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Sample records for committee current concepts

  1. Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement

    PubMed Central

    Renstrom, P; Ljungqvist, A; Arendt, E; Beynnon, B; Fukubayashi, T; Garrett, W; Georgoulis, T; Hewett, T E; Johnson, R; Krosshaug, T; Mandelbaum, B; Micheli, L; Myklebust, G; Roos, E; Roos, H; Schamasch, P; Shultz, S; Werner, S; Wojtys, E; Engebretsen, L

    2014-01-01

    The incidence of anterior cruciate ligament (ACL) injury remains high in young athletes. Because female athletes have a much higher incidence of ACL injuries in sports such as basketball and team handball than male athletes, the IOC Medical Commission invited a multidisciplinary group of ACL expert clinicians and scientists to (1) review current evidence including data from the new Scandinavian ACL registries; (2) critically evaluate high-quality studies of injury mechanics; (3) consider the key elements of successful prevention programmes; (4) summarise clinical management including surgery and conservative management; and (5) identify areas for further research. Risk factors for female athletes suffering ACL injury include: (1) being in the preovulatory phase of the menstrual cycle compared with the postovulatory phase; (2) having decreased intercondylar notch width on plain radiography; and (3) developing increased knee abduction moment (a valgus intersegmental torque) during impact on landing. Well-designed injury prevention programmes reduce the risk of ACL for athletes, particularly women. These programmes attempt to alter dynamic loading of the tibiofemoral joint through neuromuscular and proprioceptive training. They emphasise proper landing and cutting techniques. This includes landing softly on the forefoot and rolling back to the rearfoot, engaging knee and hip flexion and, where possible, landing on two feet. Players are trained to avoid excessive dynamic valgus of the knee and to focus on the “knee over toe position” when cutting. PMID:18539658

  2. Current Concepts in Conception Control

    PubMed Central

    Ringrose, C. A. Douglas

    1963-01-01

    The progressive increase in world population has become a most urgent global problem in recent years. Man has, however, been interested in controlling his reproductivity at the family level for many centuries. Historical aspects of this saga are reviewed. The modern era of conception control was ushered in by Makepeace et al. in 1937 when ovulation inhibition by progesterone was demonstrated. Confirmation of this by Pincus and associates, and development of the potent oral progestational agents, the 19-norsteroids, have made efficient reliable contraception a reality. Experience with one of these agents (Ortho-Novum, 2 mg.) in 115 patients through 805 cycles is presented. Conception control was 100% effective at this dosage. Side effects were minimal. Only three of the women discontinued the tablets because of these effects. All but five in this group of 115 preferred the oral contraceptives to methods previously employed. PMID:13973987

  3. Current concepts in osteoarthritis

    PubMed Central

    de Rezende, Márcia Uchôa; de Campos, Gustavo Constantino; Pailo, Alexandre Felício

    2013-01-01

    Osteoarthritis (OA), the most common form of joint disease, affects mainly the hips, knees, hands and feet, leading to severe disability and loss of quality of life, particularly in the elderly population. Its importance grows every year with the aging of the population, with a large increase in the elderly population compared to younger patients. The progressive understanding of the pathophysiology of OA, the perception that the process is not purely mechanical and / or aging, and clarification of the inflammatory pathways involved led recently to the clinical application of various drugs and other measures. This update aims to expose the current concepts on the pathophysiology and treatment of OA. PMID:24453655

  4. Football injuries: current concepts.

    PubMed

    Olson, David E; Sikka, Robby Singh; Hamilton, Abigail; Krohn, Austin

    2011-01-01

    Football is one of the most popular sports in the United States and is the leading cause of sports-related injury. A large focus in recent years has been on concussions, sudden cardiac death, and heat illness, all thought to be largely preventable health issues in the young athlete. Injury prevention through better understanding of injury mechanisms, education, proper equipment, and practice techniques and preseason screening may aid in reducing the number of injuries. Proper management of on-field injuries and health emergencies can reduce the morbidity associated with these injuries and may lead to faster return to play and reduced risk of future injury. This article reviews current concepts surrounding frequently seen football-related injuries. PMID:23531977

  5. HIV Disease: Current Concepts.

    ERIC Educational Resources Information Center

    Keeling, Richard P.

    1993-01-01

    Describes human immunodeficiency virus (HIV), newly characterized human retrovirus which causes chronic, progressive, immune deficiency disease, the most severe phase of which is Acquired Immune Deficiency Syndrome (AIDS). Reviews most important current epidemiologic, clinical, and virologic information about HIV and HIV disease and provides…

  6. Bone strength: current concepts.

    PubMed

    Turner, Charles H

    2006-04-01

    Bones serve several mechanical functions, including acoustic amplification in the middle ear, shielding vital organs from trauma, and serving as levers for muscles to contract against. Bone is a multiphase material made up of a tough collagenous matrix intermingled with rigid mineral crystals. The mineral gives bone its stiffness. Without sufficient mineralization, bones will plastically deform under load. Collagen provides toughness to bone making it less brittle so that it better resists fracture. Bone adapts to mechanical stresses largely by changing its size and shape, which are major determinants of its resistance to fracture. Tissue is added in regions of high mechanical stress providing an efficient means for improving bone strength. Experiments have shown that small additions of bone mineral density (BMD) (5-8%) caused by mechanical loading can improve bone strength by over 60% and extend bone fatigue life by 100-fold. Consequently, it is clear that bone tissue possesses a mechanosensing apparatus that directs osteogenesis to where it is most needed for improving bone strength. The biological processes involved in bone mechanotransduction are poorly understood and further investigation of the molecular mechanisms involved might uncover drug targets for osteoporosis. Several pathways are emerging from current research, including membrane ion channels, ATP signaling, second messengers, such as prostaglandins and nitric oxide, insulin-like growth factors, and Wnt signaling. PMID:16831941

  7. Cervical arterial dissection: current concepts .

    PubMed

    Menon, Ranjith K; Norris, John W

    2008-10-01

    The increasing use and safety of noninvasive imaging in recent years has revealed the surprising frequency of dissection of the carotid and vertebral arteries (cervical arterial dissection [CAD]) as a cause of ischemic and hemorrhagic stroke. This review is an overview of current concepts and practice of patients with CAD, but our ideas are constantly evolving with new discoveries from neurovascular imaging and medical and surgical management in this area. PMID:18990128

  8. Current Concept of Geometrical Accuracy

    NASA Astrophysics Data System (ADS)

    Görög, Augustín; Görögová, Ingrid

    2014-06-01

    Within the solving VEGA 1/0615/12 research project "Influence of 5-axis grinding parameters on the shank cutteŕs geometric accuracy", the research team will measure and evaluate geometrical accuracy of the produced parts. They will use the contemporary measurement technology (for example the optical 3D scanners). During the past few years, significant changes have occurred in the field of geometrical accuracy. The objective of this contribution is to analyse the current standards in the field of geometric tolerance. It is necessary to bring an overview of the basic concepts and definitions in the field. It will prevent the use of outdated and invalidated terms and definitions in the field. The knowledge presented in the contribution will provide the new perspective of the measurement that will be evaluated according to the current standards.

  9. Current Concepts of Maternal Nutrition

    PubMed Central

    Lowensohn, Richard I.; Stadler, Diane D.; Naze, Christie

    2016-01-01

    Background A nutrient-rich maternal diet before and during pregnancy is associated with improved fetal health, more appropriate birth weight, and increased rates of maternal and infant survival. Physicians need a better understanding of the role of diet in shaping fetal outcomes. Given this background, we reviewed and summarized articles on maternal nutrition found in MEDLINE since 1981, written in English, and limited to human subjects. For the Offspring Maternal diets high in sugar and fat lead to an increased incidence of metabolic syndrome, diabetes, and cardiovascular disease later in life. Folic acid should be supplemented prior to conception and continued through at least the first 28 days of fetal life to prevent neural tube defects, and vitamin C should be given to women who smoke to lower the incidence of asthma and wheezing in the children. Iodine deficiency is increasing, and iodine should be included in prenatal supplements. If the maternal hemoglobin is 7 g/dL or more, there is no evidence that iron supplementation is needed. Fish intake during pregnancy is protective against atopic outcomes, whereas high-meat diets contribute to elevated adult blood pressure and hypersecretion of cortisol. For the Mother Calcium supplementation lowers the risk of preeclampsia and hypertensive disease in pregnancy. Conclusions Given the limits of our current knowledge, a diet rich in whole grains, fruits, vegetables, and selected fish is desirable for the best outcomes. Diets high in sugar and fat lead to higher rates of diabetes, metabolic syndrome, and cardiovascular disease. Folic acid, iodine, and calcium in all pregnant women and vitamin C in smokers are the only supplements so far shown to be of value for routine use. The physician treating a pregnant woman should be ready to advise a healthy diet for the benefit of the fetus. Target Audience Obstetricians and gynecologists, family physicians Learning Objectives After participating in this activity, the

  10. Current concepts of severe asthma.

    PubMed

    Ray, Anuradha; Raundhal, Mahesh; Oriss, Timothy B; Ray, Prabir; Wenzel, Sally E

    2016-07-01

    The term asthma encompasses a disease spectrum with mild to very severe disease phenotypes whose traditional common characteristic is reversible airflow limitation. Unlike milder disease, severe asthma is poorly controlled by the current standard of care. Ongoing studies using advanced molecular and immunological tools along with improved clinical classification show that severe asthma does not identify a specific patient phenotype, but rather includes patients with constant medical needs, whose pathobiologic and clinical characteristics vary widely. Accordingly, in recent clinical trials, therapies guided by specific patient characteristics have had better outcomes than previous therapies directed to any subject with a diagnosis of severe asthma. However, there are still significant gaps in our understanding of the full scope of this disease that hinder the development of effective treatments for all severe asthmatics. In this Review, we discuss our current state of knowledge regarding severe asthma, highlighting different molecular and immunological pathways that can be targeted for future therapeutic development. PMID:27367183

  11. Anorectal Human Papillomavirus: Current Concepts

    PubMed Central

    Assi, Roland; Reddy, Vikram; Einarsdottir, Hulda; Longo, Walter E.

    2014-01-01

    Increased anorectal human papillomavirus (HPV) infection is related to the recent trends in sexual behavior in both homosexual and heterosexual groups and prevalence of infection with human immunodeficiency virus (HIV). Clinical presentation and natural history depend on the serotype involved. HPV 6 and 11 are found in the benign wart. Local control can be achieved with a wide selection of surgical and topical techniques. HPV 16, 18, and 31 are found in dysplastic lesions and have the potential to progress to invasive anal squamous cell carcinoma. Recognition and early management of dysplastic lesions is crucial to prevent the morbidity and mortality associated with anal cancer. While low-grade lesions can be closely observed, high-grade lesions should be eradicated. Different strategies can be used to eradicate the disease while preserving anorectal function. Studies on the efficacy of vaccination on anorectal HPV showed promising results in select population groups and led to the recent expansion of current vaccination recommendations. PMID:25506286

  12. Chronic Lymphocytic Leukemia: Current Concepts.

    PubMed

    Yu, Eun-Mi; Kittai, Adam; Tabbara, Imad A

    2015-10-01

    Chronic lymphocytic leukemia (CLL) is the most common type of leukemia in adults, and while in early, asymptomatic stages treatment is not indicated, the threat to the quality of life and increased mortality of patients posed by more advanced-stage disease necessitate therapeutic intervention. Guidelines of when and how to treat are not well-established because CLL is a disease of the elderly and it is important to balance preservation of functional status and control of the disease. Advances in molecular and genetic profiling has led to the ability to identify sub-groups of patients with CLL whose disease may respond to selected therapy. This review discusses current standard therapies in the major sub-groups of CLL based on age and functional status, in both the front-line and relapsed/refractory settings. It also provides a concise review of novel agents that have shown considerable efficacy in CLL. PMID:26408673

  13. Myasthenia Gravis—Current Concepts

    PubMed Central

    Herrmann, Christian; Lindstrom, Jon M.; Keesey, John C.; Mulder, Donald G.

    1985-01-01

    An edited summary of an Interdepartmental Conference arranged by the Department of Medicine of the UCLA School of Medicine, Los Angeles. The Director of Conferences is William M. Pardridge, MD, Associate Professor of Medicine. Current findings indicate that autoimmune myasthenia gravis is an acquired immune complex disorder of neuromuscular transmission in voluntary striated muscle. There is a break in immunologic tolerance leading to blocking and degradation of acetylcholine receptors, together with widening of the synaptic cleft associated with partial destruction, simplification and shortening of the postjunctional membrane. Thymic hyperplasia and thymoma may be present. A decremental response to nerve-muscle stimulation, blocking and jitter on single-fiber electromyography and circulating antibodies to acetylcholine receptor are detectable in most patients with generalized weakness. Although the cause of this abnormal immunologic mechanism remains to be discovered, anticholinesterases, corticosteroids, immunosuppressants, plasmapheresis or thymectomy (individually or in combination) provide control and better prognosis in most patients. ImagesFigure 1. PMID:3895751

  14. Burning mouth syndrome: Current concepts.

    PubMed

    Nasri-Heir, Cibele; Zagury, Julyana Gomes; Thomas, Davis; Ananthan, Sowmya

    2015-01-01

    Burning mouth syndrome (BMS) is a chronic pain condition. It has been described by the International Headache Society as "an intra-oral burning or dysesthetic sensation, recurring daily for more than 2 h/day for more than 3 months, without clinically evident causative lesions." BMS is frequently seen in women in the peri-menopausal and menopausal age group in an average female/male ratio of 7:1. The site most commonly affected is the anterior two-thirds of the tongue. The patient may also report taste alterations and oral dryness along with the burning. The etiopathogenesis is complex and is not well-comprehended. The more accepted theories point toward a neuropathic etiology, but the gustatory system has also been implicated in this condition. BMS is frequently mismanaged, partly because it is not well-known among healthcare providers. Diagnosis of BMS is made after other local and systemic causes of burning have been ruled out as then; the oral burning is the disease itself. The management of BMS still remains a challenge. Benzodiazepines have been used in clinical practice as the first-line medication in the pharmacological management of BMS. Nonpharmacological management includes cognitive behavioral therapy and complementary and alternative medicine (CAM). The aim of this review is to familiarize healthcare providers with the diagnosis, pathogenesis, and general characteristics of primary BMS while updating them with the current treatment options to better manage this group of patients. PMID:26929531

  15. Aphasia: Current Concepts in Theory and Practice

    PubMed Central

    Tippett, Donna C.; Niparko, John K.; Hillis, Argye E.

    2014-01-01

    Recent advances in neuroimaging contribute to a new insights regarding brain-behavior relationships and expand understanding of the functional neuroanatomy of language. Modern concepts of the functional neuroanatomy of language invoke rich and complex models of language comprehension and expression, such as dual stream networks. Increasingly, aphasia is seen as a disruption of cognitive processes underlying language. Rehabilitation of aphasia incorporates evidence based and person-centered approaches. Novel techniques, such as methods of delivering cortical brain stimulation to modulate cortical excitability, such as repetitive transcranial magnetic stimulation and transcranial direct current stimulation, are just beginning to be explored. In this review, we discuss the historical context of the foundations of neuroscientific approaches to language. We sample the emergent theoretical models of the neural substrates of language and cognitive processes underlying aphasia that contribute to more refined and nuanced concepts of language. Current concepts of aphasia rehabilitation are reviewed, including the promising role of cortical stimulation as an adjunct to behavioral therapy and changes in therapeutic approaches based on principles of neuroplasticity and evidence-based/person-centered practice to optimize functional outcomes. PMID:24904925

  16. Current projects of the National Wind Coordinating Committee

    SciTech Connect

    Rhoads, H.

    1997-12-31

    This paper summarizes the activities of the National Wind Coordinating Committee (NWCC), a multi-stakeholder collaborative formed in 1994 to support the responsible use of wind power in the USA. The NWCC`s vision is a self-sustaining commercial market for wind power - environmentally, economically, and politically sustainable. Current NWCC activities include: outreach initiatives, disseminating information about wind energy to regulators and legislators through the Wind Energy Issue Paper Series, researching distributed wind energy models, producing a wind facility permitting handbook, improving avian research, addressing transmission and resource assessment issues, and exploring sustainable development and marketing approaches.

  17. [Food allergies in paediatrics: Current concepts].

    PubMed

    Plaza-Martin, Ana María

    2016-07-01

    The concept of allergic reaction currently includes all those where an immunological reaction depends on a reaction mediated by IgE, as well as those that involve other immune mechanisms, such as T-cell regulators. There are many different clinical situations, like the classic immediate reactions (IgE mediated) such as urticaria, angioedema, immediate vomiting, abdominal pain, both upper respiratory (aphonia or rhinitis) and lower (wheezing or dyspnoea) symptom, and cardiovascular symptoms. The reactions that involve more than one organ, such as anaphylaxis, which could be an anaphylactic shock if there is cardiovascular involvement. The clinical signs and symptoms produced by non-IgE mediated reactions are usually more insidious in how they start, such as vomiting hours after the ingestion of food in enterocolitis, diarrhoea after days or weeks from starting food, dermatitis sometime after starting food. In these cases it is more difficult to associate these clinical symptoms directly with food. In this article, we attempt to clarify some concepts such as sensitisation/allergy, allergen/allergenic source, or the relationship of different clinical situations with food allergy, in order to help the paediatrician on the one hand, to prescribe strict diets in case of a suspicion based on the cause/effect relationship with the food, and on the other hand not to introduce unnecessary diets that very often have to last an excessively long time, and could lead to nutritional deficiencies in the children. PMID:26969248

  18. Current concepts in the pathophysiology of glaucoma

    PubMed Central

    Agarwal, Renu; Gupta, Suresh K; Agarwal, Puneet; Saxena, Rohit; Agrawal, Shyam S

    2009-01-01

    Glaucoma, the second leading cause of blindness, is characterized by changes in the optic disc and visual field defects. The elevated intraocular pressure was considered the prime factor responsible for the glaucomatous optic neuropathy involving death of retinal ganglion cells and their axons. Extensive investigations into the pathophysiology of glaucoma now reveal the role of multiple factors in the development of retinal ganglion cell death. A better understanding of the pathophysiological mechanisms involved in the onset and progression of glaucomatous optic neuropathy is crucial in the development of better therapeutic options. This review is an effort to summarize the current concepts in the pathophysiology of glaucoma so that newer therapeutic targets can be recognized. The literature available in the National Medical Library and online Pubmed search engine was used for literature review. PMID:19574692

  19. Psoriasis pathophysiology: current concepts of pathogenesis

    PubMed Central

    Krueger, J; Bowcock, A

    2005-01-01

    Psoriasis vulgaris is a common skin disorder characterised by focal formation of inflamed, raised plaques that constantly shed scales derived from excessive growth of skin epithelial cells. The disease is defined by a series of linked cellular changes in the skin: hyperplasia of epidermal keratinocytes, vascular hyperplasia and ectasia, and infiltration of T lymphocytes, neutrophils, and other types of leucocyte in affected skin. In a relatively short period, psoriasis vulgaris has been conceptualised as a T lymphocyte mediated autoimmune disease and new biological therapies that target T cells have just entered routine clinical practice. Similarly, rapid progress has been made towards dissecting cellular and molecular pathways of inflammation that contribute to disease pathogenesis. This short review presents current pathogenic concepts that have emerged from genetic, genomic, and cellular information obtained in basic studies and from clinical studies of selective immune targeting drugs. PMID:15708932

  20. Current Biomechanical Concepts for Rotator Cuff Repair

    PubMed Central

    2013-01-01

    For the past few decades, the repair of rotator cuff tears has evolved significantly with advances in arthroscopy techniques, suture anchors and instrumentation. From the biomechanical perspective, the focus in arthroscopic repair has been on increasing fixation strength and restoration of the footprint contact characteristics to provide early rehabilitation and improve healing. To accomplish these objectives, various repair strategies and construct configurations have been developed for rotator cuff repair with the understanding that many factors contribute to the structural integrity of the repaired construct. These include repaired rotator cuff tendon-footprint motion, increased tendon-footprint contact area and pressure, and tissue quality of tendon and bone. In addition, the healing response may be compromised by intrinsic factors such as decreased vascularity, hypoxia, and fibrocartilaginous changes or aforementioned extrinsic compression factors. Furthermore, it is well documented that torn rotator cuff muscles have a tendency to atrophy and become subject to fatty infiltration which may affect the longevity of the repair. Despite all the aforementioned factors, initial fixation strength is an essential consideration in optimizing rotator cuff repair. Therefore, numerous biomechanical studies have focused on elucidating the strongest devices, knots, and repair configurations to improve contact characteristics for rotator cuff repair. In this review, the biomechanical concepts behind current rotator cuff repair techniques will be reviewed and discussed. PMID:23730471

  1. Safety pharmacology — Current and emerging concepts

    SciTech Connect

    Hamdam, Junnat; Sethu, Swaminathan; Smith, Trevor; Alfirevic, Ana; Alhaidari, Mohammad; Atkinson, Jeffrey; Ayala, Mimieveshiofuo; Box, Helen; Cross, Michael; Delaunois, Annie; Dermody, Ailsa; Govindappa, Karthik; Guillon, Jean-Michel; Jenkins, Rosalind; Kenna, Gerry; Lemmer, Björn; Meecham, Ken; Olayanju, Adedamola; Pestel, Sabine; Rothfuss, Andreas; and others

    2013-12-01

    Safety pharmacology (SP) is an essential part of the drug development process that aims to identify and predict adverse effects prior to clinical trials. SP studies are described in the International Conference on Harmonisation (ICH) S7A and S7B guidelines. The core battery and supplemental SP studies evaluate effects of a new chemical entity (NCE) at both anticipated therapeutic and supra-therapeutic exposures on major organ systems, including cardiovascular, central nervous, respiratory, renal and gastrointestinal. This review outlines the current practices and emerging concepts in SP studies including frontloading, parallel assessment of core battery studies, use of non-standard species, biomarkers, and combining toxicology and SP assessments. Integration of the newer approaches to routine SP studies may significantly enhance the scope of SP by refining and providing mechanistic insight to potential adverse effects associated with test compounds. - Highlights: • SP — mandatory non-clinical risk assessments performed during drug development. • SP organ system studies ensure the safety of clinical participants in FiH trials. • Frontloading in SP facilitates lead candidate drug selection. • Emerging trends: integrating SP-Toxicological endpoints; combined core battery tests.

  2. Current therapeutic concepts in peripartum cardiomyopathy.

    PubMed

    Krejci, Jan; Poloczkova, Hana; Nemec, Petr

    2015-01-01

    Peripartum cardiomyopathy (PPCM) is a relatively rare disease characterized by systolic heart failure occuring towards the end of pregnancy or during the months following birth. It is most often seen in women of African descent, and its incidence seems to be slightly increasing in recent years. Other etiologies of heart failure should be excluded to determine the diagnosis of PPCM. The clinical picture corresponds to systolic heart failure. The rapid onset of the symptoms in relation to pregnancy is striking. The essential diagnostic procedures such as echocardiography, cardiac magnetic resonance imaging and endomyocardial biopsy may be beneficial in certain situations. The etiology of the disease remains unclear. Speculated causes include myocarditis, autoimmune disorders, cardiotropic virus infection, and abnormal responses to hemodynamic and hormonal changes during pregnancy. Particular attention is currently given to the concept of increased oxidative stress inducing production of proapoptotic, angiostatic and proinflammatory mediators. Recovery of left ventricular systolic function occurs in about half of the cases. Mortality has been decreasing in recent years, especially in the United States, but is still between 10-15% in less developed countries where therapeutic possibilities are limited. In addition to standard heart failure therapy, specific treatments (pentoxyfilline, bromocriptine, immunomodulatory therapy) have been tested. Mechanical circulatory support is sometimes needed. Heart transplantation is the therapeutic option for the most severe heart failure and is used in about 10% of the cases. Recurrence in subsequent pregnancy is common and therefore, another pregnancy is not recommended in many cases. PMID:25483952

  3. Migraine: current concepts and emerging therapies.

    PubMed

    Arulmozhi, D K; Veeranjaneyulu, A; Bodhankar, S L

    2005-09-01

    Migraine is a recurrent incapacitating neurovascular disorder characterized by attacks of debilitating pain associated with photophobia, phonophobia, nausea and vomiting. Migraine affects a substantial fraction of world population and is a major cause of disability in the work place. Though the pathophysiology of migraine is still unclear three major theories proposed with regard to the mechanisms of migraine are vascular (due to cerebral vasodilatation), neurological (abnormal neurological firing which causes the spreading depression and migraine) and neurogenic dural inflammation (release of inflammatory neuropeptides). The modern understanding of the pathogenesis of migraine is based on the concept that it is a neurovascular disorder. The drugs used in the treatment of migraine either abolish the acute migraine headache or aim its prevention. The last decade has witnessed the advent of Sumatriptan and the 'triptan' class of 5-HT1B/1D receptor agonists which have well established efficacy in treating migraine. Currently prophylactic treatments for migraine include calcium channel blockers, 5-HT2 receptor antagonists, beta adrenoceptor blockers and gamma-amino butyric acid (GABA) agonists. Unfortunately, many of these treatments are non specific and not always effective. Despite such progress, in view of the complexity of the etiology of migraine, it still remains undiagnosed and available therapies are underused. In this article, the diverse pieces of evidence that have linked the different theories of migraine with its pathophysiology are reviewed. Furthermore, the present therapeutic targets and futuristic approaches for the acute and prophylactic treatment of migraine, with a special emphasis to calcitonin gene-related peptide, are critically evaluated. PMID:16099727

  4. Brain damage in alcoholism: current concepts.

    PubMed

    Lishman, W A; Jacobson, R R; Acker, C

    1987-01-01

    Current views concerning the brain damage occasioned by alcohol abuse are reviewed. Diffuse cerebral changes appear to be common and partially reversible with prolonged abstinence. The possible determinants of such changes, and their relevance to functional deficits are discussed, with illustrations from work currently proceeding at the Institute of Psychiatry. Possible interactions between cortical and subcortical pathologies in contributing to the cognitive deficits shown by alcoholic patients are emphasised. PMID:3478970

  5. Current concepts in premature ovarian insufficiency.

    PubMed

    Maclaran, Kate; Panay, Nick

    2015-03-01

    Premature ovarian insufficiency (POI) is a life-changing diagnosis, with profound physical and psychological consequences. Unfortunately, there are many deficiencies in our understanding of the condition as the underlying etiology and optimum management strategies are poorly understood. Improved awareness of POI and its long-term implications has led to increased research interest in recent years. Current research has allowed a greater understanding of the changing epidemiology in POI, genetic factors in its etiology and randomized controlled trials of hormone therapy are underway to provide evidence for treatment. This article reviews the latest literature on POI to summarize current understanding and future directions. PMID:25776291

  6. Current Concepts and Future Directions of CELSS

    NASA Technical Reports Server (NTRS)

    Macelroy, R. D.; Bredt, J.

    1985-01-01

    Bioregenerative life support systems for use in space were studied. Concepts of such systems include the use of higher plants and/or microalgae as sources of food, potable water and oxygen, and as sinks for carbon dioxide and metabolic wastes. Recycling of materials within the system will require processing of food organism and crew wastes using microbiological and/or physical chemical techniques. The dynamics of material flow within the system will require monitoring, control, stabilization and maintenance imposed by computers. Studies included higher plant and algal physiology, environmental responses, and control; flight experiments for testing responses of organisms to weightlessness and increased radiation levels; and development of ground based facilities for the study of recycling within a bioregenerative life support system.

  7. Current Concepts in Dermatology: Part I

    PubMed Central

    Jackson, Robert

    1963-01-01

    Some of the more recent advances and newer concepts about certain dermatological conditions are presented. Untoward reactions to drugs, whether to systemic or topical agents, are discussed in detail; emphasis is placed on their frequency and on the diversity of clinical findings. In the management of certain skin tumours (hemangiomas and melanocytic nevi) it is essential that the natural history of the lesion be considered. It is generally agreed that the answer to the problem of staphylococcal infection of the skin will be found in the host rather than the staphylococcus. Keratoacanthoma is a pseudocarcinoma of unknown etiology and sometimes gives rise to considerable difficulty in diagnosis. Diffuse alopecia in women is now a common dermatological problem, the cause of which is unknown. The hair loss associated with it is not permanent. ImagesFig. 1 PMID:13964259

  8. Anticoagulation in Atrial Fibrillation – Current Concepts

    PubMed Central

    Katritsis, Demosthenes G; Gersh, Bernard J; Camm, A John

    2015-01-01

    This article presents the current status of the use of anticoagulation for the treatment of AF, particularly with the use of non-vitamin K-dependent anticoagulants. Comparisons between these agents and warfarin are made and methods for assessment of anticoagulant activity and reversal are discussed. PMID:26835109

  9. Current Concepts in Anaesthesia for Shoulder Surgery

    PubMed Central

    Sulaiman, Lutfi; MacFarlane, Robert J; Waseem, Mohammad

    2013-01-01

    There has been an exponential growth in the volume of shoulder surgery in the last 2 decades and a very wide variety of anaesthetic techniques have emerged to provide anaesthesia and post-operative analgesia. In this article we examine current opinion, risks, benefits and practicalities of anaesthetic practice and the provision of post-operative analgesia for shoulder surgery. PMID:24082970

  10. Historical origins of current concepts of carcinogenesis.

    PubMed

    Lawley, P D

    1994-01-01

    The first attempts to understand the causes of cancer were based on generalizations of what might now be termed a "holistic" nature, and hereditary influences were recognized at an early stage; these views survive principally through a supposed positive connection between psychological factors such as stress and diminished ability to combat the progressive development of tumors through some form of immunologically mediated rejection of potentially cancerous cells. While evidence for immunosurveillance is generally accepted, it is now widely regarded as almost wholly confined to instances where tumor viruses are involved as causative agents. The earliest theorists drew an analogy between the processes of carcinogenesis and of evolution; the cancer cells acquired the ability to outstrip their normal counterparts in their capacity for proliferation. This was even before evolution had been interpreted as involving a continuous succession of mutations. Evidence was already to hand before the end of the 18th century that exogenous agents, notably soot, a product of the "industrial revolution," could cause skin cancer. Somewhat over 100 years later, another industrial innovation, the manufacture of synthetic dyestuffs, implicated specific chemical compounds that could act systemically to cause bladder cancer. Meanwhile, the 19th century saw the establishment of the fundamentals of modern medical science; of particular relevance to cancer was the demonstration that it involved abnormalities in the process of cell division. The commencement of the 20th century was marked by a rediscovery of the concept of mutation; and it was proposed that cancer originated through uncontrolled division of somatically mutated cells. At around this time, two further important exogenous causative agents were discovered: X-rays and tumor viruses. In the late 1920s, x-radiation became the first established exogenous cause of mutagenesis. The discoverer of this phenomenon, H. J. Muller

  11. Current concepts in negative pressure wound therapy.

    PubMed

    Howe, Lisa M

    2015-05-01

    Negative pressure wound therapy (NPWT) is becoming recognized in veterinary medicine as a viable option for the management of complex wounds. NPWT has many advantages over traditional wound care and results in quicker and improved wound healing in many instances. This article discusses the art and science of NPWT, as well as the many current indications, complications, advantages and disadvantages, and future directions of NPWT in small animal veterinary medicine. This therapy will likely have a growing role in veterinary medical practice for complicated wound management and other usages in coming years. PMID:25744142

  12. Concussion: current concepts in diagnosis and management.

    PubMed

    Borich, Michael R; Cheung, Katharine L; Jones, Paul; Khramova, Vera; Gavrailoff, Lauren; Boyd, Lara A; Virji-Babul, Naznin

    2013-09-01

    Current understanding of the term "concussion" is fraught with misconceptions regarding the extent and nature of brain injury. Despite increasing attention in popular media and within the context of sports, considerable gaps exist in our knowledge of the diagnosis, underlying brain pathology, recovery of function, and optimal interventions for concussion. In this special interest article, we discuss the definition and risk factors associated with concussion, summarize and highlight some of the most widely used assessment tools, and critique the evidence for current principles of concussion management. Our evaluation has identified opportunities for novel neuroimaging techniques to improve the understanding of the pathophysiology of concussion and to evaluate the changes in the recovering brain in response to rehabilitation. In summary, a clear definition of the underlying brain pathology, the potential long-term consequences, and the risk factors of injury and recovery will help guide future research aiming to minimize the impact of injury and develop innovative and successful therapeutic approaches aimed at ameliorating the functional impairments associated with concussion. PMID:23872682

  13. Current concepts on airborne particles and health

    SciTech Connect

    Mauderly, J.L.

    1994-11-01

    Epidemiological evidence of associations between environmental particulate concentrations and both acute and chronic health effects has grown with numerous recent studies conducted in the US and other countries. An association between short-term changes in particulate levels and acute mortality now seems certain. The association is consistent among studies and coherent among indicators of mortality and morbidity. Effects observed at surprisingly low pollution levels have raised concern for current exposures even in modestly polluted cities. Toxicology did not predict the acute mortality effect, and causal mechanisms are difficult to rationalize. Present data suggest that the fine fraction of particulate pollution is more toxic than larger particles, but the contribution of specific particulate species is poorly understood.

  14. Medial thighplasty: Current concepts and practices.

    PubMed

    Bertheuil, N; Carloni, R; De Runz, A; Herlin, C; Girard, P; Watier, E; Chaput, B

    2016-02-01

    Medial thighplasty, also known as medial thigh lift, is a procedure that has been carried out for five decades. The original "Lewis" technique has undergone many changes, and thereby been rendered widely available to plastic surgeons. Given the increasingly high number of surgical reconstructions after massive weight loss, this technique is now an integral part of a surgeon's therapeutic arsenal as he strives to meet the evolving demands of patients. The objective of this article, which is based on a comprehensive review of the literature, is to summarize current knowledge on medial thighplasty and thereby allow plastic surgeons to adopt the operating technique best suited to the deformations presented by their patients and to the overall context. The different techniques, outcomes and complications are successively discussed. PMID:26433317

  15. Subtalar joint instability: current clinical concepts.

    PubMed

    Budny, Adam

    2004-07-01

    There has been extensive research and investigation into the subtalar joint (STJ), yet the biomechanics that relate to its anatomic function, especially instability after injury, are surrounded by controversy. With a mechanism of injury closely related to the classic inversion ankle sprain, chronic instability can result following trauma to the lateral ligamentous support network of either joint. Over the past decades there have been countless examples in the literature challenging the current standard of evaluation and treatment of the "subtalar sprain." New technologies have offered varied approaches to diagnostic capability, each with its own strengths and weaknesses, ranging from standard radiographs to CT and MRI. A review of the literature should aid in deciphering the controversy surrounding this aspect of podiatric medicine. PMID:15246150

  16. Current concepts of ocular adnexal surgery

    PubMed Central

    Borrelli, Maria; Geerling, Gerd

    2013-01-01

    Ophthalmic Plastic and Reconstructive Surgery is a specialized area of ophthalmology that deals with the management of deformities and abnormalities of the eyelids, lacrimal system and the orbit. An ophthalmoplastic surgeon is able to identify and correct abnormalities of the ocular adnexae such as ectropion, lid retraction, conjunctival scarring with severe entropion, that can cause secondary ocular surface disorders; manage patients with watering eye, and when needed intervene with a dacryocystorhinostomy by external or endonasal approach and moreover minimize disfigurement following enucleation or evisceration and prevent further corneal damage, alleviate complains of tearing and grittiness, but also cosmetic complaints in patients with Graves’ orbitopathy. Aim of this manuscript was to review current established and recently evolving surgical procedures. PMID:26504698

  17. Current concepts in the management of gonorrhoea.

    PubMed

    Tapsall, John

    2002-02-01

    The incidence of gonorrhoea is again rising in developed countries and a high disease rate has been maintained in less developed regions for a number of years. The need not only for treatment of the individual but also for control of gonorrhoea at a community level has increased significantly following recognition of its role in the amplification of human immunodeficiency virus (HIV) transmission. A sustainable decrease in the incidence of gonorrhoea and other sexually transmitted diseases (STDs) requires an integrated approach combining improved prevention, better diagnosis and optimal treatment. Effective antibiotic treatment is an essential element of this approach. However, antibiotic treatment of gonorrhoea has been severely hampered by the development of antibiotic resistance in Neisseria gonorrhoeae, to the extent that many therapies are no longer effective. Those treatments that retain acceptable efficacy are often unaffordable where they are most needed. Penicillins and tetracyclines should no longer be used in gonococcal disease, there are limitations on the effectiveness of newer macrolides and spectinomycin and in many parts of the world quinolones have been withdrawn from schedules for the treatment of gonorrhoea. Of all the current agents used to treat all forms of gonococcal disease, only the third generation cephalosporins (most notably ceftriaxone) have retained their efficacy; however, decreased susceptibility to these antibiotics has also appeared. Continuing reliance on antibiotic treatment for controlling gonorrhoea in the absence of other necessary approaches will see a further deterioration in the situation. In these circumstances the possibility that gonorrhoea will be untreatable becomes more real. PMID:11829728

  18. Current concepts in total femoral replacement

    PubMed Central

    Ramanathan, Deepak; Siqueira, Marcelo BP; Klika, Alison K; Higuera, Carlos A; Barsoum, Wael K; Joyce, Michael J

    2015-01-01

    Total femoral replacement (TFR) is a salvage arthroplasty procedure used as an alternative to lower limb amputation. Since its initial description in the mid-20th century, this procedure has been used in a variety of oncologic and non-oncologic indications. The most compelling advantage of TFR is the achievement of immediate fixation which permits early mobilization. It is anticipated that TFR will be increasingly performed as the rate of revision arthroplasty rises worldwide. The existing literature is mainly composed of a rather heterogeneous mix of retrospective case series and a wide assortment of case reports. Numerous TFR prostheses are currently available and the surgeon must understand the unique implications of each implant design. Long-term functional outcomes are dependent on adherence to proper technique and an appropriate physical therapy program for postoperative rehabilitation. Revision TFR is mainly performed for periprosthetic infection and the severe femoral bone loss associated with aseptic revisions. Depending on the likelihood of attaining infection clearance, it may sometimes be advisable to proceed directly to hip disarticulation without attempting salvage of the TFR. Other reported complications of TFR include hip joint instability, limb length discrepancy, device failure, component loosening, patellar maltracking and delayed wound healing. Further research is needed to better characterize the long-term functional outcomes and complications associated with this complex procedure. PMID:26716087

  19. Current Concepts in Adult Acute Rhinosinusitis.

    PubMed

    Aring, Ann M; Chan, Miriam M

    2016-07-15

    Acute rhinosinusitis is one of the most common conditions that physicians treat in ambulatory care. Most cases of acute rhinosinusitis are caused by viral upper respiratory infections. A meta-analysis based on individual patient data found that common clinical signs and symptoms were not effective for identifying patients with rhinosinusitis who would benefit from antibiotics. C-reactive protein and erythrocyte sedimentation rate are somewhat useful tests for confirming acute bacterial maxillary sinusitis. Four signs and symptoms that significantly increase the likelihood of a bacterial cause when present are double sickening, purulent rhinorrhea, erythrocyte sedimentation rate greater than 10 mm per hour, and purulent secretion in the nasal cavity. Although cutoffs vary depending on the guideline, antibiotic therapy should be considered when rhinosinusitis symptoms fail to improve within seven to 10 days or if they worsen at any time. First-line antibiotics include amoxicillin with or without clavulanate. Current guidelines support watchful waiting within the first seven to 10 days after upper respiratory symptoms first appear. Evidence on the use of analgesics, intranasal corticosteroids, and saline nasal irrigation for the treatment of acute rhinosinusitis is poor. Nonetheless, these therapies may be used to treat symptoms within the first 10 days of upper respiratory infection. Radiography is not recommended in the evaluation of uncomplicated acute rhinosinusitis. For patients who do not respond to treatment, computed tomography of the sinuses without contrast media is helpful to evaluate for possible complications or anatomic abnormalities. Referral to an otolaryngologist is indicated when symptoms persist after maximal medical therapy and if any rare complications are suspected. PMID:27419326

  20. Tinnitus--Current Concepts in Diagnosis and Management.

    ERIC Educational Resources Information Center

    Epstein, Stephen

    1997-01-01

    This article discusses the causes of tinnitus, sound or noise in the ears or head without any external stimulation. Classification of tinnitus, the essentials of medical evaluation of a patient with tinnitus, essential test procedures, and current concepts in the management of tinnitus are addressed. (CR)

  1. Current concepts in wound management and wound healing products.

    PubMed

    Davidson, Jacqueline R

    2015-05-01

    Current concepts in wound management are summarized. The emphasis is on selection of the contact layer of the bandage to promote a moist wound environment. Selection of an appropriate contact layer is based on the stage of wound healing and the amount of wound exudate. The contact layer can be used to promote autolytic debridement and enhance wound healing. PMID:25744144

  2. Current concepts in Alzheimer's Disease: molecules, models and translational perspectives.

    PubMed

    Rutten, Bart P F; Steinbusch, Harry W M

    2013-01-01

    The field of neuroscience research in AD has been evolving rapidly over the last few years, and has pinpointed a number of candidate targets for molecules with crucial role in the pathophysiology of AD. Recent developments have furthermore enabled new ways of modeling the disease, while an increasing number of preclinically validated targets is currently being taken one step forward and tested in clinical trials. These recent developments are reviewed in the current Special Issues Series on "Current concepts in Alzheimer's disease research: molecules, models and translational perspectives" in a number of state-of-the-art manuscripts. PMID:24148188

  3. Syringomyelia: current concepts in pathogenesis, diagnosis, and treatment.

    PubMed

    Rusbridge, Clare; Greitz, Dan; Iskandar, Bermans J

    2006-01-01

    Syringomyelia is a condition that results in fluid-containing cavities within the parenchyma of the spinal cord as a consequence of altered cerebrospinal fluid dynamics. This review discusses the history and the classification of the disorder, the current theories of pathogenesis, and the advanced imaging modalities used in the diagnosis. The intramedullary pulse pressure theory (a new pathophysiologic concept of syringomyelia) also is presented. In addition, the current understanding of the painful nature of this condition is discussed and the current trends in medical and surgical management are reviewed. PMID:16734077

  4. New current control concept -- Minimum time current control in the three-phase PWM converter

    SciTech Connect

    Choi, J.W.; Sul, S.K.

    1997-01-01

    In this paper, a new current controller that guarantees the fastest transient response is proposed. The basic concept is to find the optimal control voltage for tracking the reference current with minimum time under the voltage limit constraint. Though this minimum time control concept is also applicable to all the machine drive systems, this paper focuses on the current regulation in the three-phase pulse width modulation (PWM) converter. In the simulation and experimental results, it is observed that the proposed controller has much less transient time than the conventional synchronous PI regulator and the performance of the dc link voltage control is also greatly improved with the proposed current controller.

  5. Thirty Meter Telescope: current operations concepts and plans

    NASA Astrophysics Data System (ADS)

    Silva, David R.

    2008-07-01

    The Thirty Meter Telescope (TMT) will be a ground-based, 30-m optical-IR telescope with a highly segmented primary mirror located in a remote location. From the start of operations, TMT will provide a rich and diverse mix of seeing-limited and diffraction-limited instrumentation. Initially, only classical observing will be supported, although remote observing will follow almost immediately. Queue (or service) observing may be supported at a later date. TMT users will expect high facility uptime and observing efficiency as well as effective user support for planning and execution of observations. Those expectations are captured in the high-level Operations Concept Definition (OCD) document. The services and staffing needed to implement those concepts are described in the TMT Operations Plan. In this paper, high-level TMT operational concepts are summarized followed by a description of the current operations plan, including staffing model.

  6. Tropical and travel-associated norovirus: current concepts

    PubMed Central

    Ballard, Sarah-Blythe; Saito, Mayuko; Mirelman, Andrew J.; Bern, Caryn; Gilman, Robert H.

    2015-01-01

    Purpose of review We highlight recent advances relevant to understanding norovirus infections in the tropics, both in populations living in developing settings and travelers to these regions. Recent findings Because of the decrease in diarrheal disease associated with the global rollout of vaccines against rotavirus, norovirus is emerging as the predominant cause of diarrhea morbidity among children in the tropics, and evidence suggests that it contributes to adult disease in endemic populations and travelers. In addition to identifying potential target populations for preventive measures, we provide an update on norovirus vaccine development and concepts related to their implementation in low-income and middle-income countries. Summary These current concepts related to norovirus-attributable disease burden, clinical significance, and economic impact can potentially be applied to tailoring efforts to prevent and mitigate the effects of this important enteropathogen. PMID:26237546

  7. Distal humerus fractures: a review of current therapy concepts.

    PubMed

    Amir, Steinitz; Jannis, Sailer; Daniel, Rikli

    2016-06-01

    Fractures of the distal humerus in the adult comprise approximately one third of all humeral fractures. Successful management of distal humerus fractures depends on correct reduction of the fracture, reconstruction of the articular surface if needed, stability and rigidity of the fixation, and appropriate rehabilitation. In this review, we evaluated the available literature and highlighted current therapy concepts. We assessed the evolution of internal fixation and elbow arthroplasty focusing on the established surgical approaches against the background of a growing incidence of distal humeral fractures in an aging patient population. Therefore evaluating the aspect and influence of age-dependent comorbidities like osteoporosis on successful treatment. PMID:27039395

  8. Current concepts in the management of radial head fractures

    PubMed Central

    Kodde, Izaäk F; Kaas, Laurens; Flipsen, Mark; van den Bekerom, Michel PJ; Eygendaal, Denise

    2015-01-01

    Fracture of the radial head is a common injury. Over the last decades, the radial head is increasingly recognized as an important stabilizer of the elbow. In order to maintain stability of the injured elbow, goals of treatment of radial head fractures have become more and more towards restoring function and stability of the elbow. As treatment strategies have changed over the years, with an increasing amount of literature on this subject, the purpose of this article was to provide an overview of current concepts of the management of radial head fractures. PMID:26716091

  9. Electrical stimulation therapies for spinal fusions: current concepts

    PubMed Central

    Glazer, Paul A.

    2006-01-01

    Electrical stimulation therapies have been used for more than 30 years to enhance spinal fusions. Although their positive effects on spinal fusions have been widely reported, the mechanisms of action of the technologies were only recently identified. Three types of technologies are available clinically: direct current, capacitive coupling, and inductive coupling. The latter is the basis of pulsed electromagnetic fields and combined magnetic fields. This review summarizes the current concepts on the mechanisms of action, animal and clinical studies, and cost justification for the use of electrical stimulation for spinal fusions. Scientific studies support the validity of electrical stimulation treatments. The mechanisms of action of each of the three electrical stimulation therapies are different. New data demonstrates that the upregulation of several growth factors may be responsible for the clinical success seen with the use of such technologies. PMID:16604354

  10. Committees

    NASA Astrophysics Data System (ADS)

    Williams, Gwyn P.; Revesz, Peter; Arp, Uwe

    2014-03-01

    Conference Chairs NameOrganization Gwyn Williams Jefferson Lab Peter ReveszCornell High Energy Synchrotron Source Uwe ArpSynchrotron Ultraviolet Radiation Facility Programme Committee NameOrganization Alastair MacDowellAdvanced Light Source Tom ToellnerAdvanced Photon Source Amitava D RoyCenter for Advanced Microstructures and Devices Tom EllisCanadian Light Source Roberta SantarosaLaboratório Nacional de Luz Síncrotron Jerry (Jerome) HastingsLinac Coherent Light Source Steven HulbertNational Synchrotron Light Source Thomas A RabedeauStanford Synchrotron Radiation Lightsource Mark BissenSynchrotron Radiation Center Gwyn WilliamsJefferson Lab Peter ReveszCornell High Energy Synchrotron Source Uwe ArpSynchrotron Ultraviolet Radiation Facility

  11. The pediatric knee: current concepts in sports medicine.

    PubMed

    Beck, Nicholas A; Patel, Neeraj M; Ganley, Theodore J

    2014-01-01

    As the popularity and intensity of children's athletics have increased, so has the risk for knee injuries. Fractures of the tibial eminence may be treated operatively or nonoperatively depending on fracture classification, but arthrofibrosis is a potentially significant complication. Anterior cruciate ligament rupture presents treatment challenges as regards the optimal timing and method of reconstruction. A number of novel reconstructive techniques have been developed to minimize risks to the physes in this population. Recent studies have focused on the prognosis, surgical indications, and operative techniques for osteochondritis dissecans in children. A number of authors have also sought to better-define the optimal diagnostic testing and management of patellar dislocation. In this review, we provide an update on current concepts for tibial eminence fractures, anterior cruciate ligament injuries, osteochondritis dissecans of the knee, and patellar dislocation in young athletes. PMID:24045503

  12. Lumbar stabilization: core concepts and current literature, Part 1.

    PubMed

    Barr, Karen P; Griggs, Miriam; Cadby, Todd

    2005-06-01

    The factors that affect lumbar stability have been an area of extensive research. The clinical application of this research in the form of lumbar stabilization exercise programs has become a common treatment of low back pain and is also increasingly used by athletes to improve performance and by the general public for health and the prevention of injury. This article includes a review of the key concepts behind lumbar stabilization. The literature regarding how those with low back pain differ in their ability to stabilize the spine from those without low back pain is discussed, and an overview of current research that assesses the benefits of a lumbar stabilization program to treat low back pain is provided. PMID:15905663

  13. Committees

    NASA Astrophysics Data System (ADS)

    2012-11-01

    Leadership Team of the IAHR Committee for Hydraulic Machinery and Systems Eduard EGUSQUIZA, UPC Barcelona, Spain, Chair François AVELLAN, EPFL-LMH, Switzerland, Past Chair Richard K FISHER, Voith Hydro Inc., USA, Past Chair Fidel ARZOLA, Edelca, Venezuela Michel COUSTON, Alstom Hydro, France Niklas DAHLBÄCKCK, Vatenfall, Sweden Normand DESY, Andritz VA TECH Hydro Ltd., Canada Chisachi KATO, University of Tokyo, Japan Andrei LIPEJ, Turboinstitut, Slovenija Torbjørn NIELSEN, NTNU, Norway Romeo SUSAN-RESIGA, 'Politehnica' University Timisoara, Romania Stefan RIEDELBAUCH, Stuggart University, Germany Albert RUPRECHT, Stuttgart University, Germany Qing-Hua SHI, Dong Fang Electrical Machinery Co., China Geraldo TIAGO, Universidade Federal de Itajubá, Brazil International Advisory Committee Shouqi YUAN (principal) Jiangsu University China QingHua SHI (principal) Dong Fang Electrical Machinery Co. China Fidel ARZOLA EDELCA Venezuela Thomas ASCHENBRENNER Voith Hydro GmbH & Co. KG Germany Anton BERGANT Litostroj Power doo Slovenia B C BHAOYAL Research & Technology Centre India Hermod BREKKE NTNU Norway Stuart COULSON Voith Hydro Inc. USA Paul COOPER Fluid Machinery Research Inc USA V A DEMIANOV Power Machines OJSC Russia Bart van ESCH Technische Universiteit Eindhoven Netherland Arno GEHRER Andritz Hydro Graz Austria Akira GOTO Ebara Corporation Japan Adiel GUINZBURG The Boeing Company USA D-H HELLMANN KSB AG Germany Ashvin HOSANGADI Combustion Research and Flow Technology USA Byung-Sun HWANG Korea Institute of Material Science Korea Toshiaki KANEMOTO Kyushu Institute of Technology Japan Mann-Eung KIM Korean Register of Shipping Korea Jiri KOUTNIK Voith Hydro GmbH & Co. KG Germany Jinkook LEE Eaton Corporation USA Young-Ho LEE Korea Maritime University Korea Woo-Seop LIM Hyosung Goodsprings Inc Korea Jun MATSUI Yokohama National University Japan Kazuyoshi Mitsubishi H I Ltd, Japan MIYAGAWA Christophe NICOLET Power Vision Engineering Srl Switzerland Maryse PAGE Hydro

  14. Committees

    NASA Astrophysics Data System (ADS)

    2012-11-01

    Leadership Team of the IAHR Committee for Hydraulic Machinery and Systems Eduard EGUSQUIZA, UPC Barcelona, Spain, Chair François AVELLAN, EPFL-LMH, Switzerland, Past Chair Richard K FISHER, Voith Hydro Inc., USA, Past Chair Fidel ARZOLA, Edelca, Venezuela Michel COUSTON, Alstom Hydro, France Niklas DAHLBÄCKCK, Vatenfall, Sweden Normand DESY, Andritz VA TECH Hydro Ltd., Canada Chisachi KATO, University of Tokyo, Japan Andrei LIPEJ, Turboinstitut, Slovenija Torbjørn NIELSEN, NTNU, Norway Romeo SUSAN-RESIGA, 'Politehnica' University Timisoara, Romania Stefan RIEDELBAUCH, Stuggart University, Germany Albert RUPRECHT, Stuttgart University, Germany Qing-Hua SHI, Dong Fang Electrical Machinery Co., China Geraldo TIAGO, Universidade Federal de Itajubá, Brazil International Advisory Committee Shouqi YUAN (principal) Jiangsu University China QingHua SHI (principal) Dong Fang Electrical Machinery Co. China Fidel ARZOLA EDELCA Venezuela Thomas ASCHENBRENNER Voith Hydro GmbH & Co. KG Germany Anton BERGANT Litostroj Power doo Slovenia B C BHAOYAL Research & Technology Centre India Hermod BREKKE NTNU Norway Stuart COULSON Voith Hydro Inc. USA Paul COOPER Fluid Machinery Research Inc USA V A DEMIANOV Power Machines OJSC Russia Bart van ESCH Technische Universiteit Eindhoven Netherland Arno GEHRER Andritz Hydro Graz Austria Akira GOTO Ebara Corporation Japan Adiel GUINZBURG The Boeing Company USA D-H HELLMANN KSB AG Germany Ashvin HOSANGADI Combustion Research and Flow Technology USA Byung-Sun HWANG Korea Institute of Material Science Korea Toshiaki KANEMOTO Kyushu Institute of Technology Japan Mann-Eung KIM Korean Register of Shipping Korea Jiri KOUTNIK Voith Hydro GmbH & Co. KG Germany Jinkook LEE Eaton Corporation USA Young-Ho LEE Korea Maritime University Korea Woo-Seop LIM Hyosung Goodsprings Inc Korea Jun MATSUI Yokohama National University Japan Kazuyoshi Mitsubishi H I Ltd, Japan MIYAGAWA Christophe NICOLET Power Vision Engineering Srl Switzerland Maryse PAGE Hydro

  15. Current concepts and future approaches to vestibular rehabilitation.

    PubMed

    Tjernström, Fredrik; Zur, Oz; Jahn, Klaus

    2016-04-01

    Over the last decades methods of vestibular rehabilitation to enhance adaptation to vestibular loss, habituation to changing sensory conditions, and sensory reweighting in the compensation process have been developed. However, the use of these techniques still depends to a large part on the educational background of the therapist. Individualized assessment of deficits and specific therapeutic programs for different disorders are sparse. Currently, vestibular rehabilitation is often used in an unspecific way in dizzy patients irrespective of the clinical findings. When predicting the future of vestibular rehabilitation, it is tempting to foretell advances in technology for assessment and treatment only, but the current intense exchange between clinicians and basic scientists also predicts advances in truly understanding the complex interactions between the peripheral senses and central adaptation mechanisms. More research is needed to develop reliable techniques to measure sensory dependence and to learn how this knowledge can be best used-by playing off the patient's sensory strength or working on the weakness. To be able using the emerging concepts, the neuro-otological community must strive to educate physicians, physiotherapists and nurses to perform the correct examinations for assessment of individual deficits and to look for factors that might impede rehabilitation. PMID:27083886

  16. Current concepts in gastric motility in diabetes mellitus.

    PubMed

    De Block, Christophe E M; De Leeuw, Ivo H; Pelckmans, Paul A; Van Gaal, Luc F

    2006-02-01

    This review addresses the current concepts in our understanding of the epidemiology, mechanisms, symptoms, clinical consequences, diagnosis and treatment of delayed gastric emptying in patients with diabetes. Upper gastrointestinal symptoms, particularly postprandial fullness, nausea, vomiting and abdominal bloating, occur in 30-50% of patients with diabetes. The use of scintigraphic techniques, and more recently breath test, has shown that as many as 50% of diabetic patients have gastroparesis. Diabetic gastroparesis comprises a decrease in fundic and antral motor activity, a reduction or a lack of the interdigestive migrating motor complex, gastric dysrhythmias, and pylorospasms. The mechanisms involved include: autonomic neuropathy, acute hyperglycaemia, and abnormalities in gastrointestinal hormones and neuropeptides. Other possible contributing factors such as hypothyroidism and H. pylori infection are discussed as well. Because treatment is possible by means of dietary advise, prokinetics or surgical procedures, it is important to identify risk factors for and to diagnose gastroparesis to prevent morbidity by controlling gastrointestinal symptoms, and to enhance glucoregulation. Understanding the current advances is key to the development of novel therapeutic strategies and for making rational choices in the management of diabetic gastroparesis. PMID:18220621

  17. Current Mined Geologic Disposal System concept of operations

    SciTech Connect

    Daniel, R.B.; Teraoka, G.M.

    1998-07-01

    The concept of operations for the Mined Geologic Disposal System (MGDS) provides an integrated, conceptual description of the physical architecture and operating concept of the potential repository. The document facilitates a common understanding of the operations among system planners, developers and implementors by summarizing design solutions and operating concepts. During this past year, the MGDS Concept of Operations document was updated to reflect the Viability Assessment (VA) design and operating concept. Previously, this document reflected the Advanced Conceptual Design (ACD). This paper presents a description of the significant operational changes from ACD to VA design that are now captured in the concept of operations document.

  18. Current concepts and controversies on adolescent idiopathic scoliosis: Part I

    PubMed Central

    Sud, Alok; Tsirikos, Athanasios I

    2013-01-01

    Adolescent idiopathic scoliosis is the most common spinal deformity encountered by General Orthopaedic Surgeons. Etiology remains unclear and current research focuses on genetic factors that may influence scoliosis development and risk of progression. Delayed diagnosis can result in severe deformities which affect the coronal and sagittal planes, as well as the rib cage, waistline symmetry, and shoulder balance. Patient's dissatisfaction in terms of physical appearance and mechanical back pain, as well as the risk for curve deterioration are usually the reasons for treatment. Conservative management involves mainly bracing with the aim to stop or slow down scoliosis progression during growth and if possible prevent the need for surgical treatment. This is mainly indicated in young compliant patients with a large amount of remaining growth and progressive curvatures. Scoliosis correction is indicated for severe or progressive curves which produce significant cosmetic deformity, muscular pain, and patient discontent. Posterior spinal arthrodesis with Harrington instrumentation and bone grafting was the first attempt to correct the coronal deformity and replace in situ fusion. This was associated with high pseudarthrosis rates, need for postoperative immobilization, and flattening of sagittal spinal contour. Segmental correction techniques were introduced along with the Luque rods, Harri-Luque, and Wisconsin systems. Correction in both coronal and sagittal planes was not satisfactory and high rates of nonunion persisted until Cotrel and Dubousset introduced the concept of global spinal derotation. Development of pedicle screws provided a powerful tool to correct three-dimensional vertebral deformity and opened a new era in the treatment of scoliosis. PMID:23682172

  19. Diabetes and haemochromatosis: current concepts, management and prevention.

    PubMed

    Yaouanq, J M

    1995-12-01

    Haemochromatosis is a common autosomal recessive disorder of iron metabolism caused by a gene in tight linkage with HLA class I genes. Despite intensive research, the molecular defect and underlying biochemical anomaly are still unknown. Diabetes, a serious complication of haemochromatosis, is frequently associated with cirrhosis which reduces life expectancy. Its development is related to iron excess, directly or through associated liver involvement, although the precise mechanisms of iron toxicity remain unclear. New concepts concerning its pathogenesis include insulin resistance and beta-cell dysfunction which are apparent well before insulin deficiency and can be reversed if iron depletion is promptly initiated. Today, earlier recognition of iron overload through active diagnostic approaches has a direct impact in reducing the frequency of diabetes among hemochromatosis patients. Presymptomatic diagnosis in the general population and among relatives of affected subjects currently relies on the detection of increased iron stores through medical awareness and family screening. Indirect gene diagnosis with serological and molecular markers of the HLA region can be provided for relatives of proven cases. As part of a genetic counselling process, this allows the identification of at-risk subjects before the onset of iron accumulation. Isolation of the gene and identification of the metabolic defect leading to increased iron absorption may have significant implications for future diagnostic procedures and preventive strategies in haemochromatosis. PMID:8586148

  20. Human error in hospitals and industrial accidents: current concepts.

    PubMed

    Spencer, F C

    2000-10-01

    Most data concerning errors and accidents are from industrial accidents and airline injuries. General Electric, Alcoa, and Motorola, among others, all have reported complex programs that resulted in a marked reduction in frequency of worker injuries. In the field of medicine, however, with the outstanding exception of anesthesiology, there is a paucity of information, most reports referring to the 1984 Harvard-New York State Study, more than 16 years ago. This scarcity of information indicates the complexity of the problem. It seems very unlikely that simple exhortation or additional regulations will help because the problem lies principally in the multiple human-machine interfaces that constitute modern medical care. The absence of success stories also indicates that the best methods have to be learned by experience. A liaison with industry should be helpful, although the varieties of human illness are far different from a standardized manufacturing process. Concurrent with the studies of industrial and nuclear accidents, cognitive psychologists have intensively studied how the brain stores and retrieves information. Several concepts have emerged. First, errors are not character defects to be treated by the classic approach of discipline and education, but are byproducts of normal thinking that occur frequently. Second, major accidents are rarely causedby a single error; instead, they are often a combination of chronic system errors, termed latent errors. Identifying and correcting these latent errors should be the principal focus for corrective planning rather than searching for an individual culprit. This nonpunitive concept of errors is a key basis for an effective reporting system, brilliantly demonstrated in aviation with the ASRS system developed more than 25 years ago. The ASRS currently receives more than 30,000 reports annually and is credited with the remarkable increase in safety of airplane travel. Adverse drug events constitute about 25% of hospital

  1. International Commission on Radiological Protection Committee 1: Current Status and Future Directions

    SciTech Connect

    Morgan, William F.

    2015-05-19

    The International Commission on Radiological Protection (ICRP), Committee 1 (C1) considers the risk of induction of cancer and heritable disease (stochastic effects) together with the underlying mechanisms of radiation action. C1 also considers the risks, severity, and mechanisms of induction of tissue/organ damage and developmental defects (deterministic effects). The committee was significantly revamped in 2013 and last met in Abu Dhabi in October of 2013. C1 evaluated progress on two ongoing Task Groups (TG’s); TG 64 “Cancer Risk from Alpha Emitters” and TG 75 “Stem Cell Radiobiology”. Following approval from the Main Commission (MC), C1 established two new TG’s; TG 91 “Radiation Risk Inference at Low Dose and Low Dose Rate Exposure for Radiological Protection Purposes”, and TG 92 “Terminology and Definitions”. Here I will present a synopsis of the current status of C1 and outline the tasks C1 may undertake in the future.

  2. The Role and Effectiveness of Search Committees. AAHE-ERIC/Higher Education Research Currents.

    ERIC Educational Resources Information Center

    Bromert, Jane Doyle

    1984-01-01

    Perspectives concerning search committees for college faculty and administrators are considered. Most of the existing literature on college and university search committees deals with general presidential and, to a lesser extent, with administrative searches. Search committees are a fairly recent phenomenon in higher education, and their growth is…

  3. Some Current Concepts, Techniques, and Recent Findings in Urban Geography

    ERIC Educational Resources Information Center

    Getis, Arthur; Getis, Judith

    1972-01-01

    The question, Are there good reasons to teach urban geography to secondary and college students?'' is answered positively by briefly exploring (1) the concepts of wave theory analog, the critical isochrone, filtering, and equifinality; (2) the techniques of analysis of computer mapping, probabiltiy, models, and remote sensing; and (3) some recent…

  4. Science Teachers' Alternate Conceptions about Direct-Currents.

    ERIC Educational Resources Information Center

    Pardhan, Harcharan; Bano, Yasmeen

    2001-01-01

    Reports on a qualitative research study on electricity carried out in 1998 on alternative conceptions (ACs) held by a select group of middle school teachers. The study was designed to identify the nature and origin of the ACs of these teachers and relate them to other similar studies carried out by other researchers. (Contains 27 references.)…

  5. Medicalization: current concept and future directions in a bionic society.

    PubMed

    Maturo, Antonio

    2012-01-01

    The article illustrates the main features of the concept of medicalization, starting from its theoretical roots. Although it is the process of extending the medical gaze on human conditions, it appears that medicalization cannot be strictly connected to medical imperialism anymore. Other "engines" of medicalization are influential: consumers, biotechnology and managed care. The growth of research and theoretical reflections on medicalization has led to the proposal of other parallel concepts like pharmaceuticalization, genetization and biomedicalization. These new theoretical tools could be useful in the analysis of human enhancement. Human enhancement can be considered as the use of biomedical technology to improve performance on a human being who is not in need of a cure: a practice that is increasingly spreading in what might be defined as a "bionic society". PMID:22654387

  6. Medicalization: Current Concept and Future Directions in a Bionic Society

    PubMed Central

    Maturo, Antonio

    2012-01-01

    The article illustrates the main features of the concept of medicalization, starting from its theoretical roots. Although it is the process of extending the medical gaze on human conditions, it appears that medicalization cannot be strictly connected to medical imperialism anymore. Other “engines” of medicalization are influential: consumers, biotechnology and managed care. The growth of research and theoretical reflections on medicalization has led to the proposal of other parallel concepts like pharmaceuticalization, genetization and biomedicalization. These new theoretical tools could be useful in the analysis of human enhancement. Human enhancement can be considered as the use of biomedical technology to improve performance on a human being who is not in need of a cure: a practice that is increasingly spreading in what might be defined as a “bionic society”. PMID:22654387

  7. FROM CONCEPT TO EQUIVALENCY: THE 503 REGULATIONS AND THE PATHOGEN EQUIVALENCY COMMITTEE (PAPER)

    EPA Science Inventory

    Since its creation in 1985, the Pathogen Equivalency Committee (PEC) has been reviewing innovative and alternative sludge disinfection technologies with regards to their abilities to protect human health and the environment. The PEC is charged to make recommendations on whether t...

  8. FROM CONCEPT TO EQUIVALENCY: THE 503 REGULATIONS AND THE PATHOGEN EQUIVALENCY COMMITTEE

    EPA Science Inventory

    Since its creation in 1985, the Pathogen Equivalency Committee (PEC) has been reviewing innovative and alternative sludge disinfection technologies with regards to their abilities to protect human health and the environment. The PEC is charged to make recommendations on whether t...

  9. [Understanding a new conception of addiction in current clinical practices].

    PubMed

    Matsumoto, Toshihiko

    2012-02-01

    This paper described the historical process that the conception of "addiction" and "dependence" have been formed and changed. Before, the "addiction" was a prejudiced word used when people contempt an individual with compulsive drinking or taking psychoactive drugs, and this word implied moralistic and ethical faults of the individual. After that, this word describing an individual without control of drinking was taken place by the "dependence." This is the neutral and medical conception, defined by presence of tolerance and withdrawal symptoms, although it was based on the "alcoholism." which originated in the citizen movement in 1930s in U.S. Recently some professionals have preferred to use the "addiction" when describing an individual losing control of deviated, impulsive, and repetitive behavior including pathological gambling and compulsive buying. These behaviors have been discriminated form substance dependence, while clinically applied to analogical treatment to substance dependence. However, the DSM-5 draft which the American Psychiatric Association has published as a draft of new diagnostic criteria for mental disorders has classified both of substance dependence and addictive behavior into the same category, and has removed the word "dependence" in the description. In this paper, we looked back on historical conflicts between the two words of "dependence" and "addiction," and discussed the clinical meanings and problems of these words. PMID:22586939

  10. Ayurvedic medicine. Core concept, therapeutic principles, and current relevance.

    PubMed

    Chopra, Arvind; Doiphode, Vijay V

    2002-01-01

    In the prebiblical Ayurvedic origins, every creation inclusive of a human being is a model of the universe. In this model, the basic matter and the dynamic forces (Dosha) of the nature determine health and disease, and the medicinal value of any substance (plant and mineral). The Ayurvedic practices (chiefly that of diet, life style, and the Panchkarama) aim to maintain the Dosha equilibrium. Despite a holistic approach aimed to cure disease, therapy is customized to the individual's constitution (Prakruti). Numerous Ayurvedic medicines (plant derived in particular) have been tested for their biological (especially immunomodulation) and clinical potential using modern ethnovalidation, and thereby setting an interface with modern medicine. To understand Ayurvedic medicine, it would be necessary to first understand the origin, basic concept and principles of Ayurveda. PMID:11795092

  11. Current concepts regarding developmental mechanisms in diabetic retinopathy in Taiwan.

    PubMed

    Chen, Shih-Yin; Hsu, Yuan-Man; Lin, Ying-Ju; Huang, Yu-Chuen; Chen, Chao-Jung; Lin, Wei-De; Liao, Wen-Lin; Chen, Yng-Tay; Lin, Wei-Yong; Liu, Yu-Huei; Yang, Jai-Sing; Sheu, Jinn-Chyuan; Tsai, Fuu-Jen

    2016-06-01

    Diabetic retinopathy (DR) is one of the most feared complications of diabetes and is a leading cause of acquired blindness in working adults. The prevalence of undiagnosed diabetes in Taiwan is about 4%, and the annual incidence of T2D (Type 2 Diabetes) in Taiwan is 1.8% following the 1985 WHO criteria. Multiple mechanisms have been shown in T2DR with some signaling pathways, including the polyol pathway, PKC pathway, AGEs pathway, and MAPK pathway. However, the cause of vision loss in diabetic retinopathy is complex and remains incompletely understood. Herein, we try to fully understand the new concepts regarding hyperglycemia-induced biochemical pathways contributing to DR pathophysiology. Our work may be able to provide new strategies for the prevention and treatment of diabetic vascular complications. PMID:27154195

  12. LLNL current meter array--concept and system description

    SciTech Connect

    Mantrom, D.D.

    1994-11-15

    A measurement capability using a horizontal array of 10 S4 current meters mounted on a stiff floating structure with 35 m aperture has been developed to support interpretation of radar imaging of surface effects associated with internal waves. This system has been fielded three times and most recently, has collected data alongside the sea-surface footprint of a land-fixed radar imaging ship-generated internal waves. The underlying need for this measurement capability is described. The specifications resulting from this need are presented and the engineering design and deployment procedures of the platform and systems that resulted are described The current meter data are multiplexed along with meteorological and system status data on board the floating platform and are telemetered to a shore station and on to a data acquisition system. The raw data are recorded, and are then processed to form space-time images of current and strain rate (a spatial derivative of the current field). Examples of raw and processed data associated with ship-generated internal waves are presented.

  13. Current sensing for navigated electrosurgery: proof of concept

    NASA Astrophysics Data System (ADS)

    Carter, K.; Lasso, A.; Ungi, T.; Morin, E.; Fichtinger, G.

    2016-03-01

    PURPOSE: Tracked power-tools are routinely used in computer-assisted intervention and surgical systems. In order to properly perform temporal and spatial monitoring of the tracked tool with the navigation system, it is important to know when the tool, such as an electrosurgical cauterizer, is being activated during surgery. We have developed a general purpose current sensor that can be augmented to tracked surgical devices in order to inform the surgeon and the navigation system when the tool is activated. METHODS: Two non-invasive AC current sensors, two peak detector circuits, one voltage comparator circuit, and a microcontroller were used to detect when an electrosurgical cauterizer is being powered on and differentiate between the cut and coagulation modes. The system was tested by cauterizing various substances at varied power ratings. RESULTS: By comparing the ratio of amplitudes as well as the frequencies of the signals, the current sensing system is able to differentiate between on/off, cut/coagulation, as well as when cauterizer tissue. DISCUSSION: The current sensing system is able to detect when the cauterizer is being powered on and can differentiate between monopolar cut and coagulation modes. CONCLUSION: This system shows promise for detecting when the cauterizer is being powered on and in the future could be integrated with a navigation system in order to easily temporally monitor the electrosurgical tool.

  14. Anemia associated with chronic heart failure: current concepts

    PubMed Central

    Shah, Ravish; Agarwal, Anil K

    2013-01-01

    Anemia is a frequent comorbidity of heart failure and is associated with poor outcomes. Anemia in heart failure is considered to develop due to a complex interaction of iron deficiency, kidney disease, and cytokine production, although micronutrient insufficiency and blood loss may contribute. Currently, treatment of anemia of heart failure lacks clear targets and specific therapy is not defined. Intravenous iron use has been shown to benefit anemic as well as nonanemic patients with heart failure. Treatment with erythropoietin-stimulating agents has been considered alone or in combination with iron, but robust evidence to dictate clear guidelines is not currently available. Available and emerging new agents in the treatment of anemia of heart failure will need to be tested in randomized, controlled studies. PMID:23403618

  15. Acute kidney injury: current concepts and new insights

    PubMed Central

    Koza, Yavuzer

    2016-01-01

    Abstract: Background: Acute kidney injury, which was previously named as acute renal failure, is a complex clinical disorder and continues to be associated with poor outcomes. It is frequently seen in hospitalized patients, especially in critically ill patients. The primary causes of acute kidney injury are divided into three categories: prerenal, intrinsic renal and postrenal. The definition and staging of acute kidney injury are mainly based on the risk, injury, failure, loss, end-stage kidney disease (RIFLE) criteria and the acute kidney injury network (AKIN) criteria, which have previously been defined. However the clinical utility of these criteria is still uncertain. Several biomarkers such as Cystatin C and neutrophil gelatinase-associated lipocalin have been suggested for the diagnosis, severity classification and most importantly, the modification of outcome in acute kidney injury. Methods: Current literature on the definition, biomarkers, management and epidemiology of acute kidney injury was reviewed by searching keywords in Medline and PubMed databases. Results: The epidemiology, pathophysiology and diagnosis of acute kidney injury were discussed. The clinical implications of novel biomarkers and management of acute kidney injury were also discussed. Conclusions: The current definitions of acute kidney injury are based on the RIFLE, AKIN and KDIGO criteria. Although these criteria have been widely validated, some of limitations are still remain. Since acute kidney injury is common and harmful, all preventive measures should be taken to avoid its occurrence. Currently, there is no a definitive role for novel biomarkers. PMID:26804946

  16. Revisiting reflexology: Concept, evidence, current practice, and practitioner training.

    PubMed

    Embong, Nurul Haswani; Soh, Yee Chang; Ming, Long Chiau; Wong, Tin Wui

    2015-10-01

    Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and the training for reflexology practitioners. PubMed, SCOPUS, Google Scholar, and SpringerLink databases were utilized to search the following medical subject headings or keywords: foot massage, reflexology, foot reflexotherapy, reflexological treatment, and zone therapy. The articles published for the last 10 years were included. Previous systematic reviews failed to show concrete evidence for any specific effect of reflexology in any conditions. Due to its non-invasive, non-pharmacological complementary nature, reflexology is widely accepted and anecdotal evidence of positive effect reflexology in a variety of health conditions are available. Adequate training for practitioners is necessary to ensure the consistency of service provided. PMID:26587391

  17. Current concepts of blood-brain barrier development.

    PubMed

    Liebner, Stefan; Czupalla, Cathrin J; Wolburg, Hartwig

    2011-01-01

    Homeostasis of the central nervous system (CNS) microenvironment is essential for its normal function and is maintained by the blood-brain barrier (BBB). The BBB proper is made up of endothelial cells (ECs) interconnected by tight junctions (TJs) that reveal a unique morphology and biochemical composition of the body's vasculature. In this article, we focus on developmental aspects of the BBB and describe morphological as well as molecular special features of the neuro-vascular unit (NVU) involved in barrier induction. Recently, we and others identified the Wnt/b-catenin pathway as crucial for brain angiogenesis, TJ and BBB formation. Based on these findings we discuss other pathways and molecular interactions for BBB establishment and maintenance. At the morphological level, our concept favors a major role for polarized astrocytes (ACs) therein. Orthogonal arrays of particles (OAPs) that are the morphological correlate of the water channel protein aquaporin-4 (AQP4) are specifically formed in the membrane of the AC endfoot. The polarized AC endfoot and hence OAPs are dependent on agrin and dystroglycan, of which agrin is a developmentally regulated extracellular matrix (ECM) component. Understanding the mechanisms leading to BBB development will be key to the understanding of barrier maintenance that is crucial for, but frequently disturbed, in the diseased adult brain. PMID:21769778

  18. Revisiting reflexology: Concept, evidence, current practice, and practitioner training

    PubMed Central

    Embong, Nurul Haswani; Soh, Yee Chang; Ming, Long Chiau; Wong, Tin Wui

    2015-01-01

    Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and the training for reflexology practitioners. PubMed, SCOPUS, Google Scholar, and SpringerLink databases were utilized to search the following medical subject headings or keywords: foot massage, reflexology, foot reflexotherapy, reflexological treatment, and zone therapy. The articles published for the last 10 years were included. Previous systematic reviews failed to show concrete evidence for any specific effect of reflexology in any conditions. Due to its non-invasive, non-pharmacological complementary nature, reflexology is widely accepted and anecdotal evidence of positive effect reflexology in a variety of health conditions are available. Adequate training for practitioners is necessary to ensure the consistency of service provided. PMID:26587391

  19. Use of lasers in orthopedic surgery: current concepts.

    PubMed

    Abelow, S P

    1993-05-01

    A surgical laser is a new, multipurpose tool that can cut, coagulate, and vaporize tissues. It utilizes a low profile handpiece that allows easy access to tight places and small joints. The holmium laser at 2.1 microns wavelength is gaining wide acceptance among orthopedic surgeons as a useful arthroscopic surgical tool. It has a minimal amount of thermal necrosis and is able to cut and ablate tissues with great ease. Current investigation with laser tissue--agglutination and tissue welding--may make it possible to repair torn tissues with laser energy. The future will bring minimally invasive and minimally damaging laser orthopedic surgery. PMID:8327382

  20. Current concepts in management of slipped capital femoral epiphysis.

    PubMed

    Bittersohl, Bernd; Hosalkar, Harish S; Zilkens, Christoph; Krauspe, Rüdiger

    2015-01-01

    Slipped capital femoral epiphysis (SCFE) is a common hip condition that can be disabling. In this review, we provide an orientation on current trends in the clinical management of SCFE including conventional procedures and specialised surgical developments. Different methods of fixation of the epiphysis, risks of complications, and the rationale of addressing deformity, primarily or secondarily, are presented. Although improved understanding of the anatomy, vascularity and implications of residual deformity have changed management strategies, the best modality of treatment that would restore complete vascularity to the femoral head and prevent any residual deformity, impingement and early osteoarthritis remains elusive. PMID:25362879

  1. Hepatic Ischemia and Reperfusion Injury and Trauma: Current Concepts

    PubMed Central

    Papadopoulos, Dimitrios; Siempis, Thomas; Theodorakou, Eleni; Tsoulfas, Georgios

    2013-01-01

    Context Ischemia-reperfusion injury is a fascinating topic which has drawn a lot of interest in the last several years. Hepatic ischemia reperfusion injury may occur in a variety of clinical situations. These include transplantation, liver resection, trauma, and vascular surgery. Evidence Acquisition The purpose of this review was to outline the molecular mechanisms underlying hepatic I/R injury and present the latest approaches, both surgical and pharmacological, regarding the prevention of it. A comprehensive electronic literature search in MEDLINE/PubMed was performed to identify relative articles published within the last 2 years. Results The basic mechanism of hepatic ischemia – reperfusion injury is one of blood deprivation during ischemia, followed by the return of flow during reperfusion. It involves a complex series of events, such as mitochondrial deenergization, adenosine-5'-triphosphate depletion, alterations of electrolyte homeostasis, as well as Kupffer cell activation, oxidative stress changes and upregulation of proinflammatory cytokine signaling. The great number of variable pathways, with several mediators interacting with each other, leads to a high number of candidates for potential therapeutic intervention. As far as surgical approaches are concerned, the modification of existing clamping techniques and the ischemic preconditioning are the most promising techniques till recently. In the search for novel techniques of protecting against hepatic ischemia reperfusion injury, many different strategies have been used in experimental models. The biggest part of this research lies around antioxidant therapy, but other potential solutions have been explored as well. Conclusions The management of hepatic trauma, in spite of the fact that it has become increasingly nonoperative, there still remains the possibility of hepatic resection in the hepatic trauma setting, especially in severe injuries. Hence, clinicians should be familiar with the concept of

  2. Current Concepts in the Management of Rheumatoid Hand

    PubMed Central

    Longo, Umile Giuseppe; Petrillo, Stefano; Denaro, Vincenzo

    2015-01-01

    Rheumatoid arthritis (RA) is a chronic inflammatory disease caused by a T cell-driven autoimmune process, which majorly involves the diarthrodial joints. It affects 1% of the US population, and approximately 70% of patients with RA develop pathologies of the hand, especially of the metacarpophalangeal joints (MCP). Furthermore, also the extensor and flexor tendons of the fingers are frequently involved. The first line of treatment should be conservative. Three general classes of drugs are currently available for RA: nonsteroidal anti-inflammatory agents (NSAIDs), corticosteroids, and disease modifying antirheumatic drugs (DMARDs). Encouraging results have been obtained using DMARDs. However, when severe deformities occur or when patients are unresponsive to medical management and injections therapy, surgical intervention should be performed to relieve pain and restore function. Several surgical options have been described for the management of MCP joint deformities, including soft tissue procedures, arthrodesis, and prosthetic replacement. Tendons ruptures are generally managed with tendon transfer surgery, while different surgical procedures are available to treat fingers deformities. The aim of the present review is to report the current knowledge in the management of MCP joint deformities, as well as tendons damage and fingers deformities, in patients with RA. PMID:26236341

  3. Bovine digital dermatitis: Current concepts from laboratory to farm.

    PubMed

    Evans, N J; Murray, R D; Carter, S D

    2016-05-01

    Bovine digital dermatitis (DD) is a severe infectious disease causing lameness in dairy cattle worldwide and is an important ruminant welfare problem that has considerable economic issues. Bovine DD is endemic in many regions worldwide and it is important to understand this major disease so that effective control strategies can be identified. There is substantial evidence that specific treponeme phylotypes play an important causative role in bovine DD. This review considers current research, including DD Treponema spp. investigations, associated DD pathobiology, and current and potential treatment and control options. Epidemiological data, alongside new microbiological data, help delineate important transmission routes and reservoirs of infection that allow effective interventions to be identified. Better on-farm housing hygiene, pasture access, routine footbathing and claw trimming with disinfected equipment need to be implemented to significantly reduce the incidence of DD. There is a paucity of peer reviewed research into both commonly used and novel treatments. In vitro antimicrobial susceptibility studies of DD treponemes and effective treatment of human treponematoses clearly indicate that antibiotics frequently selected for DD treatments are not the most efficacious. Whilst there are understandable concerns over milk withdrawal times in dairy cattle, more needs to be done to identify, license and implement more appropriate antibiotic treatments, since continued overuse of less efficacious antibiotics, applied incorrectly, will lead to increased disease recurrence and transmission. More research is needed into methods of preventing DD that circumvent the use of antibiotics, including vaccination and transmission blocking studies, to reduce or hopefully eradicate DD in the future. PMID:27061657

  4. Anthropogenic SO{sub 2}/NO{sub x} committee--current status

    SciTech Connect

    Benkovitz, C.M.

    1993-04-01

    Current activities of the Anthropogenic SO{sub 2}/NO{sub x} Committee center around the compilation of Version 1 of the GEIA inventories. These inventories will be based on the GEIA-specified 1{degrees} by 1{degrees} grid (lower left corner at 180{degrees}W/90{degrees}S, west to east and south to north), reflect 1985 emissions and consist of two data sets: Version 1A inventories with annual emissions at one level and Version 1B inventories with seasonal emissions, two vertical levels (defined at 100 m) and sectoral split information. The basic information used for both versions of the GEIA inventories will be identical; i.e., emissions totals across both inventories will be the same. Work is being carried out in two complementary working groups; Carmen Benkovitz, Brookhaven National Laboratory, Upton, NY, USA heads the work on the annual inventory, Eva Voldner, Atmospheric Environment Services, Canada and Trevor Scholtz, ORTECH International, Canada, head the work on the seasonal inventory.

  5. Acute Compartment Syndrome of the Limbs: Current Concepts and Management

    PubMed Central

    Mabvuure, Nigel Tapiwa; Malahias, Marco; Hindocha, Sandip; Khan, Wasim; Juma, Ali

    2012-01-01

    Acute compartment syndrome (ACS) of the limb refers to a constellation of symptoms, which occur following a rise in the pressure inside a limb muscle compartment. A failure or delay in recognising ACS almost invariably results in adverse outcomes for patients. Unrecognised ACS can leave patients with nonviable limbs requiring amputation and can also be life–threatening. Several clinical features indicate ACS. Where diagnosis is unclear there are several techniques for measuring intracompartmental pressure described in this review. As early diagnosis and fasciotomy are known to be the best determinants of good outcomes, it is important that surgeons are aware of the features that make this diagnosis likely. This clinical review discusses current knowledge on the relevant clinical anatomy, aetiology, pathophysiology, risk factors, clinical features, diagnostic procedures and management of an acute presentation of compartment syndrome. PMID:23248724

  6. Epidemic keratoconjunctivitis: A review of current concepts in management

    PubMed Central

    Pihos, Andria M.

    2012-01-01

    Epidemic keratoconjunctivitis (EKC) is an ocular surface infection caused by adenovirus. To date, there are no approved topical antiadenoviral therapeutics to treat EKC. Recent research reveals that treatment with topical corticosteroids for symptomatic relief of EKC enhances adenovirus replication and delays cell shedding from the ocular surface which delays adenovirus elimination. The current management of EKC largely revolves around accurate diagnosis of the condition and implementation of disinfection protocol to prevent its spread. Development of an effective antiviral treatment that addresses inflammation and does not prolong viral shedding would provide significant benefit. The literature reports on a variety of therapeutics that could potentially satisfy this deficiency. Topical ganciclovir and povidone-iodine combination drops have shown the most recent potential, but both therapeutics need to be investigated in larger scale studies. Until an antiadenoviral option is produced, the treatment of EKC should maintain a judicious case by case approach aiming to contain its dissemination and prevent visual consequences.

  7. Current concepts in diagnosis and treatment of chronic lymphocytic leukemia

    PubMed Central

    Roliński, Jacek

    2015-01-01

    Chronic lymphocytic leukemia (CLL) is the most commonly diagnosed type of leukemia in Western Europe and North America, and represents about 30% of all leukemias in adults. Chronic lymphocytic leukemia is a disease of the elderly, who are often in poorer general health and burdened with multiple comorbidities. These factors affect the decision making when choosing an appropriate method of treatment. In recent years there has been significant progress in the treatment of chronic lymphocytic leukemia, first due to the introduction of immunochemotherapy with monoclonal antibodies and latterly small molecules, like tyrosine kinase inhibitors targeting B-cell receptor signaling. This article discusses the current diagnostic principles, the most important prognostic factors and therapeutic options, available in first-line treatment and in refractory/resistant disease, including high-risk CLL, both for patients with good and those with poor performance status. It also presents important novel molecules which have been evaluated in clinical trials. PMID:26793019

  8. Current concepts of immunology and diagnosis in amniotic fluid embolism.

    PubMed

    Benson, Michael D

    2012-01-01

    Amniotic fluid embolism (AFE) is one of the leading causes of maternal mortality and morbidity in developed countries. Current thinking about pathophysiology has shifted away from embolism toward a maternal immune response to the fetus. Two immunologic mechanisms have been studied to date. Anaphylaxis appears to be doubtful while the available evidence supports a role for complement activation. With the mechanism remaining to be elucidated, AFE remains a clinical diagnosis. It is diagnosed based on one or more of four key signs/symptoms: cardiovascular collapse, respiratory distress, coagulopathy, and/or coma/seizures. The only laboratory test that reliably supports the diagnosis is the finding of fetal material in the maternal pulmonary circulation at autopsy. Perhaps the most compelling mystery surrounding AFE is not why one in 20,000 parturients are afflicted, but rather how the vast majority of women can tolerate the foreign antigenic presence of their fetus both within their uterus and circulation? PMID:21969840

  9. Current concepts and controversies on adolescent idiopathic scoliosis: Part II

    PubMed Central

    Sud, Alok; Tsirikos, Athanasios I

    2013-01-01

    A new era in the surgical treatment of adolescent idiopathic scoliosis (AIS) opened with the introduction of pedicle screw instrumentation, which provides 3-column vertebral fixation and allows major deformity correction on the coronal, sagittal, and axial planes. A steep learning curve can be expected for spinal surgeons to become familiar with pedicle screw placement and correction techniques. Potential complications including injury to adjacent neural, vascular, and visceral structures can occur due to screw misplacement or pull-out during correction maneuvers. These major complications are better recognized as pedicle screw techniques become more popular and may result in serious morbidity and mortality. Extensive laboratory and clinical training is mandatory before pedicle screw techniques in scoliosis surgery are put to practice. Wider application, especially in developing countries, is limited by the high cost of implants. Refined correction techniques are currently developed and these utilize a lesser number of pedicle anchors which are strategically positioned to allow optimum deformity correction while reducing the neurological risk, surgical time, and blood loss, as well as instrumentation cost. Such techniques can be particularly attractive at a time when cost has major implications on provision of health care as they can make scoliosis treatment available to a wider population of patients. Pedicle screw techniques are currently considered the gold standard for scoliosis correction due to their documented superior biomechanical properties and ability to produce improved clinical outcomes as reflected by health-related quality-of-life questionnaires. Ongoing research promises further advances with the future of AIS treatment incorporating genetic counseling and possibly fusionless techniques. PMID:23798750

  10. Vitamin D and assisted reproduction technologies: current concepts

    PubMed Central

    2014-01-01

    Accumulating evidence from animal and human studies suggests that vitamin D is involved in many functions of the human reproductive system in both genders, but no comprehensive analysis of the potential relationship between vitamin D status and Assisted Reproduction Technologies (ART) outcomes is currently available. On this basis, the purpose of this systematic review and meta-analysis was to perform an in-depth evaluation of clinical studies assessing whether vitamin D status of patients undergoing ART could be related to cycle outcome variables. This issue is of interest considering that vitamin D deficiency is easily amenable to correction and oral vitamin D supplementation is cheap and without significant side effects. Surprisingly, no studies are currently available assessing vitamin D status among male partners of couples undergoing ART, while seven studies on vitamin D status of women undergoing controlled ovarian hyperstimulation (COH) for ART were found and included in the review. Results show that vitamin D deficiency is highly prevalent among women undergoing COH, ranging from 21% to 31% across studies conducted in Western countries and reaching 75-99% in Iranian studies. Data on vitamin D deficiency (25-hydroxyvitamin D serum levels <20 ng/ml) in relation to ART outcomes could be extracted from three studies and included in the meta-analysis, yielding a common risk ratio (RR) of 0.89 (95% CI 0.53-1.49) and showing a lower but not statistically significant likelihood of clinical pregnancy for vitamin-D-deficient women compared with vitamin-D-sufficient patients. In conclusion, there is insufficient evidence to support the routine assessment of vitamin D status to predict the clinical pregnancy rate in couples undergoing ART. The partly conflicting results of the available studies, potentially explaining the lack of statistical significance for a negative influence of vitamin D deficiency on clinical pregnancy rate, are likely secondary to confounders

  11. Neural Synchrony in Cortical Networks: History, Concept and Current Status

    PubMed Central

    Uhlhaas, Peter J.; Pipa, Gordon; Lima, Bruss; Melloni, Lucia; Neuenschwander, Sergio; Nikolić, Danko; Singer, Wolf

    2009-01-01

    Following the discovery of context-dependent synchronization of oscillatory neuronal responses in the visual system, the role of neural synchrony in cortical networks has been expanded to provide a general mechanism for the coordination of distributed neural activity patterns. In the current paper, we present an update of the status of this hypothesis through summarizing recent results from our laboratory that suggest important new insights regarding the mechanisms, function and relevance of this phenomenon. In the first part, we present recent results derived from animal experiments and mathematical simulations that provide novel explanations and mechanisms for zero and nero-zero phase lag synchronization. In the second part, we shall discuss the role of neural synchrony for expectancy during perceptual organization and its role in conscious experience. This will be followed by evidence that indicates that in addition to supporting conscious cognition, neural synchrony is abnormal in major brain disorders, such as schizophrenia and autism spectrum disorders. We conclude this paper with suggestions for further research as well as with critical issues that need to be addressed in future studies. PMID:19668703

  12. Current concepts of oxygen management in retinopathy of prematurity.

    PubMed

    Owen, Leah A; Hartnett, M Elizabeth

    2014-01-01

    Retinopathy of prematurity (ROP) is a potentially blinding disorder in premature infants. The underlying pathophysiology is incompletely understood, limiting the prevention and treatment of this devastating condition. Current therapies are directed toward management of aberrant neovascularization thought to result from retinal ischemia in the developing preterm retina. The molecular mediators important for development of retinal ischemia and subsequent neovascular pathology are not fully understood. However, oxygen has been shown to be a key mediator of disease and the oxygen environment for preterm infants has been extensively studied. Despite this, the optimal oxygen environment for preterm infants remains unclear and recent works seeking to clarify this relationship demonstrate somewhat disparate findings. These data further substantiate that ROP is a complex disease with multifactorial etiology including genetic and environmental factors. Therefore, while environmental factors such as oxygen are important to our understanding of the disease process and care of preterm infants, identification of the molecular mediators downstream of oxygen which are necessary for development of ROP pathology will be critical to improve prevention, diagnosis and treatment strategies. PMID:24982738

  13. Current Concepts of Articular Cartilage Restoration Techniques in the Knee

    PubMed Central

    Camp, Christopher L.; Stuart, Michael J.; Krych, Aaron J.

    2014-01-01

    Context: Articular cartilage injuries are common in patients presenting to surgeons with primary complaints of knee pain or mechanical symptoms. Treatment options include comprehensive nonoperative management, palliative surgery, joint preservation operations, and arthroplasty. Evidence Acquisition: A MEDLINE search on articular cartilage restoration techniques of the knee was conducted to identify outcome studies published from 1993 to 2013. Special emphasis was given to Level 1 and 2 published studies. Study Design: Clinical review. Level of Evidence: Level 3. Results: Current surgical options with documented outcomes in treating chondral injuries in the knee include the following: microfracture, osteochondral autograft transfer, osteochondral allograft transplant, and autologous chondrocyte transplantation. Generally, results are favorable regarding patient satisfaction and return to sport when proper treatment algorithms and surgical techniques are followed, with 52% to 96% of patients demonstrating good to excellent clinical outcomes and 66% to 91% returning to sport at preinjury levels. Conclusion: Clinical, functional, and radiographic outcomes may be improved in the majority of patients with articular cartilage restoration surgery; however, some patients may not fully return to their preinjury activity levels postoperatively. In active and athletic patient populations, biological techniques that restore the articular surface may be options that provide symptom relief and return patients to their prior levels of function. PMID:24790697

  14. Vestibular compensation and vestibular rehabilitation. Current concepts and new trends.

    PubMed

    Deveze, A; Bernard-Demanze, L; Xavier, F; Lavieille, J-P; Elziere, M

    2014-01-01

    The aim of this review is to present the current knowledge of the mechanisms underlying the vestibular compensation and demonstrating how the vestibular rehabilitation is conducted to help the recovery of balance function. Vestibular rehabilitation is based on improving the natural phenomenon called vestibular compensation that occurs after acute vestibular disturbance or chronic and gradual misbalance. Central compensation implies three main mechanisms namely adaptation, substitution and habituation. The compensation, aided by the rehabilitation aimed to compensate and/or to correct the underused or misused of the visual, proprioceptive and vestibular inputs involved in the postural control. As the strategy of equilibration is not corrected, the patient is incompletely cured and remains with inappropriate balance control with its significance on the risk of fall and impact on quality of life. The vestibular rehabilitation helps to correct inappropriate strategy of equilibrium or to accelerate a good but slow compensation phenomenon. Nowadays, new tools are more and more employed for the diagnosis of vestibular deficit (that may include various sources of impairment), the assessment of postural deficit, the control of the appropriate strategy as well to facilitate the efficiency of the rehabilitation especially in elderly people. PMID:24502905

  15. Postural tachycardia syndrome--current experience and concepts.

    PubMed

    Mathias, Christopher J; Low, David A; Iodice, Valeria; Owens, Andrew P; Kirbis, Mojca; Grahame, Rodney

    2012-01-01

    Postural tachycardia syndrome (PoTS) is a poorly understood but important cause of orthostatic intolerance resulting from cardiovascular autonomic dysfunction. PoTS is distinct from the syndromes of autonomic failure usually associated with orthostatic hypotension, such as pure autonomic failure and multiple system atrophy. Individuals affected by PoTS are mainly young (aged between 15 years and 40 years) and predominantly female. The symptoms--palpitations, dizziness and occasionally syncope--mainly occur when the patient is standing upright, and are often relieved by sitting or lying flat. Common stimuli in daily life, such as modest exertion, food ingestion and heat, are now recognized to be capable of exacerbating the symptoms. Onset of the syndrome can be linked to infection, trauma, surgery or stress. PoTS can be associated with various other disorders; in particular, joint hypermobility syndrome (also known as Ehlers-Danlos syndrome hypermobility type, formerly termed Ehlers-Danlos syndrome type III). This Review describes the characteristics and neuroepidemiology of PoTS, and outlines possible pathophysiological mechanisms of this syndrome, as well as current and investigational treatments. PMID:22143364

  16. Pituitary tumors. Current concepts in diagnosis and management.

    PubMed Central

    Aron, D C; Tyrrell, J B; Wilson, C B

    1995-01-01

    Diagnostic advances have resulted in earlier and more frequent recognition of pituitary tumors. Pituitary tumors cause problems owing to the hormones they secrete or the effects of an expanding sellar mass--hypopituitarism, visual field abnormalities, and neurologic deficits. Prolactin-secreting tumors (prolactinomas), which cause amenorrhea, galactorrhea, and hypogonadism, constitute the most common type of primary pituitary tumors, followed by growth hormone-secreting tumors, which cause acromegaly, and corticotropin-secreting tumors, which cause Cushing's syndrome. Hypersecretion of thyroid-stimulating hormone, the gonadotrophins, or alpha-subunits is unusual. Nonfunctional tumors currently represent only 10% of all clinically diagnosed pituitary adenomas, and some of these are alpha-subunit-secreting adenomas. Insights into the pathogenesis and biologic behavior of these usually benign tumors have been gained from genetic studies. We review some of the recent advances and salient features of the diagnosis and management of pituitary tumors, including biochemical and radiologic diagnosis, transsphenoidal surgery, radiation therapy, and medical therapy. Each type of lesion requires a comprehensive but individualized treatment approach, and regardless of the mode of therapy, careful follow-up is essential. Images PMID:7747500

  17. Current concepts for oil decontamination of crush injuries: a review

    PubMed Central

    2014-01-01

    This anecdotal, non-systematic review serves to explore the principles and methods of effective oil decontamination from cutaneous wounds, particularly crush injuries. The current expansion of the petroleum industry is necessary to meet increasing world demands for oil. Most stages of oil refining and applications involve significant injury risks, particularly for crush injuries that become contaminated with petroleum compounds. A literature review regarding a standard of care for effective cutaneous oil decontamination is lacking. Based on case reports, animal models, and in vitro studies identified in our expert opinion review, standard water and soap cleansing may not be an appropriate approach. Instead, the principle of ‘like dissolves like’ guides the use of lipophilic, petroleum-derived solvents to attract and subsequently dissolve the petroleum contaminant from the skin injury. Limitations include paucity of and dated literature sources regarding the topic as well as no models specifically addressing crush injuries. Our literature review found that oil decontamination of cutaneous injuries may be best accomplished with oil-based cleansers. Certainly, this topic has significant importance for the potentially carcinogenic petroleum compounds that pervade virtually every aspect of modern human life. PMID:24855490

  18. Bilateral cochlear implantation: current concepts, indications, and results.

    PubMed

    Basura, Gregory J; Eapen, Rose; Buchman, Craig A

    2009-12-01

    The optimal treatment for bilateral hearing loss continues to evolve as cochlear implant (CI) and hearing aid technologies advance, as does our understanding of the central auditory system. Ongoing discussions continue on the validity and feasibility of bilateral CI in terms of performance, justification of need, medical/surgical safety concerns, and economics. The purpose of this review article is to provide an update on the advantages and disadvantages of bilateral CI and to provide a discussion on timing (simultaneous vs. sequential), technology (bimodal vs. binaural) and feasibility. Binaural advantages are found in both adult and pediatric bilateral CI recipients, the greatest being the head shadow effect and improvements in localization and loudness summation. This theoretically offers an advantage over their unilateral implanted counterparts in terms of improved sound localization and enhanced speech perception under noisy conditions. Most investigators agree that bilateral stimulation during critical periods of development is paramount for optimizing auditory functioning in children. Currently, bilateral CI is widely accepted as a safe and effective means of bilateral auditory stimulation. PMID:19894280

  19. Current concepts in the treatment of adolescent femoroacetabular impingement.

    PubMed

    Ramachandran, Manoj; Azegami, Shin; Hosalkar, Harish S

    2013-03-01

    There is growing evidence that symptomatic femoroacetabular impingement leads to intra-articular damage and the development of early-onset osteoarthritis. Symptoms of femoroacetabular impingement often do not manifest until adulthood, but have been increasingly recognised in the paediatric and adolescent population. The surgical treatment of femoroacetabular impingement is aimed at restoring a more normal femoral head-neck offset in order to increase the clearance and prevent femoral abutment against the acetabular edge. Current methods include open and arthroscopic techniques. The latter has been combined with an open approach to gain access to the head-neck junction for osteochondroplasty. Proximal femoral and/or periacetabular osteotomies are used to treat femoroacetabular impingement associated with deformity secondary to childhood hip conditions, such as slipped capital femoral epiphysis and Legg-Calvé-Perthes disease. Some adolescents have severe degenerative joint disease at the time of presentation and may require arthroplasty or arthrodesis. The aim of this review is to identify the major trends and advancements in the management of femoroacetabular impingement in adolescents, including the outcome of studies of the surgical treatment modalities used. PMID:24432063

  20. LDL–cholesterol transport to the endoplasmic reticulum: current concepts

    PubMed Central

    Pfisterer, Simon G.; Peränen, Johan; Ikonen, Elina

    2016-01-01

    Purpose of review In this article, we summarize the present information related to the export of LDL-derived cholesterol from late endosomes, with a focus on Nieman-Pick disease, type C1 (NPC1) cholesterol delivery toward the endoplasmic reticulum (ER). We review data suggesting that several pathways may operate in parallel, including membrane transport routes and membrane contact sites (MCSs). Recent findings There is increasing appreciation that MCSs provide an important mechanism for intermembrane lipid transfer. In late endosome–ER contacts, three protein bridges involving oxysterol binding protein related protein (ORP)1L-vesicle associated membrane protein-associated protein (VAP), steroidogenic acute regulatory protein (StAR)D3-VAP and ORP5-NPC1 proteins have been reported. How much they contribute to the flux of LDL–cholesterol to the ER is currently open. Studies for lipid transfer via MCSs have been most advanced in Saccharomyces cerevisiae. Recently, a new sterol-binding protein family conserved between yeast and man was identified. Its members localize at MCSs and were named lipid transfer protein anchored at membrane contact sites (Lam) proteins. In yeast, sterol transfer between the ER and the yeast lysosome may be facilitated by a Lam protein. Summary Increasing insights into the role of MCSs in directional sterol delivery between membranes propose that they might provide routes for LDL–cholesterol transfer to the ER. Future work should reveal which specific contacts may operate for this, and how they are controlled by cholesterol homeostatic machineries. PMID:27054443

  1. Current concepts on osteonecrosis of the femoral head.

    PubMed

    Moya-Angeler, Joaquin; Gianakos, Arianna L; Villa, Jordan C; Ni, Amelia; Lane, Joseph M

    2015-09-18

    It is estimated that 20000 to 30000 new patients are diagnosed with osteonecrosis annually accounting for approximately 10% of the 250000 total hip arthroplasties done annually in the United States. The lack of level 1 evidence in the literature makes it difficult to identify optimal treatment protocols to manage patients with pre-collapse avascular necrosis of the femoral head, and early intervention prior to collapse is critical to successful outcomes in joint preserving procedures. There have been a variety of traumatic and atraumatic factors that have been identified as risk factors for osteonecrosis, but the etiology and pathogenesis still remains unclear. Current osteonecrosis diagnosis is dependent upon plain anteroposterior and frog-leg lateral radiographs of the hip, followed by magnetic resonance imaging (MRI). Generally, the first radiographic changes seen by radiograph will be cystic and sclerotic changes in the femoral head. Although the diagnosis may be made by radiograph, plain radiographs are generally insufficient for early diagnosis, therefore MRI is considered the most accurate benchmark. Treatment options include pharmacologic agents such as bisphosphonates and statins, biophysical treatments, as well as joint-preserving and joint-replacing surgeries. the surgical treatment of osteonecrosis of the femoral head can be divided into two major branches: femoral head sparing procedures (FHSP) and femoral head replacement procedures (FHRP). In general, FHSP are indicated at pre-collapse stages with minimal symptoms whereas FHRP are preferred at post-collapse symptomatic stages. It is difficult to know whether any treatment modality changes the natural history of core decompression since the true natural history of core decompression has not been delineated. PMID:26396935

  2. Cutaneous wound healing: Current concepts and advances in wound care

    PubMed Central

    Klein, Kenneth C; Guha, Somes Chandra

    2014-01-01

    A non-healing wound is defined as showing no measurable signs of healing for at least 30 consecutive treatments with standard wound care.[1] It is a snapshot of a patient's total health as well as the ongoing battle between noxious factors and the restoration of optimal macro and micro circulation, oxygenation and nutrition. In practice, standard therapies for non-healing cutaneous wounds include application of appropriate dressings, periodic debridement and eliminating causative factors.[2] The vast majority of wounds would heal by such approach with variable degrees of residual morbidity, disability and even mortality. Globally, beyond the above therapies, newer tools of healing are selectively accessible to caregivers, for various logistical or financial reasons. Our review will focus on the use of hyperbaric oxygen therapy (HBOT), as used at our institution (CAMC), and some other modalities that are relatively accessible to patients. HBOT is a relatively safe and technologically simpler way to deliver care worldwide. However, the expense for including HBOT as standard of care for recognized indications per UHMS(Undersea and Hyperbaric Medical Society) may vary widely from country to country and payment system.[3] In the USA, CMS (Centers for Medicare and Medicaid Services) approved indications for HBOT vary from that of the UHMS for logistical reasons.[1] We shall also briefly look into other newer therapies per current clinical usage and general acceptance by the medical community. Admittedly, there would be other novel tools with variable success in wound healing worldwide, but it would be difficult to include all in this treatise. PMID:25593414

  3. Current concepts on osteonecrosis of the femoral head

    PubMed Central

    Moya-Angeler, Joaquin; Gianakos, Arianna L; Villa, Jordan C; Ni, Amelia; Lane, Joseph M

    2015-01-01

    It is estimated that 20000 to 30000 new patients are diagnosed with osteonecrosis annually accounting for approximately 10% of the 250000 total hip arthroplasties done annually in the United States. The lack of level 1 evidence in the literature makes it difficult to identify optimal treatment protocols to manage patients with pre-collapse avascular necrosis of the femoral head, and early intervention prior to collapse is critical to successful outcomes in joint preserving procedures. There have been a variety of traumatic and atraumatic factors that have been identified as risk factors for osteonecrosis, but the etiology and pathogenesis still remains unclear. Current osteonecrosis diagnosis is dependent upon plain anteroposterior and frog-leg lateral radiographs of the hip, followed by magnetic resonance imaging (MRI). Generally, the first radiographic changes seen by radiograph will be cystic and sclerotic changes in the femoral head. Although the diagnosis may be made by radiograph, plain radiographs are generally insufficient for early diagnosis, therefore MRI is considered the most accurate benchmark. Treatment options include pharmacologic agents such as bisphosphonates and statins, biophysical treatments, as well as joint-preserving and joint-replacing surgeries. the surgical treatment of osteonecrosis of the femoral head can be divided into two major branches: femoral head sparing procedures (FHSP) and femoral head replacement procedures (FHRP). In general, FHSP are indicated at pre-collapse stages with minimal symptoms whereas FHRP are preferred at post-collapse symptomatic stages. It is difficult to know whether any treatment modality changes the natural history of core decompression since the true natural history of core decompression has not been delineated. PMID:26396935

  4. Concept Development in Learning Physics: The Case of Electric Current and Voltage Revisited

    NASA Astrophysics Data System (ADS)

    Koponen, Ismo T.; Huttunen, Laura

    2013-09-01

    In learning conceptual knowledge in physics, a common problem is the development and differentiation of concepts in the learning process. An important part of this development process is the re-organisation or re-structuring process in which students' conceptual knowledge and concepts change. This study proposes a new view of concept development with explicit attention given to concept development from the level of knowledge-as-pieces to the level of knowledge-as-theory. The proposed new picture is based on the view that concepts are complex constructs essentially embedded in a larger system of knowledge. Three closely connected aspects require our attention: (1) conceptions of concepts, (2) conceptions of knowledge systems, and finally, (3) conceptions of the process of change. The potential advantages of this prospective are demonstrated through the re-analysis of the concept development in the well-known case of electric current and voltage. The results show that in the concept development process, both causal knowledge and coherence of the knowledge system play crucial roles. Finally, the study points out how the theoretical position proposed here directly impacts conceptions of learning and instruction as well as what solutions are sought for problems in learning—or even what is considered a problem or success in learning.

  5. University of Swaziland Bachelor of Education Students' Conception of Current Ideas about Writing Instruction

    ERIC Educational Resources Information Center

    Jabulani, S.

    2009-01-01

    The present study investigated University of Swaziland Bachelor of Education degree (B.Ed) (Primary and secondary) students' conception of the current trends in writing instruction. The extent of their conception of these trends was examined on only four selected writing ideas namely collaborative writing, the process approach to writing, teacher…

  6. Current Concepts

    PubMed Central

    Wolfstadt, Jesse I.; Cole, Brian J.; Ogilvie-Harris, Darrell J.; Viswanathan, Sowmya; Chahal, Jaskarndip

    2015-01-01

    Context: The number of adults with osteoarthritis in the United States is expected to nearly double from 21.4 million in 2005 to 41.1 million by 2030. As a result, medical costs and associated comorbidity will exponentially increase in the coming decades. In the past decade, mesenchymal stem cells (MSCs) have emerged as a novel treatment for degenerative joint disease. Evidence Acquisition: PubMed (from 1990 to 2013) was searched to identify relevant studies. Reference lists of included studies were also reviewed. Study Design: Clinical review. Level of Evidence: Level 3. Results: We identified 9 animal and 7 human studies investigating the use of MSCs in the treatment of osteoarthritis, with varying levels of support for this therapy. Conclusion: While MSCs have shown potential for improving function and decreasing inflammation in animal studies, translation to patients is still in question. There is a great deal of heterogeneity in treatment methods. Standardizing the manufacturing and characterization of MSCs will allow for better comparisons. PMID:25553211

  7. COMMITTEES: Committees

    NASA Astrophysics Data System (ADS)

    2010-01-01

    TAUP STEERING COMMITTEE F T Avignone, University of South Carolina B C Barish, CALTECH E Bellotti, University of Milano, INFN J Bernabeu, University of Valencia A Bottino (Chair), University of Torino, INFN N Fornengo, University of Torino, INFN T Kajita, ICRR University of Tokyo C W Kim, Johns Hopkins University, KIAS V Matveev, INR Moscow J Morales, University of Zaragoza G Raffelt, MPI Munchen D Sinclair, University of Carleton M Spiro, IN2P3 TAUP 2009 INTERNATIONAL ADVISORY COMMITTEE J J Aubert, CNRS Marseille M Baldo-Ceolin, University of Padova, INFN G Bellini, University of Milano, INFN L Bergstrom, University of Stockholm R Bernabei, University of Roma Tor Vergata, INFN A Bettini, University of Padova, INFN, LSC S Bilenky, JINR Dubna D O Caldwell, UCSB J Cronin, University of Chicago A Dar, Technion Haifa G Domogatsky, INR Moscow J Ellis, CERN E Fernandez, IFAE Barcelona E Fiorini, University of Milano, INFN T Gaisser, University of Delaware G Gelmini, UCLA G Gerbier, CEA Saclay A Giazotto, INFN Pisa F Halzen, University of Wisconsin W Haxton, University of Washington T Kirsten MPI Heidelberg L Maiani, University of Roma La Sapienza, INFN A McDonald, Queen's University K Nakamura, KEK R Petronzio, INFN, University of Roma Tor Vergata L Resvanis, University of Athens F Ronga INFN, LNF C Rubbia INFN, LNGS A Smirnov, ICTP Trieste C Spiering, DESY N Spooner, University of Sheffield A Suzuki, KEK S Ting MIT, CERN M S Turner, FNAL, University of Chicago J W F Valle, IFIC Valencia D Vignaud, APC Paris G Zatsepin, INR Moscow TAUP 2009 ORGANIZING COMMITTEE R Aloisio, LNGS R Antolini, LNGS F Arneodo, LNGS Z Berezhiani, University of L'Aquila, INFN V Berezinsky, LNGS R Cerulli, LNGS E Coccia [Chair], LNGS/INFN, U of Roma Tor Vergata N D'Ambrosio, LNGS N Fornengo, University of Torino, INFN M Laubenstein, LNGS O Palamara, LNGS L Pandola [Scientific Secretary], LNGS

  8. Current concepts of Harm-Benefit Analysis of Animal Experiments - Report from the AALAS-FELASA Working Group on Harm-Benefit Analysis - Part 1.

    PubMed

    Brønstad, Aurora; Newcomer, Christian E; Decelle, Thierry; Everitt, Jeffrey I; Guillen, Javier; Laber, Kathy

    2016-06-01

    International regulations and guidelines strongly suggest that the use of animal models in scientific research should be initiated only after the authority responsible for the review of animal studies has concluded a well-thought-out harm-benefit analysis (HBA) and deemed the project to be appropriate. Although the process for conducting HBAs may not be new, the relevant factors and algorithms used in conducting them during the review process are deemed to be poorly defined or lacking by committees in many institutions. This paper presents the current concept of HBAs based on a literature review. References on cost or risk benefit from clinical trials and other industries are also included. Several approaches to HBA have been discovered including algorithms, graphic presentations and generic processes. The aim of this study is to better aid and harmonize understanding of the concepts of 'harm', 'benefit' and 'harm-benefit analysis'. PMID:27188275

  9. Historical Aspects of the Concept of "Compulsory Education": Rethinking the Rhetoric of Debates in Current Reform

    ERIC Educational Resources Information Center

    Sato, Manabu

    2008-01-01

    Current Educational Reform in Japan is oddly captured with confused conceptions of "compulsory education." The Ministry of Education blankets such connotations of it, as a national budget system, mandated school curriculum, responsible partnership of school with community and accountabilities of local school board, in defense of vested national…

  10. The Role of Current Techniques and Concepts in Peripheral Nerve Repair.

    PubMed

    Houschyar, K S; Momeni, A; Pyles, M N; Cha, J Y; Maan, Z N; Duscher, D; Jew, O S; Siemers, F; van Schoonhoven, J

    2016-01-01

    Patients with peripheral nerve injuries, especially severe injury, often face poor nerve regeneration and incomplete functional recovery, even after surgical nerve repair. This review summarizes treatment options of peripheral nerve injuries with current techniques and concepts and reviews developments in research and clinical application of these therapies. PMID:26904282

  11. The Role of Current Techniques and Concepts in Peripheral Nerve Repair

    PubMed Central

    Houschyar, K. S.; Momeni, A.; Pyles, M. N.; Cha, J. Y.; Maan, Z. N.; Duscher, D.; Jew, O. S.; Siemers, F.; van Schoonhoven, J.

    2016-01-01

    Patients with peripheral nerve injuries, especially severe injury, often face poor nerve regeneration and incomplete functional recovery, even after surgical nerve repair. This review summarizes treatment options of peripheral nerve injuries with current techniques and concepts and reviews developments in research and clinical application of these therapies. PMID:26904282

  12. Current concepts in Alzheimer’s Disease: molecules, models and translational perspectives

    PubMed Central

    2013-01-01

    The field of neuroscience research in AD has been evolving rapidly over the last few years, and has pinpointed a number of candidate targets for molecules with crucial role in the pathophysiology of AD. Recent developments have furthermore enabled new ways of modeling the disease, while an increasing number of preclinically validated targets is currently being taken one step forward and tested in clinical trials. These recent developments are reviewed in the current Special Issues Series on “Current concepts in Alzheimer's disease research: molecules, models and translational perspectives” in a number of state-of-the-art manuscripts. PMID:24148188

  13. Historical and Current Concepts of Fibrillogenesis and In vivo Amyloidogenesis: Implications of Amyloid Tissue Targeting

    PubMed Central

    Kisilevsky, Robert; Raimondi, Sara; Bellotti, Vittorio

    2016-01-01

    Historical and current concepts of in vitro fibrillogenesis are considered in the light of disorders in which amyloid is deposited at anatomic sites remote from the site of synthesis of the corresponding precursor protein. These clinical conditions set constraints on the interpretation of information derived from in vitro fibrillogenesis studies. They suggest that in addition to kinetic and thermodynamic factors identified in vitro, fibrillogenesis in vivo is determined by site specific factors most of which have yet to be identified. PMID:27243018

  14. Historical and Current Concepts of Fibrillogenesis and In vivo Amyloidogenesis: Implications of Amyloid Tissue Targeting.

    PubMed

    Kisilevsky, Robert; Raimondi, Sara; Bellotti, Vittorio

    2016-01-01

    Historical and current concepts of in vitro fibrillogenesis are considered in the light of disorders in which amyloid is deposited at anatomic sites remote from the site of synthesis of the corresponding precursor protein. These clinical conditions set constraints on the interpretation of information derived from in vitro fibrillogenesis studies. They suggest that in addition to kinetic and thermodynamic factors identified in vitro, fibrillogenesis in vivo is determined by site specific factors most of which have yet to be identified. PMID:27243018

  15. Immunotherapy for non-small cell lung cancer: current concepts and clinical trials.

    PubMed

    Mayor, Marissa; Yang, Neng; Sterman, Daniel; Jones, David R; Adusumilli, Prasad S

    2016-05-01

    Recent successes in immunotherapeutic strategies are being investigated to combat cancers that have less than ideal responses to standard of care treatment, such as non-small-cell lung cancer. In this paper, we summarize concepts and the current status of immunotherapy for non-small cell lung cancer, including salient features of the major categories of immunotherapy-monoclonal antibody therapy, immune checkpoint blockade, immunotoxins, anticancer vaccines, and adoptive cell therapy. PMID:26516195

  16. Leading-edge vortex research: Some nonplanar concepts and current challenges

    NASA Technical Reports Server (NTRS)

    Campbell, J. F.; Osborn, R. F.

    1986-01-01

    Some background information is provided for the Vortex Flow Aerodynamics Conference and that current slender wing airplanes do not use variable leading edge geometry to improve transonic drag polar is shown. Highlights of some of the initial studies combining wing camber, or flaps, with vortex flow are presented. Current vortex flap studies were reviewed to show that there is a large subsonic data base and that transonic and supersonic generic studies have begun. There is a need for validated flow field solvers to calculate vortex/shock interactions at transonic and supersonic speeds. Many important research opportunities exist for fundamental vortex flow investigations and for designing advanced fighter concepts.

  17. Snapping scapula syndrome: current concepts review in conservative and surgical treatment

    PubMed Central

    Merolla, Giovanni; Cerciello, Simone; Paladini, Paolo; Porcellini, Giuseppe

    2013-01-01

    Summary The snapping scapula, also called “washboard syndrome” is a controversial condition attributed to bony and soft tissue abnormalities. The syndrome was understimated for long time and often associated only with specific osseous abnormalities. The nodal point in the overview of the syndrome is that crepitus associated with symptomatic bursitis may be physiologic and is not uncommon a clinical presentation without any form of crepitus or craquement. In the current rewiew we analyzed the current concepts in the conservative and surgical management of snapping scapula syndrome, preceded by a description of scapular anatomy, pathophysiology of scapulothoracic articulation and clinical features of snapping scapula. PMID:23888290

  18. Occlusion in implant dentistry. A review of the literature of prosthetic determinants and current concepts.

    PubMed

    Gross, M D

    2008-06-01

    Today the clinician is faced with widely varying concepts regarding the number, location, distribution and inclination of implants required to support the functional and parafunctional demands of occlusal loading. Primary clinical dilemmas of planning for maximal or minimal numbers of implants, their axial inclination, lengths and required volume and quality of supporting bone remain largely unanswered by adequate clinical outcome research. Planning and executing optimal occlusion schemes is an integral part of implant supported restorations. In its wider sense this includes considerations of multiple inter-relating factors of ensuring adequate bone support, implant location number, length, distribution and inclination, splinting, vertical dimension aesthetics, static and dynamic occlusal schemes and more. Current concepts and research on occlusal loading and overloading are reviewed together with clinical outcome and biomechanical studies and their clinical relevance discussed. A comparison between teeth and implants regarding their proprioceptive properties and mechanisms of supporting functional and parafunctional loading is made and clinical applications made regarding current concepts in restoring the partially edentulous dentition. The relevance of occlusal traumatism and fatigue microdamage alone or in combination with periodontal or peri-implant inflammation is reviewed and applied to clinical considerations regarding splinting of adjacent implants and teeth, posterior support and eccentric guidance schemes. Occlusal restoration of the natural dentition has classically been divided into considerations of planning for sufficient posterior support, occlusal vertical dimension and eccentric guidance to provide comfort and aesthetics. Mutual protection and anterior disclusion have come to be considered as acceptable therapeutic modalities. These concepts have been transferred to the restoration of implant-supported restoration largely by default. However, in

  19. Fault current limiter based on high temperature superconductors - different concepts, test results, simulations, applications

    NASA Astrophysics Data System (ADS)

    Paul, W.; Chen, M.; Lakner, M.; Rhyner, J.; Braun, D.; Lanz, W.

    2001-05-01

    All electric equipment in a power system has to be designed to withstand the mechanical and thermal stresses of potential short-circuit currents. Any reduction of these currents can lead to significant cost savings. Among all current limiting devices, superconducting fault current limiters (SCFCL) offer ideal performance: in normal operation the SCFCL is in its superconducting state and has negligible impedance, in the event of a fault, the transition into the normal conducting state passively limits the current. Different high temperature superconductors (HTS) materials, like YBCO films, Bi2223 wires or Bi2212 bulk are under development for the use in SCFCL. Due to the brittle nature of HTS and the hot-spot problem, most HTS components for current limitation are composites comprising the HTS, a mechanical substrate or support, and an electrical bypass. The performance of the composites largely depend on the parameters: critical current density, I- V characteristics, thermal conductivity, thermal mass, and electrical bypass. Mainly two different concepts of SCFCL, namely, the “resistive” and the “shielded core” concept have been pursued in the past. In 1996 the first ever SCFCL was installed in a hydro-power plant. The device had a rated power of 1.2 MVA, it was of the “shielded core” type and was based on tubes of Bi2212-bulk material. The feasibility of the technology has been demonstrated in a one-year-endurance test. Recently more compact “resistive” SCFCLs based on the same Bi2212-bulk material have been developed. Theoretical models for the SCFCL show good agreement with experimental data. They are used to study the influence of SCFCLs in power systems in order to evaluate technical and economical advantages.

  20. Dhat syndrome: Evolution of concept, current understanding, and need of an integrated approach

    PubMed Central

    Kar, Sujita Kumar; Sarkar, Siddharth

    2015-01-01

    Dhat syndrome has often been construed as a culture-bound sexual neurosis of the Indian subcontinent. Symptoms similar to that of Dhat syndrome has been described in other cultures across different time periods. The present paper looks at the evolution of the concept of Dhat syndrome in India. The review also takes an overview of the current understanding of this syndrome in terms of nosological status as a distinct entity and its “culture-bound” status. The narrative finally attempts to discuss the integrated approach for the treatment of this disorder. PMID:26538854

  1. Chemotherapy for Good-Risk Nonseminomatous Germ Cell Tumors: Current Concepts and Controversies.

    PubMed

    In, Gino; Dorff, Tanya

    2015-08-01

    The rate of diagnosis of germ cell tumors has remained fairly constant. By the International Germ Cell Cancer Consensus Classification, roughly 60% of all metastatic germ cell tumors are classified as good risk. This group of patients has an excellent prognosis, with greater than 90% expectation of cure. Treatment standards have not changed much in recent years. This article focuses on key concepts in the development of the currently accepted first-line regimens and addresses some evolving areas of interest, if not controversy. PMID:26216822

  2. Overview of research committees status in Egypt: challenges aspirations and current situation.

    PubMed

    Younis, Inas M

    2015-01-01

    We analyze the current situation of clinical research regulatory overview in Egypt to acknowledge the strengths and define the frailties, thus inciting relevant stakeholders to find solutions and bring about change. Uniquely, Egypt possesses favorable factors ideal for a dynamic clinical research market: accessible subjects, a mosaic panel of research areas, and incomparably low cost. Yet, with a majority of participant population needy and illiterate, and in absence of robust legislative constraints, concerns are increasingly being raised, whether ethical pitfalls of clinical research are adequately addressed, and whether the safety and the rights of subjects are constantly prioritized and maintained. In a descriptive explicit literature review, we identify, review, and interpret findings from recent publications backed up by existing data derived from current declared regulations and personal experience in the field. Inferences were made that despite an affiliation to international referential guidelines, real settings implementations are far from being consistent or adherently conforming. Focal attempts at reform are observed, but without joint stakeholders' support, those attempts are doomed never to get off the ground. PMID:25897767

  3. Parametric Weight Comparison of Current and Proposed Thermal Protection System (TPS) Concepts

    NASA Technical Reports Server (NTRS)

    Myers, David E.; Martin, Carl J.; Blosser, Max L.

    1999-01-01

    A parametric weight assessment of advanced metallic panel, ceramic blanket, and ceramic tile thermal protection systems (TPS) was conducted using an implicit, one-dimensional (1 -D) thermal finite element sizing code. This sizing code contained models to ac- count for coatings, fasteners, adhesives, and strain isolation pads. Atmospheric entry heating profiles for two vehicles, the Access to Space (ATS) rocket-powered single-stage-to-orbit (SSTO) vehicle and a proposed Reusable Launch Vehicle (RLV), were used to ensure that the trends were not unique to a particular trajectory. Eight TPS concepts were compared for a range of applied heat loads and substructural heat capacities to identify general trends. This study found the blanket TPS concepts have the lightest weights over the majority of their applicable ranges, and current technology ceramic tiles and metallic TPS concepts have similar weights. A proposed, state-of-the-art metallic system which uses a higher temperature alloy and efficient multilayer insulation was predicted to be significantly lighter than the ceramic tile systems and approaches blanket TPS weights for higher integrated heat loads.

  4. The ‘structure-function’ relationship in glaucoma – past thinking and current concepts

    PubMed Central

    Malik, Rizwan; Swanson, William H.; Garway-Heath, David F

    2013-01-01

    An understanding of the relationship between functional and structural measures in primary open angle glaucoma (POAG) is necessary for both grading the severity of disease and for understanding the natural history of the condition. This article outlines the current evidence for the nature of this relationship, and highlights the current mathematical models linking structure and function. Large clinical trials demonstrate that both structural and functional change are apparent in advanced stages of disease, while, at an individual level, detectable structural abnormality may precede functional abnormality in some patients whilst the converse in true in other patients. Although the exact nature of the ‘structure-function’ relationship in POAG is still the topic of scientific debate and the subject of continuing research, this article aims to provide the clinician with an understanding of the past concepts and contemporary thinking in relation to the structure-function relationship in POAG. PMID:22339936

  5. Current Concepts on Diabetic Nephropathy and 2014 Data on Diabetic Renal Failure in Texas.

    PubMed

    Pazmino, Patricio A

    2016-01-01

    Diabetic nephropathy (DN) is the leading cause of end-stage renal disease (ESRD) in the United States and other developed countries. In 1982, diabetes accounted for 27% of patients with ESRD in the United States and rose to 36% by 1992 and to 47% in 2012. Currently, the number of prevalent cases of ESRD in the country (dialysis and transplant) exceeds more than 636,900. Primary care practitioners (PCP) provide more than 90% of the diabetic care and are well-positioned to identify, prevent, and treat initially DN. PCPs should identify DN with a urine microalbumin test, obtain a serum creatinine and glomerular filtration rate, monitor hemoglobin A1c, and treat hypertension and dyslipidemia according to current guidelines. This article reviews basic concepts and goals for DN as well as the 2014 data for diabetic renal failure in the most populous counties in Texas. The Texas counties bordering Mexico show an excessive prevalence of diabetic renal failure. PMID:27441426

  6. CURRENT ISSUES IN LANGUAGE TEACHING. REPORTS OF THE WORKING COMMITTEES OF THE NORTHEAST CONFERENCE ON THE TEACHING OF FOREIGN LANGUAGES, 1962.

    ERIC Educational Resources Information Center

    BOTTIGLIA, WILLIAM F.

    INCLUDED IN THIS VOLUME ARE THE REPORTS ON CURRENT ISSUES IN LANGUAGE TEACHING DEVELOPED BY THE WORKING COMMITTEES OF THE 1962 NORTHEAST CONFERENCE ON THE TEACHING OF FOREIGN LANGUAGES. DISCUSSIONS OF THE NATURE AND IMPLICATIONS OF LINGUISTICS, ITS SIGNIFICANCE FOR LANGUAGE TEACHING, AND ITS APPLICATION TO GRAMMAR, DRILLS, TEXTBOOKS, AND LANGUAGE…

  7. Citizens Advisory Committees. Public Participation Increases; Guides Change in American Education. Current Trends in School Policies & Programs.

    ERIC Educational Resources Information Center

    Oldham, Neild B.

    This report is designed to provide know-how, coping skills, and understanding to school personnel interested in learning about and/or setting up citizen advisory councils in their districts. The report describes the anatomy of a typical advisory committee, suggests how to get one started, what committees do and should not do, and how committees…

  8. "The Project Cannot Be Approved in Its Current Form": Feminist Visual Research Meets the Human Research Ethics Committee

    ERIC Educational Resources Information Center

    Pitt, Penelope

    2014-01-01

    This article reflects on a university human research ethics committee's unease regarding a feminist visual pilot study within the field of education. The small exploratory study proposed to explore a migrant mother's production of her son's identity through her family photograph collection. The committee requested substantial…

  9. Overview and Current Status of Analyses of Potential LEU Design Concepts for TREAT

    SciTech Connect

    Connaway, H. M.; Kontogeorgakos, D. C.; Papadias, D. D.; Wright, A. E.

    2015-10-01

    Neutronic and thermal-hydraulic analyses have been performed to evaluate the performance of different low-enriched uranium (LEU) fuel design concepts for the conversion of the Transient Reactor Test Facility (TREAT) from its current high-enriched uranium (HEU) fuel. TREAT is an experimental reactor developed to generate high neutron flux transients for the testing of nuclear fuels. The goal of this work was to identify an LEU design which can maintain the performance of the existing HEU core while continuing to operate safely. A wide variety of design options were considered, with a focus on minimizing peak fuel temperatures and optimizing the power coupling between the TREAT core and test samples. Designs were also evaluated to ensure that they provide sufficient reactivity and shutdown margin for each control rod bank. Analyses were performed using the core loading and experiment configuration of historic M8 Power Calibration experiments (M8CAL). The Monte Carlo code MCNP was utilized for steady-state analyses, and transient calculations were performed with the point kinetics code TREKIN. Thermal analyses were performed with the COMSOL multi-physics code. Using the results of this study, a new LEU Baseline design concept is being established, which will be evaluated in detail in a future report.

  10. Stereotactic radiosurgery of glomus jugulare tumors: current concepts, recent advances and future perspectives.

    PubMed

    Sager, Omer; Dincoglan, Ferrat; Beyzadeoglu, Murat

    2015-01-01

    Stereotactic radiosurgery (SRS), a very highly focused form of therapeutic irradiation, has been widely recognized as a viable treatment option in the management of intracranial pathologies including benign tumors, malign tumors, vascular malformations and functional disorders. The applications of SRS are continuously expanding thanks to the ever-increasing advances and corresponding improvements in neuroimaging, radiation treatment techniques, equipment, treatment planning and delivery systems. In the context of glomus jugulare tumors (GJT), SRS is being more increasingly used both as the upfront management modality or as a complementary or salvage treatment option. As its safety and efficacy is being evident with compiling data from studies with longer follow-up durations, SRS appears to take the lead in the management of most patients with GJT. Herein, we address current concepts, recent advances and future perspectives in SRS of GJT in light of the literature. PMID:25768334

  11. Comprehensive management of pressure ulcers in spinal cord injury: Current concepts and future trends

    PubMed Central

    Kruger, Erwin A.; Pires, Marilyn; Ngann, Yvette; Sterling, Michelle; Rubayi, Salah

    2013-01-01

    Pressure ulcers in spinal cord injury represent a challenging problem for patients, their caregivers, and their physicians. They often lead to recurrent hospitalizations, multiple surgeries, and potentially devastating complications. They present a significant cost to the healthcare system, they require a multidisciplinary team approach to manage well, and outcomes directly depend on patients' education, prevention, and compliance with conservative and surgical protocols. With so many factors involved in the successful treatment of pressure ulcers, an update on their comprehensive management in spinal cord injury is warranted. Current concepts of local wound care, surgical options, as well as future trends from the latest wound healing research are reviewed to aid medical professionals in treating patients with this difficult problem. PMID:24090179

  12. Comprehensive management of pressure ulcers in spinal cord injury: current concepts and future trends.

    PubMed

    Kruger, Erwin A; Pires, Marilyn; Ngann, Yvette; Sterling, Michelle; Rubayi, Salah

    2013-11-01

    Pressure ulcers in spinal cord injury represent a challenging problem for patients, their caregivers, and their physicians. They often lead to recurrent hospitalizations, multiple surgeries, and potentially devastating complications. They present a significant cost to the healthcare system, they require a multidisciplinary team approach to manage well, and outcomes directly depend on patients' education, prevention, and compliance with conservative and surgical protocols. With so many factors involved in the successful treatment of pressure ulcers, an update on their comprehensive management in spinal cord injury is warranted. Current concepts of local wound care, surgical options, as well as future trends from the latest wound healing research are reviewed to aid medical professionals in treating patients with this difficult problem. PMID:24090179

  13. Lumbar Degenerative Disc Disease: Current and Future Concepts of Diagnosis and Management

    PubMed Central

    Taher, Fadi; Essig, David; Lebl, Darren R.; Hughes, Alexander P.; Sama, Andrew A.; Cammisa, Frank P.; Girardi, Federico P.

    2012-01-01

    Low back pain as a result of degenerative disc disease imparts a large socioeconomic impact on the health care system. Traditional concepts for treatment of lumbar disc degeneration have aimed at symptomatic relief by limiting motion in the lumbar spine, but novel treatment strategies involving stem cells, growth factors, and gene therapy have the theoretical potential to prevent, slow, or even reverse disc degeneration. Understanding the pathophysiological basis of disc degeneration is essential for the development of treatment strategies that target the underlying mechanisms of disc degeneration rather than the downstream symptom of pain. Such strategies ideally aim to induce disc regeneration or to replace the degenerated disc. However, at present, treatment options for degenerative disc disease remain suboptimal, and development and outcomes of novel treatment options currently have to be considered unpredictable. PMID:22567411

  14. Pediatric craniofacial surgery for craniosynostosis: Our experience and current concepts: Part -1

    PubMed Central

    Anantheswar, Y. N.; Venkataramana, N. K.

    2009-01-01

    Craniostenosis is a disease characterized by untimely fusion of cranial sutures resulting in a variety of craniofacial deformities and neurological sequelae due to alteration in cranial volume and restriction of brain growth. This involves vault sutures predominantly, but cranial base is not immune. Association with a variety of syndromes makes the management decision complex. These children need careful evaluation by multiple specialists to have strategic treatment options. Parental counseling is an important and integral part of the treatment. Recent advancements in the surgical techniques and concept of team approach have significantly enhanced the safety and outcome of these children. We had an opportunity of treating 57 children with craniostenosis in the last 15 years at our craniofacial service. Out of them, 40 were nonsyndromic and 17 were syndromic variety. We describe our successful results along with individualized operative technical modifications adopted based on the current understanding of the disease. PMID:21887189

  15. Leishmaniases of the New World: current concepts and implications for future research.

    PubMed Central

    Grimaldi, G; Tesh, R B

    1993-01-01

    Recent epidemiologic studies indicate that leishmaniasis in the Americas is far more abundant and of greater public health importance than was previously recognized. The disease in the New World is caused by a number of different parasite species that are capable of producing a wide variety of clinical manifestations. The outcome of leishmanial infection in humans is largely dependent on the immune responsiveness of the host and the virulence of the infecting parasite strain. This article reviews current concepts of the clinical forms, immunology, pathology, laboratory diagnosis, and treatment of the disease as well as aspects of its epidemiology and control. Recommendations for future research on the disease and its control are made. PMID:8358705

  16. [Current surgical and adjuvant therapy concepts of malignant tumors of the facial skin and the pinna].

    PubMed

    Kolk, A; Wermker, K; Bier, H; Götz, C; Eckert, A W

    2015-02-01

    Malignant tumors of the skin had been a rare entity 2 decades ago. Today they are spread rapidly worldwide. Malignant neoplasms of the skin, the largest human organ, may occur from all structures and layers. While previously skin cancer -occurred mainly after the age of 60, the incidence increases now in younger ages. Strong sunburns in the childhood and before the age of 20 are important risk factors for the development of malignancies of the skin. An increased exposure to UV rays is found especially in the facial skin, where basal cell carcinoma, squamous cell carcinoma, malignant melanoma and Merkel cell carcinomas are the most common malignancies. Early diagnosis of malignancies and therapy-oriented mostly surgical approaches are crucial for the prognosis of all skin cancers. Therefore under the aspect of the increasing incidence these topics will be pointed out according to the latest findings including current multimodal therapy concepts and future treatment options. PMID:25658862

  17. Advisory Committees.

    ERIC Educational Resources Information Center

    ERIC Clearinghouse on Educational Management, Eugene, OR.

    This chapter of "The Best of the Best of ERIC," Volume 2, contains 14 summaries of documents and journal articles on citizen advisory committees, all of which are indexed in either "Resources in Education" or "Current Index to Journals in Education." The materials included deal with various aspects of this topic, such as the role of the school…

  18. The various types of neurogenic bladder dysfunction: an update of current therapeutic concepts.

    PubMed

    Madersbacher, H

    1990-05-01

    Increased experience with treatment strategies developed during the last 10 years in the field of neurourology justifies an update of current therapeutic concepts. Based on a rather simple, but clinically useful, classification of detrusor-sphincter dysfunction the therapeutic concepts now available for four prototypes of detrusor-sphincter dysfunction are discussed. (1) For the combination of a hyperreflexive detrusor with a hyperreflexive (spastic) sphincter, characteristic for the reflex- and the uninhibited neuropathic bladder, detrusor-sphincter dyssynergia (DSD) is still the greatest problem, and transurethral sphincterotomy is the method of choice if this situation cannot otherwise be managed. One concept is to convert detrusor hyperreflexia into hyporeflexia by adequate pharmacotherapy, which is nowadays available, and to assist or to accomplish bladder emptying by clean intermittent (self-) catheterisation (CIC) with the advantage of dry intervals in between. Japanese colleagues recommend bladder overdistension during the spinal shock phase to achieve detrusor hyporeflexia, but this procedure is rather decisive at an early stage of the disability, leaving the detrusor no chance for further rehabilitation. Another possibility is rhizotomy of the sacral posterior roots to eliminate detrusor hyperreflexia, and the simultaneous implantation of a sacral anterior root stimulator (Brindley) to achieve electrically induced micturition. From our personal experience with 12 patients this concept is ideal for female patients with unbalanced reflex bladder and otherwise uncontrollable reflex incontinence. (2) The combination of a weak detrusor with a spastic sphincter is a clear indication for CIC, as the bladder is emptied regularly, and due to the spastic sphincter, the patient stays continent as long as controlled fluid intake prohibits overflow incontinence. The implantation of an anterior sacral root stimulator is an alternative approach provided that at least

  19. Turbulent boundary layers under irregular waves and currents: Experiments and the equivalent-wave concept

    NASA Astrophysics Data System (ADS)

    Yuan, Jing

    2016-04-01

    A full-scale experimental study of turbulent boundary layer flows under irregular waves and currents is conducted with the primary objective to investigate the equivalent-wave concept by Madsen (1994). Irregular oscillatory flows following the bottom-velocity spectrum under realistic surface irregular waves are produced over two fixed rough bottoms in an oscillatory water tunnel, and flow velocities are measured using a Particle Image Velocimetry. The root-mean-square (RMS) value and representative phase lead of wave velocities have vertical variations very similar to those of the first-harmonic velocity of periodic wave boundary layers, e.g., the RMS wave velocity follows a logarithmic distribution controlled by the physical bottom roughness in the very near-bottom region. The RMS wave bottom shear stress and the associated representative phase lead can be accurately predicted using the equivalent-wave approach. The spectra of wave bottom shear stress and boundary layer velocity are found to be proportional to the spectrum of free-stream velocity. Currents in the presence of irregular waves exhibit the classic two-log-profile structure with the lower log-profile controlled by the physical bottom roughness and the upper log-profile controlled by a much larger apparent roughness. Replacing the irregular waves by their equivalent sinusoidal waves virtually makes no difference for the coexisting currents. These observations, together with the excellent agreement between measurements and model predictions, suggest that the equivalent-wave representation adequately characterizes the basic wave-current interaction under irregular waves.

  20. Recurrent anterior shoulder instability: Review of the literature and current concepts

    PubMed Central

    Sofu, Hakan; Gürsu, Sarper; Koçkara, Nizamettin; Öner, Ali; Issın, Ahmet; Çamurcu, Yalkın

    2014-01-01

    The purpose of this review article is to discuss the clinical spectrum of recurrent traumatic anterior shoulder instability with the current concepts and controversies at the scientific level. Because of increasing participation of people from any age group of the population in sports activities, health care professionals dealing with the care of trauma patients must have a thorough understanding of the anatomy, patho-physiology, risk factors, and management of anterior shoulder instability. The risk factors for recurrent shoulder dislocation are young age, participation in high demand contact sports activities, presence of Hill-Sachs or osseous Bankart lesion, previous history of ipsilateral traumatic dislocation, ipsilateral rotator cuff or deltoid muscle insufficiency, and underlying ligamentous laxity. Achieving the best result for any particular patient depends on the procedure that allows observation of the joint surfaces, provides the anatomical repair, maintains range of motion, and also can be applied with low rates of complications and recurrence. Although various surgical techniques have been described, a consensus does not exist and thus, orthopedic surgeons should follow and try to improve the current evidence-based treatment modalities for the patients. PMID:25405191

  1. Current Concepts for Anterior Cruciate Ligament Reconstruction: A Criterion–Based Rehabilitation Progression

    PubMed Central

    ADAMS, DOUGLAS; LOGERSTEDT, DAVID; HUNTER-GIORDANO, AIRELLE; AXE, MICHAEL J.; SNYDER-MACKLER, LYNN

    2013-01-01

    SYNOPSIS The management of patients after anterior cruciate ligament reconstruction should be evidence based. Since our original published guidelines in 1996, successful outcomes have been consistently achieved with the rehabilitation principles of early weight bearing, using a combination of weight-bearing and non–weight-bearing exercise focused on quadriceps and lower extremity strength, and meeting specific objective requirements for return to activity. As rehabilitative evidence and surgical technology and procedures have progressed, the original guidelines should be revisited to ensure that the most up-to-date evidence is guiding rehabilitative care. Emerging evidence on rehabilitative interventions and advancements in concomitant surgeries, including those addressing chondral and meniscal injuries, continues to grow and greatly affect the rehabilitative care of patients with anterior cruciate ligament reconstruction. The aim of this article is to update previously published rehabilitation guidelines, using the most recent research to reflect the most current evidence for management of patients after anterior cruciate ligament reconstruction. The focus will be on current concepts in rehabilitation interventions and modifications needed for concomitant surgery and pathology. PMID:22402434

  2. Ductal adenocarcinoma of the pancreatic head: A focus on current diagnostic and surgical concepts

    PubMed Central

    Ouaïssi, Mehdi; Giger, Urs; Louis, Guillaume; Sielezneff, Igor; Farges, Olivier; Sastre, Bernard

    2012-01-01

    Complete surgical resection still remains the only possibility of curing pancreatic cancer, however, only 10% of patients undergo curative surgery. Pancreatic resection currently remains the only method of curing patients, and has a 5-year overall survival rate between 7%-34% compared to a median survival of 3-11 mo for unresected cancer. Pancreatic surgery is a technically demanding procedure requiring highly standardized surgical techniques. Nevertheless, even in experienced hands, perioperative morbidity rates (delayed gastric emptying, pancreatic fistula etc.) are as high as 50%. Different strategies to reduce postoperative morbidity, such as different techniques of gastroenteric reconstruction (pancreatico-jejunostomy vs pancreatico-gastrostomy), intraoperative placement of a pancreatic main duct stent or temporary sealing of the main pancreatic duct with fibrin glue have not led to a significant improvement in clinical outcome. The perioperative application of somatostatin or its analogues may decrease the incidence of pancreatic fistulas in cases with soft pancreatic tissue and a small main pancreatic duct (< 3 mm). The positive effects of external pancreatic main duct drainage and antecolic gastrointestinal reconstruction have been observed to decrease the rate of pancreatic fistulas and delayed gastric emptying, respectively. Currently, the concept of extended radical lymphadenectomy has been found to be associated with higher perioperative morbidity, but without any positive impact on overall survival. However, there is growing evidence that portal vein resections can be performed with acceptable low perioperative morbidity and mortality but does not achieve a cure. PMID:22791941

  3. Ethics Committee or Community? Examining the identity of Czech Ethics Committees in the period of transition.

    PubMed

    Simek, Jiri; Zamykalova, Lenka; Mesanyova, Marie

    2010-09-01

    Reflecting on a three year long exploratory research of ethics committees in the Czech Republic authors discuss the current role and identity of research ethics committees. The research of Czech ethics committees focused on both self-presentation and self-understanding of ECs members, and how other stakeholders (representatives of the pharmaceutical industry) view them. The exploratory research was based on formal and informal communication with the members of the ethics committees. Members of the research team took part at six regular voluntary meetings of the ethics committees' members, organised by the Forum of Czech Ethics Committees, and at three summer schools of medical ethics. There were realised twenty-five semi-structured interviews as well as six focus group sessions and a participant observation of several regular meetings of three ethics committees. On the grounds of experience from the interviews a simple questionnaire survey was realised among the members of the ethics committees. The ethics committees comprise a community of members working voluntarily, without claims to remuneration or prestige; the unifying goal is protection of subjects of research. The principal working methods are dialogue and agreement. The members of the ethics committees thus, among other things, create an informal community, which can be to a certain extent seen as a Kantian ethical community in a weak sense. The phenomenon of ethics committees can also be described by terms of an epistemic community and a community of practice. These concepts, which are borrowed from other authors and areas, are used as a way how to think of ECs role and identity a bit differently and are meant as a contribution to the current international debate on the topic. PMID:20675735

  4. Faculty Member’s Views, Attitude and Current Practice As Regards International Committee of Medical Journal Editors Criteria for Authorship

    PubMed Central

    Jawaid, Masood; Jawaid, Shaukat Ali

    2013-01-01

    Abstract Background The objective of this study was to assess the knowledge and views of faculty members on criteria for authorship by International Committee of Medical Journal Editors (ICMJE), their current practice of choosing the authors, views on gift authorship and problems they had faced concerning authorship. Methods It was a cross sectional survey from January 2011 to July 2011 among faculty members of various private and public sector medical institutions of Pakistan through a self-administered questionnaire. Main outcome measures included awareness and use of ICMJE criteria, which contribution to research merit authorship and their perceptions about gift authorship. Results Two hundred eighteen faculty members (180 males, 38 females) participated in the study. One hundred twenty eight (58.7%) were from surgery and allied disciplines. Ninety six percent had published between one to five papers while 60(27.5%) had six to ten papers to their credit. One hundred eleven (50.9%) claimed they were aware about the authorship criteria, only twenty two (19.8%) could name this document. Only four (1.8%) could correctly state this. Only one hundred twenty (55.0%) said that all three criteria’s must be met to be eligible for authorship. Ninety three (42.7%) said that they were not included as authors though they deserved it while sixty three said they did not merit but were still included. Forty two (19.3%) said that they were not aware when they were listed as authors. Conclusion A vast majority of young faculty members are not aware of the existence of authorship criteria and gift authorship is quite common. PMID:26060616

  5. Evolution of the Treatment Integrity Concept: Current Status and Future Directions

    ERIC Educational Resources Information Center

    Gresham, Frank M.

    2009-01-01

    The concept of treatment integrity cuts across a diversity of fields involved with providing treatments or interventions to individuals. In medical treatments, the concept of "treatment compliance" or "treatment adherence" is an important and problematic issue. In the field of nutrition, the concept of "dietary adherence" is important for…

  6. Current concepts in targeting COPD pharmacotherapy: making progress towards personalized management

    PubMed Central

    Woodruff, Prescott G.; Agusti, Alvar; Roche, Nicolas; Singh, Dave; Martinez, Fernando J.

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is a common, complex and heterogeneous condition which is responsible for considerable and growing morbidity, mortality and healthcare expense worldwide. In order to decipher the complexity of COPD, it is imperative that we identify groups of patients with similar clinical characteristics, prognosis and/or therapeutic needs, so called clinical phenotypes. This strategy is logical for research but it may be of limited clinical value because clinical phenotypes may overlap in the same patient and the same clinical phenotype could result from different biological mechanisms. With the goal of matching assessment to treatment choices, the most recent iteration of GOLD reorganized treatment objectives into two categories (improving symptoms, i.e., dyspnoea and health status, and decreasing future risk, as predicted by FEV1 level and exacerbations history), thus moving closer to individualized medicine using currently available bronchodilators and anti-inflammatory medications. Yet, future therapeutic options are likely to include targeting endotypes which reflect subtypes of patients defined by a distinct pathophysiological mechanism. Specific biomarkers of these endotypes would be particularly useful for clinical practice, especially when clinical phenotype alone is insufficient to identify the underlying endotype. Currently, a limited series of potential COPD endotypes and biomarkers have been suggested. We will gain empiric knowledge from proof of concept trials in COPD with emerging drugs that target specific inflammatory pathways. In each instance, specific endotyping and biomarker efforts will likely be required for success of these trials, since the pathways are likely to be operative in only a subset of patients. Network analysis of human diseases offers the possibility of a better understanding of disease patho-biologic complexity while facilitating the development of new therapeutic alternatives and, importantly, a

  7. [New and Current Concepts of Therapy in Non-CF Bronchiectasis].

    PubMed

    Allewelt, Markus; de Roux, Andrés

    2016-05-01

    Non-CF (NCF)-bronchiectasis is a syndrome of chronic inflammation leading to dilatation of airways and structural lung damage. Improvements of diagnostic procedures increase its perceived frequency. In Germany, recent data suggest a prevalence of 67/100 000.The outcome of therapeutic interventions is critically related to thorough diagnostic procedures. Genetical or immunological disorders (cystic fibrosis, alpha-1-AT deficiency, immune deficiency syndromes) require treatment options different from idiopathic NCF-bronchiectasis.Therapy is aimed at suppression of chronic inflammation and includes continuous mobilisation of secretions, immunomodulatory strategies and antibiotic therapy, whenever required. Surgical procedures are limited to specific complications (e. g. destroyed lung after airway obstruction, uncontrolled hemorrhage)Macrolides show a variety of immunological properties with favourable results in reduction of symptoms and frequency of exacerbations. Longtime tolerance is good, if individual risk factors are excluded.Antibiotics are given according to resistance patterns in acute exacerbations and in first-time detection of Pseudomonas aeruginosa and MRSA. Inhaled antibiotics for NCF-bronchiectasis will gain importance, depending on future studies. Currently, they are only used in individualized concepts of therapy. PMID:27176062

  8. Current concepts on spinal arthrodesis in degenerative disorders of the lumbar spine

    PubMed Central

    Lykissas, Marios G; Aichmair, Alexander

    2013-01-01

    Back pain is a common chronic disorder that represents a large burden for the health care system. There is a broad spectrum of available treatment options for patients suffering from chronic lower back pain in the setting of degenerative disorders of the lumbar spine, including both conservative and operative approaches. Lumbar arthrodesis techniques can be divided into sub-categories based on the part of the vertebral column that is addressed (anterior vs posterior). Furthermore, one has to differentiate between approaches aiming at a solid fusion in contrast to motion-sparing techniques with the proposed advantage of a reduced risk of developing adjacent disc disease. However, the field of application and long-term outcomes of these novel motion-preserving surgical techniques, including facet arthroplasty, nucleus replacement, and lumbar disc arthroplasty, need to be more precisely evaluated in long-term prospective studies. Innovative surgical treatment strategies involving minimally invasive techniques, such as lateral lumbar interbody fusion or transforaminal lumbar interbody fusion, as well as percutaneous implantation of transpedicular or transfacet screws, have been established with the reported advantages of reduced tissue invasiveness, decreased collateral damage, reduced blood loss, and decreased risk of infection. The aim of this study was to review well-established procedures for lumbar spinal fusion with the main focus on current concepts on spinal arthrodesis and motion-sparing techniques in degenerative disorders of the lumbar spine. PMID:24303453

  9. Acute respiratory distress syndrome following cardiovascular surgery: current concepts and novel therapeutic approaches

    PubMed Central

    Hoegl, Sandra; Zwissler, Bernhard; Eltzschig, Holger K.; Vohwinkel, Christine

    2015-01-01

    Purpose of review This review gives an update on current treatment options and novel concepts on the prevention and treatment of the acute respiratory distress syndrome (ARDS) in cardiovascular surgery patients. Recent findings The only proven beneficial therapeutic options in ARDS are those that help to prevent further ventilator-induced lung injury, such as prone position, use of lung-protective ventilation strategies, and extracorporeal membrane oxygenation. In the future also new approaches like mesenchymal cell therapy, activation of hypoxia-elicited transcription factors or targeting of purinergic signaling may be successful outside the experimental setting. Owing to the so far limited treatment options, it is of great importance to determine patients at risk for developing ARDS already perioperatively. In this context, serum biomarkers and lung injury prediction scores could be useful. Summary Preventing ARDS as a severe complication in the cardiovascular surgery setting may help to reduce morbidity and mortality. As cardiovascular surgery patients are of greater risk to develop ARDS, preventive interventions should be implemented early on. Especially, use of low tidal volumes, avoiding of fluid overload and restrictive blood transfusion regimes may help to prevent ARDS. PMID:26598954

  10. Current Concepts and Occurrence of Epithelial Odontogenic Tumors: I. Ameloblastoma and Adenomatoid Odontogenic Tumor

    PubMed Central

    Kim, Yeon Sook

    2013-01-01

    Ameloblastomas and adenomatoid odontogenic tumors (AOTs) are common epithelial tumors of odontogenic origin. Ameloblastomas are clinico-pathologically classified into solid/multicystic, unicystic, desmoplastic, and peripheral types, and also divided into follicular, plexiform, acanthomatous, granular types, etc., based on their histological features. Craniopharyngiomas, derived from the remnants of Rathke's pouch or a misplaced enamel organ, are also comparable to the odontogenic tumors. The malignant transformation of ameloblastomas results in the formation of ameloblastic carcinomas and malignant ameloblastomas depending on cytological dysplasia and metastasis, respectively. AOTs are classified into follicular, extrafollicular, and peripheral types. Ameloblastomas are common, have an aggressive behavior and recurrent course, and are rarely metastatic, while AOTs are hamartomatous benign lesions derived from the complex system of the dental lamina or its remnants. With advances in the elucidation of molecular signaling mechanisms in cells, the cytodifferentiation of epithelial tumor cells in ameloblastomas and AOTs can be identified using different biomarkers. Therefore, it is suggested that comprehensive pathological observation including molecular genetic information can provide a more reliable differential diagnosis for the propagation and prognosis of ameloblastomas and AOTs. This study aimed to review the current concepts of ameloblastomas and AOTs and to discuss their clinico-pathological features relevant to tumorigenesis and prognosis. PMID:23837011

  11. Patients with atrial fibrillation undergoing percutaneous coronary intervention: current concepts and concerns: part II.

    PubMed

    Dzeshka, Mikhail S; Brown, Richard A; Lip, Gregory Y H

    2015-01-01

    Atrial fibrillation (AF) and coronary artery disease (CAD) often present concomitantly. Given the increased risk of thrombotic complications with either of them but different pathogenesis of clot formation, combined antithrombotic therapy is necessary in patients developing acute coronary syndrome and/or undergoing percutaneous coronary intervention (PCI). Different antithrombotic regimens in this group of patients have been summarized and discussed earlier. Triple therapy remains the treatment of choice in these patients despite the increased risk of hemorrhagic complications. Given the absence of evidence from randomized controlled trials, balancing the risk of stroke and stent thrombosis against the risk of major bleeding is a challenge. Precise stroke and bleeding risk assessment is an essential part of the decision making process regarding antithrombotic management. Continuing the discussion of current concepts and concerns of antithrombotic management in AF patients undergoing PCI, we emphasize the importance of various strategies to reduce bleeding in the modern era, namely, radial access combined with careful selection of a P2Y₁₂ receptor inhibitor, use of newer drug-eluting stents, and uninterrupted anticoagulation for patients undergoing procedures. We also focus on the role of the non-vitamin K oral anticoagulants (novel oral anticoagulants, eg, dabigatran, rivaroxaban, apixaban, and edoxaban) which are increasingly used for stroke prevention in AF. Finally, recent recommendations on the management of antithrombotic therapy in AF patients presenting with acute coronary syndrome and/or undergoing PCI as well as ongoing clinical trials and future directions are highlighted. PMID:25534093

  12. Intestinal Tissue Engineering: Current Concepts and Future Vision of Regenerative Medicine in the Gut

    PubMed Central

    Bitar, Khalil N.; Raghavan, Shreya

    2011-01-01

    Background and Purpose Functional tissue engineering of the gastrointestinal (GI) tract is a complex process aiming to aid the regeneration of structural layers of smooth muscle, intrinsic enteric neuronal plexuses, specialized mucosa and epithelial cells as well as interstitial cells. The final tissue engineered construct is intended to mimic the native GI tract anatomically and physiologically. Physiological functionality of tissue engineered constructs is of utmost importance while considering clinical translation. The construct comprises of cellular components as well as biomaterial scaffolding components. Together, these determine the immune-response a tissue engineered construct would elicit from a host upon implantation. Over the last decade, significant advances have been made to mitigate adverse host reactions. These include a quest for identifying autologous cell sources like embryonic and adult stem cells, bone marrow-derived cells, neural crest-derived cells and muscle-derived stem cells. Scaffolding biomaterials have been fabricated with increasing biocompatibility and biodegradability. Manufacturing processes have advanced to allow for precise spatial architecture of scaffolds in order to mimic in vivo milieu closely and achieve neovascularization. This review will focus on the current concepts and the future vision of functional tissue engineering of the diverse neuromuscular structures of the GI tract from the esophagus to the internal anal sphincter. PMID:22188325

  13. Treatment of brain metastases from HER-2-positive breast cancer: current status and new concepts.

    PubMed

    Bartolotti, Marco; Franceschi, Enrico; Brandes, Alba A

    2013-11-01

    Breast cancer is the second most common source of brain metastases (BM). The incidence of BM in breast cancer patients has increased over the past decade, especially among patients with HER-2-positive breast cancer. This is probably due to how aggressive the HER-2-positive disease is but also to the prolongation of survival obtained with current treatments, which allow good control of extracranial disease but are unable to cross the blood-brain barrier. At present, whole-brain radiotherapy, surgery and radiosurgery/stereotactic radiotherapy represent the cornerstone of treatment for BM, while the role of pharmacological therapy remains uncertain. Lapatinib demonstrated activity against BM from HER-2-positive breast cancer in small Phase II and retrospective studies, mainly in combination with capecitabine, and cases of dramatic responses to such treatment are present in literature. In this review we focus on the available clinical data regarding the treatment of BM from HER-2-positive breast cancer and on new concepts about the treatment and evaluation of the CNS response. PMID:24156325

  14. Current concepts: tissue engineering and regenerative medicine applications in the ankle joint

    PubMed Central

    Correia, S. I.; Pereira, H.; Silva-Correia, J.; Van Dijk, C. N.; Espregueira-Mendes, J.; Oliveira, J. M.; Reis, R. L.

    2014-01-01

    Tissue engineering and regenerative medicine (TERM) has caused a revolution in present and future trends of medicine and surgery. In different tissues, advanced TERM approaches bring new therapeutic possibilities in general population as well as in young patients and high-level athletes, improving restoration of biological functions and rehabilitation. The mainstream components required to obtain a functional regeneration of tissues may include biodegradable scaffolds, drugs or growth factors and different cell types (either autologous or heterologous) that can be cultured in bioreactor systems (in vitro) prior to implantation into the patient. Particularly in the ankle, which is subject to many different injuries (e.g. acute, chronic, traumatic and degenerative), there is still no definitive and feasible answer to ‘conventional’ methods. This review aims to provide current concepts of TERM applications to ankle injuries under preclinical and/or clinical research applied to skin, tendon, bone and cartilage problems. A particular attention has been given to biomaterial design and scaffold processing with potential use in osteochondral ankle lesions. PMID:24352667

  15. Concept Development in Learning Physics: The Case of Electric Current and Voltage Revisited

    ERIC Educational Resources Information Center

    Koponen, Ismo T.; Huttunen, Laura

    2013-01-01

    In learning conceptual knowledge in physics, a common problem is the development and differentiation of concepts in the learning process. An important part of this development process is the re-organisation or re-structuring process in which students' conceptual knowledge and concepts change. This study proposes a new view of concept…

  16. Teach for Fitness: A Manual for Teaching Fitness Concepts in K-12 Physical Education. Current Issues.

    ERIC Educational Resources Information Center

    Priest, Laurie

    This book is designed to aid and to encourage physical education teachers to incorporate the concepts of physical fitness into the physical education curriculum. The activities are written in an outline format using the following headings: (1) concept; (2) activity and/or knowledge level; (3) location (school or home); (4) time needed; (5)…

  17. Plastic Solar Cells: A Multidisciplinary Field to Construct Chemical Concepts from Current Research

    ERIC Educational Resources Information Center

    Gomez, Rafael; Segura, Jose L.

    2007-01-01

    Examples of plastic solar-cell technology to illustrate core concepts in chemistry are presented. The principles of operations of a plastic solar cell could be used to introduce key concepts, which are fundamentally important to understand photosynthesis and the basic process that govern most novel optoelectronic devices.

  18. Economic Thresholds in Soybean-Integrated Pest Management: Old Concepts, Current Adoption, and Adequacy.

    PubMed

    Bueno, A F; Paula-Moraes, S V; Gazzoni, D L; Pomari, A F

    2013-10-01

    Increasing global demands for food underline the need for higher crop yields. The relatively low costs of the most commonly used insecticides in combination with increasing soybean market prices led growers and technical advisors to debate the adequacy of recommended economic thresholds (ETs). The adoption of ETs and pest sampling has diminished in Brazil, leading to excessive pesticide use on soybean. The reduced efficacy of natural biological control, faster pest resurgence, and environment contamination are among the side-effects of pesticide abuse. To address these problems and maximize agricultural production, pest control programs must be guided by a proper integrated pest management (IPM) approach, including the ET concept. Therefore, the most appropriate time to initiate insecticide spraying in soybean is indicated by the available ETs which are supported by experiments over the last 40 years in different edapho-climatic conditions and regions with distinct soybean cultivars. Published scientific data indicate that preventive insecticide use is an expensive and harmful use of chemicals that increases the negative impact of pesticides in agroecosystems. However, the established ETs are for a limited number of species (key pests), and they only address the use of chemicals. There is a lack of information regarding secondary pests and other control strategies in addition to insecticides. It is clear then that much progress is still needed to improve ETs for pest management decisions. Nevertheless, using the current ETs provides a basis for reducing the use of chemicals in agriculture without reducing yields and overall production, thereby improving sustainability. PMID:27023207

  19. A discussion of current issues and concepts in the practice of skull-photo/craniofacial superimposition.

    PubMed

    Gordon, G M; Steyn, M

    2016-05-01

    A recent review paper on cranio-facial superimposition (CFS) stated that "there have been specific conceptual variances" from the original methods used in the practice of skull-photo superimposition, leading to poor results as far as accuracy is concerned. It was argued that the deviations in the practice of the technique have resulted in the reduced accuracies (for both failure to include and failure to exclude) that are noted in several recent studies. This paper aims to present the results from recent research to highlight the advancement of skull-photo/cranio-facial superimposition, and to discuss some of the issues raised regarding deviations from original techniques. The evolving methodology of CFS is clarified in context with the advancement of technology, forensic science and specifically within the field of forensic anthropology. Developments in the skull-photo/cranio-facial superimposition techniques have largely focused on testing reliability and accuracy objectively. Techniques now being employed by forensic anthropologists must conform to rigorous scientific testing and methodologies. Skull-photo/cranio-facial superimposition is constantly undergoing accuracy and repeatability testing which is in line with the principles of the scientific method and additionally allows for advancement in the field. Much of the research has indicated that CFS is useful in exclusion which is consistent with the concept of Popperian falsifiability - a hypothesis and experimental design which is falsifiable. As the hypothesis is disproved or falsified, another evolves to replace it and explain the new observations. Current and future studies employing different methods to test the accuracy and reliability of skull-photo/cranio-facial superimposition will enable researchers to establish the contribution the technique can have for identification purposes. PMID:26970657

  20. A Study of Second-Year Engineering Students' Alternative Conceptions about Electric Potential, Current Intensity and Ohm's Law

    ERIC Educational Resources Information Center

    Periago, M. Cristina; Bohigas, Xavier

    2005-01-01

    The aim of this research was to evaluate and analyse second-year industrial engineering and chemical engineering students prior knowledge of conceptual aspects of "circuit theory". Specifically, we focused on the basic concepts of electric potential and current intensity and on the fundamental relationship between them as expressed by Ohm's law.…

  1. Magnetic Field Due to a Finite Length Current-Carrying Wire Using the Concept of Displacement Current

    ERIC Educational Resources Information Center

    Buschauer, Robert

    2014-01-01

    In undergraduate E&M courses the magnetic field due to a finite length, current-carrying wire can be calculated using the Biot-Savart law. However, to the author's knowledge, no textbook presents the calculation of this field using the Ampere-Maxwell law: ?B [multiplied by] dl = µ[subscript 0] (I + e[subscript 0] dF/dt) [multiplied by] 1

  2. The choice of the concept of magnetic field lines or of electric current lines: Alfvén medal lecture

    NASA Astrophysics Data System (ADS)

    Akasofu, S.-I.

    2011-07-01

    In 1967, at the Birkeland Symposium in Sandefjord, Norway, Professor Hannes Alfvén stated that the second approach (in solving unsolved problems by the standard MHD theory) to cosmic electrodynamics is to "thaw" the "frozen-in" magnetic field lines. "We can illustrate essential properties of the electromagnetic state of space either by depicting the magnetic field lines or by depicting electric current lines," he said. There has been much progress in space physics since the Birkeland Symposium more than 40 years ago, but unfortunately our scientific community has not really succeeded in thawing the frozen-in field lines. Instead, it has pursued magnetic reconnection, a concept that Alfvén had been critical of. It is shown here that we have to study many unsolved problems and problems thought to be solved in terms of both the magnetic field line concept and the current system concept. In taking Alfvén's approach, we must consider the whole system, including the power supply (dynamo process) and its transmission and distribution (electric currents) and observed phenomena (power dissipation processes). Such a consideration can provide physical insight into many of our unsolved problems and problems thought to be solved. In this paper, we consider substorm onset processes, the substorm current system, sunspots, solar flares, coronal mass ejections, the interplanetary current sheet, and the magnetic field configuration of the heliosphere in terms of the current system concept. In particular, it is shown that a study of the current system is essential in substorm studies, more than changes of the magnetic field configuration in the magnetotail.

  3. [Weizsäcker's concept of time from the current viewpoint].

    PubMed

    Kiefer, Claus

    2014-01-01

    Carl Friedrich von Weizsäcker's concept of time is deeply based on the asymmetry between past and future, which he considers as a fundamental aspect of Nature. I review these ideas and their philosophical back ground and confront them with a presentation of the concept of time in modern physics. I argue that the observed irreversibility of our world can be understood from fundamental laws which are invariant under time reversal. I conclude with an outlook on the expected theory of quantum gravity. PMID:24974601

  4. RMF concept: a rotating-magnetic-field technique for driving steady plasma currents in compact toroid devices

    SciTech Connect

    McKenna, K.F.

    1980-09-01

    The generation and/or sustaining of a Compact Toroid (CT) configuration using the RMF technique is a relatively new and unknown concept. In this report the basic principles, historical development, and current theoretical understanding of this concept are reviewed. Significant experimental and theoretical results, potential problem areas, and recommendations for the direction of future work are discussed. An illustrative analysis of the application of the RMF technique to a CT reactor is presented. The results of a recent experiment, the Rotamak, in which a Spheromak-like CT plasma was produced using the RMF technique, are presented.

  5. Preschool Children's Conceptions about the Electric Current and the Functioning of Electric Appliances.

    ERIC Educational Resources Information Center

    Solomonidou, Christina; Kakana, Domna-Mika

    2000-01-01

    Examined 5- and 6-year-olds' ideas about the functioning of common electrical appliances and properties of electric current. Found that children represented current in a static way, thinking it was included in the appliance, and confounded electric current and water flow, believing external electricity was different from internal. They were…

  6. The Attitudes of the High School Students of Hail, Saudi Arabia towards the Current Educational Concepts

    ERIC Educational Resources Information Center

    Khasawneh, Kholoud Ahmed Saleem

    2014-01-01

    This study aimed to identify the attitudes of public secondary school students in the State of Hail towards the modern educational concepts, and what are the differences between them. It has been used in the study descriptive analytical method. The study was conducted on a sample of 400 male and female students, chosen randomly according to the…

  7. An overview of engineering concepts and current design algorithms for probabilistic structural analysis

    NASA Technical Reports Server (NTRS)

    Duffy, S. F.; Hu, J.; Hopkins, D. A.

    1995-01-01

    The article begins by examining the fundamentals of traditional deterministic design philosophy. The initial section outlines the concepts of failure criteria and limit state functions two traditional notions that are embedded in deterministic design philosophy. This is followed by a discussion regarding safety factors (a possible limit state function) and the common utilization of statistical concepts in deterministic engineering design approaches. Next the fundamental aspects of a probabilistic failure analysis are explored and it is shown that deterministic design concepts mentioned in the initial portion of the article are embedded in probabilistic design methods. For components fabricated from ceramic materials (and other similarly brittle materials) the probabilistic design approach yields the widely used Weibull analysis after suitable assumptions are incorporated. The authors point out that Weibull analysis provides the rare instance where closed form solutions are available for a probabilistic failure analysis. Since numerical methods are usually required to evaluate component reliabilities, a section on Monte Carlo methods is included to introduce the concept. The article concludes with a presentation of the technical aspects that support the numerical method known as fast probability integration (FPI). This includes a discussion of the Hasofer-Lind and Rackwitz-Fiessler approximations.

  8. Environmental Education in Ecuador: Conceptions and Currents in Quito's Private Elementary Schools

    ERIC Educational Resources Information Center

    Viteri, Fátima; Clarebout, Geraldine; Crauwels, Marion

    2013-01-01

    While key conceptions and the status of environmental education (EE) have been reported at various international, regional, national and local levels, those in play in the schools of Quito (Ecuador) are still relatively unknown. Of particular interest to this study are private schools: they are considerable in number in Ecuador and elsewhere, yet…

  9. Inflammatory bowel disease. Current concepts of pathogenesis and implications for therapy.

    PubMed

    Fiocchi, C

    2002-09-01

    Inflammatory bowel disease (IBD) still presents major challenges to the understanding of its cause, mechanisms of inflammation, and therapeutic choices to control the damaged tissue. Both types of IBD, ulcerative colitis and Crohn's disease, have been known and investigated for over half century but neither one is fully understood nor can be satisfactorily managed. While many gaps in our knowledge still exist, the last two decades have witnessed an unprecedented progress not only in the etiology but mainly in the mechanisms underlying the chronic inflammatory response. The pattern of IBD epidemiology has drastically changed since World War II, with an increased frequency in countries that have adopted a ''westernized'' life style. A parallel and important phenomenon is the continuous drop in age of onset in children. Unfortunately, only few epidemiological clues are available, with the exception of smoking and diet. What in smoking alters the course of IBD is still a mystery and which, among thousands of additives, could represent a risk factor will remain unknown for the foreseeable future. The current emphasis on the study of the enteric flora as the source of potential antigens against which the mucosal immune system reacts appear well justified. The data from animal models appears particularly convincing. Thus, after decades of relying almost exclusively on patient-derived information, numerous animal models are generating precious new information on IBD pathogenesis. In experimental IBD the genetic background of the animal markedly influences the course of the disease, and the same is probably true in humans. The identification of NOD2 as the first mutated gene associated with a subgroup of Crohn's disease patients is the first evidence that genetics are pointing to the right direction for understanding how the environment interacts with genes to cause IBD. For many years immunology has been the main source of scientific information on mechanisms of IBD

  10. Health literacy: applying current concepts to improve health services and reduce health inequalities.

    PubMed

    Batterham, R W; Hawkins, M; Collins, P A; Buchbinder, R; Osborne, R H

    2016-03-01

    The concept of 'health literacy' refers to the personal and relational factors that affect a person's ability to acquire, understand and use information about health and health services. For many years, efforts in the development of the concept of health literacy exceeded the development of measurement tools and interventions. Furthermore, the discourse about and development of health literacy in public health and in clinical settings were often substantially different. This paper provides an update about recently developed approaches to measurement that assess health literacy strengths and limitations of individuals and of groups across multiple aspects of health literacy. This advancement in measurement now allows diagnostic and problem-solving approaches to developing responses to identified strengths and limitations. In this paper, we consider how such an approach can be applied across the diverse range of settings in which health literacy has been applied. In particular, we consider some approaches to applying health literacy in the daily practice of health-service providers in many settings, and how new insights and tools--including approaches based on an understanding of diversity of health literacy needs in a target community--can contribute to improvements in practice. Finally, we present a model that attempts to integrate the concept of health literacy with concepts that are often considered to overlap with it. With careful consideration of the distinctions between prevailing concepts, health literacy can be used to complement many fields from individual patient care to community-level development, and from improving compliance to empowering individuals and communities. PMID:26872738

  11. [Medical aspects of current flight safety concept of air forces of the Russian Federation].

    PubMed

    Blaginin, A A; Lizogub, I N

    2012-12-01

    Issues of medical supply of aviation operations, that is part of general system of flight safety are analyzed in this article. One of the main issues is development of the system of vocational preparation of medical personnel, taking part in organization and carrying flights. This issue consists of several themes: formation of united system of education from primary to post graduate; formation of modern training facility; assurance of high potential in academic and teaching staff and providing of good basic training and high learning motivation of applicants, who wants to become a air medical officer. Fundamental principles of developed concept of medical supply of flight safety are presented. It is shown that the essential condition of good implementation of the given concept is informaltion support of all its structures. PMID:23479904

  12. Publication committee meeting

    NASA Astrophysics Data System (ADS)

    The Publications Committee has oversight responsibility for the entire AGU publications program. It is supported in this activity by the Journals Board, the Books Board, and the Translations Board. The 1982-1984 committee is chaired by Thomas Graedel. Serving with him are David Atlas, Grant Gross, Jurate Landwehr, Peter Molnar, George Reid, and Rob Van der Voo.At its November 3-4 meeting the new committee spent much of its time acquainting its elf with the scope of the program, the current problems, and the potential opportunities. In addition to setting the background against which the work of the next two years would take place, the committee

  13. Structural and functional concepts in current mouse phenotyping and archiving facilities.

    PubMed

    Kollmus, Heike; Post, Rainer; Brielmeier, Markus; Fernández, Julia; Fuchs, Helmut; McKerlie, Colin; Montoliu, Lluis; Otaegui, Pedro J; Rebelo, Manuel; Riedesel, Hermann; Ruberte, Jesús; Sedlacek, Radislav; de Angelis, Martin Hrabě; Schughart, Klaus

    2012-07-01

    Collecting and analyzing available information on the building plans, concepts, and workflow from existing animal facilities is an essential prerequisite for most centers that are planning and designing the construction of a new animal experimental research unit. Here, we have collected and analyzed such information in the context of the European project Infrafrontier, which aims to develop a common European infrastructure for high-throughput systemic phenotyping, archiving, and dissemination of mouse models. A team of experts visited 9 research facilities and 3 commercial breeders in Europe, Canada, the United States, and Singapore. During the visits, detailed data of each facility were collected and subsequently represented in standardized floor plans and descriptive tables. These data showed that because the local needs of scientists and their projects, property issues, and national and regional laws require very specific solutions, a common strategy for the construction of such facilities does not exist. However, several basic concepts were apparent that can be described by standardized floor plans showing the principle functional units and their interconnection. Here, we provide detailed information of how individual facilities addressed their specific needs by using different concepts of connecting the principle units. Our analysis likely will be valuable to research centers that are planning to design new mouse phenotyping and archiving facilities. PMID:23043807

  14. Structural and Functional Concepts in Current Mouse Phenotyping and Archiving Facilities

    PubMed Central

    Kollmus, Heike; Post, Rainer; Brielmeier, Markus; Fernández, Julia; Fuchs, Helmut; McKerlie, Colin; Montoliu, Lluis; Otaegui, Pedro J; Rebelo, Manuel; Riedesel, Hermann; Ruberte, Jesús; Sedlacek, Radislav; de Angelis, Martin Hrabě; Schughart, Klaus

    2012-01-01

    Collecting and analyzing available information on the building plans, concepts, and workflow from existing animal facilities is an essential prerequisite for most centers that are planning and designing the construction of a new animal experimental research unit. Here, we have collected and analyzed such information in the context of the European project Infrafrontier, which aims to develop a common European infrastructure for high-throughput systemic phenotyping, archiving, and dissemination of mouse models. A team of experts visited 9 research facilities and 3 commercial breeders in Europe, Canada, the United States, and Singapore. During the visits, detailed data of each facility were collected and subsequently represented in standardized floor plans and descriptive tables. These data showed that because the local needs of scientists and their projects, property issues, and national and regional laws require very specific solutions, a common strategy for the construction of such facilities does not exist. However, several basic concepts were apparent that can be described by standardized floor plans showing the principle functional units and their interconnection. Here, we provide detailed information of how individual facilities addressed their specific needs by using different concepts of connecting the principle units. Our analysis likely will be valuable to research centers that are planning to design new mouse phenotyping and archiving facilities. PMID:23043807

  15. The current status of the psychoanalytic theory of instinctual drives. I: Drive concept, classification, and development.

    PubMed

    Compton, A

    1983-07-01

    The evolution of Freud's theory of instinctual drives, with the accompanying models of a mental apparatus, is remarkable for its tenacious adherence to addressing the fundamental problems of human psychology, here phrased as the problems of body-mind-environment relationships. The concept of instinctual drives continues to be one of the most pervasive concepts of psychoanalysis, weathering considerable attack over the last several decades, although losing some clarity in the process. I have cited and discussed as basic issues of the concept of instinctual drives: the relationship of observational data and theoretical constructs in psychology; whether our construct of drives is or should be or can be purely psychological; the problem of conceptualizing the ontogenetic origin of mind; the issues of the "force-meaning conjunction" and the problem of psychic energy in psychoanalytic constructs; and the relation of our concept of instinctual drives to the concept of instincts in general. It seems that progress with these fundamental issues might be made by utilizing models that are more homologous with present knowledge in related fields than is Freud's reflex arc model of the nervous system, in order to build a better drive construct within the framework of psychoanalysis. The classification of instinctual drives remains a problem. Clinically, aggression seems to be a factor in conflict, very much like sexuality. Despite widespread acceptance of the idea of aggression as simply parallel to sexuality in all respects, there are major discrepancies. Perhaps aggression cannot be viewed as a drive after all; perhaps our drive construct needs to be modified to accommodate aggression. Certainly, controversy in this area has interfered with the production of good clinical studies which could begin to increase our understanding of aggression and its place in the human personality. The psychoanalytic theory of drive development has probably undergone less change in the last

  16. [Reorganization of the procedures and the tasks of the responsible ethics committees after the 12th AMG amendment. Concepts of the permanent working group of the medical ethics committees in Germany].

    PubMed

    Wessler, I; Burger, R; Doppelfeld, E

    2005-02-01

    Since 12(th) of August 2004 the EU Directive 2001/20/EG has been implemented into the national law. The 12th AMG amendment of 30 July 2004 and the good clinical practice decree on the conduct of clinical trials on drugs for human use of 9 August 2004 have been authorized and must be considered for new clinical trials with investigational medical products (drugs). The scope of the changes are to increase the quality of clinical trials and to continue the process of harmonization within the European Community. Based on the new law the sponsor has to apply for approval by the competent authority and for a favourable opinion by the responsible ethics committee. Both procedures are independent; a favourable opinion of the responsible ethics committee is a necessary condition before starting the trial. Thus, the role of the ethics committees has been changed; the committees are considered as an institution comparable to an authority to protect the rights and safety of human subjects involved in clinical trials. The permanent working group of the medical ethics committees in Germany has established a procedure to meet these requirements, particularly in the case of multicentre clinical trials, where only a single opinion shall be given for each member state. This article describes this procedure (application, process of ethical consideration among the leading and local ethics committees in multicentre trials, responsibilities during the trial). PMID:15726456

  17. Summary and viewgraphs from the Q-121 US/Japan advanced current drive concepts workshop

    SciTech Connect

    Bonoli, P.; Porkolab, M. ); Chan, V.; Pinsker, R.; Politzer, P. ); Darrow, D. . Plasma Physics Lab.); Ehst, D. ); Fukuyama, Atsushi ); Imai, Tsuyoshi; Watari, Tetsuo ); Itoh, Satoshi; Naka

    1990-03-09

    With the emphasis placed on current drive by ITER, which requires steady state operation in its engineering phase, it is important to bring theory and experiment in agreement for each of the schemes that could be used in that design. Both neutral beam and lower hybrid (LH) schemes are in excellent shape in that regard. Since the projected efficiency of all schemes is marginal it is also important to continue our search for more efficient processes. This workshop featured experimental and theoretical work in each processes. This workshop featured experimental and theoretical work in each of these areas, that is, validation of theory and the search for better ideas. There were a number of notable results to report, the most striking again (as with last year) the long pulse operation of TRIAM-1M. A low current was sustained for over 1 hour with LH waves, using new hall-effect sensors in the equilibrium field circuit to maintain position control. In JT-60, by sharpening the wave spectrum the current drive efficiency was improved to 0.34 {times} 10{sup 20}m{sup -2}A/W and 1.5 MA of current was driven entirely by the lower hybrid system. Also in that machine, using two different LH frequencies, the H-mode was entered. Finally, by using the LH system for startup they saved 2.5 resistive volt-sec of flux, which if extrapolated to ITER would save 40 volt-sec there. For the first time, and experiment on ECH current drive showed reasonable agreement with theory. Those experiments are reported here by James (LLNL) on the D3-D machine. Substantially lower ECH current drive than expected theoretically was observed on WT-3, but if differed by being in a low absorption regime. Nonetheless, excellent physics results were achieved in the WT-3 experiments, notably in having careful measurements of the parallel velocity distributions.

  18. An Overview of the MATISSE Instrument — Science, Concept and Current Status

    NASA Astrophysics Data System (ADS)

    Lopez, B.; Lagarde, S.; Jaffe, W.; Petrov, R.; Schöller, M.; Antonelli, P.; Beckmann, U.; Berio, P.; Bettonvil, F.; Glindemann, A.; Gonzalez, J.-C.; Graser, U.; Hofmann, K.-H.; Millour, F.; Robbe-Dubois, S.; Venema, L.; Wolf, S.; Henning, T.; Lanz, T.; Weigelt, G.; Agocs, T.; Bailet, C.; Bresson, Y.; Bristow, P.; Dugué, M.; Heininger, M.; Kroes, G.; Laun, W.; Lehmitz, M.; Neumann, U.; Augereau, J.-C.; Avila, G.; Behrend, J.; van Belle, G.; Berger, J.-P.; van Boekel, R.; Bonhomme, S.; Bourget, P.; Brast, R.; Clausse, J.-M.; Connot, C.; Conzelmann, R.; Cruzalèbes, P.; Csepany, G.; Danchi, W.; Delbo, M.; Delplancke, F.; Dominik, C.; van Duin, A.; Elswijk, E.; Fantei, Y.; Finger, G.; Gabasch, A.; Gay, J.; Girard, P.; Girault, V.; Gitton, P.; Glazenborg, A.; Gonté, F.; Guitton, F.; Guniat, S.; De Haan, M.; Haguenauer, P.; Hanenburg, H.; Hogerheijde, M.; ter Horst, R.; Hron, J.; Hugues, Y.; Hummel, C.; Idserda, J.; Ives, D.; Jakob, G.; Jasko, A.; Jolley, P.; Kiraly, S.; Köhler, R.; Kragt, J.; Kroener, T.; Kuindersma, S.; Labadie, L.; Leinert, C.; Le Poole, R.; Lizon, J.-L.; Lucuix, C.; Marcotto, A.; Martinache, F.; Martinot-Lagarde, G.; Mathar, R.; Matter, A.; Mauclert, N.; Mehrgan, L.; Meilland, A.; Meisenheimer, K.; Meisner, J.; Mellein, M.; Menardi, S.; Menut, J.-L.; Merand, A.; Morel, S.; Mosoni, L.; Navarro, R.; Nussbaum, E.; Ottogalli, S.; Palsa, R.; Panduro, J.; Pantin, E.; Parra, T.; Percheron, I.; Duc, T. P.; Pott, J.-U.; Pozna, E.; Przygodda, F.; Rabbia, Y.; Richichi, A.; Rigal, F.; Roelfsema, R.; Rupprecht, G.; Schertl, D.; Schmidt, C.; Schuhler, N.; Schuil, M.; Spang, A.; Stegmeier, J.; Thiam, L.; Tromp, N.; Vakili, F.; Vannier, M.; Wagner, K.; Woillez, J.

    2014-09-01

    MATISSE, a second generation Very Large Telescope Interferometer (VLTI) instrument, is a combined imager and spectrograph for interferometry in the 3-5 μm region (L- and M-bands) and the 8-13 μm window (N-band). MATISSE builds on the experience gained with the VLTI's first generation instruments. It employs multi-axial beam combination while also providing wavelength differential visibility and phase, and closure-phase aperture-synthesis imaging at a range of spectral resolutions. MATISSE is designed for a broad range of science goals, and its potential for studies of the discs around young stars and active galactic nuclei are highlighted. The instrument concept and operating modes are described; construction is in progress towards installation at the VLTI in 2016.

  19. Current concepts in chronic inflammatory diseases: Interactions between microbes, cellular metabolism, and inflammation.

    PubMed

    Garn, Holger; Bahn, Sabine; Baune, Bernhard T; Binder, Elisabeth B; Bisgaard, Hans; Chatila, Talal A; Chavakis, Triantafyllos; Culmsee, Carsten; Dannlowski, Udo; Gay, Steffen; Gern, James; Haahtela, Tari; Kircher, Tilo; Müller-Ladner, Ulf; Neurath, Markus F; Preissner, Klaus T; Reinhardt, Christoph; Rook, Graham; Russell, Shannon; Schmeck, Bernd; Stappenbeck, Thaddeus; Steinhoff, Ulrich; van Os, Jim; Weiss, Scott; Zemlin, Michael; Renz, Harald

    2016-07-01

    Recent research indicates that chronic inflammatory diseases, including allergies and autoimmune and neuropsychiatric diseases, share common pathways of cellular and molecular dysregulation. It was the aim of the International von-Behring-Röntgen Symposium (October 16-18, 2014, in Marburg, Germany) to discuss recent developments in this field. These include a concept of biodiversity; the contribution of urbanization, lifestyle factors, and nutrition (eg, vitamin D); and new mechanisms of metabolic and immune dysregulation, such as extracellular and intracellular RNAs and cellular and mitochondrial stress. Epigenetic mechanisms contribute further to altered gene expression and therefore to the development of chronic inflammation. These novel findings provide the foundation for further development of preventive and therapeutic strategies. PMID:27373325

  20. Defining a healthy human gut microbiome: current concepts, future directions, and clinical applications.

    PubMed

    Bäckhed, Fredrik; Fraser, Claire M; Ringel, Yehuda; Sanders, Mary Ellen; Sartor, R Balfour; Sherman, Philip M; Versalovic, James; Young, Vincent; Finlay, B Brett

    2012-11-15

    Indigenous microbiota are an essential component in the modern concept of human health, but the composition and functional characteristics of a healthy microbiome remain to be precisely defined. Patterns of microbial colonization associated with disease states have been documented, but the health-associated microbial patterns and their functional characteristics are less clear. A healthy microbiome, considered in the context of body habitat or body site, could be described in terms of ecologic stability (i.e., ability to resist community structure change under stress or to rapidly return to baseline following a stress-related change), by an idealized (presumably health-associated) composition or by a desirable functional profile (including metabolic and trophic provisions to the host). Elucidation of the properties of healthy microbiota would provide a target for dietary interventions and/or microbial modifications aimed at sustaining health in generally healthy populations and improving the health of individuals exhibiting disrupted microbiota and associated diseases. PMID:23159051

  1. Summary of Changes Related to the Individualized Education Program (IEP): Current Law and 1997 IDEA Amendments, Including Congressional Committee Comments. Final Report.

    ERIC Educational Resources Information Center

    Schrag, Judy; Ahearn, Eileen M.

    This report summarizes provisions and highlights changes for the Individualized Education Program (IEP) within the Individuals with Disabilities Education Act (IDEA) Amendments of 1997. Also included are references from the two Congressional Committee Reports--those of the Senate Labor and Human Resources Committee and the House Committee on…

  2. Realization of the German Concept for Interim Storage of Spent Nuclear Fuel - Current Situation and Prospects

    SciTech Connect

    Thomauske, B. R.

    2003-02-25

    The German government has determined a phase out of nuclear power. With respect to the management of spent fuel it was decided to terminate transports to reprocessing plants by 2005 and to set up interim storage facilities on power plant sites. This paper gives an overview of the German concept for spent fuel management focused on the new on-site interim storage concept and the applied interim storage facilities. Since the end of the year 1998, the utilities have applied for permission of on-site interim storage in 13 storage facilities and 5 storage areas; one application for the interim storage facility Stade was withdrawn due to the planned final shut down of Stade nuclear power plant in autumn 2003. In 2001 and 2002, 3 on-site storage areas and 2 on-site storage facilities for spent fuel were licensed by the Federal Office for Radiation Protection (BfS). A main task in 2002 and 2003 has been the examination of the safety and security of the planned interim storage facilities and the verification of the licensing prerequisites. In the aftermath of September 11, 2001, BfS has also examined the attack with a big passenger airplane. Up to now, these aircraft crash analyses have been performed for three on-site interim storage facilities; the fundamental results will be presented. It is the objective of BfS to conclude the licensing procedures for the applied on-site interim storage facilities in 2003. With an assumed construction period for the storage buildings of about two years, the on-site interim storage facilities could then be available in the year 2005.

  3. Current status of pregnancy-related maternal mortality in Japan: a report from the Maternal Death Exploratory Committee in Japan

    PubMed Central

    Hasegawa, Junichi; Sekizawa, Akihiko; Tanaka, Hiroaki; Katsuragi, Shinji; Osato, Kazuhiro; Murakoshi, Takeshi; Nakata, Masahiko; Nakamura, Masamitsu; Yoshimatsu, Jun; Sadahiro, Tomohito; Kanayama, Naohiro; Ishiwata, Isamu; Kinoshita, Katsuyuki; Ikeda, Tomoaki

    2016-01-01

    Objective To clarify the problems related to maternal deaths in Japan, including the diseases themselves, causes, treatments and the hospital or regional systems. Design Descriptive study. Setting Maternal death registration system established by the Japan Association of Obstetricians and Gynecologists (JAOG). Participants Women who died during pregnancy or within a year after delivery, from 2010 to 2014, throughout Japan (N=213). Main outcome measures The preventability and problems in each maternal death. Results Maternal deaths were frequently caused by obstetric haemorrhage (23%), brain disease (16%), amniotic fluid embolism (12%), cardiovascular disease (8%) and pulmonary disease (8%). The Committee considered that it was impossible to prevent death in 51% of the cases, whereas they considered prevention in 26%, 15% and 7% of the cases to be slightly, moderately and highly possible, respectively. It was difficult to prevent maternal deaths due to amniotic fluid embolism and brain disease. In contrast, half of the deaths due to obstetric haemorrhage were considered preventable, because the peak duration between the initial symptoms and initial cardiopulmonary arrest was 1–3 h. Conclusions A range of measures, including individual education and the construction of good relationships among regional hospitals, should be established in the near future, to improve primary care for patients with maternal haemorrhage and to save the lives of mothers in Japan. PMID:27000786

  4. Infantile haemangiomas of the head and neck: current concepts in management.

    PubMed

    Fowell, Christopher; Monaghan, Andrew; Nishikawa, Hiroshi

    2016-06-01

    Recent developments have improved our understanding of the clinical behaviour of haemangiomas and vascular malformations. In this paper, the second in a series of three educational reviews on vascular anomalies, we review the current trends and evidence-based management of infantile haemangiomas and their associated conditions. PMID:27025230

  5. On Pliability and Progress: Challenging Current Conceptions of Eighteenth-Century French Educational Thought

    ERIC Educational Resources Information Center

    Gilead, Tal

    2009-01-01

    Examining the educational writings of three of the eighteenth-century's most innovative thinkers, the Abbe de Saint-Pierre, Morelly and Helvetius, this article challenges the currently accepted view that it was a belief in human pliability which gave rise to the contemporary groundbreaking faith in the power of education to improve society. The…

  6. Variable Uses of Alternative Conceptions: A Case Study in Current Electricity.

    ERIC Educational Resources Information Center

    Heller, Patricia M.; Finley, Fred N.

    1992-01-01

    Fourteen elementary and middle school teachers from an inservice physics course were found to share a common core of strongly held propositions that formed a coherent, but incorrect and contradictory, model of the sequential flow of electrical current. Theoretical and practical implications of these teachers' beliefs with respect to both…

  7. Variable Uses of Alternative Conceptions: A Case Study in Current Electricity.

    ERIC Educational Resources Information Center

    Heller, Patricia; Finley, Fred

    In order to investigate the nature of students' prior knowledge of current electricity and how they applied their knowledge to different problems, 5 middle school science teachers and 11 elementary school teachers were given a written test that required them to: (1) predict what happens to the brightness of a bulb if a change is made to the…

  8. Arteriovenous malformations of the head and neck: current concepts in management.

    PubMed

    Fowell, Christopher; Jones, Robert; Nishikawa, Hiroshi; Monaghan, Andrew

    2016-06-01

    The field of vascular anomalies and their clinical management is expanding and developments in the last few years have improved the understanding of haemangiomas and vascular malformations. In this paper, the first in the series of 3 educational reviews, we review the current trends and evidence-based management of arteriovenous malformations. PMID:27020371

  9. Effective committees.

    PubMed

    Collins, Jannette

    2012-03-01

    A committee is a group of people officially delegated to perform a function, such as investigating, considering, reporting, or acting on a matter. Some committees function like task forces and work on specific, time-limited projects. When the work is finished, the committees are no longer needed. These committees are called ad hoc committees. Other committees are standing committees. They are created by the standing orders, rules, by-laws, or regulations of an organization and exist and function indefinitely (eg, finance, membership, education, nomination). Both types of committees can form subcommittees if the workloads are heavy or complex in nature. Committees can be among the most important working forces of an organization. They serve as work units of the organization, taking work and breaking it into meaningful and manageable chunks. They efficiently carry out the work of the organization. Committee work should be a rewarding experience for both the members and the organization. Committees represent, involve, and serve members, as well as provide an important training ground for future leaders of an organization. New or inexperienced members can gain valuable insight into an organization and develop confidence by serving on committees. There are several key elements of effective committees, including (1) a clear, written purpose; (2) an effective committee chair; (3) thoughtfully appointed members; and (4) well-run meetings. PMID:22386164

  10. Josephson mass current dynamics in experiments and simulations within a new model concept

    NASA Astrophysics Data System (ADS)

    Eska, G.; Gladchenko, S.; Pereverzev, S. V.

    2010-01-01

    Josephson mass currents have been investigated in superfluid 3He-B with high temporal resolution. The experimentally observed dynamics of all DC and AC Josephson effects could be modeled in detail by solving the quantum-phase-controlled equations of motion which could be adjusted for other quantum condensates as well. We show that the 3He π-state, discussed in the literature, might not be a state of 3He but nonlinear dynamics which also dominates the apparent dissipation and oscillation in the Josephson device. Four different modes were identified for Cooper pair oscillations and a pure sinusoidal current phase relationship was found for temperatures down to 0.16 mK where the device can be used as a bolometric detector.

  11. Fluorescein Sodium-Guided Surgery of Malignant Brain Tumors: History, Current Concepts, and Future Project.

    PubMed

    Schebesch, Karl-Michael; Brawanski, Alexander; Hohenberger, Christoph; Hohne, Julius

    2016-01-01

    Fluorescein sodium (FL)-guided resection has become an important and beneficial treatment method for malignant brain tumors. FL-guided resection improves the rate of gross total resection in high-grade gliomas (HGG) and cerebral metastases (CM). FL sensitively visualizes the disruption of the blood-brain barrier in the area surrounding malignant lesions, similar to contrast-enhanced T1-weighted MR sequences. This review of the current literature summarizes the history of FL in neurosurgery from 1946 until today. We discuss the molecular mechanism of FL accumulation in cerebral malignant tumors and provide an overview of the current practice of using FL and applying a dedicated surgical microscope filter. Additionally, we outline and discuss ongoing trials and future projects. PMID:26956810

  12. Current concepts in the management of recurrent anterior gleno-humeral joint instability with bone loss

    PubMed Central

    Ramhamadany, Eamon; Modi, Chetan S

    2016-01-01

    The management of recurrent anterior gleno-humeral joint instability is challenging in the presence of bone loss. It is often seen in young athletic patients and dislocations related to epileptic seizures and may involve glenoid bone deficiency, humeral bone deficiency or combined bipolar lesions. It is critical to accurately identify and assess the amount and position of bone loss in order to select the most appropriate treatment and reduce the risk of recurrent instability after surgery. The current literature suggests that coracoid and iliac crest bone block transfers are reliable for treating glenoid defects. The treatment of humeral defects is more controversial, however, although good early results have been reported after arthroscopic Remplissage for small defects. Larger humeral defects may require complex reconstruction or partial resurfacing. There is currently very limited evidence to support treatment strategies when dealing with bipolar lesions. The aim of this review is to summarise the current evidence regarding the best imaging modalities and treatment strategies in managing this complex problem relating particularly to contact athletes and dislocations related to epileptic seizures. PMID:27335809

  13. REHABILITATION AFTER ARTHROSCOPIC ROTATOR CUFF REPAIR: CURRENT CONCEPTS REVIEW AND EVIDENCE-BASED GUIDELINES

    PubMed Central

    Westgard, Paul; Chandler, Zachary; Gaskill, Trevor R.; Kokmeyer, Dirk; Millett, Peter J.

    2012-01-01

    Purpose: To provide an overview of the characteristics and timing of rotator cuff healing and provide an update on treatments used in rehabilitation of rotator cuff repairs. The authors' protocol of choice, used within a large sports medicine rehabilitation center, is presented and the rationale behind its implementation is discussed. Background: If initial nonsurgical treatment of a rotator cuff tear fails, surgical repair is often the next line of treatment. It is evident that a successful outcome after surgical rotator cuff repair is as much dependent on surgical technique as it is on rehabilitation. To this end, rehabilitation protocols have proven challenging to both the orthopaedic surgeon and the involved physical therapist. Instead of being based on scientific rationale, traditionally most rehabilitation protocols are solely based on clinical experience and expert opinion. Methods: A review of currently available literature on rehabilitation after arthroscopic rotator cuff tear repair on PUBMED / MEDLINE and EMBASE databases was performed to illustrate the available evidence behind various postoperative treatment modalities. Results: There is little high-level scientific evidence available to support or contest current postoperative rotator cuff rehabilitation protocols. Most existing protocols are based on clinical experience with modest incorporation of scientific data. Conclusion: Little scientific evidence is available to guide the timing of postsurgical rotator cuff rehabilitation. To this end, expert opinion and clinical experience remains a large facet of rehabilitation protocols. This review describes a rotator cuff rehabilitation protocol that incorporates currently available scientific literature guiding rehabilitation. PMID:22530194

  14. Current concepts in the management of recurrent anterior gleno-humeral joint instability with bone loss.

    PubMed

    Ramhamadany, Eamon; Modi, Chetan S

    2016-06-18

    The management of recurrent anterior gleno-humeral joint instability is challenging in the presence of bone loss. It is often seen in young athletic patients and dislocations related to epileptic seizures and may involve glenoid bone deficiency, humeral bone deficiency or combined bipolar lesions. It is critical to accurately identify and assess the amount and position of bone loss in order to select the most appropriate treatment and reduce the risk of recurrent instability after surgery. The current literature suggests that coracoid and iliac crest bone block transfers are reliable for treating glenoid defects. The treatment of humeral defects is more controversial, however, although good early results have been reported after arthroscopic Remplissage for small defects. Larger humeral defects may require complex reconstruction or partial resurfacing. There is currently very limited evidence to support treatment strategies when dealing with bipolar lesions. The aim of this review is to summarise the current evidence regarding the best imaging modalities and treatment strategies in managing this complex problem relating particularly to contact athletes and dislocations related to epileptic seizures. PMID:27335809

  15. Current concepts on the management of orbital blow-out fractures.

    PubMed

    Koornneef, L

    1982-09-01

    Surgical versus nonsurgical treatment of orbital blow-out fractures has been controversial in the past. In the 1950s it was advocated that all blow-out fractures be treated surgically based on the conception that extraocular muscles were blown out and trapped in the fracture hole, causing double vision and enophthalmos. Gradually, however, a shift to a more conservative approach occurred, probably because of the complications of surgery, the disappointing results in improvement of motility and enophthalmos, and the growing evidence of spontaneous improvement of double vision. This article analyzes the literature chronologically and blends this analysis with the results of a new anatomical approach to the human orbit. New theories on the mechanism of blow-out fractures are postulated. No longer is entrapment of muslces in a blow-out fracture held responsible for the severe motility problems; rather it is viewed as caused by a dysfunction of the entire motility apparatus in the fracture region. Consequently, conventional surgical treatment, repairing the orbital floor only, seems to have lost its theoretical foundation and a conservative approach is advocated until microsurgical techniques become more readily avaliable to treat the sequelae of blow-out fractures at their origin. PMID:7137815

  16. Intratumor heterogeneity, variability and plasticity: questioning the current concepts in classification and treatment of hepatocellular carcinoma.

    PubMed

    Weiskirchen, Ralf

    2016-04-01

    In the classical view, the formation of a primary tumor is the consequence of a mutational event that first affects a single cell that subsequently passes through a multitude of consecutive hyperplastic and dysplastic stages. At the end of this pathogenetic sequence a cell arises that is potentially able to expanse infinitely having capacity to form a homogenous tumor mass. In contrary to this clonal expansion concept, the majority of primary human tumors display already a startling heterogeneity that can be reflected in different morphological features, physiological activities, and genetic diversity. In the past it was speculated that this cancer cell plasticity within a tumor is the result of an adaptive process that is induced by specific inhibiting therapies. In regard to the formation of hepatocellular carcinoma (HCC) this dogma was once challenged in a recent study that analysed tumor areas that were taken from HCC patients without medical pretreatment. Most of the analyzed samples showed highly significant intratumor heterogeneity. This affected morphological attributes, immunohistochemical stainability of five tumor-associated markers [α-fetoprotein (AFP), EpCAM, CK7, CD44 and glutamine synthetase], and integrity of genes (β-catenin and p53) that are critically involved in the pathogenesis of HCC. Altogether, this study showed that intratumor heterogeneity is a frequent finding in HCC that may contribute to treatment failure and drug resistance in HCC patients. PMID:27115013

  17. Synergetic sustainability enhancement via current biofuel infrastructure: waste-to-energy concept for biodiesel production.

    PubMed

    Kwon, Eilhann; Yi, Haakrho; Jeon, Young Jae

    2013-03-19

    The concept of waste-to-energy (WtE) with regards to the utilization of byproducts from the bioethanol industry (e.g., distiller's dried grain with solubles: DDGS) was employed to enhance the renewability of biodiesel, which would be an initiative stage of a biorefinery due to the conjunction between bioethanol and biodiesel. For example, DDGS is a strong candidate for use as a biodiesel feedstock due to the tremendous amount that is regularly generated. On the basis of an estimation of possible lipid recovery from DDGS, ∼30% of the biodiesel feedstock demand in 2010 could be supported by the total DDGS generation in the same year. Considering the future expansion of the bioethanol industry up to 2020, the possible lipid recovery from DDGS would provide more than 6 times the biodiesel feedstock demand in 2010. In order to enhance the renewability of biodiesel, the transformation of lipid extracted from DDGS into fatty acid ethyl ester (FAEE) via a noncatalytic transesterification reaction under ambient pressure was investigated in this work. The newly introduced method reported here enables the combination of the esterification of free fatty acids (FFAs) and the transesterification of triglycerides into a single step. This was achieved in the presence of a porous material (i.e., charcoal), and the optimal conditions for transformation into biodiesel via this noncatalytic method were assessed at the fundamental level. PMID:23410120

  18. Intratumor heterogeneity, variability and plasticity: questioning the current concepts in classification and treatment of hepatocellular carcinoma

    PubMed Central

    2016-01-01

    In the classical view, the formation of a primary tumor is the consequence of a mutational event that first affects a single cell that subsequently passes through a multitude of consecutive hyperplastic and dysplastic stages. At the end of this pathogenetic sequence a cell arises that is potentially able to expanse infinitely having capacity to form a homogenous tumor mass. In contrary to this clonal expansion concept, the majority of primary human tumors display already a startling heterogeneity that can be reflected in different morphological features, physiological activities, and genetic diversity. In the past it was speculated that this cancer cell plasticity within a tumor is the result of an adaptive process that is induced by specific inhibiting therapies. In regard to the formation of hepatocellular carcinoma (HCC) this dogma was once challenged in a recent study that analysed tumor areas that were taken from HCC patients without medical pretreatment. Most of the analyzed samples showed highly significant intratumor heterogeneity. This affected morphological attributes, immunohistochemical stainability of five tumor-associated markers [α-fetoprotein (AFP), EpCAM, CK7, CD44 and glutamine synthetase], and integrity of genes (β-catenin and p53) that are critically involved in the pathogenesis of HCC. Altogether, this study showed that intratumor heterogeneity is a frequent finding in HCC that may contribute to treatment failure and drug resistance in HCC patients. PMID:27115013

  19. Evolution of biomarker guided therapy for heart failure: current concepts and trial evidence.

    PubMed

    Pruett, Amanda E; Lee, Amanda K; Patterson, J Herbert; Schwartz, Todd A; Glotzer, Jana M; Adams, Kirkwood F

    2015-01-01

    Optimizing management of patients with heart failure remains quite challenging despite many significant advances in drug and device therapy for this syndrome. Although a large body of evidence from robust clinical trials supports multiple therapies, utilization of these well-established treatments remains inconsistent and outcomes suboptimal in "real-world" patients with heart failure. Disease management programs may be effective, but are difficult to implement due to cost and logistical issues. Another approach to optimizing therapy is to utilize biomarkers to guide therapeutic choices. Natriuretic peptides provide additional information of significant clinical value in the diagnosis and estimation of risk inpatients with heart failure. Ongoing research suggests a potential important added role for natriuretic peptides in heart failure. Guiding therapy based on serial changes in these biomarkers may be an effective strategy to optimize treatment and achieve better outcomes in this syndrome. Initial, innovative, proof-of-concept studies have provided encouraging results and important insights into key aspects of this strategy, but well designed, large-scale, multicenter, randomized, outcome trials are needed to definitively establish this novel approach to management. Given the immense and growing public health burden of heart failure, identification of cost-effective ways to decrease the morbidity and mortality due to this syndrome is critical. PMID:24251462

  20. Evolution of Biomarker Guided Therapy for Heart Failure: Current Concepts and Trial Evidence

    PubMed Central

    Pruett, Amanda E; Lee, Amanda K; Patterson, Herbert; Schwartz, Todd A; Glotzer, Jana M; Adams, Jr, Kirkwood F

    2015-01-01

    Optimizing management of patients with heart failure remains quite challenging despite many significant advances in drug and device therapy for this syndrome. Although a large body of evidence from robust clinical trials supports multiple thera-pies, utilization of these well-established treatments remains inconsistent and outcomes suboptimal in “real-world” patients with heart failure. Disease management programs may be effective, but are difficult to implement due to cost and logistical issues. Another approach to optimizing therapy is to utilize biomarkers to guide therapeutic choices. Natriuretic peptides pro-vide additional information of significant clinical value in the diagnosis and estimation of risk inpatients with heart failure. Ongoing research suggests a potential important added role for natriuretic peptides in heart failure. Guiding therapy based on serial changes in these biomarkers may be an effective strategy to optimize treatment and achieve better outcomes in this syn-drome. Initial, innovative, proof-of-concept studies have provided encouraging results and important insights into key as-pects of this strategy, but well designed, large-scale, multicenter, randomized, outcome trials are needed to definitively estab-lish this novel approach to management. Given the immense and growing public health burden of heart failure, identification of cost-effective ways to decrease the morbidity and mortality due to this syndrome is critical. PMID:24251462

  1. Diffuse-type tenosynovial giant cell tumour: Current treatment concepts and future perspectives.

    PubMed

    Staals, Eric L; Ferrari, Stefano; Donati, Davide M; Palmerini, Emanuela

    2016-08-01

    At present, the optimal treatment strategy in patients with diffuse-type tenosynovial giant cell tumour (D-TGCT) is unclear. The purpose of this review was to describe current treatment options, and to highlight recent developments in the knowledge of the molecular pathogenesis of D-TGCT as well as related therapeutic implications. Epidemiology, clinical features, and the pathogenesis of D-TGCT and the most widely used treatment modalities are described. D-TGCT is a benign clonal neoplastic proliferation arising from the synovium. Patients are often symptomatic and require multiple surgical procedures during their lifetime. Currently, surgery is the main treatment for patients with D-TGCT, with relapse rates ranging from 14% to 55%. Radiosynovectomy and external beam radiotherapy have been used in combination with surgical excision or as single modalities. The finding that D-TGCT cells overexpress colony-stimulating factor 1 (CSF1), resulting in recruitment of CSF1 receptor (CSF1R)-bearing macrophages that are polyclonal and make up the bulk of the tumour, has led to clinical trials with CSF1R inhibitors. These inhibitors include small molecules such as imatinib, nilotinib, PLX3397, and the monoclonal antibody RG7155. In conclusion, D-TGCT impairs patients' quality of life significantly. The evidence that the pathogenetic loop of D-TGCT can be inhibited could potentially change the therapeutic armamentarium for this condition. Clinical trials of agents that target D-TGCT are currently ongoing. In the meantime, international registries should be activated in order to provide useful information on this relatively rare tumour. PMID:27267143

  2. Contribution of genosystematics to current concepts of phylogeny and classification of bryophytes.

    PubMed

    Troitsky, A V; Ignatov, M S; Bobrova, V K; Milyutina, I A

    2007-12-01

    This paper is a survey of the current state of molecular studies on bryophyte phylogeny. Molecular data have greatly contributed to developing a phylogeny and classification of bryophytes. The previous traditional systems of classification based on morphological data are being significantly revised. New data of the authors are presented on phylogeny of Hypnales pleurocarpous mosses inferred from nucleotide sequence data of the nuclear DNA internal transcribed spacers ITS1-2 and the trnL-F region of the chloroplast genome. PMID:18205621

  3. Prehospital therapeutic hypothermia after cardiac arrest--from current concepts to a future standard.

    PubMed

    Kämäräinen, Antti; Hoppu, Sanna; Silfvast, Tom; Virkkunen, Ilkka

    2009-01-01

    Therapeutic hypothermia has been shown to improve survival and neurological outcome after prehospital cardiac arrest. Existing experimental and clinical evidence supports the notion that delayed cooling results in lesser benefit compared to early induction of mild hypothermia soon after return of spontaneous circulation. Therefore a practical approach would be to initiate cooling already in the prehospital setting. The purpose of this review was to evaluate current clinical studies on prehospital induction of mild hypothermia after cardiac arrest. Most reported studies present data on cooling rates, safety and feasibility of different methods, but are inconclusive as regarding to outcome effects. PMID:19821967

  4. Prehospital therapeutic hypothermia after cardiac arrest - from current concepts to a future standard

    PubMed Central

    Kämäräinen, Antti; Hoppu, Sanna; Silfvast, Tom; Virkkunen, Ilkka

    2009-01-01

    Therapeutic hypothermia has been shown to improve survival and neurological outcome after prehospital cardiac arrest. Existing experimental and clinical evidence supports the notion that delayed cooling results in lesser benefit compared to early induction of mild hypothermia soon after return of spontaneous circulation. Therefore a practical approach would be to initiate cooling already in the prehospital setting. The purpose of this review was to evaluate current clinical studies on prehospital induction of mild hypothermia after cardiac arrest. Most reported studies present data on cooling rates, safety and feasibility of different methods, but are inconclusive as regarding to outcome effects. PMID:19821967

  5. Longitudinal emittance: An introduction to the concept and survey of measurement techniques including design of a wall current monitor

    SciTech Connect

    Webber, R.C.

    1990-03-01

    The properties of charged particle beams associated with the distribution of the particles in energy and in time can be grouped together under the category of longitudinal emittance. This article is intended to provide an intuitive introduction to the concepts longitudinal emittance; to provide an incomplete survey of methods used to measure this emittance and the related properties of bunch length and momentum spread; and to describe the detailed design of a 6 Ghz bandwidth resistive wall current monitor useful for measuring bunch shapes of moderate to high intensity beams. Overall, the article is intended to be broad in scope, in most cases deferring details to cited original papers. 37 refs., 21 figs.

  6. Multimodality Imaging of the Painful Elbow: Current Imaging Concepts and Image-Guided Treatments for the Injured Thrower's Elbow.

    PubMed

    Gustas, Cristy N; Lee, Kenneth S

    2016-09-01

    Elbow pain in overhead sport athletes is not uncommon. Repetitive throwing can lead to chronic overuse and/or acute injury to tendons, ligaments, bones, or nerves about the elbow. A thorough history and physical examination of the thrower's elbow frequently establishes the diagnosis for pain. Imaging can provide additional information when the clinical picture is unclear or further information is necessary for risk stratification and treatment planning. This article focuses on current imaging concepts and image-guided treatments for injuries commonly affecting the adult throwing athlete's elbow. PMID:27545422

  7. Current concept of transcatheter closure of atrial septal defect in adults.

    PubMed

    Akagi, Teiji

    2015-01-01

    After the introduction of catheter intervention for atrial septal defect (ASD) in the pediatric population, therapeutic advantages of this less invasive procedure were focused on adult through geriatric populations. The most valuable clinical benefits of this procedure are the significant improvement of symptoms and daily activities, which result from the closure of left to right shunt without thoracotomy and cardiopulmonary bypass surgery. These benefits contribute to increase the number of adult patients of this condition who have hesitated over surgical closure. In terms of technical point of view for catheter closure of ASD, the difficulties still exist in some morphological features of defect, or hemodynamic features in the adult population. Morphological features of difficult ASD closure are (1) large (≥30 mm) ASD, (2) wide rim deficiency, and (3) multiple defects. Hemodynamic features of difficult ASD are (1) severe pulmonary hypertension, (2) ventricular dysfunction, and (3) restrictive left ventricular compliance (diastolic dysfunction) after ASD closure. To complete the catheter ASD closure under these difficult conditions, various procedural techniques have been introduced. These are new imaging modalities such as real-time three-dimensional imaging, new technical modifications, and new concepts for hemodynamic evaluation. Especially, real-time three-dimensional transesophageal echocardiography can provide the high quality imaging for anatomical evaluation including maximum defect size, surrounding rim morphology, and the relationship between device and septal rim. In adult patients, optimal management for their comorbidities is an important issue, which includes cardiac function, atrial arrhythmias, respiratory function, and renal function. Management of atrial arrhythmias is a key issue for the long-term outcome in adult patients. Because the interventional procedures are not complication-free techniques, the establishment of a surgical back

  8. Neuroimaging Assessment of Cerebrovascular Reactivity in Concussion: Current Concepts, Methodological Considerations, and Review of the Literature

    PubMed Central

    Ellis, Michael J.; Ryner, Lawrence N.; Sobczyk, Olivia; Fierstra, Jorn; Mikulis, David J.; Fisher, Joseph A.; Duffin, James; Mutch, W. Alan C.

    2016-01-01

    Concussion is a form of traumatic brain injury (TBI) that presents with a wide spectrum of subjective symptoms and few objective clinical findings. Emerging research suggests that one of the processes that may contribute to concussion pathophysiology is dysregulation of cerebral blood flow (CBF) leading to a mismatch between CBF delivery and the metabolic needs of the injured brain. Cerebrovascular reactivity (CVR) is defined as the change in CBF in response to a measured vasoactive stimulus. Several magnetic resonance imaging (MRI) techniques can be used as a surrogate measure of CBF in clinical and laboratory studies. In order to provide an accurate assessment of CVR, these sequences must be combined with a reliable, reproducible vasoactive stimulus that can manipulate CBF. Although CVR imaging currently plays a crucial role in the diagnosis and management of many cerebrovascular diseases, only recently have studies begun to apply this assessment tool in patients with concussion. In order to evaluate the quality, reliability, and relevance of CVR studies in concussion, it is important that clinicians and researchers have a strong foundational understanding of the role of CBF regulation in health, concussion, and more severe forms of TBI, and an awareness of the advantages and limitations of currently available CVR measurement techniques. Accordingly, in this review, we (1) discuss the role of CVR in TBI and concussion, (2) examine methodological considerations for MRI-based measurement of CVR, and (3) provide an overview of published CVR studies in concussion patients. PMID:27199885

  9. Current concepts and controversies in the management of early stage Hodgkin lymphoma

    PubMed Central

    Maeda, Lauren S.; Lee, Mark; Advani, Ranjana H.

    2015-01-01

    Over the past three decades, due to the recognition of late effects related to high-dose extended field radiotherapy and heavy alkylator chemotherapy, combined modality therapy with abbreviated chemotherapy and limited field radiotherapy has emerged as the standard of care for early stage Hodgkin lymphoma, with cure rates in excess of 80%. Currently, however, controversy remains over identifying the most appropriate criteria to risk-stratify patients with early stage disease, so that those with a favorable prognosis receive limited treatment without compromising cure rates and those with unfavorable risk receive more intensified therapy. The optimal risk stratification system remains unclear, with variable definitions of favorable and unfavorable disease used by research groups in North America and Europe. Thus, comparison of clinical trial results has been challenging, and additional controversies persist regarding optimal chemotherapy regimens, duration of therapy, and the role of radiotherapy. Investigations are ongoing to assess the potential of functional imaging and biomarkers as tools for risk stratification. The collective goal is to further refine current stratification strategies to allow for an individualized, risk-adapted treatment approach that minimizes long-term late effects without compromising high cure rates. PMID:21463118

  10. Current Concepts and Ongoing Research in the Prevention and Treatment of Open Fracture Infections

    PubMed Central

    Hannigan, Geoffrey D.; Pulos, Nicholas; Grice, Elizabeth A.; Mehta, Samir

    2015-01-01

    Significance: Open fractures are fractures in which the bone has violated the skin and soft tissue. Because of their severity, open fractures are associated with complications that can result in increased lengths of hospital stays, multiple operative interventions, and even amputation. One of the factors thought to influence the extent of these complications is exposure and contamination of the open fracture with environmental microorganisms, potentially those that are pathogenic in nature. Recent Advances: Current open fracture care aims to prevent infection by wound classification, prophylactic antibiotic administration, debridement and irrigation, and stable fracture fixation. Critical Issues: Despite these established treatment paradigms, infections and infection-related complications remain a significant clinical burden. To address this, improvements need to be made in our ability to detect bacterial infections, effectively remove wound contamination, eradicate infections, and treat and prevent biofilm formation associated with fracture fixation hardware. Future Directions: Current research is addressing these critical issues. While culture methods are of limited value, culture-independent molecular techniques are being developed to provide informative detection of bacterial contamination and infection. Other advanced contamination- and infection-detecting techniques are also being investigated. New hardware-coating methods are being developed to minimize the risk of biofilm formation in wounds, and immune stimulation techniques are being developed to prevent open fracture infections. PMID:25566415

  11. Translational research in pancreatic ductal adenocarcinoma: current evidence and future concepts.

    PubMed

    Kruger, Stephan; Haas, Michael; Ormanns, Steffen; Bächmann, Sibylle; Siveke, Jens T; Kirchner, Thomas; Heinemann, Volker; Boeck, Stefan

    2014-08-21

    Pancreatic ductal adenocarcinoma (PDA) is one of the major causes for cancer death worldwide. Treatment of metastatic disease remains challenging as only certain patients benefit from advances made with the intensified chemotherapy regimen folinic acid, irinotecan and oxaliplatin, the epidermal growth factor receptor inhibitor erlotinib or the recently FDA-approved nab-paclitaxel. Up to date, no established approach for prediction of treatment response or specific treatment allocation exists. Translational research was able to identify a number of potential biomarkers that might help to improve the dismal prognosis of PDA by facilitating upfront treatment allocation. This topic highlight is focused on current evidence on potential biomarkers for tumor biology, prognosis and prediction of treatment efficacy. PMID:25152580

  12. Genetics of Age-Related Macular Degeneration: Current Concepts, Future Directions

    PubMed Central

    DeAngelis, Margaret M.; Silveira, Alexandra C.; Carr, Elizabeth A.; Kim, Ivana K.

    2014-01-01

    Age-related macular degeneration (AMD) is a progressive degenerative disease which leads to blindness, affecting the quality of life of millions of Americans. More than 1.75 million individuals in the United States are affected by the advanced form of AMD. The etiological pathway of AMD is not yet fully understood, but there is a clear genetic influence on disease risk. To date, the 1q32 (CFH) and 10q26 (PLEKHA1/ARMS2/HTRA1) loci are the most strongly associated with disease; however, the variation in these genomic regions alone is unable to predict disease development with high accuracy. Therefore, current genetic studies are aimed at identifying new genes associated with AMD and their modifiers, with the goal of discovering diagnostic or prognostic biomarkers. Moreover, these studies provide the foundation for further investigation into the pathophysiology of AMD by utilizing a systems-biology-based approach to elucidate underlying mechanistic pathways. PMID:21609220

  13. Current Concepts of Bone Tissue Engineering for Craniofacial Bone Defect Repair

    PubMed Central

    Fishero, Brian Alan; Kohli, Nikita; Das, Anusuya; Christophel, John Jared; Cui, Quanjun

    2014-01-01

    Craniofacial fractures and bony defects are common causes of morbidity and contribute to increasing health care costs. Successful regeneration of bone requires the concomitant processes of osteogenesis and neovascularization. Current methods of repair and reconstruction include rigid fixation, grafting, and free tissue transfer. However, these methods carry innate complications, including plate extrusion, nonunion, graft/flap failure, and donor site morbidity. Recent research efforts have focused on using stem cells and synthetic scaffolds to heal critical-sized bone defects similar to those sustained from traumatic injury or ablative oncologic surgery. Growth factors can be used to augment both osteogenesis and neovascularization across these defects. Many different growth factor delivery techniques and scaffold compositions have been explored yet none have emerged as the universally accepted standard. In this review, we will discuss the recent literature regarding the use of stem cells, growth factors, and synthetic scaffolds as alternative methods of craniofacial fracture repair. PMID:25709750

  14. Birdshot chorioretinopathy: current knowledge and new concepts in pathophysiology, diagnosis, monitoring and treatment.

    PubMed

    Minos, Evangelos; Barry, Robert J; Southworth, Sue; Folkard, Annie; Murray, Philip I; Duker, Jay S; Keane, Pearse A; Denniston, Alastair K

    2016-01-01

    Birdshot chorioretinopathy (BCR) is a rare form of chronic, bilateral, posterior uveitis with a distinctive clinical phenotype, and a strong association with HLA-A29. It predominantly affects people in middle age. Given its rarity, patients often encounter delays in diagnosis leading to delays in adequate treatment, and thus risking significant visual loss. Recent advances have helped increase our understanding of the underlying autoimmune mechanisms involved in disease pathogenesis, and new diagnostic approaches such as multimodality imaging have improved our ability to both diagnose and monitor disease activity. Whilst traditional immunosuppressants may be effective in BCR, increased understanding of immune pathways is enabling development of newer treatment modalities, offering the potential for targeted modulation of immune mediators. In this review, we will discuss current understanding of BCR and explore recent developments in diagnosis, monitoring and treatment of this disease. Synonyms for BCR: Birdshot chorioretinopathy, Birdshot retinochoroiditis, Birdshot retino-choroidopathy, Vitiliginous choroiditis. Orphanet number: ORPHA179 OMIM: 605808. PMID:27175923

  15. Feedbacks between geomorphology and biota controlling Earth surface processes and landforms: A review of foundation concepts and current understandings

    NASA Astrophysics Data System (ADS)

    Corenblit, Dov; Baas, Andreas C. W.; Bornette, Gudrun; Darrozes, José; Delmotte, Sébastien; Francis, Robert A.; Gurnell, Angela M.; Julien, Frédéric; Naiman, Robert J.; Steiger, Johannes

    2011-06-01

    This review article presents recent advances in the field of biogeomorphology related to the reciprocal coupling between Earth surface processes and landforms, and ecological and evolutionary processes. The aim is to present to the Earth Science community ecological and evolutionary concepts and associated recent conceptual developments for linking geomorphology and biota. The novelty of the proposed perspective is that (1) in the presence of geomorphologic-engineer species, which modify sediment and landform dynamics, natural selection operating at the scale of organisms may have consequences for the physical components of ecosystems, and particularly Earth surface processes and landforms; and (2) in return, these modifications of geomorphologic processes and landforms often feed back to the ecological characteristics of the ecosystem (structure and function) and thus to biological characteristics of engineer species and/or other species (adaptation and speciation). The main foundation concepts from ecology and evolutionary biology which have led only recently to an improved conception of landform dynamics in geomorphology are reviewed and discussed. The biogeomorphologic macroevolutionary insights proposed explicitly integrate geomorphologic niche-dimensions and processes within an ecosystem framework and reflect current theories of eco-evolutionary and ecological processes. Collectively, these lead to the definition of an integrated model describing the overall functioning of biogeomorphologic systems over ecological and evolutionary timescales.

  16. Current Concepts in Pediatric Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia

    PubMed Central

    Bernt, Kathrin M.; Hunger, Stephen P.

    2014-01-01

    The t(9;22)(q34;q11) or Philadelphia chromosome creates a BCR–ABL1 fusion gene encoding for a chimeric BCR–ABL1 protein. It is present in 3–4% of pediatric acute lymphoblastic leukemia (Ph+ ALL), and about 25% of adult ALL cases. Prior to the advent of tyrosine kinase inhibitors (TKI), Ph+ ALL was associated with a very poor prognosis despite the use of intensive chemotherapy and frequently hematopoietic stem-cell transplantation (HSCT) in first remission. The development of TKIs revolutionized the therapy of Ph+ ALL. Addition of the first generation ABL1 class TKI imatinib to intensive chemotherapy dramatically increased the survival for children with Ph+ ALL and established that many patients can be cured without HSCT. In parallel, the mechanistic understanding of Ph+ ALL expanded exponentially through careful mapping of pathways downstream of BCR–ABL1, the discovery of mutations in master regulators of B-cell development such as IKZF1 (Ikaros), PAX5, and early B-cell factor (EBF), the recognition of the complex clonal architecture of Ph+ ALL, and the delineation of genomic, epigenetic, and signaling abnormalities contributing to relapse and resistance. Still, many important basic and clinical questions remain unanswered. Current clinical trials are testing second generation TKIs in patients with newly diagnosed Ph+ ALL. Neither the optimal duration of therapy nor the optimal chemotherapy backbone are currently defined. The role of HSCT in first remission and post-transplant TKI therapy also require further study. In addition, it will be crucial to continue to dig deeper into understanding Ph+ ALL at a mechanistic level, and translate findings into complementary targeted approaches. Expanding targeted therapies hold great promise to decrease toxicity and improve survival in this high-risk disease, which provides a paradigm for how targeted therapies can be incorporated into treatment of other high-risk leukemias. PMID:24724051

  17. Methadone, QTc prolongation and torsades de pointes: Current concepts, management and a hidden twist in the tale?

    PubMed Central

    Mujtaba, Sobia; Romero, Jorge; Taub, Cynthia C.

    2013-01-01

    Methadone is a drug that has found widespread utility in the management of opioid addiction and pain. Along with its popularity, methadone has also earned an infamous reputation for causing prolongation of the QT interval and an increased risk of torsades de pointes. In this article we will give a brief overview of the long QT syndromes, followed by an in-depth look at the current pathophysiologic mechanisms of methadone induced QT prolongation, a review of the existing literature and the current concepts regarding the prevention and management of methadone induced torsades de pointes. In addition, we explore the idea and implications of a genetic link between methadone induced prolongation of the QT interval and torsades de pointes. PMID:24653586

  18. AGU Committees

    NASA Astrophysics Data System (ADS)

    Administrative Committees are responsible for those functions required for the overall performance or well-being of AGU as an organization. These committees are Audit and Legal Affairs, Budget and Finance*, Development, Nominations*, Planning, Statutes and Bylaws*, Tellers.Operating Committees are responsible for the policy direction and operational oversight of AGU's primary programs. The Operating Committees are Education and Human Resources, Fellows*, Information Technology, International Participation*, Meetings, Public Affairs, Public Information, Publications*.

  19. Nonlinear current-voltage characteristics based on semiconductor nanowire networks enable a new concept in thermoelectric device optimization

    NASA Astrophysics Data System (ADS)

    Diaz Leon, Juan J.; Norris, Kate J.; Hartnett, Ryan J.; Garrett, Matthew P.; Tompa, Gary S.; Kobayashi, Nobuhiko P.

    2016-08-01

    Thermoelectric (TE) devices that produce electric power from heat are driven by a temperature gradient (Δ T = T_{{hot}} - T_{{cold}}, T hot: hot side temperature, T cold: cold side temperature) with respect to the average temperature ( T). While the resistance of TE devices changes as Δ T and/or T change, the current-voltage ( I- V) characteristics have consistently been shown to remain linear, which clips generated electric power ( P gen) within the given open-circuit voltage ( V OC) and short-circuit current ( I SC). This P gen clipping is altered when an appropriate nonlinearity is introduced to the I- V characteristics—increasing P gen. By analogy, photovoltaic cells with a large fill factor exhibit nonlinear I- V characteristics. In this paper, the concept of a unique TE device with nonlinear I- V characteristics is proposed and experimentally demonstrated. A single TE device with nonlinear I- V characteristics is fabricated by combining indium phosphide (InP) and silicon (Si) semiconductor nanowire networks. These TE devices show P gen that is more than 25 times larger than those of comparable devices with linear I- V characteristics. The plausible causes of the nonlinear I- V characteristics are discussed. The demonstrated concept suggests that there exists a new pathway to increase P gen of TE devices made of semiconductors.

  20. Current concepts on the virulence mechanisms of meticillin-resistant Staphylococcus aureus

    PubMed Central

    David, Michael Z.; Salata, Robert A.

    2012-01-01

    Meticillin-resistant Staphylococcus aureus (MRSA) strains are prevalent bacterial pathogens that cause both health care and community-associated infections. Increasing resistance to commonly prescribed antibiotics has made MRSA a serious threat to public health throughout the world. The USA300 strain of MRSA has been responsible for an epidemic of community-associated infections in the US, mostly involving skin and soft tissue but also more serious invasive syndromes such as pneumonia, severe sepsis and endocarditis. MRSA strains are particularly serious and potentially lethal pathogens that possess virulence mechanisms including toxins, adhesins, enzymes and immunomodulators. One of these is Panton–Valentine leukocidin (PVL), a toxin associated with abscess formation and severe necrotizing pneumonia. Earlier studies suggested that PVL was a major virulence factor in community-associated MRSA infections. However, some recent data have not supported this association while others have, leading to controversy. Therefore, investigators continue to search for additional mechanisms of pathogenesis. In this review, we summarize the current understanding of the biological basis of MRSA virulence and explore future directions for research, including potential vaccines and antivirulence therapies under development that might allow clinicians to more successfully treat and prevent MRSA infections. PMID:22745137

  1. Orthopedic disorders of the knee in hemophilia: A current concept review.

    PubMed

    Rodriguez-Merchan, E Carlos; Valentino, Leonard A

    2016-06-18

    The knee is frequently affected by severe orthopedic changes known as hemophilic arthropathy (HA) in patients with deficiency of coagulation factor VIII or IX and thus this manuscript seeks to present a current perspective of the role of the orthopedic surgeon in the management of these problems. Lifelong factor replacement therapy (FRT) is optimal to prevent HA, however adherence to this regerous treatment is challenging leading to breakthrough bleeding. In patients with chronic hemophilic synovitis, the prelude to HA, radiosynovectomy (RS) is the optimal to ameliorate bleeding. Surgery in people with hemophilia (PWH) is associated with a high risk of bleeding and infection, and must be performed with FRT. A coordinated effort including orthopedic surgeons, hematologists, physical medicine and rehabilitation physicians, physiotherapists and other team members is key to optimal outcomes. Ideally, orthopedic procedures should be performed in specialized hospitals with experienced teams. Until we are able to prevent orthopedic problems of the knee in PWH will have to continue performing orthopedic procedures (arthrocentesis, RS, arthroscopic synovectomy, hamstring release, arthroscopic debridement, alignment osteotomy, and total knee arthroplasty). By using the aforementioned procedures, the quality of life of PWH will be improved. PMID:27335812

  2. Hand Blisters in Major League Baseball Pitchers: Current Concepts and Management.

    PubMed

    McNamara, Andrew R; Ensell, Scott; Farley, Timothy D

    2016-01-01

    Friction blisters are a common sequela of many athletic activities. Their significance can range from minor annoyance to major performance disruptions. The latter is particularly true in baseball pitchers, who sustain repeated trauma between the baseball seams and the fingers of the pitching hand, predominately at the tips of the index and long fingers. Since 2010, 6 Major League Baseball (MLB) players accounted for 7 stints on the disabled list (DL) due to blisters. These injuries resulted in a total of 151 days spent on the DL. Since 2012, 8 minor league players spent time on the DL due to blisters. Moreover, there have been several documented and publicized instances of professional baseball pitchers suffering blisters that did not require placement on the DL but did result in injury time and missed starts. The purpose of this article is to review the etiology and pathophysiology of friction blisters with particular reference to baseball pitchers; provide an overview of past and current prevention methods; and discuss our experience in treating friction blisters in MLB pitchers. PMID:26991565

  3. Orthopedic disorders of the knee in hemophilia: A current concept review

    PubMed Central

    Rodriguez-Merchan, E Carlos; Valentino, Leonard A

    2016-01-01

    The knee is frequently affected by severe orthopedic changes known as hemophilic arthropathy (HA) in patients with deficiency of coagulation factor VIII or IX and thus this manuscript seeks to present a current perspective of the role of the orthopedic surgeon in the management of these problems. Lifelong factor replacement therapy (FRT) is optimal to prevent HA, however adherence to this regerous treatment is challenging leading to breakthrough bleeding. In patients with chronic hemophilic synovitis, the prelude to HA, radiosynovectomy (RS) is the optimal to ameliorate bleeding. Surgery in people with hemophilia (PWH) is associated with a high risk of bleeding and infection, and must be performed with FRT. A coordinated effort including orthopedic surgeons, hematologists, physical medicine and rehabilitation physicians, physiotherapists and other team members is key to optimal outcomes. Ideally, orthopedic procedures should be performed in specialized hospitals with experienced teams. Until we are able to prevent orthopedic problems of the knee in PWH will have to continue performing orthopedic procedures (arthrocentesis, RS, arthroscopic synovectomy, hamstring release, arthroscopic debridement, alignment osteotomy, and total knee arthroplasty). By using the aforementioned procedures, the quality of life of PWH will be improved. PMID:27335812

  4. Anti-IgE therapy with omalizumab for severe asthma: current concepts and potential developments.

    PubMed

    Pelaia, Girolamo; Vatrella, Alessandro; Busceti, Maria Teresa; Gallelli, Luca; Terracciano, Rosa; Maselli, Rosario

    2015-01-01

    The humanized monoclonal anti-IgE antibody omalizumab is currently the only biologic drug approved for asthma treatment. Omalizumab inhibits allergic responses by binding to serum immunoglobulins E (IgE), thus preventing their interactions with cellular IgE receptors. Omalizumab is also capable of down-regulating the expression of high affinity IgE receptors on inflammatory cells, as well as the numbers of eosinophils in both peripheral blood and induced sputum. The clinical effects of omalizumab include relevant improvements in respiratory symptoms and quality of life, paralleled by a marked reduction of asthma exacerbations, emergency room visits, and use of systemic corticosteroids and rescue bronchodilators. Moreover, some recent studies suggest potential benefits of omalizumab also in non allergic phenotypes of severe asthma. Very interesting are also further recent reports referring to the potential inhibitory effect of omalizumab with regard to bronchial structural changes, especially occurring in severe asthma and globally defined as airway remodeling. Omalizumab is relatively well tolerated, and only very rarely induces anaphylactic reactions. Therefore, this drug represents a valid option as add-on therapy for patients with severe persistent asthma, inadequately controlled by high doses of standard inhaled treatments. PMID:25523898

  5. Current concepts on the virulence mechanisms of meticillin-resistant Staphylococcus aureus.

    PubMed

    Watkins, Richard R; David, Michael Z; Salata, Robert A

    2012-09-01

    Meticillin-resistant Staphylococcus aureus (MRSA) strains are prevalent bacterial pathogens that cause both health care and community-associated infections. Increasing resistance to commonly prescribed antibiotics has made MRSA a serious threat to public health throughout the world. The USA300 strain of MRSA has been responsible for an epidemic of community-associated infections in the US, mostly involving skin and soft tissue but also more serious invasive syndromes such as pneumonia, severe sepsis and endocarditis. MRSA strains are particularly serious and potentially lethal pathogens that possess virulence mechanisms including toxins, adhesins, enzymes and immunomodulators. One of these is Panton-Valentine leukocidin (PVL), a toxin associated with abscess formation and severe necrotizing pneumonia. Earlier studies suggested that PVL was a major virulence factor in community-associated MRSA infections. However, some recent data have not supported this association while others have, leading to controversy. Therefore, investigators continue to search for additional mechanisms of pathogenesis. In this review, we summarize the current understanding of the biological basis of MRSA virulence and explore future directions for research, including potential vaccines and antivirulence therapies under development that might allow clinicians to more successfully treat and prevent MRSA infections. PMID:22745137

  6. Immune responses towards intestinal bacteria--current concepts and future perspectives.

    PubMed

    Duchmann, R; Neurath, M; Märker-Hermann, E; Meyer Zum Büschenfelde, K H

    1997-05-01

    The intestinal mucosa constitutes an important barrier as it separates each individual from a large array of antigens within the bowel lumen. These luminal antigens may either be derived from pathogens or may be derived from harmless constituents such as ingested food or the normal intestinal flora. The dichotomy of potentially harmful and potentially harmless antigens encountered by the mucosal immune system poses the important task that, with regard to bacteria-derived antigens, the gut associated immune system is required to mount an efficient host defense against pathogenic bacteria but to maintain at the same time the regulatory control mechanisms which protect the human organism from hyperresponsiveness, and thus chronic inflammation, towards antigens from the normal intestinal flora. In the present review, we discuss variable host and bacterial factors which are likely to determine whether the immune response to pathogenic or normal intestinal bacteria will have beneficial or detrimental consequences for the human organism. Using infections with the prototype enteropathogens V. cholerae and enteropathogenic E. coli (ETEC), Y. enterocolitica induced reactive arthritis (ReA) and in more detail, inflammatory bowel diseases (IBD) as exemplary clinical situations, we review current hypotheses of how bacteria or their products are encountered by cellular components of the specific immune system and how this may relate to disease pathogenesis and the development of new treatment strategies. PMID:9188147

  7. Current concepts in the diagnosis and management of cytokine release syndrome

    PubMed Central

    Lee, Daniel W.; Gardner, Rebecca; Porter, David L.; Louis, Chrystal U.; Ahmed, Nabil; Jensen, Michael; Grupp, Stephan A.

    2014-01-01

    As immune-based therapies for cancer become potent, more effective, and more widely available, optimal management of their unique toxicities becomes increasingly important. Cytokine release syndrome (CRS) is a potentially life-threatening toxicity that has been observed following administration of natural and bispecific antibodies and, more recently, following adoptive T-cell therapies for cancer. CRS is associated with elevated circulating levels of several cytokines including interleukin (IL)-6 and interferon γ, and uncontrolled studies demonstrate that immunosuppression using tocilizumab, an anti-IL-6 receptor antibody, with or without corticosteroids, can reverse the syndrome. However, because early and aggressive immunosuppression could limit the efficacy of the immunotherapy, current approaches seek to limit administration of immunosuppressive therapy to patients at risk for life-threatening consequences of the syndrome. This report presents a novel system to grade the severity of CRS in individual patients and a treatment algorithm for management of CRS based on severity. The goal of our approach is to maximize the chance for therapeutic benefit from the immunotherapy while minimizing the risk for life threatening complications of CRS. PMID:24876563

  8. Stromal vascular fraction: A regenerative reality? Part 1: Current concepts and review of the literature.

    PubMed

    Nguyen, Andrew; Guo, James; Banyard, Derek A; Fadavi, Darya; Toranto, Jason D; Wirth, Garrett A; Paydar, Keyianoosh Z; Evans, Gregory R D; Widgerow, Alan D

    2016-02-01

    Stromal Vascular Fraction (SVF) is a heterogeneous collection of cells contained within adipose tissue that is traditionally isolated using enzymes such as collagenase. With the removal of adipose cells, connective tissue and blood from lipoaspirate, comes the SVF, a mix including mesenchymal stem cells, endothelial precursor cells, T regulatory cells, macrophages, smooth muscle cells, pericytes and preadipocytes. In part 1 of our 2-part series, we review the literature with regards to the intensifying interest that has shifted toward this mixture of cells, particularly due to its component synergy and translational potential. Trials assessing the regenerative potential of cultured Adipose Derived Stem Cells (ADSCs) and SVF demonstrate that SVF is comparably effective in treating conditions ranging from radiation injuries, burn wounds and diabetes, amongst others. Aside from their use in chronic conditions, SVF enrichment of fat grafts has proven a major advance in maintaining fat graft volume and viability. Many SVF studies are currently in preclinical phases or are moving to human trials. Overall, regenerative cell therapy based on SVF is at an early investigative stage but its potential for clinical application is enormous. PMID:26565755

  9. Organ Preservation: Current Concepts and New Strategies for the Next Decade

    PubMed Central

    Guibert, Edgardo E.; Petrenko, Alexander Y.; Balaban, Cecilia L.; Somov, Alexander Y.; Rodriguez, Joaquín V.; Fuller, Barry J.

    2011-01-01

    Summary Organ transplantation has developed over the past 50 years to reach the sophisticated and integrated clinical service of today through several advances in science. One of the most important of these has been the ability to apply organ preservation protocols to deliver donor organs of high quality, via a network of organ exchange to match the most suitable recipient patient to the best available organ, capable of rapid resumption of life-sustaining function in the recipient patient. This has only been possible by amassing a good understanding of the potential effects of hypoxic injury on donated organs, and how to prevent these by applying organ preservation. This review sets out the history of organ preservation, how applications of hypothermia have become central to the process, and what the current status is for the range of solid organs commonly transplanted. The science of organ preservation is constantly being updated with new knowledge and ideas, and the review also discusses what innovations are coming close to clinical reality to meet the growing demands for high quality organs in transplantation over the next few years. PMID:21566713

  10. Current Concepts and Diagnosis of IgG4-Related Pancreatitis (Type 1 AIP).

    PubMed

    Kawa, Shigeyuki

    2016-08-01

    Although now considered to be a member of the systemic entity of immunoglobulin G4- (IgG4-) related disease, IgG4-related pancreatitis is generally referred to as type 1 autoimmune pancreatitis (AIP). Type 1 AIP was established based on a pathological background of lymphoplasmacytic sclerosing pancreatitis, high serum IgG4 concentration, and abundant IgG4-bearing plasma cell infiltration. The characteristic clinical features of type 1 AIP, such as elderly male preponderance, obstructive jaundice, and mass-forming lesions in the pancreas, often mimic those of pancreatic cancer. However, because AIP responds favorably to corticosteroid treatment, careful differentiation from pancreatic cancer is required. An AIP diagnosis is currently based on the 2011 International Consensus Diagnostic Criteria for AIP, which are based on high sensitivity, selectivity, and accuracy. Over the long term, AIP can progress to a chronic condition, with pancreatic stone formation and atrophy resembling that of chronic pancreatitis. Although AIP has been linked to the complication of malignancies, it remains controversial whether an association exists between the disease and tumor formation. PMID:27466795

  11. Atypical teratoid/rhabdoid tumors-current concepts, advances in biology, and potential future therapies.

    PubMed

    Frühwald, Michael C; Biegel, Jaclyn A; Bourdeaut, Franck; Roberts, Charles W M; Chi, Susan N

    2016-06-01

    Atypical teratoid/rhabdoid tumor (AT/RT) is the most common malignant CNS tumor of children below 6 months of age. The majority of AT/RTs demonstrate genomic alterations in SMARCB1 (INI1, SNF5, BAF47) or, to a lesser extent, SMARCA4 (BRG1) of the SWItch/sucrose nonfermentable chromatin remodeling complex. Recent transcription and methylation profiling studies suggest the existence of molecular subgroups. Thus, at the root of these seemingly enigmatic tumors lies a network of factors related to epigenetic regulation, which is not yet completely understood. While conventional-type chemotherapy may have significant survival benefit for certain patients, it remains to be determined which patients will eventually prove resistant to chemotherapy and thus need novel therapeutic strategies. Elucidation of the molecular consequences of a disturbed epigenome has led to the identification of a series of transduction cascades, which may be targeted for therapy. Among these are the pathways of cyclin D1/cyclin-dependent kinases 4 and 6, Hedgehog/GLI1, Wnt/ß-catenin, enhancer of zeste homolog 2, and aurora kinase A, among others. Compounds specifically targeting these pathways or agents that alter the epigenetic state of the cell are currently being evaluated in preclinical settings and in experimental clinical trials for AT/RT. PMID:26755072

  12. Allogeneic hematopoietic SCT in children with ALL: current concepts of ongoing prospective SCT trials.

    PubMed

    Schrauder, A; von Stackelberg, A; Schrappe, M; Cornish, J; Peters, Christina

    2008-06-01

    The definition of indications for allogeneic SCT in children with high-risk (HR) ALL in the first remission or after the first or subsequent relapse depends on biological features, response to treatment and survival after chemotherapy alone. As the results of frontline and relapse protocols are improving over time, there is a strong need for prospective SCT trials, ensuring a well-standardized procedure regarding all relevant components that are potentially responsible for heterogeneity in post-SCT outcome. Therefore, in 2003, the ALL-BFM and the ALL-REZ BFM Study Group initiated a prospective, international, multicenter trial (ALL-SCT-BFM 2003). This trial will now be extended to a larger consortium, trial ALL-SCT-BFM-international (ALL-SCT-BFMi). Strict rules define HLA-typing, donor selection, conditioning regimen, GvHD prophylaxis and therapy as well as standards of supportive care to reduce treatment-related mortality and establish an early GVL effect. Moreover, comprehensive and closely reviewed documentation and serious adverse event reporting shall ensure high study quality. Case-by-case discussions of any fatal or critical course during annual meetings will improve the culture of failure management and lead to modifications of guidelines of supportive care. Finally, the results of these prospective trials will determine the current potential of the different SCT procedures in HR or relapsed childhood ALL. PMID:18545248

  13. Current and future concepts of the design of the intraocular lens.

    PubMed

    Jaffe, N S

    1985-01-01

    Anterior chamber lenses are currently much less popular than posterior chamber lenses. They are mainly used in conjunction with intracapsular cataract extraction, as a secondary lens implant, and as a back up lens in case of intraoperative complications of extracapsular cataract extraction. A major disadvantage of anterior chamber lenses is improper sizing. Rigid lenses cause the greatest ocular tenderness and present serious problems with errors in sizing but they are the easiest to explant. Semiflexible and flexible lenses show a greater tendency to develop peripheral anterior synechiae. This makes explanation a very difficult procedure. Posterior chamber lenses are the most popular today. There is a trend toward all-PMMA lenses because of concern over the biocompatibility of polypropylene. The use of a laser ridge may inhibit posterior capsule opacification and facilitate YAG laser posterior capsulectomy. Ultraviolet blockers are being incorporated as a copolymer of a mechanical additive. There is a major trend towards capsular bag fixation of posterior chamber lenses as a result of complications associated with sulcus-fixated lenses. These include: disruption of the blood-aqueous barrier due to loop penetration of the ciliary body; chafing of the posterior surface of the iris leading to transillumination defects, microhyphaemas, and pigment dispersion glaucoma. It is predicted that the number of cataract extractions and the percentage of intraocular lens implantations will continue to increase due to demographic factors. Budgetary allocations for research and development will increase because of the involvement of some of the giants of medical industry. This will lead to new implant materials and new surgical techniques. PMID:3879394

  14. Rapid assessment of health needs in mass emergencies: review of current concepts and methods.

    PubMed

    Guha-Sapir, D

    1991-01-01

    The increase in the number of natural disasters and their impact on population is of growing concern to countries at risk and agencies involved in health and humanitarian action. The numbers of persons killed or disabled as a result of earthquakes, cyclones, floods and famines have reached record levels in the last decade. Population density, rampant urbanization and climatic changes have brought about risk patterns that are exposing larger and larger sections of populations in developing countries to life-threatening natural disasters. Despite substantial spending on emergency relief, the approaches to relief remain largely ad hoc and amateurish, resulting generally in inappropriate and/or delayed action. In recent years, mass emergencies of the kind experienced in Bangladesh or the Sahelian countries have highlighted the importance of rapid assessment of health needs for better allocation of resources and relief management. As a result, the development of techniques for rapid assessment of health needs has been identified as a priority for effective emergency action. This article sketches the health context of disasters in terms of mortality and morbidity patterns; it describes initial assessment techniques currently used and their methodological biases and constraints; it also discusses assessment needs which vary between different types of disasters and the time frame within which assessments are undertaken. Earthquakes, cyclones, famines, epidemics or refugees all have specific risk profiles and emergency conditions which differ for each situation. Vulnerability to mortality changes according to age and occupation, for earthquakes and famines. These risk factors then have significant implications for the design of rapid assessment protocols and checklists. Experiences from the field in rapid survey techniques and estimation of death rates are discussed, with emphasis on the need for a reliable denominator even for the roughest assessment. Finally, the

  15. Current Concepts in the Molecular Genetics and Management of Thyroid Cancer: An Update for Radiologists.

    PubMed

    Kelil, Tatiana; Keraliya, Abhishek R; Howard, Stephanie A; Krajewski, Katherine M; Braschi-Amirfarzan, Marta; Hornick, Jason L; Ramaiya, Nikhil H; Tirumani, Sree Harsha

    2016-01-01

    Substantial improvement in the understanding of the oncogenic pathways in thyroid cancer has led to identification of specific molecular alterations, including mutations of BRAF and RET in papillary thyroid cancer, mutation of RAS and rearrangement of PPARG in follicular thyroid cancer, mutation of RET in medullary thyroid cancer, and mutations of TP53 and in the phosphatidylinositol 3'-kinase (PI3K)/AKT1 pathway in anaplastic thyroid cancer. Ultrasonography (US) and US-guided biopsy remain cornerstones in the initial workup of thyroid cancer. Surgery is the mainstay of treatment, with radioactive iodine (RAI) therapy reserved for differentiated subtypes. Posttreatment surveillance of thyroid cancer is done with US of the thyroid bed as well as monitoring of tumor markers such as serum thyroglobulin and serum calcitonin. Computed tomography (CT), magnetic resonance imaging, and fluorine 18 fluorodeoxyglucose positron emission tomography/CT are used in the follow-up of patients with negative iodine 131 imaging and elevated tumor markers. Certain mutations, such as mutations of BRAF in papillary thyroid carcinoma and mutations in RET codons 883, 918, and 928, are associated with an aggressive course in medullary thyroid carcinoma, and affected patients need close surveillance. Treatment options for metastatic RAI-refractory thyroid cancer are limited. Currently, Food and Drug Administration-approved molecularly targeted therapies for metastatic RAI-refractory thyroid cancer, including sorafenib, lenvatinib, vandetanib, and cabozantinib, target the vascular endothelial growth factor receptor and RET kinases. Imaging plays an important role in assessment of response to these therapies, which can be atypical owing to antiangiogenic effects. A wide spectrum of toxic effects is associated with the molecularly targeted therapies used in thyroid cancer and can be detected at restaging scans. (©)RSNA, 2016. PMID:27618325

  16. Validity: applying current concepts and standards to gynecologic surgery performance assessments.

    PubMed

    LeClaire, Edgar L; Nihira, Mikio A; Hardré, Patricia L

    2015-08-01

    from 0 to 1 across all forms of evidence. Weighted kappa values ranged 0.60-0.91. Validity claims in gynecologic surgical assessment over-rely on generalizability evidence. No test-criterion evidence was observed. Increased awareness of current standards and systematic argument development is needed for gynecologic performance assessments. PMID:25416024

  17. Conference Committees: Conference Committees

    NASA Astrophysics Data System (ADS)

    2009-09-01

    International Programm Committee (IPC) Harald Ade NCSU Sadao Aoki University Tsukuba David Attwood Lawrence Berkeley National Laboratory/CXRO Christian David Paul Scherrer Institut Peter Fischer Lawrence Berkeley National Laboratory Adam Hitchcock McMaster University Chris Jacobsen SUNY, Stony Brook Denis Joyeux Lab Charles Fabry de l'Institut d'Optique Yasushi Kagoshima University of Hyogo Hiroshi Kihara Kansai Medical University Janos Kirz SUNY Stony Brook Maya Kiskinova ELETTRA Ian McNulty Argonne National Lab/APS Alan Michette Kings College London Graeme Morrison Kings College London Keith Nugent University of Melbourne Zhu Peiping BSRF Institute of High Energy Physics Francois Polack Soleil Christoph Quitmann Paul Scherrer Institut Günther Schmahl University Göttingen Gerd Schneider Bessy Hyun-Joon Shin Pohang Accelerator Lab Jean Susini ESRF Mau-Tsu Tang NSRRC Tony Warwick Lawrence Berkeley Lab/ALS Local Organizing Committee Christoph Quitmann Chair, Scientific Program Charlotte Heer Secretary Christian David Scientific Program Frithjof Nolting Scientific Program Franz Pfeiffer Scientific Program Marco Stampanoni Scientific Program Robert Rudolph Sponsoring, Financials Alfred Waser Industry Exhibition Robert Keller Public Relation Markus Knecht Computing and WWW Annick Cavedon Proceedings and Excursions and Accompanying Persons Program Margrit Eichler Excursions and Accompanying Persons Program Kathy Eikenberry Excursions and Accompanying Persons Program Marlies Locher Excursions and Accompanying Persons Program

  18. THE CURRENT STATUS OF CITIZENS' ADVISORY COMMITTEES WITH EMPHASIS ON THOSE FOR SCHOOL BUILDING NEEDS IN THE CENTRAL SCHOOLS OF NEW YORK STATE.

    ERIC Educational Resources Information Center

    MARLOW, FRANK M.

    STATISTICAL INFORMATION ABOUT CITIZENS' ADVISORY COMMITTEES, WITH EMPHASIS ON SCHOOL BUILDING NEEDS, IS PRESENTED. THE STATISTICS WERE OBTAINED FROM QUESTIONNAIRES SENT TO SCHOOL ADMINISTRATORS IN CENTRAL NEW YORK STATE, DISCUSSING SCHOOL ENROLLMENT, DISTANCE FROM CLASS I CITIES, AND THE MAKE-UP OF ADVISORY COMMITTEES AND THEIR FUNCTIONS. (JH)

  19. Occlusion for implant-supported fixed dental prostheses in partially edentulous patients: a literature review and current concepts.

    PubMed

    Yuan, Judy Chia-Chun; Sukotjo, Cortino

    2013-04-01

    Implant treatment has become the treatment of choice to replace missing teeth in partially edentulous areas. Dental implants present different biological and biomechanical characteristics than natural teeth. Occlusion is considered to be one of the most important factors contributing to implant success. Most literature on implant occlusal concepts is based on expert opinion, anecdotal experiences, in vitro and animal studies, and only limited clinical research. Furthermore, scientific literature regarding implant occlusion, particularly in implant-supported fixed dental prostheses remains controversial. In this study, the current status of implant occlusion was reviewed and discussed. Further randomized clinical research to investigate the correlation between implant occlusion, the implant success rate, and its risk factors is warranted to determine best clinical practices. PMID:23678387

  20. The regulation of mammalian mRNA transcription by long non-coding RNAs: Recent discoveries and current concepts

    PubMed Central

    Kugel, Jennifer F.; Goodrich, James A.

    2013-01-01

    Summary Transcription by RNA polymerase II (Pol II) is a tightly controlled process critical to normal cellular metabolism. Understanding how transcriptional regulation is orchestrated has mainly involved identifying and characterizing proteins that function as transcription factors. During the past decade, however, an increasing number of long non-coding RNAs (lncRNAs) have been identified as transcriptional regulators. This revelation has spurred new discoveries, novel techniques, and paradigm shifts, which together are redefining our understanding of transcriptional control and broadening our view of RNA function. Here we summarize recent discoveries concerning the role of lncRNAs as regulators of mammalian mRNA transcription, with a focus on key concepts that are guiding current research in the field. PMID:23414324

  1. Occlusion for implant-supported fixed dental prostheses in partially edentulous patients: a literature review and current concepts

    PubMed Central

    Sukotjo, Cortino

    2013-01-01

    Implant treatment has become the treatment of choice to replace missing teeth in partially edentulous areas. Dental implants present different biological and biomechanical characteristics than natural teeth. Occlusion is considered to be one of the most important factors contributing to implant success. Most literature on implant occlusal concepts is based on expert opinion, anecdotal experiences, in vitro and animal studies, and only limited clinical research. Furthermore, scientific literature regarding implant occlusion, particularly in implant-supported fixed dental prostheses remains controversial. In this study, the current status of implant occlusion was reviewed and discussed. Further randomized clinical research to investigate the correlation between implant occlusion, the implant success rate, and its risk factors is warranted to determine best clinical practices. PMID:23678387

  2. Review on δ-Transformation-Induced Plasticity (TRIP) Steels with Low Density: The Concept and Current Progress

    NASA Astrophysics Data System (ADS)

    Yi, H. L.

    2014-09-01

    Novel alloys with high aluminum addition, so-called δ-transformation-induced plasticity (TRIP), have been developed recently for the third generation of advanced high strength steels for automotive applications, which are promising owing to the potential weldability as well as the combination of strength and ductility. In addition, the high aluminum addition results in a density reduction of approximately 5% in these δ-TRIP alloys without sacrificing the Young's modulus in uniaxial tensile tests. The origin of δ-TRIP concept is introduced first with a review of the published work on δ-TRIP alloys. This review will include methodology for retention of δ-ferrite in casting, rolling and welding conditions, microstructure evolution by austempering, as well as microstructures-properties relationship involving the roles of blocky and lath retained austenite. In addition, currently unresolved problems will be discussed regarding the fundamentals of materials design, automotive application, and industrial manufacturing.

  3. In vitro testing to a panel of potential chemotherapeutics and current concepts of chemotherapy in benign meningiomas.

    PubMed

    Balik, Vladimir; Sulla, Igor; Park, Hun Ho; Sarissky, Marek

    2015-09-01

    Treatment of benign meningiomas remains a challenge, especially when they involve the skull-base or when surgery and radiation fail. Moreover, a recent in vitro MTT (3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide) study testing hydroxyurea, temozolomide and other targeting agents failed to identify drugs effective in their treatment; therefore the search for further more effective agents continues. We performed a thorough review of in vitro investigations, animal studies and human clinical trials and endeavoured to integrate our results of MTT assay into current concepts of chemotherapy in benign meningiomas. Our results demonstrated that other chemotherapeutics with various mechanisms of action have the potential to be incorporated into second line therapy. Our study shows for the first time that chemosensitivity/resistance may be associated with histopathological variants of benign meningiomas. PMID:26099192

  4. 76 FR 44017 - Risk Communication Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-22

    ... HUMAN SERVICES Food and Drug Administration Risk Communication Advisory Committee; Notice of Meeting... the public. Name of Committee: Risk Communication Advisory Committee. General Function of the... work, as discussed in previous meetings, by current and former members of the Risk...

  5. Anthropogenic SO{sub 2}/NO{sub x} committee summary of current status--annual inventory

    SciTech Connect

    Benkovitz, C.M.

    1992-06-01

    At the First GEIA Workshop on Global Emissions Inventories, held in Baltimore, MD on December 1--2, 1991, data on anthropogenic emissions of sulfur and nitrogen developed by Dignon (1992) were selected to form the basis for the GEIA SO{sub 2} and NO{sub x} annual inventories. The Dignon data include emissions from fuel combustion only and currently extend to 1980. The methodology used was detailed in Dignon and Hameed (1985) and consists of statistical regression models based on available emissions data from the U.S and some other member countries of the Organization of Economic Cooperation and Development (OECD), which includes Australia, Canada, Japan and western European countries. Control regulations are incorporated via the use of different statistical parameter The grid definition from these inventories was also adopted for the GEIA grid: origin at 180{degree}W, 90{degree}S, 1{degree} {times} 1{degree} resolution (i.e., 360 cells in the longitude direction, 180 cells in the latitude direction). To upgrade the basic GEIA inventories, data for the different geographic regions being solicited from researchers located within these areas. This paper contains the upgrades which have been accomplished to date.

  6. Stroke: current concepts.

    PubMed

    Albertson, Megan; Sharma, Jitendra

    2014-11-01

    Cerebrovascular accidents (CVAs) are the leading cause of disability and the fourth leading cause of death in the U.S. The WHO defines stroke as "rapidly developing clinical signs of focal disturbance of cerebral function lasting more than 24 hours with no apparent cause other than of vascular origin." Strokes are subdivided into two major classifications: ischemic (80-87 percent) andhemorrhagic (13-20 percent). Ischemic strokes occur from thrombi, emboli, or global hypoperfusion. Hemorrhagic strokes are either parenchymal (10 percent of all strokes) or subarachnoid (3 percent of all strokes). There are a variety of recognized risk factors for stroke which include: age, race, family history, hypertension, diabetes mellitus, atherosclerosis, cardiac arrhythmias, prosthetic valves, hyperlipidemia, cigarette smoking, and others (drugs or hormones). The initial assessment of a patient suspected of stroke should be done quickly enough to ensure maximal reperfusion of brain tissue. The steps to achieve this goal are: 1) exclude an intracranial hemorrhage, 2) assess for contraindications to thrombolytics, 3) characterize the infarct. The workup for a patient should first include a history (especially the time when neurologic symptoms began), a physical exam (including the NIHSS), and imaging studies (to rule out hemorrhagic components). In addition, several lab studies can also be obtained including: PT/INR, glucose, complete blood count, metabolic panel, creatine kinase, ECG, echocardiogram, lipid panel, carotid Doppler, MRA or CTA. Acute management of a stroke is primarily focused on stabilizing the patient and allowing as much reperfusion as possible for at-risk brain tissue. Stroke management in the acute setting includes: use of thrombolytics if indicated, and re-assessment to monitor progression. Several trials have been completed in pursuit of safety and effectiveness of intra-arterial stroke therapy for patients outside the recommended thrombolytic time window, but so far they are only experimental treatment options. The best preventative measures for first time or recurrent stroke are: starting or switching antiplatelet therapy, treatment of cardiovascular risk factors (atrial fibrillation and carotid stenosis), optimization of hypertension, dyslipidemia and diabetes mellitus management, and smoking cessation. PMID:25508996

  7. Stroke: current concepts.

    PubMed

    Albertson, Megan; Sharma, Jitendra

    2014-11-01

    Cerebrovascular accidents (CVAs) are the leading cause of disability and the fourth leading cause of death in the U.S. The WHO defines stroke as "rapidly developing clinical signs of focal disturbance of cerebral function lasting more than 24 hours with no apparent cause other than of vascular origin." Strokes are subdivided into two major classifications: ischemic (80-87 percent) andhemorrhagic (13-20 percent). Ischemic strokes occur from thrombi, emboli, or global hypoperfusion. Hemorrhagic strokes are either parenchymal (10 percent of all strokes) or subarachnoid (3 percent of all strokes). There are a variety of recognized risk factors for stroke which include: age, race, family history, hypertension, diabetes mellitus, atherosclerosis, cardiac arrhythmias, prosthetic valves, hyperlipidemia, cigarette smoking, and others (drugs or hormones). The initial assessment of a patient suspected of stroke should be done quickly enough to ensure maximal reperfusion of brain tissue. The steps to achieve this goal are: 1) exclude an intracranial hemorrhage, 2) assess for contraindications to thrombolytics, 3) characterize the infarct. The workup for a patient should first include a history (especially the time when neurologic symptoms began), a physical exam (including the NIHSS), and imaging studies (to rule out hemorrhagic components). In addition, several lab studies can also be obtained including: PT/INR, glucose, complete blood count, metabolic panel, creatine kinase, ECG, echocardiogram, lipid panel, carotid Doppler, MRA or CTA. Acute management of a stroke is primarily focused on stabilizing the patient and allowing as much reperfusion as possible for at-risk brain tissue. Stroke management in the acute setting includes: use of thrombolytics if indicated, and re-assessment to monitor progression. Several trials have been completed in pursuit of safety and effectiveness of intra-arterial stroke therapy for patients outside the recommended thrombolytic time window, but so far they are only experimental treatment options. The best preventative measures for first time or recurrent stroke are: starting or switching antiplatelet therapy, treatment of cardiovascular risk factors (atrial fibrillation and carotid stenosis), optimization of hypertension, dyslipidemia and diabetes mellitus management, and smoking cessation. PMID:25490795

  8. Current Concepts in Dyslexia.

    ERIC Educational Resources Information Center

    Hartstein, Jack, Ed.

    The purpose of this book is to provide the reader with an overall view of the terms, people, and studies involved in the evaluation of dyslexic children. The topics discussed in the nine chapters are: "Introduction to Learning Disorders for the Ophthalmologist," by Jack Hartstein; "Interdisciplinary Approach to the Diagnosis of Reading Problems,"…

  9. Current concept of photocarcinogenesis.

    PubMed

    Nishisgori, Chikako

    2015-09-26

    There is ample evidence demonstrating that solar ultraviolet light (UV) induces human skin cancers. First, epidemiological studies have demonstrated a negative correlation between the latitude of residence and incidence and mortality rates of both melanoma and non-melanoma skin cancers in homogeneous populations. Second, skin cancer can be produced in mice by UV irradiation; the action spectrum of photocarcinogenesis falls into UVB (280-320 nm). Third, patients with genetic disorders that lead to deficiencies in repairing UV-induced DNA damage are prone to develop cancers in sun-exposed areas of the skin. Photocarcinogenesis is a multistage process that involves initiation, promotion, and progression. In addition UV induced immunosuppression is closely involved in photocarcinogenesis. Accumulation of DNA lesions caused by UV in several cancer related genes plays a crucial role in carcinogenesis. Indeed, even in actinic keratosis, precancerous lesions, genetic alterations can be observed. A conventional knowledge demonstrated that UVB induced DNA lesion causes genetic mutation (initiation) and UVB-inflammation (sunburn) induces promotion. However recent findings revealed that the photocarcinogenesis pathway is more complex consequences where each of these processes, mediated by various cellular, biochemical, and molecular changes, are closely related to each other. The pyrimidine photoproducts that result from direct DNA damage induced by UV are involved in developing skin cancer through mutations that lead to the upregulation or downregulation of signal transduction pathways, cell cycle dysregulation, and depletion of antioxidant defenses. In addition pyrimidine dimers have been shown to trigger UV induced immunosuppression, which also plays an important role in photocarcinogenesis, partly by upregulation of IL-10, an immunosuppressive cytokine. UV also produces oxidative stress and oxidative DNA damage in skin cells, which cause alteration of the genes involved in the cell cycle, apoptosis and modification of cell signaling by redox regulation, resulting in inflammation. It has been shown that in Ogg1 knockout mice which are deficient in repairing 8-oxo-7, 8-dihydroguanine (8-oxoG), UVB irradiation up-regulates the inflammatory gene, implying that 8-oxoG is involved in triggering inflammation. In this review I summarize the state of the art knowledge regarding photocarcinogenesis including experimental data and implication for clinical viewpoints. PMID:26177397

  10. Current concepts in psychodermatology.

    PubMed

    Gupta, Madhulika A; Gupta, Aditya K

    2014-06-01

    Several diagnoses in the new DSM-5 chapter on 'Obsessive-Compulsive and Related Disorders' directly relate to psychodermatology. The new excoriation (skin-picking) disorder (SPD) and trichotillomania (TTM) both manifest as recurrent body-focused repetitive behaviors that have compulsive and dissociative features, the latter being more prevalent in TTM than SPD. The DSM-5 refers to SPD and TTM occurring without full awareness or preceding tension, however does not specifically mention the possible role of dissociation. This has important treatment implications, as patients with high dissociative symptoms are not likely to respond to the standard treatments for obsessive-compulsive disorder. Body dysmorphic disorder (BDD), which is frequently associated with cutaneous body image (CBI) dissatisfaction, is present in 9%-15% of dermatology patients. Treatment guidelines in dermatology are increasingly considering the psychosocial morbidity related to CBI in their treatment outcome measures. The presence of BDD, if unrecognized, may therefore directly affect the dermatologic treatment regimens offered to the patient. PMID:24740235