Sample records for subsequent 5-year period

  1. Fasting Plasma Insulin at 5 Years of Age Predicted Subsequent Weight Increase in Early Childhood over a 5-Year Period-The Da Qing Children Cohort Study.

    Directory of Open Access Journals (Sweden)

    Yan Yan Chen

    Full Text Available The association between hyperinsulinemia and obesity is well known. However, it is uncertain especially in childhood obesity, if initial fasting hyperinsulinemia predicts obesity, or obesity leads to hyperinsulinemia through insulin resistance.To investigate the predictive effect of fasting plasma insulin on subsequent weight change after a 5-year interval in childhood.424 Children from Da Qing city, China, were recruited at 5 years of age and followed up for 5 years. Blood pressure, anthropometric measurements, fasting plasma insulin, glucose and triglycerides were measured at baseline and 5 years later.Fasting plasma insulin at 5 years of age was significantly correlated with change of weight from 5 to 10 years (ΔWeight. Children in the lowest insulin quartile had ΔWeight of 13.08±0.73 kg compare to 18.39±0.86 in the highest insulin quartile (P<0.0001 in boys, and similarly 12.03±0.71 vs 15.80±0.60 kg (P<0.0001 in girls. Multivariate analysis showed that the predictive effect of insulin at 5 years of age on subsequent weight gain over 5 years remained statistically significant even after the adjustment for age, sex, birth weight, TV-viewing time and weight (or body mass index at baseline. By contrast, the initial weight at 5 years of age did not predict subsequent changes in insulin level 5 years later. Children who had both higher fasting insulin and weight at 5 years of age showed much higher levels of systolic blood pressures, fasting plasma glucose, the homeostasis model assessment for insulin resistance (HOMA-IR and triglycerides at 10 years of age.Fasting plasma insulin at 5 years of age predicts weight gain and cardiovascular risk factors 5 year later in Chinese children of early childhood, but the absolute weight at 5 years of age did not predict subsequent change in fasting insulin.

  2. Marital status and living situation during a 5-year period are associated with a subsequent 10-year cognitive decline in older men: The FINE study

    NARCIS (Netherlands)

    Gelder, van B.M.; Tijhuis, M.; Kalmijn, S.; Giampaoli, S.; Nissinen, A.; Kromhout, D.


    We investigate the association between marital status and living situation (over 5 years) on 10-year subsequent cognitive decline. The study population consisted of 1,042 men aged 70-89 years in 1990, who participated in the longitudinal Finland, Italy, the Netherlands Elderly (known as FINE) Study.

  3. [International adoption from Ethiopia in a 5-year period]. (United States)

    Martínez Ortiz, A; Domínguez Pinilla, N; Wudineh, M; González-Granado, L I


    An increase in the number of internationally adopted children has been observed in the last few years. The country of origin that has experienced a greater increase is Ethiopia. The health of internationally adopted children from Ethiopia has not been extensively assessed to date. The main objective of the study is to determine the prevalence of infectious diseases in children adopted from Ethiopia, and to assess their nutritional status. A prospective, observational cohort study was conducted using the medical records of 251 children adopted from Ethiopia to Spain in the period from Jan 1, 2006 and December 31, 2010. The mean age of the children was 7 months (range 1-120). Abnormalities were detected on physical examination in 56.6%. In 90% of cases the child was less than 5 years-old. Half of the sample had a weight below the third percentile, with some degree of malnutrition in 65% of the children. HIV exposure was not uncommon (4.8%). Low weight and acute gastroenteritis were the main findings in this cohort. Infectious diseases should be systematically assessed. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  4. Subsequent Neoplasms in 5-Year Survivors of Childhood Cancer: The Childhood Cancer Survivor Study (United States)

    Whitton, John; Leisenring, Wendy; Mertens, Ann C.; Hammond, Sue; Stovall, Marilyn; Donaldson, Sarah S.; Meadows, Anna T.; Robison, Leslie L.; Neglia, Joseph P.


    Background The occurrence of subsequent neoplasms has direct impact on the quantity and quality of life in cancer survivors. We have expanded our analysis of these events in the Childhood Cancer Survivor Study (CCSS) to better understand the occurrence of these events as the survivor population ages. Methods The incidence of and risk for subsequent neoplasms occurring 5 years or more after the childhood cancer diagnosis were determined among 14 359 5-year survivors in the CCSS who were treated from 1970 through 1986 and who were at a median age of 30 years (range = 5–56 years) for this analysis. At 30 years after childhood cancer diagnosis, we calculated cumulative incidence at 30 years of subsequent neoplasms and calculated standardized incidence ratios (SIRs), excess absolute risks (EARs) for invasive second malignant neoplasms, and relative risks for subsequent neoplasms by use of multivariable Poisson regression. Results Among 14 359 5-year survivors, 1402 subsequently developed 2703 neoplasms. Cumulative incidence at 30 years after the childhood cancer diagnosis was 20.5% (95% confidence interval [CI] = 19.1% to 21.8%) for all subsequent neoplasms, 7.9% (95% CI = 7.2% to 8.5%) for second malignant neoplasms (excluding nonmelanoma skin cancer), 9.1% (95% CI = 8.1% to 10.1%) for nonmelanoma skin cancer, and 3.1% (95% CI = 2.5% to 3.8%) for meningioma. Excess risk was evident for all primary diagnoses (EAR = 2.6 per 1000 person-years, 95% CI = 2.4 to 2.9 per 1000 person-years; SIR = 6.0, 95% CI = 5.5 to 6.4), with the highest being for Hodgkin lymphoma (SIR = 8.7, 95% CI = 7.7 to 9.8) and Ewing sarcoma (SIR = 8.5, 95% CI = 6.2 to 11.7). In the Poisson multivariable analysis, female sex, older age at diagnosis, earlier treatment era, diagnosis of Hodgkin lymphoma, and treatment with radiation therapy were associated with increased risk of subsequent neoplasm. Conclusions As childhood cancer survivors progress through adulthood, risk of subsequent neoplasms

  5. Temporal Trends in Treatment and Subsequent Neoplasm Risk Among 5-Year Survivors of Childhood Cancer, 1970-2015. (United States)

    Turcotte, Lucie M; Liu, Qi; Yasui, Yutaka; Arnold, Michael A; Hammond, Sue; Howell, Rebecca M; Smith, Susan A; Weathers, Rita E; Henderson, Tara O; Gibson, Todd M; Leisenring, Wendy; Armstrong, Gregory T; Robison, Leslie L; Neglia, Joseph P


    Cancer treatments are associated with subsequent neoplasms in survivors of childhood cancer. It is unknown whether temporal changes in therapy are associated with changes in subsequent neoplasm risk. To quantify the association between temporal changes in treatment dosing and subsequent neoplasm risk. Retrospective, multicenter cohort study of 5-year cancer survivors diagnosed before age 21 years from pediatric tertiary hospitals in the United States and Canada between 1970-1999, with follow-up through December 2015. Radiation and chemotherapy dose changes over time. Subsequent neoplasm 15-year cumulative incidence, cumulative burden, and standardized incidence ratios for subsequent malignancies, compared by treatment decade. Multivariable models assessed relative rates (RRs) of subsequent neoplasms by 5-year increments, adjusting for demographic and clinical characteristics. Mediation analyses assessed whether changes in rates of subsequent neoplasms over time were mediated by treatment variable modifications. Among 23 603 survivors of childhood cancer (mean age at diagnosis, 7.7 years; 46% female) the most common initial diagnoses were acute lymphoblastic leukemia, Hodgkin lymphoma, and astrocytoma. During a mean follow-up of 20.5 years (374 638 person-years at risk), 1639 survivors experienced 3115 subsequent neoplasms, including 1026 malignancies, 233 benign meningiomas, and 1856 nonmelanoma skin cancers. The most common subsequent malignancies were breast and thyroid cancers. Proportions of individuals receiving radiation decreased (77% for 1970s vs 33% for 1990s), as did median dose (30 Gy [interquartile range, 24-44] for 1970s vs 26 Gy [interquartile range, 18-45] for 1990s). Fifteen-year cumulative incidence of subsequent malignancies decreased by decade of diagnosis (2.1% [95% CI, 1.7%-2.4%] for 1970s, 1.7% [95% CI, 1.5%-2.0%] for 1980s, 1.3% [95% CI, 1.1%-1.5%] for 1990s). Reference absolute rates per 1000 person-years were 1.12 (95% CI, 0

  6. Subsequent Malignant Neoplasms in a Population-Based Cohort of Pediatric Cancer Patients: A Focus on the First 5 Years. (United States)

    Pole, Jason D; Gu, Lan Ying; Kirsh, Victoria; Greenberg, Mark L; Nathan, Paul C


    The purpose was to describe the development of subsequent malignant neoplasms (SMN) among a population-based cohort of pediatric cancer patients, with a focus on SMNs that occurred within the first 5 years from diagnosis. The cohort was identified from POGONIS, an active provincial registry. Cohort members were Ontario residents ages 0 to 14.9 years at primary diagnosis between January 1985 and December 2008. SMNs that developed <18 years were captured by POGONIS, whereas SMNs diagnosed later were identified through linkage. Cumulative incidence and standardized incidence ratios (SIR) were calculated, and proportional hazards models were estimated to examine factors associated with SMN development. A total of 7,920 patients were eligible. 2.4% (188/7,920) developed 197 SMNs. Mean follow-up time was 10.7 years (SD = 7.6 years; range, 0.0-26.4 years) with mean time to SMN of 8.5 years (SD = 6.3 years; range, 0.0-24.9 years). The SIR for the development of a SMN was 9.9 [95% confidence interval (CI), 8.6-11.4]. 40.6% of SMNs (80/197) developed within 5 years. Early SMNs were more likely to be leukemia and lymphoma. Factors associated with early SMN were primary diagnosis of a bone tumor (OR, 4.88; 95% CI, 1.52-15.60), exposure to radiotherapy (OR, 1.82; 95% CI, 1.02-3.22), and the highest dose of epipodophyllotoxin (OR, 3.74; 95% CI, 1.88-7.42). Over 40% of SMNs diagnosed in childhood cancer patients occurred in the first 5 years after diagnosis, suggesting a need for early and ongoing surveillance. The early development of certain SMNs reinforces the need for early and continued surveillance at all stages for pediatric cancer patients. ©2015 American Association for Cancer Research.

  7. Insomnia symptoms and subsequent psychotropic medication: a register-linked study with 5-year follow-up. (United States)

    Haaramo, Peija; Lallukka, Tea; Lahelma, Eero; Hublin, Christer; Rahkonen, Ossi


    This study examined the associations of insomnia symptoms with subsequent psychotropic medication, reflecting mental health. Postal baseline surveys among 40- to 60-year-old employees of the city of Helsinki, Finland, were collected in 2000-2002 (N = 6,227, response rate 67%, 78% women) and longitudinally linked with national register data on prescribed reimbursed medication. Insomnia symptoms at baseline comprised difficulties in initiating and maintaining sleep, and non-restorative sleep. All purchased psychotropic medication 5-7 years prior to and 5 years after baseline was included. Outcomes were any psychotropic medication; antidepressants; and anxiolytics, hypnotics, and sedatives. Covariates included socio-demographic and work-related factors, health behaviors, lifetime mental disorders, and prior psychotropic medication. Logistic regression analysis was used to calculate odds ratios (OR) and their 95% confidence intervals (CI). Insomnia symptoms were associated with higher frequency of subsequent psychotropic medication prescriptions. The associations were strongest for frequent insomnia symptoms (women OR 3.55, 95% CI 2.64-4.77; men OR 4.64, 95% CI 2.49-8.66, adjusted for age and prior medication), but also rare and occasional symptoms were associated with psychotropic medication. Further adjustments had negligible effects. Insomnia symptoms were associated with prescribed psychotropic medication during follow-up in a dose-response manner. Attention should be given to the prevention of insomnia symptoms to curb subsequent mental problems.

  8. 77 FR 26232 - Medicaid Program; State Plan Home and Community-Based Services, 5-Year Period for Waivers... (United States)


    ... 447 RIN 0938-AO53 Medicaid Program; State Plan Home and Community-Based Services, 5-Year Period for Waivers, Provider Payment Reassignment, and Setting Requirements for Community First Choice; Correction... Federal Register entitled ``Medicaid Program; State Plan Home and Community-Based Services, 5- Year Period...

  9. Urinary phthalates from 168 girls and boys measured twice a year during a 5-year period

    DEFF Research Database (Denmark)

    Mouritsen, A; Frederiksen, H; Sørensen, K


    . Methods: This was a longitudinal study of 168 healthy children (84 girls) examined every 6 months for 5 years. Serum levels of dehydroepiandrostenedione sulfate (DHEAS), Δ4-androstenedione, testosterone, and urinary morning excretion of 14 phthalate metabolites, corresponding to 7 different phthalate....../kg) was associated with lower levels of DHEAS at 11 years of age but higher levels of testosterone at 13 years of age. The same trend was observed for MBP excretion, albeit not statistically significant. A lower age at pubarche was observed in boys with excretion of MBP above the geometric group mean (11.0 vs 12.......3 years, P = 0.005). Conclusion: Our data indicate that exposure to dibutyl phthalate isomers (DBP) (in girls) and butylbenzyl phthalate (in boys) are negatively associated with adrenal androgen levels and in boys positively associated with testosterone level at 13 years of age. High exposure to DBP...

  10. Do energy density and dietary fiber influence subsequent 5-year weight changes in adult men and women?

    DEFF Research Database (Denmark)

    Iqbal, Sofia I; Helge, Jørn W; Heitmann, Berit L


    the associations between ED and subsequent changes in BW, and despite a general belief that ED is a major determinant of obesity, the present study did not generally lend support for an association. However, among certain subgroups, an energy-dense diet may be a risk factor for weight development....

  11. Oral cancer prevalence in Western population of Maharashtra, India, for a period of 5 years

    Directory of Open Access Journals (Sweden)

    Padhiar Rutvij Ajay


    Materials and Methods: Data were collected from the previous records of patients from June 2011 to June 2016 for 5 years. A total of 81,325 patients' data were obtained. Details regarding patient's habits, age, gender, and site with OC were recorded. The data recorded were tabulated in the MS Excel and subjected to statistical analysis using SPSS software 16. Data were analyzed using Student's t-test and Chi-square test. Results: The prevalence of OC was 0.1%. The majority of patients were tobacco chewers (41.5%, followed by the group of those who were smokers, tobacco chewers, and alcoholic (28.1%. Majority of patients were in the age group of 60 years and above, followed by 40–59 with a male predominance, and buccal mucosa was the most common site followed by alveolus. Smokeless tobacco consumed in India is one of the most common forms of tobacco, leading to cause OC. Conclusion: There is need to spread awareness about this tobacco-related cancer and immediate consultation on suspicion of cancer. There should be regular oral checkup for male and female patients above 40 years for the early detection of cancer and its prevention.

  12. Regional experiences of tissue donation and forensic medicine in hamburg - results of a 5-year period. (United States)

    Wulff, Birgit; Müller, Katja; Heinemann, Axel; Püschel, Klaus


    We present the operational organization and daily workflow of our Hamburg model and the results of the years 2007-2011 concerning donation of corneas, musculoskeletal and, since 2010, cardiovascular tissues. Each of the about 3,600 deceased every year undergoes an evaluation process by two coordinators on duty, the tissue coordinator and the family coordinator. All donation connected issues are carried out within the standardized protocols of a quality management system and documented in a special data base. Two catamnestic surveys evaluated the satisfaction of donor families retrospectively. The inclusion rate for cornea donation was 23% and for musculoskeletal donation 10%, with a decrease after the 75 years age restriction of musculoskeletal donors in 2011 defined by the contracting tissue bank German Institute for Cell and Tissue Replacement gGmbH (DIZG), Berlin. Since 2007 1,268 corneas were explanted altogether, reflecting an increasing explantation rate from 156 (University Medical Center Hamburg-Eppendorf (UMC: 9) in 2007 up to 304 (UMC: 52) in 2011. Overall 173 musculoskeletal donors (5 years) and 11 cardiovascular donors (2 years) spent tissues. The consent rate was much higher. The evaluation of the families reflected a positive feedback for the guiding of the donation process. Forensic institutes can act as an interface between donors and recipients without neglecting forensic investigations. They are uniquely positioned to recognize potential donors. In addition, the contact with a physician of the forensic institute may help families during the mourning phase.

  13. Morbidity and mortality in the antiphospholipid syndrome during a 5-year period: a multicentre prospective study of 1000 patients

    DEFF Research Database (Denmark)

    Cervera, R; Khamashta, M A; Shoenfeld, Y


    OBJECTIVES: To identify the main causes of morbidity and mortality in patients with antiphospholipid syndrome (APS) during a 5-year period and to determine clinical and immunological parameters with prognostic significance. METHODS: The clinical and immunological features of a cohort of 1000...

  14. Squamous cell carcinoma of the oral cavity; An unselected material from a 5-year period

    Energy Technology Data Exchange (ETDEWEB)

    Lindeloev, B.; Kirkegaard, J.; Hansen, H.S. (Copenhagen Univ. Hospital (Denmark). Dept. of Head and Neck Oncology Copenhagen Univ. Hospital (Denmark). Dept. of Otolaryngology)


    Three hundred and four patients with squamous cell carcinomas of the oral cavity were treated at the Finsen Institute in cooperation with the ENT-surgical departments between 1978 and 1982. The primary treatment consisted of radiotherapy alone in 74%, surgery alone in 4%, and a combination of radiotherapy and surgery in 15% of the patients. 2% received other treatment (cryotherapy), 5% did not complete the planned radiotherapy, and 1% were not treated at all. Of 203 patients with tumour remnant or first recurrence, 45% were operated, 2% received radiotherapy, and 2% combined treatment. This treatment strategy made 38% of the patients free of disease in the follow-up period (3 1/2 to 8 years) or until the patients died from other causes. Fifty-nine percent of the patients died from their oral carcinomas. Tumour size (T), lymph node status (N), and tumour stage were as expected important prognostic factors. (orig.).

  15. Presentation and outcome of clinical poor performance in one health district over a 5-year period: 2002–2007 (United States)

    Cox, Stephen J; Holden, John D


    Background The detection, assessment, and management of primary care poor performance raise difficult issues for all those involved. Guidance has largely focused on managing the most serious cases where patient safety is severely compromised. The management of primary care poor performance has become an increasingly important part of primary care trust (PCT) work, but its modes of presentation and prevalence are not well known. Aim To report the prevalence, presentation modes, and management of primary care poor performance cases presenting to one PCT over a 5-year period. Design of study A retrospective review of primary care poor performance cases in one district. Setting St Helens PCT administered 35 practices with 130 GPs on the performers list, caring for 190 110 patients in North West England, UK. Method Cases presenting during 2002–2007 were initially reviewed by the chair of the PCT clinical executive committee. Anonymised data were then jointly reviewed by the assessor and another experienced GP advisor. Results There were 102 individual presentations (20 per year or one every 2–3 weeks) where clinician performance raised significant cause for concern occurred over the 5-year period. These concerns related to 37 individual clinicians, a range of 1–14 per clinician (mean 2.7). Whistleblowing by professional colleagues on 43 occasions was the most common presentation, of which 26 were from GPs about GPs. Patient complaints (18) were the second most common presentation. Twenty-seven clinicians were GPs, of whom the General Medical Council (GMC) were notified or involved in 13 cases. Clinicians were supported locally, and remedying was exclusively locally managed in 14 cases, and shared with an external organisation (such as the GMC or deanery) in another 12. Conclusion Professional whistleblowing and patient complaints were the most common sources of presentation. Effective PCT teams are needed to manage clinicians whose performance gives cause for

  16. Changes in Social Exclusion Indicators and Psychological Distress Among Homeless People Over a 2.5-Year Period. (United States)

    Van Straaten, Barbara; Rodenburg, Gerda; Van der Laan, Jorien; Boersma, Sandra N; Wolf, Judith R L M; Van de Mheen, Dike


    Although homelessness is inherently associated with social exclusion, homeless individuals are rarely included in conventional studies on social exclusion. Use of longitudinal survey data from a cohort study on homeless people in four major Dutch cities ( n  = 378) allowed to examine: changes in indicators of social exclusion among homeless people over a 2.5-year period after reporting to the social relief system, and associations between changes in indicators of social exclusion and changes in psychological distress. Multinomial logistic regression analysis was applied to investigate the associations between changes in indicators of social exclusion and changes in psychological distress. Improvements were found in various indicators of social exclusion, whereas financial debts showed no significant improvement. Changes in unmet care needs, health insurance, social support from family and relatedness to others were related to changes in psychological distress. This study demonstrated improvements in various indicators of social exclusion among homeless people over a period of 2.5 years, and sheds light on the concept of social exclusion in relation to homelessness.

  17. Characterization and evolution of exposure to volatile organic compounds in the Spanish shoemaking industry over a 5-year period. (United States)

    Estevan, Carmen; Ferri, Francisca; Sogorb, Miguel Angel; Vilanova, Eugenio


    This study measured inhalation exposure to 13 volatile organic compounds (VOCs) among workers in the leatherwear industry in Spain, examined the changes in those exposures over a 5-year period, and documented local exhaust ventilation practices that affected exposure. In collaboration with an occupational risk prevention company, air samples were collected from 849 workers' personal breathing zones using personal air pumps with activated charcoal tubes. VOCs were analyzed using a GC/MS-optimized method modified in our laboratory from that proposed by Spanish authorities (INSHT). Airborne concentrations were compared with occupational exposure limit (OEL) values from the European authorities. The most frequently detected VOCs were acetone (98.1%), toluene (94.8%), n-hexane (71.2%) and other C6-C7 branched alkyl hydrocarbons (97.5%). Other frequently detected VOCs were MEK (64.9%), ethylacetate (60.7%), and cyclohexane (29.3%). Benzene was detected in 24.6% of samples. Although all the samples were taken while workers performed tasks judged to have the highest VOC exposure potential, only 14% of samples showed excessive aggregate exposure, and chemical-specific OELs were exceeded in a relatively small number of cases: 7.2% for n-hexane, 2.8% for toluene, 0.6% for acetone, and 0.4% for hexane isomers. Over the study period, a diminished use of n-hexane in solvent formulations and an increased use of branched hexane and heptane isomers were observed. Six factors relating to work location conditions and types were evaluated. Most high-exposure cases were associated with three task types. The presence of local exhaust ventilation was an important exposure control, but significant exposures despite the use of local exhaust were observed. Although n-hexane exposures significantly decreased over the study period, the overall level of VOC exposure did not decrease. More effective exposure prevention measures need to be implemented.

  18. Endovascular Therapy Research in Lower Limb Peripheral Arterial Disease Published Over a 5-Year Period: Who is Publishing and Where? (United States)

    Asadi, H; Lee, R J; Sheehan, M; Thanaratam, P; Lee, D M; Lee, A M; Lee, M J


    Peripheral arterial disease (PAD) is being increasingly managed by endovascular therapies. In this study, we identified the clinical services publishing research as well as the journals of publication over a 5-year period. Twenty keywords and phrases related to endovascular intervention were identified, and a literature search was performed through the PubMed database from January 2009 to January 2014. Inclusion criteria were English language, study population more than five patients, and matching the keyword search. Eligible studies were collated into a database and classified by journal of publication, PubMed number, article title, publishing clinical service, type of publication, country of origin, and authors. 825 studies from 114 different journals were identified. 297 papers were excluded. Of the 528 included papers, 204 (39%) were published by Vascular Surgery (VS), 157 (30%) by Interventional Radiology (IR), 101 (19%) by Cardiology, 43 (8%) by Angiology, 6 (1%) by Vascular Medicine, and 17 (3%) from miscellaneous services. 283 (54%) studies originated from Europe, 157 (30%) from North America, 76 (14%) from Asia, 6 from Australia, 3 each from South America and Africa. IR published the most papers on PAD endovascular intervention in Europe with VS second while this trend was reversed in the USA. The 528 papers were published in 98 different journals with retrospective case series (72%), the majority. IR continues to play a significant research role in endovascular intervention in PAD, particularly in Europe, and specifically in below the knee intervention, pedal intervention, and drug-eluting technologies.

  19. Bipolar disorder recurrence prevention using self-monitoring daily mood charts: case reports from a 5 year period. (United States)

    Yasui-Furukori, Norio; Nakamura, Kazuhiko


    Mood symptoms in bipolar disorders are significantly related to psychosocial events, and the personalized identification of symptom triggers is important. Ecological momentary assessments have been used in paper-and-pencil form to explore emotional reactivity to daily life stress in patients with bipolar disorder. However, there are few data on long-term recurrence prevention effects using ecological momentary assessments. Subjects were three outpatients with bipolar disorder who had a history of at least one admission. They recorded self-monitoring daily mood charts using a 5-point Likert scale. Paper-and-pencil mood charts included mood, motivation, thinking speed, and impulsivity. Additionally, they recorded waking time, bedtime, and medication compliance. Fewer manic or depressive episodes including admissions occurred after self-monitoring daily mood charts compared to patients' admissions in the past 3 years. This study suggests that self-monitoring daily mood in addition to mood stabilizing medication has some effect on recurrence prevention in follow-up periods of at least 5 years. Further studies with rigorous designs and large sample sizes are needed.

  20. Bipolar disorder recurrence prevention using self-monitoring daily mood charts: case reports from a 5 year period

    Directory of Open Access Journals (Sweden)

    Yasui-Furukori N


    Full Text Available Norio Yasui-Furukori, Kazuhiko Nakamura Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan Abstract: Mood symptoms in bipolar disorders are significantly related to psychosocial events, and the personalized identification of symptom triggers is important. Ecological momentary assessments have been used in paper-and-pencil form to explore emotional reactivity to daily life stress in patients with bipolar disorder. However, there are few data on long-term recurrence prevention effects using ecological momentary assessments. Subjects were three outpatients with bipolar disorder who had a history of at least one admission. They recorded self-monitoring daily mood charts using a 5-point Likert scale. Paper-and-pencil mood charts included mood, motivation, thinking speed, and impulsivity. Additionally, they recorded waking time, bedtime, and medication compliance. Fewer manic or depressive episodes including admissions occurred after self-monitoring daily mood charts compared to patients’ admissions in the past 3 years. This study suggests that self-monitoring daily mood in addition to mood stabilizing medication has some effect on recurrence prevention in follow-up periods of at least 5 years. Further studies with rigorous designs and large sample sizes are needed. Keywords: bipolar disorders, recurrence, self-monitoring, ecological momentary assessments

  1. Reproducibility and Temporal Structure in Weekly Resting-State fMRI over a Period of 3.5 Years (United States)

    Choe, Ann S.; Jones, Craig K.; Joel, Suresh E.; Muschelli, John; Belegu, Visar; Caffo, Brian S.; Lindquist, Martin A.; van Zijl, Peter C. M.; Pekar, James J.


    Resting-state functional MRI (rs-fMRI) permits study of the brain’s functional networks without requiring participants to perform tasks. Robust changes in such resting state networks (RSNs) have been observed in neurologic disorders, and rs-fMRI outcome measures are candidate biomarkers for monitoring clinical trials, including trials of extended therapeutic interventions for rehabilitation of patients with chronic conditions. In this study, we aim to present a unique longitudinal dataset reporting on a healthy adult subject scanned weekly over 3.5 years and identify rs-fMRI outcome measures appropriate for clinical trials. Accordingly, we assessed the reproducibility, and characterized the temporal structure of, rs-fMRI outcome measures derived using independent component analysis (ICA). Data was compared to a 21-person dataset acquired on the same scanner in order to confirm that the values of the single-subject RSN measures were within the expected range as assessed from the multi-participant dataset. Fourteen RSNs were identified, and the inter-session reproducibility of outcome measures—network spatial map, temporal signal fluctuation magnitude, and between-network connectivity (BNC)–was high, with executive RSNs showing the highest reproducibility. Analysis of the weekly outcome measures also showed that many rs-fMRI outcome measures had a significant linear trend, annual periodicity, and persistence. Such temporal structure was most prominent in spatial map similarity, and least prominent in BNC. High reproducibility supports the candidacy of rs-fMRI outcome measures as biomarkers, but the presence of significant temporal structure needs to be taken into account when such outcome measures are considered as biomarkers for rehabilitation-style therapeutic interventions in chronic conditions. PMID:26517540

  2. Molecular epidemiology of Acinetobacter baumannii and Acinetobacter nosocomialis in Germany over a 5-year period (2005-2009). (United States)

    Schleicher, X; Higgins, P G; Wisplinghoff, H; Körber-Irrgang, B; Kresken, M; Seifert, H


    To investigate the species distribution within the Acinetobacter calcoaceticus-Acinetobacter baumannii complex and the molecular epidemiology of A. baumannii and Acinetobacter nosocomialis, 376 Acinetobacter isolates were collected prospectively from hospitalized patients at 15 medical centres in Germany during three surveillance studies conducted over a 5-year period. Species identification was performed by molecular methods. Imipenem minimum inhibitory concentrations (MIC) were determined by broth microdilution. The prevalence of the most common carbapenemase-encoding genes was investigated by oxacillinase (OXA) -multiplex polymerase chain reaction (PCR). The molecular epidemiology was investigated by repetitive sequence-based PCR (rep-PCR; DiversiLab™). Acinetobacter pittii was the most prevalent Acinetobacter species (n = 193), followed by A. baumannii (n = 140), A. calcoaceticus (n = 10) and A. nosocomialis (n = 8). The majority of A. baumannii was represented by sporadic isolates (n = 70, 50%) that showed unique rep-PCR patterns, 25 isolates (18%) clustered with one or two other isolates, and only 45 isolates (32%) belonged to one of the previously described international clonal lineages. The most prevalent clonal lineage was international clone (IC) 2 (n = 34) and IC 1 (n = 6). According to CLSI, 25 A. baumannii isolates were non-susceptible to imipenem (MIC ≥ 8 mg/L), all of which produced an OXA-58-like or OXA-23-like carbapenemase. The rate of imipenem susceptibility among A. baumannii isolates decreased from 96% in 2005 to 76% in 2009. All other Acinetobacter isolates were susceptible to imipenem. The population structure of carbapenem-susceptible A. baumannii in Germany is highly diverse. Imipenem non-susceptibility was strongly associated with the clonal lineages IC 2 and IC 1. These data underscore the high clonality of carbapenem-resistant A. baumannii isolates. © 2012 The Authors. Clinical Microbiology and Infection © 2012 European Society of

  3. Endovascular Therapy Research in Lower Limb Peripheral Arterial Disease Published Over a 5-Year Period: Who is Publishing and Where?

    Energy Technology Data Exchange (ETDEWEB)

    Asadi, H.; Lee, R. J.; Sheehan, M.; Thanaratam, P.; Lee, D. M.; Lee, A. M.; Lee, M. J., E-mail: [Beaumont Hospital, Interventional Radiology Service, Department of Radiology, Royal College of Surgeons in Ireland Medical School (Ireland)


    IntroductionPeripheral arterial disease (PAD) is being increasingly managed by endovascular therapies. In this study, we identified the clinical services publishing research as well as the journals of publication over a 5-year period.MethodsTwenty keywords and phrases related to endovascular intervention were identified, and a literature search was performed through the PubMed database from January 2009 to January 2014. Inclusion criteria were English language, study population more than five patients, and matching the keyword search. Eligible studies were collated into a database and classified by journal of publication, PubMed number, article title, publishing clinical service, type of publication, country of origin, and authors.Results825 studies from 114 different journals were identified. 297 papers were excluded. Of the 528 included papers, 204 (39%) were published by Vascular Surgery (VS), 157 (30%) by Interventional Radiology (IR), 101 (19%) by Cardiology, 43 (8%) by Angiology, 6 (1%) by Vascular Medicine, and 17 (3%) from miscellaneous services. 283 (54%) studies originated from Europe, 157 (30%) from North America, 76 (14%) from Asia, 6 from Australia, 3 each from South America and Africa. IR published the most papers on PAD endovascular intervention in Europe with VS second while this trend was reversed in the USA. The 528 papers were published in 98 different journals with retrospective case series (72%), the majority.ConclusionIR continues to play a significant research role in endovascular intervention in PAD, particularly in Europe, and specifically in below the knee intervention, pedal intervention, and drug-eluting technologies.

  4. High-Dose Glycine Treatment of Refractory Obsessive-Compulsive Disorder and Body Dysmorphic Disorder in a 5-Year Period

    Directory of Open Access Journals (Sweden)

    W. Louis Cleveland


    Full Text Available This paper describes an individual who was diagnosed with obsessive-compulsive disorder (OCD and body dysmorphic disorder (BDD at age 17 when education was discontinued. By age 19, he was housebound without social contacts except for parents. Adequate trials of three selective serotonin reuptake inhibitors, two with atypical neuroleptics, were ineffective. Major exacerbations following ear infections involving Group A -hemolytic streptococcus at ages 19 and 20 led to intravenous immune globulin therapy, which was also ineffective. At age 22, another severe exacerbation followed antibiotic treatment for H. pylori. This led to a hypothesis that postulates deficient signal transduction by the N-methyl-D-aspartate receptor (NMDAR. Treatment with glycine, an NMDAR coagonist, over 5 years led to robust reduction of OCD/BDD signs and symptoms except for partial relapses during treatment cessation. Education and social life were resumed and evidence suggests improved cognition. Our findings motivate further study of glycine treatment of OCD and BDD.

  5. Compliance with supportive periodontal therapy. Part 1. Risk of non-compliance in the first 5-year period. (United States)

    Novaes, A B; Novaes, A B


    Supportive periodontal therapy (SPT) is needed for the success of periodontal therapy; however, patient compliance is poor. This study evaluates records from non-compliant patients in an attempt to identify a profile of patients with a higher risk of becoming non-compliant. Data on 874 patients who had completed active periodontal treatment up to 5 years earlier and who had begun SPT were analyzed for risk of non-compliance. The factors evaluated were gender (326 males and 548 females); type of therapy (surgical or non-surgical) and age ( or =51 years) and the relationships among them. The overall rate of non-compliance was 46.8%, and the relative risk for non-compliance was greater in the younger age groups (risk factors for non-compliance, but the association of the 3 factors produced interesting results. This study suggests that certain patient groups have a higher risk of non-compliance and that clinicians should intensify their efforts in motivating and instructing these patient groups in the importance of SPT.

  6. Isolation of Salmonella Enteritidis phage type 30 from a single almond orchard over a 5-year period. (United States)

    Uesugi, Aaron R; Danyluk, Michelle D; Mandrell, Robert E; Harris, Linda J


    In 2001, Salmonella Enteritidis phage type (PT) 30 was isolated from drag swabs of 17 61-ha almond orchards on three farms linked to an outbreak of salmonellosis associated with consumption of raw almonds. The objective of this study was to evaluate the long-term persistence of Salmonella Enteritidis PT 30 in one of the almond orchards associated with the outbreak. Swabs (gauze saturated with full-strength sterile evaporated skim milk and attached to string) were pulled along the orchard floor in a standardized manner for 55 m. At each sample time, two pooled samples (four swabs each) were collected from each orchard quadrant. Swabs were enriched for Salmonella using a delayed secondary enrichment procedure developed for isolation of Salmonella from poultry houses. Suspect Salmonella isolates were selected, confirmed, serotyped, and phage typed, and pulsed-field gel electrophoresis (PFGE) patterns were determined after cleavage with XbaI and BlnI. Salmonella was recovered infrequently from pooled samples collected from January through July (3 of 56 samples, 5.3%). In general, Salmonella isolation frequency per sample time increased during and immediately after the harvest, when large amounts of dust were generated in or near the orchard: August, 4 (20%) of 20 samples; September, 13 (20%) of 64 samples; October, 27 (42%) of 64 samples; November, 4 (25%) of 16 samples; and December, 2 (25%) of 8 samples. All 53 Salmonella isolates during the 5 years were identified as Salmonella Enteritidis PT 30, and two PFGE patterns that differed by the presence of an approximately 40-kb fragment were identified. These data demonstrate the potential for long-term environmental persistence of Salmonella in almond orchards.

  7. Surveillance of Antibiotic Resistance among Hospital- and Community-Acquired Toxigenic Clostridium difficile Isolates over 5-Year Period in Kuwait.

    Directory of Open Access Journals (Sweden)

    Wafaa Y Jamal

    Full Text Available Clostridium difficile infection (CDI is a leading and an important cause of diarrhea in a healthcare setting especially in industrialized countries. Community-associated CDI appears to add to the burden on healthcare setting problems. The aim of the study was to investigate the antimicrobial resistance of healthcare-associated and community-acquired C. difficile infection over 5 years (2008-2012 in Kuwait. A total of 111 hospital-acquired (HA-CD and 35 community-acquired Clostridium difficile (CA-CD clinical isolates from stool of patients with diarrhoea were studied. Antimicrobial susceptibility testing of 15 antimicrobial agents against these pathogens was performed using E test method. There was no evidence of resistance to amoxicillin-clavulanic acid, daptomycin, linezolid, piperacillin-tazobactam, teicoplanin and vancomycin by both HA-CD and CA-CD isolates. Metronidazole had excellent activity against CA-CD but there was a 2.9% resistance rate against HA-CD isolates. Ampicillin, clindamycin, levofloxacin and imipenem resistance rates among the HC-CD vs. CA-CD isolates were 100 vs. 47.4%; 43 vs. 47.4%; 100 vs. 100% and 100 vs. 89%, respectively. An unexpected high rifampicin resistance rate of 15.7% emerged amongst the HA-CD isolates. In conclusion, vancomycin resistance amongst the HA-CD and CA-CD isolates was not encountered in this series but few metronidazole resistant hospital isolates were isolated. High resistance rates of ampicillin, clindamycin, levofloxacin, and imipenem resistance were evident among both CA-CD and HA-CD isolates. Rifampicin resistance is emerging among the HA-CD isolates.

  8. [Outcome of treating initial tuberculosis in the area south of Seville in a 5-year period (1994-1998]. (United States)

    Campos Rodríguez, F; Muñoz Lucena, F; Umbría Domínguez, S; Méndez, C; Nogales Pérez, M


    To analyze the outcome of treating initial tuberculosis (ITB) in the hospital district south of Seville (Spain). A descriptive study of treatment outcome in cases of ITB in our district between 1 January 1994 and 31 December 1998. Outcome was classified according to World Health Organization guidelines:successful (S) potentially unsuccessful (PU), exitus (EX) and transferred out (T).Four hundred fifty-four patients (mean age 35 years) were enrolled; 22% were HIV+ and 21% were intravenous drug users (IVDU). Treatment was self-administered in all cases, with 98% being given the standard prescription of 6 or 9 drugs. No subsequent case history was found for 15 cases, such that outcome could not be assessed. Of the 439 evaluable cases, outcome was S for 74% (326/439), PU for 16% (70/439), EX for 8% (36/439) and T for 6. Outcome for HIV + patients was poorer than for HIV- patients (S: 35/98 versus 291/341, p HIV+ patients was higher than that of HIV- patients (EX:18/98 versus 18/341, p treatment failure were recorded and up to 78% (31/40)were cases of loss of follow-up or abandonment. The variable most closely related to PU was IVDU status (OR = 10.5, p HIV+ and IVDU, which are the factors associated with poorer outcome of self-administered treatment, indicating that supervised treatment is advisable in cases where those factors are present.

  9. Comparative analysis of immediate functional loading and immediate nonfunctional loading to traditional healing periods: a 5-year follow-up of 550 dental implants. (United States)

    Degidi, Marco; Iezzi, Giovanna; Perrotti, Vittoria; Piattelli, Adriano


    Clinical, radiographical, and histological findings have shown that immediately loaded implants show the presence of mineralized tissues at the interface. The aim of this study was to compare an immediate loading protocol with a two-staged one using an implant with a square thread design. One hundred fifty-five consecutive patients (71 men, 84 women), aged between 18 and 78 years (mean: 54 years) participated in this study. A total of 550 implants (Maestro; BioHorizons, Birmingham, AL, USA) were inserted. In group A, 264 implants were inserted in 82 patients with immediate functional loading with occlusal contact if the patients were completely edentulous, or with immediate nonfunctional loading without occlusal contact if the patients were partially edentulous. In group B, 286 implants were inserted in 73 patients with a one-stage or two-stage surgical procedure. All patients were followed for at least 5 years. In the immediately loaded implants group, three implants failed, all in posterior mandibular sites, with an overall 98.8% 5-year survival rate. In the control group, no implant failed, with a 100% 5-year survival rate. No statistically significant differences were found in the survival rates of the implants in the two groups. A very high implant survival rate was also present in our series for the immediately loaded implants. All the three failed implants were retrieved from the same patient, who had poor oral hygiene, after a loading period of 5 years. These data can suggest that, from a clinical point of view, an abbreviated healing period is compatible with the development and maintenance over a longer time period (5 years) of mineralized tissues at the interface with dental implants. We can then conclude that shorter healing periods can be highly satisfactory from a clinical point of view.

  10. A retrospective study of the prevalence and outcomes of syphilis in pregnancy in a 5-year period. (United States)

    Ebenezer, Emily D; Benjamin, Santosh J; Sahni, Rani D; Prakash, John A J; Chelliah, Hepsy; Mathews, Jiji E


    To determine the prevalence of syphilis in pregnancy and to assess the effect of syphilis on maternal and perinatal outcomes. In a retrospective study, data were reviewed for pregnant women who tested positive for syphilis during routine prenatal screening at a center in India between January 2011 and December 2015. Women with both a positive venereal disease research laboratory (VDRL) test and a positive Treponema pallidum hemagglutination assay (TPHA) were considered to have syphilis, and their maternal and fetal outcomes were assessed. Among 51 164 pregnant women who underwent VDRL testing during the study period, 343 women were VDRL-positive (seropositivity rate 0.7%) and 18 were both VDRL- and TPHA-positive and were considered to have syphilis (seropositivity rate gestational-age neonates. Although the prevalence of syphilis was low in the study population, women who were affected had adverse perinatal outcomes. Routine screening of all pregnant women for syphilis as early as possible in pregnancy, with appropriate treatment and follow-up of affected women and newborns, should be done to reduce adverse pregnancy outcomes. © 2017 International Federation of Gynecology and Obstetrics.

  11. Clinical management of unruptured intracranial aneurysm in Germany: a nationwide observational study over a 5-year period (2005-2009). (United States)

    Walendy, Victor; Stang, Andreas


    Our aim was to provide nationwide age-standardised rates (ASR) on the usage of endovascular coiling and neurosurgical clipping for unruptured intracranial aneurysm (UIA) treatment in Germany. Nationwide observational study using the Diagnosis-Related-Groups (DRG) statistics for the years 2005-2009 (overall 83 million hospitalisations). From 2005 to 2009, overall 39 155 hospitalisations with a diagnosis of UIA occurred in Germany. Age-specific and age-standardised hospitalisation rates for UIA with the midyear population of Germany in 2007 as the standard. Of the 10 221 hospitalisations with UIA during the observation period, 6098 (59.7%) and 4123 (40.3%) included coiling and clipping, respectively. Overall hospitalisation rates for UIA increased by 39.5% (95% CI 24.7% to 56.0%) and 50.4% (95% CI 39.6% to 62.1%) among men and women, respectively. In 2005, the ASR per 100 000 person years for coiling was 0.7 (95% CI 0.62 to 0.78) for men and 1.7 (95% CI 1.58 to 1.82) for women. In 2009, the ASR was 1.0 (95% CI 0.90 to 1.10) and 2.4 (95% CI 2.24 to 2.56), respectively. Similarly, the ASR for clipping in 2005 amounted to 0.6 (95% CI 0.52 to 0.68) for men and 1.1 (95% CI 1.00 to 1.20) for women. These rates increased in 2009 to 0.8 (95% CI 0.72 to 0.88) and 1.7 (95% CI 1.58 to 1.82), respectively. We observed a marked geographical variation of ASR for coiling and less pronounced for clipping. For the federal state of Saarland, the ASR for coiling was 5.64 (95% CI 4.76 to 6.52) compared with 0.68 (95% CI 0.48 to 0.88; per 100 000 person years) in Saxony-Anhalt, whereas, ASR for clipping were highest in Rhineland-Palatinate (2.48, 95% CI 2.17 to 4.75) and lowest in Saxony-Anhalt (0.52, 95% CI 0.34 to 0.70). To the best of our knowledge, we presented the first representative, nationwide analysis of the clinical management of UIA in Germany. The ASR increased markedly and showed substantial geographical variation among federal states for all treatment modalities

  12. Psychiatric features in perpetrators of homicide-unsuccessful-suicide at Weskoppies Hospital in a 5-year period

    Directory of Open Access Journals (Sweden)

    Paul Sussman


    Full Text Available Background. In the absence of medical literature reporting on homicide-unsuccessful-suicide (HUS cases in which the perpetrator is referred for forensic psychiatric observation present an opportunity to explore psychiatric features pertaining to the event. Objective. To identify possible contributing psychiatric features in HUS cases. Method. A retrospective, single-centre, descriptive study was conducted, in which were reviewed clinical records of HUS subjects referred for observation to Weskoppies Hospital from December 2005 to January 2011. Socio-demographic and psychiatric information was obtained. Results. Nine cases were reviewed. The median age of the subjects was 29 years and 7 subjects were male. Five cases involved family members. Cases involving couples demonstrated male subjects and cases involving filicide demonstrated female subjects. Only 1 case involved the use of a firearm. At the time of the incident, 4 of the cases had no psychiatric diagnosis but notable interpersonal difficulties. Psychotic disorders were diagnosed in 3 subjects, a depressive disorder in 1 subject and a depressive and anxiety disorder in 1 subject. Conclusion. Subjects commonly used less lethal methods than shooting. The high rate of psychiatric disorders diagnosed is in keeping with court referrals occurring when a mental illness is suspected. Some cases may require specialised probing before psychosis becomes apparent. Identification of psychosocial stressors and failure of coping mechanisms during periods of strife within an intimate relationship may be a focus of future research in homicide-suicide cases. Separation should possibly be investigated as an independent factor which promotes the interpersonal difficulty associated with homicide-suicide.

  13. Peri-implant bone tissues around retrieved human implants after time periods longer than 5 years: a retrospective histologic and histomorphometric evaluation of 8 cases. (United States)

    Iezzi, Giovanna; Piattelli, Adriano; Mangano, Carlo; Shibli, Jamil A; Vantaggiato, Giovanni; Frosecchi, Massimo; Di Chiara, Claudio; Perrotti, Vittoria


    Only rarely, it is possible to find in the literature histological reports of human retrieved implants, especially after several years of functional loading. These implants can help us in understanding the reactions of peri-implant bone. The aim of this study was to perform a histologic and histomorphometric analysis of the peri-implant tissues behavior and of the bone-titanium interface in titanium dental implants retrieved from patients after time periods longer than 5 years. The archives of the Implant Retrieval Center of the Dental School of the University of Chieti-Pescara, Italy were searched for human dental implants, retrieved after a loading period of more than 5 years. A total of 8 implants were found: 3 of these had been retrieved after 5 years, 1 after 6 years, one after 10 years, 1 after 14 years, 1 after 18 years, 1 after 22 years. Only the bone to implant contact in the three best threads was evaluated. Compact, mature, lamellar bone, with few and small marrow spaces, was present around the implants. Osteons with Haversian canals were present inside some threads, in close proximity to the interface, at both cortical and trabecular regions. Other osteons had a direction perpendicular to the direction of the long axis of the implants. Numerous reversal lines were present. At higher magnification, no gaps or fibrous, connective tissues were present at the interface. The BIC of the three best threads for all implants varied from 94 to 100 %.In conclusion, within the limitations of the present report histology showed that implants with different surfaces all presented the potential to maintain osseointegration over a long period, with a continuous remodeling at the interface, as indicated by the presence of reversal lines.

  14. Lead exposure in young children over a 5-year period from urban environments using alternative exposure measures with the US EPA IEUBK model - A trial. (United States)

    Gulson, Brian; Taylor, Alan; Stifelman, Marc


    The US Environmental Protection Agency (EPA) Integrated Exposure Uptake Biokinetic (IEUBK) model has been widely used to predict blood lead (PbB) levels in children especially around industrial sites. Exposure variables have strongly focussed on the major contribution of lead (Pb) in soil and interior dust to total intake and, in many studies, site-specific data for air, water, diet and measured PbB were not available. We have applied the IEUBK model to a comprehensive data set, including measured PbB, for 108 children monitored over a 5-year period in Sydney, New South Wales, Australia. To use this data set, we have substituted available data (with or without modification) for standard inputs as needed. For example, as an alternative measure for soil Pb concentration (μg/g), we have substituted exterior dust sweepings Pb concentration (μg/g). As alternative measures for interior dust Pb concentration (μg/g) we have used 1) 30-day cumulative petri dish deposition data (PDD) (as µg Pb/m2/30days), or 2) hand wipe data (as μg Pb/hand). For comparison, simulations were also undertaken with estimates of dust Pb concentration derived from a prior regression of dust Pb concentration (μg/g) on dust Pb loading (μg/ft2) as concentration is the unit specified for the Model. Simulations for each subject using observed data aggregated over the 5-year interval of the study, the most usual application of the IEUBK model, showed using Wilcoxon tests that there was a significant difference between the observed values and the values predicted by the Model containing soil with hand wipes (p application of the IEUBK model, results in predicted PbB about 22% (range 0 to 52%) higher than those from soil with PDD data sets. Geometric mean contributions estimated from the Model to total Pb intake for a child aged 1-2 years was 0.09% for air, 42% for diet, 5.3% for water and 42% for soil and dust. Our results indicate that it is feasible to use alternative measures of soil and dust

  15. [Development of chronic human chagas cardiopathy in the hinterland of the Paraíba State, Brazil, in a 4.5 year period]. (United States)

    Pereira, J B; da Cunha, R V; Willcox, H P; Coura, J R


    Two sectional studies about chronic Chagas' disease were performed at a 4.5 year interval, involving the urban populations of Agua Branca, Catingueira, Emas, Imaculada, Mãe D'Agua, Olho D'Agua, Piancó and São José de Caiana counties in the Sertão region of the State of Paraíba. The evolution of heart disease was evaluated in 125 matched pairs of chronic chagasic and non-chagasic patients of the same sex, age and county of origin through electrocardiograms (ECG) at rest. The following evaluation criteria were considered: unchanged - no change in the original ECG pattern; progressive-changes in ECG pattern from normal to abnormal or deterioration of ECG abnormalities; and ECG normalization. In chagasic patients evolution of the disease was unchanged in 101 (80.8%), progressive in 13 (10.4%) and ECG normalization in 11 (8.8%), while those observed in non-chagasic patients were respectively values 117 (93.6%), 6 (4.8%) and 2%) patients. Findings indicate that the share of Chagas-linked etiological component affecting the development of chronic Chagas cardiopathy was 5.9% with an estimated annual average of 1.3%. There was no significant difference in the frequency of progressive disease between the sexes either in the chagasic or in the non-chagasic group. On the other hand, progression of heart disease occurred earlier among chagasic patients. Lethality caused by heart disease was 1.6% (2 cases) in the chagasic group and zero in the non-chagasic group during the period under survey. These morbidity and mortality rates were significantly lower than those found in endemic areas such as Virgem da Lapa and Pains-Iguatama in the State of Minas Gerais and can probably be attributed to the weaker pathogenic it of human infection by Trypanosoma cruzi in the Paraíba hinterland.

  16. Effect of dry period length on milk production in subsequent lactation

    DEFF Research Database (Denmark)

    Sørensen, J.T.; Enevoldsen, Carsten


    The effect of planned dry period lengths of 4, 7, and 10 wk on subsequent lactational yield was estimated with 366 cows in an experiment in which dry period was manipulated independently of milk yield prior to drying off. In two herds, all three treatments were compared within herd; in six herds......, two treatments were compared within herd. Compared with a 7-wk planned dry period, a 3-wk decrease lowered the level of milk production by 2.8 kg of 4% FCM/d in the first 84 d of the subsequent lactation, whereas a 3-wk increase raised the level of milk production by .5 kg/d. In the first 168 d...... of the subsequent lactation, the difference between 4-wk and 7-wk planned dry periods was 2.7 kg/d, and the difference between 7- and 10-wk periods was .4 kg/d. There was no indication of interaction among planned dry period length and lactation number, days open in previous lactation, previous milk yield, breed...

  17. Differences in predictors of 5-year survival over a 10-year period in two cohorts of elderly nursing home residents in Sweden. (United States)

    Sund Levander, Märta; Milberg, Anna; Rodhe, Nils; Tingström, Pia; Grodzinsky, Ewa


    The aim was to compare 5-year survival in two included cohorts (from year 2000 and year 2007) of 249 nursing home residents (NHR) in this retrospective, comparative study. The cohorts were compared regarding chronic diseases, medication, physical/cognitive/nutritional status, body mass index, body temperature and 5-year mortality. Factors correlated with 5-year survival were determined using Cox regression analysis. In average, cohort 2007 survived 31 ± 16 months and cohort 2000, 38 ± 13 months, p nursing homes (NH), more dependent in activities of daily living (ADL), had dementia, stroke, autoimmune disease and treatment with antidepressants, while malnutrition and treatment with paracetamol were more common 2000. In 2000, medication with antidepressants, the presence of stroke and diabetes, irrespective of gender, and in women cardiovascular disease, two to threefold significantly increased survival, while autoimmune disease, influenza vaccination and dependency in ADL decreased survival. In 2007, maintaining BMI, irrespective of gender, and autoimmune disease and COPD in women significantly increased survival, while malnutrition, influenza vaccination, dependency in ADL and medication with sedatives/tranquillisers or paracetamol severely reduced survival. The present results indicate a trend that individuals are older and frailer when admitted to NH and that survival time after admission has been shortened. Hence, the need of daily support and care has increased, irrespective of housing. Also, predictors of survival, possible to influence, have changed. © 2016 Nordic College of Caring Science.

  18. Case Series of HIV Infection-Associated Arteriopathy: Diagnosis, Management, and Outcome Over a 5-Year period at Maharaj Nakorn Chiang Mai Hospital, Chiang Mai University. (United States)

    Orrapin, Saritphat; Reanpang, Termpong; Orrapin, Saranat; Arwon, Supapong; Kattipathanapong, Thanate; Lekwanavijit, Suree; Rerkasem, Kittipan


    Patients infected with human immunodeficiency virus (HIV) can present with 4 pathology types: drug-induced vasospasm (ergotism), arterial limb ischemia, critical limb ischemia, and aneurysm. Although these problems are common vascular problems, they result in increased morbidity and mortality in HIV-infected patients, especially aneurysm. Patients with these problems tend to be diagnosed with difficulty because of atypical symptoms and signs. Because of lack of data in treatment outcome literature, our report explores and provides information on HIV infection-related arteriopathy. There were 17 patients in our 5-year review. There was no death in patients except the aneurysm type. The survival of aneurysm patients was significantly lower than from other pathologies (P = .003). Our case series showed good short-term outcome, and patients were not at risk for less beneficial surgical procedures. © The Author(s) 2015.

  19. Factors in Dry Period Associated with Intramammary Infection and Subsequent Clinical Mastitis in Early Postpartum Cows

    Directory of Open Access Journals (Sweden)

    Kansuda Leelahapongsathon


    Full Text Available The objective of this study was to determine cow characteristics and farm management factors during the dry period associated with early postparturient intramammary infection (IMI and subsequent clinical mastitis (CM. Data were collected three times: before drying off (P1, during the dry period (P2, and 5 to 14 days after calving (P3, using questionnaires and farm investigation. Milk samples were aseptically collected for bacterial identification at P1 and P3. Factors associated with IMI and CM were analyzed using multiple logistic regression models. The final model showed that IMI in early postpartum was significantly associated with full insertion of dry cow antibiotic, dry cows in barns with a combination of tie and free stalls, body condition score (BCS in dry period and after calving, and milk yield before drying off. For IMI cows, factors significantly associated with clinical expression of mastitis were having daily barn cleaning, teat disinfected with alcohol before administration of dry cow therapy, BCS before drying off, milk yield before drying off, and days in milk at drying off. In conclusion, both cow and farm management factors are associated with the IMI rate and subsequent expression of clinical signs of mastitis in early postpartum cows.

  20. Prevalence of membranoproliferative glomerulonephritis at Hospital General de México “Dr. Eduardo Liceaga” over a 5-year period

    Directory of Open Access Journals (Sweden)

    C.A. Mendoza-Cerpa


    Full Text Available Background: Membranoproliferative glomerulonephritis is a pattern of glomerular lesion with a variety of causes. It can be classified by using direct immunofluorescence into immune complex-mediated membranoproliferative glomerulonephritis and complement-mediated membranoproliferative glomerulonephritis. Objective: Determine the prevalence of membranoproliferative glomerulonephritis by biopsy (light microscopy, direct immunofluorescence and electron microscopy, categorise them according to the most recent classification, identify possible causes and determine certain epidemiological and clinical characteristics. Material and method: A descriptive, cross-sectional study was carried out, selecting renal biopsies with a membranoproliferative pattern at 5 years at Hospital General de México. Age, gender, clinical syndrome and immunofluorescence and electron microscopy results were obtained. Biopsies lacking immunofluorescence or electron microscopy results were excluded. Results: 133 biopsies diagnosed as membranoproliferative glomerulonephritis were obtained. The average annual rate was 3.37%, while average age was 31.35 ± 16 years. The disorder affected mostly women (60.15%, n = 80. Nephrotic syndrome was the most common clinical presentation (48.12%, n = 64, while autoimmune disease was the most common cause (77.77%, n = 91. Conclusions: Direct immunofluorescence is indispensable for classifying membranoproliferative glomerulonephritis. Resumen: Antecedentes: La glomerulonefritis membranoproliferativa es un patrón de lesión glomerular con diferentes etiologías. Se clasifica por inmunofluorescencia directa en: glomerulonefritis membranoproliferativa mediada por complejos inmunes y glomerulonefritis membranoproliferativa mediada por complemento. Objetivo: Determinar la prevalencia de las glomerulonefritis membranoproliferativas mediante la biopsia (microscopía de luz, inmunofluorescencia directa y microscop

  1. Emission measurements of alkenes, alkanes, SO2, and NO2 from stationary sources in Southeast Texas over a 5 year period using SOF and mobile DOAS (United States)

    Johansson, John K. E.; Mellqvist, Johan; Samuelsson, Jerker; Offerle, Brian; Lefer, Barry; Rappenglück, Bernhard; Flynn, James; Yarwood, Greg


    A mobile platform for flux measurements of VOCs (alkanes and alkenes), SO2, and NO2 emissions using the Solar Occultation Flux (SOF) method and mobile differential optical absorption spectroscopy (DOAS) was used in four different studies to measure industrial emissions. The studies were carried out in several large conglomerates of oil refineries and petrochemical industries in Southeast and East Texas in 2006, 2009, 2011, and 2012. The measured alkane emissions from the Houston Ship Channel (HSC) have been fairly stable between 2006 and 2011, averaging about 11,500 kg/h, while the alkene emissions have shown greater variations. The ethene and propene emissions measured from the HSC were 1511 kg/h and 878 kg/h, respectively, in 2006, while dropping to roughly 600 kg/h for both species in 2009 and 2011. The results were compared to annual inventory emissions, showing that measured VOC emissions were typically 5-15 times higher, while for SO2 and NO2 the ratio was typically 0.5-2. AP-42 emission factors were used to estimate meteorological effects on alkane emissions from tanks, showing that these emissions may have been up to 35-45% higher during the studies than the annual average. A more focused study of alkene emissions from a petrochemical complex in Longview in 2012 identified two upset episodes, and the elevation of the total emissions during the measurement period due to the upsets was estimated to be approximately 20%. Both meteorological and upset effects were small compared to the factor of 5-15, suggesting that VOC emissions are systematically and substantially underestimated in current emission inventories.

  2. Incidence and 5-year survival rate for head and neck cancers in Grenada compared to the African American population over the period 1991-2010. (United States)

    du Plessis, Maira; Hage, Robert


    Very little data exist on the incidence and burden of cancer in the individual Caribbean countries. Some data are available for larger areas, reported under a bigger geographical region; Latin America and the Caribbean, but many of the individual countries are not included. One of the main reasons is a lack of official cancer registries. Data are usually collected from hospital records or private physician records, and since it is not in an official registry, these data are not always accessible for inclusion in databases such as SEER and GLOBOCAN. Grenada is one of the countries that currently does not have a registry. Our aim is to report on the incidence for head and neck cancer with subcategories; hypopharynx, oropharynx, oral cavity, salivary glands, and larynx from data collected by the sole ear nose and throat specialist over a 20-year period. The age adjusted incidence per 100,000 for these cancers, whether combined or individually, is lower than that of similar populations. The incidence in males is only slightly higher than those reported in some parts of Africa. In females, only Eastern Africa is reported to have a lower incidence than that found in our study. While the incidence of oral cancers is lower than that of African Americans, the survival rate is comparable. Socioeconomic status, lack of infrastructure, and advanced stage at diagnosis appear to be closely related to the survival rate. Incidence reports suggest that incidence of head and neck cancers in individuals of African descent is lower than other populations. It is therefore not surprising that the incidence in Grenada is relatively low, although the incidence may be underestimated.

  3. Effect of nutritional immunomodulation and heat stress during the dry period on subsequent performance of cows. (United States)

    Fabris, Thiago F; Laporta, Jimena; Corra, Fabiana N; Torres, Yazielis M; Kirk, David J; McLean, Derek J; Chapman, J D; Dahl, Geoffrey E


    among treatments in hematocrit, total protein, and body condition score. Cows offered CLOG, CL, and HTOG treatments had greater body weight during the dry period (794.9 ± 17.9, 746.8 ± 16.7, and 762.9 ± 14.9 kg, respectively) than HT cows (720 ± 16.2 kg). Gestation length was approximately 4 d longer for CL cows compared with HT cows. Cows offered CLOG, CL, and HTOG treatments produced more milk (41.3 ± 1.6, 40.7 ± 1.6, and 40.5 ± 1.6 kg/d, respectively) than HT treatment (35.9 ± 1.6 kg/d). Body weight after parturition and DMI were evaluated up to 60 DIM and averaged 661.5 ± 15.8 and 19.4 ± 0.7 kg/d, respectively, with no differences observed among treatments. These results confirm that exposure of dry cows to heat stress negatively affects milk yield in the subsequent lactation. Active cooling of dry cows and OG supplementation can reduce the negative effects of heat stress in the dry period on subsequent performance. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  4. TODDLERS (1 - 5 YEARS)

    African Journals Online (AJOL)


    Crèches, play schools and nursery schools bombard the toddler with air-borne micro-organisms and allergens. Some toddlers may have a genetic predisposition to atopic dermatitis, but apart from this, the toddler years are a relatively quiet period dermatologically, superseded to a large extent by upper respiratory tract.

  5. Effects of presynchronization during the preservice period on subsequent ovarian activity in lactating dairy cows. (United States)

    López-Gatius, F; Murugavel, K; Santolaria, P; Yániz, J; López-Béjar, M


    Among the strategies aimed at overcoming difficulties in estrus detection in dairy herds, presynchronization with two PGF2alpha treatments 14 days apart before a timed AI protocol has been related to a significant increase in pregnancy rates. The aim of the present study was to evaluate the effects of presynchronization during the preservice period on subsequent ovarian activity in clinically normal lactating dairy cows. A second objective was to evaluate the incidence of reproductive disorders on Day 50 postpartum. Depending on the chronological order of parturition, cows were alternately assigned to a control (n=102) or treatment (n=101) group. Animals in the treatment group were administered two cloprostenol treatments 14 days apart, beginning on Day 22 postpartum. The reproductive tract of each animal was examined ultrasonographically on Days 43 and 50 postpartum to monitor ovarian structures and uterine contents. Blood samples were collected on Day 50 for progesterone determination. Cows were inspected for signs of estrus between Days 50 and 71 postpartum and were then inseminated. Follicular persistence rates were similar in the presynchronized (14.9%) and control (13.7%) groups. Cows in the presynchronized group showed a lower metritis-pyometra rate (0% ovarian cyst rate (3% /=1ng/ml) on Day 50 postpartum (76.2% > 52.9%; P=0.0005); a higher estrus detection rate (73.3% > 47.1%; P 44%; P 15.7%; P=0.02) than controls. Our results indicate that presynchronization during the preservice period reduces the incidence of ovarian cysts and metritis-pyometra determined on Day 50, and improves ovarian activity from Days 50 to 71 postpartum along with pregnancy rates in clinically normal lactating dairy cows.

  6. Meals of differing caloric content do not alter physical activity behavior during a subsequent simulated recess period in children

    National Research Council Canada - National Science Library

    Smith, Kelly J; Pohle-Krauza, Rachael; Uhas, Samantha; Barkley, Jacob E


    .... This is of importance as a typical school lunch is HC. If this type of meal negatively impacts subsequent physical activity behavior, the ability of post-lunch recess periods as a means to increase energy expenditure...

  7. Effects of dry period length and dietary energy source on lactation curve characteristics over 2 subsequent lactations

    NARCIS (Netherlands)

    Chen, J.; Kok, A.; Remmelink, G.J.; Gross, J.J.; Bruckmaier, R.M.; Kemp, B.; Knegsel, Van A.T.M.


    This study evaluated the effects of dry period (DP) length and dietary energy source on lactation curve characteristics over 2 subsequent lactations. It also evaluated the relationships of energy balance or metabolic status in early lactation with lactation curve characteristics in dairy cows.

  8. Period effects in the risk of subsequent labour market marginalisation in young suicide attempters. (United States)

    Niederkrotenthaler, T; Helgesson, M; Rahman, S; Wang, M; Mittendorfer-Rutz, E


    Suicide attempt in young age is associated with subsequent labour market marginalisation, but little is known about how marginalisation is affected by changes in suicide attempt rates and social insurance legislation and by age differences. Prospective cohort study based on register linkage of > 2.4 million Swedish residents per birth cohort, aged 19-40 years in 1999; 2004 and 2009, respectively, and followed up for 4 years. Suicide attempters treated in inpatient care in the three years preceding study entry (n > 7000 per cohort) were compared with the general population of the same age without attempt (1987 to end of follow-up). Hazard ratios (HR) and 95% confidence intervals for long-term unemployment (>180 days), sickness absence (>90 days) and disability pension were calculated with Cox regression, adjusted for several risk markers. Additional analyses were stratified by age (below/above 30 years). Across all cohorts, suicide attempt was associated with subsequent labour market marginalisation. Estimates were generally highest for disability pension [e.g. 2009 cohort: adjusted (a) HR = 2.7], followed by sickness absence (2009 cohort: aHR = 2.3) and unemployment (2009 cohort: aHR = 1.5). aHRs were higher in the 2004 and 2009 cohorts compared with the 1999 cohort. For disability pension, for example, aHRs were 2.39, 3.90 and 2.68 for the 1999, 2004 and 2009 cohorts, respectively. Stratification revealed marginal age differences. It seems to have become more difficult for suicide attempters to establish themselves on the labour market in later cohorts, which might result from changes in social insurance regulations. There were no considerable age differences.

  9. Effects of carbohydrate, branched-chain amino acids, and arginine in recovery period on the subsequent performance in wrestlers

    Directory of Open Access Journals (Sweden)

    Jang Tsong-Rong


    Full Text Available Abstract Many athletes need to participate in multiple events in a single day. The efficient post-exercise glycogen recovery may be critical for the performance in subsequent exercise. This study examined whether post-exercise carbohydrate supplementation could restore the performance in the subsequent simulated wrestling match. The effect of branched-chain amino acids and arginine on glucose disposal and performance was also investigated. Nine well-trained male wrestlers participated in 3 trials in a random order. Each trial contained 3 matches with a 1-hr rest between match 1 and 2, and a 2-hr rest between match 2 and 3. Each match contained 3 exercise periods interspersed with 1-min rests. The subjects alternated 10-s all-out sprints and 20-s rests in each exercise period. At the end of match 2, 3 different supplementations were consumed: 1.2 g/kg glucose (CHO trial, 1 g/kg glucose + 0.1 g/kg Arg + 0.1 g/kg BCAA (CHO+AA trial, or water (placebo trial. The peak and average power in the 3 matches was similar in the 3 trials. After the supplementation, CHO and CHO+AA trial showed significantly higher glucose and insulin, and lower glycerol and non-esterified fatty acid concentrations than the placebo trial. There was no significant difference in these biochemical parameters between the CHO and CHO+AA trials. Supplementation of carbohydrate with or without BCAA and arginine during the post-match period had no effect on the performance in the following simulated match in wrestlers. In addition, BCAA and arginine did not provide additional insulinemic effect.

  10. Meals of differing caloric content do not alter physical activity behavior during a subsequent simulated recess period in children. (United States)

    Smith, Kelly J; Pohle-Krauza, Rachael; Uhas, Samantha; Barkley, Jacob E


    Research on adults and animals has demonstrated that chronic and acute overfeeding can alter physical activity behavior. However, there are no assessments of the acute effects of high-calorie (HC) meals on physical activity behavior in children. This is of importance as a typical school lunch is HC. If this type of meal negatively impacts subsequent physical activity behavior, the ability of post-lunch recess periods as a means to increase energy expenditure may be lessened. To assess the effect of two meals of differing caloric content, HC and low calorie (LC), on children's subsequent physical activity behavior. Nineteen healthy children (aged 6-10) completed two laboratory sessions where they were fed lunch with HC or LC content, but equivalent macronutrient distribution. Children had 15 min to consume as much of the meal as possible per session. Children consumed 659.5 ± 101.3 kcal in the HC condition and 291.8 ± 12.1 kcal in the LC condition. After the meal, children went to a gymnasium for 40 min. In the gymnasium children had free-choice access to obstacle courses, various sports equipment, and a table with sedentary activities. Children could play with any of the activities in any amount they wished for the entire activity session. Children's physical activity was monitored with accelerometers and that data was converted into caloric expenditure. Each child ate all meals and participated in the free-choice activity sessions with no other children present. Caloric expenditure during the free-choice activity sessions was not significantly different (p = 0.4) between the HC (89.2 ± 27.3 kcals) and LC (83.4 ± 34.9 kcals) conditions. However, caloric balance (kcals eaten-kcals expended) was 2.74-fold greater (p < 0.001) in the HC condition (Δ 570.3 ± 92.2 kcals) than the LC condition (Δ 208.4 ± 32.0 kcals). Children did not alter their physical activity behavior during a free-choice activity session after consuming a HC meal

  11. Effects of dry period length and dietary energy source on lactation curve characteristics over 2 subsequent lactations. (United States)

    Chen, J; Kok, A; Remmelink, G J; Gross, J J; Bruckmaier, R M; Kemp, B; van Knegsel, A T M


    This study evaluated the effects of dry period (DP) length and dietary energy source on lactation curve characteristics over 2 subsequent lactations. It also evaluated the relationships of energy balance or metabolic status in early lactation with lactation curve characteristics in dairy cows. Holstein-Friesian dairy cows (n=167) were assigned randomly to 1 of 3 DP lengths (0-, 30-, or 60-d) and 1 of 2 early-lactation diets (glucogenic or lipogenic) for 2 subsequent lactations. In the second lactation following DP length treatments, 19 cows in the 0-d DP group were assigned to a 0→67-d DP group (actual days dry: 67±8d). Cows were allocated to this new group when they had a milk yield of lactations. Blood samples were taken weekly from calving to wk 4 after calving. A Wilmink lactation curve for each lactation was modeled based on FPCM yield records from calving through 305 DIM. During the first lactation following DP length treatments, cows with a 0- or 30-d DP had lower peak yield, later time of peak yield, and lower FPCM305 than cows with a 60-d DP. In the second lactation following DP length treatments, cows with a 0- or 30-d DP had lower peak yield than cows with a 60-d DP. In both lactations, lactation persistency was not affected by DP length and none of the lactation curve characteristics were affected by diet. In parity >2 cows, total FPCM yield and average daily FPCM yield throughout 2 lactations did not differ among DP lengths. In addition, average energy balance in the first 4wk after calving had a negative relationship with peak yield and FPCM305, and a positive relationship with lactation persistency. Average plasma concentrations of free fatty acids and β-hydroxybutyrate had a positive relationship with peak yield and FPCM305, and a negative relationship with lactation persistency. Shortening or omitting the DP affected lactation curve characteristics in both lactations after implementation of DP length treatments but did not compromise FPCM yield

  12. Hospitalizations associated with malignant neoplasia and in situ carcinoma in the anus and penis in men and women during a 5-year period (2009-2013) in Spain: An epidemiological study. (United States)

    López, Noelia; Gil-de-Miguel, Ángel; Pascual-García, Raquel; Gil-Prieto, Ruth


    Approximately 40,000 new cases of anal cancer and 26,000 new cases of penile cancer occurred in 2012 worldwide. Human Papillomavirus (HPV) infection is responsible for 88.3% and 33.0% of these cancers, respectively. The aim of this study was to describe the hospital burden associated with malignant neoplasm (MN) and in situ carcinoma (ISC) in the anus and penis in Spain from 2009 to 2013. This observational, retrospective study used discharge information obtained from the national surveillance system for hospital data, Conjunto Mínimo Básico de Datos, provided by the Ministry of Health. We found 3,668 hospitalizations due to MN and ISC in the anus for both genders, and more than 55% of these hospitalizations occurred in men and were associated with a lower median age of hospitalization (p 14 y old and 1.604 per 100,000 women aged > 14 y old, p 14 y old. The hospitalization rate due to MN and ISC in the anus in males increased significantly during this period (p = 0.048). Our study provides relevant information about the hospital burden of anal and penile MN and ISC in Spain. This information could be useful for cost effectiveness analysis of universal HPV vaccination and for future HPV vaccination impact monitoring in Spain, and for other countries of similar socioeconomic status.

  13. Single center experience over a 5-year period with sequential Transarterial Chemoembolization (TACE) in the treatment of Hepatocellular Carcinoma (HCC); Sequentielle transarterielle Chemoembolisation (TACE) des hepatozellulaeren Karzinoms (HCC) - Erfahrungsbericht eines einzelnen Zentrums ueber 5 Jahre

    Energy Technology Data Exchange (ETDEWEB)

    Herber, S.C.; Schneider, J.; Kummer, I.; Manzl, N.; Dueber, C.; Pitton, M.B. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie; Otto, G.; Moench, C. [Mainz Univ. (Germany). Transplantationschirurgie und Chirurgie von Leber, Gallenwegen, Pankreas; Woerns, M.; Kanzler, S.; Schuchmann, M. [Mainz Univ. (Germany). I. Medizinische Klinik; Junginger, T. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Allgemein- und Abdominalchirurgie


    Purpose: To analyze the course of disease of patients treated with sequential TACE and to evaluate the dependent and independent prognostic factors for patient survival using the Cox Proportional Hazard Model. Materials and Methods: 94 patients palliatively treated with TACE. Patients were selected if they had been treated at least 3 times. The TACE procedure was carried out at 8-week intervals using a suspension consisting of a fixed dosage of Mitomycin C (10 mg) and 10 ml Lipiodol. Follow-up investigations included contrast-enhanced multislice CT before and after TACE and assessment of the laboratory test results (i. e., blood count, liver enzymes, and coagulation). Results: In 66.7 % of the patients, multifocal tumors were found. In 16.0 % of the patients, the tumor load represented more then 50 % of the liver volume. In 23.4 % of the cases, a portal vein thrombosis was found in the initial CT scan. The mean survival for the total cohort was 24.1 months (95 %-CI 20.1 - 28.2). During the investigation period, 72/94 of the patients died. The cumulative 1-year, 2-year, and 3-year survival rates are 71.6 %, 33.9 %, und 17.2 %, respectively. A median of 6.0 {+-} 3.1 (range 14, n total = 612 TACE) was performed in each patient. A total of 62.5 % patients died because of tumor progression whereas 18.1 % died due to progressive liver failure. Patients in whom the tumor responded to the TACE treatment and who did not develop ascites or those with Okuda stage I or unifocal tumor growth showed a survival benefit whereas the presence of portal vein thrombosis was associated with a significantly poor outcome (p < 0.05). The Child-Pugh stage was not statistically significant for the disease course; the occurrence of new tumor lesions had no influence with regard to 1-year and 2-year survival but had a significant influence on long-term survival (p < 0,05). Independent prognostic factors are (multivariate analysis; p < 0.05): number of TACE performed, tumor type (i. e

  14. Effect of different dry period lengths on milk production and somatic cell count in subsequent lactation on commercial Dutch dairy herds.

    NARCIS (Netherlands)

    Steeneveld, W.; Schukken, Y.H.; Knegsel, van A.T.M.; Hogeveen, H.


    Shortening the dry period (DP) has been proposed as a management strategy to improve energy balance in early lactation. It is well known that both shortening and complete omission of the DP reduces milk production in the subsequent lactations. In most of these studies milk production data were

  15. Latino Children's Body Mass Index at 2–3.5 Years Predicts Sympathetic Nervous System Activity at 5 Years (United States)

    Harley, Kim G.; Neilands, Torsten B.; Tambellini, Katelyn; Lustig, Robert H.; Boyce, W. Thomas; Eskenazi, Brenda


    Abstract Background: To understand whether the relationship between young children's autonomic nervous system (ANS) responses predicted their BMI, or vice versa, the association between standardized BMI (zBMI) at 2, 3.5, and 5 years of age and ANS reactivity at 3.5–5 years of age, and whether zBMI predicts later ANS reactivity or whether early ANS reactivity predicts later zBMI, was studied. Methods: Low-income, primarily Latino children (n=112) were part of a larger cohort study of mothers recruited during early pregnancy. Study measures included maternal prenatal weight, children's health behaviors (i.e., time watching television, fast food consumption, and time playing outdoors), children's height and weight at 2, 3.5, and 5 years, and children's ANS reactivity at 3.5 and 5 years. ANS measures of sympathetic nervous system (i.e., pre-ejection period) and parasympathetic nervous system (i.e., respiratory sinus arrhythmia) activity were monitored during rest and four challenges. Reactivity was calculated as the difference between mean challenge response and rest. Structural equation models analyzed the relationship between children's zBMI at 2, 3.5, and 5 years and ANS reactivity at 3.5 and 5 years, adjusting for mother's BMI, children's behaviors, and changes in height. Results: There was no association between zBMI and ANS cross-sectionally. Children with high zBMI at 2 or 3.5 years or large zBMI increases from 2 to 3.5 years of age had decreased sympathetic activity at 5 years. Neither sympathetic nor parasympathetic reactivity at 3.5 years predicted later zBMI. Conclusions: Increased zBMI early in childhood may dampen young children's SNS responses later in life. PMID:24745554

  16. Stunting at 5 Years Among SGA Newborns. (United States)

    Xie, Chuanbo; Epstein, Leonard H; Eiden, Rina D; Shenassa, Edmond D; Li, Xiuhong; Liao, Yan; Wen, Xiaozhong


    To compare risk of stunting at 5 years across etiological subgroups of small for gestational age (SGA) newborns. We analyzed data of a subsample (N = 1100) of the Early Childhood Longitudinal Study-Birth Cohort. We defined SGA as birth weight SGA subgroups, adjusting for confounders. SGA subgroup with maternal short stature (odds ratio [OR] = 3.88; 95% confidence interval [CI] = 2.16-6.96) or inadequate GWG (OR = 2.18; 95% CI = 1.23-3.84) had higher risk of stunting at 5 years, compared with the SGA subgroup without the corresponding risk factor. SGA newborns with both maternal smoking and inadequate GWG during pregnancy had much higher risk of stunting at 5 years (OR = 3.10; 95% CI = 1.21-7.91), compared with SGA newborns without any of these 2 SGA risk factors. Etiological subgroups of SGA differed in risk of stunting at 5 years. SGA newborns of inadequate GWG mothers who smoke and SGA newborns of short mothers were at particularly high risk of stunting. Copyright © 2016 by the American Academy of Pediatrics.

  17. The declining impact of piracy on maritime transport in the Indian Ocean: Statistical analysis of 5-year vessel tracking data


    Vespe, Michele; Greidanus, Harm; Alvarez, Marlene Alvarez


    The analysis of the declining impact of piracy on maritime routes and vessel behaviours in the Indian Ocean is here performed using Long Range Identification and Tracking (LRIT) reports. A 5-year archive of vessel position data covering the period characterized by the highest number of attacks and the subsequent decline provides a unique source for data-driven statistical analysis that highlights changes in routing and sailing speeds. The work, besides demonstrating the value of LRIT data for...

  18. Conservative, non-surgical management of patients presenting with impacted lower third molars: a 5-year study. (United States)

    Hill, C M; Walker, R V


    Our aim was to find out what happened over a period of 5 years to fully or partially impacted mandibular third molars that were left alone. The change in emphasis towards non-intervention in patients with asymptomatic impacted wisdom teeth over the past few years was accompanied by considerable debate as to the eventual outcome of such teeth. Examination of a number of factors including smoking, extent of eruption, depth of periodontal pocket, and history of pericoronitis failed to show any predictive factors that would indicate which teeth would subsequently require removal. However, about one-third of the teeth in this series had to be removed within the 5-year period. Although this does not allow a 'lifetime extrapolation', it blurs the edges of our current thinking about asymptomatic wisdom teeth and certainly suggests that further (possibly longer term) studies need to be completed. It does, however, provide little support for the reintroduction of prophylactic removal of wisdom teeth.

  19. Impact of physical activity domains on subsequent physical activity in youth: a 5-year longitudinal study. (United States)

    Hardie Murphy, Michelle; Rowe, David A; Woods, Catherine B


    This study evaluates how domains of physical activity (PA) in youth predict later PA and assesses factors influencing changes in sports participation. Young people from the Children's Sport Participation and Physical Activity study (n = 873; baseline age 10-18 years; 30.4% male) completed self-report surveys in 2009 and 2014. In a multiple linear regression analysis, participation frequency in club sport (β = 0.18) and extracurricular sport (β = 0.13) significantly predicted PA 5 years later, adjusted for age, sex and urban/rural classification (P sports participation were high (males 79.3-85.5%; females 74.8-83.2%). Uptake and dropout of specific sports varied widely. Despite high levels of migration into and out of Gaelic games, they remained popular at follow-up. Weight training was the only sport that increased in both sexes (P motivations for taking up a new sport. Other commitments, a lack of interest and time were important factors leading to sports dropout. PA promotion strategies should include youth sport, take into consideration what sports are attractive to young people and address reasons for uptake and dropout.

  20. Clinical characteristics and outcome of patients diagnosed with psychogenic nonepileptic seizures: a 5-year review.

    LENUS (Irish Health Repository)

    O'Sullivan, S S


    OBJECTIVE: The goal of this article was to describe the clinical characteristics and outcomes of patients diagnosed with psychogenic nonepileptic seizures (PNES). METHODS: We conducted a retrospective review of patients diagnosed with PNES in a 5-year period. RESULTS: Fifty patients with PNES were identified, giving an estimated incidence of 0.91\\/100,000 per annum. Thirty-eight were included for review, 15 of whom were male (39%). Eighteen patients had been diagnosed with epilepsy as well as PNES (47%). We demonstrated a gender difference in our patients, with males having higher seizure frequencies, more antiepileptic drug use, and a longer interval before diagnosis of PNES. Females were diagnosed with other conversion disorders more often than males. Impaired social function was observed in PNES, as was resistance to psychological interventions with a subsequent poor response to treatments. CONCLUSIONS: PNES remains a difficult condition to treat, and may affect males in proportions higher than those described in previous studies.

  1. Effects of dry period length and concentrate protein content in late lactation on body condition score change and subsequent lactation performance of thin high genetic merit dairy cows. (United States)

    Dale, A J; Purcell, P J; Wylie, A R G; Gordon, A W; Ferris, C P


    Improving body condition score of thin cows in late lactation is necessary, because cows that are thin at drying off exhibit decreased fertility postpartum and are at increased risk of disease and of being culled in the subsequent lactation. Offering a diet low in crude protein (CP) content in late lactation may help to improve body condition score (BCS) at drying off, whereas imposing an extended dry period (EDP) has been advocated as another way to increase BCS at calving. To test these hypotheses, 65 thin cows (mean BCS 2.25 at 14 wk precalving) were managed on 1 of 3 treatments between 13 and 9 wk prepartum: normal protein control {NP; grass silage + 5 kg/d of a normal protein concentrate [228 g of CP/kg of dry matter (DM)]}, low protein [LP; grass silage + 5 kg/d of a low-protein concentrate (153 g of CP/kg of DM)], or EDP (cows dried off at 13 wk precalving and offered a grass silage-only diet). Both NP and LP cows were dried off at wk 8 prepartum, after which all cows were offered a grass silage-only diet until calving. After calving, all cows were offered a common diet (supplying 11.1 kg of concentrate DM/cow per day) for 19 wk. Between 13 and 9 wk prepartum, LP cows had lower DM intake, milk yield, and body weight than NP cows. Whereas EDP cows had lower serum β-hydroxybutyrate and fatty acid concentrations than those of NP cows, BCS at wk 9 prepartum did not differ between treatments. Cows on the LP treatment continued to have lower DMI and BW than those of NP and EDP cows between 8 wk prepartum and calving, but only EDP cows had a higher BCS at calving. Treatment did not affect calving difficulty score or calf birth weight. Although all cows were offered a common diet postpartum, cows on the LP treatment had lower DM intake and milk fat + plus protein yield than cows on any other treatment during the 19-wk period postpartum, but we found no differences in any postpartum indicator of body tissue reserves. The treatments imposed from wk 13 to 9 prepartum

  2. Dietary predictors of 5-year changes in waist circumference

    DEFF Research Database (Denmark)

    Halkjaer, Jytte; Tjønneland, Anne; Overvad, Kim


    intake was positively associated. Sex differences occurred for vegetables, high-fat dairy products, and processed meat. CONCLUSIONS: The results suggest that a diet low in fruits and red meat and high in snack foods was associated with larger waist circumference gains in both sexes. Furthermore, in women...... to intake from red meat, vegetables, fruit, butter, and high-fat dairy products, whereas intake from potatoes, processed meat, poultry, and snack foods was positively associated. For men, red meat and fruit intakes were inversely associated with 5-year difference in waist circumference, whereas snack foods...... a diet low in vegetables, butter, and high-fat dairy products, and high in poultry, potatoes, and processed meat were likely determinants of subsequent gain at the waist....

  3. Henoch schonlein purpura--a 5-year review and proposed pathway.

    Directory of Open Access Journals (Sweden)

    Louise Watson

    Full Text Available Henoch Schonlein Purpura (HSP is the commonest systemic vasculitis of childhood typically presenting with a palpable purpuric rash and frequently involving the renal system. We are the first group to clinically assess, critically analyse and subsequently revise a nurse led monitoring pathway for this condition.A cohort of 102 children presenting with HSP to a secondary/tertiary level UK paediatric hospital over a five year period, were monitored using a nurse led care pathway. Using this cohort, the incidence (6.21 cases per 100,000 children per year and natural disease course of HSP nephritis (46% initial renal inflammation; 9% subsequent renal referral; 1% renal biopsy and immunosuppression was determined. Older patients were at higher risk of requiring a renal referral (renal referral 12.3 (8.4-13.5 years vs. normal outcome 6.0 (3.7-8.5 years; p<0.01. A normal urinalysis on day 7 had a 97% (confidence interval 90 to 99% negative predictive value in predicting a normal renal outcome.Using this data and existing literature base, The Alder Hey Henoch Schonlein Purpura Pathway was developed, a revised pathway for the screening of poor renal outcome in HSP. This is based on a six-month monitoring period for all patients presenting with HSP, which importantly prioritises patients according to the urine findings on day 7 and thus intensively monitors those at higher risk of developing nephritis. The pathway could be easily adapted for use in different settings and resources.The introduction of a standardised pathway for the monitoring of HSP will facilitate the implementation of disease registries to further our understanding of the condition and permit future clinical trials.

  4. Postpolio syndrome: a 5 year follow-up. (United States)

    Stanghelle, J K; Festvåg, L V


    The purpose of this investigation was to study subjective symptoms, medical and social situation, pulmonary function and physical work capacity during a period of 3-5 years in patients with the postpolio syndrome. We evaluated 68 patients consecutively admitted to our hospital because of postpolio syndrome, and re-evaluated 63 of the same patients 3-5 years later, 43 women and 20 men with mean age 55 +/- 10 (1 SD) years at the second evaluation. The patients answered a questionnaire about their subjective symptoms and medical and social situation, and underwent spirometry as well as symptom-limited exercise stress testing. Most patients experienced increasing symptoms and physical disability related to their polio, while the majority reported that their mental health were unchanged or improved. The lung function was in average moderately reduced of restrictive type, and only minor changes were found during the 3-5 years. A pronounced reduction in peak oxygen uptake was seen at the first evaluation, especially in women. At the second examination, peak oxygen uptake was further decreased, especially in men, more than predicted from increasing age. The patients increased their body mass index significantly during the same period. These results indicate that subjective symptoms and physical disability related to polio increased with increasing age in these patients with the post-polio syndrome, and cardiorespiratory deconditioning and weight gain also became increasing problems in most patients. However, the mental status of the patients remained stable or improved, possibly due to our comprehensive re-rehabilitation and educational programme.

  5. University Hospital Waterford: 5-year experience of cutaneous melanoma. (United States)

    Sehgal, R; Cheung, C X; Alradadi, R; Healy, D A; Landers, R; O'Donoghue, G T


    The incidence of cutaneous melanoma (CM) continues to rise in Ireland. Despite significant advances in melanoma molecular therapy, surgery remains the mainstay of treatment for CM. The University Hospital Waterford (UHW) prospectively maintained CM registry was established in 2010. To summarize 5-year experience (2010-2015) of primary CM presenting to UHW. Data were retrospectively obtained from a central electronic pathology and radiology repository augmented by HIPE data and theatre logs. Data collected included patient demographics and clinico-pathological characteristics, specimen number, size, anatomical location, melanoma subtype, Breslow thickness, Clark's level, ulceration, and mitosis. 592 CMs were managed in UHW during the study period. Overall, females comprised the majority of cases with mean age at presentation 60.78 ± 18.29 years. The most commonly affected anatomical location was the lower limb (26.7%) followed by the back (15.1%), upper limb (15.07%), and face (14.40%). Superficial spreading and lentigo maligna were the most common histological subtype accounting for 19.8 and 20%, respectively. Overall, the mean Breslow depth was 2.4 ± 3.7 mm with corresponding Clark's Level III. Sentinel lymph node positivity was 39/103 (37.89%) most commonly located in the axilla (53.8%) and groin (30.7%). There has been a steady increase in the number of cutaneous melanoma presentations over the past 5-years to the South East Cancer Centre. Patients are managed best by prompt surgical excision and multidisciplinary management. Our results are in keeping with international standards and work continues in determining overall 5-year survival and recurrence rates.

  6. Loop electrosurgical excision of the cervix and subsequent risk for spontaneous preterm delivery: a population-based study of singleton deliveries during a 9-year period

    DEFF Research Database (Denmark)

    Noehr, Bugge; Jensen, Allan; Frederiksen, Kirsten


    OBJECTIVE: Our aim was to assess the association between loop electrosurgical excision procedure (LEEP) and the subsequent risk for spontaneous preterm delivery, with the use of population-based data from various nationwide registries. STUDY DESIGN: The study population consisted of all singleton...

  7. The period of the follicular phase during which the uterus of mares shows estrus-like echotexture influences the subsequent pregnancy rate

    NARCIS (Netherlands)

    Mateu-Sánchez, S; Newcombe, J R; Garcés-Narro, C; Cuervo-Arango, J


    The interval from both spontaneous and prostaglandin (PGF)-induced luteolysis to ovulation is greatly variable in mares. Several reports have shown a positive association between the length of the interval from PGF treatment to ovulation (ITO) and the subsequent pregnancy rate (PR). However, it is

  8. Immediately loaded zygomatic implants: a 5-year prospective study. (United States)

    Davó, Rubén; Malevez, Chantal; Pons, Olivia


    This prospective study was designed to assess the long-term outcome of immediately loaded zygomatic implants placed in atrophic maxillae. Forty-two consecutively treated patients received 81 zygomatic implants and 140 conventional implants for oral rehabilitation and were followed for 5 years. Complete arch rehabilitation was accomplished in 37 patients and partial arch rehabilitation in 5 (one zygomatic implant in combination with two conventional implants). Outcome measures were prosthetic and implant failures, and complications. Twelve zygomatic and 22 conventional implants in 6 patients were not reviewed as patients were lost to follow-up. One zygomatic implant was removed at the 3-year follow-up visit because of lack of osseointegration and disturbances around the zygomatic region. The success rate of zygomatic implants was 98.5% (68/69). Six conventional implants were lost, with a success rate of 94.9% (112/118). One of the definitive prostheses was changed after 4 years of follow-up. Six complications occurred during the entire follow-up period. The 5-year prognosis was found to be good for immediately loaded zygomatic implants together with conventional implants in severely resorbed maxillae.

  9. Simultaneous observation of the GnRH pulse generator activity and plasma concentrations of metabolites and insulin during fasting and subsequent refeeding periods in Shiba goats. (United States)

    Matsuyama, Shuichi; Ohkura, Satoshi; Ichimaru, Toru; Sakurai, Katsuyasu; Tsukamura, Hiroko; Maeda, Kei-ichiro; Okamura, Hiroaki


    The time course of GnRH pulse generator activity and plasma concentrations of energy substrates and insulin were simultaneously observed in female goats during 4-day fasting and subsequent refeeding in the presence or absence of estrogen for a better understanding of the mechanism of energetic control of gonadotropin secretion in ruminants. The GnRH pulse generator activity was electrophysiologically assessed with the intervals of characteristic increases in multiple-unit activity (MUA volleys) in the mediobasal hypothalamus. In estradiol-treated ovariectomized (OVX+E2) goats, the MUA volley intervals increased as fasting progressed. Plasma concentrations of non-esterified fatty acid and ketone body increased, while those of acetic acid and insulin decreased during fasting. The MUA volley intervals and plasma concentrations of those metabolites and insulin were restored to pre-fasting levels after subsequent refeeding. In ovariectomized (OVX) goats, changes in plasma metabolites and insulin concentrations were similar to those in OVX+E2 goats, but the MUA volley intervals were not altered. The present results demonstrated that fasting suppressed GnRH pulse generator activity in an estrogen-dependent manner. Changes in plasma concentrations of energy substrates and insulin during fasting were associated with the GnRH pulse generator activity in the presence of estrogen, but not in the absence of the steroid in female goats.

  10. Laparoscopic sleeve gastrectomy for morbid obesity: 5-year results. (United States)

    Alexandrou, Andreas; Athanasiou, Antonios; Michalinos, Adamantios; Felekouras, Evangelos; Tsigris, Christos; Diamantis, Theodoros


    Data concerning the long-term efficacy of laparoscopic sleeve gastrectomy in the treatment of morbid obesity remain scarce. In this retrospective, the authors present 5-year follow-up of 30 patients having undergone laparoscopic sleeve gastrectomy. Since 2004, 30 patients underwent laparoscopic sleeve gastrectomy and completed 5 years of follow-up. Five patients were subsequently subjected to laparoscopic Roux-en-Y gastric bypass and were excluded from further analysis. The remaining 25 patients comprised the study population. Mean excess weight loss was 65.2 ± 6.1%, 64.7 ± 5.6%, 62 ± 4.9%, 58.2 ± 5.5%, and 56.4 ± 5.8% for the first 5 years, respectively. There were no deaths, nor any major morbidity. Remission of comorbidities was observed in 40% to 80.9% of cases. Laparoscopic sleeve gastrectomy is a safe and effective means of treatment of morbid obesity both in the short and in the long term. More research is needed to better predict which patient will benefit most from this operation. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Psychosocial changes after cosmetic surgery: a 5-year follow-up study. (United States)

    von Soest, Tilmann; Kvalem, Ingela L; Skolleborg, Knut C; Roald, Helge E


    Most studies examining psychosocial changes after cosmetic surgery have short follow-up periods and therefore provide limited information about long-term effects of such surgery. Moreover, studies that identify whether preexisting patient characteristics are associated with poor psychosocial outcomes after cosmetic surgery are lacking. The current study provides information about both of these issues. Questionnaire data from 130 female Norwegian cosmetic surgery patients were obtained before and 5 years after surgery. The questionnaire consisted of measures on appearance satisfaction, self-esteem, psychological problems, and patients' evaluation of the outcome of surgery. Data from a representative sample of 838 Norwegian women, aged 22 to 55 years, were used for comparison purposes. Analyses revealed an improvement in both general appearance satisfaction and satisfaction with the body part operated on 5 years after surgery. A small increase in self-esteem was observed as well. High rates of preoperative psychological problems and low self-esteem were related to more negative changes in some of the psychosocial measures after surgery compared with patients with better psychological health. Furthermore, factors associated with the actual decision to undergo surgery were related to changes in psychological health and patients' evaluation of the outcome of surgery. This study indicates that cosmetic surgery has positive long-term effects on appearance-related variables. However, surgeons should be particularly aware of patients with psychological problems, as these may compromise patient satisfaction with the effects of cosmetic surgery. Factors affecting the decision itself to undergo cosmetic surgery may also be relevant for subsequent psychosocial outcomes. Therapeutic, II.

  12. 75 FR 66724 - Endangered and Threatened Species; 5-Year Review (United States)


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE... (NOAA), Commerce. ACTION: Notice of availability of a 5-year review for the U.S. Distinct Population... electronic message to [email protected] . Electronic copies of the 5-year review are available online...

  13. Fluoroless Catheter Ablation of Cardiac Arrhythmias: A 5-Year Experience. (United States)

    Razminia, Mansour; Willoughby, Michael Cameron; Demo, Hany; Keshmiri, Hesam; Wang, Theodore; D'Silva, Oliver J; Zheutlin, Terry A; Jibawi, Hakeem; Okhumale, Paul; Kehoe, Richard F


    Catheter ablations have been traditionally performed with the use of fluoroscopic guidance, which exposes the patient and staff to the inherent risks of radiation. We have developed techniques to eliminate the use of fluoroscopy during cardiac ablations and have been performing completely fluoroless catheter ablations on our patients for over 5 years. We present a retrospective analysis of the safety, efficacy, and feasibility data from 500 consecutive patients who underwent nonfluoroscopic catheter ablation, targeting a total of 639 arrhythmias, including atrioventricular reciprocating tachycardia (AVRT), atrioventricular nodal reentrant tachycardia (AVNRT), atrial tachycardia (AT), atrial fibrillation (AF), premature ventricular contractions (PVCs), and ventricular tachycardia (VT). We perform fluoroless ablations using intracardiac electrograms, electroanatomic mapping, and for most cases intracardiac echocardiography. Our experience includes exclusively endocardial cardiac ablations. The mean follow-up was 20.5 months. Recurrence rate for AVRT was 6.5%, for AVNRT 2.5%, for macro-reentrant AT 6.4%, for focal AT 5.4%, for AF 22.6%, for PVC 6.7%, and for VT 21.4%. Major complications occurred in five patients (1.0%); minor complications occurred in three patients (0.6%). No deaths occurred. Fluoroscopy was used in one instance, for 0.3 minutes, to confirm venous access. Completely fluoroless catheter ablations may be routinely performed for all endocardial ablations without compromising safety, efficacy, or procedural duration. © 2017 The Authors. Pacing and Clinical Electrophysiology published by Wiley Periodicals, Inc.


    Directory of Open Access Journals (Sweden)

    V. A. Hariton


    Full Text Available A brief overview of the strategic planning documents in the aviation industry, defined the legal status of the developed "National Plan for Science and Technology in the aircraft industry for the period up to 2025 and the subsequent prospect" assesses its role and place in the strategic planning documents, the relationship with the main documents. Disclosed structure of the National Plan and the goal of scientific and technological potential, defined by the National Plan.

  15. Medical Care and Your 4- to 5-Year-Old (United States)

    ... and how well he or she communicates. continue Developmental Milestones Developmental milestones for 4-year-olds include being able to: ... kids understand the concept of gender identify colors Developmental milestones for 5-year-olds include being able to: ...

  16. Fitness and Your 4-to 5-Year Old (United States)

    ... Pregnancy Healthy Food Shopping Healthy Drinks for Kids Fitness and Your 4- to 5-Year-Old KidsHealth > ... the risk of serious illnesses later in life. Fitness for Preschoolers Physical activity guidelines for preschoolers recommend ...

  17. The longitudinal impact of partner coping in couples following 5 years of unsuccessful fertility treatments

    DEFF Research Database (Denmark)

    Peterson, B D; Pirritano, M; Christensen, Ulla


    Participants were Danish men and women about to start a cycle of assisted reproduction treatment who were followed for a 5 year period of unsuccessful treatments. Multilevel modeling using the actor-partner interdependence model was used to examine the couple as the unit of analysis. RESULTS Active and passive...... have a significant impact on the other member of the couple over time in men and women undergoing infertility treatments over a 5 year period. Physicians and mental health professionals can educate men and women regarding the ineffectiveness of avoidance coping strategies as well as the beneficial...

  18. Spontaneous resolution of chalazion after 3 to 5 years. (United States)

    Honda, Michio; Honda, Kyoko


    To report the first three cases of spontaneous resolution of chalazia after 3 to 5 years. Patients with chalazia who visited Honda Eye Clinic were observed and treated between 1991 and 2008. Chalazia were diagnosed by deliberate palpation of lids and observation of external appearance of lids. Histopathologic examination of excised specimens was performed to confirm the diagnosis. All data were obtained from the regular daily clinical practices and recordings with informed consent. Three chalazia completely resolved without medications or surgical interventions after 3 to 5 years. Excisions of chalazia of patients aged older than 50 years were few. Chalazion may be a self-limiting disorder even in the long-term.

  19. Outcome from 5-year live surgical demonstrations in urinary stone treatment: are outcomes compromised?

    NARCIS (Netherlands)

    Legemate, Jaap D.; Zanetti, Stefano P.; Baard, Joyce; Kamphuis, Guido M.; Montanari, Emanuele; Traxer, Olivier; de la Rosette, Jean Jmch


    To compare intra- and post-operative outcomes of endourological live surgical demonstrations (LSDs) and routine surgical practice (RSP) for urinary stones. Consecutive ureterorenoscopic (URS) and percutaneous (PNL) urinary stone procedures over a 5-year period were reviewed. Procedures were divided

  20. A 5-year Prospective study on Chest Trauma in Children | Misauno ...

    African Journals Online (AJOL)

    Chest trauma is an important cause of mortality in children worldwide. In this study we present our experience with childhood chest trauma within a five years period. This was a 5-year prospective study of consecutive patients with chest trauma. Data entered into a pre-planned proforma included demographic information, ...

  1. Behavioural Problems among Visually Impaired between 6 Months and 5 Years. (United States)

    Tirosh, E.; Shnitzer, M. R.; Davidovitch, M.; Cohen, A.


    Israeli legally blind infants and children (N=182) between the ages of 6 months and 5 years were systematically assessed over a period of 13 years. Behavioral problems were documented in 49%. The most frequent disorders were anxiety disorders, oppositional disorder with or without attention deficit hyperactivity, and avoidant disorder with or…

  2. Renal adenoma in a 5-year-old Labrador retriever: big is not always bad. (United States)

    Lillakas, Kristina


    A 5-year-old Labrador retriever was presented with anorexia, hematuria, and a 3-week history of mild lethargy, periodic inappetance, and weight loss. A firm mass in the cranial abdomen was discovered on physical examination. Following clinical work-up the owners elected euthanasia. On postmortem examination, histopathology determined that the mass was a benign renal adenoma.

  3. Renal adenoma in a 5-year-old Labrador retriever: Big is not always bad


    Lillakas, Kristina


    A 5-year-old Labrador retriever was presented with anorexia, hematuria, and a 3-week history of mild lethargy, periodic inappetance, and weight loss. A firm mass in the cranial abdomen was discovered on physical examination. Following clinical work-up the owners elected euthanasia. On postmortem examination, histopathology determined that the mass was a benign renal adenoma.

  4. Management of Testicular torsion in Mulago Hospital over a 5-year ...

    African Journals Online (AJOL)

    Management of Testicular torsion in Mulago Hospital over a 5-year period. Ibingira C B R. hI hled (Surg). 1-ecturer in Anatom!; Makerere University hfedical School. P O Box 7072, I

  5. Mid-facial Fractures: A 5-year Retrospective Review in a Nigerian ...

    African Journals Online (AJOL)

    facial fractures, of patients seen and treated at the Lagos University Teaching Hospital, Lagos, Nigeria over a 5-year period. Materials and Methods: All cases of mid-facial fractures diagnosed and treated at the Department of Oral and ...

  6. A 5 - year surveillance of wound infections at a rural tertiary hospital ...

    African Journals Online (AJOL)

    Background: Wound infections are associated with increased morbidity and mortality. Objectives: To determine the prevalence, aetiology and susceptibility profile of bacterial agents of wound infection among in- and- out patients at a rural tertiary hospital in Nigeria, within a 5 year period. Methods: Wound swabs collected ...

  7. Clinical Evaluation of Small Diameter Straumann Implants in Partially Edentulous Patients: A 5-Year Retrospective Study

    Directory of Open Access Journals (Sweden)

    S. OZER


    Full Text Available Objective: The aim of the present study was to retrospectively evaluate small-diameter (3.3 mm Straumann® dental implants placed in the maxilla or the mandible over a period of 5 years in function.Materials and Methods: Twenty- eight partially edentulous patients received a total of 48 implants over a 5-year period. After the standard healing period (3 to 6 months, the implants were restored with single-tooth prostheses or fixed partial dentures. All patients were followed according to a strict maintenance program with regular recalls. The cumulative survival rates of implants were analyzed and prosthetic complications were assessed.Results: After 5 years of function, one single 10-mm-long implant in the maxillary premolar region was lost because of recurrent peri-implant infection in a female patient. Two single 10-mm-long maxillary implants placed in the posterior region were lost due to body fracture. The cumulative 5-year survival rate of the implants was 93.75 %. The most common prosthetic complication was loosening of the occlusal screw.Conclusion: Within the limited observation period and the number of patients included in this study, it may be concluded that the use of small-diameter implants appears to be predictable if clinical guidelines are followed and appropriate prosthetic restorations are provided. However, it should be noted that fatigue fracture may occur.

  8. Clinical prediction of 5-year survival in systemic sclerosis

    DEFF Research Database (Denmark)

    Fransen, Julie Munk; Popa-Diaconu, D; Hesselstrand, R


    Systemic sclerosis (SSc) is associated with a significant reduction in life expectancy. A simple prognostic model to predict 5-year survival in SSc was developed in 1999 in 280 patients, but it has not been validated in other patients. The predictions of a prognostic model are usually less accura...

  9. Malaria Parasitemia in Children Aged less than 5 Years Presenting ...

    African Journals Online (AJOL)

    Background: Malaria is a significant cause of morbidity and mortality in sub Saharan Africa. Fever is the commonest manifestation and Children aged less than 5 years are most vulnerable. An appraisal of this disease among these children is important to reducing the impact of the disease. Objective: To determine the ...

  10. Cold nodule thyroid — A 5 year retrospective study


    Sajithkumar, V. I.; Rathore, P. K.


    FNAC and histopathological reports of 50 patients with cold nodule thyroid who underwent surgery during the last 5 years were analysed. FNAC showed malignancy in 12% of cases whereas histopathological examination in 16% of cases. In this study an attempt has been made to find out the role of frozen section in cold nodule thyroid.

  11. Analyzing 5 years of EC-TEL proceedings

    NARCIS (Netherlands)

    Reinhardt, Wolfgang; Meier, Christian; Drachsler, Hendrik; Sloep, Peter


    Reinhardt, W., Meier, C., Drachsler, H., & Sloep, P. B. (2011). Analyzing 5 years of EC-TEL proceedings. In C. D. Kloos, D. Gillet, R. M. Crespo García, F. Wild, & M. Wolpers (Eds.), Towards Ubiquitous Learning: 6th European Conference of Technology Enhanced Learning, EC-TEL 2011 (pp. 531-536).

  12. Epidemiology of rotavirus diarrhea in children under 5 years in ...

    African Journals Online (AJOL)

    We aimed to determine the prevalence of group A rotavirus (RVA) in children below 5 years with diarrhea in two regions of Northern Cameroon (North West and Far North Regions) so as to improve our knowledge on the burden of rotavirus disease for imminent introduction of a rotavirus vaccine. Methods: Stool samples ...

  13. Neonatal outcomes after early rescue intracytoplasmic sperm injection: an analysis of a 5-year period. (United States)

    Huang, Bo; Qian, Kun; Li, Zhou; Yue, Jing; Yang, Wei; Zhu, Guijin; Zhang, Hanwang


    To evaluate the safety and efficacy of early rescue intracytoplasmic sperm injection (ICSI). Retrospective cohort study. Teaching hospital. There were 13,232 ovarian stimulation cycles (IVF, n = 9,631; ICSI, n = 2,871; early rescue ICSI, n = 730) that resulted in the delivery of 5,001 babies (IVF, n = 3,670; ICSI, n = 1,095; early rescue ICSI, n = 246) from August 2008 to August 2013. Early rescue ICSI. Clinical pregnancy rates, neonatal outcomes, and congenital birth defects were analyzed. The early rescue ICSI cycles did not seem to have a negative effect on the clinical pregnancy rate (43.42%) when IVF cycles (45.33%) were compared with ICSI cycles (44.39%). In the early rescue ICSI group, a total of 254 clinical pregnancies were achieved: 197 (33.67%) live births, 38 (6.49%) miscarriages, 2 (0.79%) induced abortions, 3 (1.18%) fetal deaths, and 4 pregnancies (1.57%) without completion at follow-up. Overall, the multiple gestations, the delivery method, mean gestational age, preterm deliveries, mean birth weight, and rate of congenital birth defects of the early rescue ICSI group were similar to those in the conventional IVF and ICSI groups. Early rescue ICSI had similar clinical pregnancy rates when compared with conventional IVF and ICSI, in addition to the delivery of healthy children. The clinical evidence from the early rescue ICSI group did not show an elevated rate of malformations. Early rescue ICSI seems to be a safe alternative method for individuals with total fertilization failure or near total fertilization failure when compared with conventional IVF treatment. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  14. The Trend of Twin Pregnancy Over a 5-year Period in a University ...

    African Journals Online (AJOL)

    Twin pregnancy is associated with increased perinatal mortality, preterm deliveries and maternal complications, especially in developing countries. The obstetrics result of twin deliveries at the Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos, Nigeria between January 2002 and December 2006 were ...

  15. Gastroesophageal Acid Reflux Control 5 Years After Antireflux Surgery, Compared With Long-term Esomeprazole Therapy. (United States)

    Hatlebakk, Jan G; Zerbib, Frank; Bruley des Varannes, Stanislas; Attwood, Stephen E; Ell, Christian; Fiocca, Roberto; Galmiche, Jean-Paul; Eklund, Stefan; Långström, Göran; Lind, Tore; Lundell, Lars R


    We compared the ability of laparoscopic antireflux surgery (LARS) and esomeprazole to control esophageal acid exposure, over a 5-year period, in patients with chronic gastroesophageal reflux disease (GERD). We also studied whether intraesophageal and intragastric pH parameters off and on therapy were associated with long-term outcomes. We analyzed data from a prospective, randomized, open-label trial comparing the efficacy and safety of LARS vs esomeprazole (20 or 40 mg/d) over 5 years in patients with chronic GERD. Ambulatory intraesophageal and intragastric 24-hour pH monitoring data were compared between groups before LARS or the start of esomeprazole treatment, and 6 months and 5 years afterward. A secondary aim was to evaluate the association between baseline and 6-month pH parameters and esomeprazole dose escalation, reappearance of GERD symptoms, and treatment failure over 5 years in patients receiving LARS or esomeprazole. In the LARS group (n = 116), the median 24-hour esophageal acid exposure was 8.6% at baseline and 0.7% after 6 months and 5 years (P esomeprazole group (n = 151), the median 24-hour esophageal acid exposure was 8.8% at baseline, 2.1% after 6 months, and 1.9% after 5 years (P esomeprazole). Gastric acidity was stable in both groups. Patients who required a dose increase to 40 mg/d had more severe supine reflux at baseline, and decreased esophageal acid exposure (P esomeprazole therapy. However, patients receiving LARS had significantly greater reductions in 24-hour esophageal acid exposure after 6 months and 5 years. Esophageal and gastric pH, off and on therapy, did not predict long-term outcomes of patients. Abnormal supine acid exposure predicted esomeprazole dose escalation. ClinicalTrials.Gov identifier: NCT00251927 (available: Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

  16. Achalasia 5 years following Roux-en-y gastric bypass


    Torghabeh, Mehyar Hefazi; Afaneh, Cheguevara; Saif, Taha; Dakin, Gregory F.


    Oesophageal achalasia is a rare, but serious condition in which the motility of the lower oesophageal sphincter (LES) is inhibited. This disorder of idiopathic aetiology complicates the peristaltic function and relaxation of the LES that may cause symptoms such as dysphagia, epigastric pain, and regurgitation of an obstructed food. The following case describes achalasia in a patient 5 years following a laparoscopic Roux-en-Y gastric bypass (RYGB). The patient underwent a laparoscopic Heller m...

  17. Prone Breast Intensity Modulated Radiation Therapy: 5-Year Results

    Energy Technology Data Exchange (ETDEWEB)

    Osa, Etin-Osa O.; DeWyngaert, Keith [Department of Radiation Oncology, New York University School of Medicine, New York, New York (United States); Roses, Daniel [Department of Surgery, New York University School of Medicine, New York, New York (United States); Speyer, James [Department of Medical Oncology, New York University School of Medicine, New York, New York (United States); Guth, Amber; Axelrod, Deborah [Department of Surgery, New York University School of Medicine, New York, New York (United States); Fenton Kerimian, Maria [Department of Radiation Oncology, New York University School of Medicine, New York, New York (United States); Goldberg, Judith D. [Department of Population Health, New York University School of Medicine, New York, New York (United States); Formenti, Silvia C., E-mail: [Department of Radiation Oncology, New York University School of Medicine, New York, New York (United States)


    Purpose: To report the 5-year results of a technique of prone breast radiation therapy delivered by a regimen of accelerated intensity modulated radiation therapy with a concurrent boost to the tumor bed. Methods and Materials: Between 2003 and 2006, 404 patients with stage I-II breast cancer were prospectively enrolled into 2 consecutive protocols, institutional trials 03-30 and 05-181, that used the same regimen of 40.5 Gy/15 fractions delivered to the index breast over 3 weeks, with a concomitant daily boost to the tumor bed of 0.5 Gy (total dose 48 Gy). All patients were treated after segmental mastectomy and had negative margins and nodal assessment. Patients were set up prone: only if lung or heart volumes were in the field was a supine setup attempted and chosen if found to better spare these organs. Results: Ninety-two percent of patients were treated prone, 8% supine. Seventy-two percent had stage I, 28% stage II invasive breast cancer. In-field lung volume ranged from 0 to 228.27 cm{sup 3}, mean 19.65 cm{sup 3}. In-field heart volume for left breast cancer patients ranged from 0 to 21.24 cm{sup 3}, mean 1.59 cm{sup 3}. There was no heart in the field for right breast cancer patients. At a median follow-up of 5 years, the 5-year cumulative incidence of isolated ipsilateral breast tumor recurrence was 0.82% (95% confidence interval [CI] 0.65%-1.04%). The 5-year cumulative incidence of regional recurrence was 0.53% (95% CI 0.41%-0.69%), and the 5-year overall cumulative death rate was 1.28% (95% CI 0.48%-3.38%). Eighty-two percent (95% CI 77%-85%) of patients judged their final cosmetic result as excellent/good. Conclusions: Prone accelerated intensity modulated radiation therapy with a concomitant boost results in excellent local control and optimal sparing of heart and lung, with good cosmesis. Radiation Therapy Oncology Group protocol 1005, a phase 3, multi-institutional, randomized trial is ongoing and is evaluating the equivalence of a similar dose and

  18. Self-esteem and relapse in schizophrenia: a 5-year follow-up study. (United States)

    Holding, Joanne C; Tarrier, Nicholas; Gregg, Lynsey; Barrowclough, Christine


    This study investigated the association between an interview-based measure of self-esteem and subsequent clinical outcome in recent-onset schizophrenia. A cohort 5-year follow-up design with retrospective chart assessment of clinical outcomes was used. Relapse rates during 5 years were very high, with 92% of the sample relapsing. Self-esteem consisted of two dimensions, negative evaluation of self (NES) and positive evaluation of self (PES). Survival analysis indicated that high NES was significantly associated with shorter time to relapse; and PES, with longer survival time. The participants with high PES were three times more likely to have delayed relapse; no other covariates were significant. PES seemed to buffer the adverse effects of NES. The results indicate that social cognition in the form of self-evaluation may be implicated in clinical outcome and symptom exacerbation in schizophrenia.This study investigated the association between an interview-based measure of self-esteem and subsequent clinical outcome in recent-onset schizophrenia. A cohort 5-year follow-up design with retrospective chart assessment of clinical outcomes was used. Relapse rates during 5 years were very high, with 92% of the sample relapsing. Self-esteem consisted of two dimensions, negative evaluation of self (NES) and positive evaluation of self (PES). Survival analysis indicated that high NES was significantly associated with shorter time to relapse; and PES, with longer survival time. The participants with high PES were three times more likely to have delayed relapse; no other covariates were significant. PES seemed to buffer the adverse effects of NES. The results indicate that social cognition in the form of self-evaluation may be implicated in clinical outcome and symptom exacerbation in schizophrenia.

  19. Olfactory dysfunction predicts 5-year mortality in older adults.

    Directory of Open Access Journals (Sweden)

    Jayant M Pinto

    Full Text Available Prediction of mortality has focused on disease and frailty, although antecedent biomarkers may herald broad physiological decline. Olfaction, an ancestral chemical system, is a strong candidate biomarker because it is linked to diverse physiological processes. We sought to determine if olfactory dysfunction is a harbinger of 5-year mortality in the National Social Life, Health and Aging Project [NSHAP], a nationally representative sample of older U.S. adults. 3,005 community-dwelling adults aged 57-85 were studied in 2005-6 (Wave 1 and their mortality determined in 2010-11 (Wave 2. Olfactory dysfunction, determined objectively at Wave 1, was used to estimate the odds of 5-year, all cause mortality via logistic regression, controlling for demographics and health factors. Mortality for anosmic older adults was four times that of normosmic individuals while hyposmic individuals had intermediate mortality (p<0.001, a "dose-dependent" effect present across the age range. In a comprehensive model that included potential confounding factors, anosmic older adults had over three times the odds of death compared to normosmic individuals (OR, 3.37 [95%CI 2.04, 5.57], higher than and independent of known leading causes of death, and did not result from the following mechanisms: nutrition, cognitive function, mental health, smoking and alcohol abuse or frailty. Olfactory function is thus one of the strongest predictors of 5-year mortality and may serve as a bellwether for slowed cellular regeneration or as a marker of cumulative toxic environmental exposures. This finding provides clues for pinpointing an underlying mechanism related to a fundamental component of the aging process.

  20. Ankle-Brachial Index as a Predictor of Mortality in Hemodialysis: A 5-Year Cohort Study. (United States)

    Miguel, Jair Baptista; Matos, Jorge Paulo Strogoff de; Lugon, Jocemir Ronaldo


    Abnormal ankle-brachial index (ABI) has been found to be a strong predictor of mortality in some hemodialysis populations in studies with relatively short periods of follow-up, lower than 2 years. This study aimed to assess the predictive value of abnormal ABI as a risk factor for death among patients on maintenance hemodialysis after a 5-year follow-up. A total of 478 patients on hemodialysis for at least 12 months were included in the study. ABI measurement was performed using a mercury column sphygmomanometer and portable Doppler. Patients were divided into 3 groups according to ABI (low: 1.3) and followed for a 60-month period. The prevalence rates of low, normal and high ABI were 26.8%, 64.6% and 8.6%, respectively. The 5-year survival rate was lower in the groups with low ABI (44.1%, Phemodialysis patients.

  1. Antipsychotic Prescriptions for Children Aged 5 Years or Younger

    Directory of Open Access Journals (Sweden)

    Ana Lòpez-De Fede


    Full Text Available The use of antipsychotics in very young children is of concern given the lack of empirical evidence in their efficacy and long-term impact on children’s health. This study examined the prescription of antipsychotics among children aged ≤5 years enrolled in a state Medicaid program. Secondary data analysis was conducted using the Medicaid administrative data of a southeastern state. Using SAS 9.3, descriptive statistics were performed to examine socio-demographic characteristics, psychiatric diagnoses, off-label use, receipt of medications from multiple psychotropic drug classes, and receipt of non-pharmacologic psychiatric services among children aged ≤5 years who received antipsychotic prescriptions in calendar year (CY 2011. A total of 112 children in the target age group received antipsychotics in CY 2011, the most common prescription being risperidone. The most common listed psychiatric diagnosis was attention deficit hyperactivity disorder. Two in five children received antipsychotics for off-label use. Three in four children also received medications from at least one other psychotropic drug class. More than half did not receive adjunct psychiatric services. State-level policies offering specific guidance and recommendations for antipsychotic use among very young children are urgently needed. Future research is warranted to examine long-term impact of such practices on children’s growth and development.

  2. Congenital heart defects and associated comorbidities – 5 years of experience


    Adrian Hruşcă; Simona Căinap; Andreea L. Răchişan; Tudor L. Pop; Manuel Chira; Simona Opriţa; Nicolae Miu; Mariana Andreica


    Objective: Cardiovascular malformations are a common cause of neonatal and infant death. We undertook this study to determine the prevalence and spectrum of cardiovascular malformations in a pediatric population, the prevalence of other associated anomalies and genetic syndromes among infants with cardiovascular malformations. Material and Methods: We based the study on a pediatric population admitted at the 2nd Clinic of Pediatrics, for a period of 5 years, diagnosed with a congenit...

  3. Mindfulness intervention for child abuse survivors: A 2.5-year follow-up


    Earley, MD; Chesney, MA; Frye, J.; Greene, PA; Berman, B; Kimbrough, E


    © 2014 Wiley Periodicals, Inc. Objective: The present study reports on the long-term effects of a mindfulness-based stress reduction (MBSR) program for adult survivors of childhood sexual abuse. Method: Of the study participants, 73% returned to the clinic for a single-session follow-up assessment of depression, posttraumatic stress disorder (PTSD), anxiety, and mindfulness at 2.5 years. Results: Repeated measures mixed regression analyses revealed significant long-term improvements in depres...

  4. How to reduce scientific irreproducibility: the 5-year reflection. (United States)

    Fiala, Clare; Diamandis, Eleftherios P


    We discuss in depth six causes of scientific irreproducibility and their ramifications for the clinical sciences: fraud, unfounded papers published by prominent authorities, bias, technical deficiencies, fragmented science and problems with big data. Some proposed methods to combat this problem are briefly described, including an effort to replicate results from some high impact papers and a proposal that authors include detailed preclinical data in papers with supposedly high translational value. We here advocate for a 5-year reflection on papers with seemingly high clinical/translational potential, published alongside the original paper where authors reflect on the quality, reproducibility and impact of their findings. These reflections can be used as a benchmark for credibility, and begin a virtuous cycle of improving the quality of published findings in the literature.

  5. Achalasia 5 years following Roux-en-y gastric bypass

    Directory of Open Access Journals (Sweden)

    Mehyar Hefazi Torghabeh


    Full Text Available Oesophageal achalasia is a rare, but serious condition in which the motility of the lower oesophageal sphincter (LES is inhibited. This disorder of idiopathic aetiology complicates the peristaltic function and relaxation of the LES that may cause symptoms such as dysphagia, epigastric pain, and regurgitation of an obstructed food. The following case describes achalasia in a patient 5 years following a laparoscopic Roux-en-Y gastric bypass (RYGB. The patient underwent a laparoscopic Heller myotomy without a fundoplication. Although achalasia seems to be a rare occurrence in obese patients, this is the third case documented in a patient who previously had an RYGB. The role of performing a fundoplication in these patients remains to be elucidated.

  6. Achalasia 5 years following Roux-en-y gastric bypass (United States)

    Torghabeh, Mehyar Hefazi; Afaneh, Cheguevara; Saif, Taha; Dakin, Gregory F.


    Oesophageal achalasia is a rare, but serious condition in which the motility of the lower oesophageal sphincter (LES) is inhibited. This disorder of idiopathic aetiology complicates the peristaltic function and relaxation of the LES that may cause symptoms such as dysphagia, epigastric pain, and regurgitation of an obstructed food. The following case describes achalasia in a patient 5 years following a laparoscopic Roux-en-Y gastric bypass (RYGB). The patient underwent a laparoscopic Heller myotomy without a fundoplication. Although achalasia seems to be a rare occurrence in obese patients, this is the third case documented in a patient who previously had an RYGB. The role of performing a fundoplication in these patients remains to be elucidated. PMID:26195880

  7. How do 5-year-olds understand questions?

    DEFF Research Database (Denmark)

    Sauerland, Uli; Grohmann, Kleanthes; Teresa Guasti, Maria


    The comprehension of constituent questions is an important topic for language acquisition research and for applications in the diagnosis of language impairment. This article presents the results of a study investigating the comprehension of different types of questions by 5-year-old, typically...... developing children across 19 European countries, 18 different languages, and 7 language (sub-)families. The study investigated the effects of two factors on question formation: (a) whether the question contains a simple interrogative word like ‘who’ or a complex one like ‘which princess’, and (b) whether...... the question word was related to the sentential subject or object position of the verb. The findings show that there is considerable variation among languages, but the two factors mentioned consistently affect children’s performance. The cross-linguistic variation shows that three linguistic factors facilitate...

  8. Statistical analyses for NANOGrav 5-year timing residuals (United States)

    Wang, Yan; Cordes, James M.; Jenet, Fredrick A.; Chatterjee, Shami; Demorest, Paul B.; Dolch, Timothy; Ellis, Justin A.; Lam, Michael T.; Madison, Dustin R.; McLaughlin, Maura A.; Perrodin, Delphine; Rankin, Joanna; Siemens, Xavier; Vallisneri, Michele


    In pulsar timing, timing residuals are the differences between the observed times of arrival and predictions from the timing model. A comprehensive timing model will produce featureless residuals, which are presumably composed of dominating noise and weak physical effects excluded from the timing model (e.g. gravitational waves). In order to apply optimal statistical methods for detecting weak gravitational wave signals, we need to know the statistical properties of noise components in the residuals. In this paper we utilize a variety of non-parametric statistical tests to analyze the whiteness and Gaussianity of the North American Nanohertz Observatory for Gravitational Waves (NANOGrav) 5-year timing data, which are obtained from Arecibo Observatory and Green Bank Telescope from 2005 to 2010. We find that most of the data are consistent with white noise; many data deviate from Gaussianity at different levels, nevertheless, removing outliers in some pulsars will mitigate the deviations.

  9. [Durability of bonding between 4-META/MMA-TBB resin to dentin pretreated with 10-3. The effect of 10-3 pretreating period and subsequent glutaraldehyde treatment]. (United States)

    Takarada, K; Kojima, M; Ishihara, K; Nakabayashi, N


    Adhesion durability between dentin pretreated with 10-3 and 4-META/MMA-TBB resin was studied. Reduction of etching periods with 10-3 was not so effective as expected. The weakening of bond strength during immersion in water at 37 degrees C to the dentin pretreated for 1 sec occurred faster than those for either 5 sec or 10 sec. The strength decreased from 12 MPa at 1 day to 9 MPa at 3 months, 3 MPa at 6 months and finally 2 MPa at 1 year in the case of 1 sec pretreated dentin. On the other hand, the strength became half after the storage in water for 1 year in the cases of 5 and 10 sec pretreated dentins. Combination of 10-3 pretreatment and subsequent glutaraldehyde treatment could stabilize the decrease but not completely. SEM and TEM examinations suggested that dentinal collagen exposed by the etching but not entangled and impregnated by poly (4-META-co-MMA) easily deteriorated by water during the longer immersion. Collagen modified with 10-3 and then with glutaraldehyde was also changed by the longer immersion.

  10. Cardiac dimensions over 5 years in highly trained long-distance runners and sprinters. (United States)

    Calderón, Francisco Javier; Díaz, Victor; Peinado, Ana B; Benito, Pedro J; Maffulli, Nicola


    We assessed the changes in cardiac morphology between elite endurance-trained runners (n = 42) and elite sprinters (n = 34) over a 5-year period. In addition, we studied the relationship between heart size and maximum oxygen consumption (VO2 max). At the beginning of 5 consecutive seasons, all athletes underwent an incremental running test to determine VO2 max and a color-coded pulsed Doppler examination to determine baseline echocardiographic variables. We hypothesized that cardiac morphology had reached its upper limit in elite athletes, and showed only minor changes during 5 years of regular training. Although all echocardiographic variables remained stable in nearly all sprinters studied, in the endurance runners (who presented higher cardiac cavity dimensions compared with sprinters), variations in heart morphology became evident from the third season, and were within established physiological limits. Only 6 (17%) endurance runners and 3 (9%) sprinters showed a left ventricular internal diameter of > 60 mm (the threshold pathological value) at end diastole at some point during the observational period. Moreover, no statistically significant association was detected between changes in VO2 max and changes in heart size. After 5 years of intense training, the changes of the echocardiographic variables examined remained different between endurance runners and sprinters.

  11. Equatorial annual oscillation with QBO-driven 5-year modulation in NCEP data

    Directory of Open Access Journals (Sweden)

    H. G. Mayr


    Full Text Available An analysis is presented of the stratospheric zonal wind and temperature variations supplied by the National Center for Environmental Prediction (NCEP. The derived zonal-mean variations are employed. Stimulated by modeling studies, the data are separated into the hemispherically symmetric and anti-symmetric components, and spectral analysis is applied to study the 12-month annual oscillation (AO and the quasi-biennial oscillation (QBO. For data samples that cover as much as 40 years, the zonal wind results reveal a pronounced 5-year modulation of the symmetric AO in the lower stratosphere, which is confined to equatorial latitudes. This modulation is also seen in the temperature variations but extends to high latitudes, qualitatively consistent with published model results. A comparison between different time intervals of the data indicates that the signature of the 5-year oscillation is larger when the QBO of 30 months is more pronounced. Thus there is circumstantial evidence that this particular QBO period is involved in generating the oscillation as was shown in a modeling study (Mayr et al., 2000. In agreement with the model, the spectral analysis also reveals a weak anti-symmetric 5-year oscillation in the zonal wind data, which could interact with the strong anti-symmetric AO to produce the modulation of the symmetric AO. The 30-month QBO is well suited to be synchronized by, and phase-locked to, the equatorial semi-annual oscillation (SAO, and this may explain why this QBO periodicity and its 5-year spin-off are observed to persist for many cycles.

  12. Chiropractic management of a 5-year-old boy with urinary and bowel incontinence. (United States)

    Kamrath, Keith R


    The purpose of this article is to describe chiropractic management of a 5-year-old boy with urinary and bowel incontinence. A 5-year-old boy presented with the primary symptoms of a complete lack of bowel and bladder control with prior surgical correction for lumbar meningocele, spinal lipoma, and tethered spinal cord. Examination revealed spinal and pelvic dysfunction. Chiropractic treatment methods included using the Activator adjusting instrument and shortwave diathermy to the lumbar spine and sacrum. A total of 5 treatments were initially provided over a period of 4 weeks. After the initial treatment period, he was able to maintain satisfactory control of his bladder and bowel, day and night, for a period of approximately 6 months. A second course of treatments was initiated approximately 6 months later because of a recurrence of bladder and bowel incontinence. Four additional treatments were provided over a period of 4 weeks. This second course of treatment reestablished satisfactory control of bladder and bowel function. For this patient, chiropractic care was successful in establishing satisfactory bladder and bowel control.

  13. An intensive 5-year-long influenza vaccination campaign is effective among doctors but not nurses. (United States)

    Friedl, A; Aegerter, C; Saner, E; Meier, D; Beer, J H


    To double the vaccination rates of hospital employees from 20 to 40% by specific interventions over a 5-year period (2003-2007). The secondary endpoint was to compare the effects of the avian influenza in 2005 (intervention period) and the H1N1 influenza pandemic in 2009 (follow-up period, 2008-2009) on vaccination rates. Free vaccination and its intensive propagation from 2003-2007 in a 400-bed teaching hospital with 1,687 hospital employees. Annual vaccination rates were obtained from 2003 through 2009. Yearly vaccination rates for the intervention period from 2003-2007 and the observational follow-up period of 2008-2009. The overall rate for seasonal influenza vaccination changed non-significantly during the intervention period from 20% in 2003 to 27% in 2007. At the end of the follow-up period in 2009, the vaccination rate was 26%, which was not significantly higher compared with that in 2003. Physicians interestingly increased from 34% in 2003 to 62% in 2007 and to 66% in 2009 (p vaccination. The difference between nurses and doctors in 2007 is highly significant (p vaccine uptake was 33% (p vaccine in 2003). Overall, the vaccination rates did not increase over the 7-year study period. Interventions were successful for physicians but not for nurses. The vaccine uptake was significantly higher during the threat of avian influenza and the influenza A/H1N1v pandemic.

  14. A 5-year retrospective study on Replace Select Tapered dental implants. (United States)

    Pettersson, Pelle; Sennerby, Lars


    Long-term data regarding survival and crestal bone loss for Replace Select Tapered implants (Nobel Biocare AB, Gothenburg, Sweden) are lacking. The study aims to present the 5-year outcomes from a retrospective analysis of Replace Select Tapered implants placed and restored in consecutive patients. A total of 88 consecutive patients (32 male, 56 female, mean age 65 ± 12 years) treated by one clinician (PP) were clinically and radiographically evaluated during at least 5 years of function. A total of 271 dental implants (Replace Select Tapered, Nobel Biocare AB) with an oxidized surface (TiUnite, Nobel Biocare AB) had been placed in both jaws (228 in the maxilla, 43 in the mandible). The majority of implants were placed in healed sites (n = 244), while 27 implants were immediately placed in extraction sockets. The majority of implants (n = 262) healed for 3 to 4 months prior to loading, and nine implants were immediately loaded. A total of 121 implant-supported restorations were delivered; 42 single tooth replacements, 61 fixed partial bridges, 14 fixed full bridges, and 4 fixed partial implant-tooth connected bridges. The marginal bone level was measured in intraoral radiographs taken after surgery (baseline), and after 1, 2, 3, 4, and 5 years. Fifty-one patients with 160 implants were followed throughout the study. One implant failed at healing abutment connection 4 months after insertion, resulting in a cumulative survival rate of 99.6%. The average crestal bone loss was 0.9 ± 1.6 mm after 1 year and 0.1 mm ± 2.4 after 5 years. There were 14.8% of measured implants that showed more than 2 mm and 5.2% more than 3 mm bone loss after 5 years, with no progression since the 1-year examination. One patient (2.0%) treated with six implants presented with significant crestal bone loss and recurrent peri-implant purulent infections at all implants. The present retrospective 5-year study showed high survival rate and steady crestal bone

  15. Impact of functional determinants on 5.5-year mortality in Amazon riparian elderly

    Directory of Open Access Journals (Sweden)

    Tiago C. Antonini

    Full Text Available ABSTRACT Objective To ascertain whether modifiable physical performance–based measurements predicted 5.5-year mortality in a riparian elderly cohort in the Amazon rainforest region. Methods A longitudinal study evaluating the impact of functional determinants on 5.5-year mortality in a riparian elderly cohort from Maués City in the state of Amazonas, Brazil, was performed. The study was a follow-up of a previous observational investigation that evaluated various fitness tests in 630 Amazonian riparian elderly (291 males and 339 females aged 72.3 ± 8.0 (60–99 years old. The cohort was selected for its adverse environmental conditions, which increased the risk of falls yet required maintenance of good physical condition for carrying out relatively rigorous daily activities, and restricted access to specialized health services. Official death records were obtained from the Maués Municipal Health Department. Results A total of 80 study participants (12.7% died over the 5.5-year study period. Kaplan-Meier regression analysis showed significant association between Timed Up and Go (TUG test scores ≥ 14 seconds and mortality risk, independent of sex, age, and other health variables. Conclusions The study results suggest that the TUG test can be used as an indicator for initiating therapeutic and preventive actions, including conducting exercises or physical activities adapted to the health and functional conditions of the elderly, by identifying elderly people with a higher relative risk of mortality.

  16. Association between advanced oxidation protein products and 5-year mortality risk among amazon riparian elderly population. (United States)

    Silva, T O; Jung, I E C; Moresco, R N; Barbisan, F; Ribeiro, E E; Ribeiro, E A M; Motta, K; Britto, E; Tasch, E; Bochi, G; Duarte, M M F; Oliveira, A R; Marcon, M; Belló, C; dos Santos Montagner, G F; da Cruz, I B M


    Proteins are important targets of several modifications caused by oxidative stress, leading to structural changes and consequently partial or total loss of their functions. The oxidized proteins include advanced oxidation protein products (AOPP) derived from oxidation-modified albumin, as well as fibrinogen and lipoproteins. An increase in AOPP levels indicates an oxidative stress state and the presence of coexisting inflammation. Several investigations have also suggested an association between high AOPP levels and aging-related diseases. However, the link between elevated AOPP levels and elderly mortality risk has not yet been investigated. Here, we report on a 5-year longitudinal study that investigated the potential association between AOPP levels and mortality using a population-based representative sample of riparian elders living in Brazilian Amazon region (Maués-AM). Age, sex, socioeconomic and cultural conditions, chronic morbidities, polypharmacy, and previous morbidities were also tested as potential confounders. The AOPP levels were measured in 540 (84.78%) individuals, all of whom were followed over a 5-year period in order to establish the mortality rate. Within this study period, 74 (13.7%) elders died and 466 (86.3%) survived. The AOPP levels were higher among the elders who died within the 5-year period (46.27 ± 40.6 mmol/L) compared with those who survived (36.79 ± 20.84 mmol/L) (p = 0.002). The analysis confirmed the link between high AOPP levels and mortality risk, independent of other intervenient factors. These results suggest that elevated AOPP levels could be used to predict mortality risk in elderly patients.

  17. A 5-year experience with an elective scholarly concentrations program (United States)

    George, Paul; Green, Emily P.; Park, Yoon S.; Gruppuso, Philip A.


    Problem Programs that encourage scholarly activities beyond the core curriculum and traditional biomedical research are now commonplace among US medical schools. Few studies have generated outcome data for these programs. The goal of the present study was to address this gap. Intervention The Scholarly Concentration (SC) Program, established in 2006 at the Warren Alpert Medical School of Brown University, is a 4-year elective program that not only encourages students to pursue scholarly work that may include traditional biomedical research but also seeks to broaden students’ focus to include less traditional areas. We compared characteristics and academic performance of SC students and non-SC students for the graduating classes of 2010–2014. Context Approximately one-third of our students opt to complete an SC during their 4-year undergraduate medical education. Because this program is additional to the regular MD curriculum, we sought to investigate whether SC students sustained the academic achievement of non-SC students while at the same time producing scholarly work as part of the program. Outcome Over 5 years, 35% of students elected to enter the program and approximately 81% of these students completed the program. The parameters that were similar for both SC and non-SC students were age at matriculation, admission route, proportion of undergraduate science majors, and number of undergraduate science courses. Most academic indicators, including United States Medical Licensing Examinations scores, were similar for the two groups; however, SC students achieved more honors in the six core clerkships and were more likely to be inducted into the medical school's two honor societies. Residency specialties selected by graduates in the two groups were similar. SC students published an average of 1.3 peer-reviewed manuscripts per student, higher than the 0.8 manuscripts per non-SC student (p=0.013). Conclusions An elective, interdisciplinary scholarly program with

  18. Clinical spectrum and outcome of pulmonary nocardiosis: 5-year experience

    Directory of Open Access Journals (Sweden)

    Akashdeep Singh


    Full Text Available Background: Pulmonary nocardiosis is a rare but a life-threatening infection caused by Nocardia spp. The diagnosis is often missed and delayed resulting in delay in appropriate treatment and thus higher mortality. Aim: In this study, we aim to evaluate the clinical spectrum and outcome of patients with pulmonary nocardiosis. Methods: A retrospective, 5-year (2009-2014 review of demographic profile, risk factors, clinical manifestations, imaging findings, treatment, and outcome of patients with pulmonary nocardiosis admitted to a tertiary care hospital. Results: The median age of the study subjects was 54 years (range, 16-76 and majority of them (75% were males. The risk factors for pulmonary nocardiosis identified in our study were long-term steroid use (55.6%, chronic lung disease (52.8%, diabetes (27.8%, and solid-organ transplantation (22.2%. All the patients were symptomatic, and the most common symptoms were cough (91.7%, fever (78%, and expectoration (72%. Almost two-third of the patients were initially misdiagnosed and the alternative diagnosis included pulmonary tuberculosis (n = 7, community-acquired pneumonia (n = 5, lung abscess (n = 4, invasive fungal infection (n = 3, lung cancer (n = 2, and Wegener′s granulomatosis (n = 2. The most common radiographic features were consolidation (77.8% and nodules (56%. The mortality rate for indoor patients was 33% despite treatment. Higher mortality rate was observed among those who had brain abscess (100.0%, HIV positivity (100%, need for mechanical ventilation (87.5%, solid-organ transplantation (50%, and elderly (age > 60 years patients (43%. Conclusion: The diagnosis of pulmonary nocardiosis is often missed and delayed resulting in delay in appropriate treatment and thus high mortality. A lower threshold for diagnosing pulmonary nocardiosis needs to be exercised, in chest symptomatic patients with underlying chronic lung diseases or systemic immunosuppression, for the early diagnosis, and

  19. Trends in the prescription of clozapine in a psychiatric hospital: a 5-year observational study

    Directory of Open Access Journals (Sweden)

    Gabriela Danielski Niehues


    Full Text Available Abstract Introduction Clozapine is a well-recognized effective treatment for some patients with treatment-resistant schizophrenia (TRS. Although it has potential benefits and approximately 30% of patients have a clinical indication for clozapine use, prescription rates are low. Objective To evaluate clozapine prescription trends over a 5-year period in a tertiary psychiatric hospital. Methods In this observational study, data prospectively collected by the Medical and Statistical File Service (Serviço de Arquivo Médico e Estatístico and the Pharmacy Division of Instituto de Psiquiatria de Santa Catarina between January 2010 and December 2014 were summarized and analyzed by investigators blinded to data collection. The number of 100 mg clozapine pills dispensed by the Pharmacy Division to the inpatient units was the outcome and considered a proxy measure of clozapine prescriptions. The number of occupied inpatient unit beds and the number of patients admitted with F20-F29 (ICD-10 diagnoses during the study period were considered to be possible confounders. Results A multiple linear regression model showed that time in months was independently associated with an increase in the number of clozapine pills dispensed by the Pharmacy Division (β coefficient = 15.82; 95% confidence interval 10.88-20.75. Conclusion Clozapine prescriptions were found to have increased during the 5-year period studied, a trend that is opposite to reports from several other countries.

  20. Trends in the prescription of clozapine in a psychiatric hospital: a 5-year observational study. (United States)

    Niehues, Gabriela Danielski; Balan, Alexandre Balestieri; Prá, Vinicius Brum; Pellizzaro, Raphaela Santos; da Silva, Paulo Roberto Antunes; Niehues, Manuela Danielski; Costa, Ana Paula; Schwarzbold, Marcelo Liborio; Diaz, Alexandre Paim


    Clozapine is a well-recognized effective treatment for some patients with treatment-resistant schizophrenia (TRS). Although it has potential benefits and approximately 30% of patients have a clinical indication for clozapine use, prescription rates are low. To evaluate clozapine prescription trends over a 5-year period in a tertiary psychiatric hospital. In this observational study, data prospectively collected by the Medical and Statistical File Service (Serviço de Arquivo Médico e Estatístico) and the Pharmacy Division of Instituto de Psiquiatria de Santa Catarina between January 2010 and December 2014 were summarized and analyzed by investigators blinded to data collection. The number of 100 mg clozapine pills dispensed by the Pharmacy Division to the inpatient units was the outcome and considered a proxy measure of clozapine prescriptions. The number of occupied inpatient unit beds and the number of patients admitted with F20-F29 (ICD-10) diagnoses during the study period were considered to be possible confounders. A multiple linear regression model showed that time in months was independently associated with an increase in the number of clozapine pills dispensed by the Pharmacy Division (β coefficient = 15.82; 95% confidence interval 10.88-20.75). Clozapine prescriptions were found to have increased during the 5-year period studied, a trend that is opposite to reports from several other countries.

  1. A 5-year study of adenoviruses causing conjunctivitis in Izmir, Turkey. (United States)

    Erdin, Begüm Nalça; Pas, Suzan D; Durak, İsmet; Schutten, Martin; Sayıner, A Arzu


    Adenoviruses are a common cause of conjunctivitis. Genotypes are diverse and differ according to population and geographical distribution of the virus. There is limited data regarding ocular adenoviral infections and genotype distribution in Turkey. This study aimed to determine the adenovirus genotypes and their epidemiological features among patients with conjunctivitis between 2006 and 2010, in Izmir, Turkey. Adenoviral DNA was detected by PCR in 213 of 488 (44%) of the ocular samples collected from patients with viral conjunctivitis during the 5-year study period. Of these, 101 (47%) were randomly chosen and genotyped by sequence analysis. Seven genotypes were identified, including 3, 4, 8, 11, 19, 37, and 53. Genotype 8 and 4 were the dominant types detected in 67 (66.3%) and 25 (24.7%) of the samples, respectively. Other five genotypes (3, 11, 19, 37, 53) were detected in 9 (8.9%) samples. Genotype and seasonal differences observed throughout the study. Human adenoviruse (HAdV)-8 was the most frequent type, except 2008. The prevalence of genotype 4 increased starting from 2006, became dominant in 2008 and decreased in the following years. The peak season was mostly spring months, although it was possible to detect positive samples throughout the year. In conclusion, genotype 8 followed by genotype 4 was the most frequent adenoviral types causing conjunctivitis during the 5-year study period. Findings suggest that there is a slow shift between genotypes throughout the years. © 2014 Wiley Periodicals, Inc.

  2. EXPOSE-E: an ESA astrobiology mission 1.5 years in space. (United States)

    Rabbow, Elke; Rettberg, Petra; Barczyk, Simon; Bohmeier, Maria; Parpart, André; Panitz, Corinna; Horneck, Gerda; von Heise-Rotenburg, Ralf; Hoppenbrouwers, Tom; Willnecker, Rainer; Baglioni, Pietro; Demets, René; Dettmann, Jan; Reitz, Guenther


    The multi-user facility EXPOSE-E was designed by the European Space Agency to enable astrobiology research in space (low-Earth orbit). On 7 February 2008, EXPOSE-E was carried to the International Space Station (ISS) on the European Technology Exposure Facility (EuTEF) platform in the cargo bay of Space Shuttle STS-122 Atlantis. The facility was installed at the starboard cone of the Columbus module by extravehicular activity, where it remained in space for 1.5 years. EXPOSE-E was returned to Earth with STS-128 Discovery on 12 September 2009 for subsequent sample analysis. EXPOSE-E provided accommodation in three exposure trays for a variety of astrobiological test samples that were exposed to selected space conditions: either to space vacuum, solar electromagnetic radiation at >110 nm and cosmic radiation (trays 1 and 3) or to simulated martian surface conditions (tray 2). Data on UV radiation, cosmic radiation, and temperature were measured every 10 s and downlinked by telemetry. A parallel mission ground reference (MGR) experiment was performed on ground with a parallel set of hardware and samples under simulated space conditions. EXPOSE-E performed a successful 1.5-year mission in space.

  3. Developmental potential in the first 5 years for children in developing countries (United States)

    Grantham-McGregor, Sally; Cheung, Yin Bun; Cueto, Santiago; Glewwe, Paul; Richter, Linda; Strupp, Barbara


    Summary Many children younger than 5 years in developing countries are exposed to multiple risks, including poverty, malnutrition, poor health, and unstimulating home environments, which detrimentally affect their cognitive, motor, and social-emotional development. There are few national statistics on the development of young children in developing countries. We therefore identified two factors with available worldwide data—the prevalence of early childhood stunting and the number of people living in absolute poverty—to use as indicators of poor development. We show that both indicators are closely associated with poor cognitive and educational performance in children and use them to estimate that over 200 million children under 5 years are not fulfilling their developmental potential. Most of these children live in south Asia and sub-Saharan Africa. These disadvantaged children are likely to do poorly in school and subsequently have low incomes, high fertility, and provide poor care for their children, thus contributing to the intergenerational transmission of poverty. PMID:17208643

  4. [5 years ATLS (Advanced Trauma Life Support) courses in Switzerland]. (United States)

    Scharplatz, D; Sutter, P M


    Five years ATLS (Advanced Trauma Life Support) in Switzerland are analysed, the problems are discussed and the changes during this period are demonstrated. ATLS Switzerland is a part of the Swiss surgical Society, introduced by the ATLS International Faculty in 1998. Switzerland with 4 official languages needs a special structure. For this reason a decentralisation of the courses was necessary with the need of five regional universities where ATLS courses are offered. Statistics of the rising amount of courses demonstrate the enormous rush for ATLS courses in our country. Three courses in 1998 where followed by six courses in 1999, up to 18 courses in 2002. 2001 was the first year with ATLS in the Swiss Army. Since 1.1.2003 Paul Martin Sutter, Biel ist the new National Director, successor of Domenic Scharplatz, Thusis.

  5. Configuring balanced scorecards for measuring health system performance: evidence from 5 years' evaluation in Afghanistan. (United States)

    Edward, Anbrasi; Kumar, Binay; Kakar, Faizullah; Salehi, Ahmad Shah; Burnham, Gilbert; Peters, David H


    In 2004, Afghanistan pioneered a balanced scorecard (BSC) performance system to manage the delivery of primary health care services. This study examines the trends of 29 key performance indicators over a 5-year period between 2004 and 2008. Independent evaluations of performance in six domains were conducted annually through 5,500 patient observations and exit interviews and 1,500 provider interviews in >600 facilities selected by stratified random sampling in each province. Generalized estimating equation (GEE) models were used to assess trends in BSC parameters. There was a progressive improvement in the national median scores scaled from 0-100 between 2004 and 2008 in all six domains: patient and community satisfaction of services (65.3-84.5, pfinancial domain also showed improvement until 2007 (84.4-95.7, pperformance benchmarking during the 5-year period. However, scorecard reconfigurations are needed to integrate effectiveness and efficiency measures and accommodate changes in health systems policy and strategy architecture to ensure its continued relevance and effectiveness as a comprehensive health system performance measure. The process of BSC design and implementation can serve as a valuable prototype for health policy planners managing performance in similar health care contexts. Please see later in the article for the Editors' Summary.

  6. Antenatal and postnatal growth and 5-year cognitive outcome in very preterm infants. (United States)

    Leppänen, Marika; Lapinleimu, Helena; Lind, Annika; Matomäki, Jaakko; Lehtonen, Liisa; Haataja, Leena; Rautava, Päivi


    To study how antenatal growth affects cognitive outcome in very preterm infants and to determine whether there is an association between growth in any particular time period between birth and 5 years of age and cognitive outcome. Small for gestational age (SGA) and non-SGA infants were analyzed separately, because antenatal growth may affect postnatal growth. Very low birth weight (Intelligence-Revised. The association between growth and full-scale IQ (FSIQ) was studied. Growth in length and height was not associated with 5-year cognitive outcome. However, weight (r = 0.18, P = .04) and HC growth (r = 0.25, P = .01) between birth and 2 years of corrected age correlated to FSIQ in non-SGA children. In SGA children, HC growth (r = 0.33, P = .03) around term age correlated to FSIQ. Cognitive outcome was similar in SGA and non-SGA very preterm infants. Growth affected cognition positively in both subgroups, but the critical time period was different.

  7. Avian influenza in Australia: a summary of 5 years of wild bird surveillance. (United States)

    Grillo, V L; Arzey, K E; Hansbro, P M; Hurt, A C; Warner, S; Bergfeld, J; Burgess, G W; Cookson, B; Dickason, C J; Ferenczi, M; Hollingsworth, T; Hoque, Mda; Jackson, R B; Klaassen, M; Kirkland, P D; Kung, N Y; Lisovski, S; O'Dea, M A; O'Riley, K; Roshier, D; Skerratt, L F; Tracey, J P; Wang, X; Woods, R; Post, L


    Avian influenza viruses (AIVs) are found worldwide in numerous bird species, causing significant disease in gallinaceous poultry and occasionally other species. Surveillance of wild bird reservoirs provides an opportunity to add to the understanding of the epidemiology of AIVs. This study examined key findings from the National Avian Influenza Wild Bird Surveillance Program over a 5-year period (July 2007-June 2012), the main source of information on AIVs circulating in Australia. The overall proportion of birds that tested positive for influenza A via PCR was 1.9 ± 0.1%, with evidence of widespread exposure of Australian wild birds to most low pathogenic avian influenza (LPAI) subtypes (H1-13, H16). LPAI H5 subtypes were found to be dominant and widespread during this 5-year period. Given Australia's isolation, both geographically and ecologically, it is important for Australia not to assume that the epidemiology of AIV from other geographic regions applies here. Despite all previous highly pathogenic avian influenza outbreaks in Australian poultry being attributed to H7 subtypes, widespread detection of H5 subtypes in wild birds may represent an ongoing risk to the Australian poultry industry. © 2015 Australian Veterinary Association.

  8. Children's television exposure and behavioral and social outcomes at 5.5 years: does timing of exposure matter? (United States)

    Mistry, Kamila B; Minkovitz, Cynthia S; Strobino, Donna M; Borzekowski, Dina L G


    The American Academy of Pediatrics recommends children > or = 2 years of age limit daily media exposure to media exposure influences children's health. Our goal was to examine relations among children's early, concurrent, and sustained television exposure and behavioral and social skills outcomes at 5.5 years. We analyzed data collected prospectively from the Healthy Steps for Young Children national evaluation. Television exposure was defined as > 2 hours of daily use (at 30-33 months and 5.5 years) and television in child's bedroom (at 5.5 years). At 5.5 years, outcomes were assessed by using the Child Behavior Checklist and social skills using the Social Skills Rating System. Linear regression was used to estimate the effect of television exposure on behavioral and social skills outcomes. Sixteen percent of parents reported that their child watched > 2 hours of television daily at 30 to 33 months only, 15% reported > 2 hours of television daily at 5.5 years only, and 20% reported > 2 hours of television daily at both times. Forty-one percent of the children had televisions in their bedrooms at 5.5 years. In adjusted analyses, sustained television viewing was associated with behavioral outcomes. Concurrent television exposure was associated with fewer social skills. For children with heavy television viewing only in early childhood, there was no consistent relation with behavioral or social skills outcomes. Having a television in the bedroom was associated with sleep problems and less emotional reactivity at 5.5 years but was not associated with social skills. Sustained exposure is a risk factor for behavioral problems, whereas early exposure that is subsequently reduced presents no additional risk. For social skills, concurrent exposure was more important than sustained or early exposure. Considering the timing of media exposure is vital for understanding the consequences of early experiences and informing prevention strategies.

  9. Bariatric Surgery versus Intensive Medical Therapy for Diabetes - 5-Year Outcomes. (United States)

    Schauer, Philip R; Bhatt, Deepak L; Kirwan, John P; Wolski, Kathy; Aminian, Ali; Brethauer, Stacy A; Navaneethan, Sankar D; Singh, Rishi P; Pothier, Claire E; Nissen, Steven E; Kashyap, Sangeeta R


    Long-term results from randomized, controlled trials that compare medical therapy with surgical therapy in patients with type 2 diabetes are limited. We assessed outcomes 5 years after 150 patients who had type 2 diabetes and a body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) of 27 to 43 were randomly assigned to receive intensive medical therapy alone or intensive medical therapy plus Roux-en-Y gastric bypass or sleeve gastrectomy. The primary outcome was a glycated hemoglobin level of 6.0% or less with or without the use of diabetes medications. Of the 150 patients who underwent randomization, 1 patient died during the 5-year follow-up period; 134 of the remaining 149 patients (90%) completed 5 years of follow-up. At baseline, the mean (±SD) age of the 134 patients was 49±8 years, 66% were women, the mean glycated hemoglobin level was 9.2±1.5%, and the mean BMI was 37±3.5. At 5 years, the criterion for the primary end point was met by 2 of 38 patients (5%) who received medical therapy alone, as compared with 14 of 49 patients (29%) who underwent gastric bypass (unadjusted P=0.01, adjusted P=0.03, P=0.08 in the intention-to-treat analysis) and 11 of 47 patients (23%) who underwent sleeve gastrectomy (unadjusted P=0.03, adjusted P=0.07, P=0.17 in the intention-to-treat analysis). Patients who underwent surgical procedures had a greater mean percentage reduction from baseline in glycated hemoglobin level than did patients who received medical therapy alone (2.1% vs. 0.3%, P=0.003). At 5 years, changes from baseline observed in the gastric-bypass and sleeve-gastrectomy groups were superior to the changes seen in the medical-therapy group with respect to body weight (-23%, -19%, and -5% in the gastric-bypass, sleeve-gastrectomy, and medical-therapy groups, respectively), triglyceride level (-40%, -29%, and -8%), high-density lipoprotein cholesterol level (32%, 30%, and 7%), use of insulin (-35%, -34%, and -13%), and

  10. School-related injuries: a retrospective 5-year evaluation. (United States)

    Kraus, R; Horas, U; Szalay, G; Alt, V; Kaiser, M; Schnettler, R


    Children and adolescents spend up to 50% of their time at school. The purpose of this study was to assess injury patterns of school accidents (along with their treatment) in the trauma center of a German university hospital, and to compare these data to those in the literature. All school accidents treated in a level 1 pediatric trauma center over a five-year period were statistically analyzed in a retrospective manner by chart review. There were 1,399 school accidents that were treated in our department. Average age of the injured person was 11.8 years, with a boy:girl ratio of 3:2. Almost 40% of the injuries occurred during school sports. The most frequently injured region was the upper extremity, including the hand (36.8%). Distortion and contusion was the most frequent diagnosis among all injuries. Sixteen percent of the cases had to be treated surgically and/or under general anesthesia, and 16% of the patients had to be admitted to the hospital. It can be concluded that special attention must be paid during school sporting activities and breaks because they account for most of the accidents. Traffic education may reduce severe injuries. Specific knowledge of the growing long bones of the upper extremity and the hand is important for the diagnosis and treatment of school accidents.

  11. Overuse and traumatic extremity injuries in schoolchildren surveyed with weekly text messages over 2.5 years

    DEFF Research Database (Denmark)

    Jespersen, E; Holst, R; Franz, C


    The objectives of this prospective cohort study were to report the incidence, prevalence, and duration of traumatic and overuse injuries during a period of 2.5 years and to estimate the odds of injury types. In all, 1259 schoolchildren, aged 6-12, were surveyed each week with an automated mobile ...

  12. Natural course of behavioral addictions: a 5-year longitudinal study. (United States)

    Konkolÿ Thege, Barna; Woodin, Erica M; Hodgins, David C; Williams, Robert J


    Resolving the theoretical controversy on the labeling of an increasing number of excessive behaviors as behavioral addictions may also be facilitated by more empirical data on these behavioral problems. For instance, an essential issue to the classification of psychiatric disorders is information on their natural course. However, longitudinal research on the chronic vs. episodic nature of behavioral addictions is scarce. The aim of the present study, therefore, was to provide data on prevalence, substance use comorbidity, and five-year trajectories of six excessive behaviors-namely exercising, sexual behavior, shopping, online chatting, video gaming, and eating. Analyses were based on the data of the Quinte Longitudinal Study, where a cohort of 4,121 adults from Ontario, Canada was followed for 5 years (2006 to 2011). The response rate was 21.3%, while retention rate was 93.9%. To assess the occurrence of each problem behavior, a single self-diagnostic question asked people whether their over-involvement in the behavior had caused significant problems for them in the past 12 months. To assess the severity of each problem behavior reported, the Behavioral Addiction Measure was administered. A mixed design ANOVA was used to investigate symptom trajectories over time for each problem behavior and whether these symptom trajectories varied as a function of sex. The large majority of people reported having problematic over-involvement for just one of these behaviors and just in a single time period. A main effect of time was found for each problem behavior, indicating a moderately strong decrease in symptom severity across time. The time x sex interaction was insignificant in each model indicating that the decreasing trend is similar for males and females. The data also showed that help seeking was very low in the case of excessive sexual behavior, shopping, online chatting, and video gaming but substantially more prevalent in the case of excessive eating and

  13. Change in Psychosocial Health Status Over 5 Years in Relation to Adults' Hearing Ability in Noise. (United States)

    Stam, Mariska; Smit, Jan H; Twisk, Jos W R; Lemke, Ulrike; Smits, Cas; Festen, Joost M; Kramer, Sophia E

    The aim of this study was to establish the longitudinal relationship between hearing ability in noise and psychosocial health outcomes (i.e., loneliness, anxiety, depression, distress, and somatization) in adults aged 18 to 70 years. An additional objective was to determine whether a change in hearing ability in noise over a period of 5 years was associated with a change in psychosocial functioning. Subgroup effects for a range of factors were investigated. Longitudinal data of the web-based Netherlands Longitudinal Study on Hearing (NL-SH) (N = 508) were analyzed. The ability to recognize speech in noise (i.e., the speech-reception-threshold [SRTn]) was measured with an online digit triplet test at baseline and at 5-year follow-up. Psychosocial health status was assessed by online questionnaires. Multiple linear regression analyses and longitudinal statistical analyses (i.e., generalized estimating equations) were performed. Poorer SRTn was associated longitudinally with more feelings of emotional and social loneliness. For participants with a high educational level, the longitudinal association between SRTn and social loneliness was significant. Changes in hearing ability and loneliness appeared significantly associated only for specific subgroups: those with stable pattern of hearing aid nonuse (increased emotional and social loneliness), who entered matrimony (increased social loneliness), and low educational level (less emotional loneliness). No significant longitudinal associations were found between hearing ability and anxiety, depression, distress, or somatization. Hearing ability in noise was longitudinally associated with loneliness. Decline in hearing ability in noise was related to increase in loneliness for specific subgroups of participants. One of these subgroups included participants whose hearing deteriorated over 5 years, but who continued to report nonuse of hearing aids. This is an important and alarming finding that needs further investigation.

  14. Astrovirus gastroenteritis in hospitalized children of less than 5 years of age in Taiwan, 2009. (United States)

    Tseng, Wei-Chen; Wu, Fang-Tzy; Hsiung, Chao A; Chang, Wan-Chi; Wu, Ho-Sheng; Wu, Ching-Yi; Lin, Jen-Shiou; Yang, Shun-Cheng; Hwang, Kao-Pin; Huang, Yhu-Chering


    Acute gastroenteritis is a common illness in children under 5 years old. Although rotavirus is a leading cause, other viruses including astrovirus are also important, but have been the subject of limited studies. This is a prospective study to investigate astrovirus gastroenteritis in hospitalized children in Taiwan. From January 2009 to December 2009, children below 5 years of age admitted to three hospitals in Taiwan due to acute gastroenteritis were eligible for this study. Stool specimens were sent for the detection of astrovirus by reverse transcriptase polymerase chain reaction; once positive for astrovirus, the sequencing and phylogenetic analysis of each strain was performed. A total of 989 children were enrolled during the study period. The overall positive rate of astrovirus was 1.6%, ranging from 1.03% to 2.26% in different hospitals, while rotavirus accounted for 20.2% of the patients. Six of the 16 children (37.5%) with astroviral infection had documented coinfection with rotavirus. The median age of infection was 28.2 months. The seasonal distribution of astrovirus peaked from April to June. Diarrhea alone (40% vs. 2.1%, p fever, vomiting and diarrhea (30% vs. 71%, p = 0.0062) in children with astroviral infection alone than in those with rotaviral infection alone. The mean duration of diarrhea was significantly longer in patients with mixed infection than those with astroviral infection alone (6.8 vs. 4.2 days, p = 0.013). Respiratory symptoms were noted in 10 children (62.5%). Serotype HAstV-1 was the most common (68.8%). Astrovirus accounted for 1.6% of infections in children under 5 years hospitalized with acute gastroenteritis in Taiwan. Compared with those caused by rotavirus, the incidence of gastroenteritis in hospitalized children caused by astrovirus was low and the disease severity was mild. Copyright © 2012. Published by Elsevier B.V.

  15. Matching Subsequences in Trees

    DEFF Research Database (Denmark)

    Bille, Philip; Gørtz, Inge Li


    Given two rooted, labeled trees P and T the tree path subsequence problem is to determine which paths in P are subsequences of which paths in T. Here a path begins at the root and ends at a leaf. In this paper we propose this problem as a useful query primitive for XML data, and provide new...

  16. Body composition during fetal development and infancy through the age of 5 years (United States)

    Toro-Ramos, T; Paley, C; Pi-Sunyer, FX; Gallagher, D


    Fetal body composition is an important determinant of body composition at birth, and it is likely to be an important determinant at later stages in life. The purpose of this work is to provide a comprehensive overview by presenting data from previously published studies that report on body composition during fetal development in newborns and the infant/child through 5 years of age. Understanding the changes in body composition that occur both in utero and during infancy and childhood, and how they may be related, may help inform evidence-based practice during pregnancy and childhood. We describe body composition measurement techniques from the in utero period to 5 years of age, and identify gaps in knowledge to direct future research efforts. Available literature on chemical and cadaver analyses of fetal studies during gestation is presented to show the timing and accretion rates of adipose and lean tissues. Quantitative and qualitative aspects of fetal lean and fat mass accretion could be especially useful in the clinical setting for diagnostic purposes. The practicality of different pediatric body composition measurement methods in the clinical setting is discussed by presenting the assumptions and limitations associated with each method that may assist the clinician in characterizing the health and nutritional status of the fetus, infant and child. It is our hope that this review will help guide future research efforts directed at increasing the understanding of how body composition in early development may be associated with chronic diseases in later life. PMID:26242725

  17. Specialist Pediatric Palliative Care Referral Practices in Pediatric Oncology: A Large 5-year Retrospective Audit (United States)

    Ghoshal, Arunangshu; Salins, Naveen; Damani, Anuja; Deodhar, Jayita; Muckaden, MaryAnn


    Purpose: To audit referral practices of pediatric oncologists referred to specialist pediatric palliative care services. Patients and Methods: Retrospective review of medical case records of pediatric palliative care patients over a period of 5 years from January 1, 2010 to December 31, 2014. Descriptive summaries of demographic, clinical variables, and patient circumstances at the time of referral and during end-of-life care were examined. Results: A total of 1135 patients were referred from pediatric oncology with a gradual increasing trend over 5 years. About 84.6% consultations took place in the outpatient setting. In 97.9% of the cases, parents were the primary caregivers. Availability of specialist pediatric health-care services at local places was available in 21.2% cases and 48% families earned palliative radiotherapy. Only 4.9% patients had more than 2 follow-ups. 90.8% of the patients were cared for at home in the last days of illness by local general practitioners. 70.6% of the deaths were anticipated. Conclusions: Oncologists referred patients late in the course of disease trajectory. Most of the referrals were made for counseling and communication, but many patients had high symptom burden during referral. PMID:27559254

  18. Ocular findings in Norwegian patients with ataxia-telangiectasia: a 5 year prospective cohort study. (United States)

    Riise, Ruth; Ygge, Jan; Lindman, Carl; Stray-Pedersen, Asbjørg; Bek, Toke; Rødningen, Olaug Kristin; Heiberg, Arvid


    To describe the outcome of ophthalmologic examination of 10 Norwegian children with ataxia-telangiectasia (AT) followed through 5 years. Ten Norwegian patients with AT aged 2-22 years (three females, seven males) were examined. The diagnosis was confirmed clinically as well as with molecular genetic studies. Conventional ophthalmologic examination was performed and supplemented by photographs of the conjunctiva, video recordings and registration of eye motility in five consecutive years. Additionally conjunctival biopsies were performed at the end of the follow-up period. General ataxia was usually detected when the child started to walk. All children over the age of 4 years had abnormal saccade movements, a form of ocular motor apraxia. Conjunctival telangiectasias were mostly visible at 4-5 years, primarily within the palpebral fissure. Immunohistochemical examination of conjunctival biopsies showed an increased number of cross-sections of blood vessels and neurons surrounded by glial tissue. There was a tendency to slightly earlier onset of conjunctival telangiectasias in the patients homozygous for a founder mutation compared with the other patients. The diagnosis of AT can be supported at preschool age by the onset of ocular motor apraxia and conjunctival telangiectasias. The findings become more prominent with age. The conjunctival telangiectasias seem to appear slightly earlier in the patients who are homozygous for a Norwegian founder mutation than in the rest of the patients.

  19. Overview of 5-year followup outcomes in the drug abuse treatment outcome studies (DATOS). (United States)

    Hubbard, Robert L; Craddock, S Gail; Anderson, Jill


    Followup results from the Drug Abuse Treatment Outcome Studies (DATOS) 1-year and 5-year followups were used to describe the long-term outcomes of drug treatment and to further clarify the relationship between treatment duration and post-treatment outcomes in four treatment modalities: outpatient methadone, long-term residential (LTR), outpatient drug free (ODF), and short-term inpatient. Methods replicating those used in earlier analyses of the DATOS 1-year followup of 2,966 patients admitted to treatment in 1991-1993 and those of the Treatment Outcome Prospective Study patients admitted in 1979-1981 were employed. DATOS is a non-experimental longitudinal study conducted within the natural settings of 96 treatment programs in the U.S.A. The study followed patients during and after treatment at specified periods of time. Prevalence of drug use and behaviors were evaluated for the year prior to treatment; and the post-treatment time frames defined by the 1- and 5-year followups. In addition, the multivariate analytic technique of generalized estimating equations was used to examine the relationship of treatment duration and outcomes across both followups while also controlling for patient characteristics and pretreatment levels of behaviors. The 5-year stratified followup sample included 1,393 of the same individuals in the 1-year followup sample. Analyses were restricted to patients participating in both followups. Reductions in prevalence of cocaine use in the year after treatment (compared to the preadmission year) by patients were associated with longer treatment durations (particularly 6 months or more in LTR and ODF). In addition, reductions in illegal activity and increases in full-time employment were related to treatment stays of 6 months or longer for patients in LTR. The DATOS results from the 1-year and 5-year post-treatment followup combined suggest the stability of outcomes of substance abuse treatment. While results are generally consistent with the

  20. Angioedema: 5 years' experience, with a review of the disorder's presentation and treatment. (United States)

    Megerian, C A; Arnold, J E; Berger, M


    Angioedema is a problem that the otolaryngologist-head and neck surgeon is often asked to treat. This report concerns 17 patients admitted for care during a 5-year period. At their initial presentation, 94% of these patients manifested signs and symptoms of angioedema in the head and neck; three of them required urgent tracheotomy or intubation. As treatment of complement-mediated angioedema is distinct, an etiology-specific diagnostic and treatment protocol is presented. Of the patients, 35% had recent initiation of angiotensin-converting enzyme (ACE) inhibitor therapy for hypertension, and 6% demonstrated classic hereditary angioedema. However, the majority of them (59%) had unclear etiologies for their symptoms. Since angioedema is the final result of several possible abnormalities, a thorough knowledge of the differential diagnosis and clinical presentation is vital to patient management.

  1. Risk map for wolf threats to livestock still predictive 5 years after construction.

    Directory of Open Access Journals (Sweden)

    Adrian Treves

    Full Text Available Risk maps are spatial models of environmental hazards such as predation on livestock. We tested the long-term validity of a published risk map built from locations where Wisconsin wolves attacked livestock from 1999-2006. Using data collected after model construction, we verified the predictive accuracy of the risk map exceeded 91% for the period 2007-2011. Predictive power lasting 5 years or more substantiates the claim that risk maps are both valid and verified tools for anticipating spatial hazards. Classification errors coincided with verifier uncertainty about which wolves might be responsible. Perceived threats by wolves to domestic animals were not as well predicted (82% as verified attacks had been and errors in classification coincided with incidents involved domestic animals other than bovids and verifier uncertainty about which wolves were involved. We recommend risk maps be used to target interventions selectively at high-risk sites.

  2. A 5-year experience of the changing management of ectopic pregnancy. (United States)

    Berry, Janet; Davey, Mark; Hon, Mei-See; Behrens, Renée


    This retrospective audit reviewed all ectopic pregnancies over a 5-year period in a district general hospital setting. Of 215 ectopic pregnancies identified, notes were available for 208 (97%). 202 cases were determined to have been diagnosed and managed as ectopic pregnancies. Six cases were excluded as they were pregnancies of unknown location managed as such. The proportion of patients managed non-surgically has increased following the introduction of our consultant-led early pregnancy assessment unit from 25% prior to 31% currently. The success rates have improved in both those managed expectantly (50%-73%) and those with methotrexate (75%-90%). There has been a corresponding drop in those managed surgically from 75% to 69%, and a reduction in negative laparoscopies from 13% to 6%. Provided recommended criteria and follow-up are adhered to, non-surgical management has been shown to have comparative safety to traditional surgical management with acceptable efficacy and patient acceptability.

  3. Tympanoplasty: a 5-year review of results using the a la demanda (AAD) technique. (United States)

    Olaizola, F


    The effectiveness of different surgical procedures to eradicate cholesteatoma in the middle ear was studied. The author reviewed 1405 cases conducted during 10 years (1974 to 1984) and found that the most important causes of failure are pocket cholesteatoma and residual cholesteatoma. With the goal of diminishing these factors, a la demanda (AAD) technique has been used for the past 5 years, with optimistic results--only 2.4% failures during this period. Other causes of failures have also been studied. The evolution of the surgical technique has had two orientations: to improve the results and to eliminate the failures. In the author's clinic there has been a percentage of failures, which has motivated an orientation toward more resolutive and destructive instead of conservative, techniques.

  4. Ankle-Brachial Index as a Predictor of Mortality in Hemodialysis: A 5-Year Cohort Study

    Directory of Open Access Journals (Sweden)

    Jair Baptista Miguel

    Full Text Available Abstract Background: Abnormal ankle-brachial index (ABI has been found to be a strong predictor of mortality in some hemodialysis populations in studies with relatively short periods of follow-up, lower than 2 years. Objective: This study aimed to assess the predictive value of abnormal ABI as a risk factor for death among patients on maintenance hemodialysis after a 5-year follow-up. Methods: A total of 478 patients on hemodialysis for at least 12 months were included in the study. ABI measurement was performed using a mercury column sphygmomanometer and portable Doppler. Patients were divided into 3 groups according to ABI (low: 1.3 and followed for a 60-month period. Results: The prevalence rates of low, normal and high ABI were 26.8%, 64.6% and 8.6%, respectively. The 5-year survival rate was lower in the groups with low ABI (44.1%, P<0.0001 and high ABI (60.8%, P= 0.025 than in the group with normal ABI (71.7%. Cox regression was used to evaluate the association between ABI and mortality, adjusting for potential confounders. Using normal ABI as reference, a low, but not a high ABI was found to be an independent risk factor for all-cause mortality (HR2.57; 95% CI, 1.84-3.57 and HR 1.62; 95% CI, 0.93-2.83, respectively. Conclusions: long-term survival rates of patients with either low or high ABI were lower than the one from those with normal ABI. However, after adjustment for potential confounders, only low ABI persisted as an independent risk factor for all-cause mortality among hemodialysis patients.

  5. [The Octabaix study. Baseline assessment and 5 years of follow-up]. (United States)

    Ferrer, Assumpta; Formiga, Francesc; Padrós, Gloria; Badia, Teresa; Almeda, Jesús; Octabaix, Grupo Estudio

    This is a review of a prospective, community-based study with a follow-up period of 5years. It is a study of 328 participants aged 85 at baseline, of which 62% were female, 53% widows, and a third of them living alone. High blood pressure was observed in 75.9%, dyslipidaemia in 51.2%, and diabetes in 17.7%. At baseline the median Barthel Index was 95, the Spanish version of the Mini-Mental State Examination was 28, the Charlson index 1, the Mini Nutritional Assessment 25, the Gijón test 10, the visual analogue scale of the Quality of Life Test was 60, and with a mean of 6.1 prescription drugs. A lower quality of life was also associated with female gender, a phenotype of frailty, heart failure, and a high level of social risk. At 5years of follow-up, the mortality rate was high, with 138 (42.1%) of the population sample dying at the end of the period. It represents an annual mortality rate of 8.4%. Thus, a common denominator of this review has been the high importance of functionality and overall comorbidity factors associated with mortality in this very old age group, compared to other more traditional factors in younger populations. Several studies of frailty have also been assessed in this group, as well as falls, nutritional risk, diabetes and successful aging, including important aspects to better understand this population group. Copyright © 2016 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Configuring balanced scorecards for measuring health system performance: evidence from 5 years' evaluation in Afghanistan.

    Directory of Open Access Journals (Sweden)

    Anbrasi Edward


    Full Text Available BACKGROUND: In 2004, Afghanistan pioneered a balanced scorecard (BSC performance system to manage the delivery of primary health care services. This study examines the trends of 29 key performance indicators over a 5-year period between 2004 and 2008. METHODS AND FINDINGS: Independent evaluations of performance in six domains were conducted annually through 5,500 patient observations and exit interviews and 1,500 provider interviews in >600 facilities selected by stratified random sampling in each province. Generalized estimating equation (GEE models were used to assess trends in BSC parameters. There was a progressive improvement in the national median scores scaled from 0-100 between 2004 and 2008 in all six domains: patient and community satisfaction of services (65.3-84.5, p<0.0001; provider satisfaction (65.4-79.2, p<0.01; capacity for service provision (47.4-76.4, p<0.0001; quality of services (40.5-67.4, p<0.0001; and overall vision for pro-poor and pro-female health services (52.0-52.6. The financial domain also showed improvement until 2007 (84.4-95.7, p<0.01, after which user fees were eliminated. By 2008, all provinces achieved the upper benchmark of national median set in 2004. CONCLUSIONS: The BSC has been successfully employed to assess and improve health service capacity and service delivery using performance benchmarking during the 5-year period. However, scorecard reconfigurations are needed to integrate effectiveness and efficiency measures and accommodate changes in health systems policy and strategy architecture to ensure its continued relevance and effectiveness as a comprehensive health system performance measure. The process of BSC design and implementation can serve as a valuable prototype for health policy planners managing performance in similar health care contexts. Please see later in the article for the Editors' Summary.

  7. A 5-year Evaluation and Results of Treatment of Chronic Llocked Dislocations of the Shoulder Joint

    Directory of Open Access Journals (Sweden)

    Syawash Mirsaid Ghazi


    Full Text Available Background:Chronic neglected dislocation of the shoulder joint can be defined as a neglected dislocation for more than a 3 week period.However, it has been shown that the negligence could range from a 24 hour period to 6 months1. Depending on age,signs, symptoms,etiology and types of dislocation, conservative treatment or surgical intervention could be considered.Methods: In this study, 16 patients (13 were male and 3 were female were treated with chronic shoulder dislocations, 3 of which had bilateral dislocations. The age of this group ranged from 13-65 years with a mean age of 34 years. These patients were treated by closed or open reduction, either anterior, posterior or both approaches. Of 19 dislocations, 6 were anterior unilateral, 7 posterior unilateral, 1 anterior bilateral and 2 posterior bilateral dislocations. The mean period between dislocations and treatments was 3 months (from 4 weeks to 11 months,And the mean follow up period was 40 months (from 21 months to 5 years.Results: This study has shown that treatment varies according to pathology. In  this study the mean size of head defects was 35% and the extent of severity determined the approach. Findings at the last follow up were assessed according to Rowe and Zarins score and of the 19 shoulders assessed, 9 showed good and 10 showed excellent results. There was no recurrence of the dislocation in any patient.Conclusion:In some selected instances, open reduction of a chronic locked neglected shoulder dislocation of a 6 months period or more in young patients is recommended.This method is, however, contraindicated in elderly patients; in such cases a shoulder prosthesis is indicated.  

  8. A prospective cohort study of endodontic treatments of 1,369 root canals: results after 5 years. (United States)

    Ricucci, Domenico; Russo, John; Rutberg, Michael; Burleson, Josef A; Spångberg, Larz S W


    The purpose of this prospective study was: 1) to follow-up a large number of endodontic treatments performed by a single operator, periodically checked over a 5-year period; and 2) to correlate outcome to a number of clinical variables. This prospective study included all consecutive cases during the selected time period. All cases were followed regularly for a 5-year period. At the 5-year end point of the study, 470 patients with 816 treated teeth and with 1,369 treated root canals were available for evaluation. The overall rate of success among the 816 teeth/1,369 root canals available for evaluation was 88.6%/90.3%. The success rate for 435 teeth/793 root canals undergoing vital pulp therapy was 91.5%/93.1%. Teeth/root canals with necrotic pulp but without detectable periapical bone lesion were successfully treated in 89.5%/92.3%. If the pulp necrosis was complicated by apical periodontitis, the success rate fell to 82.7% for the teeth and 84.1% for the root canals (P = .037). Teeth with periapical lesion length was identified. Excess of root canal filling material decreases success. Infected pulp space should be treated with an effective intracanal dressing. The quality of the coronal restoration or the placement of intracanal post retentions does not affect treatment outcome. Copyright © 2011 Mosby, Inc. All rights reserved.

  9. Implant-supported mandibular overdentures retained with ball or bar attachments: a randomized prospective 5-year study

    DEFF Research Database (Denmark)

    Gotfredsen, K; Holm, B


    Astra Tech dental implants placed in the anterior part of the mandible. The denture attachment system for the patients was chosen randomly by drawing lots. Eleven patients drew the bar attachment system and fifteen patients drew the ball attachment system. Plaque Index, Gingival Index, and probing......PURPOSE: The aim of the present study was to evaluate the periimplant conditions and the maintenance requirements for implant-supported overdentures in the mandible retained with ball or bar attachments during a 5-year period. MATERIALS AND METHODS: Twenty-six completely edentulous patients had two...... pocket depth were assessed around each implant. Periotest values were recorded, and periodically identical intraoral radiographs were obtained with a specially designed film-holding device. RESULTS: No implants were lost from baseline to the 5-year registration. The periimplant conditions were very...

  10. Prognosis for Emergency Physician with Substance Abuse Recovery: 5-year Outcome Study

    Directory of Open Access Journals (Sweden)

    John S. Rose


    Full Text Available Introduction: Emergency physicians (EPs are reported to have a higher rate of substance use disorder (SUD than most specialties, although little is known about their prognosis. We examined the outcomes of emergency physician compared to other physicians in the treatment of substance use disorders in Physician Health Programs (PHP. Methods: This study used the dataset from a 5-year, longitudinal, cohort study involving 904 physicians with diagnoses of SUD consecutively admitted to one of 16 state PHPs between 1995 and 2001. We compared 56 EPs to 724 other physicians. Main outcome variables were rates of relapse, successful completion of monitoring, and return to clinical practice. Results: EPs had a higher than expected rate of SUD (odds ratio [OR] 2.7 confidence interval [CI]: 2.1–3.5, p,0.001. Half of each group (49% of EPs and 50% of the others enrolled in a PHP due to alcohol-related problems. Over a third of each group (38% of EPs and 34% of the others enrolled due to opioid use. During monitoring by the PHPs, 13% of EPs had at least one positive drug test compared to 22% of the other physicians; however, this difference was not significant (p¼0.13. At the end of the 5-year follow-up period, 71% of EPs and 64% of other physicians had completed their contracts and were no longer required to be monitored (OR 1.4 [CI: 0.8-2.6], p ¼ 0.31. The study found that the proportion of EPs (84% continuing their medical practice was generally as high as that of other physicians (72% (OR 2.0 [CI: 1.0–4.1], p ¼ 0.06. Conclusion: In the study EPs did very well in the PHPs with an 84% success rate in completion and return to clinical practice at 5 years. Of the 3 outcome variables measured, rates of relapse, successful completion of monitoring, and return to clinical practice, EPs had a high rate of success on all variables compared to the other physician cohort. These data support the conclusion that EM physicians do well following treatment of SUD

  11. Cognitive deficit and poverty in the first 5 years of childhood in Bangladesh. (United States)

    Hamadani, Jena D; Tofail, Fahmida; Huda, Syed N; Alam, Dewan S; Ridout, Deborah A; Attanasio, Orazio; Grantham-McGregor, Sally M


    We aimed to determine the timing and size of the cognitive deficit associated with poverty in the first 5 years of life and to examine the role of parental characteristics, pre- and postnatal growth, and stimulation in the home in Bangladeshi children. We hypothesized that the effect of poverty on cognition begins in infancy and is mainly mediated by these factors. We enrolled 2853 singletons, a subsample from a pregnancy supplementation trial in a poor rural area. We assessed mental development at 7, 18, and 64 months; anthropometry at birth, 12, 24, and 64 months; home stimulation at 18 and 64 months; and family's socioeconomic background. In multiple regression analyses, we examined the effect of poverty at birth on IQ at 64 months and the extent that other factors mediated the effect. A mean cognitive deficit of 0.2 (95% confidence interval -0.4 to -0.02) z scores between the first and fifth wealth quintiles was apparent at 7 months and increased to 1.2 (95% confidence interval -1.3 to -1.0) z scores of IQ by 64 months. Parental education, pre- and postnatal growth in length, and home stimulation mediated 86% of the effects of poverty on IQ and had independent effects. Growth in the first 2 years had larger effects than later growth. Home stimulation had effects throughout the period. Effects of poverty on children's cognition are mostly mediated through parental education, birth size, growth in the first 24 months, and home stimulation in the first 5 years. Copyright © 2014 by the American Academy of Pediatrics.

  12. A 5-year review of pattern of placenta previa in Ilorin, Nigeria. (United States)

    Omokanye, L O; Olatinwo, A W O; Salaudeen, A G; Ajiboye, A D; Durowade, K A


    Placenta previa, a major cause of obstetric hemorrhage, is potentially life-threatening to the mother and frequently results in high perinatal morbidity and mortality. This is a retrospective study of all cases of placenta previa managed at the University of Ilorin Teaching Hospital over a 5-year from January 2011 to December 2015. A pro forma template was used to harvest information from case notes of patients involved in the study. There were a total of 10,250 deliveries over the 5-year study and 164 cases of placenta previa were managed during this period; giving an incidence of 1.6% of the total deliveries. Of these patients, 65.9% were unbooked while 34.1% were booked. 110 (67%) were above 30 years of age and 51.2% were grand multiparous women. The majority (81.7%) of the patients belonged to the low socioeconomic class. Painless vaginal bleeding (62.2%), intrapartum hemorrhage (22.6%), and abnormal lie presentation (8.5%) were the most common mode of presentation. Vaginal delivery occurred in (29.3%) of patients while 70. 7% were delivered through cesarean section. There was a significant association between patients' age, parity, booking status, and types of placenta previa ( P < 0.05). Similarly, there was a significant association between gestational age at delivery, mode of delivery, intraoperative blood loss, and birth weight at delivery and types of placenta previa ( P < 0.05). Perinatal mortality was 12.2%, 15.6% of babies had severe birth asphyxia, and there was no maternal mortality. From this study, the risk factors for placenta previa are advanced maternal age above 35 years, grand multiparity, and booking status. Early recognition, appropriate referral of these patients and availability of ultrasound facilities, blood transfusion facilities, improvement in neonatal facilities and trained personnel will go a long way in reducing the perinatal mortality from placenta previa.

  13. Disability in young adults following major trauma: 5 year follow up of survivors

    Directory of Open Access Journals (Sweden)

    Connelly James B


    Full Text Available Abstract Background Injuries are a major cause of mortality and morbidity in young people. Despite this, the long-term consequences for young survivors of severe injury are relatively unexplored. Methods Population based cohort study involving 5 year post injury structured interview of all cases of major trauma (Injury Severity Score > 15 identified retrospectively for 12 month period (1988 to 1989 within former Yorkshire Health Authority area of the United Kingdom. Results 125 individuals aged 11–24 years at time of injury were identified. Of these, 109 (87% were interviewed. Only 20% (95% CI 14–29% of those interviewed reported no disability. Mean Office of Population Census and Surveys (OPCS disability score of the remainder was 7.5 (median 5.8, range 0.5 to 19.4. The most commonly encountered areas of disability were behaviour (54%, 95% CI 45–63%, intellectual functioning (39%, 95% CI 31–49% and locomotion (29%, 95% CI 22–39%. Many respondents reported that their daily lives were adversely affected by their health problems for example, causing problems with work, 54% (95% CI 45–63%, or looking after the home, 28% (95% CI 21–38%. Higher OPCS scores were usually but not always associated with greater impact on daily activities. The burden of caring responsibilities fell largely on informal carers. 51% (95% CI 42–61% of those interviewed would have liked additional help to cope with their injury and disability. Conclusion The study has revealed significant disability amongst a cohort of young people 5 years post severe injury. Whilst many of these young people were coping well with the consequences of their injuries, others reported continuing problems with the activities of daily life. The factors underpinning the young people's differing experiences and social outcome should be explored.

  14. Double crown-retained maxillary overdentures: 5-year follow-up. (United States)

    Frisch, Eberhard; Ziebolz, Dirk; Ratka-Krüger, Petra; Rinke, Sven


    There is a lack of data concerning implant-supported overdentures (IODs) retained by double crowns in the edentulous maxilla. To perform a retrospective evaluation of clinical outcomes (survival/success rates) of maxillary overdentures retained on four implants via double crowns. Between 1993 and 2011, 28 patients with edentulous maxillae were restored with overdentures supported by four implants with a Morse taper connection (Ankylos, Dentsply Friadent, Mannheim, Germany) and double crowns according to the Marburg Double Crown (MDC) technique in a private practice. For retrospective evaluation of implant and prosthetic survival (in situ criterion) and success (event-free observational period), only patients attending a professional maintenance program were included (n = 20). Twenty patients (13 female/ seven male, mean age: 63.45 ± 7.18 years) with 80 implants met the inclusion criteria. The mean follow-up period was 5.64 ± 3.50 years. One implant was lost (cumulative survival rate: 98.75%). Eight implants (10.1%) in two patients (10%) showed peri-implantitis; both patients were active smokers (cumulative success rate: 88.75%). All dentures were still functional (prosthetic survival rate 100%) at the time of investigation. Technical maintenance procedures (e.g., abutment loosening, screw loosening, acrylic fracture or relining) were required at a rate of 0.222/patient-year. Within the limitations of this study, we conclude that MDC-IODs are a promising treatment alternative for edentulous maxillae offering high implant and prosthesis survival rates > 98% and a limited incidence of biological and technical complications after a mean observational period of >5 years. © 2013 Wiley Periodicals, Inc.

  15. Lenke 1C and 5C spinal deformities fused selectively: 5-year outcomes of the uninstrumented compensatory curves. (United States)

    Ilgenfritz, Ryan M; Yaszay, Burt; Bastrom, Tracey P; Newton, Peter O


    Multicenter review of prospectively collected data. To analyze the natural history of uninstrumented compensatory curves prospectively during a 5-year postoperative period in patients with selectively fused Lenke type 1C and 5C adolescent idiopathic scoliosis. After a selective fusion for 1C and 5C adolescent idiopathic scoliosis curve types, there is concern that uninstrumented compensatory curves will continue to progress over time. However, to date, there have been no studies using prospectively collected data beyond 2 years to determine the natural history of these uninstrumented compensatory curves. Lenke 1C and 5C adolescent idiopathic scoliosis cases, prospectively collected from a multicenter study were analyzed. All patients underwent a selective fusion (1C only thoracic curve fused; 5C only thoracolumbar/lumbar curve fused). Preoperative, first-erect, 1-year, 2-year, and 5-year postoperative coronal, sagittal, and axial (Perdriolle) radiographical outcomes were compared using repeated measures analysis of variance with Bonferroni post hoc comparisons (P 5C curves were reviewed. Preoperative compensatory curve Cobb angles were 40° ± 6° and 25° ± 9°, respectively. In Lenke 1C curves, the uninstrumented compensatory lumbar curves were corrected by 32% ± 16% at first erect, 44% ± 17% correction at 1 year, 38% ± 15% correction at 2 years, and 39% ± 19% at 5 years. In Lenke 5C curves, the uninstrumented compensatory thoracic curves were corrected by a mean of 37% ± 29% at first erect, 42% ± 29% at 1 year, 37% ± 29% at 2 years, and 30% ± 23% at 5 years. The sagittal and axial measures of the compensatory curves remained stable during the postoperative period. In Lenke 1C and 5C adolescent idiopathic scoliosis deformity patterns fused selectively, the uninstrumented compensatory curves adjust to match the instrumented primary curve and do not seem to progress between 1 and 5 years postoperatively.

  16. Risk Factors Predicting Colorectal Cancer Recurrence Following Initial Treatment: A 5-year Cohort Study (United States)

    Zare-Bandamiri, Mohammad; Fararouei, Mohammad; Zohourinia, Shadi; Daneshi, Nima; Dianatinasab, Mostafa


    Purpose: Recurrence is one of the most important factors influencing survival of colorectal cancer patients. Subjects and Methods: In this cohort study, clinical and demographic characteristics of 561 patients with colorectal cancer were collected from 2010 to 2015. Medical records and telephone interviews were used to define the patient’s clinical status including the date of any recurrence during the study period. The multivariate Cox model was used as the main strategy for analyzing data. Results: Some 239 (42.6%) patients experienced cancer recurrence during the 5-year follow-up period. Those with an older age at diagnosis had a higher risk of cancer recurrence than their younger counterparts [Hazard Ratio (HR) >70 y /<50 y= 1.65, P=0.01]. Rectal cancer had a greater risk of disease recurrence compared with other tumor sites [HR colon/ rectum=1.53, P=0.02]. Stage 3 cancer had a higher risk than stage 1 cancer [HR stage 3/ stage 1=4.30, P<0.001], and positive lympho-vascular invasion was also a risk factor [HR yes/ no=2.03, P<0.001]. Finally, tumor size , number of dissected lymph nodes, proportion of positive lymph nodes, perineural invasion and type of treatment did not significantly predict recurrence. Conclusion: Access to enhanced medical services including cancer diagnosis at an early stage and optimal treatment is needed to improve the survival and quality of life of CRC patients. Creative Commons Attribution License

  17. A modified surgical approach to a case of mandibular fracture in a 5-year-old girl

    Directory of Open Access Journals (Sweden)

    Attiguppe R Prabhakar


    Full Text Available Injuries to the face are far more uncommon than other injuries in children. However, when they occur they can pose considerable management challenges to concerned specialists and the subsequent functional and esthetic impact to the growing child can be overwhelming. Here is a report of a 5-year-old girl diagnosed with fracture of the body of the mandible and an associated fracture of the parasymphysis. This paper presents a unique treatment modality considering the various anatomic and developmental factors in such young children.

  18. Assessment of dental caries predictors in 6-year-old school children - results from 5-year retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Masood Mohd


    Full Text Available Abstract Background This was a retrospective cohort study undertaken to assess the rate and pattern of dental caries development in 6-year-old school children followed-up for a period of 5 years, and to identify baseline risk factors that were associated with 5 years caries experience in Malaysian children. Methods This 5-years retrospective cohort study comprised primary school children initially aged 6 years in 2004. Caries experience of each child was recorded annually using World Health Organization criteria. The rates of dental caries were recorded in prevalence and incidence density of carious lesions from baseline to final examination. Risk assessment was done to assess relative risk for caries after 5 years in children with baseline caries status. Simple and multiple logistic regression analysis were performed to identify significant independent risk factors for caries. Results The sample consisted of 1830 school children. All components of DMFT showed significant differences between baseline and final examination. Filled teeth (FT component of the DMFT showed the greatest increases. Results revealed the initial baseline caries level in permanent dentition was a strong predictor for future caries after 5 years (RR=3.78, 95% CI=3.48-4.10, P0.001. Logistic regression analysis showed significant association between caries occurrence and residence (urban/rural (OR=1.80, Pp observed from baseline and after 5 years was 5.80 persons/100 person-year of observation. The rate of new caries-affected tooth (IDt in the period from baseline and after 5-years was 0.76 teeth/100 teeth-year of observation. Conclusion The majority of 12-year-old school children (70% were caries-free and most of the caries were concentrated in only a small proportion (30% of them. We found that the presence of caries in permanent teeth at the age of 6 years was a strong predictor of future caries development in this population. The strong evidence of early permanent teeth

  19. Animal evolution and atmospheric pO2: is there a link between gradual animal adaptation to terrain elevation due to Ural orogeny and survival of subsequent hypoxic periods? (United States)

    Kurbel, Sven


    Considering evolution of terrestrial animals as something happening only on flat continental plains seems wrong. Many mountains have arisen and disappeared over the geologic time scale, so in all periods some areas of high altitude existed, with reduced oxygen pressure (pO2) and increased aridity. During orogeny, animal species of the raising terrain can slowly adapt to reduced oxygen levels.This review proposes that animal evolution was often driven by atmospheric oxygen availability. Transitions of insect ancestors and amphibians out of water are here interpreted as events forced by the lack of oxygen in shallow and warm water during Devonian. Hyperoxia during early Carboniferous allowed giant insects to be predators of lowlands, forcing small amphibians to move to higher terrains, unsuitable to large insects due to reduced pO2. In arid mountainous habitats, ascended animals evolved in early reptiles with more efficient lungs and improved circulation. Animals with alveolar lungs became the mammalian ancestors, while those with respiratory duct lungs developed in archosaurs. In this interpretation, limb precursors of wings and pneumatised bones might have been adaptations for moving on steep slopes.Ural mountains have risen to an estimated height of 3000 m between 318 and 251 Mya. The earliest archosaurs have been found on the European Ural side, estimated 275 Myr old. It is proposed that Ural orogeny slowly elevated several highland habitats within the modern Ural region to heights above 2500 m. Since this process took near 60 Myr, animals in these habitats fully to adapted to hypoxia.The protracted P-Tr hypoxic extinction event killed many aquatic and terrestrial animals. Devastated lowland areas were repopulated by mammaliaformes that came down from mountainous areas. Archosaurs were better adapted to very low pO2, so they were forced to descend to the sea level later when the lack of oxygen became severe. During the Triassic period, when the relative content

  20. Targeted neurosurgical outreach: 5-year follow-up of operative skill transfer and sustainable care in Lima, Peru. (United States)

    Duenas, Vincent J; Hahn, Edward J; Aryan, Henry E; Levy, Michael V; Jandial, Rahul


    This study evaluates the efficacy of operative skill transfer in the context of targeted pediatric outreach missions. In addition, the ability to implement surgical care improvements that are sustainable is investigated. Three 1-week targeted neurosurgical missions were performed (2004-2006) to teach neuroendoscopy, which included donation of the necessary equipment so newly acquired surgical skills could be performed by local neurosurgeons in between and after the departure of the mission team. After the targeted missions were completed, 5 years of neuroendoscopy case follow-up data were obtained. After performing pediatric neurosurgery missions in 2004-2006, with a focus on teaching neuroendoscopy, the host team demonstrated the sustainability of our didactic efforts in the subsequent 5 years by performing cases independently for their citizens. To date, a total of 196 operations have been performed in the past 5 years independent of any visiting team. Effective operative skill transfer to host neurosurgeons can be accomplished with limited international team visits utilizing a targeted approach that minimizes expenditures on personnel and capital. With the priority being teaching of an operative technique, as opposed to perennially performing operations by the mission team, sustainable surgical care was achieved after missions officially concluded.

  1. 77 FR 26361 - Medicaid Program; State Plan Home and Community-Based Services, 5-Year Period for Waivers... (United States)


    ... Deficit Reduction Act of 2005 and amended by the Patient Protection and Affordable Care Act of 2010... States to effectively manage their Medicaid resources. \\1\\ Affordable Care Act: Patient Protection and... syndrome, or Alzheimer's disease. In many cases, without the provision of HCBS, these conditions may...

  2. Isolation of Salmonella Enteritidis Phage Type 30 from a Single Almond Orchard over a 5-Year Period

    National Research Council Canada - National Science Library

    Uesugi, Aaron R; Danyluk, Michelle D; Mandrell, Robert E; Harris, Linda J


    In 2001, Salmonella Enteritidis phage type (PT) 30 was isolated from drag swabs of 17 61-ha almond orchards on three farms linked to an outbreak of salmonellosis associated with consumption of raw almonds...

  3. Retrospective analysis of Steven Johnson syndrome and toxic epidermal necrolysis over a period of 5 years from northern Karnataka, India. (United States)

    Naveen, Kikkeri Narayanasetty; Pai, Varadraj V; Rai, Vijetha; Athanikar, Sharatchandra B


    Cutaneous drug reactions are the most common type of adverse drug reactions. Adverse cutaneous drug reactions form 2-3% of the hospitalized patients. 2% of these are potentially serious. This study aims to detect the drugs commonly implicated in Steven Johnson Syndrome-Toxic Epidermal Necrosis (SJS-TEN). A retrospective analysis was done in all patients admitted in the last five years in SDM hospital with the diagnosis of SJS-TEN. A total of 22 patients with SJS-TEN were studied. In 11 patients anti-epileptics was the causal drug and in 7, anti-microbials was the causal drug. Recovery was much faster in case of anti epileptics induced SJS-TEN as compared to that induced by ofloxacin. SJS-TEN induced by ofloxacin has a higher morbidity and mortality compared to anti convulsants.

  4. Bipolar disorder recurrence prevention using self-monitoring daily mood charts: case reports from a 5 year period


    Yasui-Furukori N; Nakamura K


    Norio Yasui-Furukori, Kazuhiko Nakamura Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan Abstract: Mood symptoms in bipolar disorders are significantly related to psychosocial events, and the personalized identification of symptom triggers is important. Ecological momentary assessments have been used in paper-and-pencil form to explore emotional reactivity to daily life stress in patients with bipolar disorder. However, there are few data on l...

  5. The clinical course of hepatitis E virus infection in patients of a tertiary Dutch hospital over a 5-year period

    NARCIS (Netherlands)

    Riezebos-Brilman, Annelies; Verschuuren, Erik A. M.; van Son, Willem J.; van Imhoff, Gustaaf W.; Brugemann, Johan; Blokzijl, Hans; Niesters, Hubert G. M.


    Background: Hepatitis E virus (HEV) has long been known as a major cause of acute hepatitis in developing countries with occasional travel-related cases in developed countries, most of them belonging to genotype 1. Currently, genotype 3 HEV is recognized as an emerging public health issue in

  6. The Prevalence of Specific Language Impairment in 5-year-old Persian-Speaking Children in Shiraz City of Iran – 2015

    Directory of Open Access Journals (Sweden)

    Mohammad Majid Oryadi-Zanjani


    Full Text Available Background: Specific Language Impairment (SLI is one of the most common developmental problems resulting in referral to speech therapy clinics in the preschool years. A number of studies have been conducted to determine the prevalence of SLI in different populations. However, the prevalence of childhood language disorders in Iranian population is unknown because of the limited epidemiologic studies in the field. The aim of this study was therefore, to estimate the prevalence of SLI in 5-year-old Persian-speaking children. Methods: This research was an epidemiological study which conducted in a three-month period in the spring of 2015 in Shiraz. The sample size was 180 children aged 5 years old including 95 boys and 85 girls whom recruited from 12 preschool centers of 9 urban areas in Shiraz by stratified sampling. The EpiSLI system was used to diagnose SLI. The Persian version of Test of language Development (TOLD-P: 3 was employed to evaluate the children’s oral language skills. A number of descriptive statistics were calculated. In addition, Chi-square test was used to analyze the correlation between the prevalence of SLI with sex and area. The significant level was set to 0.05. Results: The estimated prevalence of SLI in the population under study was estimated to be %3.3. In addition, the estimated prevalence of SLI in boys and girls was 4.2% and 2.4%, respectively. There were no significant correlation between the estimated prevalence of SLI with sex and area (P>0.05. Conclusion: According to the findings of this study, it is important to employ screening system to find preschool children with SLI to prevent subsequent problems.

  7. Reactions to Rituximab in an Outpatient Infusion Center: A 5-Year Review. (United States)

    Levin, Amy S; Otani, Iris M; Lax, Timothy; Hochberg, Ephraim; Banerji, Aleena

    Reactions to rituximab occur frequently, with up to 77% of patients developing a reaction during initial exposure. The safety of rechallenging patients after a reaction is not clear and standard guidelines are lacking. To better understand clinical decision making surrounding rituximab reactions and subsequent rechallenge. We performed a 5-year retrospective review of all rituximab reactions at a large academic outpatient infusion center. Patients' demographic characteristics, clinical symptoms, and management of reactions were reviewed. Reaction severity was classified using standard criteria. Between June 2006 and January 2011, 67 patients (mean age, 58 ± 13 years, 54% men) with at least 1 rituximab reaction were identified. Most reactions occurred during the first exposure to rituximab (63%). Most reactions (n = 59 [88%]) were grade 1 or 2. Fifty-one patients (n = 51 [88%]) were rechallenged with rituximab on the same day as the initial reaction. Most patients with a grade 1 reaction tolerated rechallenge. Conversely, all 4 patients with a grade 3 reaction had a reaction during rechallenge. The outcome of same-day rechallenge after an initial grade 2 reaction was varied; most patients (26 of 31 [84%]) tolerated same-day challenge, but 5 patients had a reaction (all grade 1-2 severity). Consistent with previous data, our observations suggest that patients who experience grade 1 reactions to rituximab can be safely rechallenged the same day. A grade 3 or 4 reaction should prompt referral to an allergy specialist for risk assessment before additional rituximab administration. Further research is needed to understand the optimal management of patients with grade 2 reactions. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  8. Broad based tension-free synthetic sling for stress urinary incontinence: 5-year outcome. (United States)

    Shah, Darshan K; Paul, Elliot M; Amukele, Samuel; Eisenberg, Evan R; Badlani, Gopal H


    The use of nonabsorbable synthetic material has been questioned due to reports of erosion and infection. We present the 5-year followup outcome of stress urinary incontinence (SUI) treated using polypropylene mesh as a pubovaginal sling. A retrospective analysis was performed of 58 consecutive patients who underwent pubovaginal sling procedures using polypropylene mesh since April 1996 for types II and III SUI at our institution. The technique included a single midline anterior vaginal wall incision with full-thickness flaps. Broad based polypropylene mesh was used to support the vesicourethral junction entering the retropubic space through the endopelvic fascia and bone anchors were used for fixation. Patient satisfaction was evaluated during followup office visits and/or telephone interview by an individual not involved in any surgeries. All procedure failures were evaluated by urodynamics. Of the 58 patients 49 were available for analysis. Average followup was 59.34 months (range 29 to 77). Of the 49 patients 40 (81.63%) were dry and 2 (4.08%) improved (1 pad daily). De novo urgency and urgency related incontinence was reported in 1 case each. Three patients (8.16%) had recurrent SUI, while prolonged retention developed with subsequent urethrolysis required in 2 (4.08%). None of the patients have experienced infection, nonhealing or erosion of the synthetic slings to date. In our experience polypropylene mesh used as a broad based tension-free sling was successful for treating all types of SUI. In our opinion technique and case selection have a bearing on outcomes.

  9. Outcomes using wedge stem with full hydroxiapatite coverage with a minimum of 5 years' follow-up. (United States)

    Godoy-Monzon, D; Buttaro, M; Comba, F; Zanotti, G; Piccaluga, F; Neira-Borrajo, I

    Total Hip Arthroplsty (THA) using uncemented stems is a popular practice in the last decades. The implant survivorship is crtitical and a less than 10% revision at 10 years is been propesed for commercialization and use. To analyse the clinicoradiological results of an uncemented hydroxiapatite covered wedge stem with a 5 years minimum follow up. Prospective study, patients aged from 21-75years were included. All patients received an Element stem (Exactech) and uncemented cup with crosslink poly and 32 mm metal head, and posterior approach with piriformis retention was used. Scheduled clinical and radiographic evaluation at 3 weeks, 3-6 month, year and subsequent years using Harris Hip Score and Merle d'Aubigné Postel. Intraoperative and during follow up complications were recorded. One hundred and fourteen total hip replacements in 104 patients: 54 females and 50 males (52%/48%). Follow-up of 5.7 years (range, 5-6.2years). Average age 56.8years (range, 42-75years). Clinical evaluation the Merle d'Aubigné score improved 6.8 points and from the initianl Harris Hip Score 47.3 to 93.1 points at last follow up. Radiographic evaluation shows osteointegration in all stems. And in 6 cases (5.3% at 3 months subsidence was detected, average 1.4 mm (range 0-2.6 mm) with no clinical manifestation, 3 cases of subsidence were associated to intraoperative fractures (1 greater trochanter and 2 in the calcar area, all resolved with wire cerclaje). Subjective evaluation: 86 cases (82.6%) excellent, 9 patients (8.6%) good, 6 cases (5.9%) satisfactory and 3 cases (2.9%) poor. All poor results linked to the intraoperative complications. No patient lost during follow up period. No femoral pain dislocation or aseptic or loosening detected. All implants were in situ at last follow up. The radiological results confirm the benefits of this type of stem with good osteointegration. The clinical and subjective results are promising. With good surgical technical and without complications the

  10. Multicenter Analysis of Midterm Clinical Outcomes of Arthroscopic Labral Repair in the Hip: Minimum 5-Year Follow-up. (United States)

    Hevesi, Mario; Krych, Aaron J; Johnson, Nick R; Redmond, John M; Hartigan, David E; Levy, Bruce A; Domb, Benjamin G


    The technique of hip arthroscopic surgery is advancing and becoming more commonly performed. However, most current reported results are limited to short-term follow-up, and therefore, the durability of the procedure is largely unknown. To perform a multicenter analysis of mid-term clinical outcomes of arthroscopic hip labral repair and determine the risk factors for patient outcomes. Cohort study; Level of evidence, 3. Prospectively collected data of primary hip arthroscopic labral repair performed at 4 high-volume centers between 2008 and 2011 were reviewed retrospectively. Patients were assessed preoperatively and postoperatively with the visual analog scale (VAS), modified Harris Hip Score (mHHS), and Hip Outcome Score-Sports-Specific Subscale (HOS-SSS) at a minimum of 5 years' follow-up. Factors including age, body mass index (BMI), Tönnis grade, and cartilage grade were analyzed in relation to outcome scores, and revision rates were determined. Failure was defined as subsequent ipsilateral hip surgery, including revision arthroscopic surgery and open hip surgery. A total of 303 patients (101 male, 202 female) with a mean age of 32.0 years (range, 10.7-58.9 years) were followed for a mean of 5.7 years (range, 5.0-7.9 years). Patients achieved mean improvements in VAS of 3.5 points, mHHS of 20.1 points, and HOS-SSS of 29.3 points. Thirty-seven patients (12.2%) underwent revision arthroscopic surgery, and 12 (4.0%) underwent periacetabular osteotomy, resurfacing, or total hip arthroplasty during the study period. Patients with a BMI >30 kg/m2 had a mean mHHS score 9.5 points lower and a mean HOS-SSS score 15.9 points lower than those with a BMI ≤30 kg/m2 ( P 35 years at surgery had a mean mHHS score 4.5 points lower and a HOS-SSS score 6.7 points lower than those aged ≤35 years ( P = .03). Patients with Tönnis grade 2 radiographs demonstrated a 12.5-point worse mHHS score ( P = .02) and a 23.0-point worse HOS-SSS score ( P arthroscopic labral repair

  11. 77 FR 5491 - Endangered and Threatened Species; Initiation of 5-Year Review for Sei Whales (United States)


    ...; Initiation of 5-Year Review for Sei Whales AGENCY: National Marine Fisheries Service (NMFS), National Oceanic...; request for information. SUMMARY: NMFS announces a 5-year review of sei whales (Balaenoptera borealis... of any such information on sei whales that has become available since that has become available since...

  12. Global strategy for the diagnosis and management of asthma in children 5 years and younger

    DEFF Research Database (Denmark)

    Hurd, Suzanne S; Lemanske, Robert F; Becker, Allan


    in Children 5 Years and Younger, an effort has been made to present the special challenges that must be taken into account in managing asthma in children during the first 5 years of life, including difficulties with diagnosis, the efficacy and safety of drugs and drug delivery systems, and the lack of data...

  13. Hypomineralized second primary molars: Prevalence data in Dutch 5-year-olds

    NARCIS (Netherlands)

    Elfrink, M.E.C.; Schuller, A.A.; Weerheijm, K.L.; Veerkamp, J.S.J.


    The aim of this cross-sectional observational study was to report on the prevalence of hypomineralizations in second primary molars in 5-year-old Dutch children. In the study 386 (45% girls) 5-year-old Dutch children, all insured by a Health Insurance Fund, participated. Scoring criteria for molar

  14. Validity and reliability of the attachment insecurity screening inventory (AISI) 2-5 years

    NARCIS (Netherlands)

    Wissink, I.B.|info:eu-repo/dai/nl/293037817; Stams, G.J.J.M.; Colonnesi, C.; Asscher, J.J.|info:eu-repo/dai/nl/288661834; Hoeve, M.; Noom, M.J.; Polderman, Nelleke; Kellaert-Knol, Marijke G.


    The Attachment Insecurity Screening Inventory (AISI) 2–5 years is a parent-report questionnaire for assessing attachment insecurity in preschoolers. Validity and reliability of the AISI 2–5 years were examined in a general sample (n = 429) and in a clinical sample (n = 71). Confirmatory factor

  15. A 5-Year Longitudinal Study of Fatigue in Patients With Late-Onset Sequelae of Poliomyelitis

    NARCIS (Netherlands)

    Tersteeg, Irene M.; Koopman, Fieke S.; Stolwijk-Swüste, Janneke M.; Beelen, Anita; Nollet, Frans


    Tersteeg IM, Koopman FS, Stolwijk-Swuste JM, Beelen A, Nollet F, on behalf of the CARPA Study Group. A 5-year longitudinal study of fatigue in patients with late-onset sequelae of poliomyelitis. Arch Phys Med Rehabil 2011; 92:899-904. Objectives: To study the severity and 5-year course of fatigue in

  16. Usability of the Primary Measures of Music Audiation (PMMA) with 5-Year-Old Korean Children (United States)

    Lee, Jooyoung


    The purpose of this study was to determine whether a standardized test of music aptitude developed for American children yields results, which may have valid interpretation when used with 5-year-old Korean children. The specific questions regarding the Primary Measures of Music Audiation (PMMA) norms were: (1) Does PMMA when used with 5-year-old…

  17. 20-Year Risks of Breast-Cancer Recurrence after Stopping Endocrine Therapy at 5 Years

    NARCIS (Netherlands)

    Pan, Hongchao; Gray, Richard; Braybrooke, Jeremy; Davies, Christina; Taylor, Carolyn; McGale, Paul; Peto, Richard; Pritchard, Kathleen I.; Bergh, Jonas; Dowsett, Mitch; Hayes, Daniel F.; Albain, K.; Anderson, S.; Arriagada, R.; Barlow, W.; Bartlett, J.; Bergsten‐Nordström, E.; Bliss, J.; Boccardo, F.; Bradley, R.; Brain, E.; Cameron, D.; Clarke, M.; Coates, A.; Coleman, R.; Correa, C.; Costantino, J.; Cuzick, J.; Davidson, N.; Dodwell, D.; Di Leo, A.; Ewertz, M.; Forbes, J.; Gelber, R.; Gnant, M.; Goldhirsch, A.; Goodwin, P.; Hill, C.; Ingle, J.; Jagsi, R.; Janni, W.; Loibl, S.; MacKinnon, E.; Martin, M.; Mukai, H.; Norton, L.; Ohashi, Y.; Paik, S.; Perez, E.; Piccart, M.; Pierce, L.; Poortmans, P.; Raina, V.; Ravdin, P.; Regan, M.; Robertson, J.; Rutgers, E.; Slamon, D.; Sparano, J.; Swain, S.; Tutt, A.; Viale, G.; von Minckwitz, G.; Wang, X.; Whelan, T.; Wilcken, N.; Winer, E.; Wolmark, N.; Wood, W.; Zambetti, M.; Alberro, J. A.; Ballester, B.; Deulofeu, P.; Fábregas, R.; Fraile, M.; Gubern, J. M.; Janer, J.; Moral, A.; de Pablo, J. L.; Peñalva, G.; Puig, P.; Ramos, M.; Rojo, R.; Santesteban, P.; Serra, C.; Solà, M.; Solarnau, L.; Solsona, J.; Veloso, E.; Vidal, S.; Abe, O.; Abe, R.; Enomoto, K.; Kikuchi, K.; Koyama, H.; Masuda, H.; Nomura, Y.; Sakai, K.; Sugimachi, K.; Toi, M.; Tominaga, T.; Uchino, J.; Yoshida, M.; Haybittle, J. L.; Leonard, C. F.; Calais, G.; Garaud, P.; Collett, V.; Delmestri, A.; Sayer, J.; Harvey, V. J.; Holdaway, I. M.; Kay, R. G.; Mason, B. H.; Forbes, J. F.; Balic, M.; Bartsch, R.; Fesl, C.; Fitzal, F.; Fohler, H.; Greil, R.; Jakesz, R.; Marth, C.; Mlineritsch, B.; Pfeiler, G.; Singer, C. F.; Steger, G. G.; Stöger, H.; Canney, P.; Yosef, H. M. A.; Focan, C.; Peek, U.; Oates, G. D.; Powell, J.; Durand, M.; Mauriac, L.; Dolci, S.; Larsimont, D.; Nogaret, J. M.; Philippson, C.; Piccart, M. J.; Masood, M. B.; Parker, D.; Price, J. J.; Lindsay, M. A.; Mackey, J.; Hupperets, P. S. G. J.; Bates, T.; Blamey, R. W.; Chetty, U.; Ellis, I. O.; Mallon, E.; Morgan, D. A. L.; Patnick, J.; Pinder, S.; Lohrisch, C.; Nichol, A.; Bramwell, V. H.; Chen, B. E.; Gelmon, K.; Goss, P. E.; Levine, M. N.; Parulekar, W.; Pater, J. L.; Shepherd, L. E.; Tu, D.; Berry, D.; Broadwater, G.; Cirrincione, C.; Muss, H.; Weiss, R. B.; Abu‐Zahra, H. T.; Portnoj, S. M.; Bowden, S.; Brookes, C.; Dunn, J.; Fernando, I.; Lee, M.; Poole, C.; Rea, D.; Spooner, D.; Barrett‐Lee, P. J.; Mansel, R. E.; Monypenny, I. J.; Gordon, N. H.; Davis, H. L.; Sestak, I.; Lehingue, Y.; Romestaing, P.; Dubois, J. B.; Delozier, T.; Griffon, B.; Mace Lesec’h, J.; de La Lande, B.; Mouret‐Fourme, E.; Mustacchi, G.; Petruzelka, L.; Pribylova, O.; Owen, J. R.; Harbeck, N.; Jänicke, F.; Meisner, C.; Schmitt, M.; Thomssen, C.; Meier, P.; Shan, Y.; Shao, Y. F.; Zhao, D. B.; Chen, Z. M.; Howell, A.; Swindell, R.; Boddington, C.; Burrett, J. A.; Cutter, D.; Duane, F.; Evans, V.; Gettins, L.; Godwin, J.; James, S.; Kerr, A.; Liu, H.; Mannu, G.; McHugh, T.; Morris, P.; Read, S.; Wang, Y.; Wang, Z.; Albano, J.; de Oliveira, C. F.; Gervásio, H.; Gordilho, J.; Ejlertsen, B.; Jensen, M. B.; Johansen, H.; Mouridsen, H.; Palshof, T.; Gelman, R. S.; Harris, J. R.; Henderson, C.; Shapiro, C. L.; Christiansen, P.; Mouridsen, H. T.; Fehm, T.; Trampisch, H. J.; Dalesio, O.; de Vries, E. G. E.; Rodenhuis, S.; van Tinteren, H.; Comis, R. L.; Davidson, N. E.; Robert, N.; Sledge, G.; Solin, L. J.; Sparano, J. A.; Tormey, D. C.; Dixon, J. M.; Forrest, P.; Jack, W.; Kunkler, I.; Rossbach, J.; Klijn, J. G. M.; Treurniet‐Donker, A. D.; van Putten, W. L. J.; Rotmensz, N.; Veronesi, U.; Bartelink, H.; Bijker, N.; Bogaerts, J.; Cardoso, F.; Cufer, T.; Julien, J. P.; van de Velde, C. J. H.; Cunningham, M. P.; Brufsky, A. M.; Coleman, R. E.; Llombart, H. A.; Huovinen, R.; Joensuu, H.; Costa, A.; Bonadonna, G.; Gianni, L.; Valagussa, P.; Goldstein, L. J.; Bonneterre, J.; Fargeot, P.; Fumoleau, P.; Kerbrat, P.; Luporsi, E.; Namer, M.; Carrasco, E.; Segui, M. A.; Eiermann, W.; Hilfrich, J.; Jonat, W.; Kaufmann, M.; Kreienberg, R.; Schumacher, M.; Bastert, G.; Rauschecker, H.; Sauer, R.; Sauerbrei, W.; Schauer, A.; Blohmer, J. U.; Costa, S. D.; Eidtmann, H.; Gerber, B.; Jackisch, C.; de Schryver, A.; Vakaet, L.; Belfiglio, M.; Nicolucci, A.; Pellegrini, F.; Pirozzoli, M. C.; Sacco, M.; Valentini, M.; McArdle, C. S.; Smith, D. C.; Stallard, S.; Dent, D. M.; Gudgeon, C. A.; Hacking, A.; Murray, E.; Panieri, E.; Werner, I. D.; Galligioni, E.; Leone, B.; Vallejo, C. T.; Zwenger, A.; Lopez, M.; Erazo, A.; Medina, J. Y.; Horiguchi, J.; Takei, H.; Fentiman, I. S.; Hayward, J. L.; Rubens, R. D.; Skilton, D.; Scheurlen, H.; Sohn, H. C.; Untch, M.; Dafni, U.; Markopoulos, C.; Fountzilas, G.; Mavroudis, D.; Klefstrom, P.; Blomqvist, C.; Saarto, T.; Gallen, M.; Tinterri, C.; Margreiter, R.; de Lafontan, B.; Mihura, J.; Roché, H.; Asselain, B.; Salmon, R. J.; Vilcoq, J. R.; André, F.; Delaloge, S.; Koscielny, S.; Michiels, S.; Rubino, C.; A'Hern, R.; Ellis, P.; Kilburn, L.; Yarnold, J. R.; Benraadt, J.; Kooi, M.; van de Velde, A. O.; van Dongen, J. A.; Vermorken, J. B.; Castiglione, M.; Colleoni, M.; Collins, J.; Gelber, R. D.; Lindtner, J.; Price, K. N.; Regan, M. M.; Rudenstam, C. M.; Senn, H. J.; Thuerlimann, B.; Bliss, J. M.; Chilvers, C. E. D.; Coombes, R. C.; Hall, E.; Marty, M.; Buyse, M.; Possinger, K.; Schmid, P.; Wallwiener, D.; Bighin, C.; Bruzzi, P.; del Mastro, L.; Dozin, B.; Pastorino, S.; Pronzato, P.; Sertoli, M. R.; Foster, L.; George, W. D.; Stewart, H. J.; Stroner, P.; Borovik, R.; Hayat, H.; Inbar, M. J.; Peretz, T.; Robinson, E.; Camerini, T.; Formelli, F.; Martelli, G.; Di Mauro, M. G.; Perrone, F.; Amadori, D.; Martoni, A.; Pannuti, F.; Camisa, R.; Musolino, A.; Passalacqua, R.; Iwata, H.; Shien, T.; Ikeda, T.; Inokuchi, K.; Sawa, K.; Sonoo, H.; Sadoon, M.; Tulusan, A. H.; Kohno, N.; Miyashita, M.; Takao, S.; Ahn, J. H.; Jung, K. H.; Korzeniowski, S.; Skolyszewski, J.; Ogawa, M.; Yamashita, J.; Bastiaannet, E.; Liefers, G. J.; Christiaens, R.; Neven, P.; Paridaens, R.; van den Bogaert, W.; Braun, S.; Martin, P.; Romain, S.; Janauer, M.; Seifert, M.; Sevelda, P.; Zielinski, C. C.; Hakes, T.; Hudis, C. A.; Wittes, R.; Giokas, G.; Kondylis, D.; Lissaios, B.; de la Huerta, R.; Sainz, M. G.; Ro, J.; Camphausen, K.; Danforth, D.; Lichter, A.; Lippman, M.; Smart, D.; Steinberg, S.; D’Amico, C.; Lioce, M.; Paradiso, A.; Ohno, S.; Bass, G.; Brown, A.; Bryant, J.; Dignam, J.; Fisher, B.; Geyer, C.; Mamounas, E. P.; Redmond, C.; Wickerham, L.; Aihara, T.; Hozumi, Y.; Baum, M.; Jackson, I. M.; Palmer, M. K.; Ingle, J. N.; Suman, V. J.; Bengtsson, N. O.; Emdin, S.; Jonsson, H.; Venturini, M.; Lythgoe, J. P.; Kissin, M.; Erikstein, B.; Hannisdal, E.; Jacobsen, A. B.; Reinertsen, K. V.; Varhaug, J. E.; Gundersen, S.; Hauer‐Jensen, M.; Høst, H.; Nissen‐Meyer, R.; Mitchell, A. K.; Robertson, J. F. R.; Ueo, H.; Di Palma, M.; Mathé, G.; Misset, J. L.; Levine, M.; Morimoto, K.; Takatsuka, Y.; Crossley, E.; Harris, A.; Talbot, D.; Taylor, M.; Cocconi, G.; di Blasio, B.; Ivanov, V.; Paltuev, R.; Semiglazov, V.; Brockschmidt, J.; Cooper, M. R.; Falkson, C. I.; Hadji, P.; A’Hern, R.; Makris, A.; Parton, M.; Pennert, K.; Powles, T. J.; Smith, I. E.; Gazet, J. C.; Browne, L.; Graham, P.; Corcoran, N.; Clack, G.; van Poznak, C.; Deshpande, N.; di Martino, L.; Douglas, P.; Lindtner, A.; Notter, G.; Bryant, A. J. S.; Ewing, G. H.; Firth, L. A.; Krushen‐Kosloski, J. L.; Anderson, H.; Killander, F.; Malmström, P.; Rydén, L.; Arnesson, L. G.; Carstensen, J.; Dufmats, M.; Fohlin, H.; Nordenskjöld, B.; Söderberg, M.; Carpenter, J. T.; Murray, N.; Royle, G. T.; Simmonds, P. D.; Crowley, J.; Gralow, J.; Hortobagyi, G.; Livingston, R.; Martino, S.; Osborne, C. K.; Ravdin, P. M.; Bondesson, T.; Celebioglu, F.; Dahlberg, K.; Fornander, T.; Fredriksson, I.; Frisell, J.; Göransson, E.; Iiristo, M.; Johansson, U.; Lenner, E.; Löfgren, L.; Nikolaidis, P.; Perbeck, L.; Rotstein, S.; Sandelin, K.; Skoog, L.; Svane, G.; af Trampe, E.; Wadström, C.; Maibach, R.; Thürlimann, B.; Holli, K.; Rouhento, K.; Safra, T.; Brenner, H.; Hercbergs, A.; Yoshimoto, M.; Paterson, A. H. G.; Fyles, A.; Meakin, J. W.; Panzarella, T.; Bahi, J.; Lemonnier, J.; Martin, A. L.; Reid, M.; Spittle, M.; Bishop, H.; Bundred, N. J.; Forsyth, S.; Pinder, S. E.; Deutsch, G. P.; Kwong, D. L. W.; Pai, V. R.; Senanayake, F.; Rubagotti, A.; Hackshaw, A.; Houghton, J.; Ledermann, J.; Monson, K.; Tobias, J. S.; Carlomagno, C.; de Laurentiis, M.; de Placido, S.; Williams, L.; Bell, R.; Hinsley, S.; Marshall, H. C.; Pierce, L. J.; Solomayer, E.; Horsman, J. M.; Lester, J.; Winter, M. C.; Buzdar, A. U.; Hsu, L.; Love, R. R.; Ahlgren, J.; Garmo, H.; Holmberg, L.; Liljegren, G.; Lindman, H.; Wärnberg, F.; Asmar, L.; Jones, S. E.; Aft, R.; Gluz, O.; Liedtke, C.; Nitz, U.; Litton, A.; Wallgren, A.; Karlsson, P.; Linderholm, B. K.; Chlebowski, R. T.; Caffier, H.


    The administration of endocrine therapy for 5 years substantially reduces recurrence rates during and after treatment in women with early-stage, estrogen-receptor (ER)-positive breast cancer. Extending such therapy beyond 5 years offers further protection but has additional side effects. Obtaining

  18. Epidemiology and mortality of burns in the Lucknow Region, India--a 5 year study. (United States)

    Kumar, Sachil; Ali, Wahid; Verma, Anoop K; Pandey, Abhishek; Rathore, Shiuli


    Nearly 95% of global burn deaths and disabilities are estimated to occur in low and middle income countries of the world. Burns are extremely common and are a major public health problem in a developing country like India. The purpose of this study was to record and evaluate the causes and the magnitude of the fatal burns retrospectively. An analysis of autopsy records revealed 2225 (10.7%) cases of burns among the total autopsies done over 5 years period (1st January 2008-27th November 2012) in the mortuary of Forensic Medicine & Toxicology, K.G.M.U., Lucknow. The majority of deaths (88.8%) occurred between 10 and 49 years of age group with a preponderance of females (87.5%). The flame burns were seen in 60.1% of the victims. The majority of burn incidents were suicidal (38.6%) in nature followed by accidental (37.3%) and homicidal (24.1%) deaths. The percentages of burns with a total body surface area (TBSA) over 50% were observed in most of the cases (82.5%). In most of the cases deaths occurred within a week (82%) and most of the victims died from septicaemia and pneumonia (43.7%) followed by neurogenic shock (28.5%). The results of this study provide the necessary information to implement programmes for health education relating to prevention of burns focusing on the domestic setting. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  19. Long-term weight regain after gastric bypass: a 5-year prospective study. (United States)

    Magro, Daniéla Oliveira; Geloneze, Bruno; Delfini, Regis; Pareja, Bruna Contini; Callejas, Francisco; Pareja, José Carlos


    A certain weight gain occurs after obesity surgery compared to the lower weight usually observed between 18 and 24 months postsurgery. The objective of this study was to evaluate weight regain in patients submitted to gastric bypass over a 5-year follow-up period. A longitudinal prospective study was conducted on 782 obese patients of both genders. Only patients with at least 2 years of surgery were included. The percentage of excess body mass index (BMI) loss at 24, 36, 48, and 60 months postsurgery was compared to the measurements obtained at 18 months after surgery. Surgical therapeutic failure was also evaluated. Percent excess BMI loss was significant up to 18 months postsurgery (p < 0.001), with a mean difference in BMI of 1.06 kg/m2 compared to 12 months postsurgery. Percent BMI loss was no longer significant after 24 months, and weight regain became significant within 48 months after surgery (p < 0.01). Among the patients who presented weight regain, a mean 8% increase was observed within 60 months compared to the lowest weight obtained at 18 months after surgery. The percentage of surgical failure was higher in the superobese group at all times studied, reaching 18.8% at 48 months after surgery. Weight regain was observed within 24 months after surgery in approximately 50% of patients. Both weight regain and surgical failure were higher in the superobese group. Studies in regard to metabolic and hormonal mechanisms underlying weight regain might elucidate the causes of this finding.

  20. Spiritual peace predicts 5-year mortality in congestive heart failure patients. (United States)

    Park, Crystal L; Aldwin, Carolyn M; Choun, Soyoung; George, Login; Suresh, Damodhar P; Bliss, Deborah


    Spirituality is favorably related to depression, quality of life, hospitalizations, and other important outcomes in congestive heart failure (CHF) patients but has not been examined as a predictor of mortality risk in this population. Given the well-known difficulties in managing CHF, we hypothesized that spirituality would be associated with lower mortality risk, controlling for baseline demographics, functional status, health behaviors, and religiousness. Participants were 191 CHF patients (64% male; M age = 68.6 years, SD = 10.1) who completed a baseline survey and were then followed for 5 years. Nearly 1/3 of the sample (32%) died during the study period. Controlling for demographics and health status, smoking more than doubled the risk of mortality, whereas alcohol consumption was associated with slightly lower risk of mortality. Importantly, adherence to healthy lifestyle recommendations was associated with halved mortality risk. Although both religion and spirituality were associated with better health behaviors at baseline in bivariate analyses, a proportional hazard model showed that only spirituality was significantly associated with reduced mortality risk (by 20%), controlling for demographics, health status, and health behaviors. Experiencing spiritual peace, along with adherence to a healthy lifestyle, were better predictors of mortality risk in this sample of CHF patients than were physical health indicators such as functional status and comorbidity. Future research might profitably examine the efficacy of attending to spiritual issues along with standard lifestyle interventions. (c) 2016 APA, all rights reserved).

  1. Secondary breast cancer: a 5-year population-based study with review of the literature. (United States)

    Klingen, Tor Audun; Klaasen, Herman; Aas, Hans; Chen, Ying; Akslen, Lars A


    Secondary tumours in the breast are rare. Based on literature, an incidence of 0.4-2% is reported. In this population-based study, secondary breast tumours from a 5-year period (2001-2005), not including metastasis from contralateral breast carcinoma, were reviewed (Vestfold County, Norway). A total of 722 patients with breast malignancies were found in this population (89.3% from Vestfold County Hospital). Ten of these, approximately 1.4%, were metastatic tumours, representing four cutaneous melanomas, three pulmonary carcinomas and three malignant lymphomas. The tumours were often solitary, palpable and close to the skin. Radiologically, the lesions mostly resembled primary carcinomas by mammography and ultrasound, which differs from other studies. Comparison with a known primary tumour and use of immunohistochemical profiling is of crucial importance. Melanoma markers (Melan-A, HMB-45, S-100 protein), lung cancer markers (Cytokeratins, TTF1, Chromogranin, Synapthophysin) and lymphoid markers (CD3, CD20) usually help to confirm a secondary breast tumour diagnosis. This approach is especially indicated in diffusely growing tumours with lack of glandular structure and high-grade cytological features, and staining for ER and GCDFP15 may be helpful. Thus, the diagnosis of a breast metastasis may be suspected by careful mammography and ultrasound imaging, although some cases have atypical radiological features, and histological examination might be necessary to ensure a correct diagnosis and appropriate treatment.

  2. Pancreas transplantation with grafts from donors deceased after circulatory death (DCD): 5 years single center experience. (United States)

    Kopp, Wouter; Lam, Hwai-Ding; Schaapherder, A F M; Huurman, Volkert; van der Boog, Paul; de Koning, Eelco; de Fijter, Johan W; Baranski, Andrzej; Braat, Andries


    Donation after circulatory death (DCD) pancreas transplantation has been shown to be an additional way to deal with donor organ shortages. The results of 5-year DCD pancreas transplantation are presented. A retrospective, single center analysis (2011 - 2015) was performed to compare the results of donation after brain death (DBD) to DCD pancreas transplantation. During the study period, 104 pancreas transplantations (83 from DBD and 21 from DCD) were performed. Median pancreas donor risk index (PDRI) was 1.47, (DBD 1.61 vs. DCD 1.35 (p=0.144)). Without the factor DCD, PDRI from DCD donors was significantly lower (DBD 1.61 vs DCD 0.97 (p<0.001). Donor age was the only donor related risk factor associated with pancreas graft survival (HR 1.06, p=0.037). Postoperative bleeding and kidney DGF occurred more frequently in recipients from DCD (p=0.006). However, DCD pancreata had a lower incidence of thrombosis. Kidney and pancreas graft survival were equally good in both groups. Pancreas transplantation from DCD donors yields comparable results to DBD donors when PDRI of DCD are relatively low. Most DCD donors are younger donors with trauma as cause of death. These DCD pancreas grafts may be a better option to cope with increasing organ shortages than exploring the limits with older (and higher PDRI) DBD donors.

  3. Sports Participation in Youth as a Predictor of Physical Activity: A 5-Year Longitudinal Study. (United States)

    Hardie Murphy, Michelle; Rowe, David Anthony; Woods, Catherine B


    The contribution of sports related factors to predicting long-term physical activity (PA) are unclear. The purpose of this study is to examine tracking of PA during key transition periods in youth and to determine the longitudinal associations between sports club participation and PA. Participants (n = 873, baseline age 10 to 18 years) completed self-report surveys in 2009 and 2014 that included the PACE+ PA tool and sports club participation questions. Spearman correlations assessed PA tracking. ANCOVA analyses examined predictors (sports participation at baseline) of PA (follow-up), adjusting for (a) age and sex; and (b) age, sex, and baseline PA. Tracking of PA was weak-to-moderate (ρ = .16 to .47). Greater sports participation frequency at baseline significantly predicted PA at follow-up (P sports at an elite level had a medium-to-large effect on PA levels 5 years later [d = .75 adjusting for (a); d = .60 adjusting for (b)]. PA should be promoted in youth as tracking coefficients suggest it can, to an extent, continue into later life. The standard achieved in sport has a role in predicting later PA. PA promotion strategies should include frequent, high quality opportunities for sports participation.

  4. Municipal solid waste management in Tehran: Changes during the last 5 years. (United States)

    Malmir, Tahereh; Tojo, Yasumasa


    The situation of waste management in Tehran was a typical example of it in developing countries. The amount of municipal solid waste has been increasing and the city has depended on landfill for municipal solid waste management. However, in recent years, various measures have been taken by the city, such as collecting recyclables at the source and increasing the capacity of waste-processing facilities. As a result, significant changes in the waste stream are starting to occur. This study investigated the nature of, and reasons for, the marked changes in the waste stream from 2008 to 2012 by analysing the municipal solid waste statistics published by the Tehran Waste Management Organization in 2013 and survey data on the physical composition of the municipal solid waste. The following trends were identified: Although the generation of municipal solid waste increased by 10% during the 5-year period, the amount of waste directly disposed of to landfill halved and resource recovery almost doubled. An increase in the capacity of a waste-processing facility contributed significantly to these changes. The biodegradable fraction going to landfill was estimated by using the quantity and the composition of each input to the landfill. The estimated result in 2012 decreased to 49% of its value in 2008. © The Author(s) 2016.

  5. A 5-year exercise program in children improves muscle strength without affecting fracture risk. (United States)

    Fritz, Jesper; Cöster, Marcus E; Stenevi-Lundgren, Susanna; Nilsson, Jan-Åke; Dencker, Magnus; Rosengren, Björn E; Karlsson, Magnus K


    High level of physical activity (PA) is associated with great muscle strength and high fracture risk. This prospective controlled population-based study evaluated how a pediatric PA intervention program influenced muscle strength and fracture risk. We carried out a school-based exercise intervention program with 200 min of PA per week for 5 years in 335 girls and 408 boys aged 6-9 years at study start. An age-matched control cohort including 756 girls and 782 boys continued with 60 min of PA per week. We registered fractures during the study period and calculated rate ratio. In a sub-sample, including 74 girls and 107 boys in the intervention and 51 girls and 54 boys in the control group, we measured knee flexion and extension strength by a computerized dynamometer and leg composition by dual energy X-ray absorptiometry. Group comparisons were adjusted for differences in age, baseline value for the measured parameter and changes in height. Children in the intervention group had a rate ratio to sustain a fracture of 1.03 (0.78, 1.36) (mean and 95 % confidence interval) (p = 0.79). The annual gain in flexion peak torque muscle strength was greater in both girls (at 60°/s) [1.1 Nm (0.5, 1.8), p fracture risk.

  6. Configuring Balanced Scorecards for Measuring Health System Performance: Evidence from 5 Years' Evaluation in Afghanistan (United States)

    Edward, Anbrasi; Kumar, Binay; Kakar, Faizullah; Salehi, Ahmad Shah; Burnham, Gilbert; Peters, David H.


    Background In 2004, Afghanistan pioneered a balanced scorecard (BSC) performance system to manage the delivery of primary health care services. This study examines the trends of 29 key performance indicators over a 5-year period between 2004 and 2008. Methods and Findings Independent evaluations of performance in six domains were conducted annually through 5,500 patient observations and exit interviews and 1,500 provider interviews in >600 facilities selected by stratified random sampling in each province. Generalized estimating equation (GEE) models were used to assess trends in BSC parameters. There was a progressive improvement in the national median scores scaled from 0–100 between 2004 and 2008 in all six domains: patient and community satisfaction of services (65.3–84.5, pscorecard reconfigurations are needed to integrate effectiveness and efficiency measures and accommodate changes in health systems policy and strategy architecture to ensure its continued relevance and effectiveness as a comprehensive health system performance measure. The process of BSC design and implementation can serve as a valuable prototype for health policy planners managing performance in similar health care contexts. Please see later in the article for the Editors' Summary PMID:21814499

  7. Dental erosion among South Brazilian adolescents: A 2.5-year longitudinal study. (United States)

    Brusius, C D; Alves, L S; Susin, C; Maltz, M


    This population-based longitudinal study investigated the incidence, progression and risk factors for dental erosion among South Brazilian adolescents. Eight hundred and one schoolchildren attending 42 public and private schools were clinically examined at 12 years of age; clinical examinations were repeated after 2.5 years (SD=0.3). After tooth cleaning and drying, permanent incisors and first molars were classified using the Basic Erosive Wear Examination (BEWE) scoring criteria. Questionnaires were used to collect data on socio-demographic characteristics, dietary habits, toothbrushing frequency and general health. Poisson regression analysis was used to assess the association between dental erosion incidence and explanatory variables, with adjusted incidence risk ratios (IRR) and 95% CI estimated. Among those who did not have dental erosion at baseline, 49 of 680 schoolchildren (7.1%; 95% CI=5.2-9.1) developed erosive lesions over the follow-up period. Among schoolchildren who had dental erosion at baseline, 31 of 121 (25.4%; 95% CI=17.6-33.3) had new or more severe lesions. Boys were more likely to develop dental erosion than girls (IRR=1.88; 95% CI=1.06-3.32). A moderate incidence of dental erosion was observed among South Brazilian adolescents, with boys being at higher risk. The high progression rate of 25% observed here is very concerning, and it should be taken in consideration when designing preventive strategies for dental erosion. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Colorectal stenting for colonic obstruction: The indications, complications, effectiveness and outcome-5-Year review

    Energy Technology Data Exchange (ETDEWEB)

    Athreya, S. [Department of Radiology, Gartnavel General Hospital, Great Western Road, Glasgow (United Kingdom)]. E-mail:; Moss, J. [Department of Radiology, Gartnavel General Hospital, Great Western Road, Glasgow (United Kingdom)]. E-mail:; Urquhart, G. [Department of Radiology, Southern General Hospital, Glasgow (United Kingdom); Edwards, R. [Department of Radiology, Gartnavel General Hospital, Great Western Road, Glasgow (United Kingdom); Downie, A. [Department of Radiology, Victoria Infirmary, Glasgow (United Kingdom); Poon, F.W. [Department of Radiology, Royal Infirmary, Glasgow (United Kingdom)


    Introduction: Currently self-expanding metallic stents are being used for palliation and acute decompression of colonic obstruction. The aim of this study is to review our experience of using these metallic stents over a 5-year period. Materials and methods: Case records of 102 patients who had colorectal stenting between 1998 and 2004 were reviewed retrospectively. The indications for colorectal stenting, efficacy of the procedure in relieving the obstruction, complications and clinical outcome were analysed. Results: Ninety-nine patients had malignant disease and in three patients a benign cause of obstruction was demonstrated. All procedures were performed during normal working hours. Stenting was technically successful in 87 patients (85%). A single stent was placed in 80 patients. Seven patients required two stents. Of the successful cases, 67 had stents placed by fluoroscopy alone and 20 by a combined fluoroscopy/endoscopy procedure. Four percent had early complications (within 30 days) which included four perforations. There were late complications (over 30 days) in 9% which included five stent migrations, two blocked stents and one colovesical fistula. Ninety percent (n = 76) of the successful patients needed no further radiological or surgical intervention later. Survival ranged from 14 days to 2 years. Conclusion: Colorectal stenting when technically successful is an effective procedure for both preoperative and palliative decompression of colonic obstruction.

  9. Profile Of Sindromic Patients Craniosynostosis for 5 years in dr.Soetomo Hospital Surabaya

    Directory of Open Access Journals (Sweden)

    Indri Lakhsmi Putri


    Full Text Available Craniosynostosis is a premature cover of one or more sutures, which may occur as part of syndrome (syndromic or as a separate defect / isolated defect (nonsyndromic. Cohen and Kreirborg state the incidence of Apert and Crouzon syndromes of 15.5: 1,000,000 and 16.5: 1,000,000 per birth. The incidence of craniosynostosis in Indonesia still not handled properly, as well as low recognition in this disorder. RSUD Dr. Soetomo as an eastern referral hospital, which has one of the centers of plastic surgery education in Indonesia, where craniosynostosis syndromic often occurs, so we have total cases handled in Indonesia. This is a retrospective descriptive study discusses more about the profile of patients syndromic craniosynostosis for 5 years in dr. Soetomo Surabaya, performed on twenty-four first syndromic craniosynostosis patients at Dr. Soetomo Surabaya period 1 January 2008 - 31 December 2013. Out of 24 total patients, 12 cases of apert (29%, 6 crouton cases (54% and 3 cases of Pfeiffer (17% were obtained. Based on sex, more commonly found in women (54%. With the most common age, the patient comes first is aged 5-10 years (37%. Each patient has an average of 2 surgeries, with a type of surgical action on cranial vault remodeling patients. Abnormalities of syndromic craniosinostosis found the most common in women and apert syndrome in RSUD dr.Sutomo. Where the most common age when the arrival of 5-10 years, caused by the late diagnosis of the disorder.

  10. Survival Rate of Short, Locking Taper Implants with a Plateau Design: A 5-Year Retrospective Study

    Directory of Open Access Journals (Sweden)

    Kemal Özgür Demiralp


    Full Text Available Background. Short implants have become popular in the reconstruction of jaws, especially in cases with limited bone height. Shorter implants, those with locking tapers and plateau root shapes, tend to have longer survival times. We retrospectively investigated the cumulative survival rates of Bicon short implants (<8 mm according to patient variables over a 5-year period. Materials and Methods. This study included 111 consecutively treated patients with 371 implants supporting fixed or removable prosthetics. Data were evaluated to acquire cumulative survival rates according to gender, age, tobacco use, surgical procedure, bone quality, and restoration type. Statistics were performed using chi-square, Mann-Whitney, and Kruskal Wallis H tests. Results. The survival rate was 97.3% with, on average, 22.8 months of follow-up. Patients older than 60 years had higher failure rate than the other age groups (P<0.05. Placed region, age, and bone quality had adverse effects on survival rate in the <8 mm implant group with statistically significant difference (P<0.05. Conclusions. Approximately 23-month follow-up data indicate that short implants with locking tapers and plateau-type roots have comparable survival rates as other types of dental implants. However, due to limitations of study, these issues remain to be further investigated in future randomized controlled clinical trials.

  11. A 5-year retrospective study of cobalt-chromium-based single crowns inserted in a private practice. (United States)

    Ortorp, Anders; Ascher, Aron; Svanborg, Per


    The aim of this retrospective study was to evaluate the clinical performance of cobalt-chromium (Co-Cr) single crowns. Ninety restorations were placed in 55 patients, and follow-up examinations were performed annually for 5 years. Six patients (8 crowns) were regarded as dropouts. During the follow-up period, 15 (17%) crowns/abutment teeth experienced some type of complication; 8 (9%) of these were regarded as failures. The cumulative survival rate was estimated at 90.3% over 5 years, though only 3 (3%) crowns had complications that could be related to the crown material. The results suggest that Co-Cr single crowns are a promising alternative to other alloys used in fixed prosthodontics.

  12. Insertion of Balloon Retained Gastrostomy Buttons: A 5-Year Retrospective Review of 260 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Power, Sarah, E-mail:; Kavanagh, Liam N.; Shields, Mary C.; Given, Mark F.; Keeling, Aoife N.; McGrath, Frank P.; Lee, Michael J., E-mail: [Beaumont Hospital, Department of Radiology (Ireland)


    Radiologically inserted gastrostomy (RIG) is an established way of maintaining enteral nutrition in patients who cannot maintain nutrition orally. The purpose of this study was to evaluate the safety and efficacy of primary placement of a wide bore button gastrostomy in a large, varied patient population through retrospective review. All patients who underwent gastrostomy placement from January 1, 2004 to January 1, 2009 were identified. 18-Fr gastrostomy buttons (MIC-Key G) were inserted in the majority. Follow-up ranged from 6 months to 4.5 years. A total of 260 patients (M:F 140:120, average age 59.2 years) underwent gastrostomy during the study period. Overall success rate for RIG placement was 99.6 %, with success rate of 95.3 % for primary button insertion. Indications included neurological disorders (70 %), esophageal/head and neck malignancy (21 %), and other indications (9 %). Major and minor complication rates were 1.2 and 12.8 %, respectively. Thirty-day mortality rate was 6.8 %. One third of patients underwent gastrostomy reinsertion during the study period, the main indication for which was inadvertent catheter removal. Patency rate was high at 99.5 %. The maximum number of procedures in any patient was 8 (n = 2), and the average tube dwell time was 125 days. Primary radiological insertion of a wide bore button gastrostomy is a safe technique, with high success rate, high patency rate, and low major complication rate. We believe that it is feasible to attempt button gastrostomy placement in all patients, once tract length is within limits of tube length. If difficulty is encountered, then a standard tube may simply be placed instead.

  13. Clinical performance and marginal adaptation of class II direct and semidirect composite restorations over 3.5 years in vivo. (United States)

    Spreafico, Roberto C; Krejci, Ivo; Dietschi, Didier


    The study evaluated the clinical performance and marginal adaptation of direct and semi-direct class II composite restorations in a split-mouth design over 3.5 years. 44 upper posterior teeth in 11 adults with primary carious lesions were treated with 22 direct and 22 semi-direct restorations. Conventional cavities were prepared for both types of restorations. A fine fine hybrid composite (APH) and a multifunctional adhesive system (Prisma universal bond 3) were used for all restorations. The incremental "3-sited light curing" technique was applied to direct restorations. Semi-direct inlays were prefabricated on silicone casts and post-cured using light and heat. Clinical performance was evaluated using modified USPHS parameters, while marginal adaptation was judged on replicas, using SEM and a standardized evaluation technique. Clinical results after 3.5 years revealed a 100% retention rate with no fractures, sensitivity or recurrent caries for both types of restorations. SEM-evaluation of the occlusal margins showed at the tooth-restoration interface relatively low rates of marginal openings over the observation period (4-8%). Marginal restoration fractures ranged between 1 and 2%, marginal tooth fractures between 3 and 9%. Differences between the restorative techniques and after the different time observation periods were not statistically significant. Proportions of marginal fractures and openings at the restoration-luting composite interface were less than 10% after 3.5 years. The results indicated no significant differences for direct and semi-direct fine hybrid composite restorations in medium size cavities in posterior teeth with respect to clinical performance and marginal adaptation over 3.5 years.

  14. Proximal Femur Bone Density Decreases up to 5 Years After Total Hip Arthroplasty in Young, Active Patients. (United States)

    Nam, Denis; Barrack, Robert L; Clohisy, John C; Nunley, Ryan M


    The number of young, active patients undergoing hip arthroplasty continues to increase. The purpose of this study was to evaluate femoral bone density over a 5-year period after hip arthroplasty in young, active patients. A total of 96 patients (103 hips) with a presymptomatic University of California at Los Angeles (UCLA) score ≥6 who had a total hip arthroplasty (THA; 45 hips) or surface replacement arthroplasty (SRA; 58 hips) were prospectively enrolled. UCLA and Harris Hip Scores were collected preoperatively and postoperatively, and dual energy X-ray absorptiometry scans were performed at 6 weeks, 6 months, 1 year, 2 years, and 5 years postoperatively. Bone density was analyzed for 7 traditional Gruen zones in both groups and 6 femoral neck zones in the SRA group. Bone density ratios were calculated for change in bone density compared with baseline. No differences were present in the preoperative or postoperative UCLA or Harris Hip Scores between the SRA and THA cohorts (P = .07-.7). In the THA group, bone density never returned to baseline during the 5-year period in Gruen zones 1 (91.2% of baseline), 2 (94.8%), 6 (97.3%), and 7 (89.2%). There were no decreases in bone mineral density ratio for the femoral Gruen zones in the SRA group at any interval. Femoral neck bone density after SRA increased on the lateral, tension side up to 5 years postoperatively (P femur in Gruen zones 1, 2, and 7 over time. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Prediction of treatment response at 5-year follow-up in a randomized clinical trial of behaviorally based couple therapies. (United States)

    Baucom, Brian R; Atkins, David C; Rowe, Lorelei Simpson; Doss, Brian D; Christensen, Andrew


    Building on earlier work examining predictors of short- and moderate-term treatment response, demographic, intrapersonal, communication, and interpersonal variables were examined as predictors of clinically significant outcomes 5 years after couples completed 1 of 2 behaviorally based couple therapies. One hundred and thirty-four couples were randomly assigned to Integrative Behavioral Couple Therapy (IBCT; Jacobson & Christensen, 1998) or Traditional Behavioral Couple Therapy (TBCT; Jacobson & Margolin, 1979) and followed for 5 years after treatment. Outcomes include clinically significant change categories of relationship satisfaction and marital status at 5-year follow-up. Optimal subsets of predictors were selected using an automated, bootstrapped selection procedure based on Bayesian information criterion. Higher levels of commitment and being married for a longer period of time were associated with decreased likelihood of divorce or separation (odds ratio [OR] = 1.39, p = .004; OR = 0.91, p = .015). Being married for a longer period of time was also associated with increased likelihood of positive, clinically significant change (OR = 1.12, p = .029). Finally, higher levels of wife-desired closeness were associated with increased odds of positive, clinically significant change and decreased odds of divorce for moderately distressed, IBCT couples (OR = 1.16, p = .002; OR = 0.85, p = .007, respectively), whereas the opposite was true for moderately distressed, TBCT couples (OR = 0.77, p < .001; OR = 1.17, p = .002, respectively). Commitment-related variables are associated with clinically significant outcomes at 5-year follow-up as well as at termination and moderate-term follow-up. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  16. The 3.5-year survival rates of primary molars treated according to three treatment protocols: a controlled clinical trial. (United States)

    Mijan, Maite; de Amorim, Rodrigo Guedes; Leal, Soraya Coelho; Mulder, Jan; Oliveira, Luciana; Creugers, Nico H J; Frencken, Jo E


    This study aimed to test the hypothesis that there is no difference in the survival rates of molars treated according to the conventional restorative treatment (CRT) using amalgam, atraumatic restorative treatment (ART) using high-viscosity glass ionomer, and ultraconservative treatment (UCT) protocol after 3.5 years. Cavitated primary molars were treated according to CRT, ART, and UCT (small cavities were restored with ART and medium/large cavities were daily cleaned with toothpaste/toothbrush under supervision). Molar extractions resulting from toothache, sepsis, or pulp exposure were failures. The Kaplan-Meier method was used to estimate the survival curves. The numbers of treated teeth, among the 302 6-7-year-old children, were 341 (CRT), 244 (ART), and 281 (for UCT group: 109 small ART, 166 open cavities, and 6 combinations). Protocol groups were similar at baseline regarding gender and mean decayed missing filled tooth score, but not regarding age and type of surface. The numbers of molars extracted were 22 (CRT), 16 (ART), and 26 (UCT). Fistulae were most often recorded. After 3.5 years, the cumulative survival rate ± standard error for all molars treated was 90.9 ± 2.0 % with CRT, 90.4 ± 2.4 % with ART, and 88.6 ± 1.9 % with UCT (p = 0.13). Only a type of surface effect was observed over the 3.5-year period: survival rates for molars were higher for single- than for multiple-surface cavities. There was no difference in the cumulative survival rates of primary molars treated according to the CRT, ART, and UCT protocols over a 3.5-year period. Keeping cavities in primary molars biofilm-free might be another treatment option alongside restoring such cavities through conventional and ART protocols.

  17. Time trends in intracranial bleeding associated with direct oral anticoagulants: a 5-year cohort study. (United States)

    Hogg, Kerstin; Bahl, Bharat; Latrous, Meriem; Scaffidi Argentina, Sarina; Thompson, Jesse; Chatha, Aasil Ayyaz; Castellucci, Lana; Stiell, Ian G


    Over the past 5 years, dabigatran, rivaroxaban and apixaban were approved for stroke prevention. Phase III studies have shown a lower risk of intracranial bleeding with these direct oral anticoagulants than with warfarin; however, there is a lack of real-life data to validate this. We analyzed time trends in atraumatic intracranial bleeding from 2009 to 2013 among patients prescribed oral anticoagulants and those not prescribed oral anticoagulants. We used ICD-10-CA (enhanced Canadian version of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems) codes to identify all patients with atraumatic intracranial bleeding who presented to our neurosurgical centre (serving a population of more than 1.2 million). Trained researchers extracted data on anticoagulant medications used in the week before diagnosis of the intracranial bleed. Provincial prescription data for oral anticoagulants were obtained from IMS Brogan CompuScript Market Dynamics. The primary outcome was the time trend in incident intracranial bleeds associated with oral anticoagulation during the period 2009-2013. The secondary outcomes were the time trend in intracranial bleeds not associated with oral anticoagulation and the provincial prescribing patterns for oral anticoagulants during the same period. A total of 2050 patients presented with atraumatic intracranial bleeds during the study period. Of the 371 (18%) prescribed an anticoagulant in the week before presentation, 335 were prescribed an oral anticoagulant. There was an increasing time trend in intracranial bleeding associated with oral anticoagulants (p = 0.009; 6 additional events per year) and in intracranial bleeding not associated with oral anticoagulation (p = 0.06). During 2013, prescriptions for warfarin decreased to 70% of all oral anticoagulant prescriptions in the province, whereas those for dabigatran and rivaroxaban increased to 17% and 12%, respectively. We observed increasing

  18. Does early establishment of favorable oral health behavior influence caries experience at age 5 years? (United States)

    Wigen, Tove I; Wang, Nina J


    The purpose was to study associations between tooth brushing frequency, use of fluoride lozenges and consumption of sugary drinks at 1.5 years of age and having caries experience at 5 years of age. This study was based on data from the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health and by the Public Dental Services. A total of 1095 children were followed from pregnancy to the age of 5 years. Questionnaires regarding oral health behavior were completed by the parents at 1.5 and 5 years of age. Clinical and radiographic examination of the children was performed at the age of 5 years. In multiple logistic regression, having caries experience at 5 years of age was associated with; at 1.5 years of age having the teeth brushed less than twice daily (OR = 2.1, CI = 1.3-3.6) and being offered sugary drinks at least once a week (OR = 1.8, CI = 1.1-2.9) when controlled for family characteristics and oral health behavior at 5 years of age. Tooth brushing frequency and consumption of sugary drinks in early childhood were related to caries development during pre-school age, independent of family characteristics and oral health behavior at 5 years of age. The results indicate that early established habits regarding tooth brushing and consumption of sugary drinks have long-term effects on caries development. Parents encountering difficulties in establishing favorable oral health behavior in children's first years of life should receive special attention from health personnel.

  19. Care for overweight children attending the 5-year preventive child health examination in general practice

    DEFF Research Database (Denmark)

    Andersen, Merethe Kousgaard; Christensen, Bo; Søndergaard, Jens


    -assessed overweight at the 5-year preventive child health examination (PCHE).Results. Out of 1135 children attending the 5-year PCHE, 171 were assessed overweight by the GP. According to the Danish body mass index (kg/m(2)) growth charts, 147 children were overweight. The GPs addressed their concern about the child......% of cases.Conclusion. Various care activities were carried out for most children with GP-assessed overweight at the 5-year PCHE. However, the GP did not raise concern about the child's weight with the parents in almost one third of the children. It seems that there is a potential for improving...

  20. Persistence of Multidrug-Resistant Acinetobacter baumannii Isolates Harboring blaOXA-23 and bap for 5 Years. (United States)

    Sung, Ji Youn; Koo, Sun Hoe; Kim, Semi; Kwon, Gye Cheol


    The emergence and dissemination of carbapenemase-producing Acinetobacter baumannii isolates have been reported worldwide, and A. baumannii isolates harboring blaOXA-23 are often resistant to various antimicrobial agents. Antimicrobial resistance can be particularly strong for biofilm-forming A. baumannii isolates. We investigated the genetic basis for carbapenem resistance and biofilm-forming ability of multidrug-resistant (MDR) clinical isolates. Ninety-two MDR A. baumannii isolates were collected from one university hospital located in the Chungcheong area of Korea over a 5-year period. Multiplex PCR and DNA sequencing were performed to characterize carbapenemase and bap genes. Clonal characteristics were analyzed using REP-PCR. In addition, imaging and quantification of biofilms were performed using a crystal violet assay. All 92 MDR A. baumannii isolates involved in our study contained the blaOXA-23 and bap genes. The average absorbance of biomass in Bap-producing strains was much greater than that in non-Bap-producing strains. In our study, only three REP-PCR types were found, and the isolates showing type A or type B were found more than 60 times among unique patients during the 5 years of surveillance. These results suggest that the isolates have persisted and colonized for 5 years, and biofilm formation ability has been responsible for their persistence and colonization.

  1. A Single Centre Retrospective Evaluation of Laparoscopic Rectal Resection with TME for Rectal Cancer: 5-Year Cancer-Specific Survival

    Directory of Open Access Journals (Sweden)

    Raoul Quarati


    Full Text Available Laparoscopic colon resection has established its role as a minimally invasive approach to colorectal diseases. Better long-term survival rate is suggested to be achievable with this approach in colon cancer patients, whereas some doubts were raised about its safety in rectal cancer. Here we report on our single centre experience of rectal laparoscopic resections for cancer focusing on short- and long-term oncological outcomes. In the last 13 years, 248 patients underwent minimally invasive approach for rectal cancer at our centre. We focused on 99 stage I, II, and III patients with a minimum follow-up period of 5 years. Of them 43 had a middle and 56 lower rectal tumor. Laparoscopic anterior rectal resection was performed in 71 patients whereas laparoscopic abdomino-perineal resection in 28. The overall mortality rate was 1%; the overall morbidity rate was 29%. The 5-year disease-free survival rate was 69.7%, The 5-year overall survival rate was 78.8%.

  2. The impact of rotavirus vaccination on emergency department visits and hospital admissions for acute diarrhea in children under 5 years

    Directory of Open Access Journals (Sweden)

    Rodrigo Locatelli Pedro Paulo

    Full Text Available Summary Introduction: Acute diarrheal disease is the second cause of death in children under 5 years. In Brazil, from 2003 to 2009, acute diarrhea was responsible for nearly 100,000 hospital admissions per year and 4% of the deaths in children under 5 years. Rotavirus is the leading cause of severe acute diarrhea worldwide. In 2006, the rotavirus monovalent vaccine (RV1 was added to the Brazilian National Immunization Program. Objectives: To analyze the impact of the RV1 on emergency department (ED visits and hospital admissions for acute diarrhea. Method: A retrospective ecologic study at the University Hospital, University of São Paulo. The study analyzed the pre-vaccine (2003–2005 and the post-vaccine (2007–2009 periods. We screened the main diagnosis of all ED attendances and hospital admissions of children under 5 years in an electronic registry system database and calculated the rates of ED visits and hospital admissions. The reduction rate was analyzed according to the following formula: reduction (% = (1 - odds ratio x 100. Results: The rates of ED visits for acute diarrhea was 85.8 and 80.9 per 1,000 total ED visits in the pre and post vaccination periods, respectively, resulting in 6% reduction (95CI 4 to 9%, p<0.001. The rates of hospital admissions for acute diarrhea was 40.8 per 1,000 in the pre-vaccine period and dropped to 24.9 per 1,000 hospitalizations, resulting in 40% reduction (95CI 22 to 54%, p<0.001. Conclusion: The introduction of the RV1 vaccine resulted in 6% reduction in the ED visits and 40% reduction in hospital admissions for acute diarrhea.

  3. Immediate loading of tapered implants placed in postextraction sockets: retrospective analysis of the 5-year clinical outcome. (United States)

    Mura, Priamo


    using the top of the implant as the reference point with negative values indicating a level below the reference point. Forty-eight patients, accounting for 66 implants, have passed the 5-year follow-up. No implants have failed resulting in a 5-year cumulative implant survival rate of 100%. Three patients, with six implants, withdrew during the course of the follow-up; one patient passed away and two patients moved. Five patients with seven implants did not show up at 5 years recall. At the 5-year follow-up, majority of the implants that were followed demonstrated normal periimplant mucosa and no visible plaque. The mean bone level at 5-year follow-up was -2.45mm (SD 1.29, n=63) demonstrating a level in line with the first thread. Mean marginal bone loss from implant inserting to 5 years was 0.56 mm (SD 1.98, n=63). In regard with complications, a fracture of the ceramic crown was reported 5 years after implant insertion in a patient who developed bruxism. No other biologic nor mechanical complications were reported. This retrospective 5-year follow-up study of 56 patients treated with implants immediately placed in postextraction sockets and immediately loaded demonstrates good treatment outcome with regard to implant survival, soft tissue condition, and marginal bone response. © 2010 Wiley Periodicals, Inc.

  4. Laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity (AMOS): a prospective, 5-year, Swedish nationwide study. (United States)

    Olbers, Torsten; Beamish, Andrew J; Gronowitz, Eva; Flodmark, Carl-Erik; Dahlgren, Jovanna; Bruze, Gustaf; Ekbom, Kerstin; Friberg, Peter; Göthberg, Gunnar; Järvholm, Kajsa; Karlsson, Jan; Mårild, Staffan; Neovius, Martin; Peltonen, Markku; Marcus, Claude


    Severe obesity in adolescence is associated with reduced life expectancy and impaired quality of life. Long-term benefits of conservative treatments in adolescents are known to be modest, whereas short-term outcomes of adolescent bariatric surgery are promising. We aimed to compare 5-year outcomes of adolescent surgical patients after Roux-en-Y gastric bypass with those of conservatively treated adolescents and of adults undergoing Roux-en-Y gastric bypass, in the Adolescent Morbid Obesity Surgery (AMOS) study. We did a nationwide, prospective, non-randomised controlled study of adolescents (aged 13-18 years) with severe obesity undergoing Roux-en-Y gastric bypass at three specialised paediatric obesity treatment centres in Sweden. We compared clinical outcomes in adolescent surgical patients with those of matched adolescent controls undergoing conservative treatment and of adult controls undergoing Roux-en-Y gastric bypass. The primary outcome measure was change in BMI over 5 years. We used multilevel mixed-effect regression models to assess longitudinal changes. This trial is registered with, number NCT00289705. Between April, 2006, and May, 2009, 100 adolescents were recruited to the study, of whom 81 underwent Roux-en-Y gastric bypass (mean age 16·5 years [SD 1·2], bodyweight 132·8 kg [22·1], and BMI 45·5 kg/m(2) [SD 6·1]). 80 matched adolescent controls and 81 matched adult controls were enrolled for comparison of outcomes. The change in bodyweight in adolescent surgical patients over 5 years was -36·8 kg (95% CI -40·9 to -32·8), resulting in a reduction in BMI of -13·1 kg/m(2) (95% CI -14·5 to -11·8), although weight loss less than 10% occurred in nine (11%). Mean BMI rose in adolescent controls (3·3 kg/m(2), 95% CI 1·1-4·8) over the 5-year study period, whereas the BMI change in adult controls was similar to that in adolescent surgical patients (mean change -12·3 kg/m(2), 95% CI -13·7 to -10·9). Comorbidities and

  5. NASA Web-Enabled Landsat Data 5 year Land Cover Land Use Change Product V001 (United States)

    National Aeronautics and Space Administration — The Web-Enabled Landsat Data (WELD) 5-year Land Cover Land Use Change (LCLUC) is a composite of 30 m land use land change product for the contiguous United States...

  6. Long-term (5 year) safety of bronchial thermoplasty: Asthma Intervention Research (AIR) trial

    DEFF Research Database (Denmark)

    Thomson, Neil C; Rubin, Adalberto S; Niven, Robert M


    Bronchial thermoplasty (BT) is a bronchoscopic procedure that improves asthma control by reducing excess airway smooth muscle. Treated patients have been followed out to 5 years to evaluate long-term safety of this procedure....

  7. Extended long-term (5 years) outcomes of triangle tilt surgery in obstetric brachial plexus injury. (United States)

    Nath, Rahul K; Somasundaram, Chandra


    We evaluated the "extended" long-term (5 years) functional outcomes in obstetric brachial plexus injury (OBPI) patients, who underwent triangle tilt surgery between February 2005 and January 2008. Twenty two children (9 girls and 13 boys, mean age at surgery was 5.8 years; ranging 2.1-11.8 years old), who initially presented with medial rotation contracture and scapula deformity secondary to obstetric brachial plexus injury were included in this study. Functional movements were evaluated pre-operatively, and 5 years following triangle tilt surgery by modified Mallet scale. Here, we report long-term (5 years) follow-up of triangle tilt surgery for 22 OBPI patients. Upper extremity functional movements such as, external rotation (2.5±0.6 to 4.1±0.8, ptriangle tilt surgery improved all shoulder functions significantly, and maintained over the extended long-term (5 years) in these patients.

  8. A 5-year retrospective analysis of Necrotizing fasciitis: A single center experiences

    Directory of Open Access Journals (Sweden)

    Kiralj Aleksandar I


    Full Text Available Background/Aim. Necrotizing fasciitis (NF is usually an acute infection of superficial fascia with rapid progression in around soft tissue. If not promptly recognized and aggressively treated NF usualy leads to sepsis and multiorgan failure with fatal outcome, thus early diagnosis and prompt surgical treatment are crucial for healing of these patients. The aim of this article was to evaluate the clinical presentation of all patients with acute NF diagnosed and treated in surgical clinics of Clinical Center of Vojvodina, Novi Sad, Serbia. Methods. The medical records of patients treated for acute NF localized on a different parts of the body in Clinical Center of Vojvodina, Novi Sad, Serbia, during a 5- year period (from January 2008 to December 2012 were retrospectively evaluated. This study enrolled patients admitted via Emergency Center of Vojvodina with the diagnosis of acute NF either as the primary diagnosis or with the diagnosis at discharge after surgical treatment. Results. During a 5-year period there were 216 patients with final diagnosis of acute NF. Most of our patients (140 - 64.81% were admitted with the initial diagnosis of cellulitis, abscesses, phlegmons or sepsis. Unfortunately, the clinical symptoms of acute NF were atypical at time of initial examination. Pain and swelling of the affected localization were the most presented bias of symptoms (183 - 84.72%. The majority of our patients were male (164 - 75.92%. Among the 216 patients, the most common pre-existing single factor was drug abuse (39 - 18.05%, followed by obesity (38 - 17.59% and diabetes mellitus (31 - 14.35%. Trauma was most common etiological factor (22 - 10.8% in infected wounds, followed by abdominal (15 - 6.94% and orthopedic (11 - 5.09% surgical intervention. In the present study idiopathic acute NF was diagnosed in 22 (10.18% patients and more than one etiological factor were diagnosed in 20 (9.25% patients. The majority of our patients had type I acute NF

  9. Evaluation of a new, low-dose levonorgestrel intrauterine contraceptive system over 5 years of use. (United States)

    Gemzell-Danielsson, Kristina; Apter, Dan; Dermout, Sylvia; Faustmann, Thomas; Rosen, Kimberly; Schmelter, Thomas; Merz, Martin; Nelson, Anita


    To evaluate the efficacy and safety of a new, low-dose levonorgestrel intrauterine contraceptive system (LNG-IUS 12) for up to 5 years of use. In this Phase III study, 2885 nulliparous and parous women aged 18-35 years were randomized to LNG-IUS 8 or LNG-IUS 12 for 3 years. After 3 years, women using LNG-IUS 12 could continue for up to 2 additional years (5 years total). The primary outcome was occurrence of pregnancy (Pearl Index). Secondary outcomes included safety, bleeding, dysmenorrhea, discontinuations, and user satisfaction. From August 2007 through May 2008, out of 2885 women who were enrolled, 1453 were randomized to LNG-IUS 12. Placement was attempted in 1452/1453 (full analysis set). Mean age at baseline was 27.1 years; 39.5% were nulliparous. The cumulative 5-year Pearl Index (PI) was 0.29; the 5-year cumulative failure rate was 1.4%. The 5-year PI for ectopic pregnancy was 0.18. Over 5 years, 55.3% of women reported study drug-related treatment-emergent adverse events (TEAEs). Crude incidences of pelvic inflammatory disease, uterine perforation, and complete/partial LNG-IUS 12 expulsion were 0.6%, 0.2%, and 3.7%, respectively. Women using LNG-IUS 12 generally experienced less frequent bleeding over time. The incidence of amenorrhea during the last 90-day reference interval (end of Year 5) was 22.6%. Overall, 870 (59.9%) and 550 (37.9%) women completed 3 and 5 years of treatment, respectively; 77.8% of women who entered the extension phase completed 5 years of use. Over 5 years, 22.6% discontinued due to TEAEs, including 13 women who discontinued due to pregnancy; 76 discontinued due to bleeding problems including amenorrhea; and 163 discontinued due to desire for pregnancy, 71.2% of whom conceived within 12 months. In this study including parous and nulliparous women, LNG-IUS 12 was highly effective over 5 years of use and associated with a favorable safety profile. LNG-IUS 12 offers women a low-dose contraceptive option for up to 5 years. Copyright

  10. A review of subsequence time series clustering. (United States)

    Zolhavarieh, Seyedjamal; Aghabozorgi, Saeed; Teh, Ying Wah


    Clustering of subsequence time series remains an open issue in time series clustering. Subsequence time series clustering is used in different fields, such as e-commerce, outlier detection, speech recognition, biological systems, DNA recognition, and text mining. One of the useful fields in the domain of subsequence time series clustering is pattern recognition. To improve this field, a sequence of time series data is used. This paper reviews some definitions and backgrounds related to subsequence time series clustering. The categorization of the literature reviews is divided into three groups: preproof, interproof, and postproof period. Moreover, various state-of-the-art approaches in performing subsequence time series clustering are discussed under each of the following categories. The strengths and weaknesses of the employed methods are evaluated as potential issues for future studies.

  11. A Review of Subsequence Time Series Clustering (United States)

    Teh, Ying Wah


    Clustering of subsequence time series remains an open issue in time series clustering. Subsequence time series clustering is used in different fields, such as e-commerce, outlier detection, speech recognition, biological systems, DNA recognition, and text mining. One of the useful fields in the domain of subsequence time series clustering is pattern recognition. To improve this field, a sequence of time series data is used. This paper reviews some definitions and backgrounds related to subsequence time series clustering. The categorization of the literature reviews is divided into three groups: preproof, interproof, and postproof period. Moreover, various state-of-the-art approaches in performing subsequence time series clustering are discussed under each of the following categories. The strengths and weaknesses of the employed methods are evaluated as potential issues for future studies. PMID:25140332

  12. Spatio-temporal variation of landfill gas in pilot-scale semi-aerobic and anaerobic landfills over 5years. (United States)

    Wu, Xiaohui; Yue, Bo; Huang, Qifei; Wang, Qi; Lin, Ye; Zhang, Wei; Yan, Zhuoyi


    Variation of CH4, CO2, and O2 concentrations in layers of different depths in semi-aerobic and anaerobic landfills was analyzed over a period of 5years. The results showed that most of the municipal solid waste became basically stable after 5years of landfill disposal. In the upper and middle layer, the concentration of CH4 in the semi-aerobic landfill was significantly lower than that in the anaerobic landfill in different landfill periods, while in the lower layer, there was little difference in the CH4 concentration between the semi-aerobic and anaerobic landfills. The average concentration of CH4 and CO2 in the anaerobic landfill was always higher than that in the semi-aerobic landfill, while the O2 concentration showed an opposite variation in different landfill periods. This was related to the aerobic reaction of landfill waste around the perforated pipe in the semi-aerobic landfill, which inhibited effective landfill gas generation. Copyright © 2016. Published by Elsevier B.V.

  13. Compared with feeding infants breast milk or cow-milk formula, soy formula feeding does not affect subsequent reproductive organ size at 5 years of age. (United States)

    Andres, Aline; Moore, Mary B; Linam, Leann E; Casey, Patrick H; Cleves, Mario A; Badger, Thomas M


    Literature reports suggest that phytochemicals, such as isoflavones found in soybeans, impair reproductive function in animals and raise the possibility that consuming soy infant formula could alter hormonally sensitive organ development in children. This study compared reproductive organs volumes and structural characteristics in children at age 5 y who were enrolled in the Beginnings study long-term cohort. Breast bud, uterus, ovaries, prostate, and testes volumes and characteristics were assessed by ultrasonography in 101 children (50 boys and 51 girls) aged 5 y who were breastfed (n = 35) or fed cow-milk formula (n = 32) or soy formula (n = 34) as infants. Analyses were adjusted for race, gestational age, and birth weight. Among girls, no significant differences were found in breast bud, ovarian, or uterine volumes; counts of ovaries with cysts; ovarian cysts numbers; ovarian cyst size; and uterine shape between the diet groups. Among boys, no significant differences were found in breast bud, testes, or prostate volumes or structural characteristics between the diet groups. In this cohort, no early infant feeding effects were found on reproductive organs volumes and structural characteristics in children age 5 y. The follow-up of these children through puberty is planned and should help delineate potential early infant feeding effect on reproductive function later in life. © 2015 American Society for Nutrition.

  14. Epidemiology of rotavirus diarrhea in children under 5 years in Northern Cameroon


    Ndze, Valentine Ngum; Akum, Achidi Eric; Kamga, Gonsu Hortense; Enjema, Lyonga Emilia; Esona, Mathew Dioh; Banyai, Krisztian; Therese, Obama Abena Marie


    Background Rotavirus still remains the major cause of diarrhea in children below 5 years. No data on rotavirus epidemiology is available in the Northern regions of Cameroon. We aimed to determine the prevalence of group A rotavirus (RVA) in children below 5 years with diarrhea in two regions of Northern Cameroon (North West and Far North Regions) so as to improve our knowledge on the burden of rotavirus disease for imminent introduction of a rotavirus vaccine. Methods Stool samples were colle...

  15. Treatment of Class II Division 2 Malocclusion Using the Forsus Fatigue Resistance Device and 5-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Ezgi Atik


    Full Text Available This case report presents the treatment of a 14-year-and-8-month-old boy with Class II division 2 mandibular retrusion, severe deep bite, and concave profile. The Forsus fatigue resistance device (FRD was effective in correcting both skeletal and dental parameters. At 5-year posttreatment follow-up, the teeth were well aligned and the occlusion was stable. FRD application with appropriate treatment time can result with prominent changes in the facial profile and dentition, and the outcomes can be maintained at the long-term follow-up periods.

  16. Is zero central line-associated bloodstream infection rate sustainable? A 5-year perspective. (United States)

    Erdei, Carmina; McAvoy, Linda L; Gupta, Munish; Pereira, Sunita; McGowan, Elisabeth C


    Adoption and implementation of evidence-based measures for catheter care leads to reductions in central line-associated bloodstream infection (CLABSI) rates in the NICU. The purpose of this study is to evaluate whether this rate reduction is sustainable for at least 1 year and to identify key determinants of this sustainability at the NICU of the Floating Hospital for Children at Tufts Medical Center. We reviewed the incidence of CLABSIs in the NICU temporally to the implementation of new practice policies and procedures, from July 2008 to December 2013. Adoption of standardized care practices, including bundles and checklists, was associated with a significant reduction of the CLABSI rate to zero for >370 consecutive days in our NICU in 2012. Overall, our CLABSI rates decreased from 4.1 per 1000 line days in 2009 (13 infections; 3163 line days) to 0.94 in 2013 (2 infections; 2115 line days), which represents a 77% reduction over a 5-year period. In the first quarter of 2013, there was a brief increase in CLABSI rate to 3.3 per 1000 line days; after a series of interventions, the CLABSI rate was maintained at zero for >600 days. Ongoing training, surveillance, and vigilance with catheter insertion and maintenance practices and improved documentation were identified as key drivers for success. High-quality training, strict compliance with evidence-based guidelines, and thorough documentation is associated with significant reductions in CLABSIs. Mindful organizing may lead to a better understanding of what goes into a unit's ability to handle peak demands and sustain extraordinary performance in the long-term. Copyright © 2015 by the American Academy of Pediatrics.

  17. Insight, psychopathology, explanatory models and outcome of schizophrenia in India: a prospective 5-year cohort study

    Directory of Open Access Journals (Sweden)

    Johnson Shanthi


    Full Text Available Abstract Background The sole focus of models of insight on bio-medical perspectives to the complete exclusion of local, non-medical and cultural constructs mandates review. This study attempted to investigate the impact of insight, psychopathology, explanatory models of illness on outcome of first episode schizophrenia. Method Patients diagnosed to have DSM IV schizophrenia (n = 131 were assessed prospectively for insight, psychopathology, explanatory models of illness at baseline, 6, 12 and 60 months using standard instruments. Multiple linear and logistic regression and generalized estimating equations (GEE were employed to assess predictors of outcome. Results We could follow up 95 (72.5% patients. Sixty-five of these patients (68.4% achieved remission. There was a negative relationship between psychosis rating and insight scores. Urban residence, fluctuating course of the initial illness, and improvement in global functioning at 6 months and lower psychosis rating at 12 months were significantly related to remission at 5 years. Insight scores, number of non-medical explanatory models and individual explanatory models held during the later course of the illness were significantly associated with outcome. Analysis of longitudinal data using GEE showed that women, rural residence, insight scores and number of non-medical explanatory models of illness held were significantly associated with BPRS scores during the study period. Conclusions Insight, the disease model and the number of non-medical model positively correlated with improvement in psychosis arguing for a complex interaction between the culture, context and illness variables. These finding argue that insight and explanatory models are secondary to psychopathology, course and outcome of the illness. The awareness of mental illness is a narrative act in which people make personal sense of the many challenges they face. The course and outcome of the illness, cultural context

  18. Auditory performance of cochlear implant children aged 2-5 years. (United States)

    Thawin, Cheamchit; Kanchanalarp, Chanida; Lertsukprasert, Krisna; Cheewaruangroj, Wichit; Khantapasuantara, Kanjalak; Ruencharoen, Suwimol


    To assess the categories of auditory performance in prelingual deaf children after implantation. Prospective study The present study consisted of one boy and four girls aged between 2 and 5 years old at the time of implantation. All subjects had bilateral profound sensorineural hearing loss and received no substantial benefit from amplification. Three subjects were implanted with Med-El combi 40+ with CIS strategy and two subjects received multichanal monopolar Nucleus 24 cochlear implant with ACE strategy. After implantation, all subjects undertook a program ofhabilitation at the Speech and Hearing Clinic Ramathibodi Hospital. The Categories of Auditory Performance (CAP) score was determined at regular intervals prior to implantation, immediately at the initial mapping (0) and 3, 6, 12 and 18 months after the implantation. The results showed that before implantation, only three children showed awareness of environment sounds, CAP score level 1, and that immediately after mapping, all of the children demonstrated awareness of the environmental sounds. Moreover, two of these children showed awareness of speech sounds, CAP score level 2. The CAP scores were gradually increased over a 12-month period. At the 12-month assessment interval, four children could discriminate two speech sounds, CAP score level 4 and one child understood phrases without lip reading, CAP score level 5. 18 months after of implantation, the CAP score for four children increased to level 5. One child understood conversation without lip reading with a familiar talker, CAP score level 6. Furthermore, children with congenital hearing loss who underwent implantation at a younger age received more benefit from the implantation. The CAP score was found to be a useful and sensitive tool to evaluate the outcome of auditory receptive abilities in young congenital deaf children who underwent cochlear implantation. The accessible outcome measurement will provide information for parents and professionals to

  19. Molecular typing of Treponema pallidum: a 5-year surveillance in Shanghai, China. (United States)

    Dai, Ting; Li, Kang; Lu, Haikong; Gu, Xin; Wang, Qianqiu; Zhou, Pingyu


    Previously, a small study showed that 14f was the predominant subtype of Treponema pallidum in Shanghai, China. The result was quite different from the genotype distribution in other areas of China. This study aimed to identify the strain types of Treponema pallidum in samples collected over a 5-year period in Shanghai. From 2007 to 2011, genital swabs were collected from patients with syphilis from the Shanghai Skin Disease Hospital. Positive specimens were typed by the enhanced typing method by adding a tp0548 gene to the existing arp and tpr genotype system. In total, 304 of the 372 enrolled patients yielded fully typeable DNA. Ten arp types (4, 6, 8, 9, 11, 12, 13, 14, 15, and 19), 3 tpr types (a, d, and o), and 5 tp0548 types (a, c, f, g, and i) were identified. In total, 12 subtypes were identified with a combination of the arp and tpr genes. Subtype 14d was found in 270 samples (88.8%). When the combination included the tp0548 gene, the 12 CDC subtypes identified were divided into 14 strain types. The predominant type was 14d/f (88.8%), followed by 15d/f (3.6%), 13d/f (1.3%), and 19d/c (1.3%). Two of the 44 14d/f-infected patients and both of the 19d/c-infected patients who underwent a lumbar puncture were diagnosed with neurosyphilis. This study showed that the predominant type in Shanghai was 14d/f. While this is in keeping with data from other areas in China, it is different from an earlier report showing that 14f is the most common genotype in Shanghai. Further studies are needed to better understand the association between strain types and neurosyphilis.

  20. A 5-year follow-up study of users of benzodiazepine: starting with diazepam versus oxazepam. (United States)

    Tvete, Ingunn Fride; Bjørner, Trine; Skomedal, Tor


    Drug dependency may develop during long-term benzodiazepine use, indicated, for example, by dose escalation. The first benzodiazepine chosen may affect the risk of dose escalation. To detect possible differences in benzodiazepine use between new users of diazepam and oxazepam over time. This 5-year prescription database study included 19 747 new benzodiazepine users, inhabitants of Norway, aged 30-60 years, with first redemption for diazepam or oxazepam. Individuals starting on diazepam versus oxazepam were analysed by logistic regression with sex, age, other drug redemptions, prescriber's specialty, household income, education level, type of work, and vocational rehabilitation support as background variables. Time to reach a daily average intake of ≥1 defined daily doses (DDD) over a 3-month period was analysed using a Cox proportional hazard regression model. New users of oxazepam had a higher risk for dose escalation compared with new users of diazepam. This was true even when accounting for differences in sociodemographic status and previous drug use (hazard ratio [HR] 1.33, 95% confidence interval = 1.17 to 1.51). Most doctors prescribed, according to recommendations, oxazepam to individuals they may have regarded as prone to and at risk of dependency. However, these individuals were at higher risk for dose escalation even when accounting for differences in sociodemographic status and previous drug use. Differences between the two user groups could be explained by different preferences for starting drug, DDD for oxazepam being possibly too low, and some unaccounted differences in illness. © British Journal of General Practice 2016.

  1. [Prognosis and treatment of membranous glomerulonephritis-a 5-year prospective study]. (United States)

    Covic, A; Căruntu, I D; Marian, D; Volovăţ, C; Ghiciuc, C; Costin, C; Florea, L; Cotuţiu, C; Covic, M


    The aims of the study were to describe the clinical, pathological and biological features of membranous GN and to prospectively evaluate the relationships between individual negative prognostic factors--type of therapy and outcome. Between 1993-1998, 13/150 (8.7%) consecutive patients with renal biopsy had membranous GN (M = 62%, age = 42.5 +/- 14.5 years). Main (major) findings in these patients were: asymptomatic proteinuria--23.1%, heavy proteinuria (> 10 g/day)--33.3%, microscopic hematuria--53.8%, increased plasma creatinine levels--33.3%, hypertension--23.1% cases. 60% of the patients with nephrotic proteinuria had an underlying cause (infection, malignancy, immune-mediated systemic diseases). 40% of the patients with nephrotic proteinuria had 0 or less than 2 negative prognostic factors (without any of the recognized severe morphological changes). The following differentiated treatment protocols were applied: no treatment for asymptomatic proteinuria (group A), i.v. methyl-prednisolone boluses + prednisone 1 mg/kgc/day 3 months for those patients with few negative prognostic factors (group B), and steroids (as above) + cyclophosphamide (2 mg/kgc/day 3 months) or the Ponticelli regime in patients with important risk factors (group C). Outcome after a median follow-up period of 24 months was: complete remission in all cases from groups A + B (with only one exception were the underlying cause was breast malignancy); in group C in 75% of the subjects a complete or partial remission (proteinuria < 1 g/day) was obtained. Only one case progressed to chronic renal failure. There were no secondary effects from corticoids or immunosuppressive therapy. In membranous GN treatment should be tailored to the presence and type of negative prognostic factors. Even in high-risk patients combined steroids and immunosuppressive therapy determines a favorable outcome in 75% of the cases, without severe adverse effects.

  2. Depression and smoking: a 5-year prospective study of patients with major depressive disorder. (United States)

    Holma, Irina A K; Holma, K Mikael; Melartin, Tarja K; Ketokivi, Mikko; Isometsä, Erkki T


    Major depressive disorder (MDD) and smoking are major public health problems and epidemiologically strongly associated. However, the relationship between smoking and depression and whether this is influenced by common confounding factors remain unclear, in part due to limited longitudinal data on covariation. In the Vantaa Depression Study, psychiatric out- and inpatients with DSM-IV MDD and aged 20-59 years at were followed from baseline to 6 months, 18 months, and 5 years. We investigated course of depression, smoking, and comorbid alcohol-use disorders among the 214 patients (79.6% of 269) participating at least three time points; differences between smoking versus nonsmoking patients, and covariation of MDD, smoking, and alcohol-use disorders. Overall, 31.3% of the patients smoked regularly, 41.1% intermittently, and 27.6% never. Smokers were younger, had more alcohol-use disorders and Cluster B and C personality disorder symptoms, a higher frequency of lifetime suicide attempts, higher neuroticism, smaller social networks, and lower perceived social support than never smokers. Smoking and depression had limited longitudinal covariation. Depression, smoking, and alcohol-use disorders all exhibited strong autoregressive tendencies. Among adult psychiatric MDD patients, smoking is strongly associated with substance-use and personality disorders, which may confound research on the impact of smoking. Rather than depression or smoking covarying or predicting each other, depression, smoking, and alcohol-use disorders each have strong autoregressive tendencies. These findings are more consistent with common factors causing their association than either of the conditions strongly predisposing to the other. © 2013 Wiley Periodicals, Inc.

  3. Neonatal Infections: a 5-Year Analysis in a Neonatal Care Unit in North East of Iran

    Directory of Open Access Journals (Sweden)

    Hassan Boskabadi


    Full Text Available Background: Neonatal infections are one of the major causes of death in Iran. Since identifying the risk factors, types, site, bacterial causes, and case fatality rate of an infection can be effective in selecting preventive and therapeutic methods, and appropriate supportive measures, this study aimed to investigate the aforementioned factors in the neonatal intensive care unit (NICU of Ghaem Hospital in Mashhad- Iran during a 5-year period.Materials and Methods: This cross-sectional study was conducted from Jan 2010 to Jun 2016 on 221 infants diagnosed with infections (positive blood, cerebrospinal fluid, or urine cultures, and radiographic evidence of lung infection as well as laboratory and clinical evidence of infection. Data collection tools consisted of a researcher-made questionnaire including maternal and neonatal characteristics and clinical and laboratory evaluation. Moreover, the infants were followed up until hospital discharge or death. Data were analyzed using SPSS-16.Results: The incidence of neonatal infection was 11.6%. About 70% of the infants were born preterm and 52% of the infected infants were born by cesarean. The most common pathogens of sepsis were gram-negative bacteria (55%, coagulase-negative staphylococci (35% and other gram-positive bacteria (10%. There were three main causes of infection of central nervous system (CNS: Klebsiella (66%, Escherichia coli (17%, and Acinetobacter (17%. Infant mortality rate due to infection was 28.1%. The causes of death included meningitis (60%, sepsis (27%, and UTI (16%.Conclusion: According to our study, the prevalence of infection and mortality rate in our ward is higher compared to developed countries. The most common cause of infections was gram-negative bacteria, but coagulase-negative staphylococci become more prevalent and needs more attention.

  4. Gambling and Problem Gambling in Victoria, Australia: Changes over 5 years. (United States)

    Abbott, Max; Stone, Christine A; Billi, Rosa; Yeung, Kristal


    Rates of gambling and gambling-related harm fluctuate over time, influenced by availability, adaptation and demographic change, among other things. Assessing change is compromised by methodological variation. The main aim of this paper is to assess change in gambling participation and problems in adult Victorians over a 5-year period. Data are from the Victorian Gambling Study (VGS) 2008-2012 (n = 15,000) and the 2003 Victorian Longitudinal Attitudes Survey (n = 8479). An additional aim was to determine the impact of methodological differences on prevalence estimates. Despite gambling availability increasing and more activities being included participation rates declined substantially. Decreases occurred across almost all demographic groups and gambling activities. When adjustments were made for methodological differences there were no significant changes in problem, moderate risk and low risk gambling. Males and people with lower education had higher rates in both surveys. In the latter survey, two groups that experienced large participation reductions, namely young adults and metropolitan residents, emerged as additional groups with higher rates of problem and moderate-risk gambling. Further research is required to discover why overall rates of harm may have plateaued when participation continues to fall and why some groups with reduced participation experience increased harm. The findings suggest that availability and total consumption models are over-simplistic. They further suggest that to be effective prevention programmes will need to extend beyond gambling availability to include interventions directed towards individuals at risk and wider environmental determinants of vulnerability and harm. Additionally this study found that restricting administration of the problem gambling measure to subsets of gamblers generate significantly lower prevalence estimates, implying that many previous surveys under-portray gambling-related harm and that without appropriate

  5. Quality of reporting in oncology phase II trials: A 5-year assessment through systematic review. (United States)

    Langrand-Escure, Julien; Rivoirard, Romain; Oriol, Mathieu; Tinquaut, Fabien; Rancoule, Chloé; Chauvin, Frank; Magné, Nicolas; Bourmaud, Aurélie


    Phase II clinical trials are a cornerstone of the development in experimental treatments They work as a "filter" for phase III trials confirmation. Surprisingly the attrition ratio in Phase III trials in oncology is significantly higher than in any other medical specialty. This suggests phase II trials in oncology fail to achieve their goal. Objective The present study aims at estimating the quality of reporting in published oncology phase II clinical trials. A literature review was conducted among all phase II and phase II/III clinical trials published during a 5-year period (2010-2015). All articles electronically published by three randomly-selected oncology journals with Impact-Factors>4 were included: Journal of Clinical Oncology, Annals of Oncology and British Journal of Cancer. Quality of reporting was assessed using the Key Methodological Score. 557 articles were included. 315 trials were single-arm studies (56.6%), 193 (34.6%) were randomized and 49 (8.8%) were non-randomized multiple-arm studies. The Methodological Score was equal to 0 (lowest level), 1, 2, 3 (highest level) respectively for 22 (3.9%), 119 (21.4%), 270 (48.5%) and 146 (26.2%) articles. The primary end point is almost systematically reported (90.5%), while sample size calculation is missing in 66% of the articles. 3 variables were independently associated with reporting of a high standard: presence of statistical design (p-value <0.001), multicenter trial (p-value = 0.012), per-protocol analysis (p-value <0.001). Screening was mainly performed by a sole author. The Key Methodological Score was based on only 3 items, making grey zones difficult to translate. This literature review highlights the existence of gaps concerning the quality of reporting. It therefore raised the question of the suitability of the methodology as well as the quality of these trials, reporting being incomplete in the corresponding articles.

  6. Cognitive-behaviour therapy for health anxiety in medical patients (CHAMP): a randomised controlled trial with outcomes to 5 years. (United States)

    Tyrer, Peter; Salkovskis, Paul; Tyrer, Helen; Wang, Duolao; Crawford, Michael J; Dupont, Simon; Cooper, Sylvia; Green, John; Murphy, David; Smith, Georgina; Bhogal, Sharandeep; Nourmand, Shaeda; Lazarevic, Valentina; Loebenberg, Gemma; Evered, Rachel; Kings, Stephanie; McNulty, Antoinette; Lisseman-Stones, Yvonne; McAllister, Sharon; Kramo, Kofi; Nagar, Jessica; Reid, Steven; Sanatinia, Rahil; Whittamore, Katherine; Walker, Gemma; Philip, Aaron; Warwick, Hilary; Byford, Sarah; Barrett, Barbara


    Health anxiety is an under-recognised but frequent cause of distress that is potentially treatable, but there are few studies in secondary care. To determine the clinical effectiveness and cost-effectiveness of a modified form of cognitive-behaviour therapy (CBT) for health anxiety (CBT-HA) compared with standard care in medical outpatients. Randomised controlled trial. Five general hospitals in London, Middlesex and Nottinghamshire. A total of 444 patients aged 16-75 years seen in cardiology, endocrinology, gastroenterology, neurology and respiratory medicine clinics who scored ≥ 20 points on the Health Anxiety Inventory (HAI) and satisfied diagnostic requirements for hypochondriasis. Those with current psychiatric disorders were excluded, but those with concurrent medical illnesses were not. Cognitive-behaviour therapy for health anxiety - between 4 and 10 1-hour sessions of CBT-HA from a health professional or psychologist trained in the treatment. Standard care was normal practice in primary and secondary care. Primary - researchers masked to allocation assessed patients at baseline, 3, 6, 12, 24 months and 5 years. The primary outcome was change in the HAI score between baseline and 12 months. Main secondary outcomes - costs of care in the two groups after 24 and 60 months, change in health anxiety (HAI), generalised anxiety and depression [Hospital Anxiety and Depression Scale (HADS)] scores, social functioning using the Social Functioning Questionnaire and quality of life using the EuroQol-5 Dimensions (EQ-5D), at 6, 12, 24 and 60 months, and deaths over 5 years. Of the 28,991 patients screened over 21 months, 5769 had HAI scores of ≥ 20 points. Improvement in HAI scores at 3 months was significantly greater in the CBT-HA group (mean number of sessions = 6) than in the standard care, and this was maintained over the 5-year period (overall p  < 0.0001), with no loss of efficacy between 2 and 5 years. Differences in the generalised anxiety ( p

  7. Vitamin D status and 5-year changes in periodontal disease measures among postmenopausal women: the Buffalo OsteoPerio Study. (United States)

    Millen, Amy E; Andrews, Christopher A; LaMonte, Michael J; Hovey, Kathleen M; Swanson, Mya; Genco, Robert J; Wactawski-Wende, Jean


    Vitamin D is hypothesized to prevent periodontal disease progression through its immune-modulating properties and its role in maintaining systemic calcium concentrations. The authors investigated associations between plasma 25-hydroxyvitamin D [25(OH)D] (collected 1997 to 2000) and the 5-year change in periodontal disease measures from baseline (1997 to 2000) to follow-up (2002 to 2005) among 655 postmenopausal women in a Women's Health Initiative Observational Study ancillary study. Exploratory analyses were conducted in 628 women who also had 25(OH)D measures at follow-up. Four continuous measures of the 5-year change in periodontal disease were assessed using alveolar crest height (ACH), clinical attachment level (CAL), probing depth (PD), and percentage of gingival sites that bled on assessment. Linear regression was used to estimate β-coefficients, standard errors, and P values corresponding to change in periodontal disease (a 1-mm change in ACH, CAL, or PD or a 1-unit change in the percentage of gingival sites that bled) for a 10-nmol/L difference in 25(OH)D. Models were adjusted for age, education, dental visit frequency, smoking, diabetes status, current medications affecting bone health, baseline measures of periodontal disease, body mass index, and recreational physical activity. No statistically significant associations were observed between baseline 25(OH)D and change in periodontal disease measures, overall or in a subset (n = 442) of women with stable 25(OH)D concentrations [25(OH)D change periodontal disease status. No association between baseline 25(OH)D and the subsequent 5-year change in periodontal disease measures was observed. Vitamin D status may not influence periodontal disease progression. More studies are needed to confirm these results.

  8. Auditory-Verbal Comprehension Development of 2-5 Year Old Normal Persian Speaking Children in Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Fariba Yadegari


    Full Text Available Background and Aim: Understanding and defining developmental norms of auditory comprehension is a necessity for detecting auditory-verbal comprehension impairments in children. We hereby investigated lexical auditory development of Persian (Farsi speaking children.Methods: In this cross-sectional study, auditory comprehension of four 2-5 year old normal children of adult’s child-directed utterance at available nurseries was observed by researchers primarily to gain a great number of comprehendible words for the children of the same age. The words were classified into nouns, verbs and adjectives. Auditory-verbal comprehension task items were also considered in 2 sections of subordinates and superordinates auditory comprehension. Colored pictures were provided for each item. Thirty 2-5 year old normal children were randomly selected from nurseries all over Tehran. Children were tested by this task and subsequently, mean of their correct response were analyzed. Results: The findings revealed that there is a high positive correlation between auditory-verbal comprehension and age (r=0.804, p=0.001. Comparing children in 3 age groups of 2-3, 3-4 and 4-5 year old, showed that subordinate and superordinate auditory comprehension of the former group is significantly lower (p0.05, while the difference between subordinate and superordinate auditory comprehension was significant in all age groups (p<0.05.Conclusion: Auditory-verbal comprehension develop much faster at lower than older ages and there is no prominent difference between word linguistic classes including nouns, verbs and adjectives. Slower development of superordinate auditory comprehension implies semantic hierarchical evolution of words.

  9. Evaluation of Nutritional Status Post Laparoscopic Sleeve Gastrectomy-5-Year Outcomes. (United States)

    Al-Mutawa, Aliaa; Al-Sabah, Salman; Anderson, Alfred Kojo; Al-Mutawa, Mohammad


    Obesity is considered a public health problem and has led to advancements in bariatric surgery. Laparoscopic sleeve gastrectomy (LSG) had become the most performed procedure worldwide; however, its consequences on nutritional status in the short and long term are of concern. A retrospective analysis of medical records and bariatric database of patients who underwent LSG from October 2008-September 2015 at Al-Amiri Hospital, Kuwait, was performed. Data regarding nutritional status along with demographic data were collected over a 5-year follow-up period. One thousand seven hundred ninety-three patients comprising of 74% females and 26% males were included. The greatest % total body weight loss (%TBWL) was at 18 months post-LSG (33%), corresponding to a % excess weight loss (%EWL) of 73.8%. With regard to nutritional status, vitamin B1 showed a significant drop at 3-5 years post-op in comparison to pre-op value, but stayed within the normal range throughout the study. Red blood cells count, hemoglobin, and hematocrit also showed a significant drop starting from 6 months post-op until the fifth year of follow-up. On the other hand, vitamins B6 and B12 showed a significant increase at 6 months post-op and decreased afterwards, but did not reach pre-op values. Vitamin D also showed a significant increase throughout the study period from deficient value at the pre-op time, but remained insufficient. Albumin, transferrin, folate, ferritin, iron, and vitamin B2 showed no significant changes at 5 years post-LSG compared to pre-op values. Little is known about the nutritional status and optimal nutritional care plan post-LSG, especially in the longer term. Nutritional deficiencies were prevalent prior and post-LSG. Some of the nutritional parameters improved and even reached the abnormal high level post-LSG. These observations highlight the importance of pre- and post-operative nutritional assessment and tailored supplementation to ensure optimal nutritional status.


    Directory of Open Access Journals (Sweden)

    Sunil Vitthalrao Jagtap


    Full Text Available INTRODUCTION Oral cancer is one of the commonest cancer in the world. It is known that oral carcinoma begins with multiple cumulative epigenetic and genetic changes that caused by various carcinogens which ultimately lead to clinical and microscopic visible changes called invasive neoplasm. Oral cancer has a very poor prognosis because it is not detected when it is a small lesion and in early stage. Oral examination and histopathology of lesion plays important role in detecting oral cancers. AIMS AND OBJECTIVES To study clinical presentation, prevalence, histopathological types and grades of various malignant oral lesions. MATERIALS AND METHODS This study is retrospective and prospective analytical type. Study period was 5 years from May 2010 to April 2015. Detailed clinical data, relevant investigations and complete histopathological examination was done and data analysed. RESULTS This study includes a total of 135 consecutive cases of malignant oral lesions during study period. The common associated risk factor observed was habituated to tobacco chewing (91.11%. Males were commonly affected 98/135 cases (72.59% than females 37/135 (27.41% with ratio M: F is 2.6:1. The maximum number of patients were from 40-49 years of age group. Site wise distribution of malignant lesion was common in buccal mucosa (45.12% followed by tongue (23.71%, gingiva (16.34%, lip (7.35%, etc. On histopathological examination of total 135 cases, conventional squamous cell carcinoma was diagnosed in 122 cases (90.36%, verrucous carcinoma in 8 (5.94%, followed by malignant melanoma (0.74%, mucoepidermoid carcinoma (0.74%, polymorphous low grade adenocarcinoma (0.74%. CONCLUSION Oral cancer is a major health problem in India. Proper clinical examination and histopathological examination are important tools to diagnose premalignant and malignant lesions of oral cavity. The early detection and treatment plays important role in prognosis of disease. Patient’s awareness of

  11. Examining implicit metacognition in 3.5-year-old children: An eye-tracking and pupillometric study

    Directory of Open Access Journals (Sweden)

    Markus ePaulus


    Full Text Available The current study examined early signs of implicit metacognitive monitoring in 3.5-year-old children. During a learning phase children had to learn paired associates. In the test phase, children had to perform a recognition task and choose the correct associate for a given target among four possible answers. Subsequently, children’s explicit confidence judgments and their fixation time allocation at the confidence scale were assessed. Analyses showed that explicit confidence judgments did not differ for remembered compared to non-remembered items. In contrast, children’s fixation patterns on the confidence scale were affected by the correctness of their memory, as children looked longer to high confidence ratings when they correctly remembered the associated item. Moreover, analyses of pupil size revealed pupil dilations for correctly remembered, but not incorrectly remembered items. The results converge with recent behavioral findings that reported evidence for implicit metacognitive memory monitoring processes in 3.5-year-old children. The study suggests that implicit metacognitive abilities might precede the development of explicit metacognitive knowledge.

  12. Prospective clinical study of prosthetic treatment outcome of implantretained-removable-partial-denture during 5 year-follow-ups

    Directory of Open Access Journals (Sweden)

    Mehran Bahrami


    Full Text Available Background IRRPD offers patients the ability to upgrade their treatment planning to implant-supported-overdentures (ISOs or implant-supported-fixed-prostheses (ISFPs through insertion of more implants in the future after the loss of the remaining natural teeth. Aims The purpose of this prospective-clinical-study was to evaluate the success rate and treatment outcome of IRRPD for 15 patients, during at least 5-year-follow-ups after prosthetic rehabilitation with respect to implant mobility, peri-implant-marginal-bone-levels, and prosthetic complications. Methods 15 successive patients were attended the Department of Implantology and Prosthodontics in TUMS, and received Implant-Retained-Removable-Partial-Dentures (IRRPDs. Two standard-size-dental-implants (Implantium/Dentium system, internal hexagon, Seoul, South Korea were placed in distal-extension-areas for each patient. After the osseointegration period, all patients received IRRPDs using two Ball attachments. All the participated patients were followed-up at least for 5 years, and the survival rate of 30 implants was evaluated. The patients’ satisfaction of function, phonetics, and aesthetics was assessed by means of questionnaire. Results None of the studied patients reported any prosthetic complications during the follow-up-periods such as attachment loosening, metal housing loosening, or denture fracture. No implants failure was recorded, so that the cumulative-implant-survival rate was 100 per cent. The mean marginal-bone-resorption (MBR around the two implants was 0.9mm with a range of 0.5–1.4mm. Teeth aesthetics was judged as excellent or very good by 86.7 per cent of the patients, while phonetics and mastication were considered excellent or very good by 66.7 per cent and 73.3 per cent of the patients, respectively. Conclusion 15 patients received 30 implants for the fabrication of IRRPDs in the posterior-edentulous-sites. The IRRPDs were delivered to the patients by the same

  13. The temporal outcomes of open versus arthroscopic knotted and knotless rotator cuff repair over 5 years. (United States)

    Lucena, Thomas R; Lam, Patrick H; Millar, Neal L; Murrell, George Ac


    The present study aimed to determine how repair technique influenced structural and clinical outcomes at 5 years post-surgery. Three cohorts of patients had repair of a symptomatic rotator cuff tear using (i) an open double-row mattress repair technique (n = 25); (ii) arthroscopic single-row simple suture knotted technique (n = 25); or (iii) arthroscopic single-row inverted mattress knotless technique (n = 36) by one surgeon. Standardized patient- and examiner-determined outcomes were obtained pre-operatively and postoperatively with a validated protocol, ultrasound were also performed at the same time. Retear occurred more often after open repair (48%) at 5 years than after arthroscopic knotted (33%) and arthroscopic knotless (26%) repair. Retear was associated with increasing age, pre-operative tear size and weaker pre-operative and 5 years postoperative cuff strength. Between 2 years and 5 years, the open repair group experienced an increase in the frequency of pain during activity, as well as in the difficulty experienced and the severity of pain during overhead activities (p arthroscopic knotless repair group. At 5-year follow-up, arthroscopic rotator cuff repair techniques resulted in fewer retears and better outcomes compared to an open double-row technique.

  14. Virtual HDR CyberKnife SBRT for Localized Prostatic Carcinoma: 5-year Disease-free Survival and Toxicity Observations

    Directory of Open Access Journals (Sweden)

    Donald Blake Fuller


    Full Text Available PURPOSEProstate stereotactic body radiotherapy (SBRT may substantially recapitulate the dose distribution of high-dose-rate (HDR brachytherapy, representing an externally delivered Virtual HDR treatment method. Herein we present 5-year outcomes from a cohort of consecutively treated Virtual HDR SBRT prostate cancer patients.METHODSSeventy-nine patients were treated from 2006 - 2009, 40 low-risk and 39 intermediate-risk, under IRB-approved clinical trial, to 38 Gy in 4 fractions. The planning target volume (PTV included prostate plus a 2-mm volume expansion in all directions, with selective use of a 5-mm prostate-to-PTV expansion and proximal seminal vesicle coverage in intermediate-risk patients, to better cover potential extraprostatic disease; rectal PTV margin reduced to zero in all cases. The prescription dose covered > 95% of the PTV (V100 >= 95%, with a minimum 150% PTV dose escalation to create HDR-like PTV dose distribution.RESULTSMedian pre-SBRT PSA level of 5.6 ng/mL decreased to 0.05 ng/mL 5 years out and 0.02 ng/mL 6 years out. At least one PSA bounce was seen in 55 patients (70% but only 3 of them subsequently relapsed, Biochemical-relapse-free survival was 100% and 92% for low-risk and intermediate-risk patients, respectively, by ASTRO definition (98% and 92% by Phoenix definition. Local relapse did not occur, distant metastasis-free survival was 100% and 95% by risk-group, and disease-specific survival was 100%. Acute and late grade 2 GU toxicity incidence was 10% and 9%, respectively; with 6% late grade 3 GU toxicity. Acute urinary retention did not occur. Acute and late grade 2 GI toxicity was 0% and 1%, respectively, with no grade 3 or higher toxicity. Of patients potent pre-SBRT, 65% remained so at 5 years.CONCLUSIONSVirtual HDR prostate SBRT creates a very low PSA nadir, a high rate of 5-year disease-free survival and an acceptable toxicity incidence, with results closely resembling those reported post-HDR brachytherapy.

  15. Post-operative delirium is associated with increased 5-year mortality. (United States)

    Moskowitz, Eliza E; Overbey, Douglas M; Jones, Teresa S; Jones, Edward L; Arcomano, Todd R; Moore, John T; Robinson, Thomas N


    Post-operative delirium is associated with increased short term morbidity and mortality. Limited data exists on long term outcomes for older adults with postoperative delirium. We hypothesize that postoperative delirium is associated with increased 5-year mortality. Patients ≥50 years undergoing elective operations with planned intensive care unit (ICU) admissions were prospectively enrolled. The Confusion Assessment Method ICU (CAM-ICU) was used to diagnose delirium. The primary outcome variable was 5-year mortality. 172 patients were enrolled with an average age of 64 years. The overall incidence of delirium was 44% (75/172). At 5-years post-operatively, mortality was higher (59%, 41/70) in patients with delirium compared to patients without delirium (13%, 12/94, p delirium were 7.35 fold greater (95% CI: 1.49-36.18). Postoperative delirium is associated with increased long term mortality. Published by Elsevier Inc.

  16. Soluble urokinase plasminogen activator receptor and hypertension among black South Africans after 5 years

    DEFF Research Database (Denmark)

    Botha, Shani; Fourie, Carla Mt; Schutte, Rudolph


    in participants who developed hypertension. Participants were 1.41 times more likely (P=0.015) to develop hypertension with 1 s.d. increase in percentage change in suPAR levels over 5 years. Change in systolic blood pressure was associated with baseline suPAR in hypertensive participants and change in su...... hypertension over 5 years, compared with those who remained normotensive; and second, whether hypertension is associated with suPAR. This substudy is embedded in the South African leg of the Prospective Urban and Rural Epidemiology study, performed in the North West Province. We investigated 429 normotensive...... individuals, of which 191 developed hypertension and 238 remained normotensive over 5 years. We determined suPAR from plasma (ethylenediaminetetraacetic acid) samples with the suPARnostic ELISA Kit and blood pressure with an OMRON HEM-757 device. Despite similar mean baseline suPAR levels (P=0.43), su...

  17. Nut intake and 5-year changes in body weight and obesity risk in adults

    DEFF Research Database (Denmark)

    Freisling, Heinz; Noh, Hwayoung; Slimani, Nadia


    weight gain over 5 years (-0.07 kg; 95% CI -0.12 to -0.02) (P trend = 0.025) and had 5% lower risk of becoming overweight (RR 0.95; 95% CI 0.92-0.98) or obese (RR 0.95; 95% CI 0.90-0.99) (both P trend risk...... overweight or obese after 5 years was investigated using multivariate Poisson regressions stratified according to baseline body mass index (BMI). RESULTS: On average, study participants gained 2.1 kg (SD 5.0 kg) over 5 years. Compared to non-consumers, subjects in the highest quartile of nut intake had less...... of becoming overweight or obese....

  18. The Infant Aphakia Treatment Study Contact Lens Experience to Age 5 Years. (United States)

    Russell, Buddy; DuBois, Lindreth; Lynn, Michael; Ward, Michael A; Lambert, Scott R


    To describe our experience treating a cohort of unilateral aphakic infants with contact lenses in the Infant Aphakia Treatment Study (IATS). Fifty-seven of the 114 infants in the IATS were randomized to contact lens wear; all were followed until age 5 years, although a few had lapses in care. An examination under anesthesia, including keratometry, was performed at the time of enrollment and at approximately 1 year of age; keratometry was performed again at 5 years of age. A traveling examiner assessed visual acuity at approximately 1 year of age and again at 4.5 years of age. Twenty-four treated eyes (46%) wore silicone elastomer (SE) contact lenses, 11 eyes (19%) rigid gas permeable (GP) contact lenses and 17 eyes (29%) wore both lens types at various points of time. Median logMAR visual acuity was +0.70 (interquartile range (IQR), +0.30 to 1.20) in the SE group and 2.03 (IQR, +0.20 to 2.28) in the GP group at age 4.5 years. The mean (±SD) keratometric power of the treated eyes was 46.3±2.8 diopter (D) at baseline, 44.6±2.3 D at 1 year of age, and 44.3±1.7 D at 5 years of age. Keratometric astigmatism of treated eyes was 1.98±1.37 D at baseline, 1.62±0.98 D at 1 year of age, and 2.00±1.00 D at 5 years of age. Thirteen contact lens-related adverse events occurred among 7 patients after age 1 year. A cohort of infants with unilateral aphakia successfully wore contact lenses with relatively few adverse events.

  19. A 5 year prospective study of patient-relevant outcomes after total knee replacement

    DEFF Research Database (Denmark)

    Nilsdotter, A-K; Toksvig-Larsen, S; Roos, E M


    OBJECTIVE: To prospectively describe self-reported outcomes up to 5 years after total knee replacement (TKR) in Osteoarthritis (OA) and to study which patient-relevant factors may predict outcomes for pain and physical function (PF). METHODS: 102 consecutive patients with knee OA, 63 women and 39...... men, mean age 71 (51-86) assigned for TKR at the Department of Orthopaedics at Lund University Hospital were included in the study. The self-administered questionnaires Knee injury and Osteoarthritis Outcome Score (KOOS) and SF-36 were mailed preoperatively and 6 months, 12 months and at 5 years...

  20. Caries-inhibiting effect of professional fluoride gel application in low-caries children initially aged 4.5-6.5 years.

    NARCIS (Netherlands)

    Rijkom, H.M. van; Truin, G.J.; Hof, M.A. van 't


    It was the purpose of the study to investigate the caries-reducing effect of semi-annual professional fluoride gel application in a low-caries child population initially aged 4.5-6.5 years during a 4-year follow-up period. In a double-blind randomised controlled trial (n = 773) the effect of sodium

  1. Partial Breast Radiation Therapy With Proton Beam: 5-Year Results With Cosmetic Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Bush, David A., E-mail: [Department of Radiation Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Do, Sharon [Department of Radiation Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Lum, Sharon; Garberoglio, Carlos [Department of Surgical Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Mirshahidi, Hamid [Department of Medical Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Patyal, Baldev; Grove, Roger; Slater, Jerry D. [Department of Radiation Oncology, Loma Linda University Medical Center, Loma Linda, California (United States)


    Purpose: We updated our previous report of a phase 2 trial using proton beam radiation therapy to deliver partial breast irradiation (PBI) in patients with early stage breast cancer. Methods and Materials: Eligible subjects had invasive nonlobular carcinoma with a maximal dimension of 3 cm. Patients underwent partial mastectomy with negative margins; axillary lymph nodes were negative on sampling. Subjects received postoperative proton beam radiation therapy to the surgical bed. The dose delivered was 40 Gy in 10 fractions, once daily over 2 weeks. Multiple fields were treated daily, and skin-sparing techniques were used. Following treatment, patients were evaluated with clinical assessments and annual mammograms to monitor toxicity, tumor recurrence, and cosmesis. Results: One hundred subjects were enrolled and treated. All patients completed the assigned treatment and were available for post-treatment analysis. The median follow-up was 60 months. Patients had a mean age of 63 years; 90% had ductal histology; the average tumor size was 1.3 cm. Actuarial data at 5 years included ipsilateral breast tumor recurrence-free survival of 97% (95% confidence interval: 100%-93%); disease-free survival of 94%; and overall survival of 95%. There were no cases of grade 3 or higher acute skin reactions, and late skin reactions included 7 cases of grade 1 telangiectasia. Patient- and physician-reported cosmesis was good to excellent in 90% of responses, was not changed from baseline measurements, and was well maintained throughout the entire 5-year follow-up period. Conclusions: Proton beam radiation therapy for PBI produced excellent ipsilateral breast recurrence-free survival with minimal toxicity. The treatment proved to be adaptable to all breast sizes and lumpectomy cavity configurations. Cosmetic results appear to be excellent and unchanged from baseline out to 5 years following treatment. Cosmetic results may be improved over those reported with photon

  2. Vertical distribution of the Saharan Air Layer from 5 years of CALIPSO observations (United States)

    Tsamalis, C.; Chédin, A.


    The Saharan Air Layer (SAL) forms as dry and hot air moves across the Sahara desert. SAL, containing substantial amounts of mineral dust, is a dominant feature that influences the large scale environment from West Africa to eastern tropical America, inhibiting tropical cyclogenesis and Atlantic hurricane formation. Furthermore, SAL dust aerosols have a strong impact on the energy budget through the so-called direct and indirect effects. The SAL has been studied with dedicated campaigns at the two sides of the Atlantic or using space observations due to lack of systematic in situ measurements away from the continents. However the campaigns are restricted in time, while satellite observations of thermodynamic variables are affected by the presence of dust. Moreover, satellite measurements of aerosols, particularly in the visible, mostly provide column integrated properties like the optical depth, without information about the vertical distribution. On the other hand, new generation infrared sounders now bring reliable information on the dust layer mean altitude, but their new established results need further validation. However, the two-wavelength lidar CALIOP, launched on board CALIPSO in April 2006, permits an accurate determination of the aerosol vertical distribution, on a global scale. Thanks to depolarisation at 532 nm, CALIOP is able to discriminate between dust and other types of aerosols, which generally do not depolarize light. Here, the L2 5 km aerosol layer product (version 3.01) is used to calculate the vertical distribution of the dust aerosols above the Atlantic during the last 5 years (June 2006 - May 2011) with a horizontal resolution of 1 degree for the four seasons. More specifically, two classes of aerosols are used from the L2 product: dust and polluted dust, in order to take into account the change of dust aerosols optical properties with transport. Results show the latitudinal displacement of the SAL between winter [-5, 15]°N and summer [10

  3. Participation in an Intensive Longitudinal Study with Weekly Web Surveys Over 2.5 Years. (United States)

    Barber, Jennifer; Kusunoki, Yasamin; Gatny, Heather; Schulz, Paul


    Technological advances have made it easier for researchers to collect more frequent longitudinal data from survey respondents via personal computers, smartphones, and other mobile devices. Although technology has led to an increase in data-intensive longitudinal studies, little is known about attrition from such studies or the differences between respondents who complete frequently administered surveys in a timely manner, and respondents who do not. We examined respondent characteristics and behaviors associated with continued and on-time participation in a population-based intensive longitudinal study, using weekly web-based survey interviews over an extended period. We analyzed data from the Relationship Dynamics and Social Life study, an intensive longitudinal study that collected weekly web-based survey interviews for 2.5 years from 1003 18- and 19-year-olds to investigate factors shaping the dynamics of their sexual behavior, contraceptive use, and pregnancies. Ordinary least squares and logistic regression analyses showed background respondent characteristics measured at baseline were associated with the number of days respondents remained enrolled in the study, the number of interviews they completed, and the odds that they were late completing interviews. In addition, we found that changes in pregnancy-related behaviors reported in the weekly interviews were associated with late completion of interviews. Specifically, after controlling for sociodemographic, personality, contact information, and prior experience variables, we found that weekly reports such as starting to have sex (odds ratio [OR] 1.17, 95% CI 1.03-1.32, P=.01), getting a new partner (OR 1.76, 95% CI 1.53-2.03, Psurvey completion. However, young women who reported changes in pregnancy-related behaviors also had lower levels of study attrition, and completed more interviews overall, than did their counterparts. We found that measures of participation in a longitudinal study with weekly web

  4. Motor trajectories from birth to 5 years of children born at less than 30 weeks' gestation: early predictors and functional implications. Protocol for a prospective cohort study. (United States)

    Spittle, Alicia J; McGinley, Jennifer L; Thompson, Deanne; Clark, Ross; FitzGerald, Tara L; Mentiplay, Benjamin F; Lee, Katherine J; Olsen, Joy E; Burnett, Alice; Treyvaud, Karli; Josev, Elisha; Alexander, Bonnie; Kelly, Claire E; Doyle, Lex W; Anderson, Peter J; Cheong, Jeanie Ly


    Motor impairments are one of the most frequently reported adverse neurodevelopmental consequences in children born compare the prevalence of motor impairment from birth to 5 years of age between children born at structural or functional biomarkers that can predict motor impairments at 5 years are detectable in the neonatal period; 2) to investigate the association between motor impairments and concurrent deficits in body structure and function at 5 years of age; and 3) to explore how motor impairments at 5 years (including abnormalities of gait, postural control and strength) are associated with concurrent functional outcomes, including physical activity, cognitive ability, learning ability, and behavioural and emotional problems. Prospective longitudinal cohort study. 150 preterm children (born at 36 completed weeks' gestation and weighing > 2499g) admitted to the Royal Women's Hospital, Melbourne, were recruited at birth and will be invited to participate in a 5-year follow-up study. This study will examine previously collected data (from birth to 2 years) that comprise detailed motor assessments, and structural and functional brain MRI images. At 5 years, preterm and term, children will be examined using comprehensive motor assessments, including: the Movement Assessment Battery for Children (2nd edition) and measures of gait function through spatiotemporal (assessed with the GAITRite® Walkway) and dynamic postural control (assessed with Microsoft Kinect) variables; and hand grip strength (assessed with a dynamometer); and measures of physical activity (assessed using accelerometry), cognitive development (assessed with Wechsler Preschool and Primary Scale of Intelligence), and emotional and behavioural status (assessed with the Strengths and Difficulties Questionnaire and the Developmental and Wellbeing Assessment). At the 5-year assessment, parents/caregivers will be asked to complete questionnaires on demographics, physical activity, activities of daily

  5. Influence of Emotional Facial Expressions on 3-5-Year-Olds' Face Recognition (United States)

    Freitag, Claudia; Schwarzer, Gudrun


    Three experiments examined 3- and 5-year-olds' recognition of faces in constant and varied emotional expressions. Children were asked to identify repeatedly presented target faces, distinguishing them from distractor faces, during an immediate recognition test and during delayed assessments after 10 min and one week. Emotional facial expression…

  6. Anthropometry, muscular strength and aerobic capacity up to 5 years after pediatric burns

    NARCIS (Netherlands)

    Disseldorp, Laurien M; Mouton, Leonora J; Van der Woude, Lucas H V; Van Brussel, Marco|info:eu-repo/dai/nl/30481962X; Nieuwenhuis, Marianne K


    OBJECTIVE: Physical functioning is of major importance after burns in many areas of life, in both the short and the long term. This cross-sectional study aimed to describe anthropometry, muscular strength and aerobic capacity in children and adolescents between 0.5-5 years after burns over 10% TBSA.

  7. Anthropometry, muscular strength and aerobic capacity up to 5 years after pediatric burns

    NARCIS (Netherlands)

    Disseldorp, Laurien M.; Mouton, Leonora J.; Van der Woude, Lucas H. V.; Van Brussel, Marco; Nieuwenhuis, Marianne K.


    Objective: Physical functioning is of major importance after burns in many areas of life, in both the short and the long term. This cross-sectional study aimed to describe anthropometry, muscular strength and aerobic capacity in children and adolescents between 0.5-5 years after burns over 10% TBSA.

  8. Predicting severe motor impairment in preterm children at age 5 years

    NARCIS (Netherlands)

    Synnes, Anne; Anderson, Peter J.; Grunau, Ruth E.; Dewey, Deborah; Moddemann, Diane; Tin, Win; Davis, Peter G.; Doyle, Lex W.; Foster, Gary; Khairy, May; Nwaesei, Chukwuma; Schmidt, Barbara; D'Ilario, Judy; Cairnie, Janice; Dix, Joanne; Adams, Beth Anne; Warriner, Erin; Kim, Mee-Hai Marie; Argus, Brenda; Callanan, Catherine; Davis, Noni; Duff, Julianne; McDonald, Marion; Asztalos, Elizabeth; Hohn, Denise; Lacy, Maralyn; Haslam, Ross; Barnett, Christopher; Goodchild, Louise; Lontis, Rosslyn Marie; Fraser, Simon; Keng, Julie; Saunders, Kerryn; Opie, Gillian; Kelly, Elaine; Woods, Heather; Marchant, Emma; Turner, Anne-Marie; Magrath, Emma; Williamson, Amanda; Bairam, Aida; Bélanger, Sylvie; Fraser, Annie; Blayney, Marc; Lemyre, Brigitte; Frank, Jane; Solimano, Alfonso; Hubber-Richard, Philippa; Rogers, Marilyn; Mackay, Margot; Petrie-Thomas, Julianne; Butt, Arsalan; van Wassenaer, Aleid; Nuytemans, Debbie; Houtzager, Bregje; van Sonderen, Loekie; Regev, Rivka; Itzchack, Netter; Arnon, Shmuel; Chalaf, Adiba; Ohlsson, Arne; O'Brien, Karel; Hamilton, Anne-Marie; Chan, May Lee; Sankaran, Koravangattu; Proctor, Pat; Golan, Agneta; Goldsch-Lerman, Esther; Reynolds, Graham; Dromgool, Barbara; Meskell, Andra; Parr, Vanessa; Maher, Catherine; Broom, Margaret; Kecskes, Zsuzsoka; Ringland, Cathy; McMillan, Douglas; Spellen, Elizabeth; Sauve, Reginald S.; Christianson, Heather; Anseeuw-Deeks, Deborah; Creighton, Dianne; Heath, Jennifer; Alvaro, Ruben; Chiu, Aaron; Porter, Ceceile; Turner, Gloria; Granke, Naomi; Penner, Karen; Bow, Jane; Mulder, Antonius; Wassenberg, Renske; van der Hoeven, Markus; Clarke, Maxine; Parfitt, Judy; Parker, Kevin; Ryan, Heather; Saunders, Cory; Schulze, Andreas; Wermuth, Inga; Hilgendorff, Anne; Flemmer, Andreas W.; Herlenius, Eric; Legnevall, Lena; Lagercrantz, Hugo; Matthew, Derek; Amos, Wendy; Tulsiani, Suresh; Tan-Dy, Cherrie; Turner, Marilyn; Phelan, Constance; Shinwell, Eric S.; Levine, Michael; Juster-Reicher, Ada; Grier, Patricia; Vachon, Julie; Perepolkin, Larissa; Barrington, Keith J.; Sinha, Sunil Kumar; Fritz, Susan; Walti, Herve; Royer, Diane; Halliday, Henry; Millar, David; Mayes, Clifford; McCusker, Christopher; McLaughlin, Olivia; Fahnenstich, Hubert; Tillmann, Bettina; Weber, Peter; Wariyar, Unni; Embleton, Nicholas; Swamy, Ravi; Bucher, Hans U.; Fauchere, Jean-Claude; Dietz, Vera; Harikumar, Chidambara; Asztalos, Elizabeth V.; Gent, Michael; Fraser, William; Hey, Edmund; Thorpe, Kevin; Gray, Shari; Roberts, Robin S.; Chambers, Carole; Costantini, Lorrie; Yacura, Wendy; McGean, Erin; Scapinello, Lori


    Objective To determine whether the ability to predict severe motor impairment at age 5 years improves between birth and 18 months. Design Ancillary study of the Caffeine for Apnea of Prematurity Trial. Setting and Patients International cohort of very low birth weight children who were assessed

  9. Nutrition and mental development of 4-5-year old children on macrobiotic diets.

    NARCIS (Netherlands)

    Herens, M.C.; Dagnelie, P.C.; Kleber, R.J.; Mol, M.C.; Staveren, van W.A.


    Mental development of 4–5-year old children on macrobiotic diets (almost devoid of animal foods and fat) with long-term growth deficits, was studied using the Snijders-Oomen Non-verbal Intelligence (SON) scale. In addition, food consumption and behavioural style of the children, and family and

  10. Efficacy and safety of raltegravir for treatment of HIV for 5 years in the BENCHMRK studies

    DEFF Research Database (Denmark)

    Eron, Joseph J; Cooper, David A; Steigbigel, Roy T


    Two randomised, placebo-controlled trials-BENCHMRK-1 and BENCHMRK-2-investigated the efficacy and safety of raltegravir, an HIV-1 integrase strand-transfer inhibitor. We report final results of BENCHMRK-1 and BENCHMRK-2 combined at 3 years (the end of the double-blind phase) and 5 years (the end ...

  11. Blood pressure profile in children aged 3 - 5 years: Relationship to ...

    African Journals Online (AJOL)

    Background. Blood pressure measurement is not commonly done in children. Most of the studies done in Nigeria so far on blood pressure and hypertension are in older children. Objectives. To determine the blood pressure profile in children aged 3 - 5 years, establish the relationship between their blood pressure and age, ...

  12. Determinants of acute diarrhoea in children aged 0 – 5 years in ...

    African Journals Online (AJOL)

    Objective: To establish the prevalence and determinants of acute diarrhoea in children aged 0 – 5 years in Uganda. Design: Cross-sectional study using the 2000/2001 Uganda Demographic and Health Survey (UDHS) dataset. Subjects: Information was derived from the women's questionnaire done on sampled mothers ...

  13. The 5-Year Outlook on Science and Technology 1981. Source Materials Volume 2. (United States)

    National Science Foundation, Washington, DC.

    This is the second of two volumes of source documents commissioned by the National Science Foundation in preparing the second 5-Year Outlook on Science and Technology for transmission to the Congress. This volume consists of the views of individuals selected by the Committee on Science, Engineering and Public Policy of the American Association for…

  14. The Growth of Very-low-birth-weight Infants at 5 Years Old in Taiwan

    Directory of Open Access Journals (Sweden)

    Pei-Wei Wang


    Conclusion: The growth of VLBW infants was lower than that of healthy full-term infants through 5 years of age. The cognitive performance for VLBW children was also decreased compared to that of the control group, and there was an association between slower growth and decreased cognitive ability.

  15. Performance of a Press-Lam bridge : a 5-year load-testing and monitoring program (United States)

    D. S. Gromala; R. C. Moody; M. M. Sprinkel


    This paper summarizes the results of load tests on an experimental highway bridge erected and put into service on the George Washington National Forest in Virginia in 1977. The bridge, made entirely of Press-Lam, a laminated veneer lumber (LVL) product, was load tested 1 month, 1 year, and 5 years after erection. The bridge continues to perform quite well and,...

  16. 76 FR 50448 - Endangered and Threatened Species; 5-Year Reviews for 17 Evolutionarily Significant Units and... (United States)


    ...; (2) Snake River spring/ summer-run Chinook salmon; (3) Puget Sound Chinook salmon; (4) Lower Columbia River Chinook salmon; (5) Upper Willamette Chinook salmon; (6) Snake River fall-run Chinook salmon; (7...; (10) Snake River sockeye salmon; and (11) Ozette Lake sockeye salmon. We did not complete a 5-year...

  17. 5-Year survival of ART restorations with and without cavity disinfection.

    NARCIS (Netherlands)

    Farag, A.; Sanden, W.J.M. van der; Abdelwahab, H.; Mulder, J.; Frencken, J.E.F.M.


    OBJECTIVES: The null-hypothesis tested was that there is no difference between the survival of ART restorations with, and without, cavity disinfection among adolescents after 5 years. METHODS: Eligible students were allocated to one of the treatment groups. One operator placed a total of 90

  18. Intranasal LH-RH treatment of cryptorchidism. A clinical trial and 5 years follow-up

    DEFF Research Database (Denmark)

    Thorup, Jørgen Mogens; Mauritzen, K; Skakkebaek, N E


    The effect of intranasal LH-RH on cryptorchidism was investigated in 45 prepubertal boys with 68 undescended testes. A daily dose of 1.2 mg LH-RH was given for 4 weeks. A total of 16 testes (24%) descended. Follow-up examination 5 years later showed that relapse had occurred in two cases. Fifty...

  19. Genetic factor analyses of specific cognitive abilities in 5-year-old Dutch children

    NARCIS (Netherlands)

    Rietveld, M.J.H.; van Baal, G.C.M.; Dolan, C.V.; Boomsma, D.I.


    The genetic and environmental factor structures of intellectual abilities in 5-year-old Dutch twins were examined. Six subtests of the RAKIT, a Dutch intelligence test, were administered to 209 twin pairs. The subtests were categorized as either verbal or nonverbal. The genetic covariance structure

  20. Verbal Competence in Narrative Retelling in 5-Year-Olds with Unilateral Cleft Lip and Palate (United States)

    Klintö, Kristina; Salameh, Eva-Kristina; Lohmander, Anette


    Background: Research regarding expressive language performance in children born with cleft palate is sparse. The relationship between articulation/phonology and expressive language skills also needs to be further explored. Aims: To investigate verbal competence in narrative retelling in 5-year-old children born with unilateral cleft lip and palate…

  1. Effect of Psychological Intervention on Marital Satisfaction of Mothers with Slow Pace Under 5 Years Children

    Directory of Open Access Journals (Sweden)

    Mehran Soleymani


    Full Text Available Objectives: Objective of this study was investigating impact of early psychological interventions on marital satisfaction of mothers with slow pace under 5 years children. Considering variables of the research, that is, early psychological interventions and marital satisfaction, research hypotheses was as follows: "early psychological interventions affect marital satisfaction of mothers with slow pace under 5 years children" and it was examined. Methods: This research is of experimental type and pretest-posttest plan with control groups was used. Statistical population included all mothers with slow pace under 5 years children in Urmia. To this end, 40 mothers with slow pace children were selected as the sample in a non-random manner by convenience sampling. They were assigned randomly into two groups of 20 (20 test group and 20 control group, and finally psychological interventions were conducted on one of groups randomly. In order to evaluate marital satisfaction, Enrich marital satisfaction questionnaire with 47 items was used. Data were analyzed by univariate analysis of covariance. Results: findings showed that there is significant difference between two groups in posttest in overall score of marital satisfaction as well as in some elements such as conventional responses, marital satisfaction, personality issues, marital relationships, conflict resolution, leisure, parenting, family and friends, and ideological orientation and sexual relations (P<0.005, and no significant difference was observed in financial supervision and roles related to gender equality. Discusion: Psychological interventions were effective in promoting marital satisfaction in mothers with slow pace under 5 years children.

  2. Infant nutrition in relation to eating behaviour and fruit and vegetable intake at age 5 years

    NARCIS (Netherlands)

    Möller, Lisanne M.; de Hoog, Marieke L. A.; van Eijsden, Manon; Gemke, Reinoud J. B. J.; Vrijkotte, Tanja G. M.


    Infant nutrition may influence eating behaviour and food preferences in later life. The present study explores whether exclusive breast-feeding duration and age at introduction of solid foods are associated with children's eating behaviour and fruit and vegetable intake at age 5 years. Data were

  3. Therapeutic Community in a California Prison: Treatment Outcomes after 5 Years (United States)

    Zhang, Sheldon X.; Roberts, Robert E. L.; McCollister, Kathryn E.


    Therapeutic communities have become increasingly popular among correctional agencies with drug-involved offenders. This quasi-experimental study followed a group of inmates who participated in a prison-based therapeutic community in a California state prison, with a comparison group of matched offenders, for more than 5 years after their initial…

  4. cardiovascular disease risk factors in 5-year-old urban south african

    African Journals Online (AJOL)

    CARDIOVASCULAR DISEASE RISK. FACTORS IN 5-YEAR-OLD URBAN. SOUTH AFRICAN CHILDREN. THE BIRTH TO TEN STUDY. Krisela Steyn, Thea de Wet, Linda Richter, Noel Cameron, aomi S Levitt, Christopher MorrelI. Background. A birth cohort study, the Birth to Ten (BIT) study, commenced in the greater ...

  5. A Case Series of Marijuana Exposures in Pediatric Patients Less than 5 Years of Age (United States)

    Wang, George Sam; Narang, Sandeep K.; Wells, Kathryn; Chuang, Ryan


    Objective: In Colorado, there has been a large increase in medical marijuana dispensaries and licenses for the use of medical marijuana over the past year. This is a retrospective case series of marijuana exposures that have presented to the emergency department (ED) in children less than 5 years of age. Methods: We performed a retrospective chart…

  6. Delayed refractory hyperventilation following endoscopic third ventriculostomy in a 5-year-old boy. (United States)

    Merola, J; Liang, E; Hoskins, J; Balakrishnan, V; Gan, P


    We present the case of a 5-year-old boy who developed a delayed onset intractable hyperventilation following endoscopic third ventriculostomy. The proposed aetiology of this exceptionally rare phenomenon is discussed. To our knowledge, previous cases have only been reported in the adult population.

  7. Early Book Stages, 0-5 Years [and] Creciendo con Libros (Growing [up] with Books). [Videotape. (United States)

    Holguin, Roxanna

    Using a lighthearted and simple approach, this 23-minute videotape in English and Spanish versions presents interactions between parents and children while reading books. The children in the videotape range in age from 0 to 5 years. The video is introduced by scenes of children enjoying books while narration discussing the impact of reading to…

  8. Thermal detection thresholds in 5-year-old preterm born children; IQ does matter.

    NARCIS (Netherlands)

    Graaf, J. de; Valkenburg, A.J.; Tibboel, D.; Dijk, M.


    BACKGROUND: Experiencing pain at newborn age may have consequences on one's somatosensory perception later in life. Children's perception for cold and warm stimuli may be determined with the Thermal Sensory Analyzer (TSA) device by two different methods. AIM: This pilot study in 5-year-old children

  9. The Development of Regulatory Functions from Birth to 5 Years: Insights from Premature Infants (United States)

    Feldman, Ruth


    This study examined physiological, emotional, and attentional regulatory functions as predictors of self-regulation in 125 infants followed 7 times from birth to 5 years. Physiological regulation was assessed by neonatal vagal tone and sleep-wake cyclicity; emotion regulation by response to stress at 3, 6, and 12 months; and attention regulation…

  10. Hydatid lung cyst in a 5-year-old boy presenting with prolonged fever

    African Journals Online (AJOL)

    A 5-year-old boy from a remote rural area in Kashmir, North India, where the Gujjar and Bakarwallah tribes keep cattle ... child came from a rural area and had close contact with livestock and dogs. The hydatid serological test was positive .... Patología Aparato. Respiratorio 1993;122:13. 17. Kuzucu A, Soysal O, Ozgel M, ...

  11. Wyoming Community College Commission Agency 5 Year Strategic Plan, 2014-2018 (United States)

    Wyoming Community College Commission, 2017


    In 2009, the Wyoming Community College Commission was tasked to create a blue-ribbon panel that would forge a Strategic Plan for the Community College System as a whole. This 5 year strategic plan will serve as a road map moving forward, barring any new legislative, commission or federal requirements that may require a change in the agency's…

  12. Wyoming Community College Commission Agency 5 Year Strategic Plan, 2015-2019 (United States)

    Wyoming Community College Commission, 2017


    In 2009, the Wyoming Community College Commission was tasked to create a blue-ribbon panel that would forge a Strategic Plan for the Community College System as a whole. This 5 year strategic plan will serve as a road map moving forward, barring any new legislative, commission or federal requirements that may require a change in the agency's…

  13. Sexual function in multiple sclerosis. A 5-year follow-up study

    DEFF Research Database (Denmark)

    Stenager, E; Stenager, E N; Jensen, K


    Sexual dysfunction is known to occur in multiple sclerosis (MS). The purpose of the study is to describe the change in sexual function and symptoms in a longitudinal study. Forty-nine patients (27 females, 22 males) with definite MS were interviewed and examined with 5 years interval. The number...

  14. a 5-year evaluation of the effect of introduction of subspecialty ...

    African Journals Online (AJOL)


  15. Factors increasing the caries risk of second primary molars in 5-year-old Dutch children

    NARCIS (Netherlands)

    Elfrink, Marlies E C; Schuller, Annemarie A; Veerkamp, Jaap S J; Poorterman, Jan H G; Moll, Henriette A; ten Cate, Bob J M

    BACKGROUND: Caries is still a prevalent condition in 5-year-old children. At present, knowledge regarding some aetiological factors, like deciduous molar hypomineralization (DMH), is limited. AIM: To investigate aetiological factors both directly and indirectly associated with caries in second

  16. The introduction of the 5-year impact factor : does it benefit statistics journals?

    NARCIS (Netherlands)

    van Nierop, Erjen

    In this paper, we investigate the effects of the introduction of 5-year impact factors. We collect impact factor data for all disciplines available in the Journal Citation Reports. For all these categories, we give insights into the relationship between the traditional 2-year impact factor and the

  17. HRCT features in a 5-year-old child with follicular bronchiolitis

    Energy Technology Data Exchange (ETDEWEB)

    Reittner, P.; Fotter, R.; Lindbichler, F.; Tillich, M. [Department of Radiology, Karl-Franzens University and University Hospital Graz, Auenbruggerplatz 9, A-8036 Graz (Austria); Varga, E.M.; Zach, M. [Department of Pediatrics, Karl-Franzens University and University Hospital Graz, Graz (Austria); Popper, H. [Department of Pathology, Karl-Franzens University and University Hospital Graz, Graz (Austria)


    High-resolution CT (HRCT) is the most sensitive radiographic method to image small airways disease. We discuss the HRCT features of follicular bronchiolitis in a 5-year-old boy and correlate them with the histopathological findings. The changes described include centrilobular nodules, bronchiectasis and bronchiolectasis, branching opacities and areas of reduced lung attenuation. (orig.) With 2 figs., 5 refs.

  18. Child development at 5 years of age predicted mathematics ability and schooling outcomes in Malawian adolescents. (United States)

    Gandhi, Mihir; Teivaanmaki, Tiina; Maleta, Kenneth; Duan, Xiaolian; Ashorn, Per; Cheung, Yin Bun


    This study aimed to examine the association between child development at 5 years of age and mathematics ability and schooling outcomes at 12 years of age in Malawian children. A prospective cohort study looking at 609 rural Malawian children. Outcome measures were percentage of correctly answered mathematics questions, highest school grade completed and number of times repeating school grades at 12 years of age. A child development summary score obtained at 5 years of age was the main exposure variable. Regression analyses were used to estimate the association and adjust for confounders. Sensitivity analysis was performed by handling losses to follow-up with multiple imputation (MI) method. The summary score was positively associated with percentage of correctly answered mathematics questions (p = 0.057; p = 0.031 MI) and with highest school grade completed (p = 0.096; p = 0.070 MI), and negatively associated with number of times repeating school grades (p = 0.834; p = 0.339 MI). Fine motor score at 5 years was independently associated with the mathematic score (p = 0.032; p = 0.011 MI). The association between child development and mathematics ability did not depend on school attendance. Child development at 5 years of age showed signs of positive association with mathematics ability and possibly with highest school grade completed at 12 years of age. © 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.

  19. Asymptomatic malaria in children under 5 years old in Benin City ...

    African Journals Online (AJOL)

    ... not affect significantly the prevalence of asymptomatic malaria. Age, gender and anaemia were significantly associated with asymptomatic malaria. Conclusion: Interventions to reduce asymptomatic malaria are advocated. Keywords: Asymptomatic malaria, Benin City, Children under 5 years. An Erratum was published for ...

  20. Pancreas transplantation with grafts from donors deceased after circulatory death (DCD) : 5 years single center experience

    NARCIS (Netherlands)

    Kopp, Wouter H; Lam, Hwai-Ding; Schaapherder, Alexander F M; Huurman, Volkert A L; van der Boog, Paul; de Koning, Eelco; de Fijter, Johan W; Baranski, Andrzej; Braat, Andries E


    INTRODUCTION: Donation after circulatory death (DCD) pancreas transplantation has been shown to be an additional way to deal with donor organ shortages. The results of 5-year DCD pancreas transplantation are presented. METHODS: A retrospective, single center analysis (2011 - 2015) was performed to

  1. Asthma and mode of birth delivery: A study in 5-year-old Dutch twins.

    NARCIS (Netherlands)

    van Beijsterveldt, C.E.M.; Boomsma, D.I.


    Several studies report caesarean section (CS) to be a risk factor for childhood asthma. We used data from a large cohort of 5-year-old twins to examine the relationship between mode of birth delivery and asthma. The extent to which an infant is exposed to maternal vaginal flora may protect against

  2. A retrospective multicenter study comparing metal-ceramic and composite single crowns performed in public general dentistry: 5-year results. (United States)

    Overmeer, Jennie; Narby, Birger; Hjalmarsson, Lars; Arnrup, Kristina; Eliasson, Alf


    Objective The aim of this study was to evaluate and compare the 5-year survival and complication rate of metal-ceramic (MC) and composite single crowns performed within Public Dental Service, general dentistry, in three Swedish counties and with patients' gender, tooth position, root canal treatment and the presence of a post-and-core taken into account. Methods Data were collected from dental records of 600 patients who had received either an MC (n = 300) or a composite (n = 300) crown on a premolar or molar tooth in the year 2005 and where 5 years of follow-up data were available. Status at treatment completion and at follow-up was recorded, together with any history of intervention during the follow-up period. Results The 5-year survival rate for MC crowns was higher than for composite crowns (93% versus 70%; p < 0.001). This difference was stable, irrespective of the county, patients' gender or tooth position. No gender difference in survival rate was seen for MC crowns, while the survival of composite crowns was significantly higher among women than among men (75% versus 65%; p < 0.05). For MC crowns, there was a tendency toward a lower survival rate for endodontically treated teeth without a post-and-core (83%) as compared to those provided with a post-and-core (93%) and to vital teeth (94%). Surviving composite crowns had recordings of significantly more complications than MC crowns (p < 0.001). Conclusion On premolars and molars, MC crowns have a better medium-term prognosis and fewer complications than composite crowns.

  3. Dopaminergic therapy and subthalamic stimulation in Parkinson's disease: a review of 5-year reports. (United States)

    Romito, Luigi M; Albanese, Alberto


    The long-term efficacy and safety of deep brain stimulation (DBS) implant for Parkinson's disease (PD) is described in several recent papers. This procedure has been reported to permit a stable reduction of dopaminergic therapy requirements for up to 5 years, although some expectation of deterioration in non-dopaminergic signs has been recently stated. Our aim is to perform a literature-based review of papers available describing long-term post-operative follow-up after a bilateral implant for subthalamic DBS (STN-DBS). Only peer-reviewed published papers with a post-operative follow-up of at least 5 years were considered. Clinical outcome, disease progression and side effects were assessed at baseline and 2 (or 3 years) and 5 years after surgery. Seven papers were included in the review. A total of 238 patients were analyzed. STN-DBS was confirmed to be an effective treatment for selected patients with PD. In all studies, off-related motor symptoms improved dramatically, compared with pre-implant, at 2 (or 3, according to the study) years and this result persisted at 5-year evaluations. Antiparkinsonian drug reductions, improvements in motor fluctuations and dyskinesias, functional measures and the progression of underlying PD were also reported in all series. Some axial scores, in particular postural stability and speech, improved transiently. Persisting adverse effects included eyelid opening apraxia, weight gain, psychiatric disorders, depression, dysarthria, dyskinesias, and apathy. The present review of the 5-year observations confirms that STN-DBS is a powerful method in the management of PD, but its long-term effects must be thoroughly assessed.

  4. Early EEG Grade and Outcome at 5 Years After Mild Neonatal Hypoxic Ischemic Encephalopathy. (United States)

    Murray, Deirdre M; O'Connor, Catherine M; Ryan, C Anthony; Korotchikova, Irina; Boylan, Geraldine B


    More than half of all infants with neonatal hypoxic ischemic encephalopathy (HIE) are graded as mild and do not meet current criteria for therapeutic hypothermia. These infants are often not enrolled in follow-up, and hence our knowledge of their long-term outcome is sparse. We wished to compare 5-year outcomes in a group of infants with mild, moderate, and severe HIE, graded with both early EEG and clinical assessment, none of whom were treated with therapeutic hypothermia. Term infants with HIE and a healthy comparison group were recruited at birth. Both groups had early continuous EEG recordings. Cognitive and motor outcome was assessed at 5 years. Outcome was available in 53 infants with HIE and 30 infants in the comparison group at 5 years. Infants with mild HIE at birth (n = 22) had significantly lower full-scale IQ, verbal IQ, and performance IQ than comparison infants (n = 30) at 5 years (P = .001, .001, and 0.004, respectively). No difference in cognitive measures was seen between infants with mild and moderate grades HIE. Intact survival at 5 years varied across EEG grade HIE at 6 hours after birth; 75% in mild, 46% in moderate, 43% in major abnormalities, and 0% with inactive EEGs, compared with 97% in the comparison group. Survivors of mild HIE, graded clinically or by early EEG, have higher rates of disability than their peers and have cognitive outcomes similar to that of children with moderate encephalopathy in an uncooled HIE cohort. Copyright © 2016 by the American Academy of Pediatrics.

  5. Predictive model for 5-year mortality after breast cancer surgery in Taiwan residents. (United States)

    Huang, Su-Hsin; Loh, Joon-Khim; Tsai, Jinn-Tsong; Houg, Ming-Feng; Shi, Hon-Yi


    Few studies of breast cancer surgery outcomes have used longitudinal data for more than 2 years. This study aimed to validate the use of the artificial neural network (ANN) model to predict the 5-year mortality of breast cancer patients after surgery and compare predictive accuracy between the ANN model, multiple logistic regression (MLR) model, and Cox regression model. This study compared the MLR, Cox, and ANN models based on clinical data of 3632 breast cancer patients who underwent surgery between 1996 and 2010. An estimation dataset was used to train the model, and a validation dataset was used to evaluate model performance. The sensitivity analysis was also used to assess the relative significance of input variables in the prediction model. The ANN model significantly outperformed the MLR and Cox models in predicting 5-year mortality, with higher overall performance indices. The results indicated that the 5-year postoperative mortality of breast cancer patients was significantly associated with age, Charlson comorbidity index (CCI), chemotherapy, radiotherapy, hormone therapy, and breast cancer surgery volumes of hospital and surgeon (all P < 0.05). Breast cancer surgery volume of surgeon was the most influential (sensitive) variable affecting 5-year mortality, followed by breast cancer surgery volume of hospital, age, and CCI. Compared with the conventional MLR and Cox models, the ANN model was more accurate in predicting 5-year mortality of breast cancer patients who underwent surgery. The mortality predictors identified in this study can also be used to educate candidates for breast cancer surgery with respect to the course of recovery and health outcomes.

  6. A 5-Year Follow-up Study on the Relationship between Obstructive Sleep Apnea and Parkinson Disease. (United States)

    Sheu, Jau-Jiuan; Lee, Hsin-Chien; Lin, Herng-Ching; Kao, Li-Ting; Chung, Shiu-Dong


    Sleep disturbances are among the most common nonmotor symptoms of Parkinson disease. However, no large epidemiological data regarding the association between obstructive sleep apnea (OSA) and Parkinson disease have been reported. The goal of this study was to investigate the risk for Parkinson disease during a 5-y follow-up period after a diagnosis of OSA using a population-based dataset. The data for this retrospective longitudinal cohort study were retrieved from the Taiwan Longitudinal Health Insurance Database 2000. We identified 1,532 patients with OSA as the study cohort and randomly selected 7,660 patients as the comparison cohort. Each subject was individually followed up for a 5-y period to identify those in whom Parkinson disease subsequently developed. Stratified Cox proportional hazard regressions were performed as a means of comparing the 5-y risk of subsequent Parkinson disease between the study cohort and comparison cohort. Of the 9,192 total patients, Parkinson disease developed in 0.73% during the 5-y follow-up period: 1.24% and 0.63% in the OSA and control cohorts, respectively. After censoring patients who died during the follow-up period and adjusting for socio-demographic characteristics, the hazard ratio (HR) of Parkinson disease during the 5-y follow-up period for patients with OSA was 2.26 (95% confidence interval [CI] = 1.32-3.88) compared with comparison patients. In addition, among females, the adjusted HR of Parkinson disease was 3.54 (95% CI = 1.50-8.34) for patients with OSA compared to patients without OSA. However, among males, there was no significantly increased hazard of Parkinson disease for patients with OSA compared to those without OSA. Female patients with OSA were found to be at a significant risk of subsequent Parkinson disease during a 5-y follow-up period. © 2015 American Academy of Sleep Medicine.

  7. A 5-Year Investigation of Children's Adaptive Functioning Following Conformal Radiation Therapy for Localized Ependymoma

    Energy Technology Data Exchange (ETDEWEB)

    Netson, Kelli L.; Conklin, Heather M. [Department of Psychology, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Wu Shengjie; Xiong Xiaoping [Department of Biostatistics, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Merchant, Thomas E., E-mail: [Division of Radiation Oncology, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States)


    Purpose: Conformal and intensity modulated radiation therapies have the potential to preserve cognitive outcomes in children with ependymoma; however, functional behavior remains uninvestigated. This longitudinal investigation prospectively examined intelligence quotient (IQ) and adaptive functioning during the first 5 years after irradiation in children diagnosed with ependymoma. Methods and Materials: The study cohort consisted of 123 children with intracranial ependymoma. Mean age at irradiation was 4.60 years (95% confidence interval [CI], 3.85-5.35). Serial neurocognitive evaluations, including an age-appropriate IQ measure and the Vineland Adaptive Behavior Scales (VABS), were completed before irradiation, 6 months after treatment, and annually for 5 years. A total of 579 neurocognitive evaluations were included in these analyses. Results: Baseline IQ and VABS were below normative means (P<.05), although within the average range. Linear mixed models revealed stable IQ and VABS across the follow-up period, except for the VABS Communication Index, which declined significantly (P=.015). Annual change in IQ (-.04 points) did not correlate with annual change in VABS (-.90 to +.44 points). Clinical factors associated with poorer baseline performance (P<.05) included preirradiation chemotherapy, cerebrospinal fluid shunt placement, number and extent of surgical resections, and younger age at treatment. No clinical factors significantly affected the rate of change in scores. Conclusions: Conformal and intensity modulated radiation therapies provided relative sparing of functional outcomes including IQ and adaptive behaviors, even in very young children. Communication skills remained vulnerable and should be the target of preventive and rehabilitative interventions.

  8. Results of a 5-year contraceptive trial in parous and nulliparous women with a new LNG-IUS. (United States)

    Wildemeersch, Dirk; Goldstuck, Norman D; Jackers, Geert


    To report on the contraceptive performance and continuation of a new T-shaped LNG-IUS, releasing 20 μg of levonorgestrel/day, in both parous and nulliparous nulliparous women after 5 years of use. An observational prospective contraceptive study conducted in parous and nulliparous women up to 48 years of age. The study was conducted in a sample size of 356 women of whom 67.1% were parous and 32.9% were nulliparous with mean age of 35.1 (range 15-48). The total cumulative observation period was 27 269 woman-months. Only one accidental pregnancy was observed and two expulsions were reported with no partial expulsions. There were 12.7% medical removals for abnormal bleeding, pain and other medical reasons, mostly not related to the use of the LNG-IUS, and 13.3% removals in women wishing to become pregnant. The discontinuation rate at 5 years amounts to 25.7% including women with pregnancy wish, who used the LNG-IUS for an average of 44 months. There were no serious adverse events (e.g. perforation, pelvic inflammatory disease). The LNG-IUS used in this study is highly effective and well tolerated resulting in a high continuation of use. The only two expulsions that occurred during the study is remarkable. The ease and safety of insertion together with optimal retention is considered an advance in intrauterine contraceptive device technology.

  9. Hylan GF-20 Viscosupplementation in the Treatment of Symptomatic Osteoarthritis of the Knee: Clinical Effect Survivorship at 5 Years. (United States)

    Boutefnouchet, Tarek; Puranik, Guru; Holmes, Esther; Bell, Karl M


    Controversies remain surrounding the choice of hyaluronic acid products and patient selection. A study was conducted to report the long-term survivorship of intra-articular injection effect of high molecular weight hyaluronic preparation hylan GF-20 (Synvisc-One) for patients with symptomatic knee osteoarthritis. A retrospective observational analysis of a single therapeutic series was carried out. The analysis was conducted to determine therapeutic effect survivorship taking arthroplasty and any other surgical interventions as endpoint results. Seventy-seven consecutive patients (82 knees) were followed up for five years. At one-year follow-up, 71 knees (87%) responded to treatment and only 8 knees (10%) were offered arthroplasty due to persistence of symptoms. At five-year follow-up, 41 (50%) were still considered responders. During the study period, repeat injection was given in 9 knees (11%). Arthroplasty (either total or unicompartmental) was required in 26 (31%). Kaplan-Meier survivorship analysis of therapeutic effect demonstrated 67% survival at 5 years with arthroplasty as endpoint and 58% survival at 5 years with all secondary interventions as endpoint. This study demonstrates a significantly longer duration of clinical benefit of hylan GF-20 injection. Present results may suggest a notion of an ideal delay therapeutic strategy for patients not ready to receive an arthroplasty. Further studies will be required to help characterise these subsets of patients.


    Directory of Open Access Journals (Sweden)

    Natalia Sergeyevna Morozova


    Full Text Available ABSTRACT Objectives: To compare the outcomes of surgical treatment with lumbar fixation using nitinol rods without fusion and with standard lumbar fixation with titanium rods and interbody fusion. Methods: Treatment results of 70 patients with degenerative lumbar scoliosis aged 40 to 82 were analyzed. In all cases pedicle screws and nitinol rods with a diameter of 5.5 mm were used. Thirty patients underwent fixation at L1-S1 and 40 patients underwent fixation at L1-L5. Spinal fusion was not performed. All patients had radiography, CT and MRI performed. The results were assessed according to the Oswestry scale, SRS 22, SF 36 and VAS. The minimum follow-up period for all patients was 2.5 years. For the control group, consisting of 72 patients, pedicle fixation with titanium rods and interbody fusion in the lumbosacral region were performed. Results: The average level of deformity correction equaled 25° (10° - 38°. The analysis of X-ray and CT-scans revealed a single patient with implant instability, two patients with bone resorption around the screws and one patient with rod fractures. Functional radiography 2.5 years after surgery showed an average mobility of the lumbar spine of 21° (15° - 30°. There were no problems at the adjacent levels. Conclusions: The use of nitinol rods in spinal deformity surgery is promising. This technology is an alternative to rigid fixation. Continued gathering of clinical data and its further evaluation is necessary.

  11. Proximal First Metatarsal Osteotomy and Mc Bride Procedure in Hallux Valgus: 5-years results of 25 cases

    Directory of Open Access Journals (Sweden)

    Ali Yeganeh


    Full Text Available More than 130 operations have been described for the treatment of hallux valgus, However, no evidence that any of these methods of treatment are superior to the others has been described, excepting studies in the long term. The aim of this study was to analyse a series of patients who had undergone Proximal osteotomy of first metatarsal and Mc Bride procedure and had been followed up for 5 years. In This prospective study During a 6 years period, (2005-2010, 25 feet in 24 cases with hallux valgus underwent Proximal first metatarsal osteotomy and MCbride procedure, With a mean follow-up of 3/5±1/5 years. The cases were evaluated by American Orthopaedics Foot & Ankle Society HalluxMetatarsophalangeal-interphalangeal scale (AOFAS/HMI. Pre and post hallux valgus angle (HVA, intermetatarsal angle (1-2IMA, and the correlation between the angles and patient satisfaction were statistically evaluated. The mean angular corrections for hallux valgus (HVA, and intermetatarsal angle (IMA were 28 and 10/6 degrees respectively. 13 Patients reported good to excellent results, while in 11 cases dissatisfaction were reported. Proximal first metatarsal osteotomy and Mc Bride procedure for hallux valgus is an acceptable procedure in Patients with hallux valgus deformity correction.Pain and first MTP joint contractures are two main side effects.

  12. Randomized Comparison of Uterine Artery Embolization (UAE) with Surgical Treatment in Patients with Symptomatic Uterine Fibroids (REST Trial): Subanalysis of 5-Year MRI Findings

    Energy Technology Data Exchange (ETDEWEB)

    Ananthakrishnan, Ganapathy, E-mail: [Gartnavel General Hospital, Department of Interventional Radiology (United Kingdom); Murray, Lilian, E-mail: [Vital Statistics (United Kingdom); Ritchie, Moira, E-mail: [Gartnavel General Hospital, Department of Interventional Radiology (United Kingdom); Murray, Gordon, E-mail: [Centre for Population Health Sciences, University of Edinburgh, Department of Medical Statistics (United Kingdom); Bryden, Fiona, E-mail: [Stobhill Hospital (United Kingdom); Lassman, Sue, E-mail: [Gartnavel General Hospital, Department of Interventional Radiology (United Kingdom); Lumsden, Mary Ann, E-mail: [Room 12, Level 4, Walton Building, Department of Medical Education and Gynaecology, Reproductive and Maternal Medicine (United Kingdom); Moss, Jon G., E-mail: [Gartnavel General Hospital, Department of Interventional Radiology (United Kingdom)


    Purpose. To report 5-year contrast-enhanced magnetic resonance imaging findings of the REST trial recruits who underwent either uterine artery embolization (UAE) or myomectomy. Methods. A total of 157 patients were randomized to UAE or surgery (hysterectomy or myomectomy). Ninety-nine patients who had UAE and eight patients who had myomectomy were analyzed. MRI scans at baseline, 6 months, and 5 years were independently interpreted by two radiologists. Dominant fibroid diameter, uterine volume, total fibroid infarction (complete 100 %, almost complete 90-99 %, partial <90 %), and new fibroid formation were the main parameters assessed and related to the need for reintervention. Results. In the UAE group, mean {+-} standard deviation uterine volume was 670 {+-} 503, 422 {+-} 353, and 292 {+-} 287 mL at baseline, 6 months, and 5 years, respectively. Mean dominant fibroid diameter was 7.6 {+-} 3.0, 5.8 {+-} 2.9, and 5 {+-} 2.9 cm at baseline, 6 months, and 5 years. Fibroid infarction at 6 months was complete in 35 % of women, almost complete in 29 %, and partial in 36 %. Need for reintervention was 19, 10, and 33 % in these groups, respectively (p = 0.123). No myomectomy cases had further intervention. At 5 years, the prevalence of new fibroid was 60 % in the myomectomy group and 7 % in the UAE group (p = 0.008). Conclusion. There is a further significant reduction in both uterine volume and dominant fibroid diameter between 6 months and 5 years after UAE. Complete fibroid infarction does not translate into total freedom from a subsequent reintervention. New fibroid formation is significantly higher after myomectomy.

  13. Early determinants of overweight at 4.5 years in a population-based longitudinal study. (United States)

    Dubois, L; Girard, M


    The roots of the obesity epidemic need to be traced back as early in life as possible in order to develop effective means for preventing obesity and its health consequences in the future. The aim of this paper is to examine a broad range of factors that may simultaneously contribute to childhood overweight in a population-based cohort of children followed from birth to 4.5 years, to determine which factors exert the most influence in early life. The analyses were performed using data from the Quebec Longitudinal Study of Child Development 1998-2002 (QLSCD). The study follows a representative sample (n=2103) of children born in 1998 in the Canadian province of Quebec. Measured height and weight were available for 1550 children aged 4.5 years. At 4.5 years, BMI was analyzed using the US CDC sex- and age-specific growth charts. In order to study children at their highest weights at various ages, odds ratios were presented for high birth weight, weight-for-stature at or above the 95th percentile at 5 months, and BMI at or above the 95th percentile at 4.5 years. Monthly weight gain between birth and five months has been analyzed. Children were also evaluated by the Z-score obtained from the standardized weight divided by height. Factors potentially related to children's weight include sex, gestational age and birth rank, breastfeeding, mothers' smoking status during pregnancy, family type at child's birth, and family income before pregnancy and when the children were 5 months and 4.5 years old. Other parental factors such as height and overweight/obesity (based on BMI) and other maternal factors (age, education, immigrant status) were also part of the analysis. Being in the highest quintiles of weight gain between birth and 5 months, as well as maternal smoking during pregnancy, almost double the odds of being overweight at 4.5 years. Parental overweight or obesity also increased the odds of being overweight at this age, as well as being raised in middle-income or in

  14. Situational analysis and future directions of AYUSH: An assessment through 5-year plans of India. (United States)

    Samal, Janmejaya


    AYUSH is an acronym for Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy. These are the six indigenous systems of medicine practiced in India. A department called Department of Indian System of medicine was created in March 1995 and renamed to AYUSH in November 2003 with a focus to provide increased attention for the development of these systems. Very recently, in 2014, a separate ministry was created under the union Government of India, which is headed by a minister of state. Planning regarding these systems of medicine was a part of 5-year planning process since 1951. Since then many developments have happened in this sector albeit the system was struggling with a great degree of uncertainty at the time of 1(st)5-year plan. A progressive path of development could be observed since the first to the 12(th)5-year plan. It was up to the 7(th)plan the growth was little sluggish and from 8(th)plan onward the growth took its pace and several innovative development processes could be observed thereafter. The system is gradually progressing ahead with a vision to be a globally accepted system, as envisaged in 11(th)5-year plan. Currently, AYUSH system is a part of mainstream health system implemented under National Rural Health Mission (NRHM). NRHM came into play in 2005 but implemented at ground level in 2006 and introduced the scheme of "Mainstreaming of AYUSH and revitalization of local health traditions" to strengthen public health services. This scheme is currently in operation in its second phase, since 1(st)April 2012, with the 12(th)5-year plan. The scheme was primarily brought in to operation with three important objectives; choice of treatment system to the patients, strengthen facility functionally and strengthen the implementation of national health programmes, however, in some places it seems to be a forced medical pluralism owing to a top-down approach by the union government without considerable involvement of the concerned community. In this

  15. Relationship between persistent pain and 5-year mortality: a population-based prospective cohort study. (United States)

    Shega, Joseph W; Andrew, Melissa; Kotwal, Ashwin; Lau, Denys T; Herr, Keela; Ersek, Mary; Weiner, Debra K; Chin, Marshall H; Dale, William


    To assess the association between self-reported noncancer pain and 5-year mortality. Cohort. Community-dwelling older adults. Canadian Study of Health and Aging 1996 wave. Registrar of Vital Statistics-established 5-year mortality. Noncancer pain was assessed using the 5-point verbal descriptor scale, dichotomized into no or very mild versus moderate, severe, or very severe pain. Frailty was the accumulation of health deficits. Cognitive status (Modified Mini-Mental State Examination) and depressed mood (five-item mental health screening questionnaire) were also assessed. Multivariable logistic regression and Cox proportional hazards were used to analyze the relationship between pain and 5-year mortality. Of 5,703 participants, 4,694 (82.3%) had complete data for analysis; 1,663 of these (35.4%) reported moderate, severe, or very severe pain, and 1,343 (28.6%) had died at 5-year follow-up. Four hundred ninety-six of those who died (29.8%) reported moderate, severe, or very severe pain and 847 (27.9%) no or very mild pain. Multivariate logistic analysis found that individuals with moderate, severe, or very severe pain had lower odds of 5-year mortality than those with no or very mild pain (odds ratio=0.78, 95% confidence interval (CI)=0.66-0.92; P<.001). The risk of death was lower in persons reporting moderate or greater pain than in those with no or very mild pain (HR=0.85, 95% CI=0.75-0.96; P=.01). An interaction between pain and sex explained this effect. Men with pain were not significantly more likely than men without pain to die (HR=1.00, 95% CI=0.84-1.19; P=.99), whereas women without pain (HR=0.54, 95% CI=0.47-0.63; P<0.01) and women with pain (HR=0.40; CI=0.33-0.47; P<.01) had less risk of death than men without and with pain, respectively. Older women with pain were less likely to die within 5 years than older women without pain, men in pain, or men without pain. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

  16. Convergent and incremental predictive validity of clinician, self-report, and structured interview diagnoses for personality disorders over 5 years. (United States)

    Samuel, Douglas B; Sanislow, Charles A; Hopwood, Christopher J; Shea, M Tracie; Skodol, Andrew E; Morey, Leslie C; Ansell, Emily B; Markowitz, John C; Zanarini, Mary C; Grilo, Carlos M


    Research has demonstrated poor agreement between clinician-assigned personality disorder (PD) diagnoses and those generated by self-report questionnaires and semistructured diagnostic interviews. No research has compared prospectively the predictive validity of these methods. We investigated the convergence of these 3 diagnostic methods and tested their relative and incremental validity in predicting independent, multimethod assessments of psychosocial functioning performed prospectively over 5 years. Participants were 320 patients in the Collaborative Longitudinal Personality Disorders Study diagnosed with PDs by therapist, self-report, and semistructured interview at baseline. We examined the relative incremental validity of therapists' naturalistic ratings relative to these other diagnostic methods for predicting psychosocial functioning at 5-year follow-up. Hierarchical linear regression analyses revealed that both the self-report questionnaire and semistructured interview PD diagnoses had significant incremental predictive validity over the PD diagnoses assigned by a treating clinician. Although, in some cases, the clinicians' ratings for individual PDs did have validity for predicting subsequent functioning, they did not generally provide incremental prediction beyond the other methods. These findings remained robust in a series of analyses restricted to a subsample of therapist ratings based on clinical contact of 1 year or greater. These results from a large clinical sample echo previous research documenting limited agreement between clinicians' naturalistic PD diagnoses and those from self-report and semistructured interview methods. They extend prior work by providing the first evidence about the relative predictive validity of these different methods. Our findings challenge the validity of naturalistic PD diagnoses and suggest the use of structured diagnostic instruments. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  17. Maternal and early postnatal nutrition and mental health of offspring by age 5 years: a prospective cohort study. (United States)

    Jacka, Felice N; Ystrom, Eivind; Brantsaeter, Anne Lise; Karevold, Evalill; Roth, Christine; Haugen, Margaretha; Meltzer, Helle Margrete; Schjolberg, Synnve; Berk, Michael


    Diet quality is related to the risk for depression and anxiety in adults and adolescents; however, the possible impact of maternal and early postnatal nutritional exposures on children's subsequent mental health is unexplored. The large prospective Norwegian Mother and Child Cohort Study recruited pregnant women between 1999 and 2008. Data were collected from mothers during pregnancy and when children were 6 months and 1.5, 3, and 5 years of age. Latent growth curve models were used to model linear development in children's internalizing and externalizing problems from 1.5 to 5 years of age as a function of diet quality during pregnancy and at 1.5 and 3 years. Diet quality was evaluated by dietary pattern extraction and characterized as "healthy" or "unhealthy." The sample comprised 23,020 eligible women and their children. Adjustments were made for variables including sex of the child, maternal depression, maternal and paternal age, maternal educational attainment, household income, maternal smoking before and during pregnancy, mothers' parental locus of control, and marital status. Higher intakes of unhealthy foods during pregnancy predicted externalizing problems among children, independently of other potential confounding factors and childhood diet. Children with a high level of unhealthy diet postnatally had higher levels of both internalizing and externalizing problems. Moreover, children with a low level of postnatal healthy diet also had higher levels of both internalizing and externalizing problems. Among this large cohort of mothers and children, early nutritional exposures were independently related to the risk for behavioral and emotional problems in children. Copyright © 2013 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  18. Measles Antibody Titres In 0-5 Years Children At Aligarh

    Directory of Open Access Journals (Sweden)

    Kandpal S D


    Full Text Available Research Question: What is the level of measles antibodies in 0-5 year children? Objectives: 1.To assess the pattern of decline of maternal antibodies in 0-9 months infants. 2. To estimate the seropositivity for measles antibodies in vaccinated 9 months infants. Study design: Cross- sectional. Setting: Rural areas of District Aligarh, U.P. Participants: 456 children in the age group of 0-5 years. Statistical analysis: Percentages, correlation coefficient. Results: 1. In all the study subjects below 9 months of age, the transplacentally acquired maternal measles antibodies showed a linear decline with increase in age. Out of 202 study subjects who had been immunized against measles 195(96.50% were seropositive and 7(3.5% were seronegative for measles antibodies.

  19. Short communication. Growth and nodulation of cowpea after 5 years of consecutive composted tannery sludge amendment

    Directory of Open Access Journals (Sweden)

    Ana R. L. Miranda


    Full Text Available Tannery industry releases high amounts of tannery sludge which are currently composted and used in agricultural soils. The consecutive amendment of such composted tannery sludge (CTS may affect soil microrganisms, such as rhizobia. In this study, we evaluated the effects of 5-year repeated CTS amendment on growth, nodulation, and yield of cowpea (Vigna unguiculata L. CTS was applied in different amounts (0, 2.5, 5, 10 and 20 Mg/ha to a sandy soil. Amendment of CTS increased soil pH, electrical conductivity (EC, sodium and chromium content. Plant growth, nodulation, N accumulation, and cowpea yield increased up to 10 Mg/ha; however, above this rate, these variables decreased. After 5 years of CTS amendment, the increase in soil chemical properties, particularly EC and Na content, exerted negative effects on the growth, nodulation, and yield of cowpea.

  20. Safety and efficacy of tiotropium in children aged 1-5 years with persistent asthmatic symptoms

    DEFF Research Database (Denmark)

    Vrijlandt, Elianne J L E; El Azzi, Georges; Vandewalker, Mark


    : This exploratory 12-week, randomised, double-blind, placebo-controlled, parallel-group, phase 2/3, regulatory multicentre trial was done at 32 hospitals, clinics, and clinical research units in 11 countries in Asia, Europe, and North America. Children aged 1-5 years with at least a 6-month history of persistent...... asthmatic symptoms and a need for inhaled corticosteroids were eligible. Patients were randomly allocated using an interactive voice or web-based response system to receive once-daily tiotropium 2·5 μg, tiotropium 5 μg, or placebo as an add-on to inhaled corticosteroids with or without additional controller....... INTERPRETATION: To our knowledge, our small study is the first to assess the safety and efficacy of tiotropium in children aged 1-5 years with persistent asthmatic symptoms. Tolerability of tiotropium was similar to that of placebo, which is consistent with previous findings in older populations. Although mean...

  1. Estimated exposures to perfluorinated compounds in infancy predict attenuated vaccine antibody concentrations at age 5-years

    DEFF Research Database (Denmark)

    Grandjean, Philippe; Heilmann, Carsten; Weihe, Pal


    Perfluorinated alkylate substances (PFASs) are highly persistent and may cause immunotoxic effects. PFAS-associated attenuated antibody responses to childhood vaccines may be affected by PFAS exposures during infancy, where breastfeeding adds to PFAS exposures. Of 490 members of a Faroese birth...... cohort, 275 and 349 participated in clinical examinations and provided blood samples at ages 18 months and 5 years. PFAS concentrations were measured at birth and at the clinical examinations. Using information on duration of breastfeeding, serum-PFAS concentration profiles during infancy were estimated......, with decreases by up to about 20% for each two-fold higher exposure, while associations for serum concentrations at ages 18 months and 5 years were weaker. Modeling of serum-PFAS concentration showed levels for age 18 months that were similar to those measured. Concentrations estimated for ages 3 and 6 months...

  2. Separable sustained and selective attention factors are apparent in 5-year-old children

    DEFF Research Database (Denmark)

    Underbjerg, Mette; George, Melanie S; Thorsen, Poul


    In adults and older children, evidence consistent with relative separation between selective and sustained attention, superimposed upon generally positive inter-test correlations, has been reported. Here we examine whether this pattern is detectable in 5-year-old children from the healthy...... of attention at the age of 5 with the results reflecting a similar factor structure to that obtained in older children and adults. The results are discussed in light of contemporary models of attention function. Given the potential advantages of early intervention for attention difficulties, the findings...... population. A new test battery (TEA-Ch(J)) was adapted from measures previously used with adults and older children and administered to 172 5-year-olds. Test-retest reliability was assessed in 60 children. Ninety-eight percent of the children managed to complete all measures. Discrimination of visual...

  3. Cardiovascular Risk Factors and 5-year Mortality in the Copenhagen Stroke Study

    DEFF Research Database (Denmark)

    Kammersgaard, Lars Peter; Olsen, Tom Skyhøj


    BACKGROUND: The treatment of cardiovascular risk factors has improved over the recent years and may have improved survival. The aim of this study was to investigate the up-to-date prognostic significance of cardiovascular risk factors for 5-year survival in a large unselected ischemic stroke...... and questionnaire for cardiovascular risk factors, age, and sex. Follow-up was performed 5 years after stroke, and data on mortality were obtained for all, except 6, who had left the country. Five-year mortality was calculated by the Kaplan-Meier procedure and the influence of multiple predictors was analyzed...... by Cox proportional hazards analyses adjusted for age, gender, stroke severity, and risk factor profile. RESULTS: In Kaplan-Meier analyses atrial fibrillation (AF), ischemic heart disease, diabetes, and previous stroke were associated with increased mortality, while smoking and alcohol intake were...

  4. Screw fixation for atlantoaxial dislocation related to Down syndrome in children younger than 5 years. (United States)

    Ito, Kenyu; Imagama, Shiro; Ito, Zenya; Ando, Kei; Kobayashi, Kazuyoshi; Hida, Tetsuro; Ishikawa, Yoshimoto; Ishiguro, Naoki


    The aim of this study was to present cases of upper cervical fixation in Down syndrome patients younger than 5 years. In two cases, C1 lateral mass screws were installed. However, owing to the irreducible atlantoaxial dislocation, the screw backed out and fractured. Therefore, O-C2 fusion was performed. Furthermore, C2 bilateral lamina screws were added to the C2 pedicle screw for reinforcement. C1-C2 fusion is an option for Down syndrome patients younger than 5 years with atlantoaxial dislocation, when the dislocation is reducible. If the dislocation is irreducible, or the implant cannot be firmly secured, the fixation range should be expanded to O-C2 or below.

  5. Cardiovascular risk factors and 5-year mortality in the Copenhagen Stroke Study

    DEFF Research Database (Denmark)

    Kammersgaard, Lars Peter; Olsen, Tom Skyhøj


    BACKGROUND: The treatment of cardiovascular risk factors has improved over the recent years and may have improved survival. The aim of this study was to investigate the up-to-date prognostic significance of cardiovascular risk factors for 5-year survival in a large unselected ischemic stroke...... and questionnaire for cardiovascular risk factors, age, and sex. Follow-up was performed 5 years after stroke, and data on mortality were obtained for all, except 6, who had left the country. Five-year mortality was calculated by the Kaplan-Meier procedure and the influence of multiple predictors was analyzed...... by Cox proportional hazards analyses adjusted for age, gender, stroke severity, and risk factor profile. RESULTS: In Kaplan-Meier analyses atrial fibrillation (AF), ischemic heart disease, diabetes, and previous stroke were associated with increased mortality, while smoking and alcohol intake were...

  6. Predicting an asthma exacerbation in children 2 to 5 years of age

    DEFF Research Database (Denmark)

    Swern, A.S.; Tozzi, C.A.; Knorr, B.


    BACKGROUND: Asthma exacerbations in young children are prevalent. Identification of symptoms or other factors that are precursors of asthma exacerbations would be useful for early treatment and prevention. OBJECTIVES: To determine whether diary symptoms and beta2-agonist use before an exacerbation...... could predict an asthma exacerbation in children 2 to 5 years of age. METHODS: Post hoc analyses were conducted on data collected in a study of 689 patients 2 to 5 years of age with asthma symptoms, randomly assigned to montelukast, 4 mg, or placebo daily for 12 weeks. During the study, 196 patients had...... an exacerbation. Caregiver-reported information (daytime cough, breathing difficulties, limitation of activity, nighttime cough or awakening, daytime and nighttime beta2-agonist use) were analyzed using general estimating equations with an exchangeable within-subject log odds ratio regression structure...

  7. External validation of a 5-year survival prediction model after elective abdominal aortic aneurysm repair. (United States)

    DeMartino, Randall R; Huang, Ying; Mandrekar, Jay; Goodney, Philip P; Oderich, Gustavo S; Kalra, Manju; Bower, Thomas C; Cronenwett, Jack L; Gloviczki, Peter


    The benefit of prophylactic repair of abdominal aortic aneurysms (AAAs) is based on the risk of rupture exceeding the risk of death from other comorbidities. The purpose of this study was to validate a 5-year survival prediction model for patients undergoing elective repair of asymptomatic AAA .05 indicating goodness of fit). Across different populations of patients, assessment of age and level of cardiac, pulmonary, and renal disease can accurately predict 5-year survival in patients with AAA <6.5 cm undergoing repair. This risk prediction model is a valid method to assess mortality risk in determining potential overall survival benefit from elective AAA repair. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  8. Body, coping and self-identity. A qualitative 5-year follow-up study of stroke

    DEFF Research Database (Denmark)

    Pallesen, Hanne


    method. A total of 10 men and 5 women, aged 42-84, participated. All had suffered first-time stroke 5 years earlier. Results: After 5 years, participants had greater acceptance of their situation compared with immediately after participating in the rehabilitation programme. However, they described how...... they still had to deal with the consequences of stroke. They had suffered further illnesses and additions to side effects of the stroke. In dealing with their disabilities and changes to self-identity and life patterns, they seemed to be in a continuous process of change that never truly stabilised....... They coped with this continuous process in at least two different ways, including resignation or personal growth. Conclusion: Stroke survivors suffered considerable ongoing and changing difficulties in relation to disability, self-perception and to coping with a new life. This continuous process of change...

  9. [Bilateral blindness and visual impairment in children aged 0-5 years in the women's and children's hospital of Yaounde]. (United States)

    Bella, Lucienne Assumpta; Eballea, André Omgbwa; Kouam, Jeanne Mayouego


    A retrospective study covering the period from March 2002 to December 2008 at the Yaounde Women's and Children's Hospital sought to identify the causes of blindness and severe visual impairment in children younger than 5 years old. Of the 55 cases recorded (prevalence: 2.4%), 33 patients were boys and 22 girls. Total blindness were found among 69% of the group, while 31% had severe visually impairment. The most frequent anatomical sites of the disease leading to blindness and severe visual impairment were the lens (27.3%), the visual cortex (25.5%) and the retina (14.5 %). As the initial prognosis is severe, close collaboration between all those responsible for these children must be set up to enable early specialised management and education.

  10. Motor vehicle collisions and their demographics: a 5-year retrospective study of the Hamilton-Wentworth Niagara region. (United States)

    Lemieux, Carolyne E; Fernandes, John R; Rao, Chitra


    This retrospective study examined population demographics associated with motor vehicle collision (MVC) fatalities over a 5-year period in the Hamilton-Wentworth Niagara region. Variables were drawn from the five factors proposed by Fierro (1) for investigating deaths caused by transportation: human, chemical, environmental, vehicular, and highway. Factors analyzed included age, gender, position to the vehicle, site(s) of injury, toxicology, environmental contributors, and vehicular findings. From 1999 to 2004, there were 321 MVC fatalities that primarily involved males 20 to 29 years of age and commonly drivers or pedestrians. Cars and trucks were the most frequent vehicles. Fatalities occurred most often on local and regional roads on Fridays and Sundays between 6 pm and 6 am. Mechanical failure and weather conditions were not significant contributors. Toxicological analyses (275/321) were performed on the majority of the study population. Ethanol was present in isolation and with other substances, especially cannabis, mostly in male drivers 20-59 years of age.

  11. Vitamin D stored in fat tissue during a 5-year intervention affects serum 25-hydroxyvitamin D levels the following year

    DEFF Research Database (Denmark)

    Martinaityte, Ieva; Kamycheva, Elena; Didriksen, Allan


    Research Unit at The University Hospital of North Norway. 76 subjects were included after participation in a 3-5 year prevention of type 2 diabetes study, and were administered 20,000 IU of vitamin D or placebo / week. During the 12-month follow-up period, blood samples were drawn at the beginning....... At the inclusion mean serum 25(OH)D levels were 122 and 71 nmol/L in vitamin D and placebo groups, respectively. Serum 25(OH)D remained significantly higher in the vitamin D group compared to the placebo group throughout, and was 84.5 and 73.1 nmol/L, respectively after 12 months. In the vitamin D group, adipose...

  12. A 5-year prospective study of single-tooth replacements supported by the Astra Tech implant: a pilot study

    DEFF Research Database (Denmark)

    Gotfredsen, Klaus


    BACKGROUND: Implant-supported single-tooth replacements are an increasingly used method to replace teeth, especially in young patients. Therefore, long-term validation of different treatment modalities with different implant systems is of great importance. PURPOSE: The aim of the present study...... was to make a biologic, technical, and aesthetic evaluation of single-tooth replacement supported by the Astra Tech implant (Astra Tech AB, Mölndal, Sweden) during a 5-year period. MATERIALS AND METHODS: Twenty patients were divided into two consecutively treated groups. In group A the implants were placed...... "early" in the extraction sockets, and standard single-tooth abutments were used. In group B the implants were placed "delayed," and preparable abutments were used. Clinical examinations including registration of plaque, bleeding, crown lengths, soft tissue marginal level, papilla height, complications...

  13. Learn from the burn: The High Park Fire 5 years later (United States)

    Sue Miller; Charles Rhodes; Pete Robichaud; Sandra Ryan; Jen Kovecses; Carl Chambers; Sara Rathburn; Jared Heath; Stephanie Kampf; Codie Wilson; Dan Brogan; Brad Piehl; Mary Ellen Miller; John Giordanengo; Erin Berryman; Monique Rocca


    It has been 5 years since the High Park Fire burned over 85,000 acres in Northern Colorado, causing extensive property damage, loss of life, and severe impacts to the water quality of the Poudre River. In the fall of 2016, a conference was organized by the USFS Rocky Mountain Research Station and the Coalition for the Poudre River Watershed to discuss what has been...

  14. A 5-year journey with cutis laxa in an Indian child: The de barsy syndrome revisited

    Directory of Open Access Journals (Sweden)

    Abhijit Dutta


    Full Text Available De Barsy syndrome (DBS, synonymously known as autosomal recessive cutis laxa type III, is an extremely rare condition clinically characterized by cutis laxa, a progeroid appearance, and ophthalmologic abnormalities. We present here an account of 5-year follow-up since the birth of an Indian boy with DBS, who had a few rare and unusual manifestations. In addition, our case probably represents the first reported case of DBS from India.

  15. Prenatal Lead Exposure and Weight of 0- to 5-Year-Old Children in Mexico City


    Afeiche, Myriam; Peterson, Karen E.; S?nchez, Brisa N.; Cantonwine, David; Lamadrid-Figueroa, H?ctor; Schnaas, Lourdes; Ettinger, Adrienne S.; Hern?ndez-Avila, Mauricio; Hu, Howard; T?llez-Rojo, Martha M.


    Background: Cumulative prenatal lead exposure, as measured by maternal bone lead burden, has been associated with smaller weight of offspring at birth and 1 month of age, but no study has examined whether this effect persists into early childhood. Objective: We investigated the association of perinatal maternal bone lead, a biomarker of cumulative prenatal lead exposure, with children?s attained weight over time from birth to 5 years of age. Methods: Children were weighed at birth and at seve...

  16. Cohort Study of Severe Bronchiolitis during Infancy and Risk of Asthma by Age 5 Years. (United States)

    Balekian, Diana S; Linnemann, Rachel W; Hasegawa, Kohei; Thadhani, Ravi; Camargo, Carlos A

    Severe bronchiolitis (ie, bronchiolitis requiring hospital admission) is thought to markedly increase asthma risk, with 30%-50% developing asthma by age 5 years. To date, studies of this association are small, and most are from outside the United States. The objective of this study was to investigate the association between severe bronchiolitis and risk of asthma in a US birth cohort. We studied a cohort nested within the Massachusetts General Hospital Obstetric Maternal Study (MOMS), a prospective cohort of pregnant women enrolled during 1998-2006. Children of mothers enrolled in MOMS were included in the analysis if they received care within our health system (n = 3653). Diagnoses and medications were extracted from the children's electronic health records; we also examined pregnancy and perinatal risk factors collected for the underlying pregnancy study. The birth cohort was 52% male, 49% white, and 105 infants (2.9%) had severe bronchiolitis. Overall, 421 children (11.5%) developed asthma by age 5 years. Among the children with severe bronchiolitis, 27.6% developed asthma by age 5 years. In multivariable logistic regression adjusting for 12 risk factors, severe bronchiolitis remained a strong risk factor for developing asthma by age 5 years (odds ratio 2.57; 95% confidence interval 1.61-4.09). In a large Boston birth cohort, the frequency of severe bronchiolitis and childhood asthma was similar to published data. Among children with severe bronchiolitis, the risk of developing asthma was lower than prior studies but still high (27.6%). This difference may be due to different study designs, populations, and outcome definitions studied. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  17. Polaris the Cepheid returns: 4.5 years of monitoring from ground and space


    Bruntt, H.; Evans, N. R.; Stello, D.; Penny, A. J.; Eaton, J. A.; Buzasi, D. L.; Sasselov, D. D.; Preston, H. L.; Miller-Ricci, E.


    We present the analysis of 4.5 years of nearly continuous observations of the classical Cepheid Polaris, which comprise the most precise data available for this star. We have made spectroscopic measurements from ground and photometric measurements from the WIRE star tracker and the SMEI instrument on the Coriolis satellite. Measurements of the amplitude of the dominant oscillation (P = 4 days), that go back more than a century, show a decrease from 120 mmag to 30 mmag (V magnitude) around the...

  18. Development and verification of child observation sheet for 5-year-old children. (United States)

    Fujimoto, Keiko; Nagai, Toshisaburo; Okazaki, Shin; Kawajiri, Mie; Tomiwa, Kiyotaka


    The aim of the study was to develop a newly devised child observation sheet (COS-5) as a scoring sheet, based on the Childhood Autism Rating Scale (CARS), for use in the developmental evaluation of 5-year-old children, especially focusing on children with autistic features, and to verify its validity. Seventy-six children were studied. The children were recruited among participants of the Japan Children's Cohort Study, a research program implemented by the Research Institute of Science and Technology for Society (RISTEX) from 2004 to 2009. The developmental evaluation procedure was performed by doctors, clinical psychologists, and public health nurses. The COS-5 was also partly based on the Kyoto Scale of Psychological Development 2001 (Kyoto Scale 2001). Further, the Developmental Disorders Screening Questionnaire for 5-Years-Olds, PDD-Autism Society Japan Rating Scale (PARS), doctor interview questions and neurological examination for 5-year-old children, and the Draw-a-Man Test (DAM) were used as evaluation scales. Eighteen (25.4%) children were rated as Suspected, including Suspected PDD, Suspected ADHD and Suspected MR. The COS-5 was suggested to be valid with favorable reliability (α=0.89) and correlation with other evaluation scales. The COS-5 may be useful, with the following advantages: it can be performed within a shorter time frame; it facilitates the maintenance of observation quality; it facilitates sharing information with other professions; and it is reliable to identify the autistic features of 5-year-old children. In order to verify its wider applications including the screening of infants (18months to 3years old) by adjusting the items of younger age, additional study is needed. Copyright © 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  19. Thinning cherry-maple stands in West Virginia: 5-year results (United States)

    Neil I. Lamson; H. Clay. Smith; H. Clay. Smith


    In northern West Virginia, 60-year-old cherry-maple stands were thinned to 75,60, and 45 percent relative stand density. Analysis of 5-year growth data showed that basal-area growth was not reduced by thinning. Cubic-foot and board-foot volume growth decreased slightly. Individual-tree growth of all trees, dominant/codominant trees, and the 50 largest diameter trees...

  20. Multiple maxillary and mandibular supernumerary teeth in twins: 5-year follow-up


    Liu, Jeng-Fen; Chen, Hui-Ling


    This is a case report of multiple supernumerary teeth of identical twins with 5 years of follow-up. The occurrence of supernumerary teeth in twins is an unusual event. This case report describes 7-year-old Taiwanese twin brothers who both presented with multiple supernumerary teeth in the premaxillary and mandibular premolar regions. The supernumerary premolars developed much later than the premaxillary supernumerary teeth in these twins. The supernumerary premolars caused impaction of the ma...

  1. Cartilaginous avulsion fracture of the tibial spine in a 5-year-old girl

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Ryul; Song, Ji Hun; Lee, Ju Hong [Chonbuk National University, Medical School, Department of Orthopaedic Surgery, Jeonju (Korea); Lee, Sang Yong [Chonbuk National University, Medical School, Department of Diagnostic Radiology, Jeonju (Korea); Yoo, Wan Hee [Chonbuk National University, Medical School, Department of Rheumatology, Jeonju (Korea)


    Fractures of the tibial spine usually occur in children aged 8 to 14 years. Usually, radiographs will demonstrate a tibial spine fracture, with the degree of displacement. Tibial spine fractures in younger children have not been reported in the previously published literature. We report a tibial spine fracture that occurred in 5-year-old girl. The cartilaginous avulsion fracture of the tibial spine was not revealed by radiographs because it was limited to the cartilaginous portion of the proximal tibia. (orig.)

  2. Fusiform aneurysms detected 5 years after removal of an atrial myxoma

    Energy Technology Data Exchange (ETDEWEB)

    Oguz, K.K.; Firat, M.M.; Cila, A. [Radiology Dept., Hacettepe Univ., Ankara (Turkey)


    Neurological signs frequently accompany atrial myxomas. Association of multiple cerebral aneurysms in patients with atrial myxomas are less common than embolic infarctions. The development of aneurysms years after the cardiac tumor removal is rare, and few MR images have been reported to date. A case of multiple peripheral fusiform aneurysms detected 5 years after tumor resection is presented in this report, together with MR images and CT and angiographic images. (orig.)

  3. Socioeconomic status and changes in body mass from 3 to 5 years


    De Spiegelaere, M; Dramaix, M.; Hennart, P.


    The influence of social status on the development of body mass was analysed in a retrospective cohort study of 675 Belgian children monitored between the ages of 3 and 5 years by the preventive medical services in Brussels. At age 3, no association between excess weight and social status was observed. Adiposity rebound before age 5 was inversely related to body mass at age 3 and was independent of social status. The social influences on obesity observed in adolescence cannot...

  4. Low antibiotic resistance among anaerobic Gram-negative bacteria in periodontitis 5 years following metronidazole therapy. (United States)

    Dahlen, G; Preus, H R


    The objective of this study was to assess antibiotic susceptibility among predominant Gram-negative anaerobic bacteria isolated from periodontitis patients who 5 years prior had been subject to mechanical therapy with or without adjunctive metronidazole. One pooled sample was taken from the 5 deepest sites of each of 161 patients that completed the 5 year follow-up after therapy. The samples were analyzed by culture. A total number of 85 anaerobic strains were isolated from the predominant subgingival flora of 65/161 patient samples, identified, and tested for antibiotic susceptibility by MIC determination. E-tests against metronidazole, penicillin, amoxicillin, amoxicillin + clavulanic acid and clindamycin were employed. The 73/85 strains were Gram-negative rods (21 Porphyromonas spp., 22 Prevotella/Bacteroides spp., 23 Fusobacterium/Filifactor spp., 3 Campylobacter spp. and 4 Tannerella forsythia). These were all isolated from the treated patients irrespective of therapy procedures (+/-metronidazole) 5 years prior. Three strains (Bifidobacterium spp., Propionibacterium propionicum, Parvimonas micra) showed MIC values for metronidazole over the European Committee on Antimicrobial Susceptibility Testing break point of >4 μg/mL. All Porphyromonas and Tannerella strains were highly susceptible. Metronidazole resistant Gram-negative strains were not found, while a few showed resistance against beta-lactam antibiotics. In this population of 161 patients who had been subject to mechanical periodontal therapy with or without adjunct metronidazole 5 years prior, no cultivable antibiotic resistant anaerobes were found in the predominant subgingival microbiota. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Conservative treatment of a radicular cyst in a 5-year-old child: a case report. (United States)

    Delbem, A C B; Cunha, R F; Vieira, A E M; Pugliesi, D M C


    The present report describes the management of a radicular cyst in a 5-year-old child. The treatment comprised extraction of the primary teeth involved followed by marsupialization. A removable appliance with a resin extension penetrating into the cystic cavity was used to help decompress the lesion. This treatment allowed rapid healing of the lesion and eruption of the permanent incisors without the need for orthodontic treatment.

  6. Implementation of cerebral microdialysis at a community-based hospital: A 5-year retrospective analysis


    Chen, Jeff W.; Rogers, Shana L.; Gombart, Zoe J.; Adler, David E.; Cecil, Sandy


    Background: Cerebral microdialysis (MD) provides valuable information about brain metabolism under normal and pathologic conditions. The CMA 600 microdialysis analyzer received US Food and Drug Administration (FDA) approval for clinical use in the United States in 2005. Since then, cerebral MD has been increasingly utilized nationally in the multimodal monitoring of traumatic brain injury (TBI), stroke, aneurysmal subarachnoid hemorrhage, and brain tumors. We describe a 5-year, single-institu...

  7. Using the presurgical psychological evaluation to predict 5-year weight loss outcomes in bariatric surgery patients. (United States)

    Marek, Ryan J; Ben-Porath, Yossef S; Dulmen, Manfred H M van; Ashton, Kathleen; Heinberg, Leslie J


    Psychosocial factors contribute to poorer weight loss outcomes following bariatric surgery; however, findings on associations between preoperative psychiatric diagnoses, psychological testing, and weight loss are inconsistent. Examine associations between presurgical psychiatric diagnoses derived from a semi-structured clinical interview and test scores from the Minnesota Multiphasic Personality-Inventory-2 - Restructured Form (MMPI-2-RF) and 5-year Body Mass Index (BMI) outcomes. Cleveland Clinic Bariatric and Metabolic Institute METHODS: 446 consecutively consented patients who underwent a Roux-en-Y gastric bypass (RYGB) at least 5 years prior were included in the study. A majority were women (74.2%) and Caucasian (66.2%). Patients' mean presurgical BMI was 49.14 kg/m2 [SD = 9.50 kg/m2]. Psychiatric diagnoses were obtained from a presurgical, semi-structured clinical interview and all participants were administered the MMPI-2-RF at their presurgical evaluations. BMIs were collected at 4 postoperative time points across a 5-year trajectory. This prospective design utilized latent growth curve modeling. Older patients evidenced a slower rate of BMI reduction over time. A presurgical diagnosis of Binge Eating Disorder predicted higher BMIs at the 5-year outcome. Scores on MMPI-2-RF measures of emotional and behavioral dysfunction domains incrementally predicted poorer weight loss outcomes. Preoperative indicators of psychopathology, notably indicators that are dimensional in nature, are important in predicting postoperative outcomes. Closer follow-up with patients who evidence presurgical psychological factors, both before and after surgery, may help improve outcomes. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  8. Development of Speech Intelligibility Measurement Test for 3 to 5 Years Old Normal Children


    Fatemeh Hoseyni; Zahra Agha Rasouli; Farhad Torabi Nezhad; Sara Heydari


    Background and Aim: Speech intelligibility is defined as a measure of effectiveness of understanding speech. It has many applications such as nomination of speech disorder intensity. Different methods and speech tasks have been designed for assessment of speech intelligibility amongst which word identification tasks have high validity. This study aimed to provide a test to measure speech intelligibility among children aged 3 to 5 years old.Methods: Many words were collected and content validi...

  9. Bifocal Spinal Cord Injury without Radiographic Abnormalities in a 5-Year Old Boy: A Case Report

    Directory of Open Access Journals (Sweden)

    K. G. Snoek


    Full Text Available We present the extremely unusual case of a 5-year-old boy with a bifocal (cervical as well as lumbar spinal cord injury without radiographic abnormalities (SCIWORAs. The MRI showed cord oedema at the level of C2 and T10. We propose that during the motor vehicle crash severe propulsion of the head with a flexed lumbar region resulted in a traction injury to the lower thoracic and lumbar spine and maximum flexion caused SCIWORA in C2.

  10. Psychopathic personality traits in 5?year old twins: the importance of genetic and shared environmental influences


    Tuvblad, Catherine; Fanti, Kostas A.; Andershed, Henrik; Colins, Olivier F.; Larsson, Henrik


    There is limited research on the genetic and environmental bases of psychopathic personality traits in children. In this study, psychopathic personality traits were assessed in a total of 1189 5-year-old boys and girls drawn from the Preschool Twin Study in Sweden. Psychopathic personality traits were assessed with the Child Problematic Traits Inventory, a teacher-report measure of psychopathic personality traits in children ranging from 3 to 12?years old. Univariate results showed that genet...

  11. Survival without disability to age 5 years after neonatal caffeine therapy for apnea of prematurity. (United States)

    Schmidt, Barbara; Anderson, Peter J; Doyle, Lex W; Dewey, Deborah; Grunau, Ruth E; Asztalos, Elizabeth V; Davis, Peter G; Tin, Win; Moddemann, Diane; Solimano, Alfonso; Ohlsson, Arne; Barrington, Keith J; Roberts, Robin S


    Very preterm infants are prone to apnea and have an increased risk of death or disability. Caffeine therapy for apnea of prematurity reduces the rates of cerebral palsy and cognitive delay at 18 months of age. To determine whether neonatal caffeine therapy has lasting benefits or newly apparent risks at early school age. Five-year follow-up from 2005 to 2011 in 31 of 35 academic hospitals in Canada, Australia, Europe, and Israel, where 1932 of 2006 participants (96.3%) had been enrolled in the randomized, placebo-controlled Caffeine for Apnea of Prematurity trial between 1999 and 2004. A total of 1640 children (84.9%) with birth weights of 500 to 1250 g had adequate data for the main outcome at 5 years. Combined outcome of death or survival to 5 years with 1 or more of motor impairment (defined as a Gross Motor Function Classification System level of 3 to 5), cognitive impairment (defined as a Full Scale IQcaffeine from that for the 807 children assigned to placebo (21.1% vs 24.8%; odds ratio adjusted for center, 0.82; 95% CI, 0.65-1.03; P = .09). The rates of death, motor impairment, behavior problems, poor general health, deafness, and blindness did not differ significantly between the 2 groups. The incidence of cognitive impairment was lower at 5 years than at 18 months and similar in the 2 groups (4.9% vs 5.1%; odds ratio adjusted for center, 0.97; 95% CI, 0.61-1.55; P = .89). Neonatal caffeine therapy was no longer associated with a significantly improved rate of survival without disability in children with very low birth weights who were assessed at 5 years.

  12. Family and individual therapy in anorexia nervosa. A 5-year follow-up. (United States)

    Eisler, I; Dare, C; Russell, G F; Szmukler, G; le Grange, D; Dodge, E


    There is evidence that specific psychological treatments are effective in patients with eating disorders. Our goal was to determine by means of a controlled trial whether psychological treatments, previously found to be effective in anorexia nervosa, gave rise to enduring benefits. A 5-year follow-up was conducted on patients who had participated in a previous trial of family therapy for anorexia and bulimia nervosa. Family therapy or individual supportive therapy had been administered to 80 outpatients for 1 year beginning on discharge from hospital after weight restoration. The 80 patients had been subdivided into 4 prognostically homogeneous groups of which 2 turned out to be the most important: patients with early onset and short history of anorexia nervosa, and patients with late-onset anorexia nervosa. At the 5-year follow-up, the efficacy of the outpatient therapies was again assessed by the maintenance of weight, and the categories of general outcome and dimensions of clinical functioning defined by the Morgan-Russell scales. Significant improvements were found in the group of 80 patients as a whole, mainly attributable to the natural outcome of anorexia nervosa, and most evident in the early onset and short history group, as expected. Within 2 of the prognostic groups, significant benefits attributable to previous psychological treatments were still evident, favoring family therapy for patients with early onset and short history of anorexia nervosa and favoring individual supportive therapy for patients with late-onset anorexia nervosa. Much of the improvements found at a 5-year follow-up can be attributed to the natural outcome of the illness. Nevertheless, it was still possible to detect long-term benefits of psychological therapies completed 5 years previously.

  13. Australian children with cleft palate achieve age-appropriate speech by 5 years of age. (United States)

    Chacon, Antonia; Parkin, Melissa; Broome, Kate; Purcell, Alison


    Children with cleft palate demonstrate atypical speech sound development, which can influence their intelligibility, literacy and learning. There is limited documentation regarding how speech sound errors change over time in cleft palate speech and the effect that these errors have upon mono-versus polysyllabic word production. The objective of this study was to examine the phonetic and phonological speech skills of children with cleft palate at ages 3 and 5. A cross-sectional observational design was used. Eligible participants were aged 3 or 5 years with a repaired cleft palate. The Diagnostic Evaluation of Articulation and Phonology (DEAP) Articulation subtest and a non-standardised list of mono- and polysyllabic words were administered once for each child. The Profile of Phonology (PROPH) was used to analyse each child's speech. N = 51 children with cleft palate participated in the study. Three-year-old children with cleft palate produced significantly more speech errors than their typically-developing peers, but no difference was apparent at 5 years. The 5-year-olds demonstrated greater phonetic and phonological accuracy than the 3-year-old children. Polysyllabic words were more affected by errors than monosyllables in the 3-year-old group only. Children with cleft palate are prone to phonetic and phonological speech errors in their preschool years. Most of these speech errors approximate typically-developing children by 5 years. At 3 years, word shape has an influence upon phonological speech accuracy. Speech pathology intervention is indicated to support the intelligibility of these children from their earliest stages of development. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Epidemiology of rotavirus diarrhea in children under 5 years in Northern Cameroon. (United States)

    Ndze, Valentine Ngum; Akum, Achidi Eric; Kamga, Gonsu Hortense; Enjema, Lyonga Emilia; Esona, Mathew Dioh; Banyai, Krisztian; Therese, Obama Abena Marie


    Rotavirus still remains the major cause of diarrhea in children below 5 years. No data on rotavirus epidemiology is available in the Northern regions of Cameroon. We aimed to determine the prevalence of group A rotavirus (RVA) in children below 5 years with diarrhea in two regions of Northern Cameroon (North West and Far North Regions) so as to improve our knowledge on the burden of rotavirus disease for imminent introduction of a rotavirus vaccine. Stool samples were collected during 2010 and 2011 from 390 children below 5 years presenting with diarrhea in four hospitals in Northern Cameroon and were screened for rotavirus group A by reverse transcription-polymerase chain reaction. This study revealed that 42.8% of the children below 5 years had group A rotavirus infection, 46.5% in the Far North region while the North West had a prevalence of 33.9%. Of the 252 hospitalized and the 138 outpatient children, 124(49.2%) and 43(31.2%) (P=0.00085), respectively, were positive for group A rotavirus. Children below 24 months were most affected (44.7%), while the age group 49-60 months had the lowest prevalence (25%). The RVA prevalence was 44.6% in the urban and 28.9% in the rural settings of our study. It was observed that the proportion of children with diarrhea who had rotavirus accompanied with fever and vomiting in the outpatient group and inpatient group were 13.0% and 28.6% respectively, P=0.03. This study showed high incidence of rotavirus infection especially among hospitalized children in Northern Cameroon, suggesting that rotavirus is a major cause of childhood morbidity and mortality in this area.

  15. Employment trajectories after spinal cord injury: results from a 5-year prospective cohort study. (United States)

    Ferdiana, Astri; Post, Marcel W; Hoekstra, Trynke; van der Woude, Luccas H; van der Klink, Jac J; Bültmann, Ute


    To identify different employment trajectories in individuals with spinal cord injury (SCI) after discharge from initial rehabilitation and to determine predictors of different trajectories from demographic, injury, functional, and psychological characteristics. Prospective cohort study with baseline measurement at the start of active rehabilitation, a measurement at discharge, and follow-up measurements at 1, 2, and 5 years after discharge. Eight rehabilitation centers with SCI units in The Netherlands. People with acute SCI (N=176), aged between 18 and 60 years at baseline, who completed at least 2 follow-up measurements. Not applicable. Employment was defined as having paid work for ≥ 12 h/wk. Using latent class growth mixture modeling, 3 distinct employment trajectories were identified: (1) no employment group (22.2%), that is, participants without employment pre-SCI and during 5-year follow-up; (2) low employment group (56.3%), that is, participants with pre-SCI employment and a low, slightly increasing probability of employment during 5-year follow-up; and (3) steady employment group (21.6%), that is, participants with continuous employment pre-SCI and within 5-year follow-up. Predictors of steady employment versus low employment were having secondary education (odds ratio, 4.32; 95% confidence interval, 1.69-11.02) and a higher FIM motor score (odds ratio, 1.04; 95% confidence interval, 1.01-1.06) at discharge. Distinct employment trajectories after SCI were identified. More than half of the individuals with SCI had a low employment trajectory, and only one-fifth of the individuals with SCI had a steady employment trajectory. Secondary education and higher functional independence level predicted steady employment. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  16. Multiple trauma in a 5 years child with a longitudinal follow up


    Silva, Luciana Assunção Reichert da [UNESP; Bianco, Karina Gehardt [UNESP; Silva, Pedro Ivo Santos [UNESP; Favretto, Carla Oliveira [UNESP; Cunha, Robson Frederico


    Dental-alveolar trauma in the primary dentition associated with intra-cranial injuries is not common. This article reports the management of a complex trauma involving cranial trauma and multiple luxations and avulsions of primary teeth in a five-year old boy as a consequence of a horse kick. The treatment, including the hospital intervention and dentistry procedures, is described. The clinical outcomes are reported at a 5-year follow-up.

  17. Anthropometry, muscular strength and aerobic capacity up to 5 years after pediatric burns. (United States)

    Disseldorp, Laurien M; Mouton, Leonora J; Van der Woude, Lucas H V; Van Brussel, Marco; Nieuwenhuis, Marianne K


    Physical functioning is of major importance after burns in many areas of life, in both the short and the long term. This cross-sectional study aimed to describe anthropometry, muscular strength and aerobic capacity in children and adolescents between 0.5-5 years after burns over 10% TBSA. Assessments took place in a mobile exercise lab. Demographics, burn characteristics and anthropometrics were recorded. Muscular strength in six muscle groups was measured using hand-held dynamometry and aerobic capacity was measured with a graded cardiopulmonary exercise test. Subjects' scores were compared with Dutch age- and gender-matched norm values and converted to Z-scores. The assessments were completed by 24 subjects with pediatric burns ranging from 10 to 41% TBSA and time after burn from 1 to 5 years (58.3% male; 6-18 years). On group level, no significant differences between the subjects' scores and norm values were found. No trends were seen indicating an effect of extent of burn or time after burn. Individually, eight subjects (33.3%), mostly aged 6 or 7, showed significantly low performance on at least one variable: seven for strength, one for aerobic capacity and one for both. Anthropometry, muscular strength and aerobic capacity are adequate in the majority of Dutch children and adolescents 1-5 years after 10-41% TBSA burns. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  18. Long-term life and partnership satisfaction in infertile patients: a 5-year longitudinal study. (United States)

    Schanz, Stefan; Reimer, Thorisa; Eichner, Martin; Hautzinger, Martin; Häfner, Hans-Martin; Fierlbeck, Gerhard


    To describe the long-term effects of infertility on life and partnership satisfaction. Longitudinal cohort study. A university outpatient andrology and gynecology infertility clinic. 275 men and 272 women treated for infertility between August 2000 and December 2001. None. The Life Satisfaction Questionnaire (FLZ), the Partnership Questionnaire (PFB), and sociodemographic items at baseline (T1) and 5 years later (T2). Compared with a representative sample, our male and female participants had higher Finance and Partnership scores and lower Health scores on the FLZ at T1. They also had markedly higher PFB scores, with the exception of Conflict Behavior. After 5 years (T2), 101 men and 113 women rated the Partnership and Sexuality FLZ subscales as well as all the PFB subscales statistically significantly lower than at baseline. Only the women rated the Self-esteem FLZ subscale lower than at baseline (T1). Participants who became parents had lower Leisure and Partnership FLZ subscale scores, and fathers had lower Finance FLZ subscale scores. Satisfaction declined over 5 years for both men and women, but only in the partnership-related domains. Women were more affected than men. The success of infertility treatment had only a minor influence on a couple's future satisfaction. Copyright © 2011. Published by Elsevier Inc.

  19. Sleep timing and longitudinal weight gain in 4- and 5-year-old children. (United States)

    Scharf, R J; DeBoer, M D


    Short night-time sleep duration is a possible factor contributing to childhood obesity. Our objective was to evaluate associations between sleep timing (including bedtime and waketime) and weight gain in 4- to 5-year-old children. We used cross-sectional and longitudinal regression analyses of a large, nationally representative sample of children from the Early Childhood Longitudinal Study-Birth Cohort. Data regarding the timing and duration of weekday sleep were assessed via parent questionnaire. Short sleep duration, late bedtime and early waketime were defined as those greater than one standard deviation from the mean for the group. Using linear regression adjusted for confounders, sleep duration at 4 and 5 years and bedtime at 5 years were linked to body mass index (BMI) z-score (P sleeping sleep duration (P sleep durations and later bedtimes were more likely to be obese and to gain weight over time. Pediatricians should encourage families to place children to bed at earlier times to promote longer sleep duration as a potential means of controlling weight gain. © 2014 The Authors. Pediatric Obesity © 2014 World Obesity.

  20. 5-year results of the 1.5cm incision Achilles tendon repair. (United States)

    Ling, Samuel K K; Slocum, Amanda; Lui, T H


    To study a hypothesis that the cost-effective 1.5cm medial incision Achilles tendon repair technique will provide good functional outcomes which are maintained for over 5 years. Prospective study of 12 consecutive cases with a minimal 5-year follow-up were recruited from April 2008 to November 2010. Cases whom were mentally incompetent or those which required concomitant procedures were excluded. Outcomes measures included the numeric pain rating scale, motor power strength, range of motion, functional scoring using the AOFAS hindfoot score and patient's self-assessment using the Foot and Ankle Outcome Score (FAOS). No re-ruptures or sural nerve injured were identified after a minimal 5-year follow-up. Pain was minimal at 0.5/10, calf power was 5/5 and ankle range was good (plantarflexion: 38°/dorsiflexion: 21°). The AOFAS hindfoot score was 97.4 and all 5 sub-categories of the Foot and Ankle Outcome Score (FAOS) were good. The 1.5cm medial incision repair of the Achilles tendon is an economically sound surgical technique, with minimal complications, which gives good medium length functional outcomes. IV. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Coping with multiple sclerosis: a 5-year follow-up study. (United States)

    Lode, K; Bru, E; Klevan, G; Myhr, K M; Nyland, H; Larsen, J P


    To examine how coping styles among patients with multiple sclerosis (MS) change over time and how patients' coping styles after 5 years are associated with disability pension. Seventy-six MS patients and 94 healthy controls were included in this study. The patients were examined at baseline and 5 years later. This included a neurological examination and information on disability pension and a questionnaire assessing coping (the COPE scale). Controls were registered at baseline only. Compared to healthy controls, MS patients were more passive in coping with disease related distress. This was even more pronounced 5 years later. Disability pensioned patients employed more social support, venting of emotions and behavioural disengagement at follow-up. This study shows that patients with MS employ coping styles that may be inadequate and this is not improved by adaption over time. Although patients also use strategies to enhance their lives, these findings suggest that there may be a potential for improving the lives of patients with MS through interventions that may enhance adequate coping with the disease. Copyright © 2009 The Authors. Journal compilation © 2009 Blackwell Munksgaard.

  2. Five-minute Apgar score as a marker for developmental vulnerability at 5 years of age. (United States)

    Razaz, Neda; Boyce, W Thomas; Brownell, Marni; Jutte, Douglas; Tremlett, Helen; Marrie, Ruth Ann; Joseph, K S


    To assess the relationship between the 5 min Apgar score and developmental vulnerability at 5 years of age. Population-based retrospective cohort study. Manitoba, Canada. All children born between 1999 and 2006 at term gestation, with a documented 5 min Apgar score. 5 min Apgar score. Childhood development at 5 years of age, expressed as vulnerability (absent vs present) on five domains of the Early Development Instrument: physical health, social competence, emotional maturity, language and cognitive development, and communication skills. Of the 33,883 children in the study, most (82%) had an Apgar score of 9; 1% of children had a score Apgar scores Apgar 9=1.23, 95% CI 1.05 to 1.44). Similarly, children with Apgar scores of Apgar 9=1.20, 95% CI 1.03 to 1.41). Nevertheless, the Apgar-based prognostic model had a poor sensitivity for physical vulnerability (19%, 95% CI 18% to 20%). Although the Apgar score-based prognostic model had reasonable calibration ability and risk-stratification accuracy for identifying developmentally vulnerable children, classification accuracy was poor. The risk of developmental vulnerability at 5 years of age is inversely associated with the 5 min Apgar score across its entire range, and the score can serve as a population-level indicator of developmental risk. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  3. Development of Speech Intelligibility Measurement Test for 3 to 5 Years Old Normal Children

    Directory of Open Access Journals (Sweden)

    Fatemeh Hoseyni


    Full Text Available Background and Aim: Speech intelligibility is defined as a measure of effectiveness of understanding speech. It has many applications such as nomination of speech disorder intensity. Different methods and speech tasks have been designed for assessment of speech intelligibility amongst which word identification tasks have high validity. This study aimed to provide a test to measure speech intelligibility among children aged 3 to 5 years old.Methods: Many words were collected and content validity was assessed by 9 speech-language pathologists and 1 linguist. Thirty four words with a content validity above 70% were chosen as the test words and the speech-language pathologists collected suitable pictures for the words. One hundred boys and girls aged 3 to 5 years participated in the study. Inter-rater reliability was administered to assess the test reliability.Results: An interclass correlation coefficient of 0.85 and spearman correlation coefficient of 0.81 was obtained for the speech intelligibility test.Conclusion: Speech intelligibility test has appropriate validity and reliability and is suitable for assessment of intelligibility in 3 to 5 years old children.

  4. The prevalence of dental erosion in 5-year-old preschoolers in Sharjah, United Arab Emirates. (United States)

    Gopinath, Vellore Kannan


    The aim of this study was to determine the percentage of 5-year-old preschoolers in Sharjah, affected by dental erosion and to assess the predictors. A total of 403 5-year-old children were examined of which 48.14% (n = 194) were boys and 51.86% (n = 209) were girls; 31.27% (n = 126) were Emirati and 68.73% (n = 277) were non-Emirati Arabs. Examination of dental erosion was confined to palatal surfaces of maxillary incisors using the erosion index described in the UK National Survey of Children's Dental Health, 1993. Dental caries was charted using the World Health Organization 1997 criteria. In the sample of 403 5-year-old preschoolers examined, dental erosion was apparent in 237 (58.80%) children, with 55.09% showing the dissolution of enamel and 3.72% exhibiting exposed dentin. Predictors of dental erosion as determined by logistic regression concluded that compared to Emirati citizens other Arab nationalities have 0.27 times the odds (95% confidence interval [CI] =0.18-0.42) of having tooth erosion (P erosion compared to children with no caries experience (P erosion compared to children who drink water (P erosion. Caries experience and consumption of acidic drinks were associated with dental erosion.

  5. Nasalance scores of Brazilian Portuguese speakers at 5 years of age. (United States)

    Oliveira, Débora Natália de; Sampaio-Teixeira, Ana Claudia Martins; Alvarenga, Bianca Gonçalves; Fukushiro, Ana Paula; Yamashita, Renata Paciello; Trindade, Inge Elly Kiemle


    To determine nasalance scores of Brazilian Portuguese speaking children without evident speech disorders, language delay and orofacial deformities, at age 5 years, and analyze differences between types of speech samples and genders. Twenty children were analyzed, 11 males, age ranging from 4 years and 10 months to 5 years and 11 months. The Nasometer II 6450 (KayPENTAX) was used for nasalance assessment. Speech samples were eight consonant-vowel syllables and one sequence of nine words. The significance of differences between speech samples and genders were assessed by the Tukey test and Mann-Whitney test, respectively, at a significance level of 5%. Mean nasalance scores were: /pa/= 10±4%, /pi/= 22±7%, /sa/= 11±5%, /si/= 24±11%, /ma/= 57±11%, /mi/= 73±13%, /la/= 14±9%, /li/= 25±11%, words (pipa, bis, burro, tatu, pilha, cuca, gui, fila, luz)= 20±6%. Nasalance scores of nasal syllables were significantly higher than those of oral syllables (with high or neutral vowels) and nasalance scores of oral syllables with high vowels were significantly higher than those of oral syllables with neutral vowels, for the majority of comparisons. There was no difference between genders. Normative nasalance scores for 5-year-old Brazilian children were determined. The methodology can serve as a standard for the early diagnosis of nasality deviations, such as hypernasality observed in cleft palate speech.

  6. Effects of prematurity and dysmaturity on growth at age 5 years. (United States)

    Sann, L; Darre, E; Lasne, Y; Bourgeois, J; Bethenod, M


    Forty-two term and 106 preterm appropriate for gestational age (AGA), and 43 term and 31 preterm small for gestational age (SGA) children were observed from birth to age 5 years. Parents' weight and height were also measured in 193 subjects including 97 couples. The percentage of short children was higher in SGA (17%) than in AGA (3.4%) children (P less than 0.01). This difference was significant in the preterm but not in the term children, suggesting that early failure of growth in utero can result in reduced growth in children. The findings were similar for weight and head circumference, but microcephaly was more frequent in term SGA (30%) than in preterm SGA (6.4%) children (P less than 0.05), suggesting that late impaired growth in utero can result in poor growth of the head. Height at the age of 5 years correlated with the parents' height only in AGA children, and with length at birth in SGA children. Weight of the 5-year-old children correlated with the mother's weight only in AGA children. Multivariate analysis in 66 couples and their children confirmed a greater tendency toward the influence of parental factors in AGA children and a more significant relationship with perinatal factors in SGA children.

  7. Apparent Life-Threatening Events: Patients' Health Status at 5 Years of Age. (United States)

    Steiman, Brian; Watemberg, Nathan


    The long-term significance of apparent life-threatening events (ALTE) has not been thoroughly studied. To evaluate, at age 5 years, the health status of consecutive children diagnosed with ALTE in infancy. Based on the diagnostic workup, patients were classified into two groups: a 'broad' evaluation group (at least one test/procedure related to each of the five main causes: infectious, metabolic, cardiopulmonary, gastroenterological, neurological), and a 'narrow' workup group whose evaluation did not cover all five domains. Health status around age 5 was obtained from hospital records, community clinics and parents/caregivers. We identified 132 children with ALTE. Choking (49.2%) was the most common description, followed by apnea (13.6%), suspected seizure (12.9%), cyanosis (12.1%), breath-holding spell (8.3%), and pallor (3.8%). A broad diagnostic workup was performed in 62.1% of the infants, and a narrow workup in 37.9%. At age 5 years, 56.8% of the children were healthy; 27.3% reported chronic conditions unrelated to ALTE. Twenty-one children (15.9%) had unrelated neurodevelopmental conditions, mostly attention deficit disorder. One of the 132 ALTE patients relapsed and was eventually diagnosed with epilepsy. A single episode of ALTE in infancy was neither predictive of nor associated with chronic systemic or neurological-disease at age 5 years.

  8. Sealing distal proximal caries lesions in first primary molars: efficacy after 2.5 years. (United States)

    Martignon, S; Tellez, M; Santamaría, R M; Gomez, J; Ekstrand, K R


    The prevalence of proximal caries in primary molar teeth is high in many countries. (1) To study by means of a split-mouth design the 1- and 2.5-year efficacy of sealing proximal lesions vs. flossing instructions (control) on primary molar teeth. (2) To assess children's behaviour and pain perception during the procedure. Ninety-one 4- to 6-year-old children from Bogotá, Colombia participated. Participants had to have at least two proximal lesions scored according to the following radiographic classification system: radiolucency (1) in enamel outer half, (2) restricted to enamel-dentine junction, or (3) restricted to dentine outer third. Baseline, 1- and 2.5-year follow-up bitewing radiographs were taken. Test and control lesions were randomly selected. After temporary separation test lesions were sealed (adhesive). Parents/caregivers received a flossing leaflet for their children. Progression of the lesions was assessed by means of independent reading of conventional bitewing radiographs. One-year (n = 73) test vs. control lesion progression was 27.4 vs. 50.7%, respectively (p caries baseline data. More than 88% of the participants presented positive to definitively positive behaviour and very low or low pain intensity at both first and second appointments. The sealing technique was superior to flossing instructions both after 1 and 2.5 years of follow-up and the majority of the participants had no anxiety or pain during the treatment. Copyright © 2010 S. Karger AG, Basel.

  9. Gross Motor Development in Children Aged 3-5 Years, United States 2012. (United States)

    Kit, Brian K; Akinbami, Lara J; Isfahani, Neda Sarafrazi; Ulrich, Dale A


    Objective Gross motor development in early childhood is important in fostering greater interaction with the environment. The purpose of this study is to describe gross motor skills among US children aged 3-5 years using the Test of Gross Motor Development (TGMD-2). Methods We used 2012 NHANES National Youth Fitness Survey (NNYFS) data, which included TGMD-2 scores obtained according to an established protocol. Outcome measures included locomotor and object control raw and age-standardized scores. Means and standard errors were calculated for demographic and weight status with SUDAAN using sample weights to calculate nationally representative estimates, and survey design variables to account for the complex sampling methods. Results The sample included 339 children aged 3-5 years. As expected, locomotor and object control raw scores increased with age. Overall mean standardized scores for locomotor and object control were similar to the mean value previously determined using a normative sample. Girls had a higher mean locomotor, but not mean object control, standardized score than boys (p  0.05). Conclusions In a nationally representative sample of US children aged 3-5 years, TGMD-2 mean locomotor and object control standardized scores were similar to the established mean. These results suggest that standardized gross motor development among young children generally did not differ by demographic or weight status.

  10. Re-presentations and recurrent events following initial management of the acute paediatric scrotum: a 5-year review. (United States)

    Lala, Shareena; Price, Neil; Upadhyay, Vipul


    Previous reviews report relatively low rates of post-operative complications for acute scrotal exploration. The aim of this study was to evaluate the re-presentation to hospital in boys with previous acute scrotal pathology, reviewing contralateral symptoms, post-operative complications, testicular torsion following fixation and failure of conservative management of testicular appendage (TA) torsion. All boys under 16 years presenting to our unit with an acute scrotum from January 2008 to December 2012 (5-year period) were identified. A retrospective review of clinical records was performed. A total of 683 boys presented over this 5-year period, with an overall re-presentation rate of 10%. Seventeen (25%) re-presentations were metachronous. Post-operative complication rate was 2.2%. Testicular torsion rate following orchiopexy was 0.3% (1/292). Thirty-three percent of those managed conservatively for TA torsion returned with ongoing pain; 80% underwent scrotal exploration on return. Eight boys returned following excision of a torted TA with contralateral torted TA confirmed, accounting for 2.6% (8/308) of boys with a torted TA at first presentation. This gives a number-needed-to-treat of 39 for bilateral scrotal exploration and prophylactic excision of contralateral non-torted TA, to prevent one boy from returning to hospital with a metachronous presentation. Further prolonged follow-up is needed to adequately assess recurrence rates of testicular torsion following orchiopexy to validate routine orchiopexy. Post-operative complication rates equal that of the return rate for a contralateral torted TA; this needs to be considered in proceeding to bilateral scrotal exploration on finding a torted TA at initial presentation. © 2017 Royal Australasian College of Surgeons.

  11. Effect of late medication non-compliance on outcome after heart transplantation: a 5-year follow-up. (United States)

    Dobbels, Fabienne; De Geest, Sabina; van Cleemput, Johan; Droogne, Walter; Vanhaecke, Johan


    Although non-compliance with immunosuppression therapy is increasingly recognized as a risk factor for morbidity and mortality after heart transplantation (HTX), evidence for this association is limited to 1 prospective study that assessed medication non-compliance in the early post-HTX period and used self-report. The current prospective HTX cohort study explores the predictive value of late non-compliance (>1 year after HTX) during a 5-year follow-up using the Medication Event Monitoring System (MEMS) for compliance assessment. We categorized 101 patients (86% men; aged 55 +/- 10 years; time after HTX at inclusion, 1,253 +/- 534 days) as medication non-compliers (n = 17) or compliers (n = 84) based on the MEMS. Late acute rejections, transplant coronary artery disease (TxCAD), retransplantation, and death were registered during the 5-year follow-up. Non-compliers had significantly more TxCAD (p = 0.025). Non-compliers also had a greater rate of late acute rejection (11.8% vs 2.4%) and retransplantation (13.3% vs 2.5%)), although these differences were not statistically significant. Mortality rates were similar. Kaplan Meier analysis showed that non-compliers had a significantly shorter clinical-event-free time compared with compliers (mean, 1,318 vs 1,612 days; p = 0.043). Cox regression analysis showed that the adjusted relative risk associated with non-compliance was 2.03 (p = 0.0582), after controlling for other known transplant-related risk factors for poor clinical outcome. The current study demonstrates that medication non-compliance in the late post-transplant period doubles the risk for an untoward clinical event. Non-compliance is a continuous risk factor after heart transplantation that should be targeted by compliance-enhancing interventions.

  12. Prediction of Treatment Response at 5-year Follow-up in a Randomized Clinical Trial of Behaviorally Based Couple Therapies (United States)

    Baucom, Brian R.; Atkins, David C.; Rowe, Lorelei Simpson; Doss, Brian D.; Christensen, Andrew


    Objective Building on earlier work examining predictors of short- and moderate-term treatment response, demographic, intrapersonal, communication, and interpersonal variables were examined as predictors of clinically significant outcomes five years after couples completed one of two behaviorally based couple therapies. Method One hundred and thirty-four couples were randomly assigned to Integrative Behavioral Couple Therapy (IBCT; Jacobson & Christensen, 1998) or Traditional Behavioral Couple Therapy (TBCT; Jacobson & Margolin, 1979) and followed for 5 years after treatment. Outcomes include clinically significant change categories of relationship satisfaction and marital status at 5-year follow-up. Optimal subsets of predictors were selected using an automated, bootstrapped selection procedure based on Bayesian Information Criterion. Results Higher levels of commitment and being married for a longer period of time were associated with decreased likelihood of divorce/separation (Odds Ratio [OR] = 1.39, p = .004; OR = 0.91, p = .015). Being married for a longer period of time was also associated with increased likelihood of positive, clinically significant change (OR = 1.12, p = .029). Finally, higher levels of wife desired closeness were associated with increased odds of positive, clinically significant change and decreased odds of divorce for moderately distressed, IBCT couples (OR = 1.16, p = 0.002; OR = 0.85, p = 0.007, respectively) whereas the opposite was true for moderately distressed, TBCT couples (OR = 0.77, p divorced and most likely to report improvements in relationship satisfaction five years after ending treatment. In addition, it appears that the impact of wives’ desired closeness depended on the type of treatment moderately distressed couple received. PMID:25265544

  13. 75 FR 53272 - Endangered and Threatened Species; Initiation of 5-Year Review of the Eastern Distinct Population... (United States)


    ... of 5-Year Review of the Eastern Distinct Population Segment of the Steller Sea Lion AGENCY: National..., 2010, announcing the initiation of a 5-year review of the eastern Distinct Population Segment (DPS) of..., announcing the initiation of a 5-year review of the eastern Distinct Population Segment (DPS) of the Steller...

  14. Timing and Risk Factors for a Positive Fecal Immunochemical Test in Subsequent Screening for Colorectal Neoplasms.

    Directory of Open Access Journals (Sweden)

    Tsung-Hsien Chiang

    Full Text Available Following a negative test, the performance of fecal immunochemical testing in the subsequent screening round is rarely reported. It is crucial to allocate resources to participants who are more likely to test positive subsequently following an initial negative result.To identify risk factors associated with a positive result in subsequent screening.Dataset was composed of consecutive participants who voluntarily underwent fecal tests and colonoscopy in a routine medical examination at the National Taiwan University Hospital between January 2007 and December 2011. Risk factor assessment of positive fecal test in subsequent screening was performed by using the Cox proportional hazards models.Our cohort consisted of 3783 participants during a 5-year period. In three rounds of subsequent testing, 3783, 1537, and 624 participants underwent fecal tests, respectively; 5.7%, 5.1%, and 3.9% tested positive, respectively, and the positive predictive values were 40.2%, 20.3%, and 20.8%, respectively. Age ≥60 years (adjusted hazard ratio: 1.53, 95% CI: 1.21-1.93 and male gender (1.32, 95% CI: 1.02-1.69 were risk factors; however, an interaction between age and gender was noted. Men had higher risk than women when they were <60 years of age (p = 0.002, while this difference was no longer observed when ≥60 years of age (p = 0.74. The optimal interval of screening timing for participant with baseline negative fecal test was 2 years.Following a negative test, older age and male gender are risk factors for a positive result in the subsequent rounds while the gender difference diminishes with age. Biennial screening is sufficient following a negative fecal test.

  15. Vagotomy and subsequent development of diabetes

    DEFF Research Database (Denmark)

    Starup-Linde, Jakob; Gejl, Michael; Borghammer, Per


    registration of vagotomy and/or upper gastrointestinal disease in the period 1977-2011. Controls had no subsequent diagnosis of diabetes and were matched by incidence density sampling, age and gender. Logistic regression analyses were conducted. RESULTS: 501,724 diabetes patients and 1,375,567 matched controls......BACKGROUND: Vagal signaling is involved in gastric emptying and the secretion and effect of a number of hormones regulating gluco-metabolic processes and, thus, crucial for metabolic homeostasis. PURPOSE: We hypothesized that vagotomy would increase the risk of developing type 2 diabetes...... and examined the association between vagotomy and subsequent development of diabetes. METHODS: A nested case-control study was conducted with information on cases and controls from the Danish National Patient Registry. Cases included individuals with a diabetes diagnosis subsequent (>12months) to the first...

  16. Sleep architecture in healthy 5-year-old preschool children: associations between sleep schedule and quality variables. (United States)

    Iwata, Sachiko; Iwata, Osuke; Iemura, Akiko; Iwasaki, Mizue; Matsuishi, Toyojiro


    Although disturbed sleep quality such as night awakenings and difficulties in falling asleep are common symptoms during sleep in preschool children, relationships between sleep quality and sleep schedule are mostly unknown. This study aimed to evaluate the relationships between sleep schedule and quality variables in preschool children. Sleep-wake patterns of 48 healthy 5-year-old children were assessed over 7 consecutive days using actigraphy. Children with longer sleep latency had a lower sleep quality, a later bedtime, a later sleep onset time, a shorter nocturnal sleep period and a longer daytime nap. Children with a longer nocturnal sleep period on weekends compared with weekdays had longer sleep latency and a later sleep onset time on weekdays, resulting in a lower sleep quality on weekends. An irregular bedtime on weekdays was associated with a later sleep onset time and a shorter sleep period on weekends. Sleep quality and schedule were linked with each other, which may explain why sleep problems tend to aggregate and form a wider syndrome of disturbed sleep even in young children. Strategies solely targeting the improvement of sleep quantity may not promote ideal sleep; simultaneous considerations for the sleep rhythm and quality may be required. © 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.

  17. MRI usage in a pediatric emergency department: an analysis of usage and usage trends over 5 years

    Energy Technology Data Exchange (ETDEWEB)

    Scheinfeld, Meir H. [Montefiore Medical Center, Albert Einstein College of Medicine, Department of Radiology, Division of Emergency Radiology, Bronx, NY (United States); Moon, Jee-Young; Wang, Dan [Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY (United States); Fagan, Michele J. [Montefiore Medical Center, Albert Einstein College of Medicine, Department of Pediatrics, Division of Emergency Medicine, Bronx, NY (United States); Davoudzadeh, Reubin [Montefiore Medical Center, Department of Radiology, Bronx, NY (United States); Taragin, Benjamin H. [Montefiore Medical Center, Albert Einstein College of Medicine, Department of Radiology, Division of Pediatric Radiology, Bronx, NY (United States)


    Magnetic resonance imaging (MRI) usage has anecdotally increased due to the principles of ALARA and the desire to Image Gently. Aside from a single abstract in the emergency medicine literature, pediatric emergency department MRI usage has not been described. Our objective was to determine whether MRI use is indeed increasing at a high-volume urban pediatric emergency department with 24/7 MRI availability. Also, we sought to determine which exams, time periods and demographics influenced the trend. Institutional Review Board exemption was obtained. Emergency department patient visit and exam data were obtained from the hospital database for the 2011-2015 time period. MRI usage data were normalized using emergency department patient visit data to determine usage rates. The z-test was used to compare MRI use by gender. The chi-square test was used to test for trends in MRI usage during the study period and in patient age. MRI usage for each hour and each weekday were tabulated to determine peak and trough usage times. MRI usage rate per emergency department patient visit was 0.36%. Headache, pain and rule-out appendicitis were the most common indications for neuroradiology, musculoskeletal and trunk exams, respectively. Usage in female patients was significantly greater than in males (0.42% vs. 0.29%, respectively, P<0.001). Usage significantly increased during the 5-year period (P<0.001). Use significantly increased from age 3 to 17 (0.011% to 1.1%, respectively, P<0.001). Sixty percent of exams were performed after-hours, the highest volume during the 10 p.m. hour and lowest between 4 a.m. and 9 a.m. MRI use was highest on Thursdays and lowest on Sundays (MRI on 0.45% and 0.22% of patients, respectively). MRI use in children increased during the study period, most notably in females, on weekdays and after-hours. (orig.)

  18. Neurodevelopmental Outcomes Among Extremely Preterm Infants 6.5 Years After Active Perinatal Care in Sweden. (United States)

    Serenius, Fredrik; Ewald, Uwe; Farooqi, Aijaz; Fellman, Vineta; Hafström, Maria; Hellgren, Kerstin; Maršál, Karel; Ohlin, Andreas; Olhager, Elisabeth; Stjernqvist, Karin; Strömberg, Bo; Ådén, Ulrika; Källén, Karin


    Active perinatal care increases the rate of survival of extremely preterm infants, but there are concerns that improved survival might increase the rate of disabled survivors. To determine the neurodevelopmental outcomes of a national cohort of children 6.5 years of age who had been born extremely preterm (children were assessed and compared with matched controls who had been born at term. Comparison estimates were adjusted for demographic differences. Assessments ended in February 2014, and analysis started thereafter. Cognitive ability was measured with the fourth edition of the Wechsler Intelligence Scale for Children (WISC-IV), and the mean (SD) scores of the children who had been born extremely preterm were compared with those of the controls. Clinical examinations and parental questionnaires were used for diagnosis of cerebral palsy, hearing and vision impairments, and cognition for the children who were not assessed with the WISC-IV. Of 486 eligible infants who were born extremely preterm, 441 (90.7%) were assessed at 6.5 years of age (59 by medical record review only) alongside 371 controls. The adjusted mean (SD) full-scale WISC-IV score was 14.2 (95% CI, 12.1-16.3) points lower for children who had been born extremely preterm than for controls. Cognitive disability was moderate for 18.8% of extremely preterm children and 2.2% of controls (P children and 0.3% of controls (P children and 0.0% of controls (P blindness was observed in 2.0% of extremely preterm children and 0.0% of controls (P children and 0.5% of controls (P = .07). Overall, 36.1% (95% CI, 31.7%-40.6%) of extremely preterm children had no disability, 30.4% (95% CI 26.3%-34.8%) had mild disability, 20.2% (95% CI, 16.6%-24.2%) had moderate disability, and 13.4% (95% CI, 10.5%-16.9%) had severe disability. For extremely preterm children, moderate or severe overall disability decreased with gestational age at birth (adjusted odds ratio per week, 0.65 [95% CI, 0.54-0.79]; P

  19. New psycho-pedagogic approach to obesity treatment: a 5-year follow-up. (United States)

    Buclin-Thiébaud, Sévrine; Pataky, Zoltan; Bruchez, Vanessa; Golay, Alain


    The aim of the present study was to evaluate the body weight evolution in obese patients admitted for a 2-week residential program and followed-up on ambulatory basis, as well as to evaluate factors having impact on weight evolution after 5 years. Thirty-nine obese patients participated in a 2-week structured interdisciplinary weight loss program, involving individual and group therapies, and including physical activity, nutritional education and standard cognitive-behavioral techniques. Patients were then followed-up regularly by their general practitioners for 5 years. After 5 years, 33 subjects completed the study. Seventy percent of the patients lost weight or maintained their weight loss. Total score for dietary structure, eating behavior disorders, dietary surveillance and weight management strategies, as evaluated by a validated questionnaire, was significantly lower in the weight loss group (22.4+/-4.3) as compared to maintenance group (24.4+/-6.1, p<0.05) and regain group (29.7+/-4.0, p<0.01). Patients who lost weight presented a more important follow-up on long-term weight management (p<0.05), a better dietary results (p<0.01) as well as more physical activity (p<0.05) that the regain group. The present study demonstrated that an initial multidimensional and multidisciplinary in-hospital program with a consecutive long-term ambulatory follow-up may lead to a significant weight loss (55%) and/or weight maintenance (15%). A multidisciplinary and well-designed initial treatment and long-term follow-up program is mandatory for obesity management. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  20. Association between depression in carers and malnutrition in children aged 6 months to 5 years

    Directory of Open Access Journals (Sweden)

    Keneilwe Motlhatlhedi


    Full Text Available Background:  Childhood malnutrition is an important risk factor for child mortality and underlies close to 50% of child deaths worldwide. Previous studies have found an association between maternal depression and child malnutrition, but it is not known whether this association exists in Botswana. In addition, previous studies excluded non-maternal primary caregivers (PCGs. It is unclear whether the association between primary caregiver depression and child malnutrition remains when non-maternal PCGs are included.Aim: The aim of this study was to determine if there is an association between PCG depression and malnutrition in children aged between 6 months and 5 years in Mahalapye, Botswana.Setting: The study was conducted in the child welfare clinics of Xhosa and Airstrip clinics, two primary health care facilities in Mahalapye, Botswana.Methods: This was a case control study. Cases were malnourished children aged between 6 months and 5 years, and controls were non-malnourished children matched for age and gender. The outcome of interest was depression in the PCGs of the cases and controls, which was assessed using the Patient Health Questionnaire 9 (PHQ 9, a depression screening tool.Results: From a sample of 171 children, 84 of whom were malnourished, we found that the malnourished children were significantly more likely to have depressed PCGs (odds ratio = 4.33; 95% CI: 1.89, 9.89 than non-malnourished children in the 6-month to 5-year age group; the PCGs of malnourished children also had lower educational status.Conclusion: This study found a significant association between PCG depression and child malnutrition.

  1. Corneal endothelial cell changes 5 years after laser in situ keratomileusis: femtosecond laser versus mechanical microkeratome. (United States)

    Klingler, Kyle N; McLaren, Jay W; Bourne, William M; Patel, Sanjay V


    To compare corneal endothelial cell density (ECD) and morphology between flap creation with a femtosecond laser and flap creation with a mechanical microkeratome 5 years after laser in situ keratomileusis (LASIK). Mayo Clinic, Rochester, Minnesota, USA. Prospective randomized masked paired-eye study. In this study of LASIK for myopia or myopic astigmatism, fellow eyes were randomized by ocular dominance to flap creation by a femtosecond laser or by a mechanical microkeratome. Central endothelial images were analyzed before and 3 years and 5 years after LASIK; endothelial cell variables were compared between treatments at each examination. Relationships between endothelial cell loss and contact lens wear, residual bed thickness, and preoperative refractive error were evaluated. There were no differences in the ECD, percentage of hexagonal cells, or coefficient of variation of cell area between treatments at any examination (all P = .99); the smallest detectable differences were 120 cells/mm(2), 5%, and 2%, respectively. The mean annual rate of corneal endothelial cell loss was -0.1% ± 1.2% (SD) and -0.1% ± 1.0% for the femtosecond laser and the mechanical microkeratome, respectively. Endothelial cell loss was not associated with contact lens wear, residual bed thickness, or preoperative refractive error. The energy delivered to the cornea during femtosecond laser flap creation did not affect the corneal endothelium 5 years after LASIK when compared with flap creation with a mechanical microkeratome. Corneas that have had either method of flap creation could be accepted as donor tissue for endothelial keratoplasty from the standpoint of endothelial health. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  2. Assessment of Iron Overload in Homozygous and Heterozygous Beta Thalassemic Children below 5 Years of Age

    Directory of Open Access Journals (Sweden)

    Dhiraj J. Trivedi


    Full Text Available Background: Thalassemia is a genetic disease having 3-7% carrier rate in Indians. It is transfusion dependent anemia having high risk of iron overloading. A clinical symptom of iron overload becomes detectable in second decade causing progressive liver, heart and endocrine glands damage. There is a need to assess iron overload in thalassemics below 5 years of age to protect them from complications at later age of life. Aims and objectives: Present study was undertaken to estimate serum iron status and evaluate serum transferrin saturation in both homozygous & heterozygous form of thalassemia as an index of iron overload among children of one to five years of age. Materials and Methods: Clinically diagnosed thirty cases of β thalassemia major & thirty cases of β thalassemia minor having severe anemia, hepatospleenomegaly and between 1 year to 5 years of age were included in study group and same age matched healthy controls were included in the study. RBC indices and HbA, HbA2 and HbF were estimated along with serum iron & serum Total Iron Binding Capacity (TIBC and serum transferrin levels. Results: Significant difference was observed in hemoglobin levels between control and both beta thalassemia groups. Mean Corpuscular Volume (MCV and Mean Corpuscular Hemoglobin (MCH values were reduced. Hemoglobin electrophoresis showed the elevated levels of HbF and HbA2 in both beta thalassemia groups. Among serum iron parameters, serum iron, TIBC and transferrin saturation were elevated whereas serum transferrin levels were low in thalassemia major in children below 5 years of age. Conclusion: Although clinical symptoms of iron overload have been absent in thalassemic children below five years of age, biochemical iron overloading has started at much lower age which is of great concern.

  3. Global causes of diarrheal disease mortality in children <5 years of age: a systematic review.

    Directory of Open Access Journals (Sweden)

    Claudio F Lanata

    Full Text Available Estimation of pathogen-specific causes of child diarrhea deaths is needed to guide vaccine development and other prevention strategies. We did a systematic review of articles published between 1990 and 2011 reporting at least one of 13 pathogens in children <5 years of age hospitalized with diarrhea. We included 2011 rotavirus data from the Rotavirus Surveillance Network coordinated by WHO. We excluded studies conducted during diarrhea outbreaks that did not discriminate between inpatient and outpatient cases, reporting nosocomial infections, those conducted in special populations, not done with adequate methods, and rotavirus studies in countries where the rotavirus vaccine was used. Age-adjusted median proportions for each pathogen were calculated and applied to 712 000 deaths due to diarrhea in children under 5 years for 2011, assuming that those observed among children hospitalized for diarrhea represent those causing child diarrhea deaths. 163 articles and WHO studies done in 31 countries were selected representing 286 inpatient studies. Studies seeking only one pathogen found higher proportions for some pathogens than studies seeking multiple pathogens (e.g. 39% rotavirus in 180 single-pathogen studies vs. 20% in 24 studies with 5-13 pathogens, p<0.0001. The percentage of episodes for which no pathogen could be identified was estimated to be 34%; the total of all age-adjusted percentages for pathogens and no-pathogen cases was 138%. Adjusting all proportions, including unknowns, to add to 100%, we estimated that rotavirus caused 197 000 [Uncertainty range (UR 110 000-295 000], enteropathogenic E. coli 79 000 (UR 31 000-146 000, calicivirus 71 000 (UR 39 000-113 000, and enterotoxigenic E. coli 42 000 (UR 20 000-76 000 deaths. Rotavirus, calicivirus, enteropathogenic and enterotoxigenic E. coli cause more than half of all diarrheal deaths in children <5 years in the world.

  4. Interdisciplinary rehabilitation after whiplash injury: An observational prospective 5 years outcome study. (United States)

    Haiduk, Philipp; Benz, Thomas; Lehmann, Susanne; Gysi-Klaus, Francoise; Aeschlimann, André; Michel, Beat A; Angst, Felix


    Whiplash injury associated disorders (WAD) cause high costs for public health care. Neck pain is number 16 on the global prevalence lists for the 50 most common sequelae. It is of importance to obtain long-term data on disability and working capacity outcomes after rehabilitation. Long-term prospective data of the outcome course of whiplash are sparse. The aim of this study was to quantify improvements of pain, function/role performance, vitality, and working capacity 5 years after whiplash injury and to compare the state of health to normative values at 5 years after rehabilitation.In this naturalistic, observational, prospective cohort study, 115 patients were assessed 5 years (60 months) after a multidisciplinary rehabilitation program. The assessment set consisted of the Short Form 36 (SF-36), parts of the North American Spine Society's cervical spine assessment questionnaire (NASS) and the coping strategies questionnaire (CSQ). The effects were quantified by effect size (ES) and standardized response mean (SRM). Score differences over the course were tested by the Wilcoxon-Mann-Whitney U test for significance.Comparing data between entry and 60 months after rehabilitation 8 of 15 parameters improved with large ES/SRM. Outcome between 6 and 60 months showed small to moderate ES/SRM. Working capacity increased from 0 at entry to rehabilitation to 21 h/wk at 6 months and to 30 h/wk at 60 months follow-up.After large improvements in health and working capacity in the mid-term, further important improvements were observed in the long-term course. It can be hypothesized that part of those can be attributed to the interventions during inpatient rehabilitation, for example, due to better coping strategies.

  5. Rota virus genotypes and the clinical severity of Diarrhoea among children under 5 years of age. (United States)

    Uzoma, Ezeonwu Bertilla; Chukwubuikem, Chinedu; Omoyibo, Efe; Tagbo, Oguonu


    Diarrhoeal disease still remains one of the common causes of morbidity and mortality in children under 5 years of age. It is caused notably by the different serotypes of rotavirus. To ascertain the prevalence and risk factors for rotavirus diarrhoea in children under 5 years of age seen at Federal Medical Centre, Asaba, and to determine the different serotypes and their relationship with diarrhoea severity. A hospital-based cross-sectional study in which all children under 5 years of age, with diarrhoea had their stool samples tested for rotavirus antigen with enzyme immunoassay. Significant values of variables were determined using t-tests and Chi-square tests as appropriate. One hundred and thirty-two children were studied: 52.3% were males and 46.7% were females. Children 1-11 months of age constitute 49.2%, whereas those 12-59 months were 50.8%. Only 49 (37.1%) children were ELISA positive for rotavirus and of this number, 31 (63.3%) were within 1-11 months of age, P = 0.013. The three most common rotavirus genotypes were G3P[6] in 24.5%, G1P[6] in 12.2% and G12P[8] in 10.2% of the samples, respectively. Duration of vomiting was more prolonged with G3P[6] infection, P = 0.029, whereas dehydration and the overall severity of the diarrhoea were more with G12P[8] infection, P = 0.026 and 0.010, respectively. The emerging G12 rotavirus genotype was isolated in Asaba.

  6. Elevated liver enzymes in Turner syndrome during a 5-year follow-up study. (United States)

    El-Mansoury, Mostafa; Berntorp, Kerstin; Bryman, Inger; Hanson, Charles; Innala, Eva; Karlsson, Anders; Landin-Wilhelmsen, Kerstin


    To study the prevalence and incidence of elevated liver enzymes and their relationship with body weight, metabolic factors and other diseases in Turner syndrome (TS). Five-year follow-up. Women with TS (n = 218, mean age 33 +/- 13, range 16-71 years) from outpatient clinics at university hospitals in Sweden. Fasting blood samples for aspartate (AST) and alanine aminotransferase (ALT), bilirubin, alkaline phosphatase (ALP), gamma-glutamyl transferase (GT), viral hepatitis serology and hepatic auto-antibodies, vitamin B12, blood glucose, lipids and hormones. Seventy-nine subjects (36%) had one or more liver enzyme levels higher than the reference level, the most prevalent being GT. Karyotype 45,X was present in 51% of all TS women and in 48% of those with elevated liver enzymes. Body weight, body mass index (BMI), total cholesterol, triglycerides, and apolipoproteins A and B at start were higher in TS women with elevated liver enzymes than in TS women with normal levels. At 5 years, AST, ALT and GT were increased and another 23% of patients had developed elevated liver enzymes, that is, 59% in total (36% + 23%), while in 6%, the elevated liver enzymes had been normalized and all 6% also had lowered cholesterol levels. Multivariate analysis showed that GT was correlated with total cholesterol; P = 0.0032 at start and P = 0.0005 at 5 years, independently of other factors. Liver biopsy in six TS women showed one cholangitis, one hepatitis C, two steatosis and two normal biopsies. Withdrawal of oestrogen substitution did not influence the liver enzymes. Pathological liver enzymes were common in TS women, with a prevalence of 36% at 33 years of age, an annual incidence over 5 years of 3.4%. There was no relation to karyotype, alcohol, viral hepatitis, E(2) or autoimmunity, but a connection with total serum cholesterol.

  7. Socioeconomic status, education, and aortic stiffness progression over 5 years: the Whitehall II prospective cohort study. (United States)

    Trudel, Xavier; Shipley, Martin J; McEniery, Carmel M; Wilkinson, Ian B; Brunner, Eric J


    The inverse association between socioeconomic status (SES) and cardiovascular disease (CVD) risk is well documented. Aortic stiffness assessed by aortic pulse wave velocity (PWV) is a strong predictor of CVD events. However, no previous study has examined the effect of SES on arterial stiffening over time. The present study examines this association, using several measures of SES, and attained education level in a large ageing cohort of British men and women. Participants were drawn from the Whitehall II study. The sample was composed of 3836 men and 1406 women who attended the 2008-2009 clinical examination (mean age = 65.5 years). Aortic PWV was measured in 2008-2009 and in 2012-2013 by applanation tonometry. A total of 3484 participants provided PWV measurements on both occasions. The mean difference in 5-year PWV change was examined according to household income, education, employment grade, and father's social class, using linear mixed models. PWV increase [mean: confidence interval (m/s)] over 5 years was higher among participants with lower employment grade (0.38: 0.11-0.65), household income (0.58, 95%: 0.32-0.85), and education (0.30: 0.01, 0.58), after adjusting for sociodemographic variables, BMI, alcohol consumption, smoking, and other cardiovascular risk factors, namely SBP, mean arterial pressure, heart rate, cholesterol, diabetes, and antihypertensive use. The present study supports the presence of robust socioeconomic disparities in aortic stiffness progression. Our findings suggest that arterial aging could be an important pathophysiological pathway explaining the impact of lower SES on CVD risk.


    Directory of Open Access Journals (Sweden)

    Amitoj Singh Chhina


    Full Text Available BACKGROUND : Acute respiratory infections are a leading cause of morbidity and mortality in under - five children in developing countries. Hence, the present study was undertaken to study the various risk factors, clinical profile and outcome of acute lower respiratory tract infections (ALRI in children aged 2 month to 5 years. OBJECTIVE : clinical features, laborato ry assessment and morbidity and mortality pattern associated with acute lower respiratory tract infections in children aged 2 months to 5 years. METHODS: 100 ALRI cases fulfilling WHO criteria for pneumonia, in the age group of 2 month to 5 years were evaluated for clinical profile as per a predesigned proforma in a rural medical college. RESULTS : Of cases 61% were infants and remaining 39%12 - 60 months age group, males outnumbered females with sex ratio of 1.3;1. Elevated total leukocyte counts for age were observed in only 22% of cases, of these 3% were having pneumonia, 9% severe pneumonia and 10% very severe pneumonia. Significant association was found between leukocytosis and ALRI severity (p= 0.0001 Positive blood culture was obtained in 8% of cases and was significantly associated with ALRI severity (p=. 0.027. Among the ALRI cases, 84% required oxygen supplementation at any time during the hospital stay and 8% required mechanical ventilation. The mortality rate was 1%; with 99% of cases recovering and getting discharged uneventfully. CONCLUSION : Among the clinical variables, the signs and symptoms of ALRI as per the WHO ARI Control Programme were found in almost all cases. Regarding the laboratory profile, leukocytosis and blood culture positivity w ere observed in a small percentage, but significant association with ALRI severity was observed for both. Thus, clinical signs, and not invasive blood tests are a better diagnostic tools, though the latter may provide additional therapeutic and prognostic information in severe disease

  9. Association between depression in carers and malnutrition in children aged 6 months to 5 years. (United States)

    Motlhatlhedi, Keneilwe; Setlhare, Vincent; Ganiyu, Adewale; Firth, Jacqueline


     Childhood malnutrition is an important risk factor for child mortality and underlies close to 50% of child deaths worldwide. Previous studies have found an association between maternal depression and child malnutrition, but it is not known whether this association exists in Botswana. In addition, previous studies excluded non-maternal primary caregivers (PCGs). It is unclear whether the association between primary caregiver depression and child malnutrition remains when non-maternal PCGs are included. The aim of this study was to determine if there is an association between PCG depression and malnutrition in children aged between 6 months and 5 years in Mahalapye, Botswana. The study was conducted in the child welfare clinics of Xhosa and Airstrip clinics, two primary health care facilities in Mahalapye, Botswana. This was a case control study. Cases were malnourished children aged between 6 months and 5 years, and controls were non-malnourished children matched for age and gender. The outcome of interest was depression in the PCGs of the cases and controls, which was assessed using the Patient Health Questionnaire 9 (PHQ 9), a depression screening tool. From a sample of 171 children, 84 of whom were malnourished, we found that the malnourished children were significantly more likely to have depressed PCGs (odds ratio = 4.33; 95% CI: 1.89, 9.89) than non-malnourished children in the 6-month to 5-year age group; the PCGs of malnourished children also had lower educational status. This study found a significant association between PCG depression and child malnutrition.

  10. Arthroscopic Labral Base Repair in the Hip: 5-Year Minimum Clinical Outcomes. (United States)

    Domb, Benjamin G; Yuen, Leslie C; Ortiz-Declet, Victor; Litrenta, Jody; Perets, Itay; Chen, Austin W


    Arthroscopic labral base repair (LBR) in the hip is a previously described technique designed to restore the native functional anatomy of the labrum by reproducing its seal against the femoral head. LBR has been shown to have good short-term outcomes. Hypothesis/Purpose: The purpose was to evaluate clinical outcomes of an LBR cohort with a minimum 5-year follow-up. It was hypothesized that patients who underwent LBR would continue to have significant improvement from their preoperative scores and maintain scores similar to their 2-year outcomes. Case series; Level of evidence, 4. Data for patients undergoing primary hip arthroscopic surgery with LBR from February 2008 to May 2011 with a minimum 5-year follow-up were prospectively collected and retrospectively reviewed. Patients with preoperative Tonnis osteoarthritis grade ≥2, previous hip conditions (slipped capital femoral epiphysis, avascular necrosis, Legg-Calv-Perthes disease), severe dysplasia (lateral center-edge angle arthroscopic surgery rates were 10.9% (7/64) and 17.2% (11/64). At a minimum 5-year follow-up, arthroscopic LBR continued to be a successful procedure and valid technique based on 3 PROs, the VAS, patient satisfaction, and survivorship. Significantly improved outcome scores were maintained compared with preoperative values and showed no signs of deterioration from the 2-year scores. The long-term survivorship of hip arthroscopic surgery has yet to be determined; however, these midterm results demonstrate the rates of additional procedures (both secondary arthroscopic surgery and conversion to total hip arthroplasty), that may be necessary after 2 years.

  11. Treatment outcome after neonatal cleft lip repair in 5-year-old children with unilateral cleft lip and palate. (United States)

    Košková, Olga; Vokurková, Jitka; Vokurka, Jan; Bryšova, Alena; Šenovský, Pavel; Čefelínová, Julie; Lukášová, Darina; Dorociaková, Petra; Abelovský, Juraj


    The aim of this study was to assess speech outcomes and dental arch relationship of 5-year-old Czech patients with unilateral cleft lip and palate (UCLP) who have undergone neonatal cleft lip repair and one-stage palatal closure. Twenty-three patients with UCLP, born between 2009 and 2010, were included in the study. Three universal speech parameters (hypernasality, articulation and speech intelligibility) have been devised for speech recordings evaluation. Outcomes of dental arch relationship were evaluated by applying the GOSLON Yardstick and subsequently compared with the GOSLON outcome of other cleft centers. Moderate hypernasality was present in most cases, the mean value for articulation and speech intelligibility was 2.07 and 1.93, respectively. The Kappa values for inter-examiner agreement for all the three speech outcomes ranged from 0.786 to 0.808. Sixty-three percent of patients were scored GOSLON 1 and 2, 26% GOSLON 3, and 10% GOSLON 4. GOSLON mean score was 2.35. Interrater agreement was very good, represented by kappa value of 0.867. The treatment protocol, involving neonatal cleft lip repair and one-stage palatal repair performed up to the first year of UCLP patient's life, has shown good speech outcomes and produced very good treatment results in regard to maxillary growth, comparable with other cleft centers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. Dynamic growth and deposition of hygroscopic aerosols in the nasal airway of a 5-year-old child. (United States)

    Kim, Jong Won; Xi, Jinxiang; Si, Xiuhua A


    Hygroscopic growth within the human respiratory tract can be significant, which may notably alter the behavior and fate of the inhaled aerosols. The objective of this study is to evaluate the hygroscopic effects upon the transport and deposition of nasally inhaled fine-regime aerosols in children. A physiologically realistic nasal-laryngeal airway model was developed based on magnetic resonance imaging of a 5-year-old boy. Temperature and relative humidity field were simulated using the low Reynolds number k - ε turbulence model and chemical specie transport model under a spectrum of four thermo-humidity conditions. Particle growth and transport were simulated using a well validated Lagrangian tracking model coupled with a user-defined hygroscopic growth module. The subsequent aerosol depositions for the four inhalation scenarios were evaluated on a multiscale basis such as total, subregional, and cellular-level depositions. Results of this study show that a supersaturated humid environment is possible in the nasal turbinate region and can lead to significant condensation growth (d / d(0)  > 10) of nasally inhaled aerosols. Depositions in the nasal airway can also be greatly enhanced by condensation growth with appropriate inhalation temperature and humidity. For subsaturated and mild inhalation conditions, the hygroscopic effects were found to be nonsignificant for total depositions, while exerting a large impact upon localized depositions. Copyright © 2012 John Wiley & Sons, Ltd.

  13. Effect of adhesive restorations over incomplete dentin caries removal: 5-year follow-up study in primary teeth. (United States)

    Casagrande, Luciano; Falster, Caline Angelica; Di Hipolito, Vinicius; De Góes, Mario Fernando; Straffon, Lloyd Harold; Nör, Jacques E; de Araujo, Fernando Borba


    The purpose of this study was to evaluate the effect of the materials used for indirect pulp treatment (IPT) on the long-term outcome of primary molar teeth. Forty-eight teeth with deep carious lesions, but without signs and symptoms of irreversible pulpitis, were randomly divided into 2 groups, according to the material placed on the demineralized dentin remain: (1) experimental group, adhesive system (Scotchbond Multipurpose); and (2) control group, calcium hydroxide liner (Dycal). Both groups were followed by a resin restoration application. After 4 to 5 years, the clinical and radiographic success rates between groups were similar (group 1=14 of 15; group 2=8 of 10; P=0.350). Subsequent to exfoliation, scanning electron microscopy revealed the presence of a hybrid layer at the resin-dentin interface and a microtensile bond strength of 9.63 MPa (group 1). Histological analysis showed that the pulp health status was similar in both groups. Indirect pulp treatment has a high clinical and radiographic long-term success rate in primary teeth and is not material-dependent.

  14. Subsequence Automata with Default Transitions

    DEFF Research Database (Denmark)

    Bille, Philip; Gørtz, Inge Li; Skjoldjensen, Frederik Rye


    of states and transitions) of the subsequence automaton is O(nσ) and that this bound is asymptotically optimal. In this paper, we consider subsequence automata with default transitions, that is, special transitions to be taken only if none of the regular transitions match the current character, and which do...... not consume the current character. We show that with default transitions, much smaller subsequence automata are possible, and provide a full trade-off between the size of the automaton and the delay, i.e., the maximum number of consecutive default transitions followed before consuming a character......(nσ) and delay O(1), thus matching the bound for the standard subsequence automaton construction. The key component of our result is a novel hierarchical automata construction of independent interest....

  15. Subsequence automata with default transitions

    DEFF Research Database (Denmark)

    Bille, Philip; Gørtz, Inge Li; Skjoldjensen, Frederik Rye


    of states and transitions) of the subsequence automaton is O(nσ) and that this bound is asymptotically optimal. In this paper, we consider subsequence automata with default transitions, that is, special transitions to be taken only if none of the regular transitions match the current character, and which do...... not consume the current character. We show that with default transitions, much smaller subsequence automata are possible, and provide a full trade-off between the size of the automaton and the delay, i.e., the maximum number of consecutive default transitions followed before consuming a character......(1), thus matching the bound for the standard subsequence automaton construction. Finally, we generalize the result to multiple strings. The key component of our result is a novel hierarchical automata construction of independent interest....

  16. Pedicle Subtraction Osteotomy in a 5-Year-Old Child with Congenital Kyphosis

    Directory of Open Access Journals (Sweden)

    Farzad Omidi-Kashani


    Full Text Available Vertebral anomalies may also distort the normal regional or global spinal alignment and necessitate some therapeutic interventions. Hemiepiphysiodesis is a traditional procedure usually described for these young patients but in more severe cases some type of osteotomy seems to be necessary. In this technical note, we describe a 5-year-old boy with failed previous hemiepiphysiodesis surgery, who was successfully treated with one level pedicle subtraction osteotomy. This procedure not only corrects the kyphotic deformity at the time of the procedure (not relying on future spinal growth, but also avoids more hazardous anterior approach.

  17. Malnutrition among children younger than 5 years-old in conflict zones of Chiapas, Mexico. (United States)

    Sánchez-Pérez, Héctor Javier; Hernán, Miguel A; Ríos-González, Adriana; Arana-Cedeño, Marcos; Navarro, Albert; Ford, Douglas; Micek, Mark A; Brentlinger, Paula


    We performed a cross-sectional, community-based survey, supplemented by interviews with community leaders in Chiapas, Mexico, to examine the prevalence and predictors of child malnutrition in regions affected by the Zapatista conflict. The prevalence rates of stunting, wasting, and underweight were 54.1%, 2.9%, and 20.3%, respectively, in 2666 children aged younger than 5 years. Stunting was associated with indigenous ethnicity, poverty, region of residence, and intracommunity division. The results indicate that malnutrition is a serious public health problem in the studied regions.

  18. Clinical treatment of a ruptured temporomandibular joint disc: morphological changes at 5-year follow-up. (United States)

    Cardinal, Lucas; Porto, Felipe; Agarwal, Sachin; Grossman, Eduardo


    Osteoarthrosis is a disease that affects the temporomandibular joint (TMJ). This case report chronicles the diagnosis and treatment of a patient for whom this pathological condition was accompanied by a rupture of the articular disc. The patient presented with loud sounds in the left TMJ and an irregular mandibular occlusal plane due to condylar intrusion in the glenoid fossa on the ipsilateral side. A noninvasive treatment was selected. A 4-month follow-up revealed remission of the articular sounds, and tissue regeneration was noted. These improvements remained visible at 5-year follow-up.

  19. Malnutrition Among Children Younger Than 5 Years-Old in Conflict Zones of Chiapas, Mexico (United States)

    Sánchez-Pérez, Héctor Javier; Hernán, Miguel A.; Ríos-González, Adriana; Arana-Cedeño, Marcos; Navarro, Albert; Ford, Douglas; Micek, Mark A.; Brentlinger, Paula


    We performed a cross-sectional, community-based survey, supplemented by interviews with community leaders in Chiapas, Mexico, to examine the prevalence and predictors of child malnutrition in regions affected by the Zapatista conflict. The prevalence rates of stunting, wasting, and underweight were 54.1%, 2.9%, and 20.3%, respectively, in 2666 children aged younger than 5 years. Stunting was associated with indigenous ethnicity, poverty, region of residence, and intracommunity division. The results indicate that malnutrition is a serious public health problem in the studied regions. PMID:17194868

  20. Socioeconomic status and changes in body mass from 3 to 5 years (United States)

    De Spiegelaere, M; Dramaix, M; Hennart, P


    The influence of social status on the development of body mass was analysed in a retrospective cohort study of 675 Belgian children monitored between the ages of 3 and 5 years by the preventive medical services in Brussels. At age 3, no association between excess weight and social status was observed. Adiposity rebound before age 5 was inversely related to body mass at age 3 and was independent of social status. The social influences on obesity observed in adolescence cannot be explained by a higher frequency of early adiposity rebound in children of low socioeconomic status.


  1. A case of spontaneous gastric rupture in a 5 years girl

    Directory of Open Access Journals (Sweden)

    D. Salerno


    Full Text Available We describe a case of spontaneous gastric rupture in a child of 5 years old. The patient reached us in a serious condition; the anamnesis was negative for traumatic events or gastrointestinal disorders. An abdominal X-ray and CT scan revealed free air and fluid in the abdominal cavity, leading to the diagnosis of gastro-intestinal perforation. Submitted to urgent surgery, a rupture of the posterior wall of the stomach was found that was treated with gastrectomy “à la demande”. The surgery follow-up was regular. Morphological and immunohistochemical study showed some muscular abnormalities of the muscular gastric wall.

  2. Neurocognitive development in first episode psychosis 5 years follow-up

    DEFF Research Database (Denmark)

    Barder, Helene Eidsmo; Sundet, Kjetil; Rund, Bjørn Rishovd


    battery was divided into five indices; Verbal Learning, Executive Function, Impulsivity, Motor Speed, andWorking Memory. To investigate the effect of illness severity, the sample was divided in groups based on number of relapses, and diagnostic subgroups, respectively. Impulsivity and Working Memory...... improved significantly in the first two years, followed by no change over the next three years.Motor Speed decreased significantly from2 to 5 years. Number of relapseswas significantly related to Verbal Learning and WorkingMemory, showing a small decrease and less improvement, respectively, in patients...

  3. Stable glomerular filtration rate in normotensive IDDM patients with stable microalbuminuria. A 5-year prospective study

    DEFF Research Database (Denmark)

    Mathiesen, E R; Feldt-Rasmussen, B; Hommel, E


    OBJECTIVE: To investigate the long-term course of glomerular filtration rate (GFR) in IDDM patients with microalbuminuria in order to identify patients with stable or declining kidney function over a 5-year study. RESEARCH DESIGN AND METHODS: Forty normotensive (129 +/- 11/80 +/- 8 mmHg) IDDM...... of kidney function. Efforts should be made to prevent the progression from microalbuminuria to diabetic nephropathy in every IDDM patient with microalbuminuria....... min-1.1 x 73 m-2. RESULTS: Using multiple regression analysis, the rate of decline in GFR was independently correlated to onset of diabetic nephropathy (P

  4. Montelukast reduces asthma exacerbations in 2- to 5-year-old children with intermittent asthma

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Zielen, Stefen; Garcia-Garcia, María Luz


    The PREVIA study was designed to investigate the role of montelukast, a leukotriene receptor antagonist, in the prevention of viral-induced asthma exacerbations in children aged 2 to 5 years with a history of intermittent asthma symptoms. The study was a 12-month multicenter, double-blind, parallel......-group study of patients with asthma exacerbations associated with respiratory infections and minimal symptoms between episodes. Patients were randomized to receive oral montelukast 4 or 5 mg (depending on age) (n = 278) or placebo (n = 271) once per day for 12 months. Caregivers recorded children's symptoms...

  5. Lessons learned from 15 years of KIMS and 5 years of ACROSTUDY

    DEFF Research Database (Denmark)

    Luger, Anton; Feldt-Rasmussen, Ulla; Abs, Roger


    and effectiveness of growth hormone (GH) therapy in GH-deficient children since its inception in 1987. Following closely in the footsteps of KIGS is KIMS (Pfizer International Metabolic Database). As of 2009, KIMS has been collecting data on the long-term safety and clinical outcomes of GH replacement in GH......-deficient adults for 15 years. Approximately 5 years ago, the ACROSTUDY database was established to monitor the long-term safety and effectiveness of pegvisomant in patients with acromegaly. CONCLUSIONS: By collecting data on the treatment of relatively rare conditions in routine clinical practice...

  6. Experience of bone-anchored hearing aid implantation in children younger than 5 years of age. (United States)

    Amonoo-Kuofi, Kwamena; Kelly, Andrea; Neeff, Michel; Brown, Colin R S


    To assess the practicality and benefit of Bone-anchored hearing aid (BAHA(®)) implantation in children younger than 5 years of age. FDA approval for use of BAHA(®) only exists for children 5 years of age and older. Their use in Australia is also rare, however their use for younger children is approved by the European Union. We wish to share our experience of implantation in an antipodean setting in this age group. Institutional board approval was obtained for this study. All children undergoing BAHA(®) implantation under 5 years old were included from our prospective database. We examined the variety of surgical techniques, (including skin grafting, limited soft tissue reduction and no soft tissue reduction), BAHA(®) implants and abutments used, and use of the new series 400 hydroxyapatite coatings. Demographic data obtained included age at surgery, follow up duration, gender, ethnicity and indication for surgery. Anonymous benefit questionnaires (Glasgow children's benefit inventory (GCBI) and parents' evaluation of aural performance of children (PEACH)) were completed online as well as a questionnaire on device use. Complications recorded included soft tissue reactions, implant loss/removal, abutment replacement/removal. We also assessed whether patient weight, ethnicity or socioeconomic status were risk factors for these complications. 24 Children (26 ears/26 implants) under five years were identified from the database and included in the study. There was a 14:10 male to female ratio. Patient caregivers reported subjective benefit and improved quality of life (QOL) despite setbacks and complications related to BAHA(®) usage. 10/24 (42%) of children required treatment for significant peri-implant skin reactions whilst 25% required replacement of their abutments and/or implants. An increased risk of major complication was associated with socioeconomic deprived backgrounds and in patients of New Zealand Maori and Pacific Island ethnicity but not in patients

  7. Giant parietal lobe infantile gliosarcoma in a 5-year-old child. (United States)

    Savant, Hemant V; Balasubramaniam, Srikant; Mahajan, Vijay


    The relative frequency of pediatric gliosarcoma (GSM) is 1.9% among glioblastomas and 0.5% among pediatric central nervous system tumors. A 5-year-old female child came to us with history of fever and loss of appetite since 2 weeks and right sided weakness since 4 days. Magnetic resonance imaging showed a large heterogeneously enhancing space occupying lesion in the left parieto-occipital region. A parieto-occipital craniotomy with radical excision of tumor was performed. The patient was given adjuvant therapy following surgery and survived until 9 months following surgery. The etiopathogenesis, treatment modalities and prognosis of GSM is discussed.

  8. Ulnar Head Replacement: 21 Cases; Mean Follow-Up, 7.5 Years. (United States)

    Axelsson, Peter; Sollerman, Christer; Kärrholm, Johan


    To report clinical and radiographic outcomes for the Herbert ulnar head prosthesis after a mean of 7.5 years (range, 2.0-12.5 years). We performed 22 Herbert ulnar head prosthesis arthroplasties between 2000 and 2011. Five were primary procedures, and the remaining 17 were done after an average of 2 (range, 1-5) previous operations. The mean age at surgery was 55 years (range, 31-74 years). Follow-up including clinical examination, standardized questionnaires, and radiographic examination was done after mean 7.5 years (range, 2.0-12.5 years) in 21 cases. We used the Disabilities of the Arm, Shoulder, and Hand questionnaire, the Patient-Rated Wrist Evaluation questionnaire, and the Mayo wrist score questionnaire. Pain and satisfaction were evaluated with a 10-cm visual analog scale (VAS). Measurements of range of motion and strength for grip were recorded. Wrist range of motion was not affected by the arthroplasty except for supination, which significantly improved from 55° to 70°. At follow-up, grip strength averaged 25 kg (range, 10-48 kg) in the operated wrists and 31 kg (range, 8-74 kg) on the contralateral side. Visual analog scale-pain averaged 2.9 (range, 0-8.7) during activity and 1.7 (range, 0-7) at rest. Satisfaction VAS was 8.9 (range, 4.3-10). Five patients had VAS-pain above 5 during activity, and 1 patient was dissatisfied and regretted having undergone arthroplasty. Mean outcomes were 27 (range, 5-50) for Disabilities of the Arm, Shoulder, and Hand measure, 31 (range, 0-90) for the Patient-Rated Wrist Evaluation score, and 71 (range, 30-90) for the Mayo wrist score. One patient was reoperated with capsuloplasty 9 months after the arthroplasty owing to recurrence of painful instability. Full stability was not achieved but the pain resolved. None of the implants showed any radiographic signs of loosening. The Herbert ulnar head prosthesis was a safe method of treatment and provided satisfactory midterm results for selected cases of distal radioulnar

  9. Feeding strategies used by mothers of 3-5-year-old children. (United States)

    Moore, Sue N; Tapper, Katy; Murphy, Simon


    Appropriate use of parental feeding strategies could help establish healthy childhood eating practices. Research suggests that repeated taste exposure and modelling may be effective, pressuring and restricting may be counterproductive, and rewards may be effective or counterproductive depending on their use. However, little is known about the extent to which parents employ these strategies and within what contexts. The present study explored this using qualitative interviews with twelve mothers of children aged 3-5 years. Common strategies involved modelling, attempts to influence the child's attitudes and norms, and use of moderate pressure. The results are discussed in relation to the literature.

  10. Posttraumatic stress disorder among Danish soldiers 2.5 years after military deployment in Afghanistan

    DEFF Research Database (Denmark)

    Hellerup, Janne; Andersen, Søren Bo; Høgh (Hogh), Annie


    Understanding the development of posttraumatic stress disorder (PTSD) implicates research regarding factors besides the preceding traumatic event. This study investigated the influence of predisposing personality traits on development of PTSD in a group of Danish Soldiers deployed to Afghanistan (N...... = 445). Using a prospective design data was collected using questionnaires including the NEO Five Factor Inventory and the Posttraumatic Stress Disorder Checklist. The results showed a PTSD-prevalence of 9.2% in the total sample 2.5 years after homecoming. Using Kruskal-Wallis, Mann-Whitney U...

  11. Total pancreatectomy and autoislet transplant for chronic recurrent pancreatitis in a 5-year-old boy

    Directory of Open Access Journals (Sweden)

    Shaheed Merani


    Full Text Available Childhood chronic pancreatitis is a rare disorder, which can lead to a chronically debilitating condition. The etiology of recurrent hereditary pancreatitis, which previously was classified as idiopathic, has now been attributed in certain cases to specific genetic mutations including abnormalities in the PRSS gene. We describe here the use of total pancreatectomy and autoislet transplant in a 5-year-old with chronic pancreatitis. This represents the youngest patient undergoing the procedure at our institution. The early successful outcomes for this patient, both of symptom relief and glycemic control are detailed.

  12. Diarrhea Caused by Rotavirus in Children Less than 5 Years of Age in Hanoi, Vietnam


    Nguyen, Trung Vu; Le, Phung Van; Le Huy, Chinh; Weintraub, Andrej


    Group A rotaviruses are the major cause of diarrhea in young children worldwide. From March 2001 to April 2002, 836 children less than 5 years of age were investigated in Hanoi, Vietnam. This included 587 children with diarrhea and 249 age-matched controls. Group A rotavirus was identified in 46.7% of the children with diarrhea and 3.6% of the controls, which was a significant difference. Within the diarrhea group, the highest prevalence was seen in children from 13 to 24 months of age, and t...

  13. Revisional single-anastomosis gastric bypass for a failed restrictive procedure: 5-year results. (United States)

    Bruzzi, Matthieu; Voron, Thibault; Zinzindohoue, Franck; Berger, Anne; Douard, Richard; Chevallier, Jean-Marc


    Long-term outcomes of revisional laparoscopic single anastomosis-gastric bypass for a failed restrictive procedure (rSAGB) have not been analyzed. To assess 5-year outcomes of rSAGB compared with 5-year outcomes of primary SAGB (pSAGB). University public hospital, France. One hundred twenty-six patients who underwent SAGB between October 2006 and October 2008 were included in this retrospective study. rSAGB was defined as SAGB performed after failure of a first restrictive procedure. Five-year outcomes of each procedure regarding mortality, morbidity (i.e., Clavien-Dindo score), weight loss (change in body mass index [BMI] and percentage of excess BMI loss [%EBMIL]), co-morbidities remission, and Gastrointestinal Quality of Life Index (GIQLI) score, were assessed. Thirty patients (24%) who had prior restrictive bariatric surgery (including 22 laparoscopic adjustable gastric bandings, 4 vertical banded gastroplasties, and 4 sleeve gastrectomies) underwent conversion to rSAGB. Ninety-six patients (76%) underwent primary SAGB (pSAGB group). Both groups were comparable in age, gender, BMI, and preoperative co-morbidities. Preoperative mean BMI of the rSAGB group was 45.5±7 kg/m(2). There were no deaths and the major complications rate was 10%. No increase in morbidity was found between the 2 groups. Two patients required conversion to RYGB after rSAGB because of intractable biliary reflux. At 5 years, mean BMI was 32 kg/m(2) and mean %EBMIL was 66% after rSAGB; no significant differences were found compared with pSAGB (BMI = 31 kg/m(2), %EBMIL = 73%). Co-morbidities and remission rates were statically similar. Overall, GIQLI score was significantly lower in the rSAGB group (104.1±17.6 versus 112.5±16.8, P = .025). Significant differences were found in "upper gastrointestinal symptoms" and "psychological" scores. At 5 years, rSAGB for a failed restrictive procedure was safe and effective, but quality of life and upper gastrointestinal function were lower compared

  14. Medium-term outcomes and complications after total replacement of the temporomandibular joint. Prospective outcome analysis after 3 and 5 years. (United States)

    Gruber, E A; McCullough, J; Sidebottom, A J


    In this prospective analysis, we assess the medium-term benefits, efficacy, and safety of the TMJ Concepts joint replacement system in the United Kingdom. Outcome measures of pain, maximum mouth opening, and diet were recorded preoperatively and at intervals up to 3 and 5 years. All patients who had replacement temporomandibular joints (TMJ) within a 6-year period were included. A total of 58 patients (84 joints) were followed up for 3 years (mean age 47, range 19-72) and 26 (42 joints) for 5 years (mean age 46, range 27-70). The female to male ratio was 52:6 at 3 years and 23:3 at 5 years. The most common diagnosis was degenerative disease, and the mean number of previous TMJ procedures was 2.4 (range 0-14). There were significant improvements in pain scores (7.4 reduced to 0.6 at 3 years and 0.8 at 5 years), maximum mouth opening (21.0-35.5mm at 3 years and 23.8-33.7mm at 5 years), and dietary scores (4.1-9.7 at 3 years and 3.7-9.6 at 5 years). Revision operations were required in 2 patients (not included in the outcome data) for biofilm infection of the prosthesis secondary to local infection in the head and neck. One patient had weakness of the temporal branch of the facial nerve that needed correction. TMJ replacement is an effective form of management for an irreparably damaged joint, particularly in cases of ankylosis. It lessens pain and improves function with minimal long-term morbidity. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  15. Radiographic and clinical outcomes of rooted, platform-switched, microthreaded implants with a sandblasted, large-grid, and acid-etched surface: A 5-year prospective study. (United States)

    Mei, Dong Mei; Zhao, Baodong; Xu, Hao; Wang, Yanhui


    There is no data available on the long-term outcomes of a rooted, platform-switched, microthreaded implant with a sandblasted, large-grid, and acid-etched surface. This prospective, longitudinal study evaluated the clinical and radiographic outcomes of rooted, platform-switched, microthreaded and sandblasted, large-grid, and acid-etched (SLA) surface implants for 5 years. Sixty implants were placed in sixty patients with partially edentulous maxillae or mandibles. The permanent prostheses were inserted 2-4 months after implant placement. Clinical and radiographic examinations were performed at follow-up visits scheduled postoperation, prosthesis installation, 1 year, and 5 years after surgery, to assess implant survival and success rates, biological and mechanical complications, and marginal bone loss. After 5 years' follow-up, four patients withdrawn from the study, and 56 implants achieved a 100% survival rate and 98.2% success rate. Three prosthetic complications occurred, resulting in a success rate for prostheses of 94.6%. The incidence of peri-implant mucositis was 9.1% and no peri-implantitis was diagnosed. The average marginal bone loss at the mesial aspect was 0.46 ± 0.27 mm after 1 year and 0.48 ± 0.27 mm after 5 years. The average marginal bone loss at the distal aspect was 0.46 ± 0.32 mm after 1 year and 0.50 ± 0.35 mm after 5 years. After 5 years of loading, the rooted, platform-switched, microthreaded, and SLA surface implants showed high survival and success rates, steady crestal bone levels, and excellent long-term clinical outcomes in the soft tissue. Overloading may be related to the marginal bone loss around implants, but the surgical protocol, different sites, and jaw position did not correlate with crestal bone loss. © 2017 Wiley Periodicals, Inc.

  16. Identifying acceptability and price points for purchasing micronutrient powders for children 2 to 5 years old in Nepal. (United States)

    Gunnala, Rajni; Perrine, Cria G; Subedi, Giriraj; Mebrahtu, Saba; Dahal, Pradiumna; Jefferds, Maria Elena


    Little is known about purchasing micronutrient powders (MNP) for children 2-5 years. We describe acceptability for purchasing and price points for MNP for children 2-5 years among caregivers living in districts where free MNP are distributed for children 6-23 months. Crosssectional surveys conducted 3 months after MNP program implementation in 2 districts; 15 months after implementation in 2 different districts. Chi square tests and logistic regression describe associations among sociodemographics and program exposure factors and acceptability of purchasing MNP among 1,261 mothers of children 6-23 months who had heard of MNP. Overall, 77.5% and 86.1% of mothers reported acceptability for purchasing MNP in the 3 and 15 month surveys, respectively. Positive pricing attitude (PPA) about paying 150 Nepali rupees for 60 sachets of MNP was reported by 66.3% and 73.4% of mothers. Acceptability for purchasing MNP in both time periods increased with higher wealth quintile and higher maternal education; PPA increased with higher maternal education. Controlling for socio-demographics, program exposure factors associated with acceptability for purchasing MNP included: lack of perceived barriers to MNP intake and health worker counselling (3 month surveys); knowledge of benefits of MNP intake and lack of perceived barriers to MNP intake (15 month surveys). Mothers reported acceptability for purchasing MNP and PPA for older children in Nepal. Differences in acceptability were found across socio-demographics and program exposures. Use of these results and further exploration into actual purchasing behaviour can inform future MNP distribution methods in Nepal.

  17. Causes of mortality and associated modifiable health care factors for children (< 5-years admitted at Onandjokwe Hospital, Namibia

    Directory of Open Access Journals (Sweden)

    Johnface F. Mdala


    Full Text Available Introduction: Many countries, especially those from sub-Saharan Africa, are unlikely to reach the Millennium Development Goal for under-5 mortality reduction by 2015. This study aimed to identify the causes of mortality and associated modifiable health care factors for under-5year-old children admitted to Onandjokwe Hospital, Namibia.Method: A descriptive retrospective review of the medical records of all children under fiveyears who died in the hospital for the period of 12 months during 2013, using two differentstructured questionnaires targeting perinatal deaths and post-perinatal deaths respectively.Results: The top five causes of 125 perinatal deaths were prematurity 22 (17.6%, birth asphyxia 19 (15.2%, congenital anomalies 16 (12.8%, unknown 13 (10.4% and abruptio placenta 11 (8.8%. The top five causes of 60 post-perinatal deaths were bacterial pneumonia 21 (35%, gastroenteritis 12 (20%, severe malnutrition 6 (10%, septicaemia 6 (10%, and tuberculosis 4 (6.7%. Sixty-nine (55% perinatal deaths and 42 (70% post-perinatal deaths were potentially avoidable. The modifiable factors were: late presentation to a health care facility, antenatal clinics not screening for danger signs, long distance referral, district hospitals not providing emergency obstetric care, poor monitoring of labour and admitted children in the wards, lack of screening for malnutrition, failure to repeat an HIV test in pregnant women in the third trimesteror during breastfeeding, and a lack of review of the urgent results of critically ill children.Conclusion: A significant number of deaths in children under 5-years of age could be avoided by paying attention to the modifiable factors identified in this study.

  18. prevalence and causes of blindness and low vision revisited after 5 years of eye care in Timor-Leste. (United States)

    Ramke, Jacqueline; Brian, Garry; Naduvilath, Thomas; Lee, Lucy; Qoqonokana, Mundi Qalo


    To estimate the 2010 prevalence and causes of blindness and low vision among Timor-Leste adults aged ≥40 years, and compare these to the results of a survey conducted 5 years previously. A population-based cross-sectional survey used multistage cluster random sampling proportionate to size to identify 50 clusters of 45 people each. Cause of vision loss was determined for each eye with presenting visual acuity worse than 6/18. A participation rate of 89.5% (n = 2014) was achieved. The gender-age-domicile adjusted prevalence was 7.7% (95% confidence interval [CI] 6.5, 8.8) for 6/60, and 3.6% (95% CI 2.7, 4.4) for 3/60 blindness (better eye presenting vision worse than 6/60 and 3/60, respectively) among Timorese aged ≥40 years. Cataract caused most blindness (69.3% at 6/60). The population prevalence of low vision (better eye presenting vision of 6/60 or better, but worse than 6/18) was 13.6% (95%CI 12.1, 15.1), most caused by uncorrected refractive error (57.4%) or cataract (39.5%). The prevalence and causes of blindness were unchanged compared with 5 years earlier, but low vision was less common. Unusually for a developing country, Timor-Leste has initiated a cycle of evidence-based eye care in which, although with limitations, population data are periodically available for monitoring and planning.

  19. [Incidence and risk factors of diarrheal diseases among 3-5 year old Israeli Arab children attending kindergartens]. (United States)

    Muhsen, Khitam; Athamna, Abed; Cohen, Dani


    The existing limited data on diarrheal diseases in Israel indicate higher rates and more severe illness among Arab children compared to Jewish children. To determine the incidence and risk factors of diarrheal diseases in 3-5 year old Israeli Arab children from villages of Northern Israel. We carried out a follow-up study in 343 children who attended 9 kindergartens from 3 villages of Northern Israel. Daily surveillance was conducted on children's absenteeism from the kindergartens. The causes of absenteeism were recorded based on information received from parents' interviews. During the summer vacation, the follow-up was based on biweekly interviews. We also performed a nested case control study to identify potential risk factors of diarrheal disease; data were obtained through mothers' interviews. During the follow-up period, 100 new episodes of diarrhea were recorded yielding an incidence rate of 0.51 episodes/12 child-months, while 55% of the episodes were associated with visits to the clinic. In the multivariate analysis, the risk of diarrheal diseases was increased in males (OR 2.31 95% CI 1.3-4), in children aged 4 years or less compared to older children (OR 1.76 95% CI 1.01-3.06), and when the mother's education was 8 years or less (OR 1.88, 95% CI 1.08-3.26). Having siblings younger than 5 years old was associated with a reduced risk of diarrheal diseases (OR 0.57 95% CI 0.3-0.9). The incidence rate of diarrheal diseases among Israeli Arab toddlers attending kindergartens in villages from northern Israel is high. The risk factors of diarrheal disease in this population are significantly associated with features of the child and his family rather than environmental characteristics of the community or kindergarten.

  20. Quality assessment of endoscopic retrograde cholangiopancreatography: results of a running nationwide Austrian benchmarking project after 5 years of implementation. (United States)

    Kapral, Christine; Mühlberger, Andrea; Wewalka, Friedrich; Duller, Christine; Knoflach, Peter; Schreiber, Florian


    Endoscopic retrograde cholangiopancreatography (ERCP) has a high risk of various complications. The aim of this study is to report the main ERCP outcome, that means complications and success rates, on the basis of the pooled data of a national continuous quality assessment program. This study is an uncontrolled prospective survey and provides data from both academic and community-based endoscopy centers with varying case volumes and expertise. Data were collected within a nationwide voluntary ERCP benchmarking project that was initiated by the Austrian Society of Gastroenterology and Hepatology. In total, 42 sites participated in this program for varying periods (1 month up to 5 years) and reported 13 513 procedures within 5 years. The overall complication rate in nonselected patients was 10.1%. Post-ERCP pancreatitis occurred in 4.2%, bleeding in 3.6% (0.4% clinically relevant), cholangitis in 1.4%, cardiopulmonary complications in 1.2%, perforation in 0.6%, and procedure-related deaths in 0.1% of procedures. The overall therapeutic and diagnostic target was achieved in 80.3% (2009-2011) to 84.8% (2006/2007) of procedures. The desired duct was visualized in 90.7% and cannulated in 88.8% of procedures. The aim of the running benchmarking project in ERCP is to improve patient care in Austria. The survey reflects the general effectiveness and safety of ERCP. The overall complication and success rates are consistent with the available literature data. It sets an example as a benchmarking program that might result in international or even pan-European projects in high-risk endoscopic procedures.

  1. Risk factors for coliform bacteria in backcountry lakes and streams in the Sierra Nevada mountains: a 5-year study. (United States)

    Derlet, Robert W; Ger, K Ali; Richards, John R; Carlson, James R


    To provide a 5-year longitudinal assessment of risk of acquiring disease from Sierra Nevada Wilderness area lakes and streams. This study examines the relative risk factors for harmful water microorganisms, using coliforms as an indicator. Streams and lakes in the backcountry of Yosemite and Kings Canyon National Parks and neighboring wilderness areas were selected and water was analyzed each year over a 5-year period. A total of 364 samples from lakes or streams were chosen to statistically differentiate the risk categories based on land usage, as follows: 1) areas rarely visited by humans (Wild), 2) human day-use-only areas (Day Hike), 3) areas used by backpackers with overnight camping allowed (Backpack), 4) areas primarily impacted by horses or pack animals (Pack Animal), and 5) cattle and sheep grazing tracts (Cattle). Water was collected in sterile test tubes and Millipore coliform samplers. Water was analyzed at the university microbiology lab, where bacteria were harvested and then subjected to analysis using standardized techniques. Statistical analysis to compare site categories was performed utilizing Fisher exact test and analysis of variance. A total of 364 sampling sites were analyzed. Coliforms were found in 9% (4/47) of Wild site samples, 12% (5/42) of Day Hike site samples, and 18% (20/111) of Backpacker site samples. In contrast, 63% (70/111) of Pack Animal site samples yielded coliforms, and 96% (51/53) of samples from the Cattle areas grew coliforms. Differences between Backpacker vs Cattle or Pack Animal areas were significant at P

  2. Efficacy of Essure hysteroscopic sterilization--5 years follow up of 1200 women. (United States)

    Ríos-Castillo, José E; Velasco, Esther; Arjona-Berral, José E; Monserrat Jordán, José A; Povedano-Cañizares, Balbino; Castelo-Branco, Camil


    To assess the efficacy of the Essure hysteroscopic birth control device after 5 years follow up. Retrospective analysis of case series. Outpatient hysteroscopy facility in a large teaching hospital. One-thousand three-hundred and twenty-one women who underwent hysteroscopic sterilization with Essure device (Conceptus, Inc., Mountain View, CA) between January 2003 and May 2005. Hysteroscopic tubal sterilization using Essure system. Efficacy/effectiveness, failure rate. Satisfactory insertion was accomplished in the first attempt in 1166 women (97.16%). After the second attempt, successful insertion rate rise to 98.6%. (n = 31, 2.6%). Three pregnancies had been reported after 5 years follow up, which implies an overall absolute rate of 0.25%. This represents a Pearl index of 0.05 after 72,000 months of surveillance. All of them occurred in the first year of use of the microinsert. There has been no unintended pregnancy in the next 4 years. Essure has the lowest Pearl index never published being the most effective permanent birth control system to date. Unintended pregnancies tend to occur in the first year after the insertion, and can be avoided encouraging women to accomplish the protocol.

  3. Psychosocial development of 5-year-old children with hearing loss: Risks and protective factors. (United States)

    Wong, Cara L; Ching, Teresa Y; Leigh, Greg; Cupples, Linda; Button, Laura; Marnane, Vivienne; Whitfield, Jessica; Gunnourie, Miriam; Martin, Louise


    The aims of this paper were to report on the global psychosocial functioning of 5-year-old DHH children and examine the risk and protective factors that predict outcomes. A cross-sectional analysis of data collected from a prospective, population-based longitudinal study. Parents/caregivers of 356 children completed questionnaires on psychosocial development (CDI, SDQ), functional communication (PEACH) and demographic information. Children completed standardized assessments of non-verbal cognitive ability (WNV) and language (PLS-4). On average, global psychosocial functioning was within the range of typically developing children; however, variability was high and 12% of children had scores that were more than 2 SDs below the norm. Non-verbal cognitive ability, presence of additional disabilities, language and functional communication significantly predicted outcomes. In contrast, type of hearing device, severity of hearing loss and age at intervention did not. The global psychosocial functioning of this cohort of 5-year-old DHH children fell within the range of typically developing children. The findings suggest that spoken language ability and functional communication skills are vital for healthy psychosocial development.

  4. An implantable neuroprosthesis for standing and walking in paraplegia: 5-year patient follow-up (United States)

    Guiraud, David; Stieglitz, Thomas; Koch, Klaus Peter; Divoux, Jean-Louis; Rabischong, Pierre


    We present the results of a 5-year patient follow-up after implantation of an original neuroprosthesis. The system is able to stimulate both epimysial and neural electrodes in such a way that the complete flexor-extensor chain of the lower limb can be activated without using the withdrawal reflex. We demonstrate that standing and assisted walking are possible, and the results have remained stable for 5 years. Nevertheless, some problems were noted, particularly regarding the muscle response on the epimysial channels. Analysis of the electrical behaviour and thresholds indicated that the surgical phase is crucial because of the sensitivity of the functional responses to electrode placement. Neural stimulation proved to be more efficient and more stable over time. This mode requires less energy and provides more selective stimulation. This FES system can be improved to enable balanced standing and less fatiguing gait, but this will require feedback on event detection to trigger transitions between stimulation sequences, as well as feedback to the patient about the state of his lower limbs.

  5. Advanced paternal age and mortality of offspring under 5 years of age

    DEFF Research Database (Denmark)

    Urhoj, S K; Jespersen, Louise Norman; Nissen, Marie


    splines and paternal age groups. Main results and the role of chance: Compared with children born to fathers aged 30–34 years, a statistically significant excess risk was found for children born to fathers aged 40–44 years [HR: 1.10 (95% CI: 1.00–1.21)] and children born to fathers aged 45+ years [HR: 1.......16 (95% CI: 1.02–1.32)]. When only looking at 1–5 year olds, the relative risk (HR) among children born to fathers aged 40–44 years increased to 1.24 (95% CI: 1.00–1.53) and the risk in the oldest paternal age group (45+ years) rose to 1.65 (95% CI: 1.24–2.18). The results suggest that the elevated risk......Study question: Do children born to fathers of advanced age have an increased risk of dying before the age of 5 years? Summary answer: Children born to fathers aged 40 years or more have an increased risk of dying in early childhood due to an excess risk of fatal congenital anomalies, malignancies...

  6. Correlates of resilience in the first 5 years after traumatic brain injury. (United States)

    Hanks, Robin A; Rapport, Lisa J; Waldron Perrine, Brigid; Millis, Scott R


    To examine resilience in the context of adjustment to traumatic brain injury (TBI), including the relative roles of demographic and theoretically related constructs such as coping, social support, and positive affectivity on resilience within the first 5 years postinjury. This was a cross-sectional, observational study of 67 persons with medically documented mild complicated to severe TBI. Participants completed a battery of measures including cognitive tests; questionnaires assessing self-report of emotional symptoms, perceived social support, and coping style; and a measure of resilience. Approximately 60% of the sample endorsed moderate to high levels of resilience during the first 5 years postinjury. Brain injury severity, premorbid intelligence, and cognitive flexibility did not predict resilience, as measured by the Connor-Davidson Resilience Scale. By contrast, task-oriented coping and perceived social support were strong and unique covariates of resilience. Positive and negative affectivity were related to resilience but were not unique covariates of it in the presence of task-oriented coping and perceived social support. Discriminant validity of resilience as a concept and the means of assessing it was supported by findings that emotion-oriented and avoidance coping were not meaningfully related to resilience. Overall, the findings indicate that the majority of individuals in this sample reported high levels of resilience after brain injury and that correlates of resilience in adults with TBI is similar to that observed in adults without the history of cognitive impairment. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  7. Gender Differences in Appraisal of Stress and Coping 5 Years after Heart Transplantation (United States)

    Grady, Kathleen L; Andrei, Adin-Cristian; Li, Zhi; Rybarczyk, Bruce; White-Williams, Connie; Gordon, Robert; McGee, Edwin C.


    OBJECTIVES We examined whether gender differences exist regarding stress, symptom distress, coping, adherence, and social support 5 years after heart transplantation. BACKGROUND Differences exist in health-related quality of life outcomes by gender after heart transplantation; women report poorer outcomes. METHODS Patients (n=210, female=42), were from a prospective, multi-site, study of health-related quality of life long-term after heart transplantation. Patients completed self-report instruments 5 years after heart transplantation (mean=4.98±0.17 years after transplant). Statistical analyses included two-sample t-tests, Chi-square or Fisher’s exact test, and multivariable modeling. RESULTS Women did not report more overall stress or symptom distress, but reported more difficulty adhering to the transplant regimen, yet more actual adherence than men. Women reported using more negative coping styles, but reported more satisfaction with social support. CONCLUSIONS Gender differences exist regarding appraisal of stress, coping styles, and coping resources long-term after heart transplantation. These differences may guide tailoring therapy regarding stress, poor coping, and lack of resources. PMID:26514074

  8. Gross motor skill development of 5-year-old Kindergarten children in Myanmar. (United States)

    Aye, Thanda; Oo, Khin Saw; Khin, Myo Thuzar; Kuramoto-Ahuja, Tsugumi; Maruyama, Hitoshi


    [Purpose] The purpose of this study was to examine the gross motor skill development of 5-year-old Kindergarten children in Myanmar. [Subjects and Methods] Total 472 healthy Kindergarten children (237 males, 235 females) of 2016-2017 academic year from four schools in urban area and four schools in rural area of Myanmar were recruited. The gross motor skill development of all subjects was assessed with the test of gross motor development second edition (TGMD-2). All subjects performed two trials for each gross motor skill and the performance was video recorded and scored. The assessment procedures were done according to the standardized guidelines of TGMD-2. [Results] The majority of subjects had average level of gross motor skill rank. The significant differences were found on the run and gallop of locomotor skills and the most of object control skills except the catch between males and females. The significant differences were also found between subjects from urban and rural areas. [Conclusion] Gross motor skill development of 5-year-old Kindergarten children in Myanmar had gender-based and region-based differences on both locomotor and object control skills. This study added a valuable information to the establishment of a normative reference of Kindergarten aged children for future studies.

  9. Dental caries analysis in 3- 5-years-old children: a spatial modelling. (United States)

    Afroughi, Solaiman; Faghihzadeh, Soghrat; Khaledi, Majid Jafari; Motlagh, Mehdi Ghandehari


    The main objective of this study was modelling experienced caries of deciduous teeth in 3- 5-years-old children treated in Children's Department of Tehran University of Medical Sciences, Iran, using the spatial autologistic regression. The other objective was identifying a risk pattern of decayed dents of these children. The study group consisted of 400 children (3- 5-years-old). Two groups of postgraduate and under graduate dentistry students under consideration and approval of the professors of dentistry from the Tehran University of Medical Sciences diagnosed and categorised the caries statuses of deciduous dents of the children. The caries statuses were considered as spatially correlated binary data. The appropriate model was autologistic regression. The fitted autologistic model showed that caries in the three nearest neighbours of a tooth, which includes the two adjacent and the one vertically opponent teeth, had significant effect on its caries. The computed risks based on the fitted model revealed a definite-spatial pattern of caries events. Every decayed deciduous tooth in the mouth of a preschool child threatens the three nearest teeth. The risk pattern of caries in each quarter of the teeth lattice of children from incisors to molars has an ascending rate. The dents in maxilla and posterior locations have higher risks of caries than in mandible and anterior locations. These findings are valuable in preventive health care and therapeutic approaches in dentistry of children. Copyright 2010 Elsevier Ltd. All rights reserved.

  10. The understanding and experience of mixed emotions in 3-5-year-old children. (United States)

    Smith, Joshua P; Glass, Daniel J; Fireman, Gary


    The term mixed emotions refers to the presence of two opposite-valence emotions toward a single target. Identifying when children begin to report experiencing and understanding mixed emotions is critical in identifying how skills such as adaptive functioning, coping strategies, environmental understanding, and socioemotional competence emerge. Prior research has shown that children as young as 5 years old can understand and experience mixed emotion, but perhaps appropriately sensitive methodologies can reveal these abilities in younger children. The present study evaluated 57 children between 3 and 5 years old for mixed emotion experience and understanding using an animated video clip in which a character experiences a mixed emotional episode. Ordinal logistic regression was utilized to examine the relation of gender, attention, and understanding of content to experience and understanding of mixed emotion. While only 12% of children reported experiencing mixed emotion while watching the clip, 49% of children-some as young as 3 years old-were able to recognize the mixed emotional experience of the character. Thus, mixed emotion understanding emerges earlier than previously identified and the expression of understanding may develop independently of the ability to report mixed emotion experience. These findings are discussed in relation to cognitive and developmental considerations.

  11. Factors associated with vaccination coverage in children < 5 years in Angola

    Directory of Open Access Journals (Sweden)

    Manuel Falcão Saturnino de Oliveira


    Full Text Available OBJECTIVE To analyze vaccination coverage and factors associated with a complete immunization scheme in children < 5 years old. METHODS This cross-sectional household census survey evaluated 1,209 children < 5 years old living in Bom Jesus, Angola, in 2010. Data were obtained from interviews, questionnaires, child immunization histories, and maternal health histories. The statistical analysis used generalized linear models, in which the dependent variable followed a binary distribution (vaccinated, unvaccinated and the association function was logarithmic and had the children’s individual, familial, and socioeconomic factors as independent variables. RESULTS Vaccination coverage was 37.0%, higher in children < 1 year (55.0% and heterogeneous across neighborhoods; 52.0% of children of both sexes had no immunization records. The prevalence rate of vaccination significantly varied according to child age, mother’s level of education, family size, ownership of household appliances, and destination of domestic waste. CONCLUSIONS Vulnerable groups with vaccination coverage below recommended levels continue to be present. Some factors indicate inequalities that represent barriers to full immunization, indicating the need to implement more equitable policies. The knowledge of these factors contributes to planning immunization promotion measures that focus on the most vulnerable groups.

  12. Prevalence of Malocclusion in 3- to 5-Year-Old Children in Shanghai, China

    Directory of Open Access Journals (Sweden)

    Xinhua Zhou


    Full Text Available The aim of the present study was to obtain the prevalence of malocclusions in preschool children in Shanghai, China. A cross-sectional survey was conducted among 2335 children aged 3–5 years from kindergartens. Several occlusal parameters were clinically assessed, including second deciduous molar terminal plane, canine relationship, degree of overjet and overbite, anterior and posterior crossbite, and the presence or absence of physiologic spaces and crowding. All parents of subjects were asked to fill in the oral health knowledge questionnaires. The prevalence of malocclusion in primary dentition in Shanghai was 83.9%, and no significant differences were found in genders. Data showed that the prevalence of deep overbite (63.7% was the highest in children with malocclusion, followed by deep overjet (33.9%, midline deviation (26.6%, anterior crossbite (8.0% and anterior crowding (6.5%. The results revealed a high prevalence of malocclusion in primary dentition in children aged 3–5 years old of Shanghai, especially in vertical anomalies. The need for preventive orthodontic therapy is extremely desired and oral health education about malocclusion should be strengthened.

  13. Relationship between early symptoms of alcohol craving and binge drinking 2.5 years later. (United States)

    Morgenstern, Matthis; DiFranza, Joseph R; Wellman, Robert J; Sargent, James D; Hanewinkel, Reiner


    The first self-reported symptoms of nicotine dependence (e.g., as craving) can appear within days to weeks of the onset of occasional use, and the appearance of symptoms predicts future consumption and dependence. We sought to determine whether craving for alcohol occurs in early stages of adolescent alcohol use, and whether it predicts future binge drinking, a prevalent and problematic behavior. Longitudinal (30-month) four-wave study of 3415 students (M=12.5 years at baseline) from 29 German schools. Students reported five symptoms of alcohol craving on a scale developed based on well-validated measures for tobacco. Multilevel mixed-effects logistic regression was used to predict having five or more binge episodes by last follow-up, based on the number of symptoms reported before the first lifetime binge. Multiple imputation was used to address study drop-out. At baseline, 23% reported at least one symptom, increasing to 54% at wave 4. Any report of symptoms at baseline was associated with frequency of alcohol use, being present in 100% of daily, 93% of weekly, 87% of monthly, 48% of infrequent drinkers, and 16% of ever drinkers reporting no current alcohol use. Moreover, symptoms at baseline independently predicted frequent binge drinking 2.5 years later, AOR=2.08 (95% CI 1.39, 3.11; pbinge drinking. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Plasma total and unacylated ghrelin predict 5-year changes in insulin resistance. (United States)

    Barazzoni, R; Gortan Cappellari, G; Semolic, A; Ius, M; Mamolo, L; Dore, F; Giacca, M; Zanetti, M; Vinci, P; Guarnieri, G


    Ghrelin is a gastric hormone circulating in acylated (AG) and unacylated (UG) forms, and higher plasma total ghrelin (TG) and UG may be cross-sectionally associated with lower insulin resistance in metabolic syndrome patients. The potential value of ghrelin forms in predicting insulin resistance and its time-related changes in community-based population cohorts remains unknown. We measured TG, AG and calculated UG (TG-AG) in 716 individuals from the North-East-Italy MoMa study (age: 55 ± 9 years, BMI: 29 ± 5 kg/m(2), M/F:349/367) to test the hypothesis that circulating TG and UG, but not AG are negatively associated with insulin resistance (HOMA). We further hypothesized that baseline TG and UG negatively predict 5-year HOMA changes in a 350-individual subgroup. Baseline TG and UG were associated negatively with HOMA after adjusting for gender and body mass index (BMI). Baseline gender- and BMI-adjusted TG and UG were also negatively associated with HOMA at 5-year follow-up (n = 350), and changes in TG and UG were negatively associated with changes in HOMA (P insulin resistance and may contribute to predict its time-related changes in humans. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  15. Radiometric calibration stability of the EO-1 advanced land imager: 5 years on-orbit (United States)

    Markham, B.L.; Ong, L.; Barsi, J.A.; Mendenhall, J.A.; Lencioni, D.E.; Helder, D.L.; Hollaren, D.M.; Morfitt, R.


    The Advanced Land Imager (ALI) was developed as a prototype sensor for follow on missions to Landsat-7. It was launched in November 2000 on the Earth Observing One (EO-1) satellite as a nominal one-year technology demonstration mission. As of this writing, the sensor has continued to operate in excess of 5 years. Six of the ALl's nine multi-spectral (MS) bands and the panchromatic band have similar spectral coverage as those on the Landsat-7 ETM+. In addition to on-board lamps, which have been significantly more stable than the lamps on ETM+, the ALI has a solar diffuser and has imaged the moon monthly since launch. This combined calibration dataset allows understanding of the radiometric stability of the ALI system, its calibrators and some differentiation of the sources of the changes with time. The solar dataset is limited as the mechanism controlling the aperture to the solar diffuser failed approximately 18 months after launch. Results over 5 years indicate that: the shortest wavelength band (443 nm) has degraded in response about 2%; the 482 nm and 565 nm bands decreased in response about 1%; the 660 nm, 790 nm and 868 nm bands each degraded about 5%; the 1250 nm and 1650 nm bands did not change significantly and the 2215 nm band increased in response about 2%.

  16. A 5-year prospective observational study of the outcomes of international treatment guidelines for Crohn's disease.

    LENUS (Irish Health Repository)

    Cullen, Garret


    BACKGROUND & AIMS: Therapeutic strategies for patients with Crohn\\'s disease are based on American and European guidelines. High rates of corticosteroid dependency and low remission rates are identified as weaknesses of this therapy and as justification for early introduction of biologic agents (top-down treatment) in moderate\\/severe Crohn\\'s disease. We reviewed outcomes and corticosteroid-dependency rates of patients with moderate-to-severe disease who were treated according to the international guidelines. METHODS: Consecutive patients (102) newly diagnosed with Crohn\\'s disease in 2000-2002 were identified from a prospectively maintained database. Severity of disease was scored using the Harvey-Bradshaw Index (HBI). Disease was classified by Montreal classification. Five-year follow-up data were recorded. RESULTS: Seventy-two patients had moderate\\/severe disease at diagnosis (HBI >8). Fifty-four (75%) had nonstricturing, nonpenetrating disease (B1). Sixty-four (89%) received corticosteroids, and 44 (61%) received immunomodulators. Twenty-one patients (29%) received infliximab. Thirty-nine patients (54%) required resection surgery. At a median of 5 years, 66 of 72 (92%) patients with moderate\\/severe disease were in remission (median HBI, 1). Twenty-five patients (35%) required neither surgery nor biologic therapy. CONCLUSIONS: When international treatment guidelines are strictly followed, Crohn\\'s disease patients can achieve high rates of remission and low rates of morbidity at 5 years. Indiscriminate use of biologic agents therefore is not appropriate for all patients with moderate-to-severe disease.

  17. The relation of hearing loss degrees and oral stereognosis in 5-year-old children

    Directory of Open Access Journals (Sweden)

    Seyede Zohre Mousavi


    Full Text Available Background and Aim: Oral stereognosis is the ability to recognize the objects placed in the mouth; this plays a significant role in speech sounds production. Since the children with hearing loss have articulation disorders, this study aimed to clear the relation of hearing loss degrees and oral stereognosis in 5-year-old children.Methods: In this cross-sectional non-invasive study, 40 children of 5-year-old (30 children with different degrees of hearing loss and 10 normal children were involved. Oral steriognostic test was done for all of them and the Mann-Whitney U was used for statistical analysis.Results: There were significant differences between the mean of oral stereognostic ability between the normal children and the children with severe (p<0.01 or profound hearing loss (p=0.05. There was no significant difference between the mean of oral stereognostic ability among the children with moderate, severe and profound hearing loss compared with together. Besides, there was no significant difference between the mean of the time of diagnosis among all of hearing loss and normal children.Conclusion: The study shows that the children with moderate, severe and profound hearing loss have inefficient oral stereognosis in comparison with the normal children.

  18. Pattern of Energy and Protein Intake among Stunted Children Aged 3–5 Years in Jatinangor

    Directory of Open Access Journals (Sweden)

    Geraldo Laurus


    Full Text Available Background: A child’s optimal growth can be indicated by many factors, among them is body height, therefore stunting is one of the evidences of undergrowth. Nutrition, on the other hand, is one of variables affecting growth. This study aimed to examine the nutrition intake, in the form of energy, carbohydrate, protein, and fat in stunted children aged 3–5 years in Jatinangor. Methods: This cross sectional study was carried out in September to October 2014 using the random sampling method. Dietary data from 70 stunted children aged 3–5 years in pre–school and kindegarten located in 9 urban areas in Jatinangor were collected through 3x24 Recall and Food Frequency Questionaire and analyzed. Results: Mean energy intake was 1113.6 kcal and mean carbohydrate intake was 137.4 grams. Mean protein intake was 38.4 gram and mean fat intake was 38.2 gram. Types of food highly consumed as the source of carbohydrate were white rice and biscuit, and as the source of protein were meatball, sausage, and egg. Highest consumed vegetables, fruits and snack were water spinach, cabbage, watermelon, banana, and milk respectively. Conclusions: Mean energy intake, mean carbohydrate intake, and mean fat intake are all below the recommended dietary allowance (RDA 2013 with individual value of mean energy intake is below RDA 2013 for all subjects. Mean protein intake is slightly above RDA 2013.

  19. Elderly patients with chronic kidney disease: outcomes after 5 years of follow-up. (United States)

    Heras, Manuel; Fernández-Reyes, M José; Sánchez, Rosa; Guerrero, M Teresa; Molina, Alvaro; Rodríguez, M Astrid; Alvarez-Ude, Fernando


    In recent years, chronic kidney disease (CKD) has come to be considered an epidemic problem, and there is considerable interest in early diagnosis in order to slow its progression to end-stage renal disease (ESRD) and prepare patients for dialysis and transplantation programmes. Many elderly patients are labelled as having CKD based solely on having a glomerular filtration rate (GFR) of elderly cohort. A total of 80 clinically stable patients, with a median age of 83 years (range 69-97; 69% female, 35% diabetic, 83% hypertensive) were recruited at random in our Geriatric Medicine and Nephrology Departments between January and April 2006, and monitored for 5 years. During the recruitment stage we established two groups based on baseline serum creatinine (SCr) concentration: Group 1, 38 patients with SCr 1.1mg/dl (range 1.2-3). We determined baseline blood levels of creatinine and urea, calculated eGFR using an abbreviated Modification of Diet in Renal Disease (MDRD) formula, and repeated these measurements after 5 years. We recorded baseline comorbidity according to the Charlson comorbidity index (CCI); hospital admissions; new cardiovascular events; treatments; progression to ESRD requiring dialysis; and mortality. In the 39 patients surviving after 5 years there were no significant differences between Groups 1 and 2 in total number of hospital admissions, episodes of heart failure and new ischaemic heart disease. Overall, the most commonly used drugs were diuretics (76.9%), while beta-blockers were used the least (10.3%). There were 41 deaths (51.3%): of these patients, 15 died due to overall decline, 8 due to infections, 4 due to stroke, 4 due to neoplasia, 3 due to cardiovascular problems, 2 due to complications from fractures and 5 due to unknown causes. Mortality was higher in Group 2 (66.7% vs 34.2%, P=.004) and patient age was also higher in that group (84.73 ± 5.69 vs 80.12 ± 6.5, P=.001). No significant differences in mortality were attributable to sex

  20. Survival Rates and Bone and Soft Tissue Level Changes Around One-Piece Dental Implants Placed with a Flapless or Flap Protocol: 8.5-Year Results. (United States)

    Froum, Stuart J; Khouly, Ismael

    The purpose of the current study was to determine the survival rates and to measure marginal bone changes and peri-implant conditions 8.5 years after placement of one-piece implants with an anodically oxidized surface (AOS). A total of 52 subjects who received a one-piece implant with an AOS using a flapless or flap protocol and completed a previous randomized clinical trial were contacted for a recall visit 8.5 years after implant placement (T8.5). Implant success and survival rates, probing pocket depth (PPD), presence of bleeding on probing (BoP), papilla level, and incidence of complications and peri-implant disease were assessed by a single, blinded examiner. A second blinded examiner evaluated marginal bone level changes. Results for 8.5 years were compared to those at the time of implant placement, implant loading (0.5 year), and 1 and 1.5 years follow-up. The results based on 28 patients who attended the follow-up visit (half had flapless and half a flap protocol) showed a 100% implant survival rate and a 96.4% implant success rate 8.5 years after implant placement using one-piece implants, with no difference in survival and success rates between the flapless and the flap protocol. During the same follow-up period, a significant increase in crestal bone height from 1.5 to 8.5 years was observed. Analysis suggested decreasing mean levels of bone loss with time (P rates of BoP (22.8% vs 17.9%, respectively). Papilla levels increased during the first year after implant loading. However, there was little additional change between 1.5 and 8.5 years. A total of eight fractured porcelain crowns and three crown loosenings were reported. One-piece implants with an AOS showed high survival rates and stable marginal bone and periimplant soft tissue levels regardless of whether a flapless or flap protocol was used.

  1. Clinical experiences with laser-welded titanium frameworks supported by implants in the edentulous mandible: a 5-year follow-up study. (United States)

    Ortorp, A; Linden, B; Jemt, T


    The purpose of this study was to report the 5-year clinical performance of implant-supported prostheses with laser-welded titanium frameworks and to compare their performance with that of prostheses provided with conventional cast frameworks. On a routine basis, a consecutive group of 824 edentulous patients were provided with fixed prostheses supported by implants in the edentulous mandible. In addition to conventional gold-alloy castings, patients were at random provided with 2 kinds of laser-welded titanium frameworks. In all, 155 patients were included in the 2 titanium framework groups. A control group of 53 randomly selected patients with conventional gold-alloy castings was used for comparison. Clinical and radiographic 5-year data was collected for the 3 groups. All followed patients still had fixed prostheses in the mandible after 5 years. The overall cumulative success rates were 95.9% and 99.7% for titanium-framework prostheses and implants, respectively. The corresponding success rates for the control group were 100% and 99.6%, respectively. Bone loss was 0.5 mm on average during the 5-year follow-up period. The most common complications for titanium frameworks were resin or tooth fractures, gingival inflammation, and fractures of the metal frames (10%). One of the cast frameworks fractured and was resoldered. Loose and fractured implant screw components were few (welded titanium frameworks seem to be a viable alternative to conventional castings in the edentulous mandible.

  2. Treatment of selective mutism: a 5-year follow-up study. (United States)

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


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

  3. Invasive pneumococcal disease in children aged younger than 5 years in India: a surveillance study. (United States)

    Manoharan, Anand; Manchanda, Vikas; Balasubramanian, Sundaram; Lalwani, Sanjay; Modak, Meera; Bai, Sushama; Vijayan, Ajith; Shet, Anita; Nagaraj, Savitha; Karande, Sunil; Nataraj, Gita; Yewale, Vijay N; Joshi, Shrikrishna A; Iyer, Ranganathan N; Santosham, Mathuram; Kahn, Geoffrey D; Knoll, Maria Deloria


    Invasive pneumococcal disease continues to be a major cause of morbidity and mortality among children younger than 5 years of age in India. We aimed to provide nationally representative data for the pattern of disease due to Streptococcus pneumoniae, trends in the serotype of invasive pneumococci, and invasive pneumococci antimicrobial resistance patterns, in India. In this prospective hospital-based and retrospective laboratory-based surveillance study, we prospectively enrolled children aged younger than 5 years with suspected or proven invasive pneumococcal disease from 18 hospitals or institutional centres and retrospectively included laboratory-confirmed pneumococcal isolates from ten sentinel laboratories, together representing 11 states in India. Eligibility criteria were fever higher than 38°C without localising symptoms, clinical presentation of suspected meningitis or pneumonia, and evidence of radiographic pneumonia. We cultured blood and other normally sterile body fluids, reconfirmed and serotyped pneumococcal isolates, and established antimicrobial susceptibility using standard study protocols. Between Jan 1, 2011, and June 30, 2015, we enrolled 4377 patients. Among 361 (8%) patients with culture-proven pneumococcal disease, all clinical data were known for 226 (63%); among these patients, 132 (58%) presented with pneumonia, 78 (35%) presented with meningitis, and 16 (7%) had other clinical conditions. 131 (3%) died overall and 29 (8%) patients with invasive pneumococcal disease died. Serotypes 14 (52 [14%] of 361), 1 (49 [14%]), 5 (37 [10%]), and 19F (33 [9%]) were the most common. Penicillin non-susceptibility occurred in isolates from 29 (8%) patients, co-trimoxazole resistance occurred in 239 (66%), erythromycin resistance occurred in 132 (37%), and chloramphenicol resistance occurred in 33 (9%). We found multidrug resistance in 33 (9%) of 361 patients. The proportion of positive blood cultures, number of isolates, geographical representation

  4. Corneal Nerve Regeneration After Collagen Cross-Linking Treatment of Keratoconus: A 5-Year Longitudinal Study. (United States)

    Parissi, Marlen; Randjelovic, Stefan; Poletti, Enea; Guimarães, Pedro; Ruggeri, Alfredo; Fragkiskou, Sofia; Wihlmark, Thu Ba; Utheim, Tor Paaske; Lagali, Neil


    It is unknown whether a neurotrophic deficit or pathologic nerve morphology persists in keratoconus in the long term after corneal collagen cross-linking (CXL) treatment. Nerve pathology could impact long-term corneal status in patients with keratoconus. To determine whether CXL treatment of keratoconus results in normalization of subbasal nerve density and architecture up to 5 years after treatment. Observational study of 19 patients with early-stage keratoconus indicated for a first CXL treatment with longitudinal follow-up to 5 years postoperatively (examinations were performed from 2009 to 2015; analysis was performed from February to May 2015) and 19 age-matched healthy volunteers at a primary care center and a university hospital ophthalmology department. The patients with keratoconus underwent standard epithelial-off UV-A/riboflavin CXL treatment with 30-minute UV-A exposure at 3 mW/cm2 irradiance. Central corneal subbasal nerve density and subbasal nerve architecture by use of laser-scanning in vivo confocal microscopy; subbasal nerve analysis by 2 masked observers and by use of a fully automated method; wide-field mosaics of subbasal nerve architecture by use of an automated method; and ocular surface touch sensitivity by use of contact esthesiometry. Mean (SD) age of the 19 patients with keratoconus was 27.5 (7.1) years (range, 19-44 years), and minimal corneal thickness was 428 (36) μm (range, 372-497 μm). Compared with the mean (SD) preoperative subbasal nerve density of 21.0 (4.2) mm/mm2 in healthy corneas, the mean (SD) preoperative subbasal nerve density of 10.3 (5.6) mm/mm2 in the corneas of patients with stage 1 or 2 keratoconus was reduced 51% (mean difference, 10.7 mm/mm2 [95% CI, 6.8-14.6 mm/mm2]; P corneas at final follow-up (mean reduction, 8.5 mm/mm2 [95% CI, 4.7-12.4 mm/mm2]; P corneas of patients with keratoconus compared with healthy corneas. Postoperatively, the frequency of nerve looping increased, crossings were more frequent, and

  5. Predicting 5-Year Risk of RRT in Stage 3 or 4 CKD: Development and External Validation. (United States)

    Schroeder, Emily B; Yang, Xiuhai; Thorp, Micah L; Arnold, Brent M; Tabano, David C; Petrik, Amanda F; Smith, David H; Platt, Robert W; Johnson, Eric S


    Only a minority of patients with CKD progress to renal failure. Despite the potential benefits of risk stratification in the CKD population, risk prediction models are not routinely used. Our objective was to develop and externally validate a clinically useful and pragmatic prediction model for the 5-year risk of progression to RRT in stage 3 or 4 CKD. We used a retrospective cohort design. The development cohort consisted of 22,460 Kaiser Permanente Northwest members with stage 3 or 4 CKD (baseline 2002-2008). The validation cohort consisted of 16,553 Kaiser Permanente Colorado members with stage 3-4 CKD (baseline 2006-2008). The final model included eight predictors: age, sex, eGFR, hemoglobin, proteinuria/albuminuria, systolic BP, antihypertensive medication use, and diabetes and its complications. In the Northwest and Colorado cohorts, there were 737 and 360 events, and observed 5-year Kaplan-Meier risks of 4.72% (95% confidence interval [95% CI], 4.38 to 5.06) and 2.57% (95% CI, 2.30 to 2.83), respectively. Our prediction model performed extremely well in the development cohort, with a c-statistic of 0.96, an R 2 of 79.7%, and good calibration. We had similarly good performance in the external validation cohort, with a c-statistic of 0.95, R 2 of 81.2%, and good calibration. In the external validation cohort, the observed risk was slightly lower than the predicted risk in the highest-risk quintile. Using the top quintile of predicted risk as a cutpoint gave a sensitivity of 92.2%. We developed a pragmatic prediction model and risk score for predicting the 5-year RRT risk in stage 3 and 4 CKD. This model uses variables that are typically available in routine primary care settings, and can be used to help guide important decisions such as timing of referral to nephrology and fistula placement. Copyright © 2016 by the American Society of Nephrology.

  6. Pregnancy scares and subsequent unintended pregnancy

    Directory of Open Access Journals (Sweden)

    Heather Gatny


    Full Text Available Background: A substantial number of young women experience pregnancy scares - thinking they might be pregnant, and later discovering that they are not. Although pregnancy scares are distressing events, little is known about who experiences them and whether they are important to our understanding of unintended pregnancy. Objective: We describe the young women who experience pregnancy scares, and examine the link between pregnancy scares and subsequent unintended pregnancy. Methods: We used data from the Relationship Dynamics and Social Life Study. T-tests and regression analyses were conducted using baseline and weekly data to estimate relationships between respondent characteristics and subsequent pregnancy scares. Event history methods were used to assess pregnancy scares as a predictor of unintended pregnancy. Results: Nine percent of the young women experienced a pregnancy scare during the study. African-American race, lack of two-parent family structure, lower GPA, cohabitation, and sex without birth control prior to the study are associated with experiencing a pregnancy scare and with experiencing a greater number of pregnancy scares. Further, experiencing a pregnancy scare is strongly associated with subsequent unintended pregnancy, independent of background factors. Forty percent of the women who experienced a pregnancy scare subsequently had an unintended pregnancy during the study period, relative to only 11Š of those who did not experience a pregnancy scare. Conclusions: Young women from less advantaged backgrounds are more likely to experience a pregnancy scare, and pregnancy scares are often followed by an unintended pregnancy.

  7. Television viewing through ages 2-5 years and bullying involvement in early elementary school

    NARCIS (Netherlands)

    V.J.A. Verlinden (Vincent); H.W. Tiemeier (Henning); R. Veenstra (René); C.L. Mieloo (Cathelijne); W. Jansen (Wilma); V.W.V. Jaddoe (Vincent); H. Raat (Hein); A. Hofman (Albert); F.C. Verhulst (Frank); P.W. Jansen (Pauline)


    textabstractBackground: High television exposure time at young age has been described as a potential risk factor for developing behavioral problems. However, less is known about the effects of preschool television on subsequent bullying involvement. We examined the association between television

  8. Television viewing through ages 2-5 years and bullying involvement in early elementary school

    NARCIS (Netherlands)

    Verlinden, Marina; Tiemeier, Henning; Veenstra, René; Mieloo, Cathelijne; Jansen, Wilma; Jaddoe, Vincent W. V.; Raat, Hein; Hofman, Albert; Verhulst, Frank C.; Jansen, Pauline W.


    Background: High television exposure time at young age has been described as a potential risk factor for developing behavioral problems. However, less is known about the effects of preschool television on subsequent bullying involvement. We examined the association between television viewing time

  9. Analysis of 5 years of morbidity and mortality conferences in a ...

    African Journals Online (AJOL)

    Subsequent to the institution of the MMC in 2007 we introduced a hybrid electronic medical ... and mortality conference (MMC). In 2012 a hybrid electronic medical registry (HEMR) was introduced to capture routine data ..... must encourage staff to constantly recycle information while actively excluding likely complications ...

  10. Handicap 5 years after stroke in the North East Melbourne Stroke Incidence Study. (United States)

    Gall, Seana L; Dewey, Helen M; Sturm, Jonathan W; Macdonell, Richard A L; Thrift, Amanda G


    Handicap is rarely comprehensively examined after stroke. We examined handicap among 5-year stroke survivors from an 'ideal' stroke incidence study. Survivors were assessed with the London Handicap Scale [LHS, score range: 0 (greatest handicap) to 100 (least handicap)]. Multivariable regression was used to examine demographic, risk and stroke-related factors associated with handicap. 351 of 441 (80%) survivors were assessed. Those assessed were more often Australian born than those not assessed (p handicap was present for physical independence and occupation/leisure items. Handicap was associated with older age, manual occupations, smoking, initial stroke severity, recurrent stroke and mood disorders. Reducing recurrent stroke, through better risk factor management, is likely to reduce handicap. The association between handicap and mood disorders, which are potentially modifiable, warrants further investigation. Copyright (c) 2008 S. Karger AG, Basel.

  11. Re-embodying eating: patients' experiences 5 years after bariatric surgery. (United States)

    Natvik, Eli; Gjengedal, Eva; Moltu, Christian; Råheim, Målfrid


    Health experts advise and expect patients to eat healthily after bariatric surgery. For patients, difficulties with eating might have been a long-standing, problematic part of life-a part that is not necessarily healed by surgery. Empirical research on patients' experiences of eating practices after bariatric surgery is lacking. Aiming to contribute to the development of clinical practice, we explored meanings attached to eating in the long term and sought descriptions of change and bodily sensations. We interviewed 14 patients at least 5 years after bariatric surgery. The surgical restriction forced changes in the way patients sensed their own body in eating, but the uncertainty related to maintaining weight loss in the long term remained. Meanings attached to eating transcended food as choices situated in a nourishment and health perspective, and were not necessarily changed. Eating was an existential and embodied practice, which remained an ambiguous and sensitive matter after surgery. © The Author(s) 2014.

  12. [Analysis of risk factors for bone metastasis after radical resection of colorectal cancer within 5 years]. (United States)

    Li, Ang; Tan, Zhen; Fu, Chuangang; Wang, Hao; Yuan, Jie


    To investigate the risk factors of metachronous bone metastasis after radical resection of colorectal cancer within 5 years. Clinical data of 1 749 patients with colorectal cancer, of whom 50(2.8%) patients developed metastasis to bone after operation, in the Department of Colorectal Surgery, Changhai Hospital of The Second Military Medical University from January 2001 to December 2010 were analyzed retrospectively. Univariate and multivariate analysis were performed to find the risk factors of metachronous bone metastasis from colorectal cancer using Chi square test and Logistic regression, respectively. Of 50 colorectal cancer cases with bone metastasis, 29 were male and 21 were female. The age was ≥ 60 years old in 28 cases. Tumors of 36 cases were located in the rectum and of 14 cases located in the colon. Pathology examination showed 43 cases were adenocarcinomas, 7 cases were mucinous adenocarcinoma. Forty-two cases had T3-4 stage lesions, 30 cases had lymph node metastasis, 14 cases had pulmonary metastasis, and 5 cases had liver metastasis. Univariate Chi square test indicated that factors associated with the metachronous bone metastasis of colorectal cancer within 5 years were tumor site (χ2=4.932, P=0.026), preoperative carbohydrate antigen 199 (CA199) level (χ2=4.266, P=0.039), lymph node metastasis (χ2=13.054, P=0.000) and pulmonary metastasis(χ2=35.524, P=0.000). The incidence of bone metastasis in patients with rectal cancer (3.6%, 36/991) was higher compared to those with colon cancer (1.8%, 14/758). The incidence of bone metastasis in patients with higher(> 37 kU/L) preoperative serum CA199 level (4.9%, 12/245) was higher compared to those with lower serum CA199 level (2.5%, 38/1504). The incidence of bone metastasis in patients with lymph node metastasis(4.8%,30/627) and pulmonary metastasis (11.6%, 14/121) was significantly higher compared to those without lymph node metastasis (1.8%, 20/1122) and pulmonary metastasis(2.2%, 36

  13. Torpedo maculopathy with an anisometropic amblyopia in a 5-year-old Caucasian girl: case report

    Directory of Open Access Journals (Sweden)

    Marco Dutra-Medeiros


    Full Text Available The aim of this study is to report a clinical case of asymptomatic female Caucasian children with torpedo maculopathy. A 5-year-old girl was referred to our clinic for routine evaluation. The ophthalmic examination revealed best-corrected visual acuity of 20/20 in both eyes, without any changes in the biomicroscopy. Fundus examination showed normal findings in one eye, whereas in the contralateral eye it disclosed, in the temporal sector of the macular region, a whitish, atrophic, oval chorioretinal lesion with clearly defined margins. Posterior evaluations documented the stability of the lesion. Torpedo maculopathy diagnosis is based on its characteristic shape and peculiar location. The differential diagnosis has to be estabilished versus choroidal lesions (melanoma and nevus, congenital or iatrogenic hyperplasia of the retinal pigment epithelium (RPE and particularly versus the congenital pigmented lesions associated with Gardner's syndrome.

  14. A case of ocular thelaziasis in a 2.5 years old Holstein heifer

    Directory of Open Access Journals (Sweden)

    Mousa Daradka


    Full Text Available A 2.5-years-old, Holstein lactating dairy cow was presented to the Veterinary Health Center with severe conjunctivitis and exuberant granulation tissue formation of the left eye. Upon close examination of the eye, a 2-cm long slender-shaped nematode was found in the conjunctival sac. The nematode was examined by a veterinary parasitologist and determined to be Thelazia species. The exuberant granulation tissue was surgically removed and a total of 0.5 mL of 1% levamisole was injected subconjunctivally. Levamesole was also injected subcutaneously at a dose of 10 mg/kg of body weight and repeated after 15 days. The cow made a complete recovery within 25 days following treatment. This is the first case report of ocular thelaziasis in dairy cattle in Jordan.

  15. 5 years of experience with a large-scale mentoring program for medical students

    Directory of Open Access Journals (Sweden)

    Pinilla, Severin


    Full Text Available In this paper we present our 5-year-experience with a large-scale mentoring program for undergraduate medical students at the Ludwig Maximilians-Universität Munich (LMU. We implemented a two-tiered program with a peer-mentoring concept for preclinical students and a 1:1-mentoring concept for clinical students aided by a fully automated online-based matching algorithm. Approximately 20-30% of each student cohort participates in our voluntary mentoring program. Defining ideal program evaluation strategies, recruiting mentors from beyond the academic environment and accounting for the mentoring network reality remain challenging. We conclude that a two-tiered program is well accepted by students and faculty. In addition the online-based matching seems to be effective for large-scale mentoring programs.

  16. Increased risk of stroke and transient ischemic attack in 5-year survivors of Hodgkin lymphoma

    DEFF Research Database (Denmark)

    De Bruin, Marie L; Dorresteijn, Lucille D A; van't Veer, Mars B


    BACKGROUND: Information on clinically verified stroke and transient ischemic attack (TIA) following Hodgkin lymphoma is scarce. We quantified the long-term risk of cerebrovascular disease associated with the use of radiotherapy and chemotherapy in survivors of Hodgkin lymphoma and explored...... potential pathogenic mechanisms. METHODS: We performed a retrospective cohort study among 2201 five-year survivors of Hodgkin lymphoma treated before age 51 between 1965 and 1995. We compared incidence rates of clinically verified stroke and TIA with those in the general population. We used multivariable...... Cox regression techniques to study treatment-related factors and other risk factors. All statistical tests were two-sided. RESULTS: After a median follow-up of 17.5 years, 96 patients developed cerebrovascular disease (55 strokes, 31 TIAs, and 10 with both TIA and stroke; median age = 52 years). Most...

  17. Coral reefs in Saudi Arabia: 3.5 years after the Gulf War oil spill (United States)

    Vogt, I. P.


    As a consequence of the 1991 Gulf War, 6-8 million barrels of oil were released into the marine environment and a total of 1.12 billion barrels were burned in the Kuwaiti oil fields. In order to detect delayed effects of the Gulf War pollution, six permanent transect lines were placed on Saudi Arabian offshore and inshore reefs. A comparison of three sets of video recordings taken between 1992 and 1994 indicated a significant increase in live coral cover. Therefore, it has been concluded that corals in Saudi Arabia survived the largest oil spill on record remarkably unscathed, with no visible signs of immediate or late effects up to 3.5 years after the Gulf War.

  18. Risk factors of diarrhea in children under 5 years in Al-Mukalla, Yemen. (United States)

    Bahartha, Ali S; AlEzzi, Jalil I


    To assess the risk factors associated with diarrhea among children below 5-years-old in Mukalla, Yemen, and compare with other studies.   We conducted a case-control study on 200 children (100 cases and 100 controls) who attended the Maternity and Child Hospital, outpatient-clinics, and the Primary Health Care Centers in Al-Mukalla, Hadhramout, Yemen between February and April 2013.   We found that the significant risk factors associated with diarrhea were crowded housing (odds ratio [OR] 2.02; p=0.02; confidence interval [CI] 1.03-4.01), incomplete vaccination of the child (OR=2.02; p=0.027; CI: 1.08-3.8), and recurrent diarrheal illness during the last 3 months (OR=6.61; p=0.001; CI: 3.41-12.90).   Diarrheal diseases are strongly associated with incomplete vaccination, recurrent diarrheal disease, and crowded housing.

  19. Course of intelligence deficits in early onset, first episode schizophrenia: a controlled, 5-year longitudinal study

    DEFF Research Database (Denmark)

    Jepsen, Jens Richardt Møllegaard; Fagerlund, Birgitte; Pagsberg, Anne Katrine


    predominantly been characterized as relatively stable in these studies. However, comparisons of IQs from different test versions based on the different norms may not permit unequivocal interpretations. The objective of the current study was to compare the development of intelligence in EOS patients (N = 10......Only few prospective longitudinal studies have assessed the course of intelligence deficits in early onset schizophrenia (EOS), and these have used different age appropriate versions of Wechsler Intelligence Scales and age appropriate norms. The post-psychotic development of intelligence in EOS has......) from their first psychotic episode to 5 years of post onset with that of healthy controls (N = 35) and patients who at baseline had been diagnosed with other non-affective psychoses (N = 8). The same version of a Wechsler Intelligence Scale was administered at both baseline and follow-up assessments...

  20. Foreground influence on primordial non-Gaussianity estimates: needlet analysis of WMAP 5-year data (United States)

    Cabella, P.; Pietrobon, D.; Veneziani, M.; Balbi, A.; Crittenden, R.; de Gasperis, G.; Quercellini, C.; Vittorio, N.


    We constrain the amplitude of primordial non-Gaussianity in the cosmic microwave background data taking into account the presence of foreground residuals in the maps. We generalize the needlet bispectrum estimator marginalizing over the amplitudes of thermal dust, free-free and synchrotron templates. We apply our procedure to Wilkinson Microwave Anisotropy Probe 5-year data, finding fNL = 38 +/- 47 (1σ), while the analysis without marginalization provides fNL = 35 +/- 42. Splitting the marginalization over each foreground separately, we found that the estimates of fNL are positively cross-correlated of 17 and 12 per cent with the dust and synchrotron, respectively, while a negative cross-correlation of about -10 per cent is found for the free-free component.

  1. Posterior bulk-filled resin composite restorations. A 5-year randomized controlled clinical study

    DEFF Research Database (Denmark)

    van Dijken, Jan WV; Pallesen, Ulla


    Objective: To evaluate in a randomized controlled study the 5-year clinical durability of a flowable resin composite bulk-fill technique in Class I and Class II restorations. Material and methods: 38 pairs Class I and 62 pairs Class II restorations were placed in 44 male and 42 female (mean age 52.......4 years). Each patient received at least two, as similar as possible, extended Class I or Class II restorations. In all cavities, a 1-step self-etch adhesive (Xeno V+) was applied. Randomized, one of the cavities of each pair received the flowable bulk-filled resin composite (SDR), in increments up to 4...... mm as needed to fill the cavity 2 mm short of the occlusal cavosurface. The occlusal part was completed with the nano-hybrid resin composite (Ceram X mono+). In the other cavity, the resin composite-only (Ceram X mono+) was placed in 2 mm increments. The restorations were evaluated using slightly...

  2. Low-grade fibromyxoid sarcoma, a deceptively benign tumor in a 5-year-old child. (United States)

    Menon, Seema; Krivanek, Michael; Cohen, Ralph


    Low-grade fibromyxoid sarcoma (LGFMS) is very uncommon in the pediatric population with only 20% of reported cases under the age of 18. The youngest reported case to date has been in a 4-year-old child. Lesions are usually slow growing and asymptomatic, and locations described in children have included paravertebral, thigh and intrathoracic. Although benign in appearance, these lesions can behave aggressively, with local recurrence and distant metastases primarily to lungs. These lesions can be resistant to the usual chemotherapy and radiotherapy with surgical resection being the treatment of choice. We report a case of a 5-year-old boy who presented with a mass in the left buttock.

  3. Oral glucose retention, saliva viscosity and flow rate in 5-year-old children. (United States)

    Negoro, M; Nakagaki, H; Tsuboi, S; Adachi, K; Hanaki, M; Tanaka, D; Takami, Y; Nakano, T; Kuwahara, M; Thuy, T T


    There are significant differences of glucose retention in site-specificity and individuals. Sixty-two 5-year-old nursery schoolchildren participated in this study on the relation between the viscosity of saliva and flow rate and glucose retention. Each child was instructed to rinse his/her mouth with a glucose solution (0.5 M, 5 ml) and then to spit out. Three minutes after rinsing, glucose retention was determined. Resting saliva was collected by a natural outflow method, then the flow rate was determined. A rotational viscometer was used to determine the viscosity. Glucose retention and flow rate were correlated at the left maxillary primary molars, and glucose retention and viscosity were correlated at the maxillary central primary incisors. It was concluded that glucose retention after glucose mouth rinsing was site-specific, and that glucose retention and the index of decayed, missing and filled primary teeth (dmft) were slightly correlated with the salivary viscosity and flow rate.

  4. 5-Year randomized clinical evaluation of posterior bulk-fill restorations

    DEFF Research Database (Denmark)

    van Dijken, Jan WV; Pallesen, Ulla

    Purpose/aim: To evaluate in a randomized controlled study the 5-year clinical durability of a flowable resin composite bulk-fill technique in Class I and Class II restorations. Materials and methods: 38 pairs Class I and 62 pairs Class II restorations were placed in 44 male and 42 female (mean age...... 52.4 years). Each patient received at least two, as similar as possible, extended Class I or Class II restorations. In all cavities, a 1-step self-etch adhesive (Xeno V+) was applied. Randomized, one of the cavities of each pair received the flowable bulk-filled resin composite (SDR), in increments...... up to 4mm as needed to fill the cavity 2mm short of the occlusal cavosurface. The occlusal part was completed with the nano-hybrid resin composite (Ceram X mono+). In the other cavity, the resin composite-only (Ceram X mono+) was placed in 2mm increments. The restorations were evaluated using...

  5. Mycobacterium tuberculosis complex transmission is not associated with recent immigration (≤5 years) in Florida. (United States)

    Séraphin, Marie Nancy; Lauzardo, Michael


    As tuberculosis (TB) incidence decreases in the US, foreign-born persons continue to account for a larger proportion of the burden. In these cross-sectional analyses of 1149 culture-confirmed TB cases genotyped using spoligotyping and 24-locus MIRU, we show that over a quarter of cases among the foreign-born population in Florida resulted from recent transmission of the Mycobacterium tuberculosis complex. In addition, over a third of these cases occurred among persons who had immigrated 5 years or less prior to their diagnosis. Although recent immigration was not a significant predictor of TB transmission, younger age, birthplace in the Americas, homelessness, drug use and TB lineage are risk factors for TB transmission among the foreign-born population in Florida. These data provide actionable insights into TB transmission among the foreign-born population in Florida. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Maternal Pre-Pregnancy BMI and Intelligence Quotient (IQ) in 5-Year-Old Children

    DEFF Research Database (Denmark)

    Bliddal, Mette; Olsen, Jørn; Støvring, Henrik


    BACKGROUND: An association between maternal pre-pregnancy BMI and childhood intelligence quotient (IQ) has repeatedly been found but it is unknown if this association is causal or due to confounding caused by genetic or social factors. METHODS: We used a cohort of 1,783 mothers and their 5-year...... and child IQ adjusted for a comprehensive set of potential confounders. Child IQ was assessed with the Wechsler Primary and Preschool Scales of Intelligence--Revised (WPPSI-R). RESULTS: The crude association between maternal BMI and child IQ showed that BMI was adversely associated with child IQ...... with a reduction in IQ of -0.40 point for each one unit increase in BMI. This association was attenuated after adjustment for social factors and maternal IQ to a value of -0.27 (-0.50 to -0.03). After mutual adjustment for the father's BMI and all other factors except maternal IQ, the association between paternal...

  7. SCANDCLEFT RANDOMIZED TRIALS: SPEECH OUTCOMES IN 5-YEAR-OLDS WITH UCLP - velopharyngeal competency and hypernasality

    DEFF Research Database (Denmark)

    Lohmander, Anette; Persson, Christina; Willadsen, Elisabeth


    ) operated on with different surgical methods for primary palatal repair. A secondary aim was to estimate burden of care in terms of received additional secondary surgeries and speech therapy. Design: Three parallel group, randomised clinical trials were undertaken as an international multicentre study by 10...... of secondary pharyngeal surgeries, number of fistulae, and speech therapy visits differed. Trial registration: ISRCTN29932826. Keywords: Randomised clinical trial, Scandcleft, primary palatal repair, unilateral cleft lip and palate, speech, intercentre study, cross-linguistic......Background and aim: Adequate velopharyngeal function and speech are main goals in the treatment of cleft palate. The objective was to investigate if there were differences in velopharyngeal competency (VPC) and hypernasality at age 5 years in children with unilateral cleft lip and palate (UCLP...

  8. Masticatory function and patient satisfaction with implant-supported mandibular overdentures: a prospective 5-year study

    DEFF Research Database (Denmark)

    Bakke, Merete; Holm, Betty; Gotfredsen, Klaus


    (questionnaire) and functional recordings (chewing ability, bite force, electromyographic activity) were performed with the new dentures, and again 3 months, 1 year, and 5 years after overdenture treatment. RESULTS: After treatment, all patients were able to comminute hard and tough food, the maximum bite force...... and the chewing activity increased in parallel, and the duration of the chewing cycle was reduced. Every patient felt improved function and reduction of chewing pain. However, the seven patients not fully satisfied with the function of the implant-supported mandibular overdentures were characterized by lower...... muscle activity, even before implant placement, than the entirely satisfied patients. CONCLUSION: Implant-supported mandibular overdenture treatment permits better biting and chewing function than conventional complete dentures....

  9. 5 years of experience with a large-scale mentoring program for medical students. (United States)

    Pinilla, Severin; Pander, Tanja; von der Borch, Philip; Fischer, Martin R; Dimitriadis, Konstantinos


    In this paper we present our 5-year-experience with a large-scale mentoring program for undergraduate medical students at the Ludwig Maximilians-Universität Munich (LMU). We implemented a two-tiered program with a peer-mentoring concept for preclinical students and a 1:1-mentoring concept for clinical students aided by a fully automated online-based matching algorithm. Approximately 20-30% of each student cohort participates in our voluntary mentoring program. Defining ideal program evaluation strategies, recruiting mentors from beyond the academic environment and accounting for the mentoring network reality remain challenging. We conclude that a two-tiered program is well accepted by students and faculty. In addition the online-based matching seems to be effective for large-scale mentoring programs.

  10. Effect of pregnancy on the prognosis for multiple sclerosis. A 5-year follow up investigation

    DEFF Research Database (Denmark)

    Stenager, Egon; Stenager, E N; Jensen, Knud


    INTRODUCTION: The purpose of the study was to evaluate the effect of pregnancy and childbirth on the longterm prognosis for women with multiple sclerosis (MS). METHOD AND MATERIAL: A cohort of 39 women with definite MS were identified on 1.1.1986 using a reproducible selection method. The investi......INTRODUCTION: The purpose of the study was to evaluate the effect of pregnancy and childbirth on the longterm prognosis for women with multiple sclerosis (MS). METHOD AND MATERIAL: A cohort of 39 women with definite MS were identified on 1.1.1986 using a reproducible selection method....... The investigation was initiated in 1986 when handicap was evaluated by Kurtzke Disability Status Score (DSS). At a 5-year follow up 4 had died and 6 could not participate. There were 29 women in the investigation of whom 7 were childless, 10 had onset of MS at least 6 months after last childbirth, and 12 had onset...

  11. Retinal and Optic Nerve Degeneration in Patients with Multiple Sclerosis Followed up for 5 Years. (United States)

    Garcia-Martin, Elena; Ara, Jose R; Martin, Jesus; Almarcegui, Carmen; Dolz, Isabel; Vilades, Elisa; Gil-Arribas, Laura; Fernandez, Francisco J; Polo, Vicente; Larrosa, Jose M; Pablo, Luis E; Satue, Maria


    To quantify retinal nerve fiber layer (RNFL) changes in patients with multiple sclerosis (MS) and healthy controls with a 5-year follow-up and to analyze correlations between disability progression and RNFL degeneration. Observational and longitudinal study. One hundred patients with relapsing-remitting MS and 50 healthy controls. All participants underwent a complete ophthalmic and electrophysiologic exploration and were re-evaluated annually for 5 years. Visual acuity (Snellen chart), color vision (Ishihara pseudoisochromatic plates), visual field examination, optical coherence tomography (OCT), scanning laser polarimetry (SLP), and visual evoked potentials. Expanded Disability Status Scale (EDSS) scores, disease duration, treatments, prior optic neuritis episodes, and quality of life (QOL; based on the 54-item Multiple Sclerosis Quality of Life Scale score). Optical coherence tomography (OCT) revealed changes in all RNFL thicknesses in both groups. In the MS group, changes were detected in average thickness and in the mean deviation using the GDx-VCC nerve fiber analyzer (Laser Diagnostic Technologies, San Diego, CA) and in the P100 latency of visual evoked potentials; no changes were detected in visual acuity, color vision, or visual fields. Optical coherence tomography showed greater differences in the inferior and temporal RNFL thicknesses in both groups. In MS patients only, OCT revealed a moderate correlation between the increase in EDSS and temporal and superior RNFL thinning. Temporal RNFL thinning based on OCT results was correlated moderately with decreased QOL. Multiple sclerosis patients exhibit a progressive axonal loss in the optic nerve fiber layer. Retinal nerve fiber layer thinning based on OCT results is a useful marker for assessing MS progression and correlates with increased disability and reduced QOL. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  12. Management of shortened dental arches and periodontal health: 5-year results of a randomised trial. (United States)

    Walter, M H; Marré, B; Vach, K; Strub, J; Mundt, T; Stark, H; Pospiech, P; Wöstmann, B; Heydecke, G; Kern, M; Hartmann, S; Luthardt, R; Huppertz, J; Wolfart, S; Hannak, W


    In a multicentre randomised trial (German Research Association, grants DFG WA 831/2-1 to 2-6, WO 677/2-1.1 to 2-2.1.; ISRCTN97265367), patients with complete molar loss in one jaw received either a partial removable dental prosthesis (PRDP) with precision attachments or treatment according to the SDA concept aiming at pre-molar occlusion. The objective of this current analysis was to evaluate the influence of different treatments on periodontal health. Linear mixed regression models were fitted to quantify the differences between the treatment groups. The assessment at 5 years encompassed 59 patients (PRDP group) and 46 patients (SDA group). For the distal measuring sites of the posterior-most teeth of the study jaw, significant differences were found for the plaque index according to Silness and Löe, vertical clinical attachment loss (CAL-V), probing pocket depth (PPD) and bleeding on probing. These differences were small and showed a slightly more unfavourable course in the PRDP group. With CAL-V and PPD, significant differences were also found for the study jaw as a whole. For CAL-V, the estimated group differences over 5 years amounted to 0.27 mm (95% CI 0.05; 0.48; P = 0.016) for the study jaw and 0.25 mm (95% CI 0.05; 0.45; P = 0.014) for the distal sites of the posterior-most teeth. The respective values for PPD were 0.22 mm (95% CI 0.03; 0.41; P = 0.023) and 0.32 mm (95% CI 0.13; 0.5; P = 0.001). It can be concluded that even in a well-maintained.patient group statistically significant although minor detrimental effects of PRDPs on periodontal health are measurable. © 2014 John Wiley & Sons Ltd.

  13. Functional Outcomes after Bilateral Hand Transplantation: A 3.5-Year Comprehensive Follow-Up. (United States)

    Singh, Mansher; Sisk, Geoffroy; Carty, Matthew; Sampson, Christian; Blazar, Philip; Dyer, George; Earp, Brandon; Pribaz, Julian; Pomahac, Bohdan; Talbot, Simon G


    Since the first successful hand transplantation in 1998, 72 patients have been operated on for unilateral/bilateral hand transplantation across 13 countries. There have been multiple studies evaluating the outcomes of hand transplantation; however, there is considerable variability among the outcome measures evaluated in these studies. This article reports functional outcomes in a patient with bilateral hand transplants at a mid-forearm level with serial follow-ups over 3.5 years. Different parameters used to study the functional outcomes include the Disabilities of the Arm, Shoulder, and Hand score, the Carroll test, the Hand Transplant Score System, the Short Form-36 Health Survey, and routine occupational therapy measures. Various task-oriented outcomes were also assigned to provide milestones to the recovery. The patient had a Disabilities of the Arm, Shoulder, and Hand score of 40, a Carroll test score of 48 (right) and 49 (left), and a Hand Transplant Score System score of 58 (right) and 57.5 (left) at 3.5-year follow-up. Interestingly, his objective scores did not change significantly during the follow-up, but he continued to function quite independently and is subjectively pleased with his outcomes. Multiple functional outcome measures provide an objective way to follow patients who have undergone hand transplantation. The authors propose a series of measures to elucidate subtleties in functional gains. However, use of this series in isolation may belie subjectively good results. They also propose a series of milestones in the recovery to give a better real-world explanation of progress. Therapeutic, V.

  14. Falls in children birth to 5 years: different mechanisms lead to different injuries. (United States)

    Pomerantz, Wendy J; Gittelman, Michael A; Hornung, Richard; Husseinzadeh, Heideh


    Falls are the most common cause of injury-related hospitalization in children younger than 5 years old. Most anticipatory guidance surrounding falls is around falls from windows or stairs; however, falls from furniture also are important causes of morbidity. The purpose of this study was to compare the number of children injured, ages of injured children, and injuries sustained in falls from furniture and falls from stairs in hospitalized children younger than 5 years. All records of individuals from 0 year through 4 years, hospitalized at our institution for a fall from furniture or stairs between January 1, 1996, and December 31, 2006, were retrospectively reviewed. A standard data set was abstracted from each chart. Frequencies were used to characterize the study population. χ and t tests were used to determine differences between groups. A total of 171 patients were hospitalized for falls from stairs and 318 for falls from furniture. There were no differences between the groups with regard to age, sex, race, type of insurance, length of stay, Injury Severity Score, or total cost. The most common pieces of furniture from which children fell were beds (33.0%), couches (18.9%), and chairs (17.9%). Children who fell from stairs were significantly more likely to have injuries to their head (64.3% vs. 38.1%); those that fell from furniture were more likely to sustain arm injuries (33.3% vs. 9.9%). There were significantly more skull fractures in those that fell from stairs (39.8% vs. 20.1%) and humerus fractures in those that fell from furniture (30.8% vs. 9.4%) (p injuries. Prognostic/epidemiologic study, level III.

  15. Status of medical education reform at Saga Medical School 5 years after introducing PBL. (United States)

    Oda, Yasutomo; Koizumi, Shunzo


    In Japan, problem-based learning (PBL) is a relatively new method of educating medical students that is reforming the face of medical education throughout the world, including Asia. It shifts from teacher-centered learning strategies (for example, lectures in large auditoriums) to student-centered, self-directed learning methods (for example, active discussions and problem-solving by students in small groups under the guidance of faculty tutors). Upon a recommendation by the Japan Model Core Curriculum, Saga Medical School introduced a PBL curriculum 5 years ago. A full PBL curriculum was adopted from the McMaster model through Hawaii. A description of how PBL was implemented into the 3rd and 4th year (Phase III curriculum) is given. The overall result has been good. Students who experienced PBL had increased scores on the National Medical License Exam, and Saga increased its ranking from 56th to 19th of the 80 medical schools in Japan. A key step was introduction of the educational scaffolding in PBL Step 0. Students were allowed to see page one of the PBL case, containing the chief complaint, on the weekend before meeting in small groups. Despite a perceived overall benefit to student learning, symptoms of superficial discussions by students have been observed recently. How this may be caused by poor case design is discussed. Other problems, including "silent tutors" and increased faculty workload, are discussed. It is concluded that after 5 years, Saga's implementation of a PBL curriculum has been successful. However, many additional issues, including motivation of students and preparation for PBL in the first 2 years, must still be resolved in the future. This is the first description of the positive and negative outcomes associated with the reform of medical education and the introduction of PBL to a traditional medical school curriculum in Japan.

  16. Vitamin supplementation and related nutritional status in Thai children, aged 1-5 years. (United States)

    Ratanachu-ek, Suntaree


    To evaluate the prevalence of vitamin supplementation in Thai children aged 1-5 years at Queen Sirikit National Institute of Child Health (QSNICH), parental knowledge of vitamins, practices, and related factors such as nutritional status in vitamin supplementation. A cross-sectional study was performed at the Well Child Clinic, QSNICH, from 1-31 May 2005. Five hundred parents of young children, aged 1-5 years were interviewed by using the questionnaire to obtain information regarding knowledge and practices of vitamin supplementation. Weight and length/height were measured and nutritional status was assessed using the Thai growth reference. The relationships among vitamin supplement, nutritional status, and other related factors were analyzed using Chi-square test. The p-value supplementation was 76%, including vitamin C 62%, multi-vitamin (MTV) 35%, and cod-liver oil 20%. Regarding parental knowledge of vitamins, 57% of them knew the health benefits but 74% did not know the toxic effects of vitamins. The reasons for vitamin supplementation were poor feeding 63%, under-weight 23% and unhealthy status 14%. Vitamins were obtained from over-the-counter 59%, health services 40%, and friends 1%. Vitamin supplementation was significantly higher in children over 2 years of age, whose parents knew the benefits of vitamins, and in those children with malnutrition. The prevalence of vitamin supplementation was high in malnourished children, over 2 years of age whose parents had knowledge about benefits of vitamins. Parents should be warned about the dangers of high dose of vitamin consumption.

  17. Stereopsis results at 4.5 years of age in the infant aphakia treatment study. (United States)

    Hartmann, E Eugenie; Stout, Ann U; Lynn, Michael J; Yen, Kimberly G; Kruger, Stacey J; Lambert, Scott R


    To determine whether stereopsis of infants treated for monocular cataracts varies with the type of optical correction used. Randomized prospective clinical trial. The Infant Aphakia Treatment Study randomized 114 patients with unilateral cataracts at age 1-7 months to either primary intraocular lens (IOL) or contact lens correction. At 4.5 years of age a masked examiner assessed stereopsis on these patients using 3 different tests: (1) Frisby; (2) Randot Preschool; and (3) Titmus Fly. Twenty-eight patients (25%) had a positive response to at least 1 of the stereopsis tests. There was no statistically significant difference in stereopsis between the 2 treatment groups: Frisby (contact lens, 6 [11%]; IOL, 7 [13%]; P = .99), Randot (contact lens, 3 [6%]; IOL, 1 [2%]; P = .62), or Titmus (contact lens, 8 [15%]; IOL, 13 [23%]; P = .34). The median age at surgery for patients with stereopsis was younger than for those without stereopsis (1.2 vs 2.4 months; P = .002). The median visual acuity for patients with stereopsis was better than for those without stereopsis (20/40 vs 20/252; P = .0003). The type of optical correction did not influence stereopsis outcomes. However, 2 other factors did: age at surgery and visual acuity in the treated eye at age 4.5 years. Early surgery for unilateral congenital cataract and the presence of visual acuity better than or equal to 20/40 appear to be more important than the type of initial optical correction used for the development of stereopsis. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Natural evolution of snoring: a 5-year follow-up study. (United States)

    Martikainen, K; Partinen, M; Urponen, H; Vuori, I; Laippala, P; Hasan, J


    The natural evolution of snoring was studied in a middle-aged population in Finland. A questionnaire was mailed to a stratified random sample of 1600 people aged 36-50 years in 1985 with a response rate of 75.2%; 53% of them completed also the 5-year-follow-up questionnaire. Clinical examinations (N = 36) and whole-night polygraphic recordings (N = 22) were made to habitual (every or almost every night) snorers and daily sleepy persons. A total of 626 persons completed the 5-year-follow-up questionnaire. The prevalence of habitual snoring among men was 28.3-43.8% and among women 6.3-18.8%, increasing with age. Sleepiness was common: doze-off at the wheel was reported by 23% of snorers and traffic accidents because of sleepiness by 4.5%. Hypertension was clearly more common (p = 0.002) among habitual snorers, but the self-reported rates of strokes and coronary heart disease were not increased in this study. None of the snorers had been investigated because of their snoring or sleepiness during the five years. In polygraphic recordings 11/22 showed an oxygen desaturation index (ODI4) more than 5/h; active treatment was started for 8 of them. The observed prevalence of sleep apnea syndrome with ODI4 > 10 was 1.1% in this study. Snorers, even with clear sleepiness, are passive in seeking help for their symptoms. Physicians should actively diagnose this treatable condition impairing the quality of life and increasing the risk of traffic accidents and vascular diseases.

  19. Status of Medical Education Reform at Saga Medical School 5 Years After Introducing PBL

    Directory of Open Access Journals (Sweden)

    Yasutomo Oda


    Full Text Available In Japan, problem-based learning (PBL is a relatively new method of educating medical students that is reforming the face of medical education throughout the world, including Asia. It shifts from teacher-centered learning strategies (for example, lectures in large auditoriums to student-centered, self-directed learning methods (for example, active discussions and problem-solving by students in small groups under the guidance of faculty tutors. Upon a recommendation by the Japan Model Core Curriculum, Saga Medical School introduced a PBL curriculum 5 years ago. A full PBL curriculum was adopted from the McMaster model through Hawaii. A description of how PBL was implemented into the 3rd and 4th year (Phase III curriculum is given. The overall result has been good. Students who experienced PBL had increased scores on the National Medical License Exam, and Saga increased its ranking from 56th to 19th of the 80 medical schools in Japan. A key step was introduction of the educational scaffolding in PBL Step 0. Students were allowed to see page one of the PBL case, containing the chief complaint, on the weekend before meeting in small groups. Despite a perceived overall benefit to student learning, symptoms of superficial discussions by students have been observed recently. How this may be caused by poor case design is discussed. Other problems, including “silent tutors” and increased faculty workload, are discussed. It is concluded that after 5 years, Saga's implementation of a PBL curriculum has been successful. However, many additional issues, including motivation of students and preparation for PBL in the first 2 years, must still be resolved in the future. This is the first description of the positive and negative outcomes associated with the reform of medical education and the introduction of PBL to a traditional medical school curriculum in Japan.

  20. 5-Year survival of ART restorations with and without cavity disinfection. (United States)

    Farag, A; van der Sanden, W J M; Abdelwahab, H; Mulder, J; Frencken, J E


    The null-hypothesis tested was that there is no difference between the survival of ART restorations with, and without, cavity disinfection among adolescents after 5 years. Eligible students were allocated to one of the treatment groups. One operator placed a total of 90 restorations, 45 each per treatment group, in ninety 14-15 year olds. Restorations were evaluated on replica models at baseline and after 1 and 5 years, by two calibrated and independent evaluators using the ART criteria. The independent variables were gender, mean DMFT score at baseline, cavity size (small/large), cavity type (single-/multiple surfaces) and disinfected cavity (yes/no). Statistical analyses were done using the Kaplan-Meier method and log-rank test. The cumulative survival percentage and standard error for the 61 ART restorations with and without disinfection at evaluation year 5 were 85% (S.E.=6.1%) and 80% (S.E.=7.1%), respectively: not significantly different (p=0.37) from each other. The cumulative survival percentage and standard error for all ART restorations was 97% (S.E.=2.0%) at evaluation year 1 and 82% (S.E.=4.7%) at year 5, and it was 85% (S.E.=5.4%) for single- and 77% (S.E.=9%) for multiple-surface ART restorations at year 5. The cumulative survival percentage of all ART restorations at evaluation year 5 was statistically significant higher for boys than for girls (p=0.03). Disinfecting a cavity cleaned according to ART with a 2% chlorhexidine solution is unnecessary. It is useful to introduce the ART approach systematically into the healthcare system in Egypt.

  1. Parenting style and family meals: cross-sectional and 5-year longitudinal associations. (United States)

    Berge, Jerica M; Wall, Melanie; Neumark-Sztainer, Dianne; Larson, Nicole; Story, Mary


    Research on family meals in the past decade has shown a positive association between family meal frequency and adolescent healthy dietary intake. However, less is known about factors within the home environment, such as parenting style, that may be associated with family meal patterns. The purpose of this study is to test cross-sectional and 5-year longitudinal associations between parenting styles (authoritative, authoritarian, permissive, and neglectful) and the frequency of family meals among adolescents. Data were from Project Eating Among Teens, a population-based study comprised of youth from diverse ethnic/racial and socioeconomic backgrounds. Two cohorts of adolescents (middle school and high school) completed in-class surveys in 1999 (Time 1) and mailed surveys in 2004 (Time 2). Multiple linear regression models were used to predict mean frequency of family meals at Time 1 and Time 2 from adolescent report of parenting style (both mother and father) at Time 1. Cross-sectional analyses included both adolescent cohorts (n=4,746) and longitudinal analyses included only the younger cohort (n=806) because family meal frequency was not assessed in the older cohort at Time 2. Cross-sectional results for adolescent girls indicated a positive association between maternal and paternal authoritative parenting style and frequency of family meals. For adolescent boys, maternal authoritative parenting style was associated with more frequent family meals. Longitudinal results indicated that authoritative parenting style predicted higher frequency of family meals 5 years later, but only between opposite sex parent/adolescent dyads. Future research should identify additional factors within the home environment that are associated with family meal frequency to develop effective interventions that result in increased family meals for youth. Also, future research should investigate the mealtime behaviors of authoritative parents and identify specific behaviors that dietetics

  2. Cementless Oxford medial unicompartimental knee replacement: an independent series with a 5-year-follow-up. (United States)

    Panzram, Benjamin; Bertlich, Ines; Reiner, Tobias; Walker, Tilman; Hagmann, Sébastien; Gotterbarm, Tobias


    Cemented unicompartmental knee replacement (UKR) has proven excellent long-term survival rates and functional scores in Price et al. (Clin Orthop Relat Res 435:171-180, 2005), Price and Svard (Clin Orthop Relat Res 469(1):174-179, 2011) and Murray et al. (Bone Joint Surg Br 80(6):983-989, 1998). The main causes for revision, aseptic loosening and pain of unknown origin might be addressed by cementless UKR in Liddle et al. (Bone Joint J 95-B(2):181-187, 2013), Pandit et al. (J Bone Joint Surg Am 95(15):1365-1372, 2013), National Joint Registry for England, Wales and Northern Ireland: 10th Annual Report 2013 ( , 2013), Swedish Knee Arthroplasty Register: Annual Report 2013 ( , 2013). This single-centre retrospective cohort study reports the 5-year follow-up results of our first 30 consecutively implanted cementless Oxford UKR (OUKR). Clinical outcome was measured using the OKS, AKSS, range of movement and level of pain (visual analogue scale). The results were compared to cemented OUKR in a matched-pair analysis. Implant survival was 89.7%. One revision each was performed due to tibial fracture, progression of osteoarthritis (OA) and inlay dislocation. The 5-year survival rate of the cementless group was 89.7% and of the cemented group 94.1%. Both groups showed excellent postoperative clinical scores. Cementless fixation shows good survival rates and clinical outcome compared to cemented fixation.

  3. Lobar Emphysema Distribution Is Associated With 5-Year Radiological Disease Progression. (United States)

    Boueiz, Adel; Chang, Yale; Cho, Michael H; Washko, George R; San José Estépar, Raul; Bowler, Russell P; Crapo, James D; DeMeo, Dawn L; Dy, Jennifer G; Silverman, Edwin K; Castaldi, Peter J


    Emphysema has considerable variability in its regional distribution. Craniocaudal emphysema distribution is an important predictor of the response to lung volume reduction. However, there is little consensus regarding how to define upper lobe-predominant and lower lobe-predominant emphysema subtypes. Consequently, the clinical and genetic associations with these subtypes are poorly characterized. We sought to identify subgroups characterized by upper-lobe or lower-lobe emphysema predominance and comparable amounts of total emphysema by analyzing data from 9,210 smokers with without alpha-1-antitrypsin deficiency in the Genetic Epidemiology of COPD (COPDGene) cohort. CT densitometric emphysema was measured in each lung lobe. Random forest clustering was applied to lobar emphysema variables after regressing out the effects of total emphysema. Clusters were tested for association with clinical and imaging outcomes at baseline and at 5-year follow-up. Their associations with genetic variants were also compared. Three clusters were identified: minimal emphysema (n = 1,312), upper lobe-predominant emphysema (n = 905), and lower lobe-predominant emphysema (n = 796). Despite a similar amount of total emphysema, the lower-lobe group had more severe airflow obstruction at baseline and higher rates of metabolic syndrome compared with subjects with upper-lobe predominance. The group with upper-lobe predominance had greater 5-year progression of emphysema, gas trapping, and dyspnea. Differential associations with known COPD genetic risk variants were noted. Subgroups of smokers defined by upper-lobe or lower-lobe emphysema predominance exhibit different functional and radiological disease progression rates, and the upper-lobe predominant subtype shows evidence of association with known COPD genetic risk variants. These subgroups may be useful in the development of personalized treatments for COPD. Copyright © 2017 American College of Chest Physicians. Published by Elsevier

  4. [Association of breastfeeding with behavioral problems and temperament development in children aged 4-5 years]. (United States)

    Liu, Fang; Ma, Li-Ji; Yi, Ming-Ji


    Childhood behavioral problems can predict future psychiatric disorders. Temperament development is important for a healthy personality in adulthood. This study investigated whether breastfeeding is associated with the occurrence of behavioral problems and the temperament development in preschool children. A total of 737 children (399 boys and 338 girls) aged 4-5 years in Zibo City were recruited by stratified random cluster sampling. They were born at term with a birth weight of >/= 2.5 kg. The feeding patterns and the breastfeeding duration in infancy were collected. Behavioral and temperament developments were investigated by the Achenbach Child Behavior Checklist (CBCL), temperament questionnaire for 3-7-year-old children and a self-designed inventory questionnaire. The association of feeding patterns and the breastfeeding duration with behavioral problem occurrence and the temperament development in children were analyzed by a multivariate non-conditional logistic regression analysis and a multivariate stepwise regression analysis. After controlling for confounding variables, such as family income and parental education levels, it was found that a breastfeeding duration of >/= 9 months was a protective factor against behavioral problem occurrence in boys (OR=0.184). In girls, a breastfeeding duration of >/= 9 months was also a protective factor against behavioral problem occurrence (OR=0.165), while a mixed feeding with more breast milk and less formula milk was a risk factor (OR=2.203). The factors influencing temperament development consisted of exclusive formula feeding and the duration of breastfeeding (lasting for 4-6 months or 7-9 months) as well as a mixed feeding (with more formula milk and less breast milk, more breast milk and less formula milk, or equal amount of both). The fewer amounts and the shorter duration of breastfeeding are risk factors for behavioral problems occurrence in children aged 4-5 years. Children's temperament development is

  5. The arthroscopic latarjet procedure for anterior shoulder instability: 5-year minimum follow-up. (United States)

    Dumont, Guillaume D; Fogerty, Simon; Rosso, Claudio; Lafosse, Laurent


    The arthroscopic Latarjet procedure combines the benefits of arthroscopic surgery with the low rate of recurrent instability associated with the Latarjet procedure. Only short-term outcomes after arthroscopic Latarjet procedure have been reported. To evaluate the rate of recurrent instability and patient outcomes a minimum of 5 years after stabilization performed with the arthroscopic Latarjet procedure. Case series; Level of evidence, 4. Patients who underwent the arthroscopic Latarjet procedure before June 2008 completed a questionnaire to determine whether they had experienced a dislocation, subluxation, or further surgery. The patients also completed the Western Ontario Shoulder Instability Index (WOSI). A total of 62 of 87 patients (64/89 shoulders) were contacted for follow-up. Mean follow-up time was 76.4 months (range, 61.2-100.7 months). No patients had reported a dislocation since their surgery. One patient reported having subluxations since the surgery. Thus, 1 patient (1.59%) had recurrent instability after the procedure. The mean ± standard deviation aggregate WOSI score was 90.6% ± 9.4%. Mean WOSI domain scores were as follows: Physical Symptoms, 90.1% ± 8.7%; Sports/Recreation/Work, 90.3% ± 12.9%; Lifestyle, 93.7% ± 9.8%; and Emotions, 88.7% ± 17.3%. The rate of recurrent instability after arthroscopic Latarjet procedure is low in this series of patients with a minimum 5-year follow-up. Patient outcomes as measured by the WOSI are good. © 2014 The Author(s).

  6. Visual impairment corrected via cataract surgery and 5-year survival in a prospective cohort. (United States)

    Fong, Calvin Sze-Un; Mitchell, Paul; Rochtchina, Elena; de Loryn, Tania; Tan, Ava Grace; Wang, Jie Jin


    To compare mortality risk between cataract surgical patients with corrected and persistent visual impairment. Cohort study. A total of 1864 consecutive patients, aged ≥64 years, undergoing phacoemulsification surgery at Westmead Hospital were followed annually for 5 years postoperatively. Visual impairment status in the surgical eye was categorized as none (presenting visual acuity [VA], ≥20/40), mild (VA visual impairment before surgery, 60.4% (n = 544), 15.5% (n = 140), and 24.1% (n = 217) had no, mild, or moderate-severe visual impairment in the surgical eye, respectively, 1 month postoperatively. Age-standardized 5-year mortality rates were nonsignificantly lower in patients with either mild (24.7%, 95% confidence interval [CI] 16.5%-32.9%) or no visual impairment (24.1%, 95% CI 19.9%-28.4%) post surgery compared to that in patients whose moderate-severe visual impairment persisted (30.6%, 95% CI 23.3%-37.9%). After adjusting for age, sex, smoking, body mass index, and individual comorbid conditions, such as hypertension, diabetes, angina, myocardial infarction, stroke, transient ischemic attack, and kidney disease, patients with no visual impairment 1 month postoperatively had a lower mortality risk (HR 0.73, 95% CI 0.52-1.01) compared to those with persistent moderate-severe visual impairment after surgery. This finding was significant (HR 0.71, 95% CI 0.51-0.99) after additional adjustment for number of medications taken (continuous variable) and number (≥3 vs visual impairment in older patients with phacoemulsification surgery was associated with a lower mortality risk, compared to surgical patients whose visual impairment persisted postoperatively. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. [Hyponatremia and tolvaptan : what is the situation 5 years after approval?]. (United States)

    Hensen, J


    The diuretic tolvaptan has been approved for more than 5 years for the indications of euvolemic hyponatremia due to syndrome of inappropriate antidiuretic hormone (SIADH) secretion. In recent years many patients have been treated with tolvaptan and many physicians could gather practical experience. Other countries, such as the USA had already gained greater experience, also in the indications for hypervolemic hyponatremia. After approval was granted more than 5000 patients worldwide were included in the so-called hyponatremia register and 22 active centers in Germany with 317 patients participated. Although some details from this now concluded register have been published, the final publication of the multinational post-authorization safety study on tolvaptan in the treatment of SIADH has not yet been published. In the years 2012 and 2013 two warning letters were issued on tolvaptan. The first letter warned of the risk of a faster increase in serum sodium using tolvaptan and provided detailed information on how the risk of osmotic demeyelination can be minimized. So far only one proven case of osmotic demelination syndrome (ODS) is known; however, this occurred following incorrect use of tolvaptan in a monotherapy. The second warning letter provided information on the potential risk (reversible) of liver damage by tolvaptan, which resulted from the TEMPO 3:4 study. In this study tolvaptan was used in a higher dosage for therapy of autosomal dominant polycystic kidney disease. Although the European renal best practice (ERBP) guidelines from 2014 did not recommend tolvaptan for the indications of SIADH, other guidelines came to different conclusions. In summary, 5 years after the approval of tolvaptan there is still no consensus. At the current time many questions still remain unanswered. Initiation of therapy with tolvaptan remains reserved for experienced physicians in hospitals. Treatment must be adapted on the basis of a clinical estimation of the individual

  8. Prevalence, intensity and impact of dental pain in 5-year-old preschool children. (United States)

    Moura-Leite, Fabíola Rocha; Ramos-Jorge, Maria Letícia; Bonanato, Karina; Paiva, Saul Martins; Vale, Míriam Pimenta; Pordeus, Isabela Almeida


    The aim of this study was to assess the impact of clinical oral health conditions, and the prevalence, intensity and the impact of dental pain on daily living among 5-year-old preschool children. A cross-sectional survey was carried out on a sample of 578 children attending preschools in Belo Horizonte, Brazil. Data were collected by means of a pretested questionnaire given to the parents and a visual analogue scale of faces applied to the children. The children underwent dental examinations. According to the parents' reports, the lifetime prevalence of dental pain was 25.0% (95% confidence interval, 95% CI = 21.4 to 28.6), and dental pain caused crying in 16.8% (95% CI = 13.6 to 19.9) of the children; 10.7% (95% CI = 8.1 to 13.3) of children had dental pain in the 2 months prior to the dental examination. Among this group of children with dental pain, 59.3% experienced a negative impact as a result of pain. The following clinical conditions had mostly caused dental pain in the 2 months prior to the dental examination: root remnants, fistula and pulp caries. This recent pain resulted in a visit to the clinician in 13.6% of the children. Prevalence, intensity and the impact of dental pain in 5-year-old children were high in Belo Horizonte, Brazil. Dental pain assessed in the present study was associated with avoidable pathological factors. However, only few children were treated professionally for the dental pain they were experiencing. Public policies should be developed and implemented to promote fair, comprehensive treatment for the population.

  9. Prospective 5-year survival rate data following open-wedge valgus high tibial osteotomy. (United States)

    Bode, Gerrit; von Heyden, Johanna; Pestka, Jan; Schmal, Hagen; Salzmann, Gian; Südkamp, Norbert; Niemeyer, Philipp


    Open-wedge high tibial osteotomy using internal plate fixation is a well-established and frequently performed treatment option for the management of medial compartment osteoarthritis (OA) in the young and active patients. The present study provides survival rate and functional outcome preoperatively and after 6, 12, 24, 36 and 60 months following open-wedge high tibial osteotomy. Hypothesis of the authors was high survival rates after 5 years with still remaining satisfying functional results. Sixty-two patients suffering from tibial conditioned knee joint varus deformity and medial compartment OA that underwent high tibial osteotomy using an internal plate fixator (TomoFix™, Synthes) were included. Functional outcome was evaluated prior to surgery and in the further clinical course using standard instruments (IKDC score, Lysholm score). Treatment failure was defined as the need for total knee arthroplasty (TKA). Fifty-one patients (mean age 46.8 ± 10.2 years) were available at a mean of 60.5 (SD ± 2.5) months (follow-up rate 82.3 %) postoperatively. Sixty-month IKDC (69.4 % SD ± 18.6) and Lysholm (76.6 SD ± 20.5) improved significantly when comparing with preoperative values (IKDC 44.6 SD ± 17.8; Lysholm 52.1 SD ± 20.8). Two of 51 subjects underwent TKA, resulting in a survival rate of 96 % among those patients followed (51 of 60; 85 %). Overall complication rate was 8.6 %. With a survival rate of over 96 % at 5 years, high tibial osteotomy seems to be a reliable treatment option with satisfying clinical outcome. Functional outcome was stable following 60 months. While a delay of the necessity for TKA seems likely with regard to the survival rate demonstrated in this article, possible avoidance needs to be demonstrated by longer follow-up studies. Therapeutic case series, Level IV.

  10. Seminar program for postgraduate specialty training in general practice: proposal for a 5-year thematic catalogue (United States)

    Sommer, Susanne; Baum, Erika; Magez, Julia; Chenot, Jean-Francois; Weckmann, Gesine; Steinhäuser, Jost; Heim, Susanne; Schneider, Dagmar; Fuchs, Stephan


    Introduction: In different German regions, seminar programs have been conducted for General practice residents. In each region, selection and teaching of learning content is conducted in a different manner. So far, no structured, standardized curriculum has been implemented nationwide. We have investigated, if the development of a common 5-year program of learning topics is conceivable between the different university departments of General practice in Germany. Method: The seminar program working group of the DEGAM (German College of General Practitioners and Family Physicians) has conducted an online survey based on information gathered via preliminary telephone conference (n=7; physicians with postgraduate teaching experience) among all German university departments of General Practice and two non-university teaching institutions, identified via the internet. 884 topics were extracted from 14 Seminar programs. The topics were entered in a database, discussed and categorized: Practice management/practice work flow/standardized documentation forms/quality management (n=33 topics), common acute and chronic diseases, including disease management programs (n=29 topics), communication, neurological, psychological and psychiatric consultations (n=24 topics), common medical problems, including eye, ear, nose, throat, skin and pediatric problems (n=99 Topics) family physicians general approach, including epidemiology, shared decision making, test of time (n=42 Topics). These topics have been rated for priority and desirable number of teaching-units. Results: A catalogue of 111 topics was designed, encompassing 160 teaching units. There is a suggestion of wide topics collections plus an add-on catalogue. Conclusion: A proposal for a 5-year-thematic catalogue for postgraduate training of general practice residents in Germany has been developed. This newly developed curriculum has the potential to improve knowledge and skills that have not been covered during in-house and

  11. Comparison of the inpatients admitted during the recent 5 years (January 1994-December 1998) with those admitted during the previous 5 years (January 1989-December 1993): a clinico-statistical study. (United States)

    Noguchi, R; Ohishi, S; Koga, C; Nagao, Y; Okinaga, S; Kusukawa, J; Kameyama, T


    As society ages, the composition of the diseases that occur within it changes accordingly. With that in mind, we examined the characteristics and trends in the recent inpatients and compared these recent inpatients with those of a previous report to identify the changes that accompany the aging of society. Subjects were 1,534 cases (men 56.9%, female 43.1%, average age 47.1 years) who were hospitalized at Kurume University Hospital for treatment during the 5-year period from January 1st, 1994 through December 31st, 1998. The ratio of inpatients over 65 years old was about 1.8 times higher than in the previous study, showing a clear trend toward an increased overall age of inpatients. As for the types of disease observed, the most common malignancies were epithelial tumor, followed by other benign tumors, as well as 76 cases which included diseases resembling tumor (epulis and exostosis etc.). A majority of the patients (55.6%) were directed to the Hospital by their dentist, a finding similar to that of the previous report. As for geographical distribution, 93.3% of the inpatients lived within 40 km of the center of Kurume City where our oral surgery is located, an increase of about 10% from the last report. In other words, our results showed a reduction in the sphere of treatment distribution.

  12. Irritable bowel syndrome--prognosis and diagnostic safety. A 5-year follow-up study

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Munck, L K; Andersen, J R


    with irritable bowel syndrome as the final and only abdominal diagnosis in the period 1977-79 were followed up in 1984. Seventeen patients died during the follow-up period; two of these were considered diagnostic failures (chronic pancreatitis and pancreatic cancer). Of the remaining 95 patients, 93 were...

  13. Reciprocal Relations Between Harsh Discipline and Children's Externalizing Behavior in China: A 5-Year Longitudinal Study. (United States)

    Wang, Meifang; Liu, Li


    This research examined the overtime reciprocal relations between maternal and paternal harsh discipline and children's externalizing behavior. Seven hundred two father-mother dyads of children (6-9 years of age at baseline) completed measures of parental harsh discipline and children's externalizing behavior at five time points, 1 year apart. Autoregressive latent trajectory models revealed that maternal and paternal corporal punishment predicted subsequent children's externalizing behavior (parent-driven effects), whereas children's externalizing behavior predicted subsequent maternal and paternal psychological aggression (child-driven effects). The parent-driven effects became stronger, whereas the child-driven effects were equally strong across time. Furthermore, the parent-driven effects for corporal punishment were found for both boys and girls, whereas the child-driven effects for psychological aggression were found only for boys. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

  14. Longitudinal growth of French singleton children born after in vitro fertilization and intracytoplasmic sperm injection. Body mass index up to 5 years of age. (United States)

    Meddeb, L; Pauly, V; Boyer, P; Montjean, D; Devictor, B; Curel, L; Seng, P; Sambuc, R; Gervoise Boyer, M


    The literature presents conflicting results on the epigenetic effect of in vitro fertilization (IVF) on the short-term and mid-term growth of children. These contradictory results may be related to the use of heterogeneous methodologies and non-longitudinal data. The goal of this study was to compare the body mass index (BMI) of children conceived via IVF and spontaneous conception (SC) children, using longitudinal data from birth to 5 years. This study compared 118 singleton children born after in vitro fertilization, with or without intracytoplasmic sperm injection (ICSI), selected from a pre-existing single-center cohort to 320 SC children from the same geographic area. BMI and its evolution were analyzed using the mixed-effect model during three periods: before standing acquisition (from birth to 1 year of age), during standing acquisition, and the following period from 2 to 5 years of age. BMI means were not significantly different between groups regardless of the period, when adjusting for confounding factors related to parents, pregnancy, and children's characteristics and lifestyle. Nevertheless, during the standing acquisition period, children born after IVF-ICSI presented a less significant decrease in BMI (P<0.05). In addition, for each period we identified influencing factors (maternal BMI, level of wealth indicator) associated with BMI. In the study population, the suspected epigenetic influence of IVF reported in the literature was not observed for BMI from birth to 5 years of age. Further investigations need to be conducted to determine if the suspected influence of IVF on adiposity could be expressed through other parameters. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  15. [Long-term effect of hypertension on neurobehavioral and cardiac function in the apparently healthy community-dwelling elderly: a 5-year follow-up study]. (United States)

    Hamada, Tomio; Chikamori, Taishiro; Nishinaga, Masanori; Doi, Yoshinori


    Recently, it has been reported that hypertension causes not only cerebro-cardiovascular diseases, but also a decline of cognitive function in the elderly. However, it is not clear whether or not aging and hypertension have a latent effect on the cognitive-neurobehavioral and cardiac functions in healthy elderly whose scores of basic activities of daily living (ADL) are fully maintained. We evaluated the effect of aging and hypertension on cognitive-neurobehavioral and cardiac functions in 25 healthy community-dwelling elderly subjects (mean age: 69 y.o.) whose scores of basic ADL were fully maintained. Subjects were followed over a 5-year period, and the following examinations were performed before and after a 5-year follow-up: echocardiography, 24-hr ambulatory blood pressure monitoring (ABPM), and cognitive-neurobehavioral function test. Left ventricular mass index was significantly increased in the hypertensive (HT) subjects relative to the normotensive (NT) subjects over the 5 years (% change: 3% for HT vs. -0.8% for NT, p = 0.03). The number of non-dippers significantly increased over the 5 years in the HT group (initially: 20% [2/10] vs. follow-up: 58% [7/12], p = 0.04). Visuospatial cognitive performance scale scores for evaluation of higher cognitive-neurobehavioral functions significantly deteriorated in the HT subjects (initially; 2,344 +/- 110 vs. 2,380 +/- 102, ns, and follow-up: 2,149 +/- 181 vs. 2,356 +/- 159, p = 0.04). Hypertension contributes to the impairment of the cognitive-neurobehavioral function in the elderly by latently affecting the functions of multiple organs. This occurs even if basic ADL is maintained for 5 years. Therefore, it is important to control BP not only to prevent cardiovascular events, but also to preserve the neurobehavioral function.

  16. Relationship between perinatal antioxidant vitamin and heavy metal levels and the growth and cognitive development of children at 5 years of age. (United States)

    Liu, Yongfang; Chen, Qian; Wei, Xiaoping; Chen, Li; Zhang, Xuan; Chen, Ke; Chen, Jie; Li, Tingyu


    To evaluate how prenatal exposure to antioxidant vitamins and heavy metals affects subsequent development. Maternal serum and cord serum levels of antioxidant vitamins (A, E, and C) were determined. Full-state, performance, and verbal intelligence quotients (FSIQ, PIQ, and VIQ, respectively) of 97 children were assessed at 5 years of age. The placental transport ratio (PTR: cord level relative to maternal serum level) of vitamin A (VA) was associated positively with FSIQ score (p=0.041), vitamin E (VE)-PTR was associated positively with PIQ (p=0.002) and FSIQ (p=0.025) scores, and cord serum cadmium (Cd) level was correlated negatively with VIQ score (p=0.025) at 5 years of age. High VE-PTR protected against low PIQ (OR=0.025; p=0.021) and FSIQ (OR<0.001; p=0.004). High maternal age was a protective factor against low VIQ (OR=0.661; 95% CI, 0.500- 0.875; p=0.004) and FSIQ (OR=0.700; 95% CI, 0.512-0.957; p=0.025). A higher maternal education (OR=0.038; 95% CI, 0.003-0.458; p=0.010) and economic level (OR=0.047; 95% CI, 0.004-0.579; p=0.017) were protective against a low FSIQ score. VA-PTR predicted physical growth. VA-PTR and VE-PTR predicted intelligence test performance at 5 years old. High Cd in cord blood may negatively affect subsequent intelligence.

  17. Aetiologies of non-malaria febrile episodes in children under 5 years in sub-Saharan Africa

    NARCIS (Netherlands)

    Kiemde, Francois; Spijker, René; Mens, Petra F.; Tinto, Halidou; Boele, Michael; Schallig, Henk D. F. H.


    ObjectivesTo provide an overview of the most frequent aetiologies found in febrile episodes of children under 5 years from sub-Saharan Africa. MethodsMEDLINE and EMBASE were searched for publications in English and French on non-malaria fever episodes in African children under 5 years of age, which

  18. 5-year clinical performance of resin composite versus resin modified glass ionomer restorative system in non-carious cervical lesions

    DEFF Research Database (Denmark)

    Franco, Eduardo Batista; Benetti, Ana Raquel; Ishikiriama, Sérgio Kiyoshi


    To comparatively assess the 5-year clinical performance of a 1-bottle adhesive and resin composite system with a resin-modified glass ionomer restorative in non-carious cervical lesions.......To comparatively assess the 5-year clinical performance of a 1-bottle adhesive and resin composite system with a resin-modified glass ionomer restorative in non-carious cervical lesions....

  19. Prevalent Opportunistic Infections Associated with HIV-positive Children 0-5 years in Benin City, Nigeria

    Directory of Open Access Journals (Sweden)

    Imade, P. E.


    Full Text Available A total of 620 HIV positive children 0-5 years attending University of Benin Teaching Hospital, Benin City, were examined in this study. They were grouped into less than 1 year and 1-5 years based on CDC classification system. 218 children were under 1 year and 402 were 1-5 years. The overall results showed that malaria infection recorded the highest prevalence with 71.10% in less than 1 year and 76.37% in 1-5 years. This was followed by Oral Candidiasis 38.07% in less than 1 year and 50% in 1-5 years. Bacteraemia had 23.40% and 30.60% in less than 1 year and 1-5 years respectively. Diarrhoea, 14.22% in less than 1 year and 17.66% in 1-5 years. Otitis media had 10.55% and 10.95% in less than 1 year and 1-5 years respectively. Similarly, 590 apparently healthy HIV-negative children within the same age group were evaluated for the presence of these infections. There was a statistical significance between opportunistic infections and HIV infection (P < 0.001. Malaria infection was the most prevalent opportunistic infection in this population and may probably be due to environmental condition of this locality as well as the low immune status of the children.

  20. Growth references for height, weight and body mass index of twins aged 0-2.5 years

    NARCIS (Netherlands)

    Dommelen, P. van; Gunst, M. de; Vaart, A.D. van; Buuren, S. van; Boomsma, D.


    Aim: To determine the size of the growth deficit in Dutch monozygotic and dizygotic twins aged 0-2.5 years as compared to singletons and to construct reference growth charts for twins. Methods: Growth of twins was studied using longitudinal data on over 4000 twins aged 0-2.5 years of the Netherlands

  1. Growth references for height, weight and body mass index of twins aged 0–2.5 years.

    NARCIS (Netherlands)

    Dommelen, P.; de Gunst, M.C.M.; van der Vaart, A.W.; van Buuren, S.; Boomsma, D.I.


    Aim: To determine the size of the growth deficit in Dutch monozygotic and dizygotic twins aged 0-2.5 years as compared to singletons and to construct reference growth charts for twins. Methods: Growth of twins was studied using longitudinal data on over 4000 twins aged 0-2.5 years of the Netherlands

  2. Post-traumatic stress symptoms 5 years after military deployment to Afghanistan: an observational cohort study. (United States)

    Eekhout, Iris; Reijnen, Alieke; Vermetten, Eric; Geuze, Elbert


    Deployment can put soldiers at risk of developing post-traumatic stress symptoms. Despite several longitudinal studies, little is known about the timing of an increase in post-traumatic stress symptoms relative to pre-deployment. Longitudinal studies starting pre-deployment, in which participants are repeatedly measured over time, are warranted to assess the timing of an increase in symptoms to ultimately assess the timing of an increase in treatment demand after deployment. In this large observational cohort study, Dutch military personnel who were deployed to Afghanistan as part of the International Security Assistance Forces between March, 2005, and September, 2008, were assessed for post-traumatic stress symptoms with the Self-Rating Inventory for Post-traumatic Stress Disorder (SRIP) questionnaire. Participants were assessed 1 month before deployment and followed up at 1 month, 6 months, 12 months, 2 years, and 5 years after deployment, with changes in SRIP scores compared with pre-deployment using a mixed model analysis. The primary outcome was the total score of post-traumatic stress symptoms measured with SRIP at pre-deployment and the five follow-up assessments, with a score of 38 used as the cutoff to indicate substantial post-traumatic stress symptoms. Between March, 2005, and September, 2008, 1007 participants were recruited to this study. The results show two important effects of deployment on post-traumatic stress symptoms. A short-term symptom increase within the first 6 months after deployment (symptom increase coefficient for SRIP score vs pre-deployment [β] 0·99, 95% CI 0·50-1·48); and a long-term symptom increase at 5 years after deployment (β 1·67, 1·14-2·20). This study underlines the importance of long-term monitoring of the psychological health of soldiers after deployment because early detection of symptoms is essential to early treatment, which is related to improved psychological health. Dutch Ministry of Defense. Copyright © 2016

  3. Epidemiological analysis of maxillofacial fractures treated at a university hospital, Xinjiang, China: A 5-year retrospective study. (United States)

    Mijiti, Ainiwaer; Ling, Wang; Tuerdi, Maimaitituerxun; Maimaiti, Abudukelimujiang; Tuerxun, Julaiti; Tao, Yao Zhi; Saimaiti, Adilijiang; Moming, Adili


    To investigate the epidemiological characteristics of maxillofacial fractures treated at a university hospital, Xinjiang, China over a 5-year period. Between 2006 and 2010, a total of 1350 patients with maxillofacial fractures were reviewed retrospectively. The data collected included demographics, aetiology, site of fracture, time regarding injuries, presence of associated injuries, treatment modalities, and