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Sample records for subjects completed treatment

  1. Completion of treatment planning

    International Nuclear Information System (INIS)

    Lief, Eugene

    2008-01-01

    The outline of the lecture included the following topics: entering prescription; plan printout; print and transfer DDR; segment BEV; export to R and V; physician approval; and second check. Considerable attention, analysis and discussion. The summary is as follows: Treatment planning completion is a very responsible process which requires maximum attention; Should be independently checked by the planner, physicist, radiation oncologist and a therapist; Should not be done in a last minute rush; Proper communication between team members; Properly set procedure should prevent propagation of an error by one individual to the treatment: the error should be caught by somebody else. (P.A.)

  2. Predictors of Sex Offender Treatment Completion.

    Science.gov (United States)

    Moore, Donna L.; Bergman, Barbara A.; Knox, Pamela L.

    1999-01-01

    Reviews records of 126 incarcerated offenders who participated in a prison-based sex offender treatment program. Discriminate function analysis reveals that offenders who completed treatment were more often diagnosed with a substance disorder, had a history of nonviolence offenses, and were less often diagnosed as having an antisocial personality…

  3. Endodontic treatment completion following emergency pulpectomy.

    LENUS (Irish Health Repository)

    Lynch, C D

    2010-06-01

    Emergency pulpectomy is frequently performed to relieve pain experienced by patients following acute episodes of endodontic pain, or to limit the risks of infection or possible root resorption following traumatic pulpal exposures. The aim of this study was to examine subsequent patient attendance for completion of root canal treatment following pulpectomy procedures in a dental emergency unit.

  4. A Complete Theory of Everything (Will Be Subjective

    Directory of Open Access Journals (Sweden)

    Marcus Hutter

    2010-09-01

    Full Text Available Increasingly encompassing models have been suggested for our world. Theories range from generally accepted to increasingly speculative to apparently bogus. The progression of theories from ego- to geo- to helio-centric models to universe and multiverse theories and beyond was accompanied by a dramatic increase in the sizes of the postulated worlds, with humans being expelled from their center to ever more remote and random locations. Rather than leading to a true theory of everything, this trend faces a turning point after which the predictive power of such theories decreases (actually to zero. Incorporating the location and other capacities of the observer into such theories avoids this problem and allows to distinguish meaningful from predictively meaningless theories. This also leads to a truly complete theory of everything consisting of a (conventional objective theory of everything plus a (novel subjective observer process. The observer localization is neither based on the controversial anthropic principle, nor has it anything to do with the quantum-mechanical observation process. The suggested principle is extended to more practical (partial, approximate, probabilistic, parametric world models (rather than theories of everything. Finally, I provide a justification of Ockham’s razor, and criticize the anthropic principle, the doomsday argument, the no free lunch theorem, and the falsifiability dogma.

  5. Human Amygdala Represents the Complete Spectrum of Subjective Valence

    Science.gov (United States)

    Jin, Jingwen; Zelano, Christina; Gottfried, Jay A.

    2015-01-01

    Although the amygdala is a major locus for hedonic processing, how it encodes valence information is poorly understood. Given the hedonic potency of odor stimuli and the amygdala's anatomical proximity to the peripheral olfactory system, we combined high-resolution fMRI with pattern-based multivariate techniques to examine how valence information is encoded in the amygdala. Ten human subjects underwent fMRI scanning while smelling 9 odorants that systematically varied in perceived valence. Representational similarity analyses showed that amygdala codes the entire dimension of valence, ranging from pleasantness to unpleasantness. This unidimensional representation significantly correlated with self-reported valence ratings but not with intensity ratings. Furthermore, within-trial valence representations evolved over time, prioritizing earlier differentiation of unpleasant stimuli. Together, these findings underscore the idea that both spatial and temporal features uniquely encode pleasant and unpleasant odor valence in the amygdala. The availability of a unidimensional valence code in the amygdala, distributed in both space and time, would create greater flexibility in determining the pleasantness or unpleasantness of stimuli, providing a mechanism by which expectation, context, attention, and learning could influence affective boundaries for guiding behavior. SIGNIFICANCE STATEMENT Our findings elucidate the mechanisms of affective processing in the amygdala by demonstrating that this brain region represents the entire valence dimension from pleasant to unpleasant. An important implication of this unidimensional valence code is that pleasant and unpleasant valence cannot coexist in the amygdale because overlap of fMRI ensemble patterns for these two valence extremes obscures their unique content. This functional architecture, whereby subjective valence maps onto a pattern continuum between pleasant and unpleasant poles, offers a robust mechanism by which context

  6. Tuberculosis incidence and treatment completion among Ugandan prison inmates

    Science.gov (United States)

    Schwitters, A.; Kaggwa, M.; Omiel, P.; Nagadya, G.; Kisa, N.; Dalal, S.

    2016-01-01

    SUMMARY BACKGROUND The Uganda Prisons Service (UPS) is responsible for the health of approximately 32 500 inmates in 233 prisons. In 2008 a rapid UPS assessment estimated TB prevalence at 654/100 000, three times that of the general population (183/100 000). Although treatment programs exist, little is known about treatment completion in sub-Saharan African prisons. METHODS We conducted a retrospective study of Ugandan prisoners diagnosed with TB from June 2011 to November 2012. We analyzed TB diagnosis, TB-HIV comorbidity and treatment completion from national registers and tracked prison transfers and releases. RESULTS A total of 469 prisoners were diagnosed with TB over the 1.5-year period (incidence 955/100 000 person-years). Of 466 prisoners starting treatment, 48% completed treatment, 43% defaulted, 5% died and 4% were currently on treatment. During treatment, 12% of prisoners remaining in the same prison defaulted, 53% of transfers defaulted and 81% of those released were lost to follow-up. The odds of defaulting were 8.36 times greater among prisoners who were transferred during treatment. CONCLUSIONS TB incidence and treatment default are high among Ugandan prisoners. Strategies to improve treatment completion and prevent multidrug resistance could include avoiding transfer of TB patients, improving communications between prisons to ensure treatment follow-up after transfer and facilitating transfer to community clinics for released prisoners. PMID:24902552

  7. Predicting Drug Court Treatment Completion Using the MMPI-2-RF

    Science.gov (United States)

    Mattson, Curtis; Powers, Bradley; Halfaker, Dale; Akeson, Steven; Ben-Porath, Yossef

    2012-01-01

    We examined the ability of the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008) substantive scales to predict Drug Court treatment completion in a sample of individuals identified as being at risk for failure to complete the program. Higher scores on MMPI-2-RF scales…

  8. Barriers to Successful Treatment Completion in Child Sexual Abuse Survivors

    Science.gov (United States)

    McPherson, Paul; Scribano, Philip; Stevens, Jack

    2012-01-01

    Child sexual abuse (CSA) often requires psychological treatment to address the symptoms of victim trauma. Barriers to entry and completion of counseling services can compromise long-term well-being. An integrated medical and mental health evaluation and treatment model of a child advocacy center (CAC) has the potential to reduce barriers to mental…

  9. Factors that might be predictive of completion of vaginismus treatment.

    Science.gov (United States)

    Özdel, Kadir; Yılmaz Özpolat, Ayşegül; Çeri, Özge; Kumbasar, Hakan

    2012-01-01

    Vaginismus is defined as a recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with sexual intercourse. The aim of this study was to assess the level of symptoms of depression, anxiety, obsessive-compulsive symptoms, and perfectionism among patients with vaginismus, as well as to determine if these clinical variables are related to the completion of treatment. The study included 20 women with vaginismus and their spouses that were referred as outpatients to Ankara University, School of Medicine, Department of Psychiatry, Consultation and Liaison Unit. All couples underwent cognitive behavioral therapy, which was administered as 40-60-min weekly sessions. At the first (assessment) session, the female patients were assessed using a sociodemographic evaluation form, the Hamilton Rating Scale for Depression (HAM-D), the Hamilton Rating Scale for Anxiety (HAM-A), the Maudsley Obsessive-Compulsive Inventory (MOCI), the Multidimensional Perfectionism Scale (MPS), and the Golombok Rust Inventory of Sexual Satisfaction (GRISS). The male spouses were evaluated using the GRISS. The same scales were administered after the completion of treatment to those that completed the treatment. The correlation between completion of treatment, and an elevated level of anxiety and self-oriented perfectionism was significant (P Vaginismus is not only a sexual dysfunction, but it is related to multiple components of mental health. Anxiety and a perfectionist personality trait were important factors associated with the completion of treatment; therefore, these factors should be evaluated before treatment.

  10. Functional Impressions in Complete Denture and Overdenture Treatment

    OpenAIRE

    Hrvoje Kršek; Nikša Dulčić

    2015-01-01

    Tooth loss can cause loss of occlusal, masticatory, esthetic, physiognomic, phonetic and psychosocial function of patients. The most frequently used treatment method of completely edentulous patients and patients with a small number of remaining teeth are complete dentures or overdentures. One of the most important clinical and laboratory procedures in their fabrication is functional impression taking. The aim of this paper was to present procedures of taking functional impressions in fab...

  11. Functional Impressions in Complete Denture and Overdenture Treatment

    Directory of Open Access Journals (Sweden)

    Hrvoje Kršek

    2015-01-01

    Full Text Available Tooth loss can cause loss of occlusal, masticatory, esthetic, physiognomic, phonetic and psychosocial function of patients. The most frequently used treatment method of completely edentulous patients and patients with a small number of remaining teeth are complete dentures or overdentures. One of the most important clinical and laboratory procedures in their fabrication is functional impression taking. The aim of this paper was to present procedures of taking functional impressions in fabrication of complete dentures and overdentures, using standardized techniques and materials. An accurate functional impression together with other correctly performed clinical and laboratory procedures ensure good retention and stability of dentures, which is a precondition for restoring patients’ lost functions.

  12. SSRI treatment suppresses dream recall frequency but increases subjective dream intensity in normal subjects.

    Science.gov (United States)

    Pace-Schott, E F; Gersh, T; Silvestri, R; Stickgold, R; Salzman, C; Hobson, J A

    2001-06-01

    Clinical lore and a small number of published studies report that the selective serotonin reuptake inhibitors (SSRIs) intensify dreaming. This study examines the dream effects of paroxetine and fluvoxamine in order to both increase clinical knowledge of these agents and to test an important potential method for probing the relationship between REM sleep neurobiology and dreaming in humans. Fourteen normal, paid volunteers (4 males, 10 females; mean age 27.4 year, range 22--39) free of medical or neuropsychiatric symptoms as well as of psychotropic or sleep affecting drugs completed a 31-day home-based study consisting of: 7 days drug-free baseline; 19 days on either 100 mg fluvoxamine (7 Ss) or 20 mg paroxetine (7 Ss) in divided morning and evening doses; and 5 days acute discontinuation. Upon awakening, subjects wrote dream reports, self-scored specific emotions in their reports and rated seven general dream characteristics using 5-point Likert scales. Dream reports were independently scored for bizarreness, movement and number of visual nouns by three judges. REM sleep-related measures were obtained using the Nightcap ambulatory sleep monitor. Mean dream recall frequency decreased during treatment compared with baseline. Dream report length and judge-rated bizarreness were greater during acute discontinuation compared with both baseline and treatment and this effect was a result of the fluvoxamine-treated subjects. The subjective intensity of dreaming increased during both treatment and acute discontinuation compared with baseline. Propensity to enter REM sleep was decreased during treatment compared with baseline and acute discontinuation and the intensity of REM sleep increased during acute discontinuation compared with baseline and treatment. The decrease in dream frequency during SSRI treatment may reflect serotonergic REM suppression while the augmented report length and bizarreness during acute SSRI discontinuation may reflect cholinergic rebound from

  13. The effectiveness of hypnotherapy in the treatment of subjective tinnitus

    Directory of Open Access Journals (Sweden)

    Shirin Moghtaderi

    2012-12-01

    Full Text Available Background and Aim: Tinnitus is an annoying disease cause major problems including insomnia, impaired concentration, and reduced quality of life. This study aimed to investigate the effectiveness of hypnotherapy in the treatment of subjective tinnitus.Methods: This was a pilot experimental study with pre- and post-test method. 20 people suffered from subjective tinnitus were divided equally in two groups of experimental and control. The two groups were matched according to age and severity of tinnitus. They completed tinnitus clinical questionnaires before and after the test and the severity of their tinnitus was recorded by a number from one to ten. Experimental group went under hypnotherapy for 10 sessions. The control group did not perform any psychological treatment. The gathered data were statistically analyzed using Student's t-test (independent and dependent.Results: There were significant differences between the pre-test and post-test scores of each group and also, between the post-test scores of experimental and control groups (p = 0.001 for all.Conclusion: The results showed that hypnotherapy could effectively reduce the seventy of tinnitus in patients in the experimental group; in other words, the results confirm the effectiveness of medical hypnosis in the treatment of subjective tinnitus.

  14. Orthodontic treatment of a complete transposed impacted maxillary canine

    Directory of Open Access Journals (Sweden)

    Pi-Huei Liu

    2015-03-01

    Full Text Available Tooth transposition is a positional interchange of two adjacent teeth. Transposition most often occurs at maxillary canine. Moving transposed teeth to their normal positions is challenging because this requires bodily movement and translation of one tooth to pass another. This procedure may cause damage to the teeth or supporting structures. We report a case of complete transposition of maxillary canine and lateral incisor. Transposed teeth were successfully moved orthodontically to their normal positions. Multiple mechanics were meticulously applied to achieve complete correction of the tooth positions and to minimize root resorption and/or periodontal defects of canine and lateral incisors. Factors concerning treatment planning for transposed teeth are discussed.

  15. Biomass Morphology Subjected to Different Chemical Treatment

    Science.gov (United States)

    Sutan, Norsuzailina Mohamed; Masjida Mazlan, Siti; Taib, Siti Noor Linda; Lee, Delsye Teo Ching; Hassan, Alsidqi; Kudnie Sahari, Siti; Mohamad Said, Khairul Anwar; Rahman Sobuz, Habibur

    2018-03-01

    A growing interest of sugarcane bagasse fibre composite has been observed in recent years due to its attractiveness properties such as low specific weight, renewable source and producible with low investment at low cost. However, these materials have a low interfacial adhesion between fibre and matrix which lead to reduction in certain mechanical properties of the composite. To overcome this problem, studies show that certain chemical treatments on the surface of the fibres are some alternatives that significantly increase the adhesion reinforcement/matrix, in some cases improving its mechanical properties. The objective of this study was to evaluate the effect of different type of chemical treatment which are alkali and acid treatment on sugarcane bagasse fibre surface morphology. Seeking to improve the adhesion fibre matrix, the fibre has been treated with 5% of NaOH and 5% of HCL solution with added of bagasse fibre used in the range of 0% to 3% of cement weight respectively. Through SEM investigation, it is confirmed that chemical treatment helps to remove hemicelluloses from raw bagasse fiber as well as improved fibre matrix adhesion.

  16. Complete physico-chemical treatment for coke plant effluents.

    Science.gov (United States)

    Ghose, M K

    2002-03-01

    Naturally found coal is converted to coke which is suitable for metallurgical industries. Large quantities of liquid effluents produced contain a large amount of suspended solids, high COD, BOD, phenols, ammonia and other toxic substances which are causing serious pollution problem in the receiving water to which they are discharged. There are a large number of coke plants in the vicinity of Jharia Coal Field (JCF). Characteristics of the effluents have been evaluated. The present effluent treatment systems were found to be inadequate. Physico-chemical treatment has been considered as a suitable option for the treatment of coke plant effluents. Ammonia removal by synthetic zeolite, activated carbon for the removal of bacteria, viruses, refractory organics, etc. were utilized and the results are discussed. A scheme has been proposed for the complete physico-chemical treatment, which can be suitably adopted for the recycling, reuse and safe disposal of the treated effluent. Various unit process and unit operations involved in the treatment system have been discussed. The process may be useful on industrial scale at various sites.

  17. Candidal Arthritis After Complete Treatment of Systemic Candidiasis

    Directory of Open Access Journals (Sweden)

    Wen-Bin Hsieh

    2005-04-01

    Full Text Available Over the last few decades, the incidence of invasive candidal infections in neonatal intensive care units has increased dramatically. Various complications, such as arthritis, endocarditis, meningitis, and endophthalmitis, have been reviewed. We present the case of a premature infant with systemic candidemia. Arthritis was discovered 6 months after completion of amphotericin B therapy, and was successfully treated with oral fluconazole for 6 weeks. We conclude that long-term follow-up is particularly important in patients with treated candidemia. To prevent complications, prolonged treatment with high-dose amphotericin B is suggested for systemic fungal infection, and oral fluconazole is an effective alternative for candidal arthritis.

  18. Complete characteristics of rating estimations economic development of subjects of the Russian Federation

    Directory of Open Access Journals (Sweden)

    Khamid Nurislamovich Gizatullin

    2012-03-01

    Full Text Available This paper allocates complete characteristics of indicators of economic development of subjects of the Russian Federation. Their system representation has appeared more informative, than system of simple social and economic indexes as allows reflecting variety of communications between them, providing preserving and development of researched objects. It is established that at deterioration of state of the economy of regions of their structure change the role in formation of base indicators. At the first stage it is expressed by change of a vector of development with an opposite direction; on the second — in transition from an optimum condition of available structures on periphery; on the third — in the termination of their participation in forming of under laying echelons. At transition of subsystems of social and economic indexes from the first on the second echelon the contribution of the moved potential from structures «resource-product» and «process» for elements of activization increases, for structures «object», on the contrary, decreases, while for final elements the opposite situation is observed. As approaching the top echelon there is a reduction of interaction of base indicators from structures «resource-product» and «process», and on the contrary, growth to structures «object». The conclusion is drawn that successful social and economic activity of regions is determined by synchronous interaction of all allocated structures («resource-product», «process» and «object». Use of the offered algorithm on the basis of complete characteristics allows not only to find out problem regions, but also shows possibility of management on the basis of revealed statistical regularities their condition by forming of optimum mutual relations between the allocated subsystems and, finally, creation of the big possibilities for realization of the having potential

  19. Early vs late orthodontic treatment of deepbite: a prospective clinical trial in growing subjects.

    Science.gov (United States)

    Baccetti, Tiziano; Franchi, Lorenzo; Giuntini, Veronica; Masucci, Caterina; Vangelisti, Andrea; Defraia, Efisio

    2012-07-01

    The aim of this prospective clinical trial was to compare the outcomes of prepubertal vs pubertal treatment of deepbite patients with a protocol including biteplane and fixed appliances. A sample of 58 subjects with deepbite completed the study. A total of 34 subjects received treatment with removable biteplane appliances in the mixed dentition at a prepubertal stage of skeletal maturation (early treatment group), and 24 subjects were treated at a pubertal stage of skeletal maturation in the permanent dentition (late treatment group). All subjects of both groups were reevaluated after an average period of 15 months after the completion of fixed appliance therapy. Treatment outcomes were assessed statistically after a phase with removable biteplane appliances and at the posttreatment observation. Treatment duration was significantly shorter in the early treatment group than in the late treatment group. Overbite reduction was significantly greater in the late treatment group (-3.1 mm) than in the early treatment group (-1.4 mm). In the late treatment group, 92% of the patients had a corrected overbite 1 year after therapy. Treatment of deepbite at puberty in the permanent dentition leads to significantly more favorable outcomes than treatment before puberty in the mixed dentition. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  20. Day-care treatment for multiple drug abusing adolescents: social factors linked with completing treatment.

    Science.gov (United States)

    Feigelman, W

    1987-01-01

    By identifying some of the social correlates linked with completing day-care drug abuse treatment, the present study has sought to broaden understanding of how drug rehabilitations are effected. As the findings have demonstrated, completing care is a result of a complex array of causes and their interaction. The disposition of the entering patient (i.e., their determination and other strengths) has a great bearing on treatment outcome. It is also a result of the patient's family, their motivations, resources and perseverance in enduring a long course of demanding therapeutic interventions. In addition, it is the product of meanings shared and transmitted between the patient's family and the treatment staff. Patients and their families project positive attitudes about the value of the therapeutic enterprise as well as a compliant demeanor. As staff recognize that patients and parents are acting cooperatively, then such perceptions tend to create self-fulfilling prophecies. The data has established that older adolescent patients are more likely to possess the motivational resources needed for program completion than younger patients. Apparently, self-referred patients are also more inclined to meet the demands of program requirements than those referred by the courts or other outside social agencies, although the differences fell short of the .05 level of statistical significance. Those completing the program are less likely to be diagnosed as depressed at intake. Parental characteristics comprise another group of variables that are related to treatment completion. Parents of higher occupational rank, who have had mental health care for themselves, and who are of Jewish ethnicity appear to possess useful strengths for meeting program challenges. The pattern of spouse mutuality in dealing with a child's needs as it exists preceding and during treatment seems to be another useful asset for successfully getting through this form of treatment. While parents with the

  1. Prison-based rehabilitation: Predictors of offender treatment participation and treatment completion

    NARCIS (Netherlands)

    Bosma, A.; Kunst, M.; Dirkzwager, A.J.E.; Nieuwbeerta, Paul|info:eu-repo/dai/nl/138622973

    2016-01-01

    The purpose of the current study was to examine to what extent risk factors and treatment readiness were related to engagement (i.e., participation and completion) in prison-based rehabilitation programs. The sample consisted of the total 6-month inflow of male detainees in the Netherlands who were

  2. Masticatory performance and oral health-related quality of life before and after complete denture treatment.

    Science.gov (United States)

    Yamamoto, Saori; Shiga, Hiroshi

    2018-03-13

    To clarify the relationship between masticatory performance and oral health-related quality of life (OHRQoL) before and after complete denture treatment. Thirty patients wearing complete dentures were asked to chew a gummy jelly on their habitual chewing side, and the amount of glucose extraction during chewing was measured as the parameter of masticatory performance. Subjects were asked to answer the Oral Health Impact Profile (OHIP-J49) questionnaire, which consists of 49 questions related to oral problems. The total score of 49 question items along with individual domain scores within the seven domains (functional limitation, pain, psychological discomfort, physical disability, psychological disability, social disability and handicap) were calculated and used as the parameters of OHRQoL. These records were obtained before treatment and 3 months after treatment. Each parameter of masticatory performance and OHRQoL was compared before treatment and after treatment. The relationship between masticatory performance and OHRQoL was investigated, and a stepwise multiple linear regression analysis was performed. Both masticatory performance and OHRQoL were significantly improved after treatment. Furthermore, masticatory performance was significantly correlated with some parameters of OHRQoL. The stepwise multiple linear regression analysis showed functional limitation and pain as important factors affecting masticatory performance before treatment and functional limitation as important factors affecting masticatory performance after treatment. These results suggested that masticatory performance and OHRQoL are significantly improved after treatment and that there is a close relationship between the two. Moreover, functional limitation was found to be the most important factor affecting masticatory performance. Copyright © 2018 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  3. Normative and Subjective Need for Orthodontic Treatment within ...

    African Journals Online (AJOL)

    Objective: To evaluate and compare the normative and subjective need for orthodontic treatment within different age groups in Turkey. Methods: One thousand and sixteen patients from seven different demographic regions of Turkey (Marmara, Black Sea, East Anatolia, Southeastern Anatolia, Mediterranean, Aegean,

  4. Family information needs at childhood cancer treatment completion.

    Science.gov (United States)

    Wakefield, Claire E; Butow, Phyllis; Fleming, Catharine A K; Daniel, Gunar; Cohn, Richard J

    2012-04-01

    Despite the recognized importance of information provision across the cancer trajectory, little research has investigated family information needs recently after childhood cancer. This mixed-methods, multiperspective, study explored the information needs of families of childhood cancer survivors in the first year post-treatment. In total, 112 semi-structured telephone interviews were conducted with 19 survivors (mean age 16.2 years, off treatment for ≤36 months), 44 mothers, 34 fathers, and 15 siblings. Interviews were analyzed inductively, line-by-line, using the framework of Miles and Huberman. Emergent themes were cross-tabulated by sample characteristics using QSR NVivo8. Participant views were mixed regarding the need for a "finishing treatment review" with their oncologist (the primary information source for most families); however, many mothers (29/44) and fathers (17/34) and most siblings (14/15) reported receiving insufficient information post-treatment. Information regarding fertility and how to prepare for likely post-treatment challenges were the most cited unmet needs. Online support was ranked highest by survivors (mean score: 7/2/10) and siblings (7.4/10), whilst parents preferred an information booklet (often due to concerns about accessing accurate and relevant information from the Internet). While many participants reported feelings of isolation/loneliness, many were reluctant to attend face-to-face support groups/seminars. Family members of survivors may experience the most acute unmet needs for information about fertility and in preparation for post-treatment challenges. However, provision of the correct amount of information at the right time for each family member during a highly stressful period remains clinically challenging. Copyright © 2011 Wiley Periodicals, Inc.

  5. Failure after Success: Correlates of Recidivism among Individuals Who Successfully Completed Coerced Drug Treatment

    Science.gov (United States)

    Sung, Hung-En; Belenko, Steven

    2005-01-01

    A subset of criminal offenders diverted from prison to treatment return to crime after successful completion of treatment. Identifying correlates of recidivism among treatment completers will improve our ability to help treated offenders to better capitalize on their treatment experiences. Data from 156 mandated clients of long-term residential…

  6. Artificial gait in complete spinal cord injured subjects: how to assess clinical performance

    Directory of Open Access Journals (Sweden)

    Karla Rocha Pithon

    2015-02-01

    Full Text Available Objective Adapt the 6 minutes walking test (6MWT to artificial gait in complete spinal cord injured (SCI patients aided by neuromuscular electrical stimulation. Method Nine male individuals with paraplegia (AIS A participated in this study. Lesion levels varied between T4 and T12 and time post injured from 4 to 13 years. Patients performed 6MWT 1 and 6MWT 2. They used neuromuscular electrical stimulation, and were aided by a walker. The differences between two 6MWT were assessed by using a paired t test. Multiple r-squared was also calculated. Results The 6MWT 1 and 6MWT 2 were not statistically different for heart rate, distance, mean speed and blood pressure. Multiple r-squared (r2 = 0.96 explained 96% of the variation in the distance walked. Conclusion The use of 6MWT in artificial gait towards assessing exercise walking capacity is reproducible and easy to apply. It can be used to assess SCI artificial gait clinical performance.

  7. Analysis of Blended Learning Implementation on Waste Treatment Subjects in Agricultural Vocational School

    Science.gov (United States)

    Sugiarti, Y.; Nurmayani, S.; Mujdalipah, S.

    2018-02-01

    Waste treatment is one of the productive subjects in vocational high school in programs of Agricultural Processing Technology which is one of the objectives learning has been assigned in graduate competency standards (SKL) of Vocational High School. Based on case studies that have been conducted in SMK Pertanian Pembangunan Negeri Lembang, waste treatment subjects had still use the lecture method or conventional method, and students are less enthusiastic in learning process. Therefore, the implementation of more interactive learning models such as blended learning with Edmodo is one of alternative models to resolve the issue. So, the purpose of this study is to formulate the appropriate learning syntax for the implementation of blended learning with Edmodo to agree the requirement characteristics of students and waste treatment subject and explain the learning outcome obtained by students in the cognitive aspects on the subjects of waste treatment. This research was conducted by the method of classroom action research (CAR) with a Mc. Tagart model. The result from this research is the implementation of blended learning with Edmodo on the subjects of waste treatment can improve student learning outcomes in the cognitive aspects with the maximum increase in the value of N-gain 0.82, as well as student learning completeness criteria reaching 100% on cycle 2. Based on the condition of subject research the formulation of appropriate learning syntax for implementation of blended learning model with Edmodo on waste treatment subject are 1) Self-paced learning, 2) Group networking, 3) Live Event- collaboration, 4) Association - communication, 5) Assessment - Performance material support. In summary, implementation of blended learning model with Edmodo on waste treatment subject can improve improve student learning outcomes in the cognitive aspects and conducted in five steps on syntax.

  8. Renegotiating "best treatment practice" and professional subject positions

    DEFF Research Database (Denmark)

    Søndergaard, Katia Dupret

    the professionals strive for is being able to meet patients as humans rather than meeting them as diagnosed patients. I will explore how situated and local enactments of these treatment ideals, for example dissolving the role of expert have complex constitutive effects and create alternative subject positions...... other. The analysis indicates that an argument of prevention may be a reinforcing motivation factor and possibility of subjectivation for the personnel. A possibility to construct a story about oneself, that facilitates the staff development as self-managing professional, in line with modern management...... strategies, where governing strategies are made invisible, and where management strategies are converted to individual existential projects. A central argument is that the individual ethical project of the introduction of a new treatment approach melts together with psychiatric treatment. There is no longer...

  9. Patient Characteristics Associated with HCV Treatment Adherence, Treatment Completion, and Sustained Virologic Response in HIV Coinfected Patients

    Directory of Open Access Journals (Sweden)

    Glenn Wagner

    2011-01-01

    Full Text Available Background. Hepatitis C (HCV treatment efficacy among HIV patients is limited by poor treatment adherence and tolerance, but few studies have examined the psychosocial determinants of treatment adherence and outcomes. Methods. Chart abstracted and survey data were collected on 72 HIV patients who had received pegylated interferon and ribavirin to assess correlates of treatment adherence, completion, and sustained virologic response (SVR. Results. Nearly half (46% the sample had active psychiatric problems and 13% had illicit drug use at treatment onset; 28% reported <100% treatment adherence, 38% did not complete treatment (mostly due to virologic nonresponse, and intent to treat SVR rate was 49%. Having a psychiatric diagnosis was associated with nonadherence, while better HCV adherence was associated with both treatment completion and SVR. Conclusions. Good mental health may be an indicator of HCV treatment adherence readiness, which is in turn associated with treatment completion and response, but further research is needed with new HCV treatments emerging.

  10. Subjectivity

    Directory of Open Access Journals (Sweden)

    Jesús Vega Encabo

    2015-11-01

    Full Text Available In this paper, I claim that subjectivity is a way of being that is constituted through a set of practices in which the self is subject to the dangers of fictionalizing and plotting her life and self-image. I examine some ways of becoming subject through narratives and through theatrical performance before others. Through these practices, a real and active subjectivity is revealed, capable of self-knowledge and self-transformation. 

  11. Correlates of substance abuse treatment completion among disadvantaged communities in Cape Town, South Africa

    Directory of Open Access Journals (Sweden)

    Pasche Sonja

    2010-03-01

    Full Text Available Abstract Background Completion of substance abuse treatment is a proximal indicator of positive treatment outcomes. To design interventions to improve outcomes, it is therefore important to unpack the factors contributing to treatment completion. To date, substance abuse research has not examined the factors associated with treatment completion among poor, disadvantaged communities in developing countries. This study aimed to address this gap by exploring client-level factors associated with treatment completion among poor communities in South Africa. Methods Secondary data analysis was conducted on cross-sectional survey data collected from 434 persons residing in poor communities in Cape Town, South Africa who had accessed substance abuse treatment in 2006. Results Multiple regression analyses revealed that therapeutic alliance, treatment perceptions, abstinence-specific social support, and depression were significant partial predictors of treatment completion. Conclusions Findings suggest that treatment completion rates of individuals from poor South African communities can be enhanced by i improving perceptions of substance abuse treatment through introducing quality improvement initiatives into substance abuse services, ii strengthening clients' abstinence-oriented social networks and, iii strengthening the counselor-client therapeutic alliance.

  12. Vaccination against hepatitis A and B in persons subject to homelessness in inner Sydney: vaccine acceptance, completion rates and immunogenicity.

    Science.gov (United States)

    Poulos, Roslyn G; Ferson, Mark J; Orr, Karen J; McCarthy, Michele A; Botham, Susan J; Stern, Jerome M; Lucey, Adrienne

    2010-04-01

    To determine acceptance, completion rates and immunogenicity of the standard vaccination schedule for hepatitis A (HAV) and B (HBV) in persons subject to homelessness. A convenience sample of clients (n=201) attending a medical clinic for homeless and disadvantaged persons in Sydney was enrolled. Serological screening for HAV and HBV was undertaken. An appropriate vaccination program was instituted. Post-vaccination serology determined serological response. Although many clients had serological evidence of past infection, at least 138 (69%) clients had the potential to benefit from vaccination. For hepatitis A and B vaccinations, completion rates were 73% (73 of 100 clients) and 75% (69 of 92 clients), respectively; after vaccination, protective antibody was found in 98.2% (56 of 57) and 72% (36 of 50) of clients, respectively. A successful vaccination program can be mounted with a vulnerable population. We consider a clinic with a well-established history of acceptance and utilisation by the target group; a low staff turnover and regular clientele; inclusion of vaccination as part of routine client care; and counselling (part of pre- and post-serological testing) essential components in achieving good vaccination completion rates. © 2010 The Authors. Journal Compilation © 2010 Public Health Association of Australia.

  13. Diclofenac delays micropore closure following microneedle treatment in human subjects.

    Science.gov (United States)

    Brogden, Nicole K; Milewski, Mikolaj; Ghosh, Priyanka; Hardi, Lucia; Crofford, Leslie J; Stinchcomb, Audra L

    2012-10-28

    Drugs absorbed poorly through the skin are commonly delivered via injection with a hypodermic needle, which is painful and increases the risk of transmitting infectious diseases. Microneedles (MNs) selectively and painlessly permeabilize the outermost skin layer, allowing otherwise skin-impermeable drugs to cross the skin through micron-sized pores and reach therapeutic concentrations. However, rapid healing of the micropores prevents further drug delivery, blunting the clinical utility of this unique transdermal technique. We present the first human study demonstrating that micropore lifetime can be extended following MN treatment. Subjects received one-time MN treatment and daily topical application of diclofenac sodium. Micropore closure was measured with impedance spectroscopy, and area under the admittance-time curve (AUC) was calculated. AUC was significantly higher at MN+diclofenac sodium sites vs. placebo, suggesting slower rates of micropore healing. Colorimetry measurements confirmed the absence of local erythema and irritation. This mechanistic human proof-of-concept study demonstrates that micropore lifetime can be prolonged with simple topical administration of a non-specific cyclooxygenase inhibitor, suggesting the involvement of subclinical inflammation in micropore healing. These results will allow for longer patch wear time with MN-enhanced delivery, thus increasing patient compliance and expanding the transdermal field to a wider variety of clinical conditions. Copyright © 2012 Elsevier B.V. All rights reserved.

  14. Diclofenac delays micropore closure following microneedle treatment in human subjects

    Science.gov (United States)

    Brogden, Nicole K.; Milewski, Mikolaj; Ghosh, Priyanka; Hardi, Lucia; Crofford, Leslie J.; Stinchcomb, Audra L.

    2013-01-01

    Drugs absorbed poorly through the skin are commonly delivered via injection with a hypodermic needle, which is painful and increases the risk of transmitting infectious diseases. Microneedles (MNs) selectively and painlessly permeabilize the outermost skin layer, allowing otherwise skin-impermeable drugs to cross the skin through micron-sized pores and reach therapeutic concentrations. However, rapid healing of the micropores prevents further drug delivery, blunting the clinical utility of this unique transdermal technique. We present the first human study demonstrating that micropore lifetime can be extended following MN treatment. Subjects received one-time MN treatment and daily topical application of diclofenac sodium. Micropore closure was measured with impedance spectroscopy, and area under the admittance–time curve (AUC) was calculated. AUC was significantly higher at MN + diclofenac sodium sites vs. placebo, suggesting slower rates of micropore healing. Colorimetry measurements confirmed the absence of local erythema and irritation. This mechanistic human proof-of-concept study demonstrates that micropore lifetime can be prolonged with simple topical administration of a non-specific cyclooxygenase inhibitor, suggesting the involvement of subclinical inflammation in micropore healing. These results will allow for longer patch wear time with MN-enhanced delivery, thus increasing patient compliance and expanding the transdermal field to a wider variety of clinical conditions. PMID:22929967

  15. Comparison Predominant Oral micro-flora in Subjects with and without Complete Denture Referred to Yazd Dentistry Department

    Directory of Open Access Journals (Sweden)

    Abbas Ali Jafari

    2014-11-01

    Results: The non-aureus staphylococcus and alpha-hemolytic streptococci showed the highest positive culture among the isolated microorganisms in both groups, whereas beta hemolytic streptococci showed the least percent of isolated microorganism in both groups. The higher density of non-aureus Staphylococci, α-hemolitic Streptococci, Gram negative cocobasillus, non-pathogenic Neisseria, Candida and Corynebacterium were recovered from oral samples of denture users in compare with dentate subjects (P= 0.0001. There was also seen a statistical significant correlation between the number of isolated microorganisms and the duration of denture utilization in denture users (P=0.013. Conclusion: Results of the present study showed that complete denture can be act as a predisposal factor in overgrowing of several oral micro-flora particularly Candida, non-aureus Staphylococci, α-hemolytic streptococci, gram negative cocobacillus, non-pathogenic Neisseria, and Corynebacterium, which emphasized the users denture hygine.

  16. Treatment of 63 Subjects With Digital Mucous Cysts With Percutaneous Sclerotherapy Using Polidocanol.

    Science.gov (United States)

    Esson, Gavin A; Holme, Stephen A

    2016-01-01

    Digital mucous cysts (digital myxoid cysts or DMCs) are benign cystic swellings typically affecting the digital distal interphalangeal joint or the proximal nail fold. Many treatment modalities exist; however, permanent scarring, wound infection, and recurrence are common. Polidocanol sclerotherapy has been reported as a potential treatment. To assess the efficacy and safety of percutaneous polidocanol sclerotherapy in the treatment of DMC. The authors performed polidocanol sclerotherapy in 63 patients (23 men and 40 women). For each patient, the DMC contents were extruded and 3% polidocanol (0.02-0.5 mL) was injected to gently refill the cyst to its previous size. Subjects were reviewed after 6 weeks and offered a second treatment if necessary, and reviewed again after 12 weeks. Changes in lesions and adverse reactions were noted. Of the 63 subjects treated, 43 (68.3%) experienced complete resolution of the cyst by 6 weeks, and 49 (77.8%) experienced complete resolution by 12 weeks. Side effects were minor and had resolved in all patients by 12-week review. Percutaneous polidocanol sclerotherapy is a simple, safe, and effective approach to treating DMC, and is suitable for office-based practice.

  17. Orthodontic Treatment Completion and Discontinuation in a Rural Sample from North Central Appalachia in the USA

    Directory of Open Access Journals (Sweden)

    Chris A. Martin

    2017-07-01

    Full Text Available BackgroundOrthodontics has inherent demands, requiring regular appointments and active patient engagement, but relatively little is established in regard to rates of completion of treatment and possible factors affecting successful completion. These factors may be particularly important for cultural minority groups, such as those in rural Appalachia, given the environmental, social, and economic complexities affecting access to and utilization of treatment.Design and methodsA naturalistic study design was employed, using retrospective data from a rural outpatient general dental office in July 2012. Chart abstraction yielded 219 (55.3% female orthodontic patients (M age = 11.0 [3.7]. Chi-square tests for independence were conducted for categorical dependent variables. For continuous variables, t-tests were conducted. A logistic multivariate regression analysis was conducted to predict completion/non-completion of treatment, with age, gender, distance traveled, type of malocclusion, and payment type as predictors.ResultsOverall, 49.8% of this sample successfully completed orthodontic treatment. Greater successful conclusion of treatment was found in self-pay patients (i.e., 74% versus those whose care was funded through Medicaid/Children’s Health Insurance Program (i.e., 34% or through private insurance (i.e., 36%. Age, gender, and distance to the office from home had no association relative to successful completion of treatment, although average one-way distance to travel for care was considerable (i.e., 38.8 miles.ConclusionRate of successful orthodontic treatment completion was low in this rural sample. Treatment outcome was related to the form of payment for services, with self-pay associated with the highest rate of successful completion.

  18. Tuberculosis Treatment Completion in a United States/Mexico Binational Context

    Directory of Open Access Journals (Sweden)

    Celina I. Valencia

    2017-05-01

    Full Text Available BackgroundTuberculosis (TB remains a salient public health issue along the U.S./Mexico border. This study seeks to identify the social and structural factors, which are associated with TB disease burden in the binational geographic region. Identification of barriers of treatment completion provides the necessary framework for developing evidence-based interventions that are culturally relevant and context specific for the U.S./Mexico border region.MethodsRetrospective study of data extracted from medical charts (n = 439 from Yuma County Health Department (YCHD (n = 160 and Centro de Salud San Luis Río Colorado (n = 279. Patients currently accessing TB treatment at either facility were excluded from the study. Chi-square, unadjusted odds ratios, and logistic regression were utilized to identify characteristics associated with successful TB treatment in this population.FindingsThe study population was predominantly male (n = 327. Females were more likely to complete TB treatment (OR = 3.71. The absence of drug use and/or the absence of an HIV positive diagnosis were found to be predictors of TB treatment completion across both clinical sites. Forty-four percent (43.59% (n = 85 TB patients treated at CDS San Luis did not complete treatment versus 40.35% (n = 49 of TB patients who did not complete treatment at YCHD. Moving from the area or being deported was the highest category (20.78% for incomplete TB treatment in the population (n = 64 across both clinical sites.

  19. Adverse events and treatment completion for latent tuberculosis in jail inmates and homeless persons.

    Science.gov (United States)

    Lobato, Mark N; Reves, Randall R; Jasmer, Robert M; Grabau, John C; Bock, Naomi N; Shang, Nong

    2005-04-01

    Recently, a short-course treatment using 60 daily doses of rifampin and pyrazinamide was recommended for latent tuberculosis (TB) infection (LTBI). To determine the acceptability, tolerability, and completion of treatment. Observational cohort study. Five county jails and TB outreach clinics for homeless populations in three cities. Study staff enrolled 1,211 patients (844 inmates and 367 homeless persons). Sites used 60 daily doses of rifampin and pyrazinamide, an approved treatment regimen for LTBI. Types and frequency of drug-related adverse events and outcomes of treatment. Prior to treatment, 25 of 1,178 patients (2.1%) had a serum aminotransferase measurement at least 2.5 times the upper limit of normal. Patients who reported excess alcohol use in the past 12 months were more likely than other patients to have an elevated pretreatment serum aminotransferase level (odds ratio, 2.1; 95% confidence interval, 1.1 to 6.1; p = 0.03). Treatment was stopped in 66 of 162 patients (13.4%) who had a drug-related adverse event. Among 715 patients who had serum aminotransferase measured during treatment, 43 patients (6.0%) had an elevation > 5 times the upper limits of normal, including one patient who died of liver failure attributed to treatment. In multivariate analyses, increasing age, an abnormal baseline aspartate aminotransferase level, and unemployment within the past 24 months were independent risk factors for hepatotoxicity. Completion rates were similar in jail inmates (47.5%) and homeless persons (43.6%). This study detected the first treatment-associated fatality with the rifampin and pyrazinamide regimen, prompting surveillance that detected unacceptable levels of hepatotoxicity and retraction of recommendations for its routine use. Completion rates for LTBI treatment using a short-course regimen exceeds historical rates using isoniazid. Efforts to identify an effective short-course treatment for LTBI should be given a high priority.

  20. Young female cancer survivors' use of fertility care after completing cancer treatment

    Science.gov (United States)

    Kim, Jayeon; Mersereau, Jennifer E.; Su, H. Irene; Whitcomb, Brian W.; Malcarne, Vanessa L.; Gorman, Jessica R.

    2016-01-01

    Purpose To investigate factors associated with female young adult cancer survivors’ (YCS) use of fertility care (FC), including consultation or fertility treatment, after completing their cancer treatment. Methods In this cross-sectional study, females between that ages of 18 and 35 years who had been diagnosed with childhood, adolescent, or young adult cancers completed a 20-min web-based survey that included demographics, reproductive history, use of FC, fertility-related informational needs, and reproductive concerns. Results A total of 204 participants completed the survey. Participants’ mean age was 28.3±4.5 years. Thirty (15%) participants reported using FC after cancer treatment. The majority of participants recalled not receiving enough information about FP options at the time of cancer diagnosis (73%). In multivariable analysis, those with higher concerns about having children because of perceived risk to their personal health (P=0.003) were less likely to report use of FC after cancer treatment. Those who had used FC before cancer treatment (P=0.003) and who felt less fertile than age-matched women (P=0.02) were more likely to use FC after their cancer treatment. Conclusions While most YCS in this cohort believed that they did not receive enough information about fertility and most wanted to have children, the vast majority did not seek FC. The findings of this study offer further evidence of the need for improved education and emotional support regarding reproductive options after cancer treatment is completed. Targeted discussions with YCS about appropriate post-treatment FC options may improve providers’ capacity to help YCS meet their parenthood goals. PMID:26939923

  1. Subjective visual vertical after treatment of benign paroxysmal positional vertigo

    Directory of Open Access Journals (Sweden)

    Maristela Mian Ferreira

    Full Text Available Abstract Introduction: Otolith function can be studied by testing the subjective visual vertical, because the tilt of the vertical line beyond the normal range is a sign of vestibular dysfunction. Benign paroxysmal positional vertigo is a disorder of one or more labyrinthine semicircular canals caused by fractions of otoliths derived from the utricular macula. Objective: To compare the subjective visual vertical with the bucket test before and immediately after the particle repositioning maneuver in patients with benign paroxysmal positional vertigo. Methods: We evaluated 20 patients. The estimated position where a fluorescent line within a bucket reached the vertical position was measured before and immediately after the particle repositioning maneuver. Data were tabulated and statistically analyzed. Results: Before repositioning maneuver, 9 patients (45.0% had absolute values of the subjective visual vertical above the reference standard and 2 (10.0% after the maneuver; the mean of the absolute values of the vertical deviation was significantly lower after the intervention (p < 0.001. Conclusion: There is a reduction of the deviations of the subjective visual vertical, evaluated by the bucket test, immediately after the particle repositioning maneuver in patients with benign paroxysmal positional vertigo.

  2. Normative and Subjective Need for Orthodontic Treatment within ...

    African Journals Online (AJOL)

    2018-01-30

    Jan 30, 2018 ... orthodontic treatment within different age groups in Turkey. Methods: One ... Professionals usually classify the normative need for. Original Article ..... orthodontic services among adolescents in the United States. Am. J Orthod ...

  3. Risk of cervical cancer after completed post-treatment follow-up of cervical intraepithelial neoplasia

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Helmerhorst, Theo; Habbema, Dik

    2012-01-01

    To compare the risk of cervical cancer in women with histologically confirmed cervical intraepithelial neoplasia who returned to routine screening after having completed post-treatment follow-up with consecutive normal smear test results with women with a normal primary smear test result....

  4. Parental Homework Completion and Treatment Knowledge during Group Parent-Child Interaction Therapy

    Science.gov (United States)

    Ros, Rosmary; Graziano, Paulo A.; Hart, Katie C.

    2017-01-01

    The purpose of this study was to examine how parental homework completion, session attendance, and treatment knowledge influenced parenting practices and confidence in using learned skills during behavioral parent training (BPT). Parents of 54 preschoolers (M[subscript age] = 5.07, 82% Hispanic/Latino) with externalizing behavior problems…

  5. Subjective-objective sleep discrepancy among older adults: associations with insomnia diagnosis and insomnia treatment.

    Science.gov (United States)

    Kay, Daniel B; Buysse, Daniel J; Germain, Anne; Hall, Martica; Monk, Timothy H

    2015-02-01

    Discrepancy between subjective and objective measures of sleep is associated with insomnia and increasing age. Cognitive behavioural therapy for insomnia improves sleep quality and decreases subjective-objective sleep discrepancy. This study describes differences between older adults with insomnia and controls in sleep discrepancy, and tests the hypothesis that reduced sleep discrepancy following cognitive behavioural therapy for insomnia correlates with the magnitude of symptom improvement reported by older adults with insomnia. Participants were 63 adults >60 years of age with insomnia, and 51 controls. At baseline, participants completed sleep diaries for 7 days while wearing wrist actigraphs. After receiving cognitive behavioural therapy for insomnia, insomnia patients repeated this sleep assessment. Sleep discrepancy variables were calculated by subtracting actigraphic sleep onset latency and wake after sleep onset from respective self-reported estimates, pre- and post-treatment. Mean level and night-to-night variability in sleep discrepancy were investigated. Baseline sleep discrepancies were compared between groups. Pre-post-treatment changes in Insomnia Severity Index score and sleep discrepancy variables were investigated within older adults with insomnia. Sleep discrepancy was significantly greater and more variable across nights in older adults with insomnia than controls, P ≤ 0.001 for all. Treatment with cognitive behavioural therapy for insomnia was associated with significant reduction in the Insomnia Severity Index score that correlated with changes in mean level and night-to-night variability in wake after sleep onset discrepancy, P insomnia. © 2014 European Sleep Research Society.

  6. MASTICATION, PHONETICS AND ESTHETICS AS A FINAL RESULT OF PARTIAL OR COMPLETE DENTURE TREATMENT.

    Directory of Open Access Journals (Sweden)

    Kalina Georgieva

    2015-08-01

    Full Text Available Three target groups- dentists/ dental students, dental technicians and patients were asked to fill in an anonymous questionnaire about their satisfaction of the final results after prosthetic treatment with removable dentures using a scale from 1 to 5 (1- completely dissatisfied, 2-dissatisfied, 3-indifferent, 4-satisfied, 5-completely satisfied. The mean results (including colour, shape and size of artificial teeth, arrangement of front teeth, colour of artificial gums, phonetics, mastication, natural smile, enough space for tongue for all three groups of respondents were compared. Dental technicians (4,34 are more satisfied than dentists/dental students (3,62 and patients (3,53. A successful outcome of prosthetic treatment depends on one hand on the professional approach of the dental team and on the other hand on the patient’s motivation and cooperation. The predictive final results and realistic expectations lead to satisfaction of all participants in the treatment process.

  7. TREATMENT FOR CHRONIC HEART FAILURE IN ELDERLY SUBJECTS

    Directory of Open Access Journals (Sweden)

    A. S. Poskrebysheva

    2014-07-01

    Full Text Available The treatment of chronic heart failure (CHF in patients over 60 years of age may be a challenge to a general practitioner. The physiological features of the elderly and significant comorbidity frequently have a considerable impact on the effects of drugs and the magnitude of side effects. Reduced sinus node automatism, significant atherosclerosis of the aorta and great vessels, and renal dysfunction - all should be borne in mind when choosing a drug and its dosage regimen. The paper considers non-drug treatment modalities, as well as the specific features of use of some groups of drugs and therapy for concomitant diseases in elderly patients with CHF.

  8. Outpatient treatment of alcohol use disorders among subjects 60+ years

    DEFF Research Database (Denmark)

    Andersen, Kjeld; Bogenschutz, Michael P; Bühringer, Gerhard

    2015-01-01

    BACKGROUND: The proportion of 60+ years with excessive alcohol intake varies in western countries between 6-16 % among men and 2-7 % among women. Specific events related to aging (e.g. loss of job, physical and mental capacity, or spouse) may contribute to onset or continuation of alcohol use...... into the possible interaction of service system differences and related patient characteristics in predictionof treatment outcome. TRIAL REGISTRATION: Clinical Trials.gov NCT02084173 , March 7, 2014....

  9. Metabolic and Inflammatory Changes with Orlistat and Sibutramine Treatment in Obese Malaysian Subjects.

    Science.gov (United States)

    Al-Tahami, Belqes Abdullah Mohammad; Al-Safi Ismail, Ab Aziz; Sanip, Zulkefli; Yusoff, Zurkurnai; Shihabudin, Tg Muzaffar Tm; Singh, Taran Singh Pall; Rasool, Aida Hanum Ghulam

    2017-01-01

    Obesity is associated with numerous health problems, particularly metabolic and cardiovascular complications. This study aimed to assess the effects that, nine months of pharmacological intervention with orlistat or sibutramine, on obese Malaysians' body weight and compositions, metabolic profiles and inflammatory marker. Seventy-six obese subjects were randomly placed into two groups. The first group received three daily 120 mg dosages of orlistat for nine months (n=39), and the second group received a once daily 10 or 15 mg dosage of sibutramine for nine months (n=37). Baseline measurements for weight, body mass index (BMI), waist circumference (WC), body fat percentage (BF), visceral fat (VF), adiponectin, fasting plasma glucose (FPG), fasting insulin, pancreatic B cell secretory capacity (HOMA%B), insulin sensitivity (HOMA%S), insulin resistance (HOMA-IR) and serum high sensitivity C-reactive protein (hs-CRP) were performed and repeated during the sixth and ninth months of treatment. Twenty-four subjects completed the trial in both groups. For both groups, weight, BMI, WC, BF, VF, HOMA-IR and hs-CRP were significantly lower at the end of the nine month intervention. However, there were no significant differences between the two groups for these parameters with nine months treatment. There was a significant decrease in FPG in orlistat group; while fasting insulin and HOMA%B reduced in sibutramine group. For both groups, there were also significant increases in adiponectin levels and HOMA%S at the end of the nine month intervention. Nine months of treatment with orlistat and sibutramine not only reduced weight but also significantly improved BMI, WC, BF, VF, FPG, adiponectin, fasting insulin, HOMA%B, HOMA%S, HOMA-IR and hs-CRP. These improvements could prove useful in the reduction of metabolic and cardiovascular risks in obese subjects.

  10. Diagnosis and treatment of orofacial pain in a patient with unserviceable complete dentures: A clinical report.

    Science.gov (United States)

    Selecman, Audrey M; Ahuja, Swati A

    2018-02-08

    An ill-fitting complete denture has the potential to create pain and discomfort as well as conceal or confound the diagnosis of other primary sources of orofacial pain such as trigeminal neuralgia. Guidelines of the American Academy of Orofacial Pain offer an evidence-based approach for the assessment, diagnosis, and management of orofacial pain. A complete and accurate differential diagnosis is paramount to the success of treatment as well as to the circumvention of unnecessary therapy. The purpose of this clinical report was to emphasize an evidence-based approach to the diagnosis and treatment of orofacial pain in a patient with edentulism and a history of prolonged denture wear. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  11. Efficiency evaluation for nanomaterials applied in well bottom zone treatment after completion of well construction

    Directory of Open Access Journals (Sweden)

    GREZINA Olga Anatolyevna,

    2017-11-01

    Full Text Available Efficient development of low production wells is not possible without the bottom zone treatment, both during the well development phase when its construction is completed and in the process of flow rate reduction during the operation phase. The efficiency evaluation for the new technology, including one in which nanomaterials are used, implies comparison of the actual level achieved after the new technology has been applied with the projected baseline level that might be achieved by the previously applied technique. The paper presents geological and statistical modeling of the bottom zone acid-implosion treatment performed with the hydrochloric acid solution in combination with the shock-wave effect characterized by cyclic recurrence and dynamic mode. The analyzed results have been achieved in the low permeable carbonate reservoir of a very complex geological structure in oil operating facility. The nature and the extent of geological-technological parameters influence on the acidimplosion treatment results were determined by the multiple regression method, and the most influential parameters were selected; recommendations for boreholes selection and technological parameters of treatment were made. Models to forecast flow rate and oil production growth, reduction of fractional oil content in the well production, the acid-implosion impact duration were elaborated. The models can be used to evaluate efficiency of bottom zone treatment technologies after completion of well construction with nanomaterials application.

  12. The association of subjective orthodontic treatment need with oral health-related quality of life.

    Science.gov (United States)

    Kragt, Lea; Jaddoe, Vincent; Wolvius, Eppo; Ongkosuwito, Edwin

    2017-08-01

    The existing body of evidence reports an inconsistent association between subjective and objective orthodontic treatment need. The concept of oral health-related quality of life (OHRQoL) might help to explain the differences in subjective and objective orthodontic treatment need. Our aim was to investigate the association of subjective orthodontic treatment with OHRQoL in children. This cross-sectional study was embedded in the Generation R Study, a population-based prospective cohort study. OHRQoL and subjective orthodontic treatment need were assessed by parental questionnaires. Questionnaire items were individually compared among children with no, borderline and definite subjective orthodontic need. The association between subjective orthodontic treatment need and OHRQoL was investigated in multivariate regression analysis with weighted least squares. Differences by sex and levels of objective orthodontic treatment need were evaluated. In total, 3774 children were included in the analysis. Children with borderline subjective orthodontic treatment need and those with definite subjective orthodontic treatment need had significantly poorer OHRQoL based on the fully adjusted model (adjusted regression coefficient (aβ)=-0.49, 95% CI: -0.75, -0.30; (aβ)=-1.58, 95% CI: -1.81, -1.58, respectively). The association between subjective orthodontic treatment need and OHRQoL was stronger in girls than in boys and stronger in children with objective orthodontic treatment need than in those with none. Oral health-related quality of life is poorer in children with subjective orthodontic treatment need. This has not been investigated before in such a large-population-based study and clearly offers an explanation for the lack of concurrence between objective and subjective orthodontic treatment need. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. A method for the automatic quantification of the completeness of pulmonary fissures: evaluation in a database of subjects with severe emphysema

    Energy Technology Data Exchange (ETDEWEB)

    Rikxoort, Eva M. van; Goldin, Jonathan G.; Galperin-Aizenberg, Maya; Abtin, Fereidoun; Kim, Hyun J.; Lu, Peiyun; Shaw, Greg; Brown, Matthew S. [University of California-Los Angeles, Center for Computer Vision and Imaging Biomarkers and Thoracic Imaging Research Group, Department of Radiological Sciences, David Geffen School of Medicine, Los Angeles, CA (United States); Ginneken, Bram van [Radboud University Nijmegen Medical Centre, Diagnostic Image Analysis Group, Department of Radiology, Nijmegen (Netherlands); University Medical Center Utrecht, Image Sciences Institute, Department of Radiology, Utrecht (Netherlands)

    2012-02-15

    To propose and evaluate a technique for automatic quantification of fissural completeness from chest computed tomography (CT) in a database of subjects with severe emphysema. Ninety-six CT studies of patients with severe emphysema were included. The lungs, fissures and lobes were automatically segmented. The completeness of the fissures was calculated as the percentage of the lobar border defined by a fissure. The completeness score of the automatic method was compared with a visual consensus read by three radiologists using boxplots, rank sum tests and ROC analysis. The consensus read found 49% (47/96), 15% (14/96) and 67% (64/96) of the right major, right minor and left major fissures to be complete. For all fissures visually assessed as being complete the automatic method resulted in significantly higher completeness scores (mean 92.78%) than for those assessed as being partial or absent (mean 77.16%; all p values <0.001). The areas under the curves for the automatic fissural completeness were 0.88, 0.91 and 0.83 for the right major, right minor and left major fissures respectively. An automatic method is able to quantify fissural completeness in a cohort of subjects with severe emphysema consistent with a visual consensus read of three radiologists. (orig.)

  14. Support after the completion of cancer treatment: perspectives of Australian adolescents and their families.

    Science.gov (United States)

    Wakefield, C E; McLoone, J; Butow, P; Lenthen, K; Cohn, R J

    2013-07-01

    Young people recovering from cancer may lack adequate support post-treatment, yet little is known about the types of support and information young Australians and their families need. This study investigated adolescent/young adult cancer survivors' and their families' perceptions of care and support needs after completing cancer treatment. Seventy semi-structured interviews were conducted with 19 survivors (mean age 16.1 years), 21 mothers, 15 fathers and 15 siblings. Interviews were recorded, transcribed and analysed using the conceptual framework of Miles and Huberman. Post-treatment, participants regarded medical staff positively but were reluctant to ask for their help fearing it may deflect resources away from patients still receiving treatment. Appraisals of social workers' and psychologists' support post-treatment were mixed. Formal emotional support was rarely accessed and participants reported that any additional funds should be directed to greater psychological support in this period. Participants also reported the need for additional financial support post-treatment. Clinicians need to be aware that while young people and their families may not demand support post-treatment, they may 'suffer in silence' or burden family members and friends with the responsibility of providing emotional support, though they may be experiencing distress also. © 2013 John Wiley & Sons Ltd.

  15. Very low calorie diet without aspartame in obese subjects: improved metabolic control after 4 weeks treatment.

    Science.gov (United States)

    Norén, Erik; Forssell, Henrik

    2014-07-28

    Very low calorie diet (VLCD) is routinely used in programs for treatment of obesity and before bariatric surgery in order to reduce risk of postoperative complications. Aspartame, an artificial sweetener, is commonly used in VLCD and is well approved as a food additive without any adverse effects. The development of a new fructose containing VLCD formula without aspartame raises questions as to effects on glucose and lipid control. As part of an ongoing study of a novel bariatric surgery procedure, twenty-five obese subjects with mean body mass index (BMI) 39.8 kg/m2 and mean age of 48.8 years enrolled in a single center observational study. Seven subjects presented with type 2 diabetes mellitus. The subjects underwent four weeks dietary treatment with VLCD Slanka (Slanka). Blood samples including fasting plasma glucose, HbA1c, cholesterol and triglycerides were performed at start and after four weeks of diet. Blood pressure and weight were noted. All subjects completed the diet without any adverse events. Mean weight reduction was 8.2 kg with 95% confidence interval 7.1-9.2 kg (p = 0.001). Excess weight (i.e. proportion of weight exceeding BMI 25) loss decreased by median 19.5% (inter quartile range (IQR) 16,8-24,2). Median fasting plasma glucose was at inclusion 5,6 mmol/l (IQR 5,3-6,8) and after diet 4.8 mmol/l (IQR 4,6-5,2) (p = 0.001). Median HbA1c changed from 39 mmol/mol (IQR 37-44) to 37 mmol/mol (IQR 35-43) (p = 0.001). There was also significant reduction in cholesterol and triglyceride levels as well as in systolic blood pressure. Changes in other monitored blood chemistry values were without clinical importance. Four weeks treatment with fructose containing VLCD of obese subjects preparing for bariatric surgery gave a substantial weight reduction without any significant negative metabolic effects.

  16. Masseter muscle fatigue during sustained clenching in subjects with complete dentures, implant-supported prostheses, and natural teeth.

    Science.gov (United States)

    Jacobs, R; van Steenberghe, D

    1993-03-01

    A sustained submaximal (50%) clenching effort was performed in four patient groups to establish whether implant-supported prosthetic reconstructions influence myoelectrical signal parameters. The first group consisted of patients with natural teeth in both jaws. The other three groups consisted of patients who were edentulous in both jaws: one group had complete dentures; one had an overdenture in the mandible on two implants connected by a bar; and the third had an implant-supported fixed prosthesis in either the maxilla or the mandible. Surface electromyography indicated an increased myoelectrical output level that paralleled a higher bite force level for implant-supported reconstructions compared with complete dentures. Power spectrum analysis revealed a downward shift of the mean power frequency during sustained clenching in all groups except the implant-supported fixed prosthesis. The absence of a spectral shift in the latter group probably reflected a fear of biting too hard and fracturing the prosthesis.

  17. Treatment with Ipilimumab: A Case Report of Complete Response in a Metastatic Malignant Melanoma Patient

    Directory of Open Access Journals (Sweden)

    Alfredo Addeo

    2013-05-01

    Full Text Available Introduction: Over the past year, 3 agents have been approved for the treatment of melanoma by the Food and Drug Administration. These include pegylated interferon α-2b for stage III melanoma, vemurafenib for unresectable or metastatic melanoma with BRAF V600E mutation, and ipilimumab for unresectable or metastatic melanoma. Case Presentation: We present here the case of a 65-year-old Caucasian male diagnosed with advanced melanoma in April 2011 and treated with ipilimumab (Yervoy®, a monoclonal antibody targeting cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4, as second-line treatment after progression with dacarbazine, for (wild-type BRAF metastatic melanoma. The patient was referred to us for several painful lumps on his right arm. A biopsy of one of them revealed melanoma. CT and PET scans did not show any other lesions or a primary site. The patient was started on first-line chemotherapy with dacarbazine 850 mg/m2 on day 1, every 3 weeks. After 3 cycles, the patient showed disease progression with an increase in size of the skin metastasis. Second-line treatment was started with ipilimumab 3 mg/kg on day 1, every 3 weeks. At the end of the treatment, after 4 cycles, we documented a complete clinical response with total resolution of the skin metastasis. At the time of writing this paper, our patient had finished his treatment more than 9 months earlier and is still in complete remission. Conclusion: This is a paradigmatic case where, despite extensive metastatic disease, treatment with ipilimumab has confirmed its efficacy. It is still an open question why only a minority of patients have such a remarkable response, and further trials are warranted to address this important question.

  18. Adjuvant radiochemotherapy in the treatment of completely resected, locally advanced gastric cancer

    International Nuclear Information System (INIS)

    Baeza, Mario R.; Osvaldo Giannini, T.; Raul Rivera, S.; Gonzalez, Pablo; Gonzalez, Julio; Vergara, Ernesto; Castillo, Cesar del; Madrid, Jorge; Vines, Eugenio

    2001-01-01

    Purpose: To analyze the efficacy and toxicity of adjuvant whole abdomen irradiation (WAI) and concomitant chemotherapy in the treatment of completely resected, high-risk gastric cancer. Methods and Materials: Between October 1990 and September 1997, 52 patients with completely resected gastric cancer, with lymph node and/or serosal involvement, were treated. Ages were 16-78 (median, 53.5) years. Treatment was either total- or sub-total gastrectomy, followed by WAI, 2100 cGy/21 fractions plus a 2400 cGy/16 fractions boost to the tumor bed. Chemotherapy consisted of either 5-fluorouracil (5-FU) 450-500 mg/m 2 i.v. for 5 days first and 5th week or 200-300 mg/m 2 continuous infusion during irradiation. No further chemotherapy was given. Results: With a minimum follow-up of 30 months and a median follow-up of 43.5 months, 25 of the 52 patients have died. Overall 5-year survival rate is 54%. Three patients sustained Grade 3-5 complications. Two patients with Grade 5 complications (malabsorption syndrome) died 31 and 56 months after the beginning of the treatment, respectively, with no evidence of recurrent tumor. For patients with involvement of the lymph nodes alone (n=19) the 5-year survival was 69%, which was significantly better than the 36% 5-year survival observed for those patients with both serosal and lymph node involvement (n=26, p=0.004). Conclusion: Adjuvant radiochemotherapy, WAI, and concomitant 5-FU, is a feasible and a fairly well-tolerated treatment for patients with locally advanced (involvement of the lymph nodes or serosa) gastric carcinoma who undergo complete resection. The 54% overall 5-year survival compares favorably with the survival reported after surgery alone for those patients

  19. Complete Neoadjuvant Treatment for Rectal Cancer: The Brown University Oncology Group CONTRE Study.

    Science.gov (United States)

    Perez, Kimberly; Safran, Howard; Sikov, William; Vrees, Matthew; Klipfel, Adam; Shah, Nishit; Schechter, Steven; Oldenburg, Nicklas; Pricolo, Victor; Rosati, Kayla; Dipetrillo, Thomas

    2017-06-01

    Following preoperative chemoradiation and surgery, many patients with stage II to III rectal cancer are unable to tolerate full-dose adjuvant chemotherapy. BrUOG R-224 was designed to assess the impact of COmplete Neoadjuvant Treatment for REctal cancer (CONTRE), primary chemotherapy followed by chemoradiation and surgery, on treatment delivery, toxicities, and pathologic response at surgery. Patients with clinical stage II to III (T3 to T4 and/or N1 to N2) rectal cancer received 8 cycles of modified FOLFOX6 followed by capecitabine 825 mg/m bid concurrent with 50.4 Gy intensity-modulated radiation therapy. Surgery was performed 6 to 10 weeks after chemoradiation. Thirty-nine patients were enrolled between August 2010 and June 2013. Median age was 61 years (30 to 79 y); 7 patients (18%) were clinical stage II and 32 (82%) stage III. Thirty-six patients (92%) received all 8 cycles of mFOLFOX6, of whom 35 completed subsequent chemoradiation; thus 89% of patients received CONTRE as planned. No unexpected toxicities were reported. All patients had resolution of bleeding and improvement of obstructive symptoms, with no complications requiring surgical intervention. Pathologic complete response (ypT0N0) was demonstrated in 13 patients (33%; 95% CI, 18.24%-47.76%). CONTRE seems to be a well-tolerated alternative to the current standard treatment sequence. Evaluating its impact on long-term outcomes would require a large randomized trial, but using pathologic response as an endpoint, it could serve as a platform for assessing the addition of novel agents to preoperative treatment in stage II to III rectal cancer.

  20. Folic acid treatment increases homocysteine remethylation and methionine transmethylation in healthy subjects

    NARCIS (Netherlands)

    Stam, F.; Smulders, Y.M.; van Guldener, C.; Jakobs, C.A.J.M.; Stehouwer, C.D.A.; van der Meer, K.

    2005-01-01

    Folic acid treatment decreases plasma total homocysteine concentrations in healthy subjects, but the effects on homocysteine metabolism are unknown. In the present study, we investigated the effect of 3 weeks of oral treatment with 5 mg of folic acid on one-carbon flux rates in 12 healthy subjects,

  1. Evaluation of treatment response for breast cancer: are we entering the era of "biological complete remission"?

    Institute of Scientific and Technical Information of China (English)

    Li Bian; Tao Wang; Yi Liu; Hui-Qiang Zhang; Jin-Jie Song; Shao-Hua Zhang; Shi-Kai Wu; San-Tai Song; Ze-Fei Jiang

    2012-01-01

    Breast cancer is one of the most common malignancies in women.The post-operative recurrence and metastasis are the leading causes of breast cancer-related mortality.In this study,we tried to explore the role of circulating tumor cell (CTC) detection combination PET/CT technology evaluating the prognosis and treatment response of patients with breast cancer; meanwhile,we attempted to assess the concept of "biological complete remission" (bCR) in this regard.A 56-year-old patient with breast cancer (T2N1M1,stage Ⅳ left breast cancer,with metastasis to axillary lymph nodes and lungs) received 6 cycles of salvage treatment with albumin-bound paclitaxel plus capecitabine and trastuzumab.Then,she underwent CTC detection and PET/CT for efficacy evaluation.CTC detection combination PET/CT is useful for the evaluation of the biological efficacy of therapies for breast cancer.The bCR of the patient appeared earlier than the conventional clinical imaging complete remission and promised the histological (pathological) complete remission.The integrated application of the concepts including bCR,imageological CR,and histological CR can achieve the early and accurate assessment of biological therapeutic reponse and prognosis of breast cancer.

  2. Urine osmolality in treatment-naïve HIV-positive subjects in ...

    African Journals Online (AJOL)

    Urine osmolality is not commonly evaluated in routine clinical practice and in human immunodeficiency virus (HIV) subjects. The factors that influence urine osmolality have not been completely identified. The aim of this study was to evaluate urine osmolality in treatment‑naïve HIV subjects and to identify the factors that may ...

  3. Assessment of complete unilateral cleft lip and palate treatment outcome using EUROCRAN index and associated factors.

    Science.gov (United States)

    Arshad, Anas Imran; Alam, Mohammad Khursheed; Khamis, Mohd Fadhli

    2017-09-01

    Assessment of treatment outcome is the only non-invasive approach to identify the effects of cleft lip and palate repair and modify management accordingly. Here the aim is to assess the outcome of complete unilateral cleft lip and palate (CUCLP) patients using EUROCRAN index and to check whether there are any factors associated with the treatment outcome. It is a retrospective cross sectional study. Dental models were collected from archives of two cleft referral centers in Pakistan. Five blinded examiners scored 101 models twice at two week interval. The primary outcome was mean EUROCRAN scores based on dental arch relationships and palatal surface morphology. A mean(SD) score of 2.72 (0.76) and 2.20 (0.73) was determined based on dental arch relationships and palatal surface morphology, respectively. According to the final logistic regression model, modified Millard technique (cheiloplasty) and Veau-Wardill-Kilners' method (palatoplasty) had higher odds of producing unfavorable treatment outcome. Present study determined a fair and a fair to poor treatment outcome based on dental arch relationships and palatal surface morphology, respectively. Our study suggests a significant association between treatment outcome and primary surgical techniques for lip and palate. These findings could warrant a modification of management protocols to ensure improvement in future cleft outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Transcript Profiling Distinguishes Complete Treatment Responders With Locally Advanced Cervical Cancer

    Directory of Open Access Journals (Sweden)

    Jorge Fernandez-Retana

    2015-04-01

    Full Text Available Cervical cancer (CC mortality is a major public health concern since it is the second cause of cancer-related deaths among women. Patients diagnosed with locally advanced CC (LACC have an important rate of recurrence and treatment failure. Conventional treatment for LACC is based on chemotherapy and radiotherapy; however, up to 40% of patients will not respond to conventional treatment; hence, we searched for a prognostic gene signature able to discriminate patients who do not respond to the conventional treatment employed to treat LACC. Tumor biopsies were profiled with genome-wide high-density expression microarrays. Class prediction was performed in tumor tissues and the resultant gene signature was validated by quantitative reverse transcription–polymerase chain reaction. A 27-predictive gene profile was identified through its association with pathologic response. The 27-gene profile was validated in an independent set of patients and was able to distinguish between patients diagnosed as no response versus complete response. Gene expression analysis revealed two distinct groups of tumors diagnosed as LACC. Our findings could provide a strategy to select patients who would benefit from neoadjuvant radiochemotherapy-based treatment.

  5. The Quality of POLST Completion to Guide Treatment: A 2-State Study.

    Science.gov (United States)

    Moss, Alvin H; Zive, Dana M; Falkenstine, Evan C; Dunithan, Courtney

    2017-09-01

    Physician Orders for Life-Sustaining Treatment (POLST) need to be complete and consistent to allow health care personnel to honor patient preferences in a time of emergency. The purpose of our study was to evaluate the quality of POLST completion to guide treatment for level of medical intervention. This cross-sectional study combined data from the Oregon and West Virginia POLST registries for the study period January 1, 2010, through December 31, 2016. All POLST form resuscitation (section A) and level of medical intervention (section B) orders were reviewed. Percent of POLST form orders in sections A and B with and without contradictions. During the study period, there were 268,386 POLST forms in the Oregon POLST Registry and 10,122 forms in the West Virginia e-Directive Registry. Of the forms, 99.2% in Oregon and 96.6% in West Virginia contained orders in both sections A and B. There were contradictions on 0.11% of forms from Oregon and 2.53% from West Virginia. The quality of POLST form completion in the Oregon and West Virginia registries is good with less than 10% of forms lacking orders in sections A and B and containing contradictory orders. This study indicates what type of results are possible with statewide education, likely through POLST Paradigm Programs. Further research is needed to determine the quality of POLST form completion in other states and other factors that contribute to their quality. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  6. Integrating the child into home and community following the completion of cancer treatment.

    Science.gov (United States)

    Labay, Larissa E; Mayans, Sherri; Harris, Michael B

    2004-01-01

    The present article examines the period of time immediately following the completion of treatment for childhood cancer. The unique concerns experienced by families at this stage of the cancer treatment are examined, and the specific challenges that children face as they renegotiate roles and relationships that are necessary for successful reintegration into family, school, and community settings are discussed. Obstacles to successful reintegration that are frequently encountered by patients and families are reviewed, as well as variables that may promote optimal adjustment during this transitional period. The need for continued research in this area is highlighted, and specific research questions are identified. An emphasis is placed on applying a socioecological framework to research and clinical work with pediatric oncology patients at this stage of the cancer experience.

  7. Life experiences of patients who have completed tuberculosis treatment: a qualitative investigation in southeast Brazil

    Science.gov (United States)

    2013-01-01

    Background Despite being curable, tuberculosis is still a stigmatized disease. Not only is TB patients’ suffering due to its clinical manifestations, but also because of society’s prejudice, embarrassing situations, and even self-discrimination. This study aims to investigate psychosocial experiences of patients who have completed tuberculosis treatment in São Carlos a municipality in the interior of São Paulo State, Brazil. Methods This study, of a clinical-qualitative nature, sought to understand the meanings provided by the participants themselves. Fifteen individuals, who had successfully completed tuberculosis treatment, participated in this research. The sample size was established using the information saturation criterion. Data were collected by means of interviews with in-depth open-ended questions. Data were treated by categorizing and analyzing content according to themes. Results Regardless of all progress, this study found that TB still causes patients to suffer from fear of transmission, social prejudice, and death. Despite the fact that the emotional support provided by families and healthcare professionals is considered essential to treatment adherence and completion, participants in this study reveal that friends and colleagues have distanced themselves from them for fear of contagion and/or prejudice. Ignorance about the disease and its transmission modes can be found in the interviewees’ statements, which seems to indicate that they have become vectors of transmission of stigma themselves. Patients’ medical leave from work during treatment may be due to both their health conditions and their attempt to avoid social/emotional embarrassment. There are accounts that TB has caused psychosocial damage to patients’ lives and that they feel more fatigue and lassitude and have begun to pay more attention to their own health. Conclusions Healthcare workers should be aware of the ways TB treatment affect patients’ psychosocial life and

  8. Functional aspects of treatment with implant-supported single crowns: a quality control study in subjects with tooth agenesis

    DEFF Research Database (Denmark)

    Goshima, Kenichi; Lexner, Michala O; Thomsen, Carsten Eckhart

    2010-01-01

    -Related Quality of Life (OHRQoL) in subjects with tooth agenesis. MATERIAL AND METHODS: In nine females and nine males (32 + or - 10 years) with agenesis treated with one to four ISSC (68% in the premolar region), the treatment effect and masticatory function were assessed. The evaluation was performed first...... after implant placement shortly before crown cementation, and again 1 month after cementation. It consisted of questionnaires [including Oral Health Impact Profile (OHIP-49)] and functional examination with plastic strips, the Dental Prescale Film and the Occluzer system, Xylitol color-changeable gum...... with ISSCs in subjects with tooth agenesis significantly increased masticatory function subjectively and clinically as well as OHRQoL. However, as the functional parameters before replacement of the teeth corresponded to values in subjects with complete dentitions, the functional importance of the increase...

  9. What factors predict individual subjects' re-learning of words during anomia treatment?

    Directory of Open Access Journals (Sweden)

    William Hayward

    2014-04-01

    Full Text Available A growing number of studies are addressing methodological approaches to treating anomia in persons with aphasia. What is missing from these studies are validated procedures for determining which words have the greatest potential for recovery. The current study evaluates the usefulness of several word-specific variables and one subject-specific measure in predicting success in re-learning problematic words. Methods: Two participants, YPR and ODH, presented with fluent aphasia and marked anomia. YPR’s Aphasia Quotient on the Western Aphasia Battery was 58.8; ODH’s AQ was 79.5. Stimuli were 96 pictures chosen individually for each participant from among those that they named incorrectly on multiple baselines. Subsequently, participants were presented with each picture and asked to indicate whether they could name it covertly, or “in their head.” Each subject completed a biweekly anomia treatment for these pictures. We performed separate statistical analyses for each subject. Dependent variables included whether each word was learned during treatment (Acquisition and the number of sessions required to learn each word (#Sessions. We used logistic regression models to evaluate the association of (self-reported covert naming success with Acquisition, and linear regression models to assess the relationship between (self-reported covert naming success and #Sessions. Starting with the predictors of covert naming accuracy, number of syllables (#syllables, number of phonemes (#phonemes, and frequency, we used backwards elimination methods to select the final regression models. Results: By the end of 25 treatment sessions, YPR had learned 90.2% (37/41 of the covertly correct words but only 70.4% (38/54 of the covertly incorrect words. In the unadjusted analysis, covert naming was significantly associated with Acquisition, OR=3.89, 95% CI: (1.19, 12.74, p=0.025. The result remained significant after adjustment for #phonemes (the only other predictor

  10. The completeness of cancer treatment data on the National Health Collections.

    Science.gov (United States)

    Gurney, Jason; Sarfati, Diana; Dennett, Elizabeth; Koea, Jonathan

    2013-08-30

    The New Zealand Ministry of Health (MoH) maintains a number of National Collections, which contain data on diagnoses, procedures and service provision for patients. There are concerns that these collections may underestimate the provision of cancer treatment, but the extent to which this is true is largely unknown. In this brief report, we focus on the Auckland region to illustrate the extent to which the National Collections undercount receipt of surgery in patients with breast, colon or renal cancer, and receipt of chemo- and/or radiotherapy for breast cancer patients with regional extent of disease (all diagnosed 2006-2008). We collected treatment data from the National collections and augmented this with data from Cancer Centres, breast cancer registers, private hospitals and personal clinician databases. The National Collections were used to determine 'baseline' treatment data, and we then compared receipt of treatment to that observed on the augmented dataset. We found that the National Collections undercounted receipt of surgery by 13-19%, and receipt of chemo- or radiotherapy for breast cancer patients by 18% and 16% respectively. Our observations clearly point toward (1) a non-reporting private hospital 'effect' on surgery data completeness; and (2) underreporting of adjuvant therapy to the MoH by service providers.

  11. Dental case manager encounters: the association with retention in dental care and treatment plan completion.

    Science.gov (United States)

    Lemay, Celeste A; Tobias, Carol; Umez-Eronini, Amarachi A; Brown, Carolyn; McCluskey, Amanda; Fox, Jane E; Bednarsh, Helene; Cabral, Howard J

    2013-01-01

    Little is known about dental case managers as few programs have been scientifically evaluated. The goal of this study was to explore the impact of dental case manager on retention in dental care and completion of treatment plans, while specifically exploring the number of dental case manager encounters. Fourteen programs enrolled people with HIV/AIDS (PLWHA) in dental care and a longitudinal study between 2007 and 2009. The 758 participants had a total of 2715 encounters with a dental case manager over twelve months: 29% had a single encounter; 21% had two; 27% had 3-4 and; 23% had 5-29 encounters. Adjusting for baseline characteristics, participants receiving more encounters were significantly more likely to complete their Phase 1 treatment plan, be retained in dental care, and experience improvements in overall oral health status. Organizations considering efforts to improve the oral health of vulnerable, hard-to-engage populations should consider these findings when planning interventions. ©2012 Special Care Dentistry Association and Wiley Periodicals, Inc.

  12. Rapid and Complete Remission of Metastatic Adrenocortical Carcinoma Persisting 10 Years After Treatment With Mitotane Monotherapy

    Science.gov (United States)

    Ghorayeb, Nada El; Rondeau, Geneviève; Latour, Mathieu; Cohade, Christian; Olney, Harold; Lacroix, André; Perrotte, Paul; Sabourin, Alexis; Mazzuco, Tania L; Bourdeau, Isabelle

    2016-01-01

    Abstract Mitotane has been used for more than 5 decades as therapy for adrenocortical carcinoma (ACC). However its mechanism of action and the extent of tumor response remain incompletely understood. To date no cases of rapid and complete remission of metastatic ACC with mitotane monotherapy has been reported. A 52-year-old French Canadian man presented with metastatic disease 2 years following a right adrenalectomy for stage III nonsecreting ACC. He was started on mitotane which was well tolerated despite rapid escalation of the dose. The patient course was exceptional as he responded to mitotane monotherapy after only few months of treatment. Initiation of chemotherapy was not needed and he remained disease-free with good quality of life on low maintenance dose of mitotane during the following 10 years. A germline heterozygous TP53 exon 4 polymorphism c.215C>G (p. Pro72Arg) was found. Immunohistochemical stainings for IGF-2 and cytoplasmic β-catenin were positive. Advanced ACC is an aggressive disease with poor prognosis and the current therapeutic options remain limited. These findings suggest that mitotane is a good option for the treatment of metastatic ACC and might result in rapid complete remission in selected patients. PMID:27043680

  13. Predictors of latent tuberculosis infection treatment completion in the US private sector: an analysis of administrative claims data.

    Science.gov (United States)

    Stockbridge, Erica L; Miller, Thaddeus L; Carlson, Erin K; Ho, Christine

    2018-05-29

    Factors that affect latent tuberculosis infection (LTBI) treatment completion in the US have not been well studied beyond public health settings. This gap was highlighted by recent health insurance-related regulatory changes that are likely to increase LTBI treatment by private sector healthcare providers. We analyzed LTBI treatment completion in the private healthcare setting to facilitate planning around this important opportunity for tuberculosis (TB) control in the US. We analyzed a national sample of commercial insurance medical and pharmacy claims data for people ages 0 to 64 years who initiated daily dose isoniazid treatment between July 2011 and March 2014 and who had complete data. All individuals resided in the US. Factors associated with treatment completion were examined using multivariable generalized ordered logit models and bivariate Kruskal-Wallis tests or Spearman correlations. We identified 1072 individuals with complete data who initiated isoniazid LTBI treatment. Treatment completion was significantly associated with less restrictive health insurance, age Private sector healthcare claims data provide insights into LTBI treatment completion patterns and patient/provider behaviors. Such information is critical to understanding the opportunities and limitations of private healthcare in the US to support treatment completion as this sector's role in protecting against and eliminating TB grows.

  14. Subjective response as a consideration in the pharmacogenetics of alcoholism treatment.

    Science.gov (United States)

    Roche, Daniel Jo; Ray, Lara A

    2015-01-01

    Currently available pharmacological treatments for alcoholism have modest efficacy and high individual variability in treatment outcomes, both of which have been partially attributed to genetic factors. One path to reducing the variability and improving the efficacy associated with these pharmacotherapies may be to identify overlapping genetic contributions to individual differences in both subjective responses to alcohol and alcoholism pharmacotherapy outcomes. As acute subjective response to alcohol is highly predictive of future alcohol related problems, identifying such shared genetic mechanisms may inform the development of personalized treatments that can effectively target converging pathophysiological mechanisms that convey risk for alcoholism. The focus of this review is to revisit the association between subjective response to alcohol and the etiology of alcoholism while also describing genetic contributions to this relationship, discuss potential pharmacogenetic approaches to target subjective response to alcohol in order to improve the treatment of alcoholism and examine conceptual and methodological issues associated with these topics, and outline future approaches to overcome these challenges.

  15. The Hepatitis C treatment experience: Patients' perceptions of the facilitators of and barriers to uptake, adherence and completion.

    Science.gov (United States)

    Sublette, Victoria A; Smith, Sian K; George, Jacob; McCaffery, Kirsten; Douglas, Mark W

    2015-01-01

    This study explores the perceptions of patients receiving treatment for Hepatitis C to determine what factors influence their decision to commence treatment, ability to maintain adherence and complete their treatment program. Semi-structured interview techniques were used in a qualitative study of 20 patients undergoing treatment for Chronic Hepatitis C (CHC). To explore patients' perceived barriers and facilitators of Hepatitis C treatment adherence and completion. Analysis of patient interviews identified four key themes: (1) motivations for commencing CHC treatment - fear of death and ridding themselves of stigma and shame; (2) the influential role of provider communication - patients reported that information and feedback that was personalised to their needs and lifestyles was the most effective for improving adherence to treatment; (3) facilitators of treatment adherence and completion - social, emotional and practical support improved adherence and completion, as did temporarily ceasing employment; (4) barriers to treatment adherence and completion - these included side effects, stigma, a complicated dosing schedule and limitations of the public healthcare system. To increase treatment adherence and completion rates, a patient-centred approach is required that addresses patients' social, practical, and emotional support needs and adaptive coping strategies.

  16. Increased cortisol awakening response after completing the summer treatment program in children with ADHD.

    Science.gov (United States)

    Okabe, Rumiko; Okamura, Hisayoshi; Egami, Chiyomi; Tada, Yasuhiro; Anai, Chizuru; Mukasa, Akiko; Iemura, Akiko; Nagamitsu, Shinichiro; Furusho, Junichi; Matsuishi, Toyojiro; Yamashita, Yushiro

    2017-08-01

    Little is known about the cortisol awakening response (CAR) in children with attention deficit hyperactivity disorder (ADHD). Here, we examined the CAR in children with ADHD and their mothers before, immediately after, and 4months after an intensive summer treatment program (STP). Participants were 37 children aged 7-12years who completed the STP in 2009 and 2010, and their mothers. Daily saliva samples for cortisol measurement were collected twice daily at awakening and 30min afterwards at pre-STP, post-STP, and during a follow-up measurement period. ADHD symptom scores were evaluated by parents, and participants completed the Kid-KINDL R QOL questionnaire. CAR was low in children with ADHD before the STP, and increased to the control range 4months after STP. Maternal CAR also tended to increase after STP. Changes in the CAR in children tended to correlate with an improved ADHD inattention scores (p=0.091), physical health (p=0.070), and school life subscales scores in the Kid-KINDL R (p=0.079). We demonstrated that STP improved the behavior and QOL of children with ADHD. Our results indicate that STP could lead to improvements in HPA axis function, as reflected by increased CAR after STP. Copyright © 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  17. Treatment of Complete and Partial Obstruction of the Nasolacrimal System with Polyurethane Stents: Initial Experience

    International Nuclear Information System (INIS)

    Pulido-Duque, Juan M.; Reyes, Ricardo; Carreira, Jose M.; Vega, Francisco; Gorriz, Elias; Pardo, M. Dolores; Perez, Francisco; Maynar, Manuel

    1998-01-01

    Purpose: To present our experience in the treatment of nasolacrimal occlusion by means of polyurethane stents. Methods: Forty polyurethane stents were placed under fluoroscopic guidance in 35 consecutive patients with epiphora due to total or partial obstruction of the nasolacrimal system. The set designed by Song was used in all patients. The procedure was performed by introducing a guidewire through the superior punctum into the canaliculus and advancing it across the obstruction into the inferior meatus of the nasal cavity. After pulling out the guidewire, the stent was advanced in retrograde fashion and released into the sac and the nasolacrimal duct.Results: The technical success rate was 100%. The average time for the procedure was 25 min (range 10-60 min). Immediate complications were: mild pain (n= 5), severe pain (n= 1), minimal epistaxis (n= 7), and moderate epistaxis (n= 1). No major complications occurred. The last clinical control revealed complete resolution of epiphora in 35 eyes and partial resolution in four; one patient did not improve. Conclusion: This technique for treatment of obstruction of the nasolacrimal system is simple and safe, and may obviate the use of more invasive procedures

  18. Women’s experiences and preferences regarding breast imaging after completing breast cancer treatment

    Directory of Open Access Journals (Sweden)

    Brandzel S

    2017-02-01

    Full Text Available Susan Brandzel,1 Dori E Rosenberg,1 Dianne Johnson,1 Mary Bush,1 Karla Kerlikowske,2–5 Tracy Onega,6,7 Louise Henderson,8 Larissa Nekhlyudov,9,10 Wendy DeMartini,11 Karen J Wernli1 1Group Health Research Institute, Group Health Cooperative, Seattle, WA, 2Department of Medicine, 3Department of Epidemiology, 4Department of Biostatistics, 5Department of Veterans Affairs, University of California, San Francisco, San Francisco, CA, 6Department of Biomedical Data Science, 7Department of Epidemiology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH, 8Department of Radiology, University of North Carolina, Chapel Hill, NC, 9Department of Population Medicine, Harvard Medical School, 10Department of Medicine, Brigham and Women’s Hospital, Boston, MA, 11Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA Background: After treatment for breast cancer, most women receive an annual surveillance mammography to look for subsequent breast cancers. Supplemental breast MRI is sometimes used in addition to mammography despite the lack of clinical evidence for it. Breast imaging after cancer treatment is an emotionally charged experience, an important part of survivorship care, and a topic about which limited patient information exists. We assessed women’s experiences and preferences about breast cancer surveillance imaging with the goal of determining where gaps in care and knowledge could be filled. Participants and methods: We conducted six focus groups with a convenience sample of 41 women in California, North Carolina, and New Hampshire (USA. Participants were aged 38–75 years, had experienced stage 0–III breast cancer within the previous 5 years, and had completed initial treatment. We used inductive thematic analysis to identify key themes from verbatim transcripts. Results: Women reported various types and frequencies of surveillance imaging and a range of surveillance imaging

  19. Predicting Rapid Relapse Following Treatment for Chemical Dependence: A Matched-Subjects Design.

    Science.gov (United States)

    Svanum, Soren; McAdoo, William George

    1989-01-01

    Persons who underwent residential treatment for chemical dependency were identified as three-month treatment failures (N=52) or successes (N=52). Subjects were matched on Minnesota Multiphasic Personality Inventory (MMPI) scores. Found posttreatment depression, anxiety, and sleep problems strongly related to failure among psychiatric MMPI group;…

  20. Initial treatment of complete rotator cuff tear and transition to surgical treatment: systematic review of the evidence

    Science.gov (United States)

    Abdul-Wahab, Taiceer A.; Betancourt, Jean P.; Hassan, Fadi; Thani, Saeed Al.; Choueiri, Hened; Jain, Nitin B.; Malanga, Gerard A.; Murrell, William D.; Prasad, Anil; Verborgt, Olivier

    2016-01-01

    Summary Background rotator cuff tear affects many people. Natural history, and evidence for non-operative treatment remains limited. Our objective is to assess evidence available for the efficacy and morbidity of commonly used systemic medications, physiotherapy, and injections alongside evaluating any negative long-term effects. Methods a systematic search was performed of PubMed, Cochrane, EMBASE and CINAHL dates (1 January 1960 – 1 December 2014), search terms: ‘rotator cuff tear’, ‘natural history’, ‘atraumatic’, ‘injection’, ‘physiotherapy’ or ‘physical therapy’, ‘injection’, ‘corticosteroid’, ‘PRP‘, ‘MSC’, risk of conservative treatment’, and ‘surgical indication’. Results eleven studies were included. The mean Coleman Methodology Score modified for conservative therapy is 69.21 (range 88–44) (SD 12.31). This included 2 RCTs, 7 prospective, and 2 retrospective studies. Evidence suggests it is safe to monitor symptomatic rotator cuff tears, as tear size and symptoms are not correlated with pain, function, and/or ultimate outcome. Conclusions complete rotator cuff tears may be effectively treated with injections, exercise in the short and intermediate terms respectively. Negative effect of corticosteroids on rotator cuff tissue has not been demonstrated. Timing to end conservative treatment is unknown, but likely indicated when a patient demonstrates increased weakness and loss of function not recoverable by physiotherapy. PMID:27331030

  1. Predictors of Treatment Completion for Families Referred to Trauma Focused-Cognitive Behavioral Therapy after Child Abuse.

    Science.gov (United States)

    Celano, Marianne; NeMoyer, Amanda; Stagg, Anna; Scott, Nikia

    2018-05-22

    Despite advances in the dissemination of evidence-based therapy for abuse-related traumatic stress, many referred children fail to complete treatment. Using archival data from a sample of children participating in trauma-focused cognitive behavioral therapy (TF-CBT) at a hospital-based child advocacy center, analyses explored the impact of baseline child traumatic stress symptoms, a second (nonprimary) caregiver's treatment attendance, and the number of assessment sessions on treatment completion while controlling for demographic variables. We conducted analyses separately for the total sample (n = 77) and for a subsample of children 6 years of age or older (n = 65) who completed measures of traumatic stress. Families who completed TF-CBT had fewer pretreatment assessment sessions, odds ratio (OR) = 0.41, 95% CI [0.19, 0.88], and greater nonprimary caregiver session attendance, OR = 1.30, 95% CI [1.03, 1.64], than families who did not complete treatment. Child age, race, and insurance status did not predict treatment completion. Among children at least 6 years of age, treatment completion was related to younger child age, OR = 0.76, 95% CI [0.59, 0.98], and fewer diagnostic evaluation sessions, OR = 0.29, 95% CI [0.11, 0.74], but not to baseline traumatic stress symptoms. Findings may suggest benefits of shortening the assessment period and including a second caregiver in TF-CBT. Copyright © 2018 International Society for Traumatic Stress Studies.

  2. Completion of Multidisciplinary Treatment for Persistent Postconcussive Symptoms Is Associated With Reduced Symptom Burden.

    Science.gov (United States)

    Janak, Jud C; Cooper, Douglas B; Bowles, Amy O; Alamgir, Abul H; Cooper, Sharon P; Gabriel, Kelley P; Pérez, Adriana; Orman, Jean A

    To investigate the pre- to posttreatment changes in both posttraumatic stress disorder (PTSD) and persistent postconcussive symptoms (PPCSs). We studied 257 active-duty patients with a history of mild traumatic brain injury (mTBI) who completed multidisciplinary outpatient treatment at Brooke Army Medical Center TBI Clinic from 2008 to 2013. This treatment program included cognitive rehabilitation; vestibular interventions; headache management; and integrated behavioral healthcare to address co-occurring psychiatric conditions such as PTSD, depression, and sleep disturbance. A 1-group; preexperimental, pre- to posttreatment study. The Neurobehavioral Symptom Inventory (NSI) was used to assess PPCSs, and the PTSD Checklist-Military Version (PCL-M) was used to asses PTSD symptoms. Global PPCS resolution (mean NSI: 35.0 pre vs 23.8 post; P < .0001; d = 0.72) and PTSD symptom resolution (mean PCL-M: 43.2 pre vs 37.7 post; P < .0001; d = 0.34) were statistically significant. Compared with those with only mTBI, patients with mTBI and PTSD reported greater global PPCS impairment both pretreatment (mean NSI: 48.7 vs 27.9; P < .0001) and posttreatment (mean NSI: 36.2 vs 17.4; P < .0001). After adjusting for pretreatment NSI scores, patients with comorbid PTSD reported poorer PPCS resolution than those with mTBI alone (mean NSI: 27.9 pre vs 21.7 post; P = .0009). We found a reduction in both self-reported PPCSs and PTSD symptoms; however, future studies are needed to identify specific components of care associated with symptom reduction.

  3. Benzo(A)pyrene (BaP) treatment results in complete infertility in female pigeons

    Energy Technology Data Exchange (ETDEWEB)

    Hough, J.L.; Darrow, D.; Eaton, J.; Baird, M.B. (Masonic Medical Research Lab., Utica, NY (United States))

    1991-03-11

    BaP is a carcinogenic polycyclic aromatic hydrocarbon (PAH) and a common environmental pollutant. Show Racer and White Carneau female pigeons injected weekly with BaP for 3 for 5 months were completely infertile, with ovaries appearing necrotic or oxidized. Fertility in benzo(e)pyrene (BeP, a noncarcinogenic PAH) treated birds was the same as for corn oil treated controls, as was embryo development. Thus, infertility in BaP treated birds appears to be related to its structure-carcinogenic potential. There was no readily apparent affect of BaP treatment on testes from male birds. In order to determine whether BaP metabolites covalently bind to DNA in the ovaries of these birds, pigeons were injected with BaP or BeP, controls were injected with corn oil. Animals were sacrificed 24h later, the ovaries or testes removed, and the DNA isolated and analyzed for PAH-DNA adducts by {sup 32}P-post labeling assay. One major and one minor PAH-DNA adduct was found in ovaries and testes from BaP treated birds. However, no PAH adducts were found in BeP treated or control animals. Thus, problems with fertility may arise because of the alteration in DNA by BaP metabolite binding in ovaries where rapid cell growth occurs during egg production.

  4. Noradrenergic α1 Receptor Antagonist Treatment Attenuates Positive Subjective Effects of Cocaine in Humans: A Randomized Trial

    Science.gov (United States)

    Newton, Thomas F.; De La Garza, Richard; Brown, Gregory; Kosten, Thomas R.; Mahoney, James J.; Haile, Colin N.

    2012-01-01

    Background Preclinical research implicates dopaminergic and noradrenergic mechanisms in mediating the reinforcing effects of drugs of abuse, including cocaine. The objective of this study was to evaluate the impact of treatment with the noradrenergic α1 receptor antagonist doxazosin on the positive subjective effects of cocaine. Methods Thirteen non-treatment seeking, cocaine-dependent volunteers completed this single-site, randomized, placebo-controlled, within-subjects study. In one study phase volunteers received placebo and in the other they received doxazosin, with the order counterbalanced across participants. Study medication was masked by over-encapsulating doxazosin tablets and matched placebo lactose served as the control. Study medication treatment was initiated at 1 mg doxazosin or equivalent number of placebo capsules PO/day and increased every three days by 1 mg. After receiving 4 mg doxazosin or equivalent number of placebo capsules participants received masked doses of 20 and 40 mg cocaine IV in that order with placebo saline randomly interspersed to maintain the blind. Results Doxazosin treatment was well tolerated and doxazosin alone produced minimal changes in heart rate and blood pressure. During treatment with placebo, cocaine produced dose-dependent increases in subjective effect ratings of “high”, “stimulated”, “like cocaine”, “desire cocaine”, “any drug effect”, and “likely to use cocaine if had access” (p<.001). Doxazosin treatment significantly attenuated the effects of 20 mg cocaine on ratings of “stimulated”, “like cocaine”, and “likely to use cocaine if had access” (p<.05). There were trends for doxazosin to reduce ratings of “stimulated”, “desire cocaine”, and “likely to use cocaine if had access” (p<.10). Conclusions Medications that block noradrenergic α1 receptors, such as doxazosin, may be useful as treatments for cocaine dependence, and should be evaluated further. Trial

  5. Dental implant treatment following trauma: An investigation into the failure to complete Accident Compensation Corporation funded care.

    Science.gov (United States)

    Kennedy, R; Murray, C; Leichter, J

    2016-03-01

    Among other restorative strategies, the Accident Compensation Corporation (ACC) provides benefits for dental implant treatment to replace teeth lost as a result of trauma. While ACC has funded over 15,000 dental implants since 2002, the outcomes of this treatment and patient perceptions of this treatment have not been investigated. The aim of this study was to investigate the perceptions of the dental implant treatment outcomes and reasons for failure to complete restorative treatment in patients who had undergone trauma-related implant surgery funded by ACC between February 2006 and September 2009, but had not completed the prosthetic component of the treatment. A randomly selected sample of 399 patients, who had undergone dental implant surgery but not completed the crown restoration, was identified from the ACC database. These individuals were contacted by mail for expressions of interest and 181 clients were interviewed by telephone. Responses to open-ended questions were entered into an Excel spreadsheet and analysed using a general inductive technique. A common emergent theme was the high level of satisfaction expressed by participants with the implant process, however just under half of those responding felt they had been pushed into having implants and were given the impression that this was the only treatment ACC paid for. The cost of the prosthetic phase of the treatment and surgical complications were identified as the primary reasons why participants failed to complete the restorative phase of treatment, after completing the surgical phase. The results highlighted the need to better inform patients of their treatment options and to allow time for them to process this information before progressing with care. A patient decision tool may help to give greater ownership of the treatment options. Newly implemented protocols to assist dentists to better assess treatment needs may also assist in achieving improvements in perceived treatment outcomes for

  6. Treatment and post-treatment effects of facemask therapy on the sagittal pharyngeal dimensions in Class III subjects.

    Science.gov (United States)

    Baccetti, Tiziano; Franchi, Lorenzo; Mucedero, Manuela; Cozza, Paola

    2010-06-01

    The purpose of this cephalometric study was to analyse the treatment and post-treatment craniofacial effects of a facemask (FM) combined with a bite block (BB) with specific regard to the sagittal pharyngeal dimensions in subjects with a Class III malocclusion when compared with an untreated Class III control group. The FM/BB group (22 subjects, 12 females and 10 males) had a mean age pre-treatment (T1) of 8.9 +/- 1.5 years, at the end of active treatment (T2) of 10.5 +/- 1.3 years, and post-treatment (T3) of 12.6 +/- 1.9 years. The treated group was compared with a control group of 14 subjects (6 females and 8 males) with untreated Class III malocclusions that matched the FM/BB group as to age at T1, T2, and T3, observation periods and skeletal maturation. Comparisons of the T2-T1 and T3-T1 changes between the two groups were analysed with the Mann-Whitney test. Significant favourable skeletal changes in the maxilla and mandible were observed in the treated group both after Ts2 and T3. No significant short- or long-term changes in the sagittal oropharyngeal and nasopharyngeal airway dimensions were induced by maxillary protraction in subjects with a Class III malocclusion when compared with untreated controls.

  7. SUBJECTIVE DISTRESS CAUSED BY CO-SPEAKERS’ REACTIONS – REDUCTION DURING STATIONARY GROUP TREATMENT

    Directory of Open Access Journals (Sweden)

    Jelena TADIKJ

    2010-04-01

    Full Text Available Stuttering is a disorder that represents multifunctional problem. It probably exists since the beginning of mankind. Its’ frequency and severity are influenced by different factors. Among the most significant ones are the complexity of statement, speaking speed, and speakers’ emotional reaction to the whole speech situation and other co-speakers. Goal: To present the results of two-weeks intensive group stationary treatment of adults who stutter, especially stuttering severity and level of subjective distress caused by co-speakers’ reactions in the beginning and at the end of the treatment. Subjects: A group of 25 adults who stutter. Methodology: At the beginning and at the end of the group stationary treatment speech status was taken, consisting of counting, enumerating, repeating the sentences, reading a 100-word tale, retelling the read text, and conversation on a free subject. In the same time, subjective distress caused by 13 different co-speakers reactions was estimated. Results show that very positive results are achieved in the reduction of speech disfluences, as well as moderate reduction of subjective distress caused by co-speakers’ reactions. In the paper the results are shown in more details, and, subsequently, implications for further research and treatment.

  8. Clinical treatment planning for subjects undergoing boron neutron capture therapy at Harvard-MIT

    International Nuclear Information System (INIS)

    Zamenhof, R.G.; Palmer, M.R.; Buse, P.M.

    2001-01-01

    Treatment planning is a crucial component of the Harvard-MIT boron neutron capture therapy (BNCT) clinical trials. Treatment planning can be divided into five stages: (1) pre-planning, based on CT and MRI scans obtained when the subject arrives at the hospital and on assumed boron-10 distribution parameters; (2) subject set-up, or simulation, in the MITR-II medical therapy room to determine the boundary conditions for possible set-up configurations; (3) re-planning, following the subject simulation; (4) final localization of the subject in the medical therapy room for BNCT; and (5) final post facto recalculation of the doses delivered based on firm knowledge of the blood boron-10 concentration profiles and the neutron flux histories from precise online monitoring. The computer-assisted treatment planning is done using a specially written BNCT treatment planning code called MacNCTPLAN. The code uses the Los Alamos National Laboratory's Monte Carlo n-particle radiation transport code MCNPv.4b as the dose calculation engine and advanced anatomical model simulation based on an automatic evaluation of CT scan data. Results are displayed as isodose contours and dose-volume histograms, the latter correlated precisely with corresponding anatomical CT or MRI image planes. Examples of typical treatment planning scenarios will be presented. (author)

  9. The efficacy of individual treatment of subjective tinnitus with cognitive behavioural therapy.

    Science.gov (United States)

    Canals, Pascual; Pérez Del Valle, Belén; Lopez, Francisco; Marco, Amparo

    2016-01-01

    It has been a long time since subjective tinnitus cases were described for the first time but they still lack a treatment with proven effectiveness. The main goal of this study was to evaluate the effectiveness of cognitive behavioural therapy in these patients. Between 2012 and 2013, 310 patients that suffered from subjective tinnitus were studied. Of these, 267 were included in treatment based on cognitive behavioural therapy. The monitoring period lasted 18 months for most cases, while it lasted 21 months for 11 patients. Considering patients that interrupted their treatment as failures, the percentage of recovery was 95.7%. Cognitive behavioural therapy should always be included in the treatment of people suffering from tinnitus. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  10. Complete histological regression of Kaposi's sarcoma following treatment with protease inhibitors despite persistence of HHV-8 in lesions

    DEFF Research Database (Denmark)

    Benfield, T L; Kirk, O; Elbrønd, B

    1998-01-01

    There is no current curative treatment for HIV-related Kaposi's sarcoma. The identification of human herpesvirus-8 as a possible aetiological agent suggests potential efficacy of anti-viral agents. We report here on the complete histological remission of Kaposi's sarcoma following treatment...

  11. [The combined treatment of dysphonia in the subjects engaged in the voice and speech professions].

    Science.gov (United States)

    Stepanova, Yu E; Gotovyakhina, T V; Korneenkov, A A; Koren', E E

    The objective of the present study was to evaluate the effectiveness of the application of homeovox for the combined treatment of small vocal cord nodules and acute laryngitis in the professional voice users. A total of 40 subjects presenting with dysphonia were examined after they were divided into two study groups and two groups of comparison depending on the nosological form of the pathological condition. The subjects comprising the study groups were given traditional therapy in the combination with the intake of homeovox whereas the patients included in the two groups of comparison received the traditional treatment alone. The outcome of the treatment was evaluated on days 1, 5, and 10 after the initiation of therapy based on the analysis of the changes in the videoendostroboscopic picture of the larynx and the acoustic characteristics obtained by the computer-assisted analysis of the voice. The analysis of the results of the combined treatment has demonstrated the statistically significant differences in some acoustic parameters of the voice between the subjects with small vocal cord nodules and acute laryngitis belonging to the study groups and the groups of comparison. It is concluded that the introduction of homeovox in the combined treatment of the patients presenting with the small nodules in the vocal cords and acute catarrhal laryngitis accelerates the recovery of the acoustic characteristics of the voice within various periods after the onset of the treatment in comparison with the patients treated with the use of traditional therapy alone.

  12. Changes in head and cervical-spine postures and EMG activities of masticatory muscles following treatment with complete upper and partial lower denture.

    Science.gov (United States)

    Salonen, M A; Raustia, A M; Huggare, J A

    1994-10-01

    A clinical stomatognathic, cephalometric and electromyographic (EMG) study was performed in relation to 14 subjects (10 women, 4 men), each with an edentulous maxilla and residual mandibular dentition before and six months after treatment with complete upper and partial lower dentures. The mean age of the subjects was 54.4 years (range 43-64 years). The mean period of edentulousness and age of dentures were 22.5 years (range 15-33 years) and 14.1 (range 1.5-30 years), respectively. Natural head position was recorded (using a fluid-level method) and measured from cephalograms. EMG activity was measured in relation to masseter and temporal muscles. A decrease in clinical dysfunction index was noted in 12 of 14 subjects (86%). There was no change in cervical inclination, but a slight extension of the head was noted after treatment. Rapid recovery of the masticatory muscles was reflected in increased EMG activity, especially when biting in the maximal intercuspal position. In cases of edentulous maxilla and residual mandibular anterior dentition, treatment with a complete upper and lower partial denture had a favorable effect on craniomandibular disorders and masticatory-muscle function.

  13. The value of completion axillary treatment in sentinel node positive breast cancer patients undergoing a mastectomy: a Dutch randomized controlled multicentre trial (BOOG 2013-07)

    International Nuclear Information System (INIS)

    Roozendaal, L. M. van; Wilt, J. HW de; Dalen, T. van; Hage, J. A. van der; Strobbe, L. JA; Boersma, L. J.; Linn, S. C.; Lobbes, M. BI; Poortmans, P. MP; Tjan-Heijnen, V. CG; Van de Vijver, K. KBT; Vries, J. de; Westenberg, A. H.; Kessels, A. GH; Smidt, M. L.

    2015-01-01

    Trials failed to demonstrate additional value of completion axillary lymph node dissection in case of limited sentinel lymph node metastases in breast cancer patients undergoing breast conserving therapy. It has been suggested that the low regional recurrence rates in these trials might partially be ascribed to accidental irradiation of part of the axilla by whole breast radiation therapy, which precludes extrapolation of results to mastectomy patients. The aim of the randomized controlled BOOG 2013–07 trial is therefore to investigate whether completion axillary treatment can be safely omitted in sentinel lymph node positive breast cancer patients treated with mastectomy. This study is designed as a non-inferiority randomized controlled multicentre trial. Women aged 18 years or older diagnosed with unilateral invasive clinically T1-2 N0 breast cancer who are treated with mastectomy, and who have a maximum of three axillary sentinel lymph nodes containing micro- and/or macrometastases, will be randomized for completion axillary treatment versus no completion axillary treatment. Completion axillary treatment can consist of completion axillary lymph node dissection or axillary radiation therapy. Primary endpoint is regional recurrence rate at 5 years. Based on a 5-year regional recurrence free survival rate of 98 % among controls and 96 % for study subjects, the sample size amounts 439 per arm (including 10 % lost to follow-up), to be able to reject the null hypothesis that the rate for study and control subjects is inferior by at least 5 % with a probability of 0.8. Results will be reported after 5 and 10 years of follow-up. We hypothesize that completion axillary treatment can be safely omitted in sentinel node positive breast cancer patients undergoing mastectomy. If confirmed, this study will significantly decrease the number of breast cancer patients receiving extensive treatment of the axilla, thereby diminishing the risk of morbidity and improving quality of

  14. Fractal structure formation on the surfaces of solids subjected to high intensity electron and ion treatment

    International Nuclear Information System (INIS)

    Altajskij, M.V.; Ivanov, V.V.; Korenev, S.A.; Orelovich, O.L.; Puzynin, I.V.; Chernik, V.V.

    1997-01-01

    We discuss the results of scanning electron microscopy of surfaces of the solids subjected to high intensity electron and ion beam treatment. The appearance of fractal structures on the modified surfaces is shown. The fractal dimensions of these structures were estimated by box-counting algorithm

  15. Urine Osmolality in Treatment-naïve HIV-positive Subjects in ...

    African Journals Online (AJOL)

    2017-03-01

    Mar 1, 2017 ... commonly evaluated in routine clinical practice and in human ... the variables and urine osmolality and the strength of variables to ... function, and weight were common in treatment-naïve HIV subjects who had ... Nigeria, underweight and obesity, urine osmolality ..... associated with a salt-losing syndrome.

  16. Chernobyl NPP: Completion of LRW Treatment Plant and LRW Management on Site - 12568

    Energy Technology Data Exchange (ETDEWEB)

    Fedorov, Denis; Adamovich, Dmitry [SIA ' RADON' , Moscow (Russian Federation); Klimenko, I.; Taranenko, L. [IVL Engineering, Kiev (Ukraine)

    2012-07-01

    Since a beginning of ChNPP operation, and after a tragedy in 1986, a few thousands m3 of LRW have been collected in a storage tanks. In 2004 ChNPP started the new project on creation of LRW treatment plant (LRWTP) financed from EBRD fund. But it was stopped in 2008 because of financial and contract problems. In 2010 SIA RADON jointly with Ukrainian partners has won a tender on completion of LRWTP, in particular I and C system. The purpose of LRTP is to process liquid rad-wastes from SSE 'Chernobyl NPP' site and those liquids stored in the LRWS and SLRWS tanks as well as the would-be wastes after ChNPP Power Units 1, 2 and 3 decommissioning. The LRTP design lifetime - 20 years. Currently, the LRTP is getting ready to perform the following activities: 1. retrieval of waste from tanks stored at ChNPP LWS using waste retrieval system with existing equipment involved; 2. transfer of retrieved waste into LRTP reception tanks with partial use of existing transfer pipelines; 3. laboratory chemical and radiochemical analysis of reception tanks contest to define the full spectrum of characteristics before processing, to acknowledge the necessity of preliminary processing and to select end product recipe; 4. preliminary processing of the waste to meet the requirements for further stages of the process; 5. shrinkage (concentrating) of preliminary processed waste; 6. solidification of preliminary processed waste with concrete to make a solid-state (end product) and load of concrete compound into 200-l drums; 7. curing of end product drums in LRTP curing hall; 8. radiologic monitoring of end product drums and their loading into special overpacks; 9. overpack radiological monitoring; 10. send for disposal (ICSRM Lot 3); The current technical decisions allow to control and return to ChNPP of process media and supporting systems outputs until they satisfy the following quality norms: salt content: < 100 g/l; pH: 1 - 11; anionic surface-active agent: < 25 mg/l; oil

  17. Treatment with sirolimus results in complete responses in patients with autoimmune lymphoproliferative syndrome

    Science.gov (United States)

    Teachey, David T.; Greiner, Robert; Seif, Alix; Attiyeh, Edward; Bleesing, Jack; Choi, John; Manno, Catherine; Rappaport, Eric; Schwabe, Dirk; Sheen, Cecilia; Sullivan, Kathleen E.; Zhuang, Hongming; Wechsler, Daniel S.; Grupp, Stephan A.

    2010-01-01

    Summary We hypothesized that sirolimus, an mTOR inhibitor, may be effective in patients with autoimmune lymphoproliferative syndrome (ALPS) and treated patients who were intolerant to or failed other therapies. Four patients were treated for autoimmune cytopenias; all had a rapid complete or near complete response. Two patients were treated for autoimmune arthritis and colitis, demonstrating marked improvement. Three patients had complete resolution of lymphadenopathy and splenomegaly and all patients had a reduction in double negative T cells, a population hallmark of the disease. Based on these significant responses, we recommend that sirolimus be considered as second-line therapy for patients with steroid-refractory disease. PMID:19208097

  18. Long-Term Quality of Life Improvement in Subjects with Healed Erosive Esophagitis: Treatment with Lansoprazole

    Science.gov (United States)

    Freston, James W.; Haber, Marian M.; Atkinson, Stuart; Hunt, Barbara; Peura, David A.

    2009-01-01

    Background Gastroesophageal reflux disease (GERD) is a chronic symptomatic condition and may be associated with erosive esophagitis (EE). Considerable data on the long-term maintenance of healing of EE are available, but data on long-term GERD symptom prevention and patient quality of life (QOL) are limited. Aims To investigate QOL in subjects with healed EE who received 12 months of double-blind maintenance treatment with lansoprazole or ranitidine, followed by long-term open-label lansoprazole therapy to prevent recurrence of EE. Methods Subjects with healed EE received 12 months of double-blind maintenance treatment with lansoprazole 15 mg once daily or ranitidine 150 mg twice daily, followed by dose-titrated, open-label lansoprazole therapy for up to 82 months. Results During double-blind treatment (n = 206), lansoprazole-treated patients showed significantly (P ≤ 0.05) greater improvements than ranitidine-treated patients in the frequency, severity, and ‘bothersomeness’ of heartburn, the symptom index, problems of activity limitation, eating and drinking problems, symptom problems, health distress, and social functioning. During dose-titrated, open-label treatment (n = 195), all disease-specific QOL scales except sleep improved significantly (P lansoprazole for 12 months in healed EE subjects produced significantly greater improvements in QOL indicators than ranitidine. These improvements were sustained during dose-titrated, open-label lansoprazole treatment. PMID:19582579

  19. Access and completion of a Web-based treatment in a population-based sample of tornado-affected adolescents.

    Science.gov (United States)

    Price, Matthew; Yuen, Erica K; Davidson, Tatiana M; Hubel, Grace; Ruggiero, Kenneth J

    2015-08-01

    Although Web-based treatments have significant potential to assess and treat difficult-to-reach populations, such as trauma-exposed adolescents, the extent that such treatments are accessed and used is unclear. The present study evaluated the proportion of adolescents who accessed and completed a Web-based treatment for postdisaster mental health symptoms. Correlates of access and completion were examined. A sample of 2,000 adolescents living in tornado-affected communities was assessed via structured telephone interview and invited to a Web-based treatment. The modular treatment addressed symptoms of posttraumatic stress disorder, depression, and alcohol and tobacco use. Participants were randomized to experimental or control conditions after accessing the site. Overall access for the intervention was 35.8%. Module completion for those who accessed ranged from 52.8% to 85.6%. Adolescents with parents who used the Internet to obtain health-related information were more likely to access the treatment. Adolescent males were less likely to access the treatment. Future work is needed to identify strategies to further increase the reach of Web-based treatments to provide clinical services in a postdisaster context. (c) 2015 APA, all rights reserved).

  20. Predictive Clinical Parameters and Glycemic Efficacy of Vildagliptin Treatment in Korean Subjects with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Jin-Sun Chang

    2013-02-01

    Full Text Available BackgroundThe aims of this study are to investigate the glycemic efficacy and predictive parameters of vildagliptin therapy in Korean subjects with type 2 diabetes.MethodsIn this retrospective study, we retrieved data for subjects who were on twice-daily 50 mg vildagliptin for at least 6 months, and classified the subjects into five treatment groups. In three of the groups, we added vildagliptin to their existing medication regimen; in the other two groups, we replaced one of their existing medications with vildagliptin. We then analyzed the changes in glucose parameters and clinical characteristics.ResultsUltimately, 327 subjects were analyzed in this study. Vildagliptin significantly improved hemoglobin A1c (HbA1c levels over 6 months. The changes in HbA1c levels (ΔHbA1c at month 6 were -2.24% (P=0.000, -0.77% (P=0.000, -0.80% (P=0.001, -0.61% (P=0.000, and -0.34% (P=0.025 for groups 1, 2, 3, 4, and 5, respectively, with significance. We also found significant decrements in fasting plasma glucose levels in groups 1, 2, 3, and 4 (P<0.05. Of the variables, initial HbA1c levels (P=0.032 and history of sulfonylurea use (P=0.026 were independently associated with responsiveness to vildagliptin treatment.ConclusionVildagliptin was effective when it was used in subjects with poor glycemic control. It controlled fasting plasma glucose levels as well as sulfonylurea treatment in Korean type 2 diabetic subjects.

  1. The outcome of tuberculosis treatment in subjects with chronic kidney disease in Brazil: a multinomial analysis

    Directory of Open Access Journals (Sweden)

    Barbara Reis-Santos

    2013-09-01

    Full Text Available OBJECTIVE: To analyze the association between clinical/epidemiological characteristics and outcomes of tuberculosis treatment in patients with concomitant tuberculosis and chronic kidney disease (CKD in Brazil. METHODS: We used the Brazilian Ministry of Health National Case Registry Database to identify patients with tuberculosis and CKD, treated between 2007 and 2011. The tuberculosis treatment outcomes were compared with epidemiological and clinical characteristics of the subjects using a hierarchical multinomial logistic regression model, in which cure was the reference outcome. RESULTS: The prevalence of CKD among patients with tuberculosis was 0.4% (95% CI: 0.37-0.42%. The sample comprised 1,077 subjects. The outcomes were cure, in 58%; treatment abandonment, in 7%; death from tuberculosis, in 13%; and death from other causes, in 22%. The characteristics that differentiated the ORs for treatment abandonment or death were age; alcoholism; AIDS; previous noncompliance with treatment; transfer to another facility; suspected tuberculosis on chest X-ray; positive results in the first smear microscopy; and indications for/use of directly observed treatment, short-course strategy. CONCLUSIONS: Our data indicate the importance of sociodemographic characteristics for the diagnosis of tuberculosis in patients with CKD and underscore the need for tuberculosis control strategies targeting patients with chronic noncommunicable diseases, such as CKD.

  2. Completion of Limitation of Medical Treatment forms by junior doctors for patients with dementia: clinical, medicolegal and education perspectives.

    Science.gov (United States)

    Yoong, Jaclyn; MacPhail, Aleece; Trytel, Gael; Rajendram, Prashanti Yalini; Winbolt, Margaret; Ibrahim, Joseph E

    2017-10-01

    Objective Limitation of Medical Treatment (LMT) forms are an essential element of end-of-life care. Decision making around LMT is complex and often involves patients with dementia. Despite the complexity, junior doctors frequently play a central role in completing LMT forms. The present study sought perspectives from a range of stakeholders (hospital clinicians, medical education personnel, legal and advocacy staff) about junior doctors' roles in completing LMT forms in general and for patients with dementia. Methods Qualitative data were gathered in semi-structured interviews (SSI) and theoretical concepts were explored in roundtable discussion (RD). Participants were recruited through purposive and convenience sampling drawing on healthcare and legal personnel employed in the public hospital and aged care systems, selected from major metropolitan hospitals, healthcare and legal professional bodies and advocacy organisations in Victoria, Australia. The contents of the SSIs and RD were subject to thematic analysis using a framework approach. Data were indexed according to the topics established in the study aim; categories were systematically scrutinised, from which key themes were distilled. Results Stakeholders reported that completing LMT forms was difficult for junior doctors because of a lack of medical and legal knowledge, as well as clinical inexperience and inadequate training. Healthcare organisations (HCOs) either lacked policies about the role of junior doctors or had practices that were discordant with policy. In this process, there were substantial gaps pertaining to patients with dementia. Recommendations made by the study participants included the provision of supervised clinical exposure and additional training for junior doctors, strengthening HCO policies and explicit consideration of the needs of patients with dementia. Conclusions LMT forms should be designed for clarity and consistency across HCOs. Enhancing patient care requires appropriate

  3. Trismus following different treatment modalities for head and neck cancer: a systematic review of subjective measures.

    Science.gov (United States)

    Loh, Sook Y; Mcleod, Robert W J; Elhassan, Hassan A

    2017-07-01

    The aim of this review was to compare systematically the subjective measure of trismus between different interventions to treat head and neck cancer, particularly those of the oropharynx. Using The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) Guidelines, Six databases were searched for the text using various terms which include "oropharyngeal/head and neck cancer", "trismus/mouth opening" and the various treatment modalities. Included in the review were clinical studies (> or =10 patients). Three observers independently assessed the papers identified. Among the six studies reviewed, five showed a significantly worst outcome with regard to the quality-of-life questionnaire scores for a radiotherapy or surgery and radiotherapy (RT) ± chemotherapy or chemoradiotherapy when compared to surgery alone. Only one study showed no significant difference between surgery alone and other treatment modalities. Subjective quality-of-life measures are a concurrent part of modern surgical practice. Although subjective measures were utilised to measure post operative trismus successfully, there was no consensus as to which treatment modality had overall better outcomes, with conflicting studies in keeping with the current debate in this field. Larger and higher quality studies are needed to compare all three treatment modalities.

  4. Body attitudes in patients with eating disorders at presentation and completion of intensive outpatient day treatment.

    NARCIS (Netherlands)

    Exterkate, C.C.; Vriesendorp, P.F.; Jong, C.A.J. de

    2009-01-01

    Due to the importance of the distorted body experience in eating disorder diagnosis and treatment, we wanted to explore body attitudes of patients with eating disorders before and after 5 months of intensive specialized outpatient day treatment. We assessed 193 patients diagnosed with Anorexia

  5. Three case reports demonstrating treatment of relatively complex orthodontic cases using a completely customised lingual appliance.

    Science.gov (United States)

    Buckley, John

    2016-01-01

    It is a commonly held misconception among Irish dentists that only minor malocclusions can be treated with lingual appliances. This article demonstrates the use of contemporary completely customised lingual orthodontic appliances to treat a diverse range of malocclusions, to a satisfactory level, and thereby may disabuse clinicians of the belief that only minor malocclusions can be treated with lingual appliances.

  6. ITER central solenoid model coil heat treatment complete and assembly started

    International Nuclear Information System (INIS)

    Thome, R.J.; Okuno, K.

    1998-01-01

    A major R and D task in the ITER program is to fabricate a Superconducting Model Coil for the Central Solenoid to establish the design and fabrication methods for ITER size coils and to demonstrate conductor performance. Completion of its components is expected in 1998, to be followed by assembly with structural components and testing in a facility at JAERI

  7. OBJECTIVE AND SUBJECTIVE EVALUATION OF ADOLESCENT'S ORTHODONTIC TREATMENT NEEDS AND THEIR IMPACT ON SELF-ESTEEM.

    Science.gov (United States)

    Sharma, Anshika; Mathur, Anmol; Batra, Manu; Makkar, Diljot Kaur; Aggarwal, Vikram Pal; Goyal, Nikita; Kaur, Puneet

    2017-01-01

    To investigate the presence of association between objective and subjective evaluation of orthodontic treatment needs in adolescents and their impact on their self-esteem. Cross-sectional study with adolescents aged 10-17 years old in Sri Ganganagar city, Rajasthan, India. The objective index of orthodontic treatment need (IOTN) dental health component (DHC) and the subjective aesthetic component (AC) were used to determine the normative and the self-perception need for orthodontic treatment, respectively. The selected students were further examined for dental trauma, tooth loss, and dental caries. Rosenberg Self-Esteem Scale was applied for self-esteem level determination. Linear regression analysis was executed to test the individual association of different independent clinical variables with self-esteem scores. Among 1,140 studied adolescents, the prevalence of dental normative orthodontic treatment need was in 56.9% of individuals, whereas 53.3% of individuals considered themselves as needy for the treatment. Multivariate analyses revealed that out of all dental disorders, DHC followed by AC of IOTN had maximum impact on the self-esteem of the adolescence. Dissatisfaction with dental appearance is a strong predictor for low self-esteem in adolescence.

  8. Assessment of nasal obstruction with rhinomanometry and subjective scales and outcomes of surgical and medical treatment.

    Science.gov (United States)

    Lara-Sánchez, Hugo; Álvarez Nuño, Candelas; Gil-Carcedo Sañudo, Elisa; Mayo Iscar, Agustín; Vallejo Valdezate, Luis Ángel

    Prospective study of patients with nasal obstruction (NO) in order to measure therapeutic success by anterior active rhinomanometry (AAR), Nasal Obstruction Symptom Evaluation (NOSE) scale and Visual Analogue Scale (VAS) and to establish the correlation between these tests. Patients with NO, on whom we performed an AAR, NOSE and VAS scales at baseline and after medical treatment (topical nasal steroid) or surgery (septoplasty, turbinoplasty or septoplasty and turbinoplasty). The nasal flow obtained by the AAR and the score of both subjective scales (NOSE and VAS) were compared and analyzed. A total of 102 patients were included in the study. Surgical treatment resulted in statistically significant differences with the AAR and the subjective scales. While in patients with medical treatment there was an increase in the AAR nasal flow but without statistical significance (P=.1363). The correlation between the AAR, the NOSE and VAS scales was measured finding a strong correlation between the NOSE and VAS scales only (r=.83327). The patients with NO treated surgically have better results when these are evaluated by AAR or with subjective scales. There is no significant correlation between AAR, NOSE and VAS scales, this is considered to be because the AAR and subjective scales are complementary and measure different aspects of NO. The AAR and subjective scales are useful tools to be used together for the follow up of patients with NO. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  9. Post-treatment occlusal changes in Class II division 2 subjects treated with the Herbst appliance.

    Science.gov (United States)

    Bock, Niko; Ruf, Sabine

    2008-12-01

    The aim of this retrospective study was to analyse and compare the post-treatment occlusal changes of Class II division 2 treatment with the Herbst appliance in early adolescent, late adolescent, and adult subjects. The subjects were 37 Class II division 2 patients (19 females and 18 males) treated at the Orthodontic Department, University of Giessen, Germany. All were in the late mixed or permanent dentition and exhibited a Class II molar relationship > or =0.5 cusp width (CW) bilaterally or > or =1.0 CW unilaterally, an overbite (OB) >3.0 mm, and two upper central incisors retroclined. The subjects were divided into three skeletal maturity groups based on evaluation of hand wrist radiographs: early adolescent (n = 10, stages MP3-E to MP3-FG at start of treatment, age range: 11.3-13.2 years), late adolescent (n = 14, stages MP3-G to MP3-I at start of treatment, age range: 14.1-16.4 years), and adult (n = 13, stages R-I to R-J at the start of treatment, age range: 16.3-25.6 years). Study casts from before treatment (T1), after Herbst-Tip-Edge-Multibracket appliance treatment (T2), and after an average retention time of 27 months (T3) were analysed. Statistical analysis was undertaken using t-tests for paired and unpaired samples. For the whole sample, the molar relationship at T3 was stable in 82.4 per cent, the canine relationship in 82.9 per cent, and OB in 75.7 per cent of the cases. In the different skeletal maturity groups, the stability of the molars, canines, and overbite was as follows: early adolescents: 95.0, 100.0, and 70.0 per cent, respectively; late adolescents: 92.9, 74.1, and 85.7 per cent, respectively; and adults 61.5, 80.8, 69.2 per cent, respectively. Occlusal correction of Class II division 2 malocclusions with Herbst treatment was relatively stable 2 years post-treatment. The outcome of treatment of adolescents was more stable than that of adults.

  10. Treatment and post-treatment effects of functional therapy on the sagittal pharyngeal dimensions in Class II subjects.

    Science.gov (United States)

    Pavoni, Chiara; Cretella Lombardo, Elisabetta; Franchi, Lorenzo; Lione, Roberta; Cozza, Paola

    2017-10-01

    To evaluate the craniofacial changes induced by functional appliances with special regard to the oro and nasopharyngeal sagittal airway dimensions in subjects with dentoskeletal Class II malocclusions when compared with an untreated Class II control group immediately after therapy and at long-term observation. A group of 40 patients (21 females and 19 males) with Class II malocclusion treated consecutively either with a Bionator or an Activator followed by fixed appliances was compared with a matched control group of 31 subjects (16 females and 15 males) with untreated Class II malocclusion. The treated sample was evaluated at T1, start of treatment (mean age: 9.9 ± 1.4 years); T2, end of functional treatment and prior to fixed appliances (mean age: 11.9 ± 1.3 years); and T3, long-term observation at the end of growth (mean age: 18.2 ± 2.1 years). Statistical comparisons were performed with independent sample t tests at T1 (baseline characteristics) and for the T1-T2, T2-T3, and T1-T3 changes. During active treatment the treated group showed a significant increment in lower airway dimension (PNS-AD1), as well as a significant improvement in the upper airway dimension (PNS-AD2). A significant decrease in the upper adenoid size (AD2-H) was also found. In the longterm evaluation, a significant increase in both lower and upper airway thickness (PNS-AD1; PNS-AD2) and a significant decrease in the upper adenoid thickness were still present in the treated group. The treatment with functional appliances produced significant favorable changes during active treatment in the oro- and nasopharyngeal sagittal airway dimensions in dentoskeletal Class II subjects when compared with untreated controls, and these changes were stable in the long-term. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Comparison of treatment outcome using two definitions of rapid cycling in subjects with bipolar II disorder.

    Science.gov (United States)

    Amsterdam, Jay D; Lorenzo-Luaces, Lorenzo; DeRubeis, Robert J

    2017-02-01

    We examined differences in treatment outcome between Diagnostic and Statistical Manual Fourth Edition (DSM-IV)-defined rapid cycling and average lifetime-defined rapid cycling in subjects with bipolar II disorder. We hypothesized that, compared with the DSM-IV definition, the average lifetime definition of rapid cycling may better identify subjects with a history of more mood lability and a greater likelihood of hypomanic symptom induction during long-term treatment. Subjects ≥18 years old with a bipolar II major depressive episode (n=129) were categorized into DSM-IV- and average lifetime-defined rapid cycling and prospectively treated with either venlafaxine or lithium monotherapy for 12 weeks. Responders (n=59) received continuation monotherapy for six additional months. These exploratory analyses found moderate agreement between the two rapid-cycling definitions (κ=0.56). The lifetime definition captured subjects with more chronic courses of bipolar II depression, whereas the DSM-IV definition captured subjects with more acute symptoms of hypomania. There was no difference between rapid-cycling definitions with respect to the response to acute venlafaxine or lithium monotherapy. However, the lifetime definition was slightly superior to the DSM-IV definition in identifying subjects who went on to experience hypomanic symptoms during continuation therapy. Although sample sizes were limited, the findings suggest that the lifetime definition of rapid cycling may identify individuals with a chronic rapid-cycling course and may also be slightly superior to the DSM-IV definition in identifying individuals with hypomania during relapse-prevention therapy. These findings are preliminary in nature and need replication in larger, prospective, bipolar II studies. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. No-shows, drop-outs and completers in psychotherapeutic treatment

    DEFF Research Database (Denmark)

    Fenger, Morten Munthe; Mortensen, Erik Lykke; Poulsen, Stig Bernt

    2011-01-01

    A primary challenge in mental health services is a high rate of non-attendance (i.e. no-show and drop-out) for patients referred to treatment for psychiatric disorders.......A primary challenge in mental health services is a high rate of non-attendance (i.e. no-show and drop-out) for patients referred to treatment for psychiatric disorders....

  13. Completion of Gamma Knife radiosurgery for AVM treatment after unplanned interruption-technical note.

    Science.gov (United States)

    Raman, Hari S; Santanam, Lakshmi; Vellimana, Ananth K; Drzymala, Robert E; Tsien, Christina I; Zipfel, Gregory J

    2018-02-17

    Gamma Knife radiosurgery is an established technique for non-urgent treatment of various intracranial pathologies. Intra-procedural dislodgement of the stereotactic frame is an uncommon occurrence that could lead to abortion of ongoing treatment and necessitate more invasive treatment strategies. In this case report, we describe a novel method for resumption of Gamma Knife treatment after an unplanned intra-procedural interruption. The case example involves a radiosurgical treatment of a Spetzler-Martin grade I arteriovenous malformation. Our technique involves integration of scans and coordinate systems from two imaging sessions using the composite isodose line to resolve translational differences, thereby limiting delivery of remaining shots to the untreated region of the lesion. MRI follow-up at 13 months showed a reduction in the nidus size with no evidence of any radiation injury to the surrounding brain parenchyma. We believe this technique will allow care teams to effectively salvage interrupted Gamma Knife procedures and reduce progression to more invasive treatment options.

  14. Pre-treatment attachment anxiety predicts change in depressive symptoms in women who complete day hospital treatment for anorexia and bulimia nervosa.

    Science.gov (United States)

    Keating, Leah; Tasca, Giorgio A; Bissada, Hany

    2015-03-01

    Individuals with eating disorders are prone to depressive symptoms. This study examines whether depressive symptoms can change in women who complete intensive day treatment for anorexia and bulimia nervosa (BN), and whether these changes are associated with pre-treatment attachment insecurity. Participants were 141 women with anorexia nervosa restricting type (n = 24), anorexia nervosa binge purge type (n = 30), and BN (n = 87) who completed a day hospital treatment programme for eating disorders. They completed a pre-treatment self-report measure of attachment, and a pre-treatment and post-treatment self-report measure of depressive symptoms. Participants experienced significant reductions in depressive symptoms at post-treatment. Eating disorder diagnosis was not related to these improvements. However, participants lower in attachment anxiety experienced significantly greater improvement in depressive symptoms than those who were higher in attachment anxiety. These results suggest that clinicians may tailor eating disorders treatments to patients' attachment patterns and focus on their pre-occupation with relationships and affect regulation to improve depressive symptoms. That depressive symptoms can decrease in women who complete day hospital treatment for anorexia and BN. That improvements in depressive symptoms do not vary according to eating disorder diagnosis in these women. That patients who complete treatment and who have higher attachment anxiety experience less improvements in depressive symptoms compared to those lower in attachment anxiety. That clinicians may attend to aspects of attachment anxiety, such as need for approval and up-regulation of emotions, to improve depressive symptoms in female patients with eating disorders. © 2014 The British Psychological Society.

  15. A Randomized Clinical Trial of Methadone Maintenance for Prisoners: Prediction of Treatment Entry and Completion in Prison

    Science.gov (United States)

    Gordon, Michael S.; Kinlock, Timothy W.; Couvillion, Kathryn A.; Schwartz, Robert P.; O'Grady, Kevin

    2012-01-01

    The present report is an intent-to-treat analysis involving secondary data drawn from the first randomized clinical trial of prison-initiated methadone in the United States. This study examined predictors of treatment entry and completion in prison. A sample of 211 adult male prerelease inmates with preincarceration heroin dependence were randomly…

  16. Body representation disturbances in visual perception and affordance perception persist in eating disorder patients after completing treatment

    NARCIS (Netherlands)

    Engel, Manja M; Keizer, Anouk

    2017-01-01

    Body image disturbances (BID) are a key feature of eating disorders (ED). Clinical experience shows that BID exists in patients who Completed their Eating Disorder Treatment (CEDT), however studies concerning BID in CEDT patients are often limited to cognition and affect, measured by interviews and

  17. Endobronchial valves in severe emphysematous patients: CT evaluation of lung fissures completeness, treatment radiological response and quantitative emphysema analysis

    Energy Technology Data Exchange (ETDEWEB)

    Koenigkam-Santos, Marcel, E-mail: marcelk46@yahoo.com.br, E-mail: marcelk46@usp.b [Universidade de Sao Paulo (HCFMRP/USP), Ribeirao Preto, SP (Brazil). Hospital das Clinicas da Faculdade de Medicina; Paula, Wagner Diniz de [University of Brasilia (UnB), DF (Brazil). Brasilia University Hospital; Gompelmann, Daniela [University of Heidelberg (Germany). Department of Pneumology and Respiratory Medicine of the Chest Clinic (Thoraxklinik); Kauczor, Hans-Ulrich [University of Heidelberg (Germany). Department of Diagnostic and Interventional Radiology; Heussel, Claus Peter; Puderbach, Michael [University of Heidelberg (Germany). Department of Diagnostic and Interventional Radiology with Nuclear Medicine of the Chest Clinic (Thoraxklinik)

    2013-01-15

    Objective: To evaluate lung fissures completeness, post-treatment radiological response and quantitative CT analysis (QCTA) in a population of severe emphysematous patients submitted to endobronchial valves (EBV) implantation. Materials and Methods: Multi-detectors CT exams of 29 patients were studied, using thin-section low dose protocol without contrast. Two radiologists retrospectively reviewed all images in consensus; fissures completeness was estimated in 5% increments and post-EBV radiological response (target lobe atelectasis/volume loss) was evaluated. QCTA was performed in pre and post-treatment scans using a fully automated software. Results: CT response was present in 16/29 patients. In the negative CT response group, all 13 patients presented incomplete fissures, and mean oblique fissures completeness was 72.8%, against 88.3% in the other group. QCTA most significant results showed a reduced post-treatment total lung volume (LV) (mean 542 ml), reduced EBV-submitted LV (700 ml) and reduced emphysema volume (331.4 ml) in the positive response group, which also showed improved functional tests. Conclusion: EBV benefit is most likely in patients who have complete interlobar fissures and develop lobar atelectasis. In patients with no radiological response we observed a higher prevalence of incomplete fissures and a greater degree of incompleteness. The fully automated QCTA detected the post-treatment alterations, especially in the treated lung analysis. (author)

  18. Blunt penetration technique for treatment of a completely obstructed anastomosis after rectal resection: a case report.

    Science.gov (United States)

    Yazawa, Keiichi; Morioka, Daisuke; Matsumoto, Chizuru; Miura, Yasuhiko; Togo, Shinji

    2014-06-27

    We present a case of completely obstructed anastomosis after rectal resection which was nonsurgically and successfully treated with a blunt penetration technique using a commonly used device for transanal ileus drainage. The technique we used in this case has not been previously reported. A 79-year-old Japanese man underwent redo rectal resection for completely separated anastomosis which was caused by anastomotic leakage after a sigmoidectomy performed 3 years previously that was remedied by diverging ileostomy. Immediately after the redo surgery, fluoroscopy showed good passage through the colorectal anastomosis but no anastomotic leakage. However, fluoroscopy and colonoscopy prior to the ileostomy takedown showed complete obstruction of the anastomosis. Unlike usual anastomotic strictures, the lumen between colon oral and rectum anal to the anastomosis was completely discontinued by a membranous structure. Therefore, a conventional balloon dilatation technique was unsuitable for this condition. We applied a blunt penetration technique using a commercially available device designed as a transanal drainage system for obstructing colorectal cancer to restore the continuity between the colon oral and rectum anal to the anastomosis. After restoring the continuity, we performed conventional balloon dilatation for the anastomosis and successfully treated the anastomotic obstruction. Subsequently, the patient underwent ileostomy takedown and is currently doing well 12 months after the ileostomy takedown. The penetration technique we applied is easy and less stressful to adopt because it does not require usage of materials specialized for other particular purposes. Furthermore, we believe that this technique is superior in safety to other reported methods for this condition even if applied in the wrong direction because this technique does not utilize electrocision or sharp needle puncture.

  19. Influence of Chitosan Treatment on Surrogate Serum Markers of Cholesterol Metabolism in Obese Subjects

    Directory of Open Access Journals (Sweden)

    Dieter Lütjohann

    2018-01-01

    Full Text Available Chitosan treatment results in significantly lower serum low density lipoprotein (LDL cholesterol concentrations. To assess the working mechanisms of chitosan, we measured serum surrogate markers of cholesterol absorption (campesterol, sitosterol, cholestanol, synthesis (lathosterol, lanosterol, desmosterol, and degradation to bile acids (7α-hydroxy-cholesterol, 27-hydroxy-cholesterol, corrected for cholesterol concentration (R_sterols. Over 12 weeks, 116 obese subjects (Body Mass Index, BMI 31.7, range 28.1–38.9 kg/m2 were studied under chitosan (n = 61 and placebo treatments (n = 55. The participants were briefly educated regarding improvement of nutrition quality and energy expenditure. Daily chitosan intake was 3200 mg. Serum LDL cholesterol concentration decreased significantly more (p = 0.0252 under chitosan (−8.67 ± 18.18 mg/dL, 5.6% than under placebo treatment (−1.00 ± 24.22 mg/dL, 0.9%. This reduction was not associated with the expected greater decreases in markers of cholesterol absorption under chitosan treatment. Also, increases in markers of cholesterol synthesis and bile acid synthesis under chitosan treatment were not any greater than under placebo treatment. In conclusion, a significant selective reduction of serum LDL cholesterol under chitosan treatment is neither associated with a reduction of serum surrogate markers of cholesterol absorption, nor with increases of markers for cholesterol and bile acid synthesis.

  20. Impact of Surface Potential on Apatite Formation in Ti Alloys Subjected to Acid and Heat Treatments.

    Science.gov (United States)

    Yamaguchi, Seiji; Hashimoto, Hideki; Nakai, Ryusuke; Takadama, Hiroaki

    2017-09-24

    Titanium metal (Ti) and its alloys are widely used in orthopedic and dental fields. We have previously shown that acid and heat treatment was effective to introduce bone bonding, osteoconduction and osteoinduction on pure Ti. In the present study, acid and heat treatment with or without initial NaOH treatment was performed on typical Ti-based alloys used in orthopedic and dental fields. Dynamic movements of alloying elements were developed, which depended on the kind of treatment and type of alloy. It was found that the simple acid and heat treatment enriched/remained the alloying elements on Ti-6Al-4V, Ti-15Mo-5Zr-3Al and Ti-15Zr-4Nb-4Ta, resulting in neutral surface charges. Thus, the treated alloys did not form apatite in a simulated body fluid (SBF) within 3 days. In contrast, when the alloys were subjected to a NaOH treatment prior to an acid and heat treatment, alloying elements were selectively removed from the alloy surfaces. As a result, the treated alloys became positively charged, and formed apatite in SBF within 3 days. Thus, the treated alloys would be useful in orthopedic and dental fields since they form apatite even in a living body and bond to bone.

  1. Urine creatinine in treatment-naïve HIV subjects in eastern Nigeria.

    Science.gov (United States)

    Anyabolu, Ernest Ndukaife

    2016-01-01

    Human immunodeficiency virus (HIV) infection is a global healthcare problem. Some diseases and physiological states may be altered in HIV-infected individuals. Our objective was to evaluate urine creatinine and factors that influence urine creatinine in treatment-naïve HIV subjects in Nigeria. This was a cross-sectional study involving treatment-naïve HIV subjects in a tertiary hospital in Nigeria. Creatinine in spot and 24-hour urine samples and other relevant investigations were performed. Low urine creatinine or dilute urine was defined as 24-hour urine creatinine (24HUCr) creatinine as 24HUCr 300-3000mg and high urine creatinine or concentrated urine as 24HUCr>3000mg.Theassociation of low urine creatinine and high urine creatinine with potential risk factors was determined. The mean spot urine creatinine (SUCr) of the treatment-naïve HIV subjects was 137.21± 98.47(mg/dl), minimum value 13.3mg/dl, maximum value 533.3mg/dl and range of values 520.0mg/dl. The mean 24HUCr was 1507±781mg, minimum value 206mg, maximum value 4849mg and range of values 4643mg. Twenty four-hour urine creatinine3000mg in 24(6.4%) subjects. There was significant association between 24HUCr and serum low density lipoprotein cholesterol (LDL),serum high density lipoprotein cholesterol (HDL). There was high correlation between 24HUCr>3000mg and 24-hour urine osmolality (24HUOsm) (r=0.95), body mass index (BMI) (r=0.74), CD4 cells count (r=-0.71), serum HDL (r=-0.73). The prevalence of dilute urine and concentrated urine was low. Twenty-four hour urine osmolality. BMI, CD4 cells count and HDL were strong correlates of high urine creatinine. Lipid abnormalities were common in treatment-naïve HIV subjects with high urine creatinine. There is need for clinicians to routinely conduct urine creatinine and further search for abnormalities of serum lipids, weight changes, depressed immunity and anemia in HIV subjects with dilute or concentrated urine in the early stages of the infection.

  2. Body attitudes in patients with eating disorders at presentation and completion of intensive outpatient day treatment.

    Science.gov (United States)

    Exterkate, Cecile C; Vriesendorp, Patricia F; de Jong, Cor A J

    2009-01-01

    Due to the importance of the distorted body experience in eating disorder diagnosis and treatment, we wanted to explore body attitudes of patients with eating disorders before and after 5 months of intensive specialized outpatient day treatment. We assessed 193 patients diagnosed with Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Eating Disorder Not Otherwise Specified (EDNOS) using the Body Attitude Test (BAT), Body Mass Index (BMI), Eating Disorder Evaluation Scale (EDES) and Symptom Checklist 90 (SCL-90). Eating disorder subtypes differed in BMI, total body attitudes and negative appreciation of body size at intake, but not at termination of treatment. Following treatment, all patient groups reported large improvements in eating disorder pathology and all but the AN-Restrictive (AN-R) group, reported large improvements in overall psychological functioning. The AN patients demonstrated significant improvement in BMI, however the Anorexia Nervosa purging (AN-P) and Anorexia Nervosa restrictive (AN-R) subtypes differed in their changes in body attitudes. AN-R patients indicated no significant improvement in body attitudes. AN-P patients improved in total body attitudes, except one subscale. Patients with Bulimia Nervosa non-purging (BN-NP) subtype, Bulimia Nervosa purging (BN-P) subtype and EDNOS demonstrated similar improvements in total body attitudes (BAT). Body attitudes provide important insights into differences between eating disorder diagnostic categories and their treatment responsiveness.

  3. Complete recovery from undertreated Wernicke-Korsakoff syndrome following aggressive thiamine treatment.

    Science.gov (United States)

    Paparrigopoulos, Thomas; Tzavellas, Elias; Karaiskos, Dimitris; Kouzoupis, Anastasios; Liappas, Ioannis

    2010-01-01

    Wernicke-Korsakoff syndrome (WKS) is a neuropsychiatric condition which results from thiamine deficiency, most commonly due to alcohol abuse. The prognosis of WKS is poor and its outcome depends mainly on prompt treatment. A 52-year-old male with a ten-year history of heavy alcohol abuse was admitted in hospital and treated for WKS. Ataxic and oculomotor symptoms promptly reversed following standard treatment but no change was observed in higher mental functioning. Although the protracted WK symptoms made the patient's improvement unlikely, aggressive treatment with thiamine (600 mg/day orally and 300 mg/day intramuscularly) fully reversed the condition within two months. Even though prolongation of undertreatment of WKS typically precludes significant improvement of symptoms due to irreversible damage of the brain, at least in some cases, higher thiamine doses (over 500 mg/day) for a longer period (at least three months) than usually recommended should be tried.

  4. A novel complete-case analysis to determine statistical significance between treatments in an intention-to-treat population of randomized clinical trials involving missing data.

    Science.gov (United States)

    Liu, Wei; Ding, Jinhui

    2018-04-01

    The application of the principle of the intention-to-treat (ITT) to the analysis of clinical trials is challenged in the presence of missing outcome data. The consequences of stopping an assigned treatment in a withdrawn subject are unknown. It is difficult to make a single assumption about missing mechanisms for all clinical trials because there are complicated reactions in the human body to drugs due to the presence of complex biological networks, leading to data missing randomly or non-randomly. Currently there is no statistical method that can tell whether a difference between two treatments in the ITT population of a randomized clinical trial with missing data is significant at a pre-specified level. Making no assumptions about the missing mechanisms, we propose a generalized complete-case (GCC) analysis based on the data of completers. An evaluation of the impact of missing data on the ITT analysis reveals that a statistically significant GCC result implies a significant treatment effect in the ITT population at a pre-specified significance level unless, relative to the comparator, the test drug is poisonous to the non-completers as documented in their medical records. Applications of the GCC analysis are illustrated using literature data, and its properties and limits are discussed.

  5. Association between gingivitis and anterior gingival enlargement in subjects undergoing fixed orthodontic treatment

    Science.gov (United States)

    Zanatta, Fabricio Batistin; Ardenghi, Thiago Machado; Antoniazzi, Raquel Pippi; Pinto, Tatiana Militz Perrone; Rösing, Cassiano Kuchenbecker

    2014-01-01

    Objective The aim of this study was to investigate the association among gingival enlargement (GE), periodontal conditions and socio-demographic characteristics in subjects undergoing fixed orthodontic treatment. Methods A sample of 330 patients undergoing fixed orthodontic treatment for at least 6 months were examined by a single calibrated examiner for plaque and gingival indexes, probing pocket depth, clinical attachment loss and gingival enlargement. Socio-economic background, orthodontic treatment duration and use of dental floss were assessed by oral interviews. Associations were assessed by means of unadjusted and adjusted Poisson's regression models. Results The presence of gingival bleeding (RR 1.01; 95% CI 1.00-1.01) and excess resin around brackets (RR 1.02; 95% CI 1.02-1.03) were associated with an increase in GE. No associations were found between socio-demographic characteristics and GE. Conclusion Proximal anterior gingival bleeding and excess resin around brackets are associated with higher levels of anterior gingival enlargement in subjects under orthodontic treatment. PMID:25162567

  6. Normative and subjective need for orthodontic treatment within different age groups in a population in Turkey.

    Science.gov (United States)

    Nur Yilmaz, R B; Oktay, I; Ilhan, D; Fişekçioğlu, E; Özdemir, Fulya

    2017-12-01

    To evaluate and compare the normative and subjective need for orthodontic treatment within different age groups in Turkey. One thousand and sixteen patients from seven different demographic regions of Turkey (Marmara, Black Sea, East Anatolia, Southeastern Anatolia, Mediterranean, Aegean, and Central Anatolia Region) (mean age ± SD: 12.80 ± 3.57 years) were randomly selected and divided into six age groups (7-8,9-10,11-12,13-14,15-16, and 17-18 year-olds) and categorized according to the dental health component (DHC) of the index for orthodontic treatment need (IOTN). Additionally, the patients were asked to indicate the photograph that was most similar to their own dentition from the 10-point scale of the aesthetic component of IOTN. The DHC of IOTN was not significantly different between the six age groups (P > 0.05). However, no/slight need (aesthetic component 1-4) for orthodontic treatment according to AC of IOTN was significantly higher in 13-14,15-16, and 17-18 age groups than 7-8, 9-10, and 11-12 age groups (P age groups (P > 0.05). The normative need distribution was homogeneous within all the age groups according to DHC. However, the subjective need for orthodontic treatment was higher in the younger age groups.

  7. A Randomized Clinical Trial of Methadone Maintenance for Prisoners: Prediction of Treatment Entry and Completion in Prison.

    Science.gov (United States)

    Gordon, Michael S; Kinlock, Timothy W; Couvillion, Kathryn A; Schwartz, Robert P; O'Grady, Kevin

    2012-05-01

    The present report is an intent-to-treat analysis involving secondary data drawn from the first randomized clinical trial of prison-initiated methadone in the United States. This study examined predictors of treatment entry and completion in prison. A sample of 211 adult male prerelease inmates with preincarceration heroin dependence were randomly assigned to one of three treatment conditions: counseling only (counseling in prison; n= 70); counseling plus transfer (counseling in prison with transfer to methadone maintenance treatment upon release; n= 70); and counseling plus methadone (methadone maintenance in prison, continued in a community-based methadone maintenance program upon release; n= 71). Entered prison treatment (p prison treatment (pprison sentences may have better outcomes than younger individuals with shorter sentences, meaning they are more likely to enter and complete prison-based treatment. Furthermore, implications for the treatment of prisoners with prior heroin dependence and for conducting clinical trials may indicate the importance of examining individual characteristics and the possibility of the examination of patient preference.

  8. Factors Associated with Treatment Completion and Progress among Intrafamilial Sexual Abusers.

    Science.gov (United States)

    Chaffin, Mark

    1992-01-01

    Thirty-six father-daughter/stepdaughter sexual abusers were followed over the course of a two-year outpatient treatment program. Results supported the importance of pretreatment personality assessment and suggested that involvement of the criminal justice system does not interfere with, and may help, therapeutic progress. (Author/DB)

  9. UASB/flash aeration enable complete treatment of municipal wastewater for reuse.

    Science.gov (United States)

    Khan, Abid Ali; Gaur, Rubia Zahid; Lew, Beni; Diamantis, Vasileios; Mehrotra, Indu; Kazmi, A A

    2012-08-01

    A simple, efficient and cost-effective method for municipal wastewater treatment is examined in this paper. The municipal wastewater is treated using an upflow anaerobic sludge bed (UASB) reactor followed by flash aeration (FA) as the post-treatment, without implementing aerobic biological processes. The UASB reactor was operated without recycle, at hydraulic retention time (HRT) of 8 h and achieved consistent removal of BOD, COD and TSS of 60-70% for more than 12 months. The effect of FA on UASB effluent post-treatment was studied at different HRT (15, 30 and 60 min) and dissolved oxygen (DO) concentrations (low DO = 1-2 mg/L and high DO = 5-6 mg/L). The optimum conditions for BOD, COD and sulfide removal were 30-60 min HRT and high DO concentration inside the FA tank. The final effluent after clarification was characterized by BOD and COD values of 28-35 and 50-58 mg/L, respectively. Sulfides were removed by more than 80%, but the fecal coliform only by ~2 log. The UASB followed by FA is a simple and efficient process for municipal wastewater treatment, except for fecal coliform, enabling water and nutrients recycling to agriculture.

  10. Enhancement of in vitro interleukin-2 production in normal subjects following a single spinal manipulative treatment

    Directory of Open Access Journals (Sweden)

    Harris Glen M

    2008-05-01

    Full Text Available Abstract Background Increasing evidence supports somato-visceral effects of manual therapies. We have previously demonstrated that a single spinal manipulative treatment (SMT accompanied by audible release has an inhibitory effect on the production of proinflammatory cytokines in asymptomatic subjects. The purpose of this study is to report on SMT-related changes in the production of the immunoregulatory cytokine interleukin 2 (IL-2 and to investigate whether such changes might differ with respect to the treatment approach related to the presence or absence of an audible release (joint cavitation. Methods Of 76 asymptomatic subjects, 29 received SMT with cavitation (SMT-C, 23 were treated with SMT without cavitation (SMT-NC and 24 comprised the venipuncture control (VC group. The SMT-C and SMT-NC subjects received a single, similar force high velocity low amplitude manipulation, in the upper thoracic spine. However, in SMT-NC subjects, positioning and line of drive were not conducive to cavitation. Blood and serum samples were obtained before and then at 20 and 120 min post-intervention. The production of IL-2 in peripheral blood mononuclear cell cultures was induced by activation for 48 hr with Staphylococcal protein A (SPA and, in parallel preparations, with the combination of phorbol ester (TPA and calcium ionophore. The levels of IL-2 in culture supernatants and serum were assessed by specific immunoassays. Results Compared with VC and their respective baselines, SPA-induced secretion of IL-2 increased significantly in cultures established from both SMT-C and SMT-NC subjects at 20 min post-intervention. At 2 hr post-treatment, significant elevation of IL-2 synthesis was still apparent in preparations from SMT-treated groups though it became somewhat attenuated in SMT-NC subjects. Conversely, IL-2 synthesis induced by TPA and calcium ionophore was unaltered by either type of SMT and was comparable to that in VC group at all time points. No

  11. Eligibility for Statin Treatment in Korean Subjects with Reduced Renal Function: An Observational Study

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    Byung Sub Moon

    2016-09-01

    Full Text Available BackgroundThe purpose of this study was to investigate the relationship between statin eligibility and the degree of renal dysfunction using the Adult Treatment Panel (ATP III and the American College of Cardiology (ACC/American Heart Association (AHA guidelines in Korean adults.MethodsRenal function was assessed in 18,746 participants of the Kangbuk Samsung Health Study from January 2011 to December 2012. Subjects were divided into three groups according to estimated glomerular filtration rate (eGFR: stage 1, eGFR ≥90 mL/min/1.73 m2; stage 2, eGFR 60 to 89 mL/min/1.73 m2; and stages 3 to 5, eGFR <60 mL/min/1.73 m2. Statin eligibility in these groups was determined using the ATP III and ACC/AHA guidelines, and the risk for 10-year atherosclerotic cardiovascular disease (ASCVD was calculated using the Framingham Risk Score (FRS and Pooled Cohort Equation (PCE.ResultsThere were 3,546 (18.9% and 4,048 (21.5% statin-eligible subjects according to ATP III and ACC/AHA guidelines, respectively. The proportion of statin-eligible subjects increased as renal function deteriorated. Statin eligibility by the ACC/AHA guidelines showed better agreement with the Kidney Disease Improving Global Outcomes (KDIGO recommendations compared to the ATP III guidelines in subjects with stage 3 to 5 chronic kidney disease (CKD (κ value, 0.689 vs. 0.531. When the 10-year ASCVD risk was assessed using the FRS and PCE, the mean risk calculated by both equations significantly increased as renal function declined.ConclusionsThe proportion of statin-eligible subjects significantly increased according to worsening renal function in this Korean cohort. ACC/AHA guideline showed better agreement for statin eligibility with that recommended by KDIGO guideline compared to ATP III in subjects with CKD.

  12. Occurrence of herpes zoster varicella infections after completion of treatment for Hodgkin's disease

    International Nuclear Information System (INIS)

    Pauw, B.E. de; Janssen, J.Th.P.; Vaissier, P.; Haanen, C.

    1983-01-01

    Retrospective analysis of 210 cases of patients with Hodgkin's disease revealed an overall incidence of herpes zoster varicella of 9.5 per cent. Patients with the mixed cellular histological subtype showed a significantly increased (p < 0.05) risk as compared with the total population. More than 90 per cent of the herpes zoster varicella infections occurred after termination of treatment; a combination of radiotherapy with chemotherapy proved to be a predisposing factor. (Auth.)

  13. Complete Treatment Versus Residual Lesion - Long-Term Evolution After Acute Coronary Syndrome

    Directory of Open Access Journals (Sweden)

    Alexandre de Matos Soeiro

    Full Text Available Abstract Introduction: A recently published study raised doubts about the need for percutaneous treatment of nonculprit lesions in patients with acute coronary syndromes (ACS. Methods: Retrospective, unicentric, observational study. Objective: To analyze the long-term outcomes in patients undergoing treatment of the culprit artery, comparing those who remained with significant residual lesions in nonculprit arteries (group I versus those without residual lesions in other coronary artery beds (group II. The study included 580 patients (284 in group I and 296 in group II between May 2010 and May 2013. We obtained demographic and clinical data, as well as information regarding the coronary treatment administered to the patients. In the statistical analysis, the primary outcome included combined events (reinfarction/angina, death, heart failure, and need for reintervention. The comparison between groups was performed using the chi-square test and ANOVA. The long-term analysis was conducted with the Kaplan-Meier method, with a mean follow-up of 9.86 months. Results: The mean ages were 63 years in group I and 62 years in group II. On long-term follow-up, there was no significant difference in combined events in groups I and II (31.9% versus 35.6%, respectively, p = 0.76. Conclusion: The strategy of treating the culprit artery alone seems safe. In this study, no long-term differences in combined endpoints were observed between patients who remained with significant lesions compared with those without other obstructions.

  14. [Research on Chinese orthodontic specialists' subjective evaluation of orthodontic treatment outcome].

    Science.gov (United States)

    Song, Guang-ying; Zhao, Zhi-he; Ding, Yin; Bai, Yu-xing; Wang, Lin; He, Hong; Qian, Yu-fen; Li, Wei-ran; Xu, Tian-min

    2012-03-01

    To analyze the results of multiple Chinese orthodontic specialists' subjective evaluation of orthodontic treatment outcome, to investigate the relevance of different experiment items and to explore the weight of each monomial material. As a randomized clinical trial, with six orthodontic treatment centers and Angle's classification being regarded as two stratification factors, it contained 108 cases with integrity data, which was random extracted from 2383 cases that received orthodontic treatment in six orthodontic treatment centers during the past five years, gathering post-treatment study casts, cephalometrics and photographs of 48 cases as the research subject. Similarly taking Angle's classification as a stratification factor, 108 cases were randomly divided into 9 groups. The randomization of sampling and grouping were both generated by a pseudo-random number generator. According to the monomial and combined subjects, 69 orthodontic specialists were regarded as the raters to rank the 12 cases in each group, and to judge whether the case was qualified. Correlation analysis: the Spearman r between Post-M + C and Post-M + C + P and the Spearman r between Post-M + P and Post-M + C + P were both greater than 0.950. The Spearman r between Post-M and Post-P and the Spearman r between Post-M and Post-C were about 0.300. The Spearman r between Post-P and Post-C was 0.505. Regression analysis: the linear regression results: M + C = 0.782M + 0.308C - 0.150, M + P = 0.804M + 0.233P - 0.091, M + C + P = 0.764M + 0.243P + 0.131C - 0.291. The r(2) of above three models was greater than 0.9. It was applicable to use M + C and M + P instead of M + C + P. Study casts could not replace cephalometrics or photographs when doing subjective evaluation. Cephalometrics and photographs could not substitute for each other either. In the combined materials evaluation, model accounted for the largest percentage. Based on the regression model, for the greater part, the integration of

  15. Complete detoxification is the most effective treatment of medication-overuse headache

    DEFF Research Database (Denmark)

    Carlsen, Louise Ninett; Munksgaard, Signe Bruun; Jensen, Rigmor Højland

    2018-01-01

    /month by 46% (95% CI 34-58) compared with 22% (95% CI 11-34) in program-B ( p = 0.005), and 70% in program A versus 42% in program B were reverted to episodic headache ( p = 0.04). Migraine-days/month were reduced by 7.2 in program A ( p 0.001) and 3.6 in program B ( p = 0.002) after 6 months. Conclusion......Background There is lack of evidence on how to detoxify medication-overuse headache. Aim To compare the effect of complete stop of acute medication with restricted intake. Methods Medication-overuse headache patients were included in a prospective, outpatient study and randomized to two months...... Both detoxification programs were very effective. Detoxification without analgesics or acute migraine-medication was the most effective program. Trial registration Clinicaltrials.gov (NCT02903329)....

  16. In rape trauma PTSD, patient characteristics indicate which trauma-focused treatment they are most likely to complete.

    Science.gov (United States)

    Keefe, John R; Wiltsey Stirman, Shannon; Cohen, Zachary D; DeRubeis, Robert J; Smith, Brian N; Resick, Patricia A

    2018-04-01

    Dropout rates for effective therapies for posttraumatic stress disorder (PTSD) can be high, especially in practice settings. Although clinicians have intuitions regarding what treatment patients may complete, there are few systematic data to drive those judgments. A multivariable model of dropout risk was constructed with randomized clinical trial data (n = 160) comparing prolonged exposure (PE) and cognitive processing therapy (CPT) for rape-induced PTSD. A two-step bootstrapped variable selection algorithm was applied to identify moderators of dropout as a function of treatment condition. Employing identified moderators in a model, fivefold cross-validation yielded estimates of dropout probability for each patient in each condition. Dropout rates between patients who did and did not receive their model-indicated treatment were compared. Despite equivalent dropout rates across treatments, patients assigned to their model-indicated treatment were significantly less likely to drop out relative to patients who did not (relative risk = 0.49 [95% CI: 0.29-0.82]). Moderators included in the model were: childhood physical abuse, current relationship conflict, anger, and being a racial minority, all of which were associated with higher likelihood of dropout in PE than CPT. Individual differences among patients affect the likelihood they will complete a particular treatment, and clinicians can consider these moderators in treatment planning. In the future, treatment selection models could be used to increase the percentage of patients who will receive a full course of treatment, but replication and extension of such models, and consideration of how best to integrate them into routine practice, are needed. © 2018 Wiley Periodicals, Inc.

  17. HIV-1 viral escape in cerebrospinal fluid of subjects on suppressive antiretroviral treatment.

    Science.gov (United States)

    Edén, Arvid; Fuchs, Dietmar; Hagberg, Lars; Nilsson, Staffan; Spudich, Serena; Svennerholm, Bo; Price, Richard W; Gisslén, Magnus

    2010-12-15

    Occasional cases of viral escape in cerebrospinal fluid (CSF) despite suppression of plasma human immunodeficiency virus type 1 (HIV-1) RNA have been reported. We investigated CSF viral escape in subjects treated with commonly used antiretroviral therapy regimens in relation to intrathecal immune activation and central nervous system penetration effectiveness (CPE) rank. Sixty-nine neurologically asymptomatic subjects treated with antiretroviral therapy >6 months and plasma HIV-1 RNA penetration effectiveness rank was not a significant predictor of detectable CSF virus or CSF neopterin levels. Viral escape in CSF is more common than previously reported, suggesting that low-grade central nervous system infection may continue in treated patients. Although these findings need extension in longitudinal studies, they suggest the utility of monitoring CSF responses, as new treatment combinations and strategies modify clinical practice.

  18. Metabolomics biomarkers to predict acamprosate treatment response in alcohol-dependent subjects.

    Science.gov (United States)

    Hinton, David J; Vázquez, Marely Santiago; Geske, Jennifer R; Hitschfeld, Mario J; Ho, Ada M C; Karpyak, Victor M; Biernacka, Joanna M; Choi, Doo-Sup

    2017-05-31

    Precision medicine for alcohol use disorder (AUD) allows optimal treatment of the right patient with the right drug at the right time. Here, we generated multivariable models incorporating clinical information and serum metabolite levels to predict acamprosate treatment response. The sample of 120 patients was randomly split into a training set (n = 80) and test set (n = 40) five independent times. Treatment response was defined as complete abstinence (no alcohol consumption during 3 months of acamprosate treatment) while nonresponse was defined as any alcohol consumption during this period. In each of the five training sets, we built a predictive model using a least absolute shrinkage and section operator (LASSO) penalized selection method and then evaluated the predictive performance of each model in the corresponding test set. The models predicted acamprosate treatment response with a mean sensitivity and specificity in the test sets of 0.83 and 0.31, respectively, suggesting our model performed well at predicting responders, but not non-responders (i.e. many non-responders were predicted to respond). Studies with larger sample sizes and additional biomarkers will expand the clinical utility of predictive algorithms for pharmaceutical response in AUD.

  19. Treatment of large posttraumatic tibial bone defects using the Ilizarov method: a subjective outcome assessment.

    Science.gov (United States)

    Krappinger, Dietmar; Irenberger, Alexander; Zegg, Michael; Huber, Burkhart

    2013-06-01

    The treatment of large posttraumatic tibial bone defects using the Ilizarov method was shown to be successful in several studies. These studies, however, typically focus on the radiological and functional outcome using objective parameters only. The aim of the present study was therefore to assess the objective and subjective outcome of a consecutive series of patients with large posttraumatic tibial bone defects using the Ilizarov method. Additionally, it was our goal to assess the physical and mental stress for the patients and their relatives during the long treatment period and the general health status at final follow-up. A consecutive series of 15 patients with posttraumatic tibial bone defects of >30 mm after sustaining open tibial fractures and failure of internal fixation was included. The objective outcome was assessed at final follow-up using Paley's criteria. For the assessment of the subjective outcome, all patients were asked to evaluate their satisfaction with the function of the lower leg, the cosmetic appearance and overall outcome as well. The physical and mental stress of the treatment for the patients and the nearest relative of patients were assessed at the time of frame removal using a custom-made questionnaire. The SF-36 was used to evaluate the general health status at final follow-up. Solid bone union with stable soft tissue coverage and eradication of infection was achieved in all patients despite a high complication rate. The functional outcome at final follow-up was excellent or good in all patients. The patients' satisfaction with the overall outcome and the function of the lower extremity was high as well. The fear of amputation and complications was the major subjective burden for both the patients and their relatives. The long external fixation time is another relevant issue. The Ilizarov method is a safe option for the treatment of large posttraumatic tibial bone defects after failure of internal fixation despite the high

  20. The association between adjustment disorder diagnosed at psychiatric treatment facilities and completed suicide

    DEFF Research Database (Denmark)

    Gradus, Jaimie L; Qin, Ping; Lincoln, Alisa K

    2010-01-01

    Adjustment disorder is a diagnosis given following a significant psychosocial stressor from which an individual has difficulty recovering. The individual's reaction to this event must exceed what would be observed among similar people experiencing the same stressor. Adjustment disorder is associa...... regression analyses revealed that those diagnosed with adjustment disorder had 12 times the rate of suicide as those without an adjustment disorder diagnosis, after controlling for history of depression diagnosis, marital status, income, and the matched factors....... is associated with suicidal ideation and suicide attempt. However the association between adjustment disorder and completed suicide has yet to be examined. The current study is a population-based case control study examining this association in the population of Denmark aged 15 to 90 years. All suicides...... in Denmark from 1994 to 2006 were included, resulting in 9,612 cases. For each case, up to 30 controls were matched on gender, exact date of birth, and calendar time, yielding 199,306 controls. Adjustment disorder diagnosis was found in 7.6% of suicide cases and 0.52% of controls. Conditional logistic...

  1. [Complete hormonal and metabolic response after iodine-131 metaiodobenzylguanidine treatment in a patient diagnosed of malignant pheochromocytoma].

    Science.gov (United States)

    García Alonso, M P; Balsa Bretón, M A; Paniagua Correa, C; Castillejos Rodríguez, L; Rodríguez Pelayo, E; Mendoza Paulini, A; Ortega Valle, A; Penín González, J

    2013-01-01

    Radiolabeled metaiodobenzylguanidine is an analogue of norepinephrine used to localize tumors that express the neurohormone transporters, specifically those derived from the neural crest having a neuroendocrine origin. It is also used to treat non-surgical metastases derived from them. A review of the literature revealed symptomatic improvements associated to a decrease in hormone levels in a significant percentage of patients after (131)I-MIBG treatment. However, complete tumor remission has been described only in very few cases and hardly ever when bone metastases exist. We present a case of a patient diagnosed of malignant pheochromocytoma who achieved complete hormonal and metabolic response after (131)I-MIBG treatment (600 mCi) in spite of the presence of bone metastases. Copyright © 2012 Elsevier España, S.L. and SEMNIM. All rights reserved.

  2. Evaluation of Mechanical Properties of Glass Fiber Posts Subjected to Laser Surface Treatments.

    Science.gov (United States)

    Barbosa Siqueira, Carolina; Spadini de Faria, Natália; Raucci-Neto, Walter; Colucci, Vivian; Alves Gomes, Erica

    2016-10-01

    The aim of this study was to evaluate the influence of laser irradiation on flexural strength, elastic modulus, and surface roughness and morphology of glass fiber posts (GFPs). Laser treatment of GFPs has been introduced to improve its adhesion properties. A total of 40 GFPs were divided into 4 groups according to the irradiation protocol: GC-no irradiation, GYAG-irradiation with erbium:yttrium-aluminum-garnet [Er:YAG], GCR-irradiation with erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG), and GDI-irradiation with diode laser. The GFP roughness and morphology were evaluated through laser confocal microscopy before and after surface treatment. Three-point bending flexural test measured flexural strength and elastic modulus. Data about elastic modulus and flexural strength were subjected to one-way ANOVA and Bonferroni test (p properties of GFPs.

  3. Short-term dehydroepiandrosterone treatment increases platelet cGMP production in elderly male subjects.

    Science.gov (United States)

    Martina, Valentino; Benso, Andrea; Gigliardi, Valentina Ramella; Masha, Andi; Origlia, Carla; Granata, Riccarda; Ghigo, Ezio

    2006-03-01

    Several clinical and population-based studies suggest that dehydroepiandrosterone (DHEA) and its sulphate (DHEA-S) play a protective role against atherosclerosis and coronary artery disease in human. However, the mechanisms underlying this action are still unknown. It has recently been suggested that DHEA-S could delay atheroma formation through an increase in nitric oxide (NO) production. Twenty-four aged male subjects [age (mean +/- SEM): 65.4 +/- 0.7 year; range: 58.2-67.6 years] underwent a blinded placebo controlled study receiving DHEA (50 mg p.o. daily at bedtime) or placebo for 2 months. Platelet cyclic guanosine-monophosphate (cGMP) concentration (as marker of NO production) and serum levels of DHEA-S, DHEA, IGF-I, insulin, glucose, oestradiol (E(2)), testosterone, plasminogen activator inhibitor (PAI)-1 antigen (PAI-1 Ag), homocysteine and lipid profile were evaluated before and after the 2-month treatment with DHEA or placebo. At the baseline, all variables in the two groups were overlapping. All parameters were unchanged after treatment with placebo. Conversely, treatment with DHEA (a) increased (P < 0.001 vs. baseline) platelet cGMP (111.9 +/- 7.1 vs. 50.1 +/- 4.1 fmol/10(6) plts), DHEA-S (13.6 +/- 0.8 vs. 3.0 +/- 0.3 micromol/l), DHEA (23.6 +/- 1.7 vs. 15.3 +/- 1.4 nmol/l), testosterone (23.6 +/- 1.0 vs. 17.7 +/- 1.0 nmol/l) and E(2) (72.0 +/- 5.0 vs. 60.0 +/- 4.0 pmol/l); and (b) decreased (P < 0.05 vs. baseline) PAI-1 Ag (27.4 +/- 3.8 vs. 21.5 +/- 2.5 ng/ml) and low-density lipoprotein (LDL) cholesterol (3.4 +/- 0.2 vs. 3.0 +/- 0.2 mmol/l). IGF-I, insulin, glucose, triglycerides, total cholesterol, HDL cholesterol, HDL2 cholesterol, HDL3 cholesterol, apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB) and homocysteine levels were not modified by DHEA treatment. This study shows that short-term treatment with DHEA increased platelet cGMP production, a marker of NO production, in healthy elderly subjects. This effect is coupled with a decrease in PAI-1

  4. Substance abuse treatment engagement, completion and short-term outcomes in the Western Cape province, South Africa: Findings from the Service Quality Measures Initiative.

    Science.gov (United States)

    Myers, Bronwyn; Williams, Petal Petersen; Govender, Rajen; Manderscheid, Ron; Koch, J Randy

    2018-04-01

    Optimizing the effectiveness of substance use disorder (SUD) treatment is critical in low-and middle-income countries (LMICs) with limited opportunities for SUD treatment. This is the first study to identify targets for interventions to improve the quality of SUD treatment in a LMIC. We explored correlates of three indicators of treatment quality (treatment engagement, completion and abstinence at treatment exit) using data from a SUD performance measurement system implemented in the Western Cape Province of South Africa. The sample included data from 1094 adult treatment episodes representing 53% of the treatment episodes in 2016. Using multivariate logistic regression analyses, we modeled socio-demographic, substance use and program correlates of treatment engagement, completion, and abstinence at treatment exit. Overall, 59% of patients completed treatment (48% of patients from outpatient services). Treatment completion was associated with greater likelihood of abstinence at treatment exit. Patients were more likely to complete treatment if they engaged in treatment, were older, and had more severe drug problems (characterized by daily drug use and heroin problems) and attended programs of shorter duration. Residential treatment was associated with greater likelihood of treatment engagement, completion, and abstinence at treatment exit. Improving rates of outpatient treatment completion will enhance the effectiveness of South Africa's SUD treatment system. Interventions that promote engagement in treatment, particularly among younger patients; reduce program length through referral to step-down continuing care; and ensure better matching of drug problem to treatment level and type could improve rates of treatment completion. Copyright © 2018 Elsevier B.V. All rights reserved.

  5. [The effect of acupuncture in the treatment of insomnia. Clinical study of subjective and objective evaluation].

    Science.gov (United States)

    Montakab, H; Langel, G

    1994-01-01

    The sleep-wake cycle is the most important circadian rhythm in man and thus constitutes an excellent indicator of internal equilibrium and of health. Sleep disorders, and particularly insomnia, affect a great percentage of the population. In daily practice, an inappropriate treatment may transform a bad sleeper into an insomniac dependent on pharmaceuticals for life. It is therefore necessary to give priority to non-chemical treatments in the management of insomnia. Acupuncture, which offers a personalized treatment, is particularly indicated for reharmonizing a disturbed sleep-wake cycle. Furthermore, there is an interesting similarity between the 5000-year-old theoretical basis of Chinese medicine and the recent scientific discoveries about man's internal rhythms. Clinical and statistical studies of the effects of acupuncture on insomnia are rare and evaluate only the subjective appreciation of sleep. Objective analysis of sleep by polysomnography permits evaluation of sleep architecture and visualizes the site and depth of action of the therapeutic method. Such studies have only been conducted in relation to pharmaceutical treatments. No such study has been carried out for acupuncture. A scientific and objective evaluation of the effects of acupuncture on insomnia by polysomnography could be not only of academic but mainly of great practical interest. If the efficiency of acupuncture is thus verified, this method could be integrated and proposed along with other classical therapeutic technics.

  6. [Successful treatment with reduced-intensity cord blood transplantation for acute myeloid leukemia with complete tetraploidy (92, XXXX)].

    Science.gov (United States)

    Iwasaki, Junko; Onozawa, Masahiro; Takahashi, Shojiro; Okada, Kohei; Takahata, Mutsumi; Shigematsu, Akio; Kahata, Kaoru; Kondo, Takeshi; Hashino, Satoshi; Imamura, Masahiro; Asaka, Masahiro

    2011-03-01

    A 56-year-old female was diagnosed with acute myeloid leukemia (FAB: AML-M1). G-banding karyotype of her bone marrow showed complete tetraploidy (92, XXXX [24/24]). Although she achieved complete remission (CR) after induction therapy and maintained CR during consolidation therapy, relapse occurred only 2 months after discharge. When the relapse occurred, bone marrow karyotypic analysis showed complete tetraploidy again. The patient received reduced-intensity cord blood transplantation (RI-CBT), which induced CR for the second time. The patient is currently alive 24 months after transplantation and there have not been any signs of recurrence to date. There have been a few reports of AML with near-tetraploidy, but cases of AML with complete tetraploidy are extremely rare. Tetraploid AML has been reported to have a poor prognosis and there have been very few cases maintaining CR over the long term after chemotherapy alone. This is the first case of complete tetraploid AML successfully treated by RI-CBT. The clinical course of this case suggests that hematopoietic stem cell transplantation during the first CR phase should be considered a treatment option for tetraploid AML.

  7. [The clinical and pathological research of complete mesocolic excision on the treatment of right colon cancer].

    Science.gov (United States)

    Yang, Yingchi; Wang, Jin; Jin, Lan; Zhao, Xiaomu; Wu, Guocong; Wang, Kangli; Zhang, Zhongtao

    2016-01-01

    To verify the clinical safety of complete mesocolic excision (CME) and manufacture pathological large slices. A prospective analysis clinical data of 85 right colon cancer in patients by the same group of surgeons at the Department of General Surgery, Beijing Friendship Hospital, Capital Medical University from January 2012 to December 2013 which were divided into two groups: CME group (n=39) and traditional radical operation group (n=46) by surgical approach. CME group and control group were compared the differences of clinic and pathologic variables, precise tissues morphometry, lymph nodes harvest, mesocolic area and so on. By comparison to operation time, blood loss, postoperative complications, flatus restoring time, drainage removal time and length of stay, the security of CME was analyzed. Statistical methods included independent sample t-test, Wilcoxon rank sum test and χ(2) test. In order to manufacture pathological large slices, the CME operation specimens were fixed. The large slices were stained by routine HE staining to detection of circumferential resection margin. Mean number of total lymph nodes was increased obviously in CME group (26.8±1.9 vs. 23.2±3.4, t=4.261, P=0.000). Mean number of lymph nodes of stage Ⅰ, Ⅱ were different between two groups (25.8±3.6 vs. 18.2±4.5, 26.8±7.7 vs. 24.9±6.2, t=8.776, 2.802, P=0.000). The positive lymph nodes of CME group was higher than control group (4(7) vs. 1.5(2), P=0.032), above all with statistically significant difference. Comparing CME group with the control group, there were the larger area of mesentery ((15 555±1 263) mm(2) vs. (12 493±1 002) mm(2,) t=12.456, P=0.000), the greater distance between the tumor and the high vascular tie ((116±22) mm vs. (82±11) mm, t=9.295, P=0.000), the greater distance between the normal bowel and the high vascular tie ((92±17) mm vs. (74±10) mm, t=8.132, P=0.000) of CME, with statistically significant difference. There were no statistically significant

  8. Interferon alpha therapy for hepatitis C: treatment completion and response rates among patients with substance use disorders

    Directory of Open Access Journals (Sweden)

    Loftis Jennifer M

    2007-01-01

    Full Text Available Abstract Background Individuals with substance use disorders (SUDs are at increased risk for hepatitis C viral infection (HCV, and few studies have explored their treatment responses empirically. The objective of this study was to assess interferon alpha therapy (IFN completion and response rates among patients with HCV who had a history of comorbid SUDs. More data is needed to inform treatment strategies and guidelines for these patients. Using a medical record database, information was retrospectively collected on 307,437 veterans seen in the Veterans Integrated Service Network 20 (VISN 20 of the Veterans Healthcare Administration (VHA between 1998 and 2003. For patients treated with any type of IFN (including regular or pegylated IFN or combination therapy (IFN and ribavirin who had a known HCV genotype, IFN completion and response rates were compared among patients with a history of SUD (SUD+ Group and patients without a history of SUD (SUD- Group. Results Odds ratio analyses revealed that compared with the SUD- Group, the SUD+ Group was equally likely to complete IFN therapy if they had genotypes 2 and 3 (73.1% vs. 68.0%, and if they had genotypes 1 and 4 (39.5% vs. 39.9%. Within the sample of all patients who began IFN therapy, the SUD- and SUD+ groups were similarly likely to achieve an end of treatment response (genotypes 2 and 3, 52.8% vs. 54.3%; genotypes 1 and 4, 24.5% vs. 24.8% and a sustained viral response (genotypes 2 and 3, 42.6% vs. 41.1%; genotypes 1 and 4: 16.0% vs. 22.3%. Conclusion Individuals with and without a history of SUD responded to antiviral therapy for HCV at similar rates. Collectively, these findings suggest that patients who have co-morbid SUD and HCV diagnoses can successfully complete a course of antiviral therapy.

  9. Characterization by transmission electron microscopy of a JRQ steel subjected to different heat treatments

    International Nuclear Information System (INIS)

    Moreno G, N.

    2014-01-01

    In this work a study was conducted on the steel Astm A-533, Grade B, Class 1 of reference JRQ, for the purpose of carrying out a study by transmission electron microscopy on the size and distribution of precipitates in steel samples JRQ previously subjected to heat treatments. This because the reactor vessels of the nuclear power plant of Laguna Verde, are made of a steel Astm A-533 Grade B, Class 1. It is known that the neutron radiation causes damage primarily embrittlement in materials that are exposed to it. However, observable damage through mechanical tests result from microstructural defects and atomic, induced by the neutron radiation. In previous studies hardening by precipitation of a JRQ steel (provided by the IAEA) was induced by heat treatments, finding that the conditions of heat treatment that reproduce the hardness and stress mechanical properties of a steel Astm A-533, Grade B, Class 1 irradiated for 8 years to a fluence of 3.5 x 10 17 neutrons/cm 2 and to a temperature of 290 grades C are achieved with annealing treatments at 550 grades C. In the studied samples it was found that the more hardening phase both the heat treatments as the neutron radiation, is the bainite, being the ferrite practically unchanged. Which it gave the tone to believe that the ferrite is the phase that provides at level macro the mechanical properties in stress, since in the irradiated samples such properties remained unchanged with respect to the non-irradiated material, however changes were observed in material ductility, which may be attributable to the change of hardness in the bainite, which opens a possibility for modeling the micromechanical behavior of this material. (Author)

  10. Measuring Treatment Outcomes in Comorbid Insomnia and Fibromyalgia: Concordance of Subjective and Objective Assessments.

    Science.gov (United States)

    Mundt, Jennifer M; Crew, Earl C; Krietsch, Kendra; Roth, Alicia J; Vatthauer, Karlyn; Robinson, Michael E; Staud, Roland; Berry, Richard B; McCrae, Christina S

    2016-02-01

    In insomnia, actigraphy tends to underestimate wake time compared to diaries and PSG. When chronic pain co-occurs with insomnia, sleep may be more fragmented, including more movement and arousals. However, individuals may not be consciously aware of these arousals. We examined the baseline concordance of diaries, actigraphy, and PSG as well as the ability of each assessment method to detect changes in sleep following cognitive behavioral therapy for insomnia (CBT-I). Adults with insomnia and fibromyalgia (n = 113) were randomized to CBT-I, CBT for pain, or waitlist control. At baseline and posttreatment, participants completed one night of PSG and two weeks of diaries/actigraphy. At baseline, objective measures estimated lower SOL, higher TST, and higher SE than diaries (ps treatment-related changes. PSG values did not change significantly for any sleep parameters. However, diaries showed improvements in SOL, WASO, and SE, and actigraphy also detected the WASO and SE improvements (ps treatment-related changes than PSG; PSG failed to detect any improvements, but actigraphy demonstrated changes in WASO and SE, which were also found with diaries. In comorbid insomnia/fibromyalgia, actigraphy may therefore have utility in measuring treatment outcomes. © 2015 American Academy of Sleep Medicine.

  11. Orthodontic treatment in periodontitis‐susceptible subjects: a systematic literature review

    Science.gov (United States)

    Lindsten, Rune; Slotte, Christer; Bjerklin, Krister

    2016-01-01

    Abstract The aim is to evaluate the literature for clinical scientific data on possible effects of orthodontic treatment on periodontal status in periodontitis‐susceptible subjects. A systematic literature review was performed on studies in English using PubMed, MEDLINE, and Cochrane Library central databases (1965‐2014). By manually searching reference lists of selected studies, we identified additional articles; then we searched these publications: Journal of Periodontology, Periodontology 2000, Journal of Clinical Periodontology, American Journal of Orthodontics and Dentofacial Orthopedics, Angle Orthodontist, International Journal of Periodontics & Restorative Dentistry, and European Journal of Orthodontics. Search terms included randomized clinical trials, controlled clinical trials, prospective and retrospective clinical studies, case series >5 patients, periodontitis, orthodontics, alveolar bone loss, tooth migration, tooth movement, orthodontic extrusion, and orthodontic intrusion. Only studies on orthodontic treatment in periodontally compromised dentitions were included. One randomized controlled clinical trial, one controlled clinical trial, and 12 clinical studies were included. No evidence currently exists from controlled studies and randomized controlled clinical trials, which shows that orthodontic treatment improves or aggravates the status of periodontally compromised dentitions. PMID:29744163

  12. Improved Completion Rates and Characterization of Drug Reactions with an Intensive Chagas Disease Treatment Program in Rural Bolivia

    Science.gov (United States)

    Tornheim, Jeffrey A.; Lozano Beltran, Daniel F.; Gilman, Robert H.; Castellon, Mario; Solano Mercado, Marco A.; Sullca, Walter; Torrico, Faustino; Bern, Caryn

    2013-01-01

    Background Chagas disease treatment is limited by drug availability, adverse side effect profiles of available medications, and poor adherence. Methods Adult Chagas disease patients initiating 60-days of benznidazole were randomized to weekly or twice-weekly evaluations of medication adherence and screening for adverse drug events (ADEs). Mid-week evaluations employed phone-based evaluations. Adherence was measured by self-report, pill counts with intentional over-distribution, and Medication Event Monitoring Systems (MEMS). Prospective data were compared to historical controls treated with benznidazole at the same hospital. Results 162 prospective patients were compared to 172 historical patients. Pill counts correlated well with MEMS data (R = 0.498 for 7-day intervals, R = 0.872 for intervals >7 days). Treatment completion rates were higher among prospective than historical patients (82.1% vs. 65.1%), primarily due to lower abandonment rates. Rates of ADEs were lower among prospective than historical patients (56.8% vs. 66.9%). Twice-weekly evaluations increased identification of mild ADEs, prompting higher suspension rates than weekly evaluations. While twice-weekly evaluations identified ADEs earlier, they did not reduce incidence of moderate or severe ADEs. Many dermatologic ADEs were moderately severe upon presentation (35.6%), were not reduced by use of antihistamines, occurred among adult patients of all ages, and occurred throughout treatment, rather than the first few weeks alone. Conclusions Intensive management improved completion and identified more ADEs, but did not reduce moderate or severe ADEs. Risk of dermatologic ADEs cannot be reduced by selecting younger adults or monitoring only during the first few weeks of treatment. Pill counts and phone-based encounters are reliable tools for treatment programming in rural Bolivia. PMID:24069472

  13. Carcass characteristics and meat evaluation of Nelore cattle subjected to different antioxidant treatments

    Directory of Open Access Journals (Sweden)

    Thiago de Jesus do Carmo

    Full Text Available ABSTRACT Forty Nelore cattle were used to evaluate the effects of supplementation with different antioxidants on carcass characteristics and meat quality of feedlot cattle. Animals were fed Brachiaria brizantha hay and subjected to five treatments (control and four antioxidants: zinc, selenium, vitamin E, and selenium + vitamin E. After a 105-day feeding period, cattle were slaughtered. Tissue composition, as well as carcass proximate composition, color, tenderness, pH, and fatty acid profile were evaluated. Analysis of variance was carried out and means compared by Tukey test at 0.05 probability. The group fed selenium showed the lowest muscle amount (66.61 g/100 g compared with the other antioxidants evaluated. There was no difference among treatments for bone, fat, and comestible portion percentages as well as muscle:bone, muscle:fat, and comestible portion:bone ratios, with mean values of 16.85 g/100 g, 14.70 g/100 g, 82.99 g/100 g, 4.06, 4.85, and 4.95, respectively. Neither brightness, red, or yellow contents of the meat nor carcass pH were affected by treatments. For tenderness and losses during thawing and cooking, there were no differences among treatments, with averages of 6.43 kgf cm2, 3.22 g/100 g, and 21.15 g/100 g, respectively. Supplementation of Nelore cattle fed Brachiaria brizantha hay with antioxidants do not influence carcass characteristics or meat quality. However, vitamin E supplementation reduces the levels of omega 3 fatty acid, whereas supplementation with selenium + vitamin E promotes an increase in linoleic and palmitoleic acids and a decrease in myristoleic acid, making the supplementation feasible due to the beneficial effects provided by these acids.

  14. Microstructural evolution of AZ31 magnesium alloy subjected to sliding friction treatment

    Science.gov (United States)

    Zhang, Wei; Lu, Jinwen; Huo, Wangtu; Zhang, Yusheng; Wei, Q.

    2018-06-01

    Microstructural evolution and grain refinement mechanism in AZ31 magnesium alloy subjected to sliding friction treatment were investigated by means of transmission electron microscopy. The process of grain refinement was found to involve the following stages: (I) coarse grains were divided into fine twin plates through mechanical twinning; then the twin plates were transformed to lamellae with the accumulation of residual dislocations at the twin boundaries; (II) the lamellae were separated into subgrains with increasing grain boundary misorientation and evolution of high angle boundaries into random boundaries by continuous dynamic recrystallisation (cDRX); (III) the formation of nanograins. The mechanisms for the final stage, the formation of nanograins, can be classified into three types: (i) cDRX; (ii) discontinuous dynamic recrystallisation (dDRX); (iii) a combined mechanism of prior shear-band and subsequent dDRX. Stored strain energy plays an important role in determining deformation mechanisms during plastic deformation.

  15. Investigation of virgin coals and coals subjected to a mild acid treatment

    Energy Technology Data Exchange (ETDEWEB)

    Clark, T.M.; Evans, B.J.; Wynter, C.; Pollak, H.; Taole, S.; Radcliffe, D. [University of Michigan, Ann Arbor, MI (United States). Dept. of Chemistry

    1998-06-01

    A quantitative determination of the relative marcasite/pyrite contents in virgin coals is possible by means of {sup 57}Fe Moessbauer spectroscopy. Complications arise however, when iron-containing silicates, carbonates, or other salts are present. The application of a mild chemical treatment involving hydrofluoric acid has been employed to remove these Fe-containing phases while leaving the iron-disulfide phases unaffected. Several South African coal samples with non-iron disulfide, Fe-containing phases ranging from 18 to 30 weight percent were subjected to a hydrofluoric acid leaching at room temperature. The loss of mineral matter with HF leaching correlates well with the mineral matter residue following low temperature ashing. The {sup 57}Fe Moessbauer spectra of the resulting coal samples indicate that only FeS{sub 2} phases are present and the absence of appreciable quantities of marcasite in the coals.

  16. Fast in situ X-ray diffraction phase and stress analysis during complete heat treatment cycles of steel

    International Nuclear Information System (INIS)

    Rocha, A. da S.; Hirsch, T.

    2005-01-01

    This paper presents results obtained with a method for time and temperature resolved analysis of changes in phase composition and stresses/residual stresses during complete heat treatment cycles of steel, including quenching. Sample temperatures of up to 930 deg. C could be reached with a specially designed furnace, where fast cooling of the samples was realized by gas quenching. Measurements for phase and stress analysis could be performed with an acquisition rate of at least one value every 3 s. Results concerning residual stress relaxation during heating, and stress/residual stress development during quenching are presented and discussed for AISI E52100 ball bearing steel. The observed stress development during quenching followed the expected transformation behavior with some deviations that could be explained through the effects of surface decarburization. The system developed proved to be a suitable tool for characterizing phase and stress changes that occur during heat treatment of steels, as a function of time and temperature

  17. Communication subjective assessments of patients undergoing compulsory treatment with the severity of negative symptoms and cognitive functioning level

    Directory of Open Access Journals (Sweden)

    Kabanov T.N.

    2015-04-01

    Full Text Available The article presents the results of studies on the relationship of subjective assessments of the mentally ill with the severity of negative symptoms and cognitive functioning level. The features of patients perception of various aspects of compulsory treatment and subjective satisfaction with treatment. In a study of 94 male patients with a diagnosis of organic mental disorder and schizophrenia was used diagnostic system, consisting of patopsihologicheskogo study, formal survey map, the scale of assessment of negative symptoms SANS, questionnaire symptom levels SCL-90, self-existing problems, as well as - in Test authoring tool sheet to treatment and hospital stay (VG Bulygin, Kabanov, TN, 2011. The differences in subjective assessments of aspects of compulsory treatment and social functioning of patients with varying degrees of severity of negative symptoms and dependence of subjective assessments of the level of cognitive functioning.

  18. Repeated Treatments with Chitosan in Combination with Antibiotics Completely Eradicate Uropathogenic Escherichia coli From Infected Mouse Urinary Bladders.

    Science.gov (United States)

    Erman, Andreja; Hergouth, Veronika Križan; Blango, Matthew G; Kos, Mojca Kerec; Mulvey, Matthew A; Veranic, Peter

    2017-08-01

    Uropathogenic Escherichia coli (UPEC), the primary causative agents of urinary tract infections, colonize and invade the epithelial cells of the bladder urothelium. Infection of immature urothelial cells can result in the formation of persistent intracellular reservoirs that are refractory to antibiotic treatments. Previously, we defined a novel therapeutic strategy that used the bladder cell exfoliant chitosan to deplete UPEC reservoirs. However, although a single treatment of chitosan followed by ciprofloxacin administration had a marked effect on reducing UPEC titers within the bladder, this treatment failed to prevent relapsing bacteriuria. We show here that repeated use of chitosan in conjunction with the antibiotic ciprofloxacin completely eradicates UPEC from the urinary tract and prevents the development of relapsing bouts of bacteriuria. In addition, microscopy revealed rapid restoration of bladder integrity following chitosan treatment, indicating that chitosan can be used to effectively combat recalcitrant bladder infections without causing lasting harm to the urothelium. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  19. Complete avulsion of the adductor longus in a semi-professional football player: Rapid return to play with nonoperative treatment

    Directory of Open Access Journals (Sweden)

    Vince W Lands

    2016-01-01

    Full Text Available The adductor longus has become recognized as one of the more commonly injured muscles in the medial compartment. Acute complete rupture injuries occurring at the proximal aspect of the muscle are less common. Limited data exist regarding management of the injuries in athletes required for return to play and functioning. The current data favors operative management; however, nonoperative treatment may be a viable option. Nonoperative management of avulsion injuries of the proximal adductor longus tendon may prove equal results to surgical repair in return to play and functioning. A semi-professional football player sustained a left groin injury while participating in the play. Due to continued pain, swelling, and suspicion of injury, a magnetic resonance imaging was performed diagnosing a complete tear of proximal adductor longus tendon. Physical examination, strength, and range of motion were recorded until the patient was able to function normally without strength deficit, the range of motion loss, and the return of speed. The player was treated nonoperatively and was eventually allowed to return to play. The time of return to play was 6 weeks. Strength deficit was not appreciated or loss of motion and player was able to return to baseline function. Nonoperative management of complete avulsion injuries of the proximal adductor longus tendon result in faster return to play than operative management even if significant retraction is present.

  20. Complete remission in a colon cancer patient with a large, irresectable liver metastasis after XELOX/cetuximab/bevacizumab treatment.

    Science.gov (United States)

    Weihrauch, Martin R; Stippel, Dirk; Fries, Jochen W U; Arnold, Dirk; Bovenschulte, Henning; Coutelle, Oliver; Hacker, Ulrich

    2008-09-01

    Stage IV colorectal cancer is usually an incurable disease. However, patients with resectable metastases have 5-year disease-free survival rates of up to 30%. Even with primarily irresectable disease, cure can be achieved in patients who become operable after neoadjuvant treatment. To improve the prognosis of these patients, highly effective neoadjuvant regimens need to be developed. Here, we report the case of a 62-year-old male patient who had been diagnosed with International Union against Cancer (UICC) stage III colon cancer 7 years previously and now presented with a large, irresectable liver metastasis and enlarged perihepatic lymph nodes. After neoadjuvant treatment with cetuximab, bevacizumab and XELOX, the patient showed a complete remission and underwent surgery. Histopathologically, the resected tissue and lymph nodes were free of residual tumor. To our knowledge, this is the first report of a complete pathological response in a patient with irresectable colorectal cancer after intensive chemotherapy/anti-EGFR/ VEGF antibody therapy. This combination regimen may help to improve the survival rates for patients with irresectable disease. Copyright 2008 S. Karger AG, Basel.

  1. Treatment of gastric peritoneal carcinomatosis by combining complete surgical resection of lesions and intraperitoneal immunotherapy using catumaxomab

    International Nuclear Information System (INIS)

    Goéré, Diane; Gras-Chaput, Nathalie; Aupérin, Anne; Flament, Caroline; Mariette, Christophe; Glehen, Olivier; Zitvogel, Laurence; Elias, Dominique

    2014-01-01

    The peritoneum is one of the most frequent sites of recurrent gastric carcinoma after curative treatment, despite the administration of pre- and/or postoperative systemic chemotherapy. Indeed, the prognosis of peritoneal carcinomatosis from gastric carcinoma continues to be poor, with a median survival of less than one year with systemic chemotherapy. Whereas the prognosis of peritoneal carcinomatosis from colorectal cancer has changed with the development of locally administered hyperthermic intraperitoneal chemotherapy (HIPEC), survival results following carcinomatosis from gastric cancer remain disappointing, yielding a 5-year survival rate of less than 20%. Innovative surgical therapies such as intraperitoneal immunotherapy therefore need to be developed for the immediate postoperative period after complete cytoreductive surgery. In a recent randomised study, a clinical effect was obtained after intraperitoneal infusion of catumaxomab in patients with malignant ascites, notably from gastric carcinoma. Catumaxomab, a nonhumanized chimeric antibody, is characterized by its unique ability to bind to three different types of cells: tumour cells expressing the epithelial cell adhesion molecule (EpCAM), T lymphocytes (CD3) and also accessory cells (Fcγ receptor). Because the peritoneum is an immunocompetent organ and up to 90% of gastric carcinomas express EpCAM, intraperitoneal infusion of catumaxomab after complete resection of all macroscopic disease (as defined in the treatment of carcinomatosis from colorectal cancer) could therefore efficiently treat microscopic residual disease. The aim of this randomized phase II study is to assess 2-year overall survival after complete resection of limited carcinomatosis synchronous with gastric carcinoma, followed by an intraperitoneal infusion of catumaxomab with different total doses administered in each of the 2 arms. Close monitoring of peri-opertive mortality, morbidity and early surgical re-intervention will be done

  2. Kinetic analysis of volatile formation in milk subjected to pressure-assisted thermal treatments.

    Science.gov (United States)

    Vazquez-Landaverde, P A; Qian, M C; Torres, J A

    2007-09-01

    Volatile formation in milk subjected to pressure-assisted thermal processing (PATP) was investigated from a reaction kinetic analysis point of view to illustrate the advantages of this technology. The concentration of 27 volatiles of different chemical class in milk subjected to pressure, temperature, and time treatments was fitted to zero-, 1st-, and 2nd-order chemical reaction models. Temperature and pressure effects on rate constants were analyzed to obtain activation energy (E(a)) and activation volume (deltaV*) values. Hexanal, heptanal, octanal, nonanal, and decanal followed 1st-order kinetics with rate constants characterized by E(a) values decreasing with pressure reflecting negative deltaV* values. Formation of 2-methylpropanal, 2,3-butanedione, and hydrogen sulfide followed zero-order kinetics with rate constants increasing with temperature but with unclear pressure effects. E(a) values for 2-methylpropanal and 2,3-butanedione increased with pressure, that is, deltaV* > 0, whereas values for hydrogen sulfide remained constant, that is, deltaV* = 0. The concentration of all other volatiles, including methanethiol, remained unchanged in pressure-treated samples, suggesting large negative deltaV* values. The concentration of methyl ketones, including 2-pentanone, 2-hexanone, 2-heptanone, 2-octanone, 2-nonanone, 2-decanone, and 2-undecanone, was independent of pressure and pressure-holding time. PATP promoted the formation of few compounds, had no effect on some, and inhibited the formation of volatiles reported to be factors of the consumer rejection of "cooked" milk flavor. The kinetic behavior observed suggested that new reaction formation mechanisms were not likely involved in volatile formation in PATP milk. The application of the Le Chatelier principle frequently used to explain the high quality of pressure-treated foods, often with no supporting experimental evidence, was not necessary.

  3. Three-dimensional morphology of the palate in subjects with unilateral complete cleft lip and palate at the stage of permanent dentition

    Czech Academy of Sciences Publication Activity Database

    Šmahel, Zbyněk; Trefný, P.; Formánek, P.; Mullerová, Ž.; Peterka, Miroslav

    2004-01-01

    Roč. 41, č. 4 (2004), s. 416-423 ISSN 1055-6656 R&D Projects: GA ČR GA304/02/1383 Institutional research plan: CEZ:AV0Z5039906 Keywords : palatal size and shape Subject RIV: EA - Cell Biology Impact factor: 0.861, year: 2004

  4. Factors influencing subjective orthodontic treatment need and culture-related differences among Chinese natives and foreign inhabitants.

    Science.gov (United States)

    Xiao-Ting, Li; Tang, Yin; Huang, Xue-Lian; Wan, Hua; Chen, Yang-Xi

    2010-09-01

    The aim of this survey was to compare Chinese natives and foreign inhabitants in Chengdu, China, with respect to: (1) attitudes towards dental appearance, (2) subjective orthodontic treatment need, and (3) the main factors influencing orthodontic treatment need. A total of 522 subjects, including 227 foreign inhabitants and 295 Chinese natives in Chengdu participated in the survey. A simple random sampling method was adopted and a face-to-face interview was conducted at some public sites using a questionnaire. Data was entered by two persons synchronously using Epidata 3.0, and SPSS 13.0 was used to analyze these data. 89.0% of foreign inhabitants were satisfied with their teeth compared to only 46.8% of Chinese natives. Females were more dissatisfied with their teeth than males. Chinese natives put improving appearance as the top priority (55.9%) for seeking orthodontic treatment; however, in foreign inhabitants, the main reason for seeking treatment was to improve masticatory function (44.1%), followed by "to be pretty" (35.2%). The importance of well-aligned teeth and self-perception of psychosocial impact of malocclusion were the same two main factors influencing subjective orthodontic treatment need (P different (P differences in orthodontic treatment motives between the two target groups. (3) There were differences in subjective orthodontic treatment needs between foreign inhabitants and Chinese natives. However, the prominent influential factors were almost the same. There may be benefit to understanding subjective orthodontic needs of different races.

  5. Complete Remodeling After Conservative Treatment of a Severely Angulated Odontoid Fracture in a Patient With Osteogenesis Imperfecta: A Case Report.

    Science.gov (United States)

    Colo, Dino; Schlösser, Tom P C; Oostenbroek, Hubert J; Castelein, René M

    2015-09-15

    Case report. This is the first case report describing successful healing and remodeling of a traumatic odontoid fracture that was dislocated and severely angulated in a patient with osteogenesis imperfecta who was treated conservatively. Osteogenesis imperfecta (OI) is a rare genetic disorder resulting in a low bone mass and bone fragility, predisposing these patients to fractures that often occur at a young age. Although any bone in the body may be involved, odontoid fractures are uncommon in this population. Because of a very high fusion rate, conservative management is accepted as a safe and efficient treatment of fractures of the odontoid in children. Several authors, however, recommend surgical treatment of patients who have failure of conservative treatment and have severe angulation or displacement of the odontoid. A 5-year-old female, diagnosed with OI type I, presented with neck pain without any neurological deficits after falling out of a rocking chair backward, with her head landing first on the ground. Computed tomography confirmed a type III odontoid fracture without dislocation and she was initially treated with a rigid cervical orthosis. At 1 and 2 months of follow-up, progressive severe angulation of the odontoid was observed but conservative treatment was maintained as the space available for the spinal cord was sufficient and also considering the patient's history of OI. Eight months postinjury, she had no clinical symptoms and there was osseous healing of the fracture with remodeling of the odontoid to normal morphology. Even in patients with OI, severely angulated odontoid fractures might have the capacity for osseous healing and complete remodeling under conservative treatment. 5.

  6. Outpatient treatment of alcohol use disorders among subjects 60+ years: design of a randomized clinical trial conducted in three countries (Elderly Study).

    Science.gov (United States)

    Andersen, Kjeld; Bogenschutz, Michael P; Bühringer, Gerhard; Behrendt, Silke; Bilberg, Randi; Braun, Barbara; Ekstrøm, Claus Thorn; Forcehimes, Alyssa; Lizarraga, Christine; Moyers, Theresa B; Nielsen, Anette Søgaard

    2015-11-14

    The proportion of 60+ years with excessive alcohol intake varies in western countries between 6-16 % among men and 2-7 % among women. Specific events related to aging (e.g. loss of job, physical and mental capacity, or spouse) may contribute to onset or continuation of alcohol use disorders (AUD). We present the rationale and design of a multisite, multinational AUD treatment study for subjects aged 60+ years. 1,000 subjects seeking treatment for AUD according to DSM-5 in outpatient clinics in Denmark, Germany, and New Mexico (USA) are invited to participate in a RCT. Participants are randomly assigned to four sessions of Motivational Enhancement Treatment (MET) or to MET plus an add-on with eight sessions based on the Community Reinforcement Approach (CRA), which include a new module targeting specific problems of older adults. A series of assessment instruments is applied, including the Form-90, Alcohol Dependence Scale, Penn Alcohol Craving Scale, Brief Symptom Inventory and WHO Quality of Life. Enrolment will be completed by April 2016 and data collection by April 2017. The primary outcome is the proportion in each group who are abstinent or have a controlled use of alcohol six months after treatment initiation. Controlled use is defined as maximum blood alcohol content not exceeding 0.05 % during the last month. Total abstinence is a secondary outcome, together with quality of life andcompliance with treatment. The study will provide new knowledge about brief treatment of AUD for older subjects. As the treatment is manualized and applied in routine treatment facilities, barriers for implementation in the health care system are relatively low. Finally, as the study is being conducted in three different countries it will also provide significant insight into the possible interaction of service system differences and related patient characteristics in predictionof treatment outcome. Clinical Trials.gov NCT02084173 , March 7, 2014.

  7. The Legal Regulation of Health-Resort Treatment of Employees Under the Legislation of Subjects of the Russian Federation

    Directory of Open Access Journals (Sweden)

    Anufrieva A. V.

    2015-10-01

    Full Text Available The article analyzes the rules for health-resort treatment of employees established at the level of subjects of the Russian Federation, determines the place of these rules in the system of current legal regulation of health-resort treatment and also it evaluates their significance in the social security of employees

  8. Subjective perception of radioactivity. No change post successful treatment with radioiodine

    International Nuclear Information System (INIS)

    Freudenberg, L.S.; Mueller, S.P.; Beyer, T.; Bockisch, A.

    2009-01-01

    We assess the attitude of patients with thyroid disease towards radiation and radioactivity before and after radioiodine therapy by means of a cultural-anthropological approach. We evaluate in patient interviews how their subjective attitude towards radioactivity as an abstract term and towards radioactivity in the medical context on the basis of their personal experiences with radionuclide therapy. 29 patients with autonomously functioning thyroid lesions (17 women, 12 men, 35-79 years) were included in this study. All patients were interviewed prior to and 22-27 month post radioiodine therapy in an open dialogue with the principal investigator. Patients were asked to describe their attitude towards radioactivity in general and towards radioiodine therapy in particular. Patients were asked to use a scoring system (1: positive, 5: negative) to quantify their perception of radioactivity. The personal perception of radioactivity as an abstract term does not change significantly (p = 0.15) before and after radioiodine therapy. This perception is linked to mostly negative impressions of radiactivity. However, patients become more positive when assessing the value of radioactivity as part of their therapy regimen. Thus, we observe a significant increase in percepted value of radioactivity post radioiodine therapy (p = 0.03). Patients continue to view radioactivity as something negative despite treatment success following radioiodine therapy. Our results provide useful information for patient information by the nuclear medicine physician prior to a radioiodine therapy. (orig.)

  9. The effect of phonation into a straw on the vocal tract adjustments and formant frequencies. A preliminary MRI study on a single subject completed with acoustic results

    Czech Academy of Sciences Publication Activity Database

    Laukkanen, A. M.; Horáček, Jaromír; Krupa, P.; Švec, J. G.

    2012-01-01

    Roč. 7, č. 1 (2012), s. 50-57 ISSN 1746-8094 R&D Projects: GA ČR GA101/08/1155 Institutional research plan: CEZ:AV0Z20760514 Keywords : vocal exercises * semi-occlusions * vocal tract setting Subject RIV: BI - Acoustics Impact factor: 1.074, year: 2012 http://www.sciencedirect.com/science/article/pii/S1746809411000097

  10. Comparison of Physiological and Psychological Relaxation Using Measurements of Heart Rate Variability, Prefrontal Cortex Activity, and Subjective Indexes after Completing Tasks with and without Foliage Plants.

    Science.gov (United States)

    Park, Sin-Ae; Song, Chorong; Oh, Yun-Ah; Miyazaki, Yoshifumi; Son, Ki-Cheol

    2017-09-20

    The objective of this study was to compare physiological and psychological relaxation by assessing heart rate variability (HRV), prefrontal cortex activity, and subjective indexes while subjects performed a task with and without foliage plants. In a crossover experimental design, 24 university students performed a task transferring pots with and without a foliage plant for 3 min. HRV and oxyhemoglobin (oxy-Hb) concentration in the prefrontal cortex were continuously measured. Immediately thereafter, subjective evaluation of emotions was performed using a modified semantic differential (SD) method and a profile of mood state questionnaire (POMS). Results showed that the natural logarithmic (ln) ratio of low frequency/high frequency, as an estimate of sympathetic nerve activity, was significantly lower while performing the task with foliage plants for the average 3 min measurement interval. Oxy-Hb concentration in the left prefrontal cortex showed a tendency to decrease in the 2-3 min interval in the task with foliage plants compared to the task without plants. Moreover, significant psychological relaxation according to POMS score and SD was demonstrated when the task involved foliage plants. In conclusion, the task involving foliage plants led to more physiological and psychological relaxation compared with the task without foliage plants.

  11. Comparison of Physiological and Psychological Relaxation Using Measurements of Heart Rate Variability, Prefrontal Cortex Activity, and Subjective Indexes after Completing Tasks with and without Foliage Plants

    Directory of Open Access Journals (Sweden)

    Sin-Ae Park

    2017-09-01

    Full Text Available The objective of this study was to compare physiological and psychological relaxation by assessing heart rate variability (HRV, prefrontal cortex activity, and subjective indexes while subjects performed a task with and without foliage plants. In a crossover experimental design, 24 university students performed a task transferring pots with and without a foliage plant for 3 min. HRV and oxyhemoglobin (oxy-Hb concentration in the prefrontal cortex were continuously measured. Immediately thereafter, subjective evaluation of emotions was performed using a modified semantic differential (SD method and a profile of mood state questionnaire (POMS. Results showed that the natural logarithmic (ln ratio of low frequency/high frequency, as an estimate of sympathetic nerve activity, was significantly lower while performing the task with foliage plants for the average 3 min measurement interval. Oxy-Hb concentration in the left prefrontal cortex showed a tendency to decrease in the 2–3 min interval in the task with foliage plants compared to the task without plants. Moreover, significant psychological relaxation according to POMS score and SD was demonstrated when the task involved foliage plants. In conclusion, the task involving foliage plants led to more physiological and psychological relaxation compared with the task without foliage plants.

  12. Predictive Factors for Subjective Improvement in Lumbar Spinal Stenosis Patients with Nonsurgical Treatment: A 3-Year Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Ko Matsudaira

    Full Text Available To assess the predictive factors for subjective improvement with nonsurgical treatment in consecutive patients with lumbar spinal stenosis (LSS.Patients with LSS were enrolled from 17 medical centres in Japan. We followed up 274 patients (151 men; mean age, 71 ± 7.4 years for 3 years. A multivariable logistic regression model was used to assess the predictive factors for subjective symptom improvement with nonsurgical treatment.In 30% of patients, conservative treatment led to a subjective improvement in the symptoms; in 70% of patients, the symptoms remained unchanged, worsened, or required surgical treatment. The multivariable analysis of predictive factors for subjective improvement with nonsurgical treatment showed that the absence of cauda equina symptoms (only radicular symptoms had an odds ratio (OR of 3.31 (95% confidence interval [CI]: 1.50-7.31; absence of degenerative spondylolisthesis/scoliosis had an OR of 2.53 (95% CI: 1.13-5.65; <1-year duration of illness had an OR of 3.81 (95% CI: 1.46-9.98; and hypertension had an OR of 2.09 (95% CI: 0.92-4.78.The predictive factors for subjective symptom improvement with nonsurgical treatment in LSS patients were the presence of only radicular symptoms, absence of degenerative spondylolisthesis/scoliosis, and an illness duration of <1 year.

  13. Subjective visual vertical before and after treatment of a BPPV episode.

    Science.gov (United States)

    Faralli, Mario; Manzari, Leonardo; Panichi, Roberto; Botti, Fabio; Ricci, Giampietro; Longari, Fabrizio; Pettorossi, Vito Enrico

    2011-06-01

    The study analyses the behavior of subjective visual vertical (SVV) in benign paroxysmal positional vertigo (BPPV) before and after treatment, and offers a clinical-pathogenic interpretation. We studied 30 consecutive patients with BPPV of the posterior semicircular canal treated with the Epley repositioning maneuver. SVV was determined at three different stages: at the time of diagnosis (1st test), after the repositioning maneuver (2nd test), and then 7 days after the resolution of the clinical picture (3rd test). The main study parameter was represented by the mean of 6 consecutive measurements (SVV(0)) for each patient. SVV was also examined in 20 healthy subjects, who represented the control group. The comparison between mean values and standard deviations showed a statistical significance of p<0.05. During the first test, the degree of deviation of SVV was significantly higher in the patient group than in the control group. Tilting towards the affected side was observed in all cases. The 2nd test showed an inversion in the orientation of SVV in 16 patients, and as a result of the Epley maneuver there was a statistically significant variation in SVV(0) values in 20 patients with respect to the previous test (2nd test vs. 1st test). This involved 87% (23 patients) of those who then had a negative Dix-Hallpike test, and none of the ones in whom paroxysmal positional nystagmus persisted. Lastly, no differences emerged in the behavior of the patient group vs. the control group during the third test. SVV is often altered during active BPPV. The degree of otolithic dysfunction is never high and, in all cases, it is brief in duration. Tilting towards the dysfunctional side is essentially a constant in untreated BPPV. This could be due to a substantial loss of otoconia, with a decrease in the density and specific weight of the macula, and thus hypofunction of the receptor. The observation of a significant variation in SVV after therapeutic maneuvers has a favorable

  14. Attentional Control and Subjective Executive Function in Treatment-Naive Adults with Attention Deficit Hyperactivity Disorder

    Science.gov (United States)

    Grane, Venke Arntsberg; Endestad, Tor; Pinto, Arnfrid Farbu; Solbakk, Anne-Kristin

    2014-01-01

    We investigated performance-derived measures of executive control, and their relationship with self- and informant reported executive functions in everyday life, in treatment-naive adults with newly diagnosed Attention Deficit Hyperactivity Disorder (ADHD; n = 36) and in healthy controls (n = 35). Sustained attentional control and response inhibition were examined with the Test of Variables of Attention (T.O.V.A.). Delayed responses, increased reaction time variability, and higher omission error rate to Go signals in ADHD patients relative to controls indicated fluctuating levels of attention in the patients. Furthermore, an increment in NoGo commission errors when Go stimuli increased relative to NoGo stimuli suggests reduced inhibition of task-irrelevant stimuli in conditions demanding frequent responding. The ADHD group reported significantly more cognitive and behavioral executive problems than the control group on the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A). There were overall not strong associations between task performance and ratings of everyday executive function. However, for the ADHD group, T.O.V.A. omission errors predicted self-reported difficulties on the Organization of Materials scale, and commission errors predicted informant reported difficulties on the same scale. Although ADHD patients endorsed more symptoms of depression and anxiety on the Achenbach System of Empirically Based Assessment (ASEBA) than controls, ASEBA scores were not significantly associated with T.O.V.A. performance scores. Altogether, the results indicate multifaceted alteration of attentional control in adult ADHD, and accompanying subjective difficulties with several aspects of executive function in everyday living. The relationships between the two sets of data were modest, indicating that the measures represent non-redundant features of adult ADHD. PMID:25545156

  15. Attentional control and subjective executive function in treatment-naive adults with Attention Deficit Hyperactivity Disorder.

    Science.gov (United States)

    Grane, Venke Arntsberg; Endestad, Tor; Pinto, Arnfrid Farbu; Solbakk, Anne-Kristin

    2014-01-01

    We investigated performance-derived measures of executive control, and their relationship with self- and informant reported executive functions in everyday life, in treatment-naive adults with newly diagnosed Attention Deficit Hyperactivity Disorder (ADHD; n = 36) and in healthy controls (n = 35). Sustained attentional control and response inhibition were examined with the Test of Variables of Attention (T.O.V.A.). Delayed responses, increased reaction time variability, and higher omission error rate to Go signals in ADHD patients relative to controls indicated fluctuating levels of attention in the patients. Furthermore, an increment in NoGo commission errors when Go stimuli increased relative to NoGo stimuli suggests reduced inhibition of task-irrelevant stimuli in conditions demanding frequent responding. The ADHD group reported significantly more cognitive and behavioral executive problems than the control group on the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A). There were overall not strong associations between task performance and ratings of everyday executive function. However, for the ADHD group, T.O.V.A. omission errors predicted self-reported difficulties on the Organization of Materials scale, and commission errors predicted informant reported difficulties on the same scale. Although ADHD patients endorsed more symptoms of depression and anxiety on the Achenbach System of Empirically Based Assessment (ASEBA) than controls, ASEBA scores were not significantly associated with T.O.V.A. performance scores. Altogether, the results indicate multifaceted alteration of attentional control in adult ADHD, and accompanying subjective difficulties with several aspects of executive function in everyday living. The relationships between the two sets of data were modest, indicating that the measures represent non-redundant features of adult ADHD.

  16. Attentional control and subjective executive function in treatment-naive adults with Attention Deficit Hyperactivity Disorder.

    Directory of Open Access Journals (Sweden)

    Venke Arntsberg Grane

    Full Text Available We investigated performance-derived measures of executive control, and their relationship with self- and informant reported executive functions in everyday life, in treatment-naive adults with newly diagnosed Attention Deficit Hyperactivity Disorder (ADHD; n = 36 and in healthy controls (n = 35. Sustained attentional control and response inhibition were examined with the Test of Variables of Attention (T.O.V.A.. Delayed responses, increased reaction time variability, and higher omission error rate to Go signals in ADHD patients relative to controls indicated fluctuating levels of attention in the patients. Furthermore, an increment in NoGo commission errors when Go stimuli increased relative to NoGo stimuli suggests reduced inhibition of task-irrelevant stimuli in conditions demanding frequent responding. The ADHD group reported significantly more cognitive and behavioral executive problems than the control group on the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A. There were overall not strong associations between task performance and ratings of everyday executive function. However, for the ADHD group, T.O.V.A. omission errors predicted self-reported difficulties on the Organization of Materials scale, and commission errors predicted informant reported difficulties on the same scale. Although ADHD patients endorsed more symptoms of depression and anxiety on the Achenbach System of Empirically Based Assessment (ASEBA than controls, ASEBA scores were not significantly associated with T.O.V.A. performance scores. Altogether, the results indicate multifaceted alteration of attentional control in adult ADHD, and accompanying subjective difficulties with several aspects of executive function in everyday living. The relationships between the two sets of data were modest, indicating that the measures represent non-redundant features of adult ADHD.

  17. Influence of 17β-estradiol treatment on the expression of NF-κB in complete hydatidiform mole culture

    Directory of Open Access Journals (Sweden)

    Tatit Nurseta

    2013-12-01

    Full Text Available Background:  Genetic evidence has established a role of nuclear factor kappa B (NF-κB signaling in oncogenesis. However, activity of NF-κB in complete hydatidiform mole (CHM cell culture under 17β-estradiol (E2 treatment is not yet known. Recently, a positive cross-talk between estrogen receptor (ER and NF-κB to promote survival and progress of cancer cells to a more aggressive phenotype was established. In the present study, we examined the influence of E2 treatment on the NF-κB expression in CHM’s culture.Methods:  This experimental study measured the expression of NF-κB in CHM culture treated with E2: 10, 100, 300, 600, and 1000 pg/mL and without E2. Imunohistochemistry staining was used to assess the expression of NF-κB. Microphotographs were taken using 400x magnification. Adobe photoshop CS2 was used to assess the NF-κB expression in cell nucleus. The lower the color intensity of cell RGBbv, is the higher the expression of NF-κB in cells. ANOVA test was performed to compare the expression of NF-κB.Results: NF-κB expression as indicated by color intensity in control group was 114.84 ± 9.02. NF-κB expression in E2 treatment groups were respectively: E2 10 pg/mL: 106.30 ± 13.95; E2 100 pg/mL: 82.47 ± 4.72; E2 300 pg/mL: 82.24 ± 2.67; E2 600 pg/mL: 69.05 ± 6.47; E2 1000 pg/mL: 68.49 ± 2.37. There was progressive decline in color intensity of cells with E2 treatment indicating the increase expression of NF-κB. Significant differences with the control group occurred in doses of E2 100, 300, 600, dan 1000 pg/mL.Conclusion: Treatment of CHM trophoblast culture with escalating doses of E2 was associated with the increase of NF-κB expression in a dose dependent manner. (Med J Indones. 2013;22:197-201. doi: 10.13181/mji.v22i4.599Keywords: 17-β Estradiol, Hydatidiform mole, NF-κB

  18. Equilibrium stability of a cylindrical body subject to the internal structure of the material and inelastic behaviour of the completely compressed matrix

    Science.gov (United States)

    Gotsev, D. V.; Perunov, N. S.; Sviridova, E. N.

    2018-03-01

    The mathematical model describing the stress-strain state of a cylindrical body under the uniform radial compression effect is constructed. The model of the material is the porous medium model. The compressed skeleton of the porous medium possesses hardening elastic-plastic properties. Deforming of the porous medium under the specified compressive loads is divided into two stages: elastic deforming of the porous medium and further elastic-plastic deforming of the material with completely compressed matrix. The analytical relations that define the fields of stress and displacement at each stage of the deforming are obtained. The influence of the porosity and other physical, mechanical and geometric parameters of the construction on the size of the plastic zone is evaluated. The question of the ground state equilibrium instability is investigated within the framework of the three-dimensional linearized relationships of the stability theory of deformed bodies.

  19. Complete Restoration of Refractory Mandibular Osteoradionecrosis by Prolonged Treatment with a Pentoxifylline-Tocopherol-Clodronate Combination (PENTOCLO): A Phase II Trial

    International Nuclear Information System (INIS)

    Delanian, Sylvie; Chatel, Cecile; Porcher, Raphael; Depondt, Joel; Lefaix, Jean-Louis

    2011-01-01

    Purpose: Osteoradionecrosis (ORN) is a nonhealing wound of the bone that is difficult to manage. Combined treatment with pentoxifylline and vitamin E reduces radiation-induced fibrosis and ORN with a good prognosis. We previously showed that the combination of pentoxifylline and vitamin E with clodronate (PENTOCLO) is useful in healing sternocostal and some mandibular ORN. Is PENTOCLO effective in ORN of poor prognosis? Methods: 54 eligible patients previously irradiated for head and neck cancer (among 72 treated) a mean 5 years previously received exteriorized refractory mandibular ORN for 1.4 ± 1.8 years, mainly after local surgery and hyperbaric oxygen had been ineffective. The mean length of exposed bone (D) was 17 ± 8 mm as primary endpoint, and the mean Subjective, Objective, Management, and Analytic evaluation of injury (SOMA) score was 16 ± 4. Between August 2000 and August 2008, all patients were given daily oral PENTOCLO: 800 mg pentoxifylline, 1,000 IU vitamin E, and 1,600 mg clodronate 5 days per week alternating with 20 mg prednisone and 1,000 mg ciprofloxacin 2 days per week. The duration of treatment was related to consolidated healing. Results: Prolonged treatment (16 ± 9 months) was safe and well tolerated. All patients improved, with an exponential progressive-(f[t] = a.exp(-b.t)-and significant (p 2 -42%, D 4 -62%, D 6 -77%, D 12 -92%, and D 18 -96%, combined with iterative spontaneous sequestrectomies in 36 patients. All patients experienced complete recovery in a median of 9 months. Clinical improvement was measured in terms of discontinuation of analgesics, new fracture, closed skin fistulae, and delayed radiologic improvement: SOMA 6 -64%, SOMA 12 -89%, and SOMA 30 -96%. Conclusion: Long-term PENTOCLO treatment is effective, safe, and curative for refractory ORN and induces mucosal and bone healing with significant symptom improvement. These findings will need to be confirmed in a randomized trial.

  20. An economic evaluation of contingency management for completion of hepatitis B vaccination in those on treatment for opiate dependence.

    Science.gov (United States)

    Rafia, Rachid; Dodd, Peter J; Brennan, Alan; Meier, Petra S; Hope, Vivian D; Ncube, Fortune; Byford, Sarah; Tie, Hiong; Metrebian, Nicola; Hellier, Jennifer; Weaver, Tim; Strang, John

    2016-09-01

    To determine whether the provision of contingency management using financial incentives to improve hepatitis B vaccine completion in people who inject drugs entering community treatment represents a cost-effective use of health-care resources. A probabilistic cost-effectiveness analysis was conducted, using a decision-tree to estimate the short-term clinical and health-care cost impact of the vaccination strategies, followed by a Markov process to evaluate the long-term clinical consequences and costs associated with hepatitis B infection. Data on attendance to vaccination from a UK cluster randomized trial. Two contingency management options were examined in the trial: fixed versus escalating schedule financial incentives. Life-time health-care costs and quality-adjusted life years discounted at 3.5% annually; incremental cost-effectiveness ratios. The resulting estimate for the incremental life-time health-care cost of the contingency management strategy versus usual care was £21.86 [95% confidence interval (CI) = -£12.20 to 39.86] per person offered the incentive. For 1000 people offered the incentive, the incremental reduction in numbers of hepatitis B infections avoided over their lifetime was estimated at 19 (95% CI = 8-30). The probabilistic incremental cost per quality adjusted life-year gained of the contingency management programme was estimated to be £6738 (95% CI = £6297-7172), with an 89% probability of being considered cost-effective at a threshold of £20 000 per quality-adjusted life years gained (97.60% at £30 000). Using financial incentives to increase hepatitis B vaccination completion in people who inject drugs could be a cost-effective use of health-care resources in the UK as long as the incidence remains above 1.2%. © 2016 Society for the Study of Addiction.

  1. External beam radiotherapy boosted with high dose rate brachytherapy in completely resected uterine sarcomas. Is this a treatment option?

    Energy Technology Data Exchange (ETDEWEB)

    Pellizzon, Antonio Cassio Assis; Novaes, Paulo Eduardo Ribeiro dos Santos; Maia, Maria Aparecida Conte; Ferrigno, Robson; Fogarolli, Ricardo; Salvajoli, Joao Vitor [Hospital de Cancer A.C. Camargo, Sao Paulo, SP (Brazil). Dept. de Oncologia de Radiacao]. E-mail: pellizzon@aol.com

    2005-04-15

    Uterine sarcoma (US) is a relative rare tumor, which accounts for only about 3-5% of all uterine cancers. Aggressive cytoreductive surgery at the time of the initial diagnosis with maximum tumor debulking may lead to a prolonged survival or cure. Objective: to identify and review the role of adjuvant external beam radiation therapy (EBRT) associated with high dose rate brachytherapy (HDRB) in the management of patients presenting US with complete resection. Material and methods: this study is a retrospective analysis of 23 patients with US treated from 10/92 to 03/03, with surgery, external beam radiation therapy (EBRT) and high dose rate brachytherapy (HDRB). The inclusion criteria for study participation included: histologically proven and graded US, completely resection of tumor, Karnofsky status 60-100, absence of significant infection, and recovery from recent surgery. Results: The median age of patients was 62 years (range 39-84); ten-year actuarial disease-free and overall survivals were 42.2% and 63.4%, respectively. On univariate analysis, predictive factors for disease-free survival (DFS) were age at initial presentation (p=0.0268), parity (p=0.0441), tumor grade (p= 0.0095), cervical or vaginal invasion (p=0.0014) and node dissection at time of surgery (p= 0.0471). On multivariate analysis, the only predictive factor was cervical or vaginal invasion (p= 0.048), hazard ratio of 4.7. Conclusion: it is quite likely that neither radiotherapy nor chemotherapy alone will appreciably improve survival in US. If radiation therapy provides better locoregional tumor control, hematogenous metastases will assume an even greater proportion of treatment failures. Unfortunately, our small and heterogeneous group analyzed precludes any definitive conclusions about the impact of HDRB associated to EBRT radiation therapy on recurrence or survival. (author)

  2. External beam radiotherapy boosted with high dose rate brachytherapy in completely resected uterine sarcomas. Is this a treatment option?

    International Nuclear Information System (INIS)

    Pellizzon, Antonio Cassio Assis; Novaes, Paulo Eduardo Ribeiro dos Santos; Maia, Maria Aparecida Conte; Ferrigno, Robson; Fogarolli, Ricardo; Salvajoli, Joao Vitor

    2005-01-01

    Uterine sarcoma (US) is a relative rare tumor, which accounts for only about 3-5% of all uterine cancers. Aggressive cytoreductive surgery at the time of the initial diagnosis with maximum tumor debulking may lead to a prolonged survival or cure. Objective: to identify and review the role of adjuvant external beam radiation therapy (EBRT) associated with high dose rate brachytherapy (HDRB) in the management of patients presenting US with complete resection. Material and methods: this study is a retrospective analysis of 23 patients with US treated from 10/92 to 03/03, with surgery, external beam radiation therapy (EBRT) and high dose rate brachytherapy (HDRB). The inclusion criteria for study participation included: histologically proven and graded US, completely resection of tumor, Karnofsky status 60-100, absence of significant infection, and recovery from recent surgery. Results: The median age of patients was 62 years (range 39-84); ten-year actuarial disease-free and overall survivals were 42.2% and 63.4%, respectively. On univariate analysis, predictive factors for disease-free survival (DFS) were age at initial presentation (p=0.0268), parity (p=0.0441), tumor grade (p= 0.0095), cervical or vaginal invasion (p=0.0014) and node dissection at time of surgery (p= 0.0471). On multivariate analysis, the only predictive factor was cervical or vaginal invasion (p= 0.048), hazard ratio of 4.7. Conclusion: it is quite likely that neither radiotherapy nor chemotherapy alone will appreciably improve survival in US. If radiation therapy provides better locoregional tumor control, hematogenous metastases will assume an even greater proportion of treatment failures. Unfortunately, our small and heterogeneous group analyzed precludes any definitive conclusions about the impact of HDRB associated to EBRT radiation therapy on recurrence or survival. (author)

  3. The customer is always right? Subjective target symptoms and treatment preferences in patients with psychosis.

    Science.gov (United States)

    Moritz, Steffen; Berna, Fabrice; Jaeger, Susanne; Westermann, Stefan; Nagel, Matthias

    2017-06-01

    Clinicians and patients differ concerning the goals of treatment. Eighty individuals with schizophrenia were assessed online about which symptoms they consider the most important for treatment, as well as their experience with different interventions. Treatment of affective and neuropsychological problems was judged as more important than treatment of positive symptoms (p experience with Occupational and Sports Therapy, only a minority had received Cognitive-Behavioral Therapy, Family Therapy, and Psychoeducation with family members before. Patients appraised Talk, Psychoanalytic, and Art Therapy as well as Metacognitive Training as the most helpful treatments. Clinicians should carefully take into consideration patients' preferences, as neglect of consumers' views may compromise outcome and adherence to treatment.

  4. Characterization of dendritic morphology and neurotransmitter phenotype of thoracic descending propriospinal neurons after complete spinal cord transection and GDNF treatment

    Science.gov (United States)

    Deng, Lingxiao; Ruan, Yiwen; Chen, Chen; Frye, Christian Corbin; Xiong, Wenhui; Jin, Xiaoming; Jones, Kathryn; Sengelaub, Dale; Xu, Xiao-Ming

    2016-01-01

    After spinal cord injury (SCI), poor regeneration of damaged axons of the central nervous system (CNS) causes limited functional recovery. This limited spontaneous functional recovery has been attributed, to a large extent, to the plasticity of propriospinal neurons, especially the descending propriospinal neurons (dPSNs). Compared with the supraspinal counterparts, dPSNs have displayed significantly greater regenerative capacity, which can be further enhanced by glial cell line-derived neurotrophic factor (GDNF). In the present study, we applied a G-mutated rabies virus (G-Rabies) co-expressing green fluorescence protein (GFP) to reveal Golgi-like dendritic morphology of dPSNs. We also investigated the neurotransmitters expressed by dPSNs after labeling with a retrograde tracer Fluoro-Gold (FG). dPSNs were examined in animals with sham injuries or complete spinal transections with or without GDNF treatment. Bilateral injections of G-Rabies and FG were made into the 2nd lumbar (L2) spinal cord at 3 days prior to a spinal cord transection performed at the 11th thoracic level (T11). The lesion gap was filled with Gelfoam containing either saline or GDNF in the injury groups. Four days post-injury, the rats were sacrificed for analysis. For those animals receiving G-rabies injection, the GFP signal in the T7–9 spinal cord was visualized via 2-photon microscopy. Dendritic morphology from stack images was traced and analyzed using a Neurolucida software. We found that dPSNs in sham injured animals had a predominantly dorsal-ventral distribution of dendrites. Transection injury resulted in alterations in the dendritic distribution with dorsal-ventral retraction and lateral-medial extension. Treatment with GDNF significantly increased the terminal dendritic length of dPSNs. The density of spine-like structures was increased after injury, and treatment with GDNF enhanced this effect. For the group receiving FG injections, immunohistochemistry for glutamate, choline

  5. Subjective processes surgical treatment in patients with stages of the disease hemorrhoidal

    Directory of Open Access Journals (Sweden)

    Magno Otávio Salgado de Freitas

    2017-07-01

    Full Text Available Introduction: Hemorrhoidal disease afflicts 4.4% of the world population, being the most common anal disorder. Surgical treatment is used for about 5–10% of cases where conservative procedures have not worked. Objective: To understand the trajectory and perception of individuals submitted to surgical treatment of hemorrhoidal disease. Methods: This is a descriptive study with a qualitative approach, which emphasized Cartography as the main method in the analysis of the results. Data were produced through individual interviews recorded and transcribed in full, from March to June 2015, in a Polyclinic and in a public hospital in the municipality of Montes Claros-MG. Twelve interviews were carried out. Results: The results evidenced the existence of processes of subjectivization that, through affectations, cause individuals to demonstrate a transcendent thought, exemplified by the sensation of a self-knowledge of the disease, including correlating it with possible hereditary, behavioral and alimentary causes. There was an escalation in the various levels of health care, standardized by the public system, sometimes revealing a molar thought, preventing the occurrence of an event, reducing power and failing to achieve a plan of immanence with the complete resolution of the problem. The hard lines, evidenced by a delay in obtaining a treatment thanks for fear and shame, favored self-medication, with a worsening of symptoms. Conclusion: It was noted that there were obstacles in all levels of the SUS that made it difficult to reach the surgical treatment, but all patients were considered with surgery and with the postoperative period. Resumo: Introdução: A doença hemorroidaria aflige 4,4% da população mundial, sendo o distúrbio anal mais comum. O tratamento cirúrgico é utilizado para cerca de 5 a 10% dos casos em que os procedimentos conservadores não surtiram efeito. Objetivo: Compreender a trajetória e percepção dos indiv

  6. Subjective-objective sleep discrepancy among older adults: Associations with insomnia diagnosis and insomnia treatment

    OpenAIRE

    Kay, Daniel B.; Buysse, Daniel J.; Germain, Anne; Hall, Martica; Monk, Timothy H.

    2014-01-01

    Discrepancy between subjective and objective measures of sleep is associated with insomnia and increasing age. Cognitive behavioral therapy for insomnia improves sleep quality and decreases subjective-objective sleep discrepancy. This study describes differences between older adults with insomnia and controls in sleep discrepancy, and tests the hypothesis that reduced sleep discrepancy following cognitive behavioral therapy for insomnia correlates with the magnitude of symptom improvement rep...

  7. Predictors of Substance Abuse Assessment and Treatment Completion for Parents Involved with Child Welfare: One State's Experience in Matching across Systems.

    Science.gov (United States)

    Traube, Dorian E; He, Amy S; Zhu, Limei; Scalise, Christine; Richardson, Tyrone

    2015-01-01

    To date, few studies have examined the effect of interagency collaboration on substance abuse assessment ity of Southern California and treatment completion for parents who are involved in child welfare. The purpose of this paper is to: (1) describe a statewide, interagency collaborative program aimed at providing targeted substance abuse assessment and treatment to parents engaged in the child welfare system; (2) document the specialized assessment and treatment outcomes for parents engaged through this collaborative program; and (3) determine factors related to successful treatment completion for parents involved in the child welfare system. This is a retrospective study of an open cohort of 13,829 individuals admitted to the New Jersey Child Protection Substance Abuse Initiative (CPSAI) program from October 1, 2009, through September 30, 2010. Data were drawn from two unique administrative data sources. Multivariate Cox regression models were used to explore factors related to successfil treatment completion for parents involved in the child welfare system. Trend analysis for the total sample in the CPSAI program revealed that, of the 10,909 individuals who received a CPSAI assessment, 59% were referred to treatment. Of those referred to treatment, 40% enrolled in a treatment program. Once enrolled in a treatment program, 55% completed or were in the process of completing substance abuse treatment. These findings suggest that when adequate screening and treatment is available through a streamlined process, many of the ethnic and gender disparities present among other populations of individuals seeking treatment are minimized. Utilizing inherent child welfare case factors appears to be an important motivating element that aids parents during the assessment and treatment process.

  8. Characterization of emergent HIV resistance in treatment-naive subjects enrolled in a vicriviroc phase 2 trial.

    Science.gov (United States)

    McNicholas, Paul; Wei, Yi; Whitcomb, Jeannette; Greaves, Wayne; Black, Todd A; Tremblay, Cecile L; Strizki, Julie M

    2010-05-15

    Vicriviroc is a C-C motif chemokine receptor 5 (CCR5) antagonist that is in clinical development for the treatment of human immunodeficiency virus type 1 (HIV-1) infection. This study explored the molecular basis for the development of phenotypically resistant virus. HIV-1 RNA from treatment-naive subjects who experienced virological failure in a phase 2 dose-finding trial was evaluated for coreceptor usage and susceptibility. For viruses that exhibited reduced susceptibility to vicriviroc, envelope clones were phenotypically and genotypically characterized. Twenty-six vicriviroc-treated subjects experienced virological failure; for 24 the virus remained CCR5-tropic, and 2 had dual/X4 virus. Reduced susceptibility to vicriviroc, manifested as decreases in the maximum percent inhibition value (no increase in median inhibitory concentration), was detected in 4 of the 26 subjects who experienced virological failure. Clonal analysis of envelopes in samples from these 4 subjects revealed multiple sequence changes in gp160, principally within the variable domain 1/variable domain 2, variable domain 3, and variable domain 4 loops. However, no consistent pattern of mutations was observed across subjects. In this study, only a small proportion of treatment failures were associated with tropism changes or reduced susceptibility to vicriviroc. Genotypic analysis of cloned env sequences revealed no specific mutational pattern associated with reduced susceptibility to vicriviroc, although numerous changes were observed in the variable domain 3 loop and in other regions of gp160.

  9. The application of autologous serum eye drops in severe dry eye patients; subjective and objective parameters before and after treatment.

    Science.gov (United States)

    Jirsova, Katerina; Brejchova, Kristyna; Krabcova, Ivana; Filipec, Martin; Al Fakih, Aref; Palos, Michalis; Vesela, Viera

    2014-01-01

    To assess the impact of autologous serum (AS) eye drops on the ocular surface of patients with bilateral severe dry eye and to draw a comparison between the clinical and laboratory examinations and the degree of subjective symptoms before and after serum treatment. A three-month prospective study was conducted on 17 patients with severe dry eye. AS eye drops were applied a maximum of 12 times a day together with regular therapy. Dry eye status was evaluated by clinical examination (visual acuity, Schirmer test, tear film breakup time, vital staining, tear film debris and meniscus), conjunctival impression cytology (epithelial and goblet cell density, snake-like chromatin, HLA-DR-positive and apoptotic cells) and subjectively by the patients. The application of AS eye drops led to a significant improvement in the Schirmer test (p treatment. A significant decrease (p eyes. We found that three-month AS treatment led especially to the improvement of ocular surface dryness and damage of the epithelium. The improvement of dry eye after AS treatment correlated well with the clinical, laboratory and subjective findings. From the patients' subjective point of view, the positive effect of AS decreased with time, but still persisted up to three months after the end of therapy.

  10. The subject-fixated coaxially sighted corneal light reflex: a clinical marker for centration of refractive treatments and devices.

    Science.gov (United States)

    Chang, Daniel H; Waring, George O

    2014-11-01

    To describe the inconsistencies in definition, application, and usage of the ocular reference axes (optical axis, visual axis, line of sight, pupillary axis, and topographic axis) and angles (angle kappa, lambda, and alpha) and to propose a precise, reproducible, clinically defined reference marker and axis for centration of refractive treatments and devices. Perspective. Literature review of papers dealing with ocular reference axes, angles, and centration. The inconsistent definitions and usage of the current ocular axes, as derived from eye models, limit their clinical utility. With a clear understanding of Purkinje images and a defined alignment of the observer, light source/fixation target, and subject eye, the subject-fixated coaxially sighted corneal light reflex can be a clinically useful reference marker. The axis formed by connecting the subject-fixated coaxially sighted corneal light reflex and the fixation point, the subject-fixated coaxially sighted corneal light reflex axis, is independent of pupillary dilation and phakic status of the eye. The relationship of the subject-fixated coaxially sighted corneal light reflex axis to a refined definition of the visual axis without reference to nodal points, the foveal-fixation axis, is discussed. The displacement between the subject-fixated coaxially sighted corneal light reflex and pupil center is described not by an angle, but by a chord, here termed chord mu. The application of the subject-fixated coaxially sighted corneal light reflex to the surgical centration of refractive treatments and devices is discussed. As a clinically defined reference marker, the subject-fixated coaxially sighted corneal light reflex avoids the shortcomings of current ocular axes for clinical application and may contribute to better consensus in the literature and improved patient outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Quantifying the Benefit of a Pathologic Complete Response After Neoadjuvant Chemoradiotherapy in the Treatment of Esophageal Cancer

    International Nuclear Information System (INIS)

    Scheer, Richard V.; Fakiris, Achilles J.; Johnstone, Peter A.S.

    2011-01-01

    Purpose: To better define the benefit of a pathologic complete response (pCR) after neoadjuvant chemoradiotherapy in the treatment of esophageal and gastroesophageal cancer, we undertook a comprehensive review of the literature to derive a pooled analysis of crude survival data and quantify the survival benefit of pCR vs. residual disease at esophagectomy. Methods and Materials: In all, 22 articles were reviewed. Crude overall survival data, stratified by patients with pCR vs. those with residual disease at esophagectomy, were collected and analyzed using a chi-square analysis. The relative and absolute survival benefit of achieving a pCR were calculated and analyzed. Finally, stratified median survival times were also analyzed. Results: Overall survival for patients with pCR was 93.1%, 75.0%, and 50.0% at 2, 3, and 5 years, respectively, whereas it was 36.8%, 29.0%, and 22.6% for patients with residual tumor (p < 0.025). The mean relative survival benefit of pCR at 2, 3, and 5 years was 2.05, 2.35, and 2.84, respectively. The mean absolute survival benefit of pCR was 35.66%, 33.79%, and 33.20%, respectively. Median survival times for patients with pCR were significantly longer than for those with residual tumor (p = 0.011). Conclusion: In esophageal and gastroesophageal cancers, pCR seems to significantly increase overall survival in patients undergoing neoadjuvant chemoradiotherapy. Specifically, the data suggest that patients with pCR are two to three times more likely to survive than are those with residual tumor at esophagectomy. Moreover, these data suggest that 33-36% more patients survive when pCR is achieved than when it is not.

  12. Early Relapse of Unresectable Gallbladder Cancer after Discontinuation of Gemcitabine Monotherapy Administered for 5 Years in a Patient Who Had Complete Response to the Treatment

    Directory of Open Access Journals (Sweden)

    Koichi Suyama

    2013-10-01

    Full Text Available The tumor shrinkage effect of gemcitabine is considered to be limited in cases of advanced gallbladder cancer, and there are few reports of complete response to gemcitabine therapy in patients with this cancer. Therefore, the treatment continuation strategy in these patients, after a complete response has been achieved, still remains to be established. Here, we present the case of a 77-year-old patient with unresectable gallbladder cancer, who after showing complete response to gemcitabine monotherapy administered for 5 years, showed early relapse within only 11 months of discontinuation of the drug. Thus, it is necessary to establish a suitable treatment continuation strategy for patients who show complete response to gemcitabine treatment.

  13. Less adrenergic response to mental task during verapamil compared to amlodipine treatment in hypertensive subjects

    NARCIS (Netherlands)

    Sevre, K; Lefrandt, JD; Eide, [No Value; Smit, AJ; Rostrup, M

    2001-01-01

    We compared the effects of amlodipine and verapamil slow release on autonomic responses to a 5-min mental arithmetic test (MST) in patients with mild to moderate hypertension. Twenty subjects received 8 weeks of verapamil slow release 240 mg or amlodipine 10 mg in a double-blind crossover design,

  14. Bright light in elderly subjects with nonseasonal major depressive disorder: a double blind randomised clinical trial using early morning bright blue light comparing dim red light treatment

    Directory of Open Access Journals (Sweden)

    van Someren Eus JW

    2008-07-01

    Full Text Available Abstract Background Depression frequently occurs in the elderly. Its cause is largely unknown, but several studies point to disturbances of biological rhythmicity. In both normal aging, and depression, the functioning of the suprachiasmatic nucleus (SCN is impaired, as evidenced by an increased prevalence of day-night rhythm perturbations, such as sleeping disorders. Moreover, the inhibitory SCN neurons on the hypothalamus-pituitary adrenocortical axis (HPA-axis have decreased activity and HPA-activity is enhanced, when compared to non-depressed elderly. Using bright light therapy (BLT the SCN can be stimulated. In addition, the beneficial effects of BLT on seasonal depression are well accepted. BLT is a potentially safe, nonexpensive and well accepted treatment option. But the current literature on BLT for depression is inconclusive. Methods/Design This study aims to show whether BLT can reduce non-seasonal major depression in elderly patients. Randomized double blind placebo controlled trial in 126 subjects of 60 years and older with a diagnosis of major depressive disorder (MDD, DSM-IV/SCID-I. Subjects are recruited through referrals of psychiatric outpatient clinics and from case finding from databases of general practitioners and old-people homes in the Amsterdam region. After inclusion subjects are randomly allocated to the active (bright blue light vs. placebo (dim red light condition using two Philips Bright Light Energy boxes type HF 3304 per subject, from which the light bulbs have been covered with bright blue- or dim red light- permitting filters. Patients will be stratified by use of antidepressants. Prior to treatment a one-week period without light treatment will be used. At three time points several endocrinological, psychophysiological, psychometrically, neuropsychological measures are performed: just before the start of light therapy, after completion of three weeks therapy period, and three weeks thereafter. Discussion If BLT

  15. The relationship between the quality of drug user treatment and program completion: understanding the perceptions of women in a prison-based program.

    Science.gov (United States)

    Strauss, S M; Falkin, G P

    2000-01-01

    To determine why some women offenders complete prison-based drug user treatment and others leave early, clients' (N = 101) perceptions of various aspects of the quality of the treatment experience were compared. Analyses of both quantitative and qualitative data indicate that clients who completed the program had a more favorable perception of staff and felt empowered by the experience in treatment. Most of the clients who left early did so because of conflicts or disagreements with the program's rules. We discuss how a supportive approach to personal development may enhance client perceptions of program quality and increase retention rates.

  16. Donor dopamine treatment limits pulmonary oedema and inflammation in lung allografts subjected to prolonged hypothermia

    NARCIS (Netherlands)

    Hanusch, Christine; Nowak, Kai; Toerlitz, Patrizia; Gill, Ishar S.; Song, Hui; Rafat, Neysan; Brinkkoetter, Paul T.; Leuvenink, Henri G.; Van Ackern, Klaus C.; Yard, Benito A.; Beck, Grietje C.

    2008-01-01

    Background. Endothelial barrier dysfunction severely compromises organ function after reperfusion. Because dopamine pretreatment improves hypothermia mediated barrier dysfunction, we tested the hypothesis that dopamine treatment of lung allografts positively affects tissue damage associated with

  17. Objective QbTest and subjective evaluation of stimulant treatment in adult attention deficit-hyperactivity disorder.

    Science.gov (United States)

    Bijlenga, D; Jasperse, M; Gehlhaar, S K; Sandra Kooij, J J

    2015-01-01

    To evaluate the QbTest as an objective measure versus self-reported ADHD Rating Scale (ADHD-RS) before and during stimulant treatment in adults with ADHD. We used the subjective ADHD Rating Scale (ADHD-RS), and the objective computerized QbTest, which is a 20-minute unconditional identical pairs test that measures attention, impulsivity, and also hyperactivity using a motion-tracking system. Patients were assessed before (baseline) and during medical treatment with stimulants (follow-up) in an observational study design. Data of n=145 patients at baseline and n=82 patients at follow-up were analyzed. There were significant symptom reductions on all symptom domains, but correlations between the tests were weak. Improvement on the QbTest was independent of the patient's age, gender, educational level, ADHD subtype, co-morbid disorders, and use of other medications. Patients with worst QbTest results at baseline showed most improvement at follow-up. The QbTest was more sensitive to medication effects than the ADHD-RS. QbTest objectified clinical significant medication effect in 54% of patients who subjectively did not report any clinical effects. Symptoms dimensions of objective and subjective tests refer to different psychological constructs. The QbTest is a valuable addition to existing subjective measures to assess medication effects in ADHD patients who have difficulties reporting treatment effects. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  18. Long-acting octreotide treatment causes a sustained decrease in ghrelin concentrations but does not affect weight, behaviour and appetite in subjects with Prader-Willi syndrome.

    Science.gov (United States)

    De Waele, Kathleen; Ishkanian, Stacey L; Bogarin, Roberto; Miranda, Charmaine A; Ghatei, Mohammad A; Bloom, Stephen R; Pacaud, Danièle; Chanoine, Jean-Pierre

    2008-10-01

    Ghrelin is secreted primarily by the stomach and circulates as both acylated and desacyl ghrelin. Acylated (but not desacyl) ghrelin stimulates appetite. Both concentrations are elevated in Prader-Willi syndrome (PWS), suggesting that ghrelin may contribute to hyperphagia and overweight in these subjects. We evaluated whether long-acting octreotide (Oct) decreases acylated and desacyl ghrelin concentrations, body mass, appetite and compulsive behaviour towards food in adolescents with PWS. A 56-week prospective, randomized, cross-over trial. Nine subjects with PWS (age 14.6 (10.8-18.9) years, body mass index (BMI) Z-score +1.9 (0.6-3.0)) received either Oct (30 mg) or saline i.m. every 4 weeks for 16 weeks and were switched over to the other treatment after a 24-week washout period. Eight subjects completed the study. Oct caused a decrease in both acylated (-53%) and desacyl (-54%) fasting ghrelin concentrations (P<0.05) but did not significantly affect BMI. Oct had no significant effect on peptide YY concentrations, appetite or compulsive behaviour towards food. Oct caused a decrease in insulin-like growth factor-I concentrations, an increase in HbA1c and transient elevation of blood glucose in two subjects. Three subjects developed gallstones. Oct treatment caused a prolonged decrease in ghrelin concentrations in adolescents with PWS but did not improve body mass or appetite. Future intervention studies aiming at clarifying the role of ghrelin in PWS should focus on the administration of specific inhibitors of ghrelin secretion or ghrelin receptor activity that do not interfere with other appetite-regulating peptides.

  19. Beneficial and adverse effects of irradiation in patients repeatedly subjected to high-dosage treatment

    International Nuclear Information System (INIS)

    Roeckelein, I.

    1986-01-01

    During the period between 1978 and 1983 a total of 156 patients showing different types of tumours were subjected to high-dosage radiotherapy. The patients were treated repeatedly for primary or recurrent tumours using a radiation dose of >79 Gy. Each of the three largest groups, which were mammary carcinomas (33), cerebral tumours (25) and orohypopharyngeal tumours (22), was analysed individually. In the majority of patients the local effects of this radiotherapy were such that total or at least partial remission of the primary or recurrent tumour appeared most likely. In the groups receiving doses in the lower range the results were just as good as those achieved in subjects exposed to high doses. The survival times determined here for bearers of mammary or cerebral carcinomas were better than the relevant values given in the literature. (orig./MG) [de

  20. Subjective tinnitus assessment and treatment in clinical practice: the necessity of personalized medicine.

    Science.gov (United States)

    Van de Heyning, Paul; Gilles, Annick; Rabau, Sarah; Van Rompaey, Vincent

    2015-10-01

    Subjective tinnitus can be triggered by a variety of causes, and therefore tinnitus patients constitute a very heterogeneous population difficult to manage. In this article, we reviewed the current literature to present our conceptual model of the conscious auditory percept and tinnitus - based on experimental research - in order to explain the clinical approach to the individual tinnitus patient. Fundamental research has provided evidence to support the neurophysiological model of tinnitus developed by Jastreboff. By manipulating the limbic, autonomic and auditory systems, tinnitus retraining therapy (TRT) aims to reduce the response to the abnormal stimulus. Evidence has confirmed the effectiveness of TRT and cognitive behavioral therapy in reducing the negative impact of subjective tinnitus on the patients' quality of life. Every patient with subjective tinnitus has its unique 'tinnitus profile' which provides a guide to the necessary combination of therapeutic actions. Evidence suggests the multidisciplinary approach combining etiological therapy as well as TRT, and cognitive behavioral therapy in specialized clinics is not only effective in reducing the patient's quality of life but also cost-effective from a healthcare and societal point of view.

  1. Artificial crystals with 3d metal and palladium particles subjected to high-temperature heat treatment

    Science.gov (United States)

    Rinkevich, A. B.; Nemytova, O. V.; Perov, D. V.; Samoylovich, M. I.; Kuznetsov, E. A.

    2018-04-01

    High-temperature heat treatment has valuable impact on the structure and physical properties of artificial crystals with 3d metal and palladium particles. Artificial crystals are obtained by means of introduction of particles into the interspherical voids of opal matrices. The magnetic properties are studied at the temperatures ranging from 2 to 300 K and in fields up to 350 kOe. Microwave properties are investigated in the millimeter frequency range. The complex dielectric permittivity of several nanocomposites is measured. The influence of heat treatment up to 960 °C on the structure of artificial crystals is clarified.

  2. The Effect of Interface Treatment on Ceramic Performance and Modeling Dyneema Subjected to Ballistic Impact

    Science.gov (United States)

    2018-01-23

    Mechanical Engineering Division January 26, 2018 Professor KT Ramesh JHU/HEMI Project Director Johns Hopkins University 3400 N. Charles...Sincerely, Timothy J. Holmquist Institute Engineer ...Director Record Copy B (Contracts) Engineering Dynamics Department The Effect of Interface Treatment on Ceramic Performance and

  3. Shelf life of donkey milk subjected to different treatment and storage conditions.

    Science.gov (United States)

    Giacometti, Federica; Bardasi, Lia; Merialdi, Giuseppe; Morbarigazzi, Michele; Federici, Simone; Piva, Silvia; Serraino, Andrea

    2016-06-01

    The aim of this study was to investigate the effects of different treatment conditions on microbiological indicators of donkey milk hygiene and their evolution during shelf life at 4 and 12°C from 3 to 30d, simulating a farm-scale pasteurization and packing system. Four treatment conditions were tested: no treatment (raw milk), pasteurization (65°C × 30 min), high-pressure processing (HPP), and pasteurization plus HPP. The microbiological quality of the raw donkey milk investigated was not optimal; our results highlight the importance of raw milk management with the need for animal hygiene management and good dairy farming practices on donkey farms to improve handling procedures. The raw milk treated with HPP alone showed visible alterations with flocks, making the milk unfit for sale. The microbiological risk posed by consumption of raw donkey milk was significantly reduced by heat treatment but farm-scale packing systems cannot guarantee an extended shelf life. In contrast, the pasteurization plus HPP treatment was the most effective method to maintain microbiological milk quality. Microflora growth had little effect on pH in donkey milk: pH values were significantly different only between raw milk and pasteurized and pasteurized plus HPP milk stored at 12°C for 3d. Alkaline phosphatase activity and furosine could be used as indicators of proper pasteurization and thermal processing in donkey milk. Moreover, the presence and growth of Bacillus cereus in the case of thermal abuse hamper the wide-scale marketing of donkey milk due to the potential consequences for sensitive consumers and therefore further tests with time/temperature/high-pressure protocols associated with B. cereus are needed. Finally, our study shows that an HPP treatment of pasteurized milk after packing extends the shelf life of donkey milk and assures its microbial criteria up to 30d if properly stored at 4°C until opening; therefore, combined heat treatment and storage strategies are

  4. OBJECTIVE AND SUBJECTIVE EVALUATION OF ADOLESCENT’S ORTHODONTIC TREATMENT NEEDS AND THEIR IMPACT ON SELF-ESTEEM

    Science.gov (United States)

    Sharma, Anshika; Mathur, Anmol; Batra, Manu; Makkar, Diljot Kaur; Aggarwal, Vikram Pal; Goyal, Nikita; Kaur, Puneet

    2017-01-01

    ABSTRACT Objective: To investigate the presence of association between objective and subjective evaluation of orthodontic treatment needs in adolescents and their impact on their self-esteem. Methods: Cross-sectional study with adolescents aged 10-17 years old in Sri Ganganagar city, Rajasthan, India. The objective index of orthodontic treatment need (IOTN) dental health component (DHC) and the subjective aesthetic component (AC) were used to determine the normative and the self-perception need for orthodontic treatment, respectively. The selected students were further examined for dental trauma, tooth loss, and dental caries. Rosenberg Self-Esteem Scale was applied for self-esteem level determination. Linear regression analysis was executed to test the individual association of different independent clinical variables with self-esteem scores. Results: Among 1,140 studied adolescents, the prevalence of dental normative orthodontic treatment need was in 56.9% of individuals, whereas 53.3% of individuals considered themselves as needy for the treatment. Multivariate analyses revealed that out of all dental disorders, DHC followed by AC of IOTN had maximum impact on the self-esteem of the adolescence. Conclusions: Dissatisfaction with dental appearance is a strong predictor for low self-esteem in adolescence. PMID:28977320

  5. Increased platelet expression of glycoprotein IIIa following aspirin treatment in aspirin-resistant but not aspirin-sensitive subjects

    Science.gov (United States)

    Floyd, Christopher N; Goodman, Timothy; Becker, Silke; Chen, Nan; Mustafa, Agnesa; Schofield, Emma; Campbell, James; Ward, Malcolm; Sharma, Pankaj; Ferro, Albert

    2014-01-01

    Aims Aspirin is widely used as an anti-platelet agent for cardiovascular prophylaxis. Despite aspirin treatment, many patients experience recurrent thrombotic events, and aspirin resistance may contribute to this. We examined the prevalence of aspirin resistance in a healthy population, and investigated whether the platelet proteome differed in aspirin-resistant subjects. Methods Ninety-three healthy subjects received aspirin 300 mg daily for 28 days. Before and at the end of treatment, urine was taken to determine 11-dehydrothromboxane B2, and blood was taken to measure arachidonic acid (AA)-induced aggregation of platelet-rich plasma and to interrogate the platelet proteome by mass spectrometric analysis with further confirmation of findings using Western blotting. Results In two of the 93 subjects, neither AA-induced aggregation nor urinary 11-dehydrothromboxane B2 was effectively suppressed by aspirin, despite measurable plasma salicylate concentrations, suggesting the presence of true aspirin resistance. Despite no detectable differences in the platelet proteome at baseline, following aspirin a marked increase was seen in platelet glycoprotein IIIa expression in the aspirin-resistant but not aspirin-sensitive subjects. An increase in platelet glycoprotein IIIa expression with aspirin resistance was confirmed in a separate cohort of 17 patients with stable coronary artery disease on long term aspirin treatment, four of whom exhibited aspirin resistance. Conclusions In a healthy population, true aspirin resistance is uncommon but exists. Resistance is associated with an increase in platelet glycoprotein IIIa expression in response to aspirin. These data shed new light on the mechanism of aspirin resistance, and provide the potential to identify aspirin-resistant subjects using a novel biomarker. PMID:25099258

  6. Histological assessment of ovaries and uterus of rats subjected to nandrolone decanoate treatment.

    Science.gov (United States)

    Gerez, Juliana Rubira; Frei, Fernando; Camargo, Isabel Cristina Cherici

    2005-07-01

    This study aimed to analyze the effects of nandrolone decanoate on the ovaries and uterus of adult females rats. This drug was administered intraperitoneally, at one, two and three doses of 3 mg nandrolone decanoate/kg of body weight, respectively, in the first, second and third week of treatment. The females of the control group received a physiological solution. The rats treated with nandrolone decanoate showed estral acyclicity and there was destruction of follicular units and an absence of corpus luteum in the ovaries. In the uterus, the drug promoted morphological alterations, characterized by vacuolated epithelium and endometrial stroma fibrosis. Ovary, uterus and pituitary weights were not affected by the steroid treatment. Nandrolone decanoate affects the sexual cycle and promotes histological alterations in the ovaries and uterus of adult female rats.

  7. Electromagnetic Characterization of Carbon Nanotube Films Subject to an Oxidative Treatment at Elevated Temperature (Preprint)

    Science.gov (United States)

    2010-07-01

    response to the tip causes a redistribution of charge on the tip in order to maintain the equipotential surface of the sphere, and also results in a shift...can be obtained. In some instances these treatments lead to uncapping of nanotubes. Geng et al. [25] have shown that the surfaces of SWNT bundles...20] discovered a new and catalyst-free method for the growth of CNTs: surface decomposition of silicon carbide (SiC). This thermal decomposition

  8. Association between objective and subjective binge eating and psychopathology during a psychological treatment trial for bulimic symptoms.

    Science.gov (United States)

    Goldschmidt, Andrea B; Accurso, Erin C; Crosby, Ross D; Cao, Li; Ellison, Jo; Smith, Tracey L; Klein, Marjorie H; Mitchell, James E; Crow, Scott J; Wonderlich, Stephen A; Peterson, Carol B

    2016-12-01

    Although loss of control (LOC) while eating is a core construct of bulimia nervosa (BN), questions remain regarding its validity and prognostic significance independent of overeating. We examined trajectories of objective and subjective binge eating (OBE and SBE, respectively; i.e., LOC eating episodes involving an objectively or subjectively large amount of food) among adults participating in psychological treatments for BN-spectrum disorders (n = 80). We also explored whether changes in the frequency of these eating episodes differentially predicted changes in eating-related and general psychopathology and, conversely, whether changes in eating-related and general psychopathology predicted differential changes in the frequency of these eating episodes. Linear mixed models with repeated measures revealed that OBE decreased twice as rapidly as SBE throughout treatment and 4-month follow-up. Generalized linear models revealed that baseline to end-of-treatment reductions in SBE frequency predicted baseline to 4-month follow-up changes in eating-related psychopathology, depression, and anxiety, while changes in OBE frequency were not predictive of psychopathology at 4-month follow-up. Zero-inflation models indicated that baseline to end-of-treatment changes in eating-related psychopathology and depression symptoms predicted baseline to 4-month follow-up changes in OBE frequency, while changes in anxiety and self-esteem did not. Baseline to end-of-treatment changes in eating-related psychopathology, self-esteem, and anxiety predicted baseline to 4-month follow-up changes in SBE frequency, while baseline to end-of-treatment changes in depression did not. Based on these findings, LOC accompanied by objective overeating may reflect distress at having consumed an objectively large amount of food, whereas LOC accompanied by subjective overeating may reflect more generalized distress related to one's eating- and mood-related psychopathology. BN treatments should

  9. Methodologic treatment for the contents of inclusive physical education in the subject adapted physical activities

    Directory of Open Access Journals (Sweden)

    Annia Gómez-Valdés

    2016-08-01

    Full Text Available This work came about because of the necessity to introduce the contents relating to Inclusive Physical Education in the subject Adaptive Physical Activity, in form coherently and comprehensive for the students, for there future endeavour of a professional in Physical Culture and Sports; giving them the possibility to know what to do in each moment that the practice physical activities directed to children with Special Educative Needs. This work is structured fundamentally from the usage of activity games in the Introduction, assimilation y evaluation of what is imparted; that permits the indication of forms y didactic strategies that gives them answers to concrete situations in which they have to pay direct attention to the diversity, fostering therefore the respect for the differences in others.

  10. Applying technology to the treatment of cannabis use disorder: comparing telephone versus Internet delivery using data from two completed trials.

    Science.gov (United States)

    Rooke, Sally E; Gates, Peter J; Norberg, Melissa M; Copeland, Jan

    2014-01-01

    Technology-based interventions such as those delivered by telephone or online may assist in removing significant barriers to treatment seeking for cannabis use disorder. Little research, however, has addressed differing technology-based treatments regarding their comparative effectiveness, and how user profiles may affect compliance and treatment satisfaction. This study addressed this issue by examining these factors in online (N=225) versus telephone (N=160) delivered interventions for cannabis use, using data obtained from two previously published randomized controlled trials conducted by the current authors. Several differences emerged including stronger treatment effects (medium to large effect sizes in the telephone study versus small effect sizes in the Web study) and lower dropout in the telephone intervention (38% vs. 46%). Additionally, around half of the telephone study participants sought concurrent treatment, compared with 2% of participants in the Web study. Demographics and predictors of treatment engagement, retention and satisfaction also varied between the studies. Findings indicate that both telephone and Web-based treatments can be effective in assisting cannabis users to quit or reduce their use; however, participant characteristics may have important implications for treatment preference and outcome, with those who elect telephone-based treatment experiencing stronger outcomes. Thus, participant preference may shape study populations, adherence, and outcome. © 2013 Elsevier Inc. All rights reserved.

  11. Distributional map of the terminal and sub-terminal sugar residues of the glycoconjugates in the prepubertal and postpubertal testis of a subject affected by complete androgen insensitivity syndrome (Morris's syndrome): lectin histochemical study.

    Science.gov (United States)

    Gheri, G; Vannelli, G B; Marini, M; Zappoli Thyrion, G D; Gheri, R G; Sgambati, E

    2004-01-01

    In the present research we have investigated the distribution of the sugar residues of the glycoconjugates in the prepubertal and postpubertal testes of a subject with Morris's syndrome (CAIS, Complete Androgen Insensitivity Syndrome). For this purpose a battery of six horseradish peroxidase-conjugated lectins was used (SBA, PNA, WGA, ConA, LTA and UEAI). We have obtained a complete distributional map of the terminal and sub-terminal oligosaccharides in the tunica albuginea, interstitial tissue, lamina propria of the seminiferous tubules, Leydig cells, Sertoli cells, spermatogonia, mastocytes and endothelial cells. Furthermore the present study has shown that a large amount of sugar residues were detectable in the prepubertal and postpubertal testes but that some differences exist with particular regard to the Sertoli cells. The Sertoli cells and the Leydig cells of the retained prepubertal testis of the patient affected by Morris's syndrome were characterized by the presence of alpha-L-fucose, which was absent in the retained prepubertal testis of the normal subjects. Comparing the results on the postpubertal testis with those obtained on the same aged testis of healthy subjects we have demonstrated that alpha-L-fucose in the Sertoli and Leydig cells and D-galactose-N-acetyl-D-galactosamine in the Leydig cells are a unique feature of the subject affected by Morris's syndrome. D-galactose (ss1,3)-N-acetyl-D-galactosamine and sialic acid, which are present in the Leydig cells of the normal testis were never observed in the same cells of the postpubertal testis of the CAIS patient.

  12. Who Are the Subjects with Gambling-Related Problems Requiring Treatment? A Study in Northern Italy

    Science.gov (United States)

    Fioritti, Angelo; Marani, Silvia; Gambini, Daniele; Turino, Elsa; Piazza, Antonella

    2018-01-01

    Background: This study analyzes data related to Hospital (HOS), Public Treatment Service Dedicated to Drug Addicts (SERD), or Community Mental Health Center (CMHC) clients with a first diagnosis of Pathological Gambling (PG) in the period 2000/2016 in Northern Italy. The aims were to describe trends and characteristics of pathological gamblers (PGs) and to estimate the prevalence of other diagnoses before or after the diagnosis of PG. Methods: Participants aged over 17 years with an ICD-9 or ICD-10 PG diagnosis were selected. Results: 680 PGs were identified, mean age 47.4 years, 20% female, 13% non-natives, 30% had other mental disorders diagnoses, 9% had alcohol dependence syndrome, and 11% had drug dependence. Most participants with comorbid disorders were diagnosed before PG, with a more elevated prevalence regarding mental disorders. Almost seven years had elapsed on average between the first admission and the diagnosis of PG. Conclusions: The results of this study highlight a growing demand for PG treatment addressed not only to SERD, but also to psychiatric and hospital services, based on the increase in SERD attendance from 2013. Many of them had already been treated for mental health problems before, but their percentage remained costant over time. PMID:29652821

  13. Study on the elastic behavior of Ti-13Nb-13Zr subjected to different heat treatments

    International Nuclear Information System (INIS)

    Florencio, O.; Chaves, J.M.; Silva Junior, P.S.; Schneider, S.G.

    2010-01-01

    Study of elastic behavior of Ti-13Nb-13Zr alloy was realized through measures of anelastic relaxation (internal friction and frequency) as a function of temperature, obtained by mechanical spectroscopy using flexural vibration of the fundamental mode of the two samples, β-ST WQ heat-treated to 1170K for 30min and water quenched and β-ST WQ +670 K/3h with subsequent aging treatment at 670K for 3h. Spectra of anelastic relaxation not showed the presence of relaxation processes due to interstitial and substitutional solutes in the alloy, the dynamic elastic modulus of alloys at room temperature was 64GPa and 87GPa, respectively. After a further heat treatment at 1170K for 30 minutes, for to reduce internal stresses of the material was observed an increase in elastic modulus, with values of 87GPa and 110GPa respectively, this increment was associated with the variation of the proportions of phases α and β present in the samples, as was revealed by XRD and SEM results. (author)

  14. Energy supplementation in Santa Inês sheep subjected to estrus induction treatment

    Directory of Open Access Journals (Sweden)

    Sabrina Silva Venturi

    2016-02-01

    Full Text Available The aim of this study was to evaluate the effect of a 20% increase in dietary energy during short-term estrus induction treatment on the reproductive parameters of Santa Inês ewes. Females (n=43 were allocated into two experimental groups according to the amount of energy inclusion in the diet: maintenance diet or maintenance diet plus 20% energy. Ultrasound examinations were performed in order to detect ovulation. To assess sexual behavior, ewes were teased and further mated. Blood samples were collected for the determination of glucose and insulin concentrations. There was no difference (P>0.05 between groups in the following categories: ovulation rate (80.00% vs. 60.00%, largest follicle diameter (6.00 ± 0.20 vs. 5.90 ± 0.60, interval from device removal to ovulation (52.80 ± 14.87 vs. 59.01 ± 8.34 hours, animals in estrus (75.00% vs. 65.21%, interval from device removal to estrus (30.00 ± 15.49 vs. 30.00 ± 13.35 hours and conception rate (50.00% vs. 21.73%. There were differences (P<0.05 in the concentrations of insulin and glucose. It can be concluded that the 20% increase in energy in the diet during short-term estrus induction treatment did not affect the reproductive parameters studied.

  15. Who Are the Subjects with Gambling-Related Problems Requiring Treatment? A Study in Northern Italy

    Directory of Open Access Journals (Sweden)

    Raimondo Maria Pavarin

    2018-04-01

    Full Text Available Background: This study analyzes data related to Hospital (HOS, Public Treatment Service Dedicated to Drug Addicts (SERD, or Community Mental Health Center (CMHC clients with a first diagnosis of Pathological Gambling (PG in the period 2000/2016 in Northern Italy. The aims were to describe trends and characteristics of pathological gamblers (PGs and to estimate the prevalence of other diagnoses before or after the diagnosis of PG. Methods: Participants aged over 17 years with an ICD-9 or ICD-10 PG diagnosis were selected. Results: 680 PGs were identified, mean age 47.4 years, 20% female, 13% non-natives, 30% had other mental disorders diagnoses, 9% had alcohol dependence syndrome, and 11% had drug dependence. Most participants with comorbid disorders were diagnosed before PG, with a more elevated prevalence regarding mental disorders. Almost seven years had elapsed on average between the first admission and the diagnosis of PG. Conclusions: The results of this study highlight a growing demand for PG treatment addressed not only to SERD, but also to psychiatric and hospital services, based on the increase in SERD attendance from 2013. Many of them had already been treated for mental health problems before, but their percentage remained costant over time.

  16. Pharmacokinetics and Safety of DW1029M, a Botanical Drug for the Treatment of Diabetic Nephropathy, Following Single Doses in Healthy Subjects.

    Science.gov (United States)

    Kim, Yunjeong; Jeon, Ji-Young; Kim, Eun-Young; Lim, Cheol-Hee; Jang, Hwan Bong; Kim, Min-Gul

    2017-09-01

    DW1029M is a botanical extract of Morus albalinne root bark and Puerariae radix that is used for the treatment of diabetic nephropathy. This study evaluated the safety and pharmacokinetics of DW1029M following its administration in healthy Korean subjects. We conducted a randomized, open-label, single-dose, crossover phase 1 clinical study. During each period, subjects received 300, 600, or 1200 mg oral doses of DW1029M. Plasma concentrations of puerarin, daidzin, and daidzein were analyzed using a liquid chromatography-tandem mass spectrometry. Six healthy male subjects completed the study. The maximum concentration of the drug in the plasma (C max ) and area under the plasma drug concentration-time curve to the last measurable concentration (AUC last ) for puerarin, daidzin, and daidzein were assessed after oral administration of DW1029M. No serious adverse events or clinically or statistically significant adverse events associated with any of the drug levels were observed. The results of the measurement of vital signs, electrocardiogram, laboratory tests, and physical examinations indicated that no clinically significant changes occurred during this study. The DW1029M tablet was safe and well tolerated over a single dose range of 300-1200 mg. This pharmacokinetic study of a botanical drug may aid in the development of DW1029M. © 2017, The American College of Clinical Pharmacology.

  17. Maintenance treatment with azacytidine for patients with high-risk myelodysplastic syndromes (MDS) or acute myeloid leukaemia following MDS in complete remission after induction chemotherapy

    DEFF Research Database (Denmark)

    Grövdal, Michael; Karimi, Mohsen; Khan, Rasheed

    2010-01-01

    This prospective Phase II study is the first to assess the feasibility and efficacy of maintenance 5-azacytidine for older patients with high-risk myelodysplastic syndrome (MDS), chronic myelomonocytic leukaemia and MDS-acute myeloid leukaemia syndromes in complete remission (CR) after induction ......-IV thrombocytopenia and neutropenia occurred after 9.5 and 30% of the cycles, respectively, while haemoglobin levels increased during treatment. 5-azacytidine treatment is safe, feasible and may be of benefit in a subset of patients....

  18. Treatment-completion rates with olanzapine long-acting injection versus risperidone long-acting injection in a 12-month, open-label treatment of schizophrenia: indirect, exploratory comparisons

    Directory of Open Access Journals (Sweden)

    Ascher-Svanum H

    2012-05-01

    Full Text Available Haya Ascher-Svanum1, William S Montgomery2, David P McDonnell3, Kristina A Coleman4, Peter D Feldman11Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA; 2Eli Lilly Australia Pty Ltd, West Ryde, New South Wales, Australia; 3Eli Lilly and Company, Cork, Ireland; 4OptumInsight, Lilyfield, New South Wales, AustraliaBackground: Little is known about the comparative effectiveness of atypical antipsychotics in long-acting injection formulation. Due to the absence of head-to-head studies comparing olanzapine long-acting injection and risperidone long-acting injection, this study was intended to make exploratory, indirect, cross-study comparisons between the long-acting formulations of these two atypical antipsychotics in their effectiveness in treating patients with schizophrenia.Methods: Indirect, cross-study comparisons between olanzapine long-acting injection and risperidone long-acting injection used 12-month treatment-completion rates, because discontinuation of an antipsychotic for any cause is a recognized proxy measure of the medication's effectiveness in treating schizophrenia. Following a systematic review of the literature, two indirect comparisons were conducted using open-label, single-cohort studies in which subjects were stabilized on an antipsychotic medication before depot initiation. The first analysis compared olanzapine long-acting injection (one study with pooled data from nine identified risperidone long-acting injection studies. The second analysis was a “sensitivity analysis,” using only the most similar studies, one for olanzapine long-acting injection and one for risperidone long-acting injection, which shared near-identical study designs and involved study cohorts with near-identical patient characteristics. Pearson Chi-square tests assessed group differences on treatment-completion rates.Results: Comparison of olanzapine long-acting injection data (931 patients with the pooled data from the nine

  19. Naturalistic follow-up of subjects affected with anorexia nervosa 8 years after multimodal treatment: Personality and psychopathology changes and predictors of outcome.

    Science.gov (United States)

    Amianto, F; Spalatro, A; Ottone, L; Abbate Daga, G; Fassino, S

    2017-09-01

    Eating disorders (EDs) are serious mental illnesses of growing clinical and social impact. Despite their severity, there is still no satisfactory evidence-based treatment. Follow-up investigations are the most reliable studies to enlighten long-term outcome predictors and modifiers. In total, 59 subjects affected with anorexia nervosa were assessed 8 years after their admission into an outpatient multimodal treatment program for eating disorders. The follow-up changes in diagnostic criteria were compared with Chi-square test. Improved and not-improved subjects were compared. Clinical, personality and psychopathology features between T0 and T1 were compared with t-test for repeated measures. Correlation between T0 features and changes at T1 in personality and psychopathology features were assessed. The rate of complete remission was 42%, an overall rate of 67.8% improved, a rate of 18.6% worsened. Concerning personality, a significant decrease of harm avoidance and increase in self-directedness were evidenced. Interoceptive awareness, drive for thinness, bulimia were significantly reduced at follow-up. Many T0 personality facets were related to personality and psychopathology improvement at follow-up. Multimodal treatment encompassing psychiatric, nutritional and psychological approaches is at the moment the most reliable approach for the treatment of moderate to severe anorexia nervosa with a discrete rate of improvement. Some personality and psychopathology characteristics may represent specific factors which favor resistance and impair improvement. Future approaches should consider the personalization of therapeutic approach according to these features. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  20. Treatment of deep caries lesions in adults: randomized clinical trials comparing stepwise vs. direct complete excavation, and direct pulp capping vs. partial pulpotomy

    DEFF Research Database (Denmark)

    Bjørndal, Lars; Reit, Claes; Bruun, Gitte Hoffmann

    2010-01-01

    Less invasive excavation methods have been suggested for deep caries lesions. We tested the effects of stepwise vs. direct complete excavation, 1 yr after the procedure had been carried out, in 314 adults (from six centres) who had received treatment of a tooth with deep caries. The teeth had car...

  1. Recovery of Microsclerotia of Verticilium dahliae from Soil as Subjected to Various Treatments

    Directory of Open Access Journals (Sweden)

    Loekas Soesanto

    2002-07-01

    Full Text Available The influence of various conditions on the survival of microsclerotia of Verticilium dahliae Kleb. was studied using three sources of field-collected potato stems densely covered with naturally-formed microsclerotia. Microsclerotia were found to survive for up 2 years in potato stems not incorporated in soil. The effects of temperature, pF, including weekly variations in temperature and or pF, and various modes of incorporating potato stem tissue on the survival of microsclerotia for up to 1 year in a sandy unsterilised soil was also studied for different microsclerotia sources. Inoculum source had no signicant effect. Remarkably few microslcerotia were recovered one day after the start of experiments varying between 5.5 and 31%. Recovery remained at this level or even decreased for another month and for several treatments, also after 3 and 6 months. Only after 3 to 12 months, recovery increased to values up to 5 times higher than that of one day after start of the experiment, but recoveries did not exceed the number of microsclerotia initially incorporated into the soil. Changes in recovery may be due to variation in the level of soil mycostasis which is affected by rate of nutrient exudation from microsclerotia. Key words: survival, microsclerotia, Verticillium dahliae

  2. Evil radioactivity. Subjective perception of radioactivity in patients with thyroid disease prior to treatment with radioiodine

    International Nuclear Information System (INIS)

    Freudenberg, L.S.; Beyer, T.; Mueller, S.P.; Goerges, R.; Bockisch, A.

    2006-01-01

    Aim: We assess the perspective of patients with thyroid disease towards radiation and radioactivity by means of a cultural-anthropological approach based on qualitative measures and quantitative scores. From the interviews with the patients we evaluate as to how much radioactivity is accepted as an abstract term or as a benefit within the medical context. Patients, methods: 68 patients with autonomously functioning thyroid lesions (35 women, 33 men, 32-81 years) were included in this study. All patients were interviewed in an open dialogue with the principal investigator. Patients were asked to describe their attitude towards radioactivity in general and towards radioiodine therapy in particular. Patients were asked to use a scoring system (1=positive, 5=negative) to quantify their attitudes. Results: The responses of all patients towards radioactivity in general were heterogeneous with most responses reflecting a negative perception. Many patients expressed their associated fears about atomic energy, malignant diseases and radioactive contamination. The scoring system reflected a mostly negative opinion base. However, patients became more positive once they assumed an immediate benefit of radioactivity for the treatment of their own disease (p=0.01). Conclusions: Knowing about significant differences in patient's perception about radioactivity in general or in the clinical context may help to optimise and tailor the initial, pre-therapeutical interview towards the patient. (orig.)

  3. Evil radioactivity. Subjective perception of radioactivity in patients with thyroid disease prior to treatment with radioiodine

    Energy Technology Data Exchange (ETDEWEB)

    Freudenberg, L.S. [Universitaetsklinikum Essen (Germany). Klinik fuer Nuklearmedizin; Radiologisch-Nuklearmedizinische Gemeinschaftspraxis, Grevenbroich (Germany); Beyer, T.; Mueller, S.P.; Goerges, R.; Bockisch, A. [Universitaetsklinikum Essen (Germany). Klinik fuer Nuklearmedizin; Hopfenbach, A. [Radiologisch-Nuklearmedizinische Gemeinschaftspraxis, Grevenbroich (Germany)

    2006-07-01

    Aim: We assess the perspective of patients with thyroid disease towards radiation and radioactivity by means of a cultural-anthropological approach based on qualitative measures and quantitative scores. From the interviews with the patients we evaluate as to how much radioactivity is accepted as an abstract term or as a benefit within the medical context. Patients, methods: 68 patients with autonomously functioning thyroid lesions (35 women, 33 men, 32-81 years) were included in this study. All patients were interviewed in an open dialogue with the principal investigator. Patients were asked to describe their attitude towards radioactivity in general and towards radioiodine therapy in particular. Patients were asked to use a scoring system (1=positive, 5=negative) to quantify their attitudes. Results: The responses of all patients towards radioactivity in general were heterogeneous with most responses reflecting a negative perception. Many patients expressed their associated fears about atomic energy, malignant diseases and radioactive contamination. The scoring system reflected a mostly negative opinion base. However, patients became more positive once they assumed an immediate benefit of radioactivity for the treatment of their own disease (p=0.01). Conclusions: Knowing about significant differences in patient's perception about radioactivity in general or in the clinical context may help to optimise and tailor the initial, pre-therapeutical interview towards the patient. (orig.)

  4. [Autonomy attitudes in the treatment compliance of a cohort of subjects with continuous psychotropic drug administration].

    Science.gov (United States)

    Baumann, M; Trincard, M

    2002-01-01

    Prescriptions for psychotropic drugs are part of a general practitioner's daily routine. As with all drugs, they need to be controlled by a phenomenon of observance. Respecting prescriptions is in fact a major public health concern. Our problematic is centred on the analysis of the association between observance and autonomy in order to gain a better understanding of the links between the drug, how it is to be taken, and how the patients adapt and control it. Identifying and comparing autonomous practices psychotrope users associated with attitudes put into play by those who claim to observe or not to observe their treatment is the aim of this project. The qualitative analysis of the speech is based on the categorial analysis of the contents of 46 transcriptions of 23 women et 23 men continuous (regular monthly intake for at least 5 years), aged between 50 and 65. The majority live in couples, have professional activities, and are executives. The psychotropes with the largest consumption are: anxiolytics and antidepressors. The average duration of their consumption is more than 17 years. Two types of attitude can be distinguished through the qualitative analyse. The attitudes of non-observers towards the psychotropic drug and dependence show controlled, autonomous acts. Autonomy is an influencing factor in their observation of the prescribed treatment, it is a major component of their non-observance regarding psychotropes; thus our hypothesis is confirmed. The strategy adopted around the medication arises from autonomy of action. Organising the treatment is seen as a sign of autonomy, as taking an initiative in relation to the medical prescription, and not as rebellious, or carefree behaviour, or as a sign of inconsistency. Non-observers seem more to be involved in a step towards self-regulation. Active taking verbs such as stop, diminish, increase , and success verbs succeed the I is greatly used, reinforced in some cases by myself ; this vocabulary situates the

  5. Complete Response after Treatment with Neoadjuvant Chemoradiation with Prolonged Chemotherapy for Locally Advanced, Unresectable Adenocarcinoma of the Pancreas

    Directory of Open Access Journals (Sweden)

    Tiffany A. Pompa

    2017-01-01

    Full Text Available Surgery is the only chance for cure in pancreatic ductal adenocarcinoma. In unresectable, locally advanced pancreatic cancer (LAPC, the National Comprehensive Cancer Network (NCCN suggests chemotherapy and consideration for radiation in cases of unresectable LAPC. Here we present a rare case of unresectable LAPC with a complete histopathological response after chemoradiation followed by surgical resection. A 54-year-old female presented to our clinic in December 2013 with complaints of abdominal pain and 30-pound weight loss. An MRI demonstrated a mass in the pancreatic body measuring 6.2×3.2 cm; biopsy revealed proven ductal adenocarcinoma. Due to splenic vein/artery and contiguous celiac artery encasement, she was deemed surgically unresectable. She was started on FOLFIRINOX therapy (three cycles, intensity modulated radiation to a dose of 54 Gy in 30 fractions concurrent with capecitabine, followed by FOLFIRI, and finally XELIRI. After 8 cycles of ongoing XELIRI completed in March 2015, restaging showed a remarkable decrease in tumor size, along with PET-CT revealing no FDG-avid uptake. She was reevaluated by surgery and taken for definitive resection. Histopathological evaluation demonstrated a complete R0 resection and no residual tumor. Based on this patient and literature review, this strategy demonstrates potential efficacy of neoadjuvant chemoradiation with prolonged chemotherapy, followed by surgery, which may improve outcomes in patients deemed previously unresectable.

  6. Effect of fluoxetine on the pharmacokinetics of lansoprazole: a two-treatment period study in healthy male subjects.

    Science.gov (United States)

    Vlase, Laurian; Popa, Adina; Neag, Maria; Muntean, Dana; Leucuta, Sorin E

    2011-10-01

    Fluoxetine is an inhibitor of the main metabolizing enzymes of lansoprazole and could influence the pharmacokinetics of lansoprazole. The changes in lansoprazole pharmacokinetics could have clinical significance concerning the safety of the therapy. The aim of this study was to evaluate the pharmacokinetic interaction between fluoxetine and lansoprazole in healthy subjects. A dose of lansoprazole 30 mg, alone or in combination with fluoxetine 60 mg, was administered to 18 healthy male subjects in a two-treatment study design, separated by an 8-day period in which fluoxetine alone was administered as a single oral daily dose. Plasma concentrations of lansoprazole were determined during a 12-hour period following drug administration. Lansoprazole plasma concentrations were determined by a validated liquid chromatography-mass spectrometry method. The pharmacokinetic parameters of lansoprazole were calculated using non-compartmental analysis. In the two periods of treatment, the mean maximum plasma concentration (C(max)) values were 817 ng/mL (lansoprazole alone) and 1370 ng/mL (lansoprazole in combination with fluoxetine after pre-treatment with fluoxetine for 8 days) [p lansoprazole and suggest that the observed interaction may be clinically significant, although its clinical relevance has yet to be confirmed.

  7. EFFECT OF INVERSION ON TREATMENT OF FENCE SUBJECTED TO SAP DISPLACEMENT METHOD

    Directory of Open Access Journals (Sweden)

    Juarez Benigno Paes

    2014-03-01

    Full Text Available http://dx.doi.org/10.5902/1980509813338This work aimed to evaluate the effect of inversion of Prosopis juliflora and Leucaena leucocephala fenceposts, in distribution, penetration and retention of copper chrome borate (CCB solution applied by sapdisplacement method. The Prosopis juliflora was collected in Brazilian Agricultural Research Company(EMBRAPA and the Leucaena leucocephala at the Federal University of Campina Grande in Patos,Paraíba state, Brazil. Trees with DAP from 5.0 to 10.0 cm were employed. Disks of 2.0 cm of thicknesswere retired on the top and on the base of pieces. The external disks were then discarded and the internones were employed to determine the wood characteristics, being the round pieces with 2.0 m. A solutionof 2% of active ingredients of CCB was used to treated woods. A total of 10 pieces of each species weretreated, and five of them remained in the solution for 8 days and the five ones had their tops inverted afterthe sixth day of treatment. The pieces were seasoned; disks of 2.0 cm of thickness were taken in 5 positions along of pieces and the analyses for determination of copper and boron penetration took place. The valuesof wood characteristics indicated that the pieces were homogeneous. The absorption of the solution was of19.9 liters (Prosopis juliflora and of 17.0 liters (Leucaena leucocephala. The nominal retentions of CCBwere 7.72 and 5.34 kg active ingredients (a.i./m3, respectively. In general, the inversion of the pieces inthe preservative solution is recommended, by providing a better distribution, penetration and retention ofCCB on treated pieces.

  8. Clinical complete response (cCR) after neoadjuvant chemoradiotherapy and conservative treatment in rectal cancer. Findings from the ACCORD 12/PRODIGE 2 randomized trial

    International Nuclear Information System (INIS)

    Gérard, Jean-Pierre; Chamorey, Emmanuel; Gourgou-Bourgade, Sophie; Benezery, Karène; Laroche, Guy de; Mahé, Marc-André; Boige, Valérie; Juzyna, Béata

    2015-01-01

    Background: During the ACCORD 12 randomized trial, an evaluation of the clinical tumor response was prospectively performed after neoadjuvant chemoradiotherapy. The correlations between clinical complete response and patient characteristics and treatment outcomes are reported. Material and methods: Between 2005 and 2008 the Accord 12 trial accrued 598 patients with locally advanced rectal cancer and compared two different neoadjuvant chemoradiotherapies (Capox 50: capecitabine + oxaliplatin + 50 Gy vs Cap 45: capecitabine + 45 Gy). An evaluation of the clinical tumor response with rectoscopy and digital rectal examination was planned before surgery. A score to classify tumor response was used adapted from the RECIST definition: complete response: no visible or palpable tumor; partial response, stable and progressive disease. Results: The clinical tumor response was evaluable in 201 patients. Score was: complete response: 8% (16 patients); partial response: 68% (137 patients); stable: 21%; progression: 3%. There was a trend toward more complete response in the Capox 50 group (9.3% vs 6.7% with Cap 45). In the whole cohort of 201 pts complete response was significantly more frequent in T2 tumors (28%; p = 0.025); tumors <4 cm in diameter (14%; p = 0.017), less than half rectal circumference and with a normal CEA level. Clinical complete response observed in 16 patients was associated with more conservative treatment (p = 0.008): 2 patients required an abdomino-perineal resection, 11 an anterior resection and 3 patients benefited from organ preservation (2 local excision, 1 “watch and wait”. A complete response was associated with more ypT0 (73%; p < 0.001); ypNO (92%); R0 circumferential margin (100%). Conclusion: These data support the hypothesis that a clinical complete response assessed using rectoscopy and digital rectal examination after neoadjuvant therapy may increase the chance of a sphincter or organ preservation in selected rectal cancers

  9. Clinical complete response (cCR) after neoadjuvant chemoradiotherapy and conservative treatment in rectal cancer. Findings from the ACCORD 12/PRODIGE 2 randomized trial.

    Science.gov (United States)

    Gérard, Jean-Pierre; Chamorey, Emmanuel; Gourgou-Bourgade, Sophie; Benezery, Karène; de Laroche, Guy; Mahé, Marc-André; Boige, Valérie; Juzyna, Béata

    2015-05-01

    During the ACCORD 12 randomized trial, an evaluation of the clinical tumor response was prospectively performed after neoadjuvant chemoradiotherapy. The correlations between clinical complete response and patient characteristics and treatment outcomes are reported. Between 2005 and 2008 the Accord 12 trial accrued 598 patients with locally advanced rectal cancer and compared two different neoadjuvant chemoradiotherapies (Capox 50: capecitabine+oxaliplatin+50Gy vs Cap 45: capecitabine+45Gy). An evaluation of the clinical tumor response with rectoscopy and digital rectal examination was planned before surgery. A score to classify tumor response was used adapted from the RECIST definition: complete response: no visible or palpable tumor; partial response, stable and progressive disease. The clinical tumor response was evaluable in 201 patients. Score was: complete response: 8% (16 patients); partial response: 68% (137 patients); stable: 21%; progression: 3%. There was a trend toward more complete response in the Capox 50 group (9.3% vs 6.7% with Cap 45). In the whole cohort of 201 pts complete response was significantly more frequent in T2 tumors (28%; p=0.025); tumors <4cm in diameter (14%; p=0.017), less than half rectal circumference and with a normal CEA level. Clinical complete response observed in 16 patients was associated with more conservative treatment (p=0.008): 2 patients required an abdomino-perineal resection, 11 an anterior resection and 3 patients benefited from organ preservation (2 local excision, 1 "watch and wait". A complete response was associated with more ypT0 (73%; p<0.001); ypNO (92%); R0 circumferential margin (100%). These data support the hypothesis that a clinical complete response assessed using rectoscopy and digital rectal examination after neoadjuvant therapy may increase the chance of a sphincter or organ preservation in selected rectal cancers. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Short- and long-term subjective medical treatment outcome of trauma surgery patients: the importance of physician empathy

    Directory of Open Access Journals (Sweden)

    Steinhausen S

    2014-09-01

    Full Text Available Simone Steinhausen,1 Oliver Ommen,2 Sunya-Lee Antoine,1 Thorsten Koehler,3 Holger Pfaff,4 Edmund Neugebauer11Institute for Research in Operative Medicine (IFOM, Witten/Herdecke University, Campus Cologne-Merheim, Germany; 2Federal Centre for Health Education (BZgA, Cologne, Germany; 3Institute for Applied Social Sciences (infas, Bonn, Germany; 4Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR, Faculty of Human Science and Faculty of Medicine, University of Cologne, Germany Purpose: To investigate accident casualties’ long-term subjective evaluation of treatment outcome 6 weeks and 12 months after discharge and its relation to the experienced surgeon’s empathy during hospital treatment after trauma in consideration of patient-, injury-, and health-related factors. The long-term results are compared to the 6-week follow-up outcomes.Patients and methods: Two hundred and seventeen surgery patients were surveyed at 6 weeks, and 206 patients at 12 months after discharge from the trauma surgical general ward. The subjective evaluation of medical treatment outcome was measured 6 weeks and 12 months after discharge with the respective scale from the Cologne Patient Questionnaire. Physician Empathy was assessed with the Consultation and Relational Empathy Measure. The correlation between physician empathy and control variables with the subjective evaluation of medical treatment outcome 12 months after discharge was identified by means of logistic regression analysis under control of sociodemographic and injury-related factors.Results: One hundred and thirty-six patients were included within the logistic regression analysis at the 12-month follow-up. Compared to the 6-week follow-up, the level of subjective evaluation of medical treatment outcome was slightly lower and the association with physician empathy was weaker. Compared to patients who rated the empathy of their surgeon lower than 31 points, patients

  11. Loblolly pine growth following operational vegetation management treatments compares favorably to that achieved in complete vegetation control research trials

    Science.gov (United States)

    Dwight K. Lauer; Harold E. Quicke

    2010-01-01

    Different combinations of chemical site prep and post-plant herbaceous weed control installed at three Upper Coastal Plain locations were compared in terms of year 3 loblolly (Pinus taeda L.) pine response to determine the better vegetation management regimes. Site prep treatments were different herbicide rates applied in either July or October. Site...

  12. A new brace treatment similar for adolescent scoliosis and kyphosis based on restoration of thoracolumbar lordosis. Radiological and subjective clinical results after at least one year of treatment

    Directory of Open Access Journals (Sweden)

    van Loon Piet JM

    2012-10-01

    Full Text Available Abstract Study design A prospective treatment study with a new brace was conducted Objective. To evaluate radiological and subjective clinical results after one year conservative brace treatment with pressure onto lordosis at the thoracolumbar joint in children with scoliosis and kyphosis. Summary of background data Conservative brace treatment of adolescent scoliosis is not proven to be effective in terms of lasting correction. Conservative treatment in kyphotic deformities may lead to satisfactory correction. None of the brace or casting techniques is based on sagittal forces only applied at the thoracolumbar spine (TLI= thoracolumbar lordotic intervention. Previously we showed in patients with scoliosis after forced lordosis at the thoracolumbar spine a radiological instantaneous reduction in both coronal curves of double major scoliosis. Methods A consecutive series of 91 children with adolescent scoliosis and kyphosis were treated with a modified symmetric 30 degrees Boston brace to ensure only forced lordosis at the thoracolumbar spine. Scoliosis was defined with a Cobb angle of at least one of the curves [greater than or equal to] 25 degrees and kyphosis with or without a curve Results Before treatment start ‘in brace’ radiographs showed a strong reduction of the Cobb angles in different curves in kyphosis and scoliosis groups (sagittal n = 5 all p Conclusion Conservative treatment using thoracolumbar lordotic intervention in scoliotic and kyphotic deformities in adolescence demonstrates a marked improvement after one year also in clinical and postural criteria. An effect not obtained with current brace techniques.

  13. Z-Elongation of the transverse carpal ligament vs. complete resection for the treatment of carpal tunnel syndrome.

    Science.gov (United States)

    Castro-Menéndez, M; Pagazaurtundúa-Gómez, S; Pena-Paz, S; Huici-Izco, R; Rodríguez-Casas, N; Montero-Viéites, A

    Carpal tunnel syndrome is treated successfully by surgical release of the transverse carpal ligament (TCL). However, persistent weakness of grip and pain over the thenar and hypothenar ends of this ligament, and "pillar pain", are reported to be common complications. In order to reduce these complications, different ligament reconstruction or lengthening techniques have been proposed. The purpose of this study is compare effectiveness and complications of TCL z-lengthening technique with complete TCL section. A prospective, randomised, intervention trial was conducted on 80 patients. The patients were divided into 2 groups: 1) complete release of TCL; 2) z-lengthening of TCL according to a modified Simonetta technique. Grip strength, pillar pain and clinical and functional assessment were carried out using the Levine et al. questionnaire. No significant differences were observed (p>.05) in the postoperative reviews between the two groups as regards grip strength loss and pillar pain. There were significant differences between preoperative and postoperative mean Levine scores, but there was no difference in the mean scores of the two procedures at any time. In conclusion, according to the results, TCL z-lengthening is more effective than simple division, but there is no identifiable benefit in z-lengthening for avoiding complications. Copyright © 2016 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Pharmacological treatment and regional anesthesia techniques for pain management after completion of both conservative and surgical treatment of endometriosis and pelvic adhesions in women with chronic pelvic pain as a mandated treatment strategy

    Directory of Open Access Journals (Sweden)

    Małgorzata Malec-Milewska

    2015-05-01

    Full Text Available Introduction. Chronic pelvic pain syndrome occurs in 4–14% of women. Pain pathomechanism in this syndrome is complex, as it is common to observe the features of nociceptive, inflammatory, neuropathic and psychogenic pain. The common findings in women with pelvic pain are endometriosis and pelvic adhesions. Objective. Aim of the study was to test the effectiveness of pharmacological treatment and regional anesthesia techniques for pain control as the next step of treatment after the lack of clinical results of surgical and pharmacological methods normally used in the management of endometriosis and pelvic adhesions. Materials and method. 18 women were treated between January 2010 – October 2013 in the Pain Clinic of the Department of Anaesthesiology and Intensive Care at the Centre for Postgraduate Education in Warsaw due to chronic pelvic pain syndrome related to either endometriosis or pelvic adhesions. During the previous step of management, both conservative and surgical treatments were completed without achieving satisfactory results. Initial constant pain severity was 3–9 points on the Numeric Rating Scale, while the reported paroxysmal pain level was 7–10. The pharmacological treatment implemented was based on oral gabapentinoids and antidepressants, aided by neurolytic block of ganglion of Walther, pudendal nerve blocks and topical treatment (5% lidocaine, 10% amitriptyline, 10% gabapentin. Results. In 17 women, a significant reduction of both constant and paroxysmal pain was achieved, of which complete and permanent cessation of pain occurred in 6 cases. One patient experienced no improvement in the severity of her symptoms. Conclusions. The combination of pain management with pharmacological treatment, pudendal nerve blocks, neurolysis of ganglion impar (Walther and topical preparations in cases of chronic pelvic pain syndrome seems to be adequate medical conduct after failed or otherwise ineffective causative therapy.

  15. Psychological aspects of eating behavior as predictors of 10-y weight changes after surgical and conventional treatment of severe obesity: results from the Swedish Obese Subjects intervention study.

    Science.gov (United States)

    Konttinen, Hanna; Peltonen, Markku; Sjöström, Lars; Carlsson, Lena; Karlsson, Jan

    2015-01-01

    There is a need for a better understanding of the factors that influence long-term weight outcomes after bariatric surgery. We examined whether pretreatment and posttreatment levels of cognitive restraint, disinhibition, and hunger and 1-y changes in these eating behaviors predict short- and long-term weight changes after surgical and conventional treatments of severe obesity. Participants were from an ongoing, matched (nonrandomized) prospective intervention trial of the Swedish Obese Subjects (SOS) study. The current analyses included 2010 obese subjects who underwent bariatric surgery and 1916 contemporaneously matched obese controls who received conventional treatment. Physical measurements (e.g., weight and height) and questionnaires (e.g., Three-Factor Eating Questionnaire) were completed before the intervention and 0.5, 1, 2, 3, 4, 6, 8, and 10 y after the start of the treatment. Structural equation modeling was used as the main analytic strategy. The surgery group lost more weight and reported greater decreases in disinhibition and hunger at 1- and 10-y follow-ups (all P women) and experienced larger 1-y decreases in these behaviors (β = 0.31-0.48, P women) lost more weight 2, 6, and 10 y after surgery. In control patients, larger 1-y increases in cognitive restraint predicted a greater 2-y weight loss in both sexes. A higher tendency to eat in response to various internal and external cues shortly after surgery predicted less-successful short- and long-term weight outcomes, making postoperative susceptibility for uncontrolled eating an important indicator of targeted interventions. © 2015 American Society for Nutrition.

  16. Elevated baseline serum glutamate as a pharmacometabolomic biomarker for acamprosate treatment outcome in alcohol-dependent subjects

    Science.gov (United States)

    Nam, H W; Karpyak, V M; Hinton, D J; Geske, J R; Ho, A M C; Prieto, M L; Biernacka, J M; Frye, M A; Weinshilboum, R M; Choi, D-S

    2015-01-01

    Acamprosate has been widely used since the Food and Drug Administration approved the medication for treatment of alcohol use disorders (AUDs) in 2004. Although the detailed molecular mechanism of acamprosate remains unclear, it has been largely known that acamprosate inhibits glutamate action in the brain. However, AUD is a complex and heterogeneous disorder. Thus, biomarkers are required to prescribe this medication to patients who will have the highest likelihood of responding positively. To identify pharmacometabolomic biomarkers of acamprosate response, we utilized serum samples from 120 alcohol-dependent subjects, including 71 responders (maintained continuous abstinence) and 49 non-responders (any alcohol use) during 12 weeks of acamprosate treatment. Notably, baseline serum glutamate levels were significantly higher in responders compared with non-responders. Importantly, serum glutamate levels of responders are normalized after acamprosate treatment, whereas there was no significant glutamate change in non-responders. Subsequent functional studies in animal models revealed that, in the absence of alcohol, acamprosate activates glutamine synthetase, which synthesizes glutamine from glutamate and ammonia. These results suggest that acamprosate reduces serum glutamate levels for those who have elevated baseline serum glutamate levels among responders. Taken together, our findings demonstrate that elevated baseline serum glutamate levels are a potential biomarker associated with positive acamprosate response, which is an important step towards development of a personalized approach to treatment for AUD. PMID:26285131

  17. Corrosion resistance of Cr(III) conversion treatments applied on electrogalvanised steel and subjected to chloride containing media

    International Nuclear Information System (INIS)

    Tomachuk, C.R.; Elsner, C.I.; Di Sarli, A.R.; Ferraz, O.B.

    2010-01-01

    The corrosion resistance of pure zinc coatings can be improved through the application of suitable chemical passivation treatments. Hexavalent chromium compounds have widely been used to formulate conversion layers providing better anticorrosive protection as well as anchorage properties to painting systems. However, taking into account that they are produced using hazardous chemical compounds, the development of alternative and 'green' technologies with equivalent protective performance is a paramount purpose of many R and D laboratories working around the world. In the present paper, the corrosion behavior of zinc coatings obtained from free-cyanide alkaline baths and later subjected to a Cr 3+ based passivation treatment, with and without a sealing treatment, was studied. The experimental work involved electrochemical impedance spectroscopy measurements in 0.5 M NaCl solution, surface microstructural and morphological characterization by electronic microscopy as well as chemical analysis by EDXS. The salt spray test was also performed. The analysis and interpretation of all the data coming from this battery of tests allowed inferring that both the Cr 3+ based conversion treatment + adequate sealer presented a good corrosion resistance and, therefore, they could be used as neither a polluting nor toxic alternative to the traditional chromate coatings.

  18. Corrosion resistance of Cr(III) conversion treatments applied on electrogalvanised steel and subjected to chloride containing media

    Energy Technology Data Exchange (ETDEWEB)

    Tomachuk, C.R., E-mail: celia@br.surtec.com [Corrosion and Degradation Division, National Institute of Technology, Av. Venezuela, 82 sala 608, CEP 20081-312, Rio de Janeiro, RJ (Brazil); Elsner, C.I. [CIDEPINT: Research and Development Center in Paint Technology (CIC-CCT-CONICET-La Plata), Av. 52 s/n entre 121 y 122, CP B1900AYB, La Plata (Argentina); Di Sarli, A.R., E-mail: direccion@cidepint.gov.ar [CIDEPINT: Research and Development Center in Paint Technology (CIC-CCT-CONICET-La Plata), Av. 52 s/n entre 121 y 122, CP B1900AYB, La Plata (Argentina); Ferraz, O.B. [Corrosion and Degradation Division, National Institute of Technology, Av. Venezuela, 82 sala 608, CEP 20081-312, Rio de Janeiro, RJ (Brazil)

    2010-01-15

    The corrosion resistance of pure zinc coatings can be improved through the application of suitable chemical passivation treatments. Hexavalent chromium compounds have widely been used to formulate conversion layers providing better anticorrosive protection as well as anchorage properties to painting systems. However, taking into account that they are produced using hazardous chemical compounds, the development of alternative and 'green' technologies with equivalent protective performance is a paramount purpose of many R and D laboratories working around the world. In the present paper, the corrosion behavior of zinc coatings obtained from free-cyanide alkaline baths and later subjected to a Cr{sup 3+} based passivation treatment, with and without a sealing treatment, was studied. The experimental work involved electrochemical impedance spectroscopy measurements in 0.5 M NaCl solution, surface microstructural and morphological characterization by electronic microscopy as well as chemical analysis by EDXS. The salt spray test was also performed. The analysis and interpretation of all the data coming from this battery of tests allowed inferring that both the Cr{sup 3+} based conversion treatment + adequate sealer presented a good corrosion resistance and, therefore, they could be used as neither a polluting nor toxic alternative to the traditional chromate coatings.

  19. Polymorphism of the vitamin D3 receptor gene and bone mineral density in girls with functional hypothalamic amenorrhea subjected to oestroprogestagen treatment.

    Science.gov (United States)

    Sowińska-Przepiera, Elżbieta; Andrysiak-Mamos, Elżbieta; Syrenicz, Justyna; Jarząbek-Bielecka, Grażyna; Friebe, Zbigniew; Syrenicz, Anhelli

    2011-01-01

    We investigated whether the vitamin D3 receptor gene (VDR) polymorphism can modulate therapeutic response of functional hypothalamic amenorrhea (FHA) patients to the oestroprogestagen (EP) treatment. The study included 84 FHA girls and 50 controls. FHA patients underwent a four-year sequential EP therapy with 17-β oestradiol (2 mg from the 2(nd) to 25(th) day of the menstrual cycle) and didrogesterone (10 mg from the 16(th) to the 25(th) day). Their hormonal parameters were monitored along with bone turnover marker levels and bone mineral density (BMD). Additionally, the VDR gene BsmI polymorphism was determined. Hormonal therapy was reflected by a substantial improvement of BMD. However, the values of BMD observed after four years of treatment in FHA patients were still significantly lower than baseline bone mineral density determined in the control group (1.007 ± 0.100 vs. 1.141 ± 0.093 g/cm(2), respectively; p < 0.001). No significant effects of the VDR genotype were observed on the dynamics of BMD during consecutive years of hormonal treatment and mean bone mineral density determined after completing the therapy (1.006 ± 0.101 vs. 1.013 ± 0.114 vs. 1.006 ± 0.094 g/cm(2) for BB, bb and Bb genotypes, respectively; p = 0.973). This study did not confirm that VDR polymorphism can modulate therapeutic outcome of FHA girls subjected to the hormonal treatment. Nonetheless, this study confirmed the effectiveness of EP therapy in the simultaneous treatment of menstrual disorders and the normalisation of bone mineral density in FHA patients.

  20. Treatment with the dipeptidyl peptidase-4 inhibitor vildagliptin improves fasting islet-cell function in subjects with type 2 diabetes.

    Science.gov (United States)

    D'Alessio, David A; Denney, Amanda M; Hermiller, Linda M; Prigeon, Ronald L; Martin, Julie M; Tharp, William G; Saylan, Monica Liqueros; He, Yanling; Dunning, Beth E; Foley, James E; Pratley, Richard E

    2009-01-01

    Dipeptidyl peptidase 4 (DPP-4) inhibitors are proposed to lower blood glucose in type 2 diabetes mellitus (T2DM) by prolonging the activity of the circulating incretins, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1). Consistent with this mechanism of action, DPP-4 inhibitors improve glucose tolerance after meals by increasing insulin and reducing glucagon levels in the plasma. However, DPP-4 inhibitors also reduce fasting blood glucose, an unexpected effect because circulating levels of active GIP and GLP-1 are low in the postabsorptive state. The objective of the study was to examine the effects of DPP-4 inhibition on fasting islet function. We conducted a randomized, double-blind, placebo-controlled trial. The study was performed in General Clinical Research Centers at two University Hospitals. Forty-one subjects with T2DM were treated with metformin or diet, having good glycemic control with glycosylated hemoglobin values of 6.2-7.5%. Subjects were treated with vildagliptin (50 mg twice daily) or placebo for 3 months, followed by a 2-wk washout. Major Outcome Measure: We measured insulin secretion in response to iv glucose and arginine before and after treatment and after drug washout. There were small and comparable reductions in glycosylated hemoglobin in both groups over 3 months. Vildagliptin increased fasting GLP-1 levels in subjects taking metformin, but not those managed with diet, and raised active GIP levels slightly. DPP-4 inhibitor treatment improved the acute insulin and C-peptide responses to glucose (50 and 100% respectively; P fasting conditions. This suggests that DPP-4 inhibition has metabolic benefits in addition to enhancing meal-induced GLP-1 and GIP activity.

  1. SUBJECTIVE CURE RATES AFTER TVT PROCEDURE FOR TREATMENT OF FEMALE URINARY INCONTINENCE – A QUESTIONNAIRE BASED STUDY

    Directory of Open Access Journals (Sweden)

    Igor But

    2003-12-01

    Full Text Available Background. The aim of this study was to assess the subjective cure rate after the tension-free vaginal tape (TVT procedure in patients with stress (SUI and mixed (MUI urinary incontinence.Methods. This is a questionnaire based study done in 43 patients with SUI and 52 patients with MUI. In the assessement of the subjective cure rate the visual analogue scale and the symptom assessment index (SAI were used. Data were analyzed using nonparametric statistics.Results. The subjective cure rate assessed 19.6 months after TVT amounted to 89.3%. Urinary incontinence after TVT procedure was noted in 26 patients (27.4% and the majority of these women (73.1% were diagnosed with MUI. In patients with SUI and postoperative stable bladder a higher success rate was observed (96.7%. In 18.6% patients with SUI, de novo overactive bladder symptoms occurred. These patients estimated a significantly (p = 0.027 lower cure rate (81.9% after TVT procedure. In patients with MUI, the cure rate after TVT amounted to 85.6%. The subjective cure rate was lower (79.4% in case of persistent overactive bladder symptoms. However, it was significantly higher (97.5% in case of a postoperatively stable bladder (p = 0.016. In the group of MUI patients, the symptoms of overactive bladder disease resolved spontaneously in 17 patients (32.7% postoperatively. The patients were satisfied with TVT and 92.6% would recommend this procedure to others.Conclusions. The TVT procedure is a very effective method of treatment for stress as well as mixed urinary incontinence. The success rate of the procedure is high, however, it is influenced by bladder activity.

  2. A Case of Complete Recovery of Fluctuating Monocular Blindness Following Endovascular Treatment in Internal Carotid Artery Dissection.

    Science.gov (United States)

    Kim, Ki-Tae; Baik, Seung Guk; Park, Kyung-Pil; Park, Min-Gyu

    2015-09-01

    Monocular blindness may appear as the first symptom of internal carotid artery dissection (ICAD). However, there have been no reports that monocular visual loss repeatedly occurs and disappears in response to postural change in ICAD. A 33-year-old woman presented with transient monocular blindness (TMB) following acute-onset headache. TMB repeatedly occurred in response to postural change. Two days later, she experienced transient dysarthria and right hemiparesis in upright position. Pupil size and light reflex were normal, but a relative afferent pupillary defect was positive in the left eye. Diffusion-weighted imaging showed no acute lesion, but perfusion-weighted imaging showed perfusion delay in the left ICA territory. Digital subtraction angiography demonstrated a false lumen and an intraluminal filling defect in proximal segment of the left ICA. Carotid stenting was performed urgently. After carotid stenting, left relative afferent pupillary defect disappeared and TMB was not provoked anymore by upright posture. At discharge, left visual acuity was completely normalized. Because fluctuating visual symptoms in the ICAD may be associated with hemodynamically unstable status, assessment of the perfusion status should be done quickly. Carotid stenting may be helpful to improve the fluctuating visual symptoms and hemodynamically unstable status in selected patient with the ICAD. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  3. Parent-child inpatient treatment for children with behavioural and emotional disorders: a multilevel analysis of within-subjects effects.

    Science.gov (United States)

    Ise, Elena; Schröder, Sabine; Breuer, Dieter; Döpfner, Manfred

    2015-11-16

    The importance of parental involvement in child treatment is well-established. Several child psychiatric clinics have, therefore, set up inpatient family units where children and parents are both actively involved in the treatment. Unfortunately, evidence supporting the benefits of these units is sparse. We evaluated the effectiveness of inpatient treatment for families with severe parent-child interaction problems in a child psychiatric setting. Consecutive admissions to the parent-child ward (N = 66) were studied. A within-subjects design was used with four assessment points (baseline, admission, discharge, four-week follow-up). Outcome measures were 1) parent and teacher ratings of child behaviour, and 2) parent self-ratings of parenting practices, parental strains and parental mental health. Data were analyzed using multilevel modelling for longitudinal data (piecewise growth curve models). All parent-rated measures improved significantly during the four-week treatment period (d = 0.4 - 1.3). These improvements were significantly greater than those observed during the four-week pre-admission period. In addition, benefits were maintained during the four-week follow-up period. Only parents' self-efficacy in managing their child's behaviour showed continued improvement during follow-up. Teacher ratings of children's disruptive behaviour at school were stable during the pre-admission period and showed significant improvements at follow-up (d = 0.3 - 0.4). We conclude that parent-child inpatient treatment has positive effects on child and parent behaviour and mental health, and can therefore be recommended for children with behavioural and emotional disorders and severe parent-child interaction problems.

  4. A 10-year follow-up study of completers versus dropouts following treatment with an integrated cognitive-behavioral group therapy for eating disorders.

    Science.gov (United States)

    Okamoto, Yuri; Miyake, Yoshie; Nagasawa, Ichie; Shishida, Kazuhiro

    2017-01-01

    Cognitive-behavioral therapy (CBT) has been recommended for the treatment of eating disorders, and group therapy is known to have certain advantages over individual therapy. The aim of the current study was to compare the 10-year prognosis of patients who completed integrated group CBT with those who dropped out and to examine the effect of completion of group CBT on the prognosis. The participants were 65 adult patients with eating disorders. All patients were women and Japanese. The average age (19-37) of the patients was 25.1 ± 3.8 years, and the average body mass index (BMI) was 17.7 ± 2.0. We conducted integrated group CBT with the patients and compared eating disorder symptoms, mood states, coping styles, and self-esteem before and after therapy. Furthermore, we compared clinical features and the 10-year prognosis of patients who completed the treatment and those who dropped out. After 10 sessions of group therapy, Eating Attitudes Test scores, Profile of Mood States depression scores, and Coping Inventory for Stressful Situations emotion-oriented scores decreased, while Rosenberg's Self-Esteem Scale scores increased. Regarding the results of the 10-year follow up, the completer group had more patients with a good prognosis. In contrast, the dropout group had more patients with a poor prognosis. Those who completed the integrated group CBT had a good prognosis. Group therapy gives the patients an opportunity to form peer relationships, and helps them to develop communication and socialization skills. Furthermore, in the group therapy sessions, the patients develop self-awareness by listening to other members of the group and they also develop interpersonal relationships. This effect may be temporary, but experience of group therapy may provide hope for the patient and increase the chance of the patient continuing treatment. Retrospectively registered in University Hospital Medical Information Network in Japan: No. 000028868 (May 19th, 2017).

  5. An Innovative Approach to Improve Completeness of Treatment and Other Key Data Elements in a Population-Based Cancer Registry: A15-Month Data Submission.

    Science.gov (United States)

    Hsieh, Mei-Chin; Mumphrey, Brent; Pareti, Lisa; Yi, Yong; Wu, Xiao-Cheng

    2017-01-01

    BACKGROUND: In order to comply with the Louisiana legislative obligation and meet funding agencies’ requirement of case completeness for 12-month data submission, hospital cancer registries are mandated to submit cancer incidence data to the Louisiana Tumor Registry (LTR) within 6 months of diagnosis. However, enforcing compliance with timely reporting may result in incomplete data on adjuvant treatment received by the LTR. Although additional treatment information can be obtained via retransmission of the North American Association of Central Cancer Registries (NAACCR)–modified abstracts, consolidating multiple NAACCR-modified abstracts for the same case is extremely time consuming. To avoid a huge amount of work while obtaining timely and complete data, the LTR has requested hospital cancer registries resubmit their data 15 months after the close of the diagnosis year. The purpose of this report is to assess the improvement in the completeness of data items related to treatment, staging and site specific factors. METHODS: The LTR requested that hospital cancer registries resubmit 15-month data between April 1, 2016 and April 15, 2016 for cases diagnosed in 2014. Microsoft Visual Studio Visual Basic script was used to link and compare resubmitted data with existing data in the LTR database. Data elements used for matching same patient/tumor were name, Social Security number, date of birth, primary site, laterality, and hospital identifier number. Treatment data items were compared as known vs none/ unknown and known vs known with different code. Matched records with updated information were imported into the LTR database and flagged as modified abstract records for manual consolidation. Nonmatched records were also loaded in the LTR database as potential new cases for further investigation. RESULTS: A total of 25,207 resubmitted NAACCR abstracts were received from 38 hospitals and freestanding radiation centers. About 11.1% had at least 1 update related to

  6. Complete revascularisation versus treatment of the culprit lesion only in patients with ST-segment elevation myocardial infarction and multivessel disease (DANAMI-3—PRIMULTI)

    DEFF Research Database (Denmark)

    Engstrøm, Thomas; Kelbæk, Henning; Helqvist, Steffen

    2015-01-01

    )-guided complete revascularisation versus treatment of the infarct-related artery only. METHODS: We undertook an open-label, randomised controlled trial at two university hospitals in Denmark. Patients presenting with STEMI who had one or more clinically significant coronary stenosis in addition to the lesion...... electronically via a web-based system in permuted blocks of varying size by the clinician who did the primary PCI. All patients received best medical treatment. The primary endpoint was a composite of all-cause mortality, non-fatal reinfarction, and ischaemia-driven revascularization of lesions in non...

  7. Treatment of Children and Adolescents With Hodgkin Lymphoma Without Radiotherapy for Patients in Complete Remission After Chemotherapy

    DEFF Research Database (Denmark)

    Dörffel, Wolfgang; Rühl, Ursula; Lüders, Heike

    2013-01-01

    1995 and 2001, 925 patients with classical HL (cHL) were registered from seven European countries in German Society of Pediatric Oncology and Hematology Hodgkin Lymphoma Trial 95. Patients in treatment group 1 (TG1; early stages) received two cycles of vincristine, prednisone, procarbazine......, and doxorubicin or vincristine, prednisone, etoposide, and doxorubicin chemotherapy; additional two or four cycles of cyclophosphamide, vincristine, prednisone, and procarbazine were added in TG2 (intermediate stages) or TG3 (advanced stages), respectively. Patients in CR (assessed by computed tomography...... results in TG3 (82.6% ± 5.4% v 88.7% ± 2.0%, P = .259). Reduction of the standard radiation dose from 25 to 20 Gy did not increase failure rate. CONCLUSION: RT can be omitted in early stage HL in so defined CR following this chemotherapy. RT with 20(-35) Gy proved to be sufficient in patients...

  8. Treatment influencing down-staging in EORTC Melanoma Group sentinel node histological protocol compared with complete step-sectioning: a national multicentre study.

    Science.gov (United States)

    Riber-Hansen, Rikke; Hastrup, Nina; Clemmensen, Ole; Behrendt, Nille; Klausen, Siri; Ramsing, Mette; Spaun, Eva; Hamilton-Dutoit, Stephen Jacques; Steiniche, Torben

    2012-02-01

    Metastasis size in melanoma sentinel lymph nodes (SLNs) is an emerging prognostic factor. Two European melanoma treatment trials include SLN metastasis diameters as inclusion criteria. Whilst diameter estimates are sensitive to the number of sections examined, the level of this bias is largely unknown. We performed a prospective multicentre study to compare the European Organisation for Research and Treatment of Cancer (EORTC) recommended protocol with a protocol of complete step-sectioning. One hundred and thirty-three consecutive SLNs from seven SLN centres were analysed by five central sections 50μm apart (EORTC Protocol) followed by complete 250μm step-sectioning. Overall, 29 patients (21.8%) were SLN-positive. The EORTC Protocol missed eight of these metastases (28%), one metastasis measuring less than 0.1mm in diameter, seven measuring between 0.1 and 1mm. Complete step-sectioning at 250μm intervals (Extensive Protocol) missed one metastasis (3%) that measured less than 0.1mm. Thirteen treatment courses (34%) performed if inclusion was based on the Combined Protocol would not be performed if assessed by the EORTC Protocol. Thus, 10 patients would be without completion lymph node dissection (EORTC MINITUB study), whilst three patients would not be eligible for anti-CTLA4 trial (EORTC protocol 18071). The corresponding number with the Extensive Protocol would be three; one patient for the MINITUB registration study and two patients for the anti-CTLA4 study. Examining SLNs by close central sectioning alone (EORTC Protocol) misses a substantial number of metastases and underestimates the maximum metastasis diameter, leading to important changes in patient eligibility for various treatment protocols. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. Limited accuracy of DCE-MRI in identification of pathological complete responders after chemoradiotherapy treatment for rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gollub, Marc J. [Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY (United States); Tong, Tong [Fudan University Medical Center, Department of Radiology, Shanghai (China); Weiser, Martin [Memorial Sloan Kettering Cancer Center, Department of Surgery, Divison of Colorectal Surgery, New York, NY (United States); Zheng, Junting; Gonen, Mithat [Memorial Sloan Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY (United States); Zakian, Kristen L. [Memorial Sloan Kettering Cancer Center, Department of Medical Physics, New York, NY (United States)

    2017-04-15

    To examine whether post-chemoradiotherapy (CRT) DCE-MRI can identify rectal cancer patients with pathologic complete response (pCR). From a rectal cancer surgery database 2007-2014, 61 consecutive patients that met the following inclusion criteria were selected for analysis: (1) stage II/III primary rectal adenocarcinoma; (2) received CRT; (3) underwent surgery (4); underwent rectal DCE-MRI on a 1.5-T MRI scanner. Two experienced radiologists, in consensus, drew regions of interest (ROI) on the sagittal DCE-MRI image in the tumour bed. These were exported from ImageJ to in-house Matlab code for modelling using the Tofts model. K{sup trans}, K{sub ep} and v{sub e} values were compared to pathological response. Of the 61 initial patients, 37 had data considered adequate for fitting to obtain perfusion parameters. Among the 13 men and 24 women, median age 53 years, there were 8 pCR (22 %). K{sup trans} could not distinguish patients with pCR. For patients with 90 % or greater response, mean K{sup trans} and K{sub ep} values were statistically significant (p = 0.032 and 0.027, respectively). Using a cutoff value of K{sup trans} = 0.25 min{sup -1}, the AUC was 0.71. K{sup trans} could be used to identify patients with 90 % or more response to chemoradiotherapy for rectal cancer with an AUC of 0.7. (orig.)

  10. Efficacy of complete decongestive therapy and manual lymphatic drainage on treatment-related lymphedema in breast cancer

    International Nuclear Information System (INIS)

    Koul, Rashmi; Dufan, Tarek; Russell, Catherine; Guenther, Wanda; Nugent, Zoan; Sun Xuyan; Cooke, Andrew L.

    2007-01-01

    Objective: To evaluate the results of combined decongestive therapy and manual lymphatic drainage in patients with breast cancer-related lymphedema. Methods and Materials: The data from 250 patients were reviewed. The pre- and posttreatment volumetric measurements were compared, and the correlation with age, body mass index, and type of surgery, chemotherapy, and radiotherapy was determined. The Spearman correlation coefficients and Wilcoxon two-sample test were used for statistical analysis. Results: Of the 250 patients, 138 were included in the final analysis. The mean age at presentation was 54.3 years. Patients were stratified on the basis of the treatment modality used for breast cancer management. Lymphedema was managed with combined decongestive therapy in 55%, manual lymphatic drainage alone in 32%, and the home program in 13%. The mean pretreatment volume of the affected and normal arms was 2929 and 2531 mL. At the end of 1 year, the posttreatment volume of the affected arm was 2741 mL. The absolute volume of the affected arm was reduced by a mean of 188 mL (p < 0.0001). The type of surgery (p = 0.0142), age (p = 0.0354), and body mass index (p < 0.0001) were related to the severity of lymphedema. Conclusion: Combined decongestive therapy and manual lymphatic drainage with exercises were associated with a significant reduction in the lymphedema volume

  11. Improvement in cognitive and affective theory of mind with observation and imitation treatment in subjects with schizophrenia

    Directory of Open Access Journals (Sweden)

    Maria C. Pino

    2015-06-01

    Full Text Available Objective: the main objective of this study is to consider Theory of Mind (ToM, i.e. the ability to perceive other people in terms of thinking, believing and emotions, as a target for effective rehabilitative intervention, using Emotion and ToM Imitation Training (ETIT, aimed at improving social cognition and social functioning in schizophrenia. ToM impairment is a key feature of schizophrenia. According to recent literature, ToM is a multidimensional process requiring at least two components: cognitive and affective. Cognitive ToM seems to be a prerequisite for affective ToM, which requires intact empathic ability. Method: seven patients with schizophrenia completed ETIT treatment and were compared to 7 patients who participated in Problem Solving Training (PST. The participants were assessed at pre and post treatment regarding measures of cognitive (Advanced Theory of Mind Task and Social Situation Test and affective (Emotion Attribution Task and Eyes Task ToM and also empathy (Empathy Quotient. Results: our results showed that when compared to the control group, ETIT participants improved in three social cognition components evaluated (cognitive and affective ToM and empathy. Improvement in cognitive and affective ToM was found within the ETIT group pre and post treatment. Conclusions: Action observation and imitation could be important goals for future “low cost” rehabilitation treatment in several disorders in which the deficit of social cognition is considered as “core” to the disease. This represents a new perspective in the rehabilitation field.

  12. Structure, Texture and Phases in 3D Printed IN718 Alloy Subjected to Homogenization and HIP Treatments

    Directory of Open Access Journals (Sweden)

    Ahmad Mostafa

    2017-05-01

    Full Text Available 3D printing results in anisotropy in the microstructure and mechanical properties. The focus of this study is to investigate the structure, texture and phase evolution of the as-printed and heat treated IN718 superalloy. Cylindrical specimens, printed by powder-bed additive manufacturing technique, were subjected to two post-treatments: homogenization (1100 °C, 1 h, furnace cooling and hot isostatic pressing (HIP (1160 °C, 100 MPa, 4 h, furnace cooling. The Selective laser melting (SLM printed microstructure exhibited a columnar architecture, parallel to the building direction, due to the heat flow towards negative z-direction. Whereas, a unique structural morphology was observed in the x-y plane due to different cooling rates resulting from laser beam overlapping. Post-processing treatments reorganized the columnar structure of a strong {002} texture into fine columnar and/or equiaxed grains of random orientations. Equiaxed structure of about 150 µm average grain size, was achieved after homogenization and HIP treatments. Both δ-phase and MC-type brittle carbides, having rough morphologies, were formed at the grain boundaries. Delta-phase formed due to γ″-phase dissolution in the γ matrix, while MC-type carbides nucleates grew by diffusion of solute atoms. The presence of (Nb0.78Ti0.22C carbide phase, with an fcc structure having a lattice parameter a = 4.43 Å, was revealed using Energy dispersive spectrometer (EDS and X-ray diffractometer (XRD analysis. The solidification behavior of IN718 alloy was described to elucidate the evolution of different phases during selective laser melting and post-processing heat treatments of IN718.

  13. Changes of subtests of Wechsler Memory Scale and cognitive function in subjects with subclinical hypothyroidism following treatment with levothyroxine.

    Science.gov (United States)

    Aghili, Rokhsareh; Khamseh, Mohammad E; Malek, Mojtaba; Hadian, Ali; Baradaran, Hamid R; Najafi, Laily; Emami, Zahra

    2012-12-20

    Subclinical hypothyroidism has been reported to be associated with disturbed cognitive function. In this study, changes of subtests of the Wechsler Memory Scale and memory quotient were investigated in subjects with subclinical hypothyroidism following treatment with levothyroxine. The aim of the study was a randomized double blind placebo-controlled clinical trial. Sixty subjects (51 females and 9 males) with subclinical hypothyroidism were enrolled. Memory quotient was evaluated at the beginning of the study and three months after enrollment, using Wechsler's memory test. Subclinical hypothyroidism was defined as serum TSH level between 4.5 mU/l and 10 mU/l in the presence of normal free-T4 (0.8-2 ng/dl) and positive anti-TPO-Ab. The intervention and control groups received levothyroxine and placebo respectively for 3 months. Re-evaluation was done using the Wechsler Memory Scale at the end of the study. The mean age was 34 ±10 years, mean TSH level was 8.25 ±3.64 muIU/l. Memory quotient was similar in both groups at the beginning of the study: 105.70 ±2.1 in intervention group vs. 105.87 ±2.1 in control group (p = 0.89). At the end of the study, the memory quotient rose by 9.3 points in the intervention group and by 3.23 in the controls (p = 0.002). Analysis of the scores of Wechsler Memory subtests in the intervention group indicated significant improvement of mental control (p = 0.002), logical memory (p < 0.001), associate learning (p = 0.014), age corrected score (p = 0.002), and memory quotient (p < 0.001). This study showed the efficacy of levothyroxine for cognitive function of subjects with subclinical hypothyroidism.

  14. Replication Capacity in Relation to Immunologic and Virologic Outcomes in HIV-1 infected, Treatment-Naïve Subjects

    Science.gov (United States)

    Skowron, Gail; Spritzler, John G.; Weidler, Jodi; Robbins, Gregory K.; Johnson, Victoria A.; Chan, Ellen S.; Asmuth, David M.; Gandhi, Rajesh T.; Lie, Yolanda; Bates, Michael; Pollard, Richard B.

    2012-01-01

    Objectives To evaluate the association between baseline (BL) replication capacity (RC) [RCBL] and immunologic/virologic parameters (at BL and after 48 weeks on therapy) in HIV-1 infected subjects initiating antiretroviral therapy. Methods RCBL was determined using a modified Monogram PhenoSense HIV drug susceptibility assay on plasma HIV-1 from 321 treatment-naïve subjects from ACTG384. Univariate and multivariable analyses were performed to determine the association of RCBL with BL and on-therapy virologic and immunologic outcomes. Results Higher RCBL was associated with lower baseline CD4 (CD4BL) (r=−0.23, p<0.0001), higher baseline HIV-1 (RNABL) (r=0.25, p<0.0001), higher CD4BL activation percent (r=0.23, p<0.0001) and lower CD4BL memory count (r=−0.21, p=0.0002). In a multivariable model, week 48 CD4 increase (ΔCD448) was associated with lower CD4BL memory count and higher CD4BL naive percent (p=0.004, p=0.015, respectively). The interaction between CD4BL and RCBL was significant (p=0.018), with a positive association between RCBL and ΔCD448 in subjects with higher CD4BL, and a negative association at lower absCD4BL. Conclusions At baseline, higher RC was significantly associated with higher HIV-1 RNA, higher CD4 cell activation, lower CD4 cell count, and lower CD4 memory cell count. These factors may interact, directly or indirectly, to modify the extent to which CD4 recovery occurs in patients starting antiretroviral therapy at different baseline CD4 counts. PMID:19194319

  15. Replication capacity in relation to immunologic and virologic outcomes in HIV-1-infected treatment-naive subjects.

    Science.gov (United States)

    Skowron, Gail; Spritzler, John G; Weidler, Jodi; Robbins, Gregory K; Johnson, Victoria A; Chan, Ellen S; Asmuth, David M; Gandhi, Rajesh T; Lie, Yolanda; Bates, Michael; Pollard, Richard B

    2009-03-01

    To evaluate the association between baseline (BL) replication capacity (RC) (RCBL) and immunologic/virologic parameters (at BL and after 48 weeks on therapy) in HIV-1-infected subjects initiating antiretroviral therapy. RCBL was determined using a modified Monogram PhenoSense HIV drug susceptibility assay on plasma HIV-1 from 321 treatment-naive subjects from AIDS Clinical Trials Group 384. Univariate and multivariable analyses were performed to determine the association of RCBL with BL and on-therapy virologic and immunologic outcomes. Higher RCBL was associated with lower baseline CD4 (CD4BL) (r = -0.23, P < 0.0001), higher baseline HIV-1 RNA (r = 0.25, P < 0.0001), higher CD4BL activation percent (r = 0.23, P < 0.0001), and lower CD4BL memory count (r = -0.21, P = 0.0002). In a multivariable model, week 48 CD4 increase (DeltaCD448) was associated with lower CD4BL memory count and higher CD4BL-naive percent (P = 0.004, P = 0.015, respectively). The interaction between CD4BL and RCBL was significant (P = 0.018), with a positive association between RCBL and DeltaCD448 in subjects with higher CD4BL and a negative association at lower absCD4BL. At baseline, higher RC was significantly associated with higher HIV-1 RNA, higher CD4 cell activation, lower CD4 cell count, and lower CD4 memory cell count. These factors may interact, directly or indirectly, to modify the extent to which CD4 recovery occurs in patients starting antiretroviral therapy at different CD4BL counts.

  16. Projective modules and complete intersections

    CERN Document Server

    Mandal, Satya

    1997-01-01

    In these notes on "Projective Modules and Complete Intersections" an account on the recent developments in research on this subject is presented. The author's preference for the technique of Patching isotopic isomorphisms due to Quillen, formalized by Plumsted, over the techniques of elementary matrices is evident here. The treatment of Basic Element theory here incorporates Plumstead's idea of the "generalized dimension functions". These notes are highly selfcontained and should be accessible to any graduate student in commutative algebra or algebraic geometry. They include fully self-contained presentations of the theorems of Ferrand-Szpiro, Cowsik-Nori and the techniques of Lindel.

  17. Myocardial tissue deformation is reduced in subjects with coronary microvascular dysfunction but not rescued by treatment with Ranolazine

    Science.gov (United States)

    Nelson, Michael D.; Sharif, Behzad; Shaw, Jaime L.; Cook-Wiens, Galen; Wei, Janet; Shufelt, Chrisandra; Mehta, Puja K.; Thomson, Louise EJ; Berman, Daniel S.; Thompson, Richard B.; Handberg, Eileen M.; Pepine, Carl J.; Li, Debiao; Bairey Merz, C. Noel

    2016-01-01

    Background Patients with coronary microvascular dysfunction (CMD) often have diastolic dysfunction, representing an important therapeutic target. Ranolazine—a late-sodium current inhibitor—improves diastolic function in animal models, and subjects with obstructive CAD. We hypothesized that ranolazine would beneficially alter diastolic function in CMD. Methods To test this hypothesis, we performed retrospective tissue tracking analysis to evaluate systolic/diastolic strain, using cardiac magnetic resonance imaging cine images: a) acquired in a recently completed, randomized, double-blind, placebo-controlled, crossover trial of short-term ranolazine in subjects with CMD, and b) from 43 healthy reference controls. Results Diastolic strain rate was impaired in CMD vs. controls (circumferential diastolic strain rate: 99.9 ± 2.5%/s vs. 120.1 ± 4.0%/s, p=0.0003; radial diastolic strain rate: −199.5 ± 5.5%/s vs. −243.1 ± 9.6%/s, p=0.0008, case vs. control). Moreover, peak systolic circumferential (CS) and radial (RS) strain were also impaired in cases vs. controls (CS: −18.8 ± 0.3% vs. −20.7 ± 0.3%; RS: 35.8 ± 0.7% vs. 41.4 ± 0.9%; respectively; both p < 0.0001), despite similar and preserved ejection fraction. In contrast to our hypothesis however, we observed no significant changes in left ventricular diastolic function in CMD cases after two weeks of ranolazine vs. placebo. Conclusions The case-control comparison both confirms and extends our prior observations of diastolic dysfunction in CMD. That CMD cases were also found to have sub-clinical systolic dysfunction is a novel finding, highlighting the utility of this retrospective approach. In contrast to previous studies in obstructive CAD, ranolazine did not improve diastolic function in CMD. PMID:28004395

  18. [Androgens and prolonged complete remissions in acute non lymphoblastic leukemias. Results of a systematic treatment with stanozolol associated with chemotherapy (author's transl)].

    Science.gov (United States)

    Sotto, J J; Hollard, D; Schaerer, R; Bensa, J C; Seigneurin, D

    1975-01-01

    An androgen (stanozolol: 0,15 mg/kg/d) was systematically associated to the treatment of acute non lymphoblastic leukemias, since the beginning of induction therapy (vincristin, daunorubicin, prednisone) and throughout the maintenance period (6-mercaptopurine and methotrexate). Thirty-six patients less than 60 years old (median age: 44 years) presenting with acute non-lymphoblastic leukemia were entered to the study. Sixteen achieved complete remission (C.R.), i.e. 44% of the whole and 53% of treated patients. Out of 16 patients with complete remission, 4 relapsed during the observation period which lasted 4-1/2 years. The stability of the hematologic equilibrium in patients in C.R. is the main finding of the present study. The actuarial curve of the duration of the first complete remission reaches a "plateau"; after the 8th month only one relapse was observed in 9 patients. The rate of C.R. at 2 years is 76 +/- 23%. As compared to the results from other schedules of treatment, this rate appears significantly better, specially in the case of immunotherapy (p less than 0,001). A prospective randomized study is now suggested as to confirm this result; its therapeutic and theoretical basis and perspectives are discussed.

  19. Clinical profile of uveitis in Hansen’s disease after completion of treatment – A study of 50 cases using Polymerase Chain Reaction (PCR on aqueous humour

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    Radha Annamalai

    2016-05-01

    Full Text Available Chronic low grade anterior uveitis is the commonest cause of blindness in leprosy. It is usually asymptomatic until the late stages and patients seek help only after irreversible visual loss. We analysed patients who had a recurrence of uveitis after completion of treatment with anti-leprosy drugs and had been proven as histopathologically negative. The presence of chronic uveitis, complications and the extent of ocular damage it may cause, can continue even after treatment, emphasising the importance of follow-up, early detection and treatment. This is a prospective cohort study. Ophthalmic evaluation was performed using slit lamp examination, biomicroscopy, indirect ophthalmoscopy, applanation tonometry, corneal sensation and Schirmer’s test. Split skin microscopy was done to confirm the activity of leprosy. In patients with recalcitrant iridocyclitis, anterior chamber paracentesis was performed. The sample was analysed both by smear and polymerase chain reaction. The sequences that were targeted using PCR included genes encoding the DNA of 36-kDa antigen, 18-kDa antigen, 65-kDa antigen and the repetitive sequences among other M. leprae genes. Aqueous aspirate showed copies of mycobacterium leprae DNA in five out of twelve patients with recalcitrant anterior uveitis. Direct smear and staining with Ziehl- Neelson staining for mycobacteria was positive showing both live and dead bacilli. Live bacilli can persist in the aqueous humour even after completion of treatment. In our study this was more frequently observed in tuberculoid leprosy. This is possibly due to an immune mediated response combined with inadequate treatment dose in these patients.

  20. Analysis of microvascular perfusion with multi-dimensional complete ensemble empirical mode decomposition with adaptive noise algorithm: Processing of laser speckle contrast images recorded in healthy subjects, at rest and during acetylcholine stimulation.

    Science.gov (United States)

    Humeau-Heurtier, Anne; Marche, Pauline; Dubois, Severine; Mahe, Guillaume

    2015-01-01

    Laser speckle contrast imaging (LSCI) is a full-field imaging modality to monitor microvascular blood flow. It is able to give images with high temporal and spatial resolutions. However, when the skin is studied, the interpretation of the bidimensional data may be difficult. This is why an averaging of the perfusion values in regions of interest is often performed and the result is followed in time, reducing the data to monodimensional time series. In order to avoid such a procedure (that leads to a loss of the spatial resolution), we propose to extract patterns from LSCI data and to compare these patterns for two physiological states in healthy subjects: at rest and at the peak of acetylcholine-induced perfusion peak. For this purpose, the recent multi-dimensional complete ensemble empirical mode decomposition with adaptive noise (MCEEMDAN) algorithm is applied to LSCI data. The results show that the intrinsic mode functions and residue given by MCEEMDAN show different patterns for the two physiological states. The images, as bidimensional data, can therefore be processed to reveal microvascular perfusion patterns, hidden in the images themselves. This work is therefore a feasibility study before analyzing data in patients with microvascular dysfunctions.

  1. Durable complete responses off all treatment in patients with metastatic malignant melanoma after sequential immunotherapy followed by a finite course of BRAF inhibitor therapy.

    Science.gov (United States)

    Wyluda, Edward J; Cheng, Jihua; Schell, Todd D; Haley, Jeremy S; Mallon, Carol; Neves, Rogerio I; Robertson, Gavin; Sivik, Jeffrey; Mackley, Heath; Talamo, Giampaolo; Drabick, Joseph J

    2015-01-01

    We report 3 cases of durable complete response (CR) in patients with BRAF-mutated metastatic melanoma who were initially treated unsuccessfully with sequential immunotherapies (high dose interleukin 2 followed by ipilimumab with or without concurrent radiation therapy). After progression during or post immunotherapy, these patients were given BRAF inhibitor therapy and developed rapid CRs. Based on the concomitant presence of autoimmune manifestations (including vitiligo and hypophysitis), we postulated that there was a synergistic effect between the prior immune therapy and the BRAF targeting agents. Accordingly, the inhibitors were gradually weaned off beginning at 3 months and were stopped completely at 9-12 months. The three patients remain well and in CR off of all therapy at up to 15 months radiographic follow-up. The institution of the BRAF therapy was associated with development of severe rheumatoid-like arthritis in 2 patients which persisted for months after discontinuation of therapy, suggesting it was not merely a known toxicity of BRAF inhibitors (arthralgias). On immunologic analysis, these patients had high levels of non-T-regulatory, CD4 positive effector phenotype T-cells, which persisted after completion of therapy. Of note, we had previously reported a similar phenomenon in patients with metastatic melanoma who failed high dose interleukin-2 and were then placed on a finite course of temozolomide with rapid complete responses that have remained durable for many years after discontinuation of temozolomide. We postulate that a finite course of cytotoxic or targeted therapy specific for melanoma given after apparent failure of prior immunotherapy can result in complete and durable remissions that may persist long after the specific cytotoxic or targeted agents have been discontinued suggesting the existence of sequence specific synergism between immunotherapy and these agents. Here, we discuss these cases in the context of the literature on

  2. Dextranomer/hyaluronic acid endoscopic injection is effective in the treatment of intermediate and high grade vesicoureteral reflux in patients with complete duplex systems.

    Science.gov (United States)

    Hunziker, Manuela; Mohanan, Nochiparambil; Puri, Prem

    2013-05-01

    Endoscopic subureteral injection of dextranomer/hyaluronic acid has become an established alternative to long-term antibiotic prophylaxis or surgical treatment for vesicoureteral reflux. We evaluated the effectiveness of endoscopic injection of dextranomer/hyaluronic acid in intermediate and high grade vesicoureteral reflux in patients with complete duplex collecting systems. A total of 123 children underwent endoscopic correction of intermediate or high grade vesicoureteral reflux using injection of dextranomer/hyaluronic acid into complete duplex systems between 2001 and 2010. Vesicoureteral reflux was diagnosed by voiding cystourethrogram, and dimercapto-succinic acid scan was performed to evaluate the presence of renal scarring. Followup ultrasound and voiding cystourethrogram were performed 3 months after the outpatient procedure and renal ultrasound thereafter every 2 years. Mean followup was 6.7 years. Complete duplex systems were unilateral in 110 patients and bilateral in 13. Reflux severity in the 136 refluxing units was grade II in 1 (0.7%), III in 52 (38.2%), IV in 61 (44.9%) and V in 22 (16.2%). Dimercapto-succinic acid scan revealed renal functional abnormalities in 63 children (51.2%). Vesicoureteral reflux resolved after the first endoscopic injection of dextranomer/hyaluronic acid in 93 ureters (68.4%), after a second injection in 35 (25.7%) and after a third injection in 8 (5.9%). Febrile urinary tract infection developed in 5 patients (4.1%) during followup. No patient required ureteral reimplantation or experienced significant complications. Our results confirm the safety and efficacy of endoscopic injection of dextranomer/hyaluronic acid in eradicating intermediate and high grade vesicoureteral reflux in patients with complete duplex systems. We recommend this minimally invasive, 15-minute outpatient procedure as a viable option for treating intermediate and high grade vesicoureteral reflux in patients with complete duplex collecting systems

  3. First order reversal curve analysis on NdFeB nanocomposite ribbons subjected to Joule heating treatments

    Energy Technology Data Exchange (ETDEWEB)

    Pampillo, L.G. [INTECIN-Instituto de Tecnologias y ciencias de la Ingenieria ' Hilario Fernandez Long' (UBA-CONICET), Facultad de Ingenieria, Paseo Colon 850 (C1063ACV), C. A. B. A. (Argentina); Saccone, F.D., E-mail: fsaccone@fi.uba.ar [INTECIN-Instituto de Tecnologias y ciencias de la Ingenieria ' Hilario Fernandez Long' (UBA-CONICET), Facultad de Ingenieria, Paseo Colon 850 (C1063ACV), C. A. B. A. (Argentina); Knobel, M. [Instituto de Fisica Gleb Wataghin-Departamento de Fisica de Materia Condensada-Universidade Estadual de Campinas, Cidade Universitaria Zeferino Vaz, Barao Geraldo 13083-970, Campinas, Sao Paulo (Brazil); Sirkin, H.R.M. [INTECIN-Instituto de Tecnologias y ciencias de la Ingenieria ' Hilario Fernandez Long' (UBA-CONICET), Facultad de Ingenieria, Paseo Colon 850 (C1063ACV), C. A. B. A. (Argentina)

    2012-09-25

    Highlights: Black-Right-Pointing-Pointer Nd-lean amorphous precursors subjected to Joule heating. Black-Right-Pointing-Pointer Exchange-spring magnets. Black-Right-Pointing-Pointer FORC diagrams of irreversible switching fields. Black-Right-Pointing-Pointer This last techniques helped us to verify the optimized treatments conditions. - Abstract: Amorphous precursors with composition Nd{sub 4.5}Fe{sub 72-x}Co{sub 3+x}Cr{sub 2}Al{sub 1}B{sub 17.5} (x = 0, 2, 7, 12) were thermally treated by the Joule heating technique with a linearly varying electrical current. The crystallization kinetics was followed by monitoring the resistance of the ribbons during the heating up to the final applied current. Crystallized nanostructured phases coexist with an amorphous matrix, as it was observed by means of Moessbauer Spectroscopy and X-ray diffraction. The irreversible magnetic response of the Joule heated ribbons was analyzed by the First Order Reversal Curves (FORC) diagram technique. For the optimal treatments, associated with the higher maximum energy products for each sample composition, it was found that the main interaction is of a strongly dipolar characteristic. Over annealed samples show a FORC diagram that gives into account of softening, due to grain growth, for those phases precipitated at the first crystallization stage. When it is measured at 20 K, the hardest magnetic sample (Fe = 72 at.%, Co = 3 at.%, I{sub final} = 0.5 A), exhibits a diagram with characteristics corresponding to dipolar interactions of soft phases. This fact is consistent with an enhancement of the exchange length due to the increase in the soft phase stiffness as it is expected at low temperatures.

  4. Measurement of Cue-Induced Craving in Human Methamphetamine- Dependent Subjects New Methodological Hopes for Reliable Assessment of Treatment Efficacy

    Directory of Open Access Journals (Sweden)

    Zahra Alam Mehrjerdi

    2011-09-01

    Full Text Available Methamphetamine (MA is a highly addictive psychostimulant drug with crucial impacts on individuals on various levels. Exposure to methamphetamine-associated cues in laboratory can elicit measureable craving and autonomic reactivity in most individuals with methamphetamine dependence and the cue reactivity can model how craving would result in continued drug seeking behaviors and relapse in real environments but study on this notion is still limited. In this brief article, the authors review studies on cue-induced craving in human methamphetamine- dependent subjects in a laboratory-based approach. Craving for methamphetamine is elicited by a variety of methods in laboratory such as paraphernalia, verbal and visual cues and imaginary scripts. In this article, we review the studies applying different cues as main methods of craving incubation in laboratory settings. The brief reviewed literature provides strong evidence that craving for methamphetamine in laboratory conditions is significantly evoked by different cues. Cue-induced craving has important treatment and clinical implications for psychotherapists and clinicians when we consider the role of induced craving in evoking intense desire or urge to use methamphetamine after or during a period of successful craving prevention program. Elicited craving for methamphetamine in laboratory conditions is significantly influenced by methamphetamine-associated cues and results in rapid craving response toward methamphetamine use. This notion can be used as a main core for laboratory-based assessment of treatment efficacy for methamphetamine-dependent patients. In addition, the laboratory settings for studying craving can bridge the gap between somehow-non-reliable preclinical animal model studies and budget demanding randomized clinical trials.

  5. Hippocampal Proteome of Rats Subjected to the Li-Pilocarpine Epilepsy Model and the Effect of Carisbamate Treatment

    Directory of Open Access Journals (Sweden)

    José Eduardo Marques-Carneiro

    2017-07-01

    Full Text Available In adult rats, the administration of lithium–pilocarpine (LiPilo reproduces most clinical and neuropathological features of human temporal lobe epilepsy (TLE. Carisbamate (CRS possesses the property of modifying epileptogenesis in this model. Indeed, about 50% of rats subjected to LiPilo status epilepticus (SE develop non-convulsive seizures (NCS instead of motor seizures when treated with CRS. However, the mechanisms underlying these effects remain unknown. The aim of this study was to perform a proteomic analysis in the hippocampus of rats receiving LiPilo and developing motor seizures or NCS following CRS treatment. Fifteen adult male Sprague–Dawley rats were used. SE was induced by LiPilo injection. CRS treatment was initiated at 1 h and 9 h after SE onset and maintained for 7 days, twice daily. Four groups were studied after video-EEG control of the occurrence of motor seizures: a control group receiving saline (CT n = 3 and three groups that underwent SE: rats treated with diazepam (DZP n = 4, rats treated with CRS displaying NCS (CRS-NCS n = 4 or motor seizures (CRS-TLE n = 4. Proteomic analysis was conducted by 2D-SDS-PAGE. Twenty-four proteins were found altered. In the CRS-NCS group, proteins related to glycolysis and ATP synthesis were down-regulated while proteins associated with pyruvate catabolism were up-regulated. Moreover, among the other proteins differentially expressed, we found proteins related to inflammatory processes, protein folding, tissue regeneration, response to oxidative stress, gene expression, biogenesis of synaptic vesicles, signal transduction, axonal transport, microtubule formation, cell survival, and neuronal plasticity. Our results suggest a global reduction of glycolysis and cellular energy production that might affect brain excitability. In addition, CRS seems to modulate proteins related to many other pathways that could significantly participate in the epileptogenesis-modifying effect observed.

  6. Increased FDG uptake on late-treatment PET in non-tumour-affected oesophagus is prognostic for pathological complete response and disease recurrence in patients undergoing neoadjuvant radiochemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Zschaeck, Sebastian [University Hospital Carl Gustav Carus Technische Univ. Dresden (Germany). Dept. of Radiation Oncology; German Cancer Consortium (DKTK), Dresden (Germany); German Cancer Research Center (DKFZ), Heidelberg (Germany); University Hospital Carl Gustav Carus Technische Univ. Dresden (Germany). OncoRay - National Center for Radiation Research in Oncology; Hofheinz, Frank [Helmholtz-Zentrum Dresden-Rossendorf, Dresden (Germany). PET Center, Inst. of Radiopharmaceutical Cancer Research; Zoephel, Klaus; Kotzerke, Joerg [German Cancer Consortium (DKTK), Dresden (Germany); German Cancer Research Center (DKFZ), Heidelberg (Germany); University Hospital Carl Gustav Carus Technische Univ. Dresden (Germany). OncoRay - National Center for Radiation Research in Oncology; University Hospital Carl Gustav Carus, Dresden (Germany). Dept. of Nuclear Medicine; National Center for Tumor Diseases (NCT), Dresden (Germany); Buetof, Rebecca; Schmollack, Julia [University Hospital Carl Gustav Carus Technische Univ. Dresden (Germany). Dept. of Radiation Oncology; University Hospital Carl Gustav Carus Technische Univ. Dresden (Germany). OncoRay - National Center for Radiation Research in Oncology; Jentsch, Christina [University Hospital Carl Gustav Carus Technische Univ. Dresden (Germany). Dept. of Radiation Oncology; University Hospital Carl Gustav Carus Technische Univ. Dresden (Germany). OncoRay - National Center for Radiation Research in Oncology; National Center for Tumor Diseases (NCT), Dresden (Germany); Loeck, Steffen; Baumann, Michael; Krause, Mechthild [University Hospital Carl Gustav Carus Technische Univ. Dresden (Germany). Dept. of Radiation Oncology; German Cancer Consortium (DKTK), Dresden (Germany); German Cancer Research Center (DKFZ), Heidelberg (Germany); University Hospital Carl Gustav Carus Technische Univ. Dresden (Germany). OncoRay - National Center for Radiation Research in Oncology; National Center for Tumor Diseases (NCT), Dresden (Germany); Baretton, Gustavo [German Cancer Consortium (DKTK), Dresden (Germany); German Cancer Research Center (DKFZ), Heidelberg (DE); National Center for Tumor Diseases (NCT), Dresden (DE); University Hospital Carl Gustav Carus Technische Univ. Dresden (DE). Dept. of Pathology; Weitz, Juergen [German Cancer Consortium (DKTK), Dresden (DE); German Cancer Research Center (DKFZ), Heidelberg (DE); National Center for Tumor Diseases (NCT), Dresden (DE); University Hospital Carl Gustav Carus Technische Univ. Dresden (DE). Dept. of Visceral, Thoracic and Vascular Surgery

    2017-10-15

    Early side effects including oesophagitis are potential prognostic factors in patients undergoing radiochemotherapy (RCT) for locally advanced oesophageal cancer (LAEC). We assessed the prognostic value of {sup 18}F-fluorodeoxyglucose (FDG) uptake within irradiated non-tumour-affected oesophagus (NTO) during restaging positron emission tomography (PET) as a surrogate for inflammation/oesophagitis. This retrospective evaluation included 64 patients with LAEC who had completed neoadjuvant RCT and had successful oncological resection. All patients underwent FDG PET/CT before and after RCT. In the restaging PET scan maximum and mean standardized uptake values (SUV{sub max}, SUV{sub mean}) were determined in the tumour and NTO. Univariate Cox regression with respect to overall survival, local control, distant metastases and treatment failure was performed. Independence of clinically relevant parameters was tested in a multivariate Cox regression analysis. Increased FDG uptake, measured in terms of SUV{sub mean} in NTO during restaging was significantly associated with complete pathological remission (p = 0.002) and did not show a high correlation with FDG response of the tumour (rho < 0.3). In the univariate analysis, increased SUV{sub max} and SUV{sub mean} in NTO was associated with improved overall survival (p = 0.011, p = 0.004), better local control (p = 0.051, p = 0.044), a lower rate of treatment failure (p < 0.001 for both) and development of distant metastases (p = 0.012, p = 0.001). In the multivariate analysis, SUV{sub max} and SUV{sub mean} in NTO remained a significant prognostic factor for treatment failure (p < 0.001, p = 0.004) and distant metastases (p = 0.040, p = 0.011). FDG uptake in irradiated normal tissues measured on restaging PET has significant prognostic value in patients undergoing neoadjuvant RCT for LAEC. This effect may potentially be of use in treatment personalization. (orig.)

  7. Preliminary data concerning the reliability and psychometric properties of the Greek translation of the 20-item Subjective Well-Being Under Neuroleptic Treatment Scale (SWN-20

    Directory of Open Access Journals (Sweden)

    Arapidis Konstantinos

    2009-01-01

    Full Text Available Abstract Background The 20-item Subjective Well-Being Under Neuroleptic Treatment Scale (SWN-20 is a self-report scale developed in order to assess the well-being of patients receiving antipsychotic medication independent of the improvement in their psychotic symptoms. The current study reports on the reliability and the psychometric properties of the Greek translation of the SWN-20. Methods A total of 100 inpatients or outpatients with schizophrenia (79 males and 21 females, aged 42.6 ± 11.35 years old from 3 different facilities were assessed with the Positive and Negative Symptoms Scale (PANSS, the Calgary Depression Scale and the Simpson-Angus Scale, and completed the SWN-20. The statistical analysis included the calculation of Pearson product moment correlation coefficient, the Cronbach α and factor analysis with Varimax normalised rotation. Results The SWN-20 had an α value equal to 0.79 and all the items were equal. The factor analysis revealed the presence of seven factors explaining 66% of total variance. The correlation matrix revealed a moderate relationship of the SWN-20 and its factors with the PANSS-Negative (PANSS-N, PANSS-General Psychopathology (PANSS-G, the Simpson-Angus and the Calgary scales, and no relationship to age, education and income class. Discussion The Greek translation of the SWN-20 is reliable, with psychometric properties close to the original scale.

  8. Evaluation of the Fracture Toughness of a SMSS Subjected to Common Heat Treatment Cycles in an Aggressive Environment

    Science.gov (United States)

    Pieta, G.; Leite, R.; Kwietniewski, C.; Clarke, T.; Strohaecker, T.

    2010-12-01

    Supermartensitic stainless steels (SMSS) are an alternative to corrosion-prone carbon steels and expensive duplex stainless steels in offshore tubing applications for the oil and gas industry. Due to their differentiated alloying, SMSS exhibit superior toughness, corrosion resistance, and weldability properties when compared with another viable option, conventional martensitic stainless steels. However, when cathodically protected in a seawater environment they can be susceptible to embrittlement due to hydrogen charging. In the present study, SMSS samples were removed from deep water pipelines and their fracture toughness in the as-received condition and with different heat treatments was evaluated. Tests were carried out in air and in harsh environmental and loading conditions, which were ensured by subjecting specimens to cathodic overprotection, simulating effects seen in structures with complex geometries, and to incremental step loads in a synthetic seawater environment, thus favoring hydrogen diffusion to the precrack tip. The fracture surfaces of the specimens were analyzed in order to identify hydrogen-induced embrittlement and fracture toughness values of specimens tested in air were compared to values obtained in environment-assisted experiments. The influence of microstructure was evaluated by control of the retained austenite and δ-ferrite contents of the specimens. The results show a significant drop in the fracture toughness of steel in the studied environment, with a fracture mode which is clearly more brittle and dependent on microstructural characteristics of the samples.

  9. The safety and efficacy of {+/-}3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study.

    Science.gov (United States)

    Mithoefer, Michael C; Wagner, Mark T; Mithoefer, Ann T; Jerome, Lisa; Doblin, Rick

    2011-04-01

    Case reports indicate that psychiatrists administered ±3,4-methylenedioxymethamphetamine (MDMA) as a catalyst to psychotherapy before recreational use of MDMA as 'Ecstasy' resulted in its criminalization in 1985. Over two decades later, this study is the first completed clinical trial evaluating MDMA as a therapeutic adjunct. Twenty patients with chronic posttraumatic stress disorder, refractory to both psychotherapy and psychopharmacology, were randomly assigned to psychotherapy with concomitant active drug (n = 12) or inactive placebo (n = 8) administered during two 8-h experimental psychotherapy sessions. Both groups received preparatory and follow-up non-drug psychotherapy. The primary outcome measure was the Clinician-Administered PTSD Scale, administered at baseline, 4 days after each experimental session, and 2 months after the second session. Neurocognitive testing, blood pressure, and temperature monitoring were performed. After 2-month follow-up, placebo subjects were offered the option to re-enroll in the experimental procedure with open-label MDMA. Decrease in Clinician-Administered PTSD Scale scores from baseline was significantly greater for the group that received MDMA than for the placebo group at all three time points after baseline. The rate of clinical response was 10/12 (83%) in the active treatment group versus 2/8 (25%) in the placebo group. There were no drug-related serious adverse events, adverse neurocognitive effects or clinically significant blood pressure increases. MDMA-assisted psychotherapy can be administered to posttraumatic stress disorder patients without evidence of harm, and it may be useful in patients refractory to other treatments.

  10. Use of contingency management incentives to improve completion of hepatitis B vaccination in people undergoing treatment for heroin dependence: a cluster randomised trial.

    Science.gov (United States)

    Weaver, Tim; Metrebian, Nicola; Hellier, Jennifer; Pilling, Stephen; Charles, Vikki; Little, Nicholas; Poovendran, Dilkushi; Mitcheson, Luke; Ryan, Frank; Bowden-Jones, Owen; Dunn, John; Glasper, Anthony; Finch, Emily; Strang, John

    2014-07-12

    Poor adherence to treatment diminishes its individual and public health benefit. Financial incentives, provided on the condition of treatment attendance, could address this problem. Injecting drug users are a high-risk group for hepatitis B virus (HBV) infection and transmission, but adherence to vaccination programmes is poor. We aimed to assess whether contingency management delivered in routine clinical practice increased the completion of HBV vaccination in individuals receiving opioid substitution therapy. In our cluster randomised controlled trial, we enrolled participants at 12 National Health Service drug treatment services in the UK that provided opioid substitution therapy and nurse-led HBV vaccination with a super-accelerated schedule (vaccination days 0, 7, and 21). Clusters were randomly allocated 1:1:1 to provide vaccination without incentive (treatment as usual), with fixed value contingency management (three £10 vouchers), or escalating value contingency management (£5, £10, and £15 vouchers). Both contingency management schedules rewarded on-time attendance at appointments. The primary outcome was completion of clinically appropriate HBV vaccination within 28 days. We also did sensitivity analyses that examined vaccination completion with full adherence to appointment times and within a 3 month window. The trial is registered with Current Controlled Trials, number ISRCTN72794493. Between March 16, 2011, and April 26, 2012, we enrolled 210 eligible participants. Compared with six (9%) of 67 participants treated as usual, 35 (45%) of 78 participants in the fixed value contingency management group met the primary outcome measure (odds ratio 12·1, 95% CI 3·7-39·9; pcontingency management group (14·0, 4·2-46·2; pcontingency management to promote adherence to vaccination programmes. The effectiveness of routine use of contingency management to achieve long-term behaviour change remains unknown. National Institute for Health Research (RP-PG-0707

  11. Rate of Clinical Complete Response for 1 Year or More in Bone-Metastatic Breast Cancer after Comprehensive Treatments including Autologous Formalin-Fixed Tumor Vaccine.

    Science.gov (United States)

    Kuranishi, Fumito; Imaoka, Yuki; Sumi, Yuusuke; Uemae, Yoji; Yasuda-Kurihara, Hiroko; Ishihara, Takeshi; Miyazaki, Tsubasa; Ohno, Tadao

    2018-01-01

    No effective treatment has been developed for bone-metastatic breast cancer. We found 3 cases with clinical complete response (cCR) of the bone metastasis and longer overall survival of the retrospectively examined cohort treated comprehensively including autologous formalin-fixed tumor vaccine (AFTV). AFTV was prepared individually for each patient from their own formalin-fixed and paraffin-embedded breast cancer tissues. Three patients maintained cCR status of the bone metastasis for 17 months or more. Rate of cCR for 1 year or more appeared to be 15% (3/20) after comprehensive treatments including AFTV. The median overall survival time (60.0 months) and the 3- to 8-year survival rates after diagnosis of bone metastasis were greater than those of historical control cohorts in Japan (1988-2002) and in the nationwide population-based cohort study of Denmark (1999-2007). Bone-metastatic breast cancer may be curable after comprehensive treatments including AFTV, although larger scale clinical trial is required.

  12. Rate of Clinical Complete Response for 1 Year or More in Bone-Metastatic Breast Cancer after Comprehensive Treatments including Autologous Formalin-Fixed Tumor Vaccine

    Directory of Open Access Journals (Sweden)

    Fumito Kuranishi

    2018-01-01

    Full Text Available Introduction. No effective treatment has been developed for bone-metastatic breast cancer. We found 3 cases with clinical complete response (cCR of the bone metastasis and longer overall survival of the retrospectively examined cohort treated comprehensively including autologous formalin-fixed tumor vaccine (AFTV. Patients and Methods. AFTV was prepared individually for each patient from their own formalin-fixed and paraffin-embedded breast cancer tissues. Results. Three patients maintained cCR status of the bone metastasis for 17 months or more. Rate of cCR for 1 year or more appeared to be 15% (3/20 after comprehensive treatments including AFTV. The median overall survival time (60.0 months and the 3- to 8-year survival rates after diagnosis of bone metastasis were greater than those of historical control cohorts in Japan (1988–2002 and in the nationwide population-based cohort study of Denmark (1999–2007. Conclusion. Bone-metastatic breast cancer may be curable after comprehensive treatments including AFTV, although larger scale clinical trial is required.

  13. Actual driving performance and psychomotor function in healthy subjects after acute and subchronic treatment with escitalopram, mirtazapine, and placebo: a crossover trial.

    Science.gov (United States)

    Wingen, Marleen; Bothmer, John; Langer, Stefan; Ramaekers, Johannes G

    2005-04-01

    The effects of escitalopram 10 to 20 mg/day and mirtazapine 30 to 45 mg/day on actual driving and psychomotor performance of 18 healthy subjects were determined in a randomized, double-blind, placebo-controlled, multiple-dose, 3-way crossover trial. Each treatment period lasted for 15 days and was separated from the next period by a washout period of at least 13 days. Subjects received an evening dose of escitalopram 10 mg, mirtazapine 30 mg, or placebo from days 1 to 7 and an evening dose of escitalopram 20 mg, mirtazapine 45 mg, or placebo from days 8 to 15. On days 2, 9, and 16, reflecting acute period, dose increase, and steady state, respectively, the Road Tracking Test was performed. The main parameter was standard deviation of lateral position. Psychomotor performance was also assessed on days 2, 9, and 16 by laboratory computer tasks. Subjective sleep quality was measured with the Groninger Sleep Quality Scale, and mood was measured by visual analogue scales. Treatment differences were apparent during the acute treatment period, in which subjects treated with mirtazapine 30 mg performed less well on the driving test as compared to placebo. The Divided Attention Task results also revealed a significant increase in tracking error after a single dose of mirtazapine 30 mg as compared to placebo. Mirtazapine decreased feelings of alertness and contentedness. Mirtazapine did not affect performance on days 9 and 16 of treatment. Escitalopram did not affect driving, psychomotor performance, or subjective mood throughout treatment. Driving performance, as well as psychomotor functioning, was not affected by escitalopram treatment in healthy subjects. Driving performance was significantly impaired after ingestion of mirtazapine 30 mg during the acute treatment period.

  14. BiRD (Biaxin [clarithromycin]/Revlimid [lenalidomide]/dexamethasone) combination therapy results in high complete- and overall-response rates in treatment-naive symptomatic multiple myeloma.

    Science.gov (United States)

    Niesvizky, Ruben; Jayabalan, David S; Christos, Paul J; Furst, Jessica R; Naib, Tara; Ely, Scott; Jalbrzikowski, Jessica; Pearse, Roger N; Zafar, Faiza; Pekle, Karen; Larow, April; Lent, Richard; Mark, Tomer; Cho, Hearn J; Shore, Tsiporah; Tepler, Jeffrey; Harpel, John; Schuster, Michael W; Mathew, Susan; Leonard, John P; Mazumdar, Madhu; Chen-Kiang, Selina; Coleman, Morton

    2008-02-01

    This trial determined the safety and efficacy of the combination regimen clarithromycin (Biaxin), lenalidomide (Revlimid), and dexamethasone (BiRD) as first-line therapy for multiple myeloma. Patients received BiRD in 28-day cycles. Dexamethasone (40 mg) was given orally once weekly, clarithromycin (500 mg) was given orally twice daily, and lenalidomide (25 mg) was given orally daily on days 1 to 21. Objective response was defined by standard criteria (ie, decrease in serum monoclonal protein [M-protein] by at least 50%, and a decrease in urine M-protein by at least 90%). Of the 72 patients enrolled, 65 had an objective response (90.3%). A combined stringent and conventional complete response rate of 38.9% was achieved, and 73.6% of the patients achieved at least a 90% decrease in M-protein levels. This regimen did not interfere with hematopoietic stem-cell harvest. Fifty-two patients who did not go on to receive transplants received continued therapy (complete response, 37%; very good partial response, 33%). The major adverse events were thromboembolic events, corticosteroid-related morbidity, and cytopenias. BiRD is an effective regimen with manageable side effects in the treatment of symptomatic, newly diagnosed multiple myeloma. This trial was registered at www.clinicaltrials.gov as #NCT00151203.

  15. Comparison of short-term outcomes between laparoscopic-assisted and open complete mesocolic excision (CME) for the treatment of transverse colon cancer.

    Science.gov (United States)

    Wang, Yong; Zhang, Chuan; Feng, Yi-Fei; Fu, Zan; Sun, Yue-Ming

    2017-02-01

    Colorectal cancer (CRC) is the third most common cancer worldwide. Although laparoscopic-assisted complete mesocolic excision (LCME) is a superior treatment, there are few studies available on it owe to the low incidence and technical difficulty of LCME in transverse colon cancer. The clinical data of 78 patients with transverse colon cancer who were treated by LCME and open complete mesocolic excision (OCME) were retrospectively analyzed. A total of 39 cases had been treated by LCME, compared with 39 cases treated by OCME. The patient characteristics and short-term outcomes including operation time, intra-operative blood loss, length of incision, time to first flatus, first postoperative ambulation, postoperative hospitalization time, number of harvested lymph nodes, length of resected specimen and incidence of complications were evaluated. There was no case converted to OCME in LCME group. LCME had significantly shorter length of incision, shorter operation time, less intra-operative blood loss, shorter postoperative hospitalization time (Pcolon cancer due to it can provide superior short-term outcomes including less intra-operative blood loss, faster recovery and lower incidence of wound infection.

  16. Complete remission through icotinib treatment in Non-small cell lung cancer epidermal growth factor receptor mutation patient with brain metastasis: A case report

    Directory of Open Access Journals (Sweden)

    Wang Tao

    2016-01-01

    Full Text Available Brain metastasis (BM has been universally recognized as a poor prognostic factor in non-small cell lung cancer (NSCLC. Epidermal growth factor receptor (EGFR tyrosine kinase inhibitors (TKIs have shown efficacy in treating BM with an EGFR mutation. This paper reports a case of BM patient with EGFR-mutated NSCLC. According to the findings, a complete remission (CR of the BM was achieved by icotinib treatment without conducting a radiotherapy, which was followed by a resection of the primary lung cancer lesion and lymph nodes. After one-year follow-up, the disease progressed to liver metastasis and liver lesion biopsy showed a T790M mutation. The patient responded well to the combination treatment of AZD9291 and icotinib after the failure of transcatheter arterial chemoembolization (TACE. This case report suggests that icotinib has a sustainable anticancer response to BM and the combination with icotinib and AZD9291 is effective for liver metastasis with T790M.

  17. Quantitative DCE-MRI for prediction of pathological complete response following neoadjuvant treatment for locally advanced breast cancer: the impact of breast cancer subtypes on the diagnostic accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Drisis, Stylianos; Stathopoulos, Konstantinos; Chao, Shih-Li; Lemort, Marc [Institute Jules Bordet, Radiology Department, Brussels (Belgium); Metens, Thierry [Erasme University Hospital, Radiology Department, Brussels (Belgium); Ignatiadis, Michael [Institute Jules Bordet, Oncology Department, Brussels (Belgium)

    2016-05-15

    To assess whether DCE-MRI pharmacokinetic (PK) parameters obtained before and during chemotherapy can predict pathological complete response (pCR) differently for different breast cancer groups. Eighty-four patients who received neoadjuvant chemotherapy for locally advanced breast cancer were retrospectively included. All patients underwent two DCE-MRI examinations, one before (EX1) and one during treatment (EX2). Tumours were classified into different breast cancer groups, namely triple negative (TNBC), HER2+ and ER+/HER2-, and compared with the whole population (WP). PK parameters Ktrans and Ve were extracted using a two-compartment Tofts model. At EX1, Ktrans predicted pCR for WP and TNBC. At EX2, maximum diameter (Dmax) predicted pCR for WP and ER+/HER2-. Both PK parameters predicted pCR in WP and TNBC and only Ktrans for the HER2+. pCR was predicted from relative difference (EX1 - EX2)/EX1 of Dmax and both PK parameters in the WP group and only for Ve in the TNBC group. No PK parameter could predict response for ER+/HER-. ROC comparison between WP and breast cancer groups showed higher but not statistically significant values for TNBC for the prediction of pCR Quantitative DCE-MRI can better predict pCR after neoadjuvant treatment for TNBC but not for the ER+/HER2- group. (orig.)

  18. Beneficial Effects of Long-Term CPAP Treatment on Sleep Quality and Blood Pressure in Adherent Subjects With Obstructive Sleep Apnea.

    Science.gov (United States)

    Yang, Mei-Chen; Huang, Yi-Chih; Lan, Chou-Chin; Wu, Yao-Kuang; Huang, Kuo-Feng

    2015-12-01

    Obstructive sleep apnea (OSA) is associated with increased risk of cardiovascular diseases. Although CPAP is the first treatment choice for moderate-to-severe OSA, acceptance of and adherence to CPAP remain problematic. High CPAP adherence is generally defined as ≥4 h of use/night for ≥70% of the nights monitored. We investigated the long-term beneficial effects of CPAP on sleep quality and blood pressure in subjects with moderate-to-severe OSA according to high or low CPAP adherence. We retrospectively analyzed 121 subjects with moderate-to-severe OSA from August 2008 to July 2012. These subjects were divided into 3 groups: (1) no CPAP treatment (n = 29), (2) low CPAP adherence (n = 28), and (3) high CPAP adherence (n = 64). All subjects were followed up for at least 1 y. The 3 groups were compared regarding anthropometric and polysomnographic variables, presence of cardiovascular comorbidities, and blood pressure at baseline and at the last follow-up. The no-treatment group showed significant increases in oxygen desaturation index and blood pressure. The high-adherence group showed significant improvement in daytime sleepiness, apnea-hypopnea index (AHI), oxygen desaturation index, and blood pressure. Although the AHI was also significantly decreased after CPAP treatment in the low-adherence group, blood pressure remained unchanged. CPAP treatment had beneficial effects on both sleep quality and blood pressure only in subjects with OSA and high CPAP adherence who used CPAP for ≥4 h/night for ≥70% of nights monitored. Subjects with low CPAP adherence received beneficial effects on AHI, but not blood pressure. Copyright © 2015 by Daedalus Enterprises.

  19. Complete pancreas traumatic transsection

    Directory of Open Access Journals (Sweden)

    H. Hodžić

    2005-02-01

    Full Text Available This report presents a case of a twenty-year old male with complete pancreas breakdown in the middle of its corpus, which was caused by a strong abdomen compression, with injuries of the spleen, the firstjejunumcurve,mesocolon transversum, left kidney, and appereance of retroperitoneal haemathoma. Surgical treatment started 70 minutes after the injury. The treatment consisted of left pancreatectomy with previous spleenectomy, haemostasis of ruptured mesocolon transversum blood vessels, left kidney exploration, suturing of the firstjejunumcurvelession and double abdomen drainage. Posttraumatic pancreatitis which appeared on the second postoperative day and prolonged drain secretion were successfully solved by conservative treatment.

  20. Clinical trial: lansoprazole 15 or 30 mg once daily vs. placebo for treatment of frequent nighttime heartburn in self-treating subjects.

    Science.gov (United States)

    Peura, D A; Riff, D S; Snoddy, A M; Fennerty, M B

    2009-09-01

    Frequent nighttime heartburn is common. Lansoprazole 15 mg is indicated for treatment of heartburn and other gastro-oesophageal reflux disease-related symptoms. To evaluate the efficacy and safety of lansoprazole in self-treating subjects with frequent nocturnal heartburn. A total of 864 subjects with heartburn on >or=2 days/week over the past month were randomized to double-blind treatment with lansoprazole 15 or 30 mg or placebo each morning. Endpoints were percentage of night times without heartburn (primary), percentage of 24-h days without heartburn and percentage of subjects without heartburn on day 1. Mean percentage of night times without heartburn was significantly greater with lansoprazole 15 mg (61.3%) or lansoprazole 30 mg (61.7%) vs. placebo (47.8%) over 14 days (P heartburn and percentage of subjects without heartburn on day 1 were significantly greater with lansoprazole 15 or 30 mg vs. placebo. Both lansoprazole 15 and 30 mg were highly effective and well tolerated in reducing symptoms in subjects with frequent nighttime heartburn. The benefit of therapy on 24-h heartburn and nighttime heartburn on day 1 of treatment was also evident. Lansoprazole 15 mg is a suitable choice for management of frequent nighttime heartburn.

  1. The characteristic and changes of the event-related potentials (ERP and brain topographic maps before and after treatment with rTMS in subjective tinnitus patients.

    Directory of Open Access Journals (Sweden)

    Haidi Yang

    Full Text Available OBJECTIVES: To compare the event-related potentials (ERPs and brain topographic maps characteristic and change in normal controls and subjective tinnitus patients before and after repetitive transcranial magnetic stimulation (rTMS treatment. METHODS AND PARTICIPANTS: The ERPs and brain topographic maps elicited by target stimulus were compared before and after 1-week treatment with rTMS in 20 subjective tinnitus patients and 16 healthy controls. RESULTS: Before rTMS, target stimulus elicited a larger N1 component than the standard stimuli (repeating soundsin control group but not in tinnitus patients. Instead, the tinnitus group pre-treatment exhibited larger amplitude of N1 in response to standard stimuli than to deviant stimuli. Furthermore tinnitus patients had smaller mismatch negativity (MMN and late discriminative negativity (LDNcomponent at Fz compared with the control group. After rTMS treatment, tinnitus patients showed increased N1 response to deviant stimuli and larger MMN and LDN compared with pre-treatment. The topographic maps for the tinnitus group before rTMS -treatment demonstrated global asymmetry between the left and right cerebral hemispheres with more negative activities in left side and more positive activities in right side. In contrast, the brain topographic maps for patients after rTMS-treatment and controls seem roughly symmetrical. The ERP amplitudes and brain topographic maps in post-treatment patient group showed no significant difference with those in controls. CONCLUSIONS: The characterical changes in ERP and brain topographic maps in tinnitus patients maybe related with the electrophysiological mechanism of tinnitus induction and development. It can be used as an objective biomarker for the evaluation of auditory central in subjective tinnitus patients. These findings support the notion that rTMS treatment in tinnitus patients may exert a beneficial effect.

  2. The characteristic and changes of the event-related potentials (ERP) and brain topographic maps before and after treatment with rTMS in subjective tinnitus patients.

    Science.gov (United States)

    Yang, Haidi; Xiong, Hao; Yu, Rongjun; Wang, Changming; Zheng, Yiqing; Zhang, Xueyuan

    2013-01-01

    To compare the event-related potentials (ERPs) and brain topographic maps characteristic and change in normal controls and subjective tinnitus patients before and after repetitive transcranial magnetic stimulation (rTMS) treatment. The ERPs and brain topographic maps elicited by target stimulus were compared before and after 1-week treatment with rTMS in 20 subjective tinnitus patients and 16 healthy controls. Before rTMS, target stimulus elicited a larger N1 component than the standard stimuli (repeating sounds)in control group but not in tinnitus patients. Instead, the tinnitus group pre-treatment exhibited larger amplitude of N1 in response to standard stimuli than to deviant stimuli. Furthermore tinnitus patients had smaller mismatch negativity (MMN) and late discriminative negativity (LDN)component at Fz compared with the control group. After rTMS treatment, tinnitus patients showed increased N1 response to deviant stimuli and larger MMN and LDN compared with pre-treatment. The topographic maps for the tinnitus group before rTMS -treatment demonstrated global asymmetry between the left and right cerebral hemispheres with more negative activities in left side and more positive activities in right side. In contrast, the brain topographic maps for patients after rTMS-treatment and controls seem roughly symmetrical. The ERP amplitudes and brain topographic maps in post-treatment patient group showed no significant difference with those in controls. The characterical changes in ERP and brain topographic maps in tinnitus patients maybe related with the electrophysiological mechanism of tinnitus induction and development. It can be used as an objective biomarker for the evaluation of auditory central in subjective tinnitus patients. These findings support the notion that rTMS treatment in tinnitus patients may exert a beneficial effect.

  3. Efficacy of a Film-Forming Medical Device Containing Piroxicam and Sun Filters in the Treatment of Multiple Actinic Keratosis Lesions in a Subject with a History of Kaposi Sarcoma

    Directory of Open Access Journals (Sweden)

    Elisabetta Scotti

    2016-10-01

    Full Text Available Actinic keratosis (AK is considered a premalignant form of skin cancer due to chronic sun exposure. In addition, human papilloma virus (HPV has been advocated a role in the pathogenesis of this clinical condition. HPV proteins (mainly E6 and E7 seem to act synergistically with ultraviolet (UV radiation in reducing the defensive mechanisms of keratinocyte apoptosis after UV damage. Data regarding the involvement of other viruses, i.e. human herpes viruses (HHV, in the pathogenesis of AK are so far controversial. HHV8 is considered the infective agent involved in the development of Kaposi sarcoma. Some experimental data have shown that AK lesions carry HHV8 in more than 30% of the bioptic samples. Topical piroxicam was shown to be effective in the treatment of AK. In addition, the molecule shows antiviral action against HPV and HHV8. Here, we report the efficacy of a medical device containing a film-forming substance (polyvinyl alcohol, chemical and physical sun filters (SPF 50+, and 0.8% piroxicam (ActixicamTM, Difa Cooper; ACTX in the treatment of multiple scalp AK lesions, unresponsive to other treatments, in a subject with Kaposi sarcoma and a history of severe contact dermatitis. The subject presented with severe involvement of the scalp, with multiple hypertrophic AK lesions. Previous lesion-directed and field-targeted treatments have not been effective. The subject was treated with ACTX applied twice daily on the affected scalp. Relevant clinical improvement was observed as soon as 1 month of therapy. Complete clinical resolution of all scalp lesions was observed after 3 months of treatment. The product was well tolerated.

  4. The influence of the design matrix on treatment effect estimates in the quantitative analyses of single-subject experimental design research.

    Science.gov (United States)

    Moeyaert, Mariola; Ugille, Maaike; Ferron, John M; Beretvas, S Natasha; Van den Noortgate, Wim

    2014-09-01

    The quantitative methods for analyzing single-subject experimental data have expanded during the last decade, including the use of regression models to statistically analyze the data, but still a lot of questions remain. One question is how to specify predictors in a regression model to account for the specifics of the design and estimate the effect size of interest. These quantitative effect sizes are used in retrospective analyses and allow synthesis of single-subject experimental study results which is informative for evidence-based decision making, research and theory building, and policy discussions. We discuss different design matrices that can be used for the most common single-subject experimental designs (SSEDs), namely, the multiple-baseline designs, reversal designs, and alternating treatment designs, and provide empirical illustrations. The purpose of this article is to guide single-subject experimental data analysts interested in analyzing and meta-analyzing SSED data. © The Author(s) 2014.

  5. Short and long term effectiveness of a subject's specific novel brain and vestibular rehabilitation treatment modality in combat veterans suffering from PTSD

    Directory of Open Access Journals (Sweden)

    Frederick Robert Carrick

    2015-06-01

    Full Text Available AbstractIntroduction: Treatment for post-traumatic stress disorder (PTSD in combat veterans that have a long-term positive clinical effect has the potential to modify the treatment of PTSD. This outcome may result in changed and saved lives of our service personnel and their families. In a previous before-after-intervention study we demonstrated high statistical and substantively significant short-term changes in the Clinician Administered DSM-IV PTSD Scale (CAPS scores after a two week trial of a subject's particular novel brain and vestibular rehabilitation (VR program. The long-term maintenance of PTSD severity reduction was the subject of this study.Material and Methods:We studied the short and long term effectiveness of a subject's particular novel brain and VR treatment of PTSD in subjects who had suffered combat-related traumatic brain injuries in terms of PTSD symptom reduction. The trial was registered as ClinicalTrials.gov Identifier: NCT02003352. We analyzed the difference in the CAPS scores pre and post treatment (one week and three months using our subjects as their matched controls. Results:The generalized least squares (GLS technique demonstrated that with our 26 subjects in the 3 timed groups the R2 within groups was 0.000, R2 between groups was 0.000 and overall the R2 was 0.000. The GLS regression was strongly statistically significant z = 21.29, p < 0.001, 95% CI [58.7, 70.63]. The linear predictive margins over time demonstrated strong statistical and substantive significance of decreasing PTSD severity scores for all timed CAPS tests.Discussion:Our investigation has the promise of the development of superior outcomes of treatments in this area that will benefit a global society. The length of the treatment intervention involved (two weeks is less that other currently available treatments and has profound implications for cost, duration of disability and outcomes in the treatment of PTSD in combat veterans.

  6. Assessing Quality of Life using the Oral Health Impact Profile (OHIP-14) in Subjects with and without Orthodontic Treatment need in Chennai, Tamil Nadu, India.

    Science.gov (United States)

    Mary, A Vinita; Mahendra, Jaideep; John, Joseph; Moses, Joyson; Ebenezar, A V Rajesh; Kesavan, R

    2017-08-01

    Dental ailments like malocclusion affect not only the functional ability and aesthetic appearance of the person but also the psychological aspect of the individual. The aim of the present study was to the find relationship between quality of life and dental malocclusion among school going adolescents in Tamil Nadu, India. A cross-sectional study was conducted among 342 subjects of age range 14-19 years. Oral health status was assessed using WHO basic oral health survey (2013), orthodontic treatment needs according to Index of Orthodontic Treatment Needs (IOTN) and oral health quality of life using Oral Health Impact Profile-14 (OHIP-14). A total of 342 subjects were interviewed and examined. The mean DMFT score was 1.86±2.77. A 203 (59.4%) did not require any orthodontic treatment while 139 (40.6%) had orthodontic treatment need ranging from mild to very severe. It was seen that malocclusion affected some aspects of OHIP-14 significantly namely functional limitation, psychological discomfort and psychological disability. The comparison of OHIP-14 scores between treatment needed and treatment not needed was highly significant (p<0.001). Hence, it is stated that there is an urgent need to educate the school children and in turn their parents regarding the malocclusion for its treatment to prevent any effect on quality of life of the young adults.

  7. Subjective Wellbeing Among Adults with Diabetes

    DEFF Research Database (Denmark)

    Holmes-Truscott, Elizabeth; Browne, Jessica L; Pouwer, Frans

    2016-01-01

    duration, body mass index, number of diabetes-related complications, and depression). Furthermore, adults with type 2 diabetes using insulin to manage their condition report the lowest levels of subjective wellbeing, and are also most likely to report dissatisfaction with their current health....... These findings suggest that living with diabetes, and in particular, living with type 2 diabetes and using insulin, strongly challenges the maintenance of subjective wellbeing.......This study examines the subjective wellbeing of Australian adults with diabetes who completed the Diabetes MILES—Australia survey, investigating by diabetes type and treatment, and by comparing with the subjective wellbeing of the general Australian adult population. In addition, the extent...

  8. Endogenous cytokinin profiles of tissue-cultured and acclimatized 'Williams' bananas subjected to different aromatic cytokinin treatments

    Czech Academy of Sciences Publication Activity Database

    Aremu, A.O.; Plačková, Lenka; Bairu, M. W.; Novák, Ondřej; Szüčová, Lucie; Doležal, Karel; Finnie, J. F.; van Staden, J.

    2014-01-01

    Roč. 214, JAN 2014 (2014), s. 88-98 ISSN 0168-9452 R&D Projects: GA MŠk(CZ) LO1204 Grant - others:GA MŠk(CZ) ED0007/01/01 Program:ED Institutional support: RVO:61389030 Keywords : Micropropagation * Musa spp. * Phytohormones Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 3.607, year: 2014

  9. Use of a Monte Carlo technique to complete a fragmented set of H2S emission rates from a wastewater treatment plant.

    Science.gov (United States)

    Schauberger, Günther; Piringer, Martin; Baumann-Stanzer, Kathrin; Knauder, Werner; Petz, Erwin

    2013-12-15

    The impact of ambient concentrations in the vicinity of a plant can only be assessed if the emission rate is known. In this study, based on measurements of ambient H2S concentrations and meteorological parameters, the a priori unknown emission rates of a tannery wastewater treatment plant are calculated by an inverse dispersion technique. The calculations are determined using the Gaussian Austrian regulatory dispersion model. Following this method, emission data can be obtained, though only for a measurement station that is positioned such that the wind direction at the measurement station is leeward of the plant. Using the inverse transform sampling, which is a Monte Carlo technique, the dataset can also be completed for those wind directions for which no ambient concentration measurements are available. For the model validation, the measured ambient concentrations are compared with the calculated ambient concentrations obtained from the synthetic emission data of the Monte Carlo model. The cumulative frequency distribution of this new dataset agrees well with the empirical data. This inverse transform sampling method is thus a useful supplement for calculating emission rates using the inverse dispersion technique. Copyright © 2013 Elsevier B.V. All rights reserved.

  10. Family history of completed suicide and characteristics of major depressive disorder: a STAR*D (sequenced treatment alternatives to relieve depression) study.

    Science.gov (United States)

    Nierenberg, Andrew A; Alpert, Jonathan E; Gaynes, Bradley N; Warden, Diane; Wisniewski, Stephen R; Biggs, Melanie M; Trivedi, Madhukar H; Barkin, Jennifer L; Rush, A John

    2008-05-01

    Clinicians routinely ask patients with non-psychotic major depressive disorder (MDD) about their family history of suicide. It is unknown, however, whether patients with a family member who committed suicide differ from those without such a history. Patients were recruited for the STAR*D multicenter trial. At baseline, patients were asked to report first-degree relatives who had died from suicide. Differences in demographic and clinical features for patients with and without a family history of suicide were assessed. Patients with a family history of suicide (n=142/4001; 3.5%) were more likely to have a family history of MDD, bipolar disorder, or any mood disorder, and familial substance abuse disorder, but not suicidal thoughts as compared to those without such a history. The group with familial suicide had a more pessimistic view of the future and an earlier age of onset of MDD. No other meaningful differences were found in depressive symptoms, severity, recurrence, depressive subtype, or daily function. A history of completed suicide in a family member was associated with minimal clinical differences in the cross-sectional presentation of outpatients with MDD. Limitations of the study include lack of information about family members who had attempted suicide and the age of the probands when their family member died. STAR*D assessments were limited to those needed to ascertain diagnosis and treatment response and did not include a broader range of psychological measures.

  11. Impact on the Quality of Erections after Completing a Low-Intensity Extracorporeal Shock Wave Treatment Cycle on a Group of 710 Patients

    Directory of Open Access Journals (Sweden)

    Héctor A. Corredor Ayala

    2017-01-01

    Full Text Available Objective. The aim of this study is to evaluate the response to low-intensity extracorporeal shock wave therapy in a group of patients with organic vascular erectile dysfunction. Materials and Methods. This is an observational retrospective study. The researchers reviewed 710 patients with a clinical diagnosis of organic vascular erectile dysfunction (ED of more than 3-month duration from male sexual health clinics of the Boston Medical Group from 12 cities in Spain and 4 in Mexico. Patients received 5 outpatient shock wave therapy sessions. They were evaluated with the erection hardness score (EHS before the first session (n = 710, at the end of the last session (n = 710, and one month after the last session (n = 412. Results. In the first examination, the EHS improved in 43.1% (306/710 of subjects compared to the baseline measurement and ability to penetrate increased from 26.8% to 44% (p<0.0001. In the second examination, the ability to penetrate was 37.9%, lower than in the first (p=0.042 but higher than the baseline (p=0.0001. Conclusions. The results suggest that the shock wave therapy with or without concomitant treatments improved the quality of erections in patients with erectile dysfunction treated in specialised male sexual health clinics. This trial is registered with NCT03237143.

  12. The muscle mass, omega-3, diet, exercise and lifestyle (MODEL) study - a randomised controlled trial for women who have completed breast cancer treatment.

    Science.gov (United States)

    McDonald, Cameron; Bauer, Judy; Capra, Sandra; Coll, Joseph

    2014-04-16

    Loss of lean body mass (LBM) is a common occurrence after treatment for breast cancer and is related to deleterious metabolic health outcomes [Clin Oncol, 22(4):281-288, 2010; Appl Physiol Nutr Metab, 34(5):950-956, 2009]. The aim of this research is to determine the effectiveness of long chain omega-3 fatty acids (LCn-3s) and exercise training alone, or in combination, in addressing LBM loss in breast cancer survivors. A total of 153 women who have completed treatment for breast cancer in the last 12 months, with a Body Mass Index (BMI) of 20 to 35 kg/m2, will be randomly assigned to one of 3 groups: 3g/d LCn-3s (N-3), a 12-week nutrition and exercise education program plus olive oil (P-LC) or the education program plus LCn-3s (EX+N-3). Participants randomised to the education groups will be blinded to treatment, and will receive either olive oil placebo (OO+N-3) or LCn-3 provision, while the N-3 group will be open label. The education program includes nine 60-75 min sessions over 12 weeks that will involve breast cancer specific healthy eating advice, plus a supervised exercise session run as a resistance exercise circuit. They will also be advised to conduct the resistance training and aerobic training 5 to 7 days per week collectively. Outcome measures will be taken at baseline, 12-weeks and 24-weeks. The primary outcome is % change in LBM as measured by the air displacement plethysmograhy. Secondary outcomes include quality of life (FACT-B + 4) and inflammation (C-Reactive protein: CRP). Additional measures taken will be erythrocyte fatty acid analysis, fatigue, physical activity, menopausal symptoms, dietary intake, joint pain and function indices. This research will provide the first insight into the efficacy of LCn-3s alone or in combination with exercise in breast cancer survivors with regards to LBM and quality of life. In addition, this study is designed to improve evidence-based dietetic practice, and how specific dietary prescription may link with

  13. Comparing subjective well-being and health-related quality of life of Australian drug users in treatment in regional and rural Victoria.

    Science.gov (United States)

    Miller, Peter G; Hyder, Shannon; Zinkiewicz, Lucy; Droste, Nicolas; Harris, Jane B

    2014-11-01

    The aim of this study is to examine the self-reported subjective well-being and health-related quality of life (HRQOL) of alcohol and other drug users and to examine whether subjective well-being in this sample would be predicted by either HRQOL and/or severity of dependence. A cross-sectional survey was conducted of 201 Victorian substance users in individual targeted outpatient treatment for a variety of types of substance use. Participants were administered an interview, including the personal well-being index, the SF-8 health survey and the severity of dependence scale, in order to assess subjective well-being, the mental health component of HRQOL and severity of drug dependence respectively. Subjective well-being was predicted by mental health aspects of HRQOL (sr(2)  = 0.03) and by employment (sr(2)  = 0.05), rather than by severity of dependence [F(5, 146) = 5.60, P well-being than do the general population. Subjective well-being was predicted by mental aspects of HRQOL and not by severity of drug dependence or by physical aspects of HRQOL. Treatment which aims to improve substance users' well-being should include mental health interventions and pathways to employment. © 2014 Australasian Professional Society on Alcohol and other Drugs.

  14. Bone mineral density in girls with functional hypothalamic amenorrhea subjected to estroprogestagen treatment--a 4-year prospective study.

    Science.gov (United States)

    Sowińska-Przepiera, Elżbieta; Chełstowski, Kornel; Friebe, Zbigniew; Syrenicz, Anhelli

    2011-11-01

    The aim of this study was to evaluate the effects of 4-year estroprogestagen therapy (EP) on the bone mineral density (BMD) of 16- to 17-year-old girls with functional hypothalamic amenorrhea (FHA, n = 78). Baseline values of hormonal parameters, bone fraction of alkaline phosphatase (BALP), and cross-linked n-telopeptide of type I collagen (Ntx) were taken along with BMD measurements. Follow-up measurements of laboratory parameters were performed after 6 months of EP treatment. BMD was measured on a yearly basis. Six-month treatment resulted in a marked increase in estradiol levels and a significant decrease in BALP and Ntx. The relative increase in BMD was highest after the second year of treatment. Based on the dynamics of BMD changes during the first year of treatment, we identified a subgroup with no or insignificant reactions to the treatment. It was characterized by significantly higher baseline BMD and markedly lower baseline Ntx compared to the patients who responded to 1-year therapy well or extremely well. Further follow-up proved, however, that this subgroup did not differ significantly in terms of the long-term prognosis for BMD normalization. In conclusion, this study showed that EP therapy is effective in the treatment of BMD disorders associated with FHA.

  15. What Works for Patients in Outpatient Treatment for Alcohol Addiction? An Explorative Study into Clients’ Evaluation of Subjective Factors and Therapy Satisfaction

    Science.gov (United States)

    Frick, Katrin M.; Loessl, Barbara; Brueck, Rigo K.; Kriston, Levente; Jaehne, Andreas; Riemann, Dieter; Gann, Horst; Batra, Anil; Wodarz, Norbert; Mann, Karl F.; Berner, Michael M.

    2011-01-01

    This explorative survey investigated clients’ evaluation of therapy elements and other supportive factors within a randomized controlled trial. The treatment of patients with alcohol dependence consisted of pharmacotherapy (acamprosate/naltrexone/placebo) and biweekly medical management (MM). Forty-nine study participants were surveyed with a questionnaire to measure both the patients’ satisfaction with the therapy and the subjective assessment of treatment elements and supportive factors. Study participants were highly satisfied with the treatment. The supportive factors previously identified by Orford et al1 were confirmed. ‘Pharmacotherapy’ was rated significantly less effective than ‘MM’ and ‘global study attendance’ (P < 0.001). The significant differences in the evaluation of treatment elements point to a preference for regular low-key contacts rather than for medication. Such contacts based on MM could be a useful intervention in clinical care, and its effectivity should be examined more closely in further research. PMID:22879748

  16. Comparison of high-sensitivity C-reactive protein and fetuin-A levels before and after treatment for subjects with subclinical hyperthyroidism.

    Science.gov (United States)

    Bilgir, Oktay; Bilgir, Ferda; Topcuoglu, Tuba; Calan, Mehmet; Calan, Ozlem

    2014-03-01

    This study was designed to show the effect of propylthiouracil treatment on sCD40L, high-sensitivity C-reactive protein, and fetuin-A levels on subjects with subclinical hyperthyroidism. After checking sCD40L, high-sensitivity C-reactive protein, and fetuin-A levels of 35 patients with subclinical hyperthyroidism, each was given 50 mg tablets of propylthiouracil three times daily. After 3 months, sCD40L, high-sensitivity C-reactive protein, and fetuin-A levels were then compared to the levels before treatment. Although high-sensitivity C-reactive protein and sCD40L levels were normal in the subclinical hyperthyroidism patients compared to the healthy controls, fetuin-A levels were statistically significantly higher (*p = 0.022). After treatment, fetuin-A levels of subclinical hyperthyroidism patients decreased statistically significantly compared to the levels before treatment (**p = 0.026). sCD40L and high-sensitivity C-reactive protein levels did not have a statistically significant difference compared to the control group and post-propylthiouracil treatment. In subclinical hyperthyroidism patients, high fetuin-A levels before propylthiouracil treatment and decreases in these levels after treatment in cases with subclinical hyperthyroidism indicated the possibility of preventing long-term cardiac complications with propylthiouracil treatment.

  17. Does Intraoperative Systematic Bacterial Sampling During Complete Cytoreductive Surgery (CRS) with Hyperthermic Intraoperative Peritoneal Chemotherapy (HIPEC) Influence Postoperative Treatment? A New Predictive Factor for Postoperative Abdominal Infectious Complications.

    Science.gov (United States)

    Dazza, Marie; Schwarz, Lilian; Coget, Julien; Frebourg, Noelle; Wood, Gregory; Huet, Emmanuel; Bridoux, Valérie; Veber, Benoit; Tuech, Jean-Jacques

    2016-12-01

    Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is an emerging curative treatment option for patients with peritoneal carcinomatosis. It has a long-term survival benefit but is associated with high rates of morbidity, ranging from 12 % to 65 %, mainly due to infectious complications. We sought to evaluate the clinical relevance of routine intraoperative bacteriological sampling following CRS/HIPEC. Between November 2010 and December 2014, every patients receiving CRS/HIPEC were included. Three samples were routinely collected from standardized locations for intraperitoneal rinsing liquid bacteriological analysis (RLBA) after completion of HIPEC. The clinical and surgical features, bacteriological results, and short-term outcomes were retrospectively reviewed. The overall mortality and morbidity rates were 5 and 45 %, respectively. Among the 75 included patients, 40 % (n = 30) had at least one positive bacterial culture. Risk factors for a positive culture were colorectal resection (adjusted hazard ratio [HR] = 3.072, 95 % CI 1.843-8.004; p = 0.009) and blood loss >1000 mL (HR = 4.272, 95 % CI 1.080-18.141; p = 0.031). Among 26 (35 %) patients with abdominal infectious complications, 13 (17 %) experienced isolated complications. A positive RLBA result was independently associated with abdominal infectious complications (HR = 5.108, 95 % CI 1.220-16.336; p = 0.024) and isolated abdominal infectious complications (HR = 4.199, 95 % CI 1.064-15.961; p = 0.04). Forty percent of the RLBA samples obtained following CRS/HIPEC tested positive for bacteria. Bacterial sampling of rinsing liquid should be systematically performed. An aggressive and immediate antibiotic strategy needs to be evaluated.

  18. Processes subject to integrated pollution control. Combustion processes: reheat and heat treatment furnaces 50 MW(th) and over

    International Nuclear Information System (INIS)

    1995-01-01

    This document, part of a series offering guidance on pollution control regulations issued by Her Majesty's Inspectorate of Pollution, focuses on combustion processes involved with reheat and heat treatment furnaces of 50 MW (th) and over. Techniques for controlling releases into air, water and to land are detailed as are the various pollution monitoring strategies. (UK)

  19. Evaluation of nevirapine and/or hydroxyurea with nucleoside reverse transcriptase inhibitors in treatment-naive HIV-1-infected subjects

    NARCIS (Netherlands)

    Blanckenberg, Daniel H.; Wood, Robin; Horban, Andrzej; Beniowski, Marek; Boron-Kaczmarska, Anna; Trocha, Hanna; Halota, Waldemar; Schmidt, Reinhold E.; Fatkenheuer, G.; Jessen, Heiko; Lange, Joep M. A.

    2004-01-01

    Objective: To examine the effect of adding nevirapine (NVP) and/or hydroxyurea (HU) to a triple nucleoside analogue reverse transcriptase inhibitor (NRTI) regimen in terms of efficacy and tolerability. Methods: HIV-1-infected, treatment-naive adults were randomized, using a factorial design, to add

  20. Low Stress Mechanical Properties of Plasma-Treated Cotton Fabric Subjected to Zinc Oxide-Anti-Microbial Treatment

    Directory of Open Access Journals (Sweden)

    Chi-Wai Kan

    2013-01-01

    Full Text Available Cotton fabrics are highly popular because of their excellent properties such as regeneration, bio-degradation, softness, affinity to skin and hygroscopic properties. When in contact with the human body, cotton fabrics offer an ideal environment for microbial growth due to their ability to retain oxygen, moisture and warmth, as well as nutrients from spillages and body sweat. Therefore, an anti-microbial coating formulation (Microfresh and Microban together with zinc oxide as catalyst was developed for cotton fabrics to improve treatment effectiveness. In addition, plasma technology was employed in the study which roughened the surface of the materials, improving the loading of zinc oxides on the surface. In this study, the low stress mechanical properties of plasma pre-treated and/or anti-microbial-treated cotton fabric were studied. The overall results show that the specimens had improved bending properties when zinc oxides were added in the anti-microbial coating recipe. Also, without plasma pre-treatment, anti-microbial-treatment of cotton fabric had a positive effect only on tensile resilience, shear stress at 0.5° and compressional energy, while plasma-treated specimens had better overall tensile properties even after anti-microbial treatment.

  1. Response to vicriviroc in treatment-experienced subjects, as determined by an enhanced-sensitivity coreceptor tropism assay: reanalysis of AIDS clinical trials group A5211.

    Science.gov (United States)

    Su, Zhaohui; Gulick, Roy M; Krambrink, Amy; Coakley, Eoin; Hughes, Michael D; Han, Dong; Flexner, Charles; Wilkin, Timothy J; Skolnik, Paul R; Greaves, Wayne L; Kuritzkes, Daniel R; Reeves, Jacqueline D

    2009-12-01

    The enhanced-sensitivity Trofile assay (Monogram Biosciences) was used to retest coreceptor use at both study screening and study entry for 118 treatment-experienced subjects in AIDS Clinical Trials Group A5211 who had CCR5-tropic (R5) virus detected by the original Trofile assay at study screening. Among 90 recipients of vicriviroc, a significantly (P< .001) greater mean reduction in HIV-1 RNA was observed in 72 subjects with R5 virus versus 15 subjects reclassified as having dual/mixed-tropic viruses at screening: -1.11 versus -0.09 log(10) copies/mL at day 14 and -1.91 versus -0.57 log(10) copies/mL at week 24, respectively. Results suggest that the enhanced-sensitivity assay is a better screening tool for determining patient eligibility for CCR5 antagonist therapy.

  2. Response to Vicriviroc in Treatment-Experienced Subjects Using an Enhanced Sensitivity Co-receptor Tropism Assay: Reanalysis of AIDS Clinical Trials Group A5211

    Science.gov (United States)

    Su, Zhaohui; Gulick, Roy M.; Krambrink, Amy; Coakley, Eoin; Hughes, Michael D.; Han, Dong; Flexner, Charles; Wilkin, Timothy J.; Skolnik, Paul R.; Greaves, Wayne L.; Kuritzkes, Daniel R.; Reeves, Jacqueline D.

    2009-01-01

    The enhanced sensitivity Trofile assay was used to re-test co-receptor usage at study screening and entry for the 118 ACTG A5211 treatment-experienced subjects who had CCR5-tropic (R5) virus by the original Trofile assay at study screening. Among 90 vicriviroc recipients, a significantly (P<0.001) greater mean reduction in HIV-1 RNA was observed in 72 subjects with R5 virus versus 15 subjects reclassified with dual/mixed-tropic viruses at screening: −1.11 vs. −0.09 (day 14), −1.91 vs. −0.57 (week 24) log10 copies/mL, respectively. Results suggest that the enhanced sensitivity assay is a better screening tool for determining patient eligibility for CCR5 antagonist therapy. PMID:19874179

  3. The effect of physical therapy treatment directed to the cervical spine or temporomandibular joint in patients with subjective tinnitus: A systematic review

    Directory of Open Access Journals (Sweden)

    Sarah Michiels

    2016-11-01

    Full Text Available Background: Tinnitus is a very common symptom that often causes distress and decreases the patient’s quality of life. Apart from the well-known causes, tinnitus can in some cases be elicited by dysfunctions of the cervical spine or the temporomandibular joint(TMJ. To date however, it is unclear whether alleviation of these dysfunctions, by physical therapy treatment, also decreases the tinnitus complaints. Such physical therapy could be an interesting treatment option for patients that are now often left without treatment.Objectives: The aim of this review was to investigate the current evidence regarding physical therapy treatment in patients with tinnitus.Data sources: The online databases Pubmed, Web of Science, Cochrane and Embase were searched up to March 2016. Two independent reviewers conducted the data extraction and methodological quality assessment.Study eligibility criteria: Only randomized controlled trials and quasi-experimental trials were included in the review. Studies had to be written in English, French, Dutch or German.Participants and interventions: The included studies investigated the effect of physical therapy treatment modalities on tinnitus severity in patients suffering from subjective tinnitus.Results: Six studies were included in this review, four investigating cervical spine treatment and two investigating TMJ treatment. These studies show positive effects of cervical spine treatment (manipulations, exercises, triggerpoint treatment on tinnitus severity. Additionally, decrease in tinnitus severity and intensity was demonstrated after TMJ treatment, following splints, occlusal adjustments as well as jaw exercises.Limitations: The risk of bias in the included studies was high, mainly due to lack of randomization, lack of blinding of subjects, therapists and/or investigators. Additionally, risk of bias is present due to incomplete presentation of the data and selective reporting. A major issue of the reviewed papers

  4. Evaluation of Nutritional Status of Cancer Patients during Treatment by Patient-Generated Subjective Global Assessment: a Hospital-Based Study.

    Science.gov (United States)

    Sharma, Dibyendu; Kannan, Ravi; Tapkire, Ritesh; Nath, Soumitra

    2015-01-01

    Cancer patients frequently experience malnutrition. Cancer and cancer therapy effects nutritional status through alterations in the metabolic system and reduction in food intake. In the present study, fifty seven cancer patients were selected as subjects from the oncology ward of Cachar Cancer Hospital and Research Centre, Silchar, India. Evaluation of nutritional status of cancer patients during treatment was carried out by scored Patient-Generated Subjective Global Assessment (PG-SGA). The findings of PG-SGA showed that 15.8% (9) were well nourished, 31.6% (18) were moderately or suspected of being malnourished and 52.6% (30) were severely malnourished. The prevalence of malnutrition was highest in lip/oral (33.33%) cancer patients. The study showed that the prevalence of malnutrition (84.2%) was high in cancer patients during treatment.

  5. Antipsychotic treatment and the risk of hip fracture in subjects with schizophrenia: a 10-year population-based case-control study.

    Science.gov (United States)

    Wu, Chi-Shin; Chang, Chia-Ming; Tsai, Yu-Ting; Huang, Ya-Wen; Tsai, Hui-Ju

    2015-09-01

    To investigate the association between antipsychotic treatment and risk of hip fracture in subjects with schizophrenia. Among patients with schizophrenia (ICD-9-CM code 295), 605 cases with hip fracture and 2,828 matched controls were identified from 2002 to 2011 using the National Health Insurance Research Database in Taiwan. The authors conducted a nested case-control study to investigate the association between antipsychotic treatment and risk of hip fracture in subjects with schizophrenia. The modifiable effects of age and gender were evaluated by stratified analysis. In addition, the effects of antipsychotic use, antipsychotic classes, and receptor-binding profiles of antipsychotics, individually, on hip fracture were estimated, and potential confounding factors were adjusted in subsequent analysis. Conditional logistic regressions were applied to determine the effect of antipsychotic treatment on hip fracture. Current antipsychotic use was associated with an increased risk for hip fracture (adjusted odds ratio [AOR] = 1.61; 95% CI, 1.24-2.10). Among current users, new users had a higher risk of hip fracture (AOR = 4.28; 95% CI, 1.76-10.36) than past users (AOR = 1.11; 95% CI, 0.79-1.56). In addition, a significant increased risk of hip fracture was noted in schizophrenia subjects with first-generation antipsychotic use (AOR = 1.59; 95%CI, 1.15-2.20) but not in those with second-generation antipsychotic use (AOR = 1.16; 95% CI, 0.91-1.48). These results extend previous findings and demonstrate an increased risk of hip fracture associated with antipsychotic use in schizophrenia subjects. Further investigation is needed to dissect the underlying mechanisms related to the effect of antipsychotic use on hip fracture in subjects at risk. © Copyright 2015 Physicians Postgraduate Press, Inc.

  6. The effect of holiday haemodialysis treatments on patient mood, adverse symptoms and subjective wellbeing using the Big Red Kidney Bus.

    Science.gov (United States)

    Sims, Jane; Bennett, Paul N; Ockerby, Cherene; Ludlow, Marie; Fairbairn, Jo; Wilson, Anne; Kerr, Peter G

    2017-02-01

    People with end-stage kidney disease receiving haemodialysis are restricted to holidays where dialysis services are readily available. Holiday dialysis in regional, rural and remote areas is particularly challenging. The aims of this study were to evaluate the wellbeing of those who received dialysis in a holiday haemodialysis bus and to measure patient well-being with that of a comparable cohort of haemodialysis patients. A three machine haemodialysis bus, the Big Red Kidney Bus, was built to enable people, their families and carers to take holidays across a range of tourist destinations in Victoria, Australia. Measures included pre-post subjective well-being, dialysis symptoms and mood questionnaires complemented by post semi-structured telephone interviews. Participating holidaymakers were positive about the haemodialysis bus service and the standard of care experienced. They reported decreased dialysis side effects of fatigue, muscle cramp and dry skin. The overall number of reported symptoms decreased, and the perceived level of bother associated with symptoms also decreased. No changes in subjective well-being and mood were detected. Mean Personal Wellbeing Index scores were significantly higher than in a comparative haemodialysis sample. The Big Red Kidney Bus provided a safe and feasible holiday dialysis service. Holidaymakers' well-being was reflected by the decreased dialysis patient side effects. © 2016 Asian Pacific Society of Nephrology.

  7. Treatment outcome and long-term stability of skeletal changes following maxillary distraction in adult subjects of cleft lip and palate

    OpenAIRE

    Satinder Pal Singh; Ashok Kumar Jena; Vidya Rattan; Ashok Kumar Utreja

    2012-01-01

    Aim : To evaluate the treatment outcome and long-term stability of skeletal changes following maxillary advancement with distraction osteogenesis in adult subjects of cleft lip and palate. Materials and Methods: Total 12 North Indian adult patients in the age range of 17-34 years with cleft lip and palate underwent advancement of maxilla by distraction osteogenesis. Lateral cephalograms recorded prior to distraction, at the end of distraction, 6 months after distraction, and at least 24 month...

  8. Assessment of facial profile changes in Class I biprotrusion adolescent subjects submitted to orthodontic treatment with extractions of four premolars

    Directory of Open Access Journals (Sweden)

    Claudia Trindade Mattos

    2012-06-01

    Full Text Available OBJECTIVE: To evaluate cephalometric changes in tooth and profile position in young adolescent individuals with Class I biprotrusion submitted to orthodontic treatment with extractions of four first premolars. METHODS: Pre and posttreatment lateral cephalometric radiographs from 20 patients with Class I biprotrusion malocclusion were used to evaluate the following measurements: nasolabial angle, distance from lips to E line, distance from lips, incisors, tip of the nose and soft tissue pogonion to Sy line. RESULTS: All measurements showed significant changes after treatment (p<0.05, except the distance from lips and soft tissue pogonion to Sy line. There was a positive correlation between the retraction of incisors and the change of upper and lower lips (0.803/0.925; p<0.001. CONCLUSION: The profile retrusion observed occurred more due to nose growth than to lips retraction. The response from soft tissues to incisors retraction showed a great variability.

  9. Favourable hypotensive effect after standardised tomato extract treatment in hypertensive subjects at high cardiovascular risk: a randomised controlled trial.

    Science.gov (United States)

    Krasińska, Beata; Osińska, Angelika; Krasińska, Aleksandra; Osiński, Maciej; Rzymski, Piotr; Tykarski, Andrzej; Krasiński, Zbigniew

    2018-01-01

    Cardiovascular (CV) diseases remain a leading global cause of death. Lowering blood pressure (BP) reduces the risk of CV complications, especially stroke and acute coronary events, and it delays the progression of kidney disease. Adequate non-pharmacological treatment improves the effectiveness of the antihypertensive therapy. A Mediterranean diet with high content of vegetables (rich in tomatoes) is associated with a reduced CV risk. The main objective of the present study was to assess whether the addition of standardised tomato extract (STE) or acetylsalicylic acid (ASA) to standard antihypertensive therapy can improve BP control in patients with arterial hypertension (HT). The study involved 82 high-risk hypertensive patients. Patients with primary HT at high to a very high total CV risk were randomised in a blinded fashion to one of two groups, i.e. the ASA and STE group. The patients had two visits, a baseline visit and one after four weeks of treatment. In all the patients, during each visit, clinical BP and ambulatory BP measurements (ABPM) were performed. Platelet aggregation was determined using the VerifyNow analyser. After four weeks of treatment in the STE group, there was a statistically significant reduction in 24-h systolic BP, diastolic BP, and mean arterial pressure values measured in ABPM (p high CV risk. This effect, together with the anti-aggregatory effect, may indicate the pleiotropic effect of tomato extract. This fact justifies further research into functional foods and gives new insights into STE as a food supplement that could have new therapeutic and prophylactic uses for the treatment of hypertensive patients with high CV risk and especially with obesity.

  10. Objective and subjective outcome in 42 patients after treatment of sialolithiasis by transoral incision of Warthon's duct

    DEFF Research Database (Denmark)

    Juul, Marie Louise; Wagner, Niels

    2014-01-01

    In this retrospective follow-up study, we present the middle-term results of transoral removal of submandibular calculi by incision in the floor of the mouth together with a patient satisfaction survey. These results will be compared with those of international studies. This is an individual...... retrospective cohort follow-up study. Forty-two patients had salivary calculi removed by incision in the mouth in the period from August 2009 to July 2012 at the Ear-nose-throat department of the North Zealand Hospital, Hillerød, Denmark. A retrospective study was carried out, focusing on the effects...... of the surgery and on patient satisfaction. The patients completed a questionnaire and underwent an objective physical exam. We found a high success rate (93 %), high patient satisfaction (94 %) and a high number of patients with no symptoms (92 %). In 94 % of the patients the gland was preserved, and there were...

  11. Effect of co-treatment with fluoxetine or mirtazapine and risperidone on the active behaviors and plasma corticosterone concentration in rats subjected to the forced swim test.

    Science.gov (United States)

    Rogóż, Zofia; Kabziński, Marcin; Sadaj, Witold; Rachwalska, Paulina; Gądek-Michalska, Anna

    2012-01-01

    Several clinical reports have postulated a beneficial effect of the addition of a low dose of risperidone to the ongoing treatment with antidepressants in treatment-resistant depression. The present study aimed to examine the effect of treatment with fluoxetine or mirtazapine, given separately or jointly with risperidone, on active behavior and plasma corticosterone level in male Wistar rats subjected to the forced swim test (FST). The obtained results showed that fluoxetine (5 mg/kg), mirtazapine (5 and 10 mg/kg) or risperidone (0.05 and 0.1 mg/kg) did not change the active behavior of rats in the FST. However, co-treatment with fluoxetine (10 mg/kg) and risperidone (0.1 mg/kg) induced an antidepressant-like effect in that test because it significantly increased the swimming time and decreased the immobility time, while combined treatment with mirtazapine at 5 and 10 mg/kg and risperidone at 0.05 and 0.1 mg/kg evoked a significant increase in the swimming time and also climbing, and decreased the immobility time. WAY 100635 (a 5-HT(1A) receptor antagonist) at a dose of 0.1 mg/kg inhibited the antidepressant-like effect induced by co-administration of fluoxetine or mirtazapine and risperidone. Active behavior in that test did not reflect an increase in general activity, since combined treatment with fluoxetine or mirtazapine and risperidone failed to enhance the exploratory activity of rats. Co-treatment with fluoxetine or mirtazapine and risperidone did not reduce the stress-induced increase in plasma corticosterone concentration in animals subjected to the FST. The obtained results indicate that risperidone applied in a low dose enhances the antidepressant-like activity of fluoxetine and mirtazapine in the FST (but does not normalize the stress-induced increase in corticosterone level in these rats), and that 5-HT(1A) receptors may play some role in these effects.

  12. Clinical Evaluation of Acupuncture as Treatment for Complications of Cerebrovascular Accidents: A Randomized, Sham-Controlled, Subject- and Assessor-Blind Trial.

    Science.gov (United States)

    Liao, Hsien-Yin; Ho, Wen-Chao; Chen, Chun-Chung; Lin, Jaung-Geng; Chang, Chia-Chi; Chen, Liang-Yu; Lee, De-Chih; Lee, Yu-Chen

    2017-01-01

    Background and Purpose . The effect of acupuncture as treatment for poststroke complications is questionable. We performed a randomized, sham-controlled double-blind study to investigate it. Methods . Patients with first-time acute stroke were randomized to receive 24 sessions of either real or sham acupuncture during an eight-week period. The primary outcome measure was change in National Institute of Health Stroke Scale (NIHSS) score. Secondary outcome measures included changes in Barthel Index (BI), Instrumental Activities of Daily Living (IADL), Hamilton Depression Rating Scale (HAM-D), and Visual Analogue Scale (VAS) for pain scores. Results . Of the 52 patients who were randomized to receive acupuncture ( n = 28) or placebo ( n = 24), 10 patients in the acupuncture group and 9 patients in the placebo group failed to complete the treatment. In total, 18 patients in the acupuncture group and 15 patients in the control group completed the treatment course. Reduction in pain was significantly greater in the acupuncture group than in the control group ( p value = 0.04). There were no significant differences in the other measures between the two groups. Conclusions . Acupuncture provided more effective poststroke pain relief than sham acupuncture treatment. However, acupuncture had no better effect on neurological, functional, and psychological improvement.

  13. Clinical Evaluation of Acupuncture as Treatment for Complications of Cerebrovascular Accidents: A Randomized, Sham-Controlled, Subject- and Assessor-Blind Trial

    Directory of Open Access Journals (Sweden)

    Hsien-Yin Liao

    2017-01-01

    Full Text Available Background and Purpose. The effect of acupuncture as treatment for poststroke complications is questionable. We performed a randomized, sham-controlled double-blind study to investigate it. Methods. Patients with first-time acute stroke were randomized to receive 24 sessions of either real or sham acupuncture during an eight-week period. The primary outcome measure was change in National Institute of Health Stroke Scale (NIHSS score. Secondary outcome measures included changes in Barthel Index (BI, Instrumental Activities of Daily Living (IADL, Hamilton Depression Rating Scale (HAM-D, and Visual Analogue Scale (VAS for pain scores. Results. Of the 52 patients who were randomized to receive acupuncture (n=28 or placebo (n=24, 10 patients in the acupuncture group and 9 patients in the placebo group failed to complete the treatment. In total, 18 patients in the acupuncture group and 15 patients in the control group completed the treatment course. Reduction in pain was significantly greater in the acupuncture group than in the control group (p value = 0.04. There were no significant differences in the other measures between the two groups. Conclusions. Acupuncture provided more effective poststroke pain relief than sham acupuncture treatment. However, acupuncture had no better effect on neurological, functional, and psychological improvement.

  14. Evaluation of the properties of anodized aluminum 6061 subjected to thermal cycling treatment using electrochemical impedance spectroscopy (EIS)

    Energy Technology Data Exchange (ETDEWEB)

    Huang Yuelong [Corrosion and Environmental Effects Laboratory (CEEL), Mork Family Department of Chemical Engineering and Materials Science, University of Southern California, Los Angeles, CA 90089-0241 (United States); Shih Hong [Lam Research Corporation, 4400 Cushing Parkway, Fremont, CA 94538 (United States)], E-mail: hong.shih@lamrc.com; Daugherty, John [Lam Research Corporation, 4400 Cushing Parkway, Fremont, CA 94538 (United States); Mansfeld, Florian [Corrosion and Environmental Effects Laboratory (CEEL), Mork Family Department of Chemical Engineering and Materials Science, University of Southern California, Los Angeles, CA 90089-0241 (United States)], E-mail: mansfeld@usc.edu

    2009-10-15

    The corrosion resistance of anodized Al 6061 produced by two different anodizing and sealing processes was evaluated for 30 days during exposure to 3.5 wt% NaCl using EIS. Thermal cycling treatments at 120, 160 and 200 deg. C have been applied for the two types of samples. The degradation of the properties of the anodized layers has been determined by thorough analysis of the EIS data for control samples and samples that had undergone thermal cycling. Scanning electron microscopy has been used to evaluate the damage to the anodized aluminum layers due to thermal cycling. It was found that the thermal treatment produced considerable damage of both the porous layer and the barrier layer. The EIS data suggest that some cracks extended into the bare metal. The damage of the oxide layers increased with increasing thermal cycling temperature for both types of samples. Self-sealing of the porous layer and the barrier layer occurred during immersion in NaCl.

  15. Sliding wear and corrosion behaviour of alloyed austempered ductile iron subjected to novel two step austempering treatment

    Science.gov (United States)

    Sethuram, D.; Srisailam, Shravani; Rao Ponangi, Babu

    2018-04-01

    Austempered Ductile Iron(ADI) is an exciting alloy of iron which offers the design engineers the best combination high strength-to-weight ratio, low cost design flexibility, good toughness, wear resistance along with fatigue strength. The two step austempering procedure helps in simultaneously improving the tensile strength as-well as the ductility to more than that of the conventional austempering process. Extensive literature survey reveals that it’s mechanical and wear behaviour are dependent on heat treatment and alloy additions. Current work focuses on characterizing the two-step ADI samples (TSADI) developed by novel heat treatment process for resistance to corrosion and wear. The samples of Ductile Iron were austempered by the two-Step Austempering process at temperatures 300°C to 450°C in the steps of 50°C.Temperaturesare gradually increased at the rate of 14°C/Hour. In acidic medium (H2SO4), the austempered samples showed better corrosive resistance compared to conventional ductile iron. It has been observed from the wear studies that TSADI sample at 350°C is showing better wear resistance compared to ductile iron. The results are discussed in terms of fractographs, process variables and microstructural features of TSADI samples.

  16. Transcriptome Analysis of mRNA and miRNA in Somatic Embryos of Larix leptolepis Subjected to Hydrogen Treatment

    Directory of Open Access Journals (Sweden)

    Yali Liu

    2016-11-01

    Full Text Available Hydrogen is a therapeutic antioxidant that has been used extensively in clinical trials. It also acts as a bioactive molecule that can alleviate abiotic stress in plants. However, the biological effects of hydrogen in somatic embryos and the underlying molecular basis remain largely unknown. In this study, the morphological and physiological influence of exogenous H2 treatment during somatic embryogenesis was characterized in Larix leptolepis Gordon. The results showed that exposure to hydrogen increased the proportions of active pro-embryogenic cells and normal somatic embryos. We sequenced mRNA and microRNA (miRNA libraries to identify global transcriptome changes at different time points during H2 treatment of larch pro-embryogenic masses (PEMs. A total of 45,393 mRNAs and 315 miRNAs were obtained. Among them, 4253 genes and 96 miRNAs were differentially expressed in the hydrogen-treated libraries compared with the control. Further, a large number of the differentially expressed mRNAs and miRNAs were related to reactive oxygen species (ROS homeostasis and cell cycle regulation. We also identified 4399 potential target genes for 285 of the miRNAs. The differential expression data and the mRNA-miRNA interaction network described here provide new insights into the molecular mechanisms that determine the performance of PEMs exposed to H2 during somatic embryogenesis.

  17. Variations of high frequency parameter of heart rate variability following osteopathic manipulative treatment in healthy subjects compared to control group and sham therapy: randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Nuria eRuffini

    2015-08-01

    Full Text Available Context: Heart Rate Variability (HRV indicates how heart rate changes in response to inner and external stimuli. HRV is linked to health status and it is an indirect marker of the autonomic nervous system (ANS function. Objective: To investigate the influence of osteopathic manipulative treatment (OMT on ANS activity through changes of High Frequency, a heart rate variability index indicating the parasympathetic activity, in healthy subjects, compared with sham therapy and control group.Methods: Sixty-six healthy subjects, both male and female, were included in the present 3-armed randomized placebo controlled within subject cross-over single blinded study. Participants were asymptomatic adults, both smokers and non-smokers and not on medications. At enrollment subjects were randomized in 3 groups: A, B, C. Standardized structural evaluation followed by a patient need-based osteopathic treatment was performed in the first session of group A and in the second session of group B. Standardized evaluation followed by a protocoled sham treatment was provided in the second session of group A and in the first session of group B. No intervention was performed in the two sessions of group C, acting as a time-control. The trial was registered on clinicaltrials.gov identifier: NCT01908920.Main Outcomes Measures: HRV was calculated from electrocardiography before, during and after the intervention, for a total amount time of 25 minutes.Results: OMT engendered a statistically significant increase of parasympathetic activity, as shown by High Frequency rate (p<0.001, and decrease of sympathetic activity, as revealed by Low Frequency rate (p<0.01; results also showed a reduction of Low Frequency/High Frequency ratio (p<0.001 and Detrended fluctuation scaling exponent (p<0.05. Conclusions: Findings suggested that OMT can influence ANS activity increasing parasympathetic function and decreasing sympathetic activity, compared to sham therapy and control group.

  18. Neurophysiological Correlates of Central Fatigue in Healthy Subjects and Multiple Sclerosis Patients before and after Treatment with Amantadine

    Directory of Open Access Journals (Sweden)

    Emiliano Santarnecchi

    2015-01-01

    Full Text Available In ten healthy subjects and in ten patients suffering from Multiple Sclerosis (MS, we investigated the cortical functional changes induced by a standard fatiguing repetitive tapping task. The Cortical Silent Period (CSP, an intracortical, mainly GABAB-mediated inhibitory phenomenon, was recorded by two different hand muscles, one acting as prime mover of the fatiguing index-thumb tapping task (First Dorsal Interosseous, FDI and the other one not involved in the task but sharing largely overlapping central, spinal, and peripheral innervation (Abductor Digiti Minimi, ADM. At baseline, the CSP was shorter in patients than in controls. As fatigue developed, CSP changes involved both the “fatigued” FDI and the “unfatigued” ADM muscles, suggesting a cortical spread of central fatigue mechanisms. Chronic therapy with amantadine annulled differences in CSP duration between controls and patients, possibly through restoration of more physiological levels of intracortical inhibition in the motor cortex. These inhibitory changes correlated with the improvement of fatigue scales. The CSP may represent a suitable marker of neurophysiological mechanisms accounting for central fatigue generation either in controls or in MS patients, involving corticospinal neural pools supplying not only the fatigued muscle but also adjacent muscles sharing an overlapping cortical representation.

  19. [The contributing risk factors, prevention and treatment of functional dependence among the oldest-old and elderly subjects].

    Science.gov (United States)

    Liu, Dianrong; Tan, Jiping; Guo, Yuhe; Ye, Guanghua; Zhu, Linqi; Zhang, Jun; Li, Yinghao; Deng, Yucheng; Wang, Guichen; Wang, Luning

    2014-10-01

    To compare the risk factors on the functional dependence between the oldest-old and elderly veterans. A cross-sectional survey was conducted among veterans ( ≥ 60 years of age) lived in 44 veterans' communities in Beijing. The socio-demographic information and history of non-communicable chronic diseases were collected via face-to-face interviews, and the functional status was assessed by the 20-item version of the Activities of Daily Living Scale. The risk factors associated with increased hazard of the functional dependence in the oldest-old ( ≥ 80 years old) were cognitive impairment, extrapyramidal diseases, cerebral infarction, transient ischemic attack, sleep disorders, hypnotics, osteoarthrosis, hypertension and fall with the odds ratio (OR) of 1.241-2.962 (all P fall, cardiovascular diseases, osteoarthrosis and hearing loss were the risk factors for that in the elderly subjects (aged 60-79 years). The OR was 1.232-5.790 (all P risk of functional dependence in both the oldest-old and elderly people. Neuropsychiatric disorders are the leading causes contributed to the functional dependence among oldest-old and elderly population. Neurodegenerative diseases in the oldest-old, stroke and depression in elderly people should be the priorities in ameliorating disability. Healthy lifestyle and avocational activities could improve the functional status of the oldest-old and elderly population.

  20. Tensile Property of ANSI 304 Stainless Steel Weldments Subjected to Cavitation Erosion Based on Treatment of Laser Shock Processing.

    Science.gov (United States)

    Zhang, Lei; Liu, Yue-Hua; Luo, Kai-Yu; Zhang, Yong-Kang; Zhao, Yong; Huang, Jian-Yun; Wu, Xu-Dong; Zhou, Chuang

    2018-05-16

    Tensile property was one important index of mechanical properties of ANSI 304 stainless steel laser weldments subjected to cavitation erosion (CE). Laser shock processing (LSP) was utilized to strengthen the CE resistance, and the tensile property and fracture morphology were analyzed through three replicated experiment times. Results showed tensile process of treated weldments was composed of elastic deformation, plastic deformation, and fracture. The elastic limit, elastic modulus, elongation, area reduction, and ultimate tensile strength of tensile sample after CE were higher in view of LSP. In the fracture surface, the fiber zone, radiation zone and shear lip zone were generated, and those were more obvious through LSP. The number and size of pores in the fracture surface were smaller, and the fracture surface was smoother and more uniform. The dimples were elongated along the unified direction due to effects of LSP, and the elongated direction was in agreement with the crack propagation direction. Their distribution and shape were uniform with deeper depth. It could be reflected that the tensile property was improved by LSP and the CE resistance was also enhanced.

  1. REAC neuromodulation treatments in subjects with severe socioeconomic and cultural hardship in the Brazilian state of Pará: a family observational pilot study.

    Science.gov (United States)

    Coelho Pereira, José Alfredo; Rinaldi, Arianna; Fontani, Vania; Rinaldi, Salvatore

    2018-01-01

    The purpose of this preliminary observational study was to evaluate the usefulness of a humanitarian initiative, aimed at improving the neuropsychological and behavioral attitude of children with severe socioeconomic and cultural hardship, in the Brazilian state of Pará. This humanitarian initiative was realized through the administration of two neuromodulation protocols, with radioelectric asymmetric conveyor (REAC) technology. During several years of clinical use, the REAC neuromodulation protocols have already proved to be effective in countering the effects of environmental stress on neuropsycho-physical functions. After the preliminary medical examination, all subjects were investigated with the Strengths and Difficulties Questionnaire (SDQ), including the impact supplement with teacher's report. After the SDQ, they received the neuromodulation treatment with REAC technology named neuro postural optimization (NPO), to evaluate their responsiveness. Subsequently, every 3 months all subjects underwent a treatment cycle of neuropsycho-physical optimization (NPPO) with REAC technology, for a total of three cycles. At the end of the last REAC-NPPO treatment cycle, all subjects were investigated once again with the SDQ. For the adequacy of the data, the Wilcoxon and the Signs tests were used. For the subdivision into clusters, the Kruskal-Wallis test was applied for the adequacy of the procedure. For all the applied tests, a statistical significance of p <0.5 was found. The results showed that the REAC-NPO and REAC-NPPO neuromodulation protocols are able to improve the quality of life, the scholastic and socialization skills, and the overall state of physical and mental health in children of a family with severe socioeconomic and cultural hardship. The REAC-NPO and REAC-NPPO neuromodulation protocols, due to their non-invasive characteristics, painlessness, and speed of administration, can be hypothesized as a treatment to improve the overall state of physical and

  2. Behavioral and stimulant treatment of hyperactive children: a therapy study with methylphenidate probes in a within-subject design.

    Science.gov (United States)

    Pelham, W E; Schnedler, R W; Bologna, N C; Contreras, J A

    1980-01-01

    Eight hyperactive children were treated with a behavioral intervention focusing on teacher and parent training over a period of 5 months. Three times, before therapy and after 3 weeks and 13 weeks of intervention, children received methylphenidate during 3-week probe periods. Each week in a probe they received either a placebo, .25 mg/kg, or .75 mg/kg methylphenidate. Classroom observation of on-task behavior suggested that effectiveness of the behavioral intervention was between that of the two dosages of medication before therapy. Both dosages resulted in higher levels of on-task behavior when administered after 13 weeks of behavioral intervention than when administered before therapy. Teacher rating data showed equivalent effects of therapy and the low dosage of methylphenidate alone but a stronger effect of the high dose alone; only the high dose resulted in improved behavior after 13 weeks of behavioral intervention. As a group, only when they received the high dose of methylphenidate after 13 weeks of behavioral intervention did children reach the level of appropriate behavior shown by nonhyperactive controls. However, this level was also reached by two children with the low dose and by one child without medication, and it was not reached by one child. The results suggest that the combination of psychostimulant medication and behavior therapy may be more effective in the short-term than either treatment alone for hyperactive children in school settings. In addition, parent ratings and clinic observation of parent-child interactions suggested that children had improved in the home setting, high-lighting the importance of behavioral parent training in the treatment of hyperactivity.

  3. Mapping and characterization of vicriviroc resistance mutations from HIV-1 isolated from treatment-experienced subjects enrolled in a phase II study (VICTOR-E1).

    Science.gov (United States)

    McNicholas, Paul M; Mann, Paul A; Wojcik, Lisa; Qiu, Ping; Lee, Erin; McCarthy, Michael; Shen, Junwu; Black, Todd A; Strizki, Julie M

    2011-03-01

    In the phase 2 VICTOR-E1 study, treatment-experienced subjects receiving 20 mg or 30 mg of the CCR5 antagonist vicriviroc (VCV), with a boosted protease containing optimized background regimen, experienced significantly greater reductions in HIV-1 viral load compared with control subjects. Among the 79 VCV-treated subjects, 15 experienced virologic failure, and of these 5 had VCV-resistant virus. This study investigated the molecular basis for the changes in susceptibility to VCV in these subjects. Sequence analysis and phenotypic susceptibility testing was performed on envelope clones from VCV-resistant virus. For select clones, an exchange of mutations in the V3 loop was performed between phenotypically resistant clones and the corresponding susceptible clones. Phenotypic resistance was manifest by reductions in the maximum percent inhibition. Clonal analysis of envelopes from the 5 subjects identified multiple amino acid changes in gp160 that were exclusive to the resistant clones, however, none of the changes were conserved between subjects. Introduction of V3 loop substitutions from the resistant clones into the matched susceptible clones was not sufficient to reproduce the resistant phenotype. Likewise, changing the substitutions in the V3 loops from resistant clones to match susceptible clones only restored susceptibility in 1 clone. There were no clearly conserved patterns of mutations in gp160 associated with phenotypic resistance to VCV and mutations both within and outside of the V3 loop contributed to the resistance phenotype. These data suggest that genotypic tests for VCV susceptibility may require larger training sets and additional information beyond V3 sequences.

  4. Barnett shale completions

    Energy Technology Data Exchange (ETDEWEB)

    Schein, G. [BJ Services, Dallas, TX (United States)

    2006-07-01

    Fractured shales yield oil and gas in various basins across the United States. A map indicating these fractured shale source-reservoir systems in the United States was presented along with the numerous similarities and differences that exist among these systems. Hydrocarbons in the organic rich black shale come from the bacterial decomposition of organic matter, primary thermogenic decomposition of organic matter or secondary thermogenic cracking of oil. The shale may be the reservoir or other horizons may be the primary or secondary reservoir. The reservoir has induced micro fractures or tectonic fractures. This paper described the well completions in the Barnett Shale in north Texas with reference to major players, reservoir properties, mineralogy, fluid sensitivity, previous treatments, design criteria and production examples. The Barnett Shale is an organic, black shale with thickness ranging from 100 to 1000 feet. The total organic carbon (TOC) averages 4.5 per cent. The unit has undergone high rate frac treatments. A review of the vertical wells in the Barnett Shale was presented along with the fracture treatment schedule and technology changes. A discussion of refracturing opportunities and proppant settling and transport revealed that additional proppant increases fluid recovery and enhances production. Compatible scale inhibitors and biocides can be beneficial. Horizontal completions in the Barnett Shale have shown better results than vertical wells, as demonstrated in a production comparison of 3 major horizontal wells in the basin. tabs., figs.

  5. A retrospective, pooled data analysis of the safety of pegaptanib sodium in the treatment of age-related macular degeneration in subjects with or without diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Dombi Theresa

    2012-08-01

    Full Text Available Abstract Background To evaluate the safety of pegaptanib sodium 0.3 mg intravitreal injection in the treatment of neovascular age-related macular degeneration in subjects with or without diabetes mellitus. Methods A pooled, retrospective, analysis was conducted of data from 9 sponsor-administered, randomized, open-label trials. Subjects who received pegaptanib by randomization or change in dose assignment, crossover design, or protocol amendment, were included. Reports of endophthalmitis, increased intraocular pressure, retinal injury, intraocular hemorrhage, traumatic cataract, hypersensitivity reactions, stroke, myocardial infarction, and other arterial thromboembolic events defined by the Antiplatelet Trialists’ Collaboration were identified by Medical Dictionary for Regulatory Activities preferred terms. Adverse events were summarized from the first injection to 42 days after the last injection. The incidence of adverse events was stratified by the presence/absence of diabetes. Results Of 1,586 subjects enrolled, 165 (10.4% had a history of diabetes mellitus and 1,421 (89.6% did not. The 2 populations were similar at baseline. Based on the comparison of prespecified ocular, hypersensitivity, and Antiplatelet Trialists’ Collaboration event terms, the safety review did not identify any notable differences between the 2 populations. Conclusions This retrospective analysis found no increased safety risk resulting from treatment with pegaptanib 0.3 mg in individuals with neovascular age-related macular degeneration and concomitant diabetes mellitus.

  6. [Barriers to ART initiation in HIV infected subjects and with treatment indication in Spain. Why don't they start their treatment? Bridgap Study].

    Science.gov (United States)

    Viciana-Fernández, Pompeyo; Falcó, Vicenç; Castaño, Manuel; de los Santos-Gil, Ignacio; Olalla-Sierra, Julián; Hernando, Asunción; Deig, Elisabet; Clotet, Bonaventura; Knobel, Hernando; Podzamczer, Daniel; Pedrol, Pere Domingo

    2015-01-01

    In Spain, HIV treatment guidelines are well known and generally followed. However, in some patients there are no plans to initiate ART despite having treatment indications. The current barriers to ART initiation are presented. A cross-sectional survey including every HIV infected patient in care in 19 hospitals across Spain in 2012, with ≥1 indication to start ART according to 2011 national treatment guidelines, who had not been scheduled for ART initiation. Reasons for deferring treatment were categorized as follows (non-exclusive categories): a) The physician thinks the indication is not absolute and prefers to defer it; b) The patient does not want to start it; c) The physician thinks ART must be started, but there is some limitation to starting it, and d) The patient has undetectable viral load in absence of ART. A total of 256 patients, out of 784 originally planned, were included. The large majority (84%) were male, median age 39 years, 57% MSM, 24% heterosexuals, and 16% IDUs. Median time since HIV diagnosis was 3 years, median CD4 count, 501 cells/mm3, median viral load 4.4 log copies/ml. Main ART indications were: CD4 count ART indication were on it. The most frequent barriers among those who did not receive it were physician-related, suggesting that the relevance of the conditions that indicate ART may need reinforcing. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  7. Precipitation of β′ phase and hardening in dental-casting Ag–20Pd–12Au–14.5Cu alloys subjected to aging treatments

    International Nuclear Information System (INIS)

    Kim, Yonghwan; Niinomi, Mitsuo; Hieda, Junko; Nakai, Masaaki; Cho, Ken; Fukui, Hisao

    2014-01-01

    The age-hardening behavior of the dental-casting Ag–20Pd–12Au–14.5Cu alloy subjected to aging treatment at around 673 K is well known, and this hardening has been widely employed in various applications. To date, the age-hardening of this alloy has been explained to attribute to the precipitation of a β phase, which is a B2-type ordered CuPd phase or PdCu x Zn 1−x phase. In this study, results obtained from microstructural observations using a transmission electron microscopy and a scanning transmission electron microscopy revealed that a fine L1 0 -type ordered β′ phase precipitated in the matrix and a coarse-structure region (consisting of Ag- and Cu-rich regions) appeared after aging treatment at 673 K and contributed to increase in hardness. The microstructure of the coarse β phase, which existed before aging treatment, did not change by aging treatment. Thus, it is concluded that the fine β′ phase precipitated by aging treatment contributed more to increase in hardness than the coarse-structure region and coarse β phase. - Highlights: • Hardness of Ag–20Pd–12Au–14.5Cu alloy increased significantly by aging treatment. • A fine β′ phase and a coarse structure region appeared after aging treatment. • The microstructure of a coarse β phase did not change by aging treatment. • It is considered that the fine β′ phase contributed most to age-hardening

  8. Microbial community dynamics of an urban drinking water distribution system subjected to phases of chloramination and chlorination treatments.

    Science.gov (United States)

    Hwang, Chiachi; Ling, Fangqiong; Andersen, Gary L; LeChevallier, Mark W; Liu, Wen-Tso

    2012-11-01

    Water utilities in parts of the U.S. control microbial regrowth in drinking water distribution systems (DWDS) by alternating postdisinfection methods between chlorination and chloramination. To examine how this strategy influences drinking water microbial communities, an urban DWDS (population ≅ 40,000) with groundwater as the source water was studied for approximately 2 years. Water samples were collected at five locations in the network at different seasons and analyzed for their chemical and physical characteristics and for their microbial community composition and structure by examining the 16S rRNA gene via terminal restriction fragment length polymorphism and DNA pyrosequencing technology. Nonmetric multidimension scaling and canonical correspondence analysis of microbial community profiles could explain >57% of the variation. Clustering of samples based on disinfection types (free chlorine versus combined chlorine) and sampling time was observed to correlate to the shifts in microbial communities. Sampling location and water age (chlorinated water, and Methylophilaceae, Methylococcaceae, and Pseudomonadaceae were more abundant in chloraminated water. No correlation was observed with minor populations that were detected frequently (water and survived through the treatment process. Transient microbial populations including Flavobacteriaceae and Clostridiaceae were also observed. Overall, reversible shifts in microbial communities were especially pronounced with chloramination, suggesting stronger selection of microbial populations from chloramines than chlorine.

  9. Electronic gaming machines and gambling disorder: A cross-cultural comparison between treatment-seeking subjects from Brazil and the United States.

    Science.gov (United States)

    Medeiros, Gustavo C; Leppink, Eric W; Yaemi, Ana; Mariani, Mirella; Tavares, Hermano; Grant, Jon E

    2015-12-15

    The objective of this paper is to perform a cross-cultural comparison of gambling disorder (GD) due to electronic gaming machines (EGM), a form of gambling that may have a high addictive potential. Our goal is to investigate two treatment-seeking samples of adults collected in Brazil and the United States, countries with different socio-cultural backgrounds. This comparison may lead to a better understanding of cultural influences on GD. The total studied sample involved 733 treatment-seeking subjects: 353 men and 380 women (average age=45.80, standard deviation ±10.9). The Brazilian sample had 517 individuals and the American sample 216. Subjects were recruited by analogous strategies. We found that the Brazilian sample was younger, predominantly male, less likely to be Caucasian, more likely to be partnered, tended to have a faster progression from recreational gambling to GD, and were more likely to endorse chasing losses. This study demonstrated that there are significant differences between treatment-seeking samples of adults presenting GD due to EGM in Brazil and in the United States. These findings suggest that cultural aspects may have a relevant role in GD due to EGM. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Fel d 1-derived synthetic peptide immuno-regulatory epitopes show a long-term treatment effect in cat allergic subjects.

    Science.gov (United States)

    Couroux, P; Patel, D; Armstrong, K; Larché, M; Hafner, R P

    2015-05-01

    Cat-PAD, the first in a new class of synthetic peptide immuno-regulatory epitopes (SPIREs), was shown to significantly improve rhinoconjunctivitis symptoms in subjects with cat allergy up to 1 year after the start of a short course of treatment. To evaluate the long-term effects of Cat-PAD on rhinoconjunctivitis symptoms following standardized allergen challenge 2 years after treatment. In a randomized, double-blind, placebo-controlled, parallel group study, subjects were exposed to cat allergen in an environmental exposure chamber (EEC) before and after treatment with two regimens of Cat-PAD (either eight doses of 3 nmol or four doses of 6 nmol) given intradermally over a 3-month period. In this follow-up study, changes from baseline in rhinoconjunctivitis symptoms were reassessed 2 years after the start of treatment. The primary endpoint showed a mean reduction in total rhinoconjunctivitis symptom scores of 3.85 units in the 4 × 6 nmol Cat-PAD group compared to placebo 2 years after the start of treatment (P = 0.13), and this difference was statistically significant in the secondary endpoint at the end of day 4 when the cumulative allergen challenge was greatest (P = 0.02). Consistent reductions in nasal symptoms of between 2 and 3 units were observed for 4 × 6 nmol Cat-PAD compared to placebo between the 2 and 3 h time points on days 1-4 of EEC challenge at 2 years (P Cat-PAD. This study is the first to provide evidence of a long-term therapeutic effect with this new class of SPIREs. © 2015 The Authors. Clinical & Experimental Allergy Published by John Wiley & Sons Ltd.

  11. Expanding subjectivities

    DEFF Research Database (Denmark)

    Lundgaard Andersen, Linda; Soldz, Stephen

    2012-01-01

    A major theme in recent psychoanalytic thinking concerns the use of therapist subjectivity, especially “countertransference,” in understanding patients. This thinking converges with and expands developments in qualitative research regarding the use of researcher subjectivity as a tool......-Saxon and continental traditions, this special issue provides examples of the use of researcher subjectivity, informed by psychoanalytic thinking, in expanding research understanding....

  12. Electrostatic Properties of PE and PTFE Subjected to Atmospheric Pressure Plasma Treatment; Correlation of Experimental Results with Atomistic Modeling

    Science.gov (United States)

    Trigwell, Steve; Boucher, Derrick; Calle, Carlos

    2006-01-01

    The use of an atmospheric pressure glow discharge (APGD) plasma was used at KSC to increase the hydrophilicity of spaceport materials to enhance their surface charge dissipation and prevent possible ESD in spaceport operations. Significant decreases in charge decay times were observed after tribocharging the materials using the standard KSC tribocharging test. The polarity and amount of charge transferred was dependent upon the effective work function differences between the respective materials. In this study, polyethylene (PE) and polytetrafluoroethylene (PTFE) were exposed to a He+O2 APGD. The pre and post treatment surface chemistry was analyzed by X-ray photoelectron spectroscopy and contact angle measurements. Semi-empirical and ab initio calculations were performed to correlate the experimental results with some plausible molecular and electronic structure features of the oxidation process. For the PE, significant surface oxidation was observed, as indicated by XPS showing C-O, C=O, and O-C=O bonding, and a decrease in the surface contact angle from 98.9 deg to 61.2 deg. For the PTFE, no C-O bonding appeared and the surface contact angle increased indicating the APGD only succeeded in cleaning the PTFE surface without affecting the surface structure. The calculations using the PM3 and DFT methods were performed on single and multiple oligomers to simulate a wide variety of oxidation scenarios. Calculated work function results suggest that regardless of oxidation mechanism, e.g. -OH, =0 or a combination thereof, the experimentally observed levels of surface oxidation are unlikely to lead to a significant change in the electronic structure of PE and that its increased hydrophilic properties are the primary reason for the observed changes in its electrostatic behavior. The calculations for PTFE argue strongly against significant oxidation of that material, as confirmed by the XPS results.

  13. The value of physical performance measurements alongside assessment of sarcopenia in predicting receipt and completion of planned treatment in non-small cell lung cancer: an observational exploratory study.

    Science.gov (United States)

    Collins, Jemima T; Noble, Simon; Chester, John; Davies, Helen E; Evans, William D; Farewell, Daniel; Lester, Jason F; Parry, Diane; Pettit, Rebecca; Byrne, Anthony

    2018-01-01

    The presence of muscle mass depletion is associated with poor outcomes and survival in cancer. Alongside muscle mass, assessment of muscle strength or physical performance is essential for the diagnosis of sarcopenia. Non-small cell lung cancer (NSCLC) is a prevalent form of cancer with high mortality, and Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) is commonly used to assess patients' suitability for treatment. However, a significant proportion of patients with good PS are unable to complete multidisciplinary team (MDT)-planned treatment. Little is known about the ability of objective measurements of physical performance in predicting patients' ability to complete MDT-planned treatment and outcomes in NSCLC. We sought to establish whether physical performance, utilising the short physical performance battery (SPPB), alongside muscle mass measurements, was able to predict receipt and completion of MDT-planned treatment, with a focus on chemotherapy in NSCLC. Participants with NSCLC treated through a single lung cancer MDT and ECOG PS 0-2 were recruited and the following assessed: body composition [bioelectrical impedance (BIA) and whole body dual-energy X-ray absorptiometry (DXA) in a subset], physical performance (SPPB), PS and nutritional status. We recorded receipt and completion of chemotherapy, as well as any adverse effects, hospitalisations, and treatment delays. We included a total of 62 participants with NSCLC, and in 26 of these, the MDT-planned treatment was chemotherapy. Participants with earlier stage disease and weight loss of performance by SPPB is quick and simple to do in clinical settings and may give better indication of likely chemotherapy treatment course completion than muscle mass alone and ECOG PS. In turn, this may identify specific targets for early functional intervention and impact on MDT decision-making and prudent use of resources.

  14. Periodontal treatment effects on endothelial function and cardiovascular disease biomarkers in subjects with chronic periodontitis: protocol for a randomized clinical trial

    Science.gov (United States)

    2011-01-01

    Background Periodontal disease (PD) is an infectious clinical entity characterized by the destruction of supporting tissues of the teeth as the result of a chronic inflammatory response in a susceptible host. It has been proposed that PD as subclinical infection may contribute to the etiology and to the pathogenesis of several systemic diseases including Atherosclerosis. A number of epidemiological studies link periodontal disease/edentulism as independent risk factor for acute myocardial infarction, peripheral vascular disease, and cerebrovascular disease. Moreover, new randomized controlled clinical trials have shown an improvement on cardiovascular surrogate markers (endothelial function, sICAM, hsPCR level, fibrinogen) after periodontal treatment. Nonetheless, such trials are still limited in terms of external validity, periodontal treatment strategies, CONSORT-based design and results consistency/extrapolation. The current study is designed to evaluate if periodontal treatment with scaling and root planning plus local delivered chlorhexidine improves endothelial function and other biomarkers of cardiovascular disease in subjects with moderate to severe periodontitis. Methods/Design This randomized, single-blind clinical trial will be performed at two health centers and will include two periodontal treatment strategies. After medical/periodontal screening, a baseline endothelium-dependent brachial artery flow-mediated dilatation (FMD) and other systemic surrogate markers will be obtained from all recruited subjects. Patients then will be randomized to receive either supragingival/subgingival plaque cleaning and calculus removal plus chlorhexidine (treatment group) or supragingival plaque removal only (control group). A second and third FMD will be obtained after 24 hours and 12 weeks in both treatment arms. Each group will consist of 49 patients (n = 98) and all patients will be followed-up for secondary outcomes and will be monitored through a coordinating

  15. Periodontal treatment effects on endothelial function and cardiovascular disease biomarkers in subjects with chronic periodontitis: protocol for a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Arce Roger M

    2011-02-01

    Full Text Available Abstract Background Periodontal disease (PD is an infectious clinical entity characterized by the destruction of supporting tissues of the teeth as the result of a chronic inflammatory response in a susceptible host. It has been proposed that PD as subclinical infection may contribute to the etiology and to the pathogenesis of several systemic diseases including Atherosclerosis. A number of epidemiological studies link periodontal disease/edentulism as independent risk factor for acute myocardial infarction, peripheral vascular disease, and cerebrovascular disease. Moreover, new randomized controlled clinical trials have shown an improvement on cardiovascular surrogate markers (endothelial function, sICAM, hsPCR level, fibrinogen after periodontal treatment. Nonetheless, such trials are still limited in terms of external validity, periodontal treatment strategies, CONSORT-based design and results consistency/extrapolation. The current study is designed to evaluate if periodontal treatment with scaling and root planning plus local delivered chlorhexidine improves endothelial function and other biomarkers of cardiovascular disease in subjects with moderate to severe periodontitis. Methods/Design This randomized, single-blind clinical trial will be performed at two health centers and will include two periodontal treatment strategies. After medical/periodontal screening, a baseline endothelium-dependent brachial artery flow-mediated dilatation (FMD and other systemic surrogate markers will be obtained from all recruited subjects. Patients then will be randomized to receive either supragingival/subgingival plaque cleaning and calculus removal plus chlorhexidine (treatment group or supragingival plaque removal only (control group. A second and third FMD will be obtained after 24 hours and 12 weeks in both treatment arms. Each group will consist of 49 patients (n = 98 and all patients will be followed-up for secondary outcomes and will be monitored

  16. An example of a complete treatment cycle for low- and medium-level waste at the nuclear research centre at Pupspitek-Serpong (Indonesia)

    International Nuclear Information System (INIS)

    Eymeri, M.J.; Gauthey, J.C.

    1993-01-01

    Nuclear power installations and nuclear research laboratories produce large quantities of liquid and solid waste in Indonesia. By controlling the entire waste treatment process from production to storage, TECHNICATOME has been able to set up for BATAN (BADAN TENEGA ATOM NASIONAL) the Indonesian nuclear research centre, a radioactive waste treatment plant on the PUPSPITEK site

  17. Motor Axonal Regeneration After Partial and Complete Spinal Cord Transection

    Science.gov (United States)

    Lu, Paul; Blesch, Armin; Graham, Lori; Wang, Yaozhi; Samara, Ramsey; Banos, Karla; Haringer, Verena; Havton, Leif; Weishaupt, Nina; Bennett, David; Fouad, Karim; Tuszynski, Mark H.

    2012-01-01

    We subjected rats to either partial mid-cervical or complete upper thoracic spinal cord transections and examined whether combinatorial treatments support motor axonal regeneration into and beyond the lesion. Subjects received cAMP injections into brainstem reticular motor neurons to stimulate their endogenous growth state, bone marrow stromal cell grafts in lesion sites to provide permissive matrices for axonal growth, and brain-derived neurotrophic factor (BDNF) gradients beyond the lesion to stimulate distal growth of motor axons. Findings were compared to several control groups. Combinatorial treatment generated motor axon regeneration beyond both C5 hemisection and complete transection sites. Yet despite formation of synapses with neurons below the lesion, motor outcomes worsened after partial cervical lesions and spasticity worsened after complete transection. These findings highlight the complexity of spinal cord repair, and the need for additional control and shaping of axonal regeneration. PMID:22699902

  18. Treatment options for subjective tinnitus: Self reports from a sample of general practitioners and ENT physicians within Europe and the USA

    Directory of Open Access Journals (Sweden)

    Hall Deborah A

    2011-11-01

    Full Text Available Abstract Background Tinnitus affects about 10-15% of the general population and risks for developing tinnitus are rising through increased exposure to leisure noise through listening to personal music players at high volume. The disorder has a considerable heterogeneity and so no single mechanism is likely to explain the presence of tinnitus in all those affected. As such there is no standardized management pathway nor singly effective treatment for the condition. Choice of clinical intervention is a multi-factorial decision based on many factors, including assessment of patient needs and the healthcare context. The present research surveyed clinicians working in six Westernized countries with the aims: a to establish the range of referral pathways, b to evaluate the typical treatment options for categories of subjective tinnitus defined as acute or chronic, and c to seek clinical opinion about levels of satisfaction with current standards of practice. Methods A structured online questionnaire was conducted with 712 physicians who reported seeing at least one tinnitus patients in the previous three months. They were 370 general practitioners (GPs and 365 ear-nose-throat specialists (ENTs from the US, Germany, UK, France, Italy and Spain. Results Our international comparison of health systems for tinnitus revealed that although the characteristics of tinnitus appeared broadly similar across countries, the patient's experience of clinical services differed widely. GPs and ENTs were always involved in referral and management to some degree, but multi-disciplinary teams engaged either neurology (Germany, Italy and Spain or audiology (UK and US professionals. For acute subjective tinnitus, pharmacological prescriptions were common, while audiological and psychological approaches were more typical for chronic subjective tinnitus; with several specific treatment options being highly country specific. All therapy options were associated with low levels

  19. Impact of age and comorbidity on treatment of non-small cell lung cancer recurrence following complete resection: A nationally representative cohort study

    Science.gov (United States)

    Wong, Melisa L.; McMurry, Timothy L.; Stukenborg, George J.; Francescatti, Amanda B.; Amato-Martz, Carla; Schumacher, Jessica R.; Chang, George J.; Greenberg, Caprice C.; Winchester, David P.; McKellar, Daniel P.; Walter, Louise C.; Kozower, Benjamin D.

    2016-01-01

    Objective Older patients with non-small cell lung cancer (NSCLC) are less likely to receive guideline-recommended treatment at diagnosis, independent of comorbidity. However, national data on treatment of postoperative recurrence are limited. We evaluated the associations between age, comorbidity, and other patient factors and treatment of postoperative NSCLC recurrence in a national cohort. Materials and Methods We randomly selected 9,001 patients with surgically resected stage I-III NSCLC in 2006–2007 from the National Cancer Data Base. Patients were followed for 5 years or until first NSCLC recurrence, new primary cancer, or death, whichever came first. Perioperative comorbidities, first recurrence, treatment of recurrence, and survival were abstracted from medical records and merged with existing registry data. Factors associated with active treatment (chemotherapy, radiation, and/or surgery) versus supportive care only were analyzed using multivariable logistic regression. Results Median age at initial diagnosis was 67; 69.7% had ≥1 comorbidity. At 5-year follow-up, 12.3% developed locoregional and 21.5% developed distant recurrence. Among patients with locoregional recurrence, 79.5% received active treatment. Older patients (OR 0.49 for age ≥75 compared with <55; 95% CI 0.27–0.88) and those with substance abuse (OR 0.43; 95% CI 0.23–0.81) were less likely to receive active treatment. Women (OR 0.62; 95% CI 0.43–0.89) and patients with symptomatic recurrence (OR 0.69; 95% CI 0.47–0.99) were also less likely to receive active treatment. Among those with distant recurrence, 77.3% received active treatment. Older patients (OR 0.42 for age ≥75 compared with <55; 95% CI 0.26–0.68) and those with any documented comorbidities (OR 0.59; 95% CI 0.38–0.89) were less likely to receive active treatment. Conclusion Older patients independent of comorbidity, patients with substance abuse, and women were less likely to receive active treatment for

  20. Comparing case-control study for treatment of proximal tibia fractures with a complete metaphyseal component in two centers with different distinct strategies

    DEFF Research Database (Denmark)

    Berven, Haakon; Brix, Michael; Izadpanah, Kaywan

    2018-01-01

    BACKGROUND: The purpose of this study was to compare two methods of stabilization for proximal tibia fractures (AO 41) with a complete metaphyseal component, external fixation with the Ilizarov wire frame, and internal fixation with locking plates. METHODS: Patients from two level 1 trauma centers...

  1. Unified treatment of complete orthonormal sets for wave functions, and Slater orbitals of particles with arbitrary spin in coordinate, momentum and four-dimensional spaces

    International Nuclear Information System (INIS)

    Guseinov, I.I.

    2007-01-01

    The new analytical relations of complete orthonormal sets for the tensor wave functions and the tensor Slater orbitals of particles with arbitrary spin in coordinate, momentum and four-dimensional spaces are derived using the properties of tensor spherical harmonics and complete orthonormal scalar basis sets of ψ α -exponential type orbitals, φ α -momentum space orbitals and z α -hyperspherical harmonics introduced by the author for particles with spin s=0, where the α=1,0,-1,-2,.... All of the tensor wave functions obtained are complete without the inclusion of the continuum and, therefore, their group of transformations is the four-dimensional rotation group O(4). The analytical formulas in coordinate space are also derived for the overlap integrals over tensor Slater orbitals with the same screening constant. We notice that the new idea presented in this work is the combination of tensor spherical harmonics of rank s with complete orthonormal scalar sets for radial parts of ψ α -, φ α - and z α -orbitals, where s=1/2,1,3/2,2,...

  2. Orthodontic Treatment Combined with Orthognathic Surgery and Simultaneous Alveolar Bone Graft of a Unilateral Complete Cleft Lip and Palate Patient: A Case Report.

    Science.gov (United States)

    Pisek, Poonsak; Manosudprasit, Montian; Wangsrimongkol, Tasanee; Jinaporntham, Suthin; Wiwatworakul, Opas

    2015-08-01

    This article aimed to present a case of 22 year-old Thai female with cleft lip and palate who had malocclusion developed from dental problems, skeletal disharmony and unrepaired alveolar cleft. The treatment was orthodontic combined with one-stage surgical correction which corrected skeletal discrepancy and alveolar cleft in single operation. After treatment, the patient had improved in facial esthetics, attaining good occlusal function and continuous maxillary dental arch. This procedure can reduce morbidity, preclude a second hospitalization and the cost of two-stage surgical correction. However this is only an alternative treatment for adult cleft patients who need late alveolar bone graft and orthognathic surgery.

  3. Immune-Inflammatory and Metabolic Effects of High Dose Furosemide plus Hypertonic Saline Solution (HSS Treatment in Cirrhotic Subjects with Refractory Ascites.

    Directory of Open Access Journals (Sweden)

    Antonino Tuttolomondo

    Full Text Available Patients with chronic liver diseases are usually thin as a result of hypermetabolism and malnutrition expressed by reduced levels of leptin and impairment of other adyponectins such as visfatin.We evaluated the metabolic and inflammatory effects of intravenous high-dose furosemide plus hypertonic saline solutions (HSS compared with repeated paracentesis and a standard oral diuretic schedule, in patients with cirrhosis and refractory ascites.59 consecutive cirrhotic patients with refractory ascites unresponsive to outpatient treatment. Enrolled subjects were randomized to treatment with intravenous infusion of furosemide (125-250mg⁄bid plus small volumes of HSS from the first day after admission until 3 days before discharge (Group A, n:38, or repeated paracentesis from the first day after admission until 3 days before discharge (Group B, n: 21. Plasma levels of ANP, BNP, Leptin, visfatin, IL-1β, TNF-a, IL-6 were measured before and after the two type of treatment.Subjects in group A were observed to have a significant reduction of serum levels of TNF-α, IL-1β, IL-6, ANP, BNP, and visfatin, thus regarding primary efficacy endpoints, in Group A vs. Group B we observed higher Δ-TNF-α, Δ-IL-1β, Δ-IL-6, Δ-ANP, Δ-BNP, Δ-visfatin, Δ-Leptin at discharge.Our findings underline the possible inflammatory and metabolic effect of saline overload correction in treatment of cirrhosis complications such as refractory ascites, suggesting a possible role of inflammatory and metabolic-nutritional variables as severity markers in these patients.

  4. Substantially Modified Ratios of Effector to Regulatory T Cells During Chemotherapy in Ovarian Cancer Patients Return to Pre-Treatment Levels at Completion: Implications for Immunotherapy

    International Nuclear Information System (INIS)

    Park, Anthony; Govindaraj, Chindu; Xiang, Sue D.; Halo, Julene; Quinn, Michael; Scalzo-Inguanti, Karen; Plebanski, Magdalena

    2012-01-01

    Ovarian cancer is the leading cause of death from gynaecological malignancy. Despite improved detection and treatment options, relapse rates remain high. Combining immunotherapy with the current standard treatments may provide an improved prognosis, however, little is known about how standard chemotherapy affects immune potential (particularly T cells) over time, and hence, when to optimally combine it with immunotherapy (e.g., vaccines). Herein, we assess the frequency and ratio of CD8+ central memory and effector T cells as well as CD4+ effector and regulatory T cells (Tregs) during the first 18 weeks of standard chemotherapy for ovarian cancer patients. In this pilot study, we observed increased levels of recently activated Tregs with tumor migrating ability (CD4+CD25 hi Foxp3+CD127−CCR4+CD38+ cells) in patients when compared to controls. Although frequency changes of Tregs as well as the ratio of effector T cells to Tregs were observed during treatment, the Tregs consistently returned to pre-chemotherapy levels at the end of treatment. These results indicate T cell subset distributions associated with recurrence may be largely resistant to being “re-set” to healthy control homeostatic levels following standard treatments. However, it may be possible to enhance T effector to Treg ratios transiently during chemotherapy. These results suggest personalized immune monitoring maybe beneficial when combining novel immuno-therapeutics with standard treatment for ovarian cancer patients

  5. Substantially Modified Ratios of Effector to Regulatory T Cells During Chemotherapy in Ovarian Cancer Patients Return to Pre-Treatment Levels at Completion: Implications for Immunotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Park, Anthony; Govindaraj, Chindu; Xiang, Sue D., E-mail: Sue.Xiang@monash.edu [Department of Immunology, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria 3004 (Australia); Halo, Julene; Quinn, Michael [Department of Oncology, Royal Women’s Hospital, Melbourne, Victoria 3052 (Australia); Scalzo-Inguanti, Karen; Plebanski, Magdalena, E-mail: Sue.Xiang@monash.edu [Department of Immunology, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria 3004 (Australia)

    2012-06-18

    Ovarian cancer is the leading cause of death from gynaecological malignancy. Despite improved detection and treatment options, relapse rates remain high. Combining immunotherapy with the current standard treatments may provide an improved prognosis, however, little is known about how standard chemotherapy affects immune potential (particularly T cells) over time, and hence, when to optimally combine it with immunotherapy (e.g., vaccines). Herein, we assess the frequency and ratio of CD8+ central memory and effector T cells as well as CD4+ effector and regulatory T cells (Tregs) during the first 18 weeks of standard chemotherapy for ovarian cancer patients. In this pilot study, we observed increased levels of recently activated Tregs with tumor migrating ability (CD4+CD25{sup hi}Foxp3+CD127−CCR4+CD38+ cells) in patients when compared to controls. Although frequency changes of Tregs as well as the ratio of effector T cells to Tregs were observed during treatment, the Tregs consistently returned to pre-chemotherapy levels at the end of treatment. These results indicate T cell subset distributions associated with recurrence may be largely resistant to being “re-set” to healthy control homeostatic levels following standard treatments. However, it may be possible to enhance T effector to Treg ratios transiently during chemotherapy. These results suggest personalized immune monitoring maybe beneficial when combining novel immuno-therapeutics with standard treatment for ovarian cancer patients.

  6. Changes in medical treatment six months after risk stratification with HeartScore and coronary artery calcification scanning of healthy middle-aged subjects

    DEFF Research Database (Denmark)

    Sørensen, Mette Hjortdal; Gerke, Oke; Lambrechtsen, Jess

    2012-01-01

    Objectives: The aim was to examine and compare the impact of HeartScore and coronary artery calcification (CAC) score on subsequent changes in the use of medication. Methods: A total of 1156 healthy men and women, aged 50 or 60, had a baseline medical examination and a coronary artery CT-scan as ......Objectives: The aim was to examine and compare the impact of HeartScore and coronary artery calcification (CAC) score on subsequent changes in the use of medication. Methods: A total of 1156 healthy men and women, aged 50 or 60, had a baseline medical examination and a coronary artery CT......-up questionnaires addressing current medication were mailed to the participants. Results: A completed questionnaire was returned by 1075 (93%) subjects. At follow up, the overall use of prophylactic medication was significantly increased. Of those with CAC (n = 462) or high HeartScore (n = 233), 21 and 19...

  7. Treatment outcome and long-term stability of skeletal changes following maxillary distraction in adult subjects of cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Satinder Pal Singh

    2012-01-01

    Full Text Available Aim : To evaluate the treatment outcome and long-term stability of skeletal changes following maxillary advancement with distraction osteogenesis in adult subjects of cleft lip and palate. Materials and Methods: Total 12 North Indian adult patients in the age range of 17-34 years with cleft lip and palate underwent advancement of maxilla by distraction osteogenesis. Lateral cephalograms recorded prior to distraction, at the end of distraction, 6 months after distraction, and at least 24 months (mean 25.5 ± 1.94 months after distraction osteogenesis were used for the evaluation of treatment outcome and long-term stability of the skeletal changes. Descriptive analysis, ANOVA, and post-hoc test were used, and P-value 0.05 was considered as a statistically significant level. Results: Maxillary distraction resulted in significant advancement of maxilla (P<0.001. Counterclockwise rotation of the palatal plane took place after maxillary distraction. The position of the mandible and facial heights were stable during distraction. During the first 6 months of the post-distraction period, the maxilla showed relapse of approximately 30%. However, after 6 months post distraction, the relapse was very negligible. Conclusions: Successful advancement of maxilla was achieved by distraction osteogenesis in adult subjects with cleft lip and palate. Most of the relapse occurred during the first 6 months of post-distraction period, and after that the outcomes were stable.

  8. Treatment outcome and long-term stability of skeletal changes following maxillary distraction in adult subjects of cleft lip and palate.

    Science.gov (United States)

    Singh, Satinder Pal; Jena, Ashok Kumar; Rattan, Vidya; Utreja, Ashok Kumar

    2012-04-01

    To evaluate the treatment outcome and long-term stability of skeletal changes following maxillary advancement with distraction osteogenesis in adult subjects of cleft lip and palate. Total 12 North Indian adult patients in the age range of 17-34 years with cleft lip and palate underwent advancement of maxilla by distraction osteogenesis. Lateral cephalograms recorded prior to distraction, at the end of distraction, 6 months after distraction, and at least 24 months (mean 25.5 ± 1.94 months) after distraction osteogenesis were used for the evaluation of treatment outcome and long-term stability of the skeletal changes. Descriptive analysis, ANOVA, and post-hoc test were used, and P-value 0.05 was considered as a statistically significant level. Maxillary distraction resulted in significant advancement of maxilla (Pmaxillary distraction. The position of the mandible and facial heights were stable during distraction. During the first 6 months of the post-distraction period, the maxilla showed relapse of approximately 30%. However, after 6 months post distraction, the relapse was very negligible. Successful advancement of maxilla was achieved by distraction osteogenesis in adult subjects with cleft lip and palate. Most of the relapse occurred during the first 6 months of post-distraction period, and after that the outcomes were stable.

  9. Reward-related brain response and craving correlates of marijuana cue exposure: a preliminary study in treatment-seeking marijuana-dependent subjects.

    Science.gov (United States)

    Goldman, Marina; Szucs-Reed, Regina P; Jagannathan, Kanchana; Ehrman, Ronald N; Wang, Ze; Li, Yin; Suh, Jesse J; Kampman, Kyle; O'Brien, Charles P; Childress, Anna Rose; Franklin, Teresa R

    2013-01-01

    : Determining the brain substrates underlying the motivation to abuse addictive drugs is critical for understanding and treating addictive disorders. Laboratory neuroimaging studies have demonstrated differential activation of limbic and motivational circuitry (eg, amygdala, hippocampus, ventral striatum, insula, and orbitofrontal cortex) triggered by cocaine, heroin, nicotine, and alcohol cues. The literature on neural responses to marijuana cues is sparse. Thus, the goals of this study were to characterize the brain's response to marijuana cues, a major motivator underlying drug use and relapse, and determine whether these responses are linked to self-reported craving in a clinically relevant population of treatment-seeking marijuana-dependent subjects. : Marijuana craving was assessed in 12 marijuana-dependent subjects using the Marijuana Craving Questionnaire-Short Form. Subsequently, blood oxygen level dependent functional magnetic resonance imaging data were acquired during exposure to alternating 20-second blocks of marijuana-related versus matched nondrug visual cues. : Brain activation during marijuana cue exposure was significantly greater in the bilateral amygdala and the hippocampus. Significant positive correlations between craving scores and brain activation were found in the ventral striatum and the medial and lateral orbitofrontal cortex (P cues and craving and extends the current literature on marijuana cue reactivity. Furthermore, the correlative relationship between craving and brain activity in reward-related regions was observed in a clinically relevant sample (treatment-seeking marijuana-dependent subjects). Results are consistent with prior findings in cocaine, heroin, nicotine, and alcohol cue studies, indicating that the brain substrates of cue-triggered drug motivation are shared across abused substances.

  10. Prolonged-release fampridine treatment improved subject-reported impact of multiple sclerosis: Item-level analysis of the MSIS-29.

    Science.gov (United States)

    Gasperini, Claudio; Hupperts, Raymond; Lycke, Jan; Short, Christine; McNeill, Manjit; Zhong, John; Mehta, Lahar R

    2016-11-15

    Prolonged-release (PR) fampridine is approved to treat walking impairment in persons with multiple sclerosis (MS); however, treatment benefits may extend beyond walking. MOBILE was a phase 2, 24-week, double-blind, placebo-controlled exploratory study to assess the impact of 10mg PR-fampridine twice daily versus placebo on several subject-assessed measures. This analysis evaluated the physical and psychological health outcomes of subjects with progressing or relapsing MS from individual items of the Multiple Sclerosis Impact Scale (MSIS-29). PR-fampridine treatment (n=68) resulted in greater improvements from baseline in the MSIS-29 physical (PHYS) and psychological (PSYCH) impact subscales, with differences of 89% and 148% in mean score reduction from baseline (n=64) at week 24 versus placebo, respectively. MSIS-29 item analysis showed that a higher percentage of PR-fampridine subjects had mean improvements in 16/20 PHYS and 6/9 PSYCH items versus placebo after 24weeks. Post hoc analysis of the 12-item Multiple Sclerosis Walking Scale (MSWS-12) improver population (≥8-point mean improvement) demonstrated differences in mean reductions from baseline of 97% and 111% in PR-fampridine MSIS-29 PHYS and PSYCH subscales versus the overall placebo group over 24weeks. A higher percentage of MSWS-12 improvers treated with PR-fampridine showed mean improvements in 20/20 PHYS and 8/9 PSYCH items versus placebo at 24weeks. In conclusion, PR-fampridine resulted in physical and psychological benefits versus placebo, sustained over 24weeks. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  11. Maintenance treatment with azacytidine for patients with high-risk myelodysplastic syndromes (MDS) or acute myeloid leukaemia following MDS in complete remission after induction chemotherapy

    DEFF Research Database (Denmark)

    Grövdal, Michael; Karimi, Mohsen; Khan, Rasheed

    2010-01-01

    chemotherapy. Sixty patients were enrolled and treated by standard induction chemotherapy. Patients that reached CR started maintenance therapy with subcutaneous azacytidine, 5/28 d until relapse. Promoter-methylation status of CDKN2B (P15 ink4b), CDH1 and HIC1 was examined pre-induction, in CR and 6, 12...... and 24 months post CR. Twenty-four (40%) patients achieved CR after induction chemotherapy and 23 started maintenance treatment with azacytidine. Median CR duration was 13.5 months, >24 months in 17% of the patients, and 18-30.5 months in the four patients with trisomy 8. CR duration was not associated......-IV thrombocytopenia and neutropenia occurred after 9.5 and 30% of the cycles, respectively, while haemoglobin levels increased during treatment. 5-azacytidine treatment is safe, feasible and may be of benefit in a subset of patients....

  12. Effect of Hydroxychloroquine Treatment on Dry Eyes in Subjects with Primary Sjögren's Syndrome: a Double-Blind Randomized Control Study.

    Science.gov (United States)

    Yoon, Chang Ho; Lee, Hyun Ju; Lee, Eun Young; Lee, Eun Bong; Lee, Won-Woo; Kim, Mee Kum; Wee, Won Ryang

    2016-07-01

    The effect of hydroxychloroquine (HCQ) on dry eye has not been fully determined. This study aimed to compare the 12-week efficacy of HCQ medication with that of a placebo in the management of dry eye in primary Sjögren's syndrome (pSS). A double-blind, randomized control study was conducted in 39 pSS subjects from May 2011 through August 2013. pSS was diagnosed based on the classification criteria of the American-European Consensus Group. Subjects received 300 mg of HCQ or placebo once daily for 12 weeks and were evaluated at baseline, 6, and 12 weeks, with a re-visit at 16 weeks after drug discontinuance. The fluorescein staining score, Schirmer test score, tear film break-up time (TBUT), and ocular surface disease index (OSDI) were measured, and tears and blood were collected for ESR, IL-6, IL-17, B-cell activating factor (BAFF), and Th17 cell analysis. Color testing was performed and the fundus was examined to monitor HCQ complications. Twenty-six subjects completed the follow-up. The fluorescein staining score and Schirmer test score did not differ significantly. The OSDI improved with medication in the HCQ group but was not significantly different between the groups. TBUT, serum IL-6, ESR, serum and tear BAFF, and the proportion of Th17 cells did not change in either group. HCQ at 300 mg daily for 12 weeks has no apparent clinical benefit for dry eye and systemic inflammation in pSS (ClinicalTrials.gov. NCT01601028).

  13. Effect of Hydroxychloroquine Treatment on Dry Eyes in Subjects with Primary Sjögren’s Syndrome: a Double-Blind Randomized Control Study

    Science.gov (United States)

    2016-01-01

    The effect of hydroxychloroquine (HCQ) on dry eye has not been fully determined. This study aimed to compare the 12-week efficacy of HCQ medication with that of a placebo in the management of dry eye in primary Sjögren's syndrome (pSS). A double-blind, randomized control study was conducted in 39 pSS subjects from May 2011 through August 2013. pSS was diagnosed based on the classification criteria of the American-European Consensus Group. Subjects received 300 mg of HCQ or placebo once daily for 12 weeks and were evaluated at baseline, 6, and 12 weeks, with a re-visit at 16 weeks after drug discontinuance. The fluorescein staining score, Schirmer test score, tear film break-up time (TBUT), and ocular surface disease index (OSDI) were measured, and tears and blood were collected for ESR, IL-6, IL-17, B-cell activating factor (BAFF), and Th17 cell analysis. Color testing was performed and the fundus was examined to monitor HCQ complications. Twenty-six subjects completed the follow-up. The fluorescein staining score and Schirmer test score did not differ significantly. The OSDI improved with medication in the HCQ group but was not significantly different between the groups. TBUT, serum IL-6, ESR, serum and tear BAFF, and the proportion of Th17 cells did not change in either group. HCQ at 300 mg daily for 12 weeks has no apparent clinical benefit for dry eye and systemic inflammation in pSS (ClinicalTrials.gov. NCT01601028). PMID:27366013

  14. Prospective assessment of nocturnal awakenings in a case series of treatment-seeking chronic insomnia patients: a pilot study of subjective and objective causes.

    Science.gov (United States)

    Krakow, Barry; Romero, Edward; Ulibarri, Victor A; Kikta, Shara

    2012-12-01

    The cause of nocturnal awakenings in patients with chronic insomnia is rarely researched. This study prospectively assessed the etiology of nocturnal awakenings (subjectively and objectively) among patients with insomnia at a private, community-based sleep medical center. Twenty adult patients with chronic insomnia enrolled between April 2008 and February 2010 met diagnostic criteria for an insomnia disorder, never previously visited a sleep specialist or underwent sleep testing, and reported no classic sleep disordered breathing symptoms. Patients completed validated scales for insomnia, sleepiness, impairment, anxiety, depression, and quality of life, a qualitative interview to assess subjective reasons for awakenings, and a diagnostic sleep study to objectively assess awakenings and their precipitants. Subjective and objective data showed clinically meaningful insomnia, primarily sleep maintenance insomnia. The most common self-reported reasons for awakenings were: uncertain cause (50%), nightmares (45%), nocturia (35%), bedroom distractions (20%), or pain (15%). No patient identified breathing symptoms as a cause. Objectively, 531 awakenings were observed in the total sample, and 478 (90%) were preceded by sleep breathing events (apnea, hypopnea, or respiratory effort-related event). Fifty-three awakenings were caused by other factors (independent leg jerks [7], spontaneous [14], and sleep that was laboratory-induced [32]). Thirty awakenings ≥ 5 min-a duration sufficient to predispose toward an insomnia episode-were each preceded by a breathing event. Among patients with insomnia with no classic sleep breathing symptoms and therefore low probability of a sleep breathing disorder, most of their awakenings were precipitated by a medical condition (sleep disordered breathing), which contrasted sharply with their perceptions about their awakenings

  15. Completely continuous and weakly completely continuous abstract ...

    Indian Academy of Sciences (India)

    An algebra A is called right completely continuous (right weakly completely continuous) ... Moreover, some applications of these results in group algebras are .... A linear subspace S(G) of L1(G) is said to be a Segal algebra, if it satisfies the.

  16. Subjective evaluation of psychosocial well-being in children and youths with overweight or obesity: the impact of multidisciplinary obesity treatment.

    Science.gov (United States)

    Fonvig, Cilius Esmann; Hamann, Sophie Amalie; Nielsen, Tenna Ruest Haarmark; Johansen, Mia Østergaard; Grønbæk, Helle Nergaard; Mollerup, Pernille Maria; Holm, Jens-Christian

    2017-12-01

    To investigate the effects of a multidisciplinary childhood obesity treatment programme on subjective evaluations of psychosocial well-being and quality of life. This longitudinal observational study included 1291 children, adolescents and young adults, 6-22 years of age, with overweight or obesity. At entry and after 2-82 months of obesity treatment, the patients evaluated the following domains of psychosocial well-being on a visual analogue scale: quality of life, mood, appetite, bullying, motivation for weight loss and body image satisfaction. The degree of overweight was calculated using a body mass index (BMI) standard deviation score (SDS) at each visit. At entry, the mean BMI SDS was 2.81 (range: 1.35-6.65, 95% confidence interval (95% CI): 2.44-3.18). After a median of 14 months of treatment, the median reduction in BMI SDS was 0.29 (95% CI: 0.26-0.31, p bullying and body image satisfaction (p < 0.0001). Larger reductions in BMI SDS were associated with greater improvements in the domains of quality of life (p = 0.001), mood (p = 0.04) and body image satisfaction (p < 0.0001), independent of BMI SDS at entry. However, improvements in psychosocial well-being were also observed in those increasing their BMI SDS (n = 315). In a large group of children and youths, psychosocial well-being improved during a multidisciplinary childhood obesity treatment programme, irrespective of the degree of obesity at treatment entry. Greater reductions in BMI SDS were associated with greater improvements in psychosocial well-being, but even in the group increasing their BMI SDS improvements were observed.

  17. Effects of dexamethasone treatment and respiratory vaccination on rectal temperature, complete blood count, and functional capacities of neutrophils in beef steers

    Science.gov (United States)

    The objective of this research was to examine the effects of dexamethasone (DEX) treatment on various aspects of immunity following administration of a multivalent respiratory vaccine, using a model intended to mimic acute versus chronic stress. Angus × Hereford steers (n = 32; 209 ± 8 kg) were str...

  18. Complete resolution of minocycline pigmentation following a single treatment with non-ablative 1550-nm fractional resurfacing in combination with the 755-nm Q-switched alexandrite laser.

    Science.gov (United States)

    Vangipuram, Ramya K; DeLozier, Whitney L; Geddes, Elizabeth; Friedman, Paul M

    2016-03-01

    Pigmentation secondary to minocycline ingestion is an uncommon adverse event affecting 3.7-14.8% of treated individuals for which few effective therapies are available. Three patterns of minocycline pigmentation have a characteristic clinical and histological appearance. The pigment composition in each variety is different and occurs at varying skin depths. Accordingly, a tailored approach according to the type of minocycline pigmentation is crucial for treatment success. The purpose of this intervention was to evaluate the efficacy of non-ablative fractional photothermolysis in combination with the Q-switched alexandrite laser for the treatment of type I minocycline pigmentation on the face. A patient with type I minocycline pigmentation was treated with non-ablative 1550-nm fractional photothermolysis followed immediately by 755-nm Q-switched alexandrite laser and then observed clinically to determine the outcome of this modality. The patient was seen in clinic 1 month later following her single treatment session and 100% clearance of all blue facial pigment was observed. Non-ablative fractional photothermolysis in combination with the 755-nm Q-switched alexandrite laser should be considered for treatment of type I minocycline pigmentation. © 2015 Wiley Periodicals, Inc.

  19. Structural Completeness in Fuzzy Logics

    Czech Academy of Sciences Publication Activity Database

    Cintula, Petr; Metcalfe, G.

    2009-01-01

    Roč. 50, č. 2 (2009), s. 153-183 ISSN 0029-4527 R&D Projects: GA MŠk(CZ) 1M0545 Institutional research plan: CEZ:AV0Z10300504 Keywords : structral logics * fuzzy logics * structural completeness * admissible rules * primitive variety * residuated lattices Subject RIV: BA - General Mathematics

  20. A case of the interval form of carbon monoxide poisoning with apallic syndrome resulted in complete recovery after treatment with oxygen at high pressure

    International Nuclear Information System (INIS)

    Matsuishi, Takeshi; Motomura, Hiroshi; Boku, Shoji; Mori, Koichi.

    1984-01-01

    A 44-year-old male patient had apallic syndrome 32 days after 12-hour coma resulting from acute carbon monoxide poisoning and could return to the social life by undergoing fifty oxygen treatments at high pressure. EEG revealed no low voltage, which is usually seen in cases of apallic syndrome. Cranial CT scan revealed that low density areas in the white matter of the brain had improved with improvement of clinical symptoms. (Namekawa, K.)

  1. Complete atrioventricular canal.

    Science.gov (United States)

    Calabrò, Raffaele; Limongelli, Giuseppe

    2006-04-05

    Complete atrioventricular canal (CAVC), also referred to as complete atrioventricular septal defect, is characterised by an ostium primum atrial septal defect, a common atrioventricular valve and a variable deficiency of the ventricular septum inflow. CAVC is an uncommon congenital heart disease, accounting for about 3% of cardiac malformations. Atrioventricular canal occurs in two out of every 10,000 live births. Both sexes are equally affected and a striking association with Down syndrome was found. Depending on the morphology of the superior leaflet of the common atrioventricular valve, 3 types of CAVC have been delineated (type A, B and C, according to Rastelli's classification). CAVC results in a significant interatrial and interventricular systemic-to-pulmonary shunt, thus inducing right ventricular pressure and volume overload and pulmonary hypertension. It becomes symptomatic in infancy due to congestive heart failure and failure to thrive. Diagnosis of CAVC might be suspected from electrocardiographic and chest X-ray findings. Echocardiography confirms it and gives anatomical details. Over time, pulmonary hypertension becomes irreversible, thus precluding the surgical therapy. This is the reason why cardiac catheterisation is not mandatory in infants (less than 6 months) but is indicated in older patients if irreversible pulmonary hypertension is suspected. Medical treatment (digitalis, diuretics, vasodilators) plays a role only as a bridge toward surgery, usually performed between the 3rd and 6th month of life.

  2. Complete atrioventricular canal

    Directory of Open Access Journals (Sweden)

    Limongelli Giuseppe

    2006-04-01

    Full Text Available Abstract Complete atrioventricular canal (CAVC, also referred to as complete atrioventricular septal defect, is characterised by an ostium primum atrial septal defect, a common atrioventricular valve and a variable deficiency of the ventricular septum inflow. CAVC is an uncommon congenital heart disease, accounting for about 3% of cardiac malformations. Atrioventricular canal occurs in two out of every 10,000 live births. Both sexes are equally affected and a striking association with Down syndrome was found. Depending on the morphology of the superior leaflet of the common atrioventricular valve, 3 types of CAVC have been delineated (type A, B and C, according to Rastelli's classification. CAVC results in a significant interatrial and interventricular systemic-to-pulmonary shunt, thus inducing right ventricular pressure and volume overload and pulmonary hypertension. It becomes symptomatic in infancy due to congestive heart failure and failure to thrive. Diagnosis of CAVC might be suspected from electrocardiographic and chest X-ray findings. Echocardiography confirms it and gives anatomical details. Over time, pulmonary hypertension becomes irreversible, thus precluding the surgical therapy. This is the reason why cardiac catheterisation is not mandatory in infants (less than 6 months but is indicated in older patients if irreversible pulmonary hypertension is suspected. Medical treatment (digitalis, diuretics, vasodilators plays a role only as a bridge toward surgery, usually performed between the 3rd and 6th month of life.

  3. [Treatment of complete acromioclavicular joint dislocation with transfer of the medial half of the coracoacromial ligament to reconstruct the coracoclavicular ligament].

    Science.gov (United States)

    Dong, Wen-Wei; Shi, Zeng-Yuan; Liu, Zheng-Xin; Mao, Hai-Jiao

    2015-04-01

    To explore the operation methods and clinical effects of transfer of the medial half of the coracoacromial ligament to reconstruct the coracoclavicular ligament in treating complete acromioclavicular joint dislocation. From January 2006 to June 2012,26 patients with acute complete acromioclavicular joint dislocation underwent surgery. Transfer of the medial half of the coracoacromial ligament to reconstruct the coracoclavicular ligament, additional clavical hoot plate and Kirschner wires fixation, were performed in all the patients. Among the patients, 18 patients were male and 8 patients were female, with an average age of 36.7 years old (ranged from 25 to 51 years). The duration from injury to operation was from 3 to 12 days with an average of 5 days. According to the Rockwood classification, 4 cases were grade III and 22 cases were grade V . Clinical manifestation included local swelling, tenderness with snapping, limitation of shoulder joint motion. In preoperative bilateral shoulder joint X-rays, the injured coracoclavicular distance was (16.2 ± 5.0) mm which was significantly wider than that of uninjured sides (7.6 ± 1.0) mm. Clinical results were evaluated according to X-rays and Constant-Murley score. All incisions obtained primary healing after operation without complication of infection, internal fixation breakage, redislocation. All the patients were followed up from 12 to 30 months with an average of 18 months. Kirschner wires and internal fixation plate were removed at 1 month and 8-10 months after operation, respectively. At final follow-up, the motion of shoulder joint recovered to normal and a no pain joint was obtained. According to Constant-Murley score, 24 cases got excellent results and 2 cases good. There was no significant difference after operation between the injured coracoclavicular distance and the uninjured contralateral side [(7.7 ± 1.2) mm vs (7.6 ± 1.0) mm), P > 0.05]. Transfer of the medial half of the coracoacromial ligament to

  4. Modifying the Sleep Treatment Education Program for Students to include technology use (STEPS-TECH): Intervention effects on objective and subjective sleep outcomes.

    Science.gov (United States)

    Barber, Larissa K; Cucalon, Maria S

    2017-12-01

    University students often have sleep issues that arise from poor sleep hygiene practices and technology use patterns. Yet, technology-related behaviors are often neglected in sleep hygiene education. This study examined whether the Sleep Treatment Education Program for Students-modified to include information regarding managing technology use (STEPS-TECH)-helps improve both subjective and objective sleep outcomes among university students. Results of an experimental study among 78 university students showed improvements in objective indicators of sleep quantity (total sleep time) and sleep quality (less awakenings) during the subsequent week for students in the STEPS-TECH intervention group compared to a control group. Exploratory analyses indicated that effects were driven by improvements in weekend days immediately following the intervention. There were also no intervention effects on subjective sleep quality or quantity outcomes. In terms of self-reported behavioral responses to educational content in the intervention, there were no group differences in sleep hygiene practices or technology use before bedtime. However, the intervention group reported less technology use during sleep periods than the control group. These preliminary findings suggest that STEPS-TECH may be a useful educational tool to help improve objective sleep and reduce technology use during sleep periods among university students. Copyright © 2017 John Wiley & Sons, Ltd.

  5. Dental compensation for skeletal Class III malocclusion by isolated extraction of mandibular teeth. Part 1: Occlusal situation 12 years after completion of active treatment.

    Science.gov (United States)

    Zimmer, Bernd; Schenk-Kazan, Sarah

    2015-05-01

    The purpose of this work was to statistically evaluate the outcomes achieved by isolated extraction of mandibular teeth (second premolars or first molars) for Class III compensation. Part A of the study dealt with the quality of outcomes at the end of active treatment, using weighted Peer Assessment Rating (PAR) scores determined on the basis of casts for 25 (14 female and 11 male) consecutive patients aged 16 ± 1.7 years at the time of debonding. These results were compared to the scores in a randomly selected control group of 25 (14 female and 11 male) patients who were 14.7 ± 1.9 years old at debonding. Part B evaluated the long-term stability of the outcomes based on 12 (all of them female) patients available for examination after a mean of 11.8 years. The mean weighted PAR scores obtained in both study parts were analyzed for statistical differences using a two-tailed paired Student's t-test at a significance level of p ≤ 0.05. Mean weighted PAR scores of 4.76 ± 3.94 and 3.92 ± 3.44 were obtained in the Class III extraction group and the control group, respectively, at the end of active treatment. This difference was not significant (p = 0.49). Among the 12 longitudinal patients, the mean score increased from 4 ± 3.46 at debonding to 6.25 ± 3.67 by the end of the 11.8-year follow-up period. This difference was significant (p = 0.0008). Treatment of Class III anomalies by isolated extraction of lower premolars or molars can yield PAR scores similar to those achieved by standard therapies. These scores, while increasing significantly, remained at a clinically acceptable level over 11.8 years. Hence this treatment modality--intended for cases that border on requiring orthognathic surgery--may also be recommended from a long-term point of view.

  6. Complete revascularisation versus treatment of the culprit lesion only in patients with ST-segment elevation myocardial infarction and multivessel disease (DANAMI-3—PRIMULTI)

    DEFF Research Database (Denmark)

    Engstrøm, Thomas; Kelbæk, Henning; Helqvist, Steffen

    2015-01-01

    BACKGROUND: Patients with acute ST-segment elevation myocardial infarction (STEMI) and multivessel coronary disease have a worse prognosis compared with individuals with single-vessel disease. We aimed to study the clinical outcome of patients with STEMI treated with fractional flow reserve (FFR...... electronically via a web-based system in permuted blocks of varying size by the clinician who did the primary PCI. All patients received best medical treatment. The primary endpoint was a composite of all-cause mortality, non-fatal reinfarction, and ischaemia-driven revascularization of lesions in non...

  7. Subjective effects, misuse, and adverse effects of osmotic-release methylphenidate treatment in adolescent substance abusers with attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Winhusen, Theresa M; Lewis, Daniel F; Riggs, Paula D; Davies, Robert D; Adler, Lenard A; Sonne, Susan; Somoza, Eugene C

    2011-10-01

    Psychostimulants are effective treatments for attention-deficit/hyperactivity disorder (ADHD) but may be associated with euphoric effects, misuse/diversion, and adverse effects. These risks are perceived by some clinicians to be greater in substance-abusing adolescents relative to non-substance-abusing adults. The present study evaluates the subjective effects, misuse/diversion, and adverse effects associated with the use of osmotic-release oral system methylphenidate (OROS-MPH), relative to placebo, for treating ADHD in adolescents with a substance use disorder (SUD) as a function of substance use severity and compared these risks with those associated with the treatment of ADHD in adults without a non-nicotine SUD. Datasets from two randomized placebo-controlled trials of OROS-MPH for treating ADHD, one conducted with 303 adolescents (13-18) with at least one non-nicotine SUD and one with 255 adult smokers (18-55), were analyzed. Outcome measures included the Massachusetts General Hospital Liking Scale, self-reported medication compliance, pill counts, and adverse events (AEs). Euphoric effects and misuse/diversion of OROS-MPH were not significantly affected by substance use severity. The euphoric effects of OROS-MPH did not significantly differ between the adolescent and adult samples. Adults rated OROS-MPH as more effective in treating ADHD, whereas adolescents reported feeling more depressed when taking OROS-MPH. The adolescents lost more pills relative to the adults regardless of treatment condition, which suggests the importance of careful medication monitoring. Higher baseline use of alcohol and cannabis was associated with an increased risk of experiencing a treatment-related AE in OROS-MPH, but baseline use did not increase the risk of serious AEs or of any particular category of AE and the adolescents did not experience more treatment-related AEs relative to the adults. With good monitoring, and in the context of substance abuse treatment, OROS-MPH can

  8. Tratamento conservador das lesões parciais e completas do manguito rotador Conservative treatment of partial and complete tears of the rotator cuff

    Directory of Open Access Journals (Sweden)

    Osvandré Lech

    2000-09-01

    Full Text Available A lesão do manguito rotador é a mais freqüente patologia do ombro. Cerca de 180 pacientes foram tratados conservadoramente nos dois Serviços nos anos de 1996 e 1997. Este grupo recebeu uma ampla gama de tratamentos (apenas medicação, exercícios caseiros, infiltração, fisioterapia, etc.. Este estudo avaliou os resultados do tratamento conservador em 26 pacientes com rupturas parcial e total do manguito rotador. O protocolo consistiu de um programa com 6 meses de duração que incluiu terapia miofascial específica, exercícios ativos assistidos e de fortalecimento dos músculos do manguito rotador e da musculatura axioescapular. Os fatores de inclusão no estudo foram: 1 realizar todo o programa com apenas um reabilitador; 2 não ter recebido infiltração; 3 não ter tido cirurgia prévia; 4 não ter reumatopatia diagnosticada. Seis meses após a alta, dezoito pacientes (69,22% apresentavam resultado satisfatório, enquanto que os demais 08 casos (30,78% foram considerados insatisfatórios e tiveram indicação cirúrgica.The lesion of rotator cuff is the most frequent lesion of the shoulder. Circa 180 patients were conservatively treated in both Clinics during the years of 1976 and 1997. This group of patients received a wide range of treatments (only medication, home exercises, infiltration, physiotherapy, etc. This study evaluated the results of the conservative treatment in 26 patients with partial and total rupture of the rotator cuff. The protocol consisted of a program with duration of 6 months including specific miofascial therapy, assisted active exercises and of strengthening of the muscles of the rotator cuff and axioscapular musculature. The inclusion criteria of the study were: 1 to carry the program with just one reabilitator; 2 no previous infiltration; 3 no previous surgery; 4 absence of diagnosed rheumatopathy. Six months after the end of treatment, eighteen patients (69,22% presented with satisfactory results, while

  9. Accounting for interactions and complex inter-subject dependency in estimating treatment effect in cluster-randomized trials with missing outcomes.

    Science.gov (United States)

    Prague, Melanie; Wang, Rui; Stephens, Alisa; Tchetgen Tchetgen, Eric; DeGruttola, Victor

    2016-12-01

    Semi-parametric methods are often used for the estimation of intervention effects on correlated outcomes in cluster-randomized trials (CRTs). When outcomes are missing at random (MAR), Inverse Probability Weighted (IPW) methods incorporating baseline covariates can be used to deal with informative missingness. Also, augmented generalized estimating equations (AUG) correct for imbalance in baseline covariates but need to be extended for MAR outcomes. However, in the presence of interactions between treatment and baseline covariates, neither method alone produces consistent estimates for the marginal treatment effect if the model for interaction is not correctly specified. We propose an AUG-IPW estimator that weights by the inverse of the probability of being a complete case and allows different outcome models in each intervention arm. This estimator is doubly robust (DR); it gives correct estimates whether the missing data process or the outcome model is correctly specified. We consider the problem of covariate interference which arises when the outcome of an individual may depend on covariates of other individuals. When interfering covariates are not modeled, the DR property prevents bias as long as covariate interference is not present simultaneously for the outcome and the missingness. An R package is developed implementing the proposed method. An extensive simulation study and an application to a CRT of HIV risk reduction-intervention in South Africa illustrate the method. © 2016, The International Biometric Society.

  10. Microstructure Evolution and Mechanical Behavior of a CMnSiAl TRIP Steel Subjected to Partial Austenitization Along with Quenching and Partitioning Treatment

    Science.gov (United States)

    Kong, H.; Chao, Q.; Cai, M. H.; Pavlina, E. J.; Rolfe, B.; Hodgson, P. D.; Beladi, H.

    2018-02-01

    The present study investigated the microstructure evolution and mechanical behavior in a low carbon CMnSiAl transformation-induced plasticity (TRIP) steel, which was subjected to a partial austenitization at 1183 K (910 °C) followed by one-step quenching and partitioning (Q&P) treatment at different isothermal holding temperatures of [533 K to 593 K (260 °C to 320 °C)]. This thermal treatment led to the formation of a multi-phase microstructure consisting of ferrite, tempered martensite, bainitic ferrite, fresh martensite, and retained austenite, offering a superior work-hardening behavior compared with the dual-phase microstructure (i.e., ferrite and martensite) formed after partial austenitization followed by water quenching. The carbon enrichment in retained austenite was related to not only the carbon partitioning during the isothermal holding process, but also the carbon enrichment during the partial austenitization and rapid cooling processes, which has broadened our knowledge of carbon partitioning mechanism in conventional Q&P process.

  11. Time to initial operative treatment following open fracture does not impact development of deep infection: a prospective cohort study of 736 subjects.

    Science.gov (United States)

    Weber, Donald; Dulai, Sukhdeep K; Bergman, Joseph; Buckley, Richard; Beaupre, Lauren A

    2014-11-01

    To evaluate the association between time to surgery, antibiotic administration, Gustilo grade, fracture location, and development of deep infection in open fractures. Prospective cohort between 2001 and 2009. Three Level 1 Canadian trauma centers. A total of 736 (791 fractures) subjects were enrolled and 686 subjects (93%; 737 fractures) provided adequate follow-up data (1-year interview and/or clinical follow-up >90 days). Demographics, injury information, time to surgery, and antibiotics were recorded. Subjects were evaluated using standardized data forms until the fracture(s) healed. Phone interviews were undertaken 1 year after the fracture. Infection requiring unplanned surgical debridement and/or sustained antibiotic therapy. Tibia/fibula fractures were most common (n = 413, 52%), followed by upper extremity (UE) (n = 285, 36%), and femoral (n = 93, 12%) fractures. Infection developed in 46 fractures (6%). The median time to surgery was 9 hours 4 minutes (interquartile range, 6 hours 39 minutes to 12 hours 33 minutes) and 7 hours 39 minutes (interquartile range, 6 hours 10 minutes to 9 hours 54 minutes) for those without and with infection, respectively (P = 0.04). Gustilo grade 3B/3C fractures accounted for 17 of 46 infections (37%) (P developed infections (P = 0.001). Multivariate regression found no association between infection and time to surgery [odds ratio (OR), 0.97; 95% confidence interval (95% CI), 0.90-1.06] or antibiotics (OR, 1.0; 95% CI, 0.90-1.05). Grades 3A (OR, 6.37; 95% CI, 1.37-29.56) and 3B/3C (OR, 12.87; 95% CI, 2.72-60.95) relative to grade 1 injuries and tibia/fibula (OR, 3.91; 95% CI, 1.33-11.53) relative to UE fractures were significantly associated with infection. Infection after open fracture was associated with increasing Gustilo grade or tibia/fibula fractures but not time to surgery or antibiotics. Prognostic level I. See instructions for authors for a complete description of levels of evidence.

  12. Health information technology interventions enhance care completion, engagement in HIV care and treatment, and viral suppression among HIV-infected patients in publicly funded settings.

    Science.gov (United States)

    Shade, Starley B; Steward, Wayne T; Koester, Kimberly A; Chakravarty, Deepalika; Myers, Janet J

    2015-04-01

    The National HIV/AIDS Strategy (NHAS) emphasizes the use of technology to facilitate coordination of comprehensive care for people with HIV. We examined the effect of six health information technology (HIT) interventions in a Ryan White-funded Special Projects of National Significance (SPNS) on care completion services, engagement in HIV care, and viral suppression. Interventions included use of surveillance data to identify out-of-care individuals, extending access to electronic health records to support service providers, use of electronic laboratory ordering and prescribing, and development of a patient portal. Data from a sample of electronic patient records from each site were analyzed to assess changes in utilization of comprehensive care (prevention screening, support service utilization), engagement in primary HIV medical care (receipt of services and use of antiretroviral therapy), and viral suppression. We used weighted generalized estimating equations to estimate outcomes while accounting for the unequal contribution of data and differences in the distribution of patient characteristics across sites and over time. We observed statistically significant changes in the desired direction in comprehensive care utilization and engagement in primary care outcomes targeted by each site. Five of six sites experienced statistically significant increases in viral suppression. These results provide additional support for the use of HIT as a valuable tool for achieving the NHAS goal of providing comprehensive care for all people living with HIV. HIT has the potential to increase utilization of services, improve health outcomes for people with HIV, and reduce community viral load and subsequent transmission of HIV. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com For affiliation see end of article.

  13. Early detection and successful treatment of Wernicke's encephalopathy in outpatients without the complete classic triad of symptoms who attended a psycho-oncology clinic.

    Science.gov (United States)

    Onishi, Hideki; Ishida, Mayumi; Tanahashi, Iori; Takahashi, Takao; Ikebuchi, Kenji; Taji, Yoshitada; Kato, Hisashi; Akechi, Tatsuo

    2018-02-26

    Wernicke's encephalopathy (WE) is a neuropsychiatric disorder caused by a thiamine deficiency. Although WE has been recognized in cancer patients, it can be overlooked because many patients do not exhibit symptoms that are typical of WE, such as delirium, ataxia, or ocular palsy. Furthermore, outpatients with WE who intermittently present at psycho-oncology clinics have not been described as far as we can ascertain. This report describes two patients who did not exhibit the complete classic triad of symptoms among a series with cancer and WE, and who attended a psycho-oncology outpatient clinic. Result Case 1, a 76-year-old woman with pancreatic cancer and liver metastasis, periodically attended a psycho-oncology outpatient clinic. She presented with delirium and ataxia as well as appetite loss that had persisted for 8 weeks. We suspected WE, which was confirmed by low serum thiamine levels and the disappearance of delirium after thiamine administration. Case 2, a 79-year-old man with advanced stomach cancer, was referred to a psycho-oncology outpatient clinic with depression that had persisted for about 1 month. He also had appetite loss that had persisted for several weeks. He became delirious during the first visit to the outpatient clinic. Our initial suspicion of WE was confirmed by low serum thiamine levels and the disappearance of delirium after thiamine administration. The key indicator of a diagnosis of WE in both patients was appetite loss. Significance of results This report emphasizes awareness of WE in the outpatient setting, even when patients do not exhibit the classical triad of WE. Appetite loss might be the key to a diagnosis of WE in the absence of other causes of delirium.

  14. The role of rehabilitation measures in reintegration of children with brain tumours or leukaemia and their families after completion of cancer treatment: a study protocol.

    Science.gov (United States)

    Peikert, Mona Leandra; Inhestern, Laura; Bergelt, Corinna

    2017-08-11

    For ill children as well as for their parents and siblings, childhood cancer poses a major challenge. Little is known about the reintegration into daily life of childhood cancer survivors and their families. The aim of this prospective observational study is to further the understanding of the role of rehabilitation measures in the reintegration process of childhood leukaemia or brain tumour survivors and their family members after the end of cancer treatment. This prospective observational study consists of three study arms: a quantitative study in cooperation with three German paediatric oncological study registries (study arm 1), a quantitative study in cooperation with a rehabilitation clinic that offers a family-oriented paediatric oncological rehabilitation programme (study arm 2) and a qualitative study at 12-month follow-up including families from the study arms 1 and 2 (study arm 3). In study arm 1, children, parents and siblings are surveyed after treatment (baseline), 4-6 months after baseline measurement and at 12-month follow-up. In study arm 2, data are collected at the beginning and at the end of the rehabilitation measure and at 12-month follow-up. Families are assessed with standardised questionnaires on quality of life, emotional and behavioural symptoms, depression, anxiety, fear of progression, coping and family functioning. Furthermore, self-developed items on rehabilitation aims and reintegration into daily life are used. Where applicable, users and non-users of rehabilitation measures will be compared regarding the outcome parameters. Longitudinal data will be analysed by means of multivariate analysis strategies. Reference values will be used for comparisons if applicable. Qualitative data will be analysed using thematic analysis. This study has been approved by the medical ethics committee of the Medical Chamber of Hamburg. Data will be published in peer-reviewed journals and presented at conferences. © Article author(s) (or their

  15. Extending the duration of treatment with progesterone and equine chorionic gonadotropin improves fertility in suckled beef cows with low body condition score subjected to timed artificial insemination.

    Science.gov (United States)

    Bilbao, M G; Massara, N; Ramos, S; Zapata, L O; Farcey, M F; Pesoa, J; Turic, E; Vázquez, M I; Bartolome, J A

    2016-07-15

    The objective of this study was to evaluate the effect of an extended progesterone treatment on follicular development and fertility in postpartum, suckled beef cows subjected to timed artificial insemination (TAI). In experiment 1, cows (n = 24) with body condition score (BCS) ≥4.5 received either a 2-g progesterone intravaginal device on Day -23 or a 0.558-g progesterone intravaginal device on Day -9. Then, all cows received 2 mg of estradiol benzoate on Day -9; removal of the device, 1-mg estradiol cypionate, and PGF2α on Day -2; and TAI on Day 0. Metabolic status was assessed between Days -9 and -2. Ovarian structures and plasma progesterone were determined weekly from Day -23 to -9, daily from Day -9 to 0, and weekly until Day 28. In experiment 2, cows (n = 302) with BCS ≥4.5 received identical treatment to cows in experiment 1, but on Day -2, cows received 400 IU of two different commercial preparations of equine chorionic gonadotropin (eCG). Ovarian structures were determined on Days -23 and -9 on a subset of cows (n = 40). Pregnancy was determined 39 days after TAI. In experiment 3, multiparous cows (n = 244) with BCS cows in experiment 1 initiated on Day -18, and on Day -2, cows received 400 IU of eCG or no treatment. Ovarian structures were determined in a subset of cows (n = 31) on Days -3, -2, -1, 0, 1, and on Day 10. Pregnancy was determined 39 days after TAI. The results indicated that in experiment 1, plasma progesterone was higher in treated than nontreated (control cows) during the first 14 days (P = 0.0001). The extended progesterone treatment increased the size of the largest follicle between Days -23 and Day -5 (Group by Day, P = 0.04) and tended to increase the size of the dominant follicle from Day -5 to Day -1 (Group by Day, P = 0.06). There was no effect of metabolic status or interaction between metabolic status and day on follicular growth. In experiment 2, extended progesterone treatment tended to increase the

  16. Barron's SAT subject test

    CERN Document Server

    Jansen, MA, Robert

    2016-01-01

    Includes one diagnostic test and three complete tests, all questions answered and explained, self-assessment guides, and subject reviews. Also features test strategies, QR codes to short instructional videos, and a detailed appendix with equations, physical constants, and a basic math review.

  17. Clonidine hydrochloride detoxification from methadone treatment--the value of naltrexone aftercare.

    Science.gov (United States)

    Rawson, R A; Washton, A M; Resnick, R B; Tennant, F S

    1984-01-01

    Treatment outcomes were compared for 2 groups of subjects detoxified from methadone using clonidine. One group of 12 subjects was encouraged to continue in treatment with naltrexone, while the other 12 subjects did not have naltrexone treatment available. Results suggested that those subjects who had naltrexone available were more successful at completing the 10 day detoxification treatment and that the relapse rate at 30 days post-treatment was significantly reduced by naltrexone treatment.

  18. Complete revascularisation versus treatment of the culprit lesion only in patients with ST-segment elevation myocardial infarction and multivessel disease (DANAMI-3—PRIMULTI): an open-label, randomised controlled trial.

    Science.gov (United States)

    Engstrøm, Thomas; Kelbæk, Henning; Helqvist, Steffen; Høfsten, Dan Eik; Kløvgaard, Lene; Holmvang, Lene; Jørgensen, Erik; Pedersen, Frants; Saunamäki, Kari; Clemmensen, Peter; De Backer, Ole; Ravkilde, Jan; Tilsted, Hans-Henrik; Villadsen, Anton Boel; Aarøe, Jens; Jensen, Svend Eggert; Raungaard, Bent; Køber, Lars

    2015-08-15

    Patients with acute ST-segment elevation myocardial infarction (STEMI) and multivessel coronary disease have a worse prognosis compared with individuals with single-vessel disease. We aimed to study the clinical outcome of patients with STEMI treated with fractional flow reserve (FFR)-guided complete revascularisation versus treatment of the infarct-related artery only. We undertook an open-label, randomised controlled trial at two university hospitals in Denmark. Patients presenting with STEMI who had one or more clinically significant coronary stenosis in addition to the lesion in the infarct-related artery were included. After successful percutaneous coronary intervention (PCI) of the infarct-related artery, patients were randomly allocated (in a 1:1 ratio) either no further invasive treatment or complete FFR-guided revascularisation before discharge. Randomisation was done electronically via a web-based system in permuted blocks of varying size by the clinician who did the primary PCI. All patients received best medical treatment. The primary endpoint was a composite of all-cause mortality, non-fatal reinfarction, and ischaemia-driven revascularization of lesions in non-infarct-related arteries and was assessed when the last enrolled patient had been followed up for 1 year. Analysis was on an intention-to-treat basis. This trial is registered with ClinicalTrials.gov, number NCT01960933. From March, 2011, to February, 2014, we enrolled 627 patients to the trial; 313 were allocated no further invasive treatment after primary PCI of the infarct-related artery only and 314 were assigned complete revascularization guided by FFR values. Median follow-up was 27 months (range 12–44 months). Events comprising the primary endpoint were recorded in 68 (22%) patients who had PCI of the infarct-related artery only and in 40 (13%) patients who had complete revascularisation (hazard ratio 0∙56, 95% CI 0∙38–0∙83; p=0∙004). In patients with STEMI and multivessel

  19. A randomized, double-masked, parallel-group, comparative study to evaluate the clinical efficacy and safety of 1% azithromycin–0.1% dexamethasone combination compared to 1% azithromycin alone, dexamethasone 0.1% alone, and vehicle in the treatment of subjects with blepharitis

    Directory of Open Access Journals (Sweden)

    Hosseini K

    2016-08-01

    Full Text Available Kamran Hosseini,1 Richard L Lindstrom,2,3 Gary Foulks,4 Kelly K Nichols5 1InSite Vision, Alameda, CA, 2Minnesota Eye Consultants, 3Department of Ophthalmology and Visual Neurosciences, University of Minnesota Medical School, Minneapolis, MN, 4Department of Ophthalmology and Vision Science, School of Medicine, University of Louisville, Louisville, KY, 5School of Optometry, University of Alabama at Birmingham, Birmingham, AL, USA Purpose: To evaluate the clinical efficacy and safety of a 1% azithromycin–0.1% dexamethasone combination in DuraSite (“combination” compared to 0.1% dexamethasone in DuraSite, 1% azithromycin in DuraSite, and vehicle in the treatment of subjects with blepharitis.Materials and methods: This was a Phase III, double-masked, vehicle-controlled, four-arm study in which 907 subjects with blepharitis were randomized to combination (n=305, 0.1% dexamethasone (n=298, 1% azithromycin (n=155, or vehicle (n=149. Ten study visits were scheduled: screening visit, days 1 and 4 (dosing phase and 15, and months 1–6 (follow-up phase. On day 1, subjects applied one drop of the study drug to the eyelid of the inflamed eye(s twice daily, and continued with twice-daily dosing for 14 days. After completing 14 days of dosing, subjects were followed for 6 months for efficacy and safety.Results: A total of 57 subjects (6.3% had complete clinical resolution at day 15: 25 (8.2%, 17 (5.7%, 8 (5.2%, and 7 (4.7% subjects in the combination-, 0.1% dexamethasone-, 1% azithromycin-, and vehicle-treatment groups, respectively. The combination was superior to 1% azithromycin and vehicle alone, but not to 0.1% dexamethasone alone. Mean composite (total clinical sign and symptom scores improved in all four treatment groups during the posttreatment evaluation phase for the intent-to-treat population, but outcomes were superior when a drop containing 0.1% dexamethasone was utilized. Clinical response was noted as early as day 4, and persisted as long

  20. Relationship between Corrected-QT Intervals and Other ECG Characteristics with Methadone Dose in Methadone Maintenance Treatment (MMT Patients and Healthy Subjects: A Case- Control Study

    Directory of Open Access Journals (Sweden)

    Mina Akbari Rad

    2017-05-01

    Full Text Available Background In this study we assessed the relationship between corrected-QT intervals and other ECG characteristics with methadone dose and other parameters in MMT patients and healthy subjects. Methods This was a case-control study which was carried out on patients underwent MMT and healthy control group who had been referred to Ebne-Sina academic hospital, Mashhad during 2014 - 2015. At the time of the study, 40 patients who received MMT therapy for at least 6 months and 40 voluntary healthy subjects who matched on age and sex enrolled in the study. 12-lead ECG was performed for all the patients. Mean QT interval, PR interval and QRS duration in every 12 leads were documented for each patient in maximum. Results To evaluate the patients, we divided 80 patients into two groups: 40 patients under treatment with Methadone and 40 voluntary participants as control group. There were 20 males and 20 females in each group. Duration of addiction was 214.80 ± 126.99 months in MMT group. Significant differences were observed in PRi between the patient and control groups (P = 0.007, and also between methadone dose and PRi (r = 0.468, P = 0.038 in males. QTc prolongation was reported in 4 patients of addicted group (10%. All of the QTc prolongation patients were female (P = 0.037. There was significant relationship between PRi and weight (P = 0.015, addiction period (P = 0.011, methadone treatment period (P = 0.018 as well as methadone dosage (P = 0.14. Methadone cut off point of 65 mg had a significant relationship with systolic blood pressure (P = 0.002, diastolic blood pressure (P = 0.013, QTCi (P = 0.016 and QRS (P = 0.044; however, no significant relationship was reported with PRi (P = 0.451. Conclusions We found that there is no exact dosage of methadone in which the side effects such as TdP (Torsade de pointes or QTc prolongation can be predicted. Female gender and methadone dosage ≥ 65 mg were risk factors of our study for QTc prolongation which

  1. Patients' perceptions, treatment need, and complexity of orthodontic re-treatment

    NARCIS (Netherlands)

    Ren, Yijin; Boxum, Christo; Sandham, John

    The aim of the present study was to investigate the subjective perception and objective treatment need and complexity of patients seeking orthodontic re-treatment. One hundred subjects (66 females, 34 males, age 26.7+/-8.2 years) seeking re-treatment were asked to complete a questionnaire which was

  2. Subjective and objective binge eating in relation to eating disorder symptomatology, depressive symptoms, and self-esteem among treatment-seeking adolescents with bulimia nervosa.

    Science.gov (United States)

    Fitzsimmons-Craft, Ellen E; Ciao, Anna C; Accurso, Erin C; Pisetsky, Emily M; Peterson, Carol B; Byrne, Catherine E; Le Grange, Daniel

    2014-07-01

    This study investigated the importance of the distinction between objective (OBE) and subjective binge eating (SBE) among 80 treatment-seeking adolescents with bulimia nervosa. We explored relationships among OBEs, SBEs, eating disorder (ED) symptomatology, depression, and self-esteem using two approaches. Group comparisons showed that OBE and SBE groups did not differ on ED symptoms or self-esteem; however, the SBE group had significantly greater depression. Examining continuous variables, OBEs (not SBEs) accounted for significant unique variance in global ED pathology, vomiting, and self-esteem. SBEs (not OBEs) accounted for significant unique variance in restraint and depression. Both OBEs and SBEs accounted for significant unique variance in eating concern; neither accounted for unique variance in weight/shape concern, laxative use, diuretic use, or driven exercise. Loss of control, rather than amount of food, may be most important in defining binge eating. Additionally, OBEs may indicate broader ED pathology, while SBEs may indicate restrictive/depressive symptomatology. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

  3. Safety, pharmacokinetics, and pharmacodynamics of TV-1380, a novel mutated butyrylcholinesterase treatment for cocaine addiction, after single and multiple intramuscular injections in healthy subjects.

    Science.gov (United States)

    Cohen-Barak, Orit; Wildeman, Jacqueline; van de Wetering, Jeroen; Hettinga, Judith; Schuilenga-Hut, Petra; Gross, Aviva; Clark, Shane; Bassan, Merav; Gilgun-Sherki, Yossi; Mendzelevski, Boaz; Spiegelstein, Ofer

    2015-05-01

    Human plasma butyrylcholinesterase (BChE) contributes to cocaine metabolism and has been considered for use in treating cocaine addiction and cocaine overdose. TV-1380 is a recombinant protein composed of the mature form of human serum albumin fused at its amino terminus to the carboxy-terminus of a truncated and mutated BChE. In preclinical studies, TV-1380 has been shown to rapidly eliminate cocaine in the plasma thus forestalling entry of cocaine into the brain and heart. Two randomized, blinded phase I studies were conducted to evaluate the safety, pharmacokinetics, and pharmacodynamics of TV-1380, following single and multiple administration in healthy subjects. TV-1380 was found to be safe and well tolerated with a long half-life (43-77 hours) and showed a dose-proportional increase in systemic exposure. Consistent with preclinical results, the ex vivo cocaine hydrolysis, TV-1380 activity clearly increased upon treatment in a dose-dependent manner. In addition, there was a direct relationship between ex vivo cocaine hydrolysis (kel ) and TV-1380 serum concentrations. There was no evidence that TV-1380 affected heart rate, the uncorrected QT interval, or the heart-rate-corrected QTcF interval. TV-1380, therefore, offers a safe once-weekly therapy to increase cocaine hydrolysis. © 2015 The Authors. The Journal of Clinical Pharmacology Published by Wiley Periodicals, Inc. on behalf of American College of Clinical Pharmacology.

  4. Subjective perception of radioactivity. No change post successful treatment with radioiodine; Strahlen bleiben boese. Keine Aenderung der subjektiven Konzepte von Radioaktivitaet nach erfolgreicher Radioiodtherapie

    Energy Technology Data Exchange (ETDEWEB)

    Freudenberg, L.S.; Mueller, S.P.; Beyer, T.; Bockisch, A. [Universitaetsklinikum Essen (Germany). Klinik fuer Nuklearmedizin

    2009-07-01

    We assess the attitude of patients with thyroid disease towards radiation and radioactivity before and after radioiodine therapy by means of a cultural-anthropological approach. We evaluate in patient interviews how their subjective attitude towards radioactivity as an abstract term and towards radioactivity in the medical context on the basis of their personal experiences with radionuclide therapy. 29 patients with autonomously functioning thyroid lesions (17 women, 12 men, 35-79 years) were included in this study. All patients were interviewed prior to and 22-27 month post radioiodine therapy in an open dialogue with the principal investigator. Patients were asked to describe their attitude towards radioactivity in general and towards radioiodine therapy in particular. Patients were asked to use a scoring system (1: positive, 5: negative) to quantify their perception of radioactivity. The personal perception of radioactivity as an abstract term does not change significantly (p = 0.15) before and after radioiodine therapy. This perception is linked to mostly negative impressions of radiactivity. However, patients become more positive when assessing the value of radioactivity as part of their therapy regimen. Thus, we observe a significant increase in percepted value of radioactivity post radioiodine therapy (p = 0.03). Patients continue to view radioactivity as something negative despite treatment success following radioiodine therapy. Our results provide useful information for patient information by the nuclear medicine physician prior to a radioiodine therapy. (orig.)

  5. Histopathological and Reproductive Evaluation in Male Rats Fed Jatropha curcas Seed Cake with or without Alkaline Hydrolysis and Subjected to Heat Treatment

    Directory of Open Access Journals (Sweden)

    Laiane Teixeira Sousa Moura

    2017-01-01

    Full Text Available Jatropha curcas cake, a by-product of biodiesel production, is rich in protein and has potential to be used in livestock feed; however, the presence of antinutritional factors and phorbol esters limits its use. Thus, this study investigated toxicological and reproductive effects in male Wistar rats after subchronic exposure to J. curcas cake subjected to detoxification procedures. Rats were divided into seven groups (n=10 and treated for 60 days. The control group received commercial feed, while experimental groups received a diet containing 5% J. curcas cake nonhydrolyzed or hydrolyzed with 5 M NaOH. The cakes were unwashed or washed with ethanol or water and were autoclaved at 121°C for 30 minutes. Alkaline hydrolysis combined with ethanol washing decreased the phorbol ester concentration in the cake by 98%. Histopathological findings included diffuse degeneration of the liver and edema around the pulmonary vessels in the nonhydrolyzed groups. In addition, nontreated females mated with males of nonhydrolyzed unwashed group showed a decreased number of live fetuses and an increased placental weight. There were no signs of toxicity in rats given hydrolyzed cakes washed and unwashed, indicating that alkaline hydrolysis associated with heat treatment is an efficient method for detoxification of the J. curcas cake.

  6. Histopathological and Reproductive Evaluation in Male Rats Fed Jatropha curcas Seed Cake with or without Alkaline Hydrolysis and Subjected to Heat Treatment.

    Science.gov (United States)

    Teixeira Sousa Moura, Laiane; Palomaris Mariano Souza, Domenica; Mendonça, Simone; de Aquino Ribeiro, José Antônio; Fernandes Sousa, Luciano; Tony Ramos, Adriano; Maiorka, Paulo César; de Araújo, Vera Lúcia; Mayumi Maruo, Viviane

    2017-01-01

    Jatropha curcas cake, a by-product of biodiesel production, is rich in protein and has potential to be used in livestock feed; however, the presence of antinutritional factors and phorbol esters limits its use. Thus, this study investigated toxicological and reproductive effects in male Wistar rats after subchronic exposure to J. curcas cake subjected to detoxification procedures. Rats were divided into seven groups ( n = 10) and treated for 60 days. The control group received commercial feed, while experimental groups received a diet containing 5% J . curcas cake nonhydrolyzed or hydrolyzed with 5 M NaOH. The cakes were unwashed or washed with ethanol or water and were autoclaved at 121°C for 30 minutes. Alkaline hydrolysis combined with ethanol washing decreased the phorbol ester concentration in the cake by 98%. Histopathological findings included diffuse degeneration of the liver and edema around the pulmonary vessels in the nonhydrolyzed groups. In addition, nontreated females mated with males of nonhydrolyzed unwashed group showed a decreased number of live fetuses and an increased placental weight. There were no signs of toxicity in rats given hydrolyzed cakes washed and unwashed, indicating that alkaline hydrolysis associated with heat treatment is an efficient method for detoxification of the J. curcas cake.

  7. Subjective and Objective Binge Eating in Relation to Eating Disorder Symptomatology, Depressive Symptoms, and Self-Esteem Among Treatment-Seeking Adolescents with Bulimia Nervosa

    Science.gov (United States)

    Fitzsimmons-Craft, Ellen E.; Ciao, Anna C.; Accurso, Erin C.; Pisetsky, Emily M.; Peterson, Carol B.; Byrne, Catherine E.; Le Grange, Daniel

    2014-01-01

    This study investigated the importance of the distinction between objective (OBE) and subjective binge eating (SBE) among 80 treatment-seeking adolescents with bulimia nervosa (BN). We explored relationships among OBEs, SBEs, eating disorder (ED) symptomatology, depression, and self-esteem using two approaches. Group comparisons showed that OBE and SBE groups did not differ on ED symptoms or self-esteem; however, the SBE group had significantly greater depression. Examining continuous variables, OBEs (not SBEs) accounted for significant unique variance in global ED pathology, vomiting, and self-esteem. SBEs (not OBEs) accounted for significant unique variance in restraint and depression. Both OBEs and SBEs accounted for significant unique variance in eating concern; neither accounted for unique variance in weight/shape concern, laxative use, diuretic use, or driven exercise. Loss of control, rather than amount of food, may be most important in defining binge eating. Additionally, OBEs may indicate broader ED pathology while SBEs may indicate restrictive/depressive symptomatology. PMID:24852114

  8. Short-term effects of an anti-inflammatory treatment on clinical parameters and serum levels of C-reactive protein and proinflammatory cytokines in subjects with periodontitis.

    Science.gov (United States)

    Renvert, Stefan; Lindahl, Christel; Roos-Jansåker, Ann-Marie; Lessem, Jan

    2009-06-01

    Periodontal disease is the most common multifactorial disease, afflicting a very large proportion of the adult population. Periodontal disease secondarily causes increases in the serum levels of C-reactive protein (CRP) and other markers of inflammation. An increased level of CRP reflects an increased risk for cardiovascular disease. The aim of the current randomized clinical trial was to evaluate the short-term effect of a combination of dipyridamole and prednisolone (CRx-102) on the levels of high-sensitivity (hs)-CRP, proinflammatory markers in blood, and clinical signs of periodontal disease. Fifty-seven patients with >/=10 pockets with probing depths >/=5 mm were randomized into two groups in this masked single-center placebo-controlled study: CRx-102 (n = 28) and placebo (n = 29). hs-CRP levels, inflammatory markers (interleukin [IL]-6, -1beta, -8, and -12, tumor necrosis factor-alpha, and interferon-gamma [IFN-gamma]), bleeding on probing (BOP), and changes in probing depths were evaluated. The subjects received mechanical non-surgical therapy after 42 days, and the study was completed after 49 days. At day 42, the differences in the hs-CRP, IFN-gamma, and IL-6 levels between the two groups were statistically significant (P <0.05), whereas no difference was found for the other inflammatory markers. There was no change in probing depth or BOP between the two groups. The administration of CRx-102 resulted in significant decreases in hs-CRP, IFN-gamma, and IL-6, but it did not significantly change BOP or probing depths.

  9. Orlistat after initial dietary/behavioural treatment: changes in body weight and dietary maintenance in subjects with sleep related breathing disorders

    Directory of Open Access Journals (Sweden)

    Tonstad Serena

    2011-03-01

    Full Text Available Abstract Background Sleep related breathing disorders (SRBD are associated with increased morbidity and mortality and weight loss is recommended to overweight or obese patients with SRBD. However, maintenance of weight loss is difficult to achieve and strategies for weight loss maintenance is needed. Orlistat is a pharmacological agent that reduces the intestinal absorption of fat and may favour long-term weight maintenance. Objective To examine the change in body weight and dietary intake during a 1-year treatment with orlistat after an initial weight loss in obese subjects with SRBD. Furthermore, to explore the dietary determinants of weight maintenance during treatment with orlistat. Methods Men and women with SRBD aged 32-62 years (n = 63 participated in a 3-month dietary intervention to increase intake of vegetables and fruit. After an initial weight loss of 3.4 kg they achieved a mean body mass index of 34.3 ± 4.7 kg/m2. Subsequently they were treated with orlistat for 1 year. During this year, dietary and behavioural interventions to attain weight loss were provided in the course of 14 group sessions. Dietary intake, energy density and food choices were assessed with a food frequency questionnaire before and after orlistat treatment. Results With orlistat, body weight decreased by a mean of 3.5 kg (95% CI 1.5, 5.5. The dietary E% from saturated fat, intake of fatty dairy products and energy density increased after 1 year while intakes of oils, fish and vegetables decreased (all P adj = 0.19 [95% CI 0.10, 0.46], and inversely associated with E% saturated fat (R2adj = 0.20 [95% CI 0.12, 0.47] and fatty dairy products (R2adj = 0.23 [95% CI 0.12, 0.49]. Conclusions Orlistat induced further weight loss, but dietary compliance declined with time. Increasing dietary protein and restricting saturated fat and fatty dairy products may facilitate weight loss with orlistat.

  10. The safety and efficacy of ±3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study

    Science.gov (United States)

    Mithoefer, Michael C; Wagner, Mark T; Mithoefer, Ann T; Jerome, Lisa; Doblin, Rick

    2011-01-01

    Case reports indicate that psychiatrists administered ±3,4-methylenedioxymethamphetamine (MDMA) as a catalyst to psychotherapy before recreational use of MDMA as ‘Ecstasy’ resulted in its criminalization in 1985. Over two decades later, this study is the first completed clinical trial evaluating MDMA as a therapeutic adjunct. Twenty patients with chronic posttraumatic stress disorder, refractory to both psychotherapy and psychopharmacology, were randomly assigned to psychotherapy with concomitant active drug (n = 12) or inactive placebo (n = 8) administered during two 8-h experimental psychotherapy sessions. Both groups received preparatory and follow-up non-drug psychotherapy. The primary outcome measure was the Clinician-Administered PTSD Scale, administered at baseline, 4 days after each experimental session, and 2 months after the second session. Neurocognitive testing, blood pressure, and temperature monitoring were performed. After 2-month follow-up, placebo subjects were offered the option to re-enroll in the experimental procedure with open-label MDMA. Decrease in Clinician-Administered PTSD Scale scores from baseline was significantly greater for the group that received MDMA than for the placebo group at all three time points after baseline. The rate of clinical response was 10/12 (83%) in the active treatment group versus 2/8 (25%) in the placebo group. There were no drug-related serious adverse events, adverse neurocognitive effects or clinically significant blood pressure increases. MDMA-assisted psychotherapy can be administered to posttraumatic stress disorder patients without evidence of harm, and it may be useful in patients refractory to other treatments. PMID:20643699

  11. An open-label, randomized, controlled, multicenter study exploring two treatment strategies of rivaroxaban and a dose-adjusted oral vitamin K antagonist treatment strategy in subjects with atrial fibrillation who undergo percutaneous coronary intervention (PIONEER AF-PCI).

    Science.gov (United States)

    Gibson, C Michael; Mehran, Roxana; Bode, Christoph; Halperin, Johnathan; Verheugt, Freek; Wildgoose, Peter; van Eickels, Martin; Lip, Gregory Y H; Cohen, Marc; Husted, Steen; Peterson, Eric; Fox, Keith

    2015-04-01

    Guidelines recommendations regarding anticoagulant therapy after percutaneous coronary intervention (PCI) among patients with atrial fibrillation (AF) rely on retrospective, nonrandomized observational data. Currently, patients are treated with triple-therapy (dual antiplatelet therapy [DAPT] + oral anticoagulation therapy), but neither the duration of DAPT nor the level of anticoagulation has been studied in a randomized fashion. Recent studies also suggest dual pathway therapy with clopidogrel plus oral anticoagulation therapy may be superior, and other studies suggest that novel oral anticoagulants such as rivaroxaban may further improve patient outcomes. PIONEER AF-PCI (ClinicalTrials.gov NCT01830543) is an exploratory, open-label, randomized, multicenter clinical study assessing the safety of 2 rivaroxaban treatment strategies and 1 vitamin K antagonist (VKA) treatment strategy in subjects who have paroxysmal, persistent, or permanent nonvalvular AF and have undergone PCI with stent placement. Approximately 2,100 subjects will be randomized in a 1:1:1 ratio to receive either rivaroxaban 15 mg once daily plus clopidogrel 75 mg daily for 12 months (a WOEST trial-like strategy), or rivaroxaban 2.5 mg twice daily (with stratification to a prespecified duration of DAPT 1, 6, or 12 months, an ATLAS trial-like strategy), or dose-adjusted VKA once daily (with stratification to a prespecified duration of DAPT 1, 6, or 12 months, traditional triple therapy). All patients will be followed up for 12 months for the primary composite end point of Thrombolysis in Myocardial Infarction major bleeding, bleeding requiring medical attention, and minor bleeding (collectively, clinically significant bleeding). The PIONEER AF-PCI study is the first randomized comparison of VKA vs novel oral anticoagulant therapy in patients with NVAF receiving antiplatelet therapy after PCI to assess the relative risks of bleeding complications. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. NS3 protease polymorphisms and genetic barrier to drug resistance of distinct hepatitis C virus genotypes from worldwide treatment-naïve subjects.

    Science.gov (United States)

    Vidal, L L; Soares, M A; Santos, A F

    2016-11-01

    Hepatitis C virus (HCV) NS3 protease inhibitors have been primarily designed against genotype 1, the one with the lowest response to dual therapy. However, less evidence of their efficacy on non-1 genotypes is available, and any such information is mostly concentrated on genotypes 2-4. This study evaluated HCV protease resistance profiles in the major six HCV genotypes and identified genetic barrier (GB) profiles to each available protease inhibitor across HCV strains from different locations worldwide. We obtained 15 099 HCV sequences from treatment-naïve subjects retrieved at the Los Alamos HCV Sequence Database. The wild-type codons of different HCV genotypes were used to analyse the smallest number of nucleotide substitution steps required for changing that codon to the closest one associated with drug resistance. The 36L and 175L RAVs were found as genetic signatures of genotypes 2-5, while the 80K RAV was found in all genotype 5 sequences. Genotypes 4 and 6 showed a higher GB to RAV mutations conferring resistance to telaprevir, while genotypes 2-5 presented baseline resistance to that drug, carrying the 36L mutation. Genotype 4 had a higher GB to simeprevir resistance, requiring three substitutions to acquire the 155K mutation. Subtype 1b showed a higher GB than subtype 1a to resistance for most PIs, with RAVs at codons 36 and 155. Geographic disparities were also found in frequencies of certain RAVs in genotypes 2 and 3. Under a scenario of unprecedented evolution of anti-HCV direct-acting agents, the genetic composition of the circulating HCV sequences should be evaluated worldwide to choose the most appropriate/feasible therapeutic schemes with the highest genetic barriers to resistance. © 2016 John Wiley & Sons Ltd.

  13. Non-completion and informed consent.

    Science.gov (United States)

    Wertheimer, Alan

    2014-02-01

    There is a good deal of biomedical research that does not produce scientifically useful data because it fails to recruit a sufficient number of subjects. This fact is typically not disclosed to prospective subjects. In general, the guidance about consent concerns the information required to make intelligent self-interested decisions and ignores some of the information required for intelligent altruistic decisions. Bioethics has worried about the 'therapeutic misconception', but has ignored the 'completion misconception'. This article argues that, other things being equal, prospective subjects should be informed about the possibility of non-completion as part of the standard consent process if (1) it is or should be anticipatable that there is a non-trivial possibility of non-completion and (2) that information is likely to be relevant to a prospective subject's decision to consent. The article then considers several objections to the argument, including the objection that disclosing non-completion information would make recruitment even more difficult.

  14. Complete colonic duplication in children.

    Science.gov (United States)

    Khaleghnejad Tabari, Ahmad; Mirshemirani, Alireza; Khaleghnejad Tabari, Nasibeh

    2012-01-01

    Complete colonic duplication is a very rare congenital anomaly that may have different presentations according to its location and size. Complete colonic duplication can occur in 15% of gastrointestinal duplication. We report two cases of complete colonic duplications, and their characteristics. We present two patients with complete colonic duplication with different types and presentations. Case 1: A 2- year old boy presented to the clinic with abdominal protrusion, difficulty to defecate, chronic constipation and mucosal prolaps covered bulging (rectocele) since he was 6 months old. The patient had palpable pelvic mass with doughy consistency. Rectal exam confirmed perirectal mass with soft consistency. The patient underwent a surgical operation that had total tubular colorectal duplication with one blind end and was treated with simple fenestration of distal end, and was discharged without complication. After two years follow up, he had normal defecation and good weight gain. Case 2: A 2 -day old infant was referred with imperforate anus and complete duplication of recto-sigmoid colon, diphallus, double bladder, and hypospadiasis. After clinical and paraclinical investigations, he underwent operations in several stages in different periods, and was discharged without complications. After four years follow up, he led a normal life. The patients with complete duplication have to be examined carefully because of the high incidence of other systemic anomalies. Treatment includes simple resection of distal common wall, fenestration, and repair other associated anomalies.

  15. Effectiveness of Acellular Dermal Matrix on Autologous Split-Thickness Skin Graft in Treatment of Deep Tissue Defect: Esthetic Subjective and Objective Evaluation.

    Science.gov (United States)

    Lee, Yoo Jung; Park, Myong Chul; Park, Dong Ha; Hahn, Hyung Min; Kim, Sue Min; Lee, Il Jae

    2017-10-01

    A split-thickness skin graft (STSG) is performed to cover a large full-thickness skin defect. Esthetic and functional deficits can result, and many studies have sought to overcome them. This study compared the effectiveness of the acellular dermal matrix (ADM) graft and STSG concerning esthetic and functional effectiveness of ADM on scar quality. Of the patients who underwent anterolateral thigh free flap from 2011 to 2015, patients who received skin graft only (n = 10) or skin graft with ADM (n = 20) for coverage of the donor site were enrolled. In all cases, autologous STSG was performed with 1:1.5 meshed 0.008-0.010-inch-thick skin. In the skin graft with ADM group, 0.008-0.013-inch-thick meshed ADM (CGderm ® ; CGBio, Inc., Seungnam, Korea) was co-grafted. Negative-pressure wound therapy (CuraVAC ® ; CGBio, Inc., Seungnam, Korea) was applied to both groups in continuous mode at -120 mmHg. We investigate early outcomes (skin loss rate, duration of negative-pressure wound therapy, days to removal of stitches, days to achieve complete healing, and complications) and late outcomes in terms of scar quality (vascularity, pigmentation, pliability and height) and graft-related symptoms (itching sensation and pain). Assessments used the Vancouver Scar Scale and the Patient and Observer Scar Assessment Scale. Skin fold was measured to evaluate the elasticity of scar tissue. In the Vancouver Scar Scale, vascularity subscore (p = 0.003) and total score (p = 0.016) were significantly lower in the skin graft with ADM group. In Patient and Observer Scar Assessment Scale, the pain (p = 0.037) and stiffness subscores (p = 0.002), and total score (p = 0.017) were significantly lower in the skin graft with ADM group. Skin graft with ADM results in better scar quality in objective and subjective aspects. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to

  16. Latino College Completion: Hawaii

    Science.gov (United States)

    Excelencia in Education (NJ1), 2012

    2012-01-01

    In 2009, Excelencia in Education launched the Ensuring America's Future initiative to inform, organize, and engage leaders in a tactical plan to increase Latino college completion. An executive summary of Latino College Completion in 50 states synthesizes information on 50 state factsheets and builds on the national benchmarking guide. Each…

  17. Latino College Completion: Pennsylvania

    Science.gov (United States)

    Excelencia in Education (NJ1), 2012

    2012-01-01

    In 2009, Excelencia in Education launched the Ensuring America's Future initiative to inform, organize, and engage leaders in a tactical plan to increase Latino college completion. An executive summary of Latino College Completion in 50 states synthesizes information on 50 state factsheets and builds on the national benchmarking guide. Each…

  18. Completeness, supervenience and ontology

    International Nuclear Information System (INIS)

    Maudlin, Tim W E

    2007-01-01

    In 1935, Einstein, Podolsky and Rosen raised the issue of the completeness of the quantum description of a physical system. What they had in mind is whether or not the quantum description is informationally complete, in that all physical features of a system can be recovered from it. In a collapse theory such as the theory of Ghirardi, Rimini and Weber, the quantum wavefunction is informationally complete, and this has often been taken to suggest that according to that theory the wavefunction is all there is. If we distinguish the ontological completeness of a description from its informational completeness, we can see that the best interpretations of the GRW theory must postulate more physical ontology than just the wavefunction

  19. Completeness, supervenience and ontology

    Energy Technology Data Exchange (ETDEWEB)

    Maudlin, Tim W E [Department of Philosophy, Rutgers University, 26 Nichol Avenue, New Brunswick, NJ 08901-1411 (United States)

    2007-03-23

    In 1935, Einstein, Podolsky and Rosen raised the issue of the completeness of the quantum description of a physical system. What they had in mind is whether or not the quantum description is informationally complete, in that all physical features of a system can be recovered from it. In a collapse theory such as the theory of Ghirardi, Rimini and Weber, the quantum wavefunction is informationally complete, and this has often been taken to suggest that according to that theory the wavefunction is all there is. If we distinguish the ontological completeness of a description from its informational completeness, we can see that the best interpretations of the GRW theory must postulate more physical ontology than just the wavefunction.

  20. The impact of a knowledge translation intervention employing educational outreach and a point-of-care reminder tool vs standard lay health worker training on tuberculosis treatment completion rates: study protocol for a cluster randomized controlled trial.

    Science.gov (United States)

    Puchalski Ritchie, Lisa M; van Lettow, Monique; Makwakwa, Austine; Chan, Adrienne K; Hamid, Jemila S; Kawonga, Harry; Martiniuk, Alexandra L C; Schull, Michael J; van Schoor, Vanessa; Zwarenstein, Merrick; Barnsley, Jan; Straus, Sharon E

    2016-09-07

    Despite availability of effective treatment, tuberculosis (TB) remains an important cause of morbidity and mortality globally, with low- and middle-income countries most affected. In many such settings, including Malawi, the high burden of disease and severe shortage of skilled healthcare workers has led to task-shifting of outpatient TB care to lay health workers (LHWs). LHWs improve access to healthcare and some outcomes, including TB completion rates, but lack of training and supervision limit their impact. The goals of this study are to improve TB care provided by LHWs in Malawi by refining, implementing, and evaluating a knowledge translation strategy designed to address a recognized gap in LHWs' TB and job-specific knowledge and, through this, to improve patient outcomes. We are employing a mixed-methods design that includes a pragmatic cluster randomized controlled trial and a process evaluation using qualitative methods. Trial participants will include all health centers providing TB care in four districts in the South East Zone of Malawi. The intervention employs educational outreach, a point-of-care reminder tool, and a peer support network. The primary outcome is proportion of treatment successes, defined as the total of TB patients cured or completing treatment, with outcomes taken from Ministry of Health treatment records. With an alpha of 0.05, power of 0.80, a baseline treatment success of 0.80, intraclass correlation coefficient of 0.1 based on our pilot study, and an estimated 100 clusters (health centers providing TB care), a minimum of 6 patients per cluster is required to detect a clinically significant 0.10 increase in the proportion of treatment successes. Our process evaluation will include interviews with LHWs and patients, and a document analysis of LHW training logs, quarterly peer trainer meetings, and mentorship meeting notes. An estimated 10-15 LHWs and 10-15 patients will be required to reach saturation in each of 2 planned interview

  1. Subjective wellbeing among adults with diabetes : Results from Diabetes MILES—Australia

    NARCIS (Netherlands)

    Holmes-truscott, Elizabeth; Browne, Jessica L.; Pouwer, F.; Speight, Jane; Cummins, Robert A.

    2016-01-01

    This study examines the subjective wellbeing of Australian adults with diabetes who completed the Diabetes MILES—Australia survey, investigating by diabetes type and treatment, and by comparing with the subjective wellbeing of the general Australian adult population. In addition, the extent to which

  2. The Intelence aNd pRezista Once A Day Study (INROADS): a multicentre, single-arm, open-label study of etravirine and darunavir/ritonavir as dual therapy in HIV-1-infected early treatment-experienced subjects.

    Science.gov (United States)

    Ruane, P J; Brinson, C; Ramgopal, M; Ryan, R; Coate, B; Cho, M; Kakuda, T N; Anderson, D

    2015-05-01

    Following antiretroviral therapy failure, patients are often treated with a three-drug regimen that includes two nucleoside/tide reverse transcriptase inhibitors [N(t)RTIs]. An alternative two-drug nucleoside-sparing regimen may decrease the pill burden and drug toxicities associated with the use of N(t)RTIs. The Intelence aNd pRezista Once A Day Study (INROADS; NCT01199939) evaluated the nucleoside-sparing regimen of etravirine 400 mg with darunavir/ritonavir 800/100 mg once-daily in HIV-1-infected treatment-experienced subjects or treatment-naïve subjects with transmitted resistance. In this exploratory phase 2b, single-arm, open-label, multicentre, 48-week study, the primary endpoint was the proportion of subjects who achieved HIV-1 RNA treatment-experienced subjects or treatment-naïve subjects with transmitted resistance was virologically efficacious and well tolerated. © 2014 British HIV Association.

  3. Complete Ureteral Avulsion

    Directory of Open Access Journals (Sweden)

    V. Gupta

    2005-01-01

    Full Text Available Complete avulsion of the ureter is one of the most serious complications of ureteroscopy. It requires open or laparoscopic intervention for repair. This case report emphasizes its management and presents recommendations for prevention in current urological practice.

  4. Development of urinary incontinence in a 7-year old boy after therapy with proton pump inhibitors and complete resolution of his clinicopathologic features of eosinophilic esophagitis after H2-receptor antagonist treatment: A case report

    Directory of Open Access Journals (Sweden)

    Rok Orel

    2017-06-01

    Full Text Available Background: Several diseases result in profound infltration of esophageal mucosa by eosinophilic granulocites, with gastroesophageal reflux disease (GERD, eosinophilic esophagitis (EoE and proton-pump-inhibitor-responsive esophageal eosinophilia (PPI-REE being the most prevalent. Proton-pump-inhibitor-responsive esophageal eosinophilia (PPI-REE is a newly recognized entity that must be differentiated from eosinophilic esophagitis (EoE.Case presentation: A 7-year old Slovenian male presented with a few-month history of chest pain, regurgitation and heartburn. First endoscopy was performed and revealed pronounced longitudinal furrows, and on hystology examination > 70 eosinophils per high power feld were found through the entire thickness of epithelium and in the submucosis with eosinophilic microabscess formation. Results of 24-hour pH-monitoring (without impedance monitoring excluded pathologic acid reflux. All allergy tests were negative. Te patient started treatment with proton pump inhibitors (PPIs for three times, twice with pantoprazole before the endoscopy and once with esomeprazole after it to exclude the diagnosis of GERD and PPI-REE. Urinary incontinence reappeared each time just few days after starting treatment and disappeared few days after stopping it. Therefore, urinary incontinence was considered as a plausible adverse effect of therapy with PPIs. As treatment with PPIs was not tolerated, a therapy with H2-receptor antagonists ranitidine was applied for more than 2 months followed by a second endoscopy. Both symptoms and esophageal eosinophilia completely resolved with ranitidine. The resolution of esophageal eosinophilia in PPI-REE has been attributed to proton pump independent antiinflammatory effects of PPIs. No such effects have been described in H2-receptor antagonists.Conclusions: Two unique phenomena were observed in the pediatric patient with profound esophageal eosinophilia: urinary incontinence as an adverse e

  5. Completeness of Lyapunov Abstraction

    DEFF Research Database (Denmark)

    Wisniewski, Rafal; Sloth, Christoffer

    2013-01-01

    the vector field, which allows the generation of a complete abstraction. To compute the functions that define the subdivision of the state space in an algorithm, we formulate a sum of squares optimization problem. This optimization problem finds the best subdivisioning functions, with respect to the ability......This paper addresses the generation of complete abstractions of polynomial dynamical systems by timed automata. For the proposed abstraction, the state space is divided into cells by sublevel sets of functions. We identify a relation between these functions and their directional derivatives along...

  6. Construction completion report

    International Nuclear Information System (INIS)

    1990-01-01

    This Construction Completion Report documents the major construction projects at the Waste Isolation Pilot Plant (WIPP) site and related information on contracts, schedules, and other areas which affected construction. This report is not intended to be an exhaustive detailed analysis of construction, but is a general overview and summary of the WIPP construction. 10 refs., 29 figs

  7. Complete Rerouting Protection

    DEFF Research Database (Denmark)

    Stidsen, Thomas K.; Kjærulff, Peter

    2005-01-01

    In this paper we present a new protection method: Complete Rerouting. This is the most capacity e cient protection method for circuit switched networks and it is, to the best of our knowledge, the first time it has been described. We implement a column generation algorithm and test the performance...

  8. Complete French Teach Yourself

    CERN Document Server

    Graham, Gaelle

    2010-01-01

    The best-selling complete course for a fun and effective way to learn French. This ISBN is for the paperback book. The corresponding audio support (ISBN: 9781444100068) is also available. The book and audio support can also be purchased as a pack (ISBN: 9781444100051).

  9. Completeness of Lyapunov Abstraction

    Directory of Open Access Journals (Sweden)

    Rafael Wisniewski

    2013-08-01

    Full Text Available In this work, we continue our study on discrete abstractions of dynamical systems. To this end, we use a family of partitioning functions to generate an abstraction. The intersection of sub-level sets of the partitioning functions defines cells, which are regarded as discrete objects. The union of cells makes up the state space of the dynamical systems. Our construction gives rise to a combinatorial object - a timed automaton. We examine sound and complete abstractions. An abstraction is said to be sound when the flow of the time automata covers the flow lines of the dynamical systems. If the dynamics of the dynamical system and the time automaton are equivalent, the abstraction is complete. The commonly accepted paradigm for partitioning functions is that they ought to be transversal to the studied vector field. We show that there is no complete partitioning with transversal functions, even for particular dynamical systems whose critical sets are isolated critical points. Therefore, we allow the directional derivative along the vector field to be non-positive in this work. This considerably complicates the abstraction technique. For understanding dynamical systems, it is vital to study stable and unstable manifolds and their intersections. These objects appear naturally in this work. Indeed, we show that for an abstraction to be complete, the set of critical points of an abstraction function shall contain either the stable or unstable manifold of the dynamical system.

  10. Dual completion method

    Energy Technology Data Exchange (ETDEWEB)

    Mamedov, N Ya; Kadymova, K S; Dzhafarov, Sh T

    1963-10-28

    One type of dual completion method utilizes a single tubing string. Through the use of the proper tubing equipment, the fluid from the low-productive upper formation is lifted by utilizing the surplus energy of a submerged pump, which handles the production from the lower stratum.

  11. A complete woman

    Indian Academy of Sciences (India)

    Lawrence

    treated me like a son in the way he encouraged my education, while my mother ... cine gives me a lot of satisfaction when I see my patients getting cured. Teaching ... thing in life as a complete woman in different roles – daughter, wife, mother ...

  12. Safety and efficacy of dolutegravir in treatment-experienced subjects with raltegravir-resistant HIV type 1 infection: 24-week results of the VIKING Study.

    Science.gov (United States)

    Eron, Joseph J; Clotet, Bonaventura; Durant, Jacques; Katlama, Christine; Kumar, Princy; Lazzarin, Adriano; Poizot-Martin, Isabelle; Richmond, Gary; Soriano, Vincent; Ait-Khaled, Mounir; Fujiwara, Tamio; Huang, Jenny; Min, Sherene; Vavro, Cindy; Yeo, Jane

    2013-03-01

    Dolutegravir (DTG; S/GSK1349572), a human immunodeficiency virus type 1 (HIV-1) integrase inhibitor, has limited cross-resistance to raltegravir (RAL) and elvitegravir in vitro. This phase IIb study assessed the activity of DTG in HIV-1-infected subjects with genotypic evidence of RAL resistance. Subjects received DTG 50 mg once daily (cohort I) or 50 mg twice daily (cohort II) while continuing a failing regimen (without RAL) through day 10, after which the background regimen was optimized, when feasible, for cohort I, and at least 1 fully active drug was mandated for cohort II. The primary efficacy end point was the proportion of subjects on day 11 in whom the plasma HIV-1 RNA load decreased by ≥0.7 log(10) copies/mL from baseline or was <400 copies/mL. A rapid antiviral response was observed. More subjects achieved the primary end point in cohort II (23 of 24 [96%]), compared with cohort I (21 of 27 [78%]) at day 11. At week 24, 41% and 75% of subjects had an HIV-1 RNA load of <50 copies/mL in cohorts I and II, respectively. Further integrase genotypic evolution was uncommon. Dolutegravir had a good, similar safety profile with each dosing regimen. Dolutegravir 50 mg twice daily with an optimized background provided greater and more durable benefit than the once-daily regimen. These data are the first clinical demonstration of the activity of any integrase inhibitor in subjects with HIV-1 resistant to RAL.

  13. Effect of methyl salicylate and methyl jasmonate pre-treatment on the volatile profile in tomato fruit subjected to chilling temperature

    Science.gov (United States)

    Tomato fruits exposed to chilling temperatures suffer aroma loss prior to visual chilling injury (CI) symptoms. Methyl salicylate (MeSA) and methyl jasmonate (MeJA) treatments were reported to alleviate the development of visual CI, however, it is unknown if the treatments alleviate internal CI in t...

  14. Long-term, interventional, open-label extension study evaluating the safety of tocilizumab treatment in patients with polyarticular-course juvenile idiopathic arthritis from Poland and Russia who completed the global, international CHERISH trial.

    Science.gov (United States)

    Opoka-Winiarska, Violetta; Żuber, Zbigniew; Alexeeva, Ekaterina; Chasnyk, Vyacheslav; Nikishina, Irina; Dębowska, Grażyna; Smolewska, Elżbieta

    2018-04-13

    Efficacy and safety of tocilizumab (TCZ), an interleukin-6 receptor inhibitor, were demonstrated in juvenile idiopathic arthritis (JIA) with polyarticular course (pJIA) in the CHERISH trial. This observational, III phase study evaluated long-term treatment of TCZ in pJIA patients was conducted by members of the Pediatric Rheumatology International Trials Organization (PRINTO) from Poland and Russia. Forty-one patients, who had completed the CHERISH core study (104 weeks), were extensionally treated with TCZ (8 mg/kg, intravenous infusion every 4 weeks). Total treatment time was from 131 to 193 weeks. The long-term safety (the primary endpoint) and efficacy were evaluated. All patients achieved ACR70 response in the core study and continued to achieve at least ACR50 response up to week 24 of this study. The safety population comprised 46.41 patient-years (PY). Rates per 100 PY of adverse (AEs) and serious events (SAEs) were 181.0 and 6.46, respectively. Pharyngitis and respiratory tract infections were the most common AEs. Except one AE (severe neutropenia), all others were classified as mild (24.4%) or moderate (29.3%). The incidence of SAEs was low (7.3%). No new safety findings were observed. The safety profile of over 2.5-year treatment with TCZ is consistent with the pre-marketing CHERISH clinical trial. Presented data and continued efficacy response support the use of TCZ in pJIA. EUDRACT No: 2011-001607-12. https://clinicaltrials.gov/ct2/show/study/NCT01575769?term=ML27783.

  15. Subjective assessment of kinesitherapy as an element of comprehensive rehabilitation process of subjects with lower spine pain

    Directory of Open Access Journals (Sweden)

    Wioletta Łubkowska

    2016-02-01

      Abstract Background. Spinal pain has triggered interest in many fields of medicine, such as orthopedics, neurology, rheumatology, and rehabilitation. Despite ongoing development of surgery techniques, a major role is played by fitness improvement treatments, which need to be promoted. The aim of the research was a subjective assessment of kinesitherapy as an element of comprehensive rehabilitation process of subjects with lower spine pain. Material/Methods. This paper has an empirical character. The research was conducted amongst a randomly selected group of 60 patients of Independent Public Health Care Unit in Choszczno, Poland (rehabilitation at an outpatients’ clinic, aged 20-51. All of them were subjected to a series of 10 kinesitherapy treatments. The research used diagnostic polling method and the following techniques: survey and implicit interview. Results. The research proved that after completion of 10 treatments, the subjects noticed a significant improvement of their health. Kinesitherapy helped return to an active professional life for those who were forced to resign or suspend their work. Subjects reported that 10 kinesitherapy treatments were enough to notice their effectiveness in lumbar spine pain reduction. Kinesitherapy treatments resulted in a reduced usage of painkillers. Conclusions. There is evidence of positive impact of physical exercise on treatment results and beneficial effects in patients with spinal pain. Proper education aimed at changing bad habits and advising how to care for spine may be a powerful way to fight for health.   Keywords: spine, pain syndromes, lumbar spine, kinesitherapy, curative exercises, improving fitness.

  16. The complete cosmicomics

    CERN Document Server

    Calvino, Italo

    2014-01-01

    The definitive edition of Calvino’s cosmicomics, bringing together all of these enchanting stories—including some never before translated—in one volume for the first time. In Italo Calvino’s cosmicomics, primordial beings cavort on the nearby surface of the moon, play marbles with atoms, and bear ecstatic witness to Earth’s first dawn. Exploring natural phenomena and the origins of the universe, these beloved tales relate complex scientific concepts to our common sensory, emotional, human world. Now, The Complete Cosmicomics brings together all of the cosmicomic stories for the first time. Containing works previously published in Cosmicomics, t zero, and Numbers in the Dark, this single volume also includes seven previously uncollected stories, four of which have never been published in translation in the United States. This “complete and definitive collection” (Evening Standard) reconfirms the cosmicomics as a crowning literary achievement and makes them available to new generations of reader...

  17. CMS Is Finally Completed

    CERN Multimedia

    2008-01-01

    Yet another step in the completion of the Large Hadron Collider was taken yesterday morning, as the final element of the Compact Muon Solenoid was lowered nearly 100 meters bellow ground. After more than eight years of work at the world's most powerful particle accelerator, scientists hope that they will be able to start initial experiments with the LHC until the end of this year.

  18. LEAR construction completed

    CERN Multimedia

    CERN PhotoLab

    1982-01-01

    In July 1982, LEAR construction was completed, the individual systems had been dry-tested. On 16 July, the first 50 MeV (309 MeV/c) protons from Linac 1 were injected and circulated. On 11 October, the first antiprotons from the AA, decelerated in the PS to 609 MeV/c, were injected. Also in 1982, acceleration, deceleration and stochastic cooling were successfully tested. See 9007366 for a more detailed description. See also 8201061, 8204131, 8309026.

  19. SHIVA laser: nearing completion

    International Nuclear Information System (INIS)

    Glaze, J.A.; Godwin, R.O.

    1977-01-01

    Construction of the Shiva laser system is nearing completion. This laser will be operating in fall 1977 and will produce over 20 terawatts of focusable power in a subnanosecond pulse. Fusion experiments will begin early in 1978. It is anticipated that thermonuclear energy release equal to one percent that of the incident light energy will be achieved with sub-millimeter deuterium-tritium targets. From other experiments densities in excess of a thousand times that of liquid are also expected

  20. SCT Barrel Assembly Complete

    CERN Multimedia

    L. Batchelor

    As reported in the April 2005 issue of the ATLAS eNews, the first of the four Semiconductor Tracker (SCT) barrels, complete with modules and services, arrived safely at CERN in January of 2005. In the months since January, the other three completed barrels arrived as well, and integration of the four barrels into the entire barrel assembly commenced at CERN, in the SR1 building on the ATLAS experimental site, in July. Assembly was completed on schedule in September, with the addition of the innermost layer to the 4-barrel assembly. Work is now underway to seal the barrel thermal enclosure. This is necessary in order to enclose the silicon tracker in a nitrogen atmosphere and provide it with faraday-cage protection, and is a delicate and complicated task: 352 silicon module powertapes, 352 readout-fibre bundles, and over 400 Detector Control System sensors must be carefully sealed into the thermal enclosure bulkhead. The team is currently verifying the integrity of the low mass cooling system, which must be d...

  1. Histopathological and Reproductive Evaluation in Male Rats Fed Jatropha curcas Seed Cake with or without Alkaline Hydrolysis and Subjected to Heat Treatment

    OpenAIRE

    Teixeira Sousa Moura, Laiane; Palomaris Mariano Souza, Domenica; Mendon?a, Simone; de Aquino Ribeiro, Jos? Ant?nio; Fernandes Sousa, Luciano; Tony Ramos, Adriano; Maiorka, Paulo C?sar; de Ara?jo, Vera L?cia; Mayumi Maruo, Viviane

    2017-01-01

    Jatropha curcas cake, a by-product of biodiesel production, is rich in protein and has potential to be used in livestock feed; however, the presence of antinutritional factors and phorbol esters limits its use. Thus, this study investigated toxicological and reproductive effects in male Wistar rats after subchronic exposure to J. curcas cake subjected to detoxification procedures. Rats were divided into seven groups (n = 10) and treated for 60 days. The control group received commercial feed,...

  2. Characterization and analyses on micro-hardness, residual stress and microstructure in laser cladding coating of 316L stainless steel subjected to massive LSP treatment

    Energy Technology Data Exchange (ETDEWEB)

    Luo, K.Y.; Jing, X.; Sheng, J. [School of Mechanical Engineering, Jiangsu University, Zhenjiang, 212013 (China); Sun, G.F. [School of Mechanical Engineering, Southeast University, Nanjing, 211189 (China); Yan, Z. [School of Mechanical Engineering, Jiangsu University, Zhenjiang, 212013 (China); Lu, J.Z., E-mail: jzlu@ujs.edu.cn [School of Mechanical Engineering, Jiangsu University, Zhenjiang, 212013 (China)

    2016-07-15

    The effects of massive laser shock peening (LSP) treatment on micro-hardness, residual stress and microstructure in four different zones of laser cladding coating was investigated. Furthermore, micro-hardness curves and residual stress distributions with and without massive LSP treatment were presented and compared, and typical microstructure in different zones of both coatings were characterized by transmission electron microscope (TEM) and cross-sectional optical microscope (OM) observations. Results and analyses showed that massive LSP treatment had an important influence on micro-hardness and residual stress of the cladding coating. Special attempt was made to the effects of massive LSP treatment on microstructure in three zones of the cladding coating. In addition, the underlying mechanism of massive LSP treatment on microstructure and mechanical properties of the cladding coating was revealed clearly. - Highlights: • Micro-hardness and residual stress curves of both coatings were presented and compared. • Typical microstructure in different zones of both coatings were characterized and analyzed. • LSP causes increased micro-activities, and induces plastic deformation layer in three zones. • Underlying mechanism of LSP on mechanical properties of cladding coating was revealed.

  3. Complete rerouting protection

    DEFF Research Database (Denmark)

    Stidsen, Thomas K.; Kjærulff, Peter

    2006-01-01

    Protection of communication against network failures is becoming increasingly important and in this paper we present the most capacity efficient protection method possible, the complete rerouting protection method, when requiring that all communication should be restored in case of a single link...... network failure. We present a linear programming model of the protection method and a column generation algorithm. For 6 real world networks, the minimal restoration overbuild network capacity is between 13% and 78%. We further study the importance of the density of the network, derive analytical bounds...

  4. TestComplete cookbook

    CERN Document Server

    Alpaev, Gennadiy

    2013-01-01

    A practical cookbook, with a perfect package of simple, medium, and advanced recipes targeted at basic programmers as well as expert software testers, who will learn to create, manage, and run automated tests. It is packed with problem-solving recipes that are supported by simple examples.If you are a software tester or a programmer who is involved with testing automation using TestComplete, this book is ideal for you! You will be introduced to the very basics of using the tool, as well as polish any previously gained knowledge in using the tool. If you are already aware of programming basics,

  5. Effects on Subclinical Heart Failure in Type 2 Diabetic Subjects on Liraglutide Treatment vs. Glimepiride Both in Combination with Metformin: A Randomized Open Parallel-Group Study.

    Science.gov (United States)

    Nyström, Thomas; Padro Santos, Irene; Hedberg, Fredric; Wardell, Johan; Witt, Nils; Cao, Yang; Bojö, Leif; Nilsson, Bo; Jendle, Johan

    2017-01-01

    We aimed to investigate the effect of liraglutide treatment on heart function in type 2 diabetes (T2D) patients with subclinical heart failure. Randomized open parallel-group trial. 62 T2D patients (45 male) with subclinical heart failure were randomized to either once daily liraglutide 1.8 mg, or glimepiride 4 mg, both add on to metformin 1 g twice a day. Mitral annular systolic (s') and early diastolic (e') velocities were measured at rest and during bicycle ergometer exercise, using tissue Doppler echocardiography. The primary endpoint was 18-week treatment changes in longitudinal functional reserve index (LFRI diastolic/systolic ). Clinical characteristics between groups (liraglutide = 33 vs. glimepiride = 29) were well matched. At baseline left ventricle ejection fraction (53.7 vs. 53.6%) and global longitudinal strain (-15.3 vs. -16.5%) did not differ between groups. There were no significant differences in mitral flow velocities between groups. For the primary endpoint, there was no treatment change [95% confidence interval] for: LFRI diastolic (-0.18 vs. -0.53 [-0.28, 2.59; p  = 0.19]), or LFRI systolic (-0.10 vs. -0.18 [-1.0, 1.7; p  = 0.54]); for the secondary endpoints, there was a significant treatment change in respect of body weight (-3.7 vs. -0.2 kg [-5.5, -1.4; p  = 0.001]), waist circumference (-3.1 vs. -0.8 cm [-4.2, -0.4; p  = 0.019]), and heart rate (HR) (6.3 vs. -2.3 bpm [-3.0, 14.2; p  = 0.003]), with no such treatment change in hemoglobin A1c levels (-11.0 vs. -9.2 mmol/mol [-7.0, 2.6; p  = 0.37]), between groups. 18-week treatment of liraglutide compared with glimepiride did not improve LFRI diastolic/systolic , but however increased HR. There was a significant treatment change in body weight reduction in favor for liraglutide treatment.

  6. Reduced glucose tolerance and insulin resistance induced by steroid treatment, relative physical inactivity, and high-calorie diet impairs the incretin effect in healthy subjects

    DEFF Research Database (Denmark)

    Hansen, K B; Vilsbøll, T; Bagger, J I

    2010-01-01

    The loss of incretin effect in patients with type 2 diabetes mellitus may be secondary to impaired glucose homeostasis. We investigated whether reduced glucose tolerance and insulin resistance induced by steroid treatment, relative physical inactivity, and high-calorie diet in healthy young males...

  7. Long-lasting complete response status of advanced stage IV gall bladder cancer and colon cancer after combined treatment including autologous formalin-fixed tumor vaccine: two case reports.

    Science.gov (United States)

    Imaoka, Yuki; Kuranishi, Fumito; Miyazaki, Tsubasa; Yasuda, Hiroko; Ohno, Tadao

    2017-09-11

    The prognosis of advanced (stage IV) cancer of the digestive organs is very poor. We have previously reported a case of advanced breast cancer with bone metastasis that was successfully treated with combined treatments including autologous formalin-fixed tumor vaccine (AFTV). Herein, we report the success of this approach in advanced stage IV (heavily metastasized) cases of gall bladder cancer and colon cancer. Case 1: A 61-year-old woman with stage IV gall bladder cancer (liver metastasis and lymph node metastasis) underwent surgery in May 2011, including partial resection of the liver. She was treated with AFTV as the first-line adjuvant therapy, followed by conventional chemotherapy. This patient is still alive without any recurrence, as confirmed with computed tomography, for more than 5 years. Case 2: A 64-year-old man with stage IV colon cancer (multiple para-aortic lymph node metastases and direct abdominal wall invasion) underwent non-curative surgery in May 2006. Following conventional chemotherapy, two courses of AFTV and radiation therapy were administered sequentially. This patient has had no recurrence for more than 5 years. We report the success of combination therapy including AFTV in cases of liver-metastasized gall bladder cancer and abdominal wall-metastasized colon cancer. Both patients experienced long-lasting, complete remission. Therefore, combination therapies including AFTV should be considered in patients with advanced cancer of the digestive organs.

  8. Simultaneous versus Sequential Accelerated Corneal Collagen Cross-Linking and Wave Front Guided PRK for Treatment of Keratoconus: Objective and Subjective Evaluation

    Directory of Open Access Journals (Sweden)

    Waleed Ali Abou Samra

    2016-01-01

    Full Text Available Aim. To compare objective and subjective outcome after simultaneous wave front guided (WFG PRK and accelerated corneal cross-linking (CXL in patients with progressive keratoconus versus sequential WFG PRK 6 months after CXL. Methods. 62 eyes with progressive keratoconus were divided into two groups; the first including 30 eyes underwent simultaneous WFG PRK with accelerated CXL. The second including 32 eyes underwent subsequent WFG PRK performed 6 months later after accelerated CXL. Visual, refractive, topographic, and aberrometric data were determined preoperatively and during 1-year follow-up period and the results compared in between the 2 studied groups. Results. All evaluated visual, refractive, and aberrometric parameters demonstrated highly significant improvement in both studied groups (all P<0.001. A significant improvement was observed in keratometric and Q values. The improvement in all parameters was stable till the end of follow-up. Likewise, no significant difference was determined in between the 2 groups in any of recorded parameters. Subjective data revealed similarly significant improvement in both groups. Conclusions. WFG PRK and accelerated CXL is an effective and safe option to improve the vision in mild to moderate keratoconus. In one-year follow-up, there is no statistically significant difference between the simultaneous and sequential procedure.

  9. Evaluation of the physicochemical properties of coffee chaff when subjected to a biological treatment and its potential impact as a raw material in subsequent biological processes or thermochemical

    International Nuclear Information System (INIS)

    Valverde Camacho, Edgar

    2014-01-01

    An investigation is carried out using white rot fungi in coffee pulp to study the impact on the physicochemical properties. The use of brushwood in thermochemical processes, biochemists is evaluated for later use and production of energy or any product with added value. The strain is selected by growth in Petri dishes and fresh pulp is then inoculated with a strain of Trametes versicolor and Pleurotus ostreatus one. Each treatment was maintained in growth for seven weeks . The measurement of each of the response variables used were subsequently performed to characterize the fresh pulp, including: concentration of cellulose, hemicellulose, lignin, extractables total polyphenols, total ash, moisture, combustion heat and thermal gravimetric analysis. Measurements in the fresh pulp and brushwood-fungal matrix is performed at the end of treatment. An impact on the concentration of extractable total polyphenols is obtained with an apparent reduction of 87.7% in the treated Pult with Trametes versicolor and 80.5% in the treated with Pleurotus ostreatus, with regard to the fresh brushwood. Lignin concentration was affected; however, errors were found in the analytical method associated with the presence of the fungus in the analysis, leading to erroneous readings in the measurement parameter. Thermogravimetric analysis have allowed to observe a change in the whole matrix microorganism-brushwood. The biological treatment has generated a positive impact on the region pyrolysis at temperatures in the range of 150 to 400 degrees centigrade, improving processes of decomposition. Both treatments have shown a stabilization of the thermolysis in the region of temperatures above 400 degrees centigrade. The impact on a larger scale of the pre-treatment is evaluated on the gasification process, specifically on the production of tars has been necessary for field tests in a pilot team and in the same way for the case of enzymatic fermentation. Tests of ergosterol concentration and

  10. GOGOL: ACADEMIC AND COMPLETE

    Directory of Open Access Journals (Sweden)

    Yuri V. Mann

    2016-12-01

    Full Text Available The ever-increasing international interest to Gogol explains the necessity of publishing a new edition of his works. The present Complete Collection of Gogol’s Works and Letters is an academic edition prepared and published by the A. M. Gorky Institute of World Literature of the Russian Academy of Sciences. It draws on rich experience of studying and publishing Gogol’s heritage in Russia but at the same time questions and underscores Gogol’s relevance for the modern reader and his place in the world culture of our time. It intends to fill in the gaps left by the previous scholarly tradition that failed to recognize some of Gogol’s texts as part of his heritage. Such are, for example, dedicatory descriptions in books and business notes. The present edition accounts not only for the completeness of texts but also for their place within the body of Gogol’s work, as part of his life-long creative process. By counterpoising different editions, it attempts to trace down the dynamics of Gogol’s creative thought while at the same time underscores the autonomy and relevance of each period in his career. For example, this collection publishes two different versions (editions of the same work: while the most recent version has become canonical at the expense of the preceding one, the latter still preserves its meaning and historical relevance. The present edition has the advantage over its predecessors since it has an actual, physical opportunity to erase the gaps, e.g. to publish the hitherto unpublished texts. However, the editors realize that new, hitherto unknown gaps may appear and the present edition will become, in its turn, outdated. At this point, there will be a necessity in the new edition.

  11. Simultaneous versus Sequential Accelerated Corneal Collagen Cross-Linking and Wave Front Guided PRK for Treatment of Keratoconus: Objective and Subjective Evaluation.

    Science.gov (United States)

    Abou Samra, Waleed Ali; El Emam, Dalia Sabry; Farag, Rania Kamel; Abouelkheir, Hossam Youssef

    2016-01-01

    Aim . To compare objective and subjective outcome after simultaneous wave front guided (WFG) PRK and accelerated corneal cross-linking (CXL) in patients with progressive keratoconus versus sequential WFG PRK 6 months after CXL. Methods . 62 eyes with progressive keratoconus were divided into two groups; the first including 30 eyes underwent simultaneous WFG PRK with accelerated CXL. The second including 32 eyes underwent subsequent WFG PRK performed 6 months later after accelerated CXL. Visual, refractive, topographic, and aberrometric data were determined preoperatively and during 1-year follow-up period and the results compared in between the 2 studied groups. Results . All evaluated visual, refractive, and aberrometric parameters demonstrated highly significant improvement in both studied groups (all P PRK and accelerated CXL is an effective and safe option to improve the vision in mild to moderate keratoconus. In one-year follow-up, there is no statistically significant difference between the simultaneous and sequential procedure.

  12. Complete cumulative index (1963-1983)

    International Nuclear Information System (INIS)

    1983-01-01

    This complete cumulative index covers all regular and special issues and supplements published by Atomic Energy Review (AER) during its lifetime (1963-1983). The complete cumulative index consists of six Indexes: the Index of Abstracts, the Subject Index, the Title Index, the Author Index, the Country Index and the Table of Elements Index. The complete cumulative index supersedes the Cumulative Indexes for Volumes 1-7: 1963-1969 (1970), and for Volumes 1-10: 1963-1972 (1972); this Index also finalizes Atomic Energy Review, the publication of which has recently been terminated by the IAEA

  13. Mechanical and Non-Destructive Study of CFRP Adhesive Bonds Subjected to Pre-Bond Thermal Treatment and De-Icing Fluid Contamination

    Directory of Open Access Journals (Sweden)

    Paweł H. Malinowski

    2018-04-01

    Full Text Available Composite materials are commonly used in many branches of industry. One of the effective methods to join the carbon fibre reinforced polymer (CFRP parts includes the use of adhesives. There is a search on effective methods for quality assurance of bonded parts. In the research here reported the influence of surface pre-bond modification on the adhesive bonds of CFRP plates has been analyzed. Adherends surface modifications, to include defects affecting the bonding quality, were obtained through surface thermal treatment, surface contamination with de-icing fluid and a combination of both the previously described treatments. Characterization of bonded joints was performed by means of mechanical testing, ultrasounds and electromechanical impedance (EMI measurements. The study here proposed has also the aim to evaluate the ability of different destructive and non-destructive techniques to assess the quality of the bonds. While mechanical tests were strongly affected by the surface modifications, results obtained ultrasound and EMI test have demonstrate only a limited ability of these techniques to differentiate between the different samples. In fact, ultrasounds did not show any changes in the bondline, due to pre-bond modifications. However, this technique was able to detect delamination in CFRP for one of the samples thermally treated at 280 °C. Electromechanical impedance (EMI measurements showed similar behavior as mechanical tests for samples thermally treated at 260 °C and 280 °C, and for the sample whose surface modification was made with a combination of thermally and de-icing fluid treatments.

  14. Modeling of combined effects of citral, linalool and beta-pinene used against Saccharomyces cerevisiae in citrus-based beverages subjected to a mild heat treatment.

    Science.gov (United States)

    Belletti, Nicoletta; Kamdem, Sylvain Sado; Tabanelli, Giulia; Lanciotti, Rosalba; Gardini, Fausto

    2010-01-01

    The aim of this work was to evaluate the antimicrobial activity of three terpenes (citral, linalool and beta-pinene), in combination with a mild heat treatment (55 degrees C, 15 min). The study has been carried out on an orange based soft drink inoculated using a wild strain of Saccharomyces cerevisiae. The results, expressed as growth/no-growth data, were analyzed with the logistic regression. A model comprising only of significant individual parameters (p < or = 0.05) and describing the relationships between terpene concentrations and the probability of having stable beverages was obtained. When citral and beta-pinene were combined, the citral concentration required to achieve a 50% probability of having stable bottles (P=0.5) dropped from 100.9 microL/L in the absence of beta-pinene to 49.3 microL/L in the presence of 20 microL/L of beta-pinene. The mixture of citral and linalool was less effective, in fact, the same probability (P=0.5) was obtained combining 60 microL/L of linalool with 35.1 microL/L of citral. The addition of 20 microL/L of linalool and beta-pinene reinforced citral bioactivity and the concentration of citral needed to reach P=0.5 fell from 100.9 microL/L in the presence of citral alone to 42.0 microL/L. The presence of both linalool and beta-pinene at a concentration of 40 or 60 microL/L in the absence of citral led to a lower spoilage probability (P=0.58 and P=0.93, respectively). It can be concluded that the antimicrobial potential of the three terpenes alone can be strengthened combining appropriate concentrations of each of them. This study confirmed also the potentiating effect of a mild temperature treatment on the antimicrobial efficacy of the molecules. Neither the thermal treatment alone nor the presence of the terpenes at their maximum concentrations (without thermal treatment) were able to guarantee the microbial stability of the beverages. 2009 Elsevier B.V. All rights reserved.

  15. Does gender moderate the subjective measurement and structural paths in behavioural and cognitive aspects of gambling disorder in treatment-seeking adults?

    Science.gov (United States)

    Smith, David; Battersby, Malcolm; Harvey, Peter

    2015-09-01

    Gender differences have been observed in the pathogenesis of gambling disorder and gambling related urge and cognitions are predictive of relapse to problem gambling. A better understanding of these mechanisms concurrently may help in the development of more directed therapies. We evaluated gender effects on behavioural and cognitive paths to gambling disorder from self-report data. Participants (N=454) were treatment-seeking problem gamblers on first presentation to a gambling therapy service between January 2012 and December 2014. We firstly investigated if aspects of gambling related urge, cognitions (interpretive bias and gambling expectancies) and gambling severity were more central to men than women. Subsequently, a full structural equation model tested if gender moderated behavioural and cognitive paths to gambling severity. Men (n=280, mean age=37.4years, SD=11.4) were significantly younger than women (n=174, mean age=48.7years, SD=12.9) (pgambling severity, gambling related urge, interpretive bias and gambling expectancies. The paths for urge to gambling severity and interpretive bias to gambling severity were stronger for men than women and statistically significant (pgambling expectancies to gambling severity were insignificant for both men and women. This study detected an important signal in terms of theoretical mechanisms to explaining gambling disorder and gender differences. It has implications for treatment development including relapse prevention. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Fabrication and characterization of selective laser melting printed Ti–6Al–4V alloys subjected to heat treatment for customized implants design

    Directory of Open Access Journals (Sweden)

    Mengke Wang

    2016-12-01

    Full Text Available Selective laser melting (SLM is a promising technique capable of rapidly fabricating customized implants having desired macro- and micro-structures by using computer-aided design models. However, the SLM-based products often have non-equilibrium microstructures and partial surface defects because of the steep thermal gradients and high solidification rates that occur during the laser melting. To meet clinical requirements, a heat treatment was used to tailor the physiochemical properties, homogenize the metallic microstructures, and eliminate surface defects, expecting to improve the cytocompatibility in vitro. Compared with the as-printed Ti–6Al–4V substrate, the heat-treated substrate had a more hydrophilic, rougher and more homogeneous surface, which should promote the early cell attachment, proliferation and osseointegration. More importantly, a crystalline rutile TiO2 layer formed during the heat treatment, which should greatly promote the biocompatibility and corrosion resistance of the implant. Compared to the untreated surfaces, the adhesion and proliferation of human bone mesenchymal stem cells (hBMSCs on heat-treated substrates were significantly enhanced, implying an excellent cytocompatibility after annealing. Therefore, these findings provide an alternative to biofunctionalized SLM-based Ti–6Al–4V implants with optimized physiochemical properties and biocompatibility for orthopedic and dental applications.

  17. Kurt Gödel, completeness, incompleteness

    Czech Academy of Sciences Publication Activity Database

    Hájek, Petr

    2007-01-01

    Roč. 82, č. 1 (2007), 012005_1-012005_4 E-ISSN 1742-6596. [Brno Kurt Gödel Days. Brno, 25.04.2007-28.04.2007] R&D Projects: GA AV ČR IAA100300503 Institutional research plan: CEZ:AV0Z10300504 Keywords : Kurt Gödel * completeness * incompleteness Subject RIV: BA - General Mathematics

  18. Grasping completions: Towards a new paradigm

    NARCIS (Netherlands)

    Lommertzen, J.; Meulenbroek, R.G.J.; Lier, R.J. van

    2006-01-01

    We studied contextual effects of amodal completion in both a primed-matching task, and a grasping task in a within-subjects design with twenty-nine participants. Stimuli were partly occluded cylindrical objects that could have indentations (or protrusions) at regular intervals along the contour. The

  19. Interpolation for completely positive maps: Numerical solutions

    Czech Academy of Sciences Publication Activity Database

    Ambrozie, Calin-Grigore; Gheondea, A.

    2018-01-01

    Roč. 61, č. 1 (2018), s. 13-22 ISSN 1220-3874 Institutional support: RVO:67985840 Keywords : Choi matrix * completely positive * convex minimization Subject RIV: BA - General Mathematics OBOR OECD: Pure mathematics Impact factor: 0.362, year: 2016 http://ssmr.ro/bulletin/volumes/61-1/node3.html

  20. Long-Term Follow-Up Study of Young Adults Treated for Unilateral Complete Cleft Lip, Alveolus, and Palate by a Treatment Protocol Including Two-Stage Palatoplasty: Speech Outcomes

    Science.gov (United States)

    Bittermann, Dirk; Janssen, Laura; Bittermann, Gerhard Koendert Pieter; Boonacker, Chantal; Haverkamp, Sarah; de Wilde, Hester; Van Der Heul, Marise; Specken, Tom FJMC; Koole, Ron; Kon, Moshe; Breugem, Corstiaan Cornelis; Mink van der Molen, Aebele Barber

    2017-01-01

    Background No consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP). Methods This was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients ≥17 years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation. Results Forty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years). Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (P<0.001). In total, 36% showed mild to moderate hypernasality during the speech assessment, and 11%–17% of the patients exhibited increased nasalance scores, assessed through nasometry. Conclusions The present study describes long-term speech outcomes after two-stage palatoplasty with hard palate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence. PMID:28573094

  1. Long-Term Follow-Up Study of Young Adults Treated for Unilateral Complete Cleft Lip, Alveolus, and Palate by a Treatment Protocol Including Two-Stage Palatoplasty: Speech Outcomes

    Directory of Open Access Journals (Sweden)

    Isabelle Francisca Petronella Maria Kappen

    2017-05-01

    Full Text Available BackgroundNo consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP.MethodsThis was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients ≥17 years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation.ResultsForty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years. Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (P<0.001. In total, 36% showed mild to moderate hypernasality during the speech assessment, and 11%–17% of the patients exhibited increased nasalance scores, assessed through nasometry.ConclusionsThe present study describes long-term speech outcomes after two-stage palatoplasty with hard palate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence.

  2. Long-Term Follow-Up Study of Young Adults Treated for Unilateral Complete Cleft Lip, Alveolus, and Palate by a Treatment Protocol Including Two-Stage Palatoplasty: Speech Outcomes.

    Science.gov (United States)

    Kappen, Isabelle Francisca Petronella Maria; Bittermann, Dirk; Janssen, Laura; Bittermann, Gerhard Koendert Pieter; Boonacker, Chantal; Haverkamp, Sarah; de Wilde, Hester; Van Der Heul, Marise; Specken, Tom Fjmc; Koole, Ron; Kon, Moshe; Breugem, Corstiaan Cornelis; Mink van der Molen, Aebele Barber

    2017-05-01

    No consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP). This was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients ≥17 years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation. Forty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years). Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (Pspeech assessment, and 11%-17% of the patients exhibited increased nasalance scores, assessed through nasometry. The present study describes long-term speech outcomes after two-stage palatoplasty with hard palate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence.

  3. Beneficial Effect of Chronic Treatment with Extracts from Rhodiola Rosea L. and Curcuma Longa L. on the Immunoreactivity of Animals Subjected to a Chronic Mild Stress Model

    Directory of Open Access Journals (Sweden)

    Vasileva Liliya V.

    2017-12-01

    Full Text Available Background: Recent studies have suggested increased levels of pro-inflammatory cytokines in depression. Aim: The present study aimed to evaluate the effect of extracts from Rhodiola and Curcuma on immunoreactivity of animals subjected to a chronic mild stress (CMS model followed by lipopolysaccharide-induced inflammation. Materials and methods: Male Wistar rats (n=56 divided in 7 groups were treated orally with: distilled water 10 ml/kg (control and CMS model groups; Rhodiola 250 mg/kg; Rhodiola 500 mg/kg; Curcuma 250 mg/kg; Curcuma 500 mg/kg, Rhodiola 250 mg/kg and Curcuma 250 mg/kg. All groups except the control were stressed daily according to a CMS protocol. Changes in glucose preference, weight gain and locomotor activity were recorded. In the sixth week the animals were challenged with LPS and rats’ sera were obtained for ELISA evaluation of TNF-α and IL-6 levels. Results: The animals from the model group decreased their weight gain, glucose preference and locomotor activity compared to controls. The groups exposed to stress and treated with Rhodiola 500 mg/kg, Curcuma 500 mg/kg and their combination increased their locomotor activity compared to the model group. High expression of the pro-inflammatory cytokines TNF-α and IL-6 were found in all groups exposed to CMS and challenged by LPS. Conclusions: The groups exposed to the stress procedure showed a variety of depression-like behavioral changes. In addition, ELISA tests showed that CMS is affecting rats’ immunity by increasing the cytokines’ levels. These changes could be reversed by administration of Rhodiola and Curcuma in combination suggesting synergic interaction regarding their anti-inflammatory and anti-stress effects.

  4. Metacognitions Are Associated with Subjective Memory Problems in Individuals on Sick Leave due to Chronic Fatigue.

    Science.gov (United States)

    Jacobsen, Henrik B; Aasvik, Julie K; Borchgrevink, Petter C; Landrø, Nils I; Stiles, Tore C

    2016-01-01

    Subjective cognitive impairments are frequent, but poorly understood in patients with chronic fatigue. We hypothesized that maladaptive metacognitive beliefs at baseline were associated with baseline subjective cognitive impairments, that they predict subjective cognitive impairments at treatment termination, and that a reduction in maladaptive metacognitive beliefs was associated with less subjective cognitive impairments at treatment termination, independent of changes in fatigue, pain, insomnia, depression, and anxiety. In this non-controlled study, patients (n = 137) on sick leave due to chronic fatigue received a 3.5-week inpatient RTW rehabilitation program. Of these patients 69 (50.4%) was referred with a ICPC-2 diagnosis of chronic fatigue. Patients completed questionnaires about metacognitive beliefs, somatic complaints, psychological complaints, and cognitive impairments before and after treatment. To test the hypotheses we performed paired t-tests of change, as well as seven hierarchical linear regressions. RESULTS showed that baseline maladaptive metacognitive beliefs were significantly associated with subjective cognitive impairments at baseline, controlling for symptoms. Score on baseline metacognitive beliefs did not predict impairments post-treatment. Testing specific maladaptive beliefs, pre-treatment scores on cognitive confidence were associated with subjective cognitive impairments both pre and post-treatment, controlling for symptoms. Post-treatment metacognitive beliefs and post-treatment cognitive confidence were associated with post-treatment subjective cognitive impairments, controlling for pre-treatment impairments and pre-treatment metacognitive beliefs, as well as pre and post-scores on symptom measures. This study reports associations between maladaptive metacognitive beliefs and subjective cognitive impairments in patients with chronic fatigue. Targeting metacognitive beliefs could prove an effective therapeutic intervention for

  5. Metacognitions are associated with subjective memory problems in patients with chronic fatigue

    Directory of Open Access Journals (Sweden)

    Henrik Børsting Jacobsen

    2016-05-01

    Full Text Available Background: Subjective cognitive impairments are frequent, but poorly understood in patients with chronic fatigue. We hypothesized that maladaptive metacognitive beliefs at baseline were associated with baseline subjective cognitive impairments, that they predict subjective cognitive impairments at treatment termination, and that a reduction in maladaptive metacognitive beliefs was associated with less subjective cognitive impairments at treatment termination, independent of changes in fatigue, pain, insomnia, depression, and anxiety.Methods: In this non-controlled study, patients (n=137 on sick leave due to chronic fatigue received a 3.5-week inpatient RTW rehabilitation program. Of these patients 69 (50.4 % was referred with a ICPC-2 diagnosis of chronic fatigue. Patients completed questionnaires about metacognitive beliefs, somatic complaints, psychological complaints, and cognitive impairments before and after treatment. To test the hypotheses we performed paired t tests of change, as well as seven hierarchical linear regressions.Results: Results showed that baseline maladaptive metacognitive beliefs were significantly associated with subjective cognitive impairments at baseline, controlling for symptoms. Score on baseline metacognitive beliefs did not predict impairments post-treatment. Testing specific maladaptive beliefs, pre-treatment scores on cognitive confidence were associated with subjective cognitive impairments both pre and post-treatment, controlling for symptoms. Post-treatment metacognitive beliefs and post-treatment cognitive confidence were associated with post-treatment subjective cognitive impairments, controlling for pre-treatment impairments and pre-treatment metacognitive beliefs, as well as pre and post scores on symptom measures. Conclusion: This study reports associations between maladaptive metacognitive beliefs and subjective cognitive impairments in patients with chronic fatigue. Targeting metacognitive beliefs

  6. BOOK REVIEW: Complete Physics

    Science.gov (United States)

    Carson, Simon

    2000-03-01

    ', begins with an emphasis on the correct use of units in calculations that is very good (although again only really appropriate for more able students) and considers scientific notation and SI units. The use of triangles for rearranging three variable equations is introduced without any discussion of how to do the algebra properly. I found this rather out of place in a book of this level; I should personally hope to see those intending to pursue the subject beyond GCSE capable of rearranging equations without recourse to methods which convey no understanding of the physical relationship. The section on the `History of Key Ideas' has a double page spread on `Forces, Motion and Energy', `Rays, Waves and Particles' and `The Earth and Beyond', followed by a chronology of physics from 400 BC to 1990. These sections are necessarily very brief. The final section, `Experimental Physics', has some useful reminders for students about investigative work and a photocopiable checklist. The book has some very attractive features. Most pages include a boxed list of `essentials' that are useful either in skimming the text to find useful information or in revision. Each double page spread into which the material is arranged includes some fairly straightforward questions to test the basic ideas. Each section ends with a set of examination questions and with a checklist of ideas that can be photocopied for students to tick off what has been covered. The contents pages of the book may also be photocopied for students to check their progress. Given that this is a brand new book, I found the inclusion of a spread on ticker-tape rather old-fashioned: video is a much better way of analysing motion. The language of the text, too, can be rather dry and academic, and the organization reflects a traditional approach to the physics curriculum. The book would be most useful, I think, to able students studying single-subject physics courses at GCSE or to those beginning A-level. At £14.00 a copy, it

  7. Reference gene selection for qRT-PCR assays in Stellera chamaejasme subjected to abiotic stresses and hormone treatments based on transcriptome datasets.

    Science.gov (United States)

    Liu, Xin; Guan, Huirui; Song, Min; Fu, Yanping; Han, Xiaomin; Lei, Meng; Ren, Jingyu; Guo, Bin; He, Wei; Wei, Yahui

    2018-01-01

    Stellera chamaejasme Linn, an important poisonous plant of the China grassland, is toxic to humans and livestock. The rapid expansion of S. chamaejasme has greatly damaged the grassland ecology and, consequently, seriously endangered the development of animal husbandry. To draft efficient prevention and control measures, it has become more urgent to carry out research on its adaptive and expansion mechanisms in different unfavorable habitats at the genetic level. Quantitative real-time polymerase chain reaction (qRT-PCR) is a widely used technique for studying gene expression at the transcript level; however, qRT-PCR requires reference genes (RGs) as endogenous controls for data normalization and only through appropriate RG selection and qRT-PCR can we guarantee the reliability and robustness of expression studies and RNA-seq data analysis. Unfortunately, little research on the selection of RGs for gene expression data normalization in S. chamaejasme has been reported. In this study, 10 candidate RGs namely, 18S , 60S , CYP , GAPCP1 , GAPDH2 , EF1B , MDH , SAND , TUA1 , and TUA6 , were singled out from the transcriptome database of S. chamaejasme , and their expression stability under three abiotic stresses (drought, cold, and salt) and three hormone treatments (abscisic acid, ABA; gibberellin, GA; ethephon, ETH) were estimated with the programs geNorm, NormFinder, and BestKeeper. Our results showed that GAPCP1 and EF1B were the best combination for the three abiotic stresses, whereas TUA6 and SAND , TUA1 and CYP , GAPDH2 and 60S were the best choices for ABA, GA, and ETH treatment, respectively. Moreover, GAPCP1 and 60S were assessed to be the best combination for all samples, and 18S was the least stable RG for use as an internal control in all of the experimental subsets. The expression patterns of two target genes ( P5CS2 and GI ) further verified that the RGs that we selected were suitable for gene expression normalization. This work is the first attempt to

  8. Reference gene selection for qRT-PCR assays in Stellera chamaejasme subjected to abiotic stresses and hormone treatments based on transcriptome datasets

    Directory of Open Access Journals (Sweden)

    Xin Liu

    2018-04-01

    Full Text Available Background Stellera chamaejasme Linn, an important poisonous plant of the China grassland, is toxic to humans and livestock. The rapid expansion of S. chamaejasme has greatly damaged the grassland ecology and, consequently, seriously endangered the development of animal husbandry. To draft efficient prevention and control measures, it has become more urgent to carry out research on its adaptive and expansion mechanisms in different unfavorable habitats at the genetic level. Quantitative real-time polymerase chain reaction (qRT-PCR is a widely used technique for studying gene expression at the transcript level; however, qRT-PCR requires reference genes (RGs as endogenous controls for data normalization and only through appropriate RG selection and qRT-PCR can we guarantee the reliability and robustness of expression studies and RNA-seq data analysis. Unfortunately, little research on the selection of RGs for gene expression data normalization in S. chamaejasme has been reported. Method In this study, 10 candidate RGs namely, 18S, 60S, CYP, GAPCP1, GAPDH2, EF1B, MDH, SAND, TUA1, and TUA6, were singled out from the transcriptome database of S. chamaejasme, and their expression stability under three abiotic stresses (drought, cold, and salt and three hormone treatments (abscisic acid, ABA; gibberellin, GA; ethephon, ETH were estimated with the programs geNorm, NormFinder, and BestKeeper. Result Our results showed that GAPCP1 and EF1B were the best combination for the three abiotic stresses, whereas TUA6 and SAND, TUA1 and CYP, GAPDH2 and 60S were the best choices for ABA, GA, and ETH treatment, respectively. Moreover, GAPCP1 and 60S were assessed to be the best combination for all samples, and 18S was the least stable RG for use as an internal control in all of the experimental subsets. The expression patterns of two target genes (P5CS2 and GI further verified that the RGs that we selected were suitable for gene expression normalization. Discussion

  9. Evaluation of citric acid and GDL in the recovery at different pH levels of Clostridium sporogenes PA 3679 spores subjected to HTST treatment conditions.

    Science.gov (United States)

    Silla Santos, M H; Torres Zarzo, J

    1996-04-01

    Spores of Clostridium sporogenes PA 3679 were treated at different temperatures (121, 126, 130 and 135 degrees C) in white asparagus purée (pH 5.8) and acidified with glucono-delta-lactone (GDL) and citric acid to pH levels of 5.5, 5.0 and 4.5. Afterwards, the spores were recovered in MPA3679 medium in various conditions: unacidified (pH 7.5), acidified with GDL (500 ppm) and acidified with citric acid (500 and 250 ppm) to pH levels of 6.5, 6.0 and 5.0. The results indicated that the pH levels, concentration and type of acid used act synergistically rather than independently. Citric acid has a stronger inhibiting effect than GDL on the recovery of C. sporogenes PA 3679 spores. At the higher heat treatments (130 and 135 degrees C) the major injury on the spores sensitize more than against the acids and low pH values.

  10. Changes in physicochemical properties and in vitro starch digestion of native and extruded maize flours subjected to branching enzyme and maltogenic α-amylase treatment.

    Science.gov (United States)

    Román, Laura; Martínez, Mario M; Rosell, Cristina M; Gómez, Manuel

    2017-08-01

    Extrusion is an increasingly used type of processing which combined with enzymatic action could open extended possibilities for obtaining clean label modified flours. In this study, native and extruded maize flours were modified using branching enzyme (B) and a combination of branching enzyme and maltogenic α-amylase (BMA) in order to modulate their hydrolysis properties. The microstructure, pasting properties, in vitro starch hydrolysis and resistant starch content of the flours were investigated. Whereas BMA treatment led to greater number of holes on the granule surface in native samples, B and BMA extruded samples showed rougher surfaces with cavities. A reduction in the retrogradation trend was observed for B and BMA native flours, in opposition to the flat pasting profile of their extruded counterparts. The glucose release increased gradually for native flours as the time of reaction did, whereas for extruded flours a fast increase of glucose release was observed during the first minutes of reaction, and kept till the end, indicating a greater accessibility to their porous structure. These results suggested that, in enzymatically treated extruded samples, changes produced at larger hierarchical levels in their starch structure could have masked a slowdown in the starch digestion properties. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Depression-like behaviors in mice subjected to co-treatment of high-fat diet and corticosterone are ameliorated by AICAR and exercise.

    Science.gov (United States)

    Liu, Weina; Zhai, Xiaofeng; Li, Haipeng; Ji, Liu

    2014-03-01

    Major depressive disorder (MDD) and type II diabetes mellitus (T2DM) are highly co-morbid, and there may be a bi-directional connection between the two. Herein, we have described a mouse model of a depression-like and insulin-resistant (DIR) state induced by the co-treatment of high-fat diet (HFD) and corticosterone (CORT). 5-Aminoimidazole-4-carboxamide-1-β-d- ribofuranoside (AICAR), a pharmacological activator of AMP-activated protein kinase (AMPK), was originally used to improve insulin resistance (IR). Interestingly, our results show a clear potential for AICAR as a putative antidepressant with a chronic action on the DIR mice. In contrast to the traditional antidepressants, AICAR as a promising antidepressant avoids reducing insulin actions of skeletal muscle in the context of long-term HFD. Exercise also produced antidepressant effects. Our data suggest that the effects of AICAR and exercise on DIR may further increase our understanding on the link between depression and diabetes. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Blood pressure response to CPAP treatment in subjects with obstructive sleep apnoea: the predictive value of 24-h ambulatory blood pressure monitoring.

    Science.gov (United States)

    Castro-Grattoni, Anabel L; Torres, Gerard; Martínez-Alonso, Montserrat; Barbé, Ferran; Turino, Cecilia; Sánchez-de-la-Torre, Alicia; Cortijo, Anunciacion; Duran-Cantolla, Joaquin; Egea, Carlos; Cao, Gonzalo; Sánchez-de-la-Torre, Manuel

    2017-10-01

    The reduction in blood pressure (BP) with continuous positive airway pressure (CPAP) is modest and highly variable. In this study, we identified the variables that predict BP response to CPAP.24-h ambulatory BP monitoring (ABPM), C-reactive protein (CRP), leptin, adiponectin and 24-h urinary catecholamine were measured before and after 6 months of CPAP in obstructive sleep apnoea (OSA) patients.Overall, 88 middle-aged, obese male patients with severe OSA (median apnoea-hypopnoea index 42 events·h -1 ) were included; 28.4% had hypertension. 62 patients finished the study, and 60 were analysed. The daytime diastolic BP (-2 mmHg) and norepinephrine (-109.5 nmol·day -1 ) were reduced after CPAP, but no changes in the 24-h BP, night-time BP, dopamine, epinephrine, CRP, leptin or adiponectin were detected. The nocturnal normotension was associated with an increased night-time-BP (+4 mmHg) after CPAP, whereas nocturnal hypertension was associated with a reduction of 24-h BP (-3 mmHg). A multivariate linear regression model showed differential night-time BP changes after CPAP. Specifically, low night-time heart rate (CPAP and support the usefulness of 24-h ABPM for OSA patients before treatment initiation. These results need to be confirmed in further studies. Copyright ©ERS 2017.

  13. Effect of the Thermomechanical Treatment on Structural and Phase Transformations in Cu-14Al-3Ni Shape Memory Alloy Subjected to High-Pressure Torsion

    Science.gov (United States)

    Lukyanov, A. V.; Pushin, V. G.; Kuranova, N. N.; Svirid, A. E.; Uksusnikov, A. N.; Ustyugov, Yu. M.; Gunderov, D. V.

    2018-04-01

    The possibilities of controlling the structure and properties of a Cu-Al-Ni shape memory alloy due to the use of different schemes of the thermomechanical treatment, including forging, homogenizing in the austenitic state and subsequent quenching, and high-pressure torsion have been found. For the first time, an ultrafine-grain structure has been produced in this alloy via severe plastic deformation using high-pressure torsion. It has been detected that high-pressure torsion using ten revolutions of the anvils leads to the formation of a nanocrystalline structure with a grain size of less than 100 nm. The subsequent short-term heating of the alloy to 800°C (10 s) in the temperature region of the existence of the homogeneous β phase made it possible to form an ultrafine-grain structure with predominant sizes of recrystallized grains of 1 and 8 μm. The quenching after heating prevented the decomposition of the solid solution. The refinement of the grain structure changed the deformation behavior of the alloy, having provided the possibility of the significant plastic deformation upon mechanical tensile tests. The coarse-grained hot-forged quenched alloy was brittle, and fracture occurred along the boundaries of former austenite grains and martensite packets. The highstrength ultrafine-grained alloy also experienced mainly the intercrystalline fracture along the high-angle boundaries of elements of the structure, the grain size of which was less by two orders than that in the initial alloy. This determined an increase in its relative elongation upon mechanical tests.

  14. On the use of the serial dilution culture method to enumerate viable phytoplankton in natural communities of plankton subjected to ballast water treatment.

    Science.gov (United States)

    Cullen, J