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Sample records for twelve patients showed

  1. Bacteriological And Clinical Evaluation Of Twelve Cases Of Post ...

    African Journals Online (AJOL)

    Bacteriological And Clinical Evaluation Of Twelve Cases Of Post-Surgical Sepsis Of Odontogenic Tumours At A ... East African Medical Journal ... Intervention: Adequate review of patient\\'s medical history, bacteriological investigations and

  2. Mythematics Solving the Twelve Labors of Hercules

    CERN Document Server

    Huber, Michael

    2009-01-01

    How might Hercules, the most famous of the Greek heroes, have used mathematics to complete his astonishing Twelve Labors? From conquering the Nemean Lion and cleaning out the Augean Stables, to capturing the Erymanthean Boar and entering the Underworld to defeat the three-headed dog Cerberus, Hercules and his legend are the inspiration for this book of fun and original math puzzles. While Hercules relied on superhuman strength to accomplish the Twelve Labors, Mythematics shows how math could have helped during his quest. How does Hercules defeat the Lernean Hydra and stop its heads from multip

  3. Transanal rectopexy - twelve case studies

    Directory of Open Access Journals (Sweden)

    Rubens Henrique Oleques Fernandes

    2012-06-01

    Full Text Available OBJECTIVES: This study analyzed the results of transanal rectopexy and showed the benefits of this surgical technique. METHOD: Twelve patients were submitted to rectopexy between 1997 and 2011. The surgical technique used was transanal rectopexy, where the mesorectum was fixed to the sacrum with nonabsorbable suture. Three patients had been submitted to previous surgery, two by the Delorme technique and one by the Thiersch technique. RESULTS: Postoperative hospital stay ranged from 1 to 4 days. One patient (8.3% had intraoperative hematoma, which was treated with local compression and antibiotics. One patient (8.3% had residual mucosal prolapse, which was resected. Prolapse recurrence was seen in one case (8.3%. Improved incontinence occurred in 75% of patients and one patient reported obstructed evacuation in the first month after surgery. No death occurred. CONCLUSION: Transanal rectopexy is a simple, low cost technique, which has shown good efficacy in rectal prolapse control.OBJETIVO: O presente estudo analisou os resultados da retopexia pela via transanal e expôs os benefícios desta técnica cirúrgica. MÉTODO: Doze pacientes com prolapso foram operados no período de 1997 a 2011. A técnica cirúrgica usada foi a retopexia transanal, onde o mesorreto foi fixado ao sacro com fio inabsorvível. Três pacientes tinham cirurgia prévia, dois pela técnica de Delorme e um pela técnica de Thiersch. RESULTADOS: A permanência hospitalar pós-operatória variou de 1- 4 dias. Uma paciente (8,3% apresentou hematoma transoperatório que foi tratado com compressão local e antibioticoterapia. Um paciente apresentou prolapso mucoso residual (8,3%, que foi ressecado. Houve recidiva da procidência em um caso (8,3%. A melhora da incontinência ocorreu em 75% dos pacientes e uma paciente apresentou bloqueio evacuatório no primeiro mês após a cirurgia. Não houve mortalidade entre os pacientes operados. CONCLUSÃO: A retopexia transanal é uma t

  4. [Twelve years of liver transplantation in Lausanne].

    Science.gov (United States)

    Mosimann, F; Bettschart, V; Gardaz, J P; Fontolliet, C; Tissot, J D; Meuwly, J Y; Chioléro, R; Gillet, M

    2001-02-01

    From 1988 to June 2000 138 transplantations were performed in 129 adult patients. Actuarial patient and graft survivals have been 80.7% and 75.4% at one year and 67.8% and 63.5% at 10 years. This compares favourably with the statistics of the European Liver Transplant Registry that collected data from more than 30,000 grafts. Over the twelve years of activity, the indications have become more liberal and the techniques have been simplified. The waiting list has therefore grown and some patients are now unfortunately dying before a graft can be found because the number of brain dead donors remains stable. In order to palliate this shortage, older donors are now being accepted even with co-morbidities and/or moderate alterations of the liver function tests. The use of live donors and the split of the best cadaveric grafts for two recipients will also reduce the gap between the demand and the offer.

  5. Twelve Girls' Band' A Modern Miracle of Traditional Music

    Institute of Scientific and Technical Information of China (English)

    YaoZhanxiong

    2004-01-01

    Twelve antique traditional instruments. Twelve spirited, pretty girls. "Twelve Girls' Band" is a traditional instrument orchestra playing well-known folk music in the form of pop. Besides age-old traditional instruments peculiar to China, such as zheng (ancient 21 to 25-stringed plucked instrument), qin (seven-stringed plucked instrument) and erhu (two-stringed Chinese fiddle),

  6. The twelve colourful stones

    International Nuclear Information System (INIS)

    Doria, R.M.

    1983-01-01

    A dynamics with twelve colourful stones is created based on the concepts of gauge and colour. It is associated different gauge fields to the same group. A group of gauge invariant Lagrangians is established. A gauge invariant mass term is introduced. The colourful stones physical insight is to be building blocks for quarks and leptons. (Author) [pt

  7. Time dependent patient no-show predictive modelling development.

    Science.gov (United States)

    Huang, Yu-Li; Hanauer, David A

    2016-05-09

    Purpose - The purpose of this paper is to develop evident-based predictive no-show models considering patients' each past appointment status, a time-dependent component, as an independent predictor to improve predictability. Design/methodology/approach - A ten-year retrospective data set was extracted from a pediatric clinic. It consisted of 7,291 distinct patients who had at least two visits along with their appointment characteristics, patient demographics, and insurance information. Logistic regression was adopted to develop no-show models using two-thirds of the data for training and the remaining data for validation. The no-show threshold was then determined based on minimizing the misclassification of show/no-show assignments. There were a total of 26 predictive model developed based on the number of available past appointments. Simulation was employed to test the effective of each model on costs of patient wait time, physician idle time, and overtime. Findings - The results demonstrated the misclassification rate and the area under the curve of the receiver operating characteristic gradually improved as more appointment history was included until around the 20th predictive model. The overbooking method with no-show predictive models suggested incorporating up to the 16th model and outperformed other overbooking methods by as much as 9.4 per cent in the cost per patient while allowing two additional patients in a clinic day. Research limitations/implications - The challenge now is to actually implement the no-show predictive model systematically to further demonstrate its robustness and simplicity in various scheduling systems. Originality/value - This paper provides examples of how to build the no-show predictive models with time-dependent components to improve the overbooking policy. Accurately identifying scheduled patients' show/no-show status allows clinics to proactively schedule patients to reduce the negative impact of patient no-shows.

  8. Hidden twelve-dimensional super Poincare symmetry in eleven dimensions

    International Nuclear Information System (INIS)

    Bars, Itzhak; Deliduman, Cemsinan; Pasqua, Andrea; Zumino, Bruno

    2004-01-01

    First, we review a result in our previous paper, of how a ten-dimensional superparticle, taken off-shell, has a hidden eleven-dimensional super Poincare symmetry. Then, we show that the physical sector is defined by three first-class constraints which preserve the full eleven-dimensional symmetry. Applying the same concepts to the eleven-dimensional superparticle, taken off-shell, we discover a hidden twelve-dimensional super Poincare symmetry that governs the theory

  9. The twelve colourful stones

    International Nuclear Information System (INIS)

    Doria, R.M.

    1984-01-01

    The gauge symmetry is extended. It is associated differents matter and gauge fields to the same group. A group of gauge invariant Lagrangians is established. A gauge invariant mass term is introduced. A massive Yang Mills is obtained. A dynamics with twelve colourful stones is created based on the concepts of gauge and colour. Structures identified as quarks and leptons are generated. A discussion about colour meaning is presented. (Author) [pt

  10. Twelve novel HGD gene variants identified in 99 alkaptonuria patients: focus on 'black bone disease' in Italy.

    Science.gov (United States)

    Nemethova, Martina; Radvanszky, Jan; Kadasi, Ludevit; Ascher, David B; Pires, Douglas E V; Blundell, Tom L; Porfirio, Berardino; Mannoni, Alessandro; Santucci, Annalisa; Milucci, Lia; Sestini, Silvia; Biolcati, Gianfranco; Sorge, Fiammetta; Aurizi, Caterina; Aquaron, Robert; Alsbou, Mohammed; Lourenço, Charles Marques; Ramadevi, Kanakasabapathi; Ranganath, Lakshminarayan R; Gallagher, James A; van Kan, Christa; Hall, Anthony K; Olsson, Birgitta; Sireau, Nicolas; Ayoob, Hana; Timmis, Oliver G; Sang, Kim-Hanh Le Quan; Genovese, Federica; Imrich, Richard; Rovensky, Jozef; Srinivasaraghavan, Rangan; Bharadwaj, Shruthi K; Spiegel, Ronen; Zatkova, Andrea

    2016-01-01

    Alkaptonuria (AKU) is an autosomal recessive disorder caused by mutations in homogentisate-1,2-dioxygenase (HGD) gene leading to the deficiency of HGD enzyme activity. The DevelopAKUre project is underway to test nitisinone as a specific treatment to counteract this derangement of the phenylalanine-tyrosine catabolic pathway. We analysed DNA of 40 AKU patients enrolled for SONIA1, the first study in DevelopAKUre, and of 59 other AKU patients sent to our laboratory for molecular diagnostics. We identified 12 novel DNA variants: one was identified in patients from Brazil (c.557T>A), Slovakia (c.500C>T) and France (c.440T>C), three in patients from India (c.469+6T>C, c.650-85A>G, c.158G>A), and six in patients from Italy (c.742A>G, c.614G>A, c.1057A>C, c.752G>A, c.119A>C, c.926G>T). Thus, the total number of potential AKU-causing variants found in 380 patients reported in the HGD mutation database is now 129. Using mCSM and DUET, computational approaches based on the protein 3D structure, the novel missense variants are predicted to affect the activity of the enzyme by three mechanisms: decrease of stability of individual protomers, disruption of protomer-protomer interactions or modification of residues in the region of the active site. We also present an overview of AKU in Italy, where so far about 60 AKU cases are known and DNA analysis has been reported for 34 of them. In this rather small group, 26 different HGD variants affecting function were described, indicating rather high heterogeneity. Twelve of these variants seem to be specific for Italy.

  11. A Hidden Twelve-Dimensional SuperPoincare Symmetry In Eleven Dimensions

    Energy Technology Data Exchange (ETDEWEB)

    Bars, Itzhak; Deliduman, Cemsinan; Pasqua, Andrea; Zumino, Bruno

    2003-12-13

    First, we review a result in our previous paper, of how a ten-dimensional superparticle, taken off-shell, has a hidden eleven-dimensional superPoincare symmetry. Then, we show that the physical sector is defined by three first-class constraints which preserve the full eleven-dimensional symmetry. Applying the same concepts to the eleven dimensional superparticle, taken off-shell, we discover a hidden twelve dimensional superPoincare symmetry that governs the theory.

  12. Twelve novel HGD gene variants identified in 99 alkaptonuria patients: focus on ‘black bone disease' in Italy

    Science.gov (United States)

    Nemethova, Martina; Radvanszky, Jan; Kadasi, Ludevit; Ascher, David B; Pires, Douglas E V; Blundell, Tom L; Porfirio, Berardino; Mannoni, Alessandro; Santucci, Annalisa; Milucci, Lia; Sestini, Silvia; Biolcati, Gianfranco; Sorge, Fiammetta; Aurizi, Caterina; Aquaron, Robert; Alsbou, Mohammed; Marques Lourenço, Charles; Ramadevi, Kanakasabapathi; Ranganath, Lakshminarayan R; Gallagher, James A; van Kan, Christa; Hall, Anthony K; Olsson, Birgitta; Sireau, Nicolas; Ayoob, Hana; Timmis, Oliver G; Le Quan Sang, Kim-Hanh; Genovese, Federica; Imrich, Richard; Rovensky, Jozef; Srinivasaraghavan, Rangan; Bharadwaj, Shruthi K; Spiegel, Ronen; Zatkova, Andrea

    2016-01-01

    Alkaptonuria (AKU) is an autosomal recessive disorder caused by mutations in homogentisate-1,2-dioxygenase (HGD) gene leading to the deficiency of HGD enzyme activity. The DevelopAKUre project is underway to test nitisinone as a specific treatment to counteract this derangement of the phenylalanine-tyrosine catabolic pathway. We analysed DNA of 40 AKU patients enrolled for SONIA1, the first study in DevelopAKUre, and of 59 other AKU patients sent to our laboratory for molecular diagnostics. We identified 12 novel DNA variants: one was identified in patients from Brazil (c.557T>A), Slovakia (c.500C>T) and France (c.440T>C), three in patients from India (c.469+6T>C, c.650–85A>G, c.158G>A), and six in patients from Italy (c.742A>G, c.614G>A, c.1057A>C, c.752G>A, c.119A>C, c.926G>T). Thus, the total number of potential AKU-causing variants found in 380 patients reported in the HGD mutation database is now 129. Using mCSM and DUET, computational approaches based on the protein 3D structure, the novel missense variants are predicted to affect the activity of the enzyme by three mechanisms: decrease of stability of individual protomers, disruption of protomer-protomer interactions or modification of residues in the region of the active site. We also present an overview of AKU in Italy, where so far about 60 AKU cases are known and DNA analysis has been reported for 34 of them. In this rather small group, 26 different HGD variants affecting function were described, indicating rather high heterogeneity. Twelve of these variants seem to be specific for Italy. PMID:25804398

  13. Twelve fundamental life histories evolving through allocation-dependent fecundity and survival.

    Science.gov (United States)

    Johansson, Jacob; Brännström, Åke; Metz, Johan A J; Dieckmann, Ulf

    2018-03-01

    An organism's life history is closely interlinked with its allocation of energy between growth and reproduction at different life stages. Theoretical models have established that diminishing returns from reproductive investment promote strategies with simultaneous investment into growth and reproduction (indeterminate growth) over strategies with distinct phases of growth and reproduction (determinate growth). We extend this traditional, binary classification by showing that allocation-dependent fecundity and mortality rates allow for a large diversity of optimal allocation schedules. By analyzing a model of organisms that allocate energy between growth and reproduction, we find twelve types of optimal allocation schedules, differing qualitatively in how reproductive allocation increases with body mass. These twelve optimal allocation schedules include types with different combinations of continuous and discontinuous increase in reproduction allocation, in which phases of continuous increase can be decelerating or accelerating. We furthermore investigate how this variation influences growth curves and the expected maximum life span and body size. Our study thus reveals new links between eco-physiological constraints and life-history evolution and underscores how allocation-dependent fitness components may underlie biological diversity.

  14. Ten colour photometry of twelve Ap-stars

    International Nuclear Information System (INIS)

    Musielok, B.; Lange, D.; Schoeneich, W.; Hildebrandt, G.; Zelwanowa, E.; Hempelmann, A.; Salmanov, G.

    1980-01-01

    Ten-colour photoelectric observations are presented for twelve Ap-stars. Improved ephemeris for seven of them is given. Phase relations between the light curves and line intensity variations are discussed. The problem of the electromagnetic flux conctancy of IOTA Cas is approached from a qualitative point of view. (author)

  15. Twelve reasons to refuse the nuclear in the MDP

    International Nuclear Information System (INIS)

    Bonduelle, A.

    2000-01-01

    The author presents twelve reasons which show that the nuclear energy has not a place in the MDP Mechanism of Clean Development: a main loophole for the developed countries, the doubtful ''additionality'' of the nuclear, the treaty ratification is more difficult with the nuclear, the domestic energy conservation is more efficient in Europe than the nuclear development, the nuclear white elephants facing the South debts, the technology transfers are doubtful, the developing countries and the sustainable development policies are evicted from the MDP, some options are more powerful in the South, the reactors and transport networks size are unsuited, the absence of democratic control, the nuclear proliferation, the nuclear safety and the wastes. (A.L.B.)

  16. Vegetative propagation of twelve fodder tree species indigenous to ...

    African Journals Online (AJOL)

    Vegetative propagation of twelve fodder tree species indigenous to the Sahel, West Africa. Catherine Ky-Dembele, Jules Bayala, Antoine Kalinganire, Fatoumata Tata Traoré, Bréhima Koné, Alain Olivier ...

  17. Morphology of the spermathecae of twelve species of Triatominae (Hemiptera, Reduviidae) vectors of Chagas disease.

    Science.gov (United States)

    Nascimento, Juliana Damieli; Ribeiro, Aline Rimoldi; Almeida, Larissa Aguiar; de Oliveira, Jader; Mendonça, Vagner José; Cilense, Mário; da Rosa, João Aristeu

    2017-12-01

    Trypanosoma cruzi, the etiological agent of Chagas disease, is transmitted by triatomines that have been described in a large number of studies. Most of those studies are related to external morphology and taxonomy, but some biochemical, genetic and physiological studies have also been published. There are a few publications in the literature about the internal organs of Triatominae, for instance the spermathecae, which are responsible for storing and maintaining the viability of the spermatozoids until the fertilization of the oocytes. This work aims to study the spermathecae of twelve species of triatomines obtained from the Triatominae Insectarium of the Faculty of Pharmaceutical Sciences, UNESP, Araraquara, using optical microscopy and scanning electron microscopy. The spermathecae of the twelve species studied showed three morphological patterns: a) P. herreri sn, P. lignarius, P. megistus, Triatoma brasiliensis, T. juazeirensis, T. sherlocki and T. tibiamaculata have spermathecae with a thin initial portion and an oval-shaped final portion; b) R. montenegrensis, R. nasutus, R. neglectus, R. pictipes and R. prolixus have tubular and winding spermathecae; c) T. infestans has oval spermathecae. In addition to the three morphological patterns, it was noted that each of the twelve species has particular features that differentiate them. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Education and Development: Twelve Considerations for Transformative Practice

    Science.gov (United States)

    VanBalkom, W. Duffie; Eastham, Sarada

    2011-01-01

    Twelve factors that are essential to consider when embarking on the process of transformative development are examined in the context of international development programming in education and training. Each factor raises a number of questions for the deliberations of policy makers, development practitioners, scholars, international educators,…

  19. Secondary Textbook Review: English, Grades Nine through Twelve.

    Science.gov (United States)

    California State Dept. of Education, Sacramento.

    This book is intended as a resource for teachers and curriculum developers who select textbooks for secondary English courses. It includes a compilation of 32 factual textbook reviews obtained from the application of a review instrument, which was based on the California "Model Curriculum Standards: Grades Nine through Twelve, English…

  20. Investigations into the myocardial metabolism of 123-I-ω-HDA in patients showing the clinical signs and symptoms of mitral valve prolapse and previously proven to have no coronary heart disease

    International Nuclear Information System (INIS)

    Voth, E.

    1987-01-01

    In 53 patients showing the clinical signs and symptoms of mitral valve prolapse (MVP) where coronary heart disease (CHD) had previously been excluded by angiography the myocardial metabolism of fatty acids was examined at rest using metabolic myocardial scintigraphy (MMS) and 123-I-ω-HDA as tracer substance. The results were correlated with those obtained by other methods of investigation (findings at rest and during exercise from ECG recordings, tests using a flow-guided catheter and radionuclide ventriculography, further from echocardiography as well as myocardial Tl redistribution scintiscanning during exercise). For purposes of reference, MMS was additionally carried out in twelve normal individuals subjected to coronary angiography to exclude both MVP and CHD. The results of this study would appear to suggest that the pathological findings revealed by myocardial Tl scintigraphy in patients showing symptoms of MVP cannot invariably be classified as 'false' but are at least to some extent attributable to impaired myocardial perfusion, vitality or metabolism. (orig./MG) [de

  1. Safety of superconducting fusion magnets: twelve problem areas

    International Nuclear Information System (INIS)

    Turner, L.R.

    1979-01-01

    Twelve problem areas of superconducting magnets for fusion reaction are described. These are: quench detection and energy dump, stationary normal region of conductor, current leads, electrical arcing, electrical shorts, conductor joints, forces from unequal currents, eddy current effects, cryostat rupture, vacuum failure, fringing field and instrumentation for safety. Priorities among these areas are suggested

  2. Safety of superconducting fusion magnets: twelve problem areas

    International Nuclear Information System (INIS)

    Turner, L.R.

    1979-01-01

    Twelve problem areas of superconducting magnets for fusion reaction are described. These are: Quench Detection and Energy Dump, Stationary Normal Region of Conductor, Current Leads, Electrical Arcing, Electrical Shorts, Conductor Joints, Forces from Unequal Currents, Eddy Current Effects, Cryostat Rupture, Vacuum Failure, Fringing Field and Instrumentation for Safety. Priorities among these areas are suggested

  3. Migraine patients consistently show abnormal vestibular bedside tests.

    Science.gov (United States)

    Maranhão, Eliana Teixeira; Maranhão-Filho, Péricles; Luiz, Ronir Raggio; Vincent, Maurice Borges

    2016-01-01

    Migraine and vertigo are common disorders, with lifetime prevalences of 16% and 7% respectively, and co-morbidity around 3.2%. Vestibular syndromes and dizziness occur more frequently in migraine patients. We investigated bedside clinical signs indicative of vestibular dysfunction in migraineurs. To test the hypothesis that vestibulo-ocular reflex, vestibulo-spinal reflex and fall risk (FR) responses as measured by 14 bedside tests are abnormal in migraineurs without vertigo, as compared with controls. Cross-sectional study including sixty individuals - thirty migraineurs, 25 women, 19-60 y-o; and 30 gender/age healthy paired controls. Migraineurs showed a tendency to perform worse in almost all tests, albeit only the Romberg tandem test was statistically different from controls. A combination of four abnormal tests better discriminated the two groups (93.3% specificity). Migraine patients consistently showed abnormal vestibular bedside tests when compared with controls.

  4. Effectiveness of community-based treatment for problem gambling: a quasi-experimental evaluation of cognitive-behavioral vs. twelve-step therapy.

    Science.gov (United States)

    Toneatto, Tony; Dragonetti, Rosa

    2008-01-01

    With the increasing availability of gambling throughout North America, there is interest in developing more effective treatments. This study compares the effectiveness of two brief outpatient treatments for problem gambling: eight sessions of Cognitive-Behavioral Therapy (n = 65) and eight sessions of a twelve-step treatment-oriented approach based on the first five steps of Gamblers Anonymous (n = 61). There were no baseline group differences on gambling-relevant variables. Twelve months post-treatment showed no group differences on key gambling variables (eg, frequency, abstinence rates, money wagered) in an analysis of completers. Participants who attended more sessions and chose an initial abstinent treatment goal appeared to achieve better outcomes.

  5. Migraine patients consistently show abnormal vestibular bedside tests

    Directory of Open Access Journals (Sweden)

    Eliana Teixeira Maranhão

    2015-01-01

    Full Text Available Migraine and vertigo are common disorders, with lifetime prevalences of 16% and 7% respectively, and co-morbidity around 3.2%. Vestibular syndromes and dizziness occur more frequently in migraine patients. We investigated bedside clinical signs indicative of vestibular dysfunction in migraineurs.Objective To test the hypothesis that vestibulo-ocular reflex, vestibulo-spinal reflex and fall risk (FR responses as measured by 14 bedside tests are abnormal in migraineurs without vertigo, as compared with controls.Method Cross-sectional study including sixty individuals – thirty migraineurs, 25 women, 19-60 y-o; and 30 gender/age healthy paired controls.Results Migraineurs showed a tendency to perform worse in almost all tests, albeit only the Romberg tandem test was statistically different from controls. A combination of four abnormal tests better discriminated the two groups (93.3% specificity.Conclusion Migraine patients consistently showed abnormal vestibular bedside tests when compared with controls.

  6. Comparative analysis and supragenome modeling of twelve Moraxella catarrhalis clinical isolates.

    Science.gov (United States)

    Davie, Jeremiah J; Earl, Josh; de Vries, Stefan P W; Ahmed, Azad; Hu, Fen Z; Bootsma, Hester J; Stol, Kim; Hermans, Peter W M; Wadowsky, Robert M; Ehrlich, Garth D; Hays, John P; Campagnari, Anthony A

    2011-01-26

    M. catarrhalis is a gram-negative, gamma-proteobacterium and an opportunistic human pathogen associated with otitis media (OM) and exacerbations of chronic obstructive pulmonary disease (COPD). With direct and indirect costs for treating these conditions annually exceeding $33 billion in the United States alone, and nearly ubiquitous resistance to beta-lactam antibiotics among M. catarrhalis clinical isolates, a greater understanding of this pathogen's genome and its variability among isolates is needed. The genomic sequences of ten geographically and phenotypically diverse clinical isolates of M. catarrhalis were determined and analyzed together with two publicly available genomes. These twelve genomes were subjected to detailed comparative and predictive analyses aimed at characterizing the supragenome and understanding the metabolic and pathogenic potential of this species. A total of 2383 gene clusters were identified, of which 1755 are core with the remaining 628 clusters unevenly distributed among the twelve isolates. These findings are consistent with the distributed genome hypothesis (DGH), which posits that the species genome possesses a far greater number of genes than any single isolate. Multiple and pair-wise whole genome alignments highlight limited chromosomal re-arrangement. M. catarrhalis gene content and chromosomal organization data, although supportive of the DGH, show modest overall genic diversity. These findings are in stark contrast with the reported heterogeneity of the species as a whole, as wells as to other bacterial pathogens mediating OM and COPD, providing important insight into M. catarrhalis pathogenesis that will aid in the development of novel therapeutic regimens.

  7. Orofacial findings in chronic granulomatous disease: report of twelve patients and review of the literature.

    Science.gov (United States)

    Dar-Odeh, Najla S; Hayajneh, Wail A; Abu-Hammad, Osama A; Hammad, Huda M; Al-Wahadneh, Adel M; Bulos, Najwa K; Mahafzah, Azmi M; Shomaf, Maha S; El-Maaytah, Mohammed A; Bakri, Faris G

    2010-02-17

    Chronic granulomatous disease is an extremely rare primary immunodeficiency syndrome that can be associated with various oral complications. This can affect high number of patients. However, data on oral complications is sparse. Here we will review the literature and describe the orofacial findings in 12 patients. The age range was 5-31 years. Oral findings were variable, and reflected a low level of oral hygiene. They included periodontitis, rampant caries, gingivitis, aphthous-like ulcers, and geographic tongue. One patient had white patches on the buccal mucosa similar to lichen planus. Another patient had a nodular dorsum of the tongue associated with fissured and geographic tongue. Biopsies from the latter two lesions revealed chronic non-specific mucositis. Panoramic radiographs showed extensive periodontitis in one patient and periapical lesions in another patient. Patients with chronic granulomatous disease may develop oral lesions reflecting susceptibility to infections and inflammation. It is also possible that social and genetic factors may influence the development of this complication. Therefore, oral hygiene must be kept at an optimum level to prevent infections that can be difficult to manage.

  8. Twelve years of fireworks market surveillance in France

    OpenAIRE

    Branka , Ruddy

    2012-01-01

    International audience; In the view of market surveillance, more than 4400 fireworks have been taken on the spot by sworn people or bought on the market in France since 1999 for inspection purposes. This paper presents the market surveillance sampling evolution during twelve years, carried out by the PYRO unit of the Accidental Risks Division of INERIS as testing body ; the related measures implemented : additional audits in importer plants, interlaboratory tests for guarantying the reliabili...

  9. Twelve Theses on Reactive Rules for the Web

    OpenAIRE

    Bry, François; Eckert, Michael

    2006-01-01

    Reactivity, the ability to detect and react to events, is an essential functionality in many information systems. In particular, Web systems such as online marketplaces, adaptive (e.g., recommender) sys- tems, and Web services, react to events such as Web page updates or data posted to a server. This article investigates issues of relevance in designing high-level programming languages dedicated to reactivity on the Web. It presents twelve theses on features desira...

  10. Ultra pressure liquid chromatography-negative electrospray ionization mass spectrometry determination of twelve halobenzoquinones at ng/L levels in drinking water.

    Science.gov (United States)

    Huang, Rongfu; Wang, Wei; Qian, Yichao; Boyd, Jessica M; Zhao, Yuli; Li, Xing-Fang

    2013-05-07

    We report here the characterization of twelve halobenzoquinones (HBQs) using electrospray ionization (ESI) high resolution quadrupole time-of-flight mass spectrometry. The high resolution negative ESI spectra of the twelve HBQs formed two parent ions, [M + H(+) + 2e(-)], and the radical M(-•). The intensities of these two parent ions are dependent on their chemical structures and on instrumental parameters such as the source temperature and flow rate. The characteristic ions of the HBQs were used to develop an ultra pressure liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method. At the UPLC flow rate (400 μL/min) and under the optimized ESI conditions, eleven HBQs showed the stable and abundant transitions [M + H(+) + 2e(-)] → X(-) (X(-) representing Cl(-), Br(-), or I(-)), while dibromo-dimethyl-benzoquinone (DBDMBQ) showed only the transition of M(-•) → Br(-). The UPLC efficiently separates all HBQs including some HBQ isomers, while the MS/MS offers exquisite limits of detection (LODs) at subng/mL levels for all HBQs except DBDMBQ. Combined with solid phase extraction (SPE), the method LOD is down to ng/L. The results from analysis of authentic samples demonstrated that the SPE-UPLC-MS/MS method is reliable, fast, and sensitive for the identification and quantification of the twelve HBQs in drinking water.

  11. Results of primary central nervous system lymphoma treated by radiation and chemotherapy. Retrospective analysis of twelve institutions in the Tokai district of Japan, 1995-1999

    International Nuclear Information System (INIS)

    Kawamura, Toshiki; Ishiguchi, Tsuneo; Shibamoto, Yuta

    2006-01-01

    We analyzed the therapeutic results and prognostic factors of 46 primary central nervous system lymphoma (PCNSL) patients who were treated at twelve institutions in the Tokai district of Japan between 1995 and 1999. We compared the results with those of a Japanese nationwide survey performed in the past. We sent each institution a questionnaire about the state of patients' disease, pathological type, method and doses of radiotherapy, regimen and intensity of chemotherapy, and patients' prognoses. The range of patients' ages was 33 to 93 years (median, 61 years). Thirty-one were men and 15 were women. The most prevalent histology was diffuse large B cell type (33 patients). We used the Kaplan-Meier method to calculate the survival rate and Cox's proportional hazards model to analyze the prognostic factors. The five-year cumulative survival rate was 25%, and the median survival time was 22.7 months. The five-year disease-free survival rate was 23%. In monovariate analysis, patients who were both younger than 60 years old and had a World Health Organization (WHO) performance status (PS) score equal to or less than 2 showed a better survival rate. Furthermore, the patients receiving systemic chemotherapy showed a significantly better local control rate. In addition, patients who received systemic chemotherapy achieved a higher complete remission rate than those not receiving it. However, no factors that significantly influenced survival rate were identified in multivariate analysis. We demonstrated that the therapeutic outcome of PCNSL patients has recently improved. In particular, patients with good PS showed better local control than those with poor PS. However, we could not identify any significant prognostic factors in PCNSL patients. (author)

  12. Orofacial findings in chronic granulomatous disease: report of twelve patients and review of the literature

    Directory of Open Access Journals (Sweden)

    Shomaf Maha S

    2010-02-01

    Full Text Available Abstract Background Chronic granulomatous disease is an extremely rare primary immunodeficiency syndrome that can be associated with various oral complications. This can affect high number of patients. However, data on oral complications is sparse. Here we will review the literature and describe the orofacial findings in 12 patients. Findings The age range was 5-31 years. Oral findings were variable, and reflected a low level of oral hygiene. They included periodontitis, rampant caries, gingivitis, aphthous-like ulcers, and geographic tongue. One patient had white patches on the buccal mucosa similar to lichen planus. Another patient had a nodular dorsum of the tongue associated with fissured and geographic tongue. Biopsies from the latter two lesions revealed chronic non-specific mucositis. Panoramic radiographs showed extensive periodontitis in one patient and periapical lesions in another patient. Conclusion Patients with chronic granulomatous disease may develop oral lesions reflecting susceptibility to infections and inflammation. It is also possible that social and genetic factors may influence the development of this complication. Therefore, oral hygiene must be kept at an optimum level to prevent infections that can be difficult to manage.

  13. Comparative analysis and supragenome modeling of twelve Moraxella catarrhalis clinical isolates

    Directory of Open Access Journals (Sweden)

    Hermans Peter WM

    2011-01-01

    Full Text Available Abstract Background M. catarrhalis is a gram-negative, gamma-proteobacterium and an opportunistic human pathogen associated with otitis media (OM and exacerbations of chronic obstructive pulmonary disease (COPD. With direct and indirect costs for treating these conditions annually exceeding $33 billion in the United States alone, and nearly ubiquitous resistance to beta-lactam antibiotics among M. catarrhalis clinical isolates, a greater understanding of this pathogen's genome and its variability among isolates is needed. Results The genomic sequences of ten geographically and phenotypically diverse clinical isolates of M. catarrhalis were determined and analyzed together with two publicly available genomes. These twelve genomes were subjected to detailed comparative and predictive analyses aimed at characterizing the supragenome and understanding the metabolic and pathogenic potential of this species. A total of 2383 gene clusters were identified, of which 1755 are core with the remaining 628 clusters unevenly distributed among the twelve isolates. These findings are consistent with the distributed genome hypothesis (DGH, which posits that the species genome possesses a far greater number of genes than any single isolate. Multiple and pair-wise whole genome alignments highlight limited chromosomal re-arrangement. Conclusions M. catarrhalis gene content and chromosomal organization data, although supportive of the DGH, show modest overall genic diversity. These findings are in stark contrast with the reported heterogeneity of the species as a whole, as wells as to other bacterial pathogens mediating OM and COPD, providing important insight into M. catarrhalis pathogenesis that will aid in the development of novel therapeutic regimens.

  14. Analyzing patients' values by applying cluster analysis and LRFM model in a pediatric dental clinic in Taiwan.

    Science.gov (United States)

    Wu, Hsin-Hung; Lin, Shih-Yen; Liu, Chih-Wei

    2014-01-01

    This study combines cluster analysis and LRFM (length, recency, frequency, and monetary) model in a pediatric dental clinic in Taiwan to analyze patients' values. A two-stage approach by self-organizing maps and K-means method is applied to segment 1,462 patients into twelve clusters. The average values of L, R, and F excluding monetary covered by national health insurance program are computed for each cluster. In addition, customer value matrix is used to analyze customer values of twelve clusters in terms of frequency and monetary. Customer relationship matrix considering length and recency is also applied to classify different types of customers from these twelve clusters. The results show that three clusters can be classified into loyal patients with L, R, and F values greater than the respective average L, R, and F values, while three clusters can be viewed as lost patients without any variable above the average values of L, R, and F. When different types of patients are identified, marketing strategies can be designed to meet different patients' needs.

  15. Analyzing Patients' Values by Applying Cluster Analysis and LRFM Model in a Pediatric Dental Clinic in Taiwan

    Science.gov (United States)

    Lin, Shih-Yen; Liu, Chih-Wei

    2014-01-01

    This study combines cluster analysis and LRFM (length, recency, frequency, and monetary) model in a pediatric dental clinic in Taiwan to analyze patients' values. A two-stage approach by self-organizing maps and K-means method is applied to segment 1,462 patients into twelve clusters. The average values of L, R, and F excluding monetary covered by national health insurance program are computed for each cluster. In addition, customer value matrix is used to analyze customer values of twelve clusters in terms of frequency and monetary. Customer relationship matrix considering length and recency is also applied to classify different types of customers from these twelve clusters. The results show that three clusters can be classified into loyal patients with L, R, and F values greater than the respective average L, R, and F values, while three clusters can be viewed as lost patients without any variable above the average values of L, R, and F. When different types of patients are identified, marketing strategies can be designed to meet different patients' needs. PMID:25045741

  16. Twelve years at DESY

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    As reported in our previous issue (page 27), on 28 February Volker Soergel stepped down after serving as Chairman of the Board of the DESY Laboratory in Hamburg since January 1981, when the previous chairman, Herwig Schopper, moved to become Director General of CERN. DESY is now headed by Bjorn Wiik. During the twelve years of Soergel's mandate, DESY substantially evolved and progressed. Dominating the landscape was the big HERA electron-proton collider - the world's first - proposed, approved, constructed and commissioned under Soergel's leadership. As well as pioneering electron-proton collisions, HERA also broke new ground in international collaboration. At the approval of the project by the German government, it had already been made clear that both the machine and its experiments had to be built with full international cooperation, using material contributions from foreign institutes. With the difficult task of transforming these requirements into hard reality, Volker Soergel succeeded brilliantly. The 'HERA model', with interested countries pledging contributions in equipment and/or manpower, established a new route to major project involvement. For HERA, the substantial Italian contribution, organized by Antonino Zichichi, was vital to the success of the project

  17. Peucedanum ostruthium (L. Koch: Morphological and phytochemical variability of twelve accessions from the Swiss alpine region

    Directory of Open Access Journals (Sweden)

    McCardell, Jessica Heather

    2016-07-01

    Full Text Available Ostruthin, a natural bioactive compound mainly occurring in the roots of Peucedanum ostruthium, is the focus of this study. P. ostruthium was collected from twelve locations in the Swiss alpine region and reared in an experimental field, subdivided into twelve lots over two years. In the spring and fall, a portion of each of the twelve accessions was harvested and separated into above and below ground plant parts. The dried plants were then extracted with 60 % ethanol using accelerated solvent extraction (ASE and analyzed using high pressure liquid chromatography (HPLC.The above and below ground plant parts were then analyzed concerning their dry matter yield (DMY, their ostruthin concentration and their ostruthin yield. Focusing on ostruthin, it was found that the below ground plant parts harvested in the fall rendered the highest ostruthin yield. Furthermore, a variability concerning ostruthin among the twelve accessions was found. This variability among the accessions is of interest with regards to a breeding program used to develop a cultivar with a high ostruthin yield.

  18. 99mTc-HM-PAO SPECT of epileptic patients showing focal paroxysm on electroencephalography

    International Nuclear Information System (INIS)

    Takaishi, Yasuko; Hashimoto, Kiyoshi; Fujino, Osamu; Kamayachi, Satoshi; Fujita, Takehisa; Enokido, Hisashi; Komatsuzaki, Hideki; Kawakami, Yasuhiko; Hirayama, Tsunenori

    1995-01-01

    The usefulness of 99m Tc-HM-PAO SPECT in diagnosing epilepsy was studied. The subjects were 33 epileptic patients, ranging in age from 5 years and 5 months to 28 years and 3 months, who showed focal paroxysm on electroencephalograms. Lowered accumulation site was found on SPECT in 19 patients. Four patients with abnormal findings on X-ray CT or MRI showed lowered accumulation and focal paroxysm at the same site. Of 29 patients with normal X-ray CT or MRI findings, 15 (52%) showed lowered accumulation. Five patients showed a focal paroxysm at the site of lowered accumulation. In 8 patients the focal paroxysm site was partly coincided with the accumulation site. In some patients the focal site predicted by the findings of clinical symptoms and the lowered accumulation site coincided. SPECT is therefore a useful method in diagnosing a focal site in epilepsy and considered to reflect the severity of disease. (Y.S.)

  19. Premarital sex in the last twelve months and its predictors among ...

    African Journals Online (AJOL)

    Background: Premarital sex increases the risk of unintended pregnancy and sexually transmitted infections including HIV if unprotected and contraception is not used. Thus, the objective of this study was to assess premarital sex in the last twelve months and its predictors among regular undergraduate students of Wollega ...

  20. Safety of superconducting fusion magnets: twelve problem areas

    International Nuclear Information System (INIS)

    Turner, L.R.

    1979-05-01

    Twelve problem areas of superconducting magnets for fusion reaction are described. These are: Quench Detection and Energy Dump, Stationary Normal Region of Conductor, Current Leads, Electrical Arcing, Electrical Shorts, Conductor Joints, Forces from Unequal Currents, Eddy Current Effects, Cryostat Rupture, Vacuum Failure, Fringing Field and Instrumentation for Safety. Each is described under the five categories: Identification and Definition, Possible Safety Effects, Current Practice, Adequacy of Current Practice for Fusion Magnets and Areas Requiring Further Analytical and Experimental Study. Priorities among these areas are suggested; application is made to the Large Coil Project at Oak Ridge National Laboratory

  1. Twelve tips for creating an academic teaching portfolio.

    Science.gov (United States)

    Little-Wienert, Kim; Mazziotti, Mark

    2018-01-01

    An academic teaching portfolio is not only a requirement at many academic teaching institutions, but it is also important in a medical educator's growth and development through documentation, reflection, evaluation, and change. Creating an academic portfolio may appear daunting at first but with careful advanced preparation, organized evidence collection of your educational work, proof of scholarship, and thorough documentation of self-reflection and change, you can produce a successful product that accurately represents your educational beliefs, accomplishments, and growth throughout your career. This article provides medical educators with twelve steps for creating a successful academic teaching portfolio.

  2. Who should do what in environmental management? Twelve principles for allocating responsibilities

    NARCIS (Netherlands)

    Mostert, E.

    2015-01-01

    In environmental management there is often discussion on the allocation of responsibilities. Such discussions can continue for a long time and can form an obstacle for effective action. In this article twelve normative principles for the allocation of responsibilities are identified, coming from

  3. Twelve-month quality of life improvement and all-cause mortality in elderly patients undergoing transcatheter aortic valve replacement.

    Science.gov (United States)

    Kleczyński, Paweł; Bagieński, Maciej; Dziewierz, Artur; Rzeszutko, Łukasz; Sorysz, Danuta; Trębacz, Jarosław; Sobczyński, Robert; Tomala, Marek; Stąpór, Maciej; Dudek, Dariusz

    2016-10-10

    Restoration of quality of life (QoL) and improvement of clinical outcomes is crucial in elderly patients undergoing transcatheter aortic valve implantation (TAVI). We sought to evaluate changes in QoL and all-cause mortality 12 months after TAVI. A total of 101 patients who underwent TAVI were included. Patients were followed for 12 months. QoL was assessed at baseline and at 1, 6 and 12 months after TAVI using EQ-5D-3L with a visual analog scale (VAS). Patients who reported some problems with mobility at baseline showed better mobility after 12 months (p = 0.001). On the other hand, those who reported issues with self-care, usual activity or pain did not show significant improvement (p = 0.41; p = 0.12; p = 0.27, respectively). Patients reporting anxiety at baseline improved 12 months later (p = 0.003). VAS score showed an incremental increase during follow-up (p<0.001). Transfemoral access was associated with higher VAS score values after 1 month (median (IQR): 65.0 (50.0-75.0) vs. 54.0 (50.0-60.0); p = 0.019) but not after 12 months (70.0 (62.5-80.0) vs. 67.5 (55.0-70.0); p = 0.07) as compared to non-transfemoral access. In multivariable regression analysis, only age and the presence of coronary chronic total occlusion were independently associated with VAS score at 12 months. In-hospital, 1-, 6- and 12-month mortality rates were 6.9%, 10.9%, 15.8 and 17.8%, respectively. TAVI provides improved QoL with relatively good clinical outcomes. However, not all components of QoL may be improved. Patients treated with transfemoral access might have better QoL than those who had non-transfemoral access, especially early after TAVI.

  4. Key lessons: Twelve factors critical to the success of WDM at the ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    English · Français ... Key lessons: Twelve factors critical to the success of WDM at the policy and at the operational levels ... from slums in central New Delhi to the city's desolate periphery face daily indignities and danger as they collect water o.

  5. The use of computerized tomography in patients showing tardive dyskinesia

    International Nuclear Information System (INIS)

    Themelis, I.

    1983-01-01

    29 patients showing moderate to markedly pronounced tardive dyskinesia (TD) and a further 29 control patients (C) under a similar long-term medication with neuroleptics that had been so chosen as to match the age and sex distributions of the former group were subjected to computered tomography, neurological examination and psychological testing. The results did not point to any correlations between the structural changes and duration of treatment and the clinical signs or symptoms of extrapyramidal disorder. This was taken as further evidence in support of the theory that the initial damage in tardive dyskinesia mainly is at the level of the basal ganglia. (orig./MG) [de

  6. Do supervised weekly exercise programs maintain functional exercise capacity and quality of life, twelve months after pulmonary rehabilitation in COPD?

    Directory of Open Access Journals (Sweden)

    Alison Jennifer A

    2007-05-01

    Full Text Available Abstract Background Pulmonary rehabilitation programs have been shown to increase functional exercise capacity and quality of life in COPD patients. However, following the completion of pulmonary rehabilitation the benefits begin to decline unless the program is of longer duration or ongoing maintenance exercise is followed. Therefore, the aim of this study is to determine if supervised, weekly, hospital-based exercise compared to home exercise will maintain the benefits gained from an eight-week pulmonary rehabilitation program in COPD subjects to twelve months. Methods Following completion of an eight-week pulmonary rehabilitation program, COPD subjects will be recruited and randomised (using concealed allocation in numbered envelopes into either the maintenance exercise group (supervised, weekly, hospital-based exercise or the control group (unsupervised home exercise and followed for twelve months. Measurements will be taken at baseline (post an eight-week pulmonary rehabilitation program, three, six and twelve months. The exercise measurements will include two six-minute walk tests, two incremental shuttle walk tests, and two endurance shuttle walk tests. Oxygen saturation, heart rate and dyspnoea will be monitored during all these tests. Quality of life will be measured using the St George's Respiratory Questionnaire and the Hospital Anxiety and Depression Scale. Participants will be excluded if they require supplemental oxygen or have neurological or musculoskeletal co-morbidities that will prevent them from exercising independently. Discussion Pulmonary rehabilitation plays an important part in the management of COPD and the results from this study will help determine if supervised, weekly, hospital-based exercise can successfully maintain functional exercise capacity and quality of life following an eight-week pulmonary rehabilitation program in COPD subjects in Australia.

  7. Linac-based radiosurgery of cerebral melanoma metastases. Analysis of 122 metastases treated in 64 patients

    International Nuclear Information System (INIS)

    Herfarth, K.K.; Pirzkall, A.; Izwekowa, O.; Wannenmacher, M.; Thilmann, C.; Debus, J.; Delorme, S.; Hofmann, U.; Schadendorf, D.; Zierhut, D.

    2003-01-01

    Purpose: Stereotactic radiosurgery is an alternative option to neurosurgical excision in the management of patients with brain metastases. We retrospectively analyzed patients with brain metastases of malignant melanoma who were treated at our institution for outcome and prognostic factors. Patients and Methods: 64 patients with 122 cerebral metastases were treated with stereotactic radiosurgery between 1986 and 2000. Twelve patients (19%) showed neurologic symptoms at the time of treatment, and 46 patients (72%) had extracerebral tumor manifestation at that time. The median dose to the 80% isodose line, prescribed to encompass the tumor margin, was 20 Gy (range, 15-22 Gy). Results: Neurologic symptoms improved in five of twelve symptomatic patients. 41 patients remained asymptomatic or unchanged in their neurologic symptoms. Only five patients (8%) temporarily worsened neurologically after therapy despite no signs of tumor progression. With a mean follow-up time of 9.4 months, actuarial local control was 81% after 1 year. There was a statistically significant dose and size dependency of local tumor control. Median actuarial survival after treatment was 10.6 months. Patients without extracerebral tumor manifestation showed a superior survival (p = 0.04). Conclusions: Despite high local tumor control rates, the prognosis of patients with cerebral metastases of malignant melanoma remains poor. Stereotactic radiosurgery has the potential of stabilizing or improving neurologic symptoms in these patients in a palliative setting. (orig.)

  8. Monocytes of patients with familial hypercholesterolemia show alterations in cholesterol metabolism

    Directory of Open Access Journals (Sweden)

    Soufi Muhidien

    2008-11-01

    Full Text Available Abstract Background Elevated plasma cholesterol promotes the formation of atherosclerotic lesions in which monocyte-derived lipid-laden macrophages are frequently found. To analyze, if circulating monocytes already show increased lipid content and differences in lipoprotein metabolism, we compared monocytes from patients with Familial Hypercholesterolemia (FH with those from healthy individuals. Methods Cholesterol and oxidized cholesterol metabolite serum levels of FH and of healthy, gender/age matched control subjects were measured by combined gas chromatography – mass spectroscopy. Monocytes from patients with FH and from healthy subjects were isolated by antibody-assisted density centrifugation. Gene expression profiles of isolated monocytes were measured using Affymetrix HG-U 133 Plus 2.0 microarrays. We compared monocyte gene expression profiles from FH patients with healthy controls using a Welch T-test with correction for multiple testing (p Results Using microarray analysis we found in FH patients a significant up-regulation of 1,617 genes and a down-regulation of 701 genes compared to monocytes from healthy individuals. These include genes of proteins that are involved in the uptake, biosynthesis, disposition, and cellular efflux of cholesterol. In addition, plasma from FH patients contains elevated amounts of sterols and oxysterols. An increased uptake of oxidized as well as of native LDL by FH monocytes combined with a down-regulation of NPC1 and ABCA1 explains the lipid accumulation observed in these cells. Conclusion Our data demonstrate that circulating FH monocytes show differences in cell physiology that may contribute to the early onset of atherosclerosis in this disease.

  9. Demonstration of anticoagulation patient self-testing feasibility at an Indian Health Service facility: A case series analysis

    Directory of Open Access Journals (Sweden)

    Schupbach RR

    2013-03-01

    Full Text Available Background: Anticoagulation patient self-testing (PST represents an alternative approach to warfarin monitoring by enabling patients to use coagulometers to test their international normalized ratio (INR values. PST offers several advantages that potentially improve warfarin management. Objective: To describe implementation and associated performance of a PST demonstration program at an Indian Health Service (IHS facility. Methods: A non-consecutive case series analysis of patients from a pharmacy-managed PST demonstration program was performed at an IHS facility in Oklahoma between July 2008 and February 2009.Results: Mean time in therapeutic range (TTR for the seven patients showed a small, absolute increase during the twelve weeks of PST compared to the twelve weeks prior to PST. Four of the seven patients had an increase in TTR during the twelve week course of PST compared to their baseline TTR. Three of four patients with increased TTR in the final eight week period of PST achieved a TTR of 100%. Of the three patients who experienced a decrease in TTR after initiating self-testing, two initially presented with a TTR of 100% prior to PST and one patient had a TTR of 100% for the final eight weeks of PST. The two patients not achieving a TTR of 100% during the twelve week PST period demonstrated an increase in TTR following the first four weeks of PST. Conclusion: Although anticoagulation guidelines now emphasize patient self-management (PSM only, optimal PST remains an integral process in PSM delivery. In the patients studied, the results of this analysis suggest that PST at the IHS facility provided a convenient, alternative method for management of chronic warfarin therapy for qualified patients. More than half of the patients demonstrated improvement in TTR. Although there is a learning curve immediately following PST initiation, the mean TTR for the entire PST period increased modestly when compared to the time period prior to PST.

  10. Dialysis-related amyloidosis of the hip joints in long-term hemodialysis patients. MRI findings of hip joints in twelve female hemodialysis patients

    International Nuclear Information System (INIS)

    Suzuki, Hitoe; Shibuya, Asuka; Ando, Minoru; Akiba, Takashi; Nitta, Kosaku

    2007-01-01

    We report a female with amyloid arthropathy of the hip joints. She was a 67-year-old woman who had been treated by hemodialysis for 22 years. She had demonstrated a 5-month history of continuous low-grade fever and pain in her left hip and she was finally unable to walk by herself. Findings on X-ray films and MRI of the hip joints suggested avascular necrosis in both femur heads. To palliate symptoms, bipolar surgery on the left hip joint was performed. Pathological examination of bone tissue specimen demonstrated that there was some , β 2 -microglobulin (β 2 -MG)-related amyloid accumulation in the femur head. Based on this clinical experience, we performed MRI screening for amyloid lesions of the hip joints in another 11 asymptomatic female patients undergoing hemodialysis for 20 years or more. Cystic lesions of the hip joints were observed in 8 patients, amyloid arthropathy in 2 patients, and fluid trapped in the joint in 1 patient. Patients with amyloidosis had significantly lower serum β 2 -MG levels than patients without amyloidosis (28.6 mg/L versus 41.4 mg/L; p=0.0339). Our findings show that dialysis-related amyloidosis of the hip joints is one of the potential and significant problems in female patients on long-term hemodialysis therapy. It may be important to screen for this pathological condition in long-term hemodialysis patients. (author)

  11. Isolation and characterization of twelve microsatellite loci for the Japanese Devilray (Mobula japanica)

    NARCIS (Netherlands)

    Poortvliet, Marloes; Galvan-Magana, Felipe; Bernardi, Giacomo; Croll, Donald A.; Olsen, Jeanine L.

    2011-01-01

    Twelve polymorphic microsatellites loci were characterized for Mobula japanica (Japanese Devilray) using an enrichment protocol. All but two loci were in Hardy-Weinberg equilibrium with no evidence of linkage disequilibrium or null-alleles for a sample of 40 individuals from two populations. The

  12. Definition of a Twelve-Point Polygonal SAA Boundary for the GLAST Mission

    International Nuclear Information System (INIS)

    Djomehri, Sabra I.; UC, Santa Cruz; SLAC

    2007-01-01

    The Gamma-Ray Large Area Space Telescope (GLAST), set to launch in early 2008, detects gamma rays within a huge energy range of 100 MeV - 300 GeV. Background cosmic radiation interferes with such detection resulting in confusion over distinguishing cosmic from gamma rays encountered. This quandary is resolved by encasing GLAST's Large Area Telescope (LAT) with an Anti-Coincidence Detector (ACD), a device which identifies and vetoes charged particles. The ACD accomplishes this through plastic scintillator tiles; when cosmic rays strike, photons produced induce currents in Photomultiplier Tubes (PMTs) attached to these tiles. However, as GLAST orbits Earth at altitudes ∼550km and latitudes between -26 degree and 26 degree, it will confront the South Atlantic Anomaly (SAA), a region of high particle flux caused by trapped radiation in the geomagnetic field. Since the SAA flux would degrade the sensitivity of the ACD's PMTs over time, a determined boundary enclosing this region need be attained, signaling when to lower the voltage on the PMTs as a protective measure. The operational constraints on such a boundary require a convex SAA polygon with twelve edges, whose area is minimal ensuring GLAST has maximum observation time. The AP8 and PSB97 models describing the behavior of trapped radiation were used in analyzing the SAA and defining a convex SAA boundary of twelve sides. The smallest possible boundary was found to cover 14.58% of GLAST's observation time. Further analysis of defining a boundary safety margin to account for inaccuracies in the models reveals if the total SAA hull area is increased by ∼20%, the loss of total observational area is < 5%. These twelve coordinates defining the SAA flux region are ready for implementation by the GLAST satellite

  13. Quantitative thallium-201 myocardial exercise scintigraphy in normal subjects and patients with normal coronary arteries

    International Nuclear Information System (INIS)

    Niemeyer, M.G.; St. Antonius Hospital Nieuwegein; Laarman, G.J.; Lelbach, S.; Cramer, M.J.; Ascoop, C.A.P.L.; Verzijlbergen, J.F.; Wall, E.E. van der; Zwinderman, A.H.; Pauwels, E.K.J.

    1990-01-01

    Quantitative thallium-201 myocardial exercise scintigraphy was tested in two patient populations representing alternative standards for cardiac normality: group I comprised 18 male uncatherized patients with a low likelihood of coronary artery disease (CAD); group II contained 41 patients with normal coronary arteriograms. Group I patients were younger, they achieved a higher rate-pressure product than group II patients; all had normal findings by phisical examination and electrocardiography at rest and exercise. Group II patients comprised 21 females, 11 patients showed abnormal electrocardiography at rest, and five patients showed ischemic ST depression during exercise. Twelve patients had sign of minimal CAD. Twelve patients revealed abnormal visual and quantitative thallium findings, three of these patients had minimal CAD. Profiles of uptake and washout of thallium-201 were derived from both patient groups, and compared with normal limits developed by Maddahi et al. Furthermore, low likelihood and angiographically normal patients may differ substantially, and both sets of normal patients should be considered when establishing criteria of abnormality in exercise thallium imaging. When commercial software containing normal limits for quantitative analysis of exercise thallium-201 imaging is used in clinical practice, it is mandatory to compare these with normal limits of uptake and washout of thallium-201, derived from the less heterogeneous group of low-likelihood subjects, which should be used in selecting a normal population to define normality. (author). 37 refs.; 3 figs; 1 tab

  14. Hepatoprotective activity of twelve novel 7'-hydroxy lignan glucosides from Arctii Fructus.

    Science.gov (United States)

    Yang, Ya-Nan; Huang, Xiao-Ying; Feng, Zi-Ming; Jiang, Jian-Shuang; Zhang, Pei-Cheng

    2014-09-17

    Twelve novel 7'-hydroxy lignan glucosides (1-12), including two benzofuran-type neolignans, two 8-O-4' neolignans, two dibenzylbutyrolactone lignans, and six tetrahydrofuranoid lignans, together with six known lignan glucosides (13-18), were isolated from the fruit of Arctium lappa L. (Asteraceae), commonly known as Arctii Fructus. Their structures were elucidated using spectroscopy (1D and 2D NMR, MS, IR, ORD, and UV) and on the basis of chemical evidence. The absolute configurations of compounds 1-12 were confirmed using rotating frame nuclear overhauser effect spectroscopy (ROESY), the circular dichroic (CD) exciton chirality method, and Rh2(OCOCF3)4-induced CD spectrum analysis. All of the isolated compounds were tested for hepatoprotective effects against D-galactosamine-induced cytotoxicity in HL-7702 hepatic cells. Compounds 1, 2, 7-12, and 17 showed significantly stronger hepatoprotective activity than the positive control bicyclol at a concentration of 1 × 10(-5) M.

  15. Millipedes (Diplopoda of twelve caves in Western Mecsek, Southwest Hungary

    Directory of Open Access Journals (Sweden)

    Angyal, D.

    2013-11-01

    Full Text Available Twelve caves of Western Mecsek, Southwest Hungary were examined between September 2010 and April 2013from the millipede (Diplopoda faunistical point of view. Ten species were found in eight caves, which consistedeutroglophile and troglobiont elements as well. The cave with the most diverse fauna was the Törökpince Sinkhole, while thetwo previously also investigated caves, the Abaligeti Cave and the Mánfai-kőlyuk Cave provided less species, which couldbe related to their advanced touristic and industrial utilization.

  16. Chronic myeloid leukemia patients sensitive and resistant to imatinib treatment show different metabolic responses.

    Directory of Open Access Journals (Sweden)

    Jiye A

    Full Text Available The BCR-ABL tyrosine kinase inhibitor imatinib is highly effective for chronic myeloid leukemia (CML. However, some patients gradually develop resistance to imatinib, resulting in therapeutic failure. Metabonomic and genomic profiling of patients' responses to drug interventions can provide novel information about the in vivo metabolism of low-molecular-weight compounds and extend our insight into the mechanism of drug resistance. Based on a multi-platform of high-throughput metabonomics, SNP array analysis, karyotype and mutation, the metabolic phenotypes and genomic polymorphisms of CML patients and their diverse responses to imatinib were characterized. The untreated CML patients (UCML showed different metabolic patterns from those of healthy controls, and the discriminatory metabolites suggested the perturbed metabolism of the urea cycle, tricarboxylic acid cycle, lipid metabolism, and amino acid turnover in UCML. After imatinib treatment, patients sensitive to imatinib (SCML and patients resistant to imatinib (RCML had similar metabolic phenotypes to those of healthy controls and UCML, respectively. SCML showed a significant metabolic response to imatinib, with marked restoration of the perturbed metabolism. Most of the metabolites characterizing CML were adjusted to normal levels, including the intermediates of the urea cycle and tricarboxylic acid cycle (TCA. In contrast, neither cytogenetic nor metabonomic analysis indicated any positive response to imatinib in RCML. We report for the first time the associated genetic and metabonomic responses of CML patients to imatinib and show that the perturbed in vivo metabolism of UCML is independent of imatinib treatment in resistant patients. Thus, metabonomics can potentially characterize patients' sensitivity or resistance to drug intervention.

  17. Patient reported outcomes in NRG Oncology RTOG 0938, evaluating two ultrahypofractionated regimens for prostate cancer.

    Science.gov (United States)

    Lukka, Himanshu R; Pugh, Stephanie L; Bruner, Deborah W; Bahary, Jean-Paul; Lawton, Colleen A F; Efstathiou, Jason A; Kudchadker, Rajat J; Ponsky, Lee E; Seaward, Samantha A; Dayes, Ian S; Gopaul, Darindra D; Michalski, Jeff M; Delouya, Guila; Kaplan, Irving D; Horwitz, Eric M; Roach, Mack; Pinover, Wayne H; Beyer, David C; Amanie, John O; Sandler, Howard M; Kachnic, Lisa A

    2018-06-15

    There is considerable interest in very short (ultrahypofractionated) radiotherapy regimens to treat prostate cancer based on potential radiobiological advantages, patient convenience and resource allocation benefits. To demonstrate that detectable changes in health related quality of life measured by the bowel and urinary domains of the Expanded Prostate Cancer Index Composite (EPIC-50) were not substantially worse than baseline. XXXX is a non-blinded randomized phase II study of NCCN low risk prostate cancer where each arm is compared to a historical control. Patients were randomized to five fractions (7.25Gy in two weeks), or twelve fractions (4.3Gy in 2.5 weeks). The co-primary endpoints were the proportion of patients with a change in EPIC bowel score at one year (baseline to one-year) >five points and in EPIC urinary score >two points tested with a one-sample binomial test. and Limitations: 127 patients were enrolled to five fractions (121 analyzed) and 128 to twelve fractions (125 analyzed). Median follow-up for all patients at the time of analysis was 3.8 years. The one year frequency for >five point change in bowel score for five and twelve fractions were 29.8%(ptwo point change in urinary score for five and twelve fractions were 45.7%(p<0.001) and 42.2%(p<0.001) respectively. For five and twelve fractions 32.9% of patients had a drop in 1 year EPIC sexual score ≥ 11 points (p=0.34) while 30.9% of patients had a drop in 1 year EPIC sexual score ≥11 points (p=0.20) in the twelve fraction arm respectively. DFS at two years is 93.3% (95% CI: 88.8, 97.8) and 88.3% (95% CI: 82.5, 94.0) in the five and twelve fraction arms, respectively. There was no late grade 4 or 5 treatment-related urinary or bowel toxicity. This study confirms that based on changes in bowel and urinary domains and toxicity (acute and late) the five and twelve fractions regimens are well tolerated. These ultrahypofractionated approaches need to be compared to current standard radiotherapy

  18. The twelve-flavor β-function and dilaton tests of the sextet scalar

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    Fodor Zoltan

    2018-01-01

    Full Text Available We discuss near-conformal gauge theories beyond the standard model (BSM where interesting results on the twelve-flavor β-function of massless fermions in the fundamental representation of the SU(3 color gauge group and dilaton tests of the light scalar with two massless fermions in the two-index symmetric tensor (sextet representation can be viewed as parts of the same BSM paradigm under investigation. The clear trend in the decreasing size of β-functions at fixed renormalized gauge coupling is interpreted as a first indicator how the conformal window (CW is approached in correlation with emergent near-conformal light scalars. BSM model building close to the CW will be influenced by differing expectations on the properties of the emergent light 0++ scalar either as a σ-particle of chiral symmetry breaking (ΧS B, or as a dilaton of scale symmetry breaking. The twelve-flavor β-function emerges as closest to the CW, perhaps near-conformal, or perhaps with an infrared fixed point (IRFP at some unexplored strong coupling inside the CW. It is premature to speculate on dilaton properties of the twelveflavor model since the near-conformal realization remains an open question. However, it is interesting and important to investigate dilaton tests of the light sextet scalar whose β-function is closest to the CW in the symmetry breaking phase and emerges as the leading candidate for dilaton tests of the light scalar. We report results from high precision analysis of the twelve-flavor β-function [1] refuting its published IRFP [2, 3]. We present our objections to recent claims [4, 5] for non-universal behavior of staggered fermions used in our analysis. We also report our first analysis of dilaton tests of the light 0++ scalar in the sextet model and comment on related post-conference developments. The dilaton test is the main thrust of this conference contribution including presentation #405 on the nf = 12 β-function and presentation #260 on dilaton

  19. Non-asthmatic patients show increased exhaled nitric oxide concentrations

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    Beatriz M. Saraiva-Romanholo

    2009-01-01

    Full Text Available OBJECTIVE: Evaluate whether exhaled nitric oxide may serve as a marker of intraoperative bronchospasm. INTRODUCTION: Intraoperative bronchospasm remains a challenging event during anesthesia. Previous studies in asthmatic patients suggest that exhaled nitric oxide may represent a noninvasive measure of airway inflammation. METHODS: A total of 146,358 anesthesia information forms, which were received during the period from 1999 to 2004, were reviewed. Bronchospasm was registered on 863 forms. From those, three groups were identified: 9 non-asthmatic patients (Bronchospasm group, 12 asthmatics (Asthma group and 10 subjects with no previous airway disease or symptoms (Control group. All subjects were submitted to exhaled nitric oxide measurements (parts/billion, spirometry and the induced sputum test. The data was compared by ANOVA followed by the Tukey test and Kruskal-Wallis followed by Dunn's test. RESULTS: The normal lung function test results for the Bronchospasm group were different from those of the asthma group (p <0.05. The median percentage of eosinophils in induced sputum was higher for the Asthma [2.46 (0.45-6.83] compared with either the Bronchospasm [0.55 (0-1.26] or the Control group [0.0 (0] (p <0.05; exhaled nitric oxide followed a similar pattern for the Asthma [81.55 (57.6-86.85], Bronchospasm [46.2 (42.0 -62.6] and Control group [18.7 (16.0-24.7] (p< 0.05. CONCLUSIONS: Non-asthmatic patients with intraoperative bronchospasm detected during anesthesia and endotracheal intubation showed increased expired nitric oxide.

  20. Somatostatin receptor scintigraphy in patients with cat-scratch disease

    International Nuclear Information System (INIS)

    Krause, R.; Schnedl, W.J.; Hoier, S.; Piswanger-Soelkner, C.; Lipp, R.W.; Daxboeck, F.; Reisinger, E.C.

    2006-01-01

    Aim: somatostatin receptor scintigraphy images various neoplastic, granulomatous, and auto-immun diseases. Cat-scratch disease in an infectious granulomatous disease usually affecting the lymphnodes. It is not known whether cat-scratch disease provides positive somatostatin receptor scintigrams. Patients, methods: twelve patients with lymphadenitis and suspected cat-scratch disease were investigated by immunofluorescence antibody testing and somatostatin receptor scintigraphy. Suppurated lymphnodes were extracted or drained and Bartonella henselae specific PCR was then performed. Results: eleven of 12 patients showed IgG antibodies against B. henselea. SRS showed positive scintigraphic results in 6 of 11 patients with CSD. B. henselae DNA was detected in tissue of lymphnodes from 4 of 5 patients with lymphnode extraction or lymphnode drainage. SRS demonstrated positive scintigrams in all patients with a positive PCR. In one patient with suspected CSD SRS was negative as well as antibody testing. Conclusion: somatostatin receptor scintigraphy correlated with positive Bartonella henselae specific PCR tests and positive Bartonella henselae specific antibody tests in patients with CSD. (orig.)

  1. Somatostatin receptor scintigraphy in patients with cat-scratch disease

    Energy Technology Data Exchange (ETDEWEB)

    Krause, R.; Schnedl, W.J.; Hoier, S. [Div. of Infectious Diseases, Dept. of Internal Medicine, Univ. Graz (Austria); Piswanger-Soelkner, C.; Lipp, R.W. [Div. of Nuclear Medicine, Dept. of Internal Medicine, Univ. Graz (Austria); Daxboeck, F. [Clinical Inst. for Hygiene and Medical Microbiology, Div. of Hospital Hygiene, Univ. of Vienna (Austria); Reisinger, E.C. [Div. of Infectious Diseases and Tropical Medicine, Dept. of Internal Medicine, Univ. Rostock (Germany)

    2006-07-01

    Aim: somatostatin receptor scintigraphy images various neoplastic, granulomatous, and auto-immun diseases. Cat-scratch disease in an infectious granulomatous disease usually affecting the lymphnodes. It is not known whether cat-scratch disease provides positive somatostatin receptor scintigrams. Patients, methods: twelve patients with lymphadenitis and suspected cat-scratch disease were investigated by immunofluorescence antibody testing and somatostatin receptor scintigraphy. Suppurated lymphnodes were extracted or drained and Bartonella henselae specific PCR was then performed. Results: eleven of 12 patients showed IgG antibodies against B. henselea. SRS showed positive scintigraphic results in 6 of 11 patients with CSD. B. henselae DNA was detected in tissue of lymphnodes from 4 of 5 patients with lymphnode extraction or lymphnode drainage. SRS demonstrated positive scintigrams in all patients with a positive PCR. In one patient with suspected CSD SRS was negative as well as antibody testing. Conclusion: somatostatin receptor scintigraphy correlated with positive Bartonella henselae specific PCR tests and positive Bartonella henselae specific antibody tests in patients with CSD. (orig.)

  2. Two-dimensional liquid chromatography consisting of twelve second-dimension columns for comprehensive analysis of intact proteins.

    Science.gov (United States)

    Ren, Jiangtao; Beckner, Matthew A; Lynch, Kyle B; Chen, Huang; Zhu, Zaifang; Yang, Yu; Chen, Apeng; Qiao, Zhenzhen; Liu, Shaorong; Lu, Joann J

    2018-05-15

    A comprehensive two-dimensional liquid chromatography (LCxLC) system consisting of twelve columns in the second dimension was developed for comprehensive analysis of intact proteins in complex biological samples. The system consisted of an ion-exchange column in the first dimension and the twelve reverse-phase columns in the second dimension; all thirteen columns were monolithic and prepared inside 250 µm i.d. capillaries. These columns were assembled together through the use of three valves and an innovative configuration. The effluent from the first dimension was continuously fractionated and sequentially transferred into the twelve second-dimension columns, while the second-dimension separations were carried out in a series of batches (six columns per batch). This LCxLC system was tested first using standard proteins followed by real-world samples from E. coli. Baseline separation was observed for eleven standard proteins and hundreds of peaks were observed for the real-world sample analysis. Two-dimensional liquid chromatography, often considered as an effective tool for mapping proteins, is seen as laborious and time-consuming when configured offline. Our online LCxLC system with increased second-dimension columns promises to provide a solution to overcome these hindrances. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Lead Time to Appointment and No-Show Rates for New and Follow-up Patients in an Ambulatory Clinic.

    Science.gov (United States)

    Drewek, Rupali; Mirea, Lucia; Adelson, P David

    High rates of no-shows in outpatient clinics are problematic for revenue and for quality of patient care. Longer lead time to appointment has variably been implicated as a risk factor for no-shows, but the evidence within pediatric clinics is inconclusive. The goal of this study was to estimate no-show rates and test for association between appointment lead time and no-show rates for new and follow-up patients. Analyses included 534 new and 1920 follow-up patients from pulmonology and gastroenterology clinics at a freestanding children's hospital. The overall rate of no-shows was lower for visits scheduled within 0 to 30 days compared with 30 days or more (23% compared with 47%, P < .0001). Patient type significantly modified the association of appointment lead time; the rate of no-shows was higher (30%) among new patients compared with (21%) follow-up patients with appointments scheduled within 30 days (P = .004). For appointments scheduled 30 or more days' lead time, no-show rates were statistically similar for new patients (46%) and follow-up patients (0.48%). Time to appointment is a risk factor associated with no-shows, and further study is needed to identify and implement effective approaches to reduce appointment lead time, especially for new patients in pediatric subspecialties.

  4. Gastric cancers of Western European and African patients show different patterns of genomic instability

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    Mulder Chris JJ

    2011-01-01

    Full Text Available Abstract Background Infection with H. pylori is important in the etiology of gastric cancer. Gastric cancer is infrequent in Africa, despite high frequencies of H. pylori infection, referred to as the African enigma. Variation in environmental and host factors influencing gastric cancer risk between different populations have been reported but little is known about the biological differences between gastric cancers from different geographic locations. We aim to study genomic instability patterns of gastric cancers obtained from patients from United Kingdom (UK and South Africa (SA, in an attempt to support the African enigma hypothesis at the biological level. Methods DNA was isolated from 67 gastric adenocarcinomas, 33 UK patients, 9 Caucasian SA patients and 25 native SA patients. Microsatellite instability and chromosomal instability were analyzed by PCR and microarray comparative genomic hybridization, respectively. Data was analyzed by supervised univariate and multivariate analyses as well as unsupervised hierarchical cluster analysis. Results Tumors from Caucasian and native SA patients showed significantly more microsatellite instable tumors (p Conclusions Gastric cancers from SA and UK patients show differences in genetic instability patterns, indicating possible different biological mechanisms in patients from different geographical origin. This is of future clinical relevance for stratification of gastric cancer therapy.

  5. Anti-Jo-1 antibody-positive patients show a characteristic necrotizing perifascicular myositis.

    Science.gov (United States)

    Mescam-Mancini, Lénaig; Allenbach, Yves; Hervier, Baptiste; Devilliers, Hervé; Mariampillay, Kuberaka; Dubourg, Odile; Maisonobe, Thierry; Gherardi, Romain; Mezin, Paulette; Preusse, Corinna; Stenzel, Werner; Benveniste, Olivier

    2015-09-01

    Idiopathic inflammatory myopathies can be classified as polymyositis, dermatomyositis, immune-mediated necrotizing myopathy, sporadic inclusion body myositis or non-specific myositis. Anti-Jo-1 antibody-positive patients are assigned to either polymyositis or dermatomyositis suggesting overlapping pathological features. We aimed to determine if anti-Jo-1 antibody-positive myopathy has a specific morphological phenotype. In a series of 53 muscle biopsies of anti-Jo-1 antibody-positive patients, relevant descriptive criteria defining a characteristic morphological pattern were identified. They were tested in a second series of anti-Jo-1 antibody-positive patients and compared to 63 biopsies from patients suffering from other idiopathic inflammatory myopathies. In anti-Jo-1 antibody-positive patients, necrotic fibres, which strongly clustered in perifascicular regions, were frequently observed. Sarcolemmal complement deposition was detected specifically in perifascicular areas. Inflammation was mainly located in the perimysium and around vessels in 90.6%. Perimysial fragmentation was observed in 90% of cases. Major histocompatibility complex class I staining was diffusely positive, with a perifascicular reinforcement. Multivariate analysis showed that criteria defining perifascicular pathology: perifascicular necrosis, atrophy, and perimysial fragmentation allow the distinction of anti-Jo-1 antibody-positive patients, among patients suffering from other idiopathic inflammatory myopathies. Anti-Jo-1 antibody-positive patients displayed perifascicular necrosis, whereas dermatomyositis patients exhibited perifascicular atrophy. © The Author (2015). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Indifference to pain syndrome in a twelve-year-old boy (case report

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    Baghdadi T

    2007-08-01

    Full Text Available Background: People vary greatly in their response to painful stimuli, from those with a low pain threshold to those with indifference to pain. However, insensitivity to pain is a rare disorder, characterized by the lack of usual subjective and objective responses to noxious stimuli. Patients who have congenital indifference to pain sustain painless injuries beginning in infancy, but have sensory responses that are otherwise normal on examination. Perception of passive movement, joint position, and vibration is normal in these patients, as are tactile thresholds and light touch perception. Case report: A twelve-year-old boy was admitted to the hospital for a painless deformity, degeneration in both knees and a neglected femoral neck fracture that was inappropriately painless. Further examination revealed normal sensory responses, perception of passive movement, joint position, vibration tactile thresholds and light touch perception. Spinal cord and brain MRI were normal as was the electromyography and nerve conduction velocity (EMG/NCV examination. There was no positive family history for this disorder. Conclusion: The deficits present in the different pain insensitivity syndromes provide insight into the complex anatomical and physiological nature of pain perception. Reports on pain asymbolia, in which pain is perceived but does not cause suffering, and related cortical conditions illustrate that there can be losses that independently involve either the sensory-discriminative component or the affective-motivational component of pain perception, thus highlighting their different anatomical localization. The paucity of experience with this entity and the resultant diagnostic problems, the severity of the associated disabling arthropathy and underscore the importance of this case report of indifference to pain.

  7. Extended investigation of the twelve-flavor β-function

    Science.gov (United States)

    Fodor, Zoltán; Holland, Kieran; Kuti, Julius; Nógrádi, Dániel; Wong, Chik Him

    2018-04-01

    We report new results from high precision analysis of an important BSM gauge theory with twelve massless fermion flavors in the fundamental representation of the SU(3) color gauge group. The range of the renormalized gauge coupling is extended from our earlier work [1] to probe the existence of an infrared fixed point (IRFP) in the β-function reported at two different locations, originally in [2] and at a new location in [3]. We find no evidence for the IRFP of the β-function in the extended range of the renormalized gauge coupling, in disagreement with [2,3]. New arguments to guard the existence of the IRFP remain unconvincing [4], including recent claims of an IRFP with ten massless fermion flavors [5,6] which we also rule out. Predictions of the recently completed 5-loop QCD β-function for general flavor number are discussed in this context.

  8. Effects of 12-week supervised treadmill training on spatio-temporal gait parameters in patients with claudication.

    Science.gov (United States)

    Konik, Anita; Kuklewicz, Stanisław; Rosłoniec, Ewelina; Zając, Marcin; Spannbauer, Anna; Nowobilski, Roman; Mika, Piotr

    2016-01-01

    The purpose of the study was to evaluate selected temporal and spatial gait parameters in patients with intermittent claudication after completion of 12-week supervised treadmill walking training. The study included 36 patients (26 males and 10 females) aged: mean 64 (SD 7.7) with intermittent claudication. All patients were tested on treadmill (Gait Trainer, Biodex). Before the programme and after its completion, the following gait biomechanical parameters were tested: step length (cm), step cycle (cycle/s), leg support time (%), coefficient of step variation (%) as well as pain-free walking time (PFWT) and maximal walking time (MWT) were measured. Training was conducted in accordance with the current TASC II guidelines. After 12 weeks of training, patients showed significant change in gait biomechanics consisting in decreased frequency of step cycle (p gait was more regular, which was expressed via statistically significant decrease of coefficient of variation (p 0.05). Twelve-week treadmill walking training programme may lead to significant improvement of temporal and spatial gait parameters in patients with intermittent claudication. Twelve-week treadmill walking training programme may lead to significant improvement of pain-free walking time and maximum walking time in patients with intermittent claudication.

  9. [Representatives of consumer associations and the "hôpital, patients, santé et territoires" law: an outline of the issues and twelve proposals].

    Science.gov (United States)

    Bréchat, Pierre-Henri; Gros, Jeannette; Haon, Michel; Jeunet, Odile; Magnin-Feysot, Christian

    2010-01-01

    Since 1996, consumers have been able to become involved in the development and implementation of national, regional and local healthcare policies, thereby demonstrating the possibility of establishing a model of democratic institution in healthcare at all levels of decision-making and policy implementation. Despite this 13-year political ambition, it is open to question whether the bill on the reform of the hospital will serve to extend the same dynamic for patients, healthcare institutions and local authorities. On 15 November 2008 and 18 April 2009, fifty-four consumer association representatives in the Franche-Comté region convened to conduct an audit of their commitments with a view to making proposals to adapt the bill aimed at reforming hospitals for the benefit of patients, healthcare and territories (HPST) before the bill is debated in Parliament (National Assembly and Senate). Despite significant investments since 1996 and some notable successes, for these representatives of consumer healthcare associations, the results are distinctly mixed. This is because they sometimes feel instrumentalized in healthcare facilities and believe that their opportunities for participation have declined since 2002. Their view is that this may diminish the power they wield at a time when the economy may be seen as becoming a substitute for public healthcare and participatory democracy. In a context of inequality in healthcare and at a time of economic crisis, this paradigm shift has tended to mobilize representatives of consumer associations. In their view, a strong counter-power is required to ensure fair and equal access to healthcare for all. They suggest twelve proposals concerning organization and professionalism at both territorial and national levels, articulated around the following principle : a representative of a consumers' association can become a regional reference in the management of the agency's regional healthcare system and may be given the means to

  10. Risk factors for delusion of theft in patients with Alzheimer's disease showing mild dementia in Japan.

    Science.gov (United States)

    Murayama, N; Iseki, E; Endo, T; Nagashima, K; Yamamoto, R; Ichimiya, Y; Arai, H; Sato, K

    2009-07-01

    The mechanism underlying delusion in Alzheimer's disease patients has not been fully clarified; however, the occurrence of delusion is a critical issue for dementia patients and their caregivers. In Japan, delusion of theft is the most frequent delusion in AD patients. We examined the risk factors for delusion of theft in AD patients showing mild dementia. Fifty-six AD patients were administered HDS-R, MMSE and COGNISTAT, including the 'speech sample', to assess their neuropsychological and social cognitive functions. The age, years of education, presence of cohabiting family members and premorbid personality traits were obtained from family members. About 25.0% of AD patients showed delusion of theft (D-group), and 75% did not (non-D-group). About 33.3% of female patients and 5.9% of male patients were included in the D-group (p theft in AD patients was related to female gender, absence of cohabiting family members, neurotic personality and retained social cognitive function.

  11. Coronary collateralization shows sex and racial-ethnic differences in obstructive artery disease patients.

    Directory of Open Access Journals (Sweden)

    Zhi Liu

    Full Text Available Coronary collateral circulation protects cardiac tissues from myocardial infarction damage and decreases sudden cardiac death. So far, it is unclear how coronary collateralization varies by race-ethnicity groups and by sex.We assessed 868 patients with obstructive CAD. Patients were assessed for collateral grades based on Rentrop grading system, as well as other covariates. DNA samples were genotyped using the Affymetrix 6.0 genotyping array. To evaluate genetic contributions to collaterals, we performed admixture mapping using logistic regression with estimated local and global ancestry.Overall, 53% of participants had collaterals. We found difference between sex and racial-ethnic groups. Men had higher rates of collaterals than women (P-value = 0.000175. White Hispanics/Latinos showed overall higher rates of collaterals than African Americans and non-Hispanic Whites (59%, 50% and 48%, respectively, P-value = 0.017, and especially higher rates in grade 1 and grade 3 collateralization than the other two populations (P-value = 0.0257. Admixture mapping showed Native American ancestry was associated with the presence of collaterals at a region on chromosome 17 (chr17:35,243,142-41,251,931, β = 0.55, P-value = 0.000127. African ancestry also showed association with collaterals at a different region on chromosome 17 (chr17: 32,266,966-34,463,323, β = 0.38, P-value = 0.00072.In our study, collateralization showed sex and racial-ethnic differences in obstructive CAD patients. We identified two regions on chromosome 17 that were likely to harbor genetic variations that influenced collateralization.

  12. Mild trigonocephaly in patients with microcephaly. Surgical results in 12 cases

    International Nuclear Information System (INIS)

    Shimoji, Takeyoshi; Yamashiro, Katsumi; Nagamine, Tomoaki; Kawakubo, Junichi

    2010-01-01

    We have recently diagnosed several cases of mild trigonocephaly associated with microcephaly. The surgical approach is often difficult to decide for such cases. Surgical treatment is often attempted if neuroradiological studies show evidence of increased intracranial pressure. Twelve patients (9 girls and 3 boys) were found to microcephaly during infancy. All patients had symptoms, including varying degrees of mental retardation, delayed language, hyperactivity, motor dysfunctions, and self-mutilation (head banging). Most patients had mild trigonocephaly with microcephaly and tended to be of short stature. Head circumferences were at least 2 standard deviations below the mean for age at the time of surgery. Mild trigonocephaly was diagnosed in all patients by means of 3-dimensional computed tomography. Magnetic resonance of the brain showed no abnormalities in any patient. Plain skull X-ray films showed marked digital markings in 8 patients. Intracranial pressure was measured under normocapnia: results were obtained in 9 patients, and intracranial pressure was increased in 8 patients. Decompressive cranioplasty was performed in all patients. After surgery, chronological measurements showed tendencies for head circumferences to increase in 7 patients. Cognitive impairment showed no change, but other symptoms showed some improvement in all patients. These results suggest that surgery is indicated for patients with mild trigonocephaly associated with microcephaly if intracranial pressure is increased and if magnetic resonance of the brain shows no abnormalities. (author)

  13. Cause of Mortality in Thermally Injured Patients

    Science.gov (United States)

    1993-01-01

    11 patients, Cladosporium species from nine patients, Penicillium species from seven patients, and Phycomycetes ( mucor species and rhizopus species...infecting organisms were filamentous fungi, Aspergillus species in 16 and Mucor species in two, and in four patients C(nlida species were the causative...surface. Twelve, or 75 %, of the 16 patients with Aspergillus wound infections died but, somewhat surprisingly, both of the patients with mucor species

  14. Long-Term Serological Follow-Up of Acute Q-Fever Patients after a Large Epidemic.

    Directory of Open Access Journals (Sweden)

    Cornelia C H Wielders

    Full Text Available Serological follow-up of acute Q-fever patients is important for detection of chronic infection but there is no consensus on its frequency and duration. The 2007-2009 Q-fever epidemic in the Netherlands allowed for long-term follow-up of a large cohort of acute Q-fever patients. The aim of this study was to validate the current follow-up strategy targeted to identify patients with chronic Q-fever.A cohort of adult acute Q-fever patients, diagnosed between 2007 and 2009, for whom a twelve-month follow-up sample was available, was invited to complete a questionnaire and provide a blood sample, four years after the acute episode. Antibody profiles, determined by immunofluorescence assay in serum, were investigated with a special focus on high titres of IgG antibodies against phase I of Coxiella burnetii, as these are considered indicative for possible chronic Q-fever.Of the invited 1,907 patients fulfilling inclusion criteria, 1,289 (67.6% were included in the analysis. At any time during the four-year follow-up period, 58 (4.5% patients were classified as possible, probable, or proven chronic Q-fever according to the Dutch Q-fever Consensus Group criteria (which uses IgG phase I ≥1:1,024 to as serologic criterion for chronic Q-fever. Fifty-two (89.7% of these were identified within the first year after the acute episode. Of the six patients that were detected for the first time at four-year follow-up, five had an IgG phase I titre of 1:512 at twelve months.A twelve-month follow-up check after acute Q-fever is recommended as it adequately detects chronic Q-fever in patients without known risk factors. Additional serological and clinical follow-up is recommended for patients with IgG phase I ≥1:512, as they showed the highest risk to progress to chronic Q-fever.

  15. Traumatic tricuspid valve insufficiency. Experience in thirteen patients.

    Science.gov (United States)

    van Son, J A; Danielson, G K; Schaff, H V; Miller, F A

    1994-11-01

    From 1964 through June 1993, thirteen patients with traumatic tricuspid insufficiency were treated surgically; all were male, and the ages ranged from 17 to 64 years (median 39 years). The condition was associated with blunt chest trauma in all patients: motor vehicle accidents in twelve and an explosion of a tank of compressed air in one. The median duration between trauma and operation was 17 years (range 1 month to 37 years). Preoperatively, six patients were in sinus rhythm and seven were in atrial fibrillation. At operation, the right ventricular function appeared moderately to severely depressed in twelve patients. In twelve patients, the anterior leaflet was flail because of chordal rupture (n = 9), rupture of anterior papillary muscle (n = 3), or tear in the anterior leaflet (n = 1). In one patient, the septal leaflet was missing and in another it was retracted and adherent to the ventricular septum. In five patients the tricuspid valve was repaired and in eight it was replaced. In seven patients in the latter group, the chordae, papillary muscles, and/or tricuspid valve leaflet(s) were found to be in a contracted and atrophic state, precluding repair. No early or late deaths occurred. At follow-up extending to 26 years (median 12 years), 12 patients are in New York Heart Association class I and one patient is in class II. Nine patients were in sinus rhythm and four were in atrial fibrillation. Although our experience indicates that good functional results can still be achieved many years after the onset of traumatic tricuspid valve insufficiency, earlier diagnosis and surgical treatment should increase the feasibility of tricuspid valve insufficiency, earlier diagnosis and surgical treatment should increase the feasibility of tricuspid valve repair, prevent progressive deterioration of right ventricular function, and increase the possibility of maintaining late sinus rhythm in a greater number of patients.

  16. MRI of the SI joints commonly shows non-inflammatory disease in patients clinically suspected of sacroiliitis

    Energy Technology Data Exchange (ETDEWEB)

    Jans, L., E-mail: lennartjans@hotmail.com [Department of Radiology and Medical Imaging, Ghent University Hospital, De Pintelaan 185, 9000 Gent (Belgium); Van Praet, L.; Elewaut, D.; Van den Bosch, F.; Carron, P. [Department of Rheumatology, Ghent University Hospital, De Pintelaan 185, 9000 Gent (Belgium); Jaremko, J.L. [Department of Radiology, University of Alberta Hospital, 8440-112 Street, Edmonton T6G 2B7, Alberta (Canada); Behaeghe, M.; Denis, A.; Huysse, W.; Lambrecht, V.; Verstraete, K. [Department of Radiology and Medical Imaging, Ghent University Hospital, De Pintelaan 185, 9000 Gent (Belgium)

    2014-01-15

    Purpose: To determine the prevalence of clinically relevant non-inflammatory disease on MRI of the sacroiliac (SI) joints in patients suspected of sacroiliitis. To assess the added value of axial imaging of the pelvis in these patients. Methods: In a retrospective study of 691 patients undergoing MRI of the SI joints from January 2006 to December 2012 for inflammatory back pain the prevalence of sacroiliitis and non-inflammatory disease was recorded. Results: In 285 (41%) patients MRI did not show any abnormal findings. In 36% of patients MRI features of sacroiliitis were present. Spinal degenerative changes were the most common non-inflammatory finding in 305 patients (44.1%) and consisted of disc degeneration in 222 (32%) patients, facet joint arthrosis in 58 (8.4%) patients and disc herniation in 25 (3.6%) patients. Hip joint disease in 44 (6.4%) patients, lumbosacral transitional anomaly in 41 (5.9%) patients, SI joint degenerative changes in 25 (3.6%) patients and diffuse idiopathic skeletal hyperostosis in 24 (3.5%) patients were also common. Osteitis condensans ilii in 17 (2.5%) patients, tumour in 11 (1.6%) patients, fracture in 8 (1.2%) patients, infection in 4 (0.6%) patients and acute spondylolysis in 2 patients (0.3%) were less frequently seen. Conclusion: Our study shows that non-inflammatory disease is more common than true sacroiliitis on MRI of the SI joints in patients with inflammatory type back pain. Axial pulse sequences may demonstrate unexpected findings that remain undetected if only coronal images are obtained. Clinical relevance statement:, MRI of the SI joints may demonstrate conditions that clinically mimic sacroiliitis. Axial imaging of the pelvis may help detect these unexpected findings.

  17. MRI of the SI joints commonly shows non-inflammatory disease in patients clinically suspected of sacroiliitis

    International Nuclear Information System (INIS)

    Jans, L.; Van Praet, L.; Elewaut, D.; Van den Bosch, F.; Carron, P.; Jaremko, J.L.; Behaeghe, M.; Denis, A.; Huysse, W.; Lambrecht, V.; Verstraete, K.

    2014-01-01

    Purpose: To determine the prevalence of clinically relevant non-inflammatory disease on MRI of the sacroiliac (SI) joints in patients suspected of sacroiliitis. To assess the added value of axial imaging of the pelvis in these patients. Methods: In a retrospective study of 691 patients undergoing MRI of the SI joints from January 2006 to December 2012 for inflammatory back pain the prevalence of sacroiliitis and non-inflammatory disease was recorded. Results: In 285 (41%) patients MRI did not show any abnormal findings. In 36% of patients MRI features of sacroiliitis were present. Spinal degenerative changes were the most common non-inflammatory finding in 305 patients (44.1%) and consisted of disc degeneration in 222 (32%) patients, facet joint arthrosis in 58 (8.4%) patients and disc herniation in 25 (3.6%) patients. Hip joint disease in 44 (6.4%) patients, lumbosacral transitional anomaly in 41 (5.9%) patients, SI joint degenerative changes in 25 (3.6%) patients and diffuse idiopathic skeletal hyperostosis in 24 (3.5%) patients were also common. Osteitis condensans ilii in 17 (2.5%) patients, tumour in 11 (1.6%) patients, fracture in 8 (1.2%) patients, infection in 4 (0.6%) patients and acute spondylolysis in 2 patients (0.3%) were less frequently seen. Conclusion: Our study shows that non-inflammatory disease is more common than true sacroiliitis on MRI of the SI joints in patients with inflammatory type back pain. Axial pulse sequences may demonstrate unexpected findings that remain undetected if only coronal images are obtained. Clinical relevance statement:, MRI of the SI joints may demonstrate conditions that clinically mimic sacroiliitis. Axial imaging of the pelvis may help detect these unexpected findings

  18. Brain aneurysm patients seen in Harare, Zimbabwe: cases review ...

    African Journals Online (AJOL)

    Setting: Parirenyatwa Group of Hospitals and Avenues Clinic, Harare, Zimbabwe. Subjects: Adult intracranial aneurysm patients. Interventions: Craniotomy and aneurysm clipping. Results: Seventeen patients were seen during the period of study. Twelve were female patients while five were male with a male to female ratio ...

  19. Evidence for Treatable Inborn Errors of Metabolism in a Cohort of 187 Greek Patients with Autism Spectrum Disorder (ASD

    Directory of Open Access Journals (Sweden)

    Martha eSpilioti

    2013-12-01

    Full Text Available We screened for the presence of inborn errors of metabolism (IEM in 187 children (105 males; 82 females, ages 4 -14 years old who presented with confirmed features of ASD. Twelve patients (7% manifested increased 3-hydroxyisovaleric acid (3-OH-IVA excretion in urine, and minor to significant improvement in autistic features was observed in seven patients following supplementation with biotin. Five diagnoses included: Lesch Nyhan syndrome (2, succinic semialdehyde dehydrogenase (SSADH deficiency (2 and phenylketonuria (1 (2.7%. Additional metabolic disturbances suggestive of IEMs included two patients whose increased urine 3-OH-IVA was accompanied by elevated methylcitrate and lactate in sera, and 30 patients that showed abnormal glucose-loading tests. In the latter group, 16/30 patients manifested increased sera beta hydroxybutyrate (b-OH-b production and 18/30 had a paradoxical increase of sera lactate. Six patients with elevated b-OH-b in sera showed improved autistic features following implementation of a ketogenic diet. Five patients showed decreased serum ketone body production with glucose loading. Twelve of 187 patients demonstrated nonspecific MRI pathology, while 25/187 had abnormal EEG findings. Finally, family history was positive for 22/187 patients (1st or 2nd degree relative with comparable symptomatology and consanguinity was documented for 12/187 patients. Our data provide evidence for a new biomarker (3-OH-IVA and novel treatment approaches in ASD patients.Concise 1 sentence take-home message: Detailed metabolic screening in a Greek cohort of autismspectrum disorder (ASD patients revealed biomarkers (urine 3-hydroxyisovaleric acid and serum b-OH-b in 7% (13/187 of patients for whom biotin supplementation or institution of a ketogenic diet resulted in mild to significant clinical improvement in autistic features.

  20. Complications and renal functional deterioration in patients with co ...

    African Journals Online (AJOL)

    E. Sharma

    2016-07-26

    Jul 26, 2016 ... (CCS) [7] with scores varying from 2 to 7. Eleven patients had CCS of 2, twelve patients had CCS of 3, nineteen patients had CCS of. 4, eighteen patients had CCS of 5, seven patients had CCS of 6 and one patient had CCS of 7 (Chart 1). Partial nephrectomy was done laparoscopically, hilar clamping.

  1. Portrayal of Life Form in Selected Biographies for Children Eight to Twelve Years of Age.

    Science.gov (United States)

    Koch, Shirley Lois

    This study describes and analyzes, in a critical literary manner, selected biographies for children eight to twelve years of age. Biographies of Jane Addams, Cesar Chavez, Mohandas Gandhi, Toyohiko Kagawa, Martin Luther King, Jr., and Albert Schweitzer are viewed from the perspective of a literary criterion based on the principles of design to…

  2. TRANSIT TIMING OBSERVATIONS FROM KEPLER. VIII. CATALOG OF TRANSIT TIMING MEASUREMENTS OF THE FIRST TWELVE QUARTERS

    Energy Technology Data Exchange (ETDEWEB)

    Mazeh, Tsevi; Nachmani, Gil; Holczer, Tomer; Sokol, Gil [School of Physics and Astronomy, Raymond and Beverly Sackler Faculty of Exact Sciences, Tel Aviv University, Tel Aviv 69978 (Israel); Fabrycky, Daniel C. [Department of Astronomy and Astrophysics, University of Chicago, 5640 Ellis Ave., Chicago, IL 60637 (United States); Ford, Eric B.; Ragozzine, Darin [Astronomy Department, University of Florida, Gainesville, FL 32111 (United States); Sanchis-Ojeda, Roberto [Department of Physics and Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA 02139 (United States); Rowe, Jason F.; Lissauer, Jack J. [NASA Ames Research Center, Moffett Field, CA 94035 (United States); Zucker, Shay [Department of Geophysical, Atmospheric and Planetary Sciences, Raymond and Beverly Sackler Faculty of Exact Sciences Tel Aviv University, 69978 Tel Aviv (Israel); Agol, Eric [Department of Astronomy, Box 351580, University of Washington, Seattle, WA 98195 (United States); Carter, Joshua A. [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States); Quintana, Elisa V. [SETI Institute, 189 Bernardo Ave, Suite 100, Mountain View, CA 94043 (United States); Steffen, Jason H. [Fermilab Center for Particle Astrophysics, P.O. Box 500, MS 127, Batavia, IL 60510 (United States); Welsh, William [Astronomy Department, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182 (United States)

    2013-10-01

    Following the works of Ford et al. and Steffen et al. we derived the transit timing of 1960 Kepler objects of interest (KOIs) using the pre-search data conditioning light curves of the first twelve quarters of the Kepler data. For 721 KOIs with large enough signal-to-noise ratios, we obtained also the duration and depth of each transit. The results are presented as a catalog for the community to use. We derived a few statistics of our results that could be used to indicate significant variations. Including systems found by previous works, we have found 130 KOIs that showed highly significant times of transit variations (TTVs) and 13 that had short-period TTV modulations with small amplitudes. We consider two effects that could cause apparent periodic TTV—the finite sampling of the observations and the interference with the stellar activity, stellar spots in particular. We briefly discuss some statistical aspects of our detected TTVs. We show that the TTV period is correlated with the orbital period of the planet and with the TTV amplitude.

  3. Prediction of liver-related events using fibroscan in chronic hepatitis B patients showing advanced liver fibrosis.

    Directory of Open Access Journals (Sweden)

    Seung Up Kim

    Full Text Available Liver stiffness measurement (LSM using transient elastography (FibroScan® can assess liver fibrosis noninvasively. This study investigated whether LSM can predict the development of liver-related events (LREs in chronic hepatitis B (CHB patients showing histologically advanced liver fibrosis.Between March 2006 and April 2010, 128 CHB patients with who underwent LSM and liver biopsy (LB before starting nucleot(side analogues and showed histologically advanced fibrosis (≥F3 with a high viral loads [HBV DNA ≥2,000 IU/mL] were enrolled. All patients were followed regularly to detect LRE development, including hepatic decompensation (variceal bleeding, ascites, hepatic encephalopathy, spontaneous bacterial peritonitis, hepatorenal syndrome and hepatocellular carcinoma (HCC.The mean age of the patient (72 men, 56 women was 52.2 years. During the median follow-up period [median 27.8 (12.6-61.6 months], LREs developed in 19 (14.8% patients (five with hepatic decompensation, 13 with HCC, one with both. Together with age, multivariate analysis identified LSM as an independent predictor of LRE development [P19 kPa were at significantly greater risk than those with LSM≤19 kPa for LRE development (HR, 7.176; 95% CI, 2.257-22.812; P = 0.001.LSM can be a useful predictor of LRE development in CHB patients showing histologically advanced liver fibrosis.

  4. Utility of Periodontal exploration in patients with Fibromyalgia

    Science.gov (United States)

    Santos-García, Rocío; Sánchez-Domínguez, Benito; Cordero, Mario D.; Rios-Santos, José V.; Jaramillo-Santos, María R.; Climent, Mariano H.

    2012-01-01

    Objetive: Fibromyalgia (FM) is a chronic pain syndrome with unknown etiology, which affects predominantly women. Mitochondrial alteration could have a role in the pathophysilogical mechanisms of inflammatory conditions as FM and periodontitis. The aim of the present study was assay the relationship between both diseases and mitochondrial dysfunction. Patient and Methods: We study the presence of periodontitis in twelve patients diagnosed of FM and mitochondrial dysfunction described. The diagnosis of FM was established according to ACR criteria and clinical symptoms were evaluated using the Fibromyalgia Impact Questionnaire (FIQ) and Beck Depression Inventory (BDI). Results: Only one patients of twelve included and agreed to participate in the study were diagnosed with periodontitis. Conclusions: Pending studies with larger numbers of patients, we can conclude that mitochondrial dysfunction in FM is a itself event not related with periodontitis. Periodontitis could be considered a exclusion criterion in all studies about mitochondrial dysfunction in patients. Key words:Peridontitis, fibromyalgia, mitocondrial dysfunction, oxidative stress. PMID:24558523

  5. Vitamin and mineral intake of twelve adolescent male Kalenjin runners in western Kenya

    DEFF Research Database (Denmark)

    Christensen, Dirk Lund; Jakobsen, Jette; Friis, H

    2005-01-01

    runners was carried out to determine their micronutrient intake. MAIN OUTCOME MEASURES: Over a two-week period, samples of the main eaten food were collected for analysis of micronutrient distribution and a daily 24 recall interview performed to determine additional food intake. RESULTS: The estimated...... mg, 1309 microg, and 79 microg, respectively. CONCLUSION: Total daily micronutrient intake of the twelve Kalenjin runners was far from adequate compared to FAO/WHO daily recommended and suggested adequate intake....

  6. Modeling Patient No-Show History and Predicting Future Outpatient Appointment Behavior in the Veterans Health Administration.

    Science.gov (United States)

    Goffman, Rachel M; Harris, Shannon L; May, Jerrold H; Milicevic, Aleksandra S; Monte, Robert J; Myaskovsky, Larissa; Rodriguez, Keri L; Tjader, Youxu C; Vargas, Dominic L

    2017-05-01

    Missed appointments reduce the efficiency of the health care system and negatively impact access to care for all patients. Identifying patients at risk for missing an appointment could help health care systems and providers better target interventions to reduce patient no-shows. Our aim was to develop and test a predictive model that identifies patients that have a high probability of missing their outpatient appointments. Demographic information, appointment characteristics, and attendance history were drawn from the existing data sets from four Veterans Affairs health care facilities within six separate service areas. Past attendance behavior was modeled using an empirical Markov model based on up to 10 previous appointments. Using logistic regression, we developed 24 unique predictive models. We implemented the models and tested an intervention strategy using live reminder calls placed 24, 48, and 72 hours ahead of time. The pilot study targeted 1,754 high-risk patients, whose probability of missing an appointment was predicted to be at least 0.2. Our results indicate that three variables were consistently related to a patient's no-show probability in all 24 models: past attendance behavior, the age of the appointment, and having multiple appointments scheduled on that day. After the intervention was implemented, the no-show rate in the pilot group was reduced from the expected value of 35% to 12.16% (p value < 0.0001). The predictive model accurately identified patients who were more likely to miss their appointments. Applying the model in practice enables clinics to apply more intensive intervention measures to high-risk patients. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  7. The cortisol awakening response in caregivers of schizophrenic offspring shows sensitivity to patient status.

    Science.gov (United States)

    Gonzalez-Bono, Esperanza; De Andres-Garcia, Sara; Moya-Albiol, Luis

    2011-01-01

    Taking care of offspring during a prolonged period of time is probably one of the most stressful life experiences for parents. The present study compares the cortisol awakening response (CAR) in 38 long-term caregivers (mothers and fathers of schizophrenic relatives) with a control group of 32 non-caregivers. Factors such as general stress, caregiver burden, patient severity, and institutionalization were studied. Although a blunted CAR was observed in caregivers in comparison with controls, this difference was not significant. Among caregivers, the absence of institutionalization for the patient is associated with a lack of CAR in caregivers in comparison with caregivers of institutionally supported patients. General stress, caregiver burden, and patient severity themselves did not favor significant changes in CAR. CAR shows greater sensitivity to institutional support than patient severity and perceived stress. Further research is needed to explain the impact of these factors on health and the psychological factors involved.

  8. Amelogenesis Imperfecta: A Non-Invasive Approach to Improve Esthetics in Young Patients. Report of Two Cases.

    Science.gov (United States)

    Cagetti, Maria Grazia; Cattaneo, Stefano; Hu, Ye Qing; Campus, Guglielmo

    Objective-Evaluate esthetic and functional efficacy of infiltrant resin (Icon, DMG, Hamburg, Germany) in Amelogenesis Imperfecta's treatment. Two adolescent patients, G.S. (13 years old) and C.M. (15 years old), affected by the hypomaturation type of Amelogenesis Imperfecta, were treated with Icon resin and were followed for twelve months. Treated teeth show an excellent aesthetical result immediately after the resin application, effect that lasts in the long-term (six and twelve months follow-up examinations); the dental wear's progression seems to be clinically arrested. Resin infiltration has proven to be a minimal invasive treatment for dental discoloration, less aggressive than conventional procedures. This approach might be recommended for a stable esthetical improvement in moderate AI's lesions especially in children and adolescents.

  9. Computerized monitoring of physical activity and sleep in postoperative abdominal surgery patients

    DEFF Research Database (Denmark)

    Bisgaard, T; Kjaersgaard, M; Bernhard, A

    1999-01-01

    OBJECTIVE: Assessment of early postoperative activity is important in the documentation of improvements of peri-operative care. This study was designed to validate computerized activity-based monitoring of physical activity and sleep (actigraphy) in patients after abdominal surgery. METHODS...... physical activity and sleep-wake cycles after major abdominal surgery.......: The study included twelve hospitalized patients after major abdominal surgery studied on day 2 to 4 after operation and twelve unhospitalized healthy volunteers. Measurements were performed for 24 consecutive hours. The actigraphy measurements were compared with self-reported activity- and sleep...

  10. Patient satisfaction with dental services rendered at School of ...

    African Journals Online (AJOL)

    Aim: To determine patient satisfaction among dental patients treated at the School of Dentistry, MUHAS. Study design: Cross-sectional clinic based study. Study participants and methods: Two hundred twelve dental patients aged 18 years and above who attended the oral surgery and restorative dental clinics were given a ...

  11. [Longitudinal genetic effects on mandibular position of female twins from six to twelve years old].

    Science.gov (United States)

    Zhu, Chang-feng; Peng, Jing

    2013-06-01

    To find the longitudinal genetic effects on mandibular position in mixed dentition. The sample used in this study consisted of lateral cephalograms of eighty-nine pairs of female twins in Beijing. With a mixed longitudinal method, the effective twins were 183 pairs(monozygous 110 pairs and dizygous 73 ones). The genetic and environmental effects on mandibular position were analyzed by statistical methods in female twins from six to twelve years old. Statistical comparisons revealed significant (Pchin is the most subjective to environment change, then the mandibular angle, and the condyle is the least. Using N and S as references, the environmental influence on heights showed different order from the most to least changeable: The mandibular angle, the condyle and the chin. In later stage of our observation, the mandibular morphology and growth type might be family inherited. For environmental influences plays important roles on mandibular position, these findings can be used in orthodontic treatment planning.

  12. A novel double quad-inverter configuration for multilevel twelve-phase open-winding converter

    DEFF Research Database (Denmark)

    Padmanaban, Sanjeevi Kumar; Blaabjerg, Frede; Wheeler, Patrick William

    2016-01-01

    This paper describes a novel proposal of double quad-inverter configuration for multilevel twelve-phase open-winding ac converter. Modular power units are developed from reconfigured eight classical three-phase voltage source inverters (VSIs). Each VSI has one additional bi-directional switching...... numerical simulation software's (Matlab/PLECS) developments. Further, the results confirm the good agreement to the developed theoretical background. Proposed converter suits the need of low-voltage/high-current applications such as ac tractions and `More-Electric Aircraft' propulsion systems....

  13. Risk factors for early treatment discontinuation in patients with obsessive-compulsive disorder

    Directory of Open Access Journals (Sweden)

    Juliana Belo Diniz

    2011-01-01

    Full Text Available INTRODUCTION: In obsessive-compulsive disorder, early treatment discontinuation can hamper the effectiveness of first-line treatments. OBJECTIVE: This study aimed to investigate the clinical correlates of early treatment discontinuation among obsessive-compulsive disorder patients. METHODS: A group of patients who stopped taking selective serotonin reuptake inhibitors (SSRIs or stopped participating in cognitive behavioral therapy before completion of the first twelve weeks (total n = 41; n = 16 for cognitive behavioral therapy and n = 25 for SSRIs were compared with a paired sample of compliant patients (n = 41. Demographic and clinical characteristics were obtained at baseline using structured clinical interviews. Chisquare and Mann-Whitney tests were used when indicated. Variables presenting a p value <0.15 for the difference between groups were selected for inclusion in a logistic regression analysis that used an interaction model with treatment dropout as the response variable. RESULTS: Agoraphobia was only present in one (2.4% patient who completed the twelve-week therapy, whereas it was present in six (15.0% patients who dropped out (p = 0.044. Social phobia was present in eight (19.5% patients who completed the twelve-week therapy and eighteen (45% patients who dropped out (p = 0.014. Generalized anxiety disorder was present in eight (19.5% patients who completed the twelve-week therapy and twenty (50% dropouts (p = 0.004, and somatization disorder was not present in any of the patients who completed the twelveweek therapy; however, it was present in six (15% dropouts (p = 0.010. According to the logistic regression model, treatment modality (p = 0.05, agoraphobia, the Brown Assessment of Beliefs Scale scores (p = 0.03 and the Beck Anxiety Inventory (p = 0.02 scores were significantly associated with the probability of treatment discontinuation irrespective of interactions with other variables. DISCUSSION AND CONCLUSION: Early treatment

  14. The role of family nutritional support in Japanese patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Watanabe, Koin; Kurose, Takeshi; Kitatani, Naomi; Yabe, Daisuke; Hishizawa, Masahiro; Hyo, Takanori; Seino, Yutaka

    2010-01-01

    We investigated the role of family support in glycemic control by nutritional self-care behavior of Japanese patients with type 2 diabetes. One hundred twelve Japanese out-patients with type 2 diabetes were recruited for the study at Kansai Electric Power Hospital. Interviews were conducted and HbA1c and triglyceride levels were measured. HbA1c levels were significantly related to family nutritional support. Patients under 60 years old with family nutritional support showed significantly lower HbA1c than patients without family support (p1 week) showed similar outcomes in glycemic control. Patients who appreciate the support and follow the advice showed lower HbA1c (6.88 +/- 0.22%) than (7.43 +/- 0.23%) patients who appreciate the advice but sometimes feel emotional barriers. Family nutritional support is useful in improving metabolic outcome of diabetic patients. Self-care practice in disease management should be carefully adjusted to the family setting of type 2 diabetic patients. Emotional barriers to family support may affect the metabolic consequences, especially in the Japanese elderly.

  15. Computerized spectral analyses of EEG in chronic schizophrenic patients

    International Nuclear Information System (INIS)

    Fujita, Haruhiro

    1985-01-01

    This study was aimed at clarifying the EEG difference between chronic schizophrenic patients and normal controls by using the EEG method of spectral analyses. Twelve comparatively homogenous chronic schizophrenic patients and the 10 healthy controls were subjected to EEG investigations. 1) The EEG of schizophrenic patients had a slowing tendency of the frequency in the frontal pole, anterior temporal and central regions of the scalp compared with control subjects. 2) There was a decrease of mutual relation among the five electrodes' peak frequency in the schizophrenic patients. 3) The EEG of schizophrenic patients had more fast waves of β 1 and β 2 band than that of control subjects. 4) A slowing tendency of the frequency in the first half regions of the scalp was not found in 3 chronic schizophrenic patients which showed defective functions in the frontal area by positron emission tomography. 5) When mental arithmetic was given, the schizophrenic patients showed an increase of fast wave in the central, posterior temporal and occipital regions of the scalp. 6) When they opened their eyes, attenuation in the α band was not so marked in the schizophrenic patients. (author)

  16. Twelve tips for teaching child development and disability to medical students.

    Science.gov (United States)

    McDonald, Jenny

    2018-02-01

    Child development is a marker of well-being in childhood and recognition of developmental delay allows timely investigation and intervention for children with developmental disabilities. Despite this, child development and disabilities are not given emphasis in the medical curriculum. This under representation of teaching combined with the stigma associated with disabilities contributes to the sub-optimal health care of people with disabilities. As well as, addressing the stigma of disability a medical undergraduate curriculum should include: the key concepts of child development; the clinical presentation of the most common developmental disabilities; developmental history taking and the infant neurodevelopmental examination. The following twelve tips provide practical advice about how to teach this knowledge and these skills during medical training.

  17. Annual economic burden of hepatitis B virus-related diseases among hospitalized patients in twelve cities in China.

    Science.gov (United States)

    Zhang, S; Ma, Q; Liang, S; Xiao, H; Zhuang, G; Zou, Y; Tan, H; Liu, J; Zhang, Y; Zhang, L; Feng, X; Xue, L; Hu, D; Cui, F; Liang, X

    2016-03-01

    A nationwide survey of hepatitis B virus (HBV)-associated economic burden has not previously been performed in China. The purpose of this study was to examine the direct, indirect, and intangible costs of HBV-related diseases within the span of one year. A random sample was taken from specialty and general hospitals across 12 cities in six provinces of China. Intangible costs were estimated based on willingness to pay or open-ended answers provided by patients. The results showed that 27 hospitals were enrolled, with a sample population of 4726 patients (77.7% response rate). The average annual costs were $4454.0 (direct), $924.3 (indirect), and $6611.10 (intangible), corresponding to 37.3%, 7.7%, and 55.1% of the total costs, respectively. The direct medical fees were substantially greater than the non-medical fees. Annual indirect costs were divided into outpatient ($112.9) and inpatient ($811.40) loss of income. The intangible costs of chronic HBV were notably higher than either the direct or indirect costs, consistent with the social stigma in China. The comparison amongst individual cities for the average ratio of direct to indirect costs revealed that the sizes of ratios were negatively correlated with the socioeconomic status of the regions. This study suggested that as a whole in China, the HBV-related diseases caused a heavy financial burden which was positively associated with disease severity. Although the intangible costs coincided with a high prevalence of discrimination against CHB patients in Chinese society, our study may serve as future reference for detailed exploration. © 2015 John Wiley & Sons Ltd.

  18. Risk factors for chronic noncontiguous diseases: Twelve-week prospective study

    Directory of Open Access Journals (Sweden)

    Lapčević Mirjana

    2004-01-01

    Full Text Available Risk factors (RF of chronic noncontiguous diseases (CND are mutual and cannot be observed individually since there is an inter-reaction (interaction of RF in various combinations, what makes so-called personality risk profile for development of particular disease. Almost all CND belong to the group of preventable diseases, because their course may be influenced and changed through RF modification and reduction. Bad habits also contribute to CND incidence. CND prevention is the first priority of primary health care physicians. The main objective of our study was to detect RF in patients during everyday activities of general practitioner, to estimate the risk of CND within the existing RF combination, to show the results of 12-week active monitoring of population with RF of CND, and with already present CND; while the secondary goal was to assess how much population is interested in active collaboration as well as to evaluate the qualification of general medicine teams for work based on defined methodology. The study was multicentric, prospective and interventional. The study included 2086 subjects, aged from 25-64 years, and it was carried out in 17 health centers throughout Serbia in the period January-April 2002. The subjects were selected by method of open clinical experiment. Thereafter, 12-week medical intervention was initiated involving non-pharmacological and pharmacological treatment. The first control was scheduled after 8, and the second after 12 months of intervention. Congruence χ2 test, ANOVA for repeated measurements and Logistic regression were used for statistical data processing. Out of a total of 2086 subjects, the following proportion of them reported specific diagnosis in their medical histories: 77% of them reported arterial hypertension (HTA, 68% - increased body mass (BMI>27Kg/m2, 66% - hyperlipoproteinemia (HLP, 34% - diabetes mellitus (DM, 56% - inadequate physical activity (PA, and 23% - cigarette smoking (CS. On the

  19. Antifouling activity of twelve demosponges from Brazil

    Directory of Open Access Journals (Sweden)

    SM. Ribeiro

    Full Text Available Benthic marine organisms are constantly exposed to fouling, which is harmful to most host species. Thus, the production of secondary metabolites containing antifouling properties is an important ecological advantage for sessile organisms and may also provide leading compounds for the development of antifouling paints. High antifouling potential of sponges has been demonstrated in the Indian and Pacific oceans and in the Caribbean and Mediterranean seas. Brazilian sponges remain understudied concerning antifouling activities. Only two scientific articles reported this activity in sponges of Brazil. The objective of this study was to test crude extracts of twelve species of sponges from Brazil against the attachment of the mussel Perna perna through laboratorial assays, and highlight promising species for future studies. The species Petromica citrina, Amphimedon viridis, Desmapsamma anchorata, Chondrosia sp., Polymastia janeirensis, Tedania ignis, Aplysina fulva, Mycale angulosa, Hymeniacidon heliophila, Dysidea etheria, Tethya rubra, and Tethya maza were frozen and freeze-dried before extraction with acetone or dichloromethane. The crude extract of four species significantly inhibited the attachment of byssus: Tethya rubra (p = 0.0009, Tethya maza (p = 0.0039, Petromica citrina (p = 0.0277, and Hymeniacidon heliophila (p = 0.00003. These species, specially, should be the target of future studies to detail the substances involved in the ability antifouling well as to define its amplitude of action.

  20. Energy and greenhouse effect. Twelve short notes

    International Nuclear Information System (INIS)

    Prevot, Henri

    2013-12-01

    The author proposes twelve brief notes aimed at discussing the reduction of fossil energy consumption in order to reduce CO 2 emissions and to improve the French energy supply security, without any useless expense. These notes address the reason for energy savings, the cost and price of a CO 2 ton, the issue of thermal regulation for buildings (it's not in compliance with the law, and results in higher expenses and increased CO 2 emissions), the introduction of a carbon tax to incite investments for energy saving, the status and health of the CO 2 European market, the support of actions aimed at reducing fossil energy consumption, the fact that bio-heat is ten times more efficient than bio-fuel and that therefore car holders should finance bio-heat, the development of hybrid uses of energy to avoid the difficulty of energy storage, the reduction of CO 2 emissions at low cost (by consuming as much renewable energy as nuclear energy but without wind or photovoltaic energy), the cost of less CO 2 , less fossil energy and less nuclear, and the interest of France to act on its own to reduce CO 2 emissions. The author proposes a brief synthesis of these notes and some proposals regarding thermal regulation for buildings, taxes, the European CO 2 market, the forest biomass, electricity production, and the European and word dimensions of these issues

  1. Retrospective Analysis of Patient Presentations at the Sydney (Australia) Royal Easter Show from 2012 to 2014.

    Science.gov (United States)

    Crabtree, Nathan; Mo, Shirley; Ong, Leon; Jegathees, Thuvarahan; Wei, Daniel; Fahey, David; Liu, Jia Jenny

    2017-04-01

    Introduction Comprehensive studies on the relationship between patient demographics and subsequent treatment and disposition at a single mass-gathering event are lacking. The Sydney Royal Easter Show (SRES; Sydney Olympic Park, New South Wales, Australia) is an annual, 14-day, agricultural mass-gathering event occurring around the Easter weekend, attracting more than 800,000 patrons per year. In this study, patient records from the SRES were analyzed to examine relationships between weather, crowd size, day of week, and demographics on treatment and disposition. This information would help to predict factors affecting patient treatment and disposition to guide ongoing training of first responders and to evaluate the appropriateness of staffing skills mix at future events. Hypothesis Patient demographics, environmental factors, and attendance would influence the nature and severity of presentations at the SRES, which would influence staffing requirements. A retrospective analysis of 4,141 patient record forms was performed for patients who presented to St John Ambulance (Australian Capital Territory, Australia) at the SRES between 2012 and 2014 inclusive. Presentation type was classified using a previously published minimum data set. Data on weather and crowd size were obtained from the Australian Bureau of Meteorology (Melbourne, Victoria, Australia) and the SRES, respectively. Statistical analyses were performed using SPSS v22 (IBM; Armonk, New York USA). Between 2012 to 2014, over 2.5 million people attended the SRES with 4,141 patients treated onsite. As expected, the majority of presentations were injuries (49%) and illnesses (46%). Although patient demographics and presentation types did not change over time, the duration of treatment increased. A higher proportion of patients were discharged to hospital or home compared to the proportion of patients discharged back to the event. Patients from rural/regional locations (accounting for 15% of all patients) were

  2. Accumulation of aluminum and barium in twelve Punjab wheat varieties and their contents in the agricultural soil

    International Nuclear Information System (INIS)

    Shar, G.Q.; Lashari, A.K.H.; Haider, S.I.

    2003-01-01

    Wheat samples of twelve varieties, grown by breeders at NIAB, Faisalabad Pakistan and its soil, were collected and analyzed for aluminum and barium content by atomic absorption spectroscopy using acetylene-nitroxide flame. For dissolution for heavy metals, aluminum and barium, wet acid digestion method was used. The experimental study was conducted using six samples for each twelve varieties of FSC and RD (Federal Seed Certification and Registration Department) as standard reference materials and representative samples, and the soil which was also collected from agricultural plot of Nuclear Inst. of Agricultural and Biology (NIAB), Faisalabad, Punjab. The characteristics mean of both elements in each variety of representative samples was found to be 28.32, 71.02, 37.41, 36.95, 28.32, 47.40, 30.14, 14.69, 25.41, 32.86, 30.14 and 41.95 for the aluminum and 12.67, 6.92, 5.67, 19.82, 3.28, 17.34, 10.25, 10.49, 8.01, 14.23, 15.16 and 6.92 mg/kg for the barium of Chakwal-86, Bakhatawar-92, Shahkar-95, Parwaz-94, Punjab-96, Bahawal pur-97, Shahkar-91, Inquilab-91, Pasban-90, Punjab-85, Faisalabad-85 and Pak-81 varieties respectively. The soil of that specific plot contains 35964.3 and 111.08 mg/kg of aluminum and barium respectively. The representative samples, which are compared with certified samples at 95% confidence limit. The purpose of this study was to study the variation in uptake of aluminum and barium in twelve different wheat varieties grown in same agricultural plot. (author)

  3. Diabetes patients show different time-course of myocardial perfusion improvement after coronary artery bypass grafting

    International Nuclear Information System (INIS)

    Lee, J. J.; Seok, J. W.; Eo, J. S.

    2005-01-01

    Diabetes mellitus is an independent risk factor of cardiovascular disease. Diabetes is known to cause microangiopathy. The microangiopathy is hardly detectable on the coronary angiography. Myocardial perfusion imaging shows the resultant perfusion status which reflects the microangiopathy. For patients who underwent revascularization, the microangiopathy could affect the myocardial perfusion improvement. Diabetes patients probably experience the different myocardial perfusion improvement as compared to the non-diabetes patients although they have similar angiographic findings. The aim of this study is to find out whether there is a time-course difference of perfusion improvement between the diabetes and non diabetes patients who showed patent angiographic findings after coronary artery grafting surgery (CABG). A total of 129 patients who underwent coronary artery bypass grafting surgery were enrolled in this study. Myocardial SPECTs performed at previous, short-term (3 month), and mid-term (1 year) to CABG. One-year follow up angiography was done 411±121 days after surgery. Graft patency was determined according to the FitzGibbon et al. Segments were assigned to vascular territories using a 20 segment model. The segments of excellent patency were included in this study. Time course differences of concerned segments were analyzed using RMANOVA. The number of segments enrolled was 764 of diabetes and 1083 of non-diabetes. At short-term follow up, reversibility score was 2.8±8.1% in diabetes and 0.3±7.5% in non-diabetes. At long-term follow up, reversibility score was 1.8±8.0% in diabetes and 0.1±7.3% in non-diabetes. The time-course of reversibility score was significantly different between the diabetes and non diabetes (p<0.001) Diabetic segments showed high residual reversibility score than non-diabetic segments after CABG although the angiographic finding was patent in both groups. This result is maybe attributable to microangiopathy induced by diabetes

  4. Cerebral perfusion changes in schizophrenia patients evaluated with Tc-99 HMPAO

    International Nuclear Information System (INIS)

    Sehweil, A.; El-Hilu, S.; Jahan, S.; Higazi, E.; Salhat, M.; Al-Mohannadi, S.; Abdel-Dayem, H.M.

    1989-01-01

    Tc-99m HMPAO has been used to image cerebral perfusion changes in 20 chronic schizophrenia patients (19 men and 1 woman), with an average age of 29 years (range, 22-48 years). All were receiving neuroleptic drugs. Twelve had received electroconvulsive therapy. All patients had abnormal studies (except one, which was normal) and poor response to treatment. Ventricular dilation and cerebral atrophy were seen in 11 patients. Seventy-seven focal lesions were detected. Forty-two lesions showed increased HMPAO retention: 26 in the basal ganglia in 14 patients (12, bilateral, two unilateral), 10 along the sylvian fissure in the parietotemporal region, three in the frontal region, and one in each of the temporal, parietal, and occipital regions. Thirty-five focal lesions showed decreased perfusion: 10 parietal, eight frontal, seven temporal, six cerebellar, and four occipital. This study demonstrates the potential value of Tc-99m HMPAO in the study of schizophrenia and other psychiatric disorders

  5. Radionuclide gastric emptying studies in patients with anorexia nervosa

    Energy Technology Data Exchange (ETDEWEB)

    Domstad, P.A.; Shih, W.J.; Humphries, L.; DeLand, F.H.; Digenis, G.A.

    1987-05-01

    To evaluate gastric emptying in anorexia nervosa patients, 26 patients (17 females, two males, ranging in age from 13 to 40 yr) with upper GI symptoms ingested 150-200 microCi (/sup 99m/Tc)triethelenetetraamine polysterene resin in cereal and were imaged in the supine position. Data were accumulated at 5 min intervals to obtain the gastric emptying time (GET). The results of the studies were divided into three categories: prolonged, 13 patients; rapid, 11; and normal 3. Twelve of 13 patients with prolonged GET were given 10 mg metoclopramide i.v. injections; nine of the 12 patients had a good response and three had no response. Five of the nine patients underwent metoclopramide therapy and four of the patients showed benefit from the therapy. One patient discontinued metoclopramide therapy because of somnolence. Although all patients had subjective symptoms of gastric dysfunction, our results indicated only 50% had objectively prolonged GET, and another 50% showed normal or even rapid GET. Therefore, this radionuclide study enables quantitatively objective documentation of gastric emptying, separation of those patients with rapid or normal GET from those with prolonged GET, thereby avoiding the possible side effects from metoclopramide medication, and prediction of effectiveness of metoclopramide therapy in patients with prolonged GET.

  6. Radionuclide gastric emptying studies in patients with anorexia nervosa

    International Nuclear Information System (INIS)

    Domstad, P.A.; Shih, W.J.; Humphries, L.; DeLand, F.H.; Digenis, G.A.

    1987-01-01

    To evaluate gastric emptying in anorexia nervosa patients, 26 patients (17 females, two males, ranging in age from 13 to 40 yr) with upper GI symptoms ingested 150-200 microCi [/sup 99m/Tc]triethelenetetraamine polysterene resin in cereal and were imaged in the supine position. Data were accumulated at 5 min intervals to obtain the gastric emptying time (GET). The results of the studies were divided into three categories: prolonged, 13 patients; rapid, 11; and normal 3. Twelve of 13 patients with prolonged GET were given 10 mg metoclopramide i.v. injections; nine of the 12 patients had a good response and three had no response. Five of the nine patients underwent metoclopramide therapy and four of the patients showed benefit from the therapy. One patient discontinued metoclopramide therapy because of somnolence. Although all patients had subjective symptoms of gastric dysfunction, our results indicated only 50% had objectively prolonged GET, and another 50% showed normal or even rapid GET. Therefore, this radionuclide study enables quantitatively objective documentation of gastric emptying, separation of those patients with rapid or normal GET from those with prolonged GET, thereby avoiding the possible side effects from metoclopramide medication, and prediction of effectiveness of metoclopramide therapy in patients with prolonged GET

  7. Twelve-year follow-up of a randomized controlled trial of comprehensive physiotherapy following disc herniation operation.

    Science.gov (United States)

    Ebenbichler, Gerold R; Inschlag, Silke; Pflüger, Verena; Stemberger, Regina; Wiesinger, Günther; Novak, Klaus; Christoph, Krall; Resch, Karl L

    2015-06-01

    To evaluate the long-term effects of postoperative comprehensive physiotherapy starting one week after lumbar disc surgery. Twelve-year follow-up of a three-armed, randomized, controlled, single-blinded clinical trial. Department of Physical Medicine & Rehabilitation. Of 111 patients following first-time, uncomplicated lumbar disc surgery who participated in the original study and completed the treatment originally allocated, 74 ((67%; 29 (73%) physiotherapy, 22 (58%) sham therapy, 23 (68%) no therapy) completed a 12-year follow-up examination. In the original study, patients had been randomly assigned to comprehensive physiotherapy, sham intervention (neck massage), or no therapy. Low Back Pain Rating Scale; best score 0, worst score 130 points). At 12 years after surgery, the group participating in comprehensive physiotherapy had significantly better functional outcomes, as rated on the Low Back Pain Rating Score, than the untreated group (mean difference: -13.2 (95% CI: (-25.4; -1.0)). Equally, there was a clinically relevant, non-significant difference between the sham therapy and no therapy (mean difference: -12.5 (95%CI: -26.1; 1.1)). Consequently, the Low Back Pain Rating Score outcome did not differ between physiotherapy and sham therapy (mean difference: -0.7 (95%CI: -14.2; 12.8)). Participating in a comprehensive physiotherapy program following lumbar disc surgery may be associated with better long-term health benefits over no intervention, but may not be superior to sham therapy. © The Author(s) 2014.

  8. Investigations of the immune state of patients irradiated for testicle tumours

    International Nuclear Information System (INIS)

    Stefanits, K.; Kuhn, E.; Csere, T.

    1985-01-01

    The authors present the results of investigation of the immune reactivity of 72 patients irradiated for testicle tumors. The responses to tuberculin and DNCB (2,4-dinitrochlorobenzol) were examined before the treatment, within twelve months after radiotherapy and three years after radiotherapy and when metastases appeared. After radiotherapy, the number of positive responses was slightly decreased in both examination methods, but the difference was in no case significant. Patients with metastases showed a significantly decreased response to DNCB compared to the results obtained before radiotherapy. 5.6% of the patients had suffered from herpes zoster. The incidence of other infective diseases was not increased. The conclusion is drawn that the moderate immunosuppression caused by radiotherapy does not exert any influence on the further way of living of patients with testicle tumors. (orig.) [de

  9. Comparative assay of fluorescent antibody test results among twelve European National Reference Laboratories using various anti-rabies conjugates

    DEFF Research Database (Denmark)

    Robardet, E.; Andrieu, S.; Rasmussen, Thomas Bruun

    2013-01-01

    Twelve National Reference Laboratories (NRLs) for rabies have undertaken a comparative assay to assess the comparison of fluorescent antibody test (FAT) results using five coded commercial anti-rabies conjugates (Biorad, Bioveta, Fujirebio, Millipore, and SIFIN conjugates). Homogenized positive...

  10. Comparisons of High School Graduation Rates of Students with Disabilities and Their Peers in Twelve Southern States

    Science.gov (United States)

    Smith, Theodore Scott; Manuel, Nancy; Stokes, Billy R.

    2012-01-01

    This study compared differences in diploma and graduation dropout rates among students with and without disabilities, analyzed differences in various graduation-types by disabilities, and offered recommendations to improve graduation rates through evidence-based practices. The geographic catchment area of this study was limited to twelve Southern…

  11. The Impact of the Financial Crisis on the Content of Twelve Bestselling US Principles of Economics Textbooks

    DEFF Research Database (Denmark)

    Madsen, Poul Thøis

    2013-01-01

    How have authors of twelve bestselling introductory US textbooks in economics responded to the traumatizing financial crisis? In general the financial crisis is described with a couple of lines here and there or it is dealt with in boxes, separate sections, or specific isolated chapters. Some...

  12. Sensitivity of the activated partial thromboplastin time, the dilute Russell's viper venom time, and the kaolin clotting time for the detection of the lupus anticoagulant: a direct comparison using plasma dilutions.

    Science.gov (United States)

    Martin, B A; Branch, D W; Rodgers, G M

    1996-01-01

    Increasing dilutions of lupus anticoagulant (LA) plasmas from twelve patients were used to directly compare the sensitivity of four tests for LA. The tests evaluated were the modified Bell and Alton activated partial thromboplastin time (APTT), an APTT using a commercially prepared partial thromboplastin (Platelin LS APTT), a modified dilute Russell's viper venom time (DRVVT), and a modified kaolin clotting time (KCT). LAs were detected in all twelve plasmas by each of three tests and eleven of twelve plasmas in a fourth test when undiluted patient plasma was used. Repeating the tests after diluting the LA plasmas with normal platelet-free plasma (PFP) showed that the KCT was the most sensitive test for LA, detecting eleven of twelve LAs at a dilution of 10% patient plasma and ten of twelve LAs at a dilution of 5% patient plasma. The modified Bell and Alton APTT and the modified DRVVT had similar sensitivities at a patient plasma concentration of 10%, detecting seven of twelve and eight of twelve LAs, respectively. The Platelin LS APTT detected only four of twelve LAs at a patient plasma concentration of 10%. Our results indicate that the modified KCT is a sensitive method for the detection of LAs. The modified Bell and Alton APTT and the DRVVT were less sensitive.

  13. The effects of planting density and cultural intensity on loblolly pine crown characteristics at age twelve

    Science.gov (United States)

    Madison Akers; Michael Kane; Robert Teskey; Richard Daniels; Dehai Zhao; Santosh Subedi

    2012-01-01

    Twelve-year old loblolly pine (Pinus taeda L.) stands were analyzed for the effects of planting density and cultural intensity on tree and crown attributes. Four study installations were located in the Piedmont and Upper Coastal Plain regions of the U.S. South. The treatments included six planting densities (740, 1480, 2220, 2960, 3700, 4440 trees...

  14. Provider portrayals and patient-provider communication in drama and reality medical entertainment television shows.

    Science.gov (United States)

    Jain, Parul; Slater, Michael D

    2013-01-01

    Portrayals of physicians on medical dramas have been the subject of research attention. However, such research has not examined portrayals of interactions between physicians and patients, has not compared physician portrayals on medical dramas versus on medical reality programs, and has not fully examined portrayals of physicians who are members of minority groups or who received their education internationally. This study content-analyzes 101 episodes (85 hours) of such programs broadcast during the 2006-2007 viewing season. Findings indicate that women are underrepresented as physicians on reality shows, though they are no longer underrepresented as physicians on dramas. However, they are not as actively portrayed in patient-care interactions as are male physicians on medical dramas. Asians and international medical graduates are underrepresented relative to their proportion in the U.S. physician population, the latter by almost a factor of 5. Many (but certainly not all) aspects of patient-centered communication are modeled, more so on reality programs than on medical dramas. Differences in patient-provider communication portrayals by minority status and gender are reported. Implications for public perception of physicians and expectations regarding provider-patient interaction are discussed.

  15. Risk of stress urinary incontinence twelve years after the first pregnancy and delivery.

    Science.gov (United States)

    Viktrup, Lars; Rortveit, Guri; Lose, Gunnar

    2006-08-01

    To estimate the impact of onset of stress urinary incontinence in first pregnancy or postpartum period, for the risk of symptoms 12 years after the first delivery. In a longitudinal cohort study, 241 women answered validated questions about stress urinary incontinence after first delivery and 12 years later. Twelve years after first delivery the prevalence of stress urinary incontinence was 42% (102 of 241). The 12-year incidence was 30% (44 of 146). The prevalence of stress urinary incontinence 12 years after first pregnancy and delivery was significantly higher (Ppregnancy (56%, 37 of 66) and in women with onset shortly after delivery (78%, 14 of 18) compared with those without initial symptoms (30%, 44 of 146). In 70 women who had onset of symptoms during first pregnancy or shortly after the delivery but remission 3 months postpartum, a total of 40 (57%) had stress urinary incontinence 12 years later. In 11 women with onset of symptoms during the first pregnancy or shortly after delivery but no remission 3 months postpartum, a total of 10 (91%) had stress urinary incontinence 12 years later. Cesarean during first delivery was significantly associated with a lower risk of incontinence. Other obstetric factors were not significantly associated with the risk of incontinence 12 years later. Patients who were overweight before their first pregnancy were at increased risk. Onset of stress urinary incontinence during first pregnancy or puerperal period carries an increased risk of long-lasting symptoms.

  16. Work environment perceptions following relocation to open-plan offices: A twelve-month longitudinal study.

    Science.gov (United States)

    Bergström, Jessica; Miller, Michael; Horneij, Eva

    2015-01-01

    A workplace's design can have various positive or negative effects on the employees and since the 1970s the advantages and disadvantages of open-plan offices have been discussed. The aim of this study was to investigate perceived health, work environment and self-estimated productivity one month before and at three, six and twelve months after relocation from individual offices to an open-plan office environment. Employees from three departments within the same company group and who worked with relatively similar tasks and who were planned to be relocated from private offices to open-plan offices were invited to participate. Questionnaires comprising items from The Salutogenic Health Indicator Scale, The Work Experience Measurement Scale, the questionnaire by Brennan et al. about perceived performance and one question from the Work Ability Index were sent to participants one month before relocation (baseline) to open-plan offices and then at three, six and twelve months after relocation. At baseline, 82 questionnaires were sent out. The response rate was 85%. At the follow-ups 77-79 questionnaires were sent out and the response-rate was 70%-81%. At follow-ups, perceived health, job satisfaction and performance had generally deteriorated. The results of the study indicate that employees' perception of health, work environment and performance decreased during a 12 month period following relocation from individual offices to open-plan offices.

  17. The effects of Thalamic Deep Brain Stimulation on speech dynamics in patients with Essential Tremor: An articulographic study.

    Directory of Open Access Journals (Sweden)

    Doris Mücke

    Full Text Available Acoustic studies have revealed that patients with Essential Tremor treated with thalamic Deep Brain Stimulation (DBS may suffer from speech deterioration in terms of imprecise oral articulation and reduced voicing control. Based on the acoustic signal one cannot infer, however, whether this deterioration is due to a general slowing down of the speech motor system (e.g., a target undershoot of a desired articulatory goal resulting from being too slow or disturbed coordination (e.g., a target undershoot caused by problems with the relative phasing of articulatory movements. To elucidate this issue further, we here investigated both acoustics and articulatory patterns of the labial and lingual system using Electromagnetic Articulography (EMA in twelve Essential Tremor patients treated with thalamic DBS and twelve age- and sex-matched controls. By comparing patients with activated (DBS-ON and inactivated stimulation (DBS-OFF with control speakers, we show that critical changes in speech dynamics occur on two levels: With inactivated stimulation (DBS-OFF, patients showed coordination problems of the labial and lingual system in terms of articulatory imprecision and slowness. These effects of articulatory discoordination worsened under activated stimulation, accompanied by an additional overall slowing down of the speech motor system. This leads to a poor performance of syllables on the acoustic surface, reflecting an aggravation either of pre-existing cerebellar deficits and/or the affection of the upper motor fibers of the internal capsule.

  18. Clinical characteristics in patients showing ischemic electrocardiographic changes during adenosine triphosphate loading single-photon emission computed tomography

    International Nuclear Information System (INIS)

    Ohtaki, Yuka; Chikamori, Taishiro; Hida, Satoshi; Tanaka, Hirokazu; Igarashi, Yuko; Hatano, Tsuguhisa; Usui, Yasuhiro; Miyagi, Manabu; Yamashina, Akira

    2010-01-01

    Although ischemic electrocardiographic (ECG) changes during dipyridamole or adenosine infusion have been reported as a marker for severe coronary artery disease (CAD), few studies have focused on ST-segment changes with adenosine triphosphate (ATP)-loading myocardial single-photon emission computed tomography (SPECT). Between January 2003 and August 2008, 4650 consecutive patients underwent ATP-loading SPECT. After 1412 patients with left bundle branch block, pacemaker rhythm, or previous coronary revascularization were excluded, 16 out of 3238 patients (0.5%) showed ischemic ST-segment depression during ATP-loading myocardial SPECT. They were aged 67±11 years; 10 were men and 6 women. Of these patients, 8 demonstrated perfusion abnormalities, whereas the remaining 8 showed normal myocardial perfusion imaging. In 6 of the 8 patients with abnormal SPECT, coronary angiography was performed, revealing left main trunk disease in 1 patient, 3-vessel disease in 4, 1-vessel disease with proximal left ascending artery occlusion in 1, and an insignificant lesion in 1. By contrast, no major cardiac event was observed in the 8 patients with normal SPECT during follow-up for an average of 2 years. The prevalence of ischemic ST-segment changes during ATP loading is very rare. However, this finding should be taken into account since almost half of the patients, particularly those with perfusion abnormalities, may have severe CAD which requires coronary revascularization. (author)

  19. Twelve recommendations for integrating existing systematic reviews into new reviews: EPC guidance.

    Science.gov (United States)

    Robinson, Karen A; Chou, Roger; Berkman, Nancy D; Newberry, Sydne J; Fu, Rongwei; Hartling, Lisa; Dryden, Donna; Butler, Mary; Foisy, Michelle; Anderson, Johanna; Motu'apuaka, Makalapua; Relevo, Rose; Guise, Jeanne-Marie; Chang, Stephanie

    2016-02-01

    As time and cost constraints in the conduct of systematic reviews increase, the need to consider the use of existing systematic reviews also increases. We developed guidance on the integration of systematic reviews into new reviews. A workgroup of methodologists from Evidence-based Practice Centers developed consensus-based recommendations. Discussions were informed by a literature scan and by interviews with organizations that conduct systematic reviews. Twelve recommendations were developed addressing selecting reviews, assessing risk of bias, qualitative and quantitative synthesis, and summarizing and assessing body of evidence. We provide preliminary guidance for an efficient and unbiased approach to integrating existing systematic reviews with primary studies in a new review. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Cognitive behavioral group therapy in panic disorder patients: the efficacy of CBGT versus drug treatment.

    Science.gov (United States)

    Dannon, Pinhas N; Gon-Usishkin, M; Gelbert, A; Lowengrub, K; Grunhaus, L

    2004-01-01

    The aim of our study was to evaluate the effectiveness of Cognitive Behavioral Group Therapy (CBGT) in the treatment of Panic Disorder (PD) and to compare the treatment outcome of CBGT versus Paroxetine pharmacotherapy. Fifty seven patients referred to our anxiety disorder clinic for the treatment of PD were randomly allocated to receive either CBGT or Paroxetine. Follow up was done by a masked rater after four and twelve weeks of treatment in order to compare the efficacy of CBGT versus Paroxetine. CBGT and Paroxetine were both effective in the short-term treatment of PD. Assessments at weeks four and twelve of treatment showed no statistically significant differences between the two groups in terms of treatment outcome. Treatment with CBGT alone for the acute phase of PD appears to be equally efficacious to treatment with Paroxetine alone. Our study shows that CBGT produced beneficial results, for it was associated with a reduction in the number and frequency of panic attacks and with an improved feeling of well-being.

  1. Twelve-Year Trends of PM10 and Visibility in the Hefei Metropolitan Area of China

    Directory of Open Access Journals (Sweden)

    Lin Huang

    2016-01-01

    Full Text Available China has been experiencing severe air pollution and previous studies have mostly focused on megacities and a few hot spot regions. Hefei, the provincial capital city of Anhui province, has a population of near 5 million in its metropolitan area, but its air quality has not been reported in literature. In this study, daily PM10 and visibility data in 2001–2012 were analyzed to investigate the air quality status as well as the twelve-year pollution trends in Hefei. The results reveal that Hefei has been suffering high PM10 pollution and low visibility during the study period. The annual average PM10 concentrations are 2~3 times of the Chinese Ambient Air Quality Standard. PM10 shows fluctuating variation in 2001–2007 and has a slightly decreasing trend after 2008. The annual average visibility range is generally lower than 7 km and shows a worsening trend from 2001 to 2006 followed by an improving trend from 2007 to 2012. Wind speed, precipitation, and relative humidity have negative effects on PM10 concentrations in Hefei, while temperature could positively or negatively affect PM10. The results provide a general understanding of the status and long-term trends of PM10 pollution and visibility in a typical second-tier city in China.

  2. Visual evoked potentials show strong positive association with intracranial pressure in patients with cryptococcal meningitis

    Directory of Open Access Journals (Sweden)

    Marcelo Adriano da Cunha Silva Vieira

    2015-04-01

    Full Text Available Objective : To verify the relationship between intracranial pressure and flash visual evoked potentials (F-VEP in patients with cryptococcal meningitis. Method The sample included adults diagnosed with cryptococcal meningitis admitted at a reference hospital for infectious diseases. The patients were subjected to F-VEP tests shortly before lumbar puncture. The Pearson’s linear correlation coefficient was calculated and the linear regression analysis was performed. Results : Eighteen individuals were subjected to a total of 69 lumbar punctures preceded by F-VEP tests. At the first lumbar puncture performed in each patient, N2 latency exhibited a strong positive correlation with intracranial pressure (r = 0.83; CI = 0.60 - 0.94; p < 0.0001. The direction of this relationship was maintained in subsequent punctures. Conclusion : The intracranial pressure measured by spinal tap manometry showed strong positive association with the N2 latency F-VEP in patients with cryptococcal meningitis.

  3. [Long-term clinical course of sequelae in patients with neonatal anoxic encephalopathy resulting in profound mental retardation and motor disturbance].

    Science.gov (United States)

    Ishizaki, A; Kubota, M; Fueki, N; Shinozaki, M; Kurata, K; Takei, M; Sakamoto, K

    1993-01-01

    A long-term observation has been made in 58 patients (30 males and 28 females) with severe sequelae of neonatal anoxic encephalopathy. They aged from 8 months to 65 years. All of them had motor disturbances and profound mental retardation. Motor function was improved in 4 patients with aging. In contrast, motor activity deteriorated in 11 cases, of which 4 showed a mental regression. Among them, patients who had originally better motor ability than sitting were likely to deteriorate by uncontrollable epilepsy and/or excessive administration of anticonvulsants. Regression of the patients with worse motor ability like bedridden appeared to attributable hypertonia of muscles and bodily deformation. Fifteen cases showed an exacerbation of general condition which originated predominantly to respiratory distress. Twelve patients died including 6 exacerbated cases. Exacerbation or death may have occurred frequently in specific periods of infancy, adolescence and youth with the patients who showed very low motor function such as bedridden and no locomotion.

  4. Twelve massless flavors and three colors below the conformal window

    International Nuclear Information System (INIS)

    Fodor, Zoltan; Holland, Kieran; Kuti, Julius; Nogradi, Daniel; Schroeder, Chris

    2011-01-01

    We report new results for a frequently discussed gauge theory with twelve fermion flavors in the fundamental representation of the SU(3) color gauge group. The model, controversial with respect to its conformality, is important in non-perturbative studies searching for a viable composite Higgs mechanism beyond the Standard Model (BSM). In comparison with earlier work, our new simulations apply larger volumes and probe deeper in fermion and pion masses toward the chiral limit. Investigating the controversy, we subject the model to opposite hypotheses with respect to the conformal window. In the first hypothesis, below the conformal window, we test chiral symmetry breaking (χSB) with its Goldstone spectrum, F π , the χSB condensate, and several composite hadron states as analytic functions of the fermion mass when varied in a limited range with our best effort to control finite volume effects. In the second test, for the alternate hypothesis inside the conformal window, we probe conformal behavior driven by a single anomalous mass dimension under the assumption of unbroken chiral symmetry at vanishing fermion mass. Our results at fixed gauge coupling, based on the assumptions of the two hypotheses we define, show low level of confidence in the conformal scenario with leading order scaling analysis. Relaxing the important assumption of leading mass-deformed conformality with its conformal finite size scaling would require added theoretical understanding of the scaling violation terms in the conformal analysis and a comprehensive test of its effects on the confidence level of the fits. Results for the running coupling, based on the force between static sources, and preliminary indications for the finite temperature transition are also presented. Staggered lattice fermions with stout-suppressed taste breaking are used throughout the simulations.

  5. Acute porphyrias: clinical spectrum of hodpitalized patients

    International Nuclear Information System (INIS)

    Sheerani, M.; Urfy, M.Z.; Shahid, B.; Hassan, A.

    2007-01-01

    To determine characteristics, clinical features and triggers of acute porphyria in hospitalized patients presenting to a tertiary care center in Pakistan. Case records of 26 patients hospitalized with diagnosis were identified through computerized hospital patients data. The diagnosis of acute porphyria was based on pertinent clinical features and laboratory investigations after exclusion of other alternative diagnosis and patients previously diagnosed as porphyric. The data was analyzed through SPSS software version 11.0. Twelve patients (46.2%) were males. Mean age was 21 years. Most common manifestation were gastrointestinal (n=22; 88.5%) followed by neurological symptoms (n=14; 54%). Neurological manifestations included seizures (n=9; 34.6%) and neuropathy (n=6; 23%). One patient presented with depression and insomnia. Family history was positive in (n=8; 30.8%). Eighteen (69%) had history of previous attacks at their presentation to the hospital. Most common precipitating factor was eating outside (n=18; 69%). Porphyrias are uncommon and cryptic group of diseases. This study shows a slightly different gender distribution, earlier onset of symptoms, higher number of neuropsychiatric symptoms (especially seizures), more distal neuropathies and different precipitant in the studied subset of patients than described previously in the western studies. (author)

  6. Progressive resistance training in head and neck cancer patients undergoing concomitant chemoradiotherapy

    DEFF Research Database (Denmark)

    Lonkvist, Camilla K; Vinther, Anders; Zerahn, Bo

    2017-01-01

    was feasibility measured as attendance to training sessions. Secondary endpoints included changes in functional performance, muscle strength, and body composition measured by Dual-energy X-ray Absorptiometry (DXA) scans. Furthermore, sarcomeric protein content, pentose phosphate pathway (PPP) activity......, and glycolysis were determined in muscle biopsies. Results: Twelve patients with p16 positive oropharyngeal cancer were enrolled. The primary endpoint was met with 9 of the 12 patients completing at least 25 of 36 planned training sessions. The mean attendance rate was 77%. Functional performance was maintained...... resistance training (PRT) program during CCRT is feasible in the clinical setting before planning initiation of a larger randomized study which is the long-term goal. Study design: Prospective pilot study. Methods: Twelve patients receiving CCRT were planned to attend a 12-week PRT program. Primary endpoint...

  7. Relationship Between Plasma Homocystein Levels and Polyneuropaty in Patients Using Levodopa For Idiopathic Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Mithat Bedir

    2012-06-01

    Full Text Available Objective: Recent studies showed high plasma homocysteine levels in patients treated with Levodopa for Parkinson’s disease (PD. Homocysteine, due to its exotoxic effect, might be the cause of polyneuropathy seen in PD. In this study, our aim was to show the correlation between high concentration of plasma homocysteine levels and polyneuropathy associated with PD.. Material and Methods: Forty-one patients with PD receiving levodopa treatment (patient group and 30 healthy subjects (control group were included in this study. We compared the two groups in terms of electrophysiological findings. Twelve patients had high plasma homocysteine levels and 29 of them had low plasma homocysteine levels. Results: Six of the 41 patients had sensorial polyneuropathy and decreased compound muscle action potantiel amplitude compared to controls. Two patients had high plasma homocysteine levels, two patients had nearly high plasma homocysteine levels, two patients had low plasma homocysteine levels who had sensorial polyneuropathy. Conclusion: Although in our study, we did not show any correlation between polyneuropathy and high plasma homocysteine levels, further studies including homogeneous groups of younger patients with PD are needed. (The Me di cal Bul - le tin of Ha se ki 2012; 50: 53-8

  8. Prospective study on 12 patients of salivary glands radiotherapy as treatment of salivary stasis in patients suffering from amyotrophic lateral sclerosis; etude prospective sur 12 patients de radiotherapie des glandes salivaires comme traitement de la stase salivaire chez des patients atteints de sclerose laterale amyotrophique

    Energy Technology Data Exchange (ETDEWEB)

    Assouline, A.; Delanian, S. [Oncologie radiotherapie, centre clinique de la Porte-de-Saint-Cloud, Boulogne (France); Lenglet, T.; Bruneteau, G.; Le Forestier, N.; Salachas, F.; Lebouteux, M.; Abdelnour, M.; Meininger, V.; Pradat, P.F. [Departement des maladies du systeme nerveux, groupe hospitalier Pitie-Salpetriere, AP-HP, Paris (France)

    2011-10-15

    The authors report a study which aimed at assessing the efficiency and tolerance of salivary gland radiotherapy in patients suffering from amyotrophic lateral sclerosis. Twelve patients have been treated by conformational irradiation after a planning scanography with support mask. Results are discussed in terms of salivary discomfort (almost immediate disappearance in 11 cases), and other minor effects. Although a greater number of patients is still needed, the treatment gives promising results. Short communication

  9. Effects of cisapride on colonic transit in patients with progressive systemic sclerosis

    International Nuclear Information System (INIS)

    Wang, S.J.; Lin, W.Y.; Lan, J.L.; Chen, D.Y.; Chen, Y.H.; Hsieh, T.Y.

    2002-01-01

    Progressive systemic sclerosis (PSS) may involve any portion of the gastrointestinal tract including the colon. Constipation is common in patients with PSS. Cisapride, a benzamide derivative, is a potentially useful agent in the treatment if chronic idiopathic constipation. The effect of cisapride on colonic transit was evaluated in 16 PSS patients by radionuclide colonic transit method. Static images were acquired at regular times, then the geometric center (GC) values were calculated. Each patient received cisapride orally three times a day for a week. The median GC at 4 hours was 0.351 in patients before treatment and 0.775 after treatment. The difference is significant with a p value of 0.026. The median GC at 24 hours was 1.957 in patients before treatment and significantly increased to 2.509 after treatment. The p value was 0.038. Clinically, twelve patients had symptoms of constipation and 8 of them showed improvement of the symptoms after administration of cisapride. The result showed acceleration in colonic transit in response to cisapride. We conclude that cisapride is effective in the treatment of constipation in patients with PSS

  10. Wall motion index, estimated glomerular filtration rate and mortality risk in patients with heart failure or myocardial infarction: a pooled analysis of 18,010 patients

    DEFF Research Database (Denmark)

    Schou, Morten; Torp-Pedersen, Christian; Gustafsson, Finn

    2008-01-01

    screening registers (N=18,010) including patients admitted with HF or MI. Ten years follow-up was recorded and formal testing for interactions between eGFR and LVEF with respect to outcome was done. RESULTS: Twelve-thousand-and-ninety patients died. A significant interaction (P=0.010) was found and each...

  11. PDT in periodontal disease of HAART resistance patients

    Science.gov (United States)

    Giovani, Elcio M.; Noro-Filho, Gilberto A.; Caputo, Bruno V.; Casarin, Renato; Costa, Claudio; Salgado, Daniela; Santos, Camila C.

    2016-03-01

    HIV/Aids patients present a change of microbiota associated with host immunodeficiency. Photodynamic therapy (PDT) showed as a promising and viable alternative in reducing microbiota. Present study evaluate effectiveness of photodynamic therapy in periodontal disease of AIDS patients with highly activity antiretroviral therapy (HAART) failure, measuring the clinical periodontal parameters and periodontal microbiota. Twelve patients with HARRT resistance (R group) divided into two groups (control and PDT) and 12 patients with no HAART resistance (NR group) divided into two groups (control and PDT). The results show the difference in baseline of CD4 cells count, NR group 640.0 +/- 176.2 cells/mm3 R group and 333.3 +/- 205.8 cells / mm3 (pperiodontal parameters (PD and CAL), PDT was more effective than the control group only in the NR group (p periodontal parameters between the both R groups (p>0.05%). Microbiological evaluation in R group presents a general reduction in the Aa at 3 and 6 months. Furthermore, demonstrated a reduction of Pg in all groups at 6 months and in R group at 3 months. The impact assessment of photodynamic therapy in patients with different levels of immunosuppression determined that the combination of mechanical periodontal treatment with photodynamic therapy in patients with HAART failure did not cause additional benefits. Therefore, PDT in this study could not been indicated in HAART resistance patients.

  12. Patient experience shows little relationship with hospital quality management strategies.

    NARCIS (Netherlands)

    Groene, O.; Arah, O.A.; Klazinga, N.S.; Wagner, C.; Bartels, P.D.; Kristensen, S.; Saillour, F.; Thompson, C.A.; Pfaff, H.; DerSarkissian, M.; Suñol, R.

    2015-01-01

    Objectives: Patient-reported experience measures are increasingly being used to routinely monitor the quality of care. With the increasing attention on such measures, hospital managers seek ways to systematically improve patient experience across hospital departments, in particular where outcomes

  13. Patient Experience Shows Little Relationship with Hospital Quality Management Strategies

    NARCIS (Netherlands)

    Groene, Oliver; Arah, Onyebuchi A.; Klazinga, Niek S.; Wagner, Cordula; Bartels, Paul D.; Kristensen, Solvejg; Saillour, Florence; Thompson, Andrew; Thompson, Caroline A.; Pfaff, Holger; Dersarkissian, Maral; Sunol, Rosa

    2015-01-01

    Patient-reported experience measures are increasingly being used to routinely monitor the quality of care. With the increasing attention on such measures, hospital managers seek ways to systematically improve patient experience across hospital departments, in particular where outcomes are used for

  14. Risk assessment of K basin twelve-inch drain valve failure from a postulated seismic initiating event

    International Nuclear Information System (INIS)

    MORGAN, R.G.

    1999-01-01

    The Spent Nuclear Fuel (SNF) Project will transfer metallic SNF from the Hanford 105 K-East and 105 K-West Basins to safe interim storage in the Canister Storage Building in the 200 Area. The initial basis for design, fabrication, installation, and operation of the fuel removal systems was that the basin leak rates which could result from a postulated accident condition would not be excessive relative to reasonable recovery operations. However, an additional potential K Basin water leak path is through the K Basin drain valves. Three twelve-inch drain valves are located in the main basin bays along the north wall. The sumps containing the valves are filled with concrete which covers the drain valve body. Visual observations suggest that only the valve's bonnet and stem are exposed above the basin concrete floor. It was recognized, however, that damage of the drain valve bonnet or stem during a seismic initiating event could provide a potential K Basin water leak path. The objectives of this activity are to: (1) evaluate the risk of damaging the three twelve-inch drain valves located along the north wall of the main basin from a seismic initiating event, and (2) determine the associated potential leak rate from a damaged valve

  15. Risk assessment of K basin twelve-inch drain valve failure from a postulated seismic initiating event

    Energy Technology Data Exchange (ETDEWEB)

    MORGAN, R.G.

    1999-04-06

    The Spent Nuclear Fuel (SNF) Project will transfer metallic SNF from the Hanford 105 K-East and 105 K-West Basins to safe interim storage in the Canister Storage Building in the 200 Area. The initial basis for design, fabrication, installation, and operation of the fuel removal systems was that the basin leak rates which could result from a postulated accident condition would not be excessive relative to reasonable recovery operations. However, an additional potential K Basin water leak path is through the K Basin drain valves. Three twelve-inch drain valves are located in the main basin bays along the north wall. The sumps containing the valves are filled with concrete which covers the drain valve body. Visual observations suggest that only the valve's bonnet and stem are exposed above the basin concrete floor. It was recognized, however, that damage of the drain valve bonnet or stem during a seismic initiating event could provide a potential K Basin water leak path. The objectives of this activity are to: (1) evaluate the risk of damaging the three twelve-inch drain valves located along the north wall of the main basin from a seismic initiating event, and (2) determine the associated potential leak rate from a damaged valve.

  16. Superficial femoral artery TASC D Registry: twelve-month effectiveness analysis of the Pulsar-18 SE nitinol stent in patients with critical limb ischemia.

    Science.gov (United States)

    Lichtenberg, M; Stahlhoff, W; Boese, D

    2013-08-01

    Single center observational study analyzing the primary patency rate and freedom from target lesions revascularization rate of the Pulsar-18 nitinol stent after recanalization of long superficial femoral artery (SFA) occlusions (TASC D) in 22 patients with critical limb ischemia (CLI). Between 1/2011 and 7/2011, 22 consecutive patients (9 male, 13 female) with chronic total occlusions (CTO) of the femoro-popliteal arteries presenting with CLI (17 patients with Rutherford 4 score, and 5 patients with Rutherford 5 score) were enrolled and successfully recanalized using the Pulsar-18 self-expanding (SE) nitinol stent (BIOTRONIK AG, Buelach, Switzerland). Primary patency at 12 months was defined as no binary restenosis (>50%) on Duplex ultrasound (PSVRPulsar-18 SE nitinol stent was 77% with a per protocol restenosis in 5 of 22 patients. Seventeen patients showed a walking capacity on treadmill test >300 meters (Rutherford II). Two patients with a documented restenosis were Rutherford, these patients were treated conservatively. Three patients with restenosis and a Rutherford III score were scheduled for an endovascular target lesion revascularization leading to a freedom from target lesion revascularization rate of 86%. Endovascular intervention of long SFA occlusions using subintimal or intraluminal recanalization technique with implantation of the Pulsar-18 SE nitinol stent in CLI patients is safe and clinically effective with a primary patency rate after 12 months of 77% and a freedom from target lesion revascularization rate of 86%.

  17. Prospective study on 12 patients of salivary glands radiotherapy as treatment of salivary stasis in patients suffering from amyotrophic lateral sclerosis

    International Nuclear Information System (INIS)

    Assouline, A.; Delanian, S.; Lenglet, T.; Bruneteau, G.; Le Forestier, N.; Salachas, F.; Lebouteux, M.; Abdelnour, M.; Meininger, V.; Pradat, P.F.

    2011-01-01

    The authors report a study which aimed at assessing the efficiency and tolerance of salivary gland radiotherapy in patients suffering from amyotrophic lateral sclerosis. Twelve patients have been treated by conformational irradiation after a planning scanography with support mask. Results are discussed in terms of salivary discomfort (almost immediate disappearance in 11 cases), and other minor effects. Although a greater number of patients is still needed, the treatment gives promising results. Short communication

  18. Oxidative stress and body composition in prostate cancer and benign prostatic hyperplasia patients.

    Science.gov (United States)

    Cimino, Sebastiano; Favilla, Vincenzo; Russo, Giorgio Ivan; Galvano, Fabio; Li Volti, Giovanni; Barbagallo, Ignazio; Giofrè, Salvatore Vincenzo; D'Orazio, Nicolantonio; DI Rosa, Alessandro; Madonia, Massimo; Morgia, Giuseppe

    2014-09-01

    To investigate the role of body composition and oxidative stress measured by total thiol groups (TTG) levels in prostate specimens of patients affected by benign prostatic hyperplasia (BPH) or prostate cancer (PCa). From January 2011 to January 2013, a cohort of 150 consecutive male patients who underwent first prostate biopsy were enrolled. Twelve-core needle biopsy was performed as standard procedure, while twelve more needle tissue cores matched with the previous group were also collected for glutathione determination. After definitive diagnosis, measurement of glutathione was performed in the correspondent one matched prostatic sample where PCa or BPH were identified. A day after the prostatic biopsy, body composition was estimated by air plethysmography (BOD POD®). A significant difference of TTG was observed in BPH and PCa patients; 34 nanomole (nmol) reagent sulfihydrylc (RSH)/ mg protein vs. 1.1 nmol RSH/ mg protein respectively (p<0.05). In BPH patients, a negative correlation was found between TTG and age (r=-0.46; p<0.05), while, in PCa patients, a positive correlation was observed between TTG and fat mass (FM) (r=0.76; p<0.01) and waist circumference (WC) (r=0.49; p<0.05). Multivariate linear regression analysis showed TTG to be negatively associated with age (β-coefficient=-0.4; p<0.05) in BPH patients and positively with FM (β-coefficient=3.4; p<0.01) and WC (β-coefficient=2.7; p<0.05) in PCa patients. Aging determines a progressive reduction of TTG in BPH patients, while in PCa subjects glutathione concentrations are significantly lower and FM and WC are associated with an unbalance of its levels. Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  19. THE ELM SURVEY. II. TWELVE BINARY WHITE DWARF MERGER SYSTEMS

    International Nuclear Information System (INIS)

    Kilic, Mukremin; Brown, Warren R.; Kenyon, S. J.; Prieto, Carlos Allende; Agueeros, M. A.; Heinke, Craig

    2011-01-01

    We describe new radial velocity and X-ray observations of extremely low-mass white dwarfs (ELM WDs, ∼0.2 M sun ) in the Sloan Digital Sky Survey Data Release 4 and the MMT Hypervelocity Star survey. We identify four new short period binaries, including two merger systems. These observations bring the total number of short period binary systems identified in our survey to 20. No main-sequence or neutron star companions are visible in the available optical photometry, radio, and X-ray data. Thus, the companions are most likely WDs. Twelve of these systems will merge within a Hubble time due to gravitational wave radiation. We have now tripled the number of known merging WD systems. We discuss the characteristics of this merger sample and potential links to underluminous supernovae, extreme helium stars, AM CVn systems, and other merger products. We provide new observational tests of the WD mass-period distribution and cooling models for ELM WDs. We also find evidence for a new formation channel for single low-mass WDs through binary mergers of two lower mass objects.

  20. Prostate cancer patient subsets showing improved bNED control with adjuvant androgen deprivation

    International Nuclear Information System (INIS)

    Anderson, Penny R.; Hanlon, Alexandra L.; Movsas, Benjamin; Hanks, Gerald E.

    1997-01-01

    Purpose: Cooperative groups have investigated the outcome of androgen deprivation therapy combined with radiation therapy in prostate cancer patients with variable pretreatment prognostic indicators. This report describes an objective means of selecting patients for adjuvant hormonal therapy by a retrospective matched case/control comparison of outcome between patients with specific pretreatment characteristics who receive adjuvant hormones (RT + H) vs. patients with identical pretreatment characteristics treated with radiation therapy alone (RT). In addition, this report shows the 5-year bNED control for patients selected by this method for RT + H vs. RT alone. Methods and Materials: From (10(88)) to (12(93)), 517 T1-T3 NXM0 patients with known pretreatment PSA level were treated at Fox Chase Cancer Center. Four hundred fifty-nine of those patients were treated with RT alone while 58 were treated with RT + H. The patients were categorized according to putative prognostic factors indicative of bNED control, which include the palpation stage, Gleason score, and pretreatment PSA. We compared actuarial bNED control rates according to treatment group within each of the prognostic groups. In addition, we devised a retrospective matched case/control selection of RT patients for comparison with the RT + H group. Five-year bNED control was compared for the two treatment groups, excluding the best prognosis group, using 56 RT + H patients and 56 matched (by stage, grade, and pretreatment PSA level) controls randomly selected from the RT alone group. bNED control for the entire group of 517 patients was then analyzed multivariately using step-wise Cox regression to determine independent predictors of outcome. Covariates considered for entry into the model included stage (T1/T2AB vs. T2C/T3), grade (2-6 vs. 7-10), pretreatment PSA (0-15 vs. > 15), treatment (RT vs. RT + H), and center of prostate dose. bNED failure is defined as PSA ≥1.5 ngm/ml and rising on two consecutive

  1. Twelve Tips for teaching medical professionalism at all levels of medical education.

    Science.gov (United States)

    Al-Eraky, Mohamed Mostafa

    2015-01-01

    Review of studies published in medical education journals over the last decade reveals that teaching medical professionalism is essential, yet challenging. According to a recent Best Evidence in Medical Education (BEME) guide, there is no consensus on a theoretical or practical model to integrate the teaching of professionalism into medical education. The aim of this article is to outline a practical manual for teaching professionalism at all levels of medical education. Drawing from research literature and author's experience, Twelve Tips are listed and organised in four clusters with relevance to (1) the context, (2) the teachers, (3) the curriculum, and (4) the networking. With a better understanding of the guiding educational principles for teaching medical professionalism, medical educators will be able to teach one of the most challenging constructs in medical education.

  2. Effects of vaginal progesterone on pain and uterine contractility in patients with threatened abortion before twelve weeks of pregnancy.

    Science.gov (United States)

    Palagiano, A; Bulletti, C; Pace, M C; DE Ziegler, D; Cicinelli, E; Izzo, A

    2004-12-01

    Fifty women with previous diagnosis of inadequate luteal phase and threatened abortion underwent a prospective, randomized, double-blind study in one medical center carried out with a parallel trial. The primary objective was to establish the effects of vaginal progesterone (Crinone 8%) in reducing both pain and uterine contractions (UCs). The gel with or without (placebo) vaginal progesterone was administered once a day since the diagnosis of threatened abortion and for 5 days. The efficacy on pain symptom amelioration was evaluated by a 5-score intensity gradation, while the UCs were evaluated by ultrasound. The secondary objective of the study was to evaluate the outcome of the pregnancies. The use of progesterone was effective both on pain relief and on the frequency of the UCs that decreased after 5 days of vaginal progesterone administration (P pregnancy and spontaneous abortion in both study groups after 60 days showed that 4 patients of group A and 8 patients of group B miscarried (P threatened abortion benefit from vaginal progesterone by a reduction of UCs and pain. The use of vaginal progesterone improved the outcome of pregnancies complicated by threatened abortion and previous diagnosis of inadequate luteal phase.

  3. Usefulness of dipyridamole stress myocardial imaging in patients who have exercise limitations due to various orthopedic disorders

    International Nuclear Information System (INIS)

    Tagawa, Hirofumi; Ashihara, Toshiaki; Fukuyama, Takaya; Matsui, Kanji; Yamamoto, Sumiki; Yamamoto, Susumu

    1994-01-01

    To evaluate the presence of coronary artery disease in patients unable to exercise adequately because of chronic rheumatoid arthritis, osteoarthritis, hip bone fractures or disk herniation, we performed dipyridamole-stress thallium-201 myocardial imaging in thirty-three patients. Twelve of the 33 patients showed perfusion defect and redistribution by thallium imaging. Coronary angiography was performed in 9 patients out of these 12 dipyridamole-positive patients and significant coronary artery stenosis was detected in 7 of them (78%). Due to these results of dipyridamole-imaging and coronary angiograms, surgical intervention for the underlying bone or joint disorder was performed under cardioprotective strategy in 15 patients, in which no cardiovascular events occurred. Thus, dipyridamole-stress myocardial imaging is a satisfactory alternative to the exercise test for detecting coronary artery disease in patients with bone or joint disorders. (author)

  4. Twelve-year history of late-life depression and subsequent feelings to God.

    Science.gov (United States)

    Braam, Arjan W; Schaap-Jonker, Hanneke; van der Horst, Marleen H L; Steunenberg, Bas; Beekman, Aartjan T F; van Tilburg, Willem; Deeg, Dorly J H

    2014-11-01

    Growing evidence shows several possible relations between religiousness and late-life depression. Emotional aspects of religiousness such as facets of the perceived relationship with God can be crucial in this connection. The aim of the current study was to examine the association between the course of late-life depression and feelings about God and religious coping. Longitudinal survey study; naturalistic; 12-year follow-up. Longitudinal Aging Study Amsterdam; population-based, in three regions in The Netherlands. A subsample of 343 respondents (mean age: 77.2 years), including all respondents with high levels of depressive symptoms at any measurement cycle between 1992 and 2003 (assessed by using the Center for Epidemiologic Studies Depression Scale and the Diagnostic Interview Schedule) and a random sample of nondepressed respondents who completed a postal questionnaire in 2005. Scales on God Image and Religious Coping. Twelve-year depression course trajectories serve as predicting variables and are specified according to recency and seriousness. Persistent and emergent depression are significantly associated with fear of God, feeling wronged by God, and negative religious coping. In terms of negative religious coping, significant associations were observed after adjustment for concurrent depression with a history of repeated minor depression and previous major depression. Late-life depression seems to maintain a pervasive relationship over time with affective aspects of religiousness. Religious feelings may parallel the symptoms of anhedonia or a dysphoric mood and could represent the experience of an existential void. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  5. Effect of the composition of extra virgin olive oils on the differentiation and antioxidant capacities of twelve monovarietals.

    Science.gov (United States)

    Fuentes, Edwar; Paucar, Fiorela; Tapia, Francisco; Ortiz, Jaime; Jimenez, Paula; Romero, Nalda

    2018-03-15

    The effect of the composition of twelve varieties of extra virgin olive oils (EVOOs) on their differentiation based in agronomic criteria and on the antioxidant capacity was studied. Principal component analysis permitted an overview of the samples and their compositions, showing evidence of grouping and correlation between antioxidant capacity, oleuropein and ligstroside derivatives (OLD) and specific extinction at 270. Oleic and linoleic acids, 3,4-DHPEA-EA and p-HPEA-EDA (OLD), unsaturated/saturated ratio and induction time (IT) allowed the correct classification of samples according to year of harvest, ripening stage and variety. The antioxidant capacity of EVOOs was satisfactory predicted through a partial least square model based on ΔK, hydroxytyrosol, pinoresinol, oleuropein derivate and IT. Validation of the model gave a correlation R>0.83 and an error of 7% for independent samples. This model could be a useful tool for the olive industry to highlight the nutritional quality of EVOOs and improve their marketing. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Bright ideas: Twelve steps to break our energy addiction - with technologies and policy options that are available today

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-12-31

    The deleterious effects of excessive energy use, the effects of climate change and Canadian commitments under the Kyoto Protocol are discussed. The discussion takes the form of a series of recommendations to show that contrary to skeptics, it is possible to achieve our Kyoto commitments and even exceed them, with technology already at our disposal. A series of twelve recommendations are made, each recommendation accompanied by a brief discussion of its major virtues and contributions to a more sustainable energy future. The recommendations are: (1) reward efficiency and responsibility; (2) set mandatory efficiency targets for industry; (3) build more efficient and livable cities; (4) impose fuel efficiency standards; (5) increase funding for public transportation; (6) improve freight transportation; (7) adopt energy-efficient building code standards for new buildings; (8) introduce a national retrofit program for existing buildings; (9) set higher efficiency standards for appliances; (10) support the renewable energy industry; (11) reduce demand for electric power; and (12) implement a renewable portfolio standard.

  7. Neuromusculoskeletal disorders in patients with Type 2 diabetes ...

    African Journals Online (AJOL)

    Usual line of management of diabetes patients is drug and diet with their physical needs usually receiving minimal attention. Among the physical needs, requiring attention is their neuromusculoskeletal disorders. This study was designed to investigate the effect of a twelve-week therapeutic exercise on ...

  8. Case report of a young stroke patient showing interim normalization of the MRI diffusion-weighted imaging lesion

    International Nuclear Information System (INIS)

    Ostwaldt, Ann-Christin; Usnich, Tatiana; Nolte, Christian H.; Villringer, Kersten; Fiebach, Jochen B.

    2015-01-01

    In acute ischemic stroke, diffusion weighted imaging (DWI) shows hyperintensities and is considered to indicate irreversibly damaged tissue. We present the case of a young stroke patient with unusual variability in the development of signal intensities within the same vessel territory. A 35-year-old patient presented with symptoms of global aphasia and hypesthesia of the left hand. MRI demonstrated a scattered lesion in the MCA territory. After rtPA therapy the patient received further MRI examination, three times on day 1, and once on day 2, 3, 5 and 43. The posterior part of the lesion showed the usual pattern with increasing DWI hyperintensity and decreased ADC, as well as delayed FLAIR positivity. However, the anterior part of the lesion, which was clearly visible in the first examination completely normalized on the first day and only reappeared on day 2. This was accompanied by a normalization of the ADC as well as an even further delayed FLAIR positivity. We showed that interim normalization of DWI and ADC in the acute phase can not only be found in rodent models of stroke, but also in humans. We propose that DWI lesion development might be more variable during the first 24 h after stroke than previously assumed

  9. The poetics of comic in the «The Twelve Chairs» novel (to the problem of a funny word

    Directory of Open Access Journals (Sweden)

    Kildyaeva Yu.I.

    2017-05-01

    Full Text Available the article deals with the role of a funny word in the comic structure of «The Twelve Chairs» by I. Ilf and E. Petrov. The researcher reveals its different functions taking into account authors’ strategy, directed to the creation of a special type of comic.

  10. Comparative analysis of family poultry production in twelve African countries

    International Nuclear Information System (INIS)

    Goodger, W.J.; Bennett, T.B.; Dwinger, R.H.

    2002-01-01

    The purpose of the research was to conduct a survey on family poultry to obtain information on disease prevalence, feeding practices, and the management of poultry housing in twelve African countries. The survey data were collected during both the wet and dry seasons and summarised (average and standard deviation) by country, village/region, season, and survey question. The disease data results show that three (greenish/bloody diarrhoea, swollen head, and coughing) of top four reported symptoms are part of Newcastle disease's presenting signs. Chick mortality was also higher in the wet season, when there is a higher incidence of Newcastle disease. This was also supported by the individual country data in that those countries with high chick mortality data also had low hatchability in the wet season with Egypt being the only exception. The types of housing used for shelter for family poultry was quite variable and presented a challenge to determine the level of cleaning/sanitation to assist in controlling Newcastle disease. On the one hand, a large percentage of households reported never cleaning the poultry house (e.g., Cameroon, Morocco, Mauritius, and Sudan). On the other hand, 34% of the responses to housing type were either trees or other forms of housing that would be difficult to clean i.e., old car, fence, surrounding wall, etc. Obviously, these results should be closely examined when instituting control programs for Newcastle disease. The large variety of available scavenged feed without any data on intake raises the question of how to balance the ration for the flock. Family poultry scientists need to determine a method to estimate intake which could assist in determining what supplementary feed is necessary if any. This challenge may be one of the most important aspects to family poultry management because of the importance of nutrition to poultry production with the added difficulty of providing balanced nutrition in an extensive system. (author)

  11. Initial post marketing experience with lacosamide in adult patients with epilepsy.

    Science.gov (United States)

    Harden, Cynthia L; Cohn, Aaron; Lowe, Merredith; Serrano, Enrique

    2012-02-01

    The outcomes of adult epilepsy patients prescribed lacosamide for additional seizure control. Responders were defined as having at least a 50% decrease in seizure frequency Sixty-seven patients were evaluated. Forty-six out of 67 patients (69%) were responders. Twelve of 14 patients not taking sodium channel-acting AEDs were responders (86%) and 34/53 patients taking sodium channel-acting AEDs were responders (64%) (difference not significant). Copyright © 2011 Elsevier B.V. All rights reserved.

  12. Ultra-low microcurrent in the management of diabetes mellitus, hypertension and chronic wounds: Report of twelve cases and discussion of mechanism of action

    Science.gov (United States)

    Lee, Bok Y.; AL-Waili, Noori; Stubbs, Dean; Wendell, Keith; Butler, Glenn; AL-Waili, Thia; AL-Waili, Ali

    2010-01-01

    Oxidative stress plays a major role in the pathogenesis of both types of diabetes mellitus and cardiovascular diseases including hypertension. The low levels of antioxidants accompanied by raised levels of markers of free radical damage play a major role in delaying wound healing. Ultra-low microcurrent presumably has an antioxidant effect, and it was shown to accelerate wound healing. The purpose of the study is to investigate the efficacy of ultra-low microcurrent delivered by the Electro Pressure Regeneration Therapy (EPRT) device (EPRT Technologies-USA, Simi Valley, CA) in the management of diabetes, hypertension and chronic wounds. The EPRT device is an electrical device that sends a pulsating stream of electrons in a relatively low concentration throughout the body. The device is noninvasive and delivers electrical currents that mimic the endogenous electric energy of the human body. It is a rechargeable battery-operated device that delivers a direct current (maximum of 3 milliAmperes) of one polarity for 11.5 minutes, which then switched to the opposite polarity for another 11.5 minutes. The resulting cycle time is approximately 23min or 0.000732 Hz and delivers a square wave bipolar current with a voltage ranging from 5V up to a maximum of 40 V. The device produces a current range of 3 mA down to 100 nA. Twelve patients with long standing diabetes, hypertension and unhealed wounds were treated with EPRT. The patients were treated approximately for 3.5 h/day/5 days a week. Assessment of ulcer was based on scale used by National Pressure Ulcer Advisory Panel Consensus Development Conference. Patients were followed-up with daily measurement of blood pressure and blood glucose level, and their requirement for medications was recorded. Treatment continued from 2-4 months according to their response. Results showed that diabetes mellitus and hypertension were well controlled after using this device, and their wounds were markedly healed (30-100%). The patients

  13. Which dimensions of fatigue should be measured in patients with rheumatoid arthritis? A Delphi study

    NARCIS (Netherlands)

    Nikolaus, Stephanie; Bode, Christina; Taal, Erik; van de Laar, Mart A F J

    2012-01-01

    Objective: Rheumatoid arthritis (RA) patients experience fatigue as a multidimensional symptom. The aim of the present study was to use health professionals and patients alike to identify which dimensions of fatigue should be measured in RA. Methods: Twelve fatigue dimensions were constructed, based

  14. A patient with Graves’ disease showing only psychiatric symptoms and negativity for both TSH receptor autoantibody and thyroid stimulating antibody

    Directory of Open Access Journals (Sweden)

    Hamasaki Hidetaka

    2012-12-01

    Full Text Available Abstract Background Both thyroid stimulating hormone (TSH and thyroid stimulating antibody (TSAb negative Graves’s disease (GD is extremely rare. Here we present such a patient. Case presentation The patient was a 76-year-old woman who was diagnosed as having schizophrenia forty years ago. She did not show characteristic symptoms for hyperthyroidism, such as swelling of thyroid, exophthalmos, tachycardia and tremor, however, she showed only psychomotor agitation. Serum free triiodothyronine and free thyroxine levels were elevated and TSH level was suppressed, suggesting the existence of hyperthyroidism. However, both the first generation TSH receptor autoantibody (TRAb1 and the thyroid stimulating autoantibody (TSAb were negative. Slightly increased blood flow and swelling was detected by thyroid echography. Thyroid scintigraphy demonstrated diffuse and remarkably elevated uptake of 123I uptake. Finally, we diagnosed her as having GD. She was treated by using methimazole, and hyperthyroidism and her psychiatric symptoms were promptly ameliorated. Discussion We experienced a patient with GD who did not show characteristic symptoms except for psychiatric symptoms, and also showed negativity for both TRAb1 and TSAb. Thyroid autoantibody-negative GD is extremely rare. Thyroid scintigraphy was useful to diagnose such a patient.

  15. Early microstructural white matter changes in patients with HIV: A diffusion tensor imaging study

    Directory of Open Access Journals (Sweden)

    Stubbe-Drger Bianca

    2012-05-01

    Full Text Available Abstract Background Previous studies have reported white matter (WM brain alterations in asymptomatic patients with human immunodeficiency virus (HIV. Methods We compared diffusion tensor imaging (DTI derived WM fractional anisotropy (FA between HIV-patients with and without mild macroscopic brain lesions determined using standard magnetic resonance imaging (MRI. We furthermore investigated whether WM alterations co-occurred with neurocognitive deficits and depression. We performed structural MRI and DTI for 19 patients and 19 age-matched healthy controls. Regionally-specific WM integrity was investigated using voxel-based statistics of whole-brain FA maps and region-of-interest analysis. Each patient underwent laboratory and neuropsychological tests. Results Structural MRI revealed no lesions in twelve (HIV-MRN and unspecific mild macrostructural lesions in seven patients (HIV-MRL. Both analyses revealed widespread FA-alterations in all patients. Patients with HIV-MRL had FA-alterations primarily adjacent to the observed lesions and, whilst reduced in extent, patients with HIV-MRN also exhibited FA-alterations in similar regions. Patients with evidence of depression showed FA-increase in the ventral tegmental area, pallidum and nucleus accumbens in both hemispheres, and patients with evidence of HIV-associated neurocognitive disorder showed widespread FA-reduction. Conclusion These results show that patients with HIV-MRN have evidence of FA-alterations in similar regions that are lesioned in HIV-MRL patients, suggesting common neuropathological processes. Furthermore, they suggest a biological rather than a reactive origin of depression in HIV-patients.

  16. Platelet production, clearance and distribution in patients with idiopathic thrombocytopenic purpura

    International Nuclear Information System (INIS)

    Isaka, Yoshinari; Kambayashi, Junichi; Kimura, Kazufumi

    1990-01-01

    We have studied 8 normal subjects, and 12 patients with idiopathic thrombocytopenic purpura whose platelet counts ranged from 9x10 9 /L to 40x10 9 /L. Autologous platelets labeled with 111 In-tropolone were used for evaluation of mean platelet survival, platelet turnover, platelet sequestration sites, and platelet production (turnover) to clearance (sum of platelet uptake in the liver and the spleen) ratio. Platelet survival correlated directly with platelet counts. There was no significant correlation between the platelet sequestration pattern and platelet count, survival, or turnover. Sum of platelet uptake in the liver and the spleen showed a significant inverse correlation with platelet survival. No significant correlation was found between platelet turnover and platelet count. There was a significant correlation between the platelet production and clearance index when all subjects were analyzed. The distribution of platelet turnover showed considerable individual variation; eight of twelve patients showed platelet turnover less than mean minus 2SD of the control value, but others showed normal range. We conclude that although platelet destruction mechanism in RES shows a primary role of thrombocytopenia, impaired rate of effective thrombopoiesis may also contribute to disease severity in ITP. (author)

  17. Patients with bulimia nervosa do not show typical neurodevelopment of cognitive control under emotional influences.

    Science.gov (United States)

    Dreyfuss, Michael F W; Riegel, Melissa L; Pedersen, Gloria A; Cohen, Alexandra O; Silverman, Melanie R; Dyke, Jonathan P; Mayer, Laurel E S; Walsh, B Timothy; Casey, B J; Broft, Allegra I

    2017-08-30

    Bulimia nervosa (BN) emerges in the late teen years and is characterized by binge eating and related compensatory behaviors. These behaviors often co-occur with periods of negative affect suggesting an association between emotions and control over eating behavior. In the current study, we examined how cognitive control and neural processes change under emotional states of arousal in 46 participants with (n=19) and without (n=27) BN from the ages of 18-33 years. Participants performed a go/nogo task consisting of brief negative, positive and neutral emotional cues and sustained negative, positive and neutral emotional states of arousal during functional magnetic resonance imaging (fMRI). Overall task performance improved with age for healthy participants, but not for patients with BN. These age-dependent behavioral effects were paralleled by diminished recruitment of prefrontal control circuitry in patients with BN with age. Although patients with BN showed no difference in performance on the experimental manipulations of negative emotions, sustained positive emotions related to improved performance among patients with BN. Together the findings highlight a neurodevelopmental approach towards understanding markers of psychopathology and suggest that sustained positive affect may have potential therapeutic effects on maintaining behavioral control in BN. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  18. Patients with polymyositis show changes in muscle protein charges

    DEFF Research Database (Denmark)

    Bartels, E M; Jacobsen, Søren; Rasmussen, L

    1989-01-01

    Polymyositis (PM) appears with indolent proximal muscle weakness and is an inflammatory disease with breakdown of muscle cells. In our study the protein charge concentrations of the contractile proteins in the A and I bands were determined, applying a microelectrode technique. Patients with PM sh...

  19. TKA patients with unsatisfying knee function show changes in neuromotor synergy pattern but not joint biomechanics.

    Science.gov (United States)

    Ardestani, Marzieh M; Malloy, Philip; Nam, Denis; Rosenberg, Aaron G; Wimmer, Markus A

    2017-12-01

    Nearly 20% of patients who have undergone total knee arthroplasty (TKA) report persistent poor knee function. This study explores the idea that, despite similar knee joint biomechanics, the neuro-motor synergies may be different between high-functional and low-functional TKA patients. We hypothesized that (1) high-functional TKA recruit a more complex neuro-motor synergy pattern compared to low-functional TKA and (2) high-functional TKA patients demonstrate more stride-to-stride variability (flexibility) in their synergies. Gait and electromyography (EMG) data were collected during level walking for three groups of participants: (i) high-functional TKA patients (n=13); (ii) low-functional TKA patients (n=13) and (iii) non-operative controls (n=18). Synergies were extracted from EMG data using non-negative matrix factorization. Analysis of variance and Spearman correlation analyses were used to investigate between-group differences in gait and neuro-motor synergies. Results showed that synergy patterns were different among the three groups. Control subjects used 5-6 independent neural commands to execute a gait cycle. High functional TKA patients used 4-5 independent neural commands while low-functional TKA patients relied on only 2-3 independent neural commands to execute a gait cycle. Furthermore, stride-to-stride variability of muscles' response to the neural commands was reduced up to 15% in low-functional TKAs compared to the other two groups. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Reversion of methacholine induced bronchoconstriction with inhaled diazepam in patients with asthma

    OpenAIRE

    Miric, Mirjana; Ristic, Sinisa; Joksimovic, Bojan N; Medenica, Snezana; Racic, Maja; Ristic, Slavica; Joksimovic, Vedrana R; Skipina, Mirjana

    2016-01-01

    Background: Benzodiazepines have a direct bronchodilatory effect. Methacholine is a non-selective muscarinic receptor agonist causing bronchoconstriction. Aim: To examine the effects of inhaled benzodiazepines, modulating bronchoconstriction induced by methacholine in patients with asthma. Patients and Methods: Twelve patients with well controlled asthma were studied. On the first day, after determining the initial values of pulmonary function, a dose response curve was carried out with progr...

  1. Disk degenerative disease in childhood: Scheuermann's disease, Schmorl's nodes, and the limbus vertebra: MRI findings in 12 patients

    International Nuclear Information System (INIS)

    Swischuk, L.E.; John, S.D.; Allbery, S.

    1998-01-01

    Twelve pediatric patients were studied with MRI. All had various disk problems including Scheuermann's disease, Schmorl's nodes and limbus vertebrae. All patients shared loss of disk height, altered disk hydration and variable herniation of nuclear material. (orig.)

  2. Mesenchymal stromal cells of osteosarcoma patients do not show evidence of neoplastic changes during long-term culture.

    Science.gov (United States)

    Buddingh, Emilie P; Ruslan, S Eriaty N; Reijnders, Christianne M A; Szuhai, Karoly; Kuijjer, Marieke L; Roelofs, Helene; Hogendoorn, Pancras C W; Maarten Egeler, R; Cleton-Jansen, Anne-Marie; Lankester, Arjan C

    2015-01-01

    In vitro expanded mesenchymal stromal cells (MSCs) are increasingly used as experimental cellular therapy. However, there have been concerns regarding the safety of their use, particularly with regard to possible oncogenic transformation. MSCs are the hypothesized precursor cells of high-grade osteosarcoma, a tumor with often complex karyotypes occurring mainly in adolescents and young adults. To determine if MSCs from osteosarcoma patients could be predisposed to malignant transformation we cultured MSCs of nine osteosarcoma patients and five healthy donors for an average of 649 days (range 601-679 days). Also, we compared MSCs derived from osteosarcoma patients at diagnosis and from healthy donors using genome wide gene expression profiling. Upon increasing passage, increasing frequencies of binucleate cells were detected, but no increase in proliferation suggestive of malignant transformation occurred in MSCs from either patients or donors. Hematopoietic cell specific Lyn substrate 1 (HLCS1) was differentially expressed (fold change 0.25, P value 0.0005) between MSCs of osteosarcoma patients (n = 14) and healthy donors (n = 9). This study shows that although HCLS1 expression was downregulated in MSCs of osteosarcoma patients and binucleate cells were present in both patient and donor derived MSCs, there was no evidence of neoplastic changes to occur during long-term culture.

  3. Budesonide/formoterol and formoterol provide similar rapid relief in patients with acute asthma showing refractoriness to salbutamol

    Directory of Open Access Journals (Sweden)

    Lombardi DM

    2006-01-01

    Full Text Available Abstract Background To compare the efficacy and safety of budesonide/formoterol (Symbicort® with formoterol (Oxis® in the treatment of patients with acute asthma who showed evidence of refractoriness to short-acting β2-agonist therapy. Methods In a 3 hour, randomized, double-blind study, a total of 115 patients with acute asthma (mean FEV1 40% of predicted normal and a refractory response to salbutamol (mean reversibility 2% of predicted normal after inhalation of 400 μg, were randomized to receive either budesonide/formoterol (320/9 μg, 2 inhalations at t = -5 minutes and 2 inhalations at 0 minutes [total dose 1280/36 μg] or formoterol (9 μg, 2 inhalations at t = -5 minutes and 2 inhalations at 0 minutes [total dose 36 μg]. The primary efficacy variable was the average FEV1 from the first intake of study medication to the measurement at 90 minutes. Secondary endpoints included changes in FEV1 at other timepoints and change in respiratory rate at 180 minutes. Treatment success, treatment failure and patient assessment of the effectiveness of the study medication were also measured. Results FEV1 increased after administration of the study medication in both treatment groups. No statistically significant difference between the treatment groups was apparent for the primary outcome variable, or for any of the other efficacy endpoints. There were no statistically significant between-group differences for treatment success, treatment failure or patient assessment of medication effectiveness. Both treatments were well tolerated. Conclusion Budesonide/formoterol and formoterol provided similarly rapid relief of acute bronchoconstriction in patients with asthma who showed evidence of refractoriness to a short-acting β2-agonist.

  4. Multiple Determinations of Sperm DNA Fragmentation Show That Varicocelectomy Is Not Indicated for Infertile Patients with Subclinical Varicocele

    Directory of Open Access Journals (Sweden)

    Agustín García-Peiró

    2014-01-01

    Full Text Available Varicocele is one of the most common causes of low semen quality, which is reflected in high percentages of sperm cells with fragmented DNA. While varicocelectomy is usually performed to ameliorate a patient’s fertility, its impact on sperm DNA integrity in the case of subclinical varicocele is poorly documented. In this study, multiple DNA fragmentation analyses (TUNEL, SCD, and SCSA were performed on semen samples from sixty infertile patients with varicocele (15 clinical varicoceles, 19 clinical varicoceles after surgical treatment, 16 subclinical varicoceles, and 10 subclinical varicoceles after surgical treatment. TUNEL, SCD, and SCSA assays all showed substantial sperm DNA fragmentation levels that were comparable between subclinical and clinical varicocele patients. Importantly, varicocelectomy did improve sperm quality in patients with clinical varicocele; however, this was not the case in patients with subclinical varicocele. In summary, although infertile patients with clinical and subclinical varicocele have similar sperm DNA quality, varicocelectomy should only be advised for patients with clinical varicocele.

  5. Commercializing Government-sponsored Innovations: Twelve Successful Buildings Case Studies

    Science.gov (United States)

    Brown, M. A.; Berry, L. G.; Goel, R. K.

    1989-01-01

    This report examines the commercialization and use of R and D results funded by DOE's Office of Buildings and Community Systems (OBCS), an office that is dedicated to improving the energy efficiency of the nation's buildings. Three goals guided the research described in this report: to improve understanding of the factors that hinder or facilitate the transfer of OBCS R and D results, to determine which technology transfer strategies are most effective and under what circumstances each is appropriate, and to document the market penetration and energy savings achieved by successfully-commercialized innovations that have received OBCS support. Twelve successfully-commercialized innovations are discussed here. The methodology employed involved a review of the literature, interviews with innovation program managers and industry personnel, and data collection from secondary sources. Six generic technology transfer strategies are also described. Of these, contracting R and D to industrial partners is found to be the most commonly used strategy in our case studies. The market penetration achieved to date by the innovations studied ranges from less than 1% to 100%. For the three innovations with the highest predicted levels of energy savings (i.e., the flame retention head oil burner, low-E windows, and solid-state ballasts), combined cumulative savings by the year 2000 are likely to approach 2 quads. To date the energy savings for these three innovations have been about 0.2 quads. Our case studies illustrate the important role federal agencies can play in commercializing new technologies.

  6. Efficacy and adverse effects of icotinib in treatment of 30 NSCLC patients with brain metastases

    Directory of Open Access Journals (Sweden)

    Yu-hong DAI

    2016-06-01

    Full Text Available Objective  To evaluate the efficacy and adverse effects of icotinib in the treatment for non-small cell lung cancer (NSCLC patients with brain metastases. Methods  This study was performed at Tongji Hospital Cancer Center over the period between September 2011 and November 2015. Thirty cases of advanced NSCLC patients with icotinib monotherapy were enrolled, all with brain metastases, the median follow-up time being 24 months (5.5-49.0 months, with no case censored. The follow-up rate was 100%, and the data of efficacy and adverse effects were collected. Results  The intracranial progression-free survival (iPFS was 9.6 months, while no patient exhibited complete remission (CR, 8 patients showed partial remission (PR and 14 showed stable disease (SD in the intracranial foci. The intracranial disease control rate (DCR was 73.3%, and the objective remission rate (ORR was 26.7%. The extracranial progression-free survival (ePFS was 10.1 months, while no patient exhibited CR, 11 patients showed PR and 11 patients showed SD in the extracranial foci. The extracranial DCR was 73.3%, and the ORR was 36.7%. The one-year survival rate was 63.8% in all the 30 patients. Twelve (40.0% of the total 30 patients developed rash, five (16.7% developed grade 1 diarrhea, one (3.3% developed grade 2 transaminase elevation. None of the patients experienced headache, nausea, vomiting, fatigue, etc. Conclusion  Icotinib hydrochloride is effective and safe for NSCLC patients with brain metastasis. DOI: 10.11855/j.issn.0577-7402.2016.06.11

  7. The effect of TIcagrelor administered through a nasogastric tube to COMAtose patients undergoing acute percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Ratcovich, Hanna; Sadjadieh, Golnaz; Andersson, Hedvig B

    2017-01-01

    resuscitated after an out of hospital cardiac arrest (OHCA) and undergoing primary percutaneous coronary intervention (pPCI). METHODS AND RESULTS: Blood samples were drawn at baseline and at two, four, six, eight, 12, and 24 hours and then daily for up to five days after administration of a 180 mg ticagrelor...... loading dose (LD), followed by 90 mg twice daily in 44 patients. The primary endpoint was the occurrence of high platelet reactivity (HPR) 12 hours after the LD. Assessment by VerifyNow (VFN) showed 96 (15.25-140.5) platelet reactivity units (PRU), and five (12%) patients exhibited HPR. Multiplate...... analysis showed 19 (12-29) units (U) at twelve hours, and three patients (7%) had HPR. Ticagrelor and its main metabolite AR-C124910XX concentrations were 85.2 (37.2-178.5) and 18.3 (6.4-52.4) ng/mL. Median times to sufficient platelet inhibition below the HPR limit were 3 (2-6) hours (VFN) and 4 (2...

  8. In vitro antibacterial and antifungal activities of twelve sponges collected from the Anambas Islands, Indonesia

    Directory of Open Access Journals (Sweden)

    Masteria Yunovilsa Putra

    2016-09-01

    Full Text Available Objective: To evaluate antimicrobial activities in methanolic extracts of twelve sponges collected from the Anambas Islands, Indonesia. Methods: The antibacterial activity of methanolic extracts was tested against two Grampositive bacteria, viz. Bacillus subtilis (ATCC 6633 and Staphylococcus aureus (ATCC 25923, and two Gram-negative bacteria, viz. Eschericia coli (ATCC 25922 and Vibrio anguillarum (ATCC 19264 using the disk diffusion assay. The antifungal activity was similarly tested against Candida albicans (ATCC 10231 and Aspergillus niger (ATCC 16404. The minimum inhibitory concentrations of promising sponges extracts were determined by the microdilution technique. Results: All the sponge species in this study showed antimicrobial activities against at least one of the test strains. Antibacterial activities were observed in 66.7% of the sponges extracts, while 30.0% of the extracts exhibited antifungal activities. Among them, the extracts of the sponges Stylissa massa and Axinyssa sp. were the most active against four tested bacteria and the yeast Candida albicans. The sponge Theonella swinhoei and two species of Xestospongia also displayed significant activities against two fungal pathogens Candida albicans and Aspergillus niger. Conclusions: Antimicrobial activities were demonstrated in extracts from various marine sponges collected from the Anambas Islands, Indonesia. The most promising sponges among them were Stylissa massa and Axinyssa sp. This is the first report of antimicrobial activity in extracts of marine sponges from the Indonesian Anambas Islands.

  9. Conservative surgery and radiotherapy in the treatment of breast cancer. Preliminary results of 148 patients

    International Nuclear Information System (INIS)

    Faria, S.L.; Chiminazzo Junior, H.; Koseki, N.; Oliveira Filho, J.A. de

    1986-01-01

    The combination of tumoral resection and radiotherapy with preservation of the breast is called conservative treatment of breast cancer. The literature considers this treatment a good option if used by an experient team and with appropriate equipment. This paper shows the results of 148 cases of breast cancer treated by this conservative approach at Centro de Oncologia Campinas. Follow-up varied from 3 to 87 months (mean 28) considered by the histological diagnosis. Overall actuarial survival of 5 years was 77% disease-free survival 55%. Twelve patients (8%) presented local relapse and 13 (9%) had distant metastases as the first therapeutic failure. Cosmetic results were considered good and fair in 89% of patients. These results are similar to others published in the literature (Author) [pt

  10. Does high-dose metformin cause lactic acidosis in type 2 diabetic patients after CABG surgery? A double blind randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Rahman Ghafari

    2011-06-01

    Full Text Available Metformin is a dimethyl biguanide oral anti-hyperglycemic agent. Lactic acidosis due to metformin is a fatal metabolic condition that limits its use in patients in poor clinical condition, consequently reducing the number of patients who benefit from this medication. In a double blind randomized clinical trial, we investigated 200 type 2 diabetic patients after coronary artery bypass surgery in the open heart ICU of the Mazandaran Heart Center, and randomly assigned them to equal intervention and control groups. The intervention group received regular insulin infusion along with 2 metformin 500 mg tablets every twelve hours, while the control group received only intravenous insulin with 2 placebo tablets every twelve hours. Lactate level, pH, base excess, blood glucose and serum creatinine were measured over five 12 h periods, with data averaged for each period. The primary outcome in this study was high lactate levels. Comparison between the 2 groups was made by independent Student’s t-test. To compare changes in multiple measures in each group and analysis of group interaction, a repeated measurement ANOVA test was used. There was no significant difference between the 2 groups regarding pH, base excess, or bicarbonate intake (P>0.05. No patient showed lactic acidosis in either group. Lactate levels were 23.0 vs 23.4 in the insulin-metformin and insulin only groups when the study was started, respectively. At the end of the study, those levels were 18.7 vs 18.9, respectively. In addition, the ANOVA repeated measurement test did not show a significant difference in terms of changes in the amount of lactate level between the 2 groups during the five measurement tests of the study period (P>0.05. High-dose metformin (1,000 mg twice daily with insulin does not cause lactic acidosis in type 2 diabetic patients after coronary artery

  11. New Eyes on the Universe Twelve Cosmic Mysteries and the Tools We Need to Solve Them

    CERN Document Server

    Webb, Stephen

    2012-01-01

    "New Eyes on the Universe -- Twelve Cosmic Mysteries and the Tools We Need to Solve Them" gives an up-to-date broad overview of some of the key issues in modern astronomy and cosmology. It describes the vast amount of observational data that the new generation of observatories and telescopes are currently producing, and how that data might solve some of the outstanding puzzles inherent in our emerging world view. Included are questions such as: What is causing the Universe to blow itself apart? What could be powering the luminous gamma-ray bursters? Where is all the matter in the Uni

  12. Twelve-year experience of radioembolization for colorectal hepatic metastases in 214 patients: survival by era and chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Lewandowski, Robert J.; Memon, Khairuddin; Hickey, Ryan; Gates, Vanessa L.; Atassi, Bassel; Vouche, Michael; Atassi, Rohi; Desai, Kush; Hohlastos, Elias; Sato, Kent; Habib, Ali [Robert H. Lurie Comprehensive Cancer Center, Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Chicago, IL (United States); Mulcahy, Mary F.; Kircher, Sheetal; Newman, Steven B.; Nimeiri, Halla; Benson, Al B. [Northwestern University, Department of Medicine, Division of Hematology and Oncology, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL (United States); Marshall, Karen; Williams, Melissa; Salzig, Krystina; Salem, Riad [Robert H. Lurie Comprehensive Cancer Center, Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Chicago, IL (United States); Northwestern University, Department of Medicine, Division of Hematology and Oncology, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL (United States)

    2014-10-15

    The aim of this study was to analyze the safety, treatment characteristics and survival outcomes of Yttrium-90 (Y90) radioembolization for unresectable colorectal carcinoma (CRC) liver metastases refractory to standard of care therapy. A total of 214 patients with CRC metastases were treated with Y90 radioembolization over 12 years. Toxicity was assessed using National Cancer Institute common terminology criteria. Overall survival was analyzed from date of diagnosis of primary cancer, hepatic metastases and from the first Y90. Uni/multivariate analyses were performed. Substratification by era of chemotherapeutics was performed. Most patients were male (60 %) and <65 years old (61 %). Of them, 98 % had been exposed to chemotherapy. Grade 3 lymphocyte, bilirubin, albumin, ALP and AST toxicities were observed in 39 %, 11 %, 10 %, 8 % and 4 % of patients, respectively. Grade 4 lymphocyte and ALP toxicities were observed in 5 % and 3 % of patients, respectively. Median overall survival was 43.0, 34.6, and 10.6 months from date of diagnosis of primary cancer, hepatic metastases and first Y90, respectively. Survival was significantly longer in patients: (1) who received ≤2 cytotoxic drugs (n = 104) than those who received 3 (n = 110) (15.2 vs. 7.5 months, p = 0.0001); and (2) who received no biologic agents (n = 52) compared with those that did (n = 162) (18.6 vs. 9.4 months, p = 0.0001). Multivariate analyses identified ≤2 cytotoxic agents, no exposure to biologics, ECOG 0, tumor burden <25 %, lack of extrahepatic disease and albumin >3 g/dL as independent predictors of survival. In this largest metastatic CRC series published to date, Y90 radioembolization was found to be safe; survival varied by prior therapy. Further studies are required to further refine the role of Y90 in metastatic CRC. (orig.)

  13. Panel-based whole exome sequencing identifies novel mutations in microphthalmia and anophthalmia patients showing complex Mendelian inheritance patterns.

    Science.gov (United States)

    Riera, Marina; Wert, Ana; Nieto, Isabel; Pomares, Esther

    2017-11-01

    Microphthalmia and anophthalmia (MA) are congenital eye abnormalities that show an extremely high clinical and genetic complexity. In this study, we evaluated the implementation of whole exome sequencing (WES) for the genetic analysis of MA patients. This approach was used to investigate three unrelated families in which previous single-gene analyses failed to identify the molecular cause. A total of 47 genes previously associated with nonsyndromic MA were included in our panel. WES was performed in one affected patient from each family using the AmpliSeq TM Exome technology and the Ion Proton TM platform. A novel heterozygous OTX2 missense mutation was identified in a patient showing bilateral anophthalmia who inherited the variant from a parent who was a carrier, but showed no sign of the condition. We also describe a new PAX6 missense variant in an autosomal-dominant pedigree affected by mild bilateral microphthalmia showing high intrafamiliar variability, with germline mosaicism determined to be the most plausible molecular cause of the disease. Finally, a heterozygous missense mutation in RBP4 was found to be responsible in an isolated case of bilateral complex microphthalmia. This study highlights that panel-based WES is a reliable and effective strategy for the genetic diagnosis of MA. Furthermore, using this technique, the mutational spectrum of these diseases was broadened, with novel variants identified in each of the OTX2, PAX6, and RBP4 genes. Moreover, we report new cases of reduced penetrance, mosaicism, and variable phenotypic expressivity associated with MA, further demonstrating the heterogeneity of such disorders. © 2017 The Authors. Molecular Genetics & Genomic Medicine published by Wiley Periodicals, Inc.

  14. Model of twelve properties of a set of organic solvents with graph-theoretical and/or experimental parameters.

    Science.gov (United States)

    Pogliani, Lionello

    2010-01-30

    Twelve properties of a highly heterogeneous class of organic solvents have been modeled with a graph-theoretical molecular connectivity modified (MC) method, which allows to encode the core electrons and the hydrogen atoms. The graph-theoretical method uses the concepts of simple, general, and complete graphs, where these last types of graphs are used to encode the core electrons. The hydrogen atoms have been encoded by the aid of a graph-theoretical perturbation parameter, which contributes to the definition of the valence delta, delta(v), a key parameter in molecular connectivity studies. The model of the twelve properties done with a stepwise search algorithm is always satisfactory, and it allows to check the influence of the hydrogen content of the solvent molecules on the choice of the type of descriptor. A similar argument holds for the influence of the halogen atoms on the type of core electron representation. In some cases the molar mass, and in a minor way, special "ad hoc" parameters have been used to improve the model. A very good model of the surface tension could be obtained by the aid of five experimental parameters. A mixed model method based on experimental parameters plus molecular connectivity indices achieved, instead, to consistently improve the model quality of five properties. To underline is the importance of the boiling point temperatures as descriptors in these last two model methodologies. Copyright 2009 Wiley Periodicals, Inc.

  15. Commercializing government-sponsored innovations: Twelve successful buildings case studies

    Energy Technology Data Exchange (ETDEWEB)

    Brown, M.A.; Berry, L.G.; Goel, R.K.

    1989-01-01

    This report examines the commercialization and use of R and D results funded by DOE's Office of Buildings and Community Systems (OBCS), an office that is dedicated to improving the energy efficiency of the nation's buildings. Three goals guided the research described in this report: to improve understanding of the factors that hinder or facilitate the transfer of OBCS R and D results, to determine which technology transfer strategies are most effective and under what circumstances each is appropriate, and to document the market penetration and energy savings achieved by successfully-commercialized innovations that have received OBCS support. Twelve successfully-commercialized innovations are discussed here. The methodology employed involved a review of the literature, interviews with innovation program managers and industry personnel, and data collection from secondary sources. Six generic technology transfer strategies are also described. Of these, contracting R and D to industrial partners is found to be the most commonly used strategy in our case studies. The market penetration achieved to date by the innovations studied ranges from less than 1% to 100%. For the three innovations with the highest predicted levels of energy savings (i.e., the flame retention head oil burner, low-E windows, and solid-state ballasts), combined cumulative savings by the year 2000 are likely to approach 2 quads. To date the energy savings for these three innovations have been about 0.2 quads. Our case studies illustrate the important role federal agencies can play in commercializing new technologies. 27 refs., 21 figs., 4 tabs.

  16. Impact of physician preferences for homeopathic or conventional medicines on patients with musculoskeletal disorders: results from the EPI3-MSD cohort.

    Science.gov (United States)

    Rossignol, Michel; Begaud, Bernard; Engel, Pierre; Avouac, Bernard; Lert, France; Rouillon, Frederic; Bénichou, Jacques; Massol, Jacques; Duru, Gerard; Magnier, Anne-Marie; Guillemot, Didier; Grimaldi-Bensouda, Lamiae; Abenhaim, Lucien

    2012-10-01

    The objective of this study was to assess the effect of physician practicing preferences (PPP) in primary care for homeopathy (Ho), CAM (Complementary and alternative medicines) with conventional medicine (Mx) or exclusively conventional medicine (CM) on patients with musculoskeletal disorders (MSDs), with reference to clinical progression, drug consumption, side effects and loss of therapeutic opportunity. The EPI3-MSD study was a nationwide observational cohort of a representative sample of general practitioners (GP) and their patients in France. Recruitment of GP was stratified by PPP, which was self-declared. Diagnoses and comorbidities were recorded by GP at inclusion. Patients completed a standardized telephone interview at inclusion, one, three and twelve months, including MSD-functional scales and medication consumption. 1153 MSD patients were included in the three PPP groups. Patients did not differ between groups except for chronicity of MSDs (>12 weeks), which was higher in the Ho group (62.1%) than in the CM (48.6%) and Mx groups (50.3%). The twelve-month development of specific functional scores was identical across the three groups after controlling for baseline score (p > 0.05). After adjusting for propensity scores, NSAID use over 12 months was almost half in the Ho group (OR, 0.54; 95%CI, 0.38-0.78) as compared to the CM group; no difference was found in the Mx group (OR, 0.81; 95% CI: 0.59-1.15). MSD patients seen by homeopathic physicians showed a similar clinical progression when less exposed to NSAID in comparison to patients seen in CM practice, with fewer NSAID-related adverse events and no loss of therapeutic opportunity. Copyright © 2012 John Wiley & Sons, Ltd.

  17. Splenic tuberculosis. Report of twelve cases

    International Nuclear Information System (INIS)

    Adil, A.; Chikhaoui, N.; Ousehal, A.; Kadiri, R.

    1995-01-01

    Tuberculosis of the spleen is not exceptional. The authors report ten cases which occurred with a predominance in young male adults. All patients had at least one other site of tuberculosis without any HIV infection. All patients had focal splenic lesions in the form of scattered hypo-echogenic and hypodense nodules. These nodules had a pseudo-tumor appearance in one case. CT-guided puncture was performed in one case. Splenic tuberculosis is not as rare as is sometimes thought. The CT-guided splenic puncture is now performed routinely and remains the ideal diagnostic approach. (authors). 9 refs., 5 figs

  18. I-123 metaiodobenzylguanidine cardiac scintigraphy in patients with an implanted permanent pacemaker

    International Nuclear Information System (INIS)

    Nakata, Akio; Hirota, Satoshi; Tsuji, Hiroshi; Takazakura, Eisuke

    1995-01-01

    Tl scintigraphic abnormalities have been reported in patients with an implanted permanent pacemaker, but little is known about the MIBG scintigraphic findings in such patients. This study was performed to assess the MIBG scintigraphic findings in patients with an implanted permanent pacemaker, and to test the hypothesis that imaging characteristics of MIBG scintigraphy differ according to its mode. Twelve patients (4 men and 8 women, mean age: 72.4±9.5 years), who had undergone the implantation of a permanent pacemaker for bradyarrhythmias, underwent MIBG scintigraphy. The patients were divided into VVI pacemaker and DDD pacemaker groups. The tomograms were divided into nine segments and the MIBG defect in each segment scored on a scale ranging from 0 (normal uptake) to 3 (no uptake). Total MIBG defect scores were generated by summing the scores for the nine segments in each patient. MIBG scintigraphic abnormalities were found in ten of the twelve patients. The six patients with the VVI pacemaker manifested MIBG scintigraphic abnormalities. These MIBG scintigraphic abnormalities were observed in all segments, particularly in the posterior segments. The mean total defect score of the VVI group was higher than that of the DDD group (14.8±9.8 vs 3.0±3.5, respectively p<0.05). Therefore, we conclude that despite several limitations of the study, MIBG scintigraphic abnormalities occur in patients with implanted permanent pacemakers, and that such abnormalities are more prominent with the VVI than DDD pacemaker. (author)

  19. Viral respiratory tract infections among patients with acute undifferentiated fever in Vietnam

    NARCIS (Netherlands)

    Phuong, Hoang Lan; Nga, Tran T. T.; van Doornum, Gerard J.; Groen, Jan; Binh, Tran Q.; Giao, Phan T.; Hung, Le Q.; Nams, Nguyen V.; Kager, P. A.; de Vries, Peter J.

    2010-01-01

    To investigate the proportion of viral respiratory tract infections among acute undifferentiated fevers (AUFs) at primary health facilities in southern Vietnam during 2001-2005, patients with AUF not caused by malaria were enrolled at twelve primary health facilities and a clinic for malaria control

  20. Metabolic status of 1088 patients after renal transplantation: assessment of twelve years monitoring in Algiers Mustapha Hospital.

    Science.gov (United States)

    Yargui, Lyece; Chettouh, Houria; Boukni, Hamama; Mokhtari, Nassima; Berhoune, Arezki

    2014-01-01

    Since the introduction of monitoring levels of immunosuppressive medications in our service in July 2000, 1088 kidney transplant patients were received for therapeutic drug monitoring and regular follow-up. The aim of this study was to retrospectively analyze the data on these renal graft patients in Algeria and correlate with our 12 years' experience with calcineurin inhibitor (CNI) measurements. In addition, during this period, we also examined other bioche-mical parameters. The analysis was focused on the difference of effect of cyclosporin A (CsA; 623 patients) and Tacrolimus (Tac; 465 patients) on lipid and glucose metabolism and their side-effects, if any, on the renal function. The mean age at the time of transplantation was 36.1 years. A great majority of the transplanted kidneys had been taken from living related donors (88.6%). Three-quarters of all grafts were transplanted in our country (79.5%). Dyslipidemia and renal dysfunction were the most common adverse effects of CsA and Tac exposure, with a frequency of 21.4% and 10.3%, respectively. Both the CNIs had a similar effect on the lipid levels. The highest incidence occurred at 3-12 months after renal graft. Tac seemed to have more side-effects on glycemia, causing the onset of diabetes mellitus more than two-fold than CsA (6.9% vs. 3.1%). A significant difference was observed during 12-24 months after transplantation. However, Tac was associated with the most favorable effects on renal function estimated with the Modification of Diet in Renal Disease (MDRD) formula.

  1. Brain MRI screening showing evidences of early central nervous system involvement in patients with systemic sclerosis.

    Science.gov (United States)

    Mohammed, Reem Hamdy A; Sabry, Yousriah Y; Nasef, Amr A

    2011-05-01

    Systemic sclerosis is a multisystem autoimmune collagen disease where structural and functional abnormalities of small blood vessels prevail. Transient ischemic attacks, ischemic stroke, and hemorrhage have been reported as primary consequence of vascular central nervous system affection in systemic sclerosis. Magnetic resonance imaging is considered to be the most sensitive diagnostic technique for detecting symptomatic and asymptomatic lesions in the brain in cases of multifocal diseases. The objective of this study is to detect subclinical as well as clinically manifest cerebral vasculopathy in patients with systemic sclerosis using magnetic resonance imaging. As much as 30 female patients with systemic sclerosis aged 27-61 years old, with disease duration of 1-9 years and with no history of other systemic disease or cerebrovascular accidents, were enrolled. Age-matched female control group of 30 clinically normal subjects, underwent brain magnetic resonance examination. Central nervous system (CNS) involvement in the form of white matter hyperintense foci of variable sizes were found in significantly abundant forms in systemic sclerosis patients on magnetic resonance evaluation than in age-related control group, signifying a form of CNS vasculopathy. Such foci showed significant correlation to clinical features of organic CNS lesion including headaches, fainting attacks and organic depression as well as to the severity of peripheral vascular disease with insignificant correlation with disease duration. In conclusion, subclinical as well as clinically manifest CNS ischemic vasculopathy is not uncommon in systemic sclerosis patients and magnetic resonance imaging is considered a sensitive noninvasive screening tool for early detection of CNS involvement in patients with systemic sclerosis.

  2. Positron emission CT and X-ray CT findings in chronic obstructive pulmonary diseases

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Yoshikazu; Murata, Kiyoshi; Ito, Harumi; Senda, Michio; Yonekura, Yoshiharu; Konishi, Junji; Nishimura, Koichi; Izumi, Takahide; Oshima, Shunsaku

    1987-08-01

    Positron emission CT and X-ray CT were performed in fifteen patients with emphysema confirmed SAB and twelve patients with clinical DPB. In patients with emphysema, 20 of 36 areas showed a central pattern and their perfusion scintigrams showed stripe-signs. On the other hand, the patients with DPB showed outer layer progression of the disease.

  3. Total body irradiation therapy for thymectomized myasthenic patients and immunological evaluations

    Energy Technology Data Exchange (ETDEWEB)

    Yamanaka, Nobukazu; Tanaka, Masayuki; Kurihara, Teruyuki (Miyazaki Medical College (Japan))

    1983-06-01

    Three patients with intractable myasthenia gravis (MG) were treated with total body irradiation (TBI). All the three patients had been unstable after extended thymectomy and poorly responding to prednisolone therapy. Radiation therapy consisted of 10 doses of 10 rads/day given over five weeks. After the radiation therapy the three patients improved clinically, and an objective parameter, area of M-waves also improved. No significant side effects were noted. TBI therapy can be considered as a safe method to induce selective reduction of circulating lymphocytes. This was indeed achieved, as evidenced by a drop of the lymphocyte counts to the levels of 20-40 % of the pretreatment level. The effects were persistent over twelve weeks. Early radiosensitivity of B lymphocytes were recognized. The levels of T..gamma.. cells were low before TBI therapy, increasing gradually during TBI therapy and returned to normal range after twelve weeks. Serum anti-AChR antibody titers decreased in all the cases, but it was impossible to determine whether the decrement was due to the therapy or natural course after thymectomy. Two of our three cases had a significant percentage decrement of the titers after TBI therapy. We suggest that TBI therapy is a safe method of immunosupperssive treatment for the myasthenic patients after thymectomy.

  4. Total body irradiation therapy for thymectomized myasthenic patients and immunological evaluations

    International Nuclear Information System (INIS)

    Yamanaka, Nobukazu; Tanaka, Masayuki; Kurihara, Teruyuki

    1983-01-01

    Three patients with intractable myasthenia gravis (MG) were treated with total body irradiation (TBI). All the three patients had been unstable after extended thymectomy and poorly responding to prednisolone therapy. Radiation therapy consisted of 10 doses of 10 rads/day given over five weeks. After the radiation therapy the three patients improved clinically, and an objective parameter, area of M-waves also improved. No significant side effects were noted. TBI therapy can be considered as a safe method to induce selective reduction of circulating lymphocytes. This was indeed achieved, as evidenced by a drop of the lymphocyte counts to the levels of 20-40 % of the pretreatment level. The effects were persistent over twelve weeks. Early radiosensitivity of B lymphocytes were recognized. The levels of Tγ cells were low before TBI therapy, increasing gradually during TBI therapy and returned to normal range after twelve weeks. Serum anti-AChR antibody titers decreased in all the cases, but it was impossible to determine whether the decrement was due to the therapy or natural course after thymectomy. Tow of our three cases had a significant percentage decrement of the titers after TBI therapy. We suggest that TBI therapy is a safe method of immunosupperssive treatment for the myasthenic patients after thymectomy. (author)

  5. Twelve single nucleotide polymorphisms on chromosome 19q13.2-13.3

    DEFF Research Database (Denmark)

    Yin, Jiaoyang; Vogel, Ulla; Gerdes, Lars Ulrik

    2003-01-01

    The genetic susceptibility to basal cell carcinoma (BCC) among Danish psoriatic patients was investigated in association studies with 12 single nucleotide polymorphisms on chromosome 19q13.2-3. The results show a significant association between BCC and the A-allele of a polymorphism in ERCCI exon4...

  6. Electromyographic evaluation of implant-supported prostheses in hemimandibulectomy-reconstructed patients.

    Science.gov (United States)

    Dellavia, Claudia; Romeo, Eugenio; Ghisolfi, Marco; Chiapasco, Matteo; Sforza, Chiarella; Ferrario, Virgilio F

    2007-06-01

    To assess the clinical conditions, patient's satisfaction and functional outcomes in oral neoplasia patients with hemimandibulectomy, bone reconstruction and implant-supported prosthesis. Twelve patients after mandibular resection (with and without condyle), reconstruction and successful fixed implant-supported prosthesis rehabilitation were examined. Patients underwent clinical evaluation and filled in a questionnaire about their satisfaction toward oral functions. Surface electromyography (EMG) of the masticatory muscles was performed during a 15-s unilateral gum chewing test. EMG potentials were standardized as percentage of a maximum clench on cotton rolls and compared with reference data obtained from 20 healthy subjects. Excellent clinical and radiological parameters were found. Patients stated a decreased post-rehabilitation satisfaction toward mastication and phonetics, but an increased attention to oral care. Only patients with condylar resection reported augmented esthetic scores. In both the resected and the remaining sides, chewing frequency was higher in the patients than in the reference group (Wilcoxon's rank-sum test, Pchewing were more variable in the reconstructed patients than in control subjects; the difference was significant only in the non-operated side (P<0.01). Post-rehabilitation median scores of the questionnaire indicated a positive judgment of the treatment. EMG analysis showed that functional recovery in hemimandibulectomy patients was satisfactory, although some alterations were observed in the non-operated side of mastication.

  7. [Beneficial effect of preferred music on cognitive functions in minimally conscious state patients].

    Science.gov (United States)

    Verger, J; Ruiz, S; Tillmann, B; Ben Romdhane, M; De Quelen, M; Castro, M; Tell, L; Luauté, J; Perrin, F

    2014-11-01

    Several studies have shown that music can boost cognitive functions in normal and brain-damaged subjects. A few studies have suggested a beneficial effect of music in patients with a disorder of consciousness but it is difficult to conclude since they did not use quantified measures and a control condition/group. The aim of the present study was to compare the effect of music to that of a continuous sound on the relational behavior of patients in a minimally conscious state (MCS). Behavioral responses of six MCS patients were evaluated using items from the Coma Recovery Scale-Revised. Weekly evaluation sessions were carried out, over four weeks, under two conditions: following the presentation of either the patient's preferred music, or following a continuous sound (control condition). Qualitative and quantitative analyses showed that twelve of the eighteen sessions (66.6%) showed a better result for the music condition than for the control condition. This new protocol suggests that preferred music has a beneficial effect on the cognitive abilities of MCS patients. The results further suggest that cerebral plasticity may be enhanced in autobiographical (emotional and familiar) contexts. These findings should now be further extended with an increased number of patients to further validate the hypothesis of the beneficial effect of music on cognitive recovery. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  8. Management of brain metastasis in a patient with advanced epithelial ovarian carcinoma by gamma-knife radiosurgery.

    Science.gov (United States)

    Nikolaoul, Marinos; Stamenković, Srdjan; Stergiou, Christos; Skarleas, Christos; Torrens, Michael

    2015-01-01

    Brain metastases from epithelial ovarian cancer (EOC) are rare events. We present a rare case of single ovarian cancer metastasis to the brain treated with gamma-knife radiosurgery (GKRS). A 65-year-old woman with advanced EOC presented with severe neurologic symptoms. A single brain metastasis of 3.2 cm with surrounding edema in the left parietal lobe was detected by brain magnetic resonance imaging (MRI) scan during the work-up. The decision to perform GKRS was due to a surgical inaccessibility of intracranial lesion. Twelve weeks after the procedure, the MRI scan showed reduction in the diameter of brain metastasis and surrounding edema and the patient returned to good mental and motor performance.The patient survived for 22 months following treatment and died from a progressive intra-abdominal disease. Prognosis of ovarian cancer patients with brain metastases is generally poor regardless of treatment. Our case shows that GKRS as primary treatment modality for the control of ovarian cancer metastases to the brain was effective and can be considered as a treatment of choice if international selection criteria are followed.

  9. Graves' Disease Patients with Persistent Hyperthyroidism and Diffuse Lymphoplasmacytic Infiltration in the Thyroid Show No Histopathological Compatibility with IgG4-Related Disease.

    Directory of Open Access Journals (Sweden)

    Eijun Nishihara

    Full Text Available IgG4-related disease is a novel disease entity characterized by diffuse lymphoplasmacytic infiltration rich in IgG4-positive plasma cells and fibrosis into multiple organs. There is still controversy over whether some thyroid diseases are actually IgG4-related disease. The objective of this study was to elucidate the clinicopathological features of Graves' disease with diffuse lymphoplasmacytic infiltration in the thyroid.Among 1,484 Graves' disease patients who underwent thyroidectomy, we examined their histopathological findings including the degree of lymphoplasmacytic and fibrotic infiltration and levels of IgG4-positive plasma cells in the thyroid. Their clinical pictures were defined by laboratory and ultrasonographic evaluation.A total of 11 patients (0.74% showed diffuse lymphoplasmacytic infiltration in the stroma of the thyroid gland. Meanwhile, other patients showed variable lymphoid infiltration ranging from absent to focally dense but no aggregation of plasma cells in the thyroid gland. Based on the diagnostic criteria of IgG4-related disease, 5 of the 11 subjects had specifically increased levels of IgG4-positive plasma cells in the thyroid. Fibrotic infiltration was present in only 1 patient developing hypothyroidism after anti-thyroid drug treatment for 4 years, but not in the other 10 patients with persistent hyperthyroidism. Obliterative phlebitis was not identified in any of the 11 subjects. Thyroid ultrasound examination showed 1 patient developing hypothyroidism who had diffuse hypoechogenicity, but the other hyperthyroid patients had a coarse echo texture.In our study, Graves' disease patients with persistent hyperthyroidism who had diffuse lymphoplasmacytic infiltration rich in IgG4-positive plasma cells in the thyroid showed no concomitant fibrosis or obliterative phlebitis.

  10. CRT-D Therapy in Patients with Decompensated NYHA Class-Four CHF

    Directory of Open Access Journals (Sweden)

    Faisal Zaeem

    2012-01-01

    Full Text Available Background. ACC-HRS Guidelines for Cardiac Resynchronization Therapy ICD implantation (CRT-D do not include patients with advanced nonambulatory NYHA class-four CHF due to an expectation of limited survival. There is little data available from these large multicenter randomized studies to support or refute this claim. Purpose. We evaluated the outcomes of patients with advanced nonambulatory NYHA class-four CHF who received CRT-D devices as an attempt to improve the clinical status and promote hospital discharge. Methods. Sixteen (of our six hundred and seventy CRT-D patients were classified as advanced nonambulatory NYHA Class four inotrope/vasodilator/diuretic-dependent patients. These patients were analyzed retrospectively for weaning success to oral medications, hospital discharge, hemodynamic stability, and survival over eighteen months. Results. Thirteen of sixteen patients were discharged to home within two weeks of implantation. The survival to hospital discharge, as well as at six, twelve, and eighteen months was positive (ninety-four percent, seventy-five percent, sixty-nine percent, sixty-nine percent, resp.. The groups showed significant improvements in systolic blood pressure, renal function, left ventricular ejection fraction, and CHF class. Conclusion. CRT-D in advanced nonambulatory NYHA four patients proved feasible and beneficial. These findings suggest that the strategy merits further study.

  11. Evaluation of therapeutically induced hypertension in patients with delayed cerebral vasospasm by xenon-enhanced computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Touho, Hajime; Karasawa, Jun; Ohnishi, Hideyuki; Shishido, Hisashi; Yamada, Keisuke; Shibamoto, Keiji [Osaka Neurological Inst., Toyonaka (Japan)

    1992-08-01

    Serial cerebral blood flow (CBF) measurement were made with stable xenon-enhanced computed tomography in 20 patients with angiographically confirmed reputerd intracranial aneurysms, before and during induced hypertension with continuous infusion of dopamine. All patients showed angiogaphic vasospasm during their course. Twelve patients without symptomatic vasospasm (Group 1) had the lowest hemispheric CBF on the craniotomy side of 31.6[+-]6.8 ml/100 gm/min on days 4-9 (control value, 40.1[+-]2.0 ml/100 gm/min), while the other eight patients with symptomatic vasopsasm (Group 2) had the lowest hemispheric CBF on the craniotomy side of 25.0[+-]7.6 ml/100 gm/min on days 10-14. The critical hemispheric CBF inducing neurological deficits was about 20 ml/ 100 gm/min in Group 2. Dysautoregulation was usually present in Groups 1 and 2, but therapeutically induced hypertension could reverse the delayed neurological deficits, it begun early at the stage of delayed vasospasm. (author).

  12. Rehabilitation of discharged patients with Chronic Obstructive Pulmonary Disease

    DEFF Research Database (Denmark)

    Morsø, Lars; Sall Jensen, Morten; von Plessen, Christian

    2017-01-01

    BACKGROUND: Rehabilitation after hospital stay implies several benefits for patients with chronic obstructive pulmonary disease (COPD); still few patients are referred and participate in rehabilitation programs. We conducted a case study to investigate the effects of interventions targeting...... the referral, uptake, and completion for a program of early rehabilitation in the primary health-care sector. METHODS: We undertook targeted initiatives to make patients participate in an individualized rehabilitation program with gradual increased intensity. After discharge, primary care COPD nurses....... RESULTS: Sixteen (23% of discharged patients) patients were referred to rehabilitation. In comparison, only 1 (0.8%) in 131 patients from Vejle hospital was referred to Vejle hospital. Twelve patients completed rehabilitation, all having severe COPD. All started the program within 2 weeks and proceeded...

  13. Osseous involvement in AIDS patients

    International Nuclear Information System (INIS)

    Marchiori, Edson; Pereira, Abercio Arantes

    1995-01-01

    The radiological findings of eight patients with the acquired immunodeficiency syndrome (AIDS) who developed bone lesions were analyzed in conjunction with twelve similar published cases. Our series included three patients with lymphoma, two with bacillary angiomatosis, two with tuberculosis and one with staphylococcal osteomyelitis. All the lesions were lithic regardless of the etiology. Both in our cases and in those previously published bone repair was only seen in cases of bacillary angiomatosis treated with erythromycin. No pathognomonic findings were observed. However, the association of skin and bone lesions in immuno deficient patients should always bring the consideration of bacillary angiomatosis in the differential diagnosis. This is particularly relevant since this a condition amenable to treatment once correctly identified. The radiological findings in the lymphoma and tuberculosis patients have not been described previously. (author). 9 refs., 7 figs., 3 tabs

  14. A survey of innovation through duplication in the reduced genomes of twelve parasites.

    Directory of Open Access Journals (Sweden)

    Jeremy D DeBarry

    Full Text Available We characterize the prevalence, distribution, divergence, and putative functions of detectable two-copy paralogs and segmental duplications in the Apicomplexa, a phylum of parasitic protists. Apicomplexans are mostly obligate intracellular parasites responsible for human and animal diseases (e.g. malaria and toxoplasmosis. Gene loss is a major force in the phylum. Genomes are small and protein-encoding gene repertoires are reduced. Despite this genomic streamlining, duplications and gene family amplifications are present. The potential for innovation introduced by duplications is of particular interest. We compared genomes of twelve apicomplexans across four lineages and used orthology and genome cartography to map distributions of duplications against genome architectures. Segmental duplications appear limited to five species. Where present, they correspond to regions enriched for multi-copy and species-specific genes, pointing toward roles in adaptation and innovation. We found a phylum-wide association of duplications with dynamic chromosome regions and syntenic breakpoints. Trends in the distribution of duplicated genes indicate that recent, species-specific duplicates are often tandem while most others have been dispersed by genome rearrangements. These trends show a relationship between genome architecture and gene duplication. Functional analysis reveals: proteases, which are vital to a parasitic lifecycle, to be prominent in putative recent duplications; a pair of paralogous genes in Toxoplasma gondii previously shown to produce the rate-limiting step in dopamine synthesis in mammalian cells, a possible link to the modification of host behavior; and phylum-wide differences in expression and subcellular localization, indicative of modes of divergence. We have uncovered trends in multiple modes of duplicate divergence including sequence, intron content, expression, subcellular localization, and functions of putative recent duplicates that

  15. Twelve Years of the HST Advanced Camera for Surveys : Calibration Update

    Science.gov (United States)

    Grogin, Norman A.

    2014-06-01

    The Advanced Camera for Surveys (ACS) has been a workhorse HST imager for over twelve years, subsequent to its Servicing Mission 3B installation. The once defunct ACS Wide Field Channel (WFC) has now been operating longer since its Servicing Mission 4 repair than it had originally operated prior to its 2007 failure. Despite the accumulating radiation damage to the WFC CCDs during their long stay in low Earth orbit, ACS continues to be heavily exploited by the HST community as both a prime and a parallel detector. Conspicuous examples include the recently completed HST Multi-cycle Treasury programs, and the ongoing HST Frontier Fields (HFF) program.We review recent developments in ACS calibration that enable the continued high performance of this instrument, with particular attention the to the Wide Field Channel. Highlights include: 1) the refinement of the WFC geometric distortion solution and its time dependency; 2) the efficacy of both pixel-based and catalog-based corrections for the worsening WFC charge-transfer efficiency (CTE); 3) the extension of pixel-based CTE correction to the WFC 2K subarray mode; and 4) a novel "self-calibration" technique appropriate for large-number stacks of deep WFC exposures (such as the HFF targets) that provides superior reductions compared to the standard CALACS reduction pipeline.

  16. Whole-Proteome Analysis of Twelve Species of Alphaproteobacteria Links Four Pathogens

    Directory of Open Access Journals (Sweden)

    Yunyun Zhou

    2013-11-01

    Full Text Available Thousands of whole-genome and whole-proteome sequences have been made available through advances in sequencing technology, and sequences of millions more organisms will become available in the coming years. This wealth of genetic information will provide numerous opportunities to enhance our understanding of these organisms including a greater understanding of relationships among species. Researchers have used 16S rRNA and other gene sequences to study the evolutionary origins of bacteria, but these strategies do not provide insight into the sharing of genes among bacteria via horizontal transfer. In this work we use an open source software program called pClust to cluster proteins from the complete proteomes of twelve species of Alphaproteobacteria and generate a dendrogram from the resulting orthologous protein clusters. We compare the results with dendrograms constructed using the 16S rRNA gene and multiple sequence alignment of seven housekeeping genes. Analysis of the whole proteomes of these pathogens grouped Rickettsia typhi with three other animal pathogens whereas conventional sequence analysis failed to group these pathogens together. We conclude that whole-proteome analysis can give insight into relationships among species beyond their phylogeny, perhaps reflecting the effects of horizontal gene transfer and potentially providing insight into the functions of shared genes by means of shared phenotypes.

  17. Analysis of allergen immunotherapy studies shows increased clinical efficacy in highly symptomatic patients

    DEFF Research Database (Denmark)

    Howarth, P; Malling, Hans-Jørgen; Molimard, M

    2011-01-01

    them. Thus, clinical studies of AIT can neither establish baseline symptom levels nor limit the enrolment of patients to those with the most severe symptoms. Allergen immunotherapy treatment effects are therefore diluted by patients with low symptoms for a particular pollen season. The objective...... tertiles). The difference observed in the average score in each tertile in active vs placebo-treated patients was assessed. This allowed an estimation of the efficacy that could be achieved in patients from sites where symptoms were high during the pollen season. Results:  An increased treatment effect...... of this analysis was to assess the effect possible to achieve with AIT in the groups of patients presenting the most severe allergic symptoms. Methods:  Study centres were grouped into tertiles categorized according to symptom severity scores observed in the placebo patients in each centre (low, middle and high...

  18. Rehabilitation of Discharged Patients With Chronic Obstructive Pulmonary Disease—Are New Strategies Needed?

    Directory of Open Access Journals (Sweden)

    Lars Morsø

    2017-01-01

    Full Text Available Background: Rehabilitation after hospital stay implies several benefits for patients with chronic obstructive pulmonary disease (COPD; still few patients are referred and participate in rehabilitation programs. We conducted a case study to investigate the effects of interventions targeting the referral, uptake, and completion for a program of early rehabilitation in the primary health-care sector. Methods: We undertook targeted initiatives to make patients participate in an individualized rehabilitation program with gradual increased intensity. After discharge, primary care COPD nurses and physiotherapists guided patients through progressing exercises in small groups online. Patients proceeded to class-based exercises, patient education and/or leisure activities, or continued telerehabilitation. We evaluated the effects of the intervention by assessing referral rates, completion, and readmission. Results: Sixteen (23% of discharged patients patients were referred to rehabilitation. In comparison, only 1 (0.8% in 131 patients from Vejle hospital was referred to Vejle hospital. Twelve patients completed rehabilitation, all having severe COPD. All started the program within 2 weeks and proceeded to the online-guided exercises within 4 weeks. Study data showed that after 30 days, 1 (6.3% of the 16 patients in the rehabilitation program had been readmitted compared to 8 (14.8% of 55 patients who were not referred. After 90 days, 2 (12.5% and 11 (20.0% patients were readmitted, respectively. The readmission rate showed a nonsignificant decline in patients participating in rehabilitation. Conclusion: This case study showed that the referral rate of patients with COPD to early municipal rehabilitation is extremely low without a targeted effort and still insufficient in spite of a focused intervention. We showed that completion of a municipal rehabilitation program shortly after discharge is possible even for patients with severe COPD. The findings from

  19. The great controversy : the individual's struggle between good and evil in the Testaments of the Twelve Patriarchs and in their Jewish and Christian contexts

    NARCIS (Netherlands)

    Bruin, Tom de

    2013-01-01

    The Testaments of the Twelve Patriarchs are an early Christian work. The argumentation in this work finds its foundation in the struggle between good and evil. In the Testaments this struggle is applied individually, which is a theme found only in Christian works.

  20. A cognitive brain-computer interface for patients with amyotrophic lateral sclerosis.

    Science.gov (United States)

    Hohmann, M R; Fomina, T; Jayaram, V; Widmann, N; Förster, C; Just, J; Synofzik, M; Schölkopf, B; Schöls, L; Grosse-Wentrup, M

    2016-01-01

    Brain-computer interfaces (BCIs) are often based on the control of sensorimotor processes, yet sensorimotor processes are impaired in patients suffering from amyotrophic lateral sclerosis (ALS). We devised a new paradigm that targets higher-level cognitive processes to transmit information from the user to the BCI. We instructed five ALS patients and twelve healthy subjects to either activate self-referential memories or to focus on a process without mnemonic content while recording a high-density electroencephalogram (EEG). Both tasks are designed to modulate activity in the default mode network (DMN) without involving sensorimotor pathways. We find that the two tasks can be distinguished after only one experimental session from the average of the combined bandpower modulations in the theta- (4-7Hz) and alpha-range (8-13Hz), with an average accuracy of 62.5% and 60.8% for healthy subjects and ALS patients, respectively. The spatial weights of the decoding algorithm show a preference for the parietal area, consistent with modulation of neural activity in primary nodes of the DMN. © 2016 Elsevier B.V. All rights reserved.

  1. Disk degenerative disease in childhood: Scheuermann`s disease, Schmorl`s nodes, and the limbus vertebra: MRI findings in 12 patients

    Energy Technology Data Exchange (ETDEWEB)

    Swischuk, L.E. [Departments of Radiology and Pediatrics, Children`s Hospital, University of Texas, Galveston, TX (United States); John, S.D.; Allbery, S. [Children`s Hospital, University of Texas Medical Branch, Galveston, Texas (United States)

    1998-05-01

    Twelve pediatric patients were studied with MRI. All had various disk problems including Scheuermann`s disease, Schmorl`s nodes and limbus vertebrae. All patients shared loss of disk height, altered disk hydration and variable herniation of nuclear material. (orig.) With 6 figs., 1 tab., 14 refs.

  2. Prognostic nutritional index is associated with survival after total gastrectomy for patients with gastric cancer.

    Science.gov (United States)

    Ishizuka, Mitsuru; Oyama, Yusuke; Abe, Akihito; Tago, Kazuma; Tanaka, Genki; Kubota, Keiichi

    2014-08-01

    To investigate the influence of clinical characteristics including nutritional markers on postoperative survival in patients undergoing total gastrectomy (TG) for gastric cancer (GC). One hundred fifty-four patients were enrolled. Uni- and multivariate analyses using the Cox proportional hazard model were performed to explore the most valuable clinical characteristic that was associated with postoperative survival. Multivariate analysis using twelve clinical characteristics selected from univariate analyses revealed that age (≤ 72/>72), carcinoembryonic antigen (≤ 20/>20) (ng/ml), white blood cell count (≤ 9.5/>9.5) (× 10(3)/mm(3)), prognostic nutritional index (PNI) (≤ 45/>45) and lymph node metastasis (negative/positive) were associated with postoperative survival. Kaplan-Meier analysis and log-rank test showed that patients with higher PNI (>45) had a higher postoperative survival rate than those with lower PNI (≤ 45) (p<0.001). PNI is associated with postoperative survival of patients undergoing TG for GC and is able to divide such patients into two independent groups before surgery. Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  3. Long-term follow-up in sacroiliac joint pain patients treated with radiofrequency ablative therapy

    Directory of Open Access Journals (Sweden)

    Flávio Ramalho Romero

    2015-06-01

    Full Text Available Sacroiliac joint (SIJ pain is responsible for up to 40% of all cases of lumbar back pain. Objective Report the long-term efficacy of radiofrequency denervation for sacroiliac joint pain at six, twelve and eighteen months.Method Third-two adults’ patients with sacroiliac join pain diagnosis were included for a prospective study. Primary outcome measure was pain intensity on the Numeric Rating Scale (NRS. Secondary outcome measure was Patient Global Impression of Change Scale (PGIC.Results Short-term pain relief was observed, with the mean NRS pain score decreasing from 7.7 ± 1.8 at baseline to 2.8 ± 1.2 at one month and to 3.1 ± 1.9 at six months post-procedure (p < 0.001. Long-term pain relief was sustained at twelve and eighteen months post-procedure, with NRS pain remaining at 3.4 ± 2.1 and 4.0 ± 2.7, respectively.Conclusion Radiofrequency denervation of the SIJ can significantly reduce pain in selected patients with sacroiliac syndrome.

  4. Establishing construct validity for the thyroid-specific patient reported outcome measure (ThyPRO)

    DEFF Research Database (Denmark)

    Watt, Torquil; Bjorner, Jakob Bue; Groenvold, Mogens

    2009-01-01

    , evaluating lack of convergent validity (item-own scale polyserial correlation correlation higher than item-own scale correlation) of the hypothesized scale structure. Analyses were repeated in clinical and sociodemographic subgroups and with Pearson...... complete convergent validity and only two instances of lack of discriminant validity. Pearson correlations yielded similar results. Across all subgroups, convergent validity was complete, and discriminant validity was found in 99.2% of tests. Lack of discriminant validity was mainly between physical...... correlations. Reliability was estimated by Cronbach's alpha, both conventionally and with polychoric correlations. RESULTS: In total, 904 patients (69%) responded. Initial multitrait scaling analysis identified 25 scaling errors. Twelve items were omitted from the scale structure, and a re-analysis showed...

  5. Twelve tips for developing and delivering a massive open online course in medical education.

    Science.gov (United States)

    Pickering, James D; Henningsohn, Lars; DeRuiter, Marco C; de Jong, Peter G M; Reinders, Marlies E J

    2017-07-01

    Massive open online courses (MOOCs) are a novel mode of online learning. They are typically based on higher education courses and can attract a high number of learners, often in the thousands. They are distinct from on-campus education and deliver the learning objectives through a series of short videos, recommended readings and discussion fora, alongside automated assessments. Within medical education the role of MOOCs remains unclear, with recent proposals including continuing professional development, interprofessional education or integration into campus-based blended learning curricula. In this twelve tips article, we aim to provide a framework for readers to use when developing, delivering and evaluating a MOOC within medical education based on the literature and our own experience. Practical advice is provided on how to design the appropriate curriculum, engage with learners on the platform, select suitable assessments, and comprehensively evaluate the impact of your course.

  6. Emergency arterial embolization of upper gastrointestinal and jejunal tumors: An analysis of 12 patients with severe bleeding.

    Science.gov (United States)

    Zandrino, F; Tettoni, S M; Gallesio, I; Summa, M

    2017-01-01

    The goal of this study was to retrospectively assess the efficacy of emergency percutaneous transcatheter arterial embolization in patients with severe bleeding due to upper gastrointestinal or jejunal tumor. Twelve patients (7 men, 5 women; mean age, 74 years±14 (SD); range: 54-86 years) with severe bleeding from the upper gastrointestinal tract, with failed endoscopic treatment not eligible for emergency surgery were treated by emergency percutaneous transcatheter arterial embolization. The bleeding cause was gastric tumor in 7 patients, duodenal tumor in 4 patients and jejunal tumor in one patient. Procedure details and follow-up were reviewed. Twelve embolization procedures were performed using various embolic agents. Embolization was achieved and bleeding was stopped in all patients. Five patients underwent surgery within the 30 days following embolization. In the remaining 7 patients, no bleeding occurred at 1 month follow-up in 6 patients and bleeding recurred in one patient at 1 month. In this later patient, endoscopic treatment was successful. The results of our study suggest that transcatheter arterial embolization is safe and effective in patients with severe arterial bleeding due to upper gastrointestinal or jejunal tumor. In some patients, transcatheter arterial embolization can be used as a bridge to surgery. Copyright © 2016 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  7. Developing and Testing Twelve-Step Facilitation for Adolescents with Substance Use Disorder: Manual Development and Preliminary Outcomes

    Directory of Open Access Journals (Sweden)

    John F. Kelly

    2016-01-01

    Full Text Available Adolescent substance use disorder treatment programs are often based on the 12-step philosophy of Alcoholics Anonymous and/or link adolescents to these free resources. Despite this, no studies have developed and rigorously tested a twelve-step facilitation (TSF intervention for young people, leaving a significant evidence gap. This study describes the first systematic development of an outpatient adolescent TSF treatment. An integrated twelve-step facilitation (iTSF treatment incorporated TSF, motivational enhancement therapy, and cognitive behavioral therapy elements and was developed in an iterative manner with weekly feedback provided by 36 adolescents ( M age 17 years [SD = 1.4]; 52.8% white with DSM-IV substance use disorder recruited from the community. Assessments were conducted at baseline and at three and six months. Participants completed 6 of 10 sessions on average (8 participants completed all 10. Notable treatment developments were the inclusion of “in-services” led by Marijuana Anonymous members, including parents in a portion of individual sessions to provide a rationale for TSF, and use of a Socratic therapeutic interaction style. Acceptability and feasibility of the treatment were excellent (treatment satisfaction was 4.29 [SD = 0.59] out of 5. In keeping with TSF theory, the intervention substantially increased 12-step participation, and greater participation related to greater abstinence. iTSF is a replicable manualized treatment that can be implemented and tested in outpatient settings. Given the widespread compatibility of iTSF with the current adolescent treatment, if found efficacious, iTSF could be relatively easily adopted, implemented, and sustained and could provide an evidence-based option that could undergird current practice.

  8. Endovascular Exclusion of an Abdominal Aortic Aneurysm in Patients with Concomitant Abdominal Malignancy: Early Experience

    Energy Technology Data Exchange (ETDEWEB)

    Choi, You Ri; Chang, Nam Kyu [Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of); Shin, Hyo Hyun; Oh, Hyun Jun; Kim, Jae Kyu; Choi, Soo Jin Na; Chung, Sang Young [Chonnam National University Hospital, Gwangju (Korea, Republic of); Yim, Nam Yeol [Armed Forces Yangju Hospital, Yangju (Korea, Republic of)

    2010-08-15

    To assess the outcomes of endovascular aortic aneurysm repair (EVAR) for the treatment of an abdominal aortic aneurysm in patients undergoing curative surgical treatment for concomitant abdominal malignancy. The study included 12 patients with abdominal neoplasia and an abdominal aortic aneurysm (AAA), which was treated by surgery and stent EVAR. The neoplasm consisted of the gastric, colorectal, pancreas, prostate, and gall bladder. The follow up period was 3-21 months (mean 11.8 months). All medical records and imaging analyses were reviewed by CTA and/or color Doppler US, retrospectively. Successful endoluminal repair was accomplished in all twelve patients. The mean interval time between EVAR and surgery was 58.6 days. Small amounts of type 2 endoleaks were detected in two patients (17%). One patient developed adult respiratory distress syndrome after Whipple's operation 20 days after surgery, which led to hopeless discharge. No procedure-related mortality, morbidity, or graft-related infection was noted. Exclusion of AAA in patients with accompanying malignancy show with a relatively low procedure morbidity and mortality. Hence, endoluminal AAA repair in patients with synchronous neoplasia may allow greater flexibility in the management of an offending malignancy

  9. Endovascular Exclusion of an Abdominal Aortic Aneurysm in Patients with Concomitant Abdominal Malignancy: Early Experience

    International Nuclear Information System (INIS)

    Choi, You Ri; Chang, Nam Kyu; Shin, Hyo Hyun; Oh, Hyun Jun; Kim, Jae Kyu; Choi, Soo Jin Na; Chung, Sang Young; Yim, Nam Yeol

    2010-01-01

    To assess the outcomes of endovascular aortic aneurysm repair (EVAR) for the treatment of an abdominal aortic aneurysm in patients undergoing curative surgical treatment for concomitant abdominal malignancy. The study included 12 patients with abdominal neoplasia and an abdominal aortic aneurysm (AAA), which was treated by surgery and stent EVAR. The neoplasm consisted of the gastric, colorectal, pancreas, prostate, and gall bladder. The follow up period was 3-21 months (mean 11.8 months). All medical records and imaging analyses were reviewed by CTA and/or color Doppler US, retrospectively. Successful endoluminal repair was accomplished in all twelve patients. The mean interval time between EVAR and surgery was 58.6 days. Small amounts of type 2 endoleaks were detected in two patients (17%). One patient developed adult respiratory distress syndrome after Whipple's operation 20 days after surgery, which led to hopeless discharge. No procedure-related mortality, morbidity, or graft-related infection was noted. Exclusion of AAA in patients with accompanying malignancy show with a relatively low procedure morbidity and mortality. Hence, endoluminal AAA repair in patients with synchronous neoplasia may allow greater flexibility in the management of an offending malignancy

  10. Double Filtration Plasma Apheresis Shortens Hospital Admission Duration of Patients With Severe Hypertriglyceridemia-Associated Acute Pancreatitis.

    Science.gov (United States)

    Chang, Chiz-Tzung; Tsai, Tsung-Yu; Liao, Hsin-Yi; Chang, Chia-Ming; Jheng, Jyun-Shan; Huang, Wen-Hsin; Chou, Che-Yi; Chen, Chao-Jung

    2016-04-01

    The treatment effectiveness of double filtration plasma apheresis (DFPP) on severe hypertriglyceridemia-associated acute pancreatitis (STAP) has been questioned because the currently defined serum triglyceride level--1000 mg/dL--is too low for STAP. Given this, we aimed to investigate DFPP effectiveness when we elevated STAP definition to 5000 mg/dL serum triglyceride. We performed nested case-control studies for STAP patients and divided them into groups "with" or "without" DFPP. We further recruited outpatient asymptomatic hypertriglyceridemia patients with STAP history, then divided them into groups "with" or "without" prophylactic DFPP once every 3 to 6 months for 2 years. We observed hospitalization duration and STAP recurrence between patients with and patients without DFPP. Twelve STAP patients receiving DFPP had a median hospitalization of 5 days, whereas 24 patients without DFPP had 10 days (P = 0.009). Six outpatient referrals with STAP history receiving prophylactic DFPP showed no STAP recurrences whereas 6 without DFPP showed 3 recurrences (P = 0.046). For the 25 patients whose serum triglyceride exceeded 5000 mg/dL, 11 receiving DFPP had median hospitalization of 5 days while 14 without DFPP had 11 days (P = 0.012). When applied to serum triglyceride in excess of 5000 mg/dL, DFPP removes oxidized and inflammatory lipoproteins, shortens hospitalization duration, and minimizes STAP recurrence.

  11. Granulocytic sarcoma of the ovary in a nonleukemic patient.

    Science.gov (United States)

    Aguiar, R C; Pozzi, D H; Chamone, D A

    1993-01-01

    We report a case of granulocytic sarcoma of the ovary preceding acute myeloid leukemia by twelve months, with no evidence of any hematological involvement at the time of first diagnosis. The patient was initially treated with surgery and chemotherapy for undifferentiated lymphoma and, although this aggressive protocol resulted in a complete response, granulocytic sarcoma recurred as extramedullary disease, followed by the appearance of acute myeloid leukemia. We discuss the clinical, histopathological and immunohistochemical features of the disease, the differential diagnosis and, in particular, the role of early aggressive treatment on the outcome of the patient.

  12. What about Gender in Climate Change? Twelve Feminist Lessons from Development

    Directory of Open Access Journals (Sweden)

    Anne Jerneck

    2018-02-01

    Full Text Available Adaptation and mitigation are two key responses to climate change. In the global South they prompt many questions: what is the direction and degree of change needed? How can new climate change policies be aligned with existing development initiatives? How are core social relations such as gender understood and prioritized in relation to technical and other solutions? In search of synergies between adaptation, development and mitigation, this article asks a pertinent question for sub-Saharan small-scale agriculture in particular: what can adaptation and mitigation learn from development debates on social goal setting, institutional change and gender equality? From the perspective of sustainability science and feminist literature, three main findings emerge. First, as regards social goal setting, adaptation and mitigation should, like development, support the escape out of poverty, ill-health and food-insecurity. Second, as regards institutions, adaptation and mitigation should address how gender regulates access to, use of and control over resources in terms of labor, land and strategic decision-making power. Third, as regards gender equality, adaptation and mitigation should learn from how development in theory and practice has addressed gender, women, nature and the environment. At its core, the analysis contributes twelve salient themes that can significantly inform adaptation and mitigation in research, policy and practice, thus serving as inspiration for a critical debate on much needed synergetic trajectories.

  13. High-energy, twelve-channel laser facility (DEFIN) for spherical irradiation of thermonuclear targets

    International Nuclear Information System (INIS)

    Basov, N.G.; Danilov, A.E.; Krokhin, O.N.; Kruglov, B.V.; Mikhailov, Yu.A.; Sklizkov, G.V.; Fedotov, S.I.; Fedorov, A.N.

    This paper describes a high-energy, twelve-channel laser facility (DELFIN) intended for high-temperature heating of thermonuclear targets with spherical symmetry. The facility includes a neodymium-glass laser with the ultimate radiation energy of 10 kJ, a pulse length of approximately 10 -10 to 10 -9 s, beam divergence of 5 x 10 -4 radians, a vacuum chamber in which laser radiation interacts with the plasma, and a system of diagnostic instrumentation for the observation of laser beam and plasma parameters. Described are the optical scheme and construction details of the laser facility. Presented is an analysis of focusing schemes for target irradiation and described is the focusing scheme of the DELFIN facility, which is capable of attaining a high degree of spherical symmetry in irradiating targets with maximum beam intensity at the target surface of approximately 10 15 W/cm 2 . This paper examines the most important problems connected with the physical investigations of thermonuclear laser plasma and the basic diagnostic problems involved in their solution

  14. Large-Scale No-Show Patterns and Distributions for Clinic Operational Research

    Directory of Open Access Journals (Sweden)

    Michael L. Davies

    2016-02-01

    Full Text Available Patient no-shows for scheduled primary care appointments are common. Unused appointment slots reduce patient quality of care, access to services and provider productivity while increasing loss to follow-up and medical costs. This paper describes patterns of no-show variation by patient age, gender, appointment age, and type of appointment request for six individual service lines in the United States Veterans Health Administration (VHA. This retrospective observational descriptive project examined 25,050,479 VHA appointments contained in individual-level records for eight years (FY07-FY14 for 555,183 patients. Multifactor analysis of variance (ANOVA was performed, with no-show rate as the dependent variable, and gender, age group, appointment age, new patient status, and service line as factors. The analyses revealed that males had higher no-show rates than females to age 65, at which point males and females exhibited similar rates. The average no-show rates decreased with age until 75–79, whereupon rates increased. As appointment age increased, males and new patients had increasing no-show rates. Younger patients are especially prone to no-show as appointment age increases. These findings provide novel information to healthcare practitioners and management scientists to more accurately characterize no-show and attendance rates and the impact of certain patient factors. Future general population data could determine whether findings from VHA data generalize to others.

  15. Large-Scale No-Show Patterns and Distributions for Clinic Operational Research.

    Science.gov (United States)

    Davies, Michael L; Goffman, Rachel M; May, Jerrold H; Monte, Robert J; Rodriguez, Keri L; Tjader, Youxu C; Vargas, Dominic L

    2016-02-16

    Patient no-shows for scheduled primary care appointments are common. Unused appointment slots reduce patient quality of care, access to services and provider productivity while increasing loss to follow-up and medical costs. This paper describes patterns of no-show variation by patient age, gender, appointment age, and type of appointment request for six individual service lines in the United States Veterans Health Administration (VHA). This retrospective observational descriptive project examined 25,050,479 VHA appointments contained in individual-level records for eight years (FY07-FY14) for 555,183 patients. Multifactor analysis of variance (ANOVA) was performed, with no-show rate as the dependent variable, and gender, age group, appointment age, new patient status, and service line as factors. The analyses revealed that males had higher no-show rates than females to age 65, at which point males and females exhibited similar rates. The average no-show rates decreased with age until 75-79, whereupon rates increased. As appointment age increased, males and new patients had increasing no-show rates. Younger patients are especially prone to no-show as appointment age increases. These findings provide novel information to healthcare practitioners and management scientists to more accurately characterize no-show and attendance rates and the impact of certain patient factors. Future general population data could determine whether findings from VHA data generalize to others.

  16. Effect of Ankle-foot Orthosis on Lower Limb Muscle Activities and Static Balance of Stroke Patients Authors’ Names

    OpenAIRE

    Lee, Youngmin; Her, Jin Gang; Choi, Youngeun; Kim, Heesoo

    2014-01-01

    [Purpose] This study examined the effects of an ankle-foot orthosis worn during balance training on lower limb muscle activity and static balance of chronic stroke patients. [Subjects] The subjects were twenty-five inpatients receiving physical therapy for chronic stroke. [Methods] The chronic stroke patients were divided into two groups: thirteen patients were assigned to the ankle-foot orthosis group, while the remaining twelve patients wore only their shoes. Each group performed balance tr...

  17. Changes in six-minute walking distance during pulmonary rehabilitation in patients with COPD and in healthy subjects

    Directory of Open Access Journals (Sweden)

    Imen Ben Cheikh Rejbi

    2010-07-01

    Full Text Available Imen Ben Cheikh Rejbi1, Yassine Trabelsi1, Afef Chouchene1, Wafa Ben Turkia1, Helmi Ben Saad1, Abdelkarim Zbidi1, Abdelhamid Kerken2, Zouhair Tabka11Department of Physiology and Lung Testing, Faculty of Medicine of Sousse, Tunisia; 2Department of Biophysics, Faculty of Medicine of Monastir, TunisiaBackground: The six-minute walking distance (6MWD test has demonstrated validity and reliability to assess changes in functional capacity following pulmonary rehabilitation in patients with chronic obstructive lung disease. However, no attempt has been made to establish an iterative measurement of 6MWD during the overall period of pulmonary rehabilitation. Therefore, the aim of this study was to evaluate the impact of a twelve-week rehabilitation program on the iterative weekly measurement of 6MWD in chronic obstructive pulmonary disease (COPD patients and healthy subjects.Methods: Twenty-six patients with COPD and nine age-matched healthy subjects were studied. Measurements were taken at baseline and after twelve weeks except for the 6MWD. The exercise measurements included a six-minute walking test (6MWT and an incremental exercise test. Oxygen saturation, heart rate, and dyspnea will be monitored during all these tests. Results: At baseline there were significant differences between groups, except in age, body mass index, and oxygen saturation. After 12 weeks, there was no significant change in lung function in patients with COPD and healthy subjects. The 6MWD, peak oxygen uptake VO2peak and anaerobic threshold increased significantly after training in both groups (P < 0.01. The averaged trace of the 6MWD of patients with COPD and healthy subjects was followed-up respectively by a logarithmic and linear fitting. 6MWD showed a plateau after eight weeks in patients with COPD, however, it increased continually overall in healthy subjects.Conclusion: Both patients with COPD and healthy subjects demonstrated functional responses to training but with

  18. The correlation of the thalamic lesions on MRI with cerebral cortical blood flow in patients with lacunar infarction

    International Nuclear Information System (INIS)

    Nabatame, Hidehiko; Nakamura, Kazuo; Matsuda, Minoru; Fujimoto, Naoki; Fukuyama, Hidenao.

    1995-01-01

    We performed MRI and measured cerebral blood flow (CBF) using 123 I-IMP SPECT microsphere model in twenty three right-handed patients with lacunar infarction. Twelve of 23 patients showed chronic deterioration of dysarthria and gait disturbance. The mental function of the patients was evaluated by the Mini-Mental State (MMS) examination. The area of high intensity on T2-weighted images was quantitatively analyzed in the cerebral white matter (WM), lenticular nucleus (LN) and thalamus (THA). The score of MMS was positively correlated with the local CBF in the bilateral frontal, parietal, temporal and occipital cortices (p<0.05). Also, the area of high intensity in the left THA showed a significant negative correlation with local CBF of the bilateral frontal, parietal, temporal and occipital cortices (p<0.001). The high intensity areas of the bilateral LN, right WM and right THA had a significant but weaker negative correlation with local CBF of some cortices. These findings suggest that thalamic lesions on the dominant side play an important role in the reduction of cortical blood flow and the deterioration of mental functions in patients with lacunar infarction. (author)

  19. Phantom shocks in patients with implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Moons, Philip; Zwisler, Ann-Dorthe

    2013-01-01

    of phantom shocks.METHODS AND RESULTS: The design was secondary explorative analyses of data from a randomized controlled trial. One hundred and ninety-six patients with first-time ICD implantation (79% male, mean age 58 years) were randomized (1 : 1) to either combined rehabilitation or a control group...... questions regarding the experience of phantom shocks, date, time, and place. Twelve patients (9.4%) experienced a phantom shock, 7 in the intervention group and 5 in the control group (NS). Neither age, sex, quality of life nor perceived health at baseline was significantly related to the probability...

  20. Development of twelve microsatellite loci in the red tree corals Primnoa resedaeformis and Primnoa pacifica

    Science.gov (United States)

    Morrison, Cheryl L.; Springmann, Marcus J.; Shroades, Kelsey; Stone, Robert P.

    2015-01-01

    A suite of tetra-, penta-, and hexa-nucleotide microsatellite loci were developed from Roche 454 pyrosequencing data for the cold-water octocorals Primnoa resedaeformis and P. pacifica. Twelve of 98 primer sets tested consistently amplified in 30 P. resedaeformis samples from Baltimore Canyon (western North Atlantic Ocean) and in 24 P. pacifica samples (Shutter Ridge, eastern Gulf of Alaska). The loci displayed moderate levels of allelic diversity (average 7.5 alleles/locus) and heterozygosity (average 47 %). Levels of genetic diversity were sufficient to produce unique multi-locus genotypes and to distinguish species. These common species are long-lived (hundreds of years) and provide essential fish habitat (P. pacifica), yet populations are provided little protection from human activities. These loci will be used to determine regional patterns of population connectivity to inform effective marine spatial planning and ecosystem-based fisheries management.

  1. Impact of an intensive dynamic exercise program on oxidative stress and on the outcome in patients with fibromyalgia

    Directory of Open Access Journals (Sweden)

    Amal F Soliman

    2016-01-01

    Conclusion Twelve weeks of intensive dynamic exercise program should be recommended to patients with FM as it was effective in decreasing the oxidative stress parameters, increasing the antioxidant parameters, and improving the clinical outcome of this disease.

  2. Treatment outcome in patients with vulvar cancer: comparison of concurrent radiotherapy to postoperative radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ja Young; Kim, Sung Hwan; Kim, Ki Won; Park, Dong Choon; Yoon, Joo Hee; Yoon, Sei Chul [St. Vincent' s Hospital, The Catholic University of Korea School of Medicine, Seoul (Korea, Republic of); Yu, Mina [St. Mary' s Hospital, The Catholic University of Korea School of Medicine, Seoul (Korea, Republic of)

    2012-03-15

    To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy. Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications. Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.

  3. An optimized voxel-based morphometry study in the evaluation of brain structural abnormalities in anisometropic amblyopia patients

    International Nuclear Information System (INIS)

    Liu Shengyuan; Zhang Jing; Zhang Quan; Yin Huiming; Zhang Lihong; Li Wei; Zhang Yunting

    2012-01-01

    Objective: To investigate possible neural mechanism of anisometropic amblyopia by analysing the whole brain volume changes both in grey matter and white matter using optimized voxel-based morphometry (VBM). Methods: Twelve anisometropic amblyopia patients and 12 age,gender and handedness matched healthy volunteers underwent 3-dimensional (3D) fast spoiled gradient echo (FSPGR) sequence scanning on 1.5 Tesla MR system. Raw data was processed and analyzed using statistical parametric mapping (SPM) 5. Results: Compared to healthy controls,the grey matter exhibiting significantly decreased volume in patients included right cuneus, bilateral occipital gyrus, right middle frontal gyrus, left middle temporal gyrus, right superior temporal gyrus, right precuneus,and middle part of right cingulate gyrus (clusters > 10). The grey matter showing increased volume in patients included right cerebellum,right parahippocampal gyrus, left precentral gyrus,and left superior frontal gyrus (clusters > 10). The white matter volume in bilateral optic radiation and internal capsule, especially right optic radiation, decreased significantly in patient group (clusters > 10 ). No white matter showed significantly increased volume in patient group. Conclusion: VBM can be used to investigate the changes of grey matter volume and white matter volume in the whole brain of anisometropic amblyopia children, it provides a method to illustrate the presumed neuro-mechanism from a morphologic point of view. (authors)

  4. Animal Robot Assisted-therapy for Rehabilitation of Patient with Post-Stroke Depression

    Science.gov (United States)

    Zikril Zulkifli, Winal; Shamsuddin, Syamimi; Hwee, Lim Thiam

    2017-06-01

    Recently, the utilization of therapeutic animal robots has expanded. This research aims to explore robotics application for mental healthcare in Malaysia through human-robot interaction (HRI). PARO, the robotic seal PARO was developed to give psychological effects on humans. Major Depressive Disorder (MDD) is a common but severe mood disorder. This study focuses on the interaction protocol between PARO and patients with MDD. Initially, twelve rehabilitation patients gave subjective evaluation on their first interaction with PARO. Next, therapeutic interaction environment was set-up with PARO in it to act as an augmentation strategy with other psychological interventions for post-stroke depression. Patient was exposed to PARO for 20 minutes. The results of behavioural analysis complemented with information from HRI survey question. The analysis also observed that the individual interactors engaged with the robot in diverse ways based on their needs Results show positive reaction toward the acceptance of an animal robot. Next, therapeutic interaction is set-up for PARO to contribute as an augmentation strategy with other psychological interventions for post-stroke depression. The outcome is to reduce the stress level among patients through facilitated therapy session with PARO

  5. Twelve Years of Education and Public Outreach with the Fermi Gamma-ray Space Telescope

    Science.gov (United States)

    Cominsky, Lynn R.; McLin, K. M.; Simonnet, A.; Fermi E/PO Team

    2013-04-01

    During the past twelve years, NASA's Fermi Gamma-ray Space Telescope has supported a wide range of Education and Public Outreach (E/PO) activities, targeting K-14 students and the general public. The purpose of the Fermi E/PO program is to increase student and public understanding of the science of the high-energy Universe, through inspiring, engaging and educational activities linked to the mission’s science objectives. The E/PO program has additional more general goals, including increasing the diversity of students in the Science, Technology, Engineering and Mathematics (STEM) pipeline, and increasing public awareness and understanding of Fermi science and technology. Fermi's multi-faceted E/PO program includes elements in each major outcome category: ● Higher Education: Fermi E/PO promotes STEM careers through the use of NASA data including research experiences for students and teachers (Global Telescope Network), education through STEM curriculum development projects (Cosmology curriculum) and through enrichment activities (Large Area Telescope simulator). ● Elementary and Secondary education: Fermi E/PO links the science objectives of the Fermi mission to well-tested, customer-focused and NASA-approved standards-aligned classroom materials (Black Hole Resources, Active Galaxy Education Unit and Pop-up book, TOPS guides, Supernova Education Unit). These materials have been distributed through (Educator Ambassador and on-line) teacher training workshops and through programs involving under-represented students (after-school clubs and Astro 4 Girls). ● Informal education and public outreach: Fermi E/PO engages the public in sharing the experience of exploration and discovery through high-leverage multi-media experiences (Black Holes planetarium and PBS NOVA shows), through popular websites (Gamma-ray Burst Skymap, Epo's Chronicles), social media (Facebook, MySpace), interactive web-based activities (Space Mysteries, Einstein@Home) and activities by

  6. Twelve clinically significant points in medulloblastoma

    International Nuclear Information System (INIS)

    Sugiyama, Kazuhiko; Yamasaki, Fumiyuki; Kajiwara, Yoshinori; Watanabe, Yosuke; Takayasu, Takeshi; Kurisu, Kaoru

    2011-01-01

    Though medulloblastoma is the most common malignant brain tumor during childhood, only 80 newly-diagnosed tumors develos every year, as the annual incidence is extremely rare with an occurrence of 0.5 per 100,000 children younger than 15-year-old and of 0.7 per 100,000 for the entire population. Images obtained of medulloblastoma are characterized by a round heterogeously-enhanced mass in or adjacent to the VIth ventricle. Objectives of surgical treatment are the maximum resectioning of the main mass and the relief of the obstructive hydrocephalus. Cerebellar mutism occurs a few days after one fourth of medulloblastoma surgery, and lasts approximately for 50 days followed by subsequent dysarthria. Pathological subtypes include classic medulloblastoma, desmoplastic/nodular medulloblastoma, medulloblastoma with extensive nodularity, large cell/anaplastic medulloblastoma, all corresponding to World Health Organization (WHO) grade IV. According to age, residual tumor size, and disseminated staging, patients are divided into average-risk group, high-risk group, or baby-medulloblastoma after surgery. Standard treatment in average-risk group includes 23.4-Gy cranio-spinal irradiation (CSI) with posterior boost followed by chemotherapy consisting of cisplatin (CDDP), alkylating agents, and vincristine. Patients in high-risk group receive over 36-Gy CSI with boost radiotherapy to nodular lesions before, concomitantly with, or followed by dose-intensity chemotherapy. In cases with gross total removal, or desmoplastic/nodular pathology radiotherapy for patients younger than 3-year-old are often delayed until they turn 3-year-old, and are able to survive for long time by appropriate chemotherapy alone. Adolescent survivors with childhood medulloblastoma have a number of late adverse effects regarding another neoplasm, neuro-cognitive function, endocrine activity, cardiovascular organs, and skeletal system. Comprehensive follow-up and support system are mandatory. (author)

  7. European ancestry predominates in neuromyelitis optica and multiple sclerosis patients from Brazil.

    Directory of Open Access Journals (Sweden)

    Doralina Guimarães Brum

    Full Text Available BACKGROUND: Neuromyelitis optica (NMO is considered relatively more common in non-Whites, whereas multiple sclerosis (MS presents a high prevalence rate, particularly in Whites from Western countries populations. However, no study has used ancestry informative markers (AIMs to estimate the genetic ancestry contribution to NMO patients. METHODS: Twelve AIMs were selected based on the large allele frequency differences among European, African, and Amerindian populations, in order to investigate the genetic contribution of each ancestral group in 236 patients with MS and NMO, diagnosed using the McDonald and Wingerchuck criteria, respectively. All 128 MS patients were recruited at the Faculty of Medicine of Ribeirão Preto (MS-RP, Southeastern Brazil, as well as 108 healthy bone marrow donors considered as healthy controls. A total of 108 NMO patients were recruited from five Neurology centers from different Brazilian regions, including Ribeirão Preto (NMO-RP. PRINCIPAL FINDINGS: European ancestry contribution was higher in MS-RP than in NMO-RP (78.5% vs. 68.7% patients. In contrast, African ancestry estimates were higher in NMO-RP than in MS-RP (20.5% vs. 12.5% patients. Moreover, principal component analyses showed that groups of NMO patients from different Brazilian regions were clustered close to the European ancestral population. CONCLUSIONS: Our findings demonstrate that European genetic contribution predominates in NMO and MS patients from Brazil.

  8. Vibrational modes of isolated substitution impurities in twelve compounds AN B8-N with the blende structure

    International Nuclear Information System (INIS)

    Plumelle, Pierre

    1979-01-01

    We have studied a particular point defect, the isolated substitution in twelve compounds CuCl, CuBr, CuI, ZnTe, CdTe, ZnS, ZnSe, GaAs, GaP, InSb, InP and GaSb. The model of the perfect lattice is a rigid ion model with eleven parameters. Infrared localized vibrational modes of impurities are observed in a series of samples. By comparison of these experimental results with the calculated values it is possible to determine the perturbation for each particular case. A relation obtained between a force constant of the perfect crystal and the force constant of the impurity suggests that no change is introduced by the isoelectronic impurities. (author) [fr

  9. AIP mutations in Brazilian patients with sporadic pituitary adenomas: a single-center evaluation

    Science.gov (United States)

    Kasuki, Leandro; de Azeredo Lima, Carlos Henrique; Ogino, Liana; Camacho, Aline H S; Chimelli, Leila; Korbonits, Márta

    2017-01-01

    Aryl hydrocarbon receptor-interacting protein (AIP) gene mutations (AIPmut) are the most frequent germline mutations found in apparently sporadic pituitary adenomas (SPA). Our aim was to evaluate the frequency of AIPmut among young Brazilian patients with SPA. We performed an observational cohort study between 2013 and 2016 in a single referral center. AIPmut screening was carried out in 132 SPA patients with macroadenomas diagnosed up to 40 years or in adenomas of any size diagnosed until 18 years of age. Twelve tumor samples were also analyzed. Leukocyte DNA and tumor tissue DNA were sequenced for the entire AIP-coding region for evaluation of mutations. Eleven (8.3%) of the 132 patients had AIPmut, comprising 9/74 (12%) somatotropinomas, 1/38 (2.6%) prolactinoma, 1/10 (10%) corticotropinoma and no non-functioning adenomas. In pediatric patients (≤18 years), AIPmut frequency was 13.3% (2/15). Out of the 5 patients with gigantism, two had AIPmut, both truncating mutations. The Y268* mutation was described in Brazilian patients and the K273Rfs*30 mutation is a novel mutation in our patient. No somatic AIP mutations were found in the 12 tumor samples. A tumor sample from an acromegaly patient harboring the A299V AIPmut showed loss of heterozygosity. In conclusion, AIPmut frequency in SPA Brazilian patients is similar to other populations. Our study identified two mutations exclusively found in Brazilians and also shows, for the first time, loss of heterozygosity in tumor DNA from an acromegaly patient harboring the A299V AIPmut. Our findings corroborate previous observations that AIPmut screening should be performed in young patients with SPA. PMID:29074612

  10. Management of brain metastasis in a patient with advanced epithelial ovarian carcinoma by gamma-knife radiosurgery

    Directory of Open Access Journals (Sweden)

    Nikolaou Marinos

    2015-01-01

    Full Text Available Introduction. Brain metastases from epithelial ovarian cancer (EOC are rare events. We present a rare case of single ovarian cancer metastasis to the brain treated with gamma-knife radiosurgery (GKRS. Case Outline. A 65-year-old woman with advanced EOC presented with severe neurologic symptoms. A single brain metastasis of 3.2 cm with surrounding edema in the left parietal lobe was detected by brain magnetic resonance imaging (MRI scan during the work-up. The decision to perform GKRS was due to a surgical inaccessibility of intracranial lesion. Twelve weeks after the procedure, the MRI scan showed reduction in the diameter of brain metastasis and surrounding edema and the patient returned to good mental and motor performance. The patient survived for 22 months following treatment and died from a progressive intra-abdominal disease. Prognosis of ovarian cancer patients with brain metastases is generally poor regardless of treatment. Conclusion. Our case shows that GKRS as primary treatment modality for the control of ovarian cancer metastases to the brain was effective and can be considered as a treatment of choice if international selection criteria are followed.

  11. Cytokine profiles show heterogeneity of interferon-β response in multiple sclerosis patients

    DEFF Research Database (Denmark)

    Hegen, Harald; Adrianto, Indra; Lessard, Christopher J

    2016-01-01

    OBJECTIVE: To evaluate serum cytokine profiles for their utility to determine the heterogeneous responses to interferon (IFN)-β treatment in patients with multiple sclerosis (MS). METHODS: Patients with relapsing-remitting MS (RRMS) or clinically isolated syndrome receiving de novo IFN-β treatment...... were included in this prospective, observational study. Number of relapses and changes in disability were assessed 2 years prior to and 2 years after initiation of treatment. Sera were collected at baseline and after 3 months on therapy. Cytokine levels in sera were assessed by Luminex multiplex assays...

  12. Aerobic training in aquatic environment improves the position sense of stroke patients: A randomized clinical trial

    OpenAIRE

    Flávia de Andrade e Souza Mazuchi; Aline Bigongiari; Juliana Valente Francica; Patricia Martins Franciulli; Luis Mochizuki; Joseph Hamill; Ulysses Fernandes Ervilha

    2018-01-01

    Abstract AIMS (Stroke patients often present sensory-motor alterations and less aerobic capacity. Joint position sense, which is crucial for balance and gait control, is also affected in stroke patients). To compare the effect of two exercise training protocols (walking in deep water and on a treadmill) on the knee position sense of stroke patients. METHODS This study was designed as a randomized controlled clinical trial. Twelve adults, who suffered a stroke at least one year prior to the ...

  13. Diagnostic value of kinetic analysis using dynamic FDG PET in immunocompetent patients with primary CNS lymphoma

    International Nuclear Information System (INIS)

    Nishiyama, Yoshihiro; Yamamoto, Yuka; Monden, Toshihide; Sasakawa, Yasuhiro; Satoh, Katashi; Ohkawa, Motoomi; Kawai, Nobuyuki

    2007-01-01

    The purpose of this study was to investigate the accumulation of FDG in immunocompetent patients with primary central nervous system (CNS) lymphoma using qualitative and quantitative PET images and to compare baseline with follow-up PET after therapy. Twelve immunocompetent patients with CNS lymphoma were examined. Dynamic emission data were acquired for 60 min immediately following injection of FDG. In seven patients, repeated PET studies were performed after treatment. Applying a three-compartment five-parameter model, K 1 , k 2 , k 3 , k 4 , vascular fraction (V B ) and cerebral metabolic rate of glucose (CMR Glc ) were obtained. We evaluated the FDG uptake visually using qualitative and parametric images and quantitatively using parametric images. A total of 12 lesions were identified in ten patients with newly diagnosed CNS lymphoma. On visual analysis, ten lesions showed an increase on qualitative images, eight showed an increase on K 1 images, 12 showed an increase on k 3 images and ten showed an increase on CMR Glc images. On quantitative analysis, k 2 , k 3 and CMR Glc values of the lesion were significantly different from those of the normal grey matter (p 3 and CMR Glc images. The K 1 , k 2 , k 3 and CMR Glc values after treatment were significantly different from those obtained before treatment (p 3 , using dynamic FDG PET might be helpful for diagnosis of CNS lymphoma and for monitoring therapeutic assessment. (orig.)

  14. Guidelines for patient-specific jawline definition with titanium implants in esthetic, deformity, and malformation surgery

    OpenAIRE

    Mommaerts, Maurice Yves

    2016-01-01

    Context: Asymmetry and unfavorable esthetics of the jawline have become possible to correct in three dimensions using computer aided design and computer aided manufacturing. Aims: The aim of this study was to provide esthetic, technical, and operative guidelines for mandibular angle and border augmentation using patient-specific titanium implants made by selective laser melting. Settings and Design: University hospital - prospective registry. Subjects and Methods: Twelve patients and 17 impla...

  15. Use of Machine-Learning Approaches to Predict Clinical Deterioration in Critically Ill Patients: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Tadashi Kamio

    2017-06-01

    Full Text Available Introduction: Early identification of patients with unexpected clinical deterioration is a matter of serious concern. Previous studies have shown that early intervention on a patient whose health is deteriorating improves the patient outcome, and machine-learning-based approaches to predict clinical deterioration may contribute to precision improvement. To date, however, no systematic review in this area is available. Methods: We completed a search on PubMed on January 22, 2017 as well as a review of the articles identified by study authors involved in this area of research following the preferred reporting items for systematic reviews and meta-analyses (PRISMA guidelines for systematic reviews. Results: Twelve articles were selected for the current study from 273 articles initially obtained from the PubMed searches. Eleven of the 12 studies were retrospective studies, and no randomized controlled trials were performed. Although the artificial neural network techniques were the most frequently used and provided high precision and accuracy, we failed to identify articles that showed improvement in the patient outcome. Limitations were reported related to generalizability, complexity of models, and technical knowledge. Conclusions: This review shows that machine-learning approaches can improve prediction of clinical deterioration compared with traditional methods. However, these techniques will require further external validation before widespread clinical acceptance can be achieved.

  16. Vaccines with dendritic cells in prostate cancer patients

    International Nuclear Information System (INIS)

    Kvalheim, G.

    2004-01-01

    It has been shown that autologous D Cs pulsed with peptides specific for prostate specific Ag (PSA) or prostate-specific membrane Ag are capable of stimulating potent CT L in vitro. However there is evidence to believe that multiple tumour derived antigens would be more potent to elicit anti-tumour responses. Based on these observations a Phase I/II clinical trial in has been initiated. Autologous monocyte-derived dendritic cells (DC s) were transfected with mRNA from three prostate cancer cell lines (DU145, LNCaP and P C-3) and used for vaccination. Twenty patients have been enrolled and 19 have finished vaccination. Each patient received at least four weekly injections. Of them, 10 patients were vaccinated intranodally under ultrasonic guidance and 9 others received the vaccine intradermally. Safety and feasibility were evaluated. No evidence of toxicity and adverse events was observed. Immune response was measured as DTH and by vitro immunoassays including ELISPOT, T cell proliferation test and cytotoxicity test in pre- and post-vaccination peripheral blood samples. Twelve patients developed a specific immune response to tumour cells. Ten patients showed a significant decrease in log slope PSA. Patients with lower PSA tend to give a better response. The early clinical outcome was significantly related to immune responses (p<0.05). We conclude that the strategy of vaccinating with mRNA transfected D Cs functions to elicit cellular immune responses specific for antigens associated with prostate cancer cells and such responses may result in a clinical benefit for the patients

  17. The Stability of DSM Personality Disorders over Twelve to Eighteen Years

    Science.gov (United States)

    Nestadt, Gerald; Di, Chongzhi; Samuels, J F; Bienvenu, O J; Reti, I M; Costa, P; Eaton, William W; Bandeen-Roche, Karen

    2009-01-01

    Background Stability of personality disorders is assumed in most nomenclatures; however, the evidence for this is limited and inconsistent. The aim of this study is to investigate the stability of DSM-III personality disorders in a community sample of eastern Baltimore residents unselected for treatment. Methods Two hundred ninety four participants were examined on two occasions by psychiatrists using the same standardized examination twelve to eighteen years apart. All the DSM-III criteria for personality disorders were assessed. Item-response analysis was adapted into two approaches to assess the agreement between the personality measures on the two occasions. The first approach estimated stability in the underlying disorder, correcting for error in trait measurement, and the second approach estimated stability in the measured disorder, without correcting for item unreliability. Results Five of the ten personality disorders exhibited moderate stability in individuals: antisocial, avoidant, borderline, histrionic, and schizotypal. Associated estimated ICCs for stability of underlying disorder over time ranged between approximately 0.4 and 0.7–0.8. A sixth disorder, OCPD, exhibited appreciable stability with estimated ICC of approximately 0.2–0.3. Dependent, narcissistic, paranoid, and schizoid disorders were not demonstrably stable. Conclusions The findings suggest that six of the DSM personality disorder constructs themselves are stable, but that specific traits within the DSM categories are both of lesser importance than the constructs themselves and require additional specification. PMID:19656527

  18. Rivastigmine in Wernicke-Korsakoff's syndrome: five patients with rivastigmine showed no more improvement than five patients without rivastigmine.

    NARCIS (Netherlands)

    Luykx, H.J.; Dorresteijn, L.D.A.; Haffmans, P.M.; Bonebakker, A.; Kerkmeer, M.; Hendriks, V.M.

    2008-01-01

    AIMS: To evaluate whether rivastigmine, an achetylcholinesterase inhibitor (AChEl), may be effective in restoring memory in Wernicke-Korsakoff's syndrome (WKS). METHODS: Five patients treated with rivastigmine for a period of 6 months were compared with five matched control patients, who received 6

  19. Metagenomic binning reveals the functional roles of core abundant microorganisms in twelve full-scale biogas plants

    DEFF Research Database (Denmark)

    Campanaro, Stefano; Treu, Laura; Kougias, Panagiotis

    2018-01-01

    and environmental factors on MAGs abundance and to investigate the methanogenic performance of the biogas plants. Prediction of the functional properties of MAGs was obtained analyzing their KEGG pathways and their carbohydrate active domains. Network analysis allowed investigation of species-species associations......The aim of this work was to elucidate the microbial ecology in twelve mesophilic and thermophilic full-scale biogas plants using a genome-centric metagenomic approach. In this study both biogas plants treating manure and those treating sludge from waste water treatment plants were considered...... and shed light on syntrophic interactions between members belonging to the anaerobic digestion dark matter (phylum Fermentibacteria). By stratifying and comparing different levels of information, it was predicted that some MAGs have a crucial role in the manure-supplemented thermophilic biogas plants...

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  1. Early assessment and identification of posttraumatic stress disorder, satisfaction with appearance and coping in patients with burns.

    Science.gov (United States)

    Dahl, Oili; Wickman, Marie; Björnhagen, Viveca; Friberg, Mona; Wengström, Yvonne

    2016-12-01

    The first year after severe burn is a psychologically challenging period for the patient. Patients may still struggle with burn-related physical and psychological problems such as posttraumatic stress disorder (PTSD) and body image dissatisfaction (BID). This study investigates the presence of PTSD, BID and coping, at three, six and twelve months after discharge for early identification of patients in need of focused support during rehabilitation. Fifty-two adult patients with different degrees of burns were followed at three, six and twelve months after discharge and 36 patients completed all assessment points. A standardized clinical protocol was used for systematic assessment of PTSD (IES-R), BID (SWAP-Swe) and Coping (CBQ). The follow-up included an intervention with a burn nurse as a complement to the existing program. Approximately half of the patients had a risk of developing PTSD three months after discharge from hospital, and body image dissatisfaction was found to potentially predict risk of PTSD during follow-up. The findings suggest that it is important to include patients with less extensive burns in follow-up as this group is at risk of development of PTSD. Using standardized questionnaires in early follow-up along with assessment of body image dissatisfaction may facilitate detection of psychological problems. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  2. Cerebral blood flow and cerebrovascular reserve capacity in patients with occlusion or severe stenosis of cerebral arterial trunk

    Energy Technology Data Exchange (ETDEWEB)

    Yoshinaga, Shinya; Tanaka, Akira; Nakayama, Yoshiya; Tomonaga, Masamichi [Fukuoka Univ., Chikushino (Japan). Chikushi Hospital

    1997-12-01

    The cerebral blood flow (CBF) and the cerebrovascular reserve capacity (CVRC) were sequentially measured using a xenon enhanced CT scan in patients with transient ischemic attack or minor stroke due to an occlusion or a severe stenosis of the cerebral arterial trunk. The patients consisted of twelve males and one female ranging from 37 to 71 years of age (53 years on average). The vascular lesion was located in the internal carotid artery (7 patients) and in the middle cerebral artery (6 patients). Eleven patients received antiplatelet drug therapy, while two other patients underwent STA-MCA anastomosis. The CBF measurements were initially done within one month after the attack and then from 6 to 24 months (12 months on average) after the first study. Only one of 13 patients demonstrated a reattack during the period of observation and the CVRC decreased to 0% from the 14% level observed prior to the reattack, although the CBF was preserved. In the other twelve patients without a reattack, the CVRC was found to improve to 29.4% from 9.9% with statistical significance, even though the CBF remained the same in the first study. This study suggests hemodynamic insult to be closely related to the decreased in the CVRC, while STA-MCA anastomosis does not for prevent hemodynamic reattack based on a decrease in the CVRC in the early stage. (author)

  3. Radioresistant DNA synthesis in cells of patients showing increased chromosomal sensitivity to ionizing radiation

    International Nuclear Information System (INIS)

    Barenfeld, L.S.; Pleskach, N.M.; Bildin, V.N.; Prokofjeva, V.V.; Mikhelson, V.M.

    1986-01-01

    The rate of DNA synthesis after γ-irradiation was studied either by analysis of the steady-state distribution of daughter [ 3 H]DNA in alkaline sucrose gradients or by direct assay of the amount of [ 3 H]thymidine incorporated into DNA of fibroblasts derived from a normal donor (LCH882) and from Down's syndrome (LCH944), Werner's syndrome (WS1LE) and xeroderma pigmentosum (XP2LE) patients with chromosomal sensitivity to ionizing radiation. Doses of γ-irradiation that markedly inhibited the rate of DNA synthesis in normal human cells caused almost no inhibition of DNA synthesis in the cells from the affected individuals. The radioresistant DNA synthesis in Down's syndrome cells was mainly due to a much lower inhibition of replicon initiation than that in normal cells; these cells were also more resistant to damage that inhibited replicon elongation. Our data suggest that radioresistant DNA synthesis may be an intrinsic feature of all genetic disorders showing increased radiosensitivity in terms of chromosome aberrations. (orig.)

  4. Dextrose in the banked blood products does not seem to affect the blood glucose levels in patients undergoing liver transplantation

    Science.gov (United States)

    Cheng, Kwok-Wai; Chen, Chao-Long; Cheng, Yu-Fan; Tseng, Chia-Chih; Wang, Chih-Hsien; Chen, Yaw-Sen; Wang, Chih-Chi; Huang, Tung-Liang; Eng, Hock-Liew; Chiu, King-Wah; Wang, Shih-Hor; Lin, Chih-Che; Lin, Tsan-Shiun; Liu, Yueh-Wei; Jawan, Bruno

    2005-01-01

    AIM: Hyperglycemia commonly seen in liver transplantation (LT) has often been attributed to the dextrose in the storage solution of blood transfusion products. The purpose of the study is to compare the changes of the blood glucose levels in transfused and non-transfused patients during LT. METHODS: A retrospective study on 60 biliary pediatric patients and 16 adult patients undergoing LT was carried out. Transfused pediatric patients were included in Group I (GI), those not transfused in Group II (GII). Twelve adult patients were not given transfusion and assigned to Group III (GIII); whereas, four adult patients who received massive transfusion were assigned to Group IV (GIV). The blood glucose levels, volume of blood transfused, and the volume of crystalloid infused were recorded, compared and analyzed. RESULTS: Results showed that the changes in blood glucose levels during LT for both non-transfused and minimally transfused pediatric groups and non-transfused and massively-transfused adult groups were almost the same. CONCLUSION: We conclude that blood transfusion does not cause significant changes in the blood glucose levels in this study. PMID:15884124

  5. Peer teaching in medical education: twelve reasons to move from theory to practice.

    Science.gov (United States)

    Ten Cate, Olle; Durning, Steven

    2007-09-01

    To provide an estimation of how often peer teaching is applied in medical education, based on reports in the literature and to summarize reasons that support the use of this form of teaching. We surveyed the 2006 medical education literature and categorised reports of peer teaching according to educational distance between students teaching and students taught, group size, and level of formality of the teaching. Subsequently, we analysed the rationales for applying peer teaching. Most reports were published abstracts in either Medical Education's annual feature 'Really Good Stuff' or the AMEE's annual conference proceedings. We identified twelve distinct reasons to apply peer teaching, including 'alleviating faculty teaching burden', 'providing role models for junior students', 'enhancing intrinsic motivation' and 'preparing physicians for their future role as educators'. Peer teaching appears to be practiced often, but many peer teaching reports do not become full length journal articles. We conclude that specifically 'near-peer teaching' appears beneficial for student teachers and learners as well as for the organisation. The analogy of the 'journeyman', as intermediate between 'apprentice' and 'master', with both learning and teaching tasks, is a valuable but yet under-recognized source of education in the medical education continuum.

  6. Estimation of admixture of twelve quark bag state in sup 4 He nucleus

    CERN Document Server

    Mosallem, A M

    2002-01-01

    The p sup 4 He elastic scattering at the energy range from 0.695 to 393 GeV is analyzed in the framework of the Glauber theory. The Glauber amplitudes were evaluated using isospin-averaged nucleon-nucleon amplitudes and the sup 4 He wave function as a superposition of the Gaussian functions. The values of the calculated differential cross sections usually exceed the experimental ones. In order to overcome the discrepancy, it is assumed following to the paper by L. G. Dakno and N. N. Nikolaev that the ground state wave function of sup 4 He has an admixture of a twelve quark bag. Neglecting all transition amplitudes, the p - 12q bag scattering amplitude was chosen in a simple Gaussian form.The inclusion of the 12q bag leads to decreasing the p sup 4 He differential cross section and to a shift of the dip position to a large values of t what is needed for a successful description of the experimental data. While fitting the data it is found that the weight of the 12q bag state in the ground state of the sup 4 He ...

  7. Plasma levels of acylated ghrelin in patients with functional dyspepsia

    Science.gov (United States)

    Kim, Yeon Soo; Lee, Joon Seong; Lee, Tae Hee; Cho, Joo Young; Kim, Jin Oh; Kim, Wan Jung; Kim, Hyun Gun; Jeon, Seong Ran; Jeong, Hoe Su

    2012-01-01

    AIM: To investigate the relationship between plasma acylated ghrelin levels and the pathophysiology of functional dyspepsia. METHODS: Twenty-two female patients with functional dyspepsia and twelve healthy volunteers were recruited for the study. The functional dyspepsia patients were each diagnosed based on the Rome III criteria. Eligible patients completed a questionnaire concerning the severity of 10 symptoms. Plasma acylated ghrelin levels before and after a meal were determined in the study participants using a commercial human acylated enzyme immunoassay kit; electrogastrograms were performed for 50 min before and after a standardized 10-min meal containing 265 kcal. RESULTS: There were no significant differences in plasma acylated ghrelin levels between healthy volunteers and patients with functional dyspepsia. However, in patients with functional dyspepsia, there was a negative correlation between fasting plasma acylated ghrelin levels and the sum score of epigastric pain (r = -0.427, P = 0.047) and a positive correlation between the postprandial/fasting plasma acylated ghrelin ratio and the sum score of early satiety (r = 0.428, P =0.047). Additionally, there was a negative correlation between fasting acylated ghrelin plasma levels and fasting normogastria (%) (r = -0.522, P = 0.013). Interestingly, two functional dyspepsia patients showed paradoxically elevated plasma acylated ghrelin levels after the meal. CONCLUSION: Abnormal plasma acylated ghrelin levels before or after a meal may be related to several of the dyspeptic symptoms seen in patients with functional dyspepsia. PMID:22611317

  8. Happy employees lead to loyal patients. Survey of nurses and patients shows a strong link between employee satisfaction and patient loyalty.

    Science.gov (United States)

    Atkins, P M; Marshall, B S; Javalgi, R G

    1996-01-01

    A strong relationship exists between employee satisfaction and patients' perceptions of the quality of their care, measured in terms of their intent to return and to recommend the hospital to others. Employee dissatisfaction can negatively affect quality of care and have an adverse effect on patient loyalty and, thus hospital profitability. Therefore, health care marketers should regularly measure employee satisfaction as one way to monitor service quality. Health care marketers must work more closely with their human-resource departments to understand and influence employees' work environment and maintain a high level of job satisfaction. Marketers also should place an increased emphasis on both employee and patient perceptions of satisfaction when developing internal and external strategic marketing plans and formulating future research.

  9. IgG subclass reactivity to Trypanosoma cruzi in chronic chagasic patients.

    Science.gov (United States)

    Hernández-Becerril, N; Nava, A; Reyes, P A; Monteón, V M

    2001-01-01

    The anti-Trypanosoma cruzi antibodies isotype profile in Chagas' disease has been studied in relation to different clinical manifestations. A high titer of IgG anti-T. cruzi antibodies is found in patients with cardiac involvement, while a high titer of IgA anti-T. cruzi antibodies is associated with digestive forms. The aim of this work was to analyze the IgG subclass reactivity of anti-T. cruzi antibodies in patients with chronic Chagasic cardiomyopathy. Twelve consecutive chagasic patients were analyzed for IgG subclass reactivity to a T. cruzi antigenic extract. They had a complete clinical evaluation, peripheral EKG, echocardiography, left ventriculogram, and coronariography. All patients came from rural areas of Mexico and had lived in endemic zones for over seven years. They presented left ventricular endsystolic dimension above 42 mm in 58% (7/12) and ejection fraction below 50% in 58% (7/12). We found that IgG1 and IgG2 anti-T. cruzi antibodies showed higher titer than IgG3 antibodies, with consistently low titer of IgG4 antibodies. Expression of the four IgG subclasses of anti-T. cruzi antibodies suggest a mixed Th1/Th2-like immune response under a probably continuous chronic antigenic stimulation. On the other hand, high levels of IgG2 anti-T. cruzi antibodies showed a tendency to be associated with severe cardiomegaly. Our results suggest that a mixed Th1/Th2-like immune response may take place in chronic chagasic patients under a chronic antigenic stimulation.

  10. AIP mutations in Brazilian patients with sporadic pituitary adenomas: a single-center evaluation

    Directory of Open Access Journals (Sweden)

    Paula Bruna Araujo

    2017-11-01

    Full Text Available Aryl hydrocarbon receptor-interacting protein (AIP gene mutations (AIPmut are the most frequent germline mutations found in apparently sporadic pituitary adenomas (SPA. Our aim was to evaluate the frequency of AIPmut among young Brazilian patients with SPA. We performed an observational cohort study between 2013 and 2016 in a single referral center. AIPmut screening was carried out in 132 SPA patients with macroadenomas diagnosed up to 40 years or in adenomas of any size diagnosed until 18 years of age. Twelve tumor samples were also analyzed. Leukocyte DNA and tumor tissue DNA were sequenced for the entire AIP-coding region for evaluation of mutations. Eleven (8.3% of the 132 patients had AIPmut, comprising 9/74 (12% somatotropinomas, 1/38 (2.6% prolactinoma, 1/10 (10% corticotropinoma and no non-functioning adenomas. In pediatric patients (≤18 years, AIPmut frequency was 13.3% (2/15. Out of the 5 patients with gigantism, two had AIPmut, both truncating mutations. The Y268* mutation was described in Brazilian patients and the K273Rfs*30 mutation is a novel mutation in our patient. No somatic AIP mutations were found in the 12 tumor samples. A tumor sample from an acromegaly patient harboring the A299V AIPmut showed loss of heterozygosity. In conclusion, AIPmut frequency in SPA Brazilian patients is similar to other populations. Our study identified two mutations exclusively found in Brazilians and also shows, for the first time, loss of heterozygosity in tumor DNA from an acromegaly patient harboring the A299V AIPmut. Our findings corroborate previous observations that AIPmut screening should be performed in young patients with SPA.

  11. Characterization of socioeconomic status of Japanese patients with atopic dermatitis showing poor medical adherence and reasons for drug discontinuation.

    Science.gov (United States)

    Murota, Hiroyuki; Takeuchi, Satoshi; Sugaya, Makoto; Tanioka, Miki; Onozuka, Daisuke; Hagihara, Akihito; Saeki, Hidehisa; Imafuku, Shinichi; Abe, Masatoshi; Shintani, Yoichi; Kaneko, Sakae; Masuda, Koji; Hiragun, Takaaki; Inomata, Naoko; Kitami, Yuki; Tsunemi, Yuichiro; Abe, Shinya; Kobayashi, Miwa; Morisky, Donald E; Furue, Masutaka; Katoh, Norihito

    2015-09-01

    Patients' high adherence to medication is indispensable for the management of skin diseases including atopic dermatitis. We previously showed poor medication adherence in Japanese dermatological patients. This study was conducted to determine the level of adherence to oral or topical medication in Japanese patients with atopic dermatitis, attempting to characterize the socioeconomic status of those patients with poor adherence. A web questionnaire survey on demographic data as well as adherence level was conducted on patients registered in the monitoring system. Adherence level was assessed with Morisky Medication Adherence Scale-8 (MMAS-8). Among a total of 3096 respondents with dermatological disorders, data of 1327 subjects with atopic dermatitis were extracted and analyzed. More than 80% of subjects felt that both oral and topical medications were safe and efficacious, while less than 60% of them were satisfied with their treatment. Levels of adherence to oral and topical treatments were evaluated with MMAS-8, giving scores of 4.6 and 4.2, respectively. Demographic factors such as gender, marital status, state of employment, alcohol consumption, frequency of hospital visits, and experience of drug effectiveness had a significant impact on the degree of adherence to treatment. Medication adherence level in Japanese subjects with atopic dermatitis was relatively low compared with that of other chronic diseases. Our survey has characterized patients with poor adherence, who are good targets for interventions to maximize potentially limited healthcare resources. Copyright © 2015 Z. Published by Elsevier Ireland Ltd.. All rights reserved.

  12. The Danish patient safety experience: the Act on Patient Safety in the Danish Health care system

    DEFF Research Database (Denmark)

    Lundgaard, Mette; Rabøl, Louise; Jensen, Elisabeth Agnete Brøgger

    2005-01-01

    This paper describes the process that lead to the passing of the Act for Patient Safety in the Danisk health care sytem, the contents of the act and how the act is used in the Danish health care system. The act obligates frontline health care personnel to report adverse events, hospital owners...... to act on the reports and the National Board of Health to commuicate the learning nationally. The act protects health care providers from sanctions as a result of reporting. In January 2004, the Act on Patient Safety in the Danish health care system was put into force. In the first twelve months 5740...... adverse events were reported. the reports were analyzed locally (hospital and region), anonymized ad then sent to the National Board af Health. The Act on Patient Safety has driven the work with patient safety forward but there is room for improvement. Continuous and improved feedback from all parts...

  13. The social, cultural and medicinal use of kava for twelve Tongan born men living in Auckland, New Zealand.

    Science.gov (United States)

    Nosa, Vili; Ofanoa, Malakai

    2009-02-01

    Kava consumption is a very popular practise amongst Pacific people especially amongst the Tongan communities. The purpose of this paper is to identify some of the key cultural, social and medicinal elements of kava use amongst Tongan men. Twelve face to face interviews in this study were undertaken. The paper argues that kava drinking is strongly linked to many of the ceremonial, social and cultural obligations that are deeply embedded within the Tongan culture. The positive uses of kava include medicinal purposes, male bonding, alternative to alcohol consumption, reaffirming and establishing relationships amongst other Tongan men, The men also stated negative uses of kava such as it made them lazy, tired so they were not able to go to work, a lack of sexual activities by being too tired have sex with their partners, and very expensive to buy in New Zealand. The aim of this paper is to discuss and examine the social, cultural and medicinal kava use amongst twelve Tongan born men living in Auckland, New Zealand. The study used qualitative methods, specifically individual interviews were conducted in Tongan or English. Participants were recruited through community networks in Auckland. A number of Tongan churches, Tongan medical clinics such as Langimailie, and kava clubs were approached to recruit participants. The open ended interview schedule covered themes such as access, quantity, frequency, and problems associated with kava use. The interviews were conducted by a Tongan researcher either in English or Tongan. All interviews were translated and transcribed into English. A thematic analysis based on multiple readings of the transcripts was used The analysis identified commonalities and differences. The study was granted ethical approval by the University of Auckland Human Subjects Ethics Committee in December 2004. Interviews were conducted at the beginning of 2005. Interviews were undertaken in a place where the participants felt comfortable. Interview times

  14. Prediction of response to revascularization in patients with renal artery stenosis by Tc-99m-ethylene dicysteine captopril scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Ugur, O.; Ergun, E.L.; Peksoy, I.; Cekirge, S. [Hacettepe Univ., Ankara (Turkey). Medical School; Serdengecti, M.; Karacalioglu, O.

    1999-04-01

    The aim of the present study was to assess the predictive value of captopril scintigraphy with the new renal agent {sup 99m}Tc-ethylene dicysteine ({sup 99m}Tc-EC) for post-interventional improvement in blood pressure. Twelve patients who had persistently high blood pressure with previous demonstration of various degrees of renal artery lesion on angiography were included into the study. Baseline and captopril scintigraphies were performed on the same day at 4 hour intervals after the injection of 74 and 296 MBq of {sup 99m}Tc-EC, respectively. All patients had percutaneous transluminal angioplasty (PTA), and improvement in blood pressure was evaluated 3-6 months after the intervention. {sup 99m}Tc-EC captopril scintigraphy successfully predicted a positive or negative outcome in 11 of 12 patients. In one patient with captopril induced renal function deterioration, scintigraphy failed to predict post-interventional response. Our preliminary findings showed that {sup 99m}Tc-EC captopril scintigraphy can be used to determine patients who will benefit from revascularization. (author)

  15. Risk assessment of K Basin twelve-inch and four-inch drain valve failure from a postulated seismic initiating event

    Energy Technology Data Exchange (ETDEWEB)

    MORGAN, R.G.

    1999-06-23

    The Spent Nuclear Fuel (SNF) Project will transfer metallic SNF from the Hanford 105 K-East and 105 K-West Basins to safe interim storage in the Canister Storage Building in the 200 Area. The initial basis for design, fabrication, installation, and operation of the fuel removal systems was that the basin leak rate which could result from a postulated accident condition would not be excessive relative to reasonable recovery operations. However, an additional potential K Basin water leak path is through the K Basin drain valves. Three twelve-inch drain valves are located in the main basin bays along the north wall. Five four-inch drain valves are located in the north and south loadout pits (NLOP and SLOP), the weasel pit, the technical viewing pit, and the discharge chute pit. The sumps containing the valves are filled with concrete which covers the drain valve body. Visual observations indicate that only the valve's bonnet and stem are exposed above the basin concrete floor for the twelve-inch drain valve and that much less of the valve's bonnet and stem are exposed above the basin concrete floor for the five four-inch drain valves. It was recognized, however, that damage of the drain valve bonnet or stem during a seismic initiating event could provide a potential K Basin water leak path. The objectives of this analysis are to: (1) evaluate the likelihood of damaging the three twelve-inch drain valves located along the north wall of the main basin and the five four-inch drain valves located in the pits from a seismic initiating event, and (2) determine the likelihood of exceeding a specific consequence (initial leak rate) from a damaged valve. The analysis process is a risk-based uncertainty analysis where each variable is modeled using available information and engineering judgement. The uncertainty associated with each variable is represented by a probability distribution (probability density function). Uncertainty exists because of the inherent

  16. A virtual reality-integrated program for improving social skills in patients with schizophrenia: a pilot study.

    Science.gov (United States)

    Rus-Calafell, Mar; Gutiérrez-Maldonado, José; Ribas-Sabaté, Joan

    2014-03-01

    Social skills training (SST) intervention has shown its efficacy to improve social dysfunction in patients with psychosis; however the implementation of new skills into patients' everyday functioning is difficult to achieve. In this study, we report results from the application of a virtual reality (VR) integrated program as an adjunct technique to a brief social skills intervention for patients with schizophrenia. It was predicted that the intervention would improve social cognition and performance of patients as well as generalisation of the learned responses into patient's daily life. Twelve patients with schizophrenia or schizoaffective disorder completed the study. They attended sixteen individual one-hour sessions, and outcome assessments were conducted at pre-treatment, post-treatment and four-month follow-up. The results of a series of repeated measures ANOVA revealed significant improvement in negative symptoms, psychopathology, social anxiety and discomfort, avoidance and social functioning. Objective scores obtained through the use of the VR program showed a pattern of learning in emotion perception, assertive behaviours and time spent in a conversation. Most of these gains were maintained at four-month follow-up. The reported results are based on a small, uncontrolled pilot study. Although there was an independent rater for the self-reported and informant questionnaires, assessments were not blinded. The results showed that the intervention may be effective for improving social dysfunction. The use of the VR program contributed to the generalisation of new skills into the patient's everyday functioning. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Increased strength of the scapular stabilizer and lumbar muscles after twelve weeks of Pilates training using the Reformer machine: A pilot study.

    Science.gov (United States)

    Dos Santos, Núbia Tomain Otoni; Raimundo, Karoline Cipriano; da Silva, Sheila Aparecida; Souza, Lara Andrade; Ferreira, Karoline Carregal; Borges Santo Urbano, Zuleika Ferreira; Gasparini, Andréa Licre Pessina; Bertoncello, Dernival

    2017-01-01

    The aim of this work was to analyze muscle strength in Pilates novices who used the Reformer equipment during twelve training sessions. Twenty-four healthy young female volunteers, who were non-smokers and did not exercise regularly, were split into a control group (mean age 28 ± 4 years and BMI 24.55 ± 3.21 kg/m 2 ) and a training group (mean age 29 ± 4 years and BMI 22.69 ± 2.87 kgm 2 ). The data were checked for normality using the Kolmogorov-Smirnov test, and were then analyzed using the t-test (p Pilates group). The corresponding values for the lumbar muscles were 53.83 ± 11.66/53.28 ± 11.14 (control group) and 54.75 ± 10.27/64.80 ± 10.20 (Pilates group). After twelve sessions of Pilates with the Reformer equipment, there were improvements in lumbar extensor and scapular stabilizer strength. Several benefits are reported by practitioners of Pilates, but until now, there has been limited scientific evidence of the improvement of strength in the trunk and limbs after application of the technique. Published by Elsevier Ltd.

  18. Cognitive Decline in Patients with Chronic Hydrocephalus and Normal Aging: ‘Growing into Deficits'

    Directory of Open Access Journals (Sweden)

    Marlijn H. de Beer

    2016-10-01

    Full Text Available Background/Aim: To explore the theory of ‘growing into deficits', a concept known from developmental neurology, in a series of cases with chronic hydrocephalus (CH. Methods: Patients were selected from the Amsterdam Dementia Cohort and underwent extensive dementia screening. Results: Twelve patients with CH were selected, in whom Alzheimer's disease was considered unlikely, based on biomarker information and follow-up. Mean Mini-Mental State Examination score was 24 (range 7-30. Most patients were functioning on a level of mild dementia [Clinical Dementia Rating score of 0.5 in 8/11 (66.7% patients]. On neuropsychological examination, memory and executive functions, as well as processing speed were most frequently impaired. Conclusion: In our opinion, the theory of ‘growing into deficits' shows a parallel with the clinical course of CH and normal aging when Alzheimer's disease was considered very unlikely, because most of these patients were functioning well for a very large part of their lives. The altered cerebrospinal fluid dynamics might make the brain more vulnerable to aging-related changes, leading to a faster cognitive decline in CH patients compared to healthy subjects, especially in case of concomitant brain damage such as traumatic brain injury or meningitis.

  19. CT of splenic and perisplenic abnormalities in septic patients

    Energy Technology Data Exchange (ETDEWEB)

    Balthazar, E.J.; Hilton, S.; Naidich, D.; Megibow, A.; Levine, R.

    1985-01-01

    Splenic and perisplenic pathology, demonstrated by CT examination in 14 septic patients, was correlated with the clinical course and with surgical and pathologic findings available. Twelve patients were intravenous drug addicts and two patients developed bacteremia associated with bacterial endocarditis. The CT fingings were divided into three groups: (1) Single wedge-shaped peripherally located defects were seen in five patients; there was good response to medical therapy without other complications. (2) Larger and/or multiple, rounded or oval lesions were present in five patients; two of these patients had splenic abscesses proven on subsequent splenectomy. (3) Multiple splenic lesions and fissures associated with perisplenic and subphrenic fluid collections were seen in four patients; infected splenic infarcts, splenic fractures, and infected perisplenic hemorrhagic fluid collections were found in this group of patients. The CT examination in septic patients can reliably demonstrate splenic and perisplenic pathology, and its appearance contributes greatly to the overall clinical assessment and surgical approach.

  20. CT of splenic and perisplenic abnormalities in septic patients

    International Nuclear Information System (INIS)

    Balthazar, E.J.; Hilton, S.; Naidich, D.; Megibow, A.; Levine, R.

    1985-01-01

    Splenic and perisplenic pathology, demonstrated by CT examination in 14 septic patients, was correlated with the clinical course and with surgical and pathologic findings available. Twelve patients were intravenous drug addicts and two patients developed bacteremia associated with bacterial endocarditis. The CT fingings were divided into three groups: (1) Single wedge-shaped peripherally located defects were seen in five patients; there was good response to medical therapy without other complications. (2) Larger and/or multiple, rounded or oval lesions were present in five patients; two of these patients had splenic abscesses proven on subsequent splenectomy. (3) Multiple splenic lesions and fissures associated with perisplenic and subphrenic fluid collections were seen in four patients; infected splenic infarcts, splenic fractures, and infected perisplenic hemorrhagic fluid collections were found in this group of patients. The CT examination in septic patients can reliably demonstrate splenic and perisplenic pathology, and its appearance contributes greatly to the overall clinical assessment and surgical approach

  1. Unique spectrum of SPAST variants in Estonian HSP patients: presence of benign missense changes but lack of exonic rearrangements

    Directory of Open Access Journals (Sweden)

    Gross-Paju Katrin

    2010-03-01

    Full Text Available Abstract Background Hereditary spastic paraplegia (HSP is a clinically and genetically heterogeneous disorder that can be an autosomal-dominant, autosomal-recessive, or X-linked disease. The most common autosomal-dominant form of the disease derives from mutations in the SPAST gene. Methods The aim of this study was to analyze 49 patients diagnosed with HSP from the Estonian population for sequence variants of the SPAST gene and to describe the associated phenotypes. Healthy control individuals (n = 100 with no family history of HSP were also analyzed. All patient samples were screened using denaturing high performance liquid chromatography (DHPLC and multiplex ligation-dependent probe amplification (MLPA assay. Samples with abnormal DHPLC and MLPA profiles were sequenced, with the same regions sequenced in control samples. Results Sequence variants of SPAST were identified in 19/49 HSP patients (38.8%, twelve among them had pathogenic mutations. Within the latter group there was one sporadic case. Eight patients had pure, and four - complex HSP. The twelve variants were identified: seven pathogenic (c.1174-1G>C, c.1185delA, c.1276C>T, c.1352_1356delGAGAA, c.1378C>A, c.1518_1519insTC, c.1841_1842insA and five non-pathogenic (c.131C>T, c.484G>A, c.685A>G, c.1245+202delG, c.1245+215G>C. Only 2 of these mutations had previously been described (c.131C>T, c.1245+202delG. Three mutations, c.1174-1G>C, c.1276 C>T, c.1378C>A, showed intrafamilial segregation. Conclusion This study identified new variants of the SPAST gene which included benign missense variants and short insertions/deletions. No large rearrangements were found. Based on these data, 7 new pathogenic variants of HSP are associated with clinical phenotypes.

  2. Echocardiographic evaluation of patients with systemic lupus erythematosus

    International Nuclear Information System (INIS)

    Hameed, S.; Malik, L.M.

    2007-01-01

    Cardiac disease occurs in various forms and is a common cause of death in systemic lupus erythematosus. The objective was to detect cardiac abnormalities by transthoracic echocardiography and determine their association in SLE patients. We conducted a transthoracic echocardiographic study in 48 inpatients with systemic lupus erythematosus. Clinical and serological evaluation to confirm the diagnosis of lupus was done in all patients. There were 44 women (91.6%) and 4 men with a mean age of 26 years. Anti ds DNA was positive in 34 patients (68.75%). Transthoracic echocardiography revealed abnormality in 28 patients (58.33%). Of these, 16 patients (57%) had pericardial involvement with variable amount of effusion. Twelve patients (43%) had some valvular involvement and some degree of myocardial systolic dysfunction was found in 12 patients (43%). Only 4 patients (14%) had all three abnormalities. Anti ds DNA was positive in 71% of patients with cardiac abnormalities. Cardiac involvement is common in patients with systemic lupus erythematosus. Serological abnormalities had an association with cardiac abnormalities, and were found to be more prevalent in young patients. (author)

  3. Two new genera and twelve new species of Graphidaceae from Puerto Rico: a case for higher endemism of lichenized fungi in islands of the Caribbean?

    Science.gov (United States)

    Joel A. Mercado-Diaz; Robert Lücking; Sittiporn Parnmen

    2014-01-01

    Two new genera and twelve new species of Graphidaceae are described from Puerto Rico. The two new genera, Borinquenotrema and Paratopeliopsis, are based on a combination of molecular sequence data and phenotype characters. Borinquenotrema, with the single new species B. soredicarpum, features rounded ascomata developing beneath and persistently covered with soralia and...

  4. The web-surfing bariatic patient: the role of the internet in the decision-making process.

    Science.gov (United States)

    Paolino, Luca; Genser, Laurent; Fritsch, Sylvie; De' Angelis, Nicola; Azoulay, Daniel; Lazzati, Andrea

    2015-04-01

    Health-related information on the Internet is constantly increasing, but its quality and accountability are difficult to assess. Patients browse the Net to get more information, but the impact of the Internet on their decisions about surgical techniques, referral centers, or surgeon choice are still not clear. This study aimed to describe the role of the Internet in the decision-making process of obese patients seeking bariatric surgery. Two hundred and twelve candidates for bariatric surgery were asked to answer a questionnaire evaluating their access to the Internet, the usefulness and trustworthiness of Internet-retrieved information, the verification of the information, and the role of the information in the decision-making process. Two hundred and twelve patients answered the questionnaire. Of these, 95.1% had access to the Internet and 77.8% reported having researched about bariatric surgery. Their main interests were the surgical techniques (81.4%) and other patients' experiences (72.3%). The favorite Web sites were those affiliated to public hospitals or edited by other patients. The accountability of the e-information was mainly evaluated by discussion with the general practitioner (GP) (83.0%) or family members and friends (46.8%). One patient in four decided to undergo bariatric surgery mainly based on e-information, while discussion about treatment options with the GP and the hospital reputation were taken into account in 77.8 and 51.7% of cases, respectively. Most patients seeking bariatric surgery search for health information online. E-information seems to have an important role in the decision-making process of patients who are candidates for bariatric surgery.

  5. Patients with severe acquired brain injury show increased arousal in tilt-table training

    DEFF Research Database (Denmark)

    Riberholt, Christian G; Thorlund, Jonas Bloch; Mehlsen, Jesper

    2013-01-01

    Patients with severe acquired brain injury (ABI) are often mobilised using a tilt-table. Complications such as orthostatic intolerance have been reported. The primary objective of this study was to investigate if using a tilt-table was feasible for mobilising patients with severe ABI admitted...... for sub-acute rehabilitation. We also investigated change in arousal, treatment duration before termination due to orthostatic reactions and change in muscle tone....

  6. Epiphyseal involvement in unicameral bone cysts

    International Nuclear Information System (INIS)

    Capanna, R.; Ruggieri, P.; Biagini, R.; Horn, J. van

    1986-01-01

    Twelve patients are reported in whom a unicameral bone cyst was found to involve the epiphysis or apophysis across an open growth plate. Nine patients showed pathologic fracture. In four patients a growth disturbance was found. A varying amount of varus angulation was present in most cases. No patient had functional impairment. (orig.)

  7. Epiphyseal involvement in unicameral bone cysts

    Energy Technology Data Exchange (ETDEWEB)

    Capanna, R.; Ruggieri, P.; Biagini, R.; Horn, J. van

    1986-08-01

    Twelve patients are reported in whom a unicameral bone cyst was found to involve the epiphysis or apophysis across an open growth plate. Nine patients showed pathologic fracture. In four patients a growth disturbance was found. A varying amount of varus angulation was present in most cases. No patient had functional impairment.

  8. Evaluation of the single radiosensitivity in patients subjected to medical exposure that show severe skin reactions

    International Nuclear Information System (INIS)

    Di Giorgio, M.; Vallerga, M.B.; Portas, M.; Perez, M.R.

    2006-01-01

    signs after 5 months. So much the micronucleus frequency like the comet essay showed compatible values with a normal radiosensitivity. In the case 2 it was observed a partial answer, with resistant pain to the analgesic ones and sharpen again crisis. In this case, both essays indicated hypersensitivity to the lR in the lymphocytes of the patient's outlying blood. It was concludes that the bio indicators of individual radiosensitivity can be of utility for the radioleisures prevention, by means of the personalized adaptation of therapeutic outlines that imply the use of IR. Also, in situations of accidental overexposure to IR, these indicators would have predict value, contributing to the design of therapeutic strategies. (Author)

  9. A gene co-expression network in whole blood of schizophrenia patients is independent of antipsychotic-use and enriched for brain-expressed genes

    DEFF Research Database (Denmark)

    de Jong, Simone; Boks, Marco P M; Fuller, Tova F

    2012-01-01

    Despite large-scale genome-wide association studies (GWAS), the underlying genes for schizophrenia are largely unknown. Additional approaches are therefore required to identify the genetic background of this disorder. Here we report findings from a large gene expression study in peripheral blood...... of schizophrenia patients and controls. We applied a systems biology approach to genome-wide expression data from whole blood of 92 medicated and 29 antipsychotic-free schizophrenia patients and 118 healthy controls. We show that gene expression profiling in whole blood can identify twelve large gene co......, and regulated by the major histocompatibility (MHC) complex, which is intriguing in light of the fact that common allelic variants from the MHC region have been implicated in schizophrenia. This suggests that the MHC increases schizophrenia susceptibility via altered gene expression of regulatory genes...

  10. Follow-up home visits with registered dietitians have a positive effect on the functional and nutritional status of geriatric medical patients after discharge

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Kjær, Stine; Hansen, Birthe Stenbæk

    2013-01-01

    Objective:To assess the additional benefits of individualized nutritional counselling by a registered dietitian in geriatric patients' home after discharge from hospital, in relation to risk of re-admissions, functional status, nutritional status, use of social services and mortality.Design:Twelv......Objective:To assess the additional benefits of individualized nutritional counselling by a registered dietitian in geriatric patients' home after discharge from hospital, in relation to risk of re-admissions, functional status, nutritional status, use of social services and mortality.......Design:Twelve-week single-blind randomized controlled study.Setting and subjects:Geriatric medical patients (65+ years) at nutritional risk.Interventions:Participants were randomly allocated to receive a visit in their homes, either three individualized nutritional counselling by a registered dietitian complemented......, rehabilitation capacity), nutritional status (weight, BMI, energy and protein intake), need of social services (home care, home nursing, meals-on-wheels) and mortality.Results:One hundred and fifty-two patients were included; 132 (87%) completed the first and 124 (82%) the second data collection after 12 weeks...

  11. PET/CT With 68Ga-DOTA-TATE for Diagnosis of Neuroendocrine: Differentiation in Patients With Castrate-Resistant Prostate Cancer.

    Science.gov (United States)

    Gofrit, Ofer Nathan; Frank, Stephen; Meirovitz, Amichay; Nechushtan, Hovav; Orevi, Marina

    2017-01-01

    Castrate-resistant prostate cancer (CRPC) often shows histological evidence of neuroendocrine differentiation (NED). To evaluate the extent of NED in patients with CRPC, we used PET/CT with Ga-[DOTA-Tyr]-octreotate (Ga-DOTA-TATE), a somatostatin analog that binds somatostatin receptor 2 with high affinity. This radiotracer is used in imaging of neuroendocrine tumors. Twelve patients (mean age, 65 [SD, 12] years) with CRPC were studied. Their mean prostate-specific antigen level at scanning was 85.6 (SD, 144.6) ng/mL. PET/CT images were obtained after the injection of 120 to 200 MBq of Ga-DOTA-TATE. All participants had at least 1 blastic metastasis demonstrating uptake of Ga-DOTA-TATE (mean SUVmax of 5.3 [SD, 2.3]). In 6 patients, moderately high to high uptakes (SUVmax, >5) were seen. Patients with multiple bone metastases had a significantly higher SUVmax compared with patients with few metastases (mean of 5.8 vs 3.8, P = 0.05). In 4 patients, lytic bone lesions or lymph node metastases also showed uptake of the tracer (mean SUVmax of 7.2 [SD, 3.2]). Uptake of the radiotracer was also observed in bones showing normal architecture in CT, suggesting that NED cells appear early during metastases development. Uptake of Ga-DOTA-TATE is a common finding in metastases of CRPC patients, suggesting that NED is frequent in these patients. In half of the patients, widespread uptake of Ga-DOTA-TATE was observed. This suggests that the possibility of treating selected CRCP patients with anti-neuroendocrine tumor therapies should be explored and that Ga-DOTA-TATE scanning could have a role in predicting the efficacy of these treatments.

  12. Hospital pharmacists' and patients' views about what constitutes effective communication between pharmacists and patients.

    Science.gov (United States)

    Chevalier, Bernadette A M; Watson, Bernadette M; Barras, Michael A; Cottrell, William N

    2017-12-06

    The study's objective was to explore hospital pharmacists' and patients' views about what constitutes effective communication exchanges between pharmacists and patients. This was a novel theory-based qualitative study using semi-structured interviews to elicit patients' and pharmacists' perspectives. Pharmacists providing clinical pharmacy services in either inpatient or outpatient settings were recruited first. Eligible patients had been admitted to a study pharmacist's practice area and were prescribed three or more medications to manage a chronic disease(s). Following each pharmacist-patient medication counselling session, semi-structured interviews were held separately with patients and pharmacists. Participants were asked questions intended to explore their views about what constitutes an effective pharmacist-patient conversation. Audio recordings were transcribed verbatim, analysed using a process of inductive thematic analysis and then mapped to Communication Accommodation Theory strategies. Observational notes and reflexive note taking were conducted throughout. Twelve pharmacists each engaged four individual patients for a total of 48 pharmacist-patient conversations (resulting in 48 separate interviews with pharmacists and patients). An overall shared goal was the assurance of patients' confidence in managing their medications at home. Themes included shared colloquialisms/slang, well-explained information, engagement, established rapport and empowerment. Participants provided rich exemplars for each of the themes. Pharmacists and patients provided valuable insights about what makes pharmacist-patient interactions effective. Patient-identified preferences for pharmacist-patient exchanges may help guide pharmacy students and practitioners to engage patients in effective conversations. © 2017 Royal Pharmaceutical Society.

  13. Frequency of Cardiac Arrhythmias in Patients with Aluminum Phosphide Poisoning

    Directory of Open Access Journals (Sweden)

    Umair Aziz

    2015-12-01

    Full Text Available Background: Cardiac failure is the major lethal consequence of aluminum phosphide (AlP poisoning. This study was designed to determine the frequency of cardiac arrhythmias in patients with AlP poisoning. Methods: In this prospective cross-sectional study, patients with definitive history of AlP poisoning treated at emergency department of Allied Hospital Faisalabad, Faisalabad, Pakistan, from July 2013 to November 2014 were included. On admission, twelve-lead electrocardiogram (ECG was performed for all patients. During admission, all patients underwent continuous cardiac monitoring using a cardiac monitor. If an arrhythmia was suspected on the cardiac monitor, another ECG was obtained immediately.  Results: During the study period, 100 patients with AlP poisoning (63% men were treated at Allied Hospital Faisalabad. Mean age of the patients was 26.7 ± 7.9 years ranging from 16 to 54 years. Tachycardia was detected in 68 patients and bradycardia in 12 patients. Hypotension was observed in 75 patients. Eighty patients developed cardiac arrhythmia. The most frequent arrhythmia was atrial fibrillation (31% of patients followed by ventricular fibrillation (20%, ventricular tachycardia (17%, 3rd degree AV block (7% and 2nd degree AV block (5%. In total, 78 patients died, depicting a 78% mortality rate following wheat pill poisoning. Among those who died, seventy-one patients had cardiac arrhythmia. Comparison of death rate between patients with and without cardiac arrhythmia showed a significant difference (71/80 (88.8% vs. 7/20 (35%; P < 0.001.  Conclusion: Wheat pill poisoning causes a very high mortality, and circulatory collapse is the major cause of death among these patients. Most of the patients with AlP poisoning develop cardiac arrhythmias which are invariably life threatening. Early detection of cardiac disorders and proper management of arrhythmias may reduce mortalities.

  14. Genetic Variability Studies on Twelve Genotypes of Rice (Oryza sativa L. for Growth and Yield Performance in South Eastern Nigeria

    Directory of Open Access Journals (Sweden)

    Vincent N. ONYIA

    2017-03-01

    Full Text Available Twelve genotypes of rice collected from the National Cereals Research Institute (NCRI, Badeggi, Bida, Niger State, Nigeria were evaluated to estimate the magnitude of genetic variability and relationship of some agronomic traits of rice and their contributions to yield. The results obtained showed a significant difference (p ≤ 0.05 among the genotypes in all the traits studied. Genotype ‘WAB 35-1-FX2’ produced a significantly higher grain yield of 3.40 t/ha compared with all the other genotypes in the two years combined. Genotypes ‘WAB 33-25’, ‘WAB 56-1-FX2’, ‘WAB 56-39’, ‘WAB 56-125’, ‘ITA 150’ and ‘FAROX 16 (LC’ were the most stable grain yielding genotypes across the two years of the experiment. High broad sense heritability (h2bs was associated with grain yield (h2bs = 98.63%, number of spikelets/panicle (98.78%, plant height (98.34% for the first year planting, whereas in the second year planting, days to 50% flowering (96.72%, days to maturity (94.14% and grain yield (83.33% were among the traits that showed high broad sense heritability. The two years combined correlation analysis showed that grain yield correlated significantly and positively with number of spikelets/panicle (r = 0.2358*, number of panicles/m2 (r = 0.1895*, number of fertile spikelets/panicle (r = 0.1672* and 1,000 grain weight (r = 0.1247*, indicating that these traits can be phenotypic basis for improving grain yield of rice. Conversely, grain yield exhibited negative correlation with days to 50% flowering (-0.3009 and days to maturity (-0.2650, though not significant. This suggests that rice grain yield can be improved by selecting early flowering and maturing genotypes especially under heat and drought prone conditions.

  15. O uso da toxina botulínica no tratamento da distonia laríngea (disfonia espasmódica: estudo preliminar com doze pacientes Use of botulinum toxin in the treatment of laryngeal dystonia (spasmodic dysphonia: preliminary study of twelve patients

    Directory of Open Access Journals (Sweden)

    Hélio A. G. Teive

    2001-03-01

    Full Text Available A distonia laríngea (disfonia espasmódica é distúrbio do movimento caracterizado por contrações involuntárias da musculatura laríngea envolvida no processo de vocalização. A utilização da toxina botulínica no tratamento da distonia laríngea trouxe consideráveis benefícios clínicos. Descrevemos os resultados preliminares do uso terapêutico da toxina botulínica no tratamento da distonia laríngea em 12 pacientes. Após investigação clínica, os pacientes foram submetidos a videolaringoestroboscopia para confirmação diagnóstica e as injeções de toxina botulínica foram realizadas através de punção da membrana cricotireóidea em direção ao músculo tireoaritenóideo, com uso de eletromiografia. A maioria dos pacientes submetidos ao tratamento com toxina botulínica apresentou melhora significativa da distonia laríngea (83% dos casos, com duração média do efeito de quatro meses, sem efeitos colaterais significativos.Laryngeal dystonia (spasmodic dysphonia is a movement disorder characterized by involuntary contractions of laryngeal muscles involved with vocalization. The introduction of botulinum toxin in the treatment of laryngeal dystonia had a major clinical impact due to the striking improvement of symptoms. We report the preliminary results of therapeutical use of botulinum toxin in the treatment of twelve patients with laryngeal dystonia. After an extensive clinical evaluation, the patients underwent a videostroboscopic exam for diagnostic confirmation. Botulinum toxin was injected in the cricothyreoid membrane, directed towards the thyreoaritenoid muscle, with the aid of eletromyography needles. Most of patients who underwent botulinum toxin injection had a significant improvement of their symptoms (83%, with effects lasting for four months in average and without important side effects.

  16. Bupropion Shows Different Effects on Brain Functional Connectivity in Patients With Internet-Based Gambling Disorder and Internet Gaming Disorder

    Directory of Open Access Journals (Sweden)

    Sujin Bae

    2018-04-01

    Full Text Available IntroductionInternet gaming disorder (IGD and gambling disorder (GD share similar clinical characteristics but show different brain functional connectivity patterns. Bupropion is known to be effective for the treatment of patients with IGD and GD. We hypothesized that bupropion may be effective for the treatment of Internet-based gambling disorder (ibGD and IGD and that the connections between the default mode network (DMN and cognitive control network (CCN would be different between ibGD and IGD patients after 12 weeks of bupropion treatment.Methods16 patients with IGD, 15 patients with ibGD, and 15 healthy subjects were recruited in this study. At baseline and after 12 weeks of bupropion treatment, the clinical symptoms of patients with IGD or ibGD were assessed, and brain activity was evaluated using resting state functional magnetic resonance imaging.ResultsAfter the 12-week bupropion treatment, clinical symptoms, including the severity of IGD or GD, depressive symptoms, attention, and impulsivity improved in both groups. In the IGD group, the functional connectivity (FC within the posterior DMN as well as the FC between the DMN and the CCN decreased following treatment. Moreover, the FC within the DMN in the IGD group was positively correlated with changes in Young Internet Addiction Scale scores after the bupropion treatment period. In the ibGD group, the FC within the posterior DMN decreased while the FC within the CCN increased after the bupropion treatment period. Moreover, the FC within the CCN in the ibGD group was significantly greater than that in the IGD group.ConclusionBupropion was effective in improving clinical symptoms in patients with IGD and ibGD. However, there were differences in the pharmacodynamics between the two groups. After 12 weeks of bupropion treatment, the FC within the DMN as well as between the DMN and CCN decreased in patients with IGD, whereas the FC within the CCN increased in patients with ibGD.

  17. Bupropion Shows Different Effects on Brain Functional Connectivity in Patients With Internet-Based Gambling Disorder and Internet Gaming Disorder.

    Science.gov (United States)

    Bae, Sujin; Hong, Ji Sun; Kim, Sun Mi; Han, Doug Hyun

    2018-01-01

    Internet gaming disorder (IGD) and gambling disorder (GD) share similar clinical characteristics but show different brain functional connectivity patterns. Bupropion is known to be effective for the treatment of patients with IGD and GD. We hypothesized that bupropion may be effective for the treatment of Internet-based gambling disorder (ibGD) and IGD and that the connections between the default mode network (DMN) and cognitive control network (CCN) would be different between ibGD and IGD patients after 12 weeks of bupropion treatment. 16 patients with IGD, 15 patients with ibGD, and 15 healthy subjects were recruited in this study. At baseline and after 12 weeks of bupropion treatment, the clinical symptoms of patients with IGD or ibGD were assessed, and brain activity was evaluated using resting state functional magnetic resonance imaging. After the 12-week bupropion treatment, clinical symptoms, including the severity of IGD or GD, depressive symptoms, attention, and impulsivity improved in both groups. In the IGD group, the functional connectivity (FC) within the posterior DMN as well as the FC between the DMN and the CCN decreased following treatment. Moreover, the FC within the DMN in the IGD group was positively correlated with changes in Young Internet Addiction Scale scores after the bupropion treatment period. In the ibGD group, the FC within the posterior DMN decreased while the FC within the CCN increased after the bupropion treatment period. Moreover, the FC within the CCN in the ibGD group was significantly greater than that in the IGD group. Bupropion was effective in improving clinical symptoms in patients with IGD and ibGD. However, there were differences in the pharmacodynamics between the two groups. After 12 weeks of bupropion treatment, the FC within the DMN as well as between the DMN and CCN decreased in patients with IGD, whereas the FC within the CCN increased in patients with ibGD.

  18. Exploring Content Schemata Influence on L2 Reading: The Hunted Fox and Twelve and Not Stupid

    Directory of Open Access Journals (Sweden)

    Amizura Hanadi Mohd Radzi

    2014-10-01

    Full Text Available This paper will discuss the aspects of content schemata in second language reading among diploma level students who were taking a reading course in Universiti Teknologi MARA Perlis. In this qualitative case study, the researcher had selected two short stories that are categorized as content-familiar texts, i.e. The Hunted Fox and Twelve and Not Stupid. Six participants were asked to write a 150-word entry response on the short story and a grading criteria was used to assess the participants’ level of comprehension. An in-depth interview was also conducted on each participant. The entry responses and the interview patterns were analyzed to determine whether content schemata had contributed to the learners’ understanding of the text. This study discovered that content schemata had contributed to the learners’ understanding of the text because the learners’ comprehension was facilitated by their background knowledge on the content-familiar texts.

  19. Twelve month follow-up on a randomised controlled trial of relaxation training for post-stroke anxiety.

    Science.gov (United States)

    Golding, Katherine; Fife-Schaw, Chris; Kneebone, Ian

    2017-09-01

    To follow up participants in a randomised controlled trial of relaxation training for anxiety after stroke at 12 months. Twelve month follow-up to a randomised controlled trial, in which the control group also received treatment. Community. Fifteen of twenty one original participants with post-stroke anxiety participated in a one year follow-up study. A self-help autogenic relaxation CD listened to five times a week for one month, immediately in the intervention group and after three months in the control group. Hospital Anxiety and Depression Scale-Anxiety subscale and the Telephone Interview of Cognitive Status for inclusion. Hospital Anxiety and Depression Scale-Anxiety subscale for outcome. All measures were administered by phone. Anxiety ratings reduced significantly between pre and post-intervention, and between pre-intervention and one year follow-up ( χ 2 (2) = 22.29, p autogenic relaxation CD appear to be maintained after one year.

  20. Uptake of radionuclide thorium by twelve native plants grown in uranium mill tailings soils from south part of China

    International Nuclear Information System (INIS)

    Yan, Xun

    2016-01-01

    Highlights: • Screen dominant plants grown in uranium mill tailings soils. • Quantify the content of "2"3"2Th of soil samples from uranium mill tailings. • Quantify the transfer factor, bioconcentration factor and phytoremediation factor. • Screen out the plant species capable of remediating radionuclide contaminated soils. • Guide the reuse of study area in future. - Abstract: The concentrations of thorium ("2"3"2Th) in soil from a uranium mill tailings repository in South China were analyzed. The results showed that all the soil samples were acidic and the concentrations of "2"3"2Th in all the soil samples were more than the natural radionuclide content in soil of China. Through the field investigation, twelve kinds of dominant plants were discovered. The total quantity of "2"3"2Th in the whole plant is highest in rice flat sedge. We also found that Miscanthus floridulus has the greatest transfer factor (TF) for "2"3"2Th, rice flat sedge has the greatest bioconcentration factor (BF) for "2"3"2Th. At the mean time, M. floridulus has the greatest phytoremediation factor (PF) for "2"3"2Th. On the basis of the above conclusions and the definition for hyperaccumulator, rice flat sedge and M. floridulus could be the candidates of phytoremediation for radionuclide "2"3"2Th in the soil.

  1. Uptake of radionuclide thorium by twelve native plants grown in uranium mill tailings soils from south part of China

    Energy Technology Data Exchange (ETDEWEB)

    Yan, Xun, E-mail: m13836295186@163.com

    2016-08-01

    Highlights: • Screen dominant plants grown in uranium mill tailings soils. • Quantify the content of {sup 232}Th of soil samples from uranium mill tailings. • Quantify the transfer factor, bioconcentration factor and phytoremediation factor. • Screen out the plant species capable of remediating radionuclide contaminated soils. • Guide the reuse of study area in future. - Abstract: The concentrations of thorium ({sup 232}Th) in soil from a uranium mill tailings repository in South China were analyzed. The results showed that all the soil samples were acidic and the concentrations of {sup 232}Th in all the soil samples were more than the natural radionuclide content in soil of China. Through the field investigation, twelve kinds of dominant plants were discovered. The total quantity of {sup 232}Th in the whole plant is highest in rice flat sedge. We also found that Miscanthus floridulus has the greatest transfer factor (TF) for {sup 232}Th, rice flat sedge has the greatest bioconcentration factor (BF) for {sup 232}Th. At the mean time, M. floridulus has the greatest phytoremediation factor (PF) for {sup 232}Th. On the basis of the above conclusions and the definition for hyperaccumulator, rice flat sedge and M. floridulus could be the candidates of phytoremediation for radionuclide {sup 232}Th in the soil.

  2. Diffusion tensor magnetic resonance imaging may show abnormalities in the normal-appearing cervical spinal cord from patients with multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Fernanda Miraldi

    2013-09-01

    Full Text Available Objective This study aims to evaluate “in vivo” the integrity of the normal-appearing spinal cord (NASC in patients with multiple sclerosis (MS compared to controls, using diffusion tensor MR imaging. Methods We studied 32 patients with MS and 17 without any neurologic disorder. Fractional anisotropy (FA, axial diffusivity (AD, radial diffusivity (RD and mean diffusivity (MD were calculated within regions of interest at C2 and C7 levels in the four columns of the spinal cord. Results At C2, FA value was decreased in MS patients. Besides, RD value was higher in MS than in controls. At C7, MD values were increased in MS. Conclusion The NASC in the right column of the cervical spinal cord showed abnormal FA, RD and MD values, which is possibly related to demyelination, since the FA abnormality was related to the RD and not to the AD.

  3. Systemic therapy in younger and elderly patients with advanced biliary cancer: sub-analysis of ABC-02 and twelve other prospective trials.

    Science.gov (United States)

    McNamara, Mairéad Geraldine; Bridgewater, John; Lopes, Andre; Wasan, Harpreet; Malka, David; Jensen, Lars Henrik; Okusaka, Takuji; Knox, Jennifer J; Wagner, Dorothea; Cunningham, David; Shannon, Jenny; Goldstein, David; Moehler, Markus; Bekaii-Saab, Tanios; Valle, Juan W

    2017-04-12

    Outcomes in younger (ABC) receiving palliative chemotherapy are unclear. This study assessed outcomes in those receiving monotherapy or combination therapy in thirteen prospective systemic-therapy trials. Multivariable analysis explored the impact of therapy on progression-free (PFS) and overall survival (OS) in two separate age cohort groups: ABC, younger patients are rare, and survival in elderly patients in receipt of systemic therapy for advanced disease, whether monotherapy or combination therapy, is similar to that of non-elderly patients, therefore age alone should not influence decisions regarding treatment.

  4. [11C]WAY-100635 PET imaging of 5-HT1A receptor binding in patients with temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Sasai, Taeko; Matsuura, Masato; Itou, Shigeo; Suhara, Tetsuya; Yahata, Noriaki; Okubo, Yoshiro

    2006-01-01

    To understand the role of 5-HT in human temporal lobe epilepsy, here we measured 5-HT 1A receptor binding potential by positron emission tomography (PET) with [carbonyl- 11 C]WAY100635, a selective 5-HT 1A receptor antagonist, in patients with temporal lobe epilepsy and normal controls. Twelve patients with temporal lobe epilepsy and seventeen healthy controls participated in the study. For each subject, we conducted PET and magnetic resonance imaging (MRI), by which we measured the 5-HT 1A receptor binding potential, the R1-value, a relative indicator of cerebral blood flow in regions of interest, and the volume of gray matter. Patients with temporal lobe epilepsy showed significantly reduced 5-HT 1A receptor binding potential in the temporal lobe. The laterality of the reduction was coincided with the epileptogenic foci estimated by a scalp electroencephalography (EEG). In contrast, the R1-value and gray matter volume showed no difference between the patient and control groups. Our study revealed that 5-HT 1A receptor binding was reduced significantly at the epileptogenic foci. We suggest that PET imaging with [carbonyl- 11 C]WAY100635 is potentially a useful non-invasive method for determining the epileptogenic foci. (author)

  5. Patients with eating disorders showed no signs of coeliac disease before and after nutritional intervention.

    Science.gov (United States)

    Kaltsa, Maria; Garoufi, Anastasia; Tsitsika, Artemis; Tsirogianni, Alexandra; Papasteriades, Chryssa; Kossiva, Lydia

    2015-07-01

    This study assessed the presence of specific antibodies for coeliac disease in outpatients suffering from eating disorders before and after nutritional intervention. We also evaluated whether those patients should undergo regular screening for coeliac disease. The sample consisted of 154 patients with a mean age of 16.7 years - ranging from one to 19 years of age - suffering from eating disorders. Serology screening for coeliac disease and total immunoglobulin A (IgA) levels was evaluated in the 154 children before the nutritional intervention and in 104 patients after the intervention. The patients consumed an adequate amount of gluten in both phases. Postintervention evaluation revealed that 92 patients (88.5%) achieved a normal body weight, while the remaining 12 (11.5%) became obese. Postprandial abdominal discomfort and pain were resolved. The serology tests were negative in all patients, before and after intervention. None displayed IgA deficiency. To the best of our knowledge, this was the first prospective study where patients underwent a screening serology for coeliac disease before and after nutritional intervention. No indication of the coexistence of eating disorders and coeliac disease was documented, and the patients in our study were unlikely to require regular screening for coeliac disease. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  6. Venous digital subtraction angiography of the renal arteries in hypertensive patients

    International Nuclear Information System (INIS)

    Brecht, G.; Harder, T.; Franken, T.

    1984-01-01

    We carried out 1890 venous digital subtraction angiograms; this included 113 patients with hypertension in order to exclude renal artery stenosis. On four occasions it was used following surgery on a renal artery. Renal artery stenosis or occlusion was demonstrated in twelve patients, and other vascular diseases or anomalies were found in 24. Two abnormal renal arteries were found following renal artery surgery. The results are compared with smaller groups of patients examined by DSA, and with the results of conventional subtraction methods reported in the literature. In only eight patients (6.8%) DSA provided insufficient information and had to be supplemented by aortography. The method has proved to be a valuable and simple screening method for the investigation of hypertension. (orig.) [de

  7. C-reactive protein in patients with aggressive periodontitis

    Directory of Open Access Journals (Sweden)

    Jaroslav Mysak

    2017-12-01

    Full Text Available Background/purpose: The aim of this study was to evaluate and compare the systemic levels of C-reactive protein (CRP in peripheral blood samples of patients with aggressive periodontitis during the first twelve months of periodontal treatment, at exactly six month interval measurements, and compare them with clinical periodontal parameters. Materials and methods: All patients (N = 45 were examined prior to the initiation of periodontal treatment. Patients were divided into two groups GAgP (Generalised form of aggressive periodontitis, N = 23 and group LAgP (Localised form of aggressive periodontitis, N = 22. Control group (CON included 60 individuals with healthy periodontium. The levels of CRP were determined in both groups GAgP and LAgP three times in 6 month intervals during the periodontal treatment. Results: CRP is a plasma protein that reflects the extent of the acute phase response to inflammation and is one of the markers of choice for monitoring this response. In our study, CRP levels decreased in course of periodontal treatment in both groups (GAgP and LAgP in a similar way as bleeding on probing (BOP and probing pocket depth (PPD indices. Conclusion: Our study results showed that CRP levels, as well as bleeding on probing (BOP and probing pocket depth (PPD, indices decreased in course of periodontal treatment in patients with generalised and localised aggressive periodontitis. Therefore this marker might be exploitable as a means to evaluate periodontal health in patients with aggressive periodontitis. Keywords: aggressive periodontitis, C-reactive protein, periodontal index, cardiovascular diseases

  8. Peripheral vascular insufficiency impairs functional capacity in patients with heart failure

    Directory of Open Access Journals (Sweden)

    Renato Murayama

    2014-04-01

    Full Text Available INTRODUCTION: Heart failure (HF is a complex syndrome in which effort limitation is associated with deterioration of peripheral musculature. Improving survival rates among these patients have led to the appearance of cases in which other pathologies are associated with HF, such as peripheral vascular insufficiency (PVI. The combination of these two pathologies is common, with significant repercussions for affected patients. OBJECTIVE: To compare functional limitations and quality of life between patients with HF in isolation or HF + PVI. METHOD: Twelve patients with HF+PVI were paired to 12 patients with HF in isolation. All had ejection fraction 0.05. CONCLUSIONS: The study participants who had mixed disease exhibited a greater degree of functional impairment than the group with HF, without reporting worsened quality of life.

  9. Analysis of FBN1 allele expression by dermal fibroblasts from Marfan syndrome patients

    Energy Technology Data Exchange (ETDEWEB)

    Putman, E.A.; Cao, S.N.; Milewicz, D.M. [Univ. of Texas Medical School, Houston, TX (United States)

    1994-09-01

    Screening for mutations in the FBN1 cDNA from Marfan patient cell strains has detected mutations in only 10-15% of patients. In an attempt to explain this poor detection rate, we examined FBN1 allele expression and fibrillin synthesis by 26 cell strains from Marfan patients. DNA from the patients and 10 controls was assessed for the presence of a polymorphic Rsa I restriction site in the 3{prime} untranslated region of the FBN1 gene. Twelve of 26 patient and 5 of 10 control DNAs were heterozygous. Fibroblast RNA from the heterozygous cell strains was reverse-transcribed and subsequently PCR amplified using a [{sup 32}P]-labelled primer, digested with Rsa I and analyzed. Although 3 samples showed no transcript from one allele by ethidium bromide staining, a Betagen scanner detected low levels (10-15%) of that allele. In addition, there was unequal expression of the two alleles in three other patients; for example, only 30% expression from one allele. The remaining patients and the controls had equal expression of each allele. Fibrillin protein synthesis by fibroblasts from these heterozygous patients was also examined. After a 30 minute pulse with [{sup 35}S]-cysteine, cell lysates were collected and proteins analyzed by SDS-PAGE. The amount of fibrillin produced relative to a reference protein was determined using a Betagen scanner. Fibrillin protein synthesis was reduced in 2 of the 3 patients with very low RNA production from one of the FBN1 alleles. All other Marfan and control cell strains showed normal amounts of fibrillin synthesized. The low expression levels from one allele may contribute to, but not fully account for, the low detection rate of FBN1 mutations. Interestingly, protein synthesis levels were not affected in 4 of 6 cell strains demonstrating low levels of RNA expression.

  10. 30-days mortality in patients with perforated peptic ulcer: A national audit

    Science.gov (United States)

    Nakano, Anne; Bendix, Jørgen; Adamsen, Sven; Buck, Daniel; Mainz, Jan; Bartels, Paul; Nørgård, Bente

    2008-01-01

    Background In 2005, The Danish National Indicator Project (DNIP) reported findings on patients hospitalized with perforated ulcer. The indicator “30-days mortality” showed major discrepancy between the observed mortality of 28% and the chosen standard (10%). Rationale An audit committee was appointed to examine quality problems linked to the high mortality. The purpose was to (i) examine patient characteristics, (ii) evaluate the appropriateness of the standard, and (iii) audit all cases of deaths within 30 days after surgery. Methods Four hundred and twelve consecutive patients were included and used for the analyses of patient characteristics. The evaluation of the standard was based on a literature review, and a structured audit was performed according to the 115 deaths that occurred. Results The mean age was 69.1 years, 42.0% had one co-morbid disease and 17.7% had two co-morbid diseases. 45.9% had an American Association of Anaesthetists score of 3–4. We found no results on mortality in studies similar to ours. The audit process indicated that the postoperative observation of patients was insufficient. Discussion As a result of this study, the standard for mortality was increased to 20%, and the new indicators for postoperative monitoring were developed. The DNIP continues to evaluate if these initiatives will improve the results on mortality. PMID:22312201

  11. Radiological response and clinical outcome in patients with femoral bone metastases after radiotherapy

    International Nuclear Information System (INIS)

    Harada, Hideyuki; Katagiri, Hirohisa; Kamata, Minoru

    2010-01-01

    We evaluated the radiological response and clinical outcome in patients with femoral bone metastases after radiotherapy. 102 consecutive patients with femoral metastases without pathological fracture were treated by surgery or radiotherapy between 2002 and 2005. Twelve of them initially treated with surgery were excluded from this study. The remaining 90 patients with 102 lesions underwent radiation therapy as the initial treatment. Twelve patients who died within 30 days by disease progression and 6 who were lost to follow-up were excluded. The remaining 72 patients with 84 lesions including 43 impending fractures were enrolled in this analysis. Radiological changes were categorized into complete response, partial response, no change, and progressive disease based on plain radiograph findings. Pain relief was reviewed for 77 painful lesions. The median radiation dose was 30 Gy. No re-irradiation was performed. 35 lesions (42%) achieved radiological responses median 3 months after radiotherapy. Pain relief was obtained in 36 of 77 lesions (47%). There was no significant correlation between radiological response and pain relief (P=0.166). Eleven lesions eventually required surgery and considered as treatment failure. The treatment failure rate in the radiological progressive disease (PD) group (8/19, 42%) was significantly higher than that in the non-PD group (3/65, 5%) (P<0.001). Among 43 impending fracture lesions, 15 lesions (36%) experienced radiological response and 35 lesions (81%) required no surgical interventions. Our data suggest that radiotherapy can enable metastatic bone healing and avoid surgery in many lesions. However, radiological PD lesions often require surgery after radiotherapy. (author)

  12. Twelve-Week Treatment With Liraglutide as Add-on to Insulin in Normal-Weight Patients With Poorly Controlled Type 1 Diabetes

    DEFF Research Database (Denmark)

    Frandsen, Christian S; Dejgaard, Thomas F; Holst, Jens J

    2015-01-01

    OBJECTIVE: This study investigated the efficacy and safety of once-daily liraglutide 1.2 mg versus placebo as add-on to insulin treatment in normal-weight patients with poorly controlled type 1 diabetes. RESEARCH DESIGN AND METHODS: In a randomized (1:1), double-blind, placebo-controlled design, 40...... patients with type 1 diabetes (HbA1c ≥8% [64 mmol/mol]) received once-daily liraglutide 1.2 mg or placebo for 12 weeks. Continuous glucose monitoring was performed before and at the end of treatment. The primary end point was change in HbA1c. Secondary end points included change in insulin dose, weight...... was more frequently associated with gastrointestinal adverse effects. The incidence of hypoglycemia did not differ between groups. CONCLUSIONS: Liraglutide significantly reduces body weight and insulin requirements but has no additional effect on HbA1c in normal-weight patients with type 1 diabetes...

  13. Long-term monitoring shows hepatitis B virus resistance to entecavir in nucleoside-naïve patients is rare through 5 years of therapy.

    Science.gov (United States)

    Tenney, Daniel J; Rose, Ronald E; Baldick, Carl J; Pokornowski, Kevin A; Eggers, Betsy J; Fang, Jie; Wichroski, Michael J; Xu, Dong; Yang, Joanna; Wilber, Richard B; Colonno, Richard J

    2009-05-01

    Patients with chronic hepatitis B virus (HBV) infection who develop antiviral resistance lose benefits of therapy and may be predisposed to further resistance. Entecavir (ETV) resistance (ETVr) results from HBV reverse transcriptase substitutions at positions T184, S202, or M250, which emerge in the presence of lamivudine (LVD) resistance substitutions M204I/V +/- L180M. Here, we summarize results from comprehensive resistance monitoring of patients with HBV who were continuously treated with ETV for up to 5 years. Monitoring included genotypic analysis of isolates from all patients at baseline and when HBV DNA was detectable by polymerase chain reaction (> or = 300 copies/mL) from Years 1 through 5. In addition, genotyping was performed on isolates from patients experiencing virologic breakthrough (> or = 1 log(10) rise in HBV DNA). In vitro phenotypic ETV susceptibility was determined for virologic breakthrough isolates, and for HBV containing novel substitutions emerging during treatment. The results over 5 years of therapy showed that in nucleoside-naïve patients, the cumulative probability of genotypic ETVr and genotypic ETVr associated with virologic breakthrough was 1.2% and 0.8%, respectively. In contrast, a reduced barrier to resistance was observed in LVD-refractory patients, as the LVD resistance substitutions, a partial requirement for ETVr, preexist, resulting in a 5-year cumulative probability of genotypic ETVr and genotypic ETVr associated with breakthrough of 51% and 43%, respectively. Importantly, only four patients who achieved < 300 copies/mL HBV DNA subsequently developed ETVr. Long-term monitoring showed low rates of resistance in nucleoside-naïve patients during 5 years of ETV therapy, corresponding with potent viral suppression and a high genetic barrier to resistance. These findings support ETV as a primary therapy that enables prolonged treatment with potent viral suppression and minimal resistance.

  14. Analyzing Patients’ Values by Applying Cluster Analysis and LRFM Model in a Pediatric Dental Clinic in Taiwan

    Directory of Open Access Journals (Sweden)

    Hsin-Hung Wu

    2014-01-01

    Full Text Available This study combines cluster analysis and LRFM (length, recency, frequency, and monetary model in a pediatric dental clinic in Taiwan to analyze patients’ values. A two-stage approach by self-organizing maps and K-means method is applied to segment 1,462 patients into twelve clusters. The average values of L, R, and F excluding monetary covered by national health insurance program are computed for each cluster. In addition, customer value matrix is used to analyze customer values of twelve clusters in terms of frequency and monetary. Customer relationship matrix considering length and recency is also applied to classify different types of customers from these twelve clusters. The results show that three clusters can be classified into loyal patients with L, R, and F values greater than the respective average L, R, and F values, while three clusters can be viewed as lost patients without any variable above the average values of L, R, and F. When different types of patients are identified, marketing strategies can be designed to meet different patients’ needs.

  15. [Leisure-time sport activities and cardiac outpatient therapy in coronary patients].

    Science.gov (United States)

    Heitkamp, Hans-Christian; Schimpf, Thomas M; Hipp, Arno; Niess, Andreas

    2005-03-01

    Exercise intensity in coronary patients is controlled by heart rate measurements. Very few investigations have compared the maximum heart rate in cardiac outpatient groups, in leisure-time sport activities, and especially in swimming. Within different exercise conditions 21 coronary patients, nine in well-compensated cardiac condition joining a training group and twelve joining the exercise group with lower intensity, without signs of heart failure, engaged in an incremental bicycle ergometry. A six-lead ECG was derived at the same time with a 24-h ECG. The performance tolerance was measured by the pulse limit derived in 20 patients; one patient failed to show signs of subjective or objective ischemia. During a 24-h ECG monitoring, the patients took part in a 1-h standardized cardiac outpatient program, a standardized swimming program 4 x 25 m, and a typical self-selected leisure-time activity. The patients showed a peak work capacity of 2.2 W/kg and a symptom-free work capacity of 1.3 W/kg. The derived upper heart rate limit was passed during swimming by 19, during leisure-time activity by 16, and during cardiac outpatient program by two patients. The maximum of the mean overriding the limit occurred in leisure-time activity. Signs of ischemia occurred during ergometry in 15, during swimming training in ten patients, during leisure-time activity in eight, and during cardiac outpatient therapy in one. Arrhythmia leisure-time sport activity in 15, during cardiac outpatient therapy in 17, and during swimming in eight patients. Arrhythmia Lown IVa occurred in one patient each during ergometry, leisure sports, and during the night. Coronary patients are in danger to exercise beyond the pulse limit during swimming and other leisure-time sports and not during cardiac outpatient therapy. The upper heart rate limit should be observed during swimming and other endurance leisure-time activities, and is of little importance during cardiac outpatient therapy.

  16. Service use and costs for people with long-term neurological conditions in the first year following discharge from in-patient neuro-rehabilitation: a longitudinal cohort study.

    Directory of Open Access Journals (Sweden)

    Diana Jackson

    Full Text Available BACKGROUND: Knowledge of the configuration and costs of community rehabilitation and support for people with long-term neurological conditions (LTNCs is needed to inform future service development and resource allocation. In a multicentre prospective cohort study evaluating community service delivery during the year post-discharge from in-patient neuro-rehabilitation, a key objective was to determine service use, costs, and predictors of these costs. METHODS: Patients consecutively admitted over one year to all nine London specialised (Level 1 in-patient neuro-rehabilitation units were recruited on discharge. They or their carers completed postal/web-based questionnaires at discharge and six and twelve months later, providing demographic data and measures of impairment, disability, service needs and provision. This paper describes health and social care service use, informal care and associated costs. Regression models using non-parametric boot-strapping identified predictors of costs over time. RESULTS: Overall, 152 patients provided consistent data. Mean formal service costs fell significantly from £13,290 (sd £19,369 during the first six months to £9,335 (sd £19,036 from six-twelve months, (t = 2.35, P<0.05, mainly due to declining health service use. At six months, informal care was received on average for 8.2 hours/day, mean cost £14,615 (sd 23,305, comprising 52% of overall care costs. By twelve months, it had increased to 8.8 hours per day, mean cost £15,468 (sd £25,534, accounting for 62% of overall care costs. Being younger and more disabled predicted higher formal care costs, explaining 32% and 30% of the variation in costs respectively at six and twelve months. CONCLUSION: Community services for people with LTNCs carry substantial costs that shift from health to social care over time, increasing the burden on families. Prioritising rehabilitation services towards those in greatest need could limit access to others needing on

  17. Patterns of disturbed myocardial perfusion in patients with coronary artery disease. Regional myocardial perfusion in angina pectoris

    International Nuclear Information System (INIS)

    Selwyn, A.P.; Forse, G.; Fox, K.; Jonathan, A.; Steiner, R.

    1981-01-01

    Fifty patients who presented with angina pectoris were studied to examine the disturbances of regional myocardial perfusion during stress. Each patient underwent 16-point precordial mapping of the ECG during an exercise test, and coronary and left ventricular angiography. Regional myocardial perfusion was assessed using an atrial pacing test and a short-lived radionuclide, krypton-81m. Eleven patients had negative exercise tests and uniform increases in myocardial activity of krypton-81m of 98 +/- 18.0% during pacing. Ten patients performed 30,000-43,000 J in positive exercise tests. These patients showed abnormal coronary anatomy and increases in myocardial activity of krypton-81m to remote and jeopardized myocardium at the onset of pacing. However, further pacing produced a decrease in activity in the affected segment of 68.0 +/- 9.0% accompanied by ST-segment depression and angina. Twelve patients achieved 26,000-32,000 J in positive exercise tests and had significant coronary artery disease. Atrial pacing produced increased activity of krypton-81m to remote myocardium. The jeopardized segment at first showed no change and then a decrease in regional activity of krypton-81m (89.0 +/- 17%) accompanied by ST-segment depression and chest pain. Seventeen patients achieved only 7000-22,000 J in positive exercise tests. These patients showed abnormal coronary anatomy and developed decreases in regional activity of krypton-81m to the affected segment of myocardium starting at the onset of atrial pacing and decreasing by 88 +/- 0 7.0% below control. We conclude that different patterns of disturbed myocardial distribution of krypton-81m are present during stress-induced ischemia in patients with coronary artery disease. There was a close temporal relationship between these disturbances and ST-segment depression

  18. Recurrent and multiple bladder tumors show conserved expression profiles

    International Nuclear Information System (INIS)

    Lindgren, David; Fioretos, Thoas; Månsson, Wiking; Höglund, Mattias; Gudjonsson, Sigurdur; Jee, Kowan Ja; Liedberg, Fredrik; Aits, Sonja; Andersson, Anna; Chebil, Gunilla; Borg, Åke; Knuutila, Sakari

    2008-01-01

    Urothelial carcinomas originate from the epithelial cells of the inner lining of the bladder and may appear as single or as multiple synchronous tumors. Patients with urothelial carcinomas frequently show recurrences after treatment making follow-up necessary. The leading hypothesis explaining the origin of meta- and synchronous tumors assumes a monoclonal origin. However, the genetic relationship among consecutive tumors has been shown to be complex in as much as the genetic evolution does not adhere to the chronological appearance of the metachronous tumors. Consequently, genetically less evolved tumors may appear chronologically later than genetically related but more evolved tumors. Forty-nine meta- or synchronous urothelial tumors from 22 patients were analyzed using expression profiling, conventional CGH, LOH, and mutation analyses. We show by CGH that partial chromosomal losses in the initial tumors may not be present in the recurring tumors, by LOH that different haplotypes may be lost and that detected regions of LOH may be smaller in recurring tumors, and that mutations present in the initial tumor may not be present in the recurring ones. In contrast we show that despite apparent genomic differences, the recurrent and multiple bladder tumors from the same patients display remarkably similar expression profiles. Our findings show that even though the vast majority of the analyzed meta- and synchronous tumors from the same patients are not likely to have originated directly from the preceding tumor they still show remarkably similar expressions profiles. The presented data suggests that an expression profile is established early in tumor development and that this profile is stable and maintained in recurring tumors

  19. Patient risk perceptions for carotid endarterectomy: which patients are strongly averse to surgery?

    Science.gov (United States)

    Bosworth, Hayden B; Stechuchak, Karen M; Grambow, Steven C; Oddone, Eugene Z

    2004-07-01

    Patient risk perception for surgery may be central to their willingness to undergo surgery. This study examined potential factors associated with patient aversion of surgery. This is a secondary data analysis of a prospective cohort study that examined patients referred for evaluation of carotid artery stenosis at five Veterans Affairs Medical Centers. The study collected demographic, clinical, and psychosocial information related to surgery. This analysis focused on patient response to a question assessing their aversion to surgery. Among the 1065 individuals, at the time of evaluation for carotid endarterectomy (CEA), 66% of patients had no symptoms, 16% had a transient ischemic attack, and 18% had stroke. Twelve percent of patients referred for CEA evaluation were averse to surgery. In adjusted analyses, increased age, black race, no previous surgery, lower level of chance locus of control, less trust of physicians, and less social support were significantly related to greater likelihood of surgery aversion among individuals referred for CEA evaluation. Patient degree of medical comorbidity and a validated measure of preoperative risk score were not associated with increased aversion to surgery. In previous work, aversion to CEA was associated with lack of receipt of CEA even after accounting for patient clinical appropriateness for surgery. We identified important patient characteristics associated with aversion to CEA. Interventions designed to assist patient decision making should focus on these more complex factors related to CEA aversion rather than the simple explanation of clinical usefulness.

  20. Celiac disease: management of persistent symptoms in patients on a gluten-free diet.

    Science.gov (United States)

    Dewar, David H; Donnelly, Suzanne C; McLaughlin, Simon D; Johnson, Matthew W; Ellis, H Julia; Ciclitira, Paul J

    2012-03-28

    To investigate all patients referred to our center with non-responsive celiac disease (NRCD), to establish a cause for their continued symptoms. We assessed all patients referred to our center with non-responsive celiac disease over an 18-mo period. These individuals were investigated to establish the eitiology of their continued symptoms. The patients were first seen in clinic where a thorough history and examination were performed with routine blood work including tissue transglutaminase antibody measurement. They were also referred to a specialist gastroenterology dietician to try to identift any lapses in the diet and sources of hidden gluten ingestion. A repeat small intestinal biopsy was also performed and compared to biopsies from the referring hospital where possible. Colonoscopy, lactulose hydrogen breath testing, pancreolauryl testing and computed tomography scan of the abdomen were undertaken if the symptoms persisted. Their clinical progress was followed over a minimum of 2 years. One hundred and twelve consecutive patients were referred with NRCD. Twelve were found not to have celiac disease (CD). Of the remaining 100 patients, 45% were not adequately adhering to a strict gluten-free diet, with 24 (53%) found to be inadvertently ingesting gluten, and 21 (47%) admitting non-compliance. Microscopic colitis was diagnosed in 12% and small bowel bacterial overgrowth in 9%. Refractory CD was diagnosed in 9%. Three of these were diagnosed with intestinal lymphoma. After 2 years, 78 patients remained well, eight had continuing symptoms, and four had died. In individuals with NRCD, a remediable cause can be found in 90%: with continued gluten ingestion as the leading cause. We propose an algorithm for investigation.

  1. Aliphatic hydrocarbon and polycyclic aromatic hydrocarbon geochemistry of twelve major rivers in the Northwest Territories

    International Nuclear Information System (INIS)

    Backus, S.; Swyripa, M.; Peddle, J.; Jeffries, D.S.

    1995-01-01

    Suspended sediment and water samples collected from twelve major rivers in the Northwest Territories were analyzed for aliphatic hydrocarbons and polycyclic aromatic hydrocarbons (PAHs) to assess the sources and transport of hydrocarbons entering the Arctic Ocean. Three stations on the Mackenzie River and one station near the mouth of eleven other northern rivers were selected for sampling. Samples were collected on the Mackenzie River on four occasions to characterize spring, summer and fall flow conditions and once on the remaining eleven rivers during high flow conditions. The Mackenzie River is distinctively different then the other eleven rivers. Naturally occurring hydrocarbons predominate in the river. These hydrocarbons include biogenic alkanes, diagenic PAHs, petrogenic alkanes, and PAHs from oil seeps and/or bitumens. Anthropogenic inputs of PAHs are low as indicated by low concentrations of combustion PAHs. Alkyl PAH distributions indicate that a significant component of the lower molecular weight PAH fraction is petrogenic. The majority of the high molecular weight PAHs, together with the petrogenic PAHs have a principal source in the Mackenzie River

  2. The patient had a normal magnetic resonance imaging and temporal lobe epilepsy secondary to a porencephalic cyst but showed structural lesions (hippocampal sclerosis)☆

    Science.gov (United States)

    Matsubara, Teppei; Ayuzawa, Satoshi; Aoki, Tsukasa; Fujiomto, Ayataka; Osuka, Satoru; Matsumura, Akira

    2013-01-01

    Patients with a porencephalic cyst frequently develop intractable temporal lobe epilepsy (TLE). We report a surgically-treated male patient with intractable mesial TLE (mTLE) secondary to a porencephalic cyst. Although magnetic resonance imaging showed no hippocampal abnormalities, long-term video-electrocorticography revealed seizure onset discharges in the hippocampus. Temporal lobectomy brought an end to the patient's seizures. Hippocampal sclerosis was histopathologically confirmed (dual pathology). Careful evaluation of hippocampal epileptogenicity is required, and temporal lobectomy, which is less invasive than hemispherectomy, can be a treatment of choice for patients with mTLE secondary to a porencephalic cyst. PMID:25667851

  3. SPM analysis and cognitive dysfunctions in patients with transient global amnesia

    International Nuclear Information System (INIS)

    Jeong, Young Jin; Kang, Do Young; Yun, Go Un; Park, Kyung Won; Kim, Jae Woo

    2004-01-01

    Transient global amnesia (TGA) is known as a disease of benign nature characterized with clinically transient global antegrade amnesia and a variable degree of global retrograde memory impairment, but it usually resolved within 24 hours. The aims of this study are to assess the alterations in regional cerebral blood flow (rCBF) by Tc-99m HMPAO SPECT imaging with statistical parametric mapping (SPM) analysis and to verify the cognitive deficits by neuropsychological test in TGA patients. Twelve patients with TGA and age-matched normal control subjects participated in this study. Tc-99m HMPAO SPECT was performed within 1 to 19 days (mean duration: 7.3:±5.2 days) after the events to measure the rCBF. SPECT images were analyzed using SPM (SPM99) with Matlab 5.3. Seoul Neuropsychological Screening Battery test was also done within 2 to 8 days (mean duration 3.8±2.2 days) for cognitive functions in 8 of 12 patients with TGA. The SPM analysis of SPECT images showed significantly decreased rCBF in the left inferior frontal gyrus (Brodmann area 9), the left supramarginal gyrus (Brodmann area 40), the left postcentral gyrus (Brodmann area 40) and the left precentral gyrus (Brodmann area 4) in patients with TGA (uncorrected p<0.01). Neuropsychological test findings represented that several cognitive functions. such as, verbal memory, visual memory, phonemic fluency and confrontational naming, were impaired in patients with TGA compared with normal control. Additionally, on SPM analysis, we found lesions of hyperperfusion in contralateral cerebral hemisphere. Our study shows perfusion deficits in the left cerebral hemisphere in patients with TGA and several cognitive dysfunctions. And we found after clinical symptoms were completely resolved, the lesions of hypoperfusion were still remained. We found that functional quantitative neuroimaging study and neuropsychological test are useful to understand underlying pathomachanism of TGA

  4. SPM analysis and cognitive dysfunctions in patients with transient global amnesia

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Young Jin; Kang, Do Young; Yun, Go Un; Park, Kyung Won; Kim, Jae Woo [School of Medicine, Donga University, Busan (Korea, Republic of)

    2004-07-01

    Transient global amnesia (TGA) is known as a disease of benign nature characterized with clinically transient global antegrade amnesia and a variable degree of global retrograde memory impairment, but it usually resolved within 24 hours. The aims of this study are to assess the alterations in regional cerebral blood flow (rCBF) by Tc-99m HMPAO SPECT imaging with statistical parametric mapping (SPM) analysis and to verify the cognitive deficits by neuropsychological test in TGA patients. Twelve patients with TGA and age-matched normal control subjects participated in this study. Tc-99m HMPAO SPECT was performed within 1 to 19 days (mean duration: 7.3:{+-}5.2 days) after the events to measure the rCBF. SPECT images were analyzed using SPM (SPM99) with Matlab 5.3. Seoul Neuropsychological Screening Battery test was also done within 2 to 8 days (mean duration 3.8{+-}2.2 days) for cognitive functions in 8 of 12 patients with TGA. The SPM analysis of SPECT images showed significantly decreased rCBF in the left inferior frontal gyrus (Brodmann area 9), the left supramarginal gyrus (Brodmann area 40), the left postcentral gyrus (Brodmann area 40) and the left precentral gyrus (Brodmann area 4) in patients with TGA (uncorrected p<0.01). Neuropsychological test findings represented that several cognitive functions. such as, verbal memory, visual memory, phonemic fluency and confrontational naming, were impaired in patients with TGA compared with normal control. Additionally, on SPM analysis, we found lesions of hyperperfusion in contralateral cerebral hemisphere. Our study shows perfusion deficits in the left cerebral hemisphere in patients with TGA and several cognitive dysfunctions. And we found after clinical symptoms were completely resolved, the lesions of hypoperfusion were still remained. We found that functional quantitative neuroimaging study and neuropsychological test are useful to understand underlying pathomachanism of TGA.

  5. Patient agency and contested notions of disability in social assistance applications in South Africa.

    Science.gov (United States)

    Kelly, Gabrielle

    2017-02-01

    Problems in fairly allocating welfare and health resources are very often located in the spaces where citizens interact directly with state workers. This study draws on observations of doctor-patient encounters in disability assessments for the South African disability grant (DG) to examine how doctor-patient interactions and patient agency shape social welfare allocation in a context of high poverty and inequality. Data were gathered via interviews with healthcare workers and observations of doctor-patient interactions in twelve clinics and three hospitals in the Western Cape province between October 2013 and August 2014. Twenty-four doctors were interviewed, of whom seventeen were observed conducting a total of 216 consultations with patients. Two training sessions of DG assessors were also observed. Findings show that interactions between doctors and patients are sites of negotiation and contestation over rights to social assistance. Claimants' understanding of disability differed from biomedical and bureaucratic definitions. Patients attempted to influence doctors' decisions through narratives of suffering and performances of disability. Others used verbal or physical abuse as a form of protest against perceived unfair treatment. To defend themselves from these pressures and maintain authority in these interactions, doctors employed coping strategies that distanced and objectified claimants. This resulted in strained doctor-patient relationships and made the DG system confusing to the public. This demonstrates the importance of considering trust, power dynamics and the exercise of agency by both patients and providers in understanding policy implementation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. The clinical value of bilateral breast MR imaging: is it worth performing on patients showing suspicious microcalcifications on mammography?

    Energy Technology Data Exchange (ETDEWEB)

    Akita, Ayano; Tanimoto, Akihiro; Kuribayashi, Sachio [Keio University, Department of Diagnostic Radiology, School of Medicine, Tokyo (Japan); Jinno, Hiromitsu [Keio University, Department of Surgery, School of Medicine, Tokyo (Japan); Kameyama, Kaori [Keio University, Division of Diagnostic Pathology, School of Medicine, Tokyo (Japan)

    2009-09-15

    The purpose of this study was to evaluate the clinical value of bilateral breast magnetic resonance (MR) imaging (MRI) in patients showing suspicious microcalcifications on mammography and negative ultrasound findings. Fifty patients underwent MRI before stereotactic vacuum-assisted breast biopsy (SVAB). MR findings were classified into five types for interpretation, and types 4 and 5 were considered malignant. SVAB revealed 13 carcinomas and 37 benign lesions. Malignant lesions were more frequently found in cases of positive MRI diagnoses than in negative MRI diagnoses (P < 0.001). Mammography had a sensitivity of 100%, a specificity of 24% and an accuracy of 44%, whereas mammography plus MRI had a sensitivity of 85%, a specificity of 100% and an accuracy of 96%. In the evaluation of mammographically detected microcalcifications, bilateral breast MRI is of good diagnostic value and may alter the indications for SVAB. (orig.)

  7. Surface plasmon resonance analysis shows an IgG-isotype-specific defect in ABO blood group antibody formation in patients with common variable immunodeficiency

    Directory of Open Access Journals (Sweden)

    Michael Bernhard Fischer

    2015-05-01

    Full Text Available Background: Common variable immunodeficiency (CVID is the most common clinically severe primary immunodeficiency and comprises a heterogeneous group of patients with recurrent severe bacterial infections due to the failure to produce IgG antibodies after exposure to infectious agents and immunization. Diagnostic recommendations for antibody failure include assessment of isoagglutinins. We have readdressed this four decades old but still accepted recommendation with up to date methodology.Methods: Anti-A/B IgM- and IgG-antibodies were measured by Diamed-ID Micro Typing, surface plasmon resonance (SPR using the Biacore® device and flow cytometry.Results: When Diamed-ID Micro Typing was used, CVID patients (n=34 showed IgG- and IgM-isoagglutinins that were comparable to healthy volunteers (n=28, while all XLA patients (n=8 had none. Anti-A/B IgM-antibodies were present in more than 2/3 of the CVID patients and showed binding kinetics comparable to anti-A/B IgM-antibodies from healthy individuals. A correlation could be found in CVID patients between levels of anti-A/B IgM-antibodies and levels of serum IgM and PnP-IgM-antibodies. In contrast in CVID patients as a group ABO antibodies were significantly decreased when assessed by SPR, which correlated with levels of switched memory, non-switched memory and naïve B cells, but all CVID patients had low/undetectable anti-A/B IgG-antibodies.Conclusion: These results indicate that conventional isoagglutinin assessment and assessment of anti-A/B IgM antibodies are not suited for the diagnosis of impaired antibody production in CVID. Examination of anti-A/B IgG antibodies by SPR provides a useful method for the diagnosis of IgG antibody failure in all CVID patients studied, thus indicating an important additional rationale to start immunoglobulin replacement therapy early in these patients, before post-infectious sequelae develop.

  8. Effectiveness of Videogames on Balance and Fear of Falling in Chronic Stroke Patient

    Directory of Open Access Journals (Sweden)

    Neshat Rahimi S.Monfared

    2015-03-01

    Full Text Available Objectives: Balance disorder is one of the most common problems after stroke causes falling and fear of falling in some patients. The balance based video games are newly used in people with motor problems. It is very important to use different interventions for balance issues. The aim of this study is to determine the effectiveness of videogame on balance and fear of falling in one participant. Methods: This experimental study was done in a single subject system, A-B design for one patient with chronic stroke. This method including repetitive measures conducted in two phases, baseline and then twelve intervention sessions. Berg Balance Scale, Timed up and go, Functional Reach, the maximum weight bearing in different directions and the deviation from center were conducted for balance assessing. Fear of falling questionnaire was used to assess fear of falling. Analysis of results was done by C-statistic, Bayesian factor, Mann Whitney U, and visual analysis graphs. Results: The results showed significant improvement for balance skills, the maximum force produced by lower extremities and reducing fear of falling parameters. But the deviation from center graphs did not showed distinct pattern. Discussion: All analysis confirmed the efficacy of videogames on balance skills and fear of falling improvement. However, the deviation from center did not show improvement and it seems to need more studies.

  9. Serial dynamic CT scan in patients with acute basal ganglia infarctions

    International Nuclear Information System (INIS)

    Node, Yoji; Nakazawa, Shozo; Tsuji, Yukihide.

    1987-01-01

    Dynamic computed tomography (CT) was performed on 15 patients (37 to 93 years of age) with acute basal ganglia infarctions, and the perfusion patterns of the infarcted regions on CT were evaluated. The initial dynamic CT was performed within 12 hours after onset, while the serial studies of the dynamic CT were performed on the 3rd and 7th days. The left-over-right ratio in the peak value in the basal ganglia in 15 normal subjects was 1.01 ± 0.03 (mean ± SD), so there were no differences in the peak values of the bilateral basal ganglia. We also examined the left-over-right ratio in the peak value and in the rapid-washout ratio in the basal ganglia in the 15 normal subjects. There was no difference in the peak values of the bilateral basal ganglia. The mean rapid-washout ratio was 0.62 ± 0.11 (mean ± SD). The prognoses of these patients three months after onset were as follows: 8 showed a good recovery, 5 had a moderate disability, and 2 had a severe disability. The perfusions on admission were as follows. 10 were hypoperfusions, 3 were hypo + late perfusions, one was a normoperfusion, and one was a late perfusion. There was a tendency for the rapid-washout ratio decrease more in the hypo + late perfusion group than in the other groups. Twelve patients showed an iso-density, while 3 showed a low density, on admission. The ''low-density'' group showed a decrease in the A/N ratio of the peak value. We performed serial dynamic CT in 11 cases. The group with severe disabilities (2 cases) showed a hypo + late perfusion in the initial CT, one case kept a hypo + late perfusion, and another case changed to a hypoperfusion; also, there was a tendency for there to be a poor improvement in the A/N ratio of the peak value in these two ''severe-disability'' patients. (J.P.N.)

  10. ELECTROENCEPHALOGRAPHY SHOWING DYING BRAIN IN A PATIENT WITH ACUTE BACLOFEN POISONING

    Directory of Open Access Journals (Sweden)

    A. Y. Mikhaylov

    2017-01-01

    Full Text Available We report a case of acute baclofen poisoning in a 23-year-old female patient, who committed suicide, which led to the development of a deep coma. The electroencephalogram on the first day recorded the phenomenon of “burst suppression”, which was seen as a sign of a dying brain. Subsequent studies have shown positive changes of the electroencephalogram and regression of neurological symptoms. Thus, the phenomenon of “burst suppression” in the depression of consciousness to deep coma and given adequate treatment, can be reversible.

  11. CT evaluation of the damaged upper limb muscle in patients with Duchenne type progressive muscular dystrophy (DMD)

    International Nuclear Information System (INIS)

    Saito, Hiroshi; Matsuke, Yutaka.

    1992-01-01

    In order to evaluate the changes of CT numbers and cross sectional areas of the muscles, we determined CT scores of the muscle. In twelve patients with Duchenne type progressive muscular dystrophy (DMD), we assessed the difference of CT scores of the muscle and the correlation between CT score of the muscle and 9-stage classification of upper extremities. CT scores of the subscapularis muscle and infraspinatus muscle were significantly lower than deltoideus muscle at the level of the shoulder, and flexor muscles showed also significantly lower than extensor muscles at the level of the upper extremity. Good correlations between CT score of the muscle and 9-stage classification of upper extremities were observed in the muscles of shoulder and upper arm. (author)

  12. CT evaluation of the damaged upper limb muscle in patients with Duchenne type progressive muscular dystrophy (DMD)

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Hiroshi (Anan Central Hospital, Tokushima (Japan)); Matsuke, Yutaka

    1992-04-01

    In order to evaluate the changes of CT numbers and cross sectional areas of the muscles, we determined CT scores of the muscle. In twelve patients with Duchenne type progressive muscular dystrophy (DMD), we assessed the difference of CT scores of the muscle and the correlation between CT score of the muscle and 9-stage classification of upper extremities. CT scores of the subscapularis muscle and infraspinatus muscle were significantly lower than deltoideus muscle at the level of the shoulder, and flexor muscles showed also significantly lower than extensor muscles at the level of the upper extremity. Good correlations between CT score of the muscle and 9-stage classification of upper extremities were observed in the muscles of shoulder and upper arm. (author).

  13. The courage to change: Patient perceptions of 12-Step fellowships

    Science.gov (United States)

    2011-01-01

    Background From a health services perspective, peer-based resources merit special attention. Participation in self-help fellowships, like the Twelve Step Groups (TSGs), have been shown to improve outcomes of patients with substance use disorder (SUD) and they represent a valuable adjunct to the SUD treatment system. This study investigated the relationship between patient perceptions of TSGs and the intent to participate in TSGs after receiving detoxification treatment. Methods We included 139 patients that entered a detoxification unit (detox) in Kristiansand, Norway. We analyzed factors associated with the intention to participate in TSGs post-discharge with contingency tables and ordinal regression analysis. Results Forty-eight percent of patients had participated in TSGs before entering detox. Respondents saw more advantages than disadvantages in TSG participation, but only 40% of patients showed high intentions of participating in TSGs post-discharge. A high intention to participate in TSGs was most strongly correlated with the notion that participation in TSGs could instill the courage to change. In a multivariate analysis, the perception that TSGs were beneficial was the strongest factor related to a high intention of TSG participation after treatment. Conclusions Our findings increased the understanding of factors most likely to influence decisions to attend TSGs in SUD treatment contexts with uncommon TSG participation. Our results suggested that the majority of patients may be sufficiently influenced by highlighting the potential gains of TSG participation. Treatment programs that do not focus on self-help group attendance during and after treatment should consider implementing facilitative measures to enhance utilization of these fellowships. PMID:22171827

  14. The courage to change: Patient perceptions of 12-Step fellowships

    Directory of Open Access Journals (Sweden)

    Vederhus John-Kåre

    2011-12-01

    Full Text Available Abstract Background From a health services perspective, peer-based resources merit special attention. Participation in self-help fellowships, like the Twelve Step Groups (TSGs, have been shown to improve outcomes of patients with substance use disorder (SUD and they represent a valuable adjunct to the SUD treatment system. This study investigated the relationship between patient perceptions of TSGs and the intent to participate in TSGs after receiving detoxification treatment. Methods We included 139 patients that entered a detoxification unit (detox in Kristiansand, Norway. We analyzed factors associated with the intention to participate in TSGs post-discharge with contingency tables and ordinal regression analysis. Results Forty-eight percent of patients had participated in TSGs before entering detox. Respondents saw more advantages than disadvantages in TSG participation, but only 40% of patients showed high intentions of participating in TSGs post-discharge. A high intention to participate in TSGs was most strongly correlated with the notion that participation in TSGs could instill the courage to change. In a multivariate analysis, the perception that TSGs were beneficial was the strongest factor related to a high intention of TSG participation after treatment. Conclusions Our findings increased the understanding of factors most likely to influence decisions to attend TSGs in SUD treatment contexts with uncommon TSG participation. Our results suggested that the majority of patients may be sufficiently influenced by highlighting the potential gains of TSG participation. Treatment programs that do not focus on self-help group attendance during and after treatment should consider implementing facilitative measures to enhance utilization of these fellowships.

  15. The usefulness of measurement of whole body count in assessing bone marrow metastasis in cancer patients with increased periarticular bone uptake on follow-up bone scan: a comparison with bone marrow scan

    International Nuclear Information System (INIS)

    Jin, Seong Chan; Choi, Yun Young; Cho, Suk Shin

    2003-01-01

    Increased periarticular uptake could be associated with peripheral bone marrow expansion in cancer patients with axial bone marrow metastasis. We compared bone scan and bone marrow scan to investigate whether the increased whole body count in patients with increased periarticular uptake on bone scan is useful in the diagnosis of axial marrow metastasis, and evaluate the role of additional bone marrow scan in these cases. Twelve patients with malignant diseases who showed increased periarticular uptake on bone scan were included. Whole body count was measured on bone scan and it is considered to be increased when the count is more than twice of other patients. Bone marrow scan was taken within 3-7 days. Five hematologic malignancy, 3 stomach cancer, 2 breast cancer, 1 prostate cancer and 1 lung canner were included. All three patients with increased whole body count on bone scan showed axial marrow suppression and peripheral marrow expansion. Eight of 9 patients without increased whole body count showed axial marrow suppression and peripheral marrow expansion. One turned out to be blastic crisis of chronic myelogeneous leukemia, and seven showed normal axial marrow with peripheral marrow expansion in chronic anemia of malignancy. The last one without increased whole body count showed normal bone marrow scan finding. Increased whole body count on bone scan could be a clue to axial bone marrow metastasis in cancer patients with increased periarticular uptake, and bone marrow scan is a valuable method for differential diagnosis in these cases

  16. Cardiac arrhythmia with premature ventricular contractures induced by interferon beta in a patient with multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Igor Sobol

    2015-03-01

    Full Text Available Multiple sclerosis (MS is an immune-mediated inflammatory and neurodegenerative disease of the central nervous system. Interferon (IFN beta is an active ingredient of five out of twelve disease modifying treatments approved for MS. We report a case of IFN-beta-induced cardiac arrhythmia with premature ventricular contractures in a patient recently diagnosed with MS.

  17. Radiotherapy Results of Breast Cancer Patients with Metastatic Bone Disease

    Directory of Open Access Journals (Sweden)

    Ahmet Dirier

    2006-01-01

    Full Text Available Breast cancer patients with bone metastasis who had admitted to Dicle University Department of Radiation Oncology for palliative radiation therapy between September 2001 and December 2003 were evaluated. There were 31 patients (26 female, 5 male. Median age was 43 years (range 23-79. Histopathological subtypes were infiltrating ductal carcinoma (88%, tubulolobuler carcinoma (6% and inflammatory carcinoma (6%. Loci of bone metastasis were vertebra only in twelve patients (39%, non-vertebral bones only in 8 patients (26% and both vertebral and nonvertebral bones in 11 patients (35%. Two patients had refused radiotherapy. Radiation doses were 3000 cGy with 10 fractions in 15 patients, 2000 cGy with 5 fractions in 6 patients and 800 cGy single fraction in eight patients. Complete palliation of pain was achieved in 18 patients (62% and partial palliation was achieved in 11 patients (38%. Treatment related toxicity was grade I-II dermatitis. In conclusion; same respons rates in terms of palliation can be achieved in the three radiotherapy schedules.

  18. Mismatch negativity, social cognition, and functional outcomes in patients after traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Hui-yan Sun

    2015-01-01

    Full Text Available Mismatch negativity is generated automatically, and is an early monitoring indicator of neuronal integrity impairment and functional abnormality in patients with brain injury, leading to decline of cognitive function. Antipsychotic medication cannot affect mismatch negativity. The present study aimed to explore the relationships of mismatch negativity with neurocognition, daily life and social functional outcomes in patients after brain injury. Twelve patients with traumatic brain injury and 12 healthy controls were recruited in this study. We examined neurocognition with the Wechsler Adult Intelligence Scale-Revised China, and daily and social functional outcomes with the Activity of Daily Living Scale and Social Disability Screening Schedule, respectively. Mismatch negativity was analyzed from electroencephalogram recording. The results showed that mismatch negativity amplitudes decreased in patients with traumatic brain injury compared with healthy controls. Mismatch negativity amplitude was negatively correlated with measurements of neurocognition and positively correlated with functional outcomes in patients after traumatic brain injury. Further, the most significant positive correlations were found between mismatch negativity in the fronto-central region and measures of functional outcomes. The most significant positive correlations were also found between mismatch negativity at the FCz electrode and daily living function. Mismatch negativity amplitudes were extremely positively associated with Social Disability Screening Schedule scores at the Fz electrode in brain injury patients. These experimental findings suggest that mismatch negativity might efficiently reflect functional outcomes in patients after traumatic brain injury.

  19. Brain natriuretic peptide is a potent vasodilator in aged human microcirculation and shows a blunted response in heart failure patients

    DEFF Research Database (Denmark)

    Edvinsson, Marie-Louise; Uddman, Erik; Edvinsson, Lars

    2014-01-01

    in the forearm was measured by laser Doppler Flowmetry. Local heating (+44°C, 10 min) was used to evoke a maximum local dilator response. RESULTS: Non-invasive iontophoretic administration of either BNP or acetylcholine (ACh), a known endothelium-dependent dilator, elicited an increase in local flow. The nitric......, the vasodilator responses to ACh and to local heating were only somewhat attenuated in CHF patients. Thus, dilator capacity and nitric oxide signalling were not affected to the same extent as BNP-mediated dilation, indicating a specific downregulation of the latter response. CONCLUSIONS: The findings show...... for the first time that microvascular responses to BNP are markedly reduced in CHF patients. This is consistent with the hypothesis of BNP receptor function is downregulated in CHF....

  20. Nucleoside Analog-treated Chronic Hepatitis B Patients showed Reduced Expression of PECAM-1 Gene in Peripheral Blood Mononuclear Cells in Bangladesh

    Science.gov (United States)

    Tabassum, Shahina; Ullah Munshi, Saif; Hossain, Marufa; Imam, Akhter

    2014-01-01

    ABSTRACT Background and aim Assessment of therapeutic response is important for monitoring the prognosis and to take decision for cessation of nucleoside analogues therapy in chronic hepatitis B patients. In addition to serum alanine aminotransferase (ALT), hepatitis B virus (HBV) deoxyribonucleic acid (DNA) load and HBeAg status, identification of molecular markers associated with host immune response would be essential to assess therapeutic response. In this regard the current study was performed with the aim to detect expression of platelet endothelial cell adhesion molecule (PECAM)-I gene in peripheral blood monocytes (PBMCs) of treated chronic hepatitis B patients and also to correlate expression of this gene with serum HBV DNA load and serum ALT levels. Materials and methods The study analyzed 60 chronic hepatitis B (CHB) patients, including 30 untreated and 30 nucleoside analogs treated and 10 healthy controls. PECAM-1 gene expression/ transcripts were detected by conventional RT-PCR. Results The expression PECAM-1 mRNA in the PBMCs of CHB patients was significantly higher in untreated (3.17 ± 0.75) than the treated patients (1.64 ± 0.29) (p Tabassum S, Munshi SU, Hossain M, Imam A. Nucleoside Analog-treated Chronic Hepatitis B Patients showed Reduced Expression of PECAM-1 Gene in Peripheral Blood Mononuclear Cells in Bangladesh. Euroasian J Hepato-Gastroenterol 2014;4(2):87-91. PMID:29699354

  1. Prevalence of hypodontia in Chinese orthodontic patients

    Directory of Open Access Journals (Sweden)

    Pambudi Rahardjo

    2006-12-01

    Full Text Available Hypodontia is a phenomenon of congenitally missing teeth in human. A thousand and twelve panoramic radiographs of Chinese orthodontic patients were examined for agenesis of permanent teeth including third molars. The patients with missing teeth were divided into four group: the patients with missing less than 4 molars, missing all third molars, hypodontia and oligodontia. The result revealed, 210 patients affected one or more teeth agenesis with a total of 455 teeth missing. The prevalence of tooth agenesis was maxillary third molar 259 (56.9%, mandibular third molar 143 (31.4%, mandibular second premolar 15 (3.3%, mandibular lateral incisors 13 (2.8%, maxillary lateral incisors 8 (1.7%, maxillary second premolars 7 (1.5%, other teeth 10 (2.2% respectively. Of the mesial mandibular first permanent molar, mandibular second premolars were the most frequent missing teeth. Although hypodontia did not represent a public health problem, from orthodontic point of view it might cause esthetic and masticatory function disorders as well as more complex mechanotherapy of a patient.

  2. SU-F-T-558: ArcCheck for Patient Specific QA in Stereotactic Ablative Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Ramachandran, P [Peter MacCallum Cancer Centre, Melbourne (Australia); RMIT University, Bundoora (Australia); Tajaldeen, A; Esen, N; Geso, M [RMIT University, Bundoora (Australia); Taylor, D; Wanigaratne, D; Roozen, K; Kron, T [Peter MacCallum Cancer Centre, Melbourne (Australia)

    2016-06-15

    Purpose: Stereotactic Ablative Radiotherapy (SABR) is one of the most preferred treatment techniques for early stage lung cancer. This technique has been extended to other treatment sites like Spine, Liver, Scapula, Sternum etc., This has resulted in increased physics QA time on machine. In this study, we’ve tested the feasibility of using ArcCheck as an alternative method to replace film dosimetry. Methods: Twelve patients with varied diagnosis of Lung, Liver, scapula, sternum and Spine undergoing SABR were selected for this study. Pre-treatment QA was performed for all the patients which include ionization chamber and film dosimetry. The required gamma criteria for each SABR plan to pass QA and proceed to treatment is 95% (3%,1mm). In addition to this routine process, the treatment plans were exported on to an ArcCheck phantom. The planned and measured dose from the ArcCheck device were compared using four different gamma criteria: 2%,2 mm, 3%,2 mm, 3%,1 mm and 3%, 3 mm. In addition to this, we’ve also introduced errors to gantry, collimator and couch angle to assess sensitivity of the ArcCheck with potential delivery errors. Results: The ArcCheck mean passing rates for all twelve cases were 76.1%±9.7% for gamma criteria 3%,1 mm, 89.5%±5.3% for 2%,2 mm, 92.6%±4.2% for 3%,2 mm, and 97.6%±2.4% for 3%,3 mm gamma criteria. When SABR spine cases are excluded, we observe ArcCheck passing rates higher than 95% for all the studied cases with 3%, 3mm, and ArcCheck results in acceptable agreement with the film gamma results. Conclusion: Our ArcCheck results at 3%, 3 mm were found to correlate well with our non-SABR spine routine patient specific QA results (3%,1 mm). We observed significant reduction in QA time on using ArcCheck for SABR QA. This study shows that ArcCheck could replace film dosimetry for all sites except SABR spine.

  3. SU-F-T-558: ArcCheck for Patient Specific QA in Stereotactic Ablative Radiotherapy

    International Nuclear Information System (INIS)

    Ramachandran, P; Tajaldeen, A; Esen, N; Geso, M; Taylor, D; Wanigaratne, D; Roozen, K; Kron, T

    2016-01-01

    Purpose: Stereotactic Ablative Radiotherapy (SABR) is one of the most preferred treatment techniques for early stage lung cancer. This technique has been extended to other treatment sites like Spine, Liver, Scapula, Sternum etc., This has resulted in increased physics QA time on machine. In this study, we’ve tested the feasibility of using ArcCheck as an alternative method to replace film dosimetry. Methods: Twelve patients with varied diagnosis of Lung, Liver, scapula, sternum and Spine undergoing SABR were selected for this study. Pre-treatment QA was performed for all the patients which include ionization chamber and film dosimetry. The required gamma criteria for each SABR plan to pass QA and proceed to treatment is 95% (3%,1mm). In addition to this routine process, the treatment plans were exported on to an ArcCheck phantom. The planned and measured dose from the ArcCheck device were compared using four different gamma criteria: 2%,2 mm, 3%,2 mm, 3%,1 mm and 3%, 3 mm. In addition to this, we’ve also introduced errors to gantry, collimator and couch angle to assess sensitivity of the ArcCheck with potential delivery errors. Results: The ArcCheck mean passing rates for all twelve cases were 76.1%±9.7% for gamma criteria 3%,1 mm, 89.5%±5.3% for 2%,2 mm, 92.6%±4.2% for 3%,2 mm, and 97.6%±2.4% for 3%,3 mm gamma criteria. When SABR spine cases are excluded, we observe ArcCheck passing rates higher than 95% for all the studied cases with 3%, 3mm, and ArcCheck results in acceptable agreement with the film gamma results. Conclusion: Our ArcCheck results at 3%, 3 mm were found to correlate well with our non-SABR spine routine patient specific QA results (3%,1 mm). We observed significant reduction in QA time on using ArcCheck for SABR QA. This study shows that ArcCheck could replace film dosimetry for all sites except SABR spine.

  4. Effects of methimazole treatment on growth hormone (GH) response to GH-releasing hormone in patients with hyperthyroidism.

    Science.gov (United States)

    Giustina, A; Ferrari, C; Bodini, C; Buffoli, M G; Legati, F; Schettino, M; Zuccato, F; Wehrenberg, W B

    1990-12-01

    In vitro studies have demonstrated that thyroid hormones can enhance basal and stimulated growth hormone secretion by cultured pituitary cells. However, both in man and in the rat the effects of high thyroid hormone levels on GH secretion are unclear. The aim of our study was to test the GH response to human GHRH in hyperthyroid patients and to evaluate the effects on GH secretion of short- and long-term pharmacological decrease of circulating thyroid hormones. We examined 10 hyperthyroid patients with recent diagnosis of Graves' disease. Twelve healthy volunteers served as controls. All subjects received a bolus iv injection of GHRH(1-29)NH2, 100 micrograms. Hyperthyroid patients underwent a GHRH test one and three months after starting antithyroid therapy with methimazole, 10 mg/day po. GH levels at 15, 30, 45, 60 min and GH peak after stimulus were significantly lower in hyperthyroid patients than in normal subjects. The GH peak was also delayed in hyperthyroid patients. After one month of methimazole therapy, most of the hyperthyroid patients had thyroid hormone levels in the normal range, but they did not show significant changes in GH levels after GHRH, and the GH peak was again delayed. After three months of therapy with methimazole, the hyperthyroid patients did not show a further significant decrease in serum thyroid hormone levels. However, mean GH levels from 15 to 60 min were significantly increased compared with the control study. The GH peak after GHRH was also earlier than in the pre-treatment study.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. [Biofeedback treatment for acute whiplash patients].

    Science.gov (United States)

    Gálvez-Hernández, Carmen Lizette; Rodríguez-Ortiz, María Dolores; Del Río-Portilla, Yolanda

    2016-01-01

    The aim of this study is to evaluate the physiological and psychological effect after an electromyographic biofeedback treatment in combination with progressive muscular relaxation training in patients with acute whiplash. Twelve patients with acute whiplash volunteered to participate in a quasi-experimental design and a control group. Two months maximum after car accident, severity levels II and I. previous history of persistent pain or serious previous injury. The groups were randomly divided in two (treatment and waiting list groups). We used electromyographic measures of the trapezius muscles with psychometric tests: Beck Anxiety and Depression Inventory; Oswestry Pain Disability Questionnaire; Visual Analog Scale of Pain; TAMPA Scale for Kinesiophobia. The treatment consisted in electromyographic biofeedback after progressive muscular relaxation training. There were significant intra-group differences before and after treatment in muscular symmetry and subjective pain perception in the treatment group. We achieved a significant change (clinical and statistical) in subjective pain perception and muscular symmetry. This study highlights the importance of multidisciplinary work in acute pain patients and the effectiveness of clinical psychophysiological strategies with acute whiplash patients.

  6. Weight of preterm newborns during the first twelve weeks of life

    Directory of Open Access Journals (Sweden)

    L.M. Anchieta

    2003-06-01

    Full Text Available A longitudinal and prospective study was carried out at two state-operated maternity hospitals in Belo Horizonte during 1996 in order to assess the weight of preterm appropriate-for-gestational-age newborns during the first twelve weeks of life. Two hundred and sixty appropriate-for-gestational-age preterm infants with birth weight <2500 g were evaluated weekly. The infants were divided into groups based on birth weight at 250-g intervals. Using weight means, somatic growth curves were constructed and adjusted to Count's model. Absolute (g/day and relative (g kg-1 day-1 velocity curves were obtained from a derivative of this model. The growth curve was characterized by weight loss during the 1st week (4-6 days ranging from 5.9 to 13.3% (the greater the percentage, the lower the birth weight, recovery of birth weight within 17 and 21 days, and increasingly higher rates of weight gain after the 3rd week. These rates were proportional to birth weight when expressed as g/day (the lowest and the highest birth weight neonates gained 15.9 and 30.1 g/day, respectively. However, if expressed as g kg-1 day-1, the rates were inversely proportional to birth weight (during the 3rd week, the lowest and the highest weight newborns gained 18.0 and 11.5 g kg-1 day-1, respectively. During the 12th week the rates were similar for all groups (7.5 to 10.2 g kg-1 day-1. The relative velocity accurately reflects weight gain of preterm infants who are appropriate for gestational age and, in the present study, it was inversely proportional to birth weight, with a peak during the 3rd week of life, and a homogeneous behavior during the 12th week for all weight groups.

  7. Radiofrequency catheter ablation for electrical storm in a patient with dilated cardiomyopathy.

    Science.gov (United States)

    Kolettis, Theofilos M; Naka, Katerina K; Katsouras, Christos S

    2005-01-01

    We report a case of successful radiofrequency catheter ablation in a patient with dilated cardiomyopathy, who presented with multiple, haemodynamically poorly tolerated episodes of monomorphic ventricular tachycardia, resistant to antiarrhythmic drug treatment. The ablation procedure consisted of focal ablation of three mapped left ventricular sites, using pace and activation mapping. Additional linear ablation lesions were created across these sites. After the procedure, the patient remained free of tachycardia episodes and seven days post-ablation he underwent implantation of a cardioverter-defibrillator. During a twelve-month follow-up period, the patient has remained free of monomorphic ventricular tachycardia episodes. Radiofrequency catheter ablation is feasible in electrical storm, using conventional mapping techniques, even in haemodynamically unstable tachycardias.

  8. Neurological presentations, imaging, and associated anomalies in 50 patients with sacral agenesis.

    Science.gov (United States)

    Emami-Naeini, Parisa; Rahbar, Ziba; Nejat, Farideh; Kajbafzadeh, Abdolmohammad; El Khashab, Mostafa

    2010-10-01

    Sacral agenesis is an uncommon congenital disorder that involves multiple organs. We studied neurological manifestations of the disease, common associated disorders, and their relation with extent of bony malformation. We investigated neurological manifestations of 50 patients with sacral agenesis. Patients were evaluated for previous procedures, ambulation, limb abnormalities, vertebral alignment, recurrent urinary tract infection, urinary incontinence, dribbling, dimple, lower extremities weakness, myelomeningocele (MMC), and lipomyelomenangocele. Weakness of lower extremities was seen in 37 (74%) patients. Concurrent weakness of proximal and distal muscles of the lower limb was statistically associated with a type of bony aplasia (P = .001). However, paraplegia was seen in only 2 of 44 children over the age of 1, and the rest could walk. Myelodysplastic syndromes were seen in 21 patients. Sacral agenesis is diagnosed in children with concomitant MMC at younger ages and reveals more severe symptoms. Progression of neurological disorders was seen in 19 patients, in all of whom MRI showed tethering of the spinal cord. Urinary disorders including diurnal urinary incontinence (in 30 of 35 children over age 4) and recurrent urinary tract infections (in 37) were also common. Imperforate anus was seen in 11 patients. Twelve children over age 4 reported fecal incontinence, a problem that had statistically significant association with imperforate anus (P = .013). Different disorders can concurrently affect patients with sacral agenesis that may have profound impressions on patients and their families. Early diagnosis, thorough evaluation, and proper intervention are of utmost importance as they can prevent or lessen future complications.

  9. [Retrospective study of the implementation of the qualitative PCR technique in biological samples for monitoring toxoplasmosis in pediatric patients receiving hematopoietic stem cell transplantation].

    Science.gov (United States)

    Nigro, Mónica G; Figueroa, Carlos; Ledesma, Bibiana A

    2014-01-01

    Toxoplasmosis is an opportunistic infection caused by the parasite Toxoplasma gondii. The infection is severe and difficult to diagnose in patients receiving allogeneic hematopoietic stem cell transplantation (HSCT). Twelve patients receiving HSCT were monitored post-transplant, by qualitative PCR at the Children's Hospital S.A.M.I.C. "Prof. Dr. Juan P. Garrahan". The monitoring of these patients was defined by a history of positive serology for toxoplasmosis in the donor or recipient and because their hematologic condition did not allow the use of trimethoprim-sulfamethoxazole for prophylaxis. During the patients' monitoring, two of them with positive PCR results showed signs of illness by T. gondii and were treated with pyrimethamine-clindamycin. In two other patients, toxoplasmosis was the cause of death and an autopsy finding, showing negative PCR results. Four patients without clinical manifestations received treatment for toxoplasmosis because of positive PCR detection. In four patients there were no signs of toxoplasmosis disease and negative PCR results during follow-up. The qualitative PCR technique proved useful for the detection of toxoplasmosis reactivation in HSCT recipients, but has limitations in monitoring and making clinical decisions due to the persistence of positive PCR over time and manifestations of toxicity caused by the treatment. Copyright © 2014 Asociación Argentina de Microbiología. Publicado por Elsevier España. All rights reserved.

  10. Antisocial alcoholic patients show as much improvement at 14-month follow-up as non-antisocial alcoholic patients

    NARCIS (Netherlands)

    Verheul, R.; van den Brink, W.; Koeter, M. W.; Hartgers, C.

    1999-01-01

    The authors investigated the impact of DSM-III-R adult criteria for antisocial personality disorder (and co-occurrence of childhood conduct or mood disorder) on one-year changes of multi-domain problem severity in 309 alcoholic patients. Adult antisocial traits were associated with more drug, legal,

  11. The impact of FDG-PET in the management of patients with salivary gland malignancy

    International Nuclear Information System (INIS)

    Otsuka, Hideaki; Graham, M.M.; Kogame, Masahiro; Nishitani, Hiromu

    2005-01-01

    The aim of this study was to evaluate the impact of fluorodeoxyglucose (FDG)-PET in the management of patients with salivary gland malignancy. We performed 45 FDG PET studies in 31 patients with salivary malignant tumors, using PET (33 studies) and PET/CT (12 studies). Patients comprised 21 males and 10 females with a mean age of 69 y (range 38-89). Nineteen patients had a single study, ten patients had 2 and two patients had 3 studies. Twelve studies were performed for initial staging and 33 studies for restaging. Four patients of the initial staging group were restaged with PET after therapy. Histology consisted of 8 adenocarcinomas, 8 squamous cell carcinomas, 4 adenoid cystic carcinomas, 4 carcinoma ex pleomorphic adenomas, 2 mucoepidermoid carcinomas, 2 poorly differentiated carcinomas, 1 salivary duct carcinoma, 1 lymphoepithelial carcinoma and 1 melanoma. PET findings were reviewed with the clinical and radiologic findings and the impact of PET on staging and patient management was determined. In the initial staging group, all 12 primary lesions (100%) showed positive FDG uptake (5 squamous cell carcinomas, 2 adenocarcinomas, 2 poorly differentiated carcinomas, 1 carcinoma ex pleomorphic adenoma, 1 salivary duct carcinoma, 1 lymphoepithelial carcinoma). Three patients (25%) had FDG positive distant disease (liver, bone, lymph nodes); surgery was canceled and therapy changed to chemoradiation. One patient (9%) with no FDG uptake in the neck nodes avoided a planned neck dissection. In the restaging group (33 studies in 23 patients), 5 patients (22%) had FDG positive distant disease, which changed the treatment from surgery to chemoradiation or other. A second primary lesion was detected in one patient (4%). One patient (4%) with clinically suspected recurrence was able to avoid other invasive procedures because of the negative PET. Overall, FDG PET resulted in a major change in management in 11 of 31 patients (35%). This study shows that FDG PET has a

  12. Differential effects of saturated and monounsaturated fats on postprandial lipemia and glucagon-like peptide 1 responses in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Thomsen, Claus; Storm, Hanne; Holst, Jens Juul

    2003-01-01

    , insulin, fatty acids, triacylglycerol, gastric inhibitory polypeptide, and GLP-1 to saturated- and monounsaturated-rich test meals. DESIGN: Twelve overweight patients with type 2 diabetes ingested 3 meals randomly: an energy-free soup with 50 g carbohydrate (control meal), the control meal plus 100 g...

  13. Cardiac asthma in elderly patients: incidence, clinical presentation and outcome

    Directory of Open Access Journals (Sweden)

    Ray Patrick

    2007-05-01

    Full Text Available Abstract Background Cardiac asthma is common, but has been poorly investigated. The objective was to compare the characteristics and outcome of cardiac asthma with that of classical congestive heart failure (CHF in elderly patients. Methods Prospective study in an 1,800-bed teaching hospital. Results Two hundred and twelve consecutive patients aged ≥ 65 years presenting with dyspnea due to CHF (mean age of 82 ± 8 years were included. Findings of cardiac echocardiography and natriuretic peptides levels were used to confirm CHF. Cardiac asthma patients were defined as a patient with CHF and wheezing reported by attending physician upon admission to the emergency department. The CHF group (n = 137 and the cardiac asthma group (n = 75, differed for tobacco use (34% vs. 59%, p 2 (47 ± 15 vs. 41 ± 11 mmHg, p Conclusion Patients with cardiac asthma represented one third of CHF in elderly patients. They were more hypercapnic and experienced more distal airway obstruction. However, outcomes were similar.

  14. Reasons for not receiving thrombolytic therapy in patients with acute myocardial infarction admitted to Bu-Ali Sina Hospital in Qazvin (2013-14)

    OpenAIRE

    MM. Daei; M. Karimi Rad; M. Khalaja

    2017-01-01

    This hospital-based cross-sectional study was conducted in 2013-14 in Qazvin Bu-Ali Sina Hospital. 170 patients with acute myocardial infarction who not receiving thrombolytic therapy entered the study and were analyzed. Medical history, physical examination, twelve lead ECG and cardiac biomarkers were obtained. The mean age of the patients was 63.4±14.4 years (from 19 to 90 years). 110 (64.7%) of the patients were male and 48 (28.2%) were diabetic. 86 (50%) of patients due to late present...

  15. Health care employee perceptions of patient-centered care.

    Science.gov (United States)

    Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L

    2015-03-01

    Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspectives is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among U.S. Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, they identified several areas for improvement. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. © The Author(s) 2014.

  16. Interventional effect of multiple LDR on splenocyte apoptosis and immunity on twelve-week diabetic rats

    International Nuclear Information System (INIS)

    Li Yanbo; Wang Zhicheng; Li Pengwu; Guo Wei; Zhao Hongguang; Liu Yang; Gong Shouliang; Guo Caixia

    2009-01-01

    In order to explore the effect of multiple low dose irradiation (LDR) on the apoptosis of splenocytes, immune factors and lymphocyte subgroups in twelve-week diabetes mellitus (DM), the experiment was carried out with control, DM and DM+LDR groups. The irradiation dose every time was 25, 50 and 75 mGy respectively, and the irradiated times were 15. At the eighth weekend after the DM rats were irradiated, the percentages of CD4 + , CD8 + T lymphocytes and TCR α β were detected by flowcytometry (FCM). The content of IL-2 in both serum and supernatant of cultured splenocytes were detected by ELISA. And the apoptotic rate of splenocytes was detected by FCM and TUNEL respectively. The result shows that as compared with that in the control, the body weight (BW) decreases both in the DM and the DM + LDR groups, particularly in the DM group. The blood glucose (BG) level in the DM+LDR groups is higher than that in the control, but lower than that in the DM group. As compared with those in the control, the percentages of TCR α β and CD4 + T cells, the content of IL-2 in serum and supernatant of cultured splenocytes, and the apoptotic rate of splenocytes in DM + LDR groups increase significantly. However, as compared with those in the DM group, the percentages of TCR α β, CD4 + and CD8 + T cells and the splenocyte apoptotic rates in the DM+LDR groups decrease while the content of IL-2 and the ratio of CD4 + /CD8 + T cells increase. It is obvious that the multiple LDR could regulate and weaken the loss of BW and increase of BG caused by DM, correct the imbalance of lymphocyte subgroups and immune factors, decrease the increment of splenocyte apoptosis resulted from DM. Multiple LDR could result in body protection. (authors)

  17. Generalized deep-tissue hyperalgesia in patients with chronic low-back pain

    DEFF Research Database (Denmark)

    O'Neill, Søren; Manniche, Claus; Graven-Nielsen, Thomas

    2007-01-01

    be demonstrated in a group of patients with chronic low-back pain with intervertebral disc herniation. Twelve patients with MRI confirmed lumbar intervertebral disc herniation and 12 age and sex matched controls were included. Subjects were exposed to quantitative nociceptive stimuli to the infraspinatus...... in the anterior tibialis muscle compared to controls. In conclusion, generalized deep-tissue hyperalgesia was demonstrated in chronic low-back pain patients with radiating pain and MRI confirmed intervertebral disc herniation, suggesting that this central sensitization should also be addressed in the pain......Some chronic painful conditions including e.g. fibromyalgia, whiplash associated disorders, endometriosis, and irritable bowel syndrome are associated with generalized musculoskeletal hyperalgesia. The aim of the present study was to determine whether generalized deep-tissue hyperalgesia could...

  18. Semantic strategy training increases memory performance and brain activity in patients with prefrontal cortex lesions.

    Science.gov (United States)

    Miotto, Eliane C; Savage, Cary R; Evans, Jonathan J; Wilson, Barbara A; Martin, Maria G M; Balardin, Joana B; Barros, Fabio G; Garrido, Griselda; Teixeira, Manoel J; Amaro Junior, Edson

    2013-03-01

    Memory deficit is a frequent cognitive disorder following acquired prefrontal cortex lesions. In the present study, we investigated the brain correlates of a short semantic strategy training and memory performance of patients with distinct prefrontal cortex lesions using fMRI and cognitive tests. Twenty-one adult patients with post-acute prefrontal cortex (PFC) lesions, twelve with left dorsolateral PFC (LPFC) and nine with bilateral orbitofrontal cortex (BOFC) were assessed before and after a short cognitive semantic training using a verbal memory encoding paradigm during scanning and neuropsychological tests outside the scanner. After the semantic strategy training both groups of patients showed significant behavioral improvement in verbal memory recall and use of semantic strategies. In the LPFC group, greater activity in left inferior and medial frontal gyrus, precentral gyrus and insula was found after training. For the BOFC group, a greater activation was found in the left parietal cortex, right cingulated and precuneus after training. The activation of these specific areas in the memory and executive networks following cognitive training was associated to compensatory brain mechanisms and application of the semantic strategy. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. Percutaneous Endoscopic Colostomy (PEC): An Effective Alternative in High Risk Patients with Recurrent Sigmoid Volvulus

    International Nuclear Information System (INIS)

    Khan, M. A. S.; Ullah, S.; Beckly, D.; Oppong, F. C.

    2013-01-01

    Treatment of recurrent sigmoid volvulus is a major challenge in frail and elderly patients with multiple co-morbidities. Early management involves endoscopic decompression with high success rate, however, its recurrence make it a real challenge as most of these patients are not suitable for major colonic resection. The aim of this study was to assess the role of percutaneous endoscopic colostomy (PEC) in the treatment of recurrent sigmoid volvulus in these patients. Twelve PEC procedures were performed in 8 patients under our care. This prevented major colonic resection in 7 patients. One patient underwent sigmoid resection and died with postoperative complications. Two patients experienced minor complications. Three patients required repeat procedures for permanent PEC tube placement. Six patients managed permanently with PEC procedure. PEC is an effective treatment for recurrent sigmoid volvulus in high-risk elderly patients. (author)

  20. Treatment outcomes using CBT-IA with Internet-addicted patients.

    Science.gov (United States)

    Young, Kimberly S

    2013-12-01

    Internet Gaming Disorder, a subtype of Internet Addiction, is now classified in Section 3 of the DSM-5. Cognitive behavioral therapy (CBT) has been suggested in treating Internet addiction as this modality has been shown to be an effective treatment for similar impulse control disorders. Given the daily and necessary use of the Internet and technology in general compared to other compulsive syndromes, a specialized form of CBT has been developed called Cognitive-Behavioral Therapy for Internet Addiction (CBT-IA). CBT-IA is a comprehensive three phase approach that includes behavior modification to control compulsive Internet use, cognitive restructuring to identify, challenge, and modify cognitive distortions that lead to addictive use, and harm reduction techniques to address and treat co-morbid issues associated with the disorder. As the first model of its kind, this study examines 128 clients to measure treatment outcomes using CBT-IA. Clients were evaluated using the Internet Addiction Test (IAT) to classify subjects and were administered twelve weekly sessions of CBT-IA. Treatment outcomes were measured at the end of the twelve weeks, one-month, three months and at six month post-treatment. RESULTS showed that over 95% of clients were able to manage symptoms at the end of the twelve weeks and 78% sustained recovery six months following treatment. RESULTS found that CBT-IA was effective at ameliorating symptoms associated with Internet addiction after twelve weekly sessions and consistently over one-month, three months, and six months after therapy. Further research implications such as investigating long-term outcome effects of the model with larger client populations and treatment differences among the subtypes of Internet addiction or with other cultural populations using CBT-IA are discussed.

  1. Discordance between olfactory psychophysical measurements and olfactory event related potentials in five patients with olfactory dysfunction following upper respiratory infection.

    Science.gov (United States)

    Guan, Jing; Ni, Dao-feng; Wang, Jian; Gao, Zhi-qiang

    2009-07-05

    Subjective olfactory tests are easy to perform and popularly applied in the clinic, but using only these, it is difficult to diagnose all disorders of the olfactory system. The olfactory event related potentials technique offers further insight into the olfactory system and is an ideal objective test. This analysis was of subjective and objective data on the olfactory function of twelve patients with loss of smell associated with an upper respiratory infection (URI). We tested the twelve patients with URI induced olfactory loss by medical history, physical examination of the head and neck, olfactory tests and medical imaging. Olfactory function was assessed by Toyota and Takagi olfactometry including olfactory detection and recognition thresholds and olfactory event-related potentials (OERPs) recorded with OEP-98C Olfactometer. An unusual phenomenon was observed in five patients in whom the subjective detection and recognition thresholds were normal, while the expected OERPs were not detectable. We suggest that the discordance between olfactory psychophysical measurements and OERPs might be the results of abnormal electrophysiology related with olfactory neuropathy caused by viral URI. In addition, the measurement of OERPs might play a significant role in evaluating olfactory dysfunction.

  2. Discordance between olfactory psychophysical measurements and olfactory event related potentials in five patients with olfactory dysfunction following upper respiratory infection

    Institute of Scientific and Technical Information of China (English)

    GUAN Jing; NI Dao-feng; WANG Jian; GAO Zhi-qiang

    2009-01-01

    Background Subjective olfactory tests are easy to perform and popularly applied in the clinic, but using only these, it is difficult to diagnose all disorders of the olfactory system. The olfactory event related potentials technique offers further insight into the olfactory system and is an ideal objective test. This analysis was of subjective and objective data on the olfactory function of twelve patients with loss of smell associated with an upper respiratory infection (URI). Methods We tested the twelve patients with URI induced olfactory loss by medical history, physical examination of the head and neck, olfactory tests and medical imaging. Olfactory function was assessed by Toyota and Takagi olfactometry including olfactory detection and recognition thresholds and olfactory event-related potentials (OERPs) recorded with OEP-98C Olfactometer. Results An unusual phenomenon was observed in five patients in whom the subjective detection and recognition thresholds were normal, while the expected OERPs were not detectable. Conclusions We suggest that the discordance between olfactory psychophysical measurements and OERPs might be the results of abnormal electrephysiology related with olfactory neuropathy caused by viral URI. In addition, the measurement of OERPs might play a significant role in evaluating olfactory dysfunction.

  3. Anti-alpha interferon immunization: safety and immunogenicity in asymptomatic HIV positive patients at high risk of disease progression.

    Science.gov (United States)

    Gringeri, A; Santagostino, E; Mannucci, P M; Siracusano, L; Marinoni, A; Criscuolo, M; Carcagno, M; Fall, L S; M'Bika, J P; Bizzini, B

    1995-05-01

    A randomized, placebo-controlled trial was designed to evaluate safety and immunogenicity of an anti-cytokine vaccine in high risk HIV-positive patients. This strategy was aimed to modulate the impaired cytokine regulation in AIDS. Twelve asymptomatic patients on antiretroviral therapy for at least 1 year and with CD4 cell counts between 100-300/mm3 were randomized to receive adjuvanted formol-inactivated interferon alpha-2a (IFN alpha) and continue the current antiretroviral treatment, whatever it was, or to receive the adjuvant alone and the current antiretroviral treatment. All patients received 4 i.m. injections monthly, followed by booster injections every 3 months. Clinical status, immunology and virology were monitored. Immune response to vaccination was evaluated in term of antibody detection (ELISA) and serum anti-IFN alpha neutralizing capacity. Only local discomfort and transient fever were reported. All vaccines except one showed increased levels of anti-IFN alpha Abs and developed serum IFN alpha neutralizing capacity. Viral load did not increase in vaccinees while it remained unchanged or even increased in placebo-treated patients. None of them showed HIV-related symptoms and all had their CD4 cell counts stabilized over 18 months, whereas 2 placebo-treated patients developed full-blow AIDS. In conclusion, anti-IFN alpha vaccine was safe and immunogenic. Stable clinical and immunological status over 18 months was observed in vaccinees coupled to increased serum IFN alpha neutralizing capacity.

  4. Functional networks of motor inhibition in conversion disorder patients and feigning subjects

    Directory of Open Access Journals (Sweden)

    Thomas Hassa

    2016-01-01

    Full Text Available The neural correlates of motor inhibition leading to paresis in conversion disorder are not well known. The key question is whether they are different of those of normal subjects feigning the symptoms. Thirteen conversion disorder patients with hemiparesis and twelve healthy controls were investigated using functional magnetic resonance tomography under conditions of passive motor stimulation of the paretic/feigned paretic and the non-paretic hand. Healthy controls were also investigated in a non-feigning condition. During passive movement of the affected right hand conversion disorder patients exhibited activations in the bilateral triangular part of the inferior frontal gyri (IFG, with a left side dominance compared to controls in non-feigning condition. Feigning controls revealed for the same condition a weak unilateral activation in the right triangular part of IFG and an activity decrease in frontal midline areas, which couldn't be observed in patients. The results suggest that motor inhibition in conversion disorder patients is mediated by the IFG that was also involved in inhibition processes in normal subjects. The activity pattern in feigning controls resembled that of conversion disorder patients but with a clear difference in the medial prefrontal cortex. Healthy controls showed decreased activity in this region during feigning compared to non-feigning conditions suggesting a reduced sense of self-agency during feigning. Remarkably, no activity differences could be observed in medial prefrontal cortex for patients vs healthy controls in feigning or non-feigning conditions suggesting self-agency related activity in patients to be in between those of non-feigning and feigning healthy subjects.

  5. Functional networks of motor inhibition in conversion disorder patients and feigning subjects.

    Science.gov (United States)

    Hassa, Thomas; de Jel, Esther; Tuescher, Oliver; Schmidt, Roger; Schoenfeld, Mircea Ariel

    2016-01-01

    The neural correlates of motor inhibition leading to paresis in conversion disorder are not well known. The key question is whether they are different of those of normal subjects feigning the symptoms. Thirteen conversion disorder patients with hemiparesis and twelve healthy controls were investigated using functional magnetic resonance tomography under conditions of passive motor stimulation of the paretic/feigned paretic and the non-paretic hand. Healthy controls were also investigated in a non-feigning condition. During passive movement of the affected right hand conversion disorder patients exhibited activations in the bilateral triangular part of the inferior frontal gyri (IFG), with a left side dominance compared to controls in non-feigning condition. Feigning controls revealed for the same condition a weak unilateral activation in the right triangular part of IFG and an activity decrease in frontal midline areas, which couldn't be observed in patients. The results suggest that motor inhibition in conversion disorder patients is mediated by the IFG that was also involved in inhibition processes in normal subjects. The activity pattern in feigning controls resembled that of conversion disorder patients but with a clear difference in the medial prefrontal cortex. Healthy controls showed decreased activity in this region during feigning compared to non-feigning conditions suggesting a reduced sense of self-agency during feigning. Remarkably, no activity differences could be observed in medial prefrontal cortex for patients vs healthy controls in feigning or non-feigning conditions suggesting self-agency related activity in patients to be in between those of non-feigning and feigning healthy subjects.

  6. Gender identity shows a high correlation with Prader score in patients with disorders of sex development (DSD) presenting in mid childhood.

    Science.gov (United States)

    Chowdhury, Tanvir K; Chowdhury, Md Zonaid; Mili, Fahmida; Hutson, John M; Banu, Tahmina

    2014-05-01

    In developing countries like Bangladesh, delayed presentation for disorders of sex development (DSD) is common, and provides some special problems for management. There remains significant controversy about appropriate sex assignment in this group. We aimed, therefore, to assess gender identity (GI) in 50 consecutive patients with DSD presenting to a referral centre in Chittagong, Bangladesh, and correlate it with Prader score, to see if the latter could be used to predict GI. A cross-sectional, case-control study of 50 consecutive children with DSD and 50 children with vascular anomalies was conducted in the Pediatric Surgical Clinic, Chittagong Medical College and Hospital. After informed consent, patients and controls provided oral answers to a GI questionnaire and had a detailed history and physical examination. Sex-typed activities were assessed by observations of a structured toy play and the child's selection of a toy to keep. Both patients and parents then completed the Child Game Participation Questionnaire. There were no differences in age (2-16 years, mean 8.74) between controls and DSD patients (11 46, XX DSD, 32 46, XY DSD, 4 MGD, 3 ovo-testicular DSD). Fifteen of the DSD patients (30 %) came from consanguineous marriages and only 2 of the control patients had consanguinity of their parents. For the 13-question GI interview, there was no overall difference between DSD cases and controls. For the 46, XX DSD subgroup, there was a significantly higher score (11.1 ± 7.1) compared with control girls (4.5 ± 4.7) (p gender-related behaviour correlated with Prader score for DSD patients (r = 0.61) (p gender-role behaviour should be assessed routinely in DSD patients presenting after the neonatal period, so that sex assignment is in accordance with behaviour. Prader scores showed a good correlation with GI and gender role behaviour.

  7. Management and prognosis of patients with high-grade soft tissue sarcomas

    International Nuclear Information System (INIS)

    Alvegaard, T.A.

    1989-01-01

    Doxorubicin is one of the most active single agents in metastatic soft tissue sarcoma. This was the rationale for the evaluation og doxorubicin in an adjuvant situation for patients with high-grade soft tissue sarcoma in a randomized, Scandinavian, multicenter joint care program, which was carried out from January 1981 to February 1986, and included 240 patients. These patients comprised the base series for the investigations of the importance of the surgical margin and radiotherapy for local tumor control; the accuracy of malignancy grading and tumor typing; prognostic factors, including DNA content; and epidemiologic risk factors. The results showed that the use of doxorubicin as adjuvant chemotherapy did not have clinical benefit in patients with high-grade soft tissue sarcoma. The overall local tumor control was high (94 %) for radically operated on extremity-located tumors due to strict classification of surgical margins. The only risk factor for local recurrence was marginal surgery without radiotherapy with a four times higher risk than after compartmental or wide surgery. Twelve percent of the operations reported as radical were classified as marginal, demonstrating the importance of reevaluation of surgical margins, and in these patients the local recurrence rate was 37 %. The 5-year metastasis-free survival for the whole patients series was 55 %, with the extremes 79 % for the patients with no or only one risk factor and 0 % for those with four or five risk factors. The five prognostic factors found could be used for selection of high-risk patients for adjuvant chemotherapy in the future. The epidemiologic study gave limited support for an association between occupational phenoxy-acid exposure and soft tissue sarcoma development. (98 refs.)

  8. Clinical and molecular characterization of Chilean patients with Léri-Weill dyschondrosteosis.

    Science.gov (United States)

    Rodríguez, Fernando Adrián; Unanue, Nancy; Hernandez, María Isabel; Basaure, Javiera; Heath, Karen Elise; Cassorla, Fernando

    2013-01-01

    Léri-Weill dyschondrosteosis (LWD) is a mesomelic dysplasia with disproportionate short stature associated with short stature homeobox-containing gene (SHOX) haploinsufficiency. The objective of this study was to improve the diagnosis of patients with suspected LWD through molecular analysis. Twelve patients from 11 families with a clinical diagnosis of LWD were analyzed with multiplex ligation-dependent probe amplification to detect deletions and duplications of SHOX and its enhancer regions. High resolution melting and sequencing was employed to screen for mutations in SHOX coding exons. The molecular-based screening strategy applied in these patients allowed detection of five SHOX deletions and two previously unreported SHOX missense mutations. Molecular studies confirmed the clinical diagnosis of LWD in seven out of 12 patients, which provided support for therapeutic decisions and improved genetic counseling in their families.

  9. Horizontal canal benign paroxysmal positional vertigo: diagnosis and treatment of 37 patients

    Directory of Open Access Journals (Sweden)

    Eliana Teixeira Maranhão

    2015-06-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV, the most frequent cause of vertigo is associated with high morbidity in the elderly population. The most common form is linked to debris in the posterior semicircular canal. However, there has been an increasing number of reported BPPV cases involving the horizontal canals. The purpose of this article is to highlight the clinical features, diagnosis, and treatment in 37 patients with horizontal canal BPPV; twenty-six with geotropic nystagmus, and eleven with the apogeotropic form. Treatment consisted of the Gufoni manoeuver in eighteen patients (48.6%, the barbecue 360° maneuver in twelve patients (32.4%, both manoeuvers in four patients (10.8%, both manoeuvers plus head shaking in one patient (2.7%, and the Gufoni maneuver plus head shaking in two patients. Cupulolithiasis patients were asked to sleep in a forced prolonged position. We obtained a complete resolution of vertigo and nystagmus in 30 patients (81.0% on the initial visit.

  10. Pancreatic changes in patients with primary sclerosing cholangitis: MR cholangiopancreatography and MRI findings

    International Nuclear Information System (INIS)

    Ozkavukcu, Esra; Erden, Ayse; Erden, Ilhan

    2009-01-01

    Purpose: To evaluate the possible pancreatic changes and their frequencies in patients with primary sclerosing cholangitis (PSC) on MR cholangiopancreatography (MRCP), and conventional abdominal MRI. Materials and Methods: Patient group consisted of 29 PSC (13 male, 16 female) cases, whereas cohort 1 consisted of 12 female patients with primary biliary cirrhosis, and cohort 2 consisted of 17 patients (6 male, 11 female) with non-immune chronic liver disease. Two radiologists retrospectively evaluated the MR examinations paying special attention to the pancreatic size (atrophy or enlargement), T1- and T2-signal intensity of the pancreas, focal pancreatic lesion, capsule-like rim, peripancreatic edema or fluid, fascial thickening, and pancreatic ducts (dilatation or narrowing). The results are expressed as percentages. Three groups were compared using Pearson chi-square test for each feature. However, only p-value for 'dilatation of the pancreatic duct' was determined, whereas p-value could not be calculated because of the insufficient number of subjects/sequences for the other features. Results: Twelve PSC patients (41.3%) had pancreatic abnormalities. The most common pancreatic changes in PSC patients were decreased T1-signal intensity (44%) and dilatation of the pancreatic duct (13.8%), respectively. Increased T2-signal intensity was also shown in 2 PSC patients (6.9%). Conclusion: Even PSC patients without any sign of pancreatitis, can show MR changes in the pancreatic parenchyma or the pancreatic duct. The etiologies of these changes, and whether they are unique to PSC, are still controversial. Histopathological studies bringing light to these pancreatic changes are needed.

  11. Neuroactive steroid levels are modified in cerebrospinal fluid and plasma of post-finasteride patients showing persistent sexual side effects and anxious/depressive symptomatology.

    Science.gov (United States)

    Melcangi, Roberto Cosimo; Caruso, Donatella; Abbiati, Federico; Giatti, Silvia; Calabrese, Donato; Piazza, Fabrizio; Cavaletti, Guido

    2013-10-01

    Observations performed in a subset of subjects treated with finasteride (an inhibitor of the enzyme 5α-reductase) for male pattern hair loss seem to indicate that sexual dysfunction as well as anxious/depressive symptomatology may occur at the end of the treatment and continue after discontinuation. A possible hypothesis to explain depression symptoms after finasteride treatment might be impairment in the levels of neuroactive steroids. Therefore, neuroactive steroid levels were evaluated in paired plasma and cerebrospinal fluid samples obtained from male patients who received finasteride for the treatment of androgenic alopecia and who, after drug discontinuation, still show long-term sexual side effects as well as anxious/depressive symptomatology. The levels of neuroactive steroids were evaluated by liquid chromatography-tandem mass spectrometry in three postfinasteride patients and compared to those of five healthy controls. Neuroactive steroid levels in plasma and cerebrospinal fluid of postfinasteride patients and healthy controls. At the examination, the three postfinasteride patients reported muscular stiffness, cramps, tremors, and chronic fatigue in the absence of clinical evidence of any muscular disorder or strength reduction. Severity and frequency of the anxious/depressive symptoms were quite variable; overall, all the subjects had a fairly complex and constant neuropsychiatric pattern. Assessment of neuroactive steroid levels in patients showed some interindividual differences. However, the most important finding was the comparison of their neuroactive steroid levels with those of healthy controls. Indeed, decreased levels of tetrahydroprogesterone, isopregnanolone and dihydrotestosterone and increased levels of testosterone and 17β-estradiol were reported in cerebrospinal fluid of postfinasteride patients. Moreover, decreased levels of dihydroprogesterone and increased levels of 5α-androstane-3α,17β-diol and 17β-estradiol were observed in

  12. How can general paediatric training be optimised in highly specialised tertiary settings? Twelve tips from an interview-based study of trainees.

    Science.gov (United States)

    Al-Yassin, Amina; Long, Andrew; Sharma, Sanjiv; May, Joanne

    2017-01-01

    Both general and subspecialty paediatric trainees undertake attachments in highly specialised tertiary hospitals. Trainee feedback suggests that mismatches in expectations between trainees and supervisors and a perceived lack of educational opportunities may lead to trainee dissatisfaction in such settings. With the 'Shape of Training' review (reshaping postgraduate training in the UK to focus on more general themes), this issue is likely to become more apparent. We wished to explore the factors that contribute to a positive educational environment and training experience and identify how this may be improved in highly specialised settings. General paediatric trainees working at all levels in subspecialty teams at a tertiary hospital were recruited (n=12). Semistructured interviews were undertaken to explore the strengths and weaknesses of training in such a setting and how this could be optimised. Appreciative inquiry methodology was used to identify areas of perceived best practice and consider how these could be promoted and disseminated. Twelve best practice themes were identified: (1) managing expectations by acknowledging the challenges; (2) educational contracting to identify learning needs and opportunities; (3) creative educational supervision; (4) centralised teaching events; (5) signposting learning opportunities; (6) curriculum-mapped pan-hospital teaching programmes; (7) local faculty groups with trainee representation; (8) interprofessional learning; (9) pastoral support systems; (10) crossover weeks to increase clinical exposure; (11) adequate clinical supervision; and (12) rota design to include teaching and clinic time. Tertiary settings have strengths, as well as challenges, for general paediatric training. Twelve trainee-generated tips have been identified to capitalise on the educational potential within these settings. Trainee feedback is essential to diagnose and improve educational environments and appreciative inquiry is a useful tool for

  13. Efficacy of Denosumab for Osteoporosis in Two Patients with Adult-Onset Still’s Disease—Denosumab Efficacy in Osteoporotic Still’s Disease Patients

    Directory of Open Access Journals (Sweden)

    Daiki Kumaki

    2018-03-01

    Full Text Available Adult-onset Still’s disease (AOSD is an autoimmune inflammatory disorder. Glucocorticoids are often used for AOSD, which may induce complicating glucocorticoid-induced osteoporosis (GIO. An anti-resorption drug, denosumab, has recently been approved for osteoporosis treatment in Japan. However, the drug’s efficacy for GIO in AOSD is largely unknown. This retrospective, consecutive case series investigated two patients with GIO in AOSD to examine the effects of denosumab on bone metabolism. Bone turnover markers, and bone mineral density (BMD of the lumbar 1–4 spine (L-BMD and bilateral total hips (H-BMD were followed for six months in a male patient and for twelve months in a female patient. No fractures or severe side effects, such as hypocalcemia, were observed during the observational period. Bone turnover markers were basically suppressed, and L-BMD and H-BMD were increased by denosumab in both patients. Our findings suggest that denosumab is a suitable candidate drug for GIO in AOSD.

  14. Tuberculosis in patients with end-stage renal disease

    International Nuclear Information System (INIS)

    Kim, Hyo Cheol; Goo, Jin Mo; Chung, Myung Jin; Moon, Min Hoan; Koh, Young Hwan; Im, Jung Gi

    2001-01-01

    The purpose of our study was to describe the clinical and radiological manifestations of tuberculosis in patients with end-stage renal disease. The medical records, chest radiographs, and CT scans of 42 patients with tuberculosis among 871 consecutive patients with end-stage renal disease were reviewed. Patterns of initial chest radiographs were categorized as primary, postprimary, miliary, or atypical, according to the predominant radiologic findings. Chest radiographs and CT scans revealed pulmonary tuberculosis in 28 patients and extrapulmonary tuberculosis in 15. The pattern of chest radiographs indicative of pulmonary tuberculosis was primary in 12 cases, postprimary in 11, miliary in one, demonstrated atypical infiltrates in three, and was normal in one. Tuberculosis involved the extrathoracic lymph nodes in six cases, the peritoneum in four, the spine in three, and the bone marrow in two. The primary pattern, seen in 12 patients, manifested as pleural effusion or segmental consolidation, and in ten of the twelve the former was dominant. The radiological pattern of pulmonary tuberculosis in end-stage renal disease is often primary, and extrapulmonary involvement is frequent

  15. Evaluation of the interdisciplinary PSYMEPHY treatment on patients with fibromyalgia: a randomized control trial.

    Science.gov (United States)

    Martín, Josune; Torre, Fernando; Aguirre, Urko; González, Nerea; Padierna, Angel; Matellanes, Begoña; Quintana, José Ma

    2014-04-01

    Fibromyalgia (FM) is a chronic disorder that can have a devastating effect on patients' lives. This study assessed the efficacy of a 6-week interdisciplinary treatment that combines coordinated PSYchological, Medical, Educational, and PHYsiotherapeutic interventions (PSYMEPHY) compared with standard pharmacologic care. The study was a randomized controlled trial (54 participants in the PSYMEPHY group and 56 in the control group [CG] ) with follow-up at 6 months. PSYMEPHY patients were also assessed at 12 months. The main outcomes were changes in total Fibromyalgia Impact Questionnaire (FIQ) score, pain, fatigue, morning tiredness, anxiety, and use of pain coping strategies as measured by the FIQ, the visual analog scale, and the Coping with Chronic Pain Questionnaire. After the 6-month assessment, patients in the CG were offered the PSYMEPHY treatment, and completed all of the instruments immediately after treatment, and at 6- and 12-month follow-up visits (N = 93). Subjects received therapy at two different outpatient clinical locations. Fibromyalgia patients. Six months after the intervention, significant improvements in total FIQ score (P = 0.04), and pain (P = 0.03) were seen in the PSYMEPHY group compared with controls. Twelve months after the intervention, all patients in the PSYMEPHY group maintained statistically significant improvements in total FIQ score, and pain, and showed an improvement in fatigue, rested, anxiety, and current pain compared with baseline. Data from the control patients who underwent the PSYMEPHY intervention corroborated the initial results. This study highlights the beneficial effects of an interdisciplinary treatment for FM patients in a hospital pain management unit. A 6-week interdisciplinary intervention showed significant improvement in key domains of fibromyalgia, as quality of life, pain, fatigue, rested, and anxiety at 12 months. Wiley Periodicals, Inc.

  16. Clinical study of GFR and split renal GFR in evaluating the glomerular function in patients with type 2 diabetes

    International Nuclear Information System (INIS)

    Fu Hongliang; Li Jinsong; Li Jianing; Wu Jingchuan; Yang Shurong; Gu Zhenhui; Zou Renjian; Shi Haihong

    2003-01-01

    Objective: To assess glomerular filtration function in patients with type 2 diabetes by glomerular filtration rate (GFR) and split GFR, namely left GFR (LGFR) and right GFR (RGFR). Methods: Fifty-one patients with type 2 diabetes were classified by urine albumin analysis into three groups, normalalbuminuria group (NA), microalbuminuria group(MA) and macroalbuminuria group (MAA) . Twelve patients without diabetes were included into control group. 99 Tc m -DTPA renography was performed on all these cases. GFR and split GFR were calculated by Gates formula. Results: 1) GFR, LGFR and RGFR of NA group were lower than that of the control group. 2) GFR, LGFR and RGFR were significantly correlated with the urine albumin level (r=-0.457, -0.412, -0.424, respectively, P all < 0.01). 3) In all 51 cases, there were 5 cases whose GFR were normal while split GFR were abnormal. Conclusions: 1) GFR and split GFR measurement can detect the incipient damage of glomerular function more sensitively than urine albumin analysis and show the degree of the damage correctly. 2) Split GFR measurement can improve the evaluation of the glomerular function in type 2 diabetes patients

  17. Standard Enucleation with Aluminium Oxide Implant (Bioceramic Covered with Patient's Sclera

    Directory of Open Access Journals (Sweden)

    Gian Luigi Zigiotti

    2012-01-01

    Full Text Available Purpose. We describe in our study a modified standard enucleation, using sclera harvested from the enucleated eye to cover the prosthesis in order to insert a large porous implant and to reduce postoperative complication rates in a phthisis globe. Methods. We perform initially a standard enucleation. The porous implant (Bioceramic is then covered only partially by the patient's sclera. The implant is inserted in the posterior Tenon's space with the scleral covering looking at front. All patients were followed at least for twelve months (average followup 16 months. Results. We performed nineteen primary procedures (19 patients, 19 eyes, M; F and secondary, to fill the orbital cavity in patients already operated by standard evisceration (7 patients, 7 eyes. There were no cases of implant extrusion. The orbital volume was well reintegrated. Conclusion. Our procedure was safe and effective. All patients had a good cosmetic result after final prosthetic fitting and we also achieved good prothesis mobility.

  18. Introducing a checking technician allows pharmacists to spend more time on patient-focused activities.

    Science.gov (United States)

    Napier, Patti; Norris, Pauline; Braund, Rhiannon

    2018-04-01

    Internationally there is an increasing focus on the clinical and cognitive services that pharmacists can provide. Lack of time has been identified as a barrier to pharmacists increasing their clinical activities. Within the pharmacy workplace there are many tasks that can only be performed by a pharmacist. The final accuracy check of a dispensed prescription is currently the sole responsibility of pharmacists in New Zealand. This takes up a significant amount of time during a pharmacist's work day. The introduction of a checking technician role has been suggested to allow pharmacists more time to do more patient focused work. To investigate the amount of time pharmacy staff spend on specific activities and to establish whether the introduction of a checking technician into twelve pilot sites increased the amount of time that the pharmacists could spend on patient focused activities. This study utilised a self-reported work sampling technique in twelve pilot sites, selected from both the hospital and community settings. Work sampling using an electronic device was conducted at two time-points (before the implementation of a Pharmacy Accuracy Checking Technician (PACT) role and when the PACT was in place). Data was collected at 10 min intervals for the period of five days, a working week. Tasks were grouped into patient focused, dispensing and personal activities. The introduction of the PACT into the pilot sites saw a mean increase of 19% in pharmacists' patient focused activities and a mean 20% decrease in dispensing activities. The introduction of a checking technician role into New Zealand pharmacies demonstrated the potential to provide pharmacists with more time to spend on patient focused activities. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Effect of intra-hepatic arterial infusion chemotherapy for patients with liver metastasis from breast cancer

    International Nuclear Information System (INIS)

    Liu Dezhong; Li Huai; Zeng Huiying; Yang Ling

    2001-01-01

    Objective: To evaluate the efficacy of intra-hepatic arterial infusion chemotherapy for patients with liver metastasis from breast cancer. Methods: 1993-1998 years, Thirty four patients with liver metastasis from breast cancer had received epi-adriamycin, cisplatin, mitomycin and 5-fluorouracil by intrahepatic arterial infusion chemotherapy. Twelve patients had received embolization. Results: Six patients (17.65%) had a complete response, 12 patients (35.29%) had a partial response. The overall response rate was 52.94%. Cumulative survival rates at 1, 2, 3 and 4 years were 56.90%, 25.00%, 5.00% and 5.00% respectively (Kaplan-Meier method). The median overall survival time was 11.5 months. Conclusion: Intra-hepatic arterial infusion chemotherapy is safe and effective for liver metastasis from breast cancer and should be the first choice of treatment for these patients

  20. In vitro and genetic diversity studies of twelve accessions of aerial yams (D. bulbifera and D. alata) in Ghana

    International Nuclear Information System (INIS)

    Katsekpor, C.

    2014-07-01

    Aerial yams (D. bulbifera and D. alata) are usually among the dioscoreaceae, in that they are cultivated not only for their tubers but also for the bulbils that develop at the leaf axils of the vine. Twelve accessions collected from five geographic regions were evaluated for morphological characteristics. The results indicate that the 12 accessions exhibited similarity with respect to 11 traits but were variable with respect to 5. Bulbils from the twelve accessions of aerial yams collected from the experimental field, were analysed for proximate composition including moisture, crude protein, crude ash, crude fat, crude fibre and carbohydrate content using the Association of Official Analytical Chemist (AOAC) method. Elemental composition of the bulbils was also determined through instrumental neutron activation analysis (INAA). Accession S recorded the highest crude protein (6.77 %), crude fibre (3.38 %) and carbohydrate (25.39 %) contents. Bulbils from D, G and T recorded the highest crude fat (0.56 %), moisture (72.97 %) and crude ash (7.96 %) content respectively. Accession V recorded the highest amount of magnesium (143.43 mg/100g), potassium (2644.4 mg/100g), chlorine (3272.2 mg/100g) and copper (1.116 mg/100g). Bulbils from accession F also recorded the highest amount of aluminum (5.26 mg/100g) and manganese (0.43 mg/100g), while accession B, C, E and R also recorded highest percentages of vanadium (0.037 mg/100g), sodium (26.63 mg/100g), calcium (333.5 mg/100g) and zinc (4.53 mg/100g) respectively. Nodal explants of 12 accessions of the aerial yam were cultured in vitro on Murashige and Skoog (MS) medium supplemented with varying concentrations of kinetin with or without activated charcoal, as assessed for ability to regenerate plantlets with distinct shoots, leaves and roots. The highest regeneration of plantlets was achieved at kinetin concentration of 2.0 mg/l with activated charcoal. Kinetin concentration beyond 2.0 mg/l proved to be phytotoxic and

  1. The Prevalence of Occult Celiac Disease among Patients with Functional Dyspepsia: A Study from the Western Region of Iran

    Directory of Open Access Journals (Sweden)

    Ali Asghar Keshavarz

    2010-01-01

    Full Text Available Objective. The prevalence of Celiac Disease (CD is high in Iran, and evaluation of CD is not part of the routine screening procedure for dyspeptic patients; therefore, cases of occult CD may be missed. This study aimed to investigate the prevalence of occult CD among dyspeptic patients who presented at a gastroenterology clinic in the Western region of Iran. Methods. In this descriptive, cross-sectional prospective study, patients who had a history of at least 12 weeks of upper abdominal discomfort were eligible to participate in the study during a 14-month recruitment period. Patients with a clinical or paraclinical data in favor of organic causes were excluded from the study. Enrolled patients were screened for IgA antiendomysium antibody (EMA and IgA antitissue transglutaminase antibody (tTG. Those who screened positive for EMA/tTG received a confirmatory diagnostic biopsy for Marsh classification of CD. Results. From 225 potential participants with dyspepsia, 55 patients were excluded due to having explainable organic causes. The study sample included 170 patients with “functional dyspepsia.” Mean age of participants was 31 years and 55.8% were female. Twelve patients (7% had positive tests (EMA/tTG, of which 10 were female (83.4%. According to Rome II criteria, all twelve patients with positive tests had “dysmotility type dyspepsia.” Based on Marsh classification, six patients were consistent with “Marsh I,” four with “Marsh II,” and two with the “Marsh III” classification. Conclusions. In this study, the prevalence of CD in dyspeptic patients was high. As a result, this study suggests that screening by serology tests (EMA/tTG is justifiable for the detection of CD among functional dyspeptic patients in the tertiary centers in our country.

  2. Predictors of Death in Contemporary Adult Patients With Eisenmenger Syndrome

    DEFF Research Database (Denmark)

    Kempny, Aleksander; Hjortshøj, Cristel Sørensen; Gu, Hong

    2017-01-01

    : In a multicenter approach, we identified adults with Eisenmenger syndrome under follow-up between 2000 and 2015. We examined survival and its association with clinical, electrocardiographic, echocardiographic, and laboratory parameters. RESULTS: We studied 1098 patients (median age, 34.4 years; range, 16.......1-84.4 years; 65.1% female; 31.9% with Down syndrome). The majority had a posttricuspid defect (n=643, 58.6%), followed by patients with a complex (n=315, 28.7%) and pretricuspid lesion (n=140, 12.7%). Over a median follow-up of 3.1 years (interquartile range, 1.4-5.9), allowing for 4361.6 patient......-years observation, 278 patients died and 6 underwent transplantation. Twelve parameters emerged as significant predictors of death on univariable analysis. On multivariable Cox regression analysis, only age (hazard ratio [HR], 1.41/10 years; 95% confidence interval [CI], 1.24-1.59; P

  3. Oxaliplatin-induced acquired long QT syndrome with torsades de pointes and myocardial injury in a patient with dilated cardiomyopathy and rectal cancer

    Directory of Open Access Journals (Sweden)

    Rei-Yeuh Chang

    2013-08-01

    Full Text Available A 67-year-old woman presented with a history of dilated cardiomyopathy with congestive heart failure since 2003, who subsequently developed lower rectal cancer (adenocarcinoma with liver, bone, and lymph node metastasis. Abdominoperineal resection and hepatectomy were performed. The patient received two rounds of intravenous chemotherapy, including 12 and six courses of FOLFOX4 (5-fluorouracil, leucovorin, and oxaliplatin; 85 mg/m2 per cycle. She underwent a third round of intravenous FOLFOX4 because of tumor progression. During the 21st course of FOLFOX4 regimen, the patient developed ST segment depression in lead II and prolongation of QT interval with polymorphic ventricular tachycardia, torsades de pointes right after the start of oxaliplatin infusion. Immediate defibrillation and cardiopulmonary resuscitation were administered, and the patient regained spontaneous circulation and consciousness. Twelve-lead electrocardiogram showed ST segment elevation in III, aVF, and ST segment depression in V4–6 after resuscitation. To our knowledge, prolongation of QT interval with torsades de pointes and coronary spasm with myocardial injury that were stabilized in one patient following oxaliplatin infusion has not been reported. We present a patient with these rare complications.

  4. Handgrip strength shows no improvements in geriatric patients with persistent inflammation during hospitalization

    DEFF Research Database (Denmark)

    Norheim, Kristoffer Larsen; Bautmans, Ivan; Kjaer, Michael

    2017-01-01

    PURPOSE: Hospital-associated deconditioning due to a combination of illness and inactivity is a serious problem for elderly adults. Here we investigate whether persistence in inflammatory status affects changes in physical function during short-term hospitalization. METHODS: This was a prospective...... observational study in elderly medical patients at a geriatric department. Measurements were obtained at admission and one week after admission and included de Morton Mobility Index (DEMMI) test, 30-second chair stand test (30-s CST), 4-m gait speed (4-m GST) test, handgrip strength, activity levels determined...... with ActivPALs, and concentrations of circulating C-reactive protein (CRP) from blood samples. Only patients with inflammation (C-reactive protein levels ≥10mg·L(-1)) at admission were included in this study. They were divided into those with continued inflammation (CI: CRP remained ≥10mg·L(-1)) and those...

  5. Patients with severe head trauma who talk and then deteriorate

    Energy Technology Data Exchange (ETDEWEB)

    Isayama, Kazuo; Nakazawa, Shozo; Kobayashi, Shiro; Yokota, Hiroyuki; Ikeda, Yukio; Yajima, Kouzo; Yano, Masami; Otsuka, Toshibumi

    1987-08-01

    Patients with severe head trauma who talk and then deteriorate (or die) are analyzed by means of clinical signs, computerized tomography (CT), and outcome. The twelve severely head-injured patients had an initial verbal score on the Glasgow coma scale (GCS) of 3 or more and a GCS score of 9 or more. There were 8 male and 4 female patients. The ages of these patients ranged from 23 to 85 years (average age 60.9 years); nine of the patients were older than 60 years of age. An initial CT revealed subdural hematoma in 7 cases and traumatic subarachnoid hemorrhage in 8 cases. Serial CT could be used for 9 cases; delayed intracerebral hematoma was found in 5 patients, and acute cerebral swelling, in 3 patients. The elderly tended to have the hematoma, while the young tended to have acute cerebral swelling. Concerning the Glasgow outcome scale of cases of head trauma who talk and then deteriorate three months after trauma, there was moderate disability in 2 cases and a persistent vegetative state in one, while 9 had died.

  6. Emerging Good Practices for Transforming Value Assessment: Patients' Voices, Patients' Values.

    Science.gov (United States)

    Perfetto, Eleanor M; Harris, Jason; Mullins, C Daniel; dosReis, Susan

    2018-04-01

    Patient engagement is a transformative strategy for improving value assessment. US value framework developers have increased engagement activities, but more needs to be learned about how to best achieve meaningful patient engagement in value assessment. The objective was to glean good practices in patient engagement emerging from patient community experiences, to be used in value assessment. The National Health Council Value Workgroup conducted a survey and held a focus group with its member advocacy organizations to gather experiences with value framework developers and views on emerging good practices. Ten of 13 organizations completed the survey; reporting 13 interactions with four framework developers. Most rated experiences as "good" to "very good." Emerging good practices included (1) engage early; (2) engage a range of patients; (3) leverage patient-provided information, data resources, and outreach mechanisms; (4) be transparent; and (5) appreciate and accommodate resource constraints. Twelve of 13 organizations participated in the focus group, and this produced 30 emerging good practices in four areas: (1) timing; (2) methodology and data; (3) partnering; and (4) characterizing engagement. Patient engagement was limited in early development of value frameworks but has increased in the past few years. Patient groups report positive experiences that can serve as emerging good practices. These groups also reported experienced challenges in their interactions and recommended good practices to mitigate those challenges. The growing pool of patient engagement experiences can be translated into good practices to advance a patient-centered, value-driven health care ecosystem. Lessons learned from these early experiences can help establish recommend emerging good practices that can eventually result in best practices and standards in the field. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc

  7. Analyses of Twelve New Whole Genome Sequences of Cassava Brown Streak Viruses and Ugandan Cassava Brown Streak Viruses from East Africa: Diversity, Supercomputing and Evidence for Further Speciation

    Science.gov (United States)

    Ndunguru, Joseph; Sseruwagi, Peter; Tairo, Fred; Stomeo, Francesca; Maina, Solomon; Djinkeng, Appolinaire; Kehoe, Monica; Boykin, Laura M.

    2015-01-01

    Cassava brown streak disease is caused by two devastating viruses, Cassava brown streak virus (CBSV) and Ugandan cassava brown streak virus (UCBSV) which are frequently found infecting cassava, one of sub-Saharan Africa’s most important staple food crops. Each year these viruses cause losses of up to $100 million USD and can leave entire families without their primary food source, for an entire year. Twelve new whole genomes, including seven of CBSV and five of UCBSV were uncovered in this research, doubling the genomic sequences available in the public domain for these viruses. These new sequences disprove the assumption that the viruses are limited by agro-ecological zones, show that current diagnostic primers are insufficient to provide confident diagnosis of these viruses and give rise to the possibility that there may be as many as four distinct species of virus. Utilizing NGS sequencing technologies and proper phylogenetic practices will rapidly increase the solution to sustainable cassava production. PMID:26439260

  8. Analyses of Twelve New Whole Genome Sequences of Cassava Brown Streak Viruses and Ugandan Cassava Brown Streak Viruses from East Africa: Diversity, Supercomputing and Evidence for Further Speciation.

    Directory of Open Access Journals (Sweden)

    Joseph Ndunguru

    Full Text Available Cassava brown streak disease is caused by two devastating viruses, Cassava brown streak virus (CBSV and Ugandan cassava brown streak virus (UCBSV which are frequently found infecting cassava, one of sub-Saharan Africa's most important staple food crops. Each year these viruses cause losses of up to $100 million USD and can leave entire families without their primary food source, for an entire year. Twelve new whole genomes, including seven of CBSV and five of UCBSV were uncovered in this research, doubling the genomic sequences available in the public domain for these viruses. These new sequences disprove the assumption that the viruses are limited by agro-ecological zones, show that current diagnostic primers are insufficient to provide confident diagnosis of these viruses and give rise to the possibility that there may be as many as four distinct species of virus. Utilizing NGS sequencing technologies and proper phylogenetic practices will rapidly increase the solution to sustainable cassava production.

  9. TRPA1 polymorphisms in chronic and complete spinal cord injury patients with neuropathic pain: a pilot study.

    Science.gov (United States)

    Vidal Rodriguez, Sonia; Castillo Aguilar, Inmaculada; Cuesta Villa, Luis; Serrano Saenz de Tejada, Francisco

    2017-01-01

    Pilot study. Single-nucleotide polymorphisms (SNPs) in TRPA1 gene are related to the etiology of chronic pain. The study is a pilot study with the primary objective of analyzing these SNPs in Spanish patients with chronic and complete spinal cord injury (SCI) and neuropathic pain (NPP). Asepeyo Hospital Department of Chronic and Complete SCI. Twelve patients with chronic and complete SCI and NPP, and 12 patients with chronic and complete SCI with no pain were reviewed. International Spinal Cord Injury Pain Classification (LANSS) and visual analog score (VAS) were chosen to classify pain syndrome. SNPs were identified by melting analysis after DNA amplification with real-time fluorescence PCR. There were differences in rs11988795 variant: GG homozygous ( p  = 0.01) and G allele ( p  = 0.001) were more frequent in SCI patients with no pain. There were differences in rs13255063 variant: TT homozygous were prevalent ( p  = 0.03) in patients with NPP. Until now this is the first study to show a description of TRPA1 SNPs in Spanish patients with chronic and complete SCI and NPP. These results suggest that GG genotype in rs11988795 variant and G allele could be protective factors against NPP. TT genotype in rs13255063 variant could be a risk factor for NPP. Neuropathic pain after spinal cord injuries may have genetic contributions.

  10. Transitioning HIV-Positive Adolescents to Adult Care: Lessons Learned From Twelve Adolescent Medicine Clinics.

    Science.gov (United States)

    Tanner, Amanda E; Philbin, Morgan M; DuVal, Anna; Ellen, Jonathan; Kapogiannis, Bill; Fortenberry, J Dennis

    2016-01-01

    To maximize positive health outcomes for youth with HIV as they transition from youth to adult care, clinical staff need strategies and protocols to help youth maintain clinic engagement and medication adherence. Accordingly, this paper describe transition processes across twelve clinics within the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) to provide lessons learned and inform the development of transition protocols to improve health outcomes as youth shift from adolescent to adult HIV care. During a large multi-method Care Initiative program evaluation, three annual visits were completed at each site from 2010-2012 and conducted 174 semi-structured interviews with clinical and program staff (baseline n=64, year 1 n=56, year 2=54). The results underscore the value of adhering to recent American Academy of Pediatrics (AAP) transition recommendations, including: developing formal transition protocols, preparing youth for transition, facilitating youth's connection to the adult clinic, and identifying necessary strategies for transition evaluation. Transitioning youth with HIV involves targeting individual-, provider-, and system-level factors. Acknowledging and addressing key barriers is essential for developing streamlined, comprehensive, and context-specific transition protocols. Adolescent and adult clinic involvement in transition is essential to reduce service fragmentation, provide coordinated and continuous care, and support individual and community level health. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Nucleic acids in mummified plant seeds: screening of twelve specimens by gel-electrophoresis, molecular hybridization and DNA cloning.

    Science.gov (United States)

    Rollo, F; La Marca, A; Amici, A

    1987-02-01

    Twelve seed specimens of varying ages and from different archaeological sites were analyzed for the presence of polymerized DNA and RNA. Amongst the samples tested, one of Vitis vinifera from an archaeological site in Iran (2,000-3,000 B.C.) was found to be completely devoid of nucleic acids. Zea mais seeds of Precolumbial age from Peru (about 800 A.D.) contained depolymerized DNA and RNA. Samples of Vitis vinifera and Rubus sp. from a Lombard archaeological site (800 A.D.) as well as radiocarbon dated seeds from the site of the "Spring Sanctuary" near Metaponto (I-IV century B.C.) were found to contain polymerized DNA and rRNA bands. However the electrophoretic properties of the rRNAs in one case and hybridization experiments performed with cloned seed DNA in the other, clearly demonstrated that the polymerized nucleic acids were not of plant origin.

  12. CT findings of laryngeal tuberculosis : comparison with laryngeal carcinoma

    International Nuclear Information System (INIS)

    Kim, Man Deuk; Kim, Dong Ik; Lee, Byung Hee; Sung, Ki Joon; Jung, Tae Sub; Cho, Jae Min; Yune, Heun Yune; Kim, Sun Yong

    1996-01-01

    To determine the value of CT(Computerized Tomography) in the diagnosis of laryngeal tuberculosis and to assess to what extent its characteristic findings different from those of laryngeal carcinoma. CT scans of twelve patients with laryngeal tuberculosis were reviewed and compared with those of fifteen patients with laryngeal cancer, retrospectively. Clinical symptoms, laryngoscopic examinations and the presence of pulmonary tuberculosis chest radiographs were also reviewed. In laryngeal tuberculosis, bilateral symmetric or asymmetric involvement was noted in nine(75%) patients, while unilateral involvement was seen in three(25%). This was significantly different from laryngeal cancer in which unilateral involvement was noted in twelve patients(80%). Diffuse thickening of the free margin of the epiglottis was a characteristic and frequent finding in tuberculosis(n=6, 50%). No deep submucosal infiltration of preepiglottic and paralaryngeal fat spaces is seen in tuberculosis in spite of large areas of involvement of laryngeal mucosa, while twelve patients(80%) with laryngeal cancer showed thickened deep infiltration which resulted in a submucosal mass. CT was useful in the diagnosis of laryngeal tuberculosis and its CT findings were characterized by bilateral involvement, thickening of the free margin of the epiglottis and good preservation of preepiglottic and paralaryngeal fat spaces in spite of large areas of involvement

  13. Focal hemodynamic patterns of status epilepticus detected by susceptibility weighted imaging (SWI)

    Energy Technology Data Exchange (ETDEWEB)

    Aellen, Jerome; Kottke, Raimund; Springer, Elisabeth; Weisstanner, Christian; El-Koussy, Marwan; Schroth, Gerhard; Wiest, Roland; Gralla, Jan; Verma, Rajeev K. [University of Bern, University Institute for Diagnostic and Interventional Neuroradiology, University Hospital Bern and Inselspital, Bern (Switzerland); Abela, Eugenio; Schindler, Kaspar [University of Bern, Department of Neurology, Inselspital, Bern (Switzerland); Buerki, Sarah E. [Inselspital, Department of Neuropaediatrics, University Children' s Hospital, Bern (Switzerland)

    2014-11-15

    To investigate pathological findings in the susceptibility weighted imaging (SWI) of patients experiencing convulsive (CSE) or non-convulsive status epilepticus (NCSE) with focal hyperperfusion in the acute setting. Twelve patients (six with NCSE confirmed by electroencephalogram (EEG) and six patients with CSE with seizure event clinically diagnosed) underwent MRI in this acute setting (mean time between onset of symptoms and MRI was 3 h 8 min), including SWI, dynamic susceptibility contrast MR imaging (DSC) and diffusion-weighted imaging (DWI). MRI sequences were retrospectively evaluated and compared with EEG findings (10/12 patients), and clinical symptoms. Twelve out of 12 (100 %) patients showed a focal parenchymal area with pseudo-narrowed cortical veins on SWI, associated with focal hyperperfused areas (increased cerebral blood flow (CBF) and mean transit time (MTT) shortening), and cortical DWI restriction in 6/12 patients (50 %). Additionally, these areas were associated with ictal or postical EEG patterns in 8/10 patients (80 %). Most frequent acute clinical findings were aphasia and/or hemiparesis in eight patients, and all of them showed pseudo-narrowed veins in those parenchymal areas responsible for these symptoms. In this study series with CSE and NCSE patients, SWI showed focally pseudo-narrowed cortical veins in hyperperfused and ictal parenchymal areas. Therefore, SWI might have the potential to identify an ictal region in CSE/NCSE. (orig.)

  14. Focal hemodynamic patterns of status epilepticus detected by susceptibility weighted imaging (SWI)

    International Nuclear Information System (INIS)

    Aellen, Jerome; Kottke, Raimund; Springer, Elisabeth; Weisstanner, Christian; El-Koussy, Marwan; Schroth, Gerhard; Wiest, Roland; Gralla, Jan; Verma, Rajeev K.; Abela, Eugenio; Schindler, Kaspar; Buerki, Sarah E.

    2014-01-01

    To investigate pathological findings in the susceptibility weighted imaging (SWI) of patients experiencing convulsive (CSE) or non-convulsive status epilepticus (NCSE) with focal hyperperfusion in the acute setting. Twelve patients (six with NCSE confirmed by electroencephalogram (EEG) and six patients with CSE with seizure event clinically diagnosed) underwent MRI in this acute setting (mean time between onset of symptoms and MRI was 3 h 8 min), including SWI, dynamic susceptibility contrast MR imaging (DSC) and diffusion-weighted imaging (DWI). MRI sequences were retrospectively evaluated and compared with EEG findings (10/12 patients), and clinical symptoms. Twelve out of 12 (100 %) patients showed a focal parenchymal area with pseudo-narrowed cortical veins on SWI, associated with focal hyperperfused areas (increased cerebral blood flow (CBF) and mean transit time (MTT) shortening), and cortical DWI restriction in 6/12 patients (50 %). Additionally, these areas were associated with ictal or postical EEG patterns in 8/10 patients (80 %). Most frequent acute clinical findings were aphasia and/or hemiparesis in eight patients, and all of them showed pseudo-narrowed veins in those parenchymal areas responsible for these symptoms. In this study series with CSE and NCSE patients, SWI showed focally pseudo-narrowed cortical veins in hyperperfused and ictal parenchymal areas. Therefore, SWI might have the potential to identify an ictal region in CSE/NCSE. (orig.)

  15. Energy Homeostasis and Body Weight before and after Cessation of Block and Replacement Therapy in Euthyroid Patients with Graves' Disease

    Directory of Open Access Journals (Sweden)

    Lars P. Klieverik

    2011-01-01

    Full Text Available Patients with Graves' hyperthyroidism (GH treated with a combination of thyrostatic drugs and T4, that is, block and replacement therapy (BRT, often report body weight (BW gain. We aimed to determine changes in BW and energy metabolism upon cessation of BRT in these patients, and to identify possible endocrine determinants. We analysed 22 patients with GH (i during BRT, and (ii 12 weeks after BRT cessation. Patients were euthyroid at both visits. There were no differences in BW or resting energy expenditure (REE between visits. At visit 1, after 13.5 (9.5–48.0 months of BRT, serum free (FT4 correlated positively with REE (=0.433, =0.044 and negatively with body fat % (=−0.450, =0.035. Plasma FT3 and FT3/FT4 ratio showed an increase 12 w after cessation of BRT (20%, <0.0001 and 16%, =0.007, resp.. Moreover, the relative change in FT3/FT4 ratio showed a significant, positive correlation with the relative change in REE between the 2 visits (=0.465, =0.029. In conclusion, serum FT4 determines REE in euthyroid patients with GH treated with BRT. Twelve weeks after BRT cessation, BW and energy homeostasis are unaltered. However, as serum FT3/FT4 ratio increases after cessation of BRT, which is a positive determinant of changes in REE, a longer term BW decrease is likely to occur.

  16. Deliberate ingestion of foreign bodies by institutionalised psychiatric hospital patients and prison inmates.

    LENUS (Irish Health Repository)

    O'Sullivan, S T

    2012-02-03

    Deliberate and recurrent foreign body ingestion is a common problem among institutionalised patients. We review our experience with 36 cases of deliberate foreign body ingestion by prisoners or psychiatric patients, thirty of whom were institutionalised at the time of ingestion. Symptoms were frequently severe in the prison inmate group but, in contrast, psychiatric patients presented with few, if any, symptoms. A majority of objects pass spontaneously or remain in situ without complication. Twenty-four patients were discharged following initial evaluation and without specific treatment. Eight of these were reviewed electively and discharged within one week. Twelve patients were admitted for observation, seven of whom were discharged within 48 hrs. Upper gastrointestinal endoscopy was performed in four patients and an intragastric foreign body identified in two cases. Laparotomy was performed in two cases for unresolving mechanical intestinal obstruction. Management should be conservative when possible, with surgery indicated only for complications.

  17. Essential fatty acid deficiency in patients with severe fat malabsorption

    DEFF Research Database (Denmark)

    Jeppesen, Palle B; Christensen, Michael Søberg; Høy, Carl-Erik

    1997-01-01

    Essential fatty acid deficiency is commonly described in patients receiving parenteral nutrition, but the occurrence in patients with severe fat malabsorption not receiving parenteral nutrition is uncertain. One hundred twelve patients were grouped according to their degree of fat malabsorption......: group 1, 50% (n = 15). Fecal fat was measured by the method of Van de Kamer the last 2 of 5 d of a 75-g fat diet. Serum fatty acids in the phospholipid fraction were measured by gas-liquid chromatography after separation...... by thin-layer chromatography and expressed as a percentage of total fatty acids. The concentration of linoleic acid in groups 1, 2, 3, and 4 was 21.7%, 19.4%, 16.4%, and 13.4% respectively (P acid in groups 1, 2, 3, and 4 was 0.4%, 0.4%, 0.3% and 0.3%, respectively...

  18. Treatment results and prognostic indicators in thymic epithelial tumors: a clinicopathological analysis of 45 patients.

    Science.gov (United States)

    Ansari, Mansour; Dehsara, Farzin; Mohammadianpanah, Mohammad; Mosalaei, Ahmad; Omidvari, Shapour; Ahmadloo, Niloofar

    2014-07-01

    Thymomas are rare epithelial tumors arising from thymus gland. This study aims at investigating the clinical presentation, prognostic factors and treatment outcome of forty five patients with thymoma and thymic carcinoma. Forty-five patients being histologically diagnosed with thymoma or thymic carcinoma that were treated and followed-up at a tertiary academic hospital during January 1987 and December 2008 were selected for the present study. Twelve patients were solely treated with surgery, 14 with surgery followed by adjuvant radiotherapy, 12 with sequential combined treatment of surgery, radiotherapy and/or chemotherapy and 7 with non-surgical approach including radiotherapy and/or chemotherapy.  Tumors were classified based on the new World Health Organization (WHO) histological classification. There were 18 women and 27 men with a median age of 43 years. Twelve patients (26.7%) had stage I, 7 (17.8%) had stage II, 23 (51%) had stage III and 2 (4.5%) had stage IV disease. Tumors types were categorized as type A (n=4), type AB (n=10), type B1 (n=9), type B2 (n=10), type B3 (n=5) and type C (n=7). In univariate analysis for overall survival, disease stage (P=0.001), tumor size (P=0.017) and the extent of surgical resection (P<0.001) were prognostic factors. Regarding the multivariate analysis, only the extent of the surgical resection (P<0.001) was the independent prognostic factor and non-surgical treatment had a negative influence on the survival. The 5-year and 10-year overall survival rates were 70.8% and 62.9%, respectively. Complete surgical resection is the most important prognostic factor in patients with thymic epithelial tumors.

  19. Effect Of Pressure Support Versus Unassisted Breathing Through A Tracheostomy Collar On Weaning Duration In Patients Requiring Prolonged Mechanical Ventilation: A Randomized Trial

    Science.gov (United States)

    Jubran, Amal; Grant, Brydon J.B.; Duffner, Lisa A.; Collins, Eileen G.; Lanuza, Dorothy M.; Hoffman, Leslie A.; Tobin, Martin J.

    2013-01-01

    Context Patients requiring prolonged mechanical ventilation (more than 21 days) are commonly weaned at long-term acute care hospitals (LTACHs). The most effective method of weaning such patients has not been investigated. Objective To compare weaning duration with pressure support versus unassisted breathing through a tracheostomy (trach collar) in patients transferred to a LTACH for weaning from prolonged ventilation. Design, Settings, and Participants Between 2000 and 2010, a randomized study was conducted in tracheotomized patients transferred to a single LTACH for weaning from prolonged ventilation. Of 500 patients who underwent a five-day screening procedure, 316 failed and were randomly assigned to wean with pressure support (n=155) or a trach collar (n=161). Six- and twelve-month survival was also determined. Main outcome measure Primary outcome was weaning duration. Secondary outcome was survival at six and twelve months after enrollment. Results Of 316 patients, four were withdrawn and not included in analysis. Of 152 patients in the pressure-support arm, 68 (44.7%) were weaned; 22 (14.5%) died. Of 160 patients in the trach-collar arm, 85 (53.1%) were weaned; 16 (10.0%) died. Median weaning time was shorter with trach collar than with pressure support: 15 [interquartile range, 8–25] versus 19 [12–31] days, p=0.004. The hazard ratio (HR) for successful weaning rate was higher with trach collar than with pressure support (HR, 1.43; 95% confidence interval [CI], 1.03–1.98, p<0.03) after adjusting for baseline clinical covariates. Trach collar achieved faster weaning than did pressure support among subjects who failed the screening procedure at 12–120 hours (HR, 3.33; 95% CI, 1.44–7.70, p<0.01), whereas weaning time was equivalent with the two methods in patients who failed the screening procedure within 0–12 hours. Mortality was equivalent in the pressure-support and trach-collar arms at six months (55.9% versus 51.3%; 4.7 difference, 95% CI −6

  20. Twelve tips for assessment psychometrics.

    Science.gov (United States)

    Coombes, Lee; Roberts, Martin; Zahra, Daniel; Burr, Steven

    2016-01-01

    It is incumbent on medical schools to show, both to regulatory bodies and to the public at large, that their graduating students are "fit for purpose" as tomorrow's doctors. Since students graduate by virtue of passing assessments, it is vital that schools quality assure their assessment procedures, standards, and outcomes. An important part of this quality assurance process is the appropriate use of psychometric analyses. This begins with development of an empowering, evidence-based culture in which assessment validity can be demonstrated. Preparation prior to an assessment requires the establishment of appropriate rules, test blueprinting and standard setting. When an assessment has been completed, the reporting of test results should consider reliability, assessor, demographic, and long-term analyses across multiple levels, in an integrated way to ensure the information conveyed to all stakeholders is meaningful.

  1. The Effect of Screen-to-Screen Versus Face-to-Face Consultation on Doctor-Patient Communication: An Experimental Study with Simulated Patients.

    Science.gov (United States)

    Tates, Kiek; Antheunis, Marjolijn L; Kanters, Saskia; Nieboer, Theodoor E; Gerritse, Maria Be

    2017-12-20

    Despite the emergence of Web-based patient-provider contact, it is still unclear how the quality of Web-based doctor-patient interactions differs from face-to-face interactions. This study aimed to examine (1) the impact of a consultation medium on doctors' and patients' communicative behavior in terms of information exchange, interpersonal relationship building, and shared decision making and (2) the mediating role of doctors' and patients' communicative behavior on satisfaction with both types of consultation medium. Doctor-patient consultations on pelvic organ prolapse were simulated, both in a face-to-face and in a screen-to-screen (video) setting. Twelve medical interns and 6 simulated patients prepared 4 different written scenarios and were randomized to perform a total of 48 consultations. Effects of the consultations were measured by questionnaires that participants filled out directly after the consultation. With respect to patient-related outcomes, satisfaction, perceived information exchange, interpersonal relationship building, and perceived shared decision making showed no significant differences between face-to-face and screen-to-screen consultations. Patients' attitude toward Web-based communication (b=-.249, P=.02 and patients' perceived time and attention (b=.271, P=.03) significantly predicted patients' perceived interpersonal relationship building. Patients' perceived shared decision making was positively related to their satisfaction with the consultation (b=.254, P=.005). Overall, patients experienced significantly greater shared decision making with a female doctor (mean 4.21, SD 0.49) than with a male doctor (mean 3.66 [SD 0.73]; b=.401, P=.009). Doctor-related outcomes showed no significant differences in satisfaction, perceived information exchange, interpersonal relationship building, and perceived shared decision making between the conditions. There was a positive relationship between perceived information exchange and doctors

  2. Study protocol: a randomised controlled trial investigating the effect of exercise training on peripheral blood gene expression in patients with stable angina

    Directory of Open Access Journals (Sweden)

    Crossman David C

    2010-10-01

    Full Text Available Abstract Background Exercise training has been shown to reduce angina and promote collateral vessel development in patients with coronary artery disease. However, the mechanism whereby exercise exerts these beneficial effects is unclear. There has been increasing interest in the use of whole genome peripheral blood gene expression in a wide range of conditions to attempt to identify both novel mechanisms of disease and transcriptional biomarkers. This protocol describes a study in which we will assess the effect of a structured exercise programme on peripheral blood gene expression in patients with stable angina, and correlate this with changes in angina level, anxiety, depression, and exercise capacity. Methods/Design Sixty patients with stable angina will be recruited and randomised 1:1 to exercise training or conventional care. Patients randomised to exercise training will attend an exercise physiology laboratory up to three times weekly for supervised aerobic interval training sessions of one hour in total duration. Patients will undergo assessments of angina, anxiety, depression, and peripheral blood gene expression at baseline, after six and twelve weeks of training, and twelve weeks after formal exercise training ceases. Discussion This study will provide comprehensive data on the effect of exercise training on peripheral blood gene expression in patients with angina. By correlating this with improvement in angina status we will identify candidate peripheral blood transcriptional markers predictive of improvements in angina level in response to exercise training. Trial Registration Clinicaltrials.gov identifier: NCT01147952

  3. Effects of recombinant human granulocyte colony-stimulating factor on leucopenia in zidovudine-treated patients with AIDS and AIDS related complex, a phase I/II study

    NARCIS (Netherlands)

    van der Wouw, P. A.; van Leeuwen, R.; van Oers, R. H.; Lange, J. M.; Danner, S. A.

    1991-01-01

    Twelve male patients, eight with the acquired immunodeficiency syndrome (AIDS) and four with AIDS related complex (ARC), who had zidovudine associated neutropenia (less than 1 x 10(9) neutrophils/l) were treated with recombinant human granulocyte colony-stimulating factor (G-CSF) in a phase I/II

  4. Venous thromboembolism in acute spinal cord injury patients

    Directory of Open Access Journals (Sweden)

    Saraf Shyam

    2007-01-01

    Full Text Available Background : The western literature on deep vein thrombosis (DVT and pulmonary embolism (PE following spinal cord injury (SCI report an alarmingly high incidence, necessitating thromboprophylaxis. The literature on incidence from the Asian subcontinent is scanty and from India is almost nonexistent. Materials and Methods : Seventy hospitalized acute SCI patients presenting within five days of the injury were included in the present analysis. Forty-two cases were subjected to color Doppler studies and 28 cases had to be subjected to venography due to lack of facility at some point of time. The clinical course of the patients was closely observed during the period of hospitalization. All except 14 were managed nonoperatively. Thromboprophylaxis was not given to any patient at any stage; however, treatment was instituted in those showing the features of DVT on investigations. Results : Twelve patients died during the period of hospitalization. Deep vein thrombosis could be detected in seven patients only, three in the proximal and four in the distal segment of the lower limb and of these three died. Based on the clinical course and positive investigation report in favor of DVT, we presumed that the cause of death in these three patients was pulmonary embolism. In the other nine, in the absence of an autopsy report, the cause of deaths was considered as pulmonary infection, asphyxia, diaphragmatic paralysis, hematemesis, cervicomedullary paralysis etc. Clinical features to diagnose DVT were of little help. Conclusions : There is a much lower incidence (10% of DVT and PE following spinal cord injury (SCI in India than what is reported from the western countries. Higher age group and quadriplegia were the only factors which could be correlated. Deep vein thrombosis extending proximal to the knee was significant. In the absence of autopsy and other screening tests like D-dimer test or 125I fibrogen uptake study, the true incidence of venous

  5. Desferrioxamine-induced long bone changes in thalassaemic patients - Radiographic features, prevalence and relations with growth

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Y.L.; Li, C.K.; Pang, L.M.; Chik, K.W

    2000-08-01

    AIM: To study the radiographic findings of desferrioxamine-induced bone dysplasia, its prevalence and relation to growth in thalassaemic patients. MATERIALS AND METHODS: A cross-sectional study was performed in 35 thalassaemic patients on a hypertransfusion scheme and chelation therapy at a dose not exceeding 50 mg/kg/day. Radiographs of the left hand taken for bone age assessment in consecutive patients over the past 12 months were evaluated for signs of desferrioxamine-induced bone dysplasia. The findings were correlated with data on growth, chelation and body iron content. RESULTS: Twelve of 35 patients had evidence of desferrioxamine-induced long bone dysplasia. There was no significant difference in the groups with and without radiographic evidence of bone dysplasia with respect to the height percentile at time of initiation of therapy, height percentile at time of radiography, skeletal age delay, age at starting chelation, chelation dose and duration, units of blood transfused, average chelation dose, and serum ferritin levels at time of radiography. Both groups showed a reduced percentile growth with a significantly greater reduction (P = 0.03) in the patients with dysplastic change. CONCLUSION: Desferrioxamine-induced bone dysplasia is associated with height reduction and can be seen in patients receiving desferrioxamine chelation therapy at doses of less than 50 mg/kg/day. Awareness of the diagnosis is of importance as reduction of the desferrioxamine dose may improve bone growth. Chan, Y. L. (2000)

  6. Preliminary Investigations Showing Venous Thromboembolism Recurrence in Patients with Residual Venous Obstruction in Singaporean Population.

    Science.gov (United States)

    Sule, Ashish Anil; Er, Chaozer; Chong, Claudia Y X; Chin, Han Xin; Chin, Tay Jam

    2017-12-01

    This study aims to determine the association of residual venous obstruction (RVO) with recurrent venous thromboembolism (VTE). A retrospective cohort study was conducted determining if RVO on ultrasonography is associated with recurrent VTE in a Singaporean population. The subjects were identified from the Vascular Diagnostic Laboratory patients' record of Tan Tock Seng Hospital (TTSH), Singapore between 2008 and 2013. All the patients included had RVO after 3 months of anticoagulation. Data such as age, gender, race, thrombus location, etiology, history of malignancy, thrombophilia screen, treatment duration, and follow-up were recorded for analysis. Statistical analysis was performed using Stata/SE 13.1 (StataCorp LLC). The study was approved by the National Healthcare Group Domain Specific Review Board (DSRB), Singapore. Out of the 34 patients who had RVO, 6 (17.6%) developed VTE recurrence. Patients were treated with anticoagulation for a mean time of 24.5 months. The mean follow-up time for VTE recurrence was 25.4 months. Out of the six patients who had VTE recurrence, one had common iliac vein involvement, four had superficial femoral vein and common femoral vein involvement, zero had popliteal vein involvement, and one had calf veins involvement. There was a significant association between thrombophilia ( p  = 0.0195) and malignancy ( p  = 0.020) at inclusion with the risk of recurrent VTE. The presence of RVO after 3 months of anticoagulation is likely to increase the risk of VTE recurrence. Larger studies with RVO are needed to evaluate if there is an increased risk of VTE recurrence in the Asian population.

  7. Twelve Monkeys, the Kassandra dilemma and innovation diffusion: transdisciplinary lessons for animal and environmental activism

    Directory of Open Access Journals (Sweden)

    Sarah Rutherford Smith

    2014-07-01

    Full Text Available Animal activists and environmental activists believe that the world and its inhabitants face devastating consequences in the future if behaviour towards and the treatment of animals and the environment do not change. However, despite their predictions many people are not swayed to change their behaviour. This article suggests that these activists experience what is known as Kassandra’s dilemma; the conundrum of knowing what the future holds but being unable to prevent events from happening. Drawing on the film, Twelve Monkeys and Greek mythology this article explores this mythological dilemma and explains how this dilemma is a lived experience for activists. The article suggests that activists can resolve Kassandra’s dilemma by taking a transdisciplinary approach towards animal and environmental activism. Thus, in order to escape Kassandra’s dilemma the article suggests that animal and environmental activists require transdisciplinary knowledge; knowledge of the actual and potential harm done to animals and the environment and how this can be prevented as well as knowledge on how to successfully convey this knowledge to others. The article highlights innovation diffusion theory as an example of the type of transdisciplinary knowledge that could assist in escaping from Kassandra’s dilemma and in order to better advocate on behalf of animals and the environment.

  8. Correlation between clinical severity and type and degree of pectus excavatum in twelve brachycephalic dogs.

    Science.gov (United States)

    Hassan, Elham A; Hassan, Marwa H; Torad, Faisal A

    2018-05-18

    The aim of the study was to correlate the clinical severity of pectus excavatum with its type and degree based on objective radiographic evaluation. Twelve brachycephalic dogs were included. Grading of the clinical severity was done based on a 6-point grading score. Thoracic radiographs were used to calculate the frontosagittal and vertebral indices at the tenth thoracic vertebra and the vertebra overlying the excavatum. Correlation between the clinical severity score and frontosagittal and vertebral indices was evaluated using Pearson's correlation coefficient. Typical pectus excavatum was recorded in the caudal sternum in seven dogs, with a mean clinical severity score of 1.7 ± 1.4, whereas in five dogs, atypical mid-sternal deviation was recorded with a mean clinical severity score of 3.8 ± 0.7. A strong correlation (r=0.7) was recorded between the clinical severity score and vertebral index in the atypical form, whereas a weak correlation (r=0.02) was recorded in the typical form (Pcorrelated (r=0.3) in the typical form of pectus excavatum, whereas it was strongly correlated (r=0.9) in the atypical form. Pectus excavatum in dogs is associated with compressive cardiopulmonary dysfunction, which depends mainly on the site/type of deviation rather than the degree of deviation.

  9. Fatty acid metabolism in symptomatic patients with mitral valve prolapse but without coronary artery disease - comparison with 201Tl myocardial perfusion scintigraphy

    International Nuclear Information System (INIS)

    Voth, E.; Schicha, H.; Neumann, P.; Emrich, D.; Tebbe, U.

    1987-01-01

    Using 123 I-ω-heptadecanoic acid (HDA) and 201 Tl, respectively, myocardial fatty acid metabolism and perfusion were studied in 51 symptomatic patients with mitral valve prolapse (MVP) as diagnosed by ventriculography, and no evidence of coronary artery disease. Twelve subjects with normal coronary arteries and normal ventriculogram served as a control group for the evaluation of elimination kinetics of HDA. In the control group, the mean elimination half-life was 26.1±3.6 min, whereas the patients with MVP had a mean value of 25.0±6.4 min. In patients with MVP, a high incidence concerning abnormalities of accumulation and/or elimination of HDA occurred, namely accumulation defects in 31% and both prolonged and shortened elimination half-lives in 16% and 29%, respectively. Myocardial perfusion scintigraphy using 201 Tl showed abnormalities in 76%. Correlations were found between decreased uptake of HDA and prolonged elimination half-life as well as defects by 201 Tl, presumably due to ischemia based on small-vessel disease or abnormalities of cellular metabolism. (orig.) [de

  10. Characteristics of the Motor Units during Sternocleidomastoid Isometric Flexion among Patients with Mechanical Neck Disorder and Asymptomatic Individuals.

    Directory of Open Access Journals (Sweden)

    Chia-Chi Yang

    Full Text Available Mechanical neck disorder is a widespread and non-neurological musculoskeletal condition resulting from modern lifestyles. Presently, the fundamental electrophysiological properties of the motor units of the sternocleidomastoid muscles and the characteristics of the short-term synchronization of the motor unit in patients with neck pain are ambiguous. This study therefore aims to clarify the fundamental electrophysiological properties of the motor units of the sternocleidomastoid muscles in patients with mechanical neck disorder and in asymptomatic individuals. We further investigated whether alterations in the degree of motor unit short-term synchronization occur. The surface electrophysiological signals of the bilateral sternal heads of the sternocleidomastoid muscles of twelve patients with mechanical neck disorder and asymptomatic individuals were detected at 25% of the maximum voluntary contraction during cervical isometric flexion and then decomposed into individual motor unit action potential trains. We found that the patients with mechanical neck disorder showed significantly higher initial and mean firing rates of the sternocleidomastoid muscles and displayed substantially lower motor unit short-term synchronization values compared with the asymptomatic subjects. Consequently, these convincing findings support the assertion that patients with mechanical neck disorder display altered neuromuscular control strategies, such as the reinforcement of motor unit recruitment firing rates in the sternocleidomastoid muscles. The motor units of these patients also revealed neural recruitment strategies with relatively poor efficiency when executing the required motor tasks.

  11. Characteristics of the Motor Units during Sternocleidomastoid Isometric Flexion among Patients with Mechanical Neck Disorder and Asymptomatic Individuals.

    Science.gov (United States)

    Yang, Chia-Chi; Su, Fong-Chin; Yang, Po-Ching; Lin, Hwai-Ting; Guo, Lan-Yuen

    2016-01-01

    Mechanical neck disorder is a widespread and non-neurological musculoskeletal condition resulting from modern lifestyles. Presently, the fundamental electrophysiological properties of the motor units of the sternocleidomastoid muscles and the characteristics of the short-term synchronization of the motor unit in patients with neck pain are ambiguous. This study therefore aims to clarify the fundamental electrophysiological properties of the motor units of the sternocleidomastoid muscles in patients with mechanical neck disorder and in asymptomatic individuals. We further investigated whether alterations in the degree of motor unit short-term synchronization occur. The surface electrophysiological signals of the bilateral sternal heads of the sternocleidomastoid muscles of twelve patients with mechanical neck disorder and asymptomatic individuals were detected at 25% of the maximum voluntary contraction during cervical isometric flexion and then decomposed into individual motor unit action potential trains. We found that the patients with mechanical neck disorder showed significantly higher initial and mean firing rates of the sternocleidomastoid muscles and displayed substantially lower motor unit short-term synchronization values compared with the asymptomatic subjects. Consequently, these convincing findings support the assertion that patients with mechanical neck disorder display altered neuromuscular control strategies, such as the reinforcement of motor unit recruitment firing rates in the sternocleidomastoid muscles. The motor units of these patients also revealed neural recruitment strategies with relatively poor efficiency when executing the required motor tasks.

  12. Affect School for chronic benign pain patients showed improved alexithymia assessments with TAS-20

    Directory of Open Access Journals (Sweden)

    Thulesius Hans O

    2010-06-01

    Full Text Available Abstract Background Alexithymia is a disturbance associated with psychosomatic disorders, pain syndromes, and a variety of psychiatric disorders. The Affect School (AS based on Tomkins Affect Theory is a therapy focusing on innate affects and their physiological expressions, feelings, emotions and scripts. In this pilot study we tried the AS-intervention method in patients with chronic benign pain. Methods The AS-intervention, with 8 weekly group sessions and 10 individual sessions, was offered to 59 patients with chronic non-malignant pain at a pain rehabilitation clinic in Sweden 2004-2005. Pre and post intervention assessments were done with the Hospital Anxiety and Depression scale (HAD, the Toronto Alexithymia Scale-20 (TAS-20, the Visual Analogue Scale for pain assessment (VAS-pain, the European Quality of Life health barometer (EQoL and the Stress and Crisis Inventory-93 (SCI-93. After the group sessions we used Bergdahl's Questionnaire for assessing changes in interpersonal relations, general well-being and evaluation of AS. Results The AS intervention was completed by 54 out of 59 (92% patients. Significant reductions in total TAS-20 post-test scores (p = 0.0006 as well as TAS-20 DIF and DDF factors (Difficulties Identifying Feelings, and Difficulties Describing Feelings were seen (p = 0.0001, and p = 0.0008 while the EOT factor (Externally Oriented Thinking did not change. Improvements of HAD-depression scores (p = 0.04, EQoL (p = 0.02 and self-assessed changes in relations to others (p Conclusions This pilot study involving 59 patients with chronic benign pain indicates that the alexithymia DIF and DDF, as well as depression, social relations and quality of life may be improved by the Affect School therapeutic intervention.

  13. PCSK9 Inhibitors Show Value for Patients and the US Health Care System.

    Science.gov (United States)

    Cheng, Wei-Han; Gaudette, Étienne; Goldman, Dana P

    2017-12-01

    Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors were approved by the US Food and Drug Administration (FDA) as cholesterol-lowering therapies for patients with familial hypercholesterolemia or atherosclerotic cardiovascular disease. To estimate the long-term health and economic value of PCSK9 inhibitors for Americans (51 years and older). We conducted simulations using the Future Elderly Model, an established dynamic microsimulation model to project the lifetime outcomes for the US population aged 51 years and older. Health effects estimates and confidence intervals from published meta-analysis studies were used to project changes in life expectancy, quality-adjusted life-years, and lifetime medical spending resulting from the use of PCSK9 inhibitors. We considered two treatment scenarios: 1) current FDA eligibility and 2) an extended eligibility scenario that includes patients with no pre-existing cardiovascular disease but at high risk. We assumed that the price of PCSK9 inhibitors was discounted by 35% in the first 12 years and by 57% thereafter, with gradual uptake of the drug in eligible populations. Use of PCSK9 inhibitors by individuals covered by current FDA approval would extend life expectancy at the age of 51 years by an estimated 1.1 years and would yield a lifetime net value of $5800 per person. If use was extended to those at high risk for cardiovascular disease, PCSK9 inhibitors would generate a lifetime net benefit of $14,100 per person. Expanded access to PCSK9 inhibitors would offer positive long-term net value for patients and the US health care system at the current discounted prices. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  14. Untitled

    African Journals Online (AJOL)

    Traumatic dental injuries. Traumatic dental injuries and their management among children aged 6-12 years ... Records of all sixty seven (67) dental patients aged six to twelve years who ... anterior teeth in children shows that the prevalence is ...

  15. A fabric phase sorptive extraction-High performance liquid chromatography-Photo diode array detection method for the determination of twelve azole antimicrobial drug residues in human plasma and urine.

    Science.gov (United States)

    Locatelli, Marcello; Kabir, Abuzar; Innosa, Denise; Lopatriello, Teresa; Furton, Kenneth G

    2017-01-01

    This paper reports a novel fabric phase sorptive extraction-high performance liquid chromatography-photodiode array detection (FPSE-HPLC-PDA) method for the simultaneous extraction and analysis of twelve azole antimicrobial drug residues that include ketoconazole, terconazole, voriconazole, bifonazole, clotrimazole, tioconazole, econazole, butoconazole, miconazole, posaconazole, ravuconazole, and itraconazole in human plasma and urine samples. The selected azole antimicrobial drugs were well resolved by using a Luna C 18 column (250mm×4.6mm; 5μm particle size) in gradient elution mode within 36min. The analytical method was calibrated and validated in the range from 0.1 to 8μg/mL for all the drug compounds. Blank human plasma and urine were used as the sample matrix for the analysis; while benzyl-4-hydroxybenzoate was used as the internal standard (IS). The limit of quantification of the FPSE-HPLC-PDA method was found as 0.1μg/mL and the weighted-matrix matched standard calibration curves of the drugs showed a good linearity upto a concentration of 8μg/mL. The parallelism tests were also performed to evaluate whether overrange sample can be analyzed after dilution, without compromising the analytical performances of the validated method. The intra- and inter-day precision (RSD%) values were found ≤13.1% and ≤13.9%, respectively. The intra- and inter-day trueness (bias%) values were found in the range from -12.1% to 10.5%. The performances of the validated FPSE-HPLC-PDA were further tested on real samples collected from healthy volunteers after a single dose administration of itraconazole and miconazole. To the best of our knowledge, this is the first FPSE extraction procedure applied on plasma and urine samples for the simultaneous determination of twelve azole drugs possessing a wide range of logK ow values (extending from 0.4 for fluconazole to 6.70 of butoconazole) and could be adopted as a rapid and robust green analytical tool for clinical and

  16. Does lean management improve patient safety culture? An extensive evaluation of safety culture in a radiotherapy institute.

    Science.gov (United States)

    Simons, Pascale A M; Houben, Ruud; Vlayen, Annemie; Hellings, Johan; Pijls-Johannesma, Madelon; Marneffe, Wim; Vandijck, Dominique

    2015-02-01

    The importance of a safety culture to maximize safety is no longer questioned. However, achieving sustainable culture improvements are less evident. Evidence is growing for a multifaceted approach, where multiple safety interventions are combined. Lean management is such an integral approach to improve safety, quality and efficiency and therefore, could be expected to improve the safety culture. This paper presents the effects of lean management activities on the patient safety culture in a radiotherapy institute. Patient safety culture was evaluated over a three year period using triangulation of methodologies. Two surveys were distributed three times, workshops were performed twice, data from an incident reporting system (IRS) was monitored and results were explored using structured interviews with professionals. Averages, chi-square, logistical and multi-level regression were used for analysis. The workshops showed no changes in safety culture, whereas the surveys showed improvements on six out of twelve dimensions of safety climate. The intention to report incidents not reaching patient-level decreased in accordance with the decreasing number of reports in the IRS. However, the intention to take action in order to prevent future incidents improved (factorial survey presented β: 1.19 with p: 0.01). Due to increased problem solving and improvements in equipment, the number of incidents decreased. Although the intention to report incidents not reaching patient-level decreased, employees experienced sustained safety awareness and an increased intention to structurally improve. The patient safety culture improved due to the lean activities combined with an organizational restructure, and actual patient safety outcomes might have improved as well. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. A qualitative study into the impact of fasting within a large tertiary hospital in Australia--the patients' perspective.

    Science.gov (United States)

    Carey, Sharon K; Conchin, Simone; Bloomfield-Stone, Susan

    2015-07-01

    This qualitative study aims to explore the physical and emotional impact of fasting from the patients' perspective. Fasting patients in hospital is common practice and generally viewed as necessary for symptom management or for safety of healthcare provision. Negative impacts of repeated or prolonged fasting on nutritional status have been well researched, but little is documented as to how fasting impacts an individual patient's psyche. Qualitative descriptive design within a tertiary hospital in Sydney, Australia. Twelve patients having had prolonged periods of continuous or intermittent fasting were invited to participate in a semi-structured interview between January-September 2012. Questions for interview explored each patient's experience of fasting, including physical and emotional impacts, interpretation of communication regarding fasting and the process of recommencing on fluids or foods. An inductive thematic analysis approach was used. Analyses showed six main themes: physical impacts; emotional impacts; food as structure; nil by mouth as jargon; fear of food re-introduction; and dissatisfaction regarding unnecessary fasting. Overwhelmingly, thirst was reported as the worst physical effect of fasting. In the first few days of fasting, patients became emotionally fixated on food. This quickly dissipated leading to a lack of appetite and fear of starting to eat again. Discomfort experienced by patients coupled with lack of appetite resulting from prolonged fasting and difficulty with food re-introduction strengthens the argument for reducing fasting times in hospital. When patients are fasted, proper hydration and establishing alternate routes of medication administration should be a priority. It is well recognised that fasting for prolonged periods is detrimental to health outcomes, but this study also shows the distress that fasting can cause. Inadequate hospital systems and out-dated practices need to be replaced with evidence-based, patient

  18. Evaluation of central nervous system in patients with glycogen storage disease type 1a.

    Science.gov (United States)

    Aydemir, Yusuf; Gürakan, Figen; Saltık Temizel, İnci Nur; Demir, Hülya; Oğuz, Kader Karlı; Yalnızoğlu, Dilek; Topçu, Meral; Özen, Hasan; Yüce, Aysel

    2016-01-01

    We aimed to evaluate structure and functions of central nervous system (CNS) in children with glycogen storage disease (GSD) type 1a. Neurological examination, psychometric tests, electroencephalography (EEG), magnetic resonance imaging (MRI), visual evoked potentials (VEP) and brainstem auditory evoked potentials (BAEP) were performed. The results were compared between patients with good and poor metabolic control and healthy children. Twenty-three patients with GSD type 1a were studied. Twelve patients were in poor metabolic control group and 11 patients in good metabolic control group. Five patients had intellectual disability, 10 had EEG abnormalities, seven had abnormal VEP and two had abnormal BAEP results. MRI was abnormal in five patients. There was significant correlation between the number of hypoglycemic attacks and MRI abnormalities. Central nervous system may be affected in GSD type 1a even in patients with normal neurologic examination. Accumulation of abnormal results in patients with poor metabolic control supports the importance of metabolic control in GSD type 1a.

  19. Ecological conversion efficiency and its influencers in twelve species of fish in the Yellow Sea Ecosystem

    Science.gov (United States)

    Tang, Qisheng; Guo, Xuewu; Sun, Yao; Zhang, Bo

    2007-09-01

    The ecological conversion efficiencies in twelve species of fish in the Yellow Sea Ecosystem, i.e., anchovy ( Engraulis japonicus), rednose anchovy ( Thrissa kammalensis), chub mackerel ( Scomber japonicus), halfbeak ( Hyporhamphus sajori), gizzard shad ( Konosirus punctatus), sand lance ( Ammodytes personatus), red seabream ( Pagrus major), black porgy ( Acanthopagrus schlegeli), black rockfish ( Sebastes schlegeli), finespot goby ( Chaeturichthys stigmatias), tiger puffer ( Takifugu rubripes), and fat greenling ( Hexagrammos otakii), were estimated through experiments conducted either in situ or in a laboratory. The ecological conversion efficiencies were significantly different among these species. As indicated, the food conversion efficiencies and the energy conversion efficiencies varied from 12.9% to 42.1% and from 12.7% to 43.0%, respectively. Water temperature and ration level are the main factors influencing the ecological conversion efficiencies of marine fish. The higher conversion efficiency of a given species in a natural ecosystem is acquired only under the moderate environment conditions. A negative relationship between ecological conversion efficiency and trophic level among ten species was observed. Such a relationship indicates that the ecological efficiency in the upper trophic levels would increase after fishing down marine food web in the Yellow Sea ecosystem.

  20. Lung fibrosis in deceased HIV-infected patients with Pneumocystis pneumonia

    Directory of Open Access Journals (Sweden)

    Erica J Shaddock

    2012-06-01

    Full Text Available Background. Pneumocystis pneumonia (PcP is one of the most common opportunistic infections found in patients with HIV. The prognosis if ventilation is required is poor, with mortality of 36 - 80%. Although more recent studies have shown improved survival, our experience has been that close to 100% of such patients die, and we therefore decided to investigate further. Methods. All patients with confirmed or suspected PcP who died owing to respiratory failure were eligible for the study. Where consent was obtained, trucut lung biopsies were performed post mortem, stored in formalin and sent for histopathological assessment. Results. Twelve adequate lung biopsies were obtained from 1 July 2008 to 28 February 2011 – 3 from men and 9 from women. The mean age was 34.7 years (range 24 - 46, and the mean admission CD4 count was 20.8 (range 1 - 68 cells/μl and median 18.5 cells/μl. All specimens demonstrated typical PcP histopathology; in addition, 9 showed significant interstitial fibrosis. Three had co-infection with cytomegalovirus (CMV, two of which had fibrosis present. There was no evidence of TB or other fungal infections. Conclusion. The high mortality seen in this cohort of PcP patients was due to intractable respiratory failure from interstitial lung fibrosis. whereas the differential includes ventilator induced lung injury, drug resistance or co-infections, we suggest that this is part of the disease progression in certain individuals. Further studies are required to identify interventions that could modify this process and improve outcomes in patients with PcP who require mechanical ventilation. S Afr J HIV Med 2012;13(2:64-67.

  1. Visual and SPM analysis of regional cerebral perfusion with Tc-99m ECD brain SPECT in patients with developmental language disorder

    International Nuclear Information System (INIS)

    Yoon, Joon Kee; Lee, Myung Hoon; Joh, Chul Woo; Yoon, Seok Nam; Oh, Eun Young

    2003-01-01

    Developmental language disorder (DLD) refers to inadequate language acquisition at the expected age in children with otherwise normal development. However, language delay can be observed in patients with other developmental disoder (ODD). We, therefore, evaluated regional cerebral perfusion pattern in patients with DLD and ODD by means of visual and SPM analysis. Twelve patients, who underwent Tc-99m ECD brain SPECT within 3 weeks of their first visit, were included in the study. Psychological and language tests classified the patients into 2 groups ; 6 with DLD (3-7 yr, 5 male and I female) and 6 with ODD (2-6 yr, 6 male). Visual analysis for regional cerebral perfusion was done in each patient. SPM with 7 controls (age=7) was performed to evaluate difference between 2 groups using t-test. P value of less than 0.005 was considered to be significant. All patients had significant language delay for their age (9 month 3.5 yr). Among 6 patients with ODD, 4 had pervasive developmental disorder, 1 mental retardation and 1 attachment disorder. Visual analysis revealed significant perfusion decrease in only 1 patient with DLD and 2 with ODD ; the regions were left parieto-temporal cortex, both frontal and cerebellar cortices, and right temporal cortex respectively. Nine of 12 patients showed normal perfusion. SPM demonstrated perfusion decrease in left inferior frontal cortex and left superior parietal cortex (Wernicke's area) in patients with DLD, while, in patients with ODD, perfusion decrease was mostly located in the right hemisphere (lateral frontoorbital gyrus, occipitotemporal gyrus, cuneus and cerebellum). Corpus callosum showed no significant perfusion abnormality in both groups. Regional cerebral perfusion of patients with DLD, which was mainly located in the speech area, is quite different from that of ODD-patients with language delay. While SPM successfully revealed this difference in perfusion pattern, visual analysis had limited value

  2. Visual and SPM analysis of regional cerebral perfusion with Tc-99m ECD brain SPECT in patients with developmental language disorder

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Joon Kee; Lee, Myung Hoon; Joh, Chul Woo; Yoon, Seok Nam; Oh, Eun Young [College of Medicine, Univ. of Ajou, Suwon (Korea, Republic of)

    2003-07-01

    Developmental language disorder (DLD) refers to inadequate language acquisition at the expected age in children with otherwise normal development. However, language delay can be observed in patients with other developmental disoder (ODD). We, therefore, evaluated regional cerebral perfusion pattern in patients with DLD and ODD by means of visual and SPM analysis. Twelve patients, who underwent Tc-99m ECD brain SPECT within 3 weeks of their first visit, were included in the study. Psychological and language tests classified the patients into 2 groups ; 6 with DLD (3-7 yr, 5 male and I female) and 6 with ODD (2-6 yr, 6 male). Visual analysis for regional cerebral perfusion was done in each patient. SPM with 7 controls (age=7) was performed to evaluate difference between 2 groups using t-test. P value of less than 0.005 was considered to be significant. All patients had significant language delay for their age (9 month 3.5 yr). Among 6 patients with ODD, 4 had pervasive developmental disorder, 1 mental retardation and 1 attachment disorder. Visual analysis revealed significant perfusion decrease in only 1 patient with DLD and 2 with ODD ; the regions were left parieto-temporal cortex, both frontal and cerebellar cortices, and right temporal cortex respectively. Nine of 12 patients showed normal perfusion. SPM demonstrated perfusion decrease in left inferior frontal cortex and left superior parietal cortex (Wernicke's area) in patients with DLD, while, in patients with ODD, perfusion decrease was mostly located in the right hemisphere (lateral frontoorbital gyrus, occipitotemporal gyrus, cuneus and cerebellum). Corpus callosum showed no significant perfusion abnormality in both groups. Regional cerebral perfusion of patients with DLD, which was mainly located in the speech area, is quite different from that of ODD-patients with language delay. While SPM successfully revealed this difference in perfusion pattern, visual analysis had limited value.

  3. Effectiveness of a Multimodal Therapy for Patients with Chronic Low Back Pain Regarding Pre-Admission Healthcare Utilization

    Science.gov (United States)

    Borys, Constanze; Lutz, Johannes; Strauss, Bernhard; Altmann, Uwe

    2015-01-01

    Objective The aim of the study was to examine the effectiveness of an intensive inpatient three-week multimodal therapy. We focused especially on the impact on the multimodal therapy outcome of the pre-admission number of treatment types patients had received and of medical specialist groups patients had consulted. Methods 155 patients with chronic low back pain and indication for multimodal therapy were evaluated with respect to pain intensity, depression, anxiety, well-being, and pre-admission health care utilization. In our controlled clinical trial we compared N = 66 patients on the waiting list with N = 89 patients who received immediate treatment. The waiting list patients likewise attended multimodal therapy after the waiting period. Longitudinal post-treatment data for both were collected at three- and twelve-month follow-ups. The impact of pre-admission health care utilization on multimodal therapy outcome (post) was analysed by structural equation model. Results Compared to the control group, multimodal therapy patients’ pain intensity and psychological variables were significantly reduced. Longitudinal effects with respect to pre-measures were significant at three-month follow-up for pain intensity (ES = -0.48), well-being (ES = 0.78), anxiety (ES = -0.33), and depression (ES = -0.30). Effect sizes at twelve-month follow-up were small for anxiety (ES = -0.22), and moderate for general well-being (ES = 0.61). Structural equation model revealed that a higher number of pre-admission treatment types was associated with poorer post-treatment outcomes in pain intensity, well-being, and depression. Conclusion Multimodal therapy proved to be effective with regard to improvements in pain intensity, depression, anxiety, and well-being. The association between treatment effect and number of pre-admission pain treatment types suggests that patients would benefit more from attending multimodal therapy in an earlier stage of health care. PMID:26599232

  4. Chemoradiotherapy with or without consolidation chemotherapy using cisplatin and 5-fluorouracil in anal squamous cell carcinoma: long-term results in 31 patients

    Directory of Open Access Journals (Sweden)

    Roh Jae

    2008-01-01

    Full Text Available Abstract Background The objectives of this study were to evaluate long-term results of concurrent chemoradiotherapy (CRT with 5-fluorouracil and cisplatin and the potential benefit of consolidation chemotherapy in patients with anal squamous cell carcinoma (ASCC. Methods Between January 1995 and February 2006, 31 patients with ASCC were treated with CRT. Radiotherapy was administered at 45 Gy over 5 weeks, followed by a boost of 9 Gy to complete or partial responders. Chemotherapy consisted of 5-fluorouracil (750 or 1,000 mg/m2 daily on days 1 to 5 and days 29 to 33; and, cisplatin (75 or 100 mg/m2 on day 2 and day 30. Twelve patients had T3–4 disease, whereas 18 patients presented with lymphadenopathy. Twenty-one (67.7% received consolidation chemotherapy with the same doses of 5-fluorouracil and cisplatin, repeated every 4 weeks for maximum 4 cycles. Results Nineteen patients (90.5% completed all four courses of consolidation chemotherapy. After CRT, 28 patients showed complete responses, while 3 showed partial responses. After a median follow-up period of 72 months, the 5-year overall, disease-free, and colostomy-free survival rates were 84.7%, 82.9% and 96.6%, demonstrating that CRT with 5-fluorouracil and cisplatin yields a good outcome in terms of survival and sphincter preservation. No differences in 5-year OS and DFS rates between patients treated with CRT alone and CRT with consolidation chemotherapy was observed. Conclusion our study shows that CRT with 5-FU and cisplatin, with or without consolidation chemotherapy, was well tolerated and proved highly encouraging in terms of long-term survival and the preservation of anal function in ASCC. Further trials with a larger patient population are warranted in order to evaluate the potential role of consolidation chemotherapy.

  5. Teaching patient care to students: A blended learning approach in radiography education

    Energy Technology Data Exchange (ETDEWEB)

    Bleiker, Jill, E-mail: j.bleiker@ex.ac.uk [College of Engineering, Mathematics and Physical Sciences, University of Exeter, Stocker Road, Exeter EX4 4QL (United Kingdom); Knapp, Karen M.; Frampton, Ian [College of Engineering, Mathematics and Physical Sciences, University of Exeter, Stocker Road, Exeter EX4 4QL (United Kingdom)

    2011-08-15

    Understanding the complexity of the patient-practitioner interaction is a challenging area for radiography students early in their programmes. A small scale research project was undertaken to develop blended learning resources for the teaching of patient care to radiography students. Its purpose was to utilise experiences gathered from interviews with ex-patients to produce video clips of patient-practitioner interactions so that students might gain some insight into the reality of the clinical setting, thus enabling them to link theory with practice. A total of eight interviews with ex-patients were carried out and the transcripts used to generate scripts which were enacted and filmed by a professional acting company. Thematic analysis of the study data initiated the generation of scenarios, which formed the basis of the videos. Twelve scenes showing patient-practitioner interactions in various parts of a medical imaging department and four 'talking heads' clips were produced. These were loaded onto the university's virtual learning environment and made available for viewing together with self-test and evaluation questionnaires. A pilot study was carried out; evaluation of the videos by second year student radiographers was positive. The main study was carried out using first year students with similarly positive findings and the videos are now publically available for teaching purposes. Further work in this promising area of e-learning could further utilise patients' experiences, and using the same technology, might offer students of other professions the opportunity to gain vicarious experience prior to their first encounters with patients and the general public. In conclusion, research leading to the production of simulations of real-life patient-practitioner interactions delivered using blended learning is a useful pedagogical tool in the education of radiography students.

  6. Teaching patient care to students: A blended learning approach in radiography education

    International Nuclear Information System (INIS)

    Bleiker, Jill; Knapp, Karen M.; Frampton, Ian

    2011-01-01

    Understanding the complexity of the patient-practitioner interaction is a challenging area for radiography students early in their programmes. A small scale research project was undertaken to develop blended learning resources for the teaching of patient care to radiography students. Its purpose was to utilise experiences gathered from interviews with ex-patients to produce video clips of patient-practitioner interactions so that students might gain some insight into the reality of the clinical setting, thus enabling them to link theory with practice. A total of eight interviews with ex-patients were carried out and the transcripts used to generate scripts which were enacted and filmed by a professional acting company. Thematic analysis of the study data initiated the generation of scenarios, which formed the basis of the videos. Twelve scenes showing patient-practitioner interactions in various parts of a medical imaging department and four 'talking heads' clips were produced. These were loaded onto the university's virtual learning environment and made available for viewing together with self-test and evaluation questionnaires. A pilot study was carried out; evaluation of the videos by second year student radiographers was positive. The main study was carried out using first year students with similarly positive findings and the videos are now publically available for teaching purposes. Further work in this promising area of e-learning could further utilise patients' experiences, and using the same technology, might offer students of other professions the opportunity to gain vicarious experience prior to their first encounters with patients and the general public. In conclusion, research leading to the production of simulations of real-life patient-practitioner interactions delivered using blended learning is a useful pedagogical tool in the education of radiography students.

  7. [Concomitant oncopathological changes in the prostate of urinary bladder cancer patients undergoing radical cystoprostateectomy].

    Science.gov (United States)

    Komyakov, B K; Sergeev, A V; Fadeev, V A; Ismailov, K I; Ulyanov, A Yu; Shmelev, A Yu; Onoshko, M V

    2017-09-01

    To determine the incidence of spreading bladder transitional cell carcinoma and primary adenocarcinoma to the prostate in patients with bladder cancer undergoing radical cystectomy. From 1995 to 2016, 283 men underwent radical cystectomy with removal of the bladder, perivesical tissue, prostate, seminal vesicles and pelvic lymph nodes. Prostate sparing cystectomy was performed in 45 (13.7%) patients. The whole prostate and the apex of the prostate were preserved in 21 (6.4%) and 24 (7.3%) patients, respectively. The spread of transitional cell cancer of the bladder to the prostate occurred in 50 (15.2%) patients. Twelve (3.6%) patients were found to have primary prostate adenocarcinoma. Clinically significant prostate cancer was diagnosed in 4 (33.3%) patients. We believe that the high oncological risk of prostate sparing cystectomy, despite some functional advantages, dictates the need for complete removal of the prostate in the surgical treatment of bladder cancer.

  8. Arthritis patients show long-term benefits from 3 weeks intensive exercise training directly following hospital discharge

    NARCIS (Netherlands)

    Bulthuis, Y.; Drossaers-Bakker, K.W.; Drossaers-Bakker, K.W.; Taal, Erik; Rasker, Johannes J.; Oostveen, J.; van 't Pad Bosch, P.; Oosterveld, F.; van de Laar, Mart A F J

    2007-01-01

    Objective: To examine the efficacy of short-term intensive exercise training (IET) directly following hospital discharge. - Methods: In the Disabled Arthritis Patients Post-hospitalization Intensive Exercise Rehabilitation (DAPPER) study, patients with rheumatoid arthritis or osteoarthritis were

  9. Plasma erythropoietin by high-detectability immunoradiometric assay in untreated and treated patients with polycythaemia vera and essential thrombocythaemia

    Energy Technology Data Exchange (ETDEWEB)

    Carneskog, J.; Kutti, J.; Wadenvik, H. [Univ. of Goeteborg, Sahlgrenska Univ. Hospital, Dept. of Medicine, Haematology Section (Sweden); Lundberg, P.A.; Lindstedt, G. [Univ. of Goeteborg, Sahlgrenska Univ. Hospital, Dept. of Clinical Chemistry and Transfusion Medicine (Sweden)

    1998-12-31

    By using an immunoradiometric method with a stated detection limit of {<=}1 IU/l (stated normal reference limit in adults 3.7-16 IU/l) we determined EDTA-plasma erythropoietin (EPO) in 58 patients with polycythaemia vera (PV) and 49 patients with essential thrombocythaemia (ET). At the time of blood sampling, 20 of the PV patients were newly diagnosed and untreated, 23 were treated by phlebotomy only, and 30 also received myelosuppressive treatment (with 32P, hydroxyurea of alpha-interferon). Of the ET patients 24 were untreated and 28 received myelosuppressive therapy. For comparison plasma EPO was also determined in 10 patients with pseudopolycythaemia (PP). In this latter group the results for plasma EPO agreed well with the cited normal reference limits. The majority of untreated PV patients (12/20) had undetectable plasma EPO concentration, and the remainder all had values below the lower normal reference limit. Plasma EPO in PV was not significantly influenced by phlebotomy therapy. Twelve of the 24 untreated ET patients (50%) had plasma EPO values below the reference interval (undetectable in 2 patients). The mean EPO concentration was significantly lower in PV patients receiving phlebotomy therapy than in patients with untreated ET. In the total material of PV and ET treated with myelosuppressive agents the PV patients showed significantly lower values for EPO concentration than did patients with ET. The present results support the view that EPO measurements by high-detectability methods are diagnostically useful and should be included in the panel of new criteria for the diagnosis of PV. (au) 20 refs.

  10. Decision Making under Risk Condition in Patients with Parkinson’s Disease: A Behavioural and fMRI Study

    Directory of Open Access Journals (Sweden)

    Kirsten Labudda

    2010-01-01

    Full Text Available We aimed to study whether previously described impairment in decision making under risky conditions in patients with Parkinson's disease (PD is affected by deficits in using information about potential incentives or by processing feedback (in terms of fictitious gains and losses following each decision. Additionally, we studied whether the neural correlates of using explicit information in decision making under risk differ between PD patients and healthy subjects. We investigated ten cognitively intact PD patients and twelve healthy subjects with the Game of Dice Task (GDT to assess risky decision making, and with an fMRI paradigm to analyse the neural correlates of information integration in the deliberative decision phase. Behaviourally, PD patients showed selective impairment in the GDT but not on the fMRI task that did not include a feedback component. Healthy subjects exhibited lateral prefrontal, anterior cingulate and parietal activations when integrating decision-relevant information. Despite similar behavioural patterns on the fMRI task, patients exhibited reduced parietal activation. Behavioural results suggest that PD patients’ deficits in risky decision making are dominated by impaired feedback utilization not compensable by intact cognitive functions. Our fMRI results suggest similarities but also differences in neural correlates when using explicit information for the decision process, potentially indicating different strategy application even if the interfering feedback component is excluded.

  11. The effect of posterior and lateral approach on patient-reported outcome measures and physical function in patients with osteoarthritis, undergoing total hip replacement

    DEFF Research Database (Denmark)

    Rosenlund, Signe; Broeng, Leif; Jensen, Carsten

    2014-01-01

    BACKGROUND: Total hip replacement provides pain relief and improves physical function and quality of life in patients with end-stage hip osteoarthritis. The incidence of hip replacement operations is expected to increase due to the growing elderly population. Overall, the posterior approach...... Outcome Score, subscale of "Physical function Short form" (HOOS-PS) Secondary outcome measures include two other subscales of HOOS ("Pain" and "Hip related Quality of Life"), physical activity level (UCLA activity score), limping (HHS) and general health status (EQ-5D-3L). Explorative outcomes include...... physical function and pain; however, this has not been investigated in a randomised controlled trial with a twelve-month follow-up. We hypothesized that the lateral approach has an inferior outcome in patient-reported outcome compared with the posterior approach after one year. METHODS/DESIGN: The trial...

  12. Salvage whole abdominal radiation therapy for ovarian cancer: a twelve year experience

    International Nuclear Information System (INIS)

    Baker, Katherine; Reddy, Susheel; Lee, Myung-Sook; Geest, Koen de; Lincoln, Sarah; Sarin, Pramilla; Graham, James; Yordan, Edgardo; Reddy, Salitha

    1996-01-01

    Purpose: 1) To evaluate whole abdominal radiation therapy (WART) as a salvage modality in patients with epithelial ovarian carcinoma who have failed one or more chemotherapeutic regimens; 2) To assess the feasibility and long-term toxicity of such treatment. Materials and Methods: Between June 1983 and October 1994, 51 patients who had failed one or more chemotherapeutic regimens received WART. Forty-seven patients had epithelial ovarian carcinoma, the remaining had primary carcinoma of the peritoneal cavity. Forty patients (78%) had FIGO stage III and IV disease. Grade III and IV tumors were seen in 29 patients (57%). The residual disease was classified as being either microscopic or macroscopic disease depending on the status after the laparotomy prior to radiation treatment, irrespective of the extent of disease prior to debulking. In 22 patients (43%) macroscopic disease was present after laparotomy, while the remaining 29 patients (57%) had only microscopic disease present. Twenty patients (39%) had residual disease limited to the pelvis, and 31 patients (61%) had upper abdominal involvement. An open field technique was used to deliver planned doses of 25Gy to the whole abdomen with shielding of the kidneys posteriorly after 12Gy. Boost fields to the pelvis and/or areas of gross residual disease were treated when indicated. The Kaplan-Meier Method was used to calculate survival data from the initiation of radiation until death or recurrence. Median follow-up for surviving patients was 53 months, with a range of 17 to 122 months. Results: Five patients (10%) were unable to complete therapy secondary to acute toxicity. An additional fourteen patients (27%) required a one to five week break usually secondary to cytopenias. Four year actuarial survival and recurrence-free survival rates for the entire group of patients were 32% and 23% respectively. For patients with microscopic residual disease, survival and recurrence-free survival rates were 48% and 37

  13. Cholelithiasis in patients on the kidney transplant waiting list

    Science.gov (United States)

    Brito, André Thiago Scandiuzzi; Azevedo, Luiz Sergio; Nahas, Willian Carlos; Matheus, André Siqueira; Jukemura, José

    2010-01-01

    OBJECTIVES To evaluate the prevalence of cholecystopathy in chronic renal patients awaiting kidney transplants. INTRODUCTION The prevalence and management of cholelithiasis in renal transplant patients is not well established. METHODS A total of 342 chronic renal failure patients on the waiting list for a kidney transplant were studied. Patients were evaluated for the presence of cholelithiasis and related symptoms, previous cholecystectomies and other abdominal surgeries, time on dialysis, and general data (gender, age, number of pregnancies, and body mass index). RESULTS Cholelithiasis was found in 41 out of 342 patients (12%). Twelve of these patients, all symptomatic, had previously undergone cholecystectomies. Five out of 29 patients who had not undergone surgery were symptomatic. Overall, 17 patients (41.5%) were symptomatic. Their mean age was 54 (range 32–74) years old; 61% were female, and their mean body mass index was 25.4. Nineteen (76%) out of 25 women had previously been pregnant, with an average of 3.6 pregnancies per woman. CONCLUSIONS The frequency of cholelithiasis was similar to that reported in the literature for the general population. However, the high frequency of symptomatic patients points toward an indication of routine pre-transplant cholecystectomy to avoid serious post-transplant complications. PMID:20454496

  14. Experience in thyroid scintigraphy with Ethiopian patients

    International Nuclear Information System (INIS)

    Demena, Solomon

    1993-01-01

    One thousand and thirty seven thyroid scintigraphy examinations done in the Nuclear Medicine Unit of Tikur Anbesma Hospital, Addis Abeba, Ethiopia between December 1984 and September 1989 were analyzed to assess their diagnostic value. Thirty one percent of the referrals were to investigate clinically detectable solitary nodules, and of these fifty-six percent had ''cold'' nodules and twenty-three percent ''hot'' nodules. Fifty-five percent of the referrals for evaluation of goitre were for multi nodular goitres and twelve percent for diffuse. Thirteen of fifty-three cases with suspected ectopic thyroid tissue were positive. Little useful information was obtained in the evaluation of goitre. It is concluded that thyroid scintigraphy was an unnecessary investigation in the evaluation of goitres in euthyroid patients. Its primary role was in the investigation of the solitary nodule, ectopic thyroid tissue and the retresternal goitre. Therefore, only selected patients should be investigated with thyroid scintigraphy

  15. Intrathecally enhanced spinal CT in the early diagnosis of cerebrospinal fluid-borne metastasis in pediatric patients with primary brain tumors

    International Nuclear Information System (INIS)

    Wang, H.; Rosenbaum, A.E.; Ahn, H.S.; Zinreich, S.J.; Diffley, D.M.; Killmond, T.A.; Strauss, L.C.

    1987-01-01

    Early diagnosis and treatment of asymptomatic intraspinal cerebrospinal fluid-borne metastases can obviate serious sequelae in pediatric patients with known intracranial tumors. MR imaging is a superior imaging modality; however, in very young patients who need general anesthesia for immobilization and also for evaluation of small subarachnoid seedings, the authors found CT to be a valuable alternative. Twelve patients ranging in age from 3 months to 13 years underwent CT screening of the entire spine after intrathecal enhancement with 3-5 ml of metrizamide (100 mg iodine per milliliter) via a lumbar puncture. Intrathecal spinal metastases were found in 67% of the studied patients and even in a patient whose MR imaging examination failed to disclose the lesion

  16. Alcoholics Anonymous and twelve-step recovery: a model based on social and cognitive neuroscience.

    Science.gov (United States)

    Galanter, Marc

    2014-01-01

    In the course of achieving abstinence from alcohol, longstanding members of Alcoholics Anonymous (AA) typically experience a change in their addiction-related attitudes and behaviors. These changes are reflective of physiologically grounded mechanisms which can be investigated within the disciplines of social and cognitive neuroscience. This article is designed to examine recent findings associated with these disciplines that may shed light on the mechanisms underlying this change. Literature review and hypothesis development. Pertinent aspects of the neural impact of drugs of abuse are summarized. After this, research regarding specific brain sites, elucidated primarily by imaging techniques, is reviewed relative to the following: Mirroring and mentalizing are described in relation to experimentally modeled studies on empathy and mutuality, which may parallel the experiences of social interaction and influence on AA members. Integration and retrieval of memories acquired in a setting like AA are described, and are related to studies on storytelling, models of self-schema development, and value formation. A model for ascription to a Higher Power is presented. The phenomena associated with AA reflect greater complexity than the empirical studies on which this article is based, and certainly require further elucidation. Despite this substantial limitation in currently available findings, there is heuristic value in considering the relationship between the brain-based and clinical phenomena described here. There are opportunities for the study of neuroscientific correlates of Twelve-Step-based recovery, and these can potentially enhance our understanding of related clinical phenomena. © American Academy of Addiction Psychiatry.

  17. Common genomic signaling among initial DNA damage and radiation-induced apoptosis in peripheral blood lymphocytes from locally advanced breast cancer patients

    DEFF Research Database (Denmark)

    Henríquez-Hernández, Luis Alberto; Pinar, Beatriz; Carmona-Vigo, Ruth

    2013-01-01

    PURPOSE: To investigate the genomic signaling that defines sensitive lymphocytes to radiation and if such molecular profiles are consistent with clinical toxicity; trying to disclose the radiobiology mechanisms behind these cellular processes. PATIENTS AND METHODS: Twelve consecutive patients...... suffering from locally advanced breast cancer and treated with high-dose hyperfractionated radiotherapy were recruited. Initial DNA damage was measured by pulsed-field gel electrophoresis and radiation-induced apoptosis was measured by flow cytometry. Gene expression was assessed by DNA microarray. RESULTS...

  18. A patient with coexisting narcolepsy and morbid jealousy showing favourable response to fluoxetine.

    Science.gov (United States)

    Wing, Y. K.; Lee, S.; Chiu, H. F.; Ho, C. K.; Chen, C. N.

    1994-01-01

    A 37 year old Chinese man suffered from coexisting narcolepsy and morbid jealousy which were precipitated by head injury 5 years previously. Fluoxetine 20 mg/day reduced his narcoleptic symptoms and morbid jealousy but not his sleepiness. On defaulting treatment, the patient's symptoms and marital problem recurred. A common central serotonin disturbance might be involved in mediating the sleep disorder and associated psychopathology. PMID:8140016

  19. DTI and VBM reveal white matter changes without associated gray matter changes in patients with idiopathic restless legs syndrome

    Science.gov (United States)

    Belke, Marcus; Heverhagen, Johannes T; Keil, Boris; Rosenow, Felix; Oertel, Wolfgang H; Stiasny-Kolster, Karin; Knake, Susanne; Menzler, Katja

    2015-01-01

    Background and Purpose We evaluated cerebral white and gray matter changes in patients with iRLS in order to shed light on the pathophysiology of this disease. Methods Twelve patients with iRLS were compared to 12 age- and sex-matched controls using whole-head diffusion tensor imaging (DTI) and voxel-based morphometry (VBM) techniques. Evaluation of the DTI scans included the voxelwise analysis of the fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD). Results Diffusion tensor imaging revealed areas of altered FA in subcortical white matter bilaterally, mainly in temporal regions as well as in the right internal capsule, the pons, and the right cerebellum. These changes overlapped with changes in RD. Voxel-based morphometry did not reveal any gray matter alterations. Conclusions We showed altered diffusion properties in several white matter regions in patients with iRLS. White matter changes could mainly be attributed to changes in RD, a parameter thought to reflect altered myelination. Areas with altered white matter microstructure included areas in the internal capsule which include the corticospinal tract to the lower limbs, thereby supporting studies that suggest changes in sensorimotor pathways associated with RLS. PMID:26442748

  20. Myofascial trigger points in cluster headache patients: a case series

    Directory of Open Access Journals (Sweden)

    Rico-Villademoros Fernando

    2008-12-01

    Full Text Available Abstract Active myofascial trigger points (MTrPs have been found to contribute to chronic tension-type headache and migraine. The purpose of this case series was to examine if active trigger points (TrPs provoking cluster-type referred pain could be found in cluster headache patients and, if so, to evaluate the effectiveness of active TrPs anaesthetic injections both in the acute and preventive headache's treatment. Twelve patients, 4 experiencing episodic and 8 chronic cluster headache, were studied. TrPs were found in all of them. Abortive infiltrations could be done in 2 episodic and 4 chronic patients, and preemptive infiltrations could be done in 2 episodic and 5 chronic patients, both kind of interventions being successful in 5 (83.3% and in 6 (85.7% of the cases respectively. When combined with prophylactic drug therapy, injections were associated with significant improvement in 7 of the 8 chronic cluster patients. Our data suggest that peripheral sensitization may play a role in cluster headache pathophysiology and that first neuron afferent blockade can be useful in cluster headache management.

  1. Cramp-fasciculation syndrome in patients with and without neural autoantibodies.

    Science.gov (United States)

    Liewluck, Teerin; Klein, Christopher J; Jones, Lyell K

    2014-03-01

    We investigated the clinical, electrophysiological and neural autoantibody characteristics in cramp-fasciculation syndrome (CFS) patients. We reviewed Mayo Clinic records from 2000 to 2011 to identify clinically defined CFS patients who underwent neural autoantibody testing. Stored sera of patients who tested positive for antibodies to voltage-gated potassium channel complex (VGKC complex) were analyzed further for leucine-rich glioma-inactivated 1 (LGI1) or contactin-associated protein-2 immunoglobulin G (CASPR2-IgG) antibodies. Thirty-seven patients were identified. Twelve were seropositive for neural autoantibodies. Clinical manifestations were similar in seropositive and seronegative patients, although central and autonomic neuronal hyperexcitability symptoms were more common in seropositive cases. No patients had a malignancy. Repetitive tibial nerve stimulation at 10 Hz revealed longer afterdischarges in seropositive patients. Two of 7 patients with VGKC-complex autoimmunity demonstrated LGI1 or CASPR2-IgG antibodies. Only 2 of 12 seropositive patients required immunotherapy. VGKC-complex autoimmunity occurs in a minority of CFS patients. Antibody positivity was associated with extramuscular manifestations, typically without malignancy. Target antigens within the VGKC complex remain unknown in most patients. Published 2013 by Wiley Periodicals, Inc. This article is a US Government work and, as such, is in the public domain in the United States of America.

  2. Feasibility analysis of loop colostomy closure in patients under local anesthesia

    Directory of Open Access Journals (Sweden)

    Abreu Rone Antônio Alves de

    2006-01-01

    Full Text Available PURPOSE: To verify prospectively the practicability of performing loop colostomy closure under local anesthesia and sedation. METHODS: In this study, 21 patients underwent this operation. Lidocaine 2% and bupivacaine 0.5% were utilized. Pain was evaluated during the operation, on the first postoperative day and at hospital discharge. Intraoperative events, postoperative complications and the acceptability of this procedure were analyzed. RESULTS: The mean duration of the operation was 133 minutes (range: 85 to 290 minutes. The mean postoperative hospitalization was four days (range: one to twelve days. No patients died. Complications occurred in two patients (9.4%: abdominal wall hematoma and operative wound infection. With regard to pain severity, scores of less than or equal to three were indicated in the intraoperative evaluation by 80% of the patients (17/21 and on the first postoperative day by 85% (18/21. At hospital discharge, 95.2% of the patients (20/21 said they were in favor of the local anesthesia technique. CONCLUSION: Loop colostomy closure under local anesthesia and sedation is feasible, safe and acceptable to patients.

  3. Novel silicone stent to treat tracheobronchial lesions: results of 35 patients.

    Science.gov (United States)

    Saueressig, Maurício G; Sanches, Paulo R S; Macedo Neto, Amarilio V; Moreschi, Alexandre H; Oliveira, Hugo G; Xavier, Rogerio G

    2010-12-01

    We describe a case series of 35 patients with either benign (14) or malignant (21) tracheal stenosis who were treated using a novel silicone stent, the HCPA-1, designed to prevent migration. Between March 2001 and September 2008, 13 women and 22 men received 41 HCPA-1 stents. The median duration of stenting in benign cases was 457 days (range, 4-2,961 days). Successful stent removal with curative results was accomplished in 2 patients with tracheomalacia and 1 with post-intubation stenosis. In malignant cases, the median duration of stenting was 162 days (range, 1-1,279 days). Five patients had tumor progression with obstruction requiring repeated laser resection, dilatation, or additional stents. Two patients died due to airway obstruction despite bronchoscopic intervention. Twelve patients with malignant lesions died with the stent in place. At the end of the study, 3 patients with malignant disease remained alive; 2 were lost to follow-up. The HCPA-1 stent proved to be safe, with no severe complications during the study period, and effective in improving quality of life with relief of dyspnea.

  4. The estimated cost of "no-shows" in an academic pediatric neurology clinic.

    Science.gov (United States)

    Guzek, Lindsay M; Gentry, Shelley D; Golomb, Meredith R

    2015-02-01

    Missed appointments ("no-shows") represent an important source of lost revenue for academic medical centers. The goal of this study was to examine the costs of "no-shows" at an academic pediatric neurology outpatient clinic. This was a retrospective cohort study of patients who missed appointments at an academic pediatric neurology outpatient clinic during 1 academic year. Revenue lost was estimated based on average reimbursement for different insurance types and visit types. The yearly "no-show" rate was 26%. Yearly revenue lost from missed appointments was $257,724.57, and monthly losses ranged from $15,652.33 in October 2013 to $27,042.44 in January 2014. The yearly revenue lost from missed appointments at the academic pediatric neurology clinic represents funds that could have been used to improve patient access and care. Further work is needed to develop strategies to decrease the no-show rate to decrease lost revenue and improve patient care and access. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Differences in Rhodococcus equi Infections Based on Immune Status and Antibiotic Susceptibility of Clinical Isolates in a Case Series of 12 Patients and Cases in the Literature

    Science.gov (United States)

    Suzuki, Yasuhiro; Ribes, Julie A.; Thornton, Alice

    2016-01-01

    Rhodococcus equi is an unusual zoonotic pathogen that can cause life-threatening diseases in susceptible hosts. Twelve patients with R. equi infection in Kentucky were compared to 137 cases reported in the literature. Although lungs were the primary sites of infection in immunocompromised patients, extrapulmonary involvement only was more common in immunocompetent patients (P antibiotics, preferably selected from vancomycin, imipenem, clarithromycin/azithromycin, ciprofloxacin, rifampin, or cotrimoxazole. Local antibiograms should be checked prior to using cotrimoxazole due to developing resistance. PMID:27631004

  6. Embolotherapy for pulmonary arteriovenous malformations in patients with hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber syndrome)

    DEFF Research Database (Denmark)

    Andersen, P E; Kjeldsen, A D; Oxhøj, H

    1998-01-01

    experienced an improved functional level. One patient experienced severe pleurisy and another a rise in temperature following treatment, but otherwise no symptomatic complications were observed. CONCLUSION: Embolotherapy is a definitive treatment for PAVMs: it is very effective with a high success rate......PURPOSE: To evaluate the clinical results of embolization of pulmonary arteriovenous malformations (PAVMs) in patients with hereditary hemorrhagic telangiectasia (HHT), the Rendu-Osler-Weber syndrome. MATERIAL AND METHODS: Twelve patients in the county of Fyn, Denmark, were treated...... with transcatheter embolization of 20 PAVMs using 12 detachable silicone balloons and 26 steel coils. RESULTS: All PAVMs were completely occluded and we observed a significant rise in PaO2 after treatment and a significant decrease in right-to-left shunt estimated by contrast echocardiography. All patients...

  7. Twelve-month safety and efficacy of inhaled fluticasone propionate in children aged 1 to 3 years with recurrent wheezing

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Allen, David; Milanowski, Janusz

    2004-01-01

    , exacerbations, and requirements for oral steroid treatment and more symptom-free days and days without use of rescue treatment. CONCLUSIONS: Twelve months of treatment with inhaled FP (100 microg twice daily) in preschool children aged 1 to 3 years with recurrent wheeze has no effect on growth and no other......OBJECTIVE: Our aim was to compare the 12-month safety and efficacy of fluticasone propionate (FP) and sodium cromoglycate (SCG) in children aged 1 to 3 years with mild to moderate recurrent wheeze. METHODS: The study was a randomized, parallel-group, open-label multicenter study of 625 children......, aged 1 to 3 years, with recurrent wheeze randomized in a 3:1 ratio to treatment for 52 weeks with FP (100 microg twice daily) via metered-dose inhaler and Babyhaler spacer device or SCG (5 mg 4 times daily) via metered-dose inhaler and Nebuhaler spacer device, respectively. RESULTS...

  8. Management and outcome of patients with pancreatic trauma

    Directory of Open Access Journals (Sweden)

    Ravinder Pal Singh

    2017-01-01

    Full Text Available Introduction: Pancreatic trauma is a rare entity occurring in 0.2% of patients with blunt trauma abdomen. Once the diagnosis is made, the management of patients is dependent on multiple variables. Conservative management, suture repair, drainage, and resection have been utilized with varying degree of success. This study is aimed to evaluate the management of patients with pancreatic trauma. Materials and Methods: This was a prospective study done in the Department of Surgery in Dayanand Medical College and Hospital where forty hemodynamically stable patients diagnosed to have pancreatic trauma on contrast-enhanced computed tomography abdomen were included in the study. Results: Out of forty patients taken in this study, 38 were male and two were female with age ranging from 3 to 50 years. Road traffic accident was the most common cause of pancreatic injury. Pancreatic injuries were graded according to the American Association for Surgery in Trauma scale. Twelve patients had Grade I and II injuries. Grade III was the most common injury occurring in 14 patients. Twenty-four patients underwent surgical management. Mortality rate was 45% and it was in direct correlation with the severity of injury. Conclusion: Grade I and II pancreatic injury can be managed conservatively depending upon the hemodynamic status of the patient. Grade III and IV injuries have a better prognosis if managed surgically.

  9. Health Care Employee Perceptions of Patient-Centered Care: A Photovoice Project

    Science.gov (United States)

    Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L.

    2015-01-01

    Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspective is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, several areas for improvement were identified. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. PMID:25274626

  10. Treatment Results and Prognostic Indicators in Thymic Epithelial Tumors: A Clinicopathological Analysis of 45 Patients

    Directory of Open Access Journals (Sweden)

    Mansour Ansari

    2014-07-01

    Full Text Available Background: Thymomas are rare epithelial tumors arising from thymus gland. This study aims at investigating the clinical presentation, prognostic factors and treatment outcome of forty five patients with thymoma and thymic carcinoma. Methods: Forty-five patients being histologically diagnosed with thymoma or thymic carcinoma that were treated and followed-up at a tertiary academic hospital during January 1987 and December 2008 were selected for the present study. Twelve patients were solely treated with surgery, 14 with surgery followed by adjuvant radiotherapy, 12 with sequential combined treatment of surgery, radiotherapy and/or chemotherapy and 7 with non-surgical approach including radiotherapy and/or chemotherapy. Tumors were classified based on the new World Health Organization (WHO histological classification. Results: There were 18 women and 27 men with a median age of 43 years. Twelve patients (26.7% had stage I, 7 (17.8% had stage II, 23 (51% had stage III and 2 (4.5% had stage IV disease. Tumors types were categorized as type A (n=4, type AB (n=10, type B1 (n=9, type B2 (n=10, type B3 (n=5 and type C (n=7. In univariate analysis for overall survival, disease stage (P=0.001, tumor size (P=0.017 and the extent of surgical resection (P<0.001 were prognostic factors. Regarding the multivariate analysis, only the extent of the surgical resection (P<0.001 was the independent prognostic factor and non-surgical treatment had a negative influence on the survival. The 5-year and 10-year overall survival rates were 70.8% and 62.9%, respectively. Conclusion: Complete surgical resection is the most important prognostic factor in patients with thymic epithelial tumors.

  11. Prescription Pattern of Analgesic Drugs for Patients Receiving Palliative Care in a Teaching Hospital in India.

    Science.gov (United States)

    Menezes, Vishma Hydie; Nair, Shoba N; Soumya, M S; Tarey, S D

    2016-01-01

    Drugs used in the palliative care unit for managing symptoms are major contributors toward the expenditure occurring in palliative care. This study was conducted to understand the prescription pattern of analgesic drugs in the patients who are receiving palliative care in a teaching hospital in India by a retrospective study of case records. Case record based, retrospective, descriptive study was conducted at the Pain and Palliative Care Department of St. John's Medical College Hospital, Bengaluru. Case record files of all patients referred to Pain and Palliative Care Department for the treatment of pain in the year of 2012 were studied. Patients' age, gender, diagnoses, numerical pain rating scale (0-10), drugs prescribed, dosage, frequency, route of administration were recorded. The difference in drug utilization between the genders was done using Chi-square test. Data were collected from 502 patients of which 280 (56%) were males and 222 (44%) were females. Twelve percent of patients had mild pain (1-3), 34% had moderate pain (4-6), and 54% had severe pain (7-10). The most commonly used analgesic drugs were opioids (47%), followed by nonsteroidal anti-inflammatory drugs (36%). The opioids used were tramadol (56%), and morphine (38%). Ninety percent of patients with numerical pain scale more than 6 received morphine. There was no difference in analgesic drug utilization with regards to gender. Prescription pattern differed depending on the severity of pain. Opioids were the most commonly used drugs for pain management. The study shows that prescription pattern in palliative care unit of this hospital was in accordance with WHO pain management guidelines. The study showed the current trend in prescription of analgesic drugs in the teaching hospital where the study was conducted.

  12. Portrayal of medical decision making around medical interventions life-saving encounters on three medical television shows.

    Science.gov (United States)

    Schwei, Rebecca J; Jacobs, Elizabeth A; Wingert, Katherine; Montague, Enid

    2015-07-01

    Previous literature has shown that patients obtain information about the medical system from television shows. Additionally, shared decision making is regularly cited as the ideal way to make decisions during a medical encounter. Little information exists surrounding the characteristics of medical decision-making, such as who makes the decision, on medical television shows. We evaluate the characteristics of medical decisions in lifesaving encounters on medical television shows and evaluate if these characteristics were different on staged and reality television shows. We coded type of medical intervention, patient's ability to participate in decision, presence of patient advocate during decision, final decision maker, decision to use intervention, and controversy surrounding decision on three television shows. Frequencies by show were calculated and differences across the three television shows and between staged (ER) and reality ( BostonMed and Hopkins ) television shows were assessed with chi-square tests. The final data set included 37 episodes, 137 patients and 593 interventions. On ER, providers were significantly more likely to make the decision about the medical intervention without informing the patient when a patient was capable of making a decision compared to BostonMed or Hopkins (ptelevision shows we analyzed. It is possible that what patients see on television influences their expectations surrounding the decision making process and the use of medical interventions in everyday healthcare encounters.

  13. Clinical and biomarker changes in premanifest Huntington disease show trial feasibility: a decade of the PREDICT-HD study

    Directory of Open Access Journals (Sweden)

    Jane S Paulsen

    2014-04-01

    Full Text Available There is growing consensus that intervention and treatment of Huntington disease (HD should occur at the earliest stage possible. Various early-intervention methods for this fatal neurodegenerative disease have been identified, but preventive clinical trials for HD are limited by a lack of knowledge of the natural history of the disease and a dearth of appropriate outcome measures. Objectives of the current study are to document the natural history of premanifest HD progression in the largest cohort ever studied and to develop a battery of imaging and clinical markers of premanifest HD progression that can be used as outcome measures in preventive clinical trials. PREDICT-HD is a 32-site, international, observational study of premanifest HD, with annual examination of 1013 participants with premanifest HD and 301 gene-expansion negative controls between 2001 and 2012. Findings document 39 variables representing imaging, motor, cognitive, functional, and psychiatric domains, showing different rates of decline between premanifest Huntington disease and controls. Required sample size and models of premanifest HD are presented to inform future design of clinical and preclinical research. Preventive clinical trials in premanifest HD with participants who have a medium or high probability of motor onset are calculated to be as resource-effective as those conducted in diagnosed HD and could interrupt disease seven to twelve years earlier. Methods and measures for preventive clinical trials in premanifest HD more than a dozen years from motor onset are also feasible. These findings represent the most thorough documentation of a clinical battery for experimental therapeutics in stages of premanifest HD, the time period for which effective intervention may provide the most positive possible outcome for patients and their families affected by this devastating disease.

  14. Influence of Resistance Training on Neuromuscular Function and Physical Capacity in ALS Patients

    DEFF Research Database (Denmark)

    Jensen, Line; Djurtoft, J.B.; Bech, Rune Dueholm

    2017-01-01

    Objectives. The present study aimed to explore the effect of resistance training in patients with amyotrophic lateral sclerosis (ALS), a disease characterized by progressive motor neuron loss and muscle weakness. Materials and Methods. Following a 12-week “lead-in” control period, a population...... of ALS patients from Funen, Denmark, completed a 12-week resistance training program consisting of 2-3 sessions/week. Neuromuscular function (strength and power) and voluntary muscle activation (superimposed twitch technique) were evaluated before and after both control and training periods. Physical...... capacity tests (chair rise and timed up and go), the revised ALS functional rating scale (ALSFRS-R) scores, and muscle cross sectional area (histology) were also assessed. Results. Of twelve ALS patients assessed for eligibility, six were included and five completed the study. Training did...

  15. Power Doppler ultrasonography of painful Achilles tendons and entheses in patients with and without spondyloarthropathy-a comparison with clinical examination and contrast-enhanced MRI

    DEFF Research Database (Denmark)

    Wiell, Charlotte; Szkudlarek, Marcin; Hasselquist, Maria

    2013-01-01

    The objective of this study was to describe ultrasonography (US) and magnetic resonance imaging (MRI) findings at painful Achilles tendons and entheses in patients with and without spondyloarthropathy (SpA and non-SpA) and healthy control persons (CTRLs). Particularly, we aimed to investigate...... if any changes differentiate SpA from non-SpA. Finally, we investigated the reliability of US compared to clinical examination of Achilles tendinopathy, using MRI as gold standard reference. Twelve SpA patients and 15 non-SpA patients with pain and tenderness at at least one Achilles tendon and...

  16. Effect of repetitive transcranial magnetic stimulation in drug resistant depressed patients

    International Nuclear Information System (INIS)

    Chung, Yong An; Yoo, Ie Ryung; Kang, Bong Joo; Chae, Jeong Ho; Lee, Hye Won; Moon, Hyun Jin; Kim, Sung Hoon; Sohn, Hyung Sun; Chung, Soo Kyo

    2007-01-01

    Repetitive transcranial magnetic stimulation (rTMS) has recently been clinically applied in the treatment of drug resistant depressed patients. There are mixed findings about the efficacy of rTMS on depression. Furthermore, the influence of rTMS on the physiology of the brain is not clear. We prospectively evaluated changes of regional cerebral blood flow (rCBF) between pre- and post-rTMS treatment in patients with drug resistant depression. Twelve patients with drug-resistant depression (7 male, 5 female; age range; 19∼ 52 years; mean age: 29.3 ± 9.3 years) were given rTMS on right prefrontal lobe with low frequency (1 Hz) and on left prefrontal lobe with high frequency (20 Hz), with 20-minute-duration each day for 3 weeks. Tc-99m ECD brain perfusion SPECT was obtained before and after rTMS treatment. The changes of cerebral perfusion were analyzed using statistical parametric mapping (SPM; t=3.14, uncorrected ρ < 0.01, voxel = 100). Following areas showed significant increase in rCBF after 3 weeks rTMS treatment: the cingulate gyrus, fusiform gyrus of right temporal lobe, precuneus, and left lateral globus pallidus. Significant decrement was noted in the precental and middle frontal gyrus of right frontal lobe, and fusiform gyrus of left occipital lobe. Low-frequency rTMS on the right prefrontal cortex and high-frequency rTMS on the left prefrontal cortex for 3 weeks as an add-on regimen have increased and decreased rCBF in the specific brain regions in drug-resistant depressed patients. Further analyses correlating clinical characteristics and treatment paradigm with functional imaging data may be helpful in clarifying the pathophysiology of drug-resistant patients

  17. Effect of repetitive transcranial magnetic stimulation in drug resistant depressed patients

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Yong An; Yoo, Ie Ryung; Kang, Bong Joo; Chae, Jeong Ho; Lee, Hye Won; Moon, Hyun Jin; Kim, Sung Hoon; Sohn, Hyung Sun; Chung, Soo Kyo [The Catholic University of Korea, Seoul (Korea, Republic of)

    2007-02-15

    Repetitive transcranial magnetic stimulation (rTMS) has recently been clinically applied in the treatment of drug resistant depressed patients. There are mixed findings about the efficacy of rTMS on depression. Furthermore, the influence of rTMS on the physiology of the brain is not clear. We prospectively evaluated changes of regional cerebral blood flow (rCBF) between pre- and post-rTMS treatment in patients with drug resistant depression. Twelve patients with drug-resistant depression (7 male, 5 female; age range; 19{approx} 52 years; mean age: 29.3 {+-} 9.3 years) were given rTMS on right prefrontal lobe with low frequency (1 Hz) and on left prefrontal lobe with high frequency (20 Hz), with 20-minute-duration each day for 3 weeks. Tc-99m ECD brain perfusion SPECT was obtained before and after rTMS treatment. The changes of cerebral perfusion were analyzed using statistical parametric mapping (SPM; t=3.14, uncorrected {rho} < 0.01, voxel = 100). Following areas showed significant increase in rCBF after 3 weeks rTMS treatment: the cingulate gyrus, fusiform gyrus of right temporal lobe, precuneus, and left lateral globus pallidus. Significant decrement was noted in the precental and middle frontal gyrus of right frontal lobe, and fusiform gyrus of left occipital lobe. Low-frequency rTMS on the right prefrontal cortex and high-frequency rTMS on the left prefrontal cortex for 3 weeks as an add-on regimen have increased and decreased rCBF in the specific brain regions in drug-resistant depressed patients. Further analyses correlating clinical characteristics and treatment paradigm with functional imaging data may be helpful in clarifying the pathophysiology of drug-resistant patients.

  18. Care package for anxiety disorders: no-show and dropout of standardised, time restricted treatment

    DEFF Research Database (Denmark)

    Tranberg, Hanne; Mortensen, Erik Lykke; Lau, Marianne Engelbrecht

    Background: Psychotherapy has shown to be efficacious but therapy effectiveness in mental health services is compromised by patients who fail to show up for assessment, treatment start and stay in treatment. Predictors for patient non-attendance (no-show and dropout) have been identified as patient...... or therapist characteristics. Organisational variables are sparsely studied although waiting time may affect no-show and dropout. In order to reduce waiting time the Mental Health Services in Denmark have introduced care packages in the treatment of non-psychotic disorders. Care packages are courses...... and if demographic and clinical variables were predictors for no-show and dropout. Methods: The study was a quasi-experimental pre-post study in a naturalistic setting in the Mental Health Services, Capital Region of Denmark. Two samples of patients, aged above 18 years and referred for treatment for anxiety...

  19. A Randomized Controlled Trial of Puncturing and Bloodletting at Twelve Hand Jing Points to Treat Acute Carbon Monoxide Poisoning as Adjunct to First Aid Treatment: A Study Protocol

    Directory of Open Access Journals (Sweden)

    Ying Yue

    2015-01-01

    Full Text Available Background. Acute carbon monoxide poisoning (ACOP is a significant cause of morbidity and mortality in many countries. Twelve Hand Jing Points (THJP have been believed to be effective to treat all kinds of emergency calls in traditional Chinese medicine (TCM for more than 3000 years. This randomized controlled trial (RCT is designed to evaluate the effectiveness of THJP in curing acute carbon monoxide poisoning in first aid treatment. This paper reports the protocol of the trial. Methods/Design. This RCT is a multicenter, randomized, controlled study undergoing in China. The compliant patients are divided into the bloodletting group and standard of care group. With first aid treatments given to both of the groups, the bloodletting group is bleeding at THJP upon being hospitalized. Primary outcomes and secondary outcomes will be measured and compared between these two groups. Before treatment, immediately after treatment, and 30 minutes, 1 hour, and 4 hours after treatment, patients’ basic vital signs and state of consciousness were observed. Before treatment and 1 and 4 hours after treatment, carboxyhemoglobin concentration in venous blood samples was detected. Discussion. The objective of this study is to provide convincing evidence to clarify the efficacy and safety of THJP for early treatment of acute carbon monoxide poisoning.

  20. Energy policies and the adaptations to the new economic framework: The case of twelve countries during the 1973-1983 period

    International Nuclear Information System (INIS)

    Bourgeois, B.; Criqui, P.; Percebois, J.

    1986-10-01

    Based upon case studies on twelve energy importing countries in 1973 (United States, Japan, Federal Republic of Germany, France, United Kingdom, Italy, Brazil, Argentina, Ivory Coast, India, South Korea and Thailand), this paper is an attempt to illustrate the diversity of national energy policies and industrial strategies which have been set up to adjust to the transformation of the world economy in the field of energy and international trade since 1973. Analysing some simple indicators such as the share of oil imports in total energy imports, the rate of national self-reliance for energy and the energy intensity of GDP, we show that the energy policies implemented in industrialised countries lead to quite homogeneous global results, whereas the responses of developing countries as regards oil shocks were more heterogeneous. Some countries have emphasized the decrease in the energy content of GDP whereas others have stressed the development of the national supply or the diversification of energy imports. The consequences of these choices will differ according to the future energy context (if there are sharp cuts in oil prices in particular). In all cases the influence of the socio-political and institutional context on energy options can be clearly observed. In a second part, we study the respective weight of energy and manufactured goods exchanges in the evolution of the balance of trade, using the following indicators: share of the energy and of the manufactured goods balance in total GDP and the ratio of the energy balance to the manufactured goods balance. Then very diverse situations can be observed. However four countries (Japan, FRG, Italy and South Korea) show rather similar features: a large manufactured goods surplus, which far exceeds the energy deficit. In other words some countries have chosen to compensate for their energy vulnerability by an aggressive commercial policy on external markets; on the contrary others have deliberately oriented

  1. Osseous involvement in AIDS patients; Comprometimento osseo no paciente com sindrome da imunodeficiencia adquirida

    Energy Technology Data Exchange (ETDEWEB)

    Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia]|[Universidade Federal, Rio de Janeiro, RJ (Brazil); Pereira, Abercio Arantes [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina

    1995-07-01

    The radiological findings of eight patients with the acquired immunodeficiency syndrome (AIDS) who developed bone lesions were analyzed in conjunction with twelve similar published cases. Our series included three patients with lymphoma, two with bacillary angiomatosis, two with tuberculosis and one with staphylococcal osteomyelitis. All the lesions were lithic regardless of the etiology. Both in our cases and in those previously published bone repair was only seen in cases of bacillary angiomatosis treated with erythromycin. No pathognomonic findings were observed. However, the association of skin and bone lesions in immuno deficient patients should always bring the consideration of bacillary angiomatosis in the differential diagnosis. This is particularly relevant since this a condition amenable to treatment once correctly identified. The radiological findings in the lymphoma and tuberculosis patients have not been described previously. (author). 9 refs., 7 figs., 3 tabs.

  2. Antimicrobial susceptibility testing before first-line treatment for Helicobacter pylori infection in patients with dual or triple antibiotic resistance.

    Science.gov (United States)

    Cosme, Angel; Montes, Milagrosa; Ibarra, Begoña; Tamayo, Esther; Alonso, Horacio; Mendarte, Usua; Lizasoan, Jacobo; Herreros-Villanueva, Marta; Bujanda, Luis

    2017-05-14

    To evaluate the efficacy of antimicrobial susceptibility-guided therapy before first-line treatment for infection in patients with dual or triple antibiotic resistance. A total of 1034 patients infected by Helicobacter pylori ( H. pylori ) during 2013-2014 were tested for antimicrobial susceptibility. 157 of 1034 (15%) patients showed resistance to two (127/1034; 12%) and to three (30/1034; 3%) antibiotics. Sixty-eight patients with dual H. pylori -resistance (clarithromycin, metronidazole or levofloxacin) were treated for 10 d with triple therapies: OAL (omeprazole 20 mg b.i.d., amoxicillin 1 g b.i.d., and levofloxacin 500 mg b.i.d.) 43 cases, OAM (omeprazole 20 mg b.i.d., amoxicillin 1 g b.i.d., and metronidazole 500 mg b.i.d.) 12 cases and OAC (omeprazole 20 mg b.id., amoxicillin 1 g b.i.d., and clarithromycin 500 mg b.i.d.) 13 cases based on the antimicrobial susceptibility testing. Twelve patients showed triple H. pylori -resistance (clarithromycin, metronidazole and levofloxacin) and received for 10 d triple therapy with OAR (omeprazole 20 mg b.id., amoxicillin 1 g b.i.d., and rifabutin 150 mg b.i.d.). Eradication was confirmed by 13C-urea breath test. Adverse effects and compliance were assessed by a questionnaire. Intention-to-treat eradication rates were: OAL (97.6%), OAM (91.6%), OAC (92.3%) and OAR (58.3%). Cure rate was significantly higher in naïve patients treated with OAR-10 compared to patients who had two or three previous treatment failures (83% vs 33%). Adverse events rates for OAL, OAM, OAC and OAR were 22%, 25%, 23% and 17%, respectively, all of them mild-moderate. Antimicrobial susceptibility-guided triple therapies during 10 d for first-line treatment leads to an eradication rate superior to 90% in patients with dual antibiotic H. pylori resistance.

  3. De novo SOX10 Nonsense Mutation in a Patient with Kallmann Syndrome, Deafness, Iris Hypopigmentation, and Hyperthyroidism.

    Science.gov (United States)

    Wang, Fang; Zhao, Shaoli; Xie, Yanhong; Yang, Wenjun; Mo, Zhaohui

    2018-03-01

    Kallmann syndrome (KS) is a clinically and genetically heterogeneous disorder characterized by hypogonadotropic hypogonadism and olfactory dysfunction. Recently, mutations in SOX10, a well-known causative gene of Waardenburg syndrome (WS), have been identified in a few KS patients with additional developmental defects including hearing loss. However, the understanding of SOX10 mutation associates with KS and other clinical consequences remains fragmentary. A 30-year-old Chinese male patient presented with no pubertal sex development when he was at the age of twelve years. Additionally, he showed anosmia, sensory deafness, and blue irises. Last year, he developed clinical symptoms of hyperthyroidism with a fast heartbeat, heat intolerance and weight loss. Blood examinations revealed low levels of FSH, LH, and testosterone. Thyroid function showed high levels of FT3, FT4 and extremely low level of TSH. Molecular analysis detected a de novo (c.565G>T/p.E189X) mutation in SOX10, which has previously been reported in a patient with WS4 (WS with Hirschsprung). The mutation was predicted to be probably damaging. These results highlight the significance of SOX10 haploinsufficiency as a genetic cause of KS. Importantly, our result implies that the same SOX10 mutation can underlie both typical KS and WS, while the correlation between SOX10 and hyperthyroidism still needs to be clarified in the future. © 2018 by the Association of Clinical Scientists, Inc.

  4. Posterior fossa reconstruction using titanium plate for the treatment of cerebellar ptosis after decompression for Chiari malformation.

    Science.gov (United States)

    Udani, Vikram; Holly, Langston T; Chow, Daniel; Batzdorf, Ulrich

    2014-01-01

    We describe our use of a perforated titanium plate to perform a partial posterior fossa cranioplasty in the treatment of cerebellar ptosis and dural ectasia after posterior fossa decompression (PFD). Twelve patients who had undergone PFD underwent posterior fossa reconstruction using a titanium plate. Symptoms were related to either descent of the cerebellum into the decompression or to dural ectasia into the craniectomy defect. Twelve patients who had undergone large suboccipital craniectomies and who presented with persistent headaches and some with neurological symptoms related to syringomyelia, underwent reoperation with placement of a small titanium plate. Ten of 12 patients showed symptomatic improvement after reoperation. Placement of a titanium plate appears to be an effective method of treatment of cerebellar ptosis and dural ectasia after PFD for Chiari malformation. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Physical Stress Echocardiography: Prediction of Mortality and Cardiac Events in Patients with Exercise Test showing Ischemia

    Directory of Open Access Journals (Sweden)

    Ana Carla Pereira de Araujo

    2014-11-01

    Full Text Available Background: Studies have demonstrated the diagnostic accuracy and prognostic value of physical stress echocardiography in coronary artery disease. However, the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia is limited. Objective: To evaluate the effectiveness of physical stress echocardiography in the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia. Methods: This is a retrospective cohort in which 866 consecutive patients with exercise test positive for myocardial ischemia, and who underwent physical stress echocardiography were studied. Patients were divided into two groups: with physical stress echocardiography negative (G1 or positive (G2 for myocardial ischemia. The endpoints analyzed were all-cause mortality and major cardiac events, defined as cardiac death and non-fatal acute myocardial infarction. Results: G2 comprised 205 patients (23.7%. During the mean 85.6 ± 15.0-month follow-up, there were 26 deaths, of which six were cardiac deaths, and 25 non-fatal myocardial infarction cases. The independent predictors of mortality were: age, diabetes mellitus, and positive physical stress echocardiography (hazard ratio: 2.69; 95% confidence interval: 1.20 - 6.01; p = 0.016. The independent predictors of major cardiac events were: age, previous coronary artery disease, positive physical stress echocardiography (hazard ratio: 2.75; 95% confidence interval: 1.15 - 6.53; p = 0.022 and absence of a 10% increase in ejection fraction. All-cause mortality and the incidence of major cardiac events were significantly higher in G2 (p < 0. 001 and p = 0.001, respectively. Conclusion: Physical stress echocardiography provides additional prognostic information in patients with exercise test positive for myocardial ischemia.

  6. Effect of nutritional support on mitochondrial complex I activity in malnourished patients with anorexia nervosa.

    Science.gov (United States)

    De-Mateo-Silleras, Beatriz; Alonso-Torre, Sara R; Redondo-del-Río, Paz; Jeejeebhoy, Khursheed; Miján-de-la-Torre, Alberto

    2013-11-01

    Previous studies have shown a reduction in lymphocyte mitochondrial complex I activity (CIA) in malnourished patients, which is restored after refeeding. Our aim was to evaluate the usefulness of CIA as an indicator of nutritional status in anorexia nervosa patients. Twelve malnourished anorexia nervosa females (mean age, 24.5 years) were admitted to the Eating Disorders Unit. Basal and weekly anthropometrics, bioelectric impedance (BIA), body composition, and CIA were performed until discharge. Patients were matched to 25 healthy females and refeeding was adjusted according to the Unit's protocol. Statistics were used as appropriated and significance was reached at p anorexia nervosa have lower CIA than controls that is not recovered after refeeding. This could be because of a low FFM exacerbated by physical inactivity while in hospital.

  7. Use of information sources by cancer patients: results of a systematic review of the research literature

    Directory of Open Access Journals (Sweden)

    Kalyani Ankem

    2006-01-01

    Full Text Available Objectives. Existing findings on cancer patients' use of information sources were synthesized to 1 rank the most and least used information sources and the most helpful information sources and to 2 find the impact of patient demographics and situations on use of information sources. Method. . To synthesize results found across studies, a systematic review was conducted. Medline and CINAHL were searched to retrieve literature on cancer patients' information source use. The retrieved articles were carefully selected according to predetermined criteria, and several articles were eliminated in a systematic approach. Analysis. The twelve articles that met the criteria were systematically analysed by extracting data from articles and summarizing data for the purpose of synthesis to determine the meaning of findings on most used information sources, least used information sources, most helpful information sources, effect of patient characteristics on preference for an information source, and effect of patient situations on preference for an information source. Results. In descending order of use, health care professionals, medical pamphlets, and family and friends were most used information sources. Internet and support groups were least used. In descending order of helpfulness, books, health care professionals and medical pamphlets were found to be most helpful information sources. Younger patients used health care professionals and certain forms of written information sources more than older patients. Conclusion. . The systematic review shows that many areas of cancer patients' information source use have been either neglected or barely analysed. An in-depth understanding of cancer patients' use of information sources and the characteristics in information sources they consider to be helpful is important for developing successful interventions to better inform patients.

  8. Differentiation of medial or lateral temporal lobe epilepsy by F-18-fluorodeoxyglucose positron emission tomography: comparative study with magnetic resonance imaging in 113 surgically and pathologically proven patients

    International Nuclear Information System (INIS)

    Lee, Dong Soo; Lee, Sang Kun; Chang, Ki Hyun; Chung, Chun Kee; Choi, Ki Young; Chung, June Key; Lee, Myung Chul

    1999-01-01

    As mesial temporal lobe epilepsy (TLE) shows hypometabolism of medial and lateral temporal lobe, we investigated whether symmetric uptake of F-18-FDG in medial temporal lobes can differentiate mesial from lateral TLE. In 113 patients (83 mesial TLE, 30 lateral TLE) who underwent anterior temporal lobectomy and/or corticectomy with good surgical outcome, we performed F-18-FDG PET and compared F-18-FDG uptake of medial and lateral temporal lobes. All the patients with mesial TLE had hippocampal sclerosis except one congenital abnormal hippocampus. Patients with lateral TLE revealed cerebromalacia, microdysgenesis, arteriovenous malformation, old contusion, and cortical dysplasia. Sensitivity of F-18-FDG PET and MR for mesial TLE was 84% (70/83) and 73% (62/83), respectively. Sensitivity of F-18-FDG PET and MR for lateral TLE was 90% (27/30) and 66% (20/30), respectively. Twelve patients were normal on F-18-FDG PET. 101 patients had hypometabolism of lateral temporal lobe. Among 88 patients who showed hypometabolism of medial temporal lobe as well as lateral temporal lobe, 70 were mesial TLE patients and 18 were lateral TLE on pathologic examination. Positive predictive value of medial temporal hypometabolism for mesial TLE was 80%. Among 13 patients who showed hypometabolism of only lateral temporal lobe, 4 were mesial TLE and 9 were lateral TLE. Positive predictive value of hypometabolism of lateral temporal lobe for the diagnosis of lateral TLE was 69% (9/ 13). Normal MR findings stood against medial TLE, whose negative predictive value was 66%. Lateral temporal lobe epilepsy should be suspected when there is decreased F-18-FDG uptake in lateral temporal lobe with normal uptake in medial temporal lobe

  9. Oral Surgical Procedures Performed Safely in Patients With Head and Neck Arteriovenous Malformations: A Retrospective Case Series of 12 Patients.

    Science.gov (United States)

    Karim, Abdul Basit; Lindsey, Sean; Bovino, Brian; Berenstein, Alejandro

    2016-02-01

    This case series describes patients with head and neck arteriovenous malformations who underwent oral and maxillofacial surgical procedures combined with interventional radiology techniques to minimize blood loss. Twelve patients underwent femoral cerebral angiography to visualize the extent of vascular malformation. Before the surgical procedures, surgical sites were devascularized by direct injection of hemostatic or embolic agents. Direct puncture sclerotherapy at the base of surgical sites was performed using Surgiflo or n-butylcyanoacrylate glue. Surgical procedures were carried out in routine fashion. A hemostatic packing of FloSeal, Gelfoam, and Avitene was adapted to the surgical sites. Direct puncture sclerotherapy with Surgiflo or n-butylcyanoacrylate glue resulted in minimal blood loss intraoperatively. Local application of the FloSeal, Gelfoam, and Avitene packing sustained hemostasis and produced excellent healing postoperatively. Patients with arteriovenous malformations can safely undergo routine oral and maxillofacial surgical procedures with minimal blood loss when appropriate endovascular techniques and local hemostatic measures are used by the interventional radiologist and oral and maxillofacial surgeon. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Plasma bile acids show a positive correlation with body mass index and are negatively associated with cognitive restraint of eating in obese patients

    Directory of Open Access Journals (Sweden)

    Philip ePrinz

    2015-06-01

    Full Text Available Bile acids may be involved in the regulation of food intake and energy metabolism. The aim of the study was to investigate the association of plasma bile acids with body mass index (BMI and the possible involvement of circulating bile acids in the modulation of physical activity and eating behavior. Blood was obtained in a group of hospitalized patients with normal weight (BMI 18.5-25 kg/m2, underweight (anorexia nervosa, BMI 50 kg/m2, n=14-15/group and plasma bile acid concentrations assessed. Physical activity and plasma bile acids were measured in a group of patients with anorexia nervosa (BMI 14.6±0.3 kg/m2, n=43. Lastly, in a population of obese patients (BMI 48.5±0.9 kg/m2, n=85, psychometric parameters related to disordered eating and plasma bile acids were assessed. Plasma bile acids showed a positive correlation with BMI (r=0.26, p=0.03 in the population of patients with broad range of BMI (9-85 kg/m2, n=74. No associations were observed between plasma bile acids and different parameters of physical activity in anorexic patients (p>0.05. Plasma bile acids were negatively correlated with cognitive restraint of eating (r=-0.30, p=0.008, while no associations were observed with other psychometric eating behavior-related parameters (p>0.05 in obese patients. In conclusion, these data may point towards a role of bile acids in the regulation of body weight. Since plasma bile acids are negatively correlated with the cognitive restraint of eating in obese patients, this may represent a compensatory adaptation to prevent further overeating.

  11. Sex on show. Issues of privacy and dignity in a Forensic mental health hospital: Nurse and patient views.

    Science.gov (United States)

    Quinn, Chris; Happell, Brenda

    2015-08-01

    To explore perceptions of privacy and dignity for sexual relationships in a Forensic mental health hospital. The role of nurses in forensic mental health hospitals is frequently complicated by opposing expectations of therapeutic relationships and maintaining security. What can result is an over-emphasis on risk reduction by controlling patient behaviour, which can extend to patient intimacy and sexual relationships. An exploratory, qualitative approach. Individual interviews were conducted with 12 nurses and 10 patients in a forensic mental health hospital. Thematic data analysis was undertaken to identify the main themes. The need for a private and dignified place for patient intimacy was one major theme to emerge from this research from both nurse and patient participants and is the focus of this article. A disparity is reported between the level of support reported by nurse participants with the experience of the patient participants. Sexual intimacy and sexual relationships are important components of normal human behaviour. Institutional rules and rule adherence create barriers for patients, forcing their intimacy and sexual relationships into secrecy. There is a need for further research to consider the benefits and risks of patient intimacy and sexual relationships for long-term patients in forensic mental health settings. Patients in forensic hospitals are sexually active and seek support from nurses. Nurses are in an ideal role to recognise the important part they can play in supporting the intimacy and sexual relationship needs of patients. Strategies to assist in developing confidence in responding to normal human behaviour is a matter of priority. © 2015 John Wiley & Sons Ltd.

  12. Twelve-year course and outcome predictors of anorexia nervosa.

    Science.gov (United States)

    Fichter, Manfred M; Quadflieg, Norbert; Hedlund, Susanne

    2006-03-01

    The current study presents the long-term course of anorexia nervosa (AN) over 12 years in a large sample of 103 patients diagnosed according to criteria in the 4th ed. of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Assessments were made at the beginning of therapy, at the end of therapy, at the 2-year follow-up, at the 6-year follow-up, and at the 12-year follow-up. Self-rating and an expert-rating interview data were obtained. The participation rate at the 12-year follow-up was 88% of those alive. There was substantial improvement during therapy, a moderate (in many instances nonsignificant) decline during the first 2 years posttreatment, and further improvement from 3 to 12 years posttreatment. Based on a global 12-year outcome score, 27.5% had a good outcome, 25.3% an intermediate outcome, 39.6% had a poor outcome, and 7 (7.7%) were deceased. At the 12-year follow-up 19.0% had AN, 9.5% had bulimia nervosa-purging type (BN-P), 19.0% were classified as eating disorder not otherwise specified (EDNOS). A total of 52.4% showed no major DSM-IV eating disorder and 0% had binge eating disorder (BED). Systematic-strictly empirically based-model building resulted in a parsimonious model including four predictors of unfavorable 12-year outcome explaining 45% of the variance, that is, sexual problems, impulsivity, long duration of inpatient treatment, and long duration of an eating disorder. Mortality was high and symptomatic recovery protracted. Impulsivity, symptom severity, and chronicity were the important factors for predicting the 12-year outcome.

  13. Clinicopathological features of mycosis fungoides in patients exposed to Agent Orange during the Vietnam War.

    Science.gov (United States)

    Jang, Min Soo; Jang, Jun Gyu; Han, Sang Hwa; Park, Jong Bin; Kang, Dong Young; Kim, Sang Tae; Suh, Kee Suck

    2013-08-01

    There are no reports on the clinicopathological features of mycosis fungoides (MF) among veterans exposed to Agent Orange, one of the herbicides used during the Vietnam War. To evaluate the clinical, histopathological and genotypic findings of Vietnam War veterans with MF and a positive history of exposure to Agent Orange, we performed a comparative clinicopathological study between MF patients with a history of Agent Orange exposure and those without a history of Agent Orange exposure. Twelve Vietnam War veterans with MF were identified. The mean interval from Agent Orange exposure to diagnosis was 24.5 years (range, 9-35). Skin lesions were significantly present on exposed and unexposed areas. Most patients (75%) experienced pruritus (mean visual analog scale score of 6.7). MF was manifested by plaques in 10 patients and by lichenification in five. Histopathological features of most cases were consistent with MF. Biopsy specimens also demonstrated irregular acanthosis (66.7%). In the comparative study, MF patients with a history of Agent Orange exposure differed significantly from those without exposure to Agent Orange in demographic and clinical characteristics. In addition, patients with exposure had an increased tendency for lesions in the exposed area. Notably, our patients showed a higher frequency (33.3%) of mycosis fungoides palmaris et plantaris than in previous studies. Histologically, irregular acanthosis was more frequently observed than ordinary MF. Our results indicate that dermatologists should pay close attention to these clinicopathological differences. Careful assessment of history of exposure to defoliants is warranted in some cases suspicious for MF. © 2013 Japanese Dermatological Association.

  14. Study protocol: to investigate effects of highly specialized rehabilitation for patients with multiple sclerosis. A randomized controlled trial of a personalized, multidisciplinary intervention

    Directory of Open Access Journals (Sweden)

    Sørensen Jan

    2012-09-01

    Full Text Available Abstract Background Multiple sclerosis (MS is a complex, chronic and progressive disease and rehabilitation services can provide important support to patients. Few MS rehabilitation programs have been shown to provide health improvements to patients in a cost-effective manner. The objective of this study is to assess the effects in terms of changes measured by a variety of standardized quality of life, mastery, coping, compliance and individual goal-related endpoints. This combination provides the basis for analyzing the complexity of MS and outcomes of a personalized rehabilitation. Methods/Design Patients with MS referred to hospital rehabilitation services will be randomized to either early admission (within two months or usual admission (after an average waiting time of eight months. They will complete a battery of standardized health outcome instruments prior to randomization, and again six and twelve months after randomization, and a battery of goal-related outcome measures at admission and discharge, and again one, six and twelve months after randomization. Discussion The results of the study are expected to contribute to further development of MS rehabilitation services and to discussions about the design and content of such services. The results will also provide additional information to health authorities responsible for providing and financing rehabilitation services. Trial registration Current Controlled Trials (ISRCTN05245917

  15. How patients with gout become engaged in disease management: a constructivist grounded theory study.

    Science.gov (United States)

    Howren, Alyssa; Cox, Susan M; Shojania, Kam; Rai, Sharan K; Choi, Hyon K; De Vera, Mary A

    2018-06-01

    Prior qualitative research on gout has focused primarily on barriers to disease management. Our objective was to use patients' perspectives to construct an explanatory framework to understand how patients become engaged in the management of their gout. We recruited a sample of individuals with gout who were participating in a proof-of-concept study of an eHealth-supported collaborative care model for gout involving rheumatology, pharmacy, and dietetics. Semistructured interviews were used. We analyzed transcripts using principles of constructivist grounded theory involving initial coding, focused coding and categorizing, and theoretical coding. Twelve participants with gout (ten males, two females; mean age, 66.5 ± 13.3 years) were interviewed. The analysis resulted in the construction of three themes as well as a framework describing the dynamically linked themes on (1) processing the diagnosis and management of gout, (2) supporting management of gout, and (3) interfering with management of gout. In this framework, patients with gout transition between each theme in the process of becoming engaged in the management of their gout and may represent potential opportunities for healthcare intervention. Findings derived from this study show that becoming engaged in gout management is a dynamic process whereby patients with gout experience factors that interfere with gout management, process their disease and its management, and develop the practical and perceptual skills necessary to manage their gout. By understanding this process, healthcare providers can identify points to adapt care delivery and thereby improve health outcomes.

  16. Prolonged Tp-e Interval in Down Syndrome Patients with Congenitally Normal Hearts.

    Science.gov (United States)

    Kucuk, Mehmet; Karadeniz, Cem; Ozdemir, Rahmi; Meşe, Timur

    2018-03-25

    Heterogeneity of ventricular repolarization has been assessed by using the QT dispersion in Down syndrome (DS) patients with congenitally normal hearts. However, novel repolarization indexes, the Tp-e interval and Tp-e/QT ratio, have not previously been evaluated in these patients. The aim of this study was to evaluate the Tp-e interval and Tp-e/QT ratio in DS patients without congenital heart defects. Twelve-lead surface electrocardiograms of 160 DS patients and 110 age- and sex-matched healthy controls were used to evaluate and compare the Tp-e interval, Tp-e dispersion, and Tp-e/QT ratio. Heart rate, Tp-e interval, Tp-e dispersion, Tp-e/QT and Tp-e/QTc ratios were significantly higher in DS group than in the controls. Myocardial repolarization indexes in DS patients with congenitally normal hearts were found to be prolonged compared to those in normal controls. Further evaluation is warranted to reveal a relationship between prolonged repolarization indexes and arrhythmic events in these patients. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  17. Corrections of lower limb deformities in patients with diastrophic dysplasia.

    Science.gov (United States)

    Al Kaissi, Ali; Kenis, Vladimir; Melchenko, Eugeniy; Chehida, Farid Ben; Ganger, Rudolf; Klaushofer, Klaus; Grill, Franz

    2014-11-01

    Accurate understanding of the cause of the underlying pathology in children with diastrophic dysplasia would help in designing targeted management of their locomotion. Diastrophic dysplasia was diagnosed in twelve patients (nine girls and three boys; age range 1-14 years), all of whom presented with small stature and apparent short extremities. Club foot (mostly talipes equinovarus) was the most frequent and consistent abnormality. Concomitant abnormalities such as hip flexion contracture, flexion contractures of the knees with excessive valgus deformity and lateral patellar subluxation, were also encountered. Muscle ultrasound and muscle magnetic resonance imaging imaging showed no myopathic changes and muscle biopsies and the respiratory chain were normal. Serum choline kinase and plasma lactate concentrations were normal. Surgical correction of the foot and ankle in patients with diastrophic dysplasia is extremely difficult because of the markedly distorted anatomy. In all of these children, plantigrade foot was achieved along with the improved function of the locomotor system. Mutations of the diastrophic dysplasia sulfate transporter (also known as solute carrier family 26 member 2) were encountered. Arthrogryposis multiplex is the usual terminology used to describe the abnormality in infants with multiple contractures. Diligent orthopaedic care should be provided based on an accurate understanding of the associated syndromes in such children. © 2014 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.

  18. Intra-articular gouty tophi of the knee: CT and MR imaging in 12 patients

    International Nuclear Information System (INIS)

    Chen, C.K.H.; Yeh Lee Ren; Pan Huay-Ben; Yang Chien-Fang; National Yang-Ming Univ., Taipei; Lu Yih-Chau; Wang Jyh-Seng; Resnick, D.; California Univ., Los Angeles, CA

    1999-01-01

    Objective. To define the imaging characteristics of intra-articular tophi of the knee. Design and patients. Twelve patients with intra-articular tophi in the knee were studied with routine MR imaging, gadolinium (Gd)-enhanced MR imaging, and CT over a 4-year period. There were 11 men and one woman, 25-82 years of age (mean age 48 years). Four patients did not have a documented history of gout at the time of the MR examination. The diagnosis of intra-articular tophi was provided by arthroscopy and histological examination (5 patients), by microscopic study of joint fluid (5 patients), or by characteristic clinical, laboratory and imaging findings (2 patients). Results. In 15 MR examinations the tophi were located purely intra-articularly in 10 knees. In the remaining five MR studies, periarticular soft tissues or bone, or both, were involved. All the intra-articular tophi manifested low to intermediate signal intensity on both T1- and T2-weighted images. All five Gd-enhanced MR examinations demonstrated a heterogeneous peripheral enhancement. All 10 CT scans showed varying degrees of stippled calcifications within the tophi. The nature of the calcifications was confirmed on histological examination in three patients. Conclusion. Presenting clinical manifestations of gout may relate to intra-articular tophaceous deposits. Such deposits present as masses on MR images with low to intermediate signal intensity on both T1- and T2-weighted images and a characteristic enhancement pattern following intravenous Gd administration. These features relate primarily to internal calcifications, which are most evident on CT images. MR evaluation (including Gd administration) supplemented, in some cases, with CT scanning allows accurate diagnosis of intra-articular tophaceous deposits. (orig.)

  19. Cerebral perfusion imaging in HIV positive patients

    International Nuclear Information System (INIS)

    Kundley, Kshama; Chowdhury, D.; Lele, V.R.; Lele, R.D.

    1998-01-01

    Full text: Twelve human immunodeficiency virus (HIV) positive patients were studied by SPECT cerebral perfusion imaging 1 hour post injection of 15 mCi of 99m Tc-ECD under ideal conditions with a triple head gamma camera (Prism 3000 X P LEUHR), fanbeam collimators followed by Folstein Mini Mental Status Examination (FMMSE) and AIDS dementia complex (ADC) staging on the same day. All 12 patients were male, in the age range of 23-45 y (mean 31 y). The infected status was diagnosed by ELISA (10 patients) or Western blot (5 patients). The interval between diagnosis and imaging ranged from 1 month - 35 months (mean 15.3 months). Two patients were alcoholic and 2 were smokers. None of them had CNS disorder clinically. ADC staging and FMMSE could be performed in 4 patients. Two patients were normal (stage 0) and 2 were subclinical (stage 0.5) on ADC staging. FMMSE revealed normal or near normal status (mean score 35; maximum score 36). Cerebral perfusion images were interpreted simultaneously by 3 observers blind towards history and examination using semi-quantitative and quantitative methods by consensus. It revealed multiple areas of hypoperfusion, viz. temporal (11 patients (91 %), parietal 10 patients (83%), frontal 9 patients (75%, pre and post central gyrus 7 patients (58%), occipital 6 patients (50%) cingulate gyrus and cerebellum 5 patients (41%) and thalamic in 2 patients (16%). Hyper perfusion in caudate nuclei was noted in 10 patients (83%). The study reveals presence of multiple perfusion abnormalities on cerebral perfusion imaging in HIV positive patients who have normal/near normal mental status suggesting precedence of perfusion abnormality over clinically apparent mental deficit

  20. One digit interruption: the altered force patterns during functionally cylindrical grasping tasks in patients with trigger digits.

    Directory of Open Access Journals (Sweden)

    Po-Tsun Chen

    Full Text Available Most trigger digit (TD patients complain that they have problems using their hand in daily or occupational tasks due to single or multiple digits being affected. Unfortunately, clinicians do not know much about how this disease affects the subtle force coordination among digits during manipulation. Thus, this study examined the differences in force patterns during cylindrical grasp between TD and healthy subjects. Forty-two TD patients with single digit involvement were included and sorted into four groups based on the involved digits, including thumb, index, middle and ring fingers. Twelve healthy subjects volunteered as healthy controls. Two testing tasks, holding and drinking, were performed by natural grasping with minimal forces. The relations between the force of the thumb and each finger were examined by Pearson correlation coefficients. The force amount and contribution of each digit were compared between healthy controls and each TD group by the independent t test. The results showed all TD groups demonstrated altered correlation patterns of the thumb relative to each finger. Larger forces and higher contributions of the index finger were found during holding by patients with index finger involved, and also during drinking by patients with affected thumb and with affected middle finger. Although no triggering symptom occurred during grasping, the patients showed altered force patterns which may be related to the role of the affected digit in natural grasping function. In conclusion, even if only one digit was affected, the subtle force coordination of all the digits was altered during simple tasks among the TD patients. This study provides the information for the future studies to further comprehend the possible injuries secondary to the altered finger coordination and also to adopt suitable treatment strategies.

  1. One digit interruption: the altered force patterns during functionally cylindrical grasping tasks in patients with trigger digits.

    Science.gov (United States)

    Chen, Po-Tsun; Lin, Chien-Ju; Jou, I-Ming; Chieh, Hsiao-Feng; Su, Fong-Chin; Kuo, Li-Chieh

    2013-01-01

    Most trigger digit (TD) patients complain that they have problems using their hand in daily or occupational tasks due to single or multiple digits being affected. Unfortunately, clinicians do not know much about how this disease affects the subtle force coordination among digits during manipulation. Thus, this study examined the differences in force patterns during cylindrical grasp between TD and healthy subjects. Forty-two TD patients with single digit involvement were included and sorted into four groups based on the involved digits, including thumb, index, middle and ring fingers. Twelve healthy subjects volunteered as healthy controls. Two testing tasks, holding and drinking, were performed by natural grasping with minimal forces. The relations between the force of the thumb and each finger were examined by Pearson correlation coefficients. The force amount and contribution of each digit were compared between healthy controls and each TD group by the independent t test. The results showed all TD groups demonstrated altered correlation patterns of the thumb relative to each finger. Larger forces and higher contributions of the index finger were found during holding by patients with index finger involved, and also during drinking by patients with affected thumb and with affected middle finger. Although no triggering symptom occurred during grasping, the patients showed altered force patterns which may be related to the role of the affected digit in natural grasping function. In conclusion, even if only one digit was affected, the subtle force coordination of all the digits was altered during simple tasks among the TD patients. This study provides the information for the future studies to further comprehend the possible injuries secondary to the altered finger coordination and also to adopt suitable treatment strategies.

  2. Azithromycin add-on therapy in high-risk postendoscopic sinus surgery patients failing corticosteroid irrigations: A clinical practice audit.

    Science.gov (United States)

    Maniakas, Anastasios; Desrosiers, Martin

    2014-01-01

    Chronic rhinosinusitis (CRS) has a high potential for recurrence after endoscopic sinus surgery (ESS), despite a postoperative therapy of topical corticosteroid irrigations. Azithromycin (AZI) is a macrolide antibiotic with anti-inflammatory properties that may be of benefit in such steroid-unresponsive patients. Follow-up study was performed to (1) review the effectiveness of the management strategy of adding AZI in high-risk post-ESS patients failing standard management and (2) identify predict