Acute intermittent porphyria presenting as progressive muscular ...

African Journals Online (AJOL)

Acute intermittent porphyria, the most common porphyria affecting the nervous system, typically presents with neurovisceral crises followed by a motor neuropathy. We describe a 23-year-old black South African man presenting with a progressive stuttering, lower motor neuron syndrome developing over months. He had not ...

Acute intermittent porphyria in Argentina: an update.

Science.gov (United States)

Cerbino, Gabriela Nora; Gerez, Esther Noemí; Varela, Laura Sabina; Melito, Viviana Alicia; Parera, Victoria Estela; Batlle, Alcira; Rossetti, María Victoria

2015-01-01

Porphyrias are a group of metabolic diseases that arise from deficiencies in the heme biosynthetic pathway. A partial deficiency in hydroxymethylbilane synthase (HMBS) produces a hepatic disorder named Acute Intermittent Porphyria (AIP); the acute porphyria is more frequent in Argentina. In this paper we review the results obtained for 101 Argentinean AIP families and 6 AIP families from foreign neighbour countries studied at molecular level at Centro de Investigaciones sobre Porfirinas y Porfirias (CIPYP). Thirty-five different mutations were found, of which 14 were described for the first time in our population. The most prevalent type of mutations was the missense mutations (43%) followed by splice defects (26%) and small deletions (20%). An odd case of a double heterozygous presentation of AIP in a foreign family from Paraguay is discussed. Moreover, it can be noted that 38 new families were found carrying the most frequent mutation in Argentina (p.G111R), increasing to 55.66% the prevalence of this genetic change in our population and adding further support to our previous hypothesis of a founder effect for this mutation in Argentina. Identification of patients with an overt AIP is important because treatment depends on an accurate diagnosis, but more critical is the identification of asymptomatic relatives to avoid acute attacks which may progress to death.

American Porphyria Foundation

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... Nicole Castelano Gregary Edwards Megan Parrish ~ How the dog I didn't want became the dog I'd always dreamed of Darnisha Davenport Liz ... or through the site for commercial or public purposes. The American Porphyria Foundation (APF) Tax Forms 990 ...

Porphyria Treatment Options

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... Nicole Castelano Gregary Edwards Megan Parrish ~ How the dog I didn't want became the dog I'd always dreamed of Darnisha Davenport Liz ... or through the site for commercial or public purposes. The American Porphyria Foundation (APF) Tax Forms 990 ...

Anesthetic implication of tricuspid valve replacement in a patient with acute intermittent porphyria

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Kianoush Saberi

2016-01-01

Full Text Available Facing a patient with acute intermittent porphyria (AIP, there is narrow safety margin which circumscribe all the therapeutic actions including choice of drugs. This would become even more complicated when it comes to a stressful and drug-dependent process like a cardiopulmonary bypass. According to author′s researches, no specific AIP case of tricuspid valve (TV replacement is reported recently. Furthermore, fast-track anesthesia was safely used in this 37-year-old male known the case of AIP, who was a candidate for TV replacement and removing the port catheter. The patient was extubated subsequently, only 3 h after entering the Intensive Care Unit.

Acute Intermittent Porphyria (AIP)

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... the Healthcare Professionals area of our site. PBS Documentary AIP Diagnosis Stories **Diagnostic Testing for the Acute ... be administered only by physicians experienced in the management of porphyrias in a hospital setting. Panhematin is ...

Congenital Erythropoietic Porphyria (CEP)

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... subsequent pregnancies in CEP families. Standard Therapies Treatment Avoidance of sunlight is essential to prevent the skin ... or public purposes. The American Porphyria Foundation (APF) Tax Forms 990 are readily available to the public. ...

Genetics Home Reference: porphyria

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... A characteristic of X-linked inheritance is that fathers cannot pass X-linked traits to their sons. ... PubMed Badminton MN, Elder GH. Molecular mechanisms of dominant expression in porphyria. J Inherit Metab Dis. 2005; ...

Acute Porphyria Presenting as Epilepsia Partialis Continua

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Thi Phuoc Yen Tran

2013-06-01

Full Text Available Purpose: The porphyrias are a defect in the biosynthesis of heme which can be associated with different neurological symptoms during acute attacks such as peripheral neuropathy, mental disturbance and seizures. So far, there have only been a few case reports of status epilepticus, none of which were of epilepsia partialis continua (EPC. We present here two cases of hereditary coproporphyria (HCP manifesting EPC as part of the clinical presentation. Method: The patients' medical charts, EEG and imaging studies were carefully reviewed. Results: Case 1 is a 49-year-old male who first presented a tonic-clonic seizure. Case 2 is a 30-year-old male who came to the emergency room for a convulsive status epilepticus. Both evolved to EPC over the next days. EPC persisted despite several antiepileptic drug trials. Diagnosis of HCP was confirmed by a high level of urine, fecal and serum porphyrins in both cases and by genetic testing in one. Over the last 3 years, the first patient has continued to present non-disabling EPC and has had four tonic-clonic seizures associated with alcohol consumption. The second patient died from brain edema one month and half after admission. Conclusion: Acute porphyrias should be included in the differential diagnosis of new onset status epilepticus, including EPC. Their recognition is important as it modifies significantly patient management, since many anticonvulsants are porphyrogenic.

European specialist porphyria laboratories: diagnostic strategies, analytical quality, clinical interpretation, and reporting as assessed by an external quality assurance program.

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Aarsand, Aasne K; Villanger, Jørild H; Støle, Egil; Deybach, Jean-Charles; Marsden, Joanne; To-Figueras, Jordi; Badminton, Mike; Elder, George H; Sandberg, Sverre

2011-11-01

The porphyrias are a group of rare metabolic disorders whose diagnosis depends on identification of specific patterns of porphyrin precursor and porphyrin accumulation in urine, blood, and feces. Diagnostic tests for porphyria are performed by specialized laboratories in many countries. Data regarding the analytical and diagnostic performance of these laboratories are scarce. We distributed 5 sets of multispecimen samples from different porphyria patients accompanied by clinical case histories to 18-21 European specialist porphyria laboratories/centers as part of a European Porphyria Network organized external analytical and postanalytical quality assessment (EQA) program. The laboratories stated which analyses they would normally have performed given the case histories and reported results of all porphyria-related analyses available, interpretative comments, and diagnoses. Reported diagnostic strategies initially showed considerable diversity, but the number of laboratories applying adequate diagnostic strategies increased during the study period. We found an average interlaboratory CV of 50% (range 12%-152%) for analytes in absolute concentrations. Result normalization by forming ratios to the upper reference limits did not reduce this variation. Sixty-five percent of reported results were within biological variation-based analytical quality specifications. Clinical interpretation of the obtained analytical results was accurate, and most laboratories established the correct diagnosis in all distributions. Based on a case-based EQA scheme, variations were apparent in analytical and diagnostic performance between European specialist porphyria laboratories. Our findings reinforce the use of EQA schemes as an essential tool to assess both analytical and diagnostic processes and thereby to improve patient care in rare diseases.

Primary hemochromatosis presented by porphyria cutanea tarda: a case report.

NARCIS (Netherlands)

Bovenschen, H.J.; Vissers, W.H.P.M.

2009-01-01

We present a 27-year-old female Caucasian patient, who initially presented with extensive fragility and blistering of mainly the dorsal side of both hands. Histology and urine porphyrin analysis confirmed the diagnosis of porphyria cutanea tarda. Internal screening for underlying disease revealed

Weight Loss & Acute Porphyria

Science.gov (United States)

... Nicole Castelano Gregary Edwards Megan Parrish ~ How the dog I didn't want became the dog I'd always dreamed of Darnisha Davenport Liz ... or through the site for commercial or public purposes. The American Porphyria Foundation (APF) Tax Forms 990 ...

Investigations on gamma ray induced chlorophyll variegated mutants

International Nuclear Information System (INIS)

Datta, S.K.; Dwivedi, A.K.; Banerji, B.K.

1995-01-01

Considering economic importance of chlorophyll variegation in floriculture trade an attempt was made for cytological, anatomical and biochemical analysis of four Bougainvillea and Lantana depressa chlorophyll variegated mutants for better and clear understanding of origin of chlorophyll variegation. No cytological evidence could be detected for their origin. Anatomical and biochemical examinations revealed that chlorophyll variegation in these mutants were due to changes in biosynthesis pathways and time of chlorophyll synthesis in palisade and spongy mesophyll cells. (author). 7 refs., 3 figs., 3 tabs

Markers for vulnerability in acute porphyria. A hypothesis paper.

Science.gov (United States)

Thunell, S; Andersson, C; Carlmark, B; Floderus, Y; Grönqvist, S O; Harper, P; Henrichson, A; Lindh, U

1995-04-01

Previously symptomatic and permanently asymptomatic carriers of a gene mutation for acute intermittent porphyria as well as matched controls were screened with regard to a series of variables of possible relevance to the development of porphyric symptoms. The basis for the study was a concept of acute porphyria as a condition of a permanent system overload of oxidative stress, with long term effects on hepatic and renal tissue, and with instances of periodic overload of free radicals giving rise to acute neurologic involvement. Leukocyte concentrations of manganese, calcium, iron and zinc, as well as erythrocyte calcium differed between the groups, acute intermittent porphyria gene carriers, irrespective of previous porphyric illness, showing significantly higher levels than the controls. Manganese was found to be the most discriminative component of all the 78 variables investigated, accounting for about 98 per cent of the variance between the groups. An increment, by a factor of four, in cellular manganese is suggestive of an increase, in acute intermittent porphyria, of a manganese associated enzyme, e.g. glutamine synthetase, pyruvate carboxylase or mitochondrial superoxide dismutase. The best fit into the model considered is provided by a theory focused on superoxide dismutase, induced in response to superoxide anion radical produced from aminolaevulinic acid. In porphyria gene carriers seemingly resistant to porphyric manifestations, an increase in potentially prooxidant cellular iron is matched by a proportional increment in manganese, i.e. presumably by a corresponding mitochondrial superoxide dismutase induction. This mechanism is not operative in porphyric individuals prone to development of neuropsychiatric symptoms. In acute intermittent porphyria with a history of porphyric illness there is a positive correlation between erythrocyte manganese and serum folate and a negative correlation between leukocyte ferrochelatase activity and serum cobalamin

Urinary metabolic profiling of asymptomatic acute intermittent porphyria using a rule-mining-based algorithm.

Science.gov (United States)

Luck, Margaux; Schmitt, Caroline; Talbi, Neila; Gouya, Laurent; Caradeuc, Cédric; Puy, Hervé; Bertho, Gildas; Pallet, Nicolas

2018-01-01

Metabolomic profiling combines Nuclear Magnetic Resonance spectroscopy with supervised statistical analysis that might allow to better understanding the mechanisms of a disease. In this study, the urinary metabolic profiling of individuals with porphyrias was performed to predict different types of disease, and to propose new pathophysiological hypotheses. Urine 1 H-NMR spectra of 73 patients with asymptomatic acute intermittent porphyria (aAIP) and familial or sporadic porphyria cutanea tarda (f/sPCT) were compared using a supervised rule-mining algorithm. NMR spectrum buckets bins, corresponding to rules, were extracted and a logistic regression was trained. Our rule-mining algorithm generated results were consistent with those obtained using partial least square discriminant analysis (PLS-DA) and the predictive performance of the model was significant. Buckets that were identified by the algorithm corresponded to metabolites involved in glycolysis and energy-conversion pathways, notably acetate, citrate, and pyruvate, which were found in higher concentrations in the urines of aAIP compared with PCT patients. Metabolic profiling did not discriminate sPCT from fPCT patients. These results suggest that metabolic reprogramming occurs in aAIP individuals, even in the absence of overt symptoms, and supports the relationship that occur between heme synthesis and mitochondrial energetic metabolism.

Porphyria Cutanea Tarda in a Patient with End-Stage Renal Disease: A Case of Successful Treatment with Deferoxamine and Ferric Carboxymaltose

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Natacha Rodrigues

2017-01-01

Full Text Available Porphyria cutanea tarda (PCT is a rare disease, with a strong association with hepatitis C virus. PCT is particularly problematic in end-stage renal disease patients as they have no renal excretion of porphyrins and these are poorly dialyzed. Also, conventional treatment of PCT is compromised in these patients as hydroxychloroquine is contraindicated, phlebotomies with the stipulated frequency are poorly tolerated in already anaemia-prone patients, and iron-chelating agents are less efficient in removing iron and contribute to worsening anaemia. The authors report a patient on haemodialysis, with hepatitis C infection, that is diagnosed with PCT. Despite the good clinical results with deferoxamine, she became dependent on blood transfusions because of her ferropenic state. Every time oxide iron was started, the patient developed clinical features of the disease, resolving after the suspension of the drug. A decision was made to start the patient on ferric carboxymaltose, which was well tolerated without disease symptoms and need of further blood transfusions. This case suggests that deferoxamine is efficient in treatment of porphyria cutanea tarda. Also, ferric carboxymaltose may be a valuable option for refractory anaemia in patients with this disease and end-stage renal disease, as it seems to provide iron without clinical relapse of the disease.

Preclinical Development of a Subcutaneous ALAS1 RNAi Therapeutic for Treatment of Hepatic Porphyrias Using Circulating RNA Quantification

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Amy Chan

2015-01-01

Full Text Available The acute hepatic porphyrias are caused by inherited enzymatic deficiencies in the heme biosynthesis pathway. Induction of the first enzyme 5-aminolevulinic acid synthase 1 (ALAS1 by triggers such as fasting or drug exposure can lead to accumulation of neurotoxic heme intermediates that cause disease symptoms. We have demonstrated that hepatic ALAS1 silencing using siRNA in a lipid nanoparticle effectively prevents and treats induced attacks in a mouse model of acute intermittent porphyria. Herein, we report the development of ALN-AS1, an investigational GalNAc-conjugated RNAi therapeutic targeting ALAS1. One challenge in advancing ALN-AS1 to patients is the inability to detect liver ALAS1 mRNA in the absence of liver biopsies. We here describe a less invasive circulating extracellular RNA detection assay to monitor RNAi drug activity in serum and urine. A striking correlation in ALAS1 mRNA was observed across liver, serum, and urine in both rodents and nonhuman primates (NHPs following treatment with ALN-AS1. Moreover, in donor-matched human urine and serum, we demonstrate a notable correspondence in ALAS1 levels, minimal interday assay variability, low interpatient variability from serial sample collections, and the ability to distinguish between healthy volunteers and porphyria patients with induced ALAS1 levels. The collective data highlight the potential utility of this assay in the clinical development of ALN-AS1, and in broadening our understanding of acute hepatic porphyrias disease pathophysiology.

Population ecology of variegate darter (Etheostoma variatum) in Virginia

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Argentina, Jane E.; Angermeier, Paul; Hallerman, Eric M.

2013-01-01

Variegate darters (Etheostoma variatum) were listed as endangered in Virginia in 1992. Reasons for listing included habitat degradation and concerns about current and future impacts of coal mining throughout their Virginia range. Prior to this research, little was known about variegate darter distribution, habitat use, or populations in Virginia. Two primary goals of this research were to gain knowledge about the current population ecology and the relationship between landscape-level factors (e.g., land cover changes, watershed size, isolation from other populations) on current and past variegate darter population sizes.We investigated distribution, habitat suitability, population genetics, and population size and structure of variegate darters in the upper Big Sandy River drainage, Buchanan, Dickenson, and Wise Co., Virginia. Our results indicate variegate darters are primarily found in the Levisa Fork, with highest densities and abundances between its confluence with Dismal Creek and the Virginia-Kentucky border. Sporadic occurrences in smaller tributaries to the Levisa and Tug forks indicate they exist more widely in low densities, especially near the confluence with the Tug and Levisa mainstems. Detection of variegate darters in smaller tributaries was inconsistent, with reach-level occupancy estimates varying among years. We detected young-of-year variegate darters every year we sampled, but age 1+ darters were indistinguishable from older darters based on standard length.Variegate darter population size and stability in Virginia were estimated via multiple methods, including site occupancy surveys, mark-recapture studies, and population genetic analysis. Using mark-recapture methods at five sites, we estimated overall population size in 2011 to be approximately 12,800 individuals in the 35-km reach between the Levisa Fork - Dismal Creek confluence and the Virginia-Kentucky border. Age structure seemed stable, with breeding adults and young-of-year collected

Competing Hegemonic Projects within China's Variegated Capitalism

DEFF Research Database (Denmark)

Mulvad, Andreas Christian Møller

2014-01-01

This article investigates the variegated model of capitalism emerging in China through a comparative analysis of two contrasting local government approaches developed in Chongqing and Guangdong. From 2007 to 2012, elite politicians and intellectuals articulated the Chongqing and Guangdong models...... of his Guangdong counterpart Wang Yang. Future studies should expand upon the key theoretical insight of the paper: that the emergent variegated capitalism approach to political–economic analysis needs a stronger ideational component....

Melatonin modulates drug-induced acute porphyria

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Sandra M. Lelli

Full Text Available This work investigated the modulation by melatonin (Mel of the effects of the porphyrinogenic drugs 2-allyl-2-isopropylacetamide (AIA and 3,5-diethoxycarbonyl-1,4-dihydro-2,4,6-collidine (DDC on oxidative environment, glucose biosynthesis and heme pathway parameters. Administration of Mel before rat intoxication with AIA/DDC showed a clear beneficial effect in all cases. Mel induced decreases of 42% and 35% in the excretion of the hemeprecursors 5-aminolevulinic acid (ALA and porphobilinogen (PBG, respectively, and a 33% decrease in the induction of the heme regulatory enzyme 5-aminolevulinic acid-synthase (ALA-S. The activity of the glucose metabolism enzyme phosphoenolpyruvate carboxykinase (PEPCK, which had been diminished by the porphyrinogenic treatment, was restored by 45% when animals were pre-treated with Mel. Mel abolished the modest decrease in glucose 6-phospatase (G6Pase activity caused by AIA/DDC treatment. The oxidative status of lipids was attenuated by Mel treatment in homogenates by 47%, whereas no statistically significant AIA/DDC-induced increase in thiobarbituric acid reactive substances (TBARS was observed in microsomes after Mel pre-treatment. We hypothesize that Mel may be scavenging reactive species of oxygen (ROS that could be damaging lipids, PEPCK, G6Pase and ferrochelatase (FQ. Additionally, Mel administration resulted in the repression of the key enzyme ALA-S, and this could be due to an increase in glucose levels, which is known to inhibit ALA-S induction. The consequent decrease in levels of the heme precursors ALA and PBG had a beneficial effect on the drug-induced porphyria. The results obtained open the possibility of further research on the use of melatonin as a co-treatment option in acute porphyria. Keywords: Melatonin, Glucose synthesis, Heme pathway, Acute porphyria, Oxidative stress

Congenital erythropoietic porphyria in an African hedgehog (Atelerix albiventris).

Science.gov (United States)

Wolff, Carlos; Corradini, Paulina; Cortés, Galaxia

2005-06-01

A 6-mo-old, male African hedgehog (Atelerix albiventris) presented with a history of pink urine and demonstrating pink-colored teeth and mild hepatomegaly on examination. Urinalysis revealed no physical, chemical, or cellular abnormalities other than a pink color and fluorescence under ultraviolet light (UV). Also under UV, intense fluorescence of teeth, feet, and spines was noted. Porphyria was suspected. Spectrophotometric evaluation of urine showed extremely elevated levels of copro- and uroporphyrins. Analysis of the urine by thin-layer chromatography showed an abnormal pattern of excreted porphyrin intermediates. Urine high-performance thin-layer chromatography showed that excreted porphyrins were 90-95% of the type-I isomeric form, suggestive of congenital erythropoietic porphyria.

Porphyria Cutanea Tarda Presenting with Scleroderma, Ichthyosis, Alopecia, and Vitiligo

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Megan E. MacGillivray

2018-05-01

Full Text Available Porphyria cutanea tarda (PCT is a cutaneous porphyria that presents later in life with cutaneous findings in sun-exposed sites. We report a complex case of PCT in a 67-year-old woman with an unusual constellation of cutaneous findings: scleroderma, acquired ichthyosis, and nonscarring alopecia. Possible triggers for her PCT include tamoxifen treatment for breast cancer and carrier status of the hemochromatosis gene. High-dose chloroquine was used to successfully achieve clinical remission and normalize her uroporphyrins. While on chloroquine she developed extensive classic vitiligo. It is not clear if this is another feature of her complex and unusual PCT, or a consequence of her antimalarial therapy.

South African Medical Journal - Vol 87, No 6 (1997)

African Journals Online (AJOL)

Variegate porphyria in South Africa, 1688 - 1996 - new developments in an old disease · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Richard J. Hift, Peter N. Meissner, Anne V. Corrigall, Mel R. Ziman, Lavinia A. Petersen, Doreen M. Meissner, Brandon P.

Lead Poisoning Can Be Easily Misdiagnosed as Acute Porphyria and Nonspecific Abdominal Pain

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Ming-Ta Tsai

2017-01-01

Full Text Available Lead poisoning (LP is less commonly encountered in emergency departments (ED. However, lead exposure still occurs, and new sources of poisoning have emerged. LP often goes unrecognized due to a low index of suspicion and nonspecific symptoms. We present a case of a 48-year-old man who had recurring abdominal pain with anemia that was misdiagnosed. His condition was initially diagnosed as nonspecific abdominal pain and acute porphyria. Acute porphyria-like symptoms with a positive urine porphyrin test result led to the misdiagnosis; testing for heme precursors in urine is the key to the differential diagnosis between LP and acute porphyria. The final definitive diagnosis of lead toxicity was confirmed based on high blood lead levels after detailed medical history taking. The lead poisoning was caused by traditional Chinese herbal pills. The abdominal pain disappeared after a course of chelating treatment. The triad for the diagnosis of lead poisoning should be a history of medicine intake, anemia with basophilic stippling, and recurrent abdominal pain.

Radiological features in congenital erythropoietic porphyria (Gunther's disease). Report of three cases

Energy Technology Data Exchange (ETDEWEB)

Levesque, M.; Legmann, P.; Le Cloirec, A.; Deybach, J.C.; Nordmann, Y.

1988-01-01

Gunther's disease or congenital erythropoietic porphyria is a rare and severe disorder comprising cutaneous and haemolytic symptoms. Photocutaneous lesions are responsible for scleroderma-like calcifications and deformities of the extremities visible on X-rays. Hemolytic manifestations lead to diffuse major osteopenia. Soft tissue calcifications of the fingers can be seen even in young patients. One case reported here is the first illustration of intracranial calcifications located on dura-mater and calvarium.

Differential diagnosis of acute abdominal pain – acute intermittent porphyria

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Mislav Klobučić

2011-08-01

Full Text Available Acute intermittent porphyria (AIP is a rare autosomal dominant disorder of heme biosynthesis in liver due to deficiency of porphobilinogen deaminase enzyme. Clinically, AIP is dominatedby a colicky type pain, which does not subside after taking usual analgesics. Additional frequent symptoms are vomiting, hypertension, peripheral neuropathy, seizures, depression, delirium and coma. This paper reported a case of a twenty-fi- ve-year-old female patient, who had undergone a period of six days between the first presentationto the medical department and the diagnosis confirmation. It has accentuated possible mistakes in symptomatic therapy administration as well as dangers of a delayed diagnosis.

Acute intermittent porphyria: Diagnostic dilemma and treatment options

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Mohan Deep Kaur

2015-01-01

Full Text Available Acute intermittent porphyria (AIP presents with diverse group of symptoms making its early diagnosis difficult. Delaying diagnosis and treatment of AIP can be fatal or can cause long term or permanent neurological damage. We present here a case report of AIP where the diagnosis was missed. The diversity of symptoms and details concerning the treatment options for AIP are discussed.

Acute intermittent porphyria: Diagnostic dilemma and treatment options

Science.gov (United States)

Kaur, Mohan Deep; Hazarika, Nita; Saraswat, Namita; Sood, Rajesh

2015-01-01

Acute intermittent porphyria (AIP) presents with diverse group of symptoms making its early diagnosis difficult. Delaying diagnosis and treatment of AIP can be fatal or can cause long term or permanent neurological damage. We present here a case report of AIP where the diagnosis was missed. The diversity of symptoms and details concerning the treatment options for AIP are discussed. PMID:26330726

Red cell survival and sequestration in acute intermittent porphyria

International Nuclear Information System (INIS)

Nawalkha, P.L.; Soni, S.G.; Agrawal, V.K.; Misra, S.N.

1980-01-01

Life span and sequestration of red cells have been studied in twenty one proved cases of acute intermittent porphyria of different age and sex group from Bikaner District, Rajasthan State (India). Chromium-51 labelled red cells were used in the study and the excess count method of Bughe Jones and Szur was used to calculate the index of sequestration. The mean apparent half survival time of erythrocytes in the control subjects was 25.9 +- 2.9 (S.D.) days and the same in the prophyria patients was 27.0 +- 3.8 days. This shows that the life span of red cells is normal in both the patient and the control. Excess destruction of red blood cells was found to take place in either spleen or liver in the disease and no excess accumulation of erythrocytes occurred over spleen as compared to liver. (M.G.B.)

Insulin resistance in porphyria cutanea tarda.

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Calcinaro, F; Basta, G; Lisi, P; Cruciani, C; Pietropaolo, M; Santeusanio, F; Falorni, A; Calafiore, R

1989-06-01

It has been reported that patients with porphyria cutanea tarda (PCT) develop carbohydrate (CHO) intolerance and manifest diabetes melitus (DM) more frequently than the normal population. In order to verify whether this is due to insulin resistance we studied 5 patients with PCT and 5 normal subjects matched for age, sex and weight. In all the patients an evaluation consisted of the glycemic curve and insulin response to an iv glucose tolerance test (IVGTT: 0.33 g/kg) as well as of an evaluation of the circulating monocyte insulin receptors. Blood samples were drawn in the basal state to measure plasma levels of NEFA, glycerol, and intermediate metabolites. The patients with PCT showed normal glucose tolerance which was obtained, however, at the expense of the elevated insulin levels: therefore a condition of insulin resistance was demonstrated in these subjects. An involvement of the lipid metabolism, observed by the raised levels of plasma NEFA and glycerol, was also evident. The insulin binding to circulating monocytes was reduced but not enough to justify the degree of insulin resistance observed. Therefore, it could be hypothesized, in agreement with similar studies, that a postreceptor defect is responsible for the insulin-resistance observed in patients with PCT and that the reduction of insulin receptors is determined by the down regulation in response to elevated insulinemic levels. An alteration of the porphyrin metabolism might be responsible for this disorder.

Genetics Home Reference: mosaic variegated aneuploidy syndrome

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... In MVA syndrome, growth before birth is slow (intrauterine growth restriction). After birth, affected individuals continue to grow at ... InfoSearch: Warburton Anyane Yeboa syndrome KidsHealth from Nemours: Intrauterine Growth Restriction ... mosaic variegated aneuploidy syndrome 1 MalaCards: ...

Molecular Basis Underlying Leaf Variegation of a Moth Orchid Mutant (Phalaenopsis aphrodite subsp. formosana

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Chi-Chu Tsai

2017-07-01

Full Text Available Leaf variegation is often the focus of plant breeding. Here, we studied a variegated mutant of Phalaenopsis aphrodite subsp. formosana, which is usually used as a parent of horticultural breeding, to understand its anatomic and genetic regulatory mechanisms in variegation. Chloroplasts with well-organized thylakoids and starch grains were found only in the mesophyll cells of green sectors but not of yellow sectors, confirming that the variegation belongs to the chlorophyll type. The two-dimensional electrophoresis and LC/MS/MS also reveal differential expressions of PsbP and PsbO between the green and yellow leaf sectors. Full-length cDNA sequencing revealed that mutant transcripts were caused by intron retention. When conditioning on the total RNA expression, we found that the functional transcript of PsbO and mutant transcript of PsbP are higher expressed in the yellow sector than in the green sector, suggesting that the post-transcriptional regulation of PsbO and PsbP differentiates the performance between green and yellow sectors. Because PsbP plays an important role in the stability of thylakoid folding, we suggest that the negative regulation of PsbP may inhibit thylakoid development in the yellow sectors. This causes chlorophyll deficiency in the yellow sectors and results in leaf variegation. We also provide evidence of the link of virus CymMV and the formation of variegation according to the differential expression of CymMV between green and yellow sectors.

The high frequency of variegated forms after in vitro mutagenesis in Saintpaulia ionantha Wendl.

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Marek Gaj

2014-01-01

Full Text Available The leaf-explants of Saintpaulia ionantha Wendl. var.'miniature' were treated by different doses of MNH and cultured on shoot regeneration medium. A strong toxic effect of some MNH doses on explant survival during the first two subcultures was noticed. The explants surviving treatment regenerated shoots with the efficiency comparable to the control. The high number of shoots regenerated from mutagenised leaves showed chlorophyll chimerism (so-called variegated forms. The use of 5 mM MNH for 1.5 or 2 h was found very effective, as 100% of survived explants regenerated variegated shoots. Besides hundreds of variegated forms also leaf-shape and flower-colour variants were observed in MNH-treated culture. Somaclonal variation was not observed in the control culture. The results indicate the great efficiency of in vitro applied MNH for in-duction of morphological variants of Saintpaulia, and especially variegated forms.

Genética de Coffea. XVIII - Variegação no cafeeiro Leaf variegation in coffee plants

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A. Carvalho

1954-01-01

Full Text Available A variegação das fôlhas do cafeeiro tanto em plantas novas como em plantas adultas tem sido freqüentemente observada. Plantas variegadas podem ocorrer espontaneamente nas progénies das diversas variedades de Coffea arabica L., motivo porque não devem constituir variedade distinta dessa espécie, como foi proposto por Cramer. As plantas variegadas em estudo puderam ser agrupadas em duas categorias, isto é, aquelas em que a variegação não se acha associada com anomalias na forma e textura das folhas e aquelas nas quais a variegação é acompanhada dessas anomalias. No primeiro grupo o padrão de variegação não é uniforme para tôdas as fôlhas, enquanto no segundo grupo o padrão é semelhante para tôda a planta. Usualmente apenas alguns ramos das plantas do primeiro grupo são variegados. Observou-se algumas vezes que as duas fôlhas do mesmo verticilo têm padrões semelhantes de variegação. Encontraram-se também fôlhas variegadas nas quais a metade da lâmina é variegada ou mesmo albina, enquanto a outra metade apresenta a côr verde normal. Os dados genéticos obtidos, embora preliminares para a maioria das plantas variegadas em investigação, permitiram concluir que o padrão de variegação da planta 180, pertencente ao primeiro grupo, é herdado pelo citoplasma e não é transmitido pelo pólen. O padrão de variegação da planta 253-21, pertencente ao segundo grupo, no entanto, parece ser transmitido pelo polen.Leaf variegation in coffee plants is a relatively common abnormality, and variegated seedlings have been found to occur spontaneously in progenies of most varieties of Coffea arabica L. For this reason it is thought that variegated types should not be described as distinct varieties, as it was done before by Cramer. Variegated coffee plants can be grouped in two categories : first, those in which variegated leaves are normal in shape and texture, but do not show a uniform variegation pattern; and second, those

Terpene-induced porphyria and the illness of Vincent van Gogh

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Lambrecht, R.; Cable, E.; Cable, J.; Clements, E.; Donohue, S.; Greene, Y.; Srivastava, K.; Arnold, W.; Bonkovsky, H. (Univ. of Massachusetts Medical Center, Worcester (United States) Univ. of Kansas Medical Center, Kansas City (United States))

1992-01-01

Vincent van Gogh suffered from recurrent bouts of an illness that may have been acute porphyria and abused camphor and alcohol, the latter particularly in the form of absinthe, a liqueur distilled from wormwood that was popular in 19th C France. To learn whether camphor or terpenes found in absinthe are porphyrogenic, the authors studied them in cultures of chick embryo liver cells. All were found to be porphyrogenic, especially in the presence of deferoxamine. The terpenes also induced the activity and protein amount of 5-aminolevulinate synthase and heme oxygenase, and induced activities of benzphetamine demethylase. The degree of porphyrin and enzyme induction produced by 1mM camphor was similar to that produced by 50uM glutethimide, a potent porphyrogen. Potency of pinene and thujone were lower. Camphor and glutethimide both produced accumulations of 8- and 7-COOH porphyrins, whereas pinene and thujone produced 4- and 2-COOH porphyrin accumulation. The authors conclude that camphor, pinen and thujone are porphyrogenic, cable of exacerbating acute porphyria, and may have done so in van Gogh.

Variegate porphyria in South Africa, 1688 - 1996 - new ...

African Journals Online (AJOL)

Specific suppression of haem synthesis with intravenous ... by abdominal pain, paralysis and the passage of red urine. This was .... In the marrow haem synthesis is also Iimrted by .... serum urea levels being elevated in 53% of subjects. 80th.

DNA triplet repeats mediate heterochromatin-protein-1-sensitive variegated gene silencing.

Science.gov (United States)

Saveliev, Alexander; Everett, Christopher; Sharpe, Tammy; Webster, Zoë; Festenstein, Richard

2003-04-24

Gene repression is crucial to the maintenance of differentiated cell types in multicellular organisms, whereas aberrant silencing can lead to disease. The organization of DNA into chromatin and heterochromatin is implicated in gene silencing. In chromatin, DNA wraps around histones, creating nucleosomes. Further condensation of chromatin, associated with large blocks of repetitive DNA sequences, is known as heterochromatin. Position effect variegation (PEV) occurs when a gene is located abnormally close to heterochromatin, silencing the affected gene in a proportion of cells. Here we show that the relatively short triplet-repeat expansions found in myotonic dystrophy and Friedreich's ataxia confer variegation of expression on a linked transgene in mice. Silencing was correlated with a decrease in promoter accessibility and was enhanced by the classical PEV modifier heterochromatin protein 1 (HP1). Notably, triplet-repeat-associated variegation was not restricted to classical heterochromatic regions but occurred irrespective of chromosomal location. Because the phenomenon described here shares important features with PEV, the mechanisms underlying heterochromatin-mediated silencing might have a role in gene regulation at many sites throughout the mammalian genome and modulate the extent of gene silencing and hence severity in several triplet-repeat diseases.

Low-Dose Hydroxychloroquine is as Effective as Phlebotomy in Treatment of Patients with Porphyria Cutanea Tarda

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Singal, Ashwani K.; Kormos-Hallberg, Csilla; Lee, Chul; Sadagoparamanujam, V.-M.; Grady, James J.; Freeman, Daniel H.; Anderson, Karl E.

2012-01-01

Background & Aims Porphyria cutanea tarda (PCT) is an iron-related disorder caused by reduced activity of hepatic uroporphyrinogen decarboxylase (UROD); it can be treated by phlebotomy or low doses of hydroxychloroquine. We performed a prospective pilot study to compare the efficacy and safety of these therapies. Methods We analyzed data from 48 consecutive patients with well-documented PCT to characterize susceptibility factors; patients were treated with phlebotomy (450 mL, every 2 weeks until they had serum ferritin levels of 20 ng/mL) or low-dose hydroxychloroquine (100 mg orally, twice weekly, until at least 1 month after they had normal plasma levels of porphyrin). We compared the time required to achieve a normal plasma porphyrin concentration (remission, the primary outcome) for 17 patients treated with phlebotomy and 13 treated with hydroxychloroquine. Results The time to remission was a median 6.9 months for patients that received phlebotomy and 6.1 months for patients treated with hydroxychloroquine treatment (6.7 and 6.5 months for randomized patients), a difference that was not significant (Log Rank P=.06 and P=.95, respectively). The sample size was insufficient to confirm noninferiority of hydroxychloroquine treatment (hazard ratio [HR], 2.19; 95% confidence interval [CI], 0.95–5.06) for all patients. Patients that received hydroxychloroquine had substantially better compliance. There were no significant side effects of either treatment. Conclusions Hydroxychloroquine, 100 mg twice weekly, is as effective and safe as phlebotomy in patients with PCT, although noninferiority was not established. Given these results, higher-dose regimens of hydroxychloroquine, which have more side effects, do not seem justified. Compliance was better and projected costs were lower for hydroxychloroquine than phlebotomy treatment. Long-term studies are needed to compare durability of response. PMID:22985607

Porfiria cutânea tardia Porphyria cutanea tarda

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Fátima Mendonça Jorge Vieira

2006-12-01

Full Text Available Trata-se de revisão sobre a porfiria cutânea tardia em que são abordados a fisiopatogenia, as características clínicas, as doenças associadas, os fatores desencadeantes, a bioquímica, a histopatologia, a microscopia eletrônica, a microscopia de imunofluorescência e o tratamento da doença.This is a review article of porphyria cutanea tarda addressing pathophysiology, clinical features, associated conditions, triggering factors, biochemistry, histopathology, electronic microscopy, immunofluorescence microscopy and treatment of the disease.

Illness Perception and Psychological Distress in Persons with Porphyria Cutanea Tarda.

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Andersen, Janice; Nordin, Karin; Sandberg, Sverre

2016-06-15

Porphyria cutanea tarda (PCT) requires long-term treatment and follow-up, although many patients experience life-long remission. The aim of this cross-sectional postal survey was to describe and investigate the association between illness perception, health complaints, self-reported symptoms and distress in persons with PCT. The participants perceived PCT as a chronic condition with high levels of personal and treatment control. Persons who reported active symptoms scored higher on perceived illness threat, total health complaints and psychological distress compared with those in remission or latent phases. However, a higher perception of illness threat and the total burden of health complaints were more closely associated with psychological distress than were perceived PCT symptoms activity. This has implications for clinical consultation; dermatologists should be attentive to symptoms activity, but also recognize that patients in remission with a high perceived illness threat and multiple health complaints might be especially vulnerable to psychological distress with regards to PCT.

MR imaging of acute intermittent porphyria mimicking reversible posterior leukoencephalopathy syndrome

International Nuclear Information System (INIS)

Utz, N.; Kinkel, B.; Hedde, J.P.; Bewermeyer, H.

2001-01-01

Reversible posterior leukoencephalopathy syndrome (PLS) is characterized by headache, altered mental function, visual disturbances and seizures. Neuroimaging studies suggest a white-matter oedema, predominantly in the posterior parietal-temporal-occipital regions of the brain. We present the case of a 30-year-old woman who had suffered her first attack of acute intermittent porphyria (AIP). Following 1 week of abdominal pain she developed several generalized seizures, and hallucinations, and exhibited a progressive deterioration of the consciousness. T2-weighted images, especially fluid-attenuated inversion recovery (FLAIR) sequences showed bilateral lesions in the posterior frontal, parietal and occipital cortex and subcortical white matter. Following treatment with haematin and a high carbohydrate diet the patient's condition improved. Follow-up magnetic resonance imaging (MRI) revealed complete resolution of the lesions. To our knowledge, this is the first report concerning a completely reversible PLS in AIP. (orig.)

Porfiria aguda intermitente: relato de caso e revisão da literatura Acute intermittent porphyria: case report and review of the literature

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Daniela von Ah Lopes

2008-12-01

caso de porfiria aguda intermitente no pós-operatório de cirurgia bariátrica.Acute intermittent porphyria is an unusual pathology with potentially severe consequences when not early detected. Among the possible causes of porphyric crises decrease of caloric intake has been described. A case of acute intermittent porphyria in the late postoperative period of a bariatric surgery performed for treatment of obesity is reported. A review of the diagnostic aspects and management of this pathology in the intensive care unit follows. A 31 year old woman was admitted in the intensive care unit three weeks after a bariatric surgery, with decreased level of consciousness and respiratory distress. The patient evolved with psychomotor agitation, mental confusion, abdominal pain and proximal tetraparesis. Diagnosis investigation disclosed severe hyponatremia (92mEq/L, hypomagnesemia, hypophosfatemia and hypocalcemia and cloudy urine without hematuria. Acute porphyria was suspected and the urine test detected high delta amino-levulinic acid and porphobilinogen. Treatment consisted of a correction of electrolyte disturbances and high carbohydrate intake. Hematin and heme arginate were not used, due to the difficulty to acquire the medication. After 8 months the patient progressed with full recovery of muscle strength and a clinical improvement. Acute intermittent porphyria has signs and symptoms common to several clinical, neurological, psychiatric and gastroenterological pathologies, which complicate diagnosis. Therefore, acute intermittent porphyria should be included in the differential diagnosis of neurological, psychiatric and gastroenterological alterations when results of all other exams are normal. Attention must be given to patients undergoing surgery mainly bariatric that, in addition to procedure stress, substantially limit the total caloric intake, potentially triggering crises. Review of literature did not disclose any report of acute intermittent porphyria crisis

Porfirias poco frecuentes: Casos detectados en la población argentina Non frequent porphyrias in the argentinean population

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V A Melito

2006-12-01

Full Text Available Las porfirias son consecuencia de fallas en el metabolismo del hemo. Se clasifican según el tipo de sintomatología clínica prevalente o el órgano donde se expresa preferencialmente la falla metabólica. En general la deficiencia enzimática está asociada a mutaciones en los genes que codifican para cada una de las enzimas. Están descritos 7 tipos de porfiria diferentes. Se transmiten por carácter autosómico dominante a excepción de la PCE, la PHE y la NPA que son recesivas. Sin embargo, están reportadas variantes homocigotas para el resto de las porfirias de pronóstico y evolución mucho más grave que la forma heterocigota. La descripción de estos casos poco frecuentes, sus tratamientos y evolución, facilitarían tanto el diagnóstico diferencial de la porfiria como el conocimiento de las posibilidades terapéuticas en cada caso. Asimismo para las porfirias heterocigotas con manifestación infantil, su identificación temprana y tratamiento aseguraría una mejor evolución minimizando los riesgos asociados. Se han diagnosticado 5 casos de porfirias agudas en niñas: 2 de PAI, 2 de PV y 1 de CPH. Entre las porfirias cutáneas se presentan 25 casos de PCT infantil, el primer caso de PHE en Argentina, 4 casos de PCE infantil y 1 en un adulto y 2 casos de PPE con compromiso hepatobiliar.The Porphyrias are a group of diseases resulting from partial deficiencies in one of the heme biosynthetic enzymes. These disorders can be classified on the basis of their clinical manifestations or according the organ where the metabolic deficiency is mainly expressed. In general this enzyme deficiency is associated with mutations in the genes which codify each enzyme. There are 7 types of Porphyrias. They are autosomal dominant disorders with the exception of PCE, PHE and NPA which are recessive. However, some rare and severe cases with recessive inheritance have also been reported. The description of these infrequent cases and their treatments and

The microbial flora of the different gut regions of the variegated ...

African Journals Online (AJOL)

The microbial flora of the gut regions and gut contents of the variegated grasshopper Zonocerus variegatus instars was studied using the pour plate technique. The gut sections (Fore-, mid-, and hind-gut) harboured a variety organisms mainly bacteria, fungi and mould. Yeasts species isolated were Candida, ...

Mass spectrometric characterisation of a condensation product between porphobilinogen and indolyl-3-acryloylglycine in urine of patients with acute intermittent porphyria.

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Marcos, Josep; Ibañez, Maria; Ventura, Rosa; Segura, Jordi; To-Figueras, Jordi; Pozo, Oscar J

2015-07-01

We document the presence of a previously unknown species in the urine of patients with acute intermittent porphyria (AIP). The compound was fully characterised by liquid chromatography tandem mass spectrometry. Interpretation of both full spectrum acquisition and product ion spectra acquired in positive and negative ionisation modes by quadrupole time of flight MS allowed for the identification of a condensation product arising from porphobilinogen (PBG, increased in the urine of AIP patients) and indolyl-3-acryloylglycine (IAG, derived from indolylacrylic acid and present in human urine). The structure was unequivocally confirmed through comparison between the selected reaction monitoring chromatograms obtained from the urinary species and the condensation product qualitatively synthesised in the laboratory. Owing to the large amounts of both PBG and IAG in urine of AIP patients, the possible ex vivo formation of PBG-IAG in urine samples was evaluated. The product was spontaneously formed at room temperature, at 4 °C and even during storage at -20 °C when spiking a control sample with PBG. A positive correlation was found between PBG and PBG-IAG in samples collected from AIP patients. However, no correlation was found between PBG-IAG and IAG. Purified PBG-IAG did not form the characteristic chromogen after application of p-dimethylaminobenzaldehyde in HCl, thus suggesting that the current techniques used to measure PBG in urine of AIP patients based on Ehlrich's reaction do not detect this newly characterised PBG-IAG fraction. Copyright © 2015 John Wiley & Sons, Ltd.

A Study on the Feeding and Growth Patterns of the Variegated ...

African Journals Online (AJOL)

The feeding and growth patterns of the variegated grasshopper, Zonocerus variegatus (L) were studied in the laboratory to ascertain the amount of food intake, food assimilated and faeces excreted by its nymph and adult stages on a mixed diet of Cassava (Manihot esculenta) and Siam weed (Chromolaena odorata) leaves.

Arabidopsis VARIEGATED 3 encodes a chloroplasttargeted, zinc-finger protein required for chloroplast and palisade cell development

DEFF Research Database (Denmark)

Næsted, Henrik; Holm, A.; Jenkins, T.

2004-01-01

The stable, recessive Arabidopsis variegated 3 (var3) mutant exhibits a variegated phenotype due to somatic areas lacking or containing developmentally retarded chloroplasts and greatly reduced numbers of palisade cells. The VAR3 gene, isolated by transposon tagging, encodes the 85.9 kDa VAR3...... that pigment profiles are qualitatively similar in wild type and var3, although var3 accumulates lower levels of chlorophylls and carotenoids. These results indicate that VAR3 is a part of a protein complex required for normal chloroplast and palisade cell development....

Renal failure affects the enzymatic activities of the three first steps in hepatic heme biosynthesis in the acute intermittent porphyria mouse.

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Carmen Unzu

Full Text Available Chronic kidney disease is a long-term complication in acute intermittent porphyria (AIP. The pathophysiological significance of hepatic overproduction of the porphyrin precursors aminolevulinate acid (ALA and porphobilinogen (PBG in chronic kidney disease is unclear. We have investigated the effect of repetitive acute attacks on renal function and the effect of total or five-sixth nephrectomy causing renal insufficiency on hepatic heme synthesis in the porphobilinogen deaminase (PBGD-deficient (AIP mouse. Phenobarbital challenge in the AIP-mice increased urinary porphyrin precursor excretion. Successive attacks throughout 14 weeks led to minor renal lesions with no impact on renal function. In the liver of wild type and AIP mice, 5/6 nephrectomy enhanced transcription of the first and rate-limiting ALA synthase. As a consequence, urinary PBG excretion increased in AIP mice. The PBG/ALA ratio increased from 1 in sham operated AIP animals to over 5 (males and over 13 (females in the 5/6 nephrectomized mice. Total nephrectomy caused a rapid decrease in PBGD activity without changes in enzyme protein level in the AIP mice but not in the wild type animals. In conclusion, high concentration of porphyrin precursors had little impact on renal function. However, progressive renal insufficiency aggravates porphyria attacks and increases the PBG/ALA ratio, which should be considered a warning sign for potentially life-threatening impairment in AIP patients with signs of renal failure.

Arabidopsis VARIEGATED 3 encodes a chloroplast-targeted, zinc-finger protein required for chloroplast and palisade cell development

DEFF Research Database (Denmark)

Næsted, Henrik; Holm, Agnethe; Jenkins, Tom

2004-01-01

The stable, recessive Arabidopsis variegated 3 (var3) mutant exhibits a variegated phenotype due to somatic areas lacking or containing developmentally retarded chloroplasts and greatly reduced numbers of palisade cells. The VAR3 gene, isolated by transposon tagging, encodes the 85.9 kDa VAR3...... that pigment profiles are qualitatively similar in wild type and var3, although var3 accumulates lower levels of chlorophylls and carotenoids. These results indicate that VAR3 is a part of a protein complex required for normal chloroplast and palisade cell development....

Hemochromatosis (HFE) gene mutations and response to chloroquine in porphyria cutanea tarda.

Science.gov (United States)

Stölzel, Ulrich; Köstler, Erich; Schuppan, Detlef; Richter, Matthias; Wollina, Uwe; Doss, Manfred O; Wittekind, Christian; Tannapfel, Andrea

2003-03-01

To examine the role of hemochromatosis (HFE) gene mutations, which are associated with porphyria cutanea tarda (PCT), in the therapeutic response to chloroquine. We retrospectively analyzed a database (Excel version 2001 [Microsoft Excel, Redmond, Wash]; date range of search, 1985-1999) of chloroquine-treated patients with PCT on whether HFE mutations (C282Y and H63D) might have influenced the clinical response, urinary porphyrin excretion, liver enzyme activities, and serum iron markers. Serum samples and corresponding complete sets of data before and after therapy were available in 62 of 207 patients with PCT who were treated exclusively with chloroquine. Academic teaching hospital. For treatment, low-dose chloroquine diphosphate, 125 to 250 mg twice weekly, was used during a median time of 16 months (range, 12-26 months). Of the 62 German patients with PCT, 37 (60%) carries HFE mutations. Chloroquine therapy was accompanied by clinical remission and reduced urinary porphyrin excretion (P<.001) in the 24 patients (39%) with HFE wild type as well as in 35 HFE heterozygous patients with PCT (56%). Decreases of serum iron markers following chloroquine therapy were limited to patients with PCT and HFE wild type. All patients homozygous for the C282Y mutation (3 [5%] of 62) had high serum iron, ferritin, and transferrin saturation and failed to respond to chloroquine treatment. The therapeutic response to chloroquine was not compromised by C282Y heterozygosity and compound heterozygosity of HFE mutations. Because HFE C282Y homozygotes (+/+) did not respond to chloroquine and a decrease in serum iron concentration was limited to patients with PCT and HFE wild type, phlebotomy should be first-line therapy in patients with PCT and HFE mutations.

Porphyria Cutanea Tarda (PCT experience in Victoria, Australia: A case series and literature review

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Quynh Le

2018-01-01

Full Text Available Background Porphyria Cutanea Tarda (PCT is a metabolic disorder resulting from a deficiency of hepatic enzyme uroporphyrinogen decarboxylase (UROD. UROD deficiency results in the accumulation of porphyrins, which are phototoxic and hepatotoxic. PCT patients are at increased risk of developing hepatocellular carcinoma. Aims We aim to describe a series of PCT patients presenting to a tertiary center over 35-year period from the 1980s to December 2015 and review current literature to date on PCT, with a focus on PCT management. Methods A search of the center’s dermatology department and biochemistry database were performed to identify patients diagnosed with PCT. Demographic data, underlying risk factors and management details were obtained. Statistical tests were performed to identify any possible association between the variables of interest. Results 34 patients were included in this study. Mean age of diagnosis was 48 years and there was no gender difference. 12 patients had Hepatitis C infection, 25 had excessive alcohol consumption, 13 had hereditary haemochromatosis. Eight patients developed oestrogen-associated or hormonal replacement therapy (HRT induced PCT. 33 patients (97 per cent responded to venesection. Six (18 per cent patients were prescribed hydroxychloroquine, either alone or concurrently with venesection. They all achieved remission. Average duration of follow up is 13 years. One patient developed hepatocellular carcinoma (HCC. Conclusion Our study has reinforced venesection as an effective treatment for PCT. Low dose hydroxychloroquine can be used in patients where venesection is contraindicated or not tolerated. General measures such as alcohol abstinence, visible violet light protection and trauma avoidance are recommended.

Porfiria cutánea tardía: Reporte de 5 casos Porphyria cutanea tarda: Five cases report

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J L Iribas

2008-03-01

Full Text Available La PCT es la más común de las porfirias. Es una fotodermatosis que resulta de la deficiencia de la UPD, enzima perteneciente a la vía de síntesis del hemo. Presentamos la evolución de cinco casos de PCT; cuatro de PCT familiar y uno de PCT esporádica. En dos de los pacientes pertenecientes al grupo de PCT tipo II, encontramos como factor de riesgo, el consumo de alcohol, y en la paciente con PCT tipo I se detectó serología positiva para VHC. Todos los pacientes fueron tratados con cloroquina y flebotomías repetidas. Rápidamente se detectó mejoría clínica y bioquímica. Se observó que la porfirinuria continuó en descenso aún luego de suspendida la terapéutica. Tres de los pacientes con PCT familiar persisten en remisión clínica y con ausenciade recaídas tras más de 10 años de seguimiento. Aconsejamos en pacientes que padecen PCT la búsqueda de factores asociados (VHC, HIV, genes de HH y desencadenantes exógenos (consumo excesivo de alcohol, hierro en la dieta e ingesta de estrógenos que de ser controlados o evitados, junto con el tratamiento oportuno, contribuyen a un satisfactorio control de la enfermedad.The porphyria cutanea tarda is the most frequent porphyria, it is a photodermatosis secondary to uroporphyrinogen decarboxylase deficiency; this enzyme belongs to the haem synthesis pathway. We present on this paper the evolution of five cases of PCT, four of them with familiar type and one of them sporadic type. In two patients belonging to PCT type II, we found alcohol addiction as a serious risk, while on the other patients PCT type I we found HCV positive serology. All patients were treated with chloroquine and phlebotomies. We could observe a good response not only clinical but biochemical. We could also see that the porphyrins urinary level continued descending once the drug was withdrew. Three of the patients with familiar PCT remains in clinical remission without any relapses in ten years of control. We advice

Heredity of flake- and stripe-variegated traits and their introduction into Japanese day-neutral winter-flowering sweet pea (Lathyrus odoratus L.) cultivars.

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Yagishita, Yoshimi; Hara, Yasuhide; Nakayama, Masayoshi

2018-01-01

Sweet pea ( Lathyrus odoratus L.) is a major cut flower in Japan, generally grown in greenhouses in winter to spring. The wild-type sweet pea is a long-day summer-flowering plant. The day-neutral winter-flowering ability, which allows cut-flower production in Japan, is a recessive phenotype that emerged by spontaneous mutation. Although Japanese winter-flowering cultivars and additionally spring-flowering cultivars, which have semi-long-day flowering ability generated by crossing the winter- and summer-flowering cultivars, have superior phenotypes for cut flowers, they have limited variation in color and fragrance. In particular, variegated phenotypes do not appear in modern winter- and spring-flowering cultivars, only in summer-flowering cultivars. We try to expand the phenotypic diversity of Japanese cut flower cultivars. In the processes, we introduced the variegated phenotypes by crossing with summer-flowering cultivars, and succeeded in breeding some excellent cultivars. During breeding, we analyzed the segregation ratios and revealed the heredity of the phenotypes. Here we review the heredity of these variegated phenotypes and winter-flowering phenotypes and their related genes. We also describe how we introduced the trait into winter-flowering cultivars, tracing their pedigrees to show both phenotypes and genotypes of the progeny at each generation. This knowledge is useful for the efficient breeding of new variegated cultivars.

A rare case of acute intermittent porphyria with ichthyosis vulgaris in a young boy

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Garima Agrawal Varshney

2018-01-01

Full Text Available Acute intermittent porphyria (AIP and ichthyosis vulgaris both are autosomal dominant disorders with incomplete penetrance caused by the deficiency of porphobilinogen deaminase enzyme and filaggrin protein, respectively. We report a rare case of a 9-year-old boy having two genetic diseases with an unclear association. An acute attack of AIP is characterized by gastrointestinal symptoms and neuropsychiatric manifestations. Although rare in the first decade of life, the presence of reddish urine with a typical presentation such as abdominal pain, hypertension, seizure, and paresthesias lead us to the diagnosis of AIP. The precipitating factor in the present case was prolonged fasting in Ramadan.

Whole Exome Sequencing Identified a Novel Heterozygous Mutation in HMBS Gene in a Chinese Patient With Acute Intermittent Porphyria With Rare Type of Mild Anemia

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Yongjiang Zheng

2018-04-01

Full Text Available Acute intermittent porphyria (AIP is a rare hereditary metabolic disease with an autosomal dominant mode of inheritance. Germline mutations of HMBS gene causes AIP. Mutation of HMBS gene results into the partial deficiency of the heme biosynthetic enzyme hydroxymethylbilane synthase. AIP is clinically manifested with abdominal pain, vomiting, and neurological complaints. Additionally, an extreme phenotypic heterogeneity has been reported in AIP patients with mutations in HMBS gene. Here, we investigated a Chinese patient with AIP. The proband is a 28-year-old Chinese male manifested with severe stomach ache, constipation, nausea and depression. Proband’s father and mother is normal. Proband’s blood sample was collected and genomic DNA was extracted. Whole exome sequencing and Sanger sequencing identified a heterozygous novel single nucleotide deletion (c.809delC in exon 12 of HMBS gene in the proband. This mutation leads to frameshift followed by formation of a truncated (p.Ala270Valfs∗2 HMBS protein with 272 amino acids comparing with the wild type HMBS protein of 361 amino acids. This mutation has not been found in proband’s unaffected parents as well as in 100 healthy normal control. According to the variant interpretation guidelines of American College of Medical Genetics and Genomics (ACMG, this variant is classified as “likely pathogenic” variant. Our findings expand the mutational spectra of HMBS gene related AIP which are significant for screening and genetic diagnosis for AIP.

Mutations in circularly permuted GTPase family genes AtNOA1/RIF1/SVR10 and BPG2 suppress var2-mediated leaf variegation in Arabidopsis thaliana.

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Qi, Yafei; Zhao, Jun; An, Rui; Zhang, Juan; Liang, Shuang; Shao, Jingxia; Liu, Xiayan; An, Lijun; Yu, Fei

2016-03-01

Leaf variegation mutants constitute a unique group of chloroplast development mutants and are ideal genetic materials to dissect the regulation of chloroplast development. We have utilized the Arabidopsis yellow variegated (var2) mutant and genetic suppressor analysis to probe the mechanisms of chloroplast development. Here we report the isolation of a new var2 suppressor locus SUPPRESSOR OF VARIEGATION (SVR10). Genetic mapping and molecular complementation indicated that SVR10 encodes a circularly permuted GTPase that has been reported as Arabidopsis thaliana NITRIC OXIDE ASSOCIATED 1 (AtNOA1) and RESISTANT TO INHIBITION BY FOSMIDOMYCIN 1 (RIF1). Biochemical evidence showed that SVR10/AtNOA1/RIF1 likely localizes to the chloroplast stroma. We further demonstrate that the mutant of a close homologue of SVR10/AtNOA1/RIF1, BRASSINAZOLE INSENSITIVE PALE GREEN 2 (BPG2), can also suppress var2 leaf variegation. Mutants of SVR10 and BPG2 are impaired in photosynthesis and the accumulation of chloroplast proteins. Interestingly, two-dimensional blue native gel analysis showed that mutants of SVR10 and BPG2 display defects in the assembly of thylakoid membrane complexes including reduced levels of major photosynthetic complexes and the abnormal accumulation of a chlorophyll-protein supercomplex containing photosystem I. Taken together, our findings suggest that SVR10 and BPG2 are functionally related with VAR2, likely through their potential roles in regulating chloroplast protein homeostasis, and both SVR10 and BPG2 are required for efficient thylakoid protein complex assembly and photosynthesis.

Scleral necrosis in congenital erythropoietic porphyria: A case report and review of the literature

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Shweta Agarwal

2015-01-01

Full Text Available A 28-year-old presented with complaints of severe pain and redness in the left eye since 2 weeks. He had similar complaints in the right eye 2 years back for which he had undergone a scleral patch graft. Best corrected visual acuity was 20/20 in both eyes. The right had a well vascularized scleral graft and rest of the anterior segment was normal. The left eye had inferior conjunctival congestion with an area of the scleral melt with uveal show just temporal to the limbus in the interpalbebral area. The cornea was clear and anterior chamber was quiet in the left eye. Applanation tonometry and fundus evaluation were normal in both eyes. Physical examination revealed hyperpigmented skin lesion, hypertrichosis and absorption of distal phalanges. Laboratory, ocular and physical findings confirmed the diagnosis of congenital erythropoietic porphyria. He was on oral steroids 40 mg/day since 2 weeks and topical antibiotics and lubricants. He was advised to continue the same and was taken up for scleral patch graft with fibrin glue in the left eye. Postoperatively he was continued on topical and oral steroids and lubricants.3 weeks later the left eye had stabilized however patient came with a melt in the right eye. Since it was an early melt, we went ahead with cyanoacrylate glue and bandage contact lens in the right eye and started him on topical steroids for the right eye also. Three months later both the eyes were stable, and the patient was gradually tapered off the steroids.

Obervations on the Induction of Position Effect Variegation of Euchromatic Genes in Drosophila Melanogaster

OpenAIRE

Pokholkova, G. V.; Makunin, I. V.; Belyaeva, E. S.; Zhimulev, I. F.

1993-01-01

In the T(1;2)dor(var7) translocation, the 1A-2B7-8 segment of the X chromosome is brought to the vicinity of 2R-chromosome heterochromatin resulting in position effect variegation of dor, BR-C and more distal genes, as well as compaction of chromatin in this segment. By irradiation of T(1;2)dor(var7), nine reversions (rev) to a normal phenotype were recovered. In two cases (rev27, rev226), the 1A-2B7-8 section is relocated to the 19A region of the X chromosome, forming free duplications (1A-2...

Aspectos anatômicos da variegação na folha do cafeeiro Anatomical features of leaf variegation in coffee plants

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D. M. Dedecca

1957-01-01

, ao mesmo tempo que foi impedida a formação de um verdadeiro parênquima paliçádico. A grande atividade da gema apical dos cafeeiros que exibem êste tipo de variegação, tal como pode ser observada pelas freqüentes modificações na sua morfologia, conduziu essas plantas a um intenso desenvolvimento vegetativo, servindo de evidência em favor da hipótese de que distúrbios vários devem ter ocorrido durante o desenvolvimento daquelas fôlhas.Two different types of leaf variegation in coffee plants are studied on the anatomical viewpoint, and their histological differences are described, when compared with normal, green leaves. In the first case, variegated leaves are normal in shape and texture, and show different variegation patterns, being histologically identical with green leaves of normal plants. The variegation seems to be due to disturbances in the chlorophyll-producing mechanism, resulting in the formation of large, green and normal chloroplasts, aad small, yellowish and abnormal chloroplasts. The distribution at random of cells having one of these two kinds of chloroplasts can be accounted for the different variegation patterns observed. In the second example, the variegation pattern is uniform throughout the entire plant, and is a more complex phenomenon, since besides being variegated the leaves present several malformations. The anatomical study has revealed that, in this case, the chloroplasts are always normal, the variegation being rather due to the presence of an 1-3-layered hialine hypodermis, which occurs right beneath the upper epidermis. The malformations, represented by abnormalities in the shape and texture of the leaf blade, are mainly due to the lackness of a true palisade parenchyma. This tissue shows all grades of disorganization in the various portions of the leaf, being sometimes present as small patches or palisade cells or lacking completely in other instances. It is suggested that disturbances of any kind should have occurred

Acute intermittent porphyria: A single-base deletion and a nonsense mutation in the human hydroxymethylbilane synthase gene, predicting truncations of the enzyme polypeptide

Energy Technology Data Exchange (ETDEWEB)

Lee, G.L.; Astrin, K.H.; Desnick, R.J. [Mount Sinai School of Medicine, New York, NY (United States)

1995-08-28

Acute intermittent porphyria (AIP) is an autosomal-dominant inborn error of metabolism that results from the half-normal activity of the third enzyme in the heme biosynthetic pathway, hydroxymethylbilane synthase (HMB-synthase). AIP is an ecogenetic condition, since the life-threatening acute attacks are precipitated by various factors, including drugs, alcohol, fasting, and certain hormones. Biochemical diagnosis is problematic, and the identification of mutations in the HMB-synthase gene provides accurate detection of presymptomatic heterozygotes, permitting avoidance of the acute precipitating factors. By direct solid-phase sequencing, two mutations causing AIP were identified, an adenine deletion at position 629 in exon 11(629delA), which alters the reading frame and predicts premature truncation of the enzyme protein after amino acid 255, and a nonsense mutation in exon 12 (R225X). These mutations were confirmed by either restriction enzyme analysis or family studies of symptomatic patients, permitting accurate presymptomatic diagnosis of affected relatives. 29 refs., 2 figs.

A filter paper dry blood spot procedure for acute intermittent porphyria population screening by use of whole blood uroporphyrinogen-I-synthase assay.

Science.gov (United States)

Johansson, L; Thunell, S; Wetterberg, L

1984-03-13

A filter paper dry blood spot procedure for the determination of whole blood uroporphyrinogen-I-synthase (UIS) activity is presented. The method is based on the concept of enzyme specific activity, the enzyme activity being related to the haemoglobin concentration of the assay sample. The diagnostic capacity with regard to the acute intermittent porphyria (AIP) gene carrier state is shown to be equivalent to that of a washed red cell reference method. On grounds of easy capillary blood sampling, uncomplicated and safe mail specimen transport and simple laboratory reception routines, the method is stated to be well adapted for use in AIP preadolescent population screening.

Is it justifiable to assert that clinical lycanthropy may be correlated to porphyria cutanea tarda?

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Lorenzo Martini

2017-10-01

Full Text Available Scope of this study is to demonstrate an old theory expressed in 1963, when Illis (Guy’s Hospital in London established a correlation between the clinical lycanthropy and congenital porphyria cutanea tarda. We had the fortune to live in a village where they say a lycanthrope lives too and is accustomed to hid himself at home for the 3 days when on the full moon, when he becomes (and behaves as a werewolf. Werewolves like to walk around before dawn craving for water and since We love to walk very early in the morning (as philosopher Emanuel Kant used to do, We have had this chance to encounter this mysterious man, who is a normal man with a regular lifestyle according to lunar cycle. He presents a very pale face with scares and blisters and generally when somebody asks him about this cutaneous manifestations he says he detests sun and light and his skin reacts by this way. We attempted to treat this individual by a pomade containing rutin, diosmin,Centella asiatica,niacinamide and escin. Results are encouraging as well.

Medicinudløst hudkløe, sår og blærer hos tre patienter med pseudoporfyri

DEFF Research Database (Denmark)

Þorsteinsdóttir, Sunna; Velander, Marie Juul; Bygum, Anette

2015-01-01

Pseudoporphyria cutanea tarda is a well described bullous skin disorder which resembles porphyria cutanea tarda. However, the levels of porphyrins in plasma, urine and faeces are normal. We present three cases of patients with classical symptoms of pseudoporhyria. Two of the patients developed ps...... pseudoporphyria after the combination of intensive sunbathing and medications well known to cause pseudoporphyria. The third case received haemodialysis and furosemide....

Medicinudløst hudkløe, sår og blærer hos tre patienter med pseudoporfyri

DEFF Research Database (Denmark)

Thorsteinsdóttir, Sunna; Velander, Marie Juul; Bygum, Anette

2015-01-01

Pseudoporphyria cutanea tarda is a well described bullous skin disorder which resembles porphyria cutanea tarda. However, the levels of porphyrins in plasma, urine and faeces are normal. We present three cases of patients with classical symptoms of pseudoporphyria. Two of the patients developed p...... pseudoporphyria after the combination of intensive sunbathing and medications well known to cause pseudoporphyria. The third case received haemodialysis and furosemide....

Investigating changes in basal conditions of Variegated Glacier prior to and during its 1982–1983 surge

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M. Jay-Allemand

2011-08-01

Full Text Available Variegated Glacier (Alaska is known to surge periodically after a sufficient amount of cumulative mass balance is reached, but this observation is difficult to link with changes in the basal conditions. Here, using a 10-yr dataset, consisting of surface topography and surface velocity observations along a flow line for 25 dates, we have reconstructed the evolution of the basal conditions prior to and during the 1982–1983 surge. The model solves the full-Stokes problem along the central flow line using the finite element method. For the 25 dates of the dataset, the basal friction parameter distribution is inferred using the inverse method proposed by Arthern and Gudmundsson (2010. This method is here slightly modified by incorporating a regularisation term in the cost function to avoid short wavelength changes in the friction parameter. Our results indicate that dramatic changes in the basal conditions occurred between 1973 to 1983. Prior to the surge, periodic changes can be observed between winter and summer, with a regular increase of the sliding from 1973 to 1982. During the surge, the basal friction decreased dramatically and an area of very low friction moved from the upper part of the glacier to its terminus. Using a more complex friction law, these changes in basal sliding are then interpreted in terms of basal water pressure. Our results support that dramatic changes took place in the subglacial drainage system of Variegated Glacier, moving from a relatively efficient drainage system prior to the surge to an inefficient one during the surge. By reconstructing the water pressure evolution at the base of the glacier it is possible to propose a scenario for the hydrological history leading to the occurrence of a surge.

Stomatal Responses to Light and Drought Stress in Variegated Leaves of Hedera helix1

Science.gov (United States)

Aphalo, Pedro J.; Sánchez, Rodolfo A.

1986-01-01

Direct and indirect mechanisms underlying the light response of stomata were studied in variegated leaves of the juvenile phase of Hedera helix L. Dose response curves of leaf conductance were measured with blue and red light in leaves kept in normal or in an inverted position. In the green portions of the leaves, the sensitivity to blue light was nearly 100 times higher than that to red light. No response to red light was observed in the white portions of the leaves up to 90 micromoles per square meter per second. Red light indirectly affected leaf conductance while blue light had a direct effect. Leaf conductance was found to be more sensitive to drought stress and showed a more persistent aftereffect in the white portions of the leaves. A differential effect of drought stress on the responses to blue and red light was also observed. PMID:16664900

Weakener of white (Wow), a gene that modifies the expression of the white eye color locus and that suppresses position effect variegation in Drosophila melanogaster.

Science.gov (United States)

Birchler, J A; Bhadra, U; Rabinow, L; Linsk, R; Nguyen-Huynh, A T

1994-08-01

A locus is described in Drosophila melanogaster that modifies the expression of the white eye color gene. This trans-acting modifier reduces the expression of the white gene in the eye, but elevates the expression in other adult tissues. Because of the eye phenotype in which the expression of white is lessened but not eliminated, the newly described locus is called the Weakener of white (Wow). Northern analysis reveals that Wow can exert an inverse or direct modifying effect depending upon the developmental stage. Two related genes, brown and scarlet, that are coordinately expressed with white, are also affected by Wow. In addition, Wow modulates the steady state RNA level of the retrotransposon, copia. When tested with a white promoter-Alcohol dehydrogenase reporter. Wow confers the modifying effect to the reporter, suggesting a requirement of the white regulatory sequences for mediating the response. In addition to being a dosage sensitive regulator of white, brown, scarlet and copia, Wow acts as a suppressor of position effect variegation. There are many dosage sensitive suppressors of position effect variegation and many dosage-sensitive modifiers of gene expression. The Wow mutations provide evidence for an overlap between the two types of modifiers.

Characterization of a new potyvirus causing mosaic and flower variegation in Catharanthus roseus in Brazil

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Sheila Conceição Maciel

2011-12-01

Full Text Available Catharanthus roseus is a perennial, evergreen herb in the family Apocynaceae, which is used as ornamental and for popular medicine to treat a wide assortment of human diseases. This paper describes a new potyvirus found causing mosaic symptom, foliar malformation and flower variegation in C. roseus. Of 28 test-plants inoculated mechanically with this potyvirus, only C. roseus and Nicotiana benthamiana developed systemic mosaic, whereas Chenopodium amaranticolor and C. quinoa exhibited chlorotic local lesions. The virus was transmitted by Aphis gossypii and Myzus nicotianae. When the nucleotide sequence of the CP gene (768nt was compared with other members of the Potyviridae family, the highest identities varied from 67 to 76 %. For the 3' UTR (286nt, identities varied from 16.8 to 28.6 %. The name Catharanthus mosaic virus (CatMV is proposed for this new potyvirus.

FitzPatrick Lecture: King George III and the porphyria myth - causes, consequences and re-evaluation of his mental illness with computer diagnostics.

Science.gov (United States)

Peters, Timothy

2015-04-01

Recent studies have shown that the claim that King George III suffered from acute porphyria is seriously at fault. This article explores some of the causes of this misdiagnosis and the consequences of the misleading claims, also reporting on the nature of the king's recurrent mental illness according to computer diagnostics. In addition, techniques of cognitive archaeology are used to investigate the nature of the king's final decade of mental illness, which resulted in the appointment of the Prince of Wales as Prince Regent. The results of this analysis confirm that the king suffered from bipolar disorder type I, with a final decade of dementia, due, in part, to the neurotoxicity of his recurrent episodes of acute mania. © 2015 Royal College of Physicians.

Effects of Elevated Ozone on Polka Dot Plant (Hypoestes phyllostachya) with Variegated Leaves.

Science.gov (United States)

Sui, J X; Wen, M X; Jia, L L; Chen, Y J; Li, C H; Zhang, L

2017-10-01

In this study, impacts of O 3 on four cultivars ('Rose', 'Pink', 'Blush' and 'White') of the polka dot plant with variegated leaves were investigated for the first time. Ozone fumigation [(120 ± 20 ppb) for 14 days (8 h day -1 , from 8:30 to 16:30)] resulted in visible foliar injuries, decreased contents of pigments (chlorophyll a and b, and carotenoid), the inhibition of photosynthesis, the increase of quantum yield of non-regulated heat dissipation and fluorescence emission (Y(NO)), and the damage of cell membrane. Elevated O 3 increased the content of anthocyanin (Ant). 'White' showed the highest, and 'Rose' the lowest amount of injured leaf area, indicating that the former was the most sensitive, and the latter the most tolerant to O 3 stress. After O 3 exposure, the highest Ant content was found in 'Rose', followed by 'Pink', 'Blush', and 'White'. Levels of Ant were likely responsible for the different sensitivities to O 3 due to their roles in photoprotection.

Hexachlorobenzene impairs glucose metabolism in a rat model of porphyria cutanea tarda: a mechanistic approach

Energy Technology Data Exchange (ETDEWEB)

Mazzetti, Marta Blanca; Taira, Maria Cristina; Lelli, Sandra Marcela; Viale, Leonor Carmen San Martin de [Departamento de Quimica Biologica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, C1428BGA, Ciudad Autonoma Buenos Aires (Argentina); Dascal, Eduardo; Basabe, Juan Carlos [Centro de Investigaciones Endocrinologicas (CEDIE). Hospital de Ninos, Dr. Ricardo Gutierrez, C1425EDF, Ciudad Autonoma Buenos Aires (Argentina)

2004-01-01

Hexachlobenzene (HCB), one of the most persistent environmental pollutants, induces porphyria cutanea tarda (PCT). The aim of this work was to analyze the effect of HCB on some aspects of glucose metabolism, particularly those related to its neosynthesis in vivo. For this purpose, a time-course study on gluconeogenic enzymes, pyruvate carboxylase (PC), phosphoenolpyruvate carboxykinase (PEPCK), glucose-6-phosphatase (G-6-Pase) and on pyruvate kinase (PK), a glycolytic enzyme, was carried out. Plasma glucose and insulin levels, hepatic glycogen, tryptophan contents, and the pancreatic insulin secretion pattern stimulated by glucose were investigated. Oxidative stress and heme pathway parameters were also evaluated. HCB treatment decreased PC, PEPCK, and G-6-Pase activities. The effect was observed at an early time point and grew as the treatment progressed. Loss of 60, 56, and 37%, respectively, was noted at the end of the treatment when a considerable amount of porphyrins had accumulated in the liver as a result of drastic blockage of uroporphyrinogen decarboxylase (URO-D) (95% inhibition). The plasma glucose level was reduced (one-third loss), while storage of hepatic glucose was stimulated in a time-dependent way by HCB treatment. A decay in the normal plasma insulin level was observed as fungicide intoxication progressed (twice to four times lower). However, normal insulin secretion of perifused pancreatic Langerhans islets stimulated by glucose during the 3rd and 6th weeks of treatment did not prove to be significantly affected. HCB promoted a time-dependent increase in urinary chemiluminiscence (fourfold) and hepatic malondialdehide (MDA) content (fivefold), while the liver tryptophan level was only raised at the longest intoxication times. These results would suggest that HCB treatment does not cause a primary alteration in the mechanism of pancreatic insulin secretion and that the changes induced by the fungicide on insulin levels would be an adaptative

Premature Calcifications of Costal Cartilages: A New Perspective Premature Calcifications of Costal Cartilages: A New Perspective

International Nuclear Information System (INIS)

Rhomberg, W.; Schuster, A.

2014-01-01

Calcifications of the costal cartilages occur, as a rule, not until the age of 30 years. The knowledge of the clinical significance of early and extensive calcifications is still incomplete. Materials and Methods. A search was made to find patients below the age of 30 years who showed distinct calcifications of their lower costal cartilages by viewing 360 random samples of intravenous pyelograms and abdominal plain films. The histories, and clinical and laboratory findings of these patients were analyzed. Results. Nineteen patients fulfilled the criteria of premature calcifications of costal cartilages (CCCs). The patients had in common that they were frequently referred to a hospital and were treated by several medical disciplines. Nevertheless many complaints of the patients remained unsolved. Premature CCCs were often associated with rare endocrine disorders, inborn errors of metabolism, and abnormal hematologic findings. Among the metabolic disorders there were 2 proven porphyrias and 7 patients with a suspected porphyria but with inconclusive laboratory findings. Conclusion. Premature CCCs are unlikely to be a normal variant in skeletal radiology. The findings in this small group of patients call for more intensive studies, especially in regard to the putative role of a porphyria

Infrared spectroscopy: a potential tool in huanglongbing and citrus variegated chlorosis diagnosis.

Science.gov (United States)

Cardinali, Marcelo Camponez do Brasil; Villas Boas, Paulino Ribeiro; Milori, Débora Marcondes Bastos Pereira; Ferreira, Ednaldo José; França e Silva, Marina; Machado, Marcos Antonio; Bellete, Barbara Sayuri; da Silva, Maria Fatima das Graças Fernandes

2012-03-15

Huanglongbing (HLB) and citrus variegated chlorosis (CVC) are serious threats to citrus production and have caused considerable economic losses worldwide, especially in Brazil, which is one of the biggest citrus producers in the world. Neither disease has a cure nor an efficient means of control. They are also generally confused with each other in the field since they share similar initial symptoms, e.g., yellowing blotchy leaves. The most efficient tool for detecting these diseases is by polymerase chain reaction (PCR). However, PCR is expensive, is not high throughput, and is subject to cross reaction and contamination. In this report, a diagnostic method is proposed for detecting HLB and CVC diseases in leaves of sweet orange trees using attenuated total reflectance Fourier transform infrared spectroscopy and the induced classifier via partial least-squares regression. Four different leaf types were considered: healthy, CVC-symptomatic, HLB-symptomatic, and HLB-asymptomatic. The results show a success rate of 93.8% in correctly identifying these different leaf types. In order to understand which compounds are responsible for the spectral differences between the leaf types, samples of carbohydrates starch, sucrose, and glucose, flavonoids hesperidin and naringin, and coumarin umbelliferone were also analyzed. The concentration of these compounds in leaves may vary due to biotic stresses. Copyright © 2012 Elsevier B.V. All rights reserved.

Sexual differences in destructive capability and midgut enzyme activities in adult variegated grasshoppers Zonocerus variegatus (LINNAEUS, 1758 (Orthoptera: Pyrgomorphidae

Directory of Open Access Journals (Sweden)

Ademolu Kehinde O.

2016-12-01

Full Text Available The variegated grasshopper Zonocerus variegatus is a polyphagous insect, feeding on numerous food and cash crops. The present study aimed to investigate the sexual variations in the destructive capability of the adult insects and the composition of leaves damaged by them, as well as in the levels of midgut microbial flora and digestive enzymes (cellulase, amylase and α-glucosidase. The results showed that females consumed and caused more damage to cassava leaves than their male congeners. The leaves damaged by males contained more nutrients than those damaged by females. The gut microbial flora and enzyme assay showed that females had significantly larger colony forming units and a non-significant difference in enzyme activities. It can thus be concluded that adult females are more destructive than males.

Peculiarities of 137Cs accumulation by macromycetes in dry bors of Ukrainian Polessye

International Nuclear Information System (INIS)

Orlov, O.O.; Kurbet, T.B.; Kalyish, O.B.; Prishchepa, O.L.

2001-01-01

The main ecological peculiarities of dry bor in Ukrainian Polessye were given. Research were carried out in Central Polessie of Ukraine during 1997 - 1999. Results were obtained due to spectrometric measurement of specific activity of 137 Cs in fruit bodies of mushrooms and in the soil. Species composition of macromycetes was divided on homogeneous groups on intensity of 13 7Cs accumulation. Amanita porphyria, A. muscaria and Tricholoma portentosum belong to the group of weak 137 Cs accumulation from the soil (TF = 15 - 20); Amanita pantherina, A. phalloides, Cantharellus cibarius, Boletus edulis, Tricholoma flavovirens and Laccaria laccata - to the group of moderate radionuclide accumulation (TF = 30 - 55). The group of strong 137 Cs accumulation (TF = 100 - 180) consists of Suillus variegates, S. bovines and Hydnum imbricatum; and group of very strong accumulation (TF 200 - 280) - of Xerocomus badius, Lactarius rufus, Russula xerampelina, Cortinarius varius and Paxillus involutus. Cortinarius sanguineus (with TF 400) is an accumulator of 137 Cs. Comparative evaluation of dry bor was given from the point of view of purchase of edible macromycetes in it

Development and systematic validation of qPCR assays for rapid and reliable differentiation of Xylella fastidiosa strains causing citrus variegated chlorosis.

Science.gov (United States)

Li, Wenbin; Teixeira, Diva C; Hartung, John S; Huang, Qi; Duan, Yongping; Zhou, Lijuan; Chen, Jianchi; Lin, Hong; Lopes, Silvio; Ayres, A Juliano; Levy, Laurene

2013-01-01

The xylem-limited, Gram-negative, fastidious plant bacterium Xylella fastidiosa is the causal agent of citrus variegated chlorosis (CVC), a destructive disease affecting approximately half of the citrus plantations in the State of São Paulo, Brazil. The disease was recently found in Central America and is threatening the multi-billion U.S. citrus industry. Many strains of X. fastidiosa are pathogens or endophytes in various plants growing in the U.S., and some strains cross infect several host plants. In this study, a TaqMan-based assay targeting the 16S rDNA signature region was developed for the identification of X. fastidiosa at the species level. Another TaqMan-based assay was developed for the specific identification of the CVC strains. Both new assays have been systematically validated in comparison with the primer/probe sets from four previously published assays on one platform and under similar PCR conditions, and shown to be superior. The species specific assay detected all X. fastidiosa strains and did not amplify any other citrus pathogen or endophyte tested. The CVC-specific assay detected all CVC strains but did not amplify any non-CVC X. fastidiosa nor any other citrus pathogen or endophyte evaluated. Both sets were multiplexed with a reliable internal control assay targeting host plant DNA, and their diagnostic specificity and sensitivity remained unchanged. This internal control provides quality assurance for DNA extraction, performance of PCR reagents, platforms and operators. The limit of detection for both assays was equivalent to 2 to 10 cells of X. fastidiosa per reaction for field citrus samples. Petioles and midribs of symptomatic leaves of sweet orange harbored the highest populations of X. fastidiosa, providing the best materials for detection of the pathogen. These new species specific assay will be invaluable for molecular identification of X. fastidiosa at the species level, and the CVC specific assay will be very powerful for the

Anesthesia for hemicolectomy in a known porphyric with cecal malignancy

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B K Naithani

2015-01-01

Full Text Available Intraoperative management of a known acute intermittent porphyria patient is a challenge requiring awareness of factors, which trigger an acute crisis, clinical features of a porphyric attack, knowledge of safe pharmacologic intervention, and preparedness for reintubation and ventilatory support. The classical signs of a porphyric crisis such as pain abdomen, vomiting and neuropsychiatric symptoms are masked under general anesthesia and can be confused with postoperative pain and vomiting and postoperative cognitive dysfunction, especially for intra-abdominal surgeries. Eternal vigilance for onset of an acute crisis is imperative. After a crisis of acute intermittent porphyria, residual paresis may persist for years in the absence of further attacks.

A triply cloned strain of xylella fastidiosa multiplies and induces symptoms of citrus variegated chlorosis in sweet orange

Science.gov (United States)

Li; Zreik; Fernandes; Miranda; Teixeira; Ayres; Garnier; Bov

1999-08-01

Xylella fastidiosa isolate 8.1.b obtained from a sweet orange tree affected by citrus variegated chlorosis in the state of Sao Paulo, Brazil, and shown in 1993 to be the causal agent of the disease, was cloned by repeated culture in liquid and on solid PW medium, yielding triply cloned strain 9a5c. The eighth and the 16th passages of strain 9a5c were mechanically inoculated into sweet orange plants. Presence of X. fastidiosa in sweet orange leaves of shoots having grown after inoculation (first-flush shoots) was detected by DAS-ELISA and PCR. Thirty-eight days after inoculation, 70% of the 20 inoculated plants tested positive, and all plants gave strong positive reactions 90 days after inoculation. Symptoms first appeared after 3 months and were conspicuous after 5 months. X. fastidiosa was reisolated from sweet orange leaves, 44 days after inoculation. These results indicate that X. fastidiosa strain 9a5c, derived from pathogenic isolate 8.1.b by triply cloning, is also pathogenic. Strain 9a5c is now used for the X. fastidiosa genome sequencing project undertaken on a large scale in Brazil.http://link. springer-ny.com/link/service/journals/00284/bibs/39n2p106.html

Molybdenite Re-Os dating of Mo-Th-Nb-REE rich marbles: pre-Variscan processes in Moldanubian Variegated Group (Czech Republic

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Drábek Milan

2015-06-01

Full Text Available In an effort to contribute to the discussion concerning the age of rocks of the Moldanubian Variegated Group, we have undertaken Re-Os dating of molybdenite of banded carbonatite-like marbles (CLM from the graphite mine Václav at Bližná (Southern Bohemia, which belong to the metamorphic sequence of this group. The Re-Os model ages for the molybdenites range between 493 and 497 Ma and apparently correspond to the early stages of metamorphism connected with pre-Variscan rift-related tectono-metamorphic events, which affected and recrystallized sedimentary CLM material rich in Mo-Th-Nb-REE. The molybdenite bearing carbonatite like marbles situated in the footwall of Bližná graphite mine have been interpreted as carbonates with a large share of volcano-detritic material derived from contemporaneous primitive alkaline (carbonatite-like volcanism deposited in a shallow marine lagoonal environment. There is no geological evidence for the participation of fluids mobilized from host rocks in the formation of the CLM. Because the Re-Os chronometer in molybdenite is demonstrably stable through later Variscan facies metamorphism, the molybdenite chronometer has not been affected by subsequent thermal overprints associated with the Variscan orogeny.

Circadian variation in metabolite and enzyme activities in the femoral and thoracic muscles of adult variegated grasshoppers, Zonocerus variegatus (Linnaeus, 1758 (Orthoptera: Pyrgomorphidae

Directory of Open Access Journals (Sweden)

Ademolu Kehinde Olutoyin

2018-03-01

Full Text Available The African variegated grasshopper, Zonocerus variegatus, exhibits daily variations in its feeding and destructive activities. A study to investigate circadian variation in metabolites (lipids, protein, glucose, K+, Ca2+, Mg2+, Cl− concentrations and enzymes (lipase, amylase, proteinase, α-glucosidase activities in the femoral and thoracic muscles of adult Z. variegatus was carried out by collecting samples at 06:00, 12:00, 18:00 and 24:00 hrs GMT. The four enzymes were present throughout the day in both thoracic and femoral muscles but at varying levels. Significantly (p<0.05 higher enzymes activities were measured during the day (between 06:00 and 18:00 hours GMT (except proteinase than at night (24:00 hrs. Organic substances in the two tissues were present in significantly higher concentrations during the day than at night. Similarly, significantly more inorganic substances were recorded in the afternoon (12:00-18:00 hrs than at night in both femoral and thoracic muscles. It can thus be concluded that locomotor activities in Z. variegatus reach a peak during the day.

Porphyrins profile by high performance liquid chromatography ...

African Journals Online (AJOL)

E. Fateen

2008-09-07

Sep 7, 2008 ... acid dehydratase porphyria (ADP), acute intermittent por- phyria (AIP) ..... affecting motor neurons, and can lead to respiratory and bul- bar paralysis and ... variable degrees of fatty damage and chronic inflammatory changes [1]. ..... ppix influences the hematologic status and iron metabolism in patients with ...

A novel FKRP-related muscular dystrophy founder mutation in South ...

African Journals Online (AJOL)

porphyria variegata, familial hypercholesterolaemia, Gaucher's dis- ease and autosomal recessive polycystic kidney disease.[7-11]. FKRP founder mutations have been described in a number of populations around the world, for example the c.826C>A. (p.Leu276Ile) FKRP mutation in 20 LGMD German patients[12].

Mutaciones del gen de la Hemocromatosis en donantes de sangre voluntarios y en pacientes con Porfiria cutánea tarda en Chile Mutations of hemochromatosis gene in volunteer blood donors and Chilean porphyria cutanea tarda patients

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Carlos Wolff F

2006-10-01

Full Text Available La acumulación de hierro hepático asociada a mutaciones en el gen HFE de la hemocromatosis hereditaria (HH en los pacientes con porfiria cutánea tarda (PCT podría tener un papel en la etiología y en la expresión clínica de esta enfermedad. Se estudió la frecuencia de las mutaciones H63D y C282Y en un grupo de pacientes con PCT y se la comparó con la observada en un grupo de donantes voluntarios de sangre. Los pacientes con PCT fueron catalogados como portadores de la forma hereditaria o adquirida de la enfermedad, según presentaran o no mutaciones en el gen uroporfirinógeno decarboxilasa (UROD. El 50% de los pacientes con PCT eran portadores de la forma genética de la enfermedad, porcentaje significativamente mayor que lo informado en otras series. El 23% de los donantes voluntarios de sangre eran portadores de la mutación H63D y 2.4% lo era de la mutación C282Y. Frecuencias similares a lo encontrado por otros autores en población chilena de etnia blanca, en población argentina y española, pero significativamente más alta que lo encontrado en estudios en población aborigen araucana. Esto tiene, probablemente, relación con el predominio de ascendencia española en la población blanca chilena. La frecuencia de mutación en el gen HFE en pacientes con PCT no fue significativamente diferente que la observada en donantes voluntarios de sangre. Tampoco hubo diferencias significativas en la frecuencia de estas mutaciones entre los casos con PCT adquirida respecto de aquellos en que ésta era de origen genético. Los resultados obtenidos no permiten afirmar que exista asociación entre la PCT y la condición de portador de mutaciones del gen HFE de la hemocromatosis hereditaria.In patients with porphyria cutanea tarda (PCT, hepatic iron accumulation associated to hereditary hemochromatosis (HH could play a role in the etiology and in the clinical expression of the disease. The H63D and C282Y mutations of the HFE gene frequency were

Variegated operation of MAPS reactors after enmasse' coolant channel replacement: a tale-tell signature of high standard fuel bundle production quality

International Nuclear Information System (INIS)

Jena, J.K.; Sahu, J.K.; Arularasan, V.; Sivagurnathan, D.; Rathakrishnan, S.; Ramamurthy, K.

2009-01-01

After the Enmasse' Coolant Channel Replacement (EMCCR) of both the reactors of Madras Atomic Power Station (MAPS), they have put up a good performance, as far as core integrity is considered. This is a tale-tell signature of the high quality of the fuel bundles manufactured by Nuclear Fuel Complex (NFC), Hyderabad. Both the reactor cores have been loaded with various types of fuel bundles viz. Natural Uranium (NU), Depleted Uranium (DU), and Deeply Depleted Uranium (DDU) and were operated at different power level with different flux configuration at different stages of operation. Even around 1026 low burn up bundle (<2500 MWD/TeU) were transferred from MAPS-1 to MAPS-2, first time in the history of PHWRS. During all such variegated operations, the Primary Heat Transport (PHT) system 131 I activity, which is synonymous with the core integrity, was maintaining low for most of the reactor operation period. However, recently a low burn up fuel bundle failure has been observed in MAPS-1. Even though the overall failure rate is very low, the cause of such failure needs to be ascertained for taking appropriate action to maintain the high standards of quality in the manufacturing process of the fuel bundles. (author)

Porphyria

Science.gov (United States)

... may include: Beta-carotene supplements to lessen photosensitivity Chloroquine in low doses to reduce levels of porphyrins ... skin Avoid sunlight as much as possible and use sunscreen when outside Eat a high-carbohydrate diet ...

Alternation of host plants as a survival mechanism of leafhoppers Dilobopterus costalimai and Oncometopia facialis (Hemiptera: Cicadellidae, vectors of the Citrus Variegated Chlorosis (CVC

Directory of Open Access Journals (Sweden)

Milanez José Maria

2001-01-01

Full Text Available Dilobopterus costalimai (Young and Oncometopia facialis (Signoret are two of the most important species of citrus leafhoppers, vectors of bacterium Xylella fastidiosa which causes the Citrus Variegated Chlorosis (CVC disease. To develop a rearing technique for these species under laboratory conditions, the egg laying preference and nymph development were studied in different breeding systems: Rangpur lime (Citrus limonia and "falso boldo" (Vernonia condensata as host plants. Trials were set up in a randomized block design with three treatments (n=8. Females of D. costalimai had particular preference for ovipositing on Rangpur lime leaves while O. facialis females placed a higher number of eggs on "falso boldo", but it did not differ statistically from the Rangpur lime. The nymphal viability of D. costalimai was null in Rangpur lime and 58% in "falso boldo". For O. facialis the nymphal viability was 25 and 78% in Rangpur lime and "falso boldo", respectively. "Falso boldo" is more suitable as a host plant to rear the two species of citrus leafhoppers. The alternation of host plants seems to be an important survival mechanism of the CVC-vector species, as shown in natural conditions.

Beach almond (Terminalia catappa, Combretaceae seed production and predation by scarlet macaws (Ara macao and variegated squirrels (Sciurus variegatoides

Directory of Open Access Journals (Sweden)

Jonathan J. Henn

2014-09-01

Full Text Available Knowledge of ecological impacts of exotic beach almond (Terminalia catappa in the central Pacific of Costa Rica are little known, but studies have found this species to be a potentially important food source for endangered scarlet macaws (Ara macao. In this study, reproductive phenology and seed predation by variegated squirrels (Sciurus variegatoides and scarlet macaws were measured during March and April 2011 on beaches of central Pacific coastal Costa Rica. Seed productivity and predation levels were quantified on a weekly basis for 111 beach almond trees to assess the importance of beach almond as a food source for scarlet macaws and the extent of resource partitioning between seed predators. Seed production of the trees was great (about 194 272 seeds and approximately 67% of seeds were predated by seed predators. Macaws consumed an estimated 49% of seeds while squirrels consumed 18%. Additionally, evidence of resource partitioning between squirrels and macaws was found. Scarlet macaws preferred to feed on the northern side and edge of the canopy while squirrels preferred to feed on the southern and inside parts of the canopy. Both species ate most seeds on the ocean side of the tree. Despite the status of this tree as an exotic species, the beach almond appears to be an important resource for scarlet macaw population recovery. The resource produced by this tree should be taken into account as reforestation efforts continue in Costa Rica. Rev. Biol. Trop. 62 (3: 929-938. Epub 2014 September 01.

JIL-1 and Su(var)3-7 Interact Genetically and Counteract Each Other's Effect on Position-Effect Variegation in Drosophila

Science.gov (United States)

Deng, Huai; Cai, Weili; Wang, Chao; Lerach, Stephanie; Delattre, Marion; Girton, Jack; Johansen, Jørgen; Johansen, Kristen M.

2010-01-01

The essential JIL-1 histone H3S10 kinase is a key regulator of chromatin structure that functions to maintain euchromatic domains while counteracting heterochromatization and gene silencing. In the absence of the JIL-1 kinase, two of the major heterochromatin markers H3K9me2 and HP1a spread in tandem to ectopic locations on the chromosome arms. Here we address the role of the third major heterochromatin component, the zinc-finger protein Su(var)3-7. We show that the lethality but not the chromosome morphology defects associated with the null JIL-1 phenotype to a large degree can be rescued by reducing the dose of the Su(var)3-7 gene and that Su(var)3-7 and JIL-1 loss-of-function mutations have an antagonistic and counterbalancing effect on position-effect variegation (PEV). Furthermore, we show that in the absence of JIL-1 kinase activity, Su(var)3-7 gets redistributed and upregulated on the chromosome arms. Reducing the dose of the Su(var)3-7 gene dramatically decreases this redistribution; however, the spreading of H3K9me2 to the chromosome arms was unaffected, strongly indicating that ectopic Su(var)3-9 activity is not a direct cause of lethality. These observations suggest a model where Su(var)3-7 functions as an effector downstream of Su(var)3-9 and H3K9 dimethylation in heterochromatic spreading and gene silencing that is normally counteracted by JIL-1 kinase activity. PMID:20457875

Citrus Functional Genomics and Molecular Modeling in Relation to Citrus sinensis (Sweet Orange) Infection with Xylella fastidiosa (Citrus Variegated Chlorosis).

Science.gov (United States)

Dwivedi, Upendra N; Tiwari, Sameeksha; Prasanna, Pragya; Awasthi, Manika; Singh, Swati; Pandey, Veda P

2016-08-01

Citrus are among the economically most important fruit tree crops in the world. Citrus variegated chlorosis (CVC), caused by Xylella fastidiosa infection, is a serious disease limiting citrus production at a global scale. With availability of citrus genomic resources, it is now possible to compare citrus expressed sequence tag (EST) data sets and identify single-nucleotide polymorphisms (SNPs) within and among different citrus cultivars that can be exploited for citrus resistance to infections, citrus breeding, among others. We report here, for the first time, SNPs in the EST data sets of X. fastidiosa-infected Citrus sinensis (sweet orange) and their functional annotation that revealed the involvement of eight C. sinensis candidate genes in CVC pathogenesis. Among these genes were xyloglucan endotransglycosylase, myo-inositol-1-phosphate synthase, and peroxidase were found to be involved in plant cell wall metabolism. These have been further investigated by molecular modeling for their role in CVC infection and defense. Molecular docking analyses of the wild and the mutant (SNP containing) types of the selected three enzymes with their respective substrates revealed a significant decrease in the binding affinity of substrates for the mutant enzymes, thus suggesting a decrease in the catalytic efficiency of these enzymes during infection, thereby facilitating a favorable condition for infection by the pathogen. These findings offer novel agrigenomics insights in developing future molecular targets and strategies for citrus fruit cultivation in ways that are resistant to X. fastidiosa infection, and by extension, with greater harvesting efficiency and economic value.

Skin changes in chronic kidney disease

OpenAIRE

Joanna M. Przepiórka-Kosińska; Katarzyna M. Chyl-Surdacka; Joanna Bartosińska; Dorota Krasowska; Grażyna Chodorowska

2017-01-01

Chronic kidney disease causes skin changes which may sometimes be the first sign of kidney failure. Specific skin changes include acquired perforating dermatosis, porphyria cutanea tarda, pseudoporphyria, calcinosis and nephrogenic systemic fibrosis. The majority of patients present with cutaneous manifestations which are classified as non-specific, including xerosis, pruritus, pigmentation disturbances, nail plate abnormalities, uraemic frost and gynaecomastia. Treatment improving kidney fun...

Filiform serrated adenomatous polyposis arising in a diverted rectum of an inflammatory bowel disease patient

DEFF Research Database (Denmark)

Klarskov, Louise; Mogensen, Anne Mellon; Jespersen, Niels

2011-01-01

Klarskov L, Mogensen AM, Jespersen N, Ingeholm P, Holck S. Filiform serrated adenomatous polyposis arising in a diverted rectum of an inflammatory bowel disease patient. APMIS 2011; 119: 393-8. A 54-year-old man, previously colectomized for inflammatory bowel disease, developed carcinoma in the i......Klarskov L, Mogensen AM, Jespersen N, Ingeholm P, Holck S. Filiform serrated adenomatous polyposis arising in a diverted rectum of an inflammatory bowel disease patient. APMIS 2011; 119: 393-8. A 54-year-old man, previously colectomized for inflammatory bowel disease, developed carcinoma...... during the adenoma carcinoma sequence included the acquisition of CK7 expression in the malignant portion. Gastric mucin may play a role in the initial step of the neoplastic evolution and CK7 may denote neoplastic progression. This case confirms the notion of a widely variegated morphology of precursor...

Chemotherapy in the management of brain metastases: the emerging role of fotemustine for patients with melanoma and NSCLC.

Science.gov (United States)

Addeo, Raffaele; Zappavigna, Silvia; Luce, Amalia; Facchini, Sergio; Caraglia, Michele

2013-09-01

An estimated 20 - 40% of cancer patients will develop brain metastases that are the most common intracranial tumors in adults. Patients with cerebral metastases represent a variegate group where selection of the most appropriate treatment depends on many patient- and disease-related factors. The impact of therapeutic option on overall survival is lacking and it is important to consider quality of life (QOL) when treating patients with brain metastases. A considerable proportion of patients are treated with palliative approaches such as whole-brain radiotherapy. The role of chemotherapy was limited in the past. Recently, several chemotherapeutic agents have been identified as potentially useful. This article examines the pharmacokinetics, efficacy and safety and tolerability of fotemustine (FTM) for the management of patients with cerebral metastasis from melanoma and non-small cell lung cancer (NSCLC). FTM is a third-generation nitrosourea that has proved its efficacy on brain metastases of melanoma and showed promising results for the treatment of brain metastasis of NSCLC because of its ability to pass the blood-brain barrier.

Symptomatic Porphyria

African Journals Online (AJOL)

found in all livers, their numbers varied widely and they were seldom conspicuous in a given cell. The iron was mostly present in peribiliary lysosomes but free ferritin particles were occasionally observed in mito- chondria and the cytoplasmic ground substance in un- stained sections. Moderate amounts of lipid were present.

Pseudoporfyri er et symptomkompleks

DEFF Research Database (Denmark)

Velander, Marie Juul; Þorsteinsdóttir, Sunna; Bygum, Anette

2015-01-01

Pseudoporphyria is a photosensitive bullous disease, which resembles porphyria cutanea tarda. Normal porphyrin levels in urine, stool and blood define pseudoporphyria. Pseudoporphyria is associated with chronic renal failure, haemodialysis, a variety of drugs (e.g. naproxen, nabumetone, furosemid......, ciprofloxacin, voriconazole, acitretin), tanning beds and UVA exposure. Treatment consists of UV protection and cessation of suspected agents. Patients in haemodialysis can benefit from treatment with N-acetylcysteine or glutathione....

Mutations in ash1 and trx enhance P-element-dependent silencing in Drosophila melanogaster.

Science.gov (United States)

McCracken, Allen; Locke, John

2016-08-01

In Drosophila melanogaster, the mini-w(+) transgene in Pci is normally expressed throughout the adult eye; however, when other P or KP elements are present, a variegated-eye phenotype results, indicating random w(+) silencing during development called P-element-dependent silencing (PDS). Mutant Su(var)205 and Su(var)3-7 alleles act as haplo-suppressors/triplo-enhancers of this variegated phenotype, indicating that these heterochromatic modifiers act dose dependently in PDS. Previously, we recovered a spontaneous mutation of P{lacW}ci(Dplac) called P{lacW}ci(DplacE1) (E1) that variegated in the absence of P elements, presumably due to the insertion of an adjacent gypsy element. From a screen for genetic modifiers of E1 variegation, we describe here the isolation of five mutations in ash1 and three in trx that enhance the E1 variegated phenotype in a dose-dependent and cumulative manner. These mutant alleles enhance PDS at E1, and in E1/P{lacW}ci(Dplac), but suppress position effect variegation (PEV) at In(1)w(m)(4). This opposite action is consistent with a model where ASH1 and TRX mark transcriptionally active chromatin domains. If ASH1 or TRX function is lost or reduced, heterochromatin can spread into these domains creating a sink that diverts heterochromatic proteins from other variegating locations, which then may express a suppressed phenotype.

Urinary porphyrin excretion in hepatitis C infection

OpenAIRE

Vogeser, Michael; Jacob, Karl; Zachoval, Reinhart

1999-01-01

A high prevalence of hepatitis C virus infection in porphyria cutanea tarda in some populations suggests a close link between viral hepatitis and alteration of porphyrin metabolism. Moreover, there is evidence of a role of porphyrinopathies in hepatocarcinogenesis. The aim of our study was to obtain data on the prevalence and patterns of heme metabolism alterations in patients with chronic hepatitis C virus infection. Urinary porphyrin excretion was prospectively studied in 100 consecutive ou...

Skin changes in chronic kidney disease

Directory of Open Access Journals (Sweden)

Joanna M. Przepiórka-Kosińska

2017-04-01

Full Text Available Chronic kidney disease causes skin changes which may sometimes be the first sign of kidney failure. Specific skin changes include acquired perforating dermatosis, porphyria cutanea tarda, pseudoporphyria, calcinosis and nephrogenic systemic fibrosis. The majority of patients present with cutaneous manifestations which are classified as non-specific, including xerosis, pruritus, pigmentation disturbances, nail plate abnormalities, uraemic frost and gynaecomastia. Treatment improving kidney function (dialysis therapy or kidney transplantation also leads to the resolution of skin lesions.

Ekstrahepatiske manifestationer af hepatitis C-virus-infektion

DEFF Research Database (Denmark)

Risum, Malene

2011-01-01

Hepatitis C does not only affect the liver, but also manifests outside the liver. The skin, kidneys and nervous system are often involved due to mixed cryoglobulinaemia. Porphyria cutanea tarda, lymphoma and thyroid diseases among others can also attend a chronic infection, but the exact...... pathogenesis behind these manifestations is not clearly mapped. Antiviral treatment is reported to induce sustained virological response in more than half of the treated patients with a variable clinical response in the extrahepatic manifestations....

Management of chimera and in vitro mutagenesis for development of new flower color/shape and chlorophyll variegated mutants in chrysanthemum

Energy Technology Data Exchange (ETDEWEB)

Datta, S.K. [CSIR, Madhyamgram Experimental Farm, Bose Institute, Kolkata (India)], E-mail: subodhskdatta@rediffmail.com; Chakrabarty, D [Floriculture Laboratory, National Botanical Research Institute, Lucknow (India)

2008-07-01

Induced mutagenesis has played a major role in the development of many new flower color/shape mutant varieties in ornamentals. The main bottleneck with vegetatively propagated plants is that the mutation appears as a chimera whether developed through bud sport or through induced mutation. The size of the mutant sector varies from a narrow streak on a petal to the entire flower and from a portion of a branch to the entire branch. When a portion of a branch or entire branch is mutated, the mutant tissue can be isolated; on the other hand, a small sector of a mutated branch or flower cannot be isolated using the available conventional propagation techniques. A novel technique has been standardized in our laboratory for the management of chimeric tissues through direct shoot regeneration from chrysanthemum florets. 'Kasturba Gandhi', a large white flowered chrysanthemum, developed few chimeric yellow florets due to spontaneous mutation. Using in vitro protocol new yellow florets were established in pure form. In vitro mutagenesis experiments were conducted treating ray florets of chrysanthemum cultivars using gamma rays. Induced chimeric yellow, white, light yellow, light mauve and dark mauve floret color sectors and chlorophyll variegation in leaves of cv. 'Maghi' (with mauve floret and green leaves) have been established in pure form. Gamma ray induced sectorial yellow florets of cv. 'Lilith' (white floret) and yellow ray florets in both the cvs. 'Purnima' (with white florets) and 'Colchi Bahar' (with red florets) have been isolated in pure form through in vitro management. Induced sectorial flower color/shape mutations in cvs. 'Puja', 'Lalima', 'Flirt', 'Maghi' and 'Sunil' have been isolated in pure form through in vitro culture. Gamma radiation procedure and tissue culture techniques have been optimized to regenerate plants from stem internodes, stem node, shoot tip and ray florets. Present technique has opened a new way for isolating new flower color

Variegated colors of pediatric glioblastoma multiforme: what to expect?

Directory of Open Access Journals (Sweden)

Vivek Immanuel

2017-08-01

Full Text Available Malignant gliomas account for 35-45% of primary brain tumors; among these glioblastoma multiforme (GBM is the most common adult brain tumor constituting approximately 85%. Its incidence is quite less in the pediatric population and treatment of these patients is particularly challenging. Exposure to ionizing radiation is the only environmental factor found to have any significant association with GBM. Several genetic alterations associated with GBM in adults have been well documented such as epidermal growth factor receptor amplification, overexpression of mouse double minute 2 homolog also known as E3 ubiquitin-protein ligase, Phosphatase and tensin homolog gene mutation, loss of heterozygosity of chromosome 10p and isocitrate dehydrogenase-1 mutation. However, data on genetic mutations in pediatric GBM is still lacking. Exophytic brain stem gliomas are rare tumors and are usually associated with a poor prognosis. The most effective treatment in achieving long-term survival in such patients, is surgical excision of the tumor and then chemoradiotherapy followed by adjuvant chemotherapy by temozolomide. This schedule is the standard treatment for GBM patients. In view of the rarity of pediatric GBM, we report here a case of pontine GBM in a 5-year-old girl.

Spectral design flexibility of LED brings better life

Science.gov (United States)

Ou, Haiyan; Corell, Dennis; Ou, Yiyu; Poulsen, Peter B.; Dam-Hansen, Carsten; Petersen, Paul-Michael

2012-03-01

Light-emitting diodes (LEDs) are penetrating into the huge market of general lighting because they are energy saving and environmentally friendly. The big advantage of LED light sources, compared to traditional incandescent lamps and fluorescent light tubes, is the flexible spectral design to make white light using different color mixing schemes. The spectral design flexibility of white LED light sources will promote them for novel applications to improve the life quality of human beings. As an initial exploration to make use of the spectral design flexibility, we present an example: 'no blue' white LED light source for sufferers of disease Porphyria. An LED light source prototype, made of high brightness commercial LEDs applying an optical filter, was tested by a patient suffering from Porphyria. Preliminary results have shown that the sufferer could withstand the light source for much longer time than the standard light source. At last future perspectives on spectral design flexibility of LED light sources improving human being's life will be discussed, with focus on the light and health. The good health is ensured by the spectrum optimized so that vital hormones (melatonin and serotonin) are produced during times when they support human daily rhythm.

Learning about Porphyria

Science.gov (United States)

... HIV, estrogens (such as those used in oral contraceptives and prostate cancer treatment), and possibly smoking, combine ... pills, sedatives), chemicals, fasting, smoking, drinking alcohol, infections, emotional and physical stress, menstrual hormones, and exposure to ...

Porphyria cutanea tarda

DEFF Research Database (Denmark)

Bygum, A; Brandrup, F; Christiansen, L

2000-01-01

cases are sporadic but can be familiar due to mutations in the URO-D gene located on chromosome number 1. The disease may be exacerbated by environmental factors. Iron accumulation is a characteristic finding and there is an association to hereditary haemochromatosis. Therapeutic venesection reduces...

7 CFR 29.2408 - Rule 17.

Science.gov (United States)

2010-01-01

... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... percent of mixed color or variegated leaves or over 30 percent of mixed color and variegated leaves combined shall be classified as “mixed” and designated by the color symbol “M.” ...

7 CFR 29.2632 - Rule 16.

Science.gov (United States)

2010-01-01

... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... percent of mixed color or variegated leaves or over 30 percent of mixed color and variegated leaves combined shall be classified as “mixed” and designated by the color symbol “M.” ...

The iojap gene in maize

Energy Technology Data Exchange (ETDEWEB)

Martienssen, Robert

2001-12-01

The classical maize mutant iojap (Iodent japonica) has variegated green and white leaves. Green sectors have cells with normal chloroplasts whereas white sectors have cells where plastids fail to differentiate. These mutant plastids, when transmitted through the female gametophyte, do not recover in the presence of wild type Iojap. We cloned the Ij locus, and we have investigated the mechanism of epigenetic inheritance and phenotypic expression. More recently, a modifier of this type of variegation, ''Inhibitor of striate'', has also been cloned. Both the iojap and inhibitor of striate proteins have homologs in bacteria and are members of ancient conserved families found in multiple species. These tools can be used to address fundamental questions of inheritance and variegation associated with this classical conundrum of maize genetics. Since the work of Rhoades there has been considerable speculation concerning the nature of the Iojap gene product, the origin of leaf variegation and the mechanism behind the material inheritance of defective plastids. This has made Iojap a textbook paradigm for cytoplasmic inheritance and nuclear-organellar interaction for almost 50 years. Cloning of the Iojap gene in maize, and homologs in other plants and bacteria, provides a new means to address the origin of heteroplastidity, variegation and cytoplasmic inheritance in higher plants.

Somatically segregating clone of apomictic maize-tripsacum hybrid

International Nuclear Information System (INIS)

Yudin, B.F.; Lukina, L.A.

1988-01-01

The results of further study on clone AM-5, isolated in the progeny of γ-irradiated plants of the apomictic hybrid of maize with tripsacum (2n = 38) are reported. The variegated-leaf seedlings of the clone segregate somatically and produce variegated, mottled, green (phenotypically normal) plants in different ratios in the apomictic progenies. The variegated, and to a lesser degree, green segregants segregate further. The mottled apomictics as well as mottled branches of variegated seedlings maintain their phenotype on transplantation, however, these is a progressive enhancement of the characters of vegetative lethality. Lethals of two extra maize genomes to the AM-5 nucleus does not affect significantly the scope and nature of segregation. At the same time, the loss of tripsacum genome restores normal phenotype. Clone AM-5 is an example of hybrid apomictic form causing significant morphological variability, which is, nevertheless, not related with apomictic and reversion to the sexual process

Autonomic Neuropathy

Science.gov (United States)

... risk of autonomic neuropathy. Other diseases. Amyloidosis, porphyria, hypothyroidism and cancer (usually due to side effects from treatment) may also increase the risk of autonomic neuropathy. ...

Proteomic Analysis Reveals the Leaf Color Regulation Mechanism in Chimera Hosta "Gold Standard" Leaves.

Science.gov (United States)

Yu, Juanjuan; Zhang, Jinzheng; Zhao, Qi; Liu, Yuelu; Chen, Sixue; Guo, Hongliang; Shi, Lei; Dai, Shaojun

2016-03-08

Leaf color change of variegated leaves from chimera species is regulated by fine-tuned molecular mechanisms. Hosta "Gold Standard" is a typical chimera Hosta species with golden-green variegated leaves, which is an ideal material to investigate the molecular mechanisms of leaf variegation. In this study, the margin and center regions of young and mature leaves from Hosta "Gold Standard", as well as the leaves from plants after excess nitrogen fertilization were studied using physiological and comparative proteomic approaches. We identified 31 differentially expressed proteins in various regions and development stages of variegated leaves. Some of them may be related to the leaf color regulation in Hosta "Gold Standard". For example, cytosolic glutamine synthetase (GS1), heat shock protein 70 (Hsp70), and chloroplastic elongation factor G (cpEF-G) were involved in pigment-related nitrogen synthesis as well as protein synthesis and processing. By integrating the proteomics data with physiological results, we revealed the metabolic patterns of nitrogen metabolism, photosynthesis, energy supply, as well as chloroplast protein synthesis, import and processing in various leaf regions at different development stages. Additionally, chloroplast-localized proteoforms involved in nitrogen metabolism, photosynthesis and protein processing implied that post-translational modifications were crucial for leaf color regulation. These results provide new clues toward understanding the mechanisms of leaf color regulation in variegated leaves.

Adverse Health Effects in Humans Exposed to 2,3,7,8-Tetrachlorodibenzo-p-Dioxin(TCDD)

Czech Academy of Sciences Publication Activity Database

Pelclová, D.; Urban, P.; Preiss, J.; Lukáš, E.; Fenclová, Z.; Navrátil, Tomáš; Dubská, Z.; Šenholdová, Z.

2006-01-01

Roč. 21, č. 2 (2006), s. 119-138 ISSN 0048-7554 Institutional research plan: CEZ:AV0Z40400503 Keywords : chlorane * porphyria * diabetes * atherosclerosis Subject RIV: CF - Physical ; Theoretical Chemistry

Repair of DNA damage in light sensitive human skin diseases

Energy Technology Data Exchange (ETDEWEB)

Horkay, I.; Varga, L.; Tam' asi P., Gundy, S.

1978-12-01

Repair of uv-light induced DNA damage and changes in the semiconservative DNA synthesis were studied by in vitro autoradiography in the skin of patients with lightdermatoses (polymorphous light eruption, porphyria cutanea tarda, erythropoietic protoporphyria) and xeroderma pigmentosum as well as in that of healthy controls. In polymorphous light eruption the semiconservative DNA replication rate was more intensive in the area of the skin lesions and in the repeated phototest site, the excision repair synthesis appeared to be unaltered. In cutaneous prophyrias a decreased rate of the repair incorporation could be detected. Xeroderma pigmentosum was characterized by a strongly reduced repair synthesis.

Porphyria Cutanea Tarda (PCT)

Science.gov (United States)

... effective than phlebotomy or low dose hydroxychloroquine or chloroquine in treating individuals with PCT. However, these drugs may play a role in treating affected individuals in whom the use of the two front-line therapies is not ...

Porphyrin Tests

Science.gov (United States)

... Disorders Fibromyalgia Food and Waterborne Illness Fungal Infections Gout Graves Disease Guillain-Barré Syndrome Hashimoto Thyroiditis Heart ... Most porphyrias are inherited, the result of a gene mutation . They may be classified according to the ...

Testing the process of drilling - analysis of drilling performance in variegated sandstone and Keuper in Northern Germany; Der Bohrprozess auf dem Pruefstand - Analyse der Bohrleistungen im Buntsandstein und Keuper in Norddeutschland

Energy Technology Data Exchange (ETDEWEB)

Pust, G.; Tschaffler, H. [Mobil Erdgas Erdoel GmbH, Celle (Germany); Grunwald, R. [BEB Erdgas und Erdoel GmbH, Nienhagen (Germany); Gloth, H. [TU Bergakademie Freiberg (Germany); Marx, C. [ITE, Clausthal-Zellerfeld (Germany)

1998-12-31

The aim of the project launched jointly by DGMK and 5 companies from the German oil- and gas industry and two institutes for drilling technologies was to find suitable ways in which the drilling progress in formations with bad drilling conditions in Northern Germany, i.e. lower and middle variegated sandstone and Keuper can be increases in order to bring costs down. The borehole sunk in Northern Germany were surveyed and inventorised. Data were subjected to a thorough statistical analysis in order to obtain optimal drilling parameters and improve the drilling tools. Basic studies on rock damaging were also to be included in order to better understand the processes. Finally, the project aims at realising the optimal drilling parameters, increase drilling progress, use improved drilling machinery and thus cut costs. (orig.) [Deutsch] Ziel des DGMK-Gemeinschaftsprojektes mit 5 Firmen der deutschen Erdoel- und Erdgasindustrie sowie 2 bohrtechnischen Instituten war es, durch geeignete Massnahmen den Bohrfortschritt in schlechtbohrbaren Formationen in Norddeutschland, naemlich unterer und mittlerer Buntsandstein sowie Keuper, zu erhoehen und damit einen Beitrag zur Kostensenkung zu leisten. Um dieses Ziel zu erreichen, sollte eine Bestandsaufnahme der in Norddeutschland abgeteuften Bohrungen erfolgen. Die Daten sollten einer eingehenden statistischen Auswertung unterzogen werden. Hieraus sollten optimale Bohrparameter und Verbesserungen der Bohrwerkzeuge abgeleitet werden. Ferner sollten grundlegende Untersuchungen zur Gesteinszerstoerung herangezogen werden, um ein besseres Verstaendnis fuer die ablaufenden Prozesse zu bekommen. Durch die Realisierung optimaler Bohrparameter und den Einsatz verbesserter Bohrwerkszeuge sollte schliesslich die Erhoehung des Bohrfortschritts und damit eine Senkung der Kosten erreicht werden. (orig.)

Enhanced reliability and accuracy for field deployable bioforensic detection and discrimination of Xylella fastidiosa subsp. pauca, causal agent of citrus variegated chlorosis using razor ex technology and TaqMan quantitative PCR.

Science.gov (United States)

Ouyang, Ping; Arif, Mohammad; Fletcher, Jacqueline; Melcher, Ulrich; Ochoa Corona, Francisco Manuel

2013-01-01

A reliable, accurate and rapid multigene-based assay combining real time quantitative PCR (qPCR) and a Razor Ex BioDetection System (Razor Ex) was validated for detection of Xylella fastidiosa subsp. pauca (Xfp, a xylem-limited bacterium that causes citrus variegated chlorosis [CVC]). CVC, which is exotic to the United States, has spread through South and Central America and could significantly impact U.S. citrus if it arrives. A method for early, accurate and sensitive detection of Xfp in plant tissues is needed by plant health officials for inspection of products from quarantined locations, and by extension specialists for detection, identification and management of disease outbreaks and reservoir hosts. Two sets of specific PCR primers and probes, targeting Xfp genes for fimbrillin and the periplasmic iron-binding protein were designed. A third pair of primers targeting the conserved cobalamin synthesis protein gene was designed to detect all possible X. fastidiosa (Xf) strains. All three primer sets detected as little as 1 fg of plasmid DNA carrying X. fastidiosa target sequences and genomic DNA of Xfp at as little as 1 - 10 fg. The use of Razor Ex facilitates a rapid (about 30 min) in-field assay capability for detection of all Xf strains, and for specific detection of Xfp. Combined use of three primer sets targeting different genes increased the assay accuracy and broadened the range of detection. To our knowledge, this is the first report of a field-deployable rapid and reliable bioforensic detection and discrimination method for a bacterial phytopathogen based on multigene targets.

Pseudoporfyri er et symptomkompleks

DEFF Research Database (Denmark)

Velander, Marie Juul; Thorsteinsdóttir, Sunna; Bygum, Anette

2015-01-01

Pseudoporphyria is a photosensitive bullous disease, which resembles porphyria cutanea tarda. Normal porphyrin levels in urine, stool and blood define pseudoporphyria. Pseudoporphyria is associated with chronic renal failure, haemodialysis, a variety of drugs (e.g. naproxen, nabumetone, furosemide...

Secon dary dyslipidaemia

African Journals Online (AJOL)

2009-03-20

Mar 20, 2009 ... Lifest yle. Diet is regarded as the major reason for the enormous variation in cholesterol levels ... be major components of diet and may also contribute to obesity and weight gain. ... Acute intermittent porphyria. Cholestatic liver ...

The photodynamic and non-photodynamic actions of porphyrins

Directory of Open Access Journals (Sweden)

S.G. Afonso

1999-03-01

Full Text Available Porphyrias are a family of inherited diseases, each associated with a partial defect in one of the enzymes of the heme biosynthetic pathway. In six of the eight porphyrias described, the main clinical manifestation is skin photosensitivity brought about by the action of light on porphyrins, which are deposited in the upper epidermal layer of the skin. Porphyrins absorb light energy intensively in the UV region, and to a lesser extent in the long visible bands, resulting in transitions to excited electronic states. The excited porphyrin may react directly with biological structures (type I reactions or with molecular oxygen, generating excited singlet oxygen (type II reactions. Besides this well-known photodynamic action of porphyrins, a novel light-independent effect of porphyrins has been described. Irradiation of enzymes in the presence of porphyrins mainly induces type I reactions, although type II reactions could also occur, further increasing the direct non-photodynamic effect of porphyrins on proteins and macromolecules. Conformational changes of protein structure are induced by porphyrins in the dark or under UV light, resulting in reduced enzyme activity and increased proteolytic susceptibility. The effect of porphyrins depends not only on their physico-chemical properties but also on the specific site on the protein on which they act. Porphyrin action alters the functionality of the enzymes of the heme biosynthetic pathway exacerbating the metabolic deficiencies in porphyrias. Light energy absorption by porphyrins results in the generation of oxygen reactive species, overcoming the protective cellular mechanisms and leading to molecular, cell and tissue damage, thus amplifying the porphyric picture.

Ekstrahepatiske manifestationer af hepatitis C-virus-infektion

DEFF Research Database (Denmark)

Risum, Malene

2011-01-01

Hepatitis C does not only affect the liver, but also manifests outside the liver. The skin, kidneys and nervous system are often involved due to mixed cryoglobulinaemia. Porphyria cutanea tarda, lymphoma and thyroid diseases among others can also attend a chronic infection, but the exact...

Nuclear microscopy in biomedical analysis with special emphasis on clinical metal biology

Science.gov (United States)

Lindh, Ulf; Frisk, Peter; Nyström, Joakim; Danersund, Antero; Hudecek, Romuald; Lindvall, Anders; Thunell, Stig

1997-07-01

Nuclear microscopy based upon developments in high energy ion beam techniques is by now an accepted technique in many fields of research. The advancements into the biomedical field have, however, been slower than expected. A major factor explaining this tendency is the availability of nuclear microscopy. This paper reviews briefly the biomedical work using nuclear microscopy that has been carried out since the 4 th International Conference on Nuclear Microprobe Technology and Applications held in Shanghai. Nuclear microscopy of isolated individual blood cells from patients adversely affected by metal exposure from dental amalgam has been performed both before and after removal of the metallic fillings. The elemental profile of blood cells was more or less normalised after treatment. Some of these results will be presented to illustrate a medical application. Results from bulk analysis by ICP-MS of erythrocytes and plasma before and after treatment will also be presented to illustrate the difference in information content between these two approaches as well as the need for complementary information in solving biomedical problems. As part of a larger study of acute porphyria, nuclear microscopy of blood cells was included among the 78 laboratory tests. The approach in this study was unbiased in the sense that no hypothesis was formulated as to which laboratory parameters would be the most explanatory for health or disease. Multivariate discriminant analysis was applied to the large amounts of data acquired. This approach led to the hypothesis that oxidative stress increased the synthesis of manganese-dependent superoxide dismutase in the mitochondria of polymorphonuclear leukocytes, explaining the increase of manganese in these cells. Antioxidant therapy was therefore applied to a couple of patients with porphyria, however, without clinical success.

Ketogenic Diet: An Early Option for Epilepsy Treatment, Instead of A Last Choice Only

Directory of Open Access Journals (Sweden)

Huei-Shyong Wang

2012-02-01

Full Text Available Ketogenic diet (KD was usually tried as a last resort in the treatment of intractable epilepsy after failure of many antiepileptics and even epilepsy surgery. Glucose transporter-1 deficiency and pyruvate dehydrogenase deficiency must be treated with KD as the first choice because of inborn errors of glucose metabolism. Infantile spasms, tuberous sclerosis complex, Rett syndrome, Doose syndrome, Dravet syndrome, etc., appear to respond to KD, and it has been suggested by the international consensus statement to use KD early. We believe that all patients with epilepsy, except those with contraindicated situations such as pyruvate carboxylase deficiency, porphyria, β-oxidation defects, primary carnitine deficiency, etc., may try KD before trying other regimens.

Etiology of three recent diseases of citrus in São Paulo State: sudden death, variegated chlorosis and huanglongbing.

Science.gov (United States)

Bové, Joseph Marie; Ayres, Antonio Juliano

2007-01-01

, citrus variegated chlorosis (CVC), was observed in 1987 in the Triangulo Mineiro of Minas Gerais State and the northern and north-eastern parts of SSP. By 2000, the disease affected already 34% of the 200 million sweet orange trees in SSP. By 2005, the percentage had increased to 43%, and CVC was present in all citrus growing regions of Brazil. Electron microscopy showed that xylem-limited bacteria were present in all symptomatic sweet orange leaves and fruit tissues tested, but not in similar materials from healthy, symptomless trees. Bacteria were consistently cultured from twigs of CVC-affected sweet orange trees but not from twigs of healthy trees. Serological analyses showed the CVC bacterium to be a strain of Xylella fastidiosa. The disease could be reproduced and Koch's postulates fulfilled, by mechanically inoculating a pure culture of X. fastidiosa isolate 8.1.b into sweet orange seedlings. The genome of a CVC strain of X. fastidiosa was sequenced in SSP in the frame of a project supported by FAPESP and Fundecitrus. X. fastidiosa is the first plant pathogenic bacterium, the genome of which has been sequenced. Until recently, America was free of huanglongbing (HLB), but in March 2004 and August 2005, symptoms of the disease were recognized, respectively in the State of São Paulo (SSP) and in Florida, USA. HLB was known in China since 1870 and in South Africa since 1928. Because of its destructiveness and its rapid spread by efficient psyllid insect-vectors, HLB is probably the most serious citrus disease. HLB is caused by a phloem sieve tube-restricted Gram negative bacterium, not yet available in culture. In the 1990s, the bacterium was characterized by molecular techniques as a member of the alpha proteobacteria designated Candidatus Liberibacter africanus for the disease in Africa, and Candidatus Liberibacter asiaticus for HLB in Asia. In SSP, Ca. L. asiaticus is also present, but most of the trees are infected with a new species, Candidatus Liberibacter

[Postoperative cognitive deficits].

Science.gov (United States)

Kalezić, Nevena; Dimitrijević, Ivan; Leposavić, Ljubica; Kocica, Mladen; Bumbasirević, Vesna; Vucetić, Cedomir; Paunović, Ivan; Slavković, Nemanja; Filimonović, Jelena

2006-01-01

Cognitive dysfunctions are relatively common in postoperative and critically ill patients. This complication not only compromises recovery after surgery, but, if persistent, it minimizes and compromises surgery itself. Risk factors of postoperative cognitive disorders can be divided into age and comorbidity dependent, and those related to anesthesia and surgery. Cardiovascular, orthopedic and urologic surgery carries high risk of postoperative cognitive dysfunction. It can also occur in other types of surgical treatment, especially in elderly. Among risk factors of cognitive disorders, associated with comorbidity, underlying psychiatric and neurological disorders, substance abuse and conditions with elevation of intracranial pressure are in the first place in postoperative patients. Preoperative and perioperative predisposing conditions for cognitive dysfunction and their incidence were described in our paper. These are: geriatric patients, patients with substance abuse, preexisting psychiatric or cognitive disorders, neurologic disease with high intracranial pressure, cerebrovascular insufficiency, epilepsia, preeclampsia, acute intermittent porphyria, operation type, brain hypoxia, changes in blood glucose level, electrolyte imbalance, anesthetic agents, adjuvant medication and intraoperative awareness. For each of these factors, evaluation, prevention and treatment strategies were suggested, with special regard on anesthetic technique.

Porphyria Cutanea Tarda and Agent Orange

Science.gov (United States)

... Accountability & Whistleblower Protection Transparency Media Room Inside the Media Room Public Affairs News Releases Speeches Videos Publications National Observances Veterans Day Memorial Day Celebrating America's Freedoms Special Events Adaptive Sports Program Creative Arts Festival ...

MRI prognostic value in multiple myeloma

International Nuclear Information System (INIS)

Medina, G.; Mazzuco, J.; Corrado, C.; Hendler, M.

2001-01-01

Purpose: To evaluate the prognosis value of the bone marrow (BM) MR infiltration patterns in patients with MM, without treatment, and to assess the results altogether with other prognosis factors (clinical, laboratory, radiology). Materials and methods: MR was performed in 21 patients with MM. Bone lesions, plasmacytomas and osteoporosis were assessed with skeletal radiographs. Results: MR of patients with MM revealed 3 abnormal BM involvement patterns: focal (FP), diffuse (DP) and variegated (VP). Unlike others reported series, we identified MR studies with 2 or more MR patterns in 13 patients. We define this particular type as mixed pattern (MP). Conclusion: MR is more sensitive than conventional radiology in detecting bone lesions. The MR patterns combined with the other conventional staging factors provide a useful tool for disease prognosis. In our series, patients with DP, alone or combined with other patterns (mixed), were related with the worst prognosis. (author)

Tolerating Toxins: Grasshoppers that Feast on Pyrrolizidine Alkaloids §.

Science.gov (United States)

Housecroft, Catherine E

2018-03-30

The elegant grasshopper (Zonocerus elegans) and the variegated grasshopper (Z. variegatus) are among insects that deliberately consume and store pyrrolizidine alkaloids which are subsequently used in defence mechanisms.

Porphyrins

Science.gov (United States)

Gotelli, George R.; Wall, Jeffrey H.; Kabra, Pokar M.; Marton, Laurence J.

Historically the term porphyria has been used since it was coined in 1871 to describe a purple colored material extracted from pathological feces (1). The first case of porphyria was reported in 1874, (2, 3), but until the 1930 Nobel Prize winning work of Hans Fischer on the synthesis of protoporphyrin, there was little more than academic interest in porphyrin analysis. During the forty years between 1930 and 1970, the biosynthetic pathways leading to the formation of heme, and the details of porphyrin metabolism, were elucidated. During this time quantitative methods for porphyrins in biological fluids used complex and laborious solvent extraction techniques, requiring large sample volumes and hours to complete. We now know that these methods only partially separated the complex mixture of porphyrins found in biological fluids. These solvent extraction procedures fractionated the porphyrins into two broad groups, uroporphyrins (octacarboxylic) and coproporphyrins (tetracarboxylic). However, intermediate carboxylated porphyrin containing 2, 3, 5, 6, and 7 carboxyl groups are now known to exist in normal and pathlogical excreta, which were not differentiated, but which were included in the two broad uroporphyrin and copropophyrin groups.

7 CFR 331.3 - PPQ select agents and toxins.

Science.gov (United States)

2010-01-01

...) Select agents and toxins listed in paragraph (b) of this section that have been genetically modified. (d... variegated chlorosis strain). (c) Genetic elements, recombinant nucleic acids, and recombinant organisms: (1...

An ENU mutagenesis screen identifies novel and known genes involved in epigenetic processes in the mouse

Czech Academy of Sciences Publication Activity Database

Daxinger, L.; Harten, S.K.; Oey, H.; Epp, Trevor; Isbel, L.; Huang, E.; Whitelaw, N.; Apedaile, A.; Sorolla, A.; Yong, J.; Bharti, V.; Sutton, J.; Ashe, A.; Pang, Z.Y.; Wallace, N.; Gerhardt, D.J.; Blewitt, M.E.; Jeddeloh, J.A.; Whitelaw, E.

2013-01-01

Roč. 14, č. 9 (2013) ISSN 1465-6906 Institutional support: RVO:68378050 Keywords : epigenetics * variegation * forward genetics Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 10.465, year: 2013

[Mercury in three species of Suillus mushroom from some sites in Poland].

Science.gov (United States)

Mielewska, Dominika; Stefańska, Aleksandra; Wenta, Justyna; Mazur, Michalina; Bielawski, Leszek; Danisiewicz, Dorota; Dryzałowska, Anna; Falandysz, Jerzy

2008-01-01

Total mercury content have been determined in fruiting bodies of Variegated Bolete (Suillus variegates), European Cow Bolete (S. bovinus) and Slippery Jack (S. luteus) and in underlying to mushroom's surface layer of soil substrate collected from several spatially distant one from another sites in Poland. All three Suillus mushroom species independent of the site characterized were by small mercury content. The arithmetic mean values of mercury concentration in caps and stipes, respectively, were: 0.17 +/- 0.07-0.22 +/- 0.12 and 0.047 +/- 0.015-0.071 +/- 0.035 microg/g dry weight for Variegated Bolete; 0.28 +/- 0.11-0.79 +/- 0.40 and 0.17 +/- 0.07- 0.51 +/- 0.22 microg/g dw for European Cow Bolete, and 0.095 +/- 0.082-0.17 +/- 0.05 and 0.045 +/- 0.026- 0.070 +/- 0.026 microg/g dw for Slippery Jack. All three species of Suillus mushrooms bio-concentrated mercury (BCF > 1). European Cow Bolete bioconcentrated mercury relatively more efficiently when compared to two other species, and means of BCF value of this element in its caps ranged from 18 +/- 10 to 45 +/- 20, and in stipes from 9.4 +/- 7.5 to 29 +/- 11. A level of surface soil pollution with mercury was low and averaged from 0.017 +/- 0.003 do 0.029 +/- 0.020 microg/g dw.

Fluxo de seiva e fotossíntese em laranjeira 'Natal' com clorose variegada dos citros Sap flow and photosynthesis of 'Natal' sweet orange plants with citrus variegated chlorosis

Directory of Open Access Journals (Sweden)

Eduardo Caruso Machado

2006-06-01

Full Text Available O objetivo deste trabalho foi avaliar os efeitos da clorose variegada dos citros (CVC, no fluxo de seiva, trocas gasosas e atividade fotoquímica em laranjeira 'Natal', com e sem CVC, em condição de campo. O curso diário do fluxo de seiva, potencial da água na folha, assimilação de CO2, transpiração, condutância estomática e eficiência quântica máxima e efetiva do fotossistema II foram avaliados. O delineamento experimental foi em blocos ao acaso com cinco repetições. O fluxo de seiva foi 1,9 vez superior nas plantas sadias em relação às doentes. Em plantas doentes ocorreu queda de 43, 28 e 33% na assimilação de CO2, condutância estomática e transpiração, respectivamente. As plantas com CVC apresentaram fotoinibição dinâmica. Uma vez que a eficiência quântica efetiva apresentou um padrão de resposta semelhante, durante o dia, em ambos os tratamentos, o efeito protetor da fotorrespiração no aparato fotoquímico em plantas com CVC é discutido. As quedas de assimilação de CO2, transpiração e de fluxo de seiva, nas plantas com CVC, foram decorrentes do menor valor da condutância estomática, possivelmente causado pela colonização dos vasos do xilema pela Xylella fastidiosa.The objective of this work was to evaluate the effects of citrus variegated chlorosis (CVC on sap flow, gas exchanges and photochemical activity in 'Natal' sweet orange plants with and without CVC under field condition. Diurnal courses of sap flow, leaf water potential, CO2 assimilation rate and transpiration, stomatal conductance, potential and effective quantum efficiency of photosystem II were evaluated. The experiment was arranged in a random block design with five repetitions. Healthy plants showed sap flow values around 1.9 times higher than injured ones. Injured plants exhibited reductions of 43, 28 and 33% in CO2 assimilation rate, stomatal conductance and leaf transpiration, respectively. CVC-affected plants showed dynamic

Disease: H00995 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available d vitamin K-dependent clotting factors deficiency (VKCFD) is a rare congenital bleeding disorder consisting ...otein S, and protein Z. VKCFD leads to a bleeding tendency with a variegate clini

Soren Kierkegaard (1813-55): a bicentennial pathographical review.

Science.gov (United States)

Schioldann, Johan; Søgaard, Ib

2013-12-01

Researchers in the fields of psychology, psychiatry, medicine and theology have made exhaustive efforts to shed light on the elusive biography/pathography of the great Danish philosopher Søren Kierkegaard (1813-55). This 'bicentennial' article reviews his main pathographical diagnoses of, respectively, possible manic-depressive [bipolar] disease, epilepsy, complex partial seizure disorder, Landry-Guillain-Barré's acute ascending paralysis, acute intermittent porphyria with possible psychiatric manifestations, and syphilidophobia.

Clinical relevance of porphyrin determinations in porphyria

NARCIS (Netherlands)

Beukeveld, Gerhardus Johannes Jozef

1995-01-01

This thesis deals with hereditaryd iseasesin the synthesiso f heme. Heme presents a prosthetic group in a number of important proteins, like hemoglobin, cytochromes and the cytochrome P450 oxidases. In chapter 1 the heme synthesis and its regulation are described. Intermediary products in the

A MORPHOMETRIC STUDY OF THE VARIEGATED GRASSHOPPER

African Journals Online (AJOL)

BIG TIMMY

Department of Zoology, Obafemi Awolowo University, Ile-Ife, Nigeria. Correspondence a. Morphometry of the dry-season population of adult ... female specimens from Port-Harcourt were the most correctly classified compared to specimens from other locations . The present study demonstrated the morphological similarities ...

Pulmonary hypertension’s variegated landscape: a snapshot

Science.gov (United States)

Kulik, Thomas J.; Austin, Eric D.

2017-01-01

The many types of pulmonary hypertension (PH) are so protean in their biological origin, histological expression, and natural history that it is difficult to create a summary picture of the disease, or to easily compare and contrast characteristics of one type of PH with another. For newcomers to the field, however, such a picture would facilitate a broad understanding of PH. In this paper, we suggest that four characteristics are fundamental to describing the nature of various types of PH, and that taken together they define a number of patterns of PH expression. These characteristics are histopathology, developmental origin, associated clinical conditions, and potential for resolution. The “snapshot” is a way to concisely display the ways that these signal characteristics intersect in select specific types of PH, and is an effort to summarize these patterns in a way that facilitates a “big picture” comprehension of this disease. PMID:28680566

Mechanisms And Variegated Manifestations Of Inteference In ...

African Journals Online (AJOL)

Nigerian bilinguals' use of English as a second language is fraught with interference from L1 to L2, a phenomenon that is commonplace world-wide as a linguistic enterprise. But the extent of this trend in bilinguals varies from one language to another based on sociolinguistic and cultural variables. In Nigeria, manifestations ...

Human uroporphyrinogen III synthase: Molecular cloning, nucleotide sequence, and expression of a full-length cDNA

International Nuclear Information System (INIS)

Tsai, Shihfeng; Bishop, D.F.; Desnick, R.J.

1988-01-01

Uroporphyrinogen III synthase, the fourth enzyme in the heme biosynthetic pathway, is responsible for conversion of the linear tetrapyrrole, hydroxymethylbilane, to the cyclic tetrapyrrole, uroporphyrinogen III. The deficient activity of URO-synthase is the enzymatic defect in the autosomal recessive disorder congenital erythropoietic porphyria. To facilitate the isolation of a full-length cDNA for human URO-synthase, the human erythrocyte enzyme was purified to homogeneity and 81 nonoverlapping amino acids were determined by microsequencing the N terminus and four tryptic peptides. Two synthetic oligonucleotide mixtures were used to screen 1.2 x 10 6 recombinants from a human adult liver cDNA library. Eight clones were positive with both oligonucleotide mixtures. Of these, dideoxy sequencing of the 1.3 kilobase insert from clone pUROS-2 revealed 5' and 3' untranslated sequences of 196 and 284 base pairs, respectively, and an open reading frame of 798 base pairs encoding a protein of 265 amino acids with a predicted molecular mass of 28,607 Da. The isolation and expression of this full-length cDNA for human URO-synthase should facilitate studies of the structure, organization, and chromosomal localization of this heme biosynthetic gene as well as the characterization of the molecular lesions causing congenital erythropoietic porphyria

Acute Flaccid paralysis in adults: Our experience

Directory of Open Access Journals (Sweden)

Rupesh Kaushik

2014-01-01

Full Text Available Acute flaccid paralysis (AFP is a complex clinical syndrome with a broad array of potential etiologies that vary with age. We present our experience of acute onset lower motor neuron paralysis. Materials and Methods: One hundred and thirty-three consecutive adult patients presenting with weakness of duration less than four weeks over 12 months period were enrolled. Detailed history, clinical examination, and relevant investigations according to a pre-defined diagnostic algorithm were carried out. The patients were followed through their hospital stay till discharge or death. Results: The mean age was 33.27 (range 13-89 years with male preponderance (67.7%. The most common etiology was neuroparalytic snake envenomation (51.9%, followed by Guillain Barre syndrome (33.1%, constituting 85% of all patients. Hypokalemic paralysis (7.5% and acute intermittent porphyria (4.5% were the other important conditions. We did not encounter any case of acute polio mylitis in adults. In-hospital mortality due to respiratory paralysis was 9%. Conclusion: Neuroparalytic snakebite and Guillain Barre syndrome were the most common causes of acute flaccid paralysis in adults in our study.

Review: Biological imprinting: Some genetic considerations | Saad ...

African Journals Online (AJOL)

... as for interpretation of possible mechanisms implicated in its occurrence. Keywords: Genetic imprinting; Mutations; Re-sense mutation; Epigenetic alterations; DNA methylation/demethylation; Parthenogenesis; Position-effect variegation; Post-fertilization genomic imprinting; microRNA; Chromatin modifications; Pyknons ...

Lamotrigine in the treatment of psychotic depression associated with hereditary coproporphyria -- case report and a brief review of the literature.

Science.gov (United States)

Takács, Rozália; Makkos, Zoltán; Kassai-Farkas, Ákos; Pusztai, Ágnes; Ungvári, Gábor S; Gazdag, Gábor

2014-03-01

We report a successful treatment with lamotrigine of a patient with hereditary coproporphyria presenting with affective and psychotic symptoms. M.F., a 38-year-old, single woman was admitted to an acute psychiatric ward because of suddenly emerging psychosis. Ms F's hereditary coproporphyria was diagnosed 9 years before the current admission. While on treatment with olanzapine (20mg/day) the psychotic symptoms have gradually disappeared. In view of her significant mood fluctuations predominantly with depressed phases, lamotrigine was started and titrated up to 125 mg/day. Ms F's mood gradually became euthymic, suicidal ideations and anxiety disappeared. At 5-month follow-up, while still on lamotrigine, her porphyria was asymptomatic. To the best of our knowledge, this is the first report about the safe administration of lamotrigine in hereditary coproporphyria. Lamotrigine did not trigger an acute porphyric attack as confirmed by clinical and laboratory findings.

Diversity of endophytic bacterial populations and their interaction with Xylella fastidiosa in citrus plants

NARCIS (Netherlands)

Araujo, W.L.; Marcon, J.; jr. Maccheroni, W.; Elsas, van J.D.; Vuurde, van J.W.L.; Azevedo, de J.L.

2002-01-01

Citrus variegated chlorosis (CVC) is caused by Xylella fastidiosa, a phytopathogenic bacterium that can infect all Citrus sinensis cultivars. The endophytic bacterial communities of healthy, resistant, and CVC-affected citrus plants were studied by using cultivation as well as

Hepatic arachidonic acid metabolism is disrupted after hexachlorobenzene treatment

International Nuclear Information System (INIS)

Billi de Catabbi, Silvia C.; Faletti, Alicia; Fuentes, Federico; San Martin de Viale, Leonor C.; Cochon, Adriana C.

2005-01-01

Hexaclorobenzene (HCB), one of the most persistent environmental pollutants, can cause a wide range of toxic effects including cancer in animals, and hepatotoxicity and porphyria both in humans and animals. In the present study, liver microsomal cytochrome P450 (CYP)-dependent arachidonic acid (AA) metabolism, hepatic PGE production, and cytosolic phospholipase A 2 (cPLA 2 ) activity were investigated in an experimental model of porphyria cutanea tarda induced by HCB. Female Wistar rats were treated with a single daily dose of HCB (100 mg kg -1 body weight) for 5 days and were sacrificed 3, 10, 17, and 52 days after the last dose. HCB treatment induced the accumulation of hepatic porhyrins from day 17 and increased the activities of liver ethoxyresorufin O-deethylase (EROD), methoxyresorufin O-demethylase (MROD), and aminopyrine N-demethylase (APND) from day 3 after the last dose. Liver microsomes from control and HCB-treated rats generated, in the presence of NADPH, hydroxyeicosatetraenoic acids (HETEs), epoxyeicosatrienoic acids (EETs), 11,12-Di HETE, and ω-OH/ω-1-OH AA. HCB treatment caused an increase in total NADPH CYP-dependent AA metabolism, with a higher response at 3 days after the last HCB dose than at the other time points studied. In addition, HCB treatment markedly enhanced PGE production and release in liver slices. This HCB effect was time dependent and reached its highest level after 10 days. At this time cPLA 2 activity was shown to be increased. Unexpectedly, HCB produced a significant decrease in cPLA 2 activity on the 17th and 52nd day. Our results demonstrated for the first time that HCB induces both the cyclooxygenase and CYP-dependent AA metabolism. The effects of HCB on AA metabolism were previous to the onset of a marked porphyria and might contribute to different aspects of HCB-induced liver toxicity such as alterations of membrane fluidity and membrane-bound protein function. Observations also suggested that a possible role of cPLA 2 in

Advances in the management of erythropoietic protoporphyria – role of afamelanotide

Directory of Open Access Journals (Sweden)

Lane AM

2016-12-01

Full Text Available Ashley M Lane,1 Jerome T McKay,2 Herbert L Bonkovsky1 1Department of Internal Medicine, Section on Gastroenterology; 2Department of Microbiology and Immunology, Wake Forest University School of Medicine, Winston-Salem, NC, USAAbstract: Erythropoietic protoporphyria (EPP and the phenotypically similar disease X-linked protoporphyria (XLPP are inherited cutaneous porphyrias characterized clinically by acute non-blistering photosensitivity, intolerance to sunlight, and significantly reduced quality of life. They are due to marked overproduction of protoporphyrin (PP chiefly by erythroblasts and reticulocytes. In EPP, the underlying genetic defect is in the ferrochelatase gene, which encodes the final enzyme in the heme synthetic pathway. In XLPP, the genetic defect is a gain-of-function mutation, usually a four-base deletion, in the gene that encodes the enzyme 5-aminolevulinic acid synthase-2, the first and rate-controlling enzyme of heme synthesis in developing red blood cells. The excess PP causes acute and painful photosensitivity, being activated by light in the long ultraviolet to blue spectrum (380–420 nm, the Soret band. Although several treatments have been proposed, presently no very effective treatment exists for EPP or XLPP. Afamelanotide (Scenesse® is a first-in-class synthetic analog of α-melanocyte stimulating hormone. Afamelanotide mimics the naturally occurring hormone to increase skin pigmentation by increasing melanin production in melanocytes, resulting in increased sunlight tolerance in those with EPP/XLPP. Afamelanotide is currently approved for use in the European Union and Switzerland, and it is under review in the United States by the Food and Drug Administration for use in patients with EPP/XLPP. This paper provides a review of the clinical characteristics and current therapies for EPP/XLPP. We discuss the pharmacology, clinical efficacy, safety, and tolerability of afamelanotide and summarize the results of several

Avaliação de tangerinas, tangores e tangelos em relação à clorose variegada dos citros Evaluation of mandarines, tangors and tangelos in relation to the citrus variegated chlorosis (CVC

Directory of Open Access Journals (Sweden)

Simone Rodrigues da Silva

2004-04-01

Full Text Available A Clorose Variegada dos Citros (CVC, causada pela bactéria Xylella fastidiosa, é uma séria ameaça à citricultura brasileira, constituindo-se, atualmente, numa das principais doenças dos citros no Brasil. O objetivo desse trabalho foi avaliar cultivares de citros introduzidas quanto à suscetibilidade ou resistência à CVC, em condições de campo. O trabalho foi conduzido em Bebedouro-SP. Os materiais genéticos estudados foram cultivares de tangerinas e híbridos (tangores e tangelos introduzidas de bancos de germoplasma da Itália, Portugal, Espanha e Córsega. O trabalho foi constituído por 56 parcelas, com três plantas das quais uma foi inoculada, empregando-se o método de encostia, utilizando-se de mudas previamente infectadas como fontes da bactéria. Foram avaliados os sintomas da doença mediante observação visual através de notas e teste de PCR, específico para Xylella fastidiosa. Os materiais genéticos que se apresentaram positivos ao PCR, mas não apresentaram sintomas, e os que foram negativos ao PCR, possuem um potencial de utilização em programas de melhoramento genético visando à resistência e/ou à tolerância à doença.The Citrus Variegated Chlorosis (CVC, caused by the bacteria Xylella fastidiosa, is a serious threat to the Brazilian citriculture, being, actually, one of the mains diseases to the citrus in Brazil. The objective of this work was evaluate citrus cultivars, introduced according to the susceptibility or resistance to CVC, in field conditions. The research was carried in Bebedouro city - São Paulo state - Brazil. The genotypes studied were cultivars of mandarines and hybrids (tangors and tangelos, introduced from the germplasm collections of Italy, Portugal, Spain and Corsica. The work was composed by 56 portions, with 3 plants, being one of them inoculated, using the approach graft method, with infected plants. Were evaluated the symptoms of the disease by visual observation and PCR test

The Contribution of food plants to the growth, development and ...

African Journals Online (AJOL)

The Contribution of food plants to the growth, development and fecundity of Zonocerus variegatus (L) ... African Journal of Biotechnology ... The performance of the variegated grasshopper, Zonocerus variegatus (L) fed on different food plants namely cassava (Manihot esculenta), pawpaw (Carica papaya) and acalypha ...

Helper-dependent adenovirus achieve more efficient and persistent liver transgene expression in non-human primates under immunosuppression.

Science.gov (United States)

Unzu, C; Melero, I; Hervás-Stubbs, S; Sampedro, A; Mancheño, U; Morales-Kastresana, A; Serrano-Mendioroz, I; de Salamanca, R E; Benito, A; Fontanellas, A

2015-11-01

Helper-dependent adenoviral (HDA) vectors constitute excellent gene therapy tools for metabolic liver diseases. We have previously shown that an HDA vector encoding human porphobilinogen deaminase (PBGD) corrects acute intermittent porphyria mice. Now, six non-human primates were injected in the left hepatic lobe with the PBGD-encoding HDA vector to study levels and persistence of transgene expression. Intrahepatic administration of 5 × 10(12) viral particles kg(-1) (10(10) infective units kg(-1)) of HDA only resulted in transient (≈14 weeks) transgene expression in one out of three individuals. In contrast, a more prolonged 90-day immunosuppressive regimen (tacrolimus, mycophenolate, rituximab and steroids) extended meaningful transgene expression for over 76 weeks in two out of two cases. Transgene expression under immunosuppression (IS) reached maximum levels 6 weeks after HDA administration and gradually declined reaching a stable plateau within the therapeutic range for acute porphyria. The non-injected liver lobes also expressed the transgene because of vector circulation. IS controlled anticapsid T-cell responses and decreased the induction of neutralizing antibodies. Re-administration of HDA-hPBGD at week +78 achieved therapeutically meaningful transgene expression only in those animals receiving IS again at the time of this second vector exposure. Overall, immunity against adenoviral capsids poses serious hurdles for long-term HDA-mediated liver transduction, which can be partially circumvented by pharmacological IS.

The effects of chromosome rearrangements on the expression of heterochromatic genes in chromosome 2L of Drosophila melanogaster

International Nuclear Information System (INIS)

Wakimoto, B.T.; Hearn, M.G.

1990-01-01

The light (lt) gene of Drosophila melanogaster is located at the base of the left arm of chromosome 2, within or very near centromeric heterochromatin (2Lh). Chromosome rearrangements that move the lt + gene from its normal proximal position and place the gene in distal euchromatin result in mosaic or variegated expression of the gene. The cytogenetic and genetic properties of 17 lt-variegated rearrangements induced by X radiation are described in this report. The authors show that five of the heterochromatic genes adjacent to lt are subject to inactivation by these rearrangements and that the euchromatic loci in proximal 2L are not detectably affected. The properties of the rearrangements suggest that proximity to heterochromatin is an important regulatory requirement for at least six 2Lh genes. They discuss how the properties of the position effects on heterochromatic genes relate to other proximity-dependent phenomena such as transvection

porphyria, a familial disease: its diagnosis and treatment

African Journals Online (AJOL)

letter they should show to any doctor they may consult • in future.' ... decide which have done so before adult life is reached. ..... lyte balance must be carefully watched and maintained by ... fully and the best method is to work out a family tree,.

Bringing the Offshore Ashore : Transnational Production, Industrial Relations and the Reconfiguration of Sovereignty

NARCIS (Netherlands)

Lillie, Nathan

This article argues that off-shore is losing its exceptionality by being absorbed into a broader process of variegation and deterritorialization of sovereignty, and that capital's search for a new "fix" is driving this process. Capital goes off-shore by exploiting non-territorial definitions of

7 CFR 29.1080 - Variegated dark red (KD).

Science.gov (United States)

2010-01-01

... Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD CONTAINER... which usually results from excessive sunbaking during the growing process or from storing cured tobacco...

Skin diseases associated with Agent Orange and other organochlorine exposures.

Science.gov (United States)

Patterson, Andrew T; Kaffenberger, Benjamin H; Keller, Richard A; Elston, Dirk M

2016-01-01

Organochlorine exposure is an important cause of cutaneous and systemic toxicity. Exposure has been associated with industrial accidents, intentional poisoning, and the use of defoliants, such as Agent Orange in the Vietnam War. Although long-term health effects are systematically reviewed by the Institute of Medicine, skin diseases are not comprehensively assessed. This represents an important practice gap as patients can present with cutaneous findings. This article provides a systematic review of the cutaneous manifestations of known mass organochlorine exposures in military and industrial settings with the goal of providing clinically useful recommendations for dermatologists seeing patients inquiring about organochlorine effects. Patients with a new diagnosis of chloracne, porphyria cutanea tarda, cutaneous lymphomas (non-Hodgkin lymphoma), and soft-tissue sarcomas including dermatofibrosarcoma protuberans and leiomyosarcomas should be screened for a history of Vietnam service or industrial exposure. Inconclusive evidence exists for an increased risk of other skin diseases in Vietnam veterans exposed to Agent Orange including benign fatty tumors, melanomas, nonmelanoma skin cancers, milia, eczema, dyschromias, disturbance of skin sensation, and rashes not otherwise specified. Affected veterans should be informed of the uncertain data in those cases. Referral to Department of Veterans Affairs for disability assessment is indicated for conditions with established associations. Copyright © 2015 American Academy of Dermatology, Inc. All rights reserved.

Mobile Screens: The Visual Regime of Navigation

NARCIS (Netherlands)

Verhoeff, N.

2012-01-01

In this book on screen media, space, and mobility I compare synchronically, as well as diachronically, diverse and variegated screen media - their technologies and practices – as sites for virtual mobility and navigation. Mobility as a central trope can be found on the multiple levels that are

7 CFR 29.3532 - Mixed (M).

Science.gov (United States)

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Mixed (M). 29.3532 Section 29.3532 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Type 95) § 29.3532 Mixed (M). Variegated or distinctly different colors of the type mingled together...

7 CFR 29.2481 - Key to standard grademarks.

Science.gov (United States)

2010-01-01

... Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD CONTAINER.... 3—Good. 4—Fair. 5—Low. Colors L—Light brown. F—Medium brown. D—Dark brown. M—Mixed or variegated. G...

7 CFR 29.2696 - Key to standard grademarks.

Science.gov (United States)

2010-01-01

... Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD CONTAINER.... 3—Good. 4—Fair. 5—Low. Colors L—Light brown. F—Medium brown. D—Dark brown. M—Mixed or variegates. VF...

Author Details

African Journals Online (AJOL)

Development of a trap to contaminate variegated grasshoppers (Zonocerus variegatus L.) (Orthoptera: Pyrgomorphidae) with Metarrhyzium flavo-viride Gams & Rozsypal in the field. Details · Vol 40, No 1 (2007) - Articles Yam pests in the Ashanti and Brong Ahafo regions of Ghana: A study of farmers\\' indigenous technical ...

Insect pests' incidence and variations due to forest landscape ...

African Journals Online (AJOL)

No differences were found between the intensification zones, except for weeds, which appeared to be a greater constraint in the slightly degraded area. Within the insect pest, the greatest damage to crops according to farmers originated from borers and scales, followed by variegated grasshopper. Only the termites showed ...

The histone methyltransferase and putative oncoprotein MMSET is overexpressed in a large variety of human tumors

DEFF Research Database (Denmark)

Hudlebusch, Heidi Rye; Santoni-Rugiu, Eric; Simon, Ronald

2011-01-01

Multiple myeloma SET (Suppressor of variegation, Enhancer of zeste, and Trithorax) domain (MMSET) is a histone lysine methyltransferase deregulated in a subgroup of multiple myelomas with the t(4;14)(p16;q32) translocation and poor prognosis. With the aim of understanding, if MMSET can be involved...

"Real-life" treatment of chronic pain: Targets and goals.

Science.gov (United States)

Ablin, Jacob N; Buskila, Dan

2015-02-01

Treating chronic pain is a complex challenge. While textbooks and medical education classically categorize pain as originating from peripheral (nociceptive), neuropathic, or centralized origins, in real life each and every patient may present a combination of various pain sources, types, and mechanisms. Moreover, individual patients may evolve and develop differing types of pain throughout their clinical follow-up, further emphasizing the necessity to maintain clinical diligence during the evaluation and follow-up of these patients. Rational treatment of patients suffering from chronic pain must attempt at deconstructing complex pain cases, identifying variegate pain generators, and targeting them with appropriate interventions, while incorporating both pharmacological and non-pharmacological strategies, rather than focusing on the total pain level, which represents an integral of all pain types. Failing to recognize the coexistence of different types of pain in an individual patient and escalating medications only on the basis of total pain intensity are liable to lead to both ineffective control of pain and increased untoward effects. In the current review, we outline strategies for deconstructing complex pain and therapeutic suggestions. Copyright © 2015 Elsevier Ltd. All rights reserved.

Author Details

African Journals Online (AJOL)

A Study on the Feeding and Growth Patterns of the Variegated Grasshopper Zonocerus Variegatus (L) in the Laboratory Abstract PDF · Vol 5, No 1 (2011) - Articles Comparative Studies on the Larvicidal Action of Novaluron (Mosquiron® 100EC) and Moringa Oliefera (LAM) Seed Oil against Aedes Aegypti (Diptera: ...

The endogenous transposable element Tgm9 is suitable for functional analyses of soybean genes and generating novel mutants for genetic improvement of soybean

Science.gov (United States)

In soybean, variegated flowers can be caused by somatic excision of the CACTA-type transposable element Tgm9 from intron 2 of the DFR2 gene encoding dihydroflavonol-4-reductase in the anthocyanin pigment biosynthetic pathway. DFR2 has been mapped to the W4 locus where the allele containing the elem...

Author Details

African Journals Online (AJOL)

Ezeakacha, FN. Vol 5, No 1 (2011) - Articles A Study on the Feeding and Growth Patterns of the Variegated Grasshopper Zonocerus Variegatus (L) in the Laboratory Abstract PDF. ISSN: 2070-0083. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

Global Journal of Pure and Applied Sciences - Vol 8, No 4 (2002)

African Journals Online (AJOL)

The microbial flora of the different gut regions of the variegated grasshopper Zonocerus variegatus (L) (Orthoptera :Pyrgomorphidae) · EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. A.B. Idowu, M. O. Edema, 447-454. http://dx.doi.org/10.4314/gjpas.v8i4.15992 ...

Ethnic Diversity and Political Attitudes in a Nigerian University

Science.gov (United States)

Brier, Alan; Tansey, Stephen

1974-01-01

A survey of attitudes of the student population at Nigeria's University of Ife, at the outset of the civil war in 1967, revealed the development of a common set of political attitudes among the students which are variegated but in which variations are not related to tribal origins in any fundamental aspects. (EH)

Constituting Market Citizenship: Regulatory State, Market Making and Higher Education

Science.gov (United States)

Jayasuriya, Kanishka

2015-01-01

The paper makes three claims: first that regulatory state making and market making in higher education is intertwined through a project of market citizenship that shapes the "publicness" of higher education. Second, we argue that these projects of market citizenship are variegated and in Australia has taken the form of accommodation--via…

Physiological roles of plastid terminal oxidase in plant stress

Indian Academy of Sciences (India)

The absence of PTOX in plants usually results in photo-bleached variegated leaves and impaired adaptation to environment alteration. Although PTOX level and activity has been found to increase under a wide range of stress conditions, the functions of plant PTOX in stress responses are still disputed now. In this paper ...

Giant Cell Tumour of Tendon Sheath Masquerading As Trigger Finger

Directory of Open Access Journals (Sweden)

N Rahimawati

2010-11-01

Full Text Available We report a case of a 59-year-old female who presented in the general orthopaedic clinic with triggering of her right middle finger. She did not respond to conventional treatment methods; subsequently she underwent surgical open release under local anaesthesia. Five months postoperatively, the patient presented with signs and symptoms of acute flexor tenosynovitis, and was thought to have a postoperative infection. Re-examination by a hand surgeon raised the possibility of a different aetiology. Based on clinical findings and response to initial treatment, giant cell tumour of the flexor tendon sheath was suspected and later confirmed following surgical biopsy. A high index of suspicion and knowledge of the variegated presentations of giant cell tumour in the hand are beneficial in these types of cases.

Fundus autofluorescence imaging of the white dot syndromes.

Science.gov (United States)

Yeh, Steven; Forooghian, Farzin; Wong, Wai T; Faia, Lisa J; Cukras, Catherine; Lew, Julie C; Wroblewski, Keith; Weichel, Eric D; Meyerle, Catherine B; Sen, Hatice Nida; Chew, Emily Y; Nussenblatt, Robert B

2010-01-01

To characterize the fundus autofluorescence (FAF) findings in patients with white dot syndromes (WDSs). Patients with WDSs underwent ophthalmic examination, fundus photography, fluorescein angiography, and FAF imaging. Patients were categorized as having no, minimal, or predominant foveal hypoautofluorescence. The severity of visual impairment was then correlated with the degree of foveal hypoautofluorescence. Fifty-five eyes of 28 patients with WDSs were evaluated. Visual acuities ranged from 20/12.5 to hand motions. Diagnoses included serpiginous choroidopathy (5 patients), birdshot retinochoroidopathy (10), multifocal choroiditis (8), relentless placoid chorioretinitis (1), presumed tuberculosis-associated serpiginouslike choroidopathy (1), acute posterior multifocal placoid pigment epitheliopathy (1), and acute zonal occult outer retinopathy (2). In active serpiginous choroidopathy, notable hyperautofluorescence in active disease distinguished it from the variegated FAF features of tuberculosis-associated serpiginouslike choroidopathy. The percentage of patients with visual acuity impairment of less than 20/40 differed among eyes with no, minimal, and predominant foveal hypoautofluorescence (P < .001). Patients with predominant foveal hypoautofluorescence demonstrated worse visual acuity than those with minimal or no foveal hypoautofluorescence (both P < .001). Fundus autofluorescence imaging is useful in the evaluation of the WDS. Visual acuity impairment is correlated with foveal hypoautofluorescence. Further studies are needed to evaluate the precise role of FAF imaging in the WDSs.

13 Tribute Diala_Brink WEB 03.pmd

African Journals Online (AJOL)

Owner

aloneness, defeat, and death, the discriminations of race are revealed to be hollow as all humans, in their full variegated complexions, men and women, are shown to be ... image in political terms as the Fanonian wretched of the earth, it is often conflated with the image of Sisyphus, irrepressibly rebellious in his servitude; ...

Ford's Fund for the Republic: A 1950s-Era Foundation as Educator

Science.gov (United States)

Walton, Andrea

2015-01-01

Historians have recently opened up a reconsideration of the 1950s. Long characterized as a time of stolid conformity and Cold War conservatism, the era is increasingly seen in more variegated terms. Studies exploring a range of institutions, causes, and activities have illuminated ways the intellectual and social soil of postwar America gave root…

Diet in dermatology: Revisited

Directory of Open Access Journals (Sweden)

Kaimal Sowmya

2010-01-01

Full Text Available Diet has an important role to play in many skin disorders, and dermatologists are frequently faced with the difficulty of separating myth from fact when it comes to dietary advice for their patients. Patients in India are often anxious about what foods to consume, and what to avoid, in the hope that, no matter how impractical or difficult this may be, following this dictum will cure their disease. There are certain disorders where one or more components in food are central to the pathogenesis, e.g. dermatitis herpetiformis, wherein dietary restrictions constitute the cornerstone of treatment. A brief list, although not comprehensive, of other disorders where diet may have a role to play includes atopic dermatitis, acne vulgaris, psoriasis vulgaris, pemphigus, urticaria, pruritus, allergic contact dermatitis, fish odor syndrome, toxic oil syndrome, fixed drug eruption, genetic and metabolic disorders (phenylketonuria, tyrosinemia, homocystinuria, galactosemia, Refsum′s disease, G6PD deficiency, xanthomas, gout and porphyria, nutritional deficiency disorders (kwashiorkar, marasmus, phrynoderma, pellagra, scurvy, acrodermatitis enteropathica, carotenemia and lycopenemia and miscellaneous disorders such as vitiligo, aphthous ulcers, cutaneous vasculitis and telogen effluvium. From a practical point of view, it will be useful for the dermatologist to keep some dietary information handy to deal with the occasional patient who does not seem to respond in spite of the best, scientific and evidence-based therapy.

A versatile optical profilometer based on conoscopic holography sensors for acquisition of specular and diffusive surfaces in artworks

Science.gov (United States)

Gaburro, Nicola; Marchioro, Giacomo; Daffara, Claudia

2017-07-01

Surface metrology of artworks requires the design of suitable devices for in-situ non-destructive measurement together with reliable procedures for an effective analysis of such non-engineered variegate objects. To advance the state-of-the-art it has been implemented a versatile optical micro-profilometry taking advantage of the adapt- ability of conoscopic holography sensors, able to operate with irregular shapes and composite materials (diffusive, specular, and polychrome) of artworks. The scanning technique is used to obtain wide field and high spatially resolved areal profilometry. The prototype has a modular scheme based on a set of conoscopic sensors, extending the typical design based on a scanning stage and a single probe with a limited bandwidth, thus allowing the collection of heights data from surface with different scales and materials with variegate optical response. The system was optimized by characterizing the quality of the measurement with the probes triggered in continuous scanning modality. The results obtained on examples of cultural heritage objects (2D paintings, 3D height-relief) and materials (pictorial, metallic) demonstrate the versatility of the implemented device.

The molecular basis of South African genetic porphyria established ...

African Journals Online (AJOL)

ship China and were to be the brides of young men, in her case Gerrit Jansz, within weeks of their arrival. ... enabled Japanese workers to exploit the properties it shared with the eukaryotic enzyme to isolate the human ... the last voyage of the Zuytdorp, a great ship of the Dutch. East India Company, which disappeared in ...

7 CFR 29.1081 - Variegated red or scorched (KR).

Science.gov (United States)

2010-01-01

....1081 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD CONTAINER... usually results from excessive heat in the curing process. Any leaf of which 20 percent or more of its...

Deficiência hídrica agrava os sintomas fisiológicos da clorose variegada dos citros em laranjeira 'Natal' Water deficiency intensifies physiological symptoms of citrus variegated clorosis in 'Natal' sweet orange plants

Directory of Open Access Journals (Sweden)

Eduardo Caruso Machado

2007-01-01

Full Text Available A clorose variegada dos citros (CVC é uma doença que tem promovido sérios prejuízos aos laranjais das regiões Norte e Nordeste do Estado de São Paulo, onde a deficiência hídrica e as altas temperaturas são mais frequentes. Assim, este trabalho objetivou a avaliação do efeito da deficiência hídrica no desenvolvimento de sintomas fisiológicos em laranjeira 'Natal' com CVC. Foram realizadas medidas do potencial da água na folha, transpiração, condutância estomática e assimilação de CO2, em laranjeiras em condições naturais e submetidas à irrigação. O delineamento experimental foi em blocos ao acaso com cinco repetições. A condutância estomática, a transpiração diária e o potencial da água na folha foram menores nas plantas com CVC. A assimilação diária de CO2 foi menor nas laranjeiras com CVC mesmo quando irrigadas. De fato, a irrigação diminuiu o efeito da CVC, porém não impediu o estabelecimento da doença em laranjeiras inoculadas com Xylella fastidiosa. Em relação aos demais tratamentos, as plantas infectadas e mantidas sob condições naturais (sem irrigação apresentaram maior comprometimento das trocas gasosas, mesmo quando as avaliações fisiológicas foram feitas em período úmido (verão.Citrus variegated chlorosis (CVC is a disease that has caused serious economical losses in citrus grove located in the North and Northeastern regions of São Paulo State, where water deficiency and high temperature occur frequently. Therefore, the aim of this work was to evaluate the influence of water deficiency on the development of physiological symptoms in 'Natal' sweet orange plants with CVC. Measurements of leaf water potential, transpiration, stomatal conductance e CO2 assimilation were taken in plants under natural conditions and submitted to irrigation. The experimental design was in randomized blocks, with five replications. Stomatal conductance, daily transpiration and leaf water potential were

7 CFR 29.2509 - Color symbols.

Science.gov (United States)

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Color symbols. 29.2509 Section 29.2509 Agriculture...-Cured Tobacco (u.s. Types 22, 23, and Foreign Type 96) § 29.2509 Color symbols. As applied to these types, color symbols are L—light brown, F—medium brown, D—dark brown, M—mixed or variegated VF—greenish...

Flowering Trees

Indian Academy of Sciences (India)

stems and handsome foliage. Leaves are 8–10 cm long, dull green, the two thin leathery halves of the lamina fusing or the cleft between them extending beyond the middle. Flowers are gorgeous, axillary with dark purple stamens. The pod is more or less flat. B. alba is often named as B. variegate var. alba by botanists.

Glucose metabolism during fasting is altered in experimental porphobilinogen deaminase deficiency.

Science.gov (United States)

Collantes, María; Serrano-Mendioroz, Irantzu; Benito, Marina; Molinet-Dronda, Francisco; Delgado, Mercedes; Vinaixa, María; Sampedro, Ana; Enríquez de Salamanca, Rafael; Prieto, Elena; Pozo, Miguel A; Peñuelas, Iván; Corrales, Fernando J; Barajas, Miguel; Fontanellas, Antonio

2016-04-01

Porphobilinogen deaminase (PBGD) haploinsufficiency (acute intermittent porphyria, AIP) is characterized by neurovisceral attacks when hepatic heme synthesis is activated by endogenous or environmental factors including fasting. While the molecular mechanisms underlying the nutritional regulation of hepatic heme synthesis have been described, glucose homeostasis during fasting is poorly understood in porphyria. Our study aimed to analyse glucose homeostasis and hepatic carbohydrate metabolism during fasting in PBGD-deficient mice. To determine the contribution of hepatic PBGD deficiency to carbohydrate metabolism, AIP mice injected with a PBGD-liver gene delivery vector were included. After a 14 h fasting period, serum and liver metabolomics analyses showed that wild-type mice stimulated hepatic glycogen degradation to maintain glucose homeostasis while AIP livers activated gluconeogenesis and ketogenesis due to their inability to use stored glycogen. The serum of fasted AIP mice showed increased concentrations of insulin and reduced glucagon levels. Specific over-expression of the PBGD protein in the liver tended to normalize circulating insulin and glucagon levels, stimulated hepatic glycogen catabolism and blocked ketone body production. Reduced glucose uptake was observed in the primary somatosensorial brain cortex of fasted AIP mice, which could be reversed by PBGD-liver gene delivery. In conclusion, AIP mice showed a different response to fasting as measured by altered carbohydrate metabolism in the liver and modified glucose consumption in the brain cortex. Glucose homeostasis in fasted AIP mice was efficiently normalized after restoration of PBGD gene expression in the liver. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Topical problems in the biosynthesis of red blood pigment

International Nuclear Information System (INIS)

Franck, B.

1982-01-01

Uroporphyrinogen III plays a key role in the biosynthesis of heme, the red pigment of blood. In vivo studies with specifically 14 C- and 3 H-labeled precursors have revealed that the formation of uroporphyrinogen III in the organism follows several primary and subsidiary pathways. Model experiments on the pattern of biosynthesis have led to simple and effective methods of synthesizing uroporphyrin analogs and have shwon that their production is strongly favored thermodynamically, The biologically important porphyrins thus available permit a mechanistic explanantion of the light-induced dermatoses in porphyria diseases and suggest promising medical applications in diagnosis and therapy. (orig.)

Lupus community panel proposals for optimising clinical trials: 2018

Science.gov (United States)

Merrill, Joan T; Manzi, Susan; Aranow, Cynthia; Askenase, Anca; Bruce, Ian; Chakravarty, Eliza; Chong, Ben; Costenbader, Karen; Dall’Era, Maria; Ginzler, Ellen; Hanrahan, Leslie; Kalunian, Ken; Merola, Joseph; Raymond, Sandra; Rovin, Brad; Saxena, Amit; Werth, Victoria P

2018-01-01

Formidable impediments stand in the way of treatment development for lupus. These include the unwieldy size of current trials, international competition for scarce patients, complex outcome measures and a poor understanding of these outcomes in the world at large. The heterogeneity of the disease itself coupled to superimposition of variegated background polypharmacy has created enough immunological noise to virtually ensure the failure of lupus treatment trials, leaving an understandable suspicion that at least some of the results in testing failed drugs over the years may not have been negative, but merely uninterpretable. The authors have consulted with many clinical trial investigators, biopharmaceutical developers and stakeholders from government and voluntary sectors. This paper examines the available evidence that supports workable trial designs and proposes approaches to improve the odds of completing interpretable treatment development programs for lupus. PMID:29657738

A Conceptual Framework to Explain the Role of Social Environment and Multicultural Personality on Intercultural Communication Competency, Inter Role Congruence and Interaction Comfort

OpenAIRE

Omar, Rosmini; Ihtiyar, Ali; Ahmad, Fauziah Sh.

2015-01-01

The multicultural markets require marketers to gain strong interculturalcommunication competency (ICC). Several earlier studies have emphasized thesignificance of ICC in marketing. However, empirical investigations of the subjectare scarce and inconclusive. The exceptional characteristic of Malaysia with itsexceedingly variegated multicultural and combined ethnic mix makes it one of theproper examples for ICC research and analysis to explain its antecedents andconsequence in retailing industr...

Surfing the web and parkinson's law.

Science.gov (United States)

Baldwin, F D

1996-05-01

The World Wide Web accounts for much of the popular interest in the Internet and offers a rich and variegated source of medical information. It's where you'll find online attractions ranging from "The Visible Human" to collections of lawyer jokes, as well as guides to clinical materials. Here's a basic introduction to the Web, its features, and its vocabulary.

What is the Difference in Morphologic Features of the Thoracic Pedicle Between Patients With Adolescent Idiopathic Scoliosis and Healthy Subjects? A CT-based Case-control Study.

Science.gov (United States)

Gao, Bo; Gao, Wenjie; Chen, Chong; Wang, Qinghua; Lin, Shaochun; Xu, Caixia; Huang, Dongsheng; Su, Peiqiang

2017-11-01

Describing the morphologic features of the thoracic pedicle in patients with adolescent idiopathic scoliosis is necessary for placement of pedicle screws. Previous studies showed inadequate reliability owing to small sample size and heterogeneity of the patients surveyed. To use CT scans (1) to describe the morphologic features of 2718 thoracic pedicles from 60 female patients with Lenke Type 1 adolescent idiopathic scoliosis and 60 age-, sex-, and height-matched controls; and (2) to classify the pedicles in three types based on pedicle width and analyze the distribution of each type. A total of 2718 pedicles from 60 female patients with Lenke Type 1 adolescent idiopathic scoliosis and 60 matched female controls were analyzed via CT. All patients surveyed were diagnosed with adolescent idiopathic scoliosis, Lenke Type 1, at the First Affiliated Hospital of Sun Yat-sen University, and all underwent pedicle screw fixation between January 2008 and December 2013 with preoperative radiographs and CT images on file. We routinely obtained CT scans before these procedures; all patients who underwent surgery during that period had CT scans, and all were available for analysis here. Control subjects had CT scans for other clinical indications and had no abnormal findings of the spine. The control subjects were chosen to match patients in terms of age (15 ± 2.6 years versus 15 ± 2.6 years) and sex. Height of the two groups also was matched (154 ± 9 cm versus 155 ± 10 cm; mean difference, -1.06 cm; 95% CI, -1.24 to -0.81 cm; p adolescent idiopathic scoliosis (22%; 293 of 1322) compared with controls (13%; 178 of 1396) (odds ratio [OR] = 0.51; 95% CI, 0.42-0.63; p adolescent idiopathic scoliosis, they commonly occurred on the concave side 34% (228 of 661) and on the AV-SC region (32%; 43 of 136). Pedicle width on the concave side was narrower than pedicle width on the convex side and pedicle width in healthy control subjects. The apical vertebra in the structural curve was

62 case report hepatitis c virus-associated porphyria cutanea tarda

African Journals Online (AJOL)

boaz

Porhyria cutanea tarda (PCT) is a rare, inherited or acquired disorder due to decreased activity or deficiency of uroporphyrinogen decarboxylase (UROD), one of the enzymes in the haem synthetic pathway. It is characterized by cutaneous manifestations such as erosions, blisters and bulae in the dorsum of the hand, ...

Beyond bureaucracy and entrepreneurialism:examining the multiple discursive codes informing the work, careers and subjectivities of management graduates

OpenAIRE

Loacker, Bernadette Isabel; Sliwa, Martyna

2016-01-01

This paper examines how discursive codes and demands associated with ‘bureaucratic and entrepreneurial regimes’ of work and career organization shape the work, careers and subjectivities of management graduates. The study is based on an analysis of 30 narratives of management professionals who graduated from an Austrian business school in the early 1970s or 2000s. Its insights suggest that variegated discursive codes manifest in the graduates’ articulated professional practices and subjectivi...

Analytical Approach to Fictional Elements of Sandbadnameh

Directory of Open Access Journals (Sweden)

a عارفی

2014-05-01

Using stock and allegorical characters, fixed tone and style in dialogue tales, lack of variegated plot and logical and stable relationship between events make this work far from contemporary criteria of fiction writing in spite of its great volume, and introduce it as a symbolic and allegorical tale. On the other hand, bombastic and embellished prose as well as being loyal to ancient fiction writing have added to literary significance of this literary work.

Selected Jesus sayings on materialism according to the Sermon on the Mount (Matt. 5-7) in judging the so-called prosperity theology

OpenAIRE

2008-01-01

Prosperity theology is a variegated movement that overlaps both the Charismatic and non-Charismatic spectrums. This theology certainly has a Charismatic flavouring, but it is by no means limited to Pentecostalism. The prosperity message is being preached world-wide on TBN Television, radio and printed media. This gospel focuses on human potential for successful living, emphasizing health and wealth. There is a clear shift notable from theocentric providence to anthropocentric prosperity in th...

Toward an African-Christian Demonology: The Demonologies of African Traditional Religion, African Christianity, and Early Christianity in Dialogue

OpenAIRE

Moscicke, Hans

2017-01-01

Christian interactions with the spirit-world of African traditional religion (ATR) have remained problematic due, in part, to the failure of Christian missionaries to understand in detail the cosmology of ATR and the angelologies and demonologies of early Christianity. In this article I suggest a way beyond this impasse. I first survey the shape of cosmology and demonology in ATR, and then examine African Christianitys variegated responses to these traditional beliefs. Finally, I submit that ...

'I expected just to walk in, get my tablets and then walk out': on framing new community pharmacy services in the English healthcare system.

Science.gov (United States)

Latif, Asam; Waring, Justin; Watmough, Deborah; Boyd, Matthew J; Elliott, Rachel A

2018-04-19

Reconfiguration of the healthcare division of labour is becoming increasingly attractive in the context of increased patient demand and resource constraints. One example is the introduction of extended roles for pharmacists to provide patients additional support to manage their medicines, while also reducing work pressures experienced by other health professionals. Understanding how such policies are framed by those delivering and receiving care has been under-theorised. Using Goffman's frame theory, we examine one newly introduced community pharmacy service (New Medicines Service (NMS)) to illustrate how a policy intended to support patient medicine-taking through the extended roles of pharmacists is framed and where this deviates from its proposed aims. Three themes emerged: (i) the spatial-material artefacts; (ii) existing discursive culture and practice around medicine-taking; and (iii) the NMS interactions that shape and govern framing and subsequent interpretation of the NMS. Our study offers an explanatory and dynamic view of the framing process with important lessons for reconfiguring medicine management policy and practice. As well as illustrating framing as being variegated, complementary or conflicting, it also shows how this plurality and fragility had consequences for patient engagement and sense-making. The consequences for engagement and recommendations for implementing future initiatives are discussed. © 2018 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

Listener: a probe into information based material specification

DEFF Research Database (Denmark)

Ramsgaard Thomsen, Mette; Karmon, Ayelet

2011-01-01

This paper presents the thinking and making of the architectural research probe Listener. Developed as an interdisciplinary collaboration between textile design and architecture, Listener explores how information based fabrication technologies are challenging the material practices of architecture....... The paper investigates how textile design can be understood as a model for architectural production providing new strategies for material specification and allowing the thinking of material as inherently variegated and performative. The paper traces the two fold information based strategies present...

ACADIA 2010 konference: listener

DEFF Research Database (Denmark)

Ramsgaard Thomsen, Mette; Karmon, Ayelet

2010-01-01

This paper presents the thinking and making of the architectural research probe Listener. Developed as an interdisciplinary collaboration between textile design and architecture, Listener explores how information based fabrication technologies are challenging the material practices of architecture....... The paper investigates how textile design can be understood as a model for architectural production providing new strategies for material specification and allowing the thinking of material as inherently variegated and performative. The paper traces the two fold information based strategies present...

Margie Orford’s Hybrid Narratives: Crime Fiction Subgenres and the Theme of Misogyny in Daddy’s Girl and Like Clockwork

OpenAIRE

Horne, Karina Sofi

2015-01-01

This thesis sets out to identity the different types of subgenres that constitute Margie Orford’s crime fiction novels Like Clockwork and Daddy’s Girl, and to explore their connections to the extensive and variegated descriptions of misogyny that pervades both novels. The research consists of two parts: The first part provides a general description of the different subgenres that Orford’s works make use of: Classical detective fiction, hardboiled detective fiction, the police procedural/novel...

Distribution of the Sunda Colugo (Galeopterus variegatus) in Malaysia (Peninsular, Sabah, Sarawak)

OpenAIRE

Nasir, Muhammad Dzulhelmi Muhammad; Abdullah, Mohd Tajuddin

2010-01-01

There is not much information available on the distribution of the Sunda colugo (Galeopterus variegates) in Malaysia, despite it being one of only two known species in the order Dermoptera. Data on the presence of the Sunda colugo and the vernacular names used by various ethnic groups throughout Malaysia were collected and compiled from various primary and secondary sources. There were 27 locations from Peninsular, 11 locations from Sabah and 34 locations from Sarawak that reported the presen...

Echocardiographic study of left atrial myxoma

Directory of Open Access Journals (Sweden)

Dalal J

1979-01-01

Full Text Available Four cases of left atrial myxoma were diagnosed pre-operatively by echocardiography. All cases showed characteristic echocardio-graphic features of variegated shadows behind the mitral valve in diastole and within the left atrium in systole. In two cases the my-xomas were surgically removed and confirmed on histology. In one case the post-operative echocardiogram showed complete dis-appearance of the abnormal shadows. Echocardiography is the most reliable method today for the diagnosis of a myxoma.

Nutritional deficiency in citrus with symptoms of citrus variegated chlorosis disease

Directory of Open Access Journals (Sweden)

ME. Silva-Stenico

Full Text Available It is well known that citrus plants that have been infected by Xylella fastidiosa display nutritional deficiencies, probably caused by production of extracellular polymers by the bacteria that block normal nutrient flow through the xylem. The aim of this work was to study the mineral composition of specific foliar areas in different stages of infection in citrus. Thus, the concentrations of macro and micronutrients in leaves of citrus infected by X. fastidiosa were measured. Samples from four infected citrus orchards in the State of São Paulo, Brazil, were respectively collected from Santa Rita do Passa Quatro, Neves Paulista, Gavião Peixoto and Paraíso counties. The presence of X. fastidiosa in leaves was confirmed by polymerase chain reaction (PCR using specific PCR primers. To understand the variation in leaf-nutrient content in citrus plants, we used foliar nutrient values from control (non-symptomatic plants as a reference. Chemometric analysis showed that the deficiency of P and K in symptomatic trees for all orchards and high concentrations of Fe, Mn and Zn were observed in chlorotic areas, although other studies revealed deficiency of zinc in leaves. This is the first report showing that a correlation between chlorotic citrus leaf and higher concentrations of Fe, Mn and Zn are observed when infected and healthy plants were compared.

Physiological differences and changes in global DNA methylation levels in Agave angustifolia Haw. albino variant somaclones during the micropropagation process.

Science.gov (United States)

Duarte-Aké, Fátima; Castillo-Castro, Eduardo; Pool, Felipe Barredo; Espadas, Francisco; Santamaría, Jorge M; Robert, Manuel L; De-la-Peña, Clelia

2016-12-01

Global DNA methylation changes caused by in vitro conditions are associated with the subculturing and phenotypic variation in Agave angustifolia Haw. While the relationship between the development of albinism and in vitro culture is well documented, the role of epigenetic processes in this development leaves some important questions unanswered. During the micropropagation of Agave angustifolia Haw., we found three different phenotypes, green (G), variegated (V) and albino (A). To understand the physiological and epigenetic differences among the somaclones, we analyzed several morphophysiological parameters and changes in the DNA methylation patterns in the three phenotypes during their in vitro development. We found that under in vitro conditions, the V plantlets maintained their CAM photosynthetic capacity, while the A variant showed no pigments and lost its CAM photosynthetic ability. Epigenetic analysis revealed that global DNA methylation increased in the G phenotype during the first two subcultures. However, after that time, DNA methylation levels declined. This hypomethylation correlated with the appearance of V shoots in the G plantlets. A similar correlation occurred in the V phenotype, where an increase of 2 % in the global DNA methylation levels was correlated with the generation of A shoots in the V plantlets. This suggests that an "epigenetic stress memory" during in vitro conditions causes a chromatin shift that favors the generation of variegated and albino shoots.

Mutations in the Arabidopsis AtMRS2-11/AtMGT10/VAR5 Gene Cause Leaf Reticulation

Directory of Open Access Journals (Sweden)

Shuang Liang

2017-11-01

Full Text Available In higher plants, the development of functional chloroplasts is essential for photosynthesis and many other physiological processes. With a long-term goal of elucidating the genetic regulation of chloroplast development, we identified two allelic leaf variegation mutants, variegated5-1 (var5-1 and var5-2. Both mutants showed a distinct leaf reticulation phenotype of yellow paraveinal regions and green interveinal regions, and the leaf reticulation phenotype correlated with photosynthetic defects. Through the identification of mutation sites in the two mutant alleles and the molecular complementation, we confirmed that VAR5 encodes a CorA family of Mg2+ transporters also known as AtMRS2-11/AtMGT10. Using protoplast transient expression and biochemical fractionation assays, we demonstrated that AtMRS2-11/AtMGT10/VAR5 likely localizes to the chloroplast envelope. Moreover, we established that AtMRS2-11/AtMGT10/VAR5 forms large molecular weight complexes in the chloroplast and the sizes of these complexes clearly exceed those of their bacterial counterparts, suggesting the compositions of CorA Mg2+ transporter complex is different between the chloroplast and bacteria. Our findings indicate that AtMRS2-11/AtMGT10/VAR5 plays an important role in the tissue specific regulation of chloroplast development.

Photomedicine

International Nuclear Information System (INIS)

Ben-Hur, E.; Rosenthal, I.

1987-01-01

Volume I of this book contains: Basics of Photochemistry; Molecular and Cellular Photobiology; Acute Cutaneous Effects of Light; The Homology of UV-Mediated Cutaneous Carcinogenic and Aging Processes; Effects of Sunlight on the Eye; Photoimmunology; Photosensitivity to Drugs; and Porphyrias. Volume II contains: The Idiopathic Photodermatoses; Xeroderma Pigmentosum; Beta-Carotene Therapy for Erythropoietic Protoporphyria and Other Photosensitivity Diseases; Photochemotherapy of Psoriasis Using the Furocoumrains; Photochemotherapy of Various Skin Disorders; Photodynamic Therapy of Cancer; and Photoimmunotherapy. Volume III of this book contains: The Phthalocyanines: Sensitizers with Potential for Photodynamic Therapy of Cancer; Lasers in Surgery and Medicine; Lasers in Opthalmology; The Carbon Dioxide Laser in Orthopedic Surgery. Diagnostic Uses of Light; Sources and Measurements of Optical Radiation for Medical Applications; and Safety Measures in Optical Radiation Treatment

Crystal structure of a small heat-shock protein from Xylella fastidiosa reveals a distinct high-order structure.

Science.gov (United States)

Fonseca, Emanuella Maria Barreto; Scorsato, Valéria; Dos Santos, Marcelo Leite; Júnior, Atilio Tomazini; Tada, Susely Ferraz Siqueira; Dos Santos, Clelton Aparecido; de Toledo, Marcelo Augusto Szymanski; de Souza, Anete Pereira; Polikarpov, Igor; Aparicio, Ricardo

2017-04-01

Citrus variegated chlorosis is a disease that attacks economically important citrus plantations and is caused by the plant-pathogenic bacterium Xylella fastidiosa. In this work, the structure of a small heat-shock protein from X. fastidiosa (XfsHSP17.9) is reported. The high-order structures of small heat-shock proteins from other organisms are arranged in the forms of double-disc, hollow-sphere or spherical assemblies. Unexpectedly, the structure reported here reveals a high-order architecture forming a nearly square cavity.

The DCL gene of tomato is required for chloroplast development and palisade cell morphogenesis in leaves.

OpenAIRE

Keddie, J S; Carroll, B; Jones, J D; Gruissem, W

1996-01-01

The defective chloroplasts and leaves-mutable (dcl-m) mutation of tomato was identified in a Ds mutagenesis screen. This unstable mutation affects both chloroplast development and palisade cell morphogenesis in leaves. Mutant plants are clonally variegated as a result of somatic excision of Ds and have albino leaves with green sectors. Leaf midribs and stems are light green with sectors of dark green tissue but fruit and petals are wild-type in appearance. Within dark green sectors of dcl-m l...

Emergency management of acute abdomen in children.

Science.gov (United States)

Balachandran, Binesh; Singhi, Sunit; Lal, Sadhna

2013-03-01

Acute abdomen can be defined as a medical emergency in which there is sudden and severe pain in abdomen with accompanying signs and symptoms that focus on an abdominal involvement. It accounts for about 8 % of all children attending the emergency department. The goal of emergency management is to identify and treat any life-threatening medical or surgical disease condition and relief from pain. In mild cases often the cause is gastritis or gastroenteritis, colic, constipation, pharyngo-tonsilitis, viral syndromes or acute febrile illnesses. The common surgical causes are malrotation and Volvulus (in early infancy), intussusception, acute appendicitis, and typhoid and ischemic enteritis with perforation. Lower lobe pneumonia, diabetic ketoacidosis and acute porphyria should be considered in patients with moderate-severe pain with little localizing findings in abdomen. The approach to management in ED should include, in order of priority, a rapid cardiopulmonary assessment to ensure hemodynamic stability, focused history and examination, surgical consult and radiologic examination to exclude life threatening surgical conditions, pain relief and specific diagnosis. In a sick patient the initial steps include rapid IV access and normal saline 20 ml/kg (in the presence of shock/hypovolemia), adequate analgesia, nothing per oral/IV fluids, Ryle's tube aspiration and surgical consultation. An ultrasound abdomen is the first investigation in almost all cases with moderate and severe pain with localizing abdominal findings. In patients with significant abdominal trauma or features of pancreatitis, a Contrast enhanced computerized tomography (CECT) abdomen will be a better initial modality. Continuous monitoring and repeated physical examinations should be done in all cases. Specific management varies according to the specific etiology.

Multiplexed lateral flow microarray assay for detection of citrus pathogens Xylella fastidiosa and Xanthomonas axonopodis pv citri

Energy Technology Data Exchange (ETDEWEB)

Cary,; Bruce, R [Santa Fe, NM; Stubben, Christopher J [Los Alamos, NM

2011-03-22

The invention provides highly sensitive and specific assays for the major citrus pathogens Xylella fastidiosa and Xanthomonas axonopodis, including a field deployable multiplexed assay capable of rapidly assaying for both pathogens simultaneously. The assays are directed at particular gene targets derived from pathogenic strains that specifically cause the major citrus diseases of citrus variegated chlorosis (Xylella fastidiosa 9a5c) and citrus canker (Xanthomonas axonopodis pv citri). The citrus pathogen assays of the invention offer femtomole sensitivity, excellent linear dynamic range, and rapid and specific detection.

Cytological study of radiation induced alterations in cytoplasmic factors controlling male sterility in corn. Progress report, February 28, 1975--December 1, 1975

International Nuclear Information System (INIS)

Edwardson, J.R.

1975-01-01

Progress is reported on the following research projects: cytoplasmic constituents of the embryo of various gymnosperms and angiosperms; cytoplasmic male sterility in corn; modification of cytoplasmic sterility factors using gamma radiation, EMS, and ethidium bromide; selection for sterile, blight-resistant corn plants; electron microscopy study of abnormal mitochondria in cytoplasm of corn; cytoplasmic male sterility in Petunia; non-Mendelian variegation in Petunia and Nicotiana; graft transmission of cytoplasmic male sterility; cytoplasmic male sterility in Vicia faba; and studies on Blakeslee's I virus in Datura

Spatial extent of analysis influences observed patterns of population genetic structure in a widespread darter species (Percidae)

Science.gov (United States)

Argentina, Jane E.; Angermeier, Paul L.; Hallerman, Eric M.; Welsh, Stuart A.

2018-01-01

Connectivity among stream fish populations allows for exchange of genetic material and helps maintain genetic diversity, adaptive potential and population stability over time. Changes in species demographics and population connectivity have the potential to permanently alter the genetic patterns of stream fish, although these changes through space and time are variable and understudied in small‐bodied freshwater fish.As a spatially widespread, common species of benthic freshwater fish, the variegate darter (Etheostoma variatum) is a model species for documenting how patterns of genetic structure and diversity respond to increasing isolation due to large dams and how scale of study may shape our understanding of these patterns. We sampled variegate darters from 34 sites across their range in the North American Ohio River basin and examined how patterns of genetic structure and diversity within and between populations responded to historical population changes and dams within and between populations.Spatial scale and configuration of genetic structure varied across the eight identified populations, from tributaries within a watershed, to a single watershed, to multiple watersheds that encompass Ohio River mainstem habitats. This multiwatershed pattern of population structuring suggests genetic dispersal across large distances was and may continue to be common, although some populations remain isolated despite no apparent structural dispersal barriers. Populations with low effective population sizes and evidence of past population bottlenecks showed low allelic richness, but diversity patterns were not related to watershed size, a surrogate for habitat availability. Pairwise genetic differentiation (FST) increased with fluvial distance and was related to both historic and contemporary processes. Genetic diversity changes were influenced by underlying population size and stability, and while instream barriers were not strong determinants of genetic structuring or

The molecular basis for stability of heterochromatin-mediated silencing in mammals.

Science.gov (United States)

Hiragami-Hamada, Kyoko; Xie, Sheila Q; Saveliev, Alexander; Uribe-Lewis, Santiago; Pombo, Ana; Festenstein, Richard

2009-11-04

The archetypal epigenetic phenomenon of position effect variegation (PEV) in Drosophila occurs when a gene is brought abnormally close to heterochromatin, resulting in stochastic silencing of the affected gene in a proportion of cells that would normally express it. PEV has been instrumental in unraveling epigenetic mechanisms. Using an in vivo mammalian model for PEV we have extensively investigated the molecular basis for heterochromatin-mediated gene silencing. Here we distinguish 'epigenetic effects' from other cellular differences by studying ex vivo cells that are identical, apart from the expression of the variegating gene which is silenced in a proportion of the cells. By separating cells according to transgene expression we show here that silencing appears to be associated with histone H3 lysine 9 trimethylation (H3K9me3), DNA methylation and the localization of the silenced gene to a specific nuclear compartment enriched in these modifications. In contrast, histone H3 acetylation (H3Ac) and lysine 4 di or tri methylation (H3K4me2/3) are the predominant modifications associated with expression where we see the gene in a euchromatic compartment. Interestingly, DNA methylation and inaccessibility, rather than H3K9me3, correlated most strongly with resistance to de-repression by cellular activation. These results have important implications for understanding the contribution of specific factors involved in the establishment and maintenance of gene silencing and activation in vivo.

Il mare della fertilità Una analisi antropologica della tetralogia di Mishima Yukio

Directory of Open Access Journals (Sweden)

Giovanni Azzaroni

2013-05-01

Full Text Available Abstract – IT Neve di primavera è il primo romanzo della tetralogia 'Il mare della fertilità', il capolavoro dello scrittore giapponese, che si snoda in un Giappone caratterizzato sia da una cultura ancestrale sia da una invadente modernità e prelude a quel drammatico 25 novembre 1970 quando Mishima, scritte le ultime parole della tetralogia, si suicidò con l’antico rituale del seppuku. Neve di primavera è una narrazione polisemica costruita su opposizioni binarie strutturali, le vicende dei personaggi sono calate in un preciso contesto storico e culturale e per decodificarle è proposta una metodologia antropologica, nel tentativo, al tempo stesso, di coglierne le variegate e molteplici sfumature e, nel contempo, anche le interconnessioni con il tessuto ontologico che ne ha favorito il nascere e lo svilupparsi. Abstract – EN Spring snow is the first novel of the tetralogy The sea of Fertility, the masterpiece of the Japanese writer, which takes place in ancient and modern Japan. The novel is a prelude to the dramatic 25th November 1970: Mishima finished the tetralogy and committed suicide by the ancient seppuku ritual. Spring snow is a polisemic story which is constructed by binary and structural oppositions, the plot of the characters is drawn on a exact, historical and cultural context to catch either the variegated and various shadings or the relations with the ontological substratum, which helped its birth and development.

Il mare della fertilità Una analisi antropologica della tetralogia di Mishima Yukio

Directory of Open Access Journals (Sweden)

Giovanni Azzaroni

2012-01-01

Full Text Available Abstract – IT Neve di primavera è il primo romanzo della tetralogia Il mare della fertilità, il capolavoro dello scrittore giapponese, che si snoda in un Giappone caratterizzato sia da una cultura ancestrale sia da una invadente modernità e prelude a quel drammatico 25 novembre 1970 quando Mishima, scritte le ultime parole della tetralogia, si suicidò con l’antico rituale del seppuku. Neve di primavera è una narrazione polisemica costruita su opposizioni binarie strutturali, le vicende dei personaggi sono calate in un preciso contesto storico e culturale e per decodificarle è proposta una metodologia antropologica, nel tentativo, al tempo stesso, di coglierne le variegate e molteplici sfumature e, nel contempo, anche le interconnessioni con il tessuto ontologico che ne ha favorito il nascere e lo svilupparsi. Abstract – EN Spring snow is the first novel of the tetralogy The sea of Fertility, the masterpiece of the Japanese writer, which takes place in ancient and modern Japan. The novel is a prelude to the dramatic 25th November 1970: Mishima finished the tetralogy and committed suicide by the ancient seppuku ritual. Spring snow is a polisemic story which is constructed by binary and structural oppositions, the plot of the characters is drawn on a exact, historical and cultural context to catch either the variegated and various shadings or the relations with the ontological substratum, which helped its birth and development.

The molecular basis for stability of heterochromatin-mediated silencing in mammals

Directory of Open Access Journals (Sweden)

Hiragami-Hamada Kyoko

2009-11-01

Full Text Available Abstract The archetypal epigenetic phenomenon of position effect variegation (PEV in Drosophila occurs when a gene is brought abnormally close to heterochromatin, resulting in stochastic silencing of the affected gene in a proportion of cells that would normally express it. PEV has been instrumental in unraveling epigenetic mechanisms. Using an in vivo mammalian model for PEV we have extensively investigated the molecular basis for heterochromatin-mediated gene silencing. Here we distinguish 'epigenetic effects' from other cellular differences by studying ex vivo cells that are identical, apart from the expression of the variegating gene which is silenced in a proportion of the cells. By separating cells according to transgene expression we show here that silencing appears to be associated with histone H3 lysine 9 trimethylation (H3K9me3, DNA methylation and the localization of the silenced gene to a specific nuclear compartment enriched in these modifications. In contrast, histone H3 acetylation (H3Ac and lysine 4 di or tri methylation (H3K4me2/3 are the predominant modifications associated with expression where we see the gene in a euchromatic compartment. Interestingly, DNA methylation and inaccessibility, rather than H3K9me3, correlated most strongly with resistance to de-repression by cellular activation. These results have important implications for understanding the contribution of specific factors involved in the establishment and maintenance of gene silencing and activation in vivo.

Induced chlorophyll variation in pineapple c v. 'queen' by gamma irradiation (60Cobalt)

International Nuclear Information System (INIS)

Valencia, Lolita DC.

2012-01-01

Irradiation using gamma rays ( 60 Cobalt) coupled with in vitro culture techniques was undertaken to induce variation or mutation in pineapple. Calli from crown meristem tips of pineapple cv 'Queen' [Ananas comosus (L.) Merr.] were initiated using Murashiege and Skoog's basal meduim supplemented with 10mg/liter 4-amino-3,5,6-trichloro-2-pyrodinecarboxylic acid (Picloram). High percentage of growth and shoot proliferation was observed in basal medium supplemented with 50 μM benzene adenine purine (BAP) and 10 μM gibberrelic acid (GA) after 8 weeks in vitro. Regenerants derived from shoots using different doses of gamma rays (0, 5, 10, 15, 20, 25 and 30 Gy) were evaluated under laboratory conditions. Of the different doses, 15 Gy produced the most variegation in young shoots (chlorophyll variants) maintained in vitro. The variants appeared to have yellow and green color combinations of the young leaves of pineapple 'Queen' variety. When transplanted inside the greenhouse, high percentage of plantlets survival was observed, ranging from 90-95%. Of the different irradiation doses, variegation in young leaves was observed at 15, 20, 25 and 30 Gy. Further assessment on the effect of irradiation is currently being unertaken under screen house conditions. The variants produced could serve a basis for selection of ornamental-type pineapple. In addition, protocols developed on the use of in vitro culture techniques could be utilized as a tool for induced mutation breeding in pineapple. (author)

75 FR 17289 - Citrus Seed Imports; Citrus Greening and Citrus Variegated Chlorosis

Science.gov (United States)

2010-04-06

... Argentina and Jamaica after the October 6, 2009, Federal Import Quarantine Order was issued, we are... differing genetic histories. Nursery stock, plants, and other propagative plant material that can be..., Murraya, Poncirus, Severinia, Swinglea, Toddalia, Triphasia, and Vepris from Argentina, Bangladesh, Belize...

76 FR 8603 - Citrus Seed Imports; Citrus Greening and Citrus Variegated Chlorosis

Science.gov (United States)

2011-02-15

.../fdmspublic/component/main?main=DocketDetail&d=APHIS-2008-0052 . Comments on the interim rule were required to... that end, we cited a 2003 study \\6\\ by W.B. Li et al. (referred to below as Li et al.). \\6\\ Li, W.B., W... out that Li et al. was conducted only on three [[Page 8605

Overview of technical trend of optical fiber/cable and research and development strategy of Samsung

Science.gov (United States)

Kim, Jin H.

2005-01-01

Fiber-to-the-Premise (FTTP), a keyword in the current fiber and cable industry, leads us variegated directions of the research and development activities. In fact, this momentum of industry seems to be weak yet, since the bandwidth demand by market is still unbalanced to the capacity in the several market segments. However, the recent gradual recovery in metro and access network indicates a positive sign for FTTP deployment projects. It is the very preferable for us to optimize R&D strategy applicable to the current market trend of sequential investment.

Elemental composition changes in citrus affected by the CVC disease

International Nuclear Information System (INIS)

Nadai Fernandes de, A.A.; Tagliaferro, F.S.; Turra, C.; Franca de, E.J.; Bacchi, M.A.

2008-01-01

The citrus variegated chlorosis (CVC) disease results in serious economical losses for the Brazilian citriculture. The influence of CVC disease on the elemental composition of citrus plants was investigated. Leaves of sweet orange varieties Hamlin, Pera Rio and Valencia were collected from healthy and CVC-affected trees for chemical characterization by instrumental neutron activation analysis (INAA). Significant differences between healthy and CVC-affected leaves were identified for Ca, Ce, Co, Eu, Fe, K, La, Na, Nd, Rb, Sc and Sm. Rare earth elements presented consistently higher mass fractions in the healthy leaves. (author)

Metabolic pancreatitis: Etiopathogenesis and management

Directory of Open Access Journals (Sweden)

Sunil Kumar Kota

2013-01-01

Full Text Available Acute pancreatitis is a medical emergency. Alcohol and gallstones are the most common etiologies accounting for 60%-75% cases. Other important causes include postendoscopic retrograde cholangiopancreatography procedure, abdominal trauma, drug toxicity, various infections, autoimmune, ischemia, and hereditary causes. In about 15% of cases the cause remains unknown (idiopathic pancreatitis. Metabolic conditions giving rise to pancreatitis are less common, accounting for 5%-10% cases. The causes include hypertriglyceridemia, hypercalcemia, diabetes mellitus, porphyria, and Wilson′s disease. The episodes of pancreatitis tend to be more severe. In cases of metabolic pancreatitis, over and above the standard routine management of pancreatitis, careful management of the underlying metabolic abnormalities is of paramount importance. If not treated properly, it leads to recurrent life-threatening bouts of acute pancreatitis. We hereby review the pathogenesis and management of various causes of metabolic pancreatitis.

Sexual dimorphism in white campion: complex control of carpel number is revealed by Y chromosome deletions

International Nuclear Information System (INIS)

Lardon, A.; Georgiev, S.; Aghmir, A.; Le Merrer, G.; Negrutiu, I.

1999-01-01

Sexual dimorphism in the dioecious plant white campion (Silene latifolia = Melandrium album) is under the control of two main regions on the Y chromosome. One such region, encoding the gynoecium-suppressing function (GSF), is responsible for the arrest of carpel initiation in male flowers. To generate chromosomal deletions, we used pollen irradiation in male plants to produce hermaphroditic mutants (bsx mutants) in which carpel development was restored. The mutants resulted from alterations in at least two GSF chromosomal regions, one autosomal and one located on the distal half of the (p)-arm of the Y chromosome. The two mutations affected carpel development independently, each mutation showing incomplete penetrance and variegation, albeit at significantly different levels. During successive meiotic generations, a progressive increase in penetrance and a reduction in variegation levels were observed and quantified at the level of the Y-linked GSF (GSF-Y). Possible mechanisms are proposed to explain the behavior of the bsx mutations: epigenetic regulation or/and second-site mutation of modifier genes. In addition, studies on the inheritance of the hermaphroditic trait showed that, unlike wild-type Y chromosomes, deleted Y chromosomes can be transmitted through both the male and the female lines. Altogether, these findings bring experimental support, on the one hand, to the existence on the Y chromosome of genic meiotic drive function(s) and, on the other hand, to models that consider that dioecy evolved through multiple mutation events. As such, the GSF is actually a system containing more than one locus and whose primary component is located on the Y chromosome

WHITE PANICLE3, a Novel Nucleus-Encoded Mitochondrial Protein, Is Essential for Proper Development and Maintenance of Chloroplasts and Mitochondria in Rice

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Hongchang Li

2018-06-01

Full Text Available Mitochondria and chloroplasts are interacting organelles that play important roles in plant development. In addition to a small number proteins encoded by their own genomes, the majority of mitochondrial and chloroplast proteins are encoded in the cell nucleus and imported into the organelle. As a consequence, coordination between mitochondria, chloroplasts, and the nucleus is of crucial importance to plant cells. Variegated mutants are chloroplast-defective mutants and are considered to be ideal models for studying the intercommunication between these organelles. Here, we report the isolation of WHITE PANICLE3 (WP3, a nuclear gene involved in variegation, from a naturally occurring white panicle rice mutant. Disrupted expression of WP3 in the mutant leads to severe developmental defects in both chloroplasts and mitochondria, and consequently causes the appearance of white-striped leaves and white panicles in the mutant plants. Further investigation showed that WP3 encodes a protein most likely targeted to mitochondria and is specifically expressed in rice panicles. Interestingly, we demonstrate that the recessive white-panicle phenotype in the wp3 mutant is inherited in a typical Mendelian manner, while the white-striped leaf phenotype in wp3 is maternally inherited. Our data collectively suggest that the nucleus-encoded mitochondrial protein, WP3, plays an essential role in the regulation of chloroplast development in rice panicles by maintaining functional mitochondria. Therefore, the wp3 mutant is an excellent model in which to explore the communication between the nucleus, mitochondria, and chloroplasts in plant cells.

Chromatic illumination discrimination ability reveals that human colour constancy is optimised for blue daylight illuminations.

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Bradley Pearce

Full Text Available The phenomenon of colour constancy in human visual perception keeps surface colours constant, despite changes in their reflected light due to changing illumination. Although colour constancy has evolved under a constrained subset of illuminations, it is unknown whether its underlying mechanisms, thought to involve multiple components from retina to cortex, are optimised for particular environmental variations. Here we demonstrate a new method for investigating colour constancy using illumination matching in real scenes which, unlike previous methods using surface matching and simulated scenes, allows testing of multiple, real illuminations. We use real scenes consisting of solid familiar or unfamiliar objects against uniform or variegated backgrounds and compare discrimination performance for typical illuminations from the daylight chromaticity locus (approximately blue-yellow and atypical spectra from an orthogonal locus (approximately red-green, at correlated colour temperature 6700 K, all produced in real time by a 10-channel LED illuminator. We find that discrimination of illumination changes is poorer along the daylight locus than the atypical locus, and is poorest particularly for bluer illumination changes, demonstrating conversely that surface colour constancy is best for blue daylight illuminations. Illumination discrimination is also enhanced, and therefore colour constancy diminished, for uniform backgrounds, irrespective of the object type. These results are not explained by statistical properties of the scene signal changes at the retinal level. We conclude that high-level mechanisms of colour constancy are biased for the blue daylight illuminations and variegated backgrounds to which the human visual system has typically been exposed.

Secondary Metabolites of the Cuticular Abdominal Glands of Variegated Grasshopper (Zonocerus variegatus L.

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O. U. Igwe

2015-01-01

Full Text Available Chemical compounds were extracted with petroleum ether from the cuticular abdominal glands of grasshopper (Zonocerus variegatus L. and eleven compounds were characterised using Gas Chromatography/Mass Spectrometry (GC/MS technique in combination with Fourier Transform-Infrared Spectroscopy (FT-IR. The compounds analysed were 2,7-dimethyloctane (3.21%, decane (5.33%, undecane (3.81%, tridecanoic acid methyl ester (4.76%, hexadecanoic acid (9.37%, 11-octadecenoic acid methyl ester (23.18%, pentadecanoic acid, 14-methyl-methyl ester (4.43%, (Z-13-docosenoic acid (10.71%, dodecyl pentafluoropropionate (9.52%, 2-dodecyl-1,3-propanediol (6.38%, and 1,12-tridecadiene (19.30%. FT-IR analysis of the extract showed peaks at 1270.17 (C–O and C–F, 1641.48 (C=C, 2937.68 (C–H, and 3430.51 (O–H cm−1 indicating the presence of ether, alkene, alkane, alcohol, carboxylic acid, and fluoric compounds. These compounds consisted of 32.37% ester, 31.65% hydrocarbons, 20.08% fatty acid, 9.52% halogenated ester, and 6.38% alcohol. The highest component was 11-octadecenoic acid methyl ester followed by 1,12-tridecadiene. Since behavioural bioassays were not carried out, the consideration of these compounds to be pheromone semiochemicals remains a hypothesis.

Short-Chain Fatty Acids from Periodontal Pathogens Suppress Histone Deacetylases, EZH2, and SUV39H1 To Promote Kaposi's Sarcoma-Associated Herpesvirus Replication

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Yu, Xiaolan; Shahir, Abdel-Malek; Sha, Jingfeng; Feng, Zhimin; Eapen, Betty; Nithianantham, Stanley; Das, Biswajit; Karn, Jonathan; Weinberg, Aaron; Bissada, Nabil F.

2014-01-01

ABSTRACT Periodontal pathogens such as Porphyromonas gingivalis and Fusobacterium nucleatum produce five different short-chain fatty acids (SCFAs) as metabolic by-products. We detect significantly higher levels of SCFAs in the saliva of patients with severe periodontal disease. The different SCFAs stimulate lytic gene expression of Kaposi's sarcoma-associated herpesvirus (KSHV) dose dependently and synergistically. SCFAs inhibit class-1/2 histone deacetylases (HDACs) and downregulate expression of silent information regulator-1 (SIRT1). SCFAs also downregulate expression of enhancer of zeste homolog2 (EZH2) and suppressor of variegation 3-9 homolog1 (SUV39H1), which are two histone N-lysine methyltransferases (HLMTs). By suppressing the different components of host epigenetic regulatory machinery, SCFAs increase histone acetylation and decrease repressive histone trimethylations to transactivate the viral chromatin. These new findings provide mechanistic support that SCFAs from periodontal pathogens stimulate KSHV replication and infection in the oral cavity and are potential risk factors for development of oral Kaposi's sarcoma (KS). IMPORTANCE About 20% of KS patients develop KS lesions first in the oral cavity, while other patients never develop oral KS. It is not known if the oral microenvironment plays a role in oral KS tumor development. In this work, we demonstrate that a group of metabolic by-products, namely, short-chain fatty acids, from bacteria that cause periodontal disease promote lytic replication of KSHV, the etiological agent associated with KS. These new findings provide mechanistic support that periodontal pathogens create a unique microenvironment in the oral cavity that contributes to KSHV replication and development of oral KS. PMID:24501407

[Skin and chronic kidney disease].

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Rizzo, Raffaella; Mancini, Elena; Santoro, Antonio

2014-01-01

Kidneys and skin are seldom considered associated, but their relationship is more closer than generally believed. In some immunological diseases (SLE...) and genetic syndromes (tuberous sclerosis, Fabrys disease...) the cutaneous manifestations are integral parts of the clinical picture. In advanced uremia, besides the well-known itching skin lesions, calciphylaxis may appear, a typical example of cutaneous involvement secondary to the metabolic complications (calcium-phosphate imbalance) of the renal disease. Nephrogenic systemic fibrosis appears only in patients with renal failure and it has a very severe prognosis due to the systemic organ involvement. Moreover, there is a heterogeneous group of metabolic diseases, with renal involvement, that may be accompanied by skin lesions, either related to the disease itself or to its complications (diabetes mellitus, porphyrias). In systemic amyloidosis, fibrils may deposit even in dermis leading to different skin lesions. In some heroin abusers, in the presence of suppurative lesions in the sites of needle insertion, renal amyloidosis should be suspected, secondary to the chronic inflammation. Atheroembolic disease is nowadays frequently observed, as a consequence of the increasing number of invasive intravascular manoeuvres. Skin manifestations like livedo reticularis or the blue toe syndrome are the most typical signs, but often renal dysfunction is also present. In all these conditions, the skin lesion may be a first sign, a warning, that should arouse the suspicion of a more complex pathology, even with renal involvement. Being aware of this relationship is fundamental to accelerate the diagnostic process.

Clinicopathological characteristics of xeroderma pigmentosum associated with keratoacanthoma: a case report and literature review.

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Zheng, Jin-Feng; Mo, Hai-Ying; Wang, Zhen-Zheng

2014-01-01

To investigate the clinicopathological characteristics, diagnosis and differential diagnosis, and treatment of xeroderma pigmentosum associated with keratoacanthoma in an infant. The clinical manifestations of xeroderma pigmentosum associated with keratoacanthoma were assessed in an 18-month old boy. The morphological and histological features of the lesions were examined by light microscopy. An 18-month old boy was admitted with unequal size, irregularly shaped brown spots, patches and depigmentation spots on his face. A well-circumscribed hemispherical mass measuring 3 cm × 3 cm with smooth surface and brown patches was observed beneath his left lower eyelid. Light microscopic examination of the skin lesions revealed epidermal hyperkeratosis, chronic inflammatory infiltration of the superficial dermal layer, and increases in melanocytes and melanin in the basal layer. Scanning microscopy showed that the mass beneath the left lower eyelid was cup-shaped, consisting of proliferating squamous cells with a central keratin plug. The squamous epithelium was acanthotic with hypergranulosis. The adjacent epidermis formed exophytic projections resulting in a silhouette likened to lips. An associated inflammatory reaction was observed within the stroma surrounding the mass. The patient was treated with a combination of antioxidant drugs, keeping the child from light and surgical excision of the mass. No recurrence has been observed. Xeroderma pigmentosum of infancy is a rare disease, and association with keratoacanthoma is even rarer. This condition should be considered in the differential diagnosis of freckles, Rothmund-Thomson syndrome and porphyria.

Short-Term and Long-Term Biological Effects of Chronic Chemical Contamination on Natural Populations of a Marine Bivalve.

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Marine Breitwieser

Full Text Available Understanding the effects of chronic chemical contamination on natural populations of marine organisms is complex due to the combined effects of different types of pollutants and environmental parameters that can modulate the physiological responses to stress. Here, we present the effects of a chronic contamination in a marine bivalve by combining multiple approaches that provide information on individual and population health. We sampled variegated scallops (Mimachlamys varia at sites characterized by different contaminants and contamination levels to study the short and long-term (intergenerational responses of this species to physiological stress. We used biomarkers (SOD, MDA, GST, laccase, citrate synthase and phosphatases as indicators of oxidative stress, immune system alteration, mitochondrial respiration and general metabolism, and measured population genetic diversity at each site. In parallel, concentration of 14 trace metals and 45 organic contaminants (PAHs, PCBs, pesticides in tissues were measured. Scallops were collected outside and during their reproductive season to investigate temporal variability in contaminant and biomarker levels. Our analyses revealed that the levels of two biomarkers (Laccase-type phenoloxidase and malondialdehyde were significantly correlated with Cd concentration. Additionally, we observed significant seasonal differences for four of the five biomarkers, which is likely due to the scallop reproductive status at time of sampling. As a source of concern, a location that was identified as a reference site on the basis of inorganic contaminant levels presented the same level of some persistent organic pollutants (DDT and its metabolites than more impacted sites. Finally, potential long-term effects of heavy metal contamination were observed for variegated scallops as genetic diversity was depressed in the most polluted sites.

Morphological differentiation of Streptomyces viridochromogenes E-219 on solid culture

International Nuclear Information System (INIS)

Liang Xinle; Zhu Jing; Jin Yingyan

2012-01-01

The Streptomyces viridochromogenes E-219 was derived from Streptomyces viridochromogenes CGMCC4.1119 treated with 60 Co γ-rays irradiation and protoplast fusion. With the help of fluorescent probes, fluorescence microscope and electron microscopy, the morphology and development of E-219 on solid surface culture were investigated in this study. The effect of agarslant culture time on the production of Avilamycin was also studied to provide theoretical basis for industrial fermentation of selecting the appropriate seed to culture on the agarslant culture medium. The results implied that the development of colonies of Streptomyces viridochromogenes accompanied the intermittent hyhae apoptosis, and the production of spores was from the active mycelium. The colonial morphology of strain E-219 was significantly different from the original strain CGMCC4h1119. There were variegated hyphae formation in the stage of spore germination and initial hyphae development (10 h) with the live and dead segments alternated in a highly regular fashion within the same hypha. After the early single colony formation, the third phase was followed by profuse growth of the live segments derived from the variegated hypha, then the second apoptosis of the mycelia (48 h) was occurred with another quick growth, and sporulation was occurred at 96 h. Strain CGMCC4.1119 had spiral sporotrichial and round conidiophores with spike, whereas strain E-219 had linear sporotrichial, smooth and dylindrical conidiophore. The results of shake flask experiments indicated that the spores of E-219 had that highest activity when cultured on agarslant culture medium and incubated for 106 h with the production of avilamycin up to 1200 mg/L. (authors)

Short-Term and Long-Term Biological Effects of Chronic Chemical Contamination on Natural Populations of a Marine Bivalve.

Science.gov (United States)

Breitwieser, Marine; Viricel, Amélia; Graber, Marianne; Murillo, Laurence; Becquet, Vanessa; Churlaud, Carine; Fruitier-Arnaudin, Ingrid; Huet, Valérie; Lacroix, Camille; Pante, Eric; Le Floch, Stéphane; Thomas-Guyon, Hélène

2016-01-01

Understanding the effects of chronic chemical contamination on natural populations of marine organisms is complex due to the combined effects of different types of pollutants and environmental parameters that can modulate the physiological responses to stress. Here, we present the effects of a chronic contamination in a marine bivalve by combining multiple approaches that provide information on individual and population health. We sampled variegated scallops (Mimachlamys varia) at sites characterized by different contaminants and contamination levels to study the short and long-term (intergenerational) responses of this species to physiological stress. We used biomarkers (SOD, MDA, GST, laccase, citrate synthase and phosphatases) as indicators of oxidative stress, immune system alteration, mitochondrial respiration and general metabolism, and measured population genetic diversity at each site. In parallel, concentration of 14 trace metals and 45 organic contaminants (PAHs, PCBs, pesticides) in tissues were measured. Scallops were collected outside and during their reproductive season to investigate temporal variability in contaminant and biomarker levels. Our analyses revealed that the levels of two biomarkers (Laccase-type phenoloxidase and malondialdehyde) were significantly correlated with Cd concentration. Additionally, we observed significant seasonal differences for four of the five biomarkers, which is likely due to the scallop reproductive status at time of sampling. As a source of concern, a location that was identified as a reference site on the basis of inorganic contaminant levels presented the same level of some persistent organic pollutants (DDT and its metabolites) than more impacted sites. Finally, potential long-term effects of heavy metal contamination were observed for variegated scallops as genetic diversity was depressed in the most polluted sites.

Datation U_Pb : âge de mise en place du magmatisme bimodal des Jebilet centrales (chaîne Varisque, Maroc). Implications géodynamiquesU_Pb dating: emplacement age of the bimodal magmatism of central Jebilet (Variscan Belt, Morocco). Geodynamic implications

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Essaifi, Abderrahim; Potrel, Alain; Capdevila, Ramon; Lagarde, Jean-Louis

2003-01-01

The bimodal magmatism of central Jebilet is dated to 330.5 +0.68-0.83 Ma by UPb dating on zircons. This age, similar to that of the syntectonic Jebilet cordierite-bearing granitoids, corresponds to the age of the local major tectonometamorphic event. The syntectonic plutonism of the Jebilet massif, composed of tholeiitic, alkaline, and peraluminous calc-alkaline series, is variegated. Magmas emplacement was favoured by the local extension induced by the motion along the western boundary of the Carboniferous basins of the Moroccan Meseta. The Jebilet massif exemplifies the activation of various magmas sources during an episode of continental convergence and crustal wrenching.

Constructing Confucius in the Low Countries

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Trude Dijkstra

2017-02-01

Full Text Available The first translation of Confucius’s Analects into a European language was a Dutch book by Pieter van Hoorn. Printed in Batavia in 1675, it predated the better-known Latin translation, Confucius Sinarum Philosophus (1687. Whereas the introduction of Confucius in the West has often been regarded as a project of the Jesuit mission, an exploration of the Netherlandish situation points out that the ‘manufacturing’ of Confucianism was a variegated and multi-confessional affair. The process of transmitting, translating, publishing, explaining, and judging Confucius presented a challenge to Europeans from different backgrounds and allegiances, integrating not only Latin and vernacular scholarship but also Asian expertise.

Toward an African-Christian Demonology: The Demonologies of African Traditional Religion, African Christianity, and Early Christianity in Dialogue

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Moscicke, Hans

2017-11-01

Full Text Available Christian interactions with the spirit-world of African traditional religion (ATR have remained problematic due, in part, to the failure of Christian missionaries to understand in detail the cosmology of ATR and the angelologies and demonologies of early Christianity. In this article I suggest a way beyond this impasse. I first survey the shape of cosmology and demonology in ATR, and then examine African Christianitys variegated responses to these traditional beliefs. Finally, I submit that a retrieval of the early Christian mythological narrative about demons and its associated cosmology could help theologians accommodate the spirit-world of ATR within a truly African-Christian theology.

Anisian and Ladinian Beds in the Cross-Section above Srednik Valley at Križna Gora,Central Slovenia

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Matevž Demšar

2003-06-01

Full Text Available The Križna Gora and wider surroundings are built of the Paleozoic and Mesozoic rocks. Pretty extended among them are the carbonate Anisian and heterogeneously developed variegated Ladinian rocks wedging out laterally and vertically already at short distances as a result of active volcanism, tectonics and the fact that this region is situated on the margin between the Dinaric Carbonate Platform and the Slovenian Basin. The Ladinian rocks lie discordantly upon the Anisian dolomite. In the Ladinian sediments pelecypods Daonella lommeli (Wissmann are rather extended. The Ladinian beds are overlain by theCordevolian dolomite. The boundary between them in the Srednik Valley is strongly tektonized.

Phytochemical and Biological investigations of Erythrina Variegata

International Nuclear Information System (INIS)

Rahman, Mohammad Z.; Sultana, Shirin J.; Islam, Mohammad S.; Faruquee, Chowdhury F.; Ferdous, F.; Rahman, Mohammad S.; Rashid, Mohammad A.

2007-01-01

Five compounds were isolated from the n-hexane and chloroform soluble fractions of a methanol extract of the stem bark of Erythrina variegate. The structure of the isolated compounds were elucidated as alpinum isoflavone (1), epilupeol (2), 6-hydroxygenestein (3) 3-beta, 28-dihydroxylolean-12-ene (4) and stigmasterol (5) by extensive spectroscopic studies including high field NMR analyses. Different partitionates of the methanol extract exhibited mild to moderate antimicrobial activity and varying degrees of cytotoxicity. Although, alpinum isoflavone (1) has previously been reported from E. Variegata, this is the first report of isolation of compounds 2-4 and stigmasterol from this plant species. (author)

Reconstructing Historical Light Curves of Symbiotic Stars and Novae

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Jurdana-Šepić R.

2012-06-01

Full Text Available We reconstructed photometric histories of symbiotic stars and novae from direct inspection and measurement of photographic plates preserved at historical archives. We have completed the digging of the rich Asiago archive, and have started working on the Harvard plate stack, while other plate collections should be added soon. For homogeneity, we use the same UBV RCIC photometric comparison sequences used in current CCD observations. This data harvest has permitted the discovery of past undetected outbursts and secular trends, or to derive previously unknown orbital periods and recurrence times, which are essential to constrain the nature of these capricious and variegated active binaries.

Evaluation of response to immune checkpoint inhibitors: Is there a role for positron emission tomography?

Institute of Scientific and Technical Information of China (English)

Matteo Bauckneht; Roberta Piva; Gianmario Sambuceti; Francesco Grossi; Silvia Morbelli

2017-01-01

Strategies targeting intracellular negative regulators such as immune checkpoint inhibitors(ICPIs) have demonstrated significant antitumor activity across a wide range of solid tumors. In the clinical practice, the radiological effect of immunotherapeutic agents has raised several more relevant and complex challenges for the determination of their imaging-based response at single patient level. Accordingly, it has been suggested that the conventional Response Evaluation Criteria in Solid Tumors assessment alone, based on dimensional evaluation provided by computed tomography(CT), tends to underestimate the benefit of ICPIs at least in a subset of patients, supporting the need of immunerelated response criteria. Different from CT, very few data are available for the evaluation of immunotherapy by means of 18F-fluoro-2-deoxy-D-glucose positron emission tomography(FDG-PET). Moreover, since the antineoplastic activity of ICPIs is highly related to the activation of T cells against cancer cells, FDG accumulation might cause false-positive findings. Yet, discrimination between benign and malignant processes represents a huge challenge for FDG-PET in this clinical setting. Consequently, it might be of high interest to test the complex and variegated response to ICPIs by means of PET and thus it is worthwhile to ask if a similar introduction of immune-related PET-based criteria could be proposed in the future. Finally, PET might offer a new insight into the biology and pathophysiology of ICPIs thanks to a growing number of non-invasive immunediagnostic approaches based on non-FDG tracers.

[Hyperplastic changes and oral contraceptives in Anglo-Saxon countries].

Science.gov (United States)

Markuszewski, C

1978-09-18

One of the major problems being researched and studied by the World Health Organization is the incidence of harmful side effects in users of steroid contraceptives. A literature search indicates that Anglo-Saxon countries report alarming hyperplastic changes, particularly in the liver, blood clots, hyperlipidemia leading to high blood pressure, porphyria, atypical leiomyomas and cervical hyperplasia. Currently attention is being focused on the relationship between steroid contraceptives and breast cancer. Fazala and Paffenbarger in their study of 1770 women found such benign changes as fibroadenoma, mastopathia fibrosa cystica and papilloma intraductale. In women who had used oral contraceptives for 2-4 yrs, malignancies were 1.9% to 2.5% more frequent than in non-users; in 6 yrs of use, 11 times greater than in non-users. Estrogens, particularly mestranol has been recognized as being harmful to the liver. Length of usage is a definite factor. Beginning with 1960, relatively frequent occurrences of hepotoma in young women on the pill were noted. Caught at an early stage, peliosis hepatis can be reversed if the patient discontinues the use of contraceptives. In some cases, even after a long interval of 6 months to 10 yrs, the disease continued to develop. Liver cell adenoma in the U. S. occurs 1/500,00 to 1/1,000,000. After 5 to 7 yrs of using oral contraceptives, the chance of developing liver cell adenoma is 5 times greater; after 10 yrs of use, 35 times greater. Hepatomas rupture in 43.4% of cases when the patient had been on a contraceptive, while in only 22.2% in cases of non-users. The literature which the author investigated did not establish a clear proof that the hyperplastic changes discussed were due exclusively to usage of oral contraceptives.

Neoliberalization, housing institutions and variegated gentrification: how the ‘third wave’ broke in Amsterdam

NARCIS (Netherlands)

van Gent, W.P.C.

2013-01-01

Neil Smith argues that in the last two decades gentrification has become a generalized global urban phenomenon. His theory is at a high level of abstraction, as it links urban gentrification to globalization, financial capitalism and neoliberalization. With these global processes, all cities have

[Update on the biology of heme synthesis in erythroid cells].

Science.gov (United States)

Fujiwara, Tohru; Harigae, Hideo

2015-02-01

Heme is a prosthetic group of hemoproteins playing important roles in oxygen transport, detoxification, circadian rhythm, microRNA processing, regulation of transcription, and translation. The majority of heme (-85%) is synthesized in red blood cells mainly for hemoglobin production, whereas hepatocytes account for most of the rest, functioning primarily in the synthesis of cytochrome P450 enzymes and mitochondrial respiratory enzymes. Thus, failure of heme biosynthesis causes severe inherited or acquired disorders in humans, including porphyria and sideroblastic anemia. The heme biosynthetic pathway is composed of eight enzymes that work in either mitochondria or the cytoplasm, which have been extensively researched and frequently reviewed. On the other hand, the mechanisms governing transport and intracellular trafficking of heme intermediates, as well as their potential links to human diseases, are poorly understood. Herein, we focus on recent understanding of the heme biosynthetic pathway and on human disorders due to defective heme synthesis in erythroid cells, such as X-linked sideroblastic anemia and erythropoietic protoporphyria.

Morphologic Features of Extrahepatic Manifestations of Hepatitis C Virus Infection

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Huaibin M. Ko

2012-01-01

Full Text Available Cirrhosis and hepatocellular carcinoma are the prototypic complications of chronic hepatitis C virus infection in the liver. However, hepatitis C virus also affects a variety of other organs that may lead to significant morbidity and mortality. Extrahepatic manifestations of hepatitis C infection include a multitude of disease processes affecting the small vessels, skin, kidneys, salivary gland, eyes, thyroid, and immunologic system. The majority of these conditions are thought to be immune mediated. The most documented of these entities is mixed cryoglobulinemia. Morphologically, immune complex depositions can be identified in small vessels and glomerular capillary walls, leading to leukoclastic vasculitis in the skin and membranoproliferative glomerulonephritis in the kidney. Other HCV-associated entities include porphyria cutanea tarda, lichen planus, necrolytic acral erythema, membranous glomerulonephritis, diabetic nephropathy, B-cell non-Hodgkin lymphomas, insulin resistance, sialadenitis, sicca syndrome, and autoimmune thyroiditis. This paper highlights the histomorphologic features of these processes, which are typically characterized by chronic inflammation, immune complex deposition, and immunoproliferative disease in the affected organ.

Role of complement in porphyrin-induced photosensitivity

International Nuclear Information System (INIS)

Lim, H.W.; Gigli, I.

1981-01-01

Addition of porphyrins to sera of guinea pigs in vitro, followed by irradiation with 405 nm light, resulted in dose-dependent inhibitions of hemolytic activity of complement. With guinea pig as an animal model, we also found that systemically administered porphyrins, followed by irradiation with 405 nm light, resulted in dose-dependent inhibition of CH50 in vivo. The erythrocytes from porphyrin-treated guinea pigs showed an increased susceptibility to hemolysis induced by 405 nm irradiation in vitro. Clinical changes in these animals were limited to light-exposed areas and consisted of erythema, crusting, and delayed growth of hair. Histologically, dermal edema, dilation of blood vessels, and infiltration of mononuclear and polymorphonuclear cells were observed. Guinea pigs irradiated with ultraviolet-B developed erythema, but had no alteration of their complement profiles. It is suggested that complement products may play a specific role in the pathogenesis of the cutaneous lesions of some porphyrias

Nonlinear models for describing the Citrus Variegated Chlorosis in groves of two counties at northwestern Paraná state, Brazil = Modelo não-linear para a curva de progresso de incidência da Clorose Variegada dos Citros (CVC em dois municípios da região noroeste do Estado do Paraná

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Clara Matiko Ueda

2010-10-01

Full Text Available In Brazil, the production of sweet oranges has been threatened by the Citrus Variegated Chlorosis (CVC incited by the gram-negative bacterium Xylella fastidiosa (Wells. Commercial citrus groves in two counties at the Northwestern Paraná state were evaluated to estimate the disease progression by using parameterizations of nonlinear models. Groves of Citrus sinensis Osbeck, variety “Pêra”, “Valência”, “Natal” and “Folha Murcha” had all the plants evaluated for the presence of disease symptoms. Thereafter, different parameterizations of the Logistic and Gompertz models were fitted to these data. The goodness of fit was evaluated by the intrinsic (IN and parameter-effects (PE curvatures of Bates and Watts, the bias of Box and the Hougaard measures of skewness. In Loanda, the best model was the Fermi-Dirac, and in Nova Esperança the data were best fitted to the parameterization L5, which is also a parameterization from the Logistic model.A citricultura é afetada por diversas doenças, dentre as quais a Clorose Variegada dos Citros (CVC causada pela bactéria Xylella fastidiosa (Wells. Para a região noroeste do Estado do Paraná, onde foi avaliada a CVC, propõe-se encontrar modelos não-lineares de curvas de progresso de incidência da CVC que representem o percentual de plantas acometidas pela doença. Para avaliar o comprometimento dos pomares com relação à doença, foram escolhidos pomares comerciais em dois municípios, onde foi determinada a proporção de plantas doentes. Foram selecionados talhões de laranja doce (Citrus sinensis Osbeck nas variedades “Pêra”, “Valência”, “Natal” e “Folha Murcha” e a avaliação de todas as plantas do talhão foi realizada visualmente em relação à presença ou à ausência de sintomas de CVC. Para estimar o modelo que melhor se ajustou aos dados de progresso da proporção da doença em cada talhão, foram considerados modelos não-lineares decrescimento sigmoidal

Pleomorphic Hyalinizing Angiectatic Tumor of Soft Parts

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Hui-Chin Peng

2010-08-01

Full Text Available Pleomorphic hyalinizing angiectatic tumor (PHAT of soft parts is a rare, nonmetastasizing tumor of uncertain lineage which was first reported in 1996. Here, we report a case of PHAT and review the literature. A 49-year-old man presented with a soft and progressively enlarging mass over the right buttock for several years. On suspicion that the mass was a right gluteal lipoma, he underwent surgical excision. The excised lesion measured 14 × 6 × 3.5 cm. It had a variegated appearance with a white-tan to yellowish color on the cut surface. Some punctate hemorrhage and vessel thrombosis were seen. Microscopically, the tumor was a PHAT characterized by clusters of ectatic, fibrin-lined, thin-walled vessels, which were surrounded by a mitotically inert, spindled, pleomorphic, neoplastic stroma that contained a variable inflammatory component. Immunohistochemical study showed that the tumor cells were positive for CD34, and negative for S-100, HMB45 and actin. The patient experienced local recurrence 6 months later. The recurrent tumor was widely excised. No evidence of metastasis was found during the 18 months after the second operation. The recurrent lesion had a microscopic appearance that was similar to the initial lesion.

Care Wounds: Precarious Vulnerability and the Potential of Exposure.

Science.gov (United States)

Cubellis, Lauren

2018-04-07

What does it mean to offer care when the act of caring is wounding to its giver? For peer specialists-individuals with lived experience as patients in the psychiatric system-this question shapes how they use their own histories to provide support for individuals experiencing psychiatric crisis. Peer support is unique in the way it draws on empathetic resonance and depends on carefully deployed vulnerability; where one connects with others through the recognition of shared experience and mutual hurt. For peers, care works when this guidance, reassurance, and "being with"-all of which draw upon their own stories of traumatic history and variegated suffering-mitigate the present crisis being experienced by another. Drawing on twenty-eight months of fieldwork with a peer-staffed crisis respite center in the eastern United States, I argue that the peer specialist becomes the embodiment of a novel intersection of intimacy and compensation; one that poses vulnerability not as a consequence, casualty, or risk factor in the commodification of care, but as its principle vector of resonance and the assumption on which it is based. For peers, care that works-in that it creates a mutual resonance for the recipient-becomes simultaneously care that wounds its giver.

Stratigraphy and structure of the Miners Mountain area, Wayne County, Utah

Science.gov (United States)

Luedke, Robert G.

1953-01-01

The Miners Mountain area includes about 85 square miles in Wayne County, south-central Utah. The area is semiarid and characterized by cliffs and deep canyons. Formations range in age from Permian to Upper Jurassic and have an aggregate thickness of about 3,500 feet. Permian formations are the buff Coconino sandstone and the overlying white, limy, shert-containing Kaibab limestone. Unconformably overlying the Kaihab is the lower Triassic Moenkopi formation of reddish-brown and yellow mudstone, siltstone, and sandstone; it contains the Sinbad limestone member (?) in the lower part. Thin, lenticular Shinarump conglomerate unconformably overlies the Moenkopi, but grades upward into the Upper Triassic Chinle formation of variegated mudstone with some interbedded sandstone and limestone lenses. Uncomformably overlying the Chinle are the Wingate sandstone, Kayenta formation, and Navajo sandstone of the Jurassic (?) Glen Canyon group, which consist of red to white sandstone. Only the lower part of the Carmel formation of the Upper Jurassic San Rafael group is exposed in the area; it consists of variegated siltstone, sandstone, limestone, and gypsum. The conspicuous structural feature in the area is the Teasdale anticline which trends northwest, is about 14 miles long, and is asymmetric with a steeper west flank. Bounding the anticline on the northeast and east is the Capitol Reef monocline, the northern part of the Waterpocket Fold. Strata in the area are broken by steeply-dipping normal faults with small displacements, except for the Teasdale fault which has a maximum displacement of over 1,000 feet. Jointing is prominent in some formations. The major orogenic movement in the area is believed to be late Upper Cretaceous to early Tertiary. Epeirogenic uplift occurred intermittently throughout Tertiary and perhaps Quaternary time.

Better science and better race? Social Darwinism and Chinese eugenics.

Science.gov (United States)

Chung, Yuehtsen Juliette

2014-12-01

This essay explores the variegated roles played by racial, eugenic, and Social Darwinist discourse in China over roughly the last century. Using Japan as a parallel for comparison, it analyzes the introduction of the term "eugenics" into Japanese and Chinese. It then locates the deployment of eugenics and Social Darwinism as counterimperial discourse in East Asia. It offers a brief history of eugenics thinking in China across the twentieth century, focusing on the Chinese eugenicist Pan Guangdan, who used race as a category of analysis yet without any sense of hierarchy. He was critically aware of the scientific basis of eugenics and helped craft the study of eugenics in China, from biology to sociology, from economics to ethnology.

[Advances in understanding Drosophila salivary gland polytene chromosome and its applications in genetics teaching].

Science.gov (United States)

Li, Gang; Chen, Fan-guo

2015-06-01

Drosophila salivary gland polytene chromosome, one of the three classical chromosomes with remarkable characteristics, has been used as an outstanding model for a variety of genetic studies since 1934. The greatest contribution of this model to genetics has been providing extraordinary angle of view in studying interphase chromosome structure and gene expression regulation. Additionally, it has been extensively used to understand some special genetic phenomena, such as dosage compensation and position-effect variegation. In this paper, we briefly review the advances in the study of Drosophila salivary gland chromosome, and try to systematically and effectively introduce this model system into genetics teaching practice in order to steer and inspire students' interest in genetics.

The epigenetic modifier Fam208a is required to maintain epiblast cell fitness

Czech Academy of Sciences Publication Activity Database

Bhargava, Shohag; Cox, B.; Polydorou, Ch.; Grešáková, Veronika; Kořínek, Vladimír; Strnad, Hynek; Sedláček, Radislav; Epp, Trevor Allan; Chawengsaksophak, Kallayanee

2017-01-01

Roč. 7, léto (2017), č. článku 9322. ISSN 2045-2322 R&D Projects: GA ČR GA15-23165S; GA MŠk LO1419; GA MŠk(CZ) ED1.1.00/02.0109; GA MŠk ED2.1.00/19.0395; GA MŠk(CZ) LM2011032; GA MŠk(CZ) LM2015040; GA MŠk(CZ) LQ1604 Institutional support: RVO:68378050 Keywords : bone morphogenetic protein -4 * position-effect variegation * gastrulating mouse embryo * anterior-posterior axis * mesoderm differentiation * expression pattern * mice lacking * postimplantation development * definitive endoderm * primitive streak Subject RIV: EB - Genetics ; Molecular Biology OBOR OECD: Biochemistry and molecular biology Impact factor: 4.259, year: 2016

Cutaneous Manifestations of Scleroderma and Scleroderma-Like Disorders: a Comprehensive Review.

Science.gov (United States)

Ferreli, Caterina; Gasparini, Giulia; Parodi, Aurora; Cozzani, Emanuele; Rongioletti, Franco; Atzori, Laura

2017-12-01

Scleroderma refers to an autoimmune connective tissue fibrosing disease, including three different subsets: localized scleroderma, limited cutaneous systemic sclerosis, and diffuse cutaneous systemic sclerosis with divergent patterns of organ involvement, autoantibody profiles, management, and prognostic implications. Although systemic sclerosis is considered the disease prototype that causes cutaneous sclerosis, there are many other conditions that can mimic and be confused with SSc. They can be classified into immune-mediated/inflammatory, immune-mediated/inflammatory with abnormal deposit (mucinoses), genetic, drug-induced and toxic, metabolic, panniculitis/vascular, and (para)neoplastic disorders according to clinico-pathological and pathogenetic correlations. This article reviews the clinical presentation with emphasis on cutaneous disease, etiopathogenesis, diagnosis, and treatment options available for the different forms of scleroderma firstly and for scleroderma-like disorders, including scleromyxedema, scleredema, nephrogenic systemic fibrosis, eosinophilic fasciitis, chronic graft-versus-host disease, porphyria cutanea tarda, diabetic stiff-hand syndrome (diabetic cheiroartropathy), and other minor forms. This latter group of conditions, termed also scleroderma mimics, sclerodermiform diseases, or pseudosclerodermas, shares the common thread of skin thickening but presents with distinct cutaneous manifestations, skin histology, and systemic implications or disease associations, differentiating each entity from the others and from scleroderma. The lack of Raynaud's phenomenon, capillaroscopic abnormalities, or scleroderma-specific autoantibodies is also important diagnostic clues. As cutaneous involvement is the earliest, most frequent and characteristic manifestation of scleroderma and sclerodermoid disorders, dermatologists are often the first-line doctors who must be able to promptly recognize skin symptoms to provide the affected patient a correct

Analysis of frequency effect on variegated RAM styles and other parameters using 40 nm FPGA

DEFF Research Database (Denmark)

Sharma, Rashmi; Pandey, Bishwajeet; Sharma, Vaashu

2018-01-01

. This analysis has been performed using the XILINX 12.1 and IBM SPSS Statistics 21 software and VHDL language. Pipe_distributed style at comparatively lesser values of frequencies consumes the least power. Therefore, lesser values of frequencies should be maintained while observing the power. This would bloom up...

Análise espaço-temporal da clorose variegada dos citros no Noroeste do Paraná, com uso de PCR para detecção de Xylella fastidiosa = Spatio-temporal analysis of the citrus variegated chlorosis (CVC in the Northwest of Paraná, using PCR for detection of Xylella fastidiosa

Directory of Open Access Journals (Sweden)

William Mário de Carvalho Nunes

2006-07-01

Full Text Available A citricultura é afetada por inúmeras doenças, como a clorose variegada do citros (CVC, causada pela bactéria Xylella fastidiosa. O objetivo deste trabalho foi determinar a distribuição espacial da doença dentro de pomares comerciais do Noroeste do Paraná com o uso de métodos moleculares. Foram selecionados pomares sintomáticos para CVC com as variedades ‘Pêra’, ‘Valência’ e ‘Folha Murcha’ (Citrus sinensis Osbeck. Foram marcadas para cada variedade, 4 plantas-referência positivas para CVC (por sintomas e análise molecular e 8 plantas ao redor de cada uma das plantas-referência foram amostradas, num total de 36 plantas por variedade. Realizou-se o teste da Reação da Polimerase em Cadeia (PCR para detecção da bactéria e na mesma época foram conduzidas avaliações visuais de sintomas de CVC. Os resultados da análise temporal, utilizando-se os modelos Monomolecular, Logístico e Gompertz, apontaram o modelo Logístico como o que melhor se ajustou para descrever o comportamento da doença no tempo, para todas as variedades estudadas. Observou-se que o comportamento espacial da doença diferiu quando a mesma área foiavaliada pelos métodos visual e molecular, resultando em uma diferença no padrão espacial das áreas avaliadas. Portanto, ambos os métodos empregados, sintomas e PCR, foram capazes de constatar asmudanças no padrão espacial apresentado, sendo que a análise molecular (PCR foi mais sensível para detectar as mudanças ocorridas.Countless diseases affect the citriculture, as the citrus variegated chlorosis (CVC which is caused by the bacteria Xylella fastidiosa.The aim of this work was to determine the space distribution of the disease inside commercial orchards in the Northwest of Paraná, using molecular methods. Symptomatic orchards were selected for CVC with the varieties 'Pêra', 'Valência' and 'Folha Murcha' (Citrus sinensis Osbeck. For each variety, 4 positive reference-plant for CVC

MRI findings of intracranial cavernous malformations

International Nuclear Information System (INIS)

Han, Byoung Hee; Kim, Dong Ik; Cho, Yong Kuk

1995-01-01

To analyze the variable MRI features and clinical significance of intracranial cavernous malformations. Forty patients(mean age 35.4) with cavernous malformation were evaluated by MRI. Eleven patients were surgically confirmed. Cavernous malformations were divided into four categories on the basis of the MR imaging characteristics, especially on T2-weighted image. Type I lesion was defined as an extralesional subacute hemorrhage outside the low signal rim, type II as an intralesional hemorrhage surrounded by low signal rim, type III lesion as an intralesional thrombosis with variegated central core surrounded by low signal rim, and type IV lesion as a focal old hemorrhagic core with small low signal intensity. Type IV was further divided into IVa and IVb, whether the lesion has small iso-or hypersignal central core (IVa) or not (IVb). Follow-up MRI was evaluated in 12 patients who were managed conservatively. Follow-up intervals ranged from 2 weeks to 29 months (mean 6 months). Total 80 lesions were detected in 40 patients. Multiple lesions were noted in 10 patients. The topography of the cavernous malformations was supratentorial in 75% and infratentorial in 23%. There were 10 lesions in type I, 15 in type II, 21 in type III, 14 in type IVa, and 20 in type IVb. Type I lesions mainly showed mass effect and edema. Type III lesions showed minimal contrast enhancements in 7 lesions on delayed images. Type II lesions showed the characteristics of both type I and type III lesions. On follow up images, decrease in size in 5, change of type in 7, rebleeding in 2 and no change in 12 lesions were demonstrated. Hemorrhage, edema and mass effect were combined in the cases of rebleeding. On follow-up study, the estimated risk of bleeding was 32.3%/person-year and 13.7%/lesion-year. Cavernous malformations show as variable appearance, on MR imaging suggesting variable stages of evolution. The MR morphologic classification and evaluation of secondary findings are helpful to

Small cell extraskeletal osteosarcoma: a rare case report

Directory of Open Access Journals (Sweden)

Neelam Sood

2014-01-01

Full Text Available Extraskeletal osteosarcoma is a rare malignant mesenchymal neoplasm and its small cell variant is one among the rarest variant. This article describes a 60-year-old woman presenting with a large, lobulated, painful mass in left thigh with associated history of trauma since 18 months. Her magnetic resonance imaging showed a variegated mixed intensity lesion with associated cystic degeneration, necrosis and matrix arborizing nearby muscles. Fine needle aspiration cytology showed a small cell lesion with very scant osteoid. Tumor was excised and histopathological diagnosis was small cell osteosarcoma involving adjacent muscles and fat with sparing of lymph nodes. The aim of this article is to present the clinical, radiological, cyto-histological and immunohistochemical features of this extremely rare lesion.

Patient participation in patient safety still missing: Patient safety experts' views.

Science.gov (United States)

Sahlström, Merja; Partanen, Pirjo; Rathert, Cheryl; Turunen, Hannele

2016-10-01

The aim of this study was to elicit patient safety experts' views of patient participation in promoting patient safety. Data were collected between September and December in 2014 via an electronic semi-structured questionnaire and interviews with Finnish patient safety experts (n = 21), then analysed using inductive content analysis. Patient safety experts regarded patients as having a crucial role in promoting patient safety. They generally deemed the level of patient safety as 'acceptable' in their organizations, but reported that patient participation in their own safety varied, and did not always meet national standards. Management of patient safety incidents differed between organizations. Experts also suggested that patient safety training should be increased in both basic and continuing education programmes for healthcare professionals. Patient participation in patient safety is still lacking in clinical practice and systematic actions are needed to create a safety culture in which patients are seen as equal partners in the promotion of high-quality and safe care. © 2016 John Wiley & Sons Australia, Ltd.

Acute care patients discuss the patient role in patient safety.

Science.gov (United States)

Rathert, Cheryl; Huddleston, Nicole; Pak, Youngju

2011-01-01

Patient safety has been a highly researched topic in health care since the year 2000. One strategy for improving patient safety has been to encourage patients to take an active role in their safety during their health care experiences. However, little research has shed light on how patients view their roles. This study attempted to address this deficit by inductively exploring the results of a qualitative study in which patients reported their ideas about what they believe their roles should be. Patients with an overnight stay in the previous 90 days at one of three hospitals were surveyed using a mailing methodology. Of 1,040 respondents, 491 provided an open-ended response regarding what they believe the patient role should be. Qualitative analysis found several prominent themes. The largest proportion of responses (23%) suggested that patients should follow instructions given by care providers. Other prominent themes were that patients should ask questions and become informed about their conditions and treatments, and many implied that they should expect competent care. Our results suggest that patients believe they should be able to trust that they are being provided competent care, as opposed to assuming a leadership role in their safety. Our results suggest that engaging patients in safety efforts may be complex, requiring a variety of strategies. Managers must provide environments conducive to staff and patient interactions to support patients in this effort. Different types of patients may require different engagement strategies.

The neuropsychiatric ailment of Vincent Van Gogh

Directory of Open Access Journals (Sweden)

Kalyan B Bhattacharyya

2015-01-01

Full Text Available Vincent Van Gogh is one of the most celebrated creative artists of all time. All his life, he was afflicted by some kind of neurological or psychiatric disorder, which remains a mystery even today. Many historians and his personal physicians believe that he suffered from epilepsy while others felt that he was affected by Ménière′s disease. Features such as hypergraphia, atypical sexuality, and viscosity of thinking suggest the possibility of Gastaut-Geschwind phenomenon, a known complication of complex partial seizure. On the contrary, some historians feel that he was forced to sever his right ear in order to get relief from troublesome tinnitus, a complication of Ménière′s disease. He was addicted to the liquor absinthe, which is known to lead to xanthopsia, and many authorities argue that this was the reason for his penchant for the deep and bright yellow color in many of his paintings. Others have suggested the possibility of bipolar disorder, sunstroke, acute intermittent porphyria, and digitalis toxicity as well.

Awake craniotomy. A patient`s perspective.

Science.gov (United States)

Bajunaid, Khalid M; Ajlan, Abdulrazag M

2015-07-01

To report the personal experiences of patients undergoing awake craniotomy for brain tumor resection. We carried out a qualitative descriptive survey of patients` experiences with awake craniotomies for brain tumor resection. The survey was conducted through a standard questionnaire form after the patient was discharged from the hospital. Of the 9 patients who met the inclusion criteria and underwent awake craniotomy, 3 of those patients reported no recollection of the operation. Five patients had auditory recollections from the operation. Two-thirds (6/9) reported that they did not perceive pain. Five patients remembered the head clamp fixation, and 2 of those patients classified the pain from the clamp as moderate. None of the patients reported that the surgery was more difficult than anticipated. Awake craniotomy for surgical resection of brain tumors was well tolerated by patients. Most patients reported that they do not recall feeling pain during the operation. However, we feel that further work and exploration are needed in order to achieve better control of pain and discomfort during these types of operations.

Distribution of the Sunda Colugo (Galeopterus variegatus) in Malaysia (Peninsular, Sabah, Sarawak).

Science.gov (United States)

Nasir, Muhammad Dzulhelmi Muhammad; Abdullah, Mohd Tajuddin

2010-12-01

There is not much information available on the distribution of the Sunda colugo (Galeopterus variegates) in Malaysia, despite it being one of only two known species in the order Dermoptera. Data on the presence of the Sunda colugo and the vernacular names used by various ethnic groups throughout Malaysia were collected and compiled from various primary and secondary sources. There were 27 locations from Peninsular, 11 locations from Sabah and 34 locations from Sarawak that reported the presence of the Sunda colugo throughout Malaysia. The various ethnic groups of Malaysia adopted 37 different vernacular names to describe the Sunda colugo. This baseline data can be useful for the management authorities in conducting periodic monitoring and will enhance our knowledge of the population dynamics of the Sunda colugo in Malaysia.

Structure and Function of SET and MYND Domain-Containing Proteins

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Nicholas Spellmon

2015-01-01

Full Text Available SET (Suppressor of variegation, Enhancer of Zeste, Trithorax and MYND (Myeloid-Nervy-DEAF1 domain-containing proteins (SMYD have been found to methylate a variety of histone and non-histone targets which contribute to their various roles in cell regulation including chromatin remodeling, transcription, signal transduction, and cell cycle control. During early development, SMYD proteins are believed to act as an epigenetic regulator for myogenesis and cardiomyocyte differentiation as they are abundantly expressed in cardiac and skeletal muscle. SMYD proteins are also of therapeutic interest due to the growing list of carcinomas and cardiovascular diseases linked to SMYD overexpression or dysfunction making them a putative target for drug intervention. This review will examine the biological relevance and gather all of the current structural data of SMYD proteins.

Interpretation of lightcurves of atmosphereless bodies. I - General theory and new inversion schemes

Science.gov (United States)

Kaasalainen, M.; Lamberg, L.; Lumme, K.; Bowell, E.

1992-01-01

Theoretical models of light-curve inversion that can be used in photomorphography, i.e., determination of the 3D shape and/or the light-scattering behavior of the surface of a body from disk-integrated photometry. These methods can be applied to atmosphereless bodies, mainly asteroids and planetary satellites, in the solar system. The inversion comprises three steps. First, a function containing data on the shape and the albedo variegation of an asteroid is determined. In the second step, separate expressions for the inverse of the Gaussian curvature and the albedo distribution are derived from the information obtained in the first step. In the third step, the nontrivial problem of determining the radius vector of the surface from the Gaussian curvature is solved by using iterative optimization procedures.

Between the Invisible hand and the Invisible Heart. Italian Welfare Restructuring and the Quest for a New Neoliberal Hegemony

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Davide Caselli

2016-09-01

Full Text Available The article looks at the current restructuring of Italian Welfare putting it into perspective with both the structural contradictions of contemporary capitalism and the more contingent and specific condi-tions of contemporary Italy. Relying on the approach taken by the political economy of the Welfare State, the variegated neoliberalization studies and the concept of référentiel, the process is considered and ana-lysed both in its semiotic and material elements. Looking at the transformations of the key-actors in the pre-crisis Welfare Mix arrangement, an on-going entrepreneurial and financial change is identified, open-ing the door to two, complementary, scenarios: a smart-utopia private Welfare one for those able to pay and a repressive residual Welfare state for the poor.

The morphology of the Martian surface

International Nuclear Information System (INIS)

Carr, M.H.

1980-01-01

Most of the southern hemisphere of Mars is densely cratered and stands 1-3 km above the topographic datum. The northern hemisphere is more sparsely cratered and elevations are generally below the datum. A broad rise, the Tharsis bulge, centered at 14 0 S, 101 0 W, is 8000 km across and 10 km above the datum at its summit. The densely cratered terrain has two main components; very ancient crust, nearly saturated with large craters, and younger intercrater plains. In many areas the older unit is fractured and extensively dissected by small channels. The younger intercrater plains are distinctly layered in places and less dissected, less fractured, and less cratered. Both units probably date from very early in the planet's history. Cratered plains cover much of the northern hemisphere and are highly variegated. (orig.)

Die uitbouing van die Bybelse kanon in antieke Judaïsme en die vroeë Christendom

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Jörg Frey

2015-07-01

Full Text Available The development of the biblical canon in ancient Judaism and early Christianity. A brief account of the process of the development of both the Jewish and the bipartite Christian canon is given. It is argued that due to insights gained from recent textual discoveries, especially the Dead Sea Scrolls (Qumran texts, earlier theories about the history of canonisation had to be reviewed. With the New Testament canon the authors focus on the influence of Marcion as well as the various other factors that played a role in the process of canonisation. It is shown that canonisation was the result of a complicated and variegated canonical process. But in spite of the problems of the criteria used and other factors involved, the biblical canon is theologically valuable and ‘well-chosen’.

Art technologies as possible propulsars in technological innovation

DEFF Research Database (Denmark)

Jørgensen, Lars Botin

2003-01-01

kind. This discussion, of general character, constitutes the initial part of this paper. Then it briefly looks into the final terms of the papertitle and try to relate to the diffuse and discussed technological innovation. Both aspects – art and technology and technological innovation – will be dealt...... with from a historical/hermeneutic and social constructivist point of view, as the paper moves from a general principal level to a more specific, exemplary level, where three different art technologies are presented as possible propulsars in technological innovation.......Art and technology has, as the German philosopher Martin Heidegger points out, the same etymological root. A thorough investigation of the relationship between art and technology will show how this same root has manifested itself in different times and spaces bringing results of the most variegated...

Achieving patient satisfaction: resolving patient complaints.

Science.gov (United States)

Oxler, K F

1997-07-01

Patients demand to be active participants on and partners with the health care team to design their care regimen. Patients bring unique perceptions and expectations and use these to evaluate service quality and satisfaction. If customer satisfaction is not achieved and a patient complaint results, staff must have the skills to respond and launch a service recovery program. Service recovery, when done with style and panache, can retain loyal customers. Achieving patient satisfaction and resolving patient complaints require commitment from top leadership and commitment from providers to dedicate the time to understand their patients' needs.

Cendrars's Variegated Poetic Persona: Seduction and Authenticity in Prose of the Transsiberian and Nineteen Elastic Poems

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Everett F. Jacobus Jr.

1979-01-01

Full Text Available Since Cendrars recognizes the protean nature of his personal and public self, it is not surprising that the persona of his poetry escapes easy definition. My essay studies the consequences of this fact on the relationship between the poetic persona and his reader. Seduction, set against a Freudian and transactional-analysis conceptual background, provides a methodological metaphor for my analysis. In the same way that for Freud the real event of seduction only becomes psychologically effective as a fantasy and eventually as a structural pattern for the male-female relationship, our use of the seduction metaphor takes an initial naïve event between persona and reader and transforms it into a characteristic structural relationship. The persona's initial demand of intimacy from the reader is seen to be but one position in a narrative pattern which alternates the persona's attitude vis-a-vis his own narration between intimacy and detachment (or irony. The reader's role in connection with the persona is finally not one of sympathy but one of collaboration in inflecting a reading of the persona's narrated presence. Cendrars's manipulation of the persona-reader relationship is thus a primary component of his literary appeal.

Patient-centred outcomes research: perspectives of patient stakeholders.

Science.gov (United States)

Chhatre, Sumedha; Gallo, Joseph J; Wittink, Marsha; Schwartz, J Sanford; Jayadevappa, Ravishankar

2017-11-01

To elicit patient stakeholders' experience and perspectives about patient-centred care. Qualitative. A large urban healthcare system. Four patient stakeholders who are prostate cancer survivors. Experience and perspectives of patient stakeholders regarding patient-centred care and treatment decisions. Our patient stakeholders represented a diverse socio-demographic group. The patient stakeholders identified engagement and dialogue with physicians as crucial elements of patient-centred care model. The degree of patient-centred care was observed to be dependent on the situations. High severity conditions warranted a higher level of patient involvement, compared to mild conditions. They agreed that patient-centred care should not mean that patients can demand inappropriate treatments. An important attribute of patient-centred outcomes research model is the involvement of stakeholders. However, we have limited knowledge about the experience of patient stakeholders in patient-centred outcomes research. Our study indicates that patient stakeholders offer a unique perspective as researchers and policy-makers aim to precisely define patient-centred research and care.

Patients' preferences for patient-centered communication

DEFF Research Database (Denmark)

Lau, Sofie Rosenlund; Christensen, Søren Troels; Andreasen T., Jesper

2013-01-01

To investigate patients' preferences for patient-centered communication (PCC) in the encounter with healthcare professionals in an outpatient department in rural Sierra Leone.......To investigate patients' preferences for patient-centered communication (PCC) in the encounter with healthcare professionals in an outpatient department in rural Sierra Leone....

Brazilian blood donation eligibility criteria for dermatologic patients Critérios brasileiros de elegibilidade à doação de sangue para pacientes dermatológicos

Directory of Open Access Journals (Sweden)

Carlos Gustavo Wambier

2012-08-01

Full Text Available A focused and commented review on the impact of dermatologic diseases and interventions in the solidary act of donating blood is presented to dermatologists to better advise their patients. This is a review of current Brazilian technical regulations on hemotherapeutic procedures as determined by Ministerial Directive #1353/2011 by the Ministry of Health and current internal regulations of the Hemotherapy Center of Ribeirão Preto, a regional reference center in hemotherapeutic procedures. Criteria for permanent inaptitude: autoimmune diseases (>1 organ involved, personal history of cancer other than basal cell carcinoma, severe atopic dermatitis or psoriasis, pemphigus foliaceus, porphyrias, filariasis, leprosy, extra pulmonary tuberculosis or paracoccidioidomycosis, and previous use of etretinate. Drugs that impose temporary ineligibility: other systemic retinoids, systemic corticosteroids, 5-alpha-reductase inhibitors, vaccines, methotrexate, beta-blockers, minoxidil, anti-epileptic, and anti-psychotic drugs. Other conditions that impose temporary ineligibility: occupational accident with biologic material, piercing, tattoo, sexually transmitted diseases, herpes, and bacterial infections, among others. Discussion: Thalidomide is currently missing in the teratogenic drugs list. Although finasteride was previously considered a drug that imposed permanent inaptitude, according to its short halflife current restriction of 1 month is still too long. Dermatologists should be able to advise their patients about proper timing to donate blood, and discuss the impact of drug withdrawal on treatment outcomes and to respect the designated washout periods.Uma revisão centrada no impacto de doenças e intervenções dermatológicas no ato solidário de doar sangue é apresentada aos dermatologistas para melhor aconselhamento dos seus pacientes. Esta é uma revisão das atuais normas técnicas brasileiras sobre procedimentos hemoterápicos conforme

Patient Involvement in Patient Safety: A Qualitative Study of Nursing Staff and Patient Perceptions.

Science.gov (United States)

Bishop, Andrea C; Macdonald, Marilyn

2017-06-01

The risk associated with receiving health care has called for an increased focus on the role of patients in helping to improve safety. Recent research has highlighted that patient involvement in patient safety practices may be influenced by patient perceptions of patient safety practices and the perceptions of their health care providers. The objective of this research was to describe patient involvement in patient safety practices by exploring patient and nursing staff perceptions of safety. Qualitative focus groups were conducted with a convenience sample of nursing staff and patients who had previously completed a patient safety survey in 2 tertiary hospital sites in Eastern Canada. Six focus groups (June 2011 to January 2012) were conducted and analyzed using inductive thematic analysis. Four themes were identified: (1) wanting control, (2) feeling connected, (3) encountering roadblocks, and (4) sharing responsibility for safety. Both patient and nursing staff participants highlighted the importance of building a personal connection as a precursor to ensuring that patients are involved in their care and safety. However, perceptions of provider stress and nursing staff workload often reduced the ability of the nursing staff and patient participants to connect with one another and promote involvement. Current strategies aimed at increasing patient awareness of patient safety may not be enough. The findings suggest that providing the context for interaction to occur between nursing staff and patients as well as targeted interventions aimed at increasing patient control may be needed to ensure patient involvement in patient safety.

Transfer Out Patient Not Abandon The Patient

Directory of Open Access Journals (Sweden)

Deepak Gupta

2015-12-01

Full Text Available Physician-patient relationship is unique in some aspects and not-so-unique in other aspects when compared to other human interactions. Until-unless for the sake of health promotional activities, this relationship is almost always conceived in the times of human sufferings and consequently culminated when those sufferings have subsided as well as sought out happiness has ensued/been achieved. However, not all physician-patient relationships follow the normal course and/or meet the natural ends. These abnormal relationships are not inconsequential in terms of numbers and/or their effects (short-term and long term on both patients and physicians. Every country has its own baggage in the wake of why, how and what about these abnormal ends to physician-patient relationships; however, the most common causes are the patients’ inability to pay their medical bills, the conflicting goals of physicians and their patients in regards to patients’ sufferings’ management and finally the behavioral issues (patients’ and/or physicians’ interfering these relationships. Irrespective of any cause, the physicians should never forget that the patient can always discharge their physicians and discontinue their relationship with their physicians without any reason (until unless the physicians deem those patients either incapable/non-consentable to do so and/or potential threat to their own personal safety or other people’s safety. Contrarily, physicians can also discharge patients from their care but cannot abandon these patients (1-3 which mean that physicians have to ensure their discharged patients either are referred to or have sought another physician within appropriate time frame post-relationship-discontinuation. Each country has their own medico-legal liabilities that vary in terms of penalties imposed; however, irrespective of the feared legal concerns, the physicians should not forget that ethical essence of medicine is the art of healing that

Patient-oriented health technologies: Patients' perspectives and use.

Science.gov (United States)

Bauer, Amy M; Rue, Tessa; Munson, Sean A; Ghomi, Reza Hosseini; Keppel, Gina A; Cole, Allison M; Baldwin, Laura-Mae; Katon, Wayne

2017-08-01

For patient-oriented mobile health tools to contribute meaningfully to improving healthcare delivery, widespread acceptance and use of such tools by patients are critical. However, little is known about patients' attitudes toward using health technology and their willingness to share health data with providers. To investigate primary care patients' comfort sharing health information through mobile devices, and patients' awareness and use of patient portals. Patients (n=918) who visited one of 6 primary care clinics in the Northwest US completed a survey about health technology use, medical conditions, and demographics. More patients were comfortable sharing mobile health information with providers than having third parties store their information (62% vs 30%, Somers D=.33, phigher among patients with a chronic condition (AOR= 3.18, p=0.004). Comfort, awareness, and use of health technologies were variable. Practices introducing patient-facing health technologies should promote awareness, address concerns about data security, and provide education and training, especially to older adults and those with health literacy limitations. Patient-facing health technologies provide an opportunity for delivering scalable health education and self-management support, particularly for patients with chronic conditions who are already using patient portals.

Terminally ill patients as customers: the patient's perspective.

Science.gov (United States)

Seibel, Katharina; Valeo, Sara Celestina; Xander, Carola; Adami, Sandra; Duerk, Thorsten; Becker, Gerhild

2014-01-01

Consumerism in health care defines patients as self-determined, rational customers. Yet, it is questionable whether vulnerable patients, such as the terminally ill, also fulfill these criteria. Vulnerable contexts and the patient's perspective on being a customer remain relatively unexplored. The present study addresses this research gap by analyzing terminally ill patients' views on being customers. To explore the ways in which patients in palliative care refer to themselves as patients/customers, and how the patients' concepts of self-determination are related to their attitudes toward the patient/customer role. Qualitative interviews were conducted. Data were analyzed in three steps: narrative analysis, thematic content analysis, and typology construction. Researchers recruited 25 patients via the Department of Palliative Care, University Medical Center Freiburg, Germany. In many ways, palliative patients contradict the image of a self-determined customer. The palliative patient role is characterized by the concept of relational self-determination rather than an unrestricted self-determination. Self-attribution as a customer still occurs when positively associated with a person-centered, individualized treatment. Thus, the customer and patient role overlap within the palliative care setting because of the focus on the individual. The idealized customer role cannot be arbitrarily applied to all medical fields. Palliative patients are dependent on the physician, regardless of whether the customer or patient role is preferred. Hence, self-determination must be understood in relational terms, and physicians must recognize their crucial role in promoting patients' self-determination in the context of shared decision-making.

Reading the Conjuncture

DEFF Research Database (Denmark)

Flohr, Mikkel; Harrison, Yannick Nehemiah Antonio

2016-01-01

This interview with Bob Jessop covers diverse issues ranging from the challenge of defining the state to problems of conjunctural analysis and political practice. It first explores the state and state power from a strategic-relational perspective and then addresses the relation between economics...... and politics in the context of a tendentially unified world market and a continuing plurality of national states. Attention then turns to the North Atlantic financial crisis and the Eurozone crisis and their relation to a variegated global capitalism organized in the shadow of neoliberalism. Financialization...... and the rise of political capitalism are seen as leading to a loss of temporal sovereignty, problems of crisis management, an assault on democracy, and the rise of the austerity state. Closing remarks address the role of left-wing social movements and parties, such as SYRIZA and Podemos, and the difficulties...

Geometry and Mechanics in the Opening of Chiral Seed Pods

Science.gov (United States)

Armon, Shahaf; Efrati, Efi; Kupferman, Raz; Sharon, Eran

2011-09-01

We studied the mechanical process of seed pods opening in Bauhinia variegate and found a chirality-creating mechanism, which turns an initially flat pod valve into a helix. We studied configurations of strips cut from pod valve tissue and from composite elastic materials that mimic its structure. The experiments reveal various helical configurations with sharp morphological transitions between them. Using the mathematical framework of “incompatible elasticity,” we modeled the pod as a thin strip with a flat intrinsic metric and a saddle-like intrinsic curvature. Our theoretical analysis quantitatively predicts all observed configurations, thus linking the pod’s microscopic structure and macroscopic conformation. We suggest that this type of incompatible strip is likely to play a role in the self-assembly of chiral macromolecules and could be used for the engineering of synthetic self-shaping devices.

Pediatric melanoma: incidence, treatment, and prognosis

Directory of Open Access Journals (Sweden)

Saiyed FK

2017-04-01

Full Text Available Faiez K Saiyed,1 Emma C Hamilton,1 Mary T Austin,1,2 1Department of Pediatric Surgery, McGovern Medical School, 2Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Abstract: The purpose of this review is to outline recent advancements in diagnosis, treatment, and prevention of pediatric melanoma. Despite the recent decline in incidence, it continues to be the deadliest form of skin cancer in children and adolescents. Pediatric melanoma presents differently from adult melanoma; thus, the traditional asymmetry, border irregularity, color variegation, diameter >6 mm, and evolution (ABCDE criteria have been modified to include features unique to pediatric melanoma (amelanotic, bleeding/bump, color uniformity, de novo/any diameter, evolution of mole. Surgical and medical management of pediatric melanoma continues to derive guidelines from adult melanoma treatment. However, more drug trials are being conducted to determine the specific impact of drug combinations on pediatric patients. Alongside medical and surgical treatment, prevention is a central component of battling the incidence, as ultraviolet (UV-related mutations play a central role in the vast majority of pediatric melanoma cases. Aggressive prevention measures targeting sun safety and tanning bed usage have shown positive sun-safety behavior trends, as well as the potential to decrease melanomas that manifest later in life. As research into the field of pediatric melanoma continues to expand, a prevention paradigm needs to continue on a community-wide level. Keywords: melanoma, pediatric, adolescent, childhood

Medical humanitarianism, human rights and political advocacy: the case of the Israeli Open Clinic.

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Gottlieb, Nora; Filc, Dani; Davidovitch, Nadav

2012-03-01

In the context of neo-liberal retrenchments humanitarian NGOs have become alternative healthcare providers that partially fill the vacuum left by the welfare state's withdrawal from the provision of services to migrants and other marginalized populations. In many cases they thus help to build legitimacy for the state's retreat from social responsibilities. Human rights organizations play an important role in advocating for migrants' rights, but in many cases they represent a legalistic and individualized conceptualization of the right to health that limits their claims for social justice. This paper analyzes the interactions and tensions between the discourses of medical humanitarianism, human rights and political advocacy using the example of an "Open Clinic" run by an Israeli human rights organization as a case-study: In 2007 dramatically increasing patient numbers provoked an intense internal debate concerning the proposal to temporarily close the "Open Clinic" in order to press the government to take action. Based on protocols from internal meetings and parliamentary hearings and in-depth interviews, we have analyzed divergent contextualizations of the Clinic's closure. These reflect conflicting notions regarding the Clinic's variegated spectrum of roles--humanitarian, political, legitimizing, symbolic, empowering and organizational--and underlying conceptualizations of migrants' "deservingness". Our case-study thus helps to illuminate NGOs' role in the realm of migrant healthcare and points out options for a possible fruitful relationship between the divergent paradigms of medical humanitarianism, human rights and political advocacy. Copyright © 2011. Published by Elsevier Ltd.

Treatment by bloodletting in the past and present

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Čolović Nataša

2016-01-01

Full Text Available Introduction. Therapeutic bloodletting has been practiced at least 3000 years as one of the most frequent methods of treatment in general, whose value was not questioned until the 19th century, when it was gradually abandoned in Western medicine, while it is still practiced in Arabic and traditional Chinese medicine. Content. In modern medicine bloodletting is practiced for very few indications. Its concept was modeled on the process of menstrual bleeding, for which it was believed to “purge women of bad humours.” Thus, bloodletting was based more on the belief that it helps in the reestablishment of proper balance of body “humours” than on the opinion that it serves to remove excessive amount of blood as well as to remove toxic “pneumas” that accumulate in human body. It was indicated for almost all known diseases, even in the presence of severe anemia. Bloodletting was carried out by scarification with cupping, by phlebotomies (venesections, rarely by arteriotomies, using specific instruments called lancets, as well as leeches. In different periods of history bloodletting was practiced by priests, doctors, barbers, and even by amateurs. In most cases, between one half of liter and two liters of blood used to be removed. Bloodletting was harmful to vast majority of patients and in some of them it is believed that it was either fatal or that it strongly contributed to such outcome. In the 20th century in the “Western” medicine bloodletting was still practiced in the treatment of hypertension and in severe cardiac insufficiency and pulmonary edema, but these indications were later abandoned. Conclusion. Bloodletting is still indicated for a few indications such as polycythemia, haemochromatosis, and porphyria cutanea tarda, while leeches are still used in plastic surgery, replantation and other reconstructive surgery, and very rarely for other specific indications.

ETHICAL MODELS OF PHYSICIAN--PATIENT RELATIONSHIP REVISITED WITH REGARD TO PATIENT AUTONOMY, VALUES AND PATIENT EDUCATION.

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Borza, Liana Rada; Gavrilovici, Cristina; Stockman, René

2015-01-01

The present paper revisits the ethical models of patient--physician relationship from the perspective of patient autonomy and values. It seems that the four traditional models of physician--patient relationship proposed by Emanuel & Emanuel in 1992 closely link patient values and patient autonomy. On the other hand, their reinterpretation provided by Agarwal & Murinson twenty years later emphasizes the independent expression of values and autonomy in individual patients. Additionally, patient education has been assumed to join patient values and patient autonomy. Moreover, several authors have noted that, over the past few decades, patient autonomy has gradually replaced the paternalistic approach based on the premise that the physician knows what is best for the patient. Neither the paternalistic model of physician-patient relationship, nor the informative model is considered to be satisfactory, as the paternalistic model excludes patient values from decision making, while the informative model excludes physician values from decision making. However, the deliberative model of patient-physician interaction represents an adequate alternative to the two unsatisfactory approaches by promoting shared decision making between the physician and the patient. It has also been suggested that the deliberative model would be ideal for exercising patient autonomy in chronic care and that the ethical role of patient education would be to make the deliberative model applicable to chronic care. In this regard, studies have indicated that the use of decision support interventions might increase the deliberative capacity of chronic patients.

Patient involvement in patient safety: Protocol for developing an intervention using patient reports of organisational safety and patient incident reporting

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Armitage Gerry

2011-05-01

Full Text Available Abstract Background Patients have the potential to provide a rich source of information on both organisational aspects of safety and patient safety incidents. This project aims to develop two patient safety interventions to promote organisational learning about safety - a patient measure of organisational safety (PMOS, and a patient incident reporting tool (PIRT - to help the NHS prevent patient safety incidents by learning more about when and why they occur. Methods To develop the PMOS 1 literature will be reviewed to identify similar measures and key contributory factors to error; 2 four patient focus groups will ascertain practicality and feasibility; 3 25 patient interviews will elicit approximately 60 items across 10 domains; 4 10 patient and clinician interviews will test acceptability and understanding. Qualitative data will be analysed using thematic content analysis. To develop the PIRT 1 individual and then combined patient and clinician focus groups will provide guidance for the development of three potential reporting tools; 2 nine wards across three hospital directorates will pilot each of the tools for three months. The best performing tool will be identified from the frequency, volume and quality of reports. The validity of both measures will be tested. 300 patients will be asked to complete the PMOS and PIRT during their stay in hospital. A sub-sample (N = 50 will complete the PMOS again one week later. Health professionals in participating wards will also be asked to complete the AHRQ safety culture questionnaire. Case notes for all patients will be reviewed. The psychometric properties of the PMOS will be assessed and a final valid and reliable version developed. Concurrent validity for the PIRT will be assessed by comparing reported incidents with those identified from case note review and the existing staff reporting scheme. In a subsequent study these tools will be used to provide information to wards/units about their

Search for C4 developmental mutants in Panicum maximum Jacq

International Nuclear Information System (INIS)

Fladung, M.

2001-01-01

Full text: Mutant plants are useful tools for studying developmental processes in defined genetic backgrounds by comparing them with their respective wild type forms. In this sense, developmental mutants or mutations involved in the establishment of certain leaf or flower specific traits are of special interest. In particular, the evolution of C 4 photosynthesis from C 3 precursors was accompanied by severe developmental changes in leaf morphology and anatomy. Our search of such mutants was followed by the idea to approach the evolution of the C 4 syndrome from a mutagenic point of view. Variants affecting normal development of the C 4 leaf anatomy may, in fact, represent possible regressive steps in C4 photosynthesis. Seeds of the C4 grass Panicum maximum Jacq. were mutagenized using ethylmethanesulfonate (EMS) and putative variants were isolated in the M2 generation by visual inspection. Main selection characteristics were whole plant, leaf morphology and pigmentation, and growth characteristics. The choice of a polyploid species for mutagenesis experiments was based on the need of detecting rare mutants, which are possibly lethal when using a diploid plant species. These variants could be of regulatory nature, affecting both morphology and physiology of C 4 photosynthesis early in leaf development. In total, nearly 100 variants were isolated and grown to maturity. Main isolated variants, which conforms to the prediction mentioned above, were as following: large interveinal space-1 and -3 (lis1, lis3), abnormal bundle sheath (abs), midribless (mbl) and variegated leaf -1 (var1). The variant lis1 was a short plant with leaves smaller than the wild type, and had a leaf lamina with a crinkly surface. Photosynthetically, lis1 indicates a clear regression from the C 4 to the C 3 photosynthesis type, which was correlated in the leaf lamina with an increase in the distance between small veins. The variant lis3 was not similar phenotypically to lis1, but it also had very

Patient-centred Prevention among PAD Patients

DEFF Research Database (Denmark)

Pii, Kathrine Hoffmann

2015-01-01

Intro: This paper discusses a central professional dilemma in patient-centred education: on one hand the concern for ensuring patients autonomy and right to make their own decisions regarding their treatment and, on the other hand, a concern for getting patients to make the “right” decisions......-centredness is thus promoted as a way to organize health more effectively (in terms of cost and treatment outcomes) and as a way to ensure patients’ autonomy and fundamental right to make their own decisions regarding their treatment. Critical voices within social and nursing theory have however argued....... The paper shows that the programme’s attempt to facilitate that patients make their “own” decision is challenged by patients who understand the preventive programme in relational terms and even demand more intervention from the professionals in terms of expert advice, involvement, and discipline. Conclusion...

CACTA-superfamily transposable element is inserted in MYB transcription factor gene of soybean line producing variegated seeds.

Science.gov (United States)

Yan, Fan; Di, Shaokang; Takahashi, Ryoji

2015-08-01

The R gene of soybean, presumably encoding a MYB transcription factor, controls seed coat color. The gene consists of multiple alleles, R (black), r-m (black spots and (or) concentric streaks on brown seed), and r (brown seed). This study was conducted to determine the structure of the MYB transcription factor gene in a near-isogenic line (NIL) having r-m allele. PCR amplification of a fragment of the candidate gene Glyma.09G235100 generated a fragment of about 1 kb in the soybean cultivar Clark, whereas a fragment of about 14 kb in addition to fragments of 1 and 1.4 kb were produced in L72-2040, a Clark 63 NIL with the r-m allele. Clark 63 is a NIL of Clark with the rxp and Rps1 alleles. A DNA fragment of 13 060 bp was inserted in the intron of Glyma.09G235100 in L72-2040. The fragment had the CACTA motif at both ends, imperfect terminal inverted repeats (TIR), inverse repetition of short sequence motifs close to the 5' and 3' ends, and a duplication of three nucleotides at the site of integration, indicating that it belongs to a CACTA-superfamily transposable element. We designated the element as Tgm11. Overall nucleotide sequence, motifs of TIR, and subterminal repeats were similar to those of Tgm1 and Tgs1, suggesting that these elements comprise a family.

Variegated Voices - power, dominance and inequality: A Critical Discourse Analysis of the 2017 general elections in Kenya

DEFF Research Database (Denmark)

Owiso, Michael Omondi

2018-01-01

Public perceptions through various social media such as the WhatsApp, Twitter and Facebook as well as general public conversations in places of worship, bars, market places, churches, streets, funerals, public gatherings and interest group meetings during the election period of 2017 are a reflect......Public perceptions through various social media such as the WhatsApp, Twitter and Facebook as well as general public conversations in places of worship, bars, market places, churches, streets, funerals, public gatherings and interest group meetings during the election period of 2017...

Preoperative patient education: evaluating postoperative patient outcomes.

Science.gov (United States)

Meeker, B J

1994-04-01

Preoperative teaching is an important part of patient care and can prevent complications, as well as promote patient fulfillment during hospitalization. A study was conducted at Alton Ochsner Medical Foundation in New Orleans, LA, in 1989, to determine the impact of a preoperative teaching program on the incidence of postoperative atelectasis and patient satisfaction. Results showed no significant difference of postoperative complications and patient gratification after participating in a structured preoperative teaching program. As part of this study, it was identified that a patient evaluation tool for a preoperative teaching class needed to be developed. The phases of this process are explained in the following article.

Dentist–patient communication: what do patients and dentists remember following a consultation? Implications for patient compliance

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Misra S

2013-06-01

Full Text Available Sara Misra, Blánaid Daly, Stephen Dunne, Brian Millar, Mark Packer, Koula AsimakopoulouDental Institute, King's College London, London, UKBackground: There is a lack of information about the extent to which patients recall key facts of dental consultations. Forgetting health advice undermines adherence with such instructions and is a potential problem. This study assessed the quantity and type of information recalled in a dental consultation, dentist–patient agreement over the contents of the consultation, and the relationship of such recall with patient satisfaction.Methods: Using a cross-sectional design, questionnaire data were obtained from patients recruited through a letter and presenting for a routine dental consultation. General issues discussed, specific information about oral health given, dentist-performed procedures, and agreed future actions were reported independently in writing, by patients and also by the treating dentist immediately postconsultation. Additionally, patients completed a dental visit satisfaction questionnaire.Results: Responses (n = 26, 55% response rate were content-analyzed, and data on the number and type of information that was recalled were obtained. Interrater reliability was established. Inferential testing showed differences in dentist–patient recall, dentist–patient agreement, and the association between patient recall and satisfaction. Dentists recalled more information than patients (P = 0.001. Dentists further reported giving more dental health education (P = 0.006 and discussing more future actions (P = 0.002 than patients actually remembered. Technical (eg, crowns/bridges rather than psychosocial (eg, pain/embarrassment issues were reported more often (P = 0.001 by both dentists and patients. Dentist–patient agreement over issues discussed and procedures performed was higher (kappa = 0.210–0.310 than dental health education agreement and agreed future actions (kappa = 0.060–0.110. There

Constructions of the patient in healthcare communications: six patient figures.

Science.gov (United States)

Pors, Anja Svejgaard

2016-01-01

The purpose of this paper is to examine how strategic, patient-centred communication plays a part in the discursive management of expectations posed to patients and healthcare organizations. The paper provides an analysis of four documents collected as part of an ethnographic case study regarding "The Perspective of the Patient" - a Danish Hospital's patient-centred communication programme. Mapping methods inspired by Grounded Theory are used to qualify the analysis. The paper shows that strategic patient-centred communication addresses both a care-oriented approach to the patient and deploys market perceptions of patients. Market and care is seen as co-existing organizing modes that entail expectations to the patient. In the communication programme the patient is constructed in six information-seeking patient figures: affective patient; target group patient; citizen with rights; patient as a competent resource; user as active partner; and consumer. As a result, the patient-centred communication programme renders the patient as a flexible figure able to fit organizational demands of both care orientation and market concerns. This study contributes to qualitative research in organizational health communication by combining two subfields - patient-centredness and health communication - in an empirical study of how market and care are intertwined in a patient-centred communication programme. The argument goes beyond the prevalent prescriptive approaches to patient-centredness and healthcare communication, instead providing a critical analytical perspective on strategic communication and patient-centredness and showing how expectations are posed to both patient and organization.

Patient satisfaction

Directory of Open Access Journals (Sweden)

Bhanu Prakash

2010-01-01

Full Text Available Patient satisfaction is an important and commonly used indicator for measuring the quality in health care. Patient satisfaction affects clinical outcomes, patient retention, and medical malpractice claims. It affects the timely, efficient, and patient-centered delivery of quality health care. Patient satisfaction is thus a proxy but a very effective indicator to measure the success of doctors and hospitals. This article discusses as to how to ensure patient satisfaction in dermatological practice.

Patient satisfaction.

Science.gov (United States)

Prakash, Bhanu

2010-09-01

Patient satisfaction is an important and commonly used indicator for measuring the quality in health care. Patient satisfaction affects clinical outcomes, patient retention, and medical malpractice claims. It affects the timely, efficient, and patient-centered delivery of quality health care. Patient satisfaction is thus a proxy but a very effective indicator to measure the success of doctors and hospitals. This article discusses as to how to ensure patient satisfaction in dermatological practice.

Patients with epilepsy and patients with psychogenic non-epileptic seizures

DEFF Research Database (Denmark)

Turner, Katherine; Piazzini, Ada; Chiesa, Valentina

2011-01-01

and neuropsychological functions among patients with PNES, patients with epilepsy associated with PNES and patients with epilepsy. METHODS: We evaluated 66 consecutive in-patients with video-EEG recordings: 21 patients with epilepsy, 22 patients with PNES and 10 patients with epilepsy associated with PNES; 13 patients....... We observed fewer mood and anxiety disorders in patients with PNES compared with those with epilepsy. We did not find statistically significant differences in neuropsychological profiles among the 3 patient groups. CONCLUSION: This study can help to contribute to a better understanding of the impact...

Porfiria cutánea tarda: asociación con mutaciones HFE, hepatitis virales, alcohol y otros factores de riesgo en Guipúzcoa, País Vasco Porphyria cutanea tarda: An analysis of HFE gene mutations, hepatitis viruses, alcohol intake, and other risk factors in 54 patients from Guipúzcoa, Basque Country, Spain

Directory of Open Access Journals (Sweden)

A. Castiella

2008-12-01

Full Text Available Objetivo: estudiar la frecuencia de las mutaciones en el gen HFE (C282Y, H63D, S65C en un grupo de 54 pacientes con porfiria cutánea tarda (PCT y en un grupo de controles sanos (donantes de sangre en Guipúzcoa. También analizar su relación con los virus de la hepatitis B y C (VHB, VHC, alcohol y otros factores de riesgo reconocidos. Métodos: el análisis de las mutaciones se hizo mediante PCR. Se compararon las frecuencias alélicas y genotípicas. Se determinaron la probabilidad y el test de Chi cuadrado. Resultados: no encontramos asociación entre C282Y y PCT (5,76 vs. 5% controles. Se observó una alta frecuencia alélica en la mutación H63D en PCT (34,25%, pero sin ser estadísticamente significativa (controles 29,31%, debido a la alta prevalencia de esta mutación en la población vasca. La mutación S65C fue menor en PCT que en controles. Encontramos una idéntica presencia de H63D en heterocigosis en ambos grupos (38,8 vs. 38,8%. La asociación con el VHC se objetivó en el 35,18% de los pacientes y la infección por VHB en el 7,4%. Un 55,55% de los pacientes tenía un hábito alcohólico de más de 60 g etanol día. Todos eran negativos para el virus de la inmunodeficiencia humana (VIH y 1 de las 5 mujeres con PCT tomaba estrógenos. Conclusión: las mutaciones C282Y y H63D no tienen un papel relevante en los pacientes con PCT en Guipúzcoa. Los factores externos (consumo importante de alcohol y VHC parecen jugar un papel fundamental en el desarrollo de la PCT en nuestra población.Aim: to study the frequency of HFE gene mutations (C282Y, H63D, S65C in a group of 54 sporadic PCT patients and in a group of healthy controls (blood donors from Guipúzcoa, Spain. We studied the association of PCT with HCV, HBV, alcohol abuse, and other established risk factors. Methods: the analysis of mutations was made by PCR. Allelic and genotypic frequencies were compared. Probability was determined and a Chi-squared test was performed. Results

Effects of the Smartphone Application "Safe Patients" on Knowledge of Patient Safety Issues Among Surgical Patients.

Science.gov (United States)

Cho, Sumi; Lee, Eunjoo

2017-12-01

Recently, the patient's role in preventing adverse events has been emphasized. Patients who are more knowledgeable about safety issues are more likely to engage in safety initiatives. Therefore, nurses need to develop techniques and tools that increase patients' knowledge in preventing adverse events. For this reason, an educational smartphone application for patient safety called "Safe Patients" was developed through an iterative process involving a literature review, expert consultations, and pilot testing of the application. To determine the effect of "Safe Patients," it was implemented for patients in surgical units in a tertiary hospital in South Korea. The change in patients' knowledge about patient safety was measured using seven true/false questions developed in this study. A one-group pretest and posttest design was used, and a total of 123 of 190 possible participants were tested. The percentage of correct answers significantly increased from 64.5% to 75.8% (P effectively improve patients' knowledge of safety issues. This will ultimately empower patients to engage in safe practices and prevent adverse events related to surgery.

Patients for patient safety in China: a cross sectional study.

Science.gov (United States)

Zhang, Qiongwen; Li, Yulin; Li, Jing; Mao, Xuanyue; Zhang, Lijuan; Ying, Qinghua; Wei, Xin; Shang, Lili; Zhang, Mingming

2012-02-01

To investigate the baseline status of patients' awareness, knowledge, and attitudes to patient safety in China, and to determine the factors that influence patients' involvement in patient safety. We conducted a cross sectional survey using questionnaires adapted from recent studies on patient safety from outside China. The items included medical errors, infection, medication safety, and other aspects of patient safety. The questionnaire included 17 items and 5 domains. The survey was conducted between Jan. 2009 and Dec. 2010 involving 1000 patients from ten grade-A hospitals in seven provinces or cities in China. Most patients from the surgery departments completed the questionnaires voluntarily and anonymously. Five reviewers independently input the data into Microsoft Excel 2003, and the data were double-checked. Data were analyzed using SPSS 15.0 software for differences in the perceptions and attitudes of patients toward patient safety among different genders, ages, and regions. We distributed 1000 questionnaires and collected 959 completed questionnaires (response rate: 96%). Among the respondents, 58% of patients did not know what medical error is. Sixty-five percent of patients wanted disclosure of all medical errors. After errors occurred, 58% of patients wanted explanations of all possible harms that had resulted. Among 187 patients who had experienced medical errors, 83% of patients had sought appropriate legal action. About 52% of patients understood hospital infection, but 28% patients did not know that infections could occur in hospital. Seventy-eight percent of patients thought that medical staff should wash their hands before examining patients. More than half of the patients (68%) were willing to remind the staff of hygiene if they saw unsanitary conditions in a health clinic. Only 14% of patients knew the side effects of medications that they took. The majority of patients surveyed expressed willingness to contribute to patient safety, but their

Patient perspectives of patient-controlled analgesia (PCA) and methods for improving pain control and patient satisfaction.

Science.gov (United States)

Patak, Lance S; Tait, Alan R; Mirafzali, Leela; Morris, Michelle; Dasgupta, Sunavo; Brummett, Chad M

2013-01-01

This study aimed to (1) identify patient-controlled analgesia (PCA) attributes that negatively impact patient satisfaction and ability to control pain while using PCA and (2) obtain data on patient perceptions of new PCA design features. We conducted a prospective survey study of postoperative pain control among patients using a PCA device. The survey was designed to evaluate patient satisfaction with pain control, understanding of PCA, difficulties using PCA, lockout-period management, and evaluation of new PCA design features. A total of 350 eligible patients completed the survey (91%). Patients who had difficulties using PCA were less satisfied (P PCA. Forty-nine percent of patients reported not knowing if they would receive medicine when they pushed the PCA button, and of these, 22% believed that this uncertainty made their pain worse. The majority of patients preferred the proposed PCA design features for easier use, including a light on the button, making it easier to find (57%), and a PCA button that vibrates (55%) or lights up (70%), alerting the patient that the PCA pump is able to deliver more medicine. A majority of patients, irrespective of their satisfaction with PCA, preferred a new PCA design. Certain attributes of current PCA technology may negatively impact patient experience, and modifications could potentially address these concerns and improve patient outcomes.

Patient-centered care requires a patient-oriented workflow model.

Science.gov (United States)

Ozkaynak, Mustafa; Brennan, Patricia Flatley; Hanauer, David A; Johnson, Sharon; Aarts, Jos; Zheng, Kai; Haque, Saira N

2013-06-01

Effective design of health information technology (HIT) for patient-centered care requires consideration of workflow from the patient's perspective, termed 'patient-oriented workflow.' This approach organizes the building blocks of work around the patients who are moving through the care system. Patient-oriented workflow complements the more familiar clinician-oriented workflow approaches, and offers several advantages, including the ability to capture simultaneous, cooperative work, which is essential in care delivery. Patient-oriented workflow models can also provide an understanding of healthcare work taking place in various formal and informal health settings in an integrated manner. We present two cases demonstrating the potential value of patient-oriented workflow models. Significant theoretical, methodological, and practical challenges must be met to ensure adoption of patient-oriented workflow models. Patient-oriented workflow models define meaningful system boundaries and can lead to HIT implementations that are more consistent with cooperative work and its emergent features.

Cardiac patients' perception of patient-centred care: a qualitative study.

Science.gov (United States)

Esmaeili, Maryam; Cheraghi, Mohammad A; Salsali, Mahvash

2016-03-01

The aim of this study was to explore cardiac patients' perception of patient-centred care. Despite patient's importance in the process of care, less attention has been paid to experiences and expectations of patients in definitions of patient-centred care. As patients are an important element in process of patient-centred care, organizing care programs according to their perceptions and expectations will lead to enhanced quality of care and greater patient satisfaction. This study is a descriptive qualitative study. Content analysis approach was performed for data analysis. Participants were 18 cardiac patients (10 women and 8 men) hospitalized in coronary care units of teaching hospitals affiliated to Tehran University of Medical Sciences. We collected the study data through conducting personal face-to-face semi-structured interviews. The participants' perceptions of patient-centred care fell into three main themes including managing patients uncertainty, providing care with more flexibility and establishing a therapeutic communication. The second theme consisted of two sub-themes: empathizing with patients and having the right to make independent decisions. Receiving patient-centred care is essential for cardiac patients. Attention to priorities and preferences of cardiac patients and making decisions accordingly is among effective strategies for achieving patient-centred care. Cardiac care unit nurses ought to be aware that in spite of technological developments and advances, it is still important to pay attention to patients' needs and expectations in order to achieve patient satisfaction. In planning care programs, they should consider accountability towards patients' needs, flexibility in process of care and establishing medical interactions as an effective strategy for improving quality of care. © 2014 British Association of Critical Care Nurses.

[Differences in attitude toward patient-centeredness in patients and physicians].

Science.gov (United States)

Kim, Min-Jeong

2013-06-01

There have been studies on the patient-centeredness of medical students and physicians in South Korea, but no result has presented the patient-centered attitude of patients and doctors. So, this study intended to compare the attitudes of patients and doctors toward the roles that patients and physicians should play in the health care process. One hundred and fifteen doctors and 264 patients participated in this survey using a structured questionnaire, including sociodemographic data and Patient Practitioner Orientation Scale (PPOS). The PPOS comprises sharing (sharing information, take part in decision making) and caring (respecting one's feelings, interpersonal relationships) subscales. The PPOS scores of the doctors and patient were 3.02 and 3.20. In detail, the doctors' sharing and caring scores were and 3.02 and 3.48, and the those of patients were 3.14 and 3.12, respectively. This results are enough to demonstrate that patients are likely to be patient-centered with regard to sharing and that doctors tend to be patient-centered in terms of caring. The patients' desire to obtain medical information and take part in decision making (sharing) are greater than those of doctors. Doctors had more patient-centered attitude than patients in terms of respects for one's feelings and interpersonal relationships (caring).

Patient activation and use of an electronic patient portal.

Science.gov (United States)

Ancker, Jessica S; Osorio, Snezana N; Cheriff, Adam; Cole, Curtis L; Silver, Michael; Kaushal, Rainu

2015-01-01

Electronic patient portals give patients access to personal medical data, potentially creating opportunities to improve knowledge, self-efficacy, and engagement in healthcare. The combination of knowledge, self-efficacy, and engagement has been termed activation. Our objective was to assess the relationship between patient activation and outpatient use of a patient portal. Survey. A telephone survey was conducted with 180 patients who had been given access to a portal, 113 of whom used it and 67 of whom did not. The validated patient activation measure (PAM) was administered along with questions about demographics and behaviors. Portal users were no different from nonusers in patient activation. Portal users did have higher education level and more frequent Internet use, and were more likely to have precisely 2 prescription medications than to have more or fewer. Patients who chose to use an electronic patient portal were not more highly activated than nonusers, although they were more educated and more likely to be Internet users.

[Student patient relationship from the patient's point of view].

Science.gov (United States)

Beca, Juan Pablo; Browne, Francisca; Valdebenito, Carolina; Bataszew, Alexander; Martínez, María José

2006-08-01

Patients are becoming increasingly active in their relationship with medical professionals. Their relationship with medical students needing to learn clinical skills, may be specially problematic if patients are not willing to accept their involvement in the medical team. To examine patient's perceptions of their relation with medical students and their agreement to let students be part of the treating team. Qualitative study using taped semi-structured interviews addressed to inpatients from one public and one private hospital in Chile. Both groups of patients acknowledged that students dedicated more time to them, but they expressed their preference to limit student's participation to clinical history taking and physical examination. They also expected them to be observers rather than actors. Patients from the private hospital emphasized that only one student per instructor should participate in their care. Patients from the public hospital were more compliant about student's participation. The right to refuse students' involvement in their care was clearly known by all patients from the private system and by most patients from the public hospital. Patients in Chilean public and private hospitals were in general positive regarding student's participation in their care. Students' clinical practice ought to strictly respect patients's rights, and patients should be considered volunteers who generously agree to cooperate with the education of medical students.

Patient satisfaction and positive patient outcomes in ambulatory anesthesia

Directory of Open Access Journals (Sweden)

Shah U

2015-04-01

Full Text Available Ushma Shah, David T Wong, Jean Wong Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada Abstract: Most surgeries in North America are performed on an ambulatory basis, reducing health care costs and increasing patient comfort. Patient satisfaction is an important outcome indicator of the quality of health care services incorporated by the American Society of Anesthesiologists (ASA. Patient satisfaction is a complex concept that is influenced by multiple factors. A patient's viewpoint and knowledge plays an influential role in patient satisfaction with ambulatory surgery. Medical optimization and psychological preparation of the patient plays a pivotal role in the success of ambulatory surgery. Postoperative pain, nausea, and vomiting are the most important symptoms for the patient and can be addressed by multimodal drug regimens. Shared decision making, patient–provider relationship, communication, and continuity of care form the main pillars of patient satisfaction. Various psychometrically developed instruments are available to measure patient satisfaction, such as the Iowa Satisfaction with Anesthesia Scale and Evaluation du Vecu de I'Anesthesie Generale, but none have been developed specifically for ambulatory surgery. The ASA has made recommendations for data collection for patient satisfaction surveys and emphasized the importance of reporting the data to the Anesthesia Quality Institute. Future research is warranted to develop a validated tool to measure patient satisfaction in ambulatory surgery. Keywords: patient, satisfaction, anesthesia, outcomes, questionnaire, perspectives

Patient participation in patient safety and nursing input - a systematic review.

Science.gov (United States)

Vaismoradi, Mojtaba; Jordan, Sue; Kangasniemi, Mari

2015-03-01

This systematic review aims to synthesise the existing research on how patients participate in patient safety initiatives. Ambiguities remain about how patients participate in routine measures designed to promote patient safety. Systematic review using integrative methods. Electronic databases were searched using keywords describing patient involvement, nursing input and patient safety initiatives to retrieve empirical research published between 2007 and 2013. Findings were synthesized using the theoretical domains of Vincent's framework for analysing risk and safety in clinical practice: "patient", "healthcare provider", "task", "work environment", "organisation & management". We identified 17 empirical research papers: four qualitative, one mixed-method and 12 quantitative designs. All 17 papers indicated that patients can participate in safety initiatives. Improving patient participation in patient safety necessitates considering the patient as a person, the nurse as healthcare provider, the task of participation and the clinical environment. Patients' knowledge, health conditions, beliefs and experiences influence their decisions to engage in patient safety initiatives. An important component of the management of long-term conditions is to ensure that patients have sufficient knowledge to participate. Healthcare providers may need further professional development in patient education and patient care management to promote patient involvement in patient safety, and ensure that patients understand that they are 'allowed' to inform nurses of adverse events or errors. A healthcare system characterised by patient-centredness and mutual acknowledgement will support patient participation in safety practices. Further research is required to improve international knowledge of patient participation in patient safety in different disciplines, contexts and cultures. Patients have a significant role to play in enhancing their own safety while receiving hospital care. This

Incorporating Colour Information for Computer-Aided Diagnosis of Melanoma from Dermoscopy Images: A Retrospective Survey and Critical Analysis

Directory of Open Access Journals (Sweden)

Ali Madooei

2016-01-01

Full Text Available Cutaneous melanoma is the most life-threatening form of skin cancer. Although advanced melanoma is often considered as incurable, if detected and excised early, the prognosis is promising. Today, clinicians use computer vision in an increasing number of applications to aid early detection of melanoma through dermatological image analysis (dermoscopy images, in particular. Colour assessment is essential for the clinical diagnosis of skin cancers. Due to this diagnostic importance, many studies have either focused on or employed colour features as a constituent part of their skin lesion analysis systems. These studies range from using low-level colour features, such as simple statistical measures of colours occurring in the lesion, to availing themselves of high-level semantic features such as the presence of blue-white veil, globules, or colour variegation in the lesion. This paper provides a retrospective survey and critical analysis of contributions in this research direction.

Identifying niche-mediated regulatory factors of stem cell phenotypic state: a systems biology approach.

Science.gov (United States)

Ravichandran, Srikanth; Del Sol, Antonio

2017-02-01

Understanding how the cellular niche controls the stem cell phenotype is often hampered due to the complexity of variegated niche composition, its dynamics, and nonlinear stem cell-niche interactions. Here, we propose a systems biology view that considers stem cell-niche interactions as a many-body problem amenable to simplification by the concept of mean field approximation. This enables approximation of the niche effect on stem cells as a constant field that induces sustained activation/inhibition of specific stem cell signaling pathways in all stem cells within heterogeneous populations exhibiting the same phenotype (niche determinants). This view offers a new basis for the development of single cell-based computational approaches for identifying niche determinants, which has potential applications in regenerative medicine and tissue engineering. © 2017 The Authors. FEBS Letters published by John Wiley & Sons Ltd on behalf of Federation of European Biochemical Societies.

Crystallization and preliminary X-ray analysis of stationary phase survival protein E (SurE) from Xylella fastidiosa in two crystal forms

International Nuclear Information System (INIS)

Reis, Marcelo Augusto dos; Saraiva, Antonio Marcos; Santos, Marcelo Leite dos; Souza, Anete Pereira de; Aparicio, Ricardo

2012-01-01

The crystallization and preliminary analysis of two crystal forms of survival protein E from X. fastidiosa are reported. The bacterium Xylella fastidiosa is a phytopathogenic organism that causes citrus variegated chlorosis, a disease which attacks economically important crops, mainly oranges. In this communication, the crystallization and preliminary X-ray crystallographic analysis of XfSurE, a survival protein E from X. fastidiosa, are reported. Data were collected for two crystal forms, I and II, to 1.93 and 2.9 Å resolution, respectively. Crystal form I belonged to space group C2, with unit-cell parameters a = 172.36, b = 84.18, c = 87.24 Å, α = γ = 90, β = 96.59°, whereas crystal form II belonged to space group C2, with unit-cell parameters a = 88.05, b = 81.26, c = 72.84 Å, α = γ = 90, β = 94.76°

The Genus Heliopsis: Development of Varieties and Their Use in the European Gardens After the Mid 19th Century

Directory of Open Access Journals (Sweden)

Jiří Uher

2014-01-01

Full Text Available This review summarizes data on the development of varieties in historic gardens of the once very popular Ox-eyes (Heliopsis Pers., Asteraceae: Zinniinae after the mid 19th century, with regard to the development of varietal assortments in the periods corresponding to the most important architectural styles and to their fluctuating popularity. Old varietal assortments, usually derived from large-flowered H. helianthoides var. scabra, now rapidly disappear and the oldest varieties, including the once famous Lemoine’s selections, are virtually inaccessible. Until recently the most propagated Götz’s and Förster’s varieties also disappear and are replaced by modern, relatively small-flowered selections delivered from H. helianthoides var. helianthoides or patent protected variegated varieties. Neither of these groups, however, is applicable to the restoration of historic gardens. Tables show data on the origin of about eighty both still cultivated and vanished varieties.

Patients' and healthcare workers' perceptions of a patient safety advisory.

Science.gov (United States)

Schwappach, David L B; Frank, Olga; Koppenberg, Joachim; Müller, Beat; Wasserfallen, Jean-Blaise

2011-12-01

To assess patients' and healthcare workers' (hcw) attitudes and experiences with a patient safety advisory, to investigate predictors for patients' safety-related behaviors and determinants for staff support for the advisory. Cross-sectional surveys of patients (n= 1053) and hcw (n= 275). Three Swiss hospitals. Patients who received the safety advisory and hcw caring for these patients. Patient safety advisory disseminated to patients at the study hospitals. Attitudes towards and experiences with the advisory. Hcw support for the intervention and patients' intentions to apply the recommendations were modelled using regression analyses. Patients (95%) and hcw (78%) agreed that hospitals should educate patients how to prevent errors. Hcw and patients' evaluations of the safety advisory were positive and followed a similar pattern. Patients' intentions to engage in safety were significantly predicted by behavioral control, subjective norms, attitudes, safety behaviors during hospitalization and experiences with taking action. Hcw support for the campaign was predicted by rating of the advisory (Odds ratio (OR) 3.4, confidence interval (CI) 1.8-6.1, Ppatients (OR 1.9, CI 1.1-3.3, P= 0.034) and experience of unpleasant situations (OR 0.6, CI 0.4-1.0, P= 0.035). The safety advisory was well accepted by patients and hcw. To be successful, the advisory should be accompanied by measures that target norms and barriers in patients, and support staff in dealing with difficult situations.

Patient information in radiooncology. Results of a patient survey

International Nuclear Information System (INIS)

Schaefer, C.; Dietl, B.; Putnik, K.; Altmann, D.; Herbst, M.; Marienhagen, J.

2002-01-01

Background: As a result of increased interest and public demand, providing patients with adequate information about radiooncology has become more and more difficult for the doctor. Insufficient patient information can not only cause anxiety for the patient, but can also lead to legal action against the physician. In order to gain a deeper insight into our clinical practice of providing patient information, we developed a special questionnaire. We describe our first experiences in using this questionnaire at our institute. Patients and methods: We examine the amount of information and level of satisfaction, as well as the agreement of assessment between patient and physician after the provision of standard patient information before and at the end of radiotherapy. 51 consecutive patients were interviewed with a newly designed questionnaire. The first questioning with 13 items was carried out before radiotherapy and the second with ten items was done at the end of treatment. Sum scores for information and satisfaction were defined and agreement was measured by the weighted κ coefficient. Results: Global level of information and satisfaction was good, and a significant increase in information level and a significant decline in satisfaction were seen between questionnaire 1 and 2. Agreement between patient and physician was fair, for example intent of treatment resulted in a κ coefficient of 0.34, and poor for the doctor's role with a κ coefficient of -0.002. Only 52% of the patients who received palliative radiotherapy rated correctly the non-curative intent of treatment, whereas 86% of the patients who received curative radiotherapy made a correct statement. Before radiotherapy, emotional state was often both negatively and positively assessed by the patients. Conclusion: Our short questionnaire is simple and easy to understand. It provides insights into patient information with respect to assessment of the information, satisfaction level, and agreement between

Patient participation in transitional care of older patients

OpenAIRE

Dyrstad, Dagrunn Nåden

2016-01-01

PhD thesis in Health, medicine and welfare Background: Older patients often have several health challenges, with multiple medications, which leads to a need of treatment and care from diverse healthcare services. These patients are often in need of transitions from different levels of care, specifically during hospital admission and discharge. Patient participation is highlighted and stated in patients’ rights and healthcare directives, with patients being informed and involved in all trea...

Does patient satisfaction affect patient loyalty?

Science.gov (United States)

Kessler, Daniel P; Mylod, Deirdre

2011-01-01

This paper aims to investigate how patient satisfaction affects propensity to return, i.e. loyalty. Data from 678 hospitals were matched using three sources. Patient satisfaction data were obtained from Press Ganey Associates, a leading survey firm; process-based quality measures and hospital characteristics (such as ownership and teaching status) and geographic areas were obtained from the Centers for Medicare and Medicaid Services. The frequency with which end-of-life patients return to seek treatment at the same hospital was obtained from the Dartmouth Atlas. The study uses regression analysis to estimate satisfaction's effects on patient loyalty, while holding process-based quality measures and hospital and market characteristics constant. There is a statistically significant link between satisfaction and loyalty. Although satisfaction's effect overall is relatively small, contentment with certain hospitalization experience may be important. The link between satisfaction and loyalty is weaker for high-satisfaction hospitals, consistent with other studies in the marketing literature. RESEARCH LIMITATION/IMPLICATIONS: The US hospitals analyzed are not a random sample; the results are most applicable to large, non-profit teaching hospitals in competitive markets. Satisfaction ratings have business implications for healthcare providers and may be useful as a management tool for private and public purchasers. The paper is the first to show that patient satisfaction affects actual hospital choices in a large sample. Because patient satisfaction ratings are also correlated with other quality measures, the findings suggest a pathway through which individuals naturally gravitate toward higher-quality care.

Using patient acuity data to manage patient care outcomes and patient care costs.

Science.gov (United States)

Van Slyck, A; Johnson, K R

2001-01-01

This article describes actual reported uses for patient acuity data that go beyond historical uses in determining staffing allocations. These expanded uses include managing patient care outcomes and health care costs. The article offers the patient care executive examples of how objective, valid, and reliable data are used to drive approaches to effectively influence decision making in an increasingly competitive health care environment.

Can "patient keeper" help in-patients?

Science.gov (United States)

Al-Hinnawi, M F

2009-06-01

The aim of this paper is to present our "Patient Keeper" application, which is a client-server medical application. "Patient Keeper" is designed to run on a mobile phone for the client application and on a PC for the server application using J2ME and JAVA2, respectively. This application can help doctors during visits to their patients in hospitals. The client application allows doctors to store on their mobile phones the results of their diagnoses and findings such as temperature, blood pressure, medications, analysis, etc., and send this information to the server via short message service (SMS) for storage in a database. The server can also respond to any request from the client and send the result via Bluetooth, infrared, or over the air. Experimental results showed a significant improvement of the healthcare delivery and reduction for in-patient stay.

The relationship between physician humility, physician-patient communication, and patient health.

Science.gov (United States)

Ruberton, Peter M; Huynh, Ho P; Miller, Tricia A; Kruse, Elliott; Chancellor, Joseph; Lyubomirsky, Sonja

2016-07-01

Cultural portrayals of physicians suggest an unclear and even contradictory role for humility in the physician-patient relationship. Despite the social importance of humility, however, little empirical research has linked humility in physicians with patient outcomes or the characteristics of the doctor-patient visit. The present study investigated the relationship between physician humility, physician-patient communication, and patients' perceptions of their health during a planned medical visit. Primary care physician-patient interactions (297 patients across 100 physicians) were rated for the physician's humility and the effectiveness of the physician-patient communication. Additionally, patients reported their overall health and physicians and patients reported their satisfaction with the interaction. Within-physician fluctuations in physician humility and self-reported patient health positively predicted one another, and mean-level differences in physician humility predicted effective physician-patient communication, even when controlling for the patient's and physician's satisfaction with the visit and the physician's frustration with the patient. The results suggest that humble, rather than paternalistic or arrogant, physicians are most effective at working with their patients. Interventions to improve physician humility may promote better communication between health care providers and patients, and, in turn, better patient outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Using Patient Portals to Increase Engagement in Patients with Cancer.

Science.gov (United States)

Rodriguez, Elizabeth S

2018-04-03

To review patient portals which serve as a tool for patient engagement by increasing access to electronic health care information and expanding ways to communicate with health care providers. Reviews of the literature and first-hand experience. Meaningful Use requirements propelled the design and development of patient portals in recent years. Patient engagement in oncology can improve quality of life and outcomes. Oncology nurses facilitate patient adoption of patient portals and support usage. Patient education helps manage communication expectations and understanding of online medical information. Copyright © 2018 Elsevier Inc. All rights reserved.

Patient-Centeredness as Physician Behavioral Adaptability to Patient Preferences.

Science.gov (United States)

Carrard, Valérie; Schmid Mast, Marianne; Jaunin-Stalder, Nicole; Junod Perron, Noëlle; Sommer, Johanna

2018-05-01

A physician who communicates in a patient-centered way is a physician who adapts his or her communication style to what each patient needs. In order to do so, the physician has to (1) accurately assess each patient's states and traits (interpersonal accuracy) and (2) possess a behavioral repertoire to choose from in order to actually adapt his or her behavior to different patients (behavioral adaptability). Physician behavioral adaptability describes the change in verbal or nonverbal behavior a physician shows when interacting with patients who have different preferences in terms of how the physician should interact with them. We hypothesized that physician behavioral adaptability to their patients' preferences would lead to better patient outcomes and that physician interpersonal accuracy was positively related to behavioral adaptability. To test these hypotheses, we recruited 61 physicians who completed an interpersonal accuracy test before being videotaped during four consultations with different patients. The 244 participating patients indicated their preferences for their physician's interaction style prior to the consultation and filled in a consultation outcomes questionnaire directly after the consultation. We coded the physician's verbal and nonverbal behavior for each of the consultations and compared it to the patients' preferences to obtain a measure of physician behavioral adaptability. Results partially confirmed our hypotheses in that female physicians who adapted their nonverbal (but not their verbal) behavior had patients who reported more positive consultation outcomes. Moreover, the more female physicians were accurate interpersonally, the more they showed verbal and nonverbal behavioral adaptability. For male physicians, more interpersonal accuracy was linked to less nonverbal adaptability.

Patient opinion

DEFF Research Database (Denmark)

Zurita, Laura; Nøhr, Christian

2004-01-01

The paper is based upon a case study and aims to provide information abouit patients values and communication that will be useful in the design of more patient friendly health system.......The paper is based upon a case study and aims to provide information abouit patients values and communication that will be useful in the design of more patient friendly health system....

Remote Patient Management for Home Dialysis Patients

Directory of Open Access Journals (Sweden)

Eric L. Wallace

2017-11-01

Full Text Available Remote patient management (RPM offers renal health care providers and patients with end-stage kidney disease opportunities to embrace home dialysis therapies with greater confidence and the potential to obtain better clinical outcomes. Barriers and evidence required to increase adoption of RPM by the nephrology community need to be clearly defined. Ten health care providers from specialties including nephrology, cardiology, pediatrics, epidemiology, nursing, and health informatics with experience in home dialysis and the use of RPM systems gathered in Vienna, Austria to discuss opportunities for, barriers to, and system requirements of RPM as it applies to the home dialysis patient. Although improved outcomes and cost-effectiveness of RPM have been demonstrated in patients with diabetes mellitus and heart disease, only observational data on RPM have been gathered in patients on dialysis. The current review focused on RPM systems currently in use, on how RPM should be integrated into future care, and on the evidence needed for optimized implementation to improve clinical and economic outcomes. Randomized controlled trials and/or large observational studies could inform the most effective and economical use of RPM in home dialysis. These studies are needed to establish the value of existing and/or future RPM models among patients, policy makers, and health care providers.

Emerging versions of patient involvement with Patient Reported Outcomes

DEFF Research Database (Denmark)

Langstrup, Henriette

It is a central argument in the growing Danish PRO-arena, that a large-scale collection of PRO from patients in the Danish Healthcare system will pave the way for more genuine patient involvement in clinical decision-making, quality management and governance of the health services. In this paper I...... discuss how patient involvement is being (re)configured when increasingly connected to national visions of participatory healthcare. A central discussion centers on ‘meaningful use’ of patient-generated data promoting patients’ expectations and experiences as a criterion for how to proceed...... with the national use of PRO. But how do assumptions of what constitutes meaning for patients interact with the kinds of roles that patients are expected to take on with PROtools? What forms of participation are assumed to be meaningful and thus good and which are not? In sketching emerging versions of patient...

Communication and patient participation influencing patient recall of treatment discussions.

Science.gov (United States)

Richard, Claude; Glaser, Emma; Lussier, Marie-Thérèse

2017-08-01

Patient recall of treatment information is a key variable towards chronic disease (CD) management. It is unclear what communication and patient participation characteristics predict recall. To assess what aspects of doctor-patient communication predict patient recall of medication information. To describe lifestyle treatment recall, in CD primary care patients. Observational study within a RCT. Community-based primary care (PC) practices. Family physicians (n=18): practicing >5 years, with a CD patient caseload. Patients (n=159): >40 years old, English speaking, computer literate, off-target hypertension, type II diabetes and/or dyslipidaemia. Patient characteristics: age, education, number of CDs. Information characteristics: length of encounter, medication status, medication class. Communication variables: socio-emotional utterances, physician dominance and communication control scores and PACE (ask, check and express) utterances, measured by RIAS. Number of medication themes, dialogue and initiative measured by MEDICODE. Recall of CD, lifestyle treatment and medication information. Frequency of lifestyle discussions varied by topic. Patients recalled 43% (alcohol), 52% (diet) to 70% (exercise) of discussions. Two and a half of six possible medication themes were broached per medication discussion. Less than one was recalled. Discussing more themes, greater dialogue and patient initiative were significant predictors of improved medication information recall. Critical treatment information is infrequently exchanged. Active patient engagement and explicit conversations about medications are associated with improved treatment information recall in off-target CD patients followed in PC. Providers cannot take for granted that long-term off-target CD patients recall information. They need to encourage patient participation to improve recall of treatment information. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Importance of doctor-patient relationship for patient adherence with medication regimes

DEFF Research Database (Denmark)

Sokolowski, Ineta; Vedsted, Peter

Aim: It has been supposed that the relation between the doctor and the patient has implications for the adherence to medication. This study explores the effect of patient reported doctor-patient relationship on patient adherence with medication regiments. Methods: Design: Prospective cohort study...... practices. Doctor-patient relationship was measured from The Danish version of the 23-item EUROPEP questionnaire measuring patient evaluation of general practice. From the register data on prescriptions we drew all subsidised drugs redeemed at pharmacies for each patient in 2002-2005. Patients, who did...... was measured as secondary non-compliance and as persistence. The incidence rate ratio of non-adherence was calculated for different levels of the patient evaluated doctor-patient-relationship. Results: A total of 482 patients started new treatment of which 98 were non-compliant and 7 were censored. This study...

Patient satisfaction with doctor-patient interactions: a mixed methods study among diabetes mellitus patients in Pakistan.

Science.gov (United States)

Jalil, Aisha; Zakar, Rubeena; Zakar, Muhammad Zakria; Fischer, Florian

2017-02-21

Patient satisfaction with doctor-patient interactions is an indicator of physicians' competence. The satisfaction of diabetes patients is rarely studied in public diabetes clinics of Pakistan. Thus, this study aims to analyse the association between patient satisfaction and five dimensions of medical interaction: technical expertise, interpersonal aspects, communication, consultation time, and access/availability. A cross-sectional mixed methods study was conducted during July and August 2015 in the largest public diabetes outpatient clinic in Punjab province. We used the criterion sampling method to identify 1164 patients who: (i) were adult (18 years and above), (ii) had diabetes mellitus, (iii) had made at least three previous visits to the same clinic. The data was collected through face-to-face interviews. The structured part of the questionnaire was based on demographic characteristics and the Patient Satisfaction Questionnaire (PSQ-III). We translated the questionnaire into Urdu and pretested it with 25 patients in a similar context. Data storage and analysis were carried out using SPSS (version 22.0). Bivariate analyses and multinomial logistic regression model were used to generate the quantitative findings. Out of the 1164 eligible patients approached for interviews, 1095 patients completed the structured questionnaire and 186 respondents provided qualitative information in comments section. We conducted a thematic content analysis of qualitative responses in order to explain the quantitative findings. Demographic characteristics such as gender, education and occupation were significantly associated with the levels of patient satisfaction. The dimensions of doctor-patient interaction were significantly associated with patient satisfaction: technical expertise (OR = .87; 95% CI = .84-.91), interpersonal aspects (OR = .82; 95% CI = .77-.87), communication (OR = .83; 95% CI = .78-.89), time dimension (OR = .90; 95% CI = .81

Quality of Doctor-Patient Communication through the Eyes of the Patient: Variation According to the Patient's Educational Level

Science.gov (United States)

Aelbrecht, Karolien; Rimondini, Michela; Bensing, Jozien; Moretti, Francesca; Willems, Sara; Mazzi, Mariangela; Fletcher, Ian; Deveugele, Myriam

2015-01-01

Good doctor-patient communication may lead to better compliance, higher patient satisfaction, and finally, better health. Although the social variance in how physicians and patients communicate is clearly demonstrated, little is known about what patients with different educational attainments actually prefer in doctor-patient communication. In…

Clinical use of patient decision-making aids for stone patients.

Science.gov (United States)

Lim, Amy H; Streeper, Necole M; Best, Sara L; Penniston, Kristina L; Nakada, Stephen Y

2017-08-01

Patient decision-making aids (PDMAs) help patients make informed healthcare decisions and improve patient satisfaction. The utility of PDMAs for patients considering treatments for urolithiasis has not yet been published. We report our experience using PDMAs developed at our institution in the outpatient clinical setting in patients considering a variety of treatment options for stones. Patients with radiographically confirmed urolithiasis were given PDMAs regarding treatment options for their stone(s) based on their clinical profile. We assessed patients' satisfaction, involvedness, and feeling of making a more informed decision with utilization of the PDMAs using a Likert Scale Questionnaire. Information was also collected regarding previous stone passage, history and type of surgical intervention for urolithiasis, and level of education. Patients (n = 43; 18 males, 23 females and two unknown) 53 +/- 14years old were included. Patients reported that they understood the advantages and disadvantages outlined in the PDMAs (97%), that the PDMAs helped them make a more informed decision (83%) and felt more involved in the decision making process (88%). Patients reported that the aids were presented in a balanced manner and used up-to-date scientific information (100%, 84% respectively). Finally, a majority of the patients prefer an expert's opinion when making a treatment decision (98%) with 73% of patients preferring to form their own opinion based on available information. Previous stone surgery was associated with patients feeling more involved with the decision making process (p = 0.0465). PDMAs have a promising role in shared decision-making in the setting of treatment options for nephrolithiasis.

Organizational Processes and Patient Experiences in the Patient-centered Medical Home.

Science.gov (United States)

Aysola, Jaya; Schapira, Marilyn M; Huo, Hairong; Werner, Rachel M

2018-06-01

There is increasing emphasis on the use of patient-reported experience data to assess practice performance, particularly in the setting of patient-centered medical homes. Yet we lack understanding of what organizational processes relate to patient experiences. Examine associations between organizational processes practices adopt to become PCMH and patient experiences with care. We analyzed visit data from patients (n=8356) at adult primary care practices (n=22) in a large health system. We evaluated the associations between practice organizational processes and patient experience using generalized estimating equations (GEE) with an exchangeable correlation structure to account for patient clustering by practice in multivariate models, adjusting for several practice-level and patient-level characteristics. We evaluated if these associations varied by race/ethnicity, insurance type, and the degree of patient comorbidity MEASURES:: Predictors include overall PCMH adoption and adoption of six organizational processes: access and communications, patient tracking and registry, care management, test referral tracking, quality improvement and external coordination. Primary outcome was overall patient experience. In our full sample, overall PCMH adoption score was not significantly associated with patient experience outcomes. However, among subpopulations with higher comorbidities, the overall PCMH adoption score was positively associated with overall patient experience measures [0.2 (0.06, 0.4); P=0.006]. Differences by race/ethnicity and insurance type in associations between specific organizational processes and patient experience were noted. Although some organizational processes relate to patients' experiences with care irrespective of the background of the patient, further efforts are needed to align practice efforts with patient experience.

Patient-centered medical homes for patients with disabilities.

Science.gov (United States)

Hernandez, Brigida; Damiani, Marco; Wang, T Arthur; Driscoll, Carolyn; Dellabella, Peter; LePera, Nicole; Mentari, Michael

2015-01-01

The patient-centered medical home is an innovative approach to improve health care outcomes. To address the unique needs of patients with intellectual and developmental disabilities (IDDs), a large health care provider reevaluated the National Committee for Quality Assurance's 6 medical home standards: (a) enhance access and continuity, (b) identify and manage patient populations, (c) plan and manage care, (d) provide self-care and community support, (e) track and coordinate care, and (f) measure and improve performance. This article describes issues to consider when serving patients with IDDs.

PATIENT-REPORTED OUTCOMES (PROs): PUTTING THE PATIENT PERSPECTIVE IN PATIENT-CENTERED OUTCOMES RESEARCH

Science.gov (United States)

Snyder, Claire F.; Jensen, Roxanne E.; Segal, Jodi B.; Wu, Albert W.

2013-01-01

Patient-centered outcomes research (PCOR) aims to improve care quality and patient outcomes by providing information that patients, clinicians, and family members need regarding treatment alternatives, and emphasizing patient input to inform the research process. PCOR capitalizes on available data sources and generates new evidence to provide timely and relevant information and can be conducted using prospective data collection, disease registries, electronic medical records, aggregated results from prior research, and administrative claims. Given PCOR’s emphasis on the patient perspective, methods to incorporate patient-reported outcomes (PROs) are critical. PROs are defined by the U.S. Food & Drug Administration as “Any report coming directly from patients… about a health condition and its treatment.” However, PROs have not routinely been collected in a way that facilitates their use in PCOR. Electronic medical records, disease registries, and administrative data have only rarely collected, or been linked to, PROs. Recent technological developments facilitate the electronic collection of PROs and linkage of PRO data, offering new opportunities for putting the patient perspective in PCOR. This paper describes the importance of and methods for using PROs for PCOR. We (1) define PROs; (2) identify how PROs can be used in PCOR, and the critical role of electronic data methods for facilitating the use of PRO data in PCOR; (3) outline the challenges and key unanswered questions that need to be addressed for the routine use of PROs in PCOR; and (4) discuss policy and research interventions to accelerate the integration of PROs with clinical data. PMID:23774513

Patient satisfaction after receiving dental treatment among patients ...

African Journals Online (AJOL)

Background: Patient satisfaction is one of the indicators of the quality of care. Therefore it is one of the tools for evaluating the quality of care. Aim: To determine patient satisfaction after receiving dental treatment among patients attending public dental clinics in Dar-Es-Salaam. Material and methods: Five public dental clinics ...

Learning from patients: students' perceptions of patient-instructors.

Science.gov (United States)

Henriksen, Ann-Helen; Ringsted, Charlotte

2011-09-01

Prior research on the use of patients as teachers has focused on testing the effectiveness of this practice and exploring its benefits for students. However, very little is known about the added value of patient teaching and how it relates to patient-centred learning. The aim of this study was to explore whether there is added value in using patients as instructors in health professions education and, if there is, to examine how it is constituted. Group interviews were conducted with physiotherapy and occupational therapy students who had attended a 3-hour optional class entitled 'Thoughtful joint examination and respectful patient contact'. This class was delivered by patient-instructors (PIs), who were patients with rheumatism certified to teach. A semi-structured interview guide was used. Interviews continued until data saturation occurred (seven interviews). The interviews were recorded and transcribed verbatim. Data were analysed using content analysis. The main finding of this study is that PI sessions facilitate a learning environment in which the content matter is complemented by the provision of realism and individual perspectives on rheumatism, the pedagogical format is characterised by authenticity and intimacy in the style of instruction and feedback, and the PI-student relationship is characterised by balanced teacher-student power relations that support the legitimacy of learning and make space for the asking of questions and the making of mistakes. This study indicates that, in terms of power relations, the PI-student relationship differs from those between faculty teachers and students, and students and patients in the clinic. The formation of a professional identity by students may clash with the fulfilment of their learning tasks in the clinical environment. The study indicates that patient-centredness can be fostered in the PI-student relationship. This is probably supported by the absence of faculty staff involvement in PI teaching sessions

Patient-centered communication strategies for patients with aphasia: discrepancies between what patients want and what physicians do.

Science.gov (United States)

Morris, Megan A; Clayman, Marla L; Peters, Kaitlin J; Leppin, Aaron L; LeBlanc, Annie

2015-04-01

Communication during clinical encounters can be challenging with patients with communication disabilities. Physicians have the potential to positively affect the encounter by using communication strategies that engage the patient in patient-centered communication. We engaged patients and their physicians in defining their preferences for patient-centered communication strategies, then evaluated the use of the identified strategies during observed clinical encounters. We video-recorded 25 clinical encounters with persons with aphasia. All encounters were previously scheduled with community physicians and a companion was present. Following each encounter, physicians completed a brief questionnaire and the person with aphasia and his or her companion participated in a video elicitation interview. While many of the communication strategies identified and described by physicians, patients and companions were similar, patients and companions identified three additional key communication strategies. These strategies included (1) using visual aids, (2) writing down key words while speaking, and (3) using gestures. In the video recorded clinical encounters, no physicians wrote down key words while speaking and only one used a visual aid during the clinical encounter. The frequency with which physicians used gestures varied greatly, even within the same patient, suggesting the use of gestures was independent of patient or companion characteristics. To maximize patient-centered communication with patients with communication disabilities, physicians should use "disability-specific" communication strategies. Our study suggests that physicians should routinely ask patients and companions about communication preferences and then incorporate identified communication strategies into their communication style. Copyright © 2015 Elsevier Inc. All rights reserved.

Patient delay and associated factors among breast cancer patients

International Nuclear Information System (INIS)

Khan, M.A.; Khan, M.I.; Andleeb, U.

2015-01-01

Objectives: To stratify patients into various stages, calculate average patient delay and study various causes of delay to presentation. Methodology: This was a one year hospital based cross sectional study at Khyber Teaching Hospital, using non probability consecutive sampling. A simplified staging was used for this study; Early (Stage I), Intermediate (Stage II, III), and Late (Stage IV). A patient was labelled delay when >3 months had elapsed between first symptom perception and first doctor consultation. Results: 80 patients were included with age 21-80 years (mean 45.28+-13.15). 80% of the patients were married, 76.3% (n=61/80) were poor with annual income of <500 US $, 85% of patients were illiterate. The participants from Rural and Urban areas were similar (37 % vs 31%); 15% were from Afghanistan. 80% patients presented with a delay of >3 months. Most common cause of delay was false symptom interpretation in 25.3% (n=17) patients. Conclusion: Late clinical presentation is because of lack of health education, unawareness, misconceptions about treatment and strong belief in traditional medicine resulting in advanced disease. This is worsened by poverty and unavailability of health care services especially in rural areas. (author)

Ambulatory orthopaedic surgery patients' emotions when using different patient education methods.

Science.gov (United States)

Heikkinen, Katja; Salanterä, Sanna; Leppänen, Tiina; Vahlberg, Tero; Leino-Kilpi, Helena

2012-07-01

A randomised controlled trial was used to evaluate elective ambulatory orthopaedic surgery patients' emotions during internet-based patient education or face-to-face education with a nurse. The internet-based patient education was designed for this study and patients used websites individually based on their needs. Patients in the control group participated individually in face-to-face patient education with a nurse in the ambulatory surgery unit. The theoretical basis for both types of education was the same. Ambulatory orthopaedic surgery patients scored their emotions rather low at intervals throughout the whole surgical process, though their scores also changed during the surgical process. Emotion scores did not decrease after patient education. No differences in patients' emotions were found to result from either of the two different patient education methods.

Medication adherence in type 2 diabetes patients: study of patients ...

African Journals Online (AJOL)

Medication adherence in type 2 diabetes patients: study of patients in ... impact of medication adherence on the clinical outcomes of type 2 diabetes patients at ... the review of case notes of one-hundred and fifty two randomly selected patients.

The importance of patient-centered care for various patient groups.

NARCIS (Netherlands)

Boer, D. de; Delnoij, D.; Rademakers, J.

2013-01-01

Objectives: To assess differences in the importance ascribed to patient-centered care between various patient groups and demographic groups. Methods: Survey data collected using questionnaires were analyzed for patients that underwent hip or knee surgery (n=214), patients suffering from rheumatoid

Medications development for substance-use disorders: contextual influences (dis)incentivizing pharmaceutical-industry positioning.

Science.gov (United States)

Janero, David R

2014-11-01

The significant contribution of substance-use disorders (SUDs) to the global-disease burden and associated unmet medical needs has not engendered a commensurate level of pharma-industry research and development (R&D) for novel SUD therapeutics invention. Analysis of contextual factors shaping this position suggests potential routes toward incentivizing R&D commitment for that purpose. This article considers multiple primary factors that have consorted to disincentivize pharma industry's operating in the SUD space: ill-understood pathology; variegated treatments and patient profiles; involved clinical trials; and - with particular reference to SUDs-negative cultural/business stigmas and shallow commercial precedent. Industry incentivization for SUD drug innovation requires progress on several fronts, including: translational experimental data and systems; personalized, holistic SUD treatment approaches; interactions among pharma, nonindustry constituencies, and the medical profession with vested interests in countering negative stereotypes and expanding SUD treatment options; and public-private alliances focused on improving SUD pharmacotherapy. Given the well-entrenched business stance whereby the prospect of future profits in major markets largely determines drug-company R&D investment trajectory, strategic initiatives offering substantial reductions in the risks and opportunity (i.e., time and money) costs associated with SUD drug discovery are likely to be the most potent drivers for encouraging mainstream industry positioning in this therapeutic area. Such initiatives could originate from front-loaded R&D operational and back-loaded patent, regulatory, marketing and health-care policy reforms. These may be too involved and protracted for the turbulent pharmaceutical industry to entertain amid its recent retrenchment from psychiatric/CNS diseases and intense pressures to increase productivity and shareholder value.

Chronic lead intoxication; Chronische Bleiintoxikation

Energy Technology Data Exchange (ETDEWEB)

Wieseler, B.; Leng, G. [Duesseldorf Univ. (Germany). Inst. fuer Hygiene; Lenz, S.; Schultz, C. [Klinikum Remscheid GmbH, Remscheid (Germany); Wilhelm, M. [Bochum Univ. (Germany). Inst. fuer Hygiene, Sozial- und Umweltmedizin

1999-02-01

The case of a female 68 years old patient is described. Here, a chronic lead intoxication was diagnosed after a two year old medical history with increasing attacks of colic-like abdominal pain often described as life-threatening. After repeated hospitalizations and intensive search for the cause of the symptoms, porphyria and anemia was found to be a sign of a chronic lead poisoning. The blood lead concentrations were always about a level of 600 {mu}g/L. The source of exposure could not be found by now. Neither home inspection nor environmental investigations have shown a recent source of lead intake by the patient. However, a possible occupational source of lead exposure at a blast furnace was established by anamnesis for 1952 to 1962. Thus, osteoporosis induced lead mobilisation was suspected. Noticeable are the results of the six abdominal survey radiographies taken during hospitalization within one year; three radiographies were taken following clinical admission and three before discharge of the patient. In comparison, the course shows a chronic relapsing alimentary supply from metallic particles of unknown genesis. The patient was treated with the sodium salt of 2,3-dimercapto-1-propansulfonic acid (DMPS, Dimaval{sup TM}). She was free of complain afterwards. Following therapy, the blood lead concentrations fell under a level of 400 {mu}m/L, but after several weeks the lead level raised up to the original level of 600 {mu}g/L. (orig.) [Deutsch] Es wird eine 68jaehrige Patientin vorgestellt, bei der nach fast zweijaehriger Krankengeschichte, die gekennzeichnet war durch rezidivierende, teils als lebensbedrohlich geschilderte Bauchkoliken, eine chronische Bleiintoxikation diagnostiziert wurde. Erst nach wiederholten stationaeren Krankenhausaufenthalten mit intensiver Suche nach der Krankheitsursache wurden das Krankheitsbild und die Laborwerte durch Zusatzuntersuchungen ergaenzt, so dass sich in der festgestellten Porphyrie und Anaemie die Diagnose der

Communication Skills in Patient-Doctor Interactions: Learning from Patient Complaints

Directory of Open Access Journals (Sweden)

Janine W.Y. Kee

2018-06-01

Full Text Available Purpose: Despite communication skills training in medical school, junior doctors continue to demonstrate poor patient-doctor communication skills, where patient unhappiness from the encounter often manifests as patient complaints. We sought to identify crucial communication skills that should be incorporated in the communications curriculum by learning from patient complaints, to explore how the communication lapses occur. Method: 38 cases of anonymized negative patient feedback about junior doctors were analysed using qualitative content analysis. A two-step fine-coding system involving four researchers was employed. Results: Four main themes of communication errors were identified, namely: non-verbal (eye contact, facial expression and paralanguage, verbal (active listening and inappropriate choice of words, and content (poor quantity and quality of information provided; and poor attitudes (lack of respect and empathy. Discussion: Patient-doctor communication is a complex interpersonal interaction that requires an understanding of each party׳s emotional state. We identified important but overlooked communication lapses such as non-verbal paralinguistic elements that should be incorporated into communications curriculum, with an emphasis on dialectical learning. These include integrating these findings into a simulation-based communications module for training doctors at a post-graduate level as well as monitoring and analyzing patient complaints regularly to iteratively update the content of the training module. Beyond these skills training, there is also a need to highlight negative emotions of doctors in future research, as it influences their communication patterns and attitudes towards patients, ultimately shaping how patients perceive them. Keywords: Communication skills training, Patient complaints, Patient negative feedback, Patient-Doctor communication, Residency training

Transforming Patient Value: Comparison of Hospital, Surgical, and General Surgery Patients.

Science.gov (United States)

Pitt, Henry A; Tsypenyuk, Ella; Freeman, Susan L; Carson, Steven R; Shinefeld, Jonathan A; Hinkle, Sally M; Powers, Benjamin D; Goldberg, Amy J; DiSesa, Verdi J; Kaiser, Larry R

2016-04-01

Patient value (V) is enhanced when quality (Q) is increased and cost (C) is diminished (V = Q/C). However, calculating value has been inhibited by a lack of risk-adjusted cost data. The aim of this analysis was to measure patient value before and after implementation of quality improvement and cost reduction programs. Multidisciplinary efforts to improve patient value were initiated at a safety-net hospital in 2012. Quality improvement focused on adoption of multiple best practices, and minimizing practice variation was the strategy to control cost. University HealthSystem Consortium (UHC) risk-adjusted quality (patient mortality + safety + satisfaction + effectiveness) and cost (length of stay + direct cost) data were used to calculate patient value over 3 fiscal years. Normalized ranks in the UHC Quality and Accountability Scorecard were used in the value equation. For all hospital patients, quality scores improved from 50.3 to 66.5, with most of the change occurring in decreased mortality. Similar trends were observed for all surgery patients (42.6 to 48.4) and for general surgery patients (30.9 to 64.6). For all hospital patients, cost scores improved from 71.0 to 2.9. Similar changes were noted for all surgical (71.6 to 27.1) and general surgery (85.7 to 23.0) patients. Therefore, value increased more than 30-fold for all patients, 3-fold for all surgical patients, and almost 8-fold for general surgery patients. Multidisciplinary quality and cost efforts resulted in significant improvements in value for all hospitalized patients as well as general surgery patients. Mortality improved the most in general surgery patients, and satisfaction was highest among surgical patients. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

[Influence of patients' attitude on doctors' satisfaction with the doctor-patient relationship].

Science.gov (United States)

Xie, Zheng; Qiu, Ze-qi; Zhang, Tuo-hong

2009-04-18

To describe the doctors' satisfaction of the doctor-patient relationship and find out the influencing factors of the patients, gathering evidence to improve the doctor-patient relationship. This study was a cross-sectional study, in which doctors and nurses in 10 hospitals of Beijing, Shandong and Chongqing were surveyed with structured questionnaires and in-depth interviews. The mean score of the doctors' satisfaction of the doctor-patient relationship was 59.97, which was much lower than the patients'. The patients' socio-demographic characteristics, social economic status (SES) and behavior characteristics influence the interaction of the doctors and the patients. The doctors' satisfaction of the doctor-patient relationship was influenced by the patients' trust. The doctors' perspective is helpful to define the tension and the cause of the doctor-patient relationship. The patients' characteristics have important influence on the doctor-patient relationship. It's necessary to take action on the patients to improve the doctor-patient relationship.

Autoantibody signature differentiates Wilms tumor patients from neuroblastoma patients.

Directory of Open Access Journals (Sweden)

Jana Schmitt

Full Text Available Several studies report autoantibody signatures in cancer. The majority of these studies analyzed adult tumors and compared the seroreactivity pattern of tumor patients with the pattern in healthy controls. Here, we compared the autoimmune response in patients with neuroblastoma and patients with Wilms tumor representing two different childhood tumors. We were able to differentiate untreated neuroblastoma patients from untreated Wilms tumor patients with an accuracy of 86.8%, a sensitivity of 87.0% and a specificity of 86.7%. The separation of treated neuroblastoma patients from treated Wilms tumor patients' yielded comparable results with an accuracy of 83.8%. We furthermore identified the antigens that contribute most to the differentiation between both tumor types. The analysis of these antigens revealed that neuroblastoma was considerably more immunogenic than Wilms tumor. The reported antigens have not been found to be relevant for comparative analyses between other tumors and controls. In summary, neuroblastoma appears as a highly immunogenic tumor as demonstrated by the extended number of antigens that separate this tumor from Wilms tumor.

Transcriptional Adaptor ADA3 of Drosophila melanogaster Is Required for Histone Modification, Position Effect Variegation, and Transcription▿ †

OpenAIRE

Grau, Benjamin; Popescu, Cristina; Torroja, Laura; Ortuño-Sahagún, Daniel; Boros, Imre; Ferrús, Alberto

2007-01-01

The Drosophila melanogaster gene diskette (also known as dik or dAda3) encodes a protein 29% identical to human ADA3, a subunit of GCN5-containing histone acetyltransferase (HAT) complexes. The fly dADA3 is a major contributor to oogenesis, and it is also required for somatic cell viability. dADA3 localizes to chromosomes, and it is significantly reduced in dGcn5 and dAda2a, but not in dAda2b, mutant backgrounds. In dAda3 mutants, acetylation at histone H3 K9 and K14, but not K18, and at hist...

The evolving concept of "patient-centeredness" in patient-physician communication research.

Science.gov (United States)

Ishikawa, Hirono; Hashimoto, Hideki; Kiuchi, Takahiro

2013-11-01

Over the past few decades, the concept of "patient-centeredness" has been intensively studied in health communication research on patient-physician interaction. Despite its popularity, this concept has often been criticized for lacking a unified definition and operationalized measurement. This article reviews how health communication research on patient-physician interaction has conceptualized and operationalized patient-centered communication based on four major theoretical perspectives in sociology (i.e., functionalism, conflict theory, utilitarianism, and social constructionism), and discusses the agenda for future research in this field. Each theory addresses different aspects of the patient-physician relationship and communication from different theoretical viewpoints. Patient-centeredness is a multifaceted construct with no single theory that can sufficiently define the whole concept. Different theoretical perspectives of patient-centered communication can be selectively adopted according to the context and nature of problems in the patient-physician relationship that a particular study aims to explore. The present study may provide a useful framework: it offers an overview of the differing models of patient-centered communication and the expected roles and goals in each model; it does so toward identifying a communication model that fits the patient and the context and toward theoretically reconstructing existing measures of patient-centered communication. Furthermore, although patient-centered communication has been defined mainly from the viewpoint of physician's behaviors aimed at achieving patient-centered care, patient competence is also required for patient-centered communication. This needs to be examined in current medical practice. Copyright © 2013 Elsevier Ltd. All rights reserved.

Ensuring a proactive, evidence-based, patient safety approach to patient assessment.

Science.gov (United States)

Considine, Julie; Currey, Judy

2015-01-01

To argue that if all nurses were to adopt the primary survey approach (assessment of airway, breathing, circulation and disability) as the first element of patient assessment, they would be more focused on active detection of clinical deterioration rather than passive collection of patient data. Nurses are the professional group that carry the highest level of responsibility for patient assessment, accurate data collection and interpretation. The timely recognition of, and response to deteriorating patients, is dependent on the measurement and interpretation of pertinent physiological data by nurses. Discursive paper. Traditionally taught and commonly used approaches to patient assessment such as 'vital signs' and 'body systems' are not evidence-based nor framed in patient safety. The primary survey approach as the first element in patient assessment has three major advantages: (1) data are collected according to clinical importance; (2) data are collected using the same framework as most organisation's rapid response system activation criteria; and (3) the primary survey acts as a patient safety checklist, thereby decreasing the risk of failure to recognise, and therefore respond to, deteriorating patients. The vital signs and body systems approaches to patient assessment have significant limitations in identifying clinical deterioration. The primary survey approach provides nurses with a consistent, evidence-based and sequenced approach to patient assessment in every clinical setting. All nurses should use a primary survey approach as the first element of patient assessment in every patient encounter as a patient safety strategy. © 2014 John Wiley & Sons Ltd.

Labelling patients

International Nuclear Information System (INIS)

Strudwick, R.M.

2016-01-01

This article looks at how diagnostic radiographers label their patients. An ethnographic study of the workplace culture in one diagnostic imaging department was undertaken using participant observation for four months and semi-structured interviews with ten key informants. One of the key themes; the way in which radiographers label their patients, is explored in this article. It was found from the study that within the department studied the diagnostic radiographers labelled or categorised their patients based on the information that they had. This information is used to form judgements and these judgements were used to assist the radiographers in dealing with the many different people that they encountered in their work. This categorisation and labelling of the patient appears to assist the radiographer in their decision-making processes about the examination to be carried out and the patient they are to image. This is an important aspect of the role of the diagnostic radiographer. - Highlights: • I have studied the culture in one imaging department. • Radiographers label or categorise their patients. • These labels/categories are used to manage the patient. • This is an important aspect of the way in which radiographers work.

Patients' Experiences with and Attitudes towards a Diabetes Patient Web Portal

NARCIS (Netherlands)

Ronda, Maaike C. M.; Dijkhorst-Oei, Lioe-Ting; Rutten, Guy E. H. M.

2015-01-01

Objective A diabetes patient web portal allows patients to access their personal health record and may improve diabetes outcomes; however, patients' adoption is slow. We aimed to get insight into patients' experiences with a web portal to understand how the portal is being used, how patients

Patient involvement in blood transfusion safety: patients' and healthcare professionals' perspective.

Science.gov (United States)

Davis, R; Murphy, M F; Sud, A; Noel, S; Moss, R; Asgheddi, M; Abdur-Rahman, I; Vincent, C

2012-08-01

Blood transfusion is one of the major areas where serious clinical consequences, even death, related to patient misidentification can occur. In the UK, healthcare professional compliance with pre-transfusion checking procedures which help to prevent misidentification errors is poor. Involving patients at a number of stages in the transfusion pathway could help prevent the occurrence of these incidents. To investigate patients' willingness to be involved and healthcare professionals' willingness to support patient involvement in pre-transfusion checking behaviours. A cross-sectional design was employed assessing willingness to participate in pre-transfusion checking behaviours (patient survey) and willingness to support patient involvement (healthcare professional survey) on a scale of 1-7. One hundred and ten patients who had received a transfusion aged between 18 and 93 (60 male) and 123 healthcare professionals (doctors, nurses and midwives) involved in giving blood transfusions to patients. Mean scores for patients' willingness to participate in safety-relevant transfusion behaviours and healthcare professionals' willingness to support patient involvement ranged from 4.96-6.27 to 4.53-6.66, respectively. Both groups perceived it most acceptable for patients to help prevent errors or omissions relating to their hospital identification wristband. Neither prior experience of receiving a blood transfusion nor professional role of healthcare staff had an effect on attitudes towards patient participation. Overall, both patients and healthcare professionals view patient involvement in transfusion-related behaviours quite favourably and appear in agreement regarding the behaviours patients should adopt an active role in. Further work is needed to determine the effectiveness of this approach to improve transfusion safety. © 2012 The Authors. Transfusion Medicine © 2012 British Blood Transfusion Society.

Heme and erythropoieis: more than a structural role.

Science.gov (United States)

Chiabrando, Deborah; Mercurio, Sonia; Tolosano, Emanuela

2014-06-01

Erythropoiesis is the biological process that consumes the highest amount of body iron for heme synthesis. Heme synthesis in erythroid cells is finely coordinated with that of alpha (α) and beta (β)-globin, resulting in the production of hemoglobin, a tetramer of 2α- and 2β-globin chains, and heme as the prosthetic group. Heme is not only the structural component of hemoglobin, but it plays multiple regulatory roles during the differentiation of erythroid precursors since it controls its own synthesis and regulates the expression of several erythroid-specific genes. Heme is synthesized in developing erythroid progenitors by the stage of proerythroblast, through a series of eight enzymatic reactions divided between mitochondria and cytosol. Defects of heme synthesis in the erythroid lineage result in sideroblastic anemias, characterized by microcytic anemia associated to mitochondrial iron overload, or in erythropoietic porphyrias, characterized by porphyrin deposition in erythroid cells. Here, we focus on the heme biosynthetic pathway and on human erythroid disorders due to defective heme synthesis. The regulatory role of heme during erythroid differentiation is discussed as well as the heme-mediated regulatory mechanisms that allow the orchestration of the adaptive cell response to heme deficiency. Copyright© Ferrata Storti Foundation.

Communicating with patients

Science.gov (United States)

... Ask your patients about their outlooks, attitudes, and motivations. Learn the patient's perspective. Talk to the patient ... beliefs. This will help you understand the patient's motivation and let you plan the best ways to ...

Patient/Family Education for Newly Diagnosed Pediatric Oncology Patients.

Science.gov (United States)

Landier, Wendy; Ahern, JoAnn; Barakat, Lamia P; Bhatia, Smita; Bingen, Kristin M; Bondurant, Patricia G; Cohn, Susan L; Dobrozsi, Sarah K; Haugen, Maureen; Herring, Ruth Anne; Hooke, Mary C; Martin, Melissa; Murphy, Kathryn; Newman, Amy R; Rodgers, Cheryl C; Ruccione, Kathleen S; Sullivan, Jeneane; Weiss, Marianne; Withycombe, Janice; Yasui, Lise; Hockenberry, Marilyn

There is a paucity of data to support evidence-based practices in the provision of patient/family education in the context of a new childhood cancer diagnosis. Since the majority of children with cancer are treated on pediatric oncology clinical trials, lack of effective patient/family education has the potential to negatively affect both patient and clinical trial outcomes. The Children's Oncology Group Nursing Discipline convened an interprofessional expert panel from within and beyond pediatric oncology to review available and emerging evidence and develop expert consensus recommendations regarding harmonization of patient/family education practices for newly diagnosed pediatric oncology patients across institutions. Five broad principles, with associated recommendations, were identified by the panel, including recognition that (1) in pediatric oncology, patient/family education is family-centered; (2) a diagnosis of childhood cancer is overwhelming and the family needs time to process the diagnosis and develop a plan for managing ongoing life demands before they can successfully learn to care for the child; (3) patient/family education should be an interprofessional endeavor with 3 key areas of focus: (a) diagnosis/treatment, (b) psychosocial coping, and (c) care of the child; (4) patient/family education should occur across the continuum of care; and (5) a supportive environment is necessary to optimize learning. Dissemination and implementation of these recommendations will set the stage for future studies that aim to develop evidence to inform best practices, and ultimately to establish the standard of care for effective patient/family education in pediatric oncology.

Patient-controlled hospital admission for patients with severe mental disorders

DEFF Research Database (Denmark)

Thomsen, Christoffer Torgaard; Benros, Michael Eriksen; Hastrup, Lene Halling

2016-01-01

INTRODUCTION: Patient-controlled hospital admission for individuals with severe mental disorders is a novel approach in mental healthcare. Patients can admit themselves to a hospital unit for a short stay without being assessed by a psychiatrist or contacting the emergency department. Previous...... studies assessing the outcomes of patient-controlled hospital admission found trends towards reduction in the use of coercive measures and length of hospital stay; however, these studies have methodological shortcomings and small sample sizes. Larger studies are needed to estimate the effect of patient-controlled...... hospital admission on the use of coercion and of healthcare services. DESIGN AND METHODS: We aim to recruit at least 315 patients who are offered a contract for patient-controlled hospital admissions in eight different hospitals in Denmark. Patients will be followed-up for at least 1 year to compare...

Patterns of Physician-Patient Communication Associated with Patient Satisfaction.

Science.gov (United States)

Williams, M. Lee; Clampitt, Phillip G.

Using data drawn from ten initial physician/patient interviews, an original category system was employed to analyze patterns of physician/patient communication. Static analysis, interaction analysis, and Markov chain analysis were used to discover the underlying communication patterns associated with patient satisfaction. Results revealed that…

Perception of patients accessing out- patient pharmacy on the ...

African Journals Online (AJOL)

Conclusion: Patients' overall perception of pharmacy services was above average. There is need for improvement in the quality of services, especially in the availability of essential drugs at competitive prices and provision of adequate counselling and drug information services to patients. Keywords: Patient satisfaction, ...

'What do patients want?' Tailoring medicines information to meet patients' needs.

Science.gov (United States)

Young, Amber; Tordoff, June; Smith, Alesha

2017-11-01

Medicines information leaflets can equip patients to be in control of their own healthcare and support the safe and effective use of medicines. The design and content of leaflets influences patients' willingness to read them, and poor examples can cause patient confusion and anxiety. Researchers examined the literature over the past 8 years to determine the content and design of medicine information leaflets that patients prefer in order to read, understand, and use them effectively. It was found that existing leaflets do not meet patients' needs and appear ineffective. Leaflets lack the information patients seek and may contain non-essential material, affecting patients' perception of, and willingness to read them. Additionally, the acceptable leaflet length varies between patients. Application of good design principles improves readability, comprehension, and ability to locate information. Medicine information leaflets must meet patients' needs and be well designed. Tailoring information leaflets to patient characteristics and requirements would enhance effectiveness. Passive provision of pre-printed leaflets is outdated, unvalued and ineffective. Using automated computer systems for leaflet tailoring with the ability to further adapt patients' information might be the best way forward. Copyright © 2016 Elsevier Inc. All rights reserved.

Patients as educators: interprofessional learning for patient-centred care.

Science.gov (United States)

Towle, Angela; Godolphin, William

2013-01-01

Patients with chronic conditions have unique expertise that enhances interprofessional education. Although their active involvement in education is increasing, patients have minimal roles in key educational tasks. A model that brings patients and students together for patient-centred learning, with faculty playing a supportive role, has been described in theory but not yet implemented. To identify issues involved in creating an educational intervention designed and delivered by patients and document outcomes. An advisory group of community members, students and faculty guided development of the intervention (interprofessional workshops). Community educators (CEs) were recruited through community organizations with a healthcare mandate. Workshops were planned by teams of key stakeholders, delivered by CEs, and evaluated by post-workshop student questionnaires. Workshops were delivered by CEs with epilepsy, arthritis, HIV/AIDS and two groups with mental health problems. Roles and responsibilities of planning team members that facilitated control by CEs were identified. Ten workshops attended by 142 students from 15 different disciplines were all highly rated. Workshop objectives defined by CEs and student learning both closely matched dimensions of patient-centredness. Our work demonstrates feasibility and impact of an educational intervention led by patient educators facilitated but not controlled by faculty.

Patient Compliance With Electronic Patient Reported Outcomes Following Shoulder Arthroscopy.

Science.gov (United States)

Makhni, Eric C; Higgins, John D; Hamamoto, Jason T; Cole, Brian J; Romeo, Anthony A; Verma, Nikhil N

2017-11-01

To determine the patient compliance in completing electronically administered patient-reported outcome (PRO) scores following shoulder arthroscopy, and to determine if dedicated research assistants improve patient compliance. Patients undergoing arthroscopic shoulder surgery from January 1, 2014, to December 31, 2014, were prospectively enrolled into an electronic data collection system with retrospective review of compliance data. A total of 143 patients were included in this study; 406 patients were excluded (for any or all of the following reasons, such as incomplete follow-up, inaccessibility to the order sets, and inability to complete the order sets). All patients were assigned an order set of PROs through an electronic reporting system, with order sets to be completed prior to surgery, as well as 6 and 12 months postoperatively. Compliance rates of form completion were documented. Patients who underwent arthroscopic anterior and/or posterior stabilization were excluded. The average age of the patients was 53.1 years, ranging from 20 to 83. Compliance of form completion was highest preoperatively (76%), and then dropped subsequently at 6 months postoperatively (57%) and 12 months postoperatively (45%). Use of research assistants improved compliance by approximately 20% at each time point. No differences were found according to patient gender and age group. Of those completing forms, a majority completed forms at home or elsewhere prior to returning to the office for the clinic visit. Electronic administration of PRO may decrease the amount of time required in the office setting for PRO completion by patients. This may be mutually beneficial to providers and patients. It is unclear if an electronic system improves patient compliance in voluntary completion PRO. Compliance rates at final follow-up remain a concern if data are to be used for establishing quality or outcome metrics. Level IV, case series. Copyright © 2017 Arthroscopy Association of North

Participation in online patient support groups endorses patients' empowerment

NARCIS (Netherlands)

van Uden-Kraan, C. F.; Drossaert, Constance H C; Taal, E; Seydel, E. R.; van de Laar, Mart A F J

Objective: Although much has been expected of the empowering effect of taking part in online patient support groups, there is no direct evidence thus far for the effects of participation on patient empowerment. Hence our exploring to what extent patients feel empowered by their participation in

Race in California's prison fire camps for men: prison politics, space, and the racialization of everyday life.

Science.gov (United States)

Goodman, Philip

2014-09-01

The vast majority of social scientists agree that race is "socially constructed." Yet many scholars of punishment and prisons still treat race as static, self-evident categories. One result is that not enough is known about the production, meanings, and consequences of race as experienced by prisoners and those who guard and manage them. The author's research on California's prison fire camps uncovers the micro-level ways in which race is performed and imbued with meaning; he reveals how racial understandings color people and settings. One puzzle is that prisoners in California's fire camps will fight natural disasters side by side, sharing water and provisions, but separate into racial groups when in the camp itself. In part to answer this (and in part to develop better understandings of race and prisons more generally), the author unpacks the variegated nature of punishment and the spatialization of race and advocates for research that is faithful to the constructivist framework.

Mapping china and managing the world culture, cartography and cosmology in late imperial times

CERN Document Server

Smith, Richard J

2012-01-01

From the founding of the Qin dynasty in 221 BCE to the present, the Chinese have been preoccupied with the notion of ordering their world. Efforts to create and maintain order are expressed not only in China's bureaucratic institutions and methods of social and economic organization but also in Chinese philosophy, religious and secular ritual, and comprehensive systems of classifying all natural and supernatural phenomena. Mapping China and Managing the World focuses on Chinese constructions of order (zhi) and examines the most important ways in which elites in late imperial China sought to order their vast and variegated world. This book begins by exploring the role of ancient texts and maps as the two prominent symbolic devices that the Chinese used to construct cultural meaning, and looks at how changing conceptions of 'the world' shaped Chinese cartography, whilst both shifting and enduring cartographic practices affected how the Chinese regarded the wider world. Richard J. Smith goes on to examine the si...

Una storia di ‘integrazione’ nella Napoli angioina

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Rosa Smurra

2011-06-01

Full Text Available In every epoch cities have been the landing-place for immigrants. The medieval cities were also places in which have been verified numerous and variegated migratory movements that involved all classes: from economic and political elites to more humble components of social stratification. That which is presented in these pages is certainly an exemplary event, symptomatic of a general picture, all things considered, that is contradictory, giving on the one hand evidence of the persistence of phenomena such as the practice of the commerce of slaves, and on the other hand the social ransoming of an “Ethiopian” slave, by means of its inclusion in the ganglia of the Angevin kingdom and the awarding of high profile bureaucratic offices. In the urban framework of Naples in the first half of the Fourteenth century a human story is unraveled that the tangle of literary and documentary sources with architectural persistencies has made possible to reconstruct.

Transcriptome analysis of the phytobacterium Xylella fastidiosa growing under xylem-based chemical conditions.

Science.gov (United States)

Ciraulo, Maristela Boaceff; Santos, Daiene Souza; Rodrigues, Ana Claudia de Freitas Oliveira; de Oliveira, Marcus Vinícius; Rodrigues, Tiago; de Oliveira, Regina Costa; Nunes, Luiz R

2010-01-01

Xylella fastidiosa is a xylem-limited bacterium responsible for important plant diseases, like citrus-variegated chlorosis (CVC) and grapevine Pierce's disease (PD). Interestingly, in vitro growth of X. fastidiosa in chemically defined media that resemble xylem fluid has been achieved, allowing studies of metabolic processes used by xylem-dwelling bacteria to thrive in such nutrient-poor conditions. Thus, we performed microarray hybridizations to compare transcriptomes of X. fastidiosa cells grown in 3G10-R, a medium that resembles grape sap, and in Periwinkle Wilt (PW), the complex medium traditionally used to cultivate X. fastidiosa. We identified 299 transcripts modulated in response to growth in these media. Some 3G10R-overexpressed genes have been shown to be upregulated in cells directly isolated from infected plants and may be involved in plant colonization, virulence and environmental competition. In contrast, cells cultivated in PW show a metabolic switch associated with increased aerobic respiration and enhanced bacterial growth rates.

Generalized nucleation and looping model for epigenetic memory of histone modifications

Science.gov (United States)

Erdel, Fabian; Greene, Eric C.

2016-01-01

Histone modifications can redistribute along the genome in a sequence-independent manner, giving rise to chromatin position effects and epigenetic memory. The underlying mechanisms shape the endogenous chromatin landscape and determine its response to ectopically targeted histone modifiers. Here, we simulate linear and looping-driven spreading of histone modifications and compare both models to recent experiments on histone methylation in fission yeast. We find that a generalized nucleation-and-looping mechanism describes key observations on engineered and endogenous methylation domains including intrinsic spatial confinement, independent regulation of domain size and memory, variegation in the absence of antagonists, and coexistence of short- and long-term memory at loci with weak and strong constitutive nucleation. These findings support a straightforward relationship between the biochemical properties of chromatin modifiers and the spatiotemporal modification pattern. The proposed mechanism gives rise to a phase diagram for cellular memory that may be generally applicable to explain epigenetic phenomena across different species. PMID:27382173

Information structures in economics studies in the theory of markets with imperfect information

CERN Document Server

Nermuth, Manfred

1982-01-01

This book is intended as a contribution to the theory of markets with imperfect information. The subject being nearly limitless, only certain selected topics are discussed. These are outlined in the Introduction (Ch. 0). The remainder of the book is divided into three parts. All results of economic significance are contained in Parts II & III. Part I introduces the main tools for the analysis, in particular the concept of an information structure. Although most of the material presented in Part I is not original, it is hoped that the detailed and self-contained exposition will help the reader to understand not only the following pages, but also the existing technical and variegated literature on markets with imperfect information. The mathematical prerequisites needed, but not explained in the text rarely go beyond elementary calculus and probability theory. Whenever more advanced concepts are used, I have made an effort to give an intuitive explanation as well, so that the argument can also be followed o...

Writings from the Margins: German-Jewish Women Poets from the Bukovina

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Amy Colin

1997-01-01

Full Text Available Emerging at the crossroads of heterogeneous languages and cultures, German-Jewish women's poetry from the Bukovina displays the characteristics of its fascinating multilingual contextuality, yet it also bears the stigma of a double marginalization, for its representatives became time and again targets of both anti-Semitic attacks as well as gender discrimination. The present essay explores the untiring struggles of German-Jewish women authors from the Bokovina for acceptance within the Jewish and non-Jewish community. It analyzes their attempts to cope with social barriers, prejudices, and their difficult situation as both women and Jews. The essay also sets their poetry against the background of their multilingual contextuality. It is the Bukovinian biotope, where Ruthenians, Romanians, Germans, Jews, Armenians, Magyars, Poles, Lipovanes, and Hutsuls peacefully coexisted for many centuries, producing a variegated Romanian, Ruthenian, Austro-German, German-Jewish, and Yiddish literature as well as poets who were fluent in several languages.

Transcriptome Analysis of the Phytobacterium Xylella fastidiosa Growing under Xylem-Based Chemical Conditions

Directory of Open Access Journals (Sweden)

Maristela Boaceff Ciraulo

2010-01-01

Full Text Available Xylella fastidiosa is a xylem-limited bacterium responsible for important plant diseases, like citrus-variegated chlorosis (CVC and grapevine Pierce's disease (PD. Interestingly, in vitro growth of X. fastidiosa in chemically defined media that resemble xylem fluid has been achieved, allowing studies of metabolic processes used by xylem-dwelling bacteria to thrive in such nutrient-poor conditions. Thus, we performed microarray hybridizations to compare transcriptomes of X. fastidiosa cells grown in 3G10-R, a medium that resembles grape sap, and in Periwinkle Wilt (PW, the complex medium traditionally used to cultivate X. fastidiosa. We identified 299 transcripts modulated in response to growth in these media. Some 3G10R-overexpressed genes have been shown to be upregulated in cells directly isolated from infected plants and may be involved in plant colonization, virulence and environmental competition. In contrast, cells cultivated in PW show a metabolic switch associated with increased aerobic respiration and enhanced bacterial growth rates.

BRICS: an explanation in critical geography

Directory of Open Access Journals (Sweden)

Krishnendra Meena

2013-12-01

Full Text Available BRICS, an abbreviation for Brazil, Russia, India, China and South Africa, a group of five influential and emerging economies successfully completed its fifth annual summit in Durban during March 26-27, 2013. A significantly unique feature of the group is its geographical spread as evident from the location of these five constituent states which are situated in four continents. The paper seeks to explain the phenomenon of the disparate group BRICS through literature in Critical Geography as it is understood that the recent phase of globalization has created spatial patterns which were hitherto not experienced and therefore not clearly recognized in the literature on International Relations and traditional geography. Such spatially variegated groupings like the BRICS could be analyzed and interpreted in Critical Geography and Critical Geopolitics literature through three important concepts: a Space b Geographical and Geopolitical Imaginations and c Region. The paper seeks to explain BRICS through these conceptual tools.

Agrogenic degradation of soils in Krasnoyarsk forest-steppe

Science.gov (United States)

Shpedt, A. A.; Trubnikov, Yu. N.; Zharinova, N. Yu.

2017-10-01

Agrogenic degradation of soils in Krasnoyarsk forest-steppe was investigated. Paleocryogenic microtopography of microlows and microhighs in this area predetermined the formation of paragenetic soil series and variegated soil cover. Specific paleogeographic conditions, thin humus horizons and soil profiles, and long-term agricultural use of the land resulted in the formation of soils unstable to degradation processes and subjected to active wind and water erosion. Intensive mechanical soil disturbances during tillage and long-term incorporation of the underlying Late Pleistocene (Sartan) calcareous silty and clay loams into the upper soil horizons during tillage adversely affected the soil properties. We determined the contents of total and labile humus and easily decomposable organic matter and evaluated the degree of soil exhaustion. It was concluded that in the case of ignorance of the norms of land use and soil conservation practices, intense soil degradation would continue leading to complete destruction of the soil cover within large areas.

Mutation induction, evaluation and utilization for development of high yielding varieties in Indian mustard and sunflower: an overview of BARC work

International Nuclear Information System (INIS)

Jambhulkar, S.J.; Shitre, A.S.

2009-01-01

Mutation breeding programme in Indian mustard and sunflower at BARC has resulted into the development of wide spectrum of mutations for seed coat colour, chlorophyll, plant height, maturity, flower morphology, seed weight and oil content. In Indian mustard, TM1 and TM50 are high yielding yellow seed coat mutants, which were exploited in hybridisation to develop bold, yellow seed coat and high yielding genotypes. Light green leaf and variegated leaf are novel mutation in mustard. Putative mutants for drought tolerance have been isolated. Variability for zero erucic acid and zero glucosinolates genotypes have been developed in B. napus and B. juncea. In sunflower, high yielding black seed coat mutant were isolated. Extreme dwarf measuring only 11 cm is novel. Three high yielding varieties namely TM2, TM4, and TPM1 in mustard and one i.e.TAS82 in sunflower have been released for cultivation in collaboration with state agricultural universities. (author)

Characterization of Greater Middle Eastern genetic variation for enhanced disease gene discovery.

Science.gov (United States)

Scott, Eric M; Halees, Anason; Itan, Yuval; Spencer, Emily G; He, Yupeng; Azab, Mostafa Abdellateef; Gabriel, Stacey B; Belkadi, Aziz; Boisson, Bertrand; Abel, Laurent; Clark, Andrew G; Alkuraya, Fowzan S; Casanova, Jean-Laurent; Gleeson, Joseph G

2016-09-01

The Greater Middle East (GME) has been a central hub of human migration and population admixture. The tradition of consanguinity, variably practiced in the Persian Gulf region, North Africa, and Central Asia, has resulted in an elevated burden of recessive disease. Here we generated a whole-exome GME variome from 1,111 unrelated subjects. We detected substantial diversity and admixture in continental and subregional populations, corresponding to several ancient founder populations with little evidence of bottlenecks. Measured consanguinity rates were an order of magnitude above those in other sampled populations, and the GME population exhibited an increased burden of runs of homozygosity (ROHs) but showed no evidence for reduced burden of deleterious variation due to classically theorized 'genetic purging'. Applying this database to unsolved recessive conditions in the GME population reduced the number of potential disease-causing variants by four- to sevenfold. These results show variegated genetic architecture in GME populations and support future human genetic discoveries in Mendelian and population genetics.

Beyond capitalism: A critique of Max Weber’s general understanding of the Islamic discourse

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Joseph Jon Kaminski

2016-07-01

Full Text Available This article evaluates Max Weber’s overall analysis of Islam. Despite his efforts to be objective, Weber’s analysis was entrenched within a similar Orientalist discursive framework present among other Western scholars who studied non-Western traditions during the late 19th and early 20th centuries. After a review of the existing literature on Weber’s understanding of Islam and its relation to capitalism, this article critically explores other aspects of Weber’s conclusions about Islam that are equally problematic. Weber glosses over many centuries of variegated Islamic cultural history to provide a universalist account of the Islamic civilisation that reduces it to a general meta-discourse. He regularly ignores many of the more localised, regional Islamic cultural traditions altogether. As a result, Weber fails to meaningfully account for the many nuances and idiosyncrasies constitutive of the broader Islamic tradition. This article argues that Weber’s account of Islam shows a great deal of confusion and misunderstanding on his part.

Mottled Neuherberg (Mo sup(N)), a new male-lethal coat colour mutation of the house mouse (Mus musculus)

International Nuclear Information System (INIS)

Schroeder, J.H.

1975-01-01

A new semidominant X-chromosomal mutation, Mottled Neuherberg (Mo sup(N)), which causes coat colour variegation is described. Mo sup(N) arose in the second postirradiation generation after 2 x 200 R of X-rays (24 hours apart) to oocytes of X/O mice. Heterozygous Mo sup(N) females have irregular patches of fully and lightly coloured fur over the whole coat with curly vibrissae. Their viability is reduced, about 3% of the heterozygotes dying prenatally and 6 to 28% dying postnatally before weaning. Survivors are fertile without externally visible abnormalities. Hemizygous Mo sup(N) males die in utero after implantation. The recombination frequency between Mo sup(N) and tabby (Ta) was 3.65 +- 3.16% (with 95% -confidence limits). Therefore, it is suggested that Mo sup(N) is a new allele of the mottled (Mo) locus of the house mouse. Mo sup(N)-bearing ova seem to have a lower chance of becoming fertilized by wild-type spermatozoa than by Ta-bearing spermatozoa. (orig.) [de

The Principles of Tax Law Equality in The Context of Direct Taxation

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Magdalena Jarczok-Guzy

2017-10-01

Full Text Available Aim/purpose - The purpose of this article is a presentation of the principles of tax law equality with the aim of establishing the significance of these rules for the system of direct taxation in Poland. Only forms of taxation have been selected to conduct this analysis because they offer the most transparent and variegated picture of the real tax burden. Design/methodology/approach - The article follows the method of economic comparative analysis and offers a review of available literature on the subject. Findings - This analysis proves that the choice of different types of income taxation for natural persons conducting business activity has influence on tax burden. Research implications/limitations - The system of direct taxation in Poland has problems with equality rules because of different tax rates and tax returns which are available in Polish law. Originality/value/contribution - This article presents the problem of tax law equality in the context of economic theories developed by selected economists.

Patient Safety Culture

DEFF Research Database (Denmark)

Kristensen, Solvejg

of health care professional’s behaviour, habits, norms, values, and basic assumptions related to patient care; it is the way things are done. The patient safety culture guides the motivation, commitment to and know-how of the safety management, and how all members of a work place interact. This thesis......Patient safety is highly prioritised in the Danish health care system, never the less, patients are still exposed to risk and harmed every day. Implementation of a patient safety culture has been suggested an effective mean to protect patients against adverse events. Working strategically...

Long-term graft and patient survival following renal transplantation in diabetic patients

DEFF Research Database (Denmark)

Rømming Sørensen, Vibeke; Schwartz Sørensen, Søren; Feldt-Rasmussen, Bo

2006-01-01

. The groups were similar with respect to age and sex. RESULTS: The patient survival rates (diabetic versus non-diabetic patients) were 88% vs 91% (p=NS) at 1 year, 68% vs 73% (p=NS) at 5 years and 31% vs 52% (pnon-diabetic patients) were 72% vs 72...... patients, 55% were smokers. Among the diabetic patients, graft and patient survival were independent of smoking habits, blood pressure, HbA1c and total cholesterol. CONCLUSIONS: Graft survival was similar in diabetic and non-diabetic patients. For the first 5 years following renal transplantation......OBJECTIVE: To study long-term graft and patient survival following renal transplantation in diabetic and non-diabetic patients. MATERIAL AND METHODS: Over the time period 1985-99, 498 transplantations in 399 non-diabetic patients and 68 transplantations in 62 diabetic patients were performed...

Patients' Experiences with and Attitudes towards a Diabetes Patient Web Portal.

Science.gov (United States)

Ronda, Maaike C M; Dijkhorst-Oei, Lioe-Ting; Rutten, Guy E H M

2015-01-01

A diabetes patient web portal allows patients to access their personal health record and may improve diabetes outcomes; however, patients' adoption is slow. We aimed to get insight into patients' experiences with a web portal to understand how the portal is being used, how patients perceive the content of the portal and to assess whether redesign of the portal might be needed. A survey among 1500 patients with type 1 and type 2 diabetes with a login to a patient portal. 62 primary care practices and one outpatient hospital clinic, using a combined patient portal. We compared patients who requested a login but never used it or once ('early quitters') with patients who used it at least two times ('persistent users'). 632 patients (42.1%) returned the questionnaire. Their mean age was 59.7 years, 63.1% was male and 81.8% had type 2 diabetes. 413 (65.3%) people were persistent users and 34.7% early quitters. In the multivariable analysis, insulin use (OR2.07; 95%CI[1.18-3.62]), experiencing more frequently hyperglycemic episodes (OR1.30;95%CI[1.14-1.49]) and better diabetes knowledge (OR1.02, 95%CI[1.01-1.03]) do increase the odds of being a persistent user. Persistent users perceived the usefulness of the patient portal significantly more favorable. However, they also more decisively declared that the patient portal is not helpful in supporting life style changes. Early quitters felt significantly more items not applicable in their situation compared to persistent users. Both persistent users (69.8%) and early quitters (58.8%) would prefer a reminder function for scheduled visits. About 60% of both groups wanted information about medication and side-effects in their portal. The diabetes patient web portal might be improved significantly by taking into account the patients' experiences and attitudes. We propose creating separate portals for patients on insulin or not.

Improving stroke patients' care: a patient held record is not enough

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Lampe Fiona

2001-03-01

Full Text Available Abstract Background Stroke patients' care in hospital tends to be poorly organised, with poor communication and a lack of information being frequent sources of complaint. The purpose of this study was to evaluate whether a patient-held record (PHR would result in greater patient satisfaction and better care planning for stroke patients. Methods A time series control (6 months - intervention (8 months - control (6 months was used among London teaching hospital general medical and geriatric medicine inpatient wards. All stroke patients admitted to the wards during the intervention phase received a PHR and were instructed in its use. Demographic, stroke severity, social factors and outcomes were collected from all stroke patients during all phases of the study. Results Of 252 stroke patients aged 46 to 98 years entered into the study, by six months after admission 118 (46.8% had died. PHR and control group patients were well matched in terms of socio-demographic characteristics and pre-stroke ability. At six months after admission, 119 (97% patients responded to the questionnaire. Just over half (56%, 13 of intervention group patients recalled receiving a PHR. Of those patients, 59% reported reading the PHR, 27% had lost their PHR, and two-thirds said they had difficulties encouraging staff to write in the PHR. Half felt that possession of the PHR was more trouble than it was worth. PHR group patients were more satisfied with the recovery they had made (79% vs. 59%, p=0.04, but felt less able to talk to staff about their problems (61% vs. 82%, p=0.02. PHR group patients reported receiving fewer explanations about their condition (18% vs. 33%, p=0.12 and treatment (26% vs. 45%, p=0.07, and were more afraid of asking doctors questions (21% vs. 4%, p=0.01 than controls. PHR group patients were no better prepared for hospital discharge than control group patients, and both groups were ill-informed about services and benefits that might have helped

Provider and patient perception of psychiatry patient health literacy

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Bacon O

2017-06-01

Full Text Available Background: Inadequate health literacy in adults is a nationwide issue that is associated with worse health outcomes. There is a paucity of literacy regarding rates of inadequate health literacy in psychiatric populations. Objective: The aim of the study was to identify an existing tool that would easily identify patients who had inadequate health literacy, so that a targeted intervention could be performed. Secondarily we attempted to compare rates of inadequate health literacy with providers’ perception of patients’ health literacy. Methods: We assessed health literacy in a psychiatric population by administering the Brief Health Literacy Survey (BHLS. Additionally, all psychiatry residents, psychiatrists, nurse practitioners, pharmacists, and social workers were surveyed to assess their perception of patient health literacy. Differences between patient health literacy and provider expectations of patient health literacy were compared. Results: Inadequate health literacy was identified in 31 out of 61 patients (50.8% using 2 questions from the BHLS. Only 9 (29% of patients who were identified as having inadequate health literacy were identified by both BHLS questions. In contrast, almost 100% of providers identified their patients, in general, as having inadequate health literacy. Conclusions: These results identify a higher rate of health literacy in a psychiatric inpatient population than in the general population. However, providers at this institution likely over-identify health literacy. This highlights the need for a health literacy tool that can easily target patients with inadequate health literacy for an intervention.

Quality of life in patients with dental conditions: comparing patients' and providers' evaluation.

Science.gov (United States)

Sampogna, F; Johansson, V; Axtelius, B; Abeni, D; Söderfeldt, B

2009-12-01

To measure the agreement between patients and their caregivers in evaluating patients' oral quality of life. Cross-sectional study. Data collected in four Swedish dental clinics in 2004. Consecutive patients. Data were completed for 444 patients. Fifteen dentists and 12 dental hygienists agreed to participate. For each patient, the patient him/herself and his/her caregiver completed the 14-item Oral Health Impact Profile (OHIP-14), a specific instrument used to measure quality of life in oral conditions, with higher scores indicating a worse quality of life. Information on personal and clinical characteristics of patients were also collected. Median OHIP-14 scores given by caregivers and patients were calculated and compared in different subgroups of patients. Cohen's kappa was calculated to measure the agreement between the evaluation of patients and caregivers. OHIP-14 scores median values were 3.0 among patients and 9.0 among caregivers. Caregivers always gave a higher score than patients, especially in older patients and patients with lower education. The concordance between patients' and caregivers' evaluation was very low (for different OHIP-14 cutoffs: Cohen's kappa from 0.10 to 0.15). In this study, great discrepancies were observed between patients and caregivers in the evaluation of patients' oral quality of life, with caregivers overestimating the burden of dental conditions on patients. It is important to improve patient-caregiver communication, in order to increase patient satisfaction and provide better care. A good patient-caregiver relationship is essential for the patients' well-being and their adherence to treatment.

NESB patients.

Science.gov (United States)

Charles, Janice; Britt, Helena; Fahridin, Salma

2010-04-01

General practitioner consultations with patients of non-English speaking background (NESB) account for one in 10 encounters recorded in the BEACH (Bettering the Evaluation and Care of Health) program (NESB is defined as patients who reported that their primary language spoken at home is not English). We present a descriptive comparison of consultations with NESB and English speaking patients recorded between April 2007 and March 2009. Indigenous persons were excluded from the analysis to give a clearer picture of NESB patients of non- Australian origin. Only statistically significant differences with nonoverlapping 95% confidence intervals are reported.

Patients Provide Recommendations for Improving Patient Satisfaction.

Science.gov (United States)

Moore, Angelo D; Hamilton, Jill B; Krusel, Jessica L; Moore, LeeAntoinette G; Pierre-Louis, Bosny J

2016-04-01

National Committee for Quality Assurance recommends patient-centered medical homes incorporate input from patient populations; however, many health care organizations do not. This qualitative study used two open-ended questions from 148 active duty Army Soldiers and their family members to illicit recommendations for primary care providers and clinic leadership that would improve their health care experiences. Content analysis and descriptive statistics were used to analyze responses. Participant responses were related to four major themes: Access to Care, Interpersonal Interaction, Satisfaction of Care, and Quality of Care. Participants were overall satisfied with their care; however, spending less time waiting for appointments and to see the provider or specialist were the most frequently requested improvements related to Access to Care. For Interpersonal Interaction, 82% of the responses recommended that providers be more attentive listeners, courteous, patient, caring, and respectful. Decreasing wait times and improving interpersonal skills would improve health care experiences and patient satisfaction. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Pain management: association with patient satisfaction among emergency department patients.

Science.gov (United States)

Bhakta, Hemangini C; Marco, Catherine A

2014-04-01

Patient satisfaction with emergency care is associated with timeliness of care, empathy, technical competence, and information delivery. Previous studies have demonstrated inconsistent findings regarding the association between pain management and patient satisfaction. This study was undertaken to determine the association between pain management and patient satisfaction among Emergency Department (ED) patients presenting with acute painful conditions. In this survey study, a standardized interview was conducted at the Emergency Department at the University of Toledo Medical Center in May-July 2011. Participants were asked to answer 18 questions pertaining to patient satisfaction. Additional data collected included demographic information, pain scores, and clinical management. Among 328 eligible participants, 289 (88%) participated. The mean triage pain score on the verbal numeric rating scale was 8.2 and the mean discharge score was 6.0. The majority of patients (52%) experienced a reduction in pain of 2 or more points. Participants received one pain medication dose (44%), two medication doses (14%), three medication doses (5%), or four medication doses (2%). Reduction in pain scores of 2 or more points was associated with a higher number of medications administered. Reduction in pain scores was associated with higher satisfaction as scored on questions of patient perceptions of adequate assessment and response to pain, and treatment of pain. There was a significant association between patient satisfaction and a reduction in pain of 2 or more points and number of medications administered. Effective pain management is associated with improved patient satisfaction among ED patients with painful conditions. Copyright © 2014 Elsevier Inc. All rights reserved.

Doctor-patient communication and cancer patients' quality of life and satisfaction

NARCIS (Netherlands)

Ong, L. M.; Visser, M. R.; Lammes, F. B.; de Haes, J. C.

2000-01-01

In this study, the relationship between (a) doctor's and patients' communication and (b) doctors' patient-centredness during the oncological consultation and patients' quality of life and satisfaction was examined. Consultations of 96 consecutive cancer patients were recorded and content analysed by

A good patient?

DEFF Research Database (Denmark)

Campbell, Catherine; Scott, Kerry; Skovdal, Morten

2015-01-01

, physical cleanliness, honesty, gratitude and lifestyle adaptations (taking pills correctly andcoming to the clinic when told). As healthcare workers may decide to punish patients who do not live up the‘good patient persona’, many patients seek to perform within the confines of the ‘good patient persona...

Interrelation between Patient Satisfaction and Patient-Provider Communication in Diabetes Management

Directory of Open Access Journals (Sweden)

Ayse Basak Cinar

2014-01-01

Full Text Available The present study aims to assess how patient satisfaction with medical provider-patient communication can affect oral health, diabetes, and psychobehavioural measures among type 2 diabetes (T2DM patients. It is part of a prospective intervention study among randomly selected T2DM patients, in Turkey. The data analyzed were Community Periodontal Need Index (CPI, HbA1c, patient satisfaction with communication, and psychobehavioural variables. Data was collected initially and at the end of the intervention. The participants were allocated to either health coaching (HC or health education (HE. At baseline, there were no statistical differences between the HC and the HE groups on any of the measures (P>0.05. Patients in both the HC and the HE groups had low satisfaction with communication. At postintervention, the increase in patient satisfaction with communication in the HC group was significantly higher than that in the HE group (P=0.001. Principal component analysis revealed that patient satisfaction with communication shared the same cluster with clinical measures (CPI and HbA1c and quality of life in the HC group. In conclusion, the present study showed, to our knowledge for the first time, that overall patient satisfaction with medical care provider-patient communication, empowered by HC approach, was interrelated with well-being of T2DM patients, in terms of psychobehavioural and clinical measures.

Displacing the patient

DEFF Research Database (Denmark)

Pors, Anja Svejgaard

2014-01-01

is not only about disease treatment, but also about ‘information treatment’ for the purpose of increasing patient satisfaction at the hospital. The goal of patient satisfaction addresses both a care-oriented approach to the patient and also deploys market perceptions of patients as homogeneous target groups...... for which information can be standardized. In the latter approach (market orientation), the patient is also a resource for organizational development. Overall, the strategy presents an information-pursuing patient figure that makes it possible to streamline the organization's care orientation on market......Over the past decade, patient communication has become a strategic priority in Danish public hospitals: communication is a focal point of policies, plans and daily work practices. Hospitals today create communication strategies and build communication departments to improve communication...

Dentist-Patient Relationship

Directory of Open Access Journals (Sweden)

Gheorghe Raftu

2016-01-01

In the dentist-patient relationship confidence comes from the assurance that personal information(belonging to the patient will remain confidential; this is in the interest of the patient and the patient'sautonomy is recognized. There were presented several behavioral types which can lead to a physicianpatientrelationship, based on trust.

Implementing Patient Family-Centered Care Grand Rounds Using Patient/Family Advisor Narratives

Directory of Open Access Journals (Sweden)

Maureen B Fagan DNP, MHA, FNP-BC

2015-11-01

Full Text Available With the emerging trend of patient family–centered care in health care, it is essential that physicians be exposed to patient and family perspectives of care during medical education and training. Grand Rounds provides an ideal format for physicians to learn about patient family–centered care. At Brigham and Women’s Hospital, we sought to bring the voice of the patient to Patient Family–Centered Grand Rounds in order to expose clinicians to rich narratives describing the medical care received by patients/families and to ultimately change physician practice to reflect patient family–centered principles. We conducted a clinician survey and found promising results indicating that patient/family narratives can be effective at educating physicians about patient family–centered care.

Study of Knowledge and Practice of Patient Self directed Care among Diabetics Patients

Directory of Open Access Journals (Sweden)

Z. Abedini

2008-07-01

Full Text Available Background and ObjectivesDiabetic patients play the main role in the management of their disease. Adequate knowledge of this disease state and self directed patient care will improve the health of these patients. Some studies have indicated a high prevalence of diabetes complication are due to the lack of knowledge of self directed patient care and practice in diabetic patient group. The objective of this study is to measure the knowledge level of self directed patient care and practice in order to evaluate their effects on improvement of diabetic patients' health in the city of Qom, Iran.MethodsIn this cross sectional study 1004 patients with diabetes participated (During year 2006. Data were collected from patients of General Hospital metabolism and endocrine research center.An interviewing method was used to asses the demographics data, history of disease, and knowledge of self directed patient care in these patients. Data were analyzed using a descriptive statistic, chi-square, and Pearson correlation coefficient, and SPSS software.ResultsOut of 1004 observed case, 154 patients were with Diabetes type I and 850 patients with Diabetes type II. The knowledge of self directed patient care and practice level of with both types of diabetes were determined to be mostly at an intermediate level. In type I diabetic patients there was a significant relation between knowledge level of self directed patient care and gender of the patients (P=0.01. Also, there was a significant correlation between practice and age (P=0.03(, and economical status (P=0.06 of the patients. In type II diabetic patients there was a significant relation between knowledge level of self directed patient care and educational level (P=0.00(, and economical status (P=0.01 of the patients. The practice level of self directed patient care was significantly related to economical status (p=0.03 in this group of patients. ConclusionThese results indicate that an increase in knowledge

Patient-Ventilator Dyssynchrony

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Elvira-Markela Antonogiannaki

2017-11-01

Full Text Available In mechanically ventilated patients, assisted mechanical ventilation (MV is employed early, following the acute phase of critical illness, in order to eliminate the detrimental effects of controlled MV, most notably the development of ventilator-induced diaphragmatic dysfunction. Nevertheless, the benefits of assisted MV are often counteracted by the development of patient-ventilator dyssynchrony. Patient-ventilator dyssynchrony occurs when either the initiation and/or termination of mechanical breath is not in time agreement with the initiation and termination of neural inspiration, respectively, or if the magnitude of mechanical assist does not respond to the patient’s respiratory demand. As patient-ventilator dyssynchrony has been associated with several adverse effects and can adversely influence patient outcome, every effort should be made to recognize and correct this occurrence at bedside. To detect patient-ventilator dyssynchronies, the physician should assess patient comfort and carefully inspect the pressure- and flow-time waveforms, available on the ventilator screen of all modern ventilators. Modern ventilators offer several modifiable settings to improve patient-ventilator interaction. New proportional modes of ventilation are also very helpful in improving patient-ventilator interaction.

Patient-centered medical home transformation with payment reform: patient experience outcomes.

Science.gov (United States)

Heyworth, Leonie; Bitton, Asaf; Lipsitz, Stuart R; Schilling, Thad; Schiff, Gordon D; Bates, David W; Simon, Steven R

2014-01-01

To examine changes in patient experience across key domains of the patient-centered medical home (PCMH) following practice transformation with Lean quality improvement methodology inclusive of payment reform. Pre-intervention/post-intervention analysis of intervention with a comparison group, a quasi-experimental design. We surveyed patients following office visits at the intervention (n = 2502) and control (n = 1622) practices during the 15-month period before and 14-month period after PCMH Lean transformation (April-October 2009). We measured and compared pre-intervention and post-intervention levels of patient satisfaction and other indicators of patient-centered care. Propensity weights adjusted for potential case-mix differences in intervention and control groups; propensity-adjusted proportions accounted for physician-level clustering. More intervention patients were very satisfied with their care after the PCMH Lean intervention (68%) compared with pre-intervention (62%). Among control patients, there was no corresponding increase in satisfaction (63% very satisfied pre-intervention vs 64% very satisfied post-intervention). This comparison resulted in a statistical trend (P = .10) toward greater overall satisfaction attributable to the intervention. Post-intervention, patients in the intervention practice consistently rated indicators of patient-centered care higher than patients in the control practice, particularly in the personal physician and communication domain. In this domain, intervention patients reported superior provider explanations, time spent, provider concern, and follow-up instructions compared with control participants, whereas control group ratings fell in the post-intervention period (P for difference Lean enhancement with payment reform, patient experience was sustained or improved across key PCMH domains.

Quality of doctor-patient communication through the eyes of the patient: variation according to the patient's educational level.

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Aelbrecht, Karolien; Rimondini, Michela; Bensing, Jozien; Moretti, Francesca; Willems, Sara; Mazzi, Mariangela; Fletcher, Ian; Deveugele, Myriam

2015-10-01

Good doctor-patient communication may lead to better compliance, higher patient satisfaction, and finally, better health. Although the social variance in how physicians and patients communicate is clearly demonstrated, little is known about what patients with different educational attainments actually prefer in doctor-patient communication. In this study we describe patients' perspective in doctor-patient communication according to their educational level, and to what extent these perspectives lean towards the expert opinion on doctor-patient communication. In a multi-center study (Belgium, The Netherlands, UK and Italy), focus group discussions were organised using videotaped medical consultations. A mixed methods approach was used to analyse the data. Firstly, a difference in perspective in communication style was found between the lower educated participants versus the middle and higher educated participants. Secondly, lower educated participants referred positively most to aspects related to the affective/emotional area of the medical consultation, followed by the task-oriented/problem-focused area. Middle and higher educated participants positively referred most to the task-oriented/problem-focused area. The competency of the physician was an important category of communication for all participants, independent of social background. The results indicate that the preferences of lower educated participants lean more towards the expert opinion in doctor-patient communication than the middle and higher educated participants. Patients' educational level seems to influence their perspective on communication style and should be taken into account by physicians. Further quantitative research is needed to confirm these results.

Patient and Other Stakeholder Engagement in Patient-Centered Outcomes Research Institute Funded Studies of Patients with Kidney Diseases.

Science.gov (United States)

Cukor, Daniel; Cohen, Lewis M; Cope, Elizabeth L; Ghahramani, Nasrollah; Hedayati, S Susan; Hynes, Denise M; Shah, Vallabh O; Tentori, Francesca; Unruh, Mark; Bobelu, Jeanette; Cohen, Scott; Dember, Laura M; Faber, Thomas; Fischer, Michael J; Gallardo, Rani; Germain, Michael J; Ghahate, Donica; Grote, Nancy; Hartwell, Lori; Heagerty, Patrick; Kimmel, Paul L; Kutner, Nancy; Lawson, Susan; Marr, Lisa; Nelson, Robert G; Porter, Anna C; Sandy, Phillip; Struminger, Bruce B; Subramanian, Lalita; Weisbord, Steve; Young, Bessie; Mehrotra, Rajnish

2016-09-07

Including target populations in the design and implementation of research trials has been one response to the growing health disparities endemic to our health care system, as well as an aid to study generalizability. One type of community-based participatory research is "Patient Centered-Research", in which patient perspectives on the germane research questions and methodologies are incorporated into the study. The Patient-Centered Outcomes Research Institute (PCORI) has mandated that meaningful patient and stakeholder engagement be incorporated into all applications. As of March 2015, PCORI funded seven clinically-focused studies of patients with kidney disease. The goal of this paper is to synthesize the experiences of these studies to gain an understanding of how meaningful patient and stakeholder engagement can occur in clinical research of kidney diseases, and what the key barriers are to its implementation. Our collective experience suggests that successful implementation of a patient- and stakeholder-engaged research paradigm involves: (1) defining the roles and process for the incorporation of input; (2) identifying the particular patients and other stakeholders; (3) engaging patients and other stakeholders so they appreciate the value of their own participation and have personal investment in the research process; and (4) overcoming barriers and challenges that arise and threaten the productivity of the collaboration. It is our hope that the experiences of these studies will further interest and capacity for incorporating patient and stakeholder perspectives in research of kidney diseases. Copyright © 2016 by the American Society of Nephrology.

Organizing Patient Involvement

DEFF Research Database (Denmark)

Brehm Johansen, Mette

hospitals. During the last 25 years, patient involvement and quality improvement have become connected in Danish healthcare policy. However, the ideal of involving patients in quality improvement is described in very general terms and with only few specific expectations of how it is to be carried out...... in practice, as I show in the thesis. In the patient involvement literature, the difficulties of getting patient involvement in quality improvement to have in an impact on the planning and development of healthcare services is, for example, ascribed to conceptual vagueness of patient involvement, differences...... in perspectives, values and understandings between patients and healthcare professionals, or the lack of managerial attention and prioritization....

Patient Satisfaction in Obstetrics and Gynecology: Individualized Patient-centered Communication

OpenAIRE

John Yeh; Eryn E. Nagel

2010-01-01

Background Patient satisfaction is becoming an increasingly prevalent topic in medicine, but little is known about patient satisfaction in women's health and other specialties. We review current methods of improving patient satisfaction in the field of obstetrics and gynecology with the intent to increase patient satisfaction even further by enhancing and combining previously used strategies. Methods A search from inception to June 2010 for electronic literature was performed using Medline. T...

Role of effective nurse-patient relationships in enhancing patient safety.

Science.gov (United States)

Conroy, Tiffany; Feo, Rebecca; Boucaut, Rose; Alderman, Jan; Kitson, Alison

2017-08-02

Ensuring and maintaining patient safety is an essential aspect of care provision. Safety is a multidimensional concept, which incorporates interrelated elements such as physical and psychosocial safety. An effective nurse-patient relationship should ensure that these elements are considered when planning and providing care. This article discusses the importance of an effective nurse-patient relationship, as well as healthcare environments and working practices that promote safety, thus ensuring optimal patient care.

chemotherapy patients

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Katarzyna Augustyniuk

2016-02-01

Full Text Available Background . Complementary and alternative medicine (CAM practices for cancer have become popular among oncology patients. An increasing interest in alternative medicine can be explained by the inefficiency of conventional treatment, dissatisfaction with treating patients like objects, and the will to use all available treatment methods. Objectives . The authors assessed how often patients use CAM methods, and which of them are most popular. Material and methods . The study was conducted in Military Hospital no. 109 and the Independent Public Clinical Hospital no. 1 in Szczecin among 100 chemotherapy patients. This survey-based study was performed using an original questionnaire. Results. Most respondents (68% did not use alternative methods to fight the disease. The most popular treatment methods were: herbal medicine (50%, alternative medicine preparations (38% and diet (25%, and the least common: hypnosis (3% and aromatherapy (3%. Analyzed sociodemographic factors had no effects on a choice of a CAM method. Patients obtained information about CAM methods mainly from the Internet (40%, medical staff (37% and literature (31%. Conclusions . 1. Using CAM by patients receiving chemotherapy for neoplasms is quite a common phenomenon. 2. CAM were more often chosen by women. Neither the duration of the disease nor sociodemographic data had effects on making the decision to use CAM methods. 3. The most popular CAM were: herbal medicine, alternative medicine preparations, and diet. 4. Cancer patients should receive special support from nurses and doctors as well as other members of the therapeutic team. Oncology patients should never be left on their own so that they were forced to seek help and support in therapies unconfirmed by scientific investigation.

Patient perception and the barriers to practicing patient-centered communication: A survey and in-depth interview of Chinese patients and physicians.

Science.gov (United States)

Ting, Xu; Yong, Bao; Yin, Liang; Mi, Tian

2016-03-01

To investigate patient perceptions of patient-centered communication (PCC) in doctor-patient consultations and explore barriers to PCC implementation in China. This study was conducted in public teaching hospital in Guiyang, Guizhou, China. In Phase 1, patient attitudes to PCC were quantitatively assessed in 317 outpatients using modified Patient-Practitioner Orientation Scale (PPOS). In Phase 2, we conducted in-depth interviews with 20 outpatients to explore their views on PCC and expose potential barriers to PCC implementation. Participants communicated "patient-centered" preferences, particularly with regard to their doctors' empathy, communication skills, time and information sharing. Patients were more concerned about doctors exhibiting caring perspective than power sharing. Younger and highly educated patients were more likely to prefer PCC and highly educated patients paid more attention to power sharing. Several factors including inadequate time for PCC resulting from doctors' high patient-load, doctor-patient communication difficulties and excessive treatment due to inappropriate medical payment system affected PCC implementation in China. Patients expressed moderate enthusiasm for PCC in China. They expressed strong preferences concerning physician respect for patient perspective, but less concern for power sharing. Government should improve health care system by implementing PCC in daily healthcare practice to improve patient awareness and preferences. Copyright © 2016. Published by Elsevier Ireland Ltd.

Display methods of electronic patient record screens: patient privacy concerns.

Science.gov (United States)

Niimi, Yukari; Ota, Katsumasa

2013-01-01

To provide adequate care, medical professionals have to collect not only medical information but also information that may be related to private aspects of the patient's life. With patients' increasing awareness of information privacy, healthcare providers have to pay attention to the patients' right of privacy. This study aimed to clarify the requirements of the display method of electronic patient record (EPR) screens in consideration of both patients' information privacy concerns and health professionals' information needs. For this purpose, semi-structured group interviews were conducted of 78 medical professionals. They pointed out that partial concealment of information to meet patients' requests for privacy could result in challenges in (1) safety in healthcare, (2) information sharing, (3) collaboration, (4) hospital management, and (5) communication. They believed that EPRs should (1) meet the requirements of the therapeutic process, (2) have restricted access, (3) provide convenient access to necessary information, and (4) facilitate interprofessional collaboration. This study provides direction for the development of display methods that balance the sharing of vital information and protection of patient privacy.

Codification of patients' rights in Poland--the Patients' Rights Act 2008.

Science.gov (United States)

Bosek, Leszek; Pawliczak, Jakub

2010-09-01

The Act of 6 November 2008 on Patients' Rights and the Commissioner for Patients' Rights collect and safeguard patients' basic rights as well as provide, for the first time in Poland, an original concept for patients' collective rights. In addition, the new Act stipulates the specific mechanism for protecting patients' rights by the newly established body called the Commissioner for Patients' Rights. Polish reform of medical law will undoubtedly contribute to the expected ratification of the Convention on Human Rights and Biomedicine. However, the nature of codified rights is relatively abstract, and the Act cannot be read without reference to legislation related to physicians and health care institutions.

Medical terminology in online patient-patient communication: evidence of high health literacy?

Science.gov (United States)

Fage-Butler, Antoinette M; Nisbeth Jensen, Matilde

2016-06-01

Health communication research and guidelines often recommend that medical terminology be avoided when communicating with patients due to their limited understanding of medical terms. However, growing numbers of e-patients use the Internet to equip themselves with specialized biomedical knowledge that is couched in medical terms, which they then share on participatory media, such as online patient forums. Given possible discrepancies between preconceptions about the kind of language that patients can understand and the terms they may actually know and use, the purpose of this paper was to investigate medical terminology used by patients in online patient forums. Using data from online patient-patient communication where patients communicate with each other without expert moderation or intervention, we coded two data samples from two online patient forums dedicated to thyroid issues. Previous definitions of medical terms (dichotomized into technical and semi-technical) proved too rudimentary to encapsulate the types of medical terms the patients used. Therefore, using an inductive approach, we developed an analytical framework consisting of five categories of medical terms: dictionary-defined medical terms, co-text-defined medical terms, medical initialisms, medication brand names and colloquial technical terms. The patients in our data set used many medical terms from all of these categories. Our findings suggest the value of a situated, condition-specific approach to health literacy that recognizes the vertical kind of knowledge that patients with chronic diseases may have. We make cautious recommendations for clinical practice, arguing for an adaptive approach to medical terminology use with patients. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

When doctor becomes patient: challenges and strategies in caring for physician-patients.

Science.gov (United States)

Domeyer-Klenske, Amy; Rosenbaum, Marcy

2012-01-01

The current study was aimed at exploring the challenges that arise in the doctor-patient relationship when the patient is also a physician and identifying strategies physicians use to meet these challenges. No previous research has systematically investigated primary care physicians' perspectives on caring for physician-patients. Family medicine (n=15) and general internal medicine (n=14) physicians at a large Midwestern university participated in semi-structured interviews where they were asked questions about their experiences with physician-patients and the strategies they used to meet the unique needs of this patient population. Thematic analysis was used to identify common responses. Three of the challenges most commonly discussed by physician participants were: (1) maintaining boundaries between relationships with colleagues or between roles as physician/colleague/friend, (2) avoiding assumptions about patient knowledge and health behaviors, and (3) managing physician-patients' access to informal consultations, personal test results, and opinions from other colleagues. We were able to identify three main strategies clinicians use in addressing these perceived challenges: (1) Ignore the physician-patient's background, (2) Acknowledge the physician-patient's background and negotiate care, and (3) Allow care to be driven primarily by the physician-patient. It is important that primary care physicians understand the challenges inherent in treating physicians and develop a strategy with which they are comfortable addressing them. Explicitly communicating with the physician-patient to ensure boundaries are maintained, assumptions about the physician-patient are avoided, and physician-patient access is properly managed are key to providing quality care to physician-patients.

Patient Satisfaction with Collection of Patient-Reported Outcome Measures in Routine Care.

Science.gov (United States)

Recinos, Pablo F; Dunphy, Cheryl J; Thompson, Nicolas; Schuschu, Jesse; Urchek, John L; Katzan, Irene L

2017-02-01

Systematic collection of patient-reported outcome measures (PROMs) during ambulatory clinic visits can enhance communication between patient and provider, and provide the ability to evaluate outcomes of care. Little is known about patient satisfaction of PROM data collection in routine clinical care. To evaluate patient reaction to the routine collection of PROMs in the ambulatory setting. Before all ambulatory clinic visits at our neurological institute, patients electronically complete health status questionnaires. We administered an 8-question patient satisfaction survey to a sample of patients seen across the institute after their clinical visit. Of 343 patients approached, 323 agreed to participate. The majority responded that the questionnaire system was easy to use, was an appropriate length, and benefited their care overall (strongly agree or agree = 92.3%, 87.6%, and 77.3%, respectively). Provider review of the PROMs with the patient during the clinic visit was associated with significantly higher positive responses to all questions, even those regarding logistical aspects of the collection process. There were significant age and race differences in response to perceived benefit: those in the Black/other race category had a markedly lower probability of viewing the process favorably with increasing age. Systematic collection of PROMs via an electronic questionnaire appears to be well accepted by patients. A minority of patients did not feel the questionnaire content applied to their appointment or that the system was a beneficial feature of the clinical practice. The provider can significantly improve the patient's perception of PROM collection and the patient-physician encounter by reviewing the questionnaire results with the patient.

High patient satisfaction after secondary rhinoplasty in cleft lip patients

NARCIS (Netherlands)

Hens, Greet; Picavet, Valerie A.; Poorten, Vincent Vander; Schoenaers, Joseph; Jorissen, Mark; Hellings, Peter W.

2011-01-01

We surveyed the subjective outcome of secondary rhinoplasty in cleft lip patients. Questionnaires were sent to 38 patients who had undergone a secondary rhinoplasty. A total of 30 questionnaires were returned and analyzed. Patients were asked to score their preoperative and postoperative nasal

ANEMIA IN HEMODIALYSIS PATIENTS: DIABETIC VS NON DIABETIC PATIENTS

Directory of Open Access Journals (Sweden)

SH SHAHIDI

2002-12-01

Full Text Available Introduction. One of the characteristic signs of uremic syndrome is anemia. One of major factors that affects on severity of anemia in ESRD is underlying diseas. The porpuse of this study is to compaire anemia between diabetic and non diabetic ESRD patients. Methods. In a case control study we compared the mean valuse of Hb, Het, MCV, MCH, MCHC, BUN, Cr and duration of dialysis between diabetic and nondiabetic patients on chronic hemodialyis. some variables (such as age, sex, use of erythropoietin, nonderolone decaonats, folic acid, ferrous sulfate, transfusion and blood loss in recent three months and acquired kidney cysts were matched between cases and controls. Results. Means of Hb were 9±1.3 and 8 ± 1.7 in diabetic and non diabetic patients (P<0.05. Mean corposcular volume in diabetic patients (91±3.1 fl was more higher than non diabetic ones (87.1 ± 8.9 (P < 0.05. Other indices had no differences between two groups (P > 0.05. Discussion. Severity of anemia in patients with diabetic nephropathy is milder that other patients with ESRD. So, Anemia as an indicator of chronocity of renal disease in diabetics is missleading.

Outpatient management of intensively treated acute leukemia patients-the patients' perspective

DEFF Research Database (Denmark)

Jepsen, Lene Østergaard; Høybye, Mette Terp; Hansen, Dorte Gilså

2016-01-01

, responsibility and the home were performed. Twenty-two patients were interviewed the first time, and 15 of these were interviewed the second time. The data were analyzed in an everyday life relational perspective. RESULTS: Outpatient management facilitates time to be administrated by the patients and thereby...... the possibility of maintaining everyday life, which was essential to the patients. The privacy ensured by the home was important to patients, and they accepted the necessary responsibility that came with it. However, time spent together with fellow patients and their relatives was an important and highly valued...... part of their social life. CONCLUSIONS: Approached from the patient perspective, outpatient management provided a motivation for patients as it ensured their presence at home and provided the possibility of taking part in everyday life of the family, despite severe illness and intensive treatment...

Displacing the patient

DEFF Research Database (Denmark)

Pors, Anja Svejgaard

a care-oriented approach to the patient and also deploys market perceptions of patients as homogeneous target groups to which information can be standardized. In the latter approach (market orientation), the patient is also a resource for organizational development. Overall, the strategy presents...... an information-pursuing patient figure making it possible to streamline the organization's care orientation on market conditions. In contrast to a dichotomy of care and market as mutually exclusive (Mol 2008), care and market appear to be intertwined in political patient figures through which the organization...

Transforming consumer health informatics through a patient work framework: connecting patients to context.

Science.gov (United States)

Valdez, Rupa S; Holden, Richard J; Novak, Laurie L; Veinot, Tiffany C

2015-01-01

Designing patient-centered consumer health informatics (CHI) applications requires understanding and creating alignment with patients' and their family members' health-related activities, referred to here as 'patient work'. A patient work approach to CHI draws on medical social science and human factors engineering models and simultaneously attends to patients, their family members, activities, and context. A patient work approach extends existing approaches to CHI design that are responsive to patients' biomedical realities and personal skills and behaviors. It focuses on the embeddedness of patients' health management in larger processes and contexts and prioritizes patients' perspectives on illness management. Future research is required to advance (1) theories of patient work, (2) methods for assessing patient work, and (3) techniques for translating knowledge of patient work into CHI application design. Advancing a patient work approach within CHI is integral to developing and deploying consumer-facing technologies that are integrated with patients' everyday lives. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com. For numbered affiliations see end of article.

Assessing patient dose in interventional fluoroscopy using patient-dependent hybrid phantoms

Science.gov (United States)

Johnson, Perry Barnett

Interventional fluoroscopy uses ionizing radiation to guide small instruments through blood vessels or other body pathways to sites of clinical interest. The technique represents a tremendous advantage over invasive surgical procedures, as it requires only a small incision, thus reducing the risk of infection and providing for shorter recovery times. The growing use and increasing complexity of interventional procedures, however, has resulted in public health concerns regarding radiation exposures, particularly with respect to localized skin dose. Tracking and documenting patient-specific skin and internal organ dose has been specifically identified for interventional fluoroscopy where extended irradiation times, multiple projections, and repeat procedures can lead to some of the largest doses encountered in radiology. Furthermore, inprocedure knowledge of localized skin doses can be of significant clinical importance to managing patient risk and in training radiology residents. In this dissertation, a framework is presented for monitoring the radiation dose delivered to patients undergoing interventional procedures. The framework is built around two key points, developing better anthropomorphic models, and designing clinically relevant software systems for dose estimation. To begin, a library of 50 hybrid patient-dependent computational phantoms was developed based on the UF hybrid male and female reference phantoms. These phantoms represent a different type of anthropomorphic model whereby anthropometric parameters from an individual patient are used during phantom selection. The patient-dependent library was first validated and then used in two patient-phantom matching studies focused on cumulative organ and local skin dose. In terms of organ dose, patient-phantom matching was shown most beneficial for estimating the dose to large patients where error associated with soft tissue attenuation differences could be minimized. For small patients, inherent difference

Neuropathic pain in patients with spinal cord injury: report of 213 patients.

Science.gov (United States)

Teixeira, Manoel Jacobsen; Paiva, Wellingson Silva; Assis, Maruska Salles; Fonoff, Erich Talamoni; Bor-Seng-Shu, Edson; Cecon, Angelo Daros

2013-09-01

Management of neuropathic pain following spinal cord injury (SCI) can be a frustrating experience for patients since it poses a therapeutic challenge. In this article the authors describe the clinical characteristics of a group of patients with pain after spinal cord injury. In this retrospective study, 213 patients with SCI and neuropathic pain were assessed. We analyzed clinical characteristics, treatment options, and pain intensity for these patients. The main cause of SCI was spine trauma, which occurred in 169 patients, followed by tumors and infection. Complete lesions were verified in 144 patients. In our study, patients with traumatic SCI and partial lesions seem to be presented with more intense pain; however, this was not statistically significant. Neuropathic pain is a common complaint in patients with SCI and presents a treatment challenge. Knowledge of the clinical characteristics of this group of patients may help determine the best approach to intervention.

Understanding patient experience

DEFF Research Database (Denmark)

Andersen, Tariq O.; Andersen, Pernille R. D.; Kornum, Anders C.

2017-01-01

, safety) arise from getting feedback on symptoms and from continuous and comforting interaction with clinicians. With this paper, we aim to sensitise UX researchers and designers of patient-centred e-health by proposing three UX dimensions: connectedness, comprehension, and compassion.......The term 'patient experience' is currently part of a global discourse on ways to improve healthcare. This study empirically explores what patient experience is in cardiac remote monitoring and considers the implications for user experience (UX). Through interviews around the deployment of a mobile...... app that enables patients to collaborate with clinicians, we unpack experiences in six themes and present narratives of patients' lifeworlds. We find that patients' emotions are grounded in negative feelings (uncertainty, anxiety, loss of hope) and that positive experiences (relief, reassurance...

Audiology patient fall statistics and risk factors compared to non-audiology patients.

Science.gov (United States)

Criter, Robin E; Honaker, Julie A

2016-10-01

To compare fall statistics (e.g. incidence, prevalence), fall risks, and characteristics of patients who seek hearing healthcare from an audiologist to individuals who have not sought such services. Case-control study. Two groups of community-dwelling older adult patients: 25 audiology patients aged 60 years or older (M age: 69.2 years, SD: 4.5, range: 61-77) and a control group (gender- and age-matched ±2 years) of 25 non-audiology patients (M age: 69.6, SD: 4.7, range: 60-77). Annual incidence of falls (most recent 12 months) was higher in audiology patients (68.0%) than non-audiology patients (28.0%; p = .005). Audiology patients reported a higher incidence of multiple recent falls (p =.025) and more chronic health conditions (p = .028) than non-audiology patients. Significantly more audiology patients fall on an annual basis than non-audiology patients, suggesting that falls are a pervasive issue in general hearing clinics. Further action on the part of healthcare professionals providing audiologic services may be necessary to identify individuals at risk for falling.

Patient satisfaction among Spanish-speaking patients in a public health setting.

Science.gov (United States)

Welty, Elisabeth; Yeager, Valerie A; Ouimet, Claude; Menachemi, Nir

2012-01-01

Despite the growing literature on health care quality, few patient satisfaction studies have focused upon the public health setting; where many Hispanic patients receive care. The purpose of this study was to examine the differences in satisfaction between English and Spanish-speaking patients in a local health department clinical setting. We conducted a paper-based satisfaction survey of patients that visited any of the seven Jefferson County Department of Health primary care centers from March 19 to April 19, 2008. Using Chi-squared analyses we found 25% of the Spanish-speaking patients reported regularly having problems getting an appointment compared to 16.8% among English-speakers (p speaking patients controlling for center location, purpose of visit, and time spent waiting. Specifically, Spanish speaking patients were more likely to report problems getting an appointment and less likely to report having their medical problems resolved when leaving their visit as compared to those who spoke English. Findings presented herein may provide insight regarding the quality of care received, specifically regarding patient satisfaction in the public health setting. © 2011 National Association for Healthcare Quality.

Involving patients in patient safety programmes: A scoping review and consensus procedure by the LINNEAUS collaboration on patient safety in primary care.

Science.gov (United States)

Trier, Hans; Valderas, Jose M; Wensing, Michel; Martin, Helle Max; Egebart, Jonas

2015-09-01

Patient involvement has only recently received attention as a potentially useful approach to patient safety in primary care. To summarize work conducted on a scoping review of interventions focussing on patient involvement for patient safety; to develop consensus-based recommendations in this area. Scoping review of the literature 2006-2011 about methods and effects of involving patients in patient safety in primary care identified evidence for previous experiences of patient involvement in patient safety. This information was fed back to an expert panel for the development of recommendations for healthcare professionals and policy makers. The scoping review identified only weak evidence in support of the effectiveness of patient involvement. Identified barriers included a number of patient factors but also the healthcare workers' attitudes, abilities and lack of training. The expert panel recommended the integration of patient safety in the educational curricula for healthcare professionals, and expected a commitment from professionals to act as first movers by inviting and encouraging the patients to take an active role. The panel proposed a checklist to be used by primary care clinicians at the point of care for promoting patient involvement. There is only weak evidence on the effectiveness of patient involvement in patient safety. The recommendations of the panel can inform future policy and practice on patient involvement in safety in primary care.

Testing of a Model with Latino Patients That Explains the Links Among Patient-Perceived Provider Cultural Sensitivity, Language Preference, and Patient Treatment Adherence.

Science.gov (United States)

Nielsen, Jessica D Jones; Wall, Whitney; Tucker, Carolyn M

2016-03-01

Disparities in treatment adherence based on race and ethnicity are well documented but poorly understood. Specifically, the causes of treatment nonadherence among Latino patients living in the USA are complex and include cultural and language barriers. The purpose of this study was to examine whether patients' perceptions in patient-provider interactions (i.e., trust in provider, patient satisfaction, and patient sense of interpersonal control in patient-provider interactions) mediate any found association between patient-perceived provider cultural sensitivity (PCS) and treatment adherence among English-preferred Latino (EPL) and Spanish-preferred Latino (SPL) patients. Data from 194 EPL patients and 361 SPL patients were obtained using questionnaires. A series of language-specific structural equation models were conducted to test the relationship between patient-perceived PCS and patient treatment adherence and the examined mediators of this relationship among the Latino patients. No significant direct effects of patient-perceived PCS on general treatment adherence were found. However, as hypothesized, several significant indirect effects emerged. Preferred language appeared to have moderating effects on the relationships between patient-perceived PCS and general treatment adherence. These results suggest that interventions to promote treatment adherence among Latino patients should likely include provider training to foster patient-defined PCS, trust in provider, and patient satisfaction with care. Furthermore, this training needs to be customized to be suitable for providing care to Latino patients who prefer speaking Spanish and Latino patients who prefer speaking English.

Current status of patient-controlled analgesia in cancer patients.

Science.gov (United States)

Ripamonti, C; Bruera, E

1997-03-01

Patient-controlled analgesia (PCA) is a relatively new technique in which patients are able to self-administer small doses of opioid analgesics when needed. Many different devices are available for opioid infusion, including a syringe pump, disposable plastic cylinder, and battery-operated computer-driven pump. These devices allow patients to choose an intermittent (demand) bolus, continuous infusion, or both modes of administration. Parameters, such as route, drug concentration dose, frequency, and maximum daily or hourly dose, are programmed by the physician. The patient decides whether or not to take a dose. Devices can be used to deliver the drug into a running intravenous infusion, the epidural space, or subcutaneously. Controlled trials indicate that PCA is probably superior to regular opioid administration in postoperative pain. Reported advantages include greater patient satisfaction, decreased sedation and anxiety, and reduced nursing time and hospitalization. Preliminary experience suggests that PCA is also useful and safe for cancer pain, but further research is greatly needed.

Cultural competence: reflections on patient autonomy and patient good.

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Leever, Martin G

2011-07-01

Terms such as 'cultural competence' and 'transcultural nursing' have comfortably taken their place in the lexicon of health care. Their high profile is a reflection of the diversity of western societies and health care's commitment to provide care that is responsive to the values and beliefs of all who require treatment. However, the relationship between cultural competence and familiar ethical concepts such as patient autonomy has been an uneasy one. This article explores the moral foundations of cultural competence, ultimately locating them in patient autonomy and patient good. The discussion of patient good raises questions about the moral relevance of a value's rootedness in a particular culture. I argue that the moral justification for honoring cultural values has more to do with the fact that patients are strongly committed to them than it does with their cultural rootedness. Finally, I suggest an organizational approach to cultural competence that emphasizes overall organizational preparedness.

Neuropathic pain in patients with spinal cord injury: report of 213 patients

Directory of Open Access Journals (Sweden)

Manoel Jacobsen Teixeira

2013-09-01

Full Text Available Objective Management of neuropathic pain following spinal cord injury (SCI can be a frustrating experience for patients since it poses a therapeutic challenge. In this article the authors describe the clinical characteristics of a group of patients with pain after spinal cord injury. Methods In this retrospective study, 213 patients with SCI and neuropathic pain were assessed. We analyzed clinical characteristics, treatment options, and pain intensity for these patients. Results The main cause of SCI was spine trauma, which occurred in 169 patients, followed by tumors and infection. Complete lesions were verified in 144 patients. In our study, patients with traumatic SCI and partial lesions seem to be presented with more intense pain; however, this was not statistically significant. Conclusions Neuropathic pain is a common complaint in patients with SCI and presents a treatment challenge. Knowledge of the clinical characteristics of this group of patients may help determine the best approach to intervention.

[Doctor-Patient Communication Training in Simulated Situations: Emotions and Perceptions of Simulated Patients during Patient-Centered Conversations].

Science.gov (United States)

Butollo, Maria Asisa; Holzinger, Anita; Wagner-Menghin, Michaela

2018-04-13

The use of simulated patients (SPs) for doctor-patient communication training has been established in medical curricula as an important didactic method. The study addresses the question, if patients' emotions and perceptions are represented adequately in patient-centered communication. 22 of 37 SPs of the Medical University of Vienna (12 women, 10 men) were asked openly about their feelings after having acted as an SP in a semi-structured interview, which employed the Critical Incident Technique. The interviews were recorded, transcribed, separated into situational analysis units und analyzed deductively; we used the evidence based qualities of patient-centered communication and the "Nationaler Kompetenzbasierter Lernzielkatalog Medizin" as a guideline. Out of 192 analysis units, 67 were evaluated as positive and 125 as negative. The SPs reported positive feelings, such as perceiving "stability and trust in relationships" (22%), perception of congruence (15%), acceptance (27%) and empathy (36%). As to negative feelings, SPs reported "perceiving instability" (18%), "incongruence" (11%), "lack of acceptance" (40%) and "lack of empathy" (30%). Additionally, 50% of SPs were positively affected when observing students' learning success. When SPs perceived patient-centered communication, they reported positive emotions. A lack of patient centeredness, on the contrary, provoked negative emotions. An empathic attitude, as well as a "lack of acceptance" with contrary effects had the strongest influence on the SPs' mental state. The reaction of SPs to patient centeredness is sufficiently authentic to reach learning objectives, however it is also affected by reactions of SPs to the learning success of students, which is irrelevant for the real-life doctor-patient interaction. SP reactions are affected by students' attitudes. Students should therefore be prepared well before interacting with SPs in a roleplay setting. While SPs' behavior is authentic in patient

Patients' and family members' views on patient-centered communication during cancer care.

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Mazor, Kathleen M; Beard, Reneé L; Alexander, Gwen L; Arora, Neeraj K; Firneno, Cassandra; Gaglio, Bridget; Greene, Sarah M; Lemay, Celeste A; Robinson, Brandi E; Roblin, Douglas W; Walsh, Kathleen; Street, Richard L; Gallagher, Thomas H

2013-11-01

To explore patients' and family members' views on communication during cancer care and to identify those aspects of clinician-patient communication which were most important to patients and family members. We conducted a secondary data analysis of qualitative data from 137 patients with cancer and family members of patients with cancer. We used a modified version of the constant comparative method and coding paradigm of grounded theory. Patients want sensitive, caring clinicians who provide information that they need, when they need it, in a way that they can understand; who listen and respond to questions and concerns, and who attempt to understand the patient's experience. Effective information exchange and a positive interpersonal relationship with the clinician were of fundamental importance to patients and family members. These were interrelated; for instance, failure to provide information a patient needed could damage the relationship, whereas excellent listening could foster the relationship. Information exchange and relationship were also integral to decision-making, managing uncertainty, responding to emotions, and self-management. Clinicians who were responsive to patients' needs beyond the immediate medical encounter were valued. The complexity of cancer care today suggests that efforts to improve communication must be multilevel, acknowledging and addressing patient, clinician, organizational and policy barriers, and facilitators. Measurement tools are needed to assess cancer patients' and family members' experiences with communication over the course of cancer care to provide meaningful, actionable feedback to those seeking to optimize their effectiveness in communicating with patients with cancer. Copyright © 2013 John Wiley & Sons, Ltd.

Use of a Dog Visitation Program to Improve Patient Satisfaction in Trauma Patients.

Science.gov (United States)

Stevens, Penelope; Kepros, John P; Mosher, Benjamin D

Clinical staff members all recognize the importance of attaining high patient satisfaction scores. Although there are many variables that contribute to patient satisfaction, implementation of a dog visitation program has been shown to have positive effects on patient satisfaction in total joint replacement patients. This innovative practice had not previously been studied in trauma patients. The purpose of this quasi-experimental study was to determine whether dog visitation to trauma inpatients increased patient satisfaction scores with the trauma physicians. A team consisting of a dog and handler visited 150 inpatients on the trauma service. Patient satisfaction was measured using a preexisting internal tool for patients who had received dog visitation and compared with other trauma patients who had not received a visit. This study demonstrated that patient satisfaction on four of the five measured scores was more positive for the patients who had received a dog visit.

Patient life in hospital

DEFF Research Database (Denmark)

Ludvigsen, Mette Spliid

Patient life in hospital.A qualitative study of informal relationships between hospitalised patients Introduction Within a patientology framework, this PhD dissertation is about an empirical study on patient life that provides insight into the nature of informal relationships between patients...... are created through stories about three roughly framed aspects of hospitalisation: A. Being together with fellow patients entails a constant dilemma, B. Relationships between patients are restricted and extended and C. Shifting perspectives in solidarity. Conclusion Patients' hospitalisation is strongly...

Experiences of cancer patients in a patient navigation program: a qualitative systematic review.

Science.gov (United States)

Tan, Clarice Hwee Hoon; Wilson, Sally; McConigley, Ruth

2015-03-12

A patient navigation program is a model of care which entails trained personnel providing individualized and assistive care to adult oncology patients to help the patients overcome barriers. A further aim of the program is to achieve continuity of care as patients experience the complex healthcare system. Patient navigation is a new model of care in many institutions, and as such the experiences of patients in the patient navigation program remains inconclusive. The review seeks to understand the experiences of adult patients in patient navigation programs and how patient navigators impact the challenges patients encounter in the cancer care continuum. Participants of interest were adult cancer patients more than 18 years of age who are receiving or have received cancer care and are in a patient navigation program or had been in a hospital patient navigation program. Types of intervention(s)/phenomena of interest: The phenomenon of interest was the experiences of adult cancer patients who used patient navigation programs in hospital including how patient navigators impact on the challenges patients encounter in the cancer care continuum. Types of studies: This review considered studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, action research and exploratory studies. The review includes patient navigation programs within a hospital setting. Types of outcome: The review sought to understand the experiences of patients with cancer in patient navigation programs in the hospital. A three-step search strategy was used. An initial search to identify keywords was undertaken in PubMed and Science Direct followed by an expanded search using all identified keywords and index terms specific to each included database. The reference lists of included papers were then searched for any other relevant studies. Each paper was assessed independently by two reviewers for methodological quality using the Joanna

Comparing thrombin generation in patients with hemophilia A and patients on vitamin K antagonists.

Science.gov (United States)

de Koning, M L Y; Fischer, K; de Laat, B; Huisman, A; Ninivaggi, M; Schutgens, R E G

2017-05-01

Essentials It is unknown if hemophilia patients with atrial fibrillation need anticoagulation. Endogenous thrombin potentials (ETP) in hemophilia patients and patients on coumarins were compared. Severe hemophilia patients had comparable ETP to therapeutic international normalized ratio (INR). In non-severe hemophilia, 33% had higher ETP than therapeutic INR and may need anticoagulation. Click to hear Dr Negrier's perspective on global assays for assessing coagulation SUMMARY: Background It is unknown whether patients with hemophilia A with atrial fibrillation require treatment with vitamin K antagonists (VKAs) to the same extent as the normal population. Objective To compare hemostatic potential in hemophilia patients and patients on VKAs using thrombin generation (TG). Methods In this cross-sectional study, TG, initiated with 1pM tissue factor, was measured in 133 patients with severe (FVIII hemophilia A, 97 patients on a VKA with an international normalized ratio (INR) ≥ 1.5 and healthy controls. Endogenous thrombin potential (ETP) (nm*min) was compared according to FVIII level (hemophilia patients and patients on VKAs had lower median ETPs at 304 (196-449) and 176 (100-250), respectively. ETP was quite similar in severe hemophilia patients (185 [116-307]) and patients with a therapeutic INR (156 [90-225]). Compared with patients with therapeutic INR, ETP in patients with FVIII 1-19% and patients with FVIII 20-50% was higher at 296 (203-430) and 397 (219-632), respectively. All patients with therapeutic INR had an ETP hemophilia patients, 70% of patients with FVIII 1-19% and 52% of patients with FVIII 20-50% had an ETP hemophilia patients, TG was comparable to that in patients with a therapeutic INR. In one-third of non-severe hemophilia patients, TG was higher. These results suggest that anticoagulation therapy should be considered in a substantial proportion of non-severe hemophilia patients. © 2017 International Society on Thrombosis and Haemostasis.

Can patients report patient safety incidents in a hospital setting? A systematic review.

Science.gov (United States)

Ward, Jane K; Armitage, Gerry

2012-08-01

Patients are increasingly being thought of as central to patient safety. A small but growing body of work suggests that patients may have a role in reporting patient safety problems within a hospital setting. This review considers this disparate body of work, aiming to establish a collective view on hospital-based patient reporting. This review asks: (a) What can patients report? (b) In what settings can they report? (c) At what times have patients been asked to report? (d) How have patients been asked to report? 5 databases (MEDLINE, EMBASE, CINAHL, (Kings Fund) HMIC and PsycINFO) were searched for published literature on patient reporting of patient safety 'problems' (a number of search terms were utilised) within a hospital setting. In addition, reference lists of all included papers were checked for relevant literature. 13 papers were included within this review. All included papers were quality assessed using a framework for comparing both qualitative and quantitative designs, and reviewed in line with the study objectives. Patients are clearly in a position to report on patient safety, but included papers varied considerably in focus, design and analysis, with all papers lacking a theoretical underpinning. In all papers, reports were actively solicited from patients, with no evidence currently supporting spontaneous reporting. The impact of timing upon accuracy of information has yet to be established, and many vulnerable patients are not currently being included in patient reporting studies, potentially introducing bias and underestimating the scale of patient reporting. The future of patient reporting may well be as part of an 'error detection jigsaw' used alongside other methods as part of a quality improvement toolkit.

Self-transcendence and nurse-patient interaction in cognitively intact nursing home patients.

Science.gov (United States)

Haugan, Gørill; Rannestad, Toril; Hanssen, Brith; Espnes, Geir A

2012-12-01

The aim of this study was to test whether nurse-patient interaction affects cognitively intact nursing home patients' interpersonal and intrapersonal self-transcendence, as well as testing the psychometric properties of the Nurse-Patient Interaction Scale (NPIS). Self-transcendence is considered a spiritual developmental process of maturity in adulthood, and a vital resource of well-being at the end of life. The concept of self-transcendence has previously been explored in various populations, yet the nurse-patient interactions' potential influence on self-transcendence in nursing home patients has not been published previously. A cross-sectional design employing the Self-Transcendence Scale and the NPIS was adopted. A sample of 202 cognitively well-functioning nursing home patients in Norway was selected. The statistical analyses were carried out using lisrel 8.8 and structural equation modelling. Structural equation modelling-analysis indicates statistical significant effect of nurse-patient interaction on the patients' self-transcendence. Direct influence on the intrapersonal and indirect influence on the interpersonal self-transcendence aspects was disclosed. Nurse-patient interaction significantly affected both interpersonal and intrapersonal self-transcendence among cognitively intact nursing home patients. Hence, facilitating caring interventions can be significantly beneficial to older patients' self-transcendence and thereby well-being, both emotional and physical. Caring behaviour signifies the vital and ultimate qualitative nursing behaviour, which promotes self-transcendence and thereby well-being. These findings are important for clinical nursing that intends to increase patients' well-being. © 2012 Blackwell Publishing Ltd.

Patient perceptions of text-messages, email, and video in dermatologic surgery patients.

Science.gov (United States)

Hawkins, Spencer D; Barilla, Steven; Williford, Phillip Williford M; Feldman, Steven R; Pearce, Daniel J

2017-04-14

We developed dermatology patient education videos and a post-operative text message service that could be accessed universally via web based applications. A secondary outcome of the study was to assess patient opinions of text-messages, email, and video in the health care setting which is reported here. An investigator-blinded, randomized, controlled intervention was evaluated in 90 nonmelanoma MMS patients at Wake Forest Baptist Dermatology. Patients were randomized 1:1:1:1 for exposure to: 1) videos with text messages, 2) videos only, 3) text messages-only, or 4) standard of care. Assessment measures were obtained by the use of REDCap survey questions during the follow up visit. 1) 67% would like to receive an email with information about the procedure beforehand 2) 98% of patients reported they would like other doctors to use educational videos as a form of patient education 3) 88% of our patients think it is appropriate for physicians to communicate to patients via text message in certain situations. Nearly all patients desired physicians to use text-messages and video in their practice and the majority of patients preferred to receive an email with information about their procedure beforehand.

Factors Associated With Patient-perceived Hoarseness in Spasmodic Dysphonia Patients.

Science.gov (United States)

Hu, Amanda; Hillel, Al; Meyer, Tanya

2016-11-01

The American Academy of Otolaryngology-Head and Neck Surgery Clinical Practice Guidelines on Hoarseness distinguishes between hoarseness, which is a symptom perceived by the patient, and dysphonia, which is a diagnosis made by the clinician. Our objective was to determine factors that are associated with patient-perceived hoarseness in spasmodic dysphonia (SD) patients. Retrospective study. Adductor SD patients who presented for botulinum toxin injections from September 2011 to June 2012 were recruited. The main outcome variable, Voice Handicap Index-10 (VHI-10), was used to quantify patient-perceived hoarseness. Clinical data, Hospital Anxiety and Depression Scale (HADS), and VHI-10 were collected. Clinician-perceived dysphonia was measured by a speech-language pathologist with Consensus Auditory Perceptual Evaluation of Voice (CAPE-V). Statistical analysis included univariate analyses and multiple linear regression. One hundred thirty-nine SD patients had VHI-10 score of 26.0 ± 7.2 (mean ± standard deviation), disease duration of 10.5 + 7.0 years, CAPE-V overall score of 43.2 ± 21.8, HADS anxiety score of 6.7 ± 3.8, and HADS depression score of 3.6 ± 2.8. In univariate analyses, there were positive correlations (P dysphonia are associated with higher levels of patient-perceived hoarseness in SD patients. Hoarseness is a very personal symptom. Multiple factors determine its self-perception. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

The Relationships Between Doctor-Patient Affectionate Communication and Patient Perceptions and Outcomes.

Science.gov (United States)

Hesse, Colin; Rauscher, Emily A

2018-02-20

The current article combines the literature on doctor-patient communication and affectionate communication. Using Affection Exchange Theory (AET), the study predicts that the need for affection and the benefits of affectionate communication translate to the doctor-patient setting, proposing a series of relationships from both perceived doctor affectionate communication and affection deprivation to several patient outcome variables (patient perception of the doctor, patient communication with the doctor, and patient satisfaction/adherence). The results strongly supported the predictions for both affectionate communication and affection deprivation, with affectionate communication positively relating to most outcome measures and affection deprivation negatively relating to most outcome measures. Affection deprivation served as a moderator for the relationship between provider competence and patient satisfaction, although affectionate communication moderated the relationship between provider competence and patient adherence. Implications and possible directions for future research are discussed.

Patient data and patient rights: Swiss healthcare stakeholders' ethical awareness regarding large patient data sets - a qualitative study.

Science.gov (United States)

Mouton Dorey, Corine; Baumann, Holger; Biller-Andorno, Nikola

2018-03-07

There is a growing interest in aggregating more biomedical and patient data into large health data sets for research and public benefits. However, collecting and processing patient data raises new ethical issues regarding patient's rights, social justice and trust in public institutions. The aim of this empirical study is to gain an in-depth understanding of the awareness of possible ethical risks and corresponding obligations among those who are involved in projects using patient data, i.e. healthcare professionals, regulators and policy makers. We used a qualitative design to examine Swiss healthcare stakeholders' experiences and perceptions of ethical challenges with regard to patient data in real-life settings where clinical registries are sponsored, created and/or used. A semi-structured interview was carried out with 22 participants (11 physicians, 7 policy-makers, 4 ethical committee members) between July 2014 and January 2015. The interviews were audio-recorded, transcribed, coded and analysed using a thematic method derived from Grounded Theory. All interviewees were concerned as a matter of priority with the needs of legal and operating norms for the collection and use of data, whereas less interest was shown in issues regarding patient agency, the need for reciprocity, and shared governance in the management and use of clinical registries' patient data. This observed asymmetry highlights a possible tension between public and research interests on the one hand, and the recognition of patients' rights and citizens' involvement on the other. The advocation of further health-related data sharing on the grounds of research and public interest, without due regard for the perspective of patients and donors, could run the risk of fostering distrust towards healthcare data collections. Ultimately, this could diminish the expected social benefits. However, rather than setting patient rights against public interest, new ethical approaches could strengthen both

Identifying Patients at Risk and Patients in Need

DEFF Research Database (Denmark)

Schmidt, Thomas

2015-01-01

korttidssengeafsnit. Det viser sig at sygeplejerskernes anvendelse af patientmonitoreringsudstyret afhænger af tidspunkt på døgnet, og i hvilken sammenhæng systemet bruges. Behandling af patienter er udfordret af hvordan information indhentes og deles imellem klinikerne. Hyppigheden hvormed patienter monitoreres...

Salt lake Laguna de Fuente de Piedra (S-Spain) as Late Quaternary palaeoenvironmental archive

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Höbig, Nicole; Melles, Martin; Reicherter, Klaus

2014-05-01

This study deals with Late Quaternary palaeoenvironmental variability in Iberia reconstructed from terrestrial archives. In southern Iberia, endorheic basins of the Betic Cordilleras are relatively common and contain salt or fresh-water lakes due to subsurface dissolution of Triassic evaporites. Such precipitation or ground-water fed lakes (called Lagunas in Spanish) are vulnerable to changes in hydrology, climate or anthropogenic modifications. The largest Spanish salt lake, Laguna de Fuente de Piedra (Antequera region, S-Spain), has been investigated and serves as a palaeoenvironmental archive for the Late Pleistocene to Holocene time interval. Several sediment cores taken during drilling campaigns in 2012 and 2013 have revealed sedimentary sequences (up to 14 m length) along the shoreline. A multi-proxy study, including sedimentology, geochemistry and physical properties (magnetic susceptibility) has been performed on the cores. The sedimentary history is highly variable: several decimetre thick silty variegated clay deposits, laminated evaporites, and even few-centimetre thick massive gypsum crystals (i.e., selenites). XRF analysis was focussed on valuable palaeoclimatic proxies (e.g., S, Zr, Ti, and element ratios) to identify the composition and provenance of the sediments and to delineate palaeoenvironmental conditions. First age control has been realized by AMS-radiocarbon dating. The records start with approximately 2-3 m Holocene deposits and reach back to the middle of MIS 3 (GS-3). The sequences contain changes in sedimentation rates as well as colour changes, which can be summarized as brownish-beige deposits at the top and more greenish-grey deposits below as well as highly variegated lamination and selenites below ca. 6 m depth. The Younger Dryas, Bølling/Allerød, and the so-called Mystery Interval/Last Glacial Maximum have presumably been identified in the sediment cores and aligned to other climate records. In general, the cores of the Laguna de

A Patient-Specific Airway Branching Model for Mechanically Ventilated Patients

Directory of Open Access Journals (Sweden)

Nor Salwa Damanhuri

2014-01-01

Full Text Available Background. Respiratory mechanics models have the potential to guide mechanical ventilation. Airway branching models (ABMs were developed from classical fluid mechanics models but do not provide accurate models of in vivo behaviour. Hence, the ABM was improved to include patient-specific parameters and better model observed behaviour (ABMps. Methods. The airway pressure drop of the ABMps was compared with the well-accepted dynostatic algorithm (DSA in patients diagnosed with acute respiratory distress syndrome (ARDS. A scaling factor (α was used to equate the area under the pressure curve (AUC from the ABMps to the AUC of the DSA and was linked to patient state. Results. The ABMps recorded a median α value of 0.58 (IQR: 0.54–0.63; range: 0.45–0.66 for these ARDS patients. Significantly lower α values were found for individuals with chronic obstructive pulmonary disease (P<0.001. Conclusion. The ABMps model allows the estimation of airway pressure drop at each bronchial generation with patient-specific physiological measurements and can be generated from data measured at the bedside. The distribution of patient-specific α values indicates that the overall ABM can be readily improved to better match observed data and capture patient condition.

[Verbal patient information through nurses--a case of stroke patients].

Science.gov (United States)

Christmann, Elli; Holle, Regina; Schüssler, Dörte; Beier, Jutta; Dassen, Theo

2004-06-01

The article represents results of a theoretical work in the field of nursing education, with the topic: Verbal Patient Information through Nurses--A Case of Stroke Patients. The literature review and analysis show that there is a shortage in (stroke) patient information generally and a lack of successful concepts and strategies for the verbal (stroke) patient information through nurses in hospitals. The authors have developed a theoretical basis for health information as a nursing intervention and this represents a model of health information as a "communicational teach-and-learn process", which is of general application to all patients. The health information takes place as a separate nursing intervention within a non-public, face-to-face communication situation and in the steps-model of the nursing process. Health information is seen as a learning process for patients and nurses too. We consider learning as information production (constructivism) and information processing (cognitivism). Both processes are influenced by different factors and the illness-situation of patients, personality information content and the environment. For a successful health information output, it is necessary to take care of these aspects and this can be realized through a constructivational understanding of didactics. There is a need for an evaluation study to prove our concept of health information.

Validation of self assessment patient knowledge questionnaire for heart failure patients.

Science.gov (United States)

Lainscak, Mitja; Keber, Irena

2005-12-01

Several studies showed insufficient knowledge and poor compliance to non-pharmacological management in heart failure patients. Only a limited number of validated tools are available to assess their knowledge. The aim of the study was to test our 10-item Patient knowledge questionnaire. The Patient knowledge questionnaire was administered to 42 heart failure patients from Heart failure clinic and to 40 heart failure patients receiving usual care. Construct validity (Pearson correlation coefficient), internal consistency (Cronbach alpha), reproducibility (Wilcoxon signed rank test), and reliability (chi-square test and Student's t-test for independent samples) were assessed. Overall score of the Patient knowledge questionnaire had the strongest correlation to the question about regular weighing (r=0.69) and the weakest to the question about presence of heart disease (r=0.33). There was a strong correlation between question about fluid retention and questions assessing regular weighing, (r=0.86), weight of one litre of water (r=0.86), and salt restriction (r=0.57). The Cronbach alpha was 0.74 and could be improved by exclusion of questions about clear explanation (Chronbach alpha 0.75), importance of fruit, soup, and vegetables (Chronbach alpha 0.75), and self adjustment of diuretic (Chronbach alpha 0.81). During reproducibility testing 91% to 98% of questions were answered equally. Patients from Heart failure clinic scored significantly better than patients receiving usual care (7.9 (1.3) vs. 5.7 (2.2), p<0.001). Patient knowledge questionnaire is a valid and reliable tool to measure knowledge of heart failure patients.

Patient empowerment, patient participation and patient-centeredness in hospital care : A concept analysis based on a literature review

NARCIS (Netherlands)

Castro, E.M.; van Regenmortel, T.; Vanhaecht, K.; Sermeus, W.; van Hecke, A.

2016-01-01

Objectives The concepts of patient empowerment, patient participation and patient-centeredness have been introduced as part of the trend towards a more participatory health care and have largely been used interchangeably. Although these concepts have been discussed for a number of years, their exact

Displacing the Patient

DEFF Research Database (Denmark)

Pors, Anja Svejgaard

as an affective care recipient, as a citizen with rights and as an individual need-oriented user on the one hand. On the other hand, the goal of patient satisfaction also deploys market perceptions of patients as homogeneous target groups to which information can be standardised. In the latter (market orientation......), the patient is also a resource for organizational development and a customer with consumer behavior. Overall, the strategy presents an information-pursuing patient figure making it possible to streamline the organization's care orientation on market conditions. In contrast to Annemarie Mol’s dichotomy of care......The analysis is based on an empirical study of a hospital’s communication strategy entitled: 'The Perspective of the Patient'. The paper asks how the strategy organizes communication work as situated displacements of the patient. Based on methodological elements from situational analysis (Clarke...

Survey of a community-based infusion program for Australian patients with rheumatoid arthritis requiring treatment with tocilizumab: patient characteristics and drivers of patient satisfaction and patient-perceived benefits and concerns

Directory of Open Access Journals (Sweden)

Voight L

2012-04-01

Full Text Available Louisa VoightCoast Joint Care, Maroochydore, Queensland, AustraliaBackground: Tocilizumab is an effective therapy for patients with moderate to severe rheumatoid arthritis that is administered by infusion over one hour every 4 weeks. The community-based infusion (ACTiv program was introduced to Australia in August 2010 to provide accessible and convenient treatment for patients with rheumatoid arthritis who require tocilizumab. The primary objectives of this study were to determine the characteristics of patients in the ACTiv program, patient satisfaction, and patient-perceived benefits and concerns with the ACTiv program, and drivers of patient satisfaction and patient-perceived benefits and concerns.Methods: A voluntary self-administered survey was given to all 608 patients in the ACTiv program between January 27, 2011 and March 31, 2011.Results: A total of 351 surveys were returned completed, giving a response rate of 58% (351/608. Most patients in the ACTiv program were women aged 40–64 years, with a mean disease duration of 13.7 years and moderate disability, who had been in the ACTiv program for ≥5 months. Most patients (88%, 302/342 were either very satisfied or satisfied with the ACTiv program and believed that they were very unlikely or somewhat unlikely to switch from the ACTiv program (64%, 214/335. The most important benefit was the reassurance of receiving treatment from a trained nurse in a professional medical environment (33%, 102/309. The most important concern was the fear of side effects (48%, 134/280. The main drivers of patient satisfaction and patient-perceived benefits and concerns of patients were health profile, previous medication experience, and length of treatment time in the program.Conclusion: The ACTiv program is used by patients of various ages, family life situations, and locations. Patient satisfaction with the program is high, which enables patients to benefit from long-term use of tocilizumab

[QR-Code based patient tracking: a cost-effective option to improve patient safety].

Science.gov (United States)

Fischer, M; Rybitskiy, D; Strauß, G; Dietz, A; Dressler, C R

2013-03-01

Hospitals are implementing a risk management system to avoid patient or surgery mix-ups. The trend is to use preoperative checklists. This work deals specifically with a type of patient identification, which is realized by storing patient data on a patient-fixed medium. In 127 ENT surgeries data relevant for patient identification were encrypted in a 2D-QR-Code. The code, as a separate document coming with the patient chart or as a patient wristband, has been decrypted in the OR and the patient data were presented visible for all persons. The decoding time, the compliance of the patient data, as well as the duration of the patient identification was compared with the traditional patient identification by inspection of the patient chart. A total of 125 QR codes were read. The time for the decrypting of QR-Code was 5.6 s, the time for the screen view for patient identification was 7.9 s, and for a comparison group of 75 operations traditional patient identification was 27.3 s. Overall, there were 6 relevant information errors in the two parts of the experiment. This represents a ratio of 0.6% for 8 relevant classes per each encrypted QR code. This work allows a cost effective way to technically support patient identification based on electronic patient data. It was shown that the use in the clinical routine is possible. The disadvantage is a potential misinformation from incorrect or missing information in the HIS, or due to changes of the data after the code was created. The QR-code-based patient tracking is seen as a useful complement to the already widely used identification wristband. © Georg Thieme Verlag KG Stuttgart · New York.

The experiences of chronically ill patients and registered nurses when they negotiate patient care in hospital settings: a feminist poststructural approach: A qualitative study that explores negotiation of patient care between patients and chronically ill patients in hospital settings.

Science.gov (United States)

Griscti, Odette; Aston, Megan; Martin-Misener, Ruth; Mcleod, Deborah; Warner, Grace

2016-07-01

The aim of this study was to understand the experiences of chronically ill patients and registered nurse in negotiating patient care in hospital. Specifically, we explored how social and institutional discourses shaped power relations and negotiation of patient care. Current literature indicates that although nurses embrace this notion, such partnerships are not easily implemented. Most existing studies focus on the role of the nurse as the leader of the partnership with little attention paid to how social and institutional values, beliefs and practices shape nurse/patient power relations; or how these relationships are negotiated between nurses and patients. The theoretical and methodological approaches used in this study are based on the precepts of Foucault and feminist poststructural theorists. In depth interviews were conducted with eight chronically ill patients and 10 registered nurses. Both nurses and patients commented about the relationships that develop between nurses and chronically ill patients and how these relationships facilitate negotiation of patient care. Both parties described challenging moments and how institutional discourses may hinder positive negotiations of care. In this paper we highlight three themes that emerged: getting to know each other, they are not the sickest patients and finding time to listen. This study offers an innovative way of unpacking negotiation of care between chronically ill patients and registered nurses. It exposes how social and institutional discourses play a pivotal role in shaping negotiations between nurses and chronically ill patients. Negotiating care with chronically ill patients is not as asymmetric as portrayed in some of the literature and tends to be based on mutual agreements between nurses and patients. Nurses make it a point to listen to patients' needs and resist institutional discourses that preclude them from spending time with patients. © 2016 John Wiley & Sons Ltd.

Effect of the patient-to-patient communication model on dysphagia caused by total laryngectomy.

Science.gov (United States)

Tian, L; An, R; Zhang, J; Sun, Y; Zhao, R; Liu, M

2017-03-01

The study aimed to evaluate the effect of a patient-to-patient communication model on dysphagia in laryngeal cancer patients after total laryngectomy. Sixty-five patients who had undergone total laryngectomy were randomly divided into three groups: a routine communication group, a patient communication group (that received the patient-to-patient communication model) and a physician communication group. Questionnaires were used to compare quality of life and swallowing problems among all patient groups. The main factors causing dysphagia in total laryngectomy patients were related to fear and mental health. The patient communication group had improved visual analogue scale scores at one week after starting to eat. Quality of life in swallowing disorders questionnaire scores were significantly higher in the patient communication and physician communication groups than in the routine communication group. In addition, swallowing problems were much more severe in patients educated to high school level and above than in others. The patient-to-patient communication model can be used to resolve swallowing problems caused by psychological factors in total laryngectomy patients.

Patient education about cough: effect on the consulting behaviour of general practice patients.

Science.gov (United States)

Rutten, G; Van Eijk, J; Beek, M; Van der Velden, H

1991-07-01

The aim of this general practice study was to examine how the consulting behaviour of patients with a cough was affected when the tasks and responsibilities of patients, practice nurses and general practitioners were reorganized. In four 'average' single-handed general practices the effects on the consulting behaviour of patients of a rational practice policy on cough and the provision of systematic patient education on cough were compared with patient behaviour in four matched control practices. Changes of behaviour were measured in 548 patients who consulted for cough at least twice, in two successive autumn-winter periods. Significantly more patients in the experimental practice changed their behaviour to follow the practice guidelines than did patients in the control practices (56% versus 30%, P less than 0.001). The proportion of patients who continued to consult in the approved manner was greater among patients receiving intervention (66% versus 29%, P less than 0.001). This was equally true for patients who had suffered less than four episodes of cough or more than four episodes. The more often the patients received the education, the more effective it was. All patients who consulted the general practitioner for cough during the first autumn-winter period filled in a cough diary during the second period. From this it appeared that the intervention did not result in patients delaying consultation when they had a cough lasting longer than three weeks or one with 'serious' symptoms. It would appear that a rational practice policy and the provision of patient education can stimulate patients to modify their consulting behaviour. This could result in a reduction in the costs of health care.

Patient empowerment

DEFF Research Database (Denmark)

Eskildsen, Nanna Bjerg; Joergensen, Clara Ruebner; Thomsen, Thora Grothe

2017-01-01

Background There is an increased attention to and demand for patient empowerment in cancer treatment and follow-up programmes. Patient empowerment has been defined as feeling in control of or having mastery in relation to cancer and cancer care. This calls for properly developed questionnaires...... assessing empowerment from the user perspective. The aim of this review was to identify questionnaires and sub-scales measuring empowerment and manifestations of empowerment among cancer patients. Materials and methods We conducted a systematic search of the PubMed, PsycINFO and CINAHL databases....... Empowerment and multiple search terms associated with empowerment were included. We included peer-reviewed articles published in English, which described questionnaires measuring empowerment or manifestations of empowerment in a cancer setting. In addition, the questionnaire had to be a patient...

Hepatitis C Is Less Aggressive in Hemodialysis Patients than in Nonuremic Patients

Science.gov (United States)

Trevizoli, Jose Eduardo; de Paula Menezes, Raissa; Ribeiro Velasco, Lara Franciele; Amorim, Regina; de Carvalho, Mauro Birche; Mendes, Liliana Sampaio; Neto, Columbano Junqueira; de Deus Macedo, José Roberto; de Assis, Francisco; Neves, Rocha

2008-01-01

Background and objectives: The severity of liver disease among hepatitis C patients on hemodialysis is controversial. The aim of this study was to compare the clinical, biochemical, and liver histologic characteristics of hepatitis C virus (HCV) in hemodialysis patients and in those with normal renal function. Design, setting, participants, & measurements: A case-control study was carried out with 36 HCV patients on hemodialysis and 37 HCV patients with normal renal function matched for gender, age at infection, and estimated time of infection. Results: HCV patients on hemodialysis had lower levels of alanina aminotransferase and lower viral load. Hepatic fibrosis was significantly higher in the patients with normal renal function (73%) than in hemodialysis patients (47.2%, P < 0.025); the same was observed for inflammatory activity (control group 59.5% versus hemodialysis patients 27.7%, P = 0.003). In addition, the risk of tissue inflammation was four times lower in hemodialysis patients (odds ratio = 0.23, P < 0.004), and severe inflammatory activity on biopsy was the only independent risk factor for fibrosis (P < 0.001). Conclusions: The lower biochemical and inflammatory activities observed in hemodialysis patients suggest that hemodialysis and uremia may have a protective role against progression of the disease caused by HCV. PMID:18650408

76 FR 71345 - Patient Safety Organizations: Voluntary Relinquishment From Child Health Patient Safety...

Science.gov (United States)

2011-11-17

... Organizations: Voluntary Relinquishment From Child Health Patient Safety Organization, Inc. AGENCY: Agency for... notification of voluntary relinquishment from Child Health Patient Safety Organization, Inc. of its status as a Patient Safety Organization (PSO). The Patient Safety and Quality Improvement Act of 2005 (Patient Safety...

76 FR 79192 - Patient Safety Organizations: Voluntary Relinquishment From HSMS Patient Safety Organization

Science.gov (United States)

2011-12-21

... Organizations: Voluntary Relinquishment From HSMS Patient Safety Organization AGENCY: Agency for Healthcare... voluntary relinquishment from the HSMS Patient Safety Organization of its status as a Patient Safety Organization (PSO). The Patient Safety and Quality Improvement Act of 2005 (Patient Safety Act), Public Law 109...

Infrared-Guided Patient Setup for Lung Cancer Patients

International Nuclear Information System (INIS)

Lyatskaya, Yulia; James, Steven; Killoran, Joseph H.; Soto, Ricardo; Mamon, Harvey J.; Chin, Lee; Allen, Aaron M.

2008-01-01

Purpose: To evaluate the utility of an infrared-guided patient setup (iGPS) system to reduce the uncertainties in the setup of lung cancer patients. Methods and Materials: A total of 15 patients were setup for lung irradiation using skin tattoos and lateral leveling marks. Daily electronic portal device images and iGPS marker locations were acquired and retrospectively reviewed. The iGPS-based shifts were compared with the daily electronic portal device image shifts using both the central axis iGPS marker and all five iGPS markers. For shift calculation using the five markers, rotational misalignment was included. The level of agreement between the iGPS and portal imaging to evaluate the setup was evaluated as the frequency of the shift difference in the range of 0-5 mm, 5-10 mm, and >10 mm. Results: Data were obtained for 450 treatment sessions for 15 patients. The difference in the isocenter shifts between the weekly vs. daily images was 0-5 mm in 42%, 5-10 mm in 30%, and >10 mm in 10% of the images. The shifts seen using the iGPS data were 0-5 mm in 81%, 5-10 mm in 14%, and >10 mm in 5%. Using only the central axis iGPS marker, the difference between the iGPS and portal images was 10 mm in 7% in the left-right direction and 73%, 18%, and 9% in the superoinferior direction, respectively. When all five iGPS markers were used, the disagreements between the iGPS and portal image shifts >10 mm were reduced from 7% to 2% in the left-right direction and 9% to 3% in the superoinferior direction. Larger reductions were also seen (e.g., a reduction from 50% to 0% in 1 patient). Conclusion: The daily iGPS-based shifts correlated well with the daily electronic portal device-based shifts. When patient movement has nonlinear rotational components, a combination of surface markers and portal images might be particularly beneficial to improve the setup for lung cancer patients

Examining chronic care patient preferences for involvement in health-care decision making: the case of Parkinson's disease patients in a patient-centred clinic.

Science.gov (United States)

Zizzo, Natalie; Bell, Emily; Lafontaine, Anne-Louise; Racine, Eric

2017-08-01

Patient-centred care is a recommended model of care for Parkinson's disease (PD). It aims to provide care that is respectful and responsive to patient preferences, values and perspectives. Provision of patient-centred care should entail considering how patients want to be involved in their care. To understand the participation preferences of patients with PD from a patient-centred care clinic in health-care decision-making processes. Mixed-methods study with early-stage Parkinson's disease patients from a patient-centred care clinic. Study involved a modified Autonomy Preference Index survey (N=65) and qualitative, semi-structured in-depth interviews, analysed using thematic qualitative content analysis (N=20, purposefully selected from survey participants). Interviews examined (i) the patient preferences for involvement in health-care decision making; (ii) patient perspectives on the patient-physician relationship; and (iii) patient preferences for communication of information relevant to decision making. Preferences for participation in decision making varied between individuals and also within individuals depending on decision type, relational and contextual factors. Patients had high preferences for communication of information, but with acknowledged limits. The importance of communication in the patient-physician relationship was emphasized. Patient preferences for involvement in decision making are dynamic and support shared decision making. Relational autonomy corresponds to how patients envision their participation in decision making. Clinicians may need to assess patient preferences on an on-going basis. Our results highlight the complexities of decision-making processes. Improved understanding of individual preferences could enhance respect for persons and make for patient-centred care that is truly respectful of individual patients' wants, needs and values. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

CT-docking patient stretcher

International Nuclear Information System (INIS)

Mirvis, S.E.; Owens, E.; Maslyn, J.; Rizutto, M.

1990-01-01

This paper assesses the use of a patient stretcher that directly docks to a CT scanner for acutely injured and/or critically ill patients. The stretcher permits performance of radiography and acts as a platform for critical care monitoring and patient support devices. During a 1-year period, the prototype CT-docking stretcher was used for 35 patients sustaining acute trauma and 25 patients from critical care units. Observations were elicited from physicians, nurses and technologists concerning the advantages or disadvantages of the docking stretcher. Advantages of the CT-docking stretcher included time saved in moving patients to the CT table from the admitting/emergency ward, transfer of critically ill patients onto the stretcher in the controlled environment of the intensive care unit rather than the CT suite, increasing CT throughput by direct docking of the patient stretcher to the CT scanner rather than manual transfer of complex support and monitoring devices with the patient, decreased risk associated with physical movement of patients with potentially unstable spinal injuries or unstable physiologic status, and decrease in potential for injury to medical personnel performing patient transfer

PATIENT WEB PORTALS AND PATIENT-PROVIDER RELATIONSHIPS: A SUMMARY PERSPECTIVE.

Science.gov (United States)

Caldwell, Hannah D; Minkoff, Neil B; Murthy, Kalyani

2017-01-01

Patient Web portals (PWPs) have been gaining traction as a means to collect patient-reported outcomes and maintain quality patient care between office visits. PWPs have the potential to impact patient-provider relationships by rendering additional channels for communication outside of clinic visits and could help in the management of common chronic medical conditions. Studies documenting their effect in primary care settings are limited. This perspective aims to summarize the benefits and drawbacks of using PWPs in the management of chronic conditions, such as diabetes mellitus, hypertension, and asthma, focusing on communication, disease management, compliance, potential barriers, and the impact on patient-provider dynamic. After a review of these topics, we present potential future directions. We conducted an exploratory PubMed search of the literature published from inception through December 2015, and focused our subsequent searches specifically to assess benefits and drawbacks of using PWPs in the management of diabetes mellitus, hypertension, and asthma. Our search revealed several potential benefits of PWP implementation in the management of chronic conditions with regards to patient-provider relationships, such as improved communication, disease management, and compliance. We also noted drawbacks such as potentially unreliable reporting, barriers to use, and increased workload. PWPs offer opportunities for patients to report symptoms and outcomes in a timely manner and allow for secure online communication with providers. Despite the drawbacks noted, the overall benefits from successful PWP implementation could improve patient-provider relationships and help in the management of chronic conditions, such as diabetes mellitus, hypertension, and asthma.

Patients' perceptions of patient care providers with tattoos and/or body piercings.

Science.gov (United States)

Westerfield, Heather V; Stafford, Amy B; Speroni, Karen Gabel; Daniel, Marlon G

2012-03-01

This study evaluated patients' perceptions of patient care providers with visible tattoos and/or body piercings. As tattooing and body piercing are increasingly popular, research that informs nursing administrators regarding policies on patient care providers having visible tattoos and body piercings is warranted. A total of 150 hospitalized adult patients compared pictures of male and female patient care providers in uniform with and without tattoos and/or nonearlobe body piercings. Patient care providers with visible tattoos and/or body piercings were not perceived by patients in this study as more caring, confident, reliable, attentive, cooperative, professional, efficient, or approachable than nontattooed or nonpierced providers. Tattooed female providers were perceived as less professional than male providers with similar tattoos. Female providers with piercings were perceived as less confident, professional, efficient, and approachable than nonpierced female providers. Nursing administrators should develop and/or evaluate policies regarding patient care providers with visible tattoos and/or body piercings.

What is patient-centered care really? Voices of Hispanic prenatal patients.

Science.gov (United States)

Bergman, Alicia A; Connaughton, Stacey L

2013-01-01

Variations in patient-centered care (PCC) models and approaches contribute to ambiguity in how PCC is understood and defined, especially with regard to meeting the needs of diverse patient populations. One of the biggest challenges of putting PCC into practice is knowing what elements are the most important to patients. This qualitative study privileges patients' voices and adds a cultural dimension to existing health communication research on PCC through an empirical investigation of 48 Hispanic prenatal care patients' understandings and expectations of PCC. Semistructured interviews with 48 patients revealed five key themes in order of frequency: (a) una relación amable (a friendly relationship), (b) la atencion médica efectiva (effective medical care), (c) Español hablado (the Spanish language spoken), (d) comprensión de la información (understanding of information), and (e) eliminación del racismo (elimination of racism). The themes reflected several different assumptions and expectations with regard to PCC as compared to those espoused in many of the existing models and frameworks, such as the extent to which friendly interpersonal behaviors (e.g., smiling, making eye contact, displaying patience, and engaging in formal greetings, introductions, and farewells) were critical to patient satisfaction with the health care experience. Not only did patients feel better understood, but accompanied by friendly behaviors, information was viewed as more believable and accurate, and thus more patient-centered. The findings suggest that implementing culturally sensitive PCC approaches to caring for Hispanic prenatal care patients can include training health care staff on the importance of displaying friendly communicative behaviors such as smiling.

[Microalbuminuria in diabetic and hypertensive patients: a study of 979 patients].

Science.gov (United States)

Roberto Robles, Nicolás; Velasco, Joaquín; Mena, Cándido; Angulo, Enrique; Garrote, Timotea

2006-11-25

Microalbuminuria is a known complication of diabetes mellitus but it is also a cardiovascular risk factor commonly present among hypertensive (non diabetic) population. The prevalence of microalbuminuria is variable and it has been never estimated in our region. The aim of this study has been to determine the prevalence of microalbuminuria in hypertensive (non diabetic) and diabetic population in Extremadura (Spain). The study included diabetic patients and non-diabetic hypertensive ones randomly selected. Microalbuminuria was measured in every patient using albumin/creatinin reactive stick in fasting first morning urine. Whenever possible microalbuminuria was confirmed in laboratory by microalbuminuria/creatinina coefficient in first morning urine samples. A total of 979 patients (mean age [SD], 67.9 [10.8] years; 409 men and 570 women, 505 diabetics) were studied. The presence of microalbuminuria was found in 12.4% of hypertensive patients and in 21.4% of diabetic patients (p < 0.001). Hypertensives and normotensive diabetics showed a similar prevalence of microalbuminuria (13.3%, not significant), but it tripled in hypertensive diabetics (33.8; p < 0.01). Glicemic control was not different for microalbuminuric diabetic patients and non microalbuminuric ones. The patients receiving rennin-angiotensin axis blocking drugs do not showed less prevalence of microalbuminuria (hypertensives 10.5%, diabetics 23.5%). Microalbuminuria was confirmed in 65.4% of patients. The prevalence of microalbuminuria in Extremadura seems to be high either in diabetics or non diabetic hypertensive patients. The finding of microalbuminuria in diabetics patients correlates with hypertension but do not with glicemic control. The prevalence of microalbuminuria is high in spite of using rennin-angiotensin axis blocking drugs.

Development of a patient-reported outcome instrument for patients with lumbar radicular pain

OpenAIRE

Ibsen, Charlotte; Schiøttz-Christensen, Berit; Handberg, Charlotte; Nielsen, Claus Vinther; Hørder, Mogens; Maribo, Thomas

2017-01-01

Background Low back pain (LBP) is the leading cause to years lived with disability. 10–20% of patients with LBP experience radicular pain (lumbar radiculopathy). Patient-reported outcomes (PROs) play an important role in advancing patient-centered health care. Although patient involvement is essential to develop valid patient-centred PRO instruments patients are not always involved. The International Classification of Functioning, Disability and Health (ICF) are proposed to facilitate consist...

Patient safety in out-of-hours primary care: a review of patient records

Directory of Open Access Journals (Sweden)

Wensing Michel

2010-12-01

Full Text Available Abstract Background Most patients receive healthcare in primary care settings, but relatively little is known about patient safety. Out-of-hours contacts are of particular importance to patient safety. Our aim was to examine the incidence, types, causes, and consequences of patient safety incidents at general practice cooperatives for out-of-hours primary care and to examine which factors were associated with the occurrence of patient safety incidents. Methods A retrospective study of 1,145 medical records concerning patient contacts with four general practice cooperatives. Reviewers identified records with evidence of a potential patient safety incident; a physician panel determined whether a patient safety incident had indeed occurred. In addition, the panel determined the type, causes, and consequences of the incidents. Factors associated with incidents were examined in a random coefficient logistic regression analysis. Results In 1,145 patient records, 27 patient safety incidents were identified, an incident rate of 2.4% (95% CI: 1.5% to 3.2%. The most frequent incident type was treatment (56%. All incidents had at least partly been caused by failures in clinical reasoning. The majority of incidents did not result in patient harm (70%. Eight incidents had consequences for the patient, such as additional interventions or hospitalisation. The panel assessed that most incidents were unlikely to result in patient harm in the long term (89%. Logistic regression analysis showed that age was significantly related to incident occurrence: the likelihood of an incident increased with 1.03 for each year increase in age (95% CI: 1.01 to 1.04. Conclusion Patient safety incidents occur in out-of-hours primary care, but most do not result in harm to patients. As clinical reasoning played an important part in these incidents, a better understanding of clinical reasoning and guideline adherence at GP cooperatives could contribute to patient safety.

Patient choice modelling: how do patients choose their hospitals?

Science.gov (United States)

Smith, Honora; Currie, Christine; Chaiwuttisak, Pornpimol; Kyprianou, Andreas

2018-06-01

As an aid to predicting future hospital admissions, we compare use of the Multinomial Logit and the Utility Maximising Nested Logit models to describe how patients choose their hospitals. The models are fitted to real data from Derbyshire, United Kingdom, which lists the postcodes of more than 200,000 admissions to six different local hospitals. Both elective and emergency admissions are analysed for this mixed urban/rural area. For characteristics that may affect a patient's choice of hospital, we consider the distance of the patient from the hospital, the number of beds at the hospital and the number of car parking spaces available at the hospital, as well as several statistics publicly available on National Health Service (NHS) websites: an average waiting time, the patient survey score for ward cleanliness, the patient safety score and the inpatient survey score for overall care. The Multinomial Logit model is successfully fitted to the data. Results obtained with the Utility Maximising Nested Logit model show that nesting according to city or town may be invalid for these data; in other words, the choice of hospital does not appear to be preceded by choice of city. In all of the analysis carried out, distance appears to be one of the main influences on a patient's choice of hospital rather than statistics available on the Internet.

Putting patients first: a novel patient-centered model for medical enterprise success.

Science.gov (United States)

Dhawan, Naveen

2014-01-01

This article introduces a new way of viewing patient-customers. It encourages a greater emphasis on patients' needs and the importance of considering dimensions of the patient experience to better serve them. It also draws from examples in the general business world as they can be applied to medical enterprises. The author introduces a model that directs all business activities toward the end consumer with an underlying guidance by patient needs. A business is advised to understand its customer, design a patient-directed vision, and focus on creating a unique customer experience. The article delineates key action items for physicians and administrators that will allow them to better meet their patient-customers' needs and develop loyalty. By practicing a patient-centered approach and following these guidelines, one may ensure greater success of the medical enterprise.

Patient representatives' views on patient information in clinical cancer trials

DEFF Research Database (Denmark)

Dellson, Pia; Nilbert, Mef; Carlsson, Christina

2016-01-01

of future simplified and more attractive informed consent forms. CONCLUSIONS: The emotional and cognitive responses to written patient information reported by patient representatives provides a basis for revised formats in future trials and add to the body of information that support use of plain language......BACKGROUND: Patient enrolment into clinical trials is based on oral information and informed consent, which includes an information sheet and a consent certificate. The written information should be complete, but at the same time risks being so complex that it may be questioned if a fully informed...... consent is possible to provide. We explored patient representatives' views and perceptions on the written trial information used in clinical cancer trials. METHODS: Written patient information leaflets used in four clinical trials for colorectal cancer were used for the study. The trials included phase I...

Hereditary dentine disorders: dentinogenesis imperfecta and dentine dysplasia

Directory of Open Access Journals (Sweden)

MacKie Iain

2008-11-01

Full Text Available Abstract The hereditary dentine disorders, dentinogenesis imperfecta (DGI and dentine dysplasia (DD, comprise a group of autosomal dominant genetic conditions characterised by abnormal dentine structure affecting either the primary or both the primary and secondary dentitions. DGI is reported to have an incidence of 1 in 6,000 to 1 in 8,000, whereas that of DD type 1 is 1 in 100,000. Clinically, the teeth are discoloured and show structural defects such as bulbous crowns and small pulp chambers radiographically. The underlying defect of mineralisation often results in shearing of the overlying enamel leaving exposed weakened dentine which is prone to wear. Currently, three sub-types of DGI and two sub-types of DD are recognised but this categorisation may change when other causative mutations are found. DGI type I is inherited with osteogenesis imperfecta and recent genetic studies have shown that mutations in the genes encoding collagen type 1, COL1A1 and COL1A2, underlie this condition. All other forms of DGI and DD, except DD-1, appear to result from mutations in the gene encoding dentine sialophosphoprotein (DSPP, suggesting that these conditions are allelic. Diagnosis is based on family history, pedigree construction and detailed clinical examination, while genetic diagnosis may become useful in the future once sufficient disease-causing mutations have been discovered. Differential diagnoses include hypocalcified forms of amelogenesis imperfecta, congenital erythropoietic porphyria, conditions leading to early tooth loss (Kostmann's disease, cyclic neutropenia, Chediak-Hegashi syndrome, histiocytosis X, Papillon-Lefevre syndrome, permanent teeth discolouration due to tetracyclines, Vitamin D-dependent and vitamin D-resistant rickets. Treatment involves removal of sources of infection or pain, improvement of aesthetics and protection of the posterior teeth from wear. Beginning in infancy, treatment usually continues into adulthood with a

Patient representatives' views on patient information in clinical cancer trials.

Science.gov (United States)

Dellson, Pia; Nilbert, Mef; Carlsson, Christina

2016-02-01

Patient enrolment into clinical trials is based on oral information and informed consent, which includes an information sheet and a consent certificate. The written information should be complete, but at the same time risks being so complex that it may be questioned if a fully informed consent is possible to provide. We explored patient representatives' views and perceptions on the written trial information used in clinical cancer trials. Written patient information leaflets used in four clinical trials for colorectal cancer were used for the study. The trials included phase I-III trials, randomized and non-randomized trials that evaluated chemotherapy/targeted therapy in the neoadjuvant, adjuvant and palliative settings. Data were collected through focus groups and were analysed using inductive content analysis. Two major themes emerged: emotional responses and cognitive responses. Subthemes related to the former included individual preferences and perceptions of effect, while subthemes related to the latter were comprehensibility and layout. Based on these observations the patient representatives provided suggestions for improvement, which largely included development of future simplified and more attractive informed consent forms. The emotional and cognitive responses to written patient information reported by patient representatives provides a basis for revised formats in future trials and add to the body of information that support use of plain language, structured text and illustrations to improve the informed consent process and thereby patient enrolment into clinical trials.

Effects of Program and Patient Characteristics on Retention of Drug Treatment Patients.

Science.gov (United States)

Hser, Yih-Ing; Joshi, Vandana; Maglione, Margaret; Chou, Chih Ping; Anglin, M. Douglas

2001-01-01

Studied the effects of program and patient characteristics on patient retention in residential, out-patient, and methadone maintenance drug treatment programs. Data for 26,047 patients in 87 programs show that threshold retention rates were generally low for all 3 program types, although program practice and service provision played important…

Patients' evaluations of patient safety in English general practices: a cross-sectional study.

Science.gov (United States)

Ricci-Cabello, Ignacio; Marsden, Kate S; Avery, Anthony J; Bell, Brian G; Kadam, Umesh T; Reeves, David; Slight, Sarah P; Perryman, Katherine; Barnett, Jane; Litchfield, Ian; Thomas, Sally; Campbell, Stephen M; Doos, Lucy; Esmail, Aneez; Valderas, Jose M

2017-07-01

Description of safety problems and harm in general practices has previously relied on information from health professionals, with scarce attention paid to experiences of patients. To examine patient-reported experiences and outcomes of patient safety in primary care. Cross-sectional study in 45 general practices across five regions in the north, centre, and south of England. A version of the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) questionnaire was sent to a random sample of 6736 patients. Main outcome measures included 'practice activation' (what a practice does to create a safe environment); 'patient activation' (how proactive are patients in ensuring safe healthcare delivery); 'experiences of safety events' (safety errors); 'outcomes of safety' (harm); and 'overall perception of safety' (how safe patients rate their practice). Questionnaires were returned by 1244 patients (18.4%). Scores were high for 'practice activation' (mean [standard error] = 80.4 out of 100 [2.0]) and low for 'patient activation' (26.3 out of 100 [2.6]). Of the patients, 45% reported experiencing at least one safety problem in the previous 12 months, mostly related to appointments (33%), diagnosis (17%), patient provider communication (15%), and coordination between providers (14%). Twenty-three per cent of the responders reported some degree of harm in the previous 12 months. The overall assessment of level of safety of practices was generally high (86.0 out of 100 [16.8]). Priority areas for patient safety improvement in general practices in England include appointments, diagnosis, communication, coordination, and patient activation. © British Journal of General Practice 2017.

disease patient

Directory of Open Access Journals (Sweden)

Setareh Mamishi

2016-09-01

Full Text Available Background and Purpose: Chronic granulomatous disease (CGD is an inherited disorder of the nicotinamide adenine dinucleotide phosphate (NADPH oxidase complex. This disorder results in recurrent life-threatening bacterial and fungal infections. Aspergillus species are the most common fungal infections in these patients. Case Report: Herein, we present a case of fungal infection in a girl with CGD. We confirmed aspergillosis through the positive microscopic and macroscopic examinations, as well as radiology results. Invasive aspergillosis in this patient with pneumonia, lung abscess, and osteomyelitis of the ribs was not initially treated with amphotericin B (Am B and recombinant interferon-gamma. Conclusion: Among infectious diseases, fungal infections, in particular aspergillosis, remain a serious problem in CGD patients. Considering poor clinical response and deficient immune system, rapid diagnosis of fungal infection and optimizing the treatment of these patients are recommended.