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Sample records for twenty-five patients aged

  1. Radiation curing - twenty five years on

    International Nuclear Information System (INIS)

    Garnett, J.L.

    1995-01-01

    Progress in UV/EB curing during the past twenty five years is briefly reviewed. During this time developments in unique polymer chemistry, novel equipment design and the introduction of relevant educational programmes has enabled radiation curing to become an established technology with specific strengths in certain industries. Possible reasons for the emergence of the technology in these niche markets are discussed. Despite the worldwide recession, radiation curing is shown to be expanding at 5% per annum with the prospect of higher growth with improving economic conditions. (Author)

  2. Twenty-five years of simulator training

    International Nuclear Information System (INIS)

    Anon.

    2002-01-01

    The first training simulator for nuclear power plant personnel in Germany was commissioned twenty-five years ago. The strategy of training by simulators was developed and pursued consistently and continuously in order to ensure sound training of nuclear power plant personnel. The present thirteen simulators cover a broad range of plants. A systematic training concept also helps to ensure a high level of competence and permanent qualification of plant personnel. The anniversary was marked by a festive event at which Erich K. Steiner read a paper on 'The Importance of Simulator Training', and Professor Dr. Adolf Birkhofer spoke about 'Nuclear Technology Education and Training'. (orig.)

  3. Treatment and retreatment with omalizumab in chronic spontaneous urticaria: Real life experience with twenty-five patients.

    Science.gov (United States)

    Türk, Murat; Yılmaz, İnsu; Bahçecioğlu, Sakine Nazik

    2018-01-01

    Previous data have shown the high efficacy of omalizumab in chronic spontaneous urticaria (CSU). However, factors that may be effective on the response to therapy, relapse rates after drug discontinuation, and efficacy of retreatment remain unclear. This study aimed to determine the efficacy of omalizumab in CSU refractory to conventional therapy, to identify possible factors affecting treatment response and relapse, and also to evaluate the efficacy of retreatment on relapsed disease. The data of CSU patients treated with 300 mg/month omalizumab for at least 3 months were retrospectively analyzed. In order to evaluate the efficacy of treatment and retreatment, baseline and follow-up concomitant medication score (CMS) and urticaria activity score (UAS) were calculated. Possible factors affecting treatment response and relapse were identified. Twenty-five patients were included. The median duration of omalizumab therapy was 6 (6-12) months. Of the patients with baseline UAS 6 (5.5-6) and CMS 13 (10-15), 8 (32%) had complete response (UAS = 0) and 2 (8%) were non-responders after 3 months of therapy. None of the complete responders were positive for IgG-anti-TPO. After discontinuation of omalizumab therapy, 11 (61%) patients experienced relapse and 10 of them received retreatment with omalizumab. Half of the patients had complete response, and half had partial response (UAS = 1-4) after retreatment. No treatment related adverse events were documented. Omalizumab has high efficacy in both the treatment and retreatment of CSU; however, relapse rates after discontinuation are high. Autoimmune markers may be helpful in predicting treatment response and relapse. Copyright © 2017 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

  4. Twenty five years of fundamental theory

    International Nuclear Information System (INIS)

    Bell, J.S.

    1980-01-01

    In reviewing the last twenty five years in fundamental physics theory it is stated that there has been no revolution in this field. In the absence of gravitation, Lorentz invariance remains a requirement on fundamental laws. Einstein's theory of gravitation inspires increasing conviction on the astronomical scale. Quantum theory remains the framework for all serious effort in microphysics, and quantum electrodynamics remains the model of a fully articulated microphysical theory, completely successful in its domain. However,a number of ideas have appeared, of great theoretical interest and some phenomenological success, which may well contribute to the next decisive step. Recent work on the following topics is mentioned; gravitational radiation, singularites, black body radiation from black holes, gauge and hidden symmetry in quantum electrodynamics, the renormalization of electromagnetic and weak interaction theory, non-Abelian gauge theories, magnetic monopoles as the most striking example of solitons, and supersymmetry. (UK)

  5. Twenty five years of clusters -- from Bochum to Strasbourg

    International Nuclear Information System (INIS)

    Betts, R.R.; Chicago Univ., IL

    1994-01-01

    Developments in the area of clustering aspects of nuclear structure and reactions over the past twenty-five years are reviewed. The viewpoint is that the nucleus is an assembly of clusters. The question is whether clusters actually exist in the nucleus. Although there is abundant evidence for this in light nuclei, the situation for more complex clusters in heavier nuclei is much worse. Differential cross sections for scattering of alpha particles and heavy ions are shown

  6. After Twenty-Five Years: A Twenty-Five Year Follow-up Study of Middlesex County Vocational and Technical High School Graduates of the Class of June 1953.

    Science.gov (United States)

    Rogers, William; Zanzalari, J. Henry

    A twenty-five-year follow-up study was conducted to determine the occupational, educational, marital and armed forces experiences of the graduating class of 1953 from the Middlesex County Vocational and Technical high schools located in New Brunswick, Perth, Amboy, and Woodbridge, New Jersey. Data, in the form of questionnaire responses, were…

  7. Osteonecrosis in patients with malignant lymphoma: a review of twenty-five cases

    International Nuclear Information System (INIS)

    Engel, I.A.; Straus, D.J.; Lacher, M.; Lane, J.; Smith, J.

    1981-01-01

    A retrospective study of 25 patients with malignant lymphoma who had osteonecrosis of either the femoral or humeral head(s) was undertaken. The common factor present among all patients was the administration of intermittent steroid-containing combination chemotherapy. Seventeen Hodgkin's disease patients received chemotherapy predominantly consisting of an alkylating agent, vincristine, procarbazine, and moderate amounts of prednisone. The non-Hodgkin's lymphoma patients were on various moderate dosage steroid-containing protocols, except three who received prolonged high-dose steroid-containing chemotherapy regimens. Sixteen of the 17 Hodgkin's disease patients and five of the eight non-Hodgkin's lymphoma patients received radiotherapy to the bones that subsequently developed osteonecrosis. Two of the three non-Hodgkin's lymphoma patients who were not irradiated were treated with high-dose steroid-containing chemotherapy regimens. Symptoms developed in patients 12 months to 32 months after completion of chemotherapy and radiotherapy, respectively. Osteonecrosis was a long-term complication of treatment between 1970 and 1979 and occurred in 1.6% of the Hodgkin's disease and 0.12% of the non-Hodgkin's lymphoma patients treated. The authors conclude that the patients at highest risk for this complication are those who receive both radiotherapy to the affected bone(s) and intermittent steroid-containing multiple drug chemotherapy

  8. Twenty-five-year experience with the Björk-Shiley convexoconcave heart valve: a continuing clinical concern.

    Science.gov (United States)

    Blot, William J; Ibrahim, Michel A; Ivey, Tom D; Acheson, Donald E; Brookmeyer, Ron; Weyman, Arthur; Defauw, Joseph; Smith, J Kermit; Harrison, Donald

    2005-05-31

    The first Björk-Shiley convexoconcave (BSCC) prosthetic heart valves were implanted in 1978. The 25th anniversary provided a stimulus to summarize the research data relevant to BSCC valve fracture, patient management, and current clinical options. Published and unpublished data on the risks of BSCC valve fracture and replacement were compiled, and strategies for identifying candidates for prophylactic valve reoperation were summarized. By December 2003, outlet strut fractures (OSFs), often with fatal outcomes, had been reported in 633 BSCC valves (0.7% of 86,000 valves implanted). Fractures still continue to occur, but average rates of OSFs in 60 degrees valves are now valve characteristics, especially valve angle and size, with weaker effects associated with other manufacturing variables. OSF risks are mildly lower among women than men but decline sharply with advancing age. The risks of valve replacement typically greatly exceed those of OSF. By comparing individualized estimated risks of OSF versus valve replacement, guidelines have been developed to identify the small percentage of BSCC patients (mostly younger men) who would be expected to have a gain in life expectancy should reoperative surgery be performed. Twenty-five years after the initial BSCC valve implants, fractures continue to occur. Continued monitoring of BSCC patients is needed to track and quantify risks and enable periodic updating of guidelines for patients and their physicians.

  9. Twenty-five years of post-Bretton Woods experience: some lessons

    Directory of Open Access Journals (Sweden)

    H. ASKARI

    1999-03-01

    Full Text Available In 1971 many academic economists were predicting that the Bretton Woods system of fixed parities would collapse. Some, most notably Milton Friedman, became excited about the possibility of a floating system because the benefits of international capital mobility can only be achieved through the flexibility in the exchange rate. These economists argued that a floating exchange rate system can ensure positive results more than the fixed parities system. Twenty-five years later, however, there is still no consensus on the matter. The author reviews the post-Bretton Woods experience to highlight some policies and approaches that might be helpful for the future.

  10. Five-year follow-up of low-level laser therapy (LLLT) in patients with age-related macular degeneration (AMD)

    Science.gov (United States)

    Koev, K.; Avramov, L.; Borissova, E.

    2018-03-01

    The objective of this study was to examine long-term effects of low-level laser therapy (LLLT) in patients with age-related macular degeneration (AMD). The research was implemented for a period of five years. For LLLT, a He-Ne Laser with continuous emission at 633 nm (0.1 mW/cm2) was used in patients with AMD of all stages (dry to wet exudative forms were included). In total, 33 patients (16 men and 17 women – 66 eyes) with AMD of various stages and a mean age of 68.7 ± 4.2 years were included in the study. Progressive, exudative AMD was diagnosed in 8 eyes. 58 eyes had drusen or were depigmented. Laser radiation was applied transpupillary to the macula for six times for three minutes once in two days; 22 patients with AMD (44 eyes) were randomly selected to receive mock treatment (control group 10 men and 12 women with a mean age of 69.3 ± 4.8 years). The visual acuity was followed for a five-year period. The perimetry and Amsler test were used to screen central scotomas. The fluorescein angiography of AMD and the control groups was examined. The visual acuity remained unchanged in all patients in the control group. There was a statistically significant increase in the visual acuity (p<0.001, end of study versus baseline) for AMD patients for the period of five years after the treatment. The edema and hemorrhage in the patients with progressive, exudative AMD significantly decreased. No side effects were observed during the therapy. The prevalence of metamorphopsia, scotoma in AMD group was reduced. In conclusion, this study shows that LLLT may be a novel long-lasting therapeutic option for both forms of AMD. It is a highly-effective treatment that results in a long-term improvement of the visual acuity.

  11. The covered distance for twenty five years of the Manche waste storage 1969 - 1994

    International Nuclear Information System (INIS)

    Gourden, J.M.

    2001-01-01

    The twenty five years of the Manche plant,are narrated with the difficulties of the beginning, the problems coming from leaks or runoff that have led to improvement in the knowledge of radioactive waste behaviour and the solutions that have been brought. It is from the building of the plant until the radioactive waste management that is related in this book. (N.C.)

  12. A five-patient satisfaction pilot study of calcium hydroxylapatite injection for treatment of aging hands.

    Science.gov (United States)

    Marmur, Ellen S; Al Quran, Hanadi; De Sa Earp, Ana Paula; Yoo, Jane Y

    2009-12-01

    The process of skin aging is not limited to the face but involves every part of the body, including the hands. A common manifestation of aging of the hands is the loss of volume, which occurs as the skin loses its subcutaneous fat. Injectable dermal fillers have surfaced as a popular method to address such deficiencies. To report the use of calcium hydroxylapatite (CaHA) to address lost volume. Five female subjects with soft tissue deficiency of the dorsa of the hands were enrolled at Mount Sinai Medical Center. A solution of CaHA with 2% lidocaine in amounts of 0.3 to 1.0 mL was injected interdigitally at each of three to five insertion sites; the sites were massaged and molded up to three times to ensure an optimal cosmetic end point. Subjects were seen for a follow-up visit after 1, 4, 16, and 24 weeks. With a single injection, all subjects reached their correction goals without requiring any touch-ups. At the 24-week visit, the subjects retained the filling effect, with no adverse events and high patient satisfaction. CaHA, a new, easily injectable, safe dermal filler, has emerged as an excellent option for soft tissue augmentation in aging hands.

  13. Twenty-Five Years of Gene Therapy for ADA-SCID: From Bubble Babies to an Approved Drug.

    Science.gov (United States)

    Ferrua, Francesca; Aiuti, Alessandro

    2017-11-01

    Twenty-five years have passed since first attempts of gene therapy (GT) in children affected by severe combined immunodeficiency (SCID) due to adenosine deaminase (ADA) defect, also known by the general public as bubble babies. ADA-SCID is fatal early in life if untreated. Unconditioned hematopoietic stem cell (HSC) transplant from matched sibling donor represents a curative treatment but is available for few patients. Enzyme replacement therapy can be life-saving, but its chronic use has many drawbacks. This review summarizes the history of ADA-SCID GT over the last 25 years, starting from first pioneering studies in the early 1990s using gamma-retroviral vectors, based on multiple infusions of genetically corrected autologous peripheral blood lymphocytes. HSC represented the ideal target for gene correction to guarantee production of engineered multi-lineage progeny, but it required a decade to achieve therapeutic benefit with this approach. Introduction of low-intensity conditioning represented a crucial step in achieving stable gene-corrected HSC engraftment and therapeutic levels of ADA-expressing cells. Recent clinical trials demonstrated that gamma-retroviral GT for ADA-SCID has a favorable safety profile and is effective in restoring normal purine metabolism and immune functions in patients >13 years after treatment. No abnormal clonal proliferation or leukemia development have been observed in >40 patients treated experimentally in five different centers worldwide. In 2016, the medicinal product Strimvelis™ received marketing approval in Europe for patients affected by ADA-SCID without a suitable human leukocyte antigen-matched related donor. Positive safety and efficacy results have been obtained in GT clinical trials using lentiviral vectors encoding ADA. The results obtained in last 25 years in ADA-SCID GT development fundamentally contributed to improve patients' prognosis, together with earlier diagnosis thanks to newborn screening. These advances

  14. Normal Health-Related Quality of Life and Ability to Work Twenty-nine Years After in Situ Arthrodesis for High-Grade Isthmic Spondylolisthesis.

    Science.gov (United States)

    Joelson, Anders; Hedlund, Rune; Frennered, Karin

    2014-06-18

    The purpose of this mixed prospective and retrospective case series was to evaluate the long-term health-related quality of life and physical disability after in situ arthrodesis for high-grade isthmic spondylolisthesis. Thirty-five of forty consecutive patients who had in situ spinal arthrodesis for high-grade isthmic spondylolisthesis at a mean age of fifteen years (range, nine to twenty-five years) completed validated questionnaires (Short Form-36 [SF-36], EuroQol-5 Dimensions [EQ-5D], Zung depression scale, Oswestry disability index [ODI], Million score, and back and leg pain visual analog scale [VAS]) and underwent physical examination twenty-nine years (range, twenty-three to thirty-five years) after surgery. The mean age at the time of follow-up was forty-three years (range, thirty-seven to fifty-one years). In the absence of a formal control group, the scores on the SF-36 and EQ-5D were compared with Swedish normative data. The proportion of patients at work was compared with an age-matched control group derived from official statistics of Sweden. The Million score at the long-term follow-up was compared with the corresponding results at the mid-term follow-up of the same patients at a mean age of twenty-two years. The scores on the SF-36 and EQ-5D were similar to the scores of the general Swedish population. The mean Zung depression scale score was 30 (range, 20 to 52), the mean ODI score was 10 (range, 0 to 34), the mean back pain VAS score was 13 (range, 0 to 72), and the mean leg pain VAS score was 9 (range, 0 to 60). The Million score averaged 28 (range, 0 to 109) and was slightly worsened compared with the score of 19 (range, 0 to 94) at the mid-term follow-up (p = 0.034). The proportion of patients at work was the same as that for the age-matched general Swedish population. Our study shows good outcomes in health-related quality of life, disability, pain, and ability to work at up to twenty-nine years after in situ lumbar spine arthrodesis for high

  15. Molecular mechanisms of fluoroquinolone resistance in Pseudomonas aeruginosa isolates from cystic fibrosis patients

    DEFF Research Database (Denmark)

    Jalal, S; Ciofu, O; Høiby, Niels

    2000-01-01

    Twenty P. aeruginosa isolates were collected from six cystic fibrosis (CF) patients, aged 27 to 33, in 1994 (9 isolates) and 1997 (11 isolates) at the CF Center, Copenhagen, Denmark, and were typed by pulse-field gel electrophoresis (PFGE) or ribotyping. Five of the patients had isolates with the......Twenty P. aeruginosa isolates were collected from six cystic fibrosis (CF) patients, aged 27 to 33, in 1994 (9 isolates) and 1997 (11 isolates) at the CF Center, Copenhagen, Denmark, and were typed by pulse-field gel electrophoresis (PFGE) or ribotyping. Five of the patients had isolates...

  16. The twenty-five maiden ladies' tomb and predicaments of the feminist movement in Taiwan

    OpenAIRE

    Lee, Anru; Tang, Wen-hui Anna

    2010-01-01

    “The Twenty-five Maiden Ladies’ Tomb” is the collective burial site of the female workers who died in a ferry accident on their way to work in 1973. The fact that of the more than 70 passengers on board all 25 who died were unmarried young women, and the taboo in Taiwanese culture that shuns unmarried female ghosts, made the Tomb a fearsome place. Feminists in Gaoxiong (高雄) had for some years wanted the city government to change the tomb’s public image....

  17. [Psychiatric disturbances in five patients with MELAS syndrome].

    Science.gov (United States)

    Magner, Martin; Honzik, Tomas; Tesarova, Marketa; Dvorakova, Veronika; Hansiková, Hana; Raboch, Jiři; Zeman, Jiři

    2014-01-01

    Mitochondrial disorders of energetic metabolism (MD) represent a heterogeneous group of diseases manifesting at any age with a broad spectrum of clinical symptoms, including psychiatric disorders. The aim of the study was to characterize psychiatric symptoms and diagnoses in five patients with MELAS syndrome between the ages of 17 and 53 years. Four of MELAS patients them harbored the prevalent mitochondrial DNA (mtDNA) mutation 3243A>G, and one patient had the mtDNA mutation 12706T>C. Three patients had positive family histories for MELAS syndrome. In one patient, depression was diagnosedas the first symptom ofMELAS syndrome. Depression also preceded a stroke-like episode in one patient. Four patients had disturbed cognitive functions, confusional states occurred in three patients. One patient manifested psychotic (schizophrenia-like) symptoms. Mitochondrial disorders deserve consideration as part of the differential diagnosis, especially, if there is suspected involvement of other organ groups or positive family history of MD.

  18. Computed tomographic study of aged schizophrenic patients

    International Nuclear Information System (INIS)

    Seno, Haruo; Fujimoto, Akihiko; Ishino, Hiroshi; Shibata, Masahiro; Kuroda, Hiroyuki; Kanno, Hiroshi.

    1997-01-01

    The width of interhemispheric fissure, lateral ventricles and third ventricle were measured using cranial computed tomography (CT; linear method) in 45 elderly inpatients with chronic schizophrenia and in 28 age-matched control subjects. Twenty-three patients were men and 22 were women. In addition, Mini-Mental State Examination, Brief Psychiatric Rating Scale (BPRS) and a subclass of BPRS were undertaken in all patients. There is a significant enlargement of the maximum width of the interhemispheric fissure (in both male and female) and a significant enlargement of ventricular system (more severe in men than in women) in aged schizophrenics, as seen with CT, compared with normal controls. These findings are consistent with previous studies of non-aged schizophrenic patients. Based upon the relation between psychiatric symptoms and CT findings, the most striking is a significant negative correlation between the third ventricle enlargement and the positive and depressive symptoms in all patients. This result suggests that the advanced third ventricle enlargement may decrease these symptoms in aged schizophrenics. (author)

  19. Does the Age of Donor Kidneys Affect Nocturnal Polyuria in Patients With Successful Real Transplantation?

    Science.gov (United States)

    Mitsui, T; Morita, K; Iwami, D; Kitta, T; Kanno, Y; Moriya, K; Takeda, M; Shinohara, N

    We investigated whether the age of donor kidneys influences the incidence of nocturnal polyuria in patients with successful renal transplantation (RTX). Eighty-five patients (45 men and 40 women) undergoing RTX (median age, 47 years) were included in this study. Twenty-four-hour bladder diaries were kept for 3 days, and nocturnal polyuria was defined as a nocturnal polyuria index (nocturnal urine volume/24-hour urine volume) of >0.33. Risk factors for nocturnal polyuria were analyzed in patients with RTX by means of the Mann-Whitney U test, χ 2 test, and a logistic regression analysis. End-stage renal disease (ESRD) developed from diabetes mellitus in 16 patients (19%). Sixty-five patients (76%) received pre-transplant dialysis, with a median duration of 5 years. The median serum creatinine level and body mass index at the most recent visit were 1.2 mg/dL and 21.2 kg/m 2 , respectively. On the basis of the 24-hour bladder diaries, nocturnal polyuria was identified in 48 patients (56%). A logistic regression analysis revealed that diabetes mellitus as the original disease for ESRD was the only risk factor for nocturnal polyuria (odds ratio, 8.95; 95% confidence interval, 2.01-65.3; P = .0028). The age of donor kidneys at examination did not affect the incidence of nocturnal polyuria (P = .9402). Nocturnal polyuria was not uncommon in patients with successful RTX. Diabetes mellitus as the original disease for ESRD was the only risk factor for nocturnal polyuria, whereas the age of donor kidneys at examination did not affect the incidence of nocturnal polyuria. Thus, nocturnal polyuria is caused by recipient factors but not donor factors. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Twenty-four-hour ambulatory blood pressure monitoring in very elderly patients

    Science.gov (United States)

    Cappelleri, Claudia; Janoschka, Alin; Berli, Reto; Kohler, Sibylle; Braun-Dullaeus, Ruediger C.; Heuss, Ludwig T.; Wolfrum, Mathias

    2017-01-01

    Abstract Elevated blood pressure (BP) is frequently diagnosed in very elderly hospitalized patients. Accurate diagnosis of hypertension is challenging in the hospital environment, due to the “white coat effect,” and both overtreatment and undertreatment can adversely affect clinical outcome. Twenty-four-hour ambulatory blood pressure monitoring (ABPM) has the potential to avoid the “white coat effect” and accurately guide the management of hypertension. However, effects of the hospital environment on ABPM are unknown in the very elderly. We set out to enroll 45 patients, age ≥70 years, with elevated conventional BP during hospitalization in this observational study. It was prespecified by protocol to assess initially the difference between 24-hour BP during hospital-admission and home follow-up. Subsequent analysis should investigate the change in anxiety (Hospital Anxiety and Depression Scale-A [HADS-A]) after discharge, the correlation with change in 24-hour BP after discharge, and the prevalence of orthostatic hypertension. Thirty-one patients were included in the final analysis (age 83.5 ± 4.4 years; 71% female). Twenty-four-hour BP decreased significantly after hospital discharge (systolic from 133.5 ± 15.6 to 126.2 ± 14.4 mm Hg [millimeter of mercury], P = .008; diastolic from 71.0 ± 9.0 to 68.3 ± 8.6 mm Hg, P = .046). Anxiety level (HADS-A) decreased significantly after discharge, from 7.5 (interquartile range [IQR]: 4.0–13.8) to 5.0 (IQR: 4.0–8.0, P = .012). The change in anxiety was a predictor of change in systolic BP after discharge (F[1,20] = 5.9, P = .025). Sixty-one percent of the patients had significant orthostatic hypotension during hospital stay. In conclusion, 24-hour BP in very elderly patients is lower in the home environment than during hospitalization. This phenomenon seems to be directly linked to a lower anxiety-level at home. Reassessing hypertension at home may decrease the

  1. Suicide rates in five-year age-bands after the age of 60 years

    DEFF Research Database (Denmark)

    Shah, Ajit; Bhat, Ravi; Zarate-Escudero, Sofia

    2016-01-01

    -79 years) and the oldest old (80+ years) age groups. METHODS: Data on the number of suicides (International Classification of Diseases - ICD-10 codes, X60-84) in each of the eight five-year age-bands between the age-bands 60-64 years and 95-99 years in both gender for as many years as possible from 2000...... were ascertained from three sources: colleagues with access to national data, national statisics office websites and email contact with the national statistics offices. The population size for the corresponding years and age-bands was estimated for each country using data provided by the United Nations......BACKGROUND: There is paucity of studies examining suicide rates in narrow five-year age-bands after the age of 60 years. This study examined suicide rates in eight five-year age-bands between the age of 60 and 99 years because this will allow more precise comparison between the young old (60...

  2. What makes a bully a cyberbully? Unravelling the characteristics of cyberbullies across twenty-five European countries

    OpenAIRE

    Görzig, Anke; Ólafsson, Kjartan

    2013-01-01

    The characteristics of bullies who act face-to-face and those who do so in cyberspace were compared directly in one sample across twenty-five countries. The role of cross-country differences in technological infrastructure was also explored. Cyberbullies compared to face-to-face bullies were more likely to engage in risky online activities, spend more time online, and found it easier to be themselves online. Private access to the internet did not make a difference. Gender differences showed g...

  3. Spontaneous Pneumothorax: A retrospective study of twenty-five patients and literature review

    International Nuclear Information System (INIS)

    Batouk, A.; Jastaniah, S.; Grillo, I.A.; Malatani, T.S.; Al-Saigh, A.H.; Al-Shehri, M.Y.; Softah, A.; Ali, K.A.M.; Teklu, B.

    1996-01-01

    We present a retrospective study of 25 patients with spontaneous pneumothorax (three recurrent) comprising 16 Saudis (nine males and seven females) and eight non-Saudi's (eight males and one female), seen at the Asir Central Hospital, Abha, over a period of 45 months. Almost one-third of patients (9/25) had no underlying cause discernible by our investigational facilities (chest x-ray, ultrasonography, computed tomographic scan and flexible bronchofiberscopy). Underlying pneumonia (three patients), pulmonary tuberculosis (two patients), lung abscess (one patient) and congenital bullae (one patient) constituted the etiology in another third of the spontaneous pneumothorax patients. Other underlying pulmonary diseases, precipitating spontaneous pneumothorax in the group included pulmonary fibrosis, metastatic mesothelioma and immunosuppression in a medulloblastoma patient undergoing chemotherapy with the development of chickenpox. Closed thoracostomy tube drainage was the only method of treatment in 20 out of 25 patients, with three failures of closed thoracostomy tube drainage needing thoractomy and resection of blebs/bullae. The only complication was empyema in two of the patients. Two patients were successfully treated conservatively with observation alone. (author)

  4. Twenty-five years of the common market in coal, 1953--1978. [genesis and growth

    Energy Technology Data Exchange (ETDEWEB)

    1978-01-01

    Twenty-five years have passed since the European Coal and Steel commmunity was established. An attempt is made to show what economic integration is, what problems have arisen, and how the community has tried to overcome them. Three phases can be distinguished during the period under review--a first phase of growth in the coal industry between 1953 and 1957; a second phase marked by a plentiful supply of cheap hydrocarbons and a rapid reduction in coal output despite exceptional growth, linked with a parallel increase in overall energy requirements; and a third phase from 1973, marked by sharp price increases by the oil producing countries with repercussions on the world market in coal.

  5. Cancer Risk in Relatives of Testicular Cancer Patients by Histology Type and Age at Diagnosis: A Joint Study from Five Nordic Countries.

    Science.gov (United States)

    Kharazmi, Elham; Hemminki, Kari; Pukkala, Eero; Sundquist, Kristina; Tryggvadottir, Laufey; Tretli, Steinar; Olsen, Jörgen H; Fallah, Mahdi

    2015-08-01

    None of the population-based epidemiologic studies to date has had a large enough sample size to show the familial risk of testicular cancer (TC) by age at diagnosis for patients and their relatives or for rare histologic subtypes. To estimate absolute and relative risks of TC in relatives of TC patients by age at diagnosis in patients and their relatives and histological subtypes. In a joint population-based cohort study, 97 402 first-degree relatives of 21 254 TC patients who were diagnosed between 1955 and 2010 in five European countries were followed for cancer incidence. Standardized incidence ratios (SIRs) were estimated using histology-, age-, period-, and country-specific incidence rates as references. Lifetime cumulative risks were also calculated. The lifetime cumulative risk of TC in brothers of a patient with TC was 2.3%, which represents a fourfold increase in risk (SIR 4.1, 95% confidence interval [CI] 3.6-4.6) compared to the general population. TC in a father increased the risk by up to twofold in his son (95% CI 1.7-2.4; lifetime risk 1.2%) and vice versa. When there were two or more TC patients diagnosed in a family, the lifetime TC risk for relatives was 10-11%. Depending on age at diagnosis, twins had a 9-74% lifetime risk of TC. Family history of most of the histologic subtypes of TC increased the risk of concordant and most discordant subtypes. There was a tendency toward concordant age at diagnosis of TC among relatives. This study provides clinically relevant age-specific cancer risk estimates for relatives of TC patients. Familial TC patients tended to develop TC at an age close to the age at diagnosis of TC among their relatives, which is a novel finding of this study. This joint European population study showed that sons and brothers of testicular cancer patients are at higher risk of developing this cancer at an age close to the age at diagnosis of their relatives. Copyright © 2015. Published by Elsevier B.V.

  6. Twenty-two patients with Sotos' syndrome

    International Nuclear Information System (INIS)

    Miyake, Shota; Tada, Hiroshi; Hayashi, Michiko; Iwamoto, Hiroko; Fukushima, Yoshimitsu; Kuroki, Yoshikazu

    1985-01-01

    A retrospective study of 22 patients with Sotos' syndrome (17 boys and 5 girls) seen in the past 14 years was made respecting the age of the patients at the first visit, the age of the patients' parents at birth, neonatal abnormalities, neonatal physical characteristics, facial expression characteristics of this syndrome, growth index, and CT findings. CT showed ventricular dilation in all patients (moderate or extreme dilation in 87%, and the association of structure abnormality in the median part in many patients), subdural edema in 4 and arachnoid cyst in 2. (Namekawa, K.)

  7. The deep, hot biosphere: Twenty-five years of retrospection.

    Science.gov (United States)

    Colman, Daniel R; Poudel, Saroj; Stamps, Blake W; Boyd, Eric S; Spear, John R

    2017-07-03

    Twenty-five years ago this month, Thomas Gold published a seminal manuscript suggesting the presence of a "deep, hot biosphere" in the Earth's crust. Since this publication, a considerable amount of attention has been given to the study of deep biospheres, their role in geochemical cycles, and their potential to inform on the origin of life and its potential outside of Earth. Overwhelming evidence now supports the presence of a deep biosphere ubiquitously distributed on Earth in both terrestrial and marine settings. Furthermore, it has become apparent that much of this life is dependent on lithogenically sourced high-energy compounds to sustain productivity. A vast diversity of uncultivated microorganisms has been detected in subsurface environments, and we show that H 2 , CH 4 , and CO feature prominently in many of their predicted metabolisms. Despite 25 years of intense study, key questions remain on life in the deep subsurface, including whether it is endemic and the extent of its involvement in the anaerobic formation and degradation of hydrocarbons. Emergent data from cultivation and next-generation sequencing approaches continue to provide promising new hints to answer these questions. As Gold suggested, and as has become increasingly evident, to better understand the subsurface is critical to further understanding the Earth, life, the evolution of life, and the potential for life elsewhere. To this end, we suggest the need to develop a robust network of interdisciplinary scientists and accessible field sites for long-term monitoring of the Earth's subsurface in the form of a deep subsurface microbiome initiative.

  8. Prevalence and characteristics of resistant hypertensive patients in an Asian population

    Directory of Open Access Journals (Sweden)

    Rabia Naseem

    2017-07-01

    Conclusion: Nearly one in ten hypertensive patients had true resistant hypertension, and twenty-five percent of patients had pseudo-resistance. Resistance hypertensions is significantly associated with female gender, older age, obesity, dietary noncompliance and increased use of NSAIDs.

  9. METHYLMERCURY BIOACCUMULATION DEPENDENCE ON NORTHERN PIKE AGE AND SIZE IN TWENTY MINNESOTA LAKES

    Science.gov (United States)

    Mercury accumulation in northern pike muscle tissue (fillets) was found to be directly related to fish age and size. Measurements were made on 173 individual northern pike specimens from twenty lakes across Minnesota. Best fit regressions of mercury fillet concentration (wet wt.)...

  10. Suicide rates in five-year age-bands after the age of 60 years: the international landscape.

    Science.gov (United States)

    Shah, Ajit; Bhat, Ravi; Zarate-Escudero, Sofia; DeLeo, Diego; Erlangsen, Annette

    2016-01-01

    There is paucity of studies examining suicide rates in narrow five-year age-bands after the age of 60 years. This study examined suicide rates in eight five-year age-bands between the age of 60 and 99 years because this will allow more precise comparison between the young old (60-79 years) and the oldest old (80+ years) age groups. Data on the number of suicides (International Classification of Diseases - ICD-10 codes, X60-84) in each of the eight five-year age-bands between the age-bands 60-64 years and 95-99 years in both gender for as many years as possible from 2000 were ascertained from three sources: colleagues with access to national data, national statisics office websites and email contact with the national statistics offices. The population size for the corresponding years and age-bands was estimated for each country using data provided by the United Nations website. In men, suicide rates continued to increase for each of the seven five-year age-bands from 60-64 years to 90-94 years age-band, and then declined slightly for the 95-99 year age-band. In women, suicide rates continued to increase for each of the six five-year age-bands from 60-64 years to 85-89 years age-bands, and then declined slightly for the 90-94 years and 95-99 years age-bands. The overall global suicide rates for each of the eight five-year age-bands are sufficiently large for them to constitute a public health concern. This is especially important given the ongoing rise in the elderly population size and the paucity of data on risk and protective factors for suicide in the five-year age-bands after the age of 60 years.

  11. The Second-Language Vocabulary Trajectories of Turkish Immigrant Children in Norway from Ages Five to Ten: The Role of Preschool Talk Exposure, Maternal Education, and Coethnic Concentration in the Neighborhood

    Science.gov (United States)

    Rydland, Veslemoy; Grover, Vibeke; Lawrence, Joshua

    2014-01-01

    Little research has explored how preschools can support children's second-language (L2) vocabulary development. This study keenly followed the progress of twenty-six Turkish immigrant children growing up in Norway from preschool (age five) to fifth grade (age ten). Four different measures of preschool talk exposure (amount and diversity of…

  12. Book review: Twenty-Five Years on the Cutting Edge of Obsidian Studies: Selected Readings from the IAOS Bulletin

    Directory of Open Access Journals (Sweden)

    Sean Dolan

    2017-03-01

    Full Text Available Edited by Carolyn D. Dillian (Coastal Carolina University, Twenty-Five Years on the Cutting Edge of Obsidian Studies: Selected Readings from the IAOS Bulletin consists of 19 previously published articles from the International Association for Obsidian Studies (IAOS Bulletin. Dillian selected these articles because they provide a range of methodological and theoretical approaches concerning archaeological obsidian studies from around the world like Eretria, California, and the Near East, for example.

  13. Patient-Reported Outcome (PRO) questionnaires for young-aged to middle-aged adults with hip and groin disability

    DEFF Research Database (Denmark)

    Thorborg, K.; Tijssen, M.; Habets, B.

    2015-01-01

    BACKGROUND/AIM: To recommend Patient-Reported Outcome (PRO) questionnaires to measure hip and groin disability in young-aged to middle-aged adults. METHODS: A systematic review was performed in June 2014. The methodological quality of the studies included was determined using the COnsensus......-based Standards for the selection of health Measurement INstruments list (COSMIN) together with standardised evaluations of measurement properties of each PRO. RESULTS: Twenty studies were included. Nine different questionnaires for patients with hip disability, and one for hip and groin disability, were...

  14. Cumulative Index to Twenty Five Semiannual Reports of the Commission to the Congress. January 1947 - January 1959

    Energy Technology Data Exchange (ETDEWEB)

    McCone, John A.

    1960-01-31

    The first twenty five semiannual reports of the United States Atomic Energy Commission to Congress cover the major unclassified activities of the Commission from January 1947 through January 1959. In addition to the semiannual summaries, a series of special reports on important atomic energy programs were included in many of the semiannual reports. This cumulative name and subject index provides a guide to the information published in these reports. Beginning in 1960, the Commission will be issuing annual reports, each separately indexed, ceasing the semiannual reporting.

  15. The follow-up of patients of sixty-five years of age and younger with acute ischemic stroke and transient ischemic attacks, and elevated D-dimer levels in plasma

    Directory of Open Access Journals (Sweden)

    Magnus Vrethem

    2009-09-01

    Full Text Available D-dimer levels in plasma, a degradation product of fibrin, have been shown to correlate with the severity of ischemic stroke. In order to investigate the outcome of patients with elevated D-dimer we have carried out a follow-up study of patients of 65 years of age and younger with acute ischemic stroke or transient ischemic attacks (TIA admitted to our stroke unit from 1991 to 1992. Twenty-two of the 57 patients had elevated D-dimer levels in the plasma. High levels were associated with cardioembolic stroke. On follow-up after a mean of 12 years, 15 patients had died and six patients had suffered another stroke or TIA (three of whom were dead. Ten patients had suffered other cardiovascular events and seven of them were dead. We concluded that high levels of D-dimer in acute ischemic stroke patients on admission were associated with cardioembolic stroke and might have prognostic value for the development of further cardio- or cerebrovascular events. Advanced age was found to be an independent risk factor.

  16. Maternal age and offspring developmental vulnerability at age five: A population-based cohort study of Australian children.

    Directory of Open Access Journals (Sweden)

    Kathleen Falster

    2018-04-01

    Full Text Available In recent decades, there has been a shift to later childbearing in high-income countries. There is limited large-scale evidence of the relationship between maternal age and child outcomes beyond the perinatal period. The objective of this study is to quantify a child's risk of developmental vulnerability at age five, according to their mother's age at childbirth.Linkage of population-level perinatal, hospital, and birth registration datasets to data from the Australian Early Development Census (AEDC and school enrolments in Australia's most populous state, New South Wales (NSW, enabled us to follow a cohort of 99,530 children from birth to their first year of school in 2009 or 2012. The study outcome was teacher-reported child development on five domains measured by the AEDC, including physical health and well-being, emotional maturity, social competence, language and cognitive skills, and communication skills and general knowledge. Developmental vulnerability was defined as domain scores below the 2009 AEDC 10th percentile cut point. The mean maternal age at childbirth was 29.6 years (standard deviation [SD], 5.7, with 4,382 children (4.4% born to mothers aged <20 years and 20,026 children (20.1% born to mothers aged ≥35 years. The proportion vulnerable on ≥1 domains was 21% overall and followed a reverse J-shaped distribution according to maternal age: it was highest in children born to mothers aged ≤15 years, at 40% (95% CI, 32-49, and was lowest in children born to mothers aged between 30 years and ≤35 years, at 17%-18%. For maternal ages 36 years to ≥45 years, the proportion vulnerable on ≥1 domains increased to 17%-24%. Adjustment for sociodemographic characteristics significantly attenuated vulnerability risk in children born to younger mothers, while adjustment for potentially modifiable factors, such as antenatal visits, had little additional impact across all ages. Although the multi-agency linkage yielded a broad range of

  17. AKR-1 nuclear training reactor of Dresden Technical University turns twenty-five

    International Nuclear Information System (INIS)

    Hansen, W.

    2003-01-01

    Twenty-five years ago, in the night of July 27 to 28, 1978, the AKR-1 nuclear training reactor of the Dresden Technical University went critical for the first time and was commissioned. On the occasion of this anniversary, a colloquy was arranged with representatives from science, politics and industry, at which the reactor's history, the excellent achievements in research and training with the reactor, and the status and perspectives of this research facility were described. The AKR-1 had been built within the framework of the Nuclear Development Program of the then German Democratic Republic (GDR). The Nuclear Power Scientific Division of the Dresden Technical University had been entrusted with the responsibility, among other things, to train university personnel for the GDR Nuclear Power Program. The review by an expert group in 1996 of this plant had resulted in a recommendation in favor of long-term plant operation. A nuclear licensing procedure to this effect was initiated, and the necessary technical backfitting measures were implemented. The AKR-1 plant now equally serves for the specialized training of students and for research. (orig.) [de

  18. Management of twenty patients with neck trauma in Khartoum ENT ...

    African Journals Online (AJOL)

    Background: Neck trauma is a great surgical challenge, because there are multi organ and systems involved. Objective: To study the clinical presentation, management and outcome of twenty patients presented to Khartoum ENT Hospital with neck trauma. Methods: This is a prospective study conducted in Khartoum ENT ...

  19. Use of neuromuscular electrostimulation in the treatment of dysphagia in patients with multiple sclerosis

    NARCIS (Netherlands)

    Bogaardt, Hans; van Dam, Danielle; Wever, Nienke M.; Bruggeman, Caroline E.; Koops, Johan; Fokkens, Wytske J.

    2009-01-01

    OBJECTIVES: We explored the possible effects of neuromuscular electrostimulation on the swallowing function of patients with multiple sclerosis and swallowing problems. METHODS: Twenty-five patients (average age, 53.1 years; SD, 9.8 years) with multiple sclerosis and swallowing problems were treated

  20. Twenty-Five Year Site Plan FY2013 - FY2037

    Energy Technology Data Exchange (ETDEWEB)

    Jones, William H. [Los Alamos National Laboratory

    2012-07-12

    Los Alamos National Laboratory (the Laboratory) is the nation's premier national security science laboratory. Its mission is to develop and apply science and technology to ensure the safety, security, and reliability of the United States (U.S.) nuclear stockpile; reduce the threat of weapons of mass destruction, proliferation, and terrorism; and solve national problems in defense, energy, and the environment. The fiscal year (FY) 2013-2037 Twenty-Five Year Site Plan (TYSP) is a vital component for planning to meet the National Nuclear Security Administration (NNSA) commitment to ensure the U.S. has a safe, secure, and reliable nuclear deterrent. The Laboratory also uses the TYSP as an integrated planning tool to guide development of an efficient and responsive infrastructure that effectively supports the Laboratory's missions and workforce. Emphasizing the Laboratory's core capabilities, this TYSP reflects the Laboratory's role as a prominent contributor to NNSA missions through its programs and campaigns. The Laboratory is aligned with Nuclear Security Enterprise (NSE) modernization activities outlined in the NNSA Strategic Plan (May 2011) which include: (1) ensuring laboratory plutonium space effectively supports pit manufacturing and enterprise-wide special nuclear materials consolidation; (2) constructing the Chemistry and Metallurgy Research Replacement Nuclear Facility (CMRR-NF); (3) establishing shared user facilities to more cost effectively manage high-value, experimental, computational and production capabilities; and (4) modernizing enduring facilities while reducing the excess facility footprint. Th is TYSP is viewed by the Laboratory as a vital planning tool to develop an effi cient and responsive infrastructure. Long range facility and infrastructure development planning are critical to assure sustainment and modernization. Out-year re-investment is essential for sustaining existing facilities, and will be re-evaluated on an annual

  1. How Trust in Wikipedia Evolves: A Survey of Students Aged 11 to 25

    Science.gov (United States)

    Mothe, Josiane; Sahut, Gilles

    2018-01-01

    Introduction: Whether Wikipedia is to be considered a trusted source is frequently questioned in France. This paper reports the results of a survey examining the levels of trust shown by young people aged eleven to twenty-five. Method: We analyse the answers given by 841 young people, aged eleven to twenty-five, to a questionnaire. To our…

  2. The Twenty-five Maiden Ladies’ Tomb and Predicaments of the Feminist Movement in Taiwan

    Directory of Open Access Journals (Sweden)

    Anru Lee

    2010-01-01

    Full Text Available “The Twenty-five Maiden Ladies’ Tomb” is the collective burial site of the female workers who died in a ferry accident on their way to work in 1973. The fact that of the more than 70 passengers on board all 25 who died were unmarried young women, and the taboo in Taiwanese culture that shuns unmarried female ghosts, made the Tomb a fearsome place. Feminists in Gaoxiong (高雄 had for some years wanted the city government to change the tomb’s public image. Their calls were not answered until the Gaoxiong mayor’s office finally allocated money to clean up the gravesite and, as part of the city’s plans to develop urban tourism, to remake it into the tourist-friendly “Memorial Park for Women Labourers”. Consequently, even though the tomb renovation seemed to indicate a triumph of the feminist endeavour, it was more a result of the Gaoxiong city government’s efforts towards culture-led urban revitalization.

  3. 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

  4. Nutritional status of children under the age five in Morocco

    International Nuclear Information System (INIS)

    El Rjimati, Arbi; El Menchawy, Imane; Baddou, Issâd; El Kari, Khalid; El Haloui, Noureddine; Aguenaou, Hassan; Rabi, Baha

    2014-01-01

    Full text: Introduction: In Morocco we live nutritional, demographic and epidemiological transition. These transitions affect the nutritional status of the population, especially that of children under five years of age. They also play a guiding role in the development of strategies to be implemented to improve the situation. Aim: To describe the evolution of the nutritional status of children under five years in Morocco over the past ten years. Methods: Two national surveys were conducted in 2004 and 2011. One of the objectives of these surveys is to assess the nutritional status of children aged less than five years compared to WHO standards. Results: The surveys that included 5737 children under 5 years in 2004 and 7271 in 2011 showed according to WHO standards, at the national level , a prevalence of underweight of 3.1 % ( weight / age 2 SD) 2.6 % of which are obese (BMI for age > 3 SD), whereas the proportion of children with overweight and obesity was 10.4 % in 2004. Discussion/conclusions: These studies show that acute malnutrition almost disappeared in Morocco, however prevalence of stunting remains high, overweight and obesity among children less than five years increased in the country. (author)

  5. Twenty-five gauge vitrectomy in uveitis

    Directory of Open Access Journals (Sweden)

    Roger Roberto Wada Kamei

    2012-04-01

    Full Text Available PURPOSE: To evaluate anatomical and functional results of 25-gauge transconjunctival sutureless pars plana vitrectomy in patients with uveitis. METHODS: Vitrectomy was performed on 20 eyes with residual vitritis secondary to infectious and noninfectious uveitis. Patients were evaluated 1 week before surgery and after surgery at day 1, week 1, week 4 and week 12. Visual acuity (VA, intraocular pressure, anterior chamber cells and flare and vitreous haze were measured. RESULTS: Mean VA improved from 2.06 ± 0.94 logMAR before surgery to 0.58 ± 0.46 logMAR at week 12 (p<0.05. No case required conversion to standard 20-gauge instrumentation or suture placement, no intraoperative complications were noted. Transient postoperative hypotony was seen in three eyes. One patient with toxoplasmic retinochoroiditis had a relapse during follow-up. CONCLUSION: 25-gauge vitrectomy has proven its efficacy on cleansing vitreous opacities and improving visual acuity on patients with residual vitritis secondary to uveitis with minimal postoperative inflammation and complications.

  6. Seborrheic keratoses in five elderly patients: An appearance of raindrops and streams

    Directory of Open Access Journals (Sweden)

    Ru-zhi Zhang

    2011-01-01

    Full Text Available Five Chinese patients were found to have a linear, splayed, vertical pattern of lesions on their back, chest and abdomen. These lesions were clinically and pathologically diagnosed as seborrheic keratosis. The mean age of our patients was 77.6 years. During the follow-up period of 12-20 years, the lesions appeared to increase with age, and no malignant changes were observed on these sites. These patients had no serious underlying medical problems or malignant neoplasm, except for one patient with duodenal ulcer. While we are uncertain as to the cause of this patterning of seborrheic keratoses, we believe that it is distinct from previously reported patterns; this will contribute to research on the pathogenesis of seborrheic keratosis.

  7. Early experience with dual mobility acetabular systems featuring highly cross-linked polyethylene liners for primary hip arthroplasty in patients under fifty five years of age: an international multi-centre preliminary study.

    Science.gov (United States)

    Epinette, Jean-Alain; Harwin, Steven F; Rowan, Fiachra E; Tracol, Philippe; Mont, Michael A; Chughtai, Morad; Westrich, Geoffrey H

    2017-03-01

    To evaluate early performance of contemporary dual mobility acetabular systems with second generation annealed highly cross-linked polyethylene for primary hip arthroplasty of patients under 55 years of age. A prospective observational five years study across five centers in Europe and the USA of 321 patients with a mean age of 48.1 years was performed. Patients were assessed for causes of revision, hip instability, intra-prosthetic dissociation, Harris hip score and radiological signs of osteolysis. There were no dislocations and no intra-prosthetic dissociations. Kaplan Meier analysis demonstrated 97.51% survivorship for all cause revision and 99.68% survivorship for acetabular component revision at five years. Mean Harris hip score was 93.6. Two acetabular shells were revised for neck-rim implant impingement without dislocation and ten femoral stems were revised for causes unrelated to dual mobility implants. Contemporary highly cross-linked polyethylene dual mobility systems demonstrate excellent early clinical, radiological, and survivorship results in a cohort of patients that demand high performance from their implants. It is envisaged that DM and second generation annealed HXLPE may reduce THA instability and wear, the two most common causes of THA revision in hip arthroplasty.

  8. Age-related cutoffs for cervical movement behaviour to distinguish chronic idiopathic neck pain patients from unimpaired subjects.

    Science.gov (United States)

    Niederer, Daniel; Vogt, Lutz; Wilke, Jan; Rickert, Marcus; Banzer, Winfried

    2015-03-01

    The present study aims to develop age-dependent cutoff values in a quasi-experimental, cross-sectional diagnostic test study. One hundred and twenty (120) asymptomatic subjects (n = 100, 36♀, 18 75 years, for normative values; n = 20, 23-75 years, 15♀, for selectivity analyses) and 20 patients suffering from idiopathic neck pain (selectivity analyses, 22-71 years, 15♀) were included. Subjects performed five repetitive maximal cervical flexion/extension movements in an upright sitting position. Cervical kinematic characteristics (maximal range of motion (ROM), coefficient of variation (CV) and mean conjunct movements in rotation and flexion (CM)) were calculated from raw 3D ultrasonic data. Regression analyses were conducted to reveal associations between kinematic characteristics and age and gender and thus to determine normative values for healthy subjects. Age explains 53 % of the variance in ROM (decrease 10.2° per decade), 13 % in CV (increase 0.003 per decade) and 9 % in CM (increase 0.57° per decade). Receivers operating characteristic (ROC) analyses were conducted for differences between individual values of the kinematic characteristics and normative values to optimise cutoff values for distinguishing patients from unimpaired subjects (20 patients and 20 healthy). Cutoff values distinguished asymptomatic subjects' and chronic nonspecific neck patient's movement characteristics with sufficient quality (sensitivity 70-80 %, specificity 65-70 %). By including such classifications, the present findings expand actual research stating an age-related decrease in kinematic behaviour only using categorising span widths across decades. Future study is warranted to reveal our results' potential applicability for intervention onset decision making for idiopathic neck pain patients.

  9. Twenty-five astronomical observations that changed the world and how to make them yourself

    CERN Document Server

    Marett-Crosby, Michael

    2013-01-01

    Human history is also the record of our fascination with the sky, and to look upwards is to follow in the steps of such greats as Galileo and Newton. What they and others once saw in the heavens for the first time, amateur astronomers can discover anew using this guide to twenty-five of the greatest journeys through space.   Starting with our most visible companion the Moon, each chapter offers a step-by-step walk-through of famous astronomical observations from the history of science. Beginning with the easiest targets, sometimes even accessible with the naked eye, the challenges become progressively more difficult. Beginner astronomers and more experienced hobbyists alike can reacquaint themselves with the wonders of our fellow planets and even reach far beyond our own solar system to touch on such incredible phenomena as the birth of new stars in nebula systems and the deceptive nothingness of black holes. The would-be astronaut can spy the International Space Station in orbit with binoculars or the dooms...

  10. Twenty-Five-Year Experience With Radical Chemoradiation for Anal Cancer

    International Nuclear Information System (INIS)

    Tomaszewski, Jonathan M.; Link, Emma; Leong, Trevor; Heriot, Alexander; Vazquez, Melisa; Chander, Sarat; Chu, Julie; Foo, Marcus; Lee, Mark T.; Lynch, Craig A.; Mackay, John; Michael, Michael; Tran, Phillip; Ngan, Samuel Y.

    2012-01-01

    Purpose: To evaluate the prognostic factors, patterns of failure, and late toxicity in patients treated with chemoradiation (CRT) for anal cancer. Methods and Materials: Consecutive patients with nonmetastatic squamous cell carcinoma of the anus treated by CRT with curative intent between February 1983 and March 2008 were identified through the institutional database. Chart review and telephone follow-up were undertaken to collect demographic data and outcome. Results: Two hundred eighty-four patients (34% male; median age 62 years) were identified. The stages at diagnosis were 23% Stage I, 48% Stage II, 10% Stage IIIA, and 18% Stage IIIB. The median radiotherapy dose to the primary site was 54 Gy. A complete clinical response to CRT was achieved in 89% of patients. With a median follow-up time of 5.3 years, the 5-year rates of locoregional control, distant control, colostomy-free survival, and overall survival were 83% (95% confidence interval [CI] 78–88), 92% (95% CI, 89–96), 73% (95% CI, 68–79), and 82% (95% CI, 77–87), respectively. Higher T stage and male sex predicted for locoregional failure, and higher N stage predicted for distant metastases. Locoregional failure occurred most commonly at the primary site. Omission of elective inguinal irradiation resulted in inguinal failure rates of 1.9% and 12.5% in T1N0 and T2N0 patients, respectively. Pelvic nodal failures were very uncommon. Late vaginal and bone toxicity was observed in addition to gastrointestinal toxicity. Conclusions: CRT is a highly effective approach in anal cancer. However, subgroups of patients fare relatively poorly, and novel approaches are needed. Elective inguinal irradiation can be safely omitted only in patients with Stage I disease. Vaginal toxicity and insufficiency fractures of the hip and pelvis are important late effects that require prospective evaluation.

  11. Twenty-Five-Year Experience With Radical Chemoradiation for Anal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Tomaszewski, Jonathan M., E-mail: jonathan.tomaszewski@petermac.org [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Link, Emma [Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Leong, Trevor [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); University of Melbourne, Parkville, Victoria (Australia); Heriot, Alexander [University of Melbourne, Parkville, Victoria (Australia); Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Vazquez, Melisa [Research Division, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Chander, Sarat; Chu, Julie; Foo, Marcus; Lee, Mark T. [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Lynch, Craig A. [Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Mackay, John [University of Melbourne, Parkville, Victoria (Australia); Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Michael, Michael [University of Melbourne, Parkville, Victoria (Australia); Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Tran, Phillip [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Ngan, Samuel Y. [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); University of Melbourne, Parkville, Victoria (Australia)

    2012-06-01

    Purpose: To evaluate the prognostic factors, patterns of failure, and late toxicity in patients treated with chemoradiation (CRT) for anal cancer. Methods and Materials: Consecutive patients with nonmetastatic squamous cell carcinoma of the anus treated by CRT with curative intent between February 1983 and March 2008 were identified through the institutional database. Chart review and telephone follow-up were undertaken to collect demographic data and outcome. Results: Two hundred eighty-four patients (34% male; median age 62 years) were identified. The stages at diagnosis were 23% Stage I, 48% Stage II, 10% Stage IIIA, and 18% Stage IIIB. The median radiotherapy dose to the primary site was 54 Gy. A complete clinical response to CRT was achieved in 89% of patients. With a median follow-up time of 5.3 years, the 5-year rates of locoregional control, distant control, colostomy-free survival, and overall survival were 83% (95% confidence interval [CI] 78-88), 92% (95% CI, 89-96), 73% (95% CI, 68-79), and 82% (95% CI, 77-87), respectively. Higher T stage and male sex predicted for locoregional failure, and higher N stage predicted for distant metastases. Locoregional failure occurred most commonly at the primary site. Omission of elective inguinal irradiation resulted in inguinal failure rates of 1.9% and 12.5% in T1N0 and T2N0 patients, respectively. Pelvic nodal failures were very uncommon. Late vaginal and bone toxicity was observed in addition to gastrointestinal toxicity. Conclusions: CRT is a highly effective approach in anal cancer. However, subgroups of patients fare relatively poorly, and novel approaches are needed. Elective inguinal irradiation can be safely omitted only in patients with Stage I disease. Vaginal toxicity and insufficiency fractures of the hip and pelvis are important late effects that require prospective evaluation.

  12. Pegaptanib: choroidal neovascularization in patients with age-related macular degeneration and previous arterial thromboembolic events.

    Science.gov (United States)

    Battaglia Parodi, Maurizio; Di Bartolo, Emanuele; Brue, Claudia; Cappello, Ezio; Furino, Claudio; Giuffrida, Sebastiano; Imparato, Manuela; Reibaldi, Michele

    2018-01-01

    To evaluate the efficacy and the rate of side effects of the pegylated aptamer pegaptanib in the treatment of patients with choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) and a history of previous arterial thromboembolic events (ATEs). Twenty-three eyes of 23 patients with subfoveal CNV due to AMD and cerebrovascular accidents (n = 12) and myocardial infarction (n = 11) in the previous 6 months received intravitreal pegaptanib 0.3 mg according to a pro re nata regimen and were followed for 12 months. The paired Student t test was used to evaluate mean changes in best-corrected visual acuity (BCVA; primary outcome measure) and central foveal thickness (CFT). The mean patient age was 71.5 ± 4.6 years; there were 14 women and 9 men. The CNV was type 1, 2, and 3 in 18, 3, and 2 eyes, respectively. The mean BCVA improved from 0.67 ± 0.23 logMAR at baseline to 0.52 ± 0.31 logMAR at the end of 12-month follow-up (p = 0.044). Thirty-five percent of patients achieved ≥3 Early Treatment Diabetic Retinopathy Study lines improvement at 12 months. Mean CFT at baseline (381 ± 111 µm) decreased to 304 ± 82 µm at 12 months (p = 0.008). Patients received a mean of 4.3 ± 1.3 (range 3-7) injections. No systemic or ocular side effects occurred; no patient experienced further ATEs. Intravitreal pegaptanib can be considered a viable treatment option for patients with AMD-related CNV who are at high risk of ATEs.

  13. The effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery.

    Science.gov (United States)

    Song, Inkyung; Kim, Dong Yeon; Kim, Youn Jin

    2012-11-01

    Inflation and deflation of a pneumatic tourniquet used in total knee replacement surgery induces various changes in patient's hemodynamic and metabolic status, which may result in serious complications, especially in aged patients. Near-infrared spectroscopy (NIRS) is a monitoring device designed to estimate the regional cerebral oxygen saturation. We evaluated the effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery, using NIRS. Twenty-eight American Society of Anesthesiologists physical status I or II patients, over the age of sixty-five years undergoing total knee replacement surgery, were included. Under general anesthesia, the mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), stroke volume (SV), and regional cerebral oxygen saturation (rSO(2)) were recorded before induction of anesthesia and every 2 min after tourniquet deflation for 20 min. Arterial blood gas analysis was performed 5 min before, in addition to 0, and 10 min after tourniquet deflation. The decrease of rSO(2) was not significant during 20-min deflation period. MAP, CO and SV showed significant decrease during 2 to 12, 4 to 6 and 2 to 6-min period after tourniquet deflation, respectively (P deflation caused significant changes in hemodynamic and metabolic status, but not in regional cerebral oxygen saturation. It is recommended to monitor neurologic status, as well as hemodynamic and metabolic status to avoid serious complications, especially in aged patients.

  14. Driving safety after brain damage: follow-up of twenty-two patients with matched controls.

    Science.gov (United States)

    Katz, R T; Golden, R S; Butter, J; Tepper, D; Rothke, S; Holmes, J; Sahgal, V

    1990-02-01

    Driving after brain damage is a vital issue, considering the large number of patients who suffer from cerebrovascular and traumatic encephalopathy. The ability to operate a motor vehicle is an integral part of independence for most adults and so should be preserved whenever possible. The physician may estimate a patient's ability to drive safely based on his own examination, the evaluation of a neuropsychologist, and a comprehensive driving evaluation--testing, driving simulation, behind-the-wheel observation--with a driving specialist. This study sought to evaluate the ability of brain-damaged individuals to operate a motor vehicle safely at follow-up. These patients had been evaluated (by a physician, a neuropsychologist, and a driving specialist) and were judged able to operate a motor vehicle safely after their cognitive insult. Twenty-two brain-damaged patients who were evaluated at our institution were successfully followed up to five years (mean interval of 2.67 years). Patients were interviewed by telephone. Their driving safely was compared with a control group consisting of a close friend or spouse of each patient. Statistical analysis revealed no difference between patient and control groups in the type of driving, the incidence of speeding tickets, near accidents, and accidents, and the cost of vehicle damage when accidents occurred. The patient group was further divided into those who had, and those who had not experienced driving difficulties so that initial neuropsychologic testing could be compared. No significant differences were noted in any aspect of the neuropsychologic test battery. We conclude that selected brain-damaged patients who have passed a comprehensive driving assessment as outlined were as fit to drive as were their normal matched controls.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Scoring CT/HRCT findings among asbestos-exposed workers: effects of patient's age, body mass index and common laboratory test results

    Energy Technology Data Exchange (ETDEWEB)

    Vehmas, T.; Huuskonen, M.S. [Finnish Institute of Occupational Health, Department of Radiology, Helsinki (Finland); Kivisaari, L. [Helsinki University Central Hospital, Department of Radiology, Helsinki (Finland); Jaakkola, M.S. [Finnish Institute of Occupational Health, Department of Radiology, Helsinki (Finland); University of Birmingham, Institute of Occupational and Environmental Medicine, Birmingham (United Kingdom)

    2005-02-01

    We studied the effects of age, body mass index (BMI) and some common laboratory test results on several pulmonary CT/HRCT signs. Five hundred twenty-eight construction workers (age 38-80, mean 63 years) were imaged with spiral and high resolution CT. Images were scored by three radiologists for solitary pulmonary nodules, signs indicative of fibrosis and emphysema, ground glass opacities, bronchial wall thickness and bronchiectasis. Multivariate statistical analyses were adjusted for smoking and asbestos exposure. Increasing age, blood haemoglobin value and erythrocyte sedimentation rate correlated positively with several HRCT signs. Increasing BMI was associated with a decrease in several signs, especially parenchymal bands, honeycombing, all kinds of emphysema and bronchiectasis. The latter finding might be due to the suboptimal image quality in obese individuals, which may cause suspicious findings to be overlooked. Background data, including patient's age and body constitution, should be considered when CT/HRCT images are interpreted. (orig.)

  16. Twenty-five years of transient counting experience in French PWR units

    Energy Technology Data Exchange (ETDEWEB)

    Barthelet, B. [Electricite de France (EDF DPN), 93 - Saint-Denis (France); Savoldelli, D.; Fritz, R. [Electricite de France (EDF DPN), 93 - Noisy le Grand (France)

    2001-07-01

    For nearly twenty five years, EDF has been checking that the actual operating transients are neither more severe nor more numerous than the design basis transients. This activity of transient cycle counting and bookkeeping has enabled EDF to own a database of more than 800 reactor.years for the PWR units. The current method of transient cycle counting is presented. In the paper, we will point out the main results of transient cycle counting and lessons learned. In general, the frequencies of transients are lower than the design frequencies. In few cases, they are higher, such as the transient frequencies of the RCS lines connected to auxiliary systems often due to operating procedures or particular periodic testing. Few periodic tests were not taken into account in the design basis transient file ; they have been detected thanks to the transient cycle counting. In the last 1980's, we achieved the first updating of the design basis transient file for the PWR 900 MWe series. In the early 1990's, we updated the design basis transient file of the PWR 1300 MWe series. In fact, since design and start-up, the operating conditions have been modified (fuel cycle with stretch-out, modification of the hot leg and cold leg temperatures for the PWR 1300 MWe,...). This was the cause of many unclassified transients. In the new design basis transient file, we have created new transients and increased the frequencies of some of them. This has enabled to consider the updated design basis transient file more representative of actual operating transients. For some years, we have increasingly associated the operators with the transient cycle counting concern. We noticed progress (decreased frequencies of most transients). (authors)

  17. Twenty-five years of transient counting experience in French PWR units

    International Nuclear Information System (INIS)

    Barthelet, B.; Savoldelli, D.; Fritz, R.

    2001-01-01

    For nearly twenty five years, EDF has been checking that the actual operating transients are neither more severe nor more numerous than the design basis transients. This activity of transient cycle counting and bookkeeping has enabled EDF to own a database of more than 800 reactor.years for the PWR units. The current method of transient cycle counting is presented. In the paper, we will point out the main results of transient cycle counting and lessons learned. In general, the frequencies of transients are lower than the design frequencies. In few cases, they are higher, such as the transient frequencies of the RCS lines connected to auxiliary systems often due to operating procedures or particular periodic testing. Few periodic tests were not taken into account in the design basis transient file ; they have been detected thanks to the transient cycle counting. In the last 1980's, we achieved the first updating of the design basis transient file for the PWR 900 MWe series. In the early 1990's, we updated the design basis transient file of the PWR 1300 MWe series. In fact, since design and start-up, the operating conditions have been modified (fuel cycle with stretch-out, modification of the hot leg and cold leg temperatures for the PWR 1300 MWe,...). This was the cause of many unclassified transients. In the new design basis transient file, we have created new transients and increased the frequencies of some of them. This has enabled to consider the updated design basis transient file more representative of actual operating transients. For some years, we have increasingly associated the operators with the transient cycle counting concern. We noticed progress (decreased frequencies of most transients). (authors)

  18. Age differences in five personality domains across the life span.

    Science.gov (United States)

    Allemand, Mathias; Zimprich, Daniel; Hendriks, A A Jolijn

    2008-05-01

    The present study addresses the issue of age differences in 5 personality domains across the life span in a cross-sectional study. In contrast to most previous studies, the present study follows a methodologically more rigorous approach to warrant that age-related differences in personality structure and mean level can be meaningfully compared. It uses data on 50 items of the Five-Factor Personality Inventory (FFPI) available from a study in a large and representative Dutch sample (N = 2,494; age range: 16 to 91 years) conducted in 1996 for the purpose of establishing norms for the FFPI. After having established strict measurement invariance, tests were made for factor covariances to be equal across age groups, revealing structural continuity of personality. Additionally, factor variances were shown to be equal across age groups. A number of age differences in the mean level of the five personality domains emerged. Specifically, older adults were, on average, more agreeable and, especially, more conscientious than middle-aged and younger adults. Findings from our study suggest that both continuity and change may mark personality over the course of life. (PsycINFO Database Record (c) 2008 APA, all rights reserved).

  19. Practice effects and test-re-test reliability of the Five Digit Test in patients with stroke over four serial assessments.

    Science.gov (United States)

    Chiu, En-Chi; Koh, Chia-Lin; Tsai, Chia-Yin; Lu, Wen-Shian; Sheu, Ching-Fan; Hsueh, I-Ping; Hsieh, Ching-Lin

    2014-01-01

    To investigate practice effect and test-re-test reliability of the Five Digit Test (FDT) over four serial assessments in patients with stroke. Single-group repeated measures design. Twenty-five patients with stroke were administered the FDT in four consecutive assessments every 2 weeks. The FDT contains four parts with five indices: 'basic measures of attention and processing speed', 'selective attention', 'alternating attention', 'ability of inhibition' and 'ability of switching'. The five indices of the FDT showed trivial-to-small practice effects (Cohen's d = 0.03-0.47) and moderate-to-excellent test-re-test reliability (intra-class correlation coefficient = 0.59-0.97). Practice effects of the five indices all appeared cumulative, but one index, 'basic measures of attention and processing speed', reached a plateau after the second assessment. The minimum and maximum values of the 90% confidence interval (CI) of reliable change index modified for practice (RCIp) for this index were [-17.6, 11.2]. One of five indices of the FDT reached a plateau, whose minimum and maximum values of the 90% CI RCIp are useful to determine whether the change in an individual's score is real. However, clinicians and researchers should be cautious when interpreting the test results of these four indices over repeated assessments.

  20. Transjugular Intrahepatic Portosystemic Shunt Placement During Pregnancy: A Case Series of Five Patients

    International Nuclear Information System (INIS)

    Ingraham, Christopher R.; Padia, Siddharth A.; Johnson, Guy E.; Easterling, Thomas R.; Liou, Iris W.; Kanal, Kalpana M.; Valji, Karim

    2015-01-01

    Background and AimsComplications of portal hypertension, such as variceal hemorrhage and ascites, are associated with significant increases in both mortality and complications during pregnancy. Transjugular intrahepatic portosystemic shunt (TIPS) is a well-established procedure for treating portal hypertension, but the safety of TIPS during pregnancy is largely unknown. In this series, we review five patients who underwent TIPS placement while pregnant and describe their clinical outcomes.MethodsFive pregnant patients with cirrhosis and portal hypertension underwent elective TIPS for complications of portal hypertension (four for secondary prevention of variceal bleeding and one for refractory ascites). Outcomes measured were recurrent bleeding episodes or need for further paracenteses during pregnancy, estimated radiation dose to the fetus and gestational age at delivery. All patients were followed after delivery to evaluate technical and clinical success of the procedure.ResultsAll five patients survived pregnancy and went on to deliver successfully. When TIPS was performed for secondary prevention of variceal bleeding (n = 4), no patients demonstrated variceal bleeding after TIPS placement. When TIPS was performed for refractory ascites (n = 1), no further paracenteses were required. All patients delivered successfully, albeit prematurely. Average radiation dose estimated to the fetus was 16.3 mGy.ConclusionsThis series suggests that TIPS can be performed in selective pregnant patients with portal hypertension, with little added risk to the mother or fetus

  1. Transjugular Intrahepatic Portosystemic Shunt Placement During Pregnancy: A Case Series of Five Patients

    Energy Technology Data Exchange (ETDEWEB)

    Ingraham, Christopher R., E-mail: cringra@uw.edu; Padia, Siddharth A., E-mail: spadia@uw.edu; Johnson, Guy E., E-mail: gej@uw.edu [University of Washington, Department of Interventional Radiology (United States); Easterling, Thomas R., E-mail: easter@uw.edu [University of Washington, Department of Obstetrics and Gynecology (United States); Liou, Iris W., E-mail: irisl@medicine.washington.edu [University of Washington, Department of Medicine (United States); Kanal, Kalpana M., E-mail: kkanal@uw.edu [University of Washington, Physics Section, Department of Radiology (United States); Valji, Karim, E-mail: kvalji@uw.edu [University of Washington, Department of Interventional Radiology (United States)

    2015-10-15

    Background and AimsComplications of portal hypertension, such as variceal hemorrhage and ascites, are associated with significant increases in both mortality and complications during pregnancy. Transjugular intrahepatic portosystemic shunt (TIPS) is a well-established procedure for treating portal hypertension, but the safety of TIPS during pregnancy is largely unknown. In this series, we review five patients who underwent TIPS placement while pregnant and describe their clinical outcomes.MethodsFive pregnant patients with cirrhosis and portal hypertension underwent elective TIPS for complications of portal hypertension (four for secondary prevention of variceal bleeding and one for refractory ascites). Outcomes measured were recurrent bleeding episodes or need for further paracenteses during pregnancy, estimated radiation dose to the fetus and gestational age at delivery. All patients were followed after delivery to evaluate technical and clinical success of the procedure.ResultsAll five patients survived pregnancy and went on to deliver successfully. When TIPS was performed for secondary prevention of variceal bleeding (n = 4), no patients demonstrated variceal bleeding after TIPS placement. When TIPS was performed for refractory ascites (n = 1), no further paracenteses were required. All patients delivered successfully, albeit prematurely. Average radiation dose estimated to the fetus was 16.3 mGy.ConclusionsThis series suggests that TIPS can be performed in selective pregnant patients with portal hypertension, with little added risk to the mother or fetus.

  2. Twenty-five years of modeling multiphase flow and heat transfer

    International Nuclear Information System (INIS)

    Lyczkowski, R.W.

    1999-01-01

    This presentation will cover some of the highlights of multiphase modeling in collaboration with Professor Dimitri Gidaspow (DG) over the last roughly twenty-five years. It all started in 1972 in Idaho Falls with Charles Solbrig, who planned and initiated a project for the former USAEC to develop a computer code to replace RELAP4 to analyze the loss of coolant accident (LOCA). DG spent his sabbatical on the project in 1973. One highlight was the discovery of complex characteristics, the implications of which are still pondered by some. Fluidization research began in 1978 when the author collaboratively developed a step-by-step building-block approach to understanding the hydrodynamics of fluidized beds, an approach closely coupled to validation experiments. A grant from the USDOE to study solids circulation around a jet in a fluidized bed was awarded to DG in 1978. Following that, grants from GRI, NSF, and a contract from Westinghouse Electric Corp. allowed the early work to continue. Progress was slow since computer costs were high. Subsequent continuing support from the USDOE, NSF, EPRI, and industry has allowed research to continue, as has his collaboration. A highlight of this collaboration was the development of the monolayer energy dissipation (MED) erosion model. Multiphase flow and fluidization theory took quantum leaps with the publication of DG's Multiphase Flow and Fluidization: Continuum and Kinetic Theory Descriptions (MFF), Academic Press, San Diego (1994), for which there is essentially no competition. Only the late Professor S.L. Soo's Particulates and Continuum: Multiphase Fluid Dynamics, Hemisphere Publishing Corp., New York (1989), a textbook version of the classic monograph Multiphase Fluid Dynamics, Science Press, Beijing, China (1990), comes close. In MFF, the kinetic theory of granular flow has evolved as a potentially viable adjunct to the continuum multiphase theory, of which fluidization is one important manifestation. It must be

  3. Re-irradiation after salvage mastectomy for local recurrence after a conservative treatment: a retrospective analysis of twenty patients (Nancy: 1988-2001)

    International Nuclear Information System (INIS)

    Racadot, S.; Marchal, C.; Charra-Brunaud, C.; Peiffert, D.; Bey, P.; Verhaeghe, J.L.

    2003-01-01

    Purpose. - To retrospectively assess the efficacy of post-mastectomy re-irradiation for local relapse of breast cancer. Patients and methods. - Twenty patients, initially treated by conservative surgery and radiotherapy (50 Gy in 25 fractions over 5 weeks) were treated from 1998 to 2001 for a local relapse by salvage mastectomy and re-irradiation (either electron or photon beams). Mean age was 53 years (31-71). Reasons for re-irradiation were that the local relapses were inflammatory (4 pts), multifocal (5 pts), cutaneous (5 pts), involved the nipple (3 pts) or because the surgical margins (either muscle or skin) were involved (3 pts). The median dose of re-irradiation was 45 Gy (33-65) in 15 fractions over 33 days. Mean follow-up was 48 months (5-97). Results. - Fifteen patients remained free of a second local recurrence and 10 were still alive, without metastasis. Neither the dose of re-irradiation nor the irradiated surfaces were prognostic factors of local control (P = 0.877 and P = 0.424). Five patients developed radiation-induced pneumonitis without functional respiratory impairment. The incidence of pneumonitis seemed to be related to the biological dose of re-irradiation (P = 0.037). Other late complications occurred such as pigmentation changes (12 pts), telangiectasia (8 pts), chondritis (2 pts), parietal fibrosis (7 pts), rib fractures (4 pts), severe pain (11 pts) and lymphedema (2 pts). The increase in biological equivalent dose was highly statistically linked with the occurrence of disabling pain (P = 0.0123). Conclusion. - Parietal re-irradiation achieves good and lasting local control with an acceptable rate of acute complications but with a risk of disabling late sequelae such as severe pain. (author)

  4. Threshold Levels of Infant and Under-Five Mortality for Crossover between Life Expectancies at Ages Zero, One and Five in India: A Decomposition Analysis.

    Science.gov (United States)

    Dubey, Manisha; Ram, Usha; Ram, Faujdar

    2015-01-01

    Under the prevailing conditions of imbalanced life table and historic gender discrimination in India, our study examines crossover between life expectancies at ages zero, one and five years for India and quantifies the relative share of infant and under-five mortality towards this crossover. We estimate threshold levels of infant and under-five mortality required for crossover using age specific death rates during 1981-2009 for 16 Indian states by sex (comprising of India's 90% population in 2011). Kitagawa decomposition equations were used to analyse relative share of infant and under-five mortality towards crossover. India experienced crossover between life expectancies at ages zero and five in 2004 for menand in 2009 for women; eleven and nine Indian states have experienced this crossover for men and women, respectively. Men usually experienced crossover four years earlier than the women. Improvements in mortality below ages five have mostly contributed towards this crossover. Life expectancy at age one exceeds that at age zero for both men and women in India except for Kerala (the only state to experience this crossover in 2000 for men and 1999 for women). For India, using life expectancy at age zero and under-five mortality rate together may be more meaningful to measure overall health of its people until the crossover. Delayed crossover for women, despite higher life expectancy at birth than for men reiterates that Indian women are still disadvantaged and hence use of life expectancies at ages zero, one and five become important for India. Greater programmatic efforts to control leading causes of death during the first month and 1-59 months in high child mortality areas can help India to attain this crossover early.

  5. Therapeutic effects of diaphragmatic plication for acquired unilateral non-malignant diaphragm paralysis in twenty patients

    Directory of Open Access Journals (Sweden)

    Reza Bagheri

    2013-12-01

    Full Text Available Background: Acquired paralysis of the diaphragm is a condition caused by trauma, surgical injuries, (lung cancer surgery, esophageal surgery, cardiac surgery, thoracic surgery, and is sometimes of an unknown etiology. It can lead to dyspnea and can affect ventilatory function and patients activity. Diaphragmatic plication is a treatment method which decreases inconsistent function of diaphragm. The aim of this study is to evaluate the outcome of diaphragmatic plication in patients with acquired unilateral non-malignant diaphragmatic paralysis. Methods: From 1991 to 2011, 20 patients with acquired unilateral diaphragmatic paralysis who underwent surgery enrolled in our study in Ghaem Hospital Mashhad University of Medical Science. Patients were evaluated in terms of age, sex, BMI, clinical symptoms, dyspnea score (DS, etiology of paralysis, diagnostic methods, respiratory function tests and complication of surgery. Some tests including dyspnea score were carried out again six months after surgery. We evaluated patients with SPSS version 11.5 and Paired t-test or nonparametric equivalent. Results: Twenty patients enrolled in our study. 14 were male and 6 were female. The mean age was 58 years and the average time interval between diagnosis to surgical treatment was 38.3 months. Acquired diaphragmatic paralysis was mostly caused by trauma (in 11 patients and almost occurred on the left side (in 15 patients. Diagnostic methods included chest x-ray, CT scan, ultrasonography and sniff. Test prior to surgery the average FVC was 41.4±7 percent and the average FEV1 was 52.4±6 percent and after surgery they were 80.1±8.6 percent and 74.4±1 percent respectively. The average increase in FEV1 and FVC 63.4±4, 61.1±7.8. Performing surgery also leads to a noticeable improvement in dyspnea score in our study. Conclusion: In patients with acquired unilateral non-malignant diaphragm paralysis diaphragmatic plication is highly recommended due to the

  6. Threshold Levels of Infant and Under-Five Mortality for Crossover between Life Expectancies at Ages Zero, One and Five in India: A Decomposition Analysis.

    Directory of Open Access Journals (Sweden)

    Manisha Dubey

    Full Text Available Under the prevailing conditions of imbalanced life table and historic gender discrimination in India, our study examines crossover between life expectancies at ages zero, one and five years for India and quantifies the relative share of infant and under-five mortality towards this crossover.We estimate threshold levels of infant and under-five mortality required for crossover using age specific death rates during 1981-2009 for 16 Indian states by sex (comprising of India's 90% population in 2011. Kitagawa decomposition equations were used to analyse relative share of infant and under-five mortality towards crossover.India experienced crossover between life expectancies at ages zero and five in 2004 for menand in 2009 for women; eleven and nine Indian states have experienced this crossover for men and women, respectively. Men usually experienced crossover four years earlier than the women. Improvements in mortality below ages five have mostly contributed towards this crossover. Life expectancy at age one exceeds that at age zero for both men and women in India except for Kerala (the only state to experience this crossover in 2000 for men and 1999 for women.For India, using life expectancy at age zero and under-five mortality rate together may be more meaningful to measure overall health of its people until the crossover. Delayed crossover for women, despite higher life expectancy at birth than for men reiterates that Indian women are still disadvantaged and hence use of life expectancies at ages zero, one and five become important for India. Greater programmatic efforts to control leading causes of death during the first month and 1-59 months in high child mortality areas can help India to attain this crossover early.

  7. Effect of community-based food supplementation on improving growth of underweight children under five years of age in West Nusa Tenggara

    Directory of Open Access Journals (Sweden)

    Aman Bhakti Pulungan

    2018-01-01

    Full Text Available Background The prevalence of underweight children in West Nusa Tenggara is as high as 30%. This region had the third largest number of stunted children in the country. The local government has attempted to tackle this problem by providing supplementary food to underweight children. Objective To assess the success of the community-based food supplementation program onimproving children’s growth in West Nusa Tenggara. Methods We conducted a prospective cohort study for 10 months in Paruga District Primary Health Care Unit, Bima, West Nusa Tenggara, in year 2012. Children were given supplementary food according to the Ministry of Health’s guidelines, consisting of formula milk, high calorie biscuits, and a 60-day supply of eggs, estimated to be sufficient to normalize their weights, for their age and sex.  A child’s weight and height were measured every 3 months and the results plotted on WHO growth charts for weight-for-age, height-for-age, and weight-for-height (nutritional status. Z-score -2 SD was classified as normal for all three categories. Results Twenty-five children under five years of age participated in this study. Subjects’ median age was 29 months. None of the subjects had normal weight-for-age Z-score at the beginning of the study. Eighty-four percent (21/25 of the subjects were severely underweight. Only 8% (2/25 of the subjects had normal height-for-age Z-score and 88% (22/25 of them were severely stunted. However, 80% (20/25 of subjects had normal nutritional status (weight-for-height. Changes in weight-for-age Z-score varied throughout the study. The highest median score was in the tenth month of follow up (-3.82. The highest median height-for-age score and weight-for-height score were also in the last month of follow up. At the end of the study, only one subject had normal weight-for-age score (4% and none of the subjects had normal height-for-age scores.   Conclusion The 10-month supplementary food program for under-five

  8. A Five-Year Review of Tag Rugby Hand Injuries.

    Science.gov (United States)

    Joyce, C W; Woods, J F C; Murphy, S; Bollard, S; Kelly, J L; Carroll, S M; O'Shaughnessy, M

    2016-10-01

    Tag rugby is one of the fastest growing sports in Ireland. It is a soft-contact team game that is loosely based on the rugby league format except players try to remove Velcro tags from their opponents' shorts rather than engage in a typical rugby tackle. The purpose of this study was to examine all tag rugby associated hand injuries over a five-year period in three large tertiary referral hospitals in Ireland. Using the patient corresponding system, 228 patients with hand injury related tag rugby injuries were observed from 2010 to 2015. There were 138 males and 90 females in the study and over 40% of patients required surgery. Most of the patients were young professionals with an average age of 30. Twenty-five patients worked in the financial services whilst there were 23 teachers. Fractures accounted for 124 of the 228 injuries and mallet injuries accounted for 53. Eighty percent of all injuries occurred during the tackle. The mean number of days missed from work was 9.1±13.8 days. These injuries resulted in an average of seven hospital appointments per patient. Considering it is a soft-contact sport, it is surprising the number of hand injuries that we have observed. Although safety measures have been introduced to decrease the number of hand injuries in recent years, there is a need for further improvements. Better player education about seeking prompt medical attention once an injury occurs, coupled with longer shorts worn by players may improve measures for the sport. Copyright © 2016. Published by Elsevier Ltd.

  9. Myeloproliferative neoplasms in five multiple sclerosis patients

    DEFF Research Database (Denmark)

    Thorsteinsdottir, Sigrun; Bjerrum, Ole Weis

    2013-01-01

    The concurrence of myeloproliferative neoplasms (MPNs) and multiple sclerosis (MS) is unusual. We report five patients from a localized geographic area in Denmark with both MS and MPN; all the patients were diagnosed with MPNs in the years 2007-2012. We describe the patients' history and treatment...

  10. Efficacy and safety of endoscopic retrograde cholangiopancreatography in aged and elderly geriatric patients to treat acute cholecystitis

    Directory of Open Access Journals (Sweden)

    GAO Feng

    2013-03-01

    Full Text Available ObjectiveTo retrospectively evaluate the therapeutic efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP for treating acute cholecystitis in geriatric patients 75 years and older in age. MethodsThe clinical records of our institute were searched to identify aged (75-84 years old and elderly (85 years and older patients who underwent ERCP between January 2008 and December 2012 for new or long-term cholecystitis. The cholecystitis was clinically characterized as acute attack time(s of one to five days and diagnosis was confirmed by imaging analysis (including abdominal ultrasound, computed tomography, and/or magnetic resonance cholangiopancreatography. All surgeries were carried out with the endoscopic nasogallbladder drainage (ENGBD procedure. Postoperative symptoms (such as abdominal pain and fever and clinical findings (such as C-reactive protein (CRP level, imaging findings, and bile drainage volume and consistency were recorded, along with follow-up data of outcome and symptomology, for summary evaluation. ResultsA total 24 patients, including 13 men and 11 women between the ages of 75 and 88 (mean: 81.00±3.23 years, underwent ERCP examination. The cases included general cholecystitis (75.0%, n=18 and acalculous cholecystitis (25.0%, n=6. In addition, 13 (54.2% cases had biliary stones and two (8.3% cases had bile pancreatitis. The ENGBD tube was successfully inserted into the gallbladder in all cases. Twenty-one (87.5% patients experienced relief of abdominal pain and fever within 24 h of the surgery. CRP level decreased to normal for all (100% patients within six days of the surgery. Two (8.3% patients experienced hyperamylasemia within three days of the surgery, and both cases resolved prior to hospital release. There were no cases of ERCP-related hemorrhage, perforation, pancreatitis, or death. Follow-up time ranged from three to 12 months, during which 23 (95.8% patients showed long-term remission. The presence

  11. Age specific aetiological agents of diarrhoea in hospitalized children aged less than five years in Dar es Salaam, Tanzania

    Directory of Open Access Journals (Sweden)

    Myrmel Helge

    2011-02-01

    Full Text Available Abstract Background This study aimed to determine the age-specific aetiologic agents of diarrhoea in children aged less than five years. The study also assessed the efficacy of the empiric treatment of childhood diarrhoea using Integrated Management of Childhood Illness (IMCI guidelines. Methods This study included 280 children aged less than 5 years, admitted with diarrhoea to any of the four major hospitals in Dar es Salaam. Bacterial pathogens were identified using conventional methods. Enzyme Linked Immunosorbent Assay (ELISA and agglutination assay were used to detect viruses and intestinal protozoa, respectively. Antimicrobial susceptibility was determined using Kirby-Bauer disk diffusion method. Results At least one of the searched pathogens was detected in 67.1% of the cases, and mixed infections were detected in 20.7% of cases. Overall, bacteria and viruses contributed equally accounting for 33.2% and 32.2% of all the cases, respectively, while parasites were detected in 19.2% patients. Diarrhoeagenic Escherichia coli (DEC was the most common enteric pathogen, isolated in 22.9% of patients, followed by Cryptosporidium parvum (18.9%, rotavirus (18.1% and norovirus (13.7%. The main cause of diarrhoea in children aged 0 to 6 months were bacteria, predominantly DEC, while viruses predominated in the 7-12 months age group. Vibrio cholerae was isolated mostly in children above two years. Shigella spp, V. cholerae and DEC showed moderate to high rates of resistance to erythromycin, ampicillin, chloramphenicol and tetracycline (56.2-100%. V. cholerae showed full susceptibility to co-trimoxazole (100%, while DEC and Shigella showed high rate of resistance to co-trimoxazole; 90.6% and 93.3% respectively. None of the bacterial pathogens isolated showed resistance to ciprofloxacin which is not recommended for use in children. Cefotaxime resistance was found only in 4.7% of the DEC. Conclusion During the dry season, acute watery diarrhoea is the

  12. Infliximab therapy in pediatric patients 7 years of age and younger.

    Science.gov (United States)

    Kelsen, Judith R; Grossman, Andrew B; Pauly-Hubbard, Helen; Gupta, Kernika; Baldassano, Robert N; Mamula, Petar

    2014-12-01

    Infliximab (IFX) is efficacious for induction and maintenance of remission in pediatric patients with moderate-to-severe inflammatory bowel disease (IBD). It has, however, not been studied in patients 7 years old and younger. Our aim was to characterize efficacy and safety of IFX therapy in this cohort. This was a retrospective study of patients with IBD ages 7 years and younger, treated with IFX between 1999 and 2011. Medical records were reviewed for age of diagnosis, disease phenotype, therapy, surgery, IFX infusion dates, dose, and intervals. Outcome measures included physician global assessment, corticosteroid requirement, and adverse events. Thirty-three children (ages 2.4-7 years) were included. Twenty patients had Crohn disease, 4 had ulcerative colitis, and 9 had indeterminate colitis. Maintenance of IFX therapy at 1, 2, and 3 years was 36%, 18%, and 12%, respectively. Patients of age 5 years and younger had the lowest rates of maintenance of therapy at 25% at year 1, and 10% at years 2 and 3 combined. Nine percent of all of the patients demonstrated response measured by the physician global assessment and were steroid free at 1 year. There were 8 infusion reactions. There were no malignancies, serious infections, or deaths. IFX demonstrated a modest response rate and a low steroid-sparing effect in patients with IBD 7 years old and younger. Although this is a limited study, there appears to be a trend for decreased sustained efficacy with IFX in this age group, particularly in children 5 years old and younger, when compared with the previously published literature in older children.

  13. Early Executive Function at Age Two Predicts Emergent Mathematics and Literacy at Age Five.

    Science.gov (United States)

    Mulder, Hanna; Verhagen, Josje; Van der Ven, Sanne H G; Slot, Pauline L; Leseman, Paul P M

    2017-01-01

    Previous work has shown that individual differences in executive function (EF) are predictive of academic skills in preschoolers, kindergartners, and older children. Across studies, EF is a stronger predictor of emergent mathematics than literacy. However, research on EF in children below age three is scarce, and it is currently unknown whether EF, as assessed in toddlerhood, predicts emergent academic skills a few years later. This longitudinal study investigates whether early EF, assessed at two years, predicts (emergent) academic skills, at five years. It examines, furthermore, whether early EF is a significantly stronger predictor of emergent mathematics than of emergent literacy, as has been found in previous work on older children. A sample of 552 children was assessed on various EF and EF-precursor tasks at two years. At age five, these children performed several emergent mathematics and literacy tasks. Structural Equation Modeling was used to investigate the relationships between early EF and academic skills, modeled as latent factors. Results showed that early EF at age two was a significant and relatively strong predictor of both emergent mathematics and literacy at age five, after controlling for receptive vocabulary, parental education, and home language. Predictive relations were significantly stronger for mathematics than literacy, but only when a verbal short-term memory measure was left out as an indicator to the latent early EF construct. These findings show that individual differences in emergent academic skills just prior to entry into the formal education system can be traced back to individual differences in early EF in toddlerhood. In addition, these results highlight the importance of task selection when assessing early EF as a predictor of later outcomes, and call for further studies to elucidate the mechanisms through which individual differences in early EF and precursors to EF come about.

  14. Early Executive Function at Age Two Predicts Emergent Mathematics and Literacy at Age Five

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    Hanna Mulder

    2017-10-01

    Full Text Available Previous work has shown that individual differences in executive function (EF are predictive of academic skills in preschoolers, kindergartners, and older children. Across studies, EF is a stronger predictor of emergent mathematics than literacy. However, research on EF in children below age three is scarce, and it is currently unknown whether EF, as assessed in toddlerhood, predicts emergent academic skills a few years later. This longitudinal study investigates whether early EF, assessed at two years, predicts (emergent academic skills, at five years. It examines, furthermore, whether early EF is a significantly stronger predictor of emergent mathematics than of emergent literacy, as has been found in previous work on older children. A sample of 552 children was assessed on various EF and EF-precursor tasks at two years. At age five, these children performed several emergent mathematics and literacy tasks. Structural Equation Modeling was used to investigate the relationships between early EF and academic skills, modeled as latent factors. Results showed that early EF at age two was a significant and relatively strong predictor of both emergent mathematics and literacy at age five, after controlling for receptive vocabulary, parental education, and home language. Predictive relations were significantly stronger for mathematics than literacy, but only when a verbal short-term memory measure was left out as an indicator to the latent early EF construct. These findings show that individual differences in emergent academic skills just prior to entry into the formal education system can be traced back to individual differences in early EF in toddlerhood. In addition, these results highlight the importance of task selection when assessing early EF as a predictor of later outcomes, and call for further studies to elucidate the mechanisms through which individual differences in early EF and precursors to EF come about.

  15. Radiotherapy for carcinoma of the esophagus in aged patients

    International Nuclear Information System (INIS)

    Nomoto, Satoshi; Imada, Hajime; Yamashita, Shigeru; Terashima, Hiromi; Nakata, Hajime; Itoh, Hideaki; Ohsato, Keiichi; Okamura, Takeshi

    1995-01-01

    One hundred and fifty-four patients with esophageal carcinoma were treated with either irradiation alone or irradiation combined with surgery at the University of Occupational and Environmental Health Hospital between January 1980 and February 1992. The number of patients 75 years old and older was 25. In patients 74 years old and younger, the overall five-year survival rate by Kaplan-Meier method was 24.5%. The survival rate was best in the patients who were treated by a combination of irradiation and surgery. In patients 75 years old and older, the one-year survival rate was 59%, and the three-year rate was 20%. Aged patients had a tendency to be worse in performance status, and there was no correlation between treatment modality and survival time. We conclude that radiotherapy is useful for treating esophageal cancer in aged patients particularly when maintenance of the quality of life is considered. (author)

  16. Acute pancreatitis due to malaria: A case report of five patients and review of literature

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    Kundavaram Paul Prabhakar Abhilash

    2016-01-01

    Full Text Available Malaria is endemic in large parts of India and can cause multiorgan failure and death. Acute pancreatitis as a complication is rare and is potentially fatal. This case series describes five adult patients between 2005 and 2010 who presented with a short duration febrile illness and diagnosed to have malaria with acute pancreatitis. The mean age of the five patients with acute pancreatitis was 40.4 years and four of them were males. None of them were alcohol consumers and did not have any other risk factor for acute pancreatitis. Plasmodium falciparum was responsible for all the cases. Pancreatic enzymes were significantly elevated in all the patients with a mean serum lipase level of 1795 U/L (normal value: 1.4 mg/dl, and hyperbilirubinemia were seen in all the patients. One patient died due to multiorgan failure. Acute pancreatitis is a very rare complication of malaria, and a high index of suspicion is required in patients presenting with severe malaria and abdominal pain.

  17. Neurocognitive profiles in MSUD school-age patients.

    Science.gov (United States)

    Bouchereau, Juliette; Leduc-Leballeur, Julie; Pichard, Samia; Imbard, Apolline; Benoist, Jean-François; Abi Warde, Marie-Thérèse; Arnoux, Jean-Baptiste; Barbier, Valérie; Brassier, Anaïs; Broué, Pierre; Cano, Aline; Chabrol, Brigitte; Damon, Gilles; Gay, Claire; Guillain, Isabelle; Habarou, Florence; Lamireau, Delphine; Ottolenghi, Chris; Paermentier, Laetitia; Sabourdy, Frédérique; Touati, Guy; Ogier de Baulny, Hélène; de Lonlay, Pascale; Schiff, Manuel

    2017-05-01

    Maple syrup urine disease (MSUD), an inborn error of amino acids catabolism is characterized by accumulation of branched chain amino acids (BCAAs) leucine, isoleucine, valine and their corresponding alpha-ketoacids. Impact on the cognitive development has been reported historically, with developmental delays of varying degree. Currently, earlier diagnosis and improved management allow a better neurodevelopment, without requirement of special education. However, specific impairments can be observed, and so far, results of detailed neurocognitive assessments are not available. The aim of this study was to analyse neurocognitive profiles of French MSUD patients. This was a multicentre retrospective study on MSUD patients who underwent neurocognitive evaluation at primary school age. Twenty-one patients with classical neonatal onset MSUD were included. The patients' mean age at the time of evaluation was 8.7 years. The mean intellectual quotient (IQ) score was in the normal range (95.1 ± 12.6). In a subset of eight patients, a consistent developmental pattern of higher verbal than performance IQ was observed (mean of the difference 25.7 ± 8.7, p < 0.0001). No correlation could be established between this pattern and long-term metabolic balance (BCAA blood levels), or severity of acute metabolic imbalances, or leucine blood levels at diagnosis and time to toxin removal procedure. These data show that some MSUD patients may exhibit an abnormal neurocognitive profile with higher verbal than performance abilities. This might suggest an executive dysfunction disorder that would need to be further investigated by specialized testing. This pattern is important to detect in MSUD, as appropriate neuropsychological treatment strategies should be proposed.

  18. Age and gender might influence big five factors of personality: a preliminary report in Indian population.

    Science.gov (United States)

    Magan, Dipti; Mehta, Manju; Sarvottam, Kumar; Yadav, Raj Kumar; Pandey, R M

    2014-01-01

    Age and gender are two important physiological variables which might influence the personality of an individual. The influence of age and gender on big five personality domains in Indian population was assessed in this cross-sectional study that included 155 subjects (female = 76, male = 79) aged from 16-75 years. Big five personality factors were evaluated using 60-item NEO-Five Factor Inventory (NEO-FFI) at a single point in time. Among the big five factors of personality, Conscientiousness was positively correlated (r = 0.195; P personality traits might change with age, and is gender-dependent.

  19. Effect of Age on Allergen Responses of Allergic Patients in Southern Taiwan

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    Wen Chiang

    2004-07-01

    Full Text Available To survey airborne and food allergen patterns in southern Taiwan and to analyze the effect of age on response to different allergens, we tested samples from 4,411 allergic patients at Kaohsiung Medical University Hospital using the MAST-CLA test (new Taiwan panel. A total of 2,212 (50.1% samples showed a positive response. We grouped allergic patients into five age groups. Milk and egg white were the main food allergens in the younger groups (< 3 years old and 3-6 years old. Shrimp, crab, and shellfish were the main allergens in the groups aged 7-12, 13-18, and more than 18 years. Among airborne allergens, house dust and mites Dermatophagoides farinae and D. pteronyssinus were the main allergens in all age groups, whereas the frequency of response to cockroach allergen was low in the group aged less than 3 years, but increased in the other age groups. There was a sharp increase in the frequency of response to airborne allergens after 3 years old and a sharp decrease in response to food allergens. Among subjects allergic to both airborne and food allergens, there was a positive MAST-CLA rate of 19.9% to 26% (all five age groups, no significant difference. When we compared our results with those from Taipei Veterans General Hospital in northern Taiwan, there were significant differences for yeast, peanut, feather mix, dog dander, cockroach, D. farinae and D. pteronyssinus allergens (p < 0.01. These differences were probably caused by differences in patient location, patient age, disease patterns and allergen panels.

  20. Personality change following head injury: assessment with the NEO Five-Factor Inventory.

    Science.gov (United States)

    Lannoo, E; de Deyne, C; Colardyn, F; de Soete, G; Jannes, C

    1997-11-01

    We evaluated personality change following head injury in 68 patients at 6 months postinjury using the NEO Five-Factor Inventory to assess the five personality dimensions of the Five-Factor Model of Personality. All items had to be rated twice, once for the preinjury and once for the current status. Twenty-eight trauma patients with injuries to other parts of the body than the head were used as controls. For the head-injured group, 63 relatives also completed the questionnaire. The results showed no differences between the ratings of head-injured patients and the ratings of trauma control patients. Both groups showed significant change in the personality dimensions Neuroticism, Extraversion, and Conscientiousness. Compared to their relatives, head-injured patients report a smaller change in Extraversion and Conscientiousness. Changes were not reported on the Openness and Agreeableness scales, by neither the head-injured or their relatives, nor by the trauma controls.

  1. Influence of Psychosocial Factors on Aging among the Aged in Ihitte-Uboma Local Government Area of Imo State, Nigeria

    Science.gov (United States)

    Ojukwu, M. O.

    2016-01-01

    The major aim of this study was to examine influence of psychosocial factors on aging among the aged in Ihitte Uboma Local Government Area of Imo State, Nigeria. Ex-post facto or casual comparative research design was adopted for the study. Two hundred and twenty-five (225) old people were selected through random sampling for the study.…

  2. Cardiac abnormalities in the acquired immunodeficiency syndrome. A prospective study with a clinical-pathological correlation in twenty-one adult patients

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    Herdy Gesmar Volga Haddad

    1999-01-01

    Full Text Available OBJECTIVE - To evaluate the cardiac abnormalities and their evolution during the course of the acquired immunodeficiency syndrome, as well as to correlate clinical and pathological data. METHODS - Twenty-one patients, admitted to the hospital with the diagnosis of acquired immunodeficiency syndrome, were prospectively studied and followed until their death. Age ranged from 19 to 42 years (17 males. ECG and echocardiogram were also obtained every six months. After death, macro- and microscopic examinations were also performed. RESULTS - The most frequent causes of referral to the hospital were: diarrhea or repeated pneumonias, tuberculosis, toxoplasmosis or Kaposi sarcoma. The most frequent findings were acute or chronic pericarditis (42% and dilated cardiomyopathy (19%. Four patients died of cardiac problems: infective endocarditis, pericarditis with pericardial effusion, bacterial myocarditis and infection by Toxoplasma gondii. CONCLUSION - Severe cardiac abnormalities were the cause of death in some patients. In the majority of the patients, a good correlation existed between clinical and anatomical-pathological data. Cardiac evaluation was important to detect early manifestations and treat them accordingly, even in asymptomatic patients.

  3. Preventing Dental Caries in Children from Birth Through Age Five Years

    Science.gov (United States)

    Understanding Task Force Recommendations Preventing Dental Caries in Children from Birth Through Age Five Years The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation statement ...

  4. Treatment of Visceral Aneurysm Using Multilayer Stent: Two-Year Follow-Up Results in Five Consecutive Patients

    Energy Technology Data Exchange (ETDEWEB)

    Balderi, Alberto, E-mail: balders@libero.it; Antonietti, Alberto, E-mail: antonietti.a@ospedale.cuneo.it; Pedrazzini, Fulvio, E-mail: pedrazzini.f@ospedale.cuneo.it; Sortino, Davide, E-mail: davide.sortino@hotmail.it; Vinay, Claudia, E-mail: claudia.vinay@gmail.com; Grosso, Maurizio, E-mail: grosso.m@ospedale.cuneo.it [AO Santa Croce e Carle Hospital, Department of Radiology (Italy)

    2013-10-15

    Purpose: The present study was performed to analyze the midterm results (five consecutive patients, 2-year follow-up) of the endovascular management of visceral artery aneurysms using the Cardiatis Multilayer Flow Modulator (CMFM) (Cardiatis, Isnes, Belgium), a self-expandable stent. Materials and Methods: From August 2009 to January 2011, we implanted five CMFMs in five patients (all men; mean age 73 years) to treat two common hepatic artery aneurysms, one celiac trunk aneurysm, one splenic artery aneurysm, and one superior mesenteric artery aneurysm (diameter 25-81 mm). The primary end point was technical success. The secondary end point was stent patency, absence of aneurysm rupture or reperfusion, and shrinking of the sac at 6-, 12-, and 24-month follow-up using computed tomography angiography. Follow-up ranged from 24 to 48 months (mean 31.2). Results: Technical success was achieved in all patients. Complete exclusion of the aneurysm with sac shrinking was achieved in two patients. Two stents became occluded at 6- and 24-month follow-up, respectively; both patients were asymptomatic and were not retreated. One patient developed sac reperfusion due to incomplete aneurysm exclusion. Conclusion: Long-term results in a wider population are needed to validate the effectiveness of the CMFM.

  5. Inter- and intrarater reliability of goniometry and hand held dynamometry for patients with subacromial impingement syndrome.

    Science.gov (United States)

    Fieseler, Georg; Laudner, Kevin G; Irlenbusch, Lars; Meyer, Henrike; Schulze, Stephan; Delank, Karl-Stefan; Hermassi, Souhail; Bartels, Thomas; Schwesig, René

    2017-12-01

    The purpose of this study was to examine the intra- and interrater reliability of measuring shoulder range of motion (ROM) and strength among patients diagnosed with subacromial impingement syndrome (SAIS). Twenty-five patients (14 female patients; mean age, 60.4± 7.84 years) diagnosed with SAIS were assessed to determine the intrarater reliability for glenohumeral ROM. Twenty-five patients (16 female patients; mean age, 60.4± 7.80 years) and 76 asymptomatic volunteers (52 female volunteers; mean age, 29.4± 14.1 years) were assessed for interrater reliability. Dependent variables were active shoulder ROM and isometric strength. Intrarater reliability was fair-to-excellent for the SAIS patients (intraclass correlation coefficient [ICC], 0.52-0.97; standard error of measurement [SEM], 4.4°-9.9° N; coefficient of variation [CV], 7.1%-44.9%). Based on the ICC, 11 of 12 parameters (92%) displayed an excellent reliability (ICC> 0.75). The interrater reliability showed fair-to-excellent results (SAIS patients: ICC, 0.13-0.98; SEM, 2.3°-8.8°; CV, 3.6%-37.0%; controls: ICC, 0.11-0.96; SEM, 3.0°-35.4°; CV, 5.6%-26.4%). In accordance with the intrarater reliability, glenohumeral adduction ROM was the only parameter with an ICC below 0.75 for both samples. Painful shoulder ROM in the SAIS patients showed no influence on the quality of reliability for measurement. Therefore, these protocols should be considered reliable assessment techniques in the prevention, diagnosis, and treatment of painful shoulder conditions such as SAIS.

  6. Twenty years of society of medical informatics of b&h and the journal acta informatica medica.

    Science.gov (United States)

    Masic, Izet

    2012-03-01

    In 2012, Health/Medical informatics profession celebrates five jubilees in Bosnia and Herzegovina: a) Thirty five years from the introduction of the first automatic manipulation of data; b) Twenty five years from establishing Society for Medical Informatics BiH; c) Twenty years from establishing scientific and professional journal of the Society for Medical Informatics of Bosnia and Herzegovina "Acta Informatica Medica"; d) Twenty years from establishing first Cathdra for Medical Informatics on biomedical faculties in Bosnia and Herzegovina and e) Ten years from the introduction of "Distance learning" in medical curriculum. All of the five mentioned activities in the area of Medical informatics had special importance and gave appropriate contribution in the development of Health/Medical informatics in Bosnia And Herzegovina.

  7. Variations in GP-patient communication by ethnicity, age, and gender: evidence from a national primary care patient survey.

    Science.gov (United States)

    Burt, Jenni; Lloyd, Cathy; Campbell, John; Roland, Martin; Abel, Gary

    2016-01-01

    Doctor-patient communication is a key driver of overall satisfaction with primary care. Patients from minority ethnic backgrounds consistently report more negative experiences of doctor-patient communication. However, it is currently unknown whether these ethnic differences are concentrated in one gender or in particular age groups. To determine how reported GP-patient communication varies between patients from different ethnic groups, stratified by age and gender. Analysis of data from the English GP Patient Survey from 2012-2013 and 2013-2014, including 1,599,801 responders. A composite score was created for doctor-patient communication from five survey items concerned with interpersonal aspects of care. Mixed-effect linear regression models were used to estimate age- and gender-specific differences between white British patients and patients of the same age and gender from each other ethnic group. There was strong evidence (Pcommunication varied by both age and gender. The difference in scores between white British and other responders on doctor-patient communication items was largest for older, female Pakistani and Bangladeshi responders, and for younger responders who described their ethnicity as 'Any other white'. The identification of groups with particularly marked differences in experience of GP-patient communication--older, female, Asian patients and younger 'Any other white' patients--underlines the need for a renewed focus on quality of care for these groups. © British Journal of General Practice 2016.

  8. Relationship between age at menarche and skeletal maturation stages in Taiwanese female orthodontic patients.

    Science.gov (United States)

    Lai, Eddie Hsiang-Hua; Chang, Jenny Zwei-Chieng; Jane Yao, Chung-Chen; Tsai, Shih-Jaw; Liu, Jen-Pei; Chen, Yi-Jane; Lin, Chun-Pin

    2008-07-01

    The age at menarche reflects a pubertal girl's physiologic maturity. The aims of this study were to evaluate the relationship between the age at menarche and skeletal maturation in female orthodontic patients. Hand-wrist radiographs and lateral cephalometric radiographs from 304 adolescent female subjects (age, 8-18.9 years) were selected from the files of the Department of Orthodontics, National Taiwan University Hospital (NTUH). Hand-wrist bone maturation stages were assessed using the NTUH Skeletal Maturation Index (NTUH-SMI). Cervical vertebral maturation stages (CVMS) were determined using the latest CVMS Index. Menarcheal ages were self-reported by the patients and verified by the patients' mothers. The relationships between the NTUH-SMI or CVM stages and menarcheal status were investigated. More than 90% of the 148 subjects who had already attained menstruation had skeletal maturation beyond the NTUH-SMI stage four or CVMS III. However, the subjects who had never experienced menarche mostly had skeletal maturation before NTUH-SMI stage five or CVMS IV. During the period of orthodontic treatment, 19 females experienced their menarche. The mean age at menarche for the 167 female patients in total was 11.97 years. In average, menarche occurred between NTUH-SMI stages four and five or between CVM stages III and IV. The percentage of girls with menses increased from 1.2% at age 9 to 6.6% at age 10, 39.5% at age 11, 81.4% at age 12, 97% at age 13, and 100% at age 14. Compared with the results obtained 20 years previously, we found a downward shift of 0.47 years per decade for the mean age at menarche in female orthodontic patients. The majority of female orthodontic patients have passed the pubertal growth spurt when they experience their menarche. Menarche usually follows the pubertal growth spurt by about 1 year and occurs after NTUH-SMI stage four or CVMS III.

  9. Crossed cerebellar diaschisis demonstrated by SPECT in hemiplegic children

    International Nuclear Information System (INIS)

    Hamano, Shin-ichiro; Nara, Takahiro; Nozaki, Hidetsugu; Fukushima, Kiyomi; Imai, Masayuki; Kumagai, Koumei; Maekawa, Kihei.

    1991-01-01

    Crossed cerebellar diaschisis (CCD) in twenty five children with hemiplegia were studied using single photon emission computed tomography (SPECT) with N-isopropyl-p-I-123-iodoamphetamine. Seven of twenty-five patients had cerebral palsy, and the others were impaired by acquired brain injury between ten months and fourteen years of age. CCD was demonstrated in five patients (20%), who were impaired by acquired brain injury after seven years of age. CCD could never be detected in patients with cerebral palsy. Ipsilateral cerebellar diaschisis was also demonstrated in two patients with cerebral palsy and three with early acquired brain injury before three years of age. It is suggested that diaschisis presents itself as a different form in a contralateral and ipsilateral cerebellum before three years of age from a form which presents after seven years of age. (author)

  10. Five-year forward view: lessons from emergency care at the extremes of age.

    Science.gov (United States)

    Minhas, J S; Minhas, D; Coats, T; Banerjee, J; Roland, D

    2018-03-01

    Objective The progressive rise in demand on NHS emergency care resources is partly attributable to increases in attendances of children and older people. A quality gap exists in the care provision for the old and the young. The Five Year Forward View suggested new models of care but that the "answer is not one-size-fits-all". This article discusses the urgent need for person-centred outcome measures to bridge the gap that exists between demand and provision. Design This review is based on evidence gathered from literature searching across several platforms using a variety of search terms to account for the obvious heterogeneity, drawing on key 'think-tank' evidence. Settings Qualitative and quantitative studies examining approaches to caring for individuals at the extremes of age. Participants Individuals at the extremes of age (infants and older people). Main Outcome Measures Understanding similarities and disparities in the care of individuals at the extremes of age in an emergency and non-emergency context. Results There exists several similarities and disparities in the care of individuals at the extremes of age. The increasing burden of health disease on the economy must acknowledge the challenges that exist in managing patients in emergency settings at the extremes of age and build systems to acknowledge the traits these individuals exhibit. Conclusion Commissioners of services must optimise the models of care delivery by appreciating the similarities and differences between care requirements in these two large groups seeking emergency care.

  11. Paternal age in relation to offspring intelligence in the West of Scotland Twenty-07 prospective cohort study.

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    Elise Whitley

    Full Text Available BACKGROUND: The adverse effects of advancing maternal age on offspring's health and development are well understood. Much less is known about the impact of paternal age. METHODS: We explored paternal age-offspring cognition associations in 772 participants from the West of Scotland Twenty-07 study. Offspring cognitive ability was assessed using Part 1 of the Alice Heim 4 (AH4 test of General Intelligence and by reaction time (RT. RESULTS: There was no evidence of a parental age association with offspring RT. However, we observed an inverse U-shaped association between paternal age and offspring AH4 score with the lowest scores observed for the youngest and oldest fathers. Adjustment for parental education and socioeconomic status somewhat attenuated this association. Adjustment for number of, particularly older, siblings further reduced the scores of children of younger fathers and appeared to account for the lower offspring scores in the oldest paternal age group. CONCLUSION: We observed a paternal age association with AH4 but not RT, a measure of cognition largely independent of social and educational experiences. Factors such as parental education, socioeconomic status and number of, particularly older, siblings may play an important role in accounting for paternal age-AH4 associations. Future studies should include parental intelligence.

  12. Sociomedical sequels and quality of life in patients of old age group with proximal femoral fractures

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    T. A. Raskina

    2014-01-01

    Full Text Available The sociomedical significance of osteoporosis is determined by its sequels (vertebral and peripheral skeletal fractures that are responsible for high mortality and disability rates among persons in the old age group and accordingly for high material costs in the health care system.Objective: to study sociomedical sequels and quality of life in patients with proximal femoral fractures in the old age group.Subjects and methods. 956 patients with osteoporotic fractures were followed up. Major social sequels were traced in the patients 6, 12, and 24 months after femur fractures in relation to treatment options.Results. There were 10 (8.0% and 78 (66.7% bedridden patients in the surgical and medical treatment groups, respectively. Twenty four months after fracture, recovery of function was noted in 72 (57.6% and 32 (27.35% patients receiving surgical and medical treatment, respectively.Conclusion. The findings suggest that immediate and late sequels in patients with proximal femoral fractures depend on a treatment option.

  13. Percutaneous nephrolithotomy in very elderly patients (Age 75 and Over

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    Hüseyin Çelik

    2015-12-01

    Full Text Available Objective: Percutaneous nephrolithotomy (PNL is a minimally invasive method used safely in surgical treatment of kidney stones in the world. The first PNL surgery performed in our clinic in March 1998 and first PNL surgery was performed in June 2000 over the age of seventy which was bilaterally side. In our study, PNL operations performed for 75 years and older patients were examined. Methods: PNL operations were performed under the general anesthesia. After cystoscopy in the supine position, ureteral catheter was inserted accompanied by C-arm fluoroscopy. Afterwards, patients were taken prone position then we entered into the kidney with a metal needle with fluoroscopic on. We dilated the entrance with Amplatzer renal dilatators set until the 30 F. After the procedure, the nephrostomy catheter was placed in the renal sheath. 4 mm residual fragments after the PNL operation were accepted as clinically insignificant stone residues (CIRF. Results: 3003 PNL procedures were performed between dates March 1998 - December 2014 in total 16 years. 28 patients of total were 75 years and over. 29 PNL surgeries performed to these patients, including one bilateral PNL procedure. Mean age was 79.36 years (75-88. Twenty (74% of the patients were concluded stone free. 2 patients had tubeless PNL surgery. There was no another complication. Conclusion: PNL is a minimally invasive method has became advantageous according to open surgery because of higher safety, lower complication rates, shorter hospitalization stay, more patient comfort and higher stone free rates. PNL is a safe and effective method in the surgical treatment of urinary tract stone diseases.

  14. The effect of normal aging and age-related macular degeneration on perceptual learning.

    Science.gov (United States)

    Astle, Andrew T; Blighe, Alan J; Webb, Ben S; McGraw, Paul V

    2015-01-01

    We investigated whether perceptual learning could be used to improve peripheral word identification speed. The relationship between the magnitude of learning and age was established in normal participants to determine whether perceptual learning effects are age invariant. We then investigated whether training could lead to improvements in patients with age-related macular degeneration (AMD). Twenty-eight participants with normal vision and five participants with AMD trained on a word identification task. They were required to identify three-letter words, presented 10° from fixation. To standardize crowding across each of the letters that made up the word, words were flanked laterally by randomly chosen letters. Word identification performance was measured psychophysically using a staircase procedure. Significant improvements in peripheral word identification speed were demonstrated following training (71% ± 18%). Initial task performance was correlated with age, with older participants having poorer performance. However, older adults learned more rapidly such that, following training, they reached the same level of performance as their younger counterparts. As a function of number of trials completed, patients with AMD learned at an equivalent rate as age-matched participants with normal vision. Improvements in word identification speed were maintained at least 6 months after training. We have demonstrated that temporal aspects of word recognition can be improved in peripheral vision with training across a range of ages and these learned improvements are relatively enduring. However, training targeted at other bottlenecks to peripheral reading ability, such as visual crowding, may need to be incorporated to optimize this approach.

  15. Clinical characteristics and outcomes of bacteraemic melioidosis in a teaching hospital in a northeastern state of Malaysia: a five-year review.

    Science.gov (United States)

    Deris, Zakuan Zainy; Hasan, Habsah; Siti Suraiya, Mohd Noor

    2010-08-04

    Melioidosis is an important public health problem causing community acquired sepsis in the northeastern part of Malaysia. From January 2001 to December 2005, we reviewed case reports of all bacteraemic melioidosis admitted to a tertiary teaching hospital, Hospital Universiti Sains Malaysia. Thirty-five patients had positive blood culture for meliodosis and 27 case reports were traceable for further analysis. The mean age was 46.8 + 20.0 years. Twenty patients (74.1%) were male. The main clinical presentation was fever that occurred in 23 (85.2%) patients. Eighteen patients (66.7%) had lung involvement and three patients had liver abscess. Two patients presented with scrotal swelling, one of whom further developed Fournier's Gangrene. Nineteen (70.4%) patients had underlying diabetes, five of whom were newly diagnosed during the admission. Thirteen (48.1%) patients were treated with high-dose ceftazidime and six (22.2%) patients were treated with imipenem. Eight (29.6%) patients were not given anti-melioidosis therapy because the causative agents were not identified until after the patients died. The patients were admitted 16.8 days + 18.1. Seventeen patients (63.0%) died in this series, 13 patients of whom died within four days of admission. The wide range of clinical presentations and the fatal outcomes of melioidosis require a high level of suspicion among physicians to develop an early appropriate therapy and reduce the mortality rate.

  16. Prognostic factors and outcome of treatment in Perthes' disease: a prospective study of 368 patients with five-year follow-up.

    Science.gov (United States)

    Wiig, O; Terjesen, T; Svenningsen, S

    2008-10-01

    This nationwide prospective study was designed to determine prognostic factors and evaluate the outcome of different treatments of Perthes' disease. A total of 28 hospitals in Norway were instructed to report all new cases of Perthes' disease over a period of five years and 425 patients were reported and followed for five years. Of these, 368 with unilateral disease were included in the present study. The hips were classified radiologically according to a modified two-group Catterall classification and the lateral pillar classification. A total of 358 patients (97%) attended the five-year follow-up, when a modified three-group Stulberg classification was used as a radiological outcome measure. For patients over six years of age at diagnosis and with more than 50% necrosis of the femoral head (152 patients), the surgeons at the different hospitals had chosen one of three methods of treatment: physiotherapy (55 patients), the Scottish Rite abduction orthosis (26), and proximal femoral varus osteotomy (71). Of these hips, 146 (96%) were available for the five-year follow-up. The strongest predictor of outcome was femoral head involvement of more or less than 50% (odds ratio (OR) = 7.76, 95% confidence interval (CI) 2.82 to 21.37), followed by age at diagnosis (OR = 0.98, 95% CI 0.92 to 0.99) and the lateral pillar classification (OR = 0.62, 95% CI 0.40 to 0.98). In children over six years at diagnosis with more than 50% of femoral head necrosis, proximal femoral varus osteotomy gave a significantly better outcome than orthosis (p = 0.001) or physiotherapy (p = 0.001). There was no significant difference between the physiotherapy and orthosis groups (p = 0.36), and we found no difference in outcome after any of the treatments in children under six years (p = 0.73). We recommend proximal femoral varus osteotomy in children aged six years and over at the time of diagnosis with hips having more than 50% femoral head necrosis. The abduction orthosis should be abandoned in

  17. Five-year survival in 309 patients with colorectal liver metastases treated with radiofrequency ablation

    International Nuclear Information System (INIS)

    Gillams, A.R.; Lees, W.R.

    2009-01-01

    There is little published long-term survival data for patients with colorectal liver metastases treated with radiofrequency ablation (RFA). We present a multivariate analysis of 5-year survival in 309 patients (198 male, aged 64 (24-92)) treated at 617 sessions. Our standard protocol used internally cooled electrodes introduced percutaneously under combined US and CT guidance/monitoring. The number and size of liver metastases, the presence and location of extrahepatic disease, primary resection, clinical, chemotherapy and follow-up data were recorded. Data analysis was performed using SPSS v.10. On multivariate analysis, significant survival factors were the presence of extrahepatic disease (p < 0.001) and liver tumour volume (p = 0.001). For 123 patients with five or less metastases of 5 cm or less maximum diameter and no extrahepatic disease median survival was 46 and 36 months from liver metastasis diagnosis and ablation, respectively; corresponding 3- and 5-year survival rates were 63%, 34% and 49%, 24%. Sixty-nine patients had three or less tumours of below 3.5 cm in diameter and their 5-year survival from ablation was 33%. There were 23/617(3.7%) local complications requiring intervention. Five-year survival of 24-33% post ablation in selected patients is superior to any published chemotherapy data and approaches the results of liver resection. (orig.)

  18. Obesity among adolescents in five Arab countries: relative to gender and age

    OpenAIRE

    A.O. Musaiger; M. Al-Mannai; O. Al-Lalla; S. Saghir; I. Halahleh; M. M. Benhamed; F. Kalam; E.Y.A. Ali

    2013-01-01

    Objective: To determine the prevalence of overweight and obesity among adolescents in five Arab countries, relative to age and sex. Methods: A multistage stratified random sampling technique was used to select the secondary school students from five Arab countries (Kuwait, Libya, Palestine, Syria and United Arab Emirates). The total sample was 3,302 (1,584 males, 1,718 females). Weight and height were measured, and body mass index was used to calculate the proportion of overweight and obesity...

  19. Effects of Twenty-four Move Shadow Boxing Combined with psychosomatic relaxation on Depression and Anxiety in Patients with Type-2 Diabetes.

    Science.gov (United States)

    Zheng, Yingying; Zhou, Yiyi; Lai, Qiujia

    2015-06-01

    The aim of the current study was to observe the effects of Twenty-four Move Shadow Boxing combined with psychosomatic relaxation on depression and anxiety in patients with Type-2 Diabetes. One hundred and twenty (120) patients with Type-2 Diabetes and depressive/anxious symptoms were divided into intervention group (60 cases) and control group (60 cases) according to the minimum distribution principle of unbalanced indicators. Twenty-four Move Shadow Boxing group used this intervention combined with psychosomatic relaxation. Control group underwent conventional treatment. All the patients in the two groups completed the Self-rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) before and after treatment. Among the 52 people included in the statistical analysis, the recovery rate was 13.3%. The differences between depression and anxiety scores in the intervention group before and after treatment were statistically significant (PBoxing and psychosomatic relaxation has a beneficial auxiliary therapeutic effect on depression and anxiety accompanying Type-2 Diabetes.

  20. Predictors of low self-rated health in patients aged 65+ after total hip replacement (THA)

    DEFF Research Database (Denmark)

    Hørdam, Britta; Hemmingsen, Lars

    2013-01-01

    predicting low self-rated health after surgery. Material and method: A cross-sectional study including 287 patients aged 65+, who had had THR within 12-months were performed. Patients from five Danish counties received a mailed questionnaire assessing health status and demographic data. Short Form-36...

  1. Horror fusionis: a report of five patients.

    Science.gov (United States)

    Rutstein, R P; Bessant, B

    1996-12-01

    Horror fusionis is an uncommon anomaly and is rarely reported in the literature. Five adults with long-standing diplopia associated with horror fusionis were examined. All patients had strabismus since early childhood and had been treated at that time either with surgery, occlusion, and/or orthoptics/vision therapy. Prisms could not eliminate the diplopia. Graded occlusion was attempted with one patient but was not tolerated. Another patient with an asymmetrical dissociated vertical deviation could ignore the second image by fixating with the eye with the smaller deviation. Two patients reported the diplopia becoming less noticeable over the years. Because of its poor prognosis, the diplopia associated with horror fusionis must be differentiated from other types of diplopia occurring in adults with childhood onset strabismus.

  2. The Twenty Statement Test in Teacher Development

    Directory of Open Access Journals (Sweden)

    Ahmet Aypay

    2011-10-01

    Full Text Available The purpose of this study is to describe teacher characteristics using Twenty Statements Test (TST. Study group includes a total of thirty-five individuals, including teachers, guidance and counselors and research assistants. The study used a qualitative approach on teacher identity. TST is one of the qualitative methods that were used to determine individual self-conceptualization. Study group were requested to write twenty statements that describe themselves responding to the question “Who I am?” in a free format. The findings indicated that teachers were overwhelmingly in group c (reflective. No differences were found in terms of gender and profession. Only few significant differences have been found based on marital status. The utility of TST in teacher training and development was discussed.

  3. The Twenty Statement Test in Teacher Development

    Directory of Open Access Journals (Sweden)

    Ahmet Aypay

    2011-04-01

    Full Text Available The purpose of this study is to describe teacher characteristics using Twenty Statements Test (TST. Study group includes a total of thirty-five individuals, including teachers, guidance and counselors and research assistants. The study used a qualitative approach on teacher identity. TST is one of the qualitative methods that were used to determine individual self-conceptualization. Study group were requested to write twenty statements that describe themselves responding to the question “Who I am?” in a free format. The findings indicated that teachers were overwhelmingly in group c (reflective. No differences were found in terms of gender and profession. Only few significant differences have been found based on marital status. The utility of TST in teacher training and development was discussed

  4. Radiation therapy: A major factor in the five-year survival analysis of women with breast cancer in Lagos, Nigeria

    International Nuclear Information System (INIS)

    Makanjuola, Samira B.L.; Popoola, Abiodun O.; Oludara, Mobolaji A.

    2014-01-01

    Purpose: This retrospective study was carried out to examine five-year survival from breast cancer cases diagnosed between 2005 and May 2008 in Nigerian women. Material and methods: Two hundred and twenty-four patients were entered into the study. Five-year survival was evaluated using proportional hazard model proposed by Cox to assess variables such as age of diagnosis, menopausal status, and stage of the disease in the two treatment groups: surgery/chemotherapy or surgery/chemotherapy/radiotherapy. Results: Findings revealed that the different staging of disease and treatment are independent predictors of disease outcome whereas age of diagnosis and menopausal status although associated with low hazards, are not significant. TNM Stage I (Hazard Ratio = 0.153, 95% CI 0.45–0.51, P = 0.003), II (Hazard Ratio = 0.245, 95% CI 0.12–0.46, P = 0.0001), and III (Hazard Ratio = 0.449, 95% CI 0.31–0.46, P = 0.0001) showed significantly greater survival rates compared to TNM Stage IV for patients receiving surgery/chemotherapy. Similarly, for patients receiving surgery/chemotherapy/radiotherapy TNM Stage II (Hazard Ratio = 0.110, 95% CI 0.02–0.46, P = 0.003) and III (Hazard Ratio = 0.238, 95% CI 0.07–0.73, P = 0.012) also showed significantly greater survival rates compared to TNM Stage IV. Treatment had a significant impact on survival independent of stage, age, and menopausal status. Patients receiving surgery/chemotherapy/radiotherapy had a significant increase in survival outcome for TNM Stage (II, P = 0.045; III, P = 0.0001); age groups (40–49, P = 0.021; 50–59, P = 0.016; 60–69, P = 0.017; >70, P = 0.025); and menopausal status (premenopausal, P = 0.049; postmenopausal, P = 0.0001) compared to those receiving surgery/chemotherapy. Conclusion: The five-year breast cancer survival rate in Lagos, Nigeria 24.1% (54/224) is relatively poor compared to most countries in the world and needs to be improved. Poor survival rates are mainly attributed to late

  5. Radiotherapy for patients with malignant diseases aged 85 years or older

    International Nuclear Information System (INIS)

    Asakura, Hirofumi; Mizumoto, Masashi; Zenda, Sadamoto

    2007-01-01

    The purpose of this study was to assess the efficacy and problems of radiotherapy for patients aged 85 or older. Forty-five patients were assessed (oldest old group): They were 85 years of age or older and had received radiotherapy between September 2002 and September 2005. Sixty-nine patients, 75 years of age at the start of radiotherapy, were also assessed (old group). In the oldest old group, there were 21 men and 24 women, and median age was 87 years (range; 85-99). The sites of disease were: 10 in head and neck, 5 in lung, 5 in malignant lymphoma, 4 in skin, 4 in esophagus, 2 in breast, 2 in uterine cervix, 2 in rectum, 2 in soft tissue, 2 in metastatic bone tumor, 7 in others. The treatment was deemed curative in 49%, palliative in 40%, and others in 11%. Treatment fields were limited due to performance status (PS) or age in 13 patients. The rate of treatment completion was 91% (41/45). Eleven of 26 inpatients were admitted because of difficulty in hospital visit. Seventeen of 19 outpatients needed familial escort. Of patients completed radiotherapy, 47% of the patients achieved complete response (CR), 37% achieved partial response (PR), and 16% achieved no change (NC) in the group of curative radiotherapy, and 88% of the patients achieved effective response, and only 2 cases resulted in ineffective response in the group of palliative radiotherapy. While only one patient received grade 3 dermatitis and mucositis, other patients received grade 2 and below adverse events. Three patients resulted in deterioration of PS, and 2 patients deteriorated dementia. Although higher rates in female patients, worse PS, and limitation of treatment field were seen in the oldest old group, there were no significant difference in terms of the rate of treatment completion, effectiveness, and adverse events between the two groups. Our study showed radiotherapy is effective and well tolerated in patients aged 85 or older. Considering the oldest old requiring radiotherapy

  6. Varied autopsy findings in five treated patients with Gaucher disease and parkinsonism include the absence of Gaucher cells.

    Science.gov (United States)

    Monestime, Gianina; Borger, Daniel K; Kim, Jenny; Lopez, Grisel; Allgaeuer, Michael; Jain, Dhanpat; Vortmeyer, Alexander; Wang, Hao-Wei; Sidransky, Ellen

    2016-05-01

    Enzyme replacement therapy is standard of care for patients with Gaucher disease, as it significantly improves skeletal, visceral, and hematological symptoms. Few pathological studies have documented the extent of pathological findings in treated patients. Autopsy findings in five treated patients, who ultimately developed parkinsonism, ranged from the complete absence of Gaucher pathology to extensive involvement of multiple tissues, without correlation to age, genotype, spleen status, or dose/duration of therapy. Additional autopsies may elucidate modifiers and biomarkers contributing to disease burden and response to therapy. Published by Elsevier Inc.

  7. Long-chain polynucleotide filler for skin rejuvenation: efficacy and complications in five patients.

    Science.gov (United States)

    Park, Kui Young; Seok, Joon; Rho, Nark Kyoung; Kim, Beom Joon; Kim, Myeung Nam

    2016-01-01

    Aging well has become the new target of preventative medicine, and aesthetic dermatology can contribute to this request. The polynucleotide (PN) containing products not only fill the space, but improve tissue regeneration, resulting in more natural tissue regeneration. Five Korean women received four times injections of long-chain PN filler in two-week intervals for skin rejuvenation. About 0.05 mL of material was injected in 40 points of one-side cheek. The pore and skin thickness were markedly improved in the patients in their 30s, whereas skin tone, melanin, wrinkles, and sagging were noticeably improved for patients in their 40s. There are no serious side effects. In conclusion, intradermal long-chain PN filler injection seems to be an effective and safe treatment for skin rejuvenation. © 2015 Wiley Periodicals, Inc.

  8. 'Twenty-five years after Chernobyl accident: Safety for the future'. 2011 National report of Ukraine

    International Nuclear Information System (INIS)

    Imanaka, Tetsuji; Shindo, Mahito

    2016-02-01

    This is the Japanese translation of the Ukrainian National Report 'Twenty-five Years after Chernobyl Accident: Safety for the Future', published by the Ministry of Ukraine of Emergencies in 2011 (in Ukrainian and English). This Japanese translation is published as an outcome of the KAKENHI research project on liquidations of Nuclear Disasters in the World (headed by Tetsuji Imanaka), in which Shindo participates, and as a KUR report of the Research Reactor Institute at Kyoto University. The objective of publishing this Japanese translation is to provide basic information on how to overcome the consequences of a large-scale Nuclear Disaster for the wide range of public, including decision-makers and administrative staff. By doing so, this publication aims at invigorating discussions over measures to be applied for overcoming the consequences of the TEPCO Nuclear Disaster (started in 11th March 2011 at Fukushima), and at forming proper schemes to minimise the consequences on current and future generations. The original text of this translation tightly summarised the whole picture of the Chernobyl Nuclear Disaster, which had been the only large-scale Nuclear Disaster until 11th March 2011. More importantly, it describes all sorts of measures and schemes taken in Ukraine from 1986 to 2011 in order to overcome the consequences of the Chernobyl Nuclear Disaster, in a quite well structured manner. In other words, from the contents of this text, Japanese readers are able to learn a lot about the very problems currently facing with. Therefore, I wish many Japanese readers will read this text, and utilise the knowledge written here effectively to overcome the consequences of the TEPCO Nuclear Disaster. (J.P.N.)

  9. Parental questionnaire as a screening instrument for motor function at age five

    DEFF Research Database (Denmark)

    Nordbye-Nielsen, Kirsten; Kesmodel, Ulrik Schiøler

    2014-01-01

    , Pearson’s χ2-test, logistic regression analyses and sensitivity and specificity were used to assess the correlation between the questionnaire and the M-ABC test. Results: The best screening tool was six questions in combination: sensitivity 39.8%, specificity 87.1%. Asking if a health professional ever......Introduction: No standardised method is used to determine motor function in children in general practice in Denmark. Our aim was to evaluate the correlation between a parental questionnaire assessing motor function at the age of five years and the clinical test Movement Assessment Battery...... for Children (M-ABC), and to assess whether one or more questions could be used to screen for motor problems at the age of five years. Methods: This study was based on a parental questionnaire containing ten questions. The M-ABC was used as the gold standard. n = 755 children. The Mann-Whitney rank sum test...

  10. Driving safety among patients with automatic implantable cardioverter defibrillators.

    Science.gov (United States)

    Finch, N J; Leman, R B; Kratz, J M; Gillette, P C

    1993-10-06

    To determine the driving behavior of patients following the placement of automatic implantable cardioverter defibrillators (AICDs). Forty patients with AICDs (33 men, seven women; mean age, 62.7 years) responded to a questionnaire designed to ascertain driving behavior after hospital discharge. Despite medical advice never to drive again, 28 patients (70%) resumed driving, with the majority doing so by 8 months after AICD implantation. Of these, 11 (40%) identified themselves as the primary driver in their household. Fourteen (50%) drove daily. Two (7%) were driving and continued to drive during discharge of their AICDs. Twenty-five (91%) reported that they felt comfortable and safe while driving. A majority of patients with AICDs continue to drive after a proscription of this activity by health care workers.

  11. Reference values of reticulocyte counts in five age groups of healthy infants at rawalpindi, pakistan

    International Nuclear Information System (INIS)

    Bukhari, K.T.; Zafar, H.

    2013-01-01

    Objectives: To determine the reference range values of reticulocyte counts among various infantile age groups at tertiary care hospitals. Methods: The descriptive cross-sectional study was carried out at the Haematology Department of the Armed Forces Institute of Pathology (AFIP), Rawalpindi, from March 2010 to March 2011. The sample size was 2000 which was equally distributed between males and females across five age groups. <27 days Group I; 03 months Group II; 06 months Group III; 09 months Group IV; and 1 year Group V. Each group had 400 patients. Reticulocyte staining was used to calculate the percentage of reticulocyte in all the groups. SPSS 15 was used for statistical analysis. Results: Gender had no effect on reticulocyte count in all the five groups. The average range of reticulocyte count was 5.1 to 7.5 in Group I, observed in 272 (68%) infants, with a mean value of 1.58+-0.65. For all the remaining groups, 7.6 to 10 was the average range. The mean reticulocyte count value in Group II was 0.73+-0.37, while the values were 0.83+-0.44, 0.82+-0.44 and 0.80+-0.43 in Group III, Group IV and Group V respectively. A significant difference was seen between Group I and the remaining four (p <0.05). Conclusion: Reference values of reticulocyte counts currently used in our region were somewhat different from those currently used. (author)

  12. Radioactive iodine therapy for patients with Graves' disease aged 18 or younger

    International Nuclear Information System (INIS)

    Ogawa, Takahiro; Goshi, Kazuto; Tajiri, Junichi

    2008-01-01

    There have been few reports concerning radioactive iodine therapy (RI therapy) for Graves' disease in children, even in the United States of America (USA), and there have been no reports of such treatment in Japan. We evaluated the short-term results of RI therapy for Graves' disease aged 18 or younger. A total of 36 patients (10 male and 26 female) with Graves' disease, aged 18 and younger (range, 13 to 18 years; mean age, 15.8±1.5 years), received RI therapy on an outpatient basis at our clinic between July 1999 and July 2005. The mean interval from initiation of an antithyroid drug (ATD) to RI therapy was 25.3±21.5 months (range, 1 to 78 months). Twenty patients received therapy once, 14 twice, and 2 three times. The mean initial dose of radioactive iodine was 7.8±2.9 mCi (range, 3.6 to 13.0 mCi) and the mean total dose was 12.3±7.7 mCi (range, 3.6 to 29.8 mCi). The mean estimated weight of the thyroid gland was 42.6±23.4 g (range, 15.5 to 99.4 g) before RI therapy and 7.1±3.0 g (range, 2.0 to 13.6 g) after RI therapy. The mean follow-up period after RI therapy was 41.1±18.0 months (range, 6 to 71 months). Currently, 15 patients (42%) have hypothyroidism, 8 (22%) have subclinical hypothyroidism, 5 (14%) have euthyroidism, and 8 (22%) have subclinical hyperthyroidism. Patients taking thyroid hormone were considered hypothyroid. Patients with subclinical hypothyroidism are currently being monitored without treatment. No patients with subclinical hyperthyroidism are taking an ATD or KI (potassium iodide). A total of 36 patients with Graves' disease, aged 18 and younger, received RI therapy, and the short-term outcome in these patients were favorable. However, prolonged follow-up observation is required to confirm long-term safety. (author)

  13. Healthy ageing and home: the perspectives of very old people in five European countries.

    Science.gov (United States)

    Sixsmith, J; Sixsmith, A; Fänge, A Malmgren; Naumann, D; Kucsera, C; Tomsone, S; Haak, M; Dahlin-Ivanoff, S; Woolrych, R

    2014-04-01

    This paper reports on in-depth research, using a grounded theory approach, to examine the ways in which very old people perceive healthy ageing in the context of living alone at home within urban settings in five European countries. This qualitative study was part of a cross-national project entitled ENABLE-AGE which examined the relationship between home and healthy ageing. Interviews explored the notion of healthy ageing, the meaning and importance of home, conceptualisations of independence and autonomy and links between healthy ageing and home. Data analysis identified five ways in which older people constructed healthy ageing: home and keeping active; managing lifestyles, health and illness; balancing social life; and balancing material and financial circumstances. Older people reflected on their everyday lives at home in terms of being engaged in purposeful, meaningful action and evaluated healthy ageing in relation to the symbolic and practical affordances of the home, contextualised within constructions of their national context. The research suggests that older people perceive healthy ageing as an active achievement, created through individual, personal effort and supported through social ties despite the health, financial and social decline associated with growing older. The physicality and spatiality of home provided the context for establishing and evaluating the notion of healthy ageing, whilst the experienced relationship between home, life history and identity created a meaningful space within which healthy ageing was negotiated. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Loss of Y-chromosome does not correlate with age at onset of head and neck carcinoma: a case-control study

    Energy Technology Data Exchange (ETDEWEB)

    Silva Veiga, L.C. [Departamento de Genética, Instituto de Biociências, Universidade Estadual Paulista, Botucatu, SP (Brazil); Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Bérgamo, N.A. [Departamento de Biologia Geral, Instituto de Ciências Biológicas, Universidade Federal de Goiás, Goiânia, GO (Brazil); Reis, P.P. [Departamento de Cirurgia e Ortopedia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP (Brazil); Kowalski, L.P. [Departamento de Cirurgia de Cabeça e Pescoço e Otorrinolaringologia, Hospital A.C. Camargo, São Paulo, SP (Brazil); Rogatto, S.R. [Laboratório NeoGene, Departamento de Urologia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP (Brazil); Departamento de Pesquisa, Hospital A.C. Camargo,Fundação Antônio Prudente, São Paulo, SP (Brazil)

    2012-01-20

    Loss of Y-chromosome has been correlated with older age in males. Furthermore, current evidence indicates that Y-chromosome loss also occurs in several human tumors, including head and neck carcinomas. However, the association between Y nullisomy and the occurrence of neoplasias in elderly men has not been well established. In the present study, the association between Y-chromosome loss and head and neck carcinomas was evaluated by comparison to cells from peripheral blood lymphocytes and normal mucosa of cancer-free individuals matched for age using dual-color fluorescence in situ hybridization. Twenty-one patients ranging in age from 28 to 68 years were divided into five-year groups for comparison with 16 cancer-free individuals matched for age. The medical records of all patients were examined to obtain clinical and histopathological data. None of the patients had undergone radiotherapy or chemotherapy before surgery. In all groups, the frequency of Y-chromosome loss was higher among patients than among normal reference subjects (P < 0.0001) and was not age-dependent. These data suggest that Y-chromosome loss is a tumor-specific alteration not associated with advanced age in head and neck carcinomas.

  15. Loss of Y-chromosome does not correlate with age at onset of head and neck carcinoma: a case-control study

    International Nuclear Information System (INIS)

    Silva Veiga, L.C.; Bérgamo, N.A.; Reis, P.P.; Kowalski, L.P.; Rogatto, S.R.

    2012-01-01

    Loss of Y-chromosome has been correlated with older age in males. Furthermore, current evidence indicates that Y-chromosome loss also occurs in several human tumors, including head and neck carcinomas. However, the association between Y nullisomy and the occurrence of neoplasias in elderly men has not been well established. In the present study, the association between Y-chromosome loss and head and neck carcinomas was evaluated by comparison to cells from peripheral blood lymphocytes and normal mucosa of cancer-free individuals matched for age using dual-color fluorescence in situ hybridization. Twenty-one patients ranging in age from 28 to 68 years were divided into five-year groups for comparison with 16 cancer-free individuals matched for age. The medical records of all patients were examined to obtain clinical and histopathological data. None of the patients had undergone radiotherapy or chemotherapy before surgery. In all groups, the frequency of Y-chromosome loss was higher among patients than among normal reference subjects (P < 0.0001) and was not age-dependent. These data suggest that Y-chromosome loss is a tumor-specific alteration not associated with advanced age in head and neck carcinomas

  16. Results of Intravitreal Ranibizumab Treatment for Exudative Age-Related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Umut Karaca

    2012-01-01

    Full Text Available Pur po se: To evaluate the efficacy and safety of intravitreal ranibizumab injection for exudative age-related macular degeneration. Ma te ri al and Met hod: In this study, we included forty-eight eyes of 43 age-related macular degeneration patients followed for at least twelve months. Mean age was 73.65±8.93 years and mean follow-up time was 14.2 months. All patients received three consecutive monthly intravitreal ranibizumab injections and then were followed up with clinical examination and optic coherence tomography monthly. Re-injection was executed as needed. Re sults: Twenty patients were male (46.5% and twenty-three patients were female (53.5%. The average number of ranibizumab injection was 3.7 (3-7 per eye. Twenty-six lesions (54.2% were classic (predominantly and minimally and twenty-two (45.8% were occult. Mean best-corrected visual acuity was 46.8 letters with ETDRS chart at the initial examination and 55.5 letters at twelfth month. Mean central foveal thickness decreased from 320 microns to 269 microns. There was a statistically significant improvement in visual acuity and central foveal thickness. On the other hand, this improvement was not significant between lesion types. During follow-up, there were no systemic or serious ocular complications determined. Dis cus si on: Intravitreal ranibizumab injection is safe and effective, both anatomically and functionally, for age-related macular degeneration. (Turk J Ophthalmol 2012; 42: 25-9

  17. Radiation therapy for intracranial ependymomas: impact of age on outcome

    International Nuclear Information System (INIS)

    Pham, Houng T.; Sneed, Penny K.; Wara, William M.; Edwards, Michael S.; Wilson, Charles B.; Larson, David A.

    1997-01-01

    Purpose: The records of patients with intracranial ependymoma who received radiation therapy at UCSF were reviewed retrospectively to evaluate the impact of Karnofsky performance status (KPS), age, histology, and treatment on outcome. Materials and Methods: Between 1978 and 1996, 45 patients with intracranial ependymoma received postoperative radiation therapy. Overall survival (OS) and progression free survival (PFS) were calculated from the date of diagnosis. Median follow up for surviving patients was 72 months. Ages ranged from 4 months to 56 years, with a median of 8 years. The tumor was infratentorial in 35 and supratentorial in 10. All patients had either biopsy (3), subtotal resection (30), or gross total resection (12). There were 29 low grade and 16 anaplastic ependymomas. Thirty-seven patients received standard fractionation to a median dose of 54 Gy. Eight patients received hyperfractionation at 1.0 Gy BID to a median dose of 72 Gy. Thirty-eight patients had partial brain irradiation and seven had craniospinal irradiation. Twenty-three patients received adjuvant chemotherapy. For the infants ≤ 3 years old (n=12), all but one had a subtotal resection and most received chemotherapy prior to radiation therapy. Seven infants received radiation therapy at the time of disease progression and five had radiation therapy prior to progression. Most of the patients > 3 years old were irradiated prior to progression. Results: The five-year actuarial OS and PFS were 65% and 46% for the whole group. Histology and treatment factors such as extent of resection, hyperfractionation, and adjuvant chemotherapy did not significantly affect outcome. Overall, (25(45)) patients had disease progression. Only two patients failed in the brain outside the primary site. Six patients developed leptomeningeal spread (four concurrent with local failure and two subsequent to local failure). Five-year OS for patients ≤ 3 years old was 21% versus 80% for patients > 3 years old (p=0

  18. Familial melanoma by histology and age: joint data from five Nordic countries.

    Science.gov (United States)

    Fallah, Mahdi; Pukkala, Eero; Sundquist, Kristina; Tretli, Steinar; Olsen, Jörgen H; Tryggvadottir, Laufey; Hemminki, Kari

    2014-04-01

    We aimed to estimate lifetime cumulative risk of melanoma (CRM) in relatives of patients with melanoma by histology and age at diagnosis in patients and relatives. A population-based cohort of 238724 first-degree relatives of 46091 melanoma patients diagnosed in 1955-2010 in Nordic countries was followed for cancer incidence. The CRM (0-79 years) in first-degree relatives of a patient with superficial spreading (SSM), nodular (NM), or lentigo maligna melanoma was quite similar, ranging from 2.5% to about 3%, which represents about 2-fold increase over the general population risk. When one melanoma patient in the family was diagnosed before age 30, the CRM was about 3%. When there were > or =2 melanoma patients diagnosed before age 30 in a family, CRM for relatives was about 14%, 6% for diagnoses at age 30-59, and 5% for diagnoses at age 60 or older. Depending on age at diagnosis of same-sex twins (not known whether monozygotic/dizygotic), their CRM was about 7-21%. Although no familial case of concordant histological types of acral lentiginous/desmoplastic/compound nevus/spindle cell melanomas or malignant blue nevus was found, familial risks of discordant histological types of melanoma were interchangeably high for most of the types, e.g. higher risk of SSM when a first-degree relative had NM [standardized incidence ratios (SIR)=2.6, 95% confidence interval (CI)=2.1-3.3, n=72] or acral lentiginous (4.0, 95% CI=1.5-8.8, n=6) and vice versa. There was a tendency toward concordant age at diagnosis of melanoma among relatives of melanoma patients. Findings of this study may help clinicians to find subjects at high melanoma risk for the genetic counseling. The risk was highest when melanoma occurred in a same-sex twin, one first-degree relative diagnosed at young age ( or =2 first-degree relatives. Histological type of melanoma does not seem to play an important role in familial melanoma. This work was supported by the Nordic Cancer Union, Swedish Council for Working

  19. [Chest Injury and its Surgical Treatment in Polytrauma Patients. Five-Year Experience].

    Science.gov (United States)

    Vodička, J; Doležal, J; Vejvodová, Š; Šafránek, J; Špidlen, V; Třeška, V

    2016-01-01

    PURPOSE OF THE STUDY Thoracic trauma, one of the most frequent injuries in patients with multiple traumata, is found in 50 to 80% of these patients and it is crucial for the patient's prognosis. It accounts for 25% of all death from polytraumatic injuries. The aim of this retrospective study was an analysis of the occurrence of chest injuries in polytrauma patients and their surgical treatment in the Trauma Centre or Department of Surgery of the University Hospital Pilsen in a five-year period. MATERIAL AND METHODS Patients with injuries meeting the definition of polytrauma and an Injury Severity Score (ISS) ≥16 were included. The demographic characteristics, mechanism of multiple trauma, ISS value and chest injury were recorded in each patient. The number of injured patients in each year of the study was noted. In the patients with chest injury, the type of injury and method of treatment were assessed. The therapy was further analysed including its timing. The number of deaths due to polytrauma involving chest injury, the cause of death and its time in relation to the patient's admission to the Trauma Centre were evaluated. RESULTS In the period 2010-14, 513 polytrauma patients were treated; of them 371 (72.3%) were men with an average age of 40.5 years. The most frequent cause of injury was a traffic accident (74%). The average ISS of the whole group was 35 points. Chest injury was diagnosed in 469 patients (91.4%) of whom only five (1.1%) had penetrating injury. Pulmonary contusion was most frequent (314 patients; 67%). A total of 212 patients with chest injury underwent surgery (45.2%); urgent surgery was performed in 143 (67.5%), acute surgery in 49 (23.1%) and delayed surgery in 63 (29.7%) patients. Chest drainage was the major surgical procedure used in the whole group. Of 61 patients who died, 52 had chest injury. In this subgroup the most frequent cause of death was decompensated traumatic shock (26 patients; 50%). In the whole group, 32 polytrauma

  20. Overgeneral autobiographical memory and age of onset of childhood sexual abuse in patients with recurrent suicidal behaviour.

    Science.gov (United States)

    Crane, Catherine; Duggan, Danielle S

    2009-03-01

    To explore the association between age of onset of childhood sexual abuse (CSA) and overgeneral memory (OGM) in a clinical sample. Presence and age of onset of CSA and levels of OGM were assessed in 49 patients attending hospital following a recurrence of suicidal behaviour. Twenty six participants reported CSA. Earlier age of onset of CSA was associated with greater OGM, indexed by fewer specific and more categoric memories. The association was not accounted for either by elevated levels of depression in those reporting earlier abuse, nor by levels of general verbal fluency. The findings are consistent with previous work and support the hypothesis that abuse occurring earlier in development results in more pronounced OGM.

  1. Local patient dose diagnostic reference levels in pediatric interventional cardiology in Chile using age bands and patient weight values.

    Science.gov (United States)

    Ubeda, Carlos; Miranda, Patricia; Vano, Eliseo

    2015-02-01

    To present the results of a patient dose evaluation program in pediatric cardiology and propose local diagnostic reference levels (DRLs) for different types of procedure and age range, in addition to suggesting approaches to correlate patient dose values with patient weight. This study was the first conducted in Latin America for pediatric interventional cardiology under the auspices of the International Atomic Energy Agency. Over three years, the following data regarding demographic and patient dose values were collected: age, gender, weight, height, number of cine series, total number of cine frames, fluoroscopy time (FT), and two dosimetric quantities, dose-area product (DAP) and cumulative dose (CD), at the patient entrance reference point. The third quartile values for FT, DAP, CD, number of cine series, and the DAP/body weight ratio were proposed as the set of quantities to use as local DRLs. Five hundred and seventeen patients were divided into four age groups. Sample sizes by age group were 120 for bands used in Europe, complemented with the values of the ratio between DAP and patient weight. This permits a rough estimate of DRLs for different patient weights and the refining of these values for the age bands when there may be large differences in child size. These DRLs were obtained at the largest pediatric hospital in Chile, with an active optimization program, and could be used by other hospitals in the Latin America region to compare their current patient dose values and determine whether corrective action is appropriate. © 2015 American Association of Physicists in Medicine.

  2. Creating a Simple Electric Circuit with Children between the Ages of Five and Six

    Science.gov (United States)

    Kada, Vasiliki; Ravanis, Kostantinos

    2016-01-01

    This paper presents a study of how preschool-aged children go about creating and operating a simple electric circuit (wires, light bulb, and battery), and how they view the elements that comprise it, particularly how they view the role of the battery. The research involved 108 children aged between five and six, who were individually interviewed.…

  3. Concurrent chemoradiotherapy for limited-disease small cell lung cancer in elderly patients aged 75 years or older

    International Nuclear Information System (INIS)

    Shimizu, Toshio; Sekine, Ikuo; Sumi, Minako

    2007-01-01

    The optimal treatment for limited-disease small cell lung cancer (LD-SCLC) in patients aged 75 years or older remains unknown. Elderly patients with LD-SCLC who were treated with chemoradiotherapy were retrospectively reviewed to evaluate their demographic characteristics and the treatment delivery, drug toxicities and antitumor efficacy. Of the 94 LD-SCLC patients treated with chemotherapy and thoracic radiotherapy at the National Cancer Center Hospital between 1998 and 2003, seven (7.4%) were 75 years of age or older. All of the seven patients were in good general condition, with a performance status of 0 or 1. Five and two patients were treated with early and late concurrent chemoradiotherapy, respectively. While the four cycles of chemotherapy could be completed in only four patients, the full dose of radiotherapy was completed in all of the patients. Grade 4 neutropenia and thrombocytopenia were noted in seven and three patients, respectively. Granulocyte-colony stimulating factor support was used in five patients, red blood cell transfusion was administered in two patients and platelet transfusion was administered in one patient. Grade 3 or more severe esophagitis, pneumonitis and neutropenic fever developed in one, two and three patients, respectively, and one patient died of radiation pneumonitis. Complete response was achieved in six patients and partial response in one patient. The median survival time was 24.7 months, with three disease-free survivors for more than 5 years. Concurrent chemoradiotherapy promises to provide long-term benefit with acceptable toxicity for selected patients of LD-SCLC aged 75 years or older. (author)

  4. [Changes of twenty-four-hour profile blood pressure and its correction of patients with arterial hypertension on the background of combined antihypertensive therapy application].

    Science.gov (United States)

    Solomennchuk, T M; Slaba, N A; Prots'ko, V V; Bedzaĭ, A O

    2014-01-01

    The aim of this research was the study of efficiency and endurance antihypertensive therapy on the basis of fixed combination of enalapril and hydrochlorothiazide (HCTZ) and enalapril and HCTZ in combination with amlodipine according to the twenty-four-hour (? day-and-night) monitoring of blood pressure (? 24H BPM) of patients with arterial hypertension (AH) 2-3 severity. The study included 33 patients with 2-3 grade of hypertension (average age--54,40 ± 3.45 years). All patients performed ? 24H BPM before treatment and after 12 weeks of therapy. The combination of enalapril and HCTZ allowed to achieve target levels of blood pressure in 79% of patients, amlodipine additional purpose--in 86% of patients. We found that this therapy has a corrective effect on daily blood pressure profile, significantly reducing the load pressure and blood pressure variability. During treatment with the combination of enalapril and HCTZ combination of enalapril, HCTZ with amlodipine optimal daily profile of blood pressure after 12 weeks of reaching respectively 63.1% and 71.4% of patients. The treatment with combination of enalapril and HCTZ and adding of amlodipine is characterized by good endurance and high adherence to treatment.

  5. Nephrogenic diabetes insipidus (NDI: clinical, laboratory and genetic characterization of five Brazilian patients

    Directory of Open Access Journals (Sweden)

    Maria Helena Vaisbich

    2009-05-01

    Full Text Available INTRODUCTION: Nephrogenic diabetes insipidus is characterized by a lack of response in the distal nephron to the antidiuretic hormone arginine vasopressin. Manifestations include polyuria, polydipsia, hyposthenuria, recurrent episodes of dehydration and fever and growth failure. Most cases are caused by mutations in the AVPR2 gene. The mutant receptors are trapped intracellularly. METHOD: We studied five boys using clinical, laboratory and molecular data. The mean age at diagnosis was 14.6 months (range 6 to 24 and 12.2 years (7.8 to 19 after the follow-up period. The mean period of follow-up was 132.2 ± 50.9 months. RESULTS: The geometric means of the z-scores of weight and stature were -4.5 and -3.6, respectively, at diagnosis. At the last medical appointment, the z-scores of weight and stature were -0.3 and -0.9, respectively. Three patients were diagnosed with ureterohydronephrosis and exhibited increased post-void urine volume. Mutations in the AVPR2 gene were found in all patients, and the carrier status was confirmed in four of five cases. Two unrelated children presented identical mutations (S167L in arginine vasopressin R2. Two of the patients had a mutation that has already been described in other Brazilian families (R337X, and one patient showed a de novo mutation (Y128D in arginine vasopressin R2, since his mother's molecular analysis was normal. The recurrence risk for this family was significantly reduced. CONCLUSION: This study reports the clinical and laboratory characterization of Nephrogenic diabetes insipidus and reiterates the importance of the genetic basis that underlies the disease diagnosis and genetic counseling.

  6. Age Adjusted D-Dimer for exclusion of Pulmonary Embolism: a retrospective cohort study.

    LENUS (Irish Health Repository)

    Monks, D

    2017-08-01

    D-Dimer (DD) will increase with age and recent studies have shown the upper limit of normal can be raised in those who are low risk and over 50. We studied age adjusted D-dimer (AADD) levels to assess whether pulmonary embolism (PE) could be safely excluded. This study analysed the Emergency Department (ED) Computed Tomographic Pulmonary Angiography (CTPA) requests. There were 756 requests. The parameters studied were; age, DD value, calculated AADD, CT result and Simplified Geneva Score (SGS). The primary outcome was the diagnostic performance of AADD. One hundred and eighty-five patients were included in the final cohort. Twenty-one patients had a negative DD after age adjustment. Of these one had a PE, corresponding to a failure rate of 4.76% (1 in 22). The sensitivity of AADD was 0.96 (95% CI 0.76 to 0.99) and its specificity was 0.12 (95% CI 0.08- 0.19). AADD demonstrated a reduction in false positives with one false negative, giving rise to a failure rate higher than that of other larger studies. Further study is indicated to accurately define the diagnostic characteristics for the Irish context.

  7. Effects of five different alcoholic drinks on patients with Crohn's disease

    DEFF Research Database (Denmark)

    Hey, H.; Schmedes, A.; Nielsen, A.A.

    2007-01-01

    OBJECTIVE: Many patients with Crohn's disease (CD) complain of abdominal discomfort after alcohol intake. The aim of the present study was to investigate the effect of ethanol and sugar content in five different alcoholic drinks on abdominal discomfort in patients with CD. MATERIAL AND METHODS......: In a crossover study, two weeks apart, 12 healthy individuals and 20 patients with CD in remission consumed randomly red wine, white wine, Smirnoff Ice, Elephant Beer and pure ethanol. Blood samples were obtained for determination of serum ethanol and plasma glucose at 0, 30, 60, 90, 120 and 180 min. A self......-reported pain symptom score was used. RESULTS: There was no difference between CD patients and healthy individuals in the area under the curve (AUC) for the ethanol concentration after intake of the five different drinks. The plasma AUC for glucose in the CD patients after intake of Smirnoff Ice and Elephant...

  8. Effect of therapy on five- and ten-year survival of malignant melanoma patients

    International Nuclear Information System (INIS)

    Siffnerova; Bustova; Zikmund

    1989-01-01

    The results are reported of five-year and ten-year survival of malignant melanoma patients treated postoperatively by actinotherapy. In patients where lymph flow was not apparent, 2.5 Gy of daily doses of electron irradiation from a 6-8 MeV betatron were used centred on the scar. The total dose was 60 Gy. Where the lymph flow could be identified, cobalt or cesium sources were used to deliver a total dose of 50 Gy in 2.5 Gy daily. Both five-year and ten-year survival was significantly better than in patients treated with surgery only, without irradiation. 55% of the patients on combined management survived for more than 5 years, 86% of them without relapses. 41% patients survived for 10 years, of which 92% without relapse. In contrast, the corresponding figures for the patients treated with surgery only were 42% and 71% respectively for the five-year survival, and 26% and 70% respectively for the ten-year survival. (L.O.). 3 figs., 2 tabs

  9. The association between Neovascular Age-related Macular Degeneration and Regulatory T cells in peripheral blood

    DEFF Research Database (Denmark)

    Madelung, Christopher Fugl; Falk, Mads; Sørensen, Torben Lykke

    2015-01-01

    PURPOSE: To investigate regulatory T cells (Tregs) and subsets of the Treg population in patients with neovascular age-related macular degeneration (AMD). PATIENTS AND METHODS: Twenty-one neovascular AMD cases and 12 age-matched controls without retinal pathology were selected. Patients were...

  10. Autopsy-determined causes of death following organ transplantation in 25 patients aged 20 years or younger.

    Science.gov (United States)

    Rose, Alan G

    2003-01-01

    This study aims to examine the autopsy-determined principal and proximate causes of death in 25 patients aged 20 years or younger who died during the 10-year period from 1990 to 1999 after receiving an organ transplant at the University of Minnesota/Fairview-University Medical Center. The autopsy records of this institution were examined for organ transplant recipients who were aged 20 years or younger at the time of their death. In each case, after review of the clinical and pathological data, the principle cause of death (PCOD), as well as the proximate cause of death (PXCOD) were noted. A total of 25 recipient patients were identified (five heart, five lung, five kidney and 10 liver transplants). Seven patients died 30 days or less post-operatively and 18 died thereafter. The following categories of PCOD were encountered: operative/technical complications 28%, most (6/7) being associated with liver transplantation. Infection (24%) and chronic rejection (12%) were other important PCOD. Respiratory complications accounted for 47% of the PCOD. The following categories of PXCOD were noted: technical problems 16%, pulmonary pathology 24%, miscellaneous 32%, acute rejection 4% and nil 20%. This study revealed that technical problems in liver transplants were an important PCOD; respiratory complications and chronic rejection were additional major causes of mortality in this young age group of transplant recipients. Pulmonary pathology and technical problems were the commonest specific groups contributing to the PXCOD.

  11. Serial changes of the myocardium in patients with Duchenne's muscular dystrophy followed by cardiac nuclear imaging; Five years' observation

    Energy Technology Data Exchange (ETDEWEB)

    Nagamachi, Shigeki; Jinnouchi, Seishi; Hoshi, Hiroaki; Yoshimura, Hiroshi; Ono, Seiji; Watanabe, Katsushi (Miyazaki Medical Coll., Kiyotake (Japan)); Inoue, Kenjiro

    1990-11-01

    In order to evaluate the natural course of Duchenne's cardiomyopathy (DMD), {sup 201}Tl-SPECT and RI cardioangiography with {sup 99m}Tc-albumin were performed in 14 patients. They were examined once a year for five years except for 6 patients. Hypo-perfusion was observed in both posterior-inferior and anterior wall at 12 years of age and extended to the lateral wall and septum with aging. The degree of cardiac involvement was different in each case. Systolic parameters (LVEF, 1/3EF, 1/3ER-mean) tended to decrease with aging from 15 years of age. Diastolic parameters (%EFV, 1/3FF, 1/3FR mean) decreased gradually after 16 years of age. Hypokinetic changes of regional wall motion were observed at 15 years of age and they became severely with aging. Although phase delay appeared visually at 16 years of age, standard deviation of phase angle increased from 15 years of age. Follow up studies by {sup 201}Tl myocardial SPECT and gated pool scintigraphy revealed well the progression of cardiac involvement in patients with DMD. (author) 84 refs.

  12. Clear cell sarcoma of the kidney: patients' characteristics and improved outcome in developing countries.

    Science.gov (United States)

    Zekri, Wael; Alfaar, Ahmad Samir; Yehia, Dina; Elshafie, Maged M; Zaghloul, Mohamed Saad; El-Kinaai, Naglaa; Taha, Hala; Refaat, Amal; Younes, Alaa A

    2014-12-01

    Clear cell sarcoma of the kidney (CCSK) is a rare and aggressive tumor accounting for 5% of pediatric renal tumors with an incidence of 20 patients per year in the USA. It is bone metastasizing with poor prognosis. Our aim was to show characteristics of patients in relation to improved outcome in one of the developing countries. We included all patients diagnosed as CCSK in the period between July 2007 and March 2012 at Children's Cancer Hospital, Egypt. Patients' demographics, clinical presentation, pathology, and management were reviewed. Follow up was continued until April 2013. Twenty-five patients were identified in the defined time interval, accounting for 7% all renal tumors diagnosed at the hospital. Mean age was 36 months. Abdominal swelling and hematuria were the most common presentations. Stages I, II, III, IV, and V represented 9 (36%), 3 (12%), 8 (32%), 3 (12%), and 2 (8%), respectively. Twenty-four patients had radical nephrectomy either upfront or after neo-adjuvant chemotherapy. Surgery was followed by adjuvant chemotherapy. Abdominal radiotherapy was given for local stages II and III. Twenty-two patients reached complete remission, while one patient had stationary disease and two patients died due to progression and relapse. Overall survival was 88.5% and event-free survival was 87.8% at 45 months. Although previous studies indicate poor prognosis of CCSK, our experience shows that those patients can be treated using extensive chemotherapy combined with proper local control. © 2014 Wiley Periodicals, Inc.

  13. Visual impairment from uveitis in a reference hospital of Southeast Brazil: a retrospective review over a twenty years period.

    Science.gov (United States)

    Silva, Luci Meire Pereira da; Muccioli, Cristina; Oliveira, Filipe de; Arantes, Tiago Eugênio; Gonzaga, Lucas Renó; Nakanami, Célia Regina

    2013-01-01

    To identify the frequency and causes of uveitis leading to visual impairment in patients referred to the Low Vision Service - Department of Ophthalmology - UNIFESP, over a twenty years period. In a retrospective study, medical records of 5,461 patients were reviewed. Data from the first clinical evaluation at the Low Vision Service were collected, patient's age, gender and cause of visual impairment were analyzed. Patients with uveitis had their chart reviewed for anatomical classification and clinical diagnosis. The mean age of the patients referred to the Low Vision Service was 42.86 years and the mean age of patients with uveitis diagnosis was 25.51 years. Retinal disorders were the most common cause of visual impairment (N=2,835 patients; 51.9%) followed by uveitis (862 patients, 15.7%). Uveitis was posterior in 792 patients (91.9% of uveitis) and toxoplasmosis was the most common diagnosis (765 patients, 88.7%). In our study, uveitis represents the second cause of visual impairment in patients referred for visual rehabilitation and toxoplasmic retinochoroiditis was the most common clinical diagnosis. It affects a young working age population with a relevant social and economic impact, but the early diagnosis and treatment can improve the quality of life of these patients.

  14. Cardiac safety of trastuzumab as adjuvant treatment for Japanese patients with early breast cancer

    International Nuclear Information System (INIS)

    Ishihara, Mikiya; Mukai, Hirofumi; Nagai, Shunji; Mukohara, Toru

    2009-01-01

    Recently, randomized trials revealed that trastuzumab as adjuvant treatment was effective in human epidermal growth factor receptor 2 (HER2)-positive breast cancer patients. Safety information on adjuvant trastuzumab use in Japanese patients, especially cardiac toxicity data, is needed. We retrospectively reviewed 48 patients with early-stage HER2-positive breast cancer who were treated with curative surgery and adjuvant trastuzumab at the National Cancer Center Hospital East (Kashiwa, Japan). The cardiac safety as well as the short-term efficacy of trastuzumab were evaluated. The median age of the patients was 54 years. All patients received adjuvant or neoadjuvant cytotoxic chemotherapy. Twenty-seven patients (56%) received adjuvant radiation therapy. Forty-four patients (92%) received trastuzumab without concurrent cytotoxic chemotherapy and 4 patients (8%) on taxanes received trastuzumab concurrently. Twenty-five patients completed 1 year of trastuzumab treatment and 5 patients completed 2 years of trastuzumab treatment. Nine patients discontinued trastuzumab treatment, because of progressive disease (1 patient), decrease in left ventricular ejection fraction (LVEF; 2 patients), patient's refusal (4 patients), and other reasons (2 patients). There were five cardiac events. A decrease in LVEF to less than 50% was seen in 2 patients. The relationship between trastuzumab treatment and the cardiac events was unclear in 3 patients. The median follow-up time was 21.2 months. The disease-free survival (DFS) was 97.5% at 1 year and 92.9% at 2 years. The incidence of cardiac events caused by trastuzumab treatment was low in our analysis. Adjuvant trastuzumab treatment for up to at least 1 year should be safe for Japanese breast cancer patients. (author)

  15. How to boost a low-morale medical practice team: twenty-five strategies.

    Science.gov (United States)

    Hills, Laura

    2014-01-01

    Low morale can decrease productivity and cooperation among medical practice employees, and increase work errors, absenteeism, and turnover. That is why practice managers must be mindful of their employees' morale and develop a toolkit of strategies that they can use to assess and boost waning morale. This article suggests 25 practical and affordable strategies medical practice managers can use to increase their staffs' morale. It explores the high cost of low morale, including five invisible costs that are often overlooked but that nonetheless drain practice resources. Furthermore, this article suggests 25 warning signs of low morale and suggests 10 causes of low morale in the workplace. It also provides practice managers with a quick 10-question quiz to administer to their employees to help them assess employee morale. Finally, this article describes five easy and affordable games practice managers can play with their employees to build camaraderie and teamwork and to increase staff morale.

  16. Pain-only complaint about cochlear implant device: A five-patient pediatric experience.

    Science.gov (United States)

    Todd, Norman Wendell; Fainberg, Jolie C; Ukatu, CeIsha Chinwe; Venable, Claudia Y; Segel, Phil

    2015-09-01

    To present the case histories and management of five pediatric patients who experienced pain at the receiver-stimulator site, but no other indication that the device was failing. Patients were from a sole-surgeon pediatric practice (600 + implant surgeries before June 2013; about even proportions of Advanced Bionics, Cochlear Corporation, and MED-EL devices). The University Institutional Review Board-approved review of sole-surgeon pediatric case series. The onset of pain ranged from 2 to 16 years post implantation. Pain, not amenable to conventional medical therapy, was present regardless of whether or not the external appliance was 'on', or even being worn on the head. Four of the five patients were bilaterally implanted, but pain was only at one receiver-stimulator package. Clinical management ultimately included revision surgery in all five cases, with immediate resolution of the pain in four. For those four, the replacement cochlear implant (CI) performed well; the other patient fears pain if her replacement device is used, but continues enjoying her contralateral implant. At analysis by the company, two of five explanted devices exhibited problems: loss of hermeticity; insulation failure. Though infrequently reported, pain-only complaint by a CI user is a challenging dilemma. Pain may be the sole clinical manifestation of cochlear implant device failure. We offer a flowchart for the care of CI patients with pain, encourage a worldwide registry of such cases, and offer ideas to try to understand better the problem.

  17. Increase in age is associated with worse outcomes in alveolar bone grafting in patients with bilateral complete cleft palate.

    Science.gov (United States)

    Calvo, Adriana Maria; Trindade-Suedam, Ivy Kiemle; da Silva Filho, Omar Gabriel; Carvalho, Roberta Martineli; de Souza Faco, Renato André; Ozawa, Terumi Okada; Cintra, Flávia; Trindade, Alceu Sergio; Trindade, Inge Elly Kiemle

    2014-03-01

    This prospective study aimed at evaluating the surgical outcomes of alveolar bone grafting (ABG) in subjects with bilateral cleft lip and palate treated at the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil, by means of cone-beam computed tomography. Twenty-five patients with bilateral complete cleft lip and palate, resulting in 50 clefts, were analyzed. Subjects were divided into 2 groups according to the dentition status at the time of surgery: (1) SABG group: subjects with mixed dentition operated on before or immediately after eruption of the permanent canine (10-13 years); (2) TABG group: subjects with permanent dentition (15-23 years). Cone-beam computed tomography analysis was performed in the buccal, intermediate, and palatal views, 2 and 6 to 12 months postoperatively. In the SABG group, 96% of the grafts were classified as successful, and no failure cases were observed. In the TABG group, successful cases decreased to 65%, and failures were seen in 27% of the cleft sites. In both postoperative periods, significantly better outcomes (lower mean scores) were observed for the SABG group in all the cone-beam computed tomography views (P < 0.05). Results show that the timing of surgery is an important factor in determining the outcomes of ABG in patients with bilateral cleft lip and palate, with increasing age being associated with the worse outcomes.

  18. Two-year outcomes of pro re nata ranibizumab monotherapy for exudative age-related macular degeneration in Japanese patients

    Directory of Open Access Journals (Sweden)

    Yamamoto A

    2013-04-01

    Full Text Available Akiko Yamamoto,1 Annabelle A Okada,1 Atsuhiko Sugitani,1,2 Daisuke Kunita,1 Tosho Rii,1 Reiji Yokota1 1Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan; 2Department of Ophthalmology, Kugayama Hospital, Tokyo, Japan Purpose: To describe outcomes of intravitreal ranibizumab using a pro re nata regimen for treatment-naive exudative age-related macular degeneration (AMD, in Japanese patients over the first 2 years. Methods: Clinical records were retrospectively reviewed of 48 eyes of 48 patients with treatment-naive exudative AMD who underwent intravitreal ranibizumab therapy. After three monthly injections (induction, patients were examined monthly, and subsequent injections were performed as needed (pro re nata for any residual activity, by fundus biomicroscopy and imaging studies, regardless of severity. Results: Twenty-nine (60% of the patients were men, and 19 (40% were women; the mean age was 76.1 years. Of the 48 eyes evaluated, 17 (35% had findings consistent with polypoidal choroidal vasculopathy, and five (10% with retinal angiomatous proliferation. A mean of 6.0 ranibizumab injections were given in the first year, 3.5 in the second year, and 9.5 over the 2-year period. The best-corrected visual acuity (logarithm of minimum angle of resolution improved significantly, from 0.35 at baseline to 0.21 at 12 months (P < 0.01, and remained stable at 0.21 at 24 months (P < 0.01. The mean central macular thickness decreased significantly, from 355.4 µm at baseline to 237.9 µm at 12 months (P < 0.01 and 247.7 µm at 24 months (P < 0.01. Conclusion: Improved visual acuity and decreased central macular thickness were observed and maintained over a 2-year period, in a Japanese population receiving 3 monthly induction injections followed by a pro re nata regimen of ranibizumab for exudative AMD. Keywords: optical coherence tomography, polypoidal choroidal vasculopathy, retinal angiomatous proliferation

  19. Therapeutic effect of flurbiprofen pretreatment on the intravenous injection pain induced by propofol in patients of different ages

    Directory of Open Access Journals (Sweden)

    Song SHI

    2011-09-01

    Full Text Available Objective To evaluate the therapeutic effect of flurbiprofen pretreatment on the pain induced by propofol in patients of different ages.Methods One hundred and twenty patients with different age and undergoing general anesthesia were assigned to three groups(40 each according to their ages: 6-18 years(adolescent group,18-60 years(adult group,and over 60 years(aged group.Each group was randomly divided into two subgroups(20 each: flurbiprofen group and placebo group,and they respectively received intravenous injection of 5ml of 1mg/kg flurbiprofen(group FB or normal saline(group NS.The induction was produced by 1.5-2mg/kg Ⅳ propofol,and 1.5-2.0mg/kg Ⅳ succinylcholine was administered 20 seconds after propofol injection.Patients’ withdrawal movements,pain scores and any other discomfort complaints were assessed.Results The incidences of intravenous pain in group NS and group FB were respectively 47.9% and 11.2% in adult group,82.0% and 8.8% in adolescent group,and 28.0% and 4.7% in aged group.The incidence of withdrawal movements and pain scores were significantly lower in flurbiprofen group than in saline group regardless of ages(P < 0.05.Conclusion The pretreatment with 1.0mg/kg flurbiprofen may reduce the withdrawal movements and pain caused by propofol injection in patients of different age.

  20. Clinical characteristics of patients with conjunctivochalasis

    Directory of Open Access Journals (Sweden)

    Balci O

    2014-08-01

    Full Text Available Ozlem Balci Ophthalmology Department, Kolan Hospitalium Group, Istanbul, Turkey Purpose: To evaluate the clinical characteristics of patients with conjunctivochalasis (CCh. Methods and materials: This retrospective study enrolled 30 subjects diagnosed with conjunctivochalasis. Complete ophthalmic examination, including visual acuity assessment, slit-lamp examination, applanation tonometry, dilated funduscopy, tear break-up time, Schirmer 1 test, and fluorescein staining were performed in all patients. Age, sex, laterality, ocular history, symptoms, and clinical findings were recorded. Results: The study included 50 eyes from 30 cases. Ages ranged from 45 to 80 years, with a mean age of 65±10 years. CChs grading were as follows: 30 (60% eyes with grade 1 CCh; 15 (30% eyes with grade 2 CCh; and five (10% eyes with grade 3 CCh. CCh was located in the inferior bulbar conjunctiva in 45 (90% eyes, and in the remaining five (10% CCh was located in the superior bulbar conjunctiva. Ten (33.3% patients had no symptoms. Dryness, eye pain, redness, blurry vision, tired eye feeling, and epiphora were the symptoms encountered in the remaining twenty (63.6% patients. Altered tear meniscus was noted in all cases. The mean tear break-up time was 7.6 seconds. The mean Schirmer 1 test score was 7 mm. Pinguecula was found in ten patients. Conclusion: Dryness, eye pain, redness, blurry vision, and epiphora were the main symptoms in patients with CCh. Dryness, eye pain, and blurry vision were worsened during downgaze and blinking. So CCh should be taken into consideration in the differential diagnosis of chronic ocular irritation and epiphora. Keywords: ocular irritation, epiphora, dryness, eye pain, blurry vision

  1. Switching from pro re nata to treat-and-extend regimen improves visual acuity in patients with neovascular age-related macular degeneration.

    Science.gov (United States)

    Kvannli, Line; Krohn, Jørgen

    2017-11-01

    To evaluate the visual outcome after transitioning from a pro re nata (PRN) intravitreal injection regimen to a treat-and-extend (TAE) regimen for patients with neovascular age-related macular degeneration (AMD). A retrospective review of patients who were switched from a PRN regimen with intravitreal injections of bevacizumab, ranibizumab or aflibercept to a TAE regimen. The best corrected visual acuity (BCVA), central retinal thickness (CRT) and type of medication used at baseline, at the time of changing treatment regimen and at the end of the study were analysed. Twenty-one eyes of 21 patients met the inclusion criteria. Prior to the switch, the patients received a mean of 13.8 injections (median, 10; range, 3-39 injections) with the PRN regimen for 44 months (range, 3-100 months), which improved the visual acuity in five patients (24%). After a mean of 6.1 injections (median, 5; range, 3-14 injections) with the TAE regimen over 8 months (range, 2-16 months), the visual acuity improved in 12 patients (57%). The improvement in visual acuity during treatment with the TAE regimen was statistically significant (p = 0.005). The proportion of patients with a visual acuity of 0.2 or better was significantly higher after treatment with the TAE regimen than after treatment with the PRN regimen (p = 0.048). No significant differences in CRT were found between the two treatment regimens. Even after prolonged treatment and a high number of intravitreal injections, switching AMD patients from a PRN regimen to a strict TAE regimen significantly improves visual acuity. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  2. Empyema and bacteremic pneumococcal pneumonia in children under five years of age

    Directory of Open Access Journals (Sweden)

    Maria Regina Alves Cardoso

    2014-01-01

    Full Text Available We compared bacteremic pneumococcal pneumonia (BPP and pneumococcal empyema (PE, in terms of clinical, radiological, and laboratory findings, in under-fives. A cross-sectional nested cohort study, involving under-fives (102 with PE and 128 with BPP, was conducted at 12 centers in Argentina, Brazil, and the Dominican Republic. Among those with PE, mean age was higher; disease duration was longer; and tachypnea, dyspnea, and high leukocyte counts were more common. Among those with BPP, fever and lethargy were more common. It seems that children with PE can be distinguished from those with BPP on the basis of clinical and laboratory findings. Because both conditions are associated with high rates of morbidity and mortality, prompt diagnosis is crucial.

  3. Oncofertility in patients with stage I epithelial ovarian cancer: fertility-sparing surgery in young women of reproductive age.

    Science.gov (United States)

    Jiang, Xuan; Yang, Jiaxin; Yu, Mei; Xie, Weimin; Cao, Dongyan; Wu, Ming; Pan, Lingya; Huang, Huifang; You, Yan; Shen, Keng

    2017-08-15

    Fertility-sparing surgery is indicated for patients with stage I epithelial ovarian cancers. We sought to evaluate the clinical outcomes and oncofertility in a cohort of patients of reproductive age with stage I epithelial ovarian cancer (EOC). Overall, 108 patients of reproductive age (≤ 40 years) diagnosed with stage I EOC who were treated at Peking Union Medical College Hospital between 1999 and 2013 were included in the study. The Kaplan-Meier model and Cox regression analyses were used for the survival analysis. The type of surgery included fertility-sparing surgery (FSS) (48.1%) and radical surgery (RS) (51.9%). After a median follow-up of 83 months, we observed that grade 3 or clear-cell carcinoma was the only independent risk factor for disease-free survival and tumor-specific survival in the multivariate analysis. Patients with grade 3 or clear-cell carcinoma tended to be older than 30 years, have endometriosis, and undergo RS (p Fertility-sparing surgery did not affect disease-free survival or tumor-specific survival among patients of reproductive age with stage I EOC and among high-risk patients with stage IC2-3, grade 3, or clear-cell carcinoma. Thirty-four out of 52 (65.4%) FSS patients attempted to get pregnant. Twenty-eight (82.4%) achieved a successful pregnancy with a full-term delivery. Grade 3 or clear-cell carcinoma was the only independent risk factor for survival of patients of reproductive age with stage I EOC. FSS can be safely performed on patients of reproductive age with grade 1-2, stage I EOC. The safety of FSS for grade 3 and clear-cell carcinoma warrants further investigation.

  4. Clinical Characteristics of Dry Eye Patients With Chronic Pain Syndromes

    NARCIS (Netherlands)

    Vehof, Jelle; Smitt-Kamminga, Nicole Sillevis; Kozareva, Diana; Nibourg, Simone A.; Hammond, Christopher J.

    PURPOSE: To investigate clinical characteristics of dry eye disease (DED) patients with a chronic pain syndrome. DESIGN: Cross-sectional. study. METHODS: Four hundred twenty-five patients of a tertiary care DED patient cohort in the Netherlands were included. Chronic pain syndromes irritable bowel

  5. Sexual dysfunction is more than twice as frequent in Danish female predialysis patients compared to age- and gender-matched healthy controls

    DEFF Research Database (Denmark)

    Prescott, Lotte; Eidemak, Inge; Harrison, Adrian Paul

    2014-01-01

    PURPOSE: This study aimed to compare sexual dysfunction in Danish female predialysis patients with chronic kidney disease (CKD) stage 4-5 with age-matched healthy women in Denmark. METHODS: Twenty-seven adult female predialysis patients (CKD stage 4-5 ~ creatinine clearance ≤ 30 ml/min) without.......1, respectively, p = 0.180). CONCLUSION: Sexual dysfunction was found to be more than two times as frequent in Danish female predialysis patients with CKD stage 4-5 compared to age- and gender-matched healthy controls, and this result emphasizes the need for attention towards sexual function in the treatment...... diagnosed depression and 54 randomly assigned healthy female controls completed the questionnaires Female Sexual Function Index, Female Sexual Distress Scale, and the Major Depression Inventory. RESULTS: Predialysis patients reported lower Female Sexual Function Index scores compared to the controls (14...

  6. Gender influences headache characteristics with increasing age in migraine patients.

    Science.gov (United States)

    Bolay, Hayrunnisa; Ozge, Aynur; Saginc, Petek; Orekici, Gulhan; Uludüz, Derya; Yalın, Osman; Siva, Aksel; Bıçakçi, Şebnem; Karakurum, Başak; Öztürk, Musa

    2015-08-01

    Migraine headache is one of the most common primary headache disorders and is three times more prevalent in women than in men, especially during the reproductive ages. The neurobiological basis of the female dominance has been partly established. The present study aimed to investigate the effect of gender on the headache manifestations in migraine patients. The study group consisted of 2082 adult patients from five different hospitals' tertiary care-based headache clinics. The relationship between headache characteristics and gender was evaluated in migraine with aura (MwA) and migraine without aura (MwoA). The duration, severity, frequency of headache and associated symptoms were evaluated in both genders and age-dependent variations and analyzed in two subgroups. Women with migraine were prone to significantly longer duration and intensity of headache attacks. Nausea, phonophobia and photophobia were more prevalent in women. Median headache duration was also longer in women than in men in MwA (p = 0.013) and MwoA (p < 0.001). Median headache intensity was higher in women than in men in MwA (p = 0.010) and MwoA (p = 0.009). The frequency of nausea was significantly higher in women than in men in MwA (p = 0.049). Throbbing headache quality and associated features (nausea, photophobia, and phonophobia) were significantly more frequent in women than in men in MwoA. The gender impact varied across age groups and significant changes were seen in female migraineurs after age 30. No age-dependent variation was observed in male migraineurs. Gender has an influence on the characteristics of the headache as well as on the associated symptoms in migraine patients, and this impact varies across the age groups, particularly in women. © International Headache Society 2014.

  7. The influence of general anesthesia on the brain in aged patients with previous ischemic cerebrovascular disease

    International Nuclear Information System (INIS)

    Kokubo, Yasuaki; Kayama, Takamasa; Kondo, Rei; Oki, Masato; Takaoka, Seiji

    2008-01-01

    Whenever we discuss the overall results of surgical treatment for unruptured cerebral aneurysms, especially in aged patients, we tend to consider advanced age or general anesthesia as causes for unfavorable results. There are no reports concerning ischemic stroke events following general anesthesia in aged patients with a prior history of cerebrovascular disease. The purpose of this study is to clarify the influence of general anesthesia on the brats in aged patients with a previous history of ischemic cerebrovascular disease. The subjects were 30 consecutive patients over 70 years of age with previous ischemic cerebrovascular disease who underwent various surgeries except brain and cardiac surgery under general anesthesia. The patients were 70 to 85 years old, with a mean age of 76. Twenty-three were men and 7 were women. Surgical procedures were 12 gastrointestinal, 6 orthopedic and 4 urogenital and others. The type of cerebrovascular disease evaluated by neuroradiologist and anesthesiologist based on MR imaging was devided as follows: 16 patients had minor stroke, 7 had transient ischemic attack/reversible ischemic neurological deficit (TIA/RIND) and 7 had asymptomatic cerebral infarction. MR angiography was also assessed to evaluate the main artery in the brain. Blood pressure and arterial blood gas (PaCO 2 ) during general anesthesia were analyzed, and the rate of systemic and neurological complications following general anesthesia were evaluated. MR angiography revealed no occlusion or severe stenosis of the main artery in the brain of any of the patients. The minimum systolic blood pressure showed less than 100 mmHg transiently for 5-20 minutes in 28 of 30 patients during general anesthesia. The minimum value was 65 mmHg maintained for 5 minutes. The minimum PaCO 2 during general anesthesia was as follows: 1 case 36 mmHg. There were no neurological complications following general anesthesia in this study. One of 30 patients (3.3%) had suffered from pneumonia

  8. Thyroid carcinoma after radioiodide therapy for hyperthyroidism. Analysis based on age, latency, and administered dose of I-131

    International Nuclear Information System (INIS)

    Spencer, R.P.; Chapman, C.N.; Rao, H.

    1983-01-01

    Twenty-five reports in the medical literature of thyroid carcinomas which were detected after radioiodide therapy for hyperthyroidism were reviewed. These cases did not show a usual characteristic of radiation-associated tumors, namely a long latency period. That is, in 8/25 the latency period was under five years, and the mean latency was only 7.3 years. Further, there was no relationship between latency and age at treatment, or between latency and the dose of radioiodide employed. In 15/25 of the cases, there were known thyroid nodules. Three of the patients had thyroiditis (which itself has a correlation with thyroid carcinoma), and one individual had prior head and neck external radiation. There was no substantiating evidence that radioiodide treatment for hyperthyroidism was the cause of these thyroid carcinomas

  9. Culture and diet among Chinese American children aged 9–13 years: A qualitative study

    Science.gov (United States)

    This study examined Chinese American children's behaviors, food preferences, and cultural influences on their diet. Qualitative individual interviews were conducted with twenty-five Chinese American children aged 9-13 years in community centers and Chinese schools in Houston, TX using constructs fro...

  10. Malnutrition frequency among cerebral palsy children: Differences in onset of nutritional intervention before or after the age of five years

    Directory of Open Access Journals (Sweden)

    Bruna Nolasco Siqueira SILVA

    Full Text Available ABSTRACT Objective To evaluate the frequency of malnutrition and food consumption of children with cerebral palsy according to the age at the beginning of speech and hearing rehabilitation treatment. Methods Two to eleven-year-old children diagnosed with cerebral palsy who had up to three months of speech-language and nutritional rehabilitation were included in two reference centers in Recife, Pernambuco, Brazil. The following measurement of the children were taken: weight, knee height, arm circumference and triceps skinfold. Weight, estimated height and body mass index were classified into Z-scores according to the World Health Organization curves. Brachial circumference, triceps skinfold and arm circumference were classified according to Frisancho. The 24-hour recall was used to calculate intake of calories, proteins, calcium, iron, vitamin A, and zinc using the NutriWin software. Results A total of 68 patients were evaluated. Children older than five had a higher frequency of malnutrition when weight (.=0.02 and arm circumference (.<0.001 were considered, although there was less triceps malnutrition (.=0.002. These also had lower calorie consumption per kg/day, protein/kg/day and calcium than the younger children. Conclusion The greatest nutritional impairment after the age of five suggests that nutritional and speech therapy interventions could have a greater effect if they were performed before that age.

  11. RAPID KNEE-EXTENSIONS TO INCREASE QUADRICEPS MUSCLE ACTIVITY IN PATIENTS WITH TOTAL KNEE ARTHROPLASTY

    DEFF Research Database (Denmark)

    Husted, Rasmus Skov; Wilquin, Lousia; Jakobsen, Thomas Linding

    2017-01-01

    rapid knee-extensions were associated with greater voluntary quadriceps muscle activity during an experimental strength training session, compared to that elicited using slow knee-extensions. STUDY DESIGN: A randomized cross-over study. METHODS: Twenty-four patients (age 66.5) 4-8 weeks post total knee...... agonist muscle activity, especially if the exercise is conducted using rapid muscle contractions. PURPOSE: The purpose of this study was to examine if patients with total knee arthroplasty could perform rapid knee-extensions using a 10 RM load four to eight weeks after surgery, and the degree to which...... arthroplasty randomly performed one set of five rapid, and one set of five slow knee-extensions with the operated leg, using a load of their 10 repetition maximum, while surface electromyography recordings were obtained from the vastus medialis and lateralis of the quadriceps muscle. RESULTS: Data from 23...

  12. Rapid knee-extensions to increase quadriceps muscle activity in patients with total knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Rasmus Skov; Wilquin, Lousia; Jakobsen, Thomas Linding

    2017-01-01

    rapid knee-extensions were associated with greater voluntary quadriceps muscle activity during an experimental strength training session, compared to that elicited using slow knee-extensions. STUDY DESIGN: A randomized cross-over study. METHODS: Twenty-four patients (age 66.5) 4-8 weeks post total knee...... agonist muscle activity, especially if the exercise is conducted using rapid muscle contractions. PURPOSE: The purpose of this study was to examine if patients with total knee arthroplasty could perform rapid knee-extensions using a 10 RM load four to eight weeks after surgery, and the degree to which...... arthroplasty randomly performed one set of five rapid, and one set of five slow knee-extensions with the operated leg, using a load of their 10 repetition maximum, while surface electromyography recordings were obtained from the vastus medialis and lateralis of the quadriceps muscle. RESULTS: Data from 23...

  13. Large meta-analysis of genome-wide association studies identifies five loci for lean body mass

    DEFF Research Database (Denmark)

    Zillikens, M Carola; Demissie, Serkalem; Hsu, Yi-Hsiang

    2017-01-01

    Lean body mass, consisting mostly of skeletal muscle, is important for healthy aging. We performed a genome-wide association study for whole body (20 cohorts of European ancestry with n = 38,292) and appendicular (arms and legs) lean body mass (n = 28,330) measured using dual energy X-ray absorpt...... a meta-analysis of genome-wide association studies for whole body lean body mass and find five novel genetic loci to be significantly associated.......-ray absorptiometry or bioelectrical impedance analysis, adjusted for sex, age, height, and fat mass. Twenty-one single-nucleotide polymorphisms were significantly associated with lean body mass either genome wide (p 

  14. Mental disorders in cancer patients: observations at a tertiary care centre in Pakistan

    International Nuclear Information System (INIS)

    Iqbal, M.; Syed, G.M.S.; Siddiqui, K.S.

    2002-01-01

    To study the frequencies of metal disorders among adult cancer patients in relation to their age, gender, marital status and type of malignancy. Socio-demographic characteristics and cancer diagnoses were recorded on a data capture form. diagnoses of metal disorders were made on the basis of diagnostic and statistical manual (DSM-IV) fourth edition. Shuakat Khanum Memorial Hospital and Research Centre. Two hundred and twenty newly diagnosed cancer patients were interviewed by a clinical psychologist before commencing any cancer treatment. Diagnosis of any metal disorder was transcribed using DSM-IV criteria and data thus collected were analyzed using SPSS for Windows. Observed frequencies of various metal disorders were compared with respect to patient's age, gender, martial status and type of cancer. Sixty five percent patients presented with various mental disorder. Adjusting disorders and mood disorders accounted for 34% each, while anxiety disorder was seen in 30% and remaining had delirium and somatoform disorders. Mental disorders were more common in males, and in younger age group. The oncologist and physicians treating cancer patients should carefully evaluate their patients for symptom of associated mental disorder and provide the required clinical support. (author)

  15. Radiation therapy induced changes in male sex hormone levels in rectal cancer patients

    International Nuclear Information System (INIS)

    Dueland, Svein; Groenlie Guren, Marianne; Rune Olsen, Dag; Poulsen, Jan Peter; Magne Tveit, Kjell

    2003-01-01

    Background and purpose:To determine the effect of curative radiation therapy (46-50 Gy) on the sex hormone levels in male rectal cancer patients. Materials and methods:Twenty-five male rectal cancer patients (mean age 65 years), receiving pelvic radiation therapy (2 Gyx23-25 fractions in 5 weeks) were included. Serum testosterone, FSH and LH were determined before start of treatment, at the 10th and 25th fractions, and 4-6 weeks after completed radiotherapy. The testicular dose was determined by thermoluminescent dosimetry. Results:Five weeks of radiation therapy (46-50 Gy) resulted in a 100% increase in serum FSH, a 70% increase in LH, and a 25% reduction in testosterone levels. After treatment, 35% of the patients had serum testosterone levels below lower limit of reference. The mean radiation dose to the testicles was 8.4 Gy. A reduction in testosterone values was observed already after a mean dose of 3.3 Gy (10th fraction). Conclusion:Radiation therapy (46-50 Gy) for rectal cancer resulted in a significant increase in serum FSH and LH and a significant decrease in testosterone levels, indicating that sex hormone production is sensitive to radiation exposure in patients with a mean age of 65 years

  16. Somatic mutations in breast and serous ovarian cancer young patients: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Giselly Encinas

    2015-10-01

    Full Text Available Summary Objective: our aim was to evaluate whether somatic mutations in five genes were associated with an early age at presentation of breast cancer (BC or serous ovarian cancer (SOC. Methods: COSMIC database was searched for the five most frequent somatic mutations in BC and SOC. A systematic review of PubMed was performed. Young age for BC and SOC patients was set at ≤35 and ≤40 years, respectively. Age groups were also classified in <30years and every 10 years thereafter. Results: twenty six (1,980 patients, 111 younger and 16 studies (598, 41 younger, were analyzed for BC and SOC, respectively. In BC, PIK3CA wild type tumor was associated with early onset, not confirmed in binary regression with estrogen receptor (ER status. In HER2-negative tumors, there was increased frequency of PIK3CA somatic mutation in older age groups; in ER-positive tumors, there was a trend towards an increased frequency of PIK3CA somatic mutation in older age groups. TP53 somatic mutation was described in 20% of tumors from both younger and older patients; PTEN, CDH1 and GATA3 somatic mutation was investigated only in 16 patients and PTEN mutation was detected in one of them. In SOC, TP53 somatic mutation was rather common, detected in more than 50% of tumors, however, more frequently in older patients. Conclusion: frequency of somatic mutations in specific genes was not associated with early-onset breast cancer. Although very common in patients with serous ovarian cancer diagnosed at all ages, TP53 mutation was more frequently detected in older women.

  17. Transesofagic echocardiography in the study of patient with cerebrovascular events in who origin cardiovascular embolic is suspected

    International Nuclear Information System (INIS)

    Escobar Q, Carlos I; Jaramillo U, Mario; Tenorio, Luis F; Molina V, Claudia; Saldarriaga A, Marcela; Arango, Angela M

    2003-01-01

    Cerebrovascular events have an enormous social and economic impact. Twenty percent are of cardiac embolic origin and thirty five percent are of unknown cause or cryptogenic. In the cryptogenic group some echocardiographic findings could explain a cardiovascular origin. Echocardiography helps to study 55% of patients with cerebrovascular accidents. We present our experience during ten years since December 1992 to May 2002 in the Santa Maria cardiovascular clinic with 866 patients, 416 women and 450 men, mean age of 62:1:15 years. The five most frequent diagnoses were: aortic atheromatosis (34%), dilated cardiopathy (8.2%), ischemic cardiopathy (8.2%), left atrial spontaneous contrast (8%), patent foramen ovale (7.7%) and atrial septal aneurysm (4.5%). thirty percent of this population had a normal study. echocardiography helped to guide most of the patient's treatment. there was one esophagus rupture and fifteen minor oropharinx hemorrhages. Trans esophageal echocardiography is a very useful diagnostic method in this patient's study

  18. Twenty-five year outcome of sequential abdominopelvic radiotherapy and alkylating agent chemotherapy for ovarian carcinoma

    International Nuclear Information System (INIS)

    Bellairs, Ellen E.; Twiggs, Leo B.; Potish, Roger A.

    1997-01-01

    Purpose: A prospective study of sequential surgery, abdominopelvic radiotherapy and single agent alkylating chemotherapy was conducted to evaluate survival and toxicity in the management of ovarian carcinoma. Methods: From 1970-1976, 95 women with stage I-III epithelial ovarian carcinoma were scheduled to receive postoperative radiotherapy consisting of 20.0 Gy to the whole abdomen (1.0 Gy/day), a 29.75 Gy pelvic boost (1.75 Gy/day) and 10 subsequent courses of Melphalan (1 mg/kg/course). Endpoints were overall survival, disease-free survival(DFS), and acute and chronic toxicity. Results: The evaluable 94 patients included 19 stage I, 25 stage II, and 50 stage III. Of the latter, 21 had no palpable disease postoperatively (IIIN) and 29 had postoperative palpable disease (IIIP). Overall survival at 5, 10, 15 and 20 years was 42%, 30%, 23% and 22%. DFS for the entire group was 54% at 5 years and remained 50% from 10 to 25 years. All but two recurrences were noted within the first 27 months. No recurrence or treatment-related deaths occurred after 8 years. After 10 years, the survival of the study group became parallel to the general population. Prognostic factors were only related to stage (p<.001) and the presence of postoperative palpable disease(p<.001). DFS at 25 years was 95 % for stage I, 71% at 5 years and 66% from 10 to 25 years for stage II, and 17% at 5 years and 11% thereafter for stage III patients(p<.001). Although no stage IIIP patients were cured, 25% lived beyond 2 years. Five year DFS was significantly better in IIIN (45%) vs. IIIP (0%) patients (p<.001). The 65 patients without postoperative palpable disease, (stage I-IIIN) achieved DFS at 5 and 25 years of 69%, and 61%, respectively. Of 31 patients undergoing a second-look surgery, 84% were found to be free of tumor. Two recurred at 3.5 and 7 years after surgery. Acute tolerance was acceptable. Chronic toxicity included an 11.7% rate of small bowel obstruction requiring surgery and a 3% rate of

  19. Assessment of a five-year survival on hemodialysis in Brazil: a cohort of 3,082 incident patients

    Directory of Open Access Journals (Sweden)

    Jorge Paulo Strogoff de Matos

    2011-12-01

    Full Text Available Brazil has the third largest contingent of patients on maintenance hemodialysis (HD worldwide. However, little is known regarding survival rate and predictors of mortality risk in that population, which are the purposes of this study. A total of 3,082 patients incident on HD, from 2000 to 2004, at 25 dialysis facilities distributed among 7 out of 26 states of Brazil were followed-up until 2009. Patients were 52 ± 16 years-old, 57.8% men, and 20.4%, diabetics. The primary outcome was all causes of mortality. Data were censored at five years of follow-up. The global five-year survival rate was 58.2%. In the Cox proportional model, variables associated with risk of death were: age (hazard ratio - HR = 1.44 per decade, p < 0.0001, diabetes (HR = 1.51, p < 0.0001, serum albumin (HR = 0.76 per g/dL, p = 0.001, creatinine (HR = 0.92 per mg/dL, p < 0.0001, and phosphorus (HR = 1.06 per mg/dL, p = 0.04. The present results show that the mortality rate on HD in this Brazilian cohort was relatively low, but the population is younger and with a lower prevalence of diabetes than the ones reported for developed countries.

  20. Increased cancer risk in patients with periodontitis.

    Science.gov (United States)

    Dizdar, Omer; Hayran, Mutlu; Guven, Deniz Can; Yılmaz, Tolga Birtan; Taheri, Sahand; Akman, Abdullah C; Bilgin, Emre; Hüseyin, Beril; Berker, Ezel

    2017-12-01

    Previous studies have noted a possible association between periodontal diseases and the risk of various cancers. We assessed cancer risk in a cohort of patients with moderate to severe periodontitis. Patients diagnosed with moderate to severe periodontitis by a periodontist between 2001 and 2010 were identified from the hospital registry. Patients younger than 35 years of age or with a prior cancer diagnosis were excluded. The age- and gender-standardized incidence rates (SIR) were calculated by dividing the number of observed cases by the number of expected cases from Turkish National Cancer Registry 2013 data. A total of 280 patients were included (median age 49.6, 54% female). Median follow-up was 12 years. Twenty-five new cancer cases were observed. Patients with periodontitis had 77% increased risk of cancer (SIR 1.77, 95% CI 1.17-2.58, p = .004). Women with periodontitis had significantly higher risk of breast cancer (SIR 2.40, 95% CI 0.88-5.33) and men with periodontitis had significantly higher risk of prostate cancer (SIR 3.75, 95% CI 0.95-10.21) and hematological cancers (SIR 6.97, 95% CI 1.77-18.98). Although showing a causal association necessitates further investigation, our results support the idea that periodontitis might be associated with increased cancer risk, particularly with hematological, breast and prostate cancers.

  1. Visual outcome of ranibizumab therapy for neovascular age related macular degeneration in the black population: a report of five cases

    Directory of Open Access Journals (Sweden)

    Roopa Vemala

    2010-08-01

    Full Text Available Roopa Vemala, Bhaskar Gupta, Sobha SivaprasadLaser and Retinal Research Unit, King’s College Hospital, London SE5 9RS, UKIntroduction: Neovascular age related macular degeneration (AMD is relatively uncommon in the black population. We report the 12-month outcome of ranibizumab therapy in five black patients with choroidal neovascular membrane (CNV secondary to AMD.Material and methods: Retrospective analysis of a prospective audit database maintained for all patients on ranibizumab therapy in a retinal specialist unit that caters to a multi-ethnic cohort in London, United Kingdom.Results: At 12 months, all the 5 patients maintained stable vision (loss of less than 15 ETDRS letters. However, none of them gained more than 15 ETDRS letters. All eyes showed early subretinal fibrosis while 2 patients showed extended areas of retinal pigment atrophy.Conclusion: Our case studies indicate that ranibizumab stabilizes the vision in black patients with CNV secondary to AMD but they tend to develop early subretinal fibrosis and retinal pigment atrophy.Keywords: choroidal neovascular membrane, Afro-Caribbean, blacks

  2. Twenty-first century vaccines

    Science.gov (United States)

    Rappuoli, Rino

    2011-01-01

    In the twentieth century, vaccination has been possibly the greatest revolution in health. Together with hygiene and antibiotics, vaccination led to the elimination of many childhood infectious diseases and contributed to the increase in disability-free life expectancy that in Western societies rose from 50 to 78–85 years (Crimmins, E. M. & Finch, C. E. 2006 Proc. Natl Acad. Sci. USA 103, 498–503; Kirkwood, T. B. 2008 Nat. Med 10, 1177–1185). In the twenty-first century, vaccination will be expected to eliminate the remaining childhood infectious diseases, such as meningococcal meningitis, respiratory syncytial virus, group A streptococcus, and will address the health challenges of this century such as those associated with ageing, antibiotic resistance, emerging infectious diseases and poverty. However, for this to happen, we need to increase the public trust in vaccination so that vaccines can be perceived as the best insurance against most diseases across all ages. PMID:21893537

  3. Archaeointensity study of five Late Bronze Age fireplaces from Corent (Auvergne, France)

    OpenAIRE

    Hervé , Gwenaël; Chauvin , Annick; Milcent , Pierre-Yves; Tramon , Arthur

    2016-01-01

    International audience; Recent excavations at Corent (France) unearthed a vast Late Bronze Age settlement. The high density of fireplaces especially highlights it. The present study focuses on the archaeomagnetic study of five fireplaces. These ones were dated between 950 and 800 BCE by cross-dating of metallic and ceramic artefacts and by radiocarbon. The main objective of our study is to increase the archaeointensity database in Western Europe at the beginning of the first millennium BCE. T...

  4. Comparison of the prognosis among different age groups in elderly patients with hip fracture

    Directory of Open Access Journals (Sweden)

    Hagino Tetsuo

    2008-01-01

    patients even in the elderly. There were two in-hospital deaths in group B, 11 in group C, and two in group D. Five of the 15 deaths were inoperable cases due to poor performance status at admission. Conclusion: Walking ability at discharge and survival prognosis worsened as age advanced. On the other hand, since surgical cases achieved better walking ability than conservatively treated cases, efforts should be made to achieve better functional prognosis even in the old-olds, including surgery together with early ambulation and rehabilitation.

  5. Striving for Contribution: The Five Cs and Positive Effects of Cross-Age Peer Mentoring

    Science.gov (United States)

    Sinclair, Eric; Larson, Heidi A.

    2018-01-01

    This article explores the relationship between cross-age peer mentoring and positive life outcomes as defined by the Five Cs: competence, character, confidence, connection, and compassion. Qualified high school juniors and seniors were randomly assigned groups of 4-5 freshmen to mentor through the challenges of transitioning to secondary school.…

  6. Elderly fall patients triaged to the trauma bay: age, injury patterns, and mortality risk.

    Science.gov (United States)

    Evans, Daniel; Pester, Jonathan; Vera, Luis; Jeanmonod, Donald; Jeanmonod, Rebecca

    2015-11-01

    Falls in the elderly are a significant cause of morbidity and mortality. We sought to better categorize this patient population and describe factors contributing to their falls. This is a retrospective review of geriatric patients presenting to a level 1 community trauma center. We queried our trauma database for all patients 65 years and older presenting with fall and triaged to the trauma bay from 2008 to 2013. Researchers reviewed the patients' trauma intake paperwork to assess mechanism, injury, and location of fall, whereas discharge summaries were reviewed to determine disposition, morbidity, and mortality. A total of 650 encounters were analyzed. Five hundred thirty-nine resided at home (82.9%), 110 presented from nursing homes or assisted living (16.9%), and 1 came from hospice (0.15%). Ninety-five patients died or were placed on hospice as a result of their falls (14.7%), of which 88 came from home. Controlling for Injury Severity Score, living at home was an independent risk factor for fall-related mortality (odds ratio, 3.0). Comparing the elderly (age 65-79 years; n = 274) and the very elderly (age ≥80 years; n = 376), there were no differences in Injury Severity Score (P = .33), likelihood of death (P = .49), likelihood of C-spine injury (P = 1.0), or likelihood of other axial or long bone skeletal injury (P = .23-1.0). There was a trend for increased likelihood of head injury in very elderly patients (P = 0.06). Prevention measures to limit morbidity and mortality in elderly fall patients should be aimed at the home setting, where most severe injuries occur. Very elderly patients may be at increased risk for intracranial fall-related injuries. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Value of five-stage prognostic system in predicting short-term outcome of patients with liver cirrhosis

    Directory of Open Access Journals (Sweden)

    TIAN Yan

    2015-03-01

    Full Text Available ObjectiveTo evaluate the clinical value of five-stage prognostic system in predicting the short-term outcome of patients with liver cirrhosis, and to compare it with the Child-Turcotte-Pugh (CTP and Model of End-Stage Liver Disease (MELD scores. MethodsTwo hundred and one hospitalized patients with liver cirrhosis in the Department of Gastroenterology in the First Affiliated Hospital of Anhui Medical University from January 2011 to January 2014 were enrolled in the study and followed up for at least six months. Patients were classified accorded to the five-stage prognostic system, and the mortality rate in each stage was measured. The receiver operating characteristic (ROC curve and the area under the ROC curve (AUC were used to assess the accuracy of the five-stage prognostic system in predicting the short-term death risk of cirrhotic patients, which was then compared with the CTP and MELD scores. Categorical data were analyzed by chi-square test. Comparison of AUC was made by normal distribution Z test. Spearman′s correlation analysis was used to investigate the correlation of the five-stage prognostic system with the CTP and MELD scores. ResultsThe study used the admission time as the starting point and the death of patients or study termination time as the endpoint. Among the 201 patients, 50 (24.9% died within six months. Based on the five-stage prognostic system, the mortality rates for stages 1 to 5 were 0(0/11, 0(0/18, 4.2%(2/48, 16.3% (7/43, and 50.6%(41/81, respectively. In patients with decompensated cirrhosis (stages 3, 4, and 5, the mortality increased with stage, and the differences in mortality between patients in stages 3 and 4, 3 and 5, and 4 and 5 were all significant (χ2=3.89, 35.33, and 13.96, respectively; P=0.049, 0.000, and 0.049, respectively. The AUC for the five-stage prognostic system, five-stage prognostic system combined with CTP and MELD score, and CTP score were 0820, 0.915, 0.888, and 0

  8. A new self-administered questionnaire to determine patient experience with voice prostheses (Blom-singer valves

    Directory of Open Access Journals (Sweden)

    Kazi R

    2005-01-01

    Full Text Available Aim: To obtain information about valved speech and related issues in patients who have undergone total laryngectomy with the help of a new structured questionnaire on voice prosthesis. Settings and Design: A questionnaire-based pilot study set at a tertiary referral head and neck cancer unit. Materials and Methods: Twenty-five patients using voice prostheses, who showed no signs of recurrence after having undergone total laryngectomy were interviewed with the help of a questionnaire that assessed issues such as voice quality, valve maintenance, leakage, quality of life, humidification and hands-free system over the preceding seven days. The data was analyzed using non-parametric tests (Mann-Whitney and Spearman rank. Results: Twenty-five patients (16 males with a median age of 65 years (IQ range: 59-70 years had been using the prosthesis for a median of 6 years (IQ range: 5-10 years. The majority of the patients (n=20 were fully informed about their valve size and diameter and most were able to remove and replace their own prosthesis. Fourteen patients (60% had leakage-related issues. Women were less satisfied with their voice quality as compared to men. Overall, there appeared to be an improvement in quality of life with the use of the voice prosthesis. Conclusions: The subjects were fairly well informed about their valve and experienced a high level of satisfaction with their voice. This questionnaire serves as a valuable tool for monitoring voice rehabilitation in patients who have undergone laryngectomy.

  9. The Relationship between Drawing and Oral Language in Deaf Students Aged Three to Five

    Science.gov (United States)

    Silvestre, Nuria; Cambra, Cristina

    2009-01-01

    This study examines the relationship between drawing and oral language acquisition in deaf students aged three to five. The sample is made up of one hundred participants: fifty deaf and fifty hearing children. Goodenough's Human Figure Drawing Test and the WPPSI Scale of Intelligence geometric design subtest have been used to evaluate graphic…

  10. Analysis of economic burden for patients with cystic echinococcosis in five hospitals in northwest China.

    Science.gov (United States)

    Wang, Le; Wen, Hao; Feng, Xiaohui; Jiang, Xiaoming; Duan, Xinyu

    2012-12-01

    The direct and indirect economic burden of human cystic echinococcosis (CE) was investigated in the five specialist hydatid hospitals in Xinjiang, PR China, to provide information for health policy in the future. A total of 2018 CE patients (age range 2-88 years) attending the hospitals were studied between 2004 and 2008. The per-person direct medical cost was US$1493.12 (95% CI 1438.43-1547.80) and the per-person direct non-medical cost was US$19.67. The indirect economic cost was US$1435.96 per person, and the disability-adjusted life-years (DALY) lost was approximately 1.03 DALY/person. This study is the first to combine the human capital method with DALYs to analyse the indirect CE economic burden in northwest China. Factors such as age, occupation and hospital level should be considered when developing polices to reduce the economic burden of CE. Copyright © 2012 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

  11. Congressmember Sam Farr: Five Decades of Public Service

    OpenAIRE

    Reti, Irene H.; Farr, Sam

    2017-01-01

    Congressmember Sam Farr (born July 4, 1941) represented California’s Central Coast in the United States House of Representatives for twenty-three years until his retirement from office in 2016.  Farr also served six years as a member of the Monterey County Board of Supervisors and twelve years in the California State Assembly. This oral history, a transcript of twenty-five hours of interviews conducted by Irene Reti, director of the UCSC Library’s Regional History Project, during the period i...

  12. Perceptions of five-year competitive categories: model of how relative age influences competitiveness in masters sport.

    Science.gov (United States)

    Medic, Nikola; Young, Bradley W; Grove, J Robert

    2013-01-01

    The purpose of this study was to examine the contrasting perceptions of masters swimmers related to the first and fifth constituent years of a 5-year age category. Swimmers aged between 35 and 93 years (154 male, 184 female) were surveyed at the 2008 FINA World Masters Championships. Exploratory factor analysis indicated the existence of the following five factors considered important for preparation, attendance, and success at masters competitions: awareness of advantages, expectancy, motivation, training, and physiological capacity. One sample t-tests showed that masters swimmers are conscious of advantages that 5-year age categories afford to relatively-younger cohorts (i.e., those who are in the first year of any age category). They also perceive that, in the first compared to the fifth year of an age category, they have greater physiological capacity, engage in more training, have higher expectations to perform well, and are more motivated (all ps competitions than relatively older masters athletes. Key PointsThere are at least five psycho-social and physical factors (i.e., awareness of advantages, expectancy, motivation, training, and physiological capacity) that may explain why relatively younger masters athletes are more likely to perform better and to participate more in masters competitions than relatively older masters athletes.Masters athletes are conscious of the advantage that 5-year age categories afford to relatively younger cohorts of athletes.Differential perceptions associated with the 5-year age categories might compromise masters athletes' continuity of sport competitiveness and underlying training.

  13. B12 deficiency increases with age in hospitalized patients: a study on 14,904 samples.

    Science.gov (United States)

    Mézière, Anthony; Audureau, Etienne; Vairelles, Stéphane; Krypciak, Sébastien; Dicko, Michèle; Monié, Marguerite; Giraudier, Stéphane

    2014-12-01

    Cobalamin deficiency is responsible for hematological, neurological, neurocognitive, and neuropsychiatric impairments and is a risk factor for cardiovascular diseases, particularly in the elderly people. In order to determine B12 status in old inpatients, a total number of 14,904 hospitalized patients in whom B12 measurements were performed in five hospitals in the Paris metropolitan area were included from January 1, 2011 to December 31, 2011. The aims of the study were to determine whether age had an impact on B12 and folate deficiencies and to evaluate correlations between B12 and biological parameters-folate, hemoglobin, mean cell volume, homocystein (tHcy)-and age. Patients were aged 70.3±19.5 years. Low B12 concentration ( 17 µmol/L), 20.4% had low folate concentration (folate 17 µmol/L), and 4.7% of patients were both functional B12 and folate deficient. The B12 or folate deficient patients had lower mean cell volume level than nondeficient patients. Increase in mean cell volume and tHcy concentrations with age and decrease in B12, folate, and hemoglobin levels with age were observed. Frequency of functional B12 deficiency was 9.6% in patients aged 30-60 years and 14.2% in patients over 90 years. Frequency of functional folate deficiency was 9.5% in 30-60 years and 12.1% in >90 years. In inpatients, functional B12 deficiency and functional folate deficiency increase with age and are not associated with anemia or macrocytosis. False vitamin B deficiencies are frequent. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Postoperative cognitive dysfunction in middle-aged patients

    NARCIS (Netherlands)

    Johnson, T.; Monk, T.; Rasmussen, L.S.; Abildstrom, H.; Houx, P.J.; Korttila, K.; Kuipers, H.M.; Hanning, C.D.; Siersma, V.D.; Kristensen, D.; Canet, J.; Ibanaz, M.T.; Moller, J.T.

    2002-01-01

    Background: Postoperative cognitive dysfunction (POCD) after noncardiac surgery is strongly associated with increasing age in elderly patients; middle-aged patients (aged 40-60 yr) may be expected to have a lower incidence, although subjective complaints are frequent. Methods: The authors compared

  15. [Chronic malnutrition among children under five years of age in the northern part of Côte d'Ivoire].

    Science.gov (United States)

    Aké-Tano, Odile; Tiembré, Issaka; Konan, Yao Eugène; Donnen, Philippe; Dagnan, Simplice N'cho; Dramaix, Michelle; Koffi, Kouamé; Diarra-Nama, Alimata Jeanne

    2010-01-01

    The malnutrition of children under five years of age constitutes a major public health problem in most developing countries. A cross-section study was carried in 2003 in the northern part of Côte d'Ivoire to determine the prevalence of chronic malnutrition and to identify risk factors among children under five years of age living in urban and rural areas of the northern part of Côte d'Ivoire. A total of 292 and 268 children under five years of age residing respectively in urban and rural areas were included in the study. Their median age was 24 months. Chronic malnutrition was more frequent in children from rural areas (39.9%) than in those living in urban areas (16.7%). Malnutrition was significantly associated with the type of food consumed by children under two years of age in urban areas, and it was strongly linked to emaciation of the mother and presence of childhood fever in rural areas. In light of these results, we advocate a healthy diet and adequate health status for the mother and child to improve the nutritional status of children. Moreover, these results need to be completed and complemented by further studies for more detailed information to contribute to a better definition of actions to fight efficiently against malnutrition among children of the northern part of Côte d'Ivoire.

  16. Re-irradiation after salvage mastectomy for local recurrence after a conservative treatment: a retrospective analysis of twenty patients (Nancy: 1988-2001); Re-irradiation parietale apres mastectomie de rattrapage pour recidive d'un cancer du sein apres traitement conservateur: etude retrospective sur 20 patientes (Nancy: 1988-2001)

    Energy Technology Data Exchange (ETDEWEB)

    Racadot, S.; Marchal, C.; Charra-Brunaud, C.; Peiffert, D.; Bey, P. [Centre Alexis-Vautrin, Service de Radiotherapie, 54 - Vandoeuvre-les-Nancy (France); Verhaeghe, J.L. [Centre Alexis-Vautrin, Service de Chirurgie, 54 - Vandoeuvre-les-Nancy (France)

    2003-12-01

    Purpose. - To retrospectively assess the efficacy of post-mastectomy re-irradiation for local relapse of breast cancer. Patients and methods. - Twenty patients, initially treated by conservative surgery and radiotherapy (50 Gy in 25 fractions over 5 weeks) were treated from 1998 to 2001 for a local relapse by salvage mastectomy and re-irradiation (either electron or photon beams). Mean age was 53 years (31-71). Reasons for re-irradiation were that the local relapses were inflammatory (4 pts), multifocal (5 pts), cutaneous (5 pts), involved the nipple (3 pts) or because the surgical margins (either muscle or skin) were involved (3 pts). The median dose of re-irradiation was 45 Gy (33-65) in 15 fractions over 33 days. Mean follow-up was 48 months (5-97). Results. - Fifteen patients remained free of a second local recurrence and 10 were still alive, without metastasis. Neither the dose of re-irradiation nor the irradiated surfaces were prognostic factors of local control (P = 0.877 and P = 0.424). Five patients developed radiation-induced pneumonitis without functional respiratory impairment. The incidence of pneumonitis seemed to be related to the biological dose of re-irradiation (P = 0.037). Other late complications occurred such as pigmentation changes (12 pts), telangiectasia (8 pts), chondritis (2 pts), parietal fibrosis (7 pts), rib fractures (4 pts), severe pain (11 pts) and lymphedema (2 pts). The increase in biological equivalent dose was highly statistically linked with the occurrence of disabling pain (P = 0.0123). Conclusion. - Parietal re-irradiation achieves good and lasting local control with an acceptable rate of acute complications but with a risk of disabling late sequelae such as severe pain. (author)

  17. Study of Neurodermatitis Circumscripta Patients with Psychological Tests

    Directory of Open Access Journals (Sweden)

    Bhushan Kumar

    1982-01-01

    Full Text Available 2.54 percent of patients attending the dermatology clinic were found to have neurodermatitis circumscripta. Twenty adult male patients with the disease who were p educated at least u to high school were p subjected to detailed psychological testing. They were administered 10 cards of TAT Sinha′s anxiety scale,- self-rating depression scale of Zung and Wechsler adult intelligence scale tests. AU the patients were found to have high IO levels. Anxiety of a very high degree was observed in 55.8 percent of the patients. Anxiety levels were high in patients who were eldest in the family. Sixty five per cent of patients showed high degree of depression, which was more apparent in the younger age group. Patients with first and second ordinal position were more depressed. No relationship was found between the disease and the financial and cdcational status, duration and extent of disease and 1.Q., anxiety or depression levels. Need (n affifiation and (n achievement were the two most dominant needs expressed.

  18. Cardiovascular risk factors in patients with rheumatoid arthritis at ...

    African Journals Online (AJOL)

    The prevalence of hypertension among RA patients was 41.3%, diabetes 6.3%, dyslipidemia 71.3%, smoking 5%, obesity 22.5%, abnormal WHR 33.8%, family history of sudden death 5%, no family history of stroke or heart attack was reported. In the control group one hundred and five were screened and twenty five were ...

  19. Big Five personality and depression diagnosis, severity and age of onset in older adults.

    Science.gov (United States)

    Koorevaar, A M L; Comijs, H C; Dhondt, A D F; van Marwijk, H W J; van der Mast, R C; Naarding, P; Oude Voshaar, R C; Stek, M L

    2013-10-01

    Personality may play an important role in late-life depression. The aim of this study is to examine the association between the Big Five personality domains and the diagnosis, severity and age of onset of late-life depression. The NEO-Five Factor Inventory (NEO-FFI) was cross-sectionally used in 352 depressed and 125 non-depressed older adults participating in the Netherlands Study of Depression in Older Persons (NESDO). Depression diagnosis was determined by the Composite International Diagnostic Interview (CIDI). Severity of depression was assessed by the Inventory of Depressive Symptomatology (IDS). Logistic and linear regression analyses were applied. Adjustments were made for sociodemographic, cognitive, health and psychosocial variables. Both the presence of a depression diagnosis and severity of depression were significantly associated with higher Neuroticism (OR=1.35, 95% CI=1.28-1.43 and B=1.06, ppersonality measures. This study confirms an association between personality and late-life depression. Remarkable is the association found between high Openness and earlier age of depression onset. © 2013 Elsevier B.V. All rights reserved.

  20. Gait adaptations with aging in healthy participants and people with knee-joint osteoarthritis.

    Science.gov (United States)

    Duffell, Lynsey D; Jordan, Stevan J; Cobb, Justin P; McGregor, Alison H

    2017-09-01

    The relationship between age and gait characteristics in people with and without medial compartment osteoarthritis (OA) remains unclear. We aimed to characterize this relationship and to relate biomechanical and structural parameters in a subset of OA patients. Twenty five participants with diagnosed unilateral medial knee OA and 84 healthy participants, with no known knee pathology were recruited. 3D motion capture was used to analyse sagittal and coronal plane gait parameters while participants walked at a comfortable speed. Participants were categorized according to age (18-30, 31-59 and 60+ years), and those with and without OA were compared between and within age groups. In a subset of OA patients, clinically available Computed Tomography images were used to assess joint structure. Differences in coronal plane kinematics at the hip and knee were noted in participants with OA particularly those who were older compared with our healthy controls, as well as increased knee moments. Knee adduction moment correlated with structural parameters in the subset of OA patients. Increased knee moments and altered kinematics were observed in older participants presenting with OA only, which seem to be related to morphological changes in the joint due to OA, as opposed to being related to the initial cause of medial knee OA. Copyright © 2017. Published by Elsevier B.V.

  1. Toxicity Determinations for Five Energetic Materials, Weathered and Aged in Soil, to the Collembolan Folsomia Candida

    Science.gov (United States)

    2015-03-01

    obtained from the Soil Fauna and Ecotoxicology Research Unit, Department of Terrestrial Ecology, National Environmental Research Institute (Silkeborg...AND AGED IN SOIL , TO THE COLLEMBOLAN FOLSOMIA CANDIDA ECBC-TR-1273 Carlton T. Phillips Ronald T. Checkai Roman G. Kuperman Michael Simini...for Five Energetic Materials, Weathered and Aged in Soil , to the Collembolan Folsomia candida 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c

  2. Patients with advanced and metastatic renal cell carcinoma treated with targeted therapy in the Czech Republic: twenty cancer centres, six agents, one database.

    Science.gov (United States)

    Poprach, Alexandr; Bortlíček, Zbyněk; Büchler, Tomáš; Melichar, Bohuslav; Lakomý, Radek; Vyzula, Rostislav; Brabec, Petr; Svoboda, Marek; Dušek, Ladislav; Gregor, Jakub

    2012-12-01

    The incidence and mortality of renal cell carcinoma (RCC) in the Czech Republic are among the highest in the world. Several targeted agents have been recently approved for the treatment of advanced/metastatic RCC. Presentation of a national clinical database for monitoring and assessment of patients with advanced/metastatic RCC treated with targeted therapy. The RenIS (RENal Information System, http://renis.registry.cz ) registry is a non-interventional post-registration database of epidemiological and clinical data of patients with RCC treated with targeted therapies in the Czech Republic. Twenty cancer centres eligible for targeted therapy administration participate in the project. As of November 2011, six agents were approved and reimbursed from public health insurance, including bevacizumab, everolimus, pazopanib, sorafenib, sunitinib, and temsirolimus. As of 10 October 2011, 1,541 patients with valid records were entered into the database. Comparison with population-based data from the Czech National Cancer Registry revealed that RCC patients treated with targeted therapy are significantly younger (median age at diagnosis 59 vs. 66 years). Most RenIS registry patients were treated with sorafenib and sunitinib, many patients sequentially with both agents. Over 10 % of patients were also treated with everolimus in the second or third line. Progression-free survival times achieved were comparable to phase III clinical trials. The RenIS registry has become an important tool and source of information for the management of cancer care and clinical practice, providing comprehensive data on monitoring and assessment of RCC targeted therapy on a national level.

  3. Evaluation of Satisfaction Level in Patients With Mandibular Implant Supported Overdentures

    Directory of Open Access Journals (Sweden)

    Masoumeh khoshhal

    2016-01-01

    Full Text Available Background Implant-supported overdentures could have many benefits for patients, especially in the lower jaws. As a matter of fact, the most common reason for prescribing mandibular overdenture is dissatisfaction of patients with mandibular dentures usually because of a lack of retention, stability and function and speech difficulties. On the other hand, patients' expectations of overdenture treatments are their main disadvantage. Objectives The aim of this study was to evaluate the satisfaction of patients who had received mandibular implant supported overdenture treatment with different number of implants. Patients and Methods This study was a descriptive cross-sectional study. Twenty-five patients with a mean age of 62.7 years who had received mandibular implant supported overdenture treatment at the dental school of Hamadan University of Medical Sciences were enrolled. Among these patients, six had overdentures supported by one implant, nine had overdentures supported by two implants, two had overdentures supported by three implants, five had overdentures supported by four implants and three had overdentures supported by five implants. The visual analogue scale (VAS questionnaire was used to evaluate the general satisfaction, comfort, esthetic, fitness, satisfaction of chewing and social communication, and the data was analyzed by the analysis of variance (ANOVA test. Results All patients in all five groups were satisfied with their overdentures; however there was no significant relationship between the number of implants and fitness (P = 0.446, esthetic (P = 0.843, comfort (P = 0.805, satisfaction of chewing (P = 0.133, social communication (P = 0.322 and general satisfaction (P = 0.493. Conclusions There was no difference in satisfaction level of patients who had received mandibular overdentures with different number of implants.

  4. Local patient dose diagnostic reference levels in pediatric interventional cardiology in Chile using age bands and patient weight values

    Energy Technology Data Exchange (ETDEWEB)

    Ubeda, Carlos, E-mail: cubeda@uta.cl [Medical Technology Department, Radiological Sciences Center, Health Sciences Faculty, Tarapaca University, Arica 1000000 (Chile); Miranda, Patricia [Hemodynamic Department, Cardiovascular Service, Luis Calvo Mackenna Hospital, Santiago 7500539 (Chile); Vano, Eliseo [Radiology Department, Faculty of Medicine, Complutense University and IdIS, San Carlos Hospital, Madrid 28040 (Spain)

    2015-02-15

    Purpose: To present the results of a patient dose evaluation program in pediatric cardiology and propose local diagnostic reference levels (DRLs) for different types of procedure and age range, in addition to suggesting approaches to correlate patient dose values with patient weight. This study was the first conducted in Latin America for pediatric interventional cardiology under the auspices of the International Atomic Energy Agency. Methods: Over three years, the following data regarding demographic and patient dose values were collected: age, gender, weight, height, number of cine series, total number of cine frames, fluoroscopy time (FT), and two dosimetric quantities, dose-area product (DAP) and cumulative dose (CD), at the patient entrance reference point. The third quartile values for FT, DAP, CD, number of cine series, and the DAP/body weight ratio were proposed as the set of quantities to use as local DRLs. Results: Five hundred and seventeen patients were divided into four age groups. Sample sizes by age group were 120 for <1 yr; 213 for 1 to <5 yr; 82 for 5 to <10 yr; and 102 for 10 to <16 yr. The third quartile values obtained for DAP by diagnostic and therapeutic procedures and age range were 1.17 and 1.11 Gy cm{sup 2} for <1 yr; 1.74 and 1.90 Gy cm{sup 2} for 1 to <5 yr; 2.83 and 3.22 Gy cm{sup 2} for 5 to <10 yr; and 7.34 and 8.68 Gy cm{sup 2} for 10 to <16 yr, respectively. The third quartile value obtained for the DAP/body weight ratio for the full sample of procedures was 0.17 (Gy cm{sup 2}/kg) for diagnostic and therapeutic procedures. Conclusions: The data presented in this paper are an initial attempt at establishing local DRLs in pediatric interventional cardiology, from a large sample of procedures for the standard age bands used in Europe, complemented with the values of the ratio between DAP and patient weight. This permits a rough estimate of DRLs for different patient weights and the refining of these values for the age bands when there

  5. Local patient dose diagnostic reference levels in pediatric interventional cardiology in Chile using age bands and patient weight values

    International Nuclear Information System (INIS)

    Ubeda, Carlos; Miranda, Patricia; Vano, Eliseo

    2015-01-01

    Purpose: To present the results of a patient dose evaluation program in pediatric cardiology and propose local diagnostic reference levels (DRLs) for different types of procedure and age range, in addition to suggesting approaches to correlate patient dose values with patient weight. This study was the first conducted in Latin America for pediatric interventional cardiology under the auspices of the International Atomic Energy Agency. Methods: Over three years, the following data regarding demographic and patient dose values were collected: age, gender, weight, height, number of cine series, total number of cine frames, fluoroscopy time (FT), and two dosimetric quantities, dose-area product (DAP) and cumulative dose (CD), at the patient entrance reference point. The third quartile values for FT, DAP, CD, number of cine series, and the DAP/body weight ratio were proposed as the set of quantities to use as local DRLs. Results: Five hundred and seventeen patients were divided into four age groups. Sample sizes by age group were 120 for <1 yr; 213 for 1 to <5 yr; 82 for 5 to <10 yr; and 102 for 10 to <16 yr. The third quartile values obtained for DAP by diagnostic and therapeutic procedures and age range were 1.17 and 1.11 Gy cm 2 for <1 yr; 1.74 and 1.90 Gy cm 2 for 1 to <5 yr; 2.83 and 3.22 Gy cm 2 for 5 to <10 yr; and 7.34 and 8.68 Gy cm 2 for 10 to <16 yr, respectively. The third quartile value obtained for the DAP/body weight ratio for the full sample of procedures was 0.17 (Gy cm 2 /kg) for diagnostic and therapeutic procedures. Conclusions: The data presented in this paper are an initial attempt at establishing local DRLs in pediatric interventional cardiology, from a large sample of procedures for the standard age bands used in Europe, complemented with the values of the ratio between DAP and patient weight. This permits a rough estimate of DRLs for different patient weights and the refining of these values for the age bands when there may be large differences

  6. Five cases of acute Zika virus infection in French women of reproductive age returning from Central and South America.

    Science.gov (United States)

    Penot, P; Balavoine, S; Leplatois, A; Brichler, S; Leparc-Goffart, I; Alloui, A-C; Flusin, O; Guilleminot, J; Amellou, M; Molina, J-M

    2017-08-01

    The favorable season for Aedes albopictus circulation has started in Europe and may lead to autochthonous transmission of Zika virus. Health care providers should be familiar with evocative clinical presentations and able to give updated information to women of reproductive age infected by Zika virus. We report five laboratory-confirmed Zika virus infections imported to metropolitan France from Central and South America between January and April, 2016. The five young women were not connected and not pregnant; common presentation combined a rash with persistent arthralgia. Zika virus was identified by RT-PCR from serum or urines, between two and eight days after the onset of the symptoms. As the duration of potential materno-foetal infectivity is still unknown, we were unable to answer with certitude to the patients' questions about the time interval to respect before attempting a pregnancy: one of them became pregnant one month after the diagnosis. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  7. The second twenty-five years.

    Science.gov (United States)

    Kippley, J F

    1993-01-01

    Between 1964 and 1968, the liberal Catholic press had prepared the laity for the change expected to occur after the release of Pope Paul VI's encyclical "Humanae Vitae," but almost no one read it when it was released in July 1968. The media gave the impression that no one agreed with the Pope. The Archbishop of Baltimore denounced his dissenting priests. The media publicized the discord, resulting in his fellow bishops not supporting him or the Pope. Sound theology was limited then. Today many Catholic leaders and scholars openly defend the encyclical, e.g., since 1978, Pope John Paul II has supported the doctrine of marital noncontraception. Pope Pius XII called for every woman to breast feed. The 1969 publication of the Breastfeeding and Natural Child Spacing was the catalyst for 10 years of research which confirmed breast feeding's contraceptive effect. Family planning specialists and demographers agreed in the Bellagio Consensus in 1988 that mothers who practiced exclusive breast feeding and were amenorrheic need not use a contraceptive for the first 6 months postpartum. Recent research shows that this rule depends on the population, e.g., women in Bangladesh meeting the criteria do not need to use contraceptives for 1 year. Few natural family planning groups existed in 1968 (e.g., 1 diocese), but today there are natural family planning teachers in 49 US states and in 13 countries. Some Catholics are calling for couples wanting to marry to take a course in natural family planning. The media widely publicized the new unnatural family planning methods, especially the pill. Recently a baby magazine allocated natural family planning 2/3rd of a page. A reporter for the "Washington Post" plans to interview a Catholic leader about natural family planning, completely on his/her own initiative.

  8. Deficiencies of vitamins in CAPD patients: the effect of supplementation

    NARCIS (Netherlands)

    Boeschoten, E. W.; Schrijver, J.; Krediet, R. T.; Schreurs, W. H.; Arisz, L.

    1988-01-01

    Concentrations of the vitamins B1, B2, B6, B12, C, folic acid, A, E and beta-carotene were determined in blood and 24-h dialysate in 44 CAPD patients. Twenty-five of these patients were studied during chronic treatment (mean 313 days, range 60-1034 days). Nineteen patients were studied during

  9. Hypopigmented mycosis fungoides in a twenty-year-old Saudi woman with fair skin

    Directory of Open Access Journals (Sweden)

    Al-Ratrout J

    2006-01-01

    Full Text Available The hypopigmented variant of mycosis fungoides (MF is charactrized by the presence of hypopigmented patches as the sole manifestation of the disease. This variant is usually observed in the dark skin of African or Asian individuals particularly children, but nevertheless is an uncommonly reported presentation of the disease. The incidence of hypopigmented MF in Caucasian patients and others of fair skin color is rare. We describe hypopigmented lesions arising in a twenty-year-old Saudi woman with type IV skin color. The diagnosis of mycosis fungoides stage IA was made based on the clinico-radiological and histological features. The patient responded well to PUVA therapy and is currently clear of lesions. MF should be considered in the differential diagnosis of hypopigmented macular lesions in patients of any skin color and age. Multiple skin biopsies must be performed on different occasions so as not to miss the diagnosis; and long term follow up is recommended since recurrence is common and occasional cases behave aggressively.

  10. Mini-percutaneous Nephrolithotomy Under Total Ultrasonography in Patients Aged Less Than 3 Years: A Single-center Initial Experience from China

    Directory of Open Access Journals (Sweden)

    Bo Xiao

    2015-01-01

    Full Text Available Background: Urolithiasis in pediatric population is a serious problem with the incidence increased these years. In the management of larger stones (diameters >2 cm, percutaneous nephrolithotomy (PCNL is considered to be the gold standard. This study aimed to investigate the efficacy and safety of mini-PCNL under total ultrasonography in patients aged 38.5°C in five patients and reactive pleural effusion in one patient. Blood loss requiring transfusion, sepsis, adjacent organ injury, and kidney loss were not observed. Conclusions: This study indicated that ultrasound-guided mini-PCNL is feasible and safe in patients aged <3 years, without major complications or radiation exposure.

  11. Twenty Years of Anesthetic and Perioperative Management of Patients With Tetralogy of Fallot With Absent Pulmonary Valve.

    Science.gov (United States)

    Jochman, John D; Atkinson, Douglas B; Quinonez, Luis G; Brown, Morgan L

    2017-06-01

    Review the authors' institutional experience of the induction and perioperative airway management of children with tetralogy of Fallot with an absent pulmonary valve. Retrospective chart review. Large academic children's hospital. Patients with the diagnosis of tetralogy of Fallot with absent pulmonary valve undergoing primary cardiac repair over a 20-year period. None. Forty-four patients were identified with tetralogy of Fallot with an absent pulmonary valve from January 1995 through August 2014. Forty-two patients (95%) required surgery in their first year of life. Sixteen patients (36%) required mechanical ventilation preoperatively, including 11 neonates. Of the 28 patients not intubated preoperatively, only 1 (3.8%) exhibited minor airway obstruction following induction that was managed uneventfully. All intubations in the operating room were performed in the supine position. Five patients who were mechanically ventilated preoperatively in a lateral or prone position were supinated in the operating room without significant cardiopulmonary compromise. There were no patients who suffered cardiopulmonary arrest or required mechanical circulatory support. The median time to extubation was 2 days (range 1-13 days) in those patients who were not mechanically ventilated prior to their surgery. Ultimately, 5 patients required tracheostomy and 1 patient underwent lobectomy. Although, there was no mortality at 30 days, 4 children died within 1 year of their surgery. All the children who died had a genetic syndrome and required mechanical ventilation preoperatively. While there are theoretical concerns specific to the induction and airway management of tetralogy of Fallot with an absent pulmonary valve, there were no episodes of cardiorespiratory arrest or extracorporeal membrane oxygenation in the authors' series. Neonatal age at the time of surgery, preoperative need for mechanical ventilation, and concomitant genetic syndromes are risk factors for respiratory

  12. Endodontics and the ageing patient.

    Science.gov (United States)

    Johnstone, M; Parashos, P

    2015-03-01

    Patients are living longer and the rate of edentulism is decreasing. Endodontic treatment is an essential part of maintaining the health and well-being of the elderly. Retention of natural teeth improves the quality of life and the overall health and longevity of ageing patients. Also, teeth that might be otherwise extracted may be strategically valuable to retain a prosthesis, and elderly patients are more likely to have medical complications that may prevent dental extractions from being safely performed. The technical goals of endodontic treatment in the elderly are the same as those for younger patients. However, the pulpo-dentinal complex undergoes calcific changes over time, which may pose challenges for the clinician. The purposes of this review are to discuss age changes in the pulp and the challenges posed by diagnosing, treatment planning and treating the elderly endodontic patient. © 2015 Australian Dental Association.

  13. Psychological comorbidities and compliance to interventional treatment of patients with cutaneous vascular malformations.

    Science.gov (United States)

    Kenny, Stephanie A; Majeed, Nevin; Zhand, Naista; Glikstein, Rafael; Agid, Ronit; Dos Santos, Marlise P

    2016-08-01

    The aim of this study was to assess qualitatively the psychological stressors affecting patients with cutaneous vascular malformations and hemangiomas (CVM-H) and their impact on compliance to interventional treatment. A retrospective chart review was conducted of all patients with CVM-H treated by interventional neuroradiology at a single academic institution during a five-year period (2009-2014). Psychological complaints were documented during each clinic visit by a neuroradiologist. Compliance to interventional treatment was defined by adherence to the scheduled treatment sessions. Fisher's exact test was used to assess for associations between psychological complaints and compliance. Seventy-five patients were assessed, of whom 49 (65.3%) were female, with an age range of 2-78 years (mean age 30.2 years). All except one patient older than seven years of age (n = 71; 94.6%) had a psychological complaint, including fear of negative appearance (n = 53; 70.6%), dissatisfaction with appearance (n = 46; 61.3%), low self-esteem (n = 35; 46.6%), anxiety (n = 16; 21.3%), stress (n = 13; 17.3%), bullying (n = 5; 6.6%), and low mood (n = 4; 5.3%). Twenty-three (31%) patients were non-compliant. Low self-esteem was significantly associated with non-compliance (p = 0.0381). There is a high prevalence of psychological comorbidities among patients treated for CVM-H. This has potential implications for interventional treatment, as it was found that low self-esteem is significantly associated with non-compliance. These results suggest the need for early psychological support in these patients in order to maximize compliance to interventional treatment. © The Author(s) 2016.

  14. Hypofractionated stereotactic radiation therapy in three to five fractions for vestibular schwannoma

    International Nuclear Information System (INIS)

    Morimoto, Masahiro; Yoshioka, Yasuo; Kotsuma, Tadayuki

    2013-01-01

    The objective of this study was to retrospectively examine the outcomes of hypofractionated stereotactic radiation therapy in three to five fractions for vestibular schwannomas. Twenty-five patients with 26 vestibular schwannomas were treated with hypofractionated stereotactic radiation therapy using a CyberKnife. The vestibular schwannomas of 5 patients were associated with type II neurofibromatosis. The median follow-up time was 80 months (range: 6-167); the median planning target volume was 2.6 cm 3 (0.3-15.4); and the median prescribed dose (≥D90) was 21 Gy in three fractions (18-25 Gy in three to five fractions). Progression was defined as ≥2 mm 3-dimensional post-treatment tumor enlargement excluding transient expansion. Progression or any death was counted as an event in progression-free survival rates, whereas only progression was counted in progression-free rates. The 7-year progression-free survival and progression-free rates were 78 and 95%, respectively. Late adverse events (≥3 months) with grades based on Common Terminology Criteria for Adverse Events, v4.03 were observed in 6 patients: Grade 3 hydrocephalus in one patient, Grade 2 facial nerve disorders in two and Grade 1-2 tinnitus in three. In total, 12 out of 25 patients maintained pure tone averages ≤50 dB before hypofractionated stereotactic radiation therapy, and 6 of these 12 patients (50%) maintained pure tone averages at this level at the final audiometric follow-up after hypofractionated stereotactic radiation therapy. However, gradient deterioration of pure tone average was observed in 11 of these 12 patients. The mean pure tone averages before hypofractionated stereotactic radiation therapy and at the final follow-up for the aforementioned 12 patients were 29.8 and 57.1 dB, respectively. Treating vestibular schwannomas with hypofractionated stereotactic radiation therapy in three to five fractions may prevent tumor progression with tolerable toxicity. However, gradient

  15. Hypofractionated stereotactic radiation therapy in three to five fractions for vestibular schwannoma

    Energy Technology Data Exchange (ETDEWEB)

    Morimoto, Masahiro; Yoshioka, Yasuo [Osaka Univ., Graduate School of Medicine, Suita, Osaka (Japan); Kotsuma, Tadayuki [Kinki-chuo Chest Medical Center, Sakai, Osaka (Japan); others, and

    2013-08-15

    The objective of this study was to retrospectively examine the outcomes of hypofractionated stereotactic radiation therapy in three to five fractions for vestibular schwannomas. Twenty-five patients with 26 vestibular schwannomas were treated with hypofractionated stereotactic radiation therapy using a CyberKnife. The vestibular schwannomas of 5 patients were associated with type II neurofibromatosis. The median follow-up time was 80 months (range: 6-167); the median planning target volume was 2.6 cm{sup 3} (0.3-15.4); and the median prescribed dose ({>=}D90) was 21 Gy in three fractions (18-25 Gy in three to five fractions). Progression was defined as {>=}2 mm 3-dimensional post-treatment tumor enlargement excluding transient expansion. Progression or any death was counted as an event in progression-free survival rates, whereas only progression was counted in progression-free rates. The 7-year progression-free survival and progression-free rates were 78 and 95%, respectively. Late adverse events ({>=}3 months) with grades based on Common Terminology Criteria for Adverse Events, v4.03 were observed in 6 patients: Grade 3 hydrocephalus in one patient, Grade 2 facial nerve disorders in two and Grade 1-2 tinnitus in three. In total, 12 out of 25 patients maintained pure tone averages {<=}50 dB before hypofractionated stereotactic radiation therapy, and 6 of these 12 patients (50%) maintained pure tone averages at this level at the final audiometric follow-up after hypofractionated stereotactic radiation therapy. However, gradient deterioration of pure tone average was observed in 11 of these 12 patients. The mean pure tone averages before hypofractionated stereotactic radiation therapy and at the final follow-up for the aforementioned 12 patients were 29.8 and 57.1 dB, respectively. Treating vestibular schwannomas with hypofractionated stereotactic radiation therapy in three to five fractions may prevent tumor progression with tolerable toxicity. However, gradient

  16. Proliferation and Nonproliferation in the Early Twenty-First Century. The Permanent Five Hold the Key to Success

    International Nuclear Information System (INIS)

    Santoro, David

    2012-01-01

    are. Its core finding is that much of the success against proliferation will be determined by the role played by the permanent members of the Security Council, the so-called Permanent Five or P-5 (China, France, Russia, the United Kingdom, and the United States). It is unclear, however, whether the Five will be able and willing to play this role adequately. The developments of the first decade of the twenty-first century have not been comforting for nonproliferation. Proliferation challenges have risen and grown more complex. In response, policy tools have been developed, but their effectiveness has suffered from divisions among the P-5 and between them and the NAM states. Half a century since Ikle's article and a decade since Roberts' review, the major powers have remained at a loss to address the threat of proliferation. Winning is still possible, but it will require more than wishful thinking. In the years ahead, the challenge will be to reconcile policy effectiveness with policy legitimacy, be it to restore compliance altogether or to prevent proliferation, counter it, detect and expose noncompliance, and manage nonproliferation failures. Meeting this challenge places the P-5 at the center-stage. Much of the success against proliferation will be determined by the role that the Five choose to play. But given current shifts in international power structures (what Joseph Nye calls 'the rise of the rest') the prospects appear uncertain.68 It is important, therefore, that further research focuses on how the P-5 role can be strengthened to address proliferation, and how this role can be better aligned with today's evolving international trends

  17. The next twenty years - IAEA's role

    International Nuclear Information System (INIS)

    Tape, G.F.

    1977-01-01

    The twentieth anniversary of an institution is an appropriate time to look back and to ask what has been achieved. It is also an appropriate time to look ahead and to ask what should be the mission for the future. How can the strengths of the International Atomic Energy Agency (IAEA) be best utilized, what new opportunities should be seized upon, and what challenges should the IAEA be prepared to meet in the next twenty years? Forward planning is a very necessary activity in today's world. There are so many demands on national or institutional resources that careful analysis of options is necessary to establish priorities and ultimately to provide for implementation. But such planning must be done carefully with full appreciation for the validity and sensitivity of the input assumptions and data. Furthermore, today's plan, while setting goals and directions, cannot be so inflexible that it cannot be responsive to ever-changing political, economic and technical constraints or opportunities. Thus in looking ahead, the plan must contain provisions for flexibility to provide for further modifications in the light of ever-changing knowledge, attitudes, and world conditions. The experience of the past five years in the energy field, and especially in nuclear energy, underscores this need. In looking ahead for the next twenty years, we are attempting to describe the International Atomic Energy Agency and its role through the twentieth century. In doing so, we are automatically laying the base for the Agency's work going into the twenty-first century. In short, we are trying to visualize a programme that can serve the coming generation and, in doing so, creating a base from which the needs of the succeeding generation can be met. This is a large order and the crystal ball is less than clear. (author)

  18. Helicobacter pylori-associated gastritis and dyspepsia. The influence on migrating motor complexes

    DEFF Research Database (Denmark)

    Qvist, N; Rasmussen, L; Axelsson, C K

    1994-01-01

    Twenty-five patients with dyspepsia were included. In 19 patients with a median age of 48 (range, 20-72) years endoscopy and histologic examination of biopsy specimens from the antrum and corpus of the stomach showed Helicobacter pylori-positive gastritis as the only pathologic finding. In six...... patients with a median age of 42 (range, 32-56) years H. pylori-negative gastritis was found. After an overnight fast the patients underwent an ambulatory duodenal motility study for 6-8 h. Twenty-five young healthy men served as the control group. In patients with H. pylori-positive gastritis the duration...... (22-89 min) in the control group. The duration of phase III and the whole MMC cycle was similar in the two groups. However, in the patients with H. pylori-negative gastritis the values of the duration of the different phases of the MMC were similar to those of the patients with H. pylori...

  19. A new clinically applicable age-specific comorbidity index for preoperative risk assessment of ovarian cancer patients

    DEFF Research Database (Denmark)

    Noer, Mette Calundann; Sperling, Cecilie Dyg; Antonsen, Sofie Leisby

    2016-01-01

    Cancer Database between January 1, 2005 and December 31, 2012. The study population was divided into a development cohort (n=2020) and a validation cohort (n=1975). Age-stratified multivariate Cox regression analyses were conducted to identify comorbidities significantly impacting five-year overall....... CONCLUSION: This new age-specific comorbidity index based on self-reported information is a significant predictor of overall and cancer-specific survival in ovarian cancer. It can be used to quickly identify those ovarian cancer patients requiring special attention in terms of preoperative optimization...

  20. Bias correction of nutritional status estimates when reported age is used for calculating WHO indicators in children under five years of age.

    Science.gov (United States)

    Quezada, Amado D; García-Guerra, Armando; Escobar, Leticia

    2016-06-01

    To assess the performance of a simple correction method for nutritional status estimates in children under five years of age when exact age is not available from the data. The proposed method was based on the assumption of symmetry of age distributions within a given month of age and validated in a large population-based survey sample of Mexican preschool children. The main distributional assumption was consistent with the data. All prevalence estimates derived from the correction method showed no statistically significant bias. In contrast, failing to correct attained age resulted in an underestimation of stunting in general and an overestimation of overweight or obesity among the youngest. The proposed method performed remarkably well in terms of bias correction of estimates and could be easily applied in situations in which either birth or interview dates are not available from the data.

  1. Radiation therapy in aged lung cancer patients

    International Nuclear Information System (INIS)

    Ohtake, Eiji; Tobari, Chitose; Matsui, Kengo; Iio, Masahiro.

    1982-01-01

    The results and problems of radiotherapy were analyzed in 57 lung cancer patients more than 65 years of age (average age: 74.8 years). Of these, 45 (79%) were irradiated with a total dose exceeding 40 Gy. In these patients, the median survival was 13 months for Stages I and II, 6.5 months for Stage III, and 5 months for Stage IV. The results of combined radiotherapy and chemotherapy were better than those of radiotherapy alone. Also, slightly better results were obtained in patients treated with split-course than continuous-course irradiation. In aged lung cancer patients the prognosis was highly influenced by their respiratory function. Double cancers were present in 9 (16%) of the 57 patients. (author)

  2. Vesico-vaginal fistula repair: experience with first twenty-three ...

    African Journals Online (AJOL)

    Vesico-vaginal fistula repair: experience with first twenty-three patients seen at a tertiary hospital in north-central Nigeria. Stephen D. Ngwan, Bassey E. Edem, Ajen S. Anzaku, Barnabas A. Eke, Mohammed A. Shittu, Solomon A. Obekpa ...

  3. Spatial memory deficits in patients after unilateral selective amygdalohippocampectomy

    NARCIS (Netherlands)

    Kessels, R.P.C.; Hendriks, M.P.H.; Schouten, J.A.; Asselen, M. van; Postma, A.

    2004-01-01

    The present study investigated the differential involvement of the right and left hippocampus in various forms of spatial memory: spatial search, positional memory versus object-location binding, and coordinate versus categorical processing. Twenty-five epilepsy patients with selective

  4. Five year prognosis in patients with angina identified in primary care: incident cohort study.

    LENUS (Irish Health Repository)

    Buckley, Brian S

    2009-01-01

    OBJECTIVE: To ascertain the risk of acute myocardial infarction, invasive cardiac procedures, and mortality among patients with newly diagnosed angina over five years. DESIGN: Incident cohort study of patients with primary care data linked to secondary care and mortality data. SETTING: 40 primary care practices in Scotland. PARTICIPANTS: 1785 patients with a diagnosis of angina as their first manifestation of ischaemic heart disease, 1 January 1998 to 31 December 2001. MAIN OUTCOME MEASURES: Adjusted hazard ratios for acute myocardial infarction, coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, death from ischaemic heart disease, and all cause mortality, adjusted for demographics, lifestyle risk factors, and comorbidity at cohort entry. RESULTS: Mean age was 62.3 (SD 11.3). Male sex was associated with an increased risk of acute myocardial infarction (hazard ratio 2.01, 95% confidence interval 1.35 to 2.97), death from ischaemic heart disease (2.80, 1.73 to 4.53), and all cause mortality (1.82, 1.33 to 2.49). Increasing age was associated with acute myocardial infarction (1.04, 1.02 to 1.06, per year of age increase), death from ischaemic heart disease (1.09, 1.06 to 1.11, per year of age increase), and all cause mortality (1.09, 1.07 to 1.11, per year of age increase). Smoking was associated with subsequent acute myocardial infarction (1.94, 1.31 to 2.89), death from ischaemic heart disease (2.12, 1.32 to 3.39), and all cause mortality (2.11, 1.52 to 2.95). Obesity was associated with death from ischaemic heart disease (2.01, 1.17 to 3.45) and all cause mortality (2.20, 1.52 to 3.19). Previous stroke was associated with all cause mortality (1.78, 1.13 to 2.80) and chronic kidney disease with death from ischaemic heart disease (5.72, 1.74 to 18.79). Men were more likely than women to have coronary artery bypass grafting or percutaneous transluminal coronary angioplasty after a diagnosis of angina; older people were less likely to

  5. Satisfaction and quality of life of allergic patients following sublingual five-grass pollen tablet immunotherapy in Spain

    Science.gov (United States)

    Antolín-Amerigo, Darío; Tabar, Isabel A; del Mar Fernández-Nieto, Maria; Callejo-Melgosa, Anna M; Muñoz-Bellido, Francisco J; Martínez-Alonso, José C; Méndez-Alcalde, Jorge D; Reche, Marta; Rodríguez-Trabado, Ana; Rosado-Ingelmo, Ana; Alonso-Gómez, Alicia; Blanco-González, Rosa; Alvarez-Fernandez, José A; Botella, Isabel; Valls, Ana; Cimarra, Mercedes; Blanco, Carlos

    2017-01-01

    Background Five-grass pollen tablet is an effective and well-tolerated therapy for patients with allergic rhinoconjunctivitis (ARC). This trial sought to determine the satisfaction and health-related quality of life (HRQoL) of patients undergoing this treatment. Methods This was a cross-sectional, multicentre, observational, naturalistic study, following a discontinuous pre- and co-seasonal five-grass pollen regimen over two seasons in Spain (2012, 2013). The HRQoL of the patients was measured with the specific Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) for adults, adolescent (AdolRQLQ), or paediatric (PRQLQ) patients. Treatment satisfaction was assessed by the Satisfaction Scale for Patients Receiving Allergen Immunotherapy (ESPIA) questionnaire. Patients/investigators were surveyed on beliefs and attitudes towards the five-grass pollen tablet. ARC evolution according to allergic rhinitis and its impact on asthma (ARIA) criteria and treatment adherence were evaluated. Results Among the 591 ARC patients included, the mean (SD) HRQoL scores were 1.40 (1.1) in adults, 1.33 (1.1) in adolescents, and 1.15 (1.1) in children, indicating low levels of impairment (scale 0–6). ESPIA answers showed high levels of satisfaction, with an average score of 69.2 (scale 0–100). According to ARIA criteria, 88.2% of patients reported improvement of ARC. Moreover, this was accompanied by a reduced use of symptomatic medication. Adherence to treatment was estimated at 96.8%. In general, both patients and specialists exhibited a positive attitude towards five-grass pollen tablet treatment. Conclusion ARC patients treated with five-grass pollen tablet showed favourable levels of HRQoL and treatment satisfaction, with concomitant improvements in ARC and symptomatic medication use, which translated into high levels of treatment adherence and a positive attitude towards five-grass pollen tablet. PMID:29225657

  6. Five years of interdisciplinary research on ageing and technology: Outcomes of the Lower Saxony Research Network Design of Environments for Ageing (GAL)--an introduction to this Special Issue on Ageing and Technology.

    Science.gov (United States)

    Haux, Reinhold; Hein, Andreas; Kolb, Gerald; Künemund, Harald; Eichelberg, Marco

    2014-01-01

    This Special Issue of Informatics for Health and Social Care is presenting outcomes of the Lower Saxony Research Network Design of Environments for Ageing (abbreviated as GAL), probably one of the largest inter- and multidisciplinary research projects on aging and technology. In order to investigate and provide answers on whether new information and communication technologies can contribute to keeping, or even improving quality of life, health and self-sufficiency in ageing societies through new ways of living and new forms of care, GAL had been established as a five-year research project, running from 2008 to 2013. Ambient-assisted living technologies in personal and home environments were especially important. During the five years of research in GAL, more than seventy researchers from computer science, economics, engineering, geriatrics, gerontology, informatics, medicine, nursing science and rehabilitation pedagogy intensively collaborated in finding answers.

  7. Cold Therapy in Migraine Patients: Open-label, Non-controlled, Pilot Study

    Directory of Open Access Journals (Sweden)

    Serap Ucler

    2006-01-01

    Full Text Available Some patients with headache report that they have frequently used physical therapies such as application of cold to relieve their headache. There are only a few reported studies related to cold therapies in patients with migraine. In this study, we investigated the effect of cold application on migraine patients. Twenty-eight migraine patients were included. Cold therapy was administered to them by gel cap. Patients used this cap during their two migraine attacks. Before and after the cold therapy, headache severity was recorded by using visual analogue scale (VAS. Patients used this cap for 25 min in each application. They recorded their VAS score just after the therapy and 25 min, 1 h, 2 h and 3 h later. Two patients could not use this therapy due to side effects (one due to cold intolerance and one due to vertigo in both applications. Therefore, therapeutic efficacy was evaluated in 26 patients. Twenty-five minutes after treatment of the first attack, VAS score was decreased from 7.89 ± 1.93 to 5.54 ± 2.96 (P < 0.01. Twenty-five minutes after treatment of the second attack, VAS score was decreased from 7.7 ± 1.8 to 5.4 ± 3.55 (P < 0.01. Cold application alone may be effective in some patients suffering from migraine attacks. Its combination with conventional drugs should be investigated in future studies.

  8. The Relatives' Big Five Personality Influences the Trajectories of Recovery of Patients After Severe TBI: A Multilevel Analysis.

    Science.gov (United States)

    Haller, Chiara S

    2017-08-01

    This study examines the influence of the personality of relatives on the trajectories of recovery of patients with severe traumatic brain injury (TBI). The present subsample (N = 376) of a larger population-based, prospective, 12-month multicenter cohort study in Switzerland (2007-2011) consists of patients with severe TBI (age ≥ 16) and their relatives. The predictors are the NEO Five-Factor Inventory and time (trajectory of functioning of the patient over time). The outcomes are the patients' (a) neurological functioning; (b) reported emotional, interpersonal, cognitive, and total functioning post-injury; and (c) health-related quality of life (HRQoL). The covariates included Abbreviated Injury Scale score of the head region and age. Results for patients > 50 are (a) relatives' Extraversion influenced patients' total, interpersonal, and cognitive functioning; (b) relatives' Agreeableness influenced patients' interpersonal functioning; and (c) relatives' Conscientiousness influenced patients' physical HRQoL (ps personality traits of the relative covary with the functioning of the patient, and psychological adaptation to the loss of function may progress at a later stage after physical health improvements have been achieved. Thus, a biopsychosocial perspective on the rehabilitation process is needed. © 2016 Wiley Periodicals, Inc.

  9. Retrograde ureteroscopic holmium laser endopyelotomy in a selected population of patients with ureteropelvic junction obstruction

    DEFF Research Database (Denmark)

    Stilling, Nicolaj; Jung, Helene; Nørby, Bettina

    2009-01-01

    follow-up 110 weeks). Success criteria were defined as symptom relief and improved or preserved renal function. Results. Twenty-nine patients (66%) experienced complete symptom resolution and 10 patients (23%) had significant symptom improvement (i.e. no need for pain-killing medication). Five patients...

  10. Malnourished Under-Five Children Feeding Practices in Cipacing Village 2012

    Directory of Open Access Journals (Sweden)

    Shinta Tresna Fujianti

    2015-03-01

    Full Text Available Background: Maternal parenting, especially feeding practices, is very important in childhood period and may affect the child’s nutritional state. Proper nutrition affects the growth and development of children. The aim of this study is to describe parenting feeding practices in malnourished under-five children. Methods: A descriptive study on 43 mothers with malnourished under-five children aged 12−59 months was performed in Cipacing Village, Jatinangor, Sumedang during the periode of October−November 2012. Results: The composition of children based on their malnutrition status and description on good and poor parenting were presented in the result. Twenty two children (51.2% were severely under nourished, 18 children (41.9% were under nourished, and 3 children (7% experienced overweight. Good maternal parenting was identified in child nurturing (86%, feeding frequency (93%, feeding style (62.8%, and situation of feeding (74.4% while poor maternal parenting was observed in feeding time (55.8% and types of food given (51.2%. Conclusions: Maternal parenting plays an important role in children nutrition status.

  11. One hundred and twenty-five years of the Annals of Botany. Part 2: the years 1937 to 2012

    Science.gov (United States)

    Jackson, Michael B.

    2016-01-01

    Background Annals of Botany is a peer-reviewed plant biology journal. It was started in 1887, making it the oldest continuously published plant science title. A previous article [Jackson MB. 2015. One hundred and twenty-five years of the Annals of Botany. Part 1: the first 50 years (1887–1936). Annals of Botany 115: 1–18] summarized events leading to its founding, highlighted the individuals involved and examined the Journal’s achievements and management practices over the first 50 years to 1937. This second article covers the next 75 years. Sources of information The account draws principally on the Journal’s own records, minute books, financial accounts, original letters and notes held by the Annals of Botany Company, the Journal’s owners and managers. Content In 1937, its 51st year, the Journal was re-launched as Annals of Botany New Series and its volume numbers were reset to No. I. The present article evaluates the evolution of the New Series up to 2012, Annals of Botany’s 125th anniversary year. The period includes a 2-year run-up to World War II, six war years and their immediate aftermath, and then on through increasingly competitive times. The ebb and flow of the Journal’s fortunes are set against a roll-call of the often highly distinguished scientists who managed and edited the Journal. The article also examines an internal crisis in the 1980s that radically altered the Journal’s organization in ways that were, ultimately, to its benefit. The narrative is set against changes to economic conditions in Great Britain over the period, to the evolving nature and geographical distribution of much experimental plant science and to the digital revolution that, from the late 20th century, transformed the workings of Annals of Botany and of scientific publishing more generally. PMID:27974325

  12. The challenge of aging and pharmacoterapeutic complexity in the HIV + patient

    Directory of Open Access Journals (Sweden)

    Ramón Morillo-Verdugo

    2018-05-01

    Full Text Available Objective: To describe the current knowledge and management of aging and pharmacotherapeutic complexity in HIV + patients. Method: A review of literature was carried out, including articles, originals or reviews, published in English or Spanish, from 2007 to 2017, which analysed the aging and pharmacotherapeutic complexity in HIV + patients. The terms «Polypharmacy»/»Polypharmacy», «Aging»/»Aging», «Frailty»/»Fragility», «Pharmacotherapeutic Complexity»/»Medication Regimen Complexity» and «HIV»/”HIV» were combined. The review was carried out independently by two authors. The degree of agreement, according to the Kappa index, was analysed. Results: A total of 208 references were analysed, including, finally, only 68. An aging of the population and an increase in associated comorbidities have been identified, especially over 50 years-old. Immunological changes similar to those that are generated in a non-infected elderly population have been described. These conditions influencing the prescription of antiretroviral treatment, according to studies identified. In parallel, polypharmacy is increasingly present, being defined exclusively by the concomitant use of five drugs. Pharmacotherapeutic complexity, through the Medication Regimen Complexity Index, has begun to analyse and relate to health outcomes. There has been a need to know and apply concepts already known in non-HIV-aged population, such as de-prescription, potentially inappropriate medication, cholinergic risk, although few results are available. Conclusions: There is a growing interest to know about the relationship between HIV and aging. Pharmacotherapeutic complexity is beginning to be used as a pharmacotherapeutic follow-up criterion due to its influence on health outcomes. It is necessary to manage and incorporate new concepts that help pharmacotherapeutic optimization in this population

  13. Single-Centre Experience with Percutaneous Cryoablation of Breast Cancer in 23 Consecutive Non-surgical Patients

    International Nuclear Information System (INIS)

    Cazzato, Roberto Luigi; Lara, Christine Tunon de; Buy, Xavier; Ferron, Stéphane; Hurtevent, Gabrielle; Fournier, Marion; Debled, Marc; Palussière, Jean

    2015-01-01

    AimTo present our single-centre prospective experience on the use of cryoablation (CA) applied to treat primary breast cancer (BC) in a cohort of patients unsuitable for surgical treatment.Materials and MethodsTwenty-three consecutive post-menopausal female patients (median age 85 years; range 56–96) underwent percutaneous CA of unifocal, biopsy-proven BC, under ultrasound/computed tomography (US/CT) guidance. Clinical and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) follow-ups were systematically scheduled at 3, 12, 18 and 24 months. Local tumour control was assessed by comparing baseline and follow-up DCE-MRI.ResultsTwenty-three BC (median size 14 mm) were treated under local anaesthesia (78.3 %) or local anaesthesia and conscious sedation (21.7 %). Median number of cryo-probes applied per session was 2.0. A “dual-freezing” protocol was applied for the first ten patients and a more aggressive “triple-freezing” protocol for the remaining 13. Median follow-up was 14.6 months. Five patients recurred during follow-up and two were successfully re-treated with CA. Five patients presented immediate CA-related complications: four hematomas evolved uneventfully at 3-month follow-up and one skin burn resulted in skin inflammation and skin retraction at 3 and 12 months, respectively.ConclusionsPercutaneous CA is safe and well tolerated for non-resected elderly BC patients. Procedures can be proposed under local anaesthesia only. Given the insulation properties of the breast gland, aggressive CA protocols are required. Prospective studies are needed to better understand the potential role of CA in the local treatment of early BC

  14. Single-Centre Experience with Percutaneous Cryoablation of Breast Cancer in 23 Consecutive Non-surgical Patients

    Energy Technology Data Exchange (ETDEWEB)

    Cazzato, Roberto Luigi, E-mail: r.cazzato@unicampus.it [Institut Bergonié, Comprehensive Cancer Centre, Department of Medical Imaging (France); Lara, Christine Tunon de, E-mail: c.tunondelara@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Surgery (France); Buy, Xavier, E-mail: x.buy@bordeaux.unicancer.fr; Ferron, Stéphane, E-mail: s.ferron@bordeaux.unicancer.fr; Hurtevent, Gabrielle, E-mail: g.hurtevent@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Medical Imaging (France); Fournier, Marion, E-mail: m.fournier@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Surgery (France); Debled, Marc, E-mail: m.debled@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Medical Oncology (France); Palussière, Jean, E-mail: j.palussiere@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Medical Imaging (France)

    2015-10-15

    AimTo present our single-centre prospective experience on the use of cryoablation (CA) applied to treat primary breast cancer (BC) in a cohort of patients unsuitable for surgical treatment.Materials and MethodsTwenty-three consecutive post-menopausal female patients (median age 85 years; range 56–96) underwent percutaneous CA of unifocal, biopsy-proven BC, under ultrasound/computed tomography (US/CT) guidance. Clinical and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) follow-ups were systematically scheduled at 3, 12, 18 and 24 months. Local tumour control was assessed by comparing baseline and follow-up DCE-MRI.ResultsTwenty-three BC (median size 14 mm) were treated under local anaesthesia (78.3 %) or local anaesthesia and conscious sedation (21.7 %). Median number of cryo-probes applied per session was 2.0. A “dual-freezing” protocol was applied for the first ten patients and a more aggressive “triple-freezing” protocol for the remaining 13. Median follow-up was 14.6 months. Five patients recurred during follow-up and two were successfully re-treated with CA. Five patients presented immediate CA-related complications: four hematomas evolved uneventfully at 3-month follow-up and one skin burn resulted in skin inflammation and skin retraction at 3 and 12 months, respectively.ConclusionsPercutaneous CA is safe and well tolerated for non-resected elderly BC patients. Procedures can be proposed under local anaesthesia only. Given the insulation properties of the breast gland, aggressive CA protocols are required. Prospective studies are needed to better understand the potential role of CA in the local treatment of early BC.

  15. Bias correction of nutritional status estimates when reported age is used for calculating WHO indicators in children under five years of age

    Directory of Open Access Journals (Sweden)

    Amado D Quezada

    2016-05-01

    Full Text Available Objective.To assess the performance of a simple correction method for nutritional status estimates in children under five years of age when exact age is not available from the data. Materials and methods. The proposed method was ba- sed on the assumption of symmetry of age distributions within a given month of age and validated in a large population-based survey sample of Mexican preschool children. Results. The main distributional assumption was consistent with the data. All prevalence estimates derived from the correction method showed no statistically significant bias. In contrast, failing to correct attained age resulted in an underestimation of stunting in general and an overestimation of overweight or obesity among the youngest. Conclusions. The proposed method performed remarkably well in terms of bias correction of estimates and could be easily applied in situations in which either birth or interview dates are not available from the data.

  16. Survival of patients with Ewing's sarcoma in Yazd-Iran.

    Science.gov (United States)

    Akhavan, Ali; Binesh, Fariba; Shamshiri, Hadi; Ghanadi, Fazllolah

    2014-01-01

    The Ewing's sarcoma family is a group of small round cell tumors which accounts for 10-15% of all primary bone neoplasms. The aim of this study was to evaluate the survival of Ewing's sarcoma patients in our province and to determine of influencing factors. All patients with documented Ewing's sarcoma/ primitive neuroectodermal tumor(PNET) family pathology were enrolled in this study during a period of eight years. For all of them local and systemic therapy were carried out. Overall and event free survival and prognostic factors were evaluated. Thirty two patients were enrolled in the study. The median age was 17.5 years. Twenty (65.2%) were male and 9 (28.1%) were aged 14 years or less. Mean disease free survival was 26.8 (95%CI; 13.8-39.9) months and five year disease free survival was 26%. Mean overall survival was 38.7 months (95%CI; 25.9-50.6) and median overall survival was 24 months. Five year overall survival was 25%. From the variables evaluated , only presence of metastatic disease at presentation (p value=0. 028) and complete response (p value =0. 006) had significant relations to overall survival. Survival of Ewing's sarcoma in our province is disappointing. It seems to be mostly due to less effective treatment. Administration of adequate chemotherapy dosage, resection of tumor with negative margins and precise assessment of irradiation volume may prove helpful.

  17. Twenty-Five Year Survival of Children with Intellectual Disability in Western Australia.

    Science.gov (United States)

    Bourke, Jenny; Nembhard, Wendy N; Wong, Kingsley; Leonard, Helen

    2017-09-01

    To investigate survival up to early adulthood for children with intellectual disability and compare their risk of mortality with that of children without intellectual disability. This was a retrospective cohort study of all live births in Western Australia between January 1, 1983 and December 31, 2010. Children with an intellectual disability (n = 10 593) were identified from the Western Australian Intellectual Disability Exploring Answers Database. Vital status was determined from linkage to the Western Australian Mortality database. Kaplan-Meier product limit estimates and 95% CIs were computed by level of intellectual disability. Hazard ratios (HRs) and 95% CIs were calculated from Cox proportional hazard regression models adjusting for potential confounders. After adjusting for potential confounders, compared with those without intellectual disability, children with intellectual disability had a 6-fold increased risk of mortality at 1-5 years of age (adjusted HR [aHR] = 6.0, 95%CI: 4.8, 7.6), a 12-fold increased risk at 6-10 years of age (aHR = 12.6, 95% CI: 9.0, 17.7) and a 5-fold increased risk at 11-25 years of age (aHR = 4.9, 95% CI: 3.9, 6.1). Children with severe intellectual disability were at even greater risk. No difference in survival was observed for Aboriginal children with intellectual disability compared with non-Aboriginal children with intellectual disability. Although children with intellectual disability experience higher mortality at all ages compared with those without intellectual disability, the greatest burden is for those with severe intellectual disability. However, even children with mild to moderate intellectual disability have increased risk of death compared with unaffected children. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Biofeedback training in chronic constipation

    NARCIS (Netherlands)

    Benninga, M. A.; Büller, H. A.; Taminiau, J. A.

    1993-01-01

    Twenty nine patients, aged 5-16 years, were studied to evaluate whether biofeedback training is effective in treating children with chronic constipation and encopresis; the clinical outcome at six weeks and 12 months was also evaluated. Patients received on average five biofeedback training

  19. Iatrogenic anemia/Twenty-five million liters of blood into the sewer : comment

    NARCIS (Netherlands)

    Coene, K.L.M.; Roos, A.N.; Scharnhorst, V.

    2015-01-01

    With great interest, we have read the articles by Stefanini [1] and Levi [2] on the waste of patient blood that is left over after laboratory testing. Especially in vulnerable patient populations that are subjected to frequent laboratory testing, iatrogenic anaemia can become a significant problem.

  20. [Linear growth retardation in children under five years of age: a baseline study].

    Science.gov (United States)

    Rissin, Anete; Figueiroa, José Natal; Benício, Maria Helena D'Aquino; Batista Filho, Malaquias

    2011-10-01

    The scope of this study was to describe the prevalence of, and analyze factors associated with, linear growth retardation in children. The baseline study analyzed 2040 children under the age of five, establishing a possible association between growth delay (height/age index non-binary variables, there was a positive association with roof type and number of inhabitants per room and a negative association with income per capita, mother's schooling and birth weight. The adjusted analysis also indicated water supply, visit from the community health agent, birth delivery location, internment for diarrhea, or for pneumonia and birth weight as significant variables. Several risk factors were identified for linear growth retardation pointing to the multi-causal aspects of the problem and highlighting the need for control measures by the various hierarchical government agents.

  1. Comparison of cardiovascular disease patterns in two data sets of patients admitted at a tertiary care public hospital in Karachi five years apart

    International Nuclear Information System (INIS)

    Kazim, S.F.; Itrat, A.; Butt, N.W.; Ishaq, M.

    2009-01-01

    To compare the disease patterns in two data sets of patients, five years apart, at the National Institute of Cardiovascular Diseases (NICVD), a tertiary care cardiac hospital in Karachi. The underlying objective was to determine any changes in cardiovascular disease patterns at an acute cardiac unit over a period of five years. A retrospective descriptive study was conducted on patients admitted in West Ward, National Institute of Cardiovascular Diseases (NICVD), Karachi in September, 2000 and September, 2005. Patient's record files were reviewed and the relevant information was recorded on a proforma designed for the purpose. In September, 2000, a total of 414 patients were admitted. Of these 71.25% were males. Majority of patients (72.92%) were in the fifth decade of life or beyond. Acute coronary syndrome (ACS) was the commonest presentation, present in 39.8% of the patients. 27.3% had myocardial infarction (MI) while 10.34% were diagnosed with heart muscle diseases. The overall mortality was 3.4%. In September, 2005, a total of 446 patients were admitted. Of these, 63% were males. 71.29% were in the fifth, sixth, and seventh decades of life. 43.04% patients were admitted with acute coronary syndromes (ACS), 26% with myocardial infarction (MI) and 13.45% with heart muscle diseases. The overall mortality was 1.34%. The almost similar results in two data sets of patients five years apart suggests that the cardiovascular disease burden and pattern has not changed significantly at this center. There is a preponderance of cardiovascular illnesses in males and older age groups. ACS and MI account for majority of admissions. (author)

  2. Functional evaluation of patient after arthroscopic repair of rotator cuff tear.

    Science.gov (United States)

    Kumar, Rohit; Jadhav, Umesh

    2014-06-01

    Rotator cuff tear is a common problem either after trauma or after degenerative tear in old age group. Arthroscopic repair is the current concept of rotator cuff repair. Here, we are trying to evaluate the functional outcome after arthroscopic repair of full thickness rotator cuff tear (single row) in Indian population. Twenty five patients (14 males and 11 females) who underwent arthroscopic repair of full thickness rotator cuff tear at a single institution were included in the study. Postoperatively patient's shoulder was rated according to UCLA score, pain was graded according to the visual analog score. The range of motion was analysed and documented. The mean age of the patients were 50.48 years. The preoperative VAS score mode was 7 and post operative VAS was 1 (p value fair in 12% (n = 3), excellent in 8% (n = 2) and poor results were seen in none of the patients. The mean UCLA improved from a score of 15.84 to 30.28 with a p value advantages, hence we used a single row repair considering the Indian population and the cost effectiveness of the surgery with good to excellent results.

  3. Proceedings of the twenty-fourth water reactor safety information meeting. Volume 1: Plenary session; High burnup fuel; Containment and structural aging

    International Nuclear Information System (INIS)

    Monteleone, S.

    1997-01-01

    This three-volume report contains papers presented at the Twenty-Fourth Water Reactor Safety Information Meeting held at the Bethesda Marriott Hotel, Bethesda, maryland, October 21--23, 1996. The papers are printed in the order of their presentation in each session and describe progress and results of programs in nuclear safety research conducted in this country and abroad. Foreign participation in the meeting included papers presented by researchers from Czech Republic, Finland, France, Japan, Norway, Russia and United Kingdom. This first volume is divided into 3 sections: plenary session; high burnup fuel; and containment and structural aging. Selected papers are indexed separately for inclusion in the Energy Science and Technology Database

  4. Proceedings of the twenty-fourth water reactor safety information meeting. Volume 1: Plenary session; High burnup fuel; Containment and structural aging

    Energy Technology Data Exchange (ETDEWEB)

    Monteleone, S. [comp.] [Brookhaven National Lab., Upton, NY (United States)

    1997-01-01

    This three-volume report contains papers presented at the Twenty-Fourth Water Reactor Safety Information Meeting held at the Bethesda Marriott Hotel, Bethesda, maryland, October 21--23, 1996. The papers are printed in the order of their presentation in each session and describe progress and results of programs in nuclear safety research conducted in this country and abroad. Foreign participation in the meeting included papers presented by researchers from Czech Republic, Finland, France, Japan, Norway, Russia and United Kingdom. This first volume is divided into 3 sections: plenary session; high burnup fuel; and containment and structural aging. Selected papers are indexed separately for inclusion in the Energy Science and Technology Database.

  5. Spinal cord stimulation for refractory angina in patients implanted with cardioverter defibrillators: five case reports

    DEFF Research Database (Denmark)

    Enggaard, Thomas P; Andersen, Claus; Scherer, Christian

    2010-01-01

    Patients implanted with a cardioverter defibrillator (ICD) who are suffering from refractory angina pectoris could benefit from spinal cord stimulation (SCS) due to the well-documented pain relieving effect. However, the combined treatment remains controversial. The aim of the study is to report...... successful long-term treatment with SCS in five patients implanted with cardioverter defibrillators. The combined treatments with ICD and thoracic epidural electrical stimulation were used in five patients with refractory angina pectoris. During the procedure of the implantation, testing with the maximal...... for refractory angina pectoris can be performed in patients implanted with cardioverter defibrillators without interference. However, individual testing during implantation or re-programming the devices is mandatory in order to assess optimal safety in each patient....

  6. Ultrasonography and magnetic resonance imaging in the diagnosis of Morton's neuroma.

    Science.gov (United States)

    Fazal, Muhammad Ali; Khan, Ishrat; Thomas, Cherian

    2012-01-01

    Magnetic resonance imaging (MRI) and ultrasonography are used widely for the diagnosis of Morton's neuroma. The aim of this study was to assess the accuracy of these two modalities as diagnostic tools in Morton's neuroma. Fifty feet of 47 consecutive patients (39 women and 8 men; mean age, 46 years; age range, 36-64 years) who presented between January 1, 2005, and June 30, 2008, were included in the study. Twenty-five feet were investigated with ultrasonography and 25 with MRI. Morton's neuroma was confirmed surgically and histologically in all of the patients. A Student unpaired t test was applied. Twenty-two MRIs were diagnostic (sensitivity, 88%). Three patients with negative MRI findings underwent ultrasonography and were found to have a neuroma smaller than 5 mm. Twenty-four ultrasound scans demonstrated the neuroma (sensitivity, 96%), with five neuromas being smaller than 5 mm. Ultrasonography has a slightly higher sensitivity in the diagnosis of Morton's neuroma, particularly of neuromas smaller than 5 mm, and should be the preferred imaging modality in suspected cases, and MRI should be reserved for cases with equivocal diagnosis.

  7. Inhaled nitric oxide and high concentrations of oxygen in pediatrics patients with congenital cardiopathy and pulmonary hypertension: report of five cases

    Directory of Open Access Journals (Sweden)

    Werther Brunow de Carvalho

    Full Text Available Five patients with ages ranging from 6 months to 3 years were analyzed. All received inhaled nitric oxide (NO - 20 parts per million (ppm and oxygen (0(2 - at a concentration of 90-95% by means of an oxygen hood. Mean Pulmonary Artery Pressure (MPAP, Mean Aortic Pressure (MAoP, Pulmonary Vascular Resistance (PVR and Systemic Vascular Resistance (SVR were measured and the calculation of their relationship to pulmonary/systemic flow (Qp/Qs was performed by the catheterization' of the femoral artery vein. Three patients presented reduction in PVR and increase in Qp/Qs. There were no systemic alterations or any side effect from using NO.

  8. Plasma Free Amino Acid Profiling of Five Types of Cancer Patients and Its Application for Early Detection

    Science.gov (United States)

    Miyagi, Yohei; Higashiyama, Masahiko; Gochi, Akira; Akaike, Makoto; Ishikawa, Takashi; Miura, Takeshi; Saruki, Nobuhiro; Bando, Etsuro; Kimura, Hideki; Imamura, Fumio; Moriyama, Masatoshi; Ikeda, Ichiro; Chiba, Akihiko; Oshita, Fumihiro; Imaizumi, Akira; Yamamoto, Hiroshi; Miyano, Hiroshi; Horimoto, Katsuhisa; Tochikubo, Osamu; Mitsushima, Toru; Yamakado, Minoru; Okamoto, Naoyuki

    2011-01-01

    Background Recently, rapid advances have been made in metabolomics-based, easy-to-use early cancer detection methods using blood samples. Among metabolites, profiling of plasma free amino acids (PFAAs) is a promising approach because PFAAs link all organ systems and have important roles in metabolism. Furthermore, PFAA profiles are known to be influenced by specific diseases, including cancers. Therefore, the purpose of the present study was to determine the characteristics of the PFAA profiles in cancer patients and the possibility of using this information for early detection. Methods and Findings Plasma samples were collected from approximately 200 patients from multiple institutes, each diagnosed with one of the following five types of cancer: lung, gastric, colorectal, breast, or prostate cancer. Patients were compared to gender- and age- matched controls also used in this study. The PFAA levels were measured using high-performance liquid chromatography (HPLC)–electrospray ionization (ESI)–mass spectrometry (MS). Univariate analysis revealed significant differences in the PFAA profiles between the controls and the patients with any of the five types of cancer listed above, even those with asymptomatic early-stage disease. Furthermore, multivariate analysis clearly discriminated the cancer patients from the controls in terms of the area under the receiver-operator characteristics curve (AUC of ROC >0.75 for each cancer), regardless of cancer stage. Because this study was designed as case-control study, further investigations, including model construction and validation using cohorts with larger sample sizes, are necessary to determine the usefulness of PFAA profiling. Conclusions These findings suggest that PFAA profiling has great potential for improving cancer screening and diagnosis and understanding disease pathogenesis. PFAA profiles can also be used to determine various disease diagnoses from a single blood sample, which involves a relatively simple

  9. Plasma free amino acid profiling of five types of cancer patients and its application for early detection.

    Directory of Open Access Journals (Sweden)

    Yohei Miyagi

    Full Text Available BACKGROUND: Recently, rapid advances have been made in metabolomics-based, easy-to-use early cancer detection methods using blood samples. Among metabolites, profiling of plasma free amino acids (PFAAs is a promising approach because PFAAs link all organ systems and have important roles in metabolism. Furthermore, PFAA profiles are known to be influenced by specific diseases, including cancers. Therefore, the purpose of the present study was to determine the characteristics of the PFAA profiles in cancer patients and the possibility of using this information for early detection. METHODS AND FINDINGS: Plasma samples were collected from approximately 200 patients from multiple institutes, each diagnosed with one of the following five types of cancer: lung, gastric, colorectal, breast, or prostate cancer. Patients were compared to gender- and age- matched controls also used in this study. The PFAA levels were measured using high-performance liquid chromatography (HPLC-electrospray ionization (ESI-mass spectrometry (MS. Univariate analysis revealed significant differences in the PFAA profiles between the controls and the patients with any of the five types of cancer listed above, even those with asymptomatic early-stage disease. Furthermore, multivariate analysis clearly discriminated the cancer patients from the controls in terms of the area under the receiver-operator characteristics curve (AUC of ROC >0.75 for each cancer, regardless of cancer stage. Because this study was designed as case-control study, further investigations, including model construction and validation using cohorts with larger sample sizes, are necessary to determine the usefulness of PFAA profiling. CONCLUSIONS: These findings suggest that PFAA profiling has great potential for improving cancer screening and diagnosis and understanding disease pathogenesis. PFAA profiles can also be used to determine various disease diagnoses from a single blood sample, which involves a

  10. Congenital muscular dystrophy with merosin deficiency: MRI findings in five patients

    Energy Technology Data Exchange (ETDEWEB)

    Farina, L.; Milanesi, I.; Ciceri, E.; Savoiardo, M. [Dept. of Neuroradiology, Ist. Nazionale Neurologico C. Besta, Milan (Italy); Morandi, L.; Mora, M. [Dept. of Neuromuscular Disorders, Ist. Nazionale Neurologico C. Besta, Milan (Italy); Moroni, I.; Pantaleoni, C. [Dept. of Child Neurology, Ist. Nazionale Neurologico C. Besta, Milan (Italy)

    1998-12-01

    We present the MRI findings in five patients with congenital muscular dystrophy (CMD) and merosin (laminin {alpha} 2) deficiency, which was total in one and partial in four. In one patient with partial merosin deficiency, MRI was normal. The other four patients had supratentorial white matter abnormalities. In three, T2-weighted images revealed subcortical, deep lobar and periventricular high signal in white matter, while in the other there were only small peritrigonal areas of increased signal. On T1-weighted images, there was slightly low signal. Cortical abnormalities were absent. None of these changes were accompanied by symptoms or signs of central nervous system involvement. White matter abnormalities in a patient with CMD should prompt investigation of merosin. (orig.) With 4 figs., 11 refs.

  11. The effect of patient age on bone formation using a fully synthetic nanocrystalline bone augmentation material in maxillary sinus grafting.

    Science.gov (United States)

    Wolf, Michael; Wurm, Alexander; Heinemann, Friedhelm; Gerber, Thomas; Reichert, Christoph; Jäger, Andreas; Götz, Werner

    2014-01-01

    Maxillary sinus floor augmentation is a treatment that has been proposed for patients in whom the alveolar bone height is insufficient. This procedure is commonly used in patients aged 40 to 70 years and older. However, little information exists whether the factor of age might influence the outcome of augmentation procedures. The aim of this study was to investigate whether the patient's age has an effect on bone formation and incorporation in maxillary sinus floor augmentation procedures. A fully synthetic nanocrystalline bone augmentation material (NanoBone, Artoss) was used for sinus floor augmentation in patients with a subantral vertical bone height of at least 3 mm and maximum of 7 mm. After 7 months healing time, biopsy specimens were taken and were divided into two groups according to the patient's age. Exclusion criteria were poor general health (eg, severe renal/and or liver disease), history of a radiotherapy in the head region, chemotherapy at the time of surgical procedure, noncompensated diabetes mellitus, symptoms of a maxillary sinus disease, active periodontal or systemic diseases, smoking, and poor oral hygiene. Histologic analyses with hematoxylin-eosin stain were performed. Multinucleated osteoclast-like cells were identified by histochemical staining (tartrate-resistant acid phosphatase [TRAP]). Quantitative and age-dependent assessment of bone formation, residual bone grafting material, and soft tissue formation following sinus augmentation was performed using histomorphometric analysis and the Bonferroni adjustment of the Student t test. Twenty biopsy specimens from 17 patients were taken and divided into two groups according to age (group 1: 41 to 52 years; group 2: 66 to 71 years) containing 10 specimens each, which were analyzed in triplicate resulting in a total of 30 specimens per group. A regeneration process with varying amounts of newly formed bone surrounded by marrow-like tissue was present in all augmented regions. No signs of

  12. Neurological and functional outcomes of subdural hematoma evacuation in patients over 70 years of age

    Directory of Open Access Journals (Sweden)

    Patrick Mulligan

    2013-01-01

    Full Text Available Background: Subdural hematoma (SDH is a common disease entity treated by neurosurgical intervention. Although the incidence increases in the elderly population, there is a paucity of studies examining their surgical outcomes. Objectives: To determine the neurological and functional outcomes of patients over 70 years of age undergoing surgical decompression for subdural hematoma. Materials and Methods: We retrospectively reviewed data on 45 patients above 70 years who underwent craniotomy or burr holes for acute, chronic or mixed subdural hematomas. We analyzed both neurological and functional status before and after surgery. Results: Forty-five patients 70 years of age or older were treated in our department during the study period. There was a significant improvement in the neurological status of patients from admission to follow up as assessed using the Markwalder grading scale (1.98 vs. 1.39; P =0.005, yet no improvement in functional outcome was observed as assessed by Glasgow Outcome Score. Forty-one patients were admitted from home, however only 20 patients (44% were discharged home, 16 (36% discharged to nursing home or rehab, 6 (13% to hospice and 3 (7% died in the postoperative period. Neurological function improved in patients who were older, had a worse pre-operative neurological status, were on anticoagulation and had chronic or mixed acute and chronic hematoma. However, no improvement in functional status was observed. Conclusion: Surgical management of SDH in patients over 70 years of age provides significant improvement in neurological status, but does not change functional status.

  13. Outcomes from patients with presumed drug resistant tuberculosis in five reference centers in Brazil.

    Science.gov (United States)

    Ramalho, D M P; Miranda, P F C; Andrade, M K; Brígido, T; Dalcolmo, M P; Mesquita, E; Dias, C F; Gambirasio, A N; Ueleres Braga, J; Detjen, A; Phillips, P P J; Langley, I; Fujiwara, P I; Squire, S B; Oliveira, M M; Kritski, A L

    2017-08-15

    The implementation of rapid drug susceptibility testing (DST) is a current global priority for TB control. However, data are scarce on patient-relevant outcomes for presumptive diagnosis of drug-resistant tuberculosis (pDR-TB) evaluated under field conditions in high burden countries. Observational study of pDR-TB patients referred by primary and secondary health units. TB reference centers addressing DR-TB in five cities in Brazil. Patients age 18 years and older were eligible if pDR-TB, culture positive results for Mycobacterium tuberculosis and, if no prior DST results from another laboratory were used by a physician to start anti-TB treatment. The outcome measures were median time from triage to initiating appropriate anti-TB treatment, empirical treatment and, the treatment outcomes. Between February,16th, 2011 and February, 15th, 2012, among 175 pDR TB cases, 110 (63.0%) confirmed TB cases with DST results were enrolled. Among study participants, 72 (65.5%) were male and 62 (56.4%) aged 26 to 45 years. At triage, empirical treatment was given to 106 (96.0%) subjects. Among those, 85 were treated with first line drugs and 21 with second line. Median time for DST results was 69.5 [interquartile - IQR: 35.7-111.0] days and, for initiating appropriate anti-TB treatment, the median time was 1.0 (IQR: 0-41.2) days. Among 95 patients that were followed-up during the first 6 month period, 24 (25.3%; IC: 17.5%-34.9%) changed or initiated the treatment after DST results: 16/29 MDRTB, 5/21 DR-TB and 3/45 DS-TB cases. Comparing the treatment outcome to DS-TB cases, MDRTB had higher proportions changing or initiating treatment after DST results (p = 0.01) and favorable outcomes (p = 0.07). This study shows a high rate of empirical treatment and long delay for DST results. Strategies to speed up the detection and early treatment of drug resistant TB should be prioritized.

  14. Aberrant brain regional homogeneity and functional connectivity in middle-aged T2DM patients: a resting-state functional MRI study

    Directory of Open Access Journals (Sweden)

    Daihong Liu

    2016-09-01

    Full Text Available Type 2 diabetes mellitus (T2DM has been associated with cognitive impairment. However, its neurological mechanism remains elusive. Combining regional homogeneity (ReHo and functional connectivity (FC analyses, the present study aimed to investigate brain functional alterations in middle-aged T2DM patients, which could provide complementary information for the neural substrates underlying T2DM-associated brain dysfunction. Twenty-five T2DM patients and 25 healthy controls were involved in neuropsychological testing and structural and resting-state functional magnetic resonance imaging data acquisition. ReHo analysis was conducted to determine the peak coordinates of brain regions with abnormal local brain activity synchronization. Then, the identified brain regions were considered as seeds, and FC between these brain regions and global voxels was computed. Finally, the potential correlations between the imaging indices and neuropsychological data were also explored. Compared with healthy controls, T2DM patients exhibited higher ReHo values in the anterior cingulate gyrus and lower ReHo in right fusiform gyrus, right precentral gyrus and right medial orbit of the superior frontal gyrus. Considering these areas as seed regions, T2DM patients displayed aberrant FC, mainly in the frontal and parietal lobes. The pattern of FC alterations in T2DM patients was characterized by decreased connectivity and positive to negative or negative to positive converted connectivity. Digital Span Test forward scores revealed significant correlations with the ReHo values of the right precentral gyrus (ρ = 0.527, p = 0.014 and FC between the right fusiform gyrus and middle temporal gyrus (ρ = -0.437, p = 0.048. Our findings suggest that T2DM patients suffer from cognitive dysfunction related to spatially local and remote brain activity synchronization impairment. The patterns of ReHo and FC alterations shed light on the mechanisms underlying T2DM-associated brain

  15. Prevalence and 25 year incidence of proliferative retinopathy among Danish type 1 diabetic patients

    DEFF Research Database (Denmark)

    Grauslund, J; Green, A; Sjølie, A K

    2009-01-01

    AIMS/HYPOTHESIS: This study aimed to evaluate the prevalence of retinopathy in long-surviving type 1 diabetic patients. It also investigated the 25 year incidence of proliferative retinopathy and associated risk factors in a Danish population-based cohort. METHODS: A population-based cohort of 727...... type 1 diabetic patients from Fyn County, Denmark, was identified in 1973. In 1981-1982, baseline retinopathy was graded and other risk factors were assessed in 573 patients. Twenty-five years later, 308 patients were still alive. Of these, 201 (65.3%) were re-examined at follow-up in 2007......-2008. RESULTS: The median age and duration of diabetes at follow-up were 58.8 and 43 years, respectively. At follow-up, the prevalence of diabetic retinopathy was 97.0%. Non-proliferative retinopathy was found in 45.8%, and 51.2% had proliferative retinopathy. The 25 year incidence of proliferative retinopathy...

  16. Quality of life in patients with schizophrenia in five European countries: the EPSILON study

    NARCIS (Netherlands)

    Gaite, L.; Vázquez-Barquero, J. L.; Borra, C.; Ballesteros, J.; Schene, A.; Welcher, B.; Thornicroft, G.; Becker, T.; Ruggeri, M.; Herrán, A.

    2002-01-01

    Objective: To compare subjective quality of life (QOL) and objective, QOL indicators in patients with schizophrenia from five European sites: Amsterdam, Copenhagen, London, Santander and Verona. Method: A representative sample of 404 patients with schizophrenia, in contact with mental health

  17. Twenty-first workshop on geothermal reservoir engineering: Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    None

    1996-01-26

    PREFACE The Twenty-First Workshop on Geothermal Reservoir Engineering was held at the Holiday Inn, Palo Alto on January 22-24, 1996. There were one-hundred fifty-five registered participants. Participants came from twenty foreign countries: Argentina, Austria, Canada, Costa Rica, El Salvador, France, Iceland, Indonesia, Italy, Japan, Mexico, The Netherlands, New Zealand, Nicaragua, the Philippines, Romania, Russia, Switzerland, Turkey and the UK. The performance of many geothermal reservoirs outside the United States was described in several of the papers. Professor Roland N. Horne opened the meeting and welcomed visitors. The key note speaker was Marshall Reed, who gave a brief overview of the Department of Energy's current plan. Sixty-six papers were presented in the technical sessions of the workshop. Technical papers were organized into twenty sessions concerning: reservoir assessment, modeling, geology/geochemistry, fracture modeling hot dry rock, geoscience, low enthalpy, injection, well testing, drilling, adsorption and stimulation. Session chairmen were major contributors to the workshop, and we thank: Ben Barker, Bobbie Bishop-Gollan, Tom Box, Jim Combs, John Counsil, Sabodh Garg, Malcolm Grant, Marcel0 Lippmann, Jim Lovekin, John Pritchett, Marshall Reed, Joel Renner, Subir Sanyal, Mike Shook, Alfred Truesdell and Ken Williamson. Jim Lovekin gave the post-dinner speech at the banquet and highlighted the exciting developments in the geothermal field which are taking place worldwide. The Workshop was organized by the Stanford Geothermal Program faculty, staff, and graduate students. We wish to thank our students who operated the audiovisual equipment. Shaun D. Fitzgerald Program Manager.

  18. Existence of mutations in the homeodomain-encoding region of NKX2.5 gene in Iranian patients with tetralogy of Fallot

    Science.gov (United States)

    Kheirollahi, Majid; Khosravi, Fereshteh; Ashouri, Saeideh; Ahmadi, Alireza

    2016-01-01

    Background: Tetralogy of Fallot (TOF), the most common cyanotic heart defect and one of the most common congenital heart diseases, occurs mostly sporadically and nonsyndromically. The underlying molecular genetic mechanism is not known. Therefore, the existence of mutations in the homeodomain-encoding region of NKX2.5 gene in Iranian patients with tetralogy of Fallot is evaluated. Materials and Methods: In the present study, we analyzed the peripheral blood samples of27 patients in order to find any mutation in the 180 bp homeodomain-encoding region of NKX2.5 gene, which is known to be involved in heart development and diseases. DNA was extracted and all the samples were amplified by polymerase chain reaction (PCR) and sequenced. Results: Twenty-seven patients were included in the study. Twenty-five of them were infants and children (6 days to 11 years of age), one was a teenager (14-years of age), and another was a 33-year-old man [mean ± standard deviation (SD): 5.80 ± 3.90 years]. Thirteen patents were males (mean ± SD: 6.587077 ± 5.02 years) and 14 were females (mean ± SD: 5.0726 ± 2.81 years). One synonymous variant, i.e., c.543G>A was identified in one patient. Conclusion: Mutations in the homeodomain-encoding region of NKX2.5 gene may not have an outstanding role in etiology of tetralogy of Fallot patients in Iran. PMID:27904570

  19. Age differences in personality traits from 10 to 65: Big Five domains and facets in a large cross-sectional sample.

    Science.gov (United States)

    Soto, Christopher J; John, Oliver P; Gosling, Samuel D; Potter, Jeff

    2011-02-01

    Hypotheses about mean-level age differences in the Big Five personality domains, as well as 10 more specific facet traits within those domains, were tested in a very large cross-sectional sample (N = 1,267,218) of children, adolescents, and adults (ages 10-65) assessed over the World Wide Web. The results supported several conclusions. First, late childhood and adolescence were key periods. Across these years, age trends for some traits (a) were especially pronounced, (b) were in a direction different from the corresponding adult trends, or (c) first indicated the presence of gender differences. Second, there were some negative trends in psychosocial maturity from late childhood into adolescence, whereas adult trends were overwhelmingly in the direction of greater maturity and adjustment. Third, the related but distinguishable facet traits within each broad Big Five domain often showed distinct age trends, highlighting the importance of facet-level research for understanding life span age differences in personality. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  20. Three-Catheter Technique for Ablation of Left-Sided Accessory Pathways in Wolff-Parkinson-White is Less Expensive and Equally Successful When Compared to a Five-Catheter Technique.

    Science.gov (United States)

    Capone, Christine A; Ceresnak, Scott R; Nappo, Lynn; Gates, Gregory J; Schechter, Clyde B; Pass, Robert H

    2015-12-01

    To compare the efficacy, safety, and cost-effectiveness of a three-catheter approach with a conventional five-catheter approach for the mapping and ablation of supraventricular tachycardia in pediatric patients with Wolff-Parkinson-White Syndrome (WPW) and concealed accessory pathways (APs). A retrospective review from 2008 to 2012 of patients less than 21 years with WPW who underwent a three-catheter radiofrequency (RF) ablation of a left-sided AP (ablation, right ventricular [RV] apical, and coronary sinus [CS] decapolar catheters) was performed. The three-catheter group was compared to a control group who underwent a standard five-catheter (ablation, RV apical, CS decapolar, His catheter, and right atrial catheter) ablation for the treatment of left-sided WPW or concealed AP. Demographics, ablation outcomes, and costs were compared between groups. Twenty-eight patients met inclusion criteria with 28 control patients. The groups did not differ in gender, age, weight, or body surface area. Locations of the AP on the mitral annulus were similar between the groups. All patients were ablated via transseptal approach. Note that 28 of 28 in the three-catheter group (100%) and 27 of 28 (96%) controls were acutely successfully ablated (P = 0.31). No complications were encountered. There was no difference in procedural time, time to loss of AP conduction, or number of RF applications. Use of the three-catheter technique resulted in a total savings of $2,465/case, which includes the $680 savings from using fewer catheters as well as the savings from a shortened procedure time. Ablation in patients with WPW and a left-sided AP can be performed using three catheters with similar efficacy and safety while offering significant cost savings compared to a conventional five-catheter approach. © 2015 Wiley Periodicals, Inc.

  1. Assessment of Some Adipo cytokines Levels In Serum of Egyptian Patients Suffering From Non-Alcoholic Steatohepatitis (NASH)

    International Nuclear Information System (INIS)

    Mohammed, A.A.

    2011-01-01

    In the present study, thirty five patients with biopsy proven NASH and twenty age and sex matched healthy individuals were enrolled. Serum adiponectin, ghrelin, TNF-α and leptin levels were estimated in the serum of NASH patients and control subjects. Also, fasting insulin and blood glucose levels were measured and insulin resistance (IR) were calculated. In addition, liver function enzymes (AST, ALT), total cholesterol and triglycerides were measured, and body mass index (BMI) was calculated. The results showed significant decrease in adiponectin and ghrelin levels and significant increase in TNF-α and leptin levels in NASH group as compared to controls. Ten patients were diabetic and seven patients had BMI > 30 kg/m 2 . Also, significant positive relationship was recorded between adiponectin and ghrelin and AST/ALT ratio in the NASH group, and significant negative relationship between them and BMI and HOMA-IR

  2. Acid sphingomyelinase (Asm) deficiency patients in The Netherlands and Belgium: disease spectrum and natural course in attenuated patients.

    Science.gov (United States)

    Hollak, C E M; de Sonnaville, E S V; Cassiman, D; Linthorst, G E; Groener, J E; Morava, E; Wevers, R A; Mannens, M; Aerts, J M F G; Meersseman, W; Akkerman, E; Niezen-Koning, K E; Mulder, M F; Visser, G; Wijburg, F A; Lefeber, D; Poorthuis, B J H M

    2012-11-01

    Niemann-Pick disease (NPD) is a neurovisceral lysosomal storage disorder caused by acid sphingomyelinase (ASM) deficiency, which can be categorized as either Niemann-Pick disease type A [NPD-A], with progressive neurological disease and death in early childhood, or as Niemann-Pick disease type B [NPD-B], with a more variable spectrum of manifestations. Enzyme replacement therapy (ERT) with recombinant sphingomyelinase is currently studied as potential treatment for NPD-B patients. The objective of this study is to characterize the clinical features of patients with ASM deficiency in the Netherlands and Belgium with focus on the natural disease course of NPD-B patients. Prospective and retrospective data on ASM deficient patients were collected in The Netherlands and part of Belgium. Patients with NPD-B that could be followed prospectively were evaluated every 6-12 months for pulmonary function tests, 6 minute walk test (6 MWT), imaging (bone marrow infiltration measured by QCSI, organ volumes by MRI and CT scan of the lungs) and biochemical markers. Twenty-five patients with ASM deficiency were identified (13 males, 12 females, median age 13years, range 1-59 years). Nine patients had died at the time of the study, including four NPD-A patients at the age of 1,1, 2, 3 and five NPDB patents at the age of 5, 6, 43, 56 and 60 years. There was a high prevalence of homozygosity and compound heterozygosity for the common p.Arg608del mutation in 43% and 19% of NPD-B patients, respectively. In NPD-B patients, thrombocytopenia was present in most, while anemia and leucopenia were less common (33% and 6 % respectively). HDL cholesterol was reduced in most patients. Pulmonary disease was severe in several patients. Follow-up up to 11 years revealed a gradual decrease in platelet count. Detailed investigations in 6 NPD-B patients with follow-up in 4 patients revealed remarkable stable disease parameters up to 6 years, with some decline in pulmonary function and 6 MWT. Bone

  3. A European multicentre survey of impulse control behaviours in Parkinson's disease patients treated with short- and long-acting dopamine agonists.

    Science.gov (United States)

    Rizos, A; Sauerbier, A; Antonini, A; Weintraub, D; Martinez-Martin, P; Kessel, B; Henriksen, T; Falup-Pecurariu, C; Silverdale, M; Durner, G; Røkenes Karlsen, K; Grilo, M; Odin, P; Chaudhuri, K Ray

    2016-08-01

    Impulse control disorders (ICDs) in Parkinson's disease (PD) are associated primarily with dopamine agonist (DA) use. Comparative surveys of clinical occurrence of impulse control behaviours on longer acting/transdermal DA therapy across age ranges are lacking. The aim of this study was to assess the occurrence of ICDs in PD patients across several European centres treated with short- or long-acting [ropinirole (ROP); pramipexole (PPX)] and transdermal [rotigotine skin patch (RTG)] DAs, based on clinical survey as part of routine clinical care. A survey based on medical records and clinical interviews of patients initiating or initiated on DA treatment (both short- and long-acting, and transdermal) across a broad range of disease stages and age groups was performed. Four hundred and twenty-five cases were included [mean age 68.3 years (range 37-90), mean duration of disease 7.5 years (range 0-37)]. ICD frequencies (as assessed by clinical interview) were significantly lower with RTG (4.9%; P controlling for possible confounding factors. © 2016 EAN.

  4. Lower-limb MRI in the staging and re-staging of osteonecrosis in paediatric patients affected by acute lymphoblastic leukaemia after therapy

    Energy Technology Data Exchange (ETDEWEB)

    Ippolito, D.; Masetto, A.; Franzesi, C.T.; Bonaffini, P.A.; Sironi, S. [University of Milano-Bicocca Milan, School of Medicine, Monza (Italy); Department of Diagnostic Radiology, H. San Gerardo, Monza (Italy); Sala, A.; Biondi, A. [University of Milano-Bicocca Milan, School of Medicine, Monza (Italy); H. San Gerardo, Department of Paediatric Haematology, Monza (Italy)

    2016-04-15

    To assess the diagnostic value of MRI examination in detecting and monitoring osteonecrotic lesions (ON) in childhood acute lymphoblastic leukaemia (ALL) after chemotherapy (CHT) and/or bone marrow transplantation (BMT). Seventy-three patients (37 males, mean age 12.4 years old) with ALL after treatment underwent a lower-limb MR examination between November 2006 and March 2012. In 47 there was clinical suspicion of ON, 26 were asymptomatic. Studies were performed with a 1 T and a 1.5 T scanner, acquiring short tau inversion recovery (STIR) and T1-weighted sequences in coronal plane from the hips to the ankles. The average acquisition time was 18 min. Considering baseline and follow-up examinations, the overall number of MRI studies was 195. Fifty-four of 73 patients showed ON at MRI study, with an overall number of 323 ON (89 involving articular surface, 24 with joint deformity, JD). Twenty-five of 47 symptomatic patients showed subchondral ON lesions, 11 developed JD. Three of 26 asymptomatic patients showed subchondral bone ON at baseline examination but no JD at follow-up. Twenty-two of 28 BMT, 32/45 CHT patients developed ON. Our MRI protocol proved to be feasible in evaluating ON in paediatric patients. Studies should be addressed only to symptomatic patients. (orig.)

  5. Lower-limb MRI in the staging and re-staging of osteonecrosis in paediatric patients affected by acute lymphoblastic leukaemia after therapy

    International Nuclear Information System (INIS)

    Ippolito, D.; Masetto, A.; Franzesi, C.T.; Bonaffini, P.A.; Sironi, S.; Sala, A.; Biondi, A.

    2016-01-01

    To assess the diagnostic value of MRI examination in detecting and monitoring osteonecrotic lesions (ON) in childhood acute lymphoblastic leukaemia (ALL) after chemotherapy (CHT) and/or bone marrow transplantation (BMT). Seventy-three patients (37 males, mean age 12.4 years old) with ALL after treatment underwent a lower-limb MR examination between November 2006 and March 2012. In 47 there was clinical suspicion of ON, 26 were asymptomatic. Studies were performed with a 1 T and a 1.5 T scanner, acquiring short tau inversion recovery (STIR) and T1-weighted sequences in coronal plane from the hips to the ankles. The average acquisition time was 18 min. Considering baseline and follow-up examinations, the overall number of MRI studies was 195. Fifty-four of 73 patients showed ON at MRI study, with an overall number of 323 ON (89 involving articular surface, 24 with joint deformity, JD). Twenty-five of 47 symptomatic patients showed subchondral ON lesions, 11 developed JD. Three of 26 asymptomatic patients showed subchondral bone ON at baseline examination but no JD at follow-up. Twenty-two of 28 BMT, 32/45 CHT patients developed ON. Our MRI protocol proved to be feasible in evaluating ON in paediatric patients. Studies should be addressed only to symptomatic patients. (orig.)

  6. Lower-limb MRI in the staging and re-staging of osteonecrosis in paediatric patients affected by acute lymphoblastic leukaemia after therapy.

    Science.gov (United States)

    Ippolito, D; Masetto, A; Franzesi, C Talei; Bonaffini, P A; Sala, A; Biondi, A; Sironi, S

    2016-04-01

    To assess the diagnostic value of MRI examination in detecting and monitoring osteonecrotic lesions (ON) in childhood acute lymphoblastic leukaemia (ALL) after chemotherapy (CHT) and/or bone marrow transplantation (BMT). Seventy-three patients (37 males, mean age 12.4 years old) with ALL after treatment underwent a lower-limb MR examination between November 2006 and March 2012. In 47 there was clinical suspicion of ON, 26 were asymptomatic. Studies were performed with a 1 T and a 1.5 T scanner, acquiring short tau inversion recovery (STIR) and T1-weighted sequences in coronal plane from the hips to the ankles. The average acquisition time was 18 min. Considering baseline and follow-up examinations, the overall number of MRI studies was 195. Fifty-four of 73 patients showed ON at MRI study, with an overall number of 323 ON (89 involving articular surface, 24 with joint deformity, JD). Twenty-five of 47 symptomatic patients showed subchondral ON lesions, 11 developed JD. Three of 26 asymptomatic patients showed subchondral bone ON at baseline examination but no JD at follow-up. Twenty-two of 28 BMT, 32/45 CHT patients developed ON. Our MRI protocol proved to be feasible in evaluating ON in paediatric patients. Studies should be addressed only to symptomatic patients.

  7. Effect of aging on the configurational change of the aortic arch

    Directory of Open Access Journals (Sweden)

    Atsuhiro Kojima

    2016-04-01

    Full Text Available We explored the relationship between aging and the configuration of the aortic arch using computed tomography angiography (CTA. We retrospectively reviewed CTA obtained in 140 cases. The configuration of the aortic arch was categorized into three types based on the criteria mentioned by Madhwal et al., and the relationships between each configuration and patient characteristics were analyzed. Anomalies of the aortic arch were also explored. Twenty patients had a type-1 aortic arch (mean age, 56.1 years, 30 patients had a type-2 aortic arch (mean age, 66.3 years, and 89 patients had a type-3 aortic arch (mean age, 71.7 years. The mean age of patients with a type-3 aortic arch was significantly higher than that of patients with a type-1 aortic arch. No significant correlations between the type of aortic arch and other factors, such as smoking habit, were seen. The configuration of the aortic arch in our study appears to be significantly affected by the age of the patients.

  8. Outcome of mucormycosis after treatment: report of five cases

    Directory of Open Access Journals (Sweden)

    F. Bellazreg

    2015-07-01

    Full Text Available Mucormycoses are serious infections caused by filamentous fungi of the order Mucorales. They occur most often in immunocompromised patients. We report five cases of mucormycosis in patients hospitalized in the Infectious Diseases Department in Sousse – Tunisia between 2000 and 2013. They were 4 males and one female, mean age 60 years. Three patients were diabetic and one patient had acute leukemia. The locations of mucormycosis were rhinocerebral, rhino-orbital, auricular, pulmonary and cutaneous. The Mucorales isolated were Rhizopus arrhizus in 3 cases and Lichteimia in 2 cases. All patients were treated with amphotericin B and 2 patients had, in addition, surgical debridement. Two patients died and 2 kept peripheral facial paralysis.

  9. Perceived weight status may contribute to education inequalities in five-year weight change among mid-aged women.

    Science.gov (United States)

    Siu, Jessica; Giskes, Katrina; Shaw, Jonathan; Turrell, Gavin

    2011-06-01

    To examine education differences in five-year weight change among mid-aged adults, and to ascertain if this may be due to socioeconomic differences in perceived weight status or weight control behaviours (WCBs). Data were used from the Australian Diabetes, Obesity and Lifestyle Study. Mid-aged men and women with measured weights at both baseline (1999-2000) and follow-up (2004-2005) were included. Percent weight change over the five-year interval was calculated and perceived weight status, WCBs and highest attained education were collected at baseline. Low-educated men and women were more likely to be obese at baseline compared to their high-educated counterparts. Women with a certificate-level education had a greater five-year weight gain than those with a bachelor degree or higher. Perceived weight status or WCBs did not differ by education among men and women, however participants that perceived themselves as very overweight had less weight gain than those perceiving themselves as underweight or normal weight. WCBs were not associated with five-year weight change. The higher prevalence of overweight/obesity among low-educated women may be a consequence of greater weight gain in mid-adulthood. Education inequalities in overweight/obesity among men and women made be due (in part) to overweight or obese individuals in low-educated groups not perceiving themselves as having a weight problem. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.

  10. Twenty years of audiology in a patient with Norrie disease.

    Science.gov (United States)

    Halpin, Chris; Sims, Katherine

    2008-11-01

    To describe disease progression and treatment outcomes over a 20-year period (ages 5-25) in a young man with Norrie disease (occuloacousticocerebral dysplasia), ND; OMIM #310600. Affected individuals are born blind and develop progressive sensory loss with onset in adolescence. This disease is X-linked and has been associated with mutations of the NDP gene (Xp11.4). The patient was followed using repeated audiograms, as well as reports of educational progress and hearing aid use. The specific mutation was found by molecular analysis. The patient demonstrated progressive sensory loss with good preservation of word recognition. The loss was initially high frequency and asymmetric in adolescence and became more severe, more symmetric and affected practically all frequencies by the end of childhood. Educational progress was affected by the cognitive effects of the syndrome, and hearing aid use was very effective. A bilateral progressive sensory loss with good preservation of word recognition was documented in detail. The residual word recognition supported good use of hearing aids in this case.

  11. Pseudophakic retinal detachment in young-aged patients.

    Directory of Open Access Journals (Sweden)

    Thomas Laube

    Full Text Available To investigate the incidence and risk factors for retinal detachment (RD after cataract surgery or refractive lens exchange (RLE in patients aged below 61 years.Retrospective medical chart review of 7,886 patients (13,925 eyes who underwent cataract surgery or RLE. Patients aged below 61 years were selected. Age, gender, axial length, follow-up times, and the occurrence of RD were recorded. Additional characteristics documented for RD cases were: history of RD, preexisting retinal findings, laser capsulotomy, status of macula at RD, date and details of RD.From a total of 421 patients (677 eyes aged below 61 years 24 cases of RD were identified, resulting in an overall cumulative incidence per eyes of 3.55%. The mean follow-up time was 45 ± 32.8 months. Ninety-two % of all RDs occurred within 3.6 years from surgery. Axial length had a significant effect on the risk of RD after cataract/ RLE surgery (HR = 1.42, P = 0.0001, 95% CI 1.19-1.69. The highest incidence of RD occurred in the subgroup of 25 to 28.9 mm axial length (10.2%. With an increase in age of ten years, the hazard of postoperative RD was not significantly increased by a factor of 1.50 (P = 0.286, 95% CI 0.71-3.15. The highest incidence of RD occurred in patients aged 50-54 years (5.39%. Compared to females, males had an almost twofold not significant risk of postoperative RD (HR = 1.96, P = 0.123, 95% CI 0.83-4.63. None of the RD cases had a history of RD.Axial length is a significant risk factor for pseudophakic RD. The need for cataract surgery or RLE should be carefully considered in patients with axial lengths between 25 and 29 mm, aged 50-54 years, in males, and in case of preexisting retinal findings.

  12. Clinical experience with fixed bimonthly aflibercept dosing in treatment-experienced patients with neovascular age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Khanani AM

    2015-07-01

    Full Text Available Arshad M Khanani Sierra Eye Associates, Reno, NV, USA Purpose: To evaluate the durability of fixed bimonthly dosing of intravitreal aflibercept for neovascular age-related macular degeneration.Methods: Records of 16 patients were retrospectively reviewed. Patients received three initial 2.0 mg monthly doses of aflibercept then 8-weekly doses according to the product label. Best-corrected visual acuity (Early Treatment Diabetic Retinopathy Study [ETDRS] letters, central macular thickness, fluid on optical coherence tomography, and pigment epithelial detachment (PED were measured.Results: Prior to starting aflibercept, 13 patients had subretinal fluid (SRF, five had intraretinal fluid (IRF, four had PED, and baseline visual acuity (VA was 62 approximate ETDRS letters. Following the monthly dosing, seven patients had no improvement or decreased VA, ten patients still had SRF/IRF, and PED had worsened in one patient. At Visit 4, an average of 6.8 weeks after Visit 3, VA had decreased in seven patients, SRF/IRF had increased in 12 patients, and PED had returned in all patients who initially responded. Based on the presence of fluid after the initial monthly injections, 12 patients could not be extended to fixed bimonthly dosing.Conclusion: This case series adds to the growing body of evidence on the need for flexible dosing schedules for the personalized treatment of neovascular age-related macular degeneration. Keywords: age-related macular degeneration, AMD, bimonthly, regimen, aflibercept, case studies, retinal fluid

  13. Merkel cells carcinoma of the aged patient

    International Nuclear Information System (INIS)

    Levy, A.; Assouline, A.; Mazeron, J.J.; Chargari, C.; Krzisch, C.

    2009-01-01

    The carcinoma at Merkel cells is a rare and aggressive skin cancer, principally of the aged adult. The surgery is the fundamental treatment. The interest of the adjuvant radiotherapy is discussed for the aged patient. In the limits of this retrospective analysis, the postoperative radiotherapy appeared to bring a similar benefit as for younger patients. (N.C.)

  14. Undertreatment of anxiety and depression in patients with an implantable cardioverter-defibrillator

    DEFF Research Database (Denmark)

    Hoogwegt, Madelein T; Kupper, Nina; Theuns, Dominic A M J

    2012-01-01

    Twenty-five to 33% of patients with an implantable cardioverter-defibrillator (ICD) experience anxiety and depression, but it is not known whether their symptoms are adequately treated. We investigated (a) whether patients with clinically relevant symptoms of distress received appropriate treatme......, and (b) whether patients not treated for their emotional distress reported poorer health status using a prospective study design....

  15. Age-associated impact on presentation and outcome for penetrating thoracic trauma in the adult and pediatric patient populations.

    Science.gov (United States)

    Mollberg, Nathan M; Tabachnick, Deborah; Lin, Fang-Ju; Merlotti, Gary J; Varghese, Thomas K; Arensman, Robert M; Massad, Malek G

    2014-02-01

    Studies reporting on penetrating thoracic trauma in the pediatric population have been limited by small numbers and implied differences with the adult population. Our objectives were to report on a large cohort of pediatric patients presenting with penetrating thoracic trauma and to determine age-related impacts on management and outcome through comparison with an adult cohort. A Level I trauma center registry was queried between 2006 and 2012. All patients presenting with penetrating thoracic trauma were identified. Patient demographics, injury mechanism, injury severity, admission physiology, and outcome were recorded. Patients were compared, and outcomes were analyzed based on age at presentation, with patients 17 years or younger defining our pediatric cohort. A total of 1,423 patients with penetrating thoracic trauma were admitted during the study period. Two hundred twenty patients (15.5%) were pediatric, with 205 being adolescents (13-17 years) and 15 being children (≤ 12 years). In terms of management for the pediatric population, tube thoracostomy alone was needed in 32.7% (72 of 220), whereas operative thoracic exploration was performed in 20.0% (44 of 220). Overall mortality was 13.6% (30 of 220). There was no significant difference between the pediatric and adult population with regard to injury mechanism or severity, need for therapeutic intervention, operative approach, use of emergency department thoracotomy, or outcome. Stepwise logistic regression failed to identify age as a predictor for the need for either therapeutic intervention or mortality between the two age groups as a whole. However, subgroup analysis revealed that being 12 years or younger (odds ratio, 3.84; 95% confidence interval, 1.29-11.4) was an independent predictor of mortality. Management of traumatic penetrating thoracic injuries in terms of the need for therapeutic intervention and operative approach was similar between the adult and pediatric populations. Mortality from

  16. A five year prospective investigation of anterior pituitary function after traumatic brain injury: is hypopituitarism long-term after head trauma associated with autoimmunity?

    Science.gov (United States)

    Tanriverdi, Fatih; De Bellis, Annamaria; Ulutabanca, Halil; Bizzarro, Antonio; Sinisi, Antonio A; Bellastella, Giuseppe; Amoresano Paglionico, Vanda; Dalla Mora, Liliana; Selcuklu, Ahmed; Unluhizarci, Kursad; Casanueva, Felipe F; Kelestimur, Fahrettin

    2013-08-15

    Traumatic brain injury (TBI) has been recently recognized as a common cause of pituitary dysfunction. However, there are not sufficient numbers of prospective studies to understand the natural history of TBI induced hypopituitarism. The aim was to report the results of five years' prospective follow-up of anterior pituitary function in patients with mild, moderate and severe TBI. Moreover, we have prospectively investigated the associations between TBI induced hypopituitarism and presence of anti-hypothalamus antibodies (AHA) and anti-pituitary antibodies (APA). Twenty five patients (20 men, five women) were included who were prospectively evaluated 12 months and five years after TBI, and 17 of them also had a third-year evaluation. Growth hormone (GH) deficiency is the most common pituitary hormone deficit at one, three, and five years after TBI. Although most of the pituitary hormone deficiencies improve over time, there were substantial percentages of pituitary hormone deficiencies at the fifth year (28% GH, 4% adrenocorticotropic hormone [ACTH], and 4% gonadotropin deficiencies). Pituitary dysfunction was significantly higher in strongly AHA- and APA-positive (titers ≥1/16) patients at the fifth year. In patients with mild and moderate TBI, ACTH and GH deficiencies may improve over time in a considerable number of patients but, although rarely, may also worsen over the five-year period. However in severe TBI, ACTH and GH status of the patients at the first year evaluation persisted at the fifth year. Therefore, screening pituitary function after TBI for five years is important, especially in patients with mild TBI. Moreover, close strong associations between the presence of high titers of APA and/or AHA and hypopituitarism at the fifth year were shown for the first time.

  17. The challenge of aging and pharmacoterapeutic complexity in the HIV + patient.

    Science.gov (United States)

    Morillo-Verdugo, Ramón; Blanco Ramos, José Ramón; Abdel-Kader Martín, Laila; Álvarez de Sotomayor, María

    2018-05-01

    To describe the current knowledge and management of aging and  pharmacotherapeutic complexity in HIV + patients. A review of literature was carried out, including articles, originals or  reviews, published in English or Spanish, from 2007 to 2017, which analysed the aging and pharmacotherapeutic complexity in HIV + patients. The terms  «Polypharmacy»/»Polypharmacy», «Aging»/»Aging», «Frailty»/»Fragility»,  «Pharmacotherapeutic Complexity»/»Medication Regimen Complexity» and  «HIV»/"HIV» were combined. The review was carried out independently by two  authors. The degree of agreement, according to the Kappa index, was analysed. Results: A total of 208 references were analysed, including, finally, only 68. An  aging of the population and an increase in associated comorbidities have been  identified, especially over 50 years-old. Immunological changes similar to those  that are generated in a non-infected elderly population have been described.  These conditions influencing the prescription of antiretroviral treatment,  according to studies identified. In parallel, polypharmacy is increasingly present,  being defined exclusively by the concomitant use of five drugs.  Pharmacotherapeutic complexity, through the Medication Regimen Complexity  Index, has begun to analyse and relate to health outcomes. There has been a  need to know and apply concepts already known in non-HIV-aged population,  such as de-prescription, potentially inappropriate medication, cholinergic risk, although few results are available. There is a growing interest to know about the relationship between HIV and aging. Pharmacotherapeutic complexity is  beginning to be used as a pharmacotherapeutic follow-up criterion due to its influence on health outcomes. It is necessary to manage and incorporate new  concepts that help pharmacotherapeutic optimization in this population. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All

  18. One hundred and twenty-five years of the Annals of Botany. Part 2: the years 1937 to 2012.

    Science.gov (United States)

    Jackson, Michael B

    2016-12-01

    Annals of Botany is a peer-reviewed plant biology journal. It was started in 1887, making it the oldest continuously published plant science title. A previous article [Jackson MB. 2015. One hundred and twenty-five years of the Annals of Botany Part 1: the first 50 years (1887-1936). Annals of Botany 115: : 1-18] summarized events leading to its founding, highlighted the individuals involved and examined the Journal's achievements and management practices over the first 50 years to 1937. This second article covers the next 75 years. The account draws principally on the Journal's own records, minute books, financial accounts, original letters and notes held by the Annals of Botany Company, the Journal's owners and managers. In 1937, its 51st year, the Journal was re-launched as Annals of Botany New Series and its volume numbers were reset to No. I. The present article evaluates the evolution of the New Series up to 2012, Annals of Botany's 125th anniversary year. The period includes a 2-year run-up to World War II, six war years and their immediate aftermath, and then on through increasingly competitive times. The ebb and flow of the Journal's fortunes are set against a roll-call of the often highly distinguished scientists who managed and edited the Journal. The article also examines an internal crisis in the 1980s that radically altered the Journal's organization in ways that were, ultimately, to its benefit. The narrative is set against changes to economic conditions in Great Britain over the period, to the evolving nature and geographical distribution of much experimental plant science and to the digital revolution that, from the late 20th century, transformed the workings of Annals of Botany and of scientific publishing more generally. © The Author 2016. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. Chagas disease: national survey of seroprevalence in children under five years of age conducted in 2008.

    Science.gov (United States)

    Russomando, Graciela; Cousiño, Blanca; Sanchez, Zunilda; Franco, Laura X; Nara, Eva M; Chena, Lilian; Martínez, Magaly; Galeano, María E; Benitez, Lucio

    2017-05-01

    Since the early 1990s, programs to control Chagas disease in South America have focused on eradicating domiciliary Triatoma infestans, the main vector. Seroprevalence studies of the chagasic infection are included as part of the vector control programs; they are essential to assess the impact of vector control measures and to monitor the prevention of vector transmission. To assess the interruption of domiciliary vector transmission of Chagas disease by T. infestans in Paraguay by evaluating the current state of transmission in rural areas. A survey of seroprevalence of Chagas disease was carried out in a representative sample group of Paraguayans aged one to five years living in rural areas of Paraguay in 2008. Blood samples collected on filter paper from 12,776 children were tested using an enzyme-linked immunosorbent assay. Children whose serology was positive or undetermined (n = 41) were recalled to donate a whole blood sample for retesting. Their homes were inspected for current triatomine infestation. Blood samples from their respective mothers were also collected and tested to check possible transmission of the disease by a congenital route. A seroprevalence rate of 0.24% for Trypanosoma cruzi infection was detected in children under five years of age among the country's rural population. Our findings indicate that T. cruzi was transmitted to these children vertically. The total number of infected children, aged one to five years living in these departments, was estimated at 1,691 cases with an annual incidence of congenital transmission of 338 cases per year. We determined the impact of vector control in the transmission of T. cruzi, following uninterrupted vector control measures employed since 1999 in contiguous T. infestans-endemic areas of Paraguay, and this allowed us to estimate the degree of risk of congenital transmission in the country.

  20. Chagas disease: national survey of seroprevalence in children under five years of age conducted in 2008

    Directory of Open Access Journals (Sweden)

    Graciela Russomando

    Full Text Available BACKGROUND Since the early 1990s, programs to control Chagas disease in South America have focused on eradicating domiciliary Triatoma infestans, the main vector. Seroprevalence studies of the chagasic infection are included as part of the vector control programs; they are essential to assess the impact of vector control measures and to monitor the prevention of vector transmission. OBJECTIVE To assess the interruption of domiciliary vector transmission of Chagas disease by T. infestans in Paraguay by evaluating the current state of transmission in rural areas. METHODS A survey of seroprevalence of Chagas disease was carried out in a representative sample group of Paraguayans aged one to five years living in rural areas of Paraguay in 2008. Blood samples collected on filter paper from 12,776 children were tested using an enzyme-linked immunosorbent assay. Children whose serology was positive or undetermined (n = 41 were recalled to donate a whole blood sample for retesting. Their homes were inspected for current triatomine infestation. Blood samples from their respective mothers were also collected and tested to check possible transmission of the disease by a congenital route. FINDINGS A seroprevalence rate of 0.24% for Trypanosoma cruzi infection was detected in children under five years of age among the country’s rural population. Our findings indicate that T. cruzi was transmitted to these children vertically. The total number of infected children, aged one to five years living in these departments, was estimated at 1,691 cases with an annual incidence of congenital transmission of 338 cases per year. MAIN CONCLUSION We determined the impact of vector control in the transmission of T. cruzi, following uninterrupted vector control measures employed since 1999 in contiguous T. infestans-endemic areas of Paraguay, and this allowed us to estimate the degree of risk of congenital transmission in the country.

  1. Predictive value of developmental testing in the second year for cognitive development at five years of age

    Directory of Open Access Journals (Sweden)

    Alastair G Sutcliffe

    2010-09-01

    Full Text Available There is mixed evidence about the predictive validity of the Griffiths mental developmental scales. This study aimed to assess the predictive value of developmental assessments of children in their second year using the Griffiths mental development scales for neuro-developmental status at five years using the Wechsler preschool and primary scale of intelligence, revised (WPPSI-R. In a longitudinal study 253 children were assessed in their second year of life using the Griffiths scales and again at five years using the WPPSI-R. The scores were compared and the predictability of the WPPSI-R outcome on the basis of Griffiths scores was assessed. The WPPSI-R full scale IQ and the performance IQ at age five could be predicted moderately by the Griffiths general quotient (GQ and by the personal/social scale. The Griffiths GQ was not a significant predictor of verbal IQ at age 5. The Griffiths performance scale predicted subsequent WPPSI-R performance IQ, and marginally the Full Scale IQ. For the early identification of children at risk for language delay, the Griffiths scales may not be suitable. However, a shortened form would be useful to predict overall cognitive development from the second year to school entry, focussing on the personal-social and performance scales.

  2. Migration and Ageing of the Island Population – Five Stories from Iž

    Directory of Open Access Journals (Sweden)

    Sanja Klempić

    2002-12-01

    Full Text Available The paper analyses population development on the island of Iž during the period from 1857 to 2001, with special focus on the role that migration has on the ageing of the population. The processes that effected the demographic picture of the island during the twentieth century were high war loses in two world wars and continuous migration. Depopulation on Iž began in 1921 and has persisted until today. According to the last census, 557 persons live on the island, which is half the number that was registered in the first census. The dominant demo-reproduction processes are depopulation and ageing. All indicators in regard to the age structure show a very old population. At the same time, there is a strong return migration flow of persons that have received pensions after having worked elsewhere, which further increases the percentage of elderly in the overall population. Apart from analysis of the demographic data, the aim of the paper was also to determine the existing models of return migration, based on the example of several typical migration experiences. The authors attempted to illustrate the effect of migration on the life cycle of the Iž’s older population through five typical island stories, collected in October 2001 while interviewing persons 60 or more years of age. If a major change does not occur in regard to the present trend of emigration of the younger population (creation of jobs, revival of economic activities that have a future on the island etc. and in the behaviour of younger islanders (both those living at present on the island and those living elsewhere who would accept such new programmes, Iž will remain in the group of islands that is threatened by further ageing and depopulation.

  3. NUTRITIONAL STATUS OF MAINTENANCE HEMODIALYSIS PATIENTS WITH DIFFERENT AGES

    Directory of Open Access Journals (Sweden)

    Wenling Ye

    2012-06-01

    Full Text Available To investigate nutritional status and body composition in different ages of maintaining hemodialysis (HD patients. 129 patients (male 62, female 67 with the mean age 56.33±14.14 years on HD were divided into four groups with age under 40, 40-69, 60-69 and over 70 years. Body composition was evaluated with Multi-frequency bioelectric impedance analysis (BIA and 83 healthy subjects, matched for age and sex, were as the control. In all patients, about 6.2% were underweight with body mass index (BMI less than 18.5 Kg/m2. The incidence of underweight were 0%, 6.2%, 4.8% and 11.1% in groups under 40, 40-59, 60-69 and over 70 years respectively. Serum Creatinine, ALB, pre-ALB and normalized protein catabolic rate (nPCR were significantly decreased in patients over 70 years. The young patients under 40 years also displayed lower nPCR and CHO value compared with that of group 40-59 years. Body cell mass, lean tissue mass, lean tissue index and relative lean tissue mass in HD patients were significantly lower than that in age and sex matched control group. Meanwhile, fat mass, fat tissue index and relative fat were increase 20% than the control. They were less different between HD patients and controls in age of 40-59 years, however, difference significantly increased in other three groups and changes were most obvious in patients over 70 years. In conclusion, our study showed that nutritional status was significantly associated with the age in HD patients. Patients under 40 years and over 70 years old displayed much severer protein wasting and more fat tissue storage.

  4. Agreement and Reliability of Functional Performance and Muscle Power in Patients with Advanced Osteoarthritis of the Hip or Knee

    DEFF Research Database (Denmark)

    Villadsen, Allan; Roos, Ewa M; Overgaard, Søren

    2012-01-01

    -time repeated chair stands, and repeated unilateral knee bending). RESULTS: For single-joint and multijoint maximal peak power and functional performance measures, we demonstrated poor (CVws, approximately 25%, single-joint hip extension) and moderate (CVws, approximately 15%, multijoint leg extension press......OBJECTIVE: The purpose of this study was to test the reproducibility and clinical feasibility of three functional performance measures and five single-joint or multijoint muscle power measures. DESIGN: Twenty patients with a mean age of 68.7 ± 7.2 yrs with severe hip or knee osteoarthritis were...... assessed for test-retest reliability and agreement on two occasions 1 wk apart. The outcomes were maximal single-joint muscle power (hip extension/abduction and knee extension/flexion), maximal muscle power during multijoint leg extension press, and functional performance measures (20-m walk, five...

  5. Sonographic pattern of hydrocephalus among the under five children in Sokoto North Western Nigeria

    Directory of Open Access Journals (Sweden)

    Sule Ahmed Saidu

    2015-01-01

    Full Text Available Background: Hydrocephalus among children is an important medical problem in view of its neurological sequelae in the growing child. This situation is compounded by the acute shortage of neurosurgeons in third world countries like Nigeria; hence, the need for its early detection and proper management. Objective: Evaluation of the ultrasound (US appearances in children under 5 years of age presenting with clinical signs of raised intracranial pressure suggestive of hydrocephalus. Patients and Methods: A retrospective review of transfontanelle US scans done in 64 children (39 boys and 25 girls attending the Department of Radiology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria over a period of 2 years was carried out. The patients had a mean age of 5.0 ± 4.6 months (range: 1–60 months at the time of their US examination. Some of the clinical indications for US scan included: Congenital hydrocephalus, encephalocele, meningomyelocele, and meningitis. All scans were performed through the anterior fontanelle using SIUI Apogee 800 PLUS scanner with a curvilinear probe using multi-frequency transducer of 2–5 MHz. Results: Fifty-two patients (81.3% had hydrocephalus of congenital origin. Eleven cases (17.2% had postmeningitic hydrocephalus while only 1 case (1.6% was posthemorrhagic. Twenty-five patients (48.0% of the congenital cases were due to cerebral aqueduct stenosis. Eleven (21.2% of the congenital cases were from obstruction at the exit foramina of Luschka and Magendie resulting in the communicating type of hydrocephalus. Conclusion: Hydrocephalus is a known cause of neurological morbidity among infants in developing countries. Majority of the cases are congenital in origin and most commonly due to cerebral aqueduct stenosis. Transfontanelle US is cheap, affordable, nonhazardous, and more accessible than other imaging modalities. It should serve as the first-line investigation of infants with suspected hydrocephalus for early

  6. Pooled individual patient data from five countries were used to derive a clinical prediction rule for coronary artery disease in primary care.

    Science.gov (United States)

    Aerts, Marc; Minalu, Girma; Bösner, Stefan; Buntinx, Frank; Burnand, Bernard; Haasenritter, Jörg; Herzig, Lilli; Knottnerus, J André; Nilsson, Staffan; Renier, Walter; Sox, Carol; Sox, Harold; Donner-Banzhoff, Norbert

    2017-01-01

    To construct a clinical prediction rule for coronary artery disease (CAD) presenting with chest pain in primary care. Meta-Analysis using 3,099 patients from five studies. To identify candidate predictors, we used random forest trees, multiple imputation of missing values, and logistic regression within individual studies. To generate a prediction rule on the pooled data, we applied a regression model that took account of the differing standard data sets collected by the five studies. The most parsimonious rule included six equally weighted predictors: age ≥55 (males) or ≥65 (females) (+1); attending physician suspected a serious diagnosis (+1); history of CAD (+1); pain brought on by exertion (+1); pain feels like "pressure" (+1); pain reproducible by palpation (-1). CAD was considered absent if the prediction score is data sets based on electronic health records from diverse sites create opportunities for improving their internal and external validity. Our patient-level meta-analysis from five primary care sites should improve external validity. Our strategy for addressing site-to-site systematic variation in missing data should improve internal validity. Using principles derived from decision theory, we also discuss the problem of setting the cutoff prediction score for taking action. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Five Common Glaucoma Tests

    Science.gov (United States)

    ... About Us Donate In This Section Five Common Glaucoma Tests en Español email Send this article to ... year or two after age 35. A Comprehensive Glaucoma Exam To be safe and accurate, five factors ...

  8. QuickStats: Age-Adjusted Death Rates* for Top Five Causes of Cancer Death,(†) by Race/Hispanic Ethnicity - United States, 2014.

    Science.gov (United States)

    2016-09-16

    In 2014, the top five causes of cancer deaths for the total population were lung, colorectal, female breast, pancreatic, and prostate cancer. The non-Hispanic black population had the highest age-adjusted death rates for each of these five cancers, followed by non-Hispanic white and Hispanic groups. The age-adjusted death rate for lung cancer, the leading cause of cancer death in all groups, was 42.1 per 100,000 standard population for the total population, 45.4 for non-Hispanic white, 45.7 for non-Hispanic black, and 18.3 for Hispanic populations.

  9. RECURRENCE RATE OF HELICOBACTER PYLORI IN PATIENTS WITH PEPTIC ULCER FIVE YEARS OR MORE AFTER SUCCESSFUL ERADICATION.

    Science.gov (United States)

    Fernandes, Yuri Costa Farago; Bonatto, Gabriel da Rocha; Bonatto, Mauro Willeman

    2016-01-01

    Infection with Helicobacter pylori is highly prevalent worldwide, especially in developing countries. Its presence in the gastroduodenal mucosa is related with development of peptic ulcer and other illnesses. The eradication of H. pylori improves mucosal histology in patients with peptic ulcers. This study was aimed to verify if H. pylori recurrence occurs five years or more after confirmed eradication in patients with peptic ulcer. Moreover, we sought to determine the recurrence rate. Retrospective and longitudinal, this study was based on a sample of 201 patients from western Paraná, Brazil. The patients were diagnosed with peptic ulcer disease, in the period of 1990-2000, and followed for five years or more after successful H. pylori eradication. Patients with early recurrence - prior to five years after eradication - were excluded from the sample. During an average follow-up of 8 years, 180 patients (89.55%) remained negative, and 21 (10.45%) became positive for H. pylori infection. New ulcers appeared in two-thirds of the patients with H. pylori recurrence. The recurrence of H. pylori in patients with peptic ulcer can occur in the long-term - even if the infection had been successfully eradicated and the patients had remained free of recurrence in the first years of follow-up.

  10. Dietary quality and its structural relationships among equivalent income, emotional well-being, and a five-year subjective health in Japanese middle-aged urban dwellers.

    Science.gov (United States)

    Kodama, Sayuri; Fujii, Nobuya; Furuhata, Tadashi; Sakurai, Naoko; Fujiwara, Yoshinori; Hoshi, Tanji

    2015-01-01

    Although dietary quality in middle-age and the prime age of a person's work career might be determined by positive emotional well-being based on socioeconomic status (SES), causation among determinants of dietary quality still remains unclear. Our purpose was to elucidate the structural relationships among five-year prior dietary quality, equivalent income, emotional well-being, and a five-year subjective health by sex and age group separately. In 2003, 10,000 middle-aged urban dwellers aged 40-64 years, who lived in ward A in the Tokyo metropolitan area, were randomly selected and a questionnaire survey was conducted by mail. In 2008, we made a follow-up survey for dwellers, and were able to gather their survival status. A total of 2507, middle-aged men (n = 1112) and women (n = 1395), were examined at baseline. We created three latent variables for a structural equation modeling (SEM), five-year subjective health reported in 2003 and in 2008, dietary quality of principle food groups diversity and eating behavior in 2003, and emotional well-being constructed by enjoyment & ikigai (meaning of life) and by close people in 2003. Equivalent income in 2003 was calculated as SES indicator. In the SEM analysis of both men and women, there was an indirect effect of the equivalent income on dietary quality and on five-year subjective health, via emotional well-being explained by ikigai and having comforting people close to the individuals, significantly. There tended to be a larger direct effect of emotional well-being on the dietary quality in men than in women, and also a larger effect accompanying with aging. In women, there was a large direct effect of equivalent income on dietary quality than in men. When examined comprehensively, there appeared to be a larger effect of five-year prior equivalent income on subjective health during five-year in men than in women. This study suggests that it is necessary to support the improvement of dietary quality in middle

  11. A five-gene hedgehog signature developed as a patient preselection tool for hedgehog inhibitor therapy in medulloblastoma.

    Science.gov (United States)

    Shou, Yaping; Robinson, Douglas M; Amakye, Dereck D; Rose, Kristine L; Cho, Yoon-Jae; Ligon, Keith L; Sharp, Thad; Haider, Asifa S; Bandaru, Raj; Ando, Yuichi; Geoerger, Birgit; Doz, François; Ashley, David M; Hargrave, Darren R; Casanova, Michela; Tawbi, Hussein A; Rodon, Jordi; Thomas, Anne L; Mita, Alain C; MacDonald, Tobey J; Kieran, Mark W

    2015-02-01

    Distinct molecular subgroups of medulloblastoma, including hedgehog (Hh) pathway-activated disease, have been reported. We identified and clinically validated a five-gene Hh signature assay that can be used to preselect patients with Hh pathway-activated medulloblastoma. Gene characteristics of the Hh medulloblastoma subgroup were identified through published bioinformatic analyses. Thirty-two genes shown to be differentially expressed in fresh-frozen and formalin-fixed paraffin-embedded tumor samples and reproducibly analyzed by RT-PCR were measured in matched samples. These data formed the basis for building a multi-gene logistic regression model derived through elastic net methods from which the five-gene Hh signature emerged after multiple iterations. On the basis of signature gene expression levels, the model computed a propensity score to determine Hh activation using a threshold set a priori. The association between Hh activation status and tumor response to the Hh pathway inhibitor sonidegib (LDE225) was analyzed. Five differentially expressed genes in medulloblastoma (GLI1, SPHK1, SHROOM2, PDLIM3, and OTX2) were found to associate with Hh pathway activation status. In an independent validation study, Hh activation status of 25 medulloblastoma samples showed 100% concordance between the five-gene signature and Affymetrix profiling. Further, in medulloblastoma samples from 50 patients treated with sonidegib, all 6 patients who responded were found to have Hh-activated tumors. Three patients with Hh-activated tumors had stable or progressive disease. No patients with Hh-nonactivated tumors responded. This five-gene Hh signature can robustly identify Hh-activated medulloblastoma and may be used to preselect patients who might benefit from sonidegib treatment. ©2014 American Association for Cancer Research.

  12. Whipple's disease. Report of five cases with different clinical features

    OpenAIRE

    FERRARI,Maria de Lourdes de Abreu; VILELA,Eduardo Garcia; FARIA,Luciana Costa; COUTO,Claudia Alves; SALGADO,Célio Jefferson; LEITE,Virgínia Rios; BRASILEIRO FILHO,Geraldo; BAMBIRRA,Eduardo Alves; MENDES,Claudia Maria de Castro; CARVALHO,Silas de Castro; OLIVEIRA,Celso Affonso de; CUNHA,Aloísio Sales da

    2001-01-01

    Whipple's disease (WD) is a rare systemic disease of infectious etiology which involves the small intestine but can virtually affect any organ. We present here five cases (four males and one female) ranging in age from 20 to 59 years. All patients had intestinal involvement associated or not with clinical manifestations linked to this organ. Vegetation in the tricuspid valve was observed in one patient, suggesting endocarditis caused by Tropheryma whippelii, with disappearance of the echocard...

  13. Patient empowerment--a strategy for pain management in endodontics.

    Science.gov (United States)

    Selden, H S

    1993-10-01

    In order to promote rapid resolution of symptoms associated with root canal treatment, a multifaceted program was implemented. One-visit endodontics was performed universally, antibiotics were prescribed when infection was detected within the root canal, and nonsteroidal anti-inflammatory drugs were widely used at the time of treatment. The centerpiece of the program was the integration of various behavioral strategies designed to strengthen the patient's inherent coping capacity. The combination of clinical, pharmacological, and psychological approaches was collectively called patient empowerment. Five hundred forty patients were asked to contact the office the day after treatment. Four hundred twenty (78%) called and 390 (93%) reported a reduction in symptoms. Twenty of the 30 (7%) who were not relieved within the first 24 h reported significant improvement 1 day later. No patients experienced a flare-up or a worsening of symptoms.

  14. Primary Intracranial Germinomas: Retrospective Analysis of Five Cases.

    Science.gov (United States)

    Abdallah, Anas; Asilturk, Murad; Uysal, Mustafa Levent; Emel, Erhan; Abdallah, Betul Guler; Bilgic, Bilge; Gundogdu, Gokcen

    2018-01-01

    Primary intracranial germinomas (PIGs) are rare malignant brain tumors that represent approximately 0.2% to 1.7% of all primary intracranial tumors. PIGs have infrequent, but there is a possibility of spinal cord metastases. In this study, clinical outcomes of five consecutive PIGs have been presented. Medical records were retrospectively reviewed in 1,849 cases of intracranial tumors who underwent surgery between the years 2005 and 2015 and cases confirmed as germinoma histopathologically were included in this study. Five cases of PIGs were detected in two female (40%) and 3 male (60%) patients. The mean age was 15.2±5.6 (8-23) years. The mean follow-up period was 52.3±56.4 (9-135) months. The most common complaint was headache (60%), followed by nausea±vomiting (40%). Four cases (80%) affected the suprasellar region while the fifth patient"s tumor was localized in the pineal region. The duration between the initial symptom and time of surgical intervention ranged between 15 days and 2 months. Twelve months after the first operation, one patient presented with drop seeding metastasis. Four-year survival (with exception of the case that died as a early surgical complication) was 100%. Gross total resection (GTR) was achieved in one patient. Surgical mortality rate was 20%. PIGs" morbidity rate was 60%. PIG is a mostly malignant tumor that generally affects the pediatric age group. They are radiosensitive tumors. Subtotal or near-total resection using stereotactic guide or direct surgery to confirm the histopathological diagnosis followed by chemotherapy and whole brain or in some cases craniospinal radiotherapy rather than GTR is therefore the treatment of choice.

  15. Dementia in middle-aged patients with schizophrenia.

    Science.gov (United States)

    Nicolas, Gaël; Beherec, Laurène; Hannequin, Didier; Opolczynski, Gaëlle; Rothärmel, Maud; Wallon, David; Véra, Pierre; Martinaud, Olivier; Guillin, Olivier; Campion, Dominique

    2014-01-01

    Although numerous studies have assessed cognitive dysfunction in patients with schizophrenia, very few have focused on the diagnosis of dementia. Our objectives were to accurately diagnose dementia in a cohort of middle-aged patients with schizophrenia and to assess the type of dementia. 96 patients with schizophrenia (46 inpatients and 50 outpatients), aged 50 to 70 years, underwent a psychiatric, neurological, and neuropsychological evaluation at baseline and after a 20-month follow-up. We established a 3-step procedure: 1) diagnose dementia according to the DSM-IV criteria, using the Mattis Dementia Rating and Activities of Daily Living scales; 2) characterize dementia using brain imaging, perfusion by 99mTc-ECD-SPECT and laboratory tests including Alzheimer's disease cerebrospinal fluid biomarkers; and 3) search for genetic determinants. Fourteen patients fulfilled the diagnostic criteria of dementia. Four were diagnosed with possible or probable behavioral-variant frontotemporal dementia (bvFTD), two with probable Alzheimer's disease, two with probable vascular dementia (including one due to CADASIL), one with CNS inflammatory disease, and six could not be fully characterized. The diagnosis of dementia in middle-aged patients with schizophrenia is challenging but possible, using a multistep procedure. The most frequent condition, bvFTD, could reflect the presence of an evolutive neurodegenerative process in some patients.

  16. SPECT of aged backache patients

    International Nuclear Information System (INIS)

    Ito, Shigehiko; Nishikimi, Junzo; Mizuno, Naokado; Watanabe, Kentaro; Kondo, Masaki; Ozaki, Satoshi; Urasaki, Tetsuya; Muro, Toshiyuki

    1995-01-01

    Single photon emission computed tomography (SPECT) using 99m Tc-HMDP was performed on 53 middle-aged or elderly patients (male 20, female, 33; age range, 40-80 years old) with lumbago, i.e., 25 patients with lumbar spondylosis, 15 with lumbar degenerative spondylolisthesis, 4 with spondylolytic spondylolisthesis, 3 with compression fracture, 3 with pulurent spondylitis, 2 with spondylous osteoporosis, and 1 with spinal osteodesmosis. 99m Tc-HMDP (740 MBq) was intravenously injected and regular SPECT was performed at 3 hours. Gamma camera was performed for about 10 seconds with 5deg intervals, and 36 steps (180deg) of collection was completed after about 6 minutes. The radioisotope accumulation, the presence or absence of sthenia, and its site were evaluated. Forty-seven (88.7%) patients showed excessive accumulation, i.e., 40 (75.5%) in peripheral vertebral osteophyte, 31 (58.5%) in vertebral articulations, and 10 (18.9%) in whole vertebral body. Significantly increased bilateral excessive accumulation was admitted in the vertebral articulations of sliding disc in degenerative spondylolisthesis. SPECT is considered useful in understanding the pathophysiology of degenerative lumber diseases. (S.Y.)

  17. Neutrino masses twenty-five years later

    International Nuclear Information System (INIS)

    Valle, J.W.F.

    2003-01-01

    The discovery of neutrino mass marks a turning point in elementary particle physics, with important implications for nuclear and astroparticle physics. Here I give a brief update, where I summarize the current status of three-neutrino oscillation parameters from current solar, atmospheric, reactor and accelerator neutrino data, discuss the case for sterile neutrinos and LSND, and also the importance of tritium and double beta decay experiments probing the absolute scale of neutrino mass. In this opinionated look at the present of neutrino physics, I keep an eye in the future, and a perspective of the past, taking the opportunity to highlight Joe Schechter's pioneering contribution, which I have had the fortune to share, as his PhD student back in the early eighties

  18. Twenty-five questions for string theorists

    Energy Technology Data Exchange (ETDEWEB)

    Binetruy, Pierre; /Orsay, LPT; Kane, G.L.; /Michigan U., MCTP; Lykken, Joseph D.; /Fermilab; Nelson, Brent D.; /Pennsylvania U.

    2005-09-01

    In an effort to promote communication between the formal and phenomenological branches of the high-energy theory community, we provide a description of some important issues in supersymmetric and string phenomenology. We describe each within the context of string constructions, illustrating them with specific examples where applicable. Each topic culminates in a set of questions that we believe are amenable to direct consideration by string theorists, and whose answers we think could help connect string theory and phenomenology.

  19. Ecotourism revisited: Last twenty-five years

    Directory of Open Access Journals (Sweden)

    Chandel Abhinav

    2016-12-01

    Full Text Available The concept of ecotourism evolves differently in developing and developed nations due to which the basic principles of ecotourism are in question. The existing literature on ecotourism suggests ambiguity in conceptual understanding of ecotourism. Due to this qualm, ecotourism is evolving into various forms. Different stakeholders with varying objectives related to ecotourism make it further difficult to form the consensus on what constitutes ecotourism. Without the clear understanding of ecotourism, it is difficult to evolve ethics on which the ecotourism principles are based. The focus of this research is to find out the principle components or themes of ecotourism using a content analysis for the development of ecotourism policy and applications. This study identified six key components of ecotourism which are widely accepted by researchers and could be used to shape the fundamental understanding of ecotourism. These themes are: (1 Nature oriented travel; (2 Support of conservation; (3 Learning and appreciation; (4 Socio-economic development of local area; (5 Support and respect for local culture and (6 Local people (area participation.

  20. Paleolithic nutrition: twenty-five years later.

    Science.gov (United States)

    Konner, Melvin; Eaton, S Boyd

    2010-12-01

    A quarter century has passed since the first publication of the evolutionary discordance hypothesis, according to which departures from the nutrition and activity patterns of our hunter-gatherer ancestors have contributed greatly and in specifically definable ways to the endemic chronic diseases of modern civilization. Refinements of the model have changed it in some respects, but anthropological evidence continues to indicate that ancestral human diets prevalent during our evolution were characterized by much lower levels of refined carbohydrates and sodium, much higher levels of fiber and protein, and comparable levels of fat (primarily unsaturated fat) and cholesterol. Physical activity levels were also much higher than current levels, resulting in higher energy throughput. We said at the outset that such evidence could only suggest testable hypotheses and that recommendations must ultimately rest on more conventional epidemiological, clinical, and laboratory studies. Such studies have multiplied and have supported many aspects of our model, to the extent that in some respects, official recommendations today have targets closer to those prevalent among hunter-gatherers than did comparable recommendations 25 years ago. Furthermore, doubts have been raised about the necessity for very low levels of protein, fat, and cholesterol intake common in official recommendations. Most impressively, randomized controlled trials have begun to confirm the value of hunter-gatherer diets in some high-risk groups, even as compared with routinely recommended diets. Much more research needs to be done, but the past quarter century has proven the interest and heuristic value, if not yet the ultimate validity, of the model.

  1. Twenty-five years of life lessons

    NARCIS (Netherlands)

    Smit, Annemieke; Dorren, Luuk; Noord, Van Hans; Veraart, Josja; Cusell, Casper; Sterk, Henk Pieter

    2017-01-01

    For 25 years, Physical Geography students of the University of Amsterdam have experienced a 6-week field training in the cuesta landscape in Luxembourg around Diekirch. They studied the geology of the Gutland and surrounding areas, such as Ardennes and Eiffel. They mapped geomorphological patterns,

  2. The impact of young age on locoregional recurrence after doxorubicin-based breast conservation therapy in patients 40 years old or younger: How young is 'young'?

    International Nuclear Information System (INIS)

    Oh, Julia L.; Bonnen, Mark; Outlaw, Elesyia D.; Schechter, Naomi R.; Perkins, George H.; Strom, Eric A.; Babiera, Gildy; Oswald, Mary Jane; Allen, Pamela K.; Thames, Howard D.; Buchholz, Thomas A.

    2006-01-01

    Purpose: The aim of this study was to investigate whether patients <35 years old have similar risk of locoregional recurrence after breast conservation therapy compared with patients 35 to 40 years old. Methods and materials: We retrospectively reviewed records of 196 consecutive patients ≤40 years old who received breast conservation therapy (BCT) from 1987 to 2000 for breast cancer and compared outcomes between patients <35 years old with patients 35 to 40 years old. The majority of patients received neoadjuvant chemotherapy as part of their treatment. Multivariate analysis was performed to assess risk factors for locoregional recurrence. Results: After a median follow-up of 64 months, 22 locoregional recurrences (LRR) were observed. Twenty patients developed locoregional recurrence as their first site of relapse. Two patients had bone-only metastases before their locoregional recurrence. On multivariate analysis, age <35 years was associated with a statistically significant increased risk of locoregional recurrence. The 5-year rate of locoregional control was 87.9% in patients <35 years old compared with 91.7% in patients 35 to 40 years old (p = 0.042). Conclusions: Our finding supports an increased risk of locoregional recurrence as a function of younger age after breast conservation therapy, even among young patients 40 years old and younger

  3. Orthostatic intolerance and postural tachycardia syndrome as suspected adverse effects of vaccination against human papilloma virus

    DEFF Research Database (Denmark)

    Brinth, Louise S; Pors, Kirsten; Theibel, Ann C

    2015-01-01

    of postural orthostatic tachycardia syndrome (POTS) rested on finding a sustained heart rate increment of >30min(-1) (>40min(-1) in adolescents) or to levels >120min(-1) during orthostatic challenge. RESULTS: 35 women aged 23.3±7.1 years participated. Twenty-five had a high level of physical activity before...... vaccination and irregular periods were reported by all patients not on treatment with oral contraception. Serum bilirubin was below the lower detection limit in 17 patients. Twenty-one of the referred patients fulfilled the criteria for a diagnosis of POTS (60%, 95%CI 43-77%). All patients had orthostatic...

  4. [Mantle cell lymphoma, response to treatment and prognosis in 45 patients].

    Science.gov (United States)

    Sorigue, Marc; Sancho, Juan-Manuel; García, Olga; Vila, Jordi; Moreno, Miriam; Ribera, Josep-Maria

    2016-07-01

    Mantle cell lymphoma (MCL) is a rare lymphoproliferative disorder, with frequent relapses and a poor prognosis. This study analyzes response to treatment and prognosis in a series of MCL patients. Retrospective study of MCL patients diagnosed in a single institution between 1996 and 2013. The cohort was divided according to the treatment received. Forty-five patients were included (32 male) with a median age of 66 years old. Twenty-one received intensive chemotherapy or chemoimmunotherapy (based on high-dose cytarabine), 13 semi-intensive (without high-dose cytarabine), 8 not intensive and 3 did not require treatment. Overall response rate was 85% in the intensive and 77% in the semi-intensive treatment groups. In multivariate analysis, intensive treatment was correlated with a longer progression-free survival (hazard ratio 9.8 [95% CI 2.7-35.5], P=.001) and overall survival (4.5 [1.2-17.8], P=.03). In this retrospective series of MCL patients, intensive treatment was correlated with better outcomes than the other treatment modalities. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  5. Five-year Local Control in a Phase II Study of Hypofractionated Intensity Modulated Radiation Therapy With an Incorporated Boost for Early Stage Breast Cancer

    International Nuclear Information System (INIS)

    Freedman, Gary M.; Anderson, Penny R.; Bleicher, Richard J.; Litwin, Samuel; Li Tianyu; Swaby, Ramona F.; Ma, Chang-Ming Charlie; Li Jinsheng; Sigurdson, Elin R.; Watkins-Bruner, Deborah; Morrow, Monica; Goldstein, Lori J.

    2012-01-01

    Purpose: Conventional radiation fractionation of 1.8-2 Gy per day for early stage breast cancer requires daily treatment for 6-7 weeks. We report the 5-year results of a phase II study of intensity modulated radiation therapy (IMRT), hypofractionation, and incorporated boost that shortened treatment time to 4 weeks. Methods and Materials: The study design was phase II with a planned accrual of 75 patients. Eligibility included patients aged ≥18 years, Tis-T2, stage 0-II, and breast conservation. Photon IMRT and an incorporated boost was used, and the whole breast received 2.25 Gy per fraction for a total of 45 Gy, and the tumor bed received 2.8 Gy per fraction for a total of 56 Gy in 20 treatments over 4 weeks. Patients were followed every 6 months for 5 years. Results: Seventy-five patients were treated from December 2003 to November 2005. The median follow-up was 69 months. Median age was 52 years (range, 31-81). Median tumor size was 1.4 cm (range, 0.1-3.5). Eighty percent of tumors were node negative; 93% of patients had negative margins, and 7% of patients had close (>0 and <2 mm) margins; 76% of cancers were invasive ductal type: 15% were ductal carcinoma in situ, 5% were lobular, and 4% were other histology types. Twenty-nine percent of patients 29% had grade 3 carcinoma, and 20% of patients had extensive in situ carcinoma; 11% of patients received chemotherapy, 36% received endocrine therapy, 33% received both, and 20% received neither. There were 3 instances of local recurrence for a 5-year actuarial rate of 2.7%. Conclusions: This 4-week course of hypofractionated radiation with incorporated boost was associated with excellent local control, comparable to historical results of 6-7 weeks of conventional whole-breast fractionation with sequential boost.

  6. Five-year Local Control in a Phase II Study of Hypofractionated Intensity Modulated Radiation Therapy With an Incorporated Boost for Early Stage Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Freedman, Gary M., E-mail: Gary.Freedman@uphs.upenn.edu [Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Anderson, Penny R. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Bleicher, Richard J. [Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Litwin, Samuel; Li Tianyu [Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Swaby, Ramona F. [Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Ma, Chang-Ming Charlie; Li Jinsheng [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Sigurdson, Elin R. [Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Watkins-Bruner, Deborah [School of Nursing, Emory University, Atlanta, Georgia (United States); Morrow, Monica [Department of Surgical Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Goldstein, Lori J. [Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States)

    2012-11-15

    Purpose: Conventional radiation fractionation of 1.8-2 Gy per day for early stage breast cancer requires daily treatment for 6-7 weeks. We report the 5-year results of a phase II study of intensity modulated radiation therapy (IMRT), hypofractionation, and incorporated boost that shortened treatment time to 4 weeks. Methods and Materials: The study design was phase II with a planned accrual of 75 patients. Eligibility included patients aged {>=}18 years, Tis-T2, stage 0-II, and breast conservation. Photon IMRT and an incorporated boost was used, and the whole breast received 2.25 Gy per fraction for a total of 45 Gy, and the tumor bed received 2.8 Gy per fraction for a total of 56 Gy in 20 treatments over 4 weeks. Patients were followed every 6 months for 5 years. Results: Seventy-five patients were treated from December 2003 to November 2005. The median follow-up was 69 months. Median age was 52 years (range, 31-81). Median tumor size was 1.4 cm (range, 0.1-3.5). Eighty percent of tumors were node negative; 93% of patients had negative margins, and 7% of patients had close (>0 and <2 mm) margins; 76% of cancers were invasive ductal type: 15% were ductal carcinoma in situ, 5% were lobular, and 4% were other histology types. Twenty-nine percent of patients 29% had grade 3 carcinoma, and 20% of patients had extensive in situ carcinoma; 11% of patients received chemotherapy, 36% received endocrine therapy, 33% received both, and 20% received neither. There were 3 instances of local recurrence for a 5-year actuarial rate of 2.7%. Conclusions: This 4-week course of hypofractionated radiation with incorporated boost was associated with excellent local control, comparable to historical results of 6-7 weeks of conventional whole-breast fractionation with sequential boost.

  7. Parapneumonic effusions in children: five years’ experience

    Directory of Open Access Journals (Sweden)

    Atilla Cifci

    2017-12-01

    Full Text Available Aim: Most severe complication of respiratory tract infections that causing morbidity and mortality in children is parapneumonic effusion(PPE. PPE is a pleural exudate that is related with primary pneumonia. The early and appropriate antibiotic treatment is very important in follow-up of patients who are diagnosed as parapneumonic effusion and also the timing of interventional and surgical treatment is important to decrease morbidity and mortalitiy in whom clinical and laboratory findings are not cured enough. Materials and Methods: In this study, the clinical and laboratory findings of parapneumonic effusion one hundred patients applied to one center in five years time are discussed. Results: The mean age of patients were 52 months(1.5-156, 52 were male(52%.The 71% of patients were smaller than five years old. The mean duration of hospitalization of patients were 19.6 days(1-45 days. Most frequent spymptom in application was fever, most frequent sign were tachycardia and retractions, most frequent laboratory anormality was high white blood count. The most frequent microorganism in pleural fluid culture was S.aureus. Conclusion: The determination of pathogens causing parapneumonic effusions in our country is very important for starting most suitable treatment early and to decrease morbidity and mortality. [J Contemp Med 2017; 7(4.000: 340-347

  8. The computer-based Symbol Digit Modalities Test: establishing age-expected performance in healthy controls and evaluation of pediatric MS patients.

    Science.gov (United States)

    Bigi, Sandra; Marrie, R A; Till, C; Yeh, E A; Akbar, N; Feinstein, A; Banwell, B L

    2017-04-01

    Decreased information processing speed (IPS) is frequently reported in pediatric multiple sclerosis (MS) patients. The computerized version of the Symbol Digit Modalities Test (c-SDMT) measures IPS over eight consecutive trials per session and additionally captures changes in performance within the session. Here, we establish normative c-SDMT performance and test-retest reliability in healthy children (HC) and explore differences in the overall c-SDMT-performance between HC and MS patients. This cross-sectional study included 478 HC (237 female, 49.5%) divided into five age groups (2 years each), and 27 MS patients (22 female, 81.5%) aged 8-18 years. The average time to complete the c-SDMT increased with age (|r| 0.70, 95% CI -0.74, -0.64). Test-retest reliability was high (ICC = 0.91) in HC. The total time to complete the c-SDMT did not differ between children with MS and sex- and age- matched HC (p = 0.23). However, MS patients were less likely to show faster performance across all the successive eight trials compared to HC (p = 0.0001). Healthy children demonstrate faster IPS with increasing age, as well as during successive trials of the c-SDMT. The inability of pediatric MS patients to maintain the increase in processing speed over successive trials suggests a reduced capacity for procedural learning, possibly resulting from cognitive fatigue.

  9. Nutritional status and associated factors among children less than five years of age in tehsil Zarghoon town, District Quetta, Baluchistan

    International Nuclear Information System (INIS)

    Achakzai, P.; Khan, R.

    2016-01-01

    Background: Globally, more than one-third of mortalities in children under five years of age are attributable to malnutrition. The prevalence of malnourished children in Pakistan is inclining. A knowledge gap exists due to availability of limited literature about the nutritional status of children in rural Baluchistan. Therefore, this study assessed the magnitude and factors associated with nutritional status of children of less than five years of age in Tehsil Zarghoon Town of District Quetta. Methods: A community based cross-sectional study was conducted in two rural union councils of Tehsil Zarghoon Town of District Quetta, selected randomly. An existing questionnaire was modified and three research assistants were hired to collect data from 104 children, selected systematically. Data analysis was done using SPSS-20 and World Health Organization (WHO) Anthro software. Results: Results showed that the proportion of stunting and wasting in children comprising the study population was 48.1% and 9.7% respectively. A significant association was demonstrated between stunting and wasting and socio-demographic characteristics, child health characteristics and maternal health characteristics. Conclusion: It was concluded that the nutritional status of children under five years of age in Tehsil Zarghoon Town of district Quetta was unsatisfactory. Thus, community mobilization and incorporation of nutrition related activities in primary health care are recommended. (author)

  10. Age and associated fibrocystic changes are prognostically significant in patients with small node-negative (T1a,bN0) invasive breast cancer.

    Science.gov (United States)

    Durak, Merih Guray; Gonzalez-Angulo, Ana M; Hanrahan, Emer O; Broglio, Kristine R; Valero, Vicente; Hortobagyi, Gabriel N; Hunt, Kelly K; Sahin, Aysegul A

    2011-01-01

    Some patients with small (≤1.0 cm) node-negative (T1a,bN0) invasive breast cancer (IBC) who undergo only local therapy experience recurrences. There is limited information on prognostic factors in these patients. We sought to identify prognostic factors associated with disease-free survival (DFS) and overall survival (OS) in patients with T1a,bN0 IBC. Histologic sections from 273 T1a,bN0 IBC patients treated at M. D. Anderson Cancer Center (MDACC) between 1980 and 1999 were reviewed. Microscopic tumor size; multifocality; histologic type, grade of tumor; presence, type, grade of associated ductal carcinoma in situ (DCIS); presence of fibrocystic changes (FCC) with/without atypia; and lymphovascular invasion were identified. The Kaplan-Meier method was used to evaluate DFS and OS. Median patient age was 58 years, median follow-up period was 10.8 years, and median tumor size was 0.8 cm. Multifocal disease was identified in 26% of cases. At 10 years, the DFS and OS rates were 91% and 88%, respectively. Twenty-one percent of patients had extensive (>50%), and 30% had grade 3 DCIS. Nonproliferative FCC and proliferative FCC with/without atypia were present in 80%, 36%, and 38% of patients, respectively. In univariate analysis, age at diagnosis (p < 0.0001), grade (p = 0.015), and percent (p = 0.046) of DCIS were significantly associated with DFS; presence of FCC was associated with longer DFS and OS. In multivariable models, age and presence of FCC remained significantly associated with survival. Age at diagnosis and associated FCC are significant factors in predicting recurrence in patients with T1a,bN0 IBC. Adjuvant systemic therapy should be discussed with and considered for young patients with T1a,bN0 IBC. © 2011 Wiley Periodicals, Inc.

  11. In-111 platelets used in evaluation of emboli and thrombi in patients with cerebrovascular accident

    International Nuclear Information System (INIS)

    Kuecuek, N.O.; Aras, G.; Ibis, E.; Soylu, A.; Tascilar, N.; Yuecemen, N.; Mutluer, N.

    2000-01-01

    Studies with In-111 platelets were conducted to evaluate pulmonary embolus, deep vein thrombus and cardiac thrombus. This study aimed to evaluate active thrombi and possible new emboli in patients with cerebrovascular accident (CVA) in the first 24 hours by using autologous In-111 platelets. Twenty-five patients were included in the study. Carotid artery thrombi observed in 10 patients with this technique were confirmed by Doppler ultrasonography. Intracranial thrombi appearing in 3 cases were verified by X-ray computed tomography (CT). Scintigraphy of 8 patients who showed findings suggesting CVA in CT revealed no abnormal accumulation. This was attributed to the possibility that they were small in size, deep in location and/or were also quite aged. Abnormal accumulations observed in the lungs of 3 patients and in the mediastinum and pelvis in one patient were verified by other radiological methods. In-111 platelet study was found to be useful in patients with CVA to evaluate the active thrombi and possible emboli in the early period before clinical symptoms appeared. (author)

  12. Twenty years of home-based palliative care in Malappuram, Kerala, India: a descriptive study of patients and their care-givers.

    Science.gov (United States)

    Philip, Rekha Rachel; Philip, Sairu; Tripathy, Jaya Prasad; Manima, Abdulla; Venables, Emilie

    2018-02-14

    The well lauded community-based palliative care programme of Kerala, India provides medical and social support, through home-based care, for patients with terminal illness and diseases requiring long-term support. There is, however, limited information on patient characteristics, caregivers and programme performance. This study was carried out to describe: i) the patients enrolled in the programme from 1996 to 2016 and their diagnosis, and ii) the care-giver characteristics and palliative care support from nurses and doctors in a cohort of patients registered during 2013-2015. A descriptive study was conducted in the oldest community-based palliative clinic in Kerala. Data were collected from annual patient registers from 1996 to 2016 and patient case records during the period 2013-2015. While 91% of the patients registered in the clinic in 1996 had cancer, its relative proportion came down to 32% in 2016 with the inclusion of dementia-related illness (19%) cardiovascular accidents (17%) and severe mental illness (5%).Among patients registered during 2013-15, the median number of home visits from nurses and doctors in 12 months were five and one respectively. In the same cohort, twelve months' post-enrolment, 56% of patients died, 30% were in continuing in active care and 7% opted out. Those who opted out of care were likely to be aged care-giver at home, 85% of these care-givers being female. The changing dynamics over a 20-year period of this palliative care programme in Kerala, India, highlights the need for similar programmes to remain flexible and adapt their services in response to a growing global burden of Non Communicable Diseases. While a high death rate is expected in this population, the high proportion of patients choosing to stay in the programme suggests that home-based care is valued within this particular group. A diverse range of clinical and psycho-social support skills are required to assist families and their caregivers when caring for a

  13. Effect of alternative aging and accident simulations on polymer properties

    International Nuclear Information System (INIS)

    Bustard, L.D.; Chenion, J.; Carlin, F.; Alba, C.; Gaussens, G.; LeMeur, M.

    1985-05-01

    The influence of accident irradiation, steam, and chemical spray exposures on the behavior of twenty-three age-preconditioned polymer sample sets (twenty-one different materials) has been investigated. The test program varied the following conditions: (1) Accident simulations of irradiation and thermodynamic (steam and chemical spray) conditions were performed both sequentially and simultaneously. (2) Accident thermodynamic (steam and chemical spray) exposures were performed both with and without air present during the exposures. (3) Sequential accident irradiations were performed both at 28 0 C and 70 0 C. (4) Age preconditioning was performed both sequentially and simultaneously. (5) Sequential aging irradiations were performed both at 27 0 C and 70 0 C. (6) Sequential aging exposures were performed using two sequences: (1) thermal followed by irradiation and (2) irradiation followed by thermal. We report both general trends applicable to a majority of the tested materials as well as specific results for each polymer. Our data base consists of ultimate tensile properties at the completion of the accident exposure for three XLPO and XLPE, five EPR and EPDM, two CSPE (HYPALON), one CPE, one VAMAC, one polydiallylphtalate, and one PPS material. We also report bend test results at completion of the accident exposures for two TEFZEL materials and permanent set after compression results for three EPR, one VAMAC, one BUNA N, one SILICONE, and one VITON material

  14. Reduction of bulimia nervosa symptoms after psychostimulant initiation in patients with comorbid ADHD: five case reports.

    Science.gov (United States)

    Keshen, Aaron; Ivanova, Iryna

    2013-01-01

    Studies reveal a higher occurrence of bulimia nervosa (BN) in patients with attention deficit/hyperactivity disorder (ADHD) compared to controls. Due to this high degree of comorbidity, some clinicians have used psychostimulants in this population. The goal of this article is to describe five patients with comorbid BN and ADHD and their responses to a course of psychostimulants. After medication initiation, all five patients experienced a decrease in binge/purging and an improvement in ADHD symptoms. Overall, the medications were well tolerated. Possible mechanisms underlying the relationship between ADHD and BN, and words of caution are discussed. The need for clinical trials to further evaluate the efficacy of psychostimulants in this population is warranted.

  15. Influence Of Social Support, Duration Of Illness And Age On Quality ...

    African Journals Online (AJOL)

    This study investigated influence of social support, duration of illness, and age on the quality of life of breast cancer patients. Twenty women with breast cancer drawn from the University of Benin Teaching Hospital (UBTH) and Irrua Specialist Hospital participated in the study. One out of three hypotheses stated was ...

  16. Evaluation of the results from arthroscopic surgical treatment of rotator cuff injuries in patients aged 65 years and over

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2015-06-01

    Full Text Available OBJECTIVES: To evaluate the results from arthroscopic surgical treatment of rotator cuff injuries in patients aged 65 years and over.METHODS: Between 1998 and 2009, 168 patients underwent operations. Five cases were excluded. The remaining 163 patients were stratified according to their age group: 65-69 years (49.1%, 70-74 (26.4% and 75 years and over (24.5%. Their mean age was 71 years (range: 65-83. There were 63 male patients (38.7%. The mean length of time with pain, from the onset of symptoms to the surgery, was 23 months (range: 2 days to 240 months. Sixty-two patients (38% reported histories of trauma and 26 (16% reported that their pain worsened through exertion.RESULTS: From the UCLA criteria, 80.4% of the results were excellent, 16% good, 1.8% fair and 1.8% poor. Complications occurred in 11%. The final clinical result did not show any correlation with age progression, injury size or tendons affected. However, there was a significant association (p < 0.001 between the presence of trauma and larger injuries. The length of time between the onset of symptoms and the surgical procedure had a significant relationship (p < 0.027 with the postoperative results: the longer this time was, the worse the results were.CONCLUSION: Arthroscopic treatment of rotator cuff injuries in patients aged 65 years and over presented excellent and good results in 96.4% of the cases, according to the UCLA assessment, with a low complication rate. Advanced age did not show any influence on the postoperative clinical evolution, but the earlier the surgical treatment was instituted, the better the results were.

  17. Dental Implants in an Aged Population: Evaluation of Periodontal Health, Bone Loss, Implant Survival, and Quality of Life.

    Science.gov (United States)

    Becker, William; Hujoel, Philippe; Becker, Burton E; Wohrle, Peter

    2016-06-01

    To evaluate aged partially and fully edentulous patients who received dental implants and were maintained over time. Further, to determine how the partially and edentulous ageing populations (65 and above) with dental implants maintain bone levels, proper oral hygiene, and perceive benefits of dental implants. Since 1995, patients receiving dental implants have been prospectively entered into an Access-based computerized program (Triton Tacking System). Patient demographics (age, sex), bone quality, quantity, implant location, and type of surgery have been continuously entered into the database. The database was queried for patients receiving implants (first stage) between 66 and 93 years of age. Thirty-one patients were within this age group. Twenty-five patients returned to the clinic for periodontal and dental implant evaluation. The Periodontal Index was used to evaluate selected teeth in terms of probing depth, bleeding on probing, plaque accumulation, and mobility. Using NIH Image J, radiographs taken at second stage and last examination were measured for changes in interproximal bone levels. Once identified, each patient anomalously filled out an abbreviated quality of health life form. Due to small sample size, descriptive statistics were used to compare clinical findings. Fifteen males ranging from 78 to 84 (mean age 84 years) years and 16 females from 66 to 93 (mean age 83 years) (age range 66-93) were contacted by phone or mail and asked to return to our office for a re-examination. For this group, the first dental implants were placed in 1996 (n = initial two implants) and continuously recorded through 2013 (n = last seven implants). Thirty-one patients received a total of 84 implants. Two patients were edentulous, and the remaining were partially edentulous. Four implants were lost. Between implant placement and 6- to 7-year interval, 13 patients with 40 implants had a cumulative survival rate of 94.6%. Of the original group (n = 33), three

  18. Natural history of diabetes mellitus with special reference to age of onset and vascular complications.

    Science.gov (United States)

    Goto, Y; Toyota, T; Masuda, M; Komatsu, K; Kuriki, A

    1976-06-01

    Age and sex distribution of diabetics, seasonal incidence of diabetes, grade of hyperglycemia, frequency of vascular complications and daily living conditions were studied of 2771 diabetic patients experienced at five clinics. The cases consisted of 1587 male and 1184 female diabetics. The distribution of age of diabetes onset revealed that males predominate among diabetics but females predominate among child diabetics, and that the precentage of child was extremely low. This pattern was emphasized as characteristic of Japanese diabetic population. Distribution of fasting blood sugar at the diagnosis of diabetes was compared among the age groups of diabetes-onset and the results showed that percentage of the value exceeding 300 mg/100 ml was highest in the under 10 year-onset cases and decreased with age. The frequency of diabetic retinopathy and of ischemic ECG changes was analysed from the view point of age of diabetes onset and also the duration of the disease. The frequency of the retinopathy at the diabetes-onset was zero in the under 10 year-onset cases, 4.2% in the 10s-onset cases and increased with age. The longer the duration of the disease the higher the frequency of the retinopathy was. This increase along with the duration was most remarkable in the 10s- and 20s-onset cases and less remarkable in the 30s-onset cases. The retinopathy was significantly more frequent in female diabetics. Daily of the patients were studied by a questionnaire and the analysis of 1022 cases with diabetes of more than three years revealed that cases of patients working uneventfully and/or feeling fit were most frequent among the 30s- or 40s-onset cases and that cases of bed-disability were frequent among the cases whose diabetes was found in their twenties or younger. This study showed that the prognosis of the patients is quite different according to whether their diabetes occurred before of after 30 years of age.

  19. SPECT of aged backache patients

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Shigehiko; Nishikimi, Junzo; Mizuno, Naokado; Watanabe, Kentaro; Kondo, Masaki; Ozaki, Satoshi; Urasaki, Tetsuya; Muro, Toshiyuki [Prefectural Tajimi Hospital, Gifu (Japan)

    1995-12-01

    Single photon emission computed tomography (SPECT) using {sup 99m}Tc-HMDP was performed on 53 middle-aged or elderly patients (male 20, female, 33; age range, 40-80 years old) with lumbago, i.e., 25 patients with lumbar spondylosis, 15 with lumbar degenerative spondylolisthesis, 4 with spondylolytic spondylolisthesis, 3 with compression fracture, 3 with pulurent spondylitis, 2 with spondylous osteoporosis, and 1 with spinal osteodesmosis. {sup 99m}Tc-HMDP (740 MBq) was intravenously injected and regular SPECT was performed at 3 hours. Gamma camera was performed for about 10 seconds with 5deg intervals, and 36 steps (180deg) of collection was completed after about 6 minutes. The radioisotope accumulation, the presence or absence of sthenia, and its site were evaluated. Forty-seven (88.7%) patients showed excessive accumulation, i.e., 40 (75.5%) in peripheral vertebral osteophyte, 31 (58.5%) in vertebral articulations, and 10 (18.9%) in whole vertebral body. Significantly increased bilateral excessive accumulation was admitted in the vertebral articulations of sliding disc in degenerative spondylolisthesis. SPECT is considered useful in understanding the pathophysiology of degenerative lumber diseases. (S.Y.).

  20. Age-specific mortality among TB patients in Denmark 1998-2010

    DEFF Research Database (Denmark)

    Fløe, Andreas; Løkke, Anders; Ibsen, Rikke

    Objective: To evaluate the age-specific mortality in a national TB cohort, and to estimate relative age-specific mortality compared with matched controls, in a retrospective case-control study. Methods: Using Danish National Patient Registry, we retrospectively identified TB-patients between 1998...... to matched controls. While the difference in survival is substantial among elderly patients, a high relative risk of dying is particularly of concern among young and middle-aged adult TB patients....

  1. Five-year experience of critical incidents associated with patient-controlled analgesia in an Irish University Hospital.

    LENUS (Irish Health Repository)

    Ahmad, I

    2012-02-01

    BACKGROUND: Patient-controlled analgesia (PCA) is a common and effective means of managing post-operative pain. We sought to identify factors that may lead to critical incidents (CIs) in patient safety when using PCA in our institution. METHODS: An observational study of prospectively collected data of patients who received PCA from 2002 to 2006 was performed. All CIs were documented and analysed by staff members of the acute pain service (APS). Cause analysis of CIs was undertaken to determine if measures can be instituted to prevent recurrence of similar events. RESULTS: Over eight thousand patients (8,240) received PCA. Twenty-seven CIs were identified. Eighteen were due to programming errors. Other CIs included co-administration of opioids and oversedation. CONCLUSION: In our institution, the largest contributory factor to CIs with PCAs was programming error. Strategies to minimize this problem include better education and surveillance.

  2. Vitamin E diffused highly cross-linked polyethylene in total hip arthroplasty at five years

    DEFF Research Database (Denmark)

    Nebergall, Audrey K; Greene, M. E.; Laursen, M B

    2017-01-01

    Aims: The objective of this five-year prospective, blinded, randomised controlled trial (RCT) was to compare femoral head penetration into a Vitamin E diffused highly cross-linked polyethylene (HXLPE) liner with penetration into a medium cross-linked polyethylene control liner using......, ArComXL. This is the longest-term RCT comparing the wear performance and clinical outcome of Vitamin E diffused HXLPE with a previous generation of medium cross-linked polyethylene....... radiostereometric analysis. Patients and Methods: Patients scheduled for total hip arthroplasty (THA) were randomised to receive either the study E1 (32 patients) or the control ArComXL polyethylene (35 patients). The median age (range) of the overall cohort was 66 years (40 to 76). Results: The five-year median...

  3. Frontal dopamine D(2/3) receptor binding in drug-naive first-episode schizophrenic patients correlates with positive psychotic symptoms and gender

    DEFF Research Database (Denmark)

    Glenthoj, Birte Y; Mackeprang, Torben; Svarer, Claus

    2006-01-01

    BACKGROUND: The aim of the study was to examine extrastriatal dopamine D(2/3) receptor binding and psychopathology in schizophrenic patients, and to relate binding potential (BP) values to psychopathology. METHODS: Twenty-five drug-naive schizophrenic patients and 20 healthy controls were examined...

  4. Analysis of bone mineral density of human bones for strength ...

    Indian Academy of Sciences (India)

    The bone density (BMD) is a medical term normally referring to the amount of mineral matter per square centimetre of bones. Twenty-five patients (18 female and 7 male patients with a mean age of 71.3 years) undergoing both lumbar spine DXA scans and computed tomography imaging were evaluated to determine if HU ...

  5. Space Deficits in Parkinson’s Disease Patients: Quantitative or Qualitative Differences from Normal Controls?

    Directory of Open Access Journals (Sweden)

    D. Natsopoulos

    1993-01-01

    Full Text Available Twenty-seven patients with idiopathic Parkinson's disease (PD and the same number of normal controls (NCs were studied on a test battery including five conceptual categories of spatial ability. The two groups of subjects were matched for age, sex, years of education, socioeconomic status and non-verbal (Raven Standard Progressive Matrices intelligence. A multivariate analysis of variance (MANOVA showed that the PD patients performed less efficiently on almost all the tasks. A logistic regression analysis (LRA classified 81.48% of the subjects into the PD group and 92.59% into NC group, indicating that left-right and back-front Euclidean orientation, three dimensional mental rotation and visuospatial immediate recognition memory of mirror image patterns discriminate well between the two groups. Application of a structural model (confirmatory factor analysis demonstrated that both PD patients and the NC group stemmed from a homogeneous population, suggesting that the differences found between the two groups are of a quantitative rather than of a qualitative nature.

  6. Psychometric Properties of the Greek Version of the Patient Dignity Inventory in Advanced Cancer Patients.

    Science.gov (United States)

    Parpa, Efi; Kostopoulou, Sotiria; Tsilika, Eleni; Galanos, Antonis; Katsaragakis, Stylianos; Mystakidou, Kyriaki

    2017-09-01

    The patient dignity inventory (PDI) is an instrument to measure dignity distressing aspects at the end of life. The aims of the present study were the translation of the PDI in Greek language as well as to measure its psychometric aspects in a palliative care unit. A back-translation method was obtained at the Greek version. One hundred twenty advanced cancer patients completed the Greek version of the PDI, the Greek hospital anxiety and depression scale, the Greek schedule of attitudes toward hastened death (SAHD-Gr), and the Greek 12-item short form health survey. Confirmatory factor analysis failed to fit to the original instrument's structure and exploratory factor analysis was conducted revealing five factors ("Psychological Distress," "Body Image and Role Identity," "Self-Esteem," "Physical Distress and Dependency," and "Social Support"). The psychometric analysis of the PDI-Gr demonstrated a good concurrent validity, and the instrument discriminated well between subgroups of patients regarding age differences. Cronbach α were between 0.71 and 0.9 showing a good internal consistency. The Greek version of the PDI showed good psychometric properties in advanced cancer patients, supported the usefulness of the instrument assessing the sense of dignity distressing aspects of the terminally ill cancer patients. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  7. Visual function after strontium-90 plaque irradiation in patients with age-related subfoveal choroidal neovascularization

    Energy Technology Data Exchange (ETDEWEB)

    Jaakkola, A.; Tarkkanen, A.; Immonen, I. [Helsinki Univ. Central Hospital, Dept. of Ophthalmology (Finland); Heikkonen, J. [Helsinki Univ. Central Hospital, Dept. of Oncology (Finland)

    1999-05-01

    Purpose: To report 2-year visual and angiographic results in eyes treated with strontium plaque irradiation for subfoveal choroidal neovascular membranes (CNVM) in age-related macular degeneration. Methods: Twenty eyes with recent subfoveal CNVM were treated with local irradiation. The impact of the treatment on visual function was evaluated by visual acuity, contrast sensitivity and reading speed testing. Results: At 12 months visual acuity had improved or remained the same in 9/20 eyes (45%). At 24 months visual acuity was stable in 5/18 eyes (28%). Eyes with signs of CNVM regression (13/18,72%) lost a mean of 3.3 lines, but eyes with recurrent CNVM lost a mean of 5.1 lines of vision. The mean contrast sensitivity was better in the irradiated eyes than in the fellow eyes with late age-related macular degeneration at 24 months. Six of 17 irradiated eyes (35%) could read at least some words at 24 months. Conclusion: Visual function decreases in patients treated with strontium irradiation, but less in eyes showing regression of the CNVM than in eyes with further growth of the CNVM. (au) 20 refs.

  8. Colorectal cancer patients in a tertiary referral centre in Malaysia: a five year follow-up review.

    Science.gov (United States)

    Rashid, Mohd Radzniwan A; Aziz, Aznida Firzah Abdul; Ahmad, Saharuddin; Shah, Shamsul Azhar; Sagap, Ismail

    2009-01-01

    Colorectal cancer (CRC) is one of the major malignancies in the world. In Malaysia, CRC is fast becoming the commonest cause of cancer death. Its etiology is complex, involving both environmental and genetic factors. This study looked at the profile and outcome of five-year follow-up of patients with CRC. Retrospective case review study done on CRC patients at University Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia. Patientsandapos; socio-demographic characteristics, modalities of treatment, cancer characteristics and outcome at 5-year follow up were extracted from the case records. A total of 107 case records of patients were analyzed. Peak age of CRC presentation was 40-69 years (71.1%). Male to female ratio was 1.2:1 with Chinese predominance (52.3%). Anaemia and its related symptoms including per rectal bleeding was the commonest clinical presentation. The median duration of clinical presentation was 13 weeks (IQR 21.8). More than two-thirds presented as non-emergency cases (69.2%). Most patients presented with Dukes C stage (40.2%). The overall 5-year survival rate was 40% with local recurrence rate of 19.6%. Metastasis after curative-intend treatment (surgery with adjuvant therapy) developed in 26% of patients. Lower recurrence (p = 0.016, OR = 0.205) and metastatic disease (p = 0.02, OR = 0.24) found among the Chinese patients. Almost half of the patients defaulted follow up care (43%), most often within the first year of treatment (22.4%) and the Chinese were the least likely to default (p= 0.04, OR = 0.45). Socio-demographic profile of CRC patients in UKMMC is comparable to Asia pacific region. Apparent delay in seeking treatment gives rise to poor overall survival and local recurrence rates.

  9. Patient demands, lack of reciprocity, and burnout: a five-year longitudinal study about general practitioners.

    NARCIS (Netherlands)

    Bakker, A.B.; Schaufeli, W.B.; Sixma, H.J.; Bosveld, W.; Dierendonck, D. van

    2000-01-01

    This study among a sample of 207 general practitioners (GPs) uses a five-year longitudinal design to test a process model of burnout. On the basis of social exchange and equity theory, it is hypothesized and found that demanding patient contacts produce a lack of reciprocity in the GP-patient

  10. Poor postdischarge head growth is related to a 10% lower intelligence quotient in very preterm infants at the chronological age of five years.

    Science.gov (United States)

    Neubauer, Vera; Fuchs, Teresa; Griesmaier, Elke; Kager, Katrin; Pupp-Peglow, Ulrike; Kiechl-Kohlendorfer, Ursula

    2016-05-01

    This study examined the relationship between head growth and cognitive outcome at the age of five years in preterm infants born at less than 32 weeks of gestation from 2003 to 2009, as previous research has mostly focused on outcomes in toddlers. The head circumference of 273 very preterm infants born in Tyrol, Austria, was measured at birth, discharge, the corrected ages of three, 12 and 24 months and the chronological age of five years. Suboptimal head size was defined as a head circumference of more than one standard deviation below the mean. Full-scale intelligence quotient (IQ) at five years was determined using Wechsler Preschool and Primary Scales of Intelligence, third edition. Infants with a suboptimal head size at the age of three months had a significantly lower median IQ than those with a normal head size (90 [20-122] versus 98 [20-138], p = 0.001) and from three months onwards they were more likely to exhibit cognitive delay. A suboptimal head size from the age of three months was consistently related to a 10% lower IQ, and this study adds further evidence that head growth failure, especially during the early postdischarge period, is related to impaired cognitive abilities. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  11. Electromyographic and computed tomographic findings in five patients with monomelic spinal muscular atrophy

    NARCIS (Netherlands)

    de Visser, M.; Ongerboer de Visser, B. W.; Verbeeten, B.

    1988-01-01

    Five patients with monomelic spinal muscular atrophy are described. Clinical features included insidious onset of wasting and weakness of one limb, lack of involvement of the cranial nerves, brain stem, pyramidal tracts and sensory system, and a stable condition over a period of 4-20 years. Clinical

  12. Fluvoxamine for blonanserin-associated akathisia in patients with schizophrenia: report of five cases

    Directory of Open Access Journals (Sweden)

    Hashimoto Kenji

    2010-04-01

    Full Text Available Abstract Background Atypical antipsychotic drugs have been reported to cause fewer incidences of extrapyramidal side effects (EPS than typical antipsychotic drugs, but adverse events such as akathisia have been observed even with atypical antipsychotic drugs. Although understanding of the pathophysiology of akathisia remains limited, it seems that a complex interaction of several neurotransmitter systems plays a role in its pathophysiology. The endoplasmic reticulum protein sigma-1 receptors have been shown to regulate a number of neurotransmitter systems in the brain. Methods We report on five cases in which monotherapy of the selective serotonin reuptake inhibitor and sigma-1 receptor agonist fluvoxamine was effective in ameliorating the akathisia of patients with schizophrenia treated with the new atypical antipsychotic drug blonanserin. Results The global score on the Barnes Akathisia Scale in five patients with schizophrenia treated with blonanserin rapidly decreased after fluvoxamine treatment. Conclusion Doctors should consider that fluvoxamine may be an alternative approach in treating akathisia associated with atypical antipsychotic drugs.

  13. The result of surgical treatment in patients with cerebral aneurysms in Maharaj Nakorn Chiang Mai Hospital: a report of 225 cases.

    Science.gov (United States)

    Watcharasaksilp, Wanarak; Limpastan, Kriengsak; Norasathada, Tanya; Vaniyapong, Tanat

    2013-07-01

    Evaluate the result of intracranial aneurysm surgery in Maharaj Nakorn Chiang Mai Hospital. A retrospective study ofpatients who underwent surgery for intracranial aneurysms between 2003 and 2007. The patients'age, gender, signs and symptoms, CT brain findings, Subarachnoid hemorrhage (SAH), World Federation of Neurosurgical Society grading (WFNS), and aneurysm location were studied and correlated with outcome after surgery. Two hundred twenty five patients ofintracranial aneurysm were operated on between 2003 and 2007. Two hundred nine patients (92%) had anterior circulation aneurysms and 18 (8%) had posterior circulation aneurysms. The outcome, as evaluated by Glasgow Outcome Scale (GOS), showed good recovery and moderate disability patients (142, 62.9%) were classified as favorable outcome group whereas patients with severe disability, vegetative state, and dead (83, 36.9%) were classified as unfavorable outcome. According to WFNS grading, the patients with unruptured aneurysm and WFNS grade 1-2 had favorable outcome in 116 patients (78.37%) and unfavorable outcome in 32 patients (21.62%). Whereas the patients with WFNS grade 3-5 had favorable outcome in 32 patients (33.76%) and unfavorable outcome in 51 patients (66.23%). This study of 225 cases revealed 142 cases with favorable outcome and 83 cases with unfavorable outcome. Factors that affected the outcome were WFNS grading and age.

  14. A five-year follow-up study of Swedish adults with gender identity disorder.

    Science.gov (United States)

    Johansson, Annika; Sundbom, Elisabet; Höjerback, Torvald; Bodlund, Owe

    2010-12-01

    This follow-up study evaluated the outcome of sex reassignment as viewed by both clinicians and patients, with an additional focus on the outcome based on sex and subgroups. Of a total of 60 patients approved for sex reassignment, 42 (25 male-to-female [MF] and 17 female-to-male [FM]) transsexuals completed a follow-up assessment after 5 or more years in the process or 2 or more years after completed sex reassignment surgery. Twenty-six (62%) patients had an early onset and 16 (38%) patients had a late onset; 29 (69%) patients had a homosexual sexual orientation and 13 (31%) patients had a non-homosexual sexual orientation (relative to biological sex). At index and follow-up, a semi-structured interview was conducted. At follow-up, 32 patients had completed sex reassignment surgery, five were still in process, and five-following their own decision-had abstained from genital surgery. No one regretted their reassignment. The clinicians rated the global outcome as favorable in 62% of the cases, compared to 95% according to the patients themselves, with no differences between the subgroups. Based on the follow-up interview, more than 90% were stable or improved as regards work situation, partner relations, and sex life, but 5-15% were dissatisfied with the hormonal treatment, results of surgery, total sex reassignment procedure, or their present general health. Most outcome measures were rated positive and substantially equal for MF and FM. Late-onset transsexuals differed from those with early onset in some respects: these were mainly MF (88 vs. 42%), older when applying for sex reassignment (42 vs. 28 years), and non-homosexually oriented (56 vs. 15%). In conclusion, almost all patients were satisfied with the sex reassignment; 86% were assessed by clinicians at follow-up as stable or improved in global functioning.

  15. Do schizophrenia patients age early?

    Science.gov (United States)

    Shivakumar, Venkataram; Kalmady, Sunil V; Venkatasubramanian, Ganesan; Ravi, Vasanthapuram; Gangadhar, Bangalore N

    2014-08-01

    The etiopathogenesis of schizophrenia is poorly understood. Within the proposed "neurodegeneration paradigm", observations have been put forth for "accelerated aging" in this disorder. This proposition is largely based on the neuroscience research that demonstrates progressive changes in brain as well as other systemic abnormalities supportive of faster aging process in patients with this disorder. In this review, we have summarized the literature related to the concept of early aging in schizophrenia. These studies include P300 abnormalities & visual motion discrimination, neuroimaging findings, telomere dynamics as well as neuropathology of related brain regions. We also propose a role of vitamin D, neuroimmunological changes and elevated oxidative stress as well as mitochondrial dysfunction in addition to the above factors with 'vitamin-D deficiency' as the central paradox. Put together, the evidence supporting early aging in schizophrenia is compelling and this requires further systematic studies. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Professional and social activity of patients after heart transplant.

    Science.gov (United States)

    Marcinkowska, Urszula; Kukowka, Karol; Gałeczka, Michał; Pudlo, Robert; Zakliczyński, Michał; Zembala, Marian

    2015-01-01

    The aim of the study is to describe both professional and social activities of patients after heart transplant. Ninety-five heart transplant patients treated at the Silesian Center for Heart Diseases in Zabrze were surveyed, comprising 29 women (30.5%) and 66 men (69.5%). The average age of respondents was 54.3 years old (standard deviation (SD) = 15 years); the average period that had elapsed since the heart transplant was 7.1 years (SD = 4 years). We designed a questionnaire as a tool for collecting information from patients. Twenty-five percent of patients worked at the time of completion of the questionnaire. Eighty percent of those patients were working before and after the transplant, 20%--only after transplantation (p surveyed, 52.5% said that their financial situation had not changed whereas 34.5% of those surveyed reported a change for the worse. Thirty-seven percent of respondents reported changes in family relationships. Seventy-seven percent reported that they received help from family members, as compared with 19% who did not. Only 25.3% of the patients treated at the Silesian Centre for Heart Diseases after heart transplant are employed and it is one of the lowest employment rates in this category of patients in Europe. One third of working patients have the same work place as they had before their operation. Heart transplant is a cause of changes in family relationships. Most often family bonds are strengthened but sometimes family members become nervous, impatient and unwilling to talk about the transplant. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  17. Large meta-analysis of genome-wide association studies identifies five loci for lean body mass.

    Science.gov (United States)

    Zillikens, M Carola; Demissie, Serkalem; Hsu, Yi-Hsiang; Yerges-Armstrong, Laura M; Chou, Wen-Chi; Stolk, Lisette; Livshits, Gregory; Broer, Linda; Johnson, Toby; Koller, Daniel L; Kutalik, Zoltán; Luan, Jian'an; Malkin, Ida; Ried, Janina S; Smith, Albert V; Thorleifsson, Gudmar; Vandenput, Liesbeth; Hua Zhao, Jing; Zhang, Weihua; Aghdassi, Ali; Åkesson, Kristina; Amin, Najaf; Baier, Leslie J; Barroso, Inês; Bennett, David A; Bertram, Lars; Biffar, Rainer; Bochud, Murielle; Boehnke, Michael; Borecki, Ingrid B; Buchman, Aron S; Byberg, Liisa; Campbell, Harry; Campos Obanda, Natalia; Cauley, Jane A; Cawthon, Peggy M; Cederberg, Henna; Chen, Zhao; Cho, Nam H; Jin Choi, Hyung; Claussnitzer, Melina; Collins, Francis; Cummings, Steven R; De Jager, Philip L; Demuth, Ilja; Dhonukshe-Rutten, Rosalie A M; Diatchenko, Luda; Eiriksdottir, Gudny; Enneman, Anke W; Erdos, Mike; Eriksson, Johan G; Eriksson, Joel; Estrada, Karol; Evans, Daniel S; Feitosa, Mary F; Fu, Mao; Garcia, Melissa; Gieger, Christian; Girke, Thomas; Glazer, Nicole L; Grallert, Harald; Grewal, Jagvir; Han, Bok-Ghee; Hanson, Robert L; Hayward, Caroline; Hofman, Albert; Hoffman, Eric P; Homuth, Georg; Hsueh, Wen-Chi; Hubal, Monica J; Hubbard, Alan; Huffman, Kim M; Husted, Lise B; Illig, Thomas; Ingelsson, Erik; Ittermann, Till; Jansson, John-Olov; Jordan, Joanne M; Jula, Antti; Karlsson, Magnus; Khaw, Kay-Tee; Kilpeläinen, Tuomas O; Klopp, Norman; Kloth, Jacqueline S L; Koistinen, Heikki A; Kraus, William E; Kritchevsky, Stephen; Kuulasmaa, Teemu; Kuusisto, Johanna; Laakso, Markku; Lahti, Jari; Lang, Thomas; Langdahl, Bente L; Launer, Lenore J; Lee, Jong-Young; Lerch, Markus M; Lewis, Joshua R; Lind, Lars; Lindgren, Cecilia; Liu, Yongmei; Liu, Tian; Liu, Youfang; Ljunggren, Östen; Lorentzon, Mattias; Luben, Robert N; Maixner, William; McGuigan, Fiona E; Medina-Gomez, Carolina; Meitinger, Thomas; Melhus, Håkan; Mellström, Dan; Melov, Simon; Michaëlsson, Karl; Mitchell, Braxton D; Morris, Andrew P; Mosekilde, Leif; Newman, Anne; Nielson, Carrie M; O'Connell, Jeffrey R; Oostra, Ben A; Orwoll, Eric S; Palotie, Aarno; Parker, Stephen C J; Peacock, Munro; Perola, Markus; Peters, Annette; Polasek, Ozren; Prince, Richard L; Räikkönen, Katri; Ralston, Stuart H; Ripatti, Samuli; Robbins, John A; Rotter, Jerome I; Rudan, Igor; Salomaa, Veikko; Satterfield, Suzanne; Schadt, Eric E; Schipf, Sabine; Scott, Laura; Sehmi, Joban; Shen, Jian; Soo Shin, Chan; Sigurdsson, Gunnar; Smith, Shad; Soranzo, Nicole; Stančáková, Alena; Steinhagen-Thiessen, Elisabeth; Streeten, Elizabeth A; Styrkarsdottir, Unnur; Swart, Karin M A; Tan, Sian-Tsung; Tarnopolsky, Mark A; Thompson, Patricia; Thomson, Cynthia A; Thorsteinsdottir, Unnur; Tikkanen, Emmi; Tranah, Gregory J; Tuomilehto, Jaakko; van Schoor, Natasja M; Verma, Arjun; Vollenweider, Peter; Völzke, Henry; Wactawski-Wende, Jean; Walker, Mark; Weedon, Michael N; Welch, Ryan; Wichmann, H-Erich; Widen, Elisabeth; Williams, Frances M K; Wilson, James F; Wright, Nicole C; Xie, Weijia; Yu, Lei; Zhou, Yanhua; Chambers, John C; Döring, Angela; van Duijn, Cornelia M; Econs, Michael J; Gudnason, Vilmundur; Kooner, Jaspal S; Psaty, Bruce M; Spector, Timothy D; Stefansson, Kari; Rivadeneira, Fernando; Uitterlinden, André G; Wareham, Nicholas J; Ossowski, Vicky; Waterworth, Dawn; Loos, Ruth J F; Karasik, David; Harris, Tamara B; Ohlsson, Claes; Kiel, Douglas P

    2017-07-19

    Lean body mass, consisting mostly of skeletal muscle, is important for healthy aging. We performed a genome-wide association study for whole body (20 cohorts of European ancestry with n = 38,292) and appendicular (arms and legs) lean body mass (n = 28,330) measured using dual energy X-ray absorptiometry or bioelectrical impedance analysis, adjusted for sex, age, height, and fat mass. Twenty-one single-nucleotide polymorphisms were significantly associated with lean body mass either genome wide (p lean body mass and in 45,090 (42,360 of European ancestry) subjects from 25 cohorts for appendicular lean body mass was successful for five single-nucleotide polymorphisms in/near HSD17B11, VCAN, ADAMTSL3, IRS1, and FTO for total lean body mass and for three single-nucleotide polymorphisms in/near VCAN, ADAMTSL3, and IRS1 for appendicular lean body mass. Our findings provide new insight into the genetics of lean body mass.Lean body mass is a highly heritable trait and is associated with various health conditions. Here, Kiel and colleagues perform a meta-analysis of genome-wide association studies for whole body lean body mass and find five novel genetic loci to be significantly associated.

  18. Quality of life and self-esteem in patients submitted to surgical treatment of skin carcinomas: long-term results.

    Science.gov (United States)

    Maciel, Paula Curitiba; Veiga-Filho, Joel; Carvalho, Marcelo Prado; Fonseca, Fernando Elias Martins; Ferreira, Lydia Masako; Veiga, Daniela Francescato

    2014-01-01

    Cancer is a multifactorial disease and skin carcinomas are the most common type of cancer. Assessing quality of life and self-esteem outcomes in skin cancer patients is important because these are indicators of the results of the treatment, translating how patients face their lives and their personal relationships. To assess the late impact of the surgical treatment of head and/or neck skin carcinomas on quality of life and self-esteem of the patients. Fifty patients with head or neck skin carcinomas were enrolled. Their age ranged between 30 and 75 years, 27 were men and 23 were women. Patients were assessed with regard to quality of life and self-esteem, preoperatively and five years postoperatively. Validated instruments were used: the MOS 36-item Short-form Health Survey (SF-36) and the Rosenberg Self-esteem/EPM-UNIFESP Scale. The Wilcoxon signed-rank test was used for the statistical analysis. Twenty-two patients completed the five-year follow-up, 54.5% women and 45.5% men. Compared to the preoperative assessment, patients had an improvement in mental health (p=0.011) and in self-esteem (p=0.002). There was no statistical difference with regard to the other domains of the SF-36. Patients submitted to surgical treatment of skin carcinoma improved mental health and self-esteem in the late postsurgical testing.

  19. Quality of life and self-esteem in patients submitted to surgical treatment of skin carcinomas: long-term results*

    Science.gov (United States)

    Maciel, Paula Curitiba; Veiga-Filho, Joel; de Carvalho, Marcelo Prado; Fonseca, Fernando Elias Martins; Ferreira, Lydia Masako; Veiga, Daniela Francescato

    2014-01-01

    BACKGROUND Cancer is a multifactorial disease and skin carcinomas are the most common type of cancer. Assessing quality of life and self-esteem outcomes in skin cancer patients is important because these are indicators of the results of the treatment, translating how patients face their lives and their personal relationships. OBJECTIVE To assess the late impact of the surgical treatment of head and/or neck skin carcinomas on quality of life and self-esteem of the patients. METHODS Fifty patients with head or neck skin carcinomas were enrolled. Their age ranged between 30 and 75 years, 27 were men and 23 were women. Patients were assessed with regard to quality of life and self-esteem, preoperatively and five years postoperatively. Validated instruments were used: the MOS 36-item Short-form Health Survey (SF-36) and the Rosenberg Self-esteem/EPM-UNIFESP Scale. The Wilcoxon signed-rank test was used for the statistical analysis. RESULTS Twenty-two patients completed the five-year follow-up, 54.5% women and 45.5% men. Compared to the preoperative assessment, patients had an improvement in mental health (p=0.011) and in self-esteem (p=0.002). There was no statistical difference with regard to the other domains of the SF-36. CONCLUSION Patients submitted to surgical treatment of skin carcinoma improved mental health and self-esteem in the late postsurgical testing. PMID:25054746

  20. Age-related in-hospital mortality among patients with acute myocardial infarction

    International Nuclear Information System (INIS)

    Abid, A.R.; Rafique, S.; Ahmed, R.Z.; Anjum, A.H.; Tarin, S.M.A.

    2004-01-01

    Objective: To evaluate the in-hospital mortality of acute myocardial infarction among different age groups. Subjects and Methods: The subjects were 460 admitted patients of acute myocardial infarction who fulfilled our inclusion criteria. Patients were divided into four age groups. Group-I included patients in 20-40 years, group-II (41-50 years), group-III (51-60 years) and group-IV (>60 years). Mortality was compared between different age groups by Chi-square and linear-regression models. Results: The total in-hospital mortality was 16.7%. It gradually increased from 5.6% in group-I (20-40 years) patients to 21% in group-IV (>60 years) patients. While mortality in groups group-II (41-50 years) and group-III (51-60 years) patients was 16.7% and 18.6% respectively. A marked increase in mortality was noted with increase in age. Group- IV (>60 years) patients presented 2 hours late to the hospital than the group-I (20-40 years) patients. There was no statistical difference in site of infarction in different age groups. Old age (group-IV i.e. >60 years old) was more associated with heart failure (higher Killip class) on presentation. Lesser number of patients in group-IV received thrombolytic therapy than group-I. Only 31.09% patients in group-IV and 62.5% patients in group-I received streptokinase therapy respectively. Conclusion: In patients with acute myocardial infarction age was a powerful independent predictor of in-hospital mortality and complications. (author)

  1. Intravitreous injection of AAV2-sFLT01 in patients with advanced neovascular age-related macular degeneration: a phase 1, open-label trial.

    Science.gov (United States)

    Heier, Jeffrey S; Kherani, Saleema; Desai, Shilpa; Dugel, Pravin; Kaushal, Shalesh; Cheng, Seng H; Delacono, Cheryl; Purvis, Annie; Richards, Susan; Le-Halpere, Annaig; Connelly, John; Wadsworth, Samuel C; Varona, Rafael; Buggage, Ronald; Scaria, Abraham; Campochiaro, Peter A

    2017-07-01

    Long-term intraocular injections of vascular endothelial growth factor (VEGF)-neutralising proteins can preserve central vision in many patients with neovascular age-related macular degeneration. We tested the safety and tolerability of a single intravitreous injection of an AAV2 vector expressing the VEGF-neutralising protein sFLT01 in patients with advanced neovascular age-related macular degeneration. This was a phase 1, open-label, dose-escalating study done at four outpatient retina clinics in the USA. Patients were assigned to each cohort in order of enrolment, with the first three patients being assigned to and completing the first cohort before filling positions in the following treatment groups. Patients aged 50 years or older with neovascular age-related macular degeneration and a baseline best-corrected visual acuity score of 20/100 or less in the study eye were enrolled in four dose-ranging cohorts (cohort 1, 2 × 10 8 vector genomes (vg); cohort 2, 2 × 10 9 vg; cohort 3, 6 × 10 9 vg; and cohort 4, 2 × 10 10 vg, n=3 per cohort) and one maximum tolerated dose cohort (cohort 5, 2 × 10 10 vg, n=7) and followed up for 52 weeks. The primary objective of the study was to assess the safety and tolerability of a single intravitreous injection of AAV2-sFLT01, through the measurement of eye-related adverse events. This trial is registered with ClinicalTrials.gov, number NCT01024998. 19 patients with advanced neovascular age-related macular degeneration were enrolled in the study between May 18, 2010, and July 14, 2014. All patients completed the 52-week trial period. Two patients in cohort 4 (2 × 10 10 vg) experienced adverse events that were possibly study-drug related: pyrexia and intraocular inflammation that resolved with a topical steroid. Five of ten patients who received 2 × 10 10 vg had aqueous humour concentrations of sFLT01 that peaked at 32·7-112·0 ng/mL (mean 73·7 ng/mL, SD 30·5) by week 26 with a slight decrease to

  2. Early colonization with a group of Lactobacilli decreases the risk for allergy at five years of age despite allergic heredity.

    Directory of Open Access Journals (Sweden)

    Maria A Johansson

    Full Text Available BACKGROUND: Microbial deprivation early in life can potentially influence immune mediated disease development such as allergy. The aims of this study were to investigate the influence of parental allergy on the infant gut colonization and associations between infant gut microbiota and allergic disease at five years of age. METHODS AND FINDINGS: Fecal samples were collected from 58 infants, with allergic or non-allergic parents respectively, at one and two weeks as well as at one, two and twelve months of life. DNA was extracted from the fecal samples and Real time PCR, using species-specific primers, was used for detection of Bifidobacterium (B. adolescentis, B. breve, B. bifidum, Clostridium (C. difficile, a group of Lactobacilli (Lactobacillus (L. casei, L. paracasei and L. rhamnosus as well as Staphylococcus (S. aureus. Infants with non-allergic parents were more frequently colonized by Lactobacilli compared to infants with allergic parents (p = 0.014. However, non-allergic five-year olds acquired Lactobacilli more frequently during their first weeks of life, than their allergic counterparts, irrespectively of parental allergy (p = 0.009, p = 0.028. Further the non-allergic children were colonized with Lactobacilli on more occasions during the first two months of life (p = 0.038. Also, significantly more non-allergic children were colonized with B. bifidum at one week of age than the children allergic at five years (p = 0.048. CONCLUSION: In this study we show that heredity for allergy has an impact on the gut microbiota in infants but also that early Lactobacilli (L. casei, L. paracasei, L. rhamnosus colonization seems to decrease the risk for allergy at five years of age despite allergic heredity.

  3. New Korean Record of Twenty Eight Species of the Family Ichneumonidae (Hymenoptera

    Directory of Open Access Journals (Sweden)

    Choi, Jin-Kyung

    2014-04-01

    Full Text Available We report twenty eight ichneumonid species new to Korea. These species belong to seven subfamilies. Among them five subfamilies, Diacritinae Townes, 1965, Microleptinae Townes, 1958, Orthocentrinae F$\\ddot{o} $ 수식 이미지rster, 1869, Orthopelmatinae Schmiedeknecht, 1910, Phrudinae Townes and Townes, 1949, are newly introduced to Korean fauna. All specimens are based on the insect collection of animal systematic laboratory at the Yeungnam University Gyeongsan Campus. Photographs of habitus of newly recorded subfamilies, diagnosis of 28 species and host information are provided.

  4. Patient-physician trust: an exploratory study.

    Science.gov (United States)

    Thom, D H; Campbell, B

    1997-02-01

    Patients' trust in their physicians has recently become a focus of concern, largely owing to the rise of managed care, yet the subject remains largely unstudied. We undertook a qualitative research study of patients' self-reported experiences with trust in a physician to gain further understanding of the components of trust in the context of the patient-physician relationship. Twenty-nine patients participants, aged 26 to 72, were recruited from three diverse practice sites. Four focus groups, each lasting 1.5 to 2 hours, were conducted to explore patients' experiences with trust. Focus groups were audio-recorded, transcribed, and coded by four readers, using principles of grounded theory. The resulting consensus codes were grouped into seven categories of physician behavior, two of which related primarily to technical competence (thoroughness in evaluation and providing appropriate and effective treatment) and five of which were interpersonal (understanding patient's individual experience, expressing caring, communicating clearly and completely, building partnership/sharing power and honesty/respect for patient). Two additional categories were predisposing factors and structural/staffing factors. Each major category had multiple subcategories. Specific examples from each major category are provided. These nine categories of physician behavior encompassed the trust experiences related by the 29 patients. These categories and the specific examples provided by patients provide insights into the process of trust formation and suggest ways in which physicians could be more effective in building and maintaining trust.

  5. Tactical decisions of concentrate level, slaughter age and carcass weight of bulls of five beef breeds under Norwegian conditions

    Directory of Open Access Journals (Sweden)

    H. BONESMO

    2008-12-01

    Full Text Available Beef production based on suckler cow breeds is a relatively new production system in Norway as in most Nordic countries. To ensure the continuation of this production, profitable management practices designed for Norwegian conditions have to be established. Thus a simulation model was developed that integrates the daily feed intake, the daily live weight (LW gain, silage net energy concentration for beef production (feed units beef (FUb kg?1 dry matter and price, concentrate level and price, and carcass price for bulls of the country's five most common beef breeds. In this work the model was combined with production statistics to find general recommendations in the finishing of beef bulls under Norwegian conditions. Among all the five breeds the Limousin bulls had the highest estimated mean daily return and the Hereford bulls the lowest estimated mean daily return from 20 g concentrate kg?1 LW0.75 for the 940 FUb kg?1 silage dry matter, and from 40 g concentrate kg?1 LW0.75 for the 800 FUb kg?1 silage dry matter. Our estimated optimal slaughter ages and carcass weights shows that it pays to more intensively feed during the finishing period for all five breeds. Current farming practice in Norway for the five major breeds studied is that slaughter age is at least two months later with lighter carcass weights than the results expected from following our model estimated recommendations.

  6. Under-utilisation of preventive medication in patients with cardiovascular disease is greatest in younger age groups (PREDICT-CVD 15).

    Science.gov (United States)

    Mehta, Suneela; Wells, Sue; Riddell, Tania; Kerr, Andrew; Pylypchuk, Romana; Marshall, Roger; Ameratunga, Shanthi; Chan, Wing Cheuk; Thornley, Simon; Crengle, Sue; Harrison, Jeff; Drury, Paul; Elley, C Raina; Bell, Fionna; Jackson, Rod

    2011-06-01

    Blood pressure-lowering (BPL) and lipid-lowering (LL) medications together reduce estimated absolute five-year cardiovascular disease (CVD) risk by >40%. International studies indicate that the proportion of people with CVD receiving pharmacotherapy increases with advancing age. To compare BPL and LL medications, by sociodemographic characteristics, for patients with known CVD in primary care settings. The study population included patients aged 35-74 with known CVD assessed in primary care from July 2006 to October 2009 using a web-based computerised decision support system (PREDICT) for risk assessment and management. Clinical data linked anonymously to national sociodemographic and pharmaceutical dispensing databases. Differences in dispensing BPL and LL medications in six months before first PREDICT assessment was analysed according to age, sex, ethnicity and deprivation. Of 7622 people with CVD, 1625 <55 years old, 2862 were women and 4609 lived in deprived areas (NZDep quintiles 4/5). The study population included 4249 European, 1556 Maori, 1151 Pacific and 329 Indian peoples. BPL medications were dispensed to 81%, LL medications to 73%, both BPL and LL medications to 67%, and 87% received either class of medication. Compared with people aged 65-75, people aged 35-44 were 30-40% less likely and those aged 45-54 were 10-15% less likely to be dispensed BPL, LL medications or both. There were minimal differences in likelihood of dispensing according to sex, ethnicity or deprivation. BPL and LL medications are under-utilised in patients with known CVD in New Zealand. Only two-thirds of patients in this cohort are on both. Younger patients are considerably less likely to be on recommended medications.

  7. Age at menarche, age at menopause and duration of fertility as risk factors for osteoporosis.

    Science.gov (United States)

    Sioka, C; Fotopoulos, A; Georgiou, A; Xourgia, X; Papadopoulos, A; Kalef-Ezra, J A

    2010-02-01

    To investigate the relationship of osteopenia and osteoporosis in apparently healthy postmenopausal patients with age at menarche, age at menopause and duration of fertility. One hundred and twenty-four apparently healthy Greek postmenopausal women underwent spinal and hip X-ray absorptiometry scans. Among them, 47 were classified as normal (control group), 52 as osteopenic, and 25 as having osteoporosis. These groups were compared according to their age at menarche (three subgroups of 10-12, 13 and 14-16 years old), at menopause (three subgroups of 40-45, 46-50 and > or = 51 years old) and duration of fertility (four subgroups of 40 and 41-45 years). The groups were not found to differ statistically according to age and age at menarche. However, decreased bone mineral density was found in patients with duration of fertility not exceeding 30 years (p = 0.034) and age at menopause less than 45 years (p = 0.034). No association was found between bone mineral density in Greek postmenopausal women and either number of live births or lactation. In postmenopausal females, the cumulative exposure to endogenous estrogens, measured as years of menstruation, seems to be a significant protective factor against the development of postmenopausal osteoporosis. Age at menopause between 40 and 45 years, but not age at menarche, correlated with low bone mineral density in postmenopausal females.

  8. [Prevalence and characteristics of acute coronary syndromes in a sub-Saharan Africa population].

    Science.gov (United States)

    N'Guetta, R; Yao, H; Ekou, A; N'Cho-Mottoh, M P; Angoran, I; Tano, M; Konin, C; Coulibaly, I; Anzouan-Kacou, J B; Seka, R; Adoh, A M

    2016-04-01

    To assess prevalence, characteristics and management of acute coronary syndromes in sub-Saharan Africa population. Prospective survey from January, 2010 to December, 2013, carried out among patients aged 18 years old, admitted to intensive care unit of Abidjan Heart Institute for acute coronary syndrome (ACS). Four hundred and twenty-five (425) patients were enrolled in this study. Prevalence of ACS was 13.5%. Mean age was 55.4±11 years. Clinical presentation was predominantly ST-segment elevation myocardial infarction (STEMI) in 71.5% of subjects, non-ST-segment elevation acute coronary syndrome (NSTE-ACS) accounted for 28.5%. Two hundred and eighty patients (65.9%) were transferred by unsafe transportation. Among the 89 patients admitted within 12hours of the onset of symptoms, primary percutaneous coronary intervention was performed in 20 patients (22.5%), or 6.6% of STEMI as a whole. Twenty-five patients (8.2%) received fibrinolytic therapy with alteplase. In-hospital death rate was 10%. The prevalence of acute coronary syndromes is increasing in sub-Saharan Africa. Excessive delays of admission and limited technical facilities are the major difficulties of their management in our regions. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  9. A STUDY ON CUTANEOUS FUNGAL DISORDERS IN DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Sampath Kumar G

    2016-09-01

    Full Text Available BACKGROUND Skin problems are usually not considered and never attended in diabetics. They are usually neglected and they are only taken note of when they pose problems. Many of these skin problems that go undiagnosed diabetic patients later complicate diabetes and its treatment. The common skin infections that can cause major problems and are associated with increased blood glucose levels and Advanced Glycation Products (AGPs. Skin disorders in diabetics are usually consistent as in the medical literature, but the data is limited with respect to early stage skin disorders in diabetic patients. Awareness is needed for better understanding the importance of skin disorders in diabetes patients for prevention and management. MATERIALS AND METHODS This study was done in the Department of Dermatology, Travancore Medical College, Kollam. The study was done from June 2015 to December 2015. Sixty patients were identified and the study was conducted. INCLUSION CRITERIA The patients were known diabetic for at least five years. EXCLUSION CRITERIA Patients who were treated with immune suppressant drugs were not included in the present study. Skin scrapings were taken and were subjected to KOH preparation. The result that was available was taken for statistical analysis. The statistical analysis was done using the latest SPSS software 2015 (California. RESULTS In the present study, maximum number of fungal infections was seen in male sex, which amounted to forty one cases and was as in the female sex the number was nineteen. Out of the forty one male cases, maximum number of cases belonged to age group of forty to sixty years, which amounted to sixteen cases followed by age group sixty to eighty years, which amounted to fourteen cases followed by twenty to forty years, which amounted to seven cases. Age group zero to twenty years and age group of more than eighty years amounted to two cases each. In cases of females, age group forty to sixty years had maximum

  10. Outlook: The Next Twenty Years

    Energy Technology Data Exchange (ETDEWEB)

    Murayama, Hitoshi

    2003-12-07

    I present an outlook for the next twenty years in particle physics. I start with the big questions in our field, broken down into four categories: horizontal, vertical, heaven, and hell. Then I discuss how we attack the bigquestions in each category during the next twenty years. I argue for a synergy between many different approaches taken in our field.

  11. Compendium in astronomy a volume dedicated to professor John Xanthakis on the occasion of completing twenty-five years of scientific activities as fellow of the National Academy of Athens

    CERN Document Server

    Theocaris, Pericles; Mavridis, L

    1982-01-01

    When we first approached some colleagues allover the world to sound them about a volume dedicated to Professor John Xanthakis on the occasion of completing twenty-five years of scientific activities as fellow of the National Academy of Athens, any possible doubts as to the feasibility of the project were quickly dispelled by their warm and encouraging response. In a short time 50 authors from 15 countries, coming from a wide range of Professor Xanthakis' immediate colleagues, pupils and friends joined to produce the 36 contributions included in this volume. Some of those who where originally approached found themselves un­ able to contribute, because of the time-limit necessarily imposed. Happi­ ly, they were only few in number, and we should like to record our grat­ itude to them for their good wishes for the success of the venture. Their warm words were among the many sources of inspiring encouragement extended to us.

  12. Abnormal early gamma responses to emotional faces differentiate unipolar from bipolar disorder patients.

    Science.gov (United States)

    Liu, T Y; Chen, Y S; Su, T P; Hsieh, J C; Chen, L F

    2014-01-01

    This study investigates the cortical abnormalities of early emotion perception in patients with major depressive disorder (MDD) and bipolar disorder (BD) using gamma oscillations. Twenty-three MDD patients, twenty-five BD patients, and twenty-four normal controls were enrolled and their event-related magnetoencephalographic responses were recorded during implicit emotional tasks. Our results demonstrated abnormal gamma activity within 100 ms in the emotion-related regions (amygdala, orbitofrontal (OFC) cortex, anterior insula (AI), and superior temporal pole) in the MDD patients, suggesting that these patients may have dysfunctions or negativity biases in perceptual binding of emotional features at very early stage. Decreased left superior medial frontal cortex (smFC) responses to happy faces in the MDD patients were correlated with their serious level of depression symptoms, indicating that decreased smFC activity perhaps underlies irregular positive emotion processing in depressed patients. In the BD patients, we showed abnormal activation in visual regions (inferior/middle occipital and middle temporal cortices) which responded to emotional faces within 100 ms, supporting that the BD patients may hyperactively respond to emotional features in perceptual binding. The discriminant function of gamma activation in the left smFC, right medial OFC, right AI/inferior OFC, and the right precentral cortex accurately classified 89.6% of patients as unipolar/bipolar disorders.

  13. Breast cancer features in women under the age of 40 years

    Directory of Open Access Journals (Sweden)

    Deise Santiago Girão Eugênio

    Full Text Available Summary Objective: To describe the clinical features, imaging findings and pathological aspects of breast cancer diagnosed in women under the age of 40 years. Method: A retrospective, descriptive study was performed through analysis of medical records between November 2008 and August 2012. One hundred and twenty (120 patients were included, of whom 112 underwent mammography, 113 underwent ultrasonography, and 105 underwent magnetic resonance imaging (MRI. The histopathological data was obtained in most cases from post-surgical analysis, which was available for 113 patients. Results: The mean age at diagnosis of primary breast cancer was 34 years. Only 11 patients (9.0% had a family history of breast or ovarian cancer in first-degree relative. Ninety-two (92 patients sought medical attention after showing breast symptoms, and the presence of a palpable nodule was the main complaint. One hundred and twenty-two (122 primary tumors were diagnosed, of which 112 were invasive (95%. The most common histological type was invasive ductal carcinoma (73.8%. Luminal B was the predominant molecular subtype (42.6%. Ultrasonography was positive in 94.5% of the cases and the most common finding were nodules (94.8%. At mammography, the malignancy was observed in 92.8% and the presence of suggestive calcifications was the dominant feature. The MRI was positive in 98% of patients, and mass lesions were the most common. Conclusion: Most cases of breast cancer diagnosed in patients under the age of 40 years, in our population, had symptoms at diagnosis and tumor with more aggressive biological behavior. Despite the ultrasound has been the most widely used method, we found improved characterization of breast lesions when also used mammography and MRI.

  14. Parental questionnaire as a screening instrument for motor function at age five.

    Science.gov (United States)

    Nordbye-Nielsen, Kirsten; Kesmodel, Ulrik Schiøler

    2014-12-01

    No standardised method is used to determine motor function in children in general practice in Denmark. Our aim was to evaluate the correlation between a parental questionnaire assessing motor function at the age of five years and the clinical test Movement Assessment Battery for Children (M-ABC), and to assess whether one or more questions could be used to screen for motor problems at the age of five years. This study was based on a parental questionnaire containing ten questions. The M-ABC was used as the gold standard. n = 755 children. The Mann-Whitney rank sum test, Pearson's χ(2)-test, logistic regression analyses and sensitivity and specificity were used to assess the correlation between the questionnaire and the M-ABC test. The best screening tool was six questions in combination: sensitivity 39.8%, specificity 87.1%. Asking if a health professional ever expressed concern about the childs motor development had a sensitivity of 17.0% and a specificity of 93.9%. A parental questionnaire used as a screening instrument to identify children with motor problems has a reasonable specificity, but a low sensitivity. The six questions can be used to identify children who do not have motor function difficulties with a relatively high certainty, and it can fairly well identify children with motor function problems. This study was primarily supported by the Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA. Additional support was obtained from The Danish Health and Medicines Authority, the Lundbeck Foundation, Ludvig & Daara Elsass Foundation, the Augustinus Foundation, and Aase & Ejnar Danielsens Foundation. The Danish National Research Foundation has established the Danish Epidemiology Science Centre that initiated and created the Danish National Birth Cohort. The cohort is furthermore a result of a major grant from this Foundation. Additional support for the Danish National Birth Cohort is obtained from the Pharmacy Foundation, the Egmont

  15. Factors Associated with Streptococcal Bacteremia in Diarrheal Children under Five Years of Age and Their Outcome in an Urban Hospital in Bangladesh.

    Directory of Open Access Journals (Sweden)

    Abu Sadat Mohammad Sayeem Bin Shahid

    Full Text Available Although Streptococcal bacteremia is common in diarrheal children with high morbidity and mortality, no systematic data are available on Streptococcal bacteremia in diarrheal children. We sought to evaluate the factors associated with Streptococcal bacteremia in diarrheal children under five years of age and their outcome.We used an unmatched case-control design to investigate the associated factors with Streptococcal bacteremia in all the diarrheal children under five years of age through electronic medical record system of Dhaka hospital of International Centre for Diarrhoeal Disease Research, Bangladesh. We had simultaneously used a retrospective cohort design to further evaluate the outcome of our study children. All the enrolled children had their blood culture done between January 2010 and December 2012. Comparison was made among the children with (cases = 26 and without Streptococcal bacteremia (controls = 78. Controls were selected randomly from hospitalized diarrheal children under five years of age.Cases had proportionately higher deaths compared to controls, but it was statistically insignificant (15% vs. 10%, p = 0.49. The cases more often presented with severe dehydration, fever, respiratory distress, severe sepsis, and abnormal mental status compared to the controls (for all p<0.05. In the logistic regression analysis, after adjusting for potential confounders, it has been found that Streptococcal bacteremia in diarrheal children under five years of age was independently associated with nutritional edema (OR: 5.86, 95% CI = 1.28-26.80, hypoxemia (OR: 19.39, 95% CI = 2.14-175.91, fever (OR: 4.44, 95% CI = 1.13-17.42, delayed capillary refill time (OR: 7.00, 95% CI = 1.36-35.93, and respiratory distress (OR: 2.69, 95% CI = 1.02-7.12.The results of our analyses suggest that diarrheal children under five years of age presenting with nutritional edema, hypoxemia, fever, delayed capillary refill time, and respiratory distress may be at

  16. Five paradox on energy system management

    International Nuclear Information System (INIS)

    Frisch, J.R.

    1995-01-01

    Five paradox are detailed on energy management: internationalization of energy questions but always regional management is present, short term problems must be solved but without forgetting long term problems in environment, the third paradox is : we have time but we are in a hurry, we have reserves but ten, twenty or thirty years are necessary to adapt our energy system; the fourth paradox is : we cannot manage energy by managing only energy, for example : finances system development and environment importance. The last and fifth paradox is : the market, yes, but state too, as regulative force

  17. Are there any differences in acute adverse reactions among five low-osmolar non-ionic iodinated contrast media?

    Energy Technology Data Exchange (ETDEWEB)

    Gomi, Tatsuya; Nagamoto, Masashi; Hasegawa, Makoto; Katoh, Asako; Sugiyama, Miki; Murata, Nozomu; Kunihiro, Toshiyuki; Kohda, Ehiichi [Toho University Ohashi Medical Centre, Department of Radiology, Tokyo (Japan)

    2010-07-15

    The differences regarding adverse reactions in different low-osmolar non-ionic contrast media had not been investigated previously. Thus, the aims of this study were to identify differences in the incidence of adverse reactions in five different low-osmolar non-ionic contrast media. We prospectively recorded all adverse events associated with five different low-osmolar non-ionic contrast media used in 8,931 consecutive patients for CT. Patients were randomly assigned to five groups: iomeprol 300 mgI/ml, iopamidol 300 mgI/ml, iohexol 300 mgI/ml, iopromide 300 mgI/ml and ioversol 320 mgI/ml. Adverse events were observed in 241 patients (2.7%). The incidence of acute adverse reactions was significantly higher in the following groups: (1) iomeprol (3.9%) and iopromide (3.5%) groups, (2) patients aged 59 years or less (4.5%) compared with those aged 60 years or over (1.9%), (3) the first period (3.5%) compared with the late period (2.3%), (4) those with a past history of adverse reactions to contrast media (11.2%), and (5) patients receiving contrast media for the first time (3.3%) compared with those had received it previously (2.0%). The incidence of acute adverse reactions may be reduced in younger patients by using iopamidol, iohexol and ioversol. (orig.)

  18. Are there any differences in acute adverse reactions among five low-osmolar non-ionic iodinated contrast media?

    International Nuclear Information System (INIS)

    Gomi, Tatsuya; Nagamoto, Masashi; Hasegawa, Makoto; Katoh, Asako; Sugiyama, Miki; Murata, Nozomu; Kunihiro, Toshiyuki; Kohda, Ehiichi

    2010-01-01

    The differences regarding adverse reactions in different low-osmolar non-ionic contrast media had not been investigated previously. Thus, the aims of this study were to identify differences in the incidence of adverse reactions in five different low-osmolar non-ionic contrast media. We prospectively recorded all adverse events associated with five different low-osmolar non-ionic contrast media used in 8,931 consecutive patients for CT. Patients were randomly assigned to five groups: iomeprol 300 mgI/ml, iopamidol 300 mgI/ml, iohexol 300 mgI/ml, iopromide 300 mgI/ml and ioversol 320 mgI/ml. Adverse events were observed in 241 patients (2.7%). The incidence of acute adverse reactions was significantly higher in the following groups: (1) iomeprol (3.9%) and iopromide (3.5%) groups, (2) patients aged 59 years or less (4.5%) compared with those aged 60 years or over (1.9%), (3) the first period (3.5%) compared with the late period (2.3%), (4) those with a past history of adverse reactions to contrast media (11.2%), and (5) patients receiving contrast media for the first time (3.3%) compared with those had received it previously (2.0%). The incidence of acute adverse reactions may be reduced in younger patients by using iopamidol, iohexol and ioversol. (orig.)

  19. [Effectiveness of magnetotherapy in elderly hypertensive patients aging at different rates].

    Science.gov (United States)

    Abramovich, S G; Koriakina, A V; Brodach, L N; Akhmedzianov, Iu A; Makarychkin, S P

    2000-01-01

    Effectiveness of general magnetotherapy was studied in 84 patients with essential hypertension and 36 patients with isolated systolic arterial hypertension of old age. It is thought necessary to determine biological age of the cardiovascular system in hypertensive patients over 60 years of age to specify indications and contraindications to physiotherapy.

  20. Anemia and nutritional status of infants from two to five months of age treated in facilities of the Ministry of Health of Peru, 2012

    OpenAIRE

    Gómez-Guizado, Guillermo; Centro Nacional de Alimentación y Nutrición, Instituto Nacional de Salud. Lima, Perú. Médico cirujano especialista en Epidemiologia de Campo; Munares-García, Oscar; Centro Nacional de Alimentación y Nutrición, Instituto Nacional de Salud. Lima, Perú. Facultad de Medicina, Universidad Nacional Mayor de San Marcos. Lima, Perú. licenciado en Obstetricia, magíster en Salud Pública

    2014-01-01

    Objectives. Determine the characteristics of the levels of anemia in infants from two to five months of age treated in facilities of the Ministry of Health of Peru during 2012. Materials and methods. This cross-sectional study uses the nutritional status information system of the National Center for Food and Nutrition, National Institute of Health of Peru in 2012. Records of 7,513 infants from two to five months of age treated in small outpatient clinics, centers and hospitals of the Ministry...

  1. Experiences of 23 patients ≥ 90 years of age treated with radiation therapy

    International Nuclear Information System (INIS)

    Oguchi, Masahiko; Ikeda, Hiroshi; Watanabe, Toshikazu; Shikama, Naoto; Ohata, Takeo; Okazaki, Youichi; Kiyono, Kunihiro; Sone, Shusuke

    1998-01-01

    Purpose: To present 23 patients ≥ 90 years old treated with radiotherapy, and to retrospectively evaluate the results of radiotherapy and tolerance in these patients. Methods and Materials: The clinical records of 27 patients over 90 years of age who were treated with radiotherapy at the Department of Radiology, Shinshu University Hospital, and eight affiliated general hospitals from 1990 until 1995 were reviewed. The strategy of radiotherapy was individually planned depending on the stage of the disease and performance status (PS) of the patient; however, it was not modified, based solely on chronologic age. The overall survival rate and disease-free survival rate were determined using the Kaplan-Meier method. The Radiation Therapy Oncology Group scoring criteria of acute and late reactions of radiation therapy were used. Results: This group of patients accounted for 0.37% of all patients treated with radiotherapy in these hospitals. Of these, 23 patients in whom cancer was pathologically confirmed and whose follow-up data were available for retrospective analysis were included in the final evaluation of data. The age of the 23 patients ranged from 90 to 96 years (median 93). Tumor was untreated and in the early stage in five patients, locoregionally advanced in 13, recurrent in four, and systemic in one. Definitive radiation therapy was administered in 12 patients (13 sites), preoperative intent in one, and palliative intent in 10. The period of observation ranged from 2.5 to 6 years (median 18 months). Seven patients were alive for 15-67 months. Fourteen patients died because of intercurrent diseases or senility associated with active cancer, and two because of senility without evidence of cancer. The overall and relapse-free survival rates were 65% and 30% at 1 year and 30% and 21% at 2 years, respectively. Definitive radiation therapy was completed in 13 of 13 patients (100%), and local control was attained in 9 of 13 patients at 6 months (62%). Palliative

  2. Age Disparity in Palliative Radiation Therapy Among Patients With Advanced Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Jonathan [University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii (United States); Xu, Beibei [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Moores Cancer Center, University of California San Diego, La Jolla, California (United States); Yeung, Heidi N.; Roeland, Eric J. [Moores Cancer Center, University of California San Diego, La Jolla, California (United States); Division of Palliative Medicine, Department of Internal Medicine, University of California San Diego, La Jolla, California (United States); Martinez, Maria Elena [Moores Cancer Center, University of California San Diego, La Jolla, California (United States); Department of Family and Preventive Medicine, University of California San Diego, La Jolla, California (United States); Le, Quynh-Thu [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Mell, Loren K. [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Moores Cancer Center, University of California San Diego, La Jolla, California (United States); Murphy, James D., E-mail: j2murphy@ucsd.edu [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Moores Cancer Center, University of California San Diego, La Jolla, California (United States)

    2014-09-01

    Purpose/Objective: Palliative radiation therapy represents an important treatment option among patients with advanced cancer, although research shows decreased use among older patients. This study evaluated age-related patterns of palliative radiation use among an elderly Medicare population. Methods and Materials: We identified 63,221 patients with metastatic lung, breast, prostate, or colorectal cancer diagnosed between 2000 and 2007 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Receipt of palliative radiation therapy was extracted from Medicare claims. Multivariate Poisson regression analysis determined residual age-related disparity in the receipt of palliative radiation therapy after controlling for confounding covariates including age-related differences in patient and demographic covariates, length of life, and patient preferences for aggressive cancer therapy. Results: The use of radiation decreased steadily with increasing patient age. Forty-two percent of patients aged 66 to 69 received palliative radiation therapy. Rates of palliative radiation decreased to 38%, 32%, 24%, and 14% among patients aged 70 to 74, 75 to 79, 80 to 84, and over 85, respectively. Multivariate analysis found that confounding covariates attenuated these findings, although the decreased relative rate of palliative radiation therapy among the elderly remained clinically and statistically significant. On multivariate analysis, compared to patients 66 to 69 years old, those aged 70 to 74, 75 to 79, 80 to 84, and over 85 had a 7%, 15%, 25%, and 44% decreased rate of receiving palliative radiation, respectively (all P<.0001). Conclusions: Age disparity with palliative radiation therapy exists among older cancer patients. Further research should strive to identify barriers to palliative radiation among the elderly, and extra effort should be made to give older patients the opportunity to receive this quality of life-enhancing treatment at the end

  3. Twenty Practices of an Entrepreneurial University

    DEFF Research Database (Denmark)

    Gjerding, Allan Næs; Wilderom, Celeste P.M.; Cameron, Shona P.B.

    2006-01-01

    studies twenty organisational practices against which a University's entrepreneurship can be measured. These twenty practices or factors in effect formed the basis for an entrepreneurship audit. During a series of interviews, the extent to which the universities are seen as entrepreneurial...

  4. Beyond the five-year horizon: long-term outcome of high-risk and inoperable patients undergoing TAVR with first-generation devices.

    Science.gov (United States)

    Deutsch, Marcus-André; Erlebach, Magdalena; Burri, Melchior; Hapfelmeier, Alexander; Witt, Olivia Ganga; Ziegelmueller, Johannes Amadeus; Wottke, Michael; Ruge, Hendrik; Krane, Markus; Piazza, Nicolo; Bleiziffer, Sabine; Lange, Rüdiger

    2018-05-20

    We sought to determine the long-term outcome of high-risk patients who underwent transcatheter aortic valve replacement (TAVR) with first-generation devices with a focus on the identification of predictors for mortality and valve durability. Consecutive patients in our prospective single-centre registry undergoing TAVR with first-generation devices (n=214 CoreValve; n=86 SAPIEN) between 06/2007 and 07/2009 were retrospectively analysed (n=300, mean age 81.43±6.55 years, mean STS score 6.5±4.5%). Kaplan-Meier estimates of survival and the Cox proportional hazards model were used to identify independent predictors of all-cause-mortality. At 1, 5, and 7 years, estimated survival rates were 76.0%, 40.2%, and 23.2%, respectively. Age-adjusted baseline predictors of mortality included atrial fibrillation, impaired kidney function, peripheral artery disease, and mitral regurgitation (≥moderate). Baseline risk-adjusted procedure-related predictors for all-cause mortality included acute kidney injury, neurological events, major vascular complications, and major/life-threatening bleeding. At both five and six years, 78.2% of surviving patients were in NYHA Class I or II. PVL was ≤mild in the majority of patients at discharge and throughout follow-up. At seven years, the overall crude cumulative incidence of structural valve deterioration according to the 2017 EAPCI/ESC/EACTS definition was 14.9% (CoreValve 11.8% vs. SAPIEN 22.6%; p=0.01). Seven years after TAVR, 23.2% of high-risk patients were still alive. Independent predictors of all-cause mortality included both patient- and procedure-related factors. With a cumulative incidence of 14.9% at seven years, there is some suggestion that SVD post TAVR may become increasingly relevant during longer-term follow-up.

  5. [Causes of death among prostate cancer patients of different ages].

    Science.gov (United States)

    Dariy, E V

    2016-02-01

    To date, there is no unified approach to evaluating and treating patients with suspected prostate cancer taking into account their age and comorbidities. That was the rationale for conducting this study. To assess the clinical course of prostate cancer in men of all ages with comorbidities. The study included 408 patients aged 50 to 92 years (mean age 74.3 years) with histologically verified prostate cancer. 30 (7.4%) patients had stage T1 disease, 273 (66.9%) - T2, 91 (22.3%) - T3 and 14 (3.4%) - T4. The maximum follow-up was 22 years, the minimum one - 6 months (on average 15.4 years). During the follow-up 159 patients died (39%), 51 of them (32%) of prostate cancer, 108 (68%) - from other diseases. Among the latter the causes of death were cancer (20.4%), cardiovascular and bronchopulmonary diseases (79.6%). Cancer-specific survival rate was 41.4 +/-12,4%, the survival rate for other diseases 23.4 +/-10,6% (pcancer, especially of old age, including the option for active surveillance of patients with clinically insignificant prostate cancer.

  6. Do serum ALAT values reflect the inflammatory activity in the liver of patients with chronic viral hepatitis?

    NARCIS (Netherlands)

    Cahen, D. L.; van Leeuwen, D. J.; ten Kate, F. J.; Blok, A. P.; Oosting, J.; Chamuleau, R. A.

    1996-01-01

    A retrospective study was carried out in 40 patients with chronic viral hepatitis, to assess whether serum alanine aminotransferase reflects the inflammatory process in the liver. Twenty liver biopsy specimens were included for each disease. Five histological aspects were scored: periportal

  7. Five-grass pollen 300IR SLIT tablets: efficacy and safety in children and adolescents

    DEFF Research Database (Denmark)

    Halken, Susanne; Agertoft, Lone; Seidenberg, Jürgen

    2010-01-01

    The efficacy and safety of five-grass pollen 300IR sublingual immunotherapy (SLIT) tablets (Stallergènes SA, France) have previously been demonstrated in paediatric patients. This report presents additional data concerning efficacy at pollen peak, efficacy and safety according to age, nasal and o...

  8. Age at onset and Parkinson disease phenotype

    Science.gov (United States)

    Pagano, Gennaro; Ferrara, Nicola; Brooks, David J.

    2016-01-01

    Objective: To explore clinical phenotype and characteristics of Parkinson disease (PD) at different ages at onset in recently diagnosed patients with untreated PD. Methods: We have analyzed baseline data from the Parkinson's Progression Markers Initiative database. Four hundred twenty-two patients with a diagnosis of PD confirmed by DaTSCAN imaging were divided into 4 groups according to age at onset (onset younger than 50 years, 50–59 years, 60–69 years, and 70 years or older) and investigated for differences in side, type and localization of symptoms, occurrence/severity of motor and nonmotor features, nigrostriatal function, and CSF biomarkers. Results: Older age at onset was associated with a more severe motor and nonmotor phenotype, a greater dopaminergic dysfunction on DaTSCAN, and reduction of CSF α-synuclein and total tau. The most common presentation was the combination of 2 or 3 motor symptoms (bradykinesia, resting tremor, and rigidity) with rigidity being more common in the young-onset group. In about 80% of the patients with localized onset, the arm was the most affected part of the body, with no difference across subgroups. Conclusions: Although the presentation of PD symptoms is similar across age subgroups, the severity of motor and nonmotor features, the impairment of striatal binding, and the levels of CSF biomarkers increase with age at onset. The variability of imaging and nonimaging biomarkers in patients with PD at different ages could hamper the results of future clinical trials. PMID:26865518

  9. Response to hepatitis A and B vaccination in patients with chronic hepatitis C: 8-year follow-up.

    Science.gov (United States)

    Kalyoncu, Derya; Urganci, Nafiye

    2012-08-01

    In patients with chronic hepatitis C (CHC), superinfection with hepatitis A (HAV) or B (HAB) viruses is associated with increased morbidity and mortality. The seroconversion rate of these patients following vaccination is considered to be lower than in healthy subjects. To evaluate the response to HAV and HBV vaccination in children with CHC. Thirty patients with CHC aged from 7.3 to 18 years were compared with 50 healthy age-, gender- and body-mass-index-matched controls. Post-vaccination serological evaluation was performed 1 month after the last dose of primary vaccination, 1 month after the booster dose and once a year during follow-up. Twenty-two patients received hepatitis A vaccine and response rate was 95.4%. Thirty patients received hepatitis B vaccine and 80% responded (hepatitis Bs titres ≥10 mIU/ml). Thirty-five controls received hepatitis A vaccine and protective anti-HAV antibodies developed in all. All of the controls were vaccinated against hepatitis B virus and 90% responded. After the whole vaccination series, overall seroprotection rates were 86% in patients and 96% in controls. No significant reduction in antibody response was observed in patients or controls during 8-years follow-up. The rate of seroconversion to the HBV vaccine is lower in patients with CHC than in healthy controls but response to HAV is adequate.

  10. Age-specific association between percent body fat and pulmonary ...

    African Journals Online (AJOL)

    This study describes the association between percent body fat and pulmonary function among apparently normal twenty male children tidal volume aged 4 years and twenty male children aged 10 years in Ogbomoso. The mean functional residual capacity of the lung in male children aged 10 years was significantly higher ...

  11. Tumors and tumor - like lesions of the oro - facial region at Mayo hospital, Lahore - a five year study

    International Nuclear Information System (INIS)

    Riaz, N.; Warriach, R.A.

    2011-01-01

    The oro-facial region including the oral cavity, the maxilla and mandible and related tissues can be the site of a multitude of neoplastic conditions. These tumours have a predilection for the entire facial region; however, odontogenic tumours tend to affect the mandible more than the maxilla. We report results from a retrospective study spanning five years on the frequency, clinical presentation, sites and character of orofacial tumors seen in the main referral hospital of Pakistan. Patients and Methods: Records of consecutive patients of all age and sex seen by the author's team at the Department of Oral and Maxillofacial Surgery, Mayo Hospital with tumours affecting the oro-facial region from January 2005 to December 2009 were retrieved, coded and entered into a database. The data were then analyzed by age, sex, presenting signs and symptoms, site of lesion, and their histology. Results: A total of 237 patients with oro-facial swellings were retrieved from the registry. The complete data set was obtained for 189 patients, comprising 108 (57.9%) males and 81 (42%) females. The most common clinical presenting features were mandibular facial swelling (63%), intra-oral swelling (55%), and ulceration (29%). The tumors were found in the mandible 67 (35%), buccal mucosa 33 (17%), floor of the mouth 22 (11%) and tongue 29 (15%). The remainder making up almost 20% was found in the palate, submandibular region, pre auricular region and lips. Ninety three (49.2%) of the patients presented with lesions that were classified as malignant of which 64 (69%) were diagnosed as squamous cell carcinoma (SCC). seventy (37.0%) had benign odontogenic tumors and twenty six (13.7%) had non-odontogenic tumor - like lesions. Sixty - four (69%) of malignant tumors were squamous cell carcinoma; sixty four (86.4%) of the benign odontogenic tumors were classified as ameloblastoma. The mean age at presentation of all lesions was 40.4 years with over 50% of benign lesions in patients aged

  12. Neurovascular phenotypes in hereditary haemorrhagic telangiectasia patients according to age. Review of 50 consecutive patients aged 1 day-60 years

    International Nuclear Information System (INIS)

    Krings, T.; Ozanne, A.; Chng, S.M.; Alvarez, H.; Lasjaunias, P.L.; Rodesch, G.

    2005-01-01

    Hereditary haemorrhagic telangiectasia (HHT) is inherited as an autosomal dominant trait with varying penetrance and expressivity. Some of the most devastating consequences of this disease result from cerebral vascular malformations that manifest themselves in either arteriovenous fistulae (AVF), small nidus-type arteriovenous malformations (AVM) or micro-AVMs with a nidus less than 1 cm in size. The purpose of this study was to compare the phenotypes of CNS-manifestations of HHT with the age of the patient. The charts and angiographic films of 50 patients diagnosed with HHT according to the Curacao criteria were retrospectively evaluated concerning age of onset of symptoms, or, if not applicable of first consultation. The files were reviewed for clinical presentation, family and personal history, while the patients' angiograms were analysed with respect to the number of lesions (single and multiple), the location (superficial supratentorial, deep supratentorial, infratentorial, and spinal), and type of lesion (fistulous AVM, nidus-type AVM, and micro-AVM). A total of 75 central nervous system manifestations of HHT were found. Lesions included seven spinal cord AVFs that were all present in the paediatric age group (mean age: 2.2 years), 34 cerebral AV fistulae, all but two affected patients were less than 6 years (mean age 3.0). Sixteen nidus type AVMs (mean age: 23.1 years) and 18 micro-AVMs (mean age: 31.8 years) were found. HHT displays an age-related penetrance of clinical manifestations. Since members of the same family can present with completely different phenotypes of this disease there seems to be no relationship between the type of mutation and the phenotype of the disease. Since there seems to be a continuum of vascular abnormalities (from large fistulous areas to small AVMs and micro-AVMs) associated with HHT, the most likely determinating factor of the HHT phenotype is the timing of the revealing event in relation to the maturity of the vessel

  13. Comparison of the Rowe-Kahn Model of Successful Aging With Self-rated Health and Life Satisfaction: The West of Scotland Twenty-07 Prospective Cohort Study.

    Science.gov (United States)

    Whitley, Elise; Popham, Frank; Benzeval, Michaela

    2016-12-01

    With increasing longevity in industrialized populations, there is growing interest in what defines "successful aging" (SA). Various SA measures have been proposed but no consensus has been reached and many have been criticized for not representing the views and priorities of older people. We consider whether the Rowe-Kahn SA model captures older individual's perceptions of their own health and aging. Using two cohorts of 886 and 483 men and women from the West of Scotland Twenty-07 Study, aged around 57 and 76, respectively, we explored associations between Rowe-Kahn SA dimensions (absence of disease/disability; good physical/cognitive functioning; good interpersonal/productive social engagement) and four aspects of self-rated health and satisfaction (current general health; health for age; satisfaction with health; satisfaction with life). Respondents' self-rated health and satisfaction was generally good but few had all six Rowe-Kahn dimensions positive, the conventional definition of SA. All individual positive SA dimensions were associated with better self-rated health and satisfaction. This was consistent across age, gender, manual/nonmanual occupations, and personality. The prevalence of good self-rated health and satisfaction increased with increasing numbers of positive SA dimensions. The Rowe-Kahn model provides a functional definition of SA. Future work on ageing should include all Rowe-Kahn dimensions and consider SA as a continuum. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America.

  14. Low-dose multislice CT in febrile neutropenic patients

    International Nuclear Information System (INIS)

    Wendel, F.; Jenett, M.; Hahn, D.; Sandstede, J.; Geib, A.

    2005-01-01

    Purpose: to define the value of low-dose multislice CT in a clinical setting for early detection of pneumonia in neutropenic patients with fever of unknown origin. Materials and methods: thirty-five neutropenic patients suffering from fever of unknown origin with normal chest X-ray underwent unenhanced low-dose CT of the chest (120 kV, 10 eff. mAs, collimation 4 x 1 mm) using a multislice CT scanner. Axial und frontal slices with a thickness of 5 mm were calculated. If no pneumonia was found, standard antibiotics were given and a repeated examination was performed if fever continued. In case of pneumonia, antimycotic therapy was added and a follow-up CT was performed within one week. Regression or progression of pneumonia at follow-up served as evidence of pneumonia; lowering of fever within 48 h or inconspicuous follow-up CT was regarded as absence of pneumonia. Results: ten of 35 patients had pneumonic infiltration, which decreased or increased on follow-up CT in 3 and 6 patients, respectively. One patient revealed leucemic infiltration by bronchoalveolar lavage. Twenty-five of 35 patients had no evidence of pneumonia. Twenty of these patients were free of fever within 48 h under antibiotics; one patient died due to his basic illness. Out of 4 patients with persisting fever, 3 patients had no pneumonia on repeated examination; one patient showed disseminated micronodular infiltration. Frontal reconstructions helped to differentiate infiltration from atelectasis in 4 patients. Sensitivity and specificity for the detection of pneumonia at the first examination were 90% and 96%, negative predictive value was 96%. Conclusion: low-dose multislice CT should be performed in neutropenic patients having a fever of unknown origin and normal chest X-ray. (orig.)

  15. Lobomycosis in Colombian Amer Indian patients.

    Science.gov (United States)

    Rodríguez-Toro, G; Tellez, N

    1992-10-01

    Several foci of lobomycosis among Colombian Amer Indians population were described in the Casanare region of Colombia, near the Orinoco river on the Colombian-Venezuelan border. This paper reports 16 new patients. The prevalence of Lobo's disease was 8.5% in the Amoruas tribe. Nodular lesions were located on the elbow, scapular and lumbar regions, knees, feet and legs. Leg lesions were especially numerous, were confluent and tended to ulcerate. All cases were confirmed histologically. Two Negro patients were also described. The cases bring the total number of confirmed patients with lobomycosis in Colombia to 41. Twenty-five of these were Amer Indian patients from tribes living in the Orinoco and Amazon basins of the country.

  16. Assessment of insulin resistance in Chinese PCOS patients with normal glucose tolerance.

    Science.gov (United States)

    Gao, Jing; Zhou, Li; Hong, Jie; Chen, Chen

    2017-11-01

    The study aimed to investigate insulin resistance (IR) status in polycystic ovary syndrome (PCOS) women with normal glucose tolerance (NGT), and further to evaluate feasible diagnostic method for those patients. Three hundred and twenty-five PCOS women with NGT and ninety-five healthy age-matched controls were recruited with Rotterdam criterion and 75 g oral glucose tolerance test (OGTT). IR status was estimated following a glycemic and insulinemic OGTT (0, 30, 60, 120, and 180 min). A modified HOMA-IR formula was applied to each time-course value of glycemia and insulinemia. The predictive performance of each IR index was analyzed with the use of ROC curves. Compared with healthy controls, both non-obese and obese PCOS patients with NGT had a higher BMI, serum glucose, insulin value (p PCOS-NGT was a HOMA-M30 value of 20.36 or more (AUC: 0.753). In obese PCOS-NGT population, the best predictive performance was obtained by a HOMA-M60 value of 32.17 or more (AUC: 0.868). IR was common in Chinese PCOS women with NGT, and the early assessment of IR should be heeded. We recommended HOMA-M30 (Cutoff: 20.36) and HOMA-M60 (Cutoff: 32.17) as the best predictive parameters for non-obese and obese PCOS-NGT patients, respectively.

  17. Frozen shoulder and the Big Five personality traits.

    Science.gov (United States)

    Debeer, Philippe; Franssens, Fien; Roosen, Isabelle; Dankaerts, Wim; Claes, Laurence

    2014-02-01

    In the past, several studies have suggested the existence of a "periarthritic personality" in patients with frozen shoulder. We conducted a study to determine differences in personality traits in patients with primary and secondary frozen shoulders. We prospectively evaluated 118 patients (84 women and 34 men; mean age, 53.8 years; SD 7.56) with a frozen shoulder. Of these patients, 48 had an idiopathic frozen shoulder and 70 had a secondary frozen shoulder. Personality traits were determined by the NEO Five-Factor Inventory (NEO-FFI) scale. This questionnaire measures the 5 major personality traits and is based on the norms determined in a neutral test situation for 2415 controls. Compared with healthy controls, no differences in personality traits were found in patients with primary and secondary frozen shoulder, except for Conscientiousness and Extraversion, for which patients with secondary frozen shoulder scored significantly higher than healthy controls. Patients with primary frozen shoulder scored significantly higher on Openness to Experience than did patients with secondary frozen shoulder; on the other 4 Big Five personality traits, no significant differences were found between patients with primary and secondary frozen shoulder. More specifically, patients with idiopathic frozen shoulder did not score higher on the trait Neuroticism as would be expected from previous publications. Our study results do not indicate that patients with an idiopathic frozen shoulder have a specific personality compared with healthy controls. Only a few differences were found in personality traits when the entire frozen shoulder group was compared with healthy controls and between patients with primary and secondary frozen shoulders. The results of this study suggest that these differences are not sufficient to speak about a specific "frozen shoulder personality." Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights

  18. Diagnostic outcome of patients presenting with severe thunderclap headache at saidu teaching hospital

    International Nuclear Information System (INIS)

    Ahmad, A.; Khan, P.; Ahmad, K.; Syed, A.

    2008-01-01

    To find out the frequency of patients attending Casualty department of a Teaching Hospital with sudden severe thunderclap headache, their diagnostic out-come and follow up. The study was conducted in Casualty and Medical, Departments of Saidu Teaching Hospital, Saidu Sharif, from January 2006 to December 2006. Out of 22,000 patients with different Medical problems attended Casualty department during study period of which 128 cases had acute severe thunderclap headache. Age range was 15 to 80 years with mean age of 46+-10 years. Seventy eight patients (61%) were female and fifty (39%) were male. Protocol included proper clinical examination, basic laboratory investigations, admission to the General medical ward / Intensive care unit for observation, treatment and follow-up. CT scan of brain and or lumber puncture was performed in all the studied patients. The in-hospital follow up period was from two to fourteen days. The patients were reviewed one month later after discharge from hospital. Out of 120 patients twenty cases (15.6%) had Subarachnoid haemorrhage (SAH) seven patients (5.4%) had Cerebral infarction, five patients (3.9%) had an Intracerebral Haematoma. Five patients (3.9%) had aseptic meningitis. Two cases (1.5%) were reported as cerebral edema. One case (0.8%) had venous sinus thrombosis. As there was no specific finding on investigations and follow up of 88 cases (69%): these were labeled as idiopathic thunder-clap headache. Past history of not more than three similar episodes was present in 33 cases (25.78%). Out of these 33 cases, thirty belonged to the benign group of 88; other three cases had organic causes. Clinical diagnosis of Migraine was made in 37 cases out of these 88 cases. Attack of severe thunderclap headache is not an un-common emergency. Attack due to Subarachnoid haemorrhage (SAH) or other serious underlying disease cannot be distinguished from non specific headaches on clinical grounds alone. It is recommended that all such patients be

  19. Biological ageing and frailty markers in breast cancer patients.

    Science.gov (United States)

    Brouwers, Barbara; Dalmasso, Bruna; Hatse, Sigrid; Laenen, Annouschka; Kenis, Cindy; Swerts, Evalien; Neven, Patrick; Smeets, Ann; Schöffski, Patrick; Wildiers, Hans

    2015-05-01

    Older cancer patients are a highly heterogeneous population in terms of global health and physiological reserves, and it is often difficult to determine the best treatment. Moreover, clinical tools currently used to assess global health require dedicated time and lack a standardized end score. Circulating markers of biological age and/or fitness could complement or partially substitute the existing screening tools. In this study we explored the relationship of potential ageing/frailty biomarkers with age and clinical frailty. On a population of 82 young and 162 older non-metastatic breast cancer patients, we measured mean leukocyte telomere length and plasma levels of interleukin-6 (IL-6), regulated upon activation, normal T cell expressed and secreted (RANTES), monocyte chemotactic protein 1 (MCP-1), insulin-like growth factor 1 (IGF-1). We also developed a new tool to summarize clinical frailty, designated Leuven Oncogeriatric Frailty Score (LOFS), by integrating GA results in a single, semi-continuous score. LOFS' median score was 8, on a scale from 0=frail to 10=fit. IL-6 levels were associated with chronological age in both groups and with clinical frailty in older breast cancer patients, whereas telomere length, IGF-1 and MCP-1 only correlated with age. Plasma IL-6 should be further explored as frailty biomarker in cancer patients.

  20. Patterns of Mortality in Patients Treated with Dental Implants: A Comparison of Patient Age Groups and Corresponding Reference Populations.

    Science.gov (United States)

    Jemt, Torsten; Kowar, Jan; Nilsson, Mats; Stenport, Victoria

    2015-01-01

    Little is known about the relationship between implant patient mortality compared to reference populations. The aim of this study was to report the mortality pattern in patients treated with dental implants up to a 15-year period, and to compare this to mortality in reference populations with regard to age at surgery, sex, and degree of tooth loss. Patient cumulative survival rate (CSR) was calculated for a total of 4,231 treated implant patients from a single clinic. Information was based on surgical registers in the clinic and the National Population Register in Sweden. Patients were arranged into age groups of 10 years, and CSR was compared to that of the reference population of comparable age and reported in relation to age at surgery, sex, and type of jaw/dentition. A similar, consistent, general relationship between CSR of different age groups of implant patients and reference populations could be observed for all parameters studied. Completely edentulous patients presented higher mortality than partially edentulous patients (P age groups showed mortality similar to or higher than reference populations, while older patient age groups showed increasingly lower mortality than comparable reference populations for edentulous and partially edentulous patients (P age groups of patients compared to reference populations was observed, indicating higher patient mortality in younger age groups and lower in older groups. The reported pattern is not assumed to be related to implant treatment per se, but is assumed to reflect the variation in general health of a selected subgroup of treated implant patients compared to the reference population in different age groups.

  1. Adherence to oral rehydration therapy among in-patient children aged 1-59 months with some or no dehydration.

    Science.gov (United States)

    Migowa, A N; Gatinu, B; Nduati, R W

    2010-04-01

    To determine adherence to oral rehydration solution (ORS) among in-patients aged 1-59 months suffering from gastroenteritis and having some dehydration (SD) or no dehydration (ND) in two rural hospitals in Kenya. Children aged 1-59 months suffering from acute gastroenteritis with (SD) or (ND) were enrolled into the study, examined and medical records reviewed. On the second and third day of follow up, children were re-examined to ascertain hydration status and care-takers interviewed. Ninety-nine children were enrolled. Forty-five (75%) of the 60 children with SD received a correct prescription for ORS but only 12 (20%) received the correct amount. Among the 39 children with ND, 23 (59%) received a correct prescription for ORS, however only 16 (41%) received the correct amount. On the 3rd day, 9 (15%) of the 60 children with SD at baseline and 2 (5%) of the 39 with ND were classified as having SD. Four in five children with SD and 6 in 10 children with ND fail to receive the correct amounts of ORS.

  2. "The First Twenty Years," by Bernard J. Siegel. Annual Review of Anthropology, 22 (1993, pp. 1-34, Annual Reviews, Inc, Palo Alto

    Directory of Open Access Journals (Sweden)

    James A. Delle

    1995-05-01

    Full Text Available After twenty years as editor of the Annual Review ofAnthropology (ARA, Professor Siegel took on a daunting task with this article. In his words, he set out to "ponder the developments in the several subfields of anthropol­ogy over this period of time, as reflected in the topics selected for review in this enterprise" (p. 8. To this end Siegel, a cultural anthropologist, mined the collective knowledge contained within twenty years of the ARA. In his presentation, he considers the intellectual developments within each of the five subdisciplines separately (he includes applied anthropology, concluding with some brief remarks on the importance of maintaining a four or five field approach to anthropology. For our purposes here, I will limit my comments to his section on archaeology.

  3. Clinical and radiological evolution of a hand arthrosis in twenty-five years

    International Nuclear Information System (INIS)

    Calonje, Julio H; Botero, Misael; Gersner, Jochen

    2004-01-01

    The clinical evolution and X rays of an arthrodosis of the hand followed for 25 years is presented. This is a complement of another article published in the magazine, arthrosis viewed by a doctor patient second part. An emphasis is placed on the good results obtained with a new program of exercises. The problems related to the Alignment and instability of the wrist and its collapse are analyzed in depth in both the example X rays as well as the scannography

  4. Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year.

    Science.gov (United States)

    Gargari, M; Prete, V; Pujia, M; Ceruso, F M

    2012-10-01

    Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year. The aim of this study is to compare functional efficiency and patients satisfaction between tooth-supported and implant-supported overdenture through a questionnaire that accurately reflects the real concerns of patients with dental prosthesis. Forty-three patients were selected from the out patient clinic, Department of Dentistry "Fra G.B. Orsenigo Ospedale San Pietro F.B.F.", Rome, Italy. Their age were ranging from 61 to 83 years. Eighteen patients were rehabilitated with overdentures supported by natural teeth and twenty-five with overdentures implant-supported. DISCUSSION AND RESULT: The questionnaire proposed one year after the insertion of the prosthetis has showed that there isn't difference statistically significant in terms of function, phonetics and aesthetics between overdenture implant-supported and tooth-supported. The results of the questionnaire showed that the patients generally had a high level of satisfaction concern to the masticatory function, esthetics and phonetics. In addition, on average, they haven't difficulty in removal and insertion of the denture and in oral hygiene. They haven't in both groups problems related to fractures.

  5. Conservative care as a treatment option for patients aged 75 years and older with CKD stage V: a National survey in the Netherlands.

    Science.gov (United States)

    Susanto, Christopher; Kooman, J; Courtens, A M; Konings, C J A M

    2018-01-01

    Conservative care for patients aged 75 years and older with CKD stage 5 as a treatment option besides dialysis was proposed officially in the Netherlands in October 2016. This national survey showed the current implementation of this option in Netherlands nephrology departments. A web-based survey was sent to medical managers of 60 nephrology departments in the Netherlands in August 2016. Twenty-one medical managers (35%) completed the survey. The term "conservative care" is frequently used and well known. The estimated number of patients in whom the decision for maximal conservative care was made in 2015 was 310 of 2249 patients with CKD stage 5 age 75 years and older (range 5-50 patients per department). 164 patients became symptomatic and received no dialysis. There is no official registration for this treatment option and patient category. The practice patterns vary widely. Only one of 21 respondents reported a conservative care outpatient clinic. Formal training or education regarding conservative care is not available in most of departments. 95% of respondents discussed this treatment option with their patients. General practitioners are always being informed about their patient's decision. Their main role is providing or organizing palliative care support at the end of life and discussing advance care planning. Most respondents (86%) considered to include their patients in a prospective multicentre observational study, conservative care versus dialysis. Conservative care as a treatment option for patients with CKD stage 5 aged 75 years and older is well established. The practice patterns are varied in the Netherlands. Follow-up studies are needed to see whether the new multidisciplinary guideline facilitates harmonization of practice pattern. Funding is needed to optimize the implementation of conservative care.

  6. Personality assessment based on the five-factor model of personality structure in patients with primary open-angle glaucoma.

    Science.gov (United States)

    Mabuchi, Fumihiko; Yoshimura, Kimio; Kashiwagi, Kenji; Shioe, Kunihiko; Kanba, Shigenobu; Iijima, Hiroyuki; Tsukahara, Shigeo

    2005-01-01

    Several characteristic personality types have been reported for glaucoma patients in previous studies. However, none of the previous studies used a common structural theory of personality. In this study, we conducted a multicenter cross-sectional case-control study using the recently established five-factor model of personality structure. Personality was evaluated using the Neuroticism Extraversion Openness Five-Factor Inventory (NEO-FFI), which is a questionnaire specifically designed to test the five-factor model of personality: neuroticism (N), extraversion (E), openness (O), agreeableness (A), and conscientiousness (C). Eligible questionnaires were obtained from 196 patients with primary open-angle glaucoma (POAG) (99 men, 97 women) and 223 reference subjects with no ocular disease except cataract (87 men, 136 women). The mean score of each NEO-FFI factor for POAG patients was compared to the scores for the reference subjects. Compared with the reference subjects, the mean N score was significantly higher (P = 0.013), the mean scores for A and C were significantly lower (P = 0.007 and P = 0.001, respectively), and the mean E score tended to be lower (P = 0.055) in male POAG patients. The mean E score was significantly lower (P = 0.023) in female POAG patients. Characteristic personality traits were noted in POAG patients, and a more significant relationship was found between personality and glaucoma in men than in women.

  7. Rotator cuff injury in patients over the age of 65 years: evaluation of function, integrity and strength

    Directory of Open Access Journals (Sweden)

    Marco Antonio de Castro Veado

    2015-06-01

    Full Text Available OBJECTIVE: To retrospectively evaluate the results from patients who underwent arthroscopic treatment for rotator cuff injuries, among those aged over 65 years, observing integrity, function and strength.METHODS: Thirty-five shoulders were operated between July 2005 and July 2010, and 28 shoulders were re-evaluated regarding elevation strength and external rotation, using a digital dynamometer. Integrity was evaluated by means of ultrasound examinations. The patients, whose mean age was 70.54 years (ranging from 65 to 82 years, were followed up for a minimum of 26 months and mean of 51.18 months (ranging from 26 to 82 months. To evaluate function, the UCLA score, the Simple Shoulder Test (SST and a visual analog scale (VAS for pain were used.RESULTS: In analyzing the ultrasound scans, it was observed that the integrity of the rotator cuff was maintained in 75% of the cases at the end of the follow-up, along with the improvement in the UCLA score, which evolved from 17.46 to 32.39, i.e. excellent and good results in 89.28%. The mean SST and VAS indices were 9.86 and 1.5 respectively.CONCLUSION: Arthroscopic surgery to repair rotator cuff injuries in patients over the age of 65 years leads to improved function and pain relief, with maintenance of the integrity of the repair. The data on muscle strength were inconclusive.

  8. Twenty-year trends in the prevalence of Down syndrome and other trisomies in Europe

    DEFF Research Database (Denmark)

    Loane, Maria; Morris, Joan K; Addor, Marie-Claude

    2013-01-01

    This study examines trends and geographical differences in total and live birth prevalence of trisomies 21, 18 and 13 with regard to increasing maternal age and prenatal diagnosis in Europe. Twenty-one population-based EUROCAT registries covering 6.1 million births between 1990 and 2009 participa...

  9. Clinical and high-resolution computed tomographic findings in five patients with pulmonary tuberculosis who developed respiratory failure following chemotherapy

    International Nuclear Information System (INIS)

    Akira, Masanori; Sakatani, Mitsunori

    2001-01-01

    AIM: The purpose of this study was to describe the clinical and high-resolution computed tomographic (HRCT) findings in patients with pulmonary tuberculosis who developed respiratory failure after starting chemotherapy. MATERIALS AND METHODS: The clinical records, chest radiographs, and HRCT findings in five patients with non-miliary pulmonary tuberculosis who developed respiratory failure after starting chemotherapy were reviewed. RESULTS: Chest radiographs taken early in the course of acute respiratory failure showed progression of the original lesions with (n = 4) or without (n = 1) new areas of opacity away from the site of the original lesions. HRCT demonstrated widespread ground-glass attenuation with a reticular pattern as well as segmental or lobar consolidation with cavitation and nodules, consistent with active tuberculous foci in all five cases. Prominent interlobular septal thickening was seen in two cases. Four of the five patients had received corticosteroids. Of these five, two died and three recovered with continued corticosteroid therapy. Transbronchial biopsy in three cases showed evidence of acute alveolar damage. CONCLUSION: In selected patients with tuberculosis who develop respiratory failure following the initiation of antituberculous therapy, HRCT may be a helpful adjunct to clinical evaluation in differentiating hypersensitivity reactions (presumed to be due to the release of mycobacterial antigens) from other pulmonary complications. Akira, M. and Sakatani, M. (2001)

  10. Age of patient at the extraction of the third molar.

    Science.gov (United States)

    Kautto, A; Vehkalahti, M M; Ventä, I

    2018-04-13

    The purpose of this study was to assess the age of patients at the time of extraction of third molars. Our data included all routine and surgical extractions of third molars (n=8199 teeth) performed by general and specialist dentists of the public oral health services of the city of Helsinki over the period 2013-2014. Measurements included patient's age, gender, the identified third molar, the type of anaesthesia, the method of extraction, and the diagnosis at extraction. Patients' ages ranged from 10 to 99years. We found significant differences between younger and older age groups: third molar extractions occurred more often for women than for men below the age of 30years (Page of 40years, but the corresponding prevalences reversed after the age of 40years. Diagnoses at extraction differed between younger and older patients. We conclude that the treatment pattern of third molars at public health services varies greatly over a lifetime, and that a greater variety exists than had been reported previously from oral and maxillofacial units. Copyright © 2018 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  11. Vitrectomy in patients over 90 years of age

    Directory of Open Access Journals (Sweden)

    Muto T

    2016-01-01

    Full Text Available Tetsuya Muto, Tomoyuki Ide, Makoto Chikuda, Shigeki Machida Department of Ophthalmology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan Purpose: The aim of this study was to evaluate vitrectomy procedures performed in patients over 90 years of age at the Dokkyo Medical University Koshigaya Hospital (Koshigaya, Japan.Patients and methods: Vitrectomies were performed in nine eyes of nine patients who were over 90 years of age between May 2010 and March 2015. Factors such as the underlying vitreoretinal disease, preoperative and postoperative best-corrected visual acuity (BCVA, surgical time, postoperative body position, need for a second surgery, systemic disease, and intraoperative changes in systemic conditions have been evaluated.Results: The most common cause of the underlying vitreoretinal disease was vitreous hemorrhage derived from age-related macular degeneration and posterior dislocation of the lens secondary to a posterior capsular rupture (two cases each. The mean values for the logarithm of the minimum angle of resolution BCVA were 2.15 preoperatively and 1.46 postoperatively (P=0.020, Wilcoxon signed-rank test. The mean surgical time was 109 minutes. Prone position was needed in two cases, and no second surgeries were needed. The most common cause of systemic disease was hypertension, which was found in six cases. Transient hypertension was found in two cases during surgery, and these patients were treated using intravenous calcium blocker injections.Conclusion: Patients over 90 years of age who underwent vitrectomy procedures did not have serious problems, except transient hypertension during surgery. The BCVA significantly improved. These results indicated that vitrectomies could be performed successfully in patients over 90 years of age. Keywords: vitrectomy, underlying vitreoretinal disease, transient hypertension

  12. Twenty-five milligrams of clomiphene citrate presents positive effect on treatment of male testosterone deficiency - a prospective study

    Directory of Open Access Journals (Sweden)

    Carlos Teodósio Da Ros

    2012-08-01

    Full Text Available INTRODUCTION: Male testosterone deficiency is associated with bad sexual function and quality of life (QoL. The aim of this study was to determine whether a daily dose of 25 mg clomiphene citrate (CC is effective in stimulating the endogenous testosterone production pathway and to address the applicability of this medication as a therapeutic option for symptomatic hypogonadism. MATERIALS AND METHODS: This was a prospective study. Men with low sexual desire and testosterone levels (T below 400 ng/dL were selected to receive CC. Blood samples were obtained to determine baseline measurements of serum T, estradiol, LH, lipid profile and fasting plasma glucose. Each patient was treated with a daily dose of 25 mg CC for at least 3 months. Patients were asked if they experienced any side effects related to the use of CC and if they experienced any improvement in their sexual profile. Paired samples T-test was utilized to analyze responses to therapy. RESULTS: Our cohort consisted of 125 men with hypogonadism and low libido. Mean age was 62 years (± 11.1 years. Serum T levels ranged from 309 ng/dL (baseline, mean value to 642 ng/dL (3 months after CC initiation, mean value (p < 0.001. Serum cholesterol levels ranged from 197 to 186 mg/dL (p = 0.003. There were no statistically significant differences when comparing pre and post-treatment HDL-Cholesterol, triglycerides, fasting plasma glucose and prolactin. All men reported improvements in the post-treatment QoL scores. No serious adverse events were recorded. CONCLUSIONS: The CC was effective in stimulating the endogenous production of testosterone. A lower level of total cholesterol was verified after three months of treatment. This medication should be considered as a therapeutic option for some patients with symptomatic male testosterone deficiency.

  13. Ultrasonographic differentiation between Kikuchi's disease and lymphoma in patients with cervical lymphadenopathy

    Energy Technology Data Exchange (ETDEWEB)

    Lo, Wu-Chia [Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan (China); Chang, Wen-Cheng [Department of Pediatrics, Far Eastern Memorial Hospital, Taipei, Taiwan (China); Lin, Yu-Chin [Department of Medical Oncology and Hematology, Far Eastern Memorial Hospital, Taipei, Taiwan (China); Hsu, Yao-Peng [Department of Anatomic Pathology, Far Eastern Memorial Hospital, Taipei, Taiwan (China); Liao, Li-Jen, E-mail: liaolj@ntu.edu.tw [Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan (China); Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taiwan (China)

    2012-08-15

    Purpose: Kikuchi's disease, or histiocytic necrotizing lymphadenitis, is a self-limited necrotizing lymphadenitis. Clinically, it resembles lymphoma. We want to compare the sonographic features between Kikuchi's disease and lymphoma in patients with cervical lymphadenopathy. Materials and methods: The study protocol was approved by the institutional review board. Two hundred and twenty six cervical lymph nodes (137 nodes from 21 Kikuchi's disease patients and 89 nodes from 20 malignant lymphoma patients) were examined. The demographic and ultrasonographic characteristics of lymph nodes were collected and analyzed. Results: The Kikuchi's disease patients (mean age, 24.2 years; range, 8-57 years) were younger than those with lymphoma (mean age, 54 years; range, 13-81 years). There was no difference in laterality of nodes (p = 0.19). The nodal distribution demonstrated most enlarged neck lymph nodes located at level II, III and V. The ranges of short-axis and long-axis length were 6.5 {+-} 2.3 mm (mean {+-} SD) versus 13.4 {+-} 5.1 mm and 13.4 {+-} 5.0 mm versus 21.2 {+-} 9.2 mm for Kikuchi's disease versus lymphoma (p < 0.01), respectively. The S/R ratio of Kikuchi's disease nodes was 0.5 {+-} 0.2 compared to 0.7 {+-} 0.2 in lymphoma nodes (p < 0.01). Eighty-seven of 137 nodes (63.5%) of Kikuchi's disease, and eight of 89 nodes (9%) of malignant lymphoma had signs of cortical widening (p < 0.01). Seventy-six nodes (55.5%) of Kikuchi's disease and twenty-eight nodes (31.5%) of malignant lymphoma were matted (p < 0.01). Forty-five of 89 nodes among lymphoma and twenty-four among 137 of Kikuchi's disease had features of micronodular reticular echotexture (p < 0.01). All nodes exhibited hypoechogenicity except one lymphomatous node demonstrated isoechogenicity, and there was no difference in sharpness of border and presence of echogenic hilum between the two diseases (p > 0.05). Conclusion: Analysis of basic ultrasonographic

  14. Measurement invariance of big-five factors over the life span: ESEM tests of gender, age, plasticity, maturity, and la dolce vita effects.

    Science.gov (United States)

    Marsh, Herbert W; Nagengast, Benjamin; Morin, Alexandre J S

    2013-06-01

    This substantive-methodological synergy applies evolving approaches to factor analysis to substantively important developmental issues of how five-factor-approach (FFA) personality measures vary with gender, age, and their interaction. Confirmatory factor analyses (CFAs) conducted at the item level often do not support a priori FFA structures, due in part to the overly restrictive assumptions of CFA models. Here we demonstrate that exploratory structural equation modeling (ESEM), an integration of CFA and exploratory factor analysis, overcomes these problems with the 15-item Big Five Inventory administered as part of the nationally representative British Household Panel Study (N = 14,021; age: 15-99 years, Mage = 47.1). ESEM fitted the data substantially better and resulted in much more differentiated (less correlated) factors than did CFA. Methodologically, we extended ESEM (introducing ESEM-within-CFA models and a hybrid of multiple groups and multiple indicators multiple causes models), evaluating full measurement invariance and latent mean differences over age, gender, and their interaction. Substantively the results showed that women had higher latent scores for all Big Five factors except for Openness and that these gender differences were consistent over the entire life span. Substantial nonlinear age effects led to the rejection of the plaster hypothesis and the maturity principle but did support a newly proposed la dolce vita effect in old age. In later years, individuals become happier (more agreeable and less neurotic), more self-content and self-centered (less extroverted and open), more laid back and satisfied with what they have (less conscientious, open, outgoing and extroverted), and less preoccupied with productivity. PsycINFO Database Record (c) 2013 APA, all rights reserved

  15. Two to five repeated measurements per patient reduced the required sample size considerably in a randomized clinical trial for patients with inflammatory rheumatic diseases

    Directory of Open Access Journals (Sweden)

    Smedslund Geir

    2013-02-01

    Full Text Available Abstract Background Patient reported outcomes are accepted as important outcome measures in rheumatology. The fluctuating symptoms in patients with rheumatic diseases have serious implications for sample size in clinical trials. We estimated the effects of measuring the outcome 1-5 times on the sample size required in a two-armed trial. Findings In a randomized controlled trial that evaluated the effects of a mindfulness-based group intervention for patients with inflammatory arthritis (n=71, the outcome variables Numerical Rating Scales (NRS (pain, fatigue, disease activity, self-care ability, and emotional wellbeing and General Health Questionnaire (GHQ-20 were measured five times before and after the intervention. For each variable we calculated the necessary sample sizes for obtaining 80% power (α=.05 for one up to five measurements. Two, three, and four measures reduced the required sample sizes by 15%, 21%, and 24%, respectively. With three (and five measures, the required sample size per group was reduced from 56 to 39 (32 for the GHQ-20, from 71 to 60 (55 for pain, 96 to 71 (73 for fatigue, 57 to 51 (48 for disease activity, 59 to 44 (45 for self-care, and 47 to 37 (33 for emotional wellbeing. Conclusions Measuring the outcomes five times rather than once reduced the necessary sample size by an average of 27%. When planning a study, researchers should carefully compare the advantages and disadvantages of increasing sample size versus employing three to five repeated measurements in order to obtain the required statistical power.

  16. Factors associated with collagen deposition in lymphoid tissue in long-term treated HIV-infected patients.

    Science.gov (United States)

    Diaz, Alba; Alós, Llúcia; León, Agathe; Mozos, Anna; Caballero, Miguel; Martinez, Antonio; Plana, Montserrat; Gallart, Teresa; Gil, Cristina; Leal, Manuel; Gatell, Jose M; García, Felipe

    2010-08-24

    The factors associated with fibrosis in lymphoid tissue in long-term treated HIV-infected patients and their correlation with immune reconstitution were assessed. Tonsillar biopsies were performed in seven antiretroviral-naive patients and 29 successfully treated patients (median time on treatment, 61 months). Twenty patients received protease inhibitors-sparing regimens and nine protease inhibitor-containing regimens. Five tonsillar resections of HIV-negative individuals were used as controls. Lymphoid tissue architecture, collagen deposition (fibrosis) and the mean interfollicular CD4(+) cell count per mum were assessed. Naive and long-term treated HIV-infected patients had a higher proportion of fibrosis than did HIV-uninfected persons (P lymphoid tissue (P = 0.03) and smaller increase in peripheral CD4(+) T cells (r = -0.40, P = 0.05). The factors independently associated with fibrosis in lymphoid tissue were age (P lymphoid tissue viral load when compared with patients with undetectable lymphoid tissue viral load (median 5 vs. 12%, respectively, P = 0.017) and patients receiving a protease inhibitor-sparing vs. a protease inhibitor-containing regimen (median 8 vs. 2.5%, respectively, P = 0.04). Fibrosis in lymphoid tissue was associated with a poor reconstitution of CD4(+) T cells and long-term antiretroviral therapy did not reverse this abnormality. HIV infection, older age, a detectable level of lymphoid tissue viral load in treated patients and protease inhibitor-sparing regimens seem to favour fibrosis in lymphoid tissue.

  17. Menstrual Concerns and Intrauterine Contraception Among Adolescent Bariatric Surgery Patients

    Science.gov (United States)

    Miller, Rachel J.; Inge, Thomas H.

    2011-01-01

    Abstract Objective Adolescent obesity has dramatically increased in recent decades, and along with that so have other medical comorbidities, such as hypertension, diabetes, hyperlipidemia, nonalcoholic steatohepatitis, polycystic ovary syndrome (PCOS), and pseudotumor cerebri. Obesity and related comorbidites may be contraindications to hormonal contraception, making contraception counseling of morbidly obese adolescents more challenging. Obese adolescent females seeking bariatric surgery need effective contraception in the postoperative period. This study is designed to determine the acceptance rate of the levonorgestrel-releasing intrauterine device (IUD) and describe common menstrual problems in obese adolescent bariatric surgery patients. Methods This is a historic cohort study of adolescent females who underwent bariatric surgery over a 2-year period at a tertiary referral center for pediatric obesity. Data were systematically abstracted. The percent of patients with menstrual problems and the acceptance rate for the levonorgestrel-releasing IUD were determined. Results Twenty-five adolescents met inclusion criteria. The mean age was 17.4 years (standard deviation [SD] 2.6), and the mean body mass index (BMI) was 51.4 (SD 6.3) kg/m2. Eighty-four percent were white. Twenty-eight percent had menorrhagia, 32% had oligomenorrhea, 40% had dysmenorrhea, and 36% had PCOS. Ninety-two percent (23 of 25) underwent IUD placement. Conclusions There was a high prevalence of menstrual problems among this sample of severely obese adolescent females. The majority accepted the IUD, indicating it is a viable option among this population. PMID:21413894

  18. [The occupational radiation-induced cataract in five industrial radiographers].

    Science.gov (United States)

    Benzarti Mezni, A; Loukil, I; Hriz, N; Kallel, K; Mlaiki, N; Ben Jemaâ, A

    2012-04-01

    The industrial uses of ionizing radiation in Tunisia are expanding, especially in industry and most particularly in the nondestructive testing of welds. Thus workers operating in the non-destructive testing of welds may develop a radiation-induced cataract varying in time to onset depending on the dose. To describe the characteristics of the radiation-induced cataract in patients exposed to ionizing radiation, determine the risk factors of radiation-induced cataracts. This was an anamnestic, clinical, and environmental study of five cases of radiation-induced cataract in workers employed in non-destructive testing of welds. This series of five cases had a mean age of 30.2 years and 5.53 years of work experience, ranging from 14 months to 15 years. All the patients were male and industrial radiographers specialized in nondestructive testing of welds. The average duration of exposure to ionizing radiation was 5.53 years. None of the patients had worn protective gear such as eye goggles. The ophthalmic check-up for the five special industrial radiographers showed punctuate opacities in three cases, punctiform opacities in one eye in one case, and phacosclerosis with bilateral lens multiple crystalline stromal opacities in a case of micro-lens opacities in both eyes with opalescence of both eyes in one case. These cataracts had been declared as occupational diseases. The value of a specialized ophthalmologic surveillance among these workers and the early diagnosis of lens opacities must be emphasized. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  19. Ingestion and Pharyngeal Trauma Causing Secondary Retropharyngeal Abscess in Five Adult Patients

    Directory of Open Access Journals (Sweden)

    Sudhir B. Sharma

    2012-01-01

    Full Text Available Retropharyngeal abscess most commonly occurs in children. When present in adults the clinical features may not be typical, and associated immunosuppression or local trauma can be part of the presentation. We present a case series of five adult patients who developed foreign body ingestion trauma associated retropharyngeal abscess. The unusual pearls of each case, along with their outcomes, are discussed. Pertinent information for the emergency medicine physician regarding retropharyngeal abscess is presented as well.

  20. NRS-2002 for pre-treatment nutritional risk screening and nutritional status assessment in head and neck cancer patients.

    Science.gov (United States)

    Orell-Kotikangas, Helena; Österlund, Pia; Saarilahti, Kauko; Ravasco, Paula; Schwab, Ursula; Mäkitie, Antti A

    2015-06-01

    The aim of this study was to assess the value of nutritional risk screening-2002 (NRS-2002) as a nutritional risk screening and status assessment method and to compare it with nutritional status assessed by subjective and objective methods in the screening of head and neck cancer patients. Sixty-five consecutive patients (50 male), with a median age of 61 years (range, 33-77), with head and neck squamous cell carcinoma (HNSCC) were enrolled prior to cancer therapy. Nutritional status was assessed by NRS-2002, patient-generated subjective global assessment (PG-SGA), handgrip strength (HGS) and mid-arm muscle area (MAMA). Twenty-eight percent of patients were at nutritional risk based on NRS-2002, and 34 % were malnourished according to PG-SGA, while 43 % had low HGS. NRS-2002 cut-off score of ≥3 compared with the nutritional status according to PG-SGA showed 77 % specificity and 98 % sensitivity (K = 0.78). NRS-2002 was able to predict malnutrition (PG-SGA BC) both in men (p nutrition screening in head and neck cancer patients prior to oncological treatment.

  1. Five-year biochemical outcome following permanent interstitial brachytherapy for clinical T1-T3 prostate cancer

    International Nuclear Information System (INIS)

    Merrick, Gregory S.; Butler, Wayne M.; Galbreath, Robert W.; Lief, Jonathan H.

    2001-01-01

    Purpose: To evaluate 5-year biochemical disease-free outcome for men with clinical T1b-T3a NxM0 1977 American Joint Committee on Cancer (1997 AJCC) adenocarcinoma of the prostate gland who underwent transperineal ultrasound-guided permanent prostate brachytherapy. Methods and Materials: Four hundred twenty-five patients underwent transperineal ultrasound-guided prostate brachytherapy using either 103 Pd or 125 I, for clinical T1b-T3a NxM0 (1997 AJCC) adenocarcinoma of the prostate gland, from April 1995 to October 1999. No patient underwent pathologic lymph-node staging. One hundred ninety patients were implanted with either 103 Pd or 125 I monotherapy; 235 patients received moderate-dose external beam radiation therapy (EBRT), followed by a prostate brachytherapy boost; 163 patients received neoadjuvant hormonal manipulation, in conjunction with either 103 Pd or 125 I monotherapy (77 patients) or in conjunction with moderate-dose EBRT and a prostate brachytherapy boost (86 patients). The median patient age was 68.0 years (range, 48.2-81.3 years). The median follow-up was 31 months (range, 11-69 months). Follow-up was calculated from the day of implantation. No patient was lost to follow-up. Biochemical disease-free survival was defined by the American Society of Therapeutic Radiation and Oncology (ASTRO) consensus definition. Results: For the entire cohort, the 5-year actuarial biochemical no evidence of disease (bNED) survival rate was 94%. For patients with low-, intermediate-, and high-risk disease, the 5-year biochemical disease-free rates were 97.1%, 97.5%, and 84.4%, respectively. For hormone-naive patients, 95.7%, 96.4%, and 79.9% of patients with low-, intermediate-, and high-risk disease were free of biochemical failure. Clinical and treatment parameters predictive of biochemical outcome included: clinical stage, pretreatment prostate-specific antigen (PSA), Gleason score, risk group, age > 65 years, and neoadjuvant hormonal therapy. Isotope choice was

  2. Negative impact of asthma on patients in different age groups.

    Science.gov (United States)

    Alith, Marcela Batan; Gazzotti, Mariana Rodrigues; Montealegre, Federico; Fish, James; Nascimento, Oliver Augusto; Jardim, José Roberto

    2015-01-01

    To evaluate the impact of asthma on patients in Brazil, by age group (12-17 years, 18-40 years, and ≥ 41 years). From a survey conducted in Latin America in 2011, we obtained data on 400 patients diagnosed with asthma and residing in one of four Brazilian state capitals (São Paulo, Rio de Janeiro, Curitiba, and Salvador). The data had been collected using a standardized questionnaire in face-to-face interviews. For the patients who were minors, the parents/guardians had completed the questionnaire. The questions addressed asthma control, number of hospitalizations, number of emergency room visits, and school/work absenteeism, as well as the impact of asthma on the quality of life, sleep, and leisure. We stratified the data by the selected age groups. The proportions of patients who responded in the affirmative to the following questions were significantly higher in the 12- to 17-year age group than in the other two groups: "Have you had at least one episode of severe asthma that prevented you from playing/exercising in the last 12 months?" (p = 0.012); "Have you been absent from school/work in the last 12 months?" (p age group reported that normal physical exertion was very limiting (p = 0.010 vs. the other groups), whereas 14% of the patients in the ≥ 41-year age group described social activities as very limiting (p = 0.011 vs. the other groups). In this sample, asthma had a greater impact on the patients between 12 and 17 years of age, which might be attributable to poor treatment compliance.

  3. Hepatocellular carcinoma with neuroendocrine differentiation: clinical and imaging findings in five patients

    International Nuclear Information System (INIS)

    Park, Seong Hoon; Kang, Myeong Jin; Cho, Jin Han

    2008-01-01

    To describe the clinical and imaging findings of hepatocellular carcinoma with neuroendocrine differentiation, which is an extremely rare variant of hepatocellular carcinoma. We collected five patients who had histopathologically proven hepatocellular carcinoma with neuroendocrine differentiation, and described morphologic feature, enhancement pattern of tumors, extrahepatic manifestation and clinical findings. At CT, the tumor size ranged from 8 to 17 cm (mean: 12 cm) in maximum diameter. The tumor margin was well-defined and smooth in four patients and all tumors were heterogeneously hypoattenuating. Four tumor showed rim enhancement on arterial and portal phases. Local invasion to the portal vein, intrahepatic duct and gallbladder were seen. Extrahepatic manifestations included hepatic metastases, lymph node metastasis. At ultrasonography, the tumor showed heterogeneously hyperechoic in all patients and hypoechoic rim was found in four patients. Of four patients who were followed up, one survived for 16 months after initial diagnosis, while the other three died within 3 months after initial diagnosis. As described above, clinical and imaging findings of hepatocellular carcinoma with neuroendocrine differentiation were not specific. However, this rare variant of hepatocellular carcinoma could be considered when hepatic tumor is found in an advanced stage and shows persistent rim enhancement at CT

  4. Prevalence of rotavirus among children under five years of age with ...

    African Journals Online (AJOL)

    2016-08-16

    Aug 16, 2016 ... acute diarrhea in children under five years in Kaduna State, Nige- ria. Hence the need to introduce the vaccines into the childhood immunization program in the country. Keywords: Prevalence, Rotavirus,. Children, Kaduna State, Nigeria. Introduction. Diarrheal disease kills 1.8 million children under five.

  5. Treatment Outcome of Tuberculosis Patients under Directly Observed Treatment Short Course and Factors Affecting Outcome in Southern Ethiopia: A Five-Year Retrospective Study.

    Directory of Open Access Journals (Sweden)

    Gebremedhin Gebrezgabiher

    Full Text Available Tuberculosis (TB is one of the major public health and socio-economic issues in the 21st century globally. Assessment of TB treatment outcomes, and monitoring and evaluation of its risk factors in Directly Observed Treatment Short Course (DOTS are among the major indicators of the performance of a national TB control program. Hence, this institution-based retrospective study was conducted to determine the treatment outcome of TB patients and investigate factors associated with unsuccessful outcome at Dilla University Referral Hospital, southern Ethiopia. Five years (2008 to 2013 TB record of TB clinic of the hospital was reviewed. A total 1537 registered TB patients with complete information were included. Of these, 942 (61.3% were male, 1015 (66% were from rural areas, 544 (35.4% were smear positive pulmonary TB (PTB+, 816 (53.1% were smear negative pulmonary TB (PTB- and 177(11.5% were extra pulmonary TB (EPTB patients. Records of the 1537 TB patients showed that 181 (11.8% were cured, 1129(73.5% completed treatment, 171 (11.1% defaulted, 52 (3.4% died and 4 (0.3% had treatment failure. The overall mean treatment success rate of the TB patients was 85.2%. The treatment success rate of the TB patients increased from 80.5% in September 2008-August 2009 to 84.8% in September 2012-May 2013. Tuberculosis type, age, residence and year of treatment were significantly associated with unsuccessful treatment outcome. The risk of unsuccessful outcome was significantly higher among TB patients from rural areas (AOR = 1.63, 95% CI: 1.21-2.20 compared to their urban counterparts. Unsuccessful treatment outcome was also observed in PTB- patients (AOR = 1.77, 95% CI: 1.26-2.50 and EPTB (AOR = 2.07, 95% CI: 1.28-3.37 compared to the PTB+ patients. In conclusion, it appears that DOTS have improved treatment success in the hospital during five years. Regular follow-up of patients with poor treatment outcome and provision of health information on TB treatment to

  6. Capital in the Twenty-First Century

    DEFF Research Database (Denmark)

    Hansen, Per H.

    2014-01-01

    Review essay on: Capital in the Twenty-First Century. By Thomas Piketty . Translated by Arthur Goldhammer . Cambridge, Mass.: The Belknap Press of Harvard University Press, 2014. viii + 685 pp......Review essay on: Capital in the Twenty-First Century. By Thomas Piketty . Translated by Arthur Goldhammer . Cambridge, Mass.: The Belknap Press of Harvard University Press, 2014. viii + 685 pp...

  7. Influence of heparin on the assay of amitriptyline, clomipramine, and their metabolites

    NARCIS (Netherlands)

    Levering, S.C.M.; Oostelbos, M.C.J.M.; Toll, P.J.M.M.; Loonen, A.J.M.

    1996-01-01

    In this study the effect of the use of lithium heparin containers on the plasma levels of amitriptyline, clomipramine, and their metabolites was investigated. Twenty-five patients (10 men and 15 women, mean age 51.8 ± 14.9 years) taking either amitriptyline or clomipramine in a daily dosage varying

  8. Predictors of five-year functional ability in a longitudinal survey of men and women aged 75 to 80. The 1914-population in Glostrup, Denmark

    DEFF Research Database (Denmark)

    Schroll, M; Avlund, K; Davidsen, M

    1997-01-01

    (tiredness and dependency). Between ages 75 and 80, 24% died, 12% did not participate in the follow-up, 23% became tired performing mobility functions, 20% did not change but 21% became less tired; 19% became more dependent, 44% remained stable and only 2% improved in relation to dependency on help......-based, representative sample, the objectives were: to describe five-year outcome regarding death and functional ability to age 75 to 80, as well as individual changes in muscle strength, physical performance in simple function tests and self-reported physical activity, and relate "risk markers" to five-year outcome...

  9. 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...

  10. Idiopathic Non-histaminergic Angioedema: Successful Treatment with Omalizumab in Five Patients.

    Science.gov (United States)

    Faisant, Charles; Du Thanh, Aurélie; Mansard, Catherine; Deroux, Alban; Boccon-Gibod, Isabelle; Bouillet, Laurence

    2017-01-01

    Idiopathic non-histaminergic acquired angioedema (InH-AAE) is a rare disease characterized by AE resistant to antihistamines and a chronic course. We report five new cases of InH-AAE (two women and three men) with a rapid and dramatic response to the anti-immunoglobulin-E antibody omalizumab. In our literature review, we found 13 other relevant cases with a good response to this treatment. Overall, in 6 out of 18 patients, the doses of omalizumab required to prevent recurrences of attacks were higher than the licensed dose for chronic urticaria. No significant adverse effects have been reported.

  11. The emergence of multidrug-resistant Pseudomonas aeruginosa in cystic fibrosis patients on inhaled antibiotics

    Directory of Open Access Journals (Sweden)

    Atqah AbdulWahab

    2017-01-01

    Full Text Available Introduction: Multidrug-resistant Pseudomonas aeruginosa (MDR-PA is an important and growing issue in the care of patients with cystic fibrosis (CF, and a major cause of morbidity and mortality. Objective: The objective of the study was to describe the frequency of MDR-PA recovered from the lower respiratory samples of pediatric and adult CF patients, and its antibiotic resistance pattern to commonly used antimicrobial agents including β-lactams, aminoglycosides, and fluoroquinolones. Materials and Methods: The lower respiratory isolates of P. aeruginosa were obtained from inpatients and outpatients CF clinics from a tertiary care teaching hospital for the period from October 2014 to September 2015. The identification and antimicrobial susceptibility for all the isolates were performed by using the BD Phoenix™ and E-test in compliance with Clinical and Laboratory Standards Institute (CLSI guidelines. Results: A total of 61 P. aeruginosa samples were isolated from thirty CF patients from twenty families. Twelve sputum samples were positive for MDR-PA (seven nonmucoid and five mucoid isolates from five CF patients (five families with moderate-to-very severe lung disease given MDR-PA frequency of 19.7%. The median age of the study group was 20 (range 10–30 years. Three CF patients were on chronic inhaled tobramycin and two on nebulized colistin. The antimicrobial patterns of isolates MDR-PA showed the highest rate of resistance toward each gentamycin, amikacin, and cefepime (100%, followed by 91.7% to ciprofloxacin, 75% to tobramycin, 58.3% to meropenem, and 50% to piperacillin-tazobactam. None of the isolates were resistant to colistin during the study period. Conclusion: The study results emphasize that the emergence of a significant problem in the clinical isolates of P. aeruginosa in CF patients that dictate appropriate attention to the antibiotic management after proper surveillance.

  12. Interventions for increasing fruit and vegetable consumption in children aged five years and under.

    Science.gov (United States)

    Hodder, Rebecca K; Stacey, Fiona G; O'Brien, Kate M; Wyse, Rebecca J; Clinton-McHarg, Tara; Tzelepis, Flora; James, Erica L; Bartlem, Kate M; Nathan, Nicole K; Sutherland, Rachel; Robson, Emma; Yoong, Sze Lin; Wolfenden, Luke

    2018-01-25

    Insufficient consumption of fruits and vegetables in childhood increases the risk of future chronic diseases, including cardiovascular disease. To assess the effectiveness, cost effectiveness and associated adverse events of interventions designed to increase the consumption of fruit, vegetables or both amongst children aged five years and under. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE and Embase to identify eligible trials on 25 September 2017. We searched Proquest Dissertations and Theses and two clinical trial registers in November 2017. We reviewed reference lists of included trials and handsearched three international nutrition journals. We contacted authors of included studies to identify further potentially relevant trials. We included randomised controlled trials, including cluster-randomised controlled trials and cross-over trials, of any intervention primarily targeting consumption of fruit, vegetables or both among children aged five years and under, and incorporating a dietary or biochemical assessment of fruit or vegetable consumption. Two review authors independently screened titles and abstracts of identified papers; a third review author resolved disagreements. Two review authors independently extracted data and assessed the risks of bias of included studies; a third review author resolved disagreements. Due to unexplained heterogeneity, we used random-effects models in meta-analyses for the primary review outcomes where we identified sufficient trials. We calculated standardised mean differences (SMDs) to account for the heterogeneity of fruit and vegetable consumption measures. We conducted assessments of risks of bias and evaluated the quality of evidence (GRADE approach) using Cochrane procedures. We included 55 trials with 154 trial arms and 11,108 participants. Thirty-three trials examined the impact of child-feeding practices (e.g. repeated food exposure) in increasing child

  13. Outcomes of hip arthroscopy in patients aged 50 years or older compared with a matched-pair control of patients aged 30 years or younger.

    Science.gov (United States)

    Domb, Benjamin G; Linder, Dror; Finley, Zachary; Botser, Itamar B; Chen, Austin; Williamson, Joseph; Gupta, Asheesh

    2015-02-01

    Age has been suggested as a negative prognostic factor for hip arthroscopy. The purpose of this study was to compare patient characteristics and outcomes after hip arthroscopy in patients aged 50 years or older with a matched control group of patients aged 30 years or younger at a minimum postoperative follow-up of 2 years. Between September 2008 and March 2010, data were prospectively collected on all patients aged 50 years or older undergoing primary hip arthroscopy. Fifty-two patients met our inclusion and matching criteria, of whom all 52 (100%) were available for follow-up at a minimum of 2 years. This cohort was compared with a matched-pair control group of patients aged 30 years or younger who underwent similar procedures. The mean age of the study group was 54.8 years (range, 50 to 69 years), and that of the control group was 20.3 years (range, 13 to 30 years). The groups were matched at a 1:1 ratio, including 18 male patients (34.6%) and 34 female patients (65.4%) in each group, with a mean follow-up period of 32 months (range, 24 to 54 months). In the younger control group, the score improvement from preoperatively to 2 years' follow-up was 62.9 to 84.2 for the modified Harris Hip Score, 60.5 to 84.2 for the Non-Arthritic Hip Score, 63.1 to 86.5 for the Hip Outcome Score-Activities of Daily Living, and 42.2 to 72.7 for the Hip Outcome Score-Sport-Specific Subscale. In the older study group, the score improvement from preoperatively to 2 years' follow-up was 61.2 to 82.2 for the modified Harris Hip Score, 59.9 to 80.4 for the Non-Arthritic Hip Score, 63.9 to 83 for the Hip Outcome Score-Activities of Daily Living, and 41.2 to 64.6 for the Hip Outcome Score-Sport-Specific Subscale. All improvements in both groups were statistically significant at the 2-year postoperative follow-up (P arthroscopy should be considered a valid treatment option when treating hip pain in patients aged 50 years or older with a Tönnis arthritic grade of 0 or 1. Older patients

  14. Assessing twenty-first century skills through a teacher created video game for high school biology students

    Science.gov (United States)

    Annetta, Leonard A.; Cheng, Meng-Tzu; Holmes, Shawn

    2010-07-01

    As twenty-first century skills become a greater focus in K-12 education, an infusion of technology that meets the needs of today's students is paramount. This study looks at the design and creation of a Multiplayer Educational Gaming Application (MEGA) for high school biology students. The quasi-experimental, qualitative design assessed the twenty-first century skills of digital age literacy, inventive thinking, high productivity, and effective communication techniques of the students exposed to a MEGA. Three factors, as they pertained to these skills, emerged from classroom observations. Interaction with the teacher, discussion with peers, and engagement/time-on-task while playing the MEGA suggested that students playing an educational video game exhibited all of the projected twenty-first century skills while being engrossed in the embedded science content.

  15. Isolation and characterization of twenty-five polymorphic ...

    Indian Academy of Sciences (India)

    markers in Siniperca scherzeri Steindachner and cross-species amplification. J. Genet. .... ACT. AGT. AGTGTGTGCAAGT. AGA. 188–247. 55. 8. 0.875. 0.8185. 0.7804. 0.2352. R: .... diversity and population structure of the endangered Spanish.

  16. Technology Education: Twenty-five years of progress

    OpenAIRE

    Miranda, Michael A. De; Miyakawa, Hidetoshi

    2005-01-01

    The past 25 years has brought significant changes in the field of technology education. Contributing to these changes has been the evolution of a curriculum from the early days of industrial arts that addressed human productive practice to an emerging contemporary technological curriculum shaped by the exponential growth of technology and its impact on the extension of human capabilities, society, and the environment. The recent literature that focuses on the exponential growth of technology ...

  17. Twenty-five years of maximum-entropy principle

    Science.gov (United States)

    Kapur, J. N.

    1983-04-01

    The strengths and weaknesses of the maximum entropy principle (MEP) are examined and some challenging problems that remain outstanding at the end of the first quarter century of the principle are discussed. The original formalism of the MEP is presented and its relationship to statistical mechanics is set forth. The use of MEP for characterizing statistical distributions, in statistical inference, nonlinear spectral analysis, transportation models, population density models, models for brand-switching in marketing and vote-switching in elections is discussed. Its application to finance, insurance, image reconstruction, pattern recognition, operations research and engineering, biology and medicine, and nonparametric density estimation is considered.

  18. Does age affect prognosis in salivary gland carcinoma patients?

    DEFF Research Database (Denmark)

    Bjørndal, Kristine; Larsen, Stine R; Therkildsen, Marianne H

    2016-01-01

    in the young group were WHO performance status 0 and in disease stage I + II, and they presented with significantly more histological low grade tumors. In multivariate analysis, chronological age seemed to be of no prognostic significance to salivary gland carcinoma patients as opposed to performance status......, disease stage and histological grade. CONCLUSIONS: Salivary gland carcinoma patients over the age of 70 years have a poor prognosis compared to younger patients, which can be explained by higher disease stages, more histological high grade subtypes and a poorer performance status at the time of diagnosis.......AIM: To compare incidence, histology, treatment modalities, disease stages, and outcome in elderly patients (≥70 years) compared to younger (

  19. Health sciences librarians, patient contact, and secondary traumatic stress.

    Science.gov (United States)

    Becker, Rachel W; McCrillis, Aileen

    2015-04-01

    The purpose of this study was to determine the prevalence of secondary traumatic stress (STS) in health sciences librarians (HSLs) who have direct contact with traumatized individuals and their families. A twenty-five-item survey and the Secondary Traumatic Stress Scale (STSS) were distributed via email to three Medical Library Association email discussion lists. A total of fifty-five HSLs responded to the survey. Survey results indicate moderate levels of STS and variability of symptoms among participants. Library and employee assistance program managers should be aware of the emotional toll of patient and/or family contact for HSLs.

  20. Social cognitions about food choice in children aged five to eight years: Feasibility and predictive validity of an age appropriate measurement.

    Science.gov (United States)

    Fernandes-Machado, Sandra; Gellert, Paul; Goncalves, Sonia; Sniehotta, Falko F; Araujo-Soares, Vera

    2016-10-01

    There are currently no instruments available to measure social cognitions towards food choice in children. This study aimed to test the feasibility and predictive validity of a novel measurement tool to assess food-related social cognitions. Sixty-eight children, five to eight years old, were asked to sort cards with photographs of four fruit and four sweet/savoury snacks as a mean to measure attitudes, subjective norms, perceived behavioural control (PBC), and intention. Subsequently, food choice (dependent variable) was assessed using a laboratory food choice task in which children could gain access to sweet and savoury or fruit items, or a combination. All participants completed the tasks successfully, demonstrating feasibility of the procedure. The order in which the cards were sorted for each construct differed sufficiently and correlations between constructs were in line with previous studies. Measures of PBC, intention, attitude, and subjective norm from the mother, but not from teachers or friends, correlated significantly with subsequent food choice. It is possible to measure food-related social cognitions in children aged five to eight and these measures were predictive of observed behaviour. The new instrument can contribute to our understanding of psychological determinants of food choice in young children. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Five-year follow-up of harms and benefits of behavioral infant sleep intervention: randomized trial.

    Science.gov (United States)

    Price, Anna M H; Wake, Melissa; Ukoumunne, Obioha C; Hiscock, Harriet

    2012-10-01

    Randomized trials have demonstrated the short- to medium-term effectiveness of behavioral infant sleep interventions. However, concerns persist that they may harm children's emotional development and subsequent mental health. This study aimed to determine long-term harms and/or benefits of an infant behavioral sleep program at age 6 years on (1) child, (2) child-parent, and (3) maternal outcomes. Three hundred twenty-six children (173 intervention) with parent-reported sleep problems at age 7 months were selected from a population sample of 692 infants recruited from well-child centers. The study was a 5-year follow-up of a population-based cluster-randomized trial. Allocation was concealed and researchers (but not parents) were blinded to group allocation. Behavioral techniques were delivered over 1 to 3 individual nurse consultations at infant age 8 to 10 months, versus usual care. The main outcomes measured were (1) child mental health, sleep, psychosocial functioning, stress regulation; (2) child-parent relationship; and (3) maternal mental health and parenting styles. Two hundred twenty-five families (69%) participated. There was no evidence of differences between intervention and control families for any outcome, including (1) children's emotional (P = .8) and conduct behavior scores (P = .6), sleep problems (9% vs 7%, P = .2), sleep habits score (P = .4), parent- (P = .7) and child-reported (P = .8) psychosocial functioning, chronic stress (29% vs 22%, P = .4); (2) child-parent closeness (P = .1) and conflict (P = .4), global relationship (P = .9), disinhibited attachment (P = .3); and (3) parent depression, anxiety, and stress scores (P = .9) or authoritative parenting (63% vs 59%, P = .5). Behavioral sleep techniques have no marked long-lasting effects (positive or negative). Parents and health professionals can confidently use these techniques to reduce the short- to medium-term burden of infant sleep problems and maternal depression.

  2. OPEC/OJEC for stage 4 neuroblastoma in children over 1 year of age.

    Science.gov (United States)

    Tweddle, D A; Pinkerton, C R; Lewis, I J; Ellershaw, C; Cole, M; Pearson, A D

    2001-01-01

    This paper reports the toxicity of OPEC/OJEC chemotherapy in stage 4 neuroblastoma patients over 1 year of age. Ninety-five patients with stage 4 neuroblastoma received alternating courses of OPEC/OJEC--vincristine 1.5 mg/m2 (O), cisplatin 80 mg/m2 (P), etoposide 200 mg/m2 (E), cyclophosphamide 600 mg/m2 (C), and carboplatin 500 mg/m2 (J), every 21 days if there was haematological recovery. Seventy out of ninety-five (74%) patients completed seven or more courses and were evaluable for toxicity. Of these 70 patients, 33% had more than three episodes of fever and sepsis, 35% required more than five blood or platelet transfusions, 36% had grade 2 or more gastrointestinal toxicity and 9% had neurotoxicity. There was a median reduction in GFR of 32 ml/min/1.73 m2 (-46 to 134) and there was one toxic death. OPEC/OJEC is a well-tolerated therapy for stage 4 neuroblastoma over 1 year of age.

  3. A study of clinical assessment of frailty in patients on maintenance hemodialysis supported by cashless government scheme

    Directory of Open Access Journals (Sweden)

    Manjusha Yadla

    2017-01-01

    Full Text Available This is a prospective cohort study to assess the prevalence of frailty in patients undergoing maintenance hemodialysis (HD under the government-funded scheme at our center and to assess the relationship between frailty and falls, hospitalizations, and mortality. This was done at our center which is completely supported by the government, which provides HD to all the patients under poverty line. Epidemiological data, anthropometric measurements, comorbidities assessment, frailty assessment using Fried criteria, subsequent hospitalizations, falls, and mortality were recorded in our prevalent dialysis population at our center between October 2014 and October 2015. Two hundred and twenty-six patients were enrolled during this period. Twenty-one patients were excluded as they did not satisfy the inclusion criteria. Two hundred and five prospective patients were studied for the predictors of frailty. Frailty was present in 82% of the study population. Mean age of our study population was 44.95 ± 13.27 years. On univariate analysis, diabetes mellitus, hypertension (HTN, cerebrovascular accident (CVA, left ventricular dysfunction (LVD, peripheral vascular disease (PVD, smoking, hepatitis C, inadequate dialysis, intradialytic hypotension (IDH, interdialytic weight gain, low serum creatinine <4 mg/dL, and anemia (Hb <10 g/dL were found to be statistically significantly different between frail and nonfrail groups On multivariate regression analysis, only HTN, PVD, CVA, anemia, smoking, and IDH were found to be significant. Frailty is highly prevalent among dialysis population. Factors predicting frailty include HTN, smoking, LVD, PVD, CVA, smoking, anemia, and IDH. Frailty is a significant risk factor for falls and hospitalizations.

  4. Histological Features of Antiphospholipid Nephropathy in Patients with Systemic Lupus Erythematosus

    International Nuclear Information System (INIS)

    Naseeb, F.; Arfaj, A. A..; Hamdani, A.; Parvez, K.; Mogairen, S. A.; Kfoury, H.

    2015-01-01

    Objective:To determine the histological features of renal biopsies of Systemic Lupus Erythematosus (SLE) patients with and without antiphospholipid antibodies in Saudi population. Study Design: Cross-sectional, comparative study. Place and Duration of Study: King Khalid University Hospital, Riyadh, Saudi Arabia, from January to December 2013. Methodology: Consecutive SLE patients admitted to King Khalid University Hospital, Riyadh for renal biopsy for evaluation of proteinuria or deterioration of renal function were recruited. SLE patients with renal involvement were divided in two groups. Group one included patients with positive APS antibodies and group two included patients with negative APS antibodies. The histological features of renal biopsies of the two patients groups were compared. Data was analyzed using simple statistical analysis. Results: The mean age of APS antibodies-positive patients was 30.37 ± 10.714 years while mean age of APS negative patients was 33.62 ± 11.717 years (p=0.224). Twenty five (83.33 percentage) patients were females and 5 (16.67 percentage) patients were males in APS positive patients while 42 (89.36 percentage) were females and 5 (10.63 percentage) were males in group two. Acute lesions like thrombotic microangiopathy were in 2 (6.7 percentage) of APS positive patients while chronic lesions like focal cortical atrophy was found in 6 (20 percentage) and fibrous intimal hyperplasia was found in 9 (30 percentage). Other significant histological findings in APS antibodies positive group were glomerular basement membrane wrinkling in 12 (40 percentage), glomerular double wall contour in 17 (56.7 percentage), fibrous adhesions in 11 (36.7 percentage) patients with APS antibodies. Conclusion:Systemic Lupus Erythematosus (SLE) patients with positive APS antibodies has specific histological findings suggesting an important role of APS antibodies in the pathogenesis of APS nephropathy. (author)

  5. Age-Specific Patient Navigation Preferences Among Adolescents and Young Adults with Cancer.

    Science.gov (United States)

    Pannier, Samantha T; Warner, Echo L; Fowler, Brynn; Fair, Douglas; Salmon, Sara K; Kirchhoff, Anne C

    2017-11-23

    Patient navigation is increasingly being directed at adolescent and young adult (AYA) patients. This study provides a novel description of differences in AYA cancer patients' preferences for navigation services by developmental age at diagnosis. Eligible patients were diagnosed with cancer between ages 15 and 39 and had completed at least 1 month of treatment. Between October 2015 and January 2016, patients completed semi-structured interviews about navigation preferences. Summary statistics of demographic and cancer characteristics were generated. Differences in patient navigation preferences were examined through qualitative analyses by developmental age at diagnosis. AYAs were interviewed (adolescents 15-18 years N = 8; emerging adults 19-25 years N = 8; young adults 26-39 years N = 23). On average, participants were 4.5 years from diagnosis. All age groups were interested in face-to-face connection with a navigator and using multiple communication platforms (phone, text, email) to follow-up. Three of the most frequently cited needs were insurance, finances, and information. AYAs differed in support, healthcare, and resource preferences by developmental age; only adolescents preferred educational support. While all groups preferred financial and family support, the specific type of assistance (medical versus living expenses, partner/spouse, child, or parental assistance) varied by age group. AYAs with cancer have different preferences for patient navigation by developmental age at diagnosis. AYAs are not a one-size-fits-all population, and navigation programs can better assist AYAs when services are targeted to appropriate developmental ages. Future research should examine fertility and navigation preferences by time since diagnosis. While some navigation needs to span the AYA age range, other needs are specific to developmental age.

  6. Demoralization Syndrome Among Elderly Patients with Cancer Disease

    Directory of Open Access Journals (Sweden)

    Kai-Ting Ko

    2018-03-01

    Full Text Available Summary: Background: Demoralization is distinctive psychological distress that involves hopelessness, helplessness, loss of purpose and meaning, and existential distress. Cancer patients' demoralization has been well documented, but little is known regarding older cancer patients and the related factors. Therefore, this study evaluated demoralization syndrome in older cancer patients. Methods: Cancer patients over 61 years old (n = 113, female 59.3%, mean age 65.7 years, range 61–80 diagnosed with heterogeneous types of cancer were recruited. They completed questionnaires in a hospital's inpatient and outpatient units. Their demoralization was measured using the Demoralization Scale-Mandarin Version (DS-MV. The Patient Health Questionnaire-9 (PHQ-9, Distress Thermometer (DT, Beck Scale for Suicide Ideation (BSS, and Posttraumatic Growth Inventory (PTGI were used to measure other psychological statuses and the association with demoralization. Results: The mean DS-MV score was 28.1 (SD = 16.3. In this sample, 57.7% had moderate to high demoralization (18.6% had moderate demoralization, and 38.1% had high demoralization. Twenty-three percent reported a DT score of five and above, 5.5% reported a PHQ-9 score of 10 and above, and 23.9% reported a BSS score greater than zero. Demoralization was associated with suicide ideation, depression, distress, lower education, and the cancer site. Demoralization was not associated with posttraumatic growth, gender, work status, or religion. Conclusion: More than half of older cancer patients have moderate to high demoralization and it is associated with depression, suicide ideation, and distress. Screening and interventions that are better tailored to older cancer patients could improve the quality of care in cancer treatment. Keywords: aged, cancer, depression, hospice care/psychology, morale

  7. Prognosen for den kritisk iskaemiske underekstremitet som ikke kan revaskulariseres karkirurgisk

    DEFF Research Database (Denmark)

    Sørensen, S; Lorentzen, J E; Schroeder, T V

    1993-01-01

    were rest pain in 24 cases and gangrenous ulceration in ten. During a follow-up of eight to twenty-eight months five (15%) patients improved significantly, and complained only of claudication. Three patients, suffering rest pain, were unchanged at nine months follow-up, and 25 (74%) patients had...... that of an age- and sex-matched Danish population. The group of patients who preserved their limb could not be identified by either ankle- and toe-pressure measurements or clinical evaluation....

  8. Dedifferentiated chondrosarcoma: Radiological features, prognostic factors and survival statistics in 23 patients

    Science.gov (United States)

    Liu, Chenglei; Xi, Yan; Li, Mei; Jiao, Qiong; Zhang, Huizhen; Yang, Qingcheng; Yao, Weiwu

    2017-01-01

    Background Dedifferentiated chondrosarcoma is a rare, highly malignant tumor with a poor survival. There are many confusing issues concerning the imaging feature that can facilitate early diagnosis and the factors that might be related to outcomes. Methods Twenty-three patients with dedifferentiated chondrosarcoma confirmed by pathology were retrospectively reviewed from 2008 to 2015. The patients’ clinical information, images from radiographs (n = 17), CT (n = 19), and MRI (n = 17), histological features, treatment and prognosis were analyzed. Results There were 12 males and 11 females, and the mean age was 50.39 years old. Fourteen cases affected the axial bone (pelvis, spine), and 9 cases involved the appendicular bone. Seven (41.17%), 9 (47.36), and 12 (66.66%) lesions showed a biphasic nature on radiograph, CT and MRI, respectively. Of the lesions, 17.39% (4/23) were accompanied by pathological fractures. Histologically, the cartilage component was considered histological Grade1 in 12 patients and Grade 2 in 11 patients. The dedifferentiated component showed features of osteosarcoma in 8 cases, malignant fibrous histiocytoma in3 cases, myofibroblastic sarcoma in 1 case and spindle cell sarcoma in 11cases. Twenty-two cases were treated with surgical resection, and 17 cases achieved adequate (wide or radical) surgical margin. In 8 cases, surgery was combined with adjuvant chemotherapy. The overall median survival time was nine months; 17.4% of patients survived to five years. Conclusion Axial bone location, lung metastasis at diagnosis, inadequate surgical margin, incorrect diagnosis before surgery and pathological fractures was related to poorer outcome. Pre- or postoperative chemotherapy had no definitively effect on improved survival. PMID:28301537

  9. Circadian typology, age, and the alternative five-factor personality model in an adult women sample.

    Science.gov (United States)

    Muro, Anna; Gomà-i-Freixanet, Montserrat; Adan, Ana; Cladellas, Ramon

    2011-10-01

    Research on personality and circadian typology indicates evening-type women are more impulsive and novelty seeking, neither types are more anxious, and morning types tend to be more active, conscientious, and persistent. The purpose of this study is to examine the differences between circadian typologies in the light of the Zuckerman's Alternative Five-Factor Model (AFFM) of personality, which has a strong biological basis, in an adult sample of 412 women 18 to 55 yrs of age. The authors found morning-type women had significant higher scores than evening-type and neither-type women on Activity, and its subscales General Activity and Work Activity. In contrast, evening-type women scored significantly higher than morning-type women on Aggression-Hostility, Impulsive Sensation Seeking, and its subscale Sensation Seeking. In all groups, results were independent of age. These findings are in accordance with those previously obtained in female student samples and add new data on the AFFM. The need of using personality models that are biologically based in the study of circadian rhythms is discussed.

  10. Prenatal mercury exposure, maternal seafood consumption and associations with child language at five years.

    Science.gov (United States)

    Vejrup, Kristine; Brandlistuen, Ragnhild Eek; Brantsæter, Anne Lise; Knutsen, Helle Katrine; Caspersen, Ida Henriette; Alexander, Jan; Lundh, Thomas; Meltzer, Helle Margrete; Magnus, Per; Haugen, Margaretha

    2018-01-01

    Methyl mercury (MeHg) is a well-known neurotoxin and evidence suggests that also low level exposure may affect prenatal neurodevelopment. Uncertainty exists as to whether the maternal MeHg burden in Norway might affect child neurodevelopment. To evaluate the association between prenatal mercury exposure, maternal seafood consumption and child language and communication skills at age five. The study sample comprised 38,581 mother-child pairs in the Norwegian Mother and Child Cohort Study. Maternal mercury blood concentration in gestational week 17 was analysed in a sub-sample of 2239 women. Prenatal mercury exposure from maternal diet was calculated from a validated FFQ answered in mid-pregnancy. Mothers reported children's language and communications skills at age five by a questionnaire including questions from the Ages and Stages Questionnaire (ASQ), the Speech and Language Assessment Scale (SLAS) and the Twenty Statements about Language-Related Difficulties (language 20). We performed linear regression analyses adjusting for maternal characteristics, nutritional status and socioeconomic factors. Median maternal blood mercury concentration was 1.03μg/L, dietary mercury exposure was 0.15μg/kgbw/wk, and seafood intake was 217g/wk. Blood mercury concentrations were not associated with any language and communication scales. Increased dietary mercury exposure was significantly associated with improved SLAS scores when mothers had a seafood intake below 400g/wk in the adjusted analysis. Sibling matched analysis showed a small significant adverse association between those above the 90th percentile dietary mercury exposure and the SLAS scores. Maternal seafood intake during pregnancy was positively associated with the language and communication scales. Low levels of prenatal mercury exposure were positively associated with language and communication skills at five years. However, the matched sibling analyses suggested an adverse association between mercury and child

  11. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials

    NARCIS (Netherlands)

    Goyal, Mayank; Menon, Bijoy K.; van Zwam, Wim H.; Dippel, Diederik W. J.; Mitchell, Peter J.; Demchuk, Andrew M.; Dávalos, Antoni; Majoie, Charles B. L. M.; van der Lugt, Aad; de Miquel, Maria A.; Donnan, Geoffrey A.; Roos, Yvo B. W. E. M.; Bonafe, Alain; Jahan, Reza; Diener, Hans-Christoph; van den Berg, Lucie A.; Levy, Elad I.; Berkhemer, Olvert A.; Pereira, Vitor M.; Rempel, Jeremy; Millán, Mònica; Davis, Stephen M.; Roy, Daniel; Thornton, John; Román, Luis San; Ribó, Marc; Beumer, Debbie; Stouch, Bruce; Brown, Scott; Campbell, Bruce C. V.; van Oostenbrugge, Robert J.; Saver, Jeffrey L.; Hill, Michael D.; Jovin, Tudor G.

    2016-01-01

    In 2015, five randomised trials showed efficacy of endovascular thrombectomy over standard medical care in patients with acute ischaemic stroke caused by occlusion of arteries of the proximal anterior circulation. In this meta-analysis we, the trial investigators, aimed to pool individual patient

  12. Patient information comes of age.

    Science.gov (United States)

    Murphy, Jeannette

    2017-12-01

    This virtual issue (VI) has been assembled to coincide with the 8th Annual Patient Information Conference 2013 organised by the UK Patient Information Forum (PiF). The conference theme 'Information and support - a service in its own right' is a response to policy documents and initiatives in both Scotland and England which signal the coming of age of patient/consumer information. The VI consists of a collection of open access articles and addresses the question 'What can health science librarians do to ensure that the public are able to find, appraise and use health information?' This material provides research evidence, and examples of the types of initiatives librarians have undertaken to make information a health and care service in its own right. Two recurrent messages are that health science librarians need to form partnerships with healthcare providers and they have a role to play in improving health literacy skills. © 2013 The authors. Health Information and Libraries Journal © 2013 Health Libraries Group.

  13. Is thrombophilia a major risk factor for deep vein thrombosis of the lower extremities among Lebanese patients?

    Directory of Open Access Journals (Sweden)

    R Kreidy

    2009-07-01

    Full Text Available R Kreidy1, N Irani-Hakime21Department of Vascular Surgery, 2Department of Laboratory Medicine, Saint George Hospital, University Medical Center, University of Balamand, Beirut, LebanonAim: Factor V Leiden (R506Q mutation is the most commonly observed inherited genetic abnormality related to vein thrombosis. Lebanon has one of the highest frequencies of this mutation in the world with a prevalence of 14.4% in the general population. The aim of this study is to define risk factors including inherited genetic abnormalities among Lebanese patients with lower extremity deep vein thrombosis. We report the clinical outcome of patients with thrombophilia.Methods: From January 1998 to January 2008, 162 patients (61 males and 101 females were diagnosed with lower extremity deep vein thrombosis. Mean age was 61 years (range: 21 to 95 years.Results: The most frequent risk factors for vein thrombosis were surgery, advanced age, obesity, and cancer. Twenty-five patients had thrombophilia, 16 patients had factor V Leiden (R506Q mutation, and seven patients had MTHFR C677T mutation. Ninety-two percent of patients screened for thrombophilia were positive. Screening was requested in young patients (16, patients with recurrent (11, spontaneous (8, and extensive (5 venous thrombosis, familial history (5, pregnancy (4, estroprogestative treatment (3, and air travel (1. Nine patients had one, 11 patients had two, and five had three of these conditions. Follow-up (6 to 120 months of these 25 patients treated with antivitamin K did not reveal recurrences or complications related to venous thromboembolism.Conclusion: Factor V Leiden mutation followed by MTHFR mutation are the most commonly observed genetic abnormalities in these series. Defining risk factors and screening for thrombophilia when indicated reduce recurrence rate and complications. Recommendations for thrombophilia screening will be proposed.Keywords: venous thrombosis, risk factors, genetics, factor V

  14. The Association of Academic Health Sciences Libraries Annual Statistics: an exploratory twenty-five-year trend analysis.

    Science.gov (United States)

    Byrd, Gary D; Shedlock, James

    2003-04-01

    This paper presents an exploratory trend analysis of the statistics published over the past twenty-four editions of the Annual Statistics of Medical School Libraries in the United States and Canada. The analysis focuses on the small subset of nineteen consistently collected data variables (out of 656 variables collected during the history of the survey) to provide a general picture of the growth and changing dimensions of services and resources provided by academic health sciences libraries over those two and one-half decades. The paper also analyzes survey response patterns for U.S. and Canadian medical school libraries, as well as osteopathic medical school libraries surveyed since 1987. The trends show steady, but not dramatic, increases in annual means for total volumes collected, expenditures for staff, collections and other operating costs, personnel numbers and salaries, interlibrary lending and borrowing, reference questions, and service hours. However, when controlled for inflation, most categories of expenditure have just managed to stay level. The exceptions have been expenditures for staff development and travel and for collections, which have both outpaced inflation. The fill rate for interlibrary lending requests has remained steady at about 75%, but the mean ratio of items lent to items borrowed has decreased by nearly 50%.

  15. [Anemia and nutritional status of infants from two to five months of age treated in facilities of the Ministry of Health of Peru, 2012].

    Science.gov (United States)

    Gómez-Guizado, Guillermo; Munares-García, Oscar

    2014-01-01

    Determine the characteristics of the levels of anemia in infants from two to five months of age treated in facilities of the Ministry of Health of Peru during 2012. This cross-sectional study uses the nutritional status information system of the National Center for Food and Nutrition, National Institute of Health of Peru in 2012. Records of 7,513 infants from two to five months of age treated in small outpatient clinics, centers and hospitals of the Ministry of Health of Peru's 25 regions were analyzed. Descriptive statistics and logistic regression techniques were used for data analysis. 10.2% (95% CI 9.5-10.9) of the infants had anemia, with frequency differences by month of age (panemia were: age of 4 months (OR 1.2; 95% CI 1.0-1.5), age of 5 months (OR 1.4; 95% CI 1.2-1.6), obesity (OR 0.7; 95% CI 0.5-1.0) and chronic malnutrition (OR 1.3; 95% CI 1.0-1.6). The presence of anemia and chronic malnutrition before 6 months of age was evidenced, as well as that the probability of anemia increases with age and is associated with some components of nutritional status.

  16. Single-Fraction Carbon-Ion Radiation Therapy for Patients 80 Years of Age and Older With Stage I Non-Small Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Karube, Masataka, E-mail: mstk117@gmail.com [Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Department of Radiology, The University of Tokyo Hospital, Tokyo (Japan); Yamamoto, Naoyoshi; Nakajima, Mio [Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Yamashita, Hideomi; Nakagawa, Keiichi [Department of Radiology, The University of Tokyo Hospital, Tokyo (Japan); Miyamoto, Tadaaki; Tsuji, Hiroshi [Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Fujisawa, Takehiko [Chiba Foundation for Health Promotion and Disease Prevention, Chiba (Japan); Kamada, Tadashi [Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan)

    2016-05-01

    Purpose: In an aging society, many senior citizens want less invasive treatment because of potential medical complications. The National Institute of Radiological Sciences has started to treat stage I lung cancer with single-fraction carbon-ion radiation therapy (CIRT) as a dose escalation prospective phase 1/2 trial. We evaluated the efficacy and safety of CIRT for patients 80 years of age and older, undergoing single-fraction CIRT. Methods and Materials: Peripheral non-small cell lung cancer patients who were treated with single-fraction CIRT were prospectively followed. We analyzed the data from among these patients 80 years of age and older. Results: There were 70 patients. Median age was 83 years (range: 80-89) and median follow-up period was 42.7 months (range: 12-128 months). Three-year local control, cause-specific survival, and overall survival rates were 88.0%, 81.6%, and 72.4%, respectively. Five-year local control, cause-specific survival, and overall survival rates were 85.8%, 64.9%, and 39.7%, respectively. There were no adverse effects higher than grade 2 either in the acute or late phase in terms of skin and lung. Analgesic agents were necessary for only 5 patients (7.1%), to relieve muscular or rib fracture pain caused by irradiation. Conclusions: Single-fraction CIRT was low-risk and effective, even for the elderly.

  17. Single-Fraction Carbon-Ion Radiation Therapy for Patients 80 Years of Age and Older With Stage I Non-Small Cell Lung Cancer

    International Nuclear Information System (INIS)

    Karube, Masataka; Yamamoto, Naoyoshi; Nakajima, Mio; Yamashita, Hideomi; Nakagawa, Keiichi; Miyamoto, Tadaaki; Tsuji, Hiroshi; Fujisawa, Takehiko; Kamada, Tadashi

    2016-01-01

    Purpose: In an aging society, many senior citizens want less invasive treatment because of potential medical complications. The National Institute of Radiological Sciences has started to treat stage I lung cancer with single-fraction carbon-ion radiation therapy (CIRT) as a dose escalation prospective phase 1/2 trial. We evaluated the efficacy and safety of CIRT for patients 80 years of age and older, undergoing single-fraction CIRT. Methods and Materials: Peripheral non-small cell lung cancer patients who were treated with single-fraction CIRT were prospectively followed. We analyzed the data from among these patients 80 years of age and older. Results: There were 70 patients. Median age was 83 years (range: 80-89) and median follow-up period was 42.7 months (range: 12-128 months). Three-year local control, cause-specific survival, and overall survival rates were 88.0%, 81.6%, and 72.4%, respectively. Five-year local control, cause-specific survival, and overall survival rates were 85.8%, 64.9%, and 39.7%, respectively. There were no adverse effects higher than grade 2 either in the acute or late phase in terms of skin and lung. Analgesic agents were necessary for only 5 patients (7.1%), to relieve muscular or rib fracture pain caused by irradiation. Conclusions: Single-fraction CIRT was low-risk and effective, even for the elderly.

  18. [The influence of age and illness duration on cognitive impairment in aging patients with relapsing-remitting multiple sclerosis (RR-MS)].

    Science.gov (United States)

    Leclercq, Eugénie; Cabaret, Maryline; Guilbert, Alma; Jougleux, Caroline; Vermersch, Patrick; Moroni, Christine

    2014-09-01

    The aim of this study was to dissociate age and duration of illness effects on cognitive impairment of patients with relapsing-remitting multiple sclerosis. Cognitive impairment among patients with multiple sclerosis (MS) is well known. However, few studies were devoted to assess the respective role of disease duration and age on cognitive functions in MS patients. Therefore, two studies were carried out on relapsing-remitting MS (RR-MS) patients using some tests of the BCcogSEP--a French test battery evaluating cognitive functions in MS. The cognitive deficits of RR-MS patients aged 50 years and over and whose symptoms had been present for more than 20 years were more severe than those of MS patients with a shorter illness duration (less than 10 years) or matched-age control participants. The more impaired cognitive functions were information-processing speed, episodic memory, verbal fluency and attention. On the other hand, cognitive performances of young RR-MS patients were similar to those of older RR-MS patients when all patients had the same illness duration (8 years in this study). Older patients even achieved better performance than younger ones on verbal fluency. This can be partly explained by the theory of cognitive reserve, as reported in previous cognitive aging studies. In RR-MS patients, the influence of illness duration seems to be a predominant factor in the development of cognitive impairment.

  19. [METABOLIC STATUS OF PATIENTS OF DIFFERENT AGE GROUPS ON THE STAGES OF OSTEOARTHRITIS].

    Science.gov (United States)

    Stogov, M V; Ovchinnikov, E N; Sazonova, N V

    2015-01-01

    This study investigated the biochemical parameters of blood and urine in patients with osteoarthritis in the stages of the pathological process in different age groups. The patients of all age groups in the stages of osteoarthritis demonstrated metabolic acidosis, activation of the antioxidant system and increase in acute phase proteins. In addition to the total for all age groups metabolic shifts the characteristic age-related changes were observed: activated reaction of lipid peroxidation in middle-aged patients and negative calcium balance, with increasing energy metabolism disorders in elderly patients.

  20. Big Five personality traits and medically unexplained symptoms in later life.

    Science.gov (United States)

    van Dijk, S D M; Hanssen, D; Naarding, P; Lucassen, P; Comijs, H; Oude Voshaar, R

    2016-10-01

    Personality dysfunction has been postulated as the most clinically salient problem of persons suffering from medically unexplained symptoms (MUS) but empirical studies are scarce. This study aims to compare the personality profile of older patients suffering from MUS with two comparison groups and a control group. Ninety-six older patients with MUS were compared with 153 frequent attenders in primary care suffering from medically explained symptoms (MES), 255 patients with a past-month depressive disorder (DSM-IV-TR), and a control group of 125 older persons. The Big Five personality domains (NEO-Five-Factor Inventory) were compared between groups by multiple ANCOVAs adjusted for age, sex, education, partner status and cognitive functioning. Linear regression analyses were applied to examine the association between health anxiety (Whitley Index) and somatization (Brief Symptom Inventory). The four groups differed with respect to neuroticism (Ppersonality profile. Health anxiety and somatization were associated with a higher level of neuroticism and a lower level of extraversion and conscientiousness, irrespective whether the physical symptom was explained or not. Older patients with MUS have a specific personality profile, comparable to MES patients. Health anxiety and somatization may be better indicators of psychopathology than whether a physical symptom is medically explained or not. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  1. Personalized therapy in multiple myeloma according to patient age and vulnerability

    DEFF Research Database (Denmark)

    Palumbo, Antonio; Bringhen, Sara; Ludwig, Heinz

    2011-01-01

    Most patients with newly diagnosed multiple myeloma (MM) are aged > 65 years with 30% aged > 75 years. Many elderly patients are also vulnerable because of comorbidities that complicate the management of MM. The prevalence of MM is expected to rise over time because of an aging population. Most...... elderly patients with MM are ineligible for autologous transplantation, and the standard treatment has, until recently, been melphalan plus prednisone. The introduction of novel agents, such as thalidomide, bortezomib, and lenalidomide, has improved outcomes; however, elderly patients with MM are more......, occurrence of serious nonhematologic adverse events during treatment should be carefully taken into account to adjust doses and optimize outcomes....

  2. Collagenous gastritis: a morphologic and immunohistochemical study of 40 patients.

    Science.gov (United States)

    Arnason, Thomas; Brown, Ian S; Goldsmith, Jeffrey D; Anderson, William; O'Brien, Blake H; Wilson, Claire; Winter, Harland; Lauwers, Gregory Y

    2015-04-01

    Collagenous gastritis is a rare condition defined histologically by a superficial subepithelial collagen layer. This study further characterizes the morphologic spectrum of collagenous gastritis by evaluating a multi-institutional series of 40 patients (26 female and 14 male). The median age at onset was 16 years (range 3-89 years), including 24 patients (60%) under age 18. Twelve patients (30%) had associated celiac disease, collagenous sprue, or collagenous colitis. Hematoxylin and eosin slides were reviewed in biopsies from all patients and tenascin, gastrin, eotaxin, and IgG4/IgG immunohistochemical stains were applied to a subset. The distribution of subepithelial collagen favored the body/fundus in pediatric patients and the antrum in adults. There were increased surface intraepithelial lymphocytes (>25 lymphocytes/100 epithelial cells) in five patients. Three of these patients had associated celiac and/or collagenous sprue/colitis, while the remaining two had increased duodenal lymphocytosis without specific etiology. An eosinophil-rich pattern (>30 eosinophils/high power field) was seen in 21/40 (52%) patients. Seven patients' biopsies demonstrated atrophy of the gastric corpus mucosa. Tenascin immunohistochemistry highlighted the subepithelial collagen in all 21 specimens evaluated and was a more sensitive method of collagen detection in biopsies from two patients with subtle subepithelial collagen. No increased eotaxin expression was identified in 16 specimens evaluated. One of the twenty-three biopsies tested had increased IgG4-positive cells (100/high power field) with an IgG4/IgG ratio of 55%. In summary, collagenous gastritis presents three distinct histologic patterns including a lymphocytic gastritis-like pattern, an eosinophil-rich pattern, and an atrophic pattern. Eotaxin and IgG4 were not elevated enough to implicate these pathways in the pathogenesis. Tenascin immunohistochemistry can be used as a sensitive method of collagen detection.

  3. Early vascular aging in young and middle-aged ischemic stroke patients: the Norwegian Stroke in the Young Study.

    Directory of Open Access Journals (Sweden)

    Sahrai Saeed

    Full Text Available Ischemic stroke survivors have high risk of cardiovascular morbidity and mortality even at young age, suggesting that early arterial aging is common among such patients.We measured aortic stiffness by carotid-femoral pulse wave velocity (PWV in 205 patients (69% men aged 15-60 years with acute ischemic stroke in the prospective Norwegian Stroke in the Young Study. High for age carotid-femoral PWV was identified in the reference normogram.Patients were on average 49 ± 10 years old, 34% had a history of hypertension and 37% had metabolic syndrome (MetS. In the total study population, higher PWV was associated with history of hypertension (β = 0.18, higher age (β = 0.34, systolic blood pressure (BP (β = 0.28 and serum creatinine (β = 0.18 and lower high-density lipoprotein (HDL cholesterol (β = -0.10, all p < 0.01 in multivariate linear regression analysis (multiple R2 = 0.42, p < 0.001. High for age PWV was found in 18% of patients. In univariate analyses, known hypertension was associated with a 6-fold, MetS with a 4-fold and presence of carotid plaque with a 3.7-fold higher risk for high for age PWV (all p < 0.01. In multiple logistic regression analysis higher systolic BP (odds ratio [OR] 1.04; 95% confidence interval [CI] 1.02-1.06; p < 0.01, history of hypertension (OR 3.59; 95% CI 1.52-8.51; p < 0.01, low HDL cholesterol (OR 3.03; 95% CI 1.00-9.09; p = 0.05 and higher serum creatinine (OR 1.04; 95% CI 1.01-1.06; p < 0.01 were associated with high for age PWV.Higher PWV is common in younger and middle-aged ischemic stroke patients and associated with a clustering of classical cardiovascular risk factors. ClinicalTrials.gov NCT01597453.

  4. Retrospective analysis of two hundred thirty-five pediatric mandibular fracture cases.

    Science.gov (United States)

    Eskitascioglu, Teoman; Ozyazgan, Irfan; Coruh, Atilla; Gunay, Galip K; Yuksel, Esabil

    2009-11-01

    Maxillofacial fractures are encountered less commonly during childhood period due to anatomic, social, cultural, and environmental factors. Although the incidence of all maxillofacial fractures is 1% to 15% among pediatric and adolescent patients, this rate drops to less than 1% in children below 5 years age. Two hundred thirty-five cases (mandibular fracture were evaluated retrospectively. Patients records were examined in terms of age, gender, cause of fracture, fracture localization, number of fractures, fracture pattern, accompanying injuries, applied treatment methods, and complications. Mean age of cases was 9.2 years and 165 cases were male, 70 were female. Traffic accidents as the most common etiologic cause in all ages. Falls is the second most common cause which particularly affects children above age of 2 years. All cases had 333 fractures and the most common fracture localization was parasymphysis region (34%). The other most common fracture localizations were as follows: condyle (19%), corpus (13%), dentoalveolar region (12%), angulus (11%), symphysis region (9%), and ramus (2%). There was only a single fracture line in 145 cases, 40 cases had unilateral multiple and 50 cases had bilateral fracture lines. We applied symptomatic (conservative) treatment in 20 (8%) of our cases; fracture fixation with interdental wires or closed reduction methods were employed in 122 patients. Internal fixation with open reduction (OR) was performed on 51 (22%) patients. Both closed and OR techniques were carried out in 30 (13%) patients. Pediatric mandibular fractures, which are seen less frequently compared with those of adults, require a specific and different treatment. Although mostly less invasive methods are preferred, we believe that ORs should be considered when required.

  5. Rotator cuff surgery in patients with rheumatoid arthritis: clinical outcome comparable to age, sex and tear size matched non-rheumatoid patients.

    Science.gov (United States)

    Lim, S J; Sun, J-H; Kekatpure, A L; Chun, J-M; Jeon, I-H

    2017-09-01

    Aims This study aimed to compare the clinical outcomes of rotator cuff repair in patients with rheumatoid arthritis with those of patients who have no known history of the disease. We hypothesised that the functional outcomes are comparable between patients and without rheumatoid arthritis and may be affected by the level of disease activity, as assessed from C-reactive protein (CRP) level and history of systemic steroid intake. Patients and methods We conducted a retrospective review of the institutional surgical database from May 1995 to April 2012. Twenty-nine patients with rheumatoid arthritis who had rotator cuff repair were enrolled as the study group. Age, sex, and tear size matched patients with no disease who were selected as the control group. The mean duration of follow-up was 46 months (range 24-92 months). Clinical outcomes were assessed with the American Shoulder and Elbow Surgeons (ASES) questionnaire, Constant score and visual analogue scale (VAS). All data were recorded preoperatively and at regular postoperative follow-up visits. CRP was measured preoperatively as the disease activity marker for rheumatoid arthritis. Medication history was thoroughly reviewed in the study group. Results In patients with rheumatoid arthritis, all shoulder functional scores improved after surgery (ASES 56.1-78.1, Constant 50.8-70.5 and VAS 5.2-2.5; P rheumatoid arthritis was comparable to that of the control group (difference with control: ASES 78.1 vs. 85.5, P = 0.093; Constant 70.5 vs. 75.9, P = 0.366; VAS 2.5 vs. 1.8, P = 0.108). Patients with rheumatoid arthritis who had an elevated CRP level (> 1 mg/dl) showed inferior clinical outcomes than those with normal CRP levels. Patients with a history of systemic steroid intake showed inferior functional outcomes than those who had not taken steroids. Conclusions Surgical intervention for rotator cuff tear in patients with rheumatoid arthritis improved the shoulder functional outcome comparable to that in

  6. Mission possible: twenty-five years of university and college collaboration in baccalaureate nursing education.

    Science.gov (United States)

    Zawaduk, Cheryl; Duncan, Susan; Mahara, M Star; Tate, Betty; Callaghan, Doris; McCullough, Deborah; Chapman, Marilyn; Van Neste-Kenny, Jocelyne

    2014-10-01

    In Canada, nurse educators from five postsecondary institutions in the province of British Columbia established a collaborative nursing education initiative in 1989, with a vision to transform RN college diploma programs to baccalaureate degree programs. The principles, processes, and structures that served to develop and sustain this nursing education initiative are briefly reviewed. Curriculum, scholarship, and education legislation serve as platforms to critically explore a 25-year history (1989-2014) of successes, challenges, and transitions within this unique nursing education collaboration. The importance of curriculum development as faculty development, program evaluation as an adjunct to pedagogical scholarship, diversity of cross-institutional mandates, political interplay in nursing education, collegiality, and courageous leadership are highlighted. Nurse educators seeking to create successful collaborations must draw upon well-defined principles and organizational structures and processes to guide pedagogical practices and inquiry while remaining mindful of and engaged in professional and societal developments. Copyright 2014, SLACK Incorporated.

  7. Parieto-occipital encephalomalacia in children; clinical and electrophysiological features of twenty-seven cases.

    Science.gov (United States)

    Karaoğlu, Pakize; Polat, Ayşe İpek; Yiş, Uluç; Hız, Semra

    2015-01-01

    Brain injuries occurring at a particular time may cause damages in well-defined regions of brain. Perinatal hypoxic ischemic encephalopathy and hypoglycemia are some of the most common types of brain injuries. Neonatal hypoglycemia can cause abnormal myelination in parietal and occipital lobes resulting in parieto-occipital encephalomalacia. There is a small number of studies about clinical and electroencephalographic (EEG) features of children with parieto-occipital encephalomalacia. They might have important neurologic sequelae such as cortical visual loss, seizures, and psychomotor retardation. We aimed to evaluate the causes of parieto-occipital encephalomalacia and evaluate the clinical and electrophysiological features of children with parieto-occipital encephalomalacia. We evaluated clinical features and EEGs of 27 children with parieto-occipital encephalomalacia. Descriptive statistics were used. Hospitalization during the neonatal period was the most common cause (88.9%) of parieto-occipital brain injury. Eleven patients (40.7%) had a history of neonatal hypoglycemia. Twenty-three patients (85.2%) had epilepsy and nine of the epileptic patients (39%) had refractory seizures. Most of the patients had bilateral (50%) epileptic discharges originating from temporal, parietal, and occipital lobes (56.2%). However, some patients had frontal sharp waves and some had continuous spike and wave discharges during sleep. Visual abnormalities were evident in 15 (55.6%) patients. Twenty-two (81.5%) had psychomotor retardation. Fine motor skills, social contact and language development were impaired more than gross motor skills. In our study, most of the patients with parieto-occipital encephalomalacia had an eventful perinatal history. Epilepsy, psychomotor retardation, and visual problems were common neurologic complications.

  8. Characteristics and Outcome of Patients Diagnosed With HIV at Older Age.

    Science.gov (United States)

    Asher, Ilan; Guri, Keren Mahlab; Elbirt, Daniel; Bezalel, Shira Rosenberg; Maldarelli, Frank; Mor, Orna; Grossman, Zehava; Sthoeger, Zev M

    2016-01-01

    To characterize the clinical, virological, and immunological status at presentation as well as the outcome of patients diagnosed with HIV above the age of 50. A retrospective study of 418 patients newly diagnosed with HIV in 1 Israeli center, between the years 2004 and 2013. Patients with new HIV diagnosis ≥ 50 years of age defined as "older' and < 50 defined as "younger.' Patients were evaluated every 1 to 3 months (mean follow-up 53 ± 33 months). Patients with < 2 CD4/viral-load measurements or with < 1 year of follow-up were excluded. Time of HIV infection was estimated by HIV sequence ambiguity assay. Ambiguity index ≤ 0.43 indicated recent (≤ 1 year) HIV infection. Eighty nine (21%) patients were diagnosed with HIV at an older age. Those older patients presented with significant lower CD4 cell counts and higher viral-load compared with the younger patients. At the end of the study, the older patients had higher mortality rate (21% vs 3.5%; P < 0.001) and lower CD4 cell counts (381 ± 228 vs 483 ± 26 cells/μL; P < 0.001) compared with the younger patients. This difference was also observed between older and younger patients with similar CD4 cell counts and viral load at the time of HIV diagnosis and among patients with a recent (≤ 1 year) HIV infection. One-fifth of HIV patients are diagnosed at older age (≥ 50 years). Those older patients have less favorable outcome compared with the younger patients. This point to the need of educational and screening programs within older populations and for a closer follow-up of older HIV patients.

  9. Affective and cognitive determinants of intention to consume twenty foods that contribute to fat intake

    NARCIS (Netherlands)

    Stafleu, A.; Graaf, de C.; Staveren, van W.A.; Burema, J.

    2001-01-01

    Fishbein and Ajzen's theory of reasoned action was used as a framework to study beliefs and attitudes towards twenty foods that contribute to fat intake in a Netherlands smaple population. Subjects between 18 and 75 years of age (n = 419, response rate 23€filled out a self-administered

  10. [Brain Perfusion, Cognitive Functions, and Vascular Age in Middle Aged Patients With Essential Arterial Hypertension].

    Science.gov (United States)

    Parfenov, V A; Ostroumova, T M; Pеrepelova, E M; Perepelov, V A; Kochetkov, A I; Ostroumova, O D

    2018-05-01

    This study aimed to assess the cognitive functions and cerebral blood flow measured with arterial spin labeling (ASL) and their possible correlations with vascular age in untreated middle-aged patients with grade 1-2 essential arterial hypertension (EAH). We examined 73 subjects aged 40-59 years (33 with EAH and 40 healthy volunteers [controls]). Neuropsychological assessment included Montreal Cognitive Assessment (MoCA), Trail Making test (part A and part B), Stroop Color and Word Test, verbal fluency test (phonemic verbal fluency and semantic verbal fluency), 10‑item word list learning task. All subjects underwent brain MRI. MRI protocol included ASL. Vascular age was calculated by two techniques - using Framingham Heart Study risk tables and SCORE project scales. Patients with EAH had lower performance on phonemic verbal fluency test and lower mean MoCA score (29.2±1.4 vs. 28.1±1.7 points) compared to controls (13.4±3.2, р=0.002; 29.2±1.4, p=0.001, respectively). White matter hyperintensities (WMH) were present in 7.5 % controls and in 51.5 % EAH patients (р=0.0002). Cerebral blood flow (CBF) in EAH patients was lower in both right (39.1±5.6 vs. 45.8±3.2 ml / 100 g / min) and left frontal lobes of the brain (39.2±6.2 и 45.2±3.6 ml / 100 g / min, respectively) compared to controls (р.

  11. Is Ureter Visualization Possible on Tc-99m DMSA Scintigraphy with Vesicoureteral Reflux Patients?

    Directory of Open Access Journals (Sweden)

    Hasan Atilgan

    2014-12-01

    Full Text Available Aim: Ureter or pelvicalyceal system is not be vizualized with 99mTechnetium- dimercaptosuccinic acid (99mTc-DMSA which is accumulated by renal cortex normally. In this study the cases whose ureters are visible were reviewed with 99mTc-DMSA scintigraphy. Material and Method: 18 patients (5 females, 13 males with median age 3.5 years (min 2 months-max 18 years were included in this study. Twenty ureters and/or pelvis of 18 patients were visible in 99mTc-DMSA scintigraphy. In two patients%u2019s both ureters were visible. Vesicoureteral reflux (VUR grade, 99mTc-DMSA uptake, renal size, status of pelvicalyceal system, urea, creatinine levels were evaluated in all patients. Results: Three of the visible ureters were actually due to pelvicaliectasis. These pelvicaliectasic patients were excluded from the study. In the evaluation of the remaining 17 ureters of patients, congenital megaureter was present in three patients. Grade 3 VUR was detected in three patients, grade 4 was in three patients. VUR is seen as grade five in eight kidneys of seven patients because one of these patients has bilateral vizualized ureter. Discussion: In patients with congenital megaureter and VUR, ureters can be visible with 99mTc-DMSA scintigraphy and further imaging modalities are recommended for these patients.

  12. Age and type of aphasia in patients with stroke.

    Science.gov (United States)

    Eslinger, P J; Damasio, A R

    1981-01-01

    The age and gender of a series of patients with different types of aphasia were analysed. Regardless of gender, patients with Broca and conduction aphasias were significantly younger than those with Wernicke and global aphasias. Considering the established cerebral localisation of each of those aphasia types, it appears that, with age, stroke in the territory of the middle cerebral artery will tend to either shift posteriorly (producing Wernicke aphasia) or occupy most of the middle cerebral artery territory (producing global aphasia). But in the absence of concurrent verification of the locus of lesion in each of the cases in our sample, a possible alternative hypothesis must be entertained: that there might be age-related changes in the neurophysiological mechanism subserving language, such that some types of aphasia would tend to be more prevalent with age, regardless of lesion location. PMID:7264683

  13. [Detection of Entamoeba histolytica and Entamoeba dispar by PCR in children, less than five years of age with diarrhea, in Maracaibo, Venezuela. A preliminary study].

    Science.gov (United States)

    Bracho Mora, Angela; Rivero de Rodríguez, Zulbey; Arraiz, Nailet; Villalobos, Rafael; Urdaneta, Haydee

    2013-12-01

    To determine the prevalence of Entamoeba histolytica as a producer of diarrhea, a study was conducted in children, less than five years of age, with diarrhea who attended several out patient clinics of the Servicio Aut6nomo Hospital Universitario, Maracaibo, Venezuela. A macroscopic and microscopic examination with physiological saline, lugol and Kinyoun staining were performed to the stool samples obtained. The remainder of the sample was frozen until DNA extraction, and PCR amplification was performed separately for E. histolytica and E. dispar. Microscopic examination showed no trophozoites and/or cysts of Entamoeba histolytica/dispar/moshkovskii, or intestinal coccidians in any of the 50 samples analyzed. Parasites detected were Giardia lamblia (6%), Blastocystis sp. (4%), Pentatrichomonas hominis (2%), Ascaris lumbricoides (2%) and Trichuris trichiura (2%). By PCR, six samples (12%) had DNA of E. dispar and two (4%) had DNA from E. histolytica; no child showed association of both amoebae. The two children who had E. histolytica were one-year-old. E. dispar was detected in younger children. We suggest that the prevalence of E. histolytica in children under five years is really low.

  14. Heart Transplant in Patients with Predominantly Rheumatic Valvular Heart Disease.

    Science.gov (United States)

    Rosa, Vitor E E; Lopes, Antonio S S A; Accorsi, Tarso A D; Fernandes, Joao Ricardo C; Spina, Guilherme S; Sampaio, Roney O; Bacal, Fernando; Tarasoutchi, Flavio

    2015-09-01

    International records indicate that only 2.6% of patients with heart transplants have valvular heart disease. The study aim was to evaluate the epidemiological and clinical profile of patients with valvular heart disease undergoing heart transplantation. Between 1985 and 2013, a total of 569 heart transplants was performed at the authors' institution. Twenty patients (13 men, seven women; mean age 39.5 +/- 15.2 years) underwent heart transplant due to structural (primary) valvular disease. Analyses were made of the patients' clinical profile, laboratory data, echocardiographic and histopathological data, and mortality and rejection. Of the patients, 18 (90%) had a rheumatic etiology, with 85% having undergone previous valve surgery (45% had one or more operations), and 95% with a normal functioning valve prosthesis at the time of transplantation. Atrial fibrillation was present in seven patients (35%), while nine (45%) were in NYHA functional class IV and eight (40%) in class III. The indication for cardiac transplantation was refractory heart failure in seven patients (35%) and persistent NYHA class III/IV in ten (50%). The mean left ventricular ejection fraction (LVEF) was 26.6 +/- 7.9%. The one-year mortality was 20%. Histological examination of the recipients' hearts showed five (27.7%) to have reactivated rheumatic myocarditis without prior diagnosis at the time of transplantation. Univariate analysis showed that age, gender, LVEF, rheumatic activity and rejection were not associated with mortality at one year. Among the present patient cohort, rheumatic heart disease was the leading cause of heart transplantation, and a significant proportion of these patients had reactivated myocarditis diagnosed in the histological analyses. Thus, it appears valid to investigate the existence of rheumatic activity, especially in valvular cardiomyopathy with severe systolic dysfunction before transplantation.

  15. Five preference-based indexes in cataract and heart failure patients were not equally responsive to change.

    Science.gov (United States)

    Kaplan, Robert M; Tally, Steven; Hays, Ron D; Feeny, David; Ganiats, Theodore G; Palta, Mari; Fryback, Dennis G

    2011-05-01

    To compare the responsiveness to clinical change of five widely used preference-based health-related quality-of-life indexes in two longitudinal cohorts. Five generic instruments were simultaneously administered to 376 adults undergoing cataract surgery and 160 adults in heart failure management programs. Patients were assessed at baseline and reevaluated after 1 and 6 months. The measures were the Short Form (SF)-6D (based on responses scored from SF-36v2), Self-Administered Quality of Well-being Scale (QWB-SA), the EuroQol-5D developed by the EuroQol Group, the Health Utilities Indexes Mark 2 (HUI2) and Mark 3 (HUI3). Cataract patients completed the National Eye Institute Visual Functioning Questionnaire-25, and heart failure patients completed the Minnesota Living with Heart Failure Questionnaire. Responsiveness was estimated by the standardized response mean. For cataract patients, mean changes between baseline and 1-month follow-up for the generic indices ranged from 0.00 (SF-6D) to 0.052 (HUI3) and were statistically significant for all indexes except the SF-6D. For heart failure patients, only the SF-6D showed significant change from baseline to 1 month, whereas only the QWB-SA change was significant between 1 and 6 months. Preference-based methods for measuring health outcomes are not equally responsive to change. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Comparative evaluation of the efficacy and tolerability of itopride hydrochloride and domperidone in patients with non-ulcer dyspepsia.

    Science.gov (United States)

    Sawant, Prabha; Das, H S; Desai, Nutan; Kalokhe, S; Patil, S

    2004-08-01

    Prokinetic drugs are widely used for treatment of non-ulcer dyspepsia (NUD). To assess the efficacy and tolerability of a new prokinetic agent, itopride hydrochloride in patients of NUD and compare it with domperidone. Fifty-six patients who fulfilled the inclusion and exclusion criteria were enrolled in the study. Patients underwent upper gastrointestinal endoscopy to rule out organic pathology as a cause for their symptoms. The patient's symptoms were graded on a 4-point scale (0 to 3) at the beginning of treatment and at the end of Week-one and Week-two Patients were randomly allocated to receive either one tablet of itopride hydrochloride 50mg three times daily or one tablet of domperidone 10mg three times daily for two weeks. Pre-treatment and post-treatment hemogram, liver function and renal function tests, prolactin level and ECG were done in all patients. The response to therapy was evaluated by assessing the relief of symptoms at the end of two weeks on a 5-point scale. Statistical analysis was done using two-tailed paired t-test; Wilcoxon matched pairs ranks sum test, Mann-Whitney-U test and chi-square test as applicable. Of the fifty-five patients enrolled in the study (age range of 18-60 yrs, median age of 35yrs), 26 were males and twenty nine were females. They had a median duration of symptoms for 4 weeks. Twenty-seven patients received itopride and 28 received domperidone. One patient did not follow up in the domperidone group, thus 54 patients were evaluable for analysis. Moderate to complete symptomatic relief was observed in 22 (81%) patients in the itopride group and 19 patients (70%) in the domperidone group (p > 0.05, NS). Both the drugs were well tolerated and neither caused prolongation of QT interval nor any abnormality in any serum biochemistry values. Therapy with itopride resulted in good symptomatic relief, was safe, well tolerated and comparable in efficacy to domperidone in relieving the symptoms of NUD. By virtue of its efficacy and

  17. Twenty-third water reactor safety information meeting. Volume 3, structural and seismic engineering, primary systems integrity, equipment operability and aging, ECCS strainer blockage research and regulatory issues

    Energy Technology Data Exchange (ETDEWEB)

    Monteleone, S. [comp.] [Brookhaven National Lab., Upton, NY (United States)

    1996-03-01

    This three-volume report contains papers presented at the Twenty- Third Water Reactor Safety Information Meeting held at the Bethesda Marriott Hotel, Bethesda, Maryland, October 23-25, 1995. The papers are printed in the order of their presentation in each session and describe progress and results of programs in nuclear safety research conducted in this country and abroad. Foreign participation in the meeting included papers presented by researchers from France, Italy, Japan, Norway, Russia, Sweden, and Switzerland. This document, Volume 3, presents topics in Structural & Seismic Engineering, Primary Systems Integrity, Equipment Operability and Aging, and ECCS Strainer Blockage Research & Regulatory Issues. Individual papers have been cataloged separately.

  18. Twenty-third water reactor safety information meeting. Volume 3, structural and seismic engineering, primary systems integrity, equipment operability and aging, ECCS strainer blockage research and regulatory issues

    International Nuclear Information System (INIS)

    Monteleone, S.

    1996-03-01

    This three-volume report contains papers presented at the Twenty- Third Water Reactor Safety Information Meeting held at the Bethesda Marriott Hotel, Bethesda, Maryland, October 23-25, 1995. The papers are printed in the order of their presentation in each session and describe progress and results of programs in nuclear safety research conducted in this country and abroad. Foreign participation in the meeting included papers presented by researchers from France, Italy, Japan, Norway, Russia, Sweden, and Switzerland. This document, Volume 3, presents topics in Structural ampersand Seismic Engineering, Primary Systems Integrity, Equipment Operability and Aging, and ECCS Strainer Blockage Research ampersand Regulatory Issues. Individual papers have been cataloged separately

  19. Clinical review of tuberculous peritonitis in 39 patients in Diyarbakir, Turkey.

    Science.gov (United States)

    Tanrikulu, A Cetin; Aldemir, Mustafa; Gurkan, Fuat; Suner, Ali; Dagli, Canan Eren; Ece, Aydin

    2005-06-01

    Abdominal tuberculosis (TB) is a rare manifestation, which can be overlooked on long-lasting and non-specific findings unless a high index of suspicion is maintained. The purpose of the present study was to investigate the diagnostic features of 39 patients hospitalized with tuberculous peritonitis (TBP) in Dicle University Hospital, Turkey between January 1994 and August 2003. Twenty-two patients were male; patient age ranged between 1 and 59 years (mean: 16.2 +/- 14.4 years). There were 21 patients (54%) under 15 years of age. Thirteen children had a history of familial TB and seven adults had prior history of TB. Six (29%) of 21 pediatric cases had bacille Calmette-Guerin (BCG) scars and results of 5-tuberculin units (TU) tuberculin test were positive in seven children (18%). Of all cases, the most common presenting findings were abdominal pain (95%), ascites (92%) and abdominal distention (82%). Five of the patients had accompanying pulmonary TB, and six patients (15%) had intestinal TB who were admitted to emergency service with acute abdomen, of whom three (8%) had perforation and three (8%) had ileus. Histopathologically 20 cases (51%) were proven on abdominal ultrasonography, and computed tomography revealed most commonly ascites and thickening of peritoneum. No microbiologic evidence was obtained except three positive culture results for Mycobacterium tuberculosis. As a result, TBP should be considered for diagnosis, in patients with non-specific symptoms of abdominal pain, wasting, fever, loss of appetite, abdominal distension and even symptoms of acute abdomen, because early diagnosis and effective treatment will decrease morbidity and mortality. (c) 2005 Blackwell Publishing Asia Pty Ltd.

  20. Correlation of matrix metalloproteinase-3 expression with patient age, magnetic resonance imaging and histopathological grade in lumbar disc degeneration.

    Science.gov (United States)

    Canbay, Suat; Turhan, Nesrin; Bozkurt, Melih; Arda, Kemal; Caglar, Sukru

    2013-01-01

    The purpose of the present study is to analyze the expression of matrix metalloproteinase-3 (MMP-3), magnetic resonance imaging (MRI) grading and histopathological alterations of the intervertebral disc (IVD) for correlations with each other and with the age, gender and low back pain duration of the patients who had undergone operations for lumbar disc herniation (LDH). Forty-two patients were admitted to our clinic with signs of LDH and underwent surgery for LDH at 48 IVD levels. In all cases, specimens for histological and immunohistochemical analyses were removed from the IVD space. Lumbar IVD degeneration on MRI of the 48 IVDs from which surgical specimens had been obtained was classified into five grades using the Pfirrmann classification. In the degenerated IVD, the expression of MMP-3, MRI grading and histopathological alterations of the IVD displayed significant correlation. Increased age is closely related with aforementioned alterations. There was no correlation between MMP-3 expression and age, gender and duration of the pain. For evaluating and treating IVD degeneration, MRI is a good and non-invasive diagnostic tool to determine the severity of degeneration. MMP-3 may be a therapeutic target of the degenerated IVD.

  1. Age as a prognostic variable in patients undergoing transurethral prostatectomy

    DEFF Research Database (Denmark)

    Krogh, J; Jensen, J S; Iversen, H G

    1993-01-01

    In a retrospective study the outcome of transurethral prostatectomy (TURP) for benign prostatic hyperplasia (BPH) in patients more than 80 years old was compared to a control group of patients with a mean age ten years younger. The elderly had significantly more tissue resected and presented...... with a higher rate of preoperative urinary tract infection. More urological complications were seen among the elderly but these were generally short lived and had no influence on the morbidity, mortality and symptomatic outcome. The perioperative mortality was 3.2% among elderly and 0% in the younger age group....... A cardiorespiratory risk score could not predict patients at risk. In conclusion the age per se had no major influence on the outcome of TURP....

  2. Quantifying the risk of nosocomial infection within Ebola Holding Units: a retrospective cohort study of negative patients discharged from five Ebola Holding Units in Western Area, Sierra Leone.

    Science.gov (United States)

    Arkell, Paul; Youkee, Daniel; Brown, Colin S; Kamara, Abdul; Kamara, Thaim B; Johnson, Oliver; Lado, Marta; George, Viginia; Koroma, Fatmata; King, Matilda B; Parker, Benson E; Baker, Peter

    2017-01-01

    A central pillar in the response to the 2014 Ebola virus disease (EVD) epidemic in Sierra Leone was the role of Ebola Holding Units (EHUs). These units isolated patients meeting a suspect case definition, tested them for EVD, initiated appropriate early treatment and discharged negative patients to onward inpatient care or home. Positive patients were referred to Ebola Treatment Centres. We aimed to estimate the risk of nosocomial transmission within these EHUs. We followed up a cohort of 543 patients discharged with a negative EVD test from five EHUs in the Western Area, Sierra Leone, and examined all line-listed subsequent EVD tests from any facility in the Western Area to see whether the patient was retested within 30 days, matching by name, age and address. We defined possible readmissions as having the same name and age but uncertain address, and confirmed readmissions where name, age and address matched. We found a positive readmission rate of 3.3% (18 cases), which included 1.5% confirmed readmissions (8 cases) and 1.8% possible readmissions (10 cases). This is lower than rates previously reported. We cannot ascertain whether EVD was acquired within the EHUs or from re-exposure in the community. No demographic or clinical variables were identified as risk factors for positive readmission, likely due to our small sample size. These findings support the EHU model as a safe method for isolation of suspect EVD patients and their role in limiting the spread of EVD. © 2016 John Wiley & Sons Ltd.

  3. The Menarche Experience in Twenty-Three Foreign Countries.

    Science.gov (United States)

    Logan, Deana Dorman

    1980-01-01

    Ninety-five women (18-26 years of age) from 23 countries were interviewed regarding (1) their preparation for menarche, (2) messages from others at the time of menarche, and (3) their emotional responses to the first period. Mothers were the source of information for most girls. Others' reactions were primarily hygiene-centered. Comparisons with…

  4. Intra-Articular Analgesia and Steroid Reduce Pain Sensitivity in Knee OA Patients

    DEFF Research Database (Denmark)

    Jørgensen, Tanja Schjødt; Graven-Nielsen, Thomas; Ellegaard, Karen

    2014-01-01

    Objectives. To assess the effects of intra-articular therapy on pain sensitivity in the knee and surrounding tissues in knee OA patients. Methods. Twenty-five knee OA patients with symptomatic knee OA were included in this interventional cohort study. Pressure pain thresholds (PPT) were recorded...... muscles (control site). Results. Significantly increased PPTs were found following intra-articular injection, at both the knee (P effects were sustained for two weeks, and at some points the effect was even greater at two weeks (P 

  5. Characteristics and outcomes of patients with multiple myeloma aged 21-40 years versus 41-60 years: a multi-institutional case-control study.

    Science.gov (United States)

    Jurczyszyn, Artur; Nahi, Hareth; Avivi, Irit; Gozzetti, Alessandro; Niesvizky, Ruben; Yadlapati, Sujitha; Jayabalan, David S; Robak, Paweł; Pika, Tomas; Andersen, Kristian T; Rasche, Leo; Mądry, Krzysztof; Woszczyk, Dariusz; Raźny, Małgorzata; Usnarska-Zubkiewicz, Lidia; Knopińska-Posłuszny, Wanda; Wojciechowska, Małgorzata; Guzicka-Kazimierczak, Renata; Joks, Monika; Grosicki, Sebastian; Ciepłuch, Hanna; Rymko, Marcin; Vesole, David H; Castillo, Jorge J

    2016-12-01

    We compared the outcomes of multiple myeloma (MM) patients aged 21-40 and 41-60 years in the novel agent era. This case-control study included 1089 patients between 2000 and 2015. Cases and controls were matched for sex, International Staging System (ISS) stage and institution. There were 173 patients in the younger group and 916 patients in the older group. Younger patients presented with a higher incidence of lytic lesions (82% vs. 72%; P = 0·04) and high-risk cytogenetic abnormalities (83% vs. 68%; P = 0·007), but lower rate of elevated lactate dehydrogenase (21% vs. 44%; P < 0·001). Five- and 10-year overall survival (OS) in younger versus older patients was 83% vs. 67% and 56% vs. 39%, respectively (P < 0·001). Similar results were seen when studying the subset of 780 patients who underwent autologous transplantation. Younger patients with ISS stage 1 had a better OS than older patients (P < 0·001). There was no survival difference between younger and older patients with ISS stage 2 or 3. Younger MM patients, aged 21-40 years, treated in the era of novel agents have a better OS than their counterparts aged 41-60 years, but the survival advantage observed in younger patients was lost in more advanced stages of MM. © 2016 John Wiley & Sons Ltd.

  6. Age-specific MRI brain and head templates for healthy adults from twenty through eighty-nine years of age

    Directory of Open Access Journals (Sweden)

    Paul T Fillmore

    2015-04-01

    Full Text Available This study created and tested a database of adult, age-specific MRI brain and head templates. The participants included healthy adults from 20 through 89 years of age. The templates were done in 5-year, 10-year, and multi-year intervals from 20 through 89 years, and consist of average T1W for the head and brain, and segmenting priors for GM, WM, and CSF. It was found that age-appropriate templates provided less biased tissue classification estimates than age-inappropriate reference data and reference data based on young adult templates. This database is available for use by other investigators and clinicians for their MRI studies, as well as other types of neuroimaging and electrophysiological research (http://jerlab.psych.sc.edu/NeurodevelopmentalMRIDatabase/.

  7. Can patients determine the level of their dysphagia?

    Science.gov (United States)

    Ashraf, Hafiz Hamad; Palmer, Joanne; Dalton, Harry Richard; Waters, Carolyn; Luff, Thomas; Strugnell, Madeline; Murray, Iain Alexander

    2017-02-14

    To determine if patients can localise dysphagia level determined endoscopically or radiologically and association of gender, age, level and pathology. Retrospective review of consecutive patients presenting to dysphagia hotline between March 2004 and March 2015 was carried out. Demographics, clinical history and investigation findings were recorded including patient perception of obstruction level (pharyngeal, mid sternal or low sternal) was documented and the actual level of obstruction found on endoscopic or radiological examination (if any) was noted. All patients with evidence of obstruction including oesophageal carcinoma, peptic stricture, Schatzki ring, oesophageal pouch and cricopharyngeal hypertrophy were included in the study who had given a perceived level of dysphagia. The upper GI endoscopy reports (barium study where upper GI endoscopy was not performed) were reviewed to confirm the distance of obstructing lesion from central incisors. A previously described anatomical classification of oesophagus was used to define the level of obstruction to be upper, middle or lower oesophagus and this was compared with patient perceived level. Three thousand six hundred and sixty-eight patients were included, 42.0% of who were female, mean age 70.7 ± 12.8 years old. Of those with obstructing lesions, 726 gave a perceived level of dysphagia: 37.2% had oesophageal cancer, 36.0% peptic stricture, 13.1% pharyngeal pouches, 10.3% Schatzki rings and 3.3% achalasia. Twenty-seven point five percent of patients reported pharyngeal level (upper) dysphagia, 36.9% mid sternal dysphagia and 25.9% lower sternal dysphagia (9.5% reported multiple levels). The level of obstructing lesion seen on diagnostic testing was upper (17.2%), mid (19.4%) or lower (62.9%) or combined (0.3%). When patients localised their level of dysphagia to a single level, the kappa statistic was 0.245 ( P dysphagia were accurate in localising the obstructing pathology. With respect to pathology, patients

  8. Sublingual Immunotherapy with a Five-Grass Pollen Tablet in Adult Patients with Allergic Rhinitis: An Open, Prospective, Noninterventional, Multicenter Study

    Directory of Open Access Journals (Sweden)

    Oliver Pfaar

    2015-01-01

    Full Text Available Background. Although the safety and efficacy of sublingual immunotherapy (SLIT with a five-grass pollen tablet have been demonstrated in randomized clinical trials (RCTs, these outcomes must always be evaluated in real-life medical practice. Methods. In a prospective, open-label, noninterventional, “real-life” study in Germany, we evaluated the safety, tolerability, and effectiveness of SLIT with a five-grass pollen tablet in adults with grass-pollen-induced allergic rhinoconjunctivitis. Results. 808 adults were enrolled between September 2008 and December 2009. 35.3% of the participants experienced at least one adverse drug reaction (ADR, the most common of which were mild-to-moderate gastrointestinal and respiratory disorders. Serious ADRs considered causally related to SLIT treatment occurred in four patients. Overall, the five-grass pollen tablet was considered to have good or very good tolerability by most investigators and patients. Treatment was associated with the relief of nasal, ocular, and bronchial symptoms and decreased symptomatic medication use. However, interpretation of clinical improvements was limited by lower atmospheric grass pollen levels during the study season (relative to the preceding season. Conclusions. In a large population of patients treated in real-life medical practice, SLIT with a five-grass pollen tablet was safe and well tolerated. The patient-reported symptom relief suggests that SLIT was associated with clinical benefits.

  9. Non-verbal behavioral interactions of depressed patients with partners and strangers : The role of behavioral social support and involvement in depression persistence

    NARCIS (Netherlands)

    Hale, WW; Jansen, JHC; Bouhuys, AL; Jenner, JA; vandenHoofdakker, RH

    Excessive support seeking and lack of receiving social support have been associated with depression onset and unfavorable course of depression. It has been assumed that social support is effected by observable behaviors that express involvement. Twenty-five patients with major depression were

  10. Older age impacts on survival outcome in patients receiving curative surgery for solid cancer

    Directory of Open Access Journals (Sweden)

    Chang-Hsien Lu

    2018-07-01

    Full Text Available Summary: Background: Given the global increase in aging populations and cancer incidence, understanding the influence of age on postoperative outcome after cancer surgery is imperative. This study aimed to evaluate the impact of age on survival outcome in solid cancer patients receiving curative surgery. Methods: A total of 37,288 patients receiving curative surgeries for solid cancers between 2007 and 2012 at four affiliated Chang Gung Memorial Hospital were included in the study. All patients were categorized into age groups by decades for survival analysis. Results: The percentages of patient populations aged <40 years, 40–49 years, 50–59 years, 60–69 years, 70–79 years, and ≥80 years were 9.7%, 17.7%, 27.8%, 22.1%, 16.9%, and 5.7%, respectively. The median follow-up period was 38.9 months (range, 22.8–60.4 months and the overall, cancer-specific, and noncancer-specific mortality rates were 26.0%, 17.6%, and 8.5%, respectively. The overall mortality rate of patients in different age groups were 18.5%, 21.1%, 22.0%, 25.3%, 35.3%, and 49.0%, respectively. Compared to patients aged <40 years, more significant decrease in long-term survival were observed in aging patients. Multivariate analysis showed higher postoperative short-term mortality rates in patients older than 70 years, and the adjusted odds ratio of mortality risk ranged from 1.47 to 1.74 and 2.26 to 3.03 in patients aged 70–79 years and ≥80 years, respectively, compared to those aged <40 years. Conclusion: Aging was a negative prognostic factor of survival outcome in solid cancer patients receiving curative surgery. After adjustment of other clinicopathologic factors, the influence of age on survival outcome was less apparent in the elderly. Keywords: Age, Solid cancer, Surgical resection, Prognosis

  11. Absorptive Capacity and Innovation: An Overview of International Scientific Production of Last Twenty-Five Years

    Directory of Open Access Journals (Sweden)

    Dennys Eduardo Rossetto

    2017-02-01

    Full Text Available This work aims to achieve an overview of international scientific production on absorptive and innovation capacities in order to mapping the academic contributions already made between 1990 and 2015 (last 25 years. Bibliometric methods, and social network analysis were used to understand the behavior of 1,693 published articles and analysis of key works cited. Most notably, the growing publication with related topics, in approximate exponential growth, concentration of work into five groups and six cocitação periodic coupling groups, indicating possible fields for publication related to the themes absorptive capacity and innovation. The analysis of the key articles cited identifies the themes and methods used, as well as understand the context of the themes absorptive capacity and innovation.

  12. Phase II Study of Temozolomide and Thalidomide in Patients with Unresectable or Metastatic Leiomyosarcoma

    Directory of Open Access Journals (Sweden)

    Michelle S. Boyar

    2008-01-01

    Full Text Available We assessed the efficacy of combined temozolomide and thalidomide in patients with unresectable or metastatic leiomyosarcoma in a phase II single-institution trial. Twenty-four patients were enrolled. Temozolomide (150 mg/m2/day for 7 days every other week was administered with concomitant thalidomide (200 mg/day, and continued until unacceptable toxicity or disease progression. There were no complete responses and two (10% partial responses. Five patients (24% had stable disease for at least six months. Fourteen patients (67% progressed after a median of two-month treatment. The median overall survival (twenty-two assessable patients was 9.5 months [95% CI 7–28 months]. There were no treatment-related deaths or CTC grade 4 toxicities. Thirteen patients were dose-reduced or discontinued thalidomide due to toxicity. In conclusion, this combination of temozolomide and thalidomide provided disease stabilization in a subset of patients with advanced leiomyosarcoma. We hypothesize that temozolomide is the active agent in this regimen, and should be further studied.

  13. Gender and age influence the relationship between serum GH and IGF-I in patients with acromegaly.

    Science.gov (United States)

    Parkinson, C; Renehan, A G; Ryder, W D J; O'Dwyer, S T; Shalet, S M; Trainer, P J

    2002-07-01

    In patients with acromegaly serum IGF-I is increasingly used as a marker of disease activity. As a result, the relationship between serum GH and IGF-I is of profound interest. Healthy females secrete three times more GH than males but have broadly similar serum IGF-I levels, and women with GH deficiency require 30-50% more exogenous GH to maintain the same serum IGF-I as GH-deficient men. In a selected cohort of patients with active acromegaly, studied off medical therapy using a single fasting serum GH and IGF-I measurement, we have reported previously that, for a given GH level, women have significantly lower circulating IGF-I. To evaluate the influence of age and gender on the relationship between serum GH and IGF-I in an unselected cohort of patients with acromegaly independent of disease control and medical therapy. Sixty (34 male) unselected patients with acromegaly (median age 51 years (range 24-81 years) attending a colonoscopy screening programme were studied. Forty-five had previously received pituitary radiotherapy. Patients had varying degrees of disease control and received medical therapy where appropriate. Mean serum GH was calculated from an eight-point day profile (n = 45) and values obtained during a 75-g oral glucose tolerance test (n = 15). Serum IGF-I, IGFBP-3 and acid-labile subunit were measured and the dependency of these factors on covariates such as log10 mean serum GH, sex, age and prior radiotherapy was assessed using regression techniques. The median calculated GH value was 4.7 mU/l (range 1-104). A significant linear association was observed between serum IGF-I and log10 mean serum GH for the cohort (R = 0.5, P fall by 0.37 nmol/l per year (P = 0.04, 95% CI 0.015-0.72). In keeping with previous observations of relative GH resistance in normal and GH-deficient females we have observed lower serum IGF-I levels for equivalent mean serum GH levels in females patients with acromegaly. This gender-dependent difference is independent of

  14. Perforated gastric carcinoma in a young-age patient

    Directory of Open Access Journals (Sweden)

    Feng-Hsu Wu

    2018-06-01

    Full Text Available Perforation is a rare complication of gastric carcinoma, and it occurs in less than 5% of all gastric carcinoma cases and in less than 1% within all acute abdomen cases. The diagnosis of malignancy is usually not validated preoperatively. In previous reported English literature, all patients with perforated gastric cancer have the feature of old age. This feature might be able to guide the surgeon to impress the differential diagnosis of malignancy before or during the emergent operation of gastric perforation.This 32-year-old male patient suffered from sudden onset of epigastric pain. We performed emergent operation under the impression of hollow organ perforation. The postoperative pathologic report of gastric ulcer revealed gastric carcinoma. We performed second-stage operation of total gastrectomy with D2 lymphadenectomy smoothly 7 days later. As we know, this is the youngest patient having the condition of perforated gastric carcinoma reported in the literature. This case reminds us that it is possible for perforated gastric carcinoma to occur in young-age patients. Keywords: Gastric cancer, Acute abdomen, Gastric perforation

  15. Parotid tumor statistics for the past five years

    International Nuclear Information System (INIS)

    Yamaguchi, Soichi; Sueno, Kohei; Yamaguchi, Takeshi; Asano, Yukimi; Shiba, Kazutaka; Sekiguchi, Nao; Masuda, Takeshi

    2004-01-01

    We reviewed the case of 40 patients with parotid tumor who underwent an operation in the past five years. The patients included 23 (57.5%) males and 17 (42.5%) females. The average age was 53.4 years old with a range of 19 to 71 years. Thirty eight (95.0%) had benign tumor, and 2 (5.0%) had malignant tumor. Tc scintigraphy was performed in 37 out of the 40 patients, and 9 patients showed positive results. Six patients had warthin's tumor, and 3 had pleomorphic adenoma. In other words, 66.7% were positive for warthin's tumor. Ga scintigraphy was performed in 31 out of the 40 patients. Nine were positive out of the 10 benign tumor that showed a positive result. None of the cases had permanent facial palsy as a postoperative complication. Transient facial palsy was exhibited by 13 patients (32.5%), but they all improved 2 weeks to 6 months. In addition, we experienced 1 case of salivary fistula. Pleomorphic adenoma was noted in 63.2%, and warthin's tumor in 23.7%. There was no gender difference for pleomorphic adenoma, but 8 out of the 9 patients with warthin's tumor were men. The average age was 47.0 for pleomorphic adenoma and 58.7 for warthin's tumor which was in accordance with conventional reports. The Tc scintigraphy positive rate of warthin's tumor was low, 66.7%, in comparison with that in conventional reports. In addition, 90% of the tumors that showed positive results in Ga scintigraphy were preoperatively positive tumors, indicating the diagnostic usefulness of this. Transient facial palsy was a complication in 32.5% of the patients, which was similar to the rate in the conventional report. We experienced 1 case salivary fistula, which did not improve with conservative treatment. We opened the wounded area, and drained it by pressing. (author)

  16. Motor and non-motor symptoms in old-age onset Parkinson's disease patients.

    Science.gov (United States)

    Mendonça, Marcelo D; Lampreia, Tania; Miguel, Rita; Caetano, André; Barbosa, Raquel; Bugalho, Paulo

    2017-07-01

    Advancing age is a well-known risk factor for Parkinson's disease (PD). With population ageing it is expected that the total number of patients with PD onset at oldage increases. Information on the motor but particularly on non-motor phenotype of this late-onset population is lacking. We recruited 24 patients with PD onset at or over 75 years. Each patient was matched with 1 control patient with PD onset between the ages of 40 and 65 and matched for disease duration. Both groups were assessed with the UPDRS, the Non-motor symptoms scale (NMSS) and other scales to assess non-motor symptoms. Groups were compared with conditional logistic regression analysis. Old-age onset PD was, on average, 80 years at the time of PD onset while middle-age onset were 59. Disease duration was approximately 5 years in both groups. While no difference was observed in the total UPDRS-III scores, old-age onset PD was associated with higher axial symptoms (7.42 vs. 4.63, p = 0.011) and a higher frequency of dementia (7/24 vs. 0/24, p = 0.009). While no difference in the total number of non-motor symptoms was observed (6.79 vs. 6.22, p = 0.310), old-age onset patients had a higher prevalence of gastrointestinal symptoms (20/24 vs. 12/24, p = 0.037). For the same disease duration, older age onset is associated with worse axial motor dysfunction and dementia in PD patients. Beside gastrointestinal symptoms, non-motor symptoms are not associated with age.

  17. Patients Unicondylar Knee Replacement vs. Total Knee Replacement

    OpenAIRE

    Hedra Eskander

    2017-01-01

    The aim of this review article is to analyse the clinical effectiveness of total knee replacement (TKR) compared to unicondylar knee replacement (UKR) on patients. In terms of survival rates, revision rates and postoperative complications. The keywords used were: knee arthroplasty. Nearly three thousand articles were found on 25 August 2016. Of those, only twenty-five were selected and reviewed because they were strictly focused on the topic of this article. Compared with those who have TKR, ...

  18. Serum homocystein level in patients with scleroderma.

    Science.gov (United States)

    Nazarinia, Mohammadali; Shams, Mesbah; Kamali Sarvestani, Eskandar; Shenavande, Saeede; Khademalhosseini, Maryam; Khademalhosseini, Zeinab

    2013-01-01

    Systemic Sclerosis (SSc) is a systemic connective tissue disease. In this study, we compared the serum Homocystein (Hcy) level between patients with SSc and normal control group. The current study was conducted to determine whether serum Hcy levels are elevated in SSc patients and whether there is any correlation between Hcy levels and RP, Gastro intestinal and lung involvement. Forty one patients who fulfilled the diagnostic criteria for SSc (39 females and 5 males) and Forty four community-based healthy individuals (sex and age matched) were enrolled in to the study. Serum Hcy, vitamin B12, and folate levels were determined. Thirty three patients (70.45%) had GI involvement, twenty two patients (50%) had lung involvement and twenty seven patients (61.36%) had Raynaud's phenomena. Mean serum Hcy level in control group was 22.78 ± 6.018 μmol/L and in case group was 19.43 ± 7.205 μmol/L, shows that the serum Hcy level in control group was significantly higher than patients (P = 0.020). Serum Hcy level is significantly lower in SSc patients than in control group. There is no statistically significant correlation between serum Hcy level and organ involvements.

  19. Interventions for increasing fruit and vegetable consumption in children aged five years and under.

    Science.gov (United States)

    Hodder, Rebecca K; O'Brien, Kate M; Stacey, Fiona G; Wyse, Rebecca J; Clinton-McHarg, Tara; Tzelepis, Flora; James, Erica L; Bartlem, Kate M; Nathan, Nicole K; Sutherland, Rachel; Robson, Emma; Yoong, Sze Lin; Wolfenden, Luke

    2018-05-17

    Insufficient consumption of fruits and vegetables in childhood increases the risk of future non-communicable diseases, including cardiovascular disease. Interventions to increase consumption of fruit and vegetables, such as those focused on specific child-feeding strategies and parent nutrition education interventions in early childhood may therefore be an effective strategy in reducing this disease burden. To assess the effectiveness, cost effectiveness and associated adverse events of interventions designed to increase the consumption of fruit, vegetables or both amongst children aged five years and under. We searched CENTRAL, MEDLINE, Embase and two clinical trials registries to identify eligible trials on 25 January 2018. We searched Proquest Dissertations and Theses in November 2017. We reviewed reference lists of included trials and handsearched three international nutrition journals. We contacted authors of included studies to identify further potentially relevant trials. We included randomised controlled trials, including cluster-randomised controlled trials and cross-over trials, of any intervention primarily targeting consumption of fruit, vegetables or both among children aged five years and under, and incorporating a dietary or biochemical assessment of fruit or vegetable consumption. Two review authors independently screened titles and abstracts of identified papers; a third review author resolved disagreements. Two review authors independently extracted data and assessed the risks of bias of included studies; a third review author resolved disagreements. Due to unexplained heterogeneity, we used random-effects models in meta-analyses for the primary review outcomes where we identified sufficient trials. We calculated standardised mean differences (SMDs) to account for the heterogeneity of fruit and vegetable consumption measures. We conducted assessments of risks of bias and evaluated the quality of evidence (GRADE approach) using Cochrane procedures

  20. Effect of Virtual Reality on Cognition in Stroke Patients

    OpenAIRE

    Kim, Bo Ryun; Chun, Min Ho; Kim, Lee Suk; Park, Ji Young

    2011-01-01

    Objective To investigate the effect of virtual reality on the recovery of cognitive impairment in stroke patients. Method Twenty-eight patients (11 males and 17 females, mean age 64.2) with cognitive impairment following stroke were recruited for this study. All patients were randomly assigned to one of two groups, the virtual reality (VR) group (n=15) or the control group (n=13). The VR group received both virtual reality training and computer-based cognitive rehabilitation, whereas the cont...

  1. Cognitive impairment in schizophrenia across age groups: a case-control study.

    Science.gov (United States)

    Mosiołek, Anna; Gierus, Jacek; Koweszko, Tytus; Szulc, Agata

    2016-02-24

    The potential dynamics of cognitive impairment in schizophrenia is discussed in the literature of the field. Recent publications suggest modest changes in level of cognitive impairment after first psychotic episode. Present article attempts to explore cognitive differences between patients and controls across age groups and differences between age groups in clinical group. One hundred and twenty-eight hospitalized patients with schizophrenia (64 women and 64 men) and 68 individuals from the control group (32 women and 32 men) aged 18-55 years were examined. The patients were divided into age groups (18-25, 26-35, 36-45, 46-55). Both groups were examined using Wisconsin Card Sorting Test, Rey Auditory Verbal Learning Test, Rey Osterrieth Complex Figure Test, Trail Making Test (A and B), Stroop Test, verbal fluency test and Wechsler digit span. Patients with schizophrenia obtained significantly lower scores versus the control group in regard to all the measured cognitive functions (Mann-Whitney U; p age groups, however, statistically important impairment in executive functions (WCST) were present only in "older" groups. Patients with schizophrenia obtained less favourable results than the control group in all age groups. Deficits regarding executive functions do not seem to be at a significant level among the youngest group, whereas they are more noticeable in the group of 46-55-year-olds. Executive functions are significantly lowered in the group aged 36-45 in comparison to the "younger" groups. The level of cognitive functions shows a mild exacerbation in connection with age, whereas cognitive rigidity proved to be related to the number of years spent without hospital treatment.

  2. Quality of Life in Patients with Thalassemia Major in a Developing Country

    International Nuclear Information System (INIS)

    Siddiqui, S. H.; Ishtiaq, R.; Sajid, F.; Sajid, R.

    2014-01-01

    Objective: To determine the problems faced by thalassemic patients in their personal, psychological and social life. Study Design: A cross-sectional multi-centre survey. Place and Duration of Study: Karachi, Lahore and Quetta Centres of Fatimid Foundation, from October 2009 to October 2010. Methodology: An indigenously developed Qualifty of Life (QoL) questionnaire modified from SF-36 questionnaire was administered to 101 transfusion dependent subjects suffering from thalassemia major. Variables were analyzed using SPSS version 15 for descriptive statistics. Results: The mean age of the subjects was 10.5 years ranging from 6 - 21 years. Less than one third of the patients felt that their health was slightly worse as compared to last year. Forty five (44%) of the patients felt loneliness due to their disease. Parents of 36 (35.6%) of the children at times did not allow their children to play because of their disease. Twenty eight (27.7%) stated difficulty in mingling with children of their age. Seventy one (70.3%) of the patients reported that at some or all times they were worried about their future life and career while 70 (69.3%) admitted being taken extra care of by their friends and 56 (55.4%) by their teachers. Conclusion: The quality of life of surveyed thalassemic patients was immensely affected. Having physical impairments, social stresses, financial burdens and problems with their education and career make them very much vulnerable to psychological trauma very early in their life. All of this creates a hindrance in their way of developing into autonomous functioning adults. (author)

  3. 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.

  4. Clinicopathological features of patients with breast cancer aged 70 years or over.

    Science.gov (United States)

    Aytekin, Aydin; Karatas, Fatih; Sahin, Suleyman; Erdem, Gokmen U; Altundag, Kadri

    2017-01-01

    The risk of breast cancer (BC) increases in parallel with increasing age. Despite the increased disease burden in elderly patients, there is still a great uncertainty regarding "how to manage" BC in aging-population. The purpose of this study was to investigate the clinicopathological features and treatment approaches of patients with BC aged 70 years or over. The medical records of 4413 patients with BC followed between 1994-2015 were retrospectively analyzed. Of the 4413 patients, 238 with stage I to III disease aged 70 years or over at BC diagnosis were enrolled into this study. Patients were divided into 2 groups according to the age as group 1 (70-79 years, N=192) and group 2 (80 or over, N=46). Clinicopathological features of patients including tumor histology, grade, estrogen (ER) and progesterone receptor (PgR) status, human epidermal growth factor receptor 2 (HER2) status, tumor size, lymph node involvement (LNI), lymphovascular invasion (LVI), perineural invasion (PNI), clinical stage, type of surgery, treatments and comorbid diseases were evaluated. The median age was 74 for group 1 (range 70-79) and 82 for group 2 (range 80-92). Excluding tumor size and grade, no statictically significant difference was found between the two groups according to histopathological characteristics. Patients in group 2 had more commonly larger T stage (T4), and less frequently presented with grade I tumor (p=0.014 and p=0.044, respectively). Modified radical mastectomy and adjuvant chemotherapy were more commonly performed in group 1 (p=0.001 and p=0.001, respectively). In contrast, neoadjuvant treatment was more frequently applied in group 2 (p=0.003). There was no difference in disease-free survival (DFS) between the groups (p=0.012), however, median overall survival (OS) was significantly higher in group 1 (p=0.03). Excluding the tumor grade and tumor size, both groups had similar histopathological features. However, patients aged between 70-79 years were likely to

  5. Radionuclide esophageal transit test to detect esophageal disorders in patients with mitral valve prolapse

    International Nuclear Information System (INIS)

    Kao Chiahung; Tsai Shihchuan; Hsieh Jihfang; Ho Yungjen; Ding Hueischjy

    2000-01-01

    Aim: The origin of chest discomfort in patients with mitral valve prolapse (MVP) is controversial. Our aim was to prospectively determine the incidence of esophageal disorders in MVP patients with or without chest pain. Methods: Twenty-five MVP patients with chest pain (group A) and 25 MVP patients without chest pain (group B) underwent evaluation of esophageal motility. None of the total of 50 MVP patients had significant coronary artery disease on cardiac catheterization. Esophageal motility including esophageal mean transit time (MTT), residual fraction (RF), and retrograde index (RI) was analyzed by the radionuclide esophageal transit test (RETT). Results: In comparison with 25 age and sex-matched healthy volunteers, the results showed that: (1) 19 patients in group A (76%) had abnormal RETT findings (48% of cases with prolonged MTT, 44% of cases with higher RF, and 60% of cases with higher RI); (2) 3 patients in group B (12%) had abnormal RETT findings (8% of cases with prolonged MTT, 4% of cases with higher RF, and 8% of cases with higher RI). In addition, mean values of MTT, RF, and RI in group A patients were significantly higher than in group B patients and healthy volunteers. Conclusion: We found that the chest pain in some MVP patients may be related to abnormal esophageal motility, based on the evidence from a simple and noninvasive RETT. (orig.) [de

  6. Patterns and correlates of serum magnesium levels in subsets of type 2 diabetes mellitus patients in Nigeria

    Directory of Open Access Journals (Sweden)

    Olatunde O Odusan

    2017-01-01

    Full Text Available Background: Magnesium (Mg is the 4th most common mineral and the 2nd most abundant intracellular cation in the body. It plays major roles in various physiological activities and has been implicated in many disease states. Aim: The aim of this study was to study the patterns and correlates of serum Mg in cohorts of type 2 diabetic patients in Nigeria. Subjects and Methods: One hundred and twenty-five patients comprising 63 with type 2 diabetes mellitus (T2DM alone and 62 with diabetes and hypertension (HT were compared with fifty controls matched for sex and age. Basic data, HbA1c, and fasting blood glucose (FBG were obtained while serum Mg was measured by colorimeter. Relationship between serum Mg and glucose control was considered while serum Mg < 1.6 mg/dl was considered as hypomagnesemia. Results: The mean serum Mg of all patients was 2.06 ± 0.49 mg/dl, not statistically different from controls at 2.22 ± 0.48 mg/dl. About ¼ (23.2% of the patients had hypomagnesemia which was significantly more than 12% of controls. Although the patients with diabetes and HT were older and more of females than those with DM alone, the mean serum Mg was comparable (2.03 ± 0.49 vs. 2.09 + 0.50 mg/dl. Twenty-seven percent (27% of patients who had DM alone was more than 19.3% with HT and diabetes combined. Whereas the FBG was comparable in patients with hypomagnesemia and normal serum Mg, HbA1c was significantly higher in the hypomagnesemia group (8.39 ± 0.98 vs. 6.75 ± 1.22%, P = 0.021. Conclusion: Hypomagnesemia is common in T2DM outpatients occurring approximately one in four patients. It is associated with poor long-term control.

  7. Muscle strength and functional performance in patients at high risk of knee osteoarthritis: a follow-up study

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Aagaard, Per; Roos, Ewa M.

    2012-01-01

    PURPOSE: To investigate whether changes from 2 to 4 years post arthroscopic partial meniscectomy (APM) in mechanical muscle function and objectively measured function differ between the operated and contra-lateral leg of APM patients or compared with controls. METHODS: Twenty-two patients (age 46...

  8. Chronic recurrent multifocal osteomyelitis: a radiological and clinical investigation of five cases

    International Nuclear Information System (INIS)

    Demharter, J.; Bohndorf, K.; Michl, W.; Vogt, H.

    1997-01-01

    Objective. To make a detailed evaluation of the clinical and radiological course of five children with chronic recurrent multifocal osteomyelitis (CRMO). Emphasis was laid on the correlation between clinical data and radiological findings. Design and patients. Clinical data, histology (n=11), bone scintigraphy (n=17), and the plain radiographs (n=198) of these patients were reviewed. The mean time of observation was 6.6 years (range 1-14.5 years). Thirty-two lesions seen at the time of primary diagnosis (n=22) or during the course of the disease (n=10) were evaluated. Twenty-seven foci were located in bone; in five cases the sacroiliac joints were involved. Results. Bone scintigrams showed nearly all foci (31/32) and were especially helpful in clinically asymptomatic lesions (14/32) or foci which were radiographically difficult to detect or not seen at all (8/32). Only 14 of 32 foci were locally symptomatic clinically. In all cases with a short interval (≤3 weeks) between the onset of local symptoms and evaluation by plain radiographs (n=5) osteolysis was shown without a sclerotic margin. All bone lesions with a longer duration of local symptoms (n=7) revealed a variable radiographic pattern: osteolysis with sclerotic rim in three, a mixed lytic-sclerotic lesion in three and pure sclerosis in one. In two cases low back pain could be ascribed to sacroiliitis. Conclusion. Only careful correlation between clinical, scintigraphy and radiographic features permits an accurate assessment of disease activity in CRMO. The bone lesions detected radiographically soon after the onset of symptoms resemble those of acute osteomyelitis. (orig.)

  9. Metabolic profile and cardiovascular risk factors in adult patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency

    Directory of Open Access Journals (Sweden)

    Mouna Feki Mnif

    2012-01-01

    Full Text Available Background: In congenital adrenal hyperplasia (CAH, long-term glucocorticoid treatment coupled with increased androgens may lead to undesirable metabolic effects. The aim of our report was to determine the prevalence of metabolic abnormalities and cardiovascular risk factors in a population of adult patients with CAH due to 21 hydroxylase deficiency. Materials and Methods: Twenty-six patients (11 males and 15 females, mean age ± SD=27.4±8.2 years were recruited. Anthropometry, body composition, metabolic parameters and cardiovascular risk factors were studied. Results: Obesity (overweight included was noted in 16 patients (61.5%, with android distribution in all cases. Bioelectrical impedance showed increased body fat mass in 12 patients (46.1%. Lipid profile alterations and carbohydrate metabolism disorders were detected in seven (26.9% and five (19.2% patients respectively. Moderate hepatic cytolysis, associated with hepatic steatosis, was found in one patient. Seven patients (27% had insulin resistance. Ambulatory blood pressure monitoring showed abnormalities in six patients (23%. Increased carotid intima media thickness was found in 14 patients (53.8%. Conclusion: Adult CAH patients tend to have altered metabolic parameters and a higher prevalence of cardiovascular risk factors. Lifelong follow-up, lifestyle modifications, and attempts to adjust and reduce the glucocorticoid doses seem important.

  10. Serum and tissue angiotensin-converting enzyme in patients with alopecia areata.

    Science.gov (United States)

    Fahim, Shabnam; Montazer, Fatemeh; Tohidinik, Hamid Reza; Naraghi, Zahra Safaei; Abedini, Robabeh; Nasimi, Maryam; Ghandi, Narges

    2018-03-27

    Alopecia areata is an immune-dependent disorder characterized by the interaction of T-lymphocytes with follicular antigens. Recent studies have shown the existence of a local renin-angiotensin system in the skin, where angiotensin-converting enzyme (ACE) plays a role in autoimmunity and inflammation. The objective of this study was to evaluate serum and tissue ACE activity in patients with alopecia areata. This case-control study was conducted on patients with alopecia areata and healthy controls. Serum and tissue ACE activity were assessed and compared between the two groups. Twenty-five alopecia areata patients (60% male, mean age 32.1 ± 9.9 years) and 24 controls (50% male, mean age 37.4 ± 8.8 years) were included. Mean serum ACE activity was 52.1 ± 9 U/L in cases and 55.3 ± 14.7 U/L in controls (P = 0.37). Tissue ACE activity was significantly lower in cases in all parts of the skin i.e. epidermis (P = 0.016), follicular epithelium (P = 0.004), and endothelium (P = 0.037). Among cases, serum ACE activity was significantly higher in patients with more severe disease (P = 0.030), nonpatchy alopecia areata (alopecia universalis; ophiasis, patchy and ophiasis, diffuse) (P = 0.029), and with nail involvement (P = 0.027). The sample size was too small to draw definite conclusions. Further, most of the patients had only mild or moderate alopecia areata. Unlike in some other inflammatory diseases, the tissue level of ACE seems to be significantly lower in alopecia areata compared to normal controls. Serum ACE was significantly higher in patients with more severe disease.

  11. Effect of aquatic dual-task training on balance and gait in stroke patients

    OpenAIRE

    Kim, Kyoung; Lee, Dong-Kyu; Kim, Eun-Kyung

    2016-01-01

    [Purpose] The purpose of this study was to determine the effect of aquatic dual-task training on balance and gait in stroke patients. [Subjects and Methods] Twenty stroke patients were divided into the experimental (n=10) and control (n=10) groups. Both groups underwent neurodevelopmental treatment. The experimental group additionally underwent aquatic dual-task training for 30 minutes a day, 5 days a week, for 6 weeks. Balance was measured using the Berg balance scale, Five Times Sit-to Stan...

  12. Changes of serum sex hormones levels in aged patient with peptic ulcer

    International Nuclear Information System (INIS)

    Huang Xiuhai; Xiao Chuangqing; He Yunnan; Li Xuewen; Bi Chao; Zhang Yifan

    2005-01-01

    Objective: To investigate the changes of serum contents of testosterone (T), estradiol (E 2 ) and cortisol (Cor) in aged patients with peptic ulcer. Methods: Serum T, E 2 and Cor levels were determined with CLIA in 86 aged patients with peptic ulcer both before treatment (active stage) and after treatment for 6 weeks (healing stage) as well as in 76 controls. Results: Serum contents of T and E 2 in the patients during active stage were significantly lower than those in patients during healing stage and in controls (both P 0.05). Conclusion: A lower serum T and E 2 contents was present in aged patients with peptic ulcer during active stage. (authors)

  13. Maxillary distraction complications in cleft patients.

    Science.gov (United States)

    Jeblaoui, Y; Morand, B; Brix, M; Lebeau, J; Bettega, G

    2010-06-01

    Cleft lip and palate (CLP) patients often present with a class III malocclusion in connection with a three dimensional maxillary hypoplasia. Twenty-five to 60% of these patients need maxillary advancement. Two solutions are possible: orthognathic surgery and maxillary distraction. The purpose of this study was to evaluate the complications of maxillary distraction in CLP patients. Data was collected from the records of patients treated in our surgery unit between 2000 and 2007. Among the eight patients (four male and four female), five presented with a bilateral CLP, two with a unilateral CLP, and one with a unilateral cleft lip associated to a soft palate cleft. The average age at surgery was 17 years. All underwent a Le Fort I osteotomy with a pterygomaxillary disjunction. An external distractor was used for the first two patients and an internal distractor for the six following patients. After a seven-day latency, activation was implemented at a rate of 1mm twice a day. The average period of consolidation was four months. Maxillary advancement ranged between 7 and 19mm, with an average of 12.6mm. The average follow-up was four years. Complications were noted in seven patients: one intra-operative hemorrhage, one avulsion of a tooth anchored at the pterygoid process during osteotomy, three cases of device dysfunction, two cases of significant pain during activation, one loosening of the orthodontic arch in an external system, two cases of labial ulceration, and one maxillary sinusitis due to migration of a wisdom tooth. Complications of maxillary distraction in CLP patients were very frequent. Most were related to the device and did not interfere with the final result. This must be taken into account when indicating distraction and choosing the device. Two types of complications can occur during distraction: those related to the osteotomy and those related to the device. The complications related to the osteotomy are linked to the cicatricial ground of previous

  14. Enteric Duplication Cysts in Children: A Single-Institution Series with Forty Patients in Twenty-Six Years.

    Science.gov (United States)

    Erginel, Basak; Soysal, Feryal Gun; Ozbey, Huseyin; Keskin, Erbug; Celik, Alaattin; Karadag, Aslıhan; Salman, Tansu

    2017-02-01

    The purpose of the study was to evaluate our experience with enteric duplication cysts in 40 children during the past 26 years, while assessing the variability of their presentations and to propose an algorithm for surgical management. We retrospectively analysed sex, age, clinical presentations, duplication site, surgical treatment, presence of ectopic tissue, complications, associated anomalies, and prognosis of 40 patients with gastrointestinal tract duplications who were surgically treated in our clinic. Overall, there was a predominance of boys (28 males, 70 %; 12 females, 30 %). The presenting symptom was vomiting in 23 patients, rectal bleeding in 11 patients, abdominal mass in 10 patients, abdominal pain in 9 patients, constipation in 6 patients, cough in 2 patients, and respiratory distress in 2 patients. In 30 patients, a complete excision of the cyst with additional segmental intestinal resection and anastomosis was performed. Cystectomy was performed in seven patients, while complete excision of the cyst with additional wedge resection was performed in two. A Wrenn procedure (mucosectomy) was performed in one patient. Due to the variability in the site of enteric duplications, a wide range of presenting symptoms can exist, which is challenging for diagnosis. In children with a diagnosis of acute abdomen, enteric duplication cysts should be considered, and these children should be further investigated for additional skeletal, urogenital, and gastrointestinal system pathologies. Surgical treatment depends on the site and type of the cyst.

  15. Radiotherapy for cancer patients aged 85 or older

    International Nuclear Information System (INIS)

    Kan, Tomoko; Kodani, Kazuhiko; Michimoto, Koichi; Ogawa, Toshihide

    2009-01-01

    The purpose of this study was to investigate the clinical efficacy and problems of radiotherapy for cancer patients aged 85 or older. Fifty-three patients (26 men, 27 women) who underwent radiotherapy were analyzed retrospectively. Median age was 87 years (range; 85-99). Treatment policy was classified into curative, semi-curative (treatment field or total dose were limited due to performance status) and palliative therapy. Head-and-neck, bladder and skin cancer were the most common primary disease. The treatment was deemed curative in 27%, semi-curative in 13%, and palliative in 49%. Total dose of semi-curative therapy was almost same compared with curative therapy. The rate of treatment completion and effectiveness were not significantly different in curative therapy and semi-curative therapy. We should consider to reduce the field size to gross target volume, but to treat with substantial dose to make radiotherapy safe and effective. We must be aware that elderly patients have basically low tolerability. (author)

  16. Idiopathic avascular necrosis of the femoral heads in five members of a Moroccan family.

    Science.gov (United States)

    Sekkat, Jihane; Rachidi, Ouafaa; Janani, Saadia; Mkinsi, Ouafaa

    2012-10-01

    Avascular necrosis (AVN) is idiopathic in about 40% of cases. The pathophysiology of avascular necrosis remains incompletely elucidated. Here, we report a case that underlines the role for inherited factors in AVN of the femoral heads. Idiopathic AVN of the femoral heads occurred in five members of the same family (a woman, her two paternal aunts, her male paternal cousin and her female paternal cousin) at a mean age of 42.4 years (range, 33-58 years). Standard pelvic radiographs showed Arlet and Ficat stage 4 AVN in three patients and stage 3 in two patients. None of the patients had a history of glucocorticoid therapy, alcohol abuse, or trauma. All five patients underwent investigations for a cause, including blood cell counts, a lipid profile, coagulation tests, testing for antinuclear antibodies, hemoglobin electrophoresis, ultrasonography of the abdomen, and standard radiographs of the long limb bones. The results were normal or negative, ruling out known hereditary causes of AVN such as sickle cell anemia and Gaucher disease. Many cases of familial AVN of the femoral head have been described in patients with sickle cell anemia or Gaucher disease. However, only five families with idiopathic familial AVN of the femoral heads have been reported (three in the US and two in Taiwan). All the patients in these families had isolated bilateral AVN of the femoral heads without AVN at other sites. Copyright © 2012. Published by Elsevier SAS.

  17. The Five-Factor Model personality traits in schizophrenia: A meta-analysis.

    Science.gov (United States)

    Ohi, Kazutaka; Shimada, Takamitsu; Nitta, Yusuke; Kihara, Hiroaki; Okubo, Hiroaki; Uehara, Takashi; Kawasaki, Yasuhiro

    2016-06-30

    Personality is one of important factors in the pathogenesis of schizophrenia because it affects patients' symptoms, cognition and social functioning. Several studies have reported specific personality traits in patients with schizophrenia compared with healthy subjects. However, the results were inconsistent among studies. The NEO Five-Factor Inventory (NEO-FFI) measures five personality traits: Neuroticism (N), Extraversion (E), Openness (O), Agreeableness (A) and Conscientiousness (C). Here, we performed a meta-analysis of these personality traits assessed by the NEO-FFI in 460 patients with schizophrenia and 486 healthy subjects from the published literature and investigated possible associations between schizophrenia and these traits. There was no publication bias for any traits. Because we found evidence of significant heterogeneity in all traits among the studies, we applied a random-effect model to perform the meta-analysis. Patients with schizophrenia showed a higher score for N and lower scores for E, O, A and C compared with healthy subjects. The effect sizes of these personality traits ranged from moderate to large. These differences were not affected by possible moderator factors, such as gender distribution and mean age in each study, expect for gender effect for A. These findings suggest that patients with schizophrenia have a different personality profile compared with healthy subjects. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Orthognathic surgery in patients over 40 years of age: indications and special considerations.

    Science.gov (United States)

    Peacock, Zachary S; Lee, Cameron C Y; Klein, Katherine P; Kaban, Leonard B

    2014-10-01

    To assess indications, incidence, patient experience, and outcomes of orthognathic surgery in patients over 40 years of age. This was a retrospective cohort study of all patients who underwent orthognathic surgical procedures at Massachusetts General Hospital from 1995 to 2012. Demographic variables, including age, gender, indications, date, and type of operation, were documented. Patients were divided into 2 groups by date of operation: 1) 1995 to 2002 and 2) 2003 to 2012. The predictor variable was age (>40 vs orthognathic surgery varies by age and gender. Older patients, particularly men, tend to seek treatment for functional rather than esthetic reasons. Patients older than 40 years had longer hospital stays and an increased rate of postoperative hardware removal. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Zinc and antioxidant vitamin deficiency in patients with severe sickle cell anemia

    International Nuclear Information System (INIS)

    Hasanato, R.M. W.

    2006-01-01

    Patients with severe sickle cell anemia (SCA) have a higher potential for oxidative damage due to chronic redox imbalance in red blood cells that often leads to hemolysis, endothelial injury and recurrent vaso-occlusive episodes. This study evaluated the plasma levels of Vitamin A, C and E as indicators of antioxidants status. In addition, serum levels of zinc and copper were also estimated. Twenty-five adult patients with severe sickle cell anemia (12 males and 13 females aged 29.72+-12.94 years) and 25 matched controls were studied. Plasma levels of vitamin A, C and E were measured by HPLC technique. Serum zinc and copper levels were measured by atomic absorption spectrometry. There was significant decrease in plasma levels of vitamins A, C and E and in serum levels of zinc in patients with SCA as compared with controls (P<0.0001). Serum copper levels were significantly elevated compared with controls (P<0.0001). These findings emphasized the significant deficiencies of the antioxidant vitamins A, C and E and the trace element zinc along with the significant elevation of serum copper in patients with severe sickle cell disease. Further studies are needed to find out whether supplementation of antioxidant vitamins and zinc may ameliorate some sickle cell disease complications. (author)

  20. At-home palliative sedation for end-of-life cancer patients.

    Science.gov (United States)

    Alonso-Babarro, Alberto; Varela-Cerdeira, Maria; Torres-Vigil, Isabel; Rodríguez-Barrientos, Ricardo; Bruera, Eduardo

    2010-07-01

    Using a decision-making and treatment checklist developed to facilitate the at-home palliative sedation process, we assessed the incidence and efficacy of palliative sedation for end-of-life cancer patients with intractable symptoms who died at home. We retrospectively reviewed the medical records of 370 patients who were followed by a palliative home care team. Twenty-nine of 245 patients (12%) who died at home had received palliative sedation. The mean age of the patients who received palliative sedation was 58 +/- 17 years, and the mean age of the patients who did not receive palliative sedation was 69 +/- 15 years (p = 0.002). No other differences were detected between patients who did or did not receive palliative sedation. The most common indications for palliative sedation were delirium (62%) and dyspnea (14%). Twenty-seven patients (93%) received midazolam for palliative sedation (final mean dose of 74 mg), and two (7%) received levomepromazine (final mean dose of 125 mg). The mean time between palliative sedation initiation and time of death was 2.6 days. In 13 of the cases (45%), the palliative sedation decision was made with the patient and his or her family members, and in another 13 patients (45%), the palliative sedation decision was made only with the patient's family members. We concluded that palliative sedation may be used safely and efficaciously to treat dying cancer patients with refractory symptoms at home.

  1. Willingness to Use Mobile Health in Glaucoma Patients.

    Science.gov (United States)

    Dai, Miaomiao; Xu, Jianan; Lin, Jialiu; Wang, Zhonghao; Huang, Wenmin; Huang, Jingjing

    2017-10-01

    Development of mobile health (m-health) in China carries tremendous potential, especially for glaucoma, one of the major chronic ophthalmic diseases afflicting millions of people. However, little research has been undertaken to investigate the willingness of glaucoma patients to use m-health and the factors influencing their decisions. This was a cross-sectional study. A self-administered or face-to-face interview survey was performed on 1,487 patients with glaucoma at the outpatient glaucoma service, Zhongshan Ophthalmic Center, Sun Yat-sen University. Questionnaires captured patients' demographic data, WeChat access, and willingness to receive m-health. The data were analyzed by single factor chi-square test. Multiple logistic regression revealed the motivators and barriers to accept m-health adoption. One thousand ninety-seven valid questionnaires were obtained. Seven hundred twenty-five respondents (66.1%) were willing to participate in m-health programs. 65.4% were younger than 60 years old. 40.9% had travel time from home to hospital of >3 h. 63.6% had more than four follow-up visits for glaucoma. 86.5% experienced trouble events during clinic visits. The overall WeChat usage rate was 61.7%. Age, travel time, number of visits, trouble events in clinic, and WeChat access in patients with glaucoma were related to the willingness to use m-health (p < 0.05). Most patients with glaucoma were willing to participate in m-health programs, which are essential to increasing and improving access to care.

  2. Relation of age with symptom severity and quality of life in patients with fibromyalgia.

    Science.gov (United States)

    Jiao, Juan; Vincent, Ann; Cha, Stephen S; Luedtke, Connie A; Oh, Terry H

    2014-02-01

    To examine the relation of age with symptom severity and quality of life (QOL) in patients with fibromyalgia, and to compare physical and mental health of our female patients with those of the US female general population. We studied 978 patients with fibromyalgia from May 1, 2001 through April 30, 2004, and divided them into age groups of young (≤39 years), middle-aged (40-59 years), and older (≥60 years). They completed the Fibromyalgia Impact Questionnaire and the Short Form-36 Health Status Questionnaire (SF-36). Standardized SF-36 physical and mental health summary scores were compared with those of the US female general population of similar age. One-way analysis of variance and post hoc paired t test analyses were performed to detect differences across age groups. Pairwise comparison found young and middle-aged patients having worse fibromyalgia symptoms in all subscales except the anxiety subscale compared with older patients (P≤.01). Similarly, these young and middle-aged patients had worse QOL in the SF-36 mental component summary, as well as SF-36 general health perceptions, vitality, social functioning, and mental health index, compared with older patients (all Pfibromyalgia, with young and middle-aged patients having poorer QOL and worse fibromyalgia symptoms than do older patients. QOL in physical health was reduced more than in mental health, particularly in young patients, compared with the general population. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  3. Prostatic cancer - A retrospective study of 50 patients

    International Nuclear Information System (INIS)

    Hussain, I.; Khattak, A.M.; Shah, S.H.

    2005-01-01

    This Objective of this study was to see histologic typing of prostate cancer and its relation to patient's age, as no curative therapy exists for the advanced stages. This is a retrospective study of 50 patients suffering from prostatic adenocarcinoma and admitted at Basic Medical Sciences Institute, Jinnah Postgraduate Medical Center Karachi. A total of fifty patients between ages of 50-80 years diagnosed during the period of 1990-2001 suffering from prostate cancer were included in this study. The result showed that maximum number of tumours were in age group ranging from 61-70 years, (58% of total cases). Sixteen were (32%) well-differentiated tumours, twenty-eight (56%), moderately differentiated tumours and six (12%) were labelled as undifferentiated tumours. It was concluded that the majority of tumors were moderately differentiated tumours. Early diagnosis is useful for patients; because high grade tumours have bad prognostic markers. (author)

  4. Results of radiotherapy for brain metastases in old-aged patients

    International Nuclear Information System (INIS)

    Nieder, C.; Niewald, M.; Schnabel, K.

    1995-01-01

    To evaluate which patients older tahn 70 years will benefit by radiotherapy for their brain metastases the data of 35 patients in this age-group who were treated between 1983 and 1994 were retrospectivley analyzed. All patients were previously untreated and received a whole-brain irradiation and concomitantly corticosteroids. The median total dose was 30 Gy (fractionation: 10 times 3 Gy in 2 weeks). Six patients each received lower or higher total doses with 50.4 Gy at maximum. Six patients failed to complete their prescribed treatment (17%). The median survival of all patients who completed their radiotherapy course was 67 days only. Patients with extracerebral metastases had a median survival of 31 days. Survival was not dependent on total dose of radiotherapy. In 56% of all cases the general condition of the patients improved or remained stable at a high level. Karnofsky-performance status was the most important prognostic factor. Advanced age is an unfavourable prognostic factor. Only patients in good general condition without extracerebral metastases had survival times which justify radiotherapy for their brain metastases. (orig./MG) [de

  5. Malignant multiple sclerosis: clinical and demographic prognostic factors

    Directory of Open Access Journals (Sweden)

    Fabrício Hampshire-Araújo

    Full Text Available ABSTRACT Patients with malignant multiple sclerosis (MMS reach a significant level of disability within a short period of time (Expanded Disability Status Scale score of 6 within five years. The clinical profile and progression of the disease were analyzed in a Brazilian cohort of 293 patients. Twenty-five (8,53% patients were found to have MMS and were compared with the remaining 268 (91,47%. Women, non-white patients, older age at disease onset, shorter intervals between the first attacks, and more attacks in the first two years of the disease were all more common in the MMS group. These findings could serve as prognostic factors when making therapeutic decisions.

  6. Review of management and morbidity of pediatric craniopharyngioma patients in a low-middle-income country: a 12-year experience.

    Science.gov (United States)

    Amayiri, Nisreen; Swaidan, Maisa; Yousef, Yocoub; Halalsheh, Hadeel; Abu-Hijlih, Ramiz; Kalaldeh, Sima; Barbar, Maha; Elayyan, Maher; Faqih, Nesreen; Al-Hussaini, Maysa; Mehyar, Mustafa; Bartels, Ute; Drake, James; Musharbash, Awni; Bouffet, Eric

    2017-06-01

    Management of craniopharyngioma in children is challenging, and their quality of life can be significantly affected. Series describing this from low-middle income countries (LMIC) are few. The study provides a retrospective chart review of pediatric patients craniopharyngioma between 2003 and 2014, and treated at King Hussein Cancer Center, Jordan. Twenty-four patients (12 males) were identified. Median age at diagnosis was 7.4 years (0.9-16.4 years). Commonest symptoms were visual impairment and headache (71%). Review of seventeen preoperative MRIs showed hypothalamic involvement in 88% and hydrocephalus in 76%. Thirteen patients (54%) had multiple surgical interventions. Five patients (21%) had initial gross total resection. Eleven patients (46%) received radiotherapy and six (25%) intra-cystic interferon. Five years' survival was 87 ± 7% with a median follow-up of 4.5 years (0.3-12.3 years). Four patients (17%) died; one after post-operative cerebral infarction and three secondary to hypothalamic damage. At their last evaluation, all but one patient required multiple hormonal supplements. Ten patients (42%) had best eye visual acuity (VA) >20/40, and four (16%) were legally blind. Eleven patients (46%) were overweight/obese; one had gastric bypass surgery. Seven patients had hyperlipidemia, and eight developed fatty liver infiltration. Eleven patients (65%) were attending schools and one at college. Nine of the living patients (53%) expressed difficulty to engage in the community. Management of pediatric craniopharyngioma is particularly complex and demanding in LMIC. Multidisciplinary care is integral to optimize the care and minimize the morbidities. A management outline for LMIC is proposed.

  7. Perceptions of phantom rectum syndrome and health-related quality of life in patients following abdominoperineal resection for rectal cancer.

    Science.gov (United States)

    Fingren, Jeanette; Lindholm, Elisabet; Carlsson, Eva

    2013-01-01

    The aim of the study was to investigate how patients described their perceptions of phantom rectum syndrome after abdominoperineal resection and ostomy creation, and its influence on daily living and health-related quality of life. A further aim was to find out strategies patients use to alleviate phantom rectum syndrome sensations. Twenty-five patients who underwent abdominoperineal resection and a colostomy (18 men and 7 women; median age 5 63 years; range, 40-78 years) at Sahlgrenska University Hospital, Göteborg, Sweden, participated in the study. At follow-up 8 months postsurgery, a WOC nurse interviewed patients with a structured questionnaire about the experience of nonpainful and painful sensations in the perineal area. Health-related quality of life was evaluated using a general cancer-specific instrument (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire version 3.0). Twenty-four patients (96%) experienced painful or nonpainful phantom rectum syndrome at some point during the first 8 postoperative months. The nonpainful sensations (20 patients) occurred in connection with emptying of feces via the stoma, when performing colostomy irrigation, at rest, or in various positions. Fifteen patients experienced painful sensations, characterized as pins and needles, pain in the perineal area, stinging, and burning occurring mostly in sitting positions. Patients with painful sensations had statistically significant higher scores regarding pain and lower scores for social function than those without painful sensations (P < .031). Phantom rectum symptoms caused worries and concerns and influenced daily life in 29% (n = 5). Phantom rectum syndrome is prevalent in patients undergoing abdominoperineal resection and ostomy creation. Information about phantom rectum syndrome should be shared preoperatively and during follow-up in order to promote optimal quality of life and alleviate bothersome symptoms and concerns associated with

  8. [Depression in Patients with Age-Related Macular Degeneration].

    Science.gov (United States)

    Narváez, Yamile Reveiz; Gómez-Restrepo, Carlos

    2012-09-01

    Age-related macular degeneration is a cause for disability in the elderly since it greatly affects their quality of life and increases depression likelihood. This article discusses the negative effect depression has on patients with age-related macular degeneration and summarizes the interventions available for decreasing their depression index. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  9. Cervical vertebral maturation and dental age in coeliac patients.

    Science.gov (United States)

    Costacurta, M; Condò, R; Sicuro, L; Perugia, C; Docimo, R

    2011-07-01

    The aim of the study was to evaluate the cervical vertebral maturation and dental age, in group of patients with coelic disease (CD), in comparison with a control group of healthy subjects. At the Paediatric Dentistry Unit of PTV Hospital, "Tor Vergata" University of Rome, 120 female patients, age range 12.0-12.9 years were recruited. Among them, 60 subjects (Group 1) were affected by CD, while the control group (Group 2) consisted of 60 healthy subjects, sex and age-matched. The Group 1 was subdivided, according to the period of CD diagnosis, in Group A (early diagnosis) and Group B (late diagnosis). The skeletal age was determined by assessing the cervical vertebral maturation, while the dental age has been determined using the method codified by Demirjiyan. STATISTICS.: The analyses were performed using the SPSS software (version 16; SPSS Inc., Chicago IL, USA). In all the assessments a significant level of alpha = 0.05 was considered. There are no statistically significant differences between Group 1 and Group 2 as for chronological age (p=0.122). Instead, from the assessment of skeletal-dental age, there are statistically significant differences between Group 1 - Group 2 (pcervical vertebral maturity can be assessed with a low cost, non invasive, easy to perform exam carried out through the routine radiographic examinations such as orthopanoramic and lateral teleradiography.

  10. Outcomes of the treatment of head and neck sarcomas in a tertiary referral center

    Directory of Open Access Journals (Sweden)

    Andrew eLindford

    2015-05-01

    Full Text Available Head and neck sarcomas are a rare and heterogeneous group of tumors that pose management challenges. We report our experience with these tumors. Forty consecutive patients treated for 44 head and neck sarcomas between 1997 and 2014 were culled from our prospectively maintained head and neck database. Five patients were excluded. The adult cohort consisted 29 (83% patients of a mean age of 57.7 years, with 33 sarcomas. The most common diagnoses were undifferentiated pleomorphic sarcoma (27% and chondroblastic osteosarcoma (21%. Clear surgical margins were achieved in 24/33 (73% lesions. Twenty-two patients received radiotherapy and/or chemotherapy. Fourteen patients developed local (n=6, regional (n=1 and distant (n=7 recurrence. The overall 5-year survival was 66% with a mean survival interval of 66.5 months. Recurrent sarcoma, close (<1mm or involved surgical margins and advanced age were associated with statistically significantly reduced survival. The pediatric cohort consisted 6 (17% patients, with a mean age of nine years. Five patients had primary embryonal rhabdomyosarcomas and one had chondroblastic osteosarcoma. Clear surgical margins were achieved in 5 (83% patients. All patients received adjuvant radiotherapy and/or chemotherapy. Mean survival interval was 102 months. Three patients developed local (n=1 or distant (n=2 recurrence. Twenty-three free and 8 pedicled flaps were performed in 25 patients. 11/39 (28% lesions in 11 patients developed a complication. In conclusion, head and neck sarcomas are best managed by a multidisciplinary team at a tertiary head and neck referral centre and resection with clear margins is vital for disease control.

  11. GROWTH AND ENDOCRINE FUNCTION IN TUNISIAN THALASSEMIA MAJOR PATIENTS

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    Naouel GUIRAT

    2018-05-01

    Full Text Available Beta-thalassemia major (TM is among prevalent hereditary disorders imposing high expenses on health-care system worldwide. The patient’s survival is dependent on lifetime blood transfusion which leads to iron overload and its toxicity on various organs including endocrine glands. This article provides an overview of  endocrine disorders in beta-TM patients. This single center investigation enrolled 28 beta-TM patients (16 males, 12 females  regularly transfused with packed red cell since early years of life. For each patient were determined: age, sex, number of transfusions received, history of splenectomy and anthropometric parameters. Evaluation for hormonal status including growth, gonadal, thyroid, adrenal cortex, and parathyroid glands was done for all patients. Dual energy X-ray absorptiometry was used to diagnose osteoporosis. Assessment of iron overload status was performed by measuring the serum ferritin concentration and the results of magnetic resonance imaging T2*. Growth retardation was found in 16 of the 28 studied patients (57 %.Thirteen among them had delayed puberty. Spontaneous puberty was achieved in 16 cases. Growth hormone (GH deficiency was found in 10 cases (35 %. Seventeen among the studied patients (60 % developed disorders of glucose homeostasis. Subclinical hypothyroidism was found in six patients (21 %. Intensive chelation therapy had allowed the reversibility of this complication in five cases. Adrenal Insufficiency was found in 9 cases (32%. Hypoparathyroidism has occurred in one case. Ten of the 28 studied patients had osteoporosis (35%. Twenty-three of the 28 studied patients (82% had at least one endocrine complication.

  12. Juvenile generalized pustular psoriasis is a chronic recalcitrant disease: an analysis of 27 patients seen in a tertiary hospital in Johor, Malaysia.

    Science.gov (United States)

    Lau, Bi-Wen; Lim, Dee-Zhen; Capon, Francesca; Barker, Jonathan N; Choon, Siew-Eng

    2017-04-01

    Limited information exists regarding juvenile generalized pustular psoriasis (GPP). We aim to determine the clinical profile and outcome of Malaysians with juvenile GPP. Review of hospital case notes on patients with juvenile GPP. Twenty-seven patients with juvenile GPP were identified. Female to male ratio was 1.4:1. The median age at onset of GPP was 6.5 years. Ten patients had prior psoriasis with a median pre-pustular duration of 2.7 years. Onset of GPP was earlier in patients without prior psoriasis (5.1 years vs. 12.0 years, P = 0.002). Precipitating factors identified included stress, upper respiratory tract infection, systemic steroid use, vaccination, and pregnancy. A positive family history of psoriasis and GPP was present in six and one patient(s), respectively. Twenty-one patients had acute, five annular, and one localized variant of GPP. Arthritis was present in 22.2%. Fever, leukocytosis, and transaminitis were mainly seen in patients with acute GPP at 80.9, 72.2, and 11.1%, respectively. Among 20 patients screened, eight carry IL36RN variants and one has CARD14 mutation. IL36RN-positive patients have more severe disease characterized by early onset, low prevalence of prior plaque psoriasis, high prevalence of systemic inflammation, and need for continuous long-term systemic therapy. Acitretin and cyclosporine were effective in aborting acute GPP in 100% of 16 and 66.7% of six patients treated, respectively. However, relapses were common. Only three of the 17 patients whose initial acute GPP was controlled with systemic agents were successfully weaned off treatment. Juvenile GPP is a chronic recalcitrant disease. IL36RN-positive patients have more severe disease. © 2017 The International Society of Dermatology.

  13. [Maxillary distraction complications in cleft patients].

    Science.gov (United States)

    Jeblaoui, Y; Morand, B; Brix, M; Lebeau, J; Bettega, G

    2008-09-01

    Cleft lip and palate (CLP) patients often present with a class III malocclusion in connection with a three dimensional maxillary hypoplasia. Twenty-five to 60% of these patients require a maxillary advancement. Two solutions are possible: orthognathic surgery and maxillary distraction. The purpose of this study was to evaluate the complications of the maxillary distraction in CLP patients. Data was collected from the records of patients treated at our Surgery Unit between 2000 and 2007. Among the eight patients (four male and four female), five presented a bilateral CLP, two a unilateral CLP and one a unilateral cleft lip associated to a soft palate cleft. The average age at surgery was 17 years old. All had a Le Fort I osteotomy with a pterygomaxillary disjunction. The first two patients had external distractors and the six following internal ones. After a seven-day latency, activation was led to the rate of 1mm per day twice. The period of consolidation was four months on average. The maxillary advancement varied between 7 and 19 mm with an average of 12.6mm. The average follow-up was four years. We encountered difficulties and/or complications in seven patients: one intraoperatively haemorrhage, one avulsion of a tooth fixed at the pterygoid process during the osteotomy, three device failures, two cases of significant pains during activation, one dissociation of the dental anchorage of an external system, two labial ulcerations and one maxillary sinusitis by migration of the 18. Difficulties of maxillary distraction in CLP patients are very frequent. The majority is related to the distractors and did not interfere with the final result. But this frequency must be taken into account in the indication and in the choice of the material. Two types of complications can occur during distraction: those related to the osteotomy and those related to the material. The complications related to the osteotomy are in connection with the cicatricial ground of the CLP. They are

  14. CYTOLOGICAL EVALUATION OF MALE BREAST LESIONS IN GREATER GWALIOR : A FIVE YEAR RETROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Jagannath

    2015-03-01

    Full Text Available BACKGROUNDS: Fine needle aspiration cytology is an effective modality for diagnosis of breast lesions. Usually male breast lesions are benign and affect the young male. Most common lesion is gynaecomastia. Male breast cancer accounts for a small proportion of breast cancers. Male breast cancer usually presents at an advanced age. OBJECTIVE: The aim of this study was to examine the nature of male breast lesions and to determine the cytomorphologic patterns of these lesions. MET HODS: five year retrospective study was conducted in our institution and in that 112 patients underwent fine needle aspiration cytology of the palpable breast lump after thorough physical examination. The cytological diagnosis was classified as benign, inf lammatory, malignant and others. RESULTS: In 112 male patients diagnosed with breast lesions, the most common lesion was gynecomastia (103/112, 91.9%, followed by breast cancer (6/112, 5.4%, inflammatory (2/112, 1.8% and apocrine metaplasia (01/112, 0.9 %. Gynecomastia was commonly found in male patients less than 40 years of age, while breast cancer is seen in male patients over 40 years of age

  15. Age Effects on Upper Limb Kinematics Assessed by the REAplan Robot in Healthy School-Aged Children.

    Science.gov (United States)

    Gilliaux, Maxime; Dierckx, Floriane; Vanden Berghe, Lola; Lejeune, Thierry M; Sapin, Julien; Dehez, Bruno; Stoquart, Gaëtan; Detrembleur, Christine

    2015-05-01

    The use of kinematics is recommended to quantitatively evaluate upper limb movements. The aims of this study were to determine the age effects on upper limb kinematics and establish norms in healthy children. Ninety-three healthy children, aged 3-12 years, participated in this study. Twenty-eight kinematic indices were computed from four tasks. Each task was performed with the REAplan, a distal effector robotic device that allows upper limb displacements in the horizontal plane. Twenty-four of the 28 indices showed an improvement during childhood. Indeed, older children showed better upper limb movements. This study was the first to use a robotic device to show the age effects on upper limb kinematics and establish norms in healthy children.

  16. Bayesian Gaussian regression analysis of malnutrition for children under five years of age in Ethiopia, EMDHS 2014.

    Science.gov (United States)

    Mohammed, Seid; Asfaw, Zeytu G

    2018-01-01

    The term malnutrition generally refers to both under-nutrition and over-nutrition, but this study uses the term to refer solely to a deficiency of nutrition. In Ethiopia, child malnutrition is one of the most serious public health problem and the highest in the world. The purpose of the present study was to identify the high risk factors of malnutrition and test different statistical models for childhood malnutrition and, thereafter weighing the preferable model through model comparison criteria. Bayesian Gaussian regression model was used to analyze the effect of selected socioeconomic, demographic, health and environmental covariates on malnutrition under five years old child's. Inference was made using Bayesian approach based on Markov Chain Monte Carlo (MCMC) simulation techniques in BayesX. The study found that the variables such as sex of a child, preceding birth interval, age of the child, father's education level, source of water, mother's body mass index, head of household sex, mother's age at birth, wealth index, birth order, diarrhea, child's size at birth and duration of breast feeding showed significant effects on children's malnutrition in Ethiopia. The age of child, mother's age at birth and mother's body mass index could also be important factors with a non linear effect for the child's malnutrition in Ethiopia. Thus, the present study emphasizes a special care on variables such as sex of child, preceding birth interval, father's education level, source of water, sex of head of household, wealth index, birth order, diarrhea, child's size at birth, duration of breast feeding, age of child, mother's age at birth and mother's body mass index to combat childhood malnutrition in developing countries.

  17. Prevalence and correlates of DSM-5 eating disorders in patients with bipolar disorder.

    Science.gov (United States)

    McElroy, Susan L; Crow, Scott; Blom, Thomas J; Biernacka, Joanna M; Winham, Stacey J; Geske, Jennifer; Cuellar-Barboza, Alfredo B; Bobo, William V; Prieto, Miguel L; Veldic, Marin; Mori, Nicole; Seymour, Lisa R; Bond, David J; Frye, Mark A

    2016-02-01

    To determine prevalence rates and clinical correlates of current DSM-5 eating disorders in patients with bipolar disorder (BP). Prevalence rates of current DSM-5- and DSM-IV-defined binge eating disorder (BED), bulimia nervosa (BN), and anorexia nervosa (AN) were assessed with the Eating Disorder Diagnostic Scale (EDDS) in 1092 patients with BP. Psychiatric illness burden was evaluated with five proxy measures of BP illness severity. Medical illness burden was evaluated with the Cumulative Index Rating Scale (CIRS). Twenty-seven percent of patients had a current DSM-5 eating disorder: 12% had BED, 15% had BN, and 0.2% had AN. Rates of DSM-5-defined BED and BN were higher than clinical diagnosis rates and rates of DSM-IV-defined BED and BN. Compared with BP patients without an eating disorder, BP patients with a DSM-5 eating disorder were younger and more likely to be women; had an earlier age of onset of BP; had higher EDDS composite scores and higher degrees of suicidality, mood instability, and anxiety disorder comorbidity; and had a higher mean BMI, higher rate of obesity, and higher CIRS total scores. In a logistic regression model controlling for previously identified correlates of an eating disorder, younger age, female gender, and higher BMI remained significantly associated with an eating disorder. The EDDS has not been validated in BP patients. DSM-5-defined BED and BN are common in BP patients, possibly more common than DSM-IV-defined BED and BN, and associated with greater psychiatric and general medical illness burden. Further studies assessing DSM-5 eating disorders in people with BP are greatly needed. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Hygiene and sanitation risk factors of diarrhoeal disease among under-five children in Ibadan, Nigeria.

    Science.gov (United States)

    Oloruntoba, Elizabeth Omoladun; Folarin, Taiwo Bukola; Ayede, Adejumoke Idowu

    2014-12-01

    Diarrhoea diseases are among the leading causes of morbidity and mortality in under-five-children (U-5C) in Nigeria. Inadequate safe water, sanitation, and hygiene account for the disease burden. Cases of diarrhoea still occur in high proportion in the study area despite government-oriented interventions. To determine the hygiene and sanitation risk factors predisposing U-5C to diarrhoea in Ibadan, Nigeria. Two hundred and twenty pairs of children, matched on age, were recruited as cases and controls over a period of 5 months in Ibadan. Questionnaire and observation checklist were used to obtain information on hygiene practices from caregivers/mothers and sanitation conditions in the households of 30% of the consenting mothers/caregivers. Data were analysed using descriptive and inferential statistics. Caregivers/mothers' mean ages were 31.3 ±7.5 (cases) and 30.6 ±6.0(controls) years. The risk of diarrhoea was significantly higher among children whose mothers did not wash hands with soap before food preparation (OR=3.0, pHygiene and sanitation conditions within households were risk factors for diarrhoea. This study revealed the feasibility of developing and implementing an adequate model to establish intervention priorities in sanitation in Ibadan, Nigeria.

  19. Impact of chemotherapy-associated nausea and vomiting on patients' functional status and on costs: survey of five Canadian centres.

    OpenAIRE

    O'Brien, B J; Rusthoven, J; Rocchi, A; Latreille, J; Fine, S; Vandenberg, T; Laberge, F

    1993-01-01

    OBJECTIVE: To estimate the effect of chemotherapy-associated nausea and emesis on patients' functional status and on costs to the health care system, the patients and society before antagonists to the serotonin (5-hydroxytryptamine) receptor subtype 5-HT3 became available. DESIGN: A 5-day prospective survey between February and May 1991 of patients receiving chemotherapy for cancer. Data were obtained from questionnaires completed by nurses and patients. SETTING: Five Canadian cancer treatmen...

  20. Trends in CPAP adherence over twenty years of data collection: a flattened curve.

    Science.gov (United States)

    Rotenberg, Brian W; Murariu, Dorian; Pang, Kenny P

    2016-08-19

    Obstructive sleep apnea (OSA) is a common disorder, and continuous airway positive pressure (CPAP) is considered to be the gold standard of therapy. CPAP however is known to have problems with adherence, with many patients eventually abandoning the device. The purpose of this paper is to assess secular trends in CPAP adherence over the long term to see if there have been meaningful improvements in adherence in light of the multiple interventions proposed to do so. A comprehensive systematic literature review was conducted using the Medline-Ovid, Embase, and Pubmed databases, searching for data regarding CPAP adherence over a twenty year timeframe (1994-2015). Data was assessed for quality and then extracted. The main outcome measure was reported CPAP non-adherence. Secondary outcomes included changes in CPAP non-adherence when comparing short versus long-term, and changes in terms of behavioral counseling. Eighty-two papers met study inclusion/exclusion criteria. The overall CPAP non-adherence rate based on a 7-h/night sleep time that was reported in studies conducted over the twenty year time frame was 34.1 %. There was no significant improvement over the time frame. Behavioral intervention improved adherence rates by ~1 h per night on average. The rate of CPAP adherence remains persistently low over twenty years worth of reported data. No clinically significant improvement in CPAP adherence was seen even in recent years despite efforts toward behavioral intervention and patient coaching. This low rate of adherence is problematic, and calls into question the concept of CPAP as gold-standard of therapy for OSA.