Walijee, Hussein; Al-Hussaini, Ali; Harris, Andrew; Owens, David
There are a multitude of techniques to undertake tonsillectomy, with hot techniques such as diathermy and coblation being associated with a higher risk of secondary haemorrhage. The UK National Prospective Tonsillectomy Audit (2004) advocated cold steel dissection and ties to be the gold standard. This prospective observational study investigates the trends in tonsillectomy techniques across Wales in the last decade to establish if surgeons have adhered to this national guidance. Data relating to tonsillectomy were extracted over a 10-year period from 1 January 2003 to 31 December 2012 from the Wales Surgical Instrument Surveillance Programme database. A total of 19,195 patients were included. Time-series analysis using linear regression showed there was an increase in the number of bipolar diathermy tonsillectomies by 84% (Pearson's r = 0.762, p = 0.010) and coblation tonsillectomies by 120% (r = 0.825, p = 0.003). In contrast, there was a fall in the number of cold steel dissection tonsillectomies with ties by 60% (r = −0.939, p < 0.001). This observational study suggests that the use of bipolar and coblation techniques for tonsillectomy has increased. This deviation from national guidance may be due to these techniques being faster with less intraoperative bleeding. Further study for the underlying reasons for the increase in these techniques is warranted. PMID:26693228
Krontveit, Randi I; Trangerud, Cathrine; Nødtvedt, Ane; Dohoo, Ian; Moe, Lars; Sævik, Bente K
The aim of the study was to measure the effect of radiological hip and elbow dysplasia status and breed on overall survival in a cohort of four large dog breeds in Norway. Privately owned dogs of the Newfoundland (NF), Labrador Retriever (LR), Leonberger (LEO), and Irish Wolfhound (IW) breeds were followed prospectively from birth to 10 years of age. The age of death/euthanasia was registered. A total of 501 dogs from 103 litters were enrolled. Kaplan-Meier survival curves were used to describe breed differences in survival times. The effects of radiological hip and elbow dysplasia status as well as breed were assessed using a Cox proportional hazards model. The variables 'sex' and 'living region' were explored as potential confounders. Among LRs, 60.2% of the dogs were still alive at 10 years of age, and the corresponding figures for NFs, LEOs, and IWs were 28.8%, 16.11%, and 6.4%, respectively. Radiological hip dysplasia status and breed were found to influence overall survival. Two different time-varying effects were observed in that with the IW the hazard of death increased linearly through time, while the effect of severe radiological hip dysplasia decreased logarithmically with time. Location influenced the death hazard and dogs living in suburban areas or cities had longer mean time to death and a lower hazard compared to dogs living in the countryside. Radiological elbow dysplasia status was not found to have an effect on overall survival. PMID:22093911
Moraschini, V; Poubel, L A da C; Ferreira, V F; Barboza, E dos S P
The aim of this systematic review was to evaluate the survival and success rates of osseointegrated implants determined in longitudinal studies that conducted a follow-up of at least 10 years. A broad electronic search was conducted in MEDLINE/PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) for relevant publications in indexed journals, evaluating the clinical performance of dental implants. Using inclusion and exclusion criteria, two reviewers analyzed titles, abstracts, and complete articles, prioritizing studies of the randomized clinical trial type. A total of 23 articles were included in this review. Ten prospective studies, nine retrospective studies, and four randomized clinical trials, which evaluated 7711 implants, were selected. The mean follow-up time of the studies included was 13.4 years. All of the studies reported survival rates and mean marginal bone resorption values, with cumulative mean values of 94.6% and 1.3mm, respectively. Fourteen studies related success rates. Taking into consideration the disparate outcome measures employed to assess dental implant performance and within the limitations of this systematic review, we may affirm that osseointegrated implants are safe and present high survival rates and minimal marginal bone resorption in the long term. PMID:25467739
Gabre, P; Martinsson, T; Gahnberg, L
The aim of the study was to investigate the reasons for, and incidence of, tooth mortality over a 10-year period in mentally retarded adults receiving regular dental care. The number of teeth present in 115 individuals (mean age in 1984 was 41.0, range 19-83 years) was registered in 1984 and 1994. The reasons for tooth mortality, medication utilization, frequency of dental care visits and cooperation during dental treatment were registered and related to tooth loss. The average incidence of tooth mortality was 3.72 teeth during the 10-year period. The mean number of dental care visits per year was 6.6. Most of the 428 teeth (58%) were lost due to periodontal disease. The preventive dental care given was not sufficient to arrest oral diseases. The data indicate, however, that achievement of cooperation in dental care situations not only makes dental treatment possible, but also leads to a decreased incidence of tooth mortality. PMID:10207537
O'Dell, Sean M.; Vilardo, Brigid A.; Kern, Lee; Kokina, Anastasia; Ash, Allison N.; Seymour, Kimberly J.; Castrantas, Lauren M.; Kollar, Rachel B.; Wagner, Andrea M.; Bartholomew, Audrey; Thomas, Lisa B.
In 2008, the "Journal of Positive Behavior Interventions" ("JPBI") celebrated 10 years in publication. As the flagship journal of positive behavior support (PBS), it is important to periodically examine the research published in "JPBI" to determine whether it reflects the basic principles of PBS, to explore the ways in which PBS is being…
Shahbazi, Fatemeh; Ranjbaran, Mehdi; Karami-far, Simin; Soori, Hamid; Manesh, Hadi Jafari
Background: Kidney transplantation is a preferred treatment for many patients with end-stage renal disease (ESRD) and is far more profitable than hemodialysis. Analyzing renal transplantation data can help to evaluate the effectiveness of transplantation interventions. The aim of this study was to determine the organ survival rate after kidney transplantation during a period of 10 years (March 2001-March 2011) among transplanted patients in Arak, Markazi Province, Iran. Materials and Methods: In this historical cohort study, all recipients of kidney transplantation from Arak, Markazi Province, Iran who had medical records in Valiasr Hospital and “charity for kidney patients” of Arak, Markazi Province, Iran during a period of 10 years from March 2001 to March 2011 were included. Data collected by using checklists were completed from patients’ hospital records. Kaplan-Meier method was used to determine the graft cumulative survival rate, log-rank test to compare survival curves in subgroups, and Cox regression model to define the hazard ratio and for ruling out the intervening factors. Statistical analysis was conducted by Statistical Package for the Social Sciences (SPSS) 20 and Stata 11. Results: Mean duration of follow-up was 55.43 ± 42.02 months. By using the Kaplan-Meier method, the cumulative probability of graft survival at 1, 3, 5, 7, and 10 years was 99.1, 97.7, 94.3, 85.7, and 62.1%, respectively. The number of dialysis by controlling the effect of other variables had a significant association with the risk of graft failure [hazard ratios and 95% confidence interval (CI): 1.47 (1.02-2.13)]. Conclusion: This study showed that the graft survival rate was satisfactory in this community and was similar to the results of single-center studies in the world. Dialysis time after transplantation was a significant predictor of survival in the recipients of kidney transplantation that should be considered. PMID:26941807
Is it time to bring the “Parent” into the prevention of parent to child transmission programs in India? A study of trends over a 10-year period in a prevention of parent to child transmission clinic in India
Shiradkar, Swati; Mande, Shubhangi; Bapat, Gauri; Setia, Maninder Singh
Objectives: The present study evaluated the changes in serology and human immunodeficiency virus (HIV) testing behaviors over a 10-year period in a center in India. Methods: We used clinical data collected at the antenatal clinic from 2002 to 2011. The key outcomes were: (1) Proportion of women who opted for HIV test and those who tested positive; (2) proportion of male partners who came in for HIV test and those who tested positive; and (3) proportion of women who opted for continuation of pregnancy or for medical termination of pregnancy. Results: We tested 11,452 women for HIV over the 10-year period from 2002 to 2011. The proportion of women who opted for HIV testing was 72.0% (95% confidence interval [CI]: 70.7–73.4%). The acceptance of test increased from 35.9% (95% CI: 31.7–40.4%) in 2002 to the peak of 82.6% (95% CI: 78.6–86.8%) in 2009 (P < 0.001). The overall HIV prevalence over the decade was 0.70% (95% CI: 0.55–0.87%). The prevalence high at 1.11% (95% CI: 0.23–3.24%) in 2002 and reduced to 0.37% (95% CI: 0.12–0.87%) in 2011 (P < 0.001). Only 0.57% of male partners tested for HIV over this time period. Conclusion: Strategies to improve acceptance of testing in pregnant women should be included in the Indian guidelines. The male partners do not get tested. Thus, this component needs to be strengthened - by targeted interventions for male spouses - to make the program more effective. PMID:27190414
Voas, Robert B.; Tippetts, A. Scott; Grosz, Milton
Background Interlocks reduce driving-under-the-influence (DUI) recidivism by 64%, but offenders resist installing them, preferring to risk driving while their driver’s licenses are revoked. One method of motivating offenders to install an interlock is require it for reinstatement of their driver’s license. This report updates an earlier evaluation of the administrative reinstatement interlock program (ARIP) procedure implemented in Florida in 2002. Method Driver records and interlock program records covering 120,000 DUI offenders were followed over 10 years. The flow through the sanction system—conviction, reinstatement, interlock program, and postinterlock period—is described. Logistical regression was used to identify the characteristics of offenders who installed interlocks, and survival analysis was used to evaluate the recidivism of offenders in the various stages in the ARIP. Results At any given time, approximately one third of the convicted offenders were serving their license-revocation periods. Half of the offenders who completed their revocation periods remain unqualified for reinstatement because they do not fulfill other requirements. ARIP offenders who do qualify for reinstatement and install interlocks have lower recidivism rates while the devices are on their vehicles. Conclusions After 10 years, Florida’s ARIP is a mature system that succeeds in forcing all offenders in the program who qualify for reinstatement to install an interlock for at least 6 months. However, half of all offenders who complete their mandatory revocation period are either unable to, or choose not to, qualify for reinstatement. PMID:23442206
Prasher, V.; Gomez, G.
Background: The natural history of thyroid function in adults with Down syndrome (DS) is unknown. Method: This study investigated annual thyroid function tests in 200 adults with DS over a 10-year period. Results: Transient and persistent thyroid dysfunction was common. The 5- and 10-year incidence of definite hypothyroidism was 0.9%-1.64% and…
A 10-year study was conducted to focus on the impact of soil and climatic factors governing herbicide volatilization from an agricultural field. For the first 5 years, metolachlor [2-chloro-N-(2-ethyl-6-methylphenyl)-N-(2-methoxy-1-methylethyl) acetamide] and atrazine [6-chloro-N-ethyl-N’-(1-methyl...
Volatilization of pesticides can detrimentally affect the environment by contaminating soil and surface waters far away from where the pesticides were applied. A 10-year study was conducted to focus on the impact of soil and climatic factors governing herbicide volatilization from an agricultural f...
Thong, Meow-Keong; Bazlin, R I Raja; Wong, Kum-Thong
Clinical data on Duchenne muscular dystrophy (DMD) are lacking in developing countries. The objective of this study was to delineate the demographic characteristics, investigations, and outcome of 21 Malaysian males diagnosed with DMD over a period of 10 years. Mean age presentation was 3 years 8 months (SD 23mo; range 10 to 84mo), mean duration from first presentation to diagnosis was 3y 7mo (SD 26mo; range 5 to 84) and the mean age for loss of ambulation was 11 years (SD 25mo; range 102 to 168). There was family history of DMD in five of the 21 patients. Muscle biopsy showed confirmatory findings of DMD in the 16 patients tested. Molecular genetic analysis showed dystrophin gene deletions in 11 of these 16 patients. Four and seven of the students stopped schooling and had learning difficulties, respectively; only nine had satisfactory school performances. Eight out of 14 patients evaluated were classified as having severe to total dependency levels on the modified Barthel Index for activities of daily living assessment. DMD is associated with significant medical and social needs for a developing country such as Malaysia. Earlier referral, genetic counselling, and provision of support and rehabilitative services are the main priorities. PMID:15991868
Jang, Yong Hyun; Park, Kyung Hea; Kim, Sang Lim; Lim, Hyun Jung; Lee, Weon Ju; Lee, Seok-Jong
Background Alopecia areata (AA) is an organ-specific autoimmune disease that typically occurs in young adults. AA in the elderly is relatively rare, thus little data have been reported. Objective This study aimed to understand the clinical characteristics of AA in the elderly. Methods We performed a 10-year retrospective study of AA in the elderly who visited our dermatologic clinic from January 2002 to December 2011. A clinical review of medical records and telephone interviews were performed by two dermatologists. Results Among 1,761 patients with newly diagnosed AA, 61 (3.5%) were older than 60 years at the first visit. Among those who completed a telephone interview, 74.3% (26/35) had less than 50% of scalp-localized hair loss. There was no association between the extent of AA and hair graying (p=0.679). Favorable therapeutic response was observed in 62.9% (22/35) of cases. Conclusion AA in the elderly shows mild disease severity and favorable treatment response. There is no association between graying and the extent of AA. However, the influence of aging on the pathogenesis of AA in the elderly deserves further investigation. PMID:26273157
Fluker, J L
A 10-year survey is presented of male cases of homosexually acquired infection seen between 1962 and 1971 at Charing Cross Hospital (West London Branch). Tables showing the number of cases of syphilis, gonorrhea, and other conditions in homosexual and heterosexual males and in females are considered. Tables of other relevant data are also presented. The reasons underlying the changes illustrated, including the Act legalizing homosexual practices between consenting adult males, which became effective in 1968, are discussed. Certain pathological conditions apparently connected with homosexual practices, such as serum hepatitis, local rectal disease, and mucous colitis, are included and also some relevant manifestations of herpes genitalis and genitral warts. Homosexually acquired infection in prisoners is described. Some of the psychiatric effects of homosexuality on clinic patients and also their fears of treatment at clinics are considered, as well as the behavioral differences in response to infection between exclusively homosexuals, bi-sexuals, and married homosexuals. PMID:946948
Ray, Charles E. Gupta, Rajan; Blackwell, John
< 0.001), the primary field of investigation, with significant increases noted for primary cancer interventions (6.5% vs. 13.3%; p < 0.001), gynecologic interventions (0.2% vs. 4.5%; p < 0.001), stent-grafts (0 vs. 2.9%; p < 0.001), and spine interventions (0 vs. 1.8%; p < 0.01). Studies receiving funding also demonstrated a significant increase when comparing the early and late data sets (11.3% vs. 23.0%, respectively; p < 0.001). Conclusions. Articles published in the American radiologic literature have changed significantly over the past 10 years. Primary authors are more likely to be nonradiologists and less likely to be American. Investigations dealing primarily with nonvascular interventions are less common; however, some forms of intervention (particularly cancer interventions) are seen more frequently in the literature. The percentage of funded projects has more than doubled in the same time frame.
Mock, Steven E; Eibach, Richard P
We examined reports of sexual orientation identity stability and change over a 10-year period drawing on data from the National Survey of Midlife Development in the United States (MIDUS I and II) and tested for three patterns: (1) heterosexual stability, (2) female sexual fluidity, and (3) bisexual fluidity. Fifty-four percent of the 2,560 participants were female and the average age was approximately 47 years. At Wave 1, 2,494 (97.42%) reported a heterosexual identity, 32 (1.25%) a homosexual identity, and 34 (1.33%) a bisexual identity and somewhat more than 2% reported a different sexual orientation identity at Wave 2. Although some support for each hypothesis was found, initial sexual orientation identity interacted with gender to predict a more complex pattern. For the sample as a whole, heterosexuality was the most stable identity. For women, bisexuality and homosexuality were equally unstable and significantly less stable than heterosexuality, suggesting that sexual orientation identity fluidity is a pattern that applies more to sexual minority women than heterosexual women. For men, heterosexuality and homosexuality were both relatively stable compared to bisexuality, which stood out as a particularly unstable identity. This pattern of results was consistent with previous findings and helps to address methodological limitations of earlier research by showing the characteristics of a population-based sample of heterosexual, homosexual, and bisexual identified men and women over time. PMID:21584828
Shao, Lei; Newell, Brandon
Abnormalities in the hair can be congenital or acquired conditions. Examples of genetic disorders with associated hair abnormalities include Menkes syndrome, Netherton syndrome, uncombable hair syndrome, trichothiodystrophy, and loose anagen hair syndrome. Acquired hair abnormalities can be associated with grooming or use of various hair products. There are many patterns of hair abnormalities that can be readily identified under a light microscope. We performed a retrospective review of 129 hair mount samples from 119 patients submitted to the pathology department for microscopic examination over a 10-year span (from January 2002 to December 2011). Of the 119 patients, 63 (53%) had morphologic changes in the hair samples. Thirty-seven patients (31%) showed morphologic changes compatible with specific diagnoses of various genetic conditions, including 25 cases of loose anagen hair syndrome, 6 cases of uncombable hair syndrome, 2 cases of Netherton syndrome, 3 cases of Menkes syndrome, and 1 case of trichothiodystrophy. The other changes were considered nonspecific or nondiagnostic, with trichorrhexis nodosa in 13 patients, presence of loose anagen hairs in 12 patients, and pili torti in 1 patient. We describe the light microscopic patterns of hair abnormalities, clinical findings, and molecular defects related to those genetic conditions. Our study indicates that hair examination can be a 1st-line investigation on various pediatric conditions. PMID:24251687
... study suggests. The study found that seniors who got moderate to intense exercise retained more of their ... the next five years, versus older adults who got light exercise or none at all. On average, ...
Chadeganipour, Mostafa; Mohammadi, Rasoul; Shadzi, Shahla
Dermatophyte infections are very common worldwide and their epidemiological characteristics vary according to the geographical region and have altered in the last decades. The aim of the present investigation was to determine the diversity of causative agents of dermatophytoses and describe the epidemiological condition of infection in Isfahan, Iran, between 2003 and 2012. Specimens were collected from hair, nail, and skin and were examined by conventional methods such as direct microscopy, culture on sabouraud dextrose agar with chloramphenicol and cycloheximide (Mycosel agar) and sabouraud glucose agar, Trichophyton agars, growth on rice grains, urease test, and hair perforation test. Of 13,469 clinically suspected cases, 11.5% were affected with dermatophytoses. Tinea capitis was the most frequent form of infection (52.7%), followed by tinea corporis (24%), tinea pedis (8.9%). Trichophyton verrucosum was the most prevalent causative agent (40.6%), followed by T. mentagrophytes var. interdigitale (17.6%), Epidermophyton floccosum (13%), T. violaceum (12%), T. rubrum (4.1%). Age range of patients was between 1 and 80 years. Housewives were the most patients in our study. The study emphasizes importance of epidemiological surveys of dermatophyte species for the better management of infection. PMID:25902908
Simmons, W K; Simeon, D T; Bramble, D; Buffonge, C; Gallagher, P
Anemia during pregnancy is associated with adverse outcomes including maternal and perinatal mortality. However, health education and other public health strategies seeking to reduce its prevalence have usually met with only limited success. The study reported here surveyed anemia of pregnancy on the island of Montserrat in 1980, 1985, and 1990. This involved examination of clinic and hospital records for over 90% of all women giving birth on Montserrat in 1980 and 1985, as well as 80% of those giving birth in 1990. This examination showed a dramatic reduction in the prevalence of anemia at the time of the first prenatal visit (a drop from 82% of the study women in 1980 to 23% in 1985 and 19% in 1990) and also a marked drop at three days postpartum (from 91% in 1980 to 41% in 1985 and 39% in 1990). Logistic regression analyses indicated that after controlling for three possible confounding factors (maternal age, parity, and weeks of gestation at first prenatal visit) the difference between the risk of developing anemia during pregnancy in 1980 as compared to 1985 or 1990 was still highly significant. The reasons for the observed drop in anemia's prevalence during the survey period are not entirely clear, partly because of the retrospective nature of the study. However, better nutrition resulting from improvement in the standard of living on Montserrat during the survey period could have been important, as could changes in health education and food supplementation activities. PMID:8919721
Badran, Eman F; Al Baramki, Jumana H; Al Shamyleh, Abdulqader; Shehabi, Asem; Khuri-Bulos, Najwa
This retrospective study includes all newborn patients with culture proved candidaemia who were admitted to the neonatal intensive care unit of Jordan University Hospital through the period January 1995 to June 2006. Among 24 patients included, 13 (54.2%) died. The incidence of candidaemia was 0.27%, the mean age at diagnosis 25.9 d and the mean gestational age at birth 34.6 weeks. Species most frequently isolated were Candida albicans (50%) and C. krusei (20%). Previous gastrointestinal pathology was present in 41.7% of the cases. A comparison of cases due to C. albicans with those due to other species of Candida revealed no statistical differences in terms of demographic factors, age at onset of disease, mortality, clinical manifestations or risk factors. Based on our results, empirical antifungal therapy should be considered in neonates who have gastrointestinal pathology and other risk factors. PMID:17852924
Liu, Hui; Fero, Jutta B; Mendez, Melissa; Carpenter, Beth M; Servetas, Stephanie L; Rahman, Arifur; Goldman, Matthew D; Boren, Thomas; Salama, Nina R; Merrell, D Scott; Dubois, Andre
Helicobacter pylori from different individuals exhibits substantial genetic diversity. However, the kinetics of bacterial diversification after infection with a single strain is poorly understood. We investigated evolution of H. pylori following long-term infection in the primate stomach; Rhesus macaques were infected with H. pylori strain USU101 and then followed for 10 years. H. pylori was regularly cultured from biopsies, and single colony isolates were analyzed. At 1-year, DNA fingerprinting showed that all output isolates were identical to the input strain; however, at 5-years, different H. pylori fingerprints were observed. Microarray-based comparative genomic hybridization revealed that long term persistence of USU101 in the macaque stomach was associated with specific whole gene changes. Further detailed investigation showed that levels of the BabA protein were dramatically reduced within weeks of infection. The molecular mechanisms behind this reduction were shown to include phase variation and gene loss via intragenomic rearrangement, suggesting strong selective pressure against BabA expression in the macaque model. Notably, although there is apparently strong selective pressure against babA, babA is required for establishment of infection in this model as a strain in which babA was deleted was unable to colonize experimentally infected macaques. PMID:25804332
Olsavszky, R; Rycroft, R J; White, I R; McFadden, J P
It has been argued that for chromate sensitivity to be reduced, then ferrous sulfate should be added to cement. This has not yet been done in the UK. To explore this further, we have looked at the comparative sensitization rates of patients attending the St. John's Institute of Dermatology Contact Dermatitis Clinic between the years 1982-3 and 1992-3. Patch-test-positive rates for females were not significantly different between the 2 populations studied (1982-3, 1.59% and 1992-3, 1.99% p NS). Similarly, there was no significantly different rate between the males (1982-3, 3.99% and 1992-3, 4.25% p NS) in the same time period. There was no difference in the distribution of eczema in chromate-positive subjects, nor of cobalt co-sensitization, a crude indicator of sensitization via cement. This work demonstrates no appreciable difference in the frequency of chromate sensitivity between the early 1980s and 1990s in London. Adding ferrous sulfate to cement may help to lower the frequency in the future. PMID:9687032
Primo, Neudí Antonio; Gazzola, Vivian Bertoglio; Primo, Bruno Tochetto; Tovo, Maximiano Ferreira; Faraco Junior, Italo Medeiros
Objective This study aimed at describing the profiles of Brazilian and international studies published in orthodontic journals. Methods The sample comprised 635 articles selected from two scientific journals, i.e., Dental Press Journal of Orthodontics and American Journal of Orthodontics and Dentofacial Orthopedics, which were analyzed at three different intervals over a 10-year period (1999 - 2004 - 2009). Articles were described in terms of knowledge domain, study design, and country of origin (or state of origin for Brazilian papers). Results The most frequent study designs adopted in international studies were cohort (23.9%) and cross-sectional (21.7%) designs. Among Brazilian papers, cross-sectional studies (28.9%) and literature reviews (24.6%) showed greater frequency. The topics most often investigated were dental materials (17%) and treatment devices (12.4%) in international articles, with the latter topic being addressed by 16% of the Brazilian publications, followed by malocclusion, with 12.6%. In all cases, the most frequent countries of origin coincided with the countries of origin of each journal. Conclusions The majority of the studies analyzed featured a low level of scientific evidence. Moreover, the findings showed that journals tend to publish studies produced in their own country of origin, and that there are marked discrepancies in the number of papers published by different Brazilian states. PMID:24945515
Salmela-Aro, Katariina; Nurmi, Jari-Erik
To examine how self-esteem measured during university studies would impact on the characteristics of the work career 10 years later, 297 university students completed the Rosenberg's self-esteem inventory four times while at university and various career-related questionnaires 10 years later. Latent Growth Curve Modeling showed that a high overall…
Backround Functional and cosmetic defects in the maxillofacial region are caused by various ailments and these defects are addressed according to their need. Simplicity of procedure, intact facial function and esthetic outcome with the least possible donor site morbidity are the minimum requirements of a good reconstruction. Oro-mandibular reconstruction, although a challenge for the head and neck reconstructive surgeon, is now reliable and highly successful with excellent long-term functional and aesthetic outcomes with the use of autogenous bone grafts. Reconstruction of trauma- or mandibular oncologic defects with bony free flaps is considered the gold standard. However the the optimal reconstruction of mandibular defects is still controversial in regards to reconstructive options which include the donor site selection and the timing of surgery. The purpose of this study was to determine the outcome of different osseous reconstruction options using autogenous bone grafts for mandibular reconstructions. Methods This study was carried out on 178 patients with mandibular bone defects. They were reconstructed with autogenous bone grafts from different donor sites. At post operative visits they were evaluated for functional and cosmetic results. Results The success rate found in this study was around 90%. Only 7.6% of the cases showed poor results regarding facial contours and mouth opening. All other patients were satisfied with their cosmesis and mouth opening at the recipient sites was in the normal range during last follow-up visits. Donor sites were primarily closed in all cases and there was no hypertrophic scar. Conclusion Based on this study, autogenous bone grafts are a reliable treatment modality for the reconstruction of mandibular bone defects with predictable aesthetic and functional outcomes. As the free vascularized fibular flap has the least resorption and failure rate, it should be the first choice for most cases of mandiblular reconstruction. PMID
Yayan, Josef; Ghebremedhin, Beniam; Rasche, Kurt
Background Staphylococci can cause wound infections and community- and nosocomial-acquired pneumonia, among a range of illnesses. Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) have been rapidly increasing as a cause of infections worldwide in recent decades. Numerous reports indicate that S. aureus and MRSA are becoming resistant to many antibiotics, which makes them very dangerous. Therefore, this study retrospectively investigated the resistance to antimicrobial agents in all hospitalized patients suffering from community- or nosocomial-acquired pneumonia due to S. aureus and MRSA. Methods Information from the study groups suffering from either community- or nosocomial-acquired pneumonia caused by S. aureus or MRSA was gathered by searching records from 2004 to 2014 at the HELIOS Clinic Wuppertal, Witten/Herdecke University, Germany. The findings of antibiotic resistance were analyzed after the evaluation of susceptibility testing for S. aureus and MRSA. Results Total of 147 patients (63.9%, 95% CI 57.5%–69.8%), mean age 67.9 ± 18.5 years, with pneumonia triggered by S. aureus, and 83 patients (36.1%, 95% CI 30.2%–42.5%), mean age 72.3 ± 13.8 years, with pneumonia due to MRSA. S. aureus and MRSA developed no resistance to vancomycin (P = 0.019 vs. < 0.0001, respectively) or linezolid (P = 0.342 vs. < 0.0001, respectively). MRSA (95.3%) and S. aureus (56.3%) showed a high resistance to penicillin. MRSA (87.7%) was also found to have a high antibiotic resistance against ß-lactam antibiotics, compared to S. aureus (9.6%). Furthermore, MRSA compared to S. aureus, respectively, had increased antibiotic resistance to ciprofloxacin (90.1% vs. 17.0%), cefazolin (89.7% vs. 10.2%), cefuroxime (89.0% vs. 9.1%), levofloxacin (88.2% vs. 18.4%), clindamycin (78.0% vs. 14.7%), and erythromycin (76.5% vs. 20.8%). Conclusion No development of resistance was found to vancomycin and linezolid in patients with pneumonia caused by S. aureus and MRSA. PMID
Madanian, H.; Cravens, T.; Richard, M. S.; Edberg, N. J. T.; Westlake, J. H.; Wahlund, J. E.; Waite, J. H., Jr.; Perryman, R.
Titan hosts the most chemically complex atmosphere in the solar system. The first encounter of the Cassini spacecraft with Titan was in October 2004 with a closest approach altitude of 1147km. Since then the Cassini has made measurements of the ionospheric species over multiple flybys and has provided a unique opportunity to study long term effects on Titan's ionosphere including solar activity cycle. It has been shown that solar extreme ultraviolet radiation is the main source of ion production and production rates are highly dependent on solar zenith angle. We use data from the ion and Neutral Mass Spectrometer (INMS) and the Radio and Plasma Wave Science-Langmuir probe (RPWS-LP) instruments onboard the Cassini spacecraft to investigate changes in the ion composition of the ionosphere. We compare the observations with the results of our ionospheric models. Data from 21 targeted Titan flybys are used, covering the declining phase of solar cycle 23 into the double peak of solar cycle 24. We show that the ion densities have in fact increased during the high solar activity, especially at altitudes near the ionospheric peak, and unlike Earth, the Titan's thermosphere is contracted during high solar activity. Charge neutrality is assumed near the peak of the ionosphere, however difference exists between INMS total ion densities and RPWS-LP electron densities and it becomes more noticeable at high solar activity. This may be for several reasons including enhanced negative ion densities and increased electron recombination rates. The model results agree reasonably well with the in-situ measurements for most ion species at low and high solar activity conditions although overproduction exists for some ions (e.g. HCNH+) and underproduction is seen for some heavier species such as C7H7+.
Ramkumar, Prem N; Farber, Joseph; Arnouk, Johnny; Varner, Kevin E; Mcculloch, Patrick C
Ballet dancers are high-performance athletes who are particularly susceptible to a wide variety of musculoskeletal injuries. However, they are relatively understudied, and data on their injury rates are lacking. This retrospective study features the largest aggregate data on professional ballet dancers to date and aims to identify the most common diagnoses and areas of injury in this unique population to better direct preventative and clinical practices. The study encompassed a 10-year period from January 2000 to December 2010 of dancers from a single company. Data regarding the dancers' age, gender, location of injury, and diagnosis were collected from workers' compensation claims, company records, and medical records maintained by the treating doctors. These were analyzed to determine metrics on injury incidence, frequency, and diagnosis. Over the 10-year span, 574 injuries occurred. There were approximately 52 dancers per year for a total of 153 who danced at least one complete season during the study period. The average age was 27, and 53% were female. Given turnover with retirement and replacements, the total number of dancer-years was 520, indicating an injury incidence per annum of 1.10 (574 injuries per 520 dancer-years). The most common locations of injury were foot and ankle and the lumbar spine, with the three most common diagnoses making up greater than a third (37%) of the total. As the current largest study in professional ballet, the findings set the benchmark metrics for musculoskeletal injury to the foot, ankle, and lumbar spine sites. Future studies should aim to identify injury risk factors and modalities for prevention of these injuries. PMID:27025450
Dygrýn, Jan; Mitáš, Josef; Gába, Aleš; Rubín, Lukáš; Frömel, Karel
Active commuting (AC) to school represents a great opportunity to incorporate walking or cycling into adolescents’ everyday routine. The objective of the study was to describe changes in AC in Czech adolescents across a 10-year period in different built environments. Data from the 2001 and 2011 Czech Census of Population and Housing were used to examine the mode of transportation taken to school in 6236 adolescents. Changes in AC over time were analyzed for low and high walkable areas separately in two Czech regional cities, Olomouc and Hradec Králové. Between 2001 and 2011, the proportion of adolescents actively commuting to school decreased by 47%, from an absolute rate of 49.1% to 26%. The proportion of active commuters fell in low walkable areas by 61% and in high walkable areas by 39%. The results indicated that adolescents in 2011 were 2.7 times less (OR = 0.365, p < 0.001) likely to actively commute than in 2001. The AC behavior in Czech adolescents has a negative tendency to replicate travel-to-school patterns in adolescents previously described in more developed countries. The findings might serve as a recommendation for municipal policy. PMID:26501304
Dygrýn, Jan; Mitáš, Josef; Gába, Aleš; Rubín, Lukáš; Frömel, Karel
Active commuting (AC) to school represents a great opportunity to incorporate walking or cycling into adolescents' everyday routine. The objective of the study was to describe changes in AC in Czech adolescents across a 10-year period in different built environments. Data from the 2001 and 2011 Czech Census of Population and Housing were used to examine the mode of transportation taken to school in 6236 adolescents. Changes in AC over time were analyzed for low and high walkable areas separately in two Czech regional cities, Olomouc and Hradec Králové. Between 2001 and 2011, the proportion of adolescents actively commuting to school decreased by 47%, from an absolute rate of 49.1% to 26%. The proportion of active commuters fell in low walkable areas by 61% and in high walkable areas by 39%. The results indicated that adolescents in 2011 were 2.7 times less (OR = 0.365, p < 0.001) likely to actively commute than in 2001. The AC behavior in Czech adolescents has a negative tendency to replicate travel-to-school patterns in adolescents previously described in more developed countries. The findings might serve as a recommendation for municipal policy. PMID:26501304
Stojadinović, Saša; Svrkota, Igor; Petrović, Dejan; Denić, Miodrag; Pantović, Radoje; Milić, Vitomir
Mining, especially underground coal mining, has always been a dangerous occupation. Injuries, unfortunately, even those resulting in death, are one of the major occupational risks that all miners live with. Despite the fact that all workers are aware of the risk, efforts must be and are being made to increase the safety of mines. Injury monitoring and data analysis can provide us with valuable data on the causes of accidents and enable us to establish a correlation between the conditions in the work environment and the number of injuries, which can further lead to proper preventive measures. This article presents the data on the injuries in Serbian coal mines during a 10-year period (2000-2009). The presented results are only part of an ongoing study whose aim is to assess the safety conditions in Serbian coal mines and classify them according to that assessment. PMID:21920518
Piraccini, Bianca Maria; Triantafyllopoulou, Ioanna; Prevezas, Christos; Starace, Michela; Neri, Iria; Patrizi, Annalisa; Caserini, Maurizio; Palmieri, Renata; Rigopoulos, Dimitrios
Purpose of the Study Our aim was to perform an extensive search of the literature on the prevalence of nail psoriasis in the pediatric population and to estimate it on our own database. Procedures Searching the most important databases yielded results of 16 papers published in a 40-year period which reported the prevalence of nail psoriasis in children. Furthermore, data gathered between 2004 and 2013 at two centers specialized in nail disorders were analyzed. Results The selected papers encompassed a total of 4,853 psoriatic children, of whom 762 (15.7%) had nail involvement. Concerning our data, a total of 68,839 children were seen in pediatric skin consultation in both clinics over a period of 10 years, 0.11% of which had nail involvement. The rate of psoriatic children presenting nail alterations was 19.4% in the Greek and 15.5% in the Italian patient groups. Conclusions and Message This is the retrospective study including the largest number of cases of nail psoriasis in the pediatric population. Our data are in line with the incidence estimation of the rest of Europe. PMID:27172521
Daumit, Gail L.; Goff, Donald C.; Meyer, Jonathan M.; Davis, Vicki G.; Nasrallah, Henry A.; McEvoy, Joseph P.; Rosenheck, Robert; Davis, Sonia M.; Hsiao, John K.; Stroup, T. Scott; Lieberman, Jeffrey A.
Objective Persons with schizophrenia die earlier than the general population, in large part due to cardiovascular disease. The study objective was to examine effects of different antipsychotic treatments on estimates of 10 year coronary heart disease (CHD) risk calculated by the Framingham Heart Study formula. Method Change in ten-year risk for CHD was compared between treatment groups in 1125 patients followed for 18 months or until treatment discontinuation in the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Schizophrenia Trial. Results The covariate-adjusted mean change in 10-year CHD risk differed significantly between treatments. Olanzapine was associated with a 0.5% (SE 0.3) increase and quetiapine, a 0.3% (SE 0.3) increase; whereas risk decreased in patients treated with perphenazine, −0.5% (SE 0.3), risperidone, −0.6% (SE 0.3), and ziprasidone −0.6% (SE 0.4). The difference in 10-year CHD risk between olanzpaine and risperidone was statistically significant (p=0.004). Differences in estimated 10 year CHD risk between drugs were most marked in the tertile of subjects with a baseline CHD risk of at least 10%. Among individual CHD risk factors used in the Framingham formula, only total and HDL cholesterol levels differed between treatments. Conclusions These results indicate that the impact on 10-year CHD risk differs significantly between antipsychotic agents, with olanzapine producing the largest elevation in CHD risk of the agents studied in CATIE. PMID:18775645
Castillo, Jose M.; Curtis, Michael J.; Tan, Sim Yin
Concerns regarding whether a sufficient supply of school psychologists exists have been evident for decades. Studies have predicted that school psychology would face a critical personnel shortage that would peak in 2010, but continue into the foreseeable future. The current study is a 10-year follow-up investigation based on previously published…
Ferreira, Joaquim Armando; Santos, Eduardo J. R.; Fonseca, Antonio C.; Haase, Richard F.
This paper presents empirical findings from a 10-year longitudinal study of the educational and occupational socialization of 445 participants who were about 7 years old when first tested, and about 17 years old at the fourth time of measurement. In addition to collecting psychological measurements from the participants, behavioral reports were…
Lopes, Victor; Vasques, Catarina Margarida Silva; de Oliveira Pereira, Maria Beatriz Ferreira Leite
The aims of this study were to characterize the spontaneous physical activity of children during school recess, and to estimate variation in physical activity associated with gender and age. A MTI actigraph (Model 7164) was used with a sample of 140 boys and 131 girls, 6 to 10 years of age. MTI counts were converted to METs using a regression…
Fatemi Naeini, Farahnaz; Sadeghiyan, Hamidreza; Pourazizi, Mohsen; Najafian, Jamshid; Abtahi-Naeini, Bahareh
Background. Primary cutaneous T-cell lymphomas (CTCLs) are a group of extranodal non-Hodgkin lymphomas that may be present in the skin without any evidence of extracutaneous disease. The aim of this study was to evaluate the epidemiological characteristics of primary CTCL in Isfahan, Iran. Method. A total of 95 patients who were diagnosed as having primary CTCL were recruited during a 10-year period (2003–2013) and were classified according to the new WHO-EORTC criteria. Results. The patient group consisted of 43 (44.8%) males and 53 (55.2%) females, which indicated a female predominance (M : F ratio 1 : 1.2). The mean age at the time of diagnosis was 41.78 ± 16.88 years (range: 7–84 years). Prior to diagnosis, the lesions had persisted for a mean of 8.34 ± 4.38 years (range: 0–55 years). The age at peak diagnosis was 20–40 years (43%). The most frequent subtypes were mycosis fungoides (MF) (88.5%). Four patients died from CTCL-related complications. Conclusions. The distinguishing epidemiologic characteristics of primary CTCL, particularly those MF, in Iran, are the absence of a male predominance and lower age at diagnosis. This is likely because of the characteristic ethnic group diversity and increased susceptibility among younger population.
He, Fanggang; Li, Liliang; Bynum, Jennifer; Meng, Xiangzhi; Yan, Ping; Li, Ling; Liu, Liang
Medical disputes in China are historically poorly documented. In particular, autopsy-based evaluation and its impact on medical malpractice claims remain largely unstudied. This study aims to document autopsy findings and medical malpractice in one of the largest cities of China, Wuhan, located in Hubei Province. A total of 519 autopsies were performed by the Department of Forensic Medicine, Wuhan University School of Medicine, Wuhan, China, over a 10-year period between 2004 and 2013. Of these cases, 190 (36.6%) were associated with medical malpractice claims. Joint evaluation by forensic pathologists and clinicians confirmed that 97 (51.1%) of the 190 claims were approved medical malpractice cases. The percentage of approved malpractice cases increased with patient age and varied according to medical setting, physician specialty, and organ system. The clinico-pathological diagnostic discrepancy was significantly different among various physician specialties (P = 0.031) and organ systems (P = 0.000). Of those cases involved in malpractice claims, aortic dissection, coronary heart disease, and acute respiratory infection were most common. Association between incorrect diagnosis and malpractice was significant (P = 0.001). This is the first report on China's medical malpractice and findings at autopsy which reflects the current state of health care services in one of the biggest cities in China. PMID:26559306
Klein, Daniel N.; Kotov, Roman
The course of depressive disorders can vary considerable, with some individuals exhibiting a chronic course and poor outcomes, while others have a more episodic course and better outcomes. However it is unclear whether degree of chronicity is continuous or reflects qualitatively distinct subgroups. Using data from a 5-wave, 10-year, naturalistic study of 127 depressed outpatients, we examined whether depression chronicity lies on a continuum or manifests natural boundaries. Spline regression was used to test 7 continuous and discontinuous models of the relationship between depression during the first follow-up interval and multiple outcomes at subsequent follow-ups. In order to further validate the findings, we also created empirically-derived subgroups based on the results of the spline regression analyses and compared them on baseline clinical characteristics and long-term outcomes. There was a clear and consistent discontinuity indicating that for higher levels of chronicity during the first 30 month period, depression was linearly related to outcome; in contrast, for lower levels of chronicity, depression in the initial interval was unrelated to subsequent outcomes. The findings were strikingly consistent across the 4 follow-up evaluations using multiple outcomes and goodness-of-fit indices. In addition, the chronic group--as defined by the first follow-up period--exhibited more baseline chronic depression, anxiety and personality disorders, family history of dysthymia, and childhood adversity, and was more likely to attempt suicide and be hospitalized during follow-up, than the non-chronic group. Results suggest that there are qualitatively distinct classes of patients with more and less chronic depressions, and support the utility of longitudinal course as a means of parsing depression into more homogeneous subgroups. PMID:26845258
Klein, Daniel N; Kotov, Roman
The course of depressive disorders can vary considerable, with some individuals exhibiting a chronic course and poor outcomes, while others have a more episodic course and better outcomes. However, it is unclear whether degree of chronicity is continuous or reflects qualitatively distinct subgroups. Using data from a 5-wave, 10-year, naturalistic study of 127 depressed outpatients, we examined whether depression chronicity lies on a continuum or manifests natural boundaries. Spline regression was used to test 7 continuous and discontinuous models of the relationship between depression during the first follow-up interval and multiple outcomes at subsequent follow-ups. In order to further validate the findings, we also created empirically derived subgroups based on the results of the spline regression analyses and compared them on baseline clinical characteristics and long-term outcomes. There was a clear and consistent discontinuity indicating that for higher levels of chronicity during the first 30-month period, depression was linearly related to outcome; in contrast, for lower levels of chronicity, depression in the initial interval was unrelated to subsequent outcomes. The findings were strikingly consistent across the 4 follow-up evaluations using multiple outcomes and goodness-of-fit indices. In addition, the chronic group-as defined by the first follow-up period-exhibited more baseline chronic depression, anxiety and personality disorders, family history of dysthymia, and childhood adversity, and was more likely to attempt suicide and be hospitalized during follow-up, than the nonchronic group. Results suggest that there are qualitatively distinct classes of patients with more and less chronic depressions, and support the utility of longitudinal course as a means of parsing depression into more homogeneous subgroups. (PsycINFO Database Record PMID:26845258
Brennan, Penny L.; Schutte, Kathleen K.; Moos, Rudolf H.
This study examines the extent of group-level and intra-individual decline in alcohol consumption among adults as they traverse a 10-year interval spanning late-middle to early-old age. Further, it identifies key baseline predictors of these adults' 10-year drinking trajectories. Community residents (n=1,291; age 55 to 65 at baseline) were assessed at 4 points over a 10-year interval on demographic and health characteristics, coping responses, social context, and alcohol consumption. Descriptive cross-wave statistics, and multilevel regression analyses, indicated that in the sample overall, participants' 10-year patterns of alcohol consumption were relatively stable. However, men's patterns, and those of individuals drinking beyond recommended alcohol consumption guidelines at baseline, were more variable and showed steeper rates of decline, than did those of women and individuals drinking within recommended levels. Contrary to expectation, baseline use of substances to reduce tension and heavier reliance on avoidance coping predicted faster rate of decline in alcohol consumption. Post-hoc prospective mediation analyses suggested that this may have occurred because these and other baseline predictors heighten risk of developing new health problems which, in turn, motivate reduced alcohol consumption. PMID:20565151
Gilkinson, K.; King, E. L.; Li, M. Z.; Roddick, D.; Kenchington, E.; Han, G.
A previous study on the effects of experimental hydraulic clam dredging on seabed habitat and commercial bivalve populations revealed a lack of recovery after a 3-year post-dredging period (1998-2001) on a deep (65-75 m) offshore sandy bank on the Scotian Shelf, Canada. Follow-up sidescan sonar surveys were carried out 5 and 10 years after dredging (2003, 2008) in order to identify long-term processes of seabed recovery. Grab sampling was carried out 10 years after dredging to identify post-dredging commercial bivalve recruitment. Changes in the seafloor, including dredge tracks, were documented with a series of 7 sidescan sonar surveys between 1998 and 2008. A sediment mobility model was constructed based on modeled tidal current and hindcast wave data over this time period to quantify natural seabed disturbance and interpret changes to the dredge tracks mapped by sidescan sonar surveys. The model indicated that tidal currents had minimal effect on sediment mobilization. The main driving force associated with re-working of surficial sediments as evidenced by deterioration of dredge tracks in sonograms was annual fall/winter storms. While the annual frequency of storms and associated wave heights was variable, the observations and sediment mobility calculations suggest that the most influential variable is the magnitude of individual large storms, specifically storms with a significant wave height of ∼11 m. These storms are capable of generating mobile sediment layers of 20-30 cm thickness, equivalent to the dredge blade cutting depth. It appears that, with minor exceptions, sediment properties have returned to pre-dredging conditions 10 years after dredging in this habitat. Based on known age-length relationships, the four commercial bivalve species showed very low recruitment at the experimental site over the 10-year post-dredging period. However, this is unlikely due to a dredging effect since a similar pattern was observed in non-dredged areas.
Sunish, I P; Kalimuthu, M; Rajendran, R; Munirathinam, A; Ashok Kumar, V; Nagaraj, J; Tyagi, B K
The National Programme for the Elimination of Lymphatic Filariasis is underway in the endemic districts of Tamil Nadu State, South India, since 2001. Annual mass drug administration (MDA) was carried out by the state health department to all eligible individuals. The impact of MDAs on transmission parameters was evaluated in 2 revenue blocks, viz, one with DEC alone and the other with a combination of albendazole. After 10 years with 6 annual MDAs, the transmission indices reached low levels in both treatment arms, but still persisted. However, the DEC alone arm showed higher transmission rates, compared to the DEC+ALB arm. Few villages which demonstrated persistent transmission need to be targeted with an additional control measure viz, vector control, to achieve LF elimination. It is evident from the 10 year period of the study that inclusion of albendazole along with DEC has significantly reduced the transmission indices to almost nil level, as compared to DEC alone. PMID:25205435
Szaflarski, Jerzy P.; Altaye, Mekibib; Rajagopal, Akila; Eaton, Kenneth; Meng, XiangXiang; Plante, Elena; Holland, Scott K.
Comprehension of spoken narratives requires coordination of multiple language skills. As such, for normal children narrative skills develop well into the school years and, during this period, are particularly vulnerable in the face of brain injury or developmental disorder. For these reasons, we sought to determine the developmental trajectory of narrative processing using longitudinal fMRI scanning. 30 healthy children between the ages of 5 and 18 enrolled at ages 5, 6, or 7, were examined annually for up to 10 years. At each fMRI session, children were presented with a set of five, 30s–long, stories containing 9, 10, or 11 sentences designed to be understood by a 5 year old child. FMRI data analysis was conducted based on a hierarchical linear model (HLM) that was modified to investigate developmental changes while accounting for missing data and controlling for factors such as age, linguistic performance and IQ. Performance testing conducted after each scan indicated well above the chance (p < 0.002) comprehension performance. There was a linear increase with increasing age in bilateral superior temporal cortical activation (BA 21 and 22) linked to narrative processing. Conversely, age-related decreases in cortical activation were observed in bilateral occipital regions, cingulate and cuneus, possibly reflecting changes in the default mode networks. The dynamic changes observed in this longitudinal fMRI study support the increasing role of bilateral BAs 21 and 22 in narrative comprehension, involving non-domain-specific integration in order to achieve final story interpretation. The presence of a continued linear development of this area throughout childhood and teenage years with no apparent plateau, indicates that full maturation of narrative processing skills has not yet occurred and that it may be delayed to early adulthood. PMID:22951258
Wallenhorst, Christopher; McFerran, Don; Hall, Deborah A.
Objective: To investigate the incidence of tinnitus that burdens the health service in England. Design: This was an observational study of 4.7 million residents of England under 85 years of age who were at risk for developing clinically significant tinnitus (sigT). SigT was defined by a discharge from hospital with a primary diagnosis of tinnitus, or a primary care recording of tinnitus with subsequent related medical follow-up within 28 days. The database used was the Clinical Practice Research Datalink and individual records were linked to additional data from the Hospital Episode Statistics. The observational period was from January 1, 2002 to December 31, 2011. Age-, gender-, and calendar year-specific incidence rates for and cumulative incidences of sigT were estimated and a projection of new cases of sigT between 2012 and 2021 was performed. Results: There were 14,303 incident cases of sigT identified among 26.5 million person-years of observation. The incidence rate was 5.4 new cases of sigT per 10,000 person-years (95% confidence interval: 5.3 to 5.5). The incidence rate did not depend on gender but increased with age, peaking at 11.4 per 10,000 in the age group 60 to 69 years. The annual incidence rate of sigT increased from 4.5 per 10,000 person-years in 2002 to 6.6 per 10,000 person-years in 2011. The 10-year cumulative incidence of sigT was 58.4 cases (95% confidence interval: 57.4 to 59.4) per 10,000 residents. Nearly 324,000 new cases of sigT are expected to occur in England between 2012 and 2021. Conclusions: Tinnitus presents a burden to the health care system that has been rising in recent years. Population-based studies provide crucial underpinning evidence; highlighting the need for further research to address issues around effective diagnosis and clinical management of this heterogeneous condition. PMID:25470370
Al-Maawali, Almundher; Blaser, Susan; Yoon, Grace
Hereditary ataxias associated with cerebellar atrophy are a heterogeneous group of disorders. Selection of appropriate clinical and genetic tests for patients with cerebellar atrophy poses a diagnostic challenge. Neuroimaging is a crucial initial investigation in the diagnostic evaluation of ataxia in childhood, and the presence of cerebellar atrophy helps guide further investigations. We performed a detailed review of 300 patients with confirmed cerebellar atrophy on magnetic resonance imaging over a 10-year period. A diagnosis was established in 47% of patients: Mitochondrial disorders were most common, followed by the neuronal ceroid lipofuscinoses, ataxia telangectasia, and late GM2-gangliosidosis. We review the common causes of cerebellar atrophy in childhood and propose a diagnostic approach based on correlating specific neuroimaging patterns with clinical and genetic diagnoses. PMID:22764178
Tan, Ngiap Chuan; Nguyen, Hai V; Lye, Weng Kit; Sankari, Usha; Nadkarni, Nivedita V
Research on asthma costs often focuses on estimating average asthma costs. Trends in asthma costs and patterns of medication use, especially for those who have been followed up and under treatment, have received much less attention. This study's objective was to document asthma costs over time for asthma patients who are enrolled in an asthma care programme in Singapore and to identify its predictors, using a 10-year longitudinal dataset.The study population comprised different cohorts of 939 asthma patients entering the programme at different times during 2004-2013. Average asthma costs were estimated and the trends over time examined graphically, within and across patient cohorts. Regression analyses were conducted to examine cost predictors, with a focus on the relationship between risk factors at programme enrolment and subsequent asthma costs.The results indicate that 10-year average annual asthma cost was GBP 341 per patient. The main drivers of costs were asthma medications and consultation fees. Use of combined inhaled corticosteroid/long-acting β-agonist medications increased over time, but this was accompanied by declines in controller drug use, doctor visits and total asthma drug costs. Obesity, smoking and asthma severity were the main predictors of subsequent asthma costs, especially for females. PMID:26647437
Hardeman, François; Vandenneucker, Hilde; Van Lauwe, Johan; Bellemans, Johan
A consecutive series of 115 cementless Profix (Smith and Nephew, Memphis, USA) Total Knee Arthroplasties performed in 113 patients were followed in order to determine the functional results and survivorship at 8 to 10 years. All patients were included in a prospective database and were reviewed annually until final follow-up. Patients overall satisfaction was excellent or good in 91.3% of cases. The mean Knee Society's knee and function scores increased respectively from 49.3 and 36.7 preoperatively to 93.1 and 82.2 postoperatively. The Kaplan-Meier estimate of implant survival at 10 years was 97.1%. Two patients underwent revision and were considered as failures. One patient had a fracture of the medial condyle at 4 days post-surgery, and the other was revised for aseptic loosening of the tibial component at 6 years post-surgery. On the basis of this long-term follow-up study, we can conclude that the Profix Total Knee System is effective and safe. PMID:17064905
Lipinski, Paul; Knochenmus, Darwin D.
Water needs of the population of Indian Wells Valley, Calif., must be met through further development of ground-water resources. Studies show that annual ground-water pumpage there has increased since 1945 and has exceeded mean annual recharge since 1966. Continued and increased stress on the aquifer system of the valley is expected because population in the valley is predicted to double by 1998 and triple by 2020, based on 1977 population figures. The U.S. Geological Survey proposes a 10-year program to develop a data base to aid in evaluation of future water-management alternatives. A study plan has been developed that describes present and potential problems and objectives of the program, and outlines work items to be undertaken in the study area. (USGS)
Eriksen, Sophie Isabel; Bjerrum, Lars
Prolonged consumption of benzodiazepine drugs (BZD) and benzodiazepine receptor agonists (zolpidem, zaleplon, zopiclone; altogether Z drugs) is related to potential physiological and psychological dependence along with other adverse effects. This study aimed to analyse the prescribing of long-acting BZD (half-life >10 hr), compared to short-acting BZD in Denmark during a 10-year period. Descriptive analysis of total sales data from the Danish Register of Medicinal Product Statistics, to individuals in the primary healthcare sector, of all BZD and Z drugs in the period of 2003-2013. Prescription data derive from all community and hospital pharmacies in Denmark. The prescribing of long-acting BZD was reduced from 25.8 defined daily doses (DDD)/1000 inhabitants/day in 2003 to 8.8 DDD/1000 inhabitants/day in 2013, a relative reduction of 66%. The prescribing of short-acting BZD was reduced from 26.1 DDD/1000 inhabitants/day in 2003 to 16.4 DDD/1000 inhabitants/day in 2013, a relative reduction of 37%. Prescription data in this study did not include information about indications for initiating treatments. In addition, due to compliance problems, some of the prescribed drugs may not have been consumed according to the prescription. The observed reduction in BZD use was correlated to the introduction of new national guidelines on prescription of addictive drugs, but this study was not designed to detect a causal relationship. The prescribing of long-acting BZD decreased considerably more than the prescribing of short-acting BZD in the 10-year period. PMID:25382355
Yang, Jae-Hyuk; Yoon, Jung-Ro; Oh, Chi-Hun; Kim, Taik-Sun
Hybrid total knee arthroplasty (TKA) (uncemented femur with cemented tibia and patella) was introduced in the late 1980s to gain the theoretical advantage of durable cementless femoral fixation while avoiding the problems noted with cementless tibial fixation. From December 1992 to July 2000, 215 patients (235 knees) who underwent hybrid TKA were enrolled in this study. Five types of prosthesis (AGC, Maxim, LCS-M, LCS-APG, and Scorpio) were used. Revision rate for aseptic loosening was 16 (6.8%) of 235 knees. At 10 and 15 years, survivorship with tibial or femoral revision as the end point was 0.95 and 0.92, respectively. Hybrid TKA provides durable fixation with clinical and radiographic performance at minimum 10 years comparable with cemented series. PMID:22019322
Yamane, T; Shinoto, A; Kamegaya, M; Shinada, Y
Thirty patients over the age of 10 years, exhibiting cutaneous manifestations on the back suspected to be due to spinal dysraphism, and neurologic deficits, were studied to analyze neurologic appearance. Neurologic deficits appeared by age 5 in 26 patients. No patient complained of low-back pain or sciatica. Paralytic deformities of the lower extremities were divided into four grades for evaluation: A = no deformity, with only urinary disturbance (four cases); B = toe-limited deformity (two cases); C = toe and foot-limited deformity (six cases); D = toe, foot, ankle, and lower limb deformity (18 cases). Patients with slight neurologic disturbance, either Grade A or without urinary disturbance, were seen among the patients who had undergone a release operation by age 2, although neurologic appearance in patients in severe grades was not related to the age at release operation. Also, the release operation was thought to be effective in preventing low-back pain or sciatica. PMID:1750003
Tidwell, Vincent Carroll; Passell, Howard David; Castillo, Cesar; Moreland, Barbara
calculating water withdrawal and consumption for current and planned electric power generation; projected water demand from competing use sectors; and, surface and groundwater availability. WECC's long range planning is organized according to two target planning horizons, a 10-year and a 20-year. This study supports WECC in the 10-year planning endeavor. In this case the water implications associated with four of WECC's alternative future study cases (described below) are calculated and reported. In future phases of planning we will work with WECC to craft study cases that aim to reduce the thermoelectric footprint of the interconnection and/or limit production in the most water stressed regions of the West.
Diamond, Lisa M
Debates persist over whether bisexuality is a temporary stage of denial or transition, a stable "3rd type" of sexual orientation, or a heightened capacity for sexual fluidity. The present study uses 5 waves of longitudinal data collected from 79 lesbian, bisexual, and "unlabeled" women to evaluate these models. Both the "3rd orientation" and "fluidity" models had support, but the "transitional stage" model did not. Over 10 years, 2/3 of women changed the identity labels they had claimed at the beginning of the study, and 1/3 changed labels 2 or more times. Yet, contrary to the "transitional stage" model, more women adopted bisexual/unlabeled identities than relinquished these identities; few bisexual/unlabeled women ended up identifying as lesbian or heterosexual. Overall, the most commonly adopted identity was "unlabeled." Bisexual/unlabeled women had stable overall distributions of same-sex/other-sex attractions but greater absolute fluctuations in attractions from assessment to assessment than lesbians. All women reported declines in their ratio of same-sex to other-sex behavior over time. These findings demonstrate that the distinction between lesbianism and bisexuality is a matter of degree rather than kind. PMID:18194000
Ye, Shuang; Zhang, Wei; Yang, Jiaxin; Cao, Dongyan; Huang, Huifang; Wu, Ming; Lang, Jinghe; Shen, Keng
The aim of this single-institutional 10-year retrospective study was to investigate the clinical pattern (incidence, type, timing, and location) of venous thromboembolism (VTE) in Chinese patients with gynecologic cancer. Cases were identified by searching institutional Electronic Discharge Database. A comprehensive review of medical documentation was then performed to collect relevant data. The detection of VTE was symptom-triggered. A total of 155 VTE events were identified out of 7562 cases over the past 10-year period in our hospital. The incidence of clinically significant VTE was 2.0% in gynecologic malignancy, with vulvar cancer (3.7%) and ovarian cancer (2.5%) being the high-risk types (P = 0.01, Chi-square test). Perioperative period (35.1%) and preoperation (29.1%) were the 2 incidence peaks. Seventeen cases of pulmonary embolism (PE) occurred prior to surgery. Ovarian cancer patients were more likely to present preoperative PE compared to other site of cancer (76.4%; P = 0.01, Chi-square test). More preoperative VTE cases were complicated by PE than those in the perioperative period (39.5% vs 17.3%, P = 0.02, Chi-square test). Bilateral lower extremity deep vein thrombosis (DVT) accounted for 32.6% and there existed a preponderance of left-sided DVT (47.5% vs 17.0%, ratio 2.79:1). Femoral vein (36.6%) was the most common location for DVT. About 2.0% of the Chinese patients with gynecologic carcinoma developed clinical VTE, mostly during perioperative period and the time of diagnosis. The true incidence might have been under-estimated due to several reasons. The need for increased patient education and awareness of VTE is of importance. PMID:26683971
Sun, Hai-Lun; Pei, Dee; Lue, Ko-Huang; Chen, Yen-Lin
The relationships between uric acid and chronic disease risk factors such as metabolic syndrome, type 2 diabetes mellitus, and hypertension have been studied in adults. However, whether these relationships exist in adolescents is unknown. We randomly selected 8,005 subjects who were between 10 to 15 years old at baseline. Measurements of uric acid were used to predict the future occurrence of metabolic syndrome, hypertension, and type 2 diabetes. In total, 5,748 adolescents were enrolled and followed for a median of 7.2 years. Using cutoff points of uric acid for males and females (7.3 and 6.2 mg/dl, respectively), a high level of uric acid was either the second or third best predictor for hypertension in both genders (hazard ratio: 2.920 for males, 5.222 for females; p<0.05). However, uric acid levels failed to predict type 2 diabetes mellitus, and only predicted metabolic syndrome in males (hazard ratio: 1.658; p<0.05). The same results were found in multivariate adjusted analysis. In conclusion, a high level of uric acid indicated a higher likelihood of developing hypertension in both genders and metabolic syndrome in males after 10 years of follow-up. However, uric acid levels did not affect the occurrence of type 2 diabetes in both genders. PMID:26618358
Mohanty, Sujata; Gulati, Ujjwal; Mediratta, Akshat; Ghosh, Sujoy
Introduction: Mandibular anterior region is an uncommon site for occurrence of intrabony pathologies. Unilocular presentation of a lesion is again less common than multilocular appearance. Demographically, most lesions occur in middle to elderly age group. The study is designed to review the pathologies manifesting a combination of these rare demographic and radiological criteria. Materials and Methods: A retrospective analysis of patients with anterior unilocular radiolucencies of mandible in young patients was done. Records of past 10 years were searched. There were a total of 17 patients. Their clinical history and radiographs were reviewed from the case files and correlated with histopathological examination of the lesion. Results: Nine different pathologies constituted the sample size of 17. A wide array of lesions was found to manifest similar signs and symptoms and radiographic findings namely ameloblastoma (three), adenomatoid odontogenic tumor (AOT, four), odontogenic keratocyst (OKC, three), ossifying fibroma (OF, two), idiopathic bone cavity (IBC, one), dentigerous cyst (DC, one), radicular cyst (RC, one), central giant cell granuloma (CGCG, one), and calcifying odontogenic cyst (COC, one). Conclusion: Anterior mandible is a rare site for occurrence of intrabony pathologies. Majority of patients are females. Lesions acquire large size before they are detected. Growth occurs more in length than in width. Root resorption is not uncommon and root displacement is almost a consistent feature. PMID:24163555
Sun, Hai-Lun; Pei, Dee; Lue, Ko-Huang; Chen, Yen-Lin
The relationships between uric acid and chronic disease risk factors such as metabolic syndrome, type 2 diabetes mellitus, and hypertension have been studied in adults. However, whether these relationships exist in adolescents is unknown. We randomly selected 8,005 subjects who were between 10 to 15 years old at baseline. Measurements of uric acid were used to predict the future occurrence of metabolic syndrome, hypertension, and type 2 diabetes. In total, 5,748 adolescents were enrolled and followed for a median of 7.2 years. Using cutoff points of uric acid for males and females (7.3 and 6.2 mg/dl, respectively), a high level of uric acid was either the second or third best predictor for hypertension in both genders (hazard ratio: 2.920 for males, 5.222 for females; p<0.05). However, uric acid levels failed to predict type 2 diabetes mellitus, and only predicted metabolic syndrome in males (hazard ratio: 1.658; p<0.05). The same results were found in multivariate adjusted analysis. In conclusion, a high level of uric acid indicated a higher likelihood of developing hypertension in both genders and metabolic syndrome in males after 10 years of follow-up. However, uric acid levels did not affect the occurrence of type 2 diabetes in both genders. PMID:26618358
Vujicic, Marko; Onate, Kanecy; Laporte, Audrey; Deber, Raisa
This paper examines trends in the nursing labour market in Canada over a period of dramatic fluctuations in hospital expenditures. We add to previous analysis that covered the period 1991–1996 and use Census data from 2001 to examine the relationship between hospital expenditure and nurse labour force participation. We find that shifts in labour force participation over the period 1991–2001 had a significant impact on the nursing supply in Canada. Individuals who were trained in nursing but were working outside the profession in 1996 because of budgetary reductions and layoffs in hospitals had largely been reabsorbed back into nursing jobs by 2001. Our analysis provides further empirical evidence that the labour force participation among individuals trained in nursing is driven to a large extent by demand-side factors. PMID:22548099
Dunlop, Rosemary; Burns, Ailsa; Bermingham, Suzanne
Explored links between self-image, family structure (divorced or intact), parent-child relations, and gender at 3 intervals over 10 years during adolescence to early adulthood. Results suggest a consistent relationship between high parental care, low overprotective control, and better self-image scores with a stronger effect among subjects from…
van Rossum, Inge; Dominguez, Maria-de-Gracia; Lieb, Roselind; Wittchen, Hans-Ulrich; van Os, Jim
Evidence from clinical patient populations indicates that affective dysregulation is strongly associated with reality distortion, suggesting that a process of misassignment of emotional salience may underlie this connection. To examine this in more detail without clinical confounds, affective regulation-reality distortion relationships, and their clinical relevance, were examined in a German prospective cohort community study. A cohort of 2524 adolescents and young adults aged 14-24 years at baseline was examined by experienced psychologists. Presence of psychotic experiences and (hypo)manic and depressive symptoms was assessed at 2 time points (3.5 and up to 10 years after baseline) using the Munich-Composite International Diagnostic Interview. Associations were tested between level of affective dysregulation on the one hand and incidence of psychotic experiences, persistence of these experiences, and psychotic Impairment on the other. Most psychotic experiences occurred in a context of affective dysregulation, and bidirectional dose-response was apparent with greater level of both affective dysregulation and psychotic experiences. Persistence of psychotic experiences was progressively more likely with greater level of (hypo)manic symptoms (odds ratio [OR] trend=1.51, P<.001) and depressive symptoms (OR trend=1.15, P=.012). Similarly, psychotic experiences of clinical relevance were progressively more likely to occur with greater level of affective dysregulation (depressive symptoms: OR trend=1.28, P=.002; (hypo)manic symptoms: OR trend=1.37, P=.036). Correlated genetic liabilities underlying affective and nonaffective psychotic syndromes may be expressed as correlated dimensions in the general population. Also, affective dysregulation may contribute causally to the persistence and clinical relevance of reality distortion, possibly by facilitating a mechanism of aberrant salience attribution. PMID:19793794
Cho, Hwui-Dong; Lee, Young-Joo; Park, Kwang-Min; Kim, Ki-Hun; Kim, Jin Cheon; Ahn, Chul-Soo; Moon, Deok-Bog; Ha, Tae-Yong; Lee, Sung-Gyu
Backgrounds/Aims To understand the changing demands for hepatic resection (HR), we collected data regarding HR performed in a tertiary centre over a period of 10 years. Methods We carried out extensive search of institutional databases to identify HR cases performed between January 2005 and December 2014. A study cohort of 9,016 patients were divided into 5 disease categories, namely hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), intrahepatic duct stone disease (IHDS), colorectal cancer liver metastasis (CRLM), and uncommon/rare diseases (URD). Results There were 5,661 (62.8%) HCC cases, followed by 1441 (16.0%) CRLM, 942 (10.5%) ICC, 638 (7.1%) IHDS and 334 (3.7%) URD. The number of annual HR cases gradually increased from 443 in 2005 to 1,260 in 2015. Annual HCC cases also gradually increased, but the annual proportion of HCC cases fluctuated narrowly between 58.3% and 70.2%. Annual CRLM cases increased rapidly, and their proportion increased progressively from 4.7% to 20.5%. Annual ICC cases increased slowly, and their annual proportion fluctuated between 7.2% and 15.6%. Annual IHDS cases decreased slowly, and their annual proportion decreased progressively from 17.2% to 3.4%, while annual URD cases fluctuated, with annual proportions varying between 2.3% and 5.6%. Conclusions Annual cases of HR increased over the last 10 years in a tertiary center probably due to a center-specific centralization effect. The number of CRLM cases increased rapidly; those of HCC and ICC increased gradually, and those of IHDS declined gradually. We believe that these results reflect real changes in the types of liver disease requiring HR. PMID:27212990
Park, Hojong; Kwon, Sun U.; Kang, Dong-Wha; Kim, Jong S.; Chung, Young Soo; Shin, Sung; Han, Youngjin; Cho, Yong-Pil
Background and Purpose This study evaluated the outcome following surgery for carotid artery stenosis in a single institution during a 10-year period and the relevance of aging to access to surgery. Methods Between January 2001 and December 2010, 649 carotid endarterectomies (CEAs) were performed in 596 patients for internal carotid artery occlusive disease at our institution; 596 patients received unilateral CEAs and 53 patients received bilateral CEAs. Data regarding patient characteristics, comorbidities, stroke, mortality, restenosis, and other surgical complications were obtained from a review of medical records. Since elderly and high-risk patients comprise a significant proportion of the patient group undergoing CEAs, differences in comorbidity and mortality were evaluated according to age when the patients were divided into three age groups: <70 years, 70-79 years, and ≥80 years. Results The mean age of the included patients was 67.5 years, and 88% were men. Symptomatic carotid stenosis was observed in 65.7% of patients. The rate of perioperative stroke and death (within 30 days of the procedure) was 1.84%. The overall mortality rate was higher among patients in the 70-79 years and >80 years age groups than among those in the <70 years age group, but there was no significant difference in stroke-related mortality among these three groups. Conclusions CEA over a 10-year period has yielded acceptable outcomes in terms of stroke and mortality. Therefore, since CEA is a safe and effective strategy, it can be performed in elderly patients with acceptable life expectancy. PMID:26754779
Scheiman, Simeon; Moghaddas, Hossein S; Björnstig, Ulf; Bylund, Per-Olof; Saveman, Britt-Inger
Bicycles are a common mode of transportation and injured bicyclists cause a substantial burden on the medical sector. In Sweden, about half of fatally injured bicyclists are 65 years or older. This study analyzes the injury mechanisms, injuries, and consequences among bicyclists 65 years or older and compare with younger bicyclists (< or =64) and older adults as passenger car drivers, to give a basis for an injury preventive discussion for this age group. Umeå University Hospital's primary catchments area had 142,000 inhabitants in 2006. Nearly all injured road users in the well-defined geographic area are treated at this hospital and a 10-year data set (N=456) of injured bicyclists aged 65+ from the hospital's continuous injury registration (1997-2006) was analyzed. The results show that the annual injury incidence was 2.4 and 2.2 per 1000 men and women, respectively, aged 65 or older. For men the incidence rate was constant in the three age groups 65-74, 75-84 and 85+, while it decreased strongly for women. The incidence rate for old adults as passenger car drivers and younger bicyclists was 1.0 and 4.6, respectively. Most frequent injury mechanisms were falls when getting on or off a bicycle (20%) and by potholes or irregularities on the ground, edge of a sidewalk, or similar (13%). Only 6% were hit by cars, trucks, or buses. Half of the injured suffered fractures or dislocations, and 10% suffered concussion or more serious intracranial injuries. Getting on or off the bicycle caused most fractures (especially a high fraction of the hip and femur fractures) and resulted in 27% of all inpatient days in hospital. Three individuals died. One-third of the injured were treated as inpatients for a total of 1413 days (on average 9 days), with 69% of the days being caused by fractures. The cost for out- and inpatient acute treatment was approximately USD 4700 (SEK 33,000) per injured. The results merit an interest for this target group; bicycle injuries among older
Afsana, Faria; My Diep, Lien; Binte Munir, Sanjida; Wright, Erica; Mahmood, Sharif; Khan, A. K. Azad; Hussain, Akhtar
Background To observe changes in the prevalence of type 2 diabetes mellitus (DM) and impaired fasting glucose (IFG) and its associated risk factors in a rural Bangladeshi population over a 10-year period. Methods Three cross-sectional studies were undertaken in a rural community (aged ≥20 years) in 1999, 2004, and 2009. Structured questionnaires including sociodemographic parameters, anthropometric measurements, blood pressure, and blood glucose values were recorded. DM and IFG were diagnosed using 1999 World Health Organization criteria. Results Age standardized prevalence of DM increased significantly (P<0.001) from 1999 to 2009 (2.3%, 6.8%, and 7.9% in 1999, 2004, and 2009, respectively). The prevalence of IFG increased significantly (P=0.011) from 4.6% to 5.8% between 1999 and 2004 but then decreased from 5.8% to 5.3% during 2004 to 2009. Significant linear trends were shown in both sexes for general and central obesity as indicated by body mass index, waist circumference, and waist hip ratio (WHR). Increasing age and systolic blood pressure were significant risk factors for DM in all three studies. WHR for males was also significantly associated with the risk of DM in all three studies. WHR for females was only significantly associated with DM in 2009. Conclusion A significant rise in the prevalence of DM was observed in this population over 10 years. This increase was seen in both sexes, and in all age groups. A significant increase in the prevalence of the associated risk factors of general and central obesity was observed in both sexes. PMID:23439676
Kjonniksen, Lise; Fjortoft, Ingunn; Wold, Bente
This study examined the relationship between participation in organized youth sport and attitude to physical education (PE) during adolescence and physical activity in young adulthood. The sample comprised 630 participants who completed questionnaires over a 10-year period. Analysis of variance and regression were used to examine the relationship…
Chen, Bo; Chen, Zhanhong; Wang, Xiaojia
Background Mucinous breast carcinoma (MC) is a special type of breast cancer that presents with a large amount of extracellular mucin. MC comprises approximately 4% of all invasive breast cancers. This type of tumor has a better prognosis and higher incidence in peri- and post-menopausal patients. Pathologically, there are two main subtypes of MC: pure and mixed. In this study, we describe 10 years of experience with MC at the Zhejiang Cancer Hospital in China, specifically, clinical data, histological findings and immunohistochemical features. Methods We identified MC patients who were diagnosed as operable and completed clinical treatment from January 2001 to January 2011. The clinicopathological data included the age at diagnosis, tumor size, TNM stage, presence and number of lymph node (LN) metastases, estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER2) status and p53 expression. If the tumor was defined as mixed mucinous carcinoma (MMC), IHC was performed on a non-mucinous part, such as invasive ductal and lobular cancer. We evaluated the clinical characteristics of all MC patients using chi-square, one-way ANOVA and LSD tests. We also studied the correlations between all of the clinical parameters and LN metastasis in a binary logistic regression analysis. We used ten consecutive years of data that were collected at Zhejiang Cancer Hospital. Results We identified 48 cases of pure mucinous carcinoma (PMC) and 77 cases of MMC. The 48 PMC cases consisted of 38 PMC-A and 10 PMC-B subtypes. The MMCs were divided into two groups, those with partial mixed mucinous breast carcinoma (pMMC, 58 cases) and those with main mixed mucinous breast carcinoma (mMMC, 19 cases). pMMC was defined by tumors with less than 50% mucinous components, while mMMC was defined by tumors where the mucinous component accounted for 50% to 90% of the tumor. No significant differences in the clinicopathological characteristics were noted
Background Bibliometric studies are increasingly being used for research assessment by involving the application of statistical methods to scientific publications to obtain the bibliographics for each country. The main objective of this study was to analyse the research productivity originating from 13 Middle Eastern Arab (MEA) countries with articles published in toxicology journals. Methods Data from January 1, 2003 till December 31, 2012 were searched for documents with specific words in the toxicology field as a “source title” in any one of the 13 MEA countries. Research productivity was evaluated based on a methodology developed and used in other bibliometric studies. Research productivity was adjusted to the national population and nominal gross domestic product (GDP) per capita. Results Documents (n = 1,240) were retrieved from 73 international peer-reviewed toxicology journals. The h-index of the retrieved documents was 39. Of the 73 journal titles, 52 (69.9%) have their IF listed in the ISI Journal Citation Reports 2012; 198 documents (16.0%) were published in journals that had no official IF. After adjusting for economy and population power, Egypt (193.6), Palestine (18.1), Kingdom of Saudi Arabia (KSA) (13.0), and Jordan (11.5) had the highest research productivity. Countries with large economies, such as the Kuwait, United Arab Emirates (UAE), and Oman, tended to rank relatively low after adjustment of GDP. The total number of citations at the time of data analysis (August 4, 2013) was 10,991, with a median (interquartile range) of 4 (1–11). MEA collaborated more with countries in the MEA regions (16.7%), especially KSA, Egypt, and UAE, followed by Europe (14.4%), especially with the United Kingdom and Germany. Conclusions The present data show a promising rise and a good start for toxicology research activity in toxicology journals in the Arab world. Research output is low in some countries, which can be improved by investing in more
Bagheri, Abbas; Borhani, Morteza; Tavakoli, Mehdi; Salehirad, Shahram
Purpose: To evaluate the demographics and management outcomes of strabismus surgery in patients with third cranial nerve palsy. Methods: This retrospective study includes subjects with third cranial nerve palsy. We evaluated age, sex, laterality, severity of involvement, etiology, frequency of clinical findings, and types and results of treatments. Results: 52 patients including 29 male and 23 female subjects with mean age of 21.1±15.5 years were studied between January 1999 and January 2009. Etiologies of third nerve palsy included congenital in 16 (30.8%), trauma in 26 (50%) and other causes in 10 (19.2%) patients. In 24 patients (46.2%), the palsy was complete. The most common type of strabismus was exotropia associated with hypotropia (40%). Medical treatment was used in 25 (48%) and surgical treatment in 46 (88.4%) subjects. One time strabismus surgery was performed in 30 (65.2%), 2 times in 11 (24%) and 3 times in 5 (10.8%) subjects. The most common operation was large horizontal recession and resection in 78.2% of cases. Mean horizontal deviation in primary position was 66±29 prism diopters (PD) before surgery decreasing to 21±19, 13±12 and 6±8 PD after first, second and third surgery, respectively. Corresponding figures for mean vertical deviation were 13±15, 7±12, 4±6 and 1±2 PD, respectively. Abnormal head posture was 10-30° in 11 (21.1%) cases before treatment which completely resolved after surgery. Conclusion: Surgical management of strabismus in patients with third nerve palsy is difficult and challenging, however the majority of patients achieve ideal results with appropriate and stepwise surgical plans. PMID:25667737
Yayan, Josef; Ghebremedhin, Beniam; Rasche, Kurt
Background Pseudomonas aeruginosa is a common cause of community-acquired and nosocomial-acquired pneumonia. The development of resistance of P. aeruginosa to antibiotics is increasing globally due to the overuse of antibiotics. This article examines, retrospectively, the antibiotic resistance in patients with community-acquired versus nosocomial-acquired pneumonia caused by P. aeruginosa or multidrug-resistant (MDR) P. aeruginosa. Methods Data from patients with community-acquired and nosocomial-acquired pneumonia caused by P. aeruginosa and MDR P. aeruginosa were collected from the hospital charts at the HELIOS Clinic, Witten/Herdecke University, Wuppertal, Germany, between January 2004 and August 2014. An antibiogram was created from all study patients with community-acquired and nosocomial-acquired pneumonia caused by P. aeruginosa or MDR P. aeruginosa. Results A total of 168 patients with mean age 68.1 ± 12.8 (113 [67.3% males and 55 [32.7%] females) were identified; 91 (54.2%) had community-acquired and 77 (45.8%) had nosocomial-acquired pneumonia caused by P. aeruginosa. Patients with community-acquired versus nosocomial-acquired pneumonia had a mean age of 66.4 ± 13.8 vs. 70.1 ± 11.4 years [59 vs. 54 (64.8% vs. 70.1%) males and 32 vs. 23 (35.2% vs. 29.9%) females]. They included 41 (24.4%) patients with pneumonia due to MDR P. aeruginosa: 27 (65.9%) community-acquired and 14 (34.1%) nosocomial-acquired cases. P. aeruginosa and MDR P. aeruginosa showed a very high resistance to fosfomycin (community-acquired vs. nosocomial-acquired) (81.0% vs. 84.2%; 0 vs. 85.7%). A similar resistance pattern was seen with ciprofloxacin (35.2% vs. 24.0%; 70.4% vs. 61.5%), levofloxacin (34.6% vs. 24.5%; 66.7% vs. 64.3%), ceftazidime (15.9% vs. 30.9; 33.3% vs. 61.5%), piperacillin (24.2% vs. 29.9%; 44.4% vs. 57.1%), imipenem (28.6% vs. 27.3%; 55.6% vs. 50.0%), piperacillin and tazobactam (23.1% vs. 28.6%; 44.4% vs. 50.0%), tobramycin (28.0% vs. 17.2%; 52.0% vs. 27
Zvolensky, Michael J; Taha, Farah; Bono, Amanda; Goodwin, Renee D
The present study examined the relation between the big five personality traits and any lifetime cigarette use, progression to daily smoking, and smoking persistence among adults in the United States (US) over a ten-year period. Data were drawn from the Midlife Development in the US (MIDUS) I and II (N = 2101). Logistic regression was used to examine the relationship between continuously measured personality factors and any lifetime cigarette use, smoking progression, and smoking persistence at baseline (1995-1996) and at follow-up (2004-2006). The results revealed that higher levels of openness to experience and neuroticism were each significantly associated with increased risk of any lifetime cigarette use. Neuroticism also was associated with increased risk of progression from ever smoking to daily smoking and persistent daily smoking over a ten-year period. In contrast, conscientiousness was associated with decreased risk of lifetime cigarette use, progression to daily smoking, and smoking persistence. Most, but not all, associations between smoking and personality persisted after adjusting for demographic characteristics, depression, anxiety disorders, and substance use problems. The findings suggest that openness to experience and neuroticism may be involved in any lifetime cigarette use and smoking progression, and that conscientiousness appears to protect against smoking progression and persistence. These data add to a growing literature suggesting that certain personality factors--most consistently neuroticism--are important to assess and perhaps target during intervention programs for smoking behavior. PMID:25799395
Zvolensky, Michael J.; Taha, Farah; Bono, Amanda; Goodwin, Renee D.
The present study examined the relation between the big five personality traits and any lifetime cigarette use, progression to daily smoking, and smoking persistence among adults in the United States (US) over a ten-year period. Data were drawn from the Midlife Development in the US (MIDUS) I and II (N=2,101). Logistic regression was used to examine the relationship between continuously measured personality factors and any lifetime cigarette use, smoking progression, and smoking persistence at baseline (1995–1996) and at follow-up (2004–2006). The results revealed that higher levels of openness to experience and neuroticism were each significantly associated with increased risk of any lifetime cigarette use. Neuroticism also was associated with increased risk of progression from ever smoking to daily smoking and persistent daily smoking over a ten-year period. In contrast, conscientiousness was associated with decreased risk of lifetime cigarette use, progression to daily smoking, and smoking persistence. Most, but not all, associations between smoking and personality persisted after adjusting for demographic characteristics, depression, anxiety disorders, and substance use problems. The findings suggest that openness to experience and neuroticism may be involved in any lifetime cigarette use and smoking progression, and that conscientiousness appears to protect against smoking progression and persistence. These data add to a growing literature suggesting that certain personality factors—most consistently neuroticism—are important to assess and perhaps target during intervention programs for smoking behavior. PMID:25799395
Bhosle, S H; Zanjad, N P; Dake, M D; Godbole, H V
The present study was carried out to analyze various factors associated with death due to hanging among adolescents and to identify the areas of intervention for preventing such deaths. A retrospective study was carried out on 51 cases of adolescent deaths due to hanging, the autopsies of which were conducted by the Department of Forensic Medicine, Dr Shankarrao Chavan Government Medical College, Nanded, Maharashtra State (India), during the period between 1 January 2001 and 31 December 2010. In the present study, death by hanging among the adolescent age group was most commonly suicidal (96.08%) in nature, and only two (3.92%) cases of deaths due to accidental hanging were observed. Of the total number of suicidal deaths due to hanging among adolescents, the majority (80.39%) were among the older adolescent (15-19 years) age group. Rope and clothing items were commonly used ligature materials for committing suicide by hanging. Females outnumbered male victims (M:F ratio 1:1.13) among adolescents, contrary to the male preponderance observed among victims of the older age group (M:F ratio 1:0.44). Most of the suicidal deaths due to hanging (83.67%) among adolescents were observed at the victims' home. The predisposing and precipitating factors observed were domestic strife, examination-related stress, and physical and psychological illness. PMID:25572082
Pedersen, Michael; Benfield, Thomas L; Skinhoej, Peter; Jensen, Allan G
Background Haematogenous Staphylococcus aureus meningitis is rare but associated with high mortality. Knowledge about the disease is still limited. The objective of this study was to evaluate demographic and clinical prognostic features of bacteraemic S. aureus meningitis. Methods Nationwide surveillance in Denmark from 1991 to 2000 with clinical and bacteriological data. Risks of death were estimated by Cox proportional hazards regression analysis. Results Among 12480 cases of S. aureus bacteraemia/sepsis, we identified 96 cases of non-surgical bacteraemic S. aureus meningitis (0.8%). Incidence rates were 0.24 (95% confidence interval [CI], 0.18 to 0.30)/100 000 population between 1991–1995 and 0.13 (CI, 0.08 to 0.17)/100 000 population between 1996–2000. Mortality was 56%. After adjustment, only co morbidity (hazard ratio [HR], 3.45; CI, 1.15 to 10.30) and critical illness (Pitt score ≥ 4) (HR, 2.14; CI, 1.09 to 4.19) remained independent predictors of mortality. Conclusion The incidence, but not mortality of bacteraemic S. aureus meningitis decreased during the study period. Co morbidity and critical illness were independent predictors of a poor outcome. PMID:16542437
Groves, C J; Saunders, B P; Spigelman, A D; Phillips, R K S
Background: Duodenal cancer is one of the leading causes of death in familial adenomatous polyposis (FAP) patients. An endoscopic surveillance programme was therefore initiated in 1988, the outcome of which is described in this paper. Methods: We report the 10 year follow up of 114 patients with FAP who were prospectively screened for the presence and severity of duodenal adenomas. Results: Six of 114 patients (median age 67 years) developed duodenal adenocarcinoma. Four of these were from 11 patients who originally had Spigelman stage IV disease (advanced duodenal polyposis), which gives a 36% risk within this group of developing cancer. One case of duodenal cancer arose from 41 patients who originally had stage III disease (2%) and one cancer arose from 44 patients with original stage II disease (2%). All six patients have died: five were inoperable and one had recurrence three years after a pancreaticoduodenectomy. There was no association between duodenal cancer and site of germline mutation of the APC gene. Conclusions: Surveillance for duodenal adenocarcinoma and subsequent early referral for curative surgery has not been effective. Selection of patients with advanced but benign (Spigelman stage IV) duodenal polyposis for prophylactic pancreaticoduodenectomy should therefore be considered and can now be justified on the basis of these results. More comprehensive endoscopic surveillance of high risk (stage III and IV) patients is needed in an attempt to avoid underestimating the severity of duodenal polyposis, and to evaluate the role of endoscopic therapy in preventing advanced disease. PMID:11950808
Al-Eyadhy, Ayman A.; Temsah, Mohamad-Hani; Alhaboob, Ali A. N.; Aldubayan, Abdulmalik K.; Almousa, Nasser A.; Alsharidah, Abdulrahman M.; Alangari, Mohammed I.; Alshaya, Abdulrahman M.
OBJECTIVES: To describe the change in the management, and outcome of children with acute severe asthma (ASA) admitted to Pediatric Intensive Care Unit (PICU) at tertiary institute, as compared to previously published report in 2003. METHODS: This is a retrospective observational study. All consecutive pediatric ASA patients who were admitted to PICU during the study period were included. The data were extracted from PICU database and medical records. The Cohort in this study (2013 Cohort) was compared with the Cohort of ASA, which was published in 2003 from the same institution (2003 Cohort). RESULTS: In comparison to previous 2003 Cohort, current Cohort (2013) revealed higher mean age (5.5 vs. 3.6 years; P ≤ 0.001), higher rate of PICU admission (20.3% vs. 3.6%; P ≤ 0.007), less patients who received maintenance inhaled steroids (43.3% vs. 62.4%; P ≤ 0.03), less patients with pH <7.3 (17.9% vs. 42.9%; P ≤ 0.001). There were more patients in 2013 Cohort who received: Inhaled Ipratropium bromide (97% vs. 68%; P ≤ 0.001), intravenous magnesium sulfate (68.2% vs. none), intravenous salbutamol (13.6% vs. 3.6%; P ≤ 0.015), and noninvasive ventilation (NIV) (35.8% vs. none) while no patients were treated with theophylline (none vs. 62.5%). The median length of stay (LOS) was 2 days while mean LOS was half a day longer in the 2013 Cohort. None of our patients required intubation, and there was no mortality. CONCLUSION: We observed slight shift toward older age, considerably increased the rate of PICU admission, increased utilization of Ipratropium bromide, magnesium sulfate, and NIV as important modalities of treatment. PMID:26664561
Neudorfer, Meira; Kessner, Rivka; Goldenberg, Dafna; Lavie, Anat; Kessler, Ada
Purpose We sought to assess long-term changes in the flow parameters of retrobulbar vessels in diabetic patients. Methods The retrobulbar circulation of 138 eyes was evaluated between 1994 and 1995 and 36 eyes were reevaluated between 2004 and 2008 (study group). They were divided into four groups: eyes of diabetic patients without diabetic retinopathy (DR), eyes with nonproliferative DR, eyes with proliferative DR, and eyes of nondiabetic patients (controls). Color Doppler imaging was used to assess the flow velocities in the major retrobulbar vessels. The resistive index (RI) was calculated and compared among the groups and between the two time periods. Results RI values of the central retinal artery and posterior ciliary artery had increased in the two non-DR groups and in the nonproliferative DR group, with a surprising decrease measured in eyes with proliferative DR (P= nonsignificant [NS]). Combining the nonproliferative DR and proliferative DR groups resulted in a milder increase of the RI of the posterior ciliary artery (P= NS) and the central retinal artery (P=0.02) in the DR group compared to the other groups. Conclusion Our results demonstrate that an increase of the resistance in the retrobulbar vessels, as a part of DR, can lessen over time and may even be reversed. PMID:25473257
Voisey, Pamela; Jones, Paul; Thomas, Brychan
This paper describes a longitudinal study of over 10 years of university pre-incubation in Wales, using case studies of incubated businesses to track their performance since 2001. Surviving "graduated" businesses were investigated and quantitative and qualitative data were gathered to profile the current status of these businesses and…
Pagano, Maria E; White, William L; Kelly, John F; Stout, Robert L; Tonigan, J Scott
This study investigates the 10-year course and impact of Alcoholics Anonymous (AA)-related helping (AAH), step-work, and meeting attendance on long-term outcomes. Data were derived from 226 treatment-seeking alcoholics recruited from an outpatient site in Project MATCH and followed for 10 years post treatment. Alcohol consumption, AA participation, and other-oriented behavior were assessed at baseline, end of the 3-month treatment period, and 1, 3, and 10 years post treatment. Controlling for explanatory baseline and time-varying variables, results showed significant direct effects of AAH and meeting attendance on reduced alcohol outcomes and a direct effect of AAH on improved other-oriented interest. PMID:23327504
Klonsky, E. David; Kotov, Roman; Bakst, Shelly; Rabinowitz, Jonathan; Bromet, Evelyn J.
Little is known about the longitudinal relationship of hopelessness to attempted suicide in psychotic disorders. This study addresses this gap by assessing hopelessness and attempted suicide at multiple time-points over 10 years in a first-admission cohort with psychosis (n = 414). Approximately one in five participants attempted suicide during…
Planquette, Benjamin; Péron, Julien; Dubuisson, Etienne; Roujansky, Ariane; Laurent, Virginie; Le Monnier, Alban; Legriel, Stephane; Ferre, Alexis; Bruneel, Fabrice; Chiles, Peter G; Bedos, Jean P
Summary Chronic obstructive pulmonary disease (COPD) is a frequent source of hospitalization. Antibiotics are largely prescribed during COPD exacerbation. Our hypothesis is that large broad-spectrum antibiotics are more and more frequently prescribed. Our results confirm this trend and highlight that the increase in large broad-spectrum use in COPD exacerbation is largely unexplained. Background Acute COPD exacerbation (AECOPD) is frequently due to respiratory tract infection, and the benefit of antipseudomonal antibiotics (APA) is still debated. Health care–associated pneumonia (HCAP) was defined in 2005 and requires broad-spectrum antibiotherapy. The main objectives are to describe the antibiotic use for AECOPD in intensive care unit and to identify factors associated with APA use and AECOPD prognosis. Methods We conducted a monocentric, retrospective study on all AECOPDs in the intensive care unit treated by antibiotics for respiratory tract infection. Treatment failure (TF) was defined by death, secondary need for mechanical ventilation, or secondary systemic steroid treatment. A multivariate analysis was used to assess factors associated with APA prescription and TF. Results From January 2000 to December 2011, 111 patients were included. Mean age was 69 years (±12), mean forced expiratory volume 38% of theoretic value (±13). Thirty-five (31%) patients were intubated, and 52 (47%) were treated with noninvasive ventilation. From 107 patients, 8 (7%) cases of Pseudomonas aeruginosa were documented. APAs were prescribed in 21% of patients before 2006 versus 57% after (P=0.001). TF prevalence was 31%. Risk factors for P. aeruginosa in COPD and HCAP diagnosis did not influence APA, whereas the post-2006 period was independently associated with APA prescription (odds ratio 6.2; 95% confidence interval 1.9–20.3; P=0.0013). APA did not improve TF (odds ratio 1.09; 95% confidence interval 0.37–3.2). Conclusion HCAP guidelines were followed by an increase in APA
Kjønniksen, Lise; Torsheim, Torbjørn; Wold, Bente
Background The purpose of this study was to show how participation in leisure-time physical activity changes between ages 13 to 23, and to what extent engaging in specific types of sports tracks into young adulthood. Methods The sample comprised 630 subjects who responded to questionnaires at age 13, with seven follow-ups over a 10-year period in the Norwegian Longitudinal Health Behaviour Study. The associations between adolescent participation in global and specific types of leisure-time physical activity were examined by analyses of variance, regression analysis and growth curve analysis. Results The findings suggest that the transition from adolescence to adulthood is, on average, a period of decline in physical activity, but with the decline levelling off into adulthood. The decline was significantly greater among males than females. There were substantial individual differences in the amount of change, in particular among males. Jogging alone and cycling, recreational activities such as skiing and hiking, and ball games, showed a high degree of tracking from age 15 to 23. The findings indicate low associations between participation in specific types of activities during adolescence and global leisure-time physical activity in young adulthood, while participation in several adolescent physical activities simultaneously was moderately related to later activity. Thus, being involved in various types of physical activity may offer good opportunities for establishing lifelong involvement in physical activity, independent of the specific type of activity. Conclusion The observed variation in change might suggest a need for a more targeted approach, with a focus on subgroups of individuals. The group of inactive youth may be considered as a high risk group, and the findings suggest that adolescent males who are inactive early seem likely to continue to be inactive later. The observed heterogeneity in change highlights the limitation of previous approaches to
Koffman, Jonathan; Ho, Yuen King; Davies, Joanna; Gao, Wei; Higginson, Irene J.
Background Ageing is a growing issue for people from UK black, Asian and minority ethnic (BAME) groups. The health experiences of these groups are recognised as a ‘tracer’ to measure success in end of life patient-preferred outcomes that includes place of death (PoD). Aim To examine patterns in PoD among BAME groups who died of cancer. Material and Methods Mortality data for 93,375 cancer deaths of those aged ≥65 years in London from 2001–2010 were obtained from the UK Office for National Statistics (ONS). Decedent's country of birth was used as a proxy for ethnicity. Linear regression examined trends in place of death across the eight ethnic groups and Poisson regression examined the association between country of birth and place of death. Results 76% decedents were born in the UK, followed by Ireland (5.9%), Europe(5.4%) and Caribbean(4.3%). Most deaths(52.5%) occurred in hospital, followed by home(18.7%). During the study period, deaths in hospital declined with an increase in home deaths; trend for time analysis for those born in UK(0.50%/yr[0.36–0.64%]p<0.001), Europe (1.00%/yr[0.64–1.30%]p<0.001), Asia(1.09%/yr[0.94–1.20%]p<0.001) and Caribbean(1.03%/yr[0.72–1.30%]p<0.001). However, time consistent gaps across the geographical groups remained. Following adjustment hospital deaths were more likely for those born in Asia(Proportion ratio(PR)1.12[95%CI1.08–1.15]p<0.001) and Africa(PR 1.11[95%CI1.07–1.16]p<0.001). Hospice deaths were less likely for those born in Asia(PR 0.73 [0.68–0.80] p<0.001), Africa (PR 0.83[95%CI0.74–0.93]p<0.001), and ‘other’ geographical regions (PR0.90[95% 0.82–0.98]p<0.001). Home deaths were less likely for those born in the Caribbean(PR0.91[95%CI 0.85–0.98]p<0.001). Conclusions Location of death varies by country of birth. BAME groups are more likely to die in a hospital and less likely to die at home or in a hospice. Further investigation is needed to determine whether these differences result from
Noorollahian, Morteza; Nematy, Mohsen; Dolatian, Atiyeh; Ghesmati, Hengameh; Akhlaghi, Saeed; Khademi, Gholam Reza
Background: Oral-facial clefts including cleft lip and palate are the most common congenital malformations of the head and neck. Environmental factors such as maternal hormonal disorders, use of psychiatric medications, vitamin and folic acid deficiency, hypoxia, cigarette smoking and maternal obesity and overweight can affect the incidence of these disorders. In Iran, one of the associated problems is a lack of accurate statistics regarding the present status of the patients, which can cause a disturbance in the health programmes of Ministry of Health and Medical Education. The aim of this study was to report the status of 398 cases of cleft lip and palate in Sheikh and Imam Reza Hospitals of Mashhad over a 10-year period. Materials and Methods: This retrospective descriptive study was performed using data collection method and included the evaluation of the recorded files and completing the data forms. In this study, the file records of 398 patients referring to Mashhad Sheikh and Imam Reza (P.U.H) Hospitals were studied, from the beginning of 2002 to the end of 2011; the obtained data from the files were collected and classified. Results: The highest frequency was related to cleft palate alone (40.7%); frequencies were lower regarding the cleft lip and palate and cleft lip alone (34.41% and 24.87%, respectively). Approximately, half of the patients were from rural areas of the city and had articulation disorders. Most of the patients were the first-born children of the family and their parents were consanguineously married; about one-third of the patients had a family history of the disease. Conclusion: According to the results of the present study, cleft lip is more frequent in males and cleft palate is more prevalent in females; the obtained results are consistent with the global statistics. PMID:26712297
Dotis, John; Myserlis, Pavlos; Printza, Nikoleta; Stabouli, Stella; Gkogka, Chrysa; Pavlaki, Antigoni; Papachristou, Fotios
Peritoneal dialysis (PD) constitutes the preferred dialysis modality for children requiring renal replacement therapy with peritonitis being one of the most common complications of PD. This study was performed to evaluate the epidemiology, microbiology, and outcomes of PD-associated peritonitis in Greek children for a 10-year period. A total of 27 patients (16 males) with a mean age 121.8 ± 57.2 months were retrospective analyzed. Patients were on PD therapy for a mean duration of 45.2 ± 26.1 months. We found 23 episodes of PD-associated peritonitis occurred in 9 out of 27 patients (0.23 episodes/patient-year), with four patients experienced two or more peritonitis episodes. Gram-positive bacteria were responsible for 15 (65.2%) peritonitis episodes, with Staphylococcus aureus being the predominant specie isolated in 30.4% of cases. A total of seven episodes of exit-site infections (ESIs) were identified in five patients (0.069 episodes/patient-year) with the most common bacteria isolated being S. aureus (57.4%). Initial antibiotic treatment included intraperitoneal vancomycin plus ceftazidime in the majority of cases (82.6%). At the end of study, 12 (44.4%) patients remained on PD, 11 (41.8%) underwent renal transplantation, 2 (7.4%) shifted to hemodialysis and unfortunately, two patients (7.4%) died. Conclusively, our study revealed a noticeable low peritonitis and ESIs rate as compared to international data and represents the first evaluation of the characteristics and outcomes of peritonitis in the Greek pediatric PD population. PMID:27185324
Kamulegeya, Adriane; Kalyanyama, Boniphace M
Background Neoplasms of the oral maxillofacial area are an interesting entity characterized by differences in nomenclature and classification at different centers. We report neoplastic histopathological diagnoses seen at the departments of oral maxillofacial surgery of Muhimbili and Mulago referral hospitals in Tanzania and Uganda respectively over a 10-year period. Methods We retrieved histopathological reports archived at the departments of oral maxillofacial surgery of Muhimbili and Mulago referral hospitals in Tanzania and Uganda respectively over a 10-year period from June 1989–July 1999. Results In the period between June 1989 and July 1999, 565 and 1298 neoplastic oro-facial cases were retrieved of which 284 (50.53%) and 967 (74.54%) were malignant neoplasms at Muhimbili and Mulago hospitals respectively. Overall 67.28% of the diagnoses recorded were malignant with Kaposi's sarcoma (21.98%), Burkiits lymphoma (20.45%), and squamous cell carcinoma (15.22%) dominating that group while ameloblastoma (9.23%), fibromas (7.3%) and pleomorphic adenoma (4.95%) dominated the benign group. The high frequency of malignancies could be due to inclusion criteria and the clinical practice of selective histopathology investigation. However, it may also be due to higher chances of referrals in case of malignancies. Conclusion There is need to reexamine the slides in these two centers in order to bring them in line with the most recent WHO classification so as to allow for comparison with reports from else where. PMID:18651958
Shaw, Jon A.; Egeland, Janice A.; Endicott, Jean; Allen, Cleona R.; Hostetter, Abram M.
Objective: Prospective study of well children at risk of bipolarity to identify the frequency and pattern of potentially prodromal symptoms/behaviors for bipolar disorder type I (BPI) disorder. Method: A total of 110 at-risk children with a BPI parent and 112 children with well parents were studied. Ten-year data collection used structured and…
Chan, Jasper Fuk-Woo; Lau, Susanna Kar-Pui; Wong, Sally Cheuk-Ying; To, Kelvin Kai-Wang; So, Simon Yung-Chun; Leung, Sally Sau-Man; Chan, Siu-Mang; Pang, Chiu-Mei; Xiao, Chenlu; Hung, Ivan Fan-Ngai; Cheng, Vincent Chi-Chung; Yuen, Kwok-Yung; Woo, Patrick Chiu-Yat
In recent years, infections caused by Aspergillus sp. have become an emerging focus of clinical microbiology and infectious disease, as the number of patients infected with Aspergillus sp. has increased markedly. Although chronic pulmonary aspergillosis (CPA) is considered a 'semi-invasive' or 'intermediate' disease, little data are available for the direct comparison of CPA with invasive pulmonary aspergillosis (IPA) and pulmonary aspergilloma (PA) to quantify invasiveness. In this study, we compared the characteristics of CPA with those of IPA and PA among hospitalized patients over a 10-year period. A total of 29, 51 and 31 cases of CPA, IPA and PA, respectively, were included. An increasing trend in galactomannan antigen seropositivity rate from PA (24.1%) to CPA (35.7%) to IPA (54.9%) and an opposite trend for anti-Aspergillus antibody (PA (71.0%) to CPA (45.8%) to IPA (7.1%)) were observed. Eight percent of CPA patients were infected with more than one Aspergillus sp. The survival rate of the CPA group also fell between the survival rate of PA and IPA, confirming the intermediate severity of CPA. The survival rate of the CPA group became significantly higher than that of the IPA group from day 180 onwards until 2 years after admission (P<0.05). The survival rate of the CPA group remained lower than that of the PA group from day 30 onwards until 2 years after admission. Poor prognostic factors for CPA included older age (P=0.019), higher total leukocyte count (P=0.011) and higher neutrophil count (P=0.012) on admission. This study provided clinical and laboratory evidence for the semi-invasive properties of CPA. PMID:27094904
Chan, Jasper Fuk-Woo; Lau, Susanna Kar-Pui; Wong, Sally Cheuk-Ying; To, Kelvin Kai-Wang; So, Simon Yung-Chun; Leung, Sally Sau-Man; Chan, Siu-Mang; Pang, Chiu-Mei; Xiao, Chenlu; Hung, Ivan Fan-Ngai; Cheng, Vincent Chi-Chung; Yuen, Kwok-Yung; Woo, Patrick Chiu-Yat
In recent years, infections caused by Aspergillus sp. have become an emerging focus of clinical microbiology and infectious disease, as the number of patients infected with Aspergillus sp. has increased markedly. Although chronic pulmonary aspergillosis (CPA) is considered a ‘semi-invasive' or ‘intermediate' disease, little data are available for the direct comparison of CPA with invasive pulmonary aspergillosis (IPA) and pulmonary aspergilloma (PA) to quantify invasiveness. In this study, we compared the characteristics of CPA with those of IPA and PA among hospitalized patients over a 10-year period. A total of 29, 51 and 31 cases of CPA, IPA and PA, respectively, were included. An increasing trend in galactomannan antigen seropositivity rate from PA (24.1%) to CPA (35.7%) to IPA (54.9%) and an opposite trend for anti-Aspergillus antibody (PA (71.0%) to CPA (45.8%) to IPA (7.1%)) were observed. Eight percent of CPA patients were infected with more than one Aspergillus sp. The survival rate of the CPA group also fell between the survival rate of PA and IPA, confirming the intermediate severity of CPA. The survival rate of the CPA group became significantly higher than that of the IPA group from day 180 onwards until 2 years after admission (P<0.05). The survival rate of the CPA group remained lower than that of the PA group from day 30 onwards until 2 years after admission. Poor prognostic factors for CPA included older age (P=0.019), higher total leukocyte count (P=0.011) and higher neutrophil count (P=0.012) on admission. This study provided clinical and laboratory evidence for the semi-invasive properties of CPA. PMID:27094904
Padma, Rama; Foo, Lilian; Chia, Yin Nin; Yam, Philip; Chia, John; Khoo-Tan, HS; Yap, Swee Peng; Yeo, Richard
Objective Synchronous occurrence of endometrial and ovarian tumors is uncommon, and they affect less than 10% of women with endometrial or ovarian cancers. The aim of this study is to describe the epidemiological and clinical factors; and survival outcomes of women with these cancers. Methods This is a retrospective cohort study in a large tertiary institution in Singapore. The sample consists of women with endometrial and epithelial ovarian cancers followed up over a period of 10 years from 2000 to 2009. The epidemiological and clinical factors include age at diagnosis, histology types, grade and stage of disease. Results A total of 75 patients with synchronous ovarian and endometrial cancers were identified. However, only 46 patients met the inclusion criteria. The median follow-up was 74 months. The incidence rate for synchronous cancer is 8.7% of all epithelial ovarian cancers and 4.9% of all endometrial cancers diagnosed over this time frame. Mean age at diagnosis was 47.3 years old. The most common presenting symptom was abnormal uterine bleeding (36.9%) and 73.9% had endometrioid histology for both endometrial and ovarian cancers. The majority of the women (78%) presented were at early stages of 1 and 2. There were 6 (13.6%) cases of recurrence and the 5 year cumulative survival rate was at 84%. Conclusion In our cohort, we found that majority of women afflicted with synchronous cancer of the endometrium and ovary were younger at age of diagnosis, had early stage of cancer and good survival. PMID:22247800
Diamond, Lisa M.
Debates persist over whether bisexuality is a temporary stage of denial or transition, a stable "3rd type" of sexual orientation, or a heightened capacity for sexual fluidity. The present study uses 5 waves of longitudinal data collected from 79 lesbian, bisexual, and "unlabeled" women to evaluate these models. Both the "3rd orientation" and…
Leblanc, Line; Swisher, Raymond; Vitaro, Frank; Tremblay, Richard E.
A longitudinal and multilevel approach is used to examine the relationship between antisocial behavior during adolescence and high school social climate. The data are taken from a longitudinal study of 1,233 boys and girls who attended 217 public and private high schools. Students' disruptive behaviors were assessed yearly from 6 to 12 years of…
Tabrizi, Reza; Dehghani Nazhvani, Ali; Vahedi, Amir; Gholami, Mehdi; Zare, Raziyeh; Etemadi Parsa, Raha
Statement of the Problem: Alveolar bone necrosis induced by Herpes zoster infection is considered as a rare manifestation of osteomyelitis and few case reports are presented in the literature. Purpose: The aim of this study was to evaluate mandibular osteomyelitis caused by herpes zoster in the immunocompromised patients with histopathologically documented osteomyelitis in the mandible and herpes zoster infection. Materials and Method: 30 patients were recruited in this cross-sectional study. 19 patients were completely edentulous, 4 patients were partially edentulous and 7 with complete dentition. In all cases, specimens were analyzed using a conventional polymerase chain reaction (PCR) test for varicella zoster virus. Results: 16 patients underwent dialysis, 9 patients received chemotherapy treatments and 5 patients had transplantation (four kidneys and one liver). Histopathological assessment demonstrated a nonspecific bone necrosis exhibiting an eosinophilic, homogeneous non-vital bone tissue with peripheral resorption surrounded by reactive connective tissue. PCR test was positive in 21 cases. Conclusion: This study demonstrated that the frequency of osteomyelitis induced by herpes zoster could be more than the records provided by previous studies. Histopathological findings might be nonspecific in such patients. PCR test was not positive for all HZ induced osteomyelitis patients. PMID:25191659
Ning, Hsiao-Chen; Lin, Chia-Ni; Chiu, Daniel Tsun-Yee; Chang, Yung-Ta; Wen, Chiao-Ni; Peng, Shu-Yu; Chu, Tsung-Lan; Yu, Hsin-Ming; Wu, Tsu-Lan
Background Accurate patient identification and specimen labeling at the time of collection are crucial steps in the prevention of medical errors, thereby improving patient safety. Methods All patient specimen identification errors that occurred in the outpatient department (OPD), emergency department (ED), and inpatient department (IPD) of a 3,800-bed academic medical center in Taiwan were documented and analyzed retrospectively from 2005 to 2014. To reduce such errors, the following series of strategies were implemented: a restrictive specimen acceptance policy for the ED and IPD in 2006; a computer-assisted barcode positive patient identification system for the ED and IPD in 2007 and 2010, and automated sample labeling combined with electronic identification systems introduced to the OPD in 2009. Results Of the 2000345 specimens collected in 2005, 1023 (0.0511%) were identified as having patient identification errors, compared with 58 errors (0.0015%) among 3761238 specimens collected in 2014, after serial interventions; this represents a 97% relative reduction. The total number (rate) of institutional identification errors contributed from the ED, IPD, and OPD over a 10-year period were 423 (0.1058%), 556 (0.0587%), and 44 (0.0067%) errors before the interventions, and 3 (0.0007%), 52 (0.0045%) and 3 (0.0001%) after interventions, representing relative 99%, 92% and 98% reductions, respectively. Conclusions Accurate patient identification is a challenge of patient safety in different health settings. The data collected in our study indicate that a restrictive specimen acceptance policy, computer-generated positive identification systems, and interdisciplinary cooperation can significantly reduce patient identification errors. PMID:27494020
Wang, Jian-Bing; Gu, Meng-Jia; Shen, Peng; Huang, Qiu-Chi; Bao, Chen-Zheng; Ye, Zhen-Hua; Wang, You-Qing; Mayila, Mamat; Ye, Ding; Gu, Shi-Tong; Lin, Hong-Bo; Chen, Kun
Although several studies have evaluated the role of body weight as a risk factor for mortality, most studies have been conducted in Western populations and the findings remain controversial. We performed a prospective study to examine the association between body mass index (BMI) and all-cause mortality in Yinzhou District, Ningbo, China. At baseline, 384,533 subjects were recruited through the Yinzhou Health Information System between 2004 and 2009. The final analysis was restricted to 372,793 participants (178,333 men and 194,460 women) aged 18 years and older. Cox proportional hazards models were used to estimate hazard ratios(HRs) and 95% confidence intervals(CIs). We found an increased risk of all-cause mortality among individuals with BMI levels <22.5-24.9, although several groups were not statistically significant-adjusted HRs for persons with BMIs of <15.0, 15.0-17.4, 17.5-19.9, and 20.0-22.4 were 1.61(95% CI: 1.17-2.23), 1.07(0.94-1.20), 1.04(0.98-1.10), 1.06(1.02-1.11), respectively. In the upper BMI range, subjects with BMIs of 25.0-34.9 had a reduced risk of all-cause mortality. Sensitivity analyses excluding smokers, those with prevalent chronic disease or those with less than four years of follow-up did not materially alter these results. Our findings provide evidence for an inverse association of BMI and mortality in this population. PMID:27546611
Wang, Jian-Bing; Gu, Meng-Jia; Shen, Peng; Huang, Qiu-Chi; Bao, Chen-Zheng; Ye, Zhen-Hua; Wang, You-Qing; Mayila, Mamat; Ye, Ding; Gu, Shi-Tong; Lin, Hong-Bo; Chen, Kun
Although several studies have evaluated the role of body weight as a risk factor for mortality, most studies have been conducted in Western populations and the findings remain controversial. We performed a prospective study to examine the association between body mass index (BMI) and all-cause mortality in Yinzhou District, Ningbo, China. At baseline, 384,533 subjects were recruited through the Yinzhou Health Information System between 2004 and 2009. The final analysis was restricted to 372,793 participants (178,333 men and 194,460 women) aged 18 years and older. Cox proportional hazards models were used to estimate hazard ratios(HRs) and 95% confidence intervals(CIs). We found an increased risk of all-cause mortality among individuals with BMI levels <22.5–24.9, although several groups were not statistically significant—adjusted HRs for persons with BMIs of <15.0, 15.0–17.4, 17.5–19.9, and 20.0–22.4 were 1.61(95% CI: 1.17–2.23), 1.07(0.94–1.20), 1.04(0.98–1.10), 1.06(1.02–1.11), respectively. In the upper BMI range, subjects with BMIs of 25.0–34.9 had a reduced risk of all-cause mortality. Sensitivity analyses excluding smokers, those with prevalent chronic disease or those with less than four years of follow-up did not materially alter these results. Our findings provide evidence for an inverse association of BMI and mortality in this population. PMID:27546611
Panzarini, Sônia Regina; Pedrini, Denise; Poi, Wilson Roberto; Sonoda, Celso Koogi; Brandini, Daniela Atili; Monteiro de Castro, José Carlos
The purpose of this retrospective study was to analyze the cases of traumatic dental injuries involving root fracture and/or periodontal ligament injury (except avulsion) treated at the Discipline of Integrated Clinic, School of Dentistry of Araçatuba, São Paulo State University (UNESP), Brazil, from January 1992 to December 2002. Clinical and radiographic records from 161 patients with 287 traumatized teeth that had sustained root fracture and/or injuries to the periodontal ligament were examined. The results of this survey revealed that subluxation (25.09%) was the most common type of periodontal ligament injury, followed by extrusive luxation (19.86%). There was a predominance of young male patients and most of them did not present systemic alterations. Among the etiologic factors, the most frequent causes were falls and bicycle accidents. Injuries on extraoral soft tissues were mostly laceration and abrasion, while gingival and lip mucosa lacerations prevailed on intraoral soft tissues injuries. Radiographically, the most common finding was an increase of the periodontal ligament space. The most commonly performed treatment was root canal therapy. Within the limits of this study, it can be concluded that traumatic dental injuries occur more frequently in young male individuals, due to falls and bicycle accidents. Subluxation was the most common type of periodontal ligament injury. Root canal therapy was the type of treatment most commonly planned and performed. PMID:18949308
Choi-Kain, Lois W; Zanarini, Mary C; Frankenburg, Frances R; Fitzmaurice, Garrett M; Reich, D Bradford
The literature on borderline personality disorder (BPD) describes interpersonal disturbances as a core sector of psychopathology. The longitudinal course of these features remains poorly understood. Our aim is to describe the course of interpersonal features of BPD in a more detailed way than has been done previously. Twenty interpersonal aspects of borderline psychopathology were assessed using two reliable semi-structured diagnostic interviews at baseline and at five successive two-year follow-up waves in the ongoing McLean Study for Adult Development. Behaviorally-oriented features, such as recurrent breakups, sadism, demandingness, entitlement, regression in treatment, and boundary violations, remitted quickly and were rare at the end of follow-up. The interpersonal features slowest to remit were affective responses to being alone, active caretaking, discomfort with care, and dependency. The behavioral interpersonal features of BPD remit rapidly, while core affectively-oriented features related to intolerance of aloneness and conflicts over dependency are more persistent. PMID:20545500
Nacher, Mathieu; Guihenneuc, Chantal; Tubert-Bitter, Pascale; Chavance, Michel
Objective To assess at country level the association of mortality in under 5s with a large set of determinants. Design Longitudinal study. Setting 193 United Nations member countries, 2000-09. Methods Yearly data between 2000 and 2009 based on 12 world development indicators were used in a multivariable general additive mixed model allowing for non-linear relations and lag effects. Main outcome measure National rate of deaths in under 5s per 1000 live births Results The model retained the variables: gross domestic product per capita; percentage of the population having access to improved water sources, having access to improved sanitation facilities, and living in urban areas; adolescent fertility rate; public health expenditure per capita; prevalence of HIV; perceived level of corruption and of violence; and mean number of years in school for women of reproductive age. Most of these variables exhibited non-linear behaviours and lag effects. Conclusions By providing a unified framework for mortality in under 5s, encompassing both high and low income countries this study showed non-linear behaviours and lag effects of known or suspected determinants of mortality in this age group. Although some of the determinants presented a linear action on log mortality indicating that whatever the context, acting on them would be a pertinent strategy to effectively reduce mortality, others had a threshold based relation potentially mediated by lag effects. These findings could help designing efficient strategies to achieve maximum progress towards millennium development goal 4, which aims to reduce mortality in under 5s by two thirds between 1990 and 2015. PMID:24212105
Wusiman, Patiguli; Tuerxun, Julaiti; Ling, Wang; Tuerdi, Maimaitituerxun; Maimaiti, Abudukelimujiang; Tao, Yao Zhi; Saimait, Adilijiang; Mijiti, Ainiwaer; Moming, Adili
Retrospectively analyze the reconstruction methods and surgical outcomes of patients with middle and lower face soft tissue defects treated at our hospital over the past 10 years. 200 patients with middle and lower face soft tissue defects were surgically reconstructed at our hospital. Medical charts were retrospectively reviewed and analyzed to abstract the pertinent information. The lesion was mainly at the eyelid, lips, chin and nasal-cheek region. There were 41 (63.08 %) men and 24 (36.92 %) women. In our study, male to female ratio = 1.7:1. We used direct closure for night patients, local flap for 141 patients, free flap for 38 patients, combined flap for 12 patients involving extensive mid face and lower face defects. Most patients had their tumor resected and reconstructed in single stage procedure mostly with local advancement flap, and no flap failure was presented post-operatively. Middle and lower face soft tissue defects can be successfully treated with local flap in a single stage approach and step-by-step approach. PMID:27508131
Kiss, András; Király, László; Kutasy, Balázs; Merksz, Miklós
This prospective study was designed to address the incidence and clinical and histologic characteristics of balanitis xerotica obliterans in a large random pediatric population with phimosis. We investigated 1178 boys who presented consecutively with phimosis between 1991 and 2001. All patients who underwent complete circumcision and surgical specimens were typed histologically as early, intermediate, or late forms of this disorder or as nonspecific chronic inflammation. Patients with balanitis xerotica obliterans were controlled at 1, 6, and 12 months postoperatively, then yearly. Balanitis xerotica obliterans was found in 471 of the 1178 patients (40%), with the highest incidence in boys aged 9 to 11 years (76%). Secondary phimosis occurred in 93% of boys with balanitis xerotica obliterans and in 32% of those without the disorder. In six instances of balanitis xerotica obliterans, meatotomy and in one meatoplasty was performed, as well as circumcision. On histologic evaluation, we found 19% had early, 60% intermediate, and 21% late form of balanitis xerotica obliterans. Glanular lesions disappeared completely within 6 months in 229 out of 231 patients. Our data strongly suggest that the true incidence of childhood balanitis xerotica obliterans is higher than previously assumed. Its incidence peaks in the 9 to 11 years age group, in whom secondary phimosis was almost exclusively caused by balanitis xerotica obliterans. PMID:16060864
Booker, Alexandria; Malcarne, Vanessa L; Sadler, Georgia Robins
The public is encouraged to participate in cancer education programs because it is believed that acquiring health-promoting knowledge will motivate participants to make the recommended, evidence-based behavioral modifications that should lead to reductions in cancer morbidity and mortality. Because of the extended time that elapses between conducting a health education program and the amassing of the scientific evidence needed to establish that an education program has ultimately resulted in a reduction in morbidity and mortality, researchers have sought more proximal and intermediate outcome measures as substitutes for the more distal desired outcomes. This paper presents an analysis of research published in the Journal of Cancer Education from 2000 through 2010, in which the impact of cancer education interventions was evaluated. The focus was to identify the proximal, intermediate, and distal outcome measures used to evaluate the impact of cancer education interventions. The results showed that researchers primarily focus on measuring the varied proximal outcomes (e.g., knowledge and attitude changes) of cancer education interventions. Intermediate outcome measures (the desired behavior change itself) received less attention, while distal outcomes (changes in morbidity and mortality) were never measured. This review gives cancer education researchers a review of the proximal and intermediate outcome measures and strategies that behavioral scientists recently used to overcome the challenges of measuring distal outcomes. Future reviews could expand this analysis to studies published in other journals and health disciplines. PMID:24189833
Castellanos-Ryan, Natalie; Parent, Sophie; Vitaro, Frank; Tremblay, Richard E.; Séguin, Jean R.
Most research linking early pubertal development to substance use has focused on the effects of pubertal timing (age at which a certain stage of pubertal development is reached or pubertal status at a particular age—related to the maturation disparity hypothesis), but little research has focused on pubertal tempo (rate of growth through pubertal stages—related to the maturation compression hypothesis). However, both timing and tempo have not only been identified as important components of pubertal development, with different predictors, but have also been shown to be independently associated with other adolescent psychopathologies. Using latent growth-curve modeling, this study examined how pubertal status at age 12 and pubertal tempo (between 11 and 13 years) related to substance use from 15 to 16 years in boys from low socioeconomic backgrounds (N = 871). Results showed that both pubertal status at age 12 and tempo were significant predictors of increased levels of substance use and problems in mid to late adolescence. In an attempt to identify mechanisms that may explain the association between pubertal development and substance use it was found that sensation seeking partially mediated the association between pubertal status at age 12 and substance use behaviors. Impulse control was found to moderate the association sensation seeking had with marijuana use frequency, with high sensation-seeking scores predicting higher marijuana use frequency only at low levels of impulse control. These findings highlight the importance of considering multiple sources of individual variability in the pubertal development of boys and provide support for both the maturational disparity and compression hypotheses. PMID:24016016
Kuang, Lifen; Huang, Zhimin; Hong, Zhenzhen; Chen, Ailing; Li, Yanbing
Aims/Introduction Elevated 1-h postload plasma glucose concentration (1hPG) during oral glucose tolerance test has been linked to an increased risk of type 2 diabetes and a poorer cardiometabolic risk profile. The present study analyzed the predictability and cut-off point of 1hPG in predicting type 2 diabetes in normal glucose regulation (NGR) subjects, and evaluated the long-term prognosis of NGR subjects with elevated 1hPG in glucose metabolism, kidney function, metabolic states and atherosclerosis. Materials and Methods A total of 116 Han Chinese classified as NGR in 2002 at the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China, were investigated. Follow-up was carried out in 2012 to evaluate the progression of glucose metabolism, kidney function, metabolic syndrome and carotid atherosclerosis. Results The areas under receiver operating characteristic curves were higher for 1hPG than FPG or 2hPG (0.858 vs 0.806 vs 0.746). The cut-off value of 1hPG with the maximal sum of sensitivity and specificity in predicting type 2 diabetes in NGR subjects was 8.85 mmol/L. The accumulative incidence of type 2 diabetes in subjects with 1hPG ≥8.85 mmol/L was higher than those <8.85 mmol/L (46.2% vs 3.3%, P = 0.000; relative risk 13.846, 95% confidence interval 4.223–45.400). On follow up, the prevalence of metabolic syndrome and abnormal carotid intima-media thickness in the subjects with 1hPG ≥8.85 mmol/L tended to be higher compared with those <8.85 mmol/L. Conclusions 1hPG is a good predictor of type 2 diabetes in NGR subjects, and the best cut-off point is 8.85 mmol/L. Some tendency indicates that NGR subjects with 1hPG ≥8.85 mmol/L are more prone to metabolic syndrome and carotid atherosclerosis. PMID:26543538
Marques, Ilza Lazarini; Nackashi, John; Borgo, Hilton Coimbra; Martinelli, Angela Patrícia Menezes Cardoso; de Souza, Luiz; Dutka, Jeniffer de Cássia Rillo; Williams, William N; Pegoraro-Krook, Maria Inês
Objective : To study the growth of children with complete unilateral cleft lip and palate (UCLP) from 2 to 10 years of age and to assess whether growth varied from that of children without UCLP (typical children). Design : Physical growth was one of the outcome measures of a National Institutes of Health-sponsored longitudinal, prospective clinical trial conducted by the University of Florida and the University of São Paulo. Setting : Hospital of Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC-USP), Bauru, Brazil. Main Outcome Measures : Height and weight were prospectively measured for 360 healthy children with UCLP who were nonsyndromic, belonged to median socioeconomic status, and received health care at HRAC-USP. To compare growth of children with UCLP to that of typical children, growth curves for UCLP were developed and compared with World Health Organization curves for 2006 and 2007, which were used as reference for typical children. Third-degree polynomials were used to explain the relationship of length and weight with age. Confidence limits of 95% were used for the mean curve using the statistic Z ~ N (0,1). Results : Children with UCLP from 2 to 10 years old presented height and weight growth curves similar to those of typical children for both genders. Conclusion : Children with UCLP from 2 to 10 years old presented physical growth similar to that of typical children. PMID:24810484
Sato, Shunsuke; Nishinaka, Kazuyuki; Takahashi, Satoshi; Hirobe, Megumi; Tsukamoto, Taiji
Zonisamide is an antiepileptic drug mainly used in patients with refractory epilepsy. One of the urological adverse effects caused by zonisamide is urinary lithiasis. We reported bilateral urinary lithiasis with zonisamide developed for a short period of time. A 10 year-old girl had been treated with zonisamide for intractable epilepsy for nine years. She progressively developed microscopic hematuria as well as crystalluria while being hospitalized for ventriculoperitoneal shunt infection. A computed tomography (CT) showed bilaterally hydronephrotic kidneys obstructed by multiple ureteral calculi. What was impressive was the fact that any single urinary calculus was not identified in a CT image taken just three weeks prior to this event. Then the diagnosis was made of zonisamide-induced bilateral urinary calculi and zonisamide treatment was discontinued. However, since the deterioration of renal function and left-sided hydronephrosis progressed, we performed the construction of right-sided percutaneous nephrostomy (PNS) and the transurethral placement of a left ureteral stent. Subsequently her condition was stabilized and all of these stones were discharged. The analysis of these stones showed mainly calcium phosphatic calculus. We eventually removed both the right PNS and the left ureteral stent. Since then, there has not been any recurrence thus far. We need to recognize the risk of progressively developing renal calculi during zonisamide treatment for a relatively short period of time in the face of dehydration. PMID:24187857
Healthy food baskets have been used around the world for a variety of purposes, including: examining the difference in cost between healthy and unhealthy food; mapping the availability of healthy foods in different locations; calculating the minimum cost of an adequate diet for social policy planning; developing educational material on low cost eating and examining trends on food costs over time. In Australia, the Illawarra Healthy Food Basket was developed in 2000 to monitor trends in the affordability of healthy food compared to average weekly wages and social welfare benefits for the unemployed. It consists of 57 items selected to meet the nutritional requirements of a reference family of five. Bi-annual costing from 2000–2009 has shown that the basket costs have increased by 38.4% in the 10-year period, but that affordability has remained relatively constant at around 30% of average household incomes. PMID:22254001
Schafer, T.; Ellis, R.; Osborne, T.; Hicks Pries, C.
Long-term monitoring of restoration projects aims to determine long-term sustainability and stability of restored systems. In coastal wetlands, one indicator of restoration of ecosystem function can be seen with organic matter (specifically carbon) accretion. SL-15, a spoil island in Fort Pierce, Fl was restored in 2005, and has been monitored for return to natural condition over the last 10 years.. To assess sediment carbon accretion, sediment cores were collected in a set of eight plots, located on the SL-15 mangrove island and the surrounding seagrass recruitment area. These were analyzed for organic carbon, microbial biomass carbon, extractable carbon, and total nitrogen. The biogeochemical data collected in the previous year was compared to data collected in 2005-2007. Vegetation surveys were also completed to show the build-up of organic material in accordance with vegetation shift over the 9-year period. From this information, a trajectory has been formulated on organic carbon accretion and vegetation shift from the time of orginal restoration activities. By comparison to control sites nearby, realistic estimates of time required to reach natural levels of carbon and vegetation community structure can be calculated..
Zubrick, Stephen R.; Taylor, Catherine L.; Christensen, Daniel
Aims Oral language is the foundation of literacy. Naturally, policies and practices to promote children’s literacy begin in early childhood and have a strong focus on developing children’s oral language, especially for children with known risk factors for low language ability. The underlying assumption is that children’s progress along the oral to literate continuum is stable and predictable, such that low language ability foretells low literacy ability. This study investigated patterns and predictors of children’s oral language and literacy abilities at 4, 6, 8 and 10 years. The study sample comprised 2,316 to 2,792 children from the first nationally representative Longitudinal Study of Australian Children (LSAC). Six developmental patterns were observed, a stable middle-high pattern, a stable low pattern, an improving pattern, a declining pattern, a fluctuating low pattern, and a fluctuating middle-high pattern. Most children (69%) fit a stable middle-high pattern. By contrast, less than 1% of children fit a stable low pattern. These results challenged the view that children’s progress along the oral to literate continuum is stable and predictable. Findings Multivariate logistic regression was used to investigate risks for low literacy ability at 10 years and sensitivity-specificity analysis was used to examine the predictive utility of the multivariate model. Predictors were modelled as risk variables with the lowest level of risk as the reference category. In the multivariate model, substantial risks for low literacy ability at 10 years, in order of descending magnitude, were: low school readiness, Aboriginal and/or Torres Strait Islander status and low language ability at 8 years. Moderate risks were high temperamental reactivity, low language ability at 4 years, and low language ability at 6 years. The following risk factors were not statistically significant in the multivariate model: Low maternal consistency, low family income, health care card
Ehling, Rainer; Lutterotti, Andreas; Hegen, Harald; Di Pauli, Franziska; Auer, Michael; Deisenhammer, Florian; Reindl, Markus; Berger, Thomas
Background Multiple sclerosis (MS) has a highly heterogenic course making prediction of long term outcome very difficult. Objective The objective was to evaluate current and identify additional clinical factors that are linked to long term outcome of relapsing-remitting MS assessed by disability status 10 years after disease onset. Methods This observational study included 793 patients with relapsing-remitting MS. Clinical factors hypothesized to influence long term outcome measured by EDSS scores 10 years after disease onset were analysed by Kaplan-Meier-estimates. Multinomial logistic regression models regarding mild (EDSS ≤2.5), moderate (EDSS 3.0–5.5) or severe (EDSS ≥6.0) disability were calculated to correct for confounders. Results Secondary progression was the strongest predictor of severe disability (Hazard ratio [HR] 503.8, 95% confidence interval [CI] 160.0–1580.1); p<0.001). Complete remission of neurological symptoms at onset reduced the risk of moderate disability (HR 0.42; CI 0.23–0.77; p = 0.005), while depression (HR 3.59; CI 1.14–11.24; p = 0.028) and cognitive dysfunction (HR 4.64; CI 1.11–19.50; p = 0.036) 10 years after disease onset were associated with severe disability. Oligoclonal bands and pregnancy were not correlated with disability. Conclusion We were able to identify clinically apparent chronic depression and cognitive dysfunction to be associated with adverse long term outcome in MS and to confirm that pregnancy has no negative impact. Additionally, we emphasize the positive predictive value of complete remission of initial symptoms. PMID:27391947
Park, Jinsung; Suh, Beomseok; Shin, Dong Wook; Hong, Jun Hyuk; Ahn, Hanjong
Purpose We investigated changing patterns of primary treatment in Korean men with prostate cancer (PC) and impact of sociodemographic factors on treatment choice from a nationwide cohort over 10 years. Materials and Methods We conducted a cohort study of a 2% nationwide random sample of Korean National Health Insurance. A total of 1,382 patients who had undergone active treatments for newly diagnosed PC between 2003 and 2013 were included. Time trends in primary treatment of PC, including radical surgery, radiation therapy (RT), and androgen deprivation therapy (ADT) were analyzed. Results Total number of patients undergoing active treatments increased significantly (162%). Surgery cases showed the most significant increase, from 22.4% in 2003 to 45.4% in 2013, while the relative proportion of ADT showed a tendency to decrease from 60.3% in 2003 to 45.4% in 2013, and the relative proportion of RT was variable over 10 years (from 7.2% to 18.4%). While treatment patterns differed significantly according to age (p < 0.001) and income classes (p=0.014), there were differences in primary treatment according to residential area. In multinomial logistic regression analysis, older patients showed significant association with ADT or RT compared to surgery, while patients with higher income showed significant association with surgery. Conclusion Treatment pattern in Korean PC patients has changed remarkably over the last 10 years. Sociodemographic factors do affect the primary treatment choice. Our results will be valuable in overviewing changing patterns of primary treatment in Korean PC patients and planning future health policy for PC. PMID:26511804
Paalman, C H; van Leeuwen, F E; Aaronson, N K; de Boer, A G E M; van de Poll-Franse, L; Oldenburg, H S A; Schaapveld, M
Background: Little is known about employment outcomes after breast cancer (BC) beyond the first years after treatment. Methods: Employment outcomes were compared with a general population comparison group (N=91 593) up to 10 years after BC for 26 120 patients, diagnosed before age 55 between 2000–2005, with income and social benefits data from Statistics Netherlands. Treatment effects were studied in 14 916 patients, with information on BC recurrences and new cancer events. Results: BC survivors experienced higher risk of losing paid employment (Hazard Ratio (HR): 1.6, 95% Confidence Interval (95% CI) 1.4–1.8) or any work-related event up to 5–7 years (HR 1.5, 95% CI 1.3–1.6) and of receiving disability benefits up to 10 years after diagnosis (HR 2.0, 95% CI 1.6–2.5), with higher risks for younger patients. Axillary lymph node dissection increased risk of disability benefits (HR 1.5, 95% CI 1.4–1.7) or losing paid employment (HR 1.3, 95% CI 1.2–1.5) during the first 5 years of follow-up. Risk of disability benefits was increased among patients receiving mastectomy and radiotherapy (HR 1.2; 95% CI 1.1–1.3) and after chemotherapy (HR 1.7; 95% CI 1.5–1.9) during the first 5 years after diagnosis. Conclusions: BC treatment at least partly explains the increased risk of adverse employment outcomes up to 10 years after BC. PMID:26757424
Hart, Robert; Hermsmeyer, Jeffrey T.; Sethi, Rajiv K.; Norvell, Daniel C.
Study Design Systematic review. Clinical Questions (1) Has the proportion and number of randomized controlled trials (RCTs) as an indicator of quality of evidence regarding lumbar fusion increased over the past 10 years? (2) Is there a difference in the proportion of RCTs among the four primary fusion diagnoses (degenerative disk disease, spondylolisthesis, deformity, and adjacent segment disease) over the past 10 years? (3) Is there a difference in the type and quality of clinical outcomes measures reported among RCTs over time? (4) Is there a difference in the type and quality of adverse events measures reported among RCTs over time? (5) Are there changes in fusion surgical approach and techniques over time by diagnosis over the past 10 years? Methods Electronic databases and reference lists of key articles were searched from January 1, 2004, through December 31, 2013, to identify lumbar fusion RCTs. Fusion studies designed specifically to evaluate recombinant human bone morphogenetic protein-2 or other bone substitutes, revision surgery studies, nonrandomized comparison studies, case reports, case series, and cost-effectiveness studies were excluded. Results Forty-two RCTs between January 1, 2004, and December 31, 2013, met the inclusion criteria and form the basis for this report. There were 35 RCTs identified evaluating patients diagnosed with degenerative disk disease, 4 RCTs evaluating patients diagnosed with degenerative spondylolisthesis, and 3 RCTs evaluating patients with a combination of degenerative disk disease and degenerative spondylolisthesis. No RCTs were identified evaluating patients with deformity or adjacent segment disease. Conclusions This structured review demonstrates that there has been an increase in the available clinical database of RCTs using patient-reported outcomes evaluating the benefit of lumbar spinal fusion for the diagnoses of degenerative disk disease and degenerative spondylolisthesis. Gaps remain in the
Rabin, Laura A; Paolillo, Emily; Barr, William B
As a 10-year follow up to our original study (Rabin, Barr, & Burton, 2005), we surveyed the test usage patterns of clinical neuropsychologists in the U.S and Canada. We expanded the original questionnaire to include additional cognitive and functional domains and to address current practice-related issues. Participants were randomly selected from the combined membership lists of the National Academy of Neuropsychology and the International Neuropsychological Society. Respondents were 512 doctorate-level members (25% usable response rate; 54% women) who had been practicing neuropsychology for 15 years on average. The Wechsler Adult Intelligence Scales, followed by the Wechsler Memory Scales, Trail Making Test, California Verbal Learning Test, and Wechsler Intelligence Scale for Children, were the most commonly used tests. These top five responses were identical and in the same order as those from 10 years ago. Participants respectively identified a lack of ecological validity and difficulty comparing the meaning of standardized scores across tests as the greatest challenges associated with the selection of neuropsychological instruments and interpretation of test data. Overall, we found great consistency in assessment practices over the 10-year period. We compare results to those of previous studies and discuss challenges and implications for neuropsychology. PMID:26984127
Karam, Carma; Beauchet, Alain; Czernichow, Sebastien; de Roquefeuil, Florence; Bourez, Alain; Mansencal, Nicolas; Dubourg, Olivier
Background Surveys measuring effectiveness of public awareness campaigns in reducing cardiovascular disease (CVD) incidence have yielded equivocal findings. The aim of this study was to describe cardiovascular risk factors (CVRFs) changes over the years in an untreated population-based study. Methods Between 2007 and 2012, we conducted a screening campaign for CVRFs in men aged 40 to 65 yrs and women aged 50 to 70 yrs in the western suburbs of Paris. Data were complete for 20,324 participants of which 14,709 were untreated. Results The prevalence trend over six years was statistically significant for hypertension in men from 25.9% in 2007 to 21.1% in 2012 (p=0.002) and from 23% in 2007 to 12.7% in 2012 in women (p<0.0001). The prevalence trend of tobacco smoking decreased from 38.6% to 27.7% in men (p=0.0001) and from 22.6% to 16.8% in women (p=0.113). The Framingham 10-year risk for CVD decreased from 13.3 ± 8.2 % in 2007 to 11.7 ± 9.0 % in 2012 in men and from 8.0 ± 4.1 % to 5.9 ± 3.4 % in women. The 10-year risk of fatal CVD based on the European Systematic COronary Risk Evaluation (SCORE) decreased in men and in women (p <0.0001). Conclusions Over a 6-year period, several CVRFs have decreased in our screening campaign, leading to decrease in the 10-year risk for CVD and the 10-year risk of fatal CVD. Cardiologists should recognize the importance of community prevention programs and communication policies, particularly tobacco control and healthier diets to decrease the CVRFs in the general population. PMID:25906186
Panagiotakos, Demosthenes; Georgousopoulou, Ekavi; Notara, Venetia; Pitaraki, Evangelia; Kokkou, Eleni; Chrysohoou, Christina; Skoumas, Yannis; Metaxa, Vassiliki; Pitsavos, Christos; Stefanadis, Christodoulos
Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide, and educational level seems to be an important determinant of the disease occurrence. The aim of this work was to investigate the association between education status and 10-year incidence of CVD, controlling for various socio-demographic lifestyle and clinical factors. From May 2001 to December 2002, 1514 men and 1528 women (>18 years) without any clinical evidence of CVD or any other chronic disease, at baseline, living in greater Athens area, Greece, were enrolled. In 2011-2012, the 10-year follow-up was performed in 2583 participants (15% of the participants were lost to follow-up). Incidence of fatal or non-fatal CVD was defined according to WHO-ICD-10 criteria. Education status was measured in years of schooling. The 10-year incidence of CVD was 15.7% [95% confidence intervals (CI) 14.1%-17.4%], 19.7% in men and 11.7% in women (Pgender < 0.001). Age-and gender-adjusted analyses revealed that those with low education (<9 years of schooling) were 1.52 times more likely (95% CI 1.03-2.23%) to have CVD compared with those with high education (>12 years of schooling). People in the low education group had higher prevalence of hypertension, diabetes and dyslipidaemias, were more likely to be smokers and sedentary, had less healthy dietary habits, as compared with those in the high education group. When controlling for participants' medical history, smoking, dietary and lifestyle habits, low education was no longer significantly associated with CVD, illustrating the mediating effect of clinical and behavioural factors in the link between education and disease. It was of interest that low education status interacted with alcohol drinking, enhancing the adverse effect of low education on CVD risk (relative risk 1.44, 95% CI 0.94%-2.20%), after various adjustments made. In this study, it was concluded that low educational level was associated with increased CVD risk. This was
Lam, Phung Khanh; Tam, Dong Thi Hoai; Diet, Tran Vinh; Tam, Cao Thi; Tien, Nguyen Thi Hanh; Kieu, Nguyen Tan Thanh; Simmons, Cameron; Farrar, Jeremy; Nga, Nguyen Thi Ngoc; Qui, Phan Tu; Dung, Nguyen Minh; Wolbers, Marcel; Wills, Bridget
Background. Dengue shock syndrome (DSS) is a severe manifestation of dengue virus infection that particularly affects children and young adults. Despite its increasing global importance, there are no prospective studies describing the clinical characteristics, management, or outcomes of DSS. Methods. We describe the findings at onset of shock and the clinical evolution until discharge or death, from a comprehensive prospective dataset of 1719 Vietnamese children with laboratory-confirmed DSS managed on a single intensive care unit between 1999 and 2009. Results. The median age of patients was 10 years. Most cases had secondary immune responses, with only 6 clear primary infections, and all 4 dengue virus serotypes were represented during the 10-year study. Shock occurred commonly between days 4 and 6 of illness. Clinical signs and symptoms were generally consistent with empirical descriptions of DSS, although at presentation 153 (9%) were still febrile and almost one-third had no bleeding. Overall, 31 (2%) patients developed severe bleeding, primarily from the gastrointestinal tract, 26 of whom required blood transfusion. Only 8 patients died, although 123 of 1719 (7%) patients had unrecordable blood pressure at presentation and 417 of the remaining 1596 (26%) were hypotensive for age. The majority recovered well with standard crystalloid resuscitation or following a single colloid infusion. All cases were classified as severe dengue, while only 70% eventually fulfilled all 4 criteria for the 1997 World Health Organization classification of dengue hemorrhagic fever. Conclusions. With prompt intervention and assiduous clinical care by experienced staff, the outcome of this potentially fatal condition can be excellent. PMID:24046311
Charvat, Hadrien; Sasazuki, Shizuka; Inoue, Manami; Iwasaki, Motoki; Sawada, Norie; Shimazu, Taichi; Yamaji, Taiki; Tsugane, Shoichiro
Gastric cancer is a particularly important issue in Japan, where incidence rates are among the highest observed. In this work, we provide a risk prediction model allowing the estimation of the 10-year cumulative probability of gastric cancer occurrence. The study population consisted of 19,028 individuals from the Japanese Public Health Center cohort II who were followed-up from 1993 to 2009. A parametric survival model was used to assess the impact on the probability of gastric cancer of clinical and lifestyle-related risk factors in combination with serum anti-Helicobacter pylori antibody titres and pepsinogen I and pepsinogen II levels. Based on the resulting model, cumulative probability estimates were calculated and a simple risk scoring system was developed. A total of 412 cases of gastric cancer occurred during 270,854 person-years of follow-up. The final model included (besides the biological markers) age, gender, smoking status, family history of gastric cancer and consumption of highly salted food. The developed prediction model showed good predictive performance in terms of discrimination (optimism-corrected c-index: 0.768) and calibration (Nam and d'Agostino's χ(2) test: 14.78; p values = 0.06). Estimates of the 10-year probability of gastric cancer occurrence ranged from 0.04% (0.02, 0.1) to 14.87% (8.96, 24.14) for men and from 0.03% (0.02, 0.07) to 4.91% (2.71, 8.81) for women. In conclusion, we developed a risk prediction model for gastric cancer that combines clinical and biological markers. It might prompt individuals to modify their lifestyle habits, attend regular check-up visits or participate in screening programmes. PMID:26219435
In the past 10 years, we have observed 112 cases of EDTA-dependent pseudothrombocytopenia (PTCP) due to in vitro platelet clumping at room temperature. 93 patients had antiplatelet antibodies (48 IgM, 30 IgG, 3 IgA, and 12 had two different isotypes concomitantly). In 20% of patients, the presence of IgM antibodies characteristically accompanied platelet agglutination also at 37 degrees C, and in citrated blood. The phenomenon was not age or sex related, nor was it associated with any particular pathology or use of specific drugs, and was present in both healthy subjects and patients with various diseases. Flow cytofluorimetric analysis of CD5-positive B cells, which are responsible for autoantibody production, did not demonstrate any changes in the percentage and absolute number of this lymphocyte subset. Average follow-up was 5 years (6 months-10 years); however, previous clinical records disclosed that PTCP was present for more than 15 years in four cases, and more than 20 years in three others, with no clinical manifestation of disease. This study confirms that EDTA-dependent PTCP is a phenomenon related to the presence of natural autoantibodies with antiplatelet activity, devoid of pathological significance. Its clinical interest resides in the need for its prompt and certain recognition in order to avoid unnecessary examinations and therapeutic interventions. The best and most rapid technique for obtaining accurate platelet counts in PTCP subjects is to collect and examine EDTA blood at 37 degrees C; however, clumping will still be present in about 20% of these cases, and even in citrated blood. To obviate this phenomenon, blood should be collected in ammonium oxalate, and platelets counted in a Burker chamber. PMID:7572988
Gallagher, Tony; McEwen, Alex; Knipe, Damien
Surveys of and interviews with year-12 students in Northern Ireland over 10 years examined the impact of government science education policy by noting student participation in advanced science courses. Overall, the number of boys taking advanced courses decreased and the number of girls increased. Students retained certain stereotyped views of…
Xu, Z; Zhao, X P; Yan, T L; Wang, M; Wang, L; Wu, H J; Shang, Z J
The aim of this study was to report the clinical features, reliability, and various applications of free anterolateral thigh (ALT) flaps and to provide a 10-year retrospective review of the application of this flap in head and neck tumour patients. A retrospective study was performed of 872 patients who underwent immediate reconstruction of head and neck tumour-induced defects with ALT flaps between April 2005 and April 2014. The study sample consisted of 609 males and 263 females aged 18-79 years. The shapes and sizes of the flaps were designed individually to meet various demands of reconstruction in the head and neck region. The overall rate of successful reconstruction was 97.4%. The reasons for 57 cases of flap compromise were analyzed. The time to detection of flap crisis was often within the first 8h after surgery (64.9%). One- and two-vein anastomosis strategies in microsurgery were compared, and significant differences were observed in terms of the time to detection of flap compromise and the rate of successful flap salvage. In conclusion, the free ALT flap provides unique features for the reconstruction of oral and facial defects in a reliable and versatile approach. The ALT flap is a favourable and versatile 'workhorse' flap for head and neck reconstruction. PMID:26154948
Shalev, I; Moffitt, T E; Sugden, K; Williams, B; Houts, R M; Danese, A; Mill, J; Arseneault, L; Caspi, A
There is increasing interest in discovering mechanisms that mediate the effects of childhood stress on late-life disease morbidity and mortality. Previous studies have suggested one potential mechanism linking stress to cellular aging, disease and mortality in humans: telomere erosion. We examined telomere erosion in relation to children's exposure to violence, a salient early-life stressor, which has known long-term consequences for well-being and is a major public-health and social-welfare problem. In the first prospective-longitudinal study with repeated telomere measurements in children while they experienced stress, we tested the hypothesis that childhood violence exposure would accelerate telomere erosion from age 5 to age 10 years. Violence was assessed as exposure to maternal domestic violence, frequent bullying victimization and physical maltreatment by an adult. Participants were 236 children (49% females; 42% with one or more violence exposures) recruited from the Environmental-Risk Longitudinal Twin Study, a nationally representative 1994-1995 birth cohort. Each child's mean relative telomere length was measured simultaneously in baseline and follow-up DNA samples, using the quantitative PCR method for T/S ratio (the ratio of telomere repeat copy numbers to single-copy gene numbers). Compared with their counterparts, the children who experienced two or more kinds of violence exposure showed significantly more telomere erosion between age-5 baseline and age-10 follow-up measurements, even after adjusting for sex, socioeconomic status and body mass index (B=-0.052, s.e.=0.021, P=0.015). This finding provides support for a mechanism linking cumulative childhood stress to telomere maintenance, observed already at a young age, with potential impact for life-long health. PMID:22525489
Liang, Tian J; You, Mu Z; Xing, Pei F; Bin, Shen; Ke, Zhou Zhong; Jing, Yang
Young patients are expected to place increased demands on total hip arthroplasty (THA) because they are more active and have a longer life expectancy. The long-term outcome of the Charnley low-friction arthroplasty in young, active patients has been shown to be associated with a high degree of polyethylene wear and osteolysis. However, cementless acetabular components have been shown to be successful in young patients.We evaluated the clinical and radiographic results of 77 cementless THAs in 81 young, active patients at a mean follow-up of 7.5 years. Mean preoperative Harris Hip Score improved from 46.24 to 96.5 points at 6 years. One acetabular component showed aseptic loosening 10 years postoperatively. Three patients (3 hips) underwent bone grafts and liner renewal for severe osteolysis around the acetabular component. The rate of survival at 6 years for loosening was 98.8%, and for revision of the liner was 95.5% (95% confidence interval, 93%-98%). Mean liner wear rate was 0.125 mm/year (range, 0.0-0.39 mm/year). Acetabular osteolysis was found in 14% (9 hips) of the 67 hips and was related to polyethylene wear (P=.0024). Although there was only 1 cup loosening in this study, there was a high rate of linear wear of the polyethylene liner and acetabular osteolysis in young, active patients. Further follow-up is therefore needed, and osteolysis and polyethylene wear should continue to be observed in young, active patients. PMID:20415300
Cho, Nam H.; Oh, Tae Jung; Kim, Kyoung Min; Choi, Sung Hee; Lee, Jae Ho; Park, Kyong Soo; Jang, Hak Chul; Kim, Jong Yeol; Lee, Hong Kyu; Lim, Soo
Neck circumference, a proxy for upper-body fat, may be a unique fat depot that indicates metabolic risk beyond whole body fat. We investigated whether neck circumference is associated with development of diabetes mellitus (DM) in a subset of data with Korean Genome and Epidemiology Study (n = 3521, age range = 42–71 years). Nondiabetic subjects at the baseline were categorized into 4 groups (Q1–Q4) according to their neck circumference. Parameters related with β-cell function and insulin resistance including Epworth sleepiness scale and snoring habit were examined. The development of DM was confirmed biannually based on a 75-g oral glucose tolerance test. Over the 10 years, 2623 (74.5%) among 3521 subjects were followed-up. Among them, 632 (24.1%) developed DM. The incidence of DM increased from 17.6% in Q1 to 18.2% in Q2, to 25.4% in Q3, and to 36.0% in Q4 (P < 0.001). After adjusting for most risk factors related with DM, the relative risks of DM development were 0.989 (95% confidence interval, 0.638–1.578), 1.660 (1.025–2.687), and 1.746 (1.037–2.942) in men and 0.939 (0.540–1.769), 1.518 (0.808–2.853), and 2.077 (1.068–4.038) in women in Q2, Q3, and Q4, respectively when compared to Q1. This finding indicates negative impact from large neck circumference in the development of DM. PMID:26681338
Chen, Chuan-Yu; Liang, Hsin-Yi; Chang, Chia-Ming; Lin, Ju-Hwa; Chang, Tsung-Kai; Tsai, Hui-Ju
Increased attention has been paid to tic disorders clinically, yet relatively few studies have probed potential factors that account for the occurrence of tic disorders in the general population. In this study, we used data derived from the Taiwan's National Health Insurance Research Database to examine an array of factors related to the diagnosis of tic disorders and to further probe gender heterogeneity in clinical manifestation. Poisson regression analyses were applied to model the effects of birth cohort, period, and age, separately, on tic disorders. A total of 880 newly diagnosed tic disorders were identified from 2002 to 2009 among 100,516 youngsters in the study dataset who were born between 1997 and 2005. The results showed that a significant increase in the adjusted incidence rate ratio (IRR) was observed when age increased, with the highest adjusted IRR found at age 8-9 years. Compared to the time period from 2002 to 2005, an elevated IRR was found in the time period from 2006 to 2009 (adjusted IRR: 1.37; 95% CI: 1.05-1.80). Boys tended to be more likely to receive their initial diagnosis from psychiatrists and have higher comorbid attention-deficit/hyperactivity disorder (ADHD), as compared with their girl counterparts. In conclusion, the findings indicate that the effects of age and period, respectively, influence the occurrence of newly diagnosed tic disorders. Gender difference and higher frequent comorbid ADHD in boys than in girls were observed in this study. PMID:23680438
Bromberger, Joyce T; Kravitz, Howard M
Women are twice as likely as men to suffer from depressive symptoms/disorder. Research has focused on physiologic and psychosocial differences between men and women; an important target of study has been periods of reproductive changes. Controversy has existed regarding the extent to which the menopausal transition or postmenopause increases the risk for depressive symptoms/disorders. This paper presents findings from analyses of data from the SWAN study and an ancillary study on mental health. We found that risk for high depressive symptoms and disorder is greater during and possibly after the menopausal transition. Other factors contribute to risk for depression. PMID:21961723
Smith, Timothy R; Nanney, Allan D; Lall, Rishi R; Graham, Randall B; McClendon, Jamal; Lall, Rohan R; Adel, Joseph G; Zakarija, Anaadriana; Cote, David J; Chandler, James P
Patients who undergo craniotomy for brain neoplasms have a high risk of developing venous thromboembolism (VTE), including deep vein thromboses (DVT) and pulmonary emboli (PE). The reasons for this correlation are not fully understood. This retrospective, single-center review aimed to determine the risk factors for VTE in patients who underwent neurosurgical resection of brain tumors at Northwestern University from 1999 to 2010. Our cohort included 1148 patients, 158 (13.7%) of whom were diagnosed with DVT and 38 (3.3%) of whom were diagnosed with PE. A variety of clinical factors were studied to determine predictors of VTE, including sex, ethnicity, medical co-morbidities, surgical positioning, length of hospital stay, tumor location, and tumor histology. Use of post-operative anticoagulants and hemorrhagic complications were also investigated. A prior history of VTE was found to be highly predictive of post-operative DVT (odds ratio [OR]=7.6, p=0.01), as was the patient's sex (OR=14.2, p<0.001), ethnicity (OR=0.5, p=0.04), post-operative intensive care unit days (OR=0.2, p=0.003), and tumor histology (OR=-0.16, p=0.01). Contrary to reports in the literature, the data collected did not indicate that the administration of post-operative medical prophylaxis for VTE was significant in preventing their formation (OR=-0.14, p=0.76). Hemorrhagic complications were low (2.2%) and resultant neurologic deficit was lower still (0.7%). The study indicates that patients with high-grade primary brain tumors and metastatic lesions should receive aggressive preventative measures in the post-operative period. PMID:25533212
Hamai, Satoshi; Nakashima, Yasuharu; Mashima, Naohiko; Yamamoto, Takuaki; Kamada, Tomomi; Motomura, Goro; Imai, Hiroshi; Fukushi, Jun-Ichi; Miura, Hiromasa; Iwamoto, Yukihide
No previous studies comparing the clinical wear rates of the two different kinds of cross-linked ultra-high-molecular-weight polyethylene (XLPE), annealed and remelted, are available. We compared the creep and steady wear rates of 36 matched pairs (72 hips in total) adjusting for baseline characteristics with propensity score matching techniques. Zirconia femoral heads with 26-mm diameter were used in all cases. The femoral-head cup penetration was measured digitally on radiographs. Significantly greater creep (p=0.006) was detected in the remelted (0.234mm) than annealed (0.159mm) XLPE. However, no significant difference (p=0.19) was found between the steady wear rates (0.003 and 0.008mm/year, respectively) of the annealed and remelted XLPE. Multiple regression analyses showed that remelted XLPE is significant independent variable (p<0.001) that is positively associated with creep. However, the patient age and body weight, cup size, the liner thickness, cup inclination, follow-up periods, and postoperative Merle d'Aubigné hip score had no significant effects (p>0.05) on the steady wear rates. No patients exhibited above the osteolysis threshold of 0.1mm/year, progressive radiolucencies, osteolysis, or polyethylene fracture. This propensity-matched cohort study document no significant difference in wear resistant performances of annealed and remelted XLPE over an average period of 10 years. PMID:26751705
Gurianov, B M; Saienko, A M; Yanovych, L A
The innovative (inventive) activities of the SI "The National Research Center for Radiation Medicine of NAMS of Ukraine" for the period of 2003-2012 years is analyzed. It is established that the institution staff had filed 70 patent applications and has received 70 patents of Ukraine. The characteristic of patents by type is provided and ways to further developing of the innovative capacity of Center are identified. PMID:25191707
Guo, Hongjie; Hao, Fabao; Guo, Chunbao; Yu, Yang
Background. Portal cavernoma (PC) is the most critical condition with risk or variceal hemorrhage in pediatric patients. We retrospectively investigated the patients with PC focusing on the predictors for recurrent variceal bleeding. Methods. Between July 2003 and June 2013, we retrospectively enrolled all consecutive patients admitted to our department with a diagnosis of PC without abdominal malignancy or liver cirrhosis. The primary endpoint of this observational study was recurrent variceal bleeding. Independent predictors of recurrent variceal bleeding were identified using the logistic regression model. Results. A total of 157 patients were enrolled in the study. During the follow-up period, 24 patients exhibited onset of recurrent variceal bleeding. Acute variceal bleeding was subjected to conservative symptomatic treatment and emergency endoscopic sclerotherapy. Surgical procedure selection was based on the severity of vascular dilation and collateral circulation. Multivariate logistic regression analysis demonstrated that the presence of ascites, collateral circulation, and portal venous pressure were independent prognostic factors of recurrent variceal bleeding for patients with portal cavernoma. Conclusions. The presence of ascites, collateral circulation, and portal venous pressure evaluation are important and could predict the postsurgical recurrent variceal bleeding in patients with portal cavernoma. PMID:26949386
Sun, Can-Lan; Kersey, John H.; Francisco, Liton; Armenian, Saro H.; Baker, K. Scott; Weisdorf, Daniel J.; Forman, Stephen J.; Bhatia, Smita
Long-term morbidity after hematopoietic cell transplantation (HCT) is unknown. The risk of physical and psychological health in 324 patients who had survived 10 or more years after HCT, and a sibling comparison group (n=309) was evaluated. Using the CTCAE v3.0, the 15-year cumulative incidence of severe/life-threatening/fatal conditions was 41% (95%CI, 34–48%). HCT survivors were 5.7 times as likely to develop a severe/life-threatening condition (p<0.001), and 2.7 times as likely to report somatic distress (p<0.001) compared with siblings. Compared with allogeneic HCT recipients with no chronic GvHD, those with active chronic GvHD were at a 1.8-fold higher risk of severe/life-threatening health conditions (p=0.006), and 4.5-fold higher risk of somatic distress (p=0.04); allogeneic HCT recipients with resolved chronic GvHD were not at increased risk of morbidity compared with those with no chronic GvHD. Only 27% of the HCT survivors returned to the transplant center for their cancer-related care. The burden of long-term physical and emotional morbidity borne by survivors remains substantial, even beyond 10 years after HCT; however, specialized healthcare is underutilized. Patients, families and healthcare providers need to be made aware of the high burden, such that they can plan for post-HCT care, even many years after HCT. PMID:23583827
van Schoor, A. N.; Naude, H.; van Rensburg, M.; Pretorius, E.; Boon, J. M.
This article presents a case study indicating that "Herpes simplex" virus (HSV) encephalitis may cause permanent learning disabilities due to damage to the temporal lobes as it discusses the results of a case study extending over 10 years to determine the long-term effects on both the anatomy of the brain and the intellectual functioning of the…
van Schoor, A. N.; Naude, H.; van Rensburg, M.; Pretorius, E.; Boon, J. M.
This article presents a case study indicating that "Herpes simplex" virus (HSV) encephalitis may cause permanent learning disabilities due to damage to the temporal lobes, as it discusses the results of a case study extending over 10 years to determine the long-term effects on both the anatomy of the brain and the intellectual functioning of the…
BACKGROUND: This paper presents reliability and validity analyses of physical activity-related psychosocial questionnaires completed by 8- to 10-year-old African-American girls at baseline and follow-up assessments of pilot intervention studies in the Girls health Enrichment Multi-site Study (GEMS)....
Kirby, A.; Woodward, A.; Jackson, S.; Wang, Y.; Crawford, M. A.
Despite the increased interest in the effects of omega-3 supplementation on childrens' learning and behaviour, there are a lack of controlled studies of this kind that have utilised a typically developing population. This study investigated the effects of omega-3 supplementation in 450 children aged 8-10 years old from a mainstream school…
Favez, Nicolas; Metral, Eric; Govaerts, Patrice
This article presents a study of parental satisfaction with services provided to their child by an Early Intervention Service in Geneva, Switzerland. The Service offers psycho-educational home-based interventions for developmentally delayed children. Parents whose child used the service between 1991 and 2001 filled out a questionnaire with Likert…
Di Lorenzo, L; Zocchetti, C; Platania, A; De Francesco, G; De Metrio, R; Pirris, A; Gigante, M R
At present no official data are available for those occupational accidents which, according to current law, are not subject to notification to the Italian National Institute for Insurance of Occupational Accidents (INAIL) and which are conventionally called "minor" accidents. They can be divided into accidents with prognosis from 1 to 3 days (franchises) and accidents which do not cause absence from work (medications). The already mentioned lack of data, which is not confined to Italy, is reflected in the small number of articles published in Italian and international journals. Also information regarding the possible relationships between "minor" accidents and the life habits of injured workers, are rare. The aim of this study was to provide detailed data on the characteristics of the different kinds of occupational accidents occurring in a food factory in Apulia, southern Italy, from 1985 to 1994, as well as to verify whether any relationship existed between the different types of occupational accidents and the consumption of cigarettes and alcohol by injured workers. The company's accident register yielded data on injuries which caused absence from work; the nursing service register provided information about accidents which did not determine absence from work; personal health documents gave details of worker life habits; and the company pay roll showed the amount of "worked hours". "Minor" accidents represented 70% of all accidents occurring during the ten year period studied. "Blue collars" had more frequent and serious occupational injuries, in comparison with "technical employees". "Minor" accidents, and especially "medications", occurred more frequently during one-shift work than during three-shift work. As work seniority increased, the number of "major" accidents decreased and number of accidents without absence from work rose. Contusions were the most frequent lesions and were responsible for the majority of the 3 kinds of accidents. "Medications" together
Karbeyaz, Kenan; Akkaya, Harun; Balci, Yasemin
Murder of women generally occurs as a result of violence by their husbands and relatives. We evaluated the female victims of murder in Eskişehir, located in western Anatolia, where the education level is high in this study. Our aim was to assess and discuss data related to the victims and murderers. A total of 141 women's murder cases were analysed in the study. After a legal process and the results of the autopsies during 2002-2011 in Eskişehir, 715 subjects found to have died as a result of murder were chosen. Cases were evaluated in terms of their age, marital status, education level, relationship to the murderer, reasons for violence, type of action and reasons for death. It was determined that 48.2% (n = 68) of the victims had been killed by the husband and 7.8% (n = 11) by the ex-husband. Murderers generally stated that the reason of murder was the woman's request for divorce or breaking up (n = 40, 28.4%). In compliance with the literature, the women were most commonly killed by their husbands in our study. Enhancing women's status and preventing violence against women will decrease such murders. PMID:23910872
Lyman, Amanda; Wenger, Daniel; Landin, Lennart
This study aims to describe the epidemiology of pediatric diaphyseal forearm fractures in an urban population and the complications of titanium elastic nailing. The medical records of 456 consecutive fractures were reviewed. The annual incidence was 0.7/1000 children. Eighty-six (19%) fractures in 83 children were titanium elastic nailed. The complication rate was 24%. Dorsal entry to the radius was associated with extensor pollicis longus rupture and radial entry was associated with sensory nerve deficit in three cases each. Seventy-eight (94%) of the operated patients recovered completely. Titanium elastic nailing is effective, but associated with a high rate of complications, most of which resolve spontaneously. PMID:26919620
Hogg, James; Juhlberg, K.; Lambe, L.
Background: One hundred and forty-two children and adults with profound intellectual and multiple disabilities were identified in 1993 in a single Scottish region on whom detailed information was collected via a postal questionnaire survey. Methods: They were followed up in 2003. The time spanned represented a period of significant policy change…
Camargo, Priscila C. L. B.; Pato, Eduardo Z. S.; Campos, Silvia V.; Afonso, José E.; Carraro, Rafael M.; Costa, André N.; Teixeira, Ricardo H. O. B.; Samano, Marcos N.; Pêgo-Fernandes, Paulo M.
Lung transplantation is a well-established treatment for advanced lung diseases. In children, the diseases that most commonly lead to the need for a transplantation are cystic fibrosis, pulmonary hypertension, and bronchiolitis. However, the number of pediatric lung transplantations being performed is low compared with the number of transplants performed in the adult age group. The objective of this study was to demonstrate our experience with pediatric lung transplants over a 10-year period in a program initially designed for adults. PMID:24860860
Trimpou, Penelope; Landin-Wilhelmsen, Kerstin
Context: Growth hormone (GH) treatment increases bone mineral density (BMD) in women with postmenopausal osteoporosis. Objective: The objective was to report bone data, fractures, and quality of life (QoL) in a 10-year follow-up of women who had received GH for 3 years and compared with controls followed in parallel. Design and Setting: A follow-up of a double-blind, placebo-controlled study conducted at Sahlgrenska University Hospital was performed. Patients: Eighty women aged between 50 and 70 years with osteoporosis and estrogen hormone replacement were studied and compared with an age-matched random population sample of women (n = 120) from the World Health Organization Monitoring of Trends and Determinants in Cardiovascular Disease project (Gothenburg, Sweden). Interventions: Patients were randomized to GH 1.0 U or GH 2.5 U recombinant human GH or placebo sc daily during 3 years. All received calcium 750 mg and vitamin D 400 U and were followed up during 10 years. Main Outcome Measures: BMD and bone mineral content were measured with dual-energy X-ray absorptiometry. QoL was estimated with the 36-item Short Form. Results: GH increased BMD and bone mineral content dose dependently in all regions (P = .01, GH 1.0 U, and P = .0006, GH 2.5 U vs placebo). After 10 years the number of fractures decreased from 56% to 28% (P = .0003) in patients evenly distributed between groups. In controls, fractures increased from 8% to 32% (P = .0008). QoL did not change during GH treatment or during the 10-year follow-up and did not differ compared with controls. Conclusion: GH treatment was beneficial for bone and fracture outcome after 10 years but did not affect the QoL of the women with postmenopausal osteoporosis. PMID:26312576
Sourander, Andre; Multimaki, Petteri; Santalahti, Paivi; Parkkola, Kai; Haavisto, Antti; Helenius, Hans; Nikolakaros, Georgios; Piha, Jorma; Tamminen, Tuula; Moilanen, Irma; Kumpulainen, Kirsti; Aronen, Eeva T.; Linna, Sirkka-Liisa; Puura, Kaija; Almqvist, Fredrik
Objective: To study prevalence and factors associated with mental health service use among 18-year-old adolescent boys. Method: Predictors at age 8 and factors at age 18 associated with mental health service use during the preceding 12 months were studied in a general population sample of 2,316 Finnish boys born in 1981 attending military call-up…
Evans, Jennifer L; Tsui, Judith I; Hahn, Judith A; Davidson, Peter J; Lum, Paula J; Page, Kimberly
This study examined associations between mortality and demographic and risk characteristics among young injection drug users in San Francisco, California, and compared the mortality rate with that of the population. A total of 644 young (<30 years) injection drug users completed a baseline interview and were enrolled in a prospective cohort study, known as the UFO ("U Find Out") Study, from November 1997 to December 2007. Using the National Death Index, the authors identified 38 deaths over 4,167 person-years of follow-up, yielding a mortality rate of 9.1 (95% confidence interval: 6.6, 12.5) per 1,000 person-years. This mortality rate was 10 times that of the general population. The leading causes of death were overdose (57.9%), self-inflicted injury (13.2%), trauma/accidents (10.5%), and injection drug user-related medical conditions (13.1%). Mortality incidence was significantly higher among those who reported injecting heroin most days in the past month (adjusted hazard ratio = 5.8, 95% confidence interval: 1.4, 24.3). The leading cause of death in this group was overdose, and primary use of heroin was the only significant risk factor for death observed in the study. These findings highlight the continued need for public health interventions that address the risk of overdose in this population in order to reduce premature deaths. PMID:22227793
Wilens, Timothy E.; Martelon, MaryKate; Joshi, Gagan; Bateman, Clancey; Fried, Ronna; Petty, Carter; Biederman, Joseph
Objective: High rates of substance-use disorders (SUD) have been found in samples of adolescents and adults with attention-deficit/hyperactivity disorder (ADHD). Predictors of SUD in children with ADHD who are at risk for the development of SUDs remain understudied. The main aims of this study were to identify clinically meaningful characteristics…
Letois, Flavie; Mura, Thibault; Scali, Jacqueline; Gutierrez, Laure-Anne; Féart, Catherine; Berr, Claudine
In the last 20 years, many prospective cohort studies have assessed the relationships between food consumption and mortality. Result interpretation is mainly hindered by the limited adjustment for confounders and, to a lesser extent, the small sample sizes. The aim of this study was to investigate the association between dietary habits and all-cause mortality in a multicentre prospective cohort that included non-institutionalised, community-based elderly individuals (Three-City Study). A brief FFQ was administered at baseline. Hazard ratios (HR) and 95 % CI for all-cause mortality were estimated relative to the consumption frequency of several food groups, using Cox proportional hazards models adjusted for sex, centre, socio-demographic characteristics and health status indicators. Among the 8937 participants (mean age: 74·2 years, 60·7 % women), 2016 deaths were recorded during an average follow-up of 9 years. The risk of death was significantly lower among subjects with the highest fruit and vegetable consumption (HR 0·90; 95 % CI 0·82, 0·99, P=0·03) and with regular fish consumption (HR 0·89; 95 % CI 0·81, 0·97, P=0·01). The benefit of olive oil use was found only in women (moderate olive oil use: HR 0·80; 95 % CI 0·68, 0·94, P=0·007; intensive use: HR 0·72; 95 % CI 0·60, 0·85, P=0·0002). Conversely, daily meat consumption increased the mortality risk (HR 1·12; 95 % CI, 1·01, 1·24, P=0·03). No association was found between risk of death and diet diversity and use of various fats. These findings suggest that fruits/vegetables, olive oil and regular fish consumptions have a beneficial effect on the risk of death, independently of the socio-demographic features and the number of medical conditions. PMID:27452277
Bakshi, Jaimanti; Panda, Naresh K; Sharma, Suresh C; Gupta, Ashok; Mann, S B S
Carcinoma of larynx is a common disease in North Indian population. It is seen commonly in smokers and alcoholics. It poses a serious health problem due to its tendency to cause airway obstruction and to make the patient aphonic if total larynxgectomy is done for curing this cancer. We conducted a retrospective analysis in 690 cases of carcinoma larynx presenting to Nehru Hospital, Postgraduate Institute of Medical Education and Research, Chandigarh. Various aspects of this disease like predisposing factors, patterns of spread, histological types, various treatment modalities, their complications and response of this disease to these therapeutic options were studied in detail. PMID:23120142
Jamaiah, I; Rohela, M; Nissapatorn, V; Khoo, B L; Khoo, P S; Radhiyah, M; Aisyah, A
Malaria is still one of the most important vector-borne diseases in Malaysia, particularly in remote areas. This retrospective study was carried out to find the prevalence of malaria among patients admitted to UMMC Kuala Lumpur, from 1994-2003. A total of 86 malaria cases were analyzed. Most cases occurred among foreigners [57% (49 cases)] while Malaysians constituted 43% (37 cases). Among foreigners, Indonesians constituted the most [57% (28 cases)]. Among Malaysians, most cases occurred among the Chinese [35% (13 cases)] followed by the Malays [30% (11 cases)]. Males [70%(60 cases)] were more commonly affected. The majority of cases were within the 20-39 year age group (69%). Three species of malaria parasites were reported, of which Plasmodium vivax constituted the most [55%( 47 cases)], followed by Plasmodium falciparum [29% (25 cases)], and only four cases (5%) of Plasmodium malariae. Nine percent (8 cases) were mixed infections. In this study, 12%(10 cases) developed chloroquine resistance: 7 cases of P. falciparum, and 3 cases of P. vivax. The most common complications were jaundice and anemia [77% (23 cases)], followed by blackwater fever [13% (4 cases)] and cerebral malaria [10% (3 cases)]. Most of the complications were due to P. falciparum [43% (13 cases)]. There were no reported deaths. This new source of malaria coming from foreigners must be given serious attention, as it has great potential of increasing malaria cases in urban Malaysia. PMID:16438181
Hiatt, Keith L.; Rash, Clarence E.; Watters, Raymond W.; Adams, Mark S.
A collaborative occupational health study has been undertaken by Headquarters Army Aviation, Middle Wallop, UK, and the U.S. Army Aeromedical Research Laboratory, Fort Rucker, Alabama, to determine if the use of the Integrated Helmet and Display Sighting System (IHADSS) monocular helmet-mounted display (HMD) in the Apache AH Mk 1 attack helicopter has any long-term (10-year) effect on visual performance. The test methodology consists primarily of a detailed questionnaire and an annual battery of vision tests selected to capture changes in visual performance of Apache aviators over their flight career (with an emphasis on binocular visual function). Pilots using binocular night vision goggles serve as controls and undergo the same methodology. Currently, at the midpoint of the study, with the exception of a possible colour discrimination effect, there are no data indicating that the long-term use of the IHADSS monocular HMD results in negative effects on vision.
Land, Larry F.
Some of the topics identified for special study include: (1) The potential of saline water entering the freshwater zone from the downdip boundary; (2) the possibility of water leaking into the aquifer from an overlying aquifer; (3) the effects of urbanization on ground-water quality in local areas; (4) the movement and dissipation of a recharge water plume; (5) the influx of water from the Glen Rose Formation; (6) the effects of the fault barriers, regional dense bed, and irregular geologic framework on ground-water flow patterns; (7) natural recharge-discharge relationships; (8) the aquifer stage-storage relationship; (9) natural water-quality evolution; and (10) a refinement of the hydrogeologic framework in a local area.
Tabrizi, Reza; Aliabadi, Ehsan; Maleki, Mohammad Javad; Barouj, Mehrdad Dehghanpour
Adenoid cystic carcinoma (ACC) is both invasive and clinically unpredictable, and our aim was to evaluate the factors that affect its recurrence in the palate. We retrospectively studied 38 patients who had ACC of the palate treated surgically, and the outcome measure was recurrence during the mean (SD) followup time of 55 (18) months. Age, sex, T-stage, bony involvement, duration of follow up, histological type, perineural invasion, and surgical margins were all recorded. Results showed no association between recurrence, and age or histopathological types. However, T-stage (p=0.001), sex (p=0.04), and bony and perineural involvement (p=0.01 in each case) were significantly associated with recurrent tumour. Close superior and posterior margins (< 2mm) were also associated with recurrence (p=0.001 in each case). Large tumours with bony and perineural involvement, together with close superior and posterior surgical margins, had a higher risk of recurrence. PMID:27094499
Wang, Weihao; Huang, Xuekun; Chen, Zhuanggui; Zheng, Rui; Chen, Yulian; Zhang, Gehua; Yang, Qintai
Objective To investigate the prevalence and trends of sensitisation to common aeroallergens among outpatients with allergic rhinitis (AR) in Guangzhou, China, over the past decade. Design A retrospective study; linear-by-linear association and simple linear regression were used to determine the trends in the prevalence of aeroallergen sensitisation. Setting One grade-A hospital in Guangzhou, the largest city in southern China. Participants A total of 5486 patients (2297 males and 2489 females) who visited the ear, nose and throat outpatient clinic, from January 2005 to December 2014, were enrolled. All patients who presented with nasal hyper-reactive symptoms and who completed serological allergy testing, measuring specific IgE (sIgE) in the serum, were included. Among them, 4085 participants (2269 males and 1816 females) were diagnosed as being patients with AR. Outcome measures Prevalence and trends of sensitisation to various types of aeroallergens were assessed. Results The overall prevalence of sIgE-mediated sensitisation to aeroallergens in these patients with AR were as follows: 84.4% for house dust mites (HDMs), 23.4% for pet allergens, 21.1% for cockroaches, 9.1% for mould allergens, 7.7% for tree pollen and 6.0% for weed pollen. When all patients with nasal hyper-reactivity were stratified by decade of age, increasing age was associated with a decrease in sIgE positivity by ∼5.13% (95% CI −7.28% to −2.98%, p<0.01). Within the past decade, the prevalence of sensitisation to pet allergens in patients with AR increased at an annual rate of 1.3% (95% CI 0.85% to 1.67%, p<0.01). Conclusions This study demonstrated that HDMs comprised the most common aeroallergen in Guangzhou. The prevalence of sensitisation to aeroallergens decreased with increasing age. During the past decade, the prevalence of sensitisation to pet allergens showed an upward trend, suggesting an urgent need for its prevention and treatment. PMID:27188812
Wong, Martin C S; Tam, Wilson W S; Wang, Harry H X; Lao, X Q; Zhang, Daisy Dexing; Chan, Sky W M; Kwan, Mandy W M; Fan, Carmen K M; Cheung, Clement S K; Tong, Ellen L H; Cheung, N T; Tse, L A; Yu, Ignatius T S
This study evaluated whether short term exposures to NO2, O3, particulate matter <10 mm in diameter (PM10) were associated with higher risk of mortality. A total of 223,287 hypertensive patients attended public health-care services and newly prescribed at least 1 antihypertensive agent were followed-up for up to 5 years. A time-stratified, bi-directional case-crossover design was adopted. For all-cause mortality, significant positive associations were observed for NO2 and PM10 at lag 0-3 days per 10 μg/m(3) increase in concentration (excess risks 1.187%-2.501%). Significant positive associations were found for O3 at lag 1 and 2 days and the excess risks were 1.654% and 1.207%, respectively. We found similarly positive associations between these pollutants and respiratory disease mortality. These results were significant among those aged ≥65 years and in cold seasons only. Older hypertensive patients are susceptible to all-cause and respiratory disease-specific deaths from these air pollutants in cold weather. PMID:24953346
Yan, Su; Li, Bin; Bai, Zhen-Zhong; Wu, Jun-Qi; Xie, Da-Wei; Ma, Ying-Cai; Ma, Xu-Xiang; Zhao, Jun-Hui; Guo, Xin-Jian
AIM: To investigate the clinical epidemiological characteristics of gastric cancer in the Hehuang valley, China, to provide a reference for treatment and prevention of regional gastric cancer. METHODS: Between February 2003 and February 2013, the records of 2419 patients with gastric cancer were included in this study. The patient’s characteristics, histological and pathological features, as well as the dietary habits of the patients, were investigated. RESULTS: The clinical data showed that adenocarcinoma was the leading histological type of gastric cancer in this area. Characteristics of gastric cancer in different ethnic groups and age showed that the 60.55-65.50 years group showed the high incidence of gastric cancer in all ethnic groups. There were more male gastric cancer patients than female. Intestinal was the most common type of gastric cancer in the Hehuang valley. There was no significant difference in the proportion of sex in terms of Helicobacter pylori infection. The impact of dietary habits on gastric cancer showed that regular consumption of fried or grilled food, consumption of high-salt, high-fat and spicy food and drinking strong Boiled brick-tea were three important factors associated with gastric cancer in males and females. CONCLUSION: Differences existed in race, sex, and age of patients according to the epidemiology of gastric cancer in the Hehuang valley. Moreover, dietary habits was also an important factor contributing to gastric cancer. PMID:25132766
Abell, Jessica G; Shipley, Martin J; Ferrie, Jane E; Kivimäki, Mika; Kumari, Meena
Although an association between both sleep duration and disturbance with salivary cortisol has been suggested, little is known about the long term effects of poor quality sleep on diurnal cortisol rhythm. The aim of this study was to examine the association of poor quality sleep, categorised as recurrent short sleep duration and chronic insomnia symptoms, with the diurnal release of cortisol. We examined this in 3314 participants from an occupational cohort, originally recruited in 1985-1989. Salivary cortisol was measured in 2007-2009 and six saliva samples were collected: (1) waking, (2) waking+0.5h, (3) +2.5h, (4) +8h, (5) +12h and (6) bedtime, for assessment of the cortisol awakening response and the diurnal slope in cortisol secretion. Participants with the first saliva sample collected within 15min of waking and not on steroid medication were examined. Short sleep duration (≤5h) and insomnia symptoms (Jenkins scale, highest quartile) were measured in 1997-1999, 2003-2004 and 2007-2009. Recurrent short sleep was associated with a flatter diurnal cortisol pattern. A steeper morning rise in cortisol was observed among those reporting chronic insomnia symptoms at three time points and among those reporting short sleep twice, compared to those who never reported sleep problems. Participants reporting short sleep on three occasions had higher levels of cortisol later in the day, compared to those never reporting short sleep, indicated by a positive interaction with hours since waking (β=0.02 (95% CI: 0.01, 0.03)). We conclude that recurrent sleep problems are associated with adverse salivary cortisol patterns throughout the day. PMID:26963375
Abell, Jessica G.; Shipley, Martin J.; Ferrie, Jane E.; Kivimäki, Mika; Kumari, Meena
Although an association between both sleep duration and disturbance with salivary cortisol has been suggested, little is known about the long term effects of poor quality sleep on diurnal cortisol rhythm. The aim of this study was to examine the association of poor quality sleep, categorised as recurrent short sleep duration and chronic insomnia symptoms, with the diurnal release of cortisol. We examined this in 3314 participants from an occupational cohort, originally recruited in 1985–1989. Salivary cortisol was measured in 2007–2009 and six saliva samples were collected: (1) waking, (2) waking + 0.5 h, (3) +2.5 h, (4) +8 h, (5) +12 h and (6) bedtime, for assessment of the cortisol awakening response and the diurnal slope in cortisol secretion. Participants with the first saliva sample collected within 15 min of waking and not on steroid medication were examined. Short sleep duration (≤5 h) and insomnia symptoms (Jenkins scale, highest quartile) were measured in 1997–1999, 2003–2004 and 2007–2009. Recurrent short sleep was associated with a flatter diurnal cortisol pattern. A steeper morning rise in cortisol was observed among those reporting chronic insomnia symptoms at three time points and among those reporting short sleep twice, compared to those who never reported sleep problems. Participants reporting short sleep on three occasions had higher levels of cortisol later in the day, compared to those never reporting short sleep, indicated by a positive interaction with hours since waking (β = 0.02 (95% CI: 0.01, 0.03)). We conclude that recurrent sleep problems are associated with adverse salivary cortisol patterns throughout the day. PMID:26963375
Larson, D.L.; Lindberg, R.D.; Lane, E.; Goepfert, H.
In an attempt to determine the late effects and associated morbidity of radiotherapy on normal tissue, patients with squamous carcinoma of the oral cavity and oropharynx were retrospectively reviewed. Between 1964 and 1975, 569 patients with cancer of the floor of the mouth, oral tongue, tonsil, and retromolar trigone region of the anterior faucial pillar had their primary lesions treated by radiotherapy alone for cure. One hundred twenty-eight of the patients were evaluable for this study. Bone and soft tissue morbidity were graded according to the late radiation scoring scheme of the radiation therapy oncology group of the European Organization on Research and Treatment of Cancer, tallying only grade 4 changes. Patients were further classified according to site of tumor, age, sex, tumor stage, histologic grade, and dental status--none of which had a positive correlation with complications. Of 31 evaluable patients with cancer of the floor of the mouth (median follow-up 136 months), 71 percent (22 of 31 patients) had at least one complication involving bone (osteonecrosis, pathologic fracture) or mucus membrane (ulcer). Sixty-one percent (25 of 41 patients) with primary cancer of the oral tongue had grade 4 sequelae (median follow-up 112 months). In 26 patients with cancer of the tonsil, 13 (50 percent) had grade 4 sequelae (median follow-up 113 months). This included 11 patients with clinical and radiographic evidence of osteonecrosis, 6 of whom required mandibulectomy. Patients with cancer of the retromolar trigone region of the anterior faucial pillar fared the best (median follow-up 122 months). Late sequelae were noted in 40 percent (12 of 30 patients). The morbidity attendant to cure by radiotherapy included at least one significant complication of bone or soft tissue in 40 to 70 percent of the patients, depending on the location of the primary tumor. There was also a positive correlation with dose of radiation received.
Somers, Julian M; Moniruzzaman, Akm; Rezansoff, Stefanie N
Objectives Little research has investigated the role of migration as a potential contributor to the spatial concentration of homeless people with complex health and social needs. In addition, little is known concerning the relationship between possible migration and changes in levels of service use over time. We hypothesised that homeless, mentally ill individuals living in a concentrated urban setting had migrated from elsewhere over a 10-year period, in association with significant increases in the use of public services. Setting Recruitment was concentrated in the Downtown Eastside neighbourhood of Vancouver, Canada. Participants Participants (n=433) met criteria for chronic homelessness and serious mental illness, and provided consent to access administrative data. Methods Linked administrative data were used to retrospectively examine geographic relocation as well as rates of health, justice, and social welfare service utilisation in each of the 10 years prior to recruitment. Generalised estimating equations were used to estimate the effect of migration on service use. Results Over a 10-year period there was significant movement into Vancouver's Downtown Eastside neighbourhood (from 17% to 52% of the cohort). During the same period, there were significant annual increases in community medical services (adjusted rate ratio (ARR) per year=1.08; 95% CI 1.06 to 1.10), hospital admissions (ARR=1.08; 95% CI 1.04 to 1.11), criminal convictions (ARR=1.08; 95% CI 1.03 to 1.13), and financial assistance payments (ARR=1.04; 95% CI 1.03 to 1.06). Migration was significantly associated with financial assistance, but not with other types of services. Conclusions Significant increases in service use over a 10-year period coincided with significant migration into an urban area where relevant services were concentrated. These results highlight opportunities for early intervention in spatially diverse neighbourhoods to interrupt trajectories marked by worsening health and
The purpose of this prospective study was to evaluate survival and marginal bone loss at 10-year follow-up of implants inserted in completely edentulous arches and immediately loaded using multiple mucosa-supported stereolithographic surgical templates. The influence on marginal bone loss of the following variables was evaluated: sex, smoking habit, arch, implant position, implant diameter, and implant length. Prosthesis survival and success were also determined. STROBE guidelines were followed. One hundred and eighty-eight implants were inserted in 16 consecutively selected patients using a prefabricated metal-reinforced full-arch provisional acrylic restoration. The definitive metal-ceramic full-arch prosthesis was delivered within 2 weeks. Kappa statistics, two-way analysis of variance (ANOVA) with Bonferroni adjusted post hoc test, one-way ANOVA with Tukey's range test, and unpaired Student t-tests were used for the analysis. Four implants failed during the first year of function (maxilla 3, mandible 1), leading to a 10-year survival rate of 97.9%. The mean marginal bone loss after 10 years was 0.76 mm. The marginal bone changes were found not to be influenced significantly by the variables evaluated (P > 0.05). The prosthetic success rate was 66.7%; no prosthesis failures occurred. In conclusion the technique described is a predictable treatment option with high survival in the long-term follow-up. PMID:26740350
Long, Richard; Niruban, Selvanayagam; Heffernan, Courtney; Cooper, Ryan; Fisher, Dina; Ahmed, Rabia; Egedahl, Mary Lou; Fur, Rhonda
Introduction Compliance with the recommendation that all tuberculosis (TB) patients be tested for human immunodeficiency virus (HIV) has not yet been achieved in Canada or globally. Methods The experience of “opt-out” HIV testing of TB patients in the Province of Alberta, Canada is described over a 10-year period, 2003–2012. Testing rates are reported before and after the introduction of the “opt-out” approach. Risk factors for HIV seropositivity are described and demographic, clinical and laboratory characteristics of TB patients who were newly diagnosed versus previously diagnosed with HIV are compared. Genotypic clusters, defined as groups of two or more cases whose isolates of Mycobacterium tuberculosis had identical DNA fingerprints over the 10-year period or within 2 years of one another, were analyzed for their ability to predict HIV co-infection. Results HIV testing rates were 26% before and 90% after the introduction of “opt-out” testing. During the “opt-out” testing years those <15 or >64 years of age at diagnosis were less likely to have been tested. In those tested the prevalence of HIV was 5.6%. In the age group 15–64 years, risk factors for HIV were: age (35–64 years), Canadian-born Aboriginal or foreign-born sub-Saharan African origin, and combined respiratory and non-respiratory disease. Compared to TB patients previously known to be HIV positive, TB patients newly discovered to be HIV positive had more advanced HIV disease (lower CD4 counts; higher viral loads) at diagnosis. Large cluster size was associated with Aboriginal ancestry. Cluster size predicted HIV co-infection in Aboriginal peoples when clusters included all cases reported over 10 years but not when clusters included cases reported within 2 years of one another. Conclusion “Opt-out” HIV testing of TB patients is effective and well received. Universal HIV testing of TB patients (>80% of patients tested) has immediate (patients) and longer-term (TB/HIV program
Youn, Young Hoon; Kim, Hyeon Chang; Lim, Hyun Chul; Park, Jae Jun; Kim, Jie-Hyun; Park, Hyojin
Background/Aims A limited number of studies are available regarding the long-term natural history of post-infectious irritable bowel syndrome (PI-IBS). We aimed to investigate the long-term clinical course of PI-IBS. Methods A prospective cohort study was conducted from a 2001 shigellosis outbreak in a Korean hospital with about 2000 employees. A cohort of 124 hospital employees who were infected by Shigella sonnei due to contaminated food in the cafeteria, and 105 sex- and age-matched, non-infected, controls were serially followed for their bowel symptoms by questionnaire surveys for 10 years. Results The Shigella-infected cohort showed significantly higher odds ratio for irritable bowel syndrome (IBS) at 1-year (11.90; 95% CI, 1.49–95.58) and 3-year (3.93; 95% CI, 1.20–12.86) follow-up, compared to their controls. However, corresponding odds ratio for PI-IBS was not significantly increased at 5-year (1.88; 95% CI, 0.64–5.54) and 8-year (1.87; 95% CI, 0.62–5.19) follow-up. At 10-year follow-up survey, the prevalence of IBS was similar for the Shigella-infected cohort and their controls (23.3% versus 19.7%, P = 0.703). Risk factors which were independently associated with PI-IBS among the Shigella-infected cohort included younger age, previous history of functional bowel disorder, and longer duration of diarrhea at baseline. Conclusions Patients who were infected by Shigella sonnei experienced significantly increased risk of IBS until 3 years after shigellosis, and modestly increased risk until 8 years, but showed similar risk of IBS with uninfected controls at 10 years post-infection. PI-IBS is quite a chronic disorder, and follows a long-term natural course. PMID:26908484
Patel, D; Mulcahy, D; Curzen, N; Sullivan, A; Cunningham, D; Sparrow, J; Wright, C; Quyyumi, A; Fox, K
OBJECTIVE--To assess the long-term (four to 10 years) prognostic significance of transient ST segment changes on ambulatory ST segment monitoring after coronary artery bypass grafting (CABG). PATIENTS AND METHODS--76 patients (67 men, nine women) underwent CABG between 1982 and 1984 (n = 31) and between 1987 and 1988 (n = 45) and at a mean age of 57. All underwent 48 hours of ambulatory ST segment monitoring at a mean of 19 weeks after surgery. The results were available for assessment. All general practitioners were contacted and patients' notes reviewed. Patients were contacted by telephone. Details were recorded of intervening events (acute myocardial infarction, unstable angina, need for further revascularisation, and deaths). Event free survival curves were produced for those with and without transient ST segment changes during routine postoperative ambulatory ST segment monitoring. RESULTS--During 3213 hours of monitoring after CABG, 21 (27.6%) of 76 patients had transient ST segment changes, of which 70% were silent. Over a mean 70 month follow up period, patients with such ischaemic changes were no more likely to have either an objective (myocardial infarction or cardiac death) or subjective (unstable angina or another revascularisation) event than those patients without ischaemic changes. This finding was the same in patients operated on between 1987 and 1988 and between 1982 and 1984. CONCLUSIONS--Although ambulatory ST segment monitoring is becoming increasingly popular in some countries as a routine investigation for ischaemia in various coronary subgroups, the findings of such an investigation, when performed after CABG, do not help to identify a subgroup more likely to have an adverse outcome during up to 10 years of follow up. There seems to be no reason to perform this investigation after surgery, and particularly to refer patients for reinvestigation because of the detection of predominantly silent ST segment changes of uncertain relevance. PMID
Denes, Anna-Maria; Landin-Wilhelmsen, Kerstin; Wettergren, Yvonne; Bryman, Inger
In the normal population, loss of one of the sex chromosomes leading to monosomy (45,X) is a part of the aging process. In Turner syndrome (TS), the classic karyotype 45,X is found in up to 50% at birth, and others have a second cell line; mosaicism. The aim was to study if the chromosomal pattern in TS women changes over time. Fluorescence in situ hybridization was performed on buccal smear cells obtained twice, 10 years apart, from 42 women with TS aged 26–66 years (mean±standard deviation: 42.0±11.6). DNA probes specific for chromosomes X (DXZ1) and Y (DYZ3) were used and >100 cells were analyzed/patient. Nineteen women had monosomy (45,X) (<10% 46,XX), nine had 45,X/46,XX mosaicism, and 14 had iso, ring, or a marker chromosome at baseline. At 10 years, the percentage of diploid cells had increased in 29 of 42 women (69%), with an average increase of 5.7±13.0%. There was a positive correlation between age and % change in diploid 46,XX or 46,XY cells (r=0.38, p=0.023). This new finding might have relevance for the life expectancy in TS. PMID:25587646
Denes, Anna-Maria; Landin-Wilhelmsen, Kerstin; Wettergren, Yvonne; Bryman, Inger; Hanson, Charles
In the normal population, loss of one of the sex chromosomes leading to monosomy (45,X) is a part of the aging process. In Turner syndrome (TS), the classic karyotype 45,X is found in up to 50% at birth, and others have a second cell line; mosaicism. The aim was to study if the chromosomal pattern in TS women changes over time. Fluorescence in situ hybridization was performed on buccal smear cells obtained twice, 10 years apart, from 42 women with TS aged 26-66 years (mean±standard deviation: 42.0±11.6). DNA probes specific for chromosomes X (DXZ1) and Y (DYZ3) were used and >100 cells were analyzed/patient. Nineteen women had monosomy (45,X) (<10% 46,XX), nine had 45,X/46,XX mosaicism, and 14 had iso, ring, or a marker chromosome at baseline. At 10 years, the percentage of diploid cells had increased in 29 of 42 women (69%), with an average increase of 5.7±13.0%. There was a positive correlation between age and % change in diploid 46,XX or 46,XY cells (r=0.38, p=0.023). This new finding might have relevance for the life expectancy in TS. PMID:25587646
Grotle, Margreth; Hagen, Kare B; Natvig, Bard; Dahl, Fredrik A; Kvien, Tore K
Background Obesity is one of the most important risk factors for osteoarthritis (OA) in knee(s). However, the relationship between obesity and OA in hand(s) and hip(s) remains controversial and needs further investigation. The purpose of this study was to investigate the impact of obesity on incident osteoarthritis (OA) in hip, knee, and hand in a general population followed in 10 years. Methods A total of 1854 people aged 24–76 years in 1994 participated in a Norwegian study on musculoskeletal pain in both 1994 and 2004. Participants with OA or rheumatoid arthritis in 1994 and those above 74 years in 1994 were excluded, leaving n = 1675 for the analyses. The main outcome measure was OA diagnosis at follow-up based on self-report. Obesity was defined by a body mass index (BMI) of 30 and above. Results At 10-years follow-up the incidence rates were 5.8% (CI 4.3–7.3) for hip OA, 7.3% (CI 5.7–9.0) for knee OA, and 5.6% (CI 4.2–7.1) for hand OA. When adjusting for age, gender, work status and leisure time activities, a high BMI (> 30) was significantly associated with knee OA (OR 2.81; 95%CI 1.32–5.96), and a dose-response relationship was found for this association. Obesity was also significantly associated with hand OA (OR 2.59; 1.08–6.19), but not with hip OA (OR 1.11; 0.41–2.97). There was no statistically significant interaction effect between BMI and gender, age or any of the other confounding variables. Conclusion A high BMI was significantly associated with knee OA and hand OA, but not with hip OA. PMID:18831740
Nordentoft, M; Breum, L; Munck, L K; Nordestgaard, A G; Hunding, A; Laursen Bjaeldager, P A
OBJECTIVE--To describe mortality by suicide and other causes of death in a group of patients who attempted suicide, and to identify predictive factors. DESIGN--10 year follow up study based on records of suicide attempters in 1980. SETTING--Poisoning treatment centre at a general hospital. SUBJECTS--974 patients aged 15 and over referred to the poisoning treatment centre after deliberate self poisoning. MAIN OUTCOME MEASURES--Death by different causes registered in the Danish death cause register. RESULTS--In 10 years of follow up 306 patients died: 103 by suicide, 131 from natural causes, and 31 by accident; five were murdered, and in 36 cases the cause of death was uncertain. The standard mortality ratio was 550. Cause specific standardised mortality rates were 2960 for suicide, 236 for natural causes, 1256 for accidents, and 5459 for uncertain causes. In a Cox regression analysis, high risk factors for subsequent suicide were: more than one previous suicide attempt (relative risk 2.25), living alone (2.28), and age (1.03 per year). Predictors of death by natural causes were receiving a pension (1.69), drug misuse (2.72), more than one previous suicide attempt (2.25), age (1.06 per year), and male sex (2.49). The group of patients fulfilling at least one high risk criterion for later suicide differed significantly from the rest of the patient group in incidence of suicide, but both sensitivity and specificity were low. CONCLUSIONS--Most patients who attempted suicide were at high risk of succeeding because the risk factors, though significant, are not very specific. A strategy to prevent suicide must be directed toward the majority of those who attempt suicide. PMID:8324430
Morrison, John A; Glueck, Charles J; Wang, Ping
We evaluated the associations of teenage insulin and adolescent diet with 10-year weight gain in an analysis sample of black and white girls matched for pubertal stage, body mass index (BMI) (or fat mass), and insulin at ages 9 to 10 years. We hypothesized that preteen insulin and insulin resistance would interact with dietary factors to positively predict increases in BMI. Furthermore, we hypothesized that increased insulin and insulin resistance, interacting with higher caloric intake during adolescence, would lead to greater increments in BMI in black girls than in white girls. Prospective 10-year follow-up was performed on 215 pairs of black and white schoolgirls matched at baseline by BMI (or fat mass), insulin, and pubertal stage, with repeated measures of body habitus, insulin, and dietary intake. When matched for BMI, black girls had higher fat-free mass and white girls had higher fat mass at ages 9 to 10 years. Black-white differences in caloric intake were not significant at ages 9 to 10 years, but black girls consumed more calories at age 19 years. Black girls consumed a greater percentage of calories from fat throughout. At age 19 years, black girls had higher BMI, fat mass index, and insulin. When matched at ages 9 to 10 years for fat mass, black girls were heavier, had higher BMI, and had greater fat-free mass. By ages 18 to 19 years, black girls continued to have higher BMI, but had accrued higher fat mass and a higher percentage of body fat. By stepwise multiple regression, 10-year increases in BMI were predicted by ages 9 to 10 years BMI, 10-year change in insulin, and a 3-way interaction between ages 9 to 10 years insulin, adolescent caloric intake, and race (higher in black girls) (all Ps < .0001). Insulin at ages 9 to 10 years interacts with caloric intake to increase BMI by age 19 years. There appear to be intrinsic black-white metabolic differences that lead to greater gains in fat during adolescence in black girls. Evaluating BMI and insulin
Aslam, Tariq; Delcourt, Cécile; Holz, Frank; García-Layana, Alfredo; Leys, Anita; Silva, Rufino M; Souied, Eric
Purpose To evaluate ophthalmologists’ opinion of, and use of, micronutritional dietary supplements 10 years after publication of the first Age-Related Eye Disease Study (AREDS) study. Methods Participation was solicited from 4,000 European ophthalmologists. Responding physicians were screened, and those treating at least 40 patients with age-related macular degeneration (AMD) per month and prescribing nutrition supplements at least 4 times per month were admitted and completed a 40-item questionnaire. Results The surveyed sample included 112 general ophthalmologists and 104 retinal specialists. Most nutritional supplements (46%) were initiated when early/intermediate AMD was confirmed, although 18% were initiated on confirmation of neovascular AMD. Clinical studies were well known: 90% were aware of AREDS, with 88% aware of AREDS1 and 36% aware of the, as-yet-unpublished, AREDS2 studies. Respondents considered lutein, zeaxanthin, zinc, omega-3, and vitamins to be the most important components of nutritional supplements, with the results of AREDS2 already having been taken into consideration by many. Ophthalmologists anticipate more scientific studies as well as improved product quality but identify cost as a barrier to wider uptake. Conclusion Micronutrition is now part of the routine management of AMD for many ophthalmologists. Ophthalmologists choosing to use nutritional supplements are well-informed regarding current scientific studies. PMID:25336904
Owen, Christopher G.; Nightingale, Claire M.; Rudnicka, Alicja R.; van Sluijs, Esther M. F.; Ekelund, Ulf; Cook, Derek G.; Whincup, Peter H.
Background Travel to school may offer a convenient way to increase physical activity levels in childhood. We examined the association between method of travel to school and physical activity levels in urban multi-ethnic children. Methods and Findings 2035 children (aged 9–10 years in 2006–7) provided data on their usual method of travel to school and wore an Actigraph-GT1M activity monitor during waking hours. Associations between method of travel and mean level of physical activity (counts per minute [CPM], steps, time spent in light, moderate or vigorous activity per day) were examined in models adjusted for confounding variables. 1393 children (69%) walked or cycled to school; 161 (8%) used public transport and 481 (24%) travelled by car. White European children were more likely to walk/cycle, black African Caribbeans to travel by public transport and South Asian children to travel by car. Children travelling by car spent less time in moderate to vigorous physical activity (−7 mins, 95%CI-9,-5), and had lower CPM (−32 CPM, 95%CI-44,-19) and steps per day (−813 steps, 95%CI,-1043,-582) than walkers/cyclists. Pupils travelling by public transport had similar activity levels to walkers/cyclists. Lower physical activity levels amongst car travellers' were especially marked at travelling times (school days between 8–9 am, 3–5 pm), but were also evident on weekdays at other times and at weekends; they did not differ by gender or ethnic group. Conclusion Active travel to school is associated with higher levels of objectively measured physical activity, particularly during periods of travel but also at other times. If children travelling by car were to achieve physical activity levels (steps) similar to children using active travel, they would increase their physical activity levels by 9%. However, the population increase would be a modest 2%, because of the low proportion of car travellers in this urban population. PMID:22319596
Migdalis, Ilias; Rombopoulos, Grigorios; Hatzikou, Magdalini; Manes, Christos; Kypraios, Nikolaos; Tentolouris, Nikolaos
Objective. This study aimed to estimate the mean annual cost of treating type 2 diabetes mellitus patients (T2DM) including complications and comorbidities in Greece. Design. A noninterventional retrospective study was based on patient level data analysis (bottom-up approach) from medical records, with at least 10-year-follow-up data. Results. The total annual cost per patient for managing diabetes in Greece was estimated at € 7,111 and was, statistically significantly, higher for patients with inadequate glycemic control (Hba1c > 7%) versus patients with adequate control (Hba1c = 7%) (€ 7,783 versus € 6,366, resp.; P = 0.017). This was mainly attributed to difference in CV hospitalizations between groups 14/111 versus 4/100, respectively, OR = 3.46 (95% CI: 1.10-10.9) for inadequately controlled patients. The largest component of cost was management of comorbidities, accounting for 48% of costs, and pharmaceutical treatment at 35.9% while only 14.9% was attributed to diabetes treatment per se. Obese men and patients with poor education are the groups with higher treatment costs. Conclusions. This is the first study to capture all cost components and the real burden of diabetes in Greece. Comorbidities were found to account for almost half of total cost, significantly higher in nonoptimally controlled diabetes patients. PMID:26089887
Knight, Martin TN; Jago, Ingrid; Norris, Christopher; Midwinter, Lynne; Boynes, Christopher
Background Conventional diagnosis between axial and foraminal stenosis is suboptimal and long-term outcomes limited to posterior decompression. Aware state Transforaminal Endoscopic Lumbar Decompression and Foraminoplasty (TELDF) offers a direct aware state means of localizing and treating neuro-claudicant back pain, referred pain and weakness associated with stenosis failing to respond to conventional rehabilitation, pain management or surgery. This prospective survivability study examines the outcomes 10 years after TELDF in patients with foraminal stenosis arising from degeneration or failed back surgery. Methods For 10 years prospective data were collected on 114 consecutive patients with multilevel spondylosis and neuro-claudicant back pain, referred pain and weakness with or without failed back surgery whose symptoms had failed to respond to conventional rehabilitation and pain management and who underwent TELDF. The level responsible for the predominant presenting symptoms of foraminal stenosis, determined on clinical grounds, MRI and or CT scans, was confirmed by transforaminal probing and discography. Patients underwent TELDF at the spinal segment at which the predominant presenting symptoms were reproduced. Those that required treatment at an additional segment were excluded. Outcomes were assessed by postal questionnaire with failures being examined by the independent authors using the Visual Analogue Pain Scale (VAPS), the Oswestry Disability Index (ODI) and the Prolo Activity Score. Results Cohort integrity was 69%. 79 patients were available for evaluation after removal of the deceased (12), untraceable (17) and decliners (6) from the cohort. VAP scores improved from a pre-operative mean of 7.3 to 2.4 at year 10. The ODI improved from a mean of 58.5 at baseline to 17.5 at year 10. 72% of reviewed patients fulfilled the definition of an “Excellent” or “Good Clinical Impact” at review using the Spinal Foundation Outcome Score. Based on the Prolo
Albertson, A M; Tobelmann, R C; Engstrom, A; Asp, E H
Nutrient intakes of American children aged 2 to 10 years were compared for the years 1978 and 1988 using a unique nutrient assessment system designed and developed by the Nutrition Department at General Mills. This system integrated data from three sources: 14-day food consumption diaries collected from 4,000 households in the Market Research Corporation of America Menu Census panel surveys; serving-size data from the spring 1977 Nationwide Food Consumption Survey; and nutrient data from the Michigan State University Nutrient Data Bank. The results indicate that energy and macronutrient intakes remained fairly constant over the 10-year period. Average daily vitamin and mineral intakes were lower in 1988 than in 1978 for the majority of those studied; however, most nutrient levels remained over 100% of the Recommended Dietary Allowances (RDAs). For more than 50% of the population, the intakes of calcium, vitamin B-6, and zinc were below the RDAs. Our findings indicate the need for continued monitoring of the impact of changing food consumption patterns on the diets of American children. PMID:1452963
Bailey, Zinzi D; Slopen, Natalie; Albert, Michelle; Williams, David R
This study examined the relationship between multiple dimensions of religious involvement and transitions of tobacco smoking abstinence, persistence, cessation and relapse over 9-10 years of follow-up in a national sample of adults in the United States. Using data provided at baseline and follow-up, participants were categorized as non-smokers, persistent smokers, ex-smokers, and relapsed smokers. Religious involvement over the two time points were categorized into combinations of "high" and "low" involvement within the domains of (a) religious attendance, (b) religious importance, (c) spiritual importance, (d) religious/spiritual comfort seeking, and (e) religious/spiritual decision-making. High levels of religious involvement across five dimensions (religious attendance, religious importance, spiritual importance, religious/spiritual comfort-seeking, and religious/spiritual decision-making) were associated with lower odds of being a persistent smoker or ex-smoker. Religious involvement was not associated with smoking cessation among smokers at baseline. Interventions to increase smoking abstinence may be more effective if they draw on ties to religious and spiritual organizations and beliefs. Meanwhile, religious involvement is unlikely to affect smoking cessation effectiveness. PMID:26093070
French, David; Nadji, Nabil; Shariati, Batoul; Hatzimanolakis, Penny; Larjava, Hannu
This retrospective study with a follow-up period of 4 months to 10 years evaluated survival, success, and complication rates of implants placed using osteotome sinus floor elevation (OSFE) without added bone grafting. A total of 926 implants were placed, including 530 short implants (6 mm to 8.5 mm) and 209 implants in low residual bone height (RBH) (< 5 mm). Bone levels were evaluated at approximately 3 months and at 1, 3, and 5 years, and in some cases up to 10 years after implants were placed. The implant survival rate was 98.3% at the 5-year follow-up. Twelve of the 926 implants failed (6 preprosthetic, 6 postprosthetic). The success rate was 95.4% at a threshold of less than 1 mm of bone loss for combined systems (Straumann; Nobel Biocare). Short implant survival and success rates were statistically comparable to conventional-length implants. Low-RBH implants had a lower but acceptable survival rate of 95.7%. Adverse events were rare, with one case of infection and zero cases of vertigo reported. The findings of this study indicate that implant placement with OSFE without added bone graft is highly successful, even when short implants are used in low RBH. PMID:27031637
The conference Swift: 10 years of discovery was held in Roma at La Sapienza University on Dec. 2-5 2014 to celebrate 10 years of Swift successes. Thanks to a large attendance and a lively program, it provided the opportunity to review recent advances of our knowledge of the high-energy transient Universe both from the observational and theoretical sides. When Swift was launched on November 20, 2004, its prime objective was to chase Gamma-Ray Bursts and deepen our knowledge of these cosmic explosions. And so it did, unveiling the secrets of long and short GRBs. However, its multi-wavelength instrumentation and fast scheduling capabilities made it the most versatile mission ever flown. Besides GRBs, Swift has observed, and contributed to our understanding of, an impressive variety of targets including AGNs, supernovae, pulsars, microquasars, novae, variable stars, comets, and much more. Swift is continuously discovering rare and surprising events distributed over a wide range of redshifts, out to the most distant transient objects in the Universe. Such a trove of discoveries has been addressed during the conference with sessions dedicated to each class of events. Indeed, the conference in Rome was a spectacular celebration of the Swift 10th anniversary. It included sessions on all types of transient and steady sources. Top scientists from around the world gave invited and contributed talks. There was a large poster session, sumptuous lunches, news interviews and a glorious banquet with officials attending from INAF and ASI. All the presentations, as well as several conference pictures, can be found in the conference website (http://www.brera.inaf.it/Swift10/Welcome.html). These proceedings have been collected owing to the efforts of Paolo D’Avanzo who has followed each paper from submission to final acceptance. Our warmest thanks to Paolo for all his work. The Conference has been made possible by the support from La Sapienza University as well as from the ARAP
Zimmermann, Petra; Brückl, Tanja; Nocon, Agnes; Pfister, Hildegard; Binder, Elisabeth B.; Uhr, Manfred; Lieb, Roselind; Moffitt, Terrie E.; Caspi, Avshalom; Holsboer, Florian; Ising, Marcus
Objective The binding protein FKBP5 is an important modulator of the function of the glucocorticoid receptor, the main receptor of the stress horm one system. This turns the FKBP5 gene into a key candidate for gene-environment interactions, which are considered critical for pathogenesis of stress-related disorders. The authors explored gene-environment interactions between FKBP5 gene variants and adverse life events in predicting the first occurrence of a major depressive episode. Method The analyses were based on 884 Caucasians in a 10-year prospective community study. At baseline, they were 14–24 years old and did not fulfill criteria for a major depressive episode. The DSM-IV-based Munich Composite International Diagnostic Interview was used to assess adverse life events preceding baseline and major depressive episodes during follow-up. On the basis of previous findings, five single-nucleotide polymorphisms (SNPs) within the FKBP5 gene were selected for genotyping. Results While the authors did not observe genetic main effects, they found interactions between the five SNPs and traumatic (but not separation) events, with the strongest effect for severe trauma. The effect of trauma on incident major depressive episodes was evident among subjects homozygous for the minor alleles but not subjects with other genotypes. The findings were replicated in the U.K. Environmental Risk Longitudinal Twin Study. Conclusions These hypothesis-driven results suggest that an interaction between FKBP5 genotype and trauma is involved in the onset of depression. Subjects homozygous for the minor alleles of the investigated FKBP5 SNPs seem to be particularly sensitive to effects of trauma exposure in terms of triggering depression onset. PMID:21865530
Okwuosa, Tochi M.; Greenland, Philip; Ning, Hongyan; Liu, Kiang; Bild, Diane E.; Burke, Gregory L.; Eng, John; Lloyd-Jones, Donald M.
Objectives By examining the distribution of CAC across FRS strata in a large, multi-ethnic, community-based sample of men and women, we sought to determine if lower risk persons could potentially benefit from CAC screening. Background The 10-year Framingham risk scores (FRS) and coronary artery calcium (CAC) are predictors of coronary heart disease (CHD). CAC ≥300 is associated with the highest risk for CHD even in low risk (FRS <10%) persons; however expert groups have suggested CAC screening only in intermediate risk (FRS 10–20%) groups. Methods We included 5660 MESA participants. The number needed to screen [number of people that need to be screened to detect one person with CAC above the specified cut-point (NNS)] was used to assess the yield of screening for CAC. CAC prevalence was compared across FRS strata using chi-square tests. Results CAC >0, ≥100 and ≥300 were present in 46.4%, 20.6% and 10.1% of participants, respectively. Prevalence and amount of CAC increased with higher FRS. CAC ≥300 was observed in 1.7% and 4.4% of those with FRS 0–2.5% and 2.6–5%, respectively (NNS =59.7 and 22.7). Likewise, CAC ≥300 was observed in 24% and 30% of those with FRS 15.1–20% and >20%, respectively (NNS =4.2 and 3.3). Trends were similar when stratified by age, gender and race/ethnicity. Conclusions Our study suggests that in very low risk individuals (FRS ≤5%), the yield of screening and probability of identifying persons with clinically significant levels of CAC is low, but becomes greater in low and intermediate risk persons (FRS 5.1–20%). PMID:21527159
Pikhart, Hynek; Kubinova, Ruzena; Malyutina, Sofia; Pajak, Andrzej; Besala, Agnieszka; Bell, Steven; Peasey, Anne; Marmot, Michael; Bobak, Martin
Background: Physical functioning (PF) is an essential domain of older persons’ health and quality of life. Health behaviors are the main modifiable determinants of PF. Cross-sectionally, alcohol consumption appears to be linked to better PF, but longitudinal evidence is mixed and very little is known about alcohol consumption and longitudinal PF trajectories. Methods: We conducted longitudinal analyses of 28,783 men and women aged 45–69 years from Novosibirsk (Russia), Krakow (Poland), and seven towns of the Czech Republic. At baseline, alcohol consumption was measured by a graduated frequency questionnaire and problem drinking was evaluated using the CAGE questionnaire. PF was assessed using the Physical Functioning Subscale of the SF-36 instrument at baseline and three subsequent occasions. Growth curve modeling was used to estimate the associations between alcohol consumption and PF trajectories over 10-year follow-up. Results: PF scores declined during follow-up in all three cohorts. Faster decline in PF over time was found in Russian female frequent drinkers, Polish female moderate drinkers, and Polish male regular heavy drinkers, in comparison with regular and/or light-to-moderate drinkers. Nondrinking was associated with a faster decline compared with light drinking only in Russian men. Problem drinking and past drinking were not related to the decline rate of PF. Conclusions: This large longitudinal study in Central and Eastern European populations with relatively high alcohol intake does not strongly support the existence of a protective effect of alcohol on PF trajectories; if anything, it suggests that alcohol consumption is associated with greater deterioration in PF over time. PMID:26748094
Ritter, Philipp S; Höfler, Michael; Wittchen, Hans-Ulrich; Lieb, Roselind; Bauer, Michael; Pfennig, Andrea; Beesdo-Baum, Katja
There is ample data suggesting that individuals with bipolar disorder more frequently suffer from disturbed sleep even when euthymic. Since sleep is a process that is crucial for affective homeostasis, disturbed sleep in healthy individuals may be a risk factor for the subsequent onset of bipolar disorder. Utilizing data from a large cohort of adolescents and young adults, this study tests the hypothesis that disturbed sleep constitutes a risk factor for the later onset of bipolar disorder. A representative community sample of N = 3021 adolescents and young adults (baseline age 14-24) was assessed using the standardized Composite International Diagnostic Interview and followed-up prospectively up to 3 times over up to 10 years. Disturbed sleep at baseline was quantified utilizing the corresponding items from the self-report inventory SCL-90-R. The compound value (insomnia-score) as an ordinal parameter for the severity of sleep disturbances was used to assess associations with the incidence of bipolar disorder among participants free of major mental disorder at baseline (N = 1943) using odds ratios (OR) from logistic regressions. Analyses were adjusted for age, gender, parental mood disorder and lifetime alcohol or cannabis dependence. Poor sleep quality significantly increased the risk for the subsequent development of bipolar disorder (OR = 1.75; p = 0.001). Regarding individual sleep items, trouble falling asleep and early morning awakening were predictive for the subsequent onset of bipolar disorder. Disturbed sleep in persons otherwise free of major mental disorders appears to confer an increased risk for the subsequent onset of bipolar disorder. PMID:26228404
Yanagawa, Yasuaki; Nagata, Naoyoshi; Watanabe, Koji; Tsukada, Kunihisa; Teruya, Katsuji; Kikuchi, Yoshimi; Gatanaga, Hiroyuki; Akiyama, Junichi; Uemura, Naomi; Oka, Shinichi
Serological evidence of the epidemiological trends in Entamoeba histolytica infection is scarce, especially in nonendemic countries. We aimed to determine the antibody-positive rates over a 10-year period, and compare the trends between human immunodeficiency virus (HIV)-infected and -noninfected patients. We reviewed 3,514 patients who underwent antibody testing during the study periods, which were divided into five annual categories: 2004-2005, 2006-2007, 2008-2009, 2010-2011, and 2012-2013. Anti-E. histolytica antibody was assessed by indirect immunofluorescence assay. The antibody-positive rate increased yearly from 2004-2005 to 2012-2013 (P < 0.001), although there was no increase in the annual number of antibody tests. This trend was seen among males (18.6-28.3%; P < 0.01), females (5.4-28.2%; P < 0.01), HIV-infected patients (18.4-26.9%; P < 0.001), and non-HIV-infected patients (14.6-36.8%; P < 0.001), and HIV-infected men who have sex with men (19.4-29.1%; P < 0.001). Among antibody-positive patients, there was a significant increase in the proportion of patients with high (≥ 1,600) titers (0.7-12.9%; P < 0.001), whereas this trend was not seen in patients with low (100) or intermediate (200-800) titers (P = 0.282 and 0.409, respectively). This large hospital-based study demonstrated that positive anti-E. histolytica antibody rates increased over 10 years, even though the annual number of antibody tests remained constant. Moreover, this trend was identified in non-high-risk patients (females and non-HIV-infected patients) as well as in high-risk patients. The proportion of patients with high antibody titers significantly increased among the antibody-positive patients. PMID:27296390
Climate forecasts have been developed to assist decision making in sectors averse to, and affected by, climate risks, and agriculture is one of those. In agriculture and food security, climate information is now used on a range of timescales, from days (weather), months (seasonal outlooks) to decades (climate change scenarios). Former researchers have shown that when seasonal climate forecast information was provided to farmers prior to decision making, farmers adapted by changing their choice of planting seeds and timing or area planted. However, it is not always clear that the end-users' needs for climate information are met and there might be a large gap between information supplied and needed. It has been pointed out that even when forecasts were available, they were often not utilized by farmers and extension services because of lack of trust in the forecast or the forecasts did not reach the targeted farmers. Many studies have focused on the use of either seasonal forecasts or longer term climate change prediction, but little research has been done on the medium term, that is, 1 to 10 year future climate information. The agriculture and food system sector is one potential user of medium term information, as land use policy and cropping systems selection may fall into this time scale and may affect farmers' decision making process. Assuming that reliable information is provided and it is utilized by farmers for decision making, it might contribute to resilient farming and indeed to longer term food security. To this end, we try to determine the effect of medium term climate information on farmers' strategic decision making process. We explored the end-users' needs for climate information and especially the possible role of medium term information in agricultural system, by conducting interview surveys with farmers and agricultural experts. In this study, the cases of apple production in South Africa, maize production in Malawi and rice production in Tanzania
Desai, Chintan S; Bartz, Traci M; Gottdiener, John S; Lloyd-Jones, Donald M; Gardin, Julius M
Left ventricular (LV) mass and geometry are associated with risk of cardiovascular disease (CVD). We sought to determine whether LV mass and geometry contribute to risk prediction for CVD in adults aged ≥65 years of the Cardiovascular Health Study. We indexed LV mass to body size, denoted as LV mass index (echo-LVMI), and we defined LV geometry as normal, concentric remodeling, and eccentric or concentric LV hypertrophy. We added echo-LVMI and LV geometry to separate 10-year risk prediction models containing traditional risk factors and determined the net reclassification improvement (NRI) for incident coronary heart disease (CHD), CVD (CHD, heart failure [HF], and stroke), and HF alone. Over 10 years of follow-up in 2,577 participants (64% women, 15% black, mean age 72 years) for CHD and CVD, the adjusted hazards ratios for a 1-SD higher echo-LVMI were 1.25 (95% CI 1.14 to 1.37), 1.24 (1.15 to 1.33), and 1.51 (1.40 to 1.62), respectively. Addition of echo-LVMI to the standard model for CHD resulted in an event NRI of -0.011 (95% CI -0.037 to 0.028) and nonevent NRI of 0.034 (95% CI 0.008 to 0.076). Addition of echo-LVMI and LV geometry to the standard model for CVD resulted in an event NRI of 0.013 (95% CI -0.0335 to 0.0311) and a nonevent NRI of 0.043 (95% CI 0.011 to 0.09). The nonevent NRI was also significant with addition of echo-LVMI for HF risk prediction (0.10, 95% CI 0.057 to 0.16). In conclusion, in adults aged ≥65 years, echo-LVMI improved risk prediction for CHD, CVD, and HF, driven primarily by improved reclassification of nonevents. PMID:27457431
Moore, J.; Meitin, J. G.
network required to support real-time mission planning and data collection. The capability to share real-time data and products has only been available in the last 5-10 years. The advent of Internet-based communications technology has proven invaluable. Unique communication solutions will be described. The impact of these capabilities on the success of the project will be discussed.Selected Field Projects Focused on Tropical SystemsTable includes project acronym, time frame, primary funding source and major mobile facilities
Fearnbach, S Nicole; English, Laural K; Lasschuijt, Marlou; Wilson, Stephen J; Savage, Jennifer S; Fisher, Jennifer O; Rolls, Barbara J; Keller, Kathleen L
Energy balance is regulated by a multifaceted system of physiological signals that influence energy intake and expenditure. Therefore, variability in the brain's response to food may be partially explained by differences in levels of metabolically active tissues throughout the body, including fat-free mass (FFM) and fat mass (FM). The purpose of this study was to test the hypothesis that children's body composition would be related to their brain response to food images varying in energy density (ED), a measure of energy content per weight of food. Functional magnetic resonance imaging (fMRI) was used to measure brain response to High (>1.5kcal/g) and Low (<1.5kcal/g) ED food images, and Control images, in 36 children ages 7-10years. Body composition was measured using bioelectrical impedance analysis. Multi-subject random effects general linear model (GLM) and two-factor repeated measures analysis of variance (ANOVA) were used to test for main effects of ED (High ED vs. Low ED) in a priori defined brain regions of interest previously implicated in energy homeostasis and reward processing. Pearson's correlations were then calculated between activation in these regions for various contrasts (High ED-Low ED, High ED-Control, Low ED-Control) and child body composition (FFM index, FM index, % body fat). Relative to Low ED foods, High ED foods elicited greater BOLD activation in the left thalamus. In the right substantia nigra, BOLD activation for the contrast of High ED-Low ED foods was positively associated with child FFM. There were no significant results for the High ED-Control or Low ED-Control contrasts. Our findings support literature on FFM as an appetitive driver, such that greater amounts of lean mass were associated with greater activation for High ED foods in an area of the brain associated with dopamine signaling and reward (substantia nigra). These results confirm our hypothesis that brain response to foods varying in energy content is related to measures
Prevalent vertebral deformities predict increased mortality and increased fracture rate in both men and women: a 10-year population-based study of 598 individuals from the Swedish cohort in the European Vertebral Osteoporosis Study.
Hasserius, R; Karlsson, M K; Nilsson, B E; Redlund-Johnell, I; Johnell, O
The aim of this study was to evaluate whether a prevalent vertebral deformity predicts mortality and fractures in both men and women. In the city of Malmö, 598 individuals (298 men, 300 women; age 50-80 years) were selected from the city's population and were included in the Swedish part of the European Vertebral Osteoporosis Study (EVOS). At baseline the participants answered a questionnaire and lateral spine radiographs were performed. The prevalence of subjects with vertebral deformity was assessed using a morphometric method. The mortality during a 10-year follow-up period was determined through the register of the National Swedish Board of Health and Welfare. Eighty-five men and 43 women died during the study period. The subsequent fracture incidence during the follow-up period was ascertained by postal questionnaires, telephone interviews and by a survey of the archives of the Department of Radiology in the city hospital. Thirty-seven men and 69 women sustained a fracture during the study period. Data are presented as hazard ratios (HR) with 95% confidence interval (95% CI) within brackets. Prevalent vertebral deformity, defined as a reduction by more than 3 standard deviations (SD) in vertebral height ratio, predicted mortality during the forthcoming decade in both men [age-adjusted HR 2.4 (95% CI 1.6-3.9)] and women [age-adjusted HR 2.3 (95% CI 1.3-4.3)]. In men there was an increased mortality due to cardiovascular and pulmonary diseases and in women due to cancer. Prevalent vertebral deformity predicted an increased risk of any fracture during the forthcoming decade in both men [age-adjusted HR 2.7 (95% CI 1.4-5.3)] and women [age-adjusted HR 1.8 (95% CI 1.1-2.9)]. Prevalent vertebral deformity predicted an increased risk of any subsequent fragility fracture in women [age-adjusted HR 2.0 (95% CI 1.1-3.5)]; however, in men the increased risk was nonsignificant [age-adjusted HR 1.9 (95% CI 0.7-5.1)]. In summary, a prevalent vertebral deformity can predict
Kume, T.; Tanaka, N.; Komatsu, H.; Yoshifuji, N.; Saitoh, T. M.; Suzuki, M.; Kumagai, T.
This study was undertaken to quantify 10-year evapotranspiration (ET) in a tropical rainforest, Sarawak, Malaysia. To this aim, a simplified big-leaf model was formulated, which can consider transpiration (Et) and rainfall interception (Ei). The model was independently validated using eddy covariance fluxes, rainfall interception based on throughfall and stemflow measurements, and sap flow measurements conducted for more than two years. Consequently, our big-leaf model could successfully reproduce Et and Ei. By using the model and a 10-year meteorological data set, Et, Ei, and ET was estimated in the period between 2000 and 2009. The annual Et , Ei, and ET averaged over 10 years were estimated as 1114, 209, and 1323 mm, respectively, with the small seasonal fluctuations. The derived estimations for 10 years showed conservative year-to-year variations in Et, Ei, and ET (CV = 5-7%) against considerable year-to-year variations in annual rainfall (CV = 11%). Specific rainfall characteristics in this site could be a reason for conservative year-to-year variations in Ei. Small interannual variations in meteorological conditions and no occurrence of unusually severe drought in this study period could be a reason for the small year-to-year variations in Et. As well, we compared ET, Ei at this site with those of other tropical forests. Our forest ET was smaller than global maximum value of ET estimated in other tropical forests because of the smaller Ei, relative to annual rainfall at this site. Based on the derived characteristics of ET, we also discussed possible changes in ET, Et, and Ei in response to changes in rainfall regime at this site.
Notara, Venetia; Panagiotakos, Demosthenes B; Kouvari, Matina; Tzanoglou, Despoina; Kouli, Georgia; Mantas, Yannis; Kogias, Yannis; Stravopodis, Petros; Papanagnou, George; Zombolos, Spyros; Babatsikou, Fotοula; Koutis, Charilaos; Pitsavos, Christos
The association between long-term coffee consumption and 10-year cardiovascular disease incidence among Acute Coronary Syndrome (ACS) patients was evaluated. From 2003 to 2004, 2172 ACS consecutive patients from six major Greek hospitals were enrolled. During 2013-2014, the 10-year follow-up was performed (88% participation rate) and recurrent fatal or non-fatal ACS was recorded. Baseline coffee consumption (cups/day) was assessed using a semi-quantitative Food Frequency Questionnaire. Multi adjusted analysis revealed that 1-2 cups of coffee/day versus no consumption had an adverse effect on the ACS incidence [odds ratio (OR) = 1.35, 95% confidence interval (CI) 1.01, 1.79]. In subgroup analysis, with hypertension as strata, only the normotensive reached significance. Odds ratios for 1-2 and ≥3 cups relative to no consumption were [OR = 1.66, 95% CI 1.07, 2.60] and [OR = 1.86, 95% CI 1.06, 3.27], respectively, after controlling for potential confounders. Thus, avoidance of coffee may be of high importance to ameliorate disease prognosis among cardiac patients. PMID:26307525
Hristova-Veleva, Svetla; Haddad, Ziad; Knosp, Brian; Lambrigtsen, Bjorn; Li, P. Peggy; Poulsen, William; Seo, Eun-Kyoung; Shen, Tsae-Pyng; Turk, Francis J.; Vu, Quoc
In spite of recent improvements in hurricane track forecast accuracy, currently there are still many unanswered questions about the physical processes that determine hurricane genesis, and evolution. Furthermore, a significant amount of work remains to be done in validating and improving hurricane forecast models. None of this can be accomplished without a comprehensive set of multi-parameter observations that are relevant to both the large-scale and the storm-scale processes in the atmosphere and in the ocean. Despite the significant amount of satellite observations today, they are still underutilized in hurricane research and operations, due to complexity and volume. To facilitate hurricane research, we developed the JPL Tropical Cyclone Information System (TCIS) of multi-instrument satellite observations pertaining to: i) the thermodynamic and microphysical structure of the storms; ii) the air-sea interaction processes; iii) the larger-scale environment as depicted by the SST and the Total Precipitable Water of the environment (Hristova-Veleva et al., 2008, 2011). Our goal was to create a one-stop place to provide the researchers with an extensive set of observed hurricane data, and their graphical representation, organized in an easy way to determine when coincident observations from multiple instruments are available. In this study we use the 10+ years of passive microwave observations of Atlantic hurricanes to create composite structures that are segregated by hurricane category and by intensification rate. The use of composite structures provides a statistically robust framework (e.g. Rogers et al., 2012). We analyze the storm asymmetry as depicted by several factors - brightness temperatures and their derivatives such as a newly-develop Rain Indicator and a new convective/stratiform separation that is based on the value and the spatial variability of this Rain Indicator. The goal is to determine whether the storm morphology (in particular, the storm
Lubin, Amélie; Rossi, Sandrine; Simon, Grégory; Lanoë, Céline; Leroux, Gaëlle; Poirel, Nicolas; Pineau, Arlette; Houdé, Olivier
Are individual differences in numerical performance sustained by variations in gray matter volume in schoolchildren? To our knowledge, this challenging question for neuroeducation has not yet been investigated in typical development. We used the Voxel-Based Morphometry method to search for possible structural brain differences between two groups of 10-year-old schoolchildren (N = 22) whose performance differed only in numerical transcoding between analog and symbolic systems. The results indicated that children with low numerical proficiency have less gray matter volume in the parietal (particularly in the left intraparietal sulcus and the bilateral angular gyri) and occipito-temporal areas. All the identified regions have previously been shown to be functionally involved in transcoding between analog and symbolic numerical systems. Our data contribute to a better understanding of the intertwined relationships between mathematics learning and brain structure in healthy schoolchildren. PMID:23630510
Lubin, Amélie; Rossi, Sandrine; Simon, Grégory; Lanoë, Céline; Leroux, Gaëlle; Poirel, Nicolas; Pineau, Arlette; Houdé, Olivier
Are individual differences in numerical performance sustained by variations in gray matter volume in schoolchildren? To our knowledge, this challenging question for neuroeducation has not yet been investigated in typical development. We used the Voxel-Based Morphometry method to search for possible structural brain differences between two groups of 10-year-old schoolchildren (N = 22) whose performance differed only in numerical transcoding between analog and symbolic systems. The results indicated that children with low numerical proficiency have less gray matter volume in the parietal (particularly in the left intraparietal sulcus and the bilateral angular gyri) and occipito-temporal areas. All the identified regions have previously been shown to be functionally involved in transcoding between analog and symbolic numerical systems. Our data contribute to a better understanding of the intertwined relationships between mathematics learning and brain structure in healthy schoolchildren. PMID:23630510
In 1974, following an extensive eight-year review of professional practices in the Province of Quebec, the Professional Code and the 21 professional bills associated with it became operational. Thirty-eight professional corporations encompassing the fields of health, administration, finance, applied sciences and justice were named in the Code, and each was assigned an exclusive mandate to protect the public. The mechanisms outline for controlling professional practice and promoting public service included professional inspection and discipline, as well as regulations regarding ethics, the arbitration of accounts, the keeping of client records, and publicity. This paper discusses the effectiveness of these mechanisms over the past 10-year period. It also looks at the capabilities of the corporations to achieve their mandates in light of the legal status assigned to each--whether that be exclusive right of practice and reserve of title (21 corporations), or reserve of title only (17 corporations). PMID:10275979
Yanagawa, Yasuaki; Nagata, Naoyoshi; Watanabe, Koji; Tsukada, Kunihisa; Teruya, Katsuji; Kikuchi, Yoshimi; Gatanaga, Hiroyuki; Akiyama, Junichi; Uemura, Naomi; Oka, Shinichi
Serological evidence of the epidemiological trends in Entamoeba histolytica infection is scarce, especially in nonendemic countries. We aimed to determine the antibody-positive rates over a 10-year period, and compare the trends between human immunodeficiency virus (HIV)–infected and –noninfected patients. We reviewed 3,514 patients who underwent antibody testing during the study periods, which were divided into five annual categories: 2004–2005, 2006–2007, 2008–2009, 2010–2011, and 2012–2013. Anti-E. histolytica antibody was assessed by indirect immunofluorescence assay. The antibody-positive rate increased yearly from 2004–2005 to 2012–2013 (P < 0.001), although there was no increase in the annual number of antibody tests. This trend was seen among males (18.6–28.3%; P < 0.01), females (5.4–28.2%; P < 0.01), HIV-infected patients (18.4–26.9%; P < 0.001), and non-HIV-infected patients (14.6–36.8%; P < 0.001), and HIV-infected men who have sex with men (19.4–29.1%; P < 0.001). Among antibody-positive patients, there was a significant increase in the proportion of patients with high (≥ 1,600) titers (0.7–12.9%; P < 0.001), whereas this trend was not seen in patients with low (100) or intermediate (200–800) titers (P = 0.282 and 0.409, respectively). This large hospital-based study demonstrated that positive anti-E. histolytica antibody rates increased over 10 years, even though the annual number of antibody tests remained constant. Moreover, this trend was identified in non-high-risk patients (females and non-HIV-infected patients) as well as in high-risk patients. The proportion of patients with high antibody titers significantly increased among the antibody-positive patients. PMID:27296390
Borges, Guilherme; Angst, Jules; Nock, Matthew K.; Ruscio, Ayelet Meron; Kessler, Ronald C.
Background We report prospective associations of baseline risk factors with the first onset and persistence of suicide-related outcomes (SROs; ideation, plans, gestures, and attempts) over a 10-year interval among respondents who participated in both the 1990−02 National Comorbidity Survey (NCS) and the 2000−02 National Comorbidity Survey follow-up (NCS-2). Methods A total of 5001 NCS respondents were re-interviewed (87.6% of baseline sample) in the NCS-2. Three sets of baseline (NCS) risk factors were considered as predictors of the first onset and persistence of SROs: socio-demographics, lifetime DSM-III-R disorders, and SROs. Results New onsets included 6.2% suicide ideation, 2.3% plan, 0.7% gesture, and 0.9% attempts. More than one-third of respondents with a baseline history of suicide ideation continued to have suicide ideation at some time over the intervening decade. Persistence was lower for other SROs. The strongest predictors of later SROs were baseline SROs. Prospective associations of baseline mental disorders with later SROs were largely limited to the onset and persistence of ideation. Limitations Although data were gathered prospectively, they were based on retrospective reports at both baseline and follow-up. Conclusions Baseline history of SROs explained much of the association of mental disorders with later SROs. It is important clinically to note that many of the risk factors known to predict onset of SROs also predict persistence of SROs. PMID:17507099
Wu, Chia-Liang; Wen, Shu-Hui
Abstract Calcium channel blockers (CCBs) are widely used for reducing blood pressure of hypertensive patients. Recent reports document the beneficial effects of CCB for preventing dementia; however, the results are controversial. We aim to evaluate the risk of developing dementia among elderly hypertensive patients treated with CCB. We designed a retrospective population-based cohort study using the records of the National Health Insurance Research Database of Taiwan dated from 2000 to 2010. The study cohort comprised 82,107 hypertensive patients of more than 60 years of age, and 4004 propensity score (PS)-matched pairs were selected according to age, sex, year of hypertension diagnosis, and baseline comorbidities. We employed a robust Cox proportional hazard model to estimate the hazard ratio (HR) of developing dementia in the PS-matched cohort. The annual incidence of dementia in the CCB-exposure group was significantly lower than that in the comparator group (3.9 vs 6.9 per 1000 person-years, P < 0.01) during the follow-up period (4.4 ± 2.5 years). Based on the PS-matched cohort, the adjusted HR of dementia in the CCB-exposure group was significantly lower than that in comparator group (HR = 0.53, 95% confidence interval: 0.39–0.72, P < 0.01). Sensitivity and subgroup analyses also confirmed similar findings. Our results provided evidence for an association between CCB use and a lower risk of developing dementia among the elderly hypertensive patients. Further studies are required to explore the causal relationship between CCB use and dementia. PMID:27512890
Yang, Ya-Fei; Li, Tsai-Chung; Li, Chia-Ing; Liu, Chiu-Shong; Lin, Wen-Yuan; Yang, Sing-Yu; Chiang, Jen-Huai; Huang, Chiu-Ching; Sung, Fung-Chang; Lin, Cheng-Chieh
The purpose of this study was to examine the association of glucose variability using coefficient of variation of fasting plasma glucose (FPG-CV) and coefficient of variation of glycated hemoglobin (HbA1c-CV) to end-stage renal disease (ESRD) in 31,841 Chinese patients with type 2 diabetes.Patients with type 2 diabetes enrolled in National Diabetes Care Management Program, aged ≧30 years, and free of ESRD (n = 31,841) in January 1, 2002 to December 31, 2004 were included. Extended Cox proportional hazards regression models with competing risk of all-cause mortality were used to evaluate risk factors on ESRD incidence. Patients were followed till 2012.After a median follow-up period of 8.23 years, 1642 patients developed ESRD, giving a crude incidence rate of 6.27/1000 person-years (6.36 for men, 6.19 for women). After the multivariate adjustment, both FPG-CV and HbA1c-CV were independent predictors of ESRD with corresponding hazard ratios of 1.20 (95% confidence interval [CI] 1.01, 1.41), 1.24 (95% CI 1.05, 1.46) in HbA1c-CV from fourth to fifth quintile and 1.23 (95% CI 1.03, 1.47) in FPG-CV from fifth quintile.One-year visit-to-visit glucose variability expressed by FPG-CV and HbA1c-CV predicted development of ESRD in patients with type 2 diabetes, suggesting therapeutic strategies toward a goal to minimize glucose fluctuation. PMID:26554779
Background Cancer registries help to decrease the burden of cancers by collecting accurate and complete data. We aimed to measure the completeness of coverage of information recorded between 2000 and 2009 in a cancer registry program in Fars province, southern Iran. Methods The cancer registry program run by Shiraz University of Medical Sciences was investigated in two periods: pathology-based data from 2000 to 2007 and population-based data from 2007 to 2009. Completeness of yearly coverage was measured as the number of reported cases of cancer in each year divided by estimated cases based on 107.3 new cases per 100 000 individuals. The percentage of complete data registration (patient’s name, age, gender, address, phone number and father’s name) and correct cancer encoding was calculated for each year and compared to the maximum acceptable error rate for each item. Results A total of 29 277 non-duplicate cancer records were studied. Completeness of coverage varied from 22.68% in 2000 to 118.7% in 2008. Deficiencies in patients’ demographic data were highest for name in 2002 (0.09%), age in 2006 (2.36%), gender in 2001 (0.06%) and father’s name in 2001 (52.5%). Incomplete address (99.7%) and missing phone number (100%) were most frequent in 2000, and deficiencies in encoding information were highest in 2008 (6.36%). Conclusions The cancer registry program in Fars province (southern Iran) was considered satisfactory in terms of completeness of coverage and information about age. However, it was deficient in recording patients’ phone number and address, and father’s name. The error level for cancer encoding was unacceptably high. Enhancing hardware and software resources, education and motivation in all public and private sectors involved in the cancer registry program, and greater attention to epidemiological research are needed to increase the quality of the cancer registry program, including its completeness. PMID:23647828
Cats, Bernard P.; Tan, Karel E. W. P.
Reporting long-term ophthalmologic sequelae among ex-prematures at 6 to 10 years of age, this study compares 42 ex-premature infants who had had regressed forms of retinopathy of prematurity (ROP) during the neonatal period with 42 matched non-ROP ex-premature controls at 6 to 10 years of age. Subjects were subdivided into four groups: (1) ROP…
Ec, M.; N, R.
To holistically understand the geodynamical and crustal deformation processes between India and Antarctica, two global networks (IND and ANT) have been chosen. The objective is to geodetically connect the two continents. The IGS Station at Diego Garcia (DGAR) is the common station between the two networks. 10 years of data from 1997 to 2007 were used. By these global networks' analyses, the stations HYDE in India and MAIT at Antarctica are geodetically tied through the station DGAR. Very long baselines have been estimated from HYDE and also from Kerguelen (KERG) to other chosen IGS stations in and around India and Antarctica. Our analysis and results using ANT network show an increase in the baseline lengths between Kerguelen in Antarctic plate and other stations such as SEY1, DGAR and COCO and shortening of baseline lengths between HYDE in Indian plate and all these above stations using IND network. The analysis using ANT network also shows lengthening of baselines from Kerguelen to the sites Yaragadee (YAR1) and Tidbinbilla (TID2) in Australian plate; and Seychelles (SEY1) in Male plate, COCO in the diffuse plate boundary between India and Australia and DGAR in Capricorn plate at the rates of 5.3cm/yr, 3.8cm/yr, 5.6mm/yr, 3.03 cm/yr and 5.5 cm/yr respectively. The high rate of movement of COCO Island in comparison to Seychelles could be the result of excessive strain accumulation due to the Indo-Australia diffuse plate boundary forces acting upon this region. The estimated elastic strain accumulation shows an increasing trend of 1.27x 10-8 yr-1 in the south of Indian peninsula. Our results show the precision of approximately 3-4mm (North), 5-6 mm (East), and 10-12mm (vertical) for the estimation of site coordinates. These results provide new information on the direction and rate of Indian plate motion, the driving mechanisms of Indian plate and intraplate seismicity of the Indian Ocean on the whole.
Parkinson, Claire L.
NASA's Aqua spacecraft was launched at 2:55 a.m. on May 4, 2002, from Vandenberg Air Force Base in California, into a near-polar, sun-synchronous orbit at an altitude of 705 km. Aqua carries six Earth-observing instruments to collect data on water in all its forms (liquid, vapor, and solid) and on a wide variety of additional Earth system variables (Parkinson 2003). The design lifetime for Aqua's prime mission was 6 years, and Aqua is now well into its extended mission, approaching 10 years of successful operations. The Aqua data have been used for hundreds of scientific studies and continue to be used for scientific discovery and numerous practical applications.
Krishna Reddy, S.V.; Shaik, Ahammad Basha; Sreenivas, K.
We report our 10-year experience with penile injuries. We retrospectively reviewed the records of 156 cases of male external genitalia injuries between May 2002 and December 2012. Of these, only 26 patients presented without urethral injuries and were included in this study. Patients were divided into 4 groups: Group 1 (n = 12) with patients with penile fractures injuries; Group 2 (n = 5) with patients with penile amputation injuries; Group 3 (n = 2) with patients with penile penetrating injuries; and Group 4 (n = 7) with patients with penile soft tissue injuries. Grading of injury was done using the American Association for the Surgery of Trauma (AAST)-Organ injury scale of penile injury. Penile injuries without urethral injuries are urological emergencies which require immediate attention. PMID:25295134
Ostbye,Truls; Seim, Arnfinn; Krause, Katrina M.; Feightner, John; Hachinski, Vladimir; Sykes, Elizabeth; Hunskaar, Steinar
Urinary incontinence is common in the elderly. The epidemiology of fecal and double (urinary and fecal) incontinence is less known. The Canadian Study of Health and Aging (CSHA) is a national study of elderly living in the community at baseline (n = 8,949) and interviewed in 1991-1992, 1996, and 2001. Using data from the CSHA, we report the…
Deepa, Mohan; Anjana, Ranjit Mohan; Manjula, Datta; Venkat Narayan, KM; Mohan, Viswanathan
Aim The aim of this study was to look for temporal changes in the prevalence of diabetes and cardiometabolic risk factors in two residential colonies in Chennai. Methods Chennai Urban Population Study (CUPS) was carried out between 1996–1998 in Chennai in two residential colonies representing the middle income group (MIG) and lower income group (LIG), respectively. The MIG had twice the prevalence rate of diabetes as the LIG and higher prevalence rates of hypertension, obesity, and dyslipidemia. They were motivated to increase their physical activity, which led to the building of a park. The LIG was given standard lifestyle advice. Follow-up surveys of both colonies were performed after a period of 10 years. Results In the MIG, the prevalence of diabetes increased from 12.4 to 15.4% (24% increase), while in the LIG, it increased from 6.5 to 15.3% (135% increase, p < .001). In the LIG, the prevalence rates of central obesity (baseline vs follow-up, male: 30.8 vs 50.9%, p < .001; female: 16.9 vs 49.8%, p < .001), hypertension (8.4 vs 20.1%, p < .001), hypercholesterolemia (14.2 vs. 20.4%, p < .05), and hypertriglyceridemia (8.0 vs 23.5%, p < .001) significantly increased and became similar to that seen in the MIG. Conclusion There is a rapid reversal of socioeconomic gradient for diabetes and cardiometabolic risk factors in urban India with a convergence of prevalence rates among people in the MIG and LIG. This could have a serious economic impact on poor people in developing countries such as India. PMID:21880235
Lyons, Karen S.; Stewart, Barbara J.; Archbold, Patricia G.; Carter, Julie H.
Purpose: There is wide variability in how spouses providing care respond to their care situations. Few studies focus on the roles of both intra- and interpersonal factors in long-term spousal care, particularly in the context of Parkinson's disease (PD). The current study uses longitudinal data over a 10-year period to examine the roles of…
Lauff, Erich; Ingels, Steven J.
The Education Longitudinal Study of 2002 (ELS:2002) tracks the educational and developmental experiences of a nationally representative sample of high school sophomores in the United States. This First Look report provides a descriptive portrait of these 2002 tenth-graders a decade later, when most were about 26 years old and had been out of high…
Yang, Jinghui; Liu, Jianwei; Liu, Jing; Li, Wenyuan; Li, Xiaoying; He, Yao; Ye, Ling
Background The metabolic syndrome (MetS) has been known as partly heritable, while the number of genetic studies on MetS and metabolic-related traits among Chinese elderly was limited. Methods A cross-sectional analysis was performed among 2 014 aged participants from September 2009 to June 2010 in Beijing, China. An additional longitudinal study was carried out among the same study population from 2001 to 2010. Biochemical profile and anthropometric parameters of all the participants were measured. The associations of 23 SNPs located within 17 candidate genes (MTHFR, PPARγ, LPL, INSIG, TCF7L2, FTO, KCNJ11, JAZF1, CDKN2A/B, ADIPOQ, WFS1, CDKAL1, IGF2BP2, KCNQ1, MTNR1B, IRS1, ACE) with overweight and obesity, diabetes, metabolic phenotypes, and MetS were examined in both studies. Results In this Chinese elderly population, prevalence of overweight, central obesity, diabetes, dyslipidemia, hypertension, and MetS were 48.3%, 71.0%, 32.4%, 75.7%, 68.3% and 54.5%, respectively. In the cross-sectional analyses, no SNP was found to be associated with MetS. Genotype TT of SNP rs4402960 within the gene IGF2BP2 was associated with overweight (odds ratio (OR) = 0.479, 95% confidence interval (CI): 0.316-0.724, p = 0.001) and genotype CA of SNP rs1801131 within the gene MTHFR was associated with hypertension (OR = 1.560, 95% CI: 1.194–2.240, p = 0.001). However, these associations were not observed in the longitudinal analyses. Conclusions The associations of SNP rs4402960 with overweight as well as the association of SNP rs1801131 with hypertension were found to be statistically significant. No SNP was identified to be associated with MetS in our study with statistical significance. PMID:24959828
Chanteau, S; Glaziou, P; Plichart, C; Luquiaud, P; Plichart, R; Faucher, J F; Cartel, J L
In 1983, a cohort study to follow up the family contacts of leprosy cases was implemented in French Polynesia to assess the usefulness and applicability of phenolic glycolipid-I (PGL-I) serology in a leprosy control program. A total of 1201 contacts (666 females, 535 males) have been included in the study. The IgM anti-PGL-I seroprevalence determined on the initial sera was 17%. It was significantly higher among females than males (20% vs 15%, p = 0.02). From 1983 to 1992, 4 out of 204 (2%) anti-PGL-I seropositive contacts developed the disease (1 indeterminate, 1 BT, 1 BL, 1 LL) compared with 10 out of 997 (1%) seronegative contacts (4 indeterminate, 3 BT, 1 BB, 2 TT). Of these 10 patients, only 3 (2 indeterminate, 1 BT) converted to seropositivity when leprosy was diagnosed. The risk of developing leprosy was not significantly higher among seropositive than among seronegative groups (2% vs 1%, p = 0.2). A PGL-I circulating antigen test performed on 216 selected sera at entry into the trial showed a higher antigen prevalence when the antibody level was higher. PGL-I antigen was detectable in 5 of 12 patients tested prior to diagnosis (1 LL, 1 BL, 3 indeterminate). The median time to externalize the disease was not significantly different among antibody-positive and -negative contacts (17 vs 25 months, p = 0.3). The relative risk of developing leprosy for contact individuals was 30.8 times that of noncontacts, and 15% of the total new cases detected between 1983 and 1992 emerged from the study population.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8151183
Asgari, Samaneh; Khalili, Davood; Mehrabi, Yadollah; Kazempour-Ardebili, Sara; Azizi, Fereidoun; Hadaegh, Farzad
The objective of this study is to examine the incidence and risk factors of isolated systolic hypertension (ISH) and isolated diastolic hypertension (IDH) in a Middle Eastern population, during a median follow-up of 9.6 years. In total, 8573 subjects without hypertension, cardiovascular disease and known diabetes were recruited into the study. To calculate the incidence of ISH, those with diastolic blood pressure (DBP) ≥ 90 mmHg during follow-up, and for calculating IDH those with systolic blood pressure (SBP) ≥ 140 mmHg during follow-up, were excluded. During follow-up, 235 new cases of ISH were identified, with a crude incidence rate of 5.7/1000 person-years; the corresponding values for IDH were 470 and 10.9/1000 person-years. Using backward stepwise Cox regression analysis, older age, baseline SBP and body mass index were related to incident ISH. Regarding IDH, younger age, baseline DBP and waist circumference were associated with higher risk, whereas female gender and being married were associated with lower risk (all p < 0.05). The C-statistics for the prediction model were 0.91 for ISH and 0.76 for IDH. In conclusion, after a decade of follow-up of this Iranian population, we found an incidence of about 0.5% and 1% per year for ISH and IDH, respectively. PMID:26643588
Dantas, Thinali Sousa; de Barros Silva, Paulo Goberlânio; Sousa, Eric Fernandes; da Cunha, Maria do Pss; de Aguiar, Andréa Silvia Walter; Costa, Fábio Wildson Gurgel; Mota, Mário Rogério Lima; Alves, Ana Paula Negreiros Nunes; Sousa, Fabrício Bitu
The mortality rate associated with oral cancer is estimated at approximately 12,300 deaths per year, and the survival rate is only 40% to 50% for diagnosed patients and is closely related to the duration of time between disease perception and its diagnosis and treatment. Socioeconomic risk factors are determinants of the incidence and mortality related to oral cancer. We conducted a retrospective, cross-sectional study of 573 records of patients with oral cancer at Haroldo Juaçaba Hospital - Cancer Institute of Ceará from 2000 to 2009 to evaluate the influence of socioeconomic factors on survival and epidemiological behavior of this neoplasia in a Brazilian population. In this study, patients with oral cancer were males greater than 60 years of age, presented squamous cell carcinoma in the floor of mouth and were characterized by low education levels. A total of 573 lesions were found in oral cavities. Cox proportional hazards regression model showed that the histological type, tumor stage, and low degree of education significantly influenced survival. A lower patient survival rate was correlated with a more advanced stage of disease and a worse prognosis. Squamous cell carcinoma is associated with a higher mortality when compared with other histological types of malign neoplasia. PMID:26817864
Chomrikh, Laila; Gebuhr, Peter; Bierling, Roelf; Lind, Ulla; Zwart, Hendrik J J
Radial impaction grafting (RIG) potentially improves the durability and reliability of cementing the femoral components in revision total hip arthroplasty (THA). In this multicenter, prospective study, 88 revision THAs (87 patients) with RIG technique were performed. The average follow-up time was 7.0 years (range, 5.0-10.2). There were 14 femur fractures: 2 intraoperative, 5 within 3 months after surgery, and 7 later in the postoperative stage (range, 5-84 months). Sixteen patients were lost to follow-up and 20 died without stem re-revision. None of the patients have been re-revised for any reason during follow-up. Age was observed to be a significant factor for determining fracture risk. In conclusion, RIG can be considered a reliable surgical technique, especially for younger patients. PMID:23891061
Lee, Chun-Te; Chiang, Yi-Cheng; Huang, Jing-Yang; Tantoh, Disline M; Nfor, Oswald N; Lee, Jia-Fu; Chang, Cheng-Chen; Liaw, Yung-Po
Major depressive disorder (MDD), the most prevalent mental disorder is a global public health issue.The aim of this study was to assess the association between low income and major depressive disorder (MDD) by age and sex.The National Health Insurance Research Database (NHIRD) of Taiwan was used to retrieve data. A total of 1,743,948 participants were eligible for the study. Low-income individuals were identified from 2001 and 2003 (specifically, Group Insurance Applicants, ie, category"51" or "52") and followed from 2004 to 2010. MDD was identified using the ICD-9-CM 296.2 and 296.3 codes.Among non-low-income individuals, the MDD incidence rates increased with age in both males and females, that is, 0.35, 0.93, 0.97, 1.40 per 10,000 person-months for males and 0.41, 1.60, 1.89, 1.95 per 10,000 person-months for females aged 0 to 17, 18 to 44, 45 to 64, and ≥65 years, respectively. Low-income females (18-44 years) and males (45-64 years) had the highest incidence of MDD, which was 3.90 and 3.04, respectively, per 10,000 person-months. Among low and non-low-income individuals, the MDD incidence rates were higher in the females than males in all age groups. Males aged 45 to 64 and 0 to 17 years had highest hazard ratios (HR) of 2.789 (95% confidence interval [CI], 1.937-4.014) and 2.446 (95% CI, 1.603-3.732), respectively. The highest HRs for females were 2.663 (95% CI, 1.878-3.775) and 2.219 (CI, 1.821-2.705) in the 0 to 17 and 18- to 44-year age groups. Low income was not found to serve as a risk factor for the development of MDD in males and females aged ≥65 years.Among the non-low-income males and females, the incidence rates of MDD were found to increase with age. Low income was found to serve as a significant risk factor for MDD only in individuals under age 65. PMID:27082549
Wermuth, Lene; Cui, Xin; Greene, Naomi; Schernhammer, Eva; Ritz, Beate
Background. The electronic medical records provide new and unprecedented opportunities for large population-based and clinical studies if valid and reliable diagnoses can be obtained, to determine what information is needed to distinguish idiopathic PD from Parkinsonism in electronic medical records. Methods. Chart review of complete medical records of 2,446 patients with a hospital discharge diagnosis of PD, who, between 1996 and 2009, were registered in the Danish National Hospital Register as idiopathic PD. All patients were examined in neurology departments. Clinical features were abstracted from charts to determine Parkinsonian phenotypes and disease course, using predefined criteria for idiopathic PD. Results. Chart review verified that 2,068 (84.5%) patients met criteria for idiopathic PD. The most distinguishing features of idiopathic PD patients were asymmetric onset, and fewer atypical features at onset or follow-up compared to Parkinsonism, and the area under the curve (AUC) for these items alone is moderate (0.74–0.77) and the highest AUC (0.91) was achieved when using all clinical features recorded in addition to PD medication use and a follow-up of 5 years or more. Conclusion. To reduce disease misclassification, information extracted from medical record review with at least 5 years of follow-up after first diagnosis was key to improve diagnostic accuracy. PMID:26770868
Abdenadher, Moufida; Hamza, Asma; Fekih, Wafa; Hannachi, Imen; Zouari Bellaaj, Amel; Bradai, Mohamed Nejmeddine; Aleya, Lotfi
Many blooms of the toxic dinoflagellate Alexandrium minutum have been recorded since 1990 in the Gulf of Gabes (southwestern Mediterranean Sea). To understand the determining factors of bloom formation, we studied the distribution of A. minutum in relation to environmental factors in samples taken at shallow sandy (<1 m) beach stations and a lagoon between 1997 and 2006. This was accompanied by laboratory experiments to identify A. minutum. The species forms harmful algal blooms (HABs) in stations subjected to anthropogenic eutrophication and in confined lagoons, living under conditions of varying salinity which gives it a unique opportunity to broaden its physiological tolerance and increase its colonisation potential. Increases in phosphorus appear to be more important than nitrogen or temperature in the control of A. minutum. The stations sampled all along the coast present specific hydrographic properties (shallowness, turbulence) suggesting that factors other than temperature and nutrients influence Alexandrium distribution, the exception being Boughrara Lagoon where the species developed in accordance with published data. Our findings and their interpretations indicate that the mechanism of the sudden A. minutum blooms along the nearshore of the Gulf of Gabes was complex and differed from that of true coastal ecosystems.
Verma, Rashmi; Utreja, Ashok Kumar; Singh, Satinder Pal; Jena, Ashok Kumar
Objective: The aim of the study was to evaluate the effect of post- treatment critical evaluation on the quality of orthodontic care in a postgraduate orthodontic clinic. Materials and Methods: Orthodontic treatment outcome of 109 consecutively treated cases was evaluated in Phase-I evaluation. Following Phase-I evaluation, PTCE of each case was made mandatory. After 6-years of implementation of compulsory PTCE for each case, orthodontic treatment outcome of all consecutively treated cases (n = 126) was evaluated (Phase-II). The treatment outcome was evaluated by American Board of Orthodontics Model Grading System (ABO MGS) and Subjective evaluation (Visual Analogue Scale, VAS). Results: Based on the ABO scores, the cases were divided into three grades, that is, Grade-I, Grade-II, and Grade-III. The mean total ABO score was improved significantly in Phase-II evaluation (P < 0.01). The total number of cases in ABO Grade-II were increased significantly (P < 0.01) whereas cases in ABO Grade-I remained comparable. The VAS score was improved from 5.66 ± 0.77 at Phase-I to 6.02 ± 0.99 at Phase-II evaluation (P < 0.01). Conclusion: The implementation of PTCE significantly improved the quality of orthodontic care in a postgraduate orthodontic clinic. Clinical Significance: Grading one's own treatment improves the quality of future treatment. PMID:26392728
NEIDERHISER, JENAE M.; MARCEAU, KRISTINE; REISS, DAVID
This study examined genetic and environmental influences on associations among marital conflict about the child, parental monitoring, sibling relationship negativity, and peer delinquency during adolescence and initiation of illegal drug use by young adulthood. The sample comprised data collected longitudinally from same-sex sibling pairs and parents when the siblings were 10–18 years old (M = 14.5 and 12.9 years for Child 1 and Child 2, respectively) and 20–35 years old (M = 26.8 and 25.5 years for Child 1 and Child 2, respectively). Findings indicate four factors that explain the initiation of illegal drug use: two shaped by genetic influences and two shaped by environments shared by siblings. The two genetically shaped factors probably have distinct mechanisms: one a child-initiated coercive process in the family and the other parent and peer processes shaped by the child’s disclosure. The environmentally influenced factors seem distinctively shaped by poor parental monitoring of both sibs and the effects of siblings on each other’s deviancy. PMID:23398758
Issakainen, J; Salonen, J H; Anttila, V-J; Koukila-Kähkölä, P; Castrén, M; Liimatainen, O; Vuento, R; Ojanen, T; Koivula, I; Koskela, M; Meurman, O
Deep, respiratory tract and ear infections due to Microascaceae (Pseudallescheria, Scedosporium, Microascus or Scopulariopsis) were studied nationwide in Finland during 1993-2002. The data were based on 52,000 fungal cultures that represented about 50% of all such specimens in Finland and included all Finnish cases of profound immunosuppression. There were 39 cases that were re-evaluated as clinically significant, i.e., three pneumonias, two deep pedal infections and five wound infections, 11 sinusitis and 18 ear infections. The pedal infections and most pneumonias occurred in immunocompromised patients. Most cases, except the ear infections, were due to Pseudallescheria boydii. Two patients had lethal P. boydii pneumonia and a deep P. boydii infection of the foot contributed to a third lethal case. Two of the patients with lethal outcomes had received an allogeneic haematopoietic stem cell transplantation (AHSCT). Two patients with haematological malignancies were cured of deep site infections by a prolonged course of itraconazole. Wound, sinus and ear infections were cured or improved by local surgery or topical therapy. There were 0.8-1.7 cases of any type of infection per million inhabitants per year (MY) and 3.4 cases/1000 AHSCT. Mortality associated with Microascaceae in any type of patient was 0.06-0.12 MY. PMID:19672782
Li, J.; Li, H. C.; Li, T.; Li, X.; Yuan, N.; Zhang, T.
The debate about how speleothem δ13C to reflect paleoclimate and paleovegetation changes calls for understanding of δ13C behavior in a cave system. We have conducted a monitoring study in Furong Cave, Chongqing, China since 2005 involving multiple sites in the overlying soil and inside the cave. The measured proxies include pCO2 of the atmosphere, soil and cave air; dripping rate, pH, electronic conductivity, Ca2+, HCO3-, d13CDIC of the dripwaters; and deposition rate, d13C of seasonally selected carbonate deposits. The many observations from this study are: (1) Soil pCO2 is close to the atmospheric pCO2 in winter and reaches >10000 ppm during the summer due to high productivity under warm and wet climates. (2) The pCO2 in cave air is slightly higher than Soil pCO2 and atmospheric pCO2 in winter (400~900 ppm), but elevates up to ~2000 ppm around October due to seepage of soil CO2 into the cave. The cave air pCO2 exhibits double peaks following the seasonal rainfall (1st peak in April-June controlled by Indian monsoon and 2nd peak in July-September influenced by the North Western Pacific monsoon). The cave air pCO2 has about 2-3 month lag to the soil pCO2. (3) Under the influence of soil CO2 and rainfall, the d13CDIC of drpiwaters are depleted in the summer and enriched during the winter. During 2009-2011, southwestern China experienced extremely drought due to summer monsoon failure. The d13CDIC of dripwater in Furong Cave was strongly enriched because of low soil CO2 productivity, less transportation of soil CO2 into the cave, and high CO2 ratio from bedrock input. Dripping rate does not affect the d13CDIC significantly. (4) The d13C of speleothems is controlled by the open/closed system of the seepage pathway on the first order. Monitoring site MP1 owns a relatively open system shown by fast dripping rates, low Ca and HCO3- contents, and low carbonate deposition rate. The d13C of modern deposits from this site not only shows the seasonal variation following
Background Self-rated health (SRH) measures with different wording and reference points are often used as equivalent health indicators in public health surveys estimating health outcomes such as healthy life expectancies and mortality for older adults. Whilst the robust relationship between SRH and mortality is well established, it is not known how comparable different SRH items are in their relationship to mortality over time. We used a dynamic evaluation model to investigate the sensitivity of time-varying SRH measures with different reference points to predict mortality in older adults over time. Methods We used seven waves of data from the Australian Longitudinal Study of Ageing (1992 to 2004; N = 1733, 52.6% males). Cox regression analysis was used to evaluate the relationship between three time-varying SRH measures (global, age-comparative and self-comparative reference point) with mortality in older adults (65+ years). Results After accounting for other mortality risk factors, poor global SRH ratings increased mortality risk by 2.83 times compared to excellent ratings. In contrast, the mortality relationship with age-comparative and self-comparative SRH was moderated by age, revealing that these comparative SRH measures did not independently predict mortality for adults over 75 years of age in adjusted models. Conclusions We found that a global measure of SRH not referenced to age or self is the best predictor of mortality, and is the most reliable measure of self-perceived health for longitudinal research and population health estimates of healthy life expectancy in older adults. Findings emphasize that the SRH measures are not equivalent measures of health status. PMID:20403203
Li, Jing; Fan, Jin hu; Zhang, Bin; Yang, Hong jian; Xie, Xiao ming; Tang, Zhong hua; Li, Hui; Li, Jia yuan; Wang, Shu lian; Qiao, You lin; Huang, Rong; Zhang, Pin
Endocrine therapy (ET) is one of the main systemic treatments for patients with breast cancer. To our knowledge, few studies have addressed the performance of ET or relevant influencing factors in cancer treatment in China. By retrospectively analyzing the clinicopathological data on breast cancer collected from representative hospitals of 7 traditional areas in China in one random month from each year between year 1999 and 2008, we found that: 1) The rate of the use of hormone receptor (HR) testing was 83.8% (3529/4211), with the estrogen receptor-positive (ER+) rate and/or the progesterone receptor-positive (PR+) rate being 67.9% (2395/3529), and the ER-PR rate being 32.1% (1134/3529). 2) Of the 1599 patients who had received ET, 999 patients (58.3%) were premenopausal while 600 (41.7%) were postmenopausal; 1598 patients received adjuvant hormonal therapy (AHT), whereas only 1 patient received palliative therapy. The medications mainly administered to patients were anti-estrogen agents (80.3% [1283/1598]), followed by AIs (15.5% [248/1598]). Of the 1598 patients receiving AHT, 1416 patients (88.6%) were positive for ER and/or PR, while 75 (4.7%) were negative for both and 108 patients (6.7%) had unknown HR status. The ratio of the use of endocrine therapy for breast cancer patients with ER+ and/or PR+ status was 60.0% (1416/2395). 3) Results from the logistic regression analysis revealed that geography, occupations, and history of chemotherapy and surgery were dependent factors affecting the application of ET in breast cancer treatment in China (P<0.001). In conclusion, the use of ET on Chinese women with breast cancer is increasingly and gradually accounted into the standardized process. Economic status, occupations, and history of chemotherapy and surgery were key factors affecting the application of ET. People residing in developed areas, engaging in mental labour, having history of chemotherapy and surgery are susceptible to accept ET. PMID:25036532
Fattahi, Shirin; Vosoughhosseini, Sepideh; Moradzadeh Khiavi, Monir; Mahmoudi, Seyed Mostafa; Emamverdizadeh, Parya; Noorazar, Seyed Gholamreza; Yasamineh, Neda; Lotfi, Rana
Background and aims. Head and neck tumors are the most common complaints of people referring to different medical sections, especially in children. The aim of this study was to evaluate the prevalence of these tumors in children less than 12 years of age to provide a better perspective for future studies. Materials and methods. All the files in Department of Pathology at Tabriz Pediatric Hospital from 2001 to 2011 were screened for head and neck tumors in children under 12 years of age. Data including age and gender as well as the type, the location, and benign/malignant characteristic of the tumor were recorded. Data were analyzed by SPSS 15 statistical software, using descriptive statistics and chi-square test. Results. A total of 160 cases were identified. Most of the tumors were benign (68%) and most of the tumors occurred in the neck region (41%). The most frequent benign and malignant tumors were lymphangioma and non-Hodgkin lymphoma, respectively. The majority of benign tumors were found in children younger than 2 years old (P=0.007), but there was no age predilection for malignant tumors. Conclusion. According to our results, benign tumors were more prevalent than malignant ones. Although a low rate of benign tumors in males shows that more attention should be paid to the early diagnosis of head and neck tumors. PMID:26236435
Is there an interaction between socioeconomic status and FRAX 10-year fracture probability determined with and without bone density measures? Data from the Geelong Osteoporosis Study of female cohort.
Brennan, S L; Quirk, S E; Hosking, S M; Kotowicz, M A; Holloway, K L; Moloney, D J; Dobbins, A G; Pasco, J A
FRAX(©) evaluates 10-year fracture probabilities and can be calculated with and without bone mineral density (BMD). Low socioeconomic status (SES) may affect BMD, and is associated with increased fracture risk. Clinical risk factors differ by SES; however, it is unknown whether aninteraction exists between SES and FRAX determined with and without the BMD. From the Geelong Osteoporosis Study, we drew 819 females aged ≥50 years. Clinical data were collected during 1993-1997. SES was determined by cross-referencing residential addresses with Australian Bureau of Statistics census data and categorized in quintiles. BMD was measured by dual energy X-ray absorptiometry at the same time as other clinical data were collected. Ten-year fracture probabilities were calculated using FRAX (Australia). Using multivariable regression analyses, we examined whether interactions existed between SES and 10-year probability for hip and any major osteoporotic fracture (MOF) defined by use of FRAX with and without BMD. We observed a trend for a SES * FRAX(no-BMD) interaction term for 10-year hip fracture probability (p = 0.09); however, not for MOF (p = 0.42). In women without prior fracture (n = 518), we observed a significant SES * FRAX(no-BMD) interaction term for hip fracture (p = 0.03) and MOF (p = 0.04). SES does not appear to have an interaction with 10-year fracture probabilities determined by FRAX with and without BMD in women with previous fracture; however, it does appear to exist for those without previous fracture. PMID:25578145
Edgar, Leslie D.; Johnson, Donald M.; Cox, Casandra
This study sought to assess required information and communication technology (ICT) tasks in selected undergraduate agriculture courses in a land-grant university during a 10-year period. Selected agriculture faculty members in the fall 1999 (n = 63), 2004 (n = 55), and 2009 (n = 64) semesters were surveyed to determine the ICT tasks they required…
Drane, Denise; Micari, Marina; Light, Gregory
Peer-led small-group learning has been used quite extensively in the US to enhance performance and retention of undergraduate students in science, math, and engineering classes. This study presents the results from an evaluation of a peer-led small-group programme at a research university in the US over a 10-year period across five disciplines…
Gretton, Heather M.; Hare, Robert D.; Catchpole, Rosalind E. H.
This study examined the predictive validity of the Hare Psychopathy Checklist: Youth Version (PCL:YV; A. E. Forth, D. S. Kosson, & R. D. Hare, 2003) from adolescence to early adulthood. The authors coded the PCL:YV using file information and collected criminal record information over a 10-year follow-up period on 157 boys, ages 12 through 18,…
Chiang, Chih-Lin; Chen, Pei-Chun; Huang, Ling-Ya; Kuo, Po-Hsiu; Tung, Yu-Chi; Liu, Chen-Chung; Chen, Wei J
Objective To examine the disparities in psychiatric service utilisation over a 10-year period for patients with first admission for psychosis in relation to urban–rural residence following the implementation of universal health coverage in Taiwan. Design Population-based retrospective cohort study. Setting Taiwan's National Health Insurance Research Database, which has a population coverage rate of over 99% and contains all medical claim records of a nationwide cohort of patients with at least one psychiatric admission between 1996 and 2007. Participants 69 690 patients aged 15–59 years with first admission between 1998 and 2007 for any psychotic disorder. Main exposure measure Patients’ urban–rural residence at first admissions. Main outcome measures Absolute and relative inequality indexes of the following quality indicators after discharge from the first admission: all-cause psychiatric readmission at 2 and 4 years, dropout of psychiatric outpatient service at 30 days, and emergency department (ED) treat-and-release encounter at 30 days. Results Between 1998 and 2007, the 4-year readmission rate decreased from 65% to 58%, the 30-day dropout rate decreased from 18% to 15%, and the 30-day ED encounter rate increased from 8% to 10%. Risk of readmission has significantly decreased in rural and urban patients, but at a slower speed for the rural patients (p=0.026). The adjusted HR of readmission in rural versus urban patients has increased from 1.00 (95% CI 0.96 to 1.04) in 1998–2000 to 1.08 (95% CI 1.03 to 1.12) in 2005–2007, indicating a mild widening of the urban–rural gap. Urban–rural differences in 30-day dropout and ED encounter rates have been stationary over time. Conclusions The universal health coverage in Taiwan did not narrow urban–rural inequity of psychiatric service utilisation in patients with psychosis. Therefore, other policy interventions on resource allocation, service delivery and quality of care are needed to improve
In 1988 Bonneville Power Administration (BPA) began work on this Operations, Maintenance, and Replacement 10-Year Plan to develop a levelized program that would assure high system reliability. During the Programs in Perspective (PIP) meetings in the later summer and fall of 1988, many of the concerns to be addressed in an Operations, Maintenance, and Replacement Plan were identified. Following these PIP meetings BPA established internal work groups. During the winter and spring of 1989, these work groups developed technical background and issue papers on topics that ranged from substation maintenance to environmental protection. In addition, a customer forum group was established and met on several occasions to review work on the plan, to offer ideas and points of view, and to assure that BPA understood customer concerns. Based on recommendations from the work group reports and customer input, BPA's O M Management Team developed the draft Operations, Maintenance, and Replacement 10-Year Plan that was released for public comment during the spring of 1990. During the public review period, BPA received a number of written comments from customers and the interested public. In addition, special meetings were held with interested customers. This final Operations, Maintenance, and Replacement 10-year Plan reflects BPA's response to customers and interested public on each topic discussed in the 10-Year Plan. The plan is a distillation of BPA's strategies to achieve a levelized program over 10 years.
United States. Bonneville Power Administration.
In 1988 Bonneville Power Administration (BPA) began work on this Operations, Maintenance, and Replacement 10-Year Plan to develop a levelized program that would assure high system reliability. During the Programs in Perspective (PIP) meetings in the late summer and fall of 1988, many of the concerns to be addressed in an Operations, Maintenance, and Replacement Plan were identified. Following these PIP meetings BPA established internal work groups. During the winter and spring of 1989, these work groups developed technical background and issue papers on topics that ranged from substation maintenance to environmental protection. In addition, a customer forum group was established and met on several occasions to review work on the plan, to offer ideas and points of view, and to assure that BPA understood customer concerns. Based on recommendations from the work group reports and customer input, BPA's O M Management Team developed the draft Operations, Maintenance, and Replacement 10-Year Plan that was released for public comment during the spring of 1990. During the public review period, BPA received a number of written comments from customers and the interested public. In addition, special meetings were held with interested customers. This final Operations, Maintenance, and Replacement 10-Year Plan reflects BPA's response to customers and interested public on each topic discussed in the 10-Year Plan. The plan is a distillation of BPA's strategies to achieve a levelized program over 10 years.
De Keukeleire, Steven; Wybo, Ingrid; Naessens, Anne; Echahidi, Fedoua; Van der Beken, Mieke; Vandoorslaer, Kristof; Vermeulen, Stefan; Piérard, Denis
In order to identify current trends in anaerobic bacteraemia, a 10-year retrospective study was performed in the University Hospital Brussel, Belgium. All clinically relevant bacteraemia detected from 2004 until 2013 were included. Medical records were reviewed in an attempt to define clinical parameters that might be associated with the occurrence of anaerobic bacteraemia. 437 of the isolated organisms causing anaerobic bacteraemia were thawed, subcultured and reanalyzed using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF). There were an average of 33 cases of anaerobic bacteraemia per year during 2004-2008 compared to an average of 27 cases per year during 2009-2013 (P = 0.017), corresponding to a decrease by 19% between the first and the latter period. Also, the total number of cases of anaerobic bacteraemia per 100,000 patient days decreased from 17.3 in the period from 2004 to 2008 to 13.7 in the period 2009 to 2013 (P = 0.023). Additionally, the mean incidence of anaerobic bacteraemia decreased during the study period (1.27/1000 patients in 2004 vs. 0.94/1000 patients in 2013; P = 0.008). In contrast, the proportion of isolated anaerobic bacteraemia compared to the number of all bacteraemia remained stable at 5%. Bacteroides spp. and Parabacteroides spp. accounted for 47.1% of the anaerobes, followed by 14.4% Clostridium spp., 12.6% non-spore-forming Gram-positive rods, 10.5% anaerobic cocci, 8.2% Prevotella spp. and other Gram-negative rods and 7.1% Fusobacterium spp. The lower gastrointestinal tract (47%) and wound infections (10%) were the two most frequent sources for bacteraemia, with the origin remaining unknown in 62 cases (21%). The overall mortality rate was 14%. Further studies focusing on the antimicrobial susceptibility and demographic background of patients are needed to further objectify the currently observed trends. PMID:26923749
Rajpoot, D.; Kaupke, C. J.; Vaziri, N. D.; Rao, T. K.; Pomrantz, A.; Fikrig, S.
The objective of this study was to define the demographic, immunologic, and clinical characteristics of children with acquired immunodeficiency syndrome (AIDS) and AIDS nephropathy, and contrast this with the existing adult data. Data from 62 pediatric patients with AIDS who were treated at SUNY Health Science Center, Brooklyn, New York, between 1983 and 1993 were analyzed. Human immunodeficiency virus (HIV) infection was acquired during the neonatal period by vertical transmission (n = 60) or blood transfusion (n = 2). All children with AIDS who exhibited clinical nephropathy died (n = 16), with mean survival of 55.3 months. In contrast, 32 of 56 AIDS patients (70%) who did not manifest nephropathy were alive at the end of the study period. Patients with nephropathy were noted to have significantly lower CD4+ lymphocyte counts than those without nephropathy. These observations suggest that the predominant renal lesion in pediatric patients who acquired HIV infection during the perinatal period is focal segmental glomerulosclerosis, although a variety of other histological lesions were present. As in adults, the survival in children is dismal following the onset of clinical renal disease. In contrast to the adult population in whom multiple risk factors can potentially contribute to AIDS-associated nephropathy, occurrence of nephropathy in children with vertical HIV transmission provides convincing evidence for the pathogenetic role of HIV infection. PMID:8803430
Kushnareva, Y. E.; Murphy, A. N.
The role of mitochondria in oxidative stress is well recognized, but many questions are still to be answered. This article is intended to update our comprehensive review in 2005 by highlighting the progress in understanding of mitochondrial reactive oxygen species (ROS) metabolism over the past 10 years. We review the recently identified or re-appraised sources of ROS generation in mitochondria, such as p66shc protein, succinate dehydrogenase, and recently discovered properties of the mitochondrial antioxidant system. We also reflect upon some controversies, disputes, and misconceptions that confound the field. PMID:26071769
Baron, Ralf; Ferriero, Donna M; Frisoni, Giovanni B; Bettegowda, Chetan; Gokaslan, Ziya L; Kessler, John A; Vezzani, Annamaria; Waxman, Stephen G; Jarius, Sven; Wildemann, Brigitte; Weller, Michael
Since the launch of our journal as Nature Clinical Practice Neurology in 2005, we have seen remarkable progress in many areas of neurology research, but what does the future hold? Will advances in basic research be translated into effective disease-modifying therapies, and will personalized medicine finally become a reality? For this special Viewpoint article, we invited a panel of Advisory Board members and other journal contributors to outline their research priorities and predictions in neurology for the next 10 years. PMID:26503922
Slatcher, Richard B.; Selcuk, Emre; Ong, Anthony D.
Several decades of research have demonstrated that marital relationships have a powerful influence on physical health. However, surprisingly little is known about how marriage affects health—both in terms of psychological processes and biological ones. We investigated the associations between perceived partner responsiveness—the extent to which people feel understood, cared for and appreciated by their romantic partner—and diurnal cortisol over a 10-year period in a large sample of married and cohabitating couples in the U.S. Partner responsiveness predicted higher wakeup cortisol values and steeper (“healthier”) cortisol slopes at the 10-year follow-up, and these associations remained strong after controlling for demographic factors, depressive symptoms, agreeableness, and other positive and negative relationship factors. Further, declines in negative affect over the 10-year period mediated the prospective association between responsiveness and cortisol slope. These findings suggest that diurnal cortisol may be a key biological pathway through which social relationships impact long-term health. PMID:26015413
Over the past 10 years, the development and convergence of microbial opsin engineering, modular genetic methods for cell-type targeting and optical strategies for guiding light through tissue have enabled versatile optical control of defined cells in living systems, defining modern optogenetics. Despite widespread recognition of the importance of spatiotemporally precise causal control over cellular signaling, for nearly the first half (2005–2009) of this 10-year period, as optogenetics was being created, there were difficulties in implementation, few publications and limited biological findings. In contrast, the ensuing years have witnessed a substantial acceleration in the application domain, with the publication of thousands of discoveries and insights into the function of nervous systems and beyond. This Historical Commentary reflects on the scientific landscape of this decade-long transition. PMID:26308982
Gunawansa, Nalaka; McCall, John L; Holden, Andrew; Plank, Lindsay; Munn, Stephen R
Background Biliary complications following liver transplantation result in major morbidity. We undertook a 10-year audit of the incidence, management and outcomes of post-transplant biliary complications at the New Zealand Liver Transplant Unit. Methods Prospectively collected data on 348 consecutive liver transplants performed between February 1998 and October 2008 were reviewed. The minimum follow-up was 6 months. Results A total of 309 adult and 39 paediatric transplants were performed over the study period. Of these, 296 (85%) were whole liver grafts and 52 (15%) were partial liver grafts (24 split-liver, eight reduced-size and 20 live-donor grafts). There were 80 biliary complications, which included 63 (18%) strictures and 17 (5%) bile leaks. Partial graft, a paediatric recipient and a Roux-en-Y biliary anastomosis were independent predictors of biliary strictures. Twenty-five (40%) strictures were successfully managed non-operatively and 38 (60%) required surgery (31 biliary reconstructions, three segmental resections and four retransplants). Seven (41%) bile leaks required surgical revision and 10 (59%) were managed non-operatively. There was no mortality related directly to biliary complications. Conclusions Biliary complications affected one in five transplant recipients. Paediatric status, partial graft and Roux-en-Y anastomosis were independently associated with the occurrence of biliary strictures. Over half of the affected patients required surgical revision, but no mortality resulted from biliary complications. PMID:21609371
Background The aim of this study was to determine the subsequent risk of acute urine retention and prostate surgery in patients receiving alpha-1 blockers treatment and having a maximum urinary flow rate of less than 15ml/sec. Methods We identified patients who were diagnosed with benign prostate hyperplasia (BPH) and had a maximum uroflow rate of less than 15ml/sec between 1 January, 2002 to 31 December, 2011 from Taiwan’s National Health Insurance Research Database into study group (n = 303). The control cohort included four BPH/LUTS patients without 5ARI used for each study group, randomly selected from the same dataset (n = 1,212). Each patient was monitored to identify those who subsequently developed prostate surgery and acute urine retention. Results Prostate surgery and acute urine retention are detected in 5.9% of control group and 8.3% of study group during 10-year follow up. Compared with the control group, there was increase in the risk of prostate surgery and acute urine retention in the study group (HR = 1.83, 95% CI: 1.16 to 2.91) after adjusting for age, comorbidities, geographic region and socioeconomic status. Conclusions Maximum urine flow rate of less than 15ml/sec is a risk factor of urinary retention and subsequent prostate surgery in BPH patients receiving alpha-1 blocker therapy. This result can provide a reference for clinicians. PMID:27513673
Zmener, Osvaldo; Pameijer, Cornelis H.
Objectives. This retrospective clinical and radiographical study evaluated the 10-year outcome of one-visit endodontic treatment with gutta-percha and a methacrylate resin-based sealer. Methods. From an initial sample size of 180 patients, 89 patients with 175 root canals responded to a recall. Treatment outcome was based on predetermined clinical and radiographic criteria. Results. Root canals had been adequately filled to the working length in 80 teeth (89.88%), short in 6 instances (6.74%), while 3 (3.37%) with extrusion immediate postoperatively, showed no sealer in periradicular tissues. The difference in the outcomes of treatments with respect to age, gender, preoperative pulp or periapical status, the size of periapical lesions and the type of permanent restorations were not statistically significantly different (P > 0.05). Overall, 7 (7.86%) cases were considered clinically and radiographically a failure. A life table analysis showed a cumulative probability of success of 92.13% after 10 years with a 95% confidence interval of 83.0 to 94.0. Conclusions. The results of this retrospective clinical and radiographical study suggest that the tested methacrylate-resin based sealer used with gutta-percha performed similarly to other root canal sealers over a period 10 years. Clinical Implications. Considering the success rate after 10 years of this methacrylate resin-based sealer can be recommended as an alternative to other commonly used root canal sealers. PMID:22654909
Lehmann, Martin; Hasselhorn, Marcus
The present study longitudinally examined changes in recall in children between the ages of 8 and 10 years. Given the increasingly sophisticated use of memory strategies during this developmental period, correspondences between study and recall dynamics were of particular interest. Seventy-six children performed free-recall tasks on 5 occasions…
Abdulwahab-Ahmed, Abdullahi; Ogunleye, Oluwagbemiga Olabisi
Intravesical migration of intrauterine contraceptive device (IUCD) is rare. Early diagnosis of this rare entity is difficult because of its non-specific manifestations and very low index of suspicion. We present this case of bladder stone following intravesical migration of IUCD found to have been missing since insertion 10 years earlier. Lower abdominal discomfort and a missing vaginal string may be the only pointer to this unfortunate event in the immediate post insertion period. It is pertinent to consider the possibility of an intravesical migration of a missing IUCD in a patient presenting with lower abdominal discomfort, urinary frequency, and missing IUCD string on vaginal examination. PMID:24470853
Giugliani, Roberto; Lampe, Christina; Guffon, Nathalie; Ketteridge, David; Teles, Elisa Leão; Wraith, James E.; Jones, Simon A; Piscia-Nichols, Cheri; Lin, Ping; Quartel, Adrian; Harmatz, Paul
Mucopolysaccharidosis VI (MPS VI) is a clinically heterogeneous and progressive disorder with multiorgan manifestations caused by deficient N-acetlylgalactosamine-4-sulfatase activity. A cross-sectional Survey Study in individuals (n=121) affected with MPS VI was conducted between 2001–2002 to establish demographics, urinary glycosaminoglycan (GAG) levels, and clinical progression of disease. We conducted a Resurvey Study (ClinicalTrials.gov: NCT01387854) to obtain 10-year follow-up data, including medical histories and clinical assessments (n=59), and survival status over 12-years (n=117). Patients received a mean (SD) of 6.8 (2.2) years of galsulfase ERT between baseline (Survey Study) and follow-up. ERT patients increased in height by 20.4 cm in the 4–7 year-old baseline age group and by 16.8 cm in the 8–12 year-old baseline age group. ERT patients <13 years old demonstrated improvement in forced vital capacity (FVC) by 68% and forced expiratory volume in 1 second (FEV1) by 55%, and those ≥13 years old increased FVC by 12.8% and maintained FEV1. Patients with >200 µg/mg baseline uGAG levels increased FVC by 48% in the <13 year-old and by 15% in the ≥13 year-old baseline age group. ERT patients who completed the 6-minute walk test demonstrated a mean (SD) increase of 65.7 (100.6) m. Cardiac outcomes did not significantly improve or worsen. Observed mortality rate among naïve patients was 50% (7/14) and 16.5% (17/103) in the ERT group (unadjusted hazard ratio, 0.24; 95% CI, 0.10 to 0.59). Long-term galsulfase ERT was associated with improvements in pulmonary functions and endurance, stabilized cardiac function and increased survival. PMID:24764221
Whyte, D A; Lugton, J; Fawcett, T N
Continuing education is now recognized as essential if nursing is to develop as a profession. United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) consultations are currently seeking to establish appropriate preparation for a 'higher level of practice' in the United Kingdom. The relevance of Masters level education to developing professional roles merits examination. To this end the results of a 10-year follow-up study of graduates from the Masters programme at the University of Edinburgh are reported. The sample was the entire cohorts of nurses who graduated with a Masters degree in the academic sessions from 1986 to 1996. A postal questionnaire was designed consisting of mainly closed questions to facilitate coding and analysis but also including some open questions to allow for more qualitative data to be elicited. The findings indicated clearly that the possession of an MSc degree opened up job opportunities and where promotion was not identified, the process of study at a higher level was still perceived as relevant to the work environment. This applied as much to the context of clinical practice as to that of management, education or research. The perceived enhancement of clinical practice from a generic Masters programme was considered a significant finding. Also emerging from the data was an associated sense of personal satisfaction and achievement that related to the acquisition of academic skills and the ultimate reward of Masters status. The concept of personal growth, however, emerged as a distinct entity from that of satisfaction and achievement, relating specifically to the concept of intellectual sharing, the broadening of perspectives and the development of advanced powers of reasoning. PMID:10840240
Miller, Ashley; Franzen-Castle, Lisa; Aguirre, Trina; Krehbiel, Michelle; Colby, Sarah; Kattelmann, Kendra; Olfert, Melissa D; Mathews, Douglas; White, Adrienne
It is important to understand adult outcomes in childhood obesity prevention programs as parents and caregivers have a significant influence on the eating and physical activity habits of youth. Grounded in the social cognitive theory, the iCook 4-H study was centered on a dyad model (9-10 year-olds and their primary meal preparers) to teach healthy cooking skills, shopping and meal habits, and being active as a family. The program took place in five states and dyads (n = 54) were recruited through flyers, e-mails, and in-person contact. The focus of this article is to provide findings from adult program participants. Demographics and self-reported food intake, procurement, preparation and safety practices, feeding relationships, mealtime routines, and height and weight were collected through surveys at baseline and program completion, which spanned 3 months. Descriptive statistics including two-related samples tests and paired samples t tests were used to assess pre- and post-program survey data responses at p < 0.05 significance level. Most had a bachelor's degree (31%) or some college (29%), about half were white, 66% were married, about 30% of households participated in assistance programs, and 82% were female. At program conclusion, participants significantly improved meal planning, prioritizing healthy meal choices, shopping with a grocery list, and reading Nutrition Facts Labels. There were also significant, positive differences noted in cooking skill confidence (p = 0.015), desire to cook more meals at home, and fewer fast food meals. Adult-youth feeding interactions also significantly improved. There were also significant increases in fruit juice (100%), vegetable soup, and whole grain consumption. Based on results, adults reported improvements in meal planning, cooking, and purchasing skills that were taught in classes. PMID:26970294
... 7 Agriculture 6 2013-01-01 2013-01-01 false 10-year restoration cost-share agreements. 625.9... restoration cost-share agreements. (a) The restoration plan developed under § 625.13 forms the basis for the... agreement will: (1) Incorporate all portions of a restoration plan; (2) Be for a period of 10 years;...
... 7 Agriculture 6 2014-01-01 2014-01-01 false 10-year restoration cost-share agreements. 625.9... restoration cost-share agreements. (a) The restoration plan developed under § 625.13 forms the basis for the... agreement will: (1) Incorporate all portions of a restoration plan; (2) Be for a period of 10 years;...
Sullivan, Kieran T; Pasch, Lauri A; Lawrence, Erika; Bradbury, Thomas N
The purpose of the present study was to test a relational spillover model of physical aggression whereby physical aggression affects marital outcomes due to its effects on how spouses ask for and provide support to one another. Newlywed couples (n = 172) reported levels of physical aggression over the past year and engaged in interactions designed to elicit social support; marital adjustment, and stability were assessed periodically over the first 10 years of marriage. Multilevel modeling revealed that negative support behavior mediated the relationship between physical aggression and 10-year marital adjustment levels whereas positive support behavior mediated the relationship between physical aggression and divorce status. These findings emphasize the need to look beyond conflict when explaining how aggression affects relationships and when working with couples with a history of physical aggression who are seeking to improve their relationships. PMID:26168263
Donin, Angela S.; Nightingale, Claire M.; Owen, Chris G.; Rudnicka, Alicja R.; Perkin, Michael R.; Jebb, Susan A.; Stephen, Alison M.; Sattar, Naveed; Cook, Derek G.; Whincup, Peter H.
Background Regular breakfast consumption may protect against type 2 diabetes risk in adults but little is known about its influence on type 2 diabetes risk markers in children. We investigated the associations between breakfast consumption (frequency and content) and risk markers for type 2 diabetes (particularly insulin resistance and glycaemia) and cardiovascular disease in children. Methods and Findings We conducted a cross-sectional study of 4,116 UK primary school children aged 9–10 years. Participants provided information on breakfast frequency, had measurements of body composition, and gave fasting blood samples for measurements of blood lipids, insulin, glucose, and glycated haemoglobin (HbA1c). A subgroup of 2,004 children also completed a 24-hour dietary recall. Among 4,116 children studied, 3,056 (74%) ate breakfast daily, 450 (11%) most days, 372 (9%) some days, and 238 (6%) not usually. Graded associations between breakfast frequency and risk markers were observed; children who reported not usually having breakfast had higher fasting insulin (percent difference 26.4%, 95% CI 16.6%–37.0%), insulin resistance (percent difference 26.7%, 95% CI 17.0%–37.2%), HbA1c (percent difference 1.2%, 95% CI 0.4%–2.0%), glucose (percent difference 1.0%, 95% CI 0.0%–2.0%), and urate (percent difference 6%, 95% CI 3%–10%) than those who reported having breakfast daily; these differences were little affected by adjustment for adiposity, socioeconomic status, and physical activity levels. When the higher levels of triglyceride, systolic blood pressure, and C-reactive protein for those who usually did not eat breakfast relative to those who ate breakfast daily were adjusted for adiposity, the differences were no longer significant. Children eating a high fibre cereal breakfast had lower insulin resistance than those eating other breakfast types (p for heterogeneity <0.01). Differences in nutrient intakes between breakfast frequency groups did not account for
Penn-Barwell, J G; Bennett, P M; Mortiboy, D E; Fries, C A; Groom, A F G; Sargeant, I D
The aim of this study was to characterise severe open tibial shaft fractures sustained by the UK military personnel over 10 years of combat in Iraq and Afghanistan. The UK military Joint Theatre Trauma Registry was searched for all such injuries, and clinical records were reviewed for all patients. One hundred Gustilo-Anderson III tibia fractures in 89 patients were identified in the 10 year study period; the majority sustained injuries through explosive weapons (63, 68 %) with the remainder being injured from gunshot wounds. Three fractures were not followed up for 12 months and were therefore excluded. Twenty-two (23 %) of the remaining 97 tibial fractures were complicated by infection, with S. aureus being the causative agent in 13/22 infected fractures (59 %). Neither injury severity, mechanism, the use of an external fixator, the need for vascularised tissue transfer nor smoking status was associated with subsequent infection. Bone loss was significantly associated with subsequent infection (p < 0.0001, Fisher's exact test). This study presents 10 years of open tibial fractures sustained in Iraq and Afghanistan. Most infection in combat open tibia fractures is caused by familiar organisms, i.e. S. aureus. While the overall severity of a casualty's injuries was not associated with infection, the degree of bone loss from the fracture was. PMID:26993111
United States. Bonneville Power Administration.
Two years ago, BPA released its first-ever Operations, Maintenance, and Replacement (OM&R) 10-Year Plan. That effort broke new ground and was an extensive look at the condition of Operations, Maintenance, and Replacement on BPA`s power system. This document -- the 1992 OM&R 10-Year Plan -- uses that original plan as its foundation. It takes a look at how well BPA has accomplished the challenging task set out in the 1990 Plan. The 1992 Plan also introduces the Construction Program. Construction`s critical role in these programs is explored, and the pressures of construction workload -- such as the seasonal nature of the work and the broad swings in workload between projects and years -- are discussed. The document then looks at how situations may have changed with issues explored initially in the 1990 Plan. Importantly, this Plan also surfaces and explains some new issues that threaten to impact BPA`s ability to accomplish its OM&R workload. Finally, the document focuses on the revised strategies for Operations, Maintenance, Replacement, Construction, and Environment for the 1992 to 2001 time period, including the financial and human resources needed to accomplish those strategies.
United States. Bonneville Power Administration.
Two years ago, BPA released its first-ever Operations, Maintenance, and Replacement (OM R) 10-Year Plan. That effort broke new ground and was an extensive look at the condition of Operations, Maintenance, and Replacement on BPA's power system. This document -- the 1992 OM R 10-Year Plan -- uses that original plan as its foundation. It takes a look at how well BPA has accomplished the challenging task set out in the 1990 Plan. The 1992 Plan also introduces the Construction Program. Construction's critical role in these programs is explored, and the pressures of construction workload -- such as the seasonal nature of the work and the broad swings in workload between projects and years -- are discussed. The document then looks at how situations may have changed with issues explored initially in the 1990 Plan. Importantly, this Plan also surfaces and explains some new issues that threaten to impact BPA's ability to accomplish its OM R workload. Finally, the document focuses on the revised strategies for Operations, Maintenance, Replacement, Construction, and Environment for the 1992 to 2001 time period, including the financial and human resources needed to accomplish those strategies.
In 2006, Takahashi and Yamanaka reported the breakthrough discovery of induction of pluripotent stem cells from fibroblasts by a combination of defined factors. Ten years later, Cell editor João Monteiro brings together Shinya Yamanaka and Hans Schöler, one the original reviewers of the landmark study, to revisit the history behind the paper and its long-lasting legacy. PMID:27610558
Forsythe, Peter; Paterson, Sue
Ciclosporin is a lipophilic cyclic polypeptide with powerful immunosuppressive and immunomodulatory properties that has been used in veterinary medicine for two decades. It is a calcineurin inhibitor whose principal mode of action is to inhibit T cell activation. The drug is principally absorbed from the small intestine and is metabolised in the intestine and liver by the cytochrome P450 enzyme system. Ciclosporin is known to interact with a wide range of pharmacological agents. Numerous studies have demonstrated good efficacy for the management of canine atopic dermatitis and this has been a licensed indication since 2003. In addition to the treatment of atopic dermatitis, it has been used as an aid in the management of numerous other dermatological conditions in animals including perianal fistulation, sebaceous adenitis, pododermatitis, chronic otitis externa and pemphigus foliaceus. This article reviews the mode of action, pharmacokinetics, indications for use and efficacy of ciclosporin in veterinary dermatology. PMID:24682697