WorldWideScience

Sample records for underlying diseases generally

  1. Unified neural field theory of brain dynamics underlying oscillations in Parkinson's disease and generalized epilepsies.

    Science.gov (United States)

    Müller, E J; van Albada, S J; Kim, J W; Robinson, P A

    2017-09-07

    The mechanisms underlying pathologically synchronized neural oscillations in Parkinson's disease (PD) and generalized epilepsies are explored in parallel via a physiologically-based neural field model of the corticothalamic-basal ganglia (CTBG) system. The basal ganglia (BG) are approximated as a single effective population and their roles in the modulation of oscillatory dynamics of the corticothalamic (CT) system and vice versa are analyzed. In addition to normal EEG rhythms, enhanced activity around 4 Hz and 20 Hz exists in the model, consistent with the characteristic frequencies observed in PD. These rhythms result from resonances in loops formed between the BG and CT populations, analogous to those that underlie epileptic oscillations in a previous CT model, and which are still present in the combined CTBG system. Dopamine depletion is argued to weaken the dampening of these loop resonances in PD, and network connections then explain the significant coherence observed between BG, thalamic, and cortical population activity around 4-8 Hz and 20 Hz. Parallels between the afferent and efferent connection sites of the thalamic reticular nucleus (TRN) and BG predict low dopamine to correspond to a reduced likelihood of tonic-clonic (grand mal) seizures, which agrees with experimental findings. Furthermore, the model predicts an increased likelihood of absence (petit mal) seizure resulting from pathologically low dopamine levels in accordance with experimental observations. Suppression of absence seizure activity is demonstrated when afferent and efferent BG connections to the CT system are strengthened, which is consistent with other CTBG modeling studies. The BG are demonstrated to have a suppressive effect on activity of the CTBG system near tonic-clonic seizure states, which provides insight into the reported efficacy of current treatments in BG circuits. Sleep states of the TRN are also found to suppress pathological PD activity in accordance with

  2. Paediatric magnetic resonance enteroclysis under general anaesthesia - initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Sadigh, Sophie; Chopra, Mark; Olsen, Oeystein E.; Watson, Tom A. [Great Ormond Street Hospital NHS Foundation Trust, Department of Paediatric Radiology, London (United Kingdom); Sury, Michael R. [Great Ormond Street Hospital NHS Foundation Trust, Department of Paediatric Anaesthetics, London (United Kingdom); Shah, Neil [Great Ormond Street Hospital NHS Foundation Trust, Department of Paediatric Gastroenterology, London (United Kingdom)

    2017-06-15

    MR enterography is the accepted imaging reference standard for small bowel assessment in inflammatory bowel disease. There is an increasing cohort of children with inflammatory bowel disease presenting at an early age (<5 years) with severe disease. Younger children present a technical challenge for enterography because of the need for sedation/general anaesthesia to allow image optimisation and the need for oral contrast to allow adequate luminal assessment. Through our experiences, MR enteroclysis under general anaesthesia has proven to be a successful imaging technique for the work-up of these patients. In this paper, we present our institutional practice for performing MR enteroclysis under general anaesthesia. (orig.)

  3. Levels of oral disease in a sample of children with disability; a study carried out prior to comprehensive dental treatment under general anaesthesia.

    Science.gov (United States)

    O'Leary, I; Kinirons, M; Stewart, C; Graham, F; Hartnett, C

    2007-09-01

    To audit the levels of oral disease in those children whose disability required general anaesthesia for comprehensive dental treatment. An audit was conducted of oral disease levels in a sample of 51 children attending for treatment. The proportion of untreated decayed teeth was 72%, previously extracted 25% and restored 3%. Very high levels of debris and gingival bleeding indices were found. There were very low proportions of previous restorations and past treatment had comprised mainly extractions. There was a low restorative care index in both the primary and permanent dentitions indicating that high needs continue to exist in terms of comprehensive dental care for these Irish children.

  4. Chronic Venous Disease under pressure

    NARCIS (Netherlands)

    S.W.I. Reeder (Suzan)

    2013-01-01

    textabstractIn chapter 1 we provide a general introduction of this thesis. Chronic venous disease (CVD) is a common medical condition that affects 2-64% of the worldwide population and leads to leg ulcers in 1% of the Western population. Venous leg ulceration (VLU) has an unfavorable prognosis with

  5. Intraoperative seizures during craniotomy under general anesthesia.

    Science.gov (United States)

    Howe, John; Lu, Xiaoying; Thompson, Zoe; Peterson, Gordon W; Losey, Travis E

    2016-05-01

    An acute symptomatic seizure is a clinical seizure occurring at the time of or in close temporal association with a brain insult. We report an acute symptomatic seizure occurring during a surgical procedure in a patient who did not have a prior history of epilepsy and who did not have a lesion associated with an increased risk of epilepsy. To characterize the incidence and clinical features of intraoperative seizures during craniotomy under general anesthesia, we reviewed cases where continuous EEG was acquired during craniotomy. Records of 400 consecutive cases with propofol as general anesthesia during craniotomy were reviewed. Demographic data, indication for surgery, clinical history, history of prior seizures, duration of surgery and duration of burst suppression were recorded. Cases where seizures were observed were analyzed in detail. Two out of 400 patients experienced intraoperative seizures, including one patient who appeared to have an acute symptomatic seizure related to the surgical procedure itself and a second patient who experienced two seizures likely related to an underlying diagnosis of epilepsy. This is the first report of an acute symptomatic seizure secondary to a neurosurgical procedure. Overall, 0.5% of patients monitored experienced seizures, indicating that intraoperative seizures are rare, and EEG monitoring during craniotomies is of low yield in detecting seizures. Copyright © 2016. Published by Elsevier Ltd.

  6. Crack initiation under generalized plane strain conditions

    International Nuclear Information System (INIS)

    Shum, D.K.M.; Merkle, J.G.

    1991-01-01

    A method for estimating the decrease in crack-initiation toughness, from a reference plane strain value, due to positive straining along the crack front of a circumferential flaw in a reactor pressure vessel is presented in this study. This method relates crack initiation under generalized plane strain conditions with material failure at points within a distance of a few crack-tip-opening displacements ahead of a crack front, and involves the formulation of a micromechanical crack-initiation model. While this study is intended to address concerns regarding the effects of positive out-of- plane straining on ductile crack initiation, the approach adopted in this work can be extended in a straightforward fashion to examine conditions of macroscopic cleavage crack initiation. Provided single- parameter dominance of near-tip fields exists in the flawed structure, results from this study could be used to examine the appropriateness of applying plane strain fracture toughness to the evaluation of circumferential flaws, in particular to those in ring-forged vessels which have no longitudinal welds. In addition, results from this study could also be applied toward the analysis of the effects of thermal streaming on the fracture resistance of circumferentially oriented flaws in a pressure vessel. 37 refs., 8 figs., 1 tab

  7. Atmospheric General Circulation Changes under Global Warming

    Science.gov (United States)

    Palipane, Erool

    The work in this thesis is mainly two-fold. First we study the internal variability of the general circulation and focus our study on the annular modes and how important it is to simulate the subsynoptic scales in the circulation. In the next major section we will try to understand the mechanisms of the forced response and the mechanisms leading towards the jet shift from transient evolution in Atmospheric general circulation models. In the first part, in an attempt to assess the benefit of resolving the sub-synoptic to mesoscale processes, the spatial and temporal characteristics of the Annular Modes (AMs), in particular those related to the troposphere-stratosphere interaction, are evaluated for moderate- and high-horizontal resolution simulations with a global atmospheric general circulation model (AGCM), in comparison with the ERA40 re- analysis. Relative to the CMIP-type climate models, the IFS AGCM demonstrates notable improvement in capturing the key characteristics of the AMs. Notably, the performance with the high horizontal resolution version of the model is systematically superior to the moderate resolution on all metrics examined, including the variance of the AMs at different seasons of the year, the intrinsic e-folding time scales of the AMs, and the downward influence from the stratosphere to troposphere in the AMs. Moreover, the high-resolution simulation with a greater persistence in the intrinsic variability of the SAM projects an appreciably larger shift of the surface westerly wind during the Southern Hemisphere summer under climate change. In the second part, the response of the atmospheric circulation to greenhouse gas-induced SST warming is investigated using large ensemble experiments with two AGCMs, with a focus on the robust feature of the poleward shift of the eddy driven jet. In these experiments, large ensembles of simulations are conducted by abruptly switching the SST forcing on from January 1st to focus on the wintertime circulation

  8. Epigenetic alterations underlying autoimmune diseases.

    Science.gov (United States)

    Aslani, Saeed; Mahmoudi, Mahdi; Karami, Jafar; Jamshidi, Ahmad Reza; Malekshahi, Zahra; Nicknam, Mohammad Hossein

    2016-01-01

    Recent breakthroughs in genetic explorations have extended our understanding through discovery of genetic patterns subjected to autoimmune diseases (AID). Genetics, on the contrary, has not answered all the conundrums to describe a comprehensive explanation of causal mechanisms of disease etiopathology with regard to the function of environment, sex, or aging. The other side of the coin, epigenetics which is defined by gene manifestation modification without DNA sequence alteration, reportedly has come in to provide new insights towards disease apprehension through bridging the genetics and environmental factors. New investigations in genetic and environmental contributing factors for autoimmunity provide new explanation whereby the interactions between genetic elements and epigenetic modifications signed by environmental agents may be responsible for autoimmune disease initiation and perpetuation. It is aimed through this article to review recent progress attempting to reveal how epigenetics associates with the pathogenesis of autoimmune diseases.

  9. Gamma knife radiosurgery under general anesthesia in childhood

    International Nuclear Information System (INIS)

    Higuchi, Yoshinori; Serizawa, Toru; Nagano, Osamu

    2008-01-01

    Gamma knife radiosurgery (GKS) is an important treatment option for pediatric intracranial diseases, such as arteriovenous malformations and brain tumors. To perform GKS in children, general anesthesia is required for placing a stereotactic frame around the head of the patient, who must remain supine for the entire procedure. This report describes the anesthetic management of children who have undergone GKS at our institution. Fifty-one GKS procedures were performed in 43 patients (age range, 2-15 years). Twenty-one patients had arteriovenous malformations, and 14 patients had brain tumors. Twenty-nine patients (67.4%) received general anesthesia. All children 10 years or younger were treated under general anesthesia. General anesthesia for GKS is performed outside of the operating room and involves unique conditions. First, the patients must be transported to multiple sites in the hospital (the neuroangiography suite, the department of radiology for magnetic resonance imaging and computed tomography, and the gamma knife unit). Second, general anesthesia must be maintained in a high magnetic field. Third, medical staff, including anesthesiologists, must remain outside the room during irradiation. Safe and efficient general anesthesia is essential for performing GKS in children. (author)

  10. Endogenous Generalized Weights under DEA Control

    DEFF Research Database (Denmark)

    Agrell, Per J.; Bogetoft, Peter

    Non-parametric efficiency analysis, such as Data Envelopment Analysis (DEA) relies so far on endogenous local or exogenous general weights, based on revealed preferences or market prices. However, as DEA is gaining popularity in regulation and normative budgeting, the strategic interest of the ev......Non-parametric efficiency analysis, such as Data Envelopment Analysis (DEA) relies so far on endogenous local or exogenous general weights, based on revealed preferences or market prices. However, as DEA is gaining popularity in regulation and normative budgeting, the strategic interest...... of the evaluated industry calls for attention. We offer endogenous general prices based on a reformulation of DEA where the units collectively propose the set of weights that maximize their efficiency. Thus, the sector-wide efficiency is then a result of compromising the scores of more specialized smaller units...

  11. Oxygen general saturation after bronchography anaesthesia . under

    African Journals Online (AJOL)

    1989-08-19

    . Recordings were raken pre-operatively and at 5, 15, 30, 45, 60, 90, 120, .... Le Roux BT, Mohlala ML, Odell JA, Whitton ID. Suppurative diseases of the lung and pleural space: Pan H. Bronchiectasis. Curr Probl Surg 1986; 22 ...

  12. Generalized production planning problem under interval uncertainty

    Directory of Open Access Journals (Sweden)

    Samir A. Abass

    2010-06-01

    Full Text Available Data in many real life engineering and economical problems suffer from inexactness. Herein we assume that we are given some intervals in which the data can simultaneously and independently perturb. We consider the generalized production planning problem with interval data. The interval data are in both of the objective function and constraints. The existing results concerning the qualitative and quantitative analysis of basic notions in parametric production planning problem. These notions are the set of feasible parameters, the solvability set and the stability set of the first kind.

  13. Value maximizing maintenance policies under general repair

    International Nuclear Information System (INIS)

    Marais, Karen B.

    2013-01-01

    One class of maintenance optimization problems considers the notion of general repair maintenance policies where systems are repaired or replaced on failure. In each case the optimality is based on minimizing the total maintenance cost of the system. These cost-centric optimizations ignore the value dimension of maintenance and can lead to maintenance strategies that do not maximize system value. This paper applies these ideas to the general repair optimization problem using a semi-Markov decision process, discounted cash flow techniques, and dynamic programming to identify the value-optimal actions for any given time and system condition. The impact of several parameters on maintenance strategy, such as operating cost and revenue, system failure characteristics, repair and replacement costs, and the planning time horizon, is explored. This approach provides a quantitative basis on which to base maintenance strategy decisions that contribute to system value. These decisions are different from those suggested by traditional cost-based approaches. The results show (1) how the optimal action for a given time and condition changes as replacement and repair costs change, and identifies the point at which these costs become too high for profitable system operation; (2) that for shorter planning horizons it is better to repair, since there is no time to reap the benefits of increased operating profit and reliability; (3) how the value-optimal maintenance policy is affected by the system's failure characteristics, and hence whether it is worthwhile to invest in higher reliability; and (4) the impact of the repair level on the optimal maintenance policy. -- Highlights: •Provides a quantitative basis for maintenance strategy decisions that contribute to system value. •Shows how the optimal action for a given condition changes as replacement and repair costs change. •Shows how the optimal policy is affected by the system's failure characteristics. •Shows when it is

  14. Memory Loss, Alzheimer's Disease and General Anesthesia: A Preoperative Concern.

    Science.gov (United States)

    Thaler, Adam; Siry, Read; Cai, Lufan; García, Paul S; Chen, Linda; Liu, Renyu

    2012-02-20

    The long-term cognitive effects of general anesthesia are under intense scrutiny. Here we present 5 cases from 2 academic institutions to analyze some common features where the patient's or the patient family member has made a request to address their concern on memory loss, Alzheimer's disease and general anesthesia before surgery. Records of anesthesia consultation separate from standard preoperative evaluation were retrieved to identify consultations related to memory loss and Alzheimer's disease from the patient and/or patient family members. The identified cases were extensively reviewed for features in common. We used Google® (http://www. google.com/) to identify available online information using "anesthesia memory loss" as a search phrase. Five cases were collected as a specific preoperative consultation related to memory loss, Alzheimer's disease and general anesthesia from two institutions. All of the individuals either had perceived memory impairment after a prior surgical procedure with general anesthesia or had a family member with Alzheimer's disease. They all accessed public media sources to find articles related to anesthesia and memory loss. On May 2 nd , 2011, searching "anesthesia memory loss" in Google yielded 764,000 hits. Only 3 of the 50 Google top hits were from peer-reviewed journals. Some of the lay media postings made a causal association between general anesthesia and memory loss and/or Alzheimer's disease without conclusive scientific literature support. The potential link between memory loss and Alzheimer's disease with general anesthesia is an important preoperative concern from patients and their family members. This concern arises from individuals who have had history of cognitive impairment or have had a family member with Alzheimer disease and have tried to obtain information from public media. Proper preoperative consultation with the awareness of the lay literature can be useful in reducing patient and patient family member

  15. General Concepts in Adult Congenital Heart Disease

    OpenAIRE

    Ferit Onur Mutluer; Alpay Çeliker

    2018-01-01

    Congenital heart disease in adults (adult congenital heart disease) is a growing burden for healthcare systems. While infant mortality due to congenital heart disease in the last four decades decreased by almost 3-fold, adult congenital heart disease prevalence increased by more than 2-fold in United States. Adult congenital heart disease prevalence is expected to increase steadily until 2050 in projections. Adult congenital heart disease is a multifaceted problem with many dimensions. This m...

  16. General Concepts in Adult Congenital Heart Disease.

    Science.gov (United States)

    Mutluer, Ferit Onur; Çeliker, Alpay

    2018-01-20

    Congenital heart disease in adults (adult congenital heart disease) is a growing burden for healthcare systems. While infant mortality due to congenital heart disease in the last four decades decreased by almost 3-fold, adult congenital heart disease prevalence increased by more than 2-fold in United States. Adult congenital heart disease prevalence is expected to increase steadily until 2050 in projections. Adult congenital heart disease is a multifaceted problem with many dimensions. This manuscript aims to provide an overview of the common adult congenital heart diseases and summarize important points in management of these diseases with possible problems and complications that the patients and the physicians face.

  17. General Concepts in Adult Congenital Heart Disease

    Directory of Open Access Journals (Sweden)

    Ferit Onur Mutluer

    2018-02-01

    Full Text Available Congenital heart disease in adults (adult congenital heart disease is a growing burden for healthcare systems. While infant mortality due to congenital heart disease in the last four decades decreased by almost 3-fold, adult congenital heart disease prevalence increased by more than 2-fold in United States. Adult congenital heart disease prevalence is expected to increase steadily until 2050 in projections. Adult congenital heart disease is a multifaceted problem with many dimensions. This manuscript aims to provide an overview of the common adult congenital heart diseases and summarize important points in management of these diseases with possible problems and complications that the patients and the physicians face

  18. Bounds in the generalized Weber problem under locational uncertainty

    DEFF Research Database (Denmark)

    Juel, Henrik

    1981-01-01

    An existing analysis of the bounds on the Weber problem solution under uncertainty is incorrect. For the generalized problem with arbitrary measures of distance, we give easily computable ranges on the bounds and state the conditions under which the exact values of the bounds can be found...... with little computational effort. Numerical examples illustrate the analysis....

  19. Effects of music therapy under general anesthesia in patients ...

    African Journals Online (AJOL)

    The aim of this study is to evaluate its effects, under general anesthesia, on perioperative patient satisfaction, stress, pain, and awareness. Methods: This is a prospective, randomized, double-blind study conducted in the operating theatre of visceral surgery at Sahloul Teaching Hospital over a period of 4 months. Patients ...

  20. Cardiovascular effects of oesophageal dilation under general anaesthesia

    DEFF Research Database (Denmark)

    Jakobsen, C H; Rasmussen, V; Rosenberg, J

    1999-01-01

    under general anaesthesia. Ten consecutive patients with benign oesophageal strictures were evaluated. Arterial oxygen saturation was measured by continuous pulse oximetry, ECG was recorded continuously with a Holter tape recorder, and blood pressure was measured non-invasively every five minutes during...

  1. A retrospective comparison of dental treatment under general ...

    African Journals Online (AJOL)

    Purpose: The purpose of this study is to determine the properties of the dental procedures performed on children with dental problems under general anesthesia and compared between the patterns of dental treatment provided for intellectual disability and non.cooperate healthy child. Materials and Methods: In this ...

  2. Effects of music therapy under general anesthesia in patients ...

    African Journals Online (AJOL)

    2016-12-13

    Dec 13, 2016 ... Background: Music therapy, an innovative approach that has proven effectiveness in many medical conditions, seems beneficial also in managing surgical patients. The aim of this study is to evaluate its effects, under general anesthesia, on perioperative patient satisfaction, stress, pain, and awareness.

  3. Gauge theories under incorporation of a generalized uncertainty principle

    International Nuclear Information System (INIS)

    Kober, Martin

    2010-01-01

    There is considered an extension of gauge theories according to the assumption of a generalized uncertainty principle which implies a minimal length scale. A modification of the usual uncertainty principle implies an extended shape of matter field equations like the Dirac equation. If there is postulated invariance of such a generalized field equation under local gauge transformations, the usual covariant derivative containing the gauge potential has to be replaced by a generalized covariant derivative. This leads to a generalized interaction between the matter field and the gauge field as well as to an additional self-interaction of the gauge field. Since the existence of a minimal length scale seems to be a necessary assumption of any consistent quantum theory of gravity, the gauge principle is a constitutive ingredient of the standard model, and even gravity can be described as gauge theory of local translations or Lorentz transformations, the presented extension of gauge theories appears as a very important consideration.

  4. Radiodiagnosis of general diseases of the stomach

    International Nuclear Information System (INIS)

    Mikhajlov, A.N.

    1986-01-01

    Modern representations of X-ray diagnostics of the most wide-spread stomach diseases are shown. X-ray-anatomical-functional peculiarities of the stomach technique of its X-ray examination as well as X-ray diagnostics of diseases of the stomach are stated on the basis of data of special literature and own author experience. X-ray pattern of the operated stomach and its complications is described in detail

  5. Nicotine effects on general semantic priming in Parkinson's disease.

    Science.gov (United States)

    Holmes, Anna D; Copland, David A; Silburn, Peter A; Chenery, Helen J

    2011-06-01

    In young healthy nonsmokers, effects of nicotine on semantic processing have been observed under strategy-based priming procedures but not under more general priming procedures (Holmes, Chenery, & Copland, 2008; Holmes, Chenery, & Copland, 2010). Effects of nicotine under general priming procedures, however, may be mediated by baseline priming levels that are below optimum such as when compromised by disease. Nicotinic mechanisms may be involved in the cognitive sequalae of Parkinson's disease (PD). Evidence suggests that semantic processing may be compromised in PD but the potential benefit of nicotinic stimulation is unknown. This study investigated the effects of nicotine on semantic processing in nonsmokers with PD (n = 12) and nonsmoking matched controls (n = 17) using general priming procedures. Specifically, an automatic priming task (0.15 relatedness proportion, RP, and 200 ms stimulus onset asynchrony, SOA) and a controlled priming task (0.8 RP and 1000 ms SOA) were used. Prime-target category relation (category related, noncategory related) was also manipulated. Transdermal nicotine patches (7 mg/24 h) were administered in a double-blind, placebo-controlled, crossover design. For the automatic task, nicotine did not influence priming effects for PD. Unexpectedly, compromised automatic priming for controls was ameliorated. For the controlled task, nicotine influenced priming effects for PD but not controls. The patterns of priming and nicotine effects across the tasks suggest an age-related slowing of the rate of semantic activation for controls, which may be exacerbated in PD. Overall, the findings indicate that nicotine can improve compromised semantic processing in PD, and also influence semantic processing in healthy older individuals. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

  6. Generalized Minimum Variance Control for MDOF Structures under Earthquake Excitation

    Directory of Open Access Journals (Sweden)

    Lakhdar Guenfaf

    2016-01-01

    Full Text Available Control of a multi-degree-of-freedom structural system under earthquake excitation is investigated in this paper. The control approach based on the Generalized Minimum Variance (GMV algorithm is developed and presented. Our approach is a generalization to multivariable systems of the GMV strategy designed initially for single-input-single-output (SISO systems. Kanai-Tajimi and Clough-Penzien models are used to generate the seismic excitations. Those models are calculated using the specific soil parameters. Simulation tests using a 3DOF structure are performed and show the effectiveness of the control method.

  7. Alloimmunization in multitransfused liver disease patients: Impact of underlying disease

    Directory of Open Access Journals (Sweden)

    Meenu Bajpai

    2016-01-01

    Full Text Available Introduction: Transfusion support is vital to the management of patients with liver diseases. Repeated transfusions are associated with many risks such as transfusion-transmitted infection, transfusion immunomodulation, and alloimmunization. Materials and Methods: A retrospective data analysis of antibody screening and identification was done from February 2012 to February 2014 to determine the frequency and specificity of irregular red-cell antibodies in multitransfused liver disease patients. The clinical and transfusion records were reviewed. The data was compiled, statistically analyzed, and reviewed. Results: A total of 842 patients were included in our study. Alloantibodies were detected in 5.22% of the patients. Higher rates of alloimmunization were seen in patients with autoimmune hepatitis, cryptogenic liver disease, liver damage due to drugs/toxins, and liver cancer patients. Patients with alcoholic liver disease had a lower rate of alloimmunization. The alloimmunization was 12.7% (23/181 in females and 3.17% (21/661 in males. Antibodies against the Rh system were the most frequent with 27 of 44 alloantibodies (61.36%. The most common alloantibody identified was anti-E (11/44 cases, 25%, followed by anti-C (6/44 cases, 13.63%. Conclusion: Our findings suggest that alloimmunization rate is affected by underlying disease. Provision of Rh and Kell phenotype-matched blood can significantly reduce alloimmunization.

  8. Colonoscopic polypectomy of colorectal polyps in children under general anesthesia.

    Science.gov (United States)

    Lin, Chien-Heng; Wu, Rick Sai-Chuen; Lin, Wei-Ching; Wu, Shu-Fen; Chen, An-Chyi

    2009-02-01

    In many countries, general anesthesia is not routinely used for colonoscopic polypectomy in children because of either feasibility or cost-effectiveness issues. However, we have been using general anesthesia for colonoscopic polypectomy in pediatric patients in our hospital for the past 5 years. The aim of this study was to evaluate the safety of the procedure and the degree of satisfaction that the patients' parents and endoscopists had with the use of general anesthesia. We retrospectively analyzed the results of colonoscopic polypectomies under general anesthesia in 18 patients performed between January 2001 and December 2005. The removed polyps were examined histologically and the patients were observed to assess complications during the first 24-hour postoperative period. The patients' parents' and endoscopists' satisfaction with the use of general anesthesia was surveyed after the procedure. In our patient group, there were 10 boys and eight girls. The mean age was 5.5 +/- 3.4 years (range, 2-15 years). Seventeen of the 18 patients had rectal bleeding (mean duration, 3.7 months) as the main symptom. There were 12 patients with juvenile polyps, four with hyperplastic polyps, one with juvenile polyposis and one with Peutz-Jeghers syndrome. The majority (70.6%) of the polyps were located in the rectosigmoid colon. No significant complications related to colonoscopic polypectomy or anesthesia were observed. Satisfaction among parents and endoscopists ranged from good to excellent. General anesthesia is recommended for pediatric patients undergoing colonoscopic polypectomy.

  9. Colonoscopic Polypectomy of Colorectal Polyps in Children Under General Anesthesia

    Directory of Open Access Journals (Sweden)

    Chien-Heng Lin

    2009-02-01

    Full Text Available In many countries, general anesthesia is not routinely used for colonoscopic polypectomy in children because of either feasibility or cost-effectiveness issues. However, we have been using general anesthesia for colonoscopic polypectomy in pediatric patients in our hospital for the past 5 years. The aim of this study was to evaluate the safety of the procedure and the degree of satisfaction that the patients' parents and endoscopists had with the use of general anesthesia. We retrospectively analyzed the results of colonoscopic polypectomies under general anesthesia in 18 patients performed between January 2001 and December 2005. The removed polyps were examined histologically and the patients were observed to assess complications during the first 24-hour postoperative period. The patients' parents' and endoscopists' satisfaction with the use of general anesthesia was surveyed after the procedure. In our patient group, there were 10 boys and eight girls. The mean age was 5.5 ± 3.4 years (range, 2–15 years. Seventeen of the 18 patients had rectal bleeding (mean duration, 3.7 months as the main symptom. There were 12 patients with juvenile polyps, four with hyperplastic polyps, one with juvenile polyposis and one with Peutz-Jeghers syndrome. The majority (70.6% of the polyps were located in the rectosigmoid colon. No significant complications related to colonoscopic polypectomy or anesthesia were observed. Satisfaction among parents and endoscopists ranged from good to excellent. General anesthesia is recommended for pediatric patients undergoing colonoscopic polypectomy.

  10. Dental management of hemophiliac child under general anesthesia.

    Science.gov (United States)

    Rayen, R; Hariharan, V S; Elavazhagan, N; Kamalendran, N; Varadarajan, R

    2011-01-01

    Hemophilia is the most common inherited bleeding disorder. Hemophilic patients should be cosidered as special patients. There is no contraindication to general dental treatment for hemophiliacs, as they generally do not involve bleeding. But caution must be used with any surgical procedures that involve the local and general anesthesia. Such patients should always be managed in the setting of specialized units with appropriate clinical expertise and laboratory support. Recent advances in the management of hemophilia have enabled many hemophiliac patients to receive surgical dental procedures in an outpatient dental care on a routine basis. The purpose of this case report is to provide a few management strategies when providing full mouth rehabilitation under anesthesia and replacement therapies that are available. In addition, overviews of possible complication that may be encountered when providing such treatment are discussed here.

  11. Project management under uncertainty beyond beta: The generalized bicubic distribution

    Directory of Open Access Journals (Sweden)

    José García Pérez

    2016-01-01

    Full Text Available The beta distribution has traditionally been employed in the PERT methodology and generally used for modeling bounded continuous random variables based on expert’s judgment. The impossibility of estimating four parameters from the three values provided by the expert when the beta distribution is assumed to be the underlying distribution has been widely debated. This paper presents the generalized bicubic distribution as a good alternative to the beta distribution since, when the variance depends on the mode, the generalized bicubic distribution approximates the kurtosis of the Gaussian distribution better than the beta distribution. In addition, this distribution presents good properties in the PERT methodology in relation to moderation and conservatism criteria. Two empirical applications are presented to demonstrate the adequateness of this new distribution.

  12. CT chest under general anesthesia: pulmonary, anesthetic and radiologic dilemmas

    International Nuclear Information System (INIS)

    Mahmoud, Mohamed; Towe, Christopher; Fleck, Robert J.

    2015-01-01

    Today's practice of medicine involves ever more complex patients whose care is coordinated with multidisciplinary teams. Caring for these patients can challenge all members of the health care team. Sedation/anesthesia in infants/toddlers as well as uncooperative or intellectually or emotionally impaired children who require imaging studies of the chest are ongoing challenges. High-quality computed tomography (CT) chest imaging studies in children under general anesthesia are extremely important for accurate interpretation and subsequent medical decision-making. Anesthesia-induced atelectasis may obscure or mimic true pathology creating a significant quality issue. Obtaining a high-quality, motion-free chest imaging study in infants and children under general anesthesia remains a difficult task in many institutions. Meticulous attention to anesthesia and imaging techniques and specialized knowledge are required to properly perform and interpret chest imaging studies. In this commentary, we discuss the continuous struggle to obtain high-quality CT chest imaging under general anesthesia. We will also discuss the major concerns of the anesthesiologist, radiologist and pulmonologist and why cooperation and coordination among these providers are critical for an optimal quality study.

  13. CT chest under general anesthesia: pulmonary, anesthetic and radiologic dilemmas

    Energy Technology Data Exchange (ETDEWEB)

    Mahmoud, Mohamed [Cincinnati Children' s Hospital Medical Center, Department of Anesthesiology, Cincinnati, OH (United States); Towe, Christopher [Cincinnati Children' s Hospital Medical Center, Department of Pulmonary Medicine, Cincinnati, OH (United States); Fleck, Robert J. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2015-07-15

    Today's practice of medicine involves ever more complex patients whose care is coordinated with multidisciplinary teams. Caring for these patients can challenge all members of the health care team. Sedation/anesthesia in infants/toddlers as well as uncooperative or intellectually or emotionally impaired children who require imaging studies of the chest are ongoing challenges. High-quality computed tomography (CT) chest imaging studies in children under general anesthesia are extremely important for accurate interpretation and subsequent medical decision-making. Anesthesia-induced atelectasis may obscure or mimic true pathology creating a significant quality issue. Obtaining a high-quality, motion-free chest imaging study in infants and children under general anesthesia remains a difficult task in many institutions. Meticulous attention to anesthesia and imaging techniques and specialized knowledge are required to properly perform and interpret chest imaging studies. In this commentary, we discuss the continuous struggle to obtain high-quality CT chest imaging under general anesthesia. We will also discuss the major concerns of the anesthesiologist, radiologist and pulmonologist and why cooperation and coordination among these providers are critical for an optimal quality study.

  14. Homotopy Method for a General Multiobjective Programming Problem under Generalized Quasinormal Cone Condition

    Directory of Open Access Journals (Sweden)

    X. Zhao

    2012-01-01

    Full Text Available A combined interior point homotopy continuation method is proposed for solving general multiobjective programming problem. We prove the existence and convergence of a smooth homotopy path from almost any interior initial interior point to a solution of the KKT system under some basic assumptions.

  15. General chemistry students' understanding of the chemistry underlying climate science

    Science.gov (United States)

    Versprille, Ashley N.

    The purpose of this study is to investigate first-semester general chemistry students' understanding of the chemistry underlying climate change. The first part of this study involves the collection of qualitative data from twenty-four first-semester general chemistry students from a large Midwestern research institution. The semi-structured interview protocol was developed based on alternative conceptions identified in the research literature and the essential principles of climate change outlined in the U.S. Climate Change Science Program (CCSP) document which pertain to chemistry (CCSP, 2003). The analysis and findings from the interviews indicate conceptual difficulties for students, both with basic climate literacy and underlying chemistry concepts. Students seem to confuse the greenhouse effect, global warming, and the ozone layer, and in terms of chemistry concepts, they lack a particulate level understanding of greenhouse gases and their interaction with electromagnetic radiation, causing them to not fully conceptualize the greenhouse effect and climate change. Based on the findings from these interviews, a Chemistry of Climate Science Diagnostic Instrument (CCSI) was developed for use in courses that teach chemistry with a rich context such as climate science. The CCSI is designed for professors who want to teach general chemistry, while also addressing core climate literacy principles. It will help professors examine their students' prior knowledge and alternative conceptions of the chemistry concepts associated with climate science, which could then inform their teaching and instruction.

  16. Generalized anxiety disorder: A comorbid disease.

    Science.gov (United States)

    Nutt, David; Argyropoulos, Spilos; Hood, Sean; Potokar, John

    2006-07-01

    Generalized anxiety disorder (GAD) frequently occurs comorbidly with other conditions, including depression and somatic complaints. Comorbid GAD sufferers have increased psychologic and social impairment, request additional treatment, and have an extended course and poorer outcome than those with GAD alone; therapy should alleviate both the psychic and somatic symptoms of GAD without negatively affecting the comorbid condition. The ideal treatment would provide relief from both GAD and the comorbid condition, reducing the need for polypharmacy. Physicians need suitable tools to assist them in the detection and monitoring of GAD patients-the GADI, a new, self-rating scale, may meet this requirement. Clinical data have shown that various neurobiologic irregularities (e.g., in the GABA and serotonin systems) are associated with the development of anxiety. Prescribing physicians must take into account these abnormalities when choosing a drug. Effective diagnosis and treatment should improve patients' quality of life and their prognosis for recovery.

  17. Pricing Participating Products under a Generalized Jump-Diffusion Model

    Directory of Open Access Journals (Sweden)

    Tak Kuen Siu

    2008-01-01

    Full Text Available We propose a model for valuing participating life insurance products under a generalized jump-diffusion model with a Markov-switching compensator. It also nests a number of important and popular models in finance, including the classes of jump-diffusion models and Markovian regime-switching models. The Esscher transform is employed to determine an equivalent martingale measure. Simulation experiments are conducted to illustrate the practical implementation of the model and to highlight some features that can be obtained from our model.

  18. Generalized connective tissue disease in Crtap-/- mouse.

    Directory of Open Access Journals (Sweden)

    Dustin Baldridge

    2010-05-01

    Full Text Available Mutations in CRTAP (coding for cartilage-associated protein, LEPRE1 (coding for prolyl 3-hydroxylase 1 [P3H1] or PPIB (coding for Cyclophilin B [CYPB] cause recessive forms of osteogenesis imperfecta and loss or decrease of type I collagen prolyl 3-hydroxylation. A comprehensive analysis of the phenotype of the Crtap-/- mice revealed multiple abnormalities of connective tissue, including in the lungs, kidneys, and skin, consistent with systemic dysregulation of collagen homeostasis within the extracellular matrix. Both Crtap-/- lung and kidney glomeruli showed increased cellular proliferation. Histologically, the lungs showed increased alveolar spacing, while the kidneys showed evidence of segmental glomerulosclerosis, with abnormal collagen deposition. The Crtap-/- skin had decreased mechanical integrity. In addition to the expected loss of proline 986 3-hydroxylation in alpha1(I and alpha1(II chains, there was also loss of 3Hyp at proline 986 in alpha2(V chains. In contrast, at two of the known 3Hyp sites in alpha1(IV chains from Crtap-/- kidneys there were normal levels of 3-hydroxylation. On a cellular level, loss of CRTAP in human OI fibroblasts led to a secondary loss of P3H1, and vice versa. These data suggest that both CRTAP and P3H1 are required to maintain a stable complex that 3-hydroxylates canonical proline sites within clade A (types I, II, and V collagen chains. Loss of this activity leads to a multi-systemic connective tissue disease that affects bone, cartilage, lung, kidney, and skin.

  19. Lafora Disease and Congenital Generalized Lipodystrophy: A Case Report

    Directory of Open Access Journals (Sweden)

    Chih-Fan Tseng

    2009-12-01

    Full Text Available We report a patient with congenital generalized lipodystrophy who had suffered from seizures, myoclonus, ataxia and cognitive decline since late childhood. Lafora disease was diagnosed based on skin biopsy results, which revealed pathognomonic Lafora bodies. The results of genetic analysis for mutations in EPM2A and EPM2B genes were negative. This is the first case report describing an association between congenital generalized lipodystrophy and Lafora disease. Further studies focusing on the relationship between these two diseases and the identification of a third locus for Lafora disease are needed.

  20. Vehicle technology under CO2 constraint: a general equilibrium analysis

    International Nuclear Information System (INIS)

    Schaefer, Andreas; Jacoby, Henry D.

    2006-01-01

    A study is presented of the rates of penetration of different transport technologies under policy constraints on CO 2 emissions. The response of this sector is analyzed within an overall national level of restriction, with a focus on automobiles, light trucks, and heavy freight trucks. Using the US as an example, a linked set of three models is used to carry out the analysis: a multi-sector computable general equilibrium model of the economy, a MARKAL-type model of vehicle and fuel supply technology, and a model simulating the split of personal and freight transport among modes. Results highlight the importance of incremental improvements in conventional internal combustion engine technology, and, in the absence of policies to overcome observed consumer discount rates, the very long time horizons before radical alternatives like the internal combustion engine hybrid drive train vehicle are likely to take substantial market share

  1. Postoperative Submandibular Gland Swelling following Craniotomy under General Anesthesia

    Directory of Open Access Journals (Sweden)

    Haruka Nakanishi

    2015-01-01

    Full Text Available Objective. Reporting of a rare case of postoperative submandibular gland swelling following craniotomy. Case Report. A 33-year-old male underwent resection for a brain tumor under general anesthesia. The tumor was resected via a retrosigmoid suboccipital approach and the patient was placed in a lateral position with his face down and turned to the right. Slight swelling of the right submandibular gland was observed just after the surgery. Seven hours after surgery, edematous change around the submandibular gland worsened and he required emergent reintubation due to airway compromise. The cause of submandibular gland swelling seemed to be an obstruction of the salivary duct due to surgical positioning. Conclusion. Once submandibular swelling and edematous change around the submandibular gland occur, they can worsen and compromise the air way within several hours after operation. Adequate precaution must be taken for any predisposing skull-base surgery that requires strong cervical rotation and flexion.

  2. Respiratory Diseases in Children: studies in general practice

    NARCIS (Netherlands)

    J.H.J.M. Uijen (Hans)

    2011-01-01

    textabstractThe work presented in this thesis covers various aspects of the epidemiology, diagnosis and management of various respiratory symptoms and diseases in children frequently encountered in general practice. These respiratory tract symptoms and diseases can be categorized into symptoms and

  3. Neural correlates underlying micrographia in Parkinson's disease.

    Science.gov (United States)

    Wu, Tao; Zhang, Jiarong; Hallett, Mark; Feng, Tao; Hou, Yanan; Chan, Piu

    2016-01-01

    Micrographia is a common symptom in Parkinson's disease, which manifests as either a consistent or progressive reduction in the size of handwriting or both. Neural correlates underlying micrographia remain unclear. We used functional magnetic resonance imaging to investigate micrographia-related neural activity and connectivity modulations. In addition, the effect of attention and dopaminergic administration on micrographia was examined. We found that consistent micrographia was associated with decreased activity and connectivity in the basal ganglia motor circuit; while progressive micrographia was related to the dysfunction of basal ganglia motor circuit together with disconnections between the rostral supplementary motor area, rostral cingulate motor area and cerebellum. Attention significantly improved both consistent and progressive micrographia, accompanied by recruitment of anterior putamen and dorsolateral prefrontal cortex. Levodopa improved consistent micrographia accompanied by increased activity and connectivity in the basal ganglia motor circuit, but had no effect on progressive micrographia. Our findings suggest that consistent micrographia is related to dysfunction of the basal ganglia motor circuit; while dysfunction of the basal ganglia motor circuit and disconnection between the rostral supplementary motor area, rostral cingulate motor area and cerebellum likely contributes to progressive micrographia. Attention improves both types of micrographia by recruiting additional brain networks. Levodopa improves consistent micrographia by restoring the function of the basal ganglia motor circuit, but does not improve progressive micrographia, probably because of failure to repair the disconnected networks. © The Author (2015). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Coeliac disease : investigation of the genetic factors underlying coeliac disease

    NARCIS (Netherlands)

    Belzen, M.J. (Martine Juliana) van

    2003-01-01

    Coeliac disease is a common food intolerance with a complex genetic aetiology. It is caused by ingestion of gluten peptides from wheat and related proteins from barley and rye in genetically susceptible individuals. The disease affects the small intestine and leads to abnormalities ranging from the

  5. Mitochondrial dysfunction underlying outer retinal diseases

    DEFF Research Database (Denmark)

    Lefevere, Evy; Toft-Kehler, Anne Katrine; Vohra, Rupali

    2017-01-01

    Dysfunction of photoreceptors, retinal pigment epithelium (RPE) or both contribute to the initiation and progression of several outer retinal disorders. Disrupted Müller glia function might additionally subsidize to these diseases. Mitochondrial malfunctioning is importantly associated with outer...... of mitochondrial dysfunction, indicating that mitochondria represent a weak link in the antioxidant defenses of outer retinal cells....

  6. Chest computed tomography in children under general anesthesia - cases of an atelectasis

    International Nuclear Information System (INIS)

    Laskowska, K.; Lasek, W.; Drewa, S.; Karolkiewicz, M.; Pogorzala, M.; Wysocki, M.

    2003-01-01

    Computed tomography is a routine examination in children with diagnosed or suspected cancer. Despite the procedure is painless, it requires stillness for some time. Thus, general anesthesia is provided in selected cases. An aim of this paper was an evaluation of an atelectasis incidence in children referred to CT examination under general anesthesia. Material consisted of 11 children aged 2-61 months with neoplasmatic disease diagnosed or suspected. All of them had a regular chest CT exam under general anesthesia with lungs parenchyma, mediastinum and chest wall analyzed. In 4 of 11 children (36%) atelectasis was seen, located in supradiaphragmatic and paravertebral segments of the lungs. None of the children had clinical symptoms of atelectasis. In two of them control chest radiograms did not show any changes. In some patients general anesthesia may reduce the lungs pneumatization which can hide metastases in lungs. It could be summarized that in infants and young children sedation instead of general anesthesia in chest CT should be considered, which could improve the quality of the imaging and the safety of the examination. (author)

  7. Epigenetic mechanisms underlying nervous system diseases.

    Science.gov (United States)

    Qureshi, Irfan A; Mehler, Mark F

    2018-01-01

    Epigenetic mechanisms act as control systems for modulating genomic structure and activity in response to evolving profiles of cell-extrinsic, cell-cell, and cell-intrinsic signals. These dynamic processes are responsible for mediating cell- and tissue-specific gene expression and function and gene-gene and gene-environmental interactions. The major epigenetic mechanisms include DNA methylation and hydroxymethylation; histone protein posttranslational modifications, nucleosome remodeling/repositioning, and higher-order chromatin reorganization; noncoding RNA regulation; and RNA editing. These mechanisms are intimately involved in executing fundamental genomic programs, including gene transcription, posttranscriptional RNA processing and transport, translation, X-chromosome inactivation, genomic imprinting, retrotransposon regulation, DNA replication, and DNA repair and the maintenance of genomic stability. For the nervous system, epigenetics offers a novel and robust framework for explaining how brain development and aging occur, neural cellular diversity is generated, synaptic and neural network connectivity and plasticity are mediated, and complex cognitive and behavioral phenotypes are inherited transgenerationally. Epigenetic factors and processes are, not surprisingly, implicated in nervous system disease pathophysiology through several emerging paradigms - mutations and genetic variation in genes encoding epigenetic factors; impairments in epigenetic factor expression, localization, and function; epigenetic mechanisms modulating disease-associated factors and pathways; and the presence of deregulated epigenetic profiles in central and peripheral tissues. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. Hyperhemolysis Syndrome without Underlying Hematologic Disease

    Directory of Open Access Journals (Sweden)

    Lauren Anne Eberly

    2015-01-01

    Full Text Available Introduction. Hyperhemolysis is characterized by a life-threatening hemolytic transfusion reaction, with hemoglobin (Hb and hematocrit (Hct dropping markedly lower than before transfusion. This phenomenon, commonly described in sickle cell disease, is a rare occurrence in patients without hemoglobinopathies. Case Report. A 55-year-old male presented to the hospital after a motorcycle crash and received 10 units of cross-matched blood for active bleeding. The patient was blood group O, with a negative antibody screen. Ten days later, he represented complaining of dyspnea and was found to have a hematocrit of 12%. The direct antiglobulin test was positive for anti-immunoglobin G and complement. Indirect antiglobulin test was positive for anti-Jka alloantibodies. The presence of Jka antigen was revealed in one unit of previously transfused blood; patient’s RBCs were negative for the Jka antigen. Laboratory data demonstrated findings consistent with DHTR, as well as reticulopenia and elevated ferritin levels. He continued to show signs of active hemolysis, requiring a total of 4 subsequent units of pRBCs. Each transfusion precipitated a drop in Hb and Hct to levels lower than before transfusion; once transfusions were held, the patient slowly recovered. Discussion. Hyperhemolysis in the setting of a DHTR can occur in patients without hematologic disease.

  9. Nursing intervention in gynecologic brachytherapy under general anesthesia

    International Nuclear Information System (INIS)

    Maeda, Shoko; Goto, Yukimi; Nagai, Michiyo; Hashiguchi, Chikako; Fujii, Osamu; Ota, Yosuke; Tsujino, Kayoko; Soejima, Toshinori; Kato, Hiromi

    2010-01-01

    We reconsidered our nursing intervention in gynecologic intracavitary brachytherapy as general anesthesia was introduced. We recognized that safety, comfort, privacy protection and relief of anxiety of the patients were important points for nursing with corporation of other medical staffs. (author)

  10. Streptococcus bovis bacteremia and underlying gastrointestinal disease.

    Science.gov (United States)

    Murray, H W; Roberts, R B

    1978-07-01

    Twenty-six adults with Streptococcus bovis endocarditis and ten with bacteremia alone were studied to determine possible portals of entry. Of 36 patients (17 with endocarditis, eight with bacteremia alone), 25 had gastrointestinal lesions or manipulation. In 22, the gastrointestinal tract appeared to be the source of S bovis bacteremia. Four patients had either carcinoma of the colon (two) or potentially malignant villous adenomas (two) when first seen because of S bovis bacteremia. None of these, nor two other patients with benign colonic polyps, had bowel-related symptoms or signs prior to admission. Since S bovis is a normal intestinal tract inhabitant, bacteremia may frequently be associated with bowel lesions. Streptococcus bovis bacteremia may provide an early clue to the presence of serious and clinically unexpected gastrointestinal disease. Gastrointestinal tract evaluation should be part of S bovis bacteremia patient management, with or without endocarditis.

  11. Effect of Epidural Block under General Anesthesia on Pulse Transit Time

    International Nuclear Information System (INIS)

    Choi, Byeong Cheol; Kim, Seong Min; Jung, Dong Keun; Kim, Gi Ryon; Lee, He Jeong; Jeon, Gye Rock

    2005-01-01

    Epidural block under general anesthesia has been widely used to control postoperative pain. In this anesthetic state many hemodynamic parameters are changed. Moreover pulse transit time is influenced by this memodynamic change. PPT change in the finger and the toe due to relaxation of arterial wall muscle after general anesthesia and epidural block under general anesthesia. This study, in the both general anesthesia and epidural block under general anesthesia, ΔPTT of the toe and of the finger are measured. In addition, ΔPTT(toe-finger) of the epidural block under general anesthesia and of the general anesthesia were compared

  12. Dynamic generalized linear models for monitoring endemic diseases

    DEFF Research Database (Denmark)

    Lopes Antunes, Ana Carolina; Jensen, Dan; Hisham Beshara Halasa, Tariq

    2016-01-01

    The objective was to use a Dynamic Generalized Linear Model (DGLM) based on abinomial distribution with a linear trend, for monitoring the PRRS (Porcine Reproductive and Respiratory Syndrome sero-prevalence in Danish swine herds. The DGLM was described and its performance for monitoring control...... in sero-prevalence. Based on this, it was possible to detect variations in the growth model component. This study is a proof-of-concept, demonstrating the use of DGLMs for monitoring endemic diseases. In addition, the principles stated might be useful in general research on monitoring and surveillance...

  13. Survey of comprehensive restorative treatment for children under general anesthesia

    Directory of Open Access Journals (Sweden)

    Yai-Tin Lin

    2015-09-01

    Conclusion: Although general anesthesia provides an optimal condition for treating children with high caries risk, high failure rates of composite restorations were noted. Indirect pulp capping and ferric sulfate pulpotomy followed by stainless steel crown restorations are successful techniques and can be used to treat deep carious lesions.

  14. Characterizing QALYs under a General Rank Dependent Utility Model

    NARCIS (Netherlands)

    H. Bleichrodt (Han); J. Quiggin (John)

    1997-01-01

    textabstractThis paper provides a characterization of QALYs, the most important outcome measure in medical decision making, in the context of a general rank dependent utility model. We show that both for chronic and for nonchronic health states the characterization of QALYs depends on intuitive

  15. General principles underlying the decommissioning of nuclear facilities

    International Nuclear Information System (INIS)

    1988-03-01

    Previous statements on the use of the term 'decommissioning' by the International Atomic Energy Agency, the Atomic Energy Control Board, and the Advisory Committee on Nuclear Safety are reviewed, culminating in a particular definition for its use in this paper. Three decommissioning phases are identified and discussed, leading to eight general principles governing decommissioning including one related to financing

  16. Failure of Sierra White granite under general states of stress

    Science.gov (United States)

    Ingraham, M. D.; Dewers, T. A.; Lee, M.; Holdman, O.; Cheung, C.; Haimson, B. C.

    2017-12-01

    The effect of the intermediate principal stress on the failure of Sierra White granite was investigated by performing tests under true triaxial states of stress. Tests were performed under constant Lode angle conditions with Lode angles ranging from 0 to 30°, pure shear to axisymmetric compression. Results show that the failure of Sierra White granite is heavily dependent on the intermediate principal stress which became more dramatic as the mean stress increased. An analysis of the shear bands formed at failure was performed using an associated flow rule and the Rudnicki and Rice (1975) localization criteria. The localization analysis showed excellent agreement with experimental results. Sandia National Laboratories is a multimission laboratory managed and operated by National Technology and Engineering Solutions of Sandia LLC, a wholly owned subsidiary of Honeywell International Inc. for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-NA0003525.

  17. Thyroid functional disease: an under-recognized cardiovascular risk factor in kidney disease patients

    Science.gov (United States)

    Rhee, Connie M.; Brent, Gregory A.; Kovesdy, Csaba P.; Soldin, Offie P.; Nguyen, Danh; Budoff, Matthew J.; Brunelli, Steven M.; Kalantar-Zadeh, Kamyar

    2015-01-01

    Thyroid functional disease, and in particular hypothyroidism, is highly prevalent among chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients. In the general population, hypothyroidism is associated with impaired cardiac contractility, endothelial dysfunction, atherosclerosis and possibly higher cardiovascular mortality. It has been hypothesized that hypothyroidism is an under-recognized, modifiable risk factor for the enormous burden of cardiovascular disease and death in CKD and ESRD, but this has been difficult to test due to the challenge of accurate thyroid functional assessment in uremia. Low thyroid hormone levels (i.e. triiodothyronine) have been associated with adverse cardiovascular sequelae in CKD and ESRD patients, but these metrics are confounded by malnutrition, inflammation and comorbid states, and hence may signify nonthyroidal illness (i.e. thyroid functional test derangements associated with underlying ill health in the absence of thyroid pathology). Thyrotropin is considered a sensitive and specific thyroid function measure that may more accurately classify hypothyroidism, but few studies have examined the clinical significance of thyrotropin-defined hypothyroidism in CKD and ESRD. Of even greater uncertainty are the risks and benefits of thyroid hormone replacement, which bear a narrow therapeutic-to-toxic window and are frequently prescribed to CKD and ESRD patients. In this review, we discuss mechanisms by which hypothyroidism adversely affects cardiovascular health; examine the prognostic implications of hypothyroidism, thyroid hormone alterations and exogenous thyroid hormone replacement in CKD and ESRD; and identify areas of uncertainty related to the interplay between hypothyroidism, cardiovascular disease and kidney disease requiring further investigation. PMID:24574542

  18. Traces of Orlicz-Sobolev functions under general growth restrictions

    Czech Academy of Sciences Publication Activity Database

    Kałamajska, A.; Krbec, Miroslav

    2013-01-01

    Roč. 286, č. 7 (2013), s. 730-742 ISSN 0025-584X R&D Projects: GA ČR GAP201/10/1920 Institutional research plan: CEZ:AV0Z10190503 Keywords : Orlicz-Slobodetskii spaces * trace * trace operator Subject RIV: BA - General Mathematics Impact factor: 0.658, year: 2013 http://onlinelibrary.wiley.com/doi/10.1002/ mana .201100185/abstract

  19. Does a carpal tunnel syndrome predict an underlying disease?

    NARCIS (Netherlands)

    M.C. de Rijk (Maarten); F.H. Vermeij (Frederique); M. Suntjens (Maartje); P.A. van Doorn (Pieter)

    2007-01-01

    textabstractCarpal tunnel syndrome (CTS) may be the presenting symptom of an underlying disease such as diabetes mellitus, hypothyroidism or connective tissue disease (CTD). It was investigated whether additional blood tests (glucose level, thyroid-stimulating hormone level and erythrocyte

  20. REJUVENATING CHRONIC DISEASE MANAGEMENT IN MALAYSIAN PRIVATE GENERAL PRACTICE

    Directory of Open Access Journals (Sweden)

    PITERMAN L

    2010-01-01

    Full Text Available Rapid epidemiological transition globally has witnessed a rising prevalence of major chronic diseases such as hypertension, diabetes, hyperlipidaemia, obesity, chronic respiratory diseases and cancers over the past 30 years. In Malaysia, these conditions are commonly managed in primary care and published evidence has consistently shown suboptimal management and poor disease control. This in turn, has led to the massive burden of treating complications in secondary care, burden tothe patients and their families with regards to morbidity and premature death, and burden to the country with regards to premature loss of human capital. The crushing burden and escalating health care costs in managing chronic diseases pose a daunting challenge to our primary care system, as we remain traditionally oriented to care for acute, episodic illnesses. This paper re-examines the current evidence supporting the implementation of Wagner Chronic Care Model in primary careglobally; analyses the barriers of implementation of this model in the Malaysian private general practice through SWOT(strengths, weaknesses, opportunities and threats analysis; and discusses fundamental solutions needed to bridge the gap to achieve better outcomes.

  1. Independent Role of Underlying Kidney Disease on Renal Prognosis of Patients with Chronic Kidney Disease under Nephrology Care.

    Directory of Open Access Journals (Sweden)

    Luca De Nicola

    Full Text Available Primary kidney disease is suggested to affect renal prognosis of CKD patients; however, whether nephrology care modifies this association is unknown. We studied patients with CKD stage I-IV treated in a renal clinic and with established diagnosis of CKD cause to evaluate whether the risk of renal event (composite of end-stage renal disease and eGFR decline ≥ 40% linked to the specific diagnosis is modified by the achievement or maintenance in the first year of nephrology care of therapeutic goals for hypertension (BP ≤ 130/80 mmHg in patients with proteinuria ≥ 1 50 mg/24h and/or diabetes and ≤ 140/90 in those with proteinuria <150 mg/24h and without diabetes anemia (hemoglobin, Hb ≥ 11 g/dL, and proteinuria (≤ 0.5 g/24h. Survival analysis started after first year of nephrology care. We studied 729 patients (age 64 ± 15 y; males 59.1%; diabetes 34.7%; cardiovascular disease (CVD 44.9%; hypertensive nephropathy, HTN 53.8%; glomerulonephritis, GN 17.3%; diabetic nephropathy, DN 15.9%; tubule-interstitial nephropathy, TIN 9.5%; polycystic kidney disease, PKD 3.6%. During first year of Nephrology care, therapy was overall intensified in most patients and prevalence of main therapeutic goals generally improved. During subsequent follow up (median 3.3 years, IQR 1.9-5.1, 163 renal events occurred. Cox analysis disclosed a higher risk for PKD (Hazard Ratio 5.46, 95% Confidence Intervals 2.28-10.6 and DN (1.28,2.99-3.05, versus HTN (reference, independently of age, gender, CVD, BMI, eGFR or CKD stage, use of RAS inhibitors and achievement or maintenance in the first year of nephrology care of each of the three main therapeutic goals. No interaction was found on the risk of CKD progression between diagnostic categories and month-12 eGFR (P=0.737, as with control of BP (P=0.374, Hb (P=0.248 or proteinuria (P=0.590. Therefore, in CKD patients under nephrology care, diagnosis of kidney disease should be considered in conjunction with the main

  2. Independent Role of Underlying Kidney Disease on Renal Prognosis of Patients with Chronic Kidney Disease under Nephrology Care.

    Science.gov (United States)

    De Nicola, Luca; Provenzano, Michele; Chiodini, Paolo; Borrelli, Silvio; Garofalo, Carlo; Pacilio, Mario; Liberti, Maria Elena; Sagliocca, Adelia; Conte, Giuseppe; Minutolo, Roberto

    2015-01-01

    Primary kidney disease is suggested to affect renal prognosis of CKD patients; however, whether nephrology care modifies this association is unknown. We studied patients with CKD stage I-IV treated in a renal clinic and with established diagnosis of CKD cause to evaluate whether the risk of renal event (composite of end-stage renal disease and eGFR decline ≥ 40%) linked to the specific diagnosis is modified by the achievement or maintenance in the first year of nephrology care of therapeutic goals for hypertension (BP ≤ 130/80 mmHg in patients with proteinuria ≥ 1 50 mg/24h and/or diabetes and ≤ 140/90 in those with proteinuria nephrology care. We studied 729 patients (age 64 ± 15 y; males 59.1%; diabetes 34.7%; cardiovascular disease (CVD) 44.9%; hypertensive nephropathy, HTN 53.8%; glomerulonephritis, GN 17.3%; diabetic nephropathy, DN 15.9%; tubule-interstitial nephropathy, TIN 9.5%; polycystic kidney disease, PKD 3.6%). During first year of Nephrology care, therapy was overall intensified in most patients and prevalence of main therapeutic goals generally improved. During subsequent follow up (median 3.3 years, IQR 1.9-5.1), 163 renal events occurred. Cox analysis disclosed a higher risk for PKD (Hazard Ratio 5.46, 95% Confidence Intervals 2.28-10.6) and DN (1.28,2.99-3.05), versus HTN (reference), independently of age, gender, CVD, BMI, eGFR or CKD stage, use of RAS inhibitors and achievement or maintenance in the first year of nephrology care of each of the three main therapeutic goals. No interaction was found on the risk of CKD progression between diagnostic categories and month-12 eGFR (P=0.737), as with control of BP (P=0.374), Hb (P=0.248) or proteinuria (P=0.590). Therefore, in CKD patients under nephrology care, diagnosis of kidney disease should be considered in conjunction with the main risk factors to refine renal risk stratification.

  3. Changes of the skull in general body diseases

    International Nuclear Information System (INIS)

    Koval', G.Yu.; Perepust, L.A.; Novikova, Eh.Z.

    1984-01-01

    Changes of the skull in the following body disease are considered. Diseases: endocrine diseases, fibrous osteodystrophy, reticulohistocytoses and noninfectious granulomas, the blood system diseases, disturbance of vitamin balance. Skull roentgenograms in some above-mentioned diseases are presented and analysed

  4. 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

  5. Ebola Virus Disease Candidate Vaccines Under Evaluation in Clinical Trials

    Science.gov (United States)

    Martins, Karen A.; Jahrling, Peter B.; Bavari, Sina; Kuhn, Jens H.

    2016-01-01

    Summary Filoviruses are the etiological agents of two human illnesses: Ebola virus disease and Marburg virus disease. Until 2013, medical countermeasure development against these afflictions was limited to only a few research institutes worldwide as both infections were considered exotic due to very low case numbers. Together with the high case-fatality rate of both diseases, evaluation of any candidate countermeasure in properly controlled clinical trials seemed impossible. However, in 2013, Ebola virus was identified as the etiological agent of a large disease outbreak in Western Africa including almost 30,000 infections and more than 11,000 deaths, including case exportations to Europe and North America. These large case numbers resulted in medical countermeasure development against Ebola virus disease becoming a global public-health priority. This review summarizes the status quo of candidate vaccines against Ebola virus disease, with a focus on those that are currently under evaluation in clinical trials. PMID:27160784

  6. Declining Prevalence of Disease Vectors Under Climate Change

    Science.gov (United States)

    Escobar, Luis E.; Romero-Alvarez, Daniel; Leon, Renato; Lepe-Lopez, Manuel A.; Craft, Meggan E.; Borbor-Cordova, Mercy J.; Svenning, Jens-Christian

    2016-12-01

    More than half of the world population is at risk of vector-borne diseases including dengue fever, chikungunya, zika, yellow fever, leishmaniasis, chagas disease, and malaria, with highest incidences in tropical regions. In Ecuador, vector-borne diseases are present from coastal and Amazonian regions to the Andes Mountains; however, a detailed characterization of the distribution of their vectors has never been carried out. We estimate the distribution of 14 vectors of the above vector-borne diseases under present-day and future climates. Our results consistently suggest that climate warming is likely threatening some vector species with extinction, locally or completely. These results suggest that climate change could reduce the burden of specific vector species. Other vector species are likely to shift and constrain their geographic range to the highlands in Ecuador potentially affecting novel areas and populations. These forecasts show the need for development of early prevention strategies for vector species currently absent in areas projected as suitable under future climate conditions. Informed interventions could reduce the risk of human exposure to vector species with distributional shifts, in response to current and future climate changes. Based on the mixed effects of future climate on human exposure to disease vectors, we argue that research on vector-borne diseases should be cross-scale and include climatic, demographic, and landscape factors, as well as forces facilitating disease transmission at fine scales.

  7. 29 CFR 17.4 - What are the Secretary's general responsibilities under the Order?

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true What are the Secretary's general responsibilities under the Order? 17.4 Section 17.4 Labor Office of the Secretary of Labor INTERGOVERNMENTAL REVIEW OF DEPARTMENT OF LABOR PROGRAMS AND ACTIVITIES § 17.4 What are the Secretary's general responsibilities under the...

  8. 75 FR 38905 - To Modify Duty-Free Treatment Under the Generalized System of Preferences

    Science.gov (United States)

    2010-07-06

    ... eligible for preferential tariff treatment under the Generalized System of Preferences (GSP). 2. Pursuant... subject to competitive need limitations on the preferential treatment afforded under the GSP to eligible... eligible articles for purposes of the GSP, general note 4(d) to the HTS is modified as set forth in section...

  9. The effect of torsional muscle dysfunction and surgery on eye position under general anesthesia.

    Science.gov (United States)

    McCall, L C; Isenberg, S J; Apt, L

    1993-01-01

    Under general anesthesia, normal eyes exhibit 2.0 degrees to 2.5 degrees of extorsion. To investigate the effect of torsional muscle dysfunction and surgery on eye position under general anesthesia, we measured the torsional change before and after torsional muscle surgery in 26 eyes of 18 patients with clinical torsional muscle dysfunction. Under general anesthesia, compared with normals, eyes with preoperative intorter overaction or extorter underaction demonstrated a significant intorsional change (P extorsion while intorter strengthening procedures and extorter weakening procedures produced measurable intorsion. Superior oblique tenotomy produced a greater net torsional change than inferior oblique weakening surgery (P < .01). Under general anesthesia, eyes with preoperative torsional muscle dysfunction exhibit torsion in the direction consistent with the dysfunction. After surgery on the torsional muscles, a measurable torsional effect can be demonstrated while the patient is still under general anesthesia.

  10. A prospective randomized study comparing percutaneous nephrolithotomy under combined spinal-epidural anesthesia with percutaneous nephrolithotomy under general anesthesia.

    Science.gov (United States)

    Singh, Vishwajeet; Sinha, Rahul Janak; Sankhwar, S N; Malik, Anita

    2011-01-01

    A prospective randomized study was executed to compare the surgical parameters and stone clearance in patients who underwent percutaneous nephrolithotomy (PNL) under combined spinal-epidural anesthesia (CSEA) versus those who underwent PNL under general anesthesia (GA). Between January 2008 to December 2009, 64 patients with renal calculi were randomized into 2 groups and evaluated for the purpose of this study. Group 1 consisted of patients who underwent PNL under CSEA and Group 2 consisted of patients who underwent PNL under GA. The operative time, stone clearance rate, visual pain analog score, mean analgesic dose and mean hospital stay were compared amongst other parameters. The difference between visual pain analog score after the operation and the dose of analgesic requirement was significant on statistical analysis between both groups. PNL under CSEA is as effective and safe as PNL under GA. Patients who undergo PNL under CESA require lesser analgesic dose and have a shorter hospital stay. Copyright © 2011 S. Karger AG, Basel.

  11. Glomerular diseases and cancer: evaluation of underlying malignancy.

    Science.gov (United States)

    Pani, Antonello; Porta, Camillo; Cosmai, Laura; Melis, Patrizia; Floris, Matteo; Piras, Doloretta; Gallieni, Maurizio; Rosner, Mitchell; Ponticelli, Claudio

    2016-04-01

    Onconephrology is an emerging medical subspecialty focused on the numerous interconnections between cancer and kidney diseases. Patient with malignancies commonly experience kidney problems including acute kidney injury, tumor lysis syndrome, fluid and electrolyte disorders and chronic kidney disease, often as a consequence of the anti-cancer treatment. Conversely, a number of glomerulopathies, tubulopathies and vascular renal diseases can early signal the presence of an underlying cancer. Furthermore, the administration of immunosuppressive drugs, especially cytotoxic drugs and calcineurin inhibitors, may strongly impair the immune response increasing the risk of cancer. The objective of this review article is to: (i) discuss paraneoplastic glomerular disease, (ii) review cancer as an adverse effect of immunosuppressive agents used to treat glomerulopathies, and (iii) in the absence of international approved guidelines, propose a screening program based on expert opinion aimed at guiding nephrologists to early detect malignancies during their clinical practice.

  12. Mitochondrial haplogroups - Ischemic cardiovascular disease, other diseases, mortality, and longevity in the general population

    DEFF Research Database (Denmark)

    Benn, M.; Schwartz, M.; Nordestgaard, B.G.

    2008-01-01

    , 0.9 to 1.3]; V: 1.1 [95% CI, 0.9 to 1.4]; W/I: 1.1 [95% CI, 0.8 to 1.4]; Z: 1.1 [95% CI, 0.8 to 1.4]), and ischemic cerebrovascular disease (U: 1.1 [95% CI, 0.9 to 1.4]; T: 0.9 [95% CI, 0.7 to 1.2]; J: 1.1 [95% CI, 0.9 to 1.4]; K: 1.0 [95% CI, 0.8 to 1.4]; V: 1.1 [95% CI, 0.8 to 1.5]; W/ I: 0.8 [95......Background-Rare mutations in the mitochondrial genome may cause disease. Mitochondrial haplogroups defined by common polymorphisms have been associated with risk of disease and longevity. We tested the hypothesis that common haplogroups predict risk of ischemic cardiovascular disease, morbidity...... from other causes, mortality, and longevity in a general population of European descent. Methods and Results-We followed 9254 individuals from the Danish general population, in the Copenhagen City Heart Study, prospectively for risk of ischemic cardiovascular disease, morbidity from other causes...

  13. Dental treatment under general anesthesia for special-needs patients: analysis of the literature.

    Science.gov (United States)

    Mallineni, Sreekanth K; Yiu, Cynthia K Y

    2016-11-01

    The aim of the present review was to identify the studies published on dental treatment under general anesthesia for special-needs patients. A comprehensive search of the reported literature from January 1966 to May 2012 was conducted using PubMed, Medline, and Embase. Keywords used in the search were "dental treatment under general anesthesia", "special-needs patients", "medically-compromised patients", and "children", in various combinations. Studies published only on dental treatment under general anesthesia and in English were included. Only 10 studies were available for final analysis. Age range from 1 to 50 years, and restorative procedures, were most prevalent. Only two studies discussed repeated general anesthesia, with rates of 7.2% and 10.2%. Over time, the provision of general anesthesia for special-needs patients has changed from dental clinics to general hospitals. The demand for dental treatment for special-needs patients under general anesthesia continues to increase. Currently, there are no certain accepted protocols for the provision of dental treatment under general anesthesia. © 2015 Wiley Publishing Asia Pty Ltd.

  14. Trends in exodontia under general anaesthesia at a dental teaching hospital.

    Science.gov (United States)

    Grant, S M; Davidson, L E; Livesey, S

    1998-10-10

    To survey the use of simple exodontia for children under general anaesthesia on an out-patient basis at a Northern Dental Hospital. To monitor any effects resulting from the introduction of the Poswillo guidelines on the referral for and treatment of patients under general anaesthesia. A retrospective longitudinal analysis. A Northern Dental Hospital in England. Information was recorded from original case records of children undergoing exodontia under general anaesthesia on an out-patient basis during October between 1989 and 1997. The mean and modal age of the children decreased from 7.7 years to 6.0 years respectively in 1989 to 5.7 years and 4.0 years in 1997. The proportion receiving a general anaesthetic for orthodontic extractions substantially decreased from 18.0% in 1989 to 0.7% in 1997 and the need for repeat dental general anaesthetics within 18 months was eliminated with the introduction of a pre-general anaesthetic screening service. Dental treatment under general anaesthesia should continue to be available where it is justified. A separate assessment appointment reduces the prescription of general anaesthesia and minimises its usage for orthodontic extractions and the necessity for repeat general anaesthesia.

  15. Memory Loss, Alzheimer’s Disease and General Anesthesia: A Preoperative Concern

    Science.gov (United States)

    Thaler, Adam; Siry, Read; Cai, Lufan; García, Paul S.; Chen, Linda; Liu, RenYu

    2012-01-01

    Background The long-term cognitive effects of general anesthesia are under intense scrutiny. Here we present 5 cases from 2 academic institutions to analyze some common features where the patient’s or the patient family member has made a request to address their concern on memory loss, Alzheimer’s disease and general anesthesia before surgery. Methods Records of anesthesia consultation separate from standard preoperative evaluation were retrieved to identify consultations related to memory loss and Alzheimer’s disease from the patient and/or patient family members. The identified cases were extensively reviewed for features in common. We used Google® (http://www. google.com/) to identify available online information using “anesthesia memory loss” as a search phrase. Results Five cases were collected as a specific preoperative consultation related to memory loss, Alzheimer’s disease and general anesthesia from two institutions. All of the individuals either had perceived memory impairment after a prior surgical procedure with general anesthesia or had a family member with Alzheimer’s disease. They all accessed public media sources to find articles related to anesthesia and memory loss. On May 2nd, 2011, searching “anesthesia memory loss” in Google yielded 764,000 hits. Only 3 of the 50 Google top hits were from peer-reviewed journals. Some of the lay media postings made a causal association between general anesthesia and memory loss and/or Alzheimer’s disease without conclusive scientific literature support. Conclusion The potential link between memory loss and Alzheimer’s disease with general anesthesia is an important preoperative concern from patients and their family members. This concern arises from individuals who have had history of cognitive impairment or have had a family member with Alzheimer disease and have tried to obtain information from public media. Proper preoperative consultation with the awareness of the lay literature can

  16. 10 CFR 72.212 - Conditions of general license issued under § 72.210.

    Science.gov (United States)

    2010-01-01

    ... days prior to first storage of spent fuel under this general license. The notice may be in the form of... site parameters, including analyses of earthquake intensity and tornado missiles, are enveloped by the...

  17. Underlying diseases in syncope of children in China

    Science.gov (United States)

    Li, Chen; Cheng, Wang; Hongwei, Wang; Hong, Tian; Chaoshu, Tang; Hongfang, Jin; Junbao, Du

    2011-01-01

    Summary Background Syncope accounts for about 1–2% of emergency department visits, but the etiology in many patients with syncope is unclear. Recently, with the use of the head-up tilt test (HUT), the number of patients with unexplained syncope (UPS) has been decreasing; however, the spectrum of underlying diseases of syncope in children is unclear. This retrospective study aimed to analyze the spectrum of underlying diseases in children with syncope. Material/Methods This multi-center clinical study consisted of 888 children (417 males, 471 females, aged 5–18 yrs, median age 12.0±3.0 yrs) with syncope who came from Beijing city, Hunan province, Hubei province and Shanghai from August 1999 to March 2009. The clinical and laboratory data of children were studied and the spectrum of underlying diseases in children with syncope was analyzed. Results In 888 children with syncope, 175 (19.7%) had vasovagal syncope (VVS) with vasoinhibitory response, 35 (3.9%) had VVS with cardioinhibitory response, 73 (8.2%) had VVS with mixed response, 286 (32.2%) had postural orthostatic tachycardia syndrome (POTS), 19 (2.1%) had orthostatic hypotension, 7 (0.9%) had situational syncope, 13 (1.5%) had cardiogenic syncope, and 280 (31.5%) had unexplained syncope. Conclusions The data suggest that neurally-mediated syncope was the most common cause in children with syncope. POTS and VVS were the most common hemodynamic patterns of neurally-mediated syncope. PMID:21629199

  18. Design management of general contractor under nuclear power project EPC mode

    International Nuclear Information System (INIS)

    Su Shaojian

    2013-01-01

    Design management has not yet formed a theoretical system recognized, general contractor design managers under nuclear power project EPC Mode lack the clear theory basis. This paper aims to discuss Design management from the angle of general contractor under nuclear power project EPC mode, Gives the concept of design management Clearly, by Combining the characteristics of nuclear power project, Gives the specific content and meaning of the design management of nuclear power project. (authors)

  19. Poisson-generalized gamma empirical Bayes model for disease ...

    African Journals Online (AJOL)

    In spatial disease mapping, the use of Bayesian models of estimation technique is becoming popular for smoothing relative risks estimates for disease mapping. The most common Bayesian conjugate model for disease mapping is the Poisson-Gamma Model (PG). To explore further the activity of smoothing of relative risk ...

  20. 34 CFR 79.4 - What are the Secretary's general responsibilities under the Order?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false What are the Secretary's general responsibilities under... INTERGOVERNMENTAL REVIEW OF DEPARTMENT OF EDUCATION PROGRAMS AND ACTIVITIES § 79.4 What are the Secretary's general... state and local elected official's concerns with proposed federal financial assistance that are...

  1. 45 CFR 1152.4 - What are the Chairman's general responsibilities under the Order?

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false What are the Chairman's general responsibilities under the Order? 1152.4 Section 1152.4 Public Welfare Regulations Relating to Public Welfare (Continued... OF NATIONAL ENDOWMENT FOR THE ARTS PROGRAMS AND ACTIVITIES § 1152.4 What are the Chairman's general...

  2. Prevalence of potential underlying aetiology of macrocytic anaemia in Dutch general practice

    NARCIS (Netherlands)

    K. Stouten (Karlijn); J.A. Riedl (Jurgen); J. Droogendijk (Jolanda); Castel, R. (Rob); J.M. van Rosmalen (Joost); R.J. Van Houten; P.B. Berendes (Paul); P. Sonneveld (Pieter); M.-D. Levin (Mark-David)

    2016-01-01

    textabstractBackground: Macrocytic anaemia (MCV ≥ 100 fL) is a relatively common finding in general practice. However, literature on the prevalence of the different causes in this population is limited. The prevalence of macrocytic anaemia and its underlying aetiology were analysed in a general

  3. Under-ascertainment, under-reporting and timeliness of Iranian communicable disease surveillance system for zoonotic diseases.

    Science.gov (United States)

    Kazerooni, P A; Fararouei, M; Nejat, M; Akbarpoor, M; Sedaghat, Z

    2018-01-01

    The important steps in controlling infectious diseases are fast detection, proper treatment and on-time reporting of cases to the appropriate authorities. This study was conducted to evaluate the quality of Iranian communicable diseases surveillance system (CDSS) for zoonotic diseases in rural areas of Fars province (Iran's third largest province). The three most important evaluation indices of CDSS, namely under-ascertainment, under-reporting and timeliness, for the three most common zoonotic diseases were measured using independent data source obtained from door-to-door interviews and patients' medical records. Interviews were conducted with 48,771 households in rural areas of Fars province from April 2014 to March 2015. The medical and registration data were obtained from the CDSS and medical or health centres. Under-ascertainment, total under-reporting and timeliness (delay from the time of onset of symptoms to the time of visiting a medical or health centre, to the time of reporting visited cases to the highest level of CDSS) for leishmaniasis were 19.6%, 42.5% and 81.61 days (48.95 due to system delay), respectively. The corresponding indices for brucellosis were 0%, 41.8% and 56.5 days (22 due to system delay), respectively. For animal bite, the corresponding indices were 7.83%, 13.07% and less than 72 h, respectively (no system delay). Although the status of case reporting and timeliness of surveillance system in public sectors providing medical services are clearly better than those of the private sectors, the indices are far from the level needed by CDSS to be able to detect and handle epidemics on time. Training health personnel, especially physicians, from public and private sectors to secure their cooperation along with routine and indebt evaluation are necessary to improve CDSS in Iran. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  4. CROHN'S DISEASE: GENERAL CHARACTERISTICS AND TREATMENT WITH ADALIMUMABE BIOPHARMACEUTICAL

    Directory of Open Access Journals (Sweden)

    S. A. Marques

    2018-02-01

    Full Text Available Crohn's Disease (CD is a chronic inflammatory disease that affects the gastrointestinal system. The etiology is not fully understood, however, genetic, immunological, microbiological and environmental factors are related to its genesis. The most common manifestations of this disease are diarrhea, abdominal pain, ulcers and fistulas. In the absence of adequate treatment it can evolve into extra intestinal complications and is also an important risk factor for colon and rectal cancer. The treatment of the disease is palliative and there is no cure for the disease, being considered only the period of remission of symptoms, as a good prognosis. The biopharmaceutical, Adalimumabe, produced by recombinant DNA technology has demonstrated efficacy in the treatment of this disease, as it prevents the action of TNF-α, a cytokine involved in inflammation and is abundant in individuals with CD. Although Adalimumabe has good results, its use leads to side effects that can be mild or fatal, such as the activation of tuberculosis.

  5. Perioperative management of patients for osteo-odonto-kreatoprosthesis under general anaesthesia: A retrospective study

    Directory of Open Access Journals (Sweden)

    Rakesh Garg

    2011-01-01

    Full Text Available An osteo-odonto-keratoprosthesis (OOKP procedure is indicated in patients with failed corneal transplant but having intact retina for visual improvement. We studied perioperative concerns of patients who underwent the staged OOKP procedure. This was a retrospective analysis of patients who underwent OOKP. The information regarding symptoms, associated comorbidities, perioperative events including anaesthetic management were collected. Eight patients (five females and three males underwent the staged OOKP procedure. The median age was 18 years. The median weight was 45 kg. The median duration of loss of vision was 4 years. The aetiology of blindness included Stevens-Johnson′s syndrome (SJS (7 and chemical burn (1. Four patients had generalized skin problem due to SJS. All cases were managed under general anaesthesia, and airway management included nasotracheal intubation for stage I and orotracheal intubation for stage II. The median mallampati classification was I prior to OOKP stage I procedure while it changed to II at stage II procedure. Two patients required fibreoptic nasotracheal intubation. One patient had excessive oozing from the mucosal harvest site and was managed conservatively. In one patient, tooth harvesting was done twice as the first tooth was damaged during creating a hole in it. We conclude that OOKP requires multidisciplinary care. Anaesthesiologist should evaluate the airway carefully and disease-associated systemic involvements. The use of various drugs requires caution and steroid supplementation should be done. Airway difficulty should be anticipated, mandating thorough evaluation. Re-evaluation of airway is prudent as it may become difficult during the staged OOKP procedure.

  6. Variations in cardiovascular disease under-diagnosis in England: national cross-sectional spatial analysis

    Directory of Open Access Journals (Sweden)

    Walford Hannah

    2011-03-01

    Full Text Available Abstract Background There is under-diagnosis of cardiovascular disease (CVD in the English population, despite financial incentives to encourage general practices to register new cases. We compared the modelled (expected and diagnosed (observed prevalence of three cardiovascular conditions- coronary heart disease (CHD, hypertension and stroke- at local level, their geographical variation, and population and healthcare predictors which might influence diagnosis. Methods Cross-sectional observational study in all English local authorities (351 and general practices (8,372 comparing model-based expected prevalence with diagnosed prevalence on practice disease registers. Spatial analyses were used to identify geographic clusters and variation in regression relationships. Results A total of 9,682,176 patients were on practice CHD, stroke and transient ischaemic attack, and hypertension registers. There was wide spatial variation in observed: expected prevalence ratios for all three diseases, with less than five per cent of expected cases diagnosed in some areas. London and the surrounding area showed statistically significant discrepancies in observed: expected prevalence ratios, with observed prevalence much lower than the epidemiological models predicted. The addition of general practitioner supply as a variable yielded stronger regression results for all three conditions. Conclusions Despite almost universal access to free primary healthcare, there may be significant and highly variable under-diagnosis of CVD across England, which can be partially explained by persistent inequity in GP supply. Disease management studies should consider the possible impact of under-diagnosis on population health outcomes. Compared to classical regression modelling, spatial analytic techniques can provide additional information on risk factors for under-diagnosis, and can suggest where healthcare resources may be most needed.

  7. A comparison of disease prevalence in general practice in the Netherlands and in England & Wales.

    NARCIS (Netherlands)

    Fleming, D.; Schellevis, F.; Linden, M. van der; Westert, G.

    2006-01-01

    General practice-based morbidity surveys have been conducted in the Netherlands and in England and Wales primarily to estimate disease prevalence and examine health inequalities. We have compared disease prevalence in general practice reported in the second Dutch Natinal Survey of General Practice

  8. Update on general health risk of periodontal disease.

    Science.gov (United States)

    Slots, Jørgen

    2003-01-01

    To review the potential of periodontal infections to cause nonoral diseases. Therapeutic recommendations are provided to help patients and dental practitioners prevent systemic complications from periodontal infections. Systemic diseases from oral bacteria are mostly caused by transient bacteraemias, which can occur spontaneously from dental foci of infection, from mastication, brushing, flossing or other daily manipulations, or from dental treatments. Examples of systemic infections that may involve oral microorganisms include infective endocarditis, aspiration pneumonia, HIV-related disseminated candidiasis and cancrum oris, septicaemia associated with cancer chemotherapy and radiotherapy, necrotising faciitis and various other life-threatening infections. Inflamed gingiva constitutes a significant reservoir for herpes viruses, which have the potential to cause serious systemic diseases in immunocompromised patients. Periodontal disease may also aggravate chronic insulin insensitivity and thus interfere with glycaemic control in diabetic patients. Controversy surrounds the involvement of periodontal infections in coronary heart disease. Cumulative evidence suggests that periodontal disease can be an important cause of morbidity and mortality of various systemic diseases, especially in individuals exhibiting compromised host defence. Maintaining a healthy dentition and periodontium by means of daily oral hygiene practice and regular professional care is the most effective way of preventing systemic diseases from oral infections.

  9. General Anesthesia versus Local Anesthesia in StereotaXY (GALAXY) for Parkinson's disease: study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Holewijn, R. A.; Verbaan, D.; de Bie, R. M. A.; Schuurman, P. R.

    2017-01-01

    Background: The aim of the study is to investigate if deep brain stimulation (DBS) in the subthalamic nucleus (STN) for Parkinson's disease (PD) under general anesthesia further improves outcome by lessening postoperative cognitive, mood, and behavioral adverse effects; shorten surgical time and

  10. Generalized Vitiligo Associated Autoimmune Diseases in Japanese Patients Their Families

    Directory of Open Access Journals (Sweden)

    Tomohiko Narita

    2011-01-01

    Conclusions: Among Japanese vitiligo patients, there is a subgroup with strong evidence of genetically determined susceptibility to not only vitiligo, but also to autoimmune thyroid disease and other autoimmune disorders.

  11. Treatment Needs and Adverse Events Related to Dental Treatment under General Anesthesia for Individuals with Autism

    Science.gov (United States)

    Rada, Robert E.

    2013-01-01

    Individuals with autism can be quite challenging to treat in a routine dental-office setting, especially when extensive dental treatment and disruptive behavioral issues exist. Individuals with autism may also be at higher risk for oral disease. Frequently, general anesthesia is the only method to facilitate completion of the needed dental…

  12. Plasma YKL-40 and total and disease-specific mortality in the general population

    DEFF Research Database (Denmark)

    Johansen, Julia S; Bojesen, Stig E; Tybjaerg-Hansen, Anne

    2010-01-01

    Increased plasma YKL-40 is associated with short-term survival in patients with cardiovascular disease and cancer. We tested the hypothesis that increased plasma YKL-40 is associated with total and disease-specific mortality in the general population....

  13. Inflammatory Profile of Awake Function-Controlled Craniotomy and Craniotomy under General Anesthesia

    Directory of Open Access Journals (Sweden)

    Markus Klimek

    2009-01-01

    Results. Plasma IL-6 level significantly increased with time similarly in both groups. No significant plasma IL-8 and IL-10 change was observed in both experimental groups. The VAS pain score was significantly lower in the awake group compared to the anesthesia group at 12 hours postoperative. Postoperative anxiety and stress declined similarly in both groups. Conclusion. This study suggests that awake function-controlled craniotomy does not cause a significantly different inflammatory response than craniotomy performed under general anesthesia. It is also likely that function-controlled craniotomy does not cause a greater emotional challenge than tumor resection under general anesthesia.

  14. A comparative study of pain following endodontic treatment under general anesthesia

    Directory of Open Access Journals (Sweden)

    Feizi Ghader

    2015-01-01

    Full Text Available   Background and Aims: Postoperativee endodontic pain is an outstanding problem for dental patients. Therefore, a successful management of endodontic pain has become as one of the main dental objectives. The aim of the present study was to compare the postoperative endodontic pain in patients under general anesthesia versus local anesthesia.   Materials and Methods: For conducting this clinical trial study, 50 patients having mandibular molars candidate for root canal therapy were selected. Twenty-five patients treated under general anesthesia because of their fear, anxiety or gag reflex. Other 25 patients treated under local anesthesia. All teeth were prepared using engine-driven rotary system in a crown-down technique and filled using lateral condensation technique. Heft- parker visual analog scale was used to measure the degree of pain at 6, 12, 24, and 48 hours after the treatment. Mann-Whitney, Chi-square, and T-tests were used to compare the intensity of postoperative pain between the groups.   Results: The mean intensity of postoperative pain in local and general anesthesia groups at 6, 12 and 24 hours had statistically significant difference (P<0.05.   Conclusion: Postoperative pain in patients who treated under general anesthesia was significantly less than the patients who treated under local anesthesia.

  15. Social contact networks and disease eradicability under voluntary vaccination.

    Directory of Open Access Journals (Sweden)

    Ana Perisic

    2009-02-01

    Full Text Available Certain theories suggest that it should be difficult or impossible to eradicate a vaccine-preventable disease under voluntary vaccination: Herd immunity implies that the individual incentive to vaccinate disappears at high coverage levels. Historically, there have been examples of declining coverage for vaccines, such as MMR vaccine and whole-cell pertussis vaccine, that are consistent with this theory. On the other hand, smallpox was globally eradicated by 1980 despite voluntary vaccination policies in many jurisdictions. Previous modeling studies of the interplay between disease dynamics and individual vaccinating behavior have assumed that infection is transmitted in a homogeneously mixing population. By comparison, here we simulate transmission of a vaccine-preventable SEIR infection through a random, static contact network. Individuals choose whether to vaccinate based on infection risks from neighbors, and based on vaccine risks. When neighborhood size is small, rational vaccinating behavior results in rapid containment of the infection through voluntary ring vaccination. As neighborhood size increases (while the average force of infection is held constant, a threshold is reached beyond which the infection can break through partially vaccinated rings, percolating through the whole population and resulting in considerable epidemic final sizes and a large number vaccinated. The former outcome represents convergence between individually and socially optimal outcomes, whereas the latter represents their divergence, as observed in most models of individual vaccinating behavior that assume homogeneous mixing. Similar effects are observed in an extended model using smallpox-specific natural history and transmissibility assumptions. This work illustrates the significant qualitative differences between behavior-infection dynamics in discrete contact-structured populations versus continuous unstructured populations. This work also shows how disease

  16. Bone disease in patients with chronic kidney disease under conservative management

    Directory of Open Access Journals (Sweden)

    Carlos Perez Gomes

    Full Text Available CONTEXT AND OBJECTIVE: Few studies have focused on bone disease in patients with chronic kidney disease under conservative treatment. The objective was to evaluate bone disease in patients with chronic kidney disease. DESIGN AND SETTING: Case series, at the Nephrology Division, Hospital Universitário Pedro Ernesto. METHODS: 131 patients with creatinine clearance from 10 to 60 ml/min/1.73 m² were followed up for at least one year. Serum creatinine, albumin, calcium, phosphorus, alkaline phosphatase, total CO2 (tCO2, intact parathyroid hormone (iPTH, and alkaline phosphatase were measured. Creatinine clearance was calculated from 24-hour urine creatinine measurements and protein ingestion estimates from urea assays. RESULTS: Patients presenting creatinine clearance 144 pg/ml showed osteitis fibrosa (4, mild lesion (4 and high turnover (1. CONCLUSION: The present data suggest the importance of early control for iPTH and metabolic acidosis, among patients under conservative management for chronic kidney disease, in order to prevent complications related to bone disease.

  17. A 10-year trend of dental treatments under general anesthesia of children in Taipei Veterans General Hospital.

    Science.gov (United States)

    Chen, Yung-Pan; Hsieh, Chun-Yi; Hsu, Wen-Ting; Wu, Fu-Ya; Shih, Wen-Yu

    2017-04-01

    General anesthesia (GA) as a pediatric dental procedure is a well-established method of behavior management. However, studies of pediatric dentistry under GA have mostly focused on handicapped patients, and various retrospective studies in Taiwan have mainly reviewed only a limited number of years. The purpose of the present study was to report trends in pediatric dental treatment performed under GA over the past 10 years. A retrospective review of the hospital records of patients receiving dental treatment under GA from 2006 until 2015 was performed. The patients were divided into three age groups:  6 years. A range of information including basic patient characteristics and types of dental treatment was identified and then analyzed. A total of 791 cases ( 6 years old: 235; 549 male, 242 female) were treated under GA. The case number was found to have increased from 94 during 2006-2007 to 238 during 2014-2015, with the increase being especially pronounced among those aged 3-6 years (2006-2007: 49, 2014-2015: 165). The most common treatments (extraction, restoration, and pulp therapy) were associated with multiple dental caries (684, 86.4%). The  6-years-old group had the lowest mean number of treated teeth by stainless-steel crowns (SSCs) and fewest cases treated with pulp therapy. From 2011 onwards, the number of primary tooth extractions significantly increased, while in 2013, there was a crossover whereby the SSC count surpassed the composite resin filling count. Over the past 10 years, there has been an increased use of GA for pediatric dental treatments, in particular, in cases with multiple dental caries. In addition, there has also been an increasing trend towards extraction of primary teeth and the use of SSCs. Copyright © 2017. Published by Elsevier Taiwan LLC.

  18. Notification of occupational diseases by general practitioners in the ...

    African Journals Online (AJOL)

    One hundred and forty GPs were randoinly selected from a provincial sampling frame of 1 000 GPs. Main outcome measures. Knowledge of notification procedures for occupational diseases, and problems encountered with the reporting system. Results. Of a total of 109 GPs interviewed, 75% had diagnosed more than one ...

  19. Prevention of cardiovascular disease in a rural general practice

    Directory of Open Access Journals (Sweden)

    Elżbieta Tomiak

    2016-09-01

    The higher number of preventive consultations had an impact on a statistically significant decrease in mean blood pressure and mean SCORE value. The year-long cardiovascular disease prophylaxis programme proved less effective than expected, and neither a decrease in body weight nor an improvement in lipid metabolism was achieved in any of the groups.

  20. Generalized metabolic bone disease in Neurofibromatosis type I

    Science.gov (United States)

    Skeletal abnormalities are a recognized component of Neurofibromatosis type I (NF1), but a generalized metabolic bone defect in NF1 has not been fully characterized thus far. The purpose of this study was to characterize at the densitometric, biochemical, and pathological level the bone involvement ...

  1. Antagonism between phytohormone signalling underlies the variation in disease susceptibility of tomato plants under elevated CO2.

    Science.gov (United States)

    Zhang, Shuai; Li, Xin; Sun, Zenghui; Shao, Shujun; Hu, Lingfei; Ye, Meng; Zhou, Yanhong; Xia, Xiaojian; Yu, Jingquan; Shi, Kai

    2015-04-01

    Increasing CO2 concentrations ([CO2]) have the potential to disrupt plant-pathogen interactions in natural and agricultural ecosystems, but the research in this area has often produced conflicting results. Variations in phytohormone salicylic acid (SA) and jasmonic acid (JA) signalling could be associated with variations in the responses of pathogens to plants grown under elevated [CO2]. In this study, interactions between tomato plants and three pathogens with different infection strategies were compared. Elevated [CO2] generally favoured SA biosynthesis and signalling but repressed the JA pathway. The exposure of plants to elevated [CO2] revealed a lower incidence and severity of disease caused by tobacco mosaic virus (TMV) and by Pseudomonas syringae, whereas plant susceptibility to necrotrophic Botrytis cinerea increased. The elevated [CO2]-induced and basal resistance to TMV and P. syringae were completely abolished in plants in which the SA signalling pathway nonexpressor of pathogenesis-related genes 1 (NPR1) had been silenced or in transgenic plants defective in SA biosynthesis. In contrast, under both ambient and elevated [CO2], the susceptibility to B. cinerea highly increased in plants in which the JA signalling pathway proteinase inhibitors (PI) gene had been silenced or in a mutant affected in JA biosynthesis. However, plants affected in SA signalling remained less susceptible to this disease. These findings highlight the modulated antagonistic relationship between SA and JA that contributes to the variation in disease susceptibility under elevated [CO2]. This information will be critical for investigating how elevated CO2 may affect plant defence and the dynamics between plants and pathogens in both agricultural and natural ecosystems. © The Author 2015. Published by Oxford University Press on behalf of the Society for Experimental Biology.

  2. Antagonism between phytohormone signalling underlies the variation in disease susceptibility of tomato plants under elevated CO2

    Science.gov (United States)

    Zhang, Shuai; Li, Xin; Sun, Zenghui; Shao, Shujun; Hu, Lingfei; Ye, Meng; Zhou, Yanhong; Xia, Xiaojian; Yu, Jingquan; Shi, Kai

    2015-01-01

    Increasing CO2 concentrations ([CO2]) have the potential to disrupt plant–pathogen interactions in natural and agricultural ecosystems, but the research in this area has often produced conflicting results. Variations in phytohormone salicylic acid (SA) and jasmonic acid (JA) signalling could be associated with variations in the responses of pathogens to plants grown under elevated [CO2]. In this study, interactions between tomato plants and three pathogens with different infection strategies were compared. Elevated [CO2] generally favoured SA biosynthesis and signalling but repressed the JA pathway. The exposure of plants to elevated [CO2] revealed a lower incidence and severity of disease caused by tobacco mosaic virus (TMV) and by Pseudomonas syringae, whereas plant susceptibility to necrotrophic Botrytis cinerea increased. The elevated [CO2]-induced and basal resistance to TMV and P. syringae were completely abolished in plants in which the SA signalling pathway nonexpressor of pathogenesis-related genes 1 (NPR1) had been silenced or in transgenic plants defective in SA biosynthesis. In contrast, under both ambient and elevated [CO2], the susceptibility to B. cinerea highly increased in plants in which the JA signalling pathway proteinase inhibitors (PI) gene had been silenced or in a mutant affected in JA biosynthesis. However, plants affected in SA signalling remained less susceptible to this disease. These findings highlight the modulated antagonistic relationship between SA and JA that contributes to the variation in disease susceptibility under elevated [CO2]. This information will be critical for investigating how elevated CO2 may affect plant defence and the dynamics between plants and pathogens in both agricultural and natural ecosystems. PMID:25657213

  3. Western forest diseases and climate relations: General considerations, dwarf mistletoe and stem rusts

    Science.gov (United States)

    B. W. Geils

    2008-01-01

    This is a preliminary, draft outline for organizing information on the relation of climate to western forest diseases. The question is how to assess the threat of these diseases under a regime of climate change. Although forest diseases are often important, assessment of disease-climate relations is a challenging problem due to the multiple values at risk and the...

  4. Inflammatory profile of awake function-controlled craniotomy and craniotomy under general anesthesia

    NARCIS (Netherlands)

    M. Klimek (Markus); J.W. Hol (Jaap Willem); S.C.A. Wens (Stephan); C. Heijmans-Antonissen (Claudia); S.P. Niehof (Sjoerd); A.J. Vincent (Arnaud); J. Klein (Jan); F.J. Zijlstra (Freek)

    2009-01-01

    textabstractBackground. Surgical stress triggers an inflammatory response and releases mediators into human plasma such as interleukins (ILs). Awake craniotomy and craniotomy performed under general anesthesia may be associated with different levels of stress. Our aim was to investigate whether

  5. Factors associated with the risk of caries development after comprehensive dental rehabilitation under general anesthesia

    Directory of Open Access Journals (Sweden)

    Yai-Tin Lin

    2016-06-01

    Conclusion: This study has shown that SM count and CRA score were associated with new caries development in ECC children who needed to be treated under general anesthesia. The modified Cariogram used in this study is another significant tool for predicting new carries development in this particular population.

  6. Suspected atlantoaxial rotatory fixation-subluxation: the value of multidetector computed tomography scanning under general anesthesia

    NARCIS (Netherlands)

    Been, Henk D.; Kerkhoffs, Gino M. M. J.; Maas, Mario

    2007-01-01

    STUDY DESIGN: Clinical case reports and radiologic study. OBJECTIVES: To emphasize the value of computed tomography (CT) scan under general anesthesia in order to prevent misdiagnosing atlantoaxial rotatory fixation-subluxation in children with acute torticollis. SUMMARY OF BACKGROUND DATA: A

  7. Waiting times before dental care under general anesthesia in children with special needs in the Children's Hospital of Casablanca.

    Science.gov (United States)

    Badre, Bouchra; Serhier, Zineb; El Arabi, Samira

    2014-01-01

    Oral diseases may have an impact on quality of children's life. The presence of severe disability requires the use of care under general anesthesia (GA). However, because of the limited number of qualified health personnel, waiting time before intervention can be long. To evaluate the waiting time before dental care under general anesthesia for children with special needs in Morocco. A retrospective cohort study was carried out in pediatric dentistry unit of the University Hospital of Casablanca. Data were collected from records of patients seen for the first time between 2006 and 2011. The waiting time was defined as the time between the date of the first consultation and intervention date. 127 children received dental care under general anesthesia, 57.5% were male and the average age was 9.2 (SD = 3.4). Decay was the most frequent reason for consultation (48%), followed by pain (32%). The average waiting time was 7.6 months (SD = 4.2 months). The average number of acts performed per patient was 13.5. Waiting times were long, it is necessary to take measures to reduce delays and improve access to oral health care for this special population.

  8. Mechanisms Underlying HIV-Associated Noninfectious Lung Disease.

    Science.gov (United States)

    Presti, Rachel M; Flores, Sonia C; Palmer, Brent E; Atkinson, Jeffrey J; Lesko, Catherine R; Lau, Bryan; Fontenot, Andrew P; Roman, Jesse; McDyer, John F; Twigg, Homer L

    2017-11-01

    Pulmonary disease remains a primary source of morbidity and mortality in persons living with HIV (PLWH), although the advent of potent combination antiretroviral therapy has resulted in a shift from predominantly infectious to noninfectious pulmonary complications. PLWH are at high risk for COPD, pulmonary hypertension, and lung cancer even in the era of combination antiretroviral therapy. The underlying mechanisms of this are incompletely understood, but recent research in both human and animal models suggests that oxidative stress, expression of matrix metalloproteinases, and genetic instability may result in lung damage, which predisposes PLWH to these conditions. Some of the factors that drive these processes include tobacco and other substance use, direct HIV infection and expression of specific HIV proteins, inflammation, and shifts in the microbiome toward pathogenic and opportunistic organisms. Further studies are needed to understand the relative importance of these factors to the development of lung disease in PLWH. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  9. Histiocytoid Sweet Syndrome in a Child without Underlying Systemic Disease.

    Science.gov (United States)

    Yeom, Seung Dohn; Ko, Hye Soo; Moon, Jong Hyuk; Kang, Min Ji; Byun, Ji Won; Choi, Gwang Seong; Shin, Jeonghyun

    2017-10-01

    Sweet syndrome (acute, febrile, neutrophilic dermatosis) is characterized by the acute onset of an eruption of painful nodules or erythematous or violaceous plaques on the limbs, face and neck. These symptoms are accompanied by fever. The diagnostic features include histopathological findings of dermal neutrophilic infiltration without leukocytoclastic vasculitis or peripheral blood leukocytosis. Sweet syndrome is associated with infection, malignancies, autoimmune disease, pregnancy, and drugs. Patients with Sweet syndrome demonstrate a complete and rapid response to systemic steroid administration. Recently, a distinct variant of Sweet syndrome was reported, termed "histiocytoid Sweet syndrome", in which the infiltration of myeloperoxidase-positive histiocytoid mononuclear cells are observed (in contrast to the infiltration of neutrophils). The other clinical features are similar to those of classic Sweet syndrome. Pediatric Sweet syndrome is uncommon, and the histiocytoid type is even rarer. To date, four cases of histiocytoid Sweet syndrome have been reported in children. Herein, we describe a case of histiocytoid Sweet syndrome in an otherwise healthy 10-year-old boy with no underlying systemic disease in whom non-steroidal, anti-inflammatory drug treatment was successful.

  10. Transcriptional regulatory networks underlying gene expression changes in Huntington's disease.

    Science.gov (United States)

    Ament, Seth A; Pearl, Jocelynn R; Cantle, Jeffrey P; Bragg, Robert M; Skene, Peter J; Coffey, Sydney R; Bergey, Dani E; Wheeler, Vanessa C; MacDonald, Marcy E; Baliga, Nitin S; Rosinski, Jim; Hood, Leroy E; Carroll, Jeffrey B; Price, Nathan D

    2018-03-26

    Transcriptional changes occur presymptomatically and throughout Huntington's disease (HD), motivating the study of transcriptional regulatory networks (TRNs) in HD We reconstructed a genome-scale model for the target genes of 718 transcription factors (TFs) in the mouse striatum by integrating a model of genomic binding sites with transcriptome profiling of striatal tissue from HD mouse models. We identified 48 differentially expressed TF-target gene modules associated with age- and CAG repeat length-dependent gene expression changes in Htt CAG knock-in mouse striatum and replicated many of these associations in independent transcriptomic and proteomic datasets. Thirteen of 48 of these predicted TF-target gene modules were also differentially expressed in striatal tissue from human disease. We experimentally validated a specific model prediction that SMAD3 regulates HD-related gene expression changes using chromatin immunoprecipitation and deep sequencing (ChIP-seq) of mouse striatum. We found CAG repeat length-dependent changes in the genomic occupancy of SMAD3 and confirmed our model's prediction that many SMAD3 target genes are downregulated early in HD. © 2018 The Authors. Published under the terms of the CC BY 4.0 license.

  11. [Legendary Hwa Tuo's surgery under general anesthesia in the second century China].

    Science.gov (United States)

    Chu, Nai-Shin

    2004-12-01

    In traditional Chinese medicine, Hwa Tuo (110 ? - 208 A.D.) is one of the most famous doctors. He used only few herbs in drug treatment or applied few points in acupuncture, and achieved excellent results. His ultimate fame came from his remarkable surgical skills and his discovery of general anesthesia. According to the Chronicle of the Three Kingdoms (ca. 270 A.D.) and the Annals of the Later Han Dynasty (ca. 430 A.D.), Hwa Tuo performed operations under general anesthesia and the operations even included major ones such as dissection of gangrenous intestines. Before the surgery, he gave patient an anesthetic to drink to become drunk, numb and insensible. The anesthetic was called " foamy narcotic powder" and probably dissolved in wine. Because Confucian teachings regarded the body sacred, surgery as a form of body mutilation was not encouraged, or even became a taboo. Despite his great achievement, practice of surgery could hardly take off and the death of Hwa Tuo marked the end of Chinese surgery. Unfortunately, the composition of the anesthetic powder was not mentioned in those two books or other Chinese medical writings. The herb has been thought to be datura flower, aconite root, rhododendron flower, or jasmine root. Furthermore, Hwa Tuo's operations under general anesthesia were not described in details. Therefore, his remarkable achievement needs to be further documented. In Western medicine, the first operation under general anesthesia occurred at the Massachusetts General Hospital in 1846 when William Morton demonstrated the effectiveness of ether. How could Hwa Tuo accomplish such scientific achievement in the second century has remained a mystery. Even so, it seems quite remarkable that Hwa Tuo had come up with the idea of performing surgery under general anesthesia using the "foamy narcotic powder".

  12. Xanthelasmata, arcus corneae, and ischaemic vascular disease and death in general population: prospective cohort study

    DEFF Research Database (Denmark)

    Christoffersen, Mette; Frikke-Schmidt, Ruth; Schnohr, Peter

    2011-01-01

    To test the hypothesis that xanthelasmata and arcus corneae, individually and combined, predict risk of ischaemic vascular disease and death in the general population.......To test the hypothesis that xanthelasmata and arcus corneae, individually and combined, predict risk of ischaemic vascular disease and death in the general population....

  13. A retrospective comparison of dental treatment under general anesthesia on children with and without mental disabilities.

    Science.gov (United States)

    Sari, M E; Ozmen, B; Koyuturk, A E; Tokay, U

    2014-01-01

    The purpose of this study is to determine the properties of the dental procedures performed on children with dental problems under general anesthesia and compared between the patterns of dental treatment provided for intellectual disability and non-cooperate healthy child. In this retrospective study, the records of patients between the ages of 4 and 18 who were treated under general anesthesia were evaluated. Patients were divided into two groups: Those with intellectual disability and healthy patients who had difficulty cooperating. A statistical analysis of the mean standard deviation was conducted with a focus on two factors: Age and dental treatment methods. In this study, it was observed that restorative treatment and tooth extraction was generally higher in intellectual disability children than in their healthy children. When evaluating the health status of teeth, the value of decayed missing and filled teeth (dmf-t) was observed to be close in healthy and intellectual disability individuals in the 4-6 age groups; it was higher in individuals with intellectual disability in the 7-12 age groups. There was no significant difference in terms of periodontal treatment and fissure sealants in the 12-18 age groups. By comparing the different patient groups who received dental treatment under general anesthesia, both the number of teeth extracted and DMF-T indices were higher in the disabled group. Therefore, especially more efforts should be made at encouraging these patients to visit the dentist earlier and receive primary preventive care.

  14. Laparoscopic total extraperitoneal repair under spinal anesthesia versus general anesthesia: a randomized prospective study

    Directory of Open Access Journals (Sweden)

    Donmez T

    2016-10-01

    Full Text Available Turgut Donmez,1 Vuslat Muslu Erdem,2 Oguzhan Sunamak,3 Duygu Ayfer Erdem,2 Huseyin Imam Avaroglu1 1Department of General Surgery, 2Department of Anesthesiology and Reanimation, Lutfiye Nuri Burat State Hospital, 3Department of General Surgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey Background: Laparoscopic total extraperitoneal (TEP inguinal hernia repair is a well-known approach to inguinal hernia repair that is usually performed under general anesthesia (GA. To date, no reports compare the efficacy of spinal anesthesia (SA with that of GA for laparoscopic hernia repairs. The purpose of this study was to compare the surgical outcome of TEP inguinal hernia repair performed when the patient was treated under SA with that performed under GA. Materials and methods: Between July 2015 and July 2016, 50 patients were prospectively randomized to either the GA TEP group (Group I or the SA TEP group (Group II. Propofol, fentanyl, rocuronium, sevoflurane, and tracheal intubation were used for GA. Hyperbaric bupivacaine (15 mg and fentanyl (10 µg were used for SA to achieve a sensorial level of T3. Intraoperative events related to SA, operative and anesthesia times, postoperative complications, and pain scores were recorded. Each patient was asked to evaluate the anesthetic technique by using a direct questionnaire filled in 3 months after the operation. Results: All the procedures were completed by the allocated method of anesthesia as there were no conversions from SA to GA. Pain was significantly less for 1 h (P<0.0001 and 4 h (P=0.002 after the procedure for the SA and GA groups, respectively. There was no difference between the two groups regarding complications, hospital stay, recovery, or surgery time. Generally, patients were more satisfied with SA than GA (P<0.020. Conclusion: TEP inguinal hernia repair can be safely performed under SA, and SA was associated with less postoperative pain, better recovery, and better

  15. General health checks in adults for reducing morbidity and mortality from disease

    DEFF Research Database (Denmark)

    Krogsbøll, Lasse T; Jørgensen, Karsten Juhl; Grønhøj Larsen, Christian

    2012-01-01

    General health checks are common elements of health care in some countries. These aim to detect disease and risk factors for disease with the purpose of reducing morbidity and mortality. Most of the commonly used screening tests offered in general health checks have been incompletely studied. Also......, screening leads to increased use of diagnostic and therapeutic interventions, which can be harmful as well as beneficial. It is, therefore, important to assess whether general health checks do more good than harm....

  16. Infectious Skin Diseases in Children in General Practice: epidemiology and management

    NARCIS (Netherlands)

    R.S.A. Mohammedamin (Robbert)

    2007-01-01

    textabstractThe increasing proportion of skin diseases, especially infectious and allergic skin diseases, encountered in general practice represents a substantial part of the morbidity in children. Only limited information is available about the epidemiology of skin diseases in children in

  17. COMPARATIVE STUDY OF MODIFIED RADICAL MASTECTOMY PERFORMED UNDER LOCAL ANAESTHESIA WITH DEXMEDETOMIDINE INFUSION VS. GENERAL ANAESTHESIA

    Directory of Open Access Journals (Sweden)

    Ramesan Chayampurath

    2016-11-01

    Full Text Available BACKGROUND The incidence of breast cancer is on the rise in developing countries. Though, there have been significant advances in general anaesthesia, surgery in elderly and those with comorbid illness still have an attendant morbidity and mortality. After the introduction of local anaesthesia by Kolher in 1884 and in spite of steady refinement, local anaesthesia is still not being widely used in major general surgical procedures. MATERIALS AND METHODS The study was conducted in Government Medical College, Calicut, a tertiary care centre in Kerala. The outcome of Modified Radical Mastectomy performed under Local Anaesthesia (LA and dexmedetomidine infusion was compared to similar cases done under General Anaesthesia (GA. RESULTS Rapid recovery from sedation leading to early restoration of normal physical activity was observed in the LA group when compared to GA group. Early initiation of oral feeds was possible in the former group as Postoperative Nausea and Vomiting (PONV was significantly less. Effective postoperative pain relief and significant reduction in respiratory complications was observed in the LA group compared to GA group. CONCLUSION Modified Radical Mastectomy under LA and procedural sedation with dexmedetomidine was significantly better in selected cases when compared to similar cases done under GA with respect to early recovery pain relief and decreased incidence of respiratory complications.

  18. A General Contact Force Analysis of an Under-Actuated Finger in Robot Hand Grasping

    Directory of Open Access Journals (Sweden)

    Xuan Vinh Ha

    2016-02-01

    Full Text Available This paper develops a mathematical analysis of contact forces for the under-actuated finger in a general under-actuated robotic hand during grasping. The concept of under-actuation in robotic grasping with fewer actuators than degrees of freedom (DOF, through the use of springs and mechanical limits, allows the hand to adjust itself to an irregularly shaped object without complex control strategies and sensors. Here the main concern is the contact forces, which are important elements in grasping tasks, based on the proposed mathematical analysis of their distributions of the n-DOF under-actuated finger. The simulation results, along with the 3-DOF finger from the ADAMS model, show the effectiveness of the mathematical analysis method, while comparing them with the measured results. The system can find magnitudes of the contact forces at the contact positions between the phalanges and the object.

  19. General introduction into the Ebola virus biology and disease.

    Science.gov (United States)

    Zawilińska, Barbara; Kosz-Vnenchak, Magdalena

    2014-01-01

    Epidemic of Ebola hemorrhagic fever which appeared in the countries of West Africa in 2014, is the largest outbreak which occurred so far. The virus causing this epidemic, Zaire Ebolavirus (ZEBOV), along with four other species of Ebolaviruses is classified to the genus Ebolavirus in the family Filoviridae. ZEBOV is one of the most virulent pathogens among the viral haemorrhagic fevers, and case fatality rates up to 90% have been reported. Mortality is the result of multi-organ failure and severe bleeding complications. The aim of this review is to present the general characteristics of the virus and its biological properties, pathogenicity and epidemiology, with a focus on laboratory methods used in the diagnosis of these infections.

  20. Numerically pricing American options under the generalized mixed fractional Brownian motion model

    Science.gov (United States)

    Chen, Wenting; Yan, Bowen; Lian, Guanghua; Zhang, Ying

    2016-06-01

    In this paper, we introduce a robust numerical method, based on the upwind scheme, for the pricing of American puts under the generalized mixed fractional Brownian motion (GMFBM) model. By using portfolio analysis and applying the Wick-Itô formula, a partial differential equation (PDE) governing the prices of vanilla options under the GMFBM is successfully derived for the first time. Based on this, we formulate the pricing of American puts under the current model as a linear complementarity problem (LCP). Unlike the classical Black-Scholes (B-S) model or the generalized B-S model discussed in Cen and Le (2011), the newly obtained LCP under the GMFBM model is difficult to be solved accurately because of the numerical instability which results from the degeneration of the governing PDE as time approaches zero. To overcome this difficulty, a numerical approach based on the upwind scheme is adopted. It is shown that the coefficient matrix of the current method is an M-matrix, which ensures its stability in the maximum-norm sense. Remarkably, we have managed to provide a sharp theoretic error estimate for the current method, which is further verified numerically. The results of various numerical experiments also suggest that this new approach is quite accurate, and can be easily extended to price other types of financial derivatives with an American-style exercise feature under the GMFBM model.

  1. Prothrombin and risk of venous thromboembolism, ischemic heart disease and ischemic cerebrovascular disease in the general population

    DEFF Research Database (Denmark)

    Weischer, Maren; Juul, Klaus; Zacho, Jeppe

    2010-01-01

    OBJECTIVE: We tested the hypotheses that Prothrombin G20210A heterozygosity associate with increased risk of venous thromboembolism (VTE), ischemic heart disease (IHD), and ischemic cerebrovascular disease (ICVD) in the general population and re-tested risk of IHD and ICVD in two case...

  2. Magnetohydrodynamic flow of generalized Maxwell fluids in a rectangular micropump under an AC electric field

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Guangpu [School of Mathematical Science, Inner Mongolia University, Hohhot, Inner Mongolia 010021 (China); Jian, Yongjun, E-mail: jianyj@imu.edu.cn [School of Mathematical Science, Inner Mongolia University, Hohhot, Inner Mongolia 010021 (China); Chang, Long [School of Mathematics and Statistics, Inner Mongolia University of Finance and Economics, Hohhot, Inner Mongolia 010051 (China); Buren, Mandula [School of Mathematical Science, Inner Mongolia University, Hohhot, Inner Mongolia 010021 (China)

    2015-08-01

    By using the method of separation of variables, an analytical solution for the magnetohydrodynamic (MHD) flow of the generalized Maxwell fluids under AC electric field through a two-dimensional rectangular micropump is reduced. By the numerical computation, the variations of velocity profiles with the electrical oscillating Reynolds number Re, the Hartmann number Ha, the dimensionless relaxation time De are studied graphically. Further, the comparison with available experimental data and relevant researches is presented. - Highlights: • MHD flow of the generalized Maxwell fluids under AC electric field is analyzed. • The MHD flow is confined to a two-dimensional rectangular micropump. • Analytical solution is obtained by using the method of separation of variables. • The influences of related parameters on the MHD velocity are discussed.

  3. Magnetohydrodynamic flow of generalized Maxwell fluids in a rectangular micropump under an AC electric field

    International Nuclear Information System (INIS)

    Zhao, Guangpu; Jian, Yongjun; Chang, Long; Buren, Mandula

    2015-01-01

    By using the method of separation of variables, an analytical solution for the magnetohydrodynamic (MHD) flow of the generalized Maxwell fluids under AC electric field through a two-dimensional rectangular micropump is reduced. By the numerical computation, the variations of velocity profiles with the electrical oscillating Reynolds number Re, the Hartmann number Ha, the dimensionless relaxation time De are studied graphically. Further, the comparison with available experimental data and relevant researches is presented. - Highlights: • MHD flow of the generalized Maxwell fluids under AC electric field is analyzed. • The MHD flow is confined to a two-dimensional rectangular micropump. • Analytical solution is obtained by using the method of separation of variables. • The influences of related parameters on the MHD velocity are discussed

  4. Explicit expressions for European option pricing under a generalized skew normal distribution

    OpenAIRE

    Doostparast, Mahdi

    2017-01-01

    Under a generalized skew normal distribution we consider the problem of European option pricing. Existence of the martingale measure is proved. An explicit expression for a given European option price is presented in terms of the cumulative distribution function of the univariate skew normal and the bivariate standard normal distributions. Some special cases are investigated in a greater detail. To carry out the sensitivity of the option price to the skew parameters, numerical methods are app...

  5. The effect of music on the neurohormonal stress response to surgery under general anesthesia.

    Science.gov (United States)

    Migneault, Brigitte; Girard, François; Albert, Caroline; Chouinard, Philippe; Boudreault, Daniel; Provencher, Diane; Todorov, Alexandre; Ruel, Monique; Girard, Dominique C

    2004-02-01

    Several pharmacological interventions reduce perioperative stress hormone release during surgery under general anesthesia. Listening to music and therapeutic suggestions were also studied, but mostly in awake patients, and these have a positive effect on postoperative recovery and the need for analgesia. In this study, we evaluated the effect of listening to music under general anesthesia on the neurohormonal response to surgical stress as measured by epinephrine, norepinephrine, cortisol, and adrenocorticotropic hormone (ACTH) blood levels. Thirty female patients scheduled for abdominal gynecological procedures were enrolled and randomly divided into two groups: group NM (no music) and group M (music). In group M, music was played from after the induction of anesthesia until the end of surgery. In the NM group, the patients wore the headphones but no music was played. We established three sample times for hormonal dosage during the procedure and one in the recovery room. Hemodynamic data were recorded at all times, and postoperative consumption of morphine in the first 24 h was noted. There was no group difference at any sample time or in the postoperative period in terms of mean arterial blood pressure, heart rate, isoflurane end-tidal concentration, time of the day at which the surgery was performed, bispectral index (BIS) value, doses of fentanyl, or consumption of postoperative morphine. There was no difference between the two groups with regard to plasmatic levels of norepinephrine, epinephrine, cortisol, or ACTH at any sample time, although the blood level of these hormones significantly increased in each group with surgical stimulation. In conclusion, we could not demonstrate a significant effect of intraoperative music on surgical stress when used under general anesthesia. Listening to music under general anesthesia did not reduce perioperative stress hormone release or opioid consumption in patients undergoing gynecological surgery.

  6. Existence of Generalized Homoclinic Solutions of Lotka-Volterra System under a Small Perturbation

    Directory of Open Access Journals (Sweden)

    Yuzhen Mi

    2016-01-01

    Full Text Available This paper investigates Lotka-Volterra system under a small perturbation vxx=-μ(1-a2u-vv+ϵf(ϵ,v,vx,u,ux, uxx=-(1-u-a1vu+ϵg(ϵ,v,vx,u,ux. By the Fourier series expansion technique method, the fixed point theorem, the perturbation theorem, and the reversibility, we prove that near μ=0 the system has a generalized homoclinic solution exponentially approaching a periodic solution.

  7. Buckling of regular, chiral and hierarchical honeycombs under a general macroscopic stress state

    Science.gov (United States)

    Haghpanah, Babak; Papadopoulos, Jim; Mousanezhad, Davood; Nayeb-Hashemi, Hamid; Vaziri, Ashkan

    2014-01-01

    An approach to obtain analytical closed-form expressions for the macroscopic ‘buckling strength’ of various two-dimensional cellular structures is presented. The method is based on classical beam-column end-moment behaviour expressed in a matrix form. It is applied to sample honeycombs with square, triangular and hexagonal unit cells to determine their buckling strength under a general macroscopic in-plane stress state. The results were verified using finite-element Eigenvalue analysis. PMID:25002823

  8. Generalized Degenerative Joint Disease in Osteoprotegerin (Opg) Null Mutant Mice.

    Science.gov (United States)

    Bolon, B; Grisanti, M; Villasenor, K; Morony, S; Feige, U; Simonet, W S

    2015-09-01

    Bone structure is modulated by the interaction between receptor activator of nuclear factor-κB (RANK) and RANK ligand (RANKL). Osteoprotegerin (OPG), a decoy receptor for RANKL, modifies osteoclast-mediated bone resorption directly and spares articular cartilage indirectly in rodents with immune-mediated arthritis by preventing subchondral bone destruction. The OPG/RANKL balance also seems to be critical in maintaining joint integrity in osteoarthritis, a condition featuring articular bone and cartilage damage in the absence of profound inflammation. The current study explored the role of OPG in sparing articular cartilage by evaluating joint lesions in adult C57BL/6J mice lacking osteoprotegerin (Opg (-) (/-)). At 3, 5, 7, 9, and 12 months of age, both sexes of Opg (-) (/-) mice developed severe degenerative joint disease (DJD) characterized by progressive loss of cartilage matrix and eventually articular cartilage. Lesions developed earlier and more severely in Opg (-) (/-) mice relative to age-matched, wild-type (Opg (+) (/+)), or heterozygous (Opg (+) (/-)) littermates (P ≤ .05). The femorotibial joint was affected bilaterally at 3 months, while other key weight-bearing diarthrodial joints (eg, coxofemoral, scapulohumeral, humeroradioulnar) were affected later and unilaterally. Cortical bone in subchondral plates and long bone diaphyses of Opg (-) (/-) mice but not Opg (+/+) or Opg (+) (/-) animals was osteoporotic by 3 months of age (P ≤ .05); the extent of porosity was less than the degree of DJD. Closure of the physes in long bones (P ≤ .05) and cartilage retention in the femoral primary spongiosa (P ≤ .05) affected chiefly Opg (-) (/-) mice. These data suggest that OPG plays an essential direct role in maintaining cartilage integrity in the articular surfaces and physes. © The Author(s) 2015.

  9. Neural correlates underlying micrographia in Parkinson’s disease

    Science.gov (United States)

    Zhang, Jiarong; Hallett, Mark; Feng, Tao; Hou, Yanan; Chan, Piu

    2016-01-01

    Micrographia is a common symptom in Parkinson’s disease, which manifests as either a consistent or progressive reduction in the size of handwriting or both. Neural correlates underlying micrographia remain unclear. We used functional magnetic resonance imaging to investigate micrographia-related neural activity and connectivity modulations. In addition, the effect of attention and dopaminergic administration on micrographia was examined. We found that consistent micrographia was associated with decreased activity and connectivity in the basal ganglia motor circuit; while progressive micrographia was related to the dysfunction of basal ganglia motor circuit together with disconnections between the rostral supplementary motor area, rostral cingulate motor area and cerebellum. Attention significantly improved both consistent and progressive micrographia, accompanied by recruitment of anterior putamen and dorsolateral prefrontal cortex. Levodopa improved consistent micrographia accompanied by increased activity and connectivity in the basal ganglia motor circuit, but had no effect on progressive micrographia. Our findings suggest that consistent micrographia is related to dysfunction of the basal ganglia motor circuit; while dysfunction of the basal ganglia motor circuit and disconnection between the rostral supplementary motor area, rostral cingulate motor area and cerebellum likely contributes to progressive micrographia. Attention improves both types of micrographia by recruiting additional brain networks. Levodopa improves consistent micrographia by restoring the function of the basal ganglia motor circuit, but does not improve progressive micrographia, probably because of failure to repair the disconnected networks. PMID:26525918

  10. Functional abnormalities underlying pathological gambling in Parkinson disease.

    Science.gov (United States)

    Cilia, Roberto; Siri, Chiara; Marotta, Giorgio; Isaias, Ioannis U; De Gaspari, Danilo; Canesi, Margherita; Pezzoli, Gianni; Antonini, Angelo

    2008-12-01

    Pathological gambling (PG) may develop in patients with Parkinson disease (PD) during dopamine replacement therapy, but the underlying neural correlates are still unclear. To investigate resting state brain perfusion in PD patients with active PG compared with matched PD controls and healthy controls. Case-control study. Outpatient tertiary clinic. Eleven right-handed PD patients with active PG according to Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) criteria, 40 matched PD controls, and 29 age-matched healthy controls. All the participants underwent resting state brain perfusion single-photon emission computed tomography using technetium TC 99m ethylcysteinate dimer bicisate. All PD subjects were taking dopaminergic medication. Statistical Parametric Mapping was used for data analysis (P<.005, false discovery rate corrected). PD patients with PG showed resting state overactivity in a right hemisphere network that included the orbitofrontal cortex, the hippocampus, the amygdala, the insula, and the ventral pallidum. No areas of perfusion reduction were detected. We found that PD patients with PG have abnormal resting state dysfunction of the mesocorticolimbic network possibly associated with a drug-induced overstimulation of relatively preserved reward-related neuronal systems. These findings support the concept that PG is a "behavioral" addictive disorder.

  11. Simulating policy options for psychiatric care in general hospitals under Medicare's PPS.

    Science.gov (United States)

    Freiman, M P; Mitchell, J B; Rosenbach, M L

    1988-11-01

    Psychiatric hospitals and certain distinct part psychiatric units of general hospitals are currently exempt from diagnosis related group (DRG)-based payment under Medicare's prospective payment system (PPS), in large part due to concern about the degree to which such payment would match historical costs for these facilities. This communication simulates DRG-based payments for psychiatric admissions to general hospitals under the PPS and also under a modified version of the PPS. Two major types of modifications are made: (1) an increase in the role of outlier payments and (2) a restructuring of the DRG classification to allow for a difference in the basic payment rate, depending on whether or not care is provided in a facility that is currently exempt. When compared with cost data from just before the start of the PPS, the simulation results show the degree to which these hypothetical modifications will decrease the systematic risk of general hospitals with exempt units from receiving payments that fall short of costs.

  12. CT-guided percutaneous radiofrequency ablation of hepatic malignancies located in unusual regions under general anesthesia

    International Nuclear Information System (INIS)

    Pan Jie; Chen Shaohui; Lu Xin; Mao Yilei; Sang Xinting; Chen Fang; Li Yumei; Huang Yuguang; Jin Zhengyu

    2010-01-01

    Objective: To discuss the feasibility of CT-guided percutaneous radiofrequency ablation (RFA) of liver malignancies located in unusual regions under general anesthesia, and to assess its clinical value. Methods: Eighteen patients with a total of 26 malignant hepatic lesions were enrolled in this study. The lesions were located at diaphragmatic surface, hepatic hilum, hepatic subcapsular site,side of inferior vena cava, side of gallbladder or near by colon. Transcatheter arterial chemoembolization was performed in all patients, which was followed by CT-guided percutaneous RFA under general anesthesia. The time used for puncturing and the time used for putting the needles to the scheduled sites were recorded. A follow-up for 115 months was conducted. The complications and the therapeutic results were observed. Results: For all patients,the procedure of puncture and needle placement was completed in 1-3 minutes. A total of 35 RFA procedures were conducted for 26 lesions. No severe complications occurred. Complete necrosis was observed in 20 tumors and partial necrosis in 6 tumors. Conclusion: The result of this study indicates that CT-guided percutaneous RFA under general anesthesia is a feasible technique for the treatment of liver malignancies located at unusual regions. This technique is very helpful for reducing the manipulating difficulty and lowing the complication risk of RFA procedures. (authors)

  13. Plasma Level Formaldehyde in Children Receiving Pulpotomy Treatment under General Anesthesia.

    Science.gov (United States)

    Bagrizan, Majid; Pourgolshani, Pouya; Hosseinpour, Sepanta; Jalalpour, Golnoush; Shahrestani, Mostafa Zahmatkesh

    Formocresol has long been used by dentists for pulpotomy of primary teeth. Due to some concerns regarding its possible carcinogenicity, formocresol has been the topic of numerous studies. This study sought to assess the changes in plasma level of formaldehyde of children after receiving pulpotomy under general anesthesia. Twenty-five children between 2-6 years requiring dental treatments under general anesthesia were studied. Blood samples were taken of children before and after the procedure. Plasma level of formaldehyde was measured using high performance liquid chromatography (HPLC). A total of 106 pulpotomy treatments were performed in 25 children using 126 cotton pellets dipped in formocresol. An increase and a decrease in plasma level of formaldehyde were noted in 5 (20%) and 20 (80%) children, respectively post-operatively compared to baseline. The t-test showed no significant difference in plasma level of formaldehyde pre- and postoperatively (P=0.12). the plasma level of formaldehyde in children who had higher levels of formaldehyde prior to the operation was also higher than that of others after the operation and this association was statistically significant (P=0.001, r=0.64). The results showed no significant change in the mean plasma level of formaldehyde in children who received pulpotomy under general anesthesia compared to its baseline value.

  14. Evaluation of Detection Performance under Employment of the Generalized Detector in Radar Sensor Systems

    Directory of Open Access Journals (Sweden)

    M. S. Shbat

    2014-04-01

    Full Text Available The detection performance of the generalized detector (GD constructed based on the generalized approach to signal processing in noise is evaluated under homogeneous and non-homogeneous noise. The GD adaptive threshold is derived and defined applying an appropriate noise power estimation using the sliding window technique. The direct close expressions for the GD average probability of detection and probability of false alarm are also derived. Typical constant false alarm rate (CFAR detectors, namely, the cell averaging CFAR (CA-CFAR detector, the ordered statistic CFAR (OS-CFAR detector, the generalized censored mean level (GCML detector, and the adaptive censored greatest-of CFAR (ACGO-CFAR detector are compared with the GD by detection performance under both homogenous and non-homogeneous noise conditions, i.e. when the interfering targets are absent or present, respectively. Simulation results demonstrate a superiority of GD in detection performance in comparison with the above mentioned CFAR detectors under both homogeneous and non-homogeneous noise conditions.

  15. Forest pathogens and diseases under changing climate-A review

    International Nuclear Information System (INIS)

    Raza, M. M.; Khan, M. A.; Aslam, H. M. U.; Riaz, K.

    2015-01-01

    Changing climate threatens tree health by affecting the likelihood, frequency of occurrence, types and severity of forest diseases caused by diverse pests, resultantly altering the forest ecosystems. The present review covers the relationship between climate and diverse cases of forest diseases and potential shocks of climate change on pathogens and diseases. Biotic diseases, cankers, decays, declines, foliar diseases, root diseases and stem rust of pine have been reviewed with some illustrations of potential disease effects with predicted changing climate. The impact of changing climate on host, pathogen, and their interaction will have frequent and mostly unsympathetic outcomes to forest ecosystems. By employing the proactive and modern scientific management strategies like monitoring, modeling prediction, risk rating, planning, genetic diversity and facilitated migration, genetic protection and breeding for disease resistance and relating results to forest policy, planning as well as decision making, the suspicions innate to climate change effects can be minimized. (author)

  16. Heightened reward learning under stress in generalized anxiety disorder: a predictor of depression resistance?

    Science.gov (United States)

    Morris, Bethany H; Rottenberg, Jonathan

    2015-02-01

    Stress-induced anhedonia is associated with depression vulnerability (Bogdan & Pizzagalli, 2006). We investigated stress-induced deficits in reward learning in a depression-vulnerable group with analogue generalized anxiety disorder (GAD, n = 34), and never-depressed healthy controls (n = 41). Utilizing a computerized signal detection task, reward learning was assessed under stressor and neutral conditions. Controls displayed intact reward learning in the neutral condition, and the expected stress-induced blunting. The GAD group as a whole also showed intact reward learning in the neutral condition. When GAD subjects were analyzed as a function of prior depression history, never-depressed GAD subjects showed heightened reward learning in the stressor condition. Better reward learning under stress among GAD subjects predicted lower depression symptoms 1 month later. Robust reward learning under stress may indicate depression resistance among anxious individuals. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  17. Declining Prevalence of Disease Vectors Under Climate Change

    DEFF Research Database (Denmark)

    Escobar, Luis E.; Romero-Alvarez, Daniel; Leon, Renato

    2016-01-01

    More than half of the world population is at risk of vector-borne diseases including dengue fever, chikungunya, zika, yellow fever, leishmaniasis, chagas disease, and malaria, with highest incidences in tropical regions. In Ecuador, vector-borne diseases are present from coastal and Amazonian reg...

  18. Declining Prevalence of Disease Vectors Under Climate Change

    DEFF Research Database (Denmark)

    Escobar, Luis E.; Romero-Alvarez, Daniel; Leon, Renato

    2016-01-01

    More than half of the world population is at risk of vector-borne diseases including dengue fever, chikungunya, zika, yellow fever, leishmaniasis, chagas disease, and malaria, with highest incidences in tropical regions. In Ecuador, vector-borne diseases are present from coastal and Amazonian...

  19. Validity of tests under covariate-adaptive biased coin randomization and generalized linear models.

    Science.gov (United States)

    Shao, Jun; Yu, Xinxin

    2013-12-01

    Some covariate-adaptive randomization methods have been used in clinical trials for a long time, but little theoretical work has been done about testing hypotheses under covariate-adaptive randomization until Shao et al. (2010) who provided a theory with detailed discussion for responses under linear models. In this article, we establish some asymptotic results for covariate-adaptive biased coin randomization under generalized linear models with possibly unknown link functions. We show that the simple t-test without using any covariate is conservative under covariate-adaptive biased coin randomization in terms of its Type I error rate, and that a valid test using the bootstrap can be constructed. This bootstrap test, utilizing covariates in the randomization scheme, is shown to be asymptotically as efficient as Wald's test correctly using covariates in the analysis. Thus, the efficiency loss due to not using covariates in the analysis can be recovered by utilizing covariates in covariate-adaptive biased coin randomization. Our theory is illustrated with two most popular types of discrete outcomes, binary responses and event counts under the Poisson model, and exponentially distributed continuous responses. We also show that an alternative simple test without using any covariate under the Poisson model has an inflated Type I error rate under simple randomization, but is valid under covariate-adaptive biased coin randomization. Effects on the validity of tests due to model misspecification is also discussed. Simulation studies about the Type I errors and powers of several tests are presented for both discrete and continuous responses. © 2013, The International Biometric Society.

  20. Neural mechanisms underlying cognitive inflexibility in Parkinson's disease.

    Science.gov (United States)

    Lange, Florian; Seer, Caroline; Loens, Sebastian; Wegner, Florian; Schrader, Christoph; Dressler, Dirk; Dengler, Reinhard; Kopp, Bruno

    2016-12-01

    Cognitive inflexibility is a hallmark of executive dysfunction in Parkinson's disease (PD). This deficit consistently manifests itself in a PD-related increase in the number of perseverative errors committed on the Wisconsin Card Sorting Test (WCST). However, the neural processes underlying perseverative WCST performance in PD are still largely unknown. The present study is the first to investigate the event-related potential (ERP) correlates of cognitive inflexibility on the WCST in PD patients. Thirty-two PD patients and 35 matched control participants completed a computerized version of the WCST while the electroencephalogram (EEG) was recorded. Behavioral results revealed the expected increase in perseverative errors in patients with PD. ERP analysis focused on two established indicators of executive processes: the fronto-central P3a as an index of attentional orienting and the sustained parietal positivity (SPP) as an index of set-shifting processes. In comparison to controls, P3a amplitudes were significantly attenuated in PD patients. Regression analysis further revealed that P3a and SPP amplitudes interactively contributed to the prediction of perseverative errors in PD patients: The number of perseverative errors was only increased when both ERP amplitudes were attenuated. Notably, the two ERP markers of executive processes accounted for more than 40% of the variance in perseverative errors in PD patients. We conclude that cognitive inflexibility in PD occurs when the neural bases of multiple executive processes are affected by the pathophysiology of PD. The combined measurement of P3a and SPP might yield an electrophysiological marker of cognitive inflexibility in PD. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Multiple systemic embolism in infective endocarditis underlying in Barlow's disease.

    Science.gov (United States)

    Yu, Ziqing; Fan, Bing; Wu, Hongyi; Wang, Xiangfei; Li, Chenguang; Xu, Rende; Su, Yangang; Ge, Junbo

    2016-08-11

    Systemic embolism, especially septic embolism, is a severe complication of infective endocarditis (IE). However, concurrent embolism to the brain, coronary arteries, and spleen is very rare. Because of the risk of hemorrhage or visceral rupture, anticoagulants are recommended only if an indication is present, e.g. prosthetic valve. Antiplatelet therapy in IE is controversial, but theoretically, this therapy has the potential to prevent and treat thrombosis and embolism in IE. Unfortunately, clinical trial results have been inconclusive. We describe a previously healthy 50-year-old man who presented with dysarthria secondary to bacterial endocarditis with multiple cerebral, coronary, splenic, and peripheral emboli; antibiotic therapy contributed to the multiple emboli. Emergency splenectomy was performed, with subsequent mitral valve repair. Pathological examination confirmed mucoid degeneration and mitral valve prolapse (Barlow's disease) as the underlying etiology of the endocardial lesion. Continuous antibiotics were prescribed, postoperatively. Transthoracic echocardiography at 1.5, 3, and 6 months after the onset of his illness showed no severe regurgitation, and there was no respiratory distress, fever, or lethargy during follow-up. Although antibiotic use in IE carries a risk of septic embolism, these drugs have bactericidal and antithrombotic benefits. It is important to consider that negative blood culture and symptom resolution do not confirm complete elimination of bacteria. However, vegetation size and Staphylococcus aureus infection accurately predict embolization. It is also important to consider that bacteria can be segregated from the microbicide when embedded in platelets and fibrin. Therefore, antimicrobial therapy with concurrent antiplatelet therapy should be considered carefully.

  2. Skin as a marker of general feline health: Cutaneous manifestations of systemic disease.

    Science.gov (United States)

    Vogelnest, Linda J

    2017-09-01

    Practical relevance: Although most skin lesions occur due to diseases primarily affecting the skin, some reflect important systemic diseases. Such lesions may relate directly to the systemic disease, or may occur due to secondary skin diseases that develop because of immunosuppression. Early recognition of skin changes as a marker of systemic disease will maximise patient outcomes. Clinical challenges: In older or clearly debilitated cats presenting with skin disease, the potential for underlying systemic disease is often readily apparent. Similarly, cats presenting with severe ulcerative or multifocal nodular skin lesions, or with concurrent signs of systemic illness, will more instinctively prompt systemic evaluation. More challenging is the cat presenting with alopecic, scaling, erythemic and/or mildly crusted skin disease, with or without pruritus; hypersensitivities and infectious dermatoses are the most common considerations, but occasionally systemic disease underlies the skin changes. Knowing when screening laboratory testing, body imaging or other systemic diagnostics are indicated is not always straightforward. Evidence base: This article reviews cutaneous presentations of systemic diseases reported in the veterinary literature, and discusses important differential diagnoses. The author draws on clinical experience, published data on disease prevalence and case evaluations, and expert opinions on approach to common systemic problems to provide guidance on when investigation for underlying systemic disease is most appropriate.

  3. Genetic variation in ABCA1 predicts ischemic heart disease in the general population

    DEFF Research Database (Denmark)

    Frikke-Schmidt, Ruth; Nordestgaard, BG; Jensen, Gorm B

    2008-01-01

    We tested the hypothesis that 6 nonsynonymous single nucleotide polymorphisms (SNPs) in ATP-Binding-Cassette transporter A1 (ABCA1) affect risk of ischemic heart disease (IHD) in the general population....

  4. Ventilation and Haemodynamic Indicators in Spontaneously Breathing Pigs under General Anaesthesia

    Directory of Open Access Journals (Sweden)

    Jiří Kobr

    2010-01-01

    Full Text Available The aim of this study was to obtain ventilation and haemodynamic data of healthy piglets under general anaesthesia for future patho-physiological experimental studies. A total of 34 domestic piglets of the Czech Black Pied (Přeštice breed were used in the study. The animals (male to female ratio 8 : 9 were six weeks old and their average body mass was 22 kg. A general anaesthetic (fentanyl and azaperon was introduced via a pulmonary artery catheter and the spontaneously breathing animals were monitored for 60 min. Cardiac output and haemodynamic indicators were established using intermittent pulmonary artery thermodilution. Blood gas data were deduced using fan dynamic parameters of ventilation and ventilation indices. The study yielded reliable data of dynamic lung indicators (p 2O/kg, and haemodynamic indicators (p < 0.01 such as cardiac output 2.12 ± 0.75 l/min, pulmonary vascular resistance 3.92 ± 0.52 and systemic vascular resistance 15.8 ± 6.81 Woods units. Reliable data regarding lung dynamics, cardiac output, preload and afterload of both heart ventricles in spontaneously breathing healthy piglets under general anaesthesia were achieved.

  5. The pricing of credit default swaps under a generalized mixed fractional Brownian motion

    Science.gov (United States)

    He, Xinjiang; Chen, Wenting

    2014-06-01

    In this paper, we consider the pricing of the CDS (credit default swap) under a GMFBM (generalized mixed fractional Brownian motion) model. As the name suggests, the GMFBM model is indeed a generalization of all the FBM (fractional Brownian motion) models used in the literature, and is proved to be able to effectively capture the long-range dependence of the stock returns. To develop the pricing mechanics of the CDS, we firstly derive a sufficient condition for the market modeled under the GMFBM to be arbitrage free. Then under the risk-neutral assumption, the CDS is fairly priced by investigating the two legs of the cash flow involved. The price we obtained involves elementary functions only, and can be easily implemented for practical purpose. Finally, based on numerical experiments, we analyze quantitatively the impacts of different parameters on the prices of the CDS. Interestingly, in comparison with all the other FBM models documented in the literature, the results produced from the GMFBM model are in a better agreement with those calculated from the classical Black-Scholes model.

  6. Tourniquet-induced cardiovascular responses in anterior cruciate ligament reconstruction surgery under general anesthesia: Effect of preoperative oral amantadine

    Directory of Open Access Journals (Sweden)

    Ashraf Abd Elmawgood

    2015-01-01

    Conclusion: Preoperative oral amantadine reduced tourniquet induced hypertension and postoperative analgesic requirements in anterior cruciate ligament reconstruction surgery under general anesthesia.

  7. General Principles for the welfare of animals in production systems: the underlying science and its application.

    Science.gov (United States)

    Fraser, David; Duncan, Ian J H; Edwards, Sandra A; Grandin, Temple; Gregory, Neville G; Guyonnet, Vincent; Hemsworth, Paul H; Huertas, Stella M; Huzzey, Juliana M; Mellor, David J; Mench, Joy A; Spinka, Marek; Whay, H Rebecca

    2013-10-01

    In 2012, the World Organisation for Animal Health adopted 10 'General Principles for the Welfare of Animals in Livestock Production Systems' to guide the development of animal welfare standards. The General Principles draw on half a century of scientific research relevant to animal welfare: (1) how genetic selection affects animal health, behaviour and temperament; (2) how the environment influences injuries and the transmission of diseases and parasites; (3) how the environment affects resting, movement and the performance of natural behaviour; (4) the management of groups to minimize conflict and allow positive social contact; (5) the effects of air quality, temperature and humidity on animal health and comfort; (6) ensuring access to feed and water suited to the animals' needs and adaptations; (7) prevention and control of diseases and parasites, with humane euthanasia if treatment is not feasible or recovery is unlikely; (8) prevention and management of pain; (9) creation of positive human-animal relationships; and (10) ensuring adequate skill and knowledge among animal handlers. Research directed at animal welfare, drawing on animal behaviour, stress physiology, veterinary epidemiology and other fields, complements more established fields of animal and veterinary science and helps to create a more comprehensive scientific basis for animal care and management. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Underlying Predictors of Tobacco Smoking among Iranian Teenagers: Generalized Structural Equation Modeling

    Directory of Open Access Journals (Sweden)

    Fariba Khayyati

    2016-09-01

    Full Text Available Background: To define underlying predictors of tobacco smoking among Iranian Teenagers in a generalized structural equation model. Materials and Methods: In this cross-sectional study, a Generalized Structural Equation Model based on planned behavioral theory was used to explain the relationship among different factors such as demographic factors, subjective norms, and the intention to tobacco and, in turn, intention with tobacco use. The sample consisted of 4,422 high school students, based on census, in East Azerbaijan province, Iran. The questioner was designed adapting to the objectives of study. It was used global youth tobacco survey to design the queries of tobacco use. Results: The model had a good fit on data. Adjusting for age and gender, there was a statistically significant relationship between the intention to consumption and the following factors: working while studying (P

  9. Laparoscopic cholecystectomy performed under regional anesthesia in patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Gramatica, L; Brasesco, O E; Mercado Luna, A; Martinessi, V; Panebianco, G; Labaque, F; Rosin, D; Rosenthal, R J; Gramatica, L

    2002-03-01

    Laparoscopic cholecystectomy has been successfully performed using epidural anesthesia. We evaluated our experience with this surgical approach in high-risk patients. We present the results of 29 patients with gallstones who, between 1998 and 1999, underwent laparoscopic cholecystectomy with epidural anesthesia. All but 1 patient had chronic obstructive pulmonary disease. All 29 surgeries were successfully completed via laparoscopy and with the patients under epidural anesthesia. No patient required endotracheal intubation during surgery or pain medication afterward. Postoperatively, 1 patient developed a wound infection and 3 patients developed urinary retention. At last follow-up (12 months postop), all patients were in good health. In this series, laparoscopic cholecystectomy was feasible under epidural anesthesia and it eliminated the need for postoperative analgesia. We believe that this approach should be considered for patients who require biliary surgery but who are not good candidates for general anesthesia due to cardiorespiratory problems.

  10. Prognosis following dental implant treatment under general anesthesia in patients with special needs

    Science.gov (United States)

    2017-01-01

    Background This study retrospectively investigated outcomes following dental implantation in patients with special needs who required general anesthesia to enable treatment. Methods Patients underwent implant treatment under general anesthesia at the Clinic for the Disabled in Seoul National University Dental Hospital between January 2004 and June 2017. The study analyzed medical records and radiographs. Implant survival rates were calculated by applying criteria for success or failure. Results Of 19 patients in the study, 8 were males and 11 were females, with a mean age of 32.9 years. The patients included 11 with mental retardation, 3 with autism, 2 with cerebral palsy, 2 with schizophrenia, and 1 with a brain disorder; 2 patients also had seizure disorders. All were incapable of oral self-care due to serious cognitive impairment and could not cooperate with normal dental treatment. A total of 27 rounds of general anesthesia and 1 round of intravenous sedation were performed for implant surgery. Implant placement was performed in 3 patients whose prosthesis records could not be found, while 3 other patients had less than 1 year of follow-up after prosthetic treatment. When the criteria for implant success or failure were applied in 13 remaining patients, 3 implant failures occurred in 59 total treatments. The cumulative survival rate of implants over an average of 43.3 months (15-116 months) was 94.9%. Conclusions For patients with severe cognitive impairment who are incapable of oral self-care, implant treatment under general anesthesia showed a favorable prognosis. PMID:29090251

  11. Nonallergic rhinitis and its association with smoking and lower airway disease: A general population study

    DEFF Research Database (Denmark)

    Håkansson, Kåre; von Buchwald, Christian; Thomsen, Simon F

    2011-01-01

    The cause of nonallergic rhinitis (NAR) and its relation to lower airway disease remains unclear. The purpose of this study was to perform a descriptive analysis of the occurrence of rhinitis in a Danish general population with focus on NAR and its association with smoking and lower airway disease....

  12. The combined effect of cancer and chronic diseases on general practitioner consultation rates.

    NARCIS (Netherlands)

    Heins, M.J.; Korevaar, J.C.; Donker, G.A.; Rijken, P.M.; Schellevis, F.G.

    2015-01-01

    Aim: More than two-thirds of cancer patients have one or more chronic diseases besides cancer. The purpose of this study was to get detailed insight into the combined effect of cancer and chronic diseases on general practitioner (GP) consultation rates. Methods: From the NIVEL Primary Care Database

  13. The combined effect of cancer and chronic diseases on general practitioner consultation rates

    NARCIS (Netherlands)

    Heins, M.J.; Korevaar, J.C.; Donker, G.A.; Rijken, P.M.; Schellevis, F.G.

    2015-01-01

    Aim: More than two-thirds of cancer patients have one or more chronic diseases besides cancer. The purpose of this study was to get detailed insight into the combined effect of cancer and chronic diseases on general practitioner (GP) consultation rates. Methods: From the NIVEL Primary Care Database

  14. Treatment of Experimental Acute Radiation Disease in Mice with Probiotics, Quinolones, and General Gnotobiological Isolation

    Science.gov (United States)

    1998-09-01

    Armed Forces Ra ioloy Research Institute Treatment of Experimental Acute Radiation Disease in Mice with Probiotics , Quinolones, and General...Gnotobiological Isolation Russia State Medical University 19990119 114 Treatment of Experimental Acute Radiation Disease in Mice with Probiotics , Quinolones...subsyndromes: hematopoietic, gastrointestinal (or GI), and cardiovascular/CNS syndrome. The range for hematopoietic syndrome is considered to be 1-6 Gy, roughly

  15. Action Memorandum for General Decommissioning Activities under the Idaho Cleanup Project

    Energy Technology Data Exchange (ETDEWEB)

    S. L. Reno

    2006-10-26

    This Action Memorandum documents the selected alternative to perform general decommissioning activities at the Idaho National Laboratory (INL) under the Idaho Cleanup Project (ICP). Preparation of this Action Memorandum has been performed in accordance with the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), as amended by the "Superfund Amendments and Reauthorization Act of 1986", and in accordance with the "National Oil and Hazardous Substances Pollution Contingency Plan". An engineering evaluation/cost analysis (EE/CA) was prepared and released for public comment and evaluated alternatives to accomplish the decommissioning of excess buildings and structures whose missions havve been completed.

  16. Beam wandering statistics of twin thin laser beam propagation under generalized atmospheric conditions.

    Science.gov (United States)

    Pérez, Darío G; Funes, Gustavo

    2012-12-03

    Under the Geometrics Optics approximation is possible to estimate the covariance between the displacements of two thin beams after they have propagated through a turbulent medium. Previous works have concentrated in long propagation distances to provide models for the wandering statistics. These models are useful when the separation between beams is smaller than the propagation path-regardless of the characteristics scales of the turbulence. In this work we give a complete model for these covariances, behavior introducing absolute limits to the validity of former approximations. Moreover, these generalizations are established for non-Kolmogorov atmospheric models.

  17. Mechanisms underlying disease transmission between spatially separated animals

    NARCIS (Netherlands)

    Bunnik, van B.A.D.

    2014-01-01

    Transmission of infections between spatially separated hosts is a common problem, not only during major outbreaks of livestock diseases, but also in many other settings such as the transmission of infectious diseases between plants and crops or in healthcare settings. During the last

  18. A general circuit model for spintronic devices under electric and magnetic fields

    KAUST Repository

    Alawein, Meshal

    2017-10-25

    In this work, we present a circuit model of diffusive spintronic devices capable of capturing the effects of both electric and magnetic fields. Starting from a modified version of the well-established drift-diffusion equations, we derive general equivalent circuit models of semiconducting/metallic nonmagnets and metallic ferromagnets. In contrast to other models that are based on steady-state transport equations which might also neglect certain effects such as thermal fluctuations, spin dissipation in the ferromagnets, and spin precession under magnetic fields, our model incorporates most of the important physics and is based on a time-dependent formulation. An application of our model is shown through simulations of a nonlocal spin-valve under the presence of a magnetic field, where we reproduce experimental results of electrical measurements that demonstrate the phenomena of spin precession and dephasing (“Hanle effect”).

  19. On the thermal stability of a radiating gas under general differential approximation

    International Nuclear Information System (INIS)

    Bestman, A.R.

    1988-02-01

    The thermal stability of a radiating gas in a semi-infinite space is studied under a general differential approximation. The fluid is bounded on the axis z'=0 by a horizontal infinite wall maintained at a temperature T 0 which is high enough for radiative heat transfer to be significant. At z'=∞, the fluid is at uniform temperature T ∞ such that T 0 >T ∞ . The equations of motion under small perturbation theory reduce to a set of linear homogeneous equations with a variable coefficient subject to homogeneous boundary conditions when the unperturbed temperature is adopted as the independent variable. The solution is effected via a finite difference scheme and the Rayleigh number is determined by Newton's iterative method. (author). 8 refs

  20. Orbital Tumors Excision without Bony Marginotomy under Local and General Anesthesia

    Directory of Open Access Journals (Sweden)

    Robert A. Goldberg

    2014-01-01

    Full Text Available To present our experience of removing middle to deep orbital tumors using a combination of minimally invasive soft tissue approaches, sometimes under local anesthesia. Methods. In this retrospective case series, 30 patients (13 males and 17 females underwent tumor removal through eyelid crease (17 eyes, conjunctival (nine eyes, lateral canthal (two eyes, and transcaruncular (two eyes approaches. All tumors were located in the posterior half of the orbit. Six cases were removed under monitored anesthesia care with local block, and 24 were under general anesthesia. Results. The median (range age and follow-up duration were 48.5 (31–87 years old and 24.5 (4–375 weeks, respectively. Visual acuity and ocular motility showed improvement or no significant change in all but one patient at the latest followup. Confirmed pathologies revealed cavernous hemangioma (15 cases, pleomorphic adenoma (5 cases, solitary fibrous tumor (4 cases, neurofibroma (2 cases, schwannoma (2 cases, and orbital varix (1 case. None of the patients experienced recurrence. Conclusions. Creating a bony marginotomy increases intraoperative exposure of the deep orbit but adds substantial time and morbidity. Benign orbital tumors can often be removed safely through small soft-tissue incisions, without bone removal and under local anesthesia.

  1. Hemodynamic Effect of 2% Lidocaine with 1:80,000 Epinephrine Infiltration in Maxillofacial Surgeries under General Anesthesia

    Directory of Open Access Journals (Sweden)

    Baratollah Shaban

    2013-01-01

    Full Text Available Introduction: Epinephrine-containing lidocaine is the most used anestheic drug in dentistry. The aim of this study was to investigate the hemodynamic changes following local infiltration of 2%lidocaine with 1:80,000 epinephrine in subjects undergoing orthognatic surgery under general anesthesia. Methods: Twenty five patients without any systemic disease participated. After general anesthesia, two cartridges of 2% lidocaine + 1:80,000 epinephrine were infiltrated around the surgery site. Systolic (SBP and diastolic (DBP blood pressure, mean arterial blood pressure (MAP, heart rate (HR, and blood sugar (BS were measured in three stages: before the injection (M1, at the end of injection (M2, and 10 min after injection (M3. Results: No significant difference observed in SBP, DBP, and MAP at the end of injection and 10 min later. HR was increased significantly after injection and remained significantly higher than baseline after 10 min. BS increased slightly at the end of injection and continued to increase after 10 min. However, changes in BS were not significant. Conclusion: Using two cartridges of epinephrine-containing lidocaine have slight systemic changes in healthy subjects; as a result, this dosage could be used in patients with cardiovascular complications undergoing general anesthesia.

  2. Hemodynamic Effect of 2% Lidocaine with 1:80,000 Epinephrine Infiltration in Maxillofacial Surgeries under General Anesthesia

    Directory of Open Access Journals (Sweden)

    Baratollah Shaban

    2013-12-01

    Full Text Available Introduction: Epinephrine-containing lidocaine is the most used anestheic drug in dentistry. The aim of this study was to investigate the hemodynamic changes following local infiltration of 2% lidocaine with 1:80,000 epinephrine in subjects undergoing orthognatic surgery under general anesthesia. Methods: Twenty five patients without any systemic disease participated. After general anesthesia, two cartridges of 2% lidocaine + 1:80,000 epinephrine were infiltrated around the surgery site. Systolic (SBP and diastolic (DBP blood pressure, mean arterial blood pressure (MAP, heart rate (HR, and blood sugar (BS were measured in three stages: before the injection (M1, at the end of injection (M2, and 10 min after injection (M3. Results: No significant difference observed in SBP, DBP, and MAP at the end of injection and 10 min later. HR was increased significantly after injection and remained significantly higher than baseline after 10 min. BS increased slightly at the end of injection and continued to increase after 10 min. However, changes in BS were not significant. Conclusion: Using two cartridges of epinephrine-containing lidocaine have slight systemic changes in healthy subjects; as a result, this dosage could be used in patients with cardiovascular complications undergoing general anesthesia.

  3. [Explore the influence factors on primary lung cancer in Fujian province Han population under the use of generalized linear model].

    Science.gov (United States)

    He, Fei; Xiao, Rendong; Yu, Tingting; Zhang, Xin; Liu, Zhiqiang; Cai, Lin

    2015-08-01

    The purpose of this study was to use the data on lung cancer in Han Chinese in Fujian province to explore the value of a generalized, linear model and to investigate the impact related to environment factors on lung cancer as well as the independent and interaction effects on the development of lung cancer. SAS 9.2 was used to build a generalized linear model to evaluate the influence factors and interaction of lung cancer on both smokers and non-smokers. Results showed that the relationship of the factors was multiplied. Under the logistic regression analysis, seven risk factors and nine risk factors were noticed in smokers or in non-smokers, respectively. Heavy smokers and lung diseases appeared a positive multiplying effect on smokers while passive smoking and fresh fruits showed positive multiplying effects on non-smokers. The generalized linear models could filter suitable models thus facilitating further research on the interaction between the two. It seemed easy to carry on the comprehensive and rational analysis on related epidemiological data.

  4. Relation of ventricular premature beats to underlying heart disease.

    Science.gov (United States)

    Uretz, E F; Denes, P; Ruggie, N; Vasilomanolakis, E; Messer, J V

    1984-03-01

    The relation between ventricular premature beats (VPBs) and physiologic disease was investigated in 305 patients who had 24-hour Holter monitoring tests, cardiac catheterization and angiography. Both frequency and Lown class of VPBs were measured. Analyses showed that occurrence of VPBs at an average frequency of more than 2 per hour or occurrence of complex VPBs (Lown class greater than 2) have the highest association with the presence and severity of cardiac disease. Using these criteria, VPB severity was then compared with extent of ventricular wall motion abnormality (right anterior oblique projection segments), ejection fraction, end-diastolic pressure, category of disease (normal, coronary artery disease [CAD], valvular heart disease, dilated cardiomyopathy), age and severity of CAD (major coronary arteries with greater than 75% diameter reduction). Severe VPBs defined either by complexity or frequency were significantly correlated with extent of wall motion abnormality, ejection fraction, category of disease and age. Severe VPBs were not significantly correlated with end-diastolic pressure or severity of CAD. Discriminant analysis then showed that in addition to wall motion abnormality and ejection fraction, category of disease and age are independently correlated with VPB severity.

  5. Primary prevention of cardio-metabolic diseases in general practice: a Dutch survey of attitudes and working methods of general practitioners.

    NARCIS (Netherlands)

    Nielen, M.M.J.; Assendelft, W.J.J.; Drenthen, A.J.M.; Hombergh, P. van den; Dis, I. van; Schellevis, F.G.

    2010-01-01

    BACKGROUND: To study the attitudes and working methods of general practitioners (GPs) in primary prevention of cardiovascular diseases, diabetes mellitus and chronic kidney diseases. METHODS: A questionnaire with questions about attitude and working methods in the primary prevention of

  6. The need for repeated dental care under general anaesthesia in children.

    Science.gov (United States)

    Bücher, K; Rothmaier, K; Hickel, R; Heinrich-Weltzien, R; Kühnisch, J

    2016-06-01

    Though the use of advanced behaviour management may facilitate dental treatment in children, some patients still require comprehensive care under general anaesthesia (GA). This is especially true for young children and/or medically compromised children. Thus, this study aimed to provide information about children undergoing GA with regard to age, sex and medical conditions (ICD-10), repeated treatments, dental procedures and recall. A total of 464 medically compromised children treated under GA in a dental university clinic between 2004 and 2012 were included. Patients` records were analysed retrospectively using SPSS (Version 21.0) and R for statistical analysis. More than 75% of the patients were younger than six years when receiving initial GA. The proportion of children subjected to repeated treatments was low, at 11% for a second and dental care consisted of restorative therapy and tooth extractions. The recall behaviour observed between the first and second GA revealed no significant influence on the time elapsed in between events (p>0.05). Oral care in children with medical conditions is mostly caries-related, and repeated treatment may be necessary, though it was generally uncommon in this university-based study population.

  7. Modified Dual Second-order Generalized Integrator FLL for Frequency Estimation Under Various Grid Abnormalities

    Directory of Open Access Journals (Sweden)

    Kalpeshkumar Rohitbhai Patil

    2016-10-01

    Full Text Available Proper synchronization of Distributed Generator with grid and its performance in grid-connected mode relies on fast and precise estimation of phase and amplitude of the fundamental component of grid voltage. However, the accuracy with which the frequency is estimated is dependent on the type of grid voltage abnormalities and structure of the phase-locked loop or frequency locked loop control schemes. Among various control schemes, second-order generalized integrator based frequency- locked loop (SOGI-FLL is reported to have the most promising performance. It tracks the frequency of grid voltage accurately even when grid voltage is characterized by sag, swell, harmonics, imbalance, frequency variations etc. However, estimated frequency contains low frequency oscillations in case when sensed grid-voltage has a dc offset. This paper presents a modified dual second-order generalized integrator frequency-locked loop (MDSOGI-FLL for three-phase systems to cope with the non-ideal three-phase grid voltages having all type of abnormalities including the dc offset. The complexity in control scheme is almost the same as the standard dual SOGI-FLL, but the performance is enhanced. Simulation results show that the proposed MDSOGI-FLL is effective under all abnormal grid voltage conditions. The results are validated experimentally to justify the superior performance of MDSOGI-FLL under adverse conditions.

  8. A clinical evaluation of comprehensive dental treatment for children under general anesthesia.

    Science.gov (United States)

    Su, H L; Chen, P S

    1992-12-01

    The purpose of this study is to evaluate the comprehensive dental treatment for children under general anesthesia. From 1989 to 1991, 57 children with mean age of 3 years 2 months were treated, followed up with a minimal of 1 year. This procedure allows the dentition to be restored in one visit. Further care including preventive options and behavior shaping was provided on a 3-6 months recall schedule. The reasons for general anesthesia are that these children were either unable to accept treatment because of handicaps, extreme fear or young age. Their mean number of decayed tooth was 15 (Standard Deviation, SD = 5) and nearly three quarters of the children were under 6 years old. The most frequent treatment procedures were the extraction of teeth, composite resin restoration and Ni-Cr crown restoration. The Ni-Cr crown (1.7% failure rate) was more successful than the amalgam and composite resin restoration (9.7% failure rate). Pedo-strip crown had the highest failure rate (22%) for anterior teeth restoration. Nineteen children needed retreatment with conventional behavior guide. Six children had new caries and required further treatment. Thirty eight children returned for regular recall during the minimal 1 year follow-up period.

  9. Formocresol blood levels in children receiving dental treatment under general anesthesia.

    Science.gov (United States)

    Kahl, Jeffrey; Easton, Jillian; Johnson, Gillian; Zuk, Jeannie; Wilson, Stephen; Galinkin, Jeffrey

    2008-01-01

    The purpose of this study was to determine the presence of formocresol in the plasma of children undergoing oral rehabilitation involving pulp therapy under general anesthesia. Thirty 2- to 6-year-old preschool children were enrolled in the study. Preoperative, intra-operative, and postoperative peripheral venous samples were collected from each child. All samples were analyzed for formaldehyde and cresol levels using gas chromatography with mass spectrometry detection. Eighty-five pulpotomies were performed ranging from 1 to 5 per child. Three hundred twelve blood samples were collected. Analysis revealed that formaldehyde was undetectable above baseline plasma concentration and cresol was undetectable in all samples. Benzyl alcohol (a byproduct of cresol metabolism) was present in all samples except the baseline preoperative samples. Benzyl alcohol concentrations ranged from 0 to 1 mg/ml. Formaldehyde was undetectable above baseline plasma concentration, and cresol was undetectable in subjects receiving pulpotomy treatment under general anesthesia. Benzyl alcohol was detected in the plasma of all subjects receiving pulpotomy treatment. The levels present were far below the Food and Drug Administration's recommended daily allowance. It is unlikely that formocresol, when used in the doses typically employed for a vital pulpotomy procedure, poses any risk to children.

  10. [Advances on pharmacokinetics of traditional Chinese medicine under disease states].

    Science.gov (United States)

    Gong, Zi-peng; Chen, Ying; Zhang, Rui-jie; Yang, Qing; Zhu, Xiao-xin

    2015-01-01

    In recent years, more and more research shows that the pharmacokinetic parameter of traditional Chinese medicine can be affected by the disease states. It's possible that drug metabolic enzymes, transporters, cell membrane permeability and the change of microbes group could be interfered with physiological and pathological changes, which enables the pharmacokinetics of traditional Chinese medicine in the body to be altered, including the process of absorption, distribution, metabolism and excretion, and then the pharmacokinetic parameters of traditional chinese medicine are altered. It's found that investigating the pharmacokinetic of traditional Chinese medicine in the pathological state is more useful than that of in normal state because the great part of traditional Chinese medicine is mainly used to treat disease. This article reflects the latest research on the pharmacokinetic of traditional Chinese medicine in the disease state such as diabete, cerebral ischemia, liver injury, inflammatory disease, nervous system disorders and fever in order to provide certain reference for clinicians designing reasonable administration dose.

  11. Fatigue in the Danish general population. Influence of sociodemographic factors and disease

    DEFF Research Database (Denmark)

    Watt, T; Groenvold, M; Bjorner, J B

    2000-01-01

    OBJECTIVE: To measure the levels of fatigue in the general population, and to examine how disease and sociodemographic factors influence fatigue. DESIGN: Cross sectional questionnaire study in the Danish general population. SUBJECTS: A random, age stratified sample of 1608 people aged 20......, gender and/or whether the person was living alone. For example, General and Physical Fatigue decreased with age among healthy people, whereas scores on these scales increased with age among those with a somatic disease. CONCLUSIONS: Physical and mental diseases play essential parts for the level...... of fatigue and as modulators of the associations between sociodemographic factors and fatigue. These interactions should be taken into account in future research on fatigue and sociodemographic factors and when data from clinical studies are compared with normative data from the general population....

  12. Therapeutical approaches under investigation for treatment of Chagas disease.

    Science.gov (United States)

    Bahia, Maria Terezinha; Diniz, Lívia de Figueiredo; Mosqueira, Vanessa Carla Furtado

    2014-09-01

    A century after its discovery, American trypanosomiasis or Chagas disease remains a serious health problem in Latin America, where it affects around 7 - 8 million people. The prevalence of Chagas disease in the poorer parts of the world has meant that it has largely been neglected with limited progress that made in identifying new drugs for the treatment. The nitroheterocyclic drugs nifurtimox and benznidazole are first-line drugs available for Chagas disease with limitations that include variable efficacy, long treatment courses and toxicity. This review focuses on different therapeutic strategies that have been used for the discovery of new treatments for Chagas disease. These include combination chemotherapy, drug repositioning, re-dosing regimens for current drugs and the identification of new drugs with specified target profiles. There are currently several reasons for a more optimistic view about chemotherapy with Chagas disease. However, despite some progress being made in preclinical studies, there is yet to be an ideal drug or formulation for human treatment. One major drawback in the evaluation of potential Chagas disease therapeutics is the lack of tools available to perform the said evaluation. Indeed, there is a great need to discover a better biomarker that could determine the efficacy of potential chemotherapeutics in treated patients.

  13. General anesthetics inhibit erythropoietin induction under hypoxic conditions in the mouse brain.

    Directory of Open Access Journals (Sweden)

    Tomoharu Tanaka

    Full Text Available Erythropoietin (EPO, originally identified as a hematopoietic growth factor produced in the kidney and fetal liver, is also endogenously expressed in the central nervous system (CNS. EPO in the CNS, mainly produced in astrocytes, is induced under hypoxic conditions in a hypoxia-inducible factor (HIF-dependent manner and plays a dominant role in neuroprotection and neurogenesis. We investigated the effect of general anesthetics on EPO expression in the mouse brain and primary cultured astrocytes.BALB/c mice were exposed to 10% oxygen with isoflurane at various concentrations (0.10-1.0%. Expression of EPO mRNA in the brain was studied, and the effects of sevoflurane, halothane, nitrous oxide, pentobarbital, ketamine, and propofol were investigated. In addition, expression of HIF-2α protein was studied by immunoblotting. Hypoxia-induced EPO mRNA expression in the brain was significantly suppressed by isoflurane in a concentration-dependent manner. A similar effect was confirmed for all other general anesthetics. Hypoxia-inducible expression of HIF-2α protein was also significantly suppressed with isoflurane. In the experiments using primary cultured astrocytes, isoflurane, pentobarbital, and ketamine suppressed hypoxia-inducible expression of HIF-2α protein and EPO mRNA.Taken together, our results indicate that general anesthetics suppress activation of HIF-2 and inhibit hypoxia-induced EPO upregulation in the mouse brain through a direct effect on astrocytes.

  14. General

    Indian Academy of Sciences (India)

    Page S20: NMR compound 4i. Page S22: NMR compound 4j. General: Chemicals were purchased from Fluka, Merck and Aldrich Chemical Companies. All the products were characterized by comparison of their IR, 1H NMR and 13C NMR spectroscopic data and their melting points with reported values. General procedure ...

  15. 50 CFR 216.16 - Prohibitions under the General Authorization for Level B harassment for scientific research.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Prohibitions under the General Authorization for Level B harassment for scientific research. 216.16 Section 216.16 Wildlife and Fisheries... Prohibitions under the General Authorization for Level B harassment for scientific research. It shall be...

  16. High-utilizing Crohn's disease patients under psychosomatic therapy*

    Science.gov (United States)

    Deter, Hans-Christian; von Wietersheim, Jörn; Jantschek, Günther; Burgdorf, Friederike; Blum, Brigitta; Keller, Wolfram

    2008-01-01

    Objective Few studies have been published on health care utilization in Crohn's disease and the influence of psychological treatment on high utilizers. Methods The present sub study of a prospective multi center investigation conducted in 87 of 488 consecutive Crohn's disease (CD) patients was designed to investigate the influence of the course of Crohn's disease on health care utilization (hospital days (HD) and sick leave days (SLD) collected by German insurance companies) and to examine the conditions of high-utilizing patients. Predictors of health care utilization should be selected. Based on a standardized somatic treatment, high health care utilizing patients of the psychotherapy and control groups should be compared before and after a one-year treatment. Results Multivariate regression analysis identified disease activity at randomization as an important predictor of the clinical course (r2 = 0.28, p < 0.01). Health care utilization correlated with duration of disease (p < 0.04), but the model was not significant (r2 = 0.15, p = 0.09). The patients' level of anxiety, depression and lack of control at randomization predicted their health-related quality of life at the end of the study (r2 = 0.51, p < 0.00001). Interestingly, steroid intake and depression (t1) predicted the combined outcome measure (clinical course, HRQL, health care utilization) of Crohn's disease at the end of the study (r2 = 0.22, p < 0.001). Among high utilizers, a significantly greater drop in HD (p < 0.03) and in mean in SLD were found in the treatment compared to the control group. Conclusion The course of Crohn's disease is influenced by psychological as well as somatic factors; especially depression seems important here. A significant drop of health care utilization demonstrates the benefit of psychological treatment in the subgroup of high-utilizing CD patients. Further studies are needed to replicate the findings of the clinical outcome in this CD subgroup. PMID:18851749

  17. A Generalized Fuzzy Integer Programming Approach for Environmental Management under Uncertainty

    Directory of Open Access Journals (Sweden)

    Y. R. Fan

    2014-01-01

    Full Text Available In this study, a generalized fuzzy integer programming (GFIP method is developed for planning waste allocation and facility expansion under uncertainty. The developed method can (i deal with uncertainties expressed as fuzzy sets with known membership functions regardless of the shapes (linear or nonlinear of these membership functions, (ii allow uncertainties to be directly communicated into the optimization process and the resulting solutions, and (iii reflect dynamics in terms of waste-flow allocation and facility-capacity expansion. A stepwise interactive algorithm (SIA is proposed to solve the GFIP problem and generate solutions expressed as fuzzy sets. The procedures of the SIA method include (i discretizing the membership function grade of fuzzy parameters into a set of α-cut levels; (ii converting the GFIP problem into an inexact mixed-integer linear programming (IMILP problem under each α-cut level; (iii solving the IMILP problem through an interactive algorithm; and (iv approximating the membership function for decision variables through statistical regression methods. The developed GFIP method is applied to a municipal solid waste (MSW management problem to facilitate decision making on waste flow allocation and waste-treatment facilities expansion. The results, which are expressed as discrete or continuous fuzzy sets, can help identify desired alternatives for managing MSW under uncertainty.

  18. Epigenetic mechanisms underlying the pathogenesis of neurogenetic diseases.

    Science.gov (United States)

    Qureshi, Irfan A; Mehler, Mark F

    2014-10-01

    There have been considerable advances in uncovering the complex genetic mechanisms that underlie nervous system disease pathogenesis, particularly with the advent of exome and whole genome sequencing techniques. The emerging field of epigenetics is also providing further insights into these mechanisms. Here, we discuss our understanding of the interplay that exists between genetic and epigenetic mechanisms in these disorders, highlighting the nascent field of epigenetic epidemiology-which focuses on analyzing relationships between the epigenome and environmental exposures, development and aging, other health-related phenotypes, and disease states-and next-generation research tools (i.e., those leveraging synthetic and chemical biology and optogenetics) for examining precisely how epigenetic modifications at specific genomic sites affect disease processes.

  19. Metallic stent implantation in the treatment of malignant tracheal stenosis under general anaesthesia

    International Nuclear Information System (INIS)

    Bai Xuming; Jin Yong; Xie Hong; Cheng Long; Gu Xingshi; Chang Liuhui

    2012-01-01

    Objective: To evaluate the safety and feasibility of the tracheal stent implantation for treatment of malignant tracheal stenosis under general anaesthesia. Methods: Eighteen patients with malignant tracheal stenosis underwent preoperative 64-slice spiral CT scan and airway reconstruction. The stenotic sites were located in main tracheal trunk (5 patients), in right main bronchus (1 patient), in trachea and left main bronchus (4 patients), in trachea and right main bronchus (3 patients), in main tracheal trunk and bilateral main bronchus (5 patients). The degree of stenosis was rated 51% to 70% in 7 cases, 71% to 90% in 11 cases. All patients, 17 patients of ASA grade Ⅳ and 1 patient of grade Ⅲ, presented with severe dyspnea. Under general anaesthesia, implantation of metallic stent was performed through the sputum aspiration hole of the connecting tubing with DSA guidance. The NBP, ECG, RR, SaO 2 of the patients were recorded and compared with t test during the entire procedure. At the end of the procedure, relief of dyspnea, complications related to anesthesia and operation were recorded. Results: The success rate of stent placement was 18/18, and dyspnea was significantly relived in all patients. Slightly bloody sputum occurred in 7 cases. The stent was obstructed by sputum in 1 case,and the patient was treated with medication. There were no severe complications. The operative course were rated 11 to 9 in 17 cases, and 6 to 8 in 1 case. All 18 patients were cooperative during the procedure. Sixteen patients rated the procedure as very comfortable and 2 rated the procedure as comfortable. Respiratory rate (RR) and heart rate (HR) decreased in all patients after the operation [(37.1 ± 2.8)/min and (106.5 ± 14.2) bpm before the operation respectively, (18.6 ± 1.4)/min and (73.2 ± 7.6) bpm after the operation respectively], t=17.81 and 3.80, P<0.01. Pulse oxygen saturation (SaO 2 ) during the operation [(91.2 ± 1.8)%]increased [(76.3 ± 8.6 )% before the

  20. Getting Under the Skin: The Inscription of Dermatological Disease ...

    African Journals Online (AJOL)

    8; Papadopoulos, Bor & Legg, 1999, p. 107). Chronic cutaneous disease is often visible to others so that social factors in coping and adjustment are thus highly relevant (Papadopoulos, et al., 1999, p. 107). Psychological factors tend, however, to be overlooked in the dermatological treatment domain when the skin problem ...

  1. Yellow Vein Mosaic disease in kenaf ( Hibiscus cannabinus l.) under ...

    African Journals Online (AJOL)

    Nucleic acid spot hybridization (NASH) was used to confirm the disease and the results revealed that Begomovirus was present in kenaf sowm in the two locations during the period of the three months except in kenaf sown in July at Ilora. The results of this study revealed the importance of sowing dates on the occurrence of ...

  2. Underlying congenital heart disease in Nigerian children with ...

    African Journals Online (AJOL)

    EB

    2013-09-03

    Sep 3, 2013 ... Abstract. Background: Pneumonia is a common cause of childhood morbidity and mortality globally. Some congenital heart disease. (CHD) may predispose their sufferer to bronchopneumonia. Objective: To evaluate the contribution of CHD to pneumonia in children seen in a tertiary hospital. Methods: Over ...

  3. Underlying congenital heart disease in Nigerian children with ...

    African Journals Online (AJOL)

    Background: Pneumonia is a common cause of childhood morbidity and mortality globally. Some congenital heart disease(CHD) may predispose their sufferer to bronchopneumonia. Objective: To evaluate the contribution of CHD to pneumonia in children seen in a tertiary hospital. Methods: Over a year, consecutive ...

  4. Differences Between Expressive Suppression and Cognitive Reappraisal Between Heart Disease and Generalal Population

    Directory of Open Access Journals (Sweden)

    Seyyed Mohammad Reza Mirlohi

    2017-09-01

    Full Text Available Aim: Heart disease and emotional disorders often co-occur, but effective role in dysregulation of heart disease that is often overlooked. Evidence suggests that people with heart disease are more problems in regulating their emotions. The study compared the re-evaluation of cognitive emotion regulation commonly used two strategies- and suppression- between heart disease and the general population. Methods: Sixty men (30 with heart complaints and 30 without the condition were selected by convenience sampling method and they responded to the Emotion Regulation Questionnaire (Gross and John and a demographic questionnaire responded. To analyze the results and descriptive statistics such as frequency tables and inferential statistics, independent T-test was used SPSS software was used. Results: The result shows that heart disease and general population re-evaluation strategies groups (P<0.01. This is not only different from the strategy reassessment, but in different repression, too. (P <0.001. Conclusion: The results showed that heart disease and general population used different strategies to regulate their emotions. The key to finding the heart disease group prefer repression to regulate their emotions.

  5. High-utilizing Crohn's disease patients under psychosomatic therapy*

    Directory of Open Access Journals (Sweden)

    Jantschek Günther

    2008-10-01

    Full Text Available Abstract Objective Few studies have been published on health care utilization in Crohn's disease and the influence of psychological treatment on high utilizers. Methods The present sub study of a prospective multi center investigation conducted in 87 of 488 consecutive Crohn's disease (CD patients was designed to investigate the influence of the course of Crohn's disease on health care utilization (hospital days (HD and sick leave days (SLD collected by German insurance companies and to examine the conditions of high-utilizing patients. Predictors of health care utilization should be selected. Based on a standardized somatic treatment, high health care utilizing patients of the psychotherapy and control groups should be compared before and after a one-year treatment. Results Multivariate regression analysis identified disease activity at randomization as an important predictor of the clinical course (r2 = 0.28, p 2 = 0.15, p = 0.09. The patients' level of anxiety, depression and lack of control at randomization predicted their health-related quality of life at the end of the study (r2 = 0.51, p 2 = 0.22, p Among high utilizers, a significantly greater drop in HD (p Conclusion The course of Crohn's disease is influenced by psychological as well as somatic factors; especially depression seems important here. A significant drop of health care utilization demonstrates the benefit of psychological treatment in the subgroup of high-utilizing CD patients. Further studies are needed to replicate the findings of the clinical outcome in this CD subgroup.

  6. Recursive Subspace Identification of AUV Dynamic Model under General Noise Assumption

    Directory of Open Access Journals (Sweden)

    Zheping Yan

    2014-01-01

    Full Text Available A recursive subspace identification algorithm for autonomous underwater vehicles (AUVs is proposed in this paper. Due to the advantages at handling nonlinearities and couplings, the AUV model investigated here is for the first time constructed as a Hammerstein model with nonlinear feedback in the linear part. To better take the environment and sensor noises into consideration, the identification problem is concerned as an errors-in-variables (EIV one which means that the identification procedure is under general noise assumption. In order to make the algorithm recursively, propagator method (PM based subspace approach is extended into EIV framework to form the recursive identification method called PM-EIV algorithm. With several identification experiments carried out by the AUV simulation platform, the proposed algorithm demonstrates its effectiveness and feasibility.

  7. Normal Mode Analysis to a Poroelastic Half-Space Problem under Generalized Thermoelasticity

    Directory of Open Access Journals (Sweden)

    Chunbao Xiong

    Full Text Available Abstract The thermo-hydro-mechanical problems associated with a poroelastic half-space soil medium with variable properties under generalized thermoelasticity theory were investigated in this study. By remaining faithful to Biot’s theory of dynamic poroelasticity, we idealized the foundation material as a uniform, fully saturated, poroelastic half-space medium. We first subjected this medium to time harmonic loads consisting of normal or thermal loads, then investigated the differences between the coupled thermohydro-mechanical dynamic models and the thermo-elastic dynamic models. We used normal mode analysis to solve the resulting non-dimensional coupled equations, then investigated the effects that non-dimensional vertical displacement, excess pore water pressure, vertical stress, and temperature distribution exerted on the poroelastic half-space medium and represented them graphically.

  8. Conditional Akaike information under generalized linear and proportional hazards mixed models

    Science.gov (United States)

    Donohue, M. C.; Overholser, R.; Xu, R.; Vaida, F.

    2011-01-01

    We study model selection for clustered data, when the focus is on cluster specific inference. Such data are often modelled using random effects, and conditional Akaike information was proposed in Vaida & Blanchard (2005) and used to derive an information criterion under linear mixed models. Here we extend the approach to generalized linear and proportional hazards mixed models. Outside the normal linear mixed models, exact calculations are not available and we resort to asymptotic approximations. In the presence of nuisance parameters, a profile conditional Akaike information is proposed. Bootstrap methods are considered for their potential advantage in finite samples. Simulations show that the performance of the bootstrap and the analytic criteria are comparable, with bootstrap demonstrating some advantages for larger cluster sizes. The proposed criteria are applied to two cancer datasets to select models when the cluster-specific inference is of interest. PMID:22822261

  9. Statics of Shallow Inclined Elastic Cables under General Vertical Loads: A Perturbation Approach

    Directory of Open Access Journals (Sweden)

    Angelo Luongo

    2018-02-01

    Full Text Available The static problem for elastic shallow cables suspended at points at different levels under general vertical loads is addressed. The cases of both suspended and taut cables are considered. The funicular equation and the compatibility condition, well known in literature, are here shortly re-derived, and the commonly accepted simplified hypotheses are recalled. Furthermore, with the aim of obtaining simple asymptotic expressions with a desired degree of accuracy, a perturbation method is designed, using the taut string solution as the generator system. The method is able to solve the static problem for any distributions of vertical loads and shows that the usual, simplified analysis is just the first step of the perturbation procedure proposed here.

  10. TREATING EARLY CHILDHOOD CARIES UNDER GENERAL ANESTHESIA: A NATIONAL REVIEW OF CANADIAN DATA.

    Science.gov (United States)

    Schroth, Robert J; Quiñonez, Carlos; Shwart, Luke; Wagar, Brandon

    2016-07-01

    Many Canadian children are affected by early childhood caries (ECC) and require treatment under general anesthesia. The purpose of this study was to determine the burden of day surgery for children with ECC in Canada. Day surgery abstracts for children 6 years of age with ECC were extracted from the Canadian Institute for Health Information Discharge Abstract Database and National Ambulatory Care Reporting System for 4 years, 2010/11 to 2013/14. All provinces and territories participated except Quebec. Variables considered included sex, age, proportion of immigrants in the neighbourhood, Aboriginal concentration, material deprivation index and rurality. Rates were calculated for the pooled 4-year cohort. The overall rate of dental surgery to treat ECC was 12.1 per 1000 children 12-59 months of age, accounting for 31.0% of all day surgeries performed on this age group in Canada. Rates of dental surgery for children from neighbourhoods with a high proportion of Aboriginal people were 7.8 times those for children living in areas with a low proportion (84.5 vs. 10.9 per 1000). For children from rural regions of Canada, rates were 3.2 times those of urban dwelling children (31.2 vs. 9.8 per 1000). Children from the least-affluent regions had dental surgery rates 3.7 times higher than those from the most-affluent communities (25.7 vs. 6.9 per 1000). Total hospital-associated costs of treating ECC under general anesthesia averaged $21184545 annually. Dental surgery for ECC is far too common and occurs more often among children from the least-affluent households, rural regions and communities with a high proportion of Aboriginal people. Dental surgery rates can serve as an important population health indicator.

  11. Analysis of under- and overprescribing of antibiotics in acute otitis media in general practice.

    Science.gov (United States)

    Akkerman, Annemiek E; Kuyvenhoven, Marijke M; van der Wouden, Johannes C; Verheij, Theo J M

    2005-09-01

    To assess clinical determinants of under- and overprescribing of antibiotics according to the Dutch national guideline for patients with acute otitis media (AOM) in general practice. A total of 146 general practitioners (GPs) from the Netherlands included all patients with AOM during a 4 week period in winter, and recorded patient characteristics, clinical presentation and management. Under- and overprescribing of antibiotics in AOM was assessed using the Dutch national guideline. A total of 458 AOM consultations were recorded. In seven out of 10 consultations (310/439; excluding 19 consultations in which patients were referred to secondary care), antibiotic prescribing decisions were according to the national guideline. In 11% of all consultations (50/439), there was underprescribing and in 18% (79/439) there was overprescribing. Patients with an antibiotic indication but without an antibiotic prescription (underprescribing; n=50) had more short-term symptoms (OR: 0.93), relatively few inflammation signs (OR: 0.47) and were less severely ill (OR: 0.30), compared with patients with an antibiotic indication and an antibiotic prescription (n=167). Patients without an antibiotic indication but with an antibiotic prescription (overprescribing; n=79) were more often younger than 24 months (OR: 0.34), more severely ill (OR: 3.30) and expected more often an antibiotic as perceived by their GP (OR: 2.11), compared with patients without an antibiotic indication and without an antibiotic prescription (n=143). Clinical determinants which are stated as criteria for antibiotic treatment of AOM in the Dutch national guideline were recognized by GPs as important items, but were frequently given too much weight.

  12. A Sequence Kernel Association Test for Dichotomous Traits in Family Samples under a Generalized Linear Mixed Model.

    Science.gov (United States)

    Yan, Qi; Tiwari, Hemant K; Yi, Nengjun; Gao, Guimin; Zhang, Kui; Lin, Wan-Yu; Lou, Xiang-Yang; Cui, Xiangqin; Liu, Nianjun

    2015-01-01

    The existing methods for identifying multiple rare variants underlying complex diseases in family samples are underpowered. Therefore, we aim to develop a new set-based method for an association study of dichotomous traits in family samples. We introduce a framework for testing the association of genetic variants with diseases in family samples based on a generalized linear mixed model. Our proposed method is based on a kernel machine regression and can be viewed as an extension of the sequence kernel association test (SKAT and famSKAT) for application to family data with dichotomous traits (F-SKAT). Our simulation studies show that the original SKAT has inflated type I error rates when applied directly to family data. By contrast, our proposed F-SKAT has the correct type I error rate. Furthermore, in all of the considered scenarios, F-SKAT, which uses all family data, has higher power than both SKAT, which uses only unrelated individuals from the family data, and another method, which uses all family data. We propose a set-based association test that can be used to analyze family data with dichotomous phenotypes while handling genetic variants with the same or opposite directions of effects as well as any types of family relationships. © 2015 S. Karger AG, Basel.

  13. Dental care and treatments provided under general anaesthesia in the Helsinki Public Dental Service

    Directory of Open Access Journals (Sweden)

    Savanheimo Nora

    2012-10-01

    Full Text Available Abstract Background Dental general anaesthesia (DGA is a very efficient treatment modality, but is considered only in the last resort because of the risks posed by general anaesthesia to patients’ overall health. Health services and their treatment policies regarding DGA vary from country to country. The aims of this work were to determine the reasons for DGA in the Helsinki Public Dental Service (PDS and to assess the role of patient characteristics in the variation in reasons and in the treatments given with special focus on preventive care. Methods The data covered all DGA patients treated in the PDS in Helsinki in 2010. The data were collected from patient documents and included personal background: age ( Results The DGA patients (n=349 were aged 2.3 to 67.2 years. Immigrants predominated in the youngest age group (p Conclusions Extreme non-cooperation, dental fear and an excessive need for treatment were the main reasons for the use of comprehensive, conservative DGA in the Helsinki PDS. The reasons for the use of DGA and the treatments provided varied according to personal and medical background, and immigration status with no gender-differences. Preventive measures formed only a minor part of the dental care given under DGA.

  14. Spatially explicit models, generalized reproduction numbers and the prediction of patterns of waterborne disease

    Science.gov (United States)

    Rinaldo, A.; Gatto, M.; Mari, L.; Casagrandi, R.; Righetto, L.; Bertuzzo, E.; Rodriguez-Iturbe, I.

    2012-12-01

    Metacommunity and individual-based theoretical models are studied in the context of the spreading of infections of water-borne diseases along the ecological corridors defined by river basins and networks of human mobility. The overarching claim is that mathematical models can indeed provide predictive insight into the course of an ongoing epidemic, potentially aiding real-time emergency management in allocating health care resources and by anticipating the impact of alternative interventions. To support the claim, we examine the ex-post reliability of published predictions of the 2010-2011 Haiti cholera outbreak from four independent modeling studies that appeared almost simultaneously during the unfolding epidemic. For each modeled epidemic trajectory, it is assessed how well predictions reproduced the observed spatial and temporal features of the outbreak to date. The impact of different approaches is considered to the modeling of the spatial spread of V. cholera, the mechanics of cholera transmission and in accounting for the dynamics of susceptible and infected individuals within different local human communities. A generalized model for Haitian epidemic cholera and the related uncertainty is thus constructed and applied to the year-long dataset of reported cases now available. Specific emphasis will be dedicated to models of human mobility, a fundamental infection mechanism. Lessons learned and open issues are discussed and placed in perspective, supporting the conclusion that, despite differences in methods that can be tested through model-guided field validation, mathematical modeling of large-scale outbreaks emerges as an essential component of future cholera epidemic control. Although explicit spatial modeling is made routinely possible by widespread data mapping of hydrology, transportation infrastructure, population distribution, and sanitation, the precise condition under which a waterborne disease epidemic can start in a spatially explicit setting is

  15. The immune system, natural autoantibodies and general homeostasis in health and disease.

    Science.gov (United States)

    Poletaev, A; Boura, P

    2011-10-01

    It is generally accepted that the destination of the immune system is not only to discriminate between self and non-self but also to mount responses against non-self. During the last decades, it became evident that weak self-reactivity is a necessary condition for immune homeostasis. Natural self reactivity and the internal image created by autoantibodies, participate greatly to the maintenance of homeostasis. Under conditions of increased or altered antigenic pressure, the homeostatic status is disrupted and the organism becomes vulnerable to the emergence of diseases. "Immunculus" is the self-reactive and interconnected entity of the immune system, provided by a complicated network of natural autoantibobies of different specificity, as a mosaic picture. Quantitative changes in each part of the image are related to variations of expression of relative antigens. The immune system takes in account image information from the continuous screening of the antigenic status and compares between presented state and the desired (optimal) one. Substantial and prolonged deviations from the optimal state, triggers the induction of compensatory and reparative processes, aiming to restore molecular and functional homeostasis. So, natural autoimmunity through the ability of natural a-Abs to induce mechanisms of natural and acquired immunity, aims to prevent pathogenic processes and maintain or restore health status.

  16. [Severe asthmatic crisis during general anesthesia in a patient with IgG4 related disease].

    Science.gov (United States)

    Moriya, Machika; Oda, Shinya; Nakane, Masaki; Kawamae, Kaneyuki

    2014-04-01

    We experienced severe asthmatic crisis during general anesthesia in a 45-year-old man with IgG4-related disease, COPD and athma undergoing removal of submandibular gland. The ventilatiory failure was caused by the stimulation of the operation, sputum, and neostigmine. His serum IgG4 level was extremely high. IgG4 related disease is a recently emerging entity characterized by a diffuse or mass forming inflammatory reaction rich in IgG4-positive plasma cells associated with fibrosclerosis and obliterative phlebitis. It is associated with an elevated serum level of IgG4 and an allergic disease. We must be careful in perioperative management of the patients with IgG4-related disease because general anesthesia can induce asthmatic crisis.

  17. Effect of Governance Indicators on Under-Five Mortality in OECD Nations: Generalized Method of Moments.

    Science.gov (United States)

    Emamgholipour, Sara; Asemane, Zahra

    2016-01-01

    Today, it is recognized that factors other than health services are involved in health improvement and decreased inequality so identifying them is the main concern of policy makers and health authorities. The aim of this study was to investigate the effect of governance indicators on health outcomes. A panel data study was conducted to investigate the effect of governance indicators on child mortality rate in 27 OECD countries from 1996 to 2012 using the Generalized Method of Moments (GMM) model and EVIEWS.8 software. According to the results obtained, under-five mortality rate was significantly related to all of the research variables (p corruption and rule of law indicators decreased child mortality rate by 0.05 and 0.08%, respectively. Furthermore, 1% increase in public health expenditure per capita resulted in a 0.03% decrease in under-five mortality rate. The results of the study suggest that considering control variables, including GDP per capita, public health expenditure per capita, total fertility rate, and improvement of governance indicators (control of corruption and rule of law) would decrease the child mortality rate.

  18. Comparisons of receive array interference reduction techniques under erroneous generalized transmit beamforming

    KAUST Repository

    Radaydeh, Redha Mahmoud

    2014-02-01

    This paper studies generalized single-stream transmit beamforming employing receive array co-channel interference reduction algorithms under slow and flat fading multiuser wireless systems. The impact of imperfect prediction of channel state information for the desired user spatially uncorrelated transmit channels on the effectiveness of transmit beamforming for different interference reduction techniques is investigated. The case of over-loaded receive array with closely-spaced elements is considered, wherein it can be configured to specified interfering sources. Both dominant interference reduction and adaptive interference reduction techniques for statistically ordered and unordered interferers powers, respectively, are thoroughly studied. The effect of outdated statistical ordering of the interferers powers on the efficiency of dominant interference reduction is studied and then compared against the adaptive interference reduction. For the system models described above, new analytical formulations for the statistics of combined signal-to-interference-plus-noise ratio are presented, from which results for conventional maximum ratio transmission and single-antenna best transmit selection can be directly deduced as limiting cases. These results are then utilized to obtain quantitative measures for various performance metrics. They are also used to compare the achieved performance of various configuration models under consideration. © 1972-2012 IEEE.

  19. Office bladder distention with Electromotive Drug Administration (EMDA is equivalent to distention under General Anesthesia (GA

    Directory of Open Access Journals (Sweden)

    Azevedo Kathryn J

    2005-11-01

    Full Text Available Abstract Background Bladder distention is commonly used in diagnosis and treatment of interstitial cystitis (IC. Traditionally performed in the operating room under general or spinal anesthesia (GA, it is expensive and associated with short term morbidity. Office bladder distention using electromotive drug administration (EMDA has been suggested as an alternative that is well tolerated by patients. We report the first comparative findings of patients undergoing both office distention with EMDA and distention in the operating room (OR with GA. Methods This retrospective chart review identified 11 patients participating in two protocols of EMDA bladder distention who also underwent bladder distention under GA either prior to or after the EMDA procedure. Results The median absolute difference in bladder capacity between GA and EMDA was only 25 cc; the median percent difference was 5%. Cystoscopic findings, while not prospectively compiled, appear to have been similar. Conclusion This study represents the first comparison between distention with EMDA versus GA and confirms the technical feasibility of performing bladder distention in an office setting. The distention capacity achieved in the office was nearly identical to that in the OR and the cystoscopic findings very similar. Further investigation into the comparative morbidity, cost, and other outcome measures is warranted to define the ultimate role of EMDA bladder distention in the clinical evaluation and care of patients with IC.

  20. Characteristics of children undergoing dental extractions under general anaesthesia in Wolverhampton: 2007-2012.

    Science.gov (United States)

    Raja, A; Daly, A; Harper, R; Senghore, N; White, D; Ravaghi, V

    2016-04-22

    Studying characteristics of children requiring extractions under dental general anaesthesia (DGA) can help identify trends, which can be used to facilitate future planning of healthcare services. To report on the profile of children who underwent extractions under DGA between 2007 and 2012 at the New Cross Hospital in Wolverhampton, England.Methods Retrospective analyses of hospital records. Of the 2692 patients seen between 2007 and 2012, 49.6% were boys and 50.4% were girls. The mean age was 7.1 and 7 to 12 years was the largest age group (43%). The majority of the sample was White British (67%). Of the 8,286 teeth extracted, 85% were primary teeth and 15% permanent. More teeth were extracted in boys than girls (P = 0.002) and 'Other' ethnicities had a higher mean number of extractions compared to White British (P dental public health issue has been reinforced through the relatively high level of DGA activity reported. Though rigorous caries prevention remains the ultimate goal, a better assessment and discharge process may help reduce the need for first time DGAs as well as repeats.

  1. [Risk factors and frequency of postoperative nausea and vomiting in patients operated under general anesthesia].

    Science.gov (United States)

    Grabowska-Gaweł, Anna; Porzych, Katarzyna; Piskunowicz, Grazyna

    2006-01-01

    Postoperative nausea and vomiting belong to fairly frequent postoperative complications, but they occupy a distant position on the list of complications, which most probably result from a general conviction that they do not pose a direct threat to patients. The objective of this work is specification of factors facilitating occurrence of postoperative nausea and vomiting, and determination of frequency of their occurrence in patients operated under general anesthesia. Questionnaire about the occurrence of postoperative nausea and vomiting (PONV), was carried out and included 253 adult sick persons (102 female and 151 male patients), in the age between 23-76 (average 42.3 +/- 6.1 years), who had undergone operative procedure in the field of abdominal and urology surgery, orthopedic, thyroid surgery and laryngological, ophthalmology and plastic surgery, under general anesthesia. The questionnaire form included preoperative characteristics of a patient (age, sex, smoking, motion sickness and migraine headaches in history, and PONV occurring earlier), type of operative procedure, used anesthetic agents, and analgesic agents applied in postoperative analgesia. The anesthesiologist administering anesthetic was not informed about the investigation carried out and did not receive any additional pieces of advice regarding the type of applied anesthetic agents or the method of conducting postoperative analgesia. Visual Analogue Scale (VAS) was used in the evaluation of nausea. Nausea and vomiting were assessed every two hours within the first postoperative 12 hours and every 4 hours for the next 24 hours. Nausea and vomiting were treated as two separate complications. Nausea itself occurred in 22.7% of patients; whereas vomiting in 13.2%. Both symptoms occurred in 14.2% of patients. Nausea occurred 4.1 +/- 0.8 hours after operation; whereas vomiting after 5.3 +/- 1.1 hours. Women suffered more often than men from (R = 0.678 p patients suffering from PONV earlier (R = 0

  2. Ethnographic study of diarrhoeal diseases among under-five ...

    African Journals Online (AJOL)

    A cross-sectional design was employed to identify the local cosmology of childhood diarrhoea and its local treatment procedures. A total of 848 under-five children were identified by a quick inventory of randomly selected kebeles. Trained enumerators administered a pre-tested questionnaire in order to identify the ...

  3. A generalized-growth model to characterize the early ascending phase of infectious disease outbreaks

    OpenAIRE

    Viboud, C��cile; Simonsen, Lone; Chowell, Gerardo

    2016-01-01

    Background: A better characterization of the early growth dynamics of an epidemic is needed to dissect the important drivers of disease transmission, refine existing transmission models, and improve disease forecasts. Materials and methods: We introduce a 2-parameter generalized-growth model to characterize the ascending phase of an outbreak and capture epidemic profiles ranging from sub-exponential to exponential growth. We test the model against empirical outbreak data representing a var...

  4. Xanthelasmata, arcus corneae, and ischaemic vascular disease and death in general population: prospective cohort study

    OpenAIRE

    Christoffersen, Mette; Frikke-Schmidt, Ruth; Schnohr, Peter; Jensen, Gorm B; Nordestgaard, Børge G; Tybjærg-Hansen, Anne

    2011-01-01

    Objective To test the hypothesis that xanthelasmata and arcus corneae, individually and combined, predict risk of ischaemic vascular disease and death in the general population. Design Prospective population based cohort study. Setting The Copenhagen City Heart Study. Participants 12 745 people aged 20-93 years free of ischaemic vascular disease at baseline and followed from 1976-8 until May 2009 with 100% complete follow-up. Main outcome measures Hazard ratios for myocardial infarction, isch...

  5. Analysis of a general age-dependent vaccination model for a vertically transmitted disease

    International Nuclear Information System (INIS)

    El Doma, M.

    1995-05-01

    A SIR epidemic model of a general age-dependent vaccination for a vertically as well as horizontally transmitted disease is investigated when the total population is time dependent, and fertility, mortality and removal rates depend on age. We establish the existence and the uniqueness of the solution and obtain the asymptotic behaviour for the solution. For the steady state solution a critical vaccination coverage which will eventually eradicate the disease is determined. (author). 18 refs

  6. Under-reporting of notifiable infectious disease hospitalizations in a health board region in Ireland: room for improvement?

    LENUS (Irish Health Repository)

    Brabazon, E D

    2008-02-01

    Rapid notification of infectious diseases is essential for prompt public health action and for monitoring of these diseases in the Irish population at both a local and national level. Anecdotal evidence suggests, however, that the occurrence of notifiable infectious diseases is seriously underestimated. This study aims to assess the level of hospitalization for notifiable infectious diseases for a 6-year period in one health board region in Ireland and to assess whether or not there was any under-reporting during this period. All hospital in-patient admissions from 1997 to 2002 inclusive with a principal diagnosis relating to \\'infectious and parasitic diseases\\' (ICD codes 001-139) of residents from a health board region in Ireland were extracted from the Hospital In-Patient Enquiry System (HIPE). All notifiable infectious diseases were identified based on the 1981 Irish Infectious Disease Regulations and the data were analysed in the statistical package, JMP. These data were compared with the corresponding notification data. Analysis of the hospital in-patient admission data revealed a substantial burden associated with notifiable infectious diseases in this health board region: there were 2758 hospitalizations by 2454 residents, 17,034 bed days and 33 deaths. The statutory notification data comprises both general practitioner and hospital clinician reports of infectious disease. Therefore, only in cases where there are more hospitalizations than notifications can under-reporting be demonstrated. This occurred in nine out of 22 notifiable diseases and amounted to an additional 18% of notifications (or 572 cases) which were \\'missed\\' due to hospital clinician under-reporting. The majority of these under-reported cases were for viral meningitis (45%), infectious mononucleosis (27%), viral hepatitis C unspecified (15%) and acute encephalitis (5.8%). This study has highlighted the extent of under-reporting of hospitalized notifiable infectious diseases, in a

  7. Distrust As a Disease Avoidance Strategy: Individual Differences in Disgust Sensitivity Regulate Generalized Social Trust

    DEFF Research Database (Denmark)

    Aarøe, Lene; Osmundsen, Mathias; Petersen, Michael Bang

    2016-01-01

    Throughout human evolutionary history, cooperative contact with others has been fundamental for human survival. At the same time, social contact has been a source of threats. In this article, we focus on one particular viable threat, communicable disease, and investigate how motivations to avoid ...... social trust. We furthermore compare the effects of pathogen disgust sensitivity on generalized social trust and outgroup prejudice and explore whether generalized social trust to some extent constitutes a pathway between pathogen avoidance motivations and prejudice....

  8. The fitting of general force-of-infection models to wildlife disease prevalence data

    Science.gov (United States)

    Heisey, D.M.; Joly, D.O.; Messier, F.

    2006-01-01

    Researchers and wildlife managers increasingly find themselves in situations where they must deal with infectious wildlife diseases such as chronic wasting disease, brucellosis, tuberculosis, and West Nile virus. Managers are often charged with designing and implementing control strategies, and researchers often seek to determine factors that influence and control the disease process. All of these activities require the ability to measure some indication of a disease's foothold in a population and evaluate factors affecting that foothold. The most common type of data available to managers and researchers is apparent prevalence data. Apparent disease prevalence, the proportion of animals in a sample that are positive for the disease, might seem like a natural measure of disease's foothold, but several properties, in particular, its dependency on age structure and the biasing effects of disease-associated mortality, make it less than ideal. In quantitative epidemiology, the a??force of infection,a?? or infection hazard, is generally the preferred parameter for measuring a disease's foothold, and it can be viewed as the most appropriate way to a??adjusta?? apparent prevalence for age structure. The typical ecology curriculum includes little exposure to quantitative epidemiological concepts such as cumulative incidence, apparent prevalence, and the force of infection. The goal of this paper is to present these basic epidemiological concepts and resulting models in an ecological context and to illustrate how they can be applied to understand and address basic epidemiological questions. We demonstrate a practical approach to solving the heretofore intractable problem of fitting general force-of-infection models to wildlife prevalence data using a generalized regression approach. We apply the procedures to Mycobacterium bovis (bovine tuberculosis) prevalence in bison (Bison bison) in Wood Buffalo National Park, Canada, and demonstrate strong age dependency in the force of

  9. NOX Activation by Subunit Interaction and Underlying Mechanisms in Disease.

    Science.gov (United States)

    Rastogi, Radhika; Geng, Xiaokun; Li, Fengwu; Ding, Yuchuan

    2016-01-01

    Nicotinamide adenine dinucleotide phosphate (NAPDH) oxidase (NOX) is an enzyme complex with the sole function of producing superoxide anion and reactive oxygen species (ROS) at the expense of NADPH. Vital to the immune system as well as cellular signaling, NOX is also involved in the pathologies of a wide variety of disease states. Particularly, it is an integral player in many neurological diseases, including stroke, TBI, and neurodegenerative diseases. Pathologically, NOX produces an excessive amount of ROS that exceed the body's antioxidant ability to neutralize them, leading to oxidative stress and aberrant signaling. This prevalence makes it an attractive therapeutic target and as such, NOX inhibitors have been studied and developed to counter NOX's deleterious effects. However, recent studies of NOX have created a better understanding of the NOX complex. Comprised of independent cytosolic subunits, p47- phox , p67- phox , p40- phox and Rac , and membrane subunits, gp91- phox and p22- phox , the NOX complex requires a unique activation process through subunit interaction. Of these subunits, p47- phox plays the most important role in activation, binding and translocating the cytosolic subunits to the membrane and anchoring to p22- phox to organize the complex for NOX activation and function. Moreover, these interactions, particularly that between p47- phox and p22- phox , are dependent on phosphorylation initiated by upstream processes involving protein kinase C (PKC). This review will look at these interactions between subunits and with PKC. It will focus on the interaction involving p47- phox with p22- phox , key in bringing the cytosolic subunits to the membrane. Furthermore, the implication of these interactions as a target for NOX inhibitors such as apocynin will be discussed as a potential avenue for further investigation, in order to develop more specific NOX inhibitors based on the inhibition of NOX assembly and activation.

  10. Diagnosis of rare diseases under focus: impacts for Canadian patients.

    Science.gov (United States)

    Esquivel-Sada, Daphne; Nguyen, Minh Thu

    2018-01-01

    This paper presents an in-depth qualitative analysis of the impact of diagnosis on the lives of rare disease (RD) patients. While diagnosis may be described as a watershed step for RD patients, no extensive account of non-medical outcomes following a RD diagnosis exists within the literature. This study aims to fill this knowledge gap through an analysis of the impact of diagnosis on the lives of RD patients according to their personal experiences. Qualitative research was conducted in three provinces across Canada, with a total of 23 participants, both adult and parents of children with RD, diagnosed and not yet diagnosed. A thematic approach guided the analysis of the transcripts. The results reveal that the impacts of a RD diagnosis for both adults and paediatric patients are multifold, ranging from social to personal and medical impacts (including cases where etiological treatments for the diseases are non-existent). Furthermore, the results shed light on distinct factors that affect the scope of impacts of a diagnosis.

  11. Variation in examination and treatment offers to patients with allergic diseases in general practice

    DEFF Research Database (Denmark)

    Hansen, Dorte Gilså; Jarbøl, Dorte Ejg; Munck, Anders Peter

    2010-01-01

    disorders. SETTING: General practice in Denmark. RESULTS: In 2005, 895 (64.3%) of 1391 randomly selected general practitioners (GPs) participated in this survey. The extent of treatment offered and the involvement of staff were strongly associated with having a nurse on the practice team. Guideline...... recommendations for preparedness for anaphylactic shock in connection with allergy vaccine therapy were not fully implemented. CONCLUSION: General practice is substantially involved in the examination and treatment of patients with allergic diseases. There is room for further involvement of staff members...

  12. Kidney Disease and Youth Onset Type 2 Diabetes: Considerations for the General Practitioner

    Directory of Open Access Journals (Sweden)

    Allison B. Dart

    2012-01-01

    Full Text Available Youth onset type 2 diabetes (T2DM continues to increase worldwide, concomitant with the rising obesity epidemic. There is evidence to suggest that youth with T2DM are affected by the same comorbidities and complications as adults diagnosed with T2DM. This review highlights specifically the kidney disease associated with youth onset T2DM, which is highly prevalent and associated with a high risk of end-stage kidney disease in early adulthood. A general understanding of this complex disease by primary care providers is critical, so that at-risk individuals are identified and managed early in the course of their disease, such that progression can be modified in this high-risk group of children and adolescents. A review of the pediatric literature will include a focus on the epidemiology, risk factors, pathology, screening, and treatment of kidney disease in youth onset T2DM.

  13. High frequency of intermediate alleles on Huntington disease-associated haplotypes in British Columbia's general population.

    Science.gov (United States)

    Semaka, Alicia; Kay, Chris; Doty, Crystal N; Collins, Jennifer A; Tam, Natalie; Hayden, Michael R

    2013-12-01

    Intermediate alleles (27-35 CAG, IAs) for Huntington disease (HD) usually do not confer the disease phenotype but are prone to CAG repeat instability. Consequently, offspring are at-risk of inheriting an expanded allele in the HD range (≥36 CAG). IAs that expand into a new mutation have been hypothesized to be more susceptible to instability compared to IAs identified on the non-HD side of a family from the general population. Frequency estimates for IAs are limited and have largely been determined using clinical samples of HD or related disorders, which may result in an ascertainment bias. This study aimed to establish the frequency of IAs in a sample of a British Columbia's (B.C.) general population with no known association to HD and examine the haplotype of new mutation and general population IAs. CAG sizing was performed on 1,600 DNA samples from B.C.'s general population. Haplotypes were determined using 22 tagging SNPs across the HTT gene. 5.8% of individuals were found to have an IA, of which 60% were on HD-associated haplotypes. There was no difference in the haplotype distribution of new mutation and general population IAs. These findings suggest that IAs are relatively frequent in the general population and are often found on haplotypes associated with expanded CAG lengths. There is likely no difference in the propensity of new mutation and general population IAs to expand into the disease range given that they are both found on disease-associated haplotypes. These findings have important implications for clinical practice. © 2013 Wiley Periodicals, Inc.

  14. WrpA Is an Atypical Flavodoxin Family Protein under Regulatory Control of the Brucella abortus General Stress Response System.

    Science.gov (United States)

    Herrou, Julien; Czyż, Daniel M; Willett, Jonathan W; Kim, Hye-Sook; Chhor, Gekleng; Babnigg, Gyorgy; Kim, Youngchang; Crosson, Sean

    2016-04-01

    The general stress response (GSR) system of the intracellular pathogen Brucella abortus controls the transcription of approximately 100 genes in response to a range of stress cues. The core genetic regulatory components of the GSR are required for B. abortus survival under nonoptimal growth conditions in vitro and for maintenance of chronic infection in an in vivo mouse model. The functions of the majority of the genes in the GSR transcriptional regulon remain undefined. bab1_1070 is among the most highly regulated genes in this regulon: its transcription is activated 20- to 30-fold by the GSR system under oxidative conditions in vitro. We have solved crystal structures of Bab1_1070 and demonstrate that it forms a homotetrameric complex that resembles those of WrbA-type NADH:quinone oxidoreductases, which are members of the flavodoxin protein family. However, B. abortus WrbA-related protein (WrpA) does not bind flavin cofactors with a high affinity and does not function as an NADH:quinone oxidoreductase in vitro. Soaking crystals with flavin mononucleotide (FMN) revealed a likely low-affinity binding site adjacent to the canonical WrbA flavin binding site. Deletion of wrpA (ΔwrpA) does not compromise cell survival under acute oxidative stress in vitro or attenuate infection in cell-based or mouse models. However, a ΔwrpA strain does elicit increased splenomegaly in a mouse model, suggesting that WrpA modulates B. abortus interaction with its mammalian host. Despite high structural homology with canonical WrbA proteins, we propose that B. abortus WrpA represents a functionally distinct member of the diverse flavodoxin family. Brucella abortus is an etiological agent of brucellosis, which is among the most common zoonotic diseases worldwide. The general stress response (GSR) regulatory system of B. abortus controls the transcription of approximately 100 genes and is required for maintenance of chronic infection in a murine model; the majority of GSR-regulated genes

  15. [Perioperative management of a morbidly obese pregnant patient undergoing cesarean section under general anesthesia - case report].

    Science.gov (United States)

    Benevides, Márcio Luiz; Brandão, Verônica Cristina Moraes; Lovera, Jacqueline Ivonne Arenas

    2016-01-01

    The increased prevalence of obesity in the general population extends to women of reproductive age. The aim of this study is to report the perioperative management of a morbidly obese pregnant woman, body mass index > 50 kg/m(2), who underwent cesarean section under general anesthesia. Pregnant woman in labor, 35 years of age, body mass index 59.8 kg/m(2). Caesarean section was indicated due to the presumed fetal macrosomia. The patient refused spinal anesthesia. She was placed in the ramp position with cushions from back to head to facilitate tracheal intubation. Another cushion was placed on top of the right gluteus to create an angle of approximately 15° to the operating table. Immediately before induction of anesthesia, asepsis was carried out and sterile surgical fields were placed. Anesthesia was induced in rapid sequence, with Sellick maneuver and administration of remifentanil, propofol, and succinilcolina. Intubation was performed using a gum elastic bougie, and anesthesia was maintained with sevoflurane and remifentanil. The interval between skin incision and fetal extraction was 21 minutes, with the use of a Simpson's forceps scoop to assist in the extraction. The patient gave birth to a newborn weighing 4850 g, with Apgar scores of 2 in the 1(st) minute (received positive pressure ventilation by mask for about 2 minutes) and 8 in the 5(th) minute. The patient was extubated uneventfully. Multimodal analgesia and prophylaxis of nausea and vomiting was performed. Mother and newborn were discharged on the 4(th) postoperative day. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  16. Perioperative management of a morbidly obese pregnant patient undergoing cesarean section under general anesthesia - case report.

    Science.gov (United States)

    Benevides, Márcio Luiz; Brandão, Verônica Cristina Moraes; Lovera, Jacqueline Ivonne Arenas

    2016-01-01

    The increased prevalence of obesity in the general population extends to women of reproductive age. The aim of this study is to report the perioperative management of a morbidly obese pregnant woman, body mass index >50kg/m(2), who underwent cesarean section under general anesthesia. Pregnant woman in labor, 35 years of age, body mass index 59.8kg/m(2). Cesarean section was indicated due to the presumed fetal macrosomia. The patient refused spinal anesthesia. She was placed in the ramp position with cushions from back to head to facilitate tracheal intubation. Another cushion was placed on top of the right gluteus to create an angle of approximately 15° to the operating table. Immediately before induction of anesthesia, asepsis was carried out and sterile surgical fields were placed. Anesthesia was induced in rapid sequence, with Sellick maneuver and administration of remifentanil, propofol, and succinilcolina. Intubation was performed using a gum elastic bougie, and anesthesia was maintained with sevoflurane and remifentanil. The interval between skin incision and fetal extraction was 21min, with the use of a Simpson's forceps scoop to assist in the extraction. The patient gave birth to a newborn weighing 4850g, with Apgar scores of 2 in the 1st minute (received positive pressure ventilation by mask for about 2min) and 8 in the 5th minute. The patient was extubated uneventfully. Multimodal analgesia and prophylaxis of nausea and vomiting was performed. Mother and newborn were discharged on the 4th postoperative day. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  17. Electroconvulsive Therapy Under General Anesthesia With Cisatracurium, Laryngeal Mask Airways, and Bispectral Index.

    Science.gov (United States)

    Liu, Cai-Cai; Qian, Xiao-Yan; An, Jian-Xiong; Yu, Zeng-Lei; Wu, Jian-Ping; Wen, Hui; Cao, Zong-Xin; Wang, Yong; Fang, Qi-Wu; Williams, John P

    2016-03-01

    Electroconvulsive therapy (ECT) has dramatically reduced musculoskeletal complications when carried out with muscle relaxants under general anesthesia. However, seizure quality can be affected by the depth of anesthesia and choice of anesthetic agent. The purpose of this study was to describe a general anesthetic technique for ECT by using laryngeal mask, bispectral index (BIS), and muscle relaxant monitoring. Twenty-one patients, between ages 18 and 70 years (American Society of Anesthesiologists physical status I-III), who underwent a total of 89 sessions of ECT were examined in a retrospective study. Anesthesia was induced by use of propofol (1.0 mg/kg) followed by cisatracurium (0.2 mg/kg). The BIS, train-of-four, and end-tidal carbon dioxide were all monitored continuously. A laryngeal mask airway was used to maintain and protect the airway during the procedure. Electroconvulsive therapy stimuli were applied bilaterally when the train-of-four was assessed as being zero and BIS scores were 70. All patients then received 5 μg sufentanil and 2 mg midazolam, while titrated to maintain the BIS value at 40 to 50, before the muscle relaxation exhibited complete recovery. The mean duration of treatment process takes approximately 82.5 minutes. Mean (SD) seizure length was 58.8 (28.3) seconds, with 4.5% incidence of restimulation per treatment. Incidence of awareness was 0%. No patients exhibited delirium, nausea, vomiting, or myalgia in the postseizure phase. Bispectral index monitoring of the depth of anesthesia may have improved seizure quality, and awareness did not occur.

  18. Perioperative management of a morbidly obese pregnant patient undergoing cesarean section under general anesthesia - case report

    Directory of Open Access Journals (Sweden)

    Márcio Luiz Benevides

    Full Text Available Abstract Background and objectives: The increased prevalence of obesity in the general population extends to women of reproductive age. The aim of this study is to report the perioperative management of a morbidly obese pregnant woman, body mass index >50 kg/m2, who underwent cesarean section under general anesthesia. Case report: Pregnant woman in labor, 35 years of age, body mass index 59.8 kg/m2. Cesarean section was indicated due to the presumed fetal macrosomia. The patient refused spinal anesthesia. She was placed in the ramp position with cushions from back to head to facilitate tracheal intubation. Another cushion was placed on top of the right gluteus to create an angle of approximately 15° to the operating table. Immediately before induction of anesthesia, asepsis was carried out and sterile surgical fields were placed. Anesthesia was induced in rapid sequence, with Sellick maneuver and administration of remifentanil, propofol, and succinilcolina. Intubation was performed using a gum elastic bougie, and anesthesia was maintained with sevoflurane and remifentanil. The interval between skin incision and fetal extraction was 21 min, with the use of a Simpson's forceps scoop to assist in the extraction. The patient gave birth to a newborn weighing 4850 g, with Apgar scores of 2 in the 1st minute (received positive pressure ventilation by mask for about 2 min and 8 in the 5th minute. The patient was extubated uneventfully. Multimodal analgesia and prophylaxis of nausea and vomiting was performed. Mother and newborn were discharged on the 4th postoperative day.

  19. A retrospective analysis of episodes of single tooth extraction under general anaesthesia for adults.

    Science.gov (United States)

    Hong, B; Birnie, A

    2016-01-15

    To investigate the provision of adult dental extraction under general anaesthesia (DGA) at the Royal Cornwall Hospitals NHS Trust (RCHT)-- specifically adult single tooth DGA episodes in regards to numbers, demographics, justifications, and appropriateness regarding the use of resources. Data were collected retrospectively from the patient case notes and electronic records for the complete study cohort. This study included all episodes of adult single tooth DGA in all RCHT sites during 2014, except for mandibular third molar and impacted teeth. Each case was tested against the DGA case selection criteria empirically devised for this study. In 2014, 106 episodes of adult single tooth DGA were carried out in RCHT that met the inclusion criteria. Younger females from more socio-economically deprived areas of Cornwall were increasingly likely to have this procedure. Mental disorders were the most prevalent co-morbidity (21.7%) in this cohort. The vast majority of patients (93.4%) had previously tolerated dental treatment without the need for general anaesthesia (GA). Many referrals (46.2%) and listings (30.2%) specifically stated patient demand-driven reasons. None of the cohort had DGA due to failure of sedation. There were potentially 11 episodes that met the DGA case selection criteria. Patients waited for 126 days (median) from the referral date for an operation which took seven minutes (median) to complete. The majority (83%) of the cases were simple exodontia. Twenty patients (18.9%) had previous DGA. Potentially a considerable proportion of GA prescription appeared to be driven by patient demand rather than clinical need. This study poses a fundamental question--what drives the demand for DGA? National data collection and specific DGA case selection criteria are recommended.

  20. [Results of 30 children treated under dental general anesthesia in pediatric dentistry].

    Science.gov (United States)

    Chen, Xu; Liu, Yao; Jin, Shi-fu; Zhang, Qian; Jin, Xuan-yu

    2008-12-01

    To determine the age and sex characteristics of the children and type of dental procedures performed under dental general anesthesia (DGA) and to assess the results after six months to one year's follow-up. A sample of 30 patients treated under dental general anesthesia (DGA) during 2006-2007 in the Department of Pediatric Dentistry of China Medical University was reviewed. All the teeth were treated one time. The dental procedures performed included caries restoration, indirect pulp capping, pulpotomy, root canal therapy (RCT) and dental extraction. Oral prophylaxis and topical fluoride applications were performed on all teeth. Pit and fissure sealing was performed on all healthy premolars and molars. SPSS10.0 software package was used for statistical analysis. Chi-square test was used to analyze the difference of the sex distribution in different age group and the difference of dental procedures performed between the primary teeth and the permanent teeth. The age of the patients ranged from 19 months to 14 years. The mental retardation patients accounted for 10% and mental healthy patients accounted for 90% of the sample studied. Males were more than females with the ratio about 2 to 1 in each age group. The dental procedures performed were caries restoration (18.67%), indirect pulp capping (23.26%), pulpotomy (0.77%), RCT (29.16%), dental extractions (2.05%) and fissure sealants (26.09%). The percentage of RCT was higher than that of caries restoration in the primary teeth, whereas the result was opposite as for the permanent teeth as indicated by Chi-square test (X(2)=11.630, P=0.001). New dental caries was not found except 2 patients who suffered from dysnoesia and were not cooperative to have regular examination. Fillings were lost in 3 cases, with 3 anterior teeth and 2 posterior teeth after RCT. All the children could cooperate except two mental retardation patients during the follow-up visit. Caries restoration and RCT are the most frequently performed

  1. Oscar Renda Contracting Inc.: Request for Coverage under the Stone Quarrying, Crushing and Screening Facilities General Permit

    Science.gov (United States)

    Request for Coverage under Stone Quarrying, Crushing and Screening Facilities General Permit for Oscar Renda Contracting Inc. portable crushing operation used to process material to a pipeline project near US HWY 491 between Twin Lakes and Naschitti, NM.

  2. Improving prediction of ischemic cardiovascular disease in the general population using apolipoprotein B

    DEFF Research Database (Denmark)

    Benn, M; Nordestgaard, B; Jensen, Gorm Boje

    2007-01-01

    events than low-density lipoprotein cholesterol. Methods and Results- We studied 9231 asymptomatic women and men from the Danish general population followed prospectively for 8 years and observed the following incident events: ischemic heart disease 591, myocardial infarction 278, ischemic...

  3. Experience of aging in patients with rheumatic disease: A comparison with the general population

    NARCIS (Netherlands)

    Bode, Christina; Taal, Erik; Westerhof, Gerben Johan; van Gessel, L.; van de Laar, Mart A F J

    2012-01-01

    Objectives: Self-perceptions of aging have been shown to predict mental and physical health and even longevity. This study examined the aging perceptions of patients with rheumatic disease and compared them with the general Dutch population. Methods: Consecutive patients visiting a rheumatology

  4. Implementation of selective prevention for cardiometabolic diseases; is general practice adequately prepared ?

    NARCIS (Netherlands)

    Stol, D.M.; Hollander, M.; Nielen, M.M.J.; Badenbroek, I.F.; Schellevis, F.G.; Wit, N.J. de

    2018-01-01

    Objective: Current guidelines acknowledge the need for cardiometabolic disease (CMD) prevention and recommend five-yearly screening of a targeted population. In recent years programs for selective CMD-prevention have been developed, but implementation is challenging. The question arises if general

  5. Variation in examination and treatment offers to patients with allergic diseases in general practice

    DEFF Research Database (Denmark)

    Hansen, Dorte Gilså; Jarbøl, Dorte Ejg; Munck, Anders Peter

    2010-01-01

    recommendations for preparedness for anaphylactic shock in connection with allergy vaccine therapy were not fully implemented. CONCLUSION: General practice is substantially involved in the examination and treatment of patients with allergic diseases. There is room for further involvement of staff members...

  6. Stability analysis of a general age-dependent vaccination model of a vertically transmitted disease

    International Nuclear Information System (INIS)

    El Doma, M.

    1995-07-01

    An SIR epidemic model of a general age-dependent vaccination of a vertically as well as horizontally transmitted disease is investigated when the population is in steady state and the fertility, mortality and removal rates depends on age. We determine the steady states and examine their stabilities. (author). 24 refs

  7. An Experience of General Anesthesia in a Case of Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Sinan Yılmaz

    2017-08-01

    Full Text Available Parkinson's disease (PD is a neurodegenerative disease which is resulted from loss of dopaminergic neurones in the substantia nigra of the basal ganglia and is a characterized by the triad of resting tremor, muscle rigidity, and bradykinesia. PD is an important cause of perioperative morbidity and a major risk factor for postoperative complications in the elderly surgical patients. In these patients, the postoperative risks are determined with the presence of additional diseases, interaction of antiparkinsonian medication and anesthesic drugs. In the patients with PD, general anesthesia may mask neurological symptoms in the intraoperative period so the general anesthesia is preferred in these patients. Randomized clinical trials about the preference of anesthetic technique in the PD are not enough. Premedication, induction and continuation of anesthesia, and drugs for postoperative pain must not affect the dopamine senthesis. Treated for PD for 8 year at the age of 73, a female patient and with American Society of Anesthesiologists physical classification III (chronic kidney disease and chronic obstructive lung disease was planned for undergoing operation of L4 fracture. In this case, we aimed to report a patient with PD who underwent general anesthesia. During the operation hemodynamic data was stable and the operation was successfully carried out without any complication.

  8. Evaluation of Stress Response During Mesiodens Extraction Under General Anesthesia Using Heart Rate Variability.

    Science.gov (United States)

    Hwang, Hye-Won; Hyun, Hong-Keun; Kim, Young-Jae; Kim, Jung-Wook; Shin, Teo Jeon

    2017-05-01

    Stress related to dental treatment can be associated with negative outcomes. Heart rate variability (HRV) is an objective measurement of autonomic nervous system activity. Therefore, HRV was used to identify autonomic nervous system reactions during mesiodens extraction under general anesthesia in children. Electrocardiography was performed with customized software during treatment. HRV parameters were analyzed according to time and frequency domains during each dental procedure (local anesthesia, incision, flap, bone removal, extraction of mesiodens, and suturing). The relations of HRV parameters to age also were determined. Total autonomic nervous system activity decreased markedly after local anesthesia injection. Depending on the responses of sympathetic nerve activity, patients were categorized in a stress group and a nonstress group. The ratio of low-frequency power (LF) to high-frequency power (HF), an indication of sympathetic and parasympathetic balance, increased in the stress group after incision and flap formation. Conversely, the LF/HF ratio decreased during treatment in the nonstress group. However, HR, widely used to evaluate stress responses, did not change statistically during mesiodens extraction in either group. HRV parameters did not differ statistically according to age. The internal stress related to mesiodens extraction can be evaluated more objectively with HRV parameters than with conventional methods. Sympathetic nerve activity in the stress group differed from that in the nonstress group during the treatment procedures. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Novel approach of medialization thyroplasty with arytenoid adduction performed under general anesthesia with a laryngeal mask.

    Science.gov (United States)

    Stow, Nicholas W; Lee, Jennifer W; Cole, Ian E

    2012-02-01

    To objectively assess the voice outcomes of patients with unilateral vocal fold paralysis treated with medialization thyroplasty and arytenoid adduction suture. Case series of patients who underwent medialization thyroplasty and arytenoid adduction suture. Preoperative and postoperative voice testing was performed and the data were compared by statistical analysis. Tertiary referral teaching hospital in Sydney, Australia. All patients had a unilateral vocal fold paralysis, with a large posterior glottic gap and vocal symptoms affecting their quality of life. Thirteen patients with a diagnosis of a unilateral vocal fold paralysis with a large posterior glottic gap, vocal symptoms, and total denervation of the vocal fold underwent medialization thyroplasty and arytenoid adduction suture. The surgery was performed in a novel method under a general anesthetic using a laryngeal mask and with direct intraoperative endoscopic feedback. Preoperative and postoperative measures of voice performance were compared, including acoustic analysis (fundamental frequency, speech intensity against quiet and loud background noise, speech rate) and aerodynamic assessment (airflow, maximum phonation time). Medialization thyroplasty with arytenoid adduction suture significantly improved aerodynamic assessment and phonation duration for both male and female subjects overall. There were 2 of 13 treatment failures. Median follow-up time was 6 months. Preliminary results indicate that in selected patients with vocal fold paralysis, medialization thyroplasty with arytenoid adduction suture leads to significant improvements in objective voice measures. Longer follow-up data are required to further quantify the voice outcomes after this procedure.

  10. Mission reliability of semi-Markov systems under generalized operational time requirements

    International Nuclear Information System (INIS)

    Wu, Xiaoyue; Hillston, Jane

    2015-01-01

    Mission reliability of a system depends on specific criteria for mission success. To evaluate the mission reliability of some mission systems that do not need to work normally for the whole mission time, two types of mission reliability for such systems are studied. The first type corresponds to the mission requirement that the system must remain operational continuously for a minimum time within the given mission time interval, while the second corresponds to the mission requirement that the total operational time of the system within the mission time window must be greater than a given value. Based on Markov renewal properties, matrix integral equations are derived for semi-Markov systems. Numerical algorithms and a simulation procedure are provided for both types of mission reliability. Two examples are used for illustration purposes. One is a one-unit repairable Markov system, and the other is a cold standby semi-Markov system consisting of two components. By the proposed approaches, the mission reliability of systems with time redundancy can be more precisely estimated to avoid possible unnecessary redundancy of system resources. - Highlights: • Two types of mission reliability under generalized requirements are defined. • Equations for both types of reliability are derived for semi-Markov systems. • Numerical methods are given for solving both types of reliability. • Simulation procedure is given for estimating both types of reliability. • Verification of the numerical methods is given by the results of simulation

  11. The p - n junction under nonuniform strains: general theory and application to photovoltaics

    Science.gov (United States)

    Guin, L.; Jabbour, M. E.; Triantafyllidis, N.

    2018-01-01

    It is well known that mechanical strains influence the electronic properties of semiconductor devices. Modeling the fully coupled mechanical, electrical, and electronic responses of semiconductors is therefore essential for predicting the effects of mechanical loading on their overall electronic response. In the first part of this paper, we develop a general continuum model that couples the mechanical, electrical, and electronic responses of a finitely deformable semiconductor. The proposed model accounts for the dependence of the band edge energies, densities of states, and electronic mobilities on strain. The governing equations are derived from the basic principles of the thermomechanics of electromagnetic continua undergoing electronic transport. In particular, we find that there exists electronically induced strains that can exceed their electromagnetic (Maxwell) counterparts by an order of magnitude. In the second part, motivated by applications that involve the bending of a photovoltaic cell, we use asymptotic methods to compute the current-voltage characteristic of a p - n junction under nonuniform strains. We find that, for a typical monocrystalline silicon solar cell, the changes in dark current are significant, i.e., of the order of 20% for strains of 0.2%.

  12. Differences in pediatric dental services under general anesthesia for Medicaid and military dependent children.

    Science.gov (United States)

    Johnson, M B; Cappelli, D P; Bradshaw, B S; Mabry, J C

    2010-01-01

    This study's purpose was to compare pediatric dental services provided for Medicaid and military dependent children to determine if differences in dental treatment choices exist based on site and payment method. Subjects included 120 Medicaid patients at the University of Texas Health Science Center at San Antonio and 120 military dependents at Lackland Air Force Base, Texas. Demographic data and treatment information were abstracted for children younger than 6 years old receiving dental treatment under general anesthesia between 2002 and 2006. Data was analyzed using Wilcoxon rank sum, Kruskal-Wallis, and Fisher's exact tests. The Medicaid recipients were younger (40.2 vs 49.8 months, Psealants (P<.001). Age and gender did not affect decay rates, but those of Hispanic ethnicity did experience more decay than non-Hispanics (9.5 vs 8.6, P=.02). This study found no difference in the number of less conservative, albeit more costly, procedures performed with Medicaid children at a university compared to military dependents at a military base.

  13. Patients with special needs within treatment under general anesthesia - meta-analysis.

    Science.gov (United States)

    Stanková, M; Buček, A; Dostálová, T; Ginzelová, K; Pacáková, Z; Seydlová, M

    2011-01-01

    The study evaluates results obtained from the documentation of patients with special needs, who have undergone treatment under general anesthesia at the pediatric dentistry department. DMFT (decayed, missing, filled teeth) was used for comparison. A sample of 1,836 children from our dental clinic was evaluated. The sample was divided into two groups - special patient and disabled patient populations. A group of 5 years old children was chosen on the bases of WHO guidelines for the setting of the oral health status. A descriptive statistical analysis of the mean standard deviation was conducted with a focus on three factors: sex, age and year. A questionnaire was prepared to compare the oral health habits in the families of the patients. A literary review was conducted to compare the results with other studies from various countries. The meta-analysis using the software MedCalc was done. The DMFT of the patient was counted (disabled DMFT 11.05 - SD 4.82, special patient population 8.8 - SD 3.7) and the descriptive statistics mean standard deviation was calculated. The significant difference between the DMFT of disabled patient and special patient population was exerted (pspecial needs children is worse than in other countries.

  14. Does generalized anxiety disorder predict coronary heart disease risk factors independently of major depressive disorder?

    Science.gov (United States)

    Barger, Steven D; Sydeman, Sumner J

    2005-09-01

    Anxiety symptoms are associated with elevated coronary heart disease (CHD) risk, but it is not known whether such associations extend to anxiety disorders or if they are independent of depression. We sought to determine if generalized anxiety disorder is associated with elevated CHD risk, and whether this association is independent of or interacts with major depressive disorder. Generalized anxiety and major depressive disorders were assessed in a cross-sectional survey of a representative sample of U.S. adults aged 25-74 (N=3032). Coronary heart disease risk was determined by self-reported smoking status, body mass index, and recent medication use for hypertension, hypercholesterolemia, and diabetes. Generalized anxiety disorder independently predicted increased CHD risk (F(1,3018)=5.14; b=0.39; 95% confidence interval (0.05-0.72)) and tended to denote the greatest risk in the absence of major depressive disorder. The cross-sectional design cannot determine the causal direction of the association. Generalized anxiety disorder appears to be associated with elevated CHD risk in the general population. It may denote excess CHD risk relative to major depressive disorder, and clinicians should consider CHD risk when treating generalized anxiety disorder.

  15. Disease course and management strategy of pouch neoplasia in patients with underlying inflammatory bowel diseases.

    Science.gov (United States)

    Wu, Xian-Rui; Remzi, Feza H; Liu, Xiu-Li; Lian, Lei; Stocchi, Luca; Ashburn, Jean; Shen, Bo

    2014-11-01

    To evaluate the disease course and management strategy for pouch neoplasia. Patients undergoing ileal pouch surgery for underlying ulcerative colitis who developed low-grade dysplasia (LGD), high-grade dysplasia, or adenocarcinoma in the pouch were identified. All eligible 44 patients were evaluated. Of the 22 patients with initial diagnosis of pouch LGD, 6 (27.3%) had persistence or progression after a median follow-up of 9.5 (4.1-17.6) years. Family history of colorectal cancer was shown to be a risk factor associated with persistence or progression of LGD (P = 0.03). Of the 12 patients with pouch high-grade dysplasia, 5 (41.7%) had a history of (n = 2, 16.7%) or synchronous (n = 4, 33.3%) pouch LGD. Pouch high-grade dysplasia either persisted or progressed in 3 patients (25.0%) after the initial management, during a median time interval of 5.4 (2.2-9.2) years. Of the 14 patients with pouch adenocarcinoma, 12 (85.7%) had a history of (n = 2, 14.3%) or synchronous dysplasia (n = 12, 85.7%). After a median follow-up of 2.1 (0.6-5.2) years, 6 patients with pouch cancer (42.9%) died. Comparison of patients with a final diagnosis of pouch adenocarcinoma (14, 32.6%), and those with dysplasia (29, 67.4%) showed that patients with adenocarcinoma were older (P = 0.04) and had a longer duration from IBD diagnosis or pouch construction to the detection of pouch neoplasia (P = 0.007 and P = 0.0013). The risk for progression of pouch dysplasia can be stratified. The presence of family history of colorectal cancer seemed to increase the risk for persistence or progression for patients with pouch LGD. The prognosis for pouch adenocarcinoma was poor.

  16. Prevalence of Periodontal Disease in the General Population of India-A Systematic Review.

    Science.gov (United States)

    Shewale, Akhilesh H; Gattani, Deepti R; Bhatia, Nidhi; Mahajan, Rupali; Saravanan, S P

    2016-06-01

    Periodontal disease is a chronic inflammatory disease resulting in destruction of tissues and structures surrounding the teeth thus, if left untreated causes loss of teeth and ultimately results in edentulism, posing a great negative impact on individuals' quality of life. Hence the global epidemiological data suggests periodontal disease to be one of a major burden on oral diseases. To reduce this burden it is necessary to know the true prevalence of the disease according to which proper initiatives can be formulated. India being home to nearly 1.2 billion people and one amongst the rapidly developing country, its population requires being systemically as well as orally healthy to lead a good quality of life. However due to large heterogenecity amongst its residing population in terms of geographical area, culture, education, socioeconomic status, a variety of oral diseases like periodontal diseases are prevalent here. Even though the early studies suggested that the population is highly susceptible to the disease, the true prevalence of periodontal disease has not been found yet due to paucity in literature available. To systematically review the available literature taken from various parts of India and find the prevalence rate of periodontal disease amongst the general population of India. A literature search was performed using PUB MED, COCHRANE and EMBASE databases on August 6, 2015. Following full text assessment a thorough references search was made and potential studies were included. A Quality assessment of retrieved articles from 2(nd) round was done using a self designed questionnaire and only field survey studies were included in the systematic review. The literature search yielded six studies which had performed field surveys to find the prevalence of periodontal disease in their respective areas. These studies have observed different sets of age groups and the same has been accomplished by using Community Periodontal Index (CPI) or Community

  17. An Investigation of the Mechanism Underlying Teacher Aggression: Testing I[superscript 3] Theory and the General Aggression Model

    Science.gov (United States)

    Montuoro, Paul; Mainhard, Tim

    2017-01-01

    Background: Considerable research has investigated the deleterious effects of teachers responding aggressively to students who misbehave, but the mechanism underlying this dysfunctional behaviour remains unknown. Aims: This study investigated whether the mechanism underlying teacher aggression follows I[superscript 3] theory or General Aggression…

  18. Alcohol intake, alcohol dehydrogenase genotypes, and liver damage and disease in the Danish general population

    DEFF Research Database (Denmark)

    Tolstrup, J.S.; Gronbaek, M.; Tybjaerg-Hansen, A.

    2009-01-01

    cirrhosis were 1.7 (0.6-4.7), 2.0 (0.8-7.1), 6.5 (2.0-21), and 13 (4.6-37) (P for trendeffect of alcohol on biochemical tests or risk of liver disease. CONCLUSIONS: Increasing alcohol intake from none to low (1-6 drinks per...... week) through to moderate (7-20 drinks per week) and excessive intake (> or = 21 drinks per week) leads to stepwise increases in signs of liver damage with no threshold effect, and to an increased risk of liver disease. The minor changes in biochemical tests for low alcohol intake may not account......OBJECTIVES: We tested the hypothesis that alcohol, alone and in combination with alcohol dehydrogenase (ADH) 1B and ADH1C genotypes, affects liver damage and disease in the general population. METHODS: Information on alcohol intake and on liver disease was obtained from 9,080 men and women from...

  19. Tenotomy of the semitendinosus muscle under standing sedation versus general anesthesia: outcomes in 20 horses with fibrotic myopathy.

    Science.gov (United States)

    Suarez-Fuentes, David G; Tatarniuk, Dane M; Caston, Stephanie S; Kersh, Kevin D; Gillen, Alex M; Hays, Ashley M

    2018-02-13

    To compare outcomes after semitendinosus tenotomy performed under standing sedation versus general anesthesia. Retrospective case series. 20 horses with fibrotic myopathy of the semitendinosus muscle. Medical records (2002-2015) of horses undergoing tenotomy of the semitendinosus muscle for the treatment of fibrotic myopathy were reviewed. Signalment, history, affected muscles, restrain method, surgical procedures, and short-term outcome as well as complications were retrieved from records. Long-term outcome (gait and athletic function) was assessed at least 6 months postoperatively by conversation with the owners. Pearson's χ 2 statistical analysis was used to compare restrain method and affected muscles with overall outcome. Significance was set at P horses and under general anesthesia in 12 horses. Follow-up period ranged from 9 months to 10 years. Gait was improved to variable degrees in 8 of 14 horses when the semitendinosus muscle alone was affected and in 4 of 6 horses when both the semitendinosus and semimembranosus muscles were involved (P = .11). Six of 8 horses treated under standing sedation and 6 of 12 horses treated under general anesthesia exhibited some improvement in the characteristic fibrotic gait (P = .4473). Five of 6 athletic horses treated under standing sedation and 6 of 9 athletic horses treated under general anesthesia returned to their preinjury level of athleticism. Horses treated under standing sedation had no incisional complications; 2 of 12 horses treated under general anesthesia exhibited incisional drainage. Tenotomy of the semitendinosus muscle in horses with fibrotic myopathy leads to similar improvement in gait, whether performed under standing sedation or general anesthesia. © 2017 The American College of Veterinary Surgeons.

  20. Vaccination practices in patients with inflammatory bowel disease among general internal medicine physicians in the USA.

    Science.gov (United States)

    Gurvits, Grigoriy E; Lan, Gloria; Tan, Amy; Weissman, Arlene

    2017-06-01

    Increasing prevalence of inflammatory bowel disease (IBD) poses significant challenges to medical community. Preventive medicine, including vaccination against opportunistic infections, is important in decreasing morbidity and mortality in patients with IBD. We conduct first study to evaluate general awareness and adherence to immunisation guidelines by primary care physicians in the USA. We administered an electronic questionnaire to the research panel of the American College of Physicians (ACP) assessing current vaccination practices, barriers to vaccination and provider responsibility for administering vaccinations and compared responses with the European Crohn's and Colitis Organization consensus guidelines and expert opinion from the USA. All of surveyed physicians (276) had experience with patients with IBD and spent majority of their time in direct patient care. 49% of physicians took immunisation history frequently or always, and 76% reported never or rarely checking immunisation antibody titres with only 2% doing so routinely. 65% of physicians believed that primary care providers (PCPs) were responsible for determining patient's immunisation. Vaccine administration was felt to be the duty of primary care doctor 80% of the time. 2.5% of physicians correctly recommended vaccinations all the time. Physicians were more likely to recommend vaccination to immunocompetent than immunocompromised patients. Up to 23% of physicians would incorrectly recommend live vaccine to immunocompromised patients with IBD. Current knowledge and degree of comfort among PCPs in the USA in preventing opportunistic infections in IBD population remain low. Management of patients with IBD requires structured approach to their healthcare maintenance in everyday practice, including enhanced educational policy aimed at primary care physicians. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. A general theory of evolution based on energy efficiency: its implications for diseases.

    Science.gov (United States)

    Yun, Anthony J; Lee, Patrick Y; Doux, John D; Conley, Buford R

    2006-01-01

    We propose a general theory of evolution based on energy efficiency. Life represents an emergent property of energy. The earth receives energy from cosmic sources such as the sun. Biologic life can be characterized by the conversion of available energy into complex systems. Direct energy converters such as photosynthetic microorganisms and plants transform light energy into high-energy phosphate bonds that fuel biochemical work. Indirect converters such as herbivores and carnivores predominantly feed off the food chain supplied by these direct converters. Improving energy efficiency confers competitive advantage in the contest among organisms for energy. We introduce a term, return on energy (ROE), as a measure of energy efficiency. We define ROE as a ratio of the amount of energy acquired by a system to the amount of energy consumed to generate that gain. Life-death cycling represents a tactic to sample the environment for innovations that allow increases in ROE to develop over generations rather than an individual lifespan. However, the variation-selection strategem of Darwinian evolution may define a particular tactic rather than an overarching biological paradigm. A theory of evolution based on competition for energy and driven by improvements in ROE both encompasses prior notions of evolution and portends post-Darwinian mechanisms. Such processes may involve the exchange of non-genetic traits that improve ROE, as exemplified by cognitive adaptations or memes. Under these circumstances, indefinite persistence may become favored over life-death cycling, as increases in ROE may then occur more efficiently within a single lifespan rather than over multiple generations. The key to this transition may involve novel methods to address the promotion of health and cognitive plasticity. We describe the implications of this theory for human diseases.

  2. A generalized electron energy probability function for inductively coupled plasmas under conditions of nonlocal electron kinetics

    Science.gov (United States)

    Mouchtouris, S.; Kokkoris, G.

    2018-01-01

    A generalized equation for the electron energy probability function (EEPF) of inductively coupled Ar plasmas is proposed under conditions of nonlocal electron kinetics and diffusive cooling. The proposed equation describes the local EEPF in a discharge and the independent variable is the kinetic energy of electrons. The EEPF consists of a bulk and a depleted tail part and incorporates the effect of the plasma potential, Vp, and pressure. Due to diffusive cooling, the break point of the EEPF is eVp. The pressure alters the shape of the bulk and the slope of the tail part. The parameters of the proposed EEPF are extracted by fitting to measure EEPFs (at one point in the reactor) at different pressures. By coupling the proposed EEPF with a hybrid plasma model, measurements in the gaseous electronics conference reference reactor concerning (a) the electron density and temperature and the plasma potential, either spatially resolved or at different pressure (10-50 mTorr) and power, and (b) the ion current density of the electrode, are well reproduced. The effect of the choice of the EEPF on the results is investigated by a comparison to an EEPF coming from the Boltzmann equation (local electron kinetics approach) and to a Maxwellian EEPF. The accuracy of the results and the fact that the proposed EEPF is predefined renders its use a reliable alternative with a low computational cost compared to stochastic electron kinetic models at low pressure conditions, which can be extended to other gases and/or different electron heating mechanisms.

  3. Comparison of two general circulation models to downscale temperature and precipitation under climate change

    Science.gov (United States)

    Matyasovszky, Istvan; Bogardi, Istvan; Duckstein, Lucien

    1994-12-01

    A semiempirical approach for downscaling general circulation model (GCM) based daily atmospheric circulation patterns (CP) and predicting local climatological variables under climate change is developed. Specifically, the daily 500-hPa surface outputs of the Canadian Climate Center (CCC) and Max Planck Institute (MPI) (Germany) GCMs are linked stochastically, using a split sampling approach, to local temperature and precipitation in Nebraska. Three series of data are analyzed: historical data, 1 × CO2 GCM results and 2 × CO2 GCM results. Between these three data sets, no significant difference can be detected in either CP typology (constructed by principal component analysis and k means method) or stochastic properties of daily time series (Markov matrix). On the other hand, the average geopotential height of the 500-hPa pressure field exhibits significant change, labeled the ΔCO2 effect, between the 1 × CO2 and 2 × CO2 cases. Accordingly, climate change is assumed to be represented by the historical average geopotential height augmented by the ΔCO2 increment. It is found that both the CCC and MPI GCMs lead to predicting a winter temperature increase of 3°-6°C, a smaller but significant increase in spring and fall temperatures, and no increase in summer. The probability of precipitation occurrence is found to remain almost unchanged, as well as the dry period duration. The estimates of local response to climate change depend upon the location and the GCM used for downscaling the CP. The MPI GCM, which includes an ocean-atmosphere coupling, appears to yield smaller downscaled changes than the purely atmosphere-based CCC GCM.

  4. Adverse reactions to suxamethonium and other muscle relaxants under general anesthesia

    Energy Technology Data Exchange (ETDEWEB)

    Vervloet, D.; Nizankowska, E.; Arnaud, A.; Senft, M.; Alazia, M.; Charpin, J.

    1983-06-01

    The mechanisms of anaphylactic reactions to muscle relaxants under general anesthesia are not completely understood. Extending an earlier study, we report 41 cases of anaphylactic shock investigated by intradermal skin tests with muscle relaxants (suxamethonium, pancuronium, gallamine, nortoxiferine), in vitro leukocyte histamine release, and Prausnitz-Kuestner tests. Intradermal tests were significantly positive at concentrations ranging from 10 to 10(5) times less than those in controls. Reproducibility tested for suxamethonium at a 1-year interval in five patients was good. Histamine release induced by muscle relaxants in Tris-albumin-Ca++-Mg++ buffer showed positive results in 8/25 instances and was inhibited by antigen excess in seven cases. Addition of 50% deuterium oxide (D2O) caused significant increase of histamine release in positive cases and induced release in all five negative cases studied. Muscle relaxant-induced histamine release was inhibited by in vitro anti-IgE leukocyte desensitization. The mean maximal histamine release dropped from 58.2% +/- 9.7 to 5.8% +/- 2 (p less than 0.01). Similarly, leukocyte desensitization also inhibited histamine release induced by anti-IgE but not by formyl-L-methionyl-L-leucyl-L-phenylalanine or poly-L-arginine. Prausnitz-Kuestner tests were positive in five out of 21 cases studied and became negative after heat inactivation. These results confirm the usefulness of intradermal skin tests in diagnosis of patients' reaction to muscle relaxants and suggest an IgE-mediated rather than an idiosyncratic mechanism.

  5. Arctic storms simulated in atmospheric general circulation models under uniform high, uniform low, and variable resolutions

    Science.gov (United States)

    Roesler, E. L.; Bosler, P. A.; Taylor, M.

    2016-12-01

    The impact of strong extratropical storms on coastal communities is large, and the extent to which storms will change with a warming Arctic is unknown. Understanding storms in reanalysis and in climate models is important for future predictions. We know that the number of detected Arctic storms in reanalysis is sensitive to grid resolution. To understand Arctic storm sensitivity to resolution in climate models, we describe simulations designed to identify and compare Arctic storms at uniform low resolution (1 degree), at uniform high resolution (1/8 degree), and at variable resolution (1 degree to 1/8 degree). High-resolution simulations resolve more fine-scale structure and extremes, such as storms, in the atmosphere than a uniform low-resolution simulation. However, the computational cost of running a globally uniform high-resolution simulation is often prohibitive. The variable resolution tool in atmospheric general circulation models permits regional high-resolution solutions at a fraction of the computational cost. The storms are identified using the open-source search algorithm, Stride Search. The uniform high-resolution simulation has over 50% more storms than the uniform low-resolution and over 25% more storms than the variable resolution simulations. Storm statistics from each of the simulations is presented and compared with reanalysis. We propose variable resolution as a cost-effective means of investigating physics/dynamics coupling in the Arctic environment. Future work will include comparisons with observed storms to investigate tuning parameters for high resolution models. Sandia National Laboratories is a multi-program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-AC04-94AL85000. SAND2016-7402 A

  6. [Venereal diseases in a "general practice" in the 17th and early 18th centuries].

    Science.gov (United States)

    Fries, F; Winckelmann, H J

    2018-01-31

    The diary of the town physician Johannes Franc (1649-1725), handwritten in Latin, gives-among other diseases-an overview of sexually transmitted infections affecting citizens in Ulm such as syphilis and gonorrhea. Franc reported on his own experiences in the diary and also included many theoretical details on the causes of the diseases and the corresponding therapies, including ethical considerations. Even in ancient times, there are indications of venereal diseases. However, at the latest with the outbreak of syphilis around the year 1495, the treatment and control of the spread of venereal diseases became an important task of medicine. Before gonococci were detected by Neisser in 1879, sexually transmitted diseases were generally seen as a single disease. However, at the beginning of the 18 th century, there were several doctors who treated syphilis and gonorrhea as separate entities. Franc was one of them. Examining the milestones in the history of syphilis and gonorrhea, the present article reviews the existing theories that tried to explain the origins of these diseases. Franc's treatment patterns are illustrated. Franc's case reports indicate a fundamental change in the perception of STIs at the end of the 17 th /beginning of the 18 th century.

  7. Clinical application of self-expandable metallic stents in the treatment of malignant tracheal stenosis under general anesthesia

    International Nuclear Information System (INIS)

    Wang Weitao; Shi Haibin; Yang Zhengqiang; Liu Sheng; Zhou Chungao; Zhao Linbo; Xia Jinguo; Li Linsun

    2009-01-01

    Objective: To evaluate the safety and efficacy of self-expandable metallic stent placement for the treatment of malignant tracheal stenosis under general anesthesia and fluoroscopic guidance. Methods: Under general anesthesia the placement of self-expandable metallic stent was performed in 10 patients with malignant tracheal stenosis, the procedure was completed under fluoroscopic guidance in all patients. Results: Successful tracheal stenting was achieved in all 10 patients. In one patient, a Y-shaped stent was used as the tracheal carina was involved in the airway stenosis. The symptoms of dyspnea and asthma were markedly improved immediately after the implantation of stent in all patients. Conclusion: Tracheal implantation of self-expandable metallic stent under general anesthesia and fluoroscopic guidance is a safe and effective treatment for malignant tracheal stenosis, it can promptly relieve various symptoms caused by malignant tracheal stenosis and obviously improve patient's living quality, therefore,t his technique is of great value in clinical practice. (authors)

  8. Alcohol and tobacco use and the diseases treated in general practice

    Directory of Open Access Journals (Sweden)

    Maria Flora de Almeida

    Full Text Available Summary Objective: To characterize the use of alcohol and tobacco and correlate both to the diseases of outpatients in a general practice outpatient clinic. Method: The ASSIST (Alcohol, Smoking and Substance Involvement Screening Test questionnaire was answered by 300 randomly chosen subjects assigned to different groups according to the diseases being treated at the Outpatient General and Teaching Clinic of the Department of Internal Medicine, Hospital das Clínicas of the University of São Paulo's School of Medicine (HC-FMUSP, in the Portuguese acronym, São Paulo, Brazil. The consumption of tobacco and alcohol was characterized and its correlation with the groups of diseases being treated was calculated using Chi-square and Pearson test statistics. Results: Compared to alcohol, tobacco use was more prevalent, more intense and showed more health-, social-, legal- and financial-related damage. Tobacco smoking presented a positive significant (p<0.0001 correlation with respiratory diseases. According to the questionnaire's criteria, few alcohol users would be referred to clinical interventions in comparison to smokers. Conclusion: Respiratory diseases and tobacco use were well correlated based on the ASSIST questionnaire. The preventive value of the questionnaire was more evident in relation to tobacco than alcohol consumption.

  9. Elevated plasma YKL-40, lipids and lipoproteins, and ischemic vascular disease in the general population

    DEFF Research Database (Denmark)

    Kjaergaard, Alisa D; Johansen, Julia S; Bojesen, Stig E

    2015-01-01

    BACKGROUND AND PURPOSE: We tested the hypothesis that observationally and genetically elevated YKL-40 is associated with elevated lipids and lipoproteins and with increased risk of ischemic vascular disease. METHODS: We conducted cohort and Mendelian randomization studies in 96 110 individuals from...... the Danish general population, with measured plasma levels of YKL-40 (n=21 647), plasma lipids and lipoproteins (n=94 461), and CHI3L1 rs4950928 genotype (n=94 579). RESULTS: From 1977 to 2013, 3256 individuals developed ischemic stroke, 5629 ischemic cerebrovascular disease, 4183 myocardial infarction...

  10. Underlying mechanism of antimicrobial activity of chitosan microparticles and implications for the treatment of infectious diseases.

    Directory of Open Access Journals (Sweden)

    Soo Jin Jeon

    Full Text Available The emergence of antibiotic resistant microorganisms is a great public health concern and has triggered an urgent need to develop alternative antibiotics. Chitosan microparticles (CM, derived from chitosan, have been shown to reduce E. coli O157:H7 shedding in a cattle model, indicating potential use as an alternative antimicrobial agent. However, the underlying mechanism of CM on reducing the shedding of this pathogen remains unclear. To understand the mode of action, we studied molecular mechanisms of antimicrobial activity of CM using in vitro and in vivo methods. We report that CM are an effective bactericidal agent with capability to disrupt cell membranes. Binding assays and genetic studies with an ompA mutant strain demonstrated that outer membrane protein OmpA of E. coli O157:H7 is critical for CM binding, and this binding activity is coupled with a bactericidal effect of CM. This activity was also demonstrated in an animal model using cows with uterine diseases. CM treatment effectively reduced shedding of intrauterine pathogenic E. coli (IUPEC in the uterus compared to antibiotic treatment. Since Shiga-toxins encoded in the genome of bacteriophage is often overexpressed during antibiotic treatment, antibiotic therapy is generally not recommended because of high risk of hemolytic uremic syndrome. However, CM treatment did not induce bacteriophage or Shiga-toxins in E. coli O157:H7; suggesting that CM can be a potential candidate to treat infections caused by this pathogen. This work establishes an underlying mechanism whereby CM exert antimicrobial activity in vitro and in vivo, providing significant insight for the treatment of diseases caused by a broad spectrum of pathogens including antibiotic resistant microorganisms.

  11. CHRNA3 genotype, nicotine dependence, lung function and disease in the general population

    DEFF Research Database (Denmark)

    Kaur-Knudsen, Diljit; Nordestgaard, Børge G; Bojesen, Stig E

    2012-01-01

    The CHRNA3 rs1051730 polymorphism has been associated to chronic obstructive pulmonary disease (COPD), lung cancer and nicotine dependence in case-control studies with high smoking exposure; however, its influence on lung function and COPD severity in the general population is largely unknown. We...... genotyped 57,657 adult individuals from the Copenhagen General Population Study, of whom 34,592 were ever-smokers. Information on spirometry, hospital admissions, smoking behaviour and use of nicotinic replacement therapy was recorded. In homozygous (11%), heterozygous (44%) and noncarrier (45%) ever...

  12. Clinical and neuropsychological characteristics of general paresis misdiagnosed as primary psychiatric disease.

    Science.gov (United States)

    Yanhua, Wang; Haishan, Shi; Le, Hou; Xiaomei, Zhong; Xinru, Chen; Ling, Li; Zhangying, Wu; Dong, Zheng; Yuefen, Zhang; Yan, Tan; Xinni, Luo; Sha, Liu; Yuping, Ning

    2016-07-11

    Neurosyphilis is caused by the invasion of Treponema pallidum into the central nervous system. General paresis (GP) is a type of neurosyphilis. The main manifestation of general paresis is dementia; however, this is different from the other types of dementia, which can be cured by adequate doses of penicillin in the early stage. Neurosyphilis is the "great imitator" because it can mimic many types of medical disorders. In addition, the manifestations of neurosyphilis are not typical. Psychiatric disorders as a cause of general paresis have become more common due to the use of antibiotics. Patients with a psychiatric manifestation are often misdiagnosed. The purpose of this study was to explore the differences in the clinical and neuropsychological characteristics of general paresis between patients misdiagnosed as having a primary psychiatric disease and patients diagnosed correctly upon seeing a doctor. The results may assist clinicians in the early identification of neurosyphilis with a mental disorder. The demographic and clinical manifestations, laboratory tests, and neuroimaging and neuropsychological characteristics were analysed in 55 general paresis patients with psychiatric disorders, including 29 patients misdiagnosed as primary psychiatric disease and 26 patients diagnosed as having general paresis after being seen once by a doctor. All of the patients had positive assay results for cerebral spinal fluid (CSF) Treponema pallidum hemagglutination (TPHA). Only 43.3 % of misdiagnosed patients and 30.8 % of general paresis patients had positive results for the CSF rapid plasma reagin (RPR) test; 96.4 % patients had abnormal neuroimaging. Mood disturbances were the most common psychiatric disorder in the general paresis patients, especially agitation, between the two groups (patients with general paresis who were misdiagnosed as having primary psychiatric disease and patients who had never been misdiagnosed) (p = 0.011). Our findings reinforce the

  13. Soybean (Glycine max L. Merr.) Sprouts Germinated under Red Light Irradiation Induce Disease Resistance against Bacterial Rotting Disease

    OpenAIRE

    Dhakal, Radhika; Park, Euiho; Lee, Se-Weon; Baek, Kwang-Hyun

    2015-01-01

    Specific wavelengths of light can exert various physiological changes in plants, including effects on responses to disease incidence. To determine whether specific light wavelength had effects on rotting disease caused by Pseudomonas putida 229, soybean sprouts were germinated under a narrow range of wavelengths from light emitting diodes (LEDs), including red (650-660), far red (720-730) and blue (440-450 nm) or broad range of wavelength from daylight fluorescence bulbs. The controls were co...

  14. Among three different executive functions, general executive control ability is a key predictor of decision making under objective risk.

    Science.gov (United States)

    Schiebener, Johannes; Wegmann, Elisa; Gathmann, Bettina; Laier, Christian; Pawlikowski, Mirko; Brand, Matthias

    2014-01-01

    Executive functioning is supposed to have an important role in decision making under risk. Several studies reported that more advantageous decision-making behavior was accompanied by better performance in tests of executive functioning and that the decision-making process was accompanied by activations in prefrontal and subcortical brain regions associated with executive functioning. However, to what extent different components of executive functions contribute to decision making is still unclear. We tested direct and indirect effects of three executive functions on decision-making performance in a laboratory gambling task, the Game of Dice Task (GDT). Using Brand's model of decisions under risk (2006) we tested seven structural equation models with three latent variables that represent executive functions supposed to be involved in decision making. The latent variables were general control (represented by the general ability to exert attentional and behavioral self-control that is in accordance with task goals despite interfering information), concept formation (represented by categorization, rule detection, and set maintenance), and monitoring (represented by supervision of cognition and behavior). The seven models indicated that only the latent dimension general control had a direct effect on decision making under risk. Concept formation and monitoring only contributed in terms of indirect effects, when mediated by general control. Thus, several components of executive functioning seem to be involved in decision making under risk. However, general control functions seem to have a key role. They may be important for implementing the calculative and cognitively controlled processes involved in advantageous decision making under risk.

  15. The reliability of the twelve-item general health questionnaire (GHQ-12) under realistic assumptions.

    Science.gov (United States)

    Hankins, Matthew

    2008-10-14

    The twelve-item General Health Questionnaire (GHQ-12) was developed to screen for non-specific psychiatric morbidity. It has been widely validated and found to be reliable. These validation studies have assumed that the GHQ-12 is one-dimensional and free of response bias, but recent evidence suggests that neither of these assumptions may be correct, threatening its utility as a screening instrument. Further uncertainty arises because of the multiplicity of scoring methods of the GHQ-12. This study set out to establish the best fitting model for the GHQ-12 for three scoring methods (Likert, GHQ and C-GHQ) and to calculate the degree of measurement error under these more realistic assumptions. GHQ-12 data were obtained from the Health Survey for England 2004 cohort (n = 3705). Structural equation modelling was used to assess the fit of [1] the one-dimensional model [2] the current 'best fit' three-dimensional model and [3] a one-dimensional model with response bias. Three different scoring methods were assessed for each model. The best fitting model was assessed for reliability, standard error of measurement and discrimination. The best fitting model was one-dimensional with response bias on the negatively phrased items, suggesting that previous GHQ-12 factor structures were artifacts of the analysis method. The reliability of this model was over-estimated by Cronbach's Alpha for all scoring methods: 0.90 (Likert method), 0.90 (GHQ method) and 0.75 (C-GHQ). More realistic estimates of reliability were 0.73, 0.87 and 0.53 (C-GHQ), respectively. Discrimination (Delta) also varied according to scoring method: 0.94 (Likert method), 0.63 (GHQ method) and 0.97 (C-GHQ method). Conventional psychometric assessments using factor analysis and reliability estimates have obscured substantial measurement error in the GHQ-12 due to response bias on the negative items, which limits its utility as a screening instrument for psychiatric morbidity.

  16. Regulation of sorLA in general and in Alzheimer's disease

    DEFF Research Database (Denmark)

    Andersen, Olav Michael; Poulsen, Annemarie Svane Aavild; Zole, Egija

    Background: The Sortillin-related receptor (sorLA) is involved in cellular trafficking and processing of the Amyloid precursor protein (APP). A decrease in sorLA expression has been identified in brain tissue from patients suffering from Alzheimer's disease (AD), suggesting that sorLA may be a key...... tissue from patients with Alzheimer's disease. Conclusions: We have investigated the regulation of sorLA expression and identified several cis - and trans -regulatory elements important for the proper expression of sorLA. These studies may help to elucidate the mechanisms underlying the observ ed down...

  17. Alcohol intake, alcohol dehydrogenase genotypes, and liver damage and disease in the Danish general population

    DEFF Research Database (Denmark)

    Tolstrup, J.S.; Gronbaek, M.; Tybjaerg-Hansen, A.

    2009-01-01

    OBJECTIVES: We tested the hypothesis that alcohol, alone and in combination with alcohol dehydrogenase (ADH) 1B and ADH1C genotypes, affects liver damage and disease in the general population. METHODS: Information on alcohol intake and on liver disease was obtained from 9,080 men and women from...... volume. RESULTS: Increasing alcohol intake was associated with increasing erythrocyte volume, AST/ALT, and levels of ALT, gamma-GT, albumin, bilirubin, coagulation factors, and with decreasing levels of alkaline phosphatase. Multifactorially adjusted hazard ratios for alcoholic liver disease overall were...... 0.9 (95% confidence interval (CI), 0.6-1.4), 1.4 (0.8-2.5), 1.8 (0.9-3.5), and 4.1 (2.5-7.0) for an alcohol intake of 1-13, 14-20, 21-27, and > or = 28 drinks per week, respectively, compared with drinking alcoholic liver...

  18. Experience of aging in patients with rheumatic disease: a comparison with the general population.

    Science.gov (United States)

    Bode, Christina; Taal, Erik; Westerhof, Gerben J; van Gessel, Lidewij; van de Laar, Mart V

    2012-01-01

    Self-perceptions of aging have been shown to predict mental and physical health and even longevity. This study examined the aging perceptions of patients with rheumatic disease and compared them with the general Dutch population. Consecutive patients visiting a rheumatology clinic completed the Personal Experience of Aging Scale (PEAS) subscales: physical decline, social loss, continuous growth, and two sentence stems from the SELE instrument (What I like/do not like about getting older ...) as qualitative measures of the subjective experience of aging. A representative sample from the general Dutch population between 40 and 85 years was used as a comparison group. Participants included in this study were 208 patients with a rheumatic disease and 975 persons from the Dutch Aging Survey (DAS). Both quantitative and qualitative data showed that patients perceived aging more strongly as physical decline. These negative experiences did not extend to social and psychological domains of aging. Age-group comparisons revealed that patients in middle adulthood experienced physical aging similar to older people without a rheumatic disease. The negative experience of aging in patients is limited to the physical domain and does not extend to other domains of life. The negative experience of physical aging even in middle-aged groups warrants further studies on its effects on mental and physical health outcomes and health behavior in patients with rheumatic disease.

  19. A convenient tool to profile patients for generalized cardiovascular disease risk in primary care.

    Science.gov (United States)

    Wickramasinghe, S Rasika; DeFilippis, Andrew P; Lloyd-Jones, Donald M; Blumenthal, Roger S

    2009-04-15

    The early identification of and intervention in patients with increased risk factors for generalized cardiovascular disease greatly reduces their long-term mortality from hard coronary artery disease (CAD) events and other related co-morbidities. Thus, a number of multivariate risk factor analyses based on large-scale population studies have led to various risk-scoring models aimed at screening for those at high risk for CAD. These assessment systems, by virtue of novel diagnostic markers and better population data, have become increasingly adept at accurately predicting CAD risk in individual patients. Nevertheless, their practical application in the setting of primary care has lagged, because of a reluctance of many primary care physicians to adopt these methods. An effective risk assessment system should not only encompass the risk for hard CAD events but also include risks for related co-morbid conditions, such as stroke and heart failure, and be simple and accurate enough to be efficiently used in primary care clinics. In conclusion, in an attempt to simplify 1 of the more effective risk assessment devices for generalized cardiovascular disease risk that meets all these requirements, the investigators strongly support the model proposed by D'Agostino and colleagues and provide here a commentary on its utility in identifying patients at high risk for cardiovascular disease.

  20. Relationship between Metabolic Syndrome Components and Periodontal Disease in a Japanese General Population: the Suita Study.

    Science.gov (United States)

    Kikui, Miki; Kokubo, Yoshihiro; Ono, Takahiro; Kida, Momoyo; Kosaka, Takayuki; Yamamoto, Masaaki; Watanabe, Makoto; Maeda, Yoshinobu; Miyamoto, Yoshihiro

    2017-05-01

    A positive association between metabolic syndrome (MetS) and periodontal status has recently been noted. However, no study has evaluated the relationship by sex and in a general urban population using the uniform definition proposed in the 2009 Joint Interim Statement. The aim of this study was to clarify the relationship between MetS and periodontal status using the uniform definition in a general urban Japanese population. A total of 1,856 Japanese men and women (mean age: 66.4 years) were studied using data from the Suita study. Periodontal status was evaluated by the Community Periodontal Index (CPI). MetS was defined using the 2009 Joint Interim Statement. The associations of the MetS and its components with periodontal disease were investigated using multiple logistic regression analysis adjusting for age, drinking, and smoking. Among the components of the MetS, low HDL cholesterol level was significantly associated with periodontal disease in men and women [odds ratios (OR)=2.39 and 1.53; 95% confidence intervals=1.36-4.19 and 1.06-2.19]. Furthermore, the risk of periodontal disease showed 1.43-, 1.42-, and 1.89-fold increases in those with 2, 3, and ≥4 components, respectively, compared with those having no components (P trend <0.001). For the analysis by sex, the risk of periodontal disease was increased 2.27- and 1.76-fold in those with ≥4 components in men and women, respectively (both P trend =0.001). These findings suggest that MetS and lower HDL cholesterol are associated with periodontal disease. Subjects with two or more MetS components had a significantly higher prevalence of periodontal disease.

  1. "Unwarranted survivals" and "anomalous deaths" from coronary heart disease: prospective survey of general population.

    Science.gov (United States)

    McConnachie, A; Hunt, K; Emslie, C; Hart, C; Watt, G

    To assess survival in people who are at apparent high risk who do not develop coronary heart disease ("unwarranted survivals") and mortality in people at low risk who die from the disease ("anomalous deaths") and the extent to which these outcomes are explained by other, less visible, risk factors. Prospective general population survey. Renfrew and Paisley, Scotland. 6068 men aged 45-64 years at screening in 1972-6, allocated to "visible" risk groups on the basis of body mass index and smoking. Survival and death from coronary heart disease by age 70 years. Visible risk was a good predictor of mortality: 13% (45) of men at low risk and 45% (86) of men at high risk had died by age 70 years. Of these deaths, 12 (4%) and 44 (23%), respectively, were from coronary heart disease. In the group at low visible risk other less visible risk factors accounted for increased risk in 83% (10/12) of men who died from coronary heart disease and 29% (84/292) of men who survived. In the high risk group 81/107 who survived (76%) and 19/44 (43%) who died from coronary heart disease had lower risk after other factors were considered. Different risk factors modified risk (beyond smoking and body mass index) in the two groups. Among men at low visible risk, poor respiratory function, diabetes, previous coronary heart disease, and socioeconomic deprivation modified risk. Among men at high visible risk, height and cholesterol concentration modified risk. Differences in survival between these extreme risk groups are dramatic. Health promotion messages would be more credible if they discussed anomalies and the limits of prediction of coronary disease at an individual level.

  2. Cost of specific emergency general surgery diseases and factors associated with high-cost patients.

    Science.gov (United States)

    Ogola, Gerald O; Shafi, Shahid

    2016-02-01

    We have previously shown that overall cost of hospitalization for emergency general surgery (EGS) diseases is more than $28 billion annually and rising. The purposes of this study were to estimate the costs associated with specific EGS diseases and to identify factors associated with high-cost hospitalizations. The American Association for the Surgery of Trauma definition was used to identify hospitalizations of adult EGS patients in the 2010 National Inpatient Sample data. Cost of each hospitalization was obtained using cost-to-charge ratio in National Inpatient Sample. Regression analysis was used to estimate the cost for each EGS disease adjusted for patient and hospital characteristics. Hospitalizations with cost exceeding 75th percentile for each EGS disease were compared with lower-cost hospitalizations to identify factors associated with high cost. Thirty-one EGS diseases resulted in 2,602,074 hospitalizations nationwide in 2010 at an average adjusted cost of $10,110 (95% confidence interval, $10,086-$10,134) per hospitalization. Of these, only nine diseases constituted 80% of the total volume and 74% of the total cost. Empyema chest, colorectal cancer, and small intestine cancer were the most expensive EGS diseases with adjusted mean cost per hospitalization exceeding $20,000, while breast infection, abdominal pain, and soft tissue infection were the least expensive, with mean adjusted costs of less than $7,000 per hospitalization. The most important factors associated with high-cost hospitalizations were the number and type of procedures performed (76.2% of variance), but a region in Western United States (11.3%), Medicare and Medicaid payors (2.6%), and hospital ownership by public or not-for-profit entities (5.6%) were also associated with high-cost hospitalizations. A small number of diseases constitute a vast majority of EGS hospitalizations and their cost. Attempts at reducing the cost of EGS hospitalization will require controlling the cost of

  3. Assessment of Olfactory Function in MAPT-Associated Neurodegenerative Disease Reveals Odor-Identification Irreproducibility as a Non-Disease-Specific, General Characteristic of Olfactory Dysfunction.

    Science.gov (United States)

    Markopoulou, Katerina; Chase, Bruce A; Robowski, Piotr; Strongosky, Audrey; Narożańska, Ewa; Sitek, Emilia J; Berdynski, Mariusz; Barcikowska, Maria; Baker, Matt C; Rademakers, Rosa; Sławek, Jarosław; Klein, Christine; Hückelheim, Katja; Kasten, Meike; Wszolek, Zbigniew K

    2016-01-01

    Olfactory dysfunction is associated with normal aging, multiple neurodegenerative disorders, including Parkinson's disease, Lewy body disease and Alzheimer's disease, and other diseases such as diabetes, sleep apnea and the autoimmune disease myasthenia gravis. The wide spectrum of neurodegenerative disorders associated with olfactory dysfunction suggests different, potentially overlapping, underlying pathophysiologies. Studying olfactory dysfunction in presymptomatic carriers of mutations known to cause familial parkinsonism provides unique opportunities to understand the role of genetic factors, delineate the salient characteristics of the onset of olfactory dysfunction, and understand when it starts relative to motor and cognitive symptoms. We evaluated olfactory dysfunction in 28 carriers of two MAPT mutations (p.N279K, p.P301L), which cause frontotemporal dementia with parkinsonism, using the University of Pennsylvania Smell Identification Test. Olfactory dysfunction in carriers does not appear to be allele specific, but is strongly age-dependent and precedes symptomatic onset. Severe olfactory dysfunction, however, is not a fully penetrant trait at the time of symptom onset. Principal component analysis revealed that olfactory dysfunction is not odor-class specific, even though individual odor responses cluster kindred members according to genetic and disease status. Strikingly, carriers with incipient olfactory dysfunction show poor inter-test consistency among the sets of odors identified incorrectly in successive replicate tests, even before severe olfactory dysfunction appears. Furthermore, when 78 individuals without neurodegenerative disease and 14 individuals with sporadic Parkinson's disease were evaluated twice at a one-year interval using the Brief Smell Identification Test, the majority also showed inconsistency in the sets of odors they identified incorrectly, independent of age and cognitive status. While these findings may reflect the

  4. [Environmental sanitation and mortality associated with waterborne diseases in children under 5 years of age in Brazil].

    Science.gov (United States)

    Bellido, Jaime Gregorio; Barcellos, Christovam; Barbosa, Flavia dos Santos; Bastos, Francisco Inacio

    2010-08-01

    Determine and evaluate the relationship between the variables for water conditions, environmental sanitation, and mortality in children under 5 years of age associated with a group of waterborne diseases. An exploratory ecological study was conducted based on data obtained from the 2000 national demographic census and the Unified Health System for the 558 microregions of Brazil. The model used multiple linear regression analysis. Mortality associated with waterborne diseases in children under 5 years of age was considered to be the response variable. Water conditions, sanitation, and level of education were considered to be explanatory variables. A direct relationship was observed between inadequate sanitation in the dwelling (e.g., sewage disposal via rudimentary gutters and pits, the disposal of waste in uncultivated land or public areas) and mortality in children under 5 years of age associated with waterborne diseases. An inverse relationship was found between level of education and mortality associated with waterborne diseases in these children. The greatest health hazards related to poor sanitation were found in the microregions with a high concentration of low-income population with limited education. The general sanitation conditions and other factors related to dwelling quality and infrastructure are major determinants of mortality. Coverage of the water services, which reach 90% of households in Brazil, was not in itself found to be an important factor in the reduction of the mortality studied.

  5. Higher integrability of solutions to generalized Stokes system under perfect slip boundary conditions

    Czech Academy of Sciences Publication Activity Database

    Mácha, Václav; Tichý, J.

    2014-01-01

    Roč. 16, č. 4 (2014), s. 823-845 ISSN 1422-6928 R&D Projects: GA ČR GA201/09/0917 Institutional support: RVO:67985840 Keywords : generalized Stokes system * perfect slip boundary conditions * Lq theory Subject RIV: BA - General Math ematics Impact factor: 1.186, year: 2014 http://link.springer.com/article/10.1007%2Fs00021-014-0190-5

  6. Surgery or general medicine: a study of the reasons underlying the choice of medical specialty

    Directory of Open Access Journals (Sweden)

    Patrícia Lacerda Bellodi

    Full Text Available CONTEXT: The reality of medical services in Brazil points towards expansion and diversification of medical knowledge. However, there are few Brazilian studies on choosing a medical specialty. OBJECTIVE: To investigate and characterize the process of choosing the medical specialty among Brazilian resident doctors, with a comparison of the choice between general medicine and surgery. TYPE OF STUDY: Stratified survey. SETTING: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC-FMUSP. METHODS: A randomized sample of resident doctors in general medicine (30 and surgery (30 was interviewed. Data on sociodemographic characteristics and the moment, stability and reasons for the choice of specialty were obtained. RESULTS: The moment of choice between the two specialties differed. Surgeons (30% choose the specialty earlier, while general doctors decided progressively, mainly during the internship (43%. Most residents in both fields (73% general medicine, 70% surgery said they had considered another specialty before the current choice. The main reasons for general doctors' choice were contact with patients (50%, intellectual activities (30% and knowledge of the field (27%. For surgeons the main reasons were practical intervention (43%, manual activities (43% and the results obtained (40%. Personality was important in the choice for 20% of general doctors and for 27% of surgeons. DISCUSSION: The reasons found for the choice between general medicine and surgery were consistent with the literature. The concepts of wanting to be a general doctor or a surgeon are similar throughout the world. Personality characteristics were an important influencing factor for all residents, without statistical difference between the specialties, as was lifestyle. Remuneration did not appear as a determinant. CONCLUSION: The results from this group of Brazilian resident doctors corroborated data on choosing a medical specialty from other countries

  7. Regulation of sorLA in general and in Alzheimer's disease

    DEFF Research Database (Denmark)

    Andersen, Olav Michael; Poulsen, Annemarie Svane Aavild; Zole, Egija

    Background: The Sortillin-related receptor (sorLA) is involved in cellular trafficking and processing of the Amyloid precursor protein (APP). A decrease in sorLA expression has been identified in brain tissue from patients suffering from Alzheimer's disease (AD), suggesting that sorLA may be a key...... tissue from patients with Alzheimer's disease. Conclusions: We have investigated the regulation of sorLA expression and identified several cis - and trans -regulatory elements important for the proper expression of sorLA. These studies may help to elucidate the mechanisms underlying the observ ed down...... regulation of sorLA and the linkage to disease onset of SORL1 SNPs in AD patients....

  8. Heat-Related Mortality Projections for Cardiovascular and Respiratory Disease Under the Changing Climate in Beijing, China

    Science.gov (United States)

    Li, Tiantian; Ban, Jie; Horton, Radley M.; Bader, Daniel A.; Huang, Ganlin; Sun, Qinghua; Kinney, Patrick L.

    2015-01-01

    Because heat-related health effects tend to become more serious at higher temperatures, there is an urgent need to determine the mortality projection of specific heat-sensitive diseases to provide more detailed information regarding the variation of the sensitivity of such diseases. In this study, the specific mortality of cardiovascular and respiratory disease in Beijing was initially projected under five different global-scale General Circulation Models (GCMs) and two Representative Concentration Pathways scenarios (RCPs) in the 2020s, 2050s, and 2080s compared to the 1980s. Multi-model ensembles indicated cardiovascular mortality could increase by an average percentage of 18.4 percent, 47.8 percent, and 69.0 percent in the 2020s, 2050s, and 2080s under RCP 4.5, respectively, and by 16.6 percent, 73.8 percent and 134 percent in different decades respectively, under RCP 8.5 compared to the baseline range. The same increasing pattern was also observed in respiratory mortality. The heat-related deaths under the RCP 8.5 scenario were found to reach a higher number and to increase more rapidly during the 21st century compared to the RCP4.5 scenario, especially in the 2050s and the 2080s. The projection results show potential trends in cause-specific mortality in the context of climate change, and provide support for public health interventions tailored to specific climate-related future health risks.

  9. WrpA Is an Atypical Flavodoxin Family Protein under Regulatory Control of the Brucella abortus General Stress Response System

    Energy Technology Data Exchange (ETDEWEB)

    Herrou, Julien; Czyż, Daniel M.; Willett, Jonathan W.; Kim, Hye-Sook; Chhor, Gekleng; Babnigg, Gyorgy; Kim, Youngchang; Crosson, Sean; Stock, A. M.

    2016-02-08

    high structural homology with canonical WrbA proteins, we propose thatB. abortusWrpA represents a functionally distinct member of the diverse flavodoxin family.

    IMPORTANCEBrucella abortusis an etiological agent of brucellosis, which is among the most common zoonotic diseases worldwide. The general stress response (GSR) regulatory system ofB. abortuscontrols the transcription of approximately 100 genes and is required for maintenance of chronic infection in a murine model; the majority of GSR-regulated genes remain uncharacterized. We presentin vitroandin vivofunctional and structural analyses of WrpA, whose expression is strongly induced by GSR under oxidative conditions. Though WrpA is structurally related to NADH:quinone oxidoreductases, it does not bind redox cofactors in solution, nor does it exhibit oxidoreductase activityin vitro. However, WrpA does affect spleen inflammation in a murine infection model. Our data provide evidence that WrpA forms a new functional class of WrbA/flavodoxin family proteins.

  10. Understanding the process of patient satisfaction with nurse-led chronic disease management in general practice.

    Science.gov (United States)

    Mahomed, Rosemary; St John, Winsome; Patterson, Elizabeth

    2012-11-01

      To investigate the process of patient satisfaction with nurse-led chronic disease management in Australian general practice.   Nurses working in the primary care context of general practice, referred to as practice nurses, are expanding their role in chronic disease management; this is relatively new to Australia. Therefore, determining patient satisfaction with this trend is pragmatically and ethically important. However, the concept of patient satisfaction is not well understood particularly in relation to care provided by practice nurses.   A grounded theory study underpinned by a relativist ontological position and a relativist epistemology.   Grounded theory was used to develop a theory from data collected through in-depth interviews with 38 participants between November 2007-April 2009. Participants were drawn from a larger project that trialled a practice nurse-led, collaborative model of chronic disease management in three Australian general practices. Theoretical sampling, data collection, and analysis were conducted concurrently consistent with grounded theory methods.   Patients undergo a cyclical process of Navigating Care involving three stages, Determining Care Needs, Forming Relationship, and Having Confidence. The latter two processes are inter-related and a feedback loop from them informs subsequent cycles of Determining Care Needs. If any of these steps fails to develop adequately, patients are likely to opt out of nurse-led care.   Navigating Care explains how and why time, communication, continuity, and trust in general practitioners and nurses are important to patient satisfaction. It can be used in identifying suitable patients for practice nurse-led care and to inform the practice and organization of practice nurse-led care to enhance patient satisfaction. © 2012 Blackwell Publishing Ltd.

  11. Soybean (Glycine max L. Merr.) sprouts germinated under red light irradiation induce disease resistance against bacterial rotting disease.

    Science.gov (United States)

    Dhakal, Radhika; Park, Euiho; Lee, Se-Weon; Baek, Kwang-Hyun

    2015-01-01

    Specific wavelengths of light can exert various physiological changes in plants, including effects on responses to disease incidence. To determine whether specific light wavelength had effects on rotting disease caused by Pseudomonas putida 229, soybean sprouts were germinated under a narrow range of wavelengths from light emitting diodes (LEDs), including red (650-660), far red (720-730) and blue (440-450 nm) or broad range of wavelength from daylight fluorescence bulbs. The controls were composed of soybean sprouts germinated in darkness. After germination under different conditions for 5 days, the soybean sprouts were inoculated with P. putida 229 and the disease incidence was observed for 5 days. The sprouts exposed to red light showed increased resistance against P. putida 229 relative to those grown under other conditions. Soybean sprouts germinated under red light accumulated high levels of salicylic acid (SA) accompanied with up-regulation of the biosynthetic gene ICS and the pathogenesis- related (PR) gene PR-1, indicating that the resistance was induced by the action of SA via de novo synthesis of SA in the soybean sprouts by red light irradiation. Taken together, these data suggest that only the narrow range of red light can induce disease resistance in soybean sprouts, regulated by the SA-dependent pathway via the de novo synthesis of SA and up-regulation of PR genes.

  12. Soybean (Glycine max L. Merr. sprouts germinated under red light irradiation induce disease resistance against bacterial rotting disease.

    Directory of Open Access Journals (Sweden)

    Radhika Dhakal

    Full Text Available Specific wavelengths of light can exert various physiological changes in plants, including effects on responses to disease incidence. To determine whether specific light wavelength had effects on rotting disease caused by Pseudomonas putida 229, soybean sprouts were germinated under a narrow range of wavelengths from light emitting diodes (LEDs, including red (650-660, far red (720-730 and blue (440-450 nm or broad range of wavelength from daylight fluorescence bulbs. The controls were composed of soybean sprouts germinated in darkness. After germination under different conditions for 5 days, the soybean sprouts were inoculated with P. putida 229 and the disease incidence was observed for 5 days. The sprouts exposed to red light showed increased resistance against P. putida 229 relative to those grown under other conditions. Soybean sprouts germinated under red light accumulated high levels of salicylic acid (SA accompanied with up-regulation of the biosynthetic gene ICS and the pathogenesis- related (PR gene PR-1, indicating that the resistance was induced by the action of SA via de novo synthesis of SA in the soybean sprouts by red light irradiation. Taken together, these data suggest that only the narrow range of red light can induce disease resistance in soybean sprouts, regulated by the SA-dependent pathway via the de novo synthesis of SA and up-regulation of PR genes.

  13. Forecasting the future risk of Barmah Forest virus disease under climate change scenarios in Queensland, Australia.

    Directory of Open Access Journals (Sweden)

    Suchithra Naish

    Full Text Available BACKGROUND: Mosquito-borne diseases are climate sensitive and there has been increasing concern over the impact of climate change on future disease risk. This paper projected the potential future risk of Barmah Forest virus (BFV disease under climate change scenarios in Queensland, Australia. METHODS/PRINCIPAL FINDINGS: We obtained data on notified BFV cases, climate (maximum and minimum temperature and rainfall, socio-economic and tidal conditions for current period 2000-2008 for coastal regions in Queensland. Grid-data on future climate projections for 2025, 2050 and 2100 were also obtained. Logistic regression models were built to forecast the otential risk of BFV disease distribution under existing climatic, socio-economic and tidal conditions. The model was applied to estimate the potential geographic distribution of BFV outbreaks under climate change scenarios. The predictive model had good model accuracy, sensitivity and specificity. Maps on potential risk of future BFV disease indicated that disease would vary significantly across coastal regions in Queensland by 2100 due to marked differences in future rainfall and temperature projections. CONCLUSIONS/SIGNIFICANCE: We conclude that the results of this study demonstrate that the future risk of BFV disease would vary across coastal regions in Queensland. These results may be helpful for public health decision making towards developing effective risk management strategies for BFV disease control and prevention programs in Queensland.

  14. Forecasting the future risk of Barmah Forest virus disease under climate change scenarios in Queensland, Australia.

    Science.gov (United States)

    Naish, Suchithra; Mengersen, Kerrie; Hu, Wenbiao; Tong, Shilu

    2013-01-01

    Mosquito-borne diseases are climate sensitive and there has been increasing concern over the impact of climate change on future disease risk. This paper projected the potential future risk of Barmah Forest virus (BFV) disease under climate change scenarios in Queensland, Australia. We obtained data on notified BFV cases, climate (maximum and minimum temperature and rainfall), socio-economic and tidal conditions for current period 2000-2008 for coastal regions in Queensland. Grid-data on future climate projections for 2025, 2050 and 2100 were also obtained. Logistic regression models were built to forecast the otential risk of BFV disease distribution under existing climatic, socio-economic and tidal conditions. The model was applied to estimate the potential geographic distribution of BFV outbreaks under climate change scenarios. The predictive model had good model accuracy, sensitivity and specificity. Maps on potential risk of future BFV disease indicated that disease would vary significantly across coastal regions in Queensland by 2100 due to marked differences in future rainfall and temperature projections. We conclude that the results of this study demonstrate that the future risk of BFV disease would vary across coastal regions in Queensland. These results may be helpful for public health decision making towards developing effective risk management strategies for BFV disease control and prevention programs in Queensland.

  15. Different Temporal Patterns of Specific and General Autobiographical Memories across the Lifespan in Alzheimer's Disease.

    Science.gov (United States)

    Philippi, Nathalie; Rousseau, François; Noblet, Vincent; Botzung, Anne; Després, Olivier; Cretin, Benjamin; Kremer, Stéphane; Blanc, Frédéric; Manning, Liliann

    2015-01-01

    We compared specific (i.e., associated with a unique time and space) and general (i.e., extended or repeated events) autobiographical memories (AbM) in Alzheimer's disease (AD). The comparison aims at investigating the relationship between these two components of AbM across the lifespan and the volume of cerebral regions of interest within the temporal lobe. We hypothesized that the ability to elicit specific memories would correlate with hippocampal volume, whereas evoking general memories would be related to lateral temporal lobe. AbM was assessed using the modified Crovitz test in 18 patients with early AD and 18 matched controls. The proportions of total memories-supposed to reflect the ability to produce general memories-and specific memories retrieved were compared between AD patients and controls. Correlations to MRI volumes of temporal cortex were tested. We found different temporal patterns for specific and general memories in AD patients, with (i) relatively spared general memories, according to a temporal gradient that preserved remote memories, predominantly associated with right lateral temporal cortex volume. (ii) Conversely, the retrieval of specific AbMs was impaired for all life periods and correlated with bilateral hippocampal volumes. Our results highlight a shift from an initially episodic to a semantic nature of AbMs during AD, where the abstracted form of memories remains.

  16. Different Temporal Patterns of Specific and General Autobiographical Memories across the Lifespan in Alzheimer's Disease

    Science.gov (United States)

    Philippi, Nathalie; Rousseau, François; Noblet, Vincent; Botzung, Anne; Després, Olivier; Cretin, Benjamin; Kremer, Stéphane; Blanc, Frédéric; Manning, Liliann

    2015-01-01

    We compared specific (i.e., associated with a unique time and space) and general (i.e., extended or repeated events) autobiographical memories (AbM) in Alzheimer's disease (AD). The comparison aims at investigating the relationship between these two components of AbM across the lifespan and the volume of cerebral regions of interest within the temporal lobe. We hypothesized that the ability to elicit specific memories would correlate with hippocampal volume, whereas evoking general memories would be related to lateral temporal lobe. AbM was assessed using the modified Crovitz test in 18 patients with early AD and 18 matched controls. The proportions of total memories—supposed to reflect the ability to produce general memories—and specific memories retrieved were compared between AD patients and controls. Correlations to MRI volumes of temporal cortex were tested. We found different temporal patterns for specific and general memories in AD patients, with (i) relatively spared general memories, according to a temporal gradient that preserved remote memories, predominantly associated with right lateral temporal cortex volume. (ii) Conversely, the retrieval of specific AbMs was impaired for all life periods and correlated with bilateral hippocampal volumes. Our results highlight a shift from an initially episodic to a semantic nature of AbMs during AD, where the abstracted form of memories remains. PMID:26175549

  17. Under-Expression of Chemosensory Genes in Domiciliary Bugs of the Chagas Disease Vector Triatoma brasiliensis.

    Science.gov (United States)

    Marchant, Axelle; Mougel, Florence; Jacquin-Joly, Emmanuelle; Costa, Jane; Almeida, Carlos Eduardo; Harry, Myriam

    2016-10-01

    In Latin America, the bloodsucking bugs Triatominae are vectors of Trypanosoma cruzi, the parasite that causes Chagas disease. Chemical elimination programs have been launched to control Chagas disease vectors. However, the disease persists because native vectors from sylvatic habitats are able to (re)colonize houses-a process called domiciliation. Triatoma brasiliensis is one example. Because the chemosensory system allows insects to interact with their environment and plays a key role in insect adaption, we conducted a descriptive and comparative study of the chemosensory transcriptome of T. brasiliensis samples from different ecotopes. In a reference transcriptome built using de novo assembly, we found transcripts encoding 27 odorant-binding proteins (OBPs), 17 chemosensory proteins (CSPs), 3 odorant receptors (ORs), 5 transient receptor potential channel (TRPs), 1 sensory neuron membrane protein (SNMPs), 25 takeout proteins, 72 cytochrome P450s, 5 gluthatione S-transferases, and 49 cuticular proteins. Using protein phylogenies, we showed that most of the OBPs and CSPs for T. brasiliensis had well supported orthologs in the kissing bug Rhodnius prolixus. We also showed a higher number of these genes within the bloodsucking bugs and more generally within all Hemipterans compared to the other species in the super-order Paraneoptera. Using both DESeq2 and EdgeR software, we performed differential expression analyses between samples of T. brasiliensis, taking into account their environment (sylvatic, peridomiciliary and domiciliary) and sex. We also searched clusters of co-expressed contigs using HTSCluster. Among differentially expressed (DE) contigs, most were under-expressed in the chemosensory organs of the domiciliary bugs compared to the other samples and in females compared to males. We clearly identified DE genes that play a role in the chemosensory system. Chemosensory genes could be good candidates for genes that contribute to adaptation or plastic

  18. Under-Expression of Chemosensory Genes in Domiciliary Bugs of the Chagas Disease Vector Triatoma brasiliensis.

    Directory of Open Access Journals (Sweden)

    Axelle Marchant

    2016-10-01

    Full Text Available In Latin America, the bloodsucking bugs Triatominae are vectors of Trypanosoma cruzi, the parasite that causes Chagas disease. Chemical elimination programs have been launched to control Chagas disease vectors. However, the disease persists because native vectors from sylvatic habitats are able to (recolonize houses-a process called domiciliation. Triatoma brasiliensis is one example. Because the chemosensory system allows insects to interact with their environment and plays a key role in insect adaption, we conducted a descriptive and comparative study of the chemosensory transcriptome of T. brasiliensis samples from different ecotopes.In a reference transcriptome built using de novo assembly, we found transcripts encoding 27 odorant-binding proteins (OBPs, 17 chemosensory proteins (CSPs, 3 odorant receptors (ORs, 5 transient receptor potential channel (TRPs, 1 sensory neuron membrane protein (SNMPs, 25 takeout proteins, 72 cytochrome P450s, 5 gluthatione S-transferases, and 49 cuticular proteins. Using protein phylogenies, we showed that most of the OBPs and CSPs for T. brasiliensis had well supported orthologs in the kissing bug Rhodnius prolixus. We also showed a higher number of these genes within the bloodsucking bugs and more generally within all Hemipterans compared to the other species in the super-order Paraneoptera. Using both DESeq2 and EdgeR software, we performed differential expression analyses between samples of T. brasiliensis, taking into account their environment (sylvatic, peridomiciliary and domiciliary and sex. We also searched clusters of co-expressed contigs using HTSCluster. Among differentially expressed (DE contigs, most were under-expressed in the chemosensory organs of the domiciliary bugs compared to the other samples and in females compared to males. We clearly identified DE genes that play a role in the chemosensory system.Chemosensory genes could be good candidates for genes that contribute to adaptation or

  19. Under-Expression of Chemosensory Genes in Domiciliary Bugs of the Chagas Disease Vector Triatoma brasiliensis

    Science.gov (United States)

    Marchant, Axelle; Mougel, Florence; Jacquin-Joly, Emmanuelle; Costa, Jane; Almeida, Carlos Eduardo; Harry, Myriam

    2016-01-01

    Background In Latin America, the bloodsucking bugs Triatominae are vectors of Trypanosoma cruzi, the parasite that causes Chagas disease. Chemical elimination programs have been launched to control Chagas disease vectors. However, the disease persists because native vectors from sylvatic habitats are able to (re)colonize houses—a process called domiciliation. Triatoma brasiliensis is one example. Because the chemosensory system allows insects to interact with their environment and plays a key role in insect adaption, we conducted a descriptive and comparative study of the chemosensory transcriptome of T. brasiliensis samples from different ecotopes. Methodology/Principal Finding In a reference transcriptome built using de novo assembly, we found transcripts encoding 27 odorant-binding proteins (OBPs), 17 chemosensory proteins (CSPs), 3 odorant receptors (ORs), 5 transient receptor potential channel (TRPs), 1 sensory neuron membrane protein (SNMPs), 25 takeout proteins, 72 cytochrome P450s, 5 gluthatione S-transferases, and 49 cuticular proteins. Using protein phylogenies, we showed that most of the OBPs and CSPs for T. brasiliensis had well supported orthologs in the kissing bug Rhodnius prolixus. We also showed a higher number of these genes within the bloodsucking bugs and more generally within all Hemipterans compared to the other species in the super-order Paraneoptera. Using both DESeq2 and EdgeR software, we performed differential expression analyses between samples of T. brasiliensis, taking into account their environment (sylvatic, peridomiciliary and domiciliary) and sex. We also searched clusters of co-expressed contigs using HTSCluster. Among differentially expressed (DE) contigs, most were under-expressed in the chemosensory organs of the domiciliary bugs compared to the other samples and in females compared to males. We clearly identified DE genes that play a role in the chemosensory system. Conclusion/Significance Chemosensory genes could be good

  20. Metabolic Networks Underlying Cognitive Reserve in Prodromal Alzheimer Disease: A European Alzheimer Disease Consortium Project

    NARCIS (Netherlands)

    Morbelli, S.; Perneczky, R.; Drzezga, A.; Frisoni, G. B.; Caroli, A.; van Berckel, B.N.M.; Ossenkoppele, R.; Guedj, E.; Didic, M.; Brugnolo, A.; Naseri, M.; Sambuceti, G.; Pagani, M.; Nobili, F.

    2013-01-01

    This project aimed to investigate the metabolic basis for resilience to neurodegeneration (cognitive reserve) in highly educated patients with prodromal Alzheimer disease (AD). Methods: Sixty-four patients with amnestic mild cognitive impairment who later converted to AD dementia during follow-up,

  1. THE STUDY OF PREVALENCE AND CLINICAL PROFILE OF VALVULAR HEART DISEASES IN GOVERNMENT GENERAL HOSPITAL, KAKINADA

    Directory of Open Access Journals (Sweden)

    H. Vijay Kumar

    2017-03-01

    Full Text Available BACKGROUND Among the cardiovascular diseases acquired, valvular heart disease is one of the common causes of mortality and morbidity in India. An average of 40% of causes is rheumatic valvular heart diseases of all patients admitted with heart diseases. Male preponderance has been noted by most of the physicians in rheumatic heart disease in India. Acquired valvular heart diseases are mitral valve prolapse syndrome, papillary muscle dysfunction, the rupture of chordae tendineae, calcified mitral annulus, calcified aortic stenosis, aortic regurgitation due to syphilis, connective tissue disorders (Marfan’s syndrome, osteogenesis imperfect and systemic lupus erythematosus, atherosclerosis, hypertension and infective endocarditis. Other less common causes are recurrent pulmonary embolism, tuberculosis, cardiac tumours, carcinoid tumours, cardiac surgery for congenital cardiac anomalies and trauma. MATERIALS AND METHODS It is a prospective study on adult patients with valvular abnormalities attending to the Medicine and Cardiology Units of Government General Hospital, Kakinada, between November 2014-May 2017. Total 100 in-patients were included in this study as per inclusion and exclusion criteria. Inclusion Criteria- All patients aged 13 years and above are considered ‘adult’ and are managed by adult medicine. There is no upper age limit. Exclusion Criteria- Patients with congenital valvular heart diseases and cor pulmonale are excluded in the study. RESULTS The incidence of acquired valvular heart disease is higher in the age group of 31-40 years (32% followed by 21-30 years age group (28%. Our study also revealed relatively higher incidence of acquired valvular heart disease among the age groups of 51-60 years and above 60 years, which is due to a relatively higher incidence of mitral regurgitation due to ischaemic heart disease in this same age group. CONCLUSION Out of 100 cases studied mitral valve involvement was noted in 56 cases

  2. Longevity of animals under reactive oxygen species stress and disease susceptibility due to global warming.

    Science.gov (United States)

    Paital, Biswaranjan; Panda, Sumana Kumari; Hati, Akshaya Kumar; Mohanty, Bobllina; Mohapatra, Manoj Kumar; Kanungo, Shyama; Chainy, Gagan Bihari Nityananda

    2016-02-26

    The world is projected to experience an approximate doubling of atmospheric CO2 concentration in the next decades. Rise in atmospheric CO2 level as one of the most important reasons is expected to contribute to raise the mean global temperature 1.4 °C-5.8 °C by that time. A survey from 128 countries speculates that global warming is primarily due to increase in atmospheric CO2 level that is produced mainly by anthropogenic activities. Exposure of animals to high environmental temperatures is mostly accompanied by unwanted acceleration of certain biochemical pathways in their cells. One of such examples is augmentation in generation of reactive oxygen species (ROS) and subsequent increase in oxidation of lipids, proteins and nucleic acids by ROS. Increase in oxidation of biomolecules leads to a state called as oxidative stress (OS). Finally, the increase in OS condition induces abnormality in physiology of animals under elevated temperature. Exposure of animals to rise in habitat temperature is found to boost the metabolism of animals and a very strong and positive correlation exists between metabolism and levels of ROS and OS. Continuous induction of OS is negatively correlated with survivability and longevity and positively correlated with ageing in animals. Thus, it can be predicted that continuous exposure of animals to acute or gradual rise in habitat temperature due to global warming may induce OS, reduced survivability and longevity in animals in general and poikilotherms in particular. A positive correlation between metabolism and temperature in general and altered O2 consumption at elevated temperature in particular could also increase the risk of experiencing OS in homeotherms. Effects of global warming on longevity of animals through increased risk of protein misfolding and disease susceptibility due to OS as the cause or effects or both also cannot be ignored. Therefore, understanding the physiological impacts of global warming in relation to

  3. Longevity of animals under reactive oxygen species stress and disease susceptibility due to global warming

    Science.gov (United States)

    Paital, Biswaranjan; Panda, Sumana Kumari; Hati, Akshaya Kumar; Mohanty, Bobllina; Mohapatra, Manoj Kumar; Kanungo, Shyama; Chainy, Gagan Bihari Nityananda

    2016-01-01

    The world is projected to experience an approximate doubling of atmospheric CO2 concentration in the next decades. Rise in atmospheric CO2 level as one of the most important reasons is expected to contribute to raise the mean global temperature 1.4 °C-5.8 °C by that time. A survey from 128 countries speculates that global warming is primarily due to increase in atmospheric CO2 level that is produced mainly by anthropogenic activities. Exposure of animals to high environmental temperatures is mostly accompanied by unwanted acceleration of certain biochemical pathways in their cells. One of such examples is augmentation in generation of reactive oxygen species (ROS) and subsequent increase in oxidation of lipids, proteins and nucleic acids by ROS. Increase in oxidation of biomolecules leads to a state called as oxidative stress (OS). Finally, the increase in OS condition induces abnormality in physiology of animals under elevated temperature. Exposure of animals to rise in habitat temperature is found to boost the metabolism of animals and a very strong and positive correlation exists between metabolism and levels of ROS and OS. Continuous induction of OS is negatively correlated with survivability and longevity and positively correlated with ageing in animals. Thus, it can be predicted that continuous exposure of animals to acute or gradual rise in habitat temperature due to global warming may induce OS, reduced survivability and longevity in animals in general and poikilotherms in particular. A positive correlation between metabolism and temperature in general and altered O2 consumption at elevated temperature in particular could also increase the risk of experiencing OS in homeotherms. Effects of global warming on longevity of animals through increased risk of protein misfolding and disease susceptibility due to OS as the cause or effects or both also cannot be ignored. Therefore, understanding the physiological impacts of global warming in relation to

  4. Similarity Solutions for Generalized Variable Coefficients Zakharov-Kuznetsov Equation under Some Integrability Conditions

    International Nuclear Information System (INIS)

    Moussa, M.H.M.; El-Shiekh, Rehab M.

    2010-01-01

    In this paper, the symmetry method has been carried over to the generalized variable coefficients Zakharov-Kuznetsov equation. The infinitesimal symmetries and the optimal system are deduced and from this optimal system seven basic fields are determined, and for every vector field in the optimal system the admissible forms of the coefficients are found and this also leads us to transform the given equation into partial differential equations in two variables. After using some referenced transformations the mentioned partial differential equations eventually reduce to ordinary differential equations. The search for solutions to those equations has yielded many exact solutions in most cases. (general)

  5. COMPLICATIONS OF ORAL AND MAXILLOFACIAL SURGERY UNDER GENERAL ANESTHESIA IN TUBE-FED CHILDREN: A RETROSPECTIVE ANALYSIS.

    Science.gov (United States)

    Nguyen, Trang D; Freilich, Marshall M; Macpherson, Bruce A

    2016-06-01

    To assess morbidity and mortality associated with oral and maxillofacial surgery procedures requiring general anesthesia among children with aspiration tendency requiring enteral feeding. A retrospective chart review was conducted of children surgically treated under general anesthesia by the oral and maxillofacial surgery service at the Hospital for Sick Children in Toronto, Canada. Medical and dental records over a 9-year period (January 1, 2000 to January 1, 2010) were reviewed. Data were collected on demographics, primary illness, coexisting medical conditions, procedures performed, medications administered, type of airway management used, duration of general anesthesia, American Society of Anesthesiologists' physical status classification and adverse events. During the period reviewed, 28 children underwent 35 oral and maxillofacial surgery procedures under general anesthesia. The mean patient age was 12 years (range 4-17 years). No deaths occurred. Of the 35 surgeries, 10 (29%) were associated with at least 1adverse event. Adverse events included 1incident of respiratory distress, 2incidents of fever, 5incidents of bleeding, 1incident of seizure and 4incidents of oxygen saturation below 90% for more than 30s. Children with a history of aspiration tendency that necessitates enteral feeding, who undergo oral and maxillofacial surgery under general anesthesia, are at increased risk of morbidity. Before initiating treatment, the surgeon and parents or guardians of such children should carefully consider these risks compared with the anticipated benefit of surgery.

  6. Surgery under general anaesthesia in severe hidradenitis suppurativa : a study of 363 primary operations in 113 patients

    NARCIS (Netherlands)

    Blok, J. L.; Boersma, M.; Terra, J. B.; Spoo, J. R.; Leeman, F. W. J.; van den Heuvel, E. R.; Huizinga, J.; Jonkman, M. F.; Horvath, B.

    BackgroundTreatment of hidradenitis suppurativa (HS) is a difficult undertaking, especially as there is no consensus on what surgical technique is preferred. At our centre severe HS (Hurley II/III) is operated under general anaesthesia, mostly with the STEEP procedure. ObjectivesTo investigate

  7. 77 FR 405 - To Modify Duty-Free Treatment Under the Generalized System of Preferences and for Other Purposes

    Science.gov (United States)

    2012-01-04

    ... President determines to be import-sensitive in the context of the Generalized System of Preferences (GSP) are not eligible to receive benefits under the GSP. 2. Pursuant to section 503(b)(1)(G) of the 1974... ``Commission''), I have determined that certain articles are import- sensitive in the context of the GSP. 3. On...

  8. 77 FR 39885 - To Modify Duty-Free Treatment Under the Generalized System of Preferences, and for Other Purposes

    Science.gov (United States)

    2012-07-05

    ... Generalized System of Preferences (GSP) when imported from a least-developed beneficiary developing country. 2... subject to competitive need limitations on the preferential treatment afforded under the GSP to eligible... terminating the designation of that country as a beneficiary developing country for purposes of the GSP...

  9. 78 FR 39947 - To Modify Duty-Free Treatment Under the Generalized System of Preferences and for Other Purposes

    Science.gov (United States)

    2013-07-02

    ... designate any country a beneficiary developing country under the Generalized System of Preferences (GSP) if... designation as a beneficiary developing country for purposes of the GSP. 2. Having considered the factors set... designation as a GSP beneficiary developing country because it has not taken or is not taking steps to afford...

  10. Awake craniotomy versus craniotomy under general anesthesia for the surgical treatment of insular glioma: choices and outcomes

    NARCIS (Netherlands)

    Gravesteijn, B.Y. (B. Y.); Keizer, M.E. (M. E.); A. Vincent (Audrey); J.W. Schouten (Joost); R.J. Stolker (Robert); M. Klimek (Markus)

    2017-01-01

    textabstractObjective: To investigate differences in outcomes in patients who underwent surgery for insular glioma using an awake craniotomy (AC) vs. a craniotomy under general anesthesia (GA). Methods: Data from patients treated at our hospital between 2005 and 2015 were analyzed retrospectively.

  11. Rapid detoxification from opioid dependence under general anaesthesia versus standard methadone tapering : abstinence rates and withdrawal distress experiences

    NARCIS (Netherlands)

    Krabbe, Paul F M; Koning, Jeroen P F; Heinen, Nadia; Laheij, Robert J F; van Cauter, R M Victory; De Jong, Cor A J

    The aim of this work was to study abstinence rates and withdrawal effects of rapid detoxification of opioid-dependents under general anaesthesia (RD-GA) compared to standard methadone tapering (SMT) using a prospective clinical trial with a follow-up of 3 months, as a preliminary study at the

  12. Rapid detoxification from opioid dependence under general anaesthesia versus standard methadone tapering: abstinence rates and withdrawal distress experiences.

    NARCIS (Netherlands)

    Krabbe, P.F.M.; Koning, J.P.; Heinen, N.; Laheij, R.J.F.; Cauter, R.M.V. van; Jong, C.A.J. de

    2003-01-01

    The aim of this work was to study abstinence rates and withdrawal effects of rapid detoxification of opioid-dependents under general anaesthesia (RD-GA) compared to standard methadone tapering (SMT) using a prospective clinical trial with a follow-up of 3 months, as a preliminary study at the

  13. Mechanisms underlying neurodegeneration in Huntington disease: applications to novel disease-modifying therapies.

    Science.gov (United States)

    Ross, Christopher A; Kronenbuerger, Martin; Duan, Wenzhen; Margolis, Russell L

    2017-01-01

    The CAG repeat expansion mutation that causes Huntington Disease (HD) was discovered more than 20 years ago, yet no treatment has yet been developed to stop the relentless course of the disease. Nonetheless, substantial progress has been made in understanding HD pathogenesis. We review insights that have been gleaned from HD genetics, metabolism, and pathology; HD mouse and cell models; the structure, function and post-translational modification of normal and mutant huntingtin (htt) protein; gene expression profiles in HD cells and tissue; the neurotoxicy of mutant htt RNA; and the expression of an antisense transcript from the HD locus. We conclude that rationale therapeutics for HD is within sight, though many questions remain to be answered. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Somatic diseases in patients with schizophrenia in general practice: their prevalence and health care

    Directory of Open Access Journals (Sweden)

    Meyboom-de Jong Betty

    2009-05-01

    Full Text Available Abstract Background Schizophrenia patients frequently develop somatic co-morbidity. Core tasks for GPs are the prevention and diagnosis of somatic diseases and the provision of care for patients with chronic diseases. Schizophrenia patients experience difficulties in recognizing and coping with their physical problems; however GPs have neither specific management policies nor guidelines for the diagnosis and treatment of somatic co-morbidity in schizophrenia patients. This paper systematically reviews the prevalence and treatment of somatic co-morbidity in schizophrenia patients in general practice. Methods The MEDLINE, EMBASE, PsycINFO data-bases and the Cochrane Library were searched and original research articles on somatic diseases of schizophrenia patients and their treatment in the primary care setting were selected. Results The results of this search show that the incidence of a wide range of diseases, such as diabetes mellitus, the metabolic syndrome, coronary heart diseases, and COPD is significantly higher in schizophrenia patients than in the normal population. The health of schizophrenic patients is less than optimal in several areas, partly due to their inadequate help-seeking behaviour. Current GP management of such patients appears not to take this fact into account. However, when schizophrenic patients seek the GP's help, they value the care provided. Conclusion Schizophrenia patients are at risk of undetected somatic co-morbidity. They present physical complaints at a late, more serious stage. GPs should take this into account by adopting proactive behaviour. The development of a set of guidelines with a clear description of the GP's responsibilities would facilitate the desired changes in the management of somatic diseases in these patients.

  15. Somatic diseases in patients with schizophrenia in general practice: their prevalence and health care.

    Science.gov (United States)

    Oud, Marian J T; Meyboom-de Jong, Betty

    2009-05-09

    Schizophrenia patients frequently develop somatic co-morbidity. Core tasks for GPs are the prevention and diagnosis of somatic diseases and the provision of care for patients with chronic diseases. Schizophrenia patients experience difficulties in recognizing and coping with their physical problems; however GPs have neither specific management policies nor guidelines for the diagnosis and treatment of somatic co-morbidity in schizophrenia patients. This paper systematically reviews the prevalence and treatment of somatic co-morbidity in schizophrenia patients in general practice. The MEDLINE, EMBASE, PsycINFO data-bases and the Cochrane Library were searched and original research articles on somatic diseases of schizophrenia patients and their treatment in the primary care setting were selected. The results of this search show that the incidence of a wide range of diseases, such as diabetes mellitus, the metabolic syndrome, coronary heart diseases, and COPD is significantly higher in schizophrenia patients than in the normal population. The health of schizophrenic patients is less than optimal in several areas, partly due to their inadequate help-seeking behaviour. Current GP management of such patients appears not to take this fact into account. However, when schizophrenic patients seek the GP's help, they value the care provided. Schizophrenia patients are at risk of undetected somatic co-morbidity. They present physical complaints at a late, more serious stage. GPs should take this into account by adopting proactive behaviour. The development of a set of guidelines with a clear description of the GP's responsibilities would facilitate the desired changes in the management of somatic diseases in these patients.

  16. Systematic review of general burden of disease studies using disability-adjusted life years

    Directory of Open Access Journals (Sweden)

    Polinder Suzanne

    2012-11-01

    Full Text Available Abstract Objective To systematically review the methodology of general burden of disease studies. Three key questions were addressed: 1 what was the quality of the data, 2 which methodological choices were made to calculate disability adjusted life years (DALYs, and 3 were uncertainty and risk factor analyses performed? Furthermore, DALY outcomes of the included studies were compared. Methods Burden of disease studies (1990 to 2011 in international peer-reviewed journals and in grey literature were identified with main inclusion criteria being multiple-cause studies that quantified the burden of disease as the sum of the burden of all distinct diseases expressed in DALYs. Electronic database searches included Medline (PubMed, EMBASE, and Web of Science. Studies were collated by study population, design, methods used to measure mortality and morbidity, risk factor analyses, and evaluation of results. Results Thirty-one studies met the inclusion criteria of our review. Overall, studies followed the Global Burden of Disease (GBD approach. However, considerable variation existed in disability weights, discounting, age-weighting, and adjustments for uncertainty. Few studies reported whether mortality data were corrected for missing data or underreporting. Comparison with the GBD DALY outcomes by country revealed that for some studies DALY estimates were of similar magnitude; others reported DALY estimates that were two times higher or lower. Conclusions Overcoming “error” variation due to the use of different methodologies and low-quality data is a critical priority for advancing burden of disease studies. This can enlarge the detection of true variation in DALY outcomes between populations or over time.

  17. Hopf and Generalized Hopf Bifurcations in a Recurrent Autoimmune Disease Model

    Science.gov (United States)

    Zhang, Wenjing; Yu, Pei

    This paper is concerned with bifurcation and stability in an autoimmune model, which was established to study an important phenomenon — blips arising from such models. This model has two equilibrium solutions, disease-free equilibrium and disease equilibrium. The positivity of the solutions of the model and the global stability of the disease-free equilibrium have been proved. In this paper, we particularly focus on Hopf bifurcation which occurs from the disease equilibrium. We present a detailed study on the use of center manifold theory and normal form theory, and derive the normal form associated with Hopf bifurcation, from which the approximate amplitude of the bifurcating limit cycles and their stability conditions are obtained. Particular attention is also paid to the bifurcation of multiple limit cycles arising from generalized Hopf bifurcation, which may yield bistable phenomenon involving equilibrium and oscillating motion. This result may explain some complex dynamical behavior in real biological systems. Numerical simulations are compared with the analytical predictions to show a very good agreement.

  18. Lack of association between the TNF-α-1031genotypes and generalized aggressive periodontitis disease.

    Science.gov (United States)

    Darvishi, E; Aziziaram, Z; Yari, K; Bagheri Dehbaghi, M; Kahrizi, D; Karim, H; Vaziri, S; Zargooshi, J; Ghadiri, K; Muhammadi, S; Kazemi, E; Moradi, M T; Shokrinia, M; Mohammadi, N

    2016-09-30

    Periodontal disease is one of the most prevalent inflammatory illnesses and is a main cause of tooth loss in human population. Tumor necrosis factor-α (TNF-α) gene is one of pro-inflammatory cytokines which has important role in pathogenesis of periodontal disease. The main purpose of this study is to determine genotype abundance of TNF-α-1031 gene in both groups of patients and controls, and also investigation of relation of single nucleotide polymorphism (SNP) these genotypes with periodontal disease risk. DNA was extracted from blood tissue of 31 patients and 54 controls. The TNF-α-1031 polymorphism was evaluated by polymerase chain reaction- confronting two-pair primer (PCR-CTPP) method. In the GAP group, the frequencies of TT, TC and CC genotypes were 35.48%, 61.29 and 3.23%, respectively. In controls the frequencies of TT, TC and CC genotypes were 22.22%, 72.22%, and 5.56%, respectively. Results of this study showed that there was no significant association between TNF-α (-1031 T/C promoter) gene polymorphisms and the risk of generalized aggressive periodontitis disease.

  19. Natriuretic peptides: prediction of cardiovascular disease in the general population and high risk populations

    DEFF Research Database (Denmark)

    Hildebrandt, Per

    2009-01-01

    The natriuretic peptides, especially the B-type peptide (BNP) and its inactive split-product N-terminal proBNP (Nt-proBNP) are increasingly used in screening for heart failure, primarily with reduced systolic function, in patients with symptoms suggestive of heart failure, as well in the stable...... (General Practitioner) setting as in the acute setting. Supporting this use is a very strong prognostic value of the natriuretic peptides. This has been shown in as well heart failure as acute coronary syndromes, but also in the general population and in high-risk groups as patients with diabetes......, hypertension and coronary artery disease. This has of course raised interest for the use of the natriuretic peptides as a risk marker and for screening for heart failure with reduced systolic function in these populations. In symptomatic persons and in high risk populations, the natriuretic peptides have...

  20. [The dimethyl sulfoxide under general anesthesia: An alternative after failure without anesthesia in the painful bladder syndrome/interstitial cystitis?

    Science.gov (United States)

    Gaullier, M; Tricard, T; Mouracade, P; Saussine, C

    2018-03-08

    The intravesical instillation of dimethyl sulfoxide (iDMSO), performed without anesthestic, is a therapeutic option for the painful bladder syndrome/interstial cystitis (PBS/IC). Some patients are against those iDMSO because of bad tolerance. Our study evaluates the tolerance and the outcome of the iDMSO under general anesthetic (GA) after the failure of the iDMSO without anesthetic. From May 2013 to April 2016, 11 patients with a PBS, 9 women (81.8 %), have been treated by iDMSO without anesthetic, without improvement because of bad tolerance and no possibility to have a one hour contact between the bladder and the DMSO. The 11 patients were evaluated by mictional calendar and Sant O'Leary score. All the patients had a hydrodistension and a per os treatment without improvement. Six new iDMSO were performed under general anesthetic in ambulatory surgery with good tolerance for the 11 patients. The frequency and the nocturia before iDMSO without anesthetic and after iDMSO under general anesthetic were 32.2minutes [15; 60] and 6.3 per night [3; 10] and 126.9minutes [25; 240] and 3 per night [2; 6], so a variation respectively of 96.4minutes [0; 180] and of 3.75 per night [2; 6]. The symptom score and the problem index were 17.5 [13; 20] and 15.5 [13; 16] before and 13.5 [4; 20] and 12 [1; 16] after iDMSO under general anesthetic; a variation of 3.2 [0; 9] and 4 [0; 12]. The iDMSO under general anesthetic seems to improve objectively and subjectively the patients who are not improved by the instillations without anesthetic because of bad tolerance. 4. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  1. Spatial statistical analysis of basal stem root disease under natural field epidemic of oil palm

    Science.gov (United States)

    Kamu, Assis; Phin, Chong Khim; Seman, Idris Abu; Wan, Hoong Hak; Mun, Ho Chong

    2015-02-01

    Oil palm or scientifically known as Elaeis guineensis Jacq. is the most important commodity crop in Malaysia and has greatly contributed to the economy growth of the country. As far as disease is concerned in the industry, Basal Stem Rot (BSR) caused by Ganoderma boninence remains the most important disease. BSR disease is the most widely studied with information available for oil palm disease in Malaysia. However, there is still limited study on the spatial as well as temporal pattern or distribution of the disease especially under natural field epidemic condition in oil palm plantation. The objective of this study is to spatially identify the pattern of BSR disease under natural field epidemic using two geospatial analytical techniques, which are quadrat analysis for the first order properties of partial pattern analysis and nearest-neighbor analysis (NNA) for the second order properties of partial pattern analysis. Two study sites were selected with different age of tree. Both sites are located in Tawau, Sabah and managed by the same company. The results showed that at least one of the point pattern analysis used which is NNA (i.e. the second order properties of partial pattern analysis) has confirmed the disease is complete spatial randomness. This suggests the spread of the disease is not from tree to tree and the age of palm does not play a significance role in determining the spatial pattern of the disease. From the spatial pattern of the disease, it would help in the disease management program and for the industry in the future. The statistical modelling is expected to help in identifying the right model to estimate the yield loss of oil palm due to BSR disease in the future.

  2. A generalized-growth model to characterize the early ascending phase of infectious disease outbreaks

    DEFF Research Database (Denmark)

    Viboud, Cecile; Simonsen, Lone; Chowell, Gerardo

    2016-01-01

    the importance of sub-exponential growth for forecasting purposes.Results: We applied the generalized-growth model to 20 infectious disease outbreaks representing a range of transmission routes. We uncovered epidemic profiles ranging from very slow growth (p = 0.14 for the Ebola outbreak in Bomi, Liberia (2014...... African Ebola epidemic provided a unique opportunity to explore how growth profiles vary by geography; analysis of the largest district-level outbreaks revealed substantial growth variations (mean p = 0.59, range: 0.14–0.97). The districts of Margibi in Liberia and Bombali and Bo in Sierra Leone had near...

  3. A simple estimate of the general population frequency of the MHC susceptibility gene for autoimmune polygenic disease.

    Science.gov (United States)

    Alper, C A; Dubey, D P; Yunis, E J; Awdeh, Z

    2000-01-01

    We wished to determine the frequencies of the MHC and non-MHC susceptibility genes for polygenic autoimmune diseases like type 1 diabetes (IDDM). We used Mendelian inheritance and the Hardy-Weinberg equilibrium to calculate the frequencies of mating pairs and susceptible offspring under classical recessive and dominant inheritance of the MHC susceptibility gene. We then analyzed the distribution of haplotype sharing by affected sib pairs of the 4 MHC haplotypes in each of the kinds of mating pairs in terms of the frequency of the disease susceptibility gene. For IDDM, the analysis was consistent with a recessive, but not a dominant, MHC susceptibility gene of frequency 0.525 at a distribution of 55, 38 and 7% of affected sib pairs who share 2, 1 and 0 MHC haplotypes, respectively. A simple relationship was obtained: if inheritance is recessive, the MHC susceptibility gene frequency is the square root of the fraction of affected sib pairs who share no MHC haplotypes multiplied by 4. For recessive inheritance, affected sib pairs who share no haplotypes are solely in families where both parents are homozygous MHC-susceptible. Although homozygous MHC susceptibles represent over 25% of the population, only 2-3% of them are IDDM-susceptible at non-MHC susceptibility loci, also required for disease expression. Predictions from our analysis fit all published observations of the familial occurrence of disease. The analysis is general, simple and provides a single estimate (not a range) of the MHC susceptibility gene frequency. This approach should be applicable to other MHC-determined polygenic diseases. Copyright 2000 S. Karger AG, Basel

  4. Pelvic osteotomy under general anaesthesia combined with caudal blockade in children

    OpenAIRE

    Novotny, Milan; Rejholec, Milan

    1987-01-01

    Combined anaesthesia (Local plus General) has been used at the 1 st Clinic of Orthopaedics since 1986. A trial is described involving 21 children and comparing them with a control group of 14 cases having only inhalation anaesthesia. Caudal blockade with Bupivacaine is the local anaesthesia used to decrease stress during pelvic osteotomies. The use of combined anaesthesia provides smoothness and stability with absence of side effects and the doses of anaesthetic and post- operative analgesic ...

  5. Promoting investment under international capital mobility: An intertemporal general equilibrium analysis

    OpenAIRE

    Bovenberg, A.L.; Goulder, L.H.

    1993-01-01

    This paper uses a dynamic computable general equilibrium model to compare, in an economy open to international capital flows, the effects of two U.S. policies intended to promote domestic capital formation. The two policies -- the introduction of an investment tax credit (ITC) and a reduction in the statutory corporate income tax rate -- differ in their treatment of old (existing) and new capital. The model features adjustment dynamics, intertemporal optimization by U.S. and foreign household...

  6. A general formula considering one group delayed neutron under nonequilibrium condition

    International Nuclear Information System (INIS)

    Li Haofeng; Chen Wenzhen; Zhu Qian; Luo Lei

    2008-01-01

    A general neutron breeder formula is developed when the reactor does not reach the steady state and the reactivity changes in phase. This formula can be used to calculate the results of six groups delayed neutron model through a way of amending λ in one group delayed neutron model. The analysis shows that the solution of amended single group delayed neutron model is approximately equal to that of six-group delayed neutron model, and the amended model meets the engineering accuracy. (authors)

  7. What Differentiates Employees' Job Performance Under Stressful Situations: The Role of General Self-Efficacy.

    Science.gov (United States)

    Lu, Chang-Qin; Du, Dan-Yang; Xu, Xiao-Min

    2016-10-02

    The aim of this research is to verify the two-dimensional challenge-hindrance stressor framework in the Chinese context, and investigate the moderating effect of general self-efficacy in the stress process. Data were collected from 164 Chinese employee-supervisor dyads. The results demonstrated that challenge stressors were positively related to job performance while hindrance stressors were negatively related to job performance. Furthermore, general self-efficacy strengthened the positive relationship between challenge stressors and job performance, whereas the attenuating effect of general self-efficacy on the negative relationship between hindrance stressors and job performance was nonsignificant. These findings qualify the two-dimensional challenge-hindrance stressor framework, and support the notion that employees with high self-efficacy benefit more from the positive effect of challenge stressors in the workplace. By investigating the role of an individual difference variable in the challenge-hindrance stressor framework, this research provides a more accurate picture of the nature of job stress, and enhances our understanding of the job stressor-job performance relationship.

  8. A generalized-growth model to characterize the early ascending phase of infectious disease outbreaks.

    Science.gov (United States)

    Viboud, Cécile; Simonsen, Lone; Chowell, Gerardo

    2016-06-01

    A better characterization of the early growth dynamics of an epidemic is needed to dissect the important drivers of disease transmission, refine existing transmission models, and improve disease forecasts. We introduce a 2-parameter generalized-growth model to characterize the ascending phase of an outbreak and capture epidemic profiles ranging from sub-exponential to exponential growth. We test the model against empirical outbreak data representing a variety of viral pathogens in historic and contemporary populations, and provide simulations highlighting the importance of sub-exponential growth for forecasting purposes. We applied the generalized-growth model to 20 infectious disease outbreaks representing a range of transmission routes. We uncovered epidemic profiles ranging from very slow growth (p=0.14 for the Ebola outbreak in Bomi, Liberia (2014)) to near exponential (p>0.9 for the smallpox outbreak in Khulna (1972), and the 1918 pandemic influenza in San Francisco). The foot-and-mouth disease outbreak in Uruguay displayed a profile of slower growth while the growth pattern of the HIV/AIDS epidemic in Japan was approximately linear. The West African Ebola epidemic provided a unique opportunity to explore how growth profiles vary by geography; analysis of the largest district-level outbreaks revealed substantial growth variations (mean p=0.59, range: 0.14-0.97). The districts of Margibi in Liberia and Bombali and Bo in Sierra Leone had near-exponential growth, while the districts of Bomi in Liberia and Kenema in Sierra Leone displayed near constant incidences. Our findings reveal significant variation in epidemic growth patterns across different infectious disease outbreaks and highlights that sub-exponential growth is a common phenomenon, especially for pathogens that are not airborne. Sub-exponential growth profiles may result from heterogeneity in contact structures or risk groups, reactive behavior changes, or the early onset of interventions strategies

  9. Alzheimer's Disease as Subcellular `Cancer' --- The Scale-Invariant Principles Underlying the Mechanisms of Aging ---

    Science.gov (United States)

    Murase, M.

    1996-01-01

    Alzheimer's disease (AD) is characterized by the slow onset of neurodegeneration leading to dementia in many elderly people. The pathological hallmarks of AD are: the extracellular β-amyloid deposition in the senile plaques; the β-amyloid deposition in cerebral blood vessel walls especially in hereditary cerebral hemorrhage with amyloidosis of the Dutch type (HCHWA-D); the intracellular neurofibrillary tangle formation composed of paired helical filaments (PHF), the principal component of which is a hyperphosphorylated form of the microtubule-binding protein, tau; and neurological dysfuction and neuronal cell death in limited regions and pathways of the central nervous system. Note that β-amyloid is a truncated form of a cell surface integral membrane glycoprotein: amyloid precursor protein (APP). Despite these hallmarks, the pathogenesis of AD has been poorly understood. In the present paper, a theory of aging is proposed to give a coherent account of the origins and causes of neurodegeneration common to the diverse neurodegenerative disorders such as AD and prion (proteinaceous infectious particles) diseases in comparison with the pathogenesis of cancers. Surprisingly, the self-aggregation of denatured proteins -- such as β-amyloid, PHF and prions -- responsible for neuronal cell death resembles, in many respects, the development (or the clonal evolution) of malignant cells at the expense of the entire organism harboring them. Although neurodegenerative disorders and cancers apparently differe in pathology, they nevertheless seem to follow the same priciples regardless of the level and scale of the biological organization. It is the general principles of heritable variations and natural selection as well as the general principles of self-organization that operate, not only on different molecules, but also at different hierarchical levels and scales of the biological organizaiton, independent of the details of diseases. Traditionally, natural selection, along

  10. [Comparison of long-term dental treatment effects of children treated under general anesthesia and passive restraint].

    Science.gov (United States)

    Zhou, F; Xia, B; Zhang, S; Ma, W L; Xiao, Y M; Ge, L H

    2017-02-09

    Objective: To compare the long-term dental treatment effects, oral health habits and oral-health-related qualities of life of children treated under general anesthesia (GA) and passive restraint (PR), respectively. Methods: Twenty seven 2 to 4-year-old children treated under GA and thirty four children treated under PR were recruited in the Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology. Up to 2 years after the treatment, a follow up assessment was conducted. The data of general information, dental plaque level and the unplanned treatments were recorded and analyzed. The questionnaire of oral health habits and early childhood oral health impact scale (ECOHIS) for each child was also completed and analyzed. The survival rate and median survival time of the deciduous teeth were calculated. Multivariate analysis was performed by using Cox proportional hazard model. Results: Twenty-five children under GA and 32 under PR were finally included, with a total of 1 098 deciduous teeth. The postoperative dental plaque indicesin both GA and PR groups had significantly improved than that of before the treatments ( P= 0.019, Pbehavior management techniques. Conclusions: The long-term dental treatment effects of children treated under GA was significantly better than that of PR group. Continuous reinforcement of proper dietary and oral hygiene habits might help in maintaining the long-term treatment effect.

  11. Tight finite-key analysis for passive decoy-state quantum key distribution under general attacks

    Science.gov (United States)

    Zhou, Chun; Bao, Wan-Su; Li, Hong-Wei; Wang, Yang; Li, Yuan; Yin, Zhen-Qiang; Chen, Wei; Han, Zheng-Fu

    2014-05-01

    For quantum key distribution (QKD) using spontaneous parametric-down-conversion sources (SPDCSs), the passive decoy-state protocol has been proved to be efficiently close to the theoretical limit of an infinite decoy-state protocol. In this paper, we apply a tight finite-key analysis for the passive decoy-state QKD using SPDCSs. Combining the security bound based on the uncertainty principle with the passive decoy-state protocol, a concise and stringent formula for calculating the key generation rate for QKD using SPDCSs is presented. The simulation shows that the secure distance under our formula can reach up to 182 km when the number of sifted data is 1010. Our results also indicate that, under the same deviation of statistical fluctuation due to finite-size effects, the passive decoy-state QKD with SPDCSs can perform as well as the active decoy-state QKD with a weak coherent source.

  12. A General Asymmetric Formal Synthesis of Aza-Baylis-Hillman Type Products under Bifunctional Catalysis.

    Science.gov (United States)

    Frías, María; Carrasco, Ana Cristina; Fraile, Alberto; Alemán, José

    2018-03-02

    A new organocatalytic strategy for the synthesis of enantioenriched aza-Baylis-Hillman type products via a frustrated vinylogous reaction is presented. This process proceeds under mild conditions with good yields, completed Z/E selectivity and excellent enantioselectivities. Moreover, easy derivatizations of the final products led to important building blocks of organic synthesis such as 1,3-aminoalcohols and Lewis base catalysts. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  13. The impact of covariate misclassification using generalized linear regression under covariate-adaptive randomization.

    Science.gov (United States)

    Fan, Liqiong; Yeatts, Sharon D; Wolf, Bethany J; McClure, Leslie A; Selim, Magdy; Palesch, Yuko Y

    2018-01-01

    Under covariate adaptive randomization, the covariate is tied to both randomization and analysis. Misclassification of such covariate will impact the intended treatment assignment; further, it is unclear what the appropriate analysis strategy should be. We explore the impact of such misclassification on the trial's statistical operating characteristics. Simulation scenarios were created based on the misclassification rate and the covariate effect on the outcome. Models including unadjusted, adjusted for the misclassified, or adjusted for the corrected covariate were compared using logistic regression for a binary outcome and Poisson regression for a count outcome. For the binary outcome using logistic regression, type I error can be maintained in the adjusted model, but the test is conservative using an unadjusted model. Power decreased with both increasing covariate effect on the outcome as well as the misclassification rate. Treatment effect estimates were biased towards the null for both the misclassified and unadjusted models. For the count outcome using a Poisson model, covariate misclassification led to inflated type I error probabilities and reduced power in the misclassified and the unadjusted model. The impact of covariate misclassification under covariate-adaptive randomization differs depending on the underlying distribution of the outcome.

  14. Cesarean under general or epidural anesthesia: does it differ in terms of regional cerebral oxygenation?

    Science.gov (United States)

    Ozgen, Zehra Serpil Ustalar; Toraman, Fevzi; Erkek, Esin; Sungur, Tuba; Guclu, Pınar; Durmaz, Samime; Bilgili, Canan Okuyucu

    2014-12-01

    It is aimed to evaluate whether there is a difference in regional cerebral saturation of newborns measured by near infrared spectroscopy born either by general anesthesia or combined spinal epidural anesthesia during elective cesarean deliveries. After approval from the ethics committee of our hospital, and informed consents of the parturients were taken, 68 patients were included in the study. The regional cerebral oxygen saturations (RcSO2) of newborns were measured by near infrared spectroscopy (NIRS) measurements at 1st, 5th min after birth. In group I (n=32), general anesthesia was performed for the cesarean operation and in group II (n=36), combined spinal epidural anesthesia (CSEA) was the anesthetic management. The age of the mother, gestation, the problems related to the pregnancy, heart rate, blood pressure, oxygen saturation (SpO2) of the mother had been recorded. The measurements of the newborn were; SpO2 of right hand, RcSO2 measured by NIRS, the delivery time (from incision to the cessation of circulation in the placental cord), Apgar score. Data were analyzed using GraphPad Prism 5.0 (GraphPad Software, La Jolla, California) and presented as mean +/- SD. Results obtained in different groups were compared using upaired t-test. Differences were statistically significant at p newborns were significantly higher in Group II. Regional cerebral oxygenation measured by NIRS were significantly higher in CSEA group. Combined spinal epidural anesthesia, besides other known advantages, had been shown to be superior to general anesthesia as a means of regional cerebral oxygenation of the newborns. Copyright © 2014. Published by Elsevier B.V.

  15. Huntington disease reduced penetrance alleles occur at high frequency in the general population

    Science.gov (United States)

    Kay, Chris; Collins, Jennifer A.; Miedzybrodzka, Zosia; Madore, Steven J.; Gordon, Erynn S.; Gerry, Norman; Davidson, Mark; Slama, Ramy A.

    2016-01-01

    Objective: To directly estimate the frequency and penetrance of CAG repeat alleles associated with Huntington disease (HD) in the general population. Methods: CAG repeat length was evaluated in 7,315 individuals from 3 population-based cohorts from British Columbia, the United States, and Scotland. The frequency of ≥36 CAG alleles was assessed out of a total of 14,630 alleles. The general population frequency of reduced penetrance alleles (36–39 CAG) was compared to the prevalence of patients with HD with genetically confirmed 36–39 CAG from a multisource clinical ascertainment in British Columbia, Canada. The penetrance of 36–38 CAG repeat alleles for HD was estimated for individuals ≥65 years of age and compared against previously reported clinical penetrance estimates. Results: A total of 18 of 7,315 individuals had ≥36 CAG, revealing that approximately 1 in 400 individuals from the general population have an expanded CAG repeat associated with HD (0.246%). Individuals with CAG 36–37 genotypes are the most common (36, 0.096%; 37, 0.082%; 38, 0.027%; 39, 0.000%; ≥40, 0.041%). General population CAG 36–38 penetrance rates are lower than penetrance rates extrapolated from clinical cohorts. Conclusion: HD alleles with a CAG repeat length of 36–38 occur at high frequency in the general population. The infrequent diagnosis of HD at this CAG length is likely due to low penetrance. Another important contributing factor may be reduced ascertainment of HD in those of older age. PMID:27335115

  16. Estimation and model selection of semiparametric multivariate survival functions under general censorship.

    Science.gov (United States)

    Chen, Xiaohong; Fan, Yanqin; Pouzo, Demian; Ying, Zhiliang

    2010-07-01

    We study estimation and model selection of semiparametric models of multivariate survival functions for censored data, which are characterized by possibly misspecified parametric copulas and nonparametric marginal survivals. We obtain the consistency and root- n asymptotic normality of a two-step copula estimator to the pseudo-true copula parameter value according to KLIC, and provide a simple consistent estimator of its asymptotic variance, allowing for a first-step nonparametric estimation of the marginal survivals. We establish the asymptotic distribution of the penalized pseudo-likelihood ratio statistic for comparing multiple semiparametric multivariate survival functions subject to copula misspecification and general censorship. An empirical application is provided.

  17. Adaptive State Estimation for a Class of Nonlinear Stochastic Systems under Generalized Lipschitz Condition

    Science.gov (United States)

    Miao, Xiu-feng; Li, Long-suo; Yan, Xiu-ming

    2014-11-01

    This paper is concerned with adaptive observer design problem for a class of nonlinear stochastic systems. Unknown constant parameters are assumed to be norm bounded. In order to better use the structural knowledge of the nonlinear part, a generalized Lipschitz condition is introduced to the adaptive observer design for a class of nonlinear stochastic systems for the first time. Based on a Lyapunov-Krasovskii functional approach and stochastic Lyapunov stability theory, we present a new adaptive observer design condition with ultimately exponentially bounded in sense of mean square for errors systems in terms of linear matrix inequality (LMI). A numerical example is exploited to show the validity and feasibility of the results.

  18. A Retrospective Inquiry into the Operation of Service Custom under the American Military General Articles.

    Science.gov (United States)

    1982-05-23

    17-18 (2d ed. 1902). 42W. Clark and W. Marshall, A Treatise on the Law of Crimes 23-24 (5th ed. 1952 ). 43Rollin Perkins has written: "Courts are...readily recognize as prejudicial to good order and disci- 185See United States v. Kirchner, 1 C.M.A. 477, 4 C.M.R. 697Ŕ ( 1952 ); see generally Zoghby, Is...34, and "con- ducting himself in a very riotous manner" while on duty; 286 assaulting an innkeeper , then publicly defying one’s com- 287 manding officer to

  19. Experimental, theoretical, and mathematical elements for a possible Lie-admissible generalization of the notion of particle under strong interactions

    International Nuclear Information System (INIS)

    Santilli, R.M.

    1981-01-01

    A primary objective of the research is the achievement of clear experimental knowledge on the intrinsic characteristics of particles (such as magnetic moment, spin, space parity, etc.) under strong interactions. These characteristics, when known, have been measured a number of times, but all times for particles under long range electromagnetic interactions (e.g., for bubble chamber techniques). The same characteristics are then generally assumed to persist under the different physical conditions of the strong interactions, while no direct or otherwise final measurement under strong interactions exists at this time. The advocated physical knowledge is clearly important for controlled fusion, as well as for a serious study of the foundations of strong interactions. The paper initiates the study by considering the following alternatives. A: the electromagnetic characteristics of particles persist in the transition to the strong; or B: variations in these characteristics are physically conceivable, mathematically treatable, and experimentally detectable. The need to conduct additional experiments, and achieve a final resolution of the issue, is stressed throughout the paper. In the hope of contributing toward this future goal, the paper then reviews the quantitative treatment of possible deviations via the Lie-admissible generalization of Lie's theory, with particular reference to the Lie-admissible generalizations of Lie group, Lie algebras, and enveloping associative algebras. A generalized notion of extended particle under nonlocal nonpotential strong interactions emerge from these studies. The theory is applied to the re-elaboration of the data on the spinor symmetry via neutron interferometers. It is shown that the data are indeed consistent with a breaking of the SU(2)-spin symmetry due to nonlocal nonpotential forces. A number of experiments for the future resolution of the issue are indicated

  20. Generalized transmission line method to study the far-zone radiation of antennas under a multilayer structure

    CERN Document Server

    Wu, Xuan Hui

    2008-01-01

    This book gives a step-by-step presentation of a generalized transmission line method to study the far-zone radiation of antennas under a multilayer structure. Normally, a radiation problem requires a full wave analysis which may be time consuming. The beauty of the generalized transmission line method is that it transforms the radiation problem for a specific type of structure, say the multilayer structure excited by an antenna, into a circuit problem that can be efficiently analyzed. Using the Reciprocity Theorem and far-field approximation, the method computes the far-zone radiation due to

  1. A COMPARATIVE STUDY OF OUTCOMES AFTER MODIFIED RADICAL MASTECTOMY DONE UNDER THORACIC EPIDURAL vs. GENERAL ANAESTHESIA

    Directory of Open Access Journals (Sweden)

    Jakkula Kishore

    2017-03-01

    Full Text Available BACKGROUND In earlier days General Anaesthesia (GA was the choice for MRM, but recently Thoracic Epidural (TE analgesia is being increasingly used for MRM. TE technique has a lot of advantages over the conventional GA technique. MATERIALS AND METHODS 100 patients with carcinoma breast are divided into two groups- Thoracic Epidural (TE and General Anaesthesia (GA of 50 patients each. Four patients in TE group were converted to GA in view of patient’s anxiety during surgery. All the intraoperative parameters heart rate, blood pressure, bleeding and postoperative outcomes, seroma formation, drains, wound infection rates, flap necrosis and hospital stay are recorded. RESULTS The demographic data showed no differences between both groups. During the intraoperative period, hypertension and tachycardia were more frequent in GA group while hypotension and bradycardia more in TE group, which was statistically significant (p value <0.05. In the immediate postoperative period, nausea and vomiting were more in GA group (31% than in TE group (8.6%, which was statistically significant (p value 0.01. Also, pain scores were more in GA group than in TE group. Wound infection rates, seroma incidence, flap necrosis, length of hospital stay and hospital costs were less in TE group than GA group. CONCLUSION Use of thoracic epidural technique as a sole anaesthetic technique for MRM surgeries provides adequate operating conditions, better side effect profile, better pain management, less postoperative complications, early ambulation, early drain removal and early discharge from the hospital.

  2. Several factors influenced general practitioner participation in the implementation of a disease management programme.

    Science.gov (United States)

    Ribe, Anette Riisgaard; Fenger-Grøn, Morten; Vedsted, Peter; Bro, Flemming; Kærsvang, Lone; Vestergaard, Mogens

    2014-09-01

    Disease management programmes (DMPs) require a high degree of participation from general practitioners (GPs) in order to succeed. We aimed to describe the participation among Danish GPs in a DMP. A quality improvement project entitled the Chronic Care Compass (CCC) was introduced in 2010 by the Central Denmark Region. The project was based on DMPs targeting persons suffering from three chronic diseases (diabetes, chronic obstructive pulmonary disease and acute coronary syndrome). All GPs in the region were invited to participate. We obtained data from administrative registries and studied the participation and its association with characteristics of practices and patients. Differences in participation were assessed using binomial regression models. A total of 271 (69.1%) practices participated in the CCC. The participation was 28.9 percentage points (pp) (confidence interval (CI): 14.3; 43.6) lower among GPs who were older than 60 years versus younger than 50 years, 32.2 pp (CI: 19.1; 45.2) lower among GPs who provided few versus many chronic care consultations, 13.7 pp (CI: 1.7; 25.6) lower among GPs with lower versus medium practice gross income, and 16.9 pp (CI:6.1; 27.8) lower among GPs with a patient population with medium versus low degree of socio-economic deprivation. Participation in the CCC was lower among GPs who provided less chronic care, had a lower practice gross income and had a patient population with a higher degree of deprivation. The project was supported by the Research Unit for General Practice, Aarhus University, and the Lundbeck Foundation. not relevant.

  3. General rules for managing and surveying networks of pests, diseases, and endangered species.

    Science.gov (United States)

    Chadès, Iadine; Martin, Tara G; Nicol, Samuel; Burgman, Mark A; Possingham, Hugh P; Buckley, Yvonne M

    2011-05-17

    The efficient management of diseases, pests, or endangered species is an important global issue faced by agencies constrained by limited resources. The management challenge is even greater when organisms are difficult to detect. We show how to prioritize management and survey effort across time and space for networks of susceptible-infected-susceptible subpopulations. We present simple and robust rules of thumb for protecting desirable, or eradicating undesirable, subpopulations connected in typical network patterns (motifs). We further demonstrate that these rules can be generalized to larger networks when motifs are combined in more complex formations. Results show that the best location to manage or survey a pest or a disease on a network is also the best location to protect or survey an endangered species. The optimal starting point in a network is the fastest motif to manage, where line, star, island, and cluster motifs range from fast to slow. Managing the most connected node at the right time and maintaining the same management direction provide advantages over previously recommended outside-in strategies. When a species or disease is not detected and our belief in persistence decreases, our results recommend shifting resources toward management or surveillance of the most connected nodes. Our analytic approximation provides guidance on how long we should manage or survey networks for hard-to-detect organisms. Our rules take into account management success, dispersal, economic cost, and imperfect detection and offer managers a practical basis for managing networks relevant to many significant environmental, biosecurity, and human health issues.

  4. Strategic directions for developing the Australian general practice nurse role in cardiovascular disease management.

    Science.gov (United States)

    Halcomb, Elizabeth J; Davidson, Patricia M; Yallop, Julie; Griffiths, Rhonda; Daly, John

    2007-08-01

    Practice nursing is an integral component of British and New Zealand primary care, but in Australia it remains an emerging specialty. Despite an increased focus on the Australian practice nurse role, there has been limited strategic role development, particularly relating to national health priority areas. This paper reports the third stage of a Project exploring the Australian practice nurse role in the management of cardiovascular disease (CVD). This stage involved a consensus development conference, undertaken to identify strategic, priority recommendations for practice nurse role development. 1. Practice nurses have an important role in developing systems and processes for CVD management; 2. A change in the culture of general practice is necessary to promote acceptance of nurse-led CVD management; 3. Future research needs to evaluate specific models of care, incorporating outcome measures sensitive to nursing interventions; 4. Considerable challenges exist in conducting research in general practice; and 5. Changes in funding models are necessary for widespread practice nurse role development. The shifting of funding models provides evidence to support interdisciplinary practice in Australian general practice. The time is ripe, therefore, to engage in prospective and strategic planning to inform development of the practice nurse role.

  5. Aspiration Pneumonia in a Pediatric Patient under General Anesthesia despite Adequate Preoperative Fasting

    Directory of Open Access Journals (Sweden)

    Sang-Il Yoon

    2015-11-01

    Full Text Available Aspiration pneumonia rarely occurs during general anesthesia; however, it can result in fatal pulmonary complications. To reduce aspiration pneumonia, a preoperative fasting time of 8 hours is recommended. A 4-year-old boy with ankyloglossia was scheduled for frenotomy. He completed preoperative fasting time and had no digestive symptoms. Pulmonary aspiration due to unexpected massive vomiting occurred during anesthesia induction. The patient’s airway was immediately secured by endotracheal tube. The vomitus in the airway tract was removed by fiberoptic bronchoscopy. Abdomen radiograph taken after this event showed paralytic ileus which can cause aspiration of gastric contents. We describe a case of pneumonia caused by aspiration of gastric contents in a pediatric patient who followed fasting instructions and who was scheduled for outpatient surgery.

  6. Percolation Model of Sensory Transmission and Loss of Consciousness Under General Anesthesia

    Science.gov (United States)

    Zhou, David W.; Mowrey, David D.; Tang, Pei; Xu, Yan

    2015-09-01

    Neurons communicate with each other dynamically; how such communications lead to consciousness remains unclear. Here, we present a theoretical model to understand the dynamic nature of sensory activity and information integration in a hierarchical network, in which edges are stochastically defined by a single parameter p representing the percolation probability of information transmission. We validate the model by comparing the transmitted and original signal distributions, and we show that a basic version of this model can reproduce key spectral features clinically observed in electroencephalographic recordings of transitions from conscious to unconscious brain activities during general anesthesia. As p decreases, a steep divergence of the transmitted signal from the original was observed, along with a loss of signal synchrony and a sharp increase in information entropy in a critical manner; this resembles the precipitous loss of consciousness during anesthesia. The model offers mechanistic insights into the emergence of information integration from a stochastic process, laying the foundation for understanding the origin of cognition.

  7. Testing local-realism and macro-realism under generalized dichotomic measurements

    Science.gov (United States)

    Das, Debarshi; Mal, Shiladitya; Home, Dipankar

    2018-04-01

    Generalized quantum measurements with two outcomes are fully characterized by two real parameters, dubbed as sharpness parameter and biasedness parameter and they can be linked with different aspects of the experimental setup. It is known that sharpness parameter characterizes precision of the measurements and decreasing sharpness parameter of the measurements reduces the possibility of probing quantum features like quantum mechanical (QM) violation of local-realism (LR) or macro-realism (MR). Here we investigate the effect of biasedness together with that of sharpness of measurements and find a trade-off between those two parameters in the context of probing QM violations of LR and MR. Interestingly, we also find that the above mentioned trade-off is more robust in the latter case.

  8. Strengthening of the Walker circulation under globalwarming in an aqua-planet general circulation model simulation

    Science.gov (United States)

    Li, Tim; Zhang, Lei; Murakami, Hiroyuki

    2015-11-01

    Most climate models project a weakening of theWalker circulation under global warming scenarios. It is argued, based on a global averaged moisture budget, that this weakening can be attributed to a slower rate of rainfall increase compared to that of moisture increase, which leads to a decrease in ascending motion. Through an idealized aqua-planet simulation in which a zonal wavenumber-1 SST distribution is prescribed along the equator, we find that the Walker circulation is strengthened under a uniform 2-K SST warming, even though the global mean rainfall-moisture relationship remains the same. Further diagnosis shows that the ascending branch of the Walker cell is enhanced in the upper troposphere but weakened in the lower troposphere. As a result, a "double-cell" circulation change pattern with a clockwise (anti-clockwise) circulation anomaly in the upper (lower) troposphere forms, and the upper tropospheric circulation change dominates. The mechanism for the formation of the "double cell" circulation pattern is attributed to a larger (smaller) rate of increase of diabatic heating than static stability in the upper (lower) troposphere. The result indicates that the future change of the Walker circulation cannot simply be interpreted based on a global mean moisture budget argument.

  9. A pragmatic cluster randomized controlled trial of early intervention for chronic obstructive pulmonary disease by practice nurse-general practitioner teams: Study Protocol

    OpenAIRE

    Reddel, Helen K; Dennis, Sarah M; Middleton, Sandy; Van Schayck, CP; Crockett, Alan J; Hasan, Iqbal; Hermiz, Oshana; Vagholkar, Sanjyot; Marks, Guy B; Zwar, Nicholas A

    2012-01-01

    Abstract Background Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of disability, hospitalization, and premature mortality. General practice is well placed to diagnose and manage COPD, but there is a significant gap between evidence and current practice, with a low level of awareness and implementation of clinical practice guidelines. Under-diagnosis of COPD is a world-wide problem, limiting the benefit that could potentially be achieved through early intervention strategies ...

  10. On the Performance Analysis of Free-Space Optical Links under Generalized Turbulence and Misalignment Models

    KAUST Repository

    AlQuwaiee, Hessa

    2016-11-01

    One of the potential solutions to the radio frequency (RF) spectrum scarcity problem is optical wireless communications (OWC), which utilizes the unlicensed optical spectrum. Long-range outdoor OWC are usually referred to in the literature as free-space optical (FSO) communications. Unlike RF systems, FSO is immune to interference and multi-path fading. Also, the deployment of FSO systems is flexible and much faster than optical fibers. These attractive features make FSO applicable for broadband wireless transmission such as optical fiber backup, metropolitan area network, and last mile access. Although FSO communication is a promising technology, it is negatively affected by two physical phenomenon, namely, scintillation due to atmospheric turbulence and pointing errors. These two critical issues have prompted intensive research in the last decade. To quantify the effect of these two factors on FSO system performance, we need effective mathematical models. In this work, we propose and study a generalized pointing error model based on the Beckmann distribution. Then, we aim to generalize the FSO channel model to span all turbulence conditions from weak to strong while taking pointing errors into consideration. Since scintillation in FSO is analogous to the fading phenomena in RF, diversity has been proposed too to overcome the effect of irradiance fluctuations. Thus, several combining techniques of not necessarily independent dual-branch free-space optical links were investigated over both weak and strong turbulence channels in the presence of pointing errors. On another front, improving the performance, enhancing the capacity and reducing the delay of the communication link has been the motivation of any newly developed schemes, especially for backhauling. Recently, there has been a growing interest in practical systems to integrate RF and FSO technologies to solve the last mile bottleneck. As such, we also study in this thesis asymmetric an RF-FSO dual-hop relay

  11. Vascular disease in women: comparison of diagnoses in hospital episode statistics and general practice records in England

    Directory of Open Access Journals (Sweden)

    Wright F

    2012-10-01

    Full Text Available Abstract Background Electronic linkage to routine administrative datasets, such as the Hospital Episode Statistics (HES in England, is increasingly used in medical research. Relatively little is known about the reliability of HES diagnostic information for epidemiological studies. In the United Kingdom (UK, general practitioners hold comprehensive records for individuals relating to their primary, secondary and tertiary care. For a random sample of participants in a large UK cohort, we compared vascular disease diagnoses in HES and general practice records to assess agreement between the two sources. Methods Million Women Study participants with a HES record of hospital admission with vascular disease (ischaemic heart disease [ICD-10 codes I20-I25], cerebrovascular disease [G45, I60-I69] or venous thromboembolism [I26, I80-I82] between April 1st 1997 and March 31st 2005 were identified. In each broad diagnostic group and in women with no such HES diagnoses, a random sample of about a thousand women was selected for study. We asked each woman’s general practitioner to provide information on her history of vascular disease and this information was compared with the HES diagnosis record. Results Over 90% of study forms sent to general practitioners were returned and 88% of these contained analysable data. For the vast majority of study participants for whom information was available, diagnostic information from general practice and HES records was consistent. Overall, for 93% of women with a HES diagnosis of vascular disease, general practice records agreed with the HES diagnosis; and for 97% of women with no HES diagnosis of vascular disease, the general practitioner had no record of a diagnosis of vascular disease. For severe vascular disease, including myocardial infarction (I21-22, stroke, both overall (I60-64 and by subtype, and pulmonary embolism (I26, HES records appeared to be both reliable and complete. Conclusion Hospital admission data

  12. Application of a uniform anatomic grading system to measure disease severity in eight emergency general surgical illnesses.

    Science.gov (United States)

    Crandall, Marie L; Agarwal, Suresh; Muskat, Peter; Ross, Steven; Savage, Stephanie; Schuster, Kevin; Tominaga, Gail T; Shafi, Shahid

    2014-11-01

    Emergent general surgical diseases encompass a broad spectrum of anatomy and pathophysiology, creating challenges for outcomes assessment, research, and surgical training. The goal of this study was to measure anatomic disease severity for eight emergent general surgical diseases using the uniform grading system of the American Association for the Surgery of Trauma (AAST). The Committee on Patient Assessment and Outcomes of AAST applied the previously developed uniform grading system to eight emergent general surgical diseases using a consensus of experts. It was then reviewed and approved by the Board of Managers of AAST. Severity grades for eight commonly encountered emergent general surgical conditions were created: breast abscess, esophageal perforation, infectious colitis, pelvic inflammatory disease, perirectal abscess, pleural space infections, soft tissue infections, and surgical site infections. The range of grades from I through V, reflect progression from mild disease, limited to within the organ itself, to widespread severe disease. This article provides a uniform grading system for measuring anatomic severity of eight emergent general surgical diseases. Consistent adoption of these grades could improve standardization for quality assurance, outcomes research, and surgical training.

  13. Some new and relatively infrequent phenomena by bronchography done under general venous anesthesia and monopulmonary controlled respiration

    International Nuclear Information System (INIS)

    Georgiev, G.; Nikolov, P.

    1977-01-01

    The authors share their experience in studying some new and comparatively rare phenomena found by bronchography done under general venous anestesia and succinylcholine controlled monopulmonary respiration. They discuss the false obturation of the left upper lobar bronchus, dislocation of the bronchi due to a raised diaphragm and a false obturation of a bronchus in a one act bronchoscopy-bronchography with taking of a specimen for a histologic examination. (author)

  14. RANDOMIZED DOUBLE BLIND STUDY COMPARING ONDANSETRON, PALONOSETRON & GRANISETRON TO PREVENT POST OPERATIVE NAUSEA & VOMITING AFTER LAPAROSCOPIC SURGERIES UNDER GENERAL ANAESTHESIA

    Directory of Open Access Journals (Sweden)

    Rajendra

    2015-11-01

    Full Text Available The aim of the study is to compare the efficacy of intravenously administered 5-HT3 receptor antagonists namely Ondansetron, Palonosetron and Granisetron given as prophylaxis for postoperative nausea and vomiting in patients undergoing laparoscopic surgeries under general anaesthesia. A single dose of palonosetron (0.75 µg when given prophylactically results in a significantly lower incidence of PONV after laparoscopic surgeries than ondansetron (4mg and granisetron (2.5mg during the first 24 hours

  15. Generalized stochastic target problems for pricing and partial hedging under loss constraints - Application in optimal book liquidation

    OpenAIRE

    Bouchard , Bruno; Dang , Ngoc Minh

    2013-01-01

    International audience; We consider a singular with state constraints version of the stochastic target problems studied in Soner and Touzi (2002) and more recently Bouchard, Elie and Touzi (2008), among others. This provides a general framework for the pricing of contingent claims under risk constraints. Our extended version perfectly suits to market models with proportional transaction costs and to order book liquidation issues. Our main result is a PDE characterization of the associated pri...

  16. Emergency Department Processes for the Evaluation and Management of Persons Under Investigation for Ebola Virus Disease.

    Science.gov (United States)

    Wadman, Michael C; Schwedhelm, Shelly S; Watson, Suzanne; Swanhorst, John; Gibbs, Shawn G; Lowe, John J; Iwen, Peter C; Hayes, A Kim; Needham, Susie; Johnson, Daniel W; Kalin, Daniel J; Zeger, Wesley G; Muelleman, Robert L

    2015-09-01

    Due to the recent Ebola virus outbreak in West Africa, patients with epidemiologic risk for Ebola virus disease and symptoms consistent with Ebola virus disease are presenting to emergency departments (EDs) and clinics in the United States. These individuals, identified as a person under investigation for Ebola virus disease, are initially screened using a molecular assay for Ebola virus. If this initial test is negative and the person under investigation has been symptomatic for Ebola virus disease or some other etiology, may require further investigation to direct appropriate therapy. ED administrators, physicians, and nurses proposed processes to provide care that is consistent with other ED patients. Biocontainment unit administrators, industrial hygienists, laboratory directors, physicians, and other medical personnel examined the ED processes and offered biocontainment unit personal protective equipment and process strategies designed to ensure safety for providers and patients. ED processes for the safe and timely evaluation and management of the person under investigation for Ebola virus disease are presented with the ultimate goals of protecting providers and ensuring a consistent level of care while confirmatory testing is pending. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  17. Epidemiology of the Diseases of Wheat under Different Strategies of Supplementary Irrigation

    Directory of Open Access Journals (Sweden)

    Roberto P. Marano

    2012-01-01

    Full Text Available Wheat (Triticum aestivum L. is one of the most important and highly productive crops grown under supplementary irrigation in the central region of Santa Fe. However, its production is limited by the presence of diseases in the main stages for yield definition. The objective of this work was to assess wheat health in response to different supplementary irrigation strategies under greenhouse and field conditions. The field experiment included three treatments: dry (D, controlled deficit irrigation (CDI, and total irrigation (TI using the central pivot method. Disease incidence from stem elongation and severity in flag leaf and the leaf below the flag leaf were measured. Leaf area index (LAI, harvest index, air biomass, and yield components were determined. In greenhouse the treatments were TI and CDI, with evaluations similar to the field. The major leaf diseases observed were tan spot, leaf rust, and septoria leaf blotch. Significant differences in disease burden, LAI and yield components were observed in the different treatments. Under greenhouse conditions, only tan spot was observed. The results of this study indicated that the application of supplemental irrigation in wheat improved the yield, without increasing the incidence and severity of foliar diseases.

  18. Unraveling the mechanisms underlying postural instability in Parkinson's disease using dynamic posturography

    NARCIS (Netherlands)

    Nonnekes, J.H.; Kam, D. de; Geurts, A.C.; Weerdesteijn, V.G.M.; Bloem, B.R.

    2013-01-01

    Postural instability, one of the cardinal symptoms of Parkinson's disease (PD), has devastating consequences for affected patients. Better strategies to prevent falls are needed, but this calls for an improved understanding of the complex mechanisms underlying postural instability. We must also

  19. Worms under stress: C. elegans stress response and its relevance to complex human disease and aging

    NARCIS (Netherlands)

    Rodriguez Sanchez, M.; Snoek, L.B.; Bono, de M.; Kammenga, J.E.

    2013-01-01

    Many organisms have stress response pathways, components of which share homology with players in complex human disease pathways. Research on stress response in the nematode worm Caenorhabditis elegans has provided detailed insights into the genetic and molecular mechanisms underlying complex human

  20. Comparison of Perkins, Tono-Pen and Schiøtz tonometers in paediatric patients under general anaesthesia.

    Science.gov (United States)

    Gharaei, H; Kargozar, A; Raygan, F; Daneshvar, R

    2008-01-01

    This cross-sectional study aimed to investigate if the Tono-Pen, Schiøtz and Perkins tonometers could be used interchangeably in general practice for measuring elevated intraocular pressure. A total of 74 eyes of 37 paediatric patients under general anaesthesia were checked with all 3 tonometers. All of the tonometers gave significantly different measurements from each other. However, with a mean difference of 1.4 mmHg and 95% limits of agreement of -5.7 to +8.6, the greatest agreement was between the Perkins and Tono-Pen tonometers. The Perkins tonometer is a hand-held variant of the Goldmann tonometer (the gold standard for intraocular pressure measures). Therefore the Tono-Pen with its ease of use and safety could be a reliable device for use in general practice.

  1. Prodromal symptoms and early detection of Parkinson's disease in general practice: a nested case-control study

    NARCIS (Netherlands)

    Plouvier, A.O.A.; Hameleers, R.J.M.G.; Heuvel, E.A. van den; Bor, H.H.; Olde Hartman, T.C.; Bloem, B.R.; Weel, C. van; Lagro-Janssen, A.

    2014-01-01

    BACKGROUND: Timely diagnosis of Parkinson's disease (PD), facilitating early intervention, depends largely on the GP's awareness of early symptomatology. For general practice, it is unknown which prodromal symptoms (symptoms preceding the typical motor symptoms of PD) demand the GP's alertness.

  2. Generalized time-dependent Schrödinger equation in two dimensions under constraints

    Science.gov (United States)

    Sandev, Trifce; Petreska, Irina; Lenzi, Ervin K.

    2018-01-01

    We investigate a generalized two-dimensional time-dependent Schrödinger equation on a comb with a memory kernel. A Dirac delta term is introduced in the Schrödinger equation so that the quantum motion along the x-direction is constrained at y = 0. The wave function is analyzed by using Green's function approach for several forms of the memory kernel, which are of particular interest. Closed form solutions for the cases of Dirac delta and power-law memory kernels in terms of Fox H-function, as well as for a distributed order memory kernel, are obtained. Further, a nonlocal term is also introduced and investigated analytically. It is shown that the solution for such a case can be represented in terms of infinite series in Fox H-functions. Green's functions for each of the considered cases are analyzed and plotted for the most representative ones. Anomalous diffusion signatures are evident from the presence of the power-law tails. The normalized Green's functions obtained in this work are of broader interest, as they are an important ingredient for further calculations and analyses of some interesting effects in the transport properties in low-dimensional heterogeneous media.

  3. Optimal capacity and buffer size estimation under Generalized Markov Fluids Models and QoS parameters

    International Nuclear Information System (INIS)

    Bavio, José; Marrón, Beatriz

    2014-01-01

    Quality of service (QoS) for internet traffic management requires good traffic models and good estimation of sharing network resource. A link of a network processes all traffic and it is designed with certain capacity C and buffer size B. A Generalized Markov Fluid model (GMFM), introduced by Marrón (2011), is assumed for the sources because describes in a versatile way the traffic, allows estimation based on traffic traces, and also consistent effective bandwidth estimation can be done. QoS, interpreted as buffer overflow probability, can be estimated for GMFM through the effective bandwidth estimation and solving the optimization problem presented in Courcoubetis (2002), the so call inf-sup formulas. In this work we implement a code to solve the inf-sup problem and other optimization related with it, that allow us to do traffic engineering in links of data networks to calculate both, minimum capacity required when QoS and buffer size are given or minimum buffer size required when QoS and capacity are given

  4. Mechanisms underlying accent accommodation in early word learning: evidence for general expansion.

    Science.gov (United States)

    Schmale, Rachel; Seidl, Amanda; Cristia, Alejandrina

    2015-07-01

    Previous work reveals that toddlers can accommodate a novel accent after hearing it for only a brief period of time. A common assumption is that children, like adults, cope with nonstandard pronunciations by relying on words they know (e.g. 'this person pronounces sock as sack, therefore by black she meant block'). In this paper, we assess whether toddlers might additionally use a general expansion strategy, whereby they simply accept non-standard pronunciations when variability is expected. We exposed a group of 24-month-old English-learning toddlers to variability in indexical cues (very diverse voices from native English talkers), and another to variability in social cues (very diverse-looking silent actors); neither group was familiarized with the target novel accent. At test, both groups succeeded in recognizing a novel word when spoken in the novel accent. Thus, even when no lexical cues are available, variability can prepare young children for non-standard pronunciations. © 2014 John Wiley & Sons Ltd.

  5. The proportional Venn diagram of obstructive lung disease in the Italian general population.

    Science.gov (United States)

    Viegi, Giovanni; Matteelli, Gabriella; Angino, Anna; Scognamiglio, Antonio; Baldacci, Sandra; Soriano, Joan B; Carrozzi, Laura

    2004-10-01

    The Venn diagram of obstructive lung disease (OLD) has been recently quantified. We aimed to quantify the proportion of the general population with OLD, and the intersections of physician-diagnosed asthma, chronic bronchitis (CB), and emphysema in two Italian general population samples, in relationship to airflow obstruction (AO) determined through spirometry. We analyzed data from two prospective studies (4,353 patients) carried out in the rural area of Po River delta from 1988 to 1991 and in the urban area of Pisa from 1991 to 1993. Prevalence rates of asthma, CB, and emphysema were 5.3%, 1.5%, and 1.2% in the Po delta, and 6.5%, 2.5%, and 3.6% in Pisa. A double Venn diagram, which was used to quantify the distribution of CB, emphysema, and asthma in relation to the presence/absence of AO, identified 15 categories. Isolated AO was the most frequent category (Po delta, 11.0%; Pisa, 6.7%), followed by asthma only without AO (Po delta, 3.3%; Pisa, 4.3%). The combination of the three OLD conditions was the only category that always showed higher prevalence rates for those with AO (Po delta, 0.20%; Pisa, 0.16%) than for those without AO (Po delta, 0.04%; Pisa, 0.05%). Of those with either OLD or AO, there were 61.4% in Po delta and 38.2% in Pisa with isolated AO, 24.8% and 41.9%, respectively, with an OLD without AO, and 13.8% and 19.9%, respectively, with simultaneous OLD and AO. For both genders, the frequency of isolated asthma decreased with age, while that of isolated AO, CB-emphysema, and the combination of asthma and CB-emphysema increased. About 18% of the Italian general population samples either reported the presence of OLD or showed spirometric signs of AO. We confirmed that the Venn diagram of OLD can be quantified in the general population by extending the mutually exclusive disease categories (including a concomitant diagnosis of asthma, CB, or emphysema) to 15.

  6. TRIB1 and GCKR polymorphisms, lipid levels, and risk of ischemic heart disease in the general population

    DEFF Research Database (Denmark)

    Varbo, Anette; Benn, Marianne; Tybjærg-Hansen, Anne

    2011-01-01

    The goal of this study was to test whether TRIB1-rs2954029 and GCKR-rs1260326 associate with lipid levels and risk of ischemic heart disease (IHD) and myocardial infarction (MI) in the general population.......The goal of this study was to test whether TRIB1-rs2954029 and GCKR-rs1260326 associate with lipid levels and risk of ischemic heart disease (IHD) and myocardial infarction (MI) in the general population....

  7. [Third molar surgery under general anesthesia: a review of 180 patients].

    Science.gov (United States)

    Trost, O; Kadlub, N; Robe, N; Lépine, J; Rombi, H; Noirot-Letourneau, M T; Trouilloud, P; Malka, G

    2008-04-01

    Third molar surgery is an important part of the activity in a maxillofacial surgery department. This common activity is often under-evaluated by patients who forget its surgical aspect. The aim of this study was to evaluate our practice, and especially complications, with special consideration given to medicolegal aspects. All the patients operated between September 2004 and July 2006 were enrolled in a retrospective study. This population is described, with the indications, follow-up, and complications. One hundred and eighty patients were reviewed (sex-ratio 1, mean age 27 years). The most frequent indications were impaction and pain. The mean duration of hospitalization was 1.7 days and temporary disability, one week. Local infection occurred in 8%; there was neurological complication in 2% for the inferior alveolar nerve, and 1% for the lingual nerve. These were all transient cases. Third molar surgery is an important and profitable part of the activity in a maxillofacial surgery department. Standardized information is necessary even if the rate of complications remains low.

  8. Proper Generalized Decomposition (PGD) for the numerical simulation of polycrystalline aggregates under cyclic loading

    Science.gov (United States)

    Nasri, Mohamed Aziz; Robert, Camille; Ammar, Amine; El Arem, Saber; Morel, Franck

    2018-02-01

    The numerical modelling of the behaviour of materials at the microstructural scale has been greatly developed over the last two decades. Unfortunately, conventional resolution methods cannot simulate polycrystalline aggregates beyond tens of loading cycles, and they do not remain quantitative due to the plasticity behaviour. This work presents the development of a numerical solver for the resolution of the Finite Element modelling of polycrystalline aggregates subjected to cyclic mechanical loading. The method is based on two concepts. The first one consists in maintaining a constant stiffness matrix. The second uses a time/space model reduction method. In order to analyse the applicability and the performance of the use of a space-time separated representation, the simulations are carried out on a three-dimensional polycrystalline aggregate under cyclic loading. Different numbers of elements per grain and two time increments per cycle are investigated. The results show a significant CPU time saving while maintaining good precision. Moreover, increasing the number of elements and the number of time increments per cycle, the model reduction method is faster than the standard solver.

  9. Effect of Intravenous Infusion of Lidocaine on Pain Reduction after Cesarean Section under General Anesthesia

    Directory of Open Access Journals (Sweden)

    Anahita Hirmanpour

    2018-01-01

    Full Text Available Background: The present study was conducted to evaluate the effect of Lidocaine on pain reduction during and ileus and the need for opioids after caesarean section. Methods: For this randomized double-blind controlled clinical trial, 40 ASA I, II pregnant women who were candidates for caesarean section with general anesthesia, were randomly allocated into two groups of Lidocaine receivers and placebo using randomized block design; the Lidocaine group received 1.5 mg/kg of Lidocaine right before the surgery and then its infusion with a dose of 2 mg/kg.h until the end of the surgery and the placebo group received normal saline with the same volume and application. Patients’ pain intensity was measured using numerical rating scale (NRS, 0 (entering the recovery, 0.5, 1, 4, 12 and 24 hours after the surgery. Results: Lidocaine decreased the systolic and diastolic pressures of the patients only during the first minute after intubation, decreased the mean of arterial blood pressure at the 10th minute after intubation and 40th minute after surgery, and also decreased the mean of patients’ pain intensity, Diclofenac and Pethidine consumption, side effects (nausea and vomiting and reduced the time interval before the first time of tolerating oral liquids; but it had effect on infants’ Apgar score 1 and 5 minutes after delivery. Conclusions: Lidocaine was definitely effective on reducing the intensity of pain, opioid and non-steroidal anti-inflammatory drugs consumption and ileus after surgery with the least occurrence of side effects for mothers and infants.

  10. Chronic disease management in general practice: results from a national study.

    LENUS (Irish Health Repository)

    Darker, C

    2012-04-01

    The aim of this study was to provide baseline data on chronic disease management (CDM) provision in Irish general practice (GP). The survey instrument was previously used in a study of primary care physicians in 11 countries, thus allowing international comparisons. The response rate was 72% (380\\/527).The majority of GPs (240\\/380; 63%) reported significant changes are needed in our health care system to make CDM work better. Small numbers of routine clinical audits are being performed (95\\/380; 25%). Irish GPs use evidence based guidelines for treatment of diabetes (267\\/380; 71%), asthma \\/ COPD (279\\/380; 74%) and hypertension (297\\/380; 79%), to the same extent as international counterparts. Barriers to delivering chronic care include increased workload (379\\/380; 99%), lack of appropriate funding (286\\/380; 76%), with GPs interested in targeted payments (244\\/380; 68%). This study provides baseline data to assess future changes in CDM.

  11. Respiratory symptoms/diseases, impaired lung function, and drug use in two Italian general population samples.

    Science.gov (United States)

    Simoni, Marzia; Carrozzi, Laura; Baldacci, Sandra; Borbotti, Marco; Pistelli, Francesco; Di Pede, Francesco; Maio, Sara; Angino, Anna; Viegi, Giovanni

    2008-01-01

    Research and practice indicate that a sizeable amount of prescribed drugs is never used. To assess the habitual up-take of medicines in subjects with respiratory symptoms/diseases or impaired lung function in general population samples. Data regard 4010 subjects (8-88 years) from the rural area of Po River Delta (North Italy) and the urban area of Pisa (North-Central Italy). Analyses concern the habitual use of any or specific medicines (broncho-pulmonary, anti-allergic, cardio-vascular, diuretic) in subjects with asthma, chronic bronchitis/emphysema (COPD), COPD or chronic cough/phlegm (COPDsx), and airways obstruction (AO, FEV(1)/FVC<70%). Asthma, COPD, COPDsx, and AO were present in 6%, 5%, 21%, and 13% of cases, respectively. Only 37% and 21% of subjects with respiratory symptoms/diseases used any or specific medicines, respectively. The subjects with COPD exhibited the highest prevalence of assumption (59% for any drug, 38% for specific medicines), followed by asthmatics (42% and 30%), and subjects with AO (40% and 25%). After accounting for sex, age, residence area, smoking habit, education, and presence of comorbidity, the conditions significantly related to any medicine up-take were COPD (OR 1.65, 95% CI 1.08-2.53) and asthma (OR 1.47, 95% CI 1.01-2.12). Only asthma resulted significantly associated with the use of specific drugs (OR 3.11, 95% CI 1.94-4.97). Drug use was higher in the urban than in the rural area. The results indicate that most people in the general population do not use drugs, in spite of reported respiratory disorders. The underuse of medicines seems lower in the urban area.

  12. Men with celiac disease are shorter than their peers in the general population.

    Science.gov (United States)

    Sonti, Rajiv; Lebwohl, Benjamin; Lewis, Suzanne K; Abu Daya, Hussein; Klavan, Heather; Aguilar, Kathleen; Green, Peter H R

    2013-09-01

    Late diagnosis of celiac disease (CD) is increasingly common, the implications of which are largely unknown. Although short stature is a common sign of childhood CD, the data on the height of adult CD patients is conflicting. This study investigates the final height of men and women diagnosed with CD in adulthood and attempts to identify influencing factors. We performed a cross-sectional study of 585 adults at the Celiac Disease Center at Columbia University, comparing their height with the control population (NHANES). Patients were included if they were older than 18 years of age at diagnosis and if baseline height and weight were available. In addition, we examined for differences in demographic and physical features, mode of presentation, and concomitant illnesses in shorter versus taller celiac patients. Men (n=162) with CD diagnosed in adulthood were shorter than men in the general population (CD: 169.3 ± 10.5 vs. 177.3 ± 7.0 cm, Phypothyroidism, type I diabetes, dermatitis herpetiformis), or mode of presentation in shorter versus taller CD patients of either sex. Hemoglobin was associated with short stature in CD men (short: 13.9 g/dl, tall: 14.6 g/dl; P=0.01), but not women (short: 12.9 g/dl, tall: 13.0 g/dl, P=0.41). Short stature is a well described phenomenon in pediatric CD with the potential for 'catch-up growth' on a gluten-free diet. However, among adults with CD who had attained final height before diagnosis, we found that men, not women, are shorter relative to the general population.

  13. Associative learning, acquired equivalence, and flexible generalization of knowledge in mild Alzheimer disease.

    Science.gov (United States)

    Bódi, Nikoletta; Csibri, Eva; Myers, Catherine E; Gluck, Mark A; Kéri, Szabolcs

    2009-06-01

    Acquired equivalence is a phenomenon in which prior training to treat 2 stimuli as equivalent increases generalization between them. Previous studies demonstrated that the hippocampal complex might play an important role in acquired equivalence associative learning. In this study, we tested the possibility that acquired equivalence learning is a sensitive marker of mild Alzheimer disease (AD). In the associative learning test, antecedent stimuli were cartoon faces and consequent stimuli were different colored cartoon fishes. Each cartoon character had some pet fish and the task was to learn these face-fish associations using feedback provided after each decision. In the transfer phase, knowledge about face-fish pairs had to be generalized to new associations. AD patients exhibited mild impairments in the training phase, whereas they were profoundly impaired on the acquired equivalence test. Associative knowledge could not be transferred to a more flexible retrieval condition. These results suggest that acquired equivalence learning is specifically impaired in early AD, which may indicate the pathology of the hippocampal complex.

  14. Computer templates in chronic disease management: ethnographic case study in general practice.

    Science.gov (United States)

    Swinglehurst, Deborah; Greenhalgh, Trisha; Roberts, Celia

    2012-01-01

    To investigate how electronic templates shape, enable and constrain consultations about chronic diseases. Ethnographic case study, combining field notes, video-recording, screen capture with a microanalysis of talk, body language and data entry-an approach called linguistic ethnography. Two general practices in England. Ethnographic observation of administrative areas and 36 nurse-led consultations was done. Twenty-four consultations were directly observed and 12 consultations were video-recorded alongside computer screen capture. Consultations were transcribed using conversation analysis conventions, with notes on body language and the electronic record. The analysis involved repeated rounds of viewing video, annotating field notes, transcription and microanalysis to identify themes. The data was interpreted using discourse analysis, with attention to the sociotechnical theory. Consultations centred explicitly or implicitly on evidence-based protocols inscribed in templates. Templates did not simply identify tasks for completion, but contributed to defining what chronic diseases were, how care was being delivered and what it meant to be a patient or professional in this context. Patients' stories morphed into data bytes; the particular became generalised; the complex was made discrete, simple and manageable; and uncertainty became categorised and contained. Many consultations resembled bureaucratic encounters, primarily oriented to completing data fields. We identified a tension, sharpened by the template, between different framings of the patient-as 'individual' or as 'one of a population'. Some clinicians overcame this tension, responding creatively to prompts within a dialogue constructed around the patient's narrative. Despite their widespread implementation, little previous research has examined how templates are actually used in practice. Templates do not simply document the tasks of chronic disease management but profoundly change the nature of this work

  15. Barriers and facilitators to opportunistic chronic kidney disease screening by general practice nurses.

    Science.gov (United States)

    Sinclair, Peter M; Day, Jenny; Levett-Jones, Tracy; Kable, Ashley

    2017-10-01

    Opportunistic screening in general practice (GP) is a cost-effective and viable approach to the early identification of chronic kidney disease (CKD). This study sought to identify the barriers and facilitators to CKD screening practices of GP nurses working in a regional area of New South Wales, Australia. An eight-item elicitation questionnaire informed by the Theory of Planned Behaviour was administered to a convenience sample of 26 GP nurses. Participants identified that the advantages of CKD screening were its early detection and treatment, the reduction of disease burden, and the opportunity to increase awareness and provide disease prevention education. These positive attitudinal beliefs were offset by negative beliefs about the impost of opportunistic screening on nursing time, particularly when there were other competing clinical priorities. Participants reported that practice doctors were wary of the financial costs associated with additional non-claimable services and believed that unfunded services, regardless of patient benefit, were difficult to justify in a private business environment. Screening was enabled in GP settings with existing screening protocols or initiatives, and when patients presented with known risk factors. Barriers to screening were more frequently described and illustrated a strong focus on financial aspects of GP. Without reimbursement through the Medicare Benefits Scheme, screening was not considered an economical use of nursing time. Other competing and billable clinical services took precedence. The findings of this study can be used to inform the development and evaluation of interventions that target opportunistic CKD screening in the GP setting. © 2016 Asian Pacific Society of Nephrology.

  16. Identifying asthma and chronic obstructive pulmonary disease in patients with persistent cough presenting to general practitioners : descriptive study

    NARCIS (Netherlands)

    Thiadens, HA; de Bock, GH; Deker, FW; Huysman, JAN; Springer, MP; Postma, DS

    1998-01-01

    Objective: To determine the prevalence of asthma and chronic obstructive pulmonary disease in patients not known to have these disorders, who present in general practice with persistent cough, and to ascertain criteria to help general practitioners in diagnosis. Design: Descriptive study. Setting:

  17. General Principles and Convention on Contracts for the International Sale of Goods (CISG – Uniformity under an Interpretation Umbrella?

    Directory of Open Access Journals (Sweden)

    Laura Lassila

    2017-01-01

    Full Text Available Globalization and digitalization of international sales creates needs to harmonize rules of international commercial contracts. The question is whether the harmonization should be done by binding rules or using soft law tools or through digitalization. In this article I argue on favor of harmonization through international contracts law rules’ international interpretation.The international interpretation principles used in this article are found from on Art. 7(1 of the Convention on Contracts for the International Sale of Goods (CISG which sets three interpretation rules: international character; promoting uniformity; and observance of good faith in international trade. These principles are not only principles of the CISG, but also principles commonly recognized in international commercial practice and also in domestic contract rules. I argue that by adopting an international interpretation umbrella – the meta-principle of international interpretation, cross-border contracts could be interpreted under the same principle no matter applicable substantial law. The meta-principle functions as an interpretation umbrella covering general principles and Articles of the CISG, general principles of international commercial contracts, Lex Mercatoria, and cross-border contract provision under national law.The outcomes points out that arbitral tribunals have interpreted general principles of the CISG and Lex Mercatoria in various ways. General principles and their application in case law is analyzed in connection with the Civil Code of the Russian Federation. Tribunals found that general principles of the CISG are applicable even if the CISG is not. It follows Art.’s 7(2 logic to promote international standard to cross-border contracts where the closes connection is international commercial practice rather than any national jurisdiction.

  18. Laparoscopic cholecystectomy under continuous spinal anesthesia in a patient with Steinert's disease

    OpenAIRE

    Correia, Mariana; Santos, Angela dos; Lages, Neusa; Correia, Carlos

    2016-01-01

    ABSTRACT Steinert's disease is an intrinsic disorder of the muscle with multisystem manifestations. Myotonia may affect any muscle group, is elicited by several factors and drugs used in general anesthesia like hypnotics, sedatives and opioids. Although some authors recommend the use of regional anesthesia or combined anesthesia with low doses of opioids, the safest anesthetic technique still has to be established. We performed a continuous spinal anesthesia in a patient with Steinert's disea...

  19. Predicting the multi-domain progression of Parkinson's disease: a Bayesian multivariate generalized linear mixed-effect model.

    Science.gov (United States)

    Wang, Ming; Li, Zheng; Lee, Eun Young; Lewis, Mechelle M; Zhang, Lijun; Sterling, Nicholas W; Wagner, Daymond; Eslinger, Paul; Du, Guangwei; Huang, Xuemei

    2017-09-25

    It is challenging for current statistical models to predict clinical progression of Parkinson's disease (PD) because of the involvement of multi-domains and longitudinal data. Past univariate longitudinal or multivariate analyses from cross-sectional trials have limited power to predict individual outcomes or a single moment. The multivariate generalized linear mixed-effect model (GLMM) under the Bayesian framework was proposed to study multi-domain longitudinal outcomes obtained at baseline, 18-, and 36-month. The outcomes included motor, non-motor, and postural instability scores from the MDS-UPDRS, and demographic and standardized clinical data were utilized as covariates. The dynamic prediction was performed for both internal and external subjects using the samples from the posterior distributions of the parameter estimates and random effects, and also the predictive accuracy was evaluated based on the root of mean square error (RMSE), absolute bias (AB) and the area under the receiver operating characteristic (ROC) curve. First, our prediction model identified clinical data that were differentially associated with motor, non-motor, and postural stability scores. Second, the predictive accuracy of our model for the training data was assessed, and improved prediction was gained in particularly for non-motor (RMSE and AB: 2.89 and 2.20) compared to univariate analysis (RMSE and AB: 3.04 and 2.35). Third, the individual-level predictions of longitudinal trajectories for the testing data were performed, with ~80% observed values falling within the 95% credible intervals. Multivariate general mixed models hold promise to predict clinical progression of individual outcomes in PD. The data was obtained from Dr. Xuemei Huang's NIH grant R01 NS060722 , part of NINDS PD Biomarker Program (PDBP). All data was entered within 24 h of collection to the Data Management Repository (DMR), which is publically available ( https://pdbp.ninds.nih.gov/data-management ).

  20. Simulation study of the mechanisms underlying outbreaks of clinical disease caused by Actinobacillus pleuropneumoniae in finishing pigs

    NARCIS (Netherlands)

    Klinkenberg, D; Tobias, T J; Bouma, A; van Leengoed, L A M G; Stegeman, J A

    2014-01-01

    Actinobacillus pleuropneumoniae is a major cause of respiratory disease in pigs. Many farms are endemically infected without apparent disease, but occasionally severe outbreaks of pleuropneumonia occur. To prevent and control these outbreaks without antibiotics, the underlying mechanisms of these

  1. Quantitative evaluation of dental anxiety indicators in the serum and saliva samples of children treated under general anesthesia.

    Science.gov (United States)

    Yıldırım, Sinem; Bakkal, Meltem; Bulut, Huri; Selek, Sahabettin

    2018-01-21

    Dental anxiety level has been previously associated with oral health status. Since general anesthesia (GA) allows dental treatments to be performed in anxious children with a high number of caries, we aimed to evaluate the dental anxiety levels of these children before and after dental treatments performed under GA. Thirty-eight children with high anxiety aged between 35 and 72 months who required multiple dental treatments to be performed under GA were included in the study. Frankl's Behavior Rating Scale, sitting patterns, Facial Image Scale, and Children's Fear Survey Schedule-Dental Subscale (completed by the children's parents) were recorded before and after the dental treatments performed under GA. Pre-treatment and post-treatment biochemical parameters, including cortisol, alpha-amylase, and chromogranin A levels, in saliva and serum samples were also evaluated. The psychometric scales showed a statistically significant reduction in the post-treatment dental anxiety levels of the children compared with the pre-treatment anxiety levels. Additionally, the biochemical parameters measured in the serum and whole saliva samples showed a decrease after treatments performed under GA. Our study results suggest that performing dental treatments under GA can reduce the dental anxiety levels of children with a high number of caries.

  2. Generalized anxiety disorder in urban China: Prevalence, awareness, and disease burden.

    Science.gov (United States)

    Yu, Wei; Singh, Shikha Satendra; Calhoun, Shawna; Zhang, Hui; Zhao, Xiahong; Yang, Fengchi

    2018-02-21

    Limited published research has quantified the Generalized Anxiety Disorder (GAD) prevalence and its burden in China. This study aimed to fill in the knowledge gap and to evaluate the burden of GAD among adults in urban China. This study utilized existing data from the China National Health and Wellness Survey (NHWS) 2012-2013. Prevalence of self-reported diagnosed and undiagnosed GAD was estimated. Diagnosed and undiagnosed GAD respondents were compared with non-anxious respondents in terms of health-related quality of life (HRQoL), resource utilization, and work productivity and activity impairment using multivariate generalized linear models. A multivariate logistic model assessed the risk factors for GAD. The prevalence of undiagnosed/diagnosed GAD was 5.3% in urban China with only 0.5% of GAD respondents reporting a diagnosis. Compared with non-anxious respondents, both diagnosed and undiagnosed GAD respondents had significantly lower HRQoL, more work productivity and activity impairment, and greater healthcare resource utilization in the past six months. Age, gender, marital status, income level, insurance status, smoking, drinking and exercise behaviors, and comorbidity burdens were significantly associated with GAD. This was a patient-reported study; data are therefore subject to recall bias. The survey was limited to respondents in urban China; therefore, these results focused on urban China and may be under- or over-estimating GAD prevalence in China. Causal inferences cannot be made given the cross-sectional nature of the study. GAD may be substantially under-diagnosed in urban China. More healthcare resources should be invested to alleviate the burden of GAD. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Severe exacerbations of chronic obstructive pulmonary disease: management with noninvasive ventilation on a general medicine ward

    Directory of Open Access Journals (Sweden)

    Sirio Fiorino

    2013-04-01

    Full Text Available Introduction: Recent evidence suggests that, with a well-trained staff, severe exacerbations of chronic obstructive pulmonary disease (COPD with moderate respiratory acidosis (pH > 7.3 can be successfully treated with noninvasive mechanical ventilation (NIMV on a general respiratory care ward. We conducted an open prospective study to evaluate the efficacy of this approach on a general medicine ward. Material and methods: This study population consisted in 27 patients admitted to a general medicine ward (median nurse:patient ratio 1:12 December 1, 2004 May 31, 2006 for acute COPD exacerbation with hypercapnic respiratory failure and acidosis (arterial pH < 7.34, PaC02 > 45 mmHg. All received assist-mode NIMV (average 12 h / day via oronasal masks (inspiratory pressure 10-25 cm H2O, expiratory pressure 4-6 cm H2O to maintain O2 saturation at 90-95%. Treatment was supervised by an experienced pulmonologist, who had also provided specific training in NIMV for medical and nursing staffs (90-day course followed by periodic refresher sessions. Arterial blood pressure, O2 saturation, and respiratory rate were continuously monitored during NIMV. Based on baseline arterial pH, the COPD was classified as moderate (7.25-7.34 or severe (< 7.25. Results: In patients with moderate and severe COPD, significant improvements were seen in arterial pH after 2 (p < 0.05 and 24 h (p< 0.05 of NIMV and in the PaC02 after 24 hours (p < 0.05. Four (15% of the 27 patients died during the study hospitalization (in-hospital mortality 15%, in 2 cases due to NIMV failure. For the other 23, mean long-term survival was 14.5 months (95% CI 10.2 to 18.8, and no significant differences were found between the moderate and severe groups. Over half (61% the patients were alive 1 year after admission. Conclusions: NIMV can be a cost-effective option for management of moderate or severe COPD on a general medicine ward. Its proper use requires: close monitoring of ventilated subjects

  4. Challenges of malaria diagnosis in clinical settings and disease surveillance under reduced malaria burden in Tanzania

    Directory of Open Access Journals (Sweden)

    Donath Samuel Tarimo

    2017-01-01

    Full Text Available Febrile illnesses that are caused by malaria and other infectious diseases are a major cause of morbidity and mortality in sub-Saharan Africa. In malaria endemic countries, malaria is considered as one of the most serious febrile illnesses. Over the last two decades, major investment in malaria control has witnessed a major achievement in decline of malaria burden, however, other causes of febrile illnesses have remained prevalent. The decline in malaria burden poses challenges for the diagnosis of malaria in clinical settings, research and disease surveillance. This review highlights the challenges facing the diagnosis of malarial and nonmalarial fevers under reduced malaria burden from the perspectives of parasite diagnosis and interpretations of the diagnoses of malarial and non-malarial fevers, and the possible approaches to address the challenges for a better understanding of the dynamics of febrile illnesses under reduced malaria burden.

  5. An integrative view of mechanisms underlying generalized spike-and-wave epileptic seizures and its implication on optimal therapeutic treatments.

    Directory of Open Access Journals (Sweden)

    Boyuan Yan

    Full Text Available Many types of epileptic seizures are characterized by generalized spike-and-wave discharges. In the past, notable effort has been devoted to understanding seizure dynamics and various hypotheses have been proposed to explain the underlying mechanisms. In this paper, by taking an integrative view of the underlying mechanisms, we demonstrate that epileptic seizures can be generated by many different combinations of synaptic strengths and intrinsic membrane properties. This integrative view has important medical implications: the specific state of a patient characterized by a set of biophysical characteristics ultimately determines the optimal therapeutic treatment. Through the same view, we further demonstrate the potentiation effect of rational polypharmacy in the treatment of epilepsy and provide a new angle to resolve the debate on polypharmacy. Our results underscore the need for personalized medicine and demonstrate that computer modeling and simulation may play an important role in assisting the clinicians in selecting the optimal treatment on an individual basis.

  6. A Portable Kit for Rapid Diagnosis of Infectious Diseases under Field Conditions

    Science.gov (United States)

    1980-08-14

    counter Wallis, C. & Melnick , J. L. (1971). Enhanced detection current immunoelectrophoresis. Singapore Medical of Australia antigen in serum hepatitis...RESEARC CEWlE iir.’c.rpro~net~. P. 0. BOX 85122 ’i’J v’il bz la blact &Z SAN DIEGO, CALIFORNIA 92138 NAVAL MEDICAL RESEARCH AND) DEVELOPMENT COMMAND...DIAGNOSIS of INFECTIOUS DISEASES under FIELD CONDITIONS I / Warren R. Sanborn Head, Microbiology Branch Biological Sciences Division Naval Health

  7. Assessing the impact of vaccination programmes on burden of disease: Underlying complexities and statistical methods.

    Science.gov (United States)

    Mealing, Nicole; Hayen, Andrew; Newall, Anthony T

    2016-06-08

    It is important to assess the impact a vaccination programme has on the burden of disease after it is implemented. For example, this may reveal herd immunity effects or vaccine-induced shifts in the incidence of disease or in circulating strains or serotypes of the pathogen. In this article we summarise the key features of infectious diseases that need to be considered when trying to detect any changes in the burden of diseases at a population level as a result of vaccination efforts. We outline the challenges of using routine surveillance databases to monitor infectious diseases, such as the identification of diseased cases and the availability of vaccination status for cases. We highlight the complexities in modelling the underlying patterns in infectious disease rates (e.g. presence of autocorrelation) and discuss the main statistical methods that can be used to control for periodicity (e.g. seasonality) and autocorrelation when assessing the impact of vaccination programmes on burden of disease (e.g. cosinor terms, generalised additive models, autoregressive processes and moving averages). For some analyses, there may be multiple methods that can be used, but it is important for authors to justify the method chosen and discuss any limitations. We present a case study review of the statistical methods used in the literature to assess the rotavirus vaccination programme impact in Australia. The methods used varied and included generalised linear models and descriptive statistics. Not all studies accounted for autocorrelation and seasonality, which can have a major influence on results. We recommend that future analyses consider the strength and weakness of alternative statistical methods and justify their choice. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Dermatological spectrum of hand, foot and mouth disease from classical to generalized exanthema.

    Science.gov (United States)

    Hubiche, Thomas; Schuffenecker, Isabelle; Boralevi, Franck; Léauté-Labrèze, Christine; Bornebusch, Laure; Chiaverini, Christine; Phan, Alice; Maruani, Annabel; Miquel, Juliette; Lafon, Marie-Edith; Lina, Bruno; Del Giudice, Pascal

    2014-04-01

    Hand, foot and mouth disease (HFMD) is classically defined as a childhood fever accompanied by a rash with vesicles or erosions of the oral mucosa, hands, feet and sometimes the buttocks. Severe neurological complications are associated with enterovirus 71 outbreaks in Asia. Recently, it has been suggested that HFMD is related to coxsackie virus A6 (CV-A6) when there is an atypical rash. The objective of the study is to determine the dermatological pattern of HFMD and to identify the virus serotypes associated with a specific dermatological pattern. A prospective, cross-sectional study was conducted in 7 pediatric dermatology units in France from March 2010 to February 2012. All children with clinically suspected diagnosis of HFMD were included. Clinical data were collected and swabs from the nasopharynx and vesicles were taken for reverse transcription polymerase chain reaction and genotyping. Only children with confirmed HFMD--defined by clinical diagnosis of HFMD and positive enterovirus polymerase chain reaction results--were included for analysis. One hundred and four children consulted for suspected HFMD, including 89 (mean age: 25.7 months; sex ratio M/F 1.54) with confirmed HFMD. Seventy-eight (87.6%) had skin lesions on sites other than hand, feet and mouth. Thirty-seven (41.5%) had 5 or more anatomical sites involved (hand, feet and mouth, buttocks, legs, arms and trunk) considered as widespread exanthema. Widespread vesicular exanthema was observed with both CV-A6 and CV-A16. Peri-oral rash was associated with CV-A6 (P HFMD has a clinical spectrum ranging from classical to generalized vesicular exanthema. Generalized and atypical exanthema were observed with both CV-A6 and CV-A16 infections. CV-A6 is associated with peri-oral rash.

  9. Non-linear increase of respiratory diseases and their costs under severe air pollution.

    Science.gov (United States)

    Shen, Ying; Wu, Yiyun; Chen, Guangdi; Van Grinsven, Hans J M; Wang, Xiaofeng; Gu, Baojing; Lou, Xiaoming

    2017-05-01

    China is experiencing severe and persistent air pollution, with concentrations of fine particulate matters (PM 2.5 ) reaching unprecedentedly high levels in many cities. Quantifying the detrimental effects on health and their costs derived from high PM 2.5 levels is crucial because of the unsolved challenges to mitigate air pollution in the following decades. Using the daily monitoring data on PM 2.5 concentrations and clinic visits, we found a non-linear increase of respiratory diseases, but not for other diseases (e.g., digestive diseases) under severe air pollution. We found an increase of respiratory diseases by 1% for each 10 μg m -3 increase in PM 2.5 when the annual average daily PM 2.5 concentration was less than 50 μg m -3 ; while this ratio was doubled (around 2%) with the daily PM 2.5 concentration larger than 50 μg m -3 . Under severe air pollution (PM 2.5 concentration >150 μg m -3 ), the respiratory diseases increased by over 50% compared to that in clean days. Children are more sensitive to the severe air pollution. The increase of clinic visits, especially for adults, was observed mainly in bigger (>500 beds) hospitals. Re-allocating medical resources (e.g., doctors) from big hospitals to community hospitals can benefit the respiratory patients due to air pollution. The total medical cost of clinic visits of respiratory diseases derived from PM 2.5 pollution was estimated at 17.2-57.0 billion Yuan in 2014 in China, accounting for 0.5-1.6% of national total health expenditure. Because these medical costs only represent a small part of total health cost derived from air pollution, the reduction of associated health costs would be an important co-benefit of implementation of air pollution preventive strategies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Computer templates in chronic disease management: ethnographic case study in general practice

    Science.gov (United States)

    Swinglehurst, Deborah; Greenhalgh, Trisha; Roberts, Celia

    2012-01-01

    Objective To investigate how electronic templates shape, enable and constrain consultations about chronic diseases. Design Ethnographic case study, combining field notes, video-recording, screen capture with a microanalysis of talk, body language and data entry—an approach called linguistic ethnography. Setting Two general practices in England. Participants and methods Ethnographic observation of administrative areas and 36 nurse-led consultations was done. Twenty-four consultations were directly observed and 12 consultations were video-recorded alongside computer screen capture. Consultations were transcribed using conversation analysis conventions, with notes on body language and the electronic record. The analysis involved repeated rounds of viewing video, annotating field notes, transcription and microanalysis to identify themes. The data was interpreted using discourse analysis, with attention to the sociotechnical theory. Results Consultations centred explicitly or implicitly on evidence-based protocols inscribed in templates. Templates did not simply identify tasks for completion, but contributed to defining what chronic diseases were, how care was being delivered and what it meant to be a patient or professional in this context. Patients’ stories morphed into data bytes; the particular became generalised; the complex was made discrete, simple and manageable; and uncertainty became categorised and contained. Many consultations resembled bureaucratic encounters, primarily oriented to completing data fields. We identified a tension, sharpened by the template, between different framings of the patient—as ‘individual’ or as ‘one of a population’. Some clinicians overcame this tension, responding creatively to prompts within a dialogue constructed around the patient's narrative. Conclusions Despite their widespread implementation, little previous research has examined how templates are actually used in practice. Templates do not simply document the

  11. Management of Ménière's disease in general practice: adherence to the UK National Health Service 'Prodigy' guidelines.

    Science.gov (United States)

    Smale, E; McDonald, S; Maha, N; Short, S

    2008-08-01

    Dizziness is a common presenting complaint in primary healthcare. One differential diagnosis is Ménière's disease. The UK National Health Service 'Prodigy' guidelines have been produced to help healthcare professionals to diagnose and manage Ménière's disease. The aim of this audit was to consider how Ménière's disease is managed in general practice, and to assess how well general practitioners adhere to the Prodigy guidelines. We identified general practices near the Torbay region of south Devon which had a 'TQ' postcode. There were 41 practices, staffed by a total of 203 general practitioners. We wrote to each general practitioner, asking them to fill in a questionnaire regarding Ménière's disease. Our practice response rate was 68 per cent and our individual rate 43 per cent. The mean correct answer rate was >50 per cent. The respondents achieved this despite few being aware of any formal guidelines, and none being aware of the Prodigy guidelines. Detailed knowledge of Ménière's disease was uncommon, and formal guidelines were not frequently consulted.

  12. [Summary of the practice guideline 'Viral hepatitis and other liver diseases' (second revision) from the Dutch College of General Practitioners].

    Science.gov (United States)

    Bouma, M; van Geldrop, W J; Numans, M E; Wiersma, Tj; Goudswaard, A N

    2008-12-06

    The revised Dutch College of General Practitioners' practice guideline 'Viral hepatitis and other liver diseases' offers advice in the diagnosis and management of viral hepatitis A, B and C and other liver diseases. The guideline is important for general practitioners as well as specialists in internal medicine and gastroenterology. The emphasis is on the management of chronic hepatitis B en C, because the prevalence of these diseases has increased in the Netherlands and, in addition, the treatment options for chronic hepatitis have improved. Consequently, timely recognition and adequate referral of patients with chronic hepatitis B or hepatitis C have become more important. However, many patients with a chronic liver disease have no symptoms. Therefore, the general practitioner should be aware that a patient visiting the practice with fatigue and malaise could have a liver disease if he or she belongs to a high-risk group or has had high-risk contacts. If the general practitioner repeatedly finds increased liver transaminase values during routine examination of asymptomatic patients, additional diagnostic tests should be performed. Further tests should focus on viral hepatitis as well as on non-alcoholic fatty liver disease and non-alcoholic steatohepatitis or, depending on the history-taking, liver damage due to excessive alcohol, medication or drug use.

  13. Effectiveness of heat moisture exchangers (hmes) in preventing perioperative hypothermia among adult patients undergoing abdominal surgery under general endotracheal anaesthesia.

    Science.gov (United States)

    Anaegbu, Nc; Olatosi, Oj; Tobi, Ku

    2013-01-01

    Heat Moisture Exchangers (HMEs) conserve heat and moisture during expiration and make this available to inspired gases during subsequent inspiration. We sought to evaluate the effectiveness of HMEs in the prevention of perioperative hypothermia in patients scheduled for abdominal surgery under general anaesthesia relaxant technique with endotrachael intubation (GART.) Lagos University Teaching Hospital, in Modular theatre, Anaesthesia unit. The study was a randomized, controlled, longitudinal, interventional study Methods: 100 ASA I, II and III patients aged 18 to 65 years scheduled for abdominal surgery under GART were randomly assigned to 2 groups, groups H and C. Group H had HMEs, while group C served as controls. Core temperature measured using tympanic probe was every 10 minutes till end of anaesthesia Data from total 99 patients, 49 in group H and 50 in group C were eventually analysed. Although patients in both groups developed hypothermia in the course of anaesthesia, core temperature was significantly lower pHeat Moisture Exchangers, General endotracheal anaesthesia, Hypothermia, abdominal surgery.

  14. [Efficacy of bFGF atomization inhalation on postoperative sore throat following oral and maxillofacial surgery under general anesthesia].

    Science.gov (United States)

    Liu, Bin; Jiang, Yin-Hua; Xiao, Jian; Li, Xiao-Kun

    2016-08-01

    To observe the effect of recombinant human basic fibroblast growth factor (bFGF) atomization inhalation on postoperative sore throat following oral and maxillofacial operation under general anethesia. Forty patients in whom oral and maxillofacial operation trachea was removed under general anesthesia were randomly divided into treatment and control groups; the treatment group received bFGF 35000IU + normal saline 20 mL, compression inhalation, day 1, every 20min, continued for 3 d; the control group was given normal saline 5 mL + dexamethasone 5 mg + gentamicin 80000 U + chymotrypsin 4000 U, compression inhalation, twice a day, every 20 min, continued for 3 d. Occurrence of postoperative sore throat 12 h after operation was recorded and visual analog scale (VAS) of sore throat (swallowing) 12,24,48,72 h after operation was measured. SPSS l4.0 software package was used for statistical analysis. The incidence of sore throat in the treatment group was significantly lower than that in the control group (Poral and maxillofacial surgery after endotracheal intubation.

  15. A generalized fuzzy credibility-constrained linear fractional programming approach for optimal irrigation water allocation under uncertainty

    Science.gov (United States)

    Zhang, Chenglong; Guo, Ping

    2017-10-01

    The vague and fuzzy parametric information is a challenging issue in irrigation water management problems. In response to this problem, a generalized fuzzy credibility-constrained linear fractional programming (GFCCFP) model is developed for optimal irrigation water allocation under uncertainty. The model can be derived from integrating generalized fuzzy credibility-constrained programming (GFCCP) into a linear fractional programming (LFP) optimization framework. Therefore, it can solve ratio optimization problems associated with fuzzy parameters, and examine the variation of results under different credibility levels and weight coefficients of possibility and necessary. It has advantages in: (1) balancing the economic and resources objectives directly; (2) analyzing system efficiency; (3) generating more flexible decision solutions by giving different credibility levels and weight coefficients of possibility and (4) supporting in-depth analysis of the interrelationships among system efficiency, credibility level and weight coefficient. The model is applied to a case study of irrigation water allocation in the middle reaches of Heihe River Basin, northwest China. Therefore, optimal irrigation water allocation solutions from the GFCCFP model can be obtained. Moreover, factorial analysis on the two parameters (i.e. λ and γ) indicates that the weight coefficient is a main factor compared with credibility level for system efficiency. These results can be effective for support reasonable irrigation water resources management and agricultural production.

  16. Community cardiovascular disease risk from cross-sectional general practice clinical data: a spatial analysis.

    Science.gov (United States)

    Bagheri, Nasser; Gilmour, Bridget; McRae, Ian; Konings, Paul; Dawda, Paresh; Del Fante, Peter; van Weel, Chris

    2015-02-26

    Cardiovascular disease (CVD) continues to be a leading cause of illness and death among adults worldwide. The objective of this study was to calculate a CVD risk score from general practice (GP) clinical records and assess spatial variations of CVD risk in communities. We used GP clinical data for 4,740 men and women aged 30 to 74 years with no history of CVD. A 10-year absolute CVD risk score was calculated based on the Framingham risk equation. The individual risk scores were aggregated within each Statistical Area Level One (SA1) to predict the level of CVD risk in that area. Finally, the pattern of CVD risk was visualized to highlight communities with high and low risk of CVD. The overall 10-year risk of CVD in our sample population was 14.6% (95% confidence interval [CI], 14.3%-14.9%). Of the 4,740 patients in our study, 26.7% were at high risk, 29.8% were at moderate risk, and 43.5% were at low risk for CVD over 10 years. The proportion of patients at high risk for CVD was significantly higher in the communities of low socioeconomic status. This study illustrates methods to further explore prevalence, location, and correlates of CVD to identify communities of high levels of unmet need for cardiovascular care and to enable geographic targeting of effective interventions for enhancing early and timely detection and management of CVD in those communities.

  17. Effects of dispositional optimism on quality of life, emotional distress and disability in Parkinson's disease outpatients under rehabilitation.

    Science.gov (United States)

    Gison, Annalisa; Rizza, Federica; Bonassi, Stefano; Donati, Valentina; Giaquinto, Salvatore

    2015-01-01

    This study was performed with the aim of assessing dispositional optimism (DO) in a sample of Parkinson's disease (PD) patients, in order to evaluate its association with clinical outcomes and its impact on rehabilitation. Before entering an outpatient rehabilitation program, 58 participants suffering from idiopathic PD completed the Life Orientation Test-Revised (LOT-R) to evaluate their level of DO, the WHO-5 scale to evaluate their health-related quality of life (HR-QoL), the Hospital Anxiety and Depression Scale (HADS) to identify emotional distress, and the Barthel Index to evaluate their level of disability. All the measures were repeated four months later, at their discharge from the program. Disease stage and severity measures (Unified Parkinson's Disease Rating Scale) were also taken into consideration. Correlations and multivariate regression analyses compared DO with the health-related variables. On admission a high level of DO was found to be associated with less severe disease, a better quality of life (QoL) and lower emotional distress, but not with level of disability (Barthel Index). Consistent results were found at discharge. The level of DO di not change after rehabilitation, while anxiety was significantly reduced, especially in subjects with low LOT-R and high HADS scores. The Barthel Index values significantly improved. At discharge, participants with high DO showed the best improvements in disability and in QoL. Effects of dispositional optimism on quality of life, emotional distress and disability in Parkinson's disease outpatients under rehabilitation In conclusion, a high level of DO was associated with QoL, HADS and UPDRS both on admission and at discharge. The level of DO remained stable after rehabilitation, while disability and anxiety were reduced. Participants with high DO generally had better QoL, and better clinical and psychological performances.

  18. A Four-Year Monocentric Study of the Complications of Third Molars Extractions under General Anesthesia: About 2112 Patients

    Directory of Open Access Journals (Sweden)

    A. Guerrouani

    2013-01-01

    Full Text Available Introduction. The aim of this study was to assess the complications resulting from third molar extraction under general anesthesia. Material and Methods. The retrospective study included all patients who underwent impacted third molars extraction from January 2008 until December 2011. 7659 third molars were extracted for 2112 patients. Postoperative complications were retrieved from medical files. Results. No complications were related to general anesthesia. The most frequent postoperative complication was infection (7.15%. Lingual nerve injuries affected 1.8% of the patients. All of them were transient and were not related to tooth section. Inferior alveolar nerve injuries were reported in 0.4% of the cases. 95.8% of these patients were admitted for one-day ambulatory care, and only two patients were readmitted after discharge from hospital. Discussion. This surgical technique offers comfort for both surgeons and patients. Risks are only linked to the surgical procedure as we observed no complication resulting from general anesthesia. One-day hospitalization offers a good balance between comfort, security, and cost. The incidence of complications is in agreement with the literature data, especially regarding pain, edema, and infectious and nervous complications. It is of utmost importance to discuss indications with patients, and to provide them with clear information.

  19. Comparative Evaluation of Pediatric Patients with Mental Retardation undergoing Dental Treatment under General Anesthesia: A Retrospective Analysis.

    Science.gov (United States)

    Ahuja, Ravish; Jyoti, Bhuvan; Shewale, Vinod; Shetty, Shridhar; Subudhi, Santosh Kumar; Kaur, Manpreet

    2016-08-01

    Behavioral management of patients forms one of the foremost components of pediatric dental treatment. Some children readily cooperate with dental treatment, while others require general anesthesia as a part of treatment protocol for carrying out various dental procedures. Hence, we evaluated the pediatric patients with and without mental retardation, who underwent dental treatment under general anesthesia. The present study analyzed the record of 480 pediatric patients reporting in the department of pedodontics from 2008 to 2014. Analysis of the records of the patients who underwent dental treatment under general anesthesia was done and all the patients were divided into two study groups depending upon their mental level. For the purpose of evaluation, the patients were also grouped according to their age; 4 to 7 years, 8 to 12 years, and 13 to 18 years. Measurement of decayed, missing, and filled teeth and scores for both deciduous and permanent dentition was done before and after the commencement of the dental treatment. Chi-square test and independent t-test were used for evaluating the level of significance. While comparing the patients in the two groups, maximum number of patients is present in the age group of 13 to 18 years. While comparing the indices' score between the two study groups in various age intervals, no statistically significant results were obtained. Restorative treatment and dental extractions were the most common dental treatments that were seen at a higher frequency in the intellectual disability study group. In patients with mental retardation, a higher frequency of restorative treatment and extractions occurs as compared to healthy subjects of similar age group. Therefore, they require special attention regarding maintenance of their oral health. Special attention should be given for maintaining the oral health of patients with special health care needs as compared to their physically and mentally normal counterparts.

  20. Predictors of the number of under-five malnourished children in Bangladesh: application of the generalized poisson regression model.

    Science.gov (United States)

    Islam, Mohammad Mafijul; Alam, Morshed; Tariquzaman, Md; Kabir, Mohammad Alamgir; Pervin, Rokhsona; Begum, Munni; Khan, Md Mobarak Hossain

    2013-01-08

    Malnutrition is one of the principal causes of child mortality in developing countries including Bangladesh. According to our knowledge, most of the available studies, that addressed the issue of malnutrition among under-five children, considered the categorical (dichotomous/polychotomous) outcome variables and applied logistic regression (binary/multinomial) to find their predictors. In this study malnutrition variable (i.e. outcome) is defined as the number of under-five malnourished children in a family, which is a non-negative count variable. The purposes of the study are (i) to demonstrate the applicability of the generalized Poisson regression (GPR) model as an alternative of other statistical methods and (ii) to find some predictors of this outcome variable. The data is extracted from the Bangladesh Demographic and Health Survey (BDHS) 2007. Briefly, this survey employs a nationally representative sample which is based on a two-stage stratified sample of households. A total of 4,460 under-five children is analysed using various statistical techniques namely Chi-square test and GPR model. The GPR model (as compared to the standard Poisson regression and negative Binomial regression) is found to be justified to study the above-mentioned outcome variable because of its under-dispersion (variance variable namely mother's education, father's education, wealth index, sanitation status, source of drinking water, and total number of children ever born to a woman. Consistencies of our findings in light of many other studies suggest that the GPR model is an ideal alternative of other statistical models to analyse the number of under-five malnourished children in a family. Strategies based on significant predictors may improve the nutritional status of children in Bangladesh.

  1. Awake Craniotomy vs Craniotomy Under General Anesthesia for Perirolandic Gliomas: Evaluating Perioperative Complications and Extent of Resection.

    Science.gov (United States)

    Eseonu, Chikezie I; Rincon-Torroella, Jordina; ReFaey, Karim; Lee, Young M; Nangiana, Jasvinder; Vivas-Buitrago, Tito; Quiñones-Hinojosa, Alfredo

    2017-09-01

    A craniotomy with direct cortical/subcortical stimulation either awake or under general anesthesia (GA) present 2 approaches for removing eloquent region tumors. With a reported higher prevalence of intraoperative seizures occurring during awake resections of perirolandic lesions, oftentimes, surgery under GA is chosen for these lesions. To evaluate a single-surgeon's experience with awake craniotomies (AC) vs surgery under GA for resecting perirolandic, eloquent, motor-region gliomas. Between 2005 and 2015, a retrospective analysis of 27 patients with perirolandic, eloquent, motor-area gliomas that underwent an AC were case-control matched with 31 patients who underwent surgery under GA for gliomas in the same location. All patients underwent direct brain stimulation with neuromonitoring and perioperative risk factors, extent of resection, complications, and discharge status were assessed. The postoperative Karnofsky Performance Score (KPS) was significantly lower for the GA patients at 81.1 compared to the AC patients at 93.3 ( P = .040). The extent of resection for GA patients was 79.6% while the AC patients had an 86.3% resection ( P = .136). There were significantly more 100% total resections in the AC patients 25.9% compared to the GA group (6.5%; P = .041). Patients in the GA group had a longer mean length of hospitalization of 7.9 days compared to the AC group at 4.2 days ( P = .049). We show that AC can be performed with more frequent total resections, better postoperative KPS, shorter hospitalizations, as well as similar perioperative complication rates compared to surgery under GA for perirolandic, eloquent motor-region glioma. Copyright © 2017 by the Congress of Neurological Surgeons

  2. Lyme disease as an underlying cause of supraspinatus tendinopathy in an overhead athlete.

    Science.gov (United States)

    Coulon, Christian L; Landin, Dennis

    2012-05-01

    Supraspinatus tendinopathy is a common cause of shoulder pain seen in overhead athletes, but there appear to be no published cases that present Lyme disease as the underlying cause of tendinopathy. Lyme disease is diagnosed primarily by clinical signs and symptoms and then supported by laboratory tests, including enzyme-linked immunosorbant assay (ELISA) and Western blot testing. This case demonstrates the importance of a physical therapist's input and clinical role in reaching the correct diagnosis in an athlete with Lyme disease who had a diagnosis of rotator cuff impingement and tendinitis. A 34-year-old male tennis player was seen for physical therapy for right shoulder impingement and tendinitis diagnosed by an orthopedic surgeon. He was unable to participate in sporting activities due to impairments in strength and pain. Initial examination revealed distal supraspinatus impingement and tendinopathy. The patient was not progressing with commonly accepted interventions and began to have "arthritis-like" shoulder pain in the uninvolved left shoulder. Suspicious of an underlying condition, the physical therapist informed the physician of the patient's updated status and referred the patient to the physician to discuss the current symptoms in therapy. After testing, the patient was diagnosed with chronic Lyme disease and underwent antibiotic therapy. Many active patients spend time in the outdoors, increasing their risk of exposure to a vector for Borrelia burgdorferi. Physical therapists spend a larger portion of time with patients than other health care professionals and due to this extended contact and musculoskeletal knowledge are able to recognize atypical musculoskeletal disorders or musculoskeletal manifestations of unusual pathologies, including Lyme disease.

  3. Laboratory parameter-based machine learning model for excluding non-alcoholic fatty liver disease (NAFLD) in the general population.

    Science.gov (United States)

    Yip, T C-F; Ma, A J; Wong, V W-S; Tse, Y-K; Chan, H L-Y; Yuen, P-C; Wong, G L-H

    2017-08-01

    Non-alcoholic fatty liver disease (NAFLD) affects 20%-40% of the general population in developed countries and is an increasingly important cause of hepatocellular carcinoma. Electronic medical records facilitate large-scale epidemiological studies, existing NAFLD scores often require clinical and anthropometric parameters that may not be captured in those databases. To develop and validate a laboratory parameter-based machine learning model to detect NAFLD for the general population. We randomly divided 922 subjects from a population screening study into training and validation groups; NAFLD was diagnosed by proton-magnetic resonance spectroscopy. On the basis of machine learning from 23 routine clinical and laboratory parameters after elastic net regulation, we evaluated the logistic regression, ridge regression, AdaBoost and decision tree models. The areas under receiver-operating characteristic curve (AUROC) of models in validation group were compared. Six predictors including alanine aminotransferase, high-density lipoprotein cholesterol, triglyceride, haemoglobin A 1c , white blood cell count and the presence of hypertension were selected. The NAFLD ridge score achieved AUROC of 0.87 (95% CI 0.83-0.90) and 0.88 (0.84-0.91) in the training and validation groups respectively. Using dual cut-offs of 0.24 and 0.44, NAFLD ridge score achieved 92% (86%-96%) sensitivity and 90% (86%-93%) specificity with corresponding negative and positive predictive values of 96% (91%-98%) and 69% (59%-78%), and 87% of overall accuracy among 70% of classifiable subjects in the validation group; 30% of subjects remained indeterminate. NAFLD ridge score is a simple and robust reference comparable to existing NAFLD scores to exclude NAFLD patients in epidemiological studies. © 2017 John Wiley & Sons Ltd.

  4. [Neonatal ABO incompatibility underlies a potentially severe hemolytic disease of the newborn and requires adequate care].

    Science.gov (United States)

    Senterre, T; Minon, J-M; Rigo, J

    2011-03-01

    ABO allo-immunization is the most frequent hemolytic disease of the newborn and ABO incompatibility is present in 15-25 % of pregnancies. True ABO alloimmunization occurs in approximately one out of 150 births. Intensity is generally lower than in RhD allo-immunization. We report on three cases showing that ABO allo-immunization can lead to severe hemolytic disease of the newborn with potentially threatening hyperbilirubinemia and complications. Early diagnosis and adequate care are necessary to prevent complications in ABO incompatibility. A direct antiglobulin test is the cornerstone of diagnosis and should be performed at birth on cord blood sampling in all group infants born to O mothers, especially if of African origin. Risk factor analysis and attentive clinical monitoring during the first days of life are essential. Vigilance is even more important for infants discharged before the age of 72 h. Every newborn should be assessed for the risk of developing severe hyperbilirubinemia and should be examined by a qualified healthcare professional in the first days of life. Treatment depends on the total serum bilirubin level, which may increase very rapidly in the first 48 h of life in cases of hemolytic disease of the newborn. Phototherapy and, in severe cases, exchange transfusion are used to prevent hyperbilirubinemia encephalopathy. Intravenous immunoglobulins are used to reduce exchange transfusion. Treatments of severe hemolytic disease of the newborn should be provided and performed by trained personnel in neonatal intensive care units. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  5. Effect of Maize Hybrid and Foliar Fungicides on Yield Under Low Foliar Disease Severity Conditions.

    Science.gov (United States)

    Mallowa, Sally O; Esker, Paul D; Paul, Pierce A; Bradley, Carl A; Chapara, Venkata R; Conley, Shawn P; Robertson, Alison E

    2015-08-01

    Foliar fungicide use in the U.S. Corn Belt increased in the last decade; however, questions persist pertaining to its value and sustainability. Multistate field trials were established from 2010 to 2012 in Illinois, Iowa, Ohio, and Wisconsin to examine how hybrid and foliar fungicide influenced disease intensity and yield. The experimental design was in a split-split plot with main plots consisting of hybrids varying in resistance to gray leaf spot (caused by Cercospora zeae-maydis) and northern corn leaf blight (caused by Setosphaera turcica), subplots corresponding to four application timings of the fungicide pyraclostrobin, and sub-subplots represented by inoculations with either C. zeae-maydis, S. turcica, or both at two vegetative growth stages. Fungicide application (VT/R1) significantly reduced total disease severity relative to the control in five of eight site-years (P<0.05). Disease was reduced by approximately 30% at Wisconsin in 2011, 20% at Illinois in 2010, 29% at Iowa in 2010, and 32 and 30% at Ohio in 2010 and 2012, respectively. These disease severities ranged from 0.2 to 0.3% in Wisconsin in 2011 to 16.7 to 22.1% in Illinois in 2010. The untreated control had significantly lower yield (P<0.05) than the fungicide-treated in three site-years. Fungicide application increased the yield by approximately 6% at Ohio in 2010, 5% at Wisconsin in 2010 and 6% in 2011. Yield differences ranged from 8,403 to 8,890 kg/ha in Wisconsin 2011 to 11,362 to 11,919 kg/ha in Wisconsin 2010. Results suggest susceptibility to disease and prevailing environment are important drivers of observed differences. Yield increases as a result of the physiological benefits of plant health benefits under low disease were not consistent.

  6. Alveolar bone loss associated to periodontal disease in lead intoxicated rats under environmental hypoxia.

    Science.gov (United States)

    Terrizzi, Antonela R; Fernandez-Solari, Javier; Lee, Ching M; Bozzini, Clarisa; Mandalunis, Patricia M; Elverdin, Juan C; Conti, María Ines; Martínez, María Pilar

    2013-10-01

    Previously reported studies from this laboratory revealed that rats chronically intoxicated with lead (Pb) under hypoxic conditions (HX) impaired growth parameters and induced damages on femoral and mandibular bones predisposing to fractures. We also described periodontal inflammatory processes under such experimental conditions. Periodontitis is characterised by inflammation of supporting tissues of the teeth that result in alveolar bone loss. The existence of populations living at high altitudes and exposed to lead contamination aimed us to establish the macroscopic, biochemical and histological parameters consistent with a periodontal disease in the same rat model with or without experimental periodontitis (EP). Sixty female rats were divided into: Control; Pb (1000ppm of lead acetate in drinking water); HX (506mbar) and PbHX (both treatments simultaneously). EP was induced by placing ligatures around the molars of half of the rats during the 14 days previous to the autopsy. Hemi-mandibles were extracted to evaluate bone loss by histomorphometrical techniques. TNFα plasmatic concentration was greater (plead intoxication under hypoxic environment enhanced not only alveolar bone loss but also systemic and oral tissues inflammatory parameters, which could aggravate the physiopathological alterations produced by periodontal disease. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Diagnosis of asthma and chronic obstructive pulmonary disease in general practice

    NARCIS (Netherlands)

    VanSchayck, CP

    There may be an overlap between the clinical pictures of asthma and chronic obstructive pulmonary disease which hampers a clear distinction between the two diseases. Most symptoms presented by patients do not clearly belong exclusively to either asthma or chronic obstructive pulmonary disease. By

  8. Prognostic value of obesity on both overall mortality and cardiovascular disease in the general population.

    Directory of Open Access Journals (Sweden)

    Isabel Ponce-Garcia

    Full Text Available Obesity represents an important health problem and its association with cardiovascular risk factors is well-known. The aim of this work was to assess the correlation between obesity and mortality (both, all-cause mortality and the combined variable of all-cause mortality plus the appearance of a non-fatal first cardiovascular event in a general population sample from the south-east of Spain.This prospective cohort study used stratified and randomized two-stage sampling. Obesity [body mass index (BMI ≥ 30 kg/m(2] as a predictive variable of mortality and cardiovascular events was assessed after controlling for age, sex, cardiovascular disease history, high blood pressure, diabetes mellitus, hypercholesterolemia, high-density lipoprotein/triglycerides ratio, total cholesterol and smoking with the Cox regression model.The mean follow-up time of the 1,248 participants was 10.6 years. The incidence of all-cause mortality during this period was 97 deaths for every 10,000 person/years (95% CI: 80-113 and the incidence of all-cause mortality+cardiovascular morbidity was 143 cases for every 10,000 person/years (95% CI: 124-163. A BMI ≥ 35 kg/m(2 yielded a hazard ratio for all-cause mortality of 1.94 (95% CI: 1.11-3.42 in comparison to non-obese subjects (BMI <30 kg/m(2. For the combination of cardiovascular morbidity plus all-cause mortality, a BMI ≥ 35 kg/m(2 had a hazard ratio of 1.84 (95% CI: 1.15-2.93 compared to non-obese subjects.A BMI ≥ 35 kg/m(2 is an important predictor of both overall mortality and of the combination of cardiovascular morbidity plus all-cause mortality.

  9. Prognostic Value of Obesity on Both Overall Mortality and Cardiovascular Disease in the General Population

    Science.gov (United States)

    Ponce-Garcia, Isabel; Simarro-Rueda, Marta; Carbayo-Herencia, Julio Antonio; Divisón-Garrote, Juan Antonio; Artigao-Ródenas, Luis Miguel; Botella-Romero, Francisco; Palazón-Bru, Antonio; Martínez-St. John, Damian Robert James; Gil-Guillén, Vicente Francisco

    2015-01-01

    Background Obesity represents an important health problem and its association with cardiovascular risk factors is well-known. The aim of this work was to assess the correlation between obesity and mortality (both, all-cause mortality and the combined variable of all-cause mortality plus the appearance of a non-fatal first cardiovascular event) in a general population sample from the south-east of Spain. Materials and Methods This prospective cohort study used stratified and randomized two-stage sampling. Obesity [body mass index (BMI) ≥30 kg/m2] as a predictive variable of mortality and cardiovascular events was assessed after controlling for age, sex, cardiovascular disease history, high blood pressure, diabetes mellitus, hypercholesterolemia, high-density lipoprotein/triglycerides ratio, total cholesterol and smoking with the Cox regression model. Results The mean follow-up time of the 1,248 participants was 10.6 years. The incidence of all-cause mortality during this period was 97 deaths for every 10,000 person/years (95% CI: 80–113) and the incidence of all-cause mortality+cardiovascular morbidity was 143 cases for every 10,000 person/years (95% CI: 124–163). A BMI ≥35 kg/m2 yielded a hazard ratio for all-cause mortality of 1.94 (95% CI: 1.11–3.42) in comparison to non-obese subjects (BMI cardiovascular morbidity plus all-cause mortality, a BMI ≥35 kg/m2 had a hazard ratio of 1.84 (95% CI: 1.15–2.93) compared to non-obese subjects. Conclusions A BMI ≥35 kg/m2 is an important predictor of both overall mortality and of the combination of cardiovascular morbidity plus all-cause mortality. PMID:25992570

  10. Age- and Parkinson's disease-related evaluation of gait by General Tau Theory.

    Science.gov (United States)

    Zhang, Shutao; Qian, Jinwu; Zhang, Zhen; Shen, Linyong; Wu, Xi; Hu, Xiaowu

    2016-10-01

    The degeneration of postural control in the elderly and patients with Parkinson's disease (PD) can be debilitating and may lead to increased fall risk. This study evaluated the changes in postural control during gait affected by PD and aging using a new method based on the General Tau Theory. Fifteen patients with PD, 11 healthy old adults (HOs), and 15 healthy young adults (HYs) were recruited. Foot trajectories of each participant were monitored during walking by a three-camera Optotrak Certus(®) motion capture system. The anteroposterior direction of foot movement during stepping was analyzed by tau-G and tau-J guidance strategies. Two linear regression analyses suggested that the tau of the step-gap was strongly coupled onto the tau-J guidance during walking. The regression slope K could estimate the coupling ratio in the tau-coupling equation which reflects the performance of postural control during gait. The mean K value for the PD group, which was highest among the three groups, was approximately 0.5. Therefore, participants in the PD group walked with the poorest postural control and exhibited a relatively hard contact with the endpoint during stepping when compared with those in the HO and HY groups. The HY and HO groups obtained mean K values significantly lower than 0.5, which indicated that the gait was well controlled and ended at low speed with low deceleration. However, the HO group showed a decreased tendency for postural control, in which the mean K value was significantly higher than that of the HY group. The K value was moderately positively correlated with the double support time and negatively correlated with the stride length and walking speed. The tau-J coupling ratio can provide additional insight into gait disturbances and may serve as a reliable, objective, and quantitative tool to evaluate dynamic postural control during walking.

  11. Australian general practitioners’ current practice for chronic kidney disease (CKD detection and management

    Directory of Open Access Journals (Sweden)

    Marie Ludlow

    2017-06-01

    Full Text Available Background Guidelines for early detection of chronic kidney disease (CKD emphasise regular testing of kidney health in high-risk individuals. However, evidence suggests that CKD is not being adequately detected or appropriately managed in primary care. Aims Assess Australian general practitioners’ (GP current practice in relation to CKD detection and management. Methods This was a cross-sectional study utilising a random sample of GPs identified by interrogation of the national online telephone directory, and stratified by geographical location. Data collection occurred between October 2014 and January 2015. Of 2,815 eligible contacts, the final response rate was 23 per cent. Results Of the 656 respondents, over 90 per cent assessed kidney health at least annually in people with diabetes or high blood pressure, and 71 per cent correctly assessed kidney health every 3–6 months in a patient with Stage 3b CKD. The tests most commonly used to assess kidney health were serum creatinine (with eGFR, blood pressure and urine albumin creatinine ratio. The most commonly reported CKD management strategies were ‘blood pressure reduction using pharmacological agents’ (81 per cent and ‘glycaemic control if diabetes present’ (64 per cent. Knowledge testing highlighted that 32 per cent of respondents were not able to correctly identify how to properly assess absolute cardiovascular risk, and this was significantly more common in more experienced GPs (p=0.003. Conclusion The results indicate that Australian GPs are mainly practising in accordance with current guidelines for detection and management of patients with CKD, but with room for improvement in some areas

  12. Exposure to general anesthesia and risk of alzheimer's disease: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Seitz Dallas P

    2011-12-01

    Full Text Available Abstract Background Alzheimer's disease (AD is common among older adults and leads to significant disability. Volatile anesthetic gases administered during general anesthesia (GA have been hypothesized to be a risk factor for the development of AD. The objective of this study is to systematically review the association between exposure to GA and risk of AD. Methods We searched electronic databases including MEDLINE, Embase, and Google scholar for observational studies examining the association between exposure to GA and risk of AD. We examined study quality using a modified version of the Newcastle-Ottawa risk of bias assessment for observational studies. We used standard meta-analytic techniques to estimate pooled odds ratios (OR and 95% confidence intervals (CI. Subgroup and sensitivity analyses were undertaken to evaluate the robustness of the findings. Results A total of 15 case-control studies were included in the review. No cohort studies were identified that met inclusion criteria. There was variation in the methodological quality of included studies. There was no significant association between any exposure to GA and risk of AD (pooled OR: 1.05; 95% CI: 0.93 - 1.19, Z = 0.80, p = 0.43. There was also no significant association between GA and risk of AD in several subgroup and sensitivity analyses. Conclusions A history of exposure to GA is not associated with an increased risk of AD although there are few high-quality studies in this area. Prospective cohort studies with long-term follow-up or randomized controlled trials are required to further understand the association between GA and AD.

  13. A neural network underlying intentional emotional facial expression in neurodegenerative disease

    Directory of Open Access Journals (Sweden)

    Kelly A. Gola

    2017-01-01

    Full Text Available Intentional facial expression of emotion is critical to healthy social interactions. Patients with neurodegenerative disease, particularly those with right temporal or prefrontal atrophy, show dramatic socioemotional impairment. This was an exploratory study examining the neural and behavioral correlates of intentional facial expression of emotion in neurodegenerative disease patients and healthy controls. One hundred and thirty three participants (45 Alzheimer's disease, 16 behavioral variant frontotemporal dementia, 8 non-fluent primary progressive aphasia, 10 progressive supranuclear palsy, 11 right-temporal frontotemporal dementia, 9 semantic variant primary progressive aphasia patients and 34 healthy controls were video recorded while imitating static images of emotional faces and producing emotional expressions based on verbal command; the accuracy of their expression was rated by blinded raters. Participants also underwent face-to-face socioemotional testing and informants described participants' typical socioemotional behavior. Patients' performance on emotion expression tasks was correlated with gray matter volume using voxel-based morphometry (VBM across the entire sample. We found that intentional emotional imitation scores were related to fundamental socioemotional deficits; patients with known socioemotional deficits performed worse than controls on intentional emotion imitation; and intentional emotional expression predicted caregiver ratings of empathy and interpersonal warmth. Whole brain VBMs revealed a rightward cortical atrophy pattern homologous to the left lateralized speech production network was associated with intentional emotional imitation deficits. Results point to a possible neural mechanisms underlying complex socioemotional communication deficits in neurodegenerative disease patients.

  14. A neural network underlying intentional emotional facial expression in neurodegenerative disease.

    Science.gov (United States)

    Gola, Kelly A; Shany-Ur, Tal; Pressman, Peter; Sulman, Isa; Galeana, Eduardo; Paulsen, Hillary; Nguyen, Lauren; Wu, Teresa; Adhimoolam, Babu; Poorzand, Pardis; Miller, Bruce L; Rankin, Katherine P

    2017-01-01

    Intentional facial expression of emotion is critical to healthy social interactions. Patients with neurodegenerative disease, particularly those with right temporal or prefrontal atrophy, show dramatic socioemotional impairment. This was an exploratory study examining the neural and behavioral correlates of intentional facial expression of emotion in neurodegenerative disease patients and healthy controls. One hundred and thirty three participants (45 Alzheimer's disease, 16 behavioral variant frontotemporal dementia, 8 non-fluent primary progressive aphasia, 10 progressive supranuclear palsy, 11 right-temporal frontotemporal dementia, 9 semantic variant primary progressive aphasia patients and 34 healthy controls) were video recorded while imitating static images of emotional faces and producing emotional expressions based on verbal command; the accuracy of their expression was rated by blinded raters. Participants also underwent face-to-face socioemotional testing and informants described participants' typical socioemotional behavior. Patients' performance on emotion expression tasks was correlated with gray matter volume using voxel-based morphometry (VBM) across the entire sample. We found that intentional emotional imitation scores were related to fundamental socioemotional deficits; patients with known socioemotional deficits performed worse than controls on intentional emotion imitation; and intentional emotional expression predicted caregiver ratings of empathy and interpersonal warmth. Whole brain VBMs revealed a rightward cortical atrophy pattern homologous to the left lateralized speech production network was associated with intentional emotional imitation deficits. Results point to a possible neural mechanisms underlying complex socioemotional communication deficits in neurodegenerative disease patients.

  15. Turbulent dispersivity under conditions relevant to airborne disease transmission between laboratory animals

    Science.gov (United States)

    Halloran, Siobhan; Wexler, Anthony; Ristenpart, William

    2014-11-01

    Virologists and other researchers who test pathogens for airborne disease transmissibility often place a test animal downstream from an inoculated animal and later determine whether the test animal became infected. Despite the crucial role of the airflow in modulating the pathogen transmission, to date the infectious disease community has paid little attention to the effect of airspeed or turbulence intensity on the probability of transmission. Here we present measurements of the turbulent dispersivity under conditions relevant to experimental tests of airborne disease transmissibility between laboratory animals. We used time lapse photography to visualize the downstream transport and turbulent dispersion of smoke particulates released from a point source downstream of a standard axial fan, thus mimicking the release and transport of expiratory aerosols exhaled by an inoculated animal. We demonstrate that the fan speed counterintuitively has no effect on the downstream plume width, a result replicated with a variety of different fan types and configurations. The results point toward a useful simplification in modeling of airborne disease transmission via fan-generated flows.

  16. Are the educational differences in incidence of cardiovascular disease explained by underlying familial factors?

    DEFF Research Database (Denmark)

    Madsen, Mia; Andersen, Per K; Gerster, Mette

    2014-01-01

    To isolate the effect of education from the influence of potential underlying factors, we investigated the association of education with the risk of cardiovascular disease (CVD) and ischemic heart disease (IHD) using twin data to adjust for familial factors shared within twins, including genetic...... make-up and childhood environment. The study was based on data from the Danish Twin Registry linked to administrative and heath registers in Statistics Denmark. A total of 11,968 monozygotic and 20,464 dizygotic same sexed twins were followed from 1980 to 2009, including more than 8000 events of CVD....... Unpaired and intra-pair analyses were compared. In the unpaired analyses, an inverse educational gradient in CVD- and IHD risk was observed. This association was not replicated in the intra-pair analyses that control for shared familial factors exploiting that twins share their intrauterine- and childhood...

  17. Projection of temperature-related mortality due to cardiovascular disease in beijing under different climate change, population, and adaptation scenarios.

    Science.gov (United States)

    Zhang, Boya; Li, Guoxing; Ma, Yue; Pan, Xiaochuan

    2018-04-01

    Human health faces unprecedented challenges caused by climate change. Thus, studies of the effect of temperature change on total mortality have been conducted in numerous countries. However, few of those studies focused on temperature-related mortality due to cardiovascular disease (CVD) or considered future population changes and adaptation to climate change. We present herein a projection of temperature-related mortality due to CVD under different climate change, population, and adaptation scenarios in Beijing, a megacity in China. To this end, 19 global circulation models (GCMs), 3 representative concentration pathways (RCPs), 3 socioeconomic pathways, together with generalized linear models and distributed lag non-linear models, were used to project future temperature-related CVD mortality during periods centered around the years 2050 and 2070. The number of temperature-related CVD deaths in Beijing is projected to increase by 3.5-10.2% under different RCP scenarios compared with that during the baseline period. Using the same GCM, the future daily maximum temperatures projected using the RCP2.6, RCP4.5, and RCP8.5 scenarios showed a gradually increasing trend. When population change is considered, the annual rate of increase in temperature-related CVD deaths was up to fivefold greater than that under no-population-change scenarios. The decrease in the number of cold-related deaths did not compensate for the increase in that of heat-related deaths, leading to a general increase in the number of temperature-related deaths due to CVD in Beijing. In addition, adaptation to climate change may enhance rather than ameliorate the effect of climate change, as the increase in cold-related CVD mortality greater than the decrease in heat-related CVD mortality in the adaptation scenarios will result in an increase in the total number of temperature-related CVD mortalities. Copyright © 2018 Elsevier Inc. All rights reserved.

  18. A Clinical Experience of Dental Treatment under Ambulatory General Anesthesia for A Disabled Patient Who Accepts Only One Favorite Dental Chair

    OpenAIRE

    佐藤, 潤; 川合, 宏仁; 山崎, 信也; 相澤, 徳久; 島村, 和宏; 鈴木, 康生; サトウ, ジュン; カワイ, ヒロヨシ; ヤマザキ, シンヤ; アイザワ, ノリヒサ; シマムラ, カズヒロ; スズキ, ヤスオ; Jun, SATO; Hiroyoshi, KAWAAI; Shinya, YAMAZAKI

    2007-01-01

    In our hospital, we have many cases of ambulatory general anesthesia in the dental treatment of disabled patients. However, if the disability patients have strong refusal to enter the general anesthesia room due to strong phobia, we can not apply the general anesthesia induction. We experienced a dental treatment under ambulatory general anesthesia of a disabled patient who could not sit on any dental chair except for his favorite one. The patient was a 16-year-old boy. He was diagnosed Down ...

  19. [Extramucosal pylorotomy via the umbilical route under general anesthesia and para-umbilical cord: evaluation of intra- and postoperative analgesia].

    Science.gov (United States)

    Courrèges, P; Poddevin, F; Lecoutre, D

    1998-01-01

    To assess both intra- and postoperative analgesia in infants undergoing extramucosal pylorotomy via a circumumbilical incision under general anaesthesia with neither opioid nor muscle relaxant, associated with a paraumbilical block. Open prospective study covering a 1-year period. The study included 32 infants (age = 1.1 +/- 0.7 months, body weight = 4,427 +/- 876 g). General anaesthesia was induced with either thiopentone or halothane and, after tracheal intubation, maintained with halothane in a N2O-O2 50 vol% mixture. Para-umbilical block was obtained using 0.5 mL.kg-1 of 1% lidocaine with epinephrine. Pain was assessed using time course of respiratory rate, heart rate and mean arterial pressure. A change of more than 20% in one of these variables was considered as criterion for poor analgesia. Intraoperative analgesia was adequate in all patients but one, 3 minutes after incision. Surgical conditions were considered as being good or satisfactory in 76% and 24% of cases, respectively. Postoperative analgesia, assessed 1 and 6 hours after completion of surgery, was convenient in 90% of infants, the end of the action of the local anaesthetic resulting in a poor analgesia at the 6th hour in four of them. Provided a short bevel needle is used and basic safety rules of local anaesthesia are followed, the para-umbilical block provides adequate intra and postoperative analgesia in infants undergoing extramucosal pylorotomy via circumumbilical route.

  20. Music and Memory in Alzheimer's Disease and The Potential Underlying Mechanisms.

    Science.gov (United States)

    Peck, Katlyn J; Girard, Todd A; Russo, Frank A; Fiocco, Alexandra J

    2016-01-01

    With population aging and a projected exponential expansion of persons diagnosed with Alzheimer's disease (AD), the development of treatment and prevention programs has become a fervent area of research and discovery. A growing body of evidence suggests that music exposure can enhance memory and emotional function in persons with AD. However, there is a paucity of research that aims to identify specific underlying neural mechanisms associated with music's beneficial effects in this particular population. As such, this paper reviews existing anecdotal and empirical evidence related to the enhancing effects of music exposure on cognitive function and further provides a discussion on the potential underlying mechanisms that may explain music's beneficial effect. Specifically, this paper will outline the potential role of the dopaminergic system, the autonomic nervous system, and the default network in explaining how music may enhance memory function in persons with AD.

  1. Health Information-Seeking Patterns of the General Public and Indications for Disease Surveillance: Register-Based Study Using Lyme Disease.

    Science.gov (United States)

    Pesälä, Samuli; Virtanen, Mikko J; Sane, Jussi; Mustonen, Pekka; Kaila, Minna; Helve, Otto

    2017-11-06

    People using the Internet to find information on health issues, such as specific diseases, usually start their search from a general search engine, for example, Google. Internet searches such as these may yield results and data of questionable quality and reliability. Health Library is a free-of-charge medical portal on the Internet providing medical information for the general public. Physician's Databases, an Internet evidence-based medicine source, provides medical information for health care professionals (HCPs) to support their clinical practice. Both databases are available throughout Finland, but the latter is used only by health professionals and pharmacies. Little is known about how the general public seeks medical information from medical sources on the Internet, how this behavior differs from HCPs' queries, and what causes possible differences in behavior. The aim of our study was to evaluate how the general public's and HCPs' information-seeking trends from Internet medical databases differ seasonally and temporally. In addition, we aimed to evaluate whether the general public's information-seeking trends could be utilized for disease surveillance and whether media coverage could affect these seeking trends. Lyme disease, serving as a well-defined disease model with distinct seasonal variation, was chosen as a case study. Two Internet medical databases, Health Library and Physician's Databases, were used. We compared the general public's article openings on Lyme disease from Health Library to HCPs' article openings on Lyme disease from Physician's Databases seasonally across Finland from 2011 to 2015. Additionally, media publications related to Lyme disease were searched from the largest and most popular media websites in Finland. Both databases, Health Library and Physician's Databases, show visually similar patterns in temporal variations of article openings on Lyme disease in Finland from 2011 to 2015. However, Health Library openings show not only

  2. Attitudes toward Alzheimer's disease: a qualitative study of the role played by social representation on a convenient sample of French general practitioners.

    Science.gov (United States)

    Lahjibi-Paulet, Hayat; Dauffy Alain, Agnès; Minard, Aurélien; Gaxatte, Cédric; Saint-Jean, Olivier; Somme, Dominique

    2012-08-01

    It is commonly thought that Alzheimer's disease (AD) is under-diagnosed and that insufficient numbers of patients are receiving pharmacological treatment. These observations are often attributed to poor management of the disease by general practitioners (GPs) related to their lack of training in identifying cognitive decline. Our hypothesis is that there may be a relation between GPs' perceptions and their attitudes toward AD. We conducted a qualitative study, through semi-directive interviews focusing on their representations, of 25 GPs, masters in training courses, in Paris. Analysis of interviews revealed five general trends. AD is seen by GPs as a "disease of autonomy", without specific medical treatment. Cognitive symptoms are less meaningful in GPs' view than the loss of autonomy. The main thing is to keep the patient at home. For GPs, the family is described as an essential partner in coping with the insufficiencies of available social programs. The use of specialists is less to confirm the diagnosis than to announce the "bad news". GPs declare scepticism as to the efficacy of AD medications, only granting them a certain "care" effect or a social role. The image of AD remains highly negative. The stigma of AD is seen as a barrier to its diagnosis. This study is somewhat preliminary because of sample size. Nevertheless, the social representations of the disease influence GPs' attitudes toward making diagnoses in France. Priority seems to focus more on assisting GPs and families at the social level, rather than diagnosis or access to treatment.

  3. The elastic properties, generalized stacking fault energy and dissociated dislocations in MgB2 under different pressure

    KAUST Repository

    Feng, Huifang

    2013-05-31

    The 〈112̄0〉 perfect dislocation in MgB2 is suggested to dissociate into two partial dislocations in an energy favorable way 〈112̄0〉 → 1/2 〈112̄0〉 + SF + 1/2 〈112̄0〉. This dissociation style is a correction of the previous dissociation 〈1000〉 → 1/3 〈11̄00〉 SF + 1/3 〈 2100〉proposed by Zhu et al. to model the partial dislocations and stacking fault observed by transmission electron microscopy. The latter dissociation results in a maximal stacking fault energy rather than a minimal one according to the generalized stacking fault energy calculated from first-principles methods. Furthermore, the elastic constants and anisotropy of MgB2 under different pressure are investigated. The core structures and mobilities of the 〈112̄0〉 dissociated dislocations are studied within the modified Peierls-Nabarro (P-N) dislocation theory. The variational method is used to solve the modified P-N dislocation equation and the Peierls stress is also determined under different pressure. High pressure effects on elastic anisotropy, core structure and Peierls stress are also presented. © 2013 Springer Science+Business Media New York.

  4. Comparison of Younger and Older Adults' Acceptability of Treatment for Generalized Anxiety Disorder Co-Occurring with Parkinson's Disease

    Science.gov (United States)

    Lundervold, Duane A.; Ament, Patrick A.; Holt, Peter S.; Hunt, Lauren S.

    2013-01-01

    Acceptability ratings of medication or Behavioral Relaxation Training (BRT), for general anxiety disorder (GAD) co-occurring with Parkinson's Disease (PD) were obtained from younger ("n" = 79) and older ("n" = 54) adults. Participants read a case description of an older adult with PD and comorbid GAD followed by a description…

  5. An investigation of the mechanism underlying teacher aggression: Testing I3 theory and the General Aggression Model.

    Science.gov (United States)

    Montuoro, Paul; Mainhard, Tim

    2017-12-01

    Considerable research has investigated the deleterious effects of teachers responding aggressively to students who misbehave, but the mechanism underlying this dysfunctional behaviour remains unknown. This study investigated whether the mechanism underlying teacher aggression follows I 3 theory or General Aggression Model (GAM) metatheory of human aggression. I 3 theory explains exceptional, catastrophic events of human aggression, whereas the GAM explains common human aggression behaviours. A total of 249 Australian teachers participated in this study, including 142 primary school teachers (Mdn [age] = 35-39 years; Mdn [years teaching] = 10-14 years; 84% female) and 107 secondary school teachers (Mdn [age] = 45-49 years; Mdn [years teaching] = 15-19 years; 65% female). Participants completed four online self-report questionnaires, which assessed caregiving responsiveness, trait self-control, misbehaviour provocation, and teacher aggression. Analyses revealed that the GAM most accurately captures the mechanism underlying teacher aggression, with lower caregiving responsiveness appearing to indirectly lead to teacher aggression via higher misbehaviour provocation and lower trait self-control in serial, controlling for gender, age, years teaching, and current role (primary, secondary). This study indicates that teacher aggression proceeds from 'the person in the situation'. Specifically, lower caregiving responsiveness appears to negatively shape a teacher's affective, cognitive, and arousal states, which influence how they perceive and interpret student misbehaviour. These internal states, in turn, appear to negatively influence appraisal and decision processes, leading to immediate appraisal and impulsive actions. These results raise the possibility that teacher aggression is a form of countertransference. © 2017 The British Psychological Society.

  6. Stressors, social support, depressive symptoms and general health status of Taiwanese caregivers of persons with stroke or Alzheimer's disease.

    Science.gov (United States)

    Huang, Chiung-Yu; Sousa, Valmi D; Perng, Shao-Jen; Hwang, Mei-Yi; Tsai, Chun-Ching; Huang, Mei-Huang; Yao, Shu-Ying

    2009-02-01

    This study examined the relationships among stressors, social support, depressive symptoms and the general health status of Taiwanese caregivers of individuals with stroke or Alzheimer's disease. Caring for a disabled or cognitively impaired person can be extremely stressful and often has adverse effects on caregivers' health. While research on caregiving in Taiwan has examined caregivers' characteristics, caregivers' need and caregivers' burden in caring for older people in general, little is known about Taiwanese caregivers of individuals with stroke or Alzheimer's disease. Cross-sectional, descriptive correlation design. Data were obtained from a convenience sample of 103 Taiwanese informal caregivers in the South of Taiwan and analysed using descriptive statistics, Pearson's correlations, multiple and hierarchical regressions and t-tests. Caregivers who had lower household incomes and were taking care of individuals with more behaviour problems had more depressive symptoms. In addition, caregivers who were older and were taking care of individuals with more behaviour problems had worse general health. Caregivers who had more emotional support had less depressive symptoms. Caregivers of persons with Alzheimer's disease had more depressive symptoms and worse general health than caregivers of persons with stroke. Only emotional support moderated the relationship between one of the stressors (household income) and depressive symptoms. The findings of this study may be helpful for nurses and other health care professionals in designing effective interventions to minimise the negative impacts of stressors on the psychological and general health of caregivers in Taiwan.

  7. Skin as a marker of general feline health: Cutaneous manifestations of infectious disease.

    Science.gov (United States)

    Backel, Katherine; Cain, Christine

    2017-11-01

    Practical relevance: Infectious disease in feline patients often presents a diagnostic challenge. This article reviews the most relevant viral, bacterial and protozoal diseases and their cutaneous manifestations. Many of the diseases discussed have overlapping presentations or may mimic more common noninfectious disease processes. The purpose of the article is to reinforce knowledge of common and uncommon infectious diseases, help practitioners identify possible infectious dermatoses, create a comprehensive and prioritized differential list, and provide guidance for the diagnosis of these diseases. A working knowledge of these clinical syndromes is important if what is thought to be a case of a common disease does not respond to conventional management. This review is aimed at veterinarians who treat cats and especially those with an interest in feline dermatology. Tables are included to allow the reader to formulate a concise list of differential diagnoses for clinically similar presentations. The diagnostic approach to a case of ulcerative facial dermatitis is reviewed in a Case Notes quiz. Evidence base: This article includes up-to-date information regarding dermatologic manifestations of less commonly encountered feline cutaneous infectious diseases. Information has been drawn from the published, peer-reviewed literature and the most recent textbook chapters with a particular aim of describing and differentiating clinical lesions and the diagnostic approach to cutaneous disease, especially in unusual cases.

  8. Delayed pneumothorax after laparoscopic sigmoid colectomy in a patient without underlying lung disease

    Directory of Open Access Journals (Sweden)

    Richie K Huynh

    2014-10-01

    Full Text Available We present an unusual case of a delayed pneumothorax occurring approximately 72 h post-operatively in a patient without any underlying lung disease who had undergone laparoscopic sigmoid colon resection. The patient was in her mid-40s with a body mass index of 28.0 and had no history of smoking. Her spontaneous pneumothorax manifested without any precipitating events or complications during recovery. There was no evidence of any infectious process. There were no central line attempts and all ports were placed intra-peritoneally, and there was no evidence of any subcutaneous emphysema. One possible mechanism of injury that we propose is barotrauma from an extended period of time in Trendelenburg position. Notably, the only abnormal finding throughout the entire post-operative period preceding the delayed pneumothorax was a PO 2 desaturation the day before. This case highlights the necessity to examine and investigate any desaturation post-operatively and deliberate its possible significance. Furthermore, it demonstrates that, even during a normal recovery period for a patient without any underlying lung disease or risk factors, spontaneous pneumothorax could still develop in a delayed fashion multiple days post-operatively from a laparoscopic procedure.

  9. Focused cardiac ultrasound is feasible in the general practice setting and alters diagnosis and management of cardiac disease

    Directory of Open Access Journals (Sweden)

    James Yates

    2016-08-01

    Full Text Available Background: Ultrasound-assisted examination of the cardiovascular system with focused cardiac ultrasound by the treating physician is non-invasive and changes diagnosis and management of patient’s with suspected cardiac disease. This has not been reported in a general practice setting. Aim: To determine whether focused cardiac ultrasound performed on patients aged over 50 years changes the diagnosis and management of cardiac disease by a general practitioner. Design and setting: A prospective observational study of 80 patients aged over 50 years and who had not received echocardiography or chest CT within 12 months presenting to a general practice. Method: Clinical assessment and management of significant cardiac disorders in patients presenting to general practitioners were recorded before and after focused cardiac ultrasound. Echocardiography was performed by a medical student with sufficient training, which was verified by an expert. Differences in diagnosis and management between conventional and ultrasound-assisted assessment were recorded. Results and conclusion: Echocardiography and interpretation were acceptable in all patients. Significant cardiac disease was detected in 16 (20% patients, including aortic stenosis in 9 (11% and cardiac failure in 7 (9%, which were missed by clinical examination in 10 (62.5% of these patients. Changes in management occurred in 12 patients (15% overall and 75% of those found to have significant cardiac disease including referral for diagnostic echocardiography in 8 (10%, commencement of heart failure treatment in 3 (4% and referral to a cardiologist in 1 patient (1%. Routine focused cardiac ultrasound is feasible and frequently alters the diagnosis and management of cardiac disease in patients aged over 50 years presenting to a general practice.

  10. Bispectoral index scores of pediatric patients under dental treatment and recovery conditions: Study of children assigned for general anesthesia under propofol and isofloran regimes

    Directory of Open Access Journals (Sweden)

    Dana Tahririan

    2016-01-01

    Full Text Available Background: This study was planned to determine the relationship between bispectoral index (BIS during dental treatment and recovery conditions in children undergoing two regimes of anesthesia of propofol and isoflurane. Materials and Methods: In this single-blind clinical trial study, 57 4-7-year-old healthy children who had been referred for dental treatment under general anesthesia between 60 and 90 min were selected by convenience sampling and assigned to two groups, after obtaining their parents′ written consent. The anesthesia was induced by inhalation. For the first group, the anesthesia was preserved by a mixture of oxygen (50%, nitrous oxide (50%, and isoflurane (1%. For the second group, the anesthesia was preserved by a mixture of oxygen (50%, nitrous oxide (50%, and propofol was administered intravenously at a dose of 100 Ng/kg/min. The patients′ vital signs, BIS, and agitation scores were recorded every 10 min. The data were analyzed by repeated measure ANOVA and t-tests at a significance level of α = 0.05 using SPSS version 20. Results: The results of independent t-test for anesthesia time showed no statistically significant difference between isoflurane and propofol (P = 0.87. Controlling age, the BIS difference between the two anesthetic agents was not significant (P > 0.05; however, it was negatively correlated with the duration of anesthesia and the discharge time (P = 0.001, r = -0.308 and (P < 0.001, r = -0.55. Conclusion: The same depth of anesthesia is produced by propofol and isoflurane, but lower recovery complications from anesthesia are observed with isoflurane.

  11. Non-random biodiversity loss underlies predictable increases in viral disease prevalence.

    Science.gov (United States)

    Lacroix, Christelle; Jolles, Anna; Seabloom, Eric W; Power, Alison G; Mitchell, Charles E; Borer, Elizabeth T

    2014-03-06

    Disease dilution (reduced disease prevalence with increasing biodiversity) has been described for many different pathogens. Although the mechanisms causing this phenomenon remain unclear, the disassembly of communities to predictable subsets of species, which can be caused by changing climate, land use or invasive species, underlies one important hypothesis. In this case, infection prevalence could reflect the competence of the remaining hosts. To test this hypothesis, we measured local host species abundance and prevalence of four generalist aphid-vectored pathogens (barley and cereal yellow dwarf viruses) in a ubiquitous annual grass host at 10 sites spanning 2000 km along the North American West Coast. In laboratory and field trials, we measured viral infection as well as aphid fecundity and feeding preference on several host species. Virus prevalence increased as local host richness declined. Community disassembly was non-random: ubiquitous hosts dominating species-poor assemblages were among the most competent for vector production and virus transmission. This suggests that non-random biodiversity loss led to increased virus prevalence. Because diversity loss is occurring globally in response to anthropogenic changes, such work can inform medical, agricultural and veterinary disease research by providing insights into the dynamics of pathogens nested within a complex web of environmental forces.

  12. Can systemically generated reactive oxygen species help to monitor disease activity in generalized vitiligo? A pilot study

    Directory of Open Access Journals (Sweden)

    Richeek Pradhan

    2014-01-01

    Full Text Available Background: Generalized vitiligo is a disease with unpredictable bursts of activity, goal of treatment during the active phase being to stabilize the lesions. This emphasizes the need for a prospective marker for monitoring disease activity to help decide the duration of therapy. Aims and Objectives: In the present study, we examined whether reactive oxygen species (ROS generated in erythrocytes can be translated into a marker of activity in vitiligo. Materials and Methods: Level of intracellular ROS was measured flow cytometrically in erythrocytes from venous blood of 21 patients with generalized vitiligo and 21 healthy volunteers using the probe dichlorodihydrofluorescein diacetate. Results: The levels of ROS differed significantly between patients and healthy controls, as well as between active versus stable disease groups. In the active disease group, ROS levels were significantly lower in those being treated with systemic steroids than those that were not. ROS levels poorly correlated with disease duration or body surface area involved. Conclusion: A long-term study based on these findings can be conducted to further validate the potential role of ROS in monitoring disease activity vitiligo.

  13. Shared activity patterns arising at genetic susceptibility loci reveal underlying genomic and cellular architecture of human disease

    DEFF Research Database (Denmark)

    Baillie, J Kenneth; Bretherick, Andrew; Haley, Christopher S

    2018-01-01

    Genetic variants underlying complex traits, including disease susceptibility, are enriched within the transcriptional regulatory elements, promoters and enhancers. There is emerging evidence that regulatory elements associated with particular traits or diseases share similar patterns...... the regulation of the OCT1 cation transporter and genetic variants underlying circulating cholesterol levels. NDA strongly implicates particular cell types and tissues in disease pathogenesis. For example, distinct groupings of disease-associated regulatory regions implicate two distinct biological processes...... in the pathogenesis of ulcerative colitis; a further two separate processes are implicated in Crohn's disease. Thus, our functional analysis of genetic predisposition to disease defines new distinct disease endotypes. We predict that patients with a preponderance of susceptibility variants in each group are likely...

  14. Transcriptomic Analysis and the Expression of Disease-Resistant Genes in Oryza meyeriana under Native Condition.

    Directory of Open Access Journals (Sweden)

    Bin He

    Full Text Available Oryza meyeriana (O. meyeriana, with a GG genome type (2n = 24, accumulated plentiful excellent characteristics with respect to resistance to many diseases such as rice shade and blast, even immunity to bacterial blight. It is very important to know if the diseases-resistant genes exist and express in this wild rice under native conditions. However, limited genomic or transcriptomic data of O. meyeriana are currently available. In this study, we present the first comprehensive characterization of the O. meyeriana transcriptome using RNA-seq and obtained 185,323 contigs with an average length of 1,692 bp and an N50 of 2,391 bp. Through differential expression analysis, it was found that there were most tissue-specifically expressed genes in roots, and next to stems and leaves. By similarity search against protein databases, 146,450 had at least a significant alignment to existed gene models. Comparison with the Oryza sativa (japonica-type Nipponbare and indica-type 93-11 genomes revealed that 13% of the O. meyeriana contigs had not been detected in O. sativa. Many diseases-resistant genes, such as bacterial blight resistant, blast resistant, rust resistant, fusarium resistant, cyst nematode resistant and downy mildew gene, were mined from the transcriptomic database. There are two kinds of rice bacterial blight-resistant genes (Xa1 and Xa26 differentially or specifically expressed in O. meyeriana. The 4 Xa1 contigs were all only expressed in root, while three of Xa26 contigs have the highest expression level in leaves, two of Xa26 contigs have the highest expression profile in stems and one of Xa26 contigs was expressed dominantly in roots. The transcriptomic database of O. meyeriana has been constructed and many diseases-resistant genes were found to express under native condition, which provides a foundation for future discovery of a number of novel genes and provides a basis for studying the molecular mechanisms associated with disease

  15. 9 CFR 71.3 - Interstate movement of diseased animals and poultry generally prohibited.

    Science.gov (United States)

    2010-01-01

    ... positive to an official Johne's disease test, are not affected with any other disease referred to in this... regard to scrapie, as exposed animals, high-risk animals, suspect animals, or scrapie-positive animals... adding the words “viral hemorrhagic septicemia,” after “chlamydiosis,”; and by adding a new paragraph (c...

  16. Somatic diseases in patients with schizophrenia in general practice : their prevalence and health care

    NARCIS (Netherlands)

    Oud, Marian J. T.; Meyboom-de Jong, Betty

    2009-01-01

    Background: Schizophrenia patients frequently develop somatic co-morbidity. Core tasks for GPs are the prevention and diagnosis of somatic diseases and the provision of care for patients with chronic diseases. Schizophrenia patients experience difficulties in recognizing and coping with their

  17. Effect of screening and lifestyle counselling on incidence of ischaemic heart disease in general population

    DEFF Research Database (Denmark)

    Jørgensen, Torben; Jacobsen, Rikke Kart; Toft, Ulla

    2014-01-01

    to four times over a five year period. All participants with an unhealthy lifestyle had individually tailored lifestyle counselling at all visits (at baseline and after one and three years); those at high risk of ischaemic heart disease, according to predefined criteria, were furthermore offered six....... MAIN OUTCOME MEASURES: The primary outcome measure was incidence of ischaemic heart disease in the intervention group compared with the control group. Secondary outcome measures were stroke, combined events (ischaemic heart disease, stroke, or both), and mortality. RESULTS: 6091 (52.4%) people...... disease. Among 58,940 without a history of stroke at baseline, 1726 developed stroke. No significant difference was seen between the intervention and control groups in the primary end point (hazard ratio for ischaemic heart disease 1.03, 95% confidence interval 0.94 to 1.13) or in the secondary endpoints...

  18. Statistical analysis of general, clinical and radiographic parameters of navicular disease in the horse

    International Nuclear Information System (INIS)

    Langfeldt, N.; Hertsch, B.

    1988-01-01

    With 20,4 % the syndrome navicular disease has a remarkable part of lameness in the equine fore limb. Although intensive investigations of the last years, there is no uniform opinion in the clinical diagnosis of navicular disease. At first there is a differential description of the diagnosis of navicular disease and a presentation of the importance of this disease from the whole patients of the equine hospital of the Tierärztliche Hochschule Hannover about five years (1980-1984). After that, the importance of the identification of pain with pain provocation test and the elimination of pain by anesthetic nerve blocking are described. The result of the anesthetic block of the ''Ramus pulvinus'' of the medial and lateral palmar digital nerves is a necessary part in clinical diagnosis of navicular disease [de

  19. Participation of general practitioners in disease management: experiences from the Netherlands

    Directory of Open Access Journals (Sweden)

    L.M.G. Steuten

    2002-03-01

    Full Text Available Objective: To investigate the extent to which GPs in the Netherlands participate in disease management and how personal opinions, impeding and promoting incentives as well as physician characteristics influence their attitude towards disease management. Methods: The attitude-model of Fishbein and Ajzen was used to describe the attitude of GPs towards disease management and main influencing factors. After interviewing seventeen representatives of the GPs and testing a questionnaire, the final questionnaire was sent to all GPs in the Netherlands (7680 GPs barring those involved in the testing of the questionnaire. Results: At least 10.4% of all Dutch GPs are active in disease management. The main factors predicting a positive attitude towards disease management are the following: GPs' opinion that they are improving quality and efficiency of care when executing disease management, presence of a good quality network between actors involved prior to the start of disease management, working in a health centre, and performing sideline activities besides their daily activities as GPs. The main factors predicting a negative attitude are: GPs' opinion that the investment-time is too high, lack of reimbursement for disease management activities, working in a solo practice, and not performing any sideline activities beside their daily activities as GP. Conclusions: The factors predicting a negative attitude of Dutch GPs towards disease management dominate the factors predicting a positive attitude. The arguments in favour of disease management are matters of belief, for example concerning improvements in the quality of care, while arguments against are more concrete barriers e.g. high workload and financial reimbursement. Placed on the innovation timeline, the 10.4% participation might be taken to represent the start of a trend.

  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. 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.

  2. 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

    2017-01-01

    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. PMID:28443980

  3. Comparison of Rates of Death Having any Death-Certificate Mention of Heart, Kidney, or Liver Disease Among Persons Diagnosed with HIV Infection with those in the General US Population, 2009-2011

    OpenAIRE

    Whiteside, Y. Omar; Selik, Richard; An, Qian; Huang, Taoying; Karch, Debra; Hernandez, Angela L; Hall, H. Irene

    2015-01-01

    Objective : Compare age-adjusted rates of death due to liver, kidney, and heart diseases during 2009-2011 among US residents diagnosed with HIV infection with those in the general population. Methods : Numerators were numbers of records of multiple-cause mortality data from the national vital statistics system with an ICD-10 code for the disease of interest (any mention, not necessarily the underlying cause), divided into those 1) with and 2) without an additional code for HIV infection. Deno...

  4. Dexmedetomidine infusion during middle ear surgery under general anaesthesia to provide oligaemic surgical field: A prospective study

    Directory of Open Access Journals (Sweden)

    Kumkum Gupta

    2015-01-01

    Full Text Available Background and Aims: Middle ear surgery requires bloodless surgical field for better operating conditions, deep level of anaesthesia and rapid emergence. Recent studies suggest that α2 agonists could provide desired surgical field, sedation and analgesia. The present study was aimed to evaluate the clinical effects of dexmedetomidine infusion as anaesthetic adjuvant during middle ear surgery using operating microscope. Methods: Sixty four adult patients aged 18-58 years, American Society of Anaesthesiologists Grades I and II, of both gender were randomised into two comparable equal groups of 32 patients each for middle ear surgery under general anaesthesia with standard anaesthetic technique. After induction of general anaesthesia, patients of Group I were given dexmedetomidine infusion of 0.5 μg/kg/h and patients of Group II were given placebo infusion of normal saline. Isoflurane concentration was titrated to achieve a systolic blood pressure 30% below the baseline value. All patients were assessed intra-operatively for bleeding at surgical field, haemodynamic changes, awakening time and post-operative recovery. Results: Statistically significant reduction was observed in the required percentage of isoflurane (0.8 ± 0.6% to maintain the systolic blood pressure 30% below the baseline values in patients receiving dexmedetomidine infusion when compared to those receiving placebo infusion (1.6 ± 0.7%. Patients receiving dexmedetomidine infusion had statistically significant lesser bleeding at surgical field (P < 0.05. The mean awakening time and recovery from anaesthesia did not show any significant difference between the groups. Conclusion: Dexmedetomidine infusion can be safely used to provide oligaemic surgical field for better visualization using operating microscope for middle ear surgery.

  5. The general public's willingness to pay for tax increases to support unrestricted access to an Alzheimer's disease medication.

    Science.gov (United States)

    Oremus, Mark; Tarride, Jean-Eric; Raina, Parminder; Thabane, Lehana; Foster, Gary; Goldsmith, Charlie H; Clayton, Natasha

    2012-11-01

    Alzheimer's disease (AD) is a neurodegenerative disorder highlighted by progressive declines in cognitive and functional abilities. Our objective was to assess the general public's maximum willingness to pay ((M)WTP) for an increase in annual personal income taxes to fund unrestricted access to AD medications. We randomly recruited 500 Canadians nationally and used computer-assisted telephone interviewing to administer a questionnaire. The questionnaire contained four 'efficacy' scenarios describing an AD medication as capable of symptomatically treating cognitive decline or modifying disease progression. The scenarios also described the medication as having no adverse effects or a 30% chance of adverse effects. We randomized participants to order of scenarios and willingness-to-pay bid values; (M)WTP for each scenario was the highest accepted bid for that scenario. We conducted linear regression and bootstrap sensitivity analyses to investigate potential determinants of (M)WTP. Mean (M)WTP was highest for the 'disease modification/no adverse effects' scenario ($Can130.26) and lowest for the 'symptomatic treatment/30% chance of adverse effects' scenario ($Can99.16). Bootstrap analyses indicated none of our potential determinants (e.g. age, sex) were associated with participants' (M)WTP. The general public is willing to pay higher income taxes to fund unrestricted access to AD (especially disease-modifying) medications. Consequently, the public should favour placing new AD medications on public drug plans. As far as we are aware, no other study has elicited the general public's willingness to pay for AD medications.

  6. Structural and Mechanical Properties of Intermediate Filaments under Extreme Conditions and Disease

    Science.gov (United States)

    Qin, Zhao

    Intermediate filaments are one of the three major components of the cytoskeleton in eukaryotic cells. It was discovered during the recent decades that intermediate filament proteins play key roles to reinforce cells subjected to large-deformation as well as participate in signal transduction. However, it is still poorly understood how the nanoscopic structure, as well as the biochemical properties of these protein molecules contribute to their biomechanical functions. In this research we investigate the material function of intermediate filaments under various extreme mechanical conditions as well as disease states. We use a full atomistic model and study its response to mechanical stresses. Learning from the mechanical response obtained from atomistic simulations, we build mesoscopic models following the finer-trains-coarser principles. By using this multiple-scale model, we present a detailed analysis of the mechanical properties and associated deformation mechanisms of intermediate filament network. We reveal the mechanism of a transition from alpha-helices to beta-sheets with subsequent intermolecular sliding under mechanical force, which has been inferred previously from experimental results. This nanoscale mechanism results in a characteristic nonlinear force-extension curve, which leads to a delocalization of mechanical energy and prevents catastrophic fracture. This explains how intermediate filament can withstand extreme mechanical deformation of > 1 00% strain despite the presence of structural defects. We combine computational and experimental techniques to investigate the molecular mechanism of Hutchinson-Gilford progeria syndrome, a premature aging disease. We find that the mutated lamin tail .domain is more compact and stable than the normal one. This altered structure and stability may enhance the association of intermediate filaments with the nuclear membrane, providing a molecular mechanism of the disease. We study the nuclear membrane association

  7. Generalized acute mucocutaneous herpes simplex

    Directory of Open Access Journals (Sweden)

    Mittal R

    1994-01-01

    Full Text Available A case of generalized acute mucocutaneous herpes simplex is reported in a 15 years old boy. There was neither underlying disease nor any evidence of genetic or acquired immune deficiency.

  8. Effect of screening and lifestyle counselling on incidence of ischaemic heart disease in general population

    DEFF Research Database (Denmark)

    Jørgensen, Torben; Jacobsen, Rikke Kart; Toft, Ulla

    2014-01-01

    of Copenhagen, Denmark PARTICIPANTS: 59 616 people aged 30-60 years randomised with different age and sex randomisation ratios to an intervention group (n=11 629) and a control group (n=47 987). INTERVENTION: The intervention group was invited for screening, risk assessment, and lifestyle counselling up to four...... OUTCOME MEASURES: The primary outcome measure was incidence of ischaemic heart disease in the intervention group compared with the control group. Secondary outcome measures were stroke, combined events (ischaemic heart disease, stroke, or both), and mortality. RESULTS: 6091 (52.4%) people...... disease. Among 58 940 without a history of stroke at baseline, 1726 developed stroke. No significant difference was seen between the intervention and control groups in the primary end point (hazard ratio for ischaemic heart disease 1.03, 95% confidence interval 0.94 to 1.13) or in the secondary endpoints...

  9. Oral contraception, smoking and inflammatory bowel disease--findings in the Royal College of General Practitioners Oral Contraception Study.

    Science.gov (United States)

    Logan, R F; Kay, C R

    1989-03-01

    Data from the Royal College of General Practitioners Oral Contraception Study have been examined to determine whether oral contraceptive use was associated with the development of Crohn's disease or ulcerative colitis. Over a 17 year period Crohn's disease developed in 42 women and ulcerative colitis in 78. The incidence of both diseases was greater in oral contraceptive users compared to non-users with the rate ratio for Crohn's disease being 1.7 (95% confidence limits, 0.88, 3.2) and for ulcerative colitis being 1.3 (95% confidence limits 0.82, 2.0). For both diseases incidence was unrelated to parity or social class, but women smoking at recruitment had a greater incidence of Crohn's disease (rate ratio 1.8, 95% confidence limits 0.93, 3.3) and a reduced incidence of ulcerative colitis (rate ratio 0.68, 95% confidence limits 0.41, 1.1). Although these results are based on small numbers and could be chance findings, they are consistent with other studies showing associations between oral contraceptive use, smoking and the development of Crohn's disease and ulcerative colitis.

  10. Epidemiological features of gastro-esophageal reflux disease in Iran based on general population

    OpenAIRE

    Pourhoseingholi, Asma; Pourhoseingholi, Mohamad Amin; Moghimi-Dehkordi, Bijan; Barzegar, Farnoosh; Safaee, Azadeh; Vahedi, Mohsen; Dulaimi, David Al; Prabhakaran, Sudhakaran

    2012-01-01

    Aim The aim of this study was to evaluate the epidemiology of GERD base on population study in Tehran providence. Background Gastro-esophageal reflux disease (GERD) is a common and chronic problem. Recent reports from developing countries indicate increment in the incidence and prevalence of the disease over the past. Patients and methods This study was a cross-sectional household survey conducted from May 2006 to December 2007 in Tehran province, Iran. Participants completed a valid gastro-e...

  11. A generalized-growth model to characterize the early ascending phase of infectious disease outbreaks

    Directory of Open Access Journals (Sweden)

    Cécile Viboud

    2016-06-01

    Conclusions: Our findings reveal significant variation in epidemic growth patterns across different infectious disease outbreaks and highlights that sub-exponential growth is a common phenomenon, especially for pathogens that are not airborne. Sub-exponential growth profiles may result from heterogeneity in contact structures or risk groups, reactive behavior changes, or the early onset of interventions strategies, and consideration of “deceleration parameters” may be useful to refine existing mathematical transmission models and improve disease forecasts.

  12. Detection of heart disease by open access echocardiography: a retrospective analysis of general practice referrals.

    Science.gov (United States)

    Chambers, John; Kabir, Saleha; Cajeat, Eric

    2014-02-01

    Heart disease is difficult to detect clinically and it has been suggested that echocardiography should be available to all patients with possible cardiac symptoms or signs. To analyse the results of 2 years of open access echocardiography for the frequency of structural heart disease according to request. Retrospective database analysis in a teaching hospital open access echocardiography service. Reports of all open access transthoracic echocardiograms between January 2011 and December 2012 were categorised as normal, having minor abnormalities, or significant abnormalities according to the indication. There were 2343 open access echocardiograms performed and there were significant abnormalities in 29%, predominantly valve disease (n = 304, 13%), LV systolic dysfunction (n = 179, 8%), aortic dilatation (n = 80, 3%), or pulmonary hypertension (n = 91, 4%). If echocardiography had been targeted at a high-risk group, 267 with valve disease would have been detected (compared to 127 with murmur alone) and 139 with LV systolic dysfunction (compared to 91 with suspected heart failure alone). Most GP practices requested fewer than 10 studies, but 6 practices requested over 70 studies. Open access echocardiograms are often abnormal but structural disease may not be suspected from the clinical request. Uptake by individual practices is patchy. A targeted expansion of echocardiography in patients with a high likelihood of disease is therefore likely to increase the detection of clinically important pathology.

  13. Detection of heart disease by open access echocardiography: a retrospective analysis of general practice referrals

    Science.gov (United States)

    Chambers, John; Kabir, Saleha; Cajeat, Eric

    2014-01-01

    Background Heart disease is difficult to detect clinically and it has been suggested that echocardiography should be available to all patients with possible cardiac symptoms or signs. Aim To analyse the results of 2 years of open access echocardiography for the frequency of structural heart disease according to request. Design and setting Retrospective database analysis in a teaching hospital open access echocardiography service. Method Reports of all open access transthoracic echocardiograms between January 2011 and December 2012 were categorised as normal, having minor abnormalities, or significant abnormalities according to the indication. Results There were 2343 open access echocardiograms performed and there were significant abnormalities in 29%, predominantly valve disease (n = 304, 13%), LV systolic dysfunction (n = 179, 8%), aortic dilatation (n = 80, 3%), or pulmonary hypertension (n = 91, 4%). If echocardiography had been targeted at a high-risk group, 267 with valve disease would have been detected (compared to 127 with murmur alone) and 139 with LV systolic dysfunction (compared to 91 with suspected heart failure alone). Most GP practices requested fewer than 10 studies, but 6 practices requested over 70 studies. Conclusion Open access echocardiograms are often abnormal but structural disease may not be suspected from the clinical request. Uptake by individual practices is patchy. A targeted expansion of echocardiography in patients with a high likelihood of disease is therefore likely to increase the detection of clinically important pathology. PMID:24567615

  14. Potential distribution of pine wilt disease under future climate change scenarios.

    Directory of Open Access Journals (Sweden)

    Akiko Hirata

    Full Text Available Pine wilt disease (PWD constitutes a serious threat to pine forests. Since development depends on temperature and drought, there is a concern that future climate change could lead to the spread of PWD infections. We evaluated the risk of PWD in 21 susceptible Pinus species on a global scale. The MB index, which represents the sum of the difference between the mean monthly temperature and 15 when the mean monthly temperatures exceeds 15°C, was used to determine current and future regions vulnerable to PWD (MB ≥ 22. For future climate conditions, we compared the difference in PWD risks among four different representative concentration pathways (RCPs 2.6, 4.5, 6.0, and 8.5 and two time periods (2050s and 2070s. We also evaluated the impact of climate change on habitat suitability for each Pinus species using species distribution models. The findings were then integrated and the potential risk of PWD spread under climate change was discussed. Within the natural Pinus distribution area, southern parts of North America, Europe, and Asia were categorized as vulnerable regions (MB ≥ 22; 16% of the total Pinus distribution area. Representative provinces in which PWD has been reported at least once overlapped with the vulnerable regions. All RCP scenarios showed expansion of vulnerable regions in northern parts of Europe, Asia, and North America under future climate conditions. By the 2070s, under RCP 8.5, an estimated increase in the area of vulnerable regions to approximately 50% of the total Pinus distribution area was revealed. In addition, the habitat conditions of a large portion of the Pinus distribution areas in Europe and Asia were deemed unsuitable by the 2070s under RCP 8.5. Approximately 40% of these regions overlapped with regions deemed vulnerable to PWD, suggesting that Pinus forests in these areas are at risk of serious damage due to habitat shifts and spread of PWD.

  15. Potential distribution of pine wilt disease under future climate change scenarios.

    Science.gov (United States)

    Hirata, Akiko; Nakamura, Katsunori; Nakao, Katsuhiro; Kominami, Yuji; Tanaka, Nobuyuki; Ohashi, Haruka; Takano, Kohei Takenaka; Takeuchi, Wataru; Matsui, Tetsuya

    2017-01-01

    Pine wilt disease (PWD) constitutes a serious threat to pine forests. Since development depends on temperature and drought, there is a concern that future climate change could lead to the spread of PWD infections. We evaluated the risk of PWD in 21 susceptible Pinus species on a global scale. The MB index, which represents the sum of the difference between the mean monthly temperature and 15 when the mean monthly temperatures exceeds 15°C, was used to determine current and future regions vulnerable to PWD (MB ≥ 22). For future climate conditions, we compared the difference in PWD risks among four different representative concentration pathways (RCPs 2.6, 4.5, 6.0, and 8.5) and two time periods (2050s and 2070s). We also evaluated the impact of climate change on habitat suitability for each Pinus species using species distribution models. The findings were then integrated and the potential risk of PWD spread under climate change was discussed. Within the natural Pinus distribution area, southern parts of North America, Europe, and Asia were categorized as vulnerable regions (MB ≥ 22; 16% of the total Pinus distribution area). Representative provinces in which PWD has been reported at least once overlapped with the vulnerable regions. All RCP scenarios showed expansion of vulnerable regions in northern parts of Europe, Asia, and North America under future climate conditions. By the 2070s, under RCP 8.5, an estimated increase in the area of vulnerable regions to approximately 50% of the total Pinus distribution area was revealed. In addition, the habitat conditions of a large portion of the Pinus distribution areas in Europe and Asia were deemed unsuitable by the 2070s under RCP 8.5. Approximately 40% of these regions overlapped with regions deemed vulnerable to PWD, suggesting that Pinus forests in these areas are at risk of serious damage due to habitat shifts and spread of PWD.

  16. Digital assistance of nasogastric tube insertion in intubated patients under general anesthesia: A single-blinded prospective randomized study

    Science.gov (United States)

    Kandeel, Alrefaey; Elmorhedi, Mohammed; Abdalla, Usama

    2017-01-01

    Background: Nasogastric tube (NGT) insertion may pose a special problem in patients under general anesthesia with first attempt failure rates up to 50%. To increase insertion success rate and decreases related complications, several techniques have been developed. In this study, digital assistance technique is compared to the classic insertion technique in neck flexion. Materials and Methods: In this prospective randomized study, 160 patients were randomly allocated into two groups; control group (Group C, n = 80) where NGT tube will be inserted with the neck in flexion position and digital facilitation group (Group D, n = 80). Results: Overall success rate and first attempt success were statistically higher in Group D compared to Group C (94% vs. 81%, P = 0.02, 80% vs. 62%, P = 0.01 respectively) with significantly lower insertion time in Group D (13 ± 5 s. vs. 10 ± 3 s., P = 0.00). Conclusions: Digital assistance of NGT insertion in the anesthetized or unconscious patient is an effective, fast, and safe method that can be either used as a routine technique or as a rescue in case of failed other methods. PMID:28757827

  17. Frequency and risk factors for under- and over-treatment in stroke prevention for patients with non-valvular atrial fibrillation in general practice

    NARCIS (Netherlands)

    Arts, Derk L.; Visscher, Stefan; Opstelten, Wim; Korevaar, Joke C.; Abu-Hanna, Ameen; van Weert, Henk C. P. M.

    2013-01-01

    To determine adequacy of antithrombotic treatment in patients with non-valvular atrial fibrillation. To determine risk factors for under- and over-treatment. Retrospective, cross-sectional study of electronic health records from 36 general practitioners in 2008. General practice in the Netherlands.

  18. Genetic variation in liver x receptor alpha and risk of ischemic vascular disease in the general population

    DEFF Research Database (Denmark)

    Stender, Stefan; Frikke-Schmidt, Ruth; Anestis, Aristomenis

    2011-01-01

    Although animal studies indicate that liver X receptor alpha (LXRa) might influence risk of atherosclerosis, data in humans remain scarce. We tested the hypothesis that genetic variation in LXRa associates with risk of ischemic vascular disease and/or plasma lipid and lipoprotein levels in the ge......Although animal studies indicate that liver X receptor alpha (LXRa) might influence risk of atherosclerosis, data in humans remain scarce. We tested the hypothesis that genetic variation in LXRa associates with risk of ischemic vascular disease and/or plasma lipid and lipoprotein levels...... in the general population....

  19. Genetic variation in liver x receptor alpha and risk of ischemic vascular disease in the general population

    DEFF Research Database (Denmark)

    Stender, Stefan; Frikke-Schmidt, Ruth; Anestis, Aristomenis

    2011-01-01

    Although animal studies indicate that liver X receptor alpha (LXRα) might influence risk of atherosclerosis, data in humans remain scarce. We tested the hypothesis that genetic variation in LXRα associates with risk of ischemic vascular disease and/or plasma lipid and lipoprotein levels in the ge......Although animal studies indicate that liver X receptor alpha (LXRα) might influence risk of atherosclerosis, data in humans remain scarce. We tested the hypothesis that genetic variation in LXRα associates with risk of ischemic vascular disease and/or plasma lipid and lipoprotein levels...... in the general population....

  20. Innovation: treatment by protons of a two years old girl under general anesthesia; Innovation: traitement par protons d'une enfant de deux ans sous anesthesie generale

    Energy Technology Data Exchange (ETDEWEB)

    Pechmagre, C.; Oliveres, S.; Helfre, S.; Delacroix, S.; Ferrand, R.; Habrand, J.L.; Lacroix, F. [Institut Curie, Centre de Protontherapie, 91 - Orsay (France); Esteve, M. [Institut Curie, Dept. d' Anesthesie-Reanimation-Douleur, 91 - Orsay (France); Orbach, D. [Institut Curie, Dept. de Pediatrie, 91 - Orsay (France); Rodriguez, J. [Institut Curie, Service de Chirurgie ORL, 91 - Orsay (France)

    2006-11-15

    The proton therapy is a technique known for the treatment of skull tumors, skull base and face. Now it is possible to use it for young children because of the general anesthesia and teams collaboration. This method of treatment offers perspectives because of the number of young children treated. (N.C.)

  1. The Mechanisms of Traditional Chinese Medicine Underlying the Prevention and Treatment of Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Xiaoliang Li

    2017-09-01

    Full Text Available Parkinson's disease (PD, characterized with bradykinesia, static tremor, rigidity and disturbances in balance, is the second most common neurodegenerative disorder. Along with the largely aging population in the world, the incidence is increasing year by year, which imposes the negative impacts on patients, their families and the whole society. Traditional Chinese medicine (TCM has a positive prospect for the prevention and cure of PD due to its advantages of less side effects and multi-target effects. At present, the pathogenesis of PD is not yet fully discovered. This paper elaborates the mechanisms of TCM underlying the prevention and treatment of PD with regards to the inhibition of oxidative stress, the regulation of mitochondrial dysfunction, the reduction of toxic excitatory amino acids (EAA, the inhibition of neuroinflammation, the inhibition of neuronal apoptosis, and the inhibition of abnormal protein aggregation.

  2. Resistance Potential of Bread Wheat Genotypes Against Yellow Rust Disease Under Egyptian Climate.

    Science.gov (United States)

    Mahmoud, Amer F; Hassan, Mohamed I; Amein, Karam A

    2015-12-01

    Yellow rust (stripe rust), caused by Puccinia striiformis f. sp. tritici, is one of the most destructive foliar diseases of wheat in Egypt and worldwide. In order to identify wheat genotypes resistant to yellow rust and develop molecular markers associated with the resistance, fifty F8 recombinant inbred lines (RILs) derived from a cross between resistant and susceptible bread wheat landraces were obtained. Artificial infection of Puccinia striiformis was performed under greenhouse conditions during two growing seasons and relative resistance index (RRI) was calculated. Two Egyptian bread wheat cultivars i.e. Giza-168 (resistant) and Sakha-69 (susceptible) were also evaluated. RRI values of two-year trial showed that 10 RILs responded with RRI value >6 2 rust. However, further molecular analyses would be performed to confirm markers associated with the resistance and suitable for marker-assisted selection. Resistant RILs identified in the study could be efficiently used to improve the resistance to yellow rust in wheat.

  3. Exploring the genetics underlying autoimmune diseases with network analysis and link prediction

    KAUST Repository

    Alanis Lobato, Gregorio

    2014-02-01

    Ever since the first Genome Wide Association Study (GWAS) was carried out we have seen an important number of discoveries of biological and clinical relevance. However, there are some scientists that consider that these research outcomes and their utility are far from what was expected from this experimental design. We instead believe that the thousands of genetic variants associated with complex disorders by means of GWASs are an extremely valuable source of information that needs to be mined in a different way. Based on this philosophy, we followed a holistic perspective to analyze GWAS data and explored the structural properties of the network representation of one of these datasets with the aim to advance our understanding of the genetic intricacies underlying autoimmune human diseases. The simplicity, computational efficiency and precision of the tools proposed in this paper represent a new means to address GWAS data and contribute to the better exploitation of these rich sources of information. © 2014 IEEE.

  4. 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, psanitation 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.

  5. Effect of multidisciplinary disease management for hospitalized heart failure under a national health insurance programme.

    Science.gov (United States)

    Mao, Chun-Tai; Liu, Min-Hui; Hsu, Kuang-Hung; Fu, Tieh-Cheng; Wang, Jong-Shyan; Huang, Yu-Yen; Yang, Ning-I; Wang, Chao-Hung

    2015-09-01

    Multidisciplinary disease management programmes (MDPs) for heart failure have been shown to be effective in Western countries. However, it is not known whether they improve outcomes in a high population density country with a national health insurance programme. In total, 349 patients hospitalized because of heart failure were randomized into control and MDP groups. All-cause death and re-hospitalization related to heart failure were analyzed. The median follow-up period was approximately 2 years. Mean patient age was 60 years; 31% were women; and 50% of patients had coronary artery disease. MDP was associated with fewer all-cause deaths [hazard ratio (HR) = 0.49, 95% confidence interval (CI) = 0.27-0.91, P = 0.02] and heart failure-related re-hospitalizations (HR = 0.44, 95% CI = 0.25-0.77, P = 0.004). MDP was still associated with better outcomes for all-cause death (HR = 0.53, 95% CI = 0.29-0.98, P = 0.04) and heart failure-related re-hospitalization (HR = 0.46, 95% CI = 0.26-0.81, P = 0.007), after adjusting for age, diuretics, diabetes mellitus, chronic kidney disease, hypertension, sodium, and albumin. However, MDPs' effect on all-cause mortality and heart failure-related re-hospitalization was significantly attenuated after adjusting for angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers or β-blockers. A stratified analysis showed that MDP combined with guideline-based medication had synergistic effects. MDP is effective in lowering all-cause mortality and re-hospitalization rates related to heart failure under a national health insurance programme. MDP synergistically improves the effectiveness of guidelines-based medications for heart failure.

  6. Effect of screening and lifestyle counselling on incidence of ischaemic heart disease in general population

    DEFF Research Database (Denmark)

    Jørgensen, Torben; Jacobsen, Rikke Kart; Toft, Ulla

    2014-01-01

    OBJECTIVE: To investigate the effect of systematic screening for risk factors for ischaemic heart disease followed by repeated lifestyle counselling on the 10 year development of ischaemic heart disease at a population level. DESIGN: Randomised controlled community based trial. SETTING: Suburbs...... of Copenhagen, Denmark PARTICIPANTS: 59 616 people aged 30-60 years randomised with different age and sex randomisation ratios to an intervention group (n=11 629) and a control group (n=47 987). INTERVENTION: The intervention group was invited for screening, risk assessment, and lifestyle counselling up to four...... times over a five year period. All participants with an unhealthy lifestyle had individually tailored lifestyle counselling at all visits (at baseline and after one and three years); those at high risk of ischaemic heart disease, according to predefined criteria, were furthermore offered six sessions...

  7. Effect of screening and lifestyle counselling on incidence of ischaemic heart disease in general population

    DEFF Research Database (Denmark)

    Jørgensen, Torben; Jacobsen, Rikke Kart; Toft, Ulla

    2014-01-01

    OBJECTIVE: To investigate the effect of systematic screening for risk factors for ischaemic heart disease followed by repeated lifestyle counselling on the 10 year development of ischaemic heart disease at a population level. DESIGN: Randomised controlled community based trial. SETTING: Suburbs...... of Copenhagen, Denmark. PARTICIPANTS: 59,616 people aged 30-60 years randomised with different age and sex randomisation ratios to an intervention group (n = 11,629) and a control group (n = 47,987). INTERVENTION: The intervention group was invited for screening, risk assessment, and lifestyle counselling up...... to four times over a five year period. All participants with an unhealthy lifestyle had individually tailored lifestyle counselling at all visits (at baseline and after one and three years); those at high risk of ischaemic heart disease, according to predefined criteria, were furthermore offered six...

  8. Prescribing in general practice for people with coronary heart disease; equity by age, sex, ethnic group and deprivation.

    Science.gov (United States)

    Mathur, Rohini; Badrick, Ellena; Boomla, Kambiz; Bremner, Stephen; Hull, Sally; Robson, John

    2011-04-01

    Differences in drug prescribing for coronary heart disease have previously been identified by age, sex and ethnic group. Set in the UK, our study utilises routinely collected data from 98 general practices serving a socially diverse population in inner East London, to examine differences in prescribing rates among patients aged 35 years and over with coronary heart disease. 10,933 patients aged 35 years or more, with recorded coronary heart disease, from 98 practices in two Primary Care Trusts (PCT) in East London during 2009/2010 were included for this cross-sectional study. Multivariable logistic regression was used to assess the odds of prescribing for recommended coronary heart disease drugs by age, sex, ethnicity, social deprivation, co-morbidity and recorded reasons for not prescribing. Women are prescribed fewer recommended coronary heart disease drugs than men; Black African/Caribbean patients are prescribed fewer lipid modifying drugs and other cardiovascular drugs than White patients. Patients over age 84 are prescribed fewer lipid modifying drugs and beta blockers than patients aged 45-54. South Asian patients had the highest levels of prescribing and higher prevalence of coronary heart disease and diabetes co-morbidity. No difference in prescribing rates by social deprivation was found. Overall levels of prescribing are high but small differences between sex and ethnic groups remain and prescribing may be inequitable for women, for Black/African Caribbeans and at older ages. These differences were not explained by recorded intolerance, contraindications or declining treatment.

  9. [Differences in risk factors for disease and health problems between monks and the general population in The Netherlands].

    Science.gov (United States)

    van Meel, D; de Vrij, J H; Kunst, A E; Mackenbach, J P

    1992-08-08

    The aim of this study was to determine whether the austerely living Trappist and Benedictine monks have a lower prevalence of a number of risk factors and health problems than the general Dutch population. A written questionnaire was submitted to monks of 7 monasteries. The response was 67 per cent (134 monks). The data were compared with data from the national Health Interview Survey of 1989, which used an almost identical questionnaire. Adjustment was made for differences in age and education. Monks consume less alcohol and tobacco and have a more austere diet. Their average Quetelet index is lower. The prevalence of cardiovascular disease is lower. On the other hand, monks more often report a number of other chronic diseases, physical complaints, and problems with activities of daily life. They more often have contact with general practitioners and with consultants. The lower prevalence of a number of risk factors among monks reflects their austere way of life. It is not certain whether the lower prevalence of cardiovascular diseases can be attributed to this way of life. The fact that, in general, health problems are more prevalent among monks suggests that changes in lifestyle do not necessarily lead to compression of morbidity.

  10. Herd Immunity Against Foot-and-Mouth Disease Under Different Vaccination Practices in India.

    Science.gov (United States)

    Sharma, G K; Mahajan, S; Matura, R; Biswal, J K; Ranjan, R; Subramaniam, S; Misri, J; Bambal, R G; Pattnaik, B

    2017-08-01

    A systematic vaccination programme is ongoing in India to control the three prevailing serotypes (A, O, Asia1) of foot-and-mouth disease (FMD) virus. Under the programme, more than 120 million bovine (term bovine applicable to both cattle and buffalo in this study) population of 221 of the 666 districts in the country are being bi-annually vaccinated with trivalent vaccine since 2010. Although clinical disease has reduced in these districts because of the systematic vaccinations, an abrupt increase in the number of FMD cases was recorded in 2013. Hence, a longitudinal field study was conducted in the year 2014 to estimate the serological herd immunity level in bovines, the impact of systematic vaccinations and field efficacy of the vaccines used. Serum samples (n = 115 963) collected from 295 districts of the 18 states of the country were analysed to estimate antibody titres against structural proteins of the three serotypes. The efficacy of the vaccine was demonstrated in the control group (group-D) where animals of the group were identified by ear tags for the purpose of repeated sampling after vaccination. Progressive building of the herd immunity in the field after systematic vaccination was demonstrated. The mean antibody titre against the serotypes O, A and Asia1 was estimated as log 10 1.93 (95% CI 1.92-1.93), 2.02 (2.02-2.02) and 2.02 (2.02-2.02), respectively, in the states covered under the control programme. However, in other states herd immunity was significantly low [mean titre log 10 1.68 (95% CI 1.67-1.69), 1.77 (1.76-1.78) and 1.85 (1.84-1.86) against the three serotypes]. Inverse relationship between the herd immunity and FMD incidences was observed the states following different vaccination practices. The study helped in demarcation of FMD risk zones in the country with low herd immunity. Estimation of herd immunity kinetics in the field helped in refining the vaccination schedule under the control programme. © 2016 Blackwell Verlag GmbH.

  11. Do heart failure disease management programs make financial sense under a bundled payment system?

    Science.gov (United States)

    Eapen, Zubin J; Reed, Shelby D; Curtis, Lesley H; Hernandez, Adrian F; Peterson, Eric D

    2011-05-01

    Policy makers have proposed bundling payments for all heart failure (HF) care within 30 days of an HF hospitalization in an effort to reduce costs. Disease management (DM) programs can reduce costly HF readmissions but have not been economically attractive for caregivers under existing fee-for-service payment. Whether a bundled payment approach can address the negative financial impact of DM programs is unknown. Our study determined the cost-neutral point for the typical DM program and examined whether published HF DM programs can be cost saving under bundled payment programs. We used a decision analytic model using data from retrospective cohort studies, meta-analyses, 5 randomized trials evaluating DM programs, and inpatient claims for all Medicare beneficiaries discharged with an HF diagnosis from 2001 to 2004. We determined the costs of DM programs and inpatient care over 30 and 180 days. With a baseline readmission rate of 22.9%, the average cost for readmissions over 30 days was $2,272 per patient. Under base-case assumptions, a DM program that reduced readmissions by 21% would need to cost $477 per patient to be cost neutral. Among evaluated published DM programs, 2 of the 5 would increase provider costs (+$15 to $283 per patient), whereas 3 programs would be cost saving (-$241 to $347 per patient). If bundled payments were broadened to include care over 180 days, then program saving estimates would increase, ranging from $419 to $1,706 per patient. Proposed bundled payments for HF admissions provide hospitals with a potential financial incentive to implement DM programs that efficiently reduce readmissions. Copyright © 2011 Mosby, Inc. All rights reserved.

  12. Evaluation of cardiovascular risk in patients with Parkinson disease under levodopa treatment.

    Science.gov (United States)

    Günaydın, Zeki Yüksel; Özer, Fahriye Feriha; Karagöz, Ahmet; Bektaş, Osman; Karataş, Mehmet Baran; Vural, Aslı; Bayramoğlu, Adil; Çelik, Abdullah; Yaman, Mehmet

    2016-01-01

    Levodopa is the indispensable choice of medial therapy in patients with Parkinson disease (PD). Since L-dopa treatment was shown to increase serum homocysteine levels, a well-known risk factor for cardiovascular disorders, the patients with PD under L-dopa treatment will be at increased risk for future cardiovascular events. The objective of this study is to evaluate cardiovascular risk in patients with PD under levodopa treatment. The study population consisted of 65 patients with idiopathic PD under L-dopa treatment. The control group included 32 age and gender matched individuals who had no cognitive decline. Echocardiographic measurements, serum homocysteine levels and elastic parameters of the aorta were compared between the patients with PD and controls. As an expected feature of L-dopa therapy, the Parkinson group had significantly higher homocystein levels (15.1 ± 3.9 µmol/L vs. 11.5 ± 3.2 µmol/L, P = 0.02). Aortic distensibility was significantly lower in the patients with PD when compared to controls (4.8 ± 1.5 dyn/cm(2) vs. 6.2 ± 1.9 dyn/cm(2), P = 0.016). Additionally, the patients with PD had higher aortic strain and aortic stiffness index (13.4% ± 6.4% vs. 7.4% ± 3.6%, P homocysteine levels were found to be positively correlated with aortic stiffness index and there was a negative correlation between aortic distensibility and levels of serum homocysteine (r = 0.674, P homocysteine levels may be a possible pathophysiological mechanism.

  13. Comorbidity was associated with neurologic and psychiatric diseases: a general practice-based controlled study

    NARCIS (Netherlands)

    Nuyen, Jasper; Schellevis, François G.; Satariano, William A.; Spreeuwenberg, Peter M.; Birkner, Merrill D.; van den Bos, Geertrudis A. M.; Groenewegen, Peter P.

    2006-01-01

    BACKGROUND AND OBJECTIVE: To comprehensively examine comorbidity in unselected cohorts of patients with depression, stroke, multiple sclerosis (MS), Parkinson's disease/parkinsonism (PD/PKM), dementia, migraine, and epilepsy. METHODS: This cross-sectional study used morbidity data recorded by Dutch

  14. Comorbidity was associated with neurologic and psychiatric diseases: a general practice-based controlled study.

    NARCIS (Netherlands)

    Nuyen, J.; Schellevis, F.G.; Satariano, W.A.; Spreeuwenberg, P.M.; Birkner, M.D.; Bos, G.A.M. van den; Groenewegen, P.P.

    2006-01-01

    BACKGROUND AND OBJECTIVE: To comprehensively examine comorbidity in unselected cohorts of patients with depression, stroke, multiple sclerosis (MS), Parkinson's disease/parkinsonism (PD/PKM), dementia, migraine, and epilepsy. METHODS: This cross-sectional study used morbidity data recorded by Dutch

  15. Plasma levels of apolipoprotein E and risk of ischemic heart disease in the general population

    DEFF Research Database (Denmark)

    Rasmussen, Katrine L.; Tybjærg-Hansen, Anne; Nordestgaard, Børge G

    2016-01-01

    BACKGROUND AND AIMS: Triglyceride-rich lipoproteins are causally associated with high risk of ischemic heart disease (IHD), and apolipoprotein E (apoE) has a central role in their plasma clearance. While both quantitative and qualitative changes of apoE are established causes of rare dyslipidemia...

  16. Robotic surgery in complicated gynecologic diseases: Experience of Tri-Service General Hospital in Taiwan

    Directory of Open Access Journals (Sweden)

    Shun-Jen Tan

    2012-03-01

    Conclusion: The present analyses include various complicated gynecologic conditions, which make the estimation of the effectiveness of robotic surgery in each situation individually not appropriate. However, our experiences do show that robotic surgery is feasible and safe for patients with complicated gynecologic diseases.

  17. Visible Age-Related Signs and Risk of Ischemic Heart Disease in the General Population

    DEFF Research Database (Denmark)

    Christoffersen, Mette; Frikke-Schmidt, Ruth; Schnohr, Peter

    2014-01-01

    risk of IHD and MI increased with increasing number of visible age-related signs. CONCLUSIONS: Male pattern baldness, earlobe crease, and xanthelasmata-alone or in combination-associate with increased risk of ischemic heart disease and myocardial infarction independent of chronological age and other...

  18. Respiratory variation in peak aortic velocity accurately predicts fluid responsiveness in children undergoing neurosurgery under general anesthesia.

    Science.gov (United States)

    Morparia, Kavita G; Reddy, Srijaya K; Olivieri, Laura J; Spaeder, Michael C; Schuette, Jennifer J

    2018-04-01

    The determination of fluid responsiveness in the critically ill child is of vital importance, more so as fluid overload becomes increasingly associated with worse outcomes. Dynamic markers of volume responsiveness have shown some promise in the pediatric population, but more research is needed before they can be adopted for widespread use. Our aim was to investigate effectiveness of respiratory variation in peak aortic velocity and pulse pressure variation to predict fluid responsiveness, and determine their optimal cutoff values. We performed a prospective, observational study at a single tertiary care pediatric center. Twenty-one children with normal cardiorespiratory status undergoing general anesthesia for neurosurgery were enrolled. Respiratory variation in peak aortic velocity (ΔVpeak ao) was measured both before and after volume expansion using a bedside ultrasound device. Pulse pressure variation (PPV) value was obtained from the bedside monitor. All patients received a 10 ml/kg fluid bolus as volume expansion, and were qualified as responders if stroke volume increased >15% as a result. Utility of ΔVpeak ao and PPV and to predict responsiveness to volume expansion was investigated. A baseline ΔVpeak ao value of greater than or equal to 12.3% best predicted a positive response to volume expansion, with a sensitivity of 77%, specificity of 89% and area under receiver operating characteristic curve of 0.90. PPV failed to demonstrate utility in this patient population. Respiratory variation in peak aortic velocity is a promising marker for optimization of perioperative fluid therapy in the pediatric population and can be accurately measured using bedside ultrasonography. More research is needed to evaluate the lack of effectiveness of pulse pressure variation for this purpose.

  19. [Extramammary Paget's disease of the scrotum with underlying sweat gland adenocarcinoma: a report of six cases with literature review].

    Science.gov (United States)

    Tu, Hua; Han, Hui; Zhou, Fang-Jian; Li, Yong-Hong; Qin, Zi-Ke; Liu, Zhuo-Wei

    2009-08-01

    Extramammary Paget's disease (EMPD) of the scrotum with sweat gland adenocarcinoma is a rare malignant tumor. This study was to summarize the clinicopathologic characteristics of scrotum Paget's disease with underlying sweat gland adenocarcinoma, and analyze the treatment outcome. Clinical data of six scrotum Paget's disease patients with sweat gland adenocarcinoma, treated in Sun Yat-sen University Cancer Center from 1964 to 2004, were analyzed with literature review. The typical manifestation of scrotum Paget's disease with sweat gland adenocarcinoma was eczematoid-like skin changes. All patients underwent primary lesion resection plus uni-inguinal lymphadenectomy, one patient underwent rectus abdominis pedicle flap transplantation. Three patients died of tumor at 15, 26, 38 months after operation, respectively. Other three patients were followed up for 48, 50, 55 months, respectively, and were alive without tumor. The primary lesion resection plus uni-inguinal lymphadenectomy is the major treatment for scrotum Paget's disease with underlying sweat gland adenocarcinoma.

  20. An investigation of the mechanism underlying teacher aggression : Testing I3 theory and the General Aggression Model

    NARCIS (Netherlands)

    Montuoro, Paul; Mainhard, Tim

    2017-01-01

    Background: Considerable research has investigated the deleterious effects of teachers responding aggressively to students who misbehave, but the mechanism underlying this dysfunctional behaviour remains unknown. Aims: This study investigated whether the mechanism underlying teacher aggression

  1. Darier′s disease - Oral, general and histopathological features in a 7 year old child

    Directory of Open Access Journals (Sweden)

    Sreedevi Dharman

    2016-01-01

    Full Text Available Darier′s disease, also known as keratosis follicularis, is a rare autosomal dominant genodermatosis, manifesting clinically as hyperkeratotic, firm papule that predominates in the seborrheic areas and flexures with accompanying nail abnormalities. Heat, sweating, sunlight, and stress are exacerbating factors of the lesion. The oral lesions are asymptomatic and comprise multiple white papules in the buccal mucosa and hard palate, giving a cobblestone appearance, and it is characterized histologically by loss of desmosomal adhesion and abnormal keratinization resulting in mucocutaneous abnormalities. Pruritus, recurrent infections, and malodor can decrease the quality of life. We report a case of a 7-year-old boy with clinical and histological features of Darier′s disease.

  2. The relationship between general osteoporosis of the organism and periodontal diseases.

    Science.gov (United States)

    Jagelaviciene, Egle; Kubilius, Ricardas

    2006-01-01

    Osteoporosis and periodontitis are very prevalent diseases and are most common in middle-aged and elderly women. These diseases are related as both damage bone tissue and share common risk factors. Discussions about the association between these two bone-damaging diseases began in 1960. A hypothesis was raised that systemic imbalance in bone resorption and deposition might manifest itself in the alveolar bone earlier than in other bones. When analyzing systemic and local changes in bone density, a number of issues were investigated and attempted to answer the question of whether dental osteopenia is a local manifestation of osteoporosis having similar etiology and risk factors, or it is an independent process depending primarily on factors that cause periodontal disease. Histomorphometric and microradiographic studies showed that increasing porosity of the cortical layer in mandible resulted in the decrease in bone mass. Bone strength is best expressed through bone mineral density, and it can be called a diagnostic criterion of osteoporosis. The examination of bone mineral density is called densitometry and may be performed using dual-energy x-ray absorptiometry. Orthopantomography is a method that is widely applied in odontological practice and is also informative in determining the bone density of the mandible. It can be applied when performing orthopantomographic and vertical linear measurements, as well as in determining indices in the studies of osteoporotic changes. Since many patients attend odontological clinics, nearly all of them undergo orthopantomography. This is a good possibility to investigate osteoporotic changes in the mandible, to select individuals for further studies, and to ensure clinical benefit and good treatment results.

  3. Sex differences in correlates of intermediate phenotypes and prevalent cardiovascular disease in the general population

    Directory of Open Access Journals (Sweden)

    Renate B. Schnabel

    2015-04-01

    Full Text Available Background-There are marked sex differences in cardiovascular disease [CVD] manifestation. It is largely unknown how the distribution of CVD risk factors or intermediate phenotypes explain sex-specific differences.Methods and Results-In 5000 individuals of the population-based Gutenberg Health Study, mean age 55±11 years, 51% males, we examined sex-specific associations of classical CVD risk factors with intima-media thickness, ankle-brachial index, flow-mediated dilation, peripheral arterial tonometry, echocardiographic and electrocardiographic variables. Intermediate cardiovascular phenotypes were related to prevalent CVD (coronary artery disease, heart failure, stroke, myocardial infarction, lower extremity artery disease [LEAD] N=561.We observed differential distributions of CVD risk factors with a higher risk factor burden in men. Manifest coronary artery disease, stroke, myocardial infarction and LEAD were more frequent in men; the proportion of heart failure was higher in women. Intermediate phenotypes showed clear sex differences with more beneficial values in women. Fairly linear changes towards less beneficial values with age were observed in both sexes. In multivariable-adjusted regression analyses age, systolic blood pressure and body mass index were consistently associated with intermediate phenotypes in both sexes with different ranking according to random forests, maximum model R² 0.43. Risk factor-adjusted associations with prevalent CVD showed some differences by sex. No interactions by menopausal status were observed. Conclusions-In a population-based cohort we observed sex differences in risk factors and a broad range of intermediate phenotypes of noninvasive cardiovascular structure and function. Their relation to prevalent CVD differed markedly. Our results indicate the need of future investigations to understand sex differences in CVD manifestation.

  4. 30 CFR 285.902 - What are the general requirements for decommissioning for facilities authorized under my SAP, COP...

    Science.gov (United States)

    2010-07-01

    ... decommissioning for facilities authorized under my SAP, COP, or GAP? 285.902 Section 285.902 Mineral Resources... SAP, COP, or GAP? (a) Except as otherwise authorized by MMS under § 285.909, within 2 years following... under your SAP, COP, or GAP, you must submit a decommissioning application and receive approval from the...

  5. Hydatid disease of the Central Nervous System: imaging characteristics and general features

    International Nuclear Information System (INIS)

    Abbassioun, K.; Amirjamshidi, A.; Sabouri Deylamie, M.

    2003-01-01

    Background: Hydatid disease primarily affects the liver and typically demonstrates characteristic imaging findings. Secondary involvement due to hematogenous dissemination may be seen in almost any locations, e.g., lung, kidney, spleen, bone and central nervous system. Objectives: To review the different aspects of hydatidosis of the central nervous system briefly and discuss the pathognomonic features and rare varieties of radiological findings useful in preoperative diagnosis of the disease in the human central nervous system. Materials and Methods: In a retrospective study, the records of almost 100 cases of central nervous system hydatidosis were analyzed . The available images were reviewed by independent observers, either a radiologist or a neurosurgeon, and reported separately. Results: In skull x-ray films, nonspecific changes denoted increased intracranial pressure, skull asymmetry and curvilinear calcification in rare instances. Computed tomography and magnetic resonance imaging demonstrated the round or oval, well-defined cystic mass with an attenuation or signal intensity similar to that of cerebrospinal fluid, with no associated perifocal edema, and no contrast enhancement as the pathognomonic findings of brain hydatidosis. Similar findings were detected in hydatid cysts involving the orbit, spinal column and spinal cord with some variations. Such findings as mild perifocal edema, non homogenous contrast enhancement, non-uniform shapes, calcification and multiplicity or septations have been the atypical radiological findings. Conclusion: In endemic areas, familiarity with typical and atypical radiological manifestations of hydatid disease of the central nervous system, will be helpful in making prompt and correct preoperative diagnosis leading to a better surgical outcome

  6. Preexisting Heart Disease Underlies Newly Diagnosed Atrial Fibrillation After Acute Ischemic Stroke.

    Science.gov (United States)

    Rizos, Timolaos; Horstmann, Solveig; Dittgen, Felix; Täger, Tobias; Jenetzky, Ekkehart; Heuschmann, Peter; Veltkamp, Roland

    2016-02-01

    Whether newly diagnosed atrial fibrillation (nAF) after stroke reflects underlying heart disease and represents an increased risk of cardioembolic stroke, or whether it is triggered by neurogenic mechanisms remains uncertain. We investigated, whether cardiovascular risk factors and echocardiographic parameters in patients with nAF are similar to patients with known AF (kAF) and differ from patients without AF. Consecutive acute ischemic stroke patients were enrolled into a prospective stroke database. All patients with echocardiography were included and univariable and multivariable testing was applied to compare clinical characteristics and echocardiographic findings among patients with nAF, kAF, and no AF. A total of 1397 patients were included (male, 62.3%; median age, 71 years). AF was present in 320 (22.9%) patients. Of those, nAF was present in 36.2% (116/320) and kAF in 63.8% (204/320). No clinical or echocardiographic factor was independently associated with detection of nAF compared with kAF but a trend toward larger left atrial diameters in patients with kAF was observed (P=0.070). In contrast, patients with nAF were more often female (Pstroke severity in patients with nAF and kAF was similar, patients without AF had less severe strokes. Stroke patients with nAF and with kAF share common cardiovascular risk factors, have similar echocardiographic findings and suffer equally severe strokes. We conclude that preexisting heart disease is the major cause of AF that is first diagnosed after stroke. © 2016 American Heart Association, Inc.

  7. Quantifying the importance of disease burden on perceived general health and depressive symptoms in patients within the Mayo Clinic Biobank.

    Science.gov (United States)

    Ryu, Euijung; Takahashi, Paul Y; Olson, Janet E; Hathcock, Matthew A; Novotny, Paul J; Pathak, Jyotishman; Bielinski, Suzette J; Cerhan, James R; Sloan, Jeff A

    2015-07-03

    Deficits in health-related quality of life (HRQOL) may be associated with worse patient experiences, outcomes and even survival. While there exists evidence to identify risk factors associated with deficits in HRQOL among patients with individual medical conditions such as cancer, it is less well established in more general populations without attention to specific illnesses. This study used patients with a wide range of medical conditions to identify contributors with the greatest influence on HRQOL deficits. Self-perceived general health and depressive symptoms were assessed using data from 21,736 Mayo Clinic Biobank (MCB) participants. Each domain was dichotomized into categories related to poor health: deficit (poor/fair for general health and ≥3 for PHQ-2 depressive symptoms) or non-deficit. Logistic regression models were used to test the association of commonly collected demographic characteristics and disease burden with each HRQOL domain, adjusting for age and gender. Gradient boosting machine (GBM) models were applied to quantify the relative influence of contributors on each HRQOL domain. The prevalence of participants with a deficit was 9.5 % for perception of general health and 4.6 % for depressive symptoms. For both groups, disease burden had the strongest influence for deficit in HRQOL (63 % for general health and 42 % for depressive symptoms). For depressive symptoms, age was equally influential. The prevalence of a deficit in general health increased slightly with age for males, but remained stable across age for females. Deficit in depressive symptoms was inversely associated with age. For both HRQOL domains, risk of a deficit was associated with higher disease burden, lower levels of education, no alcohol consumption, smoking, and obesity. Subjects with deficits were less likely to report that they were currently working for pay than those without a deficit; this association was stronger among males than females. Comorbid health burden has the

  8. Predictive Characteristics of Diabetes-Associated Autoantibodies Among Children With HLA-Conferred Disease Susceptibility in the General Population

    Science.gov (United States)

    Siljander, Heli T.A.; Simell, Satu; Hekkala, Anne; Lähde, Jyrki; Simell, Tuula; Vähäsalo, Paula; Veijola, Riitta; Ilonen, Jorma; Simell, Olli; Knip, Mikael

    2009-01-01

    OBJECTIVE As data on the predictive characteristics of diabetes-associated autoantibodies for type 1 diabetes in the general population are scarce, we assessed the predictive performance of islet cell autoantibodies (ICAs) in combination with autoantibodies against insulin (IAAs), autoantibodies against GAD, and/or islet antigen 2 for type 1 diabetes in children with HLA-defined disease predisposition recruited from the general population. RESEARCH DESIGN AND METHODS We observed 7,410 children from birth (median 9.2 years) for β-cell autoimmunity and diabetes. If a child developed ICA positivity or diabetes, the three other antibodies were measured in all samples available from that individual. Persistent autoantibody positivity was defined as continued positivity in at least two sequential samples including the last available sample. RESULTS Pre-diabetic ICA positivity was observed in 1,173 subjects (15.8%), 155 of whom developed type 1 diabetes. With ICA screening, 86% of 180 progressors (median age at diagnosis 5.0 years) were identified. Positivity for four antibodies was associated with the highest disease sensitivity (54.4%) and negative predictive values (98.3%) and the lowest negative likelihood ratio (0.5). The combination of persistent ICA and IAA positivity resulted in the highest positive predictive value (91.7%), positive likelihood ratio (441.8), cumulative disease risk (100%), and specificity (100%). Young age at seroconversion, high ICA level, multipositivity, and persistent positivity for IAA were significant risk markers for type 1 diabetes. CONCLUSIONS Within the general population, the combination of HLA and autoantibody screening resulted in disease risks that are likely to be as high as those reported among autoantibody-positive siblings of children with type 1 diabetes. PMID:19755526

  9. Safety and General Considerations for the Use of Antibodies in Infectious Diseases.

    Science.gov (United States)

    Hey, Adam Seidelin

    2017-01-01

    Monocolonal antibodies are valuable potential new tools for meeting unmet needs in treating infectious dieseases and to provide alternatives and supplements to antibiotics in these times of growing resistance. Especially when considering the ability to screen for antibodies reacting to very diverse target antigens and the ability to design and engineer them to work specifically to hit and overcome their strategies, like toxins and their hiding in specific cells to evade the immuneresponse and their special features enabling killing of the infectious agents and or the cells harbouring them. Antibodies are generally very safe and adverse effects of treatments with therapeutic antibodies are usually related to exaggeration of the intended pharmacology. In this chapter general safety considerations for the use of antibodies is reviewed and the general procedures for nonclinical testing to support their clinical development. Special considerations for anti-infective mAb treatments are provided including the special features that makes nonclinical safety programs for anti-infective mAbs much more simple and restricted. However at a cost since only limited information for clinical safety and modeling can be derived from such programs. Then strategies for optimally designing antibodies are discussed including the use of combination of antibodies. Finally ways to facilitate development of more than the currently only three approved mAb based treatments are discussed with a special focus on high costs and high price and how collaboration and new strategies for development in emerging markets can be a driver for this.

  10. Association between Manganese Superoxide Dismutase (MnSOD Val-9Ala) genotypes with the risk of generalized aggressive periodontitis disease.

    Science.gov (United States)

    Kazemi, E; Moradi, M-T; Yari, K; Mousavi, S A R; Kahrizi, D

    2015-12-19

    Generalized aggressive periodontitis (GAP) is a subtype of periodontal diseases that characterized by rapid destruction of periodontal supporting tissues. The MnSOD Val-9Ala mutation of manganese superoxide dismutase gene (MnSOD Val-9Ala) and its correlation with periodontal diseases has been studied in different populations. The purpose of this study was to investigate the possible association of MnSODVal-9Ala polymorphism with periodontitis disease in sample of GAP patients in Iran for the first time. Following a GAP examination, 50 GAP patients and 100 healthy individuals were recruited. Genomic DNA was extracted from peripheral blood leukocytes and the MnSODVal-9Ala polymorphismwas detected using PCR-RFLP method. The frequency of Ala/Ala, Ala/Val and Val/Val genotypes in healthy individuals were 25, 66 and 9%, respectively. In periodontitis patients, frequencies were as Ala/Ala (12%), Ala/Val (50%) and Val/Val (38%) genotypes. There was a significant positive association between distribution of MnSOD Val-9Ala genotypes and the risk of periodontitis disease (pperiodontitis disease.

  11. A pragmatic cluster randomized controlled trial of early intervention for chronic obstructive pulmonary disease by practice nurse-general practitioner teams: Study Protocol

    Directory of Open Access Journals (Sweden)

    Bunker Jeremy M

    2012-09-01

    Full Text Available Abstract Background Chronic Obstructive Pulmonary Disease (COPD is a leading cause of disability, hospitalization, and premature mortality. General practice is well placed to diagnose and manage COPD, but there is a significant gap between evidence and current practice, with a low level of awareness and implementation of clinical practice guidelines. Under-diagnosis of COPD is a world-wide problem, limiting the benefit that could potentially be achieved through early intervention strategies such as smoking cessation, dietary advice, and exercise. General practice is moving towards more structured chronic disease management, and the increasing involvement of practice nurses in delivering chronic care. Design A pragmatic cluster randomised trial will test the hypothesis that intervention by a practice nurse-general practitioner (GP team leads to improved health-related quality of life and greater adherence with clinical practice guidelines for patients with newly-diagnosed COPD, compared with usual care. Forty general practices in greater metropolitan Sydney Australia will be recruited to identify patients at risk of COPD and invite them to attend a case finding appointment. Practices will be randomised to deliver either practice nurse-GP partnership care, or usual care, to patients newly-diagnosed with COPD. The active intervention will involve the practice nurse and GP working in partnership with the patient in developing and implementing a care plan involving (as appropriate, smoking cessation, immunisation, pulmonary rehabilitation, medication review, assessment and correction of inhaler technique, nutritional advice, management of psycho-social issues, patient education, and management of co-morbidities. The primary outcome measure is health-related quality of life, assessed with the St George’s Respiratory Questionnaire 12 months after diagnosis. Secondary outcome measures include validated disease-specific and general health related

  12. A pragmatic cluster randomized controlled trial of early intervention for chronic obstructive pulmonary disease by practice nurse-general practitioner teams: Study Protocol.

    Science.gov (United States)

    Bunker, Jeremy M; Reddel, Helen K; Dennis, Sarah M; Middleton, Sandy; Van Schayck, Cp; Crockett, Alan J; Hasan, Iqbal; Hermiz, Oshana; Vagholkar, Sanjyot; Marks, Guy B; Zwar, Nicholas A

    2012-09-07

    Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of disability, hospitalization, and premature mortality. General practice is well placed to diagnose and manage COPD, but there is a significant gap between evidence and current practice, with a low level of awareness and implementation of clinical practice guidelines. Under-diagnosis of COPD is a world-wide problem, limiting the benefit that could potentially be achieved through early intervention strategies such as smoking cessation, dietary advice, and exercise. General practice is moving towards more structured chronic disease management, and the increasing involvement of practice nurses in delivering chronic care. A pragmatic cluster randomised trial will test the hypothesis that intervention by a practice nurse-general practitioner (GP) team leads to improved health-related quality of life and greater adherence with clinical practice guidelines for patients with newly-diagnosed COPD, compared with usual care. Forty general practices in greater metropolitan Sydney Australia will be recruited to identify patients at risk of COPD and invite them to attend a case finding appointment. Practices will be randomised to deliver either practice nurse-GP partnership care, or usual care, to patients newly-diagnosed with COPD.The active intervention will involve the practice nurse and GP working in partnership with the patient in developing and implementing a care plan involving (as appropriate), smoking cessation, immunisation, pulmonary rehabilitation, medication review, assessment and correction of inhaler technique, nutritional advice, management of psycho-social issues, patient education, and management of co-morbidities.The primary outcome measure is health-related quality of life, assessed with the St George's Respiratory Questionnaire 12 months after diagnosis. Secondary outcome measures include validated disease-specific and general health related quality of life measures, smoking and immunisation

  13. Abnormal activity of corneal cold thermoreceptors underlies the unpleasant sensations in dry eye disease.

    Science.gov (United States)

    Kovács, Illés; Luna, Carolina; Quirce, Susana; Mizerska, Kamila; Callejo, Gerard; Riestra, Ana; Fernández-Sánchez, Laura; Meseguer, Victor M; Cuenca, Nicolás; Merayo-Lloves, Jesús; Acosta, M Carmen; Gasull, Xavier; Belmonte, Carlos; Gallar, Juana

    2016-02-01

    Dry eye disease (DED) affects >10% of the population worldwide, and it provokes an unpleasant sensation of ocular dryness, whose underlying neural mechanisms remain unknown. Removal of the main lachrymal gland in guinea pigs caused long-term reduction of basal tearing accompanied by changes in the architecture and density of subbasal corneal nerves and epithelial terminals. After 4 weeks, ongoing impulse activity and responses to cooling of corneal cold thermoreceptor endings were enhanced. Menthol (200 μM) first excited and then inactivated this augmented spontaneous and cold-evoked activity. Comparatively, corneal polymodal nociceptors of tear-deficient eyes remained silent and exhibited only a mild sensitization to acidic stimulation, whereas mechanonociceptors were not affected. Dryness-induced changes in peripheral cold thermoreceptor responsiveness developed in parallel with a progressive excitability enhancement of corneal cold trigeminal ganglion neurons, primarily due to an increase of sodium currents and a decrease of potassium currents. In corneal polymodal nociceptor neurons, sodium currents were enhanced whereas potassium currents remain unaltered. In healthy humans, exposure of the eye surface to menthol vapors or to cold air currents evoked unpleasant sensations accompanied by increased blinking frequency that we attributed to cold thermoreceptor stimulation. Notably, stimulation with menthol reduced the ongoing background discomfort of patients with DED, conceivably due to use-dependent inactivation of cold thermoreceptors. Together, these data indicate that cold thermoreceptors contribute importantly to the detection and signaling of ocular surface wetness, and develop under chronic eye dryness conditions an injury-evoked neuropathic firing that seems to underlie the unpleasant sensations experienced by patients with DED.

  14. Downregulation of SIRT1 signaling underlies hepatic autophagy impairment in glycogen storage disease type Ia.

    Directory of Open Access Journals (Sweden)

    Jun-Ho Cho

    2017-05-01

    Full Text Available A deficiency in glucose-6-phosphatase-α (G6Pase-α in glycogen storage disease type Ia (GSD-Ia leads to impaired glucose homeostasis and metabolic manifestations including hepatomegaly caused by increased glycogen and neutral fat accumulation. A recent report showed that G6Pase-α deficiency causes impairment in autophagy, a recycling process important for cellular metabolism. However, the molecular mechanism underlying defective autophagy is unclear. Here we show that in mice, liver-specific knockout of G6Pase-α (L-G6pc-/- leads to downregulation of sirtuin 1 (SIRT1 signaling that activates autophagy via deacetylation of autophagy-related (ATG proteins and forkhead box O (FoxO family of transcriptional factors which transactivate autophagy genes. Consistently, defective autophagy in G6Pase-α-deficient liver is characterized by attenuated expressions of autophagy components, increased acetylation of ATG5 and ATG7, decreased conjugation of ATG5 and ATG12, and reduced autophagic flux. We further show that hepatic G6Pase-α deficiency results in activation of carbohydrate response element-binding protein, a lipogenic transcription factor, increased expression of peroxisome proliferator-activated receptor-γ (PPAR-γ, a lipid regulator, and suppressed expression of PPAR-α, a master regulator of fatty acid β-oxidation, all contributing to hepatic steatosis and downregulation of SIRT1 expression. An adenovirus vector-mediated increase in hepatic SIRT1 expression corrects autophagy defects but does not rectify metabolic abnormalities associated with G6Pase-α deficiency. Importantly, a recombinant adeno-associated virus (rAAV vector-mediated restoration of hepatic G6Pase-α expression corrects metabolic abnormalities, restores SIRT1-FoxO signaling, and normalizes defective autophagy. Taken together, these data show that hepatic G6Pase-α deficiency-mediated down-regulation of SIRT1 signaling underlies defective hepatic autophagy in GSD-Ia.

  15. Gastroesophageal Reflux Disease Symptoms and Dietary Behaviors are Significant Correlates of Short Sleep Duration in the General Population: The Nagahama Study

    Science.gov (United States)

    Murase, Kimihiko; Tabara, Yasuharu; Takahashi, Yoshimitsu; Muro, Shigeo; Yamada, Ryo; Setoh, Kazuya; Kawaguchi, Takahisa; Kadotani, Hiroshi; Kosugi, Shinji; Sekine, Akihiro; Nakayama, Takeo; Mishima, Michiaki; Chiba, Tsutomu; Chin, Kazuo; Matsuda, Fumihiko

    2014-01-01

    Study Objectives: To examine relationships among gastroesophageal reflux disease (GERD) symptoms, dietary behaviors, and sleep duration in the general population. Design: Cross-sectional. Setting: Community-based. Participants: There were 9,643 participants selected from the general population (54 ± 13 y). Interventions: None. Measurements and Results: Sleep duration, sleep habits, and unfavorable dietary behaviors of each participant were assessed with a structured questionnaire. Participants were categorized into five groups according to their sleep duration: less than 5 h, 5 to less than 6 h, 6 to less than 7 h, 7 to less than 8 h, and 8 or more h per day. GERD was evaluated using the Frequency Scale for the Symptoms of GERD (FSSG) and participants having an FSSG score of 8 or more or those under treatment of GERD were defined as having GERD. Trend analysis showed that both the FSSG score and the number of unfavorable dietary habits increased with decreasing sleep duration. Further, multiple logistic regression analysis showed that both the presence of GERD (odds ratio = 1.19, 95% confidence interval (CI) = 1.07–1.32) and the number of unfavorable dietary behaviors (odds ratio = 1.19, 95% CI = 1.13–1.26) were independent and potent factors to identify participants with short sleep duration even after controlling for other confounding factors. Conclusion: The current study showed that both GERD symptoms and unfavorable dietary behaviors were significant correlates of short sleep duration independently of each other in a large sample from the general population. Citation: Murase K, Tabara Y, Takahashi Y, Muro S, Yamada R, Setoh K, Kawaguchi T, Kadotani H, Kosugi S, Sekine A, Nakayama T, Mishima M, Chiba T, Chin K, Matsuda F. Gastroesophageal reflux disease symptoms and dietary behaviors are significant correlates of short sleep duration in the general population: the Nagahama Study. SLEEP 2014;37(11):1809-1815. PMID:25364076

  16. Non-Alcoholic Fatty Liver Disease (NAFLD): new challenge for general practitioners and important burden for health authorities?

    Science.gov (United States)

    Ahmed, Mohamed H; Abu, Emmanuel O; Byrne, Christopher D

    2010-10-01

    Non-alcoholic fatty liver disease (NAFLD) is the most common cause of hepatic dysfunction encountered in general practice. A large proportion of individuals with type 2 diabetes and the metabolic syndrome develop NAFLD. NAFLD is associated with severe insulin resistance and increased risk of cardiovascular disease and can progress to non-alcoholic steato-hepatitis, liver cirrhosis and cancer. Currently the only known effective treatments for NAFLD are lifestyle changes including stable weight loss and a diet low in calories. General practitioners will increasingly play a key role in dealing with this evolving but serious epidemic of NAFLD and associated metabolic complications. However, success will depend on the appropriate systems and mechanisms being in place in primary care and the proper motivation, support and education of the patient. This review provides the primary care physician with: (a) a step-by step guide of how to identify NAFLD, (b) information to exclude common other causes of liver fat accumulation and (c) additional insight into relationships between NAFLD and other conditions such as obesity, cardiovascular disease and type 2 diabetes. Copyright © 2010 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  17. Daytime use of general practice and use of the Out-of-Hours Primary Care Service for patients with chronic disease

    DEFF Research Database (Denmark)

    Flarup, Lone; Moth, Grete; Christensen, Morten Bondo

    2014-01-01

    BACKGROUND: The importance of proactive chronic care has become increasingly evident. Yet, it is unknown whether the use of general practice (GP) during daytime may affect the use of Out-of-Hours (OOH) Primary Care Service for people with chronic disease. We aimed to analyse the association between...... use of daytime general practice (GP) and use of OOH services for heart disease, lung disease, diabetes, psychiatric disease, or cancer. In particular, we intended to study the association between OOH contacts due to chronic disease exacerbation and recent use of daytime GP. METHODS: Data comprised...... a random sample of contacts to the OOH services ('LV-KOS2011'). Included patients were categorised into the following chronic diseases: heart disease, lung disease, diabetes, psychiatric disease, or cancer. Information on face-to-face contacts to daytime GP was obtained from the Danish National Health...

  18. Mitochondrial mislocalization underlies Abeta42-induced neuronal dysfunction in a Drosophila model of Alzheimer's disease.

    Directory of Open Access Journals (Sweden)

    Kanae Iijima-Ando

    2009-12-01

    Full Text Available The amyloid-beta 42 (Abeta42 is thought to play a central role in the pathogenesis of Alzheimer's disease (AD. However, the molecular mechanisms by which Abeta42 induces neuronal dysfunction and degeneration remain elusive. Mitochondrial dysfunctions are implicated in AD brains. Whether mitochondrial dysfunctions are merely a consequence of AD pathology, or are early seminal events in AD pathogenesis remains to be determined. Here, we show that Abeta42 induces mitochondrial mislocalization, which contributes to Abeta42-induced neuronal dysfunction in a transgenic Drosophila model. In the Abeta42 fly brain, mitochondria were reduced in axons and dendrites, and accumulated in the somata without severe mitochondrial damage or neurodegeneration. In contrast, organization of microtubule or global axonal transport was not significantly altered at this stage. Abeta42-induced behavioral defects were exacerbated by genetic reductions in mitochondrial transport, and were modulated by cAMP levels and PKA activity. Levels of putative PKA substrate phosphoproteins were reduced in the Abeta42 fly brains. Importantly, perturbations in mitochondrial transport in neurons were sufficient to disrupt PKA signaling and induce late-onset behavioral deficits, suggesting a mechanism whereby mitochondrial mislocalization contributes to Abeta42-induced neuronal dysfunction. These results demonstrate that mislocalization of mitochondria underlies the pathogenic effects of Abeta42 in vivo.

  19. iPSC-Based Models to Unravel Key Pathogenetic Processes Underlying Motor Neuron Disease Development

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    Irene Faravelli

    2014-10-01

    Full Text Available Motor neuron diseases (MNDs are neuromuscular disorders affecting rather exclusively upper motor neurons (UMNs and/or lower motor neurons (LMNs. The clinical phenotype is characterized by muscular weakness and atrophy leading to paralysis and almost invariably death due to respiratory failure. Adult MNDs include sporadic and familial amyotrophic lateral sclerosis (sALS-fALS, while the most common infantile MND is represented by spinal muscular atrophy (SMA. No effective treatment is ccurrently available for MNDs, as for the vast majority of neurodegenerative disorders, and cures are limited to supportive care and symptom relief. The lack of a deep understanding of MND pathogenesis accounts for the difficulties in finding a cure, together with the scarcity of reliable in vitro models. Recent progresses in stem cell field, in particular in the generation of induced Pluripotent Stem Cells (iPSCs has made possible for the first time obtaining substantial amounts of human cells to recapitulate in vitro some of the key pathogenetic processes underlying MNDs. In the present review, recently published studies involving the use of iPSCs to unravel aspects of ALS and SMA pathogenesis are discussed with an overview of their implications in the process of finding a cure for these still orphan disorders.

  20. Posterior Reversible Encephalopathy Syndrome in Two Omani Children with Underlying Renal Diseases

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    Mohamed A. El-Naggari

    2015-08-01

    Full Text Available Posterior reversible encephalopathy syndrome (PRES is a neurological condition with a combination of clinical and radiological features. Clinical symptoms include headaches, confusion, seizures, disturbed vision or an altered level of consciousness. Classic magnetic resonance imaging (MRI findings indicate subcortical and cortical oedema, affecting mainly the posterior cerebral region. We report two paediatric cases of PRES with underlying renal diseases presenting at the Sultan Qaboos University Hospital in Muscat, Oman, in April 2010 and August 2011. The first case was an 11-year-old girl diagnosed with systemic lupus erythematosus and the second was a six-and-a-half-year-old boy on peritoneal dialysis due to multi-drug-resistant nephrotic syndrome. Both patients were hypertensive and treated with blood pressure control medications. No residual neurological dysfunction was noted in the patients at a one-year follow-up and at discharge, respectively. The role of hypertension in paediatric PRES cases, among other important risk factors, is emphasised. Additionally, MRI is an important diagnostic and prognostic tool. Prompt diagnosis and aggressive management is fundamental to preventing permanent neurological damage.

  1. Resistance Potential of Bread Wheat Genotypes Against Yellow Rust Disease Under Egyptian Climate

    Directory of Open Access Journals (Sweden)

    Amer F. Mahmoud

    2015-12-01

    Full Text Available Yellow rust (stripe rust, caused by Puccinia striiformis f. sp. tritici, is one of the most destructive foliar diseases of wheat in Egypt and worldwide. In order to identify wheat genotypes resistant to yellow rust and develop molecular markers associated with the resistance, fifty F₈ recombinant inbred lines (RILs derived from a cross between resistant and susceptible bread wheat landraces were obtained. Artificial infection of Puccinia striiformis was performed under greenhouse conditions during two growing seasons and relative resistance index (RRI was calculated. Two Egyptian bread wheat cultivars i.e. Giza-168 (resistant and Sakha-69 (susceptible were also evaluated. RRI values of two-year trial showed that 10 RILs responded with RRI value >6 2 <6. However, only 7 RILs showed RRI value <2. Five RILs expressed hypersensitive type of resistance (R against the pathogen and showed the lowest Average Coefficient of Infection (ACI. Bulked segregant analysis (BSA with eight simple sequence repeat (SSR, eight sequence-related amplified polymorphism (SRAP and sixteen random amplified polymorphic DNA (RAPD markers revealed that three SSR, three SRAP and six RAPD markers were found to be associated with the resistance to yellow rust. However, further molecular analyses would be performed to confirm markers associated with the resistance and suitable for marker-assisted selection. Resistant RILs identified in the study could be efficiently used to improve the resistance to yellow rust in wheat.

  2. Clinicopathological correlates of Alzheimer's disease in a general autopsy series from Brazil

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    Lea Tenenholz Grinberg

    Full Text Available Abstract The current neuropathological staging models of Alzheimer's disease (AD have been developed within the last 20 years. Nevertheless, they were mostly tested on Caucasians of Northern European ancestry or on Asians. Objective: To verify which of the accepted neuropathologic criteria best discriminates AD from normal aging in a well characterized Brazilian clinicopathological series. Methods: A random sample consisting of 89 subjects belonging to the Brazilian Brain Bank of the Aging Brain Study were clinically and neuropathologically fully assessed using immunohistochemistry. Clinical and functional statuses were assessed by interviewing a reliable informant. The Clinical dementia rating scale (CDR was compared to Braak and Braak stage, the consortium to establish a registry for Alzheimer's disease (CERAD score and NIA-Reagan (National Institute of Aging - Reagan Institute score. Subjects with a neuropathologic diagnosis other then AD were excluded (n=27. Results: The CDR score distribution for the 62 selected subjects was as follows: CDR0=39, CDR0.5=9, CDR³1=14. There were no differences regarding age, gender and education among the groups. CDR score correlated best with the CERAD score (r=0.5303; p<0.001 . Braak and Braak stage was significantly higher in subjects with higher CDR. Correlation of the NIA-Reagan criteria was partially disrupted because a large proportion of subjects did not fit any of its categories. Conclusions: In this series, CERAD criteria better correlated with the CDR groups. Consistent with earlier studies, some cognitively normal subjects have AD neuropathological diagnosis.

  3. Adrenal crisis in treated Addison's disease: a predictable but under-managed event.

    Science.gov (United States)

    White, Katherine; Arlt, Wiebke

    2010-01-01

    Adrenal crisis is a life-threatening event that occurs regularly in Addison's patients receiving standard replacement therapy. Patient reports suggest that it is an underestimated and under-managed event. To assess the frequency of adrenal crisis in diagnosed patients and to understand the factors contributing to the risks of adrenal crisis. We conducted a postal survey of Addison's patients in four countries, UK (n=485), Canada (n=148), Australia (n=123) and New Zealand (n=85) in 2003, asking about patients' experiences of adrenal crisis and their demographic characteristics. In 2006, a shorter follow-up survey was conducted in the UK (n=261). The frequency and causes of adrenal crisis were compared across both surveys. Demographic data from the 2003 survey were analysed to establish the main variables associated with an elevated risk of crisis. Around 8% of diagnosed cases can be expected to need hospital treatment for adrenal crisis annually. Exposure to gastric infection is the single most important factor predicting the likelihood of adrenal crisis. Concomitant diabetes and/or asthma increase the frequency of adrenal crises reported by patients. The endocrinologist has a responsibility to ensure that Addison's patients have adequate access to life-saving emergency injection materials and repeated, practical training sessions in how to use them, while the general practitioner plays a vital role as in arranging prompt emergency admissions.

  4. Biomarkers in patients with Chronic Obstructive Pulmonary Disease in general practice

    DEFF Research Database (Denmark)

    Waldorff, Frans Boch; Halling, Anders; Ledderer, Loni Kraus

    treated in primary care and to determine the added value of selected biomarkers such as microfibrillar-associated protein 4 (MFAP4) and surfactant protein D (SP-D). Methods: Prospective cohort study comprising COPD patients. A total of 38 Danish practices were included in the study. Criteria for inclusion...... were a diagnosis of COPD (ICPC code R95-), age ≥ 40 years, Danish language speaking, no severe psychiatric or cognitive disease and ability to visit the GP surgery. Prevalent as well as incident patients diagnosed with COPD were eligible. Baseline data included a patient questionnaire and validated...... questionnaires regarding respiration, activity of daily living, depression and fatigue. Further, clinical indicators of the patient’s COPD status were obtained ad well as blood samples for biomarkers. End points will include rates of exacerbations, hospitalizations, deaths and decline in lung function. Results...

  5. Biomarkers in patients with Chronic Obstructive Pulmonary Disease in general practice: A prospective cohort study

    DEFF Research Database (Denmark)

    Waldorff, Frans Boch; Halling, Anders; Ledderer, Loni

    treated in primary care and to determine the added value of selected biomarkers such as microfibrillar-associated protein 4 (MFAP4) and surfactant protein D (SP-D). Methods: Prospective cohort study comprising COPD patients. A total of 38 Danish practices were included in the study. Criteria for inclusion...... were a diagnosis of COPD (ICPC code R95-), age ≥ 40 years, Danish language speaking, no severe psychiatric or cognitive disease and ability to visit the GP surgery. Prevalent as well as incident patients diagnosed with COPD were eligible. Baseline data included a patient questionnaire and validated...... questionnaires regarding respiration, activity of daily living, depression and fatigue. Further, clinical indicators of the patient’s COPD status were obtained ad well as blood samples for biomarkers. End points will include rates of exacerbations, hospitalizations, deaths and decline in lung function. Results...

  6. Mathematical Analysis of a General Two-Patch Model of Tuberculosis Disease with Lost Sight Individuals

    Directory of Open Access Journals (Sweden)

    Abdias Laohombé

    2014-01-01

    Full Text Available A two-patch model, SEi1,…,EinIiLi,  i=1,2, is used to analyze the spread of tuberculosis, with an arbitrary number n of latently infected compartments in each patch. A fraction of infectious individuals that begun their treatment will not return to the hospital for the examination of sputum. This fact usually occurs in sub-Saharan Africa, due to many reasons. The model incorporates migrations from one patch to another. The existence and uniqueness of the associated equilibria are discussed. A Lyapunov function is used to show that when the basic reproduction ratio is less than one, the disease-free equilibrium is globally and asymptotically stable. When it is greater than one, there exists at least one endemic equilibrium. The local stability of endemic equilibria can be illustrated using numerical simulations. Numerical simulation results are provided to illustrate the theoretical results and analyze the influence of lost sight individuals.

  7. Entropy maximization under the constraints on the generalized Gini index and its application in modeling income distributions

    Science.gov (United States)

    Khosravi Tanak, A.; Mohtashami Borzadaran, G. R.; Ahmadi, J.

    2015-11-01

    In economics and social sciences, the inequality measures such as Gini index, Pietra index etc., are commonly used to measure the statistical dispersion. There is a generalization of Gini index which includes it as special case. In this paper, we use principle of maximum entropy to approximate the model of income distribution with a given mean and generalized Gini index. Many distributions have been used as descriptive models for the distribution of income. The most widely known of these models are the generalized beta of second kind and its subclass distributions. The obtained maximum entropy distributions are fitted to the US family total money income in 2009, 2011 and 2013 and their relative performances with respect to generalized beta of second kind family are compared.

  8. 77 FR 7660 - Information Regarding General Licenses A and B Under the New Executive Order of February 5, 2012

    Science.gov (United States)

    2012-02-13

    ... authorized by specific licenses issued pursuant to 31 CFR chapter V. (e) Definitions. As used in this general... (``WMDPSR''), or the Global Terrorism Sanctions Regulations, 31 CFR part 594 (``GTSR''); or (2) A person...

  9. 26 CFR 1.415(a)-1 - General rules with respect to limitations on benefits and contributions under qualified plans.

    Science.gov (United States)

    2010-04-01

    ... and disability benefits); (vii) Section 1.415(b)-1(g)(3) (regarding adjustments to applicable... survivor and disability benefits under governmental plans); (viii) Section 1.415(c)-1(b)(2)(ii) and (3)(iii... under section 414(c) (except for purposes of determining whether two or more organizations are a brother...

  10. Heterogeneity-mediated cellular adaptation and its trade-off: searching for the general principles of diseases.

    Science.gov (United States)

    Heng, Henry H

    2017-02-01

    Big-data-omics have promised the success of precision medicine. However, most common diseases belong to adaptive systems where the precision is all but difficult to achieve. In this commentary, I propose a heterogeneity-mediated cellular adaptive model to search for the general model of diseases, which also illustrates why in most non-infectious non-Mendelian diseases the involvement of cellular evolution is less predictable when gene profiles are used. This synthesis is based on the following new observations/concepts: 1) the gene only codes "parts inheritance" while the genome codes "system inheritance" or the entire blueprint; 2) the nature of somatic genetic coding is fuzzy rather than precise, and genetic alterations are not just the results of genetic error but are in fact generated from internal adaptive mechanisms in response to environmental dynamics; 3) stress-response is less specific within cellular evolutionary context when compared to known biochemical specificities; and 4) most medical interventions have their unavoidable uncertainties and often can function as negative harmful stresses as trade-offs. The acknowledgment of diseases as adaptive systems calls for the action to integrate genome- (not simply individual gene-) mediated cellular evolution into molecular medicine. © 2016 John Wiley & Sons, Ltd.

  11. Underlying diseases in dogs referred to a veterinary teaching hospital because of dyspnea: 229 cases (2003-2007).

    Science.gov (United States)

    Fonfara, Sonja; de la Heras Alegret, Lourdes; German, Alexander J; Blackwood, Laura; Dukes-McEwan, Joanna; M Noble, P-J; Burrow, Rachel D

    2011-11-01

    To identify the most frequent underlying diseases in dogs examined because of dyspnea and determine whether signalment, clinical signs, and duration of clinical signs might help guide assessment of the underlying condition and prognosis. Retrospective case series. 229 dogs with dyspnea. Case records of dogs referred for dyspnea were reviewed and grouped according to location or etiology (upper airway, lower respiratory tract, pleural space, cardiac diseases, or obesity and stress). Signalment, clinical signs at initial examination, treatment, and survival time were analyzed. Upper airway (n = 74 [32%]) and lower respiratory tract (76 [33%]) disease were the most common diagnoses, followed by pleural space (44 [19%]) and cardiac (27 [12%]) diseases. Dogs with upper airway and pleural space disease were significantly younger than dogs with lower respiratory tract and cardiac diseases. Dogs with lower respiratory tract and associated systemic diseases were significantly less likely to be discharged from the hospital. Dogs with diseases that were treated surgically had a significantly better outcome than did medically treated patients, which were significantly more likely to be examined on an emergency basis with short duration of clinical signs. In dogs examined because of dyspnea, young dogs may be examined more frequently with breed-associated upper respiratory tract obstruction or pleural space disease after trauma, whereas older dogs may be seen more commonly with progressive lower respiratory tract or acquired cardiac diseases. Nontraumatic acute onset dyspnea is often associated with a poor prognosis, but stabilization, especially in patients with cardiac disease, is possible. Obesity can be an important contributing or exacerbating factor in dyspneic dogs.

  12. Acquired cystic kidney disease: an under-recognized condition in children with end-stage renal disease.

    Science.gov (United States)

    Chan, Eugene Y H; Warady, Bradley A

    2018-01-01

    Acquired cystic kidney disease (ACKD) is a condition that occurs predominantly in patients with end-stage renal disease (ESRD). In contrast to hereditary cystic kidney disease, ACKD is characterized by the presence of multiple small cysts in bilaterally small kidneys. Limited pediatric data suggest a high incidence (21.6-45.8%) of ACKD in children on dialysis, comparable to that in adults, with an increased frequency associated with a longer duration of dialysis. Recent research has shed light on the pathogenesis of ACKD, such as activation of proto-oncogenes. Although most patients with ACKD are asymptomatic, the condition can be complicated by renal cell carcinoma. Routine surveillance should therefore be considered in at-risk populations.

  13. Evaluation of a potential parathyroid dysfunction under treatment with radioactive iodine of benign thyroid diseases

    International Nuclear Information System (INIS)

    Schumacher, Serena Christine

    2011-01-01

    The intention of the present thesis was the evaluation of a potential parathyroid dysfunction under treatment with radioactive iodine of benign thyroid diseases. It was to be examined whether a change in the parathyroid function would arise within the first week on treatment. So far there are some minor studies existing describing significant changes in the parathyroid hormone serum level within the first months after radioactive iodine therapy of benign and malignant thyroid diseases. Moreover, it is a fact that external beam-radiotherapy can induce neoplasia and that the risk for the subsequent development of primary hyperparathyroidism doubles or triples after external beam-radiotherapy of the head and neck. Up to now, however, an increased incidence for primary hyperparathyroidism following treatment with radioactive iodine ( 131 I) could not be proved. At the department of nuclear medicine of the university hospital Giessen-Marburg GmbH, location Marburg, a prospective cohort study was executed on radioactive iodine therapy of benign thyroid diseases with 105 probands (75 women / 30 men, mean age 60.62 ± 14.3 years). According to their thyroid diseases these 105 probands were classified into following subgroups: thyroid adenoma with 23 patients, multifocal thyroid autonomy with 8 patients, disseminated thyroid autonomy with 37 patients as well as the subgroup Graves' hyperthyroidism (without Graves' ophtalmopathy) and accordingly Graves' disease (with Graves' ophtalmopathy) with 37 patients. The serum level of the intact parathyroid hormone was determined directly before starting the radioactive iodine therapy on the admission day and on day 1, 3 and 5 of the radioactive iodine therapy as well as at the ambulant follow-up examination one month after the start of the therapy. In case of 99 of 105 probands the serum level of parathyroid hormone declined on treatment with 131 I with its nadir on day 3 of therapy (decline by 15.71 ng/l or 27

  14. A Bayesian Framework for Generalized Linear Mixed Modeling Identifies New Candidate Loci for Late-Onset Alzheimer's Disease.

    Science.gov (United States)

    Wang, Xulong; Philip, Vivek M; Ananda, Guruprasad; White, Charles C; Malhotra, Ankit; Michalski, Paul J; Karuturi, Krishna R Murthy; Chintalapudi, Sumana R; Acklin, Casey; Sasner, Michael; Bennett, David A; De Jager, Philip L; Howell, Gareth R; Carter, Gregory W

    2018-03-05

    Recent technical and methodological advances have greatly enhanced genome-wide association studies (GWAS). The advent of low-cost whole-genome sequencing facilitates high-resolution variant identification, and the development of linear mixed models (LMM) allows improved identification of putatively causal variants. While essential for correcting false positive associations due to sample relatedness and population stratification, LMMs have commonly been restricted to quantitative variables. However, phenotypic traits in association studies are often categorical, coded as binary case-control or ordered variables describing disease stages. To address these issues, we have devised a method for genomic association studies that implements a generalized linear mixed model (GLMM) in a Bayesian framework, called Bayes-GLMM Bayes-GLMM has four major features: (1) support of categorical, binary and quantitative variables; (2) cohesive integration of previous GWAS results for related traits; (3) correction for sample relatedness by mixed modeling; and (4) model estimation by both Markov chain Monte Carlo (MCMC) sampling and maximal likelihood estimation. We applied Bayes-GLMM to the whole-genome sequencing cohort of the Alzheimer's Disease Sequencing Project (ADSP). This study contains 570 individuals from 111 families, each with Alzheimer's disease diagnosed at one of four confidence levels. With Bayes-GLMM we identified four variants in three loci significantly associated with Alzheimer's disease. Two variants, rs140233081 and rs149372995 lie between PRKAR1B and PDGFA The coded proteins are localized to the glial-vascular unit, and PDGFA transcript levels are associated with AD-related neuropathology. In summary, this work provides implementation of a flexible, generalized mixed model approach in a Bayesian framework for association studies. Copyright © 2018, Genetics.

  15. Health improvement and prevention study (HIPS - evaluation of an intervention to prevent vascular disease in general practice

    Directory of Open Access Journals (Sweden)

    Davies Gawaine

    2010-08-01

    Full Text Available Abstract Background The Health Improvement and Prevention Study (HIPS study aims to evaluate the capacity of general practice to identify patients at high risk for developing vascular disease and to reduce their risk of vascular disease and diabetes through behavioural interventions delivered in general practice and by the local primary care organization. Methods/Design HIPS is a stratified randomized controlled trial involving 30 general practices in NSW, Australia. Practices are randomly allocated to an 'intervention' or 'control' group. General practitioners (GPs and practice nurses (PNs are offered training in lifestyle counselling and motivational interviewing as well as practice visits and patient educational resources. Patients enrolled in the trial present for a health check in which the GP and PN provide brief lifestyle counselling based on the 5As model (ask, assess, advise, assist, and arrange and refer high risk patients to a diet education and physical activity program. The program consists of two individual visits with a dietician or exercise physiologist and four group sessions, after which patients are followed up by the GP or PN. In each practice 160 eligible patients aged between 40 and 64 years are invited to participate in the study, with the expectation that 40 will be eligible and willing to participate. Evaluation data collection consists of (1 a practice questionnaire, (2 GP and PN questionnaires to assess preventive care attitudes and practices, (3 patient questionnaire to assess self-reported lifestyle behaviours and readiness to change, (4 physical assessment including weight, height, body mass index (BMI, waist circumference and blood pressure, (5 a fasting blood test for glucose and lipids, (6 a clinical record audit, and (7 qualitative data collection. All measures are collected at baseline and 12 months except the patient questionnaire which is also collected at 6 months. Study outcomes before and after the

  16. Gastroesophageal reflux disease symptoms and dietary behaviors are significant correlates of short sleep duration in the general population: the Nagahama Study.

    Science.gov (United States)

    Murase, Kimihiko; Tabara, Yasuharu; Takahashi, Yoshimitsu; Muro, Shigeo; Yamada, Ryo; Setoh, Kazuya; Kawaguchi, Takahisa; Kadotani, Hiroshi; Kosugi, Shinji; Sekine, Akihiro; Nakayama, Takeo; Mishima, Michiaki; Chiba, Tsutomu; Chin, Kazuo; Matsuda, Fumihiko

    2014-11-01

    To examine relationships among gastroesophageal reflux disease (GERD) symptoms, dietary behaviors, and sleep duration in the general population. Cross-sectional. Community-based. There were 9,643 participants selected from the general population (54 ± 13 y). None. Sleep duration, sleep habits, and unfavorable dietary behaviors of each participant were assessed with a structured questionnaire. Participants were categorized into five groups according to their sleep duration: less than 5 h, 5 to less than 6 h, 6 to less than 7 h, 7 to less than 8 h, and 8 or more h per day. GERD was evaluated using the Frequency Scale for the Symptoms of GERD (FSSG) and participants having an FSSG score of 8 or more or those under treatment of GERD were defined as having GERD. Trend analysis showed that both the FSSG score and the number of unfavorable dietary habits increased with decreasing sleep duration. Further, multiple logistic regression analysis showed that both the presence of GERD (odds ratio = 1.19, 95% confidence interval (CI) = 1.07-1.32) and the number of unfavorable dietary behaviors (odds ratio = 1.19, 95% CI = 1.13-1.26) were independent and potent factors to identify participants with short sleep duration even after controlling for other confounding factors. The current study showed that both GERD symptoms and unfavorable dietary behaviors were significant correlates of short sleep duration independently of each other in a large sample from the general population.

  17. Indirect Genetic Effects and the Spread of Infectious Disease: Are We Capturing the Full Heritable Variation Underlying Disease Prevalence?

    NARCIS (Netherlands)

    Lipschutz-Powell, D.; Woolliams, J.A.; Bijma, P.; Doeschl-Wilson, A.B.

    2012-01-01

    Reducing disease prevalence through selection for host resistance offers a desirable alternative to chemical treatment. Selection for host resistance has proven difficult, however, due to low heritability estimates. These low estimates may be caused by a failure to capture all the relevant genetic

  18. General procedures in diagnosis of malignant diseases in dogs and cats

    Directory of Open Access Journals (Sweden)

    Jovanović Milan

    2012-01-01

    Full Text Available Tumors occur in all domestic and wild animals. They are most often diagnosed in dogs and cats, and their numbers increase from year to year. In the recent years, cancer is believed to be the most frequent cause of pet deaths. A speedy and reliable diagnosis is of paramount importance because it enables the veterinarian to begin therapy and make a prognosis. The objective of an early diagnosis is to enable the detection of neoplastic diseases before the tumor spreads throughout the organism, consequently enabling the timely administration of therapy and providing greater chances for curing the animal. A tumor is diagnosed on the grounds of the anamnesis, clinical picture, and special diagnostic procedures. The most frequently applied diagnostic procedures are laboratory diagnostics, cytology, biopsy and pathohistology, imaging diagnostics (roentgenography and roentgenoscopy, ultrasound diagnostics, endoscopy, computer tomography, magnetic resonance, and scintigraphy and molecular diagnostics. Each of these methods has its advantages and faults in connection with costs, availability, sensitivity, specificity and quality of anatomic vs functional pictures. Every one of these techniques has its own field of implementation and each one provides different and additional information in connection with the nature and position of the primary lesion and the presence of metastases.

  19. Recurrent invasive pneumococcal disease in children: underlying clinical conditions, and immunological and microbiological characteristics.

    Directory of Open Access Journals (Sweden)

    Laia Alsina

    Full Text Available Clinical, immunological and microbiological characteristics of recurrent invasive pneumococcal disease (IPD in children were evaluated, differentiating relapse from reinfection, in order to identify specific risk factors for both conditions.All patients <18 years-old with recurrent IPD admitted to a tertiary-care pediatric center from January 2004 to December 2011 were evaluated. An episode of IPD was defined as the presence of clinical findings of infection together with isolation and/or pneumococcal DNA detection by Real-Time PCR in any sterile body fluid. Recurrent IPD was defined as 2 or more episodes in the same individual at least 1 month apart. Among recurrent IPD, we differentiated relapse (same pneumococcal isolate from reinfection.593 patients were diagnosed with IPD and 10 patients died. Among survivors, 23 episodes of recurrent IPD were identified in 10 patients (1.7%. Meningitis was the most frequent form of recurrent IPD (10 episodes/4 children followed by recurrent empyema (8 episodes/4 children. Three patients with recurrent empyema caused by the same pneumococcal clone ST306 were considered relapses and showed high bacterial load in their first episode. In contrast, all other episodes of recurrent IPD were considered reinfections. Overall, the rate of relapse of IPD was 0.5% and the rate of reinfection 1.2%. Five out of 7 patients with reinfection had an underlying risk factor: cerebrospinal fluid leak (n = 3, chemotherapy treatment (n = 1 and a homozygous mutation in MyD88 gene (n = 1. No predisposing risk factors were found in the remainder.recurrent IPD in children is a rare condition associated with an identifiable risk factor in case of reinfection in almost 80% of cases. In contrast, recurrent IPD with pleuropneumonia is usually a relapse of infection.

  20. Mechanisms underlying the production of false memories for famous people's names in aging and Alzheimer's disease.

    Science.gov (United States)

    Plancher, Gaën; Guyard, Anne; Nicolas, Serge; Piolino, Pascale

    2009-10-01

    It is well known that the occurrence of false memories increases with aging, but the results remain inconsistent concerning Alzheimer's disease (AD). Moreover, the mechanisms underlying the production of false memories are still unclear. Using an experimental episodic memory test with material based on the names of famous people in a procedure derived from the DRM paradigm [Roediger, H. L., III, & McDermott, K. B. (1995). Creating false memories: Remembering words not presented in lists. Journal of Experimental Psychology: Learning, Memory & Cognition, 21, 803-814], we examined correct and false recall and recognition in 30 young adults, 40 healthy older adults, and 30 patients with AD. Moreover, we evaluated the relationships between false memory performance, correct episodic memory performance, and a set of neuropsychological assessments evaluating the semantic memory and executive functions. The results clearly indicated that correct recall and recognition performance decreased with the subjects' age, but it decreased even more with AD. In addition, semantically related false recalls and false recognitions increased with age but not with dementia. On the contrary, non-semantically related false recalls and false recognitions increased with AD. Finally, the regression analyses showed that executive functions mediated related false memories and episodic memory mediated related and unrelated false memories in aging. Moreover, executive functions predicted related and unrelated false memories in AD, and episodic and semantic memory predicted semantically related and unrelated false memories in AD. In conclusion, the results obtained are consistent with the current constructive models of memory suggesting that false memory creation depends on different cognitive functions and, consequently, that the impairments of these functions influence the production of false memories.