inactivity was 48.7% (95% CI, 43.3%-54.1%). After adjusting for confounders, we found a linear trend for increasing prevalence of physical inactivity with increasing body mass index (P = .008). Women who were married or in a domestic partnership were 29% less physically active than single women (P = .044). A borderline association was detected between the presence of minor psychiatric disorders (MPD) and physical inactivity (P = .058). There was a high prevalence of inactivity. Obese women, those married or in domestic partnerships and those with MPD were more likely to lead an inactive lifestyle. These results suggest that strategies are required for breaking down barriers to physical activity in this demographic group.

  13. Surgical Assisting

    Science.gov (United States)

    ... instruction, including: Microbiology Pathophysiology Pharmacology Anatomy and physiology Medical terminology Curriculum . Course content includes: Advanced surgical anatomy Surgical microbiology Surgical pharmacology Anesthesia methods and agents Bioscience Ethical ...

  14. The management of thoracic inlet syndrome associated with Hurler's syndrome: a novel surgical technique.

    LENUS (Irish Health Repository)

    Ahsan, Rauf M

    2012-02-01

    A 21-year-old male developed significant swelling of his tongue after a respiratory arrest. The patient had a history of Hurler\\'s syndrome. Magnetic resonance imaging (MRI) angiogram delineated that the swelling was due to compression of his internal jugular veins at the level of the first rib, resulting in thoracic inlet obstruction. The standard surgical treatment of thoracic inlet obstruction was not suitable in this patient\\'s case due to his short thick neck and his characteristic Hurler\\'s syndrome body habitus. Therefore, a novel surgical strategy was used to decompress his head and neck vessels. The manubrium was widened using an iliac crest bone graft, stabilised using internal fixation plates and reconstructed with a pectoral muscle flap.

  15. Pigment dispersion syndrome associated with intraocular lens implantation: a new surgical technique.

    Science.gov (United States)

    Canut Jordana, M Isabel; Pérez Formigó, Daniel; Abreu González, Rodrigo; Nadal Reus, Jeroni

    2010-11-11

    We report the case of a myopic patient who, after intraocular lens transplant in the posterior chamber, suffered elevated intraocular pressure due to pigment dispersion, with recurrent episodes of blurred vision. The patient was treated with a new surgical technique that can avoid potential iridolenticular contact. Complete ophthalmologic examination and optical coherence tomography (OCT) of the anterior segment were performed. Contact between the pigmentary epithelium and the iris with an intraocular lens was revealed by utrasound biomicroscopy and OCT. In this case, Nd:YAG laser iridotomy and laser iridoplasty were not effective for iridolenticular separation and control of the pigment dispersion. We propose a new technique: stitches on the surface of the iris to obtain good iridolenticular separation and good intraocular pressure control. Stitches on the iris surface should be considered as optional therapy in pigmentary glaucoma secondary to intraocular lens implantation. This surgical technique can avoid potential iridolenticular contacts more definitively.

  16. SURGICAL TREATMENT OF VERTEBRAL FRACTURES ASSOCIATED WITH LOW MINERAL BONE DENSITY

    Directory of Open Access Journals (Sweden)

    V. V. Rerikh

    2010-01-01

    Full Text Available Surgical treatment of 177 patients with monolocal fractures of thoracic and lumbar vertebral bodies was performed using transpedicular fixation (n=17, transpedicular fixation and osteoplasty (n=101, vertebroplasty (n=48 or kyphoplasty (n=ll. Restoration of support ability of the fractured osteoporotic vertebrae within ventral column by means of plasty particularly in combination with internal fixation allows achievement of better clinical outcomes, improvement of the quality of life in patients in the early and late periods after surgery.

  17. Central and peripheral venous lines-associated blood stream infections in the critically ill surgical patients.

    Science.gov (United States)

    Ugas, Mohamed Ali; Cho, Hyongyu; Trilling, Gregory M; Tahir, Zainab; Raja, Humaera Farrukh; Ramadan, Sami; Jerjes, Waseem; Giannoudis, Peter V

    2012-09-04

    Critically ill surgical patients are always at increased risk of actual or potentially life-threatening health complications. Central/peripheral venous lines form a key part of their care. We review the current evidence on incidence of central and peripheral venous catheter-related bloodstream infections in critically ill surgical patients, and outline pathways for prevention and intervention. An extensive systematic electronic search was carried out on the relevant databases. Articles were considered suitable for inclusion if they investigated catheter colonisation and catheter-related bloodstream infection. Two independent reviewers engaged in selecting the appropriate articles in line with our protocol retrieved 8 articles published from 1999 to 2011. Outcomes on CVC colonisation and infections were investigated in six studies; four of which were prospective cohort studies, one prospective longitudinal study and one retrospective cohort study. Outcomes relating only to PICCs were reported in one prospective randomised trial. We identified only one study that compared CVC- and PICC-related complications in surgical intensive care units. Although our search protocol may not have yielded an exhaustive list we have identified a key deficiency in the literature, namely a paucity of studies investigating the incidence of CVC- and PICC-related bloodstream infection in exclusively critically ill surgical populations. In summary, the diverse definitions for the diagnosis of central and peripheral venous catheter-related bloodstream infections along with the vastly different sample size and extremely small PICC population size has, predictably, yielded inconsistent findings. Our current understanding is still limited; the studies we have identified do point us towards some tentative understanding that the CVC/PICC performance remains inconclusive.

  18. Surgical management of fibrotic encapsulation of the fluocinolone acetonide implant in CAPN5-associated proliferative vitreoretinopathy

    Directory of Open Access Journals (Sweden)

    Tlucek PS

    2013-06-01

    Full Text Available Paul S Tlucek,1 James C Folk,1 Warren M Sobol,2 Vinit B Mahajan1,3 1Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA; 2Retina Physicians and Surgeons, Dayton, OH, USA; 3Omics Laboratory, University of Iowa, Iowa City, IA, USA Objective: To review fibrosis of fluocinolone acetonide (FA implants in subjects with CAPN5 autosomal dominant neovascular inflammatory vitreoretinopathy (ADNIV. Methods: A retrospective case series was assembled from ADNIV patients in which there was fibrotic encapsulation of a fluocinolone acetonide implant. CAPN5 genotypes and surgical repair techniques were reviewed. Results: Two eyes of two ADNIV patients developed a fibrotic capsule over the fluocinolone acetonide implant. Both patients had Stage IV disease. Patient A had a c.731T > C mutation in the CAPN5 gene and patient B had a c.728G > T mutation. The fibrotic membrane was surgically excised and the implant function was restored. Conclusion: The exuberant fibrotic response in later stages of ADNIV may be resistant to local immunosuppression with steroids. Surgical excision of fibrotic membranes over FA implants can reestablish local steroid delivery in cases of severe proliferative vitreoretinopathy. Keywords: autosomal dominant neovascular inflammatory vitreoretinopathy, ADNIV, CAPN5, calpain-5, Retisert, fluocinolone acetonide, fibrotic encapsulation

  19. Robotic-assisted transperitoneal nephron-sparing surgery for small renal masses with associated surgical procedures: surgical technique and preliminary experience.

    Science.gov (United States)

    Ceccarelli, Graziano; Codacci-Pisanelli, Massimo; Patriti, Alberto; Ceribelli, Cecilia; Biancafarina, Alessia; Casciola, Luciano

    2013-09-01

    Small renal masses (T1a) are commonly diagnosed incidentally and can be treated with nephron-sparing surgery, preserving renal function and obtaining the same oncological results as radical surgery. Bigger lesions (T1b) may be treated in particular situations with a conservative approach too. We present our surgical technique based on robotic assistance for nephron-sparing surgery. We retrospectively analysed our series of 32 consecutive patients (two with 2 tumours and one with 4 bilateral tumours), for a total of 37 robotic nephron-sparing surgery (RNSS) performed between June 2008 and July 2012 by a single surgeon (G.C.). The technique differs depending on tumour site and size. The mean tumour size was 3.6 cm; according to the R.E.N.A.L. Nephrometry Score 9 procedures were considered of low, 14 of moderate and 9 of hight complexity with no conversion in open surgery. Vascular clamping was performed in 22 cases with a mean warm ischemia time of 21.5 min and the mean total procedure time was 149.2 min. Mean estimated blood loss was 187.1 ml. Mean hospital stay was 4.4 days. Histopathological evaluation confirmed 19 cases of clear cell carcinoma (all the multiple tumours were of this nature), 3 chromophobe tumours, 1 collecting duct carcinoma, 5 oncocytomas, 1 leiomyoma, 1 cavernous haemangioma and 2 benign cysts. Associated surgical procedures were performed in 10 cases (4 cholecystectomies, 3 important lyses of peritoneal adhesions, 1 adnexectomy, 1 right hemicolectomy, 1 hepatic resection). The mean follow-up time was 28.1 months ± 12.3 (range 6-54). Intraoperative complications were 3 cases of important bleeding not requiring conversion to open or transfusions. Regarding post-operative complications, there were a bowel occlusion, 1 pleural effusion, 2 pararenal hematoma, 3 asymptomatic DVT (deep vein thrombosis) and 1 transient increase in creatinine level. There was no evidence of tumour recurrence in the follow-up. RNSS is a safe and feasible technique

  20. Farmers’ market use is associated with fruit and vegetable consumption in diverse southern rural communities

    Science.gov (United States)

    2014-01-01

    Background While farmers’ markets are a potential strategy to increase access to fruits and vegetables in rural areas, more information is needed regarding use of farmers’ markets among rural residents. Thus, this study’s purpose was to examine (1) socio-demographic characteristics of participants; (2) barriers and facilitators to farmers’ market shopping in southern rural communities; and (3) associations between farmers’ market use with fruit and vegetable consumption and body mass index (BMI). Methods Cross-sectional surveys were conducted with a purposive sample of farmers’ market customers and a representative sample of primary household food shoppers in eastern North Carolina (NC) and the Appalachian region of Kentucky (KY). Customers were interviewed using an intercept survey instrument at farmers’ markets. Representative samples of primary food shoppers were identified via random digit dial (RDD) cellular phone and landline methods in counties that had at least one farmers’ market. All questionnaires assessed socio-demographic characteristics, food shopping patterns, barriers to and facilitators of farmers’ market shopping, fruit and vegetable consumption and self-reported height and weight. The main outcome measures were fruit and vegetable consumption and BMI. Descriptive statistics were used to examine socio-demographic characteristics, food shopping patterns, and barriers and facilitators to farmers’ market shopping. Linear regression analyses were used to examine associations between farmers’ market use with fruit and vegetable consumption and BMI, controlling for age, race, education, and gender. Results Among farmers’ market customers, 44% and 55% (NC and KY customers, respectively) reported shopping at a farmers’ market at least weekly, compared to 16% and 18% of NC and KY RDD respondents. Frequently reported barriers to farmers’ market shopping were market days and hours, “only come when I need something”, extreme

  1. Ecology of rodent-associated hantaviruses in the Southern Cone of South America: Argentina, Chile, Paraguay, and Uruguay.

    Science.gov (United States)

    Palma, R Eduardo; Polop, Jaime J; Owen, Robert D; Mills, James N

    2012-04-01

    Thirteen hantavirus genotypes, associated with at least 12 sigmodontine reservoir rodents, have been recognized in the four countries that represent the Southern Cone of South America. Host-virus relationships are not as well defined as in North America; several Southern Cone hantaviruses appear to share a common host and some viruses do not occur throughout the range of their host. Although hantavirus-host relationships in the Southern Cone are less strictly concordant with the single-host-single-virus pattern reported elsewhere, recent studies suggest that much of the ambiguity may result from an incomplete understanding of host and hantavirus systematics. Although some Southern Cone host species are habitat generalists, some sympatric species are habitat specialists, helping to explain how some strict host-virus pairings may be maintained. In some cases, host population densities were higher in peridomestic habitats and prevalence of hantavirus infection was higher in host populations in peridomestic habitats. Seasonal and multiyear patterns in climate and human disturbance affect host population densities, prevalence of infection, and disease risk to humans. Unusually high hantavirus antibody prevalence in indigenous human populations may be associated with frequent and close contact with host rodents. Ongoing studies are improving our understanding of hantavirus-host ecology and providing tools that may predict human risk.

  2. Higher preoperative Oswestry Disability Index is associated with better surgical outcome in upper lumbar disc herniations.

    Science.gov (United States)

    Saberi, Hooshang; Isfahani, Arash Vatankhahan

    2008-01-01

    To evaluate the surgical outcome in terms of functional and subjective recovery, patients who needed discectomies at L1-L2, L2-L3 and L3-L4 levels were compared with an age and sex-matched group of patients who required L4-L5 and L5-S1 discectomies. We prospectively enrolled 50 consecutive patients, referred to our center, who had L1-L2, L2-L3 and L3-L4 herniations and required surgical intervention. Likewise, a comparative group of 50 consecutive patients with herniations at L4-L5 and L5-S1 were selected. All 100 patients were treated and followed for a 1 year period. Physical examination findings as well as Oswestry Disability Questionnaire before surgery were recorded. After 1 year, patients were requested to fill the same questionnaire. Significant decline in the Oswestry Disability Index (ODI) scores was considered to be a measure of functional improvement and recovery. The mean age of patients with upper lumbar disc herniation (L1-L2, L2-L3, L3-L4) was 45.7 years and patients with lower lumbar disc herniation (L4-L5, L5-S1) had a mean age of 41.2 years. There was no statistically significant difference in age between the two groups. The preoperative Oswestry Disability (ODI) Index score had a statistically significant impact on ODI score improvement after surgery in both lower and upper lumbar disc groups. All 100 patients with either lower or upper lumbar disc herniation had statistically significant ODI change after surgical intervention (P disability (ODI of 21-40%) did not show significant improvement, while patients with ODI greater than 40% had significant reduction (P = 0.018). Surprisingly, as many as 25% of the former had even an increase in ODI scores after surgery. Gender was also a conspicuous factor in determining the surgical outcome of patients with upper lumbar disc herniation, and male patients had more reduction in ODI score than female patients (P = 0.007). Since the functional recovery in patients with herniated lumbar disc, especially

  3. Prevalence and risk factors associated with Leishmania infection in Trang Province, southern Thailand.

    Science.gov (United States)

    Manomat, Jipada; Leelayoova, Saovanee; Bualert, Lertwut; Tan-Ariya, Peerapan; Siripattanapipong, Suradej; Mungthin, Mathirut; Naaglor, Tawee; Piyaraj, Phunlerd

    2017-11-01

    Autochthonous cutaneous and visceral leishmaniasis (VL) caused by Leishmania martiniquensis and Leishmania siamensis have been considered emerging infectious diseases in Thailand. The disease burden is significantly underestimated, especially the prevalence of Leishmania infection among HIV-positive patients. A cross-sectional study was conducted to determine the prevalence and risk factors associated with Leishmania infection among patients with HIV/AIDS living in Trang province, southern Thailand, between 2015 and 2016. Antibodies against Leishmania infection were assayed using the direct agglutination test (DAT). DNA of Leishmania was detected by ITS1-PCR using the buffy coat. Species of Leishmania were also identified. Of 724 participants, the prevalence of Leishmania infection was 25.1% (182/724) using either DAT or PCR assays. Seroprevalence of Leishmania infection was 18.5% (134/724), while Leishmania DNA detected by the PCR method was 8.4% (61/724). Of these, 24.9% (180/724) were asymptomatic, whereas 0.3% (2/724) were symptomatic VL and VL/CL (cutaneous leishmaniasis). At least five species were identified: L. siamensis, L. martiniquensis, L. donovani complex, L. lainsoni, and L. major. Multivariate analysis showed that CD4+ levels Leishmania infection. Those who were PCR positive for Leishmania DNA were significantly associated with a detectable viral load, whereas non-injection drug use (NIDU) and CD4+ levels Leishmania seropositivity. A magnitude of the prevalence of underreporting Leishmania infection among Thai patients with HIV was revealed in this study. Effective public health policy to prevent and control disease transmission is urgently needed.

  4. Toxoplasma gondii infection: seroprevalence and associated risk factors among primary schoolchildren in Lagos City, Southern Nigeria

    Directory of Open Access Journals (Sweden)

    Vincent Pam Gyang

    2015-02-01

    Full Text Available INTRODUCTION: Toxoplasma gondii infection has been described as the most widespread zoonotic infection of humans and other animals. Information concerning T. gondii infection among schoolchildren is unavailable in Lagos City, Nigeria. METHODS: This cross-sectional study investigated the seroprevalence and risk factors associated with T. gondii infection among primary schoolchildren (PSC from a community located in the center of Lagos, southern Nigeria, from November 2013 to March 2014. A total of 382 PSC were screened for the presence of sera anti-T. gondii antibodies using a latex agglutination test (TOXO Test-MT, Tokyo, Japan. A cutoff titer of ≥ 1:32 was considered positive, while titers ≥ 1:1,024 indicated high responders. Questionnaires were also used to obtain data on possible risk factors from parents/guardians. RESULTS: The overall seroprevalence was 24% (91/382, and 83.5% (76/91 of seropositive PSC were classified as high responders. Among the risk factors tested, including contact with cats and soil, consumption of raw meat and vegetables, and drinking unboiled water, none showed statistical significance after multivariate adjustment. No associations were observed among age, gender, body mass index (BMI, and parents' occupation/educational level. CONCLUSIONS: The findings in this study show evidence of active infection, and hence, there is need for urgent preventive measures in this city. Further investigation is required to clarify the transmission routes. Policy makers also need to initiate prevention and control programs to protect pregnant women and immunocompromised patients in particular because they are more severely affected by T. gondii infection.

  5. Atherectomy-Associated Complications in the Southern California Vascular Outcomes Improvement Collaborative.

    Science.gov (United States)

    Azar, Yara; DeRubertis, Brian; Baril, Donald; Woo, Karen

    2018-05-01

    Atherectomy has become an increasingly utilized modality for the endovascular treatment of peripheral arterial occlusive disease. The objective of this study was to determine the incidence and risk factors for atherectomy-associated complications. A retrospective review was performed for all atherectomy procedures performed between January 2011 and December 2015 in the Southern California Vascular Outcomes Improvement Collaborative. Atherectomy was defined as laser, orbital, or excisional atherectomy. Complications were dissection, perforation, and distal embolization. Seven hundred twenty-nine atherectomy procedures were performed at 7 institutions by 27 practitioners. The mean age was 73 years with 415 (57%) males. Four hundred nineteen (57%) were diabetic, 673 (92%) hypertensive, 457 (63%) smokers, and 244 (34%) had coronary artery disease. Dissection occurred in 51 (7%) procedures, embolization in 23 (3.1%), and perforation in 12 (1.6%). The mean number of lesions treated per artery was the same at 1.6 in patients with any complication and no complication (P = 0.77). The total occluded length was 7.4 cm for complications versus 7.2 cm for no complication (P = 0.73). The total treated length was 12.9 cm for complications versus 11.3 cm for no complication (P = 0.03). The incidence of complications for Trans-Atlantic Inter-Society Consensus (TASC) C/D lesions were 13% compared to 10% for TASC A/B lesions (P = 0.05). The incidence of complications in superficial femoral/popliteal lesions was 12.9% vs. 10.4% in tibial lesions (P = 0.13). In multivariable analysis, treatment length was associated with a small increased risk of complication (odds ratio = 1.02, 95% confidence interval = 1.0-1.04). Increased treatment length is associated with an increased risk of atherectomy-associated complications. Demographic factors and comorbidities were not predictors of complications. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Abortion - surgical

    Science.gov (United States)

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

  7. Association between surgical indications, operative risk, and clinical outcome in infective endocarditis: a prospective study from the International Collaboration on Endocarditis.

    Science.gov (United States)

    Chu, Vivian H; Park, Lawrence P; Athan, Eugene; Delahaye, Francois; Freiberger, Tomas; Lamas, Cristiane; Miro, Jose M; Mudrick, Daniel W; Strahilevitz, Jacob; Tribouilloy, Christophe; Durante-Mangoni, Emanuele; Pericas, Juan M; Fernández-Hidalgo, Nuria; Nacinovich, Francisco; Rizk, Hussien; Krajinovic, Vladimir; Giannitsioti, Efthymia; Hurley, John P; Hannan, Margaret M; Wang, Andrew

    2015-01-13

    Use of surgery for the treatment of infective endocarditis (IE) as related to surgical indications and operative risk for mortality has not been well defined. The International Collaboration on Endocarditis-PLUS (ICE-PLUS) is a prospective cohort of consecutively enrolled patients with definite IE from 29 centers in 16 countries. We included patients from ICE-PLUS with definite left-sided, non-cardiac device-related IE who were enrolled between September 1, 2008, and December 31, 2012. A total of 1296 patients with left-sided IE were included. Surgical treatment was performed in 57% of the overall cohort and in 76% of patients with a surgical indication. Reasons for nonsurgical treatment included poor prognosis (33.7%), hemodynamic instability (19.8%), death before surgery (23.3%), stroke (22.7%), and sepsis (21%). Among patients with a surgical indication, surgical treatment was independently associated with the presence of severe aortic regurgitation, abscess, embolization before surgical treatment, and transfer from an outside hospital. Variables associated with nonsurgical treatment were a history of moderate/severe liver disease, stroke before surgical decision, and Staphyloccus aureus etiology. The integration of surgical indication, Society of Thoracic Surgeons IE score, and use of surgery was associated with 6-month survival in IE. Surgical decision making in IE is largely consistent with established guidelines, although nearly one quarter of patients with surgical indications do not undergo surgery. Operative risk assessment by Society of Thoracic Surgeons IE score provides prognostic information for survival beyond the operative period. S aureus IE was significantly associated with nonsurgical management. © 2014 American Heart Association, Inc.

  8. Ecological studies of neritic phytoplankton of Southern California: seasonal variations, associations, and responses to temperature elevations

    International Nuclear Information System (INIS)

    Briand, F.J.P.

    1974-01-01

    The first part of this study investigates the seasonal variations and associations of the nearshore phytoplankton communities at Seal Beach, Orange County, California. A total of 90 species was recorded in samples taken weekly from June 1972 to May 1973. On a yearly basis, the two dominant algal groups were diatoms (46 species) and dinoflagellates (36 species), accounting respectively for 64.1 percent and 30.4 percent of the total cell number, and for 20.2 percent and 79.2 percent of the total cell volume. The species diversity index (H') remained relatively stable during the year, showing no distinct seasonal pattern. The major group, composed mainly of dinoflagellates, was correlated with warm water conditions at Seal Beach. At this location, two electric power plants use sea-water for cooling purposes at the rate of six million l/min, which subjects the planktonic organisms entrained in the condenser systems to appreciable temperature increases. This problem is general in southern California, where 14 coastal power plants draw presently no less than 20 billion l/day from the ocean. The large quantities of marine phytoplankton passing through the cooling systems of the two power plants studied were found greatly reduced in numbers (41.7 percent) and in volume (33.7 percent). There was no apparent reduction in phytoplankton stocks when the intake water was cooler than 15 0 C. Species diversity (H') in the effluent was consistently lower than in the influent. Temperature elevations up to 10 0 C increased the gross primary productivity by 37 percent when intake water temperatures were 19 0 C or cooler, and reduced productivity by 22 percent when ambient water temperatures were warmer than 21.5 0 C. Since heating was consistently less damaging when applied to relatively cold water, use by coastal power plants of deep sea-water for cooling is strongly advocated. (U.S.)

  9. Genotypic Diversity Is Associated with Clinical Outcome and Phenotype in Cryptococcal Meningitis across Southern Africa.

    Directory of Open Access Journals (Sweden)

    Mathew A Beale

    Full Text Available Cryptococcal meningitis is a major cause of mortality throughout the developing world, yet little is known about the genetic markers underlying Cryptococcal virulence and patient outcome. We studied a cohort of 230 Cryptococcus neoformans (Cn isolates from HIV-positive South African clinical trial patients with detailed clinical follow-up using multi-locus sequence typing and in vitro phenotypic virulence assays, correlating these data with clinical and fungal markers of disease in the patient. South African Cn displayed high levels of genetic diversity and locus variability compared to globally distributed types, and we identified 50 sequence types grouped within the main molecular types VNI, VNII and VNB, with 72% of isolates typed into one of seven 'high frequency' sequence types. Spatial analysis of patients' cryptococcal genotype was not shown to be clustered geographically, which might argue against recent local acquisition and in favour of reactivation of latent infection. Through comparison of MLST genotyping data with clinical parameters, we found a relationship between genetic lineage and clinical outcome, with patients infected with the VNB lineage having significantly worse survival (n=8, HR 3.35, CI 1.51-7.20, p=0.003, and this was maintained even after adjustment for known prognostic indicators and treatment regimen. Comparison of fungal genotype with in vitro phenotype (phagocytosis, laccase activity and CSF survival performed on a subset of 89 isolates revealed evidence of lineage-associated virulence phenotype, with the VNII lineage displaying increased laccase activity (p=0.001 and ex vivo CSF survival (p=0.0001. These findings show that Cryptococcus neoformans is a phenotypically heterogeneous pathogen, and that lineage plays an important role in cryptococcal virulence during human infection. Furthermore, a detailed understanding of the genetic diversity in Southern Africa will support further investigation into how genetic

  10. Higher Mortality in Surgically Managed Diverticulitis is Associated with Asian Ethnicity and Right-Sided Disease.

    Science.gov (United States)

    Choi, Christine S; Koltun, Walter A; Hollenbeak, Christopher S

    2016-03-01

    Although right-sided diverticulitis is perceived to have a higher incidence among Asians and infrequently requires surgical management in comparison with sigmoid diverticulitis, it is unknown whether differences in outcomes are due to ethnic disparity or disease pathophysiology. The aim of this study was to determine the surgical outcomes for Asian and non-Asian patients with diverticulitis who underwent colectomy. Patients identifiable by ethnicity in the Nationwide Inpatient Sample with diverticulitis and colectomy between 2004 and 2010 were included. Univariate comparisons were made between Asian and non-Asian patients by using t tests for continuous variables and χ tests for categorical variables. Propensity score matching analysis was performed to compare Asian patients with otherwise similar non-Asian patients. Included were 58,142 non-Asian and 335 Asian patients with diverticulitis who underwent a colectomy. The primary outcomes were in-hospital mortality, hospital length of stay, and total costs. Asian patients were younger (56.1 vs. 59.2 years, p ethnicity variable was not uniformly collected by all states within the Nationwide Inpatient Sample database. Among patients undergoing a colectomy for diverticulitis, a higher mortality was observed in Asian patients and right-sided disease. Future longitudinal studies comparing the natural history and outcomes of management between right- and left-sided diverticulitis are necessary to investigate whether a true ethnic disparity exists.

  11. Pigment dispersion syndrome associated with intraocular lens implantation: a new surgical technique

    Directory of Open Access Journals (Sweden)

    M Isabel Canut Jordana

    2010-11-01

    Full Text Available M Isabel Canut Jordana1, Daniel Pérez Formigó1, Rodrigo Abreu González2, Jeroni Nadal Reus11Barraquer Ophthalmology Centre, Barcelona, Spain; 2University Hospital of La Candelaria, Tenerife, SpainAims: We report the case of a myopic patient who, after intraocular lens transplant in the posterior chamber, suffered elevated intraocular pressure due to pigment dispersion, with recurrent episodes of blurred vision. The patient was treated with a new surgical technique that can avoid potential iridolenticular contact.Methods: Complete ophthalmologic examination and optical coherence tomography (OCT of the anterior segment were performed.Results: Contact between the pigmentary epithelium and the iris with an intraocular lens was revealed by utrasound biomicroscopy and OCT. In this case, Nd:YAG laser iridotomy and laser iridoplasty were not effective for iridolenticular separation and control of the pigment dispersion. We propose a new technique: stitches on the surface of the iris to obtain good iridolenticular separation and good intraocular pressure control.Conclusion: Stitches on the iris surface should be considered as optional therapy in pigmentary glaucoma secondary to intraocular lens implantation. This surgical technique can avoid potential iridolenticular contacts more definitively.Keywords: pigmentary glaucoma, intraocular lens, optical coherence tomography, laser

  12. Concentrations in the Local Association. 1. The southern concentrations NGC 2516, IC 2602, Centaurus-Lupus and Upper Scorpius

    Energy Technology Data Exchange (ETDEWEB)

    Eggen, O J [Cerro Tololo Inter-American Observatory, La Serena (Chile)

    1983-07-01

    Extensive intermediate band and H..beta.. observations and the available astrometry, have been used to support the suggestions that (1) several southern concentrations of stars are moving with the Pleiades and ..cap alpha.. Persei clusters (Local Association) and (2) the Local Association contains an appreciable percentage of the main-sequence stars near the Sun but the non-random distribution of the brighter association members focuses attention on a few concentrations, or 'clusters'. (3) All of the concentrations discussed here are larger than about 10 pc and the largest, in Lupus-Centaurus, is shown to be accompanied by A to G type main-sequence stars.

  13. Avoidable surgical consultations in women with a positive screening mammogram: Experience from a southern region of the Dutch breast screening programme

    International Nuclear Information System (INIS)

    Schreutelkamp, J.L.; Kwee, R.M.; Booij, M. de; Adriaensen, M.E.A.P.M.

    2014-01-01

    Introduction: According to current Dutch guidelines, all women with a positive screening mammogram are referred for a full hospital assessment, which includes surgical consultation and radiological assessment. Surgical consultation may be unnecessary for many patients. Our objective was to determine how often surgical consultations can be avoided by radiological pre-assessment. Materials and methods: All women with a positive screening mammogram, referred to our radiology department between 2002 and 2007, were included (n = 1014). Percentage of women that was downstaged to BI-RADS category 1 or 2 by radiological pre-assessment was calculated. Negative predictive value (NPV) for malignancy was estimated from the in-hospital follow-up, which was available up to September 2012. Results: 423 of 1014 women (42%) were downstaged to BI-RADS category 1 or 2 by radiological pre-assessment. During follow-up, 8 of these 423 women (2%) developed a malignancy in the same breast. At least 6 of these malignancies were located at a different location as the original screening findings which led to the initial referral. The estimated NPV for malignancy was 99.5% (95%CI, 98.3–99.9). Conclusion: By referring women with a positive screening mammogram to the radiology department for pre-assessment, a surgical consultation was avoided in 42%, with an estimated NPV of 99.5% for malignancy

  14. The association between caudal anesthesia and increased risk of postoperative surgical complications in boys undergoing hypospadias repair.

    Science.gov (United States)

    Taicher, Brad M; Routh, Jonathan C; Eck, John B; Ross, Sherry S; Wiener, John S; Ross, Allison K

    2017-07-01

    Recent reports have suggested that caudal anesthesia may be associated with an increased risk of postoperative surgical complications. We examined our experience with caudal anesthesia in hypospadias repair to evaluate for increased risk of urethrocutaneous fistula or glanular dehiscence. All hypospadias repairs performed by a single surgeon in 2001-2014 were reviewed. Staged or revision surgeries were excluded. Patient age, weight, hypospadias severity, surgery duration, month and year of surgery, caudal anesthesia use, and postoperative complications were recorded. Bivariate and multivariate statistical analyses were performed. We identified 395 single-stage primary hypospadias repairs. Mean age was 15.6 months; 326 patients had distal (83%) and 69 had proximal (17%) hypospadias. Caudal anesthetics were used in 230 (58%) cases; 165 patients (42%) underwent local penile block at the discretion of the surgeon and/or anesthesiologist. Complications of urethrocutaneous fistula or glanular deshiscence occurred in 22 patients (5.6%) and were associated with caudal anesthetic use (OR 16.5, 95% CI 2.2-123.8, P = 0.007), proximal hypospadias (OR 8.2, 95% CI 3.3-20.0, P anesthesia was associated with an over 13-fold increase in the odds of developing postoperative surgical complications in boys undergoing hypospadias repair even after adjusting for urethral meatus location. Until further investigation occurs, clinicians should carefully consider the use of caudal anesthesia for children undergoing hypospadias repair. © 2017 John Wiley & Sons Ltd.

  15. Tattooing among high school students in southern Taiwan: The prevalence, correlates and associations with risk-taking behaviors and depression

    Directory of Open Access Journals (Sweden)

    Cheng-Fang Yen

    2012-07-01

    Full Text Available This study aims to examine the prevalence and sociodemographics, family and peer correlates of tattooing among high school students in southern Taiwan, and to examine the associations between tattooing and a variety of adolescent risk-taking behaviors and depression. A total of 9755 high school students (grades 7 to 12 in southern Taiwan were recruited into this study and completed the questionnaires. The prevalence of tattooing among the adolescents was calculated. The responses were analyzed using the logistic regression analysis models. It was found that 1% of high school students in southern Taiwan had 1 or more tattoos on their bodies. The older students who were perceived to have low family monitoring and who had friends who drink regularly, used illicit drugs, had a criminal record or were in a gang were more likely to have a tattoo. Tattooing was also found to be associated with violence, weekly alcohol consumption, illicit drug use, dropping out of school, unprotected sex, suicidal ideation/attempt, and depression. The results indicate that several demographics, family and peer factors are associated with adolescent tattooing. Tattooing may be an indicator of risk-taking behaviors in high school students.

  16. Associations between pesticide use and respiratory symptoms: A cross-sectional study in Southern Ghana

    Energy Technology Data Exchange (ETDEWEB)

    Quansah, Reginald, E-mail: reginald.quansah@ug.edu.gh [Biological, Environmental & Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra (Ghana); Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra (Ghana); Bend, John R. [Department of Pathology & Laboratory Medicine, Siebens-Drake Medical Research Institute, Schulich School of Medicine & Dentistry, Western University, London (Canada); Abdul-Rahaman, Abukari [Biological, Environmental & Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra (Ghana); Armah, Frederick Ato [Department of Environmental Science, School of Biological Sciences, College of Agriculture & Natural Sciences, University of Cape Coast, Cape Coast (Ghana); Luginaah, Isaac [Department of Geography, Western University, Ontario (Canada); Essumang, David Kofi [Environmental Health Group, Department of Chemistry, University of Cape Coast, Cape Coast (Ghana); Iddi, Samuel [Department of Statistics, University of Ghana, Legon, Accra (Ghana); Chevrier, Jonathan [Department of Epidemiology, Biostatistics and Occupational Health McGill University, Montréal, Québec (Canada); Cobbina, Samuel Jerry [Department of Ecotourism and Environmental Management, Faculty of Renewable Natural Resources, University for Development Studies, Nyankpala (Ghana); Nketiah-Amponsah, Edward [Department of Economics, University of Ghana, Legon (Ghana); Adu-Kumi, Samuel [Chemicals Control and Management Centre, Environmental Protection Agency, Accra (Ghana); Darko, Godfred [Department of Chemistry, Kwame Nkrumah University of Science and Technology, Kumasi (Ghana); Afful, Samuel [Nuclear Chemistry and Environmental Research Centre, Ghana Atomic Energy Commission, Accra (Ghana)

    2016-10-15

    Background: Indiscriminate use of pesticides is a common practice amongst farmers in Low and Middle Income Countries (LMIC) across the globe. However, there is little evidence defining whether pesticide use is associated with respiratory symptoms. Objectives: This cross-sectional study was conducted with 300 vegetable farmers in southern Ghana (Akumadan). Data on pesticide use was collected with an interviewed-administered questionnaire. The concentration of seven organochlorine pesticides and 3 pyrethroid pesticides was assayed in urine collected from a sub-population of 100 vegetable farmers by a gas chromatograph equipped with an electron capture detector (GC-ECD). Results: A statistically significant exposure-response relationship of years per day spent mixing/applying fumigant with wheezing [30–60 days/year: prevalence ratio (PR)=1.80 (95% CI 1.30, 2.50); >60days/year: 3.25 (1.70–6.33), p for trend=0.003] and hours per day spent mixing/applying fumigant with wheezing [1–2 h/day: 1.20 (1.02–1.41), 3–5 h/day: 1.45 (1.05–1.99), >5 h/day: 1.74 (1.07–2.81), p for trend=0.0225]; days per year spent mixing/applying fungicide with wheezing [30–60 days/year: 2.04 (1.31–3.17); >60days/year: 4.16 (1.72–10.08), p for trend=0.0017] and h per day spent mixing/applying fungicide with phlegm production [1–2 h/day: 1.25 (1.05–1.47), 3–5 h/day: 1.55 (1.11–2.17), >5 h/day: 1.93 (1.17–3.19), p for trend=0.0028] and with wheezing [1–2 h/day: 1.10 (1.00–1.50), 3–5 h/day: 1.20 (1.11–1.72), >5 h/day: 1.32 (1.09–2.53), p for trend=0.0088]; h per day spent mixing/applying insecticide with phlegm production [1–2 h/day: 1.23 (1.09–1.62), 3–5 h/day: 1.51 (1.20–2.58), >5 h/day: 1.85 (1.31–4.15), p for trend=0.0387] and wheezing [1–2 h/day: 1.22 (1.02–1.46), 3–5 h/day: 1.49 (1.04–2.12), >5 h/day: 1.81 (1.07–3.08), p for trend=0.0185] were observed. Statistically significant exposure-response association was also observed for a

  17. Associations between pesticide use and respiratory symptoms: A cross-sectional study in Southern Ghana

    International Nuclear Information System (INIS)

    Quansah, Reginald; Bend, John R.; Abdul-Rahaman, Abukari; Armah, Frederick Ato; Luginaah, Isaac; Essumang, David Kofi; Iddi, Samuel; Chevrier, Jonathan; Cobbina, Samuel Jerry; Nketiah-Amponsah, Edward; Adu-Kumi, Samuel; Darko, Godfred; Afful, Samuel

    2016-01-01

    Background: Indiscriminate use of pesticides is a common practice amongst farmers in Low and Middle Income Countries (LMIC) across the globe. However, there is little evidence defining whether pesticide use is associated with respiratory symptoms. Objectives: This cross-sectional study was conducted with 300 vegetable farmers in southern Ghana (Akumadan). Data on pesticide use was collected with an interviewed-administered questionnaire. The concentration of seven organochlorine pesticides and 3 pyrethroid pesticides was assayed in urine collected from a sub-population of 100 vegetable farmers by a gas chromatograph equipped with an electron capture detector (GC-ECD). Results: A statistically significant exposure-response relationship of years per day spent mixing/applying fumigant with wheezing [30–60 days/year: prevalence ratio (PR)=1.80 (95% CI 1.30, 2.50); >60days/year: 3.25 (1.70–6.33), p for trend=0.003] and hours per day spent mixing/applying fumigant with wheezing [1–2 h/day: 1.20 (1.02–1.41), 3–5 h/day: 1.45 (1.05–1.99), >5 h/day: 1.74 (1.07–2.81), p for trend=0.0225]; days per year spent mixing/applying fungicide with wheezing [30–60 days/year: 2.04 (1.31–3.17); >60days/year: 4.16 (1.72–10.08), p for trend=0.0017] and h per day spent mixing/applying fungicide with phlegm production [1–2 h/day: 1.25 (1.05–1.47), 3–5 h/day: 1.55 (1.11–2.17), >5 h/day: 1.93 (1.17–3.19), p for trend=0.0028] and with wheezing [1–2 h/day: 1.10 (1.00–1.50), 3–5 h/day: 1.20 (1.11–1.72), >5 h/day: 1.32 (1.09–2.53), p for trend=0.0088]; h per day spent mixing/applying insecticide with phlegm production [1–2 h/day: 1.23 (1.09–1.62), 3–5 h/day: 1.51 (1.20–2.58), >5 h/day: 1.85 (1.31–4.15), p for trend=0.0387] and wheezing [1–2 h/day: 1.22 (1.02–1.46), 3–5 h/day: 1.49 (1.04–2.12), >5 h/day: 1.81 (1.07–3.08), p for trend=0.0185] were observed. Statistically significant exposure-response association was also observed for a

  18. Microvascular injury of the peribiliary plexus associated with transarterial chemoembolization: a study of surgical specimens

    Energy Technology Data Exchange (ETDEWEB)

    Park, Won Kyu; Bae, Young Kyung; Hwang, Tae Yoon; Cho, Jae Ho; Chang, Jay Chun; Kim, Jae Woon; Jang, Han Won [College of Medicine, Yeungnam University, Daegu (Korea, Republic of)

    2006-11-15

    We attempted to evaluate the relationship between transarteiral chemoembolization (TACE) and injury to the peribiliary plexus by evaluating the number of microvessels in peribiliary plexus of surgical specimen. Surgical specimens were obtained from 78 hepatocellular carcinoma patients and 22 patients with liver metastases. They were divided into 4 groups (Group 1; hepatocellular carcinoma without TACE [n=30], Group 2; hepatocellular carcinoma receiving preoperative TACE once [n=37], Group 3; hepatocellular carcinoma receiving preoperative TACE more than two times [n=11] and Group 4; metastatic carcinoma of the liver patients without a history of liver disease [n=22]). Immunohistochemical staining for factor VIII-related antigen was performed in all the specimens and the number of microvessels in the inner capillary layer and the outer venous layer of the bile duct (> 200 {mu} m in diameter) was counted. The mean numbers of microvessels in the inner capillary layer were 4.50, 4.08, 1.64 and 2.05, and those in the outer venous layer were 25.23, 20.00, 18.36 and 12.32 for the 4 groups, respectively. The number of microvessels in group 4 was statistically fewer than that of group 1 ({rho} < 0.01). In the hepatocellular carcinoma patients, the number of microvessels was decreased as the number of TACE sessions was increased. The number of microvessels in the peribiliary plexus is increased in chronic liver disease patients. It may be from the increased portal pressure and flow stagnation in the sinusoidal and portal venules. TACE can have an effect on microvascular injury of the peibiliary plexus, and this can be a cause of bile duct necrosis and biloma.

  19. The association between thyroid malignancy and chronic lymphocytic thyroiditis: should it alter the surgical approach?

    Science.gov (United States)

    Büyükaşık, Oktay; Hasdemir, Ahmet Oğuz; Yalçın, Erol; Celep, Bahadır; Sengül, Serkan; Yandakçı, Kemal; Tunç, Gündüz; Küçükpınar, Tevfik; Alkoy, Seval; Cöl, Cavit

    2011-01-01

    The relation between thyroid neoplasms and chronic lymphocytic thyroiditis (CLT) is controversial. While it is accepted that focal lymphocytic thyroiditis develops secondarily to malignancy, it is not clear whether diffuse lymphocytic thyroiditis has a tendency to develop into thyroid cancer. The aim of this study was to investigate the relation between CLT and malignant tumours of the thyroid and evaluate the surgical approach to CLT cases. In this study, 917 patients operated on for thyroid diseases were investigated retrospectively. Seventy-seven (8.4%) patients histopathologically diagnosed as having CLT (either non-specific or Hashimoto's thyroiditis) were investigated for any concurrent malignant neoplasm. Fifteen patients in whom CLT and thyroid malignancy were coexisting were included in the study. In the pathological evaluation of 917 cases, malignancy in the thyroid was found in 97 (10.6%) cases. Seventy-seven cases were categorised as CLT. Of these 77, 16 (20.8%) were Hashimoto's thyroiditis (specific CLT) and the other 61 (79.2%) were non-specific CLT. In 15 cases, thyroid malignancy was found to be concurrent with CLT. Of the malignities, nine (60%) were papillary carcinoma, three (20%) medullar carcinoma, one (6.6%) follicular carcinoma, one (6.6%) Hurthle cell carcinoma, and one (6.6%) lymphoma. In our series, the rate of the development of malignancy against the background of CLT was 19.48%, while the rate in the groups without CLT was 9.76%, with a statistically significant difference between the groups (p = 0.008). CLT cases should be evaluated more carefully in terms of malignancy. If a nodule is detected on thyroiditis, the minimal surgical intervention should be lobectomy. Total thyroidectomy should be considered as preferable to subtotal thyroidectomy because of its many advantages such as controlling thyroiditis, removing the probability of reoperation, and hormonal stability.

  20. [Is surgical education associated with additional costs? A controlled economic study on the German DRG System for primary TKA].

    Science.gov (United States)

    Göbel, P; Piesche, K; Randau, T; Wimmer, M D; Wirtz, D C; Gravius, S

    2013-04-01

    Total knee arthroplasty (TKA) is one of the most common procedures in orthopaedic surgery, the cost of surgical training has as yet not been quantified. In a pilot study, we investigated the economic impact of surgical training under DRG system influences, analysing the cost-proceeds structure in surgical training for orthopaedic residents. Consecutive TKAs were performed by the most educated surgeon (Group A) having implanted ≥ 1000 TKAs, another attending (Group B) with ≥ 200 TKAs and a resident (Group C) having assisted in 25 TKAs (n = 30 patients per Group A-C). All patients were embedded in a standardised clinical pathway. By analysing the costs parameters such as numbers of blood transfusions, the operating time and the length of stay in the hospital we investigated the health care-related costs matched to the DRG-based financial refunding. Data were analysed after undergoing a analysis of variance followed by a post-hoc Scheffé procedure. On the one hand the resident generated additional costs of 1111,7 ± 97 € in comparison to the Group A surgeon and 1729,8 ± 152 € compared to the attending Group B (p > 0,05), these were generated by longer stay in hospital, longer operation time and higher need of resources. On the other hand there were significantly higher proceeds of the Group C in comparison to the attending Group B and also to Group A: 474,78 ± 82 € vs. A and 150,54 ± 52 € vs. Group B (p DRG. Overall the deficit per patient treated by the resident is 637 ± 77 € vs. Group A and 1579,3 ± 137 € vs. Group B (p > 0,05). The German DRG matrix results in higher profits accounted to the learning surgeon by increased PCCL relevant status and grouping the case to a more profitable DRG. Hereby, the additional costs are only partly redeemed. Surgical education of residents is associated with additional costs for the hospital. These costs have to be redeemed to allow good surgical training for hospitals having good teaching conditions. Georg

  1. Pre-operative and early post-operative factors associated with surgical site infection after laparoscopic sleeve gastrectomy.

    Science.gov (United States)

    Ruiz-Tovar, Jaime; Oller, Inmaculada; Llavero, Carolina; Arroyo, Antonio; Muñoz, Jose Luis; Calero, Alicia; Diez, María; Zubiaga, Lorea; Calpena, Rafael

    2013-08-01

    Surgical procedures on obese patients are expected to have a high incidence of surgical site infection (SSI). The identification of pre-operative or early post-operative risk factors for SSI may help the surgeon to identify subjects in risk and adequately optimize their status. We conducted a study of the association of comorbidities and pre- and post-operative analytical variables with SSI following laparoscopic sleeve gastrectomy for the treatment of morbid obesity. We performed a prospective study of all morbidly obese patients undergoing laparoscopic sleeve gastrectomy as a bariatric procedure between 2007 and 2011. An association of clinical and analytical variables with SSI was investigated. The study included 40 patients with a mean pre-operative body mass index (BMI) of 51.2±7.9 kg/m(2). Surgical site infections appeared in three patients (7.5%), of whom two had an intra-abdominal abscess located in the left hypochondrium and the third had a superficial incisional SSI. Pre-operatively, a BMI >45 kg/m(2) (OR 8.7; p=0.008), restrictive disorders identified by pulmonary function tests (OR 10.0; p=0.012), a serum total protein concentration 30 mcg/dL (OR 13.0; p=0.003), and a mean corpuscular volume (MCV) operative SSI. Post-operatively, a serum glucose >128 mg/dL (OR 4.7; p=0.012) and hemoglobin operative anemia and hyperglycemia as risk factors for SSI. In these situations, the surgeon must be aware of and seek to control these risk factors.

  2. [Investigation on the difference of intolerance to food between southern and northern middle-aged Chinese and its association with eating habits].

    Science.gov (United States)

    Shi, Hai-Yan; Wang, Jian-Rong; Cao, Jian; Wang, Qing-Yun; Liu, Cui-Ping

    2013-05-01

    The aim of the present study was to investigate the difference of intolerance to food between southern and northern middle-aged Chinese, and furthermore analyze its association with eating habits in both study population. ELISA was applied to determine the serum concentrations of specific IgG of 14 food anaphylactogen in 1568 healthy subjects from totally 9 districts in both southern and northern China. Life style questionnaire was also applied to investigate the daily intake of six categorizes of food associated with food intolerance. 45.8% of all subjects were found to be intolerant to certain food. 62.3% of subjects from southern China and 40.4% of subjects from northern China were found to be intolerant to certain food, the difference between southern and northern Chinese was statistically significant. Top three foods intolerant by southern Chinese were crab, egg, and cold fish, while top three food intolerant by northern Chinese were egg, crab, and milk. The differences of intolerance to crab, cold fish, soy bean, rice, and tomato between southern and northern Chinese were statistically significant. Investigation on eating habits revealed that cereals and fish were the major food consumed by subjects in our study. There was no certain association between food intolerance and eating habits. Considering that there are differences between southern and northern Chinese, southern and northern Chinese should pay attention to their daily food in order to avoid food allergy.

  3. Copper tolerance and distribution of epibiotic bacteria associated with giant kelp Macrocystis pyrifera in southern California

    NARCIS (Netherlands)

    Busch, Julia; Nascimento, Juliana Ribeiro; Magalhães, Ana Carolina Rubem; Dutilh, Bas E; Dinsdale, Elizabeth

    Kelp forests in southern California are important ecosystems that provide habitat and nutrition to a multitude of species. Macrocystis pyrifera and other brown algae that dominate kelp forests, produce negatively charged polysaccharides on the cell surface, which have the ability to accumulate

  4. Copper tolerance and distribution of epibiotic bacteria associated with giant kelp Macrocystis pyrifera in southern California

    NARCIS (Netherlands)

    Busch, J.; Nascimento, J.R.; Magalhaes, A.C.; Dutilh, B.E.; Dinsdale, E.

    2015-01-01

    Kelp forests in southern California are important ecosystems that provide habitat and nutrition to a multitude of species. Macrocystis pyrifera and other brown algae that dominate kelp forests, produce negatively charged polysaccharides on the cell surface, which have the ability to accumulate

  5. Forecast skill of synoptic conditions associated with Santa Ana winds in Southern California

    Science.gov (United States)

    Charles Jones; Francis Fujioka; Leila M.V. Carvalho

    2010-01-01

    Santa Ana winds (SAW) are synoptically driven mesoscale winds observed in Southern California usually during late fall and winter. Because of the complex topography of the region, SAW episodes can sometimes be extremely intense and pose significant environmental hazards, especially during wildfire incidents. A simple set of criteria was used to identify synoptic-scale...

  6. Surgical Satisfaction, Quality of Life, and Their Association After Gender-Affirming Surgery: A Follow-up Study.

    Science.gov (United States)

    van de Grift, Tim C; Elaut, Els; Cerwenka, Susanne C; Cohen-Kettenis, Peggy T; Kreukels, Baudewijntje P C

    2018-02-17

    We assessed the outcomes of gender-affirming surgery (GAS, or sex-reassignment surgery) 4 to 6 years after first clinical contact, and the associations between postoperative (dis)satisfaction and quality of life (QoL). Our multicenter, cross-sectional follow-up study involved persons diagnosed with gender dysphoria (DSM-IV-TR) who applied for medical interventions from 2007 until 2009. Of 546 eligible persons, 201 (37%) responded, of whom 136 had undergone GAS (genital, chest, facial, vocal cord and/or thyroid cartilage surgery). Main outcome measures were procedure performed, self-reported complications, and satisfaction with surgical outcomes (standardized questionnaires), QoL (Satisfaction With Life Scale, Subjective Happiness Scale, Cantril Ladder), gender dysphoria (Utrecht Gender Dysphoria Scale), and psychological symptoms (Symptom Checklist-90). Postoperative satisfaction was 94% to 100%, depending on the type of surgery performed. Eight (6%) of the participants reported dissatisfaction and/or regret, which was associated with preoperative psychological symptoms or self-reported surgical complications (OR = 6.07). Satisfied respondents' QoL scores were similar to reference values; dissatisfied or regretful respondents' scores were lower. Therefore, dissatisfaction after GAS may be viewed as indicator of unfavorable psychological and QoL outcomes.

  7. Psychological Variables Associated With Health-Related Quality-of-Life in Uruguayan Women Surgically Intervened for Breast Cancer

    Directory of Open Access Journals (Sweden)

    Micaela Reich

    2014-11-01

    Full Text Available AimThis study described demographic, clinical, psychological and health-related quality of life (HRQOL characteristics in women surgically intervened for breast cancer, and the present study was conducted to examine the association between these characteristics.MethodUruguayan women (N = 116 diagnosed and surgically intervened for breast cancer were assessed on demographic, clinical and psychological indicators and HRQOL, by self-report questionnaires (i.e., BDI-II, PSS, Brief-COPE, and SF-36. Study was conducted adopting a non-experimental, cross-sectional methodology. After studying associations between variables assessed, hierarchical regression analyses were performed to identify HRQOL predictors.ResultsHRQOL Physical Health Component (SF-36 was predicted by perceived stress and depression, above and beyond demographic and clinical factors. And HRQOL Mental Health Component (SF-36 was predicted by education, time elapsed since diagnosis of breast cancer, time hospitalized during the past year, perceived stress and depression.ConclusionResults suggest that psychological variables may have a significant role for HRQOL prediction, and need to be taken into account along with demographic and clinical markers in order to explain HRQOL outcomes in women with breast cancer.

  8. The incidence of surgical site dehiscence following full-thickness gastrointestinal biopsy in dogs and cats and associated risk factors.

    Science.gov (United States)

    Swinbourne, F; Jeffery, N; Tivers, M S; Artingstall, R; Bird, F; Charlesworth, T; Doran, I; Freeman, A; Hall, J; Hattersley, R; Henken, J; Hughes, J; de la Puerta, B; Rutherford, L; Ryan, T; Williams, H; Woods, S; Nicholson, I

    2017-09-01

    The objectives of this study were to: (1) document the incidence of surgical site dehiscence after full-thickness gastrointestinal biopsy in dogs and cats and (2) identify potential risk factors. Data relating to dogs and cats undergoing full-thickness gastrointestinal biopsy were reviewed retrospectively following submission of a completed questionnaire by 12 referral institutions. Outcome measures were definite dehiscence, possible dehiscence (clinical records suggestive of dehiscence but not confirmed), suspected dehiscence (definite and possible combined) and death within 14 days. Logistic regression was planned for analysis of association of dehiscence with low preoperative serum albumin, biopsy through neoplastic tissue, biopsy alongside another major abdominal surgical procedure and biopsy of the colon. Of 172 cats, two (1·2%) had definite dehiscence, and four (2·3%) had possible dehiscence. Low preoperative serum albumin was significantly associated with definite dehiscence in univariable analysis and with suspected dehiscence and death within 14 days in univariable analysis, but all odds ratios had wide 95% confidence intervals. A histopathological diagnosis of neoplasia was significantly associated with death within 14 days in univariable analysis. Of 195 dogs, two (1·0%) had definite dehiscence, and three (1·5%) had possible dehiscence. In dogs, there was no association between any outcome measure and the putative risk factors. Incidence of dehiscence following full-thickness gastrointestinal biopsy was low in this study. When determining the appropriateness of biopsy in individual cases, this information should be balanced against the potentially life-threatening consequences of dehiscence. © 2017 British Small Animal Veterinary Association.

  9. Dung Beetles Associated with Agroecosystems of Southern Brazil: Relationship with Soil Properties

    Directory of Open Access Journals (Sweden)

    Patrícia Menegaz de Farias

    Full Text Available ABSTRACT Knowing the biodiversity of dung beetles in agricultural and livestock environments is the basis for understanding the contribution that these organisms make in nutrient cycling and ecosystem functions. The aim of the present study was to investigate the structure of copronecrophagous dung beetle communities inhabiting the main agroecosystems in southern Brazil and correlate the presence of these organisms with soil properties. From December 2012 to April 2013, samples of dung beetles were taken in the municipality of Tubarão, Santa Catarina, Brazil (28° 28’ S; 48° 56’ W in corn, bean, and sugarcane crops, and in cattle pastures. Beetles were captured in 16 sampling sites, four from each agroecosystem, following a standardized methodology: 10 baited pitfall traps (feces and rotting meat at a spacing of 50 m with exposure for 48 h. The beetles were identified, weighed, and measured. Soil analyses were performed in order to correlate data on organic matter, texture, macro and micronutrients, and pH with data on the abundance of beetle species using canonical correspondence analysis. A total of 110 individuals belonging to 10 species of dung beetles was found. Twenty-four individuals from seven species (with total biomass of 2.4 g were found in the corn crop; five individuals from three species (1.8 g were found in the bean crop; 81 individuals from nine species (30.3 g were found in cattle pasture areas; and lastly, there were no dung beetles recorded in the sugarcane crop. In areas of cattle grazing, the tunnelers Dichotomius nisus and Trichillum externepunctatum correlated positively with organic matter content, whereas the roller species Canthon chalybaeus correlated positively with soil texture, preferring sandier soils. In corn crop areas, D. nisus was again correlated with organic matter content. Paracoprid dung beetle species were correlated with organic matter content in the soil, and species belonging to the roller

  10. Increased pediatric sub-specialization is associated with decreased surgical complication rates for inpatient pediatric urology procedures

    Science.gov (United States)

    Tejwani, R.; Wang, H-H. S.; Young, B. J.; Greene, N. H.; Wolf, S.; Wiener, J. S.; Routh, J. C.

    2016-01-01

    Summary Introduction Increased case volumes and training are associated with better surgical outcomes. However, the impact of pediatric urology sub-specialization on perioperative complication rates is unknown. Objectives To determine the presence and magnitude of difference in rates of common postoperative complications for elective pediatric urology procedures between specialization levels of urologic surgeons. The Nationwide Inpatient Sample (NIS), a nationally representative administrative database, was used. Study Design The NIS (1998–2009) was retrospectively reviewed for pediatric (≤18 years) admissions, using ICD-9-CM codes to identify urologic surgeries and National Surgical Quality Improvement Program (NSQIP) inpatient postoperative complications. Degree of pediatric sub-specialization was calculated using a Pediatric Proportion Index (PPI), defined as the ratio of children to total patients operated on by each provider. The providers were grouped into PPI quartiles: Q1, 0–25% specialization; Q2, 25–50%; Q3, 50–75%; Q4, 75–100%. Weighted multivariate analysis was performed to test for associations between PPI and surgical complications. Results A total of 71,479 weighted inpatient admissions were identified. Patient age decreased with increasing specialization: Q1, 7.9 vs Q2, 4.8 vs Q3, 4.8 vs Q4, 4.6 years, PSpecialization was not associated with race (P>0.20), gender (P>0.50), or comorbidity scores (P=0.10). Mortality (1.5% vs 0.2% vs 0.3% vs 0.4%, Pspecialization. Patients treated by more highly specialized surgeons incurred slightly higher costs (Q2, +4%; Q3, +1%; Q4 + 2%) but experienced shorter length of hospital stay (Q2, –5%; Q3, –10%; Q4, –3%) compared with the least specialized providers. A greater proportion of patients treated by Q1 and Q3 specialized urologists had CCS ≥2 than those seen by Q2 or Q4 urologists (12.5% and 12.2%, respectively vs 8.4% and 10.9%, respectively, P=0.04). Adjusting for confounding effects

  11. Behaviour and physiology shape the growth accelerations associated with predation risk, high temperatures and southern latitudes in Ischnura damselfly larvae.

    Science.gov (United States)

    Stoks, Robby; Swillen, Ine; De Block, Marjan

    2012-09-01

    1. To better predict effects of climate change and predation risk on prey animals and ecosystems, we need studies documenting not only latitudinal patterns in growth rate but also growth plasticity to temperature and predation risk and the underlying proximate mechanisms: behaviour (food intake) and digestive physiology (growth efficiency). The mechanistic underpinnings of predator-induced growth increases remain especially poorly understood. 2. We reared larvae from replicated northern and southern populations of the damselfly Ischnura elegans in a common garden experiment manipulating temperature and predation risk and quantified growth rate, food intake and growth efficiency. 3. The predator-induced and temperature-induced growth accelerations were the same at both latitudes, despite considerably faster growth rates in the southern populations. While the higher growth rates in the southern populations and the high rearing temperature were driven by both an increased food intake and a higher growth efficiency, the higher growth rates under predation risk were completely driven by a higher growth efficiency, despite a lowered food intake. 4. The emerging pattern that higher growth rates associated with latitude, temperature and predation risk were all (partly or completely) mediated by a higher growth efficiency has two major implications. First, it indicates that energy allocation trade-offs and the associated physiological costs play a major role both in shaping large-scale geographic variation in growth rates and in shaping the extent and direction of growth rate plasticity. Secondly, it suggests that the efficiency of energy transfer in aquatic food chains, where damselfly larvae are important intermediate predators, will be higher in southern populations, at higher temperatures and under predation risk. This may eventually contribute to the lengthening of food chains under these conditions and highlights that the prey identity may determine the influence of

  12. Complete Surgical Excision Is Essential for the Management of Patients With Breast Implant-Associated Anaplastic Large-Cell Lymphoma.

    Science.gov (United States)

    Clemens, Mark W; Medeiros, L Jeffrey; Butler, Charles E; Hunt, Kelly K; Fanale, Michelle A; Horwitz, Steven; Weisenburger, Dennis D; Liu, Jun; Morgan, Elizabeth A; Kanagal-Shamanna, Rashmi; Parkash, Vinita; Ning, Jing; Sohani, Aliyah R; Ferry, Judith A; Mehta-Shah, Neha; Dogan, Ahmed; Liu, Hui; Thormann, Nora; Di Napoli, Arianna; DiNapoli, Arianna; Lade, Stephen; Piccolini, Jorge; Reyes, Ruben; Williams, Travis; McCarthy, Colleen M; Hanson, Summer E; Nastoupil, Loretta J; Gaur, Rakesh; Oki, Yasuhiro; Young, Ken H; Miranda, Roberto N

    2016-01-10

    Breast implant-associated anaplastic large-cell lymphoma (BI-ALCL) is a rare type of T-cell lymphoma that arises around breast implants. The optimal management of this disease has not been established. The goal of this study is to evaluate the efficacy of different therapies used in patients with BI-ALCL to determine an optimal treatment approach. In this study, we applied strict criteria to pathologic findings, assessed therapies used, and conducted a clinical follow-up of 87 patients with BI-ALCL, including 50 previously reported in the literature and 37 unreported. A Prentice, Williams, and Peterson model was used to assess the rate of events for each therapeutic intervention. The median and mean follow-up times were 45 and 30 months, respectively (range, 3 to 217 months). The median overall survival (OS) time after diagnosis of BI-ALCL was 13 years, and the OS rate was 93% and 89% at 3 and 5 years, respectively. Patients with lymphoma confined by the fibrous capsule surrounding the implant had better event-free survival (EFS) and OS than did patients with lymphoma that had spread beyond the capsule (P = .03). Patients who underwent a complete surgical excision that consisted of total capsulectomy with breast implant removal had better OS (P = .022) and EFS (P = .014) than did patients who received partial capsulectomy, systemic chemotherapy, or radiation therapy. Surgical management with complete surgical excision is essential to achieve optimal EFS in patients with BI-ALCL. © 2015 by American Society of Clinical Oncology.

  13. Complete Surgical Excision Is Essential for the Management of Patients With Breast Implant–Associated Anaplastic Large-Cell Lymphoma

    Science.gov (United States)

    Clemens, Mark W.; Medeiros, L. Jeffrey; Butler, Charles E.; Hunt, Kelly K.; Fanale, Michelle A.; Horwitz, Steven; Weisenburger, Dennis D.; Liu, Jun; Morgan, Elizabeth A.; Kanagal-Shamanna, Rashmi; Parkash, Vinita; Ning, Jing; Sohani, Aliyah R.; Ferry, Judith A.; Mehta-Shah, Neha; Dogan, Ahmed; Liu, Hui; Thormann, Nora; Di Napoli, Arianna; Lade, Stephen; Piccolini, Jorge; Reyes, Ruben; Williams, Travis; McCarthy, Colleen M.; Hanson, Summer E.; Nastoupil, Loretta J.; Gaur, Rakesh; Oki, Yasuhiro; Young, Ken H.

    2016-01-01

    Purpose Breast implant–associated anaplastic large-cell lymphoma (BI-ALCL) is a rare type of T-cell lymphoma that arises around breast implants. The optimal management of this disease has not been established. The goal of this study is to evaluate the efficacy of different therapies used in patients with BI-ALCL to determine an optimal treatment approach. Patients and Methods In this study, we applied strict criteria to pathologic findings, assessed therapies used, and conducted a clinical follow-up of 87 patients with BI-ALCL, including 50 previously reported in the literature and 37 unreported. A Prentice, Williams, and Peterson model was used to assess the rate of events for each therapeutic intervention. Results The median and mean follow-up times were 45 and 30 months, respectively (range, 3 to 217 months). The median overall survival (OS) time after diagnosis of BI-ALCL was 13 years, and the OS rate was 93% and 89% at 3 and 5 years, respectively. Patients with lymphoma confined by the fibrous capsule surrounding the implant had better event-free survival (EFS) and OS than did patients with lymphoma that had spread beyond the capsule (P = .03). Patients who underwent a complete surgical excision that consisted of total capsulectomy with breast implant removal had better OS (P = .022) and EFS (P = .014) than did patients who received partial capsulectomy, systemic chemotherapy, or radiation therapy. Conclusion Surgical management with complete surgical excision is essential to achieve optimal EFS in patients with BI-ALCL. PMID:26628470

  14. General surgical complications associated with the use of long-term mechanical circulatory support devices: are we 'under-reporting' problems?

    Science.gov (United States)

    Tchantchaleishvili, Vakhtang; Umakanthan, Ramanan; Karp, Seth; Stulak, John M; Keebler, Mary E; Maltais, Simon

    2013-05-01

    Multiple complications are associated with use of ventricular assist devices (VADs). Cardiac-related complications and infections are most frequently reported. VADs, however, can also lead to a number of general surgical complications equally significant in terms of morbidity and mortality. The authors performed a systematic literature search to review current data that specifically relate general surgical complications to patients who undergo left VAD implantation. The review provides a relatively clear understanding of the spectrum of general surgical complications and shows that they contribute significantly to morbidity and mortality in these patients.

  15. Endometrial fluid associated with Essure implants placed before in vitro fertilization: Considerations for patient counseling and surgical management.

    Science.gov (United States)

    Sills, E Scott; Walsh, David J; Jones, Christopher A; Wood, Samuel H

    2015-09-01

    Essure (Bayer) received approval from the U.S. Food and Drugs Administration as a permanent non-hormonal contraceptive implant in November 2002. While the use of Essure in the management of hydrosalpinx prior to in vitro fertilization (IVF) remains off-label, it has been used specifically for this purpose since at least 2007. Although most published reports on Essure placement before IVF have been reassuring, clinical experience remains limited, and no randomized studies have demonstrated the safety or efficacy of Essure in this context. In fact, no published guidelines deal with patient selection or counseling regarding the Essure procedure specifically in the context of IVF. Although Essure is an irreversible birth control option, some patients request the surgical removal of the implants for various reasons. While these patients could eventually undergo hysterectomy, at present no standardized technique exists for simple Essure removal with conservation of the uterus. This article emphasizes new aspects of the Essure procedure, as we describe the first known association between the placement of Essure implants and the subsequent development of fluid within the uterine cavity, which resolved after the surgical removal of both devices.

  16. Measuring the association between artemisinin-based case management and malaria incidence in southern Vietnam, 1991-2010.

    Science.gov (United States)

    Peak, Corey M; Thuan, Phung Duc; Britton, Amadea; Nguyen, Tran Dang; Wolbers, Marcel; Thanh, Ngo Viet; Buckee, Caroline O; Boni, Maciej F

    2015-04-01

    In addition to being effective, fast-acting, and well tolerated, artemisinin-based combination therapies (ACTs) are able to kill certain transmission stages of the malaria parasite. However, the population-level impacts of ACTs on reducing malaria transmission have been difficult to assess. In this study on the history of malaria control in Vietnam, we assemble annual reporting on malaria case counts, coverage with insecticide-treated nets (ITN) and indoor residual spraying (IRS), and drug purchases by provincial malaria control programs from 1991 to 2010 in Vietnam's 20 southern provinces. We observe a significant negative association between artemisinin use and malaria incidence, with a 10% absolute increase in the purchase proportion of artemisinin-containing regimens being associated with a 29.1% (95% confidence interval: 14.8-41.0%) reduction in slide-confirmed malaria incidence, after accounting for changes in urbanization, ITN/IRS coverage, and two indicators of health system capacity. One budget-related indicator of health system capacity was found to have a smaller association with malaria incidence, and no other significant factors were found. Our findings suggest that including an artemisinin component in malaria drug regimens was strongly associated with reduced malaria incidence in southern Vietnam, whereas changes in urbanization and coverage with ITN or IRS were not. © The American Society of Tropical Medicine and Hygiene.

  17. Morphometric MRI features are associated with surgical outcome in mesial temporal lobe epilepsy with hippocampal sclerosis.

    Science.gov (United States)

    Garcia, Maria Teresa Fernandes Castilho; Gaça, Larissa Botelho; Sandim, Gabriel Barbosa; Assunção Leme, Idaiane Batista; Carrete, Henrique; Centeno, Ricardo Silva; Sato, João Ricardo; Yacubian, Elza Márcia Targas

    2017-05-01

    Corticoamygdalohippocampectomy (CAH) improves seizure control, quality of life, and decreases mortality for refractory mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). One-third of patients continue having seizures, and it is pivotal to determine structural abnormalities that might influence the postoperative outcome. Studies indicate that nonhippocampal regions may play a role in the epileptogenic network in MTLE-HS and could generate seizures postoperatively. The aim of this study is to analyze areas of atrophy, not always detected on routine MRI, comparing patients who became seizure free (SF) with those non seizure free (NSF) after CAH, in an attempt to establish possible predictors of surgical outcome. 105 patients with refractory MTLE-HS submitted to CAH (59 left MTLE; 46 males) and 47 controls were enrolled. FreeSurfer was performed for cortical thickness and volume estimation comparing patients to controls and SF versus NSF patients. The final sample after post processing procedures resulted in 99 patients. Cortical thickness analyses showed reductions in left insula in NSF patients compared to those SF. Significant volume reductions in SF patients were present in bilateral thalami, hippocampi and pars opercularis, left parahippocampal gyrus and right temporal pole. In NSF patients reductions were present bilaterally in thalami, hippocampi, entorhinal cortices, superior frontal and supramarginal gyri; on the left: superior and middle temporal gyri, temporal pole, parahippocampal gyrus, pars opercularis and middle frontal gyrus; and on the right: precentral, superior, middle and inferior temporal gyri. Comparison between SF and NSF patients showed ipsilateral gray matter reductions in the right entorhinal cortex (p=0.003) and contralateral parahippocampal gyrus (p=0.05) in right MTLE-HS. Patients NSF had a longer duration of epilepsy than those SF (p=0.028). NSF patients exhibited more extensive areas of atrophy than SF ones. As entorhinal

  18. Urological management (medical and surgical of BK-virus associated haemorrhagic cystitis in children following haematopoietic stem cell transplantation

    Directory of Open Access Journals (Sweden)

    Nikhil Vasdev

    2013-10-01

    Full Text Available Aim: Haemorrhagic cystitis (HC is uncommon and in its severe form potentially life threatening complication of Haematopoietic stem cell transplantation (HSCT in children. We present our single centre experience in the urological management of this clinically challenging condition. Patients and Methods: Fourteen patients were diagnosed with BK-Virus HC in our centre. The mean age at diagnosis was 8.8 years (range, 3.2-18.4 years. The mean number of days post-BMT until onset of HC was 20.8 (range, 1 – 51. While all patients tested urine positive for BKV at the clinical onset of HC, only four patients had viral quantification, with viral loads ranging from 97,000 to >1 billion/ml. 8 patients had clinical HC. Ten patients experienced acute GVHD (grade I: 6 patients, grade II: 3 patients, grade 4: 1 patient.Results: Four patients received medical management for their HC. Treatments included hyperhydration, MESNA, blood and platelet transfusion, premarin and oxybutynin (Table 6.  Two patients received both medical and surgical management which included cystoscopy with clot evacuation, bladder irrigation and supra-pubic catheter insertion. One patient received exclusive surgical management. Seven patients were treated conservatively. Conclusion: There is limited available evidence for other potential therapeutic strategies highlighting the need for more research into the pathophysiology of HSCT-associated HC. Commonly used interventions with possible clinical benefit (e.g. cidofovir, ciprofloxacin still require to be evaluated in multi-centre, high-quality studies. Potential future preventative and therapeutic options, such as modulation of conditioning, immunosuppression and engraftment, new antiviral and anti-inflammatory and less nephrotoxic agents need to be assessed.---------------------------Cite this article as:Vasdev N, Davidson A, Harkensee C, Slatter M, Gennery A, Willetts I, Thorpe A.Urological management (medical and surgical of BK

  19. Treatment of Whiplash-Associated Disorders - Part II: Medical and Surgical Interventions

    Directory of Open Access Journals (Sweden)

    Anne Conlin

    2005-01-01

    Full Text Available BACKGROUND: Whiplash-associated disorder (WAD is a term used to describe injury due to an acceleration-deceleration mechanism at the neck. In 1995, the Quebec Task Force published a report that contained evidence-based recommendations regarding the treatment of WAD based on studies completed before 1993 and consensus-based recommendations.

  20. Surgical Treatment of Cervical Spondylotic Myelopathy Associated Hypertension--A Retrospective Study of 309 Patients.

    Directory of Open Access Journals (Sweden)

    Ze-qun Li

    Full Text Available Hypertension is the most prevalent cardiovascular disease, and various risk factors are known to be involved in it. Cervical spondylotic myelopathy (CSM is the most common non-traumatic cause of myelopathy, which displays neurological symptoms and may induce systemic symptoms. To date, it is still unknown whether CSM is associated with hypertension, and if so, whether the decompression operations can attenuate CSM associated hypertension. Here, a total of 309 patients with CSM who received anterior or posterior decompression surgery were enrolled as subjects. Blood pressure measurements were performed before and within one week after the surgery. Among the 309 subjects, 144 (46.6% of them exhibited hypertension before surgery, a significantly higher ratio than that of the whole population. One week after surgery, blood pressure of 106 (73.6% patients turned back to normal. Blood pressure of another 37(25.7% patients decreased with different degrees, although still higher than normal. Moreover, it appears that both approaches were effective in improving blood pressure, while the posterior approach was more effective in decreasing systolic blood pressure. We speculate this type of hypertension might result from hyperactivity of sympathetic nervous system as the heart rate of these patients decreased after surgery as well. Collectively, compression of spinal cord in CSM patients might be associated with hypertension, and decompression surgery largely attenuated this type of hypertension. These findings prove CSM to be a potential associated factor of high blood pressure and may shed light on therapies of hypertension in clinics.

  1. Analysis of the coral associated bacterial community structures in healthy and diseased corals from off-shore of southern Taiwan.

    Science.gov (United States)

    Chiou, Shu-Fen; Kuo, Jimmy; Wong, Tit-Yee; Fan, Tung-Yung; Tew, Kwee Siong; Liu, Jong-Kang

    2010-07-01

    The methods of denaturing gradient gel electrophoresis (DGGE) and DNA sequencing were used to analyze the ribotypes of microbial communities associated with corals. Both healthy and diseased coral of different species were collected at three locations off the southern coast of Taiwan. Ribotyping results suggested that the microbial communities were diverse. The microbial community profiles, even among the same species of corals from different geographical locations, differ significantly. The coral-associated bacterial communities contain many bacteria common to the habitants of various invertebrates. However, some bacteria were unexpected. The presence of some unusual species, such as Staphylococcus, Clostridium and Legionella, associated with corals that were likely the results of human activities. Human activities, such as thermal pollution from the nearby nuclear plant, active fishing and tourism industries in the region might have all contributed to the change in bacterial communities and the death of coral colonies around the region.

  2. Surgical lighting

    NARCIS (Netherlands)

    Knulst, A.J.

    2017-01-01

    The surgical light is an important tool for surgeons to create and maintain good visibility on the surgical task. Chapter 1 gives background to the field of (surgical) lighting and related terminology. Although the surgical light has been developed strongly since its introduction a long time ago,

  3. Factors Associated with Post-Surgical Delirium in Patients Undergoing Open Heart Surgery

    Directory of Open Access Journals (Sweden)

    Yadollah Jannati

    2014-09-01

    Full Text Available Objective: The objective of the present study is to determine the incidence of delirium and the associated factors in patients undergoing open heart surgery. Methods: This is an Analytic-descriptive study conducted on 404 patients undergoing elective open heart surgery in Fatemeh Zahra Heart Center, Sari, over the period of 6 months from July to December 2011. Sampling was achieved in a nonrandomized targeted manner and delirium was assessed using NeeCham questionnaire. A trained nurse evaluated the patients for delirium and completed the risk factor checklist on days 1 to 5 after surgery. Data analyses were accomplished using survival analysis (Kaplan-Meier and Cox regression on SPSS software version 15. Results: We found that variables, including ventilation time, increased drainage during the first 24 hours, the need for re-operation in the first 24 hours, dysrhythmias, use of inotropic agents, increased use of analgesics, increased arterial carbon dioxide, lack of visitors, and use of physical restrainers were associated with the development of delirium. In addition, we found a delirium incidence of 29%. Conclusion: Diagnosis of cognitive disorders is of utmost value; therefore, further studies are required to clarify the risk factors because controlling them will help prevent delirium.

  4. Soil-transmitted helminths in southern highland Rwanda: associated factors and effectiveness of school-based preventive chemotherapy.

    Science.gov (United States)

    Staudacher, Olga; Heimer, Jakob; Steiner, Florian; Kayonga, Yvette; Havugimana, Jean M; Ignatius, Ralf; Musemakweri, Andre; Ngabo, Fidele; Harms, Gundel; Gahutu, Jean-Bosco; Mockenhaupt, Frank P

    2014-07-01

    Preventive chemotherapy of schoolchildren against soil-transmitted helminths (STHs) is widely implemented in Rwanda. However, data on its actual efficacy are lacking. We assessed prevalence, associated factors and manifestation of STH infection among schoolchildren in southern highland Rwanda as well as cure and reinfection rates. Six hundred and twenty-two children (rural, 301; urban, 321) were included preceding the administration of a single dose of 500 mg mebendazole. Before treatment, and after 2 and 15 weeks, STH infection was determined by Kato-Katz smears and by PCR assays for Ascaris lumbricoides. Clinical and anthropometric data, socio-economic status and factors potentially associated with STH infection were assessed. Soil-transmitted helminth (STH) infection was present in 38% of rural and in 13% of urban schoolchildren. Ascaris lumbricoides accounted for 96% of infections. Of these, one-third was detected by PCR exclusively. Factors associated with STH infection differed greatly between rural and urban children. Likewise, STH infection was associated with stunting and anaemia only among urban children. The cure rate after 2 weeks was 92%. Among eight non-cleared A. lumbricoides infections, seven were submicroscopic. Reinfection within 3 months occurred in 7%, but the rate was higher among rural children, and with initially present infection, particularly at comparatively high intensity. The rural-urban difference in factors associated with STH infection and in reinfection rates highlights the need for targeted interventions to reduce transmission. PCR assays may help in detecting low-level infections persisting after treatment. In southern Rwanda, mebendazole is highly effective against the STH infections predominated by A. lumbricoides. © 2014 John Wiley & Sons Ltd.

  5. Multicenter study on costs associated with two surgical procedures: GreenLight XPS 180 W versus the gold standard transurethral resection of the prostate.

    Science.gov (United States)

    Benejam-Gual, J M; Sanz-Granda, A; Budía, A; Extramiana, J; Capitán, C

    2014-01-01

    To analyze the costs associated with two surgical procedures for lower urinary tract symptoms secondary to benign prostatic hyperplasia: GreenLight XPS 180¦W versus the gold standard transurethral resection of the prostate. A multicenter, retrospective cost study was carried out from the National Health Service perspective, over a 3-month time period. Costs were broken down into pre-surgical, surgical and post-surgical phases. Data were extracted from records of patients operated sequentially, with IPSS=15, Qmax=15 mL/seg and a prostate volume of 40-80mL, adding only direct healthcare costs (€, 2013) associated with the procedure and management of complications. A total of 79 patients sequentially underwent GL XPS (n: 39) or TURP (n: 40) between July and October, 2013. Clinical outcomes were similar (94.9% and 92.5%, GL XPS and TURP, respectively) without significant differences (P=.67). The average direct cost per patient was reduced by €114 in GL XPS versus TURP patients; the cost was higher in the surgical phase with GL XPS (difference: €1,209; P<.001) but was lower in the post-surgical phase (difference: €-1,351; P<.001). The GreenLight XPS 180-W laser system is associated with a reduction in costs with respect to transurethral resection of prostate in the surgical treatment of LUTS secondary to PBH. This reduction is due to a shorter inpatient length of stay that offsets the cost of the new technology. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

  6. Recommendations for the reporting of surgically resected specimens of renal cell carcinoma: the Association of Directors of Anatomic and Surgical Pathology.

    Science.gov (United States)

    Higgins, John P; McKenney, Jesse K; Brooks, James D; Argani, Pedram; Epstein, Jonathan I

    2009-04-01

    A checklist based approach to reporting the relevant pathologic details of renal cell carcinoma resection specimens improves the completeness of the report. Karyotypic evaluation of renal neoplasms has refined but also complicated their classification. The number of diagnostic possibilities has increased and the importance of distinguishing different tumor types has been underscored by dramatic variation in prognosis and the development of targeted therapies for specific subtypes. The increasing number of recognized renal neoplasms has implications for handling renal resection specimens. Furthermore, the prognostic significance of other features of renal neoplasms related to grade and stage has been demonstrated. This guideline for the handling of renal resection specimens will focus on problem areas in the evolving practice of diagnosis, grading, and staging of renal neoplasms. The accompanying checklist will serve to ensure that all necessary details of the renal resection specimen are included in the surgical pathology report.

  7. Obstruction of peritoneal dialysis catheter is associated with catheter type and independent of omentectomy: A comparative data analysis from a transplant surgical and a pediatric surgical department.

    Science.gov (United States)

    Radtke, Josephine; Schild, Raphael; Reismann, Marc; Ridwelski, Robert-Richard; Kempf, Caroline; Nashan, Bjoern; Rothe, Karin; Koch, Martina

    2018-04-01

    Peritoneal dialysis (PD) catheter occlusion is a common complication with up to 36% of catheter obstructions described in the literature. We present a comparison of complications and outcome after implantation of PD catheters in a transplant surgical and a pediatric surgical department. We retrospectively analyzed 154 PD catheters, which were implanted during 2009-2015 by transplant surgeons (TS, University Medical Center Hamburg-Eppendorf, Germany, n=85 catheters) and pediatric surgeons (PS, Charité University Medicine Berlin, Germany, n=69 catheters) in 122 children (median (range) age 3.0 (0.01-17.1) years) for acute (n=65) or chronic (n=89) renal failure. All catheters were one-cuffed or double-cuffed curled catheters, except that straight catheters were implanted into smaller children (n=19) by TS in Hamburg. Patient characteristics and operation technique did not differ between the departments. Peritonitis was the most common complication (33 catheters, 21.4%). Leakage (n=18 catheters, 11.7%) occurred more often in children weighing <10kg (p<0.001). The incidence of obstruction and dysfunction was significantly higher in catheters used in PS than catheters used in TS (30.4% vs. 11.8%, p=0.004). Omentectomy did not reduce the incidence of catheter obstruction (p=1.0). Perforation at the catheter tips was larger and appeared to be rougher in catheters used in PS than the catheters in TS. The type of catheter and presumably the type of perforation at the catheter tip may influence the incidence of peritoneal dialysis catheter obstruction. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Plastic ingestion in aquatic-associated bird species in southern Portugal.

    Science.gov (United States)

    Nicastro, Katy R; Lo Savio, Roberto; McQuaid, Christopher D; Madeira, Pedro; Valbusa, Ugo; Azevedo, Fábia; Casero, Maria; Lourenço, Carla; Zardi, Gerardo I

    2018-01-01

    Excessive use of plastics in daily life and the inappropriate disposal of plastic products are severely affecting wildlife species in both coastal and aquatic environments. Birds are top-predators, exposed to all threats affecting their environments, making them ideal sentinel organisms for monitoring ecosystems change. We set a baseline assessment of the prevalence of marine plastic litter affecting multi-species populations of aquatic birds in southern Portugal. By examining 160 stomach contents from 8 species of aquatic birds, we show that 22.5% were affected by plastic debris. Plastic was found in Ciconia ciconia, Larus fuscus and L. michahellis. Ciconia ciconia ingested the highest amount (number of items and total mass) of plastic debris. Polydimethylsiloxane (PDMS, silicones) was the most abundant polymer and was recorded only in C. ciconia. Plastic ingestion baseline data are of crucial importance to evaluate changes through time and among regions and to define management and conservation strategies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Detection of new southern SiO maser sources associated with Mira and symbiotic stars

    International Nuclear Information System (INIS)

    Allen, D.A.; Hall, P.J.; Norris, R.P.; Troup, E.R.; Wark, R.M.; Wright, A.E.

    1989-01-01

    In 1987 July the Parkes radio telescope was used to search for 43.12 GHz SiO maser emission from southern late-type stars. We report the discovery of such emission from 12 Mira-like systems, including the symbiotic star H1-36, and discuss the implications of our data for the symbiotic stars. We identify several M-type Mira variables with unusually low SiO/infrared flux ratios, but with present data are not able to discredit the correlation between the two parameters. In addition, we present line profiles for the only other known symbiotic maser, R Aqr, at unprecedented signal-to-noise ratio; these profiles show linearly polarized emission from several components of the source. (author)

  10. The epidemiologic transition of thalassemia and associated hemoglobinopathies in southern Taiwan.

    Science.gov (United States)

    Wang, Hui-Ching; Hsieh, Li-Ling; Liu, Yi-Chang; Hsiao, Hui-Hua; Lin, Shu-Kai; Tsai, Wen-Chan; Liu, Ta-Chih

    2017-02-01

    Since 1993, following the National Thalassemia Major Prevention Program and an increase in immigration and interracial marriages, especially in southern Taiwan, the distribution of hemoglobinopathies may have changed. This study investigates the epidemiologic transition of hemoglobinopathies. We analyzed 1870 specimens collected between 2003 and 2012 in southern Taiwan, used gap-polymerase chain reaction and PCR-restriction fragment length polymorphism-based methods, and confirmed genotypes of hemoglobinopathies by DNA sequencing. We found a 91% reduction in the incidence of thalassemia major compared with samples from between 1986 and 1995. The most common genotypes of α-thalassemia and α Hb variants were the SEA type (69.4%) and Hb Quong Sze (1.54%). The most common genotypes of β-thalassemia and β Hb variants were IVS-II-654 (46.2%) and Hb E (2.2%), respectively. Compared with studies performed in different areas of and time intervals in Taiwan, a higher prevalence of -α 3.7 , Hb Quong Sze, and Hb E and a lower prevalence of the SEA type were found in this study. However, the SEA type remained the most common genotype observed. In addition, an increasing number of cases with an -α 3.7 type carrier, Hb Quong Sze carrier, and G γ (A γ δβ)° were identified following a peak of interracial marriages between 2003 and 2005, reflecting a regional difference and the impact of interracial marriage. In conclusion, global migration and international marriage have changed the distribution of hemoglobinopathies in Taiwan. A more comprehensive prenatal screening for new immigrants with a longer follow-up is warranted.

  11. Formation of regolith-collapse sinkholes in southern Illinois: Interpretation and identification of associated buried cavities

    Science.gov (United States)

    Panno, S.V.; Wiebel, C.P.; Heigold, P.C.; Reed, P.C.

    1994-01-01

    Three regolith-collapse sinkholes formed near the Dongola Unit School and the Pentecostal Church in the southern Illinois village of Dongola (Union County) during the spring of 1993. The sinkholes appeared over a three-month period that coincided with development of a new municipal well. The new well was drilled through clay-rich, valley-fill sediment into karstified limestone bedrock. The piezometric surface of the limestone aquifer is above land surface, indicating the presence of an upward hydraulic gradient in the valley and that the valley fill is acting as a confining unit. Pumping during development of the well lowered the piezometric surface of the limestone aquifer to an elevation below the base of the valley fill. It is hypothesized that drainage of water from the sediments, the resulting loss of hydrostatic pressure and buoyant force in overlying sediments, increased intergranular pressure, and the initiation of groundwater flow toward the well resulted in rapid sediment transport, subsurface erosion, and collapse of the valley-fill sediment. The sinkholes follow an approximately east-west alignment, which is consistent with one of the two dominant alignments of passages of nearby joint-controlled caves. A constant electrode-separation resistivity survey of the school playground was conducted to locate areas that might contain incipient sinkholes. The survey revealed a positive resistivity anomaly trending N75E in the southern part of the study area. The anomaly is linear, between 5 and 10 m wide, and its trend either intersects or is immediately adjacent to the three sinkholes. The anomaly is interpreted to be a series of pumping-induced cavities in the valley-fill sediments that formed over a preexisting crevice in the karstified bedrock limestone. ?? 1994 Springer-Verlag.

  12. Assessment of patient’s anxiety and expectation associated with hemodynamic changes during surgical procedure under local anesthesia

    Directory of Open Access Journals (Sweden)

    Marcos Vinícius Mendes DANTAS

    Full Text Available Abstract Introduction The dental patient’s anxiety and expectation may significantly alter their vital signs. The use of local anesthetics associated with a vasoconstrictor may also alter the vital signs of these patients, promoting hemodynamic changes that may result in emergency situations. Objective To evaluate the influence of anxiety of patients submitted to third molar extraction and the use of different anesthetic substances with adrenaline on their vital signs (oxygen saturation, heart rate, and systolic and diastolic blood pressure in different moments. Material and method Forty patients answered the questionnaire of the Dental Anxiety Scale (Corah’s Scale and fear (KleinKnecht’s Scale and were submitted to third molar extraction in two surgical times for the use of articaine or mepivacaine, both associated with adrenaline. The results were analyzed by ANOVA followed by Tukey post hoc test, Student's t test, and Pearson's correlation coefficients (α=0.05. Result There was no significant differences in saturation or heart rate. The blood pressure showed significant variations during time for both anesthetics, however mepivacaine resulted in a longer postoperative time to restore blood pressure. Patients with high or moderate anxiety and high fear index were those who had positive correlations with the highest blood pressure values. Conclusion Anxiety and fear positively influence the increase in blood pressure. Mepivacaine promoted a greater resistance to the return of normal vital signs, especially blood pressure levels.

  13. Perioperative Allogeneic Red Blood-Cell Transfusion Associated with Surgical Site Infection After Total Hip and Knee Arthroplasty.

    Science.gov (United States)

    Everhart, Joshua S; Sojka, John H; Mayerson, Joel L; Glassman, Andrew H; Scharschmidt, Thomas J

    2018-02-21

    Perioperative allogeneic red blood-cell transfusion is a suspected risk factor for surgical site infection (SSI) after total joint arthroplasty (TJA), but the interrelationships among SSI risk, transfusion dose, preoperative anemia, and the presence of coagulopathies have not been well described. Data on SSI within 1 year after surgery as well as on transfusion with blood products within 30 days after surgery were obtained for 6,788 patients who had undergone primary or revision total hip or knee arthroplasty from 2000 to 2011 in a single hospital system. Multivariate logistic regression modeling was used to determine the independent association between allogeneic red blood-cell transfusion and SSI. There was a dose-dependent association between allogeneic red blood-cell transfusion and SSI, with the infection rate increasing as the transfusion dose increased from 1 unit (odds ratio [OR] = 1.97; 95% confidence interval [CI] = 1.38, 2.79; p 3 units (OR = 7.40; CI = 4.91, 11.03; p conservation strategies. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

  14. Cost of surgical intervention for reconstructive therapy of HIV-associated facial lipoatrophy

    Directory of Open Access Journals (Sweden)

    Massella M

    2011-05-01

    Full Text Available M Massella¹, J Ivanovic², R Bellagamba², R De Vita³, L Fracasso³, V Tozzi², V Fragola¹, M Rizzica², P Narciso²¹Istituto Superiore Sanità, Rome, Italy; ²National Institute for Infectious Disease – Lazzaro Spallanzani, Rome, Italy; ³Regina Elena National Cancer Institute of Rome, ItalyAbstract: This study aims to assess direct cost of reconstructive interventions with facial fillers for treatment of HIV (human immunodeficiency virus-associated facial lipoatrophy (FLA. Evaluation was performed on data from patients enrolled in one arm of a comparative study of immediate versus delayed reconstructive treatment of facial lipoatrophy. Median costs were standardized for efficacy, estimated using data reported by physicians and patient reported outcomes. The variations of the results were evaluated with a sensitivity analysis. Evaluation was performed on 66 patients characterized by significant differences in terms of severity of FLA. Total cost resulted of €140,416.15, with a median cost per patient of €2126.04 (interquartile range [IQR]: 1599–2822. Taking into consideration severity of disease, median costs were €1641.67 (IQR: 1326.67–2126.04 and 2557.12 (IQR: 1939.34–2872.04 (P = 0.0 respectively for patients with low and high severity scores at baseline. Significant differences in term of cost-effectiveness ratios were also found between patients with different severity of FLA, and sensitivity analysis showed that these ratios increase with higher severity scores at baseline and vary widely depending on the costs of filler. Although these results cannot be considered representative because of important limitations, the present study suggests the severity of disease as an important determinant of costs.Keywords: dermal fillers, antiretroviral therapy, lipodystrophic syndrome, HAART

  15. Preoperative chemotherapy for T2 breast cancer is associated with improved surgical outcome.

    Science.gov (United States)

    Karanlik, H; Ozgur, I; Cabioglu, N; Sen, F; Erturk, K; Kilic, B; Onder, S; Deniz, M; Yavuz, E; Aydiner, A

    2015-09-01

    The aim of this study is to compare the clinical outcome in T2 breast cancer patients who underwent preoperative chemotherapy (PC) and who did not. The study also tried to define a subgroup of patients, who are more beneficial after PC in terms of lower re-excision rates, better cosmetic results and local recurrence free survival. 251 consecutive patients treated for nonmetastatic T2 invasive breast cancer were analyzed retrospectively. Of those; 141 underwent primary surgery (PS) followed by chemotherapy, whereas 110 were treated with combination of PC and surgery. The patients who were treated with PC had a significantly higher incidence of negative margins and lower rate of re-excision (5% vs. 16%, p = 0.02). Of all patients attempted breast conserving surgery (BCS), patients in the PC group were more likely to undergo BCS as their definitive operation compared to patients with PS group (BCS rates; PC group: 99% vs. PS group: 92%, p = 0.05). Multifocal disease (OR: 7, 95% Cl, 2.7-18.4, p = 0.0001) and PC (OR = 0.2; 95% CI, 0.06-0.72, p = 0.01) were factors associated with margin positivity in patients treated with BCS. There was no statistically significant difference in 5 year local-recurrence free survival rates between 2 groups. Our study shows that PC significantly decreases the re-excision in patients undergoing BCS with primary T2 breast tumors. This data suggests that any patient with a tumor greater than 2 cm might be considered for PC to increase BCS success with final negative margins. Copyright © 2015. Published by Elsevier Ltd.

  16. Association of pre-operative medication use with post-operative delirium in surgical oncology patients receiving comprehensive geriatric assessment.

    Science.gov (United States)

    Jeong, Young Mi; Lee, Eunsook; Kim, Kwang-Il; Chung, Jee Eun; In Park, Hae; Lee, Byung Koo; Gwak, Hye Sun

    2016-07-07

    Older patients undergoing surgery tend to have a higher frequency of delirium. Delirium is strongly associated with poor surgical outcomes. This study evaluated the association between pre-operative medication use and post-operative delirium (POD) in surgical oncology patients receiving comprehensive geriatric assessment (CGA). A total of 475 patients who were scheduled for cancer surgery and received CGA from January 2014 to June 2015 were included. Pre-operative medication review through CGA was conducted on polypharmacy (≥5 medications), delirium-inducing medications (DIMs), fall-inducing medications (FIMs), and potentially inappropriate medications (PIMs). POD was confirmed by psychiatric consultation, and DSM-V criteria were used for diagnosing delirium. The model fit of the prediction model was assessed by computing the Hosmer-Lemeshow goodness-of-fit test. Effect size was measured using the Nagelkerke R(2). Discrimination of the model was assessed by an analysis of the area under receiver operating curve (AUROC). Two models were constructed for multivariate analysis based on univariate analysis; model I included dementia and DIM in addition to age and sex, and model II included PIM instead of DIM of model I. Every one year increase of age increased the risk of POD by about 1.1-fold. DIM was a significant factor for POD after adjusting for confounders (AOR 12.78, 95 % CI 2.83-57.74). PIM was also a significant factor for POD (AOR 5.53, 95 % CI 2.03-15.05). The Hosmer-Lemeshow test results revealed good fits for both models (χ(2) = 3.842, p = 0.871 for model I and χ(2) = 8.130, p = 0.421 for model II). The Nagelkerke R(2) effect size and AUROC for model I was 0.215 and 0.833, respectively. Model II had the Nagelkerke R(2)effect size of 0.174 and AUROC of 0.819. These results suggest that pharmacists' comprehensive review for pre-operative medication use is critical for the post-operative outcomes like delirium in older patients.

  17. Climatic Sensitivity of a Mixed Forest Association of White Spruce and Trembling Aspen at Their Southern Range Limit

    Directory of Open Access Journals (Sweden)

    Sophan Chhin

    2016-10-01

    Full Text Available Climatic sensitivity of white spruce (Picea glauca (Moench Voss was examined growing in association with trembling aspen (Populus tremuloides Michx. at their southern limit of distribution in a transitional ecotone between the southern boreal forest and northern prairie region. The study was carried out in the Spruce Woods Provincial Park (SWPP located in southwestern Manitoba, Canada. The dry regional climate restricted trembling aspen growth during the growing season via moisture deficiency and temperature induced drought stress. Warm, mild winters also negatively affected radial growth of trembling aspen. Growth of white spruce was moderated by conditions within the aspen stands as radial growth patterns showed low variability from year to year, a low common growth signal, and a stronger response to temperature than to precipitation. Nonetheless, the dry regional climate still restricted growth of white spruce during the growing season via temperature induced drought stress. The findings of the study for white spruce support the stress gradient hypothesis in which facilitative interactions between tree species are expected under harsher environmental conditions.

  18. State of the practice for pediatric surgery--career satisfaction and concerns. A report from the American Pediatric Surgical Association Task Force on Family Issues.

    Science.gov (United States)

    Katz, Aviva; Mallory, Baird; Gilbert, James C; Bethel, Colin; Hayes-Jordan, Andrea A; Saito, Jacqueline M; Tomita, Sandra S; Walsh, Danielle S; Shin, Cathy E; Wesley, John R; Farmer, Diana

    2010-10-01

    There has been increasing interest and concern raised in the surgical literature regarding changes in the culture of surgical training and practice, and the impact these changes may have on surgeon stress and the appeal of a career in surgery. We surveyed pediatric surgeons and their partners to collect information on career satisfaction and work-family balance. The American Pediatric Surgical Association Task Force on Family Issues developed separate survey instruments for both pediatric surgeons and their partners that requested demographic data and information regarding the impact of surgical training and practice on the surgeon's opportunity to be involved with his/her family. We found that 96% of pediatric surgeons were satisfied with their career choice. Of concern was the lack of balance, with little time available for family, noted by both pediatric surgeons and their partners. The issues of work-family balance and its impact on surgeon stress and burnout should be addressed in both pediatric surgery training and practice. The American Pediatric Surgical Association is positioned to play a leading role in this effort. Copyright © 2010 Elsevier Inc. All rights reserved.

  19. Seroprevalence and risk factors associated with Babesia caballi and Theileria equi infections in donkeys from Southern Italy.

    Science.gov (United States)

    Piantedosi, D; D'Alessio, N; Di Loria, A; Di Prisco, F; Mariani, U; Neola, B; Santoro, M; Montagnaro, S; Capelli, G; Veneziano, V

    2014-12-01

    Equine piroplasmosis (EP) has been frequently described in donkeys in subtropical and tropical regions, but published data reflecting large scale surveys are very limited in Europe. The seroprevalence of Babesia caballi and Theileria equi was determined in a donkey population from Campania Region in Southern Italy using a commercial indirect fluorescent antibody test (IFAT), and the risk factors associated with the occurrence of the infection were assessed. Of 203 samples, the overall seroprevalence for EP was 57.1% (116/203), with 35.5% (72/203) for B. caballi and 44.3% (90/203) for T. equi. Co-infection was detected in 46 donkeys (22.6%). The distribution of IFAT antibody titres to B. caballi was: 1:80 (n= 67), 1:160 (n= 2), 1:320 (n= 3); while the distribution of IFAT antibody titres to T. equi was: 1:80 (n= 25), 1:160 (n= 42), 1:320 (n= 12), 1:640 (n= 8), 1:1280 (n= 3). All examined donkeys were asymptomatic, except one adult male (with a titre of 1:640 against T. equi) that showed clinical signs corresponding to the acute stage of EP, reported for the first time in Italy. The unique risk factor associated with a higher B. caballi seroprevalence was the presence of horses in the farms, while risk factors associated with a higher T. equi seroprevalence were poor body condition, presence of ruminants in the farms and milk production. The results indicate a high level of exposure in donkeys living in Southern Italy and suggest that donkeys may be an important reservoir of EP. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Basic airway skills acquisition using the American College of Surgeons/Association for Surgical Education medical student simulation-based surgical skills curriculum: Initial results.

    Science.gov (United States)

    Muratore, Sydne; Kim, Michael; Olasky, Jaisa; Campbell, Andre; Acton, Robert

    2017-02-01

    The ACS/ASE Medical Student Simulation-Based Skills Curriculum was developed to standardize medical student training. This study aims to evaluate the feasibility and validity of implementing the basic airway curriculum. This single-center, prospective study of medical students participating in the basic airway module from 12/2014-3/2016 consisted of didactics, small-group practice, and testing in a simulated clinical scenario. Proficiency was determined by a checklist of skills (1-15), global score (1-5), and letter grade (NR-needs review, PS-proficient in simulation scenario, CP-proficient in clinical scenario). A proportion of students completed pre/post-test surveys regarding experience, satisfaction, comfort, and self-perceived proficiency. Over 16 months, 240 students were enrolled with 98% deemed proficient in a simulated or clinical scenario. Pre/post-test surveys (n = 126) indicated improvement in self-perceived proficiency by 99% of learners. All students felt moderately to very comfortable performing basic airway skills and 94% had moderate to considerable satisfaction after completing the module. The ACS/ASE Surgical Skills Curriculum is a feasible and effective way to teach medical students basic airway skills using simulation. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Surgical smoke.

    Science.gov (United States)

    Fan, Joe King-Man; Chan, Fion Siu-Yin; Chu, Kent-Man

    2009-10-01

    Surgical smoke is the gaseous by-product formed during surgical procedures. Most surgeons, operating theatre staff and administrators are unaware of its potential health risks. Surgical smoke is produced by various surgical instruments including those used in electrocautery, lasers, ultrasonic scalpels, high speed drills, burrs and saws. The potential risks include carbon monoxide toxicity to the patient undergoing a laparoscopic operation, pulmonary fibrosis induced by non-viable particles, and transmission of infectious diseases like human papilloma virus. Cytotoxicity and mutagenicity are other concerns. Minimisation of the production of surgical smoke and modification of any evacuation systems are possible solutions. In general, a surgical mask can provide more than 90% protection to exposure to surgical smoke; however, in most circumstances it cannot provide air-tight protection to the user. An at least N95 grade or equivalent respirator offers the best protection against surgical smoke, but whether such protection is necessary is currently unknown.

  2. Spatial variation of dung beetle assemblages associated with forest structure in remnants of southern Brazilian Atlantic Forest

    Directory of Open Access Journals (Sweden)

    Pedro Giovâni da Silva

    2016-01-01

    Full Text Available The Brazilian Atlantic Forest is one of the world's biodiversity hotspots, and is currently highly fragmented and disturbed due to human activities. Variation in environmental conditions in the Atlantic Forest can influence the distribution of species, which may show associations with some environmental features. Dung beetles (Coleoptera: Scarabaeinae are insects that act in nutrient cycling via organic matter decomposition and have been used for monitoring environmental changes. The aim of this study is to identify associations between the spatial distribution of dung beetle species and Atlantic Forest structure. The spatial distribution of some dung beetle species was associated with structural forest features. The number of species among the sampling sites ranged widely, and few species were found in all remnant areas. Principal coordinates analysis indicated that species composition, abundance and biomass showed a spatially structured distribution, and these results were corroborated by permutational multivariate analysis of variance. The indicator value index and redundancy analysis showed an association of several dung beetle species with some explanatory environmental variables related to Atlantic Forest structure. This work demonstrated the existence of a spatially structured distribution of dung beetles, with significant associations between several species and forest structure in Atlantic Forest remnants from Southern Brazil. Keywords: Beta diversity, Species composition, Species diversity, Spatial distribution, Tropical forest

  3. Physical Activity-Related Injury and Its Associated Factors among Middle School Students in Southern China

    Directory of Open Access Journals (Sweden)

    Weicong Cai

    2018-06-01

    Full Text Available Physical activity (PA promotion is beneficial to gain and maintain optimal health, but might increase risks for physical activity-related injury (PARI. This cross-sectional study aimed to investigate the incidence rate and identify risk factors of PARI among Chinese middle school students. Selected via the method of cluster random sampling, students graded 7–8 (junior and 10–11 (senior from five middle schools (aged from 10 to 18 years old in Shantou were invited to participate in the survey. Information on socio-demography, PA involvement, sleep duration, individual safety awareness and exercise behavior, and PARI experiences in the past 12 month was collected. Multivariate logistic regression model was performed to estimate the risk factors of PARI. A total of 3082 participants completed the valid questionnaires, with an overall incidence rate of 25.1%. Boys, junior school students, sports team members, and those with lower safety awareness, living with single parent, and without any chronic conditions were at higher risks for PARI. Moreover, exercising on wet floor or with illness frequently would also be more likely to experience injury, especially those with at least 120 min per day. In conclusion, PARI was prevalent among middle school students in southern China. The above data provide insights that were focused and effective actions should be taken to prevent school-aged adolescents from PARI and maximize the benefits of PA.

  4. Implementation of central line-associated bloodstream infection prevention bundles in a surgical intensive care unit using peer tutoring.

    Science.gov (United States)

    Park, Sang-Won; Ko, Suhui; An, Hye-Sun; Bang, Ji Hwan; Chung, Woo-Young

    2017-01-01

    Central line-associated bloodstream infections (CLABSIs) can be prevented through well-coordinated, multifaceted programs. However, implementation of CLABSI prevention programs requires individualized strategies for different institutional situations, and the best strategy in resource-limited settings is uncertain. Peer tutoring may be an efficient and effective method that is applicable in such settings. A prospective intervention was performed to reduce CLABSIs in a surgical intensive care unit (SICU) at a tertiary hospital. The core interventions consisted of implementation of insertion and maintenance bundles for CLABSI prevention. The overall interventions were guided and coordinated by active educational programs using peer tutoring. The CLABSI rates were compared for 9 months pre-intervention, 6 months during the intervention and 9 months post-intervention. The CLABSI rate was further observed for three years after the intervention. The rate of CLABSIs per 1000 catheter-days decreased from 6.9 infections in the pre-intervention period to 2.4 and 1.8 in the intervention (6 m; P  = 0.102) and post-intervention (9 m; P  = 0.036) periods, respectively. A regression model showed a significantly decreasing trend in the infection rate from the pre-intervention period ( P  tutoring in a resource-limited setting was useful and effectively reduced CLABSIs. However, maintaining the reduced CLABSI rate will require further strategies.

  5. Perceived changes by peer group of social impact associated with combined orthodontic-surgical correction of class III malocclusion.

    Science.gov (United States)

    Jesani, Aliza; DiBiase, Andrew T; Cobourne, Martyn T; Newton, Timothy

    2014-09-01

    Whereas the psychosocial benefits of orthognathic treatment for the individual patient are established, there is little data relating to social perceptions in relation to changes in facial appearance as a result of combined orthodontic and orthognathic treatment. This study aimed to investigate the social impact of combined orthodontic-orthognathic surgical correction for class III malocclusion in Caucasian subjects. This cross-sectional study compared perceptions of facial appearance prior to and after orthognathic correction of class III malocclusion. Eighty undergraduate students were shown photographs of four Caucasian subjects (2 male and 2 female) pre- and post-orthognathic class III correction. Observers were asked to rate these subjects in relation to four different outcomes: (i) social competence (SC); (ii) intellectual ability (IA); (iii) psychological adjustment (PA); (iv) attractiveness. A mixed-model analysis of variance (ANOVA) was calculated to determine the effect of each variable. Statistically significant differences were found in ratings of the same face before and after treatment. After treatment, faces were rated as more psychologically adjusted, more sociable, more likely to be successful and more attractive; with the mean psychological adjustment rating being associated with the most change (before treatment=8.06 [SD 2.30]; after treatment=6.64 [SD 2.03], t=2.04, pclass III malocclusion in Caucasians, individuals are rated by young adults as being better adjusted both psychologically and socially, more likely to be successful and more attractive. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Factors associated with the healing of complex surgical wounds in the breast and abdomen: retrospective cohort study.

    Science.gov (United States)

    Borges, Eline Lima; Pires, José Ferreira; Abreu, Mery Natali Silva; Lima, Vera Lúcia de Araújo; Silva, Patrícia Aparecida Barbosa; Soares, Sônia Maria

    2016-10-10

    to estimate the healing rate of complex surgical wounds and its associated factors. retrospective cohort study from 2003 to 2014 with 160 outpatients of a Brazilian university hospital. Data were obtained through consultation of the medical records. Survival function was estimated using the Kaplan-Meier method and Cox regression model to estimate the likelihood of the occurrence of healing. the complex surgical wound healing rate was 67.8% (95% CI: 60.8-74.9). Factors associated with a higher likelihood of wound healing were segmentectomy/quadrantectomy surgery, consumption of more than 20 grams/day of alcohol, wound extent of less that 17.3 cm2 and the length of existence of the wound prior to outpatient treatment of less than 15 days, while the use of hydrocolloid covering and Marlex mesh were associated with a lower likelihood of healing. the wound healing rate was considered high and was associated with the type of surgical intervention, alcohol consumption, type of covering, extent and length of wound existence. Preventive measures can be implemented during the monitoring of the evolution of the complex surgical wound closure, with possibilities of intervention in the modifiable risk factors. estimar a taxa de cicatrização de ferida cirúrgica complexa e seus fatores associados. coorte retrospectiva de 2003 a 2014 com 160 pacientes ambulatoriais de um hospital universitário brasileiro. Os dados foram obtidos por meio de consulta aos prontuários médicos. Função de sobrevida foi estimada pelo método de Kaplan-Meier e modelo de regressão de Cox para estimação do risco de ocorrência da cicatrização. a taxa de cicatrização da ferida cirúrgica complexa foi 67,8% (IC 95%: 60,8-74,9). Os fatores associados a um maior risco de cicatrização da ferida foram cirurgia de setorectomia / quadrantectomia, consumo de mais de 20 gramas/dia de etanol, extensão da ferida menor que 17,3 cm2 e tempo de existência da ferida pré-tratamento ambulatorial inferior

  7. Chronic intravascular coagulation associated with chronic myelocytic leukemia. Use of heparin in connection with a surgical procedure.

    Science.gov (United States)

    German, H J; Smith, J A; Lindenbaum, J

    1976-10-01

    A women with Philadelphia chromosome-positive chronic myelocytic leukemia lived nearly 12 years from the time of diagnosis. During most of this period she received no therapy, and marked cyclic oscillations in the white blood cell count were documented. The last two years of her illness were marked by a hemorrhagic disorder associated with hypofibrinogenemia, thrombocytopenia, increased plasma fibrinopeptide A concentration and markedly elevated serum levels of fibrin degradation products. The coagulation disorder was rapidly reversible on several occasions with heparin therapy. After treatment with heparin and platelet transfusions, the patient underwent successful resection of a large ovarian cyst with excellent hemostasis during the procedure. Postoperatively, the administration of heparin and platelets was discontinued and a large wound hematoma developed. After resumption of therapy with heparin and platelets, the remainder of her postoperative course was uneventful. The literature on the subject is reviewed and tentative guidelines are offered concerning the management of patients with intravascular coagulation who require diagnostic or therapeutic surgical procedures.

  8. Comparative assessment of surgeons' task performance and surgical ergonomics associated with conventional and modified flank positions: a simulation study.

    Science.gov (United States)

    Fan, Yu; Kong, Gaiqing; Meng, Yisen; Tan, Shutao; Wei, Kunlin; Zhang, Qian; Jin, Jie

    2014-11-01

    Flank position is extensively used in retroperitoneoscopic urological practice. Most surgeons follow the patients' position in open approaches. However, surgical ergonomics of the conventional position in the retroperitoneoscopic surgery is poor. We introduce a modified position and evaluated task performance and surgical ergonomics of both positions with simulated surgical tasks. Twenty-one novice surgeons were recruited to perform four tasks: bead transfer, ring transfer, continuous suturing, and cutting a circle. The conventional position was simulated by setting an endo-surgical simulator parallel to the long axis of a surgical desk. The modified position was simulated by rotating the simulator 30° with respect to the long axis of the desk. The outcome measurements include task performance measures, kinematic measures for body alignment, surface electromyography, relative loading between feet, and subjective ratings of fatigue. We observed significant improvements in both task performance and surgical ergonomics parameters under the modified position. For all four tasks, subjects finished tasks faster with higher accuracy (p ergonomics part: (1) The angle between the upper body and the head was decreased by 7.4 ± 1.7°; (2) The EMG amplitude collected from shoulders and left lumber was significantly lower (p ergonomics. With a simulated surgery, we demonstrated that our modified position could significantly improve task performance and surgical ergonomics. Further studies are still warranted to validate these benefits for both patients and surgeons.

  9. The association between El Niño/Southern Oscillation events and typhoons in the Marshall Islands.

    Science.gov (United States)

    Spennemann, D H; Marschner, I C

    1995-09-01

    An analysis of the historic record of typhoons in the Marshall Islands has identified a significant association between the occurrence of the El Niño/Southern Oscillation phenomenon (ENSO) and the occurrence of typhoons in the Marshall Islands. Whilst typhoons normally occur further to the east, the warming of the ocean waters around the Marshall Islands, as part of the ENSO phenomenon, generates typhoons further to the west. The results suggest that typhoons are 2.6 times more likely to occur during ENSO years, with a 71 per cent chance of a typhoon striking during an ENSO year, and only a 26 per cent chance of one happening during a non-ENSO year. This has implications for planning and public safety, which the relevant authorities may wish to take note of.

  10. Surgical benefits of combined awake craniotomy and intraoperative magnetic resonance imaging for gliomas associated with eloquent areas.

    Science.gov (United States)

    Motomura, Kazuya; Natsume, Atsushi; Iijima, Kentaro; Kuramitsu, Shunichiro; Fujii, Masazumi; Yamamoto, Takashi; Maesawa, Satoshi; Sugiura, Junko; Wakabayashi, Toshihiko

    2017-10-01

    OBJECTIVE Maximum extent of resection (EOR) for lower-grade and high-grade gliomas can increase survival rates of patients. However, these infiltrative gliomas are often observed near or within eloquent regions of the brain. Awake surgery is of known benefit for the treatment of gliomas associated with eloquent regions in that brain function can be preserved. On the other hand, intraoperative MRI (iMRI) has been successfully used to maximize the resection of tumors, which can detect small amounts of residual tumors. Therefore, the authors assessed the value of combining awake craniotomy and iMRI for the resection of brain tumors in eloquent areas of the brain. METHODS The authors retrospectively reviewed the records of 33 consecutive patients with glial tumors in the eloquent brain areas who underwent awake surgery using iMRI. Volumetric analysis of MRI studies was performed. The pre-, intra-, and postoperative tumor volumes were measured in all cases using MRI studies obtained before, during, and after tumor resection. RESULTS Intraoperative MRI was performed to check for the presence of residual tumor during awake surgery in a total of 25 patients. Initial iMRI confirmed no further tumor resection in 9 patients (36%) because all observable tumors had already been removed. In contrast, intraoperative confirmation of residual tumor during awake surgery led to further tumor resection in 16 cases (64%) and eventually an EOR of more than 90% in 8 of 16 cases (50%). Furthermore, EOR benefiting from iMRI by more than 15% was found in 7 of 16 cases (43.8%). Interestingly, the increase in EOR as a result of iMRI for tumors associated mainly with the insular lobe was significantly greater, at 15.1%, than it was for the other tumors, which was 8.0% (p = 0.001). CONCLUSIONS This study revealed that combining awake surgery with iMRI was associated with a favorable surgical outcome for intrinsic brain tumors associated with eloquent areas. In particular, these benefits were

  11. Atmospheric circulation associated with extreme generalized frosts persistence in central-southern South America

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Gabriela V. [Centro de Investigaciones Cientificas y Transferencia de Tecnologia a la Produccion, Diamante (CICYTTTP-CONICET), Diamante, Entre Rios (Argentina); Berri, Guillermo J. [Servicio Meteorologico Nacional - CONICET, Buenos Aires (Argentina)

    2012-03-15

    Generalized frosts (GF) in central-southern South America have a strong impact due to their spatial extension, and they are especially important when they become persistent. This paper aims at identifying the atmospheric circulation features that determine the extreme GF persistence, i.e. very persistent and without persistence, and the differences between them, during the 1961-1990 winters. Since the GF without persistence group outnumbers the other one, two subgroups are composed with events selected from winters with maximum and minimum frequency of GF occurrence, respectively. Additionally, the individual event of July 1988 within the very persistent GF group is analyzed due to its exceptional persistence. GF persistence is mainly conditioned by two large-scale dynamic factors. One is the Rossby wave train propagation across the Pacific Ocean, and the other one is the location with respect to the continent and the magnitude of the confluence in the jet entrance region in subtropical latitudes. A predominantly meridional Rossby wave train propagation with a confluence region to the west of the continent prior to the event favors GF with intermediate (null) persistence depending on the greater (lesser) jet acceleration. This is conditioned by the magnitude of the confluence, which, in turn, depends on the disposition of the wave train propagation pattern. Instead, an essentially zonal propagation with a confluence region to the east of the continent favors the GF persistence for several days, yet if there is no confluence the event does not persist. The greatest persistence of an event combines the confluence/diffluence of the jet entrance/exit region, which depends on the disposition with respect to the continent of the zonally propagating Rossby wave trains. (orig.)

  12. Soil Carbon and Nutrient Changes Associated with Deforestation for Pasture in Southern Costa Rica

    Science.gov (United States)

    Huth, Timothy J.; Porder, Stephen; Chaves, Joaquin; Whiteside, Jessica H.

    2012-01-01

    We assessed the effects of deforestation on soil carbon (C) and nutrient stocks in the premontane landscape near Las Cruces Biological Station in southern Costa Rica, where forests were cleared for pasture in the mid-1960s. We excavated six soil pits to a depth of 1 m in both pasture and primary forest, and found that C stocks were 20 kg C per square meters in both settings. Nevertheless, soil delta C-13 suggests 50 percent of the forest-derived soil C above 40 cm depth has turned over since deforestation. Soil nitrogen (N) and phosphorus (P) stocks derived from the soil pits were not significantly different between land uses (P = 0.43 and 0.61, respectively). At a larger spatial scale, however, the ubiquity of ruts produced by cattle-induced erosion indicates that there are substantial soil effects of grazing in this steep landscape. Ruts averaged 13 cm deep and covered 45 percent of the landscape, and thus are evidence of the removal of 0.7 Mg C/ ha/yr, and 70, 9 and 40 kg/ha/yr of N, P and potassium (K), respectively. Subsoils in this region are 10 times less C- and N-rich, and 2 times less P- and K-rich than the topsoil. Thus, rapid topsoil loss may lead to a decline in pasture productivity in the coming decades. These data also suggest that the soil C footprint of deforestation in this landscape may be determined by the fate of soil C as it is transported downstream, rather than C turnover in situ.

  13. Differences in risk factors associated with surgical site infections following two types of cardiac surgery in Japanese patients.

    Science.gov (United States)

    Morikane, K; Honda, H; Yamagishi, T; Suzuki, S

    2015-05-01

    Differences in the risk factors for surgical site infection (SSI) following open heart surgery and coronary artery bypass graft surgery are not well described. To identify and compare risk factors for SSI following open heart surgery and coronary artery bypass graft surgery. SSI surveillance data on open heart surgery (CARD) and coronary artery bypass graft surgery (CBGB) submitted to the Japan Nosocomial Infection Surveillance (JANIS) system between 2008 and 2010 were analysed. Factors associated with SSI were analysed using univariate modelling analysis followed by multi-variate logistic regression analysis. Non-binary variables were analysed initially to determine the most appropriate category. The cumulative incidence rates of SSI for CARD and CBGB were 2.6% (151/5895) and 4.1% (160/3884), respectively. In both groups, the duration of the operation and a high American Society of Anesthesiologists' (ASA) score were significant in predicting SSI risk in the model. Wound class was independently associated with SSI in CARD but not in CBGB. Implants, multiple procedures and emergency operations predicted SSI in CARD, but none of these factors predicted SSI in CBGB. There was a remarkable difference in the prediction of risk for SSI between the two types of cardiac surgery. Risk stratification in CARD could be improved by incorporating variables currently available in the existing surveillance systems. Risk index stratification in CBGB could be enhanced by collecting additional variables, because only two of the current variables were found to be significant for the prediction of SSI. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  14. Efficacy of humidity retention bags for the reduced adsorption and improved cleaning of tissue proteins including prion-associated amyloid to surgical stainless steel surfaces.

    Science.gov (United States)

    Secker, T J; Pinchin, H E; Hervé, R C; Keevil, C W

    2015-01-01

    Increasing drying time adversely affects attachment of tissue proteins and prion-associated amyloid to surgical stainless steel, and reduces the efficacy of commercial cleaning chemistries. This study tested the efficacy of commercial humidity retention bags to reduce biofouling on surgical stainless steel and to improve subsequent cleaning. Surgical stainless steel surfaces were contaminated with ME7-infected brain homogenates and left to dry for 15 to 1,440 min either in air, in dry polythene bags or within humidity retention bags. Residual contamination pre/post cleaning was analysed using Thioflavin T/SYPRO Ruby dual staining and microscope analysis. An increase in biofouling was observed with increased drying time in air or in sealed dry bags. Humidity retention bags kept both protein and prion-associated amyloid minimal across the drying times both pre- and post-cleaning. Therefore, humidity bags demonstrate a cheap, easy to implement solution to improve surgical instrument reprocessing and to potentially reduce associated hospital acquired infections.

  15. Outbreak of hepatitis C virus infection associated with narcotics diversion by an hepatitis C virus–infected surgical technician

    Science.gov (United States)

    Warner, Amy E.; Schaefer, Melissa K.; Patel, Priti R.; Drobeniuc, Jan; Xia, Guoliang; Lin, Yulin; Khudyakov, Yury; Vonderwahl, Candace W.; Miller, Lisa; Thompson, Nicola D.

    2015-01-01

    Background Drug diversion by health care personnel poses a risk for serious patient harm. Public health identified 2 patients diagnosed with acute hepatitis C virus (HCV) infection who shared a common link with a hospital. Further investigation implicated a drug-diverting, HCV-infected surgical technician who was subsequently employed at an ambulatory surgical center. Methods Patients at the 2 facilities were offered testing for HCV infection if they were potentially exposed. Serum from the surgical technician and patients testing positive for HCV but without evidence of infection before their surgical procedure was further tested to determine HCV genotype and quasi-species sequences. Parenteral medication handling practices at the 2 facilities were evaluated. Results The 2 facilities notified 5970 patients of their possible exposure to HCV, 88% of whom were tested and had results reported to the state public health departments. Eighteen patients had HCV highly related to the surgical technician’s virus. The surgical technician gained unauthorized access to fentanyl owing to limitations in procedures for securing controlled substances. Conclusions Public health surveillance identified an outbreak of HCV infection due to an infected health care provider engaged in diversion of injectable narcotics. The investigation highlights the value of public health surveillance in identifying HCV outbreaks and uncovering a method of drug diversion and its impacts on patients. PMID:25442395

  16. Predictors associated with unplanned hospital readmission of medical and surgical intensive care unit survivors within 30 days of discharge.

    Science.gov (United States)

    Ohnuma, Tetsu; Shinjo, Daisuke; Brookhart, Alan M; Fushimi, Kiyohide

    2018-01-01

    Reducing the 30-day unplanned hospital readmission rate is a goal for physicians and policymakers in order to improve quality of care. However, data on the readmission rate of critically ill patients in Japan and knowledge of the predictors associated with readmission are lacking. We investigated predictors associated with 30-day rehospitalization for medical and surgical adult patients separately. Patient data from 502 acute care hospitals with intensive care unit (ICU) facilities in Japan were retrospectively extracted from the Japanese Diagnosis Procedure Combination (DPC) database between April 2012 and February 2014. Factors associated with unplanned hospital readmission within 30 days of hospital discharge among medical and surgical ICU survivors were identified using multivariable logistic regression analysis. Of 486,651 ICU survivors, we identified 5583 unplanned hospital readmissions within 30 days of discharge following 147,423 medical hospitalizations (3.8% readmitted) and 11,142 unplanned readmissions after 339,228 surgical hospitalizations (3.3% readmitted). The majority of unplanned hospital readmissions, 60.9% of medical and 63.1% of surgical case readmissions, occurred within 15 days of discharge. For both medical and surgical patients, the Charlson comorbidity index score; category of primary diagnosis during the index admission (respiratory, gastrointestinal, and metabolic and renal); hospital length of stay; discharge to skilled nursing facilities; and having received a packed red blood cell transfusion, low-dose steroids, or renal replacement therapy were significantly associated with higher unplanned hospital readmission rates. From patient data extracted from a large Japanese national database, the 30-day unplanned hospital readmission rate after ICU stay was 3.4%. Further studies are required to improve readmission prediction models and to develop targeted interventions for high-risk patients.

  17. Distance associated with marriage migration in a northern and a southern region of Bangladesh: an empirical study.

    Science.gov (United States)

    Rahman, Md Mizanur; Akter, Shamima; Rahman, Ataur

    2010-09-01

    This paper investigates the distribution of distance associated with marriage migration in the northern region of Rajshahi and the southern region of Khulna in Bangladesh. The study was conducted in 2007 on 2250 respondents who had migrated due to marriage. Of the wide variety of curves that fitted the distance-marriage/contact data, three are discussed: Pareto, exponential, and Pareto-exponential. Logistic regression models were used to identify the covariates of marriage distance migration. In general, the three functions work better for marriages, whereas Pareto-exponential functions are a superior fit for migrations and marriage distance. The models disclose that the distribution of distance is significantly associated with marriage migration (pPareto-exponential model was 100% stable and its shrinkage was 0.000000125. The main covariates associated with short-distance marriage migration were respondent's education, father's education and religion, whereas age at the time of marriage did not play a significant role in marriage migration. The risk of short-distance migration was greater in higher- than lower-educated Muslim families.

  18. Cannabinoid Type-1 Receptor Gene Polymorphisms Are Associated with Central Obesity in a Southern Brazilian Population

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    Janaína P. Jaeger

    2008-01-01

    Full Text Available The CB1 cannabinoid receptor and its endogenous ligands, the endocannabinoids, are involved in energy balance control, stimulating appetite and increasing body weight in wasting syndromes. Different studies have investigated the relationship between polymorphisms of the cannabinoid receptor 1 (CNR1 gene and obesity with conflicting results. In the present study, we investigated the 1359G/A (rs1049353, 3813A/G (rs12720071 and 4895A/G (rs806368 polymorphisms in the CNR1 gene in a Brazilian population of European descent. To verify the association between these variants and obesity-related traits in this population, 756 individuals were genotyped by PCR-RFLP methods. The 4895G allele was associated with waist to hip ratio (WHR (P = 0.014; P = 0.042 after Bonferroni correction. An additive effect with the GAA haplotype was associated with WHR (P = 0.028, although this statistical significance disappeared after Bonferroni correction (P = 0.084. No significant association was observed between the genotypes of the 1359G/A and 3813A/G polymorphisms and any of the quantitative variables investigated. Our findings suggest that CNR1 gene polymorphism is associated with central obesity in this Brazilian population of European ancestry.

  19. Association between primary headaches and depression in young adults in southern Brazil

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    Asdrubal Falavigna

    2013-12-01

    Full Text Available OBJECTIVE: To verify the association between depression and headache in young adults, as well as to identify the features of headache associated with depression and the influence of this mood disorder on headache-related disability. METHODS: A cross-sectional study with self-administered questionnaires about headache and depression was conducted at the Universidade de Caxias do Sul. Beck Depression Inventory (BDI and Migraine Disability Assessment (MIDAS were used to evaluate depressive symptoms and headache-related disability, respectively. Depression was considered if BDI > 15. RESULTS: A thousand and thirteen young adults were included in the study. A clear relationship was observed between headache and depression among the participants. Multivariate analyses demonstrated that nausea or vomiting related to headache and higher headacherelated disability scores were independent factors associated with depression. Migraine was more associated with depression than the other types of headache. CONCLUSION: The results demonstrate an association between headache and depression. Depressive symptoms are more likely to be found in young adults with more disabling headaches.

  20. Loop ileostomy versus total colectomy as surgical treatment for Clostridium difficile-associated disease: An Eastern Association for the Surgery of Trauma multicenter trial.

    Science.gov (United States)

    Ferrada, Paula; Callcut, Rachael; Zielinski, Martin D; Bruns, Brandon; Yeh, Daniel Dante; Zakrison, Tanya L; Meizoso, Jonathan P; Sarani, Babak; Catalano, Richard D; Kim, Peter; Plant, Valerie; Pasley, Amelia; Dultz, Linda A; Choudhry, Asad J; Haut, Elliott R

    2017-07-01

    The mortality of patients with Clostridium difficile-associated disease (CDAD) requiring surgery continues to be very high. Loop ileostomy (LI) was introduced as an alternative procedure to total colectomy (TC) for CDAD by a single-center study. To date, no reproducible results have been published. The objective of this study was to compare these two procedures in a multicentric approach to help the surgeon decide what procedure is best suited for the patient in need. This was a retrospective multicenter study conducted under the sponsorship of the Eastern Association for the Surgery of Trauma. Demographics, medical history, clinical presentation, APACHE score, and outcomes were collected. We used the Research Electronic Data Capture tool to store the data. Mann-Whitney (continuous data) and Fisher exact (categorical data) were used to compare TC with LI. Logistic regression was performed to determine predictors of mortality. A propensity score analysis was done to control for potential confounders and determine adjusted mortality rates by procedure type. We collected data from 10 centers of patients who presented with CDAD requiring surgery between July 1, 2010 and July 30, 2014. Two patients died during the surgical procedure, leaving 98 individuals in the study. The overall mortality was 32%, and 75% had postoperative complications. Median age was 64.5 years; 59% were male. Concerning preoperative patient conditions, 54% were on pressors, 47% had renal failure, and 36% had respiratory failure. When comparing TC and LI, there was no statistical difference regarding these conditions. Univariate preprocedure predictors of mortality were age, lactate, timing of operation, vasopressor use, and acute renal failure. There was no statistical difference between the APACHE score of patients undergoing either procedure (TC, 22 vs LI, 16). Adjusted mortality (controlled for preprocedure confounders) was significantly lower in the LI group (17.2% vs 39.7%; p = 0.002). This

  1. Morphology and processes associated with the accumulation of the fine-grained sediment deposit on the southern New England shelf

    Science.gov (United States)

    Twichell, David C.; McClennen, Charles E.; Butman, Bradford

    1981-01-01

    A 13,000 km2 area of the southern New England Continental Shelf which is covered by anomalously fine-grained sediment has been surveyed by means of high-resolution, seismic-reflection and side-scan sonar techniques to map its morphology and structure, and a near-bottom instrument system contributed to understanding present activity of the deposit. Seismic-reflection profiles show that the fine-grained deposit, which is as much as 13 m thick, has accumulated during the last transgression because it rests on a reflector that is geomorphically similar to and continuous with the Holocene transgressive sand sheet still exposed on the shelf to the west. The ridge and swale topography comprising the sand sheet on the shelf off New Jersey and Long Island are relict in origin as these same features are found buried under the fine sediment deposit. Southwestward migrating megaripples observed on the sonographs in the eastern part of the deposit are evidence that sediment is still actively accumulating in this area. In the western part of the deposit, where surface sediment is composed of silt plus clay, evidence of present sediment mobility consists of changes in the near-bottom, suspended-matter concentrations primarily associated with storms. Nantucket Shoals and Georges Bank are thought to be the sources for the fine-textured sediment. Storms and strong tidal currents in these shoal areas may still erode available fine-grained material, which then is transported westward by the mean drift to the southern New England Shelf, where a comparatively tranquil environment permits deposition of the fine material.

  2. Low-Frequency Earthquakes Associated with the Late-Interseismic Central Alpine Fault, Southern Alps, New Zealand

    Science.gov (United States)

    Baratin, L. M.; Chamberlain, C. J.; Townend, J.; Savage, M. K.

    2016-12-01

    Characterising the seismicity associated with slow deformation in the vicinity of the Alpine Fault may provide constraints on the state of stress of this major transpressive margin prior to a large (≥M8) earthquake. Here, we use recently detected tremor and low-frequency earthquakes (LFEs) to examine how slow tectonic deformation is loading the Alpine Fault toward an anticipated large rupture. We initially work with a continous seismic dataset collected between 2009 and 2012 from an array of short-period seismometers, the Southern Alps Microearthquake Borehole Array. Fourteen primary LFE templates are used in an iterative matched-filter and stacking routine. This method allows the detection of similar signals and establishes LFE families with common locations. We thus generate a 36 month catalogue of 10718 LFEs. The detections are then combined for each LFE family using phase-weighted stacking to yield a signal with the highest possible signal to noise ratio. We found phase-weighted stacking to be successful in increasing the number of LFE detections by roughly 20%. Phase-weighted stacking also provides cleaner phase arrivals of apparently impulsive nature allowing more precise phase and polarity picks. We then compute improved non-linear earthquake locations using a 3D velocity model. We find LFEs to occur below the seismogenic zone at depths of 18-34 km, locating on or near the proposed deep extent of the Alpine Fault. Our next step is to estimate seismic source parameters by implementing a moment tensor inversion technique. Our focus is currently on generating a more extensive catalogue (spanning the years 2009 to 2016) using synthetic waveforms as primary templates, with which to detect LFEs. Initial testing shows that this technique paired up with phase-weighted stacking increases the number of LFE families and overall detected events roughly sevenfold. This catalogue should provide new insight into the geometry of the Alpine Fault and the prevailing stress

  3. Prevention and diagnosis of ventilator-associated pneumonia: a survey on current practices in Southern Spanish ICUs.

    Science.gov (United States)

    Sierra, Rafael; Benítez, Encarnación; León, Cristóbal; Rello, Jordi

    2005-09-01

    To assess the implementation of selected ventilator-associated pneumonia (VAP) prevention strategies, and to learn how VAP is diagnosed in the ICUs of Southern Spain. Multicentric survey. The ICUs of 32 hospitals of the public health-care system of Southern Spain. Directors of ICUs. None. Twenty-eight ICUs (87.5%) returned completed questionnaires. Ventilator circuits were changed every 72 h or longer in 75% of ICUs. Use of heat and moisture exchangers and open endotracheal suction systems were reported in 96% of ICUs. Subglottic secretion drainage was never used, and 57% of ICUs checked endotracheal tube cuff pressure at least daily. Semi-recumbent position was common (93%), and 67.5% of ICUs used frequently noninvasive ventilation. Continuous enteral feeding was reported in all ICUs. Sedative infusions were usually interrupted every day in 11% of ICUs. Seventy-five percent of ICUs had specific guidelines for antibiotic therapy of VAP, but rotation of antibiotics was uncommon (11%). Twenty-nine percent of ICUs diagnosed VAP without microbiological confirmation. The most used technique for microbiologic diagnosis was qualitative culture of endotracheal aspirates (42.8%). The centers with a larger structural complexity reported using VAP therapy guidelines more frequently than the smaller centers, but they did not utilized bronchoscopic techniques for diagnosing VAP. Common prevention and diagnostic procedures in clinical practice, including large teaching institutions, significantly differed from evidence-based recommendations and reports by research groups of excellence. In addition, our study suggests that clinical practice for preventing and diagnosing VAP is variable and many opportunities exist to improve the care of patients receiving mechanical ventilation.

  4. Surgical Interventions for Organ and Limb Ischemia Associated With Primary and Secondary Antiphospholipid Antibody Syndrome With Arterial Involvement.

    Science.gov (United States)

    Hinojosa, Carlos A; Anaya-Ayala, Javier E; Bermudez-Serrato, Karla; García-Alva, Ramón; Laparra-Escareno, Hugo; Torres-Machorro, Adriana; Lizola, Rene

    2017-11-01

    The association of antiphospholipid antibody syndrome (APS) and hypercoagulability is well known. Arterial compromise leading to ischemia of organs and/or limbs in patients with APS is uncommon, frequently unrecognized, and rarely described. We evaluated our institutional experience. Retrospective review was conducted. From August 2007 to September 2016, 807 patients with diagnosis of APS were managed in our Institution. Patients with primary and secondary APS who required interventions were examined. Demographics, comorbidities, manifestations, procedures, complications, and other factors affecting outcomes were recorded. Fourteen patients (mean age 35 years old, standard deviation ±14) were evaluated and treated by our service. Six (43%) of them had primary APS and 8 (57%) had secondary APS; 11 (79%) were female. Two (14%) experienced distal aorta and iliac arteries involvement, 3 (21%) visceral vessels disease, 2 (14%) in upper and 7 (50%) in the lower extremity vasculatures. Thirteen (93%) patients underwent direct open revascularization and 1 with hand ischemia (Raynaud disease) underwent sympathectomy. During the mean follow-up period of 48 months, reinterventions included a revision of the proximal anastomosis of an aortobifemoral bypass graft, 1 (7%) abdominal exploration for bleeding, 1 (7%) graft thrombectomy, and 4 (29%) amputations (2 below the knee, 1 above the knee, and 1 transmetatarsal). One (7%) death occurred secondary to sepsis in a patient who had acute mesenteric ischemia. Significant differences in clinical manifestations and outcomes were not observed among patients with primary and secondary APS. All patients remained on systemic anticoagulation. APS is a prothrombotic disorder that may lead to arterial involvement with less frequency than the venous circulation but has significant morbidity and limb loss rate. Arterial reconstruction seems feasible in an attempt to salvage organs and limbs; however, research is necessary to establish the

  5. Cultural values associated with substance use among Hispanic emerging adults in Southern California.

    Science.gov (United States)

    Escobedo, Patricia; Allem, Jon-Patrick; Baezconde-Garbanati, Lourdes; Unger, Jennifer B

    2018-02-01

    Hispanic emerging adults are a priority population for substance use prevention, yet few studies have examined whether traditional Hispanic cultural values serve as risk or protective factors for substance use among emerging adults. This study examined the relationship between familism, respeto, fatalism, and substance use among Hispanic emerging adults. Participants (ages 18 to 25) completed surveys indicating identification with familism, respeto, and fatalism, past month use of tobacco, marijuana, hard drugs and binge drinking. Separate logistic regression models examined the association between cultural values and each substance use outcome, controlling for acculturation, age and gender. Among participants (n=1445, mean age=23, 60% female), 21% reported past month cigarette use, 18% reported past month alternative tobacco product (ATP) use, 25% reported past month marijuana use, 44% reported past month binge drinking, and 7% reported past month hard drug use. Higher fatalism scores were associated with increased ATP use. Higher familism scores were associated with binge drinking, while higher respeto scores were associated with decreased binge drinking, marijuana, and hard drug use. These findings suggest that substance use prevention and intervention programs should emphasize how substance use interferes with caring and honoring parents (respeto) and family cohesion and functioning (familism). Programs that highlight these cultural values and beliefs may be beneficial for Hispanic emerging adults and members of other collectivistic cultures. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Respiratory symptoms and active tuberculosis in a prison in Southern Brazil: associated epidemiologic variables

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    Jeane Zanini Rocha

    2013-10-01

    Full Text Available Backgound and Objectives: This study is justified by the high TB prevalence in prisons, which constitutes a public health problem and aims to estimate the prevalence of active tuberculosis (TB and determine the variables associated with respiratory symptoms in a prison in Brazil. Methods: This is a descriptive study of 262 inmates divided into respiratory symptomatic and asymptomatic groups. Samples were evaluated by microscopy following the cultivation of the sputum from symptomatic individuals. Associated epidemiological variables were also evaluated. Results: Among the 262 inmates included, 178 (68% were considered symptomatic, and of these, 25 (14% were diagnosed with active TB. The contribution of culturing in the detection of TB cases was 48%. The prevalence of active TB was 9,542/100.000. Low educational level, use of drugs and alcohol, prison recidivism, and previous TB and HIV-positive status were associated with the presence of respiratory symptoms. Being male, single, black, a prison recidivist, an alcoholic and HIV-seropositive was associated with the development of TB. The rate of TB/HIV co infection was 60%. The outcome was death in 12% of patients. Drug therapy interruption was reported by 96% of patients. Conclusions: The studied population showed a high prevalence of TB and TB/HIV co-infection. In addition, the rates of drug therapy interruption and mortality were alarmingly elevated. KEYWORDS: Epidemiology. Tuberculosis. Coinfections. HIV infection. Prisons.

  7. The incidence and clinical associated factors of interval colorectal cancers in Southern Taiwan

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    Cheng-En Tsai

    2018-03-01

    Conclusion: The prevalence of interval CRC in the present study is 3.28%. Comorbidity with ESRD and shorter ascending colon withdrawal time could be factors associated with interval CRC. Good colon preparation for the patients with ESRD and more ascending colon withdrawal time could reduce the interval CRC.

  8. Prevalence of anemia and associated factors among pregnant women in Southern Ethiopia: A community based cross-sectional study

    Science.gov (United States)

    Lebso, Meaza; Loha, Eskindir

    2017-01-01

    Background Anemia is defined as a condition in which there is less than the normal hemoglobin (Hb) level in the body. During pregnancy; iron deficiency is associated with multiple adverse outcomes for both mother and infant. Most of the studies conducted in Ethiopia on anemia during pregnancy were conducted at institution level and associated factors are not well studied and documented. Independent factors like, food security status, dietary diversity and intestinal parasites infection were considered by only a few of them. Hence, the aim of this study was to determine the prevalence of anemia and associated factors among pregnant women in Lemo District, Southern Ethiopia. Methods Community based cross- sectional study was conducted from May-June 2015. Multistage sampling was used to include 507 study participants. Anaemia was diagnosed using HemoCue HB 301 and haemoglobin concentration anemia. Results The prevalence of anemia was 23.2% (95% CI: 19.5%-26.9%). Factors associated with anemia were: low socio-economic status (AOR = 2.03, 95% CI: 1.11–3.69), trimester second (AOR = 3.09, 95%CI: 1.41–6.79) and third (AOR = 3.68, 95% CI: 1.67–8.08), gravidity three to five (AOR = 1.78, 95% CI: 1.03–3.07) and six and above (AOR = 2.59, 95%CI: 1.37–4.92), not supplemented with iron (AOR = 1.72, 95% CI: 1.02–2.91), low dietary diversity score (AOR = 3.18, 95% CI: 1.37–7.37) and hookworm infection (AOR = 2.69, 95%CI: 1.34–5.39). Conclusion Anemia has moderate public health significance in the area. Community-based interventions should be enhanced considering the identified associated factors. PMID:29228009

  9. Prevalence of anemia and associated factors among pregnant women in Southern Ethiopia: A community based cross-sectional study.

    Science.gov (United States)

    Lebso, Meaza; Anato, Anchamo; Loha, Eskindir

    2017-01-01

    Anemia is defined as a condition in which there is less than the normal hemoglobin (Hb) level in the body. During pregnancy; iron deficiency is associated with multiple adverse outcomes for both mother and infant. Most of the studies conducted in Ethiopia on anemia during pregnancy were conducted at institution level and associated factors are not well studied and documented. Independent factors like, food security status, dietary diversity and intestinal parasites infection were considered by only a few of them. Hence, the aim of this study was to determine the prevalence of anemia and associated factors among pregnant women in Lemo District, Southern Ethiopia. Community based cross- sectional study was conducted from May-June 2015. Multistage sampling was used to include 507 study participants. Anaemia was diagnosed using HemoCue HB 301 and haemoglobin concentration pregnancy, family planning before pregnancy, deworming, gravidity, iron intake in current pregnancy and soil transmitted helminthes on dependent variable anemia. The prevalence of anemia was 23.2% (95% CI: 19.5%-26.9%). Factors associated with anemia were: low socio-economic status (AOR = 2.03, 95% CI: 1.11-3.69), trimester second (AOR = 3.09, 95%CI: 1.41-6.79) and third (AOR = 3.68, 95% CI: 1.67-8.08), gravidity three to five (AOR = 1.78, 95% CI: 1.03-3.07) and six and above (AOR = 2.59, 95%CI: 1.37-4.92), not supplemented with iron (AOR = 1.72, 95% CI: 1.02-2.91), low dietary diversity score (AOR = 3.18, 95% CI: 1.37-7.37) and hookworm infection (AOR = 2.69, 95%CI: 1.34-5.39). Anemia has moderate public health significance in the area. Community-based interventions should be enhanced considering the identified associated factors.

  10. Modic changes and associated features in Southern European chronic low back pain patients.

    Science.gov (United States)

    Arana, Estanislao; Kovacs, Francisco M; Royuela, Ana; Estremera, Ana; Asenjo, Beatriz; Sarasíbar, Helena; Amengual, Guillermo; Galarraga, Isabel; Alonso, Ana; Casillas, Carlos; Muriel, Alfonso; Montoya, Julia; Ordóñez, Cristina; Martínez, Carmen; Zamora, Javier; Campillo, Carlos; Abraira, Víctor

    2011-05-01

    Conflicting reports exist regarding the prevalence of Modic changes among low back pain (LBP) patients and factors associated with their existence. To assess the prevalence of Modic changes and other findings on lumbar magnetic resonance imaging (MRI) among Spanish adult chronic LBP patients and the patient characteristics and radiological findings associated with Modic changes. A cross-sectional imaging study among chronic LBP patients. Four hundred eighty-seven patients (263 women and 224 men) undergoing lumbar spine MRI examination for chronic LBP. Gender, age, body mass index (BMI), lifetime smoking exposure, degree of physical activity, and image features (disc degeneration, type and extension of Modic changes, disc contour, annular tears, spinal stenosis, and spondylolisthesis). Ten radiologists from six hospitals across six cities in Spain consecutively recruited adult patients in whom lumbar MRI had been prescribed for LBP lasting ≥3 months. Patients' characteristics and imaging findings were assessed through previously validated instruments. A multivariate logistic regression model was developed to assess the features associated with Modic changes. Modic changes were found in 81% of the patients. The most common was Type II (51.3%), affecting only the end plate. Variables associated with Type I changes were disc contour abnormalities, spondylolisthesis, and disc degeneration. The same variables were associated with a higher risk of Type II or any type of Modic changes, as well as being male, and having a higher BMI. Modic changes are found in 81% (95% confidence interval, 77-85) of adult Spanish patients in whom an MRI is prescribed for chronic LBP. Modic changes are more likely to be found in males with a high BMI, who also show disc contour abnormalities, spondylolisthesis, or disc degeneration. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. An illustrated key to powder post beetles (Coleoptera, Bostrichidae associated with rubberwood in Thailand, with new records and a checklist of species found in Southern Thailand

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    Wisut Sittichaya

    2009-10-01

    Full Text Available An illustrated key to seventeen species of Bostrichidae recorded in association with rubberwood in Thailand is provided. A checklist is given of nine species infesting rubberwood sawn timber in sawmills in southern Thailand, with information on distribution, host trees and biology. Three species are recorded for the first time from Thailand: Cephalotoma tonkinea Lesne, Lyctoxylon dentatum (Pascoe, and Minthea reticulata Lesne.

  12. Association of apolipoprotein E polymorphism with plasma lipids and Alzheimer's disease in a Southern Brazilian population

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    de-Andrade F.M.

    2000-01-01

    Full Text Available Apolipoprotein E (protein: apo E; gene: APOE plays an important role in the multifactorial etiology of both Alzheimer's disease (AD and lipid level concentrations. The polymerase chain reaction (PCR was used to investigate the APOE gene polymorphism in 446 unrelated Caucasians, among them 23 AD patients, and 100 Afro-Brazilians living in Porto Alegre, Brazil. The frequencies of the APOE*2, APOE*3 and APOE*4 alleles were 0.075, 0.810 and 0.115 in Caucasians and 0.075, 0.700 and 0.225 in Afro-Brazilians, respectively (c2 = 8.72, P = 0.013. A highly significant association was observed between the APOE*4 allele and AD in this population-based sample. The APOE*4 frequency in AD patients (39% was about four times higher than in the general Caucasian population (11.5%. The influence of each of the three common APOE alleles on lipid traits was evaluated by the use of the average excess statistic. The E*2 allele is associated with lower levels of triglycerides and of total and non-HDL cholesterol in both men and women. Conversely, the E*4 allele is associated with higher levels of these traits in women only. The effect of APOE alleles was of greater magnitude in women.

  13. Surgical Instrument Sets for Special Operations Expeditionary Surgical Teams.

    Science.gov (United States)

    Hale, Diane F; Sexton, Justin C; Benavides, Linda C; Benavides, Jerry M; Lundy, Jonathan B

    The deployment of surgical assets has been driven by mission demands throughout years of military operations in Iraq and Afghanistan. The transition to the highly expeditious Golden Hour Offset Surgical Transport Team (GHOST- T) now offers highly mobile surgical assets in nontraditional operating rooms; the content of the surgical instrument sets has also transformed to accommodate this change. The 102nd Forward Surgical Team (FST) was attached to Special Operations assigned to southern Afghanistan from June 2015 to March 2016. The focus was to decrease overall size and weight of FST instrument sets without decreasing surgical capability of the GHOST-T. Each instrument set was evaluated and modified to include essential instruments to perform damage control surgery. The overall number of main instrument sets was decreased from eight to four; simplified augmentation sets have been added, which expand the capabilities of any main set. The overall size was decreased by 40% and overall weight decreased by 58%. The cardiothoracic, thoracotomy, and emergency thoracotomy trays were condensed to thoracic set. The orthopedic and amputation sets were replaced with an augmentation set of a prepackaged orthopedic external fixator set). An augmentation set to the major or minor basic sets, specifically for vascular injuries, was created. Through the reorganization of conventional FST surgical instrument sets to maintain damage control capabilities and mobility, the 102nd GHOST-T reduced surgical equipment volume and weight, providing a lesson learned for future surgical teams operating in austere environments. 2017.

  14. [Prevalence of wheezing and associated factors in Guarani indigenous children hospitalized for acute respiratory infections in Southern and Southeastern Brazil].

    Science.gov (United States)

    Souza, Patrícia Gomes de; Cardoso, Andrey Moreira; Sant Anna, Clemax Couto

    2014-07-01

    Prevalence of wheezing was studied in Guarani indigenous children hospitalized for acute lower respiratory tract infections in Southern and Southeastern Brazil, recruited by a surveillance routine established in villages from May 2007 to June 2008. Data were obtained from hospital records. Crude and adjusted prevalence ratios for wheezing were estimated according to categories of target variables, using Poisson regression with robust variance. Prevalence of wheezing was 58.1% (136/234). Risk factors that remained significantly associated with wheezing in the final model were: age bracket, inversely associated (0-11 months: reference; 24-35 months: 0.63, 95%CI: 0.40-0.99); hospitalization in the autumn (summer: reference; autumn: 1.58, 95%CI: 1.05-2.40); dyspnea (1.41, 95%CI: 1.09-1.83); chest indrawing (1.42, 95%CI: 1.16-1.73); crackles (1.43, 95%CI: 1.09-1.87). The results show a high disease burden related to wheezing and suggest the phenotype of early-onset persistent wheezing related to recurrence of viral respiratory infections.

  15. Prevalence and risk factors associated to Eimeria spp. infection in unweaned alpacas (Vicugna pacos) from Southern Peru.

    Science.gov (United States)

    Díaz, Pablo; Panadero, Rosario; López, Rosalía; Cordero, Aida; Pérez-Creo, Ana; López, Ceferino M; Fernández, Gonzalo; Díez-Baños, Pablo; Morrondo, Patrocinio

    2016-01-01

    A total of 350 faecal samples from unweaned alpacas over 3 months of age were collected from 23 herds in order to determine the prevalence of Eimeria spp. in Southern Peru and to identify the risk factors associated to Eimeria infection in young alpacas. Samples were examined by a flotation technique and the identification of risk factors was assessed by a logistic regression analysis. Sixty four percent of the examined animals shed Eimeria oocysts; herd prevalence was 96%, with an intra-herd prevalence of 60% (range 5.9-100%). Five different Eimeria species were identified, being E. lamae (91%), E. alpacae (87%) and E. punoensis (78%) the most prevalent; E. macusaniensis (35%) and E. ivitaensis (13%) were less common. Mixed-species infections were more frequent (78%) than single infections (22%). E. lamae was the most common monospecific infection and E. lamae/E. alpacae the most frequent association. The geographical area has a significant effect on Eimeria infection rates (74.9% wet Puna vs 37.4% dry Puna) as well as the breeding system (65.1% traditional vs 63.8% modern). In contrast, the sex of the animals (64.6% males vs 64.0% females) showed no influence on the prevalence of infection by Eimeria. The high prevalence found at both individual and herd level and the common presence of highly pathogenic Eimeria species may lead to important economic losses for alpaca breeders and could require the implementation of suitable control measures.

  16. Preseismic anomalies in soil-gas radon associated with 2016 M 6.6 Meinong earthquake, Southern Taiwan

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    Ching-Chou Fu

    2017-01-01

    Full Text Available Taiwan is tectonically situated in a terrain resulting from the oblique collision between the Philippine Sea plate and the continental margin of the Asiatic plate, with a continuous stress causing the density of strong-moderate earthquakes and regional active faults. The continuous time series of soil radon for earthquake studies have been recorded and some significant variations associated with strong earthquakes have been observed. Earthquake prediction is not still operative but these correlations should be added to the literature about seismo-geochemical transients associated to strong earthquakes. Rain-pore pressure related variations, crustal weakness at the studied faults system is consistent with the simultaneous radon anomalies observed. During the observations, a significant increase of soil radon concentrations was observed at Chunglun-T1 (CL-T1, Hsinhua (HH, Pingtung (PT, and Chihshan (CS stations approximately two weeks before the Meinong earthquake (ML = 6.6, 6 February 2016 in Southern Taiwan. The precursory changes in a multi-stations array may reflect the preparation stage of a large earthquake. Precursory signals are observed simultaneously and it can apply certain algorithms the approximate location and magnitude of the impending earthquake.

  17. Unexpected diversity and new species in the sponge-Parazoanthidae association in southern Japan.

    Science.gov (United States)

    Montenegro, Javier; Sinniger, Frederic; Reimer, James Davis

    2015-08-01

    Currently the genera Parazoanthus (family Parazoanthidae) and Epizoanthus (family Epizoanthidae) are the only sponge-associated zoantharians (Cnidaria, Anthozoa). The Parazoanthidae-sponge associations are widely distributed in tropical and subtropical waters from the intertidal to the deep sea in the Atlantic and Indo-Pacific Oceans. However, the taxonomic identification of both parties is often confused due to variable morphology and wide ecological ranges. In particular, Parazoanthidae species diversity remains poorly understood in the Indo-Pacific. In the present study, the diversity of the sponge-zoanthid association in the Indo-Pacific was investigated with 71 Parazoanthidae specimens collected from 29 different locations in Japan (n=22), Australia (n=6) and Florida, USA (n=1). For all specimens morphological analyses were performed and total DNA was extracted and amplified for four DNA markers (COI-mtDNA, mt 16S-rDNA, ITS-rDNA and ALG11-nuDNA). The combined data demonstrate that the specimens of this study are clearly different from those of all described Parazoanthus species, and lead us to erect Umimayanthus gen. n., within family Parazoanthidae, containing the three newly described species U. chanpuru sp. n., U. miyabi sp. n., U. nakama sp. n. The new genus also includes the previously described species U. parasiticus (Duchassaing and Michelotti, 1860; comb. nov.), previously belonging to the genus Parazoanthus. Neighbor joining, maximum likelihood and Bayesian posterior probability phylogenetic trees clearly demonstrate the monophyly of Umimayanthus gen. n. to the exclusion of all outgroup sequences. The phylogenetic results were also compared to morphological features, and polyp sizes, amount of sand content in tissues, types of connections between polyps, and cnidae data, in particular holotrichs-1, were useful in distinguishing the different species within this new genus. This new genus can be distinguished from all other Zoantharia by a unique and

  18. Unexpected diversity and new species in the sponge-Parazoanthidae association in southern Japan

    KAUST Repository

    Montenegro, Javier; Sinniger, Frederic; Reimer, James Davis

    2015-01-01

    © 2015 Elsevier Inc. Currently the genera Parazoanthus (family Parazoanthidae) and Epizoanthus (family Epizoanthidae) are the only sponge-associated zoantharians (Cnidaria, Anthozoa). The Parazoanthidae-sponge associations are widely distributed in tropical and subtropical waters from the intertidal to the deep sea in the Atlantic and Indo-Pacific Oceans. However, the taxonomic identification of both parties is often confused due to variable morphology and wide ecological ranges. In particular, Parazoanthidae species diversity remains poorly understood in the Indo-Pacific. In the present study, the diversity of the sponge-zoanthid association in the Indo-Pacific was investigated with 71 Parazoanthidae specimens collected from 29 different locations in Japan (n= 22), Australia (n= 6) and Florida, USA (n= 1). For all specimens morphological analyses were performed and total DNA was extracted and amplified for four DNA markers (COI-mtDNA, mt 16S-rDNA, ITS-rDNA and ALG11-nuDNA). The combined data demonstrate that the specimens of this study are clearly different from those of all described Parazoanthus species, and lead us to erect Umimayanthus gen. n., within family Parazoanthidae, containing the three newly described species U. chanpuru sp. n., U. miyabi sp. n., U. nakama sp. n. The new genus also includes the previously described species U. parasiticus (Duchassaing and Michelotti, 1860; comb. nov.), previously belonging to the genus Parazoanthus. Neighbor joining, maximum likelihood and Bayesian posterior probability phylogenetic trees clearly demonstrate the monophyly of Umimayanthus gen. n. to the exclusion of all outgroup sequences. The phylogenetic results were also compared to morphological features, and polyp sizes, amount of sand content in tissues, types of connections between polyps, and cnidae data, in particular holotrichs-1, were useful in distinguishing the different species within this new genus. This new genus can be distinguished from all other

  19. Unexpected diversity and new species in the sponge-Parazoanthidae association in southern Japan

    KAUST Repository

    Montenegro, Javier

    2015-08-01

    © 2015 Elsevier Inc. Currently the genera Parazoanthus (family Parazoanthidae) and Epizoanthus (family Epizoanthidae) are the only sponge-associated zoantharians (Cnidaria, Anthozoa). The Parazoanthidae-sponge associations are widely distributed in tropical and subtropical waters from the intertidal to the deep sea in the Atlantic and Indo-Pacific Oceans. However, the taxonomic identification of both parties is often confused due to variable morphology and wide ecological ranges. In particular, Parazoanthidae species diversity remains poorly understood in the Indo-Pacific. In the present study, the diversity of the sponge-zoanthid association in the Indo-Pacific was investigated with 71 Parazoanthidae specimens collected from 29 different locations in Japan (n= 22), Australia (n= 6) and Florida, USA (n= 1). For all specimens morphological analyses were performed and total DNA was extracted and amplified for four DNA markers (COI-mtDNA, mt 16S-rDNA, ITS-rDNA and ALG11-nuDNA). The combined data demonstrate that the specimens of this study are clearly different from those of all described Parazoanthus species, and lead us to erect Umimayanthus gen. n., within family Parazoanthidae, containing the three newly described species U. chanpuru sp. n., U. miyabi sp. n., U. nakama sp. n. The new genus also includes the previously described species U. parasiticus (Duchassaing and Michelotti, 1860; comb. nov.), previously belonging to the genus Parazoanthus. Neighbor joining, maximum likelihood and Bayesian posterior probability phylogenetic trees clearly demonstrate the monophyly of Umimayanthus gen. n. to the exclusion of all outgroup sequences. The phylogenetic results were also compared to morphological features, and polyp sizes, amount of sand content in tissues, types of connections between polyps, and cnidae data, in particular holotrichs-1, were useful in distinguishing the different species within this new genus. This new genus can be distinguished from all other

  20. Development of a Classification Scheme for Examining Adverse Events Associated with Medical Devices, Specifically the DaVinci Surgical System as Reported in the FDA MAUDE Database.

    Science.gov (United States)

    Gupta, Priyanka; Schomburg, John; Krishna, Suprita; Adejoro, Oluwakayode; Wang, Qi; Marsh, Benjamin; Nguyen, Andrew; Genere, Juan Reyes; Self, Patrick; Lund, Erik; Konety, Badrinath R

    2017-01-01

    To examine the Manufacturer and User Facility Device Experience Database (MAUDE) database to capture adverse events experienced with the Da Vinci Surgical System. In addition, to design a standardized classification system to categorize the complications and machine failures associated with the device. Overall, 1,057,000 DaVinci procedures were performed in the United States between 2009 and 2012. Currently, no system exists for classifying and comparing device-related errors and complications with which to evaluate adverse events associated with the Da Vinci Surgical System. The MAUDE database was queried for events reports related to the DaVinci Surgical System between the years 2009 and 2012. A classification system was developed and tested among 14 robotic surgeons to associate a level of severity with each event and its relationship to the DaVinci Surgical System. Events were then classified according to this system and examined by using Chi-square analysis. Two thousand eight hundred thirty-seven events were identified, of which 34% were obstetrics and gynecology (Ob/Gyn); 19%, urology; 11%, other; and 36%, not specified. Our classification system had moderate agreement with a Kappa score of 0.52. Using our classification system, we identified 75% of the events as mild, 18% as moderate, 4% as severe, and 3% as life threatening or resulting in death. Seventy-seven percent were classified as definitely related to the device, 15% as possibly related, and 8% as not related. Urology procedures compared with Ob/Gyn were associated with more severe events (38% vs 26%, p tool with moderate inter-rater agreement that can be used to better understand device-related adverse events. The majority of robotic related events were mild but associated with the device.

  1. Association between Maternal and Child Nutritional Status in Hula, Rural Southern Ethiopia: A Cross Sectional Study.

    Directory of Open Access Journals (Sweden)

    Canaan Negash

    Full Text Available Maternal and child under nutrition is highly prevalent in low-income and middle-income countries, resulting in substantial increases in mortality and overall disease burden. The aim of this baseline survey was to determine the association between selected maternal characteristics, maternal nutritional status and children's nutritional status.A survey with a cross sectional design was conducted between September and October 2012 in Hula, Ethiopia. The study subjects were 197 mothers of children between the ages of 6 and 23 months. Weight and height (mothers or recumbent length (children were measured using calibrated, standardized techniques. Seven percent of children were below -2 weight for height Z score (WHZ, 11.5% were below -2 height for age Z score (HAZ and 9.9% were below -2 weight for age Z score (WAZ. Maternal anthropometrics were associated with child nutritional status in the bivariate analysis. Maternal BMI (r = 0.16 P = 0.02 and educational status (r = 0.25 P = 0.001 were correlated with WHZ of children while maternal height (r = 0.2 P = 0.007 was correlated with HAZ of children. After multivariate analysis, children whose mothers had salary from employment had a better WHZ score (P = 0.001 and WAZ score (P<0.001. Both maternal BMI and maternal height were associated with WHZ (P = 0.04 and HAZ (P = 0.01 score of children.Having a mother with better nutritional status and salaried employment is a benefit for the nutritional status of the child. The interrelationship between maternal and child nutritional status stresses the value of improving maternal nutritional status as this should improve both maternal and child health outcomes. Therefore strategies to improve nutritional status of children should also include improving the nutritional status of the mother and empowering her financially.

  2. Cultural values associated with substance use among Hispanic adolescents in southern California.

    Science.gov (United States)

    Soto, Claradina; Unger, Jennifer B; Ritt-Olson, Anamara; Soto, Daniel W; Black, David Scott; Baezconde-Garbanati, Lourdes

    2011-01-01

    Cultural values can shape people's attitudes toward substance use and influence their risk of experimentation with drugs. This article examines the relationships between cultural values (familism, respeto, and machismo), fatalism (a culturally encouraged personality disposition), and substance use among Hispanic adolescents. In 2005, cross-sectional data were collected from 1,616 Hispanic ninth grade students in Los Angeles. Each cultural value was associated with lifetime substance use; however, these relationships depended on the type of substance and gender. Our findings suggest that it might be useful to incorporate the cultural values and address the personality trait of fatalism in prevention programs for Hispanic adolescents. The study's limitations are noted.

  3. Variation in cancer surgical outcomes associated with physician and nurse staffing: a retrospective observational study using the Japanese Diagnosis Procedure Combination Database

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    Yasunaga Hideo

    2012-05-01

    Full Text Available Abstract Background Little is known about the effects of professional staffing on cancer surgical outcomes. The present study aimed to investigate the association between cancer surgical outcomes and physician/nurse staffing in relation to hospital volume. Methods We analyzed 131,394 patients undergoing lung lobectomy, esophagectomy, gastrectomy, colorectal surgery, hepatectomy or pancreatectomy for cancer between July and December, 2007–2008, using the Japanese Diagnosis Procedure Combination database linked to the Survey of Medical Institutions data. Physician-to-bed ratio (PBR and nurse-to-bed ratio (NBR were determined for each hospital. Hospital volume was categorized into low, medium and high for each of six cancer surgeries. Failure to rescue (FTR was defined as a proportion of inhospital deaths among those with postoperative complications. Multi-level logistic regression analysis was performed to examine the association between physician/nurse staffing and FTR, adjusting for patient characteristics and hospital volume. Results Overall inhospital mortality was 1.8%, postoperative complication rate was 15.2%, and FTR rate was 11.9%. After adjustment for hospital volume, FTR rate in the group with high PBR (≥19.7 physicians per 100 beds and high NBR (≥77.0 nurses per 100 beds was significantly lower than that in the group with low PBR ( Conclusions Well-staffed hospitals confer a benefit for cancer surgical patients regarding reduced FTR, irrespective of hospital volume. These results suggest that consolidation of surgical centers linked with migration of medical professionals may improve the quality of cancer surgical management.

  4. Well-being and associated factors among elementary school teachers in southern Brazil

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    Mariane Lopez Molina

    Full Text Available ABSTRACT Purpose: to verify the prevalence of well-being and its association with sociodemographic features, health and work-related conditions, and vocal behavior in elementary school teachers in the city of Pelotas, RS. Methods: a cross-sectional observational study with 575 teachers from urban and rural areas. The participants answered a structured questionnaire that included items on sociodemographic, health and work-related conditions. The Faces Scale (Andrews was used to evaluate their psychological well-being. The Vocal Behavior Profile verified occurrences of abuse and vocal misuse. Poisson regression was used for the multivariate analysis. Results: of the total sample, 79.5% of teachers experienced well-being. It was observed that vocal behavior profile was significantly associated with well-being, and the number of students in the classroom showed a trend towards significance. Conclusion: most teachers had a satisfactory well-being perception. Moreover, a lower well-being perception in the teaching population was mainly related to abusive vocal behavior and, less clearly, to the high number of students per classroom.

  5. Factors associated with therapeutic success in HIV-positive individuals in southern Brazil.

    Science.gov (United States)

    Silveira, M P T; Maurer, P; Guttier, M C; Moreira, L B

    2015-04-01

    Therapeutic success is characterized by undetectable viral load, immune reconstitution confirmed by CD4+ T-cell count and no clinical manifestations of disease. High treatment adherence is a major determinant of therapeutic success that needs prevention of viral replication, allowing immune reconstitution. Adherence to treatment minimum wage (IQR 1·0-2·3). Therapeutic success was achieved by 90% (122 patients), and it was associated with previously undetectable viral load (PR = 1·30; 95% CI = 1·13-1·49) and treatment adherence prior to study entry (PR = 1·34; 95% CI = 1·07-1·69), independently of sex, age and previous immune status. When undetectable viral load, CD4+ cell count ≥200 cells/mm(3) and treatment adherence above 95% are included in the definition of therapeutic success, the rate was elevated (90%) and the factors associated were previous history of adherence to HAART and previous undetectable viral load. © 2014 John Wiley & Sons Ltd.

  6. Physical Exercise Practice and Associated Factors Among Undergraduate Students from a Southern Region of Brazil

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    Teixeira Marcio

    2016-12-01

    Full Text Available Purpose. The aim of the study was to analyse the prevalence and factors associated with not performing physical exercise in undergraduate students. Methods. The sample was composed of 2738 undergraduate students of Londrina city, Parana, Brazil. The dependent variables were: not performing physical exercise of moderate intensity for at least 30 minutes per week; not performing vigorous physical exercise for at least 20 minutes per week; not performing muscular strengthening exercises (8-12 repetitions in a week. The independent variables were gender, age, skin colour, marital status, housing, study pattern, year of course, paid work, and area of the course. Odds ratio (OR was estimated by multivariate analysis with the use of binary logistic regression. Results. The prevalence of undergraduate students not performing physical exercise of moderate intensity, of vigorous intensity, or muscular strengthening exercises was 47.3, 61.0, and 66.2%, respectively. Female sex was associated with a risk of not performing moderate physical exercise (OR = 1.23, vigorous physical exercise (OR = 1.47, and strengthening exercises (OR = 1.22. Undergraduate students of exact sciences (OR = 1.40 and 1.52, juridical sciences (OR = 1.48 and 1.51, and humanities (OR = 1.45 and 1.52 were at risk of not performing physical exercise of moderate or vigorous intensity, respectively. Being a 2nd (OR = 0.79, 3rd (OR = 0.74, or 4th (OR = 0.71 year student was bound with a lower likelihood of not performing physical exercise of moderate intensity. Conclusions. Intervention programmes with the aim of promoting physical exercise practice in undergraduate students should consider gender, year, and area of the course.

  7. Association between Maternal and Child Nutritional Status in Hula, Rural Southern Ethiopia: A Cross Sectional Study.

    Science.gov (United States)

    Negash, Canaan; Whiting, Susan J; Henry, Carol J; Belachew, Tefera; Hailemariam, Tewodros G

    2015-01-01

    Maternal and child under nutrition is highly prevalent in low-income and middle-income countries, resulting in substantial increases in mortality and overall disease burden. The aim of this baseline survey was to determine the association between selected maternal characteristics, maternal nutritional status and children's nutritional status. A survey with a cross sectional design was conducted between September and October 2012 in Hula, Ethiopia. The study subjects were 197 mothers of children between the ages of 6 and 23 months. Weight and height (mothers) or recumbent length (children) were measured using calibrated, standardized techniques. Seven percent of children were below -2 weight for height Z score (WHZ), 11.5% were below -2 height for age Z score (HAZ) and 9.9% were below -2 weight for age Z score (WAZ). Maternal anthropometrics were associated with child nutritional status in the bivariate analysis. Maternal BMI (r = 0.16 P = 0.02) and educational status (r = 0.25 P = 0.001) were correlated with WHZ of children while maternal height (r = 0.2 P = 0.007) was correlated with HAZ of children. After multivariate analysis, children whose mothers had salary from employment had a better WHZ score (P = 0.001) and WAZ score (Pchildren. Having a mother with better nutritional status and salaried employment is a benefit for the nutritional status of the child. The interrelationship between maternal and child nutritional status stresses the value of improving maternal nutritional status as this should improve both maternal and child health outcomes. Therefore strategies to improve nutritional status of children should also include improving the nutritional status of the mother and empowering her financially.

  8. Rhinosinusitis associated with post-dental extraction chronic oroantral fistula: outcomes of non-surgical management comprising antibiotics and local decongestion therapy.

    Science.gov (United States)

    Mishra, A K; Sinha, V R; Nilakantan, A; Singh, D K

    2016-06-01

    A non-surgical approach for managing rhinosinusitis associated with chronic oroantral fistula resulting from tooth extraction was evaluated. Twenty-six consecutive patients (15 males and 11 females) aged 28-72 years (mean, 49.81 years) were administered local decongestion therapy for 2 weeks and antibiotics for 10 days. Patients showing a reduction in Sino-Nasal Outcome Test 22 scores after two weeks continued to receive local decongestion therapy weekly for up to six weeks, while those not showing any improvement underwent surgical management. At 2 weeks, 17 patients (65.38 per cent) showed an improvement in rhinosinusitis (33.39 per cent mean reduction in Sino-Nasal Outcome Test 22 scores). The primary determinant of response was fistula size. At 6 weeks, sinusitis resolved completely in all 17 patients, and the fistula closed in 16 of these. Final Sino-Nasal Outcome Test 22 and Lund-Mackay scores showed no significant difference between the surgically treated and non-surgically treated groups. Local decongestion therapy along with antibiotics may promote resolution in this subset of rhinosinusitis patients.

  9. Completion publication of abstracts presented at the scientific meetings of the pan-African pediatric surgical association

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    Abdulrasheed A Nasir

    2013-01-01

    Full Text Available Background: The expected knowledge translation from discovery into practice occurs when presentations from major scientific meetings are published in peer-reviewed literature. The purpose of this study was to determine the extent of complete publication of peer-reviewed articles arising from presentations at the biennial meetings of the Pan-African Pediatric Surgical Association (PAPSA. Materials and Methods: All the abstracts accepted for presentation at the biennial meeting of PAPSA between 2006 and 2010 were identified from the conference abstract booklets and published abstracts in the African Journal of Paediatric Surgery. The presentations were searched for publication in Medline/PubMed, Google Scholar, and African Journal OnLine through October 2012, using key words from the abstract title and names of authors listed in the abstracts. Results: A total of 164 abstracts were accepted for presentation, consisting of 118 (72% oral/podium presentations and 46 (28% poster presentations. One hundred and thirty-three abstracts (81.1% came from African countries and 31 (18.9% from outside Africa. Overall, 49 (29.9% abstracts resulted in full-text publications in 20 peer-reviewed journals. Thirty-eight of the publications were from Africa (representing 28.6% of abstracts from Africa and 11 from outside Africa (33.3% of abstracts from outside Africa. The median time to publication was 15 months [interquartile range (IQR 5-26 months]. The publication rate was statistically significantly correlated to the year of publication (P = 0.016 and the use of comparative statistics in the study (P = 0.005, but not to the study design, study subjects, or institution. The majority of the studies were published in the African Journal of Paediatric Surgery and Pediatric Surgery International (14 and 11 of the 49 reports, respectively. The H-index for international abstracts (median 35, IQR 35-76 was significantly higher than that of African abstracts (14, 3-35 (P

  10. Implementation of central line-associated bloodstream infection prevention bundles in a surgical intensive care unit using peer tutoring

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    Sang-Won Park

    2017-10-01

    Full Text Available Abstract Background Central line-associated bloodstream infections (CLABSIs can be prevented through well-coordinated, multifaceted programs. However, implementation of CLABSI prevention programs requires individualized strategies for different institutional situations, and the best strategy in resource-limited settings is uncertain. Peer tutoring may be an efficient and effective method that is applicable in such settings. Methods A prospective intervention was performed to reduce CLABSIs in a surgical intensive care unit (SICU at a tertiary hospital. The core interventions consisted of implementation of insertion and maintenance bundles for CLABSI prevention. The overall interventions were guided and coordinated by active educational programs using peer tutoring. The CLABSI rates were compared for 9 months pre-intervention, 6 months during the intervention and 9 months post-intervention. The CLABSI rate was further observed for three years after the intervention. Results The rate of CLABSIs per 1000 catheter-days decreased from 6.9 infections in the pre-intervention period to 2.4 and 1.8 in the intervention (6 m; P = 0.102 and post-intervention (9 m; P = 0.036 periods, respectively. A regression model showed a significantly decreasing trend in the infection rate from the pre-intervention period (P < 0.001, with incidence-rate ratios of 0.348 (95% confidence interval [CI], 0.98–1.23 in the intervention period and 0.257 (95% CI, 0.07–0.91 in the post-intervention period. However, after the 9-month post-intervention period, the yearly CLABSI rates reverted to 3.0–5.4 infections per 1000 catheter-days over 3 years. Conclusions Implementation of CLABSI prevention bundles using peer tutoring in a resource-limited setting was useful and effectively reduced CLABSIs. However, maintaining the reduced CLABSI rate will require further strategies.

  11. Maternal depression and anxiety associated with dental fear in children: a cohort of adolescent mothers in Southern Brazil

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    Vanessa Polina Pereira COSTA

    2017-11-01

    Full Text Available Abstract Exposure to maternal symptoms of depression/anxiety has long-term negative consequences for child development, regardless of the contextual risk. The objective of this study was to investigate the relationship of the symptomatology of persistent maternal depression and anxiety with child dental fear. This study was nested in a cohort of adolescent mothers in southern Brazil. Symptomatology of maternal depression and anxiety was assessed during pregnancy and postpartum, when the mothers’ children were 24-36 months old, using Beck Depression Inventory and Beck Anxiety Inventory. The mothers answered a questionnaire to assess dental fear in their children, and to obtain socioeconomic and demographic data. Both mothers and their children were submitted to clinical oral examination (n= 540 dyads to obtain oral health data. Multivariate hierarchical Poisson regression analysis was used to determine associations (p < 0.05. At data collection, the prevalence of maternal depressive symptoms was 39.1%, and anxiety was observed in 27.8% of the mothers, whereas 21.6% of the children presented dental fear. In the adjusted analysis, children’s dental fear was positively associated with mothers’ presenting depressive symptomatology and caries experience. The depression symptomatology trajectory was not associated with dental fear, whereas mothers with persistent symptoms of anxiety reported higher prevalence of dental fear toward their offspring. The findings of symptomatology of maternal depression observed at data collection and persistence of anxiety may negatively impact the child’s perception of dental fear. Mothers are the main caregivers and primary models responsible for transmitting health-related behaviors; consequently, mental disorders affecting mothers may negatively impact their children.

  12. Detection of Schistosoma Antibodies and exploration of associated factors among local residents around Inlay Lake, Southern Shan State, Myanmar.

    Science.gov (United States)

    Soe, Htin Zaw; Oo, Cho Cho; Myat, Tin Ohn; Maung, Nay Soe

    2017-03-01

    Schistosomiasis is a chronic parasitic disease caused by blood flukes (trematode worms) of the genus Schistosoma. Its transmission has been reported in 78 countries affecting at least 258 million people world-wide. It was documented that S. japonicum species was prevalent in Shan State, Myanmar, but the serological study was not conducted yet. General objective of the present study was to detect schistosoma antibodies and explore associated factors among local residents living around Inlay Lake, Nyaung Shwe Township, and Southern Shan State, Myanmar. An exploratory and cross-sectional analytic study was conducted among local residents (n = 315) in selected rural health center (RHC) areas from December 2012 through June 2013. The participants were interviewed with pretested semi-structured questionnaires and their blood samples (serum) were tested using Schistosomiasis Serology Microwell ELISA test kits (sensitivity 100% and specificity 85%) which detected IgG antibodies but could not distinguish between a new and past infection. Data collected were analysed by SPSS software 16.0 and associations of variables were determined by Chi-squared test with a significant level set at 0.05. Schistosoma seroprevalence (IgG) in study area was found to be 23.8% (95% CI: 18.8-28.8%). The present study is the first and foremost study producing serological evidence of schistosoma infection-one of the neglected tropical diseases-in local people of Myanmar. The factors significantly associated with seropositivity were being male [OR = 2.6 (95% CI: 1.5-4.49), P Myanmar, and this should be further confirmed parasitologically and kept under surveillance. Proper trainings on diagnosis, treatment, prevention and control of schistosomiasis should be provided to the healthcare providers. ISRCTN ISRCTN73824458 . Registered 28 September 2014, retrospectively registered.

  13. Association between HIV infection and socio-economic status: evidence from a semirural area of southern Mozambique.

    Science.gov (United States)

    Pons-Duran, Clara; González, Raquel; Quintó, Llorenç; Munguambe, Khatia; Tallada, Joan; Naniche, Denise; Sacoor, Charfudin; Sicuri, Elisa

    2016-12-01

    To analyse the association between socio-economic status (SES) and HIV in Manhiça, a district of Southern Mozambique with one of the highest HIV prevalences in the world. Data were gathered from two cross-sectional surveys performed in 2010 and 2012 among 1511 adults and from the household census of the district's population. Fractional polynomial logit models were used to analyse the association between HIV and SES, controlling for age and sex and taking into account the nonlinearity of covariates. The inequality of the distribution of HIV infection with regard to SES was computed through a concentration index. Fourth and fifth wealth quintiles, the least poor, were associated with a reduced probability of HIV infection compared to the first quintile (OR = 0.595, P-value = 0.009 and OR = 0.474, P-value < 0.001, respectively). Probability of HIV infection peaked at 36 years and then fell, and was always higher for women regardless of age and SES. HIV infection was unequally distributed across the SES strata. Despite the high HIV prevalence across the entire population of Manhiça, the poorest are at greatest risk of being HIV infected. While women have a higher probability of being HIV positive than men, both sexes showed the same infection reduction at higher levels of SES. HIV interventions in the area should particularly focus on the poorest and on women without neglecting anyone else, as the HIV risk is high for everyone. © 2016 John Wiley & Sons Ltd.

  14. Prevalence and associated factors with alcohol use disorders among adults: a population-based study in southern Brazil.

    Science.gov (United States)

    Reisdorfer, Emilene; Büchele, Fátima; Pires, Rodrigo Otávio Moretti; Boing, Antonio Fernando

    2012-09-01

    The study aimed to describe the prevalence of alcohol use disorders in an adult population from Brazil and its association with demographic, socioeconomic, behavioral variables and health conditions. A population-based cross-sectional survey was conducted with adults (20 to 59 years) of a medium-sized city in Southern Brazil with a random sample of 1,720 individuals. Cluster sampling was done in two stages: census tract first and household second. Alcohol use disorders were measured using the Alcohol Use Disorders Identification Test (AUDIT) and associations were tested with selected variables by Poisson Regression. Results of multivariate analysis were expressed as prevalence ratios. The prevalence of alcohol use disorders in the population was 18.4% (95% CI: 16.6% - 20.3%), higher among men (29.9%) than in women (9.3%). The prevalence of abstinence was 30.6%; 6.8% of respondents had already caused problems to themselves or to others after drinking; and 10.3% reported that a relative, friend or doctor had already shown concern on their drinking. After multivariate analysis, an association with alcohol use disorders remained for: being male, age 20 to 29 years, being single, declaring to be light-skinned blacks and being an ex-smoker or current smoker. The prevalence of alcohol use disorders identified is high compared with other similar studies, with differences according to being male, age 20 to 29, skin color and tobacco use. These issues must be considered in formulating public health policies aimed at reducing problems related to alcohol use.

  15. Maternal depression and anxiety associated with dental fear in children: a cohort of adolescent mothers in Southern Brazil.

    Science.gov (United States)

    Costa, Vanessa Polina Pereira; Correa, Marcos Britto; Goettems, Marília Leão; Pinheiro, Ricardo Tavares; Demarco, Flávio Fernando

    2017-11-06

    Exposure to maternal symptoms of depression/anxiety has long-term negative consequences for child development, regardless of the contextual risk. The objective of this study was to investigate the relationship of the symptomatology of persistent maternal depression and anxiety with child dental fear. This study was nested in a cohort of adolescent mothers in southern Brazil. Symptomatology of maternal depression and anxiety was assessed during pregnancy and postpartum, when the mothers' children were 24-36 months old, using Beck Depression Inventory and Beck Anxiety Inventory. The mothers answered a questionnaire to assess dental fear in their children, and to obtain socioeconomic and demographic data. Both mothers and their children were submitted to clinical oral examination (n= 540 dyads) to obtain oral health data. Multivariate hierarchical Poisson regression analysis was used to determine associations (p depressive symptoms was 39.1%, and anxiety was observed in 27.8% of the mothers, whereas 21.6% of the children presented dental fear. In the adjusted analysis, children's dental fear was positively associated with mothers' presenting depressive symptomatology and caries experience. The depression symptomatology trajectory was not associated with dental fear, whereas mothers with persistent symptoms of anxiety reported higher prevalence of dental fear toward their offspring. The findings of symptomatology of maternal depression observed at data collection and persistence of anxiety may negatively impact the child's perception of dental fear. Mothers are the main caregivers and primary models responsible for transmitting health-related behaviors; consequently, mental disorders affecting mothers may negatively impact their children.

  16. Feeding Relationships among Six Seagrass-associated Fishes in the Northeastern Gwangyang Bay, Southern Korea

    Science.gov (United States)

    Park, Joo Myun; Kwak, Seok Nam; Han, In-Seong

    2018-03-01

    We conducted dietary analyses of six seagrass-associated fish species inhabiting northeastern Gwangyang Bay, Korea. These six species consumed a variety of benthic invertebrates and teleosts, but their preferences for different food resources varied. Although all species consumed crustaceans, the contributions of different crustacean taxa differed among the species' diets. Caridean shrimps and crabs were a significant part of the Hexagrammos agrammus and H. otakii diets, respectively, while amphipods were consumed mainly by Sebastes inermis. Caridean shrimps and prawns were abundant within the Lateolabrax japonicas diet, but were not common prey resources for Pseudopleuronectes yokohamae or S. schlegelii. Polychaetes and ophiurids were ingested by P. yokohamae, and the former prey taxon also made moderate contributions to the diets of H. agrammus and L. japonicus. With the exception of P. yokohamae, the diets of all species included teleosts. Teleosts contributed the largest proportion of the S. schlegelii diet, followed by the S. inermis and L. japonicas diets; however, H. agrammus and H. otakii rarely consumed teleosts. Non-metric multidimensional scaling (nMDS) ordination plots and permutational analysis of variance (PERMANOVA) revealed the variation in dietary composition among species and the contributions of each prey taxon. These interspecific differences in diet increase the range of food resources available to these fishes, thereby reducing competition for resources within the fish community in this region.

  17. Soft-bottom macrobenthic faunal associations in the southern Chilean glacial fjord complex

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    Carlos Ríos

    2005-12-01

    Full Text Available Macrobenthic associations were investigated at 29 sampling stations with a semi-quantitative Agassiz trawl, ranging from the South Patagonian Icefield to the Straits of Magellan in the South Chilean fjord system. A total of 1,895 individuals belonging to 131 species were collected. 19 species belong to colonial organisms, mainly Bryozoa (17 species and Octocorallia (2 species. The phylum Echinodermata was the most diverse in species number (47 species, with asteroids (25 species and ophiuroids (13 species being the best represented within this taxon. Polychaeta was the second dominant group in terms of species richness (46 species. Multidimensional scaling ordination (MDS separated two station groups, one related to fjords and channels off the South Patagonian Icefield and the second one to stations surrounding the Straits of Magellan. 45 species account for 90% of the dissimilarity between these two groups. These differences can mainly be explained by the influence of local environmental conditions determined by processes closely related to the presence/absence of glaciers. Abiotic parameters such as water depth, type of sediment and chemical features of the superficial sediment were not correlated with the numbers of individuals caught by the Agassiz trawl in each group of sampling stations.

  18. Relationship between occurrence of surgical complications and hospital finances.

    Science.gov (United States)

    Eappen, Sunil; Lane, Bennett H; Rosenberg, Barry; Lipsitz, Stuart A; Sadoff, David; Matheson, Dave; Berry, William R; Lester, Mark; Gawande, Atul A

    2013-04-17

    The effect of surgical complications on hospital finances is unclear. To determine the relationship between major surgical complications and per-encounter hospital costs and revenues by payer type. Retrospective analysis of administrative data for all inpatient surgical discharges during 2010 from a nonprofit 12-hospital system in the southern United States. Discharges were categorized by principal procedure and occurrence of 1 or more postsurgical complications, using International Classification of Diseases, Ninth Revision, diagnosis and procedure codes. Nine common surgical procedures and 10 major complications across 4 payer types were analyzed. Hospital costs and revenue at discharge were obtained from hospital accounting systems and classified by payer type. Hospital costs, revenues, and contribution margin (defined as revenue minus variable expenses) were compared for patients with and without surgical complications according to payer type. Of 34,256 surgical discharges, 1820 patients (5.3%; 95% CI, 4.4%-6.4%) experienced 1 or more postsurgical complications. Compared with absence of complications, complications were associated with a $39,017 (95% CI, $20,069-$50,394; P financial consequences for decreasing postsurgical complications.

  19. Late extensional shear zones and associated recumbent folds in the Alpujarride subduction complex, Betic Cordillera, southern Spain

    Energy Technology Data Exchange (ETDEWEB)

    Orozco, M.; Alonso-Chaves, F.; Platt, J.

    2017-11-01

    The existence in the Alpujarride Complex (Betic Cordillera, southern Spain) of a relatively continuous extensional event (following crustal thickening) is based on detailed structural studies and is consistent with the P-T paths and geochronological data established for the Alpujarride rocks. According to our research, the Alpujarride Complex contains two large-scale shear zones accommodating early Miocene extension. The shear zones contain km-scale recumbent folds, some with sheath fold geometry, and megaboudinage structures, and are closely associated with detachment faults. Large-scale folds and boudins cause dome-like undulations in the detachments, which are inferred to overlap in time with the deformation in the shear zones. One shear zone in the eastern part of the orogen is top-N; the other, in the western part, is top-E. The change in the shear direction may represent a temporal evolution in the direction of shear, possibly related to a change in the subduction direction in space and time.

  20. Locating Spatial Variation in the Association Between Wildland Fire Risk and Social Vulnerability Across Six Southern States

    Science.gov (United States)

    Poudyal, Neelam C.; Johnson-Gaither, Cassandra; Goodrick, Scott; Bowker, J. M.; Gan, Jianbang

    2012-03-01

    Wildland fire in the South commands considerable attention, given the expanding wildland urban interface (WUI) across the region. Much of this growth is propelled by higher income retirees and others desiring natural amenity residential settings. However, population growth in the WUI increases the likelihood of wildfire fire ignition caused by people, as humans account for 93% of all wildfires fires in the South. Coexisting with newly arrived, affluent WUI populations are working class, poor or otherwise socially vulnerable populations. The latter groups typically experience greater losses from environmental disasters such as wildfire because lower income residents are less likely to have established mitigation programs in place to help absorb loss. We use geographically weighted regression to examine spatial variation in the association between social vulnerability (SOVUL) and wildfire risk. In doing so, we identify "hot spots" or geographical clusters where SOVUL varies positively with wildfire risk across six Southern states—Alabama, Arkansas, Florida, Georgia, Mississippi, and South Carolina. These clusters may or may not be located in the WUI. These hot spots are most prevalent in South Carolina and Florida. Identification of these population clusters can aid wildfire managers in deciding which communities to prioritize for mitigation programming.

  1. Late extensional shear zones and associated recumbent folds in the Alpujarride subduction complex, Betic Cordillera, southern Spain

    International Nuclear Information System (INIS)

    Orozco, M.; Alonso-Chaves, F.; Platt, J.

    2017-01-01

    The existence in the Alpujarride Complex (Betic Cordillera, southern Spain) of a relatively continuous extensional event (following crustal thickening) is based on detailed structural studies and is consistent with the P-T paths and geochronological data established for the Alpujarride rocks. According to our research, the Alpujarride Complex contains two large-scale shear zones accommodating early Miocene extension. The shear zones contain km-scale recumbent folds, some with sheath fold geometry, and megaboudinage structures, and are closely associated with detachment faults. Large-scale folds and boudins cause dome-like undulations in the detachments, which are inferred to overlap in time with the deformation in the shear zones. One shear zone in the eastern part of the orogen is top-N; the other, in the western part, is top-E. The change in the shear direction may represent a temporal evolution in the direction of shear, possibly related to a change in the subduction direction in space and time.

  2. Factors associated to leisure-time sedentary lifestyle in adults of 1982 birth cohort, Pelotas, Southern Brazil

    Science.gov (United States)

    Azevedo, Mario R; Horta, Bernardo L; Gigante, Denise P; Victora, Cesar G; Barros, Fernando C

    2009-01-01

    OBJECTIVE To assess factors associated to leisure-time physical activity and sedentary lifestyle. METHODS Prospective cohort study of people born in 1982 in the city of Pelotas, southern Brazil. Data were collected at birth and during in a visit in 2004-5 when 77.4% of the cohort were evaluated, making a total of 4,297 people studied. Information about leisure-time physical activity was collected using the International Physical Activity Questionnaire. Sedentary people were defined as those with weekly physical activity below 150 minutes. The following independent variables were studied: gender, skin color, birth weight, family income at birth and income change between birth and 23 years of age. Poisson’s regression with robust adjustment of variance was used for the assessment of risk factors of sedentary lifestyle. RESULTS Men reported 334 min of weekly leisure-time physical activity compared to 112 min among women. The prevalence of sedentary lifestyle was 80.6% in women and 49.2% in men. Scores of physical activity increased as income at birth increased. Those who were currently poor or who became poor during adult life were more sedentary. CONCLUSIONS Leisure-time sedentary lifestyle in young adults was high especially among women. Physical activity during leisure time is determined by current socioeconomic conditions. PMID:19142347

  3. Using scientific evidence to improve hospital library services: Southern Chapter/Medical Library Association journal usage study.

    Science.gov (United States)

    Dee, C R; Rankin, J A; Burns, C A

    1998-07-01

    Journal usage studies, which are useful for budget management and for evaluating collection performance relative to library use, have generally described a single library or subject discipline. The Southern Chapter/Medical Library Association (SC/MLA) study has examined journal usage at the aggregate data level with the long-term goal of developing hospital library benchmarks for journal use. Thirty-six SC/MLA hospital libraries, categorized for the study by size as small, medium, or large, reported current journal title use centrally for a one-year period following standardized data collection procedures. Institutional and aggregate data were analyzed for the average annual frequency of use, average costs per use and non-use, and average percent of non-used titles. Permutation F-type tests were used to measure difference among the three hospital groups. Averages were reported for each data set analysis. Statistical tests indicated no significant differences between the hospital groups, suggesting that benchmarks can be derived applying to all types of hospital libraries. The unanticipated lack of commonality among heavily used titles pointed to a need for uniquely tailored collections. Although the small sample size precluded definitive results, the study's findings constituted a baseline of data that can be compared against future studies.

  4. Triggered surface slips in southern California associated with the 2010 El Mayor-Cucapah, Baja California, Mexico, earthquake

    Science.gov (United States)

    Rymer, Michael J.; Treiman, Jerome A.; Kendrick, Katherine J.; Lienkaemper, James J.; Weldon, Ray J.; Bilham, Roger; Wei, Meng; Fielding, Eric J.; Hernandez, Janis L.; Olson, Brian P.E.; Irvine, Pamela J.; Knepprath, Nichole; Sickler, Robert R.; Tong, Xiaopeng; Siem, Martin E.

    2011-01-01

    The April 4, 2010 (Mw7.2), El Mayor-Cucapah, Baja California, Mexico, earthquake is the strongest earthquake to shake the Salton Trough area since the 1992 (Mw7.3) Landers earthquake. Similar to the Landers event, ground-surface fracturing occurred on multiple faults in the trough. However, the 2010 event triggered surface slip on more faults in the central Salton Trough than previous earthquakes, including multiple faults in the Yuha Desert area, the southwestern section of the Salton Trough. In the central Salton Trough, surface fracturing occurred along the southern San Andreas, Coyote Creek, Superstition Hills, Wienert, Kalin, and Imperial Faults and along the Brawley Fault Zone, all of which are known to have slipped in historical time, either in primary (tectonic) slip and/or in triggered slip. Surface slip in association with the El Mayor-Cucapah earthquake is at least the eighth time in the past 42 years that a local or regional earthquake has triggered slip along faults in the central Salton Trough. In the southwestern part of the Salton Trough, surface fractures (triggered slip) occurred in a broad area of the Yuha Desert. This is the first time that triggered slip has been observed in the southwestern Salton Trough.

  5. Surgical orthodontics.

    Science.gov (United States)

    Strohl, Alexis M; Vitkus, Lauren

    2017-08-01

    The article reviews some commonly used orthodontic treatments as well as new strategies to assist in the correction of malocclusion. Many techniques are used in conjunction with surgical intervention and are a necessary compliment to orthognathic surgery. Basic knowledge of these practices will aid in the surgeon's ability to adequately treat the patient. Many orthodontists and surgeons are eliminating presurgical orthodontics to adopt a strategy of 'surgery first' orthodontics in orthognathic surgery. This has the benefit of immediate improvement in facial aesthetics and shorter treatment times. The advent of virtual surgical planning has helped facilitate the development of this new paradigm by making surgical planning faster and easier. Furthermore, using intraoperative surgical navigation is improving overall precision and outcomes. A variety of surgical and nonsurgical treatments may be employed in the treatment of malocclusion. It is important to be familiar with all options available and tailor the patient's treatment plan accordingly. Surgery-first orthodontics, intraoperative surgical navigation, virtual surgical planning, and 3D printing are evolving new techniques that are producing shorter treatment times and subsequently improving patient satisfaction without sacrificing long-term stability.

  6. Ethical issues associated with the introduction of new surgical devices, or just because we can, doesn't mean we should.

    Science.gov (United States)

    Ross, Sue; Robert, Magali; Harvey, Marie-Andrée; Farrell, Scott; Schulz, Jane; Wilkie, David; Lovatsis, Danny; Epp, Annette; Easton, Bill; McMillan, Barry; Schachter, Joyce; Gupta, Chander; Weijer, Charles

    2008-06-01

    Surgical devices are often marketed before there is good evidence of their safety and effectiveness. Our paper discusses the ethical issues associated with the early marketing and use of new surgical devices from the perspectives of the six groups most concerned. Health Canada, which is responsible for licensing new surgical devices, should amend their requirements to include rigorous clinical trials that provide data on effectiveness and safety for each new product before it is marketed. Industry should comply with all Health Canada requirements to obtain licenses for new products. Until Health Canada requires effectiveness and safety data, industry should cooperate with physicians in appropriate studies before releasing new products and should make balanced presentations of all the available evidence. Surgeons should, before using a new surgical device, assess the evidence on its effectiveness and safety and ensure they are properly trained and competent in using the device. Surgeons should provide their patients with an evaluation of the available evidence and inform them about possible complications and the surgeon's level of experience with the new device. Patients, who should be given an honest evaluation of the available evidence, possible complications, and the surgeon's experience, should be encouraged to evaluate the evidence and information to their own satisfaction to ensure that fully informed consent is given. Health institutions, responsible for regulating practice within their walls, should review new devices for safety, effectiveness, and economic impacts, before allowing their use. They should also limit the use of new surgical devices to surgeons trained and competent in the new technology. Professional societies should provide guidance on the early adoption of new surgical devices and technologies. We urge all those involved in the development, licensing, and use of new surgical devices to aim for higher ethical standards to protect the health

  7. Prevalence of anemia and associated factors among pregnant women in Southern Ethiopia: A community based cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Meaza Lebso

    Full Text Available Anemia is defined as a condition in which there is less than the normal hemoglobin (Hb level in the body. During pregnancy; iron deficiency is associated with multiple adverse outcomes for both mother and infant. Most of the studies conducted in Ethiopia on anemia during pregnancy were conducted at institution level and associated factors are not well studied and documented. Independent factors like, food security status, dietary diversity and intestinal parasites infection were considered by only a few of them. Hence, the aim of this study was to determine the prevalence of anemia and associated factors among pregnant women in Lemo District, Southern Ethiopia.Community based cross- sectional study was conducted from May-June 2015. Multistage sampling was used to include 507 study participants. Anaemia was diagnosed using HemoCue HB 301 and haemoglobin concentration <11 g/dl was classified as anaemic. Stool examinations were also done. Structured questionnaire was used as a tool to collect sociodemographic characteristics, individual dietary diversity and level of household food security data. Multivariate logistic regression model was employed to determine the effect of explanatory variables like level of education, level of household food security, dietary diversity, trimester of pregnancy, family planning before pregnancy, deworming, gravidity, iron intake in current pregnancy and soil transmitted helminthes on dependent variable anemia.The prevalence of anemia was 23.2% (95% CI: 19.5%-26.9%. Factors associated with anemia were: low socio-economic status (AOR = 2.03, 95% CI: 1.11-3.69, trimester second (AOR = 3.09, 95%CI: 1.41-6.79 and third (AOR = 3.68, 95% CI: 1.67-8.08, gravidity three to five (AOR = 1.78, 95% CI: 1.03-3.07 and six and above (AOR = 2.59, 95%CI: 1.37-4.92, not supplemented with iron (AOR = 1.72, 95% CI: 1.02-2.91, low dietary diversity score (AOR = 3.18, 95% CI: 1.37-7.37 and hookworm infection (AOR = 2.69, 95%CI: 1

  8. Association of lead, cadmium and mercury with paraoxonase 1 activity and malondialdehyde in a general population in Southern Brazil.

    Science.gov (United States)

    Almeida Lopes, Ana Carolina Bertinde; Urbano, Mariana Ragassi; Souza-Nogueira, André de; Oliveira-Paula, Gustavo H; Michelin, Ana Paula; Carvalho, Maria de Fátima H; Camargo, Alissana Ester Iakmiu; Peixe, Tiago Severo; Cabrera, Marcos Aparecido Sarria; Paoliello, Monica Maria Bastos

    2017-07-01

    Metal exposure is associated with increased oxidative stress (OS), which is considered an underlying mechanism of metal-induced toxicity. Malondialdehyde (MDA) is a final product of lipid peroxidation, and it has been extensively used to evaluate metal-induced OS. Pro-oxidant effects produced by metals can be mitigated by paraoxonase 1 (PON1), an antioxidant enzyme known to prevent cardiovascular disease and atherosclerosis. Among other factors, the Q192R polymorphism and the exposure to heavy metals have been known to alter PON1 activity. Here, we evaluated the association of blood lead (Pb), cadmium (Cd) and mercury (Hg) levels with PON1 activity, and with MDA concentrations in a randomly selected sample of Brazilian adults aged 40 years or older, living in an urban area in Southern Brazil. A total of 889 subjects were evaluated for blood Pb and Cd levels, and 832 were tested for Hg. Geometric mean of blood Pb, Cd and Hg was 1.93μg/dL, 0.06μg/L and 1.40μg/L, respectively. PON1 activity was significantly different among various genotypes: QQ (PON1=121.4U/mL), QR (PON1=87.5U/mL), and RR (PON1=55.2U/mL), p<0.001. PON1 genotypes were associated only with Cd blood levels. Those with QR genotype had Cd concentrations higher (0.07μg/L) than those with the RR genotype (0.04μg/L) with p=0.034. However, PON1 activity was not significantly associated with metal concentrations. Cluster analysis showed that men who reported to be current smokers and drinkers with higher blood Pb and Cd levels, had significantly lower PON1 activity than non-smokers or -drinkers, and women with lower Pb and Cd levels. RR genotype carriers had lower PON1 activity than those with the QR genotype, and had higher levels of Pb and Cd compared with other genotype carriers. For blood Hg, no association with PON1 activity or genotype was noted. We found low levels of Pb, Cd and Hg in environmentally exposed Brazilian adults. Cd concentrations were increased in subjects with QR genotype. Those with

  9. The Association of Elevated Serum Alanine Aminotransferase with Metabolic Syndrome in A Military Population in Southern Iran

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    B Sabayan

    2010-06-01

    Full Text Available Background: Metabolic syndrome (MetS is rapidly rising at an alarming rate through all parts of the world. Elevated serum aminotransferase was proposed as a marker for early detection of MetS. In this investigation we primarily aimed to evaluate the prevalence of MetS and its components among army and secondly to explore the association between elevated serum aminotransferase and the components of metabolic syndrome. Methods: A total of 380 army personnel from a military camp in Southern Iran participated in this cross-sectional study. Life style related characteristics, anthropometric features, serum aminotransferase and components of MetS, based on National Cholesterol Education Program—Adult Treatment Panel III, were measured. Statistical significant was set as p value less than 0.05. Results: The mean age of participants was 35.0± 7.5 year-old and the prevalence of metabolic syndrome was 8.1%. The prevalence of the components of MetS including; central obesity, abnormal fasting blood glucose, hypertension, hypertriglycridemia and low HDL cholesterol level was 8.6%, 10.4%, 18.5%, 31%, and 45.5% respectively. MetS had significant relationship with obesity (P<0.001 and abnormal Waist Circumferance/Hip Circumference ratio (P<0.001. Twenty-six percent of subjects had ALT ≥ 41 U/L and 4.9% of them had ALT ≥ 81. Elevated serum aminotransferase had significant association with presence of MetS (P= 0.007. Conclusion: Although prevalence of metabolic syndrome among the studied army population was not high, life style modification of army members is recommended. Liver function tests should be included in routine health checkup of military personnel.

  10. Factors associated with adherence to antiretroviral therapy in HIV/AIDS patients: a cross-sectional study in Southern Brazil

    Directory of Open Access Journals (Sweden)

    C.A.T. Pinheiro

    2002-10-01

    Full Text Available A cross-sectional study was conducted on HIV-infected adults being treated with antiretroviral drugs at a reference service in Southern Brazil. Participants answered a sociodemographic questionnaire and were tested by scales assessing sociocognitive variables. Adherence to treatment was assessed by a self-report inventory developed for the study. Clinical information was obtained from the patients' records. Significance tests were conducted using univariate logistic regressions followed by multivariate logistic regression analysis. A total of 195 patients participated in the study and 56.9% of them reported > or = 95% adherence on the previous two days. In univariate analysis, the odds of adherence increased with self-efficacy (a person's conviction that he/she can successfully execute the behavior required to produce a certain desired outcome in taking medications as prescribed (OR = 3.50, 95% CI 1.90-6.55, and decreased with perception of negative affect and physical concerns (OR = 0.71, 95% CI 0.53-0.95. The odds were lower for taking antiretroviral medications >4 times a day (OR = 0.44, 95% CI 0.20-0.94 and higher for patients with 8 years of schooling (OR = 2.28, 95% CI 1.12-4.66. In the multivariate analysis, self-efficacy (OR = 3.33, 95% CI 1.69-6.56 and taking medication >4 times a day (OR = 0.34, 95% CI 0.14-0.80 were independently associated with adherence. Self-efficacy was the most important predictor of adherence, followed by number of times antiretroviral medication was taken per day. Among sociodemographic and clinical variables, only the number of years of schooling was associated with adherence. Motivational interventions based on self-efficacy may be useful for increasing treatment adherence.

  11. Disappearance of electrocardiographic abnormalities associated with the arrhythmic pattern of a Barlow disease after surgical mitral valve repair

    Directory of Open Access Journals (Sweden)

    Matteo Augello

    2017-04-01

    Full Text Available We describe the case of a 46-year old female with a Barlow’s disease (MVP characterized by systolic curling of posterior left ventricular (LV wall + significant mitral annular disjunction + complex ventricular arrhythmias + syncope + inverted T waves in inferolateral leads in whom a successful surgical mitral valve rapair determined the disappearance not only of the echocardiographic but also the electrocardiographic abnormalities (in particular the inferolateral T waves inversion on basal electrocardiogram and the complex basal arrhythmic pattern. This case demonstrates that electrocardiographic abnormalities may disappear after the surgical correction of the mechanical stretch imposed on the inferior LV free wall by the prolapsing mitral valve leaflets. Electrocardiographic changes remain an important and easy marker to recognize for the identification of a high-risk subgroup of MVP patients.

  12. Costs Associated with Surgically Treated Cases of Abdominal Cystic Echinococcosis: A Single Center's Experience from 2008 to 2014, Pavia, Italy.

    Science.gov (United States)

    Narra, Roberta; Maestri, Marcello; Budke, Christine M; Tamarozzi, Francesca; Mariconti, Mara; Nicoletti, Giovanni J; Rinaldi, Francesca; Brunetti, Enrico

    2016-08-03

    Cystic echinococcosis (CE) is a globally distributed zoonosis caused by the Echinococcus granulosus sensu lato species complex. Four approaches are available for treatment of abdominal CE: surgery, percutaneous aspiration, chemotherapy with albendazole, and watch-and-wait. Allocation of patients to these different treatment options mainly depends on the stage of the cystic lesion. However, as available guidelines are not widely followed, surgery is often applied even without the correct indication outside referral centers. This is not only a disadvantage for the patient, but also a waste of money. In this study, we evaluated the cost of the surgical approach for abdominal CE by analyzing hospitalization costs for 14 patients admitted to the General Surgery Ward at the "San Matteo" Hospital Foundation in Pavia, Italy, from 2008 through 2014. We found that the total cost of a single hospitalization, including hospital stay, surgical intervention, personnel, drugs, and administrative costs ranged from €5,874 to 23,077 (median €11,033) per patient. Our findings confirm that surgery can be an expensive option. Therefore, surgical intervention should be limited to cyst types that do not benefit from nonsurgical therapies and appropriate case management can best be accomplished by using a cyst stage-specific approach. © The American Society of Tropical Medicine and Hygiene.

  13. Surgical approach and optic coherence tomographic evaluation of optic disc anomaly in association with serous macular detachment.

    Science.gov (United States)

    Güven, Dilek; Balcıoğlu, Nihal; Türker, Cağrı; Baydar, Yasemin; Sendül, Yekta

    2013-12-01

    Serous macular detachment (SMD) may accompany optic disc pit (ODP) and cause visual loss if untreated. We want to present different therapeutic approaches and interesting optical coherence tomography (OCT) findings in three consecutive cases. In this case series, two patients with SMD and one patient with partial macular detachment and inferior retinal detachment accompanying ODP were evaluated before and after surgical intervention clinically and by spectral-domain OCT. The patients were 44 (case 1), 22 (case 2) and 24 (case 3) years old. Pars plana vitrectomy (PPV) + silicone oil + laser, PPV + sulfur hexafluoride gas (SF6) + laser and pneumatic retinopexy were applied, respectively. The patients were followed for 18, 15 and 14 months. Preoperative best-corrected visual acuities (BCVAs) were 5/100, 7/10 and counting fingers at 1 m. Vision improved in all cases with resolution of subretinal fluid. Final BCVAs were 3/10, 10/10 and 1/10, respectively. OCT images revealed optic disc anomaly details and changes after surgical intervention, photoreceptor outer segment alterations at the detached area and macular surface changes. Surgical intervention should be tailored individually in cases with SMD. OCT is efficient for in vivo evaluation of this pathological condition and anatomical outcomes of surgery.

  14. Variability of the internal tide on the southern Monterey Bay continental shelf and associated bottom boundary layer sediment transport

    Science.gov (United States)

    Rosenberger, Kurt; Storlazzi, Curt; Cheriton, Olivia

    2016-01-01

    A 6-month deployment of instrumentation from April to October 2012 in 90 m water depth near the outer edge of the mid-shelf mud belt in southern Monterey Bay, California, reveals the importance regional upwelling on water column density structure, potentially accounting for the majority of the variability in internal tidal energy flux across the shelf. Observations consisted of time-series measurements of water-column currents, temperature and salinity, and near-bed currents and suspended matter. The internal tide accounted for 15–25% of the water-column current variance and the barotropic tide accounted for up to 35%. The subtidal flow showed remarkably little shear and was dominated by the 7–14 day band, which is associated with relaxations in the dominant equatorward winds typical of coastal California in the spring and summer. Upwelling and relaxation events resulted in strong near-bed flows and accounted for almost half of the current stress on the seafloor (not accounting for wave orbital velocities), and may have driven along-shelf geostrophic flow during steady state conditions. Several elevated suspended particulate matter (SPM) events occurred within 3 m of the bed and were generally associated with higher, long-period surface waves. However, these peaks in SPM did not coincide with the predicted resuspension events from the modeled combined wave–current shear stress, indicating that the observed SPM at our site was most likely resuspended elsewhere and advected along-isobath. Sediment flux was almost equal in magnitude in the alongshore and cross-shore directions. Instances of wave–current shear stress that exceeded the threshold of resuspension for the silty-clays common at these water depths only occurred when near-bed orbital velocities due to long-period surface waves coincided with vigorous near-bed currents associated with the internal tide or upwelling/relaxation events. Thus upwelling/relaxation dynamics are primarily responsible for

  15. Unstable Malaria Transmission in the Southern Peruvian Amazon and Its Association with Gold Mining, Madre de Dios, 2001–2012

    Science.gov (United States)

    Sanchez, Juan F.; Carnero, Andres M.; Rivera, Esteban; Rosales, Luis A.; Baldeviano, G. Christian; Asencios, Jorge L.; Edgel, Kimberly A.; Vinetz, Joseph M.; Lescano, Andres G.

    2017-01-01

    The reemergence of malaria in the last decade in Madre de Dios, southern Peruvian Amazon basin, was accompanied by ecological, political, and socioeconomic changes related to the proliferation of illegal gold mining. We conducted a secondary analysis of passive malaria surveillance data reported by the health networks in Madre de Dios between 2001 and 2012. We calculated the number of cases of malaria by year, geographic location, intensity of illegal mining activities, and proximity of health facilities to the Peru–Brazil Interoceanic Highway. During 2001–2012, 203,773 febrile cases were identified in Madre de Dios, of which 30,811 (15.1%) were confirmed cases of malaria; all but 10 cases were due to Plasmodium vivax. Cases of malaria rose rapidly between 2004 and 2007, reached 4,469 cases in 2005, and then declined after 2010 to pre-2004 levels. Health facilities located in areas of intense illegal gold mining reported 30-fold more cases than those in non-mining areas (ratio = 31.54, 95% confidence interval [CI] = 19.28, 51.60). Finally, health facilities located > 1 km from the Interoceanic Highway reported significantly more cases than health facilities within this distance (ratio = 16.20, 95% CI = 8.25, 31.80). Transmission of malaria in Madre de Dios is unstable, geographically heterogeneous, and strongly associated with illegal gold mining. These findings highlight the importance of spatially oriented interventions to control malaria in Madre de Dios, as well as the need for research on malaria transmission in illegal gold mining camps. PMID:27879461

  16. Patterns of species richness and diversity of insects associated with cucurbit fruits in the southern part of Cameroon.

    Science.gov (United States)

    Mokam, Didi Gaëlle; Djiéto-Lordon, Champlain; Bilong Bilong, Charles-Félix

    2014-01-01

    Patterns of species diversity and community structure of insects associated with fruits of domesticated cucurbits were investigated from January 2009 to 2011 in three localities from two agroecological zones in the southern part of Cameroon. Rarefaction curves combined with nonparametric estimators of species richness were used to extrapolate species richness beyond our own data. Sampling efforts of over 92% were reached in each of the three study localities. Data collected revealed a total of 66 insect morphospecies belonging to 37 families and five orders, identified from a set of 57,510 insects. The orders Diptera (especially Tephritidae and Lonchaeidae) and Hymenoptera (mainly Braconidae and Eulophidae) were the most important, in terms of both abundance and species richness on the one hand, and effects on agronomic performance on the other. Values for both the species diversity (Shannon and Simpson) and the species richness indices (Margalef and Berger-Parker) calculated showed that the insect communities were species-rich but dominated, all to a similar extent, by five main species (including four fruit fly species and one parasitoid). Species abundance distributions in these communities ranged from the Zipf-Mandelbrot to Mandelbrot models. The communities are structured as tritrophic networks, including cucurbit fruits, fruit-feeding species (fruit flies) and carnivorous species (parasitoids). Within the guild of the parasitoids, about 30% of species, despite their low abundance, may potentially be of use in biological control of important pests. Our field data contribute in important ways to basic knowledge of biodiversity patterns in agrosystems and constitute baseline data for the planned implementation of biological control in Integrated Pest Management. © The Author 2014. Published by Oxford University Press on behalf of the Entomological Society of America.

  17. Comparison of recreational health risks associated with surfing and swimming in dry weather and post-storm conditions at Southern California beaches using quantitative microbial risk assessment (QMRA).

    Science.gov (United States)

    Tseng, Linda Y; Jiang, Sunny C

    2012-05-01

    Southern California is an increasingly urbanized hotspot for surfing, thus it is of great interest to assess the human illness risks associated with this popular ocean recreational water sport from exposure to fecal bacteria contaminated coastal waters. Quantitative microbial risk assessments were applied to eight popular Southern California beaches using readily available enterococcus and fecal coliform data and dose-response models to compare health risks associated with surfing during dry weather and storm conditions. The results showed that the level of gastrointestinal illness risks from surfing post-storm events was elevated, with the probability of exceeding the US EPA health risk guideline up to 28% of the time. The surfing risk was also elevated in comparison with swimming at the same beach due to ingestion of greater volume of water. The study suggests that refinement of dose-response model, improving monitoring practice and better surfer behavior surveillance will improve the risk estimation. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Surgical experts: born or made?

    Science.gov (United States)

    Sadideen, Hazim; Alvand, Abtin; Saadeddin, Munir; Kneebone, Roger

    2013-01-01

    The concept of surgical expertise and the processes involved in its development are topical, and there is a constant drive to identify reliable measures of expert performance in surgery. This review explores the notion of whether surgical experts are "born" or "made", with reference to educational theory and pertinent literature. Peer-reviewed publications, books, and online resources on surgical education, expertise and training were reviewed. Important themes and aspects of expertise acquisition were identified in order to better understand the concept of a surgical expert. The definition of surgical expertise and several important aspects of its development are highlighted. Innate talent plays an important role, but is insufficient on its own to produce a surgical expert. Multiple theories that explore motor skill acquisition and memory are relevant, and Ericsson's theory of the development of competence followed by deliberate self-practice has been especially influential. Psychomotor and non-technical skills are necessary for progression in the current climate in light of our training curricula; surgical experts are adaptive experts who excel in these. The literature suggests that surgical expertise is reached through practice; surgical experts are made, not born. A deeper understanding of the nature of expert performance and its development will ensure that surgical education training programmes are of the highest possible quality. Surgical educators should aim to develop an expertise-based approach, with expert performance as the benchmark. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  19. Results of surgical excision and evaluation of factors associated with survival time in dogs with lingual neoplasia: 97 cases (1995-2008).

    Science.gov (United States)

    Culp, William T N; Ehrhart, Nicole; Withrow, Stephen J; Rebhun, Robert B; Boston, Sarah; Buracco, Paolo; Reiter, Alexander M; Schallberger, Sandra P; Aldridge, Charles F; Kent, Michael S; Mayhew, Philipp D; Brown, Dorothy C

    2013-05-15

    To describe the clinical characteristics, treatments, outcomes, and factors associated with survival time in a cohort of dogs with lingual neoplasia that underwent surgical excision. Retrospective case series. Animals-97 client-owned dogs. Medical records of dogs with a lingual tumor examined between 1995 and 2008 were reviewed. Records were included if a lingual tumor was confirmed by histologic examination and surgical excision of the mass was attempted. Data were recorded and analyzed to identify prognostic factors. Clinical signs were mostly related to the oral cavity. For 93 dogs, marginal excision, subtotal glossectomy, and near-total glossectomy were performed in 35 (38%), 55 (59%), and 3 (3%), respectively. Surgery-related complications were rare, but 27 (28%) dogs had tumor recurrence. The most common histopathologic diagnoses for the 97 dogs were squamous cell carcinoma (31 [32%]) and malignant melanoma (29 [30%]). Eighteen (19%) dogs developed metastatic disease, and the overall median survival time was 483 days. Median survival time was 216 days for dogs with squamous cell carcinoma and 241 days for dogs with malignant melanoma. Dogs with lingual tumors ≥ 2 cm in diameter at diagnosis had a significantly shorter survival time than did dogs with tumors melanoma predominate. A thorough physical examination to identify lingual tumors at an early stage and surgical treatment after tumor identification are recommended because tumor size significantly affected survival time.

  20. Delay in weight bearing in surgically treated tibial shaft fractures is associated with impaired healing: a cohort analysis of 166 tibial fractures.

    Science.gov (United States)

    Houben, I B; Raaben, M; Van Basten Batenburg, M; Blokhuis, T J

    2018-04-09

    The relation between timing of weight bearing after a fracture and the healing outcome is yet to be established, thereby limiting the implementation of a possibly beneficial effect for our patients. The current study was undertaken to determine the effect of timing of weight bearing after a surgically treated tibial shaft fracture. Surgically treated diaphyseal tibial fractures were retrospectively studied between 2007 and 2015. The timing of initial weight bearing (IWB) was analysed as a predictor for impaired healing in a multivariate regression. Totally, 166 diaphyseal tibial fractures were included, 86 cases with impaired healing and 80 with normal healing. The mean age was 38.7 years (range 16-89). The mean time until IWB was significantly shorter in the normal fracture healing group (2.6 vs 7.4 weeks, p bearing is independently associated with impaired fracture healing in surgically treated tibial shaft fractures. Unlike other factors such as fracture type or soft tissue condition, early resumption of weight bearing can be influenced by the treating physician and this factor therefore has a direct clinical relevance. This study indicates that early resumption of weight bearing should be the treatment goal in fracture fixation. 3b.

  1. North-East monsoon rainfall extremes over the southern peninsular India and their association with El Niño

    Science.gov (United States)

    Singh, Prem; Gnanaseelan, C.; Chowdary, J. S.

    2017-12-01

    variations in NE monsoon rainfall extremes during El Niño years. This study indicates that despite having strong warming in the central and eastern Pacific, NE monsoon rainfall variations over the southern peninsular India is mostly determined by SST gradient over the Indo-western Pacific region and number of systems formation in the Bay of Bengal and their land fall. The paper concludes that though the favourable large scale circulation induced by Pacific is important in modulating the NE monsoon rainfall the local air sea interaction plays a key role in modulating or driving rainfall extremes associated with El Niño.

  2. Mixed method approach for determining factors associated with late presentation to HIV/AIDS care in southern India

    Directory of Open Access Journals (Sweden)

    U N Yadav

    2016-01-01

    Full Text Available Background: Early diagnosis and treatment of human Immunodeficiency virus (HIV is not only beneficial for the people living with HIV/acquired immunodeficiency syndrome (AIDS (PLHA but for the public and society as well. The study was aimed to identify the factors associated with late presentation to HIV/AIDS care. Materials and Methods: A facility-based unmatched case-control (1:1 study along with in-depth qualitative assessment was conducted at an ART Plus center at a district hospital, Udupi, southern India. A sample of 320 HIV patients (160 cases and 160 controls was selected randomly between February and July 2014. Information regarding the patients were collected using an interviewer-administered semi-structured questionnaire. The qualitative component was assessed by in-depth interviews of 4 health professionals and 12 HIV-positive patients who were late for HIV care. The quantitative data were analyzed using Statistical Package for the Social Sciences (SPSS version 15.0. The technique of thematic analysis was adopted for the analysis of qualitative data. Results: HIV-positive individuals who lived with families [odds ratio (OR = 5.11], the patients having non-AIDS comorbidities [OR= 2.19, 95% confidence interval (CI: 1.09-4.40], the patients who perceived fear of losing family [OR = 5.00, 95% CI: 2.17-11.49], the patients who perceived fear that their status will be ruined in the community [OR= 2.00, 95% CI: 1.01-3.97], the patients who perceived fear of side effects of ART medications [OR = 4.3, 95% CI: 2.65-11.33], the patients who perceived fear of losing confidentiality [OR = 4.94, 95% CI: 2.54-9.59], the patients those who lack information available on government services [OR = 4.12, 95% CI: 2.127-8.005], and the patients who consumed alcohol [OR= 3.52, 95% CI: 1.83-6.77] were found to be independently associated with the late presentation to HIV/AIDS care after adjusting for all known confounders in a multivariable analysis. The

  3. Patient satisfaction with the perioperative surgical services and associated factors at a University Referral and Teaching Hospital, 2014: a cross-sectional study.

    Science.gov (United States)

    Gebremedhn, Endale Gebreegziabher; Lemma, Girmay Fitiwi

    2017-01-01

    Globally, increasing consideration has been given to the assessment of patient satisfaction as a method of monitor of the quality of health care provision in the health institutions. Perioperative patient satisfaction has been contemplated to be related with the level of postoperative pain intensity, patients' expectation of the outcome, patient health provider relationship, inpatient services, hospital facilities, access to care, waiting time, cost and helpfulness of treatments received. The study aimed to assess the level of patient satisfaction with perioperative surgical services and associated factors. Hospital based quantitative cross-sectional study was conducted in University of Gondar teaching hospital from April1-30, 2014. Structured Amharic version questionnaire and checklist used for data collection. All patients who operated upon during the study period were included. Both bivariate and multivariate logistic regression model used to identify the variables which had association with the dependent variable. P-values patient satisfaction with perioperative surgical services was 98.1%. The variables that had association with the outcome variable from the multivariate analysis were patient admission status (AOR=0.073, CI=0.007-0.765, P=0.029), information about the disease and operation (AOR=0.010, CI=0.001-0.140, P=0.001) and operation theatre staff attention to the patients complains (AOR=0.028, CI=0.002-0.390, P=0.008) respectively. The level of patient satisfaction with perioperative surgical services was high compared with previous studies conducted in the country and other countries in the world. Health professionals need to give emphasis for information on care provision processes, patients' health progress and patients' complaints.

  4. Surgical competence.

    Science.gov (United States)

    Patil, Nivritti G; Cheng, Stephen W K; Wong, John

    2003-08-01

    Recent high-profile cases have heightened the need for a formal structure to monitor achievement and maintenance of surgical competence. Logbooks, morbidity and mortality meetings, videos and direct observation of operations using a checklist, motion analysis devices, and virtual reality simulators are effective tools for teaching and evaluating surgical skills. As the operating theater is also a place for training, there must be protocols and guidelines, including mandatory standards for supervision, to ensure that patient care is not compromised. Patients appreciate frank communication and honesty from surgeons regarding their expertise and level of competence. To ensure that surgical competence is maintained and keeps pace with technologic advances, professional registration bodies have been promoting programs for recertification. They evaluate performance in practice, professional standing, and commitment to ongoing education.

  5. Radiographic characteristics in congenital scoliosis associated with split cord malformation: a retrospective study of 266 surgical cases.

    Science.gov (United States)

    Feng, Fan; Tan, Haining; Li, Xingye; Chen, Chong; Li, Zheng; Zhang, Jianguo; Shen, Jianxiong

    2017-10-23

    Vertebrae, ribs, and spinal cord are anatomically adjacent structures, and their close relationships are clinically important for planning better corrective surgical approach. The objective is to identify the radiographic characteristics in surgical patients with congenital scoliosis (CS) and coexisting split cord malformation (SCM). A total of 266 patients with CS and SCM underwent surgical treatment at our hospital between May 2000 and December 2015 was retrospectively identified. The demographic distribution and radiographic data were collected to investigate the characteristics of spine curve, vertebral, rib, and intraspinal anomalies. According to Pang's classification, all patients were divided into two groups: type I group is defined as two hemicords, each within a separate dural tube separated by a bony or cartilaginous medial spur, while type II group is defined as two hemicords within a single dural tube separated by a nonrigid fibrous septum. There were 104 patients (39.1%) in Type I group and 162 patients (60.9%) in Type II group. SCM was most commonly found in the lower thoracic and lumbar regions. The mean length of the septum in Type I SCM was significantly shorter than Type II SCM (2.7 vs. 5.2 segments). Patients in Type I group had a higher proportion of kyphotic deformity (22.1%). The vertebral deformities were simple in only 16.5% and multiple in 83.5% of 266 cases. Patients in Type I group presented higher prevalence of multiple (90.4%) and extensive (5.1 segments) malformation of vertebrae. In addition, hypertrophic lamina and bulbous spinous processes were more frequent in Type I group (29.7%), even developing into the "volcano-shape" deformities. Rib anomalies occurred in 62.8% of all patients and 46.1% of them were complex anomalies. The overall prevalence of other intraspinal anomalies was 42.9%. The most common coexisting intraspinal anomalies was syringomyelia (30.5%). The current study, with the largest cohort to date, demonstrated that

  6. Reconstructing Quaternary Rhine-Meuse dynamics in the southern North Sea: Architecture, seismo-lithofacies associations and malacological biozonation

    NARCIS (Netherlands)

    Rijsdijk, K.F.; Kroon, I.C.; Meijer, T.; Passchier, S.; Dijk, T.A.G.P. van; Bunnik, F.P.M.; Janse, A.C.

    2013-01-01

    Mapping the Middle to Upper Pleistocene Rhine-Meuse sequence in the southern North Sea based on new core and seismic data has allowed a detailed palaeoenvironmental re-assessment. An integrated seismo-lithostratigraphic and malacological biostratigraphic framework is correlated with the optically

  7. Surgical management of impacted incisors in associate with supernumerary teeth: a combine case report of spontaneous eruption and orthodontic extrusion.

    Science.gov (United States)

    Das, D; Misra, J

    2012-01-01

    Maxillary permanent incisors impaction is not a frequent case in dental practice, but its treatment is challenging because of its importance to facial esthetics. Supernumerary teeth are the main cause of impaction of upper incisors. Supernumerary teeth when present can cause both esthetic and pathologic problems. Early detection of such teeth is most important if complications are to be avoided. In this reported case, the orthopantamogram of a 9-year-old boy revealed two impacted supernumerary teeth in the maxillary anterior region, which was interfering with the eruption of the permanent central incisors. The impacted supernumerary teeth were surgically removed, 11 was repositioned in the arch as it was situated very high in the arch, close to the nasal floor. Twenty-one erupted spontaneously but orthodontic force was applied over 11 to bring it into the occlusion and alignment was achieved with 0.014 mm NiTi wire.

  8. Low skeletal muscle radiation attenuation and visceral adiposity are associated with overall survival and surgical site infections in patients with pancreatic cancer.

    Science.gov (United States)

    van Dijk, David P J; Bakens, Maikel J A M; Coolsen, Mariëlle M E; Rensen, Sander S; van Dam, Ronald M; Bours, Martijn J L; Weijenberg, Matty P; Dejong, Cornelis H C; Olde Damink, Steven W M

    2017-04-01

    Cancer cachexia and skeletal muscle wasting are related to poor survival. In this study, quantitative body composition measurements using computed tomography (CT) were investigated in relation to survival, post-operative complications, and surgical site infections in surgical patients with cancer of the head of the pancreas. A prospective cohort of 199 patients with cancer of the head of the pancreas was analysed by CT imaging at the L3 level to determine (i) muscle radiation attenuation (average Hounsfield units of total L3 skeletal muscle); (ii) visceral adipose tissue area; (iii) subcutaneous adipose tissue area; (iv) intermuscular adipose tissue area; and (v) skeletal muscle area. Sex-specific cut-offs were determined at the lower tertile for muscle radiation attenuation and skeletal muscle area and the higher tertile for adipose tissues. These variables of body composition were related to overall survival, severe post-operative complications (Dindo-Clavien ≥ 3), and surgical site infections (wounds inspected daily by an independent trial nurse) using Cox-regression analysis and multivariable logistic regression analysis, respectively. Low muscle radiation attenuation was associated with shorter survival in comparison with moderate and high muscle radiation attenuation [median survival 10.8 (95% CI: 8.8-12.8) vs. 17.4 (95% CI: 14.7-20.1), and 18.5 (95% CI: 9.2-27.8) months, respectively; P site infection rate, OR: 2.4 (95% CI: 1.1-5.3; P = 0.027). Low muscle radiation attenuation was associated with reduced survival, and high visceral adiposity was associated with an increase in surgical site infections. The strong correlation between muscle radiation attenuation and intermuscular adipose tissue suggests the presence of ectopic fat in muscle, warranting further investigation. CT image analysis could be implemented in pre-operative risk assessment to assist in treatment decision-making. © 2016 The Authors. Journal of Cachexia, Sarcopenia and Muscle

  9. Surgical Navigation

    DEFF Research Database (Denmark)

    Azarmehr, Iman; Stokbro, Kasper; Bell, R. Bryan

    2017-01-01

    Purpose: This systematic review investigates the most common indications, treatments, and outcomes of surgical navigation (SN) published from 2010 to 2015. The evolution of SN and its application in oral and maxillofacial surgery have rapidly developed over recent years, and therapeutic indicatio...

  10. Surgical Instrument

    NARCIS (Netherlands)

    Dankelman, J.; Horeman, T.

    2009-01-01

    The present invention relates to a surgical instrument for minimall-invasive surgery, comprising a handle, a shaft and an actuating part, characterised by a gastight cover surrounding the shaft, wherein the cover is provided with a coupler that has a feed- through opening with a loskable seal,

  11. Working and Living in Northern vs Southern Ontario Is Associated with the Duration of Compensated Time off Work: A Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    S Senthanar

    2015-07-01

    Full Text Available Background: Northern Ontario, Canada has a larger elder population, more resource-based employment, and limited access to physicians and specialists compared to southern Ontario. Given these important differences, it is possible that work disability rates will vary between the two Ontario jurisdictions. Objective: To determine the association between time lost due to workplace injuries and illnesses occurring in northern vs southern Ontario and work disability duration from 2006– 2011. Methods: The study base included all lost-time claims approved by the Workplace Safety and Insurance Board in Ontario, Canada for workplace injury or illness compensation occurring between January 1, 2006 and December 31, 2011. All eligible participants had to be 18 years of age or older at the time of making the claim and participants were excluded if one of the three variables used to determine location (claimant home postal code, workplace geographical code, and WSIB firm location were missing. Multivariable proportional hazards regression models were used to estimate hazard ratios and 95% confidence intervals adjusted for sex, age, occupation, part of body, and nature of injury relating Ontario geographical location to compensated time off work. Results: A total of 156 453 lost-time claims were approved over the study period. Injured and ill workers from northern Ontario were 16% less likely to return to work than those from southern Ontario. Adjustment for potential confounding factors had no effect. Conclusion: The disability duration in northern Ontario is longer than that in southern Ontario. Future research should focus on assessing the relevant factors associated with this observation to identify opportunities for intervention.

  12. A Hierarchical Bayesian Model for the Identification of PET Markers Associated to the Prediction of Surgical Outcome after Anterior Temporal Lobe Resection

    Directory of Open Access Journals (Sweden)

    Sharon Chiang

    2017-12-01

    Full Text Available We develop an integrative Bayesian predictive modeling framework that identifies individual pathological brain states based on the selection of fluoro-deoxyglucose positron emission tomography (PET imaging biomarkers and evaluates the association of those states with a clinical outcome. We consider data from a study on temporal lobe epilepsy (TLE patients who subsequently underwent anterior temporal lobe resection. Our modeling framework looks at the observed profiles of regional glucose metabolism in PET as the phenotypic manifestation of a latent individual pathologic state, which is assumed to vary across the population. The modeling strategy we adopt allows the identification of patient subgroups characterized by latent pathologies differentially associated to the clinical outcome of interest. It also identifies imaging biomarkers characterizing the pathological states of the subjects. In the data application, we identify a subgroup of TLE patients at high risk for post-surgical seizure recurrence after anterior temporal lobe resection, together with a set of discriminatory brain regions that can be used to distinguish the latent subgroups. We show that the proposed method achieves high cross-validated accuracy in predicting post-surgical seizure recurrence.

  13. Three-dimensional virtual operations can facilitate complicated surgical planning for the treatment of patients with jaw deformities associated with facial asymmetry: a case report.

    Science.gov (United States)

    Hara, Shingo; Mitsugi, Masaharu; Kanno, Takahiro; Nomachi, Akihiko; Wajima, Takehiko; Tatemoto, Yukihiro

    2013-09-01

    This article describes a case we experienced in which good postsurgical facial profiles were obtained for a patient with jaw deformities associated with facial asymmetry, by implementing surgical planning with SimPlant OMS. Using this method, we conducted LF1 osteotomy, intraoral vertical ramus osteotomy (IVRO), sagittal split ramus osteotomy (SSRO), mandibular constriction and mandibular border genioplasty. Not only did we obtain a class I occlusal relationship, but the complicated surgery also improved the asymmetry of the frontal view, as well as of the profile view, of the patient. The virtual operation using three-dimensional computed tomography (3D-CT) could be especially useful for the treatment of patients with jaw deformities associated with facial asymmetry.

  14. Southern Dietary Pattern is Associated with Hazard of Acute Coronary Heart Disease in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study

    Science.gov (United States)

    Shikany, James M.; Safford, Monika M.; Newby, P. K.; Durant, Raegan W.; Brown, Todd M.; Judd, Suzanne E.

    2015-01-01

    Background The association of overall diet, as characterized by dietary patterns, with risk of incident acute coronary heart disease (CHD) has not been studied extensively in samples including sociodemographic and regional diversity. Methods and Results We used data from 17,418 participants in Reasons for Geographic and Racial Differences in Stroke (REGARDS), a national, population-based, longitudinal study of white and black adults aged ≥45 years, enrolled from 2003-2007. We derived dietary patterns with factor analysis, and used Cox proportional hazards regression to examine hazard of incident acute CHD events – nonfatal myocardial infarction and acute CHD death – associated with quartiles of consumption of each pattern, adjusted for various levels of covariates. Five primary dietary patterns emerged: Convenience, Plant-based, Sweets, Southern, and Alcohol and Salad. A total of 536 acute CHD events occurred over a median (IQR) 5.8 (2.1) years of follow-up. After adjustment for sociodemographics, lifestyle factors, and energy intake, highest consumers of the Southern pattern (characterized by added fats, fried food, eggs, organ and processed meats, and sugar-sweetened beverages) experienced a 56% higher hazard of acute CHD (comparing quartile 4 to quartile 1: HR = 1.56; 95% CI: 1.17, 2.08; P for trend across quartiles = 0.003). Adding anthropometric and medical history variables to the model attenuated the association somewhat (HR = 1.37; 95% CI: 1.01, 1.85; P = 0.036). Conclusions A dietary pattern characteristic of the southern US was associated with greater hazard of CHD in this sample of white and black adults in diverse regions of the US. PMID:26260732

  15. Surgical management of aortic root disease in Marfan syndrome and other congenital disorders associated with aortic root aneurysms.

    Science.gov (United States)

    Treasure, Tom; Takkenberg, J J M; Pepper, John

    2014-10-01

    Elective root replacement in Marfan syndrome has improved life expectancy in affected patients. Three forms of surgery are now available: total root replacement (TRR) with a valved conduit, valve sparing root replacement (VSRR) and personalised external aortic root support (PEARS) with a macroporous mesh sleeve. TRR can be performed irrespective of aortic dimensions and a mechanical replacement valve is a secure and near certain means of correcting aortic valve regurgitation but has thromboembolic and bleeding risks. VSRR offers freedom from anticoagulation and attendant risks of bleeding but reoperation for aortic regurgitation runs at 1.3% per annum. A prospective multi-institutional study has found this to be an underestimate of the true rate of valve-related adverse events. PEARS conserves the aortic root anatomy and optimises the chance of maintaining valve function but average follow-up is under 5 years and so the long-term results are yet to be determined. Patients are on average in their 30s and so the cumulative lifetime need for reoperation, and of any valve-related complications, are consequently substantial. With lowering surgical risk of prophylactic root replacement, the threshold for intervention has reduced progressively over 30 years to 4.5 cm and so an increasing number of patients who are not destined to have a dissection are now having root replacement. In evaluation of these three forms of surgery, the number needed to treat to prevent dissection and the balance of net benefit and harm in future patients must be considered.

  16. Does Pre-Operative Multiple Immunosuppressive Therapy Associate with Surgical Site Infection in Surgery for Ulcerative Colitis.

    Science.gov (United States)

    Uchino, Motoi; Ikeuchi, Hiroki; Bando, Toshihiro; Hirose, Kei; Hirata, Akihiro; Chohno, Teruhiro; Sasaki, Hirofumi; Takahashi, Yoshiko; Takesue, Yoshio; Hida, Nobuyuki; Hori, Kazutoshi; Nakamura, Shiro

    2015-01-01

    Almost all surgeries for ulcerative colitis (UC) are performed under immunosuppressive conditions. Immunomodulators or biologics, with the exception of corticosteroids, do not appear to be risk factors for post-operative infectious complications. However, many patients are on multiagent immunosuppressive therapy at the time of surgery. Therefore, we evaluated the influence of pre-operative multiple immunosuppressives on the occurrence of surgical site infection (SSI) in UC. We reviewed surveillance data from 181 patients who underwent restorative proctocolectomy between January 2012 and March 2014. The incidences of SSI and the possible risk factors among patients receiving different immunosuppressive therapies were compared and analyzed. The incidence of incisional (INC) SSI was 13.3% and that of organ/space (O/S) SSI was 7.2%. The number of immunosuppressives did not significantly correlate with each incidence. Total prednisolone administration ≥12,000 mg (OR 2.6) and an American Society of Anesthesiologists score ≥3 (OR 2.8) were shown to be independent risk factors for overall SSI, whereas corticosteroid use in INC SSI (OR 17.4) and severe disease (OR 5.2) and a large amount of blood loss (OR 3.9) in O/S SSI were identified as risk factors. Although a correlation between multiple immunosuppressive therapy and SSIs was not found, it is not recommended that all patients be treated with multiple immunosuppressive therapy. Treatment strategy should be applied based on the patient's condition. © 2015 S. Karger AG, Basel.

  17. Aggressive surgical management of craniopharyngiomas

    Directory of Open Access Journals (Sweden)

    Manmohan Singh

    2013-01-01

    Full Text Available Surgical treatment of craniopharyngiomas is challenging and despite advancements it continues to pose a challenge. Proponents of subtotal resection in conjunction with radiotherapy argue that this less aggressive approach can yield appropriate results with the lower morbidity. On the contrary, other argument is that gross total resection is superior. Though surgical management of craniopharyngioma is challenging due to its location and important surrounding neurovascular structures, optimal surgical results can be expected following radical surgical excision. Radical excision of craniopharyngiomas is associated with excellent long-term recurrence free survival. Radiation induced long-term complications can be altogether avoided by excising these tumors completely.

  18. Surgical innovations in canine gonadectomy

    NARCIS (Netherlands)

    Van Goethem, Bart

    2016-01-01

    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated

  19. Republished review: Surgical management of aortic root disease in Marfan syndrome and other congenital disorders associated with aortic root aneurysms.

    Science.gov (United States)

    Treasure, Tom; Takkenberg, J J M; Pepper, John

    2016-02-01

    Elective root replacement in Marfan syndrome has improved life expectancy in affected patients. Three forms of surgery are now available: total root replacement (TRR) with a valved conduit, valve sparing root replacement (VSRR) and personalised external aortic root support (PEARS) with a macroporous mesh sleeve. TRR can be performed irrespective of aortic dimensions and a mechanical replacement valve is a secure and near certain means of correcting aortic valve regurgitation but has thromboembolic and bleeding risks. VSRR offers freedom from anticoagulation and attendant risks of bleeding but reoperation for aortic regurgitation runs at 1.3% per annum. A prospective multi-institutional study has found this to be an underestimate of the true rate of valve-related adverse events. PEARS conserves the aortic root anatomy and optimises the chance of maintaining valve function but average follow-up is under 5 years and so the long-term results are yet to be determined. Patients are on average in their 30s and so the cumulative lifetime need for reoperation, and of any valve-related complications, are consequently substantial. With lowering surgical risk of prophylactic root replacement, the threshold for intervention has reduced progressively over 30 years to 4.5 cm and so an increasing number of patients who are not destined to have a dissection are now having root replacement. In evaluation of these three forms of surgery, the number needed to treat to prevent dissection and the balance of net benefit and harm in future patients must be considered. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. 16S rRNA amplicon sequencing identifies microbiota associated with oral cancer, human papilloma virus infection and surgical treatment.

    Science.gov (United States)

    Guerrero-Preston, Rafael; Godoy-Vitorino, Filipa; Jedlicka, Anne; Rodríguez-Hilario, Arnold; González, Herminio; Bondy, Jessica; Lawson, Fahcina; Folawiyo, Oluwasina; Michailidi, Christina; Dziedzic, Amanda; Thangavel, Rajagowthamee; Hadar, Tal; Noordhuis, Maartje G; Westra, William; Koch, Wayne; Sidransky, David

    2016-08-09

    Systemic inflammatory events and localized disease, mediated by the microbiome, may be measured in saliva as head and neck squamous cell carcinoma (HNSCC) diagnostic and prognostic biomonitors. We used a 16S rRNA V3-V5 marker gene approach to compare the saliva microbiome in DNA isolated from Oropharyngeal (OPSCC), Oral Cavity Squamous Cell Carcinoma (OCSCC) patients and normal epithelium controls, to characterize the HNSCC saliva microbiota and examine their abundance before and after surgical resection.The analyses identified a predominance of Firmicutes, Proteobacteria and Bacteroidetes, with less frequent presence of Actinobacteria and Fusobacteria before surgery. At lower taxonomic levels, the most abundant genera were Streptococcus, Prevotella, Haemophilus, Lactobacillus and Veillonella, with lower numbers of Citrobacter and Neisseraceae genus Kingella. HNSCC patients had a significant loss in richness and diversity of microbiota species (p<0.05) compared to the controls. Overall, the Operational Taxonomic Units network shows that the relative abundance of OTU's within genus Streptococcus, Dialister, and Veillonella can be used to discriminate tumor from control samples (p<0.05). Tumor samples lost Neisseria, Aggregatibacter (Proteobacteria), Haemophillus (Firmicutes) and Leptotrichia (Fusobacteria). Paired taxa within family Enterobacteriaceae, together with genus Oribacterium, distinguish OCSCC samples from OPSCC and normal samples (p<0.05). Similarly, only HPV positive samples have an abundance of genus Gemellaceae and Leuconostoc (p<0.05). Longitudinal analyses of samples taken before and after surgery, revealed a reduction in the alpha diversity measure after surgery, together with an increase of this measure in patients that recurred (p<0.05). These results suggest that microbiota may be used as HNSCC diagnostic and prognostic biomonitors.

  1. Perioperative surgical complications and learning curve associated with minimally invasive transforaminal lumbar interbody fusion: a single-institute experience.

    Science.gov (United States)

    Park, Yung; Lee, Soo Bin; Seok, Sang Ok; Jo, Byung Woo; Ha, Joong Won

    2015-03-01

    As surgical complications tend to occur more frequently in the beginning stages of a surgeon's career, knowledge of perioperative complications is important to perform a safe procedure, especially if the surgeon is a novice. We sought to identify and describe perioperative complications and their management in connection with minimally invasive transforaminal lumbar interbody fusion (TLIF). We performed a retrospective chart review of our first 124 patients who underwent minimally invasive TLIF. The primary outcome measure was adverse events during the perioperative period, including neurovascular injury, implant-related complications, and wound infection. Pseudarthroses and adjacent segment pathologies were not included in this review. Adverse events that were not specifically related to spinal surgery and did not affect recovery were also excluded. Perioperative complications occurred in 9% of patients (11/124); including three cases of temporary postoperative neuralgia, two deep wound infections, two pedicle screw misplacements, two cage migrations, one dural tear, and one grafted bone extrusion. No neurologic deficits were reported. Eight complications occurred in the first one-third of the series and only 3 complications occurred in the last two-thirds of the series. Additional surgeries were performed in 6% of patients (7/124); including four reoperations (two for cage migrations, one for a misplaced screw, and one for an extruded graft bone fragment) and three hardware removals (one for a misplaced screw and two for infected cages). We found perioperative complications occurred more often in the early period of a surgeon's experience with minimally invasive TLIF. Implant-related complications were common and successfully managed by additional surgeries in this series. We suggest greater caution should be exercised to avoid the potential complications, especially when surgeon is a novice to this procedure.

  2. Phytoplankton size structure in the southern Bay of Bengal modified by the Summer Monsoon Current and associated eddies: Implications on the vertical biogenic flux..

    Digital Repository Service at National Institute of Oceanography (India)

    Jyothibabu, R; Vinayachandran, P. N.; Madhu, N.V.; Robin, R; Karman, C.; Jagadeesan, L.; Anjusha, A.

    . Mar. Syst., vol.143; 2015; 98–119 Phytoplankton Size Structure in the Southern Bay of Bengal Modified by the Summer Monsoon Current and Associated Eddies: Implications on the Vertical Biogenic Flux R. Jyothibabu1*, P. N. Vinayachandran2, N. V.... Madhu1, R.S. Robin3, C. Karnan1, L. Jagadeesan1, A. Anjusha1 1CSIR – National Institute of Oceanography, Regional Centre, Kochi, India 2Centre for Atmospheric and Ocean Sciences, Indian Institute of Science, Bangalore, India 3Integrated Coastal...

  3. Fatores associados ao uso de drogas entre adolescentes escolares Factors associated with drug use among adolescent students in southern Brazil

    Directory of Open Access Journals (Sweden)

    Beatriz Franck Tavares

    2004-12-01

    Full Text Available OBJETIVO: Investigar fatores associados ao uso de drogas entre adolescentes de escolas com ensino médio. MÉTODOS: Realizou-se um estudo transversal, em 1998, em Pelotas, RS. Um questionário anônimo, auto-aplicado em sala de aula, foi respondido por uma amostra proporcional de estudantes com idade entre 10 e 19 anos, matriculados no ensino fundamental (a partir da quinta série e no ensino médio, em todas as escolas públicas e particulares na zona urbana do município que tinham ensino médio. Realizaram-se até três revisitas para aplicação aos alunos ausentes. Os resultados foram expressos como razão de prevalências (RP. RESULTADOS: Foram entrevistados 2.410 estudantes e o índice de perdas foi de 8%. A prevalência do uso de drogas (exceto álcool e tabaco no último ano foi 17,1%. Após controle para fatores de confusão, permaneceu a associação entre uso de drogas e separação dos pais (RP=1,46; IC 95%: 1,18-1,80, relacionamento ruim ou péssimo com o pai (RP=1,67; IC 95%: 1,17-2,38, relacionamento ruim ou péssimo com a mãe (RP=2,71; IC 95%: 1,64-4,48, ter pai liberal (RP=1,36; IC 95%: 1,08-1,72, presença em casa de familiar usuário de drogas (RP=1,61; IC 95%: 1,17-2,18, ter sofrido maus tratos (RP=1,62; IC 95%: 1,27-2,07, ter sido assaltado ou roubado no ano anterior (RP=1,38; IC 95%: 1,09-1,76 e ausência de prática religiosa (RP=1,31; IC 95%: 1,07-1,59. CONCLUSÕES: O estudo indica que diversas características familiares estão associadas ao uso de drogas pelos adolescentes, fornecendo informações úteis para a compreensão integral desse problema em nosso País.OBJECTIVE: To assess factors associated with drug use among adolescent students from schools providing secondary education. METHODS: A cross-sectional study was carried out in Pelotas, Southern Brazil, in 1998. An anonymous, self-administered questionnaire was answered by a proportional sample of 10-19-year-old students, enrolled in primary (5th grade and

  4. Desert Dust Outbreaks in Southern Europe: Contribution to Daily PM10 Concentrations and Short-Term Associations with Mortality and Hospital Admissions

    Science.gov (United States)

    Stafoggia, Massimo; Zauli-Sajani, Stefano; Pey, Jorge; Samoli, Evangelia; Alessandrini, Ester; Basagaña, Xavier; Cernigliaro, Achille; Chiusolo, Monica; Demaria, Moreno; Díaz, Julio; Faustini, Annunziata; Katsouyanni, Klea; Kelessis, Apostolos G.; Linares, Cristina; Marchesi, Stefano; Medina, Sylvia; Pandolfi, Paolo; Pérez, Noemí; Querol, Xavier; Randi, Giorgia; Ranzi, Andrea; Tobias, Aurelio; Forastiere, Francesco

    2015-01-01

    Background: Evidence on the association between short-term exposure to desert dust and health outcomes is controversial. Objectives: We aimed to estimate the short-term effects of particulate matter ≤ 10 μm (PM10) on mortality and hospital admissions in 13 Southern European cities, distinguishing between PM10 originating from the desert and from other sources. Methods: We identified desert dust advection days in multiple Mediterranean areas for 2001–2010 by combining modeling tools, back-trajectories, and satellite data. For each advection day, we estimated PM10 concentrations originating from desert, and computed PM10 from other sources by difference. We fitted city-specific Poisson regression models to estimate the association between PM from different sources (desert and non-desert) and daily mortality and emergency hospitalizations. Finally, we pooled city-specific results in a random-effects meta-analysis. Results: On average, 15% of days were affected by desert dust at ground level (desert PM10 > 0 μg/m3). Most episodes occurred in spring–summer, with increasing gradient of both frequency and intensity north–south and west–east of the Mediterranean basin. We found significant associations of both PM10 concentrations with mortality. Increases of 10 μg/m3 in non-desert and desert PM10 (lag 0–1 days) were associated with increases in natural mortality of 0.55% (95% CI: 0.24, 0.87%) and 0.65% (95% CI: 0.24, 1.06%), respectively. Similar associations were estimated for cardio-respiratory mortality and hospital admissions. Conclusions: PM10 originating from the desert was positively associated with mortality and hospitalizations in Southern Europe. Policy measures should aim at reducing population exposure to anthropogenic airborne particles even in areas with large contribution from desert dust advections. Citation: Stafoggia M, Zauli-Sajani S, Pey J, Samoli E, Alessandrini E, Basagaña X, Cernigliaro A, Chiusolo M, Demaria M, Díaz J, Faustini A

  5. Desert Dust Outbreaks in Southern Europe: Contribution to Daily PM₁₀ Concentrations and Short-Term Associations with Mortality and Hospital Admissions.

    Science.gov (United States)

    Stafoggia, Massimo; Zauli-Sajani, Stefano; Pey, Jorge; Samoli, Evangelia; Alessandrini, Ester; Basagaña, Xavier; Cernigliaro, Achille; Chiusolo, Monica; Demaria, Moreno; Díaz, Julio; Faustini, Annunziata; Katsouyanni, Klea; Kelessis, Apostolos G; Linares, Cristina; Marchesi, Stefano; Medina, Sylvia; Pandolfi, Paolo; Pérez, Noemí; Querol, Xavier; Randi, Giorgia; Ranzi, Andrea; Tobias, Aurelio; Forastiere, Francesco

    2016-04-01

    Evidence on the association between short-term exposure to desert dust and health outcomes is controversial. We aimed to estimate the short-term effects of particulate matter ≤ 10 μm (PM10) on mortality and hospital admissions in 13 Southern European cities, distinguishing between PM10 originating from the desert and from other sources. We identified desert dust advection days in multiple Mediterranean areas for 2001-2010 by combining modeling tools, back-trajectories, and satellite data. For each advection day, we estimated PM10 concentrations originating from desert, and computed PM10 from other sources by difference. We fitted city-specific Poisson regression models to estimate the association between PM from different sources (desert and non-desert) and daily mortality and emergency hospitalizations. Finally, we pooled city-specific results in a random-effects meta-analysis. On average, 15% of days were affected by desert dust at ground level (desert PM10 > 0 μg/m3). Most episodes occurred in spring-summer, with increasing gradient of both frequency and intensity north-south and west-east of the Mediterranean basin. We found significant associations of both PM10 concentrations with mortality. Increases of 10 μg/m3 in non-desert and desert PM10 (lag 0-1 days) were associated with increases in natural mortality of 0.55% (95% CI: 0.24, 0.87%) and 0.65% (95% CI: 0.24, 1.06%), respectively. Similar associations were estimated for cardio-respiratory mortality and hospital admissions. PM10 originating from the desert was positively associated with mortality and hospitalizations in Southern Europe. Policy measures should aim at reducing population exposure to anthropogenic airborne particles even in areas with large contribution from desert dust advections. Stafoggia M, Zauli-Sajani S, Pey J, Samoli E, Alessandrini E, Basagaña X, Cernigliaro A, Chiusolo M, Demaria M, Díaz J, Faustini A, Katsouyanni K, Kelessis AG, Linares C, Marchesi S, Medina S, Pandolfi P, P

  6. Short-term Associations between Fine and Coarse Particulate Matter and Hospitalizations in Southern Europe: Results from the MED-PARTICLES Project

    Science.gov (United States)

    Samoli, Evangelia; Alessandrini, Ester; Cadum, Ennio; Ostro, Bart; Berti, Giovanna; Faustini, Annunziata; Jacquemin, Benedicte; Linares, Cristina; Pascal, Mathilde; Randi, Giorgia; Ranzi, Andrea; Stivanello, Elisa; Forastiere, Francesco

    2013-01-01

    Background: Evidence on the short-term effects of fine and coarse particles on morbidity in Europe is scarce and inconsistent. Objectives: We aimed to estimate the association between daily concentrations of fine and coarse particles with hospitalizations for cardiovascular and respiratory conditions in eight Southern European cities, within the MED-PARTICLES project. Methods: City-specific Poisson models were fitted to estimate associations of daily concentrations of particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5), ≤ 10 μm (PM10), and their difference (PM2.5–10) with daily counts of emergency hospitalizations for cardiovascular and respiratory diseases. We derived pooled estimates from random-effects meta-analysis and evaluated the robustness of results to co-pollutant exposure adjustment and model specification. Pooled concentration–response curves were estimated using a meta-smoothing approach. Results: We found significant associations between all PM fractions and cardiovascular admissions. Increases of 10 μg/m3 in PM2.5, 6.3 μg/m3 in PM2.5–10, and 14.4 μg/m3 in PM10 (lag 0–1 days) were associated with increases in cardiovascular admissions of 0.51% (95% CI: 0.12, 0.90%), 0.46% (95% CI: 0.10, 0.82%), and 0.53% (95% CI: 0.06, 1.00%), respectively. Stronger associations were estimated for respiratory hospitalizations, ranging from 1.15% (95% CI: 0.21, 2.11%) for PM10 to 1.36% (95% CI: 0.23, 2.49) for PM2.5 (lag 0–5 days). Conclusions: PM2.5 and PM2.5–10 were positively associated with cardiovascular and respiratory admissions in eight Mediterranean cities. Information on the short-term effects of different PM fractions on morbidity in Southern Europe will be useful to inform European policies on air quality standards. Citation: Stafoggia M, Samoli E, Alessandrini E, Cadum E, Ostro B, Berti G, Faustini A, Jacquemin B, Linares C, Pascal M, Randi G, Ranzi A, Stivanello E, Forastiere F, the MED-PARTICLES Study Group. 2013. Short

  7. [Treatment-refractory-dental-extraction-associated pyothorax involving infection by 2 species of oral originated bacteria requires surgical debridement by video assisted thoracoscopic surgery (VATS)].

    Science.gov (United States)

    Rai, Kammei; Matsuo, Kiyoshi; Yonei, Toshiro; Sato, Toshio

    2008-09-01

    Cases of septic pulmonary embolism (SPE) diagnosed clinically by CT after dental extraction rarely include verification of bacteria from the local infection site. We report the case of a 70-year-old man without background disease suffering severe pyothrax after dental extraction. We detected two species of oral bacteria from his pleural effusion. Treatment was so difficult that it required surgical debridement by video assisted thoracoscopic surgery (VATS), even after the appropriate administration of antibiotics. According to the American Heart Association (AHA) prophylaxis guidelines for preventing infective endocarditis indicate that it is uncommon to prescribe antibiotics to patients without background disease after dental extraction. No appropriate Japanese guidelines exist considering the prevention of SPE causing severe pyothorax as in our case. The hematogenous spread of bacteria such as SPE caused by sepsis after tooth extraction thus requires more attended careful consideration in clinical practice if patients are to be properly protected against potentially serious complications.

  8. Non-surgical treatment for localized gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Interium analysis of a multicenter prospective study in Japan

    International Nuclear Information System (INIS)

    Mera Kiyomi

    2004-01-01

    Although eradication of Helicobacter pylori and radiation therapy (RT) have curative potential for gastric mucosa-associated lymphoid tissue (MALT) lymphoma, no prospective study has yet been reported. This prospective study evaluated the efficacy and safety of this non-surgical treatment for localized gastric MALT lymphoma. Among the 115 eligible patients, 89 (77.3%) achieved remission with eradication therapy. Twenty five (21.7%) patients received RT as additional treatment for residual tumor and 22 (88%) achieved complete remission. No serious adverse events, such as hemorrhage or perforation of the stomach, were observed. This organ-preserving treatment for localized gastric MALT lymphoma is safe and effective and has the potential to become the standard treatment for this disease, although long-term follow up is necessary. (author)

  9. IκBα polymorphisms were associated with increased risk of gastric cancer in a southern Chinese population: a case-control study.

    Science.gov (United States)

    Wang, Shiyan; Zhang, Mingdong; Zeng, Zhirong; Tian, Linwei; Wu, Kaichun; Chu, Jianhong; Fan, Daiming; Hu, Pinjin; Sung, Joseph J Y; Yu, Jun

    2011-04-25

    Nuclear factor-kappa B inhibitor alpha (IκBα) polymorphisms were found to be associated with inflammatory diseases. However, the association between IκBα polymorphisms with gastric cancer is still unknown. We aim to investigate the association between IκBα polymorphisms and gastric cancer risk in a large population-based case-control study among southern Chinese. A population-based case-control study was conducted between 1999 and 2006 in Guangdong Province, China. A total of 1010 gastric cancer patients and 1500 healthy controls were enrolled in this study. IκBα polymorphisms were identified by sequencing of IκBα gene ranging from the 2kb promoter region to the 3.5kb genomic region. Polymorphisms in IκBα were analyzed by TaqMan SNP genotyping assay. rs17103265 deletion homozygote (-/-) had significantly increased gastric cancer risk (OR=2.11, 95% CI=1.17-3.83, P=0.01), compared with rs17103265 T homozygote (TT). rs17103265 (-/-) genotype was significantly associated with increased risk of intestinal-type gastric cancer with (OR=2.21, 95% CI=1.19-4.08, P=0.01), but not with the diffuse or mix type of gastric cancer. rs17103265 (-/-) was associated with poorly differentiated gastric cancer (OR=2.05, 95% CI=1.07-3.94, P=0.03), but not with moderately or well differentiated gastric cancer. A significant decrease in luciferase activity was observed in rs17103265 deletion allele as compared with the vector containing the rs17103265 T allele (P<0.0001). rs17103265 polymorphism was not associated with the prognosis of gastric cancer patients. IκBα rs17103265 deletion homozygote is a novel genetic risk factor for gastric carcinogenesis, especially for the development of certain subtypes of gastric cancer in southern Chinese population. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. Prevalence of gallstones in 1,229 patients submitted to surgical laparoscopic treatment of GERD and esophageal achalasia: associated cholecystectomy was a safe procedure.

    Science.gov (United States)

    Sallum, Rubens Antonio Aissar; Padrão, Eduardo Messias Hirano; Szachnowicz, Sergio; Seguro, Francisco C B C; Bianchi, Edno Tales; Cecconello, Ivan

    2015-01-01

    Association between esophageal achalasia/ gastroesophageal reflux disease (GERD) and cholelithiasis is not clear. Epidemiological data are controversial due to different methodologies applied, the regional differences and the number of patients involved. Results of concomitant cholecistectomy associated to surgical treatment of both diseases regarding safety is poorly understood. To analyze the prevalence of cholelithiasis in patients with esophageal achalasia and gastroesophageal reflux submitted to cardiomyotomy or fundoplication. Also, to evaluate the safety of concomitant cholecistectomy. Retrospective analysis of 1410 patients operated from 2000 to 2013. They were divided into two groups: patients with GERD submitted to laparocopic hiatoplasty plus Nissen fundoplication and patients with esophageal achalasia to laparoscopic cardiomyotomy plus partial fundoplication. It was collected epidemiological data, specific diagnosis and subgroups, the presence or absence of gallstones, surgical procedure, operative and clinical complications and mortality. All groups/subgroups were compared. From 1,229 patients with GERD or esophageal achalasia, submitted to laparoscopic cardiomyotomy or fundoplication, 138 (11.43%) had cholelitiasis, occurring more in females (2.38:1) with mean age of 50,27 years old. In 604 patients with GERD, 79 (13,08%) had cholelitiasis. Lower prevalence occurred in Barrett's esophagus patients 7/105 (6.67%) (p=0.037). In 625 with esophageal achalasia, 59 (9.44%) had cholelitiasis, with no difference between chagasic and idiopathic forms (p=0.677). Complications of patients with or without cholecystectomy were similar in fundoplication and cardiomyotomy (p=0.78 and p=1.00).There was no mortality or complications related to cholecystectomy in this series. Prevalence of cholelithiasis was higher in patients submitted to fundoplication (GERD). Patients with chagasic or idiopatic forms of achalasia had the same prevalence of cholelithiasis. Gallstones

  11. Southern African Journal of Environmental Education

    African Journals Online (AJOL)

    The Southern African Journal of Environmental Education (SAJEE) is an accredited and ... It is published at least once a year, by the Environmental Education Association of Southern Africa (EEASA). ... AJOL African Journals Online. HOW TO ...

  12. ANAESTHESIA FOR OPHTHALMIC SURGICAL PROCEDURES

    African Journals Online (AJOL)

    Objective: To review factors influencing the choice of anaesthesia for ophthalmic surgical procedures. ... as risk associated with general anaesthesia (8) they are more .... Wilson ME, Pandey SK, Thakur J. Paediatric cataract blindness in the ...

  13. High prevalence and associated risk factors for impaired renal function and urinary abnormalities in a rural adult population from southern China.

    Directory of Open Access Journals (Sweden)

    Qinghua Liu

    Full Text Available BACKGROUND: The prevalence of chronic kidney disease (CKD has increased and will continue to rise worldwide. However, data regarding the prevalence of CKD in a rural area of China are limited. We therefore investigated the prevalence and associated risk factors of impaired renal function and urinary abnormalities in an adult rural population in southern China. METHODS: Between December 2006 and January 2007, residents older than 20 years from four villages in Zhuhai city were randomly selected using a stratified, multistage sampling technique. All participants were interviewed and tested for hematuria, albuminuria and estimated glomerular filtration rate (eGFR. The associations between age, gender, diabetes mellitus, hypertension, hyperuricemia, education level and indicators of renal damage were examined. RESULTS: Overall, 1,214 subjects were enrolled in this study. After adjustment for age and gender, the prevalence of albuminuria was 7.1% (95% CI: 4.5, 8.1, reduced eGFR was 2.6% (95% CI: 1.7%, 3.3%, and hematuria was 4.6% (95% CI: 3.3%, 6.0%. Approximately 13.6% (95% CI: 12.0%, 15.1% of the patients had at least one indicator of renal damage, but only 8.3% were previously aware. Age, diabetes, hyperlipidemia, hypertension, hyperuricemia, use of nephrotoxic medications, coronary heart disease and history of CKD were independently associated with impaired renal function and urinary abnormalities. Additionally, age, diabetes, and hypertension were independently associated with albuminuria. Age, hypertension, hyperuricemia, central obesity, and coronary heart disease were independently associated with reduced renal function. CONCLUSIONS: The high prevalence and low awareness of impaired renal function and urinary abnormalities in this population illustrates the urgent need to implement a CKD prevention program in the rural areas of southern China.

  14. Associations between breakfast eating habits and health-promoting lifestyle, suboptimal health status in Southern China: a population based, cross sectional study.

    Science.gov (United States)

    Chen, Jieyu; Cheng, Jingru; Liu, Yanyan; Tang, Yang; Sun, Xiaomin; Wang, Tian; Xiao, Ya; Li, Fei; Xiang, Lei; Jiang, Pingping; Wu, Shengwei; Wu, Liuguo; Luo, Ren; Zhao, Xiaoshan

    2014-12-11

    Suboptimal health status (SHS) is the intermediate health state between health and disease, refers to medically undiagnosed or functional somatic syndromes, and has been a major global public health challenge. However, both the etiology and mechanisms associated with SHS are still unclear. Breakfast eating behavior is a dietary pattern marker and previous studies have presented evidence of associations between failure to consume breakfast and increased diseases. Accordingly, in view of the significance of breakfast eating behaviors with respect to health status, the associations between breakfast eating habits and healthy lifestyle, SHS require further elucidation. A cross-sectional survey was conducted within a clustered sample of 24,159 individuals aged 12-80 years in 2012-13 within the population of Southern China. Breakfast eating habits were categorically defined by consumption frequency ('scarcely, sometimes or always'). Health-promoting lifestyle was assessed via the health-promoting lifestyle profile (HPLP-II). SHS was evaluated using the medical examination report and Sub-health Measurement Scale V1.0 (SHMS V1.0). Of the 24,159 participants, the prevalence rates for the 'health' , 'SHS' , and 'disease' were 18.8%, 46.0%, and 35.2%, respectively. Overall, 19.6% of participants reported 'scarce' breakfast eating habits, with frequent breakfast eaters scoring higher on both HPLP-II and SHMS V1.0. After demographic adjustment, regression analyses revealed a significant association between breakfast eating habits and healthy lifestyle (p eating habits are significantly associated with a healthy lifestyle, and appear to be a useful predictor of a healthy lifestyle. Irregular breakfast eating habits are related to an increased risk of SHS; increased breakfast eating frequency may contribute to lowering the prevalence of SHS in Southern China.

  15. Association study between four polymorphisms in the HFE, TF and TFR genes and Parkinson's disease in southern Italy.

    Science.gov (United States)

    Greco, Valentina; De Marco, Elvira Valeria; Rocca, Francesca Emanuela; Annesi, Ferdinanda; Civitelli, Donatella; Provenzano, Giovanni; Tarantino, Patrizia; Scornaienchi, Vittorio; Pucci, Franco; Salsone, Maria; Novellino, Fabiana; Morelli, Maurizio; Paglionico, Sandra; Gambardella, Antonio; Quattrone, Aldo; Annesi, Grazia

    2011-06-01

    Iron overload may lead to neurodegenerative disorders such as Parkinson's disease (PD) and alterations of iron-related genes might be involved in the pathogenesis of this disease. The gene of haemochromatosis (HFE) encodes the HFE protein which interacts with the transferrin receptor (TFR), lowering its affinity for iron-bound transferrin (TF). We examined four known polymorphisms, C282Y and H63D in the HFE gene, G258S in the TF gene and S82G in the TFR gene, in 181 sporadic PD patients and 180 controls from Southern Italy to investigate their possible role in susceptibility to PD. No significant differences were found in genotype and allele frequencies between PD and controls for all the polymorphisms studied, suggesting that these variants do not contribute significantly to the risk of PD.

  16. Association of the Addition of Oral Antibiotics to Mechanical Bowel Preparation for Left Colon and Rectal Cancer Resections With Reduction of Surgical Site Infections.

    Science.gov (United States)

    Vo, Elaine; Massarweh, Nader N; Chai, Christy Y; Tran Cao, Hop S; Zamani, Nader; Abraham, Sherry; Adigun, Kafayat; Awad, Samir S

    2018-02-01

    Surgical site infections (SSIs) after colorectal surgery remain a significant complication, particularly for patients with cancer, because they can delay the administration of adjuvant therapy. A combination of oral antibiotics and mechanical bowel preparation (MBP) is a potential, yet controversial, SSI prevention strategy. To determine the association of the addition of oral antibiotics to MBP with preventing SSIs in left colon and rectal cancer resections and its association with the timely administration of adjuvant therapy. A retrospective review was performed of 89 patients undergoing left colon and rectal cancer resections from October 1, 2013, to December 31, 2016, at a single institution. A bowel regimen of oral antibiotics and MBP (neomycin sulfate, metronidazole hydrochloride, and magnesium citrate) was implemented August 1, 2015. Patients receiving MBP and oral antibiotics and those undergoing MBP without oral antibiotics were compared using univariate analysis. Multivariable logistic regression controlling for factors that may affect SSIs was used to evaluate the association between use of oral antibiotics and MBP and the occurrence of SSIs. Surgical site infections within 30 days of the index procedure and time to adjuvant therapy. Of the 89 patients (5 women and 84 men; mean [SD] age, 65.3 [9.2] years) in the study, 49 underwent surgery with MBP but without oral antibiotics and 40 underwent surgery with MBP and oral antibiotics. The patients who received oral antibiotics and MBP were younger than those who received only MBP (mean [SD] age, 62.6 [9.1] vs 67.5 [8.8] years; P = .01), but these 2 cohorts of patients were otherwise similar in baseline demographic, clinical, and cancer characteristics. Surgical approach (minimally invasive vs open) and case type were similarly distributed; however, the median operative time of patients who received oral antibiotics and MBP was longer than that of patients who received MBP only (391 minutes

  17. Accounting for early job turnover in recent pediatric surgery fellowship graduates: An American Pediatric Surgical Association Membership and Credentials Committee study.

    Science.gov (United States)

    Crafts, Trevor D; Bell, Teresa M; Srisuwananukorn, Andrew; Applebaum, Harry; Markel, Troy A

    2018-04-27

    Employment opportunities for graduating pediatric surgeons vary from year to year. Significant turnover among new employees indicates fellowship graduates may be unsophisticated in choosing job opportunities which will ultimately be satisfactory for themselves and their families. The purpose of this study was to assess what career, life, and social factors contributed to the turnover rates among pediatric surgeons in their first employment position. American Pediatric Surgical Association members who completed fellowship training between 2011 and 2016 were surveyed voluntarily. Only those who completed training in a pediatric surgery fellowship sanctioned by the American Board of Surgery and whose first employment involved the direct surgical care of patients were included. The survey was completed electronically and the results were evaluated using chi-squared analysis to determine which independent variables contributed to a dependent outcome of changing place of employment. 110 surveys were returned with respondents meeting inclusion criteria. 13 (11.8%) of the respondents changed jobs within the study period and 97 (88.2%) did not change jobs. Factors identified that likely contributed to changing jobs included a perceived lack of opportunity for career [p = career goals unfulfilled by practice [p = 0.011]; lack of mentorship in partners [p = 0.026]; and desire to be closer to the surgeon's or their spouse's family [p = 0.002]. Several factors appear to play a role in motivating young pediatric surgeons to change jobs early in their careers. These factors should be taken into account by senior pediatric fellows and their advisors when considering job opportunities. Survey. IV. Copyright © 2018 Elsevier Inc. All rights reserved.

  18. The American College of Surgeons/Association of Program Directors in Surgery National Skills Curriculum: adoption rate, challenges and strategies for effective implementation into surgical residency programs.

    Science.gov (United States)

    Korndorffer, James R; Arora, Sonal; Sevdalis, Nick; Paige, John; McClusky, David A; Stefanidis, Dimitris

    2013-07-01

    The American College of Surgeons/Association of Program Directors in Surgery (ACS/APDS) National Skills Curriculum is a 3-phase program targeting technical and nontechnical skills development. Few data exist regarding the adoption of this curriculum by surgical residencies. This study attempted to determine the rate of uptake and identify implementation enablers/barriers. A web-based survey was developed by an international expert panel of surgical educators (5 surgeons and 1 psychologist). After piloting, the survey was sent to all general surgery program directors via email link. Descriptive statistics were used to determine the residency program characteristics and perceptions of the curriculum. Implementation rates for each phase and module were calculated. Adoption barriers were identified quantitatively and qualitatively using free text responses. Standardized qualitative methodology of emergent theme analysis was used to identify strategies for success and details of support required for implementation. Of the 238 program directors approached, 117 (49%) responded to the survey. Twenty-one percent (25/117) were unaware of the ACS/APDS curriculum. Implementation rates for were 36% for phase I, 19% for phase II, and 16% for phase III. The most common modules adopted were the suturing, knot-tying, and chest tube modules of phase I. Over 50% of respondents identified lack of faculty protected time, limited personnel, significant costs, and resident work-hour restrictions as major obstacles to implementation. Strategies for effective uptake included faculty incentives, adequate funding, administrative support, and dedicated time and resources. Despite the availability of a comprehensive curriculum, its diffusion into general surgery residency programs remains low. Obstacles related to successful implementation include personnel, learner, and administrative issues. Addressing these issues may improve the adoption rate of the curriculum. Copyright © 2013 Mosby, Inc

  19. Post-surgical functional recovery, lumbar lordosis, and range of motion associated with MR-detectable redundant nerve roots in lumbar spinal stenosis.

    Science.gov (United States)

    Chen, Jinshui; Wang, Juying; Wang, Benhai; Xu, Hao; Lin, Songqing; Zhang, Huihao

    2016-01-01

    T1- and T2-weighted magnetic resonance images (MRI) can reveal lumbar redundant nerve roots (RNRs), a result of chronic compression and nerve elongation associated with pathogenesis of cauda equina claudication (CEC) in degenerative lumbar canal stenosis (DLCS). The study investigated effects of lumbar lordosis angle and range of motion on functional recovery in lumbar stenosis patents with and without RNRs. A retrospective study was conducted of 93 lumbar spinal stenosis patients who underwent decompressive surgery. Eligible records were assessed by 3 independent blinded radiologists for presence or absence of RNRs on sagittal T2-weighted MR (RNR and non-RNR groups), pre- and post-operative JOA score, lumbar lordosis angle, and range of motion. Of 93 total patients, the RNR group (n=37, 21/37 female) and non-RNR group (n=56; 31/56 female) had similar preoperative conditions (JOA score) and were not significantly different in age (mean 64.19 ± 8.25 vs. 62.8 ± 9.41 years), symptom duration (30.92 ± 22.43 vs. 28.64 ± 17.40 months), or follow-up periods (17.35 ± 4.02 vs. 17.75 ± 4.29 mo) (all p>0.4). The non-RNR group exhibited significantly better final JOA score (p=0.015) and recovery rate (p=0.002). RNR group patients exhibited larger lumbar lordosis angles in the neutral position (p=0.009) and extension (p=0.021) and larger range of motion (p=0.008). Poorer surgical outcomes in patients with RNRs indicated that elevated lumbar lordosis angle and range of motion increased risks of RNR formation, which in turn may cause poorer post-surgical recovery, this information is possibly useful in prognostic assessment of lumbar stenosis complicated by RNRs. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. The association of culling and death rate within 30 days after calving with productivity or reproductive performance in dairy herds in Fukuoka, Southern Japan.

    Science.gov (United States)

    Goto, Akira; Nakada, Ken; Katamoto, Hiromu

    2016-05-03

    The incidence of peripartum disorders in dairy herds negatively influences productivity and reproductive performance. Concrete data from local areas are helpful for explaining the importance of peripartum management to dairy farmers. This study was conducted to clarify the association of culling and death rate within 30 days after calving with productivity or reproductive performance in 179 dairy herds in Fukuoka, Southern Japan. A database was compiled from the records of the Livestock Improvement Association of Japan, the Dairy Cooperative Association and the Federation of Agricultural Mutual Relief Association. In this study, we created a comprehensive database of dairy farm production data for epidemiological analysis and used a general linear mixed model to analyze the association of culling and death rate within 30 days after calving with milk production or reproductive performance. The database can be used to describe, analyze and predict the risk of production. A cross-sectional analysis with contrasts was applied to investigate the association of cows served by AI/all cows, pregnant cows/cows served by AI, days open, milk yield and somatic cell counts with culling and death rate within 30 days after calving. The days open value significantly increased with increasing rate of culling and death within 30 days after calving (P for trend <0.001). No significant differences were found for the other comparisons. Our data suggest that proper feeding and management in the dry period may lead to improved postpartum reproductive performance in this dairy cow cohort.

  1. Dero (Allodero lutzi Michaelsen, 1926 (Oligochaeta: Naididae associated with Scinax fuscovarius (Lutz, 1925 (Anura: Hylidae from Semi-deciduous Atlantic Rain Forest, southern Brazil

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    FH. Oda

    Full Text Available Amphibians are hosts for a wide variety of ecto- and endoparasites, such as protozoans and parasitic worms. Naididae is a family of Oligochaeta whose species live on a wide range of substrates, including mollusks, aquatic macrophytes, sponges, mosses, liverworts, and filamentous algae. However, some species are known as endoparasitic from vertebrates, such as Dero (Allodero lutzi, which is parasitic of the urinary tracts of frogs, but also have a free-living stage. Specimens in the parasitic stage lack dorsal setae, branchial fossa, and gills. Here we report the occurrence of D. (A. lutzi associated with anuran Scinax fuscovarius from Semi-deciduous Atlantic Rain Forest in southern Brazil. The study took place at the Caiuá Ecological Station, Diamante do Norte, Paraná, southern Brazil. Seven specimens of S. fuscovarius were examined for parasites but only one was infected. Parasites occurred in ureters and urinary bladder. Previous records of this D. (A. lutzi include the Brazilian States of Santa Catarina, São Paulo, Rio de Janeiro, and Minas Gerais, as well as Cuba and North America. This is a new locality record for this species in Brazil. Reports of Dero (Allodero lutzi are rare, due to difficulty of observation, and such events are restricted only the fortuitous cases. It is important to emphasize the necessity of future studies, which are fundamental to the understanding of biological and ecological aspects of this species.

  2. A study on the determination of risk factors associated with babesiosis and prevalence of Babesia sp., by PCR amplification, in small ruminants from Southern Punjab (Pakistan

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    Iqbal F.

    2011-08-01

    Full Text Available Babesiosis is a parasitic infection due to the multiplication of tick borne parasite, Babesia sp., in erythrocytes of host, which includes a wide variety of vertebrates including small ruminants causing decreased livestock output and hence economic losses. The objective of the present study was to establish a PCR based method for the detection of Babesia sp. in small ruminant population in Southern Punjab and to determine the risk factors involve in the spread of babesiosis. A total of 107 blood samples were collected from 40 sheep and 67 goats in seven districts of Southern Punjab from randomly selected herds. Data on the characteristics of the animals and the herd were collected through questionnaires. 36 blood samples (34% of total produced the DNA fragment specific for 18S rRNA gene of Babesia sp., by PCR amplification, of which 20 were sheep and 16 were goats. Samples from all seven district contained Babesia positive samples and prevalence varied between 18 to 68%. It was observed that male animals (P = 0.009 and young animals under one year of age (P = 0.01 were more prone to the parasite. It was observed that herds consist of more than 15 animals (P = 0.007, composed of mixed species of small ruminants (P = 0.022, associated with dogs (P = 0.003 and dogs having ticks on their bodies (P = 0.011 were among the major risk factors for the spread of babesiosis in small ruminants.

  3. A study on the determination of risk factors associated with babesiosis and prevalence of Babesia sp., by PCR amplification, in small ruminants from Southern Punjab (Pakistan).

    Science.gov (United States)

    Iqbal, F; Fatima, M; Shahnawaz, S; Naeem, M; Shaikh, Rs; Ali, M; Shaikh, As; Aktas, M; Ali, M

    2011-08-01

    Babesiosis is a parasitic infection due to the multiplication of tick borne parasite, Babesia sp., in erythrocytes of host, which includes a wide variety of vertebrates including small ruminants causing decreased livestock output and hence economic losses. The objective of the present study was to establish a PCR based method for the detection of Babesia sp. in small ruminant population in Southern Punjab and to determine the risk factors involve in the spread of babesiosis. A total of 107 blood samples were collected from 40 sheep and 67 goats in seven districts of Southern Punjab from randomly selected herds. Data on the characteristics of the animals and the herd were collected through questionnaires. 36 blood samples (34% of total) produced the DNA fragment specific for 18S rRNA gene of Babesia sp., by PCR amplification, of which 20 were sheep and 16 were goats. Samples from all seven district contained Babesia positive samples and prevalence varied between 18 to 68%. It was observed that male animals (P = 0.009) and young animals under one year of age (P = 0.01) were more prone to the parasite. It was observed that herds consist of more than 15 animals (P = 0.007), composed of mixed species of small ruminants (P = 0.022), associated with dogs (P = 0.003) and dogs having ticks on their bodies (P = 0.011) were among the major risk factors for the spread of babesiosis in small ruminants.

  4. Non-apical positive surgical margins after radical prostatectomy for pT2 prostate cancer is associated with the highest risk of recurrence

    DEFF Research Database (Denmark)

    Roder, Martin Andreas; Kawa, Sandra; Scheike, Thomas

    2014-01-01

    BACKGROUND AND OBJECTIVE: To investigate how location of positive surgical margins (PSM) in pT2 tumors affect the risk of biochemical recurrence (BR). METHODS: The study includes 1,133 consecutive patients from 1995 until end of 2011, who had organ-confined disease (pT2) following RP. The location...... a 3.1-fold increased risk of BR compared to margin negative patients. Patients with pT2 apical and non-apical PSM had a 5-year biochemical recurrence-free survival of 84.9% (95% CI: 77.6-92.2%) and 78.6% (95% CI: 71.3-85.9%), respectively. In multivariate analysis, pT2 apical and non-apical PSM...... was individually associated with a 2.2- and 3.8-fold increased risk of BR compared to margin negative patients. CONCLUSION: In our cohort the location of pT2 PSM was associated with time to BR, that is, patients with non-apical pT2 PSM endured the highest risk of BR compared to apical PSM. This may indicate...

  5. Thiopurines are associated with a reduction in surgical re-resections in patients with Crohn's disease: a long-term follow-up study in a regional and academic cohort.

    Science.gov (United States)

    van Loo, Ellen S; Vosseberg, Ninke W; van der Heide, Frans; Pierie, Jean-Pierre E N; van der Linde, Klaas; Ploeg, Rutger J; Dijkstra, Gerard; Nieuwenhuijs, Vincent B

    2013-12-01

    Combination therapy of thiopurines and anti-tumor necrosis factor alpha (TNF-α) antibodies is the most effective medical treatment of Crohn's disease (CD). Data on thiopurines and anti-TNF-α antibodies in preventing surgical recurrence (need for re-resection) of CD are scarce. Therefore, we analyzed which factors were involved in surgical recurrence of CD in a large cohort of patients with CD operated in a regional and a university hospital. This is a retrospective cohort study of 567 patients who underwent surgery for CD. Clinical data and risk factors for surgical recurrence were analyzed, focusing on medical therapy and hospital type. Overall, 237 (41.8%) patients developed a surgical recurrence, after a median of 70 (2-482) months. Before surgical recurrence, 235 patients (41.4%) and 116 patients (20.5%) used thiopurines and anti-TNF-α antibodies, respectively. Multivariate analysis identified 3 independent risk factors associated with surgical recurrence of CD. A higher risk was seen in patients with colonic disease compared with patients with ileal disease (hazard ratio, 1.56; 95% confidence interval, 1.10-2.21; P = 0.012) and in patients using multiple types of medication (hazard ratio, 1.38; 95% confidence interval, 1.25-1.54; P < 0.001). However, a lower risk was seen in patients using thiopurines (hazard ratio, 0.51; 95% confidence interval, 0.34-0.77; P = 0.001). Thiopurines are effective in preventing surgical recurrence of CD. The role of anti-TNF-α antibodies seems promising as well. Combination therapy of thiopurines and anti-TNF-α antibodies for prevention of surgical recurrence of CD should be studied in a randomized trial.

  6. Prevalence of Helicobacter pylori infection and associated factors among adults in Southern Brazil: a population-based cross-sectional study

    Directory of Open Access Journals (Sweden)

    Halal Camila S

    2005-11-01

    Full Text Available Abstract Background Helicobacter pylori (Hp infection is associated with several upper gastrointestinal disorders. Local data on the epidemiology of the infection are scarce in Brazil. The purpose of this study is to measure the prevalence rate and to explore the associated factors among the adult population living in Pelotas, a southern Brazilin city. Methods This was a population-based cross-sectional study. Through a multi-stage sampling method all individuals 20 years and over living at the selected households at the urban area of the city were interviewed regarding past and current socio-economic indicators; demographic characteristics; nutritional and behavioural habits; and history of upper gastrointestinal symptoms.Hp infection was ascertained through the 13C-UBT. Due to the high prevalence, data were analysed through robust Poisson regression. All analyses took into account the family clustering of the data. Results Among 563 eligible individuals, 363 agreed to perform the 13C-UBT (refusal rate of 35.5%. Refusals were associated with female sex, consumption of mate drinking, and presence of upper gastrointestinal symptoms. The prevalence rate of H. pylori infection was 63.4% (95%CI 59.3%–69.3%. In crude analyses, prevalence was associated with increasing age, non-white skin colour, lower current family income, lower education level, higher size of the family, low socio-economic conditions in childhood, higher number of siblings and attendance to day-care centres in childhood, and presence of dyspeptic symptoms. In adjusted analysis the level of education of the father was inversely associated with the infection, whereas number of siblings and attendance to day-care centre in childhood were directly associated with it. Non-white skin colour remained significantly associated with increased prevalence even after allowing for past and current socio-economic characteristics, age and sex. Compared to non-symptomatic individuals, those

  7. Factors associated with the use of cognitive aids in operating room crises: a cross-sectional study of US hospitals and ambulatory surgical centers.

    Science.gov (United States)

    Alidina, Shehnaz; Goldhaber-Fiebert, Sara N; Hannenberg, Alexander A; Hepner, David L; Singer, Sara J; Neville, Bridget A; Sachetta, James R; Lipsitz, Stuart R; Berry, William R

    2018-03-26

    Operating room (OR) crises are high-acuity events requiring rapid, coordinated management. Medical judgment and decision-making can be compromised in stressful situations, and clinicians may not experience a crisis for many years. A cognitive aid (e.g., checklist) for the most common types of crises in the OR may improve management during unexpected and rare events. While implementation strategies for innovations such as cognitive aids for routine use are becoming better understood, cognitive aids that are rarely used are not yet well understood. We examined organizational context and implementation process factors influencing the use of cognitive aids for OR crises. We conducted a cross-sectional study using a Web-based survey of individuals who had downloaded OR cognitive aids from the websites of Ariadne Labs or Stanford University between January 2013 and January 2016. In this paper, we report on the experience of 368 respondents from US hospitals and ambulatory surgical centers. We analyzed the relationship of more successful implementation (measured as reported regular cognitive aid use during applicable clinical events) with organizational context and with participation in a multi-step implementation process. We used multivariable logistic regression to identify significant predictors of reported, regular OR cognitive aid use during OR crises. In the multivariable logistic regression, small facility size was associated with a fourfold increase in the odds of a facility reporting more successful implementation (p = 0.0092). Completing more implementation steps was also significantly associated with more successful implementation; each implementation step completed was associated with just over 50% higher odds of more successful implementation (p ≤ 0.0001). More successful implementation was associated with leadership support (p organizational context and following a multi-step implementation process. Building strong organizational support and

  8. SPACIAL DISTRIBUTION AND ASSOCIATION BETWEEN INFANT MORTALITY AND LOW BIRTH WEIGHT WITH SOCIOECONOMIC FACTORS AND HEALTH SERVICES IN THE SOUTHERN REGION OF BRAZIL.

    Directory of Open Access Journals (Sweden)

    Antonio Fernando Boing, Fernando Kel e Alexandra Crispim Boing

    2006-12-01

    Full Text Available This research aimed to realize the spacial distribution of the infant mortality rates and of the proportion of low weight newborns in the southern area of Brazil and to test the association of those indicators with socioeconomic factors and health services. It is an ecological study put together from data collected from the 1,159 municipalities comprising the southern area of Brazil in the year 2000. The independent variables were the Municipal Human Development Rate, the illiteracy rate, the Gini coefficient, the proportion of poor people and people in homes with indoor plumbing and bathrooms, the annual average of medical visits for basic medical specialties, the monthly average of home visits per family and the number of medical clinics per 10,000 inhabitants. Kolmogorov-Smirnov, ANOVA and Kruskall-Wallis tests were performed and the Spearman coefficient of correlation was calculated. A significant statistical association was established between infant mortality and all the socioeconomic indicators. As for the proportion of low birth weight, it was associated with the proportion of people in homes with indoor plumbing and bathrooms, the annual average of medical visits for basic medical specialties, the Gini coefficient, poverty levels and monthly average of home visits per family. The spacial distribution of the diseases investigated allowed the identification of areas with the worst indicators investigated and which need greater government investment and attention. The public policies in infant health care should consider the need to improve the socioeconomic conditions and accessible health services in order to reduce the inequalities in health and the magnitude of the disease.

  9. Mother knows best: occurrence and associations of resighted humpback whales suggest maternally derived fidelity to a Southern Hemisphere coastal feeding ground.

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    Jaco Barendse

    Full Text Available Site fidelity is common among migratory cetaceans, including humpback whales (Megaptera novaeangliae. In the Northern Hemisphere it has been found that fidelity to humpback whale feeding grounds is transferred maternally but this has never been shown for the species in the Southern Hemisphere. We examined this in a unique feeding area off west South Africa using resighting data of 68 individually identified humpback whales by means of photographic (tail flukes and dorsal fins and/or molecular methods (microsatellite genotyping over an 18 year span. We found short-term association patterns and recurrent visits typical of other feeding grounds. Males and females had different seasonality of attendance. Significant female-dominated presence corresponded to timing of an expected influx of females on their southward migration from the breeding ground: firstly non-nursing (possibly pregnant females in mid-spring, and mothers and calves in mid-to late summer. The potential benefit of this mid-latitude feeding area for females is illustrated by a record of a cow with known age of at least 23 years that produced calves in three consecutive years, each of which survived to at least six months of age: the first record of successful post-partum ovulation for this species in the Southern Hemisphere. We recorded association of a weaned calf with its mother, and a recurring association between a non-lactating female and male over more than two years. Moreover, three animals first identified as calves returned to the same area in subsequent years, sometimes on the same day as their mothers. This, together with numerous Parent-Offspring relations detected genetically among and between resighted and non-resighted whales is strongly suggestive of maternally derived site fidelity at a small spatial scale by a small sub-population of humpback whales.

  10. Autoantibodies in scleroderma and their association with the clinical profile of the disease. A study of 66 patients from southern Brazil.

    Science.gov (United States)

    Skare, Thelma Larocca; Fonseca, Adriano Erlon; Luciano, Alan Campos; Azevedo, Pedro Ming

    2011-01-01

    Scleroderma is a fairly rare connective tissue disease whose autoantibody profile is associated with different clinical manifestations. The prevalence of autoantibodies in scleroderma is influenced by race and genetics. To study the prevalence of anti-Scl-70, anti-centromere (ACA) and anti-U1-RNP antibodies in patients with scleroderma in southern Brazil and verify their association with clinical manifestations of the disease. A retrospective study involving 66 patients with scleroderma for the presence of anti-Scl-70, anti-centromere and anti-U1-RNP and of clinical manifestations such as Raynaud's phenomenon, digital micro scars, digital necrosis, telangiectasias, calcinosis, pulmonary fibrosis, pleuritis, pericarditis, cardiomyopathy, arthralgia and arthritis, skin sclerosis, joint contractures, tendon friction rubs, pulmonary hypertension, esophageal disorders and renal crisis. The prevalence of anti-Scl-70 was 17.8% , that of ACA was 33.3% and the prevalence of U1 RNP was 11.8%. Anti-Scl-70 was associated with the diffuse form of the disease (p = 0.015), presence of cardiomyopathies (p = 0.016) and digital micro scars (p = 0.05). Anti-centromere was more common in the limited form, although it was not statistically significant, and had a protective role associated with cardiomyopathies (p = 0.005). Anti-U1-RNP was more common in the overlap forms (p = 0.0004). The prevalence and profile of clinical associations of autoantibodies in Brazilian patients with scleroderma are similar to those found in the literature.

  11. Traffic-related air pollution associated with prevalence of asthma and COPD/chronic bronchitis. A cross-sectional study in Southern Sweden

    Directory of Open Access Journals (Sweden)

    Nihlén Ulf

    2009-01-01

    Full Text Available Abstract Background There is growing evidence that air pollution from traffic has adverse long-term effects on chronic respiratory disease in children, but there are few studies and more inconclusive results in adults. We examined associations between residential traffic and asthma and COPD in adults in southern Sweden. A postal questionnaire in 2000 (n = 9319, 18–77 years provided disease status, and self-reported exposure to traffic. A Geographical Information System (GIS was used to link geocoded residential addresses to a Swedish road database and an emission database for NOx. Results Living within 100 m of a road with >10 cars/minute (compared with having no heavy road within this distance was associated with prevalence of asthma diagnosis (OR = 1.40, 95% CI = 1.04–1.89, and COPD diagnosis (OR = 1.64, 95%CI = 1.11–2.4, as well as asthma and chronic bronchitis symptoms. Self-reported traffic exposure was associated with asthma diagnosis and COPD diagnosis, and with asthma symptoms. Annual average NOx was associated with COPD diagnosis and symptoms of asthma and chronic bronchitis. Conclusion Living close to traffic was associated with prevalence of asthma diagnosis, COPD diagnosis, and symptoms of asthma and bronchitis. This indicates that traffic-related air pollution has both long-term and short-term effects on chronic respiratory disease in adults, even in a region with overall low levels of air pollution.

  12. The first polluted river? Repeated copper contamination of fluvial sediments associated with Late Neolithic human activity in southern Jordan.

    Science.gov (United States)

    Grattan, J P; Adams, R B; Friedman, H; Gilbertson, D D; Haylock, K I; Hunt, C O; Kent, M

    2016-12-15

    The roots of pyrometallurgy are obscure. This paper explores one possible precursor, in the Faynan Orefield in southern Jordan. There, at approximately 7000cal. BP, banks of a near-perennial meandering stream (today represented by complex overbank wetland and anthropogenic deposits) were contaminated repeatedly by copper emitted by human activities. Variations in the distribution of copper in this sequence are not readily explained in other ways, although the precise mechanism of contamination remains unclear. The degree of copper enhancement was up to an order of magnitude greater than that measured in Pleistocene fluvial and paludal sediments, in contemporary or slightly older Holocene stream and pond deposits, and in the adjacent modern wadi braidplain. Lead is less enhanced, more variable, and appears to have been less influenced by contemporaneous human activities at this location. Pyrometallurgy in this region may have appeared as a byproduct of the activity practised on the stream-bank in the Wadi Faynan ~7000years ago. Copyright © 2016. Published by Elsevier B.V.

  13. Water-soluble Organic Components in Aerosols Associated with Savanna Fires in Southern Africa: Identification, Evolution and Distribution

    Science.gov (United States)

    Gao, Song; Hegg, Dean A.; Hobbs, Peter V.; Kirchstetter, Thomas W.; Magi, Brian I.; Sadilek, Martin

    2003-01-01

    During the SAFARI 2000 field campaign, both smoke aerosols from savanna fires and haze aerosols in the boundary layer and in the free troposphere were collected from an aircraft in southern Africa. These aerosol samples were analyzed for their water-soluble chemical components, particularly the organic species. A novel technique, electrospray ionization-ion trap mass spectrometry, was used concurrently with an ion chromatography system to analyze for carbohydrate species. Seven carbohydrates, seven organic acids, five metallic elements, and three inorganic anions were identified and quantified. On the average, these 22 species comprised 36% and 27% of the total aerosol mass in haze and smoke aerosols, respectively. For the smoke aerosols, levoglucosan was the most abundant carbohydrate species, while gluconic acid was tentatively identified as the most abundant organic acid. The mass abundance and possible source of each class of identified species are discussed, along with their possible formation pathways. The combustion phase of a fire had an impact on the chemical composition of the emitted aerosols. Secondary formation of sulfate, nitrate, levoglucosan, and several organic acids occurred during the initial aging of smoke aerosols. It is likely that under certain conditions, some carbohydrate species in smoke aerosols, such as levoglucosan, were converted to organic acids during upward transport.

  14. [Nursing workplace bullying and turnover intention: an exploration of associated factors at a medical center in Southern Taiwan].

    Science.gov (United States)

    Tsai, Shiau-Ting; Han, Chin-Hua; Chen, Li-Fang; Chou, Fan-Hao

    2014-06-01

    The chronic shortage of nursing staffs in hospitals continues to increasingly and negatively impact the ability of medical care systems to deliver effective care and ensure the safety of patients. Bullying is one factor known to exacerbate turnover in the nursing workplace. This study explores workplace bullying and turnover intention among nurses working at a medical center in Southern Taiwan. A cross-sectional and correlation research design was conducted using the Negative Acts Questionnaire-Revised (NAQ-R) and the Turnover Intention Questionnaire. A convenience, purposive sample of 708 nurses was recruited. Inclusion criteria included: holding an RN license, able to communicate in both Mandarin and Hokkienese, >6 months of clinical experience, and an NAQ-R score higher than 23. Data were analyzed using SPSS19.0 software. Approximately 85% of participants had experienced some degree of workplace bullying during the previous 6-month period. The trend of the turnover intention tended to the right at a high degree. A moderate, positive, and significant correlation was found between turnover intention and bullying total scores (r=.39, pturnover intention (15.10%). Based on our findings, we suggest that nurses should enhance their awareness of the negative consequences of workplace bullying. Furthermore, hospitals should implement appropriate mechanisms to decrease the phenomenon of inter-staff bullying, improve the nursing workplace environment, and reduce the rate of turnover intention.

  15. Concentrations of heavy metals in marine wild fishes captured from the southern sea of Korea and associated health risk assessments

    Science.gov (United States)

    Hwang, Dong-Woon; Kim, Seong-Soo; Kim, Seong-Gil; Kim, Dong-Sun; Kim, Tae-Hoon

    2017-12-01

    Concentrations of heavy metals (As, Cd, Cr, Cu, Hg, Pb, and Zn) were determined in edible parts (muscle) of 34 marine wild fish caught from the southern sea of Korea in 2007 and 2008 in order to understand the accumulation pattern of heavy metals in wild fish and to assess the potential health risk posed by fish consumption. The highest concentrations in the muscle of 17 pelagic and 17 demersal fishes were Zn and As, respectively, while the lowest concentration in both fishes was Cd. The mean concentrations of all metals except As in wild fish were much lower than the regulatory limits for fish and fishery products applied in a number of countries. Unlike other metals, As concentration in wild fish of this study region was relatively higher than that found in other country. Estimated daily intake (EDI) of the metals was in the range of 0.05% to 22.5% of the provisional maximum tolerable daily intakes (PMTDI). Similarly, the target hazard quotient (THQ) was below 1.0 for each metal. These results imply that the consumption of the investigated wild fish do not cause significant adverse health effects.

  16. Surgical pathology of epilepsy-associated non-neoplastic cerebral lesions: a brief introduction with special reference to hippocampal sclerosis and focal cortical dysplasia

    Science.gov (United States)

    Miyata, Hajime; Hori, Tomokatsu; Vinters, Harry V.

    2014-01-01

    Among epilepsy-associated non-neoplastic lesions, mesial temporal lobe epilepsy with hippocampal sclerosis (mTLE-HS) and malformation of cortical development (MCD) including focal cortical dysplasia (FCD), are the two most frequent causes of drug-resistant focal epilepsies constituting about 50% of all surgical pathology of epilepsy. Several distinct histological patterns have been historically recognized in both HS and FCD, and several studies have tried to perform clinicopathological correlation; results, however, have been controversial, particularly in terms of postsurgical seizure outcome. Recently, the International League Against Epilepsy constituted a Task Forces of Neuropathology and FCD within the Commission on Diagnostic Methods, to establish an international consensus of histological classification of HS and FCD, respectively, based on agreement with the recognition of the importance of defining a histopathological classification system that reliably has some clinicopathological correlation. Such consensus classifications are likely to facilitate future clinicopathological study. Meanwhile, we reviewed neuropathology of 41 surgical cases of mTLE, and confirmed three type/patterns of HS along with no HS, based on the qualitative evaluation of the distribution and severity of neuronal loss and gliosis within hippocampal formation; i.e., HS type 1 (61%) equivalent to ‘classical’ Ammon’s horn sclerosis, HS type 2 (2%) representing CA1 sclerosis, HS type 3 (17%) equivalent to end folium sclerosis, and no HS (19%). Furthermore we performed a neuropathological comparative study on mTLE-HS and dementia associated HS (d-HS) in elderly, and confirmed that neuropathological features differ between mTLE-HS and d-HS in the distribution of hippocampal neuronal loss and gliosis, morphology of reactive astrocytes and their protein expression, and presence of concomitant neurodegenerative changes particularly Alzheimer type and TDP-43 pathologies. These

  17. Cytoplasmic Hu-Antigen R (HuR) Expression is Associated with Poor Survival in Patients with Surgically Resected Cholangiocarcinoma Treated with Adjuvant Gemcitabine-Based Chemotherapy.

    Science.gov (United States)

    Toyota, Kazuhiro; Murakami, Yoshiaki; Kondo, Naru; Uemura, Kenichiro; Nakagawa, Naoya; Takahashi, Shinya; Sueda, Taijiro

    2018-05-01

    Hu-antigen R (HuR) is an RNA-binding protein that regulates the stability, translation, and nucleus-to-cytoplasm translocation of messenger RNAs (mRNAs). The aim of this study was to investigate the prognostic significance of HuR in cholangiocarcinoma patients who received adjuvant gemcitabine-based chemotherapy (AGC) after surgical resection. Nuclear and cytoplasmic HuR expression was investigated immunohistochemically in 131 patients with resected cholangiocarcinoma, including 91 patients administered AGC and 40 patients who did not receive adjuvant chemotherapy. The correlation between HuR expression and survival was evaluated by statistical analysis. High nuclear and cytoplasmic HuR expression was observed in 67 (51%) and 45 (34%) patients, respectively. Cytoplasmic HuR expression was significantly associated with lymph node metastasis (p < 0.01), while high cytoplasmic HuR expression was significantly associated with poor disease-free survival [DFS] (p = 0.03) and overall survival [OS] (p = 0.001) in the 91 patients who received AGC, but not in the 40 patients who did not receive AGC (DFS p = 0.17; OS p = 0.07). In the multivariate analysis of patients who received AGC, high cytoplasmic HuR expression was an independent predictor of poor DFS (hazard ratio [HR] 1.77; p = 0.04) and OS (HR 2.09; p = 0.02). Nuclear HuR expression did not affect the survival of enrolled patients. High cytoplasmic HuR expression was closely associated with the efficacy of AGC in patients with cholangiocarcinoma. The current findings warrant further investigations to optimize adjuvant chemotherapy regimens for resectable cholangiocarcinoma.

  18. Factors associated with quality of life among the elderly in the community of the southern triangle macro-region, Minas Gerais, Brazil.

    Science.gov (United States)

    Paiva, Michelle Helena Pereira de; Pegorari, Maycon Sousa; Nascimento, Janaína Santos; Santos, Álvaro da Silva

    2016-11-01

    This study sought to establish the socioeconomic and health factors associated with quality of life among the elderly in the community. An analytical study with a cross-sectional and quantitative approach was conducted in 2012 and 2013 with 3430 senior citizens in 24 municipalities in the Southern Triangle Macro-region of the State of Minas Gerais in Brazil. A structured questionnaire was used for socioeconomic and health variables, as well as the Katz scale, the World Health Organization Quality of Life-Bref (WHOQOL-BREF) and the World Health Organization Quality of Life Assessment for Older Adults (WHOQOL-OLD). Descriptive, bivariate statistical analysis was performed and a multiple linear regression model (p environmental domain and from the aspect of autonomy, a key influencing factor being negative health perception.

  19. Surgical Skills Beyond Scientific Management.

    Science.gov (United States)

    Whitfield, Nicholas

    2015-07-01

    During the Great War, the French surgeon Alexis Carrel, in collaboration with the English chemist Henry Dakin, devised an antiseptic treatment for infected wounds. This paper focuses on Carrel's attempt to standardise knowledge of infected wounds and their treatment, and looks closely at the vision of surgical skill he espoused and its difference from those associated with the doctrines of scientific management. Examining contemporary claims that the Carrel-Dakin method increased rather than diminished demands on surgical work, this paper further shows how debates about antiseptic wound treatment opened up a critical space for considering the nature of skill as a vital dynamic in surgical innovation and practice.

  20. Cognitive and language performance in children is associated with maternal social anxiety disorder: A study of young mothers in southern Brazil.

    Science.gov (United States)

    Castelli, Rochele Dias; Quevedo, Luciana de Ávila; Coelho, Fábio Monteiro da Cunha; Lopez, Mariane Acosta; da Silva, Ricardo Azevedo; Böhm, Denise Müller; Souza, Luciano Dias de Mattos; de Matos, Mariana Bonati; Pinheiro, Karen Amaral Tavares; Pinheiro, Ricardo Tavares

    2015-12-01

    It has been shown that maternal mental health is associated with poorer skills development in the offspring. However, the evidence evaluating the association between social anxiety disorder (SAD) and cognitive or language development, is scarce. To evaluate the association between maternal SAD and performance in cognitive and language tests in 30-month old children. This was a cohort study involving young women evaluated since pregnancy. We evaluated 520 mother-child dyads who received prenatal medical assistance through the National Public Health System in a southern Brazilian city, from October 2009 to March 2011. We used the Mini Neuropsychiatric Interview Plus (MINI Plus) to assess SAD among young mothers. Cognitive and language performance in their offspring was analyzed using the Bayley Scales of Infant and Toddler Development - 3rd Edition. We found an association between maternal SAD and performance in cognitive and language tests. Children of mothers with SAD had in average 4.5 less points in the Bayley scale, when compared to those with mothers without SAD: in the cognitive (β=-4.53 [95% CI -7.8; -1.1] p=0.008) and language subscales (β=-4.54 [95% CI -9.0; -0.5] p=0.047). Our findings suggest that children with mothers suffering from SAD have poorer cognitive abilities and language skills. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Silicic, high- to extremely high-grade ignimbrites and associated deposits from the Paraná Magmatic Province, southern Brazil

    Science.gov (United States)

    Luchetti, Ana Carolina F.; Nardy, Antonio J. R.; Madeira, José

    2018-04-01

    The Cretaceous trachydacites and dacites of Chapecó type (ATC) and dacites and rhyolites of Palmas type (ATP) make up 2.5% of the 800.000 km3 of volcanic pile in the Paraná Magmatic Province (PMP), emplaced at the onset of Gondwana breakup. Together they cover extensive areas in southern Brazil, overlapping volcanic sequences of tholeiitic basalts and andesites; occasional mafic units are also found within the silicic sequence. In the central region of the PMP silicic volcanism comprises porphyritic ATC-type, trachydacite high-grade ignimbrites (strongly welded) overlying aphyric ATP-type, rhyolite high- to extremely high-grade ignimbrites (strongly welded to lava-like). In the southwestern region strongly welded to lava-like high-grade ignimbrites overlie ATP lava domes, while in the southeast lava domes are found intercalated within the ignimbrite sequence. Characteristics of these ignimbrites are: widespread sheet-like deposits (tens to hundreds of km across); absence of basal breccias and basal fallout layers; ubiquitous horizontal to sub-horizontal sheet jointing; massive, structureless to horizontally banded-laminated rock bodies locally presenting flow folding; thoroughly homogeneous vitrophyres or with flow banding-lamination; phenocryst abundance presenting upward and lateral decrease; welded glass blobs in an 'eutaxitic'-like texture; negligible phenocryst breakage; vitroclastic texture locally preserved; scarcity of lithic fragments. These features, combined with high eruption temperatures (≥ 1000 °C), low water content (≤ 2%) and low viscosities (104-7 Pa s) suggest that the eruptions were characterized by low fountaining, little heat loss during collapse, and high mass fluxes producing extensive deposits.

  2. Genesis and petrology of Late Neoproterozoic pegmatites and aplites associated with the Taba metamorphic complex in southern Sinai, Egypt

    Energy Technology Data Exchange (ETDEWEB)

    Abdelfadil, K.M.; Asimow, P.D.; Azer, M.K.; Gahlan, H.A.

    2016-07-01

    We present new field, petrographical, mineralogical and geochemical data from late Neoproterozoic pegmatites and aplites in southern Sinai, Egypt, at the northernmost limit of the Arabian-Nubian Shield. The pegmatites cross-cut host rocks in the Taba Metamorphic Complex (TMC) with sharp contacts and are divided into massive and zoned pegmatites. Massive pegmatites are the most common and form veins, dykes and masses of variable dimensions; strikes range mainly from E-W through NW-SE to N-S. Mineralogically, the massive pegmatites are divided into K-feldspar-rich and albite-rich groups. Zoned pegmatites occur as lenses of variable dimensions, featuring a quartz core, an intermediate zone rich in K-feldspars and an outer finer-grained zone rich in albite. All compositions are highly evolved and display geochemical characteristics of post-collisional A-type granites: high SiO2, Na2O+K2O, FeO*/MgO, Ga/Al, Zr, Nb, Ga and Y alongside low CaO, MgO, Ba and Sr. They are rich in Rare Earth Elements (REE) and have extreme negative Eu anomalies (Eu/Eu*= 0.03–0.09). A genetic linkage between the pegmatites, aplites and alkali granite is confirmed by their common mild alkaline affinity and many other geochemical characteristics. These pegmatites and aplites represent the last small fraction of liquid remaining after extensive crystallization of granitic magma, injected along the foliation and into fractures of the host metamorphic rocks. The extensional tectonic regime and shallow depth of emplacement are consistent with a post-collisional environment. (Author)

  3. Thunderstorms caused by southern cyclones in Estonia

    OpenAIRE

    Kaupo Mändla; Sven-Erik Enno; Mait Sepp

    2014-01-01

    The relationships between the frequency and duration of thunderstorms, lightning and southern cyclones over Estonia are presented for the period 1950–2010. A total of 545 southern cyclones and 2106 thunderstorm days were detected, whereas 11.3% of the observed thunder days were associated with southern cyclones. At the same time, 29.2% of all southern cyclones were accompanied by thunderstorms. In the thunder season, however, this percentage was much higher, reaching up to 80% in summer month...

  4. Left septal atrial tachycardia after open-heart surgery: relevance to surgical approach, anatomical and electrophysiological characteristics associated with catheter ablation, and procedural outcomes.

    Science.gov (United States)

    Adachi, Toru; Yoshida, Kentaro; Takeyasu, Noriyuki; Masuda, Keita; Sekiguchi, Yukio; Sato, Akira; Tada, Hiroshi; Nogami, Akihiko; Aonuma, Kazutaka

    2015-02-01

    Septal atrial tachycardia (AT) can occur in patients without structural heart disease and in patients with previous catheter ablation of atrial fibrillation. We aimed to assess septal AT that occurs after open-heart surgery. This study comprised 20 consecutive patients undergoing catheter ablation of macroreentrant AT after open-heart surgery. Relevance to surgical approach, mechanisms, anatomic and electrophysiological characteristics, and outcomes were assessed. Septal AT was identified in 7 patients who had all undergone mitral valve surgery. All septal ATs were localized in the left atrial septum, whereas 10 of 13 nonseptal ATs originated from the right atrium. Patients with left septal AT had a thicker fossa ovalis (median, 4.0; 25th-75th percentile, 3.6-4.2 versus 2.3; 1.6-2.6 mm; P=0.006) and broader area of low voltage (open-heart surgery was characterized by a thicker septum, more scar burden in the septum, and repeated prolongations of the tachycardia cycle length during ablation. Such an arrhythmogenic substrate may interfere with transmural lesion formation by ablation and may account for higher likelihood of recurrence of left septal AT. © 2014 American Heart Association, Inc.

  5. Preoperative Hospitalization Is Independently Associated With Increased Risk for Venous Thromboembolism in Patients Undergoing Colorectal Surgery: A National Surgical Quality Improvement Program Database Study.

    Science.gov (United States)

    Greaves, Spencer W; Holubar, Stefan D

    2015-08-01

    An important factor in the pathophysiology of venous thromboembolism is blood stasis, thus, preoperative hospitalization length of stay may be contributory to risk. We assessed preoperative hospital length of stay as a risk factor for venous thromboembolism. We performed a retrospective review of patients who underwent colorectal operations using univariate and multivariable propensity score analyses. This study was conducted at a tertiary referral hospital. Data on patients was obtained from the American College of Surgeons National Surgical Quality Improvement Program 2005-2011 Participant Use Data Files. Short-term (30-day) postoperative venous thromboembolism was measured. Our analysis included 242,670 patients undergoing colorectal surgery (mean age, 60 years; 52.9% women); of these, 72,219 (29.9%) were hospitalized preoperatively. The overall rate of venous thromboembolism was 2.07% (1.4% deep vein thrombosis, 0.5% pulmonary embolism, and 0.2% both). On multivariable analysis, the most predictive independent risk factors for venous thromboembolism were return to the operating room (OR, 1.62 (95% CI, 1.44-1.81); p relationship between preoperative lengths of stay and risk of postoperative venous thromboembolism (p risk factor for venous thromboembolism and its associated increase in mortality after colorectal surgery, whereas laparoscopy is a strong protective variable. Further research into preoperative screening for highest-risk patients is indicated.

  6. The National Health Service Breast Screening Programme and British Association of Surgical Oncology audit of quality assurance in breast screening 1996-2001.

    Science.gov (United States)

    Sauven, P; Bishop, H; Patnick, J; Walton, J; Wheeler, E; Lawrence, G

    2003-01-01

    The National Health Service Breast Screening Programme (NHSBSP) is an example of a nationally coordinated quality assurance programme in which all the professional groups involved participate. Surgeons, radiologists and pathologists defined the clinical outcome measures against which they would subsequently be audited. The NHSBSP and the Association of Breast Surgery at BASO are jointly responsible for coordinating an annual audit of all surgical activities undertaken within the NHSBSP. The trends for key outcome measures between 1996 and 2001 are provided. The preoperative diagnosis rate (minimum standard 70 per cent or more) improved from 63 to 87 per cent. This rise was mirrored by an increase in the use of core biopsy in preference to fine-needle cytology. The proportion of patients in whom lymph node status was recorded improved from 81 to 93 per cent. There was no significant change in the number of women treated by low case-load surgeons and waiting times for surgery increased through the study interval. The BASO-NHSBSP Breast Audit has recorded major changes in clinical practice over 5 years. A key feature has been the dissemination of good practice through feedback of the results at local and national level. Copyright 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd

  7. Surgical innovations in canine gonadectomy

    OpenAIRE

    Van Goethem, Bart

    2016-01-01

    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated negative consequences (lengthy placement, impaired wound healing around bulky knots, and the effect of unsightly knots on cosmetics). A study in 9 dogs found that celiotomy closure was easily achiev...

  8. The Disability Impact and Associated Cost per Disability in Women Who Underwent Surgical Revision of Transvaginal Mesh Kits for Prolapse Repair.

    Science.gov (United States)

    Javadian, Pouya; Shobeiri, S Abbas

    2017-09-13

    The aim of this study was to investigate disability impact in patients and cost to the families of patients who have had complications of transvaginal prolapse mesh kits and underwent surgical revision. Patients who developed complications of transvaginal mesh kits for prolapse and who had undergone vaginal prolapse mesh surgical revision/removal in 2009 to 2014 at a single institution were identified by Current Procedural Terminology codes. The group was invited to complete a phone survey pertaining to the initial vaginal mesh used for prolapse surgery utilizing Sheehan Disability Scale (scale 0-10) and Years of life Lived with Disability (YLDs) questionnaires. The data collected were used to estimate the disability and cost analysis. We used our data to estimate the economic and quality-of-life impact of vaginal mesh complications on patients in the United States RESULTS: Sixty-two patients (62/198 [31.2%]) were consented to participate and completed the questionnaires by phone. Extremely disabled patients were 18 (29%) of 62 of whole cases, and 5 (8%) of 62 reported that they had no disability after vaginal mesh surgery. The median for overall disability score after vaginal mesh procedure was 8 (which reflects marked disability on a scale of 0-10). The majority of patients missed a median of 12 months of their school or work because of their mesh complications. Thirty-seven (59.6%) of 62 did not improve after mesh removal. Twenty-one (33.9%) of 62 stated that their family income dropped because of productivity loss related to mesh complications. The mean time between vaginal mesh surgery and mesh removal procedure was 4.7 years. Sheehan Disability Scale scores are significantly correlated with YLDs outcomes. Patients' overall disability score showed a significant correlation with YLDs scores (P mesh for prolapse reduction complications had a sustained disability impact that continued despite mesh removal. Likewise, the complications were associated with

  9. Crustal seismicity associated to rpid surface uplift at Laguna del Maule Volcanic Complex, Southern Volcanic Zone of the Andes

    Science.gov (United States)

    Cardona, Carlos; Tassara, Andrés; Gil-Cruz, Fernando; Lara, Luis; Morales, Sergio; Kohler, Paulina; Franco, Luis

    2018-03-01

    Laguna del Maule Volcanic Complex (LMVC, Southern Andes of Chile) has been experiencing large rates (ca. 30 cm/yr) of surface uplift as detected since 2008 by satellite geodetic measurements. Previous works have modeled the source of this deformation as an inflating rectangular sub-horizontal sill underlying LMVC at 5 km depth, which is supposedly related to an active process of magmatic replenishment of a shallow silicic reservoir. However little is known about the tectonic context on which this activity is taking place, particularly its relation with crustal seismicity that could help understanding and monitoring the current deformation process. Here we present the first detailed characterization of the seismic activity taking place at LMVC and integrate it with structural data acquired in the field in order to illuminate the possible connection between the ongoing process of surface uplift and the activation of crustal faults. Our main finding is the recognition of repetitive volcano-tectonic (VT) seismic swarms that occur periodically between 2011 and 2014 near the SW corner of the sill modeled by InSAR studies. A cross-correlation analysis of the waveforms recorded for these VT events allows identifying three different seismic families. Families F1 and F3 share some common features in the stacked waveform and its locations, which markedly differ from those of family F2. Swarms belonging to this later family are more energetic and its energy was increasing since 2011 to a peak in January 2013, which coincide with maximum vertical velocities detected by local GPS stations. This points to a common process relating both phenomena. The location of VT seismic swarms roughly coincides with the intersection of a NE-SW lineament with a WNW-ESE lineament. The former shows clear field evidences of dextral strike-slip that are fully consistent with one nodal plane of focal mechanism for well-recorded F2 events. The conjugate nodal plane of these focal mechanisms could

  10. Stability of infant and child feeding index over time and its association with nutritional status of HIV exposed infants in Sidama Zone, Southern Ethiopia: a longitudinal study.

    Science.gov (United States)

    Haile, Demewoz; Belachew, Tefera; Berhanu, Getenesh; Setegn, Tesfaye; Biadgilign, Sibhatu

    2014-12-01

    Even though many studies showed that infant and child feeding index has a statistically significant association with nutritional status, there is paucity of studies on stability of infant and child feeding index over time and its association with nutritional status of HIV exposed infants. This study aimed to investigate the stability of infant and child feeding index over time that is developed based on the current recommendations and its association with nutritional status of HIV exposed infants in Sidama Zone, Southern Ethiopia. A panel study design was conducted in health institutions in Sidama Zone from February to July, 2012. Three repeated measurements of data were collected from each HIV exposed infant aged 6-17 months over the 6 month follow-up period approximately per 2 month interval. The cross-sectional index was found stable overtime with the repeatability coefficient of 0.802 which differed significantly from zero (95% CI: 0.75-0.85). A longitudinal infant and child feeding index (L-ICFI) has a statistically significant association with length for age Z scores (LAZ) and weight for age Z scores (WAZ) at visit three (β=0.262, p=0.007; β=0.226, p=0.017), respectively. But the longitudinal index has no statistically significant association with WLZ score (p=0.552). There was no significant difference in change of LAZ and WAZ over time between L-ICFI tertiles for both female and male HIV exposed infants. The index is stable overtime at individual level even though one third of the index components were not stable. The L-CFI was associated with LAZ and WAZ but not with WLZ. However there was no significant difference in change of HAZ and WAZ over time between L-ICFI tertiles for both female and male HIV exposed infants. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Heterogeneity of Breast Cancer Associations with Common Genetic Variants in FGFR2 according to the Intrinsic Subtypes in Southern Han Chinese Women

    Directory of Open Access Journals (Sweden)

    Huiying Liang

    2015-01-01

    Full Text Available GWAS have identified variation in the FGFR2 locus as risk factors for breast cancer. Validation studies, however, have shown inconsistent results by ethnics and pathological characteristics. To further explore this inconsistency and investigate the associations of FGFR2 variants with breast cancer according to intrinsic subtype (Luminal-A, Luminal-B, ER−&PR−&HER2+, and triple negative among Southern Han Chinese women, we genotyped rs1078806, rs1219648, rs2420946, rs2981579, and rs2981582 polymorphisms in 609 patients and 882 controls. Significant associations with breast cancer risk were observed for rs2420946, rs2981579, and rs2981582 with OR (95% CI per risk allele of 1.19 (1.03–1.39, 1.24 (1.07–1.43, and 1.17 (1.01–1.36, respectively. In subtype specific analysis, above three SNPs were significantly associated with increased Luminal-A risk in a dose-dependent manner Ptrend<0.01; however, only rs2981579 was associated with Luminal-B, and none were linked to ER−&PR− subtypes (ER−&PR−&HER2+ and triple negative. Haplotype analyses also identified common haplotypes significantly associated with luminal-like subtypes (Luminal-A and Luminal-B, but not with ER−&PR− subtypes. Our results suggest that associations of FGFR2 SNPs with breast cancer were heterogeneous according to intrinsic subtype. Future studies stratifying patients by their intrinsic subtypes will provide new insights into the complex genetic mechanisms underlying breast cancer.

  12. Diversity of Dicotyledenous-Infecting Geminiviruses and Their Associated DNA Molecules in Southern Africa, Including the South-West Indian Ocean Islands

    Directory of Open Access Journals (Sweden)

    Lindy L. Esterhuizen

    2012-09-01

    Full Text Available The family Geminiviridae comprises a group of plant-infecting circular ssDNA viruses that severely constrain agricultural production throughout the temperate regions of the world, and are a particularly serious threat to food security in sub-Saharan Africa. While geminiviruses exhibit considerable diversity in terms of their nucleotide sequences, genome structures, host ranges and insect vectors, the best characterised and economically most important of these viruses are those in the genus Begomovirus. Whereas begomoviruses are generally considered to be either monopartite (one ssDNA component or bipartite (two circular ssDNA components called DNA-A and DNA-B, many apparently monopartite begomoviruses are associated with additional subviral ssDNA satellite components, called alpha- (DNA-as or betasatellites (DNA-βs. Additionally, subgenomic molecules, also known as defective interfering (DIs DNAs that are usually derived from the parent helper virus through deletions of parts of its genome, are also associated with bipartite and monopartite begomoviruses. The past three decades have witnessed the emergence and diversification of various new begomoviral species and associated DI DNAs, in southern Africa, East Africa, and proximal Indian Ocean islands, which today threaten important vegetable and commercial crops such as, tobacco, cassava, tomato, sweet potato, and beans. This review aims to describe what is known about these viruses and their impacts on sustainable production in this sensitive region of the world.

  13. Factors associated with intended use of a maternity waiting home in Southern Ethiopia: a community-based cross-sectional study.

    Science.gov (United States)

    Vermeiden, Tienke; Braat, Floris; Medhin, Girmay; Gaym, Asheber; van den Akker, Thomas; Stekelenburg, Jelle

    2018-01-19

    Although Ethiopia is scaling up Maternity Waiting Homes (MWHs) to reduce maternal and perinatal mortality, women's use of MWHs varies markedly between facilities. To maximize MWH utilization, it is essential that policymakers are aware of supportive and inhibitory factors. This study had the objective to describe factors and perceived barriers associated with potential utilization of an MWH among recently delivered and pregnant women in Southern Ethiopia. A community-based cross-sectional study was conducted between March and November 2014 among 428 recently delivered and pregnant women in the Eastern Gurage Zone, Southern Ethiopia, where an MWH was established for high-risk pregnant women to await onset of labour. The structured questionnaire contained questions regarding possible determinants and barriers. Logistic regression with 95% Confidence Intervals (CI) was used to examine association of selected variables with potential MWH use. While only thirty women (7.0%) had heard of MWHs prior to the study, 236 (55.1%), after being explained the concept, indicated that they intended to stay at such a structure in the future. The most important factors associated with intended MWH use in the bivariate analysis were a woman's education (secondary school or higher vs. no schooling: odds ratio [OR] 6.3 [95% CI 3.46 to 11.37]), her husband's education (secondary school or higher vs. no schooling: OR 5.4 [95% CI 3.21 to 9.06]) and envisioning relatively few barriers to MWH use (OR 0.32 [95% CI 0.25 to 0.39]). After adjusting for possible confounders, potential users had more frequently suffered complications in previous childbirths (adjusted odds ratio [aOR] 4.0 [95% CI 1.13 to 13.99]) and envisioned fewer barriers to MWH use (aOR 0.3 [95% CI 0.23 to 0.38]). Barriers to utilization included being away from the household (aOR 18.1 [95% CI 5.62 to 58.46]) and having children in the household cared for by the community during a woman's absence (aOR 9.3 [95% CI 2.67 to 32

  14. Asn563Ser polymorphism of CD31/PECAM-1 is associated with atherosclerotic cerebral infarction in a southern Han population

    Directory of Open Access Journals (Sweden)

    Song YM

    2014-12-01

    Full Text Available Yanmin Song, Qunfang Li, Lili Long, Ning Zhang, Yunhai Liu Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China Background: CD31, also called platelet endothelial cell adhesion molecule-1 (PECAM-1, is thought to play a role in the pathological mechanisms of atherosclerosis. Leu125Val polymorphism and elevated plasma levels of soluble PECAM-1 (sPECAM-1 were found to be associated with cerebral infarction. Our aim was to investigate the association between the Asn563Ser polymorphism of CD31/PECAM-1, plasma level of sPECAM-1, and the risk of atherosclerotic cerebral infarction (ACI in the southern Han population of the People’s Republic of China.Subjects and methods: A total of 147 subjects with ACI and 114 controls were enrolled in the study. The Asn563Ser CD31/PECAM-1 polymorphism was detected using the polymerase chain reaction–restriction fragment length polymorphism method. The plasma spECAM-1 level was measured using the enzyme-linked immunosorbent assay method.Results: In this study, statistically significant differences in Asn563Ser genotype and allele distribution were found between the cases and controls (P<0.05. Furthermore, logistic regression analysis showed that the GG genotype is associated with increase in ACI risk (odds ratio =4.862, P<0.001. The plasma level of sPECAM-1 was associated with ACI (odds ratio =1.431, P=0.038. In both the ACI and the control groups, the plasma sPECAM-1 level in subjects with the GG genotype was higher than that in subjects carrying the AA or GA genotype (P<0.05.Conclusion: Our study showed that the Asn563Ser polymorphism of CD31/PECAM-1 gene and elevated plasma sPECAM-1 level are related to ACI risk in the southern Han population of People’s Republic of China. Keywords: genetic polymorphism, CD31, platelet endothelial cell adhesion molecule-1 (PECAM-1

  15. Peritendinous calcinosis of calcaneus tendon associated with dermatomyositis: correlation between conventional radiograph, ultrasound, magnetic resonance imaging and gross surgical pathology; Calcinose peritendinea do tendao calcaneo associada a dermatomiosite: correlacao entre radiografia convencional, ultra-sonografia, ressonancia magnetica e macroscopia cirurgica

    Energy Technology Data Exchange (ETDEWEB)

    Rosa, Ana Claudia Ferreira; Gomide, Lidyane Marques de Paula; Lemes, Marcella Stival [Universidade Federal de Goias (UFG), Goiana, GO (Brazil). Faculdade de Medicina. Hospital das Clinicas; Costa, Edegmar Nunes; Rocha, Valney Luiz da [Universidade Federal de Goias (UFG), Goiania, GO (Brazil). Faculdade de Medicina. Dept. de Ortopedia; Machado, Marcio Martins; Santos Junior, Rubens Carneiro dos; Barros, Nestor de; Cerri, Giovanni Guido [Universidade Federal de Goias (UFG), Goiania, GO (Brazil). Faculdade de Medicina. Dept. de Radiologia; Sernik, Renato Antonio [Sao Paulo Univ., SP (Brazil). Hospital das Clinicas. Inst. de Radiologia; Nunes, Rodrigo Alvarenga [Universidade do Vale do Sapucai (UNIVAS), Pouso Alegre, MG (Brazil). Faculdade de Ciencias Medicas; Albieri, Alexandre Daher [Hospital de Acidentados de Goiania, GO (Brazil)

    2006-01-15

    Interstitial calcinosis is an uncommon condition in which there is either localized or widely disseminated deposition of calcium in the skin, subcutaneous tissues, muscles, and tendons. Calcinosis is often associated with collagen diseases, scleroderma and dermatomyositis. The authors report a case of interstitial calcinosis associated with dermatomyositis studied with conventional radiograph, ultrasound and magnetic resonance imaging, and correlate the imaging findings with the results of surgical pathology gross examination. (author)

  16. Clinical and Surgical Findings and Outcome Following Rumenotomy in Adult Dairy Cattle Affected with Recurrent Rumen Tympany Associated with Non-Metallic Foreign Bodies

    OpenAIRE

    Z. Bani Ismail; A. Al-Majali; K. Al-Qudah

    2007-01-01

    Medical records of 31 adult dairy cows suffering from recurrent rumen tympany for at least 1 month duration that underwent exploratory laparotomy and rumenotomy were reviewed and information was obtained on signalment, history, physical examination findings, laboratory findings and surgical findings. Cases were categorized according to surgical findings into 3 groups. Group 1 (n = 10) included cattle with reticuloruminal, metallic foreign bodies and perireticular adhesions/inflammation, group...

  17. Seroprevalence and risk factors associated with Ehrlichia canis, Anaplasma spp., Borrelia burgdorferi sensu lato, and D. immitis in hunting dogs from southern Italy.

    Science.gov (United States)

    Piantedosi, Diego; Neola, Benedetto; D'Alessio, Nicola; Di Prisco, Francesca; Santoro, Mario; Pacifico, Laura; Sgroi, Giovanni; Auletta, Luigi; Buch, Jesse; Chandrashekar, Ramaswamy; Breitschwerdt, Edward B; Veneziano, Vincenzo

    2017-10-01

    Canine vector-borne diseases (CVBDs) are caused by a range of pathogens transmitted to dogs by arthropods. The present study investigates Ehrlichia canis, Anaplasma spp., Borrelia burgdorferi sensu lato, and Dirofilaria immitis seroprevalences in hunting dogs from southern Italy. Dogs (no. 1335) were tested using a commercial in-clinic enzyme-linked immunosorbent assay kit. Odds ratios (ORs) were calculated by logistic regression analysis to identify risk factors. Overall, 138/1335 dogs (10.3%) were seroreactive to at least one CVBD pathogen. E. canis, Anaplasma spp., B. burgdorferi s.l., and D. immitis seroprevalences were 7.6, 4.4, 0.3, and 0.2%, respectively. E. canis and Anaplasma spp. co-exposures were found in 30 dogs (2.2%), compared with Anaplasma spp. and B. burgdorferi s.l. co-exposures in 2 dogs (0.1%). Adult age was a risk factor for E. canis (OR 2.35) seroreactivity whereas hunting fur-bearing animals for E. canis (OR 4.75) and Anaplasma spp. (OR 1.87), respectively. The historical presence of tick infestation was identified as a risk factor for positivity to E. canis (OR 2.08) and Anaplasma spp. (OR 2.15). Finally, larger dog pack size was significantly associated with E. canis (OR 1.85) and Anaplasma spp. (OR 2.42) exposures. The results of the present survey indicated that hunting dog populations are at relative risk of CVBDs in southern Italy. Further studies are needed to evaluate the role of hunting dogs in the epidemiology of vector-borne organisms due to sharing common environments with wild, sympatric animal populations.

  18. Misuse of antenatal care and its association with adverse outcomes of pregnancy in a Southern rural area of Vietnam.

    Science.gov (United States)

    Ngo, Thi-Thuy-Dung; Nguyen, The-Dung; Goyens, Philippe; Robert, Annie

    2018-04-01

    Researchers in Vietnam reported a high percentage of pregnant women attending ANC at least once, but an insufficient utilization of ANC services remains. The evidence demonstrating how the utilization of these services affect pregnancy outcome is not documented in Vietnam. We investigated the association between the misuse of ANC services and pregnancy outcome, and assessed other determinants associated with ANC services utilization. We conducted a prospective community-based study in Trang Bom district, Dong Nai, during 12 consecutive months. Data were collected using a structured questionnaire and medical records. Women were followed up to delivery. Misuse of ANC services, related factors and its association with adverse events were assessed using logistic regression. Out of 3301 pregnant women, 91% initiated an ANC visit within first trimester, 95% attended at least three ANC visits, but a low percentage of pregnant women underwent blood and urine tests at least once (20% and 39%, respectively). Factors significantly associated with a higher risk of adverse outcomes were lack of blood test and urine test, parity ≥ 3, ANC visits ANC attendance, and women with a low number of ANC visits. Despite a high percentage of early entry into ANC and of at least three ANC visits, misuse of ANC services still exists and contributes to adverse outcomes. There is a need to increase the awareness of women on the benefits of ANC services by educating young women as well as women with several children. Health workers should be encouraged to propose suitable ANC services to pregnant women.

  19. Phylogenetic analyses of Podaxis specimens from Southern Africa reveal hidden diversity and new insights into associations with termites

    NARCIS (Netherlands)

    Conlon, Benjamin H.; Beer, de Z.W.; Fine Licht, De Henrik H.; Aanen, Duur K.; Poulsen, Michael

    2016-01-01

    Although frequently found on mounds of the grass-cutting termite genus . Trinervitermes, virtually nothing is known about the natural history of the fungal genus . Podaxis (Agaricaceae) nor why it associates with termite mounds. More than 40 species of this secotioid genus have been described

  20. Association between DPP6 polymorphism and the risk of progressive multiple sclerosis in Northern and Southern Europeans

    DEFF Research Database (Denmark)

    Brambilla, Paola; Esposito, Federica; Lindstrom, Eva

    2012-01-01

    In this study, we investigated the role of the dipeptidyl-peptidase-6 (DPP6) gene in the etiopathogenesis of progressive forms of multiple sclerosis (PrMS). This gene emerged as a candidate gene in a genome-wide association study (GWAS) performed in an Italian sample of PrMS and controls in which...

  1. Cholera returns to southern Vietnam in an outbreak associated with consuming unsafe water through iced tea: A matched case-control study.

    Science.gov (United States)

    Nguyen, Thuong V; Pham, Quang D; Do, Quoc K; Diep, Tai T; Phan, Hung C; Ho, Thang V; Do, Hong T; Phan, Lan T; Tran, Huu N

    2017-04-01

    After more than a decade of steadily declining notifications, the number of reported cholera cases has recently increased in Vietnam. We conducted a matched case-control study to investigate transmission of cholera during an outbreak in Ben Tre, southern Vietnam, and to explore the associated risk factors. Sixty of 71 diarrheal patients confirmed to be infected with cholera by culture and diagnosed between May 9 and August 3, 2010 in Ben Tre were consecutively recruited as case-patients. Case-patients were matched 1:4 to controls by commune, sex, and 5-year age group. Risk factors for cholera were examined by multivariable conditional logistic regression. In addition, environmental samples from villages containing case-patients were taken to identify contamination of food and water sources. The regression indicated that drinking iced tea (adjusted odds ratio (aOR) = 8.40, 95% confidence interval (CI): 1.84-39.25), not always boiling drinking water (aOR = 2.62, 95% CI: 1.03-6.67), having the main source of water for use being close to a toilet (aOR = 4.36, 95% CI: 1.37-13.88), living with people who had acute diarrhea (aOR = 13.72, 95% CI: 2.77-67.97), and little or no education (aOR = 4.89, 95% CI: 1.18-20.19) were significantly associated with increased risk of cholera. In contrast, drinking stored rainwater (aOR = 0.17, 95% CI: 0.04-0.63), eating cooked seafood (aOR = 0.27, 95% CI: 0.10-0.73), and eating steamed vegetables (aOR = 0.22, 95% CI: 0.07-0.70) were protective against cholera. Vibrio cholerae O1 Ogawa carrying ctxA was found in two of twenty-five river water samples and one of six wastewater samples. The magnitude of the cholera outbreak in Ben Tre was lower than in other similar settings. This investigation identified several risk factors and underscored the importance of continued responses targeting cholera prevention in southern Vietnam. The association between drinking iced tea and cholera and the spread of V. cholerae O1, altered El Tor strains

  2. Cholera returns to southern Vietnam in an outbreak associated with consuming unsafe water through iced tea: A matched case-control study.

    Directory of Open Access Journals (Sweden)

    Thuong V Nguyen

    2017-04-01

    Full Text Available After more than a decade of steadily declining notifications, the number of reported cholera cases has recently increased in Vietnam. We conducted a matched case-control study to investigate transmission of cholera during an outbreak in Ben Tre, southern Vietnam, and to explore the associated risk factors.Sixty of 71 diarrheal patients confirmed to be infected with cholera by culture and diagnosed between May 9 and August 3, 2010 in Ben Tre were consecutively recruited as case-patients. Case-patients were matched 1:4 to controls by commune, sex, and 5-year age group. Risk factors for cholera were examined by multivariable conditional logistic regression. In addition, environmental samples from villages containing case-patients were taken to identify contamination of food and water sources. The regression indicated that drinking iced tea (adjusted odds ratio (aOR = 8.40, 95% confidence interval (CI: 1.84-39.25, not always boiling drinking water (aOR = 2.62, 95% CI: 1.03-6.67, having the main source of water for use being close to a toilet (aOR = 4.36, 95% CI: 1.37-13.88, living with people who had acute diarrhea (aOR = 13.72, 95% CI: 2.77-67.97, and little or no education (aOR = 4.89, 95% CI: 1.18-20.19 were significantly associated with increased risk of cholera. In contrast, drinking stored rainwater (aOR = 0.17, 95% CI: 0.04-0.63, eating cooked seafood (aOR = 0.27, 95% CI: 0.10-0.73, and eating steamed vegetables (aOR = 0.22, 95% CI: 0.07-0.70 were protective against cholera. Vibrio cholerae O1 Ogawa carrying ctxA was found in two of twenty-five river water samples and one of six wastewater samples.The magnitude of the cholera outbreak in Ben Tre was lower than in other similar settings. This investigation identified several risk factors and underscored the importance of continued responses targeting cholera prevention in southern Vietnam. The association between drinking iced tea and cholera and the spread of V. cholerae O1, altered El Tor

  3. Association between treatment for gonorrhoea and chlamydia and lower condom use in a cross-sectional study of female sex workers in southern India.

    Science.gov (United States)

    Legendre-Dugal, Marianne; Bradley, Janet; Rajaram, Subramanian Potty; Lowndes, Catherine M; Ramesh, Banadakoppa M; Washington, Reynold; Moses, Stephen; Blanchard, James; Alary, Michel

    2016-05-18

    To assess whether having received grey packets containing treatment for gonorrhoea and chlamydia was associated with condom use among female sex workers (FSWs) in 5 districts of southern India covered by the Avahan programme where both periodic presumptive treatment (PPT) and syndromic management were used to control these sexually transmitted infections (STIs) among FSWs. Cross-sectional study of FSWs recruited in the field in 5 districts of southern India (Bangalore, Belgaum, Bellary, Guntur and Mumbai) in 2006-2007. 1378 self-identified FSWs out of 1442 were approached to participate in the study (participation rate: 95.6%). The only exclusion criterion was to be aged <18 years. Consistent condom use (CCU) with new or occasional clients, and with the most recent repeat client as assessed using a questionnaire administered through face-to-face interviews. Using the Poisson regression to model the association between the number of grey packets received in the past 3-12 months and reported CCU, adjusting for factors associated with condom use and other potential confounders in our data, CCU was lowest among FSWs who had received ≥3 grey packets in the past 3-12 months with their new or occasional clients (adjusted prevalence ratio (APR): 0.70, 95% CI 0.57 to 0.84, p<0.001) and with the most recent repeat client (APR 0.63, 95% CI 0.51 to 0.78, p<0.001). Tests for trends showed that CCU with both types of clients decreased with the number of grey packets received (p<0.001). Since we could not distinguish grey packets used for PPT from those given for syndromic management, these results could be either due to a perception of protection conferred by PPT or by the fact that inconsistent condom users are more at risk for STIs. Further research on the potential disinhibiting effect of PPT is warranted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. Prevalence and associated factors for stunting among 6-12 years old school age children from rural community of Humbo district, Southern Ethiopia.

    Science.gov (United States)

    Bogale, Tesfahun Yonas; Bala, Elazar Tadesse; Tadesse, Minyahil; Asamoah, Benedict Oppong

    2018-05-24

    Stunting is one of the most serious and challenging public health problems in Ethiopia, which constitute a significant obstacle to achieving better child health outcomes. This study aimed to assess the prevalence and factors associated with stunting among 6-12 years old children in Humbo district, Southern Ethiopia. This was a cross-sectional study conducted among 633 children 6-12 years old living in Humbo district, Southern Ethiopia, from March to April, 2015. A multistage cluster sampling technique was used to select participants from households in eight Villages in the study area. Height was measured using standard methods and height for age Z-score was computed to assess stunting. EPI info version 3.5.4 was used for data entry, whereas Anthroplus software and SPSS version 20.0 were used for computation of height for age Z-scores and statistical analyses respectively. Simple and multiple logistic regression analyses were used to examine factors associated with stunting in the study sample, using 95% confidence limits (statistical significance set at p < 0.050). Prevalence of stunting was 57%, about, 3.5% were severely stunted, 27.3% moderately stunted and 26.4% mildly stunted, and the mean (SD) was - 1.1 (±1.2). About 7 (1.1%) boys and 15 (2.4%) girls were severely stunted. Age groups 10-12 years had significantly higher rate of stunting than others. Age (AOR = 1.7, 95% CI = 1.1-2.6), big family size (AOR = 4.6, 95% CI = 2.2-9.5) and field disposal of wastes (AOR = 2.7, 95% CI = 1.2-5.8) were factors significantly associated with stunting. This study exposed high rate of stunting among school age children. Stunting remains a noticeable attribute of rural school age children. Findings suggest the need to implement evidence-based school-aged rural children nutrition policy and strategies as well as need for intervention to improve domestic waste management system in the rural community.

  5. Surgical treatment of interrupted aortic arch associated with ventricular septal defect and patent ductus arteriosus in patients over one year of age.

    Science.gov (United States)

    Li, Zhiqiang; Li, Bin; Fan, Xiangming; Su, Junwu; Zhang, Jing; He, Yan; Liu, Yinglong

    2014-01-01

    Interrupted aortic arch (IAA) is a rare congenital anomaly affecting 1.5% of infants with congenital heart disease. Neonatal repair of IAA is required to avoid irreversible pulmonary vascular lesion. However, in China, patients with IAA associated with ventricular septal defect (VSD) and patent ductus arteriosus (PDA) over one year of age are common. So we investigated the outcome of surgical treatment of IAA with VSD and PDA in patients over one year of age. From January 2009 to December 2012, 19 patients with IAA have undergone complete single-stage repair. The patients' mean age was 4.4 years, ranging 1 to 15 years; and their mean weight was 12.8 kg, ranging 4.2 to 36.0 kg. Fifteen IAA were type A, four were type B. Preoperative cardiac catheterization data were available from all patients. Mean pulmonary arterial pressure (mPAP) and pulmonary vascular resistance (PVR) were measured. The measurements of postoperative pulmonary artery pressure were taken in the operating room at the end of the case. All patients underwent echocardiographic examinations before discharged from the hospital. In addition, cardiac catheterization and echocardiographic examinations were performed during follow-up. Selective brain perfusion through the innominate artery during aortic arch reconstruction was used in all patients. Mean follow-up was (1.6±0.8) years. There were two hospital deaths (2/19, 11%). One patient died of pulmonary hypertension crisis, and another died of postoperative low cardiac output. Five cases had other main postoperative complications but no postoperative neurologic complications. Seventeen survivors were followed up, and there were no late deaths or reoperation. Mean cross-clamp duration was (85±22) minutes and selective brain perfusion duration was (34±11) minutes. Two patients required delayed sternal closure at two days postoperatively. Intensive care unit and hospital stays were (9±8) days and (47±24) days, respectively. Pressure gradients across

  6. Open surgical simulation--a review.

    Science.gov (United States)

    Davies, Jennifer; Khatib, Manaf; Bello, Fernando

    2013-01-01

    open surgical procedure. Better quality research is needed into the benefits of open surgical simulation, and this would hopefully stimulate further development of simulators with more accurate and objective assessment tools. © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  7. The association of surgical versus natural menopause with future left ventricular structure and function: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.

    Science.gov (United States)

    Appiah, Duke; Schreiner, Pamela J; Nwabuo, Chike C; Wellons, Melissa F; Lewis, Cora E; Lima, Joao A

    2017-11-01

    To evaluate the association between surgical menopause (SM) versus natural menopause (NM) in relation to later left ventricular (LV) structure and function, while taking into account the LV parameters and other cardiovascular disease risk factor (CVDRF) levels that predate the menopausal transition. We studied 825 premenopausal women from the Coronary Artery Risk Development in Young Adults study in 1990 to 1991 (baseline, mean age 32 years) who later reached menopause by 2010 to 2011 and had echocardiograms at these two time points. During 20 years of follow-up, 508 women reached NM, whereas 317 underwent SM (34% had bilateral oophorectomy). At baseline, women who later underwent SM were more likely to be black, younger, have greater parity, and higher mean values of systolic blood pressure, body mass index, and also lower mean high-density lipoprotein cholesterol and physical activity than women who reached NM. No significant differences in LV structure/function were found between groups. In 2010 to 2011, SM women had significantly higher LV mass, LV mass/volume ratio, E/e' ratio, and impaired longitudinal and circumferential strain than NM women. SM women with bilateral oophorectomy had adverse LV measures than women with hysterectomy with ovarian conservation. Controlling for baseline echocardiographic parameters and CVDRF in linear regression models eliminated these differences between groups. Further adjustment for age at menopause/surgery and hormone therapy use did not change these results. In this study, the adverse LV structure and function observed among women with SM compared with NM were explained by their unfavorable presurgical CVDRF profiles, suggesting that premenopausal CVDRF rather than gynecologic surgery predispose SM women to elevated future cardiovascular disease risk.

  8. Natural selection and type 2 diabetes-associated mortality in an isolated indigenous community in the valley of Oaxaca, southern Mexico.

    Science.gov (United States)

    Little, Bertis B; Peña Reyes, Maria Eugenia; Malina, Robert M

    2017-03-01

    This study tests the hypothesis that natural selection is associated with type 2 diabetes (T2D)-associated mortality and fertility in a rural isolated Zapotec community in the Valley of Oaxaca, southern Mexico. Mortality data and related demographic and genealogic information were linked with data for fertility, prereproductive mortality and family history of mortality attributed to T2D. Physician verified T2D mortality (n = 27) between 1980 and 2009 and imputed T2D (n = 70) from cardiovascular mortality (68% random sample) and renal failure (44% random sample). Bootstrapping was used to obtain a robust variance estimate in survival analysis and multivariate analysis of variance. Estimated maximum natural selection by Crow's Index occurred circa 1930 and was relaxed after this time in the study population. Cox-regression survival analysis of T2D mortality with covariates (family history of T2D, cardiovascular disease, renal failure) indicated a significant hazard ratio (HR = 5.95, 95% CI: 1.38-25.67, p natural selection decreased, and favored offspring survival of non-T2D descedants. The results indicated statistically significant directional selection against T2D and imputed T2D to this population isolate. © 2016 Wiley Periodicals, Inc.

  9. Prevalence of food neophobia in pre-school children from southern Poland and its association with eating habits, dietary intake and anthropometric parameters: a cross-sectional study.

    Science.gov (United States)

    Kozioł-Kozakowska, Agnieszka; Piórecka, Beata; Schlegel-Zawadzka, Małgorzata

    2018-04-01

    The present study aimed to assess the prevalence of food neophobia in pre-school children and its association with eating habits, dietary intake and anthropometric parameters. Cross-sectional survey performed in 2012-2013. The Child Food Neophobia Scale (CFNS) adapted by Wardle, Carnell and Cooke was used to assess the level of food neophobia. Dietary intake was measured using an FFQ and dietary records from three days. Anthropometric measurements were taken to determine children's nutritional status and BMI was computed based on Polish growth charts. Wilcoxon's rank test and Pearson's rank-correlation coefficient were applied to compare the level of food neophobia and frequency of consumption of food products and nutrient intakes. Kindergartens in southern Poland located in or near Cracow. Three hundred and twenty-five pre-school children and their parents. Low neophobia was observed in 12·3 % and high neophobia in 10·8 % of the children examined. Children with a high level of neophobia were significantly less likely (Pfood neophobia were observed. High levels of neophobia are associated with diet variation and may enhance the risk of nutritional deficiencies in children.

  10. A critical evaluation of subtalar joint arthrosis associated with middle facet talocalcaneal coalition in 21 surgically managed patients: a retrospective computed tomography review. Investigations involving middle facet coalitions-part III.

    Science.gov (United States)

    Kernbach, Klaus J; Barkan, Howard; Blitz, Neal M

    2010-01-01

    Symptomatic middle facet talocalcaneal coalition is frequently associated with rearfoot arthrosis that is often managed surgically with rearfoot fusion. However, no objective method for classifying the extent of subtalar joint arthrosis exists. No study has clearly identified the extent of posterior facet arthrosis present in a large cohort treated surgically for talocalcaneal coalition through preoperative computerized axial tomography. The authors conducted a retrospective review of 21 patients (35 feet) with coalition who were surgically treated over a 12-year period for coalition on at least 1 foot. Using a predefined original staging system, the extent of the arthrosis was categorized into normal or mild (Stage I), moderate (Stage II), and severe (Stage III) arthrosis. The association of stage and age is statistically significant. All of the feet with Stage III arthrosis had fibrous coalitions. No foot with osseous coalition had Stage III arthrosis. The distribution of arthrosis staging differs between fibrous and osseous coalitions. Only fibrous coalitions had the most advanced arthrosis (Stage III), whereas osseous coalitions did not. This suggests that osseous coalitions may have a protective effect in the prevention of severe degeneration of the subtalar joint. Concomitant subtalar joint arthrosis severity progresses with age; surgeons may want to consider earlier surgical intervention to prevent arthrosis progression in patients with symptomatic middle facet talocalcaneal coalition.

  11. Pesticides in the Southern Agricultural Growth Corridor of Tanzania (SAGCOT) : a scoping study of current and future use, associated risks and identification of actions for risk mitigation

    NARCIS (Netherlands)

    Lahr, Joost; Buij, Ralph; Katagira, Franciska; Valk, van der Harold

    2016-01-01

    SAGCOT, the ‘Southern Agricultural Growth Corridor of Tanzania’, is a coordinated initiative to boost agricultural output in southern Tanzania through public and private investment, to improve food security, reduce rural poverty and sustain the environment. The ‘Sustainability and Inclusion Strategy

  12. Association between HIV status and depressive symptoms among children and adolescents in the Southern Highlands Zone, Tanzania: A case-control study.

    Science.gov (United States)

    Lwidiko, Abraham; Kibusi, Stephen Matthew; Nyundo, Azan; Mpondo, Bonaventura C T

    2018-01-01

    Children and adolescents continue to have HIV/AIDS in southern Saharan Africa. Scaling up of HIV services has significantly improved access to ARV and consequently improved on morbidity and mortality related to HIV/AIDS including opportunistic infection. Despite the above efforts, non-communicable conditions including mental disorders such as depression have been observed to contribute to the burden of disabilities about which little is documented. This study, therefore, aimed to determine the magnitude of depressive symptoms and the associated factors among HIV-infected children and adolescents. The study was a matched case-control design involving 300 cases of HIV-infected children matched by age and sex against 600 uninfected controls. Systematic sampling technique was used to select the cases while multistage sampling technique was employed to identify villages/ streets purposive and sampling technique was employed to obtain participants from households. The overall prevalence of depressive symptoms among the cohort of 900 participants was found to be 12.9%, with 27% of HIV-infected and 5.8% of HIV-uninfected children and adolescents screened positive for depressive symptoms. Multiple logistic regression revealed that being HIV-infected (AOR 1.96(1.11-3.45)), residing in a rural setting (AOR 0.61(0.39-0.96)) and history of childhood deprivation (AOR 4.76 (2.79-8.13)) were significantly associated with depressive symptoms. HIV infected adolescents are more affected by depression compared to non-infected counterparts. Childhood deprivation was significantly associated with presence of depressive symptoms. Integration of mental health evaluation and treatment into the HIV care provided for adolescents can be beneficial. More studies to delineate factors associated with depressed adolescents with HIV may add value to the body of knowledge and overall improvement of care.

  13. Risk-Association of Five SNPs in TOX3/LOC643714 with Breast Cancer in Southern China

    Directory of Open Access Journals (Sweden)

    Xuanqiu He

    2014-01-01

    Full Text Available The specific mechanism by which low-risk genetic variants confer breast cancer risk is currently unclear, with contradictory evidence on the role of single nucleotide polymorphisms (SNPs in TOX3/LOC643714 as a breast cancer susceptibility locus. Investigations of this locus using a Chinese population may indicate whether the findings initially identified in a European population are generalizable to other populations, and may provide new insight into the role of genetic variants in the etiology of breast cancer. In this case-control study, 623 Chinese female breast cancer patients and 620 cancer-free controls were recruited to investigate the role of five SNPs in TOX3/LOC643714 (rs8051542, rs12443621, rs3803662, rs4784227, and rs3112612; Linkage disequilibrium (LD pattern analysis was performed. Additionally, we evaluated how these common SNPs influence the risk of specific types of breast cancer, as defined by estrogen receptor (ER status, progesterone receptor (PR status and human epidermal growth factor receptor 2 (HER2 status. Significant associations with breast cancer risk were observed for rs4784227 and rs8051542 with odds ratios (OR of 1.31 ((95% confidence intervals (CI, 1.10–1.57 and 1.26 (95% CI, 1.02–1.56, respectively, per T allele. The T-rs8051542 allele was significantly associated with ER-positive and HER2-negative carriers. No significant association existed between rs12443621, rs3803662, and rs3112612 polymorphisms and risk of breast cancer. Our results support the hypothesis that the applicability of a common susceptibility locus must be confirmed among genetically different populations, which may together explain an appreciable fraction of the genetic etiology of breast cancer.

  14. Fast Food Consumption Pattern and Its Association with Overweight Among High School Boys in Mangalore City of Southern India.

    Science.gov (United States)

    Joseph, Nitin; Nelliyanil, Maria; Rai, Sharada; Y P, Raghavendra Babu; Kotian, Shashidhar M; Ghosh, Tanima; Singh, Manisha

    2015-05-01

    Fast foods are quite popular among children owing to taste, appearance and hype created by mass media. However, the increased incidence of lifestyle disorders seen now-a-days at an early age could be attributed to fast foods. This study was done to assess the awareness of health hazards, consumption pattern of fast foods and to find out its association with overweight among high school students. This cross-sectional study was done among boys of 3 private schools in Mangalore city in March 2012. Data was collected using a semi-structured self-administered questionnaire. Chi-square test, one-way ANOVA and binary logistic regression analysis was used for analysis. P-value ≤ 0.05 was considered as statistically significant association. Mean age of boys was 13.5±0.9 years. Out of 300 participants, 41(13.7%) were overweight and 8 (2.7%) were obese. 292(97.3%) were fast food users of which 42(14.4%) consumed it every day. Majority of participants were introduced to fast foods through television commercials 193(64.3%). 73(57%) developed this habit as they were bored with home food. Awareness of harmful effects of fast food consumption was known to 186(62%) students and this was found to be associated with the perceived need to control its usage (pconsumption of fast foods was found to influence fast food consumption among children (p=0.024). As many as 68(22.7%) and 206(68.7%) children were not eating vegetables and fruits respectively every day. Increased frequency of fast food consumption in a week was found to be associated with overweight or obesity among children after adjusting the effects of confounders (p=0.003). Awareness on health hazards of fast foods needs to be taught at schools so as to minimize its consumption. Parents have to set an example themselves by not eating fast foods and improving home food to support discouragement of fast foods. This would minimize life style disorders among children to a greater extent.

  15. Micro-surgical endodontics.

    Science.gov (United States)

    Eliyas, S; Vere, J; Ali, Z; Harris, I

    2014-02-01

    Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.

  16. Enteric bacterial pathogen detection in southern sea otters (Enhydra lutris nereis) is associated with coastal urbanization and freshwater runoff.

    Science.gov (United States)

    Miller, Melissa A; Byrne, Barbara A; Jang, Spencer S; Dodd, Erin M; Dorfmeier, Elene; Harris, Michael D; Ames, Jack; Paradies, David; Worcester, Karen; Jessup, David A; Miller, Woutrina A

    2010-01-01

    Although protected for nearly a century, California's sea otters have been slow to recover, in part due to exposure to fecally-associated protozoal pathogens like Toxoplasma gondii and Sarcocystis neurona. However, potential impacts from exposure to fecal bacteria have not been systematically explored. Using selective media, we examined feces from live and dead sea otters from California for specific enteric bacterial pathogens (Campylobacter, Salmonella, Clostridium perfringens, C. difficile and Escherichia coli O157:H7), and pathogens endemic to the marine environment (Vibrio cholerae, V. parahaemolyticus and Plesiomonas shigelloides). We evaluated statistical associations between detection of these pathogens in otter feces and demographic or environmental risk factors for otter exposure, and found that dead otters were more likely to test positive for C. perfringens, Campylobacter and V. parahaemolyticus than were live otters. Otters from more urbanized coastlines and areas with high freshwater runoff (near outflows of rivers or streams) were more likely to test positive for one or more of these bacterial pathogens. Other risk factors for bacterial detection in otters included male gender and fecal samples collected during the rainy season when surface runoff is maximal. Similar risk factors were reported in prior studies of pathogen exposure for California otters and their invertebrate prey, suggesting that land-sea transfer and/or facilitation of pathogen survival in degraded coastal marine habitat may be impacting sea otter recovery. Because otters and humans share many of the same foods, our findings may also have implications for human health.

  17. Enteric bacterial pathogen detection in southern sea otters (Enhydra lutris nereis) is associated with coastal urbanization and freshwater runoff

    Science.gov (United States)

    Miller, Melissa A.; Byrne, Barbara A.; Jang, Spencer S.; Dodd, Erin M.; Dorfmeier, Elene; Harris, Michael D.; Ames, Jack; Paradies, David; Worcester, Karen; Jessup, David A.; Miller, Woutrina A.

    2009-01-01

    Although protected for nearly a century, California’s sea otters have been slow to recover, in part due to exposure to fecally-associated protozoal pathogens like Toxoplasma gondii and Sarcocystis neurona. However, potential impacts from exposure to fecal bacteria have not been systematically explored. Using selective media, we examined feces from live and dead sea otters from California for specific enteric bacterial pathogens (Campylobacter, Salmonella, Clostridium perfringens, C. difficile and Escherichia coli O157:H7), and pathogens endemic to the marine environment (Vibrio cholerae, V. parahaemolyticus and Plesiomonas shigelloides). We evaluated statistical associations between detection of these pathogens in otter feces and demographic or environmental risk factors for otter exposure, and found that dead otters were more likely to test positive for C. perfringens, Campylobacter and V. parahaemolyticus than were live otters. Otters from more urbanized coastlines and areas with high freshwater runoff (near outflows of rivers or streams) were more likely to test positive for one or more of these bacterial pathogens. Other risk factors for bacterial detection in otters included male gender and fecal samples collected during the rainy season when surface runoff is maximal. Similar risk factors were reported in prior studies of pathogen exposure for California otters and their invertebrate prey, suggesting that land-sea transfer and/or facilitation of pathogen survival in degraded coastal marine habitat may be impacting sea otter recovery. Because otters and humans share many of the same foods, our findings may also have implications for human health. PMID:19720009

  18. PREVALENCE OF HERPES SIMPLEX VIRUS TYPE 2 AND RISK FACTORS ASSOCIATED WITH THIS INFECTION IN WOMEN IN SOUTHERN BRAZIL

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    Thais Duquia Moraes Caldeira

    2013-09-01

    Full Text Available SUMMARY The herpes simplex virus type 2 (HVS-2 is the most prevalent infection worldwide. It is a cofactor in the acquisition of human immunodeficiency virus (HIV and the persistence of human papillomavirus (HPV. This study evaluated the prevalence of HSV-2, using the polymerase chain reaction (PCR, and associated factors in patients treated at the Federal University of Rio Grande (FURG and Basic Health Units (BHU in Rio Grande, Brazil. The observed prevalence of HSV-2 was 15.6%. Among the 302 women studied, 158 had received assistance in BHU and 144 were treated at FURG. The prevalence of HSV-2 in these groups was 10.8% and 20.8%, respectively, RR 1.9 and p = 0.012. Knowledge about the Pap smear, and the presence of lesions showed no association with HSV-2 infection. Multivariate analysis showed that the variable that most influenced the risk of HSV-2 infection was the presence of HIV infection, with a relative risk of 1.9 and p = 0.04. Discussion: Genital ulcers are an important entry point for HIV, and condom use is an important strategy to reduce transmission of HIV and HSV-2.

  19. A multiple endpoint analysis of the effects of chronic exposure to sediment contaminated with Deepwater Horizon oil on juvenile Southern flounder and their associated microbiomes

    International Nuclear Information System (INIS)

    Brown-Peterson, Nancy J.; Krasnec, Michelle; Takeshita, Ryan; Ryan, Caitlin N.; Griffitt, Kimberly J.; Lay, Claire; Mayer, Gregory D.; Bayha, Keith M.; Hawkins, William E.; Lipton, Ian; Morris, Jeffrey

    2015-01-01

    Highlights: • Juvenile southern flounder were exposed to sediment mixed with different amount of oil from the Deepwater Horizon spill. • The exposure was performed for 32 days, with growth and survival assessed throughout. • After the termination of the experiment, the survivors were examined at multiple endpoints, including histopathology and microbiome analysis. • The results indicated that the flounder were adversely affected at each endpoint examined. • Growth and survival were significantly reduced. • Histopathology found effects on gills and livers of exposed fish. • The microbiomes of the exposed fish were significantly altered by the exposure to sediment-associated oil in both gills and intestines. - Abstract: Exposure to oiled sediments can negatively impact the health of fish species. Here, we examine the effects of chronic exposure of juvenile southern flounder, Paralichthys lethostigma, to a sediment-oil mixture. Oil:sediment mixtures are persistent over time and can become bioavailable following sediment perturbation or resuspension. Juvenile flounder were exposed for 32 days under controlled laboratory conditions to five concentrations of naturally weathered Macondo MC252 oil mixed into uncontaminated, field-collected sediments. The percent composition of individual polycyclic aromatic hydrocarbons (PAHs) of the weathered oil did not change after mixing with the sediment. Spiked exposure sediments contained 0.04–395 mg/kg tPAH50 (sum of 50 individual PAH concentration measurements). Mortality increased with both exposure duration and concentration of sediment-associated PAHs, and flounder exposed to concentrations above 8 mg/kg tPAH50 showed significantly reduced growth over the course of the experiment. Evident histopathologic changes were observed in liver and gill tissues of fish exposed to more than 8 mg/kg tPAH50. All fish at these concentrations showed hepatic intravascular congestion, macrovesicular hepatic vacoulation

  20. A multiple endpoint analysis of the effects of chronic exposure to sediment contaminated with Deepwater Horizon oil on juvenile Southern flounder and their associated microbiomes

    Energy Technology Data Exchange (ETDEWEB)

    Brown-Peterson, Nancy J., E-mail: nancy.brown-peterson@usm.edu [Department of Coastal Sciences, The University of Southern Mississippi, 703 East Beach Dr., Ocean Springs, MS 39564 (United States); Krasnec, Michelle, E-mail: MKrasnec@stratusconsulting.com [Abt Associates, 1881 Ninth Street, Suite 201, Boulder, Colorado 80302 (United States); Takeshita, Ryan, E-mail: RTakeshita@stratusconsulting.com [Abt Associates, 1881 Ninth Street, Suite 201, Boulder, Colorado 80302 (United States); Ryan, Caitlin N., E-mail: Caitlin.ryan@ttu.edu [The Institute of Environmental and Human Health, Department of Environmental Toxicology, Texas Tech University, Box 41163, Lubbock, TX 79409 (United States); Griffitt, Kimberly J., E-mail: kim.griffitt@gmail.com [Department of Coastal Sciences, The University of Southern Mississippi, 703 East Beach Dr., Ocean Springs, MS 39564 (United States); Lay, Claire, E-mail: claymsc@stratusconsulting.com [Abt Associates, 1881 Ninth Street, Suite 201, Boulder, Colorado 80302 (United States); Mayer, Gregory D., E-mail: greg.mayer@ttu.edu [The Institute of Environmental and Human Health, Department of Environmental Toxicology, Texas Tech University, Box 41163, Lubbock, TX 79409 (United States); Bayha, Keith M., E-mail: kmbayha@gmail.com [Department of Coastal Sciences, The University of Southern Mississippi, 703 East Beach Dr., Ocean Springs, MS 39564 (United States); Hawkins, William E., E-mail: william.hawkins@usm.edu [Department of Coastal Sciences, The University of Southern Mississippi, 703 East Beach Dr., Ocean Springs, MS 39564 (United States); Lipton, Ian, E-mail: ianlipton@stratusconsulting.com [Abt Associates, 1881 Ninth Street, Suite 201, Boulder, Colorado 80302 (United States); Morris, Jeffrey, E-mail: JMorrisMSCanyon252@stratusconsulting.com [Abt Associates, 1881 Ninth Street, Suite 201, Boulder, Colorado 80302 (United States); and others

    2015-08-15

    Highlights: • Juvenile southern flounder were exposed to sediment mixed with different amount of oil from the Deepwater Horizon spill. • The exposure was performed for 32 days, with growth and survival assessed throughout. • After the termination of the experiment, the survivors were examined at multiple endpoints, including histopathology and microbiome analysis. • The results indicated that the flounder were adversely affected at each endpoint examined. • Growth and survival were significantly reduced. • Histopathology found effects on gills and livers of exposed fish. • The microbiomes of the exposed fish were significantly altered by the exposure to sediment-associated oil in both gills and intestines. - Abstract: Exposure to oiled sediments can negatively impact the health of fish species. Here, we examine the effects of chronic exposure of juvenile southern flounder, Paralichthys lethostigma, to a sediment-oil mixture. Oil:sediment mixtures are persistent over time and can become bioavailable following sediment perturbation or resuspension. Juvenile flounder were exposed for 32 days under controlled laboratory conditions to five concentrations of naturally weathered Macondo MC252 oil mixed into uncontaminated, field-collected sediments. The percent composition of individual polycyclic aromatic hydrocarbons (PAHs) of the weathered oil did not change after mixing with the sediment. Spiked exposure sediments contained 0.04–395 mg/kg tPAH50 (sum of 50 individual PAH concentration measurements). Mortality increased with both exposure duration and concentration of sediment-associated PAHs, and flounder exposed to concentrations above 8 mg/kg tPAH50 showed significantly reduced growth over the course of the experiment. Evident histopathologic changes were observed in liver and gill tissues of fish exposed to more than 8 mg/kg tPAH50. All fish at these concentrations showed hepatic intravascular congestion, macrovesicular hepatic vacoulation

  1. Patients' satisfaction towards radiological service and associated factors in Hawassa University Teaching and referral hospital, Southern Ethiopia.

    Science.gov (United States)

    Mulisa, Teshome; Tessema, Fasil; Merga, Hailu

    2017-06-26

    Patient satisfaction, one of the main components of quality of care, is a crucial phenomenon for the overall health care delivery system. Even though a number of studies have been conducted about patient satisfaction in different health services, studies in radiology services are flimsy in Ethiopia. This study aimed at assessing patient satisfaction towards radiological service and associated factors in Hawassa University Teaching and Referral hospital. An institution based cross-sectional study was conducted among 321 adult patients presented for radiological service in the study area using stratified sampling technique. Patient satisfaction was measured using SERVQUAL (Service Quality) tool that consisted of seven items: accessibility, quality of radiological service, courtesy of radiology staff, existence of good communication with service provider and desk worker, physical environment and privacy technique. Exit interviews of patients were conducted using a structured and pretested questionnaire. Data was collected by three grade ten completed trained data collectors from May 12 to May 28, 2016. Multiple logistic regressions were used to identify independent factors associated with patient satisfaction on radiological services using SPSS version 21. The overall patient satisfaction towards radiological service was 71.6%. Satisfaction to accessibility of the service was 84.5% while it was 80.6% to courtesy of the staff. Similarly, 81.6% reported satisfied with quality of the service and 59.4% and 71% of reported satisfied with physical environment and radiological service provider respectively. On the other hand, 99.7% of the respondents were dissatisfied with privacy of the service. The study revealed that patients who attended primary school (AOR = 0.317, 95% CI: 0.11-0.88), unemployed patients (AOR = 0.067, 95% CI: 0.007-0.622) and patients who had short waiting time to enter into examination room less than one hour (AOR = 4.12, 95% CI: 1.4-11.62) were

  2. Prevalence of smear positive pulmonary tuberculosis and associated risk factors among prisoners in Hadiya Zone prison, Southern Ethiopia.

    Science.gov (United States)

    Fuge, Terefe G; Ayanto, Samuel Y

    2016-04-02

    People concentrated in congregated systems such as prisons, are important but often neglected reservoirs for tuberculosis transmission, and threaten those in the outside community. The condition is more serious in Africa particularly in Sub-Saharan Africa (SSA) due to its poor living conditions and ineffective health services. This study was conducted to determine the prevalence of smear positive pulmonary tuberculosis and associated risk factors among prisoners in Hadiya Zone prison. A cross-sectional survey was carried out from May to June 2013 in Hadiya Zone prison. Prison inmates who had history of cough for at least a week were included in the study. Three morning sputum samples were collected from suspected inmates and examined through compound light microscopy. The data obtained was analyzed using statistical software like Epidata and STATA. A total of 164 prisoners were included in the survey using active screening strategy and the point prevalence of smear positive pulmonary tuberculosis (PTB) in the prison was 349.2 per 100,000 populations; about three times higher than its prevalence in the general population. Even though lack of visit from family was the only variable identified as a risk factor for PTB (P = 0.029), almost all of the PTB positive cases were rural residents, farmers, male youngsters and those who shared cell with TB patients and chronically coughing persons as well as those who stayed in a cell that contains >100 inmates. There is high prevalence of TB in Hadiya Zone prison with possible active transmission of TB within the prison. The study also documented a number of factors which may facilitate exposures to TB though most of them are not significantly associated. Therefore, strong cooperation between prison authorities and the national tuberculosis control programmes is urgently required to develop locally appropriate interventions to reduce transmission.

  3. Associations between diet quality and physical activity measures among a southern Ontario regional sample of grade 6 students.

    Science.gov (United States)

    Woodruff, Sarah J; Hanning, Rhona M

    2010-12-01

    The purpose of this study was to determine diet quality and physical activity behaviours of grade 6 students by sex and body weight status, and to determine the associations between diet quality and physical activity behaviours. The Web-based Food Behaviour Questionnaire, which included a 24-h diet recall and the modified Physical Activity Questionnaire for Older Children (PAQ-C), was administered to a cross-section of schools (n = 405 students from 15 schools). Measured height and weight were used to calculate body mass index and weight status (Cole et al. 2000). A Canadian version of the Healthy Eating Index (HEI-C) was used to describe overall diet quality. The mean HEI-C was 69.6 (13.2) with the majority (72%) falling into the needs improvement category. The overall mean physical activity score was 3.7 out of a maximum of 5, with obese subjects being less active compared with normal weight and overweight (p < 0.001). Ordinal logistic regression analysis (of HEI-C vs. all measures of the PAQ-C, sex, and weight status) revealed that HEI-C ratings were likely to be higher in students that walked to and from school 5 days per week (vs. 0 days per week; odds ratio 3.18, p = 0.010); and were active 1 evening per week (vs. none; odds ratio 3.48, p = 0.039). The positive association between diet quality and some aspects of physical activity suggests possible clustering of health behaviours. Future research should test the potential benefits of promoting 1 health behaviour (e.g., healthy eating) with another (e.g., physical activity).

  4. Surgical management of hyperthyroidism.

    Science.gov (United States)

    Quérat, C; Germain, N; Dumollard, J-M; Estour, B; Peoc'h, M; Prades, J-M

    2015-04-01

    Hyperthyroidism includes several clinical and histopathological situations. Surgery is commonly indicated after failure of medical treatment. The aim of this study was to analyze the indications and complications of surgery as well as endocrine results. Patients operated on for hyperthyroidism between 2004 and 2012 were included in a retrospective study. Total thyroidectomy was performed for Graves' disease, toxic multinodular goiter and amiodarone-associated thyrotoxicosis; patients with toxic nodule underwent hemithyroidectomy. Pathologic analysis assessed surgical specimens; postoperative complications and resolution of hyperthyroidism were noted. Two hundred patients from 15 to 83 years old were included. One hundred and eighty-eight underwent primary surgery and 12 were re-operated for recurrent goiter (6 with subtotal thyroidectomy for multinodular goiter 25 years previously; 6 with hemithyroidectomy for solitary nodule 15 years previously). Eighty-two patients suffered from toxic multinodular goiter, 78 from Graves' disease, 35 from solitary toxic nodules and 5 from amiodarone-associated thyrotoxicosis. Fourteen papillary carcinomas (including 11 papillary microcarcinomas) and 34 healthy parathyroid glands (17%) were identified in the pathological specimens. Postoperative complications comprised 4% permanent recurrent laryngeal nerve palsy (1 year follow-up), 9% hematoma requiring surgical revision, and 3% definitive hypocalcemia. Normalization of thyroid hormone levels was observed in 198 patients. Two recurrences occurred due to incomplete resection (1 case of Graves' disease and 1 intrathoracic toxic goiter that occurred respectively 18 and 5 months after resection). Postoperative complications were more frequent in multinodular goiter (23%) than in Graves' disease (13%) (ns: P>0.05). Surgical management of hyperthyroidism enables good endocrinal control if surgery is complete. Patients need to be fully informed of all possible postoperative complications

  5. Incidence, Microbiological Profile and Risk Factors of Healthcare-Associated Infections in Intensive Care Units: A 10 Year Observation in a Provincial Hospital in Southern Poland

    Science.gov (United States)

    Kołpa, Małgorzata; Wałaszek, Marta; Gniadek, Agnieszka; Wolak, Zdzisław; Dobroś, Wiesław

    2018-01-01

    Healthcare-associated infections (HAIs) occurring in patients treated in an intensive care unit (ICU) are serious complications in the treatment process. Aetiological factors of these infections can have an impact on treatment effects, treatment duration and mortality. The aim of the study was to determine the prevalence and microbiological profile of HAIs in patients hospitalized in an ICU over a span of 10 years. The active surveillance method was used to detect HAIs in adult patients who spent over 48 h in a general ICU ward located in southern Poland between 2007 and 2016. The study was conducted in compliance with the methodology recommended by the Healthcare-associated Infections Surveillance Network (HAI-Net) of the European Centre for Disease Prevention and Control (ECDC). During the 10 years of the study, 1849 patients hospitalized in an ICU for a total of 17,599 days acquired 510 with overall HAIs rates of 27.6% and 29.0% infections per 1000 ICU days. Intubation-associated pneumonia (IAP) posed the greatest risk (15.2 per 1000 ventilator days), followed by CLA-BSI (8.0 per 1000 catheter days) and CA-UTI (3.0 per 1000 catheter days). The most common isolated microorganism was Acinetobacter baumannii (25%) followed by Coagulaase-negativ staphylococci (15%), Escherichia coli (9%), Pseudomonas aeruginosa (8%), Klebsiella pneumoniae (7%), Candida albicans (6%). Acinetobacter baumannii in 87% and were classified as extensive-drug resistant (XDR). In summary, in ICU patients pneumonia and bloodstream infections were the most frequently found. Acinetobacter baumannii strains were most often isolated from clinical materials taken from HAI patients and showed resistance to many groups of antibiotics. A trend of increasing resistance of Acinetobacter baumannii to carbapenems was observed. PMID:29324651

  6. Assessment of the prevalence of intestinal parasitosis and associated risk factors among primary school children in Chencha town, Southern Ethiopia.

    Science.gov (United States)

    Abossie, Ashenafi; Seid, Mohammed

    2014-02-14

    Parasitic infection is the most prevalent among rural communities in warm and humid regions and where water, hygiene and sanitation facilities are inadequate. Such infection occurs in rural areas where water supplies are not enough to drink and use, and in the absence of environmental sanitation, when the rubbish and other wastes increased, and sewage and waste water are not properly treated. Hence the aim of the study was to assess the prevalence of intestinal parasitosis and associated risk factors. This cross sectional study was conducted on children of the selected primary schools in Chencha town from March to May, 2012. Children were selected within age group 5-15 years. The socio-demographic, environmental and behavioral variables data were collected using structured questionnaire from the guardians of children and school teachers to assess the risk factors. Prevalence of intestinal parasitosis was determined using direct method and formol-ether concentration method. Participants' data were analyzed using SPSS version 16.0. Of 422 selected school children, 400 participated in the study with full information for analysis. The overall prevalence of intestinal parasitosis was high (81.0%). Soil-transmitted helminths (STHs) infections (63.0%) were more prevalent than protozoa infections (23.5%). The predominant parasites were A. lumbricoides (60.5%), E. histolytica/dispar (16.25%), Giardia lamblia (11.7%) and T. trichuria (9.7%). The presence of Intestinal Parasitic Infections (IPIs) have statistically significant association with the educational status of the household heads, absence of washing facility, home cleanness condition and type of latrine used with (p intestinal parasitic infections, especially soil-transmitted helminths (STHs) is very high in the school children. The high prevalence of parasitic infections in these children indicates that the protozoa and helminths concerned are very common in the environment of these villages and the results of the

  7. Prevalence of mental distress and associated factors among Hawassa University medical students, Southern Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Melese, Biniam; Bayu, Birhanu; Wondwossen, Fikir; Tilahun, Kalkidan; Lema, Seti; Ayehu, Moges; Loha, Eskindir

    2016-11-08

    Mental distress is a mental health problem expressed with variable levels of depressive, anxiety, panic or somatic symptoms. Owing to several factors tertiary level students are among the population with higher prevalence of mental distress and an even more higher prevalence has been reported in medical students. The aim of this study was to determine the prevalence of mental distress among medical students, and to evaluate contextually relevant associated factors. A cross-sectional study was conducted among medical students attending Hawassa University College of Medicine and Health Sciences in 2013/2014 academic year. Stratified random sampling was implemented with each strata representing the year of study of the students. Data on mental distress was collected using the Self-Reporting Questionnaire-20 (SRQ-20). Data was entered into and analyzed using IBM SPSS statistics 21. A cut-off point of 8 and above was used to classify students as having mental distress. Among 240 students included in the study, 72 (30%) of them were found to have mental distress. There was no significant difference in mental distress between males and females (COR = 1.18, 95% CI = 0.62-2.25). On bivariate analysis, students with age less than or equal to 21 years showed higher odds of having mental distress (COR = 2.3, 95% CI: 1.26-4.22), but because of having high correlation with students' year of study, age was excluded from the multivariate model. In this study being a pre-medicine student (AOR = 3.61, 95% CI: 1.45-8.97), perceiving medical school as very stressful (AOR = 3.89, 95% CI: 1.52-9.94), perceiving living environment as very crowded (AOR = 2.43, 95% CI: 1.24-4.77) and having a feeling of insecurity about one's safety (AOR = 2.93, 95% CI: 1.51-5.68) had statistically significant association with mental distress. In this study one-third of medical students were found to have mental distress. Designing prevention and treatment programs to address contextually

  8. High prevalence of rheumatoid factor associated with clinical manifestations of rheumatic disease in Kaingang and Guarani Indians from Southern Brazil.

    Science.gov (United States)

    Ribas, João Luiz Coelho; Utiyama, Shirley Ramos da Rosa; Nisihara, Renato Mitsunori; Boeira, Maristela; Reason, Iara Taborda de Messias

    2009-02-01

    The aim of the present study was to perform a screening for rheumatoid factor (RF) and anti-nuclear antibody in Kaingang, Guarani and Mestizos individuals from Mangueirinha Reservation, State of Paraná, Brazil, and associate it with demographic and clinical data. Serum samples from 321 aborigines (125 male and 196 female; 4-86 years old) and 180 non-Indians healthy individuals were analysed (62 male and 118 female; 2-81 years old). Antinuclear antibody (ANA) was tested by indirect immunofluorescence, and RF by agglutination in latex and turbidimetry. RF was higher in Kaingang when compared to Guarani (P = 0.009), Mestizos (P = 0.061) and non-Indians (P = 0.010). A significant increase of RF was observed in Kaingang women versus Kaingang men (P = 0.002) and, among the women, in Kaingang when compared to Mestizos and Guarani (P

  9. Early Initiation of Antenatal Care and Factors Associated with Early Antenatal Care Initiation at Health Facilities in Southern Ethiopia

    Directory of Open Access Journals (Sweden)

    Mengesha Boko Geta

    2017-01-01

    Full Text Available Antenatal care (ANC is care given to pregnant mothers to timely identify and mitigate pregnancy related problems that can harm mother or fetus. Most of Ethiopian mothers present late for ANC. The aim of this paper was to assess determinants of early antenatal care initiation among pregnant women. Mothers attending Shebedino District Health Centers for ANC between January 12 and February 18, 2015, were invited to the study. Multistage sampling technique and structured questionnaire were used to collect data by trained data collectors. Univariate and bivariate analysis were conducted to study the association between explanatory and outcome variable. Out of 608 women, 132 [21.71%] had their first ANC within the recommended time [before or at 3 months]. Media access [AOR = 2.11 95% CI 1.00, 3.22], knowledge about the correct time of ANC booking [AOR = 4.49 95% CI 2.47, 6.16], and having been advised to book within 12 weeks [AOR = 4.14 95% CI 3.80, 5.21] were determinants of first-trimester booking. Health professionals and care providers should provide full information, advice, and appropriate care about early ANC for every eligible mother.

  10. Ichthyoplankton in a southern african surf zone: Nursery area for the postlarvae of estuarine associated fish species?

    Science.gov (United States)

    Whitfield, A. K.

    1989-12-01

    The surf zone ichthyoplankton of Swartvlei Bay was studied between February 1986 and June 1987, with particular emphasis on its potential role as a nursery area for estuarine associated marine fish species. Larvae and/or postlarvae of 16 families were identified from the surf zone, with the Gobiidae, Soleidae, Sparidae and Mugilidae comprising 85·7% of all teleosts sampled. The postlarvae of several taxa (including the six most common species), which utilize the Swartvlei estuary as a juvenile nursery area, were abundant in the surf zone. Conversely, species which are common in nearshore marine waters as juveniles and adults, but seldom enter estuaries, totalled less than 8% of the surf zone ichthyoplankton assemblage. Larval and postlarval densities peaked during summer when water temperatures exceeded 19°C and the estuary mouth was open. Concentrations of ichthyoplankton were highest at those sampling stations closest to the estuary mouth during the summer period. Diel changes in total catches revealed no significant difference between day and night densities; but of the four major taxa, the Mugilidae and Sparidae tended to be more abundant during the day, the Gobiidae at night and the Soleidae showed no distinct pattern. Results from a 24 h sampling session indicated that tidal phase may also be important in governing ichthyoplankton abundance in the surf zone.

  11. Contrasting origin of two A-type rhyolite series from the Early Permian Nomgon bimodal volcanic association (Southern Mongolia)

    Science.gov (United States)

    Kozlovsky, A. M.; Yarmolyuk, V. V.; Savatenkov, V. M.; Kudryashova, E. A.

    2017-08-01

    A-type rhyolites of contrasting compositions and eruption characters were revealed among two volcanic series of the Early Permian bimodal association in the Nomgon graben. Rhyolites of the lower volcanic series formed extrusions, lava domes, and tuff horizons. They had low FeOt, Zr, Hf, Nb, Ta, Y, and REE concentrations and also a moderately depleted Nd isotope composition (ɛNd( T) = 6.7-7.1). Their formation was related to anatexis of the juvenile continental crust, triggered by the thermal effect of mafic magmas. Rhyolites of the upper volcanic series formed extensive lava flows and dikes. Their composition was characterized by high FeOt, Zr, Hf, Nb, Ta, Y, and REE concentrations, and also depleted Nd isotope characteristics (ɛNd( T) = 7.7-9.0). These rhyolite melts formed under long-term crystallizational differentiation of basaltoids in the intracrustal magmatic chambers, with limited participation of crustal contamination. The source of magmas for the upper volcanic series was the sublithospheric mantle.

  12. Prevalence of risk factors for hepatitis C and associated factors: a population-based study in southern Brazil.

    Science.gov (United States)

    Kvitko, David Timm; Bastos, Gisele Alsina Nader; Pinto, Maria Eugênia Bresolin

    2013-04-01

    The hepatitis C is a severe public health problem worldwide because its consequences. Studies which aim at determining the prevalence of risk factors are really important to understand the problem. To estimate the prevalence and factors associated with some risk factors for the disease in a community, called Restinga, located in the city of Porto Alegre, RS, Brazil. This paper is based on a population-based cross-sectional study, with systematic sampling and proportional to the size of census tracts in which 3,391 adults answered a standardized questionnaire. The prevalence of blood transfusion among the people who were interviewed was 14.98%, 60.83% of those had it before 1993. A total of 16.16% of the people had a tattoo, 7.23% wore a piercing, 1.09% said they had already injected illicit drugs and 12.39% reported previous hospitalization. Prevalence ratios showed that tattoos were more common among young people, piercings among women and illicit drugs among men. To summarize, the recognition of risk factors for hepatitis C enables proper screening of possible carriers of the hepatitis C virus, thus enabling a reduction in virus shedding. However, being only possible if health services are prepared to deal with hepatitis C virus, through education and public awareness.

  13. PREVALENCE OF RISK FACTORS FOR HEPATITIS C AND ASSOCIATED FACTORS: a population-based study in southern Brazil

    Directory of Open Access Journals (Sweden)

    David Timm KVITKO

    2013-04-01

    Full Text Available Context The hepatitis C is a severe public health problem worldwide because its consequences. Studies which aim at determining the prevalence of risk factors are really important to understand the problem. Objective To estimate the prevalence and factors associated with some risk factors for the disease in a community, called Restinga, located in the city of Porto Alegre, RS, Brazil. Method This paper is based on a population-based cross-sectional study, with systematic sampling and proportional to the size of census tracts in which 3,391 adults answered a standardized questionnaire. Results The prevalence of blood transfusion among the people who were interviewed was 14.98%, 60.83% of those had it before 1993. A total of 16.16% of the people had a tattoo, 7.23% wore a piercing, 1.09% said they had already injected illicit drugs and 12.39% reported previous hospitalization. Prevalence ratios showed that tattoos were more common among young people, piercings among women and illicit drugs among men. Conclusions To summarize, the recognition of risk factors for hepatitis C enables proper screening of possible carriers of the hepatitis C virus, thus enabling a reduction in virus shedding. However, being only possible if health services are prepared to deal with hepatitis C virus, through education and public awareness.

  14. Diversity and community structure of dung beetles (Coleoptera: Scarabaeinae associated with semi-urban fragmented agricultural land in the Malabar coast in southern India

    Directory of Open Access Journals (Sweden)

    K.S. Venugopal

    2012-07-01

    Full Text Available An evaluation of the diversity and community structure of dung beetles associated with semiurban agricultural land in the Malabar coast of southern India revealed that urbanization has led to decreased diversity compared to regional forests, and has affected the community status of dung beetles. However, contrary to expectations, species richness was observed to be equivalent to rural agricultural fields in the region. Low abundance of prominent agricultural habitat species indicates that the study area has changed as a result of habitat modification/urbanization, and the prevailing conditions are not ideal for the establishment of the most common species in agriculture belts. Prominence of two less common species, Tiniocellus spinipes and Caccobius vulcanus, indicates these generalist urban adaptable (synanthropic species have become increasingly widespread and locally abundant. The low abundance of tunnelers and rollers is attributed to fragmentation of the urban agricultural belt, low mammalian diversity and dung availability, and the hard nature of the laterite soil in the Malabar coast region.

  15. The Ambrosia Lake project archaeological investigations of three small sites associated with the southern Chacoan outlier of Kin Nizhoni, McKinley County, New Mexico

    International Nuclear Information System (INIS)

    Cullington, B.J.

    1990-01-01

    During the fall of 1987, Complete Archaeological Service Associates conducted mitigative excavations at three sites (LA50363, LA50364, and LA50371) in McKinley County, New Mexico. These sites are adjacent to the Phillips/United Nuclear Inactive Uranium Mill and Tailings site at Ambrosia Lake, New Mexico. The primary deposition at each of these sites appears to be related to a Pueblo II or Bonito Phase occupation. Temporal placement is based primarily on the cross dating of ceramics and archaeomagnetic determinations when possible. No tree-ring or radiocarbon samples are available from these sites. These Ambrosia Lake sites indicate that this area was occupied primarily by Pueblo II people who may have had close social, economic, and ceremonial ties with the people living at the nuclear community of Lower Nizhoni about 3 km south-southeast. The later component at LA50364 indicates a Pueblo III occupation by people who may have had similar ties to the people of the Kin Nizhoni nuclear community. The Ambrosia Lake sites, then, provide important information on the structure of subnuclear communities within the southern Chaco periphery

  16. Impact of Temperature Anomalies Associated with El Niño-Southern Oscillation and Indian Ocean Dipole Events on Wine Grape Maturity in Australia

    Science.gov (United States)

    Jarvis, C.; Barlow, E.; Darbyshire, R.; Eckard, R.; Goodwin, I.

    2016-12-01

    Annual grapevine growth and development are intimately linked with growing season weather conditions. Shifts in circulation patterns resulting from atmospheric teleconnections to changes in sea surface temperature (SST) anomalies associated with El Niño-Southern Oscillation (ENSO) and Indian Ocean Dipole (IOD) events can alter seasonal weather across Australia. Both ENSO and IOD events tend to peak in austral spring, when vine and berry development is especially critical and susceptible to damage. To investigate the impacts of ENSO and IOD events on the Australian wine grape growing sector, historical gridded climate data and annual vineyard grape maturity data from a variety of wine growing regions was collected and analysed. The greatest impacts on grape maturity were found when La Niña and IOD positive events occurred in tandem. During these events, significantly dry and hot conditions persist throughout the wine grape growing season, suggesting that the IOD overrides the ENSO signal. These conditions lead to a rapid, compressed growing season, which can cause logistical complications during harvest and impact grape and wine quality. Warming of equatorial SSTs in the Indian Ocean are likely to enhance the amplitude of IOD positive events, which has serious implications for wine grape production in Australia, highlighting the importance of this research.

  17. Spectral and stratigraphic mapping of hydrated minerals associated with interior layered deposits near the southern wall of Melas Chasma, Mars

    Science.gov (United States)

    Liu, Yang; Goudge, Timothy A.; Catalano, Jeffrey G.; Wang, Alian

    2018-03-01

    Orbital remote sensing data acquired from the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) onboard Mars Reconnaissance Orbiter (MRO), in conjunction with other datasets, are used to perform detailed spectral and stratigraphic analyses over a portion of south Melas Chasma, Mars. The Discrete Ordinate Radiative Transfer (DISORT) model is used to retrieve atmospherically corrected single scattering albedos from CRISM I/F data for mineral identification. A sequence of interbedded poly- and monohydrated sulfates associated with interior layered deposits (ILDs) is identified and mapped. Analyses from laboratory experiments and spectral unmixing of CRISM hyperspectral data support the hypothesis of precipitation and dehydration of multiple inputs of complex Mg-Ca-Fe-SO4-Cl brines. In this scenario, the early precipitated Mg sulfates could dehydrate into monohydrated sulfate due to catalytic effects, and the later-precipitated Mg sulfates from the late-stage "clean" brine could terminate their dehydration at mid-degree of hydration to form a polyhydrated sulfate layer due to depletion of the catalytic species (e.g., Ca, Fe, and Cl). Distinct jarosite-bearing units are identified stratigraphically above the hydrated sulfate deposits. These are hypothesized to have formed either by oxidation of a fluid containing Fe(II) and SO4, or by leaching of soluble phases from precursor intermixed jarosite-Mg sulfate units that may have formed during the later stages of deposition of the hydrated sulfate sequence. Results from stratigraphic analysis of the ILDs show that the layers have a consistent northward dip towards the interior of the Melas Chasma basin, a mean dip angle of ∼6°, and neighboring strata that are approximately parallel. These strata are interpreted as initially sub-horizontal layers of a subaqueous, sedimentary evaporite deposits that underwent post-depositional tilting from slumping into the Melas Chasma basin. The interbedded hydrated sulfate

  18. Human health risks associated with residual pesticide levels in edible tissues of slaughtered cattle in Benin City, Southern Nigeria

    Directory of Open Access Journals (Sweden)

    Isioma Tongo

    2015-01-01

    Full Text Available Pesticide residues in meat is of growing concern due to possible adverse effects on humans. Pesticide levels were assessed in five edible cattle parts: muscle, liver, kidney and tongue tissues to determine human health risk associated with consumption of these tissues. Health risk estimates were analysed using estimated daily intake (EDI, hazard quotient (HQ and hazard index (HI for two (2 age/weight categories: 1–11years/30 kg for children while 70 kg was used for adult. Risks were categorized for non-carcinogenic and carcinogenic health effects and measured at the average, maximum, 50th and 95th percentiles of the measured exposure concentrations (MEC. Total pesticide residues ranged from 2.38 to 3.86 μg/kg (muscle, 3.58 to 6.3 μg/kg (liver, 1.87 to 4.59 μg/kg (kidney and 2.54 to 4.35 μg/kg (tongue. Residual pesticide concentrations in the tissues were in the order: Liver > Tongue > Muscle > Kidney. The concentrations of all the assessed pesticides observed in the tissues were however lower than the recommended maximum residual limits (MRLs. Human health risk estimations for the children showed EDI values for heptachlor epoxide, aldrin and dieldrin exceeding threshold values. Non-cancer risk posed to children on consumption of contaminated cattle parts showed HQ values for heptachlor epoxide, aldrin, dieldrin and HI values for organochlorines exceeding 1, indicating the possibility of non-carcinogenic health risks to consumers especially children from consumption of cattle meat from the selected abattoirs.

  19. Lessons from a study in a rural community from southern Mexico: risk factors associated to transmission and reinfection of gastrointestinal parasites after albendazole treatment

    Directory of Open Access Journals (Sweden)

    Rodríguez-Pérez MA

    2011-12-01

    Full Text Available Mario A Rodríguez-Pérez1, Juan Antonio Pérez-Vega2, José Francisco Cen-Aguilar3, Rossanna Rodríguez-Canul21Centro de Biotecnología Genómica, Instituto Politécnico Nacional, Ciudad Reynosa, Tamaulipas, 2Centro de Investigación y de Estudios Avanzados del IPN Unidad Mérida, Mérida Yucatán, 3Oficina de Investigación y validación, Centro de Bachillerato Tecnológico y Agropecuario (CBTA 13, Xmatkuil, Mérida, Yucatán, MexicoPurpose: To determine the prevalence of gastrointestinal parasites and evaluate the effect of a single dose of treatment with albendazole in a sentinel group from a rural community in southern Mexico.Methods: Stool samples were collected from 1456 individuals aged ≥1 year during consecutive days, and examined for helminth infection using the modified Stoll dilution method. Additionally, 104 individuals were treated with a single dose of albendazole and evaluated over 21 weeks to assess reinfection. Questionnaires were administered to obtain individual and household-level data pertaining to behavior, demography, and socioeconomic status. Risk factors for reinfection after albendazole administration were determined using multiple logistic regression analyses.Results: The prevalence of Ascaris lumbricoides was 73.9% (95% confidence interval [CI] = 71.56%–76.14%. Albendazole was 100% effective, but eggs began to be detected by 9–12 weeks posttreatment, increasing to 100% after 21 weeks. Logistic regression analysis revealed that all individuals from this study had a probability of reinfection of 1.65× each week after treatment. The prevalence of Trichuris trichiura was 57.2% (95% CI = 54.62%–59.77% and chemotherapy was 34.7% effective. The prevalence for other minor gastrointestinal parasites ranged from 0.2% to 29.7%.Conclusion: This was a comprehensive study on gastrointestinal parasites in a rural community from southern Mexico and, to the best of the authors’ knowledge, is the first time that the effect

  20. Land-use changes, farm management and the decline of butterflies associated with semi-natural grasslands in southern Sweden

    Directory of Open Access Journals (Sweden)

    Sven G. Nilsson

    2013-11-01

    Full Text Available Currently, we are experiencing biodiversity loss on different spatial scales. One of the best studied taxonomic groups in decline is the butterflies. Here, we review evidence for such declines using five systematic studies from southern Sweden that compare old butterfly surveys with the current situation. Additionally, we provide data on butterfly and burnet moth extinctions in the region’s counties. In some local areas, half of the butterfly fauna has been lost during the last 60-100 years. In terms of extinctions, counties have lost 2-10 butterfly and burnet moth species. Land use has changed markedly with key butterfly habitats such as hay meadows disappearing at alarming rates. Grazed, mixed open woodlands have been transformed into dense coniferous forests and clear-cuts and domestic grazers have been relocated from woodlands to arable fields and semi-natural grasslands. Ley has increased rapidly and is used for bale silage repeatedly during the season. Overall, the changed and intensified land use has markedly reduced the availability of nectar resources in the landscape. Species that decline in Sweden are strongly decreasing or already extinct in other parts of Europe. Many typical grassland species that were numerous in former times have declined severely; among those Hesperia comma, Lycaena virgaureae, Lycaena hippothoe, Argynnis adippe, and Polyommatus semiargus. Also, species associated with open woodlands and wetlands such as, Colias palaeno, Boloria euphrosyne and the glade-inhabiting Leptidea sinapis have all decreased markedly. Current management practise and EU Common Agricultural Policy rules favour intensive grazing on the remaining semi-natural grasslands, with strong negative effects on butterfly diversity. Abandoned grasslands are very common in less productive areas of southern Sweden and these habitats may soon become forests. There is an urgent need for immediate action to preserve unfertilized, mown and lightly grazed

  1. Three-dimensional aesthetic assessment of class II patients before and after orthognathic surgery and its association with quantitative surgical changes.

    Science.gov (United States)

    Storms, A S; Vansant, L; Shaheen, E; Coucke, W; de Llano-Pérula, M Cadenas; Jacobs, R; Politis, C; Willems, G

    2017-12-01

    The aim of this study was to compare evaluations of the aesthetic outcome of class II orthognathic patients, as performed by observers with varying expertise using three-dimensional (3D) facial images, and to examine the relationship of aesthetic ratings in relation to quantitative surgical changes. Pre- and postoperative 3D facial images of 20 surgically treated class II patients (13 female, 7 male) were assessed for aesthetics by orthodontists, maxillofacial surgeons, and laypeople. Attractiveness ratings for the lips, chin, and overall facial aesthetics were evaluated on a 5-point Likert scale. Correlation between the aesthetic scores was obtained and quantitative surgical changes were examined. For all groups of observers, significant improvements in attractiveness scores were found, especially for the chin assessment. Orthodontists perceived the greatest improvement and laypeople the smallest. Overall, laypeople scored higher with less variability, but with lower intra- and inter-observer agreement. No significant correlation was found between the aesthetic improvement and soft tissue surgical changes. To avoid patient dissatisfaction, it is important to bear in mind that the demands and perception of aesthetic improvement after orthognathic surgery are higher for clinicians than for the general public. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Anemia and Associated Factors Among Pregnant Women Attending Antenatal Care Clinic in Wolayita Sodo Town, Southern Ethiopia.

    Science.gov (United States)

    Gedefaw, Lealem; Ayele, Asrat; Asres, Yaregal; Mossie, Andualem

    2015-04-01

    Anemia during pregnancy is a common problem which affects both the mother's and her child's health. The main aim of the study was to determine the prevalence and associated risk factors of anemia among pregnant women. We conducted a facility based cross-sectional study on 363 pregnant women attending antenatal care clinic in Wolayita Soddo Otona Hospital from January to March 2014. Sociodemographic data were collected through questionnaire based interview. Four milliliter of venous blood and five grams of fecal samples were collected from each pregnant woman. Hematological parameters were determined using CELL DYN 1800(®) (Abott, USA) Hematology analyzer. Stool samples were checked for intestinal parasites using both direct wet mount and formol-ether concentration techniques. Data were analyzed using SPSS version 20 software. Overall, the prevalence of anemia was 39.94% (95% CI: 34.7 - 45.2%), of which the majority (60%) had moderate anemia. The mean hemoglobin concentration was 11.55±2.97 g/dl. Age 15-24 years (AOR: 9.89, 95%CI:2.68-21.41), family size >5 (AOR:7.74, 95%CI:4.15-16.47), multigravida (AOR:2.66, 95%CI:1.1.31-4.53), having low income (AOR:5.81, 95%CI:2.93-14.11), current clinical illness (AOR: 6.38, 95%CI:3.13-13.00), intestinal parasitic infection (AOR:2.41, 95%CI:1.08-5.81), no history of contraceptive usage (AOR:5.02 95%CI:2.21-11.47), being in third trimesters (AOR:11.37, 95%CI:4.56-24.82), history of excess menstrual bleeding (AOR:9.82, 95%CI:3.27-21.35) and low body mass index (AOR:9.44, 95%CI:7.79-22.18) were identified as independent predictors of anemia among pregnant women. Anemia prevalence was found out to be moderate public health importance. Identified risk factors should be considered for prevention and control of anemia among pregnant women.

  3. Southern blotting.

    Science.gov (United States)

    Brown, T

    2001-05-01

    Southern blotting is the transfer of DNA fragments from an electrophoresis gel to a membrane support (the properties and advantages of the different types of membrane, transfer buffer, and transfer method are discussed in detail), resulting in immobilization of the DNA fragments, so the membrane carries a semipermanent reproduction of the banding pattern of the gel. After immobilization, the DNA can be subjected to hybridization analysis, enabling bands with sequence similarity to a labeled probe to be identified. This appendix describes Southern blotting via upward capillary transfer of DNA from an agarose gel onto a nylon or nitrocellulose membrane, using a high-salt transfer buffer to promote binding of DNA to the membrane. With the high-salt buffer, the DNA becomes bound to the membrane during transfer but not permanently immobilized. Immobilization is achieved by UV irradiation (for nylon) or baking (for nitrocellulose). A Support Protocol describes how to calibrate a UV transilluminator for optimal UV irradiation of a nylon membrane. An alternate protocol details transfer using nylon membranes and an alkaline buffer, and is primarily used with positively charged nylon membranes. The advantage of this combination is that no post-transfer immobilization step is required, as the positively charged membrane binds DNA irreversibly under alkaline transfer conditions. The method can also be used with neutral nylon membranes but less DNA will be retained. A second alternate protocol describes a transfer method based on a different transfer-stack setup. The traditional method of upward capillary transfer of DNA from gel to membrane described in the first basic and alternate protocols has certain disadvantages, notably the fact that the gel can become crushed by the weighted filter papers and paper towels that are laid on top of it. This slows down the blotting process and may reduce the amount of DNA that can be transferred. The downward capillary method described in

  4. Different dissecting orders of the pulmonary bronchus and vessels during right upper lobectomy are associated with surgical feasibility and postoperative recovery for lung cancer patients.

    Science.gov (United States)

    Zhai, Hao-Ran; Yang, Xue-Ning; Nie, Qiang; Liao, Ri-Qiang; Dong, Song; Li, Wei; Jiang, Ben-Yuan; Yang, Jin-Ji; Zhou, Qing; Tu, Hai-Yan; Zhang, Xu-Chao; Wu, Yi-Long; Zhong, Wen-Zhao

    2017-06-27

    Right upper lobectomy (RUL) for lung cancer with different dissecting orders involves the most variable anatomical structures, but no studies have analyzed its effects on postoperative recovery. This study compared the conventional surgical approach, VAB (dissecting pulmonary vessels first, followed by the bronchus), and the alternative surgical approach, aBVA (dissecting the posterior ascending arterial branch first, followed by the bronchus and vessels) on improving surgical feasibility and postoperative recovery for lung cancer patients. According to the surgical approach, consecutive lung cancer patients undergoing RUL were grouped into aBVA and VAB cohorts. Their clinical, pathologic, and perioperative characteristics were collected to compare perioperative outcomes. Three hundred one patients were selected (109 in the aBVA cohort and 192 in the VAB cohort). The mean operation time was shorter in the aBVA cohort than in the VAB cohort (164 vs. 221 min, P  0.05). The median disease-free survival was comparable for all patients in the two cohorts (not arrived vs. 41.97 months) and for patients with disease recurrences (13.25 vs. 9.44 months) (both P > 0.05). The recurrence models in two cohorts were also comparable for patients with local recurrences (6.4% vs. 7.8%), distant metastases (10.1% vs. 8.3%), and both (1.8% vs. 1.6%) (all P > 0.05). Dissecting the right upper bronchus before turning over the lobe repeatedly and dissecting veins via the aBVA approach during RUL would promote surgical feasibility and achieve comparable postoperative recovery for lung cancer patients.

  5. Natural radioactivity and associated radiation characteristic of the new high background radiation area of lambwe east southern Kenya

    International Nuclear Information System (INIS)

    Achola, S.O.; Patel, J.P.; Angeyo, H.K.; Mustapha, A.O.

    2010-01-01

    Rocks and soils from a number of areas underlined by carbonatite rocks in Kenya have been associated with high levels of natural background radioactivity. People in such high background radiation areas (HBRA), are exposed to abnormally high annual absorbed dose (that have health implications) than the global normal 1 mSvyr-1. In this paper, results of field background radiation measurements, activity concentrations of primordial radionuclides in (mainly carbonatite rock and soil) matrices, and estimated annual external effective dose rates are presented for South and North Ruri hills in Lambwe East location of Suba District, which lies roughly between latitudes 0°30'S and 1°00'S, bounded on the east by longitude 34°30'E and on the west by the shores of Lake Victoria 16 and Winnam Gulf. Altitudes in the region range from about 1000 m on the shores of Lake Victoria to above 1800 m on top of the Ruri hills. The main geological features are carbonatite formations. Twenty one samples were analyzed using high-purity germanium (HPGe) gamma-ray spectrometer. The activity concentrations ranged 14.18 - 6559.99 Bqkg-1 (average: 1396.85 Bqkg-1) for Th-232; 2.73 - 499.24 Bqkg-1 (average: 178.69 Bqkg-1) for U-238; and 56.67 - 1454.73 Bqkg-1 (average: 508.67 Bqkg-1) for K-40. The variability in Th distribution could be due to another contributing factor apart from carbonatite: Homa hills geothermal field fluids might be responsible for delivery of Th to surface rocks; some hot spots have travertine deposits. Measured absorbed dose rates in air outdoors range 700 - 6000.00 nGyh-1 (mean: 2325.84 nGy h-1); assuming 0.4 occupancy factor, these values correspond to individual annual effective dose rates of 1.717 - 14.717 mSvyr-1 (mean: 5.705 mSv yr-1). Measured absorbed dose rates are higher than calculated values since they include the contribution of cosmic rays. The natural radioactivity is fractionated with higher levels in the soils than carbonatite rocks

  6. Risk Factors Associated with Triatomines and Its Infection with Trypanosoma cruzi in Rural Communities from the Southern Region of the State of Mexico, Mexico

    Science.gov (United States)

    Medina-Torres, Imelda; Vázquez-Chagoyán, Juan C.; Rodríguez-Vivas, Roger I.; de Oca-Jiménez, Roberto Montes

    2010-01-01

    Trypanosoma cruzi prevalence in triatomines and risk factors associated to the presence of the insect were studied in 990 rural houses in the southern region of the State of Mexico, Mexico. In each house, triatomines were collected, and information related to house construction material was obtained. T. cruzi infection was diagnosed in all triatomines. A primary screening was performed using 2 × 2 contingency tables of exposure variables. All variables with P ≤ 0.20 were analyzed by logistic regression. Triatomines (N = 125) were collected from 822 houses and analyzed for T. cruzi infection. Triatoma pallidipennis (97.4%) and Triatoma dimidiata (2.6%) were identified in 52.1% of the localities and in 6.1% of the houses. Infection was found in 28.0% of triatomines, from which 28.9% were nymphs. Factors associated with triatomine infestation were flooring construction material (dirt floor: odds ratio [OR], 10.05; 95% confidence interval [CI], 5.31–18.04; P = 0.0001), house rooms (at least three rooms: OR, 2.04; 95% CI, 1.07–3.86; P = 0.028), and ceiling construction material (cardboard lamina tile: OR, 6.84; 95% CI, 1.49–31.31; P = 0.013). This study shows T. cruzi circulation in triatomines in the area of study, and because triatomines are adapted for living and reproducing in the domestic environment, there is a potential risk of Chagas disease transmission to humans. Also, we can conclude that the construction materials and house inhabitants are risk factors of triatomines infestation. PMID:20064995

  7. Preliminaries to a feasibility analysis of the Maglev proposal of the Southern California Association of Governments for the region : a seed grant study report

    Science.gov (United States)

    2009-08-30

    This is a seed grant study to perform a preliminary investigation of the system components and : generalized costs of the magnetic levitation type of high speed rail system that is proposed for the : Southern California Region, TGVbased high speed...

  8. The role of student surgical interest groups and surgical Olympiads in anatomical and surgical undergraduate training in Russia.

    Science.gov (United States)

    Dydykin, Sergey; Kapitonova, Marina

    2015-01-01

    Traditional department-based surgical interest groups in Russian medical schools are useful tools for student-based selection of specialty training. They also form a nucleus for initiating research activities among undergraduate students. In Russia, the Departments of Topographical Anatomy and Operative Surgery play an important role in initiating student-led research and providing learners with advanced, practical surgical skills. In tandem with department-led activities, student surgical interest groups prepare learners through surgical competitions, known as "Surgical Olympiads," which have been conducted in many Russian centers on a regular basis since 1988. Surgical Olympiads stimulate student interest in the development of surgical skills before graduation and encourage students to choose surgery as their postgraduate specialty. Many of the participants in these surgical Olympiads have become highly qualified specialists in general surgery, orthopedic surgery, neurosurgery, urology, gynecology, and emergency medicine. The present article emphasizes the role of student interest groups and surgical Olympiads in clinical anatomical and surgical undergraduate training in Russia. © 2015 American Association of Anatomists.

  9. The dutch surgical colorectal audit

    NARCIS (Netherlands)

    Leersum, N.J. van; Snijders, H.S.; Henneman, D.; Kolfschoten, N.E.; Gooiker, G.A.; Berge, M.G. Ten; Eddes, E.H.; Wouters, M.W.; Tollenaar, R.A.E.M.; Bemelman, W.A.; Dam, R.M. van; Elferink, M.A.; Karsten, T.M.; Krieken, J.H. van; Lemmens, V.E.; Rutten, H.J.; Manusama, E.R.; Velde, C.J. van de; Meijerink, W.J.H.J.; Wiggers, T.; Harst, E. van der; Dekker, J.W.T.; Boerma, D.

    2013-01-01

    INTRODUCTION: In 2009, the nationwide Dutch Surgical Colorectal Audit (DSCA) was initiated by the Association of Surgeons of the Netherlands (ASN) to monitor, evaluate and improve colorectal cancer care. The DSCA is currently widely used as a blueprint for the initiation of other audits, coordinated

  10. The Dutch surgical colorectal audit

    NARCIS (Netherlands)

    van Leersum, N. J.; Snijders, H. S.; Henneman, D.; Kolfschoten, N. E.; Gooiker, G. A.; ten Berge, M. G.; Eddes, E. H.; Wouters, M. W. J. M.; Tollenaar, R. A. E. M.; Bemelman, W. A.; van Dam, R. M.; Elferink, M. A.; Karsten, Th M.; van Krieken, J. H. J. M.; Lemmens, V. E. P. P.; Rutten, H. J. T.; Manusama, E. R.; van de Velde, C. J. H.; Meijerink, W. J. H. J.; Wiggers, Th; van der Harst, E.; Dekker, J. W. T.; Boerma, D.

    2013-01-01

    In 2009, the nationwide Dutch Surgical Colorectal Audit (DSCA) was initiated by the Association of Surgeons of the Netherlands (ASN) to monitor, evaluate and improve colorectal cancer care. The DSCA is currently widely used as a blueprint for the initiation of other audits, coordinated by the Dutch

  11. Abortion - surgical - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000658.htm Abortion - surgical - aftercare To use the sharing features on ... please enable JavaScript. You have had a surgical abortion. This is a procedure that ends pregnancy by ...

  12. Urogynecologic Surgical Mesh Implants

    Science.gov (United States)

    ... procedures performed to treat pelvic floor disorders with surgical mesh: Transvaginal mesh to treat POP Transabdominal mesh to treat ... address safety risks Final Order for Reclassification of Surgical Mesh for Transvaginal Pelvic Organ Prolapse Repair Final Order for Effective ...

  13. Prevalence of prenatal zinc deficiency and its association with socio-demographic, dietary and health care related factors in Rural Sidama, Southern Ethiopia: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Gebremedhin Samson

    2011-11-01

    Full Text Available Abstract Background Several studies witnessed that prenatal zinc deficiency (ZD predisposes to diverse pregnancy complications. However, scientific evidences on the determinants of prenatal ZD are scanty and inconclusive. The purpose of the present study was to assess the prevalence and determinants of prenatal ZD in Sidama zone, Southern Ethiopia. Methods A community based, cross-sectional study was conducted in Sidama zone in January and February 2011. Randomly selected 700 pregnant women were included in the study. Data on potential determinants of ZD were gathered using a structured questionnaire. Serum zinc concentration was measured using Atomic Absorption Spectrometry. Statistical analysis was done using logistic regression and linear regression. Results The mean serum zinc concentration was 52.4 (+/-9.9 μg/dl (95% CI: 51.6-53.1 μg/dl. About 53.0% (95% CI: 49.3-56.7% of the subjects were zinc deficient. The majority of the explained variability of serum zinc was due to dietary factors like household food insecurity level, dietary diversity and consumption of animal source foods. The risk of ZD was 1.65 (95% CI: 1.02-2.67 times higher among women from maize staple diet category compared to Enset staple diet category. Compared to pregnant women aged 15-24 years, those aged 25-34 and 35-49 years had 1.57 (95% CI: 1.04-2.34 and 2.18 (95% CI: 1.25-3.63 times higher risk of ZD, respectively. Women devoid of self income had 1.74 (95% CI: 1.11-2.74 time increased risk than their counterparts. Maternal education was positively associated to zinc status. Grand multiparas were 1.74 (95% CI: 1.09-3.23 times more likely to be zinc deficient than nulliparas. Frequency of coffee intake was negatively association to serum zinc level. Positive association was noted between serum zinc and hemoglobin concentrations. Altitude, history of iron supplementation, maternal workload, physical access to health service, antenatal care and nutrition education were

  14. Prevalence of herbal medicine use and associated factors among pregnant women attending antenatal care at public health facilities in Hossana Town, Southern Ethiopia: facility based cross sectional study.

    Science.gov (United States)

    Laelago, Tariku; Yohannes, Tadele; Lemango, Fiseha

    2016-01-01

    The use of herbal medicine has been on increase in many developing and industrialized countries. More pregnant women use herbal remedies to treat pregnancy related problems due to cost-effectiveness of therapy and easy access of these products. We sought to assess the prevalence of herbal medicine use and associated factors among pregnant women attending antenatal clinics of public health facilities. Facility based cross sectional study was conducted among 363 pregnant women attending antenatal clinics from May to June 2015 at public health facilities in Hossana town, Hadiya zone, Southern Ethiopia. Pretested structured questionnaire was used to collect data from each study subject. Bivariate logistic regression analysis was used to see significance of association between the outcome and independent variables. Odds ratios at 95 % CI were computed to measure the strength of the association between the outcome and the independent variables. P-value herbal medicine during current pregnancy . The herbal medicines commonly taken during current pregnancy were ginger (55.8 %), garlic (69.8 %), eucalyptus (11.6 %), tenaadam (rutachalenssis) (26.4 %), damakesse (ocimumlamiifolium) (22.8 %), feto (3.5 %) and omore (3.1 %). Being students (AOR: (5.68, 95 % CI: (1.53, 21.13), second trimester of pregnancy (AOR: 0.22, 95 % CI: (0.08, 0.76), sufficient knowledge on herbal medicine (AOR: 0.37, 95 % CI: (0.19, 0.79), no formal education (AOR: 4.41, 95 % CI: (1.11, 17.56), primary education (AOR: 4.15, 95 % CI: (1.51, 11.45) and secondary education (AOR: 2.55, 95 % CI: (1.08,6.03) were significantly associated with herbal medicine use. The findings of this study showed that herbal medicine use during pregnancy is a common experience. Commonly used herbal medicines during current pregnancy were garlic, ginger, tenaadam, damakasse and eucalyptus. Educational status, occupation, knowledge on herbal medicine and second trimester of pregnancy were the major factors

  15. Soft sediment deformation associated with the East Patna Fault south of the Ganga River, northern India: Influence of the Himalayan tectonics on the southern Ganga plain

    Science.gov (United States)

    Verma, Aditya K.; Pati, Pitambar; Sharma, Vijay

    2017-08-01

    The geomorphic, tectonic and seismic aspects of the Ganga plain have been studied by several workers in the recent decades. However, the northern part of this tectonically active plain has been the prime focus in most of the studies. The region to the south of the Ganga River requires necessary attention, especially, regarding the seismic activities. The region lying immediately south of the Outer Himalayas (i.e. the Ganga plain) responds to the stress regime of the Himalayan Frontal Thrust Zone by movement along the existing basement faults (extending from the Indian Peninsula) and creating new surface faults within the sediment cover as well. As a result, several earthquakes have been recorded along these basement faults, such as the great earthquakes of 1934 and 1988 associated with the East Patna Fault. Large zones of ground failure and liquefaction in north Bihar (close to the Himalayan front), have been recorded associated with these earthquakes. The present study reports the soft sediment deformation structures from the south Bihar associated with the prehistoric earthquakes near the East Patna Fault for the first time. The seismites have been observed in the riverine sand bed of the Dardha River close to the East Patna Fault. Several types of liquefaction-induced deformation structures such as pillar and pocket structure, thixotropic wedge, liquefaction cusps and other water escape structures have been identified. The location of the observed seismites within the deformed zone of the East Patna Fault clearly indicates their formation due to activities along this fault. However, the distance of the liquefaction site from the recorded epicenters suggests its dissociation with the recorded earthquakes so far and hence possibly relates to any prehistoric seismic event. The occurrence of the earthquakes of a magnitude capable of forming liquefaction structure in the southern Ganga plain indicates the transfer of stress regime far from the Himalayan front into

  16. Surgical options after Fontan failure

    DEFF Research Database (Denmark)

    van Melle, Joost P; Wolff, Djoeke; Hörer, Jürgen

    2016-01-01

    by the European Congenital Heart Surgeons Association among 22 member centres. Outcome of surgery to address failing Fontan was collected in 225 patients among which were patients with Fontan takedown (n=38; 17%), Fontan conversion (n=137; 61%) or HTX (n=50; 22%). RESULTS: The most prevalent indication...... for failing Fontan surgery was arrhythmia (43.6%), but indications differed across the surgical groups (p...OBJECTIVE: The objective of this European multicenter study was to report surgical outcomes of Fontan takedown, Fontan conversion and heart transplantation (HTX) for failing Fontan patients in terms of all-cause mortality and (re-)HTX. METHODS: A retrospective international study was conducted...

  17. High lung cancer surgical procedure volume is associated with shorter length of stay and lower risks of re-admission and death

    DEFF Research Database (Denmark)

    Møller, Henrik; Riaz, Sharma P; Holmberg, Lars

    2016-01-01

    It is debated whether treating cancer patients in high-volume surgical centres can lead to improvement in outcomes, such as shorter length of hospital stay, decreased frequency and severity of post-operative complications, decreased re-admission, and decreased mortality. The dataset for this anal......It is debated whether treating cancer patients in high-volume surgical centres can lead to improvement in outcomes, such as shorter length of hospital stay, decreased frequency and severity of post-operative complications, decreased re-admission, and decreased mortality. The dataset...... to their geographical population. Higher volume hospitals had shorter length of stay and the odds of re-admission were 15% lower in the highest hospital volume quintile compared with the lowest quintile. Mortality risks were 1% after 30 d and 3% after 90 d. Patients from hospitals in the highest volume quintile had...

  18. Surgical site infection among patients undergone orthopaedic ...

    African Journals Online (AJOL)

    Surgical site infection among patients undergone orthopaedic surgery at Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania. ... of surgical site infection at Muhimbili Orthopedic Institute was high. This was associated with more than 2 hours length of surgery, lack of prophylaxis use, and pre-operative hospital stay.

  19. Sero-prevalence and associated risk factors of peste des petits ruminants and contagious caprine pleuro-pneumonia in goats and sheep in the Southern Zone of Tanzania.

    Science.gov (United States)

    Mbyuzi, Albano O; Komba, Erick V G; Kimera, Sharadhuli I; Kambarage, Dominic M

    2014-09-01

    A retrospective Sero-prevalence analysis was conducted in 2012 in order to find out whether contagious caprine pleuro-pneumonia (CCPP) and peste des petits ruminants (PPR) had already been introduced in Mtwara and Lindi regions of Southern Tanzania by 2007 and 2009. A total of 477 randomly selected sera from a bank of 3500 small ruminant samples that were collected as part of Rift Valley Fever surveillance of 2007 in Mtwara and Lindi regions were used in this study. Seroconversion was also evaluated in the 504 sera that were collected in 2009 as part of disease outbreak investigations in Tandahimba and Newala districts of Mtwara region. Seroconversions to CCPP and PPR were tested using competitive ELISA. In addition, information on different variables available in the existing surveillance forms gathered during sampling was used in the analysis of risk factors associated with seropositivity to the two diseases. The overall seroprevalence of CCPP for the sera of 2007 and 2009 in goats was 52.1% (n=447) and 35.5% (n=434) respectively; while in sheep the seroprevalence was 36.7% (n=30) and 22.9% (n=70) respectively. Seroconversion to PPR in goats and sheep was 28.7% (n=434) and 35.7% (n=70) respectively based on the sera of 2009. However, no antibodies were detected in the 2007 sera. Mixed infections were detected in 7.4% (n=434) of the goat and 12.9% (n=70) of sheep samples. Significant risk factors associated with seropositivity to CCPP in 2007 included introduction of new animals in flocks (OR=3.94; 95% CI 1.86-8.36; p<0.001) and raising animals in government farms (OR=4.92; 95% CI 1.57-15.76; p=0.02); whereas, seropositivity to CCPP in 2009 increased with introduction of new animals in flocks (OR=18.82; 95% CI 8.06-43.96; p<0.001), raising animals in government farms (OR=4.04; 95% CI 2.69-6.42; p<0.001) and raising animals in Newala district (OR=2.35; 95% CI 1.53-3.62; p<0.001). On the other hand, predictors for seropositivity to PPR in 2009 were introduction of

  20. The polymorphism and haplotypes of PIN1 gene are associated with the risk of lung cancer in Southern and Eastern Chinese populations.

    Science.gov (United States)

    Lu, Jiachun; Yang, Lei; Zhao, Hongjun; Liu, Bin; Li, Yinyan; Wu, Hongxia; Li, Qingchu; Zeng, Bohang; Wang, Yunnan; Ji, Weidong; Zhou, Yifeng

    2011-11-01

    Peptidyl-prolyl cis/trans isomerase (PPIase), PIN1, has been found to be a critical catalyst that involves in multiple oncogenic signaling pathways. Recently, several putative functional polymorphisms of the PIN1 gene have been identified to be associated with cancer risk. In this study, we tested the hypothesis that two common polymorphisms, c.-842G>C (rs2233678) and c.-667C>T (rs2233679), in the PIN1 promoter are associated with risk of lung cancer. In two independent case-control studies of 1,559 lung cancer cases and 1,679 controls conducted in Southern and Eastern Chinese population, we found that compared with the most common c.-842GG genotype, the carriers of c.-842C variant genotypes (GC + CC) had a decreased risk of lung cancer (odds ratio [OR] = 0.63, 95% confidence interval [CI] = 0.51-0.78, p = 1.13 × 10(-5) ). Although no association was observed between the c.-667C>T polymorphism and cancer risk, we found that the haplotype "C-C" had a greater protective effect (OR = 0.39, 95% CI = 0.23-0.67, p = 5.03 × 10(-4) ). The stratification analysis showed that the protective role of c.-842C variants was more pronounced in current smokers (p = 4.45 × 10(-5) ), especially in male smokers (p = 6.71 × 10(-6) ) and in those who smoked more than 20 pack-years (p = 2.30 × 10(-5) ) and the c.-842C variant genotypes interacted with smoking status (P(interaction) = 0.019) or pack-years smoked (P(interaction) = 0.008) on reducing cancer risk. Further functional assay revealed that the c.-842C variant allele had a lower transcription activity in luciferase assay and a lower DNA-binding ability with nuclear proteins, and low transcription activity in western blot assay. In conclusions, our data suggest that functional c.-842C variants and haplotype "C-C" in the PIN1 promoter contribute to decreased risk of lung cancer by diminishing the promoter activity, which may be susceptibility biomarkers for lung cancer. © 2011 Wiley Periodicals, Inc.

  1. The role of the sedimentary regime in shaping the distribution of subtidal sandbank environments and the associated meiofaunal nematode communities: an example from the southern North Sea.

    Directory of Open Access Journals (Sweden)

    Michaela Schratzberger

    Full Text Available We combined sediment and faunal data to explore the role of the sedimentary regime in shaping the distribution of subtidal sandbank environments and the associated meiofaunal nematode communities at Broken Bank and Swarte Bank, in the southern North Sea. A variety of sediment transport processes occur in the area, differing in the frequency and magnitude of sediment mobility, and the continuum between erosion, translation and sediment accumulation. The seabed contained a variety of bedforms, including longitudinal furrows, and small to very large sandwaves. The bed sediments were dominated by fine and medium sands, with admixtures of silt and gravel. Based on sedimentary bedforms and grain size analysis, a total of 11 sedimentary facies were delineated, of which 8 were analysed in detail for their relationships with the meiofauna. The sedimentary facies fell clearly into groups of facies, respectively representing high, high-moderate and moderate, and episodic sediment mobility. For those sedimentary facies where daily movement of sediments and bedforms occurred ('high' sediment mobility, the resulting spatially homogeneous environments were dominated by an impoverished nematode community comprising small deposit feeders and large predators. Resistance to sediment movement and the ability to exploit alternative food sources were prominent functional features of the successful colonisers. Those facies characterised by relatively infrequent sediment mobility ('episodic' and 'high-moderate and moderate' sediment mobility comprised a heterogeneous suite of benthic habitats, containing taxonomically and functionally diverse assemblages of nematodes of various sizes, feeding types and reproductive potential. Faunal distribution patterns here indicated trade-offs between the resistance to sediment movement, environmental tolerance and competitive abilities. Our focus on diverse assemblages of organisms with high turnover times, inhabiting highly

  2. An assessment of human-elephant conflict and associated ecological and demographic factors in Nilambur, Western Ghats of Kerala, southern India

    Directory of Open Access Journals (Sweden)

    C. K. Rohini

    2016-07-01

    Full Text Available Elephant conservation carries cost in the form of human-elephant conflict and affects the wellbeing of people living near ecologically important areas.  Conflicts impart serious challenges towards the survival of Asian Elephants, which are categorized as Endangered in the IUCN Red List of Threatened Species.  Issues of wildlife conservation are least addressed in areas with less restricted categories of protection.  Hence an attempt was made to evaluate the intensity of elephant conflict and factors associated with its occurrence in villages with forest fringes of North and South Forest Divisions of Nilambur, Kerala, southern India.  It was hypothesized that variables such as number of houses, area of village, livestock population, forest frontage, and presence of water source along the forest boundary abutting the village to be the underlying correlates of conflict.  Field studies were conducted fortnightly from June 2014 to May 2015, by visiting farms and households of 17 selected forest fringe villages.  Observational methods, questionnaire surveys and secondary data collection were employed for this purpose.  A total of 277 incidents of crop depredation, 12 incidents of property damage, three human injuries, and one human death due to conflict were recorded during this period.  Crop raiding was highest during post monsoon season and it was low during pre-monsoon and monsoon seasons.  Multiple linear regression results suggest that forest frontage and livestock population were significant predictors of conflict incidence.  Information regarding the prime causes of conflict will be helpful for planning strategies for the establishment of appropriate mitigation methods.  The present study serves as baseline information which will be helpful for formulating prospective management plans.

  3. Occurrence of Phytophthora plurivora and other Phytophthora species in oak forests of southern Poland and their association with site conditions and the health status of trees.

    Science.gov (United States)

    Jankowiak, R; Stępniewska, H; Bilański, P; Kolařík, M

    2014-11-01

    Phytophthora plurivora and other Phytophthora species are known to be serious pathogens of forest trees. Little is known, however, about the presence of P. plurivora in Polish oak forests and their role in oak decline. The aims of this study were to identify P. plurivora in healthy and declining Quercus robur stands in southern Poland and to demonstrate the relationship between different site factors and the occurrence of P. plurivora. In addition, the virulence of P. plurivora and other Phytophthora species was evaluated through inoculations using 2-year-old oak seedlings. Rhizosphere soil was investigated from 39 oak stands representing different healthy tree statuses. The morphology and DNA sequences of the internal transcribed spacer regions (ITS) of the ribosomal DNA and the mitochondrial cox1 gene were used for identifications. P. plurivora, an oak fine root pathogen, was isolated from rhizosphere soil samples in 6 out of 39 stands. Additionally, Phytophthora cambivora, Phytophthora polonica and Phytophthora rosacearum-like were also obtained from several stands. The results showed a significant association between the presence of P. plurivora and the health status of oak trees. Similar relationships were also observed for all identified Phytophthora species. In addition, there was evidence for a connection between the presence of all identified Phytophthora species and some site conditions. Phytophthora spp. occurred more frequently in declining stands and in silt loam and sandy loam soils with pH ≥ 3.66. P. plurivora and P. cambivora were the only species capable of killing whole plants, producing extensive necrosis on seedling stems.

  4. MicroRNAs responding to southern rice black-streaked dwarf virus infection and their target genes associated with symptom development in rice.

    Science.gov (United States)

    Xu, Donglin; Mou, Guiping; Wang, Kang; Zhou, Guohui

    2014-09-22

    Southern rice black-streaked dwarf virus (SRBSDV) is a recently emerged rice virus that has spread across Asia. This devastating virus causes rice plants to produce a variety of symptoms during different growth stages. MicroRNAs (miRNAs) comprise a large group of 21-24-nt RNA molecules that are important regulators of plant development processes and stress responses. In this study, we used microarray profiling to investigate rice miRNAs responding to SRBSDV infection at 3, 9, 15, and 20 days post-inoculation (dpi). Expression levels of 56 miRNAs were altered in SRBSDV-infected rice plants, with these changes classified into eight different regulation patterns according to their temporal expression dynamics. Fourteen miRNAs belonging to six families (miR164, R396, R530, R1846, R1858, and R2097) were significantly regulated at 20 dpi. We used RT-qPCR to search for expression level correlations between members of these families and their putative targets at 3, 9, and 15 dpi. Some members of the miR164, R396, R530, and R1846 families were found to be positively or negatively correlated with their respective targets during 3-15 days after SRBSDV infection, whereas in more cases the rice miRNAs were not in correlation with their targets along the post-inoculation period, suggesting that some additional factors may be involved in rice miRNA-target interactions. The reported functions of rice genes targeted by the miR164, R396, R530, R1846, and R1858 families indicated that these genes are associated with symptom development. These results provide insights into miRNA-mediated SRBSDV-rice interactions. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Blood concentrations of PCBs and DDTs in an avian predator endemic to southern Africa: Associations with habitat, electrical transformers and diet.

    Science.gov (United States)

    Garcia-Heras, Marie-Sophie; Arroyo, Beatriz; Simmons, Robert E; Camarero, Pablo R; Mateo, Rafael; Mougeot, Francois

    2018-01-01

    Persistent pollutants such as organochlorine compounds (OCs) have been highlighted as a cause of population decline in avian predators. Understanding patterns of OCs contamination can be crucial for the conservation of affected species, yet little is known on these threats to African raptors. Here we report on OC concentrations in an endangered predator endemic to southern Africa, the Black Harrier Circus maurus. Blood samples were collected in 2012-2014 from wild nestlings (n = 90) and adults (n = 23) in south-western South Africa, where agriculture and urbanization have developed rapidly since the 1950s. Polychlorinated biphenyl (ΣPCB) and dichlorodiphenyltrichloroethane (ΣDDT, for p,p'-DDT + p,p'-DDE) were detected in 79% and 84% of sampled individuals, respectively, with varying concentrations among demographic groups: nestlings had significantly higher ΣPCB and p,p'-DDT concentrations than adults, while adults had higher levels of p,p'-DDE than nestlings. Levels of ΣPCB significantly increased with an index of electric transformer density, a measure of the number and power of electric transformers around active nests. We propose this index as a useful tool for assessing ΣPCB exposure risk in other wildlife. Levels of p,p'-DDE significantly increased with the proportion of wetlands within the breeding territory, and also with the proportion of bird biomass in the diet. No association was found between OC levels and the protected area status of nesting sites. Physiological effects of contaminants were also manifest in increased white blood cell counts with higher p,p'-DDT levels. Heterophil to lymphocyte ratio increased with higher ΣPCB levels, suggesting increased physiological stress and reduced immunity in contaminated individuals. Our results suggest that OCs are still a current cause of concern for endangered Black Harriers, as well as other sympatric predators. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. The Role of the Sedimentary Regime in Shaping the Distribution of Subtidal Sandbank Environments and the Associated Meiofaunal Nematode Communities: An Example from the Southern North Sea

    Science.gov (United States)

    Schratzberger, Michaela; Larcombe, Piers

    2014-01-01

    We combined sediment and faunal data to explore the role of the sedimentary regime in shaping the distribution of subtidal sandbank environments and the associated meiofaunal nematode communities at Broken Bank and Swarte Bank, in the southern North Sea. A variety of sediment transport processes occur in the area, differing in the frequency and magnitude of sediment mobility, and the continuum between erosion, translation and sediment accumulation. The seabed contained a variety of bedforms, including longitudinal furrows, and small to very large sandwaves. The bed sediments were dominated by fine and medium sands, with admixtures of silt and gravel. Based on sedimentary bedforms and grain size analysis, a total of 11 sedimentary facies were delineated, of which 8 were analysed in detail for their relationships with the meiofauna. The sedimentary facies fell clearly into groups of facies, respectively representing high, high-moderate and moderate, and episodic sediment mobility. For those sedimentary facies where daily movement of sediments and bedforms occurred (‘high’ sediment mobility), the resulting spatially homogeneous environments were dominated by an impoverished nematode community comprising small deposit feeders and large predators. Resistance to sediment movement and the ability to exploit alternative food sources were prominent functional features of the successful colonisers. Those facies characterised by relatively infrequent sediment mobility (‘episodic’ and ‘high-moderate and moderate’ sediment mobility) comprised a heterogeneous suite of benthic habitats, containing taxonomically and functionally diverse assemblages of nematodes of various sizes, feeding types and reproductive potential. Faunal distribution patterns here indicated trade-offs between the resistance to sediment movement, environmental tolerance and competitive abilities. Our focus on diverse assemblages of organisms with high turnover times, inhabiting highly dynamic

  7. [Surgical treatment of gynecomastia].

    Science.gov (United States)

    Târcoveanu, E; Lupaşcu, C; Vasilescu, A; Moldovanu, R; Ichim, Mihaela; Georgescu, St; Niculescu, D; Dănilă, N; Dimofte, G; Anton, Raluca; Crumpei, Felicia; Florea, Niculina; Ungureanu, Cristina

    2008-01-01

    -adenoma--1 case, papillary ductal carcinoma--1 case and mucinous carcinoma--1 case. From all these data, the etiological diagnosis in presented series was: pseudo-gynecomastia--5.3% (N = 6), idiopathic--64.9% (N = 73), endocrine--7.9% (N = 9), drug induce--5.3% (N = 6), metabolic--7.9% (N = 9), tumoral--8.8% (N = 10). The postoperative hospital stay was 4.04 +/- 0.26 days (range 1-12). A literature review has also been performed. The management of gynecomastia has to be performed by a multidisciplinary team. Gynecomastia it is possible to be associated with a breast cancer, even in younger people. The surgical treatment, especially the type of incision, will be chosen from point of view of Simon stages. Liposuction can be associated in selected cases.

  8. Surgical strategies in childhood craniopharyngioma

    Directory of Open Access Journals (Sweden)

    Jörg eFlitsch

    2011-12-01

    Full Text Available Craniopharyngiomas are biologically benign lesions (WHO Grade 1 of the sellar and suprasellar region, associated with a serious morbidity. About 50% of these tumors become clinically apparent during childhood. Clinical symptoms include headaches, chiasm syndrome, hydrocephalus, pituitary insufficiencies, and obesity. Growth arrest is a typical symptom in children. The treatment of craniopharyngiomas includes surgery as well as radiotherapy. The goal of surgery varies according to the tumor location and extension and may range from complete resection to biopsy. Surgical complications are well known and cause constant evaluation of surgical strategies. Diencephalic obesity is related to surgical manipulation of hypothalamic tissue. Therefore, a classification system for craniopharyngiomas based on preoperative MRI is suggested by the authors, which may help assess the surgical risk. Recurrences are frequent in craniopharyngiomas, even after complete or gross-total resection. Radiotherapy is therefore recommended to patients with incomplete resections. However, the ideal time for radiotherapy after surgery is under discussion.The treatment of craniopharyngiomas requires an interdisciplinary and multimodal approach. Each patient should receive an individually tailored treatment. Surgically, different approaches as well as different degrees of resection can be considered, depending on tumor location and tumor extension.

  9. Three-dimensional surgical simulation.

    Science.gov (United States)

    Cevidanes, Lucia H C; Tucker, Scott; Styner, Martin; Kim, Hyungmin; Chapuis, Jonas; Reyes, Mauricio; Proffit, William; Turvey, Timothy; Jaskolka, Michael

    2010-09-01

    In this article, we discuss the development of methods for computer-aided jaw surgery, which allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3-dimensional surface models from cone-beam computed tomography, dynamic cephalometry, semiautomatic mirroring, interactive cutting of bone, and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intraoperative guidance. The system provides further intraoperative assistance with a computer display showing jaw positions and 3-dimensional positioning guides updated in real time during the surgical procedure. The computer-aided surgery system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training, and assessing the difficulties of the surgical procedures before the surgery. Computer-aided surgery can make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  10. Southern Alberta system reinforcement

    Energy Technology Data Exchange (ETDEWEB)

    Rehman, A. [Alberta Electric System Operator, Calgary, AB (Canada)

    2008-07-01

    System planning for the Alberta Electric System Operator's (AESO) southern system was discussed in view of the growing interest in developing wind energy resources in the province. While Alberta currently has a total of 11,500 MW of installed wind power, southern Alberta has a very small capability for interconnecting additional wind resources. There are 3 main agencies involved in system planning for the southern region: (1) the Alberta Utilities Commission (AUC), (2) the AESO, and (3) the transmission facility owners. Transmission needs are studied by the AESO, who then applies to the AUC for approval. Transmission facility owners also apply to the AUC for approval to construct facilities. The AESO's roles are to operate the wholesale electricity market; plan the transmission system; arrange access for loads and generation; and oversee transmission system operation. The AESO is an independent agency with a public interest mandate. The AESO's queue management process has been designed to facilitate non-discriminatory system access. Development options currently being considered by the AESO include a 240 kV AC transmission line; a 500 kV AC transmission line; a 765 kV AC transmission line; a high voltage direct current (HVDC) system; and a voltage source converter (VSC) HVDC system. Radial and looped configurations are also being considered. The AESO is currently conducting a participant involvement program that involves open houses with the Canadian Wind Energy Association (CanWEA) and other provincial stakeholders. tabs., figs.

  11. Dissolved greenhouse gases (nitrous oxide and methane) associated with the natural iron-fertilized Kerguelen region (KEOPS 2 cruise) in the Southern Ocean

    Science.gov (United States)

    Farías, L.; Florez-Leiva, L.; Besoain, V.; Fernández, C.

    2014-08-01

    The concentrations of greenhouse gases (GHGs) like nitrous oxide (N2O) and methane (CH4) were measured in the Kerguelen Plateau Region (KPR), an area with annual microalgal bloom caused by natural Fe fertilization, which may stimulate microbes involved in GHG cycling. This study was carried out during the KEOPS 2 cruise during the austral spring of 2011. Two transects were sampled along and across the KRP, the north-south (N-S) transect (46-51° S, 72° E meridian) and the west-east (W-E) transect (66-75° E, 48.3° S latitude), both associated with the presence of a plateau, polar fronts and other mesoscale features. The W-E transect had N2O levels ranging from equilibrium (105%) to light supersaturation (120%) with respect to the atmosphere. CH4 levels fluctuated dramatically, with intense supersaturations (120-970%) in areas close to the coastal waters of Kerguelen Island and in the polar front (PF). There, Fe and nutrient fertilization seem to promote high total chlorophyll a (TChl a) levels. The distribution of both gases was more homogenous in the N-S transect, but CH4 peaked at southeastern stations of the KPR (A3 stations), where phytoplankton bloom was observed. Both gases responded significantly to the patchy distribution of particulate matter as Chl a, stimulated by Fe supply by complex mesoscale circulation. While CH4 appears to be produced mainly at the pycnoclines, N2O seems to be consumed superficially. Air-sea fluxes for N2O (from -10.5 to 8.65, mean 1.71 μmol m-2d-1), and for CH4 (from 0.32 to 38.1, mean 10.07 μmol m-2d-1) reflected sink and source behavior for N2O and source behavior for CH4, with considerable variability associated with a highly fluctuating wind regime and, in the case of CH4, due to its high superficial levels that had not been reported before in the Southern Ocean and may be caused by an intense microbial CH4 cycling.

  12. Prevalence and factors associated with trachoma among children aged 1–9 years in Zala district , Gamo Gofa zone, Southern Ethiopia

    Directory of Open Access Journals (Sweden)

    Mengistu K

    2016-08-01

    Full Text Available Kassahun Mengistu1 Mulugeta Shegaze2 Kifle Woldemichael3 Hailay Gesesew3,4 Yohannes Markos5 1Department of Zonal Health Office, Gamo Goffa Zone, Arba Minch, Ethiopia; 2Department of Nursing, Arba Minch University, Arba Minch, Ethiopia; 3Department of Epidemiology, Jimma University, Jimma, Ethiopia; 4Discipline of Public Health, Flinders University, Adelaide, Australia; 5Department of Medical Physiology, Jimma University, Jimma, Ethiopia Background: Trachoma is the leading cause of preventable blindness worldwide. It is common in areas where people are socioeconomically deprived. Globally, approximately 1.2 billion people live in trachoma-endemic areas, in which, 40.6 million individuals have active trachoma and 8.2 million have trichiasis. According to the World Health Organization’s 2007 report, globally close to 1.3 million people are blind due to trachoma, while approximately 84 million suffer from active trachoma. The National Survey (2007 of Ethiopia showed a prevalence of 40.1% active trachoma among children aged 1–9 years. Trachoma is still endemic in most parts of Ethiopia.Objective: To assess prevalence of trachoma and factors associated with it among children aged 1–9 years in Zala district, Gamo Gofa Zone, Southern Nations, Nationalities, and Peoples’ Region.Methods: A community-based cross-sectional study was conducted in Zala district from February 28 to March 26, 2014. A total of 611 children were examined for trachoma based on the simplified World Health Organization 1983 classification. A multistage stratified sampling technique with a systematic random sampling technique was used to select study participants. Data were collected by using a semistructured pretested questionnaire and clinical eye examination. The data were entered using EpiData version 3.1 and analyzed using SPSS version 16. Multivariable logistic regression analysis was used to identify independently associated factors.Results: The overall prevalence of

  13. Thunderstorms caused by southern cyclones in Estonia

    Directory of Open Access Journals (Sweden)

    Kaupo Mändla

    2014-05-01

    Full Text Available The relationships between the frequency and duration of thunderstorms, lightning and southern cyclones over Estonia are presented for the period 1950–2010. A total of 545 southern cyclones and 2106 thunderstorm days were detected, whereas 11.3% of the observed thunder days were associated with southern cyclones. At the same time, 29.2% of all southern cyclones were accompanied by thunderstorms. In the thunder season, however, this percentage was much higher, reaching up to 80% in summer months. The number of thunder days was largest when the centres of southern cyclones passed a measuring station at a distance less than 500 km. The number of cloud-to-ground lightning strikes related to southern cyclones was larger than that of any other thunder events. The results of our study demonstrate that the intensity of thunderstorms related to southern cyclones is higher than that of other thunderstorms. Correlation analysis revealed statistically significant relationships between the frequency of thunder days related to southern cyclones and the frequency of southern cyclones, also between the frequency of thunder days related to southern cyclones and days of other thunder events.

  14. Do psychological variables affect early surgical recovery?

    Directory of Open Access Journals (Sweden)

    Michael N Mavros

    Full Text Available BACKGROUND: Numerous studies have examined the effect of psychological variables on surgical recovery, but no definite conclusion has been reached yet. We sought to examine whether psychological factors influence early surgical recovery. METHODS: We performed a systematic search in PubMed, Scopus and PsycINFO databases to identify studies examining the association of preoperative psychological variables or interventions with objectively measured, early surgical outcomes. RESULTS: We identified 16 eligible studies, 15 of which reported a significant association between at least one psychological variable or intervention and an early postoperative outcome. However, most studies also reported psychological factors not influencing surgical recovery and there was significant heterogeneity across the studies. Overall, trait and state anxiety, state anger, active coping, subclinical depression, and intramarital hostility appeared to complicate recovery, while dispositional optimism, religiousness, anger control, low pain expectations, and external locus of control seemed to promote healing. Psychological interventions (guided relaxation, couple support visit, and psychiatric interview also appeared to favor recovery. Psychological factors unrelated to surgical outcomes included loneliness, perceived social support, anger expression, and trait anger. CONCLUSION: Although the heterogeneity of the available evidence precludes any safe conclusions, psychological variables appear to be associated with early surgical recovery; this association could bear important implications for clinical practice. Large clinical trials and further analyses are needed to precisely evaluate the contribution of psychology in surgical recovery.

  15. The association between malaria and malnutrition among under-five children in Shashogo District, Southern Ethiopia: a case-control study.

    Science.gov (United States)

    Gone, Terefe; Lemango, Fiseha; Eliso, Endale; Yohannes, Samuel; Yohannes, Tadele

    2017-01-13

    Recent studies have presented conflicting findings about whether malaria is associated with an increased or decreased risk of malnutrition. Therefore, assessing the relationship between these two disastrous diseases in the most vulnerable groups, such as in children aged below 5 years (under-five children), may lead to the discovery of new low-cost and effective aides to current methods of malnutrition prevention in malaria-endemic areas. Therefore, this study was conducted to assess the relationship between m