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Sample records for complex tfcc treatment

  1. Reconstruction of Chronic Foveal TFCC Tears with an Autologous Tendon Graft

    PubMed Central

    Bain, Gregory I.; Eng, Kevin; Lee, Yu Chao; Mcguire, Duncan; Zumstein, Matthias

    2015-01-01

    Background?A triangular fibrocartilage complex (TFCC) injury can produce distal radioulnar joint (DRUJ) instability. If the foveal attachment is avulsed, it translates distally. The footprint is separated from its origin and will become covered in synovitis, preventing healing. The authors describe a surgical technique for the treatment of instability of the DRUJ due to chronic foveal detachment of the TFCC. Technique?The procedure utilizes a loop of autologous palmaris longus tendon graft passed through the ulnar aspect of the TFCC and through an osseous tunnel in the distal ulna to reconstruct the fovel attachment. Patients and Methods?We report on nine patients with a mean age of 42. Median follow-up was 13 months. Results?The median pain scores measured were reduced from 8 to 3 postoperatively, and all had a stable DRUJ. Conclusions?This technique provides stability of the distal ulna to the radius and carpus, with potential for biologic healing through osseous integration. It is a robust, anatomically based reconstruction of the TFCC to the fovea that stabilizes the DRUJ and the ulnar-carpal sag. PMID:25709873

  2. [Ulnar-sided wrist pain in sports: TFCC lesions and fractures of the hook of the hamate bone as uncommon diagnosis].

    PubMed

    Plöger, M M; Kabir, K; Friedrich, M J; Welle, K; Burger, C

    2015-06-01

    Injuries to the hand and wrist are common sports injuries. The diagnosis and therapy of wrist injuries are becoming more important, especially in increasingly more popular ball-hitting sports, such as golf, tennis and baseball. Ulnar-sided wrist pain is initially often misdiagnosed and treated as tenosynovitis or tendinitis but tears of the triangular fibrocartilage complex (TFCC) and fractures of the hook of hamate bone, which can also occur in these sports are seldomly diagnosed. The aim of this study was to conduct a systematic review of the literature focussing on TFCC lesions and fractures of the hook of the hamate bone in racquet sports, baseball and golf. A systematic review of the literature was performed in PubMed on the occurrence of TFCC lesions and fractures of the hook of the hamate bone. All studies and case reports were included. Because of the rarity of these injuries there were no exclusion criteria concerning the number of cases. Injuries associated with ball-hitting sports, such as TFCC lesions and fractures of hook of the hamate bone are still underrepresented in the current literature on sports injuries. The diagnosis and treatment of these injuries are often delayed and can severely handicap the performance and career of affected professional as well as amateur athletes. PMID:25956726

  3. Arthroscopic Foveal Repair of the Triangular Fibrocartilage Complex

    PubMed Central

    Atzei, Andrea; Luchetti, Riccardo; Braidotti, Federica

    2015-01-01

    Background Foveal disruption of the triangular fibrocartilage complex (TFCC) is associated with distal radioulnar joint (DRUJ) instability. TFCC fixation onto the fovea is the suitable treatment, which is not achieved by conventional arthroscopic techniques. We describe an all-inside arthroscopic technique that uses a suture anchor through distal DRUJ arthroscopy for foveal repair of the TFCC. Materials and Methods Forty-eight patients with TFCC foveal tear and DRUJ instability were selected according to the Atzei–European Wrist Arthroscopy Society (EWAS) algorithm of treatment. Retrospective evaluation included pain, DRUJ instability, range of motion (ROM), grip strength, Modified Mayo Wrist Score (MMWS), and the Disabilities of the Arm, Shoulder, and Hand (DASH) Score. Description of Technique DRUJ arthroscopy was performed to débride the TFCC and the foveal area. Under arthroscopic guidance, a suture anchor was inserted via the distal foveal portal to repair the TFCC onto the fovea. Sutures were tied on the radiocarpal surface of the TFCC. Postoperative immobilization of forearm rotation was maintained for 4 weeks. Heavy tasks were allowed after 3 months. Results After a mean follow-up of 33 months, pain improved significantly but remained moderate in four patients, severe in one. DRUJ instability resolved in 44 patients. Wrist ROM increased. Grip strength, MMWS, and DASH score improved significantly. Excellent and good MMWS equaled 83.3%. Forty-one patients (85.5%) resumed previous work and sport activities. As a postoperative complication, five patients experienced neuroapraxia of the dorsal sensory branch of the ulnar nerve (DSBUN) with full spontaneous recovery. Conclusions With appropriate indications and patient selection, arthroscopic foveal repair of the TFCC may restore DRUJ stability and provide satisfactory results without significant complications. PMID:25709875

  4. Dorsal Tear of Triangular Fibrocartilage Complex: Clinical Features and Treatment.

    PubMed

    Abe, Yukio; Moriya, Atsushi; Tominaga, Yasuhiro; Yoshida, Koji

    2016-03-01

    Background?Several different triangular fibrocartilage complex (TFCC) tear patterns have been classified through the use of wrist arthroscopy. A tear of the dorsal aspect of the TFCC has been previously reported, but it is not included in Palmer original classification. Our purpose was to describe this type of tear pattern along with the clinical presentation. Methods?An isolated dorsal TFCC tear was encountered in seven wrists of six patients (three men and three women; average age was 31 years). All patients were evaluated by physical exam, X-ray, plain axial computed tomography with pronation, neutral and supination position, magnetic resonance imaging (MRI) with coronal, sagittal, and axial section and arthroscopy. Results?The clinical findings varied and included the following: tenderness at the dorsoulnar aspect of the wrist was positive in all wrists, fovea sign was positive in five wrists, and tenderness at the dorsal aspect of the distal radioulnar joint was present in one wrist. Pain with forearm rotation was positive in all wrists. The ulnar head ballottement test induced pain in all wrists, whereas dorsal instability of the ulnar head was present in one wrist with this test. The ulnocarpal stress test was positive in five wrists. Axial and sagittal images on MRI revealed the dorsal tear in five wrists. All wrists were treated with an arthroscopic capsular repair. The final functional outcome at an average follow-up of 16.1 months was four excellent and one good wrist according to the modified Mayo wrist score. Conclusions?The aim of this article is to describe our experiences with tears involving the dorsal aspect of the TFCC, which may be misdiagnosed if the surgeon is not cognizant of this injury. Type of study/level of evidence?Diagnostic/level IV. PMID:26855835

  5. Judging orthodontic treatment complexity

    PubMed Central

    Clijmans, Maïté; Medhat, Aly; Geest, An De; van Gastel, Johannes; Kellens, Annelies; Fieuws, Steffen; Willems, Guy

    2016-01-01

    Objective: The aim of the present study was to investigate possible relations between anticipated overall treatment complexity (AOTC) of an orthodontic case and malocclusion characteristics. Methods: Two groups of orthodontists (groups A and B) were asked to define perceived treatment complexity (PTC) of orthodontic cases based on 16 characteristics of malocclusion by means of a questionnaire. Each question was answered on a six-point ordinal scale, with one "not applicable" option (score 0). Group A was also asked to give the AOTC of the specific case on a five-point ordinal scale. The index of orthodontic treatment need (IOTN) score of the specific cases as well as the malocclusion characteristics were assessed by one author. Results: There is a significant relationship between IOTN and AOTC (p< 0.0001), 22% of variability is explained by differences in IOTN. Adding objective characteristics of malocclusion to explain AOTC does not significantly increase the explained variability (p = 0.086). In judging interobserver agreement, a weighted Kappa of 0.60 for group A and 0.56 for group B was found. The weighted Kappa for agreement in AOTC equals 0.06. Conclusion: The relation between IOTN and AOTC was found to be significant. Moderate agreement on PTC among observers and a low level agreement regarding AOTC were found in the present study. PMID:27007763

  6. Arthroscopic all-inside repair of Palmer type 1B triangular fibrocartilage complex tears: a technical note.

    PubMed

    Lee, Choon Key; Cho, Hyung Lae; Jung, Kwang Am; Jo, Jae Yeong; Ku, Jung Hoei

    2008-01-01

    Arthroscopic repair of peripheral dorso-ulnar triangular fibrocartilage complex (TFCC) lesions is now a preferred method. Both outside-in and inside-out techniques are commonly performed for repairing Palmer type 1B TFCC tear. But these techniques have disadvantages of making an additional skin incision to tie knots subcutaneously over the capsule. We performed an arthroscopic all-inside repair technique of Palmer type 1B TFCC tears, which is a modified method of the outside-in technique using a spinal needle. This all-inside technique is as simple as previously described arthroscopic techniques and also has advantages of vertical mattress suture and no additional incision. We recommend this technique as a useful alternative to the others for repairing Palmer type 1B TFCC tear. PMID:17668185

  7. The effect of observer experience on magnetic resonance imaging interpretation and localization of triangular fibrocartilage complex lesions.

    PubMed

    Blazar, P E; Chan, P S; Kneeland, J B; Leatherwood, D; Bozentka, D J; Kowalchick, R

    2001-07-01

    This study investigates the effect of experience of the interpreter on the ability of magnetic resonance imaging (MRI) to identify the presence and anatomic location of a triangular fibrocartilage complex (TFCC) lesion. Fifty-one patients who underwent wrist arthroscopy with preoperative MRI studies were reviewed retrospectively. Two radiologists with different levels of training and experience evaluated the MRI scans in a blinded manner. The sensitivity rates of the 2 observers for detection of TFCC lesions were 86% and 80%. The specificity rates were 96% and 80%. The accuracy rates for prediction of a TFCC tear were 83% and 61% for the 2 observers. The correct location of a TFCC lesion was predicted by the more experienced observer for 12 of 19 central, 3 of 4 radial, and 6 of 12 peripheral lesions. The less experienced observer correctly identified 8 of 19 central, 2 of 4 radial, and 2 of 12 peripheral tears. The overall accuracy rates for prediction of a TFCC lesion and its location were 69% and 37%. Our data indicate that the published accuracy rates for prediction of TFCC lesion location may be reproducible only in very specialized centers. PMID:11466652

  8. Ulnar-sided wrist pain. II. Clinical imaging and treatment

    PubMed Central

    Watanabe, Atsuya; Souza, Felipe; Vezeridis, Peter S.; Blazar, Philip

    2009-01-01

    Pain at the ulnar aspect of the wrist is a diagnostic challenge for hand surgeons and radiologists due to the small and complex anatomical structures involved. In this article, imaging modalities including radiography, arthrography, ultrasound (US), computed tomography (CT), CT arthrography, magnetic resonance (MR) imaging, and MR arthrography are compared with regard to differential diagnosis. Clinical imaging findings are reviewed for a more comprehensive understanding of this disorder. Treatments for the common diseases that cause the ulnar-sided wrist pain including extensor carpi ulnaris (ECU) tendonitis, flexor carpi ulnaris (FCU) tendonitis, pisotriquetral arthritis, triangular fibrocartilage complex (TFCC) lesions, ulnar impaction, lunotriquetral (LT) instability, and distal radioulnar joint (DRUJ) instability are reviewed. PMID:20012039

  9. Multifunctional carbon nanohorn complexes for cancer treatment.

    PubMed

    Chechetka, Svetlana A; Pichon, Benoit; Zhang, Minfang; Yudasaka, Masako; Bégin-Colin, Sylvie; Bianco, Alberto; Miyako, Eijiro

    2015-01-01

    Multifunctional carbon nanohorn (CNH) complexes were synthesized using oxidized CNH, magnetite (MAG) nanoparticles, and polyethyleneimine (PEI). The ferromagnetic MAG nanoparticles were loaded onto CNH (MAG-CNH) using iron(II) acetate and subsequent heat treatment. Chemical functionalization of the MAG-CNH complexes with PEI improved their water-dispersibility and allowed further conjugation with a fluorophore. The application of an external magnetic field significantly intensified the targeted vectorization of CNH complexes into human cervical cancer (HeLa) cells. Following cell uptake, laser irradiation of the cells showed a significant enhancement in the photothermal effects of CNHs leading to cell death. We have confirmed that the photothermal properties and ferromagnetic characteristics of CNH complexes show efficient cell elimination. The present study is an essential step toward the development of an innovative cancer therapy and a highly sensitive detection of cancer cells at the single-cell level. PMID:25319234

  10. Open Repair of the Triangular Fibrocartilage Complex from Palmar Aspect

    PubMed Central

    Moritomo, Hisao

    2015-01-01

    Background Although foveal tears of the triangular fibrocartilage complex (TFCC) can be surgically reattached to the fovea via a dorsal approach, the foveal lesion is difficult to visualize from the dorsal side because the extensor carpi ulnaris (ECU) sheath floor and the superficial dorsal limb of the radioulnar ligament hinders the view of the fovea. Materials and Methods Twenty-one patients with foveal tears were treated by an open repair method from the palmar aspect. Pain, instability, motion, and grip strength were evaluated after a mean follow-up period of 26 months, and each patient was rated according to the Mayo Modified Wrist Score (MMWS). Description of Technique A 4-cm skin incision is made on the palmar aspect of the ulnar fovea. The ulnar fovea is exposed through a transverse capsulotomy of the distal radioulnar joint. The distal aspect of the TFCC is also exposed between the ECU tendon sheath and the ulnotriquetral ligament. After curettage of the scar tissue in the fovea, the deep palmar and dorsal limbs of the TFCC are sutured back to the fovea using a suture anchor technique. Results Foveal TFCC tears could be repaired via a palmar surgical approach without violating the floor of the ECU tendon sheath and the superficial dorsal limb. Excellent results were achieved in 18 patients, and a good result was achieved in three. Conclusions Our result compared favorably with those reported for dorsal approach. The palmar surgical approach facilitates the inspection and repair of the TFCC foveal tears. Level of Evidence IV PMID:25709872

  11. Treatment of complex regional pain syndrome

    PubMed Central

    Resmini, Giuseppina; Ratti, Chiara; Canton, Gianluca; Murena, Luigi; Moretti, Antimo; Iolascon, Giovanni

    2015-01-01

    Summary Complex Regional Pain Syndrome (CRPS) is a multifactorial and disabling disorder with complex etiology and pathogenesis. Goals of therapy in CRPS should be pain relief, functional restoration, and psychological stabilization, but early interventions are needed in order to achieve these objectives. Several drugs have been used to reduce pain and to improve functional status in CRPS, despite the lack of scientific evidence supporting their use in this scenario. They include anti-inflammatory drugs, analgesics, anesthetics, anticonvulsants, antidepressants, oral muscle relaxants, corticosteroids, calcitonin, bisphosphonates, calcium channel blockers and topical agents. NSAIDs showed no value in treating CRPS. Glucocorticoids are the only anti-inflammatory drugs for which there is direct clinical trial evidence in early stage of CRPS. Opioids are a reasonable second or third-line treatment option, but tolerance and long term toxicity are unresolved issues. The use of anticonvulsants and tricyclic antidepressants has not been well investigated for pain management in CRPS. During the last years, bisphosphonates have been the mostly studied pharmacologic agents in CRPS treatment and there are good evidence to support their use in this condition. Recently, the efficacy of intravenous (IV) administration of neridronate has been reported in a randomized controlled trial. Significant improvements in VAS score and other indices of pain and quality of life in patients who received four 100 mg IV doses of neridronate versus placebo were reported. These findings were confirmed in the open-extension phase of the study, when patients formerly enrolled in the placebo group received neridronate at the same dosage, and these results were maintained at 1 year follow-up. The current literature concerning sympathetic blocks and sympathectomy techniques lacks evidence of efficacy. Low evidence was recorded for a free radical scavenger, dimethylsulphoxide (DMSO) cream (50%). The same level of efficacy was noted for vitamin C (500 mg per day for 50 days) in prevention of CRPS in patients affected by wrist fracture. In conclusion, the best available therapeutic approach to CRPS is multimodal and is based on the use of several classes of drugs, associated to early physiotherapy. Neridronate at appropriate doses is associated with clinically relevant and persistent benefits in CRPS patients. PMID:27134629

  12. Complex PTSD and phased treatment in refugees: a debate piece

    PubMed Central

    ter Heide, F. Jackie June; Mooren, Trudy M.; Kleber, Rolf J.

    2016-01-01

    Background Asylum seekers and refugees have been claimed to be at increased risk of developing complex posttraumatic stress disorder (complex PTSD). Consequently, it has been recommended that refugees be treated with present-centred or phased treatment rather than stand-alone trauma-focused treatment. This recommendation has contributed to a clinical practice of delaying or waiving trauma-focused treatment in refugees with PTSD. Objective The aim of this debate piece is to defend two theses: (1) that complex trauma leads to complex PTSD in a minority of refugees only and (2) that trauma-focused treatment should be offered to all refugees who seek treatment for PTSD. Methods The first thesis is defended by comparing data on the prevalence of complex PTSD in refugees to those in other trauma-exposed populations, using studies derived from a systematic review. The second thesis is defended using conclusions of systematic reviews and a meta-analysis of the efficacy of psychotherapeutic treatment in refugees. Results Research shows that refugees are more likely to meet a regular PTSD diagnosis or no diagnosis than a complex PTSD diagnosis and that prevalence of complex PTSD in refugees is relatively low compared to that in survivors of childhood trauma. Effect sizes for trauma-focused treatment in refugees, especially narrative exposure therapy (NET) and culturally adapted cognitive-behaviour therapy (CA-CBT), have consistently been found to be high. Conclusions Complex PTSD in refugees should not be assumed to be present on the basis of complex traumatic experiences but should be carefully diagnosed using a validated interview. In line with treatment guidelines for PTSD, a course of trauma-focused treatment should be offered to all refugees seeking treatment for PTSD, including asylum seekers. PMID:26886486

  13. 12. NORTHEAST VIEW OF THE WASTE WATER TREATMENT COMPLEX FOR ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    12. NORTHEAST VIEW OF THE WASTE WATER TREATMENT COMPLEX FOR THE PRIMARY AND 22 BAR MILLS. - U.S. Steel Duquesne Works, Auxiliary Buildings & Shops, Along Monongahela River, Duquesne, Allegheny County, PA

  14. [SYNDROME OF DIABETIC FOOT: MODERN APPROACHES OF COMPLEX TREATMENT].

    PubMed

    Galimov, O V; Khanov, V O; Saifullin, R R; Valieva, G R; Okroyan, V P

    2015-01-01

    The article presents the results of treatment of 201 patients with neuroischemic form of diabetic foot syndrome. The research included 158 women and 43 men of the middle age of 62.5 ± 11.2 years. The complex approach was applied in treatment including medicamentous treatment, revasculization of extremity, an application of modern combined collagenous coating and foot relieving using silicone insoles and orthopedic footwear. The endovascular and open reconstructive operations were performed in order to obtain the revasculization of extremity. Given complex approach allowed reducing the terms of hospital stay, the rate of ulcerous defects recurrences and relapses of ischemia of lower extremities during one year after endovascular interventions. PMID:26983262

  15. Autism Phenotypes in Tuberous Sclerosis Complex: Diagnostic and Treatment Considerations.

    PubMed

    Gipson, Tanjala T; Poretti, Andrea; Thomas, Emily A; Jenkins, Kosunique T; Desai, Sonal; Johnston, Michael V

    2015-12-01

    Tuberous sclerosis complex is a multisystem, chronic genetic condition characterized by systemic growth of benign tumors and often accompanied by epilepsy, autism spectrum disorders, and intellectual disability. Nonetheless, the neurodevelopmental phenotype of these patients is not often detailed. The authors describe 3 individuals with tuberous sclerosis complex who share common characteristics that can help to identify a distinct profile of autism spectrum disorder. These findings include typical cognitive development, expressive and pragmatic language deficits, and anxiety. The authors also describe features specific to tuberous sclerosis complex that require consideration before diagnosing an autism spectrum disorder. Identifying distinct profiles of autism spectrum disorder in tuberous sclerosis complex can help optimize treatment across the life span. PMID:26303410

  16. Clearing the complexity: immune complexes and their treatment in lupus nephritis

    PubMed Central

    Toong, Catherine; Adelstein, Stephen; Phan, Tri Giang

    2011-01-01

    Systemic lupus erythematosus (SLE) is a classic antibody-mediated systemic autoimmune disease characterised by the development of autoantibodies to ubiquitous self-antigens (such as antinuclear antibodies and antidouble-stranded DNA antibodies) and widespread deposition of immune complexes in affected tissues. Deposition of immune complexes in the kidney results in glomerular damage and occurs in all forms of lupus nephritis. The development of nephritis carries a poor prognosis and high risk of developing end-stage renal failure despite recent therapeutic advances. Here we review the role of DNA-anti-DNA immune complexes in the pathogenesis of lupus nephritis and possible new treatment strategies aimed at their control. PMID:21694945

  17. Barbed Suture as a Treatment Approach in Complex Degloving Injuries.

    PubMed

    Boudreault, David Jean-Guy; Lance, Sam H; Garcia, Jesus A

    2016-05-01

    In the late19th century, French physician Morel-Lavallée was challenged with a group of patients who sustained similar patterns of degloving injuries, which today carry his eponym. In 1853, he reported a series of cases as well as proposed strategies for the management of these complex degloving injuries. Treatment strategies have not varied significantly over the years, and these lesions continue to plague surgeons today with failure rates in excess of 50%. We present 2 case series using barbed suture in the management of these complex injuries. PMID:26954732

  18. Low glycemic index treatment for epilepsy in tuberous sclerosis complex.

    PubMed

    Larson, Anna M; Pfeifer, Heidi H; Thiele, Elizabeth A

    2012-03-01

    Retrospective chart review of 15 patients with tuberous sclerosis complex (TSC) who initiated the low glycemic index treatment (LGIT) for epilepsy management at Massachusetts General Hospital over a five-year period. Prior to dietary therapy, this cohort (average age: 8.5 years) had tried an average of 5.8 anti-epileptic drugs with incomplete seizure control. At 6 months on the LGIT, 7/15 (47%) patients experienced >50% reduction in seizure frequency. PMID:22119636

  19. Constructed wetland treatment system for upper blackfoot mining complex

    SciTech Connect

    Sanders, F.S.

    1996-12-31

    A combined passive oxidation/sedimentation (pre-treatment) and constructed wetland (polishing) system has been designed and installed to treat mine drainage at the inactive Upper Blackfoot River Mining Complex northeast of Lincoln, MT. The system is designed to treat up to 100 gpm flow with moderate heavy metal concentrations (25 to 95 mg/L Zn; lower concentrations of Pb, Cu, and As), moderate Fe concentrations (< 100 mg/L), and periodic high acidity (pH 2.6 to 3.5). The treatment scheme is flexible to accommodate a wide range of flows, metal concentrations, and acidity in order to gain cost-efficiencies and to meet restrictive discharge standards for the environmentally-sensitive Blackfoot River watershed. The wetland treatment system presently is undergoing start-up testing and initial tuning and will be operational during summer, 1996. Conceptual and engineering designs are presented along with preliminary data.

  20. Maggot Debridement Therapy in the Treatment of Complex Diabetic Wounds

    PubMed Central

    Herrington, Mark T; Swenor, Karen M; Eron, Lawrence J

    2011-01-01

    The growth and aging of the population of Hawai‘i with a high incidence of diabetes mandates a need for more effective strategies to manage the healing of complicated wounds. Maggot debridement therapy (MDT) is one alternative utilized with successful results. Observations have indicated that maggots have the ability to debride wound beds, provide anti-microbial activity and also stimulate wound healing in diabetic patients. None of the patients refused MDT due to aversion of this treatment modality and the majority of patients had minimal discomfort. In 17 of 23 patients with multiple co-morbidities, the treatment of their complex diabetic wounds by MDT resulted in improvement or cure. Maggot debridement therapy is an effective treatment of diabetic wounds. PMID:22162609

  1. [PREPARATIONS OF PAMIDRONOVIC ACID IN COMPLEX TREATMENT ON OSTEOGENESIS IMPERFECTA].

    PubMed

    Zyma, A M; Guk, Yu M; Magomedov, O M; Gayko, O G; Kincha-Polishchuk, T A

    2015-07-01

    Modern view of drug therapy in the complex treatment of orthopedic manifestations of osteogenesis imperfecta (OI) was submitted. Developed and tested system of drug correction of structural and functional state of bone tissue (BT) using drugs pamidronovic acid, depending on osteoporosis severity and type of disease. Such therapy is appropriate to apply both independently and in conjunction with surgery to correct deformations of long bones of the lower extremities. Effectiveness and feasibility of the proposed methods of drug therapy was proved, most patients resume features walking and support. PMID:26591224

  2. [Arthroscopic treatment of the ulnar impaction syndrome].

    PubMed

    Leclercq, C

    2006-11-01

    The ulnar impaction syndrome is due to hyperpressure in the ulnocarpal joint. It occurs most frequently following distal radial fractures with shortening, but can also be secondary to a primitive length discrepancy between a short radius and a long ulna (positive ulnar variance). Symptoms and clinical findings, even though characteristic, are not specific. Standard X rays show a positive ulnar variance, and sometimes a hyperpressure cyst in the lunate. CT arthroscan and MRI studies demonstrate indirect signs of hyperpressure. If medical treatment fails to improve the condition, the choice surgical technique is arthroscopic, allowing debridement of the TFCC central tear, and shortening of the horizontal aspect of the ulnar head. PMID:17361891

  3. Potential for treatment of severe autism in tuberous sclerosis complex.

    PubMed

    Gipson, Tanjala T; Gerner, Gwendolyn; Wilson, Mary Ann; Blue, Mary E; Johnston, Michael V

    2013-08-01

    The Food and Drug Administration (FDA) has approved two mechanism-based treatments for tuberous sclerosis complex (TSC)-everolimus and vigabatrin. However, these treatments have not been systematically studied in individuals with TSC and severe autism. The aim of this review is to identify the clinical features of severe autism in TSC, applicable preclinical models, and potential barriers that may warrant strategic planning in the design phase of clinical trial development. A comprehensive search strategy was formed and searched across PubMed, Embase and SCOPUS from their inception to 2/21/12, 3/16/12, and 3/12/12 respectively. After the final search date, relevant, updated articles were selected from PubMed abstracts generated electronically and emailed daily from PubMed. The references of selected articles were searched, and relevant articles were selected. A search of clinicaltrials.gov was completed using the search term "TSC" and "tuberous sclerosis complex". Autism has been reported in as many as 60% of individuals with TSC; however, review of the literature revealed few data to support clear classification of the severity of autism in TSC. Variability was identified in the diagnostic approach, assessment of cognition, and functional outcome among the reviewed studies and case reports. Objective outcome measures were not used in many early studies; however, diffusion tensor imaging of white matter, neurophysiologic variability in infantile spasms, and cortical tuber subcategories were examined in recent studies and may be useful for objective classification of TSC in future studies. Mechanism-based treatments for TSC are currently available. However, this literature review revealed two potential barriers to successful design and implementation of clinical trials in individuals with severe autism-an unclear definition of the population and lack of validated outcome measures. Recent studies of objective outcome measures in TSC and further study of applicable preclinical models present an opportunity to overcome these barriers. PMID:25254170

  4. 76 FR 39110 - Medicare Program; Section 3113: The Treatment of Certain Complex Diagnostic Laboratory Tests...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-05

    ... Certain Complex Diagnostic Laboratory Tests Demonstration AGENCY: Centers for Medicare & Medicaid Services... participate in the Treatment of Certain Complex Diagnostic Laboratory Tests Demonstration. The Demonstration... complex diagnostic laboratory test under the Demonstration. The statute requires a Report to Congress...

  5. Treatment of complex neurovascular lesions: an interdisciplinary angio suite approach

    PubMed Central

    Breyer, Tobias; Wrede, Karsten H.; Stein, Klaus-Peter; Wanke, Isabel; Grams, Astrid E.; Gizewski, Elke R.; Schlamann, Marc; Forsting, Michael; Sandalcioglu, I. Erol; Sure, Ulrich

    2014-01-01

    Objective: The objective of this study was to analyse our initial experience using an interdisciplinary angio suite approach to neurosurgical treatment of complex neurovascular lesions and expound technical feasibility and possible applications. Subjects: Six out of 451 patients with cranial or spinal neurovascular lesions were surgically treated in the angio suite (biplane angiographic system) during a 28-month observation period. Clinical baseline data, radiological and intraoperative findings as well as clinical and radiological outcome were assessed. Results: A ventral spinal perimedullary arteriovenous malformation, a ventral spinal perimedullary fistula, two diffuse frontal dural arteriovenous fistulas, a multifocal temporal arteriovenous malformation and a partially embolized fronto-temporo-basal dural arteriovenous fistula were successfully treated with angiographically confirmed complete occlusion and unimpaired neurological condition of the patients at the 12-month follow up. Conclusion: This study demonstrates the feasibility of this approach and points out possible indications, namely ventrally located spinal lesions and diffuse, deep seated cranial lesions. PMID:24409203

  6. Standardized Combination Antibiotic Treatment of Mycobacterium avium Complex Lung Disease

    PubMed Central

    Sim, Yun Su; Park, Hye Yun; Jeon, Kyeongman; Suh, Gee Young; Kwon, O Jung

    2010-01-01

    Purpose The optimal treatment regimen for Mycobacterium avium complex (MAC) lung disease has not yet been fully established. We evaluated the efficacy of standardized combination antibiotic therapy and the factors that might affect unfavorable microbiologic responses in patients with MAC pulmonary disease. Materials and Methods This retrospective study reviewed data from 96 patients (56 females; median age 59 years) treated with newly diagnosed MAC lung disease between January 2003 and December 2006. Results All patients received standardized combination antibiotic therapy, consisting of clarithromycin, rifampicin, and ethambutol. Streptomycin was additionally given in 72 patients (75%) for a median duration of 4.5 months. The overall favorable microbiologic response rate was 79% (76/96); 20 patients (21%) had unfavorable microbiologic responses, including failure to sputum conversion (n = 13), relapse (n = 3), and MAC-related death (n = 4). A positive sputum acid-fast bacillus smear at the start of treatment was an independent predictor of an unfavorable microbiologic response. Conclusion Standardized combination antibiotic therapy consisting of clarithromycin, rifampicin, and ethambutol with or without initial use of streptomycin is effective in treating patients with newly diagnosed MAC lung disease. PMID:20879056

  7. Treatment of complex tibial plateau fractures using Ilizarov technique.

    PubMed

    Lalić, Ivica; Daraboš, Nikica; Stanković, Milan; Gojković, Zoran; Obradović, Mirko; Marić, Dušan

    2014-12-01

    Complex tibial plateau fractures are most commonly caused by high-energy trauma and they are often associated with severe soft tissue injuries that can frequently result in severe complications. Ilizarov external circular fixation is an ideal method of treatment for high- energy fractures of the tibial plateau when extensive soft tissue dissection and internal fixation are contraindicated. Our research included 50 consecutive patients and clinical features of the patients were evaluated during the follow up period using the following instruments: Gustillo-Anderson, Sc- hatzker and Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/ OTA) classification methods. Bony results were evaluated using the Association of the Study and Application of the Method ofIlizarov (ASAMI) protocol. The mean functional recovery scores were obtained by the modified functional evaluation system of Karlstrom-Olerud. All fractures healed successfully. Circular fixators could be removed without anesthesia for type IV fractures at 16 weeks (range 12-21) and for type V-VI at 18 weeks (range 15-26) after the operation. According to ASA- MI bone results, there were 39 (78%) excellent, 7 (14%) good, 3 (6%) fair results and 1 (2%) poor result. Analysis of data obtained by the Karlstrom-Olerud functional evaluation system in this study yielded a mean value of 24.7 after six months, which implies recovery. Functional recovery at 12 months after surgery revealed satisfactory recovery with a mean value of 27.7, whereas the mean sco- re of 29.8 recorded at the last evaluation suggested good functional status. The treatment of patients with open and closed multiple intra-articular fractures of proximal tibia applying Ilizarov apparatus showed good functional outcome, which had positive impact on our patients' quality of life. PMID:25868312

  8. Mechanism-based Treatment in Tuberous Sclerosis Complex

    PubMed Central

    Jülich, Kristina; Sahin, Mustafa

    2014-01-01

    Background Tuberous Sclerosis Complex is a genetic multi-system disorder that affects the brain in almost every patient. It is caused by a mutation in the TSC1 or TSC2 genes, which regulate mTOR, a key player in control of cellular growth and protein synthesis. The most frequent neurologic symptoms are seizures, which occur in up to 90% of patients and are often intractable, followed by autism spectrum disorders, intellectual disability, ADHD and sleep problems. Conventional treatment has frequently proven insufficient for neurologic and behavioral symptoms, particularly seizure control. This review focuses on the role of TSC/mTOR in neuronal development and network formation, and recent mechanism-based treatment approaches. Methods We performed a literature review to identify ongoing therapeutical challenges and novel strategies. Results To achieve a better quality of life for many patients, current therapy approaches are directed at restoring dysregulated mTOR signaling. Animal studies have provided insight into aberrant neuronal network formation caused by constitutive activation of the mTOR pathway, and initial studies in TSC patients using MR diffusion tensor imaging and EEG support a model of impaired neuronal connectivity in TSC. Rapamycin, an mTOR inhibitor, has been used successfully in Tsc-deficient mice to prevent and treat seizures and behavioral abnormalities. There is recent evidence in humans of improved seizure control with mTOR inhibitors. Conclusions Current research provides insight into aberrant neuronal connectivity in TSC and the role of mTOR inhibitors as a promising therapeutical approach. PMID:24486221

  9. Investigating the reproducibility of a complex multifocal radiosurgery treatment

    PubMed Central

    Niebanck, M; Juang, T; Newton, J; Adamovics, J; Wang, Z; Oldham, M

    2013-01-01

    Stereotactic radiosurgery has become a widely used technique to treat solid tumors and secondary metastases of the brain. Multiple targets can be simultaneously treated with a single isocenter in order to reduce the set-up time to improve patient comfort and workflow. In this study, a 5-arc multifocal RapidArc treatment was delivered to multiple PRESAGE® dosimeters in order to explore the repeatability of the treatment. The three delivery measurements agreed well with each other, with less than 3% standard deviation of dose in the target. The deliveries also agreed well with the treatment plan, with gamma passing rates greater than 90% (5% dose-difference, and 2 mm distance-to-agreement criteria). The optical-CT PRESAGE® system provided a reproducible measurement for treatment verification, provided measurements were made immediately following treatment.

  10. Cyclodextrin complexes for treatment improvement in infectious diseases.

    PubMed

    Imperiale, Julieta C; Sosnik, Alejandro D

    2015-05-01

    Infectious diseases are a heterogeneous group of maladies that represent a serious burden to healthcare systems worldwide. Most of the available antimicrobial drugs display poor biopharmaceutical properties that compromise their effectiveness. Cyclodextrins (CDs) are cyclic oligosaccharides of glucopyranose formed by a variable number of repeating units that combine a hydrophilic surface with a hydrophobic cavity. The production of drug/CD complexes has become one of the most extensively investigated technology approaches to improve the stability, solubility, dissolution rate and bioavailability of drugs. The present work overviews the applications of CDs for the formulation of anti-infective agents along with the most relevant administration routes. Finally, an update on the complexes with CDs available on the market to treat infectious diseases is presented. PMID:26008196

  11. Manipulative assessment and treatment of the shoulder complex: case reports

    PubMed Central

    Donahue, Thomas; Bergmann, Thomas; Donahue, Sara; Dody, Michael

    2003-01-01

    Abstract Objective To describe a unique method of evaluation and a conservative management plan for patients with shoulder dysfunction of mechanical origin. Possible causes for this clinical presentation and a brief review of the literature are offered. Clinical Features In the 3 cases described here, symptoms included acute shoulder pain, limitation of movement, positive orthopedic tests, palpable tenderness, muscle spasm and muscle weakness. The 3 cases all resulted in differing diagnoses. Intervention and Outcome Following the use of a proposed joint dysfunction isolation test, thrusting forms of manual adjusting procedures, electrical modalities and soft tissue therapy were applied. Three cases representing different common shoulder problems (an acute episode of a chronic problem, a progressive problem resulting in capsulitis, and a occult problem associated with a motor vehicle accident) responded favorably to treatment. Conclusions There is the need for a non-surgical, conservative approach to treatment of shoulder problems before considering the more aggressive treatment approaches that carry greater iatrogenic risks. The patients’ signs and symptoms responded to a unique method of evaluation and manipulative therapy when other approaches had failed. The risk/benefit ratio suggests that conservative care be considered a potential option for similar conditions. PMID:19674612

  12. Modern Palliative Radiation Treatment: Do Complexity and Workload Contribute to Medical Errors?

    SciTech Connect

    D'Souza, Neil; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario ; Holden, Lori; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario ; Robson, Sheila; Mah, Kathy; Di Prospero, Lisa; Wong, C. Shun; Chow, Edward; Spayne, Jacqueline; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario

    2012-09-01

    Purpose: To examine whether treatment workload and complexity associated with palliative radiation therapy contribute to medical errors. Methods and Materials: In the setting of a large academic health sciences center, patient scheduling and record and verification systems were used to identify patients starting radiation therapy. All records of radiation treatment courses delivered during a 3-month period were retrieved and divided into radical and palliative intent. 'Same day consultation, planning and treatment' was used as a proxy for workload and 'previous treatment' and 'multiple sites' as surrogates for complexity. In addition, all planning and treatment discrepancies (errors and 'near-misses') recorded during the same time frame were reviewed and analyzed. Results: There were 365 new patients treated with 485 courses of palliative radiation therapy. Of those patients, 128 (35%) were same-day consultation, simulation, and treatment patients; 166 (45%) patients had previous treatment; and 94 (26%) patients had treatment to multiple sites. Four near-misses and 4 errors occurred during the audit period, giving an error per course rate of 0.82%. In comparison, there were 10 near-misses and 5 errors associated with 1100 courses of radical treatment during the audit period. This translated into an error rate of 0.45% per course. An association was found between workload and complexity and increased palliative therapy error rates. Conclusions: Increased complexity and workload may have an impact on palliative radiation treatment discrepancies. This information may help guide the necessary recommendations for process improvement for patients who require palliative radiation therapy.

  13. Treatment of complex regional pain syndrome type I with bisphosphonates

    PubMed Central

    Giusti, Andrea; Bianchi, Gerolamo

    2015-01-01

    Complex regional pain syndrome type I (CRPS-I) is a common and disabling disorder affecting a peripheral limb, usually developing after a trauma to an extremity. CRPS-I is characterised by presence of spontaneous pain, allodynia and hyperalgesia, disproportionate to the inciting event and by a variety of autonomic disturbances and trophic abnormalities. The pathophysiology of CRPS-I has not been fully understood. Experimental models have suggested that an initial triggering event may produce the release of proinflammatory neuropeptides and cytokines, generating a sort of neurogenic inflammation. Thereafter, increased microvascular permeability and intramedullary pressure, reduced oxygen extraction and cellular hypoxia maintain and make the disease worse, producing metabolic tissue acidosis. In this context, it is probable that, far from being a key player, the sympathetic nervous system contributes interacting with these mechanisms and producing vasomotor disturbances. Bisphosphonates (BPs) are potent inhibitors of osteoclastic activity widely used for the management of osteoporosis and other metabolic bone diseases. Their primary pharmacological action is the reduction of bone turnover. An enhanced osteoclastic activity has never been clearly demonstrated in CRPS-I. Therefore, it is likely that the positive effects of BPs in this condition are not related to their antiresorptive properties, but to a more complex interaction between these pharmacological agents and the pathophysiological mechanisms underlying CRPS-I. Results of several clinical trials have suggested the potential beneficial effects of BPs in CRPS-I. In five randomised controlled trials, oral and intravenous alendronate and intravenous clodronate, pamidronate and neridronate demonstrated to be effective in reducing pain and improving physical function in patients presenting with CRPS-I, with a good profile of safety and tolerability. Although these trials have a number of limitations, including the small samples enrolled, there is sufficient evidence to support the use of BPs as agents of choice in the management of CRPS-I. PMID:26557377

  14. Comparison of Chemical Composition of Complex Disinfection Byproduct (DBP) Mixtures Produced by Different Treatment Methods - slides

    EPA Science Inventory

    Analyses of the chemical composition of complex DBP mixtures, produced by different drinking water treatment processes, are essential to generate toxicity data required for assessing their risks to humans. For mixture risk assessments, whole mixture toxicology studies generally a...

  15. Comparison of Chemical Composition of Complex Disinfection Byproduct (DBP) Mixtures Produced by Different Treatment Methods

    EPA Science Inventory

    Analyses of the chemical composition of complex DBP mixtures, produced by different drinking water treatment processes, are essential to generate toxicity data required for assessing their risks to humans. For mixture risk assessments, whole mixture toxicology studies generally a...

  16. Boundary treatments for 2D elliptic mesh generation in complex geometries

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This paper presents a boundary treatment method for 2D elliptic mesh generation in complex geometries. Corresponding to Neumann- Dirichlet boundary conditions (sliding boundary conditions), the proposed method aims at achieving orthogonal and smooth nodal distribution along irregular boundaries. In ...

  17. Sodium hydroxide treatment of field water in a biopolymer complex

    SciTech Connect

    Phelps, C.H.; Sampath, K.; Shu, P.

    1990-12-18

    This paper describes a waterflood method for recovering hydrocarbonaceous fluids from an oil reservoir which has zones of varying permeability and which formation is penetrated by an injection and a production well. It comprises: first mixing into water a substantially small amount of an alkali or alkaline earth metal hydroxide sufficient to cause gelation within a substantially effective time period where the hydroxide is contained in an aqueous solution in an amount of from about 1 to about 500 ppm; thereafter placing into the solution a water thickening amount of a water soluble Xanthomonas biopolysaccharide; and complexing subsequently the biopolysaccharide with an amount of a water-soluble compound of a polyvalent metal ion selected from the group consisting of trivalent phosphorus, scandium, titanium, vanadium, chromium, manganese, iron, cobalt, copper, aluminum, arsenic, yttrium, zirconium, niobium, cadmium, tin, antimony, lanthanum, hafnium, tantalum, lead, and mixtures thereof, sufficient to cause substantially quicker gelation of the water soluble biopolysaccharide thereby forming a substantially more stable gel sufficient for use as a mobility or profile control medium in environments having low pH brines wherein the water soluble compound is added to the aqueous solution in an amount of from about 10 to about 1,000 ppm of the active polyvalent metal ion, injecting the stable gel into the reservoir via the injection well; and thereafter injecting water as a drive fluid behind the stable gel and recovering hydrocarbonaceous fluids.

  18. An efficient immersed boundary treatment for complex moving object

    NASA Astrophysics Data System (ADS)

    Liu, Cheng; Hu, Changhong

    2014-10-01

    An efficient immersed boundary treatment for simulation of flexible moving body immersed in fluid is presented. The level set signed distance function is used to indicate body surface. A simple mapping strategy is proposed to avoid costly signed distance re-initialization computations. The strategy is efficient for both rigid and deformable structures, and can be extended to 3-D case easily. With the use of signed distance function, reconstruction of flow variables on a body surface can be easily implemented through linear, bilinear or quadratic interpolation. In order to suppress the pressure oscillations caused by the role conversion of forcing points and fluid points, a modified interpolation scheme is presented by introducing a dynamic weight term to the fluid point. Together with local grid refinement and using larger time step, the pressure oscillations can be effectively diminished by the modified interpolation scheme. The proposed method is validated by 2-D numerical simulations on a uniform flow past a fixed cylinder, in-line and transversely oscillating cylinders, a flapping wing, a 3-D simulation on a uniform flow past a rectangle plane with an initial attack angle and a moving anguilliform swimmer. Present numerical results are compared with other CFD solutions as well as experimental results.

  19. Successful treatment of pegaspargase-induced acute hepatotoxicity with vitamin B complex and L-carnitine

    PubMed Central

    Karur, Vinit; Herrington, Jon D.; Walker, Mary G.

    2016-01-01

    Pegaspargase is a chemotherapy drug used in the treatment of acute lymphoblastic leukemia (ALL). One of the adverse effects of pegaspargase is hepatotoxicity, which can rapidly lead to liver failure and death. We report a patient with ALL who developed pegaspargase-induced severe hepatotoxicity that was rescued by treatment with vitamin B complex and L-carnitine. Our patient had a quicker response than prior reported cases, suggesting this treatment might be a better regimen. PMID:26722167

  20. Treatment of complex PTSD: results of the ISTSS expert clinician survey on best practices.

    PubMed

    Cloitre, Marylene; Courtois, Christine A; Charuvastra, Anthony; Carapezza, Richard; Stolbach, Bradley C; Green, Bonnie L

    2011-12-01

    This study provides a summary of the results of an expert opinion survey initiated by the International Society for Traumatic Stress Studies Complex Trauma Task Force regarding best practices for the treatment of complex posttraumatic stress disorder (PTSD). Ratings from a mail-in survey from 25 complex PTSD experts and 25 classic PTSD experts regarding the most appropriate treatment approaches and interventions for complex PTSD were examined for areas of consensus and disagreement. Experts agreed on several aspects of treatment, with 84% endorsing a phase-based or sequenced therapy as the most appropriate treatment approach with interventions tailored to specific symptom sets. First-line interventions matched to specific symptoms included emotion regulation strategies, narration of trauma memory, cognitive restructuring, anxiety and stress management, and interpersonal skills. Meditation and mindfulness interventions were frequently identified as an effective second-line approach for emotional, attentional, and behavioral (e.g., aggression) disturbances. Agreement was not obtained on either the expected course of improvement or on duration of treatment. The survey results provide a strong rationale for conducting research focusing on the relative merits of traditional trauma-focused therapies and sequenced multicomponent approaches applied to different patient populations with a range of symptom profiles. Sustained symptom monitoring during the course of treatment and during extended follow-up would advance knowledge about both the speed and durability of treatment effects. PMID:22147449

  1. Quantification of beam complexity in intensity-modulated radiation therapy treatment plans

    SciTech Connect

    Du, Weiliang Cho, Sang Hyun; Zhang, Xiaodong; Kudchadker, Rajat J.; Hoffman, Karen E.

    2014-02-15

    Purpose: Excessive complexity in intensity-modulated radiation therapy (IMRT) plans increases the dose uncertainty, prolongs the treatment time, and increases the susceptibility to changes in patient or target geometry. To date, the tools for quantitative assessment of IMRT beam complexity are still lacking. In this study, The authors have sought to develop metrics to characterize different aspects of beam complexity and investigate the beam complexity for IMRT plans of different disease sites. Methods: The authors evaluated the beam complexity scores for 65 step-and-shoot IMRT plans from three sites (prostate, head and neck, and spine) and 26 volumetric-modulated arc therapy (VMAT) plans for the prostate. On the basis of the beam apertures and monitor unit weights of all segments, the authors calculated the mean aperture area, extent of aperture shape irregularity, and degree of beam modulation for each beam. Then the beam complexity values were averaged to obtain the complexity metrics of the IMRT plans. The authors studied the correlation between the beam complexity metrics and the quality assurance (QA) results. Finally, the effects of treatment planning parameters on beam complexity were studied. Results: The beam complexity scores were not uniform among the prostate IMRT beams from different gantry angles. The lateral beams had larger monitor units and smaller shape irregularity, while the anterior-posterior beams had larger modulation values. On average, the prostate IMRT plans had the smallest aperture irregularity, beam modulation, and normalized monitor units; the head and neck IMRT plans had large beam irregularity and beam modulation; and the spine stereotactic radiation therapy plans often had small beam apertures, which may have been associated with the relatively large discrepancies between planned and QA measured doses. There were weak correlations between the beam complexity scores and the measured dose errors. The prostate VMAT beams showed greater complexity than the prostate step-and-shoot IMRT beams. In the treatment planning process, the beam complexity increased as the minimum segment area decreased and as the number of optimization iterations and the maximum number of segments increased. Conclusions: The proposed metrics were effective in characterizing the beam complexity of different disease sites and for different treatment modalities. Efforts should be made to reduce the unnecessary complexity of IMRT beams to minimize the radiation dose uncertainties.

  2. Retroperitoneal laparoscopic technique in treatment of complex renal stones: 75 cases

    PubMed Central

    2014-01-01

    Background In most hospitals, several options for the management of renal stones are available: shockwave lithotripsy, endourologic treatment, or surgery. Choice of treatment is based on the anatomic characteristics of the patient, and the location and size of the stones. In this study we assessed a retroperitoneal laparoscopic technique for treatment of complex renal stones. Methods Seventy-five patients, including 53 men and 22 women with a mean age of 47.8 years (range 18–74 y), underwent retroperitoneal laparoscopy for the treatment of complex renal stones between July 2006 and November 2012 in our hospital. Results The retroperitoneal laparoscopic procedures for treatment of complex renal stones were completely successful in 73 cases, while 2 cases converted to open surgery. The operative time was 85–190 min with a mean of 96 min. The estimated blood lost was 20–400 mL with a mean of 80 mL. After the operation 7 patients experienced urinary leakage. Ultrasonography, x-ray of the kidney, ureter and bladder, and intravenous urography were reviewed at post-procedural follow-up at 6–82 months. No hydronephrosis aggravation was found, and there was no calculus recurrence. Conclusion The merits of retroperitoneal laparoscopy for the treatment of complex renal stones include sparing the nephron, less bleeding, short hospitalization, quick postoperative recovery, and controllable procedure after training Success depends on the experience of surgeons and judicious selection of cases. PMID:24491207

  3. Fenestrated stent grafts for the treatment of complex aortic aneurysm disease: A mature treatment paradigm.

    PubMed

    Georgiadis, George S; van Herwaarden, Joost A; Antoniou, George A; Giannoukas, Athanasios D; Lazarides, Miltos K; Moll, Frans L

    2016-06-01

    The introduction of fenestrated stent grafts (SGs) to treat abdominal aortic aneurysms (AAAs) with short proximal necks began in 1999. Nowadays, the whole visceral aorta can be treated totally by endovascular means. The established use of fenestrated devices to treat complex AAAs as a first-line management option has been previously reported. An up-to-date evaluation of the literature was performed including all types of publications regarding the use of fenestrated technology to repair complex AAAs. Fenestrated repair is now an established alternative to hybrid/chimney/snorkel repairs. However, specific criteria and prerequisites are required for the use and improvement of this method. Multiple device morphologies have been used incorporating the visceral arteries in various combinations. This modular strategy connects different devices (bridging covered stents and bifurcated SGs) with the aortic main body, thus excluding the aneurysm from the circulation. Precise deployment of the fenestrated SG is mandatory for successful visceral vessel revascularization. Accurate SG sizing and customization, a high level of technical skill, and facilities with modern imaging techniques including 3D road mapping and dedicated hybrid rooms are required. Most experience has been with the custom-made Zenith Cook platform, although off-the-shelf devices have been recently implanted. More complex repairs have been performed over the last few years, but device complexity has also increased. Perioperative, mid-term, and a few recently reported long-term results are encouraging. Secondary interventions remain the main problem, similar to that observed after traditional endovascular abdominal aortic aneurysm repair (EVAR). PMID:27013644

  4. [The efficiency of complex recovery treatment of chronic obstructive pulmonary disease patients using subalin].

    PubMed

    Lemko, O I; Habor, M L; Safronova, L A; Lemko, I S; Kopynets'

    2012-01-01

    The expediency of complex recovery treatment of chronic obstructive pulmonary disease (COPD) patients on the base of artificial rock salt aerosol medium (haloaerosoltherapy) and probiotic drug subalin intake was grounded. It was revealed that additional prescription of subalin results in the more expressed lipoperoxidation's inhibition, especially in patients with COPD II st. and more considerable decrease of endogenic intoxication at COPD III st. It was shown that complex treatment with subalin usage promoted the relief of desease's clinical duration in remoted period. PMID:23356139

  5. B-complex vitamins in the prophylaxis and treatment of Wernicke-Korsakoff syndrome.

    PubMed

    Cook, C C; Thomson, A D

    Wernicke-Korsakoff syndrome, which is associated with high morbidity and mortality, is a more common neuropsychiatric sequela of alcohol misuse than is widely realized. It is easily prevented and treated with parenteral B-complex vitamins, although this treatment is widely under-utilized. PMID:9274684

  6. Complex Psychiatric Comorbidity of Treatment-Seeking Youth with Autism Spectrum Disorder and Anxiety Symptoms

    ERIC Educational Resources Information Center

    Hepburn, Susan L.; Stern, Jessica A.; Blakeley-Smith, Audrey; Kimel, Lila K.; Reaven, Judith A.

    2014-01-01

    This descriptive study examines the complexity of psychiatric comorbidity in treatment-seeking youth with ASD and anxiety symptoms. Forty-two parents of youth with ASD and anxiety (ages 8-14) completed a structured diagnostic interview (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version). Youth

  7. Complex Psychiatric Comorbidity of Treatment-Seeking Youth with Autism Spectrum Disorder and Anxiety Symptoms

    ERIC Educational Resources Information Center

    Hepburn, Susan L.; Stern, Jessica A.; Blakeley-Smith, Audrey; Kimel, Lila K.; Reaven, Judith A.

    2014-01-01

    This descriptive study examines the complexity of psychiatric comorbidity in treatment-seeking youth with ASD and anxiety symptoms. Forty-two parents of youth with ASD and anxiety (ages 8-14) completed a structured diagnostic interview (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version). Youth…

  8. Surimi wash water treatment for protein recovery: effect of chitosan-alginate complex concentration and treatment time on protein adsorption.

    PubMed

    Wibowo, Singgih; Velazquez, Gonzalo; Savant, Vivek; Torres, J Antonio

    2005-04-01

    Chitosan (Chi), a protein recovery agent for the treatment of aqueous food processing streams, appears to work by mechanical entrapment and electrostatic interaction of chitosan amino groups with anionic groups on proteins. Chitosan effectiveness for recovering soluble proteins from surimi wash water (SWW) is increased by complexation with alginate (Alg) and by adjusting complex concentration and treatment time. Flocculation at 20 degrees C with Chi-Alg at a 0.2 mixing ratio added as 20, 40, 100 and 150 mg/L SWW was aided by 5 min agitation at 130 rpm and then held at the same temperature for 30 min, 1 and 24 h. Turbidity measurements, protein determinations and qualitative FTIR analysis confirmed SWW protein adsorption which depended on Chi-Alg concentration and reaction time while turbidity reduction was affected by concentration only. No differences (p < 0.05) in protein adsorption were found between 1 and 24 h. Using 100 mg Chi-Alg complex/L SWW for 1 h achieved 83% protein adsorption and 97% turbidity reduction. PMID:15588769

  9. Cancer treatment decision-making processes for older patients with complex needs: a qualitative study

    PubMed Central

    Hughes, Jane; Farrington, Naomi; Richardson, Alison

    2015-01-01

    Objectives Although older people can experience complex health and social care needs alongside a primary cancer diagnosis, little is understood about how cancer treatment decisions are made for this population. This study aimed to investigate how cancer treatment decisions are formulated for older people with complex health and social care needs and the factors that shape these processes. Design Qualitative study involving semistructured interviews and non-participant observations. Framework approach used for data analysis. Setting Breast and colorectal cancer services in five English NHS hospital trusts. Participants Interviews: purposive sample of 22 clinicians directly involved in a face-to-face clinical role with patients regarding cancer treatment and care, maximising variation across clinical roles, tumour types and trusts. Observations: purposive sample of five cancer multidisciplinary meetings, maximising variation across location, team size and tumour type. Results The initial stages of cancer treatment decision-making are team-based, medically dominated and focused on the cancer. For patients with complex health and social care needs that extend beyond cancer pathology, later and less visible stages in the decision-making process are more haphazard and may result in less effective and workable treatment plans, as individual clinicians struggle to devise and deliver these plans without breaching time-based targets. Conclusions Service targets that focus resources solely on the presenting disease can disadvantage older patients with complex health and social care needs that extend beyond this primary diagnosis. Care should be taken to ensure time-based targets do not disincentivise thorough and timely assessment that can lead to the formulation of treatment plans tailored to individual needs and circumstances. PMID:26667015

  10. CRITICAL ANALYSIS OF THE CURRENT TREATMENT GUIDELINES FOR COMPLEX PTSD IN ADULTS.

    PubMed

    De Jongh, Ad; Resick, Patricia A; Zoellner, Lori A; van Minnen, Agnes; Lee, Christopher W; Monson, Candice M; Foa, Edna B; Wheeler, Kathleen; Broeke, Erik Ten; Feeny, Norah; Rauch, Sheila A M; Chard, Kathleen M; Mueser, Kim T; Sloan, Denise M; van der Gaag, Mark; Rothbaum, Barbara Olasov; Neuner, Frank; de Roos, Carlijn; Hehenkamp, Lieve M J; Rosner, Rita; Bicanic, Iva A E

    2016-05-01

    According to current treatment guidelines for Complex PTSD (cPTSD), psychotherapy for adults with cPTSD should start with a "stabilization phase." This phase, focusing on teaching self-regulation strategies, was designed to ensure that an individual would be better able to tolerate trauma-focused treatment. The purpose of this paper is to critically evaluate the research underlying these treatment guidelines for cPTSD, and to specifically address the question as to whether a phase-based approach is needed. As reviewed in this paper, the research supporting the need for phase-based treatment for individuals with cPTSD is methodologically limited. Further, there is no rigorous research to support the views that: (1) a phase-based approach is necessary for positive treatment outcomes for adults with cPTSD, (2) front-line trauma-focused treatments have unacceptable risks or that adults with cPTSD do not respond to them, and (3) adults with cPTSD profit significantly more from trauma-focused treatments when preceded by a stabilization phase. The current treatment guidelines for cPTSD may therefore be too conservative, risking that patients are denied or delayed in receiving conventional evidence-based treatments from which they might profit. PMID:26840244

  11. The potential of sarcospan in adhesion complex replacement therapeutics for the treatment of muscular dystrophy

    PubMed Central

    Marshall, Jamie L.; Kwok, Yukwah; McMorran, Brian; Baum, Linda G.; Crosbie-Watson, Rachelle H.

    2013-01-01

    Three adhesion complexes span the sarcolemma and facilitate critical connections between the extracellular matrix and the actin cytoskeleton: the dystrophin- and utrophin-glycoprotein complexes and α7β1 integrin. Loss of individual protein components results in a loss of the entire protein complex and muscular dystrophy. Muscular dystrophy is a progressive, lethal wasting disease characterized by repetitive cycles of myofiber degeneration and regeneration. Protein replacement therapy offers a promising approach for the treatment of muscular dystrophy. Recently, we demonstrated that sarcospan facilitates protein-protein interactions amongst the adhesion complexes and is an important therapeutic target. Here, we review current protein replacement strategies, discuss the potential benefits of sarcospan expression, and identify important experiments that must be addressed for sarcospan to move to the clinic. PMID:23601082

  12. The potential of sarcospan in adhesion complex replacement therapeutics for the treatment of muscular dystrophy.

    PubMed

    Marshall, Jamie L; Kwok, Yukwah; McMorran, Brian J; Baum, Linda G; Crosbie-Watson, Rachelle H

    2013-09-01

    Three adhesion complexes span the sarcolemma and facilitate critical connections between the extracellular matrix and the actin cytoskeleton: the dystrophin- and utrophin-glycoprotein complexes and α7β1 integrin. Loss of individual protein components results in a loss of the entire protein complex and muscular dystrophy. Muscular dystrophy is a progressive, lethal wasting disease characterized by repetitive cycles of myofiber degeneration and regeneration. Protein-replacement therapy offers a promising approach for the treatment of muscular dystrophy. Recently, we demonstrated that sarcospan facilitates protein-protein interactions amongst the adhesion complexes and is an important potential therapeutic target. Here, we review current protein-replacement strategies, discuss the potential benefits of sarcospan expression, and identify important experiments that must be addressed for sarcospan to move to the clinic. PMID:23601082

  13. Complex Psychiatric Comorbidity of Treatment-Seeking Youth With Autism Spectrum Disorder and Anxiety Symptoms

    PubMed Central

    HEPBURN, SUSAN L.; STERN, JESSICA A.; BLAKELEY-SMITH, AUDREY; KIMEL, LILA K.; REAVEN, JUDITH A.

    2015-01-01

    Anxiety disorders and other co-occurring psychiatric disorders significantly impact adaptive functioning for many children with autism spectrum disorder (ASD). This descriptive study examines the complexity of psychiatric comorbidity in treatment-seeking youth with ASD and anxiety symptoms. Forty-two parents of 8- to 14-year-old children with ASD and anxiety symptoms completed a structured psychiatric interview (K-SADS) and provided information about the child’s past and current psychological functioning as part of a screening process to enter an anxiety intervention program. Overall, comorbidity was very complex, with children obtaining an average of 4 psychiatric diagnoses (including anxiety disorders) on a structured clinical interview (range = 0–9). Onset and course differed by psychiatric disorder. Complexity of comorbidity did not differ significantly by age, sex, or autism severity. Despite clinical significance of the symptoms reported, few children were currently (or ever) engaged in mental health treatment or group psychosocial intervention. Although the specificity of the current sample limits the generalizability of these results, findings suggest that treatment-seeking children with ASD and anxiety often present with additional psychiatric symptoms, which supports a transdiagnostic approach to research and intervention in this area. Accurate assessment of comorbidity may provide valuable information for families and clinicians regarding individualized treatment approaches. PMID:25960821

  14. Amputation as an Unusual Treatment for Therapy-Resistant Complex Regional Pain Syndrome, Type 1

    PubMed Central

    Kashy, Babak K.; Abd-Elsayed, Alaa A.; Farag, Ehab; Yared, Maria; Vakili, Roya; Esa, Wael Ali Sakr

    2015-01-01

    Background Complex regional pain syndrome, type 1 (CRPS-1) causes severe pain that can be resistant to multiple treatment modalities. Amputation as a form of long-term treatment for therapy-resistant CRPS-1 is controversial. Case Report We report the case of a 38-year-old man who failed all treatment modalities for CRPS-1, including medication, steroid injections, and spinal cord stimulator implantation. Below-the-knee amputation to relieve intractable foot and ankle pain resulted in a favorable outcome for this patient. Conclusion Select patients with severe CRPS-1 who are unresponsive to all forms of treatment for pain may benefit from amputation as a last option for relief of suffering. Larger studies are needed to prove the efficacy of amputation. PMID:26730230

  15. The responsive amygdala: treatment-induced alterations in functional connectivity in pediatric complex regional pain syndrome.

    PubMed

    Simons, L E; Pielech, M; Erpelding, N; Linnman, C; Moulton, E; Sava, S; Lebel, A; Serrano, P; Sethna, N; Berde, C; Becerra, L; Borsook, D

    2014-09-01

    The amygdala is a key brain region with efferent and afferent neural connections that involve complex behaviors such as pain, reward, fear, and anxiety. This study evaluated resting state functional connectivity of the amygdala with cortical and subcortical regions in a group of chronic pain patients (pediatric complex regional pain syndrome) with age-sex matched control subjects before and after intensive physical-biobehavioral pain treatment. Our main findings include (1) enhanced functional connectivity from the amygdala to multiple cortical, subcortical, and cerebellar regions in patients compared with control subjects, with differences predominantly in the left amygdala in the pretreated condition (disease state); (2) dampened hyperconnectivity from the left amygdala to the motor cortex, parietal lobe, and cingulate cortex after intensive pain rehabilitation treatment within patients with nominal differences observed among healthy control subjects from time 1 to time 2 (treatment effects); (3) functional connectivity to several regions key to fear circuitry (prefrontal cortex, bilateral middle temporal lobe, bilateral cingulate, hippocampus) correlated with higher pain-related fear scores; and (4) decreases in pain-related fear associated with decreased connectivity between the amygdala and the motor and somatosensory cortex, cingulate, and frontal areas. Our data suggest that there are rapid changes in amygdala connectivity after an aggressive treatment program in children with chronic pain and intrinsic amygdala functional connectivity activity serving as a potential indicator of treatment response. PMID:24861582

  16. Physiotherapeutic treatment of athletic injuries to the muscle--tendon complex of the leg.

    PubMed Central

    Wise, D. D.

    1977-01-01

    An overview is presented of the most common soft-tissue injuries of the leg in athletes. A simple classification is made on the basis of cause, location of the injury and severity. These injuries can be classified into direct and indirect types. Direct injuries, which are usually the result of one episode of trauma, can be classified further into three grades of severity. Treatment is based on the severity of the injury and its location in the muscle--tendon complex. Indirect muscle--tendon injuries are the result of repetitive subacute microtrauma to the muscle--tendon complex or injury to the structures associated with muscle function (bursa, tendon sheath or fascia). Appropriate treatment regimens are suggested. PMID:902209

  17. Factors that lessen the burden of treatment in complex patients with chronic conditions: a qualitative study

    PubMed Central

    Ridgeway, Jennifer L; Egginton, Jason S; Tiedje, Kristina; Linzer, Mark; Boehm, Deborah; Poplau, Sara; de Oliveira, Djenane Ramalho; Odell, Laura; Montori, Victor M; Eton, David T

    2014-01-01

    Purpose Patients with multiple chronic conditions (multimorbidity) often require ongoing treatment and complex self-care. This workload and its impact on patient functioning and well-being are, together, known as treatment burden. This study reports on factors that patients with multimorbidity draw on to lessen perceptions of treatment burden. Patients and methods Interviews (n=50) and focus groups (n=4 groups, five to eight participants per group) were conducted with patients receiving care in a large academic medical center or an urban safety-net hospital. Interview data were analyzed using qualitative framework analysis methods, and themes and subthemes were used to identify factors that mitigate burden. Focus groups were held to confirm these findings and clarify any new issues. This study was part of a larger program to develop a patient-reported measure of treatment burden. Results Five major themes emerged from the interview data. These included: 1) problem-focused strategies, like routinizing self-care, enlisting support of others, planning for the future, and using technology; 2) emotion-focused coping strategies, like maintaining a positive attitude, focusing on other life priorities, and spirituality/faith; 3) questioning the notion of treatment burden as a function of adapting to self-care and comparing oneself to others; 4) social support (informational, tangible, and emotional assistance); and 5) positive aspects of health care, like coordination of care and beneficial relationships with providers. Additional subthemes arising from focus groups included preserving autonomy/independence and being proactive with providers. Conclusion Patients attempt to lessen the experience of treatment burden using a variety of personal, social, and health care resources. Assessing these factors in tandem with patient perceptions of treatment burden can provide a more complete picture of how patients fit complex self-care into their daily lives. PMID:24672228

  18. A new concept for the treatment of atopic dermatitis: silver-nanolipid complex (sNLC).

    PubMed

    Keck, C M; Anantaworasakul, P; Patel, M; Okonogi, S; Singh, K K; Roessner, D; Scherrers, R; Schwabe, K; Rimpler, C; Müller, R H

    2014-02-28

    In the treatment of mild to medium severe atopic dermatitis a new formulation proved to be highly efficient. The formulation is based on a combination of microsilver and nanolipid carriers (NLC) incorporated into an o/w cream and a lotion. A theory of action was proposed, the formation of silver-NLC complex (sNLC). In this study this theory was proven, and based on this new mechanism two new approaches for dealing with AD are suggested to distinctly improve AD treatment, i.e. increasing efficiency, reducing drug exposure and reducing side effects. The antimicrobial silver ions adsorb onto the surface of the negatively charged NLC (=sNLC complex). The sNLC as nanoparticles are highly adhesive to skin and bacterial surfaces, leading to a locally high concentration of silver ions killing the bacteria, much more effective than silver alone. The NLC restore the distorted skin barrier. Based on this a new two-step approach is suggested: (1) "treatment-supportive consumer care" by restoring the normal skin condition (NLC for barrier restoration plus synergistic antibacterial silver-NLC complex) and (2) "drug-loaded consumer care AD formulations". i.e. incorporating drugs into the NLC of this consumer care formulation. NLC incorporation makes the drugs more effective (penetration enhancement) and simultaneously exploits the skin normalization ability of the skin care sNLC formulation, future drug candidates being prednicarbate and tacrolimus. PMID:24378329

  19. DRESS syndrome presenting after initiation of mycobacterium avium complex osteomyelitis treatment.

    PubMed

    Blair, Paul W; Herrin, Douglas; Abaalkhail, Nawaf; Fiser, Wesley

    2015-01-01

    Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome is characterised by fever, rash, eosinophilia and organ damage that develops 2-6 weeks after the initiation of a medication. We report a case of DRESS syndrome in a 79-year-old man that developed after the introduction of rifabutin, ethambutol and clarithromycin used to treat Mycobacterium avium complex (MAC) vertebral osteomyelitis. This case highlights treatment and management challenges in a patient with known MAC vertebral osteomyelitis requiring prolonged steroids. Steroids are the mainstays of treatment for moderate to severe cases of DRESS syndrome. Initiation of steroids for the treatment of DRESS syndrome among patients with concomitant infections requires multidisciplinary collaboration for optimal management. PMID:26438676

  20. Pulsed radiofrequency treatment of complex regional pain syndrome: A case series

    PubMed Central

    Djuric, Vlad

    2014-01-01

    BACKGROUND: Various forms of sympathetic chain neurolysis (sympathectomy) have, at one time or another, held promise as effective treatment options for complex regional pain syndrome (CRPS). Complications, such as worsening pain and the development of new pain syndromes, have prevented sympathectomy from emerging as a standard intervention. In an effort to avoid poor outcomes associated with neurolysis, pulsed radiofrequency (PRF) has been proposed as a potential treatment alternative for a number of chronic neuropathic pain states, including some forms of CRPS. METHODS: The present report describes three cases in which patients diagnosed with lower extremity CRPS type I obtained substantial and lasting intervals of pain relief following PRF of the lumbar sympathetic chain. Over a period of four years, 14 fluoroscopically guided procedures using PRF lesioning of the lumbar sympathetic chain at L2, L3 and L4 were performed in three individuals with CRPS type I of the lower limb. Outcome measures included pre- and post-treatment self-reported pain and medication requirements. RESULTS: Substantial pain relief (>50%) was achieved in 91.7% of PRF applications at three months and 83.3% at six months, with some treatments resulting in persistent relief well beyond 12 months. Medication use decreased to a comparable degree, with discontinuation of opiates after all but three treatments. CONCLUSIONS: PRF lesioning of the lumbar sympathetic chain can be an effective treatment for patients with CRPS type I of the lower extremity, with the potential to provide ≥6 months of substantial pain relief. PMID:24945285

  1. Treatment for lexical retrieval using abstract and concrete words in persons with aphasia: Effect of complexity

    PubMed Central

    Kiran, Swathi; Sandberg, Chaleece; Abbott, Karen

    2009-01-01

    Background The significance of imageability and concreteness as factors for lexical tasks in aphasic individuals is under debate. No previous treatment studies have looked specifically at training abstract words compared to concrete for improved lexical retrieval in patients with chronic aphasia. Aim The goal of the present study was to determine the efficacy of a treatment for lexical retrieval that is based on models of lexical processing by utilizing abstractness as a mode of complexity. It was hypothesized that training abstract words in a category will result in improvement of those words and generalization to untrained target concrete words in the same category. Training concrete words in a category, however, will result in the retrieval of trained concrete words, but not generalization to target abstract words. Methods & Procedures A single subject experimental design across participants and behaviors was used to examine treatment and generalization. Generative naming for three categories (church, hospital, courthouse) was tested during baseline and treatment. Each treatment session was carried out in five steps: (1) category sorting, (2) feature selection, (3) yes/no feature questions, (4) word recall, and (5) free generative naming. Results Although participant 1 demonstrated neither significant learning nor generalization during abstract or concrete word training, participants 2, 3, and 4 showed significant learning during abstract word training and generalization to untrained concrete words. Participants 3 and 4 were also trained on concrete words which they improved on but did not show generalization to untrained abstract words. Conclusions The results of the present experiment support our hypothesis that training abstract words would result in greater learning and generalization to untrained concrete words. They also tentatively support the idea that generalization is facilitated by treatment focusing on more complex constructions (Kiran & Thompson, 2003; Thompson, Shapiro, Kiran, & Sobecks, 2003). PMID:19816590

  2. Mixed modality treatment planning of accelerated partial breast irradiation: to improve complex dosimetry cases

    PubMed Central

    2011-01-01

    Background Although 3D-conformal accelerated partial breast irradiation (APBI) is widely used, several questions still remain such as what are the optimal treatment planning modalities. Indeed, some patients may have an unfavorable anatomy and/or inadequate dosimetric constraints could be fulfilled ("complex cases"). In such cases, we wondered which treatment planning modality could be applied to achieve 3D-conformal APBI (2 mini-tangents and an "en face" electron field or non-coplanar photon multiple fields; or a mixed technique combining non-coplanar photon multiple fields with an "en face" electron beam). Methods From October 2007 to March 2010, 55 patients with pT1N0 breast cancer were enrolled in a phase II APBI trial. Among them, 7 patients were excluded as they were considered as "complex cases". A dosimetric comparison was performed according to the 3 APBI modalities mentioned above and assessed: planning treatment volume (PTV) coverage, PTV/whole breast ratio, lung and heart distance within irradiated field and exposure of organs at risk (OAR). Results Adequate PTV coverage was obtained with the 3 different treatment planning. Regarding OAR exposure, the "mixed technique" seemed to reduce the volume of non-target breast tissue in 4 cases compared to the other techniques (in only 1 case), with the mean V50% at 44.9% (range, 13.4 - 56.9%) for the mixed modality compared to 51.1% (range, 22.4 - 63.4%) and 51.8% (range, 23.1 - 59.5%) for the reference and non-coplanar techniques, respectively. The same trend was observed for heart exposure. Conclusions The mixed technique showed a promising trend of reducing the volume of non-target breast tissue and heart exposure doses in APBI "complex cases". PMID:22074547

  3. Amphiphilic Antimony(V) Complexes for Oral Treatment of Visceral Leishmaniasis

    PubMed Central

    Fernandes, Flaviana R.; Ferreira, Weverson A.; Campos, Mariana A.; Ramos, Guilherme S.; Kato, Kelly C.; Almeida, Gregório G.; Corrêa, José D.; Melo, Maria N.; Demicheli, Cynthia

    2013-01-01

    The need for daily parenteral administration is an important limitation in the clinical use of pentavalent antimonial drugs against leishmaniasis. In this study, amphiphilic antimony(V) complexes were prepared from alkylmethylglucamides (L8 and L10, with carbon chain lengths of 8 and 10, respectively), and their potential for the oral treatment of visceral leishmaniasis (VL) was evaluated. Complexes of Sb and ligand at 1:3 (SbL8 and SbL10) were obtained from the reaction of antimony(V) with L8 and L10, as evidenced by elemental and electrospray ionization-tandem mass spectrometry (ESI-MS) analyses. Fluorescence probing of hydrophobic environment and negative-staining transmission electron microscopy showed that SbL8 forms kinetically stabilized nanoassemblies in water. Pharmacokinetic studies with mice in which the compound was administered by the oral route at 200 mg of Sb/kg of body weight indicated that the SbL8 complex promoted greater and more sustained Sb levels in serum and liver than the levels obtained for the conventional antimonial drug meglumine antimoniate (Glucantime [Glu]). The efficacy of SbL8 and SbL10 administered by the oral route was evaluated in BALB/c mice infected with Leishmania infantum after a daily dose of 200 mg of Sb/kg for 20 days. Both complexes promoted significant reduction in the liver and spleen parasite burdens in relation to those in the saline-treated control group. The extent of parasite suppression (>99.96%) was similar to that achieved after Glu given intraperitoneally at 80 mg of Sb/kg/day. As expected, there was no significant reduction in the parasitic load in the group treated orally with Glu at 200 mg of Sb/(kg day). In conclusion, amphiphilic antimony(V) complexes emerge as an innovative and promising strategy for the oral treatment of VL. PMID:23796930

  4. Cutting through the Complexities of mTOR for the Treatment of Stroke

    PubMed Central

    Maiese, Kenneth

    2014-01-01

    On a global basis, at least 15 million individuals suffer some form of a stroke every year. Of these individuals, approximately 800,000 of these cerebrovascular events occur in the United States (US) alone. The incidence of stroke in the US has declined from the third leading cause of death to the fourth, a result that can be attributed to multiple factors that include improved vascular disease management, reduced tobacco use, and more rapid time to treatment in patients that are clinically appropriate to receive recombinant tissue plasminogen activator. However, treatment strategies for the majority of stroke patients are extremely limited and represent a critical void for care. A number of new therapeutic considerations for stroke are under consideration, but it is the mammalian target of rapamycin (mTOR) that is receiving intense focus as a potential new target for cerebrovascular disease. As part of the phosphoinositide 3-kinase (PI 3-K) and protein kinase B (Akt) cascade, mTOR is an essential component of mTOR Complex 1 (mTORC1) and mTOR Complex 2 (mTORC2) to govern cell death involving apoptosis, autophagy, and necroptosis, cellular metabolism, and gene transcription. Vital for the consideration of new therapeutic strategies for stroke is the ability to understand how the intricate and complex pathways of mTOR signaling sometimes lead to disparate clinical outcomes. PMID:24712647

  5. Phase-oriented treatment of structural dissociation in complex traumatization: overcoming trauma-related phobias.

    PubMed

    Steele, Kathy; van der Hart, Onno; Nijenhuis, Ellert R S

    2005-01-01

    The theory of structural dissociation of the personality proposes that patients with complex trauma-related disorders are characterized by a division of their personality into different prototypical parts, each with its own psychobiological underpinnings. As one or more apparently normal parts (ANPs), patients have a propensity toward engaging in evolutionary prepared action systems for adaptation to daily living to guide their actions. Two or more emotional parts (EPs) are fixated in traumatic experience. As EPs, patients predominantly engage action systems related to physical defense and attachment cry. ANP and EP are insufficiently integrated, but interact and share a number of dispositions of the personality (e.g., speaking). All parts are stuck in maladaptive action tendencies that maintain dissociation, including a range of phobias, which is a major focus of this article. Phase-oriented treatment helps patients gradually develop adaptive mental and behavioral actions, thus overcoming their phobias and structural dissociation. Phase 1, symptom reduction and stabilization, is geared toward overcoming phobias of mental contents, dissociative parts, and attachment and attachment loss with the therapist. Phase 2, treatment of traumatic memories, is directed toward overcoming the phobia of traumatic memories, and phobias related to insecure attachment to the perpetrator(s), particularly in EPs. In Phase 3, integration and rehabilitation, treatment is focused on overcoming phobias of normal life, healthy risk-taking and change, and intimacy. To the degree that the theory of structural dissociation serves as an integrative heuristic for treatment, it should be compatible with other theories that guide effective treatment of patients with complex dissociative disorders. PMID:16172081

  6. Maggot therapy in treatment of a complex hand injury complicated by mycotic infection.

    PubMed

    Bohac, M; Cambal, M; Zamborsky, R; Takac, P; Fedeles, J

    2015-01-01

    Complex injuries of the hand remain a therapeutic challenge for surgeons. We present the case of a male who suffered a devastating injury of the hand caused by a conveyor belt. The patient developed a progressive Absidia corymbifera infection of the affected soft tissues. Initial treatments with serial surgical debridement and topical and intravenous itraconazole were unsuccessful in eliminating the infection. We decided to use maggot debridement therapy in a new special design to debride all necrotic, devitalized tissue and preserve only healthy tissue and functioning structures. This maneuverer followed by negative pressure therapy allowed progressive healing. In such complex hand injuries, maggot debridement combined with negative pressure therapy could be considered to achieve effective and considerable results, although future functional morbidity may occur (Fig. 4, Ref. 18). PMID:26621165

  7. A dual wavelength-activatable gold nanorod complex for synergistic cancer treatment

    NASA Astrophysics Data System (ADS)

    Pacardo, Dennis B.; Neupane, Bhanu; Rikard, S. Michaela; Lu, Yue; Mo, Ran; Mishra, Sumeet R.; Tracy, Joseph B.; Wang, Gufeng; Ligler, Frances S.; Gu, Zhen

    2015-07-01

    A multifunctional gold nanorod (AuNR) complex is described with potential utility for theranostic anticancer treatment. The AuNR was functionalized with cyclodextrin for encapsulation of doxorubicin, with folic acid for targeting, and with a photo-responsive dextran-azo compound for intracellular controlled drug release. The interaction of a AuNR complex with HeLa cells was facilitated via a folic acid targeting ligand as displayed in the dark-field images of cells. Enhanced anticancer efficacy was demonstrated through the synergistic combination of promoted drug release upon ultraviolet (UV) light irradiation and photothermal therapy upon infrared (IR) irradiation. This multifunctional AuNR-based system represents a novel theranostic strategy for spatiotemporal delivery of anticancer therapeutics.A multifunctional gold nanorod (AuNR) complex is described with potential utility for theranostic anticancer treatment. The AuNR was functionalized with cyclodextrin for encapsulation of doxorubicin, with folic acid for targeting, and with a photo-responsive dextran-azo compound for intracellular controlled drug release. The interaction of a AuNR complex with HeLa cells was facilitated via a folic acid targeting ligand as displayed in the dark-field images of cells. Enhanced anticancer efficacy was demonstrated through the synergistic combination of promoted drug release upon ultraviolet (UV) light irradiation and photothermal therapy upon infrared (IR) irradiation. This multifunctional AuNR-based system represents a novel theranostic strategy for spatiotemporal delivery of anticancer therapeutics. Electronic supplementary information (ESI) available. See DOI: 10.1039/c5nr01568e

  8. Staged Mucosal Advancement Flap versus Staged Fibrin Sealant in the Treatment of Complex Perianal Fistulas

    PubMed Central

    van der Hagen, S. J.; Baeten, C. G.; Soeters, P. B.; van Gemert, W. G.

    2011-01-01

    Background. In this prospective randomised study, the staged mucosal advancement flap is compared with staged fibrin sealant application in the treatment of perianal fistulas. Methods. All patients with high complex cryptoglandular fistulas were randomised to closure of the internal opening by a mucosal advancement flap (MF) or injection with fibrin sealant (FS) after treatment with setons. Recurrence rate and incontinence disorders were explored. Results. The MF group (5 females and 10 males) with a median age of 51 years and a median followup of 52 months. The FS group (4 females and 11 males) with a median age of 45 years and a median followup of 49 months. Three (20%) patients of the MF group had a recurrent fistula compared to 9 (60%) of the FS group (P = 0.03). No new continence disorders developed. Conclusion. Staged FS injection has a much lower success rate compared to MF. PMID:21808642

  9. Dental Treatment Considerations for Children with Complex Medical Histories: A Case of Townes-Brock Syndrome.

    PubMed

    Elkaiali, Lujayn; Ratliff, Katelin; Oueis, Hassan

    2016-01-01

    It is common for oral health and dental care to be considered a lesser priority for children with complex medical histories than other aspects of their health care. Often, these patients are at a high risk for caries and infection due to poor oral health practices at home, special or restricted diets, and no early establishment of a dental home for routine dental care. Unfortunately, many of these patients present to their first dental visits with caries and require aggressive treatment, such as extractions instead of pulp therapy, or crowns instead of fillings, due to their high caries risk and the difficulty in safely managing them medically during treatment. A unique example of this occurred at the Children's Hospital of Michigan, where a patient with Townes-Brock syndrome (TBS) presented to the dental clinic with advanced caries. TBS is a rare autosomal dominant disorder characterized by major findings such as anomalies of the external ear, imperforate anus, renal malformations, and malformations of the hand. Like many medically complex cases, dental anomalies are not a direct consequence of TBS; however, due to the necessity of high calorie and high sugar feeding supplementation, many of these patients are at high risk for advanced dental caries. Due to this high caries risk, a more aggressive treatment plan is necessary to minimize the risk of recurrent decay and infection. It is critical to stress that even if the disease, syndrome, etc., of a patient does not have inherent dental consequences, it is imperative for regular dental care to be part of the comprehensive treatment plan for these patients. This includes the establishment of a dental home at a young age and proper oral health education of the patient's caregivers and their physicians. In the case of the patient with TBS, recommendations for daily brushing, especially after high sugar feedings was stressed, as well as the reduction of any other sweets within the diet. PMID:26882646

  10. Modeling the Complexity of Post-Treatment Drinking: It’s a Rocky Road to Relapse

    PubMed Central

    Witkiewitz, Katie; Marlatt, G. Alan

    2007-01-01

    The most widely cited road block to successful treatment outcomes for psychological and substance use disorders has been described as the return to the previous behavior, or “relapse.” The operational definition of “relapse” varies from study to study and between clinicians, but in general the term is used to indicate the return to previous levels of symptomatic behavior. One explanation for the variation in the operationalization of relapse is the wide variety of behaviors for which the term is applied, including (but not limited to): depression, substance abuse, schizophrenia, mania, sexual offending, risky sexual behavior, dieting, and the anxiety disorders. A second explanation for the multitude of definitions for relapse is the inherent complexity in the process of behavior change. In this paper we present the most recent treatment outcome research evaluating relapse rates, with a special focus on the substance use disorders. Following this review of the literature we present an argument for the operationalization of relapse as a dynamic process, which can be empirically characterized using dynamical systems theory. We support this argument by presenting results from the analysis of alcohol treatment outcomes using catastrophe modeling techniques. These results demonstrate the utility of catastrophe theory in modeling the alcohol relapse process. The implications of these analyses for the treatment of alcohol use disorders, as well as a discussion of future research incorporating nonlinear dynamical systems theory is provided. PMID:17355897

  11. Increasing complexity: which drug class to choose for treatment of hypertension in the elderly?

    PubMed

    Kaiser, Edelgard Anna; Lotze, Ulrich; Schäfer, Hans Hendrik

    2014-01-01

    Treatment of hypertension in the elderly is expected to become more complex in the coming decades. Based on the current landscape of clinical trials, guideline recommendations remain inconclusive. The present review discusses the latest evidence derived from studies available in 2013 and investigates optimal blood pressure (BP) and preferred treatment substances. Three common archetypes are discussed that hamper the treatment of hypertension in the very elderly. In addition, this paper presents the current recommendations of the NICE 2011, JNC7 2013-update, ESH/ESC 2013, CHEP 2013, JNC8 and ASH/ISH guidelines for elderly patients. Advantages of the six main substance classes, namely diuretics, beta-blockers (BBs), calcium channel blockers (CCBs), angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), and direct renin inhibitors (DRIs) are discussed. Medical and economic implications of drug administration in the very elderly are presented. Avoidance of treatment-related adverse effects has become increasingly relevant. Current substance classes are equally effective, with similar effects on cardiovascular outcomes. Selection of substances should therefore also be based on collateral advantages of drugs that extend beyond BP reduction. The combination of ACEIs and diuretics appears to be favorable in managing systolic/diastolic hypertension. Diuretics are a preferred and cheap combination drug, and the combination with CCBs is recommended for patients with isolated systolic hypertension. ACEIs and CCBs are favorable for patients with dementia, while CCBs and ARBs imply substantial cost savings due to high adherence. PMID:24711696

  12. The role of extra- and intracranial bypass in the treatment of complex aneurysms.

    PubMed

    Cenzato, Marco; Bortolotti, Carlo

    2016-03-01

    The availability of flow diverters and new endovascular techniques has greatly reduced the need and indications for bypass surgery. Nevertheless, there are situations where a bypass is the best option for a complex cerebrovascular problem. Generally, typical indications are giant aneurysms with a wide neck and/or partially calcified aneurysms with main branches or perforating arteries arising directly from the sac or from the neck itself, or fusiform aneurysms, partially calcified aneurysms. In this paper we discuss the following issues as they apply to the modern use of bypass techniques. In case of fusiform aneurysms involving the proximal bifurcations of the media or the internal carotid artery combined and coordinated evaluations and efforts by a team which includes neurosurgeons and endovascular specialists is essential. Treatment with bypass alone may not be sufficient and the combination of one or more bypasses with an endovascular treatment of occlusion, partial aneurysm embolization or flow diversion may be the best strategy. Addressing complex and fusiform aneurysm surgery requires a problem solving attitude and in this lies both the challenging and the fun side of this surgery. PMID:26947783

  13. Evidence-based treatment for adult women with child abuse-related Complex PTSD: a quantitative review

    PubMed Central

    Dorrepaal, Ethy; Thomaes, Kathleen; Hoogendoorn, Adriaan W.; Veltman, Dick J.; Draijer, Nel; van Balkom, Anton J. L. M.

    2014-01-01

    Introduction Effective first-line treatments for posttraumatic stress disorder (PTSD) are well established, but their generalizability to child abuse (CA)-related Complex PTSD is largely unknown. Method A quantitative review of the literature was performed, identifying seven studies, with treatments specifically targeting CA-related PTSD or Complex PTSD, which were meta-analyzed, including variables such as effect size, drop-out, recovery, and improvement rates. Results Only six studies with one or more cognitive behavior therapy (CBT) treatment conditions and one with a present centered therapy condition could be meta-analyzed. Results indicate that CA-related PTSD patients profit with large effect sizes and modest recovery and improvement rates. Treatments which include exposure showed greater effect sizes especially in completers’ analyses, although no differential results were found in recovery and improvement rates. However, results in the subgroup of CA-related Complex PTSD studies were least favorable. Within the Complex PTSD subgroup, no superior effect size was found for exposure, and affect management resulted in more favorable recovery and improvement rates and less drop-out, as compared to exposure, especially in intention-to-treat analyses. Conclusion Limited evidence suggests that predominantly CBT treatments are effective, but do not suffice to achieve satisfactory end states, especially in Complex PTSD populations. Moreover, we propose that future research should focus on direct comparisons between types of treatment for Complex PTSD patients, thereby increasing generalizability of results. PMID:25563302

  14. Enhancement of Auditory Fear Conditioning after Housing in a Complex Environment Is Attenuated by Prior Treatment with Amphetamine

    ERIC Educational Resources Information Center

    Briand, Lisa A.; Robinson, Terry E.; Maren, Stephen

    2005-01-01

    Prior exposure to drugs of abuse has been shown to occlude the structural plasticity associated with living in a complex environment. Amphetamine treatment may also occlude some cognitive advantages normally associated with living in a complex environment. To test this hypothesis we examined the influence of prior exposure to amphetamine on fear

  15. Enhancement of Auditory Fear Conditioning after Housing in a Complex Environment Is Attenuated by Prior Treatment with Amphetamine

    ERIC Educational Resources Information Center

    Briand, Lisa A.; Robinson, Terry E.; Maren, Stephen

    2005-01-01

    Prior exposure to drugs of abuse has been shown to occlude the structural plasticity associated with living in a complex environment. Amphetamine treatment may also occlude some cognitive advantages normally associated with living in a complex environment. To test this hypothesis we examined the influence of prior exposure to amphetamine on fear…

  16. A 10-year analysis of the "Amsterdam" protocol in the treatment of zygomatic complex fractures.

    PubMed

    Forouzanfar, Tymour; Salentijn, Erik; Peng, Gina; van den Bergh, Bart

    2013-10-01

    Despite many publications on the epidemiology, incidence and aetiology of zygomatic complex (ZC) fractures there is still a lack of information about a consensus in its treatment. The aim of the present study is to investigate retrospectively the Amsterdam protocol for surgical treatment of ZC fractures. The 10 years results and complications are presented. The study population consisted of 236 patients (170 males, 66 females, 210 ZC fractures, 26 solitary zygomatic arch fractures) with a mean age of 39.3 (SD: ±15.6) years (range 4-87 years). The mean cause of injury was traffic accident followed by violence and fall. A total of 225 plates and 943 screws were used. Twenty-eight patients presented with complications, including wound infection (9 patients) and transient paralysis of the facial nerve (one patient). Seven patients (2.8%) needed surgical retreatment of whom four patients needed secondary orbital floor reconstruction as these patients developed enophthalmos and diplopia. In conclusion this report provides important data for reaching a consensus for the treatment of these types of fractures. PMID:23375533

  17. Effect of complex treatment using visual and auditory stimuli on the symptoms of attention deficit/hyperactivity disorder in children

    PubMed Central

    Park, Mi-Sook; Byun, Ki-Won; Park, Yong-Kyung; Kim, Mi-Han; Jung, Sung-Hwa; Kim, Hong

    2013-01-01

    We investigated the effects of complex treatment using visual and auditory stimuli on the symptoms of attention deficit/hyperactivity disorder (ADHD) in children. Forty-seven male children (7–13 yr old), who were clinically diagnosed with ADHD at the Balance Brain Center in Seoul, Korea, were included in this study. The complex treatment consisted of visual and auditory stimuli, core muscle exercise, targeting ball exercise, ocular motor exercise, and visual motor integration. All subjects completed the complex treatment for 60 min/day, 2–3 times/week for more than 12 weeks. Data regarding visual and auditory reaction time and cognitive function were obtained using the Neurosync program, Stroop Color-Word Test, and test of nonverbal intelligence (TONI) at pre- and post-treatment. The complex treatment significantly decreased the total reaction time, while it increased the number of combo actions on visual and auditory stimuli (P< 0.05). The Stroop color, word, and color-word scores were significantly increased at post-treatment compared to the scores at pretreatment (P< 0.05). There was no significant change in the TONI scores, although a tendency toward an increase in these scores was observed. In conclusion, complex treatment using visual and auditory stimuli alleviated the symptoms of ADHD and improved cognitive function in children. In addition, visual and auditory function might be possible indicators for demonstrating effective ADHD intervention. PMID:24278878

  18. Finalizing a measurement framework for the burden of treatment in complex patients with chronic conditions

    PubMed Central

    Eton, David T; Ridgeway, Jennifer L; Egginton, Jason S; Tiedje, Kristina; Linzer, Mark; Boehm, Deborah H; Poplau, Sara; Ramalho de Oliveira, Djenane; Odell, Laura; Montori, Victor M; May, Carl R; Anderson, Roger T

    2015-01-01

    Purpose The workload of health care and its impact on patient functioning and well-being is known as treatment burden. The purpose of this study was to finalize a conceptual framework of treatment burden that will be used to inform a new patient-reported measure of this construct. Patients and methods Semi-structured interviews were conducted with 50 chronically ill patients from a large academic medical center (n=32) and an urban safety-net hospital (n=18). We coded themes identifying treatment burden, with the themes harmonized through discussion between multiple coders. Four focus groups, each with five to eight participants with chronic illness, were subsequently held to confirm the thematic structure that emerged from the interviews. Results Most interviewed patients (98%) were coping with multiple chronic conditions. A preliminary conceptual framework using data from the first 32 interviews was evaluated and was modified using narrative data from 18 additional interviews with a racially and socioeconomically diverse sample of patients. The final framework features three overarching themes with associated subthemes. These themes included: 1) work patients must do to care for their health (eg, taking medications, keeping medical appointments, monitoring health); 2) challenges/stressors that exacerbate perceived burden (eg, financial, interpersonal, provider obstacles); and 3) impacts of burden (eg, role limitations, mental exhaustion). All themes and subthemes were subsequently confirmed in focus groups. Conclusion The final conceptual framework can be used as a foundation for building a patient self-report measure to systematically study treatment burden for research and analytical purposes, as well as to promote meaningful clinic-based dialogue between patients and providers about the challenges inherent in maintaining complex self-management of health. PMID:25848328

  19. Stabilizing Group Treatment for Complex Posttraumatic Stress Disorder Related to Childhood Abuse Based on Psycho-Education and Cognitive Behavioral Therapy: A Pilot Study

    ERIC Educational Resources Information Center

    Dorrepaal, Ethy; Thomaes, Kathleen; Smit, Johannes H.; van Balkom, Anton J. L. M.; van Dyck, Richard; Veltman, Dick J.; Draijer, Nel

    2010-01-01

    Objective: This study tests a Stabilizing Group Treatment protocol, designed for the management of the long-term sequelae of child abuse, that is, Complex Posttraumatic Stress Disorder (Complex PTSD). Evidence-based treatment for this subgroup of PTSD patients is largely lacking. This stabilizing treatment aims at improving Complex PTSD using…

  20. Stabilizing Group Treatment for Complex Posttraumatic Stress Disorder Related to Childhood Abuse Based on Psycho-Education and Cognitive Behavioral Therapy: A Pilot Study

    ERIC Educational Resources Information Center

    Dorrepaal, Ethy; Thomaes, Kathleen; Smit, Johannes H.; van Balkom, Anton J. L. M.; van Dyck, Richard; Veltman, Dick J.; Draijer, Nel

    2010-01-01

    Objective: This study tests a Stabilizing Group Treatment protocol, designed for the management of the long-term sequelae of child abuse, that is, Complex Posttraumatic Stress Disorder (Complex PTSD). Evidence-based treatment for this subgroup of PTSD patients is largely lacking. This stabilizing treatment aims at improving Complex PTSD using

  1. Resolution of Crohn's disease and complex regional pain syndrome following treatment of paratuberculosis

    PubMed Central

    Kuenstner, J Todd; Chamberlin, William; Naser, Saleh A; Collins, Michael T; Dow, Coad Thomas; Aitken, John M; Weg, Stuart; Telega, Grzegorz; John, Kuruvilla; Haas, David; Eckstein, Torsten M; Kali, Maher; Welch, Christine; Petrie, Thomas

    2015-01-01

    A cohort of family members with various chronic diseases including Crohn’s disease, asthma, complex regional pain syndrome, hypothyroidism, type 1 diabetes mellitus, and lymphangiomatosis and/or evidence of infection by Mycobacterium avium subsp. paratuberculosis (MAP) are described in this series of case reports. MAP was cultured from the blood of three members affected by the first five diseases and there was accompanying elevated anti-MAP IgG in two members. The patient affected by the sixth disease has a markedly elevated anti-MAP titer. The two patients affected by the first four diseases have been treated with a combination of anti-MAP antibiotics and ultraviolet blood irradiation therapy with resolution of the disease symptomatology and inability to culture MAP in post treatment blood samples. These case reports of patients with MAP infections provide supportive evidence of a pathogenic role of MAP in humans. PMID:25852293

  2. Treatment of Uncertainties: Output Updating in Complex Thermal-Hydraulics (TH) Computational Codes

    SciTech Connect

    Pourgol-Mohamad, Mohammad; Mosleh, Ali; Modarres, Mohammad

    2006-07-01

    Uncertainty analysis methodology in complex system models requires a comprehensive treatment of many different types and sources of uncertainty sources. Proposed methodology as part of a broader research by the authors for an integrated methodology for uncertainty analysis of TH computational codes, allows updating of uncertainties upon availability of new information about inputs, models or output. This methodology is a statistical approach for output-based updating, with non-paired data. The proposed method employs a Gibbs MCMC sampler to estimate output distribution. Winbugs code was developed to implement the Bayesian solution proposed in this paper. The methodology is applied to the data from 200% cold leg LBLOCA test of LOFT facility. (authors)

  3. Targeting the mitochondrial electron transport chain complexes for the induction of apoptosis and cancer treatment.

    PubMed

    Rohlena, Jakub; Dong, Lan-Feng; Neuzil, Jiri

    2013-01-01

    Treatment of cancer is by no means universally successful and often manifests harmful side effects. The best way to improve the success rate and reduce the side effects would be to develop compounds that are able to kill cancer cells while leaving normal cells unaffected. In this respect, mitocans (an acronym from 'mitochondria' and 'cancer'), a summary term we proposed for compounds that induce cell death by targeting mitochondria, show an encouraging trend. Here we provide an overview of mitocans specific for the mitochondrial electron transport chain. These mitocans are particularly interesting, because a frequent consequence of electron transport chain inhibition is the induction of superoxide formation resulting in the preferential killing of cancer cells, as these tend to be more sensitive than normal cells to sudden increases in oxidative stress. Furthermore, macromolecular complexes of the electron transport chain only rarely mutate in cancer, and represent useful targets for anti-cancer drug development when widely-applicable agents are sought. PMID:22201598

  4. Resolution of Crohn's disease and complex regional pain syndrome following treatment of paratuberculosis.

    PubMed

    Kuenstner, J Todd; Chamberlin, William; Naser, Saleh A; Collins, Michael T; Dow, Coad Thomas; Aitken, John M; Weg, Stuart; Telega, Grzegorz; John, Kuruvilla; Haas, David; Eckstein, Torsten M; Kali, Maher; Welch, Christine; Petrie, Thomas

    2015-04-01

    A cohort of family members with various chronic diseases including Crohn's disease, asthma, complex regional pain syndrome, hypothyroidism, type 1 diabetes mellitus, and lymphangiomatosis and/or evidence of infection by Mycobacterium avium subsp. paratuberculosis (MAP) are described in this series of case reports. MAP was cultured from the blood of three members affected by the first five diseases and there was accompanying elevated anti-MAP IgG in two members. The patient affected by the sixth disease has a markedly elevated anti-MAP titer. The two patients affected by the first four diseases have been treated with a combination of anti-MAP antibiotics and ultraviolet blood irradiation therapy with resolution of the disease symptomatology and inability to culture MAP in post treatment blood samples. These case reports of patients with MAP infections provide supportive evidence of a pathogenic role of MAP in humans. PMID:25852293

  5. Low-intensity laser radiation in complex treatment of inflammatory diseases of parodontium

    NASA Astrophysics Data System (ADS)

    Sokolova, Irina A.; Erina, Stanislava V.

    1995-04-01

    The problem of complex treatment of inflammatory disease of parodontium has become very acute and actual at the moment. The diseases of inflammatory nature are considered to be the most vital issues of the day. The state of the local immune system of oral cavity plays the most important role in the complicated mechanism of inflammatory process development in the tissues of parodontium. Recently physical factors have become predominant in the system of complex therapy of parodontitis. The application of low-intense laser radiation (LLR) is considered to be the most important and up-to-date method in the preventive dentistry. There were 60 patients of average damage rate suffering from chronic generalizing parodontitis at the age of 25 up to 55 under observation. The major goal of examination was to get the objective results of the following methods' application: parodontium index (Russel, 1956), hygiene index (Fyodorov, Volodkina, 1971), Bacterioscopy of dental-gingival pockets content, simple and broadened stomatoscopy (Kunin, 1970), SIgA level determination in mixed saliva (Manchini et all, 1965) and R-protein level in gingival blood (Kulberg, 1990). All the patients were split into 2 groups. The first group (30 patients) has undergone the laser therapy course while the second group of 30 patients couldn't get it (LLR). Despite the kind of therapy they have undergone, all the patients have got the local anti-inflammatory medicamental therapy. The results of clinical observations have proved the fact that laser therapy application makes it possible to shorten the course of treatment in 1.5 times. The shifts of oral cavity local resistance take place in case of chronic generalizing parodontitis. The direct immunostimulating effect could be observed as a result of LLR- therapy application. The close connection of both anti-inflammatory medicamental and LLR-therapy has proved the possibility of purposeful local immune status correction in case of parodontitis.

  6. Fusariosis, a complex infection caused by a high diversity of fungal species refractory to treatment.

    PubMed

    Guarro, J

    2013-12-01

    In recent years the number of opportunistic invasive fusariosis has increased significantly, the main factors involved in these infections being reviewed here. In spite of the extensive literature published the advances in the management of disseminated fusariosis have been very poor and it remains a severe infection, refractory to treatment and with a high mortality rate. There are no ideal therapies and the presence of neutropenia has a critical part to play in the outcome of the infection. At least 70 species have been involved in fusariosis. Fusarium solani species complex is responsible for nearly 60% of the cases and F. oxysporum species complex for approximately 20% of them. Most of the infections are caused by four species, i.e. F. petroliphilum, F. keratoplasticum and other two unnamed phylogenetic species. The efficacy of amphotericin B and voriconazole, the most used antifungal drugs, for treating invasive fusariosis are controversial but in general the percentage of patients cured in the different clinical trials is low. Infections by Fusarium verticillioides seem to have the best prognosis. The recent release of complete genome sequences of the most clinically relevant species and the emergence of fungal genomics offer excellent opportunities for examining the multifactorial processes of Fusarium pathogenicity. Using knockout mutants of genes encoding sequence-specific proteins, several virulence factors have been characterized. PMID:23934595

  7. Staff Engagement During Complex Pediatric Medical Care: The Role of Patient, Family, and Treatment Variables

    PubMed Central

    Meltzer, Lisa J.; Steinmiller, Elizabeth; Simms, Steve; Grossman, Michael; Li, Yuelin

    2009-01-01

    Objective To examine the role of patient, family, and treatment variables on self-reported engagement for physicians and nurses working with pediatric complex care patients. Methods Sixty-eight physicians and 85 registered nurses at a children’s hospital reviewed eight case scenarios that varied by the patient and patient’s family (each cooperative vs. difficult) and the length of hospitalization (<30 vs. >30 days). Participants rated their engagement from highly engaged/responsive to distancing/disconnected behaviors. Results Nurses were more likely than physicians to engage in situations with a difficult patient/cooperative family but less likely to engage in situations with a cooperative patient/difficult family. Nurses were more likely to consult a colleague regarding the care of a difficult patient/difficult family, while physicians were more likely to refer a difficult patient/difficult family to a psychosocial professional. Conclusions Differences were found for engagement with “difficult” patients/families, with physicians more likely to distance themselves or refer to a psychosocial professional, while nurses were more likely to consult with a colleague. Practice Implications Communication between health care team members is essential for optimal family centered health care. Thus, interventions are needed that focus on communication and support for health care teams working with pediatric complex care patients and their families. PMID:19209401

  8. Behavioural and EEG effects of chronic rapamycin treatment in a mouse model of tuberous sclerosis complex.

    PubMed

    Cambiaghi, Marco; Cursi, Marco; Magri, Laura; Castoldi, Valerio; Comi, Giancarlo; Minicucci, Fabio; Galli, Rossella; Leocani, Letizia

    2013-04-01

    Tuberous Sclerosis Complex (TSC) is a multisystem genetic disorder caused by mutation in either Tsc1 or Tsc2 genes that leads to the hyper activation of the mTOR pathway, a key signalling pathway for synaptic plasticity. TSC is characterized by benign tumors arising in different organs and severe neuropsychiatric symptoms, such as epilepsy, intellectual disability, autism, anxiety and depressive behaviour. Rapamycin is a potent inhibitor of mTOR and its efficacy in treating epilepsy and neurological symptoms remains elusive. In a mouse model in which Tsc1 has been deleted in embryonic telencephalic neural stem cells, we analyzed anxiety- and depression-like behaviour by elevated-plus maze (EPM), open-field test (OFT), forced-swim test (FST) and tail-suspension test (TST), after chronic administration of rapamycin. In addition, spectral analysis of background EEG was performed. Rapamycin-treated mutant mice displayed a reduction in anxiety- and depression-like phenotype, as shown by the EPM/OFT and FST, respectively. These results were inline with EEG power spectra outcomes. The same effects of rapamycin were observed in wild-type mice. Notably, in heterozygous animals we did not observe any EEG and/or behavioural variation after rapamycin treatment. Together these results suggest that both TSC1 deletion and chronic rapamycin treatment might have a role in modulating behaviour and brain activity, and point out to the potential usefulness of background EEG analysis in tracking brain dysfunction in parallel with behavioural testing. PMID:23159330

  9. Treatment with at Homeopathic Complex Medication Modulates Mononuclear Bone Marrow Cell Differentiation

    PubMed Central

    Cesar, Beatriz; Abud, Ana Paula R.; de Oliveira, Carolina C.; Cardoso, Francolino; Bernardi, Raffaello Popa Di; Guimarães, Fernando S. F.; Gabardo, Juarez; de Freitas Buchi, Dorly

    2011-01-01

    A homeopathic complex medication (HCM), with immunomodulatory properties, is recommended for patients with depressed immune systems. Previous studies demonstrated that the medication induces an increase in leukocyte number. The bone marrow microenvironment is composed of growth factors, stromal cells, an extracellular matrix and progenitor cells that differentiate into mature blood cells. Mice were our biological model used in this research. We now report in vivo immunophenotyping of total bone marrow cells and ex vivo effects of the medication on mononuclear cell differentiation at different times. Cells were examined by light microscopy and cytokine levels were measured in vitro. After in vivo treatment with HCM, a pool of cells from the new marrow microenvironment was analyzed by flow cytometry to detect any trend in cell alteration. The results showed decreases, mainly, in CD11b and TER-119 markers compared with controls. Mononuclear cells were used to analyze the effects of ex vivo HCM treatment and the number of cells showing ring nuclei, niche cells and activated macrophages increased in culture, even in the absence of macrophage colony-stimulating factor. Cytokines favoring stromal cell survival and differentiation in culture were induced in vitro. Thus, we observe that HCM is immunomodulatory, either alone or in association with other products. PMID:19736221

  10. Tailoring fly ash activated with bentonite as adsorbent for complex wastewater treatment

    NASA Astrophysics Data System (ADS)

    Visa, Maria

    2012-12-01

    Used as adsorbent, alkali fly ash represents a low cost solution for advanced wastewater treatment. The alkali treatment raises sustainability issues therefore, in this research we aim to replace alkali fly ash with washed fly ash (FAw). For improving the adsorption capacity of washed fly ash, bentonite powder (B) was added, as a natural adsorbent with a composition almost identical to the fly ash. The new adsorbent was characterized by AFM, XRD, FTIR, SEM, EDS and the surface energy was evaluated by contact angle measurements. For understanding the complex adsorption process on this mixed substrate, preliminary tests were developed on synthetic wastewaters containing a single pollutant system (heavy metal), binary (two-heavy metals) and ternary (dye and two heavy metals) systems. Experiments were done on synthetic wastewaters containing methylene blue, cadmium and copper, using FAw, B and their powder mixtures. The pseudo-second order kinetics could well model all the processes, indicating a good adsorbent material which can be used for the pollutants removal from wastewater. After adsorption the substrates loaded with pollutants, annealed at 500 °C can be reused for padding in stone blocks.

  11. Surgical treatment of complex aneurysms and thoracic aortic dissections with the Frozen Elephant Trunk technique

    PubMed Central

    Dias, Ricardo Ribeiro; Duncan, José Augusto; Vianna, Diego Sarty; de Faria, Leandro Batisti; Fernandes, Fábio; Ramirez, Félix José Álvares; Mady, Charles; Jatene, Fábio Biscegli

    2015-01-01

    Objective Report initial experience with the Frozen Elephant Trunk technique. Methods From July 2009 to October 2013, Frozen Elephant Trunk technique was performed in 21 patients (66% male, mean age 56 ±11 years). They had type A aortic dissection (acute 9.6%, chronic 57.3%), type B (14.3%, all chronic) and complex aneurysms (19%). It was 9.5% of reoperations and 38% of associated procedures (25.3% miocardial revascularization, 25.3% replacement of aortic valve and 49.4% aortic valved graft). Aortic remodeling was evaluated comparing preoperative and most recent computed tomography scans. One hundred per cent of complete follow-up, mean time of 28 months. Results In-hospital mortality of 14.2%, being 50% in acute type A aortic dissection, 8.3% in chronic type A aortic dissection, 33.3% in chronic type B aortic dissection and 0% in complex aneurysms. Mean times of cardiopulmonary bypass (152±24min), myocardial ischemia (115±31min) and selective cerebral perfusion (60±15min). Main complications were bleeding (14.2%), spinal cord injury (9.5%), stroke (4.7%), prolonged mechanical ventilation (4.7%) and acute renal failure (4.7%). The need for second-stage operation was 19%. False-lumen thrombosis was obtained in 80%. Conclusion Frozen Elephant Trunk is a feasible technique and should be considered. The severity of the underlying disease justifies high mortality rates. The learning curve is a reality. This approach allows treatment of more than two segments at once. Nonetheless, if a second stage is made necessary, it is facilitated. PMID:26107452

  12. APINetworks: A general API for the treatment of complex networks in arbitrary computational environments

    NASA Astrophysics Data System (ADS)

    Niño, Alfonso; Muñoz-Caro, Camelia; Reyes, Sebastián

    2015-11-01

    The last decade witnessed a great development of the structural and dynamic study of complex systems described as a network of elements. Therefore, systems can be described as a set of, possibly, heterogeneous entities or agents (the network nodes) interacting in, possibly, different ways (defining the network edges). In this context, it is of practical interest to model and handle not only static and homogeneous networks but also dynamic, heterogeneous ones. Depending on the size and type of the problem, these networks may require different computational approaches involving sequential, parallel or distributed systems with or without the use of disk-based data structures. In this work, we develop an Application Programming Interface (APINetworks) for the modeling and treatment of general networks in arbitrary computational environments. To minimize dependency between components, we decouple the network structure from its function using different packages for grouping sets of related tasks. The structural package, the one in charge of building and handling the network structure, is the core element of the system. In this work, we focus in this API structural component. We apply an object-oriented approach that makes use of inheritance and polymorphism. In this way, we can model static and dynamic networks with heterogeneous elements in the nodes and heterogeneous interactions in the edges. In addition, this approach permits a unified treatment of different computational environments. Tests performed on a C++11 version of the structural package show that, on current standard computers, the system can handle, in main memory, directed and undirected linear networks formed by tens of millions of nodes and edges. Our results compare favorably to those of existing tools.

  13. Antianxiety medications for the treatment of complex agoraphobia: pharmacological interventions for a behavioral condition

    PubMed Central

    Perna, Giampaolo; Dacc, Silvia; Menotti, Roberta; Caldirola, Daniela

    2011-01-01

    Background Although there are controversial issues (the American view and the European view) regarding the construct and definition of agoraphobia (AG), this syndrome is well recognized and it is a burden in the lives of millions of people worldwide. To better clarify the role of drug therapy in AG, the authors summarized and discussed recent evidence on pharmacological treatments, based on clinical trials available from 2000, with the aim of highlighting pharmacotherapies that may improve this complex syndrome. Methods A systematic review of the literature regarding the pharmacological treatment of AG was carried out using MEDLINE, EBSCO, and Cochrane databases, with keywords individuated by MeSH research. Only randomized, placebo-controlled studies or comparative clinical trials were included. Results After selection, 25 studies were included. All the selected studies included patients with AG associated with panic disorder. Effective compounds included selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, selective noradrenergic reuptake inhibitors, and benzodiazepines. Paroxetine, sertraline, citalopram, escitalopram, and clomipramine showed the most consistent results, while fluvoxamine, fluoxetine, and imipramine showed limited efficacy. Preliminary results suggested the potential efficacy of inositol; D-cycloserine showed mixed results for its ability to improve the outcome of exposure-based cognitive behavioral therapy. More studies with the latter compounds are needed before drawing definitive conclusions. Conclusion No studies have been specifically oriented toward evaluating the effect of drugs on AG; in the available studies, the improvement of AG might have been the consequence of the reduction of panic attacks. Before developing a true psychopharmacology of AG it is crucial to clarify its definition. There may be several potential mechanisms involved, including fear-learning processes, balance system dysfunction, high light sensitivity, and impaired visuospatial abilities, but further studies are warranted. PMID:22090798

  14. [Asthenic syndrome in clinical course of acute period of brain concussion during complex treatment using nootropic agents].

    PubMed

    Tkachov, A V

    2008-01-01

    The comparative analysis of a complex examination of 108 persons aged from 16 till 60 years in acute period of closed craniocerebral injury (CCCT) has been done. Every participants have been divided into 2 groups depending on a nootrop medication they receive in a complex treatment. A control group consisted of 30 practically healthy people. Objective examination by means of tests was done on the 1-st, 10-th that 30-th day of treatment. Patients of 1-st (37 persons) group received piracetam in complex treatment and patients of the 2-nd group (71 persons) pramistar. Patients of the first group received a base treatment (analgetics, tranquilizers, vitamins of group B, magnesium sulfate, diuretic preparations) as well as piracetam at dosage 0.2, two tablets three times per day. The Patients of the 2-nd group received a base treatment as well as pramistar at dosage 0.6, one tablet 2 times per day. Specially developed multiaspects scales and questionnaires, MRT of the brain and EEG have been used for objectification of patient, complaints. During a complex clinico-neuropsychological examination it was found that all cases of concussion of the brain are accompanied by those or other asthenic disorders. PMID:19145827

  15. Differentiating the mTOR inhibitors everolimus and sirolimus in the treatment of tuberous sclerosis complex.

    PubMed

    MacKeigan, Jeffrey P; Krueger, Darcy A

    2015-12-01

    Tuberous sclerosis complex (TSC) is a genetic autosomal dominant disorder characterized by benign tumor-like lesions, called hamartomas, in multiple organ systems, including the brain, skin, heart, kidneys, and lung. These hamartomas cause a diverse set of clinical problems based on their location and often result in epilepsy, learning difficulties, and behavioral problems. TSC is caused by mutations within the TSC1 or TSC2 genes that inactivate the genes' tumor-suppressive function and drive hamartomatous cell growth. In normal cells, TSC1 and TSC2 integrate growth signals and nutrient inputs to downregulate signaling to mammalian target of rapamycin (mTOR), an evolutionarily conserved serine-threonine kinase that controls cell growth and cell survival. The molecular connection between TSC and mTOR led to the clinical use of allosteric mTOR inhibitors (sirolimus and everolimus) for the treatment of TSC. Everolimus is approved for subependymal giant cell astrocytomas and renal angiomyolipomas in patients with TSC. Sirolimus, though not approved for TSC, has undergone considerable investigation to treat various aspects of the disease. Everolimus and sirolimus selectively inhibit mTOR signaling with similar molecular mechanisms, but with distinct clinical profiles. This review differentiates mTOR inhibitors in TSC while describing the molecular mechanisms, pathogenic mutations, and clinical trial outcomes for managing TSC. PMID:26289591

  16. Evolving paradigms in the treatment of relapsed/refractory multiple myeloma: increased options and increased complexity

    PubMed Central

    Cornell, R F; Kassim, A A

    2016-01-01

    The use of modern therapies such as thalidomide, bortezomib and lenalidomide coupled with upfront high-dose therapy and autologous stem cell transplant (ASCT) has resulted in improved survival in patients with newly diagnosed multiple myeloma (MM). However, patients with relapsed/refractory multiple myeloma (RRMM) often have poorer clinical outcomes and might benefit from novel therapeutic strategies. Emerging therapies, such as deacetylase inhibitors, monoclonal antibodies and new proteasome inhibitors, appear promising and may change the therapeutic landscape in RRMM. A limited number of studies has shown a benefit with salvage ASCT in patients with RRMM, although there remains ongoing debate about its timing and effectiveness. Improvement in transplant outcomes has re-ignited a debate on the timing and possible role for salvage ASCT and allogeneic stem cell transplant in RRMM. As the treatment options for management of patients with RRMM become increasingly complex, physicians must consider both disease- and patient-related factors in choosing the appropriate therapeutic approach, with the goal of improving efficacy while minimizing toxicity. PMID:26726946

  17. Giant and complex aneurysms treatment with preservation of flow via bypass technique.

    PubMed

    Thines, L; Proust, F; Marinho, P; Durand, A; van der Zwan, A; Regli, L; Lejeune, J-P

    2016-02-01

    Due to their anatomical characteristics and the complexity of the procedures required to obtain their complete occlusion, the treatment of giant intracranial aneurysms is a real challenge. Direct reconstructive strategies, whether by interventional neuroradiology (coils, stents) or microsurgical (clipping) means, are not always applicable and, in patients that would not tolerate parent or collateral artery sacrifice, the adjunction of a revascularization procedure using a bypass technique might be necessary. Cerebral arterial bypasses can be classified according to their function (3 types: flow replacement, flow reversal or protective), the branching mode of the graft used (3 types: pedicled, interpositional or in situ), the sites of anastomosis (2 types: extracranial-intracranial or intracranial-intracranial) and the class of flow they are supposed to provide (3 types: low-, intermediate- or high-flow). In this article, the authors review the different aspects in the management of patients with a giant intracranial aneurysm using a bypass: preoperative work-up, types of bypass and indications, surgical techniques and results. PMID:26072226

  18. Evolving paradigms in the treatment of relapsed/refractory multiple myeloma: increased options and increased complexity.

    PubMed

    Cornell, R F; Kassim, A A

    2016-04-01

    The use of modern therapies such as thalidomide, bortezomib and lenalidomide coupled with upfront high-dose therapy and autologous stem cell transplant (ASCT) has resulted in improved survival in patients with newly diagnosed multiple myeloma (MM). However, patients with relapsed/refractory multiple myeloma (RRMM) often have poorer clinical outcomes and might benefit from novel therapeutic strategies. Emerging therapies, such as deacetylase inhibitors, monoclonal antibodies and new proteasome inhibitors, appear promising and may change the therapeutic landscape in RRMM. A limited number of studies has shown a benefit with salvage ASCT in patients with RRMM, although there remains ongoing debate about its timing and effectiveness. Improvement in transplant outcomes has re-ignited a debate on the timing and possible role for salvage ASCT and allogeneic stem cell transplant in RRMM. As the treatment options for management of patients with RRMM become increasingly complex, physicians must consider both disease- and patient-related factors in choosing the appropriate therapeutic approach, with the goal of improving efficacy while minimizing toxicity. PMID:26726946

  19. [Selective adsorption of endotoxin in the complex treatment of patients with severe sepsis].

    PubMed

    Khubutiia, M Sh; Abakumov, M M; Aleksandrova, I V; Reĭ, S I; Il'inskiĭ, M E; Khvatov, V B; Borovkova, N V; Pertsev, A S; Zinkin, V Iu

    2010-01-01

    Severe sepsis and septic shock remain the most serious problem of critical care medicine today with a mortality of 25-80%. Bacterial endotoxin is of considerable importance in the pathogenesis of sepsis. A selective hemosorbent in which endotoxin adsorption is accomplished via its binding to a synthetic peptide (LPS-A) has been recently designed in Sweden. The purpose of the study was to evaluate the efficiency of using the LPS-A in the complex treatment of patients with severe sepsis. Eight patients in whom the course of the underlying disease was complicated by the development of gram-negative sepsis in the postoperative period were examined. The patients had an APACHE II score of 20.4 +/- 4.5 LPS-A was performed using the hemosorbent Alteco LPS (Lund, Sweden) and an Aquarius hemoprocessor (Edwards Lifesciences) (U.S.A.). The use of LPS-A caused a significant reduction in endotoxin levels by 2.9 times. The level of procalcitonin was increased in all patients; after a LPS-A session, it was significantly decreased by 1.9 times. The use of LPS-A resulted in diminished tachycardia, elevated blood pressure and could reduce the doses of vasopressor amines. There was an improvement in lung gas exchange parameters. A study of the effect of LPS-A on the immune system showed a significant reduction (36.6%) in neutrophil oxygen-dependent metabolism according to the data of the spontaneous HCT test, a 2.4-fold decrease in large circulating immune complexes, and a rise in the count of mononuclear cells that died both by necrosis and apoptosis, the count of the cells significantly increased by 5.3 times in late apoptosis. A LPS-A session caused a significant drop in the blood level of endotoxin and procalcitonin and it was accompanied by a trend toward better hemodynamics and lung gas exchange and alleviated organ dysfunction. At the same time LPS-A showed the ambiguous effect on immune system parameters, which calls for further study. PMID:21395145

  20. Computer-aided patch planning for treatment of complex coarctation of the aorta

    NASA Astrophysics Data System (ADS)

    Rietdorf, Urte; Riesenkampff, Eugénie; Kuehne, Titus; Huebler, Michael; Meinzer, Hans-Peter; Wolf, Ivo

    2009-02-01

    Between five and eight percent of all children born with congenitally malformed hearts suffer from coarctations of the aorta. Some severe coarctations can only be treated by surgical repair. Untreated, this defect can cause serious damage to organ development or even lead to death. Patch repair requires open surgery. It can affect patients of any age: newborns with severe coarctation and/or hypoplastic aortic arch as well as older patients with late diagnosis of coarctation of the aorta. Another patient group are patients of varying age with re-coarctation of the aorta or hypoplastic aortic arch after surgical and/or interventional repair. If anatomy is complex and interventional treatment by catheterization, balloon angioplasty or stent placement is not possible, surgery is indicated. The choice of type of surgery depends not only on the given anatomy but also on the experience the surgical team has with each method. One surgical approach is patch repair. A patch of a suitable shape and size is sewed into the aorta to expand the aortic lumen at the site of coarctation. At present, the shape and size of the patch are estimated intra-operatively by the surgeon. We have developed a software application that allows planning of the patch pre-operatively on the basis of magnetic resonance angiographic data. The application determines the diameter of the coarctation and/or hypoplastic segment and constructs a patch proposal by calculating the difference to the normal vessel diameter pre-operatively. Evaluation of MR angiographic datasets from 12 test patients with different kinds of aortic arch stenosis shows a divergence of only (1.5+/-1.2) mm in coarctation diameters between manual segmentations and our approach, with comparable time expenditure. Following this proposal the patch can be prepared and adapted to the patient's anatomy pre-operatively. Ideally, this leads to shorter operation times and a better long-term outcome with a reduced rate of residual stenosis and re-stenosis and aneurysm formation.

  1. Generalization of the Activated Complex Theory of Reaction Rates. I. Quantum Mechanical Treatment

    DOE R&D Accomplishments Database

    Marcus, R. A.

    1964-01-01

    In its usual form activated complex theory assumes a quasi-equilibrium between reactants and activated complex, a separable reaction coordinate, a Cartesian reaction coordinate, and an absence of interaction of rotation with internal motion in the complex. In the present paper a rate expression is derived without introducing the Cartesian assumption. The expression bears a formal resemblance to the usual one and reduces to it when the added assumptions of the latter are introduced.

  2. Building a measurement framework of burden of treatment in complex patients with chronic conditions: a qualitative study

    PubMed Central

    Eton, David T; Ramalho de Oliveira, Djenane; Egginton, Jason S; Ridgeway, Jennifer L; Odell, Laura; May, Carl R; Montori, Victor M

    2012-01-01

    Background: Burden of treatment refers to the workload of health care as well as its impact on patient functioning and well-being. We set out to build a conceptual framework of issues descriptive of burden of treatment from the perspective of the complex patient, as a first step in the development of a new patient-reported measure. Methods: We conducted semistructured interviews with patients seeking medication therapy management services at a large, academic medical center. All patients had a complex regimen of self-care (including polypharmacy), and were coping with one or more chronic health conditions. We used framework analysis to identify and code themes and subthemes. A conceptual framework of burden of treatment was outlined from emergent themes and subthemes. Results: Thirty-two patients (20 female, 12 male, age 26–85 years) were interviewed. Three broad themes of burden of treatment emerged including: the work patients must do to care for their health; problem-focused strategies and tools to facilitate the work of self-care; and factors that exacerbate the burden felt. The latter theme encompasses six subthemes including challenges with taking medication, emotional problems with others, role and activity limitations, financial challenges, confusion about medical information, and health care delivery obstacles. Conclusion: We identified several key domains and issues of burden of treatment amenable to future measurement and organized them into a conceptual framework. Further development work on this conceptual framework will inform the derivation of a patient-reported measure of burden of treatment. PMID:23185121

  3. Ruthenium Complex with Benznidazole and Nitric Oxide as a New Candidate for the Treatment of Chagas Disease

    PubMed Central

    Sesti-Costa, Renata; Carneiro, Zumira A.; Silva, Maria C.; Santos, Maíta; Silva, Grace K.; Milanezi, Cristiane; da Silva, Roberto S.; Silva, João S.

    2014-01-01

    Background Chagas disease remains a serious medical and social problem in Latin America and is an emerging concern in nonendemic countries as a result of population movement, transfusion of infected blood or organs and congenital transmission. The current treatment of infected patients is unsatisfactory due to strain-specific drug resistance and the side effects of the current medications. For this reason, the discovery of safer and more effective chemotherapy is mandatory for the successful treatment and future eradication of Chagas disease. Methods and Findings We investigated the effect of a ruthenium complex with benznidazole and nitric oxide (RuBzNO2) against Trypanosoma cruzi both in vitro and in vivo. Our results demonstrated that RuBzNO2 was more effective than the same concentrations of benznidazole (Bz) in eliminating both the extracellular trypomastigote and the intracellular amastigote forms of the parasite, with no cytotoxic effect in mouse cells. In vivo treatment with the compound improved the survival of infected mice, inhibiting heart damage more efficiently than Bz alone. Accordingly, tissue inflammation and parasitism was significantly diminished after treatment with RuBzNO2 in a more effective manner than that with the same concentrations of Bz. Conclusions The complexation of Bz with ruthenium and nitric oxide (RuBzNO2) increases its effectiveness against T. cruzi and enables treatment with lower concentrations of the compound, which may reduce the side effects of Bz. Our findings provide a new potential candidate for the treatment of Chagas disease. PMID:25275456

  4. Formulation, characterization and evaluation of cyclodextrin-complexed bendamustine-encapsulated PLGA nanospheres for sustained delivery in cancer treatment.

    PubMed

    Gidwani, Bina; Vyas, Amber

    2016-03-01

    PLGA nanospheres are considered to be promising drug carrier in the treatment of cancer. Inclusion complex of bendamustine (BM) with epichlorohydrin beta cyclodextrin polymer was prepared by freeze-drying method. Phase solubility study revealed formation of AL type complex with stability constant (Ks = 645 M(-1)). This inclusion complex was encapsulated into PLGA nanospheres using solid-in-oil-in-water (S/O/W) technique. The particle size and zeta potential of PLGA nanospheres loaded with cyclodextrin-complexed BM were about 151.4 ± 2.53 nm and - 31.9 ± (-3.08) mV. In-vitro release study represented biphasic release pattern with 20% burst effect and sustained slow release. DSC studies indicated that inclusion complex incorporated in PLGA nanospheres was not in a crystalline state but existed in an amorphous or molecular state. The cytotoxicity experiment was studied in Z-138 cells and IC50 value was found to be 4.3 ± 0.11 µM. Cell viability studies revealed that the PLGA nanospheres loaded with complex exerts a more pronounced effect on the cancer cells as compared to the free drug. In conclusion, PLGA nanospheres loaded with inclusion complex of BM led to sustained drug delivery. The nanospheres were stable after 3 months of storage conditions with slight change in their particle size, zeta potential and entrapment efficiency. PMID:25391288

  5. Systems Pharmacology Dissecting Holistic Medicine for Treatment of Complex Diseases: An Example Using Cardiocerebrovascular Diseases Treated by TCM

    PubMed Central

    Wang, Yonghua; Zheng, Chunli; Huang, Chao; Li, Yan; Chen, Xuetong; Wu, Ziyin; Wang, Zhenzhong; Xiao, Wei; Zhang, Boli

    2015-01-01

    Holistic medicine is an interdisciplinary field of study that integrates all types of biological information (protein, small molecules, tissues, organs, external environmental signals, etc.) to lead to predictive and actionable models for health care and disease treatment. Despite the global and integrative character of this discipline, a comprehensive picture of holistic medicine for the treatment of complex diseases is still lacking. In this study, we develop a novel systems pharmacology approach to dissect holistic medicine in treating cardiocerebrovascular diseases (CCDs) by TCM (traditional Chinese medicine). Firstly, by applying the TCM active ingredients screened out by a systems-ADME process, we explored and experimentalized the signed drug-target interactions for revealing the pharmacological actions of drugs at a molecule level. Then, at a/an tissue/organ level, the drug therapeutic mechanisms were further investigated by a target-organ location method. Finally, a translational integrating pathway approach was applied to extract the diseases-therapeutic modules for understanding the complex disease and its therapy at systems level. For the first time, the feature of the drug-target-pathway-organ-cooperations for treatment of multiple organ diseases in holistic medicine was revealed, facilitating the development of novel treatment paradigm for complex diseases in the future. PMID:26101539

  6. Quality assurance for high dose rate brachytherapy treatment planning optimization: using a simple optimization to verify a complex optimization

    NASA Astrophysics Data System (ADS)

    Deufel, Christopher L.; Furutani, Keith M.

    2014-02-01

    As dose optimization for high dose rate brachytherapy becomes more complex, it becomes increasingly important to have a means of verifying that optimization results are reasonable. A method is presented for using a simple optimization as quality assurance for the more complex optimization algorithms typically found in commercial brachytherapy treatment planning systems. Quality assurance tests may be performed during commissioning, at regular intervals, and/or on a patient specific basis. A simple optimization method is provided that optimizes conformal target coverage using an exact, variance-based, algebraic approach. Metrics such as dose volume histogram, conformality index, and total reference air kerma agree closely between simple and complex optimizations for breast, cervix, prostate, and planar applicators. The simple optimization is shown to be a sensitive measure for identifying failures in a commercial treatment planning system that are possibly due to operator error or weaknesses in planning system optimization algorithms. Results from the simple optimization are surprisingly similar to the results from a more complex, commercial optimization for several clinical applications. This suggests that there are only modest gains to be made from making brachytherapy optimization more complex. The improvements expected from sophisticated linear optimizations, such as PARETO methods, will largely be in making systems more user friendly and efficient, rather than in finding dramatically better source strength distributions.

  7. Antiangiogenic activity of mononuclear copper(II) polypyridyl complexes for the treatment of cancers.

    PubMed

    Nagababu, Penumaka; Barui, Ayan Kumar; Thulasiram, Bathini; Devi, C Shobha; Satyanarayana, S; Patra, Chitta Ranjan; Sreedhar, Bojja

    2015-07-01

    A series of four new mononuclear copper(II) polypyridyl complexes (1-4) have been designed, developed, and thoroughly characterized by several physicochemical techniques. The CT-DNA binding properties of 1-4 have been investigated by absorption, emission spectroscopy, and viscosity measurements. All the complexes especially 1 and 4 exhibit cytotoxicity toward several cancer cell lines, suggesting their anticancer properties as observed by several in vitro assays. Additionally, the complexes show inhibition of endothelial cell (HUVECs) proliferation, indicating their antiangiogenic nature. In vivo chick embryo angiogenesis assay again confirms the antiangiogenic properties of 1 and 4. The formation of excessive intracellular ROS (H2O2 and O2(•-)) and upregulation of BAX induced by copper(II) complexes may be the plausible mechanisms behind their anticancer activities. The present study may offer a basis for the development of new transition metal complexes through suitable choice of ligands for cancer therapeutics by controlling tumor angiogenesis. PMID:26068145

  8. Technology Evaluation for the Big Spring Water Treatment System at the Y-12 National Security Complex, Oak Ridge, Tennessee

    SciTech Connect

    Becthel Jacobs Company LLC

    2002-11-01

    The Y-12 National Security Complex (Y-12 Complex) is an active manufacturing and developmental engineering facility that is located on the U.S. Department of Energy (DOE) Oak Ridge Reservation. Building 9201-2 was one of the first process buildings constructed at the Y-12 Complex. Construction involved relocating and straightening of the Upper East Fork Poplar Creek (UEFPC) channel, adding large quantities of fill material to level areas along the creek, and pumping of concrete into sinkholes and solution cavities present within the limestone bedrock. Flow from a large natural spring designated as ''Big Spring'' on the original 1943 Stone & Webster Building 9201-2 Field Sketch FS6003 was captured and directed to UEFPC through a drainpipe designated Outfall 51. The building was used from 1953 to 1955 for pilot plant operations for an industrial process that involved the use of large quantities of elemental mercury. Past operations at the Y-12 Complex led to the release of mercury to the environment. Significant environmental media at the site were contaminated by accidental releases of mercury from the building process facilities piping and sumps associated with Y-12 Complex mercury handling facilities. Releases to the soil surrounding the buildings have resulted in significant levels of mercury in these areas of contamination, which is ultimately transported to UEFPC, its streambed, and off-site. Bechtel Jacobs Company LLC (BJC) is the DOE-Oak Ridge Operations prime contractor responsible for conducting environmental restoration activities at the Y-12 Complex. In order to mitigate the mercury being released to UEFPC, the Big Spring Water Treatment System will be designed and constructed as a Comprehensive Environmental Response, Compensation, and Liability Act action. This facility will treat the combined flow from Big Spring feeding Outfall 51 and the inflow now being processed at the East End Mercury Treatment System (EEMTS). Both discharge to UEFPC adjacent to Bldg. 9201-2. The EEMTS treats mercury-contaminated groundwater that collects in sumps in the basement of Bldg. 9201-2. A pre-design study was performed to investigate the applicability of various treatment technologies for reducing mercury discharges at Outfall 51 in support of the design of the Big Spring Water Treatment System. This document evaluates the results of the pre-design study for selection of the mercury removal technology for the treatment system.

  9. [Complex treatment of elderly patients with pain reflectory manifestations of lumbosacral osteochondrosis and peripheral circulation disorder].

    PubMed

    Macheret, Ie L; Dzhuzha, T V

    2004-12-01

    Involutional age makes difficult the treatment of pain syndromes of vertebra origin. Concomitant diseases, age stress syndrome, hormone disbalance constrain the management of the disease. Combination of laser stimulation, reflexotherapy, psychodiagnostics and psychocorrection enhances the efficiency of the treatment of pain syndromes in patients with lumbo-sacral radiculitis and peripheral circulation disorder. PMID:15771075

  10. [Electrophysiological changes in a complex treatment of lumbosacral pain syndrome in patients of different age group].

    PubMed

    Sereda, V H

    2004-12-01

    The influence of two methods of treatment (pharmacological and combination with infra-red laser puncture and manual therapy) on clinical picture, electromyographic indices in 165 patients of different age group with lumbosacral radiculitis has been studied by the author. The use of these methods in treatment of such patients is substantiated by the obtained data. PMID:15771074

  11. Long-term effects of a complex behavioral treatment of essential hypertension.

    PubMed

    Lehnert, H; Kaluza, K; Vetter, H; Losse, H; Dorst, K

    1987-01-01

    A multidimensional behavioral program was developed for the treatment of essential hypertension. Over a course of 6 weeks, 108 patients of a rehabilitation center were treated with this program consisting of health education, self-monitoring of blood pressure, relaxation techniques, and a social skill training in addition to standard medical treatment alone. Blood pressure and other cardiovascular risk factors were monitored for a period of 12 months. Blood pressure levels became normotensive in both groups at the end of the 6-week training program. However, the blood pressure reduction in the behavioral treatment group was achieved with fewer patients taking antihypertensive medication than in the control group. The number of patients taking antihypertensive drugs in the treatment group was 60.2% prior to treatment and 44.4% after treatment; figures for the control group were 68% and 73.8%, respectively (p less than or equal to 0.01). Almost identical data were obtained at the 6- and 23-month follow-up examinations. No consistent changes were observed in weight, smoking, or blood lipids. These results demonstrate beneficial and long-lasting effects of a combined medical and psychologic treatment of essential hypertension as compared to medical treatment alone. PMID:3615770

  12. Typicality of Inanimate Category Exemplars in Aphasia Treatment: Further Evidence for Semantic Complexity

    ERIC Educational Resources Information Center

    Kiran, Swathi

    2008-01-01

    Purpose: The typicality treatment approach on improving naming was investigated within 2 inanimate categories ("furniture" and "clothing") using a single-subject experimental design across participants and behaviors in 5 patients with aphasia. Method: Participants received a semantic feature treatment to improve naming of either typical or…

  13. [The use of ozone and low-intensive laser irradiation in complex treatment of complicated duodenal ulcer].

    PubMed

    Mamedov, R A; Agamirova, A N; Dadashev, A I; Gasymov, É M; Kurbanov, F S; Dobrovol'skiĭ, S R

    2011-01-01

    The study is based on the examination of 12 patients with perforative duodenal ulcer and 24 patients operated on recurrent bleeding duodenal ulcer. Some component of the immune system, such as T- and B-lymphocytes rates, immunoglobulin rate and macrophagal activity, were decreased prior the beginning of the complex treatment. Normalisation of humoral and cell immunity was registered on 10-12 days after the beginning of the ozone and low-intensive laser irradiation. PMID:21983535

  14. Tactics of surgical treatment at traumatic injuries of maxillo-zygomatic-orbital complex and the lower edge of the orbit.

    PubMed

    Gvenetadze, Z; Lagvilava, G; Toradze, G; Devidze, I; Gvenetadze, G

    2014-06-01

    The maxilla-facial traumatic injuries, zygomatic - orbital complex and orbit lower edge injuries are characterized by dislocation of bone fragments, causing not only the anatomo-functional disorders but well-expressed deformity/ abnormality of the patient. 28 patients with traumatic fractures of zygomatic - alveolar complex and orbit lower edge have been studied and got surgical treatment by the authors. At admission to the hospitals, all the patients were the subjects to a classic comprehensive / complex examination including a Spiral Computed Tomography, with 3D reconstruction (three-dimensional) (in 3 projections). All the patients underwent surgical treatment under endotracheal anesthesia that included osteosynthesis of zygomatic bone body and arch and plasty of orbit lower edge. Osteosynthesis of zygomatic bone body and arch was conducted with titanium plates and screws (hanging zygomatic arch by steel wires), restoration of bony wall was carried out by prosthesis of titanium (net) plate made individually (auto-graft, taken from calvaria bone was used for restoration of orbit lower edge defect in 2 cases). According to the study materials no complications of transplanted grafts like purulency, removal reaction, or dislocation were observed. The obtained data have proved over again, that endoprothesis made of medical titasnium are effective for treatment of the patients with middle third facial traumatic injuries. PMID:25020162

  15. [Supraventricular tachycardia with wide QRS complexes during Vaughan-Williams class I anti-arrhythmic treatment. Diagnostic and therapeutic implications].

    PubMed

    Aouate, P; Frank, R; Fontaine, G; Tonet, J; Tageddine, R; Benassar, A; Turlure, A; Jacquemin, M; Laborde, J P

    1995-12-01

    The authors report 8 cases of regular tachycardia with wide QRS complexes during treatment with Vaughan-Williams class 1 antiarrhythmic drugs. These antiarrhythmics, prescribed to prevent atrial fibrillation (3 patients) and atrial flutter (5 patients), were flecainide in 4 cases, propafenone in 2 cases and cibenzoline and hydroquinidine respectively associated with digitoxine and propranolol. These wide complex tachycardias were regular atrial tachycardias with 1/1 conduction to the ventricle. The action of the drug, more pronounced on intra-atrial conduction velocities than on atrioventricular node refractoriness resulted in transformation of flutter at 300 cycles/min with 2/1 conduction and a ventricular rate of 150 cycles/min to atrial flutter at 210 cycles/min with 1/1 ventricular conduction. This acceleration of the ventricular rate was accompanied by widening of the QRS complex. Using the new ventricular tachycardia criteria recently published by Brugada resulted in a diagnostic error in 7 out of the 8 cases. The recording of a wide QRS complex tachycardia in a patient on class 1 antiarrhythmic therapy for an atrial arrhythmia should alert the physician to 1/1 atrial tachycardia despite morphological electrocardiographic criteria of ventricular tachycardia. The 1/1 atrial tachycardia may be poorly tolerated and require emergency treatment. The preventive association of a drug which slows conduction through the atrioventricular node is not always effective. PMID:8729368

  16. [Telephone hotlines as a part of complex services for tobacco dependence treatment].

    PubMed

    Králíková, E; Baska, T; Langrová, K; Vojta, M

    2005-01-01

    Telephone quitlines for smoking cessation should be included into the available tobacco dependence treatment and should be included into smoking cessation guidelines. Telephone quitlines does not mean only the help to the calling smoker, but also can increase the number of quit attempts in the general population. Especially minorities that not so often take part in the classic smoking cessation treatment, use quitlines more often (e.g. pregnant women). Quitlines are economically effective, although the most expensive form - individual counselling - should be reserved for those really willing to stop. Quitlines should be given governmental financial support (compared to other medical interventions, any smoking cessation treatment is economically more cost effective). PMID:16173615

  17. Strength and Formability Improvement of Al-Cu-Mn Aluminum Alloy Complex Parts by Thermomechanical Treatment with Sheet Hydroforming

    NASA Astrophysics Data System (ADS)

    Chen, Yi-Zhe; Liu, Wei; Yuan, Shi-Jian

    2015-05-01

    Normally, the strength and formability of aluminum alloys can be increased largely by severe plastic deformation and heat treatment. However, many plastic deformation processes are more suitable for making raw material, not for formed parts. In this article, an experimental study of the thermomechanical treatment by using the sheet hydroforming process was developed to improve both mechanical strength and formability for aluminum alloys in forming complex parts. The limiting drawing ratio, thickness, and strain distribution of complex parts formed by sheet hydroforming were investigated to study the formability and sheet-deformation behavior. Based on the optimal formed parts, the tensile strength, microhardness, grain structure, and strengthening precipitates were analyzed to identify the strengthening effect of thermomechanical treatment. The results show that in the solution state, the limiting drawing ratio of cylindrical parts could be increased for 10.9% compared with traditional deep drawing process. The peak values of tensile stress and microhardness of formed parts are 18.0% and 12.5% higher than that in T6 state. This investigation shows that the thermomechanical treatment by sheet hydroforming is a potential method for the products manufacturing of aluminum alloy with high strength and good formability.

  18. [Treatment strategy for posttraumatic complex deformity : After bilateral femoral shaft fractures].

    PubMed

    Ahrend, M; Ateschrang, A; Stöckle, U; Schröter, S

    2016-02-01

    A case of complex posttraumatic deformity after bilateral femoral shaft fractures is reported. Different possibilities for correction in cases of valgus malalignment combined with internal rotation deformity as well as shortening combined with external rotation deformity are presented. Oblique osteotomy and a motorized femoral extension nail were used. PMID:26187430

  19. Impact of Vanadium Complexes Treatment on the Oxidative Stress Factors in Wistar Rats Plasma

    PubMed Central

    Francik, R.; Krośniak, M.; Barlik, M.; Kudła, A.; Gryboś, R.; Librowski, T.

    2011-01-01

    The aim of this study was to investigate the clinical efficacy of vanadium complexes on triglycerides (TG), total cholesterol (Chol), uric acid (UA), urea (U), and antioxidant parameters: nonenzymatic (FRAP—ferric reducing ability of plasma, and reduced glutathione—GSH) and enzymatic (glutathione peroxidase—GPx, catalase—CAT, and GPx/CAT ratio) activity in the plasma of healthy male Wistar rats. Three vanadium complexes: [VO(bpy)2]SO4·2H2O, [VO(4,4′Me2bpy)2]SO4·2H2O, and Na[VO(O2)2(bpy)]·8H2O are administered by gavage during 5 weeks in two different diets such as control (C) and high fatty (F) diets. Changes of biochemical and antioxidants parameters are measured in plasma. All three vanadium complexes statistically decrease the body mass growth in comparison to the control and fatty diet. In plasma GSH was statistically increased in all vanadium complexes-treated rats from control and fatty group in comparison to only control group. Calculated GPX/CAT ratio was the highest in the control group in comparison to others. PMID:22007153

  20. Complex I Disorders: Causes, Mechanisms, and Development of Treatment Strategies at the Cellular Level

    ERIC Educational Resources Information Center

    Valsecchi, Federica; Koopman, Werner J. H.; Manjeri, Ganesh R.; Rodenburg, Richard J.; Smeitink, Jan A. M.; Willems, Peter H. G. M.

    2010-01-01

    Mitochondrial oxidative phosphorylation (OXPHOS) represents the final step in the conversion of nutrients into cellular energy. Genetic defects in the OXPHOS system have an incidence between 1:5,000 and 1:10,000 live births. Inherited isolated deficiency of the first complex (CI) of this system, a multisubunit assembly of 45 different proteins,…

  1. Generalization of the Activated Complex Theory of Reaction Rates. II. Classical Mechanical Treatment

    DOE R&D Accomplishments Database

    Marcus, R. A.

    1964-01-01

    In its usual classical form activated complex theory assumes a particular expression for the kinetic energy of the reacting system -- one associated with a rectilinear motion along the reaction coordinate. The derivation of the rate expression given in the present paper is based on the general kinetic energy expression.

  2. Complex I Disorders: Causes, Mechanisms, and Development of Treatment Strategies at the Cellular Level

    ERIC Educational Resources Information Center

    Valsecchi, Federica; Koopman, Werner J. H.; Manjeri, Ganesh R.; Rodenburg, Richard J.; Smeitink, Jan A. M.; Willems, Peter H. G. M.

    2010-01-01

    Mitochondrial oxidative phosphorylation (OXPHOS) represents the final step in the conversion of nutrients into cellular energy. Genetic defects in the OXPHOS system have an incidence between 1:5,000 and 1:10,000 live births. Inherited isolated deficiency of the first complex (CI) of this system, a multisubunit assembly of 45 different proteins,

  3. The Prescribed Pediatric Center: A Medical Day Treatment Program for Children with Complex Medical Conditions.

    ERIC Educational Resources Information Center

    Ruppert, Elizabeth S.; Karst, Thomas O.; Brogan, Mark G.

    1998-01-01

    The Prescribed Pediatric Center (Toledo, Ohio) is a community-based, multidisciplinary program for infants and children with chronic, complex medical conditions. This article describes program beginnings; the planning process; and the program's growth, development, and components. Initial program evaluation indicates positive effects on some…

  4. Multiple D2 heteroreceptor complexes: new targets for treatment of schizophrenia

    PubMed Central

    Borroto-Escuela, Dasiel O.; Pintsuk, Julia; Schäfer, Thorsten; Friedland, Kristina; Ferraro, Luca; Tanganelli, Sergio; Liu, Fang; Fuxe, Kjell

    2016-01-01

    The dopamine (DA) neuron system most relevant for schizophrenia is the meso-limbic-cortical DA system inter alia densely innervating subcortical limbic regions. The field of dopamine D2 receptors and schizophrenia changed markedly with the discovery of many types of D2 heteroreceptor complexes in subcortical limbic areas as well as the dorsal striatum. The results indicate that the D2 is a hub receptor which interacts not only with many other G protein-coupled receptors (GPCRs) including DA isoreceptors but also with ion-channel receptors, receptor tyrosine kinases, scaffolding proteins and DA transporters. Disturbances in several of these D2 heteroreceptor complexes may contribute to the development of schizophrenia through changes in the balance of diverse D2 homo- and heteroreceptor complexes mediating the DA signal, especially to the ventral striato-pallidal γ-aminobutyric acid (GABA) pathway. This will have consequences for the control of this pathway of the glutamate drive to the prefrontal cortex via the mediodorsal thalamic nucleus which can contribute to psychotic processes. Agonist activation of the A2A protomer in the A2A–D2 heteroreceptor complex inhibits D2 Gi/o mediated signaling but increases the D2 β-arrestin2 mediated signaling. Through this allosteric receptor–receptor interaction, the A2A agonist becomes a biased inhibitory modulator of the Gi/o mediated D2 signaling, which may the main mechanism for its atypical antipsychotic properties especially linked to the limbic A2A–D2 heterocomplexes. The DA and glutamate hypotheses of schizophrenia come together in the signal integration in D2–N-methyl-d-aspartate (NMDA) and A2A–D2–metabotropic glutamate receptor 5 (mGlu5) heteroreceptor complexes, especially in the ventral striatum. 5-Hydroxytryptamine 2A (5-HT2A)–D2 heteroreceptor complexes are special targets for atypical antipsychotics with high potency to block their 5-HT2A protomer signaling in view of the potential development of pathological allosteric facilitatory 5-HT2A–D2 interaction increasing D2 protomer signaling. Neurotensin (NTS1)–D2 heterocomplexes also exist in the ventral and dorsal striatum, and likely also in midbrain DA nerve cells as NTS1-D2 autoreceptor complexes where neurotensin produces antipsychotic and propsychotic actions, respectively. PMID:27141290

  5. Multiple D2 heteroreceptor complexes: new targets for treatment of schizophrenia.

    PubMed

    Borroto-Escuela, Dasiel O; Pintsuk, Julia; Schäfer, Thorsten; Friedland, Kristina; Ferraro, Luca; Tanganelli, Sergio; Liu, Fang; Fuxe, Kjell

    2016-04-01

    The dopamine (DA) neuron system most relevant for schizophrenia is the meso-limbic-cortical DA system inter alia densely innervating subcortical limbic regions. The field of dopamine D2 receptors and schizophrenia changed markedly with the discovery of many types of D2 heteroreceptor complexes in subcortical limbic areas as well as the dorsal striatum. The results indicate that the D2 is a hub receptor which interacts not only with many other G protein-coupled receptors (GPCRs) including DA isoreceptors but also with ion-channel receptors, receptor tyrosine kinases, scaffolding proteins and DA transporters. Disturbances in several of these D2 heteroreceptor complexes may contribute to the development of schizophrenia through changes in the balance of diverse D2 homo- and heteroreceptor complexes mediating the DA signal, especially to the ventral striato-pallidal γ-aminobutyric acid (GABA) pathway. This will have consequences for the control of this pathway of the glutamate drive to the prefrontal cortex via the mediodorsal thalamic nucleus which can contribute to psychotic processes. Agonist activation of the A2A protomer in the A2A-D2 heteroreceptor complex inhibits D2 Gi/o mediated signaling but increases the D2 β-arrestin2 mediated signaling. Through this allosteric receptor-receptor interaction, the A2A agonist becomes a biased inhibitory modulator of the Gi/o mediated D2 signaling, which may the main mechanism for its atypical antipsychotic properties especially linked to the limbic A2A-D2 heterocomplexes. The DA and glutamate hypotheses of schizophrenia come together in the signal integration in D2-N-methyl-d-aspartate (NMDA) and A2A-D2-metabotropic glutamate receptor 5 (mGlu5) heteroreceptor complexes, especially in the ventral striatum. 5-Hydroxytryptamine 2A (5-HT2A)-D2 heteroreceptor complexes are special targets for atypical antipsychotics with high potency to block their 5-HT2A protomer signaling in view of the potential development of pathological allosteric facilitatory 5-HT2A-D2 interaction increasing D2 protomer signaling. Neurotensin (NTS1)-D2 heterocomplexes also exist in the ventral and dorsal striatum, and likely also in midbrain DA nerve cells as NTS1-D2 autoreceptor complexes where neurotensin produces antipsychotic and propsychotic actions, respectively. PMID:27141290

  6. Operative versus non-operative treatment in complex proximal humeral fractures: a meta-analysis of randomized controlled trials.

    PubMed

    Xie, Lin; Ding, Fan; Zhao, Zhigang; Chen, Yan; Xing, Danmou

    2015-01-01

    Whether operative treatment for complex proximal humeral fractures (CPHFs) has a greater benefit over non-operative treatment remains controversial. There is no consensus on the optimal treatment in elderly patients with CPHFs. This updated meta-analysis of randomized controlled trials (RCTs) aims to investigate whether operative treatment is superior to non-operative treatment in CPHFs. The authors searched RCTs in the electronic databases (Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Medline, Embase, Springer Link, Web of Knowledge, OVID and Google Scholar) from their establishment to July 2015. Researches on operative and non-operative treatment for CPHFs were selected in this meta-analysis. The quality of all studies was assessed and effective data was pooled for this meta-analysis. Outcome measurements were functional status include constant scores (CS scores) and disabilities of the arm, shoulder and hand scores (DASH scores), total complication rates and healthy-related quality of life. The meta-analysis was performed with software revman 5.3. Nine articles with a total 518 patients (average age 70.93) met inclusion criteria. Patients were followed up for at least 1 year in all the studies. No statistical differences were found between operative and non-operative treatment in CS scores at 12 mo (months) [MD 1.06 95 % CI (-3.51, 5.62)] and 24 mo [MD -0.61 95 % CI (-5.87, 4.65)]. There are also no statistical differences between operative and non-operative treatment in DASH scores at 12 mo [MD -4.51 95 % CI (-13.49, 4.47)] and 24 mo [MD -7.43 95 % CI (-16.14, 1.27)]. Statistical differences were found between operative and non-operative treatment in total complication rates [RR 1.55, 95 % CI (1.24, 1.94)]. Statistical differences in EQ-5D at 24 mo [MD 0.15, 95 % CI (0.05, 0.24)] were found between operative and non-operative treatment but no statistical differences were found in ED-5D at 12 mo [MD 0.08, 95 % CI (-0.01, 0.17)], 15D at 12 mo [MD 0.02, 95 % CI (-0.68, 0.73)] and 15D at 24 mo [MD 0.02, 95 % CI (-0.07, 0.83)]. Operative treatments did not significantly improve the functional outcome and healthy-related quality of life in elderly patients. Instead, Operative treatment for CPHFs led to higher incidence of postoperative complications. PMID:26636016

  7. Outcomes of a Simple Treatment for Complex Regional Pain Syndrome Type I in Children

    PubMed Central

    Dietz, Frederick R.; Compton, Stephen P.

    2015-01-01

    Background Chronic Regional Pain Syndrome type I (CRPSI) in children is a disorder of unknown etiology. No standard diagnostic criteria or treatment exists. Published treatment protocols are often time and resource intensive. Nonetheless, CRPSI is not rare and can be disabling. This reports the results of a simple and inexpensive treatment protocol involving no medicines, nerve blockades, physical therapy resources or referrals to pain specialists. The patient is instructed in a self-administered massage and mobilization program. The diagnosis required allodynia (pain on light touch of the skin) and signs or the history of signs of autonomic dysfunction. Methods A chart review of patient coded for “reflex sympathetic dystrophy” or ‘autonomic dysfunction” was performed yielding a cohort of eighty-three patients treated by a common protocol. Most patients were identified in the last 15 years. Most patients with this CRPSI were doubtless coded simply as “foot pain” or “knee pain”, etc and were not identified in this search. Charts were reviewed for patient demographics and outcomes. A subset of patients filled out the Pediatric Outcomes Data Collection Instrument (PODCI) giving a validated pre-treatment disability measure. Results The cohort characteristics were similar to prior reports with respect to age, gender, location, and history of trauma. Of the 26 patients who completed the PODCI before treatment the Pain/Comfort Core Scale score mean was 20.81(0–63). The Global Functioning Scale score mean was 52.11(27–83.5). Eighty-nine percent of 51 patients who attended clinic until their outcome was definite had no or minimal residual pain. Treatment averaged 2.2 visits per patient, typically over a six-week period. Conclusions A simple, inexpensive protocol can be effective in treating CRPSI in children. The protocol is risk free, inexpensive to families and conservative of physician and physical therapy resources. Level of Evidence Therapeutic Level IV. PMID:26361462

  8. [Treatment of complex cryptoglandular anal fistulas. Does it still require an experienced surgeon?].

    PubMed

    Roig, Jos V; Garca-Armengol, Juan

    2013-02-01

    There is still controversy on the management of complex cryptoglandular fistulas, even after employing the newest, theoretically simple, techniques. A critical review of the literature was performed, in order to clarify the role of the surgeon, where the precarious balance between eradicating sepsis and maintaining anorectal influences the choice. Techniques, such as fistulotomy, immediate sphincter repair or ligature of the inter-sphincter trajectory, are discussed. The new sphincter preserving techniques, such as sealing, use of plugs and cell therapy are also analysed. However, with a few exceptions, the scientific evidence is low or zero, due to the lack of clinical trials and to the large variation in the presentations and technical details that could influence the results. For this reason, experience in treating complex cryptoglandular fistulas is still essential. PMID:22425511

  9. Transfundal stent placement for treatment of complex basilar tip aneurysm: technical note.

    PubMed

    Vasquez, Ciro; Hubbard, Molly; Jagadeesan, Bharathi Dasan; Tummala, Ramachandra Prasad

    2015-10-01

    We describe a case where a complex unruptured basilar tip aneurysm was treated with a unique method of stent-assisted coil embolization. The aneurysm was considered to have a complex anatomy since both the left posterior cerebral artery and left superior cerebellar artery originated from the dome of the aneurysm. Also, the right posterior cerebral artery was incorporated in the aneurysm neck and needed to be protected prior to coil embolization. This case describes placement of a stent across the span of the aneurysm fundus in order to preserve the two branches arising from it, and the aneurysm dome was coiled without any complication. Using modifications of existing strategies for stent-assisted coil embolization, the aneurysm was treated without any complications and all of the vessels at risk were preserved. PMID:25352580

  10. Density functional treatment of water-carbon dioxide van der Waals complex

    SciTech Connect

    Abashkin, Y.; Mele, F.; Russo, N.; Toscano, M.

    1994-12-31

    LCGTO-LSD and LCGTO-NLSD methods have been tested for the study of water-carbon dioxide weakly bound binary complex. Different local and nonlocal exchange-correlation energy functionals and many grid radial points have been used. Results show that both nonlocal corrections and a large number of radial points in the grid are mandatory for well reproducing then experimental data. 19 refs., 1 fig., 2 tabs.

  11. Simple and Complex Post-Traumatic Stress Disorder: Strategies for Comprehensive Treatment in Clinical Practice.

    ERIC Educational Resources Information Center

    Williams, Mary Beth; Sommer, John F., Jr.

    This book delivers state-of-the-art techniques and information for practitioners to help individuals, groups, families, and communities suffering from post-traumatic stress disorder (PTSD). It addresses concerns about the efficacy of critical incident stress debriefing, examines the value of a variety of innovative treatment methods, and explores…

  12. Simple and Complex Post-Traumatic Stress Disorder: Strategies for Comprehensive Treatment in Clinical Practice.

    ERIC Educational Resources Information Center

    Williams, Mary Beth; Sommer, John F., Jr.

    This book delivers state-of-the-art techniques and information for practitioners to help individuals, groups, families, and communities suffering from post-traumatic stress disorder (PTSD). It addresses concerns about the efficacy of critical incident stress debriefing, examines the value of a variety of innovative treatment methods, and explores

  13. Semantic Complexity in Treatment of Naming Deficits in Aphasia: Evidence from Well-Defined Categories

    ERIC Educational Resources Information Center

    Kiran, Swathi; Johnson, Lauren

    2008-01-01

    Purpose: Our previous work on manipulating typicality of category exemplars during treatment of naming deficits has shown that training atypical examples generalizes to untrained typical examples but not vice versa. In contrast to natural categories that consist of fuzzy boundaries, well-defined categories (e.g., "shapes") have rigid category…

  14. Semantic complexity in treatment of naming deficits in aphasia: Evidence from well-defined categories

    PubMed Central

    Kiran, Swathi; Johnson, Lauren

    2009-01-01

    Purpose Our previous work on manipulating typicality of category exemplars during treatment of naming deficits has shown that training atypical examples generalizes to untrained typical examples but not vice versa. In contrast to natural categories that consist of fuzzy boundaries, well-defined categories (e.g., shapes) have rigid category boundaries. Whether these categories illustrate typicality effects similar to natural categories is under debate. The present study addressed this question in the context of treatment for naming deficits in aphasia. Methods Using a single subject experiment design, three participants with aphasia received a semantic feature treatment to improve naming of either typical or atypical items of shapes, while generalization was tested to untrained items of the category. Results For two of the three participants, training naming of atypical examples of shapes resulted in improved naming of untrained typical examples. Training typical examples in one participant did not improve naming of atypical examples. All three participants, however, showed weak acquisition trends. Conclusions Results of the present study show equivocal support for manipulating typicality as a treatment variable within well defined categories. Instead, these results indicate that acquisition and generalization effects within well defined categories such as shapes are overshadowed by their inherent abstractness. PMID:18845698

  15. [Use of an endobronchial valve in complex treatment of patients with infiltrative pulmonary tuberculosis].

    PubMed

    Levin, A V; Tseĭmakh, E A; Zimonin, P E; Omel'chenko, S A; Nikolaeva, O B; Krasnov, D V; Skliuev, S V

    2008-01-01

    The results of treatment were analyzed in 118 patients with infiltrative pulmonary tuberculosis. In patients with infiltrative pulmonary tuberculosis, generation of therapeutic hypoventilation and atelectasis of the affected part of the lung by means of an endobronchial valve contributes to stabilization and regression of a tuberculous process, closure of decay cavities, and cessation of bacterial excretion. PMID:19062569

  16. Autonomous Modeling, Statistical Complexity and Semi-annealed Treatment of Boolean Networks

    NASA Astrophysics Data System (ADS)

    Gong, Xinwei

    This dissertation presents three studies on Boolean networks. Boolean networks are a class of mathematical systems consisting of interacting elements with binary state variables. Each element is a node with a Boolean logic gate, and the presence of interactions between any two nodes is represented by directed links. Boolean networks that implement the logic structures of real systems are studied as coarse-grained models of the real systems. Large random Boolean networks are studied with mean field approximations and used to provide a baseline of possible behaviors of large real systems. This dissertation presents one study of the former type, concerning the stable oscillation of a yeast cell-cycle oscillator, and two studies of the latter type, respectively concerning the statistical complexity of large random Boolean networks and an extension of traditional mean field techniques that accounts for the presence of short loops. In the cell-cycle oscillator study, a novel autonomous update scheme is introduced to study the stability of oscillations in small networks. A motif that corrects pulse-growing perturbations and a motif that grows pulses are identified. A combination of the two motifs is capable of sustaining stable oscillations. Examining a Boolean model of the yeast cell-cycle oscillator using an autonomous update scheme yields evidence that it is endowed with such a combination. Random Boolean networks are classified as ordered, critical or disordered based on their response to small perturbations. In the second study, random Boolean networks are taken as prototypical cases for the evaluation of two measures of complexity based on a criterion for optimal statistical prediction. One measure, defined for homogeneous systems, does not distinguish between the static spatial inhomogeneity in the ordered phase and the dynamical inhomogeneity in the disordered phase. A modification in which complexities of individual nodes are calculated yields vanishing complexity values for networks in the ordered and critical phases and for highly disordered networks, peaking somewhere in the disordered phase. Individual nodes with high complexity have, on average, a larger influence on the system dynamics. Lastly, a semi-annealed approximation that preserves the correlation between states at neighboring nodes is introduced to study a social game-inspired network model in which all links are bidirectional and all nodes have a self-input. The technique developed here is shown to yield accurate predictions of distribution of players' states, and accounts for some nontrivial collective behavior of game theoretic interest.

  17. Metabolites from invasive pests inhibit mitochondrial complex II: A potential strategy for the treatment of human ovarian carcinoma?

    PubMed

    Ferramosca, Alessandra; Conte, Annalea; Guerra, Flora; Felline, Serena; Rimoli, Maria Grazia; Mollo, Ernesto; Zara, Vincenzo; Terlizzi, Antonio

    2016-05-13

    The red pigment caulerpin, a secondary metabolite from the marine invasive green algae Caulerpa cylindracea can be accumulated and transferred along the trophic chain, with detrimental consequences on biodiversity and ecosystem functioning. Despite increasing research efforts to understand how caulerpin modifies fish physiology, little is known on the effects of algal metabolites on mammalian cells. Here we report for the first time the mitochondrial targeting activity of both caulerpin, and its closely related derivative caulerpinic acid, by using as experimental model rat liver mitochondria, a system in which bioenergetics mechanisms are not altered. Mitochondrial function was tested by polarographic and spectrophotometric methods. Both compounds were found to selectively inhibit respiratory complex II activity, while complexes I, III, and IV remained functional. These results led us to hypothesize that both algal metabolites could be used as antitumor agents in cell lines with defects in mitochondrial complex I. Ovarian cancer cisplatin-resistant cells are a good example of cell lines with a defective complex I function on which these molecules seem to have a toxic effect on proliferation. This provided novel insight toward the potential use of metabolites from invasive Caulerpa species for the treatment of human ovarian carcinoma cisplatin-resistant cells. PMID:27091429

  18. Bronchoscopic treatment of complex persistent air leaks with endobronchial one-way valves.

    PubMed

    Fiorelli, Alfonso; Costanzo, Saveria; Carelli, Emanuele; Di Costanzo, Emilio; Santini, Mario

    2016-04-01

    We reported a case series including 5 patients with persistent air-leaks refractory to standard treatment. All patients were unfit for surgery for the presence of co-morbidities and/or severe respiratory failure due to underlying lung diseases. They were successfully treated with bronchoscopic placement of endobronchial one-way valves. Air-leaks stopped in the first 24 h after the procedure in three patients and 3 and 5 days later, respectively, in the remaining two. No complications were observed and follow-up was uneventful in all patients but one died 25 days after the procedure for systemic sepsis due to peritonis. Patients with important, refractory air leaks having clinical repercussions and unfit for surgery should be early reviewed for bronchoscopic valves treatment. PMID:25245055

  19. [The Melkersson-Rosenthal syndrome as a problem of complex treatment].

    PubMed

    Trzmiel, Dorota; Kozak-Gawron, Karina; Krauze, Ewa

    2004-01-01

    The Melkersson-Rosenthal syndrome consists of triad of symptoms: recurrent oedema of lips, recurrent facial nerve paralysis and lingua plicata. Treatment is usually symptomatic and required cooperation of different specialists as: dermatologists, neurologists, dentists, laryngologists, surgeons. A rare case of Melkersson-Rosenthal syndrome in 49-year-old man was observed in the Clinic of Dermatology Silesian Medical Academy in Katowice. PMID:15865255

  20. [Local ozone therapy in the complex surgical treatment of pulmonary and pleural tuberculosis patients].

    PubMed

    Dobkin, V G; Sadovnikova, S S; Kuz'min, G P; Bondarev, G B

    2001-01-01

    The found bactericidal activity of ozone and oxygen mixture containing ozone, 10 mg/l, and ozoned solutions of furacilin (dilution 1:5000) and chlorohexidine (0.05%) against the nonspecific microflora and Mycobacteria tuberculosis allowed them to be used in the treatment of 55 patients with pleural empyema. Analyzing the outcomes of treatment in these patients versus 59 matched patients indicated that local ozone therapy accelerated sanitation and stimulation of reparative processes in this disease on the average by a fortnight. Local ozone therapy used in the preoperative preparation of patients with pulmonary tuberculosis and pleural empyema reduced the number of purulent postoperative complication to 17.7% versus 30.4% in the controls, enhanced the efficiency of multimodality treatment by 15.6% and reduced mortality by 9.5%. Analyzing the results of prevention of purulent bronchopleural complications after pleuropulmonectomy in 31 patients in the experimental group and in 35 in the control one showed that with local ozone therapy, complications occurred in 16.1 and 28.6%, respectively, and the efficiency of surgical management increased by 13.1% and mortality rates reduced by 9.6%. PMID:11763554

  1. Typicality of Inanimate Category Exemplars in Aphasia Treatment: Further Evidence for Semantic Complexity

    PubMed Central

    Kiran, Swathi

    2009-01-01

    Purpose The typicality treatment approach on improving naming was investigated within two inanimate categories (furniture and clothing) using a single subject experimental design across participants and behaviors in five patients with aphasia. Method Participants received a semantic feature treatment to improve naming of either typical or atypical items within semantic categories, while generalization was tested to untrained items of the category. The order of typicality and category trained was counterbalanced across participants. Results Results indicated that two out of four patients trained on naming of atypical examples demonstrated generalization to naming untrained typical examples. One patient showed trends towards generalization but did not achieve criterion. Further, four out of four patients trained on typical examples demonstrated no generalized naming to untrained atypical examples within the category. Also, analysis of errors indicated an evolution of errors as a result of treatment, from those with no apparent relationship to the target to primarily semantic and phonemic paraphasias. Conclusions These results extend our previous findings (Kiran & Thompson, 2003) to patients with nonfluent aphasia and to inanimate categories such as furniture and clothing. Additionally, the results provide support for the claim that training atypical examples is a more efficient method to facilitating generalization to untrained items within a category than training typical examples (Kiran, 2007). PMID:18695023

  2. Mirror visual feedback for the treatment of complex regional pain syndrome (type 1).

    PubMed

    McCabe, Candida S; Haigh, Richard C; Blake, David R

    2008-04-01

    Mirror visual feedback was originally devised as a therapeutic tool to relieve perceived involuntarily movements and paralysis in the phantom limb. Since this pioneering work was conducted in the mid-1990s, the technique has been applied to relieve pain and enhance movement in other chronic conditions such as stroke and complex regional pain syndrome (CRPS) type 1. This review describes how mirror visual feedback was first developed with amputees, its original application in CRPS, and how further research has demonstrated its potential benefit within graded motor imagery programs. We discuss the potential mechanisms behind this technique and consider the implications for clinical practice. PMID:18474189

  3. Evolving Strategies in the Treatment of Tuberous Sclerosis Complex-associated Angiomyolipomas (TSC-AML).

    PubMed

    Kapoor, Anil; Girard, Louis; Lattouf, Jean-Baptiste; Pei, York; Rendon, Ricardo; Card, Paul; So, Alan

    2016-03-01

    Tuberous sclerosis complex (TSC) is a rare autosomal dominant genetic disorder characterized by the development of numerous benign tumors that occur in multiple organ systems throughout the lifetime of the affected individuals. Renal angiomyolipomas occur in up to 80% of TSC patients, and chronic kidney disease from increasing tumor burden is the primary cause of TSC-related mortality. Our review evaluates evidence for localized and systemic therapy in the management of TSC-angiomyolipomas. Urologists or nephrologists experienced in TSC disease should coordinate the care of TSC patients with renal involvement to improve care and reduce costs. PMID:26723178

  4. Long lasting complex nocturnal hallucinations during Osmotic Release Oral System (OROS) methylphenidate treatment in a 7-year old girl.

    PubMed

    Goetz, Michal; Prihodova, Iva; Hrdlicka, Michal

    2011-01-01

    We report a case of a girl with Attention deficit hyperactivity disorder (ADHD) and Oppositional defiant disorder (ODD) who experienced a 3-hour episode of nocturnal complex bizarre visual hallucinations when treated with 18 mg Osmotic Release Oral System (OROS) methylphenidate (MPH). Nocturnal polysomnography performed two weeks later revealed REM sleep reduction (17%) and fragmentation . Two episodes of confusional arousals were recorded. This finding is typical of parasomnia associated with NREM sleep - disorder of arousal. We hypothesize that this preexisting sleep impairment represents a factor of vulnerability to MPH sleep side effects. In our search of literature, we found no report of nocturnal hallucination alone during treatment with stimulants. PMID:22167138

  5. CdS thin films obtained by thermal treatment of cadmium(II) complex precursor deposited by MAPLE technique

    NASA Astrophysics Data System (ADS)

    Rotaru, Andrei; Mietlarek-Kropidłowska, Anna; Constantinescu, Catalin; Scărişoreanu, Nicu; Dumitru, Marius; Strankowski, Michal; Rotaru, Petre; Ion, Valentin; Vasiliu, Cristina; Becker, Barbara; Dinescu, Maria

    2009-05-01

    Thin films of [Cd{SSi(O-Bu t) 3}(S 2CNEt 2)] 2, precursor for semiconducting CdS layers, were deposited on silicon substrates by Matrix-Assisted Pulsed Laser Evaporation (MAPLE) technique. Structural analysis of the obtained films by Fourier transform infrared spectroscopy (FTIR) confirmed the viability of the procedure. After the deposition of the coordination complex, the layers are manufactured by appropriate thermal treatment of the system (thin film and substrate), according to the thermal analysis of the compound. Surface morphology of the thin films was investigated by atomic force microscopy (AFM) and spectroscopic-ellipsometry (SE) measurements.

  6. Treatment of complex dissociative disorders: a comparison of interventions reported by community therapists versus those recommended by experts.

    PubMed

    Myrick, Amie C; Chasson, Gregory S; Lanius, Ruth A; Leventhal, Barry; Brand, Bethany L

    2015-01-01

    There is a paucity of empirical data to assist clinicians in choosing interventions to use with patients with complex dissociative disorder (DD; i.e., dissociative identity disorder and dissociative disorder not otherwise specified) at different stages in treatment. This study compared interventions used by a sample of international outpatient therapists treating DD clients in the 1st 2 stages of treatment with those recommended by expert DD therapists. There were many similarities between therapists' and experts' interventions, including the use of several emotion regulation and dissociation-focused interventions. However, community therapists reported significantly less focus on relationally oriented interventions, teaching and using grounding and containment skills, and stabilizing patients after revictimization by alleged perpetrators. This study has important implications for the development and implementation of training opportunities for DD therapists. PMID:25365637

  7. Bathroom greywater recycling using polyelectrolyte-complex bilayer membrane: Advanced study of membrane structure and treatment efficiency.

    PubMed

    Oh, K S; Poh, P E; Chong, M N; Chan, E S; Lau, E V; Saint, C P

    2016-09-01

    Polyelectrolyte-complex bilayer membrane (PCBM) was fabricated using biodegradable chitosan and alginate polymers for subsequent application in the treatment of bathroom greywater. In this study, the properties of PCBMs were studied and it was found that the formation of polyelectrolyte network reduced the molecular weight cut-off (MWCO) from 242kDa in chitosan membrane to 2.71kDa in PCBM. The decrease in MWCO of PCBM results in better greywater treatment efficiency, subsequently demonstrated in a greywater filtration study where treated greywater effluent met the household reclaimed water standard of <2 NTU turbidity and <30ppm total suspended solids (TSS). In addition, a further 20% improvement in chemical oxygen demand (COD) removal was achieved as compared to a single layer chitosan membrane. Results from this study show that the biodegradable PCBM is a potential membrane material in producing clean treated greywater for non-potable applications. PMID:27185127

  8. Postoperative evaluation of the surgical treatment of accessory teat and gland cistern complexes in dairy cows.

    PubMed Central

    Schmit, K A; Arighi, M; Dobson, H

    1994-01-01

    The purpose of this study was the long-term evaluation of a method of surgically repairing the abnormal condition of accessory teat and gland cistern complexes in dairy cattle. A prospective evaluation of three cows that had undergone the procedure was done. These cows were evaluated from four months to one year, postoperatively. A thorough history, physical examination, contrast radiography, and ultrasonic examination were done on each cow. A retrospective evaluation of an additional 13 cows that had also undergone the procedure was obtained four months to three years following the surgery, via owner communication. The prospective portion of this study demonstrated patency of the communication between main and accessory teat cisterns. Postoperative complications included initial slow milking and mild swelling of the involved teat. These problems resolved in all cows one to two months postoperatively. None of the 16 cows that had undergone the surgery either developed or was treated for mastitis. Likewise, none of these cows was sold or slaughtered as a result of postoperative teat problems or unsatisfactory milk production. Our study demonstrated that this particular method of surgical correction of accessory teat and gland cistern complexes is effective, is esthetically acceptable, produces minimal associated complications, and preserves the milk production capacity of the gland. Images Figure 2. Figure 4. Figure 5. Figure 6. PMID:8044754

  9. Finite element modeling of endovascular coiling and flow diversion enables hemodynamic prediction of complex treatment strategies for intracranial aneurysm.

    PubMed

    Damiano, Robert J; Ma, Ding; Xiang, Jianping; Siddiqui, Adnan H; Snyder, Kenneth V; Meng, Hui

    2015-09-18

    Endovascular interventions using coil embolization and flow diversion are becoming the mainstream treatment for intracranial aneurysms (IAs). To help assess the effect of intervention strategies on aneurysm hemodynamics and treatment outcome, we have developed a finite-element-method (FEM)-based technique for coil deployment along with our HiFiVS technique for flow diverter (FD) deployment in patient-specific IAs. We tested four clinical intervention strategies: coiling (1-8 coils), single FD, FD with adjunctive coils (1-8 coils), and overlapping FDs. By evaluating post-treatment hemodynamics using computational fluid dynamics (CFD), we compared the flow-modification performance of these strategies. Results show that a single FD provides more reduction in inflow rate than low packing density (PD) coiling, but less reduction in average velocity inside the aneurysm. Adjunctive coils add no additional reduction of inflow rate beyond a single FD until coil PD exceeds 11%. This suggests that the main role of FDs is to divert inflow, while that of coils is to create stasis in the aneurysm. Overlapping FDs decreases inflow rate, average velocity, and average wall shear stress (WSS) in the aneurysm sac, but adding a third FD produces minimal additional reduction. In conclusion, our FEM-based techniques for virtual coiling and flow diversion enable recapitulation of complex endovascular intervention strategies and detailed hemodynamics to identify hemodynamic factors that affect treatment outcome. PMID:26169778

  10. Finite Element Modeling of Endovascular Intervention Enables Hemodynamic Prediction of Complex Treatment Strategies for Coiling and Flow Diversion

    PubMed Central

    Damiano, Robert J.; Ma, Ding; Xiang, Jianping; Siddiqui, Adnan H.; Snyder, Kenneth V.; Meng, Hui

    2016-01-01

    Endovascular interventions using coil embolization and flow diversion are becoming the mainstream treatment for intracranial aneurysms (IAs). To help assess the effect of intervention strategies on aneurysm hemodynamics and treatment outcome, we have developed a finite-element-method (FEM)-based technique for coil deployment along with our HiFiVS technique for flow diverter (FD) deployment in patient-specific IAs. We tested four clinical intervention strategies: coiling (1–8 coils), single FD, FD with adjunctive coils (1–8 coils), and overlapping FDs. By evaluating post-treatment hemodynamics using computational fluid dynamics (CFD), we compared the flow-modification performance of these strategies. Results show that a single FD provides more reduction in inflow rate than low PD coiling, but less reduction in average velocity inside the aneurysm. Adjunctive coils add no additional reduction of inflow rate beyond a single FD until coil PD exceeds 11%. This suggests that the main role of FDs is to divert inflow, while that of coils is to create stasis in the aneurysm. Overlapping FDs decreases inflow rate, average velocity, and average wall shear stress (WSS) in the aneurysm sac, but adding a third FD produces minimal additional reduction. In conclusion, our FEM-based techniques for virtual coiling and flow diversion enable recapitulation of complex endovascular intervention strategies and detailed hemodynamics to identify hemodynamic factors that affect treatment outcome. PMID:26169778

  11. Complex Dynamics of an SIR Epidemic Model with Saturated Incidence Rate and Treatment.

    PubMed

    Jana, Soovoojeet; Nandi, Swapan Kumar; Kar, T K

    2016-03-01

    This paper describes a traditional SIR type epidemic model with saturated infection rate and treatment function. The dynamics of the model is studied from the point of view of stability and bifurcation. Basic reproduction number is obtained and it is shown that the model system may possess a backward bifurcation. The global asymptotic stability of the endemic equilibrium is studied with the help of a geometric approach. Optimal control problem is formulated and solved. Some numerical simulation works are carried out to validate our analytical results. PMID:26566620

  12. Complex PTSD: research directions for nosology/assessment, treatment, and public health.

    PubMed

    Ford, Julian D

    2015-01-01

    Complex posttraumatic stress disorder (CPTSD) in children and adolescents extends beyond the core PTSD symptoms to dysregulation in three psychobiological domains: (1) emotion processing, (2) self-organization (including bodily integrity), and (3) relational functioning. CPTSD research directions for the next decade and beyond are identified in three areas: (1) diagnostic classification (establishing the empirical integrity of CPTSD as a distinct form of psychopathology) and psychometric assessment [validation and refinement of measures of childhood polyvictimization and developmental trauma disorder (DTD)], (2) rigorous evaluation and refinement of interventions (and algorithms for their delivery) developed or adapted for CPTSD and DTD, and (3) the epidemiology of CPTSD and DTD, and their public health and safety impact, across the lifespan and intergenerationally, for populations, nations, and cultures. PMID:25994023

  13. Systemic effects of treatment with mTOR inhibitors in tuberous sclerosis complex: a comprehensive review.

    PubMed

    Sadowski, K; Kotulska, K; Schwartz, R A; Jóźwiak, S

    2016-04-01

    Tuberous sclerosis complex (TSC) is a genetic multisystem disorder associated with constitutive overactivation of the mammalian target of rapamycin (mTOR) pathway and characterized by development of benign tumours in various organs. mTOR inhibitors have proven to be effective in the targeted therapy of certain TSC-associated pathologies such as subependymal giant cell astrocytomas (SEGAs) and renal angiomyolipomas (AMLs). Accumulating experimental and clinical data suggest that mTOR inhibitors might have a systemic, disease-modifying influence on affected individuals. This systematic review provides an analysis of available clinical data concerning systemic effect of mTOR inhibitors and the influence of mTOR inhibition on different manifestations of TSC in individual patients. PMID:26403211

  14. Computational studies of acetylcholinesterase complexed with fullerene derivatives: a new insight for Alzheimer disease treatment.

    PubMed

    da Silva Gonçalves, Arlan; França, Tanos Celmar Costa; Vital de Oliveira, Osmair

    2016-06-01

    Here, we propose five fullerene (C60) derivatives as new drugs against Alzheimer's disease (AD). These compounds were designed to act as new human acetylcholinesterase (HssAChE) inhibitors by blocking its fasciculin II (FASII) binding site. Docking and molecular dynamic results show that our proposals bind to the HssAChE tunnel entrance, forming stable complex, and further binding free energy calculations suggest that three of the derivatives proposed here could be potent HssAChE inhibitors. We found a region formed by a set of residues (Tyr72, Asp74, Trp286, Gln291, Tyr341, and Pro344) which can be further exploited in the drug design of new inhibitors of HssAChE based on C60 derivatives. Results presented here report for the first time by a new class of molecules that can become effective drugs against AD. PMID:26219766

  15. Complex PTSD: research directions for nosology/assessment, treatment, and public health

    PubMed Central

    Ford, Julian D.

    2015-01-01

    Complex posttraumatic stress disorder (CPTSD) in children and adolescents extends beyond the core PTSD symptoms to dysregulation in three psychobiological domains: (1) emotion processing, (2) self-organization (including bodily integrity), and (3) relational functioning. CPTSD research directions for the next decade and beyond are identified in three areas: (1) diagnostic classification (establishing the empirical integrity of CPTSD as a distinct form of psychopathology) and psychometric assessment [validation and refinement of measures of childhood polyvictimization and developmental trauma disorder (DTD)], (2) rigorous evaluation and refinement of interventions (and algorithms for their delivery) developed or adapted for CPTSD and DTD, and (3) the epidemiology of CPTSD and DTD, and their public health and safety impact, across the lifespan and intergenerationally, for populations, nations, and cultures. PMID:25994023

  16. Numerical optimization of targeted delivery of charged nanoparticles to the ostiomeatal complex for treatment of rhinosinusitis

    PubMed Central

    Xi, Jinxiang; Yuan, Jiayao Eddie; Si, Xiuhua April; Hasbany, James

    2015-01-01

    Background Despite the prevalence of rhinosinusitis that affects 10%–15% of the population, current inhalation therapy shows limited efficacy. Standard devices deliver <5% of the drugs to the sinuses due to the complexity of nose structure, secluded location of the sinus, poor ventilation, and lack of control of particle motions inside the nasal cavity. Methods An electric-guided delivery system was developed to guide charged particles to the ostiomeatal complex (OMC). Its performance was numerically assessed in an MRI-based nose–sinus model. Key design variables related to the delivery device, drug particles, and patient breathing were determined using sensitivity analysis. A two-stage optimization of design variables was conducted to obtain the best performance of the delivery system using the Nelder-Mead algorithm. Results and discussion The OMC delivery system exhibited high sensitivity to the applied electric field and electrostatic charges carried by the particles. Through the synthesis of electric guidance and point drug release, the new delivery system eliminated particle deposition in the nasal valve and turbinate regions and significantly enhanced the OMC doses. An OMC delivery efficiency of 72.4% was obtained with the optimized design, which is one order of magnitude higher than the standard nasal devices. Moreover, optimization is imperative to achieve a sound delivery protocol because of the large number of design variables. The OMC dose increased from 45.0% in the baseline model to 72.4% in the optimized system. The optimization framework developed in this study can be easily adapted for the delivery of drugs to other sites in the nose such as the ethmoid sinus and olfactory region. PMID:26257521

  17. Initial experience with transluminally placed endovascular grafts for the treatment of complex vascular lesions.

    PubMed Central

    Marin, M L; Veith, F J; Cynamon, J; Sanchez, L A; Lyon, R T; Levine, B A; Bakal, C W; Suggs, W D; Wengerter, K R; Rivers, S P

    1995-01-01

    OBJECTIVES: Complex arterial occlusive, traumatic, and aneurysmal lesions may be difficult or impossible to treat successfully by standard surgical techniques when severe medical or surgical comorbidities exist. The authors describe a single center's experience over a 2 1/2-year period with 96 endovascular graft procedures performed to treat 100 arterial lesions in 92 patients. PATIENTS AND METHODS: Thirty-three patients had 36 large aortic and/or peripheral artery aneurysms, 48 had 53 multilevel limb-threatening aortoiliac and/or femoropopliteal occlusive lesions, and 11 had traumatic arterial injuries (false aneurysms and arteriovenous fistulas). Endovascular grafts were placed through remote arteriotomies under local (16[17%]), epidural (42[43%]), or general (38[40%]) anesthesia. RESULTS: Technical and clinical successes were achieved in 91% of the patients with aneurysms, 91% with occlusive lesions, and 100% with traumatic arterial lesions. These patients and grafts have been followed from 1 to 30 months (mean, 13 months). The primary and secondary patency rates at 18 months for aortoiliac occlusions were 77% and 95%, respectively. The 18-month limb salvage rate was 98%. Immediately after aortic aneurysm exclusion, a total of 6 (33%) perigraft channels were detected; 3 of these closed within 8 weeks. Endovascular stented graft procedures were associated with a 10% major and a 14% minor complication rate. The overall 30-day mortality rate for this entire series was 6%. CONCLUSIONS: This initial experience with endovascular graft repair of complex arterial lesions justifies further use and careful evaluation of this technique for major arterial reconstruction. Images Figure 1. Figure 4. Figure 5. Figure 5. Figure 6. Figure 7. Figure 8. Figure 9. Figure 11. PMID:7574926

  18. Psychophysiological predictors of working alliance among treatment-seeking women with complex trauma exposure.

    PubMed

    Doukas, Ashley; D'Andrea, Wendy; Doran, Jennifer; Pole, Nnamdi

    2014-12-01

    Research has established that trauma-related symptoms may impede the formation of a strong working alliance (i.e., interpersonal connection, trust, and shared goals between therapist and client). As the alliance is critical in trauma-focused therapy, we studied how clients' pretherapy factors, including symptoms and psychophysiological arousal, predict treatment alliance. We examined symptoms and physiological responses in 27 women who had exposure to extreme interpersonal violence; all of whom were enrolled in therapy. All had symptoms consistent with a diagnosis of posttraumatic stress disorder. Clients completed measures of working alliance and were assessed before and after treatment on measures of symptoms and autonomic arousal. Autonomic assessment included measures of skin conductance and respiratory sinus arrhythmia (RSA), taken during baseline, while viewing positive and then trauma-related slides, and during recovery. Higher alliance ratings were predicted by lower pretherapy skin conductance during trauma slides (r = -.41, p = .049) and recovery (r = -.44, p = .047) and higher RSA during baseline (r = .47, p = .027) and positive slides (r = .43, p = .044). Findings remained significant even after partialling pretherapy symptoms. These data on a high-need but understudied population suggest that sympathetic and parasympathetic arousal may help traumatized clients effectively engage in therapy, further supporting the role of parasympathetic activity in social engagement. PMID:25522730

  19. [Complex treatment of hypertrophic scars using long-wave roentgen radiation].

    PubMed

    Protsenko, T V

    1984-02-01

    The paper is concerned with a therapeutic method for hypertrophic scars including Bucky rays, pyrogenal, vitamins A, E, B12, sodium salicylate and dimexide ointment. Multimodality treatment of hypertrophic scars is effective, well tolerated and can be widely used in out-patient clinics. It makes it possible to reduce the period of therapy by 2-3 mos., and the summary dose by 2000-3000 rad (18.6-27.9 Gy) as compared to common therapy with Bucky rays only. Changes in the connective structure of scars in the process of multimodality therapy are nonspecific and account for some mechanisms of scar regression and reaffirm the efficacy of this therapeutic method. PMID:6700392

  20. Use of the Environmental Simulation Program (ESP) to Simulate Complex Waste Treatment Processes

    SciTech Connect

    MacLean, G. T.; Ho, Q. T.; Berger, S. R. K.

    2003-02-26

    The Environmental Simulation Program is a process simulator designed for aqueous based chemical processes. ESP, which is produced by OLI Systems, Inc., utilizes sophisticated activity coefficient models and predictive equations that result in the ability to simulate very complex electrolyte systems (OLI, 2002). The software comes with databanks of regressed parameters for a large number of aqueous, vapor, and solid species covering most of the elements. ESP has been used extensively at the U. S. Department of Energy Hanford Site to predict nuclear waste slurry vapor-liquid-solid equilibrium. It has and is being used to model leaching and washing of nuclear waste sludges, evaporation of nuclear waste solutions, crystallization of salts, precipitation of plutonium and other metals from waste solutions, and other processing of dilute and concentrated aqueous solutions, sludges, and slurries. The software is also used extensively to rationalize the characterization of nuclear wastes using limited data from analyses of waste samples. The OLI provided databanks suffer from a legacy interaction model that limits the accuracy when neutral solutes are important. Also, the nitrate-nitrite systems typically found in nuclear wastes are not properly parameterized in ESP databases because of the existence of sodium nitrate and nitrite ion pairs. Properties databanks for ESP have been developed at Flour Federal Services that eliminate the legacy model and provide more accurate simulation results than the OLI supplied databases for such concentrated solutions and slurries.

  1. A boundary collocation meshfree method for the treatment of Poisson problems with complex morphologies

    NASA Astrophysics Data System (ADS)

    Soghrati, Soheil; Mai, Weijie; Liang, Bowen; Buchheit, Rudolph G.

    2015-01-01

    A new meshfree method based on a discrete transformation of Green's basis functions is introduced to simulate Poisson problems with complex morphologies. The proposed Green's Discrete Transformation Method (GDTM) uses source points that are located along a virtual boundary outside the problem domain to construct the basis functions needed to approximate the field. The optimal number of Green's functions source points and their relative distances with respect to the problem boundaries are evaluated to obtain the best approximation of the partition of unity condition. A discrete transformation technique together with the boundary point collocation method is employed to evaluate the unknown coefficients of the solution series via satisfying the problem boundary conditions. A comprehensive convergence study is presented to investigate the accuracy and convergence rate of the GDTM. We will also demonstrate the application of this meshfree method for simulating the conductive heat transfer in a heterogeneous materials system and the dissolved aluminum ions concentration in the electrolyte solution formed near a passive corrosion pit.

  2. Effect of Fenton's treatment on the biodegradability of chromium-complex azo dyes.

    PubMed

    Arslan-Alaton, I; Kabdaşli, I; Teksoy, S

    2007-01-01

    Pretreatment of an acid dyebath effluent bearing a new generation chromium complex azo dyestuff (C0 = 350 mg/L) with Fenton's reagent was investigated. Preliminary optimisation (baseline) experiments were conducted to determine the Fe2+, H2O2 concentrations and pH required to the highest possible COD and colour removals. Kinetic studies were carried out at varying temperatures (20 degrees C < T < 70 degrees C) to establish a relationship between COD abatement and H2O2 consumption. The activation energy found for catalytic H2O2 decomposition (Ea = 9.8 kJ/mol) appeared to be significantly less than that of fermentative (Ea = 23 kJ/mol) and of thermal (Ea = 76 kJ/mol) H2O2 decomposition, implying that H2O2 decomposition during the Fenton's reaction occurs more spontaneously. The experimental studies indicated that approximately 30% COD and complete colour removal could be achieved under optimised Fenton pretreatment conditions (Fe2+ = 2 mM; H2O2 = 30 mM; pH = 3; at T = 60 degrees C). Long-term activated sludge experiments revealed that although the raw and pretreated acid dyebath effluent contained practically the same amount of "readily biodegradable" COD (inert COD fraction < or = 10%), biodegradation of the chemically pretreated acid dye effluent proceeded appreciably faster than that of the untreated acid dyebath effluent. PMID:17674835

  3. Deciphering the complexities of atopic dermatitis: shifting paradigms in treatment approaches.

    PubMed

    Leung, Donald Y M; Guttman-Yassky, Emma

    2014-10-01

    Atopic dermatitis (AD) is the most common chronic inflammatory skin disease. It often precedes the development of food allergy and asthma. Recent insights into AD reveal abnormalities in terminal differentiation of the epidermal epithelium leading to a defective stratum corneum, which allows enhanced allergen penetration and systemic IgE sensitization. Atopic skin is also predisposed to colonization or infection by pathogenic microbes, most notably Staphylococcus aureus and herpes simplex virus. Causes of this abnormal skin barrier are complex and driven by a combination of genetic, environmental, and immunologic factors. These factors likely account for the heterogeneity of AD onset and the severity and natural history of this skin disease. Recent studies suggest prevention of AD can be achieved through early interventions to protect the skin barrier. Onset of lesional AD requires effective control of local and systemic immune activation for optimal management. Early intervention might improve long-term outcomes for AD and reduce the systemic allergen sensitization that leads to associated allergic diseases in the gastrointestinal and respiratory tract. PMID:25282559

  4. Deciphering the Complexities of Atopic Dermatitis: Shifting Paradigms in Treatment Approaches

    PubMed Central

    Leung, Donald Y. M.; Guttman-Yassky, Emma

    2014-01-01

    Atopic dermatitis (AD) is the most common chronic inflammatory skin disease. It often precedes the development of food allergy and asthma. Recent insights into AD reveal abnormalities in terminal differentiation of the epidermal epithelium leading to a defective stratum corneum, which allows enhanced allergen penetration and systemic IgE sensitization. Atopic skin is also predisposed to colonization or infection by pathogenic microbes, most notably Staphylococcus aureus and herpes simplex virus (HSV). Causes of this abnormal skin barrier are complex and driven by a combination of genetic, environmental and immunologic factors. These factors likely account for the heterogeneity of AD onset, severity and natural history of this skin disease. Recent studies suggest prevention of AD can be achieved by early interventions protecting the skin barrier. Onset of lesional AD requires effective control of local and systemic immune activation for optimal management. Early intervention may improve long term outcomes for AD and reduce the systemic allergen sensitization leading to associated allergic diseases in the gastrointestinal and respiratory tract. PMID:25282559

  5. Efficacy investigation of transpostceliac single-port 3-channel laparoscope in the treatment of complex renal cyst.

    PubMed

    Mai, Haixing; Liu, Junle; Zhao, Li; Qu, Nan; Wang, Yalin; Huang, Cheng; Chen, Biao; Li, Yanshuai; Chen, Lijun; Zhang, Xu

    2015-01-01

    This study aims to investigate the surgical method and long-term efficacy of transpostceliac single-port 3-channel laparoscope in the treatment of complex renal cyst. A retrospective analysis was performed towards the 37 patients who underwent renal cyst unroofing decompression with single-port laparoscope from Jun. 2012 to Jul. 2013. The surgery was performed through the postceliac approach, a 2.5 cm incision was made 4-5 cm away from the iliac spine of midaxillary line, the Olympus single-port TriPort was then implanted, with the laparoscopic channel and the other two operation channels all as 5 mm. The operation was completed with the forceps and scissors which had flexible fronts. The cysts of the 37 patients were performed the appropriate surgical treatments according to their subtype grouping, on case was transferred to the open surgery, and there was no blood transfusion case. The operation time was 11-42 min, with the mean time as 23 min; the bleeding volume was 10-50 ml, with the mean volume as 26 ml; the postoperative follow-up was 1-6 months, and the ultrasound review did not find the recurrence of cyst; the postoperative lumbar scar was approximately 2.5 cm, and the patients could leave the bed and perform some acts on the exact day of the surgery; the hospitalization time was 1-2 d, with the average time as 1.2 d. The efficacy of the transpostceliac single-port 3-channel laparoscope in the treatment of complex renal cyst was positive, with low recurrence rate, and worthy of further promotion. PMID:26309695

  6. Alternative Techniques for Treatment of Complex Below-the Knee Arterial Occlusions in Diabetic Patients With Critical Limb Ischemia

    SciTech Connect

    Gandini, Roberto; Uccioli, Luigi; Spinelli, Alessio; Del Giudice, Costantino Ros, Valerio Da; Volpi, Tommaso; Meloni, Marco; Simonetti, Giovanni

    2013-02-15

    The purpose of this study was to describe alternative endovascular (EV) techniques and assess their feasibility and efficacy in minimizing failure rates in limb salvage for the treatment of complex below-the knee (BTK) occlusions that could not be crossed with a conventional antegrade access. Between December 2007 and November 2010, 1,035 patients (557 male) underwent EV treatment for critical limb ischemia in our institution. In 124 (12% [83 male], mean age 68.2 {+-} 0.5 years) patients, transfemoral antegrade revascularization attempt failed, and an alternative approach was used. Follow-up was performed at 1 and 6 months. Results were compared with 56 patients treated between November 2002 and November 2007, in whom conventional technique was unsuccessful and unconventional techniques were not adopted. Technical success was achieved in 119 (96%) patients. The limb-salvage rates were 96.8% and 83% at 1- and 6-month follow-up, respectively. Sixteen (12.9%) and 33 (26.6%) patients underwent reintervention at 1- and 6-month follow-up, respectively. Transcutaneous oxygen tension increased at 1 month (44.7 {+-} 1.1 vs. 15.7 {+-} 0.8 mmHg; p < 0.001) and remained stable at follow-up. Twenty (16.1%) patients required major amputation. Thirteen (10.4%) patients died during follow-up. In our previous experience, percutaneous transluminal angioplasty failure, amputation, and death rates were 10.9, 39.2, and 23.2%, respectively. Alternative techniques allowed a significant decrease of major amputation and death rates (p = 0.0001 and p = 0.02, respectively). The use of alternative techniques seems feasible in case of a failed antegrade BTK revascularization attempt and could minimize failure rates in the treatment of complex occlusions while providing satisfying clinical success rates at 6 months.

  7. Efficacy investigation of transpostceliac single-port 3-channel laparoscope in the treatment of complex renal cyst

    PubMed Central

    Mai, Haixing; Liu, Junle; Zhao, Li; Qu, Nan; Wang, Yalin; Huang, Cheng; Chen, Biao; Li, Yanshuai; Chen, Lijun; Zhang, Xu

    2015-01-01

    This study aims to investigate the surgical method and long-term efficacy of transpostceliac single-port 3-channel laparoscope in the treatment of complex renal cyst. A retrospective analysis was performed towards the 37 patients who underwent renal cyst unroofing decompression with single-port laparoscope from Jun. 2012 to Jul. 2013. The surgery was performed through the postceliac approach, a 2.5 cm incision was made 4-5 cm away from the iliac spine of midaxillary line, the Olympus single-port TriPort was then implanted, with the laparoscopic channel and the other two operation channels all as 5 mm. The operation was completed with the forceps and scissors which had flexible fronts. The cysts of the 37 patients were performed the appropriate surgical treatments according to their subtype grouping, on case was transferred to the open surgery, and there was no blood transfusion case. The operation time was 11-42 min, with the mean time as 23 min; the bleeding volume was 10-50 ml, with the mean volume as 26 ml; the postoperative follow-up was 1-6 months, and the ultrasound review did not find the recurrence of cyst; the postoperative lumbar scar was approximately 2.5 cm, and the patients could leave the bed and perform some acts on the exact day of the surgery; the hospitalization time was 1-2 d, with the average time as 1.2 d. The efficacy of the transpostceliac single-port 3-channel laparoscope in the treatment of complex renal cyst was positive, with low recurrence rate, and worthy of further promotion. PMID:26309695

  8. Direct access to the middle meningeal artery for embolization of complex dural arteriovenous fistula: a hybrid treatment approach.

    PubMed

    Lin, Ning; Brouillard, Adam M; Mokin, Maxim; Natarajan, Sabareesh K; Snyder, Kenneth V; Levy, Elad I; Siddiqui, Adnan H

    2014-01-01

    Endovascular embolization has become increasingly favored over microsurgical resection for treatment of complex dural arteriovenous fistulas (DAVFs). However, endovascular treatment can be restricted by tortuous transarterial access and a transvenous approach is not always feasible. We present a Borden III DAVF treated by direct access to the middle meningeal artery (MMA) and Onyx embolization performed in a hybrid operating room-angiography suite. A middle-aged patient with pulsatile headaches was found to have left transverse sinus occlusion and DAVF with retrograde cortical venous drainage fed by multiple external carotid artery (ECA) feeders. Endovascular attempts via conventional transvenous and transarterial routes were unsuccessful, and the major MMA feeder was accessed directly after temporal craniotomy was performed under neuronavigation. Onyx embolization was performed; complete occlusion of the fistula was achieved. Three-month follow-up angiography showed no residual filling; the patient remains complication-free. A combined surgical-endovascular technique in a hybrid operating room-angiography suite can be an effective treatment for DAVFs complicated by inaccessible arterial and transvenous approaches. PMID:24903968

  9. Direct access to the middle meningeal artery for embolization of complex dural arteriovenous fistula: a hybrid treatment approach.

    PubMed

    Lin, Ning; Brouillard, Adam M; Mokin, Maxim; Natarajan, Sabareesh K; Snyder, Kenneth V; Levy, Elad I; Siddiqui, Adnan H

    2015-07-01

    Endovascular embolization has become increasingly favored over microsurgical resection for treatment of complex dural arteriovenous fistulas (DAVFs). However, endovascular treatment can be restricted by tortuous transarterial access and a transvenous approach is not always feasible. We present a Borden III DAVF treated by direct access to the middle meningeal artery (MMA) and Onyx embolization performed in a hybrid operating room-angiography suite. A middle-aged patient with pulsatile headaches was found to have left transverse sinus occlusion and DAVF with retrograde cortical venous drainage fed by multiple external carotid artery (ECA) feeders. Endovascular attempts via conventional transvenous and transarterial routes were unsuccessful, and the major MMA feeder was accessed directly after temporal craniotomy was performed under neuronavigation. Onyx embolization was performed; complete occlusion of the fistula was achieved. Three-month follow-up angiography showed no residual filling; the patient remains complication-free. A combined surgical-endovascular technique in a hybrid operating room-angiography suite can be an effective treatment for DAVFs complicated by inaccessible arterial and transvenous approaches. PMID:24916414

  10. G2677T polymorphism can predict treatment outcome of Malaysians with complex partial seizures being treated with Carbamazepine.

    PubMed

    Subenthiran, S; Abdullah, N R; Muniandy, P K; Joseph, J P; Cheong, K C; Ismail, Z; Mohamed, Z

    2013-01-01

    Carbamazepine (CBZ) is used as the first line of treatment of complex partial seizures (CPS) in Malaysia. While this drug is known to be effective for the treatment of CPS, more than 30% of patients remain drug resistant to CBZ mono-therapy. We examined a possible relationship between patients' response to CBZ mono-therapy and the G2677T SNP of the ABCB1 gene. Three hundred and fourteen patients with CPS were recruited from the Neurology Department of the Kuala Lumpur Hospital, of whom 152 were responders and the other 162 were non-responders to CBZ mono-therapy. DNA was extracted from blood samples and real-time PCR was performed to detect the G2677T SNP of the ABCB1 gene. Results were described as genotype frequencies and compared by logistic regression analysis. Among the 152 responders, 74% had the GG genotype. However, among the 162 non-responders, 26.5% had the GT genotype and 39% had the TT genotype. There was a significant difference in genotype frequency (TT vs GG; odds ratio 4.70; 95% confidence interval, 2.70-8.20) between responders and non-responders. The presence of the T allele of the G2677T SNP appears to be a useful screening marker to determine if a patient is going to be resistant to CBZ as a single drug therapy in the treatment of CPS. PMID:24338387

  11. Azithromycin, rifabutin, and rifapentine for treatment and prophylaxis of Mycobacterium avium complex in rats treated with cyclosporine.

    PubMed Central

    Brown, S T; Edwards, F F; Bernard, E M; Tong, W; Armstrong, D

    1993-01-01

    Azithromycin, rifabutin, and rifapentine were used to treat or prevent disseminated Mycobacterium avium complex (MAC) infections produced in rats immunosuppressed with cyclosporine. Animals with bacteremic infections were treated 1 week after intravenous inoculation with 10(7) CFU of MAC with azithromycin, 100 mg/kg of body weight administered subcutaneously for 5 days and then 75 mg/kg on Monday, Wednesday, and Friday, or with rifabutin or rifapentine, 20 mg/kg administered intraperitoneally on Monday through Friday. All three drugs showed efficacy after 1 and 2 months. Rifabutin cleared the organisms from tissues more rapidly than azithromycin or rifapentine. To approximate prophylaxis, treatment was started 2 weeks before intravenous inoculation with 10(4) organisms. MAC infections were undetectable in treated animals after 4 months, while control animals had disseminated infections. These findings support the rationale for clinical trials of treatment and prophylaxis with these agents. The cyclosporine-treated rat appears to be a useful model in which to evaluate compounds for the treatment and prophylaxis of disseminated MAC infections. PMID:8384809

  12. The Complexity of the ERK/MAP-Kinase Pathway and the Treatment of Melanoma Skin Cancer

    PubMed Central

    Wellbrock, Claudia; Arozarena, Imanol

    2016-01-01

    The central role played by the ERK/MAPK pathway downstream of RAS in human neoplasias is best exemplified in the context of melanoma skin cancer. Signaling through the MAPK pathway is crucial for the proliferation of melanocytes, the healthy pigment cells that give rise to melanoma. However, hyper-activation of the MAPK-pathway is found in over 90% of melanomas with approximately 50% of all patients displaying mutations in the kinase BRAF, and approximately 28% of all patients harboring mutations in the MAPK-pathway up-stream regulator NRAS. This finding has led to the development of BRAF and MEK inhibitors whose application in the clinic has shown unprecedented survival responses. Unfortunately the responses to MAPK pathway inhibitors are transient with most patients progressing within a year and a median progression free survival of 7–10 months. The disease progression is due to the development of drug-resistance based on various mechanisms, many of them involving a rewiring of the MAPK pathway. In this article we will review the complexity of MAPK signaling in melanocytic cells as well as the mechanisms of action of different MAPK-pathway inhibitors and their correlation with clinical response. We will reflect on mechanisms of innate and acquired resistance that limit patient's response, with a focus on the MAPK signaling network. Because of the resurgence of antibody-based immune-therapies there is a growing feeling of failure in the targeted therapy camp. However, recent studies have revealed new windows of therapeutic opportunity for melanoma sufferers treated with drugs targeting the MAPK pathway, and these opportunities will be discussed. PMID:27200346

  13. Clinical application of operative hysteroscopy in treatment of complex hydrosalpinx prior to IVF

    PubMed Central

    Bao, Hong-Chu; Wang, Mei-Mei; Wang, Xin-Rong; Wang, Wen-Juan; Hao, Cui-Fang

    2015-01-01

    Background: In vitro fertilization and embryo transfer (IVF-ET) is the best option for patients with hydrosalpinx. However, if hydrosalpinges is not pre-treated, the therapeutic outcomes of IVF-ET would be compromised. Objective: This study aims to investigate the safety and effects of operative hysteroscopy in the treatment of patients with hydrosalpinx prior to IVF-ET, who were not indicated for laparotomy due to extensive pelvic adhesion. Materials and Methods: The study analyses retrospectively data from 10 women with hydrosalpinx, who were unable to undergo laparotomy due to extensive pelvic adhesion and treated by operative hysteroscopy prior to IVF-ET, and was assessed the effects and safety of the procedure. Results: Postoperative Hystero-salpingography demonstrated complete tubal occlusion of the diseased side in all cases. Being applied with IVF-ET for fertility after their hysteroscopy operation, 5 out of 10 patients acquired clinical pregnancy. Conclusion: Hysteroscopic tubal occlusion of the proximal part of the hydrosalpinx can effectively prevent the hydrops backflow to endometrial cavity and benefit subsequent implantation in the course of assisted reproduction without significant complications. PMID:26221131

  14. Synthesis and Biological Evaluation of Novel Folic Acid Receptor-Targeted, β-Cyclodextrin-Based Drug Complexes for Cancer Treatment

    PubMed Central

    Yin, Juan-Juan; Sharma, Sonali; Shumyak, Stepan P.; Wang, Zhi-Xin; Zhou, Zhi-Wei; Zhang, Yangde; Guo, Peixuan; Li, Chen-Zhong; Kanwar, Jagat R.; Yang, Tianxin; Mohapatra, Shyam S.; Liu, Wanqing; Duan, Wei; Wang, Jian-Cheng; Li, Qi; Zhang, Xueji; Tan, Jun; Jia, Lee; Liang, Jun; Wei, Ming Q.; Li, Xiaotian; Zhou, Shu-Feng

    2013-01-01

    Drug targeting is an active area of research and nano-scaled drug delivery systems hold tremendous potential for the treatment of neoplasms. In this study, a novel cyclodextrin (CD)-based nanoparticle drug delivery system has been assembled and characterized for the therapy of folate receptor-positive [FR(+)] cancer. Water-soluble folic acid (FA)-conjugated CD carriers (FACDs) were successfully synthesized and their structures were confirmed by 1D/2D nuclear magnetic resonance (NMR), matrix-assisted laser desorption ionization time-of-flight mass spectrometer (MALDI-TOF-MS), high performance liquid chromatography (HPLC), Fourier transform infrared spectroscopy (FTIR), and circular dichroism. Drug complexes of adamatane (Ada) and cytotoxic doxorubicin (Dox) with FACD were readily obtained by mixed solvent precipitation. The average size of FACD-Ada-Dox was 1.5–2.5 nm. The host-guest association constant Ka was 1,639 M−1 as determined by induced circular dichroism and the hydrophilicity of the FACDs was greatly enhanced compared to unmodified CD. Cellular uptake and FR binding competitive experiments demonstrated an efficient and preferentially targeted delivery of Dox into FR-positive tumor cells and a sustained drug release profile was seen in vitro. The delivery of Dox into FR(+) cancer cells via endocytosis was observed by confocal microscopy and drug uptake of the targeted nanoparticles was 8-fold greater than that of non-targeted drug complexes. Our docking results suggest that FA, FACD and FACD-Ada-Dox could bind human hedgehog interacting protein that contains a FR domain. Mouse cardiomyocytes as well as fibroblast treated with FACD-Ada-Dox had significantly lower levels of reactive oxygen species, with increased content of glutathione and glutathione peroxidase activity, indicating a reduced potential for Dox-induced cardiotoxicity. These results indicate that the targeted drug complex possesses high drug association and sustained drug release properties with good biocompatibility and physiological stability. The novel FA-conjugated β-CD based drug complex might be promising as an anti-tumor treatment for FR(+) cancer. PMID:23658721

  15. [Improved results of the trachea scar stenosis treatment by inclusion in the complex therapy of combined application diprospan and low-intensity infrared laser radiation].

    PubMed

    Israfilova, S B; Gasymov, É M

    2013-09-01

    The experience of treating 61 patients over the rumen of stenosis of the trachea was summarizes. To improve the results suggested inclusion complex diprospan treatment in combination with low intensity infrared laser radiation. The advantages of the proposed method of treatment of tracheal stenosis scarring are reduced severity of chronic inflammation, reducing the proliferation of granulation tissue. PMID:24501929

  16. Preliminary engineering evaluation of heat and digest treatment for in-tank removal of radionuclides from complexed waste

    SciTech Connect

    Klem, M.J.

    1995-09-29

    This report uses laboratory data from low temperature-ambient pressure digestion of actual complexed supernatant to evaluate digestion as a pretreatment method for waste in double-shell tanks 241-AN-102, 241-AN-107 and 241-AY-101. Digestion time requirements were developed at 100 degrees celsius to remove organic and meet NRC Class C criterion for TRU elements and NRC Class B criterion for 90Sr. The incidental waste ruling will establish the need for removal of 90Sr. Digestion pretreatment precipitates non radioactive metal ions and produces additional high-level waste solids and canisters of high level glass. This report estimates the amount of additional high-level waste produced and preliminary capital and operating costs for in-tank digestion of waste. An overview of alternative in-tank treatment methods is included

  17. Impact of reclamation treatment on the biological activity of soils of the solonetz complex in Western Siberia

    NASA Astrophysics Data System (ADS)

    Berezin, L. V.; Khamova, O. F.; Paderina, E. V.; Gindemit, A. M.

    2014-11-01

    The abundance and activity of the soil microflora were studied in a field experiment with the use of green manure crops to assess the impact of reclamation measures on the biological activity of soils of the solonetz complex. The number of microorganisms in the plow soil horizon increased in the background of the green fallows as compared to the black ones. Coefficients of mineralization, immobilization, and transformation of organic compounds were calculated for different variants of the soil treatment. The value of the mineralization coefficient indicates the intense decomposition of the green manure that entered the soil. In the first year, peas were actively decomposed, while oats, in the second year (aftereffect). The activity of the soil enzymes (invertase, urease, and catalase) was determined. A close relationship between the catalase activity and the intensity of the microbiological processes in the soils was revealed.

  18. The pleiotropic effects of decanoic acid treatment on mitochondrial function in fibroblasts from patients with complex I deficient Leigh syndrome.

    PubMed

    Kanabus, Marta; Fassone, Elisa; Hughes, Sean David; Bilooei, Sara Farahi; Rutherford, Tricia; Donnell, Maura O'; Heales, Simon J R; Rahman, Shamima

    2016-05-01

    There is growing interest in the use of the ketogenic diet (KD) to treat inherited metabolic diseases including mitochondrial disorders. However, neither the mechanism whereby the diet may be working, nor if it could benefit all patients with mitochondrial disease, is known. This study focusses on decanoic acid (C10), a component of the medium chain triglyceride KD, and a ligand for the nuclear receptor PPAR-γ known to be involved in mitochondrial biogenesis. The effects of C10 were investigated in primary fibroblasts from a cohort of patients with Leigh syndrome (LS) caused by nuclear-encoded defects of respiratory chain complex I, using mitochondrial respiratory chain enzyme assays, gene expression microarray, qPCR and flow cytometry. Treatment with C10 increased citrate synthase activity, a marker of cellular mitochondrial content, in 50 % of fibroblasts obtained from individuals diagnosed with LS in a PPAR-γ-mediated manner. Gene expression analysis and qPCR studies suggested that treating cells with C10 supports fatty acid metabolism, through increasing ACADVL and CPT1 expression, whilst downregulating genes involved in glucose metabolism (PDK3, PDK4). PCK2, involved in blocking glucose metabolism, was upregulated, as was CAT, encoding catalase. Moreover, treatment with C10 also decreased oxidative stress in complex I deficient (rotenone treated) cells. However, since not all cells from subjects with LS appeared to respond to C10, prior cellular testing in vitro could be employed as a means for selecting individuals for subsequent clinical studies involving C10 preparations. PMID:27080638

  19. Tunicate-Inspired Gallic Acid/Metal Ion Complex for Instant and Efficient Treatment of Dentin Hypersensitivity.

    PubMed

    Prajatelistia, Ekavianty; Ju, Sung-Won; Sanandiya, Naresh D; Jun, Sang Ho; Ahn, Jin-Soo; Hwang, Dong Soo

    2016-04-01

    Dentin hypersensitivity is sharp and unpleasant pains caused by exposed dentinal tubules when enamel outside of the tooth wears away. The occlusion of dentinal tubules via in situ remineralization of hydroxyapatite is the best method to alleviate the symptoms caused by dentin hypersensitivity. Commercially available dental desensitizers are generally effective only on a specific area and are relatively toxic, and their performance usually depends on the skill of the clinician. Here, a facile and efficient dentin hypersensitivity treatment with remarkable aesthetic improvement inspired by the tunicate-self-healing process is reported. As pyrogallol groups in tunicate proteins conjugate with metal ions to heal the torn body armor of a tunicate, the ingenious mechanism by introducing gallic acid (GA) as a cheap, abundant, and edible alternative to the pyrogallol groups of the tunicate combined with a varied daily intake of metal ion sources is mimicked. In particular, the GA/Fe(3+) complex exhibits the most promising results, to the instant ≈52% blockage in tubules within 4 min and ≈87% after 7 d of immersion in artificial saliva. Overall, the GA/metal ion complex-mediated coating is facile, instant, and effective, and is suggested as an aesthetic solution for treating dentin hypersensitivity. PMID:26867019

  20. Midterm Results of a Combined Biological and Mechanical Approach for the Treatment of a Complex Knee Lesion

    PubMed Central

    Filardo, G.; Di Martino, A.; Delcogliano, M.; Marcacci, M.

    2012-01-01

    Objective: Complex fractures of the tibial plateau are difficult to treat and present a high complication rate. The goal of this report is to describe a combined biological and mechanical approach to restore all morphological and functional knee properties. Methods: We treated a 50-year-old woman, who was affected by a posttraumatic osteochondral lesion and depression of the lateral tibial plateau with knee valgus deviation. The mechanical axis was corrected with a lateral tibial plateau elevation osteotomy, the damaged joint surface was replaced by a recently developed biomimetic osteochondral scaffold, and a hinged dynamic external fixator was applied to protect the graft and at the same time to allow postoperative joint mobilization. Results: A marked clinical improvement was documented at 12 months and further improved up to 5 years, with pain-free full range of motion and return to previous activities. The MRI evaluation at 12 and 24 months showed that the implant remained in site with a hyaline-like signal and restoration of the articular surface. Conclusion: This case report describes a combined surgical approach for complex knee lesions that could represent a treatment option to avoid or at least delay posttraumatic osteoarthritis and more invasive procedures. PMID:26069639

  1. Dermatan sulfate/chitosan polyelectrolyte complex with potential application in the treatment and diagnosis of vascular disease.

    PubMed

    Rasente, Rita Y; Imperiale, Julieta C; Lázaro-Martínez, Juan M; Gualco, Luciana; Oberkersch, Roxana; Sosnik, Alejandro; Calabrese, Graciela C

    2016-06-25

    Cardiovascular disease is the largest single cause of morbid-mortality in the world. However, there is still no pharmaceutical treatment that directly targets the blood vessel wall instead of just controlling the risk factors. Here, we produced polyelectrolyte complexes (PECs) by a simple and reproducible polyelectrolyte complexation method between low molecular mass dermatan sulfate (polyanionic polysaccharide) and chitosan (polycationic polysaccharide), and evaluated the cellular uptake by vascular endothelial cells. The composition and the composition homogeneity of PECs were confirmed by (13)C-CP-MAS spectroscopy and by polyacrylamide gel electrophoresis, respectively. The hydrodynamic radius, determined by dynamic light scattering, was 729±11nm. PECs were not cytotoxic for a murine heart endothelium-derived cell line. Fluorescent confocal microscopy showed the specific uptake of fluorescently-labeled PECs by endothelial cells when they were cultured alone or in the presence of macrophages. Overall, these findings confirmed the potential of these PECs for targeting different agents to the vessel wall in the prevention, diagnosis, and therapy of vascular disease. PMID:27083828

  2. A Pilot Study of Trans-Arterial Injection of 166Holmium-Chitosan Complex for Treatment of Small Hepatocellular Carcinoma

    PubMed Central

    Cho, Byoung Chul; Kim, Eun Hee; Choi, Hye Jin; Kim, Joo Hang; Roh, Jae Kyung; Chung, Hyun Cheol; Ahn, Joong Bae; Lee, Jong Doo; Lee, Jong Tae; Yoo, Nae Choon

    2005-01-01

    Percutaneous approaches, such as percutaneous ethanol injection and radiofrequency ablation, have been most widely used for hepatocellular carcinoma patients who were not eligible for surgery. New technologies to improve the efficacy are currently needed. 166Holmium is a neutron activated radionuclide, and has several beneficial radiophysical characteristics for internal radiation therapy. 166Holmium-Chitosan complex, in which chitosan is chelated with 166Holmium, was developed as a radiopharmaceutical for cancer therapy. We have conducted a pilot study to evaluate the clinical efficacy of transarterial administration of 166Holmium-Chitosan complex in patients with a single and small (< 3 cm) hepatocellular carcinoma. 166Holmium-Chitosan complex, at a dose of 20 mCi per cm of tumor mass-diameter, was administered through the artery that directly fed the tumor. Twelve patients were treated with a median follow-up duration of 26 (range: 12-61) months. The tumor diameter ranged between 1.5 and 2.5 cm. Ten patients (83%) had complete response and two (17%) had partial response. The median complete response duration was not reached. The median AFP level declined from 83.8 to 8.3 ng/mL within 2 months after treatment. No grade III/IV toxicity was observed. Grade I and II toxicities were observed in four patients (2 abdominal pain, 1 fever, and 1 AST/ALT elevation). No toxic death occurred. This preliminary study shows a promising and durable complete response rate with an acceptable safety profile. Further studies with greater accrual of patients are warranted. PMID:16385656

  3. Redox-active injectable gel using thermo-responsive nanoscale polyion complex flower micelle for noninvasive treatment of local inflammation.

    PubMed

    Pua, Min Ley; Yoshitomi, Toru; Chonpathompikunlert, Pennapa; Hirayama, Aki; Nagasaki, Yukio

    2013-12-28

    Reactive oxygen species (ROS) scavengers have not been widely used for treatment of local inflammatory reactions such as arthritis and periodontal disease because they are rapidly eliminated from the inflamed site, which results in a low therapeutic effect. Therefore, to enhance the local retention time of ROS scavengers, we developed a redox-active injectable gel (RIG) system by using poly[4-(2,2,6,6-tetramethylpiperidine-N-oxyl)aminomethylstyrene]-b-poly(ethylene glycol)-b-poly[4-(2,2,6,6-tetramethylpiperidine-N-oxyl)aminomethylstyrene] (PMNT-PEG-PMNT) triblock copolymer, which possesses ROS scavenging nitroxide radicals as side chains of the PMNT segment. Cationic PMNT segment in PMNT-PEG-PMNT forms polyion complexes with anionic poly(acrylic acid) (PAAc) to form a flower-like micelle (ca. 79 nm), which exhibits in situ thermo-irreversible gelation under physiological conditions. We confirmed the prolonged site-specific retention time of RIG by performing in vivo noninvasive electron spin resonance imaging and quantitative evaluation. In contrast to low-molecular-weight nitroxide radical compounds that disappeared from injection sites in less than 1h after subcutaneous injection, 40% of the RIG remained even at 3 days. We also found that RIG inhibits neutrophil infiltration and cytokine production, which leads to suppression of hyperalgesia. These findings indicate the potential of RIG as an innovative approach for treatment of local inflammation. PMID:24157475

  4. Pain exposure physical therapy (PEPT) compared to conventional treatment in complex regional pain syndrome type 1: a randomised controlled trial

    PubMed Central

    Barnhoorn, Karlijn J; van de Meent, Henk; van Dongen, Robert T M; Klomp, Frank P; Groenewoud, Hans; Samwel, Han; Nijhuis-van der Sanden, Maria W G; Frölke, Jan Paul M; Staal, J Bart

    2015-01-01

    Objective To compare the effectiveness of pain exposure physical therapy (PEPT) with conventional treatment in patients with complex regional pain syndrome type 1 (CRPS-1) in a randomised controlled trial with a blinded assessor. Setting The study was conducted at a level 1 trauma centre in the Netherlands. Participants 56 adult patients with CRPS-1 participated. Three patients were lost to follow-up. Interventions Patients received either PEPT in a maximum of five treatment sessions, or conventional treatment following the Dutch multidisciplinary guideline. Measurements Outcomes were assessed at baseline and at 3, 6 and 9 months after randomisation. The primary outcome measure was the Impairment level Sum Score—Restricted Version (ISS-RV), consisting of visual analogue scale for pain (VAS-pain), McGill Pain Questionnaire, active range of motion (AROM) and skin temperature. Secondary outcome measures included Pain Disability Index (PDI); muscle strength; Short Form 36 (SF-36); disability of arm, shoulder and hand; Lower Limb Tasks Questionnaire (LLTQ); 10 m walk test; timed up-and-go test (TUG) and EuroQol-5D. Results The intention-to-treat analysis showed a clinically relevant decrease in ISS-RV (6.7 points for PEPT and 6.2 points for conventional treatment), but the between-group difference was not significant (0.96, 95% CI −1.56 to 3.48). Participants allocated to PEPT experienced a greater improvement in AROM (between-group difference 0.51, 95% CI 0.07 to 0.94; p=0.02). The per protocol analysis showed larger and significant between-group effects on ISS-RV, VAS-pain, AROM, PDI, SF-36, LLTQ and TUG. Conclusions We cannot conclude that PEPT is superior to conventional treatment for patients with CRPS-1. Further high-quality research on the effects of PEPT is warranted given the potential effects as indicated by the per protocol analysis. Trial registration numbers NCT00817128 and NTR 2090. PMID:26628523

  5. Biofilm-Grown Burkholderia cepacia Complex Cells Survive Antibiotic Treatment by Avoiding Production of Reactive Oxygen Species

    PubMed Central

    Van Acker, Heleen; Sass, Andrea; Bazzini, Silvia; De Roy, Karen; Udine, Claudia; Messiaen, Thomas; Riccardi, Giovanna; Boon, Nico; Nelis, Hans J.; Mahenthiralingam, Eshwar; Coenye, Tom

    2013-01-01

    The presence of persister cells has been proposed as a factor in biofilm resilience. In the present study we investigated whether persister cells are present in Burkholderia cepacia complex (Bcc) biofilms, what the molecular basis of antimicrobial tolerance in Bcc persisters is, and how persisters can be eradicated from Bcc biofilms. After treatment of Bcc biofilms with high concentrations of various antibiotics often a small subpopulation survived. To investigate the molecular mechanism of tolerance in this subpopulation, Burkholderia cenocepacia biofilms were treated with 1024 µg/ml of tobramycin. Using ROS-specific staining and flow cytometry, we showed that tobramycin increased ROS production in treated sessile cells. However, approximately 0.1% of all sessile cells survived the treatment. A transcriptome analysis showed that several genes from the tricarboxylic acid cycle and genes involved in the electron transport chain were downregulated. In contrast, genes from the glyoxylate shunt were upregulated. These data indicate that protection against ROS is important for the survival of persisters. To confirm this, we determined the number of persisters in biofilms formed by catalase mutants. The persister fraction in ΔkatA and ΔkatB biofilms was significantly reduced, confirming the role of ROS detoxification in persister survival. Pretreatment of B. cenocepacia biofilms with itaconate, an inhibitor of isocitrate lyase (ICL), the first enzyme in the glyoxylate shunt, reduced the persister fraction approx. 10-fold when the biofilms were subsequently treated with tobramycin. In conclusion, most Bcc biofilms contain a significant fraction of persisters that survive treatment with high doses of tobramycin. The surviving persister cells downregulate the TCA cycle to avoid production of ROS and at the same time activate an alternative pathway, the glyoxylate shunt. This pathway may present a novel target for combination therapy. PMID:23516582

  6. Bortezomib (PS-341) Treatment Decreases Inflammation and Partially Rescues the Expression of the Dystrophin-Glycoprotein Complex in GRMD Dogs

    PubMed Central

    Araujo, Karla P. C.; Bonuccelli, Gloria; Duarte, Caio N.; Gaiad, Thais P.; Moreira, Dayson F.; Feder, David; Belizario, José E.; Miglino, Maria A.; Lisanti, Michael P.; Ambrosio, Carlos E.

    2013-01-01

    Golden retriever muscular dystrophy (GRMD) is a genetic myopathy corresponding to Duchenne muscular dystrophy (DMD) in humans. Muscle atrophy is known to be associated with degradation of the dystrophin-glycoprotein complex (DGC) via the ubiquitin-proteasome pathway. In the present study, we investigated the effect of bortezomib treatment on the muscle fibers of GRMD dogs. Five GRMD dogs were examined; two were treated (TD- Treated dogs) with the proteasome inhibitor bortezomib, and three were control dogs (CD). Dogs were treated with bortezomib using the same treatment regimen used for multiple myeloma. Pharmacodynamics were evaluated by measuring the inhibition of 20S proteasome activity in whole blood after treatment and comparing it to that in CD. We performed immunohistochemical studies on muscle biopsy specimens to evaluate the rescue of dystrophin and dystrophin-associated proteins in the muscles of GRMD dogs treated with bortezomib. Skeletal tissue from TD had lower levels of connective tissue deposition and inflammatory cell infiltration than CD as determined by histology, collagen morphometry and ultrastructural analysis. The CD showed higher expression of phospho-NFκB and TGF-β1, suggesting a more pronounced activation of anti-apoptotic factors and inflammatory molecules and greater connective tissue deposition, respectively. Immunohistochemical analysis demonstrated that dystrophin was not present in the sarcoplasmic membrane of either group. However, bortezomib-TD showed higher expression of α- and β-dystroglycan, indicating an improved disease histopathology phenotype. Significant inhibition of 20S proteasome activity was observed 1 hour after bortezomib administration in the last cycle when the dose was higher. Proteasome inhibitors may thus improve the appearance of GRMD muscle fibers, lessen connective tissue deposition and reduce the infiltration of inflammatory cells. In addition, proteasome inhibitors may rescue some dystrophin-associated proteins in the muscle fiber membrane. PMID:23579193

  7. [Effectiveness of 3-hydroxypyridine and succinic acid derivatives in complex treatment of primary open-angle glaucoma].

    PubMed

    Volchegorskiĭ, I A; Tur, E V; Soliannikova, O V; Rykun, V S; Sumina, M S; Dmitrienko, V N; Berdnikova, E V

    2012-01-01

    Prospective, placebo-controlled, single-blind, randomized clinical investigation of the influence of domestic 3-hydroxypyridine and succinic acid derivatives (emoxipin, reamberin, mexidol) on the effectiveness of a complex treatment of primary open-angle glaucoma (POAG) has been performed in a group of patients. It is established that intravenous infusion of 3-hydroxypyridine derivatives (emoxipin and mexidol) for two weeks, beginning 14 days after the start of POAG treatment, produced a retinoprotective action, with three months postponed changes in the central retinal artery (CRA) blood velocity. The retinoprotective effect of emoxipin (single dose, 150 mg) was manifested by reduction in the horizontal size of blind spot in two weeks, with the subsequent reduction of the CRA end-diastolic blood velocity observed three months after finish of the infusion therapy. The administration of mexidol (single dose, 300 mg) after 14 days of treatment led to widening of the summarized field of vision (test-object square, 16 mm), accompanied by a decrease in the electrosensitivity threshold of the optic nerve and the intensity of POAG-associated hypothymia. All indices of CRA blood velocity increased three months after termination of mexidol infusions. Reamberin (single dose, 400 ml 1,5% solution of reamberine, containing polyelectrolyte and meglumine succinate mixture) did not show retinoprotective action, but caused proatherogenic changes of blood lipids and 3 months postponed CRA end-diastolic blood velocity increase. The effect of mexidol (which is a derivative of both 3- hydroxypyridine and succinic acid) exceeds that of separate 3-hydroxypyridine (emoxipin) and succinic acid (reamberin) derivatives in the degree of retinoprotection and positive effect on the optic nerve condition and mood of POAG patients. PMID:23025048

  8. An approach to using conventional brachytherapy software for clinical treatment planning of complex, Monte Carlo-based brachytherapy dose distributions

    SciTech Connect

    Rivard, Mark J.; Melhus, Christopher S.; Granero, Domingo; Perez-Calatayud, Jose; Ballester, Facundo

    2009-06-15

    Certain brachytherapy dose distributions, such as those for LDR prostate implants, are readily modeled by treatment planning systems (TPS) that use the superposition principle of individual seed dose distributions to calculate the total dose distribution. However, dose distributions for brachytherapy treatments using high-Z shields or having significant material heterogeneities are not currently well modeled using conventional TPS. The purpose of this study is to establish a new treatment planning technique (Tufts technique) that could be applied in some clinical situations where the conventional approach is not acceptable and dose distributions present cylindrical symmetry. Dose distributions from complex brachytherapy source configurations determined with Monte Carlo methods were used as input data. These source distributions included the 2 and 3 cm diameter Valencia skin applicators from Nucletron, 4-8 cm diameter AccuBoost peripheral breast brachytherapy applicators from Advanced Radiation Therapy, and a 16 mm COMS-based eye plaque using {sup 103}Pd, {sup 125}I, and {sup 131}Cs seeds. Radial dose functions and 2D anisotropy functions were obtained by positioning the coordinate system origin along the dose distribution cylindrical axis of symmetry. Origin:tissue distance and active length were chosen to minimize TPS interpolation errors. Dosimetry parameters were entered into the PINNACLE TPS, and dose distributions were subsequently calculated and compared to the original Monte Carlo-derived dose distributions. The new planning technique was able to reproduce brachytherapy dose distributions for all three applicator types, producing dosimetric agreement typically within 2% when compared with Monte Carlo-derived dose distributions. Agreement between Monte Carlo-derived and planned dose distributions improved as the spatial resolution of the fitted dosimetry parameters improved. For agreement within 5% throughout the clinical volume, spatial resolution of dosimetry parameter data {<=}0.1 cm was required, and the virtual brachytherapy source data set included over 5000 data points. On the other hand, the lack of consideration for applicator heterogeneity effect caused conventional dose overestimates exceeding an order of magnitude in regions of clinical interest. This approach is rationalized by the improved dose estimates. In conclusion, a new technique was developed to incorporate complex Monte Carlo-based brachytherapy dose distributions into conventional TPS. These results are generalizable to other brachytherapy source types and other TPS.

  9. Clinical Application of Estimating Hepatitis B Virus Quasispecies Complexity by Massive Sequencing: Correlation between Natural Evolution and On-Treatment Evolution

    PubMed Central

    Homs, Maria; Caballero, Andrea; Gregori, Josep; Tabernero, David; Quer, Josep; Nieto, Leonardo; Esteban, Rafael; Buti, Maria; Rodriguez-Frias, Francisco

    2014-01-01

    Aim To evaluate HBV quasispecies (QA) complexity in the preCore/Core regions in relation to HBeAg status, and explore QA changes under natural evolution and nucleoside analogue (NUC) treatment. Methods Ultra-deep pyrosequencing of HBV preCore/Core regions in 30 sequential samples (baseline [diagnosis], treatment-free, and treatment-nonresponse) from 10 retrospectively selected patients grouped according to HBeAg status over time: HBeAg+ (N = 4), HBeAg- (N = 2), and fluctuating HBeAg (transient seroreversion/seroconversion pattern) (N = 4). QA complexity was defined by Shannon entropy, mutation frequency, nucleotide diversity, and mutation frequency of amino acids (MfAA) in preCore and Core. Results The QA was less complex in HBeAg+ than in HBeAg- or fluctuating HBeAg. High complexity in preCore was associated with decreased viral replication (preCore MfAA negatively correlated with HBV-DNA, p = 0.005). QA complexity in the treatment-free period negatively correlated with values seen during treatment. Specific variants were mainly selected in the Core region in HBeAg- and fluctuating HBeAg patients, suggesting higher immune pressure than in HBeAg+. Conclusions The negative correlation between QA natural evolution and on-treatment evolution indicates the importance of pre-treatment QA study to predict QA changes in NUC nonresponders. Study of QA complexity could be useful for managing HBV infection. PMID:25393280

  10. Treatment of a synthetic solution of galvanization effluent via the conversion of sodium cyanide into an insoluble safe complex.

    PubMed

    Ismail, Ibrahim; Abdel-Monem, Nabil; Fateen, Seif-Eddeen; Abdelazeem, Waleed

    2009-07-30

    Wastewater discharged from metal-finishing processes usually contains cyanide, a hazardous substance that is used extensively in the surface finishing industry. In the present study, a synthetic solution resembling the contaminated wastewater was chemically treated using ferrous sulfate. This simple one-step process was applied successfully to remove cyanide from metal finishing wastewater. The experiments were carried out on a synthetic solution containing ions of cyanide and zinc. The effects of mixing velocity, ratio of ferrous ions to cyanide ions, ferrous ions concentration, initial cyanide concentration, pH of solution, temperature, mixing time and zinc ions concentration were studied. The results showed that the removal efficiency of cyanide increased as the mixing velocity increased, ferrous ion molar ratio to cyanide ions increased, temperature increased and time of mixing increased at an optimum of pH 8. The reduction of cyanide concentration reached the allowable limit for wastewater discharge according to the Egyptian Environmental Law decree 44/2000, which is 0.2mg/l. The formed complexes were analyzed and the stability of each complex was studied under different pH value solutions after 7 days of contact. A typical example of electroplating wastewater from a local company in the field of metal finishing, which contains 18 mg/lCN(-) and 12 mg/l Zn(2+), was treated according to the determined optimum conditions for the treatment process and the concentration of CN(-) was reduced to 0.095 mg/l after 15 min of agitation. PMID:19135781

  11. Treatment with proteolytic enzymes decreases glomerular immune complex deposits in passive serum sickness in rats and mice

    SciTech Connect

    Emancipator, S.N.; Nakazawa, M.; Lamm, M.E.

    1986-03-05

    This study assessed the effect of protease treatment on glomerular immune complex (IC) deposition in passive serum sickness. IC containing 2.2 mg of specific rabbit antibovine gammaglobulin (Ab) and cationic bovine gammaglobulin (CBGG) at 5-fold antigen excess were given via tail vein to 140 g Sprague-Dawley rats; some rats received IC containing /sup 125/I-Ab. After maximal glomerular IC deposition (1h) a single intravenous dose of either 4 mg chymopapain plus 2 mg subtilisin (T), or saline (C) was given. By immunofluorescence (IF) 1 h later, 1/13 T rats had bright capillary wall deposits of CBGG vs 10/11 C rats (x/sup 2/ = 13.4, p < .001); 6/13 T rats had Ab vs. 10/11 C rats (x/sup 2/ = 4.05, p < .05). Isolated glomeruli from T rats given /sup 125/I-IC had 25% less Ab (3267 +/- 293 cpm/mg glomerular protein) than C rats (4327 +/- 530, p < .005). 20 g BALB/c mice given IC with CBGG and 0.3 mg Ab, or IC with native BGG (nBGG) and 1 mg Ab via tail vein received 0.5 mg chymopapain and 0.25 mg subtilisin in 5 divided intraperitoneal doses q 10 min beginning 1 h later. 20 min after the last dose, 2/15 T mice given CBGG-IC had capillary wall Ab deposits by IF vs 13/16 C mice (x/sup 2/ = 11.7, p < .001). 1/16 T mice given nBGG-IC had mesangial Ab deposits vs. 11/15 C mice (x/sup 2/ = 10.8, p < .001). The authors conclude that protease treatment can remove glomerular IC deposits.

  12. Outlook for the use of focused shock waves and pulsed electric fields in the complex treatment of malignant neoplasms.

    PubMed

    Garilevich, B A; Andrianov, Yu V; Olefir, Yu V; Zubkov, A D; Rotov, A E

    2006-01-01

    The experimental studies the synchronous action of electric field microsecond range with amplitude within the range of 1-7 kV/sm and shock waves with pressure before 100 MPa on cells membrane permeability of the mouse's ascitic tumors in vitro have shown the intensification the efficiency of the forming the irreversible pores under synchronous action. Thereby, enabling the electric field in the compression phase of shock wave pulse which can essentially reduce the electric field intensity required for breakdown cell membrane. In usual condition at amplitude of electric field, specified above, electric breakdown membrane carries basically reversible nature. At the same time in the pressure field tension phase of shock-wave pulse reversible pores, created by electric field, can grow before sizes, under which wholeness membrane is not restored. Under simultaneous action on cellular suspension the shock wave and electric field with moderate intensity cells survival is reduced in 5 once in contrast with occuring at different time's action, and in 10 once in contrast with checking. The most sensitive to influence by under study fields are cells in phase of the syntheses DNA, preparation to fission and in phase of the mitosis. Thereby, continuation of the studies on use synchronous action shock waves and pulsed electric fields in complex treatment of the tumors introduces perspective. PMID:17946761

  13. Treatment with Cationic Liposome-DNA Complexes (CLDC) Protects Mice from Lethal Western Equine Encephalitis Virus (WEEV) Challenge

    PubMed Central

    Logue, Christopher H.; Phillips, Aaron T.; Mossel, Eric C.; Ledermann, Jeremy P.; Welte, Thomas; Dow, Steve W.; Olson, Ken E.; Powers, Ann M.

    2012-01-01

    Having recently characterized a CD-1 outbred mouse model of pathogenesis for Western equine encephalitis virus, we examined the possible protective effects of cationic lipid DNA complexes (CLDC) against encephalitic arboviral infection. In this investigation, mice were pre-treated, co-treated, or post-treated with CLDC then challenged with a subcutaneous or aerosol dose of the highly virulent WEEV McMillan strain, lethal in mice 4-5 days after inoculation. Pre-treatment with CLDC provided a significant protective effect in mice, which was reflected in significantly increased survival rates. Further, in some instances a therapeutic effect of CLDC administration up to 12 hours after WEEV challenge was observed. Mice treated with CLDC had significantly increased serum IFN-?, TNF-?, and IL-12, suggesting a strong Th1-biased antiviral activation of the innate immune system. In virus-infected animals, large increases in production of IFN-?, TNF-?, MCP-1, IL-12, and IL-10 in the brain were observed by 72 hours after infection, consistent with neuroinvasion and viral replication in the CNS. These results indicate that strong non-specific activation of innate immunity with an immune therapeutic such as CLDC is capable of eliciting significant protective immunity against a rapidly lethal strain of WEEV and suggest a possible prophylactic option for exposed individuals. PMID:20452378

  14. Carpal contusions in an elite platform diver.

    PubMed

    Berkoff, David; Boggess, Blake

    2011-01-01

    Wrist and hand injuries are common in elite divers, as all correctly performed dives end with a head first entry into the water with the hands extended above the head. This case presentation was an Olympic level diver with 3 months of persistent dorsal wrist pain. MRI findings showed contiguous contusions to the lunate, capitate, hamate and distal radius and also a peripheral tear of the ulnar attachment of the triangular fibrocartilage complex (TFCC). The repeated dorsiflexion stress of entry into the water likely caused these injuries. Although the authors had suspected a TFCC injury and did find an isolated ulnar-sided peripheral tear, the complicating carpal contusions led us to choose a conservative treatment plan, which was the only intervention the patient ultimately required. PMID:22707598

  15. Carpal contusions in an elite platform diver

    PubMed Central

    Berkoff, David; Boggess, Blake

    2011-01-01

    Wrist and hand injuries are common in elite divers, as all correctly performed dives end with a head first entry into the water with the hands extended above the head. This case presentation was an Olympic level diver with 3 months of persistent dorsal wrist pain. MRI findings showed contiguous contusions to the lunate, capitate, hamate and distal radius and also a peripheral tear of the ulnar attachment of the triangular fibrocartilage complex (TFCC). The repeated dorsiflexion stress of entry into the water likely caused these injuries. Although the authors had suspected a TFCC injury and did find an isolated ulnar-sided peripheral tear, the complicating carpal contusions led us to choose a conservative treatment plan, which was the only intervention the patient ultimately required. PMID:22707598

  16. Dentin Hypersensitivity: Tunicate-Inspired Gallic Acid/Metal Ion Complex for Instant and Efficient Treatment of Dentin Hypersensitivity (Adv. Healthcare Mater. 8/2016).

    PubMed

    Prajatelistia, Ekavianty; Ju, Sung-Won; Sanandiya, Naresh D; Jun, Sang Ho; Ahn, Jin-Soo; Hwang, Dong Soo

    2016-04-01

    Many adults suffer from dentin hypersensitivity during their lifetime, which causes intense and unpleasant pain. A facile and efficient dentin hypersensitivity treatment is presented by J.-S. Ahn, D. S. Wang, and team on page 919. The approach is based on complexes of gallic acid and metal ions, inspired by the tunicate-self healing process. PMID:27091778

  17. Regulation of hippocampal Fas receptor and death-inducing signaling complex after kainic acid treatment in mice.

    PubMed

    Keller, Benjamin; García-Sevilla, Jesús A

    2015-12-01

    Kainic acid (KA)-induced brain neuronal cell death (especially in the hippocampus) was shown to be mainly mediated by the intrinsic (mitochondrial) apoptotic pathway. This study investigated the regulation of the extrinsic apoptotic pathway mediated by Fas ligand/Fas receptor and components of the indispensable death-inducing signaling complex (DISC) in the hippocampus (marked changes) and cerebral cortex (modest changes) of KA-treated mice. KA (45mg/kg) induced a severe behavioral syndrome with recurrent motor seizures (scores; maximal at 60-90min; minimal at 72h) with activation of hippocampal pro-apoptotic JNK (+2.5 fold) and increased GFAP (+57%) and nuclear PARP-1 fragmentation (+114%) 72h post-treatment (delayed neurotoxicity). In the extrinsic apoptotic pathway (hippocampus), KA (72h) reduced Fas ligand (-92%) and Fas receptor aggregates (-24%). KA (72h) also altered the contents of major DISC components: decreased FADD adaptor (-44%), reduced activation of initiator caspase-8 (-47%) and increased survival FLIP-S (+220%). Notably, KA (72h) upregulated the content of anti-apoptotic p-Ser191 FADD (+41%) and consequently the expression of p-FADD/FADD ratio (+1.9-fold), a neuroplastic index. Moreover, the p-FADD dependent transcription factor NF-κB was also increased (+61%) in the hippocampus after KA (72h). The convergent adaptation of the extrinsic apoptotic machinery 72h after KA in mice (with otherwise normal gross behavior) is a novel finding which suggests the induction of survival mechanisms to partly counteract the delayed neuronal death in the hippocampus. PMID:26044520

  18. Temporal changes of symbiont density and host fitness after rifampicin treatment in a whitefly of the Bemisia tabaci species complex.

    PubMed

    Shan, Hong-Wei; Zhang, Chang-Rong; Yan, Ting-Ting; Tang, Hai-Qin; Wang, Xiao-Wei; Liu, Shu-Sheng; Liu, Yin-Quan

    2016-04-01

    Microbial symbionts are essential or important partners to phloem-feeding insects. Antibiotics have been used to selectively eliminate symbionts from their host insects and establish host lines with or without certain symbionts for investigating functions of the symbionts. In this study, using the antibiotic rifampicin we attempted to selectively eliminate certain symbionts from a population of the Middle East-Asia Minor 1 whitefly of the Bemisia tabaci species complex, which harbors the primary symbiont "Candidatus Portiera aleyrodidarum" and two secondary symbionts "Candidatus Hamiltonella defensa" and Rickettsia. Neither the primary nor the secondary symbionts were completely depleted in the adults (F0) that fed for 48 h on a diet treated with rifampicin at concentrations of 1-100 μg/mL. However, both the primary and secondary symbionts were nearly completely depleted in the offspring (F1) of the rifampicin-treated adults. Although the F1 adults produced some eggs (F2), most of the eggs failed to hatch and none of them reached the second instar, and consequently the rifampicin-treated whitefly colony vanished at the F2 generation. Interestingly, quantitative polymerase chain reaction assays showed that in the rifampicin-treated whiteflies, the density of the primary symbiont was reduced at an obviously slower pace than the secondary symbionts. Mating experiments between rifampicin-treated and untreated adults demonstrated that the negative effects of rifampicin on host fitness were expressed when the females were treated by the antibiotic, and whether males were treated or not by the antibiotic had little contribution to the negative effects. These observations indicate that with this whitefly population it is not feasible to selectively eliminate the secondary symbionts using rifampicin without affecting the primary symbiont and establish host lines for experimental studies. However, the extinction of the whitefly colony at the second generation after rifampicin treatment indicates the potential of the antibiotic as a control agent of the whitefly pest. PMID:26412633

  19. IL-2/anti-IL-2 antibody complex treatment inhibits the development but not the progression of herpetic stromal keratitis

    PubMed Central

    Gaddipati, Subhash; Estrada, Kathleen; Rao, Pushpa; Jerome, Andrew David; Suvas, Susmit

    2014-01-01

    Interleukin-2 (IL-2) and anti-IL-2 antibody immune complex has recently been shown to expand the naturally occurring pool of CD4+Foxp3+ regulatory T cells (Foxp3+ Tregs). In this report, we showed that administration of IL-2/anti-IL-2 antibody immunocomplex to C57BL/6 mice, prior to corneal herpes simplex virus-1 (HSV-1) infection, significantly increased the pool of Foxp3+ Tregs when measured at early time-points post-infection. Increased numbers of Foxp3+ Tregs on day 2 and day 4 post-infection resulted in a marked reduction in the development of severe HSK. When compared to corneas from the control group, corneas from the immunocomplex-treated group showed a significant reduction in the amount of infectious virus on day 2 but not on day 4 post-infection. Reduced viral load was associated with two-fold increase in NK cell numbers in corneas from the immunocomplex-treated group of mice. Moreover, a dramatic reduction in the influx of CD4 T cells in inflamed corneas was determined on days 7 and 16 post-infection in the immunocomplex-treated group of infected mice. Immunocomplex treatment given on days 5, 6 and 7 post-infection significantly increased Foxp3+ Tregs in draining lymph nodes and in the spleen but failed to reduce the severity of HSK. In terms of the influx of CD4 T cells and granulocytes into inflamed corneas, no significant differences were noted between both groups of mice on day 16 post-infection. Our findings demonstrate that increasing Foxp3+ Tregs early but not late after infection in secondary lymphoid tissues is more efficacious in controlling the severity of HSK. PMID:25411200

  20. Clinical Health Outcomes Initiative in Comparative Effectiveness for Bipolar Disorder (Bipolar CHOICE): A Pragmatic Trial of Complex Treatment for a Complex Disorder

    PubMed Central

    Nierenberg, Andrew A.; Sylvia, Louisa G.; Leon, Andrew C.; Reilly-Harrington, Noreen; Shesler, Leah W.; McElroy, Susan L.; Friedman, Edward S.; Thase, Michael E.; Shelton, Richard C.; Bowden, Charles; Tohen, Mauricio; Singh, Vivek; Deckersbach, Thilo; Ketter, Terence; Kocsis, James; McInnis, Melvin G.; Schoenfeld, David; Bobo, William V.; Calabrese, Joseph R.

    2015-01-01

    Background Classic and second generation antipsychotic mood stabilizers are recommended for treatment of bipolar disorder, yet there are no randomized comparative effectiveness studies that have examined the “real-world” advantages and disadvantages of these medications Purpose We describe the strategic decisions in the design of the Clinical and Health Outcomes Initiative in Comparative Effectiveness for Bipolar Disorder (Bipolar CHOICE). This paper outlines the key issues and solutions the investigators faced in designing a clinical trial that would maximize generalizability and inform real-world clinical treatment of bipolar disorder. Methods Bipolar CHOICE was a 6-month, multi-site, prospective, randomized clinical trial of outpatients with bipolar disorder. This study compares the effectiveness of quetiapine versus lithium, each with adjunctive personalized treatments. The co-primary outcomes selected are the overall benefits and harms of the study medications (as measured by the Clinical Global Impression-Efficacy Index) and the Necessary Clinical Adjustments (a measure of the number of medication changes). Secondary outcomes are continuous measures of mood, the Framingham General Cardiovascular Risk Score and the Longitudinal Interval Follow up Evaluation Range of Impaired Functioning Tool. Results The final study design consisted of a single-blind, randomized comparative effectiveness trial of quetiapine versus lithium, plus adjunctive personalized treatment (APT), across ten sites. Other important study considerations included limited exclusion criteria to maximize generalizability, flexible dosing of APT medications to mimic real-world treatment, and an intent-to-treat analysis plan. 482 participants were randomized to the study and 364 completed. Limitations The potential limitations of the study include the heterogeneity of APT, selection of study medications, lack of a placebo-control group, and participants’ ability to pay for study medications. Conclusion We expect that this study will inform our understanding of the benefits and harms of lithium, a classic mood stabilizer, compared to quetiapine, a second generation antipsychotic with broad-spectrum activity in bipolar disorder and will provide an example of a well-designed and well-conducted randomized comparative effectiveness clinical trial. PMID:24346608

  1. Control Point Analysis comparison for 3 different treatment planning and delivery complexity levels using a commercial 3-dimensional diode array

    SciTech Connect

    Abdellatif, Ady; Gaede, Stewart

    2014-07-01

    To investigate the use of “Control Point Analysis” (Sun Nuclear Corporation, Melbourne, FL) to analyze and compare delivered volumetric-modulated arc therapy (VMAT) plans for 3 different treatment planning complexity levels. A total of 30 patients were chosen and fully anonymized for the purpose of this study. Overall, 10 lung stereotactic body radiotherapy (SBRT), 10 head-and-neck (H and N), and 10 prostate VMAT plans were generated on Pinnacle{sup 3} and delivered on a Varian linear accelerator (LINAC). The delivered dose was measured using ArcCHECK (Sun Nuclear Corporation, Melbourne, FL). Each plan was analyzed using “Sun Nuclear Corporation (SNC) Patient 6” and “Control Point Analysis.” Gamma passing percentage was used to assess the differences between the measured and planned dose distributions and to assess the role of various control point binning combinations. Of the different sites considered, the prostate cases reported the highest gamma passing percentages calculated with “SNC Patient 6” (97.5% to 99.2% for the 3%, 3 mm) and “Control Point Analysis” (95.4% to 98.3% for the 3%, 3 mm). The mean percentage of passing control point sectors for the prostate cases increased from 51.8 ± 7.8% for individual control points to 70.6 ± 10.5% for 5 control points binned together to 87.8 ± 11.0% for 10 control points binned together (2%, 2-mm passing criteria). Overall, there was an increasing trend in the percentage of sectors passing gamma analysis with an increase in the number of control points binned together in a sector for both the gamma passing criteria (2%, 2 mm and 3%, 3 mm). Although many plans passed the clinical quality assurance criteria, plans involving the delivery of high Monitor Unit (MU)/control point (SBRT) and plans involving high degree of modulation (H and N) showed less delivery accuracy per control point compared with plans with low MU/control point and low degree of modulation (prostate)

  2. Control point analysis comparison for 3 different treatment planning and delivery complexity levels using a commercial 3-dimensional diode array.

    PubMed

    Abdellatif, Ady; Gaede, Stewart

    2014-01-01

    To investigate the use of "Control Point Analysis" (Sun Nuclear Corporation, Melbourne, FL) to analyze and compare delivered volumetric-modulated arc therapy (VMAT) plans for 3 different treatment planning complexity levels. A total of 30 patients were chosen and fully anonymized for the purpose of this study. Overall, 10 lung stereotactic body radiotherapy (SBRT), 10 head-and-neck (H&N), and 10 prostate VMAT plans were generated on Pinnacle(3) and delivered on a Varian linear accelerator (LINAC). The delivered dose was measured using ArcCHECK (Sun Nuclear Corporation, Melbourne, FL). Each plan was analyzed using "Sun Nuclear Corporation (SNC) Patient 6" and "Control Point Analysis." Gamma passing percentage was used to assess the differences between the measured and planned dose distributions and to assess the role of various control point binning combinations. Of the different sites considered, the prostate cases reported the highest gamma passing percentages calculated with "SNC Patient 6" (97.5% to 99.2% for the 3%, 3mm) and "Control Point Analysis" (95.4% to 98.3% for the 3%, 3mm). The mean percentage of passing control point sectors for the prostate cases increased from 51.8 ± 7.8% for individual control points to 70.6 ± 10.5% for 5 control points binned together to 87.8 ± 11.0% for 10 control points binned together (2%, 2-mm passing criteria). Overall, there was an increasing trend in the percentage of sectors passing gamma analysis with an increase in the number of control points binned together in a sector for both the gamma passing criteria (2%, 2mm and 3%, 3mm). Although many plans passed the clinical quality assurance criteria, plans involving the delivery of high Monitor Unit (MU)/control point (SBRT) and plans involving high degree of modulation (H&N) showed less delivery accuracy per control point compared with plans with low MU/control point and low degree of modulation (prostate). PMID:24480374

  3. Reversal of brain metabolic abnormalities following treatment of AIDS dementia complex with 3'-azido-2',3'-dideoxythymidine (AZT, zidovudine): a PET-FDG study

    SciTech Connect

    Brunetti, A.; Berg, G.; Di Chiro, G.; Cohen, R.M.; Yarchoan, R.; Pizzo, P.A.; Broder, S.; Eddy, J.; Fulham, M.J.; Finn, R.D.

    1989-05-01

    Brain glucose metabolism was evaluated in four patients with acquired immunodeficiency syndrome (AIDS) dementia complex using (/sup 18/F)fluorodeoxyglucose (FDG) and positron emission tomography (PET) scans at the beginning of therapy with 3'-azido-2',3'-dideoxythymidine (AZT, zidovudine), and later in the course of therapy. In two patients, baseline, large focal cortical abnormalities of glucose utilization were reversed during the course of therapy. In the other two patients, the initial PET study did not reveal pronounced focal alterations, while the post-treatment scans showed markedly increased cortical glucose metabolism. The improved cortical glucose utilization was accompanied in all patients by immunologic and neurologic improvement. PET-FDG studies can detect cortical metabolic abnormalities associated with AIDS dementia complex, and may be used to monitor the metabolic improvement in response to AZT treatment.

  4. Colletotrichum truncatum species complex: Treatment considerations and review of the literature for an unusual pathogen causing fungal keratitis and endophthalmitis

    PubMed Central

    Squissato, Victoria; Yucel, Yeni H.; Richardson, Susan E.; Alkhotani, Alaa; Wong, David T.; Nijhawan, Navdeep; Chan, Clara C.

    2015-01-01

    We present a case of Colletotrichum truncatum species complex fungal keratitis and endophthalmitis in an 87-year-old immunocompetent male in whom oral triazole antifungals were contraindicated. The patient had recently returned from 4 months in Jamaica with a one month history of progressively increasing pain and inflammation in his left eye. Corneal samples grew a filamentous fungus and internal transcribed spacer sequencing polymerase chain reaction confirmed the presence of C. truncatum species complex. Samples showed no microbial growth. PMID:26137437

  5. Operation of a two-stage treatment train for the remediation of volatile organic compounds (VOCs) from a complex air stream

    SciTech Connect

    Manninen, M.R.; Kleinheinz, G.T.; Niemi, B.A.; Hose, J.T.

    1999-07-01

    The use of aqueous biological systems to remove contaminants from waste streams has been well documented. However, in complex waste streams containing compounds of varying chemical properties, the use of only one type of treatment system may not be the best alternative. When treating a complex waste stream, the use of treatment trains, or coupled systems, may be advantageous when compared with any single technology. The purpose of this project was to design and operate a treatment train for the effective removal and biodegradation of a complex mixture of VOCs with varying chemical properties. A bench-scale system was designed consisting of a liquid bioreactor coupled to a biofilter for removal of acetone, methanol, methyl ethyl ketone, naphthalene, alpha-pinene, and toluene. The liquid bioreactor contained an aqueous medium and an inert solid support (polystyrene bioballs) which immobilized a characterized microbial population. The biofiltration portion of the system utilized the same microbial inoculum, but employed Douglas fir bark as its solid support. As the air stream bubbled into the liquid bioreactor, the VOCs were made available to the bacteria for destruction in the aqueous medium or on the polystyrene solid support. The fugitive VOCs from the liquid bioreactor were then subsequently treated by the biofiltration unit. The six-compound VOC mixture was added to the air stream via in-line syringe pump injection. Concentrations of the VOC mixture in the main influent air stream, the effluent air stream from the liquid bioreactor, the aqueous medium in the liquid bioreactor, and the effluent air stream from the biofilter were monitored on a regular basis via an on-line gas chromatograph with a flame ionization detector (GC-FID). Successful biodegradation of the complex VOC mixture was accomplished with this treatment train, the average total VOC removal efficiency being 96.2% ({+-}2.6).

  6. Budesonide-hydroxypropyl-β-cyclodextrin inclusion complex in binary poloxamer 407/403 system for ulcerative colitis treatment: A physico-chemical study from micelles to hydrogels.

    PubMed

    Santos Akkari, Alessandra Cristina; Ramos Campos, Estefânia Vangelie; Keppler, Artur Franz; Fraceto, Leonardo Fernandes; de Paula, Eneida; Tófoli, Giovana Radomille; de Araujo, Daniele Ribeiro

    2016-02-01

    Budesonide (BUD) is a glucocorticoid widely used for the treatment of ulcerative colitis. In this work, we propose the study of the system BUD-HP-β-CD inclusion complex incorporated into PL 407 and PL407-PL403 thermoreversible hydrogels, considering physico-chemical and pharmaceutical aspects. Complexation between BUD and HP-β-CD was confirmed by phase solubility studies (1:1 stoichiometry, Kc=8662.8 M(-1)), DSC, FTIR and microscopy analyzes. BUD solubility in simulated upper and lower colon fluids was improved in a dependence of HP-β-CD and PL 407 or PL407-PL403 association. Micellar hydrodynamic diameter studies showed the interaction between HP-β-CD and PL blocks, as well as the reorganization of the micellar system in the presence of BUD and its inclusion complex. Micellization temperature (Tm) was not shifted, but sol-gel phase transition studies showed that in the presence of BUD, HP-β-CD or BUD:HP-β-CD complex, the association PL407-PL403 favored the gel formation close to the physiological temperature. Physico-chemical and in vitro release assays studies revealed no competitive displacement of BUD from the HP-β-CD cavity evoked by PL407 or PL407-PL403 addition. These findings point out the BUD-HP-β-CD in PL-based hydrogels as strategies for future investigations on development of new pharmaceutical formulations for the treatment of ulcerative colitis. PMID:26674842

  7. [Peloid therapy in the complex sanatorium treatment of children of early age with complications of perinatal brain damage].

    PubMed

    Ponomareva, S O; Babina, L M

    2003-01-01

    The search for novel approaches to multimodality prophylaxis and treatment of sequelae of perinatal nervous system affection as well as introduction of the early diagnostic criteria are topical problems in present-day pediatric neurology. Peloid therapy efficacy in combined sanatorium treatment was studied (Peloterm unit) in 44 infants aged 1 to 3 years. They suffered from sequelae of perinatal affections of the central nervous system including infantile cerebral paralysis. A positive effect (improvement of motor and psychic-speech development) was achieved in 98% cases. This indicates validity of this method in the treatment of CNS affections following perinatal affection of the brain in infants over 1 year of age. PMID:14753007

  8. Complex decongestive physical therapy and low-level laser therapy for the treatment of pediatric congenital lymphedema: a case report

    PubMed Central

    Hwang, Woon Taek; Chung, Sin Ho; Lee, Ju Sang

    2015-01-01

    [Purpose] We report the case of a pediatric patient with congenital lymphedema treated with complex decongestive physical therapy and low-level laser therapy. [Subjects and Methods] The patient was a 2 year-old girl who had lymphedema in the left upper limb since birth. Complex decongestive physical therapy and low-level laser therapy were administered for 7 sessions. [Results] The circumferences of the middle of the forearm, elbow joint, wrist, and hand of the left upper limb decreased 0.5, 3, 0.5, and 2 cm, respectively. The moisture content of the left upper limb decreased 70 mL (6.66%), while moisture ratio increased by 0.007%. [Conclusion] Complex decongestive physical therapy and low-level laser therapy are effective for reducing lymphedema in pediatric patients. PMID:26180372

  9. Photo-activatable ternary complex based on a multifunctional shielding material for targeted shRNA delivery in cancer treatment.

    PubMed

    Park, Sin-Jung; Park, Wooram; Na, Kun

    2013-11-01

    A photo-activatable ternary complex (PTC) consisting of multifunctional shielding material (MSM) with photosensitizer (PS)-conjugated chondroitin sulfate and polyethyleneimine based binary complexes containing epidermal growth factor receptor (EGFR)-shRNA delivery for CD44 targeted cancer therapy has been developed. The PTC has a negative surface charge of -37.9 mV, and a size of approximately 90 nm, and the ternary complexes were found to be stable against plasma proteins. The stable nanostructure of PTC especially could enable CD44-receptor mediated tumor-targeted delivery and PS-mediated endosomal disruption for efficient gene silencing, and an enhanced rate of cancer cell death was achieved both in vitro and in vivo. This suggests that PTC could represent a promising strategy for the delivery of other therapeutic genes for cancer therapy. PMID:23968856

  10. Analysis of lignin-carbohydrate and lignin-lignin linkages after hydrolase treatment of xylan-lignin, glucomannan-lignin and glucan-lignin complexes from spruce wood.

    PubMed

    Du, Xueyu; Pérez-Boada, Marta; Fernández, Carmen; Rencoret, Jorge; del Río, José C; Jiménez-Barbero, Jesús; Li, Jiebing; Gutiérrez, Ana; Martínez, Angel T

    2014-05-01

    Xylan-lignin (XL), glucomannan-lignin (GML) and glucan-lignin (GL) complexes were isolated from spruce wood, hydrolyzed with xylanase or endoglucanase/β-glucosidase, and analyzed by analytical pyrolysis and 2D-NMR. The enzymatic hydrolysis removed most of the polysaccharide moieties in the complexes, and the lignin content and relative abundance of lignin-carbohydrate linkages increased. Analytical pyrolysis confirmed the action of the enzymatic hydrolysis, with strong decreases of levoglucosane and other carbohydrate-derived products. Unexpectedly it also revealed that the hydrolase treatment alters the pattern of lignin breakdown products, resulting in higher amounts of coniferyl alcohol. From the anomeric carbohydrate signals in the 2D-NMR spectra, phenyl glycoside linkages (undetectable in the original complexes) could be identified in the hydrolyzed GML complex. Lower amounts of glucuronosyl and benzyl ether linkages were also observed after the hydrolysis. From the 2D-NMR spectra of the hydrolyzed complexes, it was concluded that the lignin in GML is less condensed than in XL due to its higher content in β-O-4' ether substructures (62 % of side chains in GML vs 53 % in XL) accompanied by more coniferyl alcohol end units (16 vs 13 %). In contrast, the XL lignin has more pinoresinols (11 vs 6 %) and dibenzodioxocins (9 vs 2 %) than the GML (and both have ~13 % phenylcoumarans and 1 % spirodienones). Direct 2D-NMR analysis of the hydrolyzed GL complex was not possible due to its low solubility. However, after sample acetylation, an even less condensed lignin than in the GML complex was found (with up to 72 % β-O-4' substructures and only 1 % pinoresinols). The study provides evidence for the existence of structurally different lignins associated to hemicelluloses (xylan and glucomannan) and cellulose in spruce wood and, at the same time, offers information on some of the chemical linkages between the above polymers. PMID:24531838

  11. A clinical study to identify the possible etiology of complex partial seizures using magnetic resonance imaging brain findings and its implications on treatment

    PubMed Central

    Jeniffer, V. Nancy; Udayakumar, S.; Pushpalatha, K.

    2015-01-01

    Context: Epilepsy is one of the common neurological disorders worldwide. Fundamentally, there are two types of epilepsy—primary generalized epilepsy and localization-related epilepsy. Partial seizures account for about 40% of childhood seizures in some series and can be classified as simple or complex.[1] Partial seizures, more so the complex partial seizures (CPSs), are presumed to have a structural etiology. Aims: (1) To study the magnetic resonance imaging (MRI) brain findings in CPSs in children aged 1–18 years. (2) To identify treatable causes of CPSs based on MRI findings and institute appropriate treatment. Statistical Analysis: Statistical analysis was performed using percentages and proportions. Methods: Hospital based prospective study in which MRI brain was done on all newly diagnosed children with complex partial seizures, aged 1 to 18 yrs, during the study period. Final diagnosis was made correlating clinical features, radiological features and other supportive evidences, and appropriate treatment instituted. Follow up of cases was done until the completion of treatment (maximum 6 months). Results: Among the 64 children who were clinically diagnosed to have CPSs and subjected to MRI study of the brain, 40(62.5%) children were detected to have structural lesions, of which neurocysticercosis (NCC) was noted in 17 (42.5%), tuberculoma in 12 (30%), hippocampal sclerosis (HS) in 6 (15%), gliosis in 4 (10%), and tumor in 1 (2.5%) patient. Sixty-two (96.8%) children were treated medically, and 2 (3.2%) children underwent surgery. Conclusions: Etiology of CPS based on MRI findings showed a substantial number of medically- and surgically-treatable pathologies. This study done on South Indian children showed neuro infections to be the most common cause of CPS, followed by HS, with NCC being the most common lesion noted. MRI not only identifies specific epileptogenic substrates, but also determines the specific treatment and predicts prognosis and should be the imaging modality of choice in the evaluation of CPS. PMID:26962341

  12. Illustrating idiographic methods for translation research: moderation effects, natural clinical experiments, and complex treatment-by-subgroup interactions.

    PubMed

    Ridenour, Ty A; Wittenborn, Andrea K; Raiff, Bethany R; Benedict, Neal; Kane-Gill, Sandra

    2016-03-01

    A critical juncture in translation research involves the preliminary studies of intervention tools, provider training programs, policies, and other mechanisms used to leverage knowledge garnered at one translation stage into another stage. Potentially useful for such studies are rigorous techniques for conducting within-subject clinical trials, which have advanced incrementally over the last decade. However, these methods have largely not been utilized within prevention or translation contexts. The purpose of this manuscript is to demonstrate the flexibility, wide applicability, and rigor of idiographic clinical trials for preliminary testing of intervention mechanisms. Specifically demonstrated are novel uses of state-space modeling for testing intervention mechanisms of short-term outcomes, identifying heterogeneity in and moderation of within-person treatment mechanisms, a horizontal line plot to refine sampling design during the course of a clinic-based experimental study, and the need to test a treatment's efficacy as treatment is administered along with (e.g., traditional 12-month outcomes). PMID:27012260

  13. [Efficacy of application of thiopoietines in complex of treatment of an acute adhesive ileus in patients with hepatic function disorder].

    PubMed

    Vansovych, V Ie; Il'ïna-Stogniienko, V Iu

    2012-11-01

    The peculiarities of an acute adhesive ileus (AAI) course in patients, suffering hepatic function disorder (HFD), were studied up, the additions to the conservative treatment scheme were proposed. There was established, that while HFD presence in the patients the trustworthy enhanced recurrence rate of adhesive disease is observed after operations, performed for AAM, The adhesive disease recurrence rate do not depend on the surgical access kind. Application of preparations, related to thiopoietins group and hepatoprotectors, while AAI treatment conduction, have promoted reduction of the peritoneal adhesive disease recurrence rate in terms of the three years postoperative follow-up. PMID:23272389

  14. Comparative effectiveness of a complex Ayurvedic treatment and conventional standard care in osteoarthritis of the knee – study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Traditional Indian Ayurvedic medicine uses complex treatment approaches, including manual therapies, lifestyle and nutritional advice, dietary supplements, medication, yoga, and purification techniques. Ayurvedic strategies are often used to treat osteoarthritis (OA) of the knee; however, no systematic data are available on their effectiveness in comparison with standard care. The aim of this study is to evaluate the effectiveness of complex Ayurvedic treatment in comparison with conventional methods of treating OA symptoms in patients with knee osteoarthritis. Methods and design In a prospective, multicenter, randomized controlled trial, 150 patients between 40 and 70 years, diagnosed with osteoarthritis of the knee, following American College of Rheumatology criteria and an average pain intensity of ≥40 mm on a 100 mm visual analog scale in the affected knee at baseline will be randomized into two groups. In the Ayurveda group, treatment will include tailored combinations of manual treatments, massages, dietary and lifestyle advice, consideration of selected foods, nutritional supplements, yoga posture advice, and knee massage. Patients in the conventional group will receive self-care advice, pain medication, weight-loss advice (if overweight), and physiotherapy following current international guidelines. Both groups will receive 15 treatment sessions over 12 weeks. Outcomes will be evaluated after 6 and 12 weeks and 6 and 12 months. The primary endpoint is a change in the score on the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) after 12 weeks. Secondary outcome measurements will use WOMAC subscales, a pain disability index, a visual analog scale for pain and sleep quality, a pain experience scale, a quality-of-life index, a profile of mood states, and Likert scales for patient satisfaction, patient diaries, and safety. Using an adapted PRECIS scale, the trial was identified as lying mainly in the middle of the efficacy-effectiveness continuum. Discussion This trial is the first to compare the effectiveness of a complex Ayurvedic intervention with a complex conventional intervention in a Western medical setting in patients with knee osteoarthritis. During the trial design, aspects of efficacy and effectiveness were discussed. The resulting design is a compromise between rigor and pragmatism. Trial registration NCT01225133 PMID:23701973

  15. Combined treatment of L5187Y-R and L5178Y-S cells with an antitumor platinum complex (cis-PAD) and ultraviolet light

    SciTech Connect

    Szumiel, I.

    1980-02-01

    L5178Y-R and L5178Y-S murine lymphoma cells, cross-sensitive to ultraviolet (UV) light and the antitumor platinum complex cis-PAD, were subjected to combined treatment using both these agents. The cis-PAD dose used for pre-treatment 1 hr before UV-irradiation reduced survival to about 10%. The results of such treatment were analyzed by constructing isobolograms at several log cell kill levels. In both L5178Y strains the same effect was seen: the results of combined treatment were more than additive at UV fluences; this reduced survival to not more than 0.001; sub-additive results occurred at survival levels below 0.001. The similarity of effects of combined treatment in two cell strains that differed in ability to repair ultraviolet (UV) and cis-PAD-inflicted damage, indicates that the described change from supra-additivity to sub-additivity may not depend on repair processes, but rather on the nature of DNA damage produced by both agents.

  16. Thermal treatment effects imposed on solid DNA cationic lipid complex with hexadecyltrimethylammonium chloride, observed by variable angle spectroscopic ellipsometry

    SciTech Connect

    Nizioł, Jacek

    2014-12-21

    DNA cationic lipid complexes are materials of properties required for applications in organic electronics and optoelectronics. Often, their thermal stability demonstrated by thermogravimetry is cited in the literature as important issue. However, little is known about processes occurring in heated solid DNA cationic lipid complexes. In frame of this work, thin films of Deoxyribonucleic acid-hexadecyltrimethylammonium chloride (DNA-CTMA) were deposited on silicon wafers. Samples were thermally annealed, and simultaneously, their optical functions were measured by spectroscopic ellipsometry. At lower temperatures, thermal expansion coefficient of solid DNA-CTMA was negative, but at higher temperatures positive. Thermally induced modification of absorption spectrum in UV-vis was observed. It occurred at a range of temperatures higher than this of DNA denaturation in solution. The observed phenomenon was irreversible, at least in time scale of the experiment (one day)

  17. Thermal treatment effects imposed on solid DNA cationic lipid complex with hexadecyltrimethylammonium chloride, observed by variable angle spectroscopic ellipsometry

    NASA Astrophysics Data System (ADS)

    Nizioł, Jacek

    2014-12-01

    DNA cationic lipid complexes are materials of properties required for applications in organic electronics and optoelectronics. Often, their thermal stability demonstrated by thermogravimetry is cited in the literature as important issue. However, little is known about processes occurring in heated solid DNA cationic lipid complexes. In frame of this work, thin films of Deoxyribonucleic acid-hexadecyltrimethylammonium chloride (DNA-CTMA) were deposited on silicon wafers. Samples were thermally annealed, and simultaneously, their optical functions were measured by spectroscopic ellipsometry. At lower temperatures, thermal expansion coefficient of solid DNA-CTMA was negative, but at higher temperatures positive. Thermally induced modification of absorption spectrum in UV-vis was observed. It occurred at a range of temperatures higher than this of DNA denaturation in solution. The observed phenomenon was irreversible, at least in time scale of the experiment (one day).

  18. Theoretical treatment of helix-coil transition of complexes DNA with two different ligands having different binding parameters.

    PubMed

    Karapetian, Armen T; Grigoryan, Zareh A; Mamasakhlisov, Yevgeni Sh; Minasyants, Mikayel V; Vardevanyan, Poghos O

    2016-01-01

    The melting transition of DNA-ligand complexes, allowing for two binding mechanisms to different DNA conformations is treated theoretically. The obtained results express the behavior of the experimentally measurable quantities, degree of denaturation, and concentrations of bound ligands on the temperature. The range of binding parameters is obtained, where denaturation curves become multiphasic. The possible application to the nanocomposites crystallization is discussed. PMID:25723721

  19. Treatment of complex nonunion of the shaft of the tibia using Ilizarov technique and its functional outcome

    PubMed Central

    Sahu, Ramji Lal; Ranjan, Rajni

    2016-01-01

    Background: A complex nonunion of the shaft of the tibia is a major cause of morbidity and mortality in patients with lower extremity injuries. Aims: The aim of this study was to evaluate the outcome of the functional and radiological outcome of complex nonunion shaft of tibia, treated by radical debridement, Ilizarov ring fixator with compression and distraction osteogenesis. Methods: From 2005 to 2010, sixty cases of complex nonunion shaft of tibia were included in our study. All infected nonunions were managed by radical debridement, fixed with Ilizarov ring fixator, monofocal/bifocal compression, and distraction osteogenesis. The average duration of follow-up is 36 months (26–50 months). The functional evaluation was done by using Association for the Study and Application of Methods of Ilizarov (ASAMI) scoring system and bone union with serial radiographs. Results: All patients had a successful union. The mean time for union was 7 months (5–9 months). The mean time of fixator removal is 12 months (8–14 months). Every patient had pin tract infections which were successfully treated with oral antibiotics. Four patients had an equinus deformity, one patient had insignificant limb shortening (1.5 cm), and three patients had soft tissue dystrophy. Using the ASAMI scoring system, we obtained 45 excellent, 10 good, 3 fair, and 2 poor functional results. Conclusions: The Ilizarov technique for complex nonunions has a high rate of success in achieving union and eradicating infection, bone loss, and malalignment. Radical debridement is the key step to control bone infection. PMID:27226689

  20. Integrating sequencing batch reactor with bio-electrochemical treatment for augmenting remediation efficiency of complex petrochemical wastewater.

    PubMed

    Yeruva, Dileep Kumar; Jukuri, Srinivas; Velvizhi, G; Naresh Kumar, A; Swamy, Y V; Venkata Mohan, S

    2015-01-01

    The present study evaluates the sequential integration of two advanced biological treatment methods viz., sequencing batch reactor (SBR) and bioelectrochemical treatment systems (BET) for the treatment of real-field petrochemical wastewater (PCW). Initially two SBR reactors were operated in aerobic (SBR(Ae)) and anoxic (SBR(Ax)) microenvironments with an organic loading rate (OLR) of 9.68 kg COD/m(3)-day. Relatively, SBR(Ax) showed higher substrate degradation (3.34 kg COD/m(3)-day) compared to SBR(Ae) (2.9 kg COD/m(3)-day). To further improve treatment efficiency, the effluents from SBR process were fed to BET reactors. BET(Ax) depicted higher SDR (1.92 kg COD/m(3)-day) with simultaneous power generation (17.12 mW/m(2)) followed by BET(Ae) (1.80 kg COD/m(3)-day; 14.25 mW/m(2)). Integrating both the processes documented significant improvement in COD removal efficiency due to the flexibility of combining multiple microenvironments sequentially. Results were supported with GC-MS and FTIR, which confirmed the increment in biodegradability of wastewater. PMID:25752866

  1. A Unified Treatment of the Relationship Between Ligand Substituents and Spin State in a Family of Iron(II) Complexes

    PubMed Central

    Kershaw Cook, Laurence J.; Kulmaczewski, Rafal; Mohammed, Rufeida; Dudley, Stephen; Barrett, Simon A.; Little, Marc A.

    2016-01-01

    Abstract The influence of ligands on the spin state of a metal ion is of central importance for bioinorganic chemistry, and the production of base‐metal catalysts for synthesis applications. Complexes derived from [Fe(bpp)2]2+ (bpp=2,6‐di{pyrazol‐1‐yl}pyridine) can be high‐spin, low‐spin, or spin‐crossover (SCO) active depending on the ligand substituents. Plots of the SCO midpoint temperature (T 1/2 ) in solution vs. the relevant Hammett parameter show that the low‐spin state of the complex is stabilized by electron‐withdrawing pyridyl (“X”) substituents, but also by electron‐donating pyrazolyl (“Y”) substituents. Moreover, when a subset of complexes with halogeno X or Y substituents is considered, the two sets of compounds instead show identical trends of a small reduction in T 1/2 for increasing substituent electronegativity. DFT calculations reproduce these disparate trends, which arise from competing influences of pyridyl and pyrazolyl ligand substituents on Fe‐L σ and π bonding. PMID:26929084

  2. A Unified Treatment of the Relationship Between Ligand Substituents and Spin State in a Family of Iron(II) Complexes.

    PubMed

    Kershaw Cook, Laurence J; Kulmaczewski, Rafal; Mohammed, Rufeida; Dudley, Stephen; Barrett, Simon A; Little, Marc A; Deeth, Robert J; Halcrow, Malcolm A

    2016-03-18

    The influence of ligands on the spin state of a metal ion is of central importance for bioinorganic chemistry, and the production of base-metal catalysts for synthesis applications. Complexes derived from [Fe(bpp)2 ](2+) (bpp=2,6-di{pyrazol-1-yl}pyridine) can be high-spin, low-spin, or spin-crossover (SCO) active depending on the ligand substituents. Plots of the SCO midpoint temperature (T1/2 ) in solution vs. the relevant Hammett parameter show that the low-spin state of the complex is stabilized by electron-withdrawing pyridyl ("X") substituents, but also by electron-donating pyrazolyl ("Y") substituents. Moreover, when a subset of complexes with halogeno X or Y substituents is considered, the two sets of compounds instead show identical trends of a small reduction in T1/2 for increasing substituent electronegativity. DFT calculations reproduce these disparate trends, which arise from competing influences of pyridyl and pyrazolyl ligand substituents on Fe-L σ and π bonding. PMID:26929084

  3. Fertility-preserving treatment in complex atypical hyperplasia and early endometrial cancer in young women with oral progestin: Is it effective?

    PubMed Central

    Baek, Ji Sun; Lee, Wan Ho; Kang, Woo Dae

    2016-01-01

    Objective The aim of this study is to assess the effectiveness of oral progestin treatment in women diagnosed with complex atypical hyperplasia (CAH) or grade 1 endometrial cancer (G1EC), who desire to preserve their fertility, as alternative treatment to a hysterectomy. Methods We reviewed the medical records of women younger than 45 years old that had been diagnosed with CAH or G1EC, who expressed a desire to preserve their fertility using alternative treatment at our institution. Women without evidence of myometrial invasion on pelvic magnetic resonance imaging scans were included. The study period was between 2004 and 2014. Endometrial biopsies were taken at follow-up appointments. Results We identified 31 young women with CAH or G1EC. The median age was 33 years old (range, 20 to 41), and the median period of time undertaking the treatment was 5 months (range, 1 to 12). Twenty-three patients (74.2%) achieved complete remission (CR; median time to CR was 3 months; range, 1 to 22), 16 patients (88.9%) with CAH and 7 (53.8%) with G1EC achieved CR. 6 patients (26.1%) who had achieved CR, had recurrence of the disease (median time from CR to recurrence was 12.5 months; range, 4 to 18). Eight patients (25.8%) finally underwent a hysterectomy. Conclusion Oral progestin therapy is an alternative treatment for women with CAH or G1EC who desire fertility preservation. However, more prospective studies are needed for standard progestin regimen. Also, there still remains a risk of disease progression and recurrence. Therefore, close follow-up is important during treatment and after CR. In addition, a hysterectomy is recommended as a definitive treatment after completion of childbearing. PMID:26866032

  4. The study of the complexes of nitromedicine with cytochrome c and NO-containing aqueous dosage form in the wound treatment of rats.

    PubMed

    Korobko, V M; Melnikova, N B; Panteleev, D A; Martusevich, A K; Peretyagin, S P

    2014-11-15

    The interaction of cytochrome c with nitromedicines, such as 5-nitrofural, 5-nitroxoline, metronidazole and sodium nitrite which enables the generation of nitric oxide or nitrosyl complexes in the presence of ascorbic acid or sodium ascorbate in acid medium has been investigated. The pharmaceutical compositions containing cytochrome c and nitromedicine complexes as active substances were studied in the experiments by using rats. It has been shown that positive local and systemic effects were estimated when NO-containing gel was used at burn treatment. These positive effects at the local level are due to a sufficient microcirculation index which indicates intensification of the blood flow in the microvessels in the injured area. These effects at the systemic level provide maintenance of the general heart rhythm and gradual recovery of the vegetative balance which is not observed in the animals of the control group. PMID:25135208

  5. Two-stage total hip arthroplasty for complex pelvic abnormalities: Example of hip arthrodesis conversion with concomitant treatment of pelvic and acetabular non-union.

    PubMed

    Jacquot, A; Goetzmann, T; Jullion, S; Sirveaux, F; Molé, D; Roche, O

    2016-06-01

    Hip prosthesis implantation requires a stable pelvic foundation, which may be lacking in patients with complex pelvic abnormalities (e.g., arthrodesis conversion, tumour excision, or revision with large bony defects). Many reconstructive options exist for these situations, but their outcomes vary with the initial amount of bone loss and with the technique used. We describe a two-stage arthroplasty technique (acetabular cup first, then femoral stem) and report its use in a case of arthrodesis conversion with concomitant treatment of pelvic and acetabular non-union. Clinical and radiological outcomes after 5 years are reported. This procedure can be adapted to the most complex cases of pelvic reconstruction. PMID:27052938

  6. Alternative hybrid and staged interventional treatment of congenital heart defects in critically ill children with complex and non-cardiac problems

    PubMed Central

    Chojnicki, Maciej; Jaworski, Radosław; Steffens, Mariusz; Szofer-Sendrowska, Aneta; Paczkowski, Konrad; Kwaśniak, Ewelina; Zieliński, Jacek; Gierat-Haponiuk, Katarzyna; Leszczyńska, Katarzyna

    2015-01-01

    Introduction An individually designed strategy of comprehensive alternative hybrid and staged interventional treatment (AHASIT) can be a reasonable alternative to conventional treatment of congenital heart defects, reduce the risk of cardiac surgery or interventions performed separately, and give an additional chance for critically ill children. Aim To present our experience and the results of AHASIT of severely ill or borderline children referred for surgery with the diagnosis of congenital heart defects. Material and methods A group of 22 patients with complex cardiac and non-cardiac pathologies was retrospectively selected and analyzed. An individual preoperative severity scale was established for AHASIT patients, with one point for each of the following preoperative complications: prematurity, low body weight, cyanosis, intolerance to drug therapy, failed interventional treatment prior to admission, mechanical ventilation prior to the procedure, chronic respiratory failure and non-cardiac, mainly congenital malformations (congenital diaphragmatic hernia, lower extremity agenesia, duodenal atresia) and acquired problems (newborn edema, necrotic enterocolitis, intracranial hemorrhage, liver and renal failure, anemia and thrombocytopenia, infections or colonization with drug-resistant pathogens). Results The analysis of the postoperative course showed that the patients with 5 AHASIT points or more had a more complicated postoperative course than the patients with 1 to 4 AHASIT points. Conclusions The AHASIT of pediatric congenital heart defects with complex and non-cardiac problems appeared to be an attractive option for selected severely ill patients. The strategy was found to be effective in selected neonates suffering from complex and accompanying non-cardiac pathologies, with positive final results of both cardiological intervention and planned surgery. PMID:26240625

  7. WE-F-16A-06: Using 3D Printers to Create Complex Phantoms for Dose Verification, Quality Assurance, and Treatment Planning System Commissioning in Radiotherapy

    SciTech Connect

    Kassaee, A; Ding, X; McDonough, J; Reiche, M; Witztum, A; Teo, B

    2014-06-15

    Purpose: To use 3D printers to design and construct complex geometrical phantoms for commissioning treatment planning systems, dose calculation algorithms, quality assurance (QA), dose delivery, and patient dose verifications. Methods: In radiotherapy, complex geometrical phantoms are often required for dose verification, dose delivery and calculation algorithm validation. Presently, fabrication of customized phantoms is limited due to time, expense and challenges in machining of complex shapes. In this work, we designed and utilized 3D printers to fabricate two phantoms for QA purposes. One phantom includes hills and valleys (HV) for verification of intensity modulated radiotherapy for photons, and protons (IMRT and IMPT). The other phantom includes cylindrical cavities (CC) of various sizes for dose verification of inhomogeneities. We evaluated the HV phantoms for an IMPT beam, and the CC phantom to study various inhomogeneity configurations using photon, electron, and proton beams. Gafcromic ™ films were used to quantify the dose distributions delivered to the phantoms. Results: The HV phantom has dimensions of 12 cm × 12 cm and consists of one row and one column of five peaks with heights ranging from 2 to 5 cm. The CC phantom has a size 10 cm × 14 cm and includes 6 cylindrical cavities with length of 7.2 cm and diameters ranging from 0.6 to 1.2 cm. The IMPT evaluation using the HV phantom shows good agreement as compared to the dose distribution calculated with treatment planning system. The CC phantom also shows reasonable agreements for using different algorithms for each beam modalities. Conclusion: 3D printers with submillimiter resolutions are capable of printing complex phantoms for dose verification and QA in radiotherapy. As printing costs decrease and the technology becomes widely available, phantom design and construction will be readily available to any clinic for testing geometries that were not previously feasible.

  8. [Estimation of complex surgical treatment effectiveness of lower limbs infected ulcers in patients with diabetic foot syndrome].

    PubMed

    Krymets', S A

    2013-08-01

    In a comparative aspect studied outcomes infected ulcers of the lower limbs in 169 patients with diabetic foot syndrome II - IV degree (from Meggit-Wagner). Analyzed the effectiveness of comprehensive conservative and surgical treatment of patients based on the regression of neurological symptoms by performance scales Total Symptom Score and Neuropathy Impairment Score Lower Limbs, as well the results of operative wound healing. PMID:24171289

  9. Complex-Scaling Treatment for Doubly Excited Inter-Shell Resonances in H- Interacting with Screened Coulomb (Yukawa) Potentials

    NASA Astrophysics Data System (ADS)

    Ho, Y. K.; Kar, S.

    2012-10-01

    The doubly-excited inter-shell resonance states of the hydrogen negative ion with screened Coulomb potentials are investigated in the framework of complex-scaling method. Highly correlated wave functions with terms up to 1078 in Hylleraas coordinates are used. The resonance parameters for the 2 s3 s 1 S e associated with the H ( N = 2) threshold and the 3 s4 s 1 S e state associated with the H ( N = 3) threshold for various screening strengths are reported. Comparisons are made with other available data in the literature.

  10. Materials and Fuels Complex Hazardous Waste Management Act/Resource Conservation and Recovery Act Storage and Treatment Permit Reapplication, Environmental Protection Agency Number ID4890008952

    SciTech Connect

    Holzemer, Michael J.; Hart, Edward

    2015-04-01

    Hazardous Waste Management Act/Resource Conservation and Recovery Act Storage and Treatment Permit Reapplication for the Idaho National Laboratory Materials and Fuels Complex Hazardous Waste Management Act/Resource Conservation and Recovery Act Partial Permit, PER-116. This Permit Reapplication is required by the PER-116 Permit Conditions I.G. and I.H., and must be submitted to the Idaho Department of Environmental Quality in accordance with IDAPA 58.01.05.012 [40 CFR §§ 270.10 and 270.13 through 270.29].

  11. The combined treatment with novel platinum(II) complex and anti-MUC1 increases apoptotic response in MDA-MB-231 breast cancer cells.

    PubMed

    Gornowicz, Agnieszka; Bielawska, Anna; Czarnomysy, Robert; Gabryel-Porowska, Halina; Muszyńska, Anna; Bielawski, Krzysztof

    2015-10-01

    New strategy of cancer's targeting treatment is combining monoclonal antibodies with chemotherapeutic agents. An important goal of targeted therapy appears to be a transmembrane glycoprotein type I-mucin 1 (MUC1), which is overexpressed in tumors of epithelial origin, especially in breast cancer. The goal of the study was to check the effect of monoclonal antibody against MUC1 with novel platinum(II) complex (Pt12) on selected aspects of apoptosis in human MDA-MB-231 breast cancer cells. The number of apoptotic and necrotic cells was measured using annexin V binding assay. The decrease of mitochondrial membrane potential (MMP) and DNA fragmentation was analyzed. Finally, the influence of novel platinum(II) complex (Pt12) used with anti-MUC1 on the concentration of selected markers of apoptosis such as Bax, caspase-8, -9, and caspase-3 was performed using ELISA. The results from combined treatment were compared with those obtained using monotherapy. In our study, we proved that anti-MUC1 used in combination with Pt12 strongly induced apoptosis in MDA-MB-231 breast cancer cell line. The effect was stronger than treatment with Pt12, cisplatin, anti-MUC1, and anti-MUC1 used with cisplatin. We also observed the highest decrease of MMP and the strongest DNA fragmentation after such a combined treatment. The results obtained from ELISA showed increased concentration of Bax, caspases-8, -9, -3 compared to monotherapy. Our study proved that Pt12 together with anti-MUC1 strongly induced apoptosis in estrogen-negative breast cancer cell line (MDA-MB-231). The apoptosis may go through extrinsic pathway associated with caspase-8 as well as intrinsic pathway connected with caspase-9. PMID:26112902

  12. Additive Complex Ayurvedic Treatment in Patients with Fibromyalgia Syndrome Compared to Conventional Standard Care Alone: A Nonrandomized Controlled Clinical Pilot Study (KAFA Trial).

    PubMed

    Kessler, Christian S; Ostermann, Thomas; Meier, Larissa; Stapelfeldt, Elmar; Schtte, Silvia; Duda, Joachim; Michalsen, Andreas

    2013-01-01

    Background. Fibromyalgia (FMS) is a challenging condition for health care systems worldwide. Only limited trial data is available for FMS for outcomes of complex treatment interventions of complementary and integrative (CIM) approaches. Methods. We conducted a controlled, nonrandomized feasibility study that compared outcomes in 21 patients treated with Ayurveda with those of 11 patients treated with a conventional approach at the end of a two-week inpatient hospital stay. Primary outcome was the impact of fibromyalgia on patients as assessed by the FIQ. Secondary outcomes included scores of pain intensity, pain perception, depression, anxiety, and quality of sleep. Follow-up assessments were done after 6 months. Results. At 2 weeks, there were comparable and significant improvements in the FIQ and for most of secondary outcomes in both groups with no significant in-between-group differences. The beneficial effects for both treatment groups were partly maintained for the main outcome and a number of secondary outcomes at the 6-month followup, again with no significant in-between-group differences. Discussion. The findings of this feasibility study suggest that Ayurvedic therapy is noninferior to conventional treatment in patients with severe FMS. Since Ayurveda was only used as add-on treatment, RCTs on Ayurveda alone are warranted to increase model validity. This trial is registered with NCT01389336. PMID:24073008

  13. Vanadium and cancer treatment: antitumoral mechanisms of three oxidovanadium(IV) complexes on a human osteosarcoma cell line.

    PubMed

    León, I E; Butenko, N; Di Virgilio, A L; Muglia, C I; Baran, E J; Cavaco, I; Etcheverry, S B

    2014-05-01

    We report herein the antitumor actions of three oxidovanadium(IV) complexes on MG-63 human osteosarcoma cell line. The three complexes: VO(oda), VO(oda)bipy and VO(oda)phen (oda=oxodiacetate), caused a concentration dependent inhibition of cell viability. The antiproliferative action of VO(oda)phen could be observed in the whole range of concentrations (at 2.5 μM), while VO(oda)bipy and VO(oda) showed a decrease of cell viability only at higher concentrations (at 50 and 75 μM, respectively) (p<0.01). Moreover, VO(oda)phen caused a decrease of lysosomal and mitochondrial activities at 2.5 μM, while VO(oda) and VO(oda)bipy affected neutral red uptake and mitochondrial metabolism at 50 μM (p<0.01). On the other hand, no DNA damage studied by the Comet assay could be observed in MG-63 cells treated with VO(oda) at 2.5-10 μM. Nevertheless, VO(oda)phen and VO(oda)bipy induced DNA damage at 2.5 and 10 μM, respectively (p<0.01). The generation of reactive oxygen species increased at 10 μM of VO(oda)phen and only at 100 μM of VO(oda) and VO(oda)bipy (p<0.01). Besides, VO(oda)phen and VO(oda)bipy triggered apoptosis as determined by externalization of the phosphatidylserine. The determination of DNA cleavage by agarose gel electrophoresis showed that the ability of VO(oda)(bipy) is similar to that of VO(oda), while VO(oda)(phen) showed the highest nuclease activity in this series. Overall, our results showed a good relationship between the bioactivity of the complexes and their structures since VO(oda)phen presented the most potent antitumor action in human osteosarcoma cells followed by VO(oda)bipy and then by VO(oda) according to the number of intercalating heterocyclic moieties. PMID:24199985

  14. Prothrombin Complex Concentrate and Methylene Blue for Treatment of Coagulopathy and Vasoplegia in a Pediatric Heart Transplant Patient.

    PubMed

    Lee, Jennifer K; Ing, Caleb

    2016-03-01

    Ventricular assist devices (VADs) are associated with conditions that may complicate the perioperative course of pediatric heart transplants. A 7-year-old girl with dilated cardiomyopathy supported by a Toyobo-NCVC left VAD (Toyobo-National Cardiovascular Center, Osaka, Japan), a pulsatile extracorporeal device, and preoperatively anticoagulated with warfarin presented for orthotopic heart transplant. The course was complicated by persistent bleeding treated with prothrombin complex concentrate and refractory postbypass vasoplegia treated with methylene blue. Preoperative anticoagulation and the presence of a VAD are associated with postbypass coagulopathy and vasoplegia. We describe a case in which these conditions were successfully treated with no thrombotic complications and minimal need of vasopressors for hemodynamic stability. PMID:26599739

  15. Identification and Treatment of New Inflammatory Triggers for Complex Regional Pain Syndrome: Small Intestinal Bacterial Overgrowth and Obstructive Sleep Apnea.

    PubMed

    Weinstock, Leonard B; Myers, Trisha L; Walters, Arthur S; Schwartz, Oscar A; Younger, Jarred W; Chopra, Pradeep J; Guarino, Anthony H

    2016-05-01

    Complex regional pain syndrome (CRPS) is evoked by conditions that may be associated with local and/or systemic inflammation. We present a case of long-standing CRPS in a patient with Ehlers-Danlos syndrome in which prolonged remission was attained by directing therapy toward concomitant small intestinal bacterial overgrowth, obstructive sleep apnea, and potential increased microglia activity. We theorize that cytokine production produced by small intestinal bacterial overgrowth and obstructive sleep apnea may act as stimuli for ongoing CRPS symptoms. CRPS may also benefit from the properties of low-dose naltrexone that blocks microglia Toll-like receptors and induces production of endorphins that regulate and reduce inflammation. PMID:26867023

  16. GLUT1 deficiency syndrome as a cause of encephalopathy that includes cognitive disability, treatment-resistant infantile epilepsy and a complex movement disorder

    PubMed Central

    Graham, John M.

    2012-01-01

    Glucose transporter-1 (GLUT1) deficiency syndrome is caused by heterozygous mutations in the SLC2A1 gene, resulting in impaired glucose transport into the brain. It is characterized by a low glucose concentration in the cerebrospinal fluid (hypoglycorrhachia) in the absence of hypoglycemia, in combination with low to normal lactate in the cerebrospinal fluid (CSF). It often results in treatment-resistant infantile epilepsy with progressive developmental disabilities and a complex movement disorder. Recognizing GLUT1 deficiency syndrome is important, since initiation of a ketogenic diet can reduce the frequency of seizures and the severity of the movement disorder. There can be a considerable delay in diagnosing GLUT1 deficiency syndrome, and this point is illustrated by the natural history of this disorder in a 21-year-old woman with severe, progressive neurological disabilities. Her encephalopathy consisted of treatment-resistant seizures, a complex movement disorder, progressive intellectual disability, and deceleration of her head growth after late infancy. Focused evaluation at age 21 revealed GLUT1 deficiency caused by a novel heterozygous missence mutation in exon 7 (c.938C > A; p.Ser313Try) in SLC2A1 as the cause for her disabilities. PMID:22212417

  17. Synergistic effects of resveratrol (free and inclusion complex) and sulfamethoxazole-trimetropim treatment on pathology, oxidant/antioxidant status and behavior of mice infected with Toxoplasma gondii.

    PubMed

    Bottari, Nathieli B; Baldissera, Matheus D; Tonin, Alexandre A; Rech, Virginia C; Alves, Catiane B; D'Avila, Fernanda; Thomé, Gustavo R; Guarda, Naiara S; Moresco, Rafael N; Camillo, Giovana; Vogel, Fernanda F; Luchese, Cristiane; Schetinger, Maria Rosa C; Morsch, Vera M; Tochetto, Camila; Fighera, Rafael; Nishihira, Vivian S K; Da Silva, Aleksandro S

    2016-06-01

    This study aimed to investigate the synergistic effects of resveratrol and sulfamethoxazole-trimethoprim (ST) on the treatment of mice experimentally infected by Toxoplasma gondii during the chronic phase of the disease considering infection, behavior, and oxidative/antioxidants profile aspects. For the study, 60 mice were initially divided into two groups: uninfected (n = 24) and infected by T. gondii (n = 36). These two groups were later subdivided into other groups and treated with resveratrol (free and inclusion complex containing resveratrol) alone and co-administered with ST: groups A to D were composed by healthy mice and groups E to J were consisted of animals infected by T. gondii (VEG strain). Treatments began 20 days post-infection for 10 consecutive days with oral doses of 0.5 mg kg(-1) of ST (groups B and F), 100 mg kg(-1) of free resveratrol (groups C and G) and inclusion complex of resveratrol (nanoparticles containing resveratrol) (groups D and H), and lastly an co-administration of both drugs (groups I and J). Behavioral tests (memory, anxiety and locomotion) were performed after treatment. Liver and brain fragments were collected to evaluate pathological changes, brain cysts counts, as well as oxidant and antioxidant levels. A reduction on the number of cysts in the brain of animals treated with both drugs combined was observed; there was also reduced number of lesions on both organs. This drug combined effect was also able to reduce oxidative and increase antioxidant levels in infected mice, which might be interpreted as a resveratrol protective effect. In addition, the combination of ST and resveratrol was able to prevent behavioral changes in infected mice. Therefore, the use of co-administration drugs enhances the therapeutic effect acting on a synergic way, reducing the oxidizing effects of the chemical treatment for toxoplasmosis. In addition, resveratrol in inclusion complex when co-administered with ST showed an improved therapeutic effect of ST reducing oxidative damage, liver damage and the number of cysts in the brain of T. gondii infected mice. PMID:27057672

  18. Complex role of TNF variants in psoriatic arthritis and treatment response to anti-TNF therapy: evidence and concepts.

    PubMed

    Hüffmeier, Ulrike; Mössner, Rotraut

    2014-10-01

    Psoriatic arthritis (PsA) is a chronic inflammatory disease affecting joints, and it may manifest as peripheral arthritis, dactylitis, enthesitis, spondylitis, or sacroiliitis. In the great majority of patients, PsA is accompanied by the most frequent psoriatic manifestation--psoriasis vulgaris. The major genetic risk factor for PsA is an HLA-C allele, and in recent genome-wide association studies few other susceptibility loci have as yet been identified. In this issue, Murdaca et al. (2014) describe an association of an intronic single-nucleotide polymorphism at the TNF locus (+489) with PsA, disease severity, and treatment responses to tumor necrosis factor-α blockers. PMID:25219647

  19. HIV-1 Group O Origin, Evolution, Pathogenesis, and Treatment: Unraveling the Complexity of an Outlier 25 Years Later.

    PubMed

    Bush, Shannon; Tebit, Denis M

    2015-01-01

    Twenty-five years ago, an aberrant HIV-1 (now classified as HIV-1 group O) was described from a Cameroonian HIV patient living in Belgium. The epicenter of group O was later found to be in Central Africa, overlapping with the geographical location of the central chimpanzees (Pan troglodytes troglodytes) and western gorillas (Gorilla gorilla), the likely original hosts of group O. Although the prevalence of group O has remained low at 1-2% in Cameroon, some European countries (France, Spain, Belgium) with strong colonial ties to Central Africa have reported the highest prevalence out of Africa. The sequence diversity between HIV-1 group O and M strains is huge, reaching 50 and 30% in the envelope and pol, respectively. This diversity has hindered diagnosis, monitoring, and treatment of group O-infected patients. Due to the intrinsic presence of the C181 mutation in group O, more than 60% of the approximately 30,000 individuals that live with this virus are faced with the challenge of drug resistance to some currently used antiretroviral therapies, notably the non-nucleoside reverse transcriptase inhibitors. Despite its susceptibility to most antiretroviral therapies, some group Os show a high variable baseline susceptibility to enfuvirtide (T20) and maraviroc. Group O strains are the least fit among all HIV-1 and -2 and restrict tetherin using their Nef but not Vpu as reported for group M. Although limited follow-up studies indicate that the natural course of group O is similar to that of M, these viruses are dominantly CCR5 tropic even late in infection, suggesting slow disease progression. This review summarizes important findings that marked the discovery, origin, spread, evolution, pathogenesis, and treatment of group O within the last 25 years. PMID:26450803

  20. Complexation of imazalil with beta-cyclodextrin, residue uptake, persistence, and activity against penicillium decay in citrus fruit following postharvest dip treatments.

    PubMed

    Schirra, Mario; Delogu, Giovanna; Cabras, Paolo; Angioni, Alberto; D'hallewin, Guy; Veyrat, Ana; Marcos, Jose F; Candelas, Luis González

    2002-11-01

    A method for the inclusion of imazalil (IMZ) in the beta-cyclodextrin (betaCD), structural characterization of the inclusion complex and its antifungal activity against Penicillium digitatum and P. italicum assessed by in vitro and in vivo tests are reported. According to the starting stoichiometry of betaCD with respect to IMZ, an equimolar ratio beta-cyclodextrin-IMZ (betaCD-IMZ) was detected by (1)H NMR. In vitro assays showed that the freshly prepared betaCD-IMZ was as effective as IMZ, although 1- and 4-day-old betaCD-IMZ mixtures were more effective. Studies on Star Ruby grapefruit showed no significant differences in residue uptake between treatments with an IMZ commercially available fungicide (Deccozil) or betaCD-IMZ when equal active ingredient (a.i.) concentrations (250 mg/L) and dip temperatures (20 or 50 degrees C) were used. By contrast, treatments of Tarocco oranges and Di Massa lemons with 250 mg/L betaCD-IMZ at 50 degrees C produced significant differences in residue uptake in comparison with 250 mg/L Deccozil treatments at 50 degrees C. The a.i. degradation rate in grapefruit during postquarantine and simulated marketing period (SMP) at 20 degrees C was not affected by the type of formulation used, whether at 20 or 50 degrees C. Conversely, IMZ in oranges and lemons had greater persistence when applied at 50 degrees C. All fungicide treatments showed a comparable efficacy against decay in grapefruit and oranges, whereas treatment in lemons at 250 mg/L a.i. of heated fungicides had higher suppressive effects against decay than unheated chemicals having equal a.i. concentrations and comparable activity at 1200 mg/L IMZ at 20 degrees C. PMID:12405777

  1. The Auditory Brain-Stem Response to Complex Sounds: A Potential Biomarker for Guiding Treatment of Psychosis

    PubMed Central

    Tarasenko, Melissa A.; Swerdlow, Neal R.; Makeig, Scott; Braff, David L.; Light, Gregory A.

    2014-01-01

    Cognitive deficits limit psychosocial functioning in schizophrenia. For many patients, cognitive remediation approaches have yielded encouraging results. Nevertheless, therapeutic response is variable, and outcome studies consistently identify individuals who respond minimally to these interventions. Biomarkers that can assist in identifying patients likely to benefit from particular forms of cognitive remediation are needed. Here, we describe an event-related potential (ERP) biomarker – the auditory brain-stem response (ABR) to complex sounds (cABR) – that appears to be particularly well-suited for predicting response to at least one form of cognitive remediation that targets auditory information processing. Uniquely, the cABR quantifies the fidelity of sound encoded at the level of the brainstem and midbrain. This ERP biomarker has revealed auditory processing abnormalities in various neurodevelopmental disorders, correlates with functioning across several cognitive domains, and appears to be responsive to targeted auditory training. We present preliminary cABR data from 18 schizophrenia patients and propose further investigation of this biomarker for predicting and tracking response to cognitive interventions. PMID:25352811

  2. Complex Apical Intraradicular Infection and Extraradicular Mineralized Biofilms as the Cause of Wet Canals and Treatment Failure: Report of 2 Cases.

    PubMed

    Ricucci, Domenico; Candeiro, George T M; Bugea, Calogero; Siqueira, José F

    2016-03-01

    This article describes 2 cases that showed persistent intracanal exudation (wet canal) even after several visits of antimicrobial endodontic treatment. Histologic and histobacteriologic investigation was conducted for determination of the cause. The 2 cases involved teeth with apical periodontitis lesions, which presented persistent exudation refractory to treatment after several visits. In case 1, it was not possible to achieve a dry canal, and surgery had to be performed. In case 2, attempts to dry the canal succeeded and the canal was filled, but follow-up examination showed an enlarged apical periodontitis lesion and extraction was performed. Biopsy specimens consisting of the root apex and apical periodontitis lesion for case 1 and the whole root for case 2 were subjected to histologic and histobacteriologic analyses. Both cases showed complex bacterial infection in the apical root, affecting both the intraradicular space and the outer root surface. Case 1 showed bacterial biofilms in ramifications, on untouched walls, and extending to the external root surface to form a thick and partially mineralized structure with high bacterial density. Different bacterial morphotypes were evidenced. Case 2 had a ledge on the apical canal wall created during instrumentation, which was filled with necrotic debris, filling material, and bacteria. The walls of the apical portion of the canal were covered by a bacterial biofilm, which was continuous with a thick extraradicular biofilm covering the cementum and dentin in resorptive defects. The extraradicular biofilm showed areas of mineralization and was dominated by filamentous bacteria. The 2 cases with wet canals and treatment failure were associated with complex persistent infection in the apical part of the root canal system extending to form thick and partially mineralized biofilm structures (calculus) on the outer apical root surface. PMID:26831049

  3. The Role of mTOR Inhibitors in the Treatment of Patients with Tuberous Sclerosis Complex: Evidence-based and Expert Opinions.

    PubMed

    Curatolo, Paolo; Bjørnvold, Marit; Dill, Patricia E; Ferreira, José Carlos; Feucht, Martha; Hertzberg, Christoph; Jansen, Anna; Jóźwiak, Sergiusz; Kingswood, J Christopher; Kotulska, Katarzyna; Macaya, Alfons; Moavero, Romina; Nabbout, Rima; Zonnenberg, Bernard A

    2016-04-01

    Tuberous sclerosis complex (TSC) is a genetic disorder arising from mutations in the TSC1 or TSC2 genes. The resulting over-activation of the mammalian target of rapamycin (mTOR) signalling pathway leaves patients with TSC susceptible to the growth of non-malignant tumours in multiple organs. Previously, surgery was the main therapeutic option for TSC. However, pharmacological therapy with mTOR inhibitors such as everolimus and sirolimus is now emerging as an alternate approach. Everolimus and sirolimus have already been shown to be effective in treating subependymal giant cell astrocytoma (SEGA) and renal angiomyolipoma (AML), and everolimus is currently being evaluated in treating TSC-related epilepsy. In November 2013 a group of European experts convened to discuss the current options and practical considerations for treating various manifestations of TSC. This article provides evidence-based recommendations for the treatment of SEGA, TSC-related epilepsy and renal AML, with a focus on where mTOR inhibitor therapy may be considered alongside other treatment options. Safety considerations regarding mTOR inhibitor therapy are also reviewed. With evidence of beneficial effects in neurological and non-neurological TSC manifestations, mTOR inhibitors may represent a systemic treatment for TSC. PMID:26927950

  4. Mycobacterium phlei cell wall-nucleic acid complex in the treatment of nonmuscle invasive bladder cancer unresponsive to bacillus Calmette-Guerin.

    PubMed

    Morales, Alvaro; Cohen, Zvi

    2016-02-01

    Introduction Current guidelines recommend cystectomy in patients with high risk NMIBC who fail to respond to BCG. However due to the significant morbidity and mortality of the procedure, many are not candidates or refuse it. No new treatments for this indication have been approved by the US FDA since 1998. Areas covered A cell wall-nucleic acid complex (MCNA) from M. phlei has been investigated for possible application in patients with BCG refractory NMIBC. The development of this biological from the original studies is reviewed, together with the clinical trials leading to a submission to the FDA. Its efficacy and safety are presented together with comparative analysis of alternative treatments, most of which are used off-label. In addition, new combinations of standard therapies are described as well as single agents exhibiting activity against these tumors. Expert opinion MCNA has shown activity against high risk BCG refractory bladder cancer and offers an alternative to current treatments. The clinical experience remains limited and the optimal therapeutic regimen (dose, frequency) have not been firmly established. Patients and clinicians would welcome the introduction of a compound that may delay or prevent the risks and negative impact in quality of life of cystectomy and urinary diversion. PMID:26865049

  5. New fly ash TiO2 composite for the sustainable treatment of wastewater with complex pollutants load

    NASA Astrophysics Data System (ADS)

    Visa, Maria; Isac, Luminita; Duta, Anca

    2015-06-01

    The goal of this paper was to develop a new composite obtained in mild hydrothermal conditions starting from fly ash (a waste raising significant environmental problems), and TiO2. The composite was characterized through XRD, SEM/EDX, AFM, and BET surface measurements. The composite was further used for the advanced treatment of wastewaters with multiple-pollutants load. The photocatalytic efficiency of the powder composite was tested on synthetic solutions containing a heavy metal cation (copper), a dye (methyl orange), and a surfactant (sodium dodecylbenzenesulfonate), under UV and simulated solar radiation. Comparative experiments were done in systems with and without H2O2 showing a significant increase in efficiency for methyl orange removal from mono-, bi-, and tri-pollutants solutions. The process parameters were optimized and the adsorption mechanisms are discussed, outlining that adsorption is the limiting step. Experiments also outlined that homogeneous photocatalysis (using H2O2) is less efficient then the heterogeneous process using the novel composite, both under UV and simulated solar radiation.

  6. Complex interactions among nutrients, chlorophyll-a, and microcystins in three stormwater wet detention basins with floating treatment wetlands.

    PubMed

    Hartshorn, Nicholas; Marimon, Zachary; Xuan, Zhemin; Cormier, Jessica; Chang, Ni-Bin; Wanielista, Martin

    2016-02-01

    Stormwater wet detention ponds hold a permanent pool of water and offer many beneficial uses including flood mitigation, pollution prevention, downstream erosion control, increased aesthetics, and recreational uses. Although the removal of nutrients is generally low for stormwater wet detention ponds in urban areas, floating treatment wetlands (FTWs) can be installed to offer an innovative solution toward naturally removing excess nutrients and aiding in stormwater management. To improve the stormwater reuse potential, this study assessed nutrient, microcystin, and chlorophyll-a interactions in three Florida stormwater wet detention ponds with recently implemented FTWs. Both episodic (storm events) and routine (non-storm events) sampling campaigns were carried out at the three ponds located in Ruskin, Gainesville, and Orlando. The results showed a salient negative correlation between total phosphorus and microcystin concentrations for both storm and non-storm events across all three ponds. The dominant nutrient species in correlation seemed to be total phosphorus, which correlated positively with chlorophyll-a concentrations at all ponds and sampling conditions, with the exception of Orlando non-storm events. These results showed a correlation conditional to the candidate pond and sampling conditions for microcystin and chlorophyll-a concentrations. PMID:26386430

  7. The role of the vacancy complexes of nanocompacted aluminum particles on the formation of structure during heat treatment

    NASA Astrophysics Data System (ADS)

    Gafner, Yu Ya; Baidyshev, V. S.

    2015-04-01

    The boundaries of thermal stability of the initial face-centered cubic (fcc) phase in perfect aluminum clusters with a diameter up to 3 nm have been investigated by the molecular dynamics method using a modified tight binding (TB-SMA) potential. Based on the performed computer analysis, it has been concluded that, in most cases, for aluminum clusters with sizes up to D = 2.5 nm, the most stable configuration is the structure with pentagonal symmetry. With a further increase in the number of atoms, the fcc structure becomes more stable. The influence of the degree of disorder of nanocompacted aluminum particles up to 4 nm in diameter on the formation of a crystal structure during heat treatment has been analyzed. It has been shown that, under the effect of the temperature factor, the clusters undergo a transition from the initial fcc phase to other structural modifications, including those with pentagonal symmetry, even in the case of clusters with fairly large sizes.

  8. IL-2/anti-IL-2 antibody complex treatment inhibits the development but not the progression of herpetic stromal keratitis.

    PubMed

    Gaddipati, Subhash; Estrada, Kathleen; Rao, Pushpa; Jerome, Andrew David; Suvas, Susmit

    2015-01-01

    The IL-2/anti-IL-2 Ab immunocomplex has recently been shown to expand the naturally occurring pool of CD4(+)Foxp3(+) regulatory T cells (Tregs). In this study, we show that administration of the IL-2/anti-IL-2 Ab immunocomplex to C57BL/6 mice, prior to corneal HSV-1 infection, significantly increased the pool of Foxp3(+) Tregs when measured at early time points postinfection. Increased numbers of Foxp3(+) Tregs on days 2 and 4 postinfection resulted in a marked reduction in the development of severe herpetic stromal keratitis (HSK). When compared with corneas from the control group, corneas from the immunocomplex-treated group showed a significant reduction in the amount of infectious virus on day 2 but not on day 4 postinfection. Reduced viral load was associated with a 2-fold increase in NK cell numbers in corneas from the immunocomplex-treated group of mice. Moreover, a dramatic reduction in the influx of CD4 T cells in inflamed corneas was determined on days 7 and 16 postinfection in the immunocomplex-treated group of infected mice. Immunocomplex treatment given on days 5, 6, and 7 postinfection significantly increased Foxp3(+) Tregs in draining lymph nodes and in the spleen but failed to reduce the severity of HSK. In terms of the influx of CD4 T cells and granulocytes into inflamed corneas, no significant differences were noted between both groups of mice on day 16 postinfection. Our findings demonstrate that increasing Foxp3(+) Tregs early but not late postinfection in secondary lymphoid tissues is more efficacious in controlling the severity of HSK. PMID:25411200

  9. A synthetic peptide from the third hypervariable region of major histocompatibility complex class II beta chain as a vaccine for treatment of experimental autoimmune encephalomyelitis.

    PubMed Central

    Topham, D J; Nag, B; Arimilli, S; Sriram, S

    1994-01-01

    Experimental autoimmune encephalomyelitis (EAE) is a class II major histocompatibility complex (MHC)-restricted, T-cell-mediated, demyelinating autoimmune disease of the central nervous system and represents a model for human multiple sclerosis. The present study demonstrates that vaccination of SJL/J mice with an 18-amino acid synthetic peptide from the third hypervariable region of the murine class II MHC IAs beta chain (IAs beta 58-75; 18-mer peptide) is capable of eliciting auto-anti-IAs antibodies specific for the IAs beta chain and preventing and treating EAE. A similar approach may be useful in the treatment of human autoimmune diseases in which susceptibility is linked to class II MHC genes. Images PMID:8058747

  10. Everolimus for the treatment of subependymal giant cell astrocytoma probably causing seizure aggravation in a child with tuberous sclerosis complex: a case report.

    PubMed

    Wiemer-Kruel, Adelheid; Woerle, H; Strobl, K; Bast, T

    2014-04-01

    We are reporting on a 13.5-year-old girl with tuberous sclerosis complex (TSC) who was treated with everolimus because of giant cell astrocytoma and bilateral angiomyolipoma. She suffered from pharmacoresistant partial epilepsy with clusters of tonic and tonic-clonic seizures. Treatment with carbamazepine and sulthiame had led to a stable situation for more than 2.5 years. The dosage of everolimus had to be increased and refractory status epilepticus followed after 12 days. In the absence of any other possible cause, we believe that the status epilepticus was provoked by everolimus. So far, only a few cases of possible seizure aggravation by everolimus have been reported. The clinical relevance of possible negative effects in epileptic patients remains unclear. Similar observations should be documented and reported. PMID:24293099

  11. The Ilizarov method for the treatment of complex tibial fractures and non-unions in a mass casualty setting: the 2005 earthquake in Pakistan.

    PubMed

    Tilkeridis, Konstantinos; Chari, Basavraj; Cheema, Nusrat; Tryfonidis, Marios; Khaleel, Arshad

    2015-04-01

    We report our experience in treating victims of the recent earthquake disaster in Pakistan. Our experience was based on two humanitarian missions to Islamabad: one in October 2005, 10 days after the earthquake, and the second in January 2006. The mission consisted of a team of orthopaedic surgeons and a second team of plastic surgeons. The orthopaedic team bought all the equipment for application of Ilizarov external fixators. We treated patients who had already received basic treatment in the region of the disaster and subsequently had been evacuated to Islamabad. During the first visit, we treated 12 injured limbs in 11 patients. Four of these patients were children. All cases consisted of complex multifragmentary fractures associated with severe crush injuries. All fractures involved the tibia, which were treated with Ilizarov external fixators. Nine fractures were type 3b open injuries. Eight were infected requiring debridement of infected bone and acute shortening. During a second visit, we reviewed all patients treated during our first mission. In addition, we treated 13 new patients with complex non-unions. Eight of these patients were deemed to be infected. All patients had previous treatment with monolateral fixators as well as soft tissue coverage procedures, except one patient who had had an IEF applied by another team. All these patients had revision surgery with circular frames. All patients from both groups were allowed to fully weight-bear post-operatively, after a short period of elevation to allow the flaps to take. Overall, all fractures united except one case who eventually had an amputation. Four patients had a corticotomy and lengthening, and three of them had a successful restoration of limb length. The fourth patient was the one with the eventual amputation. PMID:25764152

  12. Doxorubicin Lipid Complex Injection

    MedlinePlus

    Doxorubicin lipid complex is used to treat ovarian cancer that has not improved or that has worsened after treatment with other medications. Doxorubicin lipid complex is also used to treat Kaposi's sarcoma ( ...

  13. Vincristine Lipid Complex Injection

    MedlinePlus

    Vincristine lipid complex is used to treat a certain type of acute lymphoblastic leukemia (ALL; a type of cancer of the ... two different treatments with other medications. Vincristine lipid complex is in a class of medications called vinca ...

  14. Irinotecan Lipid Complex Injection

    MedlinePlus

    Irinotecan lipid complex is used in combination with other medications to treat pancreatic cancer that has spread to other parts of ... after treatment with other chemotherapy medications. Irinotecan lipid complex is in a class of antineoplastic medications called ...

  15. Sparfloxacin, ethambutol, and cortisol receptor inhibitor RU-40 555 treatment for disseminated Mycobacterium avium complex infection of normal C57BL/6 mice.

    PubMed Central

    Perronne, C; Cohen, Y; Truffot-Pernot, C; Grosset, J; Vildé, J L; Pocidalo, J J

    1992-01-01

    Sparfloxacin (50 mg/kg of body weight given subcutaneously each day), alone or in combination with ethambutol (50 mg/kg given subcutaneously each day), was examined for its therapeutic efficacy against experimental infection induced with the Mycobacterium avium complex in normal C57BL/6 mice. In addition, the potential anti-infective role of RU-40 555 (100 mg/kg given intraperitoneally each day), a drug that inhibits the cortisol receptors, was examined in the same model. Treatments were started 24 h after intravenous bacterial challenge and were continued for 21 days. Compared with controls, sparfloxacin or ethambutol decreased the CFU counts in spleens and lungs (P < 0.001). The sparfloxacin plus ethambutol combination was more effective than sparfloxacin alone in spleens (P < 0.001) but not in lungs. The sparfloxacin plus ethambutol plus RU-40 555 combination was more effective than the sparfloxacin plus ethambutol combination in spleens and lungs (P < 0.001). Thus, in this model, RU-40 555 enhanced the antibacterial activities of the antibiotics tested. Results of the study showed that normal C57BL/6 mice infected with the M. avium complex can be used for the evaluation of antimicrobial agents. PMID:1336944

  16. Actinide immobilization in the subsurface environment by in-situ treatment with a hydrolytically unstable organophosphorus complexant: Uranyl uptake by calcium phytate

    SciTech Connect

    Nash, K.L.; Jensen, M.P.; Schmidt, M.A.

    1997-12-31

    In addition to naturally occurring uranium and thorium, actinide ions exist in the subsurface environment as a result of accidental releases and intentional disposal practices associated with nuclear weapons production. These species present a significant challenge to cost-effective remediation of contaminated environments. An attractive approach to decreasing the probability of actinide migration in the subsurface is to transform the ions into a less mobile form by remote treatment. We have under development a process which relies on a polyfunctional organophosphorus complexant to sequester the mobile metal ions by complexation/cation exchange in the near term, and to subsequently decompose, transforming the actinides into insoluble phosphate mineral forms in the long term. Studies to date include identification of a suitable organophosphorus reagent, profiling of its decomposition kinetics, verification of the formation of phosphate mineral phases upon decomposition of the reagent, and extensive comparison of the actinide uptake ability of the calcium salt of the reagent as compared with hydroxyapatite. In this report, we briefly describe the process with focus on the cation exchange behavior of the calcium salt of the organophosphorus sequestrant.

  17. Complex agonist-like properties of ICI 182,780 (Faslodex) in human breast cancer cells that predominantly express progesterone receptor-B: implications for treatment resistance.

    PubMed

    Wu, Jianbo; Liang, Yayun; Nawaz, Zafar; Hyder, Salman M

    2005-12-01

    ICI 182,780 (Faslodex), considered a pure anti-estrogen, is approved for treatment of post-menopausal breast cancer patients who fail to respond to tamoxifen therapy. We recently reported that, like mifepristone, ICI 182,780 exhibits anti-progestin activity, blocking the progestin-dependent increase in endogenous vascular endothelial growth factor (VEGF) mRNA and protein release. Some anti-progestins have partial agonist-like activity in breast cancer cells expressing high levels of progesterone receptor B (PRB). Our results show that ICI 182,780 can also induce reporter activity from a plasmid containing a simple progestin responsive element (PRE) in these cells. Using small interfering RNA, we determined that induction is dependent on the presence of PR, estrogen receptor and SRC-1. Regulation of more complex progestin-responsive promoters was context-dependent; induction was observed from the MMTV promoter but not from the VEGF promoter. In contrast, ICI 182,780 increased the release of angiogenically active VEGF from cells expressing elevated levels of PRB. This effect was dependent on the phosphatidylinositol-3 kinase and ERK/MAPK signaling pathways. We hypothesize that these agonist-like properties of ICI 182,780 (one genomic and one non-genomic) may contribute to the acquisition of drug resistance, suggesting that both anti-hormonal and anti-angiogenic treatment may be appropriate in these patients. PMID:16273221

  18. The effect of a second dexamethasone treatment on turkeys previously challenged in an experimental Escherichia coli respiratory model of turkey osteomyelitis complex.

    PubMed

    Huff, G R; Huff, W E; Balog, J M; Rath, N C

    1999-08-01

    In two separate experiments, turkeys that had survived immunosuppression with dexamethasone (DEX) and air sac inoculation with low numbers of Escherichia coli at 5 wk of age were maintained until 13 wk of age, at which time they were given a second treatment with DEX. All mortalities and birds that were necropsied 8 and 15 d (Experiment 1) and 21 d (Experiment 2) after the last DEX injection were scored for air sacculitis/pericarditis and turkey osteomyelitis complex (TOC). In both experiments, all of the lesions that characterize TOC were reproduced, including osteomyelitis of the proximal tibia, synovitis/tendonitis, abscesses in the soft tissues, and green liver. In Experiment 1, all mortalities after Day 7 had TOC lesions, whereas 44% of mortalities had green livers. Staphylococcus aureus was isolated from 90% of all TOC lesions cultured. In Experiment 2, the incidence of mortality, air sacculitis, TOC, and green liver as well as the heterophil:lymphocyte ratio were significantly higher in birds that had previously been treated with DEX but had never been challenged with E. coli than in birds that had survived both treatment with DEX and challenge with 25 or 50 cfu of E. coli. Staphylococcus aureus was isolated from 73% of TOC lesions cultured, whereas E. coli was isolated from only 5.4% of the lesions. These studies suggest that TOC incidence may be related to a stress-induced susceptibility to opportunistic infection. PMID:10472837

  19. Efficiency of liposomal albendazole for the treatment of the patients with complex alveolar echinococcosis: a comparative analysis of CEUS, CT, and PET/CT.

    PubMed

    Li, Haitao; Song, Tao; Qin, Yongde; Liu, Wenya; Li, Xiaohong; Shao, Yingmei; Wen, Hao

    2015-11-01

    We aim to investigate the efficiency of liposomal albendazole (L-ABZ) for the treatment of complex alveolar echinococcosis (CAE) using contrast-enhanced ultrasonography (CEUS), computed tomography (CT), and positron emission tomography (PET)/CT. Twelve patients with CAE admitted to our hospital between June 2000 and June 2011 were included in this retrospective study. CEUS, CT, and PET/CT were used to evaluate the clinical efficiency of L-ABZ for these patients. Effectiveness was defined as significant response after chemotherapy. Effectiveness with clinical significance was defined as complete response after chemotherapy, and non-effectiveness was defined as no response after chemotherapy. Patients were followed up for 3-11 years. Ten patients (83.3%) had a ratio of averaged gray scale in the enhanced band to that of hepatic tissues of ≤1.1, and six patients (50.0%) had a ratio of ≤0.9 as revealed by CEUS. CT scanning results indicated an effective rate of 91.6%. PET/CT indicated a maximal standard uptake (SUVmax) of <2.5 in nine patients (75.0%), which was considered to be effective. A high uptake of fluorodeoxyglucose was observed in three patients (25.0%) with SUVmax ≥2.5, which was considered to be non-effective. Taken together, CEUS, CT, and PET/CT provide objective evaluation of the clinical efficiency of L-ABZ for the treatment of CAE. PMID:26239800

  20. Lenalidomide in the context of complex karyotype or interrupted treatment: case reviews of del(5q)MDS patients with unexpected responses

    PubMed Central

    Haase, Sabine; Heinsch, Michael; Göhring, Gudrun; Schlegelberger, Brigitte; Aul, Carlo

    2006-01-01

    Lenalidomide has particular activity in patients with transfusion-dependent del(5q) myelodysplastic syndromes (MDS), but mechanistic information is limited regarding the relationship between erythroid and cytogenetic responses. We reviewed medical records from three distinct subgroups of del(5q) MDS patients who had unexpected effects with lenalidomide treatment: 1. two patients with complex karyotypes who achieved both cytogenetic remissions and transfusion independence; 2. two patients with 5q- syndrome who took lenalidomide for less than 12 weeks but remained transfusion independent for 15+ months still displaying del(5q) metaphases after 6 and 12 months; and 3. one patient who was a non-responder on lenalidomide during treatment but became transfusion independent for 13+ months after discontinuation. All but the latter patient in this series had reduction of affected metaphases, suggesting that erythroid responses might be mediated by result from partial or complete suppression of the malignant clone, either directly or indirectly through modulation of the bone marrow microenvironment. These clinical observations illustrate the heterogeneity of del(5q)MDS pathogenesis and the diversity of lenalidomide responses within this patient subset. PMID:17111142

  1. Complications of mammalian target of rapamycin inhibitor anticancer treatment among patients with tuberous sclerosis complex are common and occasionally life-threatening.

    PubMed

    Trelinska, Joanna; Dachowska, Iwona; Kotulska, Katarzyna; Fendler, Wojciech; Jozwiak, Sergiusz; Mlynarski, Wojciech

    2015-04-01

    The aim of this study was to evaluate the most common adverse events (AEs) linked to everolimus therapy, a mammalian target of rapamycin (mTOR) inhibitor, in children and adolescents with tuberous sclerosis complex (TSC) hospitalized in one medical center. The study group included 18 patients with a diagnosis of subependymal giant cell astrocytoma or renal angiomyolipoma related to TSC. The median duration of therapy was 15 months. All clinical symptoms and laboratory abnormalities including complete blood count, fasting lipid profile, glucose level, and liver and kidney function tests were analyzed as potential AEs. The most common AEs of everolimus therapy were laboratory abnormalities (100% of patients) and infection complications (83 episodes in 15 patients). Infectious episodes of pharyngitis (67%), diarrhea (44%), stomatitis (39%), and bronchitis (39%) were the most common infections. They were mostly mild or moderate in severity (grade 1-2). In two cases, life-threatening conditions related to mTOR inhibitor treatment were encountered. The first was classified as grade 4 pleuropneumonia and Streptococcus pneumoniae sepsis, whereas the second was classified as death related to AE (grade 5) Escherichia coli sepsis. The most common laboratory abnormalities were hypercholesterolemia (13/18 patients - 72%) and hypertriglyceridemia (12/18 patients - 66%). Neutropenia (12/18 patents - 66%) and anemia (8/18 patients - 44%) were the most common hematologic toxicities. Everolimus treatment in TSC patients may lead to life-threatening outcomes, including sepsis and death. Long-lasting effects of everolimus treatment in the context of high incidences of different laboratory abnormalities found in TSC patients are another subject that should be researched further. PMID:25719621

  2. The role of mycobacterial cell wall nucleic acid complex in the treatment of bacillus Calmette–Guérin failures for non-muscle-invasive bladder cancer

    PubMed Central

    Packiam, Vignesh T.; Pearce, Shane M.; Steinberg, Gary D.

    2016-01-01

    Introduction: The treatment of high-risk non-muscle-invasive bladder cancer (NMIBC) utilizes transurethral resection followed by adjuvant intravesical immunotherapy or chemotherapy. Intravesical bacillus Calmette–Guérin (BCG) is the mainstay of adjuvant immunotherapy, but there are limited nonsurgical options for patients that fail this treatment. Mycobacterial cell wall nucleic acid complex (MCNA) is an immunotherapeutic agent utilized primarily after failure of intravesical BCG. The purpose of this paper is to provide a comprehensive review of the published literature regarding MCNA. Methods: A literature review was performed and identified studies indexed in MEDLINE® related to utilization of MCNA for patients with NMIBC. Results: Two trials assessed the efficacy of MCNA in patients with NMIBC, comprising a total of 184 patients. Most patients had carcinoma in situ (CIS) with (26%) or without (52%) concomitant papillary tumors. A minority of patients had only papillary tumors (22%). Most patients (95%) previously received BCG or other intravesical therapy prior to receiving MCNA. In the largest available trial, 25% and 19% of patients had no evidence of residual cancer in 1 and 2 years following initiation of MCNA. A total of 2.3% of patients had adverse events (AEs) leading to delay or discontinuation of therapy and 66% of patients had mild drug-related AEs. Conclusion: Based on analysis of available published data, MCNA offers a durable response for a small proportion of patients that have failed prior intravesical therapy. There still exists a large unmet need for nonsurgical treatment options for patients with NMIBC who have failed adjuvant intravesical therapies. PMID:26834838

  3. Treatment of Children with Protein – Losing Enteropathy After Fontan and Other Complex Congenital Heart Disease Procedures in Condition with Limited Human and Technical Resources

    PubMed Central

    Bejiqi, Ramush; Retkoceri, Ragip; Zeka, Naim; Bejiqi, Hana; Vuqiterna, Armend; Maloku, Arlinda

    2014-01-01

    Background Protein-losing enteropathy (PLE) is a disorder characterized by abnormal and often profound enteric protein loss. It’s relatively uncommon complication of Fontan and other complex congenital heart disease (CCHD) procedures. Because of the complexity and rarity of this disease process, the pathogenesis and pathophysiology of protein-losing enteropathy remain poorly understood, and attempts at treatment seldom yield long-term success. Aim of presentation is to describe single centre experience in diagnosis, evaluation, management and treatment of children with protein-losing enteropathy after Fontan and other CCHD procedures in the current era and in centre with limited human and technical resources, follows with a comprehensive review of protein-losing enteropathy publications, and concludes with suggestions for prevention and treatment. Material and methodology Retrospectively we analyzed patients with CCHD and protein-losing enteropathy in our institution, starting from January 2000 to December 2012. The including criteria were age between two and 17 years, to have a complex congenital heart disease and available complete documentation of cardiac surgery under cardiopulmonary bypass. Results Of all patients we evaluated 18 cases with protein-losing enteropathy, aged 6 to 19 years (mean 14±9); there were three children who had undergone screening procedure for D-transposition, one Tetralogy of Fallot, and remaining 14 patients had undergone Fontan procedures; (anatomic diagnosis are: six with tricuspid atresia, seven with d-transposition, double outlet right ventricle and pulmonary atresia and two with hypoplastic left heart syndrome). The diagnosis of protein-losing enteropathy was made at median age of 5.6 years, ranging from 13 months to 15 years. Diagnosis was made using alpha 1-antitrypsin as a gold marker in stool. By physical examination in 14 patients edema was found, in three ascites, and six patients had pleural effusion. Laboratory findings at the time of diagnosis are: abnormal enteric protein loss was documented at the time of diagnosis in all 18 patients. At the time of diagnosis all patients receiving some form of anticoagulation, 17 patients receiving other medication: 17 – diuretics and ACE inhibitors, 12 digoxin, 9 antiarrhytmics. Cross-sectional echocardiography was performed for all patients and different abnormalities were registered. In 14 patients also magnetic resonance was performed. Therapeutic approach was based on the non-specific medication (diet, diuretics, digoxin, ACE inhibitors, and anticoagulants), heparin and corticosteroids therapy. Long-term response to this type of therapy was registered in three patients. Nine patients underwent treatment with heparin and corticosteroids and no one experienced long term benefit. Despite of needs for catheter therapy or surgical intervention in our study, in the absent of technical and human resources now any one had underwent those procedures. Six patients has been transferred abroad and in five of them surgical intervention was perform. Conclusion Protein-losing enteropathy remains a devastating complication of Fontan procedure and despite in advantages in surgical and medical therapy there is no evidence that protein-losing enteropathy is less common in the current area. PMID:24757400

  4. Connections and consequences in complex systems: insights from a case study of the emergence and local impact of crisis resolution and home treatment services.

    PubMed

    Hannigan, Ben

    2013-09-01

    In this article the broad contours of a complexity perspective are outlined. Complexity ideas are then drawn on to frame an empirical examination of the connections running between different levels of organisation in health and social care, and to underpin investigation into the intended and unintended local system consequences of service development. Data are used from a study conducted in the UK's mental health field. Here, macro-level policy has led to the supplementing of longstanding community mental health teams by newer, more specialised, services. An example includes teams providing crisis resolution and home treatment (CRHT) care as an alternative to hospital admission. Using an embedded case study design, where 'the case' examined was a new CRHT team set in its surrounding organisational environment, ethnographic data (with interviews predominating) were generated in a single site in Wales over 18 months from the middle of 2007. In a large-scale context favourable to local decision-making, and against a background of a partial and disputed evidence base, the move to establish the new standalone service was contested. Whilst users valued the work of the team, and local practitioners recognised the quality of its contribution, powerful effects were also triggered across the locality's horizontal interfaces. Participants described parts of the interconnected system being closed to release resources, staff gravitating to new crisis services leaving holes elsewhere, and the most needy service users being cared for by the least experienced workers. Some community mental health team staff described unexpected increases in workload, and disputes over eligibility for crisis care with implications for system-wide working relations. Detailed data extracts are used to illustrate these connections and consequences. Concluding lessons are drawn on the use of evidence to inform policy, on the significance of local contexts and system interfaces, and on anticipating the unexpected at times of change. PMID:22386638

  5. In vitro and in vivo anticancer properties of a Calcarea carbonica derivative complex (M8) treatment in a murine melanoma model

    PubMed Central

    2010-01-01

    Background Melanoma is the most aggressive form of skin cancer and the most rapidly expanding cancer in terms of worldwide incidence. Chemotherapeutic approaches to treat melanoma have had only marginal success. Previous studies in mice demonstrated that a high diluted complex derived from Calcarea carbonica (M8) stimulated the tumoricidal response of activated lymphocytes against B16F10 melanoma cells in vitro. Methods Here we describe the in vitro inhibition of invasion and the in vivo anti-metastatic potential after M8 treatment by inhalation in the B16F10 lung metastasis model. Results We found that M8 has at least two functions, acting as both an inhibitor of cancer cell adhesion and invasion and as a perlecan expression antagonist, which are strongly correlated with several metastatic, angiogenic and invasive factors in melanoma tumors. Conclusion The findings suggest that this medication is a promising non-toxic therapy candidate by improving the immune response against tumor cells or even induce direct dormancy in malignancies. PMID:20338038

  6. Fast and accurate Monte Carlo modeling of a kilovoltage X-ray therapy unit using a photon-source approximation for treatment planning in complex media

    PubMed Central

    Zeinali-Rafsanjani, B.; Mosleh-Shirazi, M. A.; Faghihi, R.; Karbasi, S.; Mosalaei, A.

    2015-01-01

    To accurately recompute dose distributions in chest-wall radiotherapy with 120 kVp kilovoltage X-rays, an MCNP4C Monte Carlo model is presented using a fast method that obviates the need to fully model the tube components. To validate the model, half-value layer (HVL), percentage depth doses (PDDs) and beam profiles were measured. Dose measurements were performed for a more complex situation using thermoluminescence dosimeters (TLDs) placed within a Rando phantom. The measured and computed first and second HVLs were 3.8, 10.3 mm Al and 3.8, 10.6 mm Al, respectively. The differences between measured and calculated PDDs and beam profiles in water were within 2 mm/2% for all data points. In the Rando phantom, differences for majority of data points were within 2%. The proposed model offered an approximately 9500-fold reduced run time compared to the conventional full simulation. The acceptable agreement, based on international criteria, between the simulations and the measurements validates the accuracy of the model for its use in treatment planning and radiobiological modeling studies of superficial therapies including chest-wall irradiation using kilovoltage beam. PMID:26170553

  7. Fast and accurate Monte Carlo modeling of a kilovoltage X-ray therapy unit using a photon-source approximation for treatment planning in complex media.

    PubMed

    Zeinali-Rafsanjani, B; Mosleh-Shirazi, M A; Faghihi, R; Karbasi, S; Mosalaei, A

    2015-01-01

    To accurately recompute dose distributions in chest-wall radiotherapy with 120 kVp kilovoltage X-rays, an MCNP4C Monte Carlo model is presented using a fast method that obviates the need to fully model the tube components. To validate the model, half-value layer (HVL), percentage depth doses (PDDs) and beam profiles were measured. Dose measurements were performed for a more complex situation using thermoluminescence dosimeters (TLDs) placed within a Rando phantom. The measured and computed first and second HVLs were 3.8, 10.3 mm Al and 3.8, 10.6 mm Al, respectively. The differences between measured and calculated PDDs and beam profiles in water were within 2 mm/2% for all data points. In the Rando phantom, differences for majority of data points were within 2%. The proposed model offered an approximately 9500-fold reduced run time compared to the conventional full simulation. The acceptable agreement, based on international criteria, between the simulations and the measurements validates the accuracy of the model for its use in treatment planning and radiobiological modeling studies of superficial therapies including chest-wall irradiation using kilovoltage beam. PMID:26170553

  8. “Quantum Leap” in Photobiomodulation Therapy Ushers in a New Generation of Light-Based Treatments for Cancer and Other Complex Diseases: Perspective and Mini-Review

    PubMed Central

    Rodríguez-Santana, Elizabeth; Santana-Rodríguez, Karin E.; Reyes, Heberto

    2016-01-01

    Abstract Objective: Set within the context of the 2015 International Year of Light and Light-Based Technologies,and of a growing and aging world population with ever-rising healthcare needs, this perspective and mini-review focuses on photobiomodulation (PBM) therapy as an emerging, cost-effective, treatment option for cancer (i.e., solid tumors) and other complex diseases, particularly, of the eye (e.g., age-related macular degeneration, diabetic retinopathy, glaucoma, retinitis pigmentosa) and the central nervous system (e.g., Alzheimer's and Parkinson's disease). Background data: Over the last decades, primary and secondary mechanisms of PBM have been revealed. These include oxygen-dependent and oxygen-independent structural and functional action pathways. Signal and target characteristics determine biological outcome, which is optimal (or even positive) only within a given set of parameters. Methods: This study was a perspective and nonsystematic literature mini-review. Results: Studies support what we describe as a paradigm shift or “quantum leap” in the understanding and use of light and its interaction with water and other relevant photo-cceptors to restore physiologic function. Conclusions: Based on existing evidence, it is argued that PBM therapy can raise the standard of care and improve the quality of life of patients for a fraction of the cost of many current approaches. PBM therapy can, therefore,benefit large, vulnerable population groups, including the elderly and the poor, whilehaving a major impact on medical practice and public finances. PMID:26890728

  9. Linkage Disequilibrium between Polymorphisms of ABCB1 and ABCC2 to Predict the Treatment Outcome of Malaysians with Complex Partial Seizures on Treatment with Carbamazepine Mono-Therapy at the Kuala Lumpur Hospital

    PubMed Central

    Subenthiran, Soobitha; Abdullah, Noor Rain; Joseph, Joyce Pauline; Muniandy, Prem Kumar; Mok, Boon Teck; Kee, Chee Cheong; Ismail, Zakiah; Mohamed, Zahurin

    2013-01-01

    Purpose Carbamazepine (CBZ) is used as the first line of treatment of Complex Partial Seizures (CPS) in the Epilepsy Clinic, Neurology Department of Kuala Lumpur Hospital (KLH). More than 30% of the patients remain drug resistant to CBZ mono-therapy. CBZ is transported by the P-glycoprotein (P-gp). The P-gp encoded by the ABCB1 and ABCC2 genes are expressed in drug resistant patients with epilepsy. A few studies have shown significant association between CBZ resistant epilepsy and Linkage Disequilibrium (LD) with adjacent polymorphisms of these genes. Our study is aimed at determining the correlation between patients' response to CBZ mono-therapy to Single Nucleotide Polymorphisms G2677T and C3435T of the ABCB1 gene as well as G1249A and −24C>T of the ABCC2 gene. Method 314 patients with CPS were recruited from the Neurology Department of the KLH based on stringent inclusion and exclusion criteria, of whom 152 were responders and the other 162 were non-responders. DNA was extracted from their blood samples and Taqman technology for allelic discrimination was performed. Results were described as genotype frequencies. The SHEsis analysis platform was used to calculate linkage disequilibrium index and infer haplotype frequencies. Haploview was used to do permutation test to obtain a corrected p-value. Results Resistance to treatment with CBZ mono-therapy was significantly associated with the 2677TT and the 3435TT genotypes while it was not significantly associated with the G1249A and −24C>T polymorphisms. The GCGC haplotype combination of the 2677G>T, 3435C>T, 1249G>A and −24C>T respectively was found to be extremely significant (p = 1.10e−20) with good drug response to CBZ mono-therapy. Conclusion Linkage disequilibrium between the 2677G>T, 3435C>T, 1249G>A and −24C>T SNPs may be used as a reliable screening marker to determine the treatment outcome of CBZ mono-therapy with CPS irrespective of race or gender. PMID:23717663

  10. Complex Patterns of Protease Inhibitor Resistance among Antiretroviral Treatment-Experienced HIV-2 Patients from Senegal: Implications for Second-Line Therapy

    PubMed Central

    Smith, Robert A.; Ba, Selly; Toure, Macoumba; Traore, Fatou; Sall, Fatima; Pan, Charlotte; Blankenship, Lindsey; Montano, Alexandra; Olson, Julia; Dia Badiane, Ndeye Mery; Mullins, James I.; Kiviat, Nancy B.; Hawes, Stephen E.; Sow, Papa Salif; Gottlieb, Geoffrey S.

    2013-01-01

    Protease inhibitor (PI)-based antiretroviral therapy (ART) can effectively suppress HIV-2 plasma load and increase CD4 counts; however, not all PIs are equally active against HIV-2, and few data exist to support second-line therapy decisions. To identify therapeutic options for HIV-2 patients failing ART, we evaluated the frequency of PI resistance-associated amino acid changes in HIV-2 sequences from a cohort of 43 Senegalese individuals receiving unboosted indinavir (n = 18 subjects)-, lopinavir/ritonavir (n = 4)-, or indinavir and then lopinavir/ritonavir (n = 21)-containing ART. Common protease substitutions included V10I, V47A, I54M, V71I, I82F, I84V, L90M, and L99F, and most patients harbored viruses containing multiple changes. Based on genotypic data, we constructed a panel of 15 site-directed mutants of HIV-2ROD9 containing single- or multiple-treatment-associated amino acid changes in the protease-encoding region of pol. We then quantified the susceptibilities of the mutants to the HIV-2 “active” PIs saquinavir, lopinavir, and darunavir using a single-cycle assay. Relative to wild-type HIV-2, the V47A mutant was resistant to lopinavir (6.3-fold increase in the mean 50% effective concentration [EC50]), the I54M variant was resistant to darunavir and lopinavir (6.2- and 2.7-fold increases, respectively), and the L90M mutant was resistant to saquinavir (3.6-fold increase). In addition, the triple mutant that included I54M plus I84V plus L90M was resistant to all three PIs (31-, 10-, and 3.8-fold increases in the mean EC50 for darunavir, saquinavir, and lopinavir, respectively). Taken together, our data demonstrate that PI-treated HIV-2 patients frequently harbor viruses that exhibit complex patterns of PI cross-resistance. These findings suggest that sequential PI-based regimens for HIV-2 treatment may be ineffective. PMID:23571535

  11. Pre-treatment with new kynurenic acid amide dose-dependently prevents the nitroglycerine-induced neuronal activation and sensitization in cervical part of trigemino-cervical complex.

    PubMed

    Fejes-Szabó, Annamária; Bohár, Zsuzsanna; Vámos, Enikő; Nagy-Grócz, Gábor; Tar, Lilla; Veres, Gábor; Zádori, Dénes; Szentirmai, Márton; Tajti, János; Szatmári, István; Fülöp, Ferenc; Toldi, József; Párdutz, Árpád; Vécsei, László

    2014-07-01

    The systemic administration of nitroglycerine induces attacks in migraineurs and is able to activate and sensitize the trigeminal system in animals involving glutamate and α7-nicotinic acetylcholine receptors, among others. Kynurenic acid is one of the endogenous glutamate receptor antagonists, and exerts inhibitory action on the α7-nicotinic acetylcholine receptors. Since kynurenic acid penetrates the blood-brain barrier poorly, therefore a newly synthesized kynurenic acid amide, N-(2-N-pyrrolidinylethyl)-4-oxo-1H-quinoline-2-carboxamide hydrochloride (KYNAa) was used with such a side-chain substitution to facilitate brain penetration in our study. We evaluated its modulatory effect on kynurenic acid concentration in the cervical part of trigemino-cervical complex (C1-C2) and in the model of nitroglycerine-induced trigeminal activation using male Sprague-Dawley rats. One hour after 1 mmol/kg bodyweight KYNAa administration, the kynurenic acid level increased significantly in C1-C2, which returned to the basal level at 300 min measured by high-performance liquid chromatography. KYNAa pre-treatment had dose-dependent, mitigating action on nitroglycerine-induced decrease in calcitonin gene-related peptide and increase in c-Fos, neuronal nitric oxide synthase and calmodulin-dependent protein kinase II alpha expression in the C1-C2. KYNAa also mitigated the behavioural changes after nitroglycerine. Thus, in this model KYNAa is able to modulate in a dose-dependent manner the changes in neurochemical markers of activation and sensitization of the trigeminal system directly and indirectly--via forming kynurenic acid, possibly acting on peripheral and central glutamate or α7-nicotinic acetylcholine receptors. These results suggest that application of kynurenic acid derivatives could be a useful therapeutic strategy in migraine headache in the future with a different mechanism of action. PMID:24385076

  12. Galactose conjugated platinum(II) complex targeting the Warburg effect for treatment of non-small cell lung cancer and colon cancer.

    PubMed

    Wu, Meng; Li, Hong; Liu, Ran; Gao, Xiangqian; Zhang, Menghua; Liu, Pengxing; Fu, Zheng; Yang, Jinna; Zhang-Negrerie, Daisy; Gao, Qingzhi

    2016-03-01

    Malignant neoplasms exhibit a higher rate of glycolysis than normal cells; this is known as the Warburg effect. To target it, a galactose-conjugated (trans-R,R-cyclohexane-1,2-diamine)-2-chloromalonato-platinum(II) complex (Gal-Pt) was designed, synthesized, and evaluated in five human cancer cell lines and against two different xenograft tumour models. Gal-Pt exhibits much higher aqueous solubility (over 25 times) and improved cytotoxicity than oxaliplatin, especially in human colon (HT29) and lung (H460) cancer cell lines. The safety profile of Gal-Pt was investigated in vivo by exploring the maximum tolerated dose (MTD) and animal mortality rate. The ratios of the animal lethal dosage values to the cytotoxicity in HT29 (LD50/IC50) showed that Gal-Pt was associated with an increased therapeutic index by over 30-fold compared to cisplatin and oxaliplatin. We evaluated in vivo antitumor activity by single agent intravenous treatment comparison studies of Gal-Pt (50 mg/kg as 65% MTD) and cisplatin (3 mg/kg, as 80% MTD) in a H460 lung cancer xenograft model, and with oxaliplatin (7 mg/kg, as 90% MTD) in a HT29 colon cancer xenograft model. The results show that Gal-Pt was more efficacious against H460 than cisplatin, and had superior potency in HT29 cells compared to oxaliplatin under nontoxic dosage conditions. The dependency between cytotoxicity of Gal-Pt and glucose transporters (GLUTs) was investigated by using quercetin as an inhibitor of GLUTs in HT29 cells. The cytotoxic potency of Gal-Pt was highly reduced by the inhibitor, suggesting that the uptake of Gal-Pt was regulated by glucose transporters. The GLUT mediated transportability and cellular uptake of Gal-Pt was also demonstrated using a fluorescent glucose bioprobe in HT29 competition assay. PMID:26807543

  13. IL-2 / α-IL-2 Complex Treatment Cannot Be Substituted for the Adoptive Transfer of Regulatory T cells to Promote Bone Marrow Engraftment

    PubMed Central

    Mahr, Benedikt; Unger, Lukas; Hock, Karin; Pilat, Nina; Baranyi, Ulrike; Schwarz, Christoph; Maschke, Svenja; Farkas, Andreas Michael; Wekerle, Thomas

    2016-01-01

    Cell therapy with recipient Tregs achieves engraftment of allogeneic bone marrow (BM) without the need for cytoreductive conditioning (i.e., without irradiation or cytotoxic drugs). Thereby mixed chimerism and transplantation tolerance are established in recipients conditioned solely with costimulation blockade and rapamycin. However, clinical translation would be substantially facilitated if Treg-stimulating pharmaceutical agents could be used instead of individualized cell therapy. Recently, it was shown that interleukin-2 (IL-2) complexed with a monoclonal antibody (mAb) (clone JES6-1A12) against IL-2 (IL-2 complexes) potently expands and activates Tregs in vivo. Therefore, we investigated whether IL-2 complexes can replace Treg therapy in a costimulation blockade-based and irradiation-free BM transplantation (BMT) model. Unexpectedly, the administration of IL-2 complexes at the time of BMT (instead of Tregs) failed to induce BM engraftment in non-irradiated recipients (0/6 with IL-2 complexes vs. 3/4 with Tregs, p<0.05). Adding IL-2 complexes to an otherwise effective regimen involving recipient irradiation (1Gy) but no Treg transfer indeed actively triggered donor BM rejection at higher doses (0/8 with IL-2 complexes vs. 9/11 without, p<0.01) and had no detectable effect at two lower doses (3/5 vs. 9/11, p>0.05). CD8 T cells and NK cells of IL-2 complex-treated naïve mice showed an enhanced proliferative response towards donor antigens in vitro despite the marked expansion of Tregs. However, IL-2 complexes also expanded conventional CD4 T cells, CD8 T cells, NK cells, NKT cells and notably even B cells, albeit to a lesser extent. Notably, IL-2 complex expanded Tregs featured less potent suppressive functions than in vitro activated Tregs in terms of T cell suppression in vitro and BM engraftment in vivo. In conclusion, these data suggest that IL-2 complexes are less effective than recipient Tregs in promoting BM engraftment and in contrast actually trigger BM rejection, as their effect is not sufficiently restricted to Tregs but rather extends to several other lymphocyte populations. PMID:26731275

  14. EPR spectroscopy of a clinically active (1:2) copper(II)-histidine complex used in the treatment of Menkes disease: a Fourier transform analysis of a fluid CW-EPR spectrum.

    PubMed

    Gala, Lukas; Lawson, Michael; Jomova, Klaudia; Zelenicky, Lubomir; Congradyova, Andrea; Mazur, Milan; Valko, Marian

    2014-01-01

    Redox active transition metal ions (e.g., iron and copper) have been implicated in the etiology of many oxidative stress-related diseases including also neurodegenerative disorders. Unbound copper can catalyze formation of reactive oxygen species (hydroxyl radicals) via Fenton reaction/Haber-Weiss chemistry and therefore, under physiological conditions, free copper is potentially toxic and very rarely exists inside cells. Copper(II) bound to the aminoacid L-histidine represents a species discovered in blood in the mid 60s and since then extensive research on this complex was carried out. Copper bound to L-histidine represents an exchangeable pool of copper(II) in equilibrium with the most abundant blood plasma protein, human serum albumin. The structure of this complex, in aqueous solution, has been a subject of many studies and reviews, however without convincing success. The significance of the (1:2) copper(II)-L-histidine complex at physiological pH documents its therapeutic applications in the treatment of Menkes disease and more recently in the treatment of infantile hypertrophic cardioencephalomyopathy. While recently the (1:2) Cu(II)-L-His complex has been successfully crystallized and the crystal structure was solved by X-ray diffraction, the structure of the complex in fluid solution at physiological pH is not satisfactorily known. The aim of this paper is to study the (1:2) Cu(II)-L-histidine complex at low temperatures by X-band and S-band EPR spectroscopy and at physiological pH at room temperature by Fourier transform CW-EPR spectroscopy. PMID:24434671

  15. Synthesis, structural characterization and cytotoxic activity of ternary copper(II)-dipeptide-phenanthroline complexes. A step towards the development of new copper compounds for the treatment of cancer.

    PubMed

    Iglesias, Sebastián; Alvarez, Natalia; Torre, María H; Kremer, Eduardo; Ellena, Javier; Ribeiro, Ronny R; Barroso, Rafael P; Costa-Filho, Antonio J; Kramer, M Gabriela; Facchin, Gianella

    2014-10-01

    In the search for new compounds with antitumor activity, coordination complexes with different metals are being studied by our group. This work presents the synthesis and characterization of six copper complexes with general stoichiometry [Cu(L-dipeptide)(phen)]·nH2O (were phen=1,10-phenanthroline) and their cytotoxic activities against tumor cell lines. To characterize these systems, analytical and spectroscopic studies were performed in solid state (by UV-visible, IR, X-ray diffraction) including the crystal structure of four new complexes (of the six complexes studied): [Cu(Ala-Phe)(phen)]·4H2O, [Cu(Phe-Ala)(phen)]·4H2O, [Cu(Phe-Val)(phen)]·4.5H2O and [Cu(Phe-Phe)(phen)]·3H2O. In all of them, the copper ion is situated in a distorted squared pyramidal environment. The phen ligand is perpendicular to the dipeptide, therefore exposed and potentially available for interaction with biological molecules. In addition, for all the studied complexes, structural information in solution using EPR and UV-visible spectroscopies were obtained, showing that the coordination observed in solid state is maintained. The lipophilicity, DNA binding and albumin interaction were also studied. Biological experiments showed that all the complexes induce cell death in the cell lines: HeLa (human cervical adenocarcinoma), MCF-7 (human metastatic breast adenocarcinoma) and A549 (human lung epithelial carcinoma). Among the six complexes, [Cu(Ala-Phe)(phen)] presents the lowest IC50 values. Taken together all these data we hypothesize that [Cu(Ala-Phe)(phen)] may be a good candidate for further studies in vivo. PMID:25033418

  16. Synthesis, characterization and evaluation of the suppression of insulin resistance in Type-II diabetes mellitus animals by treatment with metal complex.

    PubMed

    Phanse, Mohini A; Patil, Manohar J; Abbulu, Konde

    2016-05-01

    The present study is characterized toward thespesone isolation from Thespesia populnea (Malvaceae). Subsequently it was modified and characterized to study its effect on diabetes related symptoms. The complex is administered to diabetes induced mice with the doses of 5, 10 and 20 mg/kg, p.o. and the effect of complex on the level of body weight, lipid profile and blood glucose was studied after 22 days. The results have indicated that diabetic mice show a significant (p < 0.01) decrease in the level of serum triglyceride, plasma glucose and increase in body weight. Hence the present investigation reveals that newly synthesized complex is useful in the management of Type-II diabetes mellitus because of its ability to reduce insulin resistance. PMID:27081369

  17. Synthesis, characterization and evaluation of the suppression of insulin resistance in Type-II diabetes mellitus animals by treatment with metal complex

    PubMed Central

    Phanse, Mohini A.; Patil, Manohar J.; Abbulu, Konde

    2015-01-01

    The present study is characterized toward thespesone isolation from Thespesia populnea (Malvaceae). Subsequently it was modified and characterized to study its effect on diabetes related symptoms. The complex is administered to diabetes induced mice with the doses of 5, 10 and 20 mg/kg, p.o. and the effect of complex on the level of body weight, lipid profile and blood glucose was studied after 22 days. The results have indicated that diabetic mice show a significant (p < 0.01) decrease in the level of serum triglyceride, plasma glucose and increase in body weight. Hence the present investigation reveals that newly synthesized complex is useful in the management of Type-II diabetes mellitus because of its ability to reduce insulin resistance. PMID:27081369

  18. Topical Treatment With Liposomal Sodium Copper Chlorophyllin Complex in Subjects With Facial Redness and Erythematotelangiectatic Rosacea: Case Studies.

    PubMed

    Vasily, David B

    2015-10-01

    Physicians are often presented with patients complaining of facial redness and difficult to control rosacea. The water soluble sodium copper chlorophyllin complex has been shown to have anti-oxidant, anti-inflammatory, and anti-bacterial activities in vitro and anti-redness, pore reduction, and anti-acne activities in pilot clinical studies. In these case studies, the safety and efficacy of a topical gel containing a liposomal suspension of sodium copper chlorophyllin complex was assessed in subjects with facial redness and erythematotelangiectatic rosacea. PMID:26461829

  19. Routine Depression Screening in an HIV Clinic Cohort Identifies Patients with Complex Psychiatric Co-morbidities Who Show Significant Response to Treatment

    PubMed Central

    McCullumsmith, Cheryl; Mugavero, Michael J.; Ingle-Pang, Paige E.; Raper, James L.; Willig, James H.; You, Zhiying; Batey, D. Scott; Crane, Heidi; Lawrence, Sarah T.; Wright, Charles; Treisman, Glenn; Saag, Michael S.

    2015-01-01

    This study described characteristics, psychiatric diagnoses and response to treatment among patients in an outpatient HIV clinic who screened positive for depression. Depressed (25 %) were less likely to have private insurance, less likely to have suppressed HIV viral loads, had more anxiety symptoms, and were more likely to report current substance abuse than not depressed. Among depressed, 81.2 % met diagnostic criteria for a depressive disorder; 78 % for an anxiety disorder; 61 % for a substance use disorder; and 30 % for co-morbid anxiety, depression, and substance use disorders. Depressed received significantly more treatment for depression and less HIV primary care than not depressed patients. PHQ-9 total depression scores decreased by 0.63 from baseline to 6-month follow-up for every additional attended depression treatment visit. HIV clinics can routinely screen and treat depressive symptoms, but should consider accurate psychiatric diagnosis as well as co-occurring mental disorders. PMID:23086427

  20. New ethanol and propylene glycol free gel formulations containing a minoxidil-methyl-β-cyclodextrin complex as promising tools for alopecia treatment.

    PubMed

    Lopedota, Angela; Cutrignelli, Annalisa; Denora, Nunzio; Laquintana, Valentino; Lopalco, Antonio; Selva, Stefano; Ragni, Lorella; Tongiani, Serena; Franco, Massimo

    2015-05-01

    New topical totally aqueous formulations that improve the low water solubility of minoxidil and realize an adequate permeability of drug in the skin are proposed. These formulations are lacking in propylene glycol and alcohol that are the principal irritant ingredients present in minoxidil commercial solutions. In order to enhance poor water solubility of minoxidil randomly methyl-β-cyclodextrin was used, and four hydrogels such as, calcium alginate, sodium alginate, carbopol 934 and hydroxyethylcellulose were utilized to ensure a prolonged time of contact with the scalp. The inclusion complex minoxidil/methyl-β-cyclodextrin with a molar ratio 1:1 was obtained by freeze drying and evaluated by NMR, FT-IR and DSC analysis. An apparent stability constant of formed inclusion complex was calculated by phase solubility diagram and its value was 400 M(-1). The solid inclusion complex was used to prepare gel formulations with similar dose to minoxidil commercial solution. The gels were evaluated for various technological parameters including rheological behavior, in vitro drug release and ex vivo permeation through pig skin. The best performance was observed for the calcium alginate formulation. PMID:24650036

  1. Synthesis and characterization of Cu(II), Co(II) and Ni(II) complexes of a number of sulfadrug azodyes and their application for wastewater treatment.

    PubMed

    El-Baradie, K; El-Sharkawy, R; El-Ghamry, H; Sakai, K

    2014-01-01

    The azodye ligand (HL(1)) was synthesized from the coupling of sulfaguanidine diazonium salt with 2,4-dihydroxy-benzaldehyde while the two ligands, HL(2) and HL(3), were prepared by the coupling of sulfadiazine diazonium salt with salicylaldehyde (HL(2)) and 2,4-dihydroxy-benzaldehyde (HL(3)). The prepared ligands were characterized by elemental analysis, IR, (1)H NMR and mass spectra. Cu(II), Co(II) and Ni(II) complexes of the prepared ligands have been synthesized and characterized by various spectroscopic techniques like IR, UV-Visible as well as magnetic and thermal (TG and DTA) measurements. It was found that all the ligands behave as a monobasic bidentate which coordinated to the metal center through the azo nitrogen and α-hydroxy oxygen atoms in the case of HL(1) and HL(3). HL(2) coordinated to the metal center through sulfonamide oxygen and pyrimidine nitrogen. The applications of the prepared complexes in the oxidative degradation of indigo carmine dye exhibited good catalytic activity in the presence of H2O2 as an oxidant. The reactions followed first-order kinetics and the rate constants were determined. The degradation reaction involved the catalytic action of the azo-dye complexes toward H2O2 decomposition, which can lead to the generation of HO radicals as a highly efficient oxidant attacking the target dye. The detailed kinetic studies and the mechanism of these catalytic reactions are under consideration in our group. PMID:24239761

  2. Direct nerve suture and knee immobilization in 90° flexion as a technique for treatment of common peroneal, tibial and sural nerve injuries in complex knee trauma

    PubMed Central

    Döring, Robert; Ciritsis, Bernhard; Giesen, Thomas; Simmen, Hans-Peter; Giovanoli, Pietro

    2012-01-01

    There are different ways to treat peripheral nerve injuries with concomitant defects in the lower extremity. One option is a direct nerve suture followed by immobilization of the knee in flexion as it is described for gunshot wounds that lead to lesions of the sciatic nerve and its terminal branches as well as isolated nerve lesions. We used this technique to treat a case of multiple nerve injuries of the lower extremity combined with a complex knee trauma including a lesion of both bones and the posterior capsule. To our knowledge, this technique has not yet been described for such a combined injury in literature. PMID:24968417

  3. [COMPLEX OF THE TREATMENT MEASURES IN A SYSTEM OF THE MEDICAL CARE DELIVERY TO WOUNDED PERSONS WITH THE GUN-SHOT AND MINE-EXPLOSIVE INJURIES OF THE FOOT].

    PubMed

    Korohl, S O

    2015-11-01

    Complex of the treatment measures, conducted in 302 wounded persons, suffering the gun-shot and mine-explosive injuries of the foot in 2014 - 2015 yrs, was analyzed. Primary surgical processing of the wound was conducted in all injured persons, secondary surgical processing--in 64.6%, the foot bones osteosynthesis--in 13.9%, primary immobilization, using improvised tire--in 77.8%, secondary immobilization, using the plaster splint--in 48.1%, llizarov's spokes--in 35.2%, Ilizarov's apparatus--in 18.5%, the rods apparatuses of external fixation--in 16.7%. For improvement of functioning of a modern system for the treatment-evacuation provision it is necessary, to reduce the quantity of levels of the medical help provision maximally. PMID:26939433

  4. An effective pre-treatment method for the determination of short-chain fatty acids in a complex matrix by derivatization coupled with headspace single-drop microextraction.

    PubMed

    Chen, Yuan; Li, Yun; Xiong, Yongqiang; Fang, Chenchen; Wang, Xiaotao

    2014-01-17

    We have developed a sample preparation method involving derivatization combined with headspace single-drop microextraction (HS-SDME) for the determination of short-chain fatty acids (SCFAs) in complex matrices. The derivatization of SCFAs was conducted using the BF3/ethanol method prior to HS-SDME. The HS-SDME extraction conditions for the derivatization products (ethyl esters) of SCFAs were optimized using 1.0μL of dibutylphthalate (DBP), 1000rpm stirring speed, 30% (w/v) NaCl, 20min extraction time, and 7mL of sample solution in a 12mL vial. Quantitative determination of ethyl esters was performed using gas chromatography (GC). Linear calibration curves and excellent reproducibility were obtained using these optimized extraction conditions. Compared with our previous work, the significantly lower detection limits (0.11, 0.017, 0.0060, and 0.0024μg/mL for C2 to C5 SCFAs, respectively) indicate that this new method is suitable for quantitative analysis of SCFAs in complex matrices, such as the RuO4 oxidation products of kerogen or asphaltene. PMID:24388413

  5. A psychological intervention for smoking cessation delivered as treatment for smokers with chronic obstructive pulmonary disease: Multiple needs of a complex group and recommendations for novel service development.

    PubMed

    Yap, Su Yin; Lunn, Sarah; Pang, Elizabeth; Croft, Carla; Stern, Myra

    2015-08-01

    This pilot study investigated the benefits of adjunctive psychological intervention for smokers accessing standard smoking cessation interventions. Chronic obstructive pulmonary disease (COPD) smokers attending a smoking cessation service were offered up to 12 adjunctive clinical psychology sessions. Baseline data included demographics, smoking history, and disease severity. Outcomes included attendance and quit rate. In all, 59 patients with moderate COPD were referred. Of the 20 patients who attended training sessions, 7 (35%) were relapse prevention referrals and 13 (65%) were current smokers. Of the seven relapse prevention referrals, six (86%) maintained their quit, 2 of 13 (15%) of the current smoker group maintained a 28-day quit and 3 of 13 (23%) of current smokers reduced their tobacco intake. For COPD smokers with a heavy smoking history and multiple past quit attempts, there was insufficient evidence to show that additional psychological intervention leads to higher quit rates. Significant barriers to quitting and complex medical and psychosocial needs were identified in this group, suggesting that the current 'one-size-fits-all' approach to smoking cessation may not be sufficient to meet the needs of such a complex group. PMID:25990130

  6. [Experimental and clinical rationale for complex treatment of mental disorders in clean-up workers of the Chernobyl nuclear plant accident].

    PubMed

    Neznamov, G G; Koshelev, V V; Voronina, T A; Trofimov, S S

    2002-01-01

    Piracetam is an effective drug for the treatment of asthenic and intellectual-mnestic disorders. However, this drug induces superfluous stimulation which reduces the therapeutic effect in rescuers after Chernobyl nuclear power disaster. The results of experimental and clinical investigations show that the administration of gidazepam--an atypical benzodiazepine tranquilizer--in combination with piracetam produces correction of the undesired stimulant action of the latter drug, while potentiating the nootropic (antiamnesic) and anxiolytic effects. This drug interaction led to an improvement in the therapy. PMID:12109283

  7. Comparison of the Degree of Exercise Tolerance in Children After Surgical Treatment of Complex Cardiac Defects, Assessed Using Ergospirometry and the Level of Brain Natriuretic Peptide.

    PubMed

    Mazurek, Boguslaw; Szydlowski, Leslaw; Mazurek, Magdalena; Markiewicz-Loskot, Grazyna; Pajak, Jacek; Morka, Aleksandra

    2016-02-01

    Children who underwent surgery for complex congenital heart defects present worse exercise capacity than their healthy peers. In adults and adolescents, heart failure is assessed on the basis of clinical symptoms using the New York Heart Association (NYHA) score, while in an infant Ross scale; heart failure can also be evaluated by other parameters. The purpose of this study was to compare the degree of exercise tolerance in children after surgery for complex heart defects, assessed by the ratio of maximum oxygen uptake (VO2max) and the brain natriuretic peptide (N-terminal fragment of the prohormone brain-type natriuretic peptide [NT-proBNP]) concentration.The study group consisted of 42 children, ages 9 to 17 years (mean 14.00 ± 2.72). Among them there were 22 children with tetralogy of Fallot (ToF) after total correction, 18 children with transposition of the great arteries (d-TGA) after the arterial switch operation, and 2 children with single ventricle (SV) after the Fontan operation. All but 1 child were in NYHA class I. The control group consisted of 20 healthy children. Outcomes of interest were the ratio of VO2max, determined during ergospirometry, and the level of NT-proBNP. The statistical analysis was performed and the groups were considered significantly different for P < 0.05.There was no statistically significant correlation between NT-proBNP and maximum oxygen uptake (VO2) kg min in the study group compared with the control group.The VO2max in the test group had a mean value less (34.6 ± 8.0) than controls (38.4 ± 7.7), and the differences were statistically significant (P = 0.041). In contrast, the average concentration of NT-proBNP in the study group was higher than controls (117.9 ± 74.3 vs 18.0 ± 24.5), and these differences were statistically significant (P < 0.001).After operations for complex heart defects (ToF, TGA, and SV), children have worse heart function parameters and exercise capacity than the healthy population. To control this, we recommend postoperative ergospirometry and determination of NT-proBNP concentrations. PMID:26937900

  8. Comparison of the Degree of Exercise Tolerance in Children After Surgical Treatment of Complex Cardiac Defects, Assessed Using Ergospirometry and the Level of Brain Natriuretic Peptide

    PubMed Central

    Mazurek, Boguslaw; Szydlowski, Leslaw; Mazurek, Magdalena; Markiewicz-Loskot, Grazyna; Pajak, Jacek; Morka, Aleksandra

    2016-01-01

    Abstract Children who underwent surgery for complex congenital heart defects present worse exercise capacity than their healthy peers. In adults and adolescents, heart failure is assessed on the basis of clinical symptoms using the New York Heart Association (NYHA) score, while in an infant Ross scale; heart failure can also be evaluated by other parameters. The purpose of this study was to compare the degree of exercise tolerance in children after surgery for complex heart defects, assessed by the ratio of maximum oxygen uptake (VO2max) and the brain natriuretic peptide (N-terminal fragment of the prohormone brain-type natriuretic peptide [NT-proBNP]) concentration. The study group consisted of 42 children, ages 9 to 17 years (mean 14.00 ± 2.72). Among them there were 22 children with tetralogy of Fallot (ToF) after total correction, 18 children with transposition of the great arteries (d-TGA) after the arterial switch operation, and 2 children with single ventricle (SV) after the Fontan operation. All but 1 child were in NYHA class I. The control group consisted of 20 healthy children. Outcomes of interest were the ratio of VO2max, determined during ergospirometry, and the level of NT-proBNP. The statistical analysis was performed and the groups were considered significantly different for P < 0.05. There was no statistically significant correlation between NT-proBNP and maximum oxygen uptake (VO2) kg−1 min−1 in the study group compared with the control group. The VO2max in the test group had a mean value less (34.6 ± 8.0) than controls (38.4 ± 7.7), and the differences were statistically significant (P = 0.041). In contrast, the average concentration of NT-proBNP in the study group was higher than controls (117.9 ± 74.3 vs 18.0 ± 24.5), and these differences were statistically significant (P < 0.001). After operations for complex heart defects (ToF, TGA, and SV), children have worse heart function parameters and exercise capacity than the healthy population. To control this, we recommend postoperative ergospirometry and determination of NT-proBNP concentrations. PMID:26937900

  9. Successful Treatment of Phantom Limb Pain by 1 Hz Repetitive Transcranial Magnetic Stimulation Over Affected Supplementary Motor Complex: A Case Report

    PubMed Central

    Lee, Jong-Hoo; Byun, Jeong-Hyun; Choe, Yu-Ri; Lim, Seung-Kyu; Lee, Ka-Young

    2015-01-01

    A 37-year-old man with a right transfemoral amputation suffered from severe phantom limb pain (PLP). After targeting the affected supplementary motor complex (SMC) or primary motor cortex (PMC) using a neuro-navigation system with 800 stimuli of 1 Hz repetitive transcranial magnetic stimulation (rTMS) at 85% of resting motor threshold, the 1 Hz rTMS over SMC dramatically reduced his visual analog scale (VAS) of PLP from 7 to 0. However, the 1 Hz rTMS over PMC failed to reduce pain. To our knowledge, this is the first case report of a successfully treated severe PLP with a low frequency rTMS over SMC in affected hemisphere. PMID:26361601

  10. Successful Treatment of Phantom Limb Pain by 1 Hz Repetitive Transcranial Magnetic Stimulation Over Affected Supplementary Motor Complex: A Case Report.

    PubMed

    Lee, Jong-Hoo; Byun, Jeong-Hyun; Choe, Yu-Ri; Lim, Seung-Kyu; Lee, Ka-Young; Choi, In-Sung

    2015-08-01

    A 37-year-old man with a right transfemoral amputation suffered from severe phantom limb pain (PLP). After targeting the affected supplementary motor complex (SMC) or primary motor cortex (PMC) using a neuro-navigation system with 800 stimuli of 1 Hz repetitive transcranial magnetic stimulation (rTMS) at 85% of resting motor threshold, the 1 Hz rTMS over SMC dramatically reduced his visual analog scale (VAS) of PLP from 7 to 0. However, the 1 Hz rTMS over PMC failed to reduce pain. To our knowledge, this is the first case report of a successfully treated severe PLP with a low frequency rTMS over SMC in affected hemisphere. PMID:26361601

  11. A complex interplay between PGC-1 co-activators and mTORC1 regulates hematopoietic recovery following 5-fluorouracil treatment.

    PubMed

    Basu, Sunanda

    2014-01-01

    In vitro stimulation of HSCs with growth factors generally leads to their depletion. Understanding the molecular mechanisms underlying expansion of HSCs in vivo following myeloablation could lead to successful expansion of HSCs ex vivo for therapeutic purposes. Current findings show that mTORC1 is activated in HSPCs following 5-fluorouracil treatment and that mTORC1 activation is dependent on mitochondrial ETC capacity of HSPCs. Moreover, expression of PGC-1 family members, proteins that regulate mitochondrial biogenesis, in HSPCs following 5-fluorouracil treatment changes; also, these proteins play a stage specific role in hematopoietic recovery. While PRC regulates HSCs' expansion during early recovery phase, PGC-1α regulates progenitor cell proliferation and recovery of hematopoiesis during later phase. During early recovery phase, PRC expression, mitochondrial activity and mTORC1 activation are relatively higher in PGC-1α(-/-) HSCs compared to WT HSCs, and PGC-1α(-/-) HSCs show greater expansion. Administration of rapamycin, but not NAC, during early recovery phase improves WT HSC numbers but decreases PGC-1α(-/-) HSC numbers. The current findings demonstrate that mTOR activation can increase HSC numbers provided that the energy demand created by mTOR activation is successfully met. Thus, critical tuning between mTORC1 activation and mitochondrial ETC capacity is crucial for HSC maintenance/expansion in response to mitogenic stimulation. PMID:24239965

  12. Complexity Survey.

    ERIC Educational Resources Information Center

    Gordon, Sandra L.; Anderson, Beth C.

    To determine whether consensus existed among teachers about the complexity of common classroom materials, a survey was administered to 66 pre-service and in-service kindergarten and prekindergarten teachers. Participants were asked to rate 14 common classroom materials as simple, complex, or super-complex. Simple materials have one obvious part,…

  13. Incontinence Treatment: Surgical Treatments

    MedlinePlus

    ... in Children Signs & Symptoms Symptoms of Incontinence Diarrhea Treatment Lifestyle Changes Dietary Tips Medication Bowel Management Biofeedback Surgical Treatments Newer Treatment Options Tips on Finding a Doctor ...

  14. Communication complexity and information complexity

    NASA Astrophysics Data System (ADS)

    Pankratov, Denis

    Information complexity enables the use of information-theoretic tools in communication complexity theory. Prior to the results presented in this thesis, information complexity was mainly used for proving lower bounds and direct-sum theorems in the setting of communication complexity. We present three results that demonstrate new connections between information complexity and communication complexity. In the first contribution we thoroughly study the information complexity of the smallest nontrivial two-party function: the AND function. While computing the communication complexity of AND is trivial, computing its exact information complexity presents a major technical challenge. In overcoming this challenge, we reveal that information complexity gives rise to rich geometrical structures. Our analysis of information complexity relies on new analytic techniques and new characterizations of communication protocols. We also uncover a connection of information complexity to the theory of elliptic partial differential equations. Once we compute the exact information complexity of AND, we can compute exact communication complexity of several related functions on n-bit inputs with some additional technical work. Previous combinatorial and algebraic techniques could only prove bounds of the form theta( n). Interestingly, this level of precision is typical in the area of information theory, so our result demonstrates that this meta-property of precise bounds carries over to information complexity and in certain cases even to communication complexity. Our result does not only strengthen the lower bound on communication complexity of disjointness by making it more exact, but it also shows that information complexity provides the exact upper bound on communication complexity. In fact, this result is more general and applies to a whole class of communication problems. In the second contribution, we use self-reduction methods to prove strong lower bounds on the information complexity of two of the most studied functions in the communication complexity literature: Gap Hamming Distance (GHD) and Inner Product mod 2 (IP). In our first result we affirm the conjecture that the information complexity of GHD is linear even under the uniform distribution. This strengthens the O(n) bound shown by Kerenidis et al. (2012) and answers an open problem by Chakrabarti et al. (2012). We also prove that the information complexity of IP is arbitrarily close to the trivial upper bound n as the permitted error tends to zero, again strengthening the O(n) lower bound proved by Braverman and Weinstein (2011). More importantly, our proofs demonstrate that self-reducibility makes the connection between information complexity and communication complexity lower bounds a two-way connection. Whereas numerous results in the past used information complexity techniques to derive new communication complexity lower bounds, we explore a generic way, in which communication complexity lower bounds imply information complexity lower bounds in a black-box manner. In the third contribution we consider the roles that private and public randomness play in the definition of information complexity. In communication complexity, private randomness can be trivially simulated by public randomness. Moreover, the communication cost of simulating public randomness with private randomness is well understood due to Newman's theorem (1991). In information complexity, the roles of public and private randomness are reversed: public randomness can be trivially simulated by private randomness. However, the information cost of simulating private randomness with public randomness is not understood. We show that protocols that use only public randomness admit a rather strong compression. In particular, efficient simulation of private randomness by public randomness would imply a version of a direct sum theorem in the setting of communication complexity. This establishes a yet another connection between the two areas. (Abstract shortened by UMI.).

  15. Incontinence Treatment: Surgical Treatments

    MedlinePlus

    ... Treatment Lifestyle Changes Dietary Tips Medication Bowel Management Biofeedback Surgical Treatments Newer Treatment Options Tips on Finding ... changes Dietary changes Medication Bowel management/retraining program Biofeedback therapy Surgical treatments Newer procedures or devices Tips ...

  16. Hyaluronic acid co-functionalized gold nanoparticle complex for the targeted delivery of metformin in the treatment of liver cancer (HepG2 cells).

    PubMed

    Kumar, C Senthil; Raja, M D; Sundar, D Sathish; Gover Antoniraj, M; Ruckmani, K

    2015-09-01

    In this study, green synthesis of gold nanoparticles (AuNPs) was achieved using the extract of eggplant as a reducing agent. Hyaluronic acid (HA) serves as a capping and targeting agent. Metformin (MET) was successfully loaded on HA capped AuNPs (H-AuNPs) and this formulation binds easily on the surface of the liver cancer cells. The synthesized nanoparticles were characterized by UV-Vis spectrophotometer, HR-TEM, particle size analyser and zeta potential measurement. Toxicity studies of H-AuNPs in zebra fish confirmed the in vivo safety of the AuNPs. The in vitro cytotoxicity results showed that the amount of MET-H-AuNPs enough to achieve 50% inhibition (IC50) was much lower than free MET. Flow cytometry analysis showed the significant reduction in G2/M phase after treatment with MET-H-AuNPs, and molecular level apoptosis were studied using western blotting. The novelty of this study is the successful synthesis of AuNPs with a higher MET loading and this formulation exhibited better targeted delivery as well as increased regression activity than free MET in HepG2 cells. PMID:26005140

  17. Anti-N-methyl-d-aspartate receptor encephalitis in a patient with a 7-year history of being diagnosed as schizophrenia: complexities in diagnosis and treatment

    PubMed Central

    Huang, Chaohua; Kang, Yukun; Zhang, Bo; Li, Bin; Qiu, Changjian; Liu, Shanming; Ren, Hongyan; Yang, Yanchun; Liu, Xiehe; Li, Tao; Guo, Wanjun

    2015-01-01

    Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is a form of autoimmune encephalitis associated with antibodies against the NR1 subunits of NMDARs. Although new-onset acute prominent psychotic syndromes in patients with NMDAR encephalitis have been well documented, there is a lack of case studies on differential diagnosis and treatment of anti-NMDAR encephalitis after a long-term diagnostic history of functional psychotic disorders. The present study reports an unusual case of anti-NMDAR encephalitis. The patient had been diagnosed with schizophrenia 7 years earlier, and was currently hospitalized for acute-onset psychiatric symptoms. The diagnosis became unclear when the initial psychosis was confounded with considerations of other neurotoxicities (such as neuroleptic malignant syndrome). Finally, identification of specific immunoglobulin G NR1 autoantibodies in the cerebrospinal fluid and greater effectiveness of immunotherapy over antipsychotics alone (which has been well documented in anti-NMDAR encephalitis) indicated the diagnosis of anti-NMDAR encephalitis in this case. Based on the available evidence, however, the relationship between the newly diagnosed anti-NMDAR encephalitis and the seemingly clear, long-term history of schizophrenia in the preceding 7 years is uncertain. This case report illustrates that psychiatrists should consider anti-NMDAR encephalitis and order tests for specific immunoglobulin G NR1 autoantibodies in patients presenting with disorientation, disturbance of consciousness, cognitive deficit, dyskinesia, autonomic disturbance, or rapid deterioration, even with a seemingly clear history of a psychiatric disorder and no specific findings on routine neuroimaging, electroencephalography, or cerebrospinal fluid tests in the early stage of the illness. PMID:26089673

  18. Fourier-transform spectroscopy and coupled-channels deperturbation treatment of the A {sup 1{Sigma}+}-b {sup 3{Pi}} complex of KCs

    SciTech Connect

    Kruzins, A.; Klincare, I.; Nikolayeva, O.; Tamanis, M.; Ferber, R.; Pazyuk, E. A.; Stolyarov, A. V.

    2010-04-15

    The laser-induced fluorescence (LIF) A {sup 1{Sigma}+}-b {sup 3{Pi}{yields}}X {sup 1{Sigma}+} spectra of the KCs molecule were recorded in a near infrared region by a Fourier-transform spectrometer with a resolution of 0.03 cm{sup -1}. Overall more than 200 collisionally enhanced LIF spectra were rotationally assigned to {sup 39}K{sup 133}Cs and {sup 41}K{sup 133}Cs isotopomers yielding more than 3400 rovibronic term values of the strongly mixed singlet A {sup 1{Sigma}+} and triplet b {sup 3{Pi}} states with the uncertainty of 0.003-0.01 cm{sup -1}. Experimental data massive starts from the lowest vibrational level v{sub A}=0 of the singlet and nonuniformly covers the energy range E is an element of [10 040,13 250] cm{sup -1} with rotational quantum numbers J{sup '} is an element of [7,225]. Besides the dominating regular A {sup 1{Sigma}+}-b {sup 3{Pi}}{sub {Omega}=0} interactions, the weak local heterogeneous A {sup 1{Sigma}+}-b {sup 3{Pi}}{sub {Omega}=1} perturbations have been discovered and analyzed. Coupled-channels deperturbation analysis of the experimental {sup 39}K{sup 133}Cs e-parity term values of the A {sup 1{Sigma}+}-b {sup 3{Pi}}{sub {Omega}=0,1,2} complex was accomplished in the framework of the phenomenological 4x4 Hamiltonian accounting implicitly for regular interactions with the remote {sup 1{Pi}} and {sup 3{Sigma}+} states. The diabatic potential energy curves of the A {sup 1{Sigma}+} and b {sup 3{Pi}} states, as well as relevant spin-orbit coupling matrix elements, were defined analytically with the expanded Morse oscillators model. The obtained parameters reproduce 95% of experimental data field of the {sup 39}K{sup 133}Cs isotopomer with a standard deviation of 0.004 cm{sup -1}, which is consistent with the uncertainty of the experiment. Reliability of the derived parameters was confirmed by a good agreement between the predicted and experimental term values of the {sup 41}K{sup 133}Cs isotopomer. The calculated relative intensity distributions in A-b{yields}X LIF progressions are also consistent with their experimental counterparts. The deperturbation model was applied for simulation of a pump-dump optical cycle a {sup 3{Sigma}+{yields}}A {sup 1{Sigma}+}-b {sup 3{Pi}{yields}}X {sup 1{Sigma}+} proposed for transformation of ultracold KCs molecules to their absolute ground state v{sub X}=0;J{sub X}=0.

  19. A Phase I Trial of Samarium-153-Lexidronam Complex for Treatment of Clinically Nonmetastatic High-Risk Prostate Cancer: First Report of a Completed Study

    SciTech Connect

    Valicenti, Richard K.; Trabulsi, Edouard; Intenzo, Charles; Lavarino, Jorosali; Xu Yihuan; Chervoneva, Inna

    2011-03-01

    Purpose: We completed a Phase I trial to determine the maximum tolerated dose of samarium-153 EDTMP ({sup 153}Sm) with hormonal therapy (HT) and radiation therapy (RT) in high-risk clinically nonmetastatic prostate cancer. Methods and Materials: High-risk M0 prostate cancer patients (prostate-specific antigen >20 ng/mL, Gleason score >7, or >T3) were eligible for this prospective trial of dose-escalated radioactive {sup 153}Sm-EDTMP (.25-2.0 mCi/kg) as primary or postoperative therapy. After 1 month of HT, we administered {sup 153}Sm-EDTMP followed by 4 more months of HT, 46.8 Gy to the pelvic region and 23.4 Gy to the prostate target (TD = 70.2 Gy). The primary endpoint was Grade III toxicity or higher by the National Cancer Institute Common Toxicity Criteria. Results: Twenty-nine patients enrolled (median prostate-specific antigen = 8.2 ng/mL, 27/29 (93%) T stage {>=}T2b, 24/29 (83%) had Gleason >7) and received {sup 153}Sm-EDTMP (.25 mCi/kg, 4 patients; 0.5 mCi/kg, 4 patients; 0.75 mCi/kg, 6 patients; 1.0 mCi/kg, 6 patients; 1.5 mCi/kg, 5 patients; 2.0mCi/kg, 4 patients). Twenty-eight patients underwent all planned therapy without delays (1 patient required surgery before the start of RT). With a median follow-up time of 23 months, there were 2 patients (7 %) experiencing Grade III hematologic toxicity. There were no other Grade III or IV side effects. Conclusions: Our trial demonstrates that 2 mCi/kg {sup 153}Sm -EDTMP with HT and RT was safe and feasible in men with high-risk M0 prostate cancer. A Phase II study to test this treatment is currently underway by the Radiation Therapy Oncology Group.

  20. Complex derivatives

    NASA Astrophysics Data System (ADS)

    Battiston, Stefano; Caldarelli, Guido; Georg, Co-Pierre; May, Robert; Stiglitz, Joseph

    2013-03-01

    The intrinsic complexity of the financial derivatives market has emerged as both an incentive to engage in it, and a key source of its inherent instability. Regulators now faced with the challenge of taming this beast may find inspiration in the budding science of complex systems.

  1. Designing Complexity

    ERIC Educational Resources Information Center

    Glanville, Ranulph

    2007-01-01

    This article considers the nature of complexity and design, as well as relationships between the two, and suggests that design may have much potential as an approach to improving human performance in situations seen as complex. It is developed against two backgrounds. The first is a world view that derives from second order cybernetics and radical…

  2. Softball Complex

    ERIC Educational Resources Information Center

    Ellis, Jim

    1977-01-01

    The Parks and Recreation Department of Montgomery, Alabama, has developed a five-field softball complex as part of a growing community park with facilities for camping, golf, aquatics, tennis, and picnicking. (MJB)

  3. Phonological Complexity and Language Learnability

    ERIC Educational Resources Information Center

    Gierut, Judith A.

    2007-01-01

    Purpose: To extend formal models of language learnability to applications in clinical treatment of children with functional phonological delays. Method: The focus of the narrative review is on phonological complexity. This follows from learnability theory, whereby complexity in the linguistic input to children has been shown to trigger language…

  4. Tuberous sclerosis complex.

    PubMed

    DiMario, Francis J; Sahin, Mustafa; Ebrahimi-Fakhari, Darius

    2015-06-01

    Tuberous sclerosis complex is an autosomal-dominant, neurocutaneous, multisystem disorder characterized by cellular hyperplasia and tissue dysplasia. The genetic cause is mutations in the TSC1 gene, found on chromosome 9q34, and TSC2 gene, found on chromosome 16p13. The clinical phenotypes resulting from mutations in either of the 2 genes are variable in each individual. Herein, advances in the understanding of molecular mechanisms in tuberous sclerosis complex are reviewed, and current guidelines for diagnosis, treatment, follow-up, and management are summarized. PMID:26022167

  5. TREATMENT AND DISPOSAL OF COMPLEX INDUSTRIAL WASTES

    EPA Science Inventory

    The waste effluent from operation of the Tuscaloosa, Alabama, plant of Reichhold Chemicals, Inc., results from both batch and continuous operations, contains both organic and inorganic wastes and varies both in composition and concentration. This report describes development of a...

  6. Controlling complexity

    NASA Astrophysics Data System (ADS)

    Zelinka, Ivan; Skanderova, Lenka; Davendra, Donald D.; Senkerik, Roman; Oplatkova, Zuzana

    2012-09-01

    Complex systems and dynamics are present in many parts of daily life and branches of science. This participation is continuation of our previous research, that introduced a novelty method of visualization and possible control of complex networks, that are used to visualize dynamics of evolutionary algorithms. Selected evolutionary algorithms are used as an example in order to show how its behavior can be understood as complex network and controlled via conversion into CML system - a model based on mutually joined nonlinear n equations. The main aim of this investigation was to show that dynamics of evolutionary algorithms can be converted to CML system and then controlled. Selected results of evolutionary controlled CML system are discussed here.

  7. Holographic complexity

    NASA Astrophysics Data System (ADS)

    Alishahiha, Mohsen

    2015-12-01

    For a field theory with a gravitational dual, following Susskind's proposal we define holographic complexity for a subsystem. The holographic complexity is proportional to the volume of a codimension one time slice in the bulk geometry enclosed by the extremal codimension two hypersurface appearing in the computation of the holographic entanglement entropy. The proportionally constant, up to a numerical order of 1 factor is G R where G is the Newton constant and R is the curvature of the space-time. We study this quantity in certain holographic models. We also explore a possible relation between the defined quantity and fidelity appearing in quantum information literature.

  8. Land Treatment Digital Library

    USGS Publications Warehouse

    Pilliod, David S.; Welty, Justin L.

    2013-01-01

    The Land Treatment Digital Library (LTDL) was created by the U.S. Geological Survey to catalog legacy land treatment information on Bureau of Land Management lands in the western United States. The LTDL can be used by federal managers and scientists for compiling information for data-calls, producing maps, generating reports, and conducting analyses at varying spatial and temporal scales. The LTDL currently houses thousands of treatments from BLM lands across 10 states. Users can browse a map to find information on individual treatments, perform more complex queries to identify a set of treatments, and view graphs of treatment summary statistics.

  9. Packaged Waste Treatment

    NASA Technical Reports Server (NTRS)

    1977-01-01

    This Jacksonville, Florida, apartment complex has a wastewater treatment system which clears the water, removes harmful microorganisms and reduces solid residue to ash. It is a spinoff from spacecraft waste management and environmental control technology.

  10. Researching Complexity.

    ERIC Educational Resources Information Center

    Sumara, Dennis J.

    2000-01-01

    Discusses what Complexity Theory (presented as a rubric that collects theoretical understandings from a number of domains such as ecology, biology, neurology, and education) suggests about mind, selfhood, intelligence, and practices of reading, and the import of these reconceptualizations to reader-response researchers. Concludes that developing…

  11. Complex interactions

    NASA Astrophysics Data System (ADS)

    de Régules, Sergio

    2016-04-01

    Complexity science – which describes phenomena such as collective and emergent behaviour – is the focus of a new centre where researchers are examining everything from the spread of influenza to what a healthy heartbeat looks like. Sergio de Régules reports.

  12. Amorphic complexity

    NASA Astrophysics Data System (ADS)

    Fuhrmann, G.; Gröger, M.; Jäger, T.

    2016-02-01

    We introduce amorphic complexity as a new topological invariant that measures the complexity of dynamical systems in the regime of zero entropy. Its main purpose is to detect the very onset of disorder in the asymptotic behaviour. For instance, it gives positive value to Denjoy examples on the circle and Sturmian subshifts, while being zero for all isometries and Morse-Smale systems. After discussing basic properties and examples, we show that amorphic complexity and the underlying asymptotic separation numbers can be used to distinguish almost automorphic minimal systems from equicontinuous ones. For symbolic systems, amorphic complexity equals the box dimension of the associated Besicovitch space. In this context, we concentrate on regular Toeplitz flows and give a detailed description of the relation to the scaling behaviour of the densities of the p-skeletons. Finally, we take a look at strange non-chaotic attractors appearing in so-called pinched skew product systems. Continuous-time systems, more general group actions and the application to cut and project quasicrystals will be treated in subsequent work.

  13. Managing Complexity

    SciTech Connect

    Chassin, David P.; Posse, Christian; Malard, Joel M.

    2004-08-01

    Physical analogs have shown considerable promise for understanding the behavior of complex adaptive systems, including macroeconomics, biological systems, social networks, and electric power markets. Many of today’s most challenging technical and policy questions can be reduced to a distributed economic control problem. Indeed, economically-based control of large-scale systems is founded on the conjecture that the price-based regulation (e.g., auctions, markets) results in an optimal allocation of resources and emergent optimal system control. This paper explores the state of the art in the use physical analogs for understanding the behavior of some econophysical systems and to deriving stable and robust control strategies for them. In particular we review and discussion applications of some analytic methods based on the thermodynamic metaphor according to which the interplay between system entropy and conservation laws gives rise to intuitive and governing global properties of complex systems that cannot be otherwise understood.

  14. Time complexity and gate complexity

    SciTech Connect

    Koike, Tatsuhiko; Okudaira, Yosuke

    2010-10-15

    We formulate and investigate the simplest version of time-optimal quantum computation theory (TO-QCT), where the computation time is defined by the physical one and the Hamiltonian contains only one- and two-qubit interactions. This version of TO-QCT is also considered as optimality by sub-Riemannian geodesic length. The work has two aims: One is to develop a TO-QCT itself based on a physically natural concept of time, and the other is to pursue the possibility of using TO-QCT as a tool to estimate the complexity in conventional gate-optimal quantum computation theory (GO-QCT). In particular, we investigate to what extent is true the following statement: Time complexity is polynomial in the number of qubits if and only if gate complexity is also. In the analysis, we relate TO-QCT and optimal control theory (OCT) through fidelity-optimal computation theory (FO-QCT); FO-QCT is equivalent to TO-QCT in the limit of unit optimal fidelity, while it is formally similar to OCT. We then develop an efficient numerical scheme for FO-QCT by modifying Krotov's method in OCT, which has a monotonic convergence property. We implemented the scheme and obtained solutions of FO-QCT and of TO-QCT for the quantum Fourier transform and a unitary operator that does not have an apparent symmetry. The former has a polynomial gate complexity and the latter is expected to have an exponential one which is based on the fact that a series of generic unitary operators has an exponential gate complexity. The time complexity for the former is found to be linear in the number of qubits, which is understood naturally by the existence of an upper bound. The time complexity for the latter is exponential in the number of qubits. Thus, both the targets seem to be examples satisfyng the preceding statement. The typical characteristics of the optimal Hamiltonians are symmetry under time reversal and constancy of one-qubit operation, which are mathematically shown to hold in fairly general situations.

  15. Cosmic Complexity

    NASA Technical Reports Server (NTRS)

    Mather, John C.

    2012-01-01

    What explains the extraordinary complexity of the observed universe, on all scales from quarks to the accelerating universe? My favorite explanation (which I certainty did not invent) ls that the fundamental laws of physics produce natural instability, energy flows, and chaos. Some call the result the Life Force, some note that the Earth is a living system itself (Gaia, a "tough bitch" according to Margulis), and some conclude that the observed complexity requires a supernatural explanation (of which we have many). But my dad was a statistician (of dairy cows) and he told me about cells and genes and evolution and chance when I was very small. So a scientist must look for me explanation of how nature's laws and statistics brought us into conscious existence. And how is that seemll"!gly Improbable events are actually happening a!1 the time? Well, the physicists have countless examples of natural instability, in which energy is released to power change from simplicity to complexity. One of the most common to see is that cooling water vapor below the freezing point produces snowflakes, no two alike, and all complex and beautiful. We see it often so we are not amazed. But physlc!sts have observed so many kinds of these changes from one structure to another (we call them phase transitions) that the Nobel Prize in 1992 could be awarded for understanding the mathematics of their common features. Now for a few examples of how the laws of nature produce the instabilities that lead to our own existence. First, the Big Bang (what an insufficient name!) apparently came from an instability, in which the "false vacuum" eventually decayed into the ordinary vacuum we have today, plus the most fundamental particles we know, the quarks and leptons. So the universe as a whole started with an instability. Then, a great expansion and cooling happened, and the loose quarks, finding themselves unstable too, bound themselves together into today's less elementary particles like protons and neutrons, liberating a little energy and creating complexity. Then, the expanding universe cooled some more, and neutrons and protons, no longer kept apart by immense temperatures, found themselves unstable and formed helium nuclei. Then, a little more cooling, and atomic nuclei and electrons were no longer kept apart, and the universe became transparent. Then a little more cooling, and the next instability began: gravitation pulled matter together across cosmic distances to form stars and galaxies. This instability is described as a "negative heat capadty" in which extracting energy from a gravitating system makes it hotter -- clearly the 2nd law of thermodynamics does not apply here! (This is the physicist's part of the answer to e e cummings' question: what is the wonder that's keeping the stars apart?) Then, the next instability is that hydrogen and helium nuclei can fuse together to release energy and make stars burn for billions of years. And then at the end of the fuel source, stars become unstable and explode and liberate the chemical elements back into space. And because of that, on planets like Earth, sustained energy flows support the development of additional instabilities and all kinds of complex patterns. Gravitational instability pulls the densest materials into the core of the Earth, leaving a thin skin of water and air, and makes the interior churn incessantly as heat flows outwards. And the heat from the sun, received mostly near the equator and flowing towards the poles, supports the complex atmospheric and oceanic circulations. And because or that, the physical Earth is full of natural chemical laboratories, concentrating elements here, mixing them there, raising and lowering temperatures, ceaselessly experimenting with uncountable events where new instabilities can arise. At least one of them was the new experiment called life. Now that we know that there are at least as many planets as there are stars, it is hard to imagine that nature's ceasess experimentation would not be able to produce life elsewhere -- but we don't know for sure. And life went on to cause new Instabilities, constantly evolving, with living things in an extraordinary range of environments, changing the global environment, with boom-and-bust cycles. with predators for every kInd of prey, with criminals for every possible crime, with governments to prevent them, and instabilities of the governments themselves. One of the instabilities Is that humans demand new weapons and new products of all sort, leading to serious investments in science and technology. So the natural/human world of competition and combat is structured to lead to advanced weaponry and cell phones. So here we are In 2012, with people writing essays and wondering whether their descendents will be artificial life forms travelling back into space. And, pondering what are the origins of those forces of nature that give rise to everything. Verllnde has argued that gravitation, the one force that has so far resisted our efforts at a Quantum description, is not even a fundamental force, but is itself it a statistical force, like osmosis. What an amazing turn of events! But after all I've just said, I should not be surprised a bit.

  16. Complex posterior urethral injury

    PubMed Central

    Kulkarni, Sanjay B.; Joshi, Pankaj M.; Hunter, Craig; Surana, Sandesh; Shahrour, Walid; Alhajeri, Faisal

    2015-01-01

    Objective To assess treatment strategies for seven different scenarios for treating complex pelvic fracture urethral injury (PFUI), categorised as repeat surgery for PFUI, ischaemic bulbar urethral necrosis (BUN), repair in boys and girls aged ⩽12 years, in patients with a recto-urethral fistula, or bladder neck incontinence, or with a double block at the bulbomembranous urethra and bladder neck/prostate region. Patients and methods We retrospectively reviewed the success rates and surgical procedures of these seven complex scenarios in the repair of PFUI at our institution from 2000 to 2013. Results In all, >550 PFUI procedures were performed at our centre, and 308 of these patients were classified as having a complex PFUI, with 225 patients available for follow-up. The overall success rates were 81% and 77% for primary and repeat procedures respectively. The overall success rate of those with BUN was 76%, using various methods of novel surgical techniques. Boys aged ⩽12 years with PFUI required a transpubic/abdominal approach 31% of the time, compared to 9% in adults. Young girls with PFUI also required a transpubic/abdominal urethroplasty, with a success rate of 66%. In patients with a recto-urethral fistula the success rate was 90% with attention to proper surgical principles, including a three-stage procedure and appropriate interposition. The treatment of bladder neck incontinence associated with the tear-drop deformity gave a continence rate of 66%. Children with a double block at the bulbomembranous urethra and at the bladder neck-prostate junction were all continent after a one-stage transpubic/abdominal procedure. Conclusion An understanding of complex pelvic fractures and their appropriate management can provide successful outcomes. PMID:26019978

  17. Symmetry and complexity

    NASA Astrophysics Data System (ADS)

    Mainzer, Klaus

    Symmetry and complexity in early culture and philosophy -- Symmetry and complexity in mathematics -- Symmetry and complexity in physical sciences -- Symmetry and complexity in chemical sciences -- Symmetry and complexity in life sciences -- Symmetry and complexity in economic and social sciences -- Symmetry and complexity in computer science -- Symmetry and complexity in philosophy and arts.

  18. Complex regional pain syndrome

    PubMed Central

    Sebastin, Sandeep J

    2011-01-01

    Complex regional pain syndrome (CRPS) previously known as reflex sympathetic dystrophy is a chronic neurological disorder involving the limbs characterized by disabling pain, swelling, vasomotor instability, sudomotor abnormality, and impairment of motor function. CRPS is not uncommon after hand surgery and may complicate post-operative care. There is no specific diagnostic test for CRPS and the diagnosis is based on history, clinical examination, and supportive laboratory findings. Recent modifications to diagnostic criteria have enabled clinicians to diagnose this disease more consistently. This review gives a synopsis of CRPS and discusses the diagnosis, pathophysiology, and treatment options based on the limited evidence in the literature. PMID:22022040

  19. [Carney complex].

    PubMed

    Losada Grande, Eladio José; Al Kassam Martínez, Daniel; González Boillos, Margarita

    2011-01-01

    Carney complex (CNC) is an autosomal dominantly inherited syndrome characterized by spotty skin pigmentation, cardiac and cutaneous myxoma, and endocrine overactivity. Skin pigmentation includes lentigines and blue nevi. Myxomas may occur in breast, skin and heart. Cardiac myxomas may be multiple and occur in any cardiac chamber, and are more prone to recurrence. The most common endocrine gland manifestation is an ACTH-independent Cushing's syndrome due to primary pigmented nodular adrenocortical disease (PPNAD). PPNAD may occur isolated, with no other signs of CNC. Pituitary and thyroid glands and gonads are also involved. The PRKAR1A gene, located in 17 q22-24, encodes type 1A regulatory subunit of protein kinase A. Inactivating germline mutations of this gene are found in 70% of patients with CNC. PRKAR1A is a key component of the c-AMP signaling pathway that has been implicated in endocrine tumorigenesis. Many different mutations have been reported in the PRKAR1A gene. In almost all cases the sequence change was predicted to lead to a premature stop codon and the resultant mutant mRNA was subject to nonsense-mediated mRNA decay. There is no clear genotype-phenotype correlation in patients with CNC. Genetic analysis should be performed in all CNC index cases. All affected patients should be monitored for clinical signs of CNC at least once a year. Genetic diagnosis allows for more effective preparation of more appropriate and effective therapeutic strategies and genetic counseling for patients and gene carriers, and to avoid unnecessary tests to relatives not carrying the gene. PMID:21536508

  20. Tuberous sclerosis complex.

    PubMed

    Henske, Elizabeth P; Jóźwiak, Sergiusz; Kingswood, J Christopher; Sampson, Julian R; Thiele, Elizabeth A

    2016-01-01

    Tuberous sclerosis complex (TSC) is an autosomal dominant disorder that affects multiple organ systems and is caused by loss-of-function mutations in one of two genes: TSC1 or TSC2. The disorder can affect both adults and children. First described in depth by Bourneville in 1880, it is now estimated that nearly 2 million people are affected by the disease worldwide. The clinical features of TSC are distinctive and can vary widely between individuals, even within one family. Major features of the disease include tumours of the brain, skin, heart, lungs and kidneys, seizures and TSC-associated neuropsychiatric disorders, which can include autism spectrum disorder and cognitive disability. TSC1 (also known as hamartin) and TSC2 (also known as tuberin) form the TSC protein complex that acts as an inhibitor of the mechanistic target of rapamycin (mTOR) signalling pathway, which in turn plays a pivotal part in regulating cell growth, proliferation, autophagy and protein and lipid synthesis. Remarkable progress in basic and translational research, in addition to several randomized controlled trials worldwide, has led to regulatory approval of the use of mTOR inhibitors for the treatment of renal angiomyolipomas, brain subependymal giant cell astrocytomas and pulmonary lymphangioleiomyomatosis, but further research is needed to establish full indications of therapeutic treatment. In this Primer, we review the state-of-the-art knowledge in the TSC field, including the molecular and cellular basis of the disease, medical management, major knowledge gaps and ongoing research towards a cure. PMID:27226234

  1. [Complex decongestive therapy].

    PubMed

    Heinig, B; Wollina, U

    2015-11-01

    The amount of physical pressure plays an important role in complex decongestive therapy (CDT). As a function of pressure, microcirculation takes place between blood vessels and tissue. As part of the total lymphatic system, lymphatic vessels transport the lymphatic load from the interstitial space to the blood stream. The lymphatic vessel system, characterized by specific anatomical conditions like initial lymphatic vessels, precollectors, collectors, and lymphatic strains, is the therapeutic target of complex decongestive therapy. Components of CDT include manual lymphatic drainage, compression therapy, decongestive kinesitherapy, and good skin care, which increase the transport capacity of the lymphatic vessel system. Currently, CDT is acknowledged as the main conservative treatment of lymphedema of primary and secondary genesis, lipolymphedema, and phlebolymphedema. In clinical practice, we are increasingly confronted with edema of multifactorial genesis requiring a critical discussion and stocktaking of comprehensive clinical findings in terms of the indication for CDT. Therapeutic success depends on a joint application of all CDT components and patient compliance. To an increasing extent, medical research tries to combine successfully CDT with adjunct treatment options. PMID:26315101

  2. Complexed iron removal from groundwater

    SciTech Connect

    Munter, R.; Ojaste, H.; Sutt, J.

    2005-07-01

    The paper demonstrates an intensive work carried out and results obtained on the pilot plant of the City of Kogalym Water Treatment Station (Tjumen, Siberia, Russian Federation) to elaborate on a contemporary nonreagent treatment technology for the local iron-rich groundwater. Several filter materials (Birm, Pyrolox, hydroanthracite, Everzit, granulated activated carbon) and chemical oxidants (ozone, chlorine, hydrogen peroxide, oxygen, and potassium permanganate) were tested to solve the problem with complexed iron removal from groundwater. The final elaborated technology consists of raw water intensive aeration in the gas-degas treatment unit followed by sequential filtration through hydroanthracite and the special anthracite Everzit.

  3. Hyperbaric treatment

    NASA Technical Reports Server (NTRS)

    Amoroso, Michael T.

    1990-01-01

    Viewgraphs on hyperbaric treatment are presented. Topics covered include: hyperbaric treatment - purpose; decompression sickness; sources of decompression sickness; physical description; forms of decompression sickness; hyperbaric treatment of decompression sickness; and duration of treatment.

  4. Incontinence Treatment: Newer Treatment Options

    MedlinePlus

    ... Treatment Lifestyle Changes Dietary Tips Medication Bowel Management Biofeedback Surgical Treatments Newer Treatment Options Tips on Finding ... changes Dietary changes Medication Bowel management/retraining program Biofeedback therapy Surgical treatments Newer procedures or devices Tips ...

  5. Complexity and the Arrow of Time

    NASA Astrophysics Data System (ADS)

    Lineweaver, Charles H.; Davies, Paul C. W.; Ruse, Michael

    2013-08-01

    1. What is complexity? Is it increasing? Charles H. Lineweaver, Paul C. W. Davies and Michael Ruse; 2. Directionality principles from cancer to cosmology Paul C. W. Davies; 3. A simple treatment of complexity: cosmological entropic boundary conditions on increasing complexity Charles H. Lineweaver; 4. Using complexity science to search for unity in the natural sciences Eric J. Chaisson; 5. On the spontaneous generation of complexity in the universe Seth Lloyd; 6. Emergent spatiotemporal complexity in field theory Marcelo Gleiser; 7. Life: the final frontier for complexity? Simon Conway Morris; 8. Evolution beyond Newton, Darwin, and entailing law: the origin of complexity in the evolving biosphere Stuart A. Kauffman; 9. Emergent order in processes: the interplay of complexity, robustness, correlation, and hierarchy in the biosphere D. Eric Smith; 10. The inferential evolution of biological complexity: forgetting nature by learning to nurture David C. Krakauer; 11. Information width: a way for the second law to increase complexity David Wolpert; 12. Wrestling with biological complexity: from Darwin to Dawkins Michael Ruse; 13. The role of generative entrenchment and robustness in the evolution of complexity William C. Wimsatt; 14. On the plurality of complexity-producing mechanisms Philip Clayton; Index.

  6. Enhanced Analgesic Properties and Reduced Ulcerogenic Effect of a Mononuclear Copper(II) Complex with Fenoprofen in Comparison to the Parent Drug: Promising Insights in the Treatment of Chronic Inflammatory Diseases

    PubMed Central

    Gumilar, Fernanda; Boeris, Mónica; Toso, Ricardo; Minetti, Alejandra

    2014-01-01

    Analgesic and ulcerogenic properties have been studied for the copper(II) coordination complex of the nonsteroidal anti-inflammatory drug Fenoprofen and imidazole [Cu(fen)2(im)2] (Cu: copper(II) ion; fen: fenoprofenate anion from Fenoprofen, im: imidazole). A therapeutic dose of 28 mg/kg was tested for [Cu(fen)2(im)2] and 21 mg/kg was employed for Fenoprofen calcium, administered by oral gavage in female mice to compare the therapeutic properties of the new entity. The acetic acid induced writhing test was employed to study visceral pain. The percentage of inhibition in writhing and stretching was 78.9% and 46.2% for the [Cu(fen)2(im)2] and Fenoprofen calcium, respectively. This result indicates that the complex could be more effective in diminishing visceral pain. The formalin test was evaluated to study the impact of the drugs over nociceptive and inflammatory pain. The complex is a more potent analgesic on inflammatory pain than the parent drug. Ulcerogenic effects were evaluated using a model of gastric lesions induced by hypothermic-restraint stress. Fenoprofen calcium salt caused an ulcer index of about 79 mm2 while the one caused by [Cu(fen)2(im)2] was 22 mm2. The complex diminished the development of gastric mucosal ulcers in comparison to the uncomplexed drug. Possible mechanisms of action related to both therapeutic properties have been discussed. PMID:25050353

  7. ICD Complex Operations and Maintenance Plan

    SciTech Connect

    Gibson, P. L.

    2007-06-25

    This Operations and Maintenance (O&M) Plan describes how the Idaho National Laboratory (INL) conducts operations, winterization, and startup of the Idaho CERCLA Disposal Facility (ICDF) Complex. The ICDF Complex is the centralized INL facility responsible for the receipt, storage, treatment (as necessary), and disposal of INL Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) remediation waste.

  8. SCFA lead lab technical assistance at Oak Ridge Y-12 nationalsecurity complex: Evaluation of treatment and characterizationalternatives of mixed waste soil and debris at disposal area remedialaction DARA solids storage facility (SSF)

    SciTech Connect

    Hazen, Terry

    2002-08-26

    On July 17-18, 2002, a technical assistance team from the U.S. Department of Energy (DOE) Subsurface Contaminants Focus Area (SCFA) met with the Bechtel Jacobs Company Disposal Area Remedial Action (DARA) environmental project leader to review treatment and characterization options for the baseline for the DARA Solids Storage Facility (SSF). The technical assistance request sought suggestions from SCFA's team of technical experts with experience and expertise in soil treatment and characterization to identify and evaluate (1) alternative treatment technologies for DARA soils and debris, and (2) options for analysis of organic constituents in soil with matrix interference. Based on the recommendations, the site may also require assistance in identifying and evaluating appropriate commercial vendors.

  9. Complex regional pain syndrome.

    PubMed

    Palmer, Greta

    2015-06-01

    Complex regional pain syndrome is an uncommon chronic pain condition. It develops spontaneously or following an injury. The features are limb pain, allodynia, hypersensitivity, hyperalgesia, abnormalities of the vasomotor, sudomotor and motor systems, and trophic changes, with reduced use of the affected limb. The diagnosis is clinical and one of exclusion. The emphasis of therapy is graded rehabilitation and movement of the limb with physiotherapy and occupational therapy. Psychological therapies should be offered if a patient is making no or slow progress in the acute phase, and to all patients in the chronic phase as depression can occur. The goal of pharmacotherapy is to assist functional improvement. The early phase may be managed with simple analgesia. Antineuropathic drugs including tricyclic antidepressants and antiepileptic drugs may be added. Other treatments with some evidence of effectiveness include corticosteroids, calcitonin and bisphosphonates. Vitamin C has been used for primary prevention after wrist fracture and upper and lower limb surgery. There is no evidence that it is effective for treating established complex regional pain syndrome. PMID:26648626

  10. On State Complexes and Special Cube Complexes

    ERIC Educational Resources Information Center

    Peterson, Valerie J.

    2009-01-01

    This thesis presents the first steps toward a classification of non-positively curved cube complexes called state complexes. A "state complex" is a configuration space for a "reconfigurable system," i.e., an abstract system in which local movements occur in some discrete manner. Reconfigurable systems can be used to describe, for example,…

  11. On State Complexes and Special Cube Complexes

    ERIC Educational Resources Information Center

    Peterson, Valerie J.

    2009-01-01

    This thesis presents the first steps toward a classification of non-positively curved cube complexes called state complexes. A "state complex" is a configuration space for a "reconfigurable system," i.e., an abstract system in which local movements occur in some discrete manner. Reconfigurable systems can be used to describe, for example,

  12. The Mycobacterium avium complex.

    PubMed Central

    Inderlied, C B; Kemper, C A; Bermudez, L E

    1993-01-01

    Mycobacterium avium complex (MAC) disease emerged early in the epidemic of AIDS as one of the common opportunistic infections afflicting human immunodeficiency virus-infected patients. However, only over the past few years has a consensus developed about its significance to the morbidity and mortality of AIDS. M. avium was well known to mycobacteriologists decades before AIDS, and the MAC was known to cause disease, albeit uncommon, in humans and animals. The early interest in the MAC provided a basis for an explosion of studies over the past 10 years largely in response to the role of the MAC in AIDS opportunistic infection. Molecular techniques have been applied to the epidemiology of MAC disease as well as to a better understanding of the genetics of antimicrobial resistance. The interaction of the MAC with the immune system is complex, and putative MAC virulence factors appear to have a direct effect on the components of cellular immunity, including the regulation of cytokine expression and function. There now is compelling evidence that disseminated MAC disease in humans contributes to both a decrease in the quality of life and survival. Disseminated disease most commonly develops late in the course of AIDS as the CD4 cells are depleted below a critical threshold, but new therapies for prophylaxis and treatment offer considerable promise. These new therapeutic modalities are likely to be useful in the treatment of other forms of MAC disease in patients without AIDS. The laboratory diagnosis of MAC disease has focused on the detection of mycobacteria in the blood and tissues, and although the existing methods are largely adequate, there is need for improvement. Indeed, the successful treatment of MAC disease clearly will require an early and rapid detection of the MAC in clinical specimens long before the establishment of the characteristic overwhelming infection of bone marrow, liver, spleen, and other tissue. Also, a standard method of susceptibility testing is of increasing interest and importance as new effective antimicrobial agents are identified and evaluated. Antimicrobial resistance has already emerged as an important problem, and methods for circumventing resistance that use combination therapies are now being studied. Images PMID:8358707

  13. Treatment of Mitochondrial Disorders

    PubMed Central

    Avula, Sreenivas; Parikh, Sumit; Demarest, Scott; Kurz, Jonathan; Gropman, Andrea

    2014-01-01

    Opinion statement While numerous treatments for mitochondrial disorders have been suggested, relatively few have undergone controlled clinical trials. Treatment of these disorders is challenging, as only symptomatic therapy is available. In this review we will focus on newer drugs and treatment trials in mitochondrial diseases, with a special focus on medications to avoid in treating epilepsy and ICU patient with mitochondrial disease, which has not been included in such a review. Readers are also referred to the opinion statement in A Modern Approach to the Treatment of Mitochondrial Disease published in Current Treatment Options in Neurology 2009. Many of the supplements used for treatment were reviewed in the previous abstract, and dosing guidelines were provided. The focus of this review is on items not previously covered in depth, and our discussion includes more recently studied compounds as well as any relevant updates on older compounds. We review a variety of vitamins and xenobiotics, including dichloroacetate (DCA), arginine, coenzyme Q10, idebenone, EPI-743, and exercise training. Treatment of epilepsy, which is a common feature in many mitochondrial phenotypes, warrants special consideration due to the added toxicity of certain medications, and we provide a discussion of these unique treatment challenges. Interesting, however, with only a few exceptions, the treatment strategies for epilepsy in mitochondrial cytopathies are the same as for epilepsy without mitochondrial dysfunction. We also discuss intensive care management, building upon similar reviews, adding new dimensions, and demonstrating the complexity of overall care of these patients. PMID:24700433

  14. Complex Regional Pain Syndrome

    MedlinePlus

    ... Diversity Find People About NINDS NINDS Complex Regional Pain Syndrome Information Page Synonym(s): Reflex Sympathetic Dystrophy Syndrome, ... Additional resources from MedlinePlus What is Complex Regional Pain Syndrome? Complex regional pain syndrome (CRPS) is a ...

  15. [Enduring pain II. Treatment].

    PubMed

    Baldessarini, Ross; Selle, Valerio; Vigo, Daniel V

    2013-01-01

    Pain disorders present highly challenging therapeutic problems, owing in part to complex co-morbidities associated with pain disorders, notably including psychiatric disorders characterized by depressed mood or anxiety. Many treatments are employed to treat pain-disorder patients, and most are unsatisfactory. Virtually all analgesic medicines in long-term use provide only partial efficacy and present substantial risks of adverse effects, loss of benefit over time, or dependency and risk of abuse. Commonly employed drugs with analgesic properties include non-opioids (mainly nonsteroidal anti-inflammatory agents [NSAIDs] or acetaminophen), many natural or synthetic opioids (including opiates and phenylpiperidines), some antidepressants (especially those with noradrenergic activity), a few anticonvulsants, skeletal muscle relaxants or topical remedies, and a growing variety of experimental treatments. The major overlap between pain and psychiatric disorders, as well as the currently unsatisfactory state of treatments available for chronic pain syndromes, encourage a comprehensive approach to assessment and clinical management of patients with chronic pain. Many current treatment programs for pain disorder patients offer narrowly specialized and incomplete treatment options. Ideally however, such care should be provided by multi-disciplinary teams with expertise in neurology, general medicine, pain management, physical medicine and rehabilitation, as well as psychiatry. Psychiatrists as well as pain specialists can serve an essential role in leading comprehensive assessment and general management of such complex and challenging patients who are typically only partially responsive to available treatments. PMID:24312919

  16. Turkey osteomyelitis complex.

    PubMed

    Huff, G R; Huff, W E; Rath, N C; Balog, J M

    2000-07-01

    Turkey osteomyelitis complex (TOC) is defined by the US Food Safety Inspection Service (FSIS) to include normal-appearing processed turkey carcasses that contain lesions including green discoloration of the liver, arthritis/synovitis, soft-tissue abscesses, and osteomyelitis of the proximal tibia. The lesions are associated with many different opportunistic organisms, mainly Staphylococcus aureus and Escherichia coli, suggesting that TOC incidence may be influenced more by deficiencies in the host immune response rather than by the virulence of any one organism. This syndrome is primarily a disease of adolescent male turkeys, and birds with TOC lesions have decreased indices of cell-mediated immunity, leading to the hypothesis that defects in the immune response of individuals within flocks of male turkeys may be responsible for the occurrence of these opportunistic infections. We have developed an experimental model for this disease in which treatment with dexamethasone (DEX), either with or without air sac inoculation with Escherichia coli, produces all of the lesions associated with TOC. These studies suggest that TOC is a result of stress-induced immunosuppression in a subpopulation of male turkeys that respond to the stressors in modern poultry production in a detrimental manner. Supplemental vitamin D3 treatment protected male turkeys from the immunosuppression induced by multiple treatments with DEX and resulted in decreased incidence of mortality, TOC, green liver, and isolation of bacteria from tissues, lower air sacculitis scores, and lower heterophil to lymphocyte ratios than nonsupplemented controls. Vitamin D3 also protected BW; relative weights of the liver, heart, spleen, and bursa; and clinical chemistry values from the effects of DEX treatment. The ability of vitamin D3 supplementation to protect turkeys from the immunosuppressive effects of severe stress emphasizes its role as a prohormone that affects health and disease resistance in turkeys and suggests that variation in the vitamin D receptor genotype may be involved in this disease process. This model has potential value in the identification of other nutritional and physiological immunomodulators that can decrease TOC incidence and will provide a means for the divergent selection of birds more resistant to the stressors of turkey production. In addition, this model will provide justification for management options designed to minimize stress. PMID:10901209

  17. 1. VIEW OF SEWAGE TREATMENT PLANT (BLDG. 769) SOUTH OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. VIEW OF SEWAGE TREATMENT PLANT (BLDG. 769) SOUTH OF STORAGE SHED (BLDG 773). SECURITY FENCE EAST OF SEWAGE TREATMENT PLANT. - Vandenberg Air Force Base, Space Launch Complex 3, Sewage Treatment Plant, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  18. The effects of infrared laser therapy and weightbath traction hydrotherapy as components of complex physical treatment in disorders of the lumbar spine: a controlled pilot study with follow-up

    NASA Astrophysics Data System (ADS)

    Oláh, Csaba; Oláh, Mihály; Demeter, Béla; Jancsó, Zoltán; Páll, Valéria; Bender, Tamás

    2010-02-01

    Introduction: The therapeutic modalities available for the conservative management of chronic lumbar pain included infrared laser therapy and underwater traction, which usefulness is not universally acknowledged. This study was intended to ascertain any beneficial impact of infrared laser therapy and weightbath treatment on the clinical parameters and quality of life of patients with lumbar discopathy. Material and methods: The study population comprised 54 randomised subjects. I. group of 18 patents received only infrared laser therapy to lumbar region and painful Valley points. II. group of 18 subjects each received underwater traction therapy of lumbar spine with add-on McKenzie exercise and iontophoresis. The remaining III. group treated with exercise and iontophoresis, served as control. VAS, Oswestry index, SF36 scores, range of motion, neurological findings and thermography were monitored to appraise therapeutic afficacy in lumbar discopathy. A CT or MRI scan was done at baseline and after 3 months follow-up. Result:Infrared laser therapy and underwater traction for discopathy achieved significant improvement of all study parameters, which was evident 3 months later. Among the controls, significant improvement of only a single parameter was seen in patients with lumbar discopathy. Conclusions: Infrared laser therapy and underwater traction treatment effectively mitigate pain, muscle spasms, enhance joint flexibility, and improve the quality of life of patients with lumbar discopathy.

  19. Demand Treatment!

    ERIC Educational Resources Information Center

    Join Together, Boston, MA.

    Three-quarters of the people with serious alcohol and drug problems go without treatment. This is often caused by a lack of understanding about what constitutes treatment. Few consumers, family members, and policymakers realize that effective drug and alcohol treatment exists. This publication describes a nationwide project organized by Join…

  20. Complexity analysis of angiogenesis vasculature

    NASA Astrophysics Data System (ADS)

    Mahadevan, Vijay; Tyrell, James A.; Tong, Ricky T.; Brown, Edward B.; Jain, Rakesh K.; Roysam, Badrinath

    2005-04-01

    Tumor vasculature has a high degree of irregularity as compared to normal vasculature. The quantification of the morphometric complexity in tumor images can be useful in diagnosis. Also, it is desirable in several other medical applications to have an automated complexity analysis to aid in diagnosis and prognosis under treatment. e.g. in diabetic retinopathy and in arteriosclerosis. In addition, prior efforts at segmentation of the tumor vasculature using matched filtering, template matching and splines have been hampered by the irregularity of these vessels. We try to solve both problems by introducing a novel technique for vessel detection, followed by a tracing-independent complexity analysis based on a combination of ideas. First, the vessel cross-sectional profile is modeled using a continuous and everywhere differentiable family of super-Gaussian curves. This family generates rectangular profiles that can accurately localize the vessel boundaries in microvasculature images. Second, a robust non-linear regression algorithm based on M-estimators is used to estimate the parameters that optimally characterize the vessel"s shape. A framework for the quantitative analysis of the complexity of the vasculature based on the vessel detection is presented. A set of measures that quantify the complexity are proposed viz. Squared Error, Entropy-based and Minimum Description Length-based Shape Complexities. They are completely automatic and can deal with complexities of the entire vessel unlike existing tortuousity measures which deal only with vessel centerlines. The results are validated using carefully constructed phantom and real image data with ground truth information from an expert observer.

  1. Fluoroquinolone-Gyrase-DNA Complexes

    PubMed Central

    Mustaev, Arkady; Malik, Muhammad; Zhao, Xilin; Kurepina, Natalia; Luan, Gan; Oppegard, Lisa M.; Hiasa, Hiroshi; Marks, Kevin R.; Kerns, Robert J.; Berger, James M.; Drlica, Karl

    2014-01-01

    DNA gyrase and topoisomerase IV control bacterial DNA topology by breaking DNA, passing duplex DNA through the break, and then resealing the break. This process is subject to reversible corruption by fluoroquinolones, antibacterials that form drug-enzyme-DNA complexes in which the DNA is broken. The complexes, called cleaved complexes because of the presence of DNA breaks, have been crystallized and found to have the fluoroquinolone C-7 ring system facing the GyrB/ParE subunits. As expected from x-ray crystallography, a thiol-reactive, C-7-modified chloroacetyl derivative of ciprofloxacin (Cip-AcCl) formed cross-linked cleaved complexes with mutant GyrB-Cys466 gyrase as evidenced by resistance to reversal by both EDTA and thermal treatments. Surprisingly, cross-linking was also readily seen with complexes formed by mutant GyrA-G81C gyrase, thereby revealing a novel drug-gyrase interaction not observed in crystal structures. The cross-link between fluoroquinolone and GyrA-G81C gyrase correlated with exceptional bacteriostatic activity for Cip-AcCl with a quinolone-resistant GyrA-G81C variant of Escherichia coli and its Mycobacterium smegmatis equivalent (GyrA-G89C). Cip-AcCl-mediated, irreversible inhibition of DNA replication provided further evidence for a GyrA-drug cross-link. Collectively these data establish the existence of interactions between the fluoroquinolone C-7 ring and both GyrA and GyrB. Because the GyrA-Gly81 and GyrB-Glu466 residues are far apart (17 Å) in the crystal structure of cleaved complexes, two modes of quinolone binding must exist. The presence of two binding modes raises the possibility that multiple quinolone-enzyme-DNA complexes can form, a discovery that opens new avenues for exploring and exploiting relationships between drug structure and activity with type II DNA topoisomerases. PMID:24497635

  2. Therapeutic Doll Making in Art Psychotherapy for Complex Trauma

    ERIC Educational Resources Information Center

    Stace, Sonia M.

    2014-01-01

    Therapeutic doll making can hold diverse functions for clients in therapy, particularly for those clients who are working through complex trauma histories. Recent literature pertaining to the treatment of complex trauma suggests that talking treatments have their limits; supplementary therapeutic approaches that focus on sensory, physical,

  3. Therapeutic Doll Making in Art Psychotherapy for Complex Trauma

    ERIC Educational Resources Information Center

    Stace, Sonia M.

    2014-01-01

    Therapeutic doll making can hold diverse functions for clients in therapy, particularly for those clients who are working through complex trauma histories. Recent literature pertaining to the treatment of complex trauma suggests that talking treatments have their limits; supplementary therapeutic approaches that focus on sensory, physical,…

  4. National Emphysema Treatment Trial

    PubMed Central

    Criner, Gerard J.; Sternberg, Alice L.

    2008-01-01

    The National Emphysema Treatment Trial (NETT) has published many articles reporting the various outcomes of lung volume reduction surgery versus medical treatment for patients with severe emphysema. However, long and complex clinical trials like NETT that involve both medical and surgical issues generate multiple manuscripts over a period of years and report an array of various outcomes. As a result, the essential findings of the trial may appear to be fragmented to the clinician or clinical researcher or be lost among the many medical reports published each year. In this review, we summarize in one publication the major medical and surgical outcomes of NETT. PMID:18453345

  5. Treatment of Thoracolumbar Fracture

    PubMed Central

    Kim, Byung-Guk; Shin, Dong-Eun

    2015-01-01

    The most common fractures of the spine are associated with the thoracolumbar junction. The goals of treatment of thoracolumbar fracture are leading to early mobilization and rehabilitation by restoring mechanical stability of fracture and inducing neurologic recovery, thereby enabling patients to return to the workplace. However, it is still debatable about the treatment methods. Neurologic injury should be identified by thorough physical examination for motor and sensory nerve system in order to determine the appropriate treatment. The mechanical stability of fracture also should be evaluated by plain radiographs and computed tomography. In some cases, magnetic resonance imaging is required to evaluate soft tissue injury involving neurologic structure or posterior ligament complex. Based on these physical examinations and imaging studies, fracture stability is evaluated and it is determined whether to use the conservative or operative treatment. The development of instruments have led to more interests on the operative treatment which saves mobile segments without fusion and on instrumentation through minimal invasive approach in recent years. It is still controversial for the use of these treatments because there have not been verified evidences yet. However, the morbidity of patients can be decreased and good clinical and radiologic outcomes can be achieved if the recent operative treatments are used carefully considering the fracture pattern and the injury severity. PMID:25705347

  6. Complex networks analysis of language complexity

    NASA Astrophysics Data System (ADS)

    Amancio, Diego R.; Aluisio, Sandra M.; Oliveira, Osvaldo N., Jr.; Costa, Luciano da F.

    2012-12-01

    Methods from statistical physics, such as those involving complex networks, have been increasingly used in the quantitative analysis of linguistic phenomena. In this paper, we represented pieces of text with different levels of simplification in co-occurrence networks and found that topological regularity correlated negatively with textual complexity. Furthermore, in less complex texts the distance between concepts, represented as nodes, tended to decrease. The complex networks metrics were treated with multivariate pattern recognition techniques, which allowed us to distinguish between original texts and their simplified versions. For each original text, two simplified versions were generated manually with increasing number of simplification operations. As expected, distinction was easier for the strongly simplified versions, where the most relevant metrics were node strength, shortest paths and diversity. Also, the discrimination of complex texts was improved with higher hierarchical network metrics, thus pointing to the usefulness of considering wider contexts around the concepts. Though the accuracy rate in the distinction was not as high as in methods using deep linguistic knowledge, the complex network approach is still useful for a rapid screening of texts whenever assessing complexity is essential to guarantee accessibility to readers with limited reading ability.

  7. Cyanobacterial NADPH dehydrogenase complexes

    SciTech Connect

    Ogawa, Teruo; Mi, Hualing

    2007-07-01

    Cyanobacteria possess functionally distinct multiple NADPH dehydrogenase (NDH-1) complexes that are essential to CO2 uptake, photosystem-1 cyclic electron transport and respiration. The unique nature of cyanobacterial NDH-1 complexes is the presence of subunits involved in CO2 uptake. Other than CO2 uptake, chloroplastic NDH-1 complex has similar role as cyanobacterial NDH-1 complexes in photosystem-1 cyclic electron transport and respiration (chlororespiration). In this mini-review we focus on the structure and function of cyanobacterial NDH-1 complexes and their phylogeny. The function of chloroplastic NDH-1 complex and characteristics of plants defective in NDH-1 are also described forcomparison.

  8. Mycobacterium abscessus Complex Infections in Humans

    PubMed Central

    Lee, Meng-Rui; Sheng, Wang-Huei; Hung, Chien-Ching; Yu, Chong-Jen; Lee, Li-Na

    2015-01-01

    Mycobacterium abscessus complex comprises a group of rapidly growing, multidrug-resistant, nontuberculous mycobacteria that are responsible for a wide spectrum of skin and soft tissue diseases, central nervous system infections, bacteremia, and ocular and other infections. M. abscessus complex is differentiated into 3 subspecies: M. abscessus subsp. abscessus, M. abscessus subsp. massiliense, and M. abscessus subsp. bolletii. The 2 major subspecies, M. abscessus subsp. abscessus and M. abscessus subsp. massiliense, have different erm(41) gene patterns. This gene provides intrinsic resistance to macrolides, so the different patterns lead to different treatment outcomes. M. abscessus complex outbreaks associated with cosmetic procedures and nosocomial transmissions are not uncommon. Clarithromycin, amikacin, and cefoxitin are the current antimicrobial drugs of choice for treatment. However, new treatment regimens are urgently needed, as are rapid and inexpensive identification methods and measures to contain nosocomial transmission and outbreaks. PMID:26295364

  9. Complex-I-ty in aging

    PubMed Central

    Stork, Devon A.

    2016-01-01

    The role of mitochondrial complex I in aging has been studied in both C. elegans and Drosophila, where RNAi knock down of specific complex I subunits has been shown to extend lifespan. More recently, studies in Drosophila have shown that an increase in mitochondrial activity, including complex I-like activity, can also slow aging. In this review, we discuss this apparent paradox. Improved maintenance of mitochondrial activity, mitochondrial homeostasis, may be responsible for lifespan extension in both cases. Decreased electron transport chain activity caused by reducing complex I subunit expression prompts an increase in stress response signaling that leads to enhanced mitochondrial homeostasis during aging. Increased complex I activity, as well as mitochondrial biogenesis, is expected to both directly counteract the decline in mitochondrial health that occurs during aging and may also increase cellular NAD+ levels, which have been linked to mitochondrial homeostatic mechanisms through activation of sirtuins. We suggest that manipulations that increase or decrease complex I activity both converge on improved mitochondrial homeostasis during aging, resulting in prolonged lifespan. PMID:24961226

  10. Daunorubicin Lipid Complex Injection

    MedlinePlus

    Daunorubicin lipid complex is used to treat advanced Kaposi's sarcoma (a type of cancer that causes abnormal tissue to grow on ... related to acquired immunodeficiency syndrome (AIDS). Daunorubicin lipid complex is in a class of medications called anthracyclines. ...

  11. Cytarabine Lipid Complex Injection

    MedlinePlus

    Cytarabine lipid complex is used to treat lymphomatous meningitis (a type of cancer in the covering of the spinal cord and brain). Cytarabine lipid complex is in a class of medications called antimetabolites. ...

  12. Oligocyclopentadienyl transition metal complexes

    SciTech Connect

    de Azevedo, Cristina G.; Vollhardt, K. Peter C.

    2002-01-18

    Synthesis, characterization, and reactivity studies of oligocyclopentadienyl transition metal complexes, namely those of fulvalene, tercyclopentadienyl, quatercyclopentadienyl, and pentacyclopentadienyl(cyclopentadienyl) are the subject of this account. Thermal-, photo-, and redox chemistries of homo- and heteropolynuclear complexes are described.

  13. Scabies: Treatment

    MedlinePlus

    ... Monday-Friday Closed Holidays Contact CDC-INFO Scabies General Information Scabies FAQs Workplace FAQs Epidemiology & Risk Factors Biology Disease Diagnosis Treatment Prevention & Control Resources for Health ...

  14. Congruently melting complex oxides

    SciTech Connect

    Abrahams, S.C.; Brandle, C.D. Jr.

    1988-04-26

    A device is described comprising: a material including a complex oxide, characterized in that the complex oxide is essentially free of gadolinium scandium gallium garnet, gadolinium gallium garnet and lithium niobate, and the composition of the complex oxide is congruent and differs from stoichiometry by at least 0.1 atomic percent for at least one constituent element.

  15. The nuclear pore complex

    PubMed Central

    Adam, Stephen A

    2001-01-01

    Nuclear pore complexes, the conduits for information exchange between the nucleus and cytoplasm, appear broadly similar in eukaryotes from yeast to human. Precisely how nuclear pore complexes regulate macromolecular and ionic traffic remains unknown, but recent advances in the identification and characterization of components of the complex by proteomics and genomics have provided new insights. PMID:11574060

  16. Psychodynamic treatment of depression.

    PubMed

    Luyten, Patrick; Blatt, Sidney J

    2012-03-01

    Findings reviewed in this article show that PT should be included in treatment guidelines for depression. BPT in particular has been found to be superior to control conditions, equally effective as other active psychological treatments, with treatment effects that are often maintained in the long run, conferring resistance to relapse. Moreover, BPT is as effective as pharmacotherapy in the acute treatment of mild to moderate depression, and, either as monotherapy or combined with medication, BPT is associated with better long-term outcome compared with pharmacotherapy alone. PT is accepted by many depressed patients as a viable and preferred treatment. Furthermore, LTPT and PA have shown promise in treating patients with complex psychological disorders characterized by mood problems, often with comorbid personality problems. Finally, although studies suggest that effects of PT may be achieved somewhat slower compared with other forms of psychotherapy as well as medication in the acute treatment of depression, LTPT appears to be more clinically effective and perhaps more cost effective in the long run, particularly for chronically depressed patients. As noted, these conclusions need to be interpreted within the context of important limitations. Compared with other treatments, the evidence base for PT in depression remains relatively small, despite a respectable research tradition supporting psychodynamic assumptions with regard to the causation of depression. Moreover, and perhaps most importantly, although more studies now include longer follow-up assessments, our knowledge about the long-term effects of so-called evidence-based treatments of depression remains sketchy at best. In this context, the growing evidence for the efficacy and effectiveness of LTPT is promising. Overall, it is clear that the future of the treatment of depression may lie in a combined disorder- and person-centered, tailored-made approach, which takes into account, particularly in chronic depression, the broader interpersonal context and life history of the individual. It is clear that psychodynamic therapies have an important role to play in this respect. PMID:22370494

  17. Frequency of Natural Resistance within NS5a Replication Complex Domain in Hepatitis C Genotypes 1a, 1b: Possible Implication of Subtype-Specific Resistance Selection in Multiple Direct Acting Antivirals Drugs Combination Treatment.

    PubMed

    Bagaglio, Sabrina; Andolina, Andrea; Merli, Marco; Uberti-Foppa, Caterina; Morsica, Giulia

    2016-01-01

    Different HCV subtypes may naturally harbor different resistance selection to anti-NS5a inhibitors. 2761 sequences retrieved from the Los Alamos HCV database were analyzed in the NS5a domain 1, the target of NS5a inhibitors. The NS5a resistance-associated polymorphisms (RAPs) were more frequently detected in HCV G1b compared to G1a. The prevalence of polymorphisms associated with cross-resistance to compounds in clinical use (daclatasvir, DCV, ledipasvir, LDV, ombitasvir, and OMV) or scheduled to come into clinical use in the near future (IDX719, elbasvir, and ELV) was higher in G1b compared to G1a (37/1552 (2.4%) in 1b sequences and 15/1209 (1.2%) in 1a isolates, p = 0.040). Interestingly, on the basis of the genotype-specific resistance pattern, 95 (6.1%) G1b sequences had L31M RAP to DCV/IDX719, while 6 sequences of G1a (0.5%) harbored L31M RAP, conferring resistance to DCV/LDV/IDX719/ELV (p < 0.0001). Finally, 28 (2.3%) G1a and none of G1b isolates harbored M28V RAP to OMV (p < 0.0001). In conclusion, the pattern of subtype-specific resistance selection in the naturally occurring strains may guide the treatment option in association with direct acting antivirals (DAAs) targeting different regions, particularly in patients that are difficult to cure, such as those with advanced liver disease or individuals who have failed previous DAAs. PMID:27023593

  18. Frequency of Natural Resistance within NS5a Replication Complex Domain in Hepatitis C Genotypes 1a, 1b: Possible Implication of Subtype-Specific Resistance Selection in Multiple Direct Acting Antivirals Drugs Combination Treatment

    PubMed Central

    Bagaglio, Sabrina; Andolina, Andrea; Merli, Marco; Uberti-Foppa, Caterina; Morsica, Giulia

    2016-01-01

    Different HCV subtypes may naturally harbor different resistance selection to anti-NS5a inhibitors. 2761 sequences retrieved from the Los Alamos HCV database were analyzed in the NS5a domain 1, the target of NS5a inhibitors. The NS5a resistance-associated polymorphisms (RAPs) were more frequently detected in HCV G1b compared to G1a. The prevalence of polymorphisms associated with cross-resistance to compounds in clinical use (daclatasvir, DCV, ledipasvir, LDV, ombitasvir, and OMV) or scheduled to come into clinical use in the near future (IDX719, elbasvir, and ELV) was higher in G1b compared to G1a (37/1552 (2.4%) in 1b sequences and 15/1209 (1.2%) in 1a isolates, p = 0.040). Interestingly, on the basis of the genotype-specific resistance pattern, 95 (6.1%) G1b sequences had L31M RAP to DCV/IDX719, while 6 sequences of G1a (0.5%) harbored L31M RAP, conferring resistance to DCV/LDV/IDX719/ELV (p < 0.0001). Finally, 28 (2.3%) G1a and none of G1b isolates harbored M28V RAP to OMV (p < 0.0001). In conclusion, the pattern of subtype-specific resistance selection in the naturally occurring strains may guide the treatment option in association with direct acting antivirals (DAAs) targeting different regions, particularly in patients that are difficult to cure, such as those with advanced liver disease or individuals who have failed previous DAAs. PMID:27023593

  19. Crystallization of macromolecular complexes: combinatorial complex crystallization

    NASA Astrophysics Data System (ADS)

    Stura, Enrico A.; Graille, Marc; Charbonnier, Jean-Baptiste

    2001-11-01

    The usefulness of antibody complexation, as a way of increasing the chances of crystallization needs to be re-evaluated after many antibody complexes have been crystallized and their structure determined. It is somewhat striking that among these, only a small number is a complex with a large protein antigen. The problem is that the effort of raising, cleaving and purifying an Fab is rewarded only by an extra chance of getting crystals; depending on the relative likelihood of crystallization of the complexed and uncomplexed protein. The example of the complex between HIV gp120, CD4 and an Fab fragment from a neutralizing antibody suggests that further complexation of an antigen-antibody complex with a third protein could, by increasing the number of possible combinations, improve the likelihood of crystallization. We propose the use of Ig-binding proteins as a way of extending the method from HIV gp120 to all proteins for which there are monoclonal antibodies. We discuss this technique, combinatorial complex crystallization (CCC), as part of a multi-component system for the enhancement of crystallization of macromolecular complexes. The method makes use of single Ig-binding domains from Staphylococcus aureus protein A (SpA), Peptostreptococcus magnus protein L (PpL) and the streptococcal protein G (SpG). The generality of the method depends on the ability of these domains to interact with a large repertoire of antibodies without affecting antigen binding. There is strong evidence to suggest that these Ig-binding domains bind outside the antigen-combining site of the antibody without perturbing antigen binding. It is clear from the crystal structure of the single SpG domain complexed with an Fab that the interaction involves mainly the immunoglobulin CH1 domain, a region not involved in antigen recognition. We have recently determined the structure of the complex between a human Fab and the domain D from SpA and found that steric hindrance is unlikely even for large antigens. We find that such binding involves only the well conserved framework region of the variable domain of the antibody heavy chain (VH) and does not affect the conformation of the hypervariable loops that define the antigen recognition site. Thus this domain could be used to complex to Fab or Fv fragments derived from a wide variety of antibodies. While protein A complexes with the VH domain, protein L recognizes the VL region of immunoglobulins. Our recent study of the interaction between an Fab and a domain of protein L shows that the situation is very similar. Indeed this domain binds to the VL framework region outside the antigen binding site. Since individual domains from each of these three multi-domain proteins bind to well separated and independent locations on immunoglobulins, they can be combined to search for a suitable crystalline lattice. This allows us to propose a combinatorial method as a rational way to exploit antibody complexation for the crystallographic structure determination of proteins that are otherwise difficult to crystallize. The overall method has strong parallels with other combinatorial methods used elsewhere in biology and chemistry, and we propose that together with stoichiometry variation screening (SVS), it may further enhance the probability of crystallization.

  20. Treatment of Lyme borreliosis

    PubMed Central

    2009-01-01

    Borrelia burgdorferi sensu lato is the causative agent of Lyme borreliosis in humans. This inflammatory disease can affect the skin, the peripheral and central nervous system, the musculoskeletal and cardiovascular system and rarely the eyes. Early stages are directly associated with viable bacteria at the site of inflammation. The pathogen-host interaction is complex and has been elucidated only in part. B. burgdorferi is highly susceptible to antibiotic treatment and the majority of patients profit from this treatment. Some patients develop chronic persistent disease despite repeated antibiotics. Whether this is a sequel of pathogen persistence or a status of chronic auto-inflammation, auto-immunity or a form of fibromyalgia is highly debated. Since vaccination is not available, prevention of a tick bite or chemoprophylaxis is important. If the infection is manifest, then treatment strategies should target not only the pathogen by using antibiotics but also the chronic inflammation by using anti-inflammatory drugs. PMID:20067594

  1. Treatment of Lyme borreliosis.

    PubMed

    Girschick, Hermann J; Morbach, Henner; Tappe, Dennis

    2009-01-01

    Borrelia burgdorferi sensu lato is the causative agent of Lyme borreliosis in humans. This inflammatory disease can affect the skin, the peripheral and central nervous system, the musculoskeletal and cardiovascular system and rarely the eyes. Early stages are directly associated with viable bacteria at the site of inflammation. The pathogen-host interaction is complex and has been elucidated only in part. B. burgdorferi is highly susceptible to antibiotic treatment and the majority of patients profit from this treatment. Some patients develop chronic persistent disease despite repeated antibiotics. Whether this is a sequel of pathogen persistence or a status of chronic auto-inflammation, auto-immunity or a form of fibromyalgia is highly debated. Since vaccination is not available, prevention of a tick bite or chemoprophylaxis is important. If the infection is manifest, then treatment strategies should target not only the pathogen by using antibiotics but also the chronic inflammation by using anti-inflammatory drugs. PMID:20067594

  2. Lyme borreliosis treatment.

    PubMed

    Vanousová, Daniela; Hercogová, Jana

    2008-01-01

    Lyme borreliosis is the most common human tick-borne illness in the Northern Hemisphere. The causative agent is the spirochete Borrelia burgdorferi species complex, and the hard-shell ticks of the genus Ixodes is responsible for pathogen transmission from animals to humans. The incidence of the disease is increasing year by year and although lyme disease is not fatal, it can affect the skin, heart, nervous, and musculoskeletal system with an impairment of quality of life. The appropriate diagnosis of lyme disease should be promptly treated by antibiotics to prevent late stage of the disease. The choice of antibiotics depends on many factors such as the stage of the disease, the drug efficacy, adverse effects, type of delivery, duration of treatment, and cost. Treatment failure occurs as a result of many reasons, re-infection is possible. The recommended treatment schedule in the Czech Republic is presented. PMID:18394084

  3. Combined and complex vascular malformations.

    PubMed

    Clemens, Robert K; Pfammatter, Thomas; Meier, Thomas O; Alomari, Ahmad I; Amann-Vesti, Beatrice R

    2015-03-01

    The correct diagnosis of vascular malformations is obtainable by clinical assessment and patient history in the majority of cases. Nonetheless, confusion in nomenclature, existence of multiple classifications and rarity of these lesions leads to misdiagnosis and related wrong treatment. This is especially the case in combined or complex vascular malformations or vascular malformations that are part of syndromes as these have overlapping clinical and imaging features. New entities in the field of vascular anomalies have been described recently like fibro-adipose vascular anomaly or central conducting lymphatic anomalies. PMID:25698387

  4. [A complex forearm injury caused by skateboarding].

    PubMed

    Bauer, G; Kiefer, H

    1991-12-01

    Conservative treatment of forearm fractures in children is preferred. However, in a few cases an open reduction and internal fixation are required. The case of a 15-year-old boy with a complex forearm injury following a skateboard accident is reported. The surgical treatment of these injuries is presented and the indications for open reduction and internal fixation of forearm fractures in children are discussed. PMID:1796349

  5. [Day hospital treatment in psychiatry].

    PubMed

    Eikelmann, B

    2010-03-01

    Day hospitals provide an organizational framework for complex psychiatric and psychotherapeutic treatments. They have been developed regarding treatment and in number, perhaps surprisingly, to fit existing standards in almost all domains of psychiatry. Similarities exist in the emphasis on acute treatment, in the orientation towards social inclusion, and particularly in the ability to connect with previous treatment settings. Day treatment guidelines exist only in basic form. In general the complex outpatient treatment is led by psychiatrists; the treatment is planned and pre-defined regarding time and goal orientation. It is directed exclusively at patients with severe mental health disorders and practiced by a multi-professional team. A structured treatment milieu is likely to be the main ingredient which includes all somatic-biological and many psychotherapeutic methods. Special options that for the most part have been empirically validated are available for the treatment of post-acute patients, prevention of social exclusion from families and work, detoxification of addicts and psychotherapy of personality disorders. The rapid increase of facilities is expected to persist for some time. Scientific evidence is relatively strong. Given proper indication, financial resources are used with a high degree of efficiency. PMID:20119657

  6. Sewage Treatment

    NASA Technical Reports Server (NTRS)

    1976-01-01

    A million gallon-a-day sewage treatment plant in Huntington Beach, CA converts solid sewage to activated carbon which then treats incoming waste water. The plant is scaled up 100 times from a mobile unit NASA installed a year ago; another 100-fold scale-up will be required if technique is employed for widespread urban sewage treatment. This unique sewage-plant employed a serendipitous outgrowth of a need to manufacture activated carbon for rocket engine insulation. The process already exceeds new Environmental Protection Agency Standards Capital costs by 25% compared with conventional secondary treatment plants.

  7. Assessing physiological complexity.

    PubMed

    Burggren, W W; Monticino, M G

    2005-09-01

    Physiologists both admire and fear complexity, but we have made relatively few attempts to understand it. Inherently complex systems are more difficult to study and less predictable. However, a deeper understanding of physiological systems can be achieved by modifying experimental design and analysis to account for complexity. We begin this essay with a tour of some mathematical views of complexity. After briefly exploring chaotic systems, information theory and emergent behavior, we reluctantly conclude that, while a mathematical view of complexity provides useful perspectives and some narrowly focused tools, there are too few generally practical take-home messages for physiologists studying complex systems. Consequently, we attempt to provide guidelines as to how complex systems might be best approached by physiologists. After describing complexity based on the sum of a physiological system's structures and processes, we highlight increasingly refined approaches based on the pattern of interactions between structures and processes. We then provide a series of examples illustrating how appreciating physiological complexity can improve physiological research, including choosing experimental models, guiding data collection, improving data interpretations and constructing more rigorous system models. Finally, we conclude with an invitation for physiologists, applied mathematicians and physicists to collaborate on describing, studying and learning from studies of physiological complexity. PMID:16109885

  8. Wastewater Treatment.

    ERIC Educational Resources Information Center

    Zoltek, J., Jr.; Melear, E. L.

    1978-01-01

    Presents the 1978 literature review of wastewater treatment. This review covers: (1) process application; (2) coagulation and solids separation; (3) adsorption; (4) ion exchange; (5) membrane processes; and (6) oxidation processes. A list of 123 references is also presented. (HM)

  9. Acne: Treatment

    MedlinePlus

    ... the-counter treatments are there? Benzoyl peroxide and salicylic acid are the most common and most effective over-the-counter medicines for acne. These medicines kill bacteria, dry up skin oil, and make your skin peel off. They ...

  10. Cholera Treatment

    MedlinePlus

    ... Travelers Publications, Data, & Statistics Outbreak Response Resources Health Promotion Materials Fact Sheets Posters Videos Training & Education CDC ... improve cholera symptoms in children. Related Pages Health Promotion Materials Cholera Treatment Centers Vaccines Cholera Training and ...

  11. Stroke Treatments

    MedlinePlus

    ... Another treatment option is an endovascular procedure* called mechanical thrombectomy, strongly recommended, in which trained doctors try ... the aneurysm or AVM ; it then deposits a mechanical agent, such as a coil, to prevent rupture. ...

  12. Update on multiple sclerosis treatments.

    PubMed

    Bridel, Claire; Lalive, Patrice H

    2014-01-01

    Relapsing-remitting multiple sclerosis (RRMS) management has dramatically changed over the past decade. New drugs have arrived on the market, allowing for more individualised treatment selection. However, this diversity has increased the complexity of RRMS patient follow-up. In this review, we provide summarised information about treatment efficacy, potential side-effects, follow-up recommendations, vaccinations, and pregnancy safety issues for all currently available disease modifying therapies and those awaiting approval. PMID:25247669

  13. Artistic forms and complexity.

    PubMed

    Boon, J-P; Casti, J; Taylor, R P

    2011-04-01

    We discuss the inter-relationship between various concepts of complexity by introducing a complexity 'triangle' featuring objective complexity, subjective complexity and social complexity. Their connections are explored using visual and musical compositions of art. As examples, we quantify the complexity embedded within the paintings of the Jackson Pollock and the musical works of Johann Sebastian Bach. We discuss the challenges inherent in comparisons of the spatial patterns created by Pollock and the sonic patterns created by Bach, including the differing roles that time plays in these investigations. Our results draw attention to some common intriguing characteristics suggesting 'universality' and conjecturing that the fractal nature of art might have an intrinsic value of more general significance. PMID:21382264

  14. School Phobia: Understanding a Complex Behavioural Response

    ERIC Educational Resources Information Center

    Chitiyo, Morgan; Wheeler, John J.

    2006-01-01

    School phobia affects about 5% of the school-age population. If left untreated, school phobia can have devastating long-term consequences in children challenged by this condition. Various treatment approaches have been used to explore this complex behavioural response, major among them being the psychoanalytic, psychodynamic, pharmacological and…

  15. School Phobia: Understanding a Complex Behavioural Response

    ERIC Educational Resources Information Center

    Chitiyo, Morgan; Wheeler, John J.

    2006-01-01

    School phobia affects about 5% of the school-age population. If left untreated, school phobia can have devastating long-term consequences in children challenged by this condition. Various treatment approaches have been used to explore this complex behavioural response, major among them being the psychoanalytic, psychodynamic, pharmacological and

  16. Biogeochemical Considerations and Complexities

    SciTech Connect

    Ainsworth, Calvin C.; Brockman, Fred J.; Jardine, Phillip M.

    2000-12-29

    Chapter 6 Biogeochemical Considerations and Complexities INTRODUCTION-Geochemical and microbiological processes influence the transport of any contaminant in either unsaturated or saturated environments.

  17. Complexity and schizophrenia.

    PubMed

    Fernández, Alberto; Gómez, Carlos; Hornero, Roberto; López-Ibor, Juan José

    2013-08-01

    Complexity estimators have been broadly utilized in schizophrenia investigation. Early studies reported increased complexity in schizophrenia patients, associated with a higher variability or "irregularity" of their brain signals. However, further investigations showed reduced complexities, thus introducing a clear divergence. Nowadays, both increased and reduced complexity values are reported. The explanation of such divergence is a critical issue to understand the role of complexity measures in schizophrenia research. Considering previous arguments a complementary hypothesis is advanced: if the increased irregularity of schizophrenia patients' neurophysiological activity is assumed, a "natural" tendency to increased complexity in EEG and MEG scans should be expected, probably reflecting an abnormal neuronal firing pattern in some critical regions such as the frontal lobes. This "natural" tendency to increased complexity might be modulated by the interaction of three main factors: medication effects, symptomatology, and age effects. Therefore, young, medication-naïve, and highly symptomatic (positive symptoms) patients are expected to exhibit increased complexities. More importantly, the investigation of these interacting factors by means of complexity estimators might help to elucidate some of the neuropathological processes involved in schizophrenia. PMID:22507763

  18. Child health in complex emergencies.

    PubMed Central

    Moss, William J.; Ramakrishnan, Meenakshi; Storms, Dory; Henderson Siegle, Anne; Weiss, William M.; Lejnev, Ivan; Muhe, Lulu

    2006-01-01

    Coordinated and effective interventions are critical for relief efforts to be successful in addressing the health needs of children in situations of armed conflict, population displacement, and/or food insecurity. We reviewed published literature and surveyed international relief organizations engaged in child health activities in complex emergencies. Our aim was to identify research needs and improve guidelines for the care of children. Much of the literature details the burden of disease and the causes of morbidity and mortality; few interventional studies have been published. Surveys of international relief organizations showed that most use World Health Organization (WHO), United Nations Children's Fund (UNICEF), and ministry of health guidelines designed for use in stable situations. Organizations were least likely to have formal guidelines on the management of asphyxia, prematurity, and infection in neonates; diagnosis and management of children with human immunodeficiency virus (HIV) infection; active case-finding and treatment of tuberculosis; paediatric trauma; and the diagnosis and management of mental-health problems in children. Guidelines often are not adapted to the different types of health-care workers who provide care in complex emergencies. Evidence-based, locally adapted guidelines for the care of children in complex emergencies should be adopted by ministries of health, supported by WHO and UNICEF, and disseminated to international relief organizations to ensure appropriate, effective, and uniform care. PMID:16501716

  19. Tuberous Sclerosis Complex Diagnostic Criteria Update: Recommendations of the 2012 International Tuberous Sclerosis Complex Consensus Conference

    PubMed Central

    Northrup, Hope; Krueger, Darcy A.

    2014-01-01

    BACKGROUND Tuberous sclerosis complex is highly variable in clinical presentation and findings. Disease manifestations continue to develop over the lifetime of an affected individual. Accurate diagnosis is fundamental to implementation of appropriate medical surveillance and treatment. Although significant advances have been made in the past 15 years in the understanding and treatment of tuberous sclerosis complex, current clinical diagnostic criteria have not been critically evaluated or updated since the last clinical consensus conference in 1998. METHODS The 2012 International Tuberous Sclerosis Complex Consensus Group, comprising 79 specialists from 14 countries, was organized into 12 subcommittees, each led by a clinician with advanced expertise in tuberous sclerosis complex and the relevant medical subspecialty. Each subcommittee focused on a specific disease area with important diagnostic implications and was charged with reviewing prevalence and specificity of disease-associated clinical findings and their impact on suspecting and confirming the diagnosis of tuberous sclerosis complex. RESULTS Clinical features of tuberous sclerosis complex continue to be a principal means of diagnosis. Key changes compared with 1998 criteria are the new inclusion of genetic testing results and reducing diagnostic classes from three (possible, probable, and definite) to two (possible, definite). Additional minor changes to specific criterion were made for additional clarification and simplification. CONCLUSIONS The 2012 International Tuberous Sclerosis Complex Diagnostic Criteria provide current, updated means using best available evidence to establish diagnosis of tuberous sclerosis complex in affected individuals. PMID:24053982

  20. Treatment of childhood headaches.

    PubMed

    Gupta, A; Rothner, A D

    2001-03-01

    Migraine and tension-type headaches are two of the most common types of primary headache disorders in children. Migraine is a primary central nervous system disorder characterized by triggered or spontaneous episodes of activation of trigemino-vascular complex, neurogenic inflammation around vessels and meninges, and stimulation of the peripheral and central pain pathways of the trigemino-cervical complex. The triptans, by their selective agonistic action on 5-HT1B/1D receptors, are very effective in the treatment of migraine pain and associated symptoms. Early studies on the safety and efficacy of triptans in the management of childhood migraine show encouraging results. We propose a stratified-care model for the management of migraine in children, and discuss pharmacotherapy based on the pathophysiologic mechanisms of migraine pain. Management of tension-type headaches requires comprehensive medical and psychologic evaluation and an individualized approach for a successful outcome. PMID:11898510

  1. U1A Complex

    SciTech Connect

    2014-10-28

    Some of the most sophisticated experiments in the stockpile stewardship program are conducted in an environmentally safe manner, nearly 1000 feet below the ground at the site. The U1a complex a sprawling underground laboratory and tunnel complex is home to a number of unique capabilities.

  2. Performance Improvement Assuming Complexity

    ERIC Educational Resources Information Center

    Rowland, Gordon

    2007-01-01

    Individual performers, work teams, and organizations may be considered complex adaptive systems, while most current human performance technologies appear to assume simple determinism. This article explores the apparent mismatch and speculates on future efforts to enhance performance if complexity rather than simplicity is assumed. Included are…

  3. Complexity and Relations

    ERIC Educational Resources Information Center

    Lancaster, Jeanette Elizabeth

    2013-01-01

    A central feature of complexity is that it is based on non-linear, recursive relations. However, in most current accounts of complexity such relations, while non-linear, are based on the reductive relations of a Newtonian onto-epistemological framework. This means that the systems that are emergent from the workings of such relations are a…

  4. Complexity in Picture Books

    ERIC Educational Resources Information Center

    Sierschynski, Jarek; Louie, Belinda; Pughe, Bronwyn

    2015-01-01

    One of the key requirements of Common Core State Standards (CCSS) in English Language Arts is that students are able to read and access complex texts across all grade levels. The CCSS authors emphasize both the limitations and lack of accuracy in the current CCSS model of text complexity, calling for the development of new frameworks. In response

  5. Beyond the Hox complex

    PubMed Central

    Patel, Nipam H; Prince, Victoria E

    2000-01-01

    The Hox complex is an example of a gene cluster created by tandem duplications. Recent findings suggest the Hox complex may be just part of a larger chromosomal assemblage of homeobox-containing genes that existed in the ancestor to all vertebrates. PMID:11178261

  6. Gold trifluoromethyl complexes.

    PubMed

    Gil-Rubio, Juan; Vicente, José

    2015-12-01

    This article reviews the synthesis, reactivity and applications of gold trifluoromethyl complexes, which are the only isolated perfluoroalkyl complexes of gold. The most reported examples are neutral Au(i) complexes of the type [Au(CF3)L], whereas only two Au(ii) trifluoromethyl complexes have been reported, both being diamagnetic and containing a strong Au-Au bond. A number of Au(iii) trifluoromethyl complexes have been prepared by oxidative addition of halogens or iodotrifluoromethane to Au(i) complexes or, in a few cases, by transmetallation reactions. Owing to the limitations of the available synthetic methods, a lower number of examples is known, particularly for the oxidation states (ii) and (iii). Gold trifluoromethyl complexes present singular characteristics, such as thermal stability, strong Au-C bonds and, in some cases, reactive α-C-F bonds. Some of the Au(iii) complexes reported, show unusually easy reductive elimination reactions of trifluoromethylated products which could be applied in the development of gold-catalyzed processes for the trifluoromethylation of organic compounds. PMID:26169553

  7. Visual Complexity: A Review

    ERIC Educational Resources Information Center

    Donderi, Don C.

    2006-01-01

    The idea of visual complexity, the history of its measurement, and its implications for behavior are reviewed, starting with structuralism and Gestalt psychology at the beginning of the 20th century and ending with visual complexity theory, perceptual learning theory, and neural circuit theory at the beginning of the 21st. Evidence is drawn from…

  8. Tuberculosis in complex emergencies.

    PubMed

    Coninx, Rudi

    2007-08-01

    This paper describes the key factors and remaining challenges for tuberculosis (TB) control programmes in complex emergencies. A complex emergency is "a humanitarian crisis in a country, region or society where there is total or considerable breakdown of authority resulting from internal or external conflict and which requires an international response that goes beyond the mandate or capacity of any single agency and/or the ongoing United Nations country programme." Some 200 million people are believed to live in countries affected by complex emergencies; almost all of these are developing countries that also bear the main burden of TB. The effects of complex emergencies impact on TB control programmes, interfering with the goals of identifying and curing TB patients and possibly leading to the emergence of MDR-TB. There are many detailed descriptions of aid interventions during complex emergencies; yet TB control programmes are absent from most of these reports. If TB is neglected, it may quickly result in increased morbidity and mortality, as was demonstrated in Bosnia and Herzegovina and in Somalia. TB is a major disease in complex emergencies and requires an appropriate public health response. While there is no manual to cover complex emergencies, the interagency manual for TB control in refugee and displaced populations provides valuable guidance. These programmes contribute to the body of evidence needed to compile such a manual, and should ensure that the experiences of TB control in complex emergencies lead to the establishment of evidence-based programmes. PMID:17768523

  9. Complex vague relation

    NASA Astrophysics Data System (ADS)

    Al-Husban, Rima; Salleh, Abdul Razak

    2015-12-01

    The present paper, introduces a complex vague relation (CVR) as a generalization of a vague relation by extending the range of truth-membership and false-membership functions from the closed unit interval [0, 1] to the unit circle in the complex plane. Then we introduce the basic operations on CVRs, namely complement, union and intersection. Some examples are given.

  10. Complexity in Picture Books

    ERIC Educational Resources Information Center

    Sierschynski, Jarek; Louie, Belinda; Pughe, Bronwyn

    2015-01-01

    One of the key requirements of Common Core State Standards (CCSS) in English Language Arts is that students are able to read and access complex texts across all grade levels. The CCSS authors emphasize both the limitations and lack of accuracy in the current CCSS model of text complexity, calling for the development of new frameworks. In response…

  11. Bacterial formate hydrogenlyase complex

    PubMed Central

    McDowall, Jennifer S.; Murphy, Bonnie J.; Haumann, Michael; Palmer, Tracy; Armstrong, Fraser A.; Sargent, Frank

    2014-01-01

    Under anaerobic conditions, Escherichia coli can carry out a mixed-acid fermentation that ultimately produces molecular hydrogen. The enzyme directly responsible for hydrogen production is the membrane-bound formate hydrogenlyase (FHL) complex, which links formate oxidation to proton reduction and has evolutionary links to Complex I, the NADH:quinone oxidoreductase. Although the genetics, maturation, and some biochemistry of FHL are understood, the protein complex has never been isolated in an intact form to allow biochemical analysis. In this work, genetic tools are reported that allow the facile isolation of FHL in a single chromatographic step. The core complex is shown to comprise HycE (a [NiFe] hydrogenase component termed Hyd-3), FdhF (the molybdenum-dependent formate dehydrogenase-H), and three iron-sulfur proteins: HycB, HycF, and HycG. A proportion of this core complex remains associated with HycC and HycD, which are polytopic integral membrane proteins believed to anchor the core complex to the cytoplasmic side of the membrane. As isolated, the FHL complex retains formate hydrogenlyase activity in vitro. Protein film electrochemistry experiments on Hyd-3 demonstrate that it has a unique ability among [NiFe] hydrogenases to catalyze production of H2 even at high partial pressures of H2. Understanding and harnessing the activity of the FHL complex is critical to advancing future biohydrogen research efforts. PMID:25157147

  12. COMPLEXITY IN ECOLOGICAL SYSTEMS

    EPA Science Inventory

    The enormous complexity of ecosystems is generally obvious under even the most cursory examination. In the modern world, this complexity is further augmented by the linkage of ecosystems to economic and social systems through the human use of the environment for technological pu...

  13. Visual Complexity: A Review

    ERIC Educational Resources Information Center

    Donderi, Don C.

    2006-01-01

    The idea of visual complexity, the history of its measurement, and its implications for behavior are reviewed, starting with structuralism and Gestalt psychology at the beginning of the 20th century and ending with visual complexity theory, perceptual learning theory, and neural circuit theory at the beginning of the 21st. Evidence is drawn from

  14. U1A Complex

    ScienceCinema

    None

    2015-01-09

    Some of the most sophisticated experiments in the stockpile stewardship program are conducted in an environmentally safe manner, nearly 1000 feet below the ground at the site. The U1a complex a sprawling underground laboratory and tunnel complex is home to a number of unique capabilities.

  15. Complexity and behavioral economics.

    PubMed

    Rosser, J Barkley; Rosser, Marina V

    2015-04-01

    This paper will consider the relationship between complexity economics and behavioral economics. A crucial key to this is to understand that Herbert Simon was both the founder of explicitly modern behavioral economics as well as one of the early developers of complexity theory. Bounded rationality was essentially derived from Simon's view of the impossibility of full rationality on the part of economic agents. Modern complexity theory through such approaches as agent-based modeling offers an approach to understanding behavioral economics by allowing for specific behavioral responses to be assigned to agents who interact within this context, even without full rationality. Other parts of modern complexity theory are considered in terms of their relationships with behavioral economics. Fundamentally, complexity provides an ultimate foundation for bounded rationality and hence the need to use behavioral economics in a broader array of contexts than most economists have thought appropriate. PMID:25783044

  16. Leading healthcare in complexity.

    PubMed

    Cohn, Jeffrey

    2014-12-01

    Healthcare institutions and providers are in complexity. Networks of interconnections from relationships and technology create conditions in which interdependencies and non-linear dynamics lead to surprising, unpredictable outcomes. Previous effective approaches to leadership, focusing on top-down bureaucratic methods, are no longer effective. Leading in complexity requires leaders to accept the complexity, create an adaptive space in which innovation and creativity can flourish and then integrate the successful practices that emerge into the formal organizational structure. Several methods for doing adaptive space work will be discussed. Readers will be able to contrast traditional leadership approaches with leading in complexity. They will learn new behaviours that are required of complexity leaders, along with challenges they will face, often from other leaders within the organization. PMID:25815410

  17. Treatment of subepidermal immunobullous diseases

    PubMed Central

    Culton, Donna A.; Diaz, Luis A.

    2013-01-01

    The subepidermal immunobullous diseases are a group of autoimmune blistering disorders of the skin and mucous membranes that share the common features of autoantibody deposition and blister formation at the dermal-epidermal junction or basement membrane. This group includes bullous pemphigoid, linear IgA disease, dermatitis herpetiformis, and epidermolysis bullosa acquisita, among others. Although these disorders share some common features, each disease is unique in its clinical presentation, histopathology, and immunofluorescence patterns, which allows for accurate diagnosis and disease-specific treatment strategy. Treatment of these disorders is complex and requires expert knowledge of disease pathogenesis. We review common treatment approaches for each of these disorders. PMID:22137232

  18. Antitumor effects of electrochemical treatment

    PubMed Central

    González, Maraelys Morales; Zamora, Lisset Ortíz; Cabrales, Luis Enrique Bergues; Sierra González, Gustavo Victoriano; de Oliveira, Luciana Oliveira; Zanella, Rodrigo; Buzaid, Antonio Carlos; Parise, Orlando; Brito, Luciana Macedo; Teixeira, Cesar Augusto Antunes; Gomes, Marina das Neves; Moreno, Gleyce; Feo da Veiga, Venicio; Telló, Marcos; Holandino, Carla

    2013-01-01

    Electrochemical treatment is an alternative modality for tumor treatment based on the application of a low intensity direct electric current to the tumor tissue through two or more platinum electrodes placed within the tumor zone or in the surrounding areas. This treatment is noted for its great effectiveness, minimal invasiveness and local effect. Several studies have been conducted worldwide to evaluate the antitumoral effect of this therapy. In all these studies a variety of biochemical and physiological responses of tumors to the applied treatment have been obtained. By this reason, researchers have suggested various mechanisms to explain how direct electric current destroys tumor cells. Although, it is generally accepted this treatment induces electrolysis, electroosmosis and electroporation in tumoral tissues. However, action mechanism of this alternative modality on the tumor tissue is not well understood. Although the principle of Electrochemical treatment is simple, a standardized method is not yet available. The mechanism by which Electrochemical treatment affects tumor growth and survival may represent more complex process. The present work analyzes the latest and most important research done on the electrochemical treatment of tumors. We conclude with our point of view about the destruction mechanism features of this alternative therapy. Also, we suggest some mechanisms and strategies from the thermodynamic point of view for this therapy. In the area of Electrochemical treatment of cancer this tool has been exploited very little and much work remains to be done. Electrochemical treatment constitutes a good therapeutic option for patients that have failed the conventional oncology methods. PMID:23592904

  19. Integrated nonthermal treatment system study

    SciTech Connect

    Biagi, C.; Bahar, D.; Teheranian, B.; Vetromile, J.; Quapp, W.J.; Bechtold, T.; Brown, B.; Schwinkendorf, W.; Swartz, G.

    1997-01-01

    This report presents the results of a study of nonthermal treatment technologies. The study consisted of a systematic assessment of five nonthermal treatment alternatives. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The alternatives considered were innovative nonthermal treatments for organic liquids and sludges, process residue, soil and debris. Vacuum desorption or various washing approaches are considered for treatment of soil, residue and debris. Organic destruction methods include mediated electrochemical oxidation, catalytic wet oxidation, and acid digestion. Other methods studied included stabilization technologies and mercury separation of treatment residues. This study is a companion to the integrated thermal treatment study which examined 19 alternatives for thermal treatment of MLLW waste. The quantities and physical and chemical compositions of the input waste are based on the inventory database developed by the US Department of Energy. The Integrated Nonthermal Treatment Systems (INTS) systems were evaluated using the same waste input (2,927 pounds per hour) as the Integrated Thermal Treatment Systems (ITTS). 48 refs., 68 figs., 37 tabs.

  20. [Proliferative vitreoretinopathy: curative treatment].

    PubMed

    Chiquet, C; Rouberol, F

    2014-10-01

    Proliferative vitreoretinopathy (PVR), which causes contractile fibrocellular membranes that may prevent retinal reattachment, remains one of the most severe complications of rhegmatogenous retinal detachment (RD), with an incidence of 5-11%, and one of the most frequent causes of surgical failure (50-75%). Its severity is due to the complexity of the surgery required to treat patients, and to its uncertain anatomic and functional prognosis. Curative treatment of PVR includes vitrectomy, sometimes associated with phacoemulsification or scleral buckling; systematic peeling of epiretinal membranes, occasionally retinectomy; and systematic retinopexy by endolaser photocoagulation. The current preferred internal tamponade is silicone oil. Silicone oils of various densities are undergoing comparative studies. PMID:24997865

  1. Sewage Treatment

    NASA Technical Reports Server (NTRS)

    1991-01-01

    Stennis Space Center's aquaculture research program has led to an attractive wastewater treatment for private homes. The system consists of a septic tank or tanks for initial sewage processing and a natural secondary treatment facility for further processing of septic tanks' effluent, consisting of a narrow trench, which contains marsh plants and rocks, providing a place for microorganisms. Plants and microorganisms absorb and digest, thus cleansing partially processed wastewater. No odors are evident and cleaned effluent may be discharged into streams or drainage canals. The system is useful in rural areas, costs about $1,900, and requires less maintenance than mechanical systems.

  2. BIOLOGICAL TREATMENT OF HIGH STRENGTH PETROCHEMICAL WASTEWATER

    EPA Science Inventory

    The biological treatment of a complex petrochemical wastewater containing high concentrations of organic chlorides, nitrates, and amines was initially studied using a sequence of anaerobic methanogenesis and oxygen activated sludge. Bench-scale and pilot-plant treatability studie...

  3. Acute Heart Failure Treatment

    PubMed Central

    Bellou, Abdel

    2013-01-01

    Dyspnea is the predominant symptom for patients with acute heart failure and initial treatment is largely directed towards the alleviation of this. Contrary to conventional belief, not all patients present with fluid overload and the approach to management is rapidly evolving from a solitary focus on diuresis to one that more accurately reflects the complex interplay of underlying cardiac dysfunction and acute precipitant. Effective treatment thus requires an understanding of divergent patient profiles and an appreciation of various therapeutic options for targeted patient stabilization. The key principle within this paradigm is directed management that aims to diminish the work of breathing through situation appropriate ventillatory support, volume reduction and hemodynamic improvement. With such an approach, clinicians can more efficiently address respiratory discomfort while reducing the likelihood of avoidable harm. PMID:24223323

  4. Acute Heart Failure Treatment.

    PubMed

    Levy, Phillip D; Bellou, Abdel

    2013-06-01

    Dyspnea is the predominant symptom for patients with acute heart failure and initial treatment is largely directed towards the alleviation of this. Contrary to conventional belief, not all patients present with fluid overload and the approach to management is rapidly evolving from a solitary focus on diuresis to one that more accurately reflects the complex interplay of underlying cardiac dysfunction and acute precipitant. Effective treatment thus requires an understanding of divergent patient profiles and an appreciation of various therapeutic options for targeted patient stabilization. The key principle within this paradigm is directed management that aims to diminish the work of breathing through situation appropriate ventillatory support, volume reduction and hemodynamic improvement. With such an approach, clinicians can more efficiently address respiratory discomfort while reducing the likelihood of avoidable harm. PMID:24223323

  5. Labile sulfide and sulfite in phytochelatin complexes

    SciTech Connect

    Eannetta, N.T.; Steffens, J.C. )

    1989-04-01

    Heavy metals such as cadmium induce tomato cell cultures to synthesize the metal binding polypeptides ({gamma}-Glu-Cys){sub 3} and ({gamma}-Glu-Cys){sub 4}-Gly (phytochelatins). Tomato cells selected for growth on normally lethal concentrations of CdCl{sub 2} synthesize higher quantities of these polypeptides. Cd{sup r} cells are not cross-resistant to other heavy metals, and recent work suggests that metal detoxification by these peptides may be Cd-specific. The occurrence of labile sulfur as a component of the metal complex raises questions concerning possible functions of phytochelatins besides that of Cd binding. The presence of acid-labile sulfide ion in phytochelatin complexes has been reported by several groups. We report the additional finding that labile sulfite is also present in these complexes and in higher amounts than sulfide. Sulfide and sulfite are both released from the metal binding complex by acidification or by treatment with EDTA.

  6. [Multipurpose treatment of vaginal infections].

    PubMed

    Nikolov, A; Masseva, A; Shopova, E; Georgiev, S

    2012-01-01

    Untreated bacterial vaginosis is related with many complications for non-pregnant women in reproductive age, most common from them are vaginal discharge and postoperative infections. The aim of our investigation was to compare the effectiveness of two therapeutic regimes which consist in Macmiror/Macmiror Complex alone and in combination with Feminella Vagi C for treatment of bacterial vaginosis (BV) and/or mycotic infection. 117 non-pregnant women with symptoms of vaginal infection were prospectively enrolled into two groups according their treatment. First group consist 66 women treated with Macmiror tablets and vaginal capsules followed with local application of Feminella Vagi C, the second group consist 54 women treated with Macmiror tablets and vaginal capsules only. The impact of treatment on clinical symptoms was observed at the end of medication and 20 days after it. Microbiological testing was repeated 20 days after treatment. Over than 80% (78.6 divided by 86.7%) of the cases with vaginal infection (BV and mycotic one) were successfully treated with Macmiror/Macmiror Complex. Supplement treatment with Feminella Vagi C lead to higher percentage of clinically recovery (86.7% vs 84.6%), better microbiological cleaning (86.7% vs 82.1%) and longer effect of treatment. Used medication showed higher efficacy against BV than to fungal infection. According obtained results we may conclude that bacterial vaginosis was better treated with multipurpose treatment (Nifuratel, Nistatin and vit. C) than with Macmiror alone. PMID:23234030

  7. The Evolution of Privatization at Hanford Tank Waste Treatment Complex

    SciTech Connect

    BROWN, N.R.

    2001-02-01

    Privatization acquisition strategies embody substantial contract reform principles-private financing and ownership, competition, fixed prices, and payment only upon delivery of services-which in time became the recipe for privatization of Department of Energy (DOE) Environmental Management (EM) cleanup projects. Privatization changes the federal government's approach from traditional cost-plus contracting, where the federal government pays the contractor as the project progresses, to a strategy where the federal government pays for products or services as they are delivered. To be successful, the privatization requires additional risk taking by the contractor. This paper focuses on why the Tank Waste Remediation System (TWRS) pursued privatization, how the TWRS Privatization Project matured, and why the privatization project moved to an alternate path. The paper is organized as follows: a description of the TWRS-Privatization framework, how the project changed from the original request for proposal through the decision not to proceed to Part B-2, and the lessons learned during evolution of the effort, including what worked as well as what went wrong and how such negative outcomes might be prevented in the future.

  8. B Plant complex treatment, storage, and disposal units inspection plan

    SciTech Connect

    Beam, T.G.

    1994-10-01

    Owners or operators of facilities that treat, store, and/or dispose of dangerous waste and/or mixed waste as defined by WAC 173-303, {open_quotes}Dangerous Waste Regulations,{close_quotes} must inspect their facilities to prevent malfunctions and deteriorations, operator errors, and discharges that may cause or lead to the release of hazardous waste constituents to the environment and/or cause a threat to human health. The WAC regulations require a written inspection schedule be developed, implemented, and kept at the facility.

  9. Profil'-1 measuring complex

    SciTech Connect

    Andrianov, V.R.; Petrov, A.P.

    1985-04-01

    This paper describes the Profil'-1 hydroacoustic measuring complex. The complex provides documentary information on the bottom profile of reservoirs, the configuration and geometric dimensions of underwater trenches, the spatial position of pipes in uncovered or washedout trenches, the thickness of a layer covering underwater pipes, etc. The complex can also be used to solve other industrial problems such as hydraulic exploration and searching for sunken objects. The Profil'-1 complex is designed for use on board small craft under field conditions with periodic transportation from storage bases to the operating location and back. The complex uses an echo-pulse method for determining the distance and coordinates of objects with the aid of an ultrasonic transceiver in an aqueous medium. Structurally, the complex consists of four main units: a BA-1 vertical sounding antenna unit; a BAS-1 antenna scanning unit; a BFOS-1 signal shaping and processing unit, and a BR-1 recording unit. Use of the complex in pipeline construction and the oil and gas industry will provide a considerable economic gain by reducing the number of diver inspections of underwater pipelines.

  10. Surface Treatment

    NASA Technical Reports Server (NTRS)

    Park, Cheol (Inventor); Lowther, Sharon E. (Inventor); St.Clair, Terry L. (Inventor)

    2003-01-01

    A simple surface treatment process is provided which offers a high performance surface for a variety of applications at low cost. This novel surface treatment, which is particularly useful for Ti-6Al-4V alloys, is achieved by forming oxides on the surface with a two-step chemical process and without mechanical abrasion. First, after solvent degreasing, sulfuric acid is used to generate a fresh titanium surface. Next, an alkaline perborate solution is used to form an oxide on the surface. This acid-followed-by-base treatment is cost effective and relatively safe to use in commercial applications. In addition, it is chromium-free, and has been successfully used with a sol-gel coating to afford a strong adhesive bond that exhibits excellent durability after the bonded specimens have been subjected to a harsh 72 hour water boil immersion. Phenylethynyl containing adhesives were used to evaluate this surface treatment with a novel coupling agent containing both trialkoxysilane and phenylethynyl groups. 8 Claims, 16 Drawing Sheets

  11. WATER TREATMENT

    DOEpatents

    Pitman, R.W.; Conley, W.R. Jr.

    1962-12-01

    An automated system for adding clarifying chemicals to water in a water treatment plant is described. To a sample of the floc suspension polyacrylamide or similar filter aid chemicals are added, and the sample is then put through a fast filter. The resulting filtrate has the requisite properties for monitoring in an optical turbidimeter to control the automated system. (AEC)

  12. PARACOCCIDIOIDOMYCOSIS TREATMENT.

    PubMed

    Shikanai-Yasuda, Maria Aparecida

    2015-09-01

    Considered to be an emerging endemic mycosis in Latin America, paracoccidioidomycosis is characterized by a chronic course and involvement of multiple organs in immunocompromised hosts. Infection sequelae are mainly related to pulmonary and adrenal insufficiency. The host-parasite interaction results in different expressions of the immune response depending on parasite pathogenicity, fungal load and genetic characteristics of the host. A few controlled and case series reports have shown that azoles and fast-acting sulfa derivatives are useful treatment alternatives in milder forms of the disease. For moderate/severe cases, more prolonged treatments or even parenteral routes are required especially when there is involvement of the digestive tract mucosa, resulting in poor drug absorption. Although comparative studies have reported that shorter treatment regimens with itraconazole are able to induce cure in chronically-infected patients, there are still treatment challenges such as the need for more controlled studies involving acute cases, the search for new drugs and combinations, and the search for compounds capable of modulating the immune response in severe cases as well as the paradoxical reactions. PMID:26465367

  13. PARACOCCIDIOIDOMYCOSIS TREATMENT

    PubMed Central

    SHIKANAI-YASUDA, Maria Aparecida

    2015-01-01

    SUMMARY Considered to be an emerging endemic mycosis in Latin America, paracoccidioidomycosis is characterized by a chronic course and involvement of multiple organs in immunocompromised hosts. Infection sequelae are mainly related to pulmonary and adrenal insufficiency. The host-parasite interaction results in different expressions of the immune response depending on parasite pathogenicity, fungal load and genetic characteristics of the host. A few controlled and case series reports have shown that azoles and fast-acting sulfa derivatives are useful treatment alternatives in milder forms of the disease. For moderate/severe cases, more prolonged treatments or even parenteral routes are required especially when there is involvement of the digestive tract mucosa, resulting in poor drug absorption. Although comparative studies have reported that shorter treatment regimens with itraconazole are able to induce cure in chronically-infected patients, there are still treatment challenges such as the need for more controlled studies involving acute cases, the search for new drugs and combinations, and the search for compounds capable of modulating the immune response in severe cases as well as the paradoxical reactions. PMID:26465367

  14. Scabies Treatment

    MedlinePlus

    ... Issues Listen Español Text Size Email Print Share Scabies Treatment Page Content Article Body Scabies is caused by a microscopic mite that burrows ... deposits its eggs. The rash that results from scabies is actually a reaction to the mite’s body, ...

  15. Cancer: Treatment

    MedlinePlus

    ... help you feel better. Will I lose my hair? Radiotherapy to the head and some types of chemotherapy can cause people ... lose your hair. Some people who lose their hair during cancer treatment wear a wig or hairpiece. Others cover their heads with hats, scarves or turbans. Still others leave ...

  16. [Avalanche accidents and treatment of avalanche victims].

    PubMed

    Skaiaa, Sven Christjar; Thomassen, Øyvind

    2016-03-01

    Avalanches may be provoked spontaneously or as a result of human activity, and they trigger the need for considerable rescue resources. Avalanche search and rescue operations are complex and characterised by physical and mental stress. The guidelines for resuscitation of avalanche victims may be perceived as complex and abstruse, which can lead to suboptimal treatment and an increased strain on rescue teams. The purpose of this article is to summarise the principles for medical treatment of avalanche victims. PMID:26983147

  17. Selenophene transition metal complexes

    SciTech Connect

    White, C.J.

    1994-07-27

    This research shows that selenophene transition metal complexes have a chemistry that is similar to their thiophene analogs. Selenophene coordination has been demonstrated and confirmed by molecular structure in both the {eta}{sup 5}- and the {eta}{sup 1}(Se)-coordination modes. The reaction chemistry of selenophene complexes closely resembles that of the analogous thiophene complexes. One major difference, however, is that selenophene is a better donor ligand than thiophene making the selenophene complexes more stable than the corresponding thiophene complexes. The {sup 77}Se NMR chemical shift values for selenophene complexes fall within distinct regions primarily depending on the coordination mode of the selenophene ligand. In the final paper, the C-H bond activation of {eta}{sup 1}(S)-bound thiophenes, {eta}{sup 1}(S)-benzothiophene and {eta}{sup 1}(Se)-bound selenophenes has been demonstrated. The deprotonation and rearrangement of the {eta}{sup 1}(E)-bound ligand to the carbon bound L-yl complex readily occurs in the presence of base. Reprotonation with a strong acid gives a carbene complex that is unreactive towards nucleophilic attack at the carbene carbon and is stable towards exposure to air. The molecular structure of [Cp(NO)(PPh{sub 3})Re(2-benzothioenylcarbene)]O{sub 3}SCF{sub 3} was determined and contains a Re-C bond with substantial double bond character. Methyl substitution for the thienylcarbene or selenylcarbene gives a carbene that rearranges thermally to give back the {eta}{sup 1}(E)-bound complex. Based on these model reactions, a new mechanism for the H/D exchange of thiophene over the hydrodesulfurization catalyst has been proposed.

  18. CELL-PERMEABLE PROTEIN THERAPY FOR COMPLEX I DYSFUNCTION

    PubMed Central

    Pepe, Salvatore; Mentzer, Robert M.; Gottlieb, Roberta A.

    2015-01-01

    Complex I deficiency is difficult to treat because of the size and complexity of the multi-subunit enzyme complex. Mutations or deletions in the mitochondrial genome are not amenable to gene therapy. However, animal studies have shown that yeast-derived internal NADH quinone oxidoreductase (Ndi1) can be delivered as a cell-permeable recombinant protein (Tat-Ndi1) that can functionally replace complex I damaged by ischemia/reperfusion. Current and future treatment of disorders affecting complex I are discussed, including the use of Tat-Ndi1. PMID:25005682

  19. Afterglow Complex Plasma

    SciTech Connect

    Samarian, A. A.; Boufendi, L.; Mikikian, M.

    2008-09-07

    The review of the first detailed experimental and theoretical studies of complex plasma in RF discharge afterglow is presented. The studies have been done in a frame of FAST collaborative research project between Complex Plasma Laboratory of the University of Sydney and the GREMI laboratory of Universite d'Orleans. We examined the existing models of plasma decay, presents experimental observations of dust dynamics under different afterglow complex plasma conditions, presents the experimental data obtained (in particular the presence of positively charged particles in discharge afterglow), discusses the use of dust particles as a probe to study the diffusion losses in afterglow plasmas.

  20. Complex intuitionistic fuzzy sets

    NASA Astrophysics Data System (ADS)

    Alkouri, Abdulazeez (Moh'd. Jumah) S.; Salleh, Abdul Razak

    2012-09-01

    This paper presents a new concept of complex intuitionistic fuzzy set (CIFS) which is generalized from the innovative concept of a complex fuzzy set (CFS) by adding the non-membership term to the definition of CFS. The novelty of CIFS lies in its ability for membership and non-membership functions to achieve more range of values. The ranges of values are extended to the unit circle in complex plane for both membership and non-membership functions instead of [0, 1] as in the conventional intuitionistic fuzzy functions. We define basic operations namely complement, union, and intersection on CIFSs. Properties of these operations are derived.

  1. Controllability of Complex Systems

    NASA Astrophysics Data System (ADS)

    Slotine, Jean-Jacques

    2013-03-01

    We review recent work on controllability of complex systems. We also discuss the interplay of our results with questions of synchronization, and point out key directions of future research. Work done in collaboration with Yang-Yu Liu, Center for Complex Network Research and Departments of Physics, Computer Science and Biology, Northeastern University and Center for Cancer Systems Biology, Dana-Farber Cancer Institute; and Albert-László Barabási, Center for Complex Network Research and Departments of Physics, Computer Science and Biology, Northeastern University; Center for Cancer Systems Biology, Dana-Farber Cancer Institute; and Department of Medicine, Brigham and Women's Hospital, Harvard Medical School.

  2. Complexity and robustness

    PubMed Central

    Carlson, J. M.; Doyle, John

    2002-01-01

    Highly optimized tolerance (HOT) was recently introduced as a conceptual framework to study fundamental aspects of complexity. HOT is motivated primarily by systems from biology and engineering and emphasizes, (i) highly structured, nongeneric, self-dissimilar internal configurations, and (ii) robust yet fragile external behavior. HOT claims these are the most important features of complexity and not accidents of evolution or artifices of engineering design but are inevitably intertwined and mutually reinforcing. In the spirit of this collection, our paper contrasts HOT with alternative perspectives on complexity, drawing on real-world examples and also model systems, particularly those from self-organized criticality. PMID:11875207

  3. Audits for advanced treatment dosimetry

    NASA Astrophysics Data System (ADS)

    Ibbott, G. S.; Thwaites, D. I.

    2015-01-01

    Radiation therapy has advanced rapidly over the last few decades, progressing from 3D conformal treatment to image-guided intensity modulated therapy of several different flavors, both 3D and 4D and to adaptive radiotherapy. The use of intensity modulation has increased the complexity of quality assurance and essentially eliminated the physicist's ability to judge the validity of a treatment plan, even approximately, on the basis of appearance and experience. Instead, complex QA devices and procedures are required at the institutional level. Similarly, the assessment of treatment quality through remote and on-site audits also requires greater sophistication. The introduction of 3D and 4D dosimetry into external audit systems must follow, to enable quality assurance systems to perform meaningful and thorough audits.

  4. Complex Regional Pain Syndrome

    MedlinePlus

    Complex regional pain syndrome (CRPS) is a chronic pain condition. It causes intense pain, usually in the arms, hands, legs, or feet. ... in skin temperature, color, or texture Intense burning pain Extreme skin sensitivity Swelling and stiffness in affected ...

  5. Pigment-protein complexes

    SciTech Connect

    Siegelman, H W

    1980-01-01

    The photosynthetically-active pigment protein complexes of procaryotes and eucaryotes include chlorophyll proteins, carotenochlorophyll proteins, and biliproteins. They are either integral components or attached to photosynthetic membranes. Detergents are frequently required to solubilize the pigment-protein complexes. The membrane localization and detergent solubilization strongly suggest that the pigment-protein complexes are bound to the membranes by hydrophobic interactions. Hydrophobic interactions of proteins are characterized by an increase in entropy. Their bonding energy is directly related to temperature and ionic strength. Hydrophobic-interaction chromatography, a relatively new separation procedure, can furnish an important method for the purification of pigment-protein complexes. Phycobilisome purification and properties provide an example of the need to maintain hydrophobic interactions to preserve structure and function.

  6. Complex Flow Workshop Report

    SciTech Connect

    none,

    2012-05-01

    This report documents findings from a workshop on the impacts of complex wind flows in and out of wind turbine environments, the research needs, and the challenges of meteorological and engineering modeling at regional, wind plant, and wind turbine scales.

  7. Complexity at mesoscopic lengthscale.

    PubMed

    Egami, T

    2015-09-01

    Modern materials are often complex in the structure at mesoscale. The method of pair-density function (PDF) is a powerful tool to characterize mesoscopic structure, bridging short- and long-range structures. PMID:26306189

  8. A complex legacy

    NASA Astrophysics Data System (ADS)

    Moore, Cristopher

    2011-11-01

    In his tragically short life, Alan Turing helped define what computing machines are capable of, and where they reach inherent limits. His legacy is still felt every day, in areas ranging from computational complexity theory to cryptography and quantum computing.

  9. Microsolvation in molecular complexes

    NASA Astrophysics Data System (ADS)

    Pasquini, M.; Schiccheri, N.; Piani, G.; Pietraperzia, G.; Becucci, M.; Castellucci, E.

    2008-11-01

    In this paper, we report the results of our study of the microsolvation process involving the anisole molecule. We are able to study bimolecular complexes of different compositions. Changing the second partner molecule bound to anisole, we observed complexes of different geometries, because of the large variety of interactions possible for the anisole. High-resolution electronic spectroscopy is the best tool to reveal the correct vibrationally (zero-point) averaged geometry of the complex. That is done by analysing the rovibronic structure of the electronic spectra, which are related to the equilibrium geometry of the complex as well as dynamical processes, both in the ground and in the excited state. The interpretation of the experimental results is supported by high-level quantum calculations.

  10. On complex Riemannian foliations

    NASA Astrophysics Data System (ADS)

    Ida, Cristian

    2016-01-01

    In this paper we make some general considerations about the geometry of complex Riemannian foliations, we introduce a leafwise characteristic connection and we write Einstein equations with respect to it. Next, using an one-to-one correspondence between leafwise holomorphic Riemannian metrics and leafwise anti-Khlerian metrics, we focus on the Einstein condition for a leafwise holomorphic Riemannian metric and the associated real leafwise anti-Khlerian metric on a manifold endowed with a complex foliation.

  11. NUCLEAR PORE COMPLEX BIOGENESIS

    PubMed Central

    Fernandez-Martinez, Javier; Rout, Michael P.

    2009-01-01

    SUMMARY Nuclear pore complexes (NPCs) are the sole mediators of transport between the nucleus and the cytoplasm. NPCs have a life cycle: they assemble, disassemble, turn over and age. The molecular mechanisms governing these different vital steps are beginning to emerge, suggesting key roles for the core structural scaffold of the NPC and auxiliary factors in the assembly of this large macromolecular complex, and connections between NPC maintenance, NPC turnover, and ageing of the cell. PMID:19524430

  12. CO-releasing binuclear rhodium complexes as inhibitors of nitric oxide generation in stimulated macrophages.

    PubMed

    Moragues, María E; Brines, Rita; Terencio, MaCarmen; Sancenón, Félix; Martínez-Máñez, Ramón; Alcaraz, MaJosé

    2013-12-16

    Nontoxic CO-releasing dirhodium complexes act as inhibitors of NO in stimulated macrophage cells, suggesting that novel antiinflammatory treatments could involve the use of these types of binuclear complexes. PMID:24279454

  13. Complex Regional Pain Syndrome

    MedlinePlus

    ... works, it may be repeated. Physical therapy and psychological counseling are also helpful. However, a treatment that ... my pain? If my injury has healed, why am I still in pain? Do I need any tests? What is the best treatment option for me? ...

  14. Trauma-focused CBT for youth with complex trauma

    PubMed Central

    Mannarino, Anthony P.; Kliethermes, Matthew; Murray, Laura A.

    2013-01-01

    Objectives Many youth develop complex trauma, which includes regulation problems in the domains of affect, attachment, behavior, biology, cognition, and perception. Therapists often request strategies for using evidence-based treatments (EBTs) for this population. This article describes practical strategies for applying Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for youth with complex trauma. Methods TF-CBT treatment phases are described and modifications of timing, proportionality and application are described for youth with complex trauma. Practical applications include a) dedicating proportionally more of the model to the TF-CBT coping skills phase; b) implementing the TF-CBT Safety component early and often as needed throughout treatment; c) titrating gradual exposure more slowly as needed by individual youth; d) incorporating unifying trauma themes throughout treatment; and e) when indicated, extending the TF-CBT treatment consolidation and closure phase to include traumatic grief components and to generalize ongoing safety and trust. Results Recent data from youth with complex trauma support the use of the above TF-CBT strategies to successfully treat these youth. Conclusions The above practical strategies can be incorporated into TF-CBT to effectively treat youth with complex trauma. Practice implications Practical strategies include providing a longer coping skills phase which incorporates safety and appropriate gradual exposure; including relevant unifying themes; and allowing for an adequate treatment closure phase to enhance ongoing trust and safety. Through these strategies therapists can successfully apply TF-CBT for youth with complex trauma. PMID:22749612

  15. ICDF Complex Remedial Action Report

    SciTech Connect

    W. M. Heileson

    2007-09-26

    This Idaho CERCLA Disposal Facility (ICDF) Remedial Action Report has been prepared in accordance with the requirements of Section 6.2 of the INEEL CERCLA Disposal Facility Remedial Action Work Plan. The agency prefinal inspection of the ICDF Staging, Storage, Sizing, and Treatment Facility (SSSTF) was completed in June of 2005. Accordingly, this report has been developed to describe the construction activities completed at the ICDF along with a description of any modifications to the design originally approved for the facility. In addition, this report provides a summary of the major documents prepared for the design and construction of the ICDF, a discussion of relevant requirements and remedial action objectives, the total costs associated with the development and operation of the facility to date, and identification of necessary changes to the Agency-approved INEEL CERCLA Disposal Facility Remedial Action Work Plan and the ICDF Complex Operations and Maintenance Plan.

  16. Myelodysplastic/ Myeloproliferative Neoplasms Treatment

    MedlinePlus

    ... Myeloproliferative Neoplasms Treatment Myelodysplastic/ Myeloproliferative Neoplasms Treatment Myelodysplastic/ Myeloproliferative Neoplasms Treatment (PDQ®)–Patient Version General Information About Myelodysplastic/ ...

  17. Chronic Myeloproliferative Neoplasms Treatment

    MedlinePlus

    ... Myeloproliferative Neoplasms Treatment Myelodysplastic/ Myeloproliferative Neoplasms Treatment Chronic Myeloproliferative Neoplasms Treatment (PDQ®)–Patient Version General Information About Chronic ...

  18. Lymphedema in tuberous sclerosis complex.

    PubMed

    Geffrey, Alexandra L; Shinnick, Julianna E; Staley, Brigid A; Boronat, Susana; Thiele, Elizabeth A

    2014-06-01

    Congenital lymphedema has been described as a possible rare association of tuberous sclerosis complex (TSC), with only six previous cases reported in the literature. TSC is an autosomal dominant, multisystem disorder connected to aberrant regulation of the mammalian target of rapamycin (mTOR) pathway. The aim of this study is to review cases of lymphedema in a large cohort of TSC patients. The medical records of 268 patients seen at The Herscot Center for Children and Adults with Tuberous Sclerosis Complex at the Massachusetts General Hospital from 2002 to 2012 were retrospectively reviewed for reports of lymphedema or edema of unknown etiology. Genotypic and phenotypic data were collected in accordance with institutional review board (IRB) approval. This cohort presents two new cases of congenital lymphedema in TSC patients and acquired lymphedema was found in eight additional cases. Thus, we report 10 new cases of lymphedema in TSC (4%). The two patients with congenital lymphedema were female, as were the previous six reported cases. The frequency of lymphedema reported here (4%) is higher than the estimated prevalence in the general population (0.133-0.144%), suggesting a higher frequency of lymphedema in TSC. This study shows that patients with TSC and lymphedema are more likely to be females with renal AMLs and suggests that congenital lymphedema is a gender-specific (female) manifestation of TSC. Exploration of the potential role of mTOR antagonists may be important in treatment of lymphedema in TSC patients. PMID:24668795

  19. Nipple areola complex sparing mastectomy

    PubMed Central

    Mingozzi, Matteo; Curcio, Annalisa; Buggi, Federico; Folli, Secondo

    2015-01-01

    Breast conservative therapy (BCT) is established as a safe option for most women with early breast cancer (BC). The best conservative mastectomy that can be performed, when mastectomy is unavoidable, is nipple-areola-complex sparing mastectomy (NSM), which allows the complete glandular dissection preserving the skin envelope and the nipple areola complex. In the treatment of BC, the cosmetic outcomes have become fundamental goals, as well as oncologic control. NSM is nowadays considered an alternative technique to improve the overall quality of life for women allowing excellent cosmetic results because it provides a natural appearing breast. The breast surgeon must pay attention to details and skin incision must be planned to minimize vascular impairment to the skin and the nipple. Preservation of the blood supply to the nipple is one of the most important concern during NSM because nipple or areolar necrosis is a well-described complication of this surgery. Another issue associated with the nipple preservation and the surgical technique is oncological safety related to nipple-areola-complex (NAC) involvement in patients with invasive BC. The authors present their experience on 252 NSM performed in the Breast Surgery Unit in Forlì. Careful selection of patients for this surgical procedure is imperative and many patients are not ideal candidates for this procedure because of concerns about nipple-areolar viability as women with significant large/ptotic breast, pre-existing breast scars and history of active cigarette smoking. To extend the benefits of nipple preservation to patients who are perceived to be at higher risk for nipple necrosis the authors describe technical modifications of NSM to allow nipple preservation and obtain good cosmetic outcomes. PMID:26645007

  20. Nipple areola complex sparing mastectomy.

    PubMed

    Rossi, Camilla; Mingozzi, Matteo; Curcio, Annalisa; Buggi, Federico; Folli, Secondo

    2015-12-01

    Breast conservative therapy (BCT) is established as a safe option for most women with early breast cancer (BC). The best conservative mastectomy that can be performed, when mastectomy is unavoidable, is nipple-areola-complex sparing mastectomy (NSM), which allows the complete glandular dissection preserving the skin envelope and the nipple areola complex. In the treatment of BC, the cosmetic outcomes have become fundamental goals, as well as oncologic control. NSM is nowadays considered an alternative technique to improve the overall quality of life for women allowing excellent cosmetic results because it provides a natural appearing breast. The breast surgeon must pay attention to details and skin incision must be planned to minimize vascular impairment to the skin and the nipple. Preservation of the blood supply to the nipple is one of the most important concern during NSM because nipple or areolar necrosis is a well-described complication of this surgery. Another issue associated with the nipple preservation and the surgical technique is oncological safety related to nipple-areola-complex (NAC) involvement in patients with invasive BC. The authors present their experience on 252 NSM performed in the Breast Surgery Unit in Forlì. Careful selection of patients for this surgical procedure is imperative and many patients are not ideal candidates for this procedure because of concerns about nipple-areolar viability as women with significant large/ptotic breast, pre-existing breast scars and history of active cigarette smoking. To extend the benefits of nipple preservation to patients who are perceived to be at higher risk for nipple necrosis the authors describe technical modifications of NSM to allow nipple preservation and obtain good cosmetic outcomes. PMID:26645007

  1. Cell complexes through time

    NASA Astrophysics Data System (ADS)

    Klette, Reinhard

    2000-10-01

    The history of cell complexes is closely related to the birth and development of topology in general. Johann Benedict Listing (1802 - 1882) introduced the term 'topology' into mathematics in a paper published in 1847, and he also defined cell complexes for the first time in a paper published in 1862. Carl Friedrich Gauss (1777 - 1855) is often cited as the one who initiated these ideas, but he did not publish either on topology or on cell complexes. The pioneering work of Leonhard Euler (1707 - 1783) on graphs is also often cited as the birth of topology, and Euler's work was cited by Listing in 1862 as a stimulus for his research on cell complexes. There are different branches in topology which have little in common: point set topology, algebraic topology, differential topology etc. Confusion may arise if just 'topology' is specified, without clarifying the used concept. Topological subjects in mathematics are often related to continuous models, and therefore quite irrelevant to computer based solutions in image analysis. Compared to this, only a minority of topology publications in mathematics addresses discrete spaces which are appropriate for computer-based image analysis. In these cases, often the notion of a cell complex plays a crucial role. This paper briefly reports on a few of these publications. This paper is not intended to cover the very lively progress in cell complex studies within the context of image analysis during the last two decades. Basically it stops its historic review at the time when this subject in image analysis research gained speed in 1980 - 1990. As a general point of view, the paper indicates that image analysis contributes to a fusion of topological concepts, the geometric and the abstract cell structure approach and point set topology, which may lead towards new problems for the study of topologies defined on geometric or abstract cell complexes.

  2. Quantum Complexity in Graphene

    NASA Astrophysics Data System (ADS)

    Baskaran, G.

    Carbon has a unique position among elements in the periodic table. It produces an allotrope, graphene, a mechanically robust two dimensional semimetal. The multifarious properties that graphene exhibits has few parallels among elemental metals. From simplicity, namely carbon atoms connected by pure sp2 bonds, a wealth of novel quantum properties emerge. In classical complex systems such as a spin glass or a finance market, several competing agents or elements are responsible for unanticipated and difficult to predict emergent properties. The complex (sic) structure of quantum mechanics is responsbile for an unanticipated set of emergent properties in graphene. We call this quantum complexity. In fact, most quantum systems, phenomena and modern quantum field theory could be viewed as examples of quantum complexity. After giving a brief introduction to the quantum complexity we focus on our own work, which indicates the breadth in the type of quantum phenomena that graphene could support. We review our theoretical suggestions of, (i) spin-1 collective mode in netural graphene, (ii) relativistic type of phenomena in crossed electric and magnetic fields, (iii) room temperature superconductivity in doped graphene and (iv) composite Fermi sea in neutral graphene in uniform magnetic field and (v) two-channel Kondo effect. Except for the relativistic type of phenomena, the rest depend in a fundamental way on a weak electron correlation that exists in the broad two-dimensional band of graphene.

  3. Exponential random simplicial complexes

    NASA Astrophysics Data System (ADS)

    Zuev, Konstantin; Eisenberg, Or; Krioukov, Dmitri

    2015-11-01

    Exponential random graph models have attracted significant research attention over the past decades. These models are maximum-entropy ensembles subject to the constraints that the expected values of a set of graph observables are equal to given values. Here we extend these maximum-entropy ensembles to random simplicial complexes, which are more adequate and versatile constructions to model complex systems in many applications. We show that many random simplicial complex models considered in the literature can be casted as maximum-entropy ensembles under certain constraints. We introduce and analyze the most general random simplicial complex ensemble {\\boldsymbol{? }} with statistically independent simplices. Our analysis is simplified by the observation that any distribution {{P}}(O) on any collection of objects {O}=\\{O\\}, including graphs and simplicial complexes, is maximum-entropy subject to the constraint that the expected value of -{ln}{{P}}(O) is equal to the entropy of the distribution. With the help of this observation, we prove that ensemble {\\boldsymbol{? }} is maximum-entropy subject to the two types of constraints which fix the expected numbers of simplices and their boundaries.

  4. Complexes and imagination.

    PubMed

    Kast, Verena

    2014-11-01

    Fantasies as imaginative activities are seen by Jung as expressions of psychic energy. In the various descriptions of active imagination the observation of the inner image and the dialogue with inner figures, if possible, are important. The model of symbol formation, as Jung describes it, can be experienced in doing active imagination. There is a correspondence between Jung's understanding of complexes and our imaginations: complexes develop a fantasy life. Complex episodes are narratives of difficult dysfunctional relationship episodes that have occurred repeatedly and are internalized with episodic memory. This means that the whole complex episode (the image for the child and the image for the aggressor, connected with emotions) is internalized and can get constellated in everyday relationship. Therefore inner dialogues do not necessarily qualify as active imaginations, often they are the expression of complex-episodes, very similar to fruitless soliloquies. If imaginations of this kind are repeated, new symbols and new possibilities of behaviour are not found. On the contrary, old patterns of behaviour and fantasies are perpetuated and become cemented. Imaginations of this kind need an intervention by the analyst. In clinical examples different kinds of imaginations are discussed. PMID:25331506

  5. Hydridomethyl iridium complex

    DOEpatents

    Bergman, Robert G.; Buchanan, J. Michael; Stryker, Jeffrey M.; Wax, Michael J.

    1989-01-01

    A process for functionalizing methane comprising: (a) reacting methane with a hydridoalkyl metal complex of the formula: CpIr[P(R.sub.1).sub.3 ]H(R.sub.2) wherein Cp represents a cyclopentadienyl or alkylcyclopentadienyl radical having from 1 to 5 carbon atoms; Ir represents an iridium atom; P represents a phosphorus atom; R.sub.1 represents an alkyl group; R.sub.2 represents an alkyl group having at least two carbon atoms; and H represents a hydrogen atom, in the presence of a liquid alkane R.sub.3 H having at least three carbon atoms to form a hydridomethyl complex of the formula: CpIr[P(R.sub.1).sub.3 ]HMe where Me represents a methyl radical. (b) reacting said hydridomethyl complex with an organic halogenating agent such as a tetrahalomethane or a haloform of the formulas: CX'X"X'"X"" or CHX'X"X'"; wherein X', X", X"', and X"" represent halogens selected from bromine, iodine and chlorine, to halomethyl complex of step (a) having the formula: CpIr[P(R.sub.1).sub.3 ]MeX: (c) reacting said halomethyl complex with a mercuric halide of the formula HgX.sub.2 to form a methyl mercuric halide of the formula HgMeX; and (d) reacting said methyl mercuric halide with a molecular halogen of the formula X.sub.2 to form methyl halide.

  6. Tuberous Sclerosis Complex: Perioperative Considerations

    PubMed Central

    Rabito, Matthew J.; Kaye, Alan David

    2014-01-01

    Background Tuberous sclerosis complex (TSC), also known as Bourneville disease, is an inherited, progressive neurocutaneous disorder characterized by the potential for hamartoma formation throughout the body. TSC is an autosomal dominant genetic disorder, but more than two-thirds of cases are sporadic. Methods Clinical manifestations and treatment options are discussed. Both surgical and anesthetic perioperative considerations are described in this review. Results Routine monitoring is appropriate for minor surgical procedures for patients with TSC who have mild disease manifestations. More extensive monitoring is indicated for major procedures that have the potential for significant blood loss and for patients with more severe pathology. Postoperatively, TSC patients should be admitted for monitoring and treatment after more extensive procedures or if significant organ dysfunction occurs. Postoperative complications, which may be related to either the surgery or the TSC pathology itself, may have origins in many different organs and may include seizures, severe hypertension, and bradyarrhythmias. Conclusion TSC is a rare disease with a highly variable clinical presentation and provides a multitude of challenges for the patient, the family, and the healthcare team. PMID:24940133

  7. The complex regional pain syndrome.

    PubMed

    Oaklander, Anne Louise; Horowitz, Steven H

    2015-01-01

    Complex regional pain syndrome (CRPS) is the current consensus-derived name for a syndrome usually triggered by limb trauma. Required elements include prolonged, disproportionate distal-limb pain and microvascular dysregulation (e.g., edema or color changes) or altered sweating. CRPS-II (formerly "causalgia") describes patients with identified nerve injuries. CRPS-I (formerly "reflex sympathetic dystrophy") describes most patients who lack evidence of specific nerve injuries. Diagnosis is clinical and the pathophysiology involves combinations of small-fiber axonopathy, microvasculopathy, inflammation, and brain plasticity/sensitization. Females have much higher risk and workplace accidents are a well-recognized cause. Inflammation and dysimmunity, perhaps facilitated by injury to the blood-nerve barrier, may contribute. Most patients, particularly the young, recover gradually, but treatment can speed healing. Evidence of efficacy is strongest for rehabilitation therapies (e.g., graded-motor imagery), neuropathic pain medications, and electric stimulation of the spinal cord, injured nerve, or motor cortex. Investigational treatments include ketamine, botulinum toxin, immunoglobulins, and transcranial neuromodulation. Nonrecovering patients should be re-evaluated for neurosurgically treatable causal lesions (nerve entrapment, impingement, infections, or tumors) and treatable potentiating medical conditions, including polyneuropathy and circulatory insufficiency. Earlier impressions that CRPS represents malingering or psychosomatic illness have been replaced by evidence that CRPS is a rare complication of limb injury in biologically susceptible individuals. PMID:26563805

  8. Sewage Treatment

    NASA Technical Reports Server (NTRS)

    1984-01-01

    In the early 1970's, National Space Technology Laboratories discovered that water hyacinths literally thrive on sewage; they absorb and digest nutrients and minerals from wastewater, converting sewage effluents to clean water. They offer a means of purifying water at a fraction of the cost of a conventional sewage treatment plant, and provide a bonus value in byproducts. Hyacinths must be harvested at intervals; the harvested plants are used as fertilizers, high-protein animal feed and a source of energy. Already serving a number of small towns, the "aquaculture" technique has significantly advanced with its adoption by a major U.S. city.

  9. Polymeric complexes of isonicotinic acid hydrazide with antituberculosis effects.

    PubMed

    Slivkin, A I; Lapenko, V L; Bychuk, A I; Suslina, S N; Slivkin, D A; Kornienko, S V; Belenova, A S

    2013-10-01

    We studied the effects of an analogue of isonicotinic acid hydrazide on the treatment course of experimental tuberculosis. Complex analysis has demonstrated the efficiency of isonicotinic acid hydrazide immobilized on a carrier that consisted of water-soluble cation-active analogue of chitosan (N-chlorohydroxypropyl chitosan) in a complex with cobalt ions in the therapy of experimental tuberculosis. Immunostimulating activity of the polymeric metal complex was revealed. The obtained data can be used for the development of highly effective methods for tuberculosis treatment. PMID:24288761

  10. Emergy and ecosystem complexity

    NASA Astrophysics Data System (ADS)

    Ulgiati, Sergio; Brown, Mark T.

    2009-01-01

    The question "What drives complexity?" is addressed in this paper. To answer this question, we explore the way energy and material resources of different quality flow through ecosystems and support, directly and indirectly, ecosystems growth and development. Processes of resource transformation throughout the ecosystem build order, cycle materials, generate and sustain information. Energy drives all these processes and energetic principles explain much of what is observed, including energy degradation according to the laws of thermodynamics. Emergy, a quantitative measure of the global environmental work supporting ecosystem dynamics, is used here in order to provide a deeper understanding of complexity growth and decline in ecosystems. Ecosystem complexity is discussed in this paper in relation to changes in structure, organization and functional capacity, as explained by changes in emergy, empower, and transformity.

  11. Viral quasispecies complexity measures.

    PubMed

    Gregori, Josep; Perales, Celia; Rodriguez-Frias, Francisco; Esteban, Juan I; Quer, Josep; Domingo, Esteban

    2016-06-01

    Mutant spectrum dynamics (changes in the related mutants that compose viral populations) has a decisive impact on virus behavior. The several platforms of next generation sequencing (NGS) to study viral quasispecies offer a magnifying glass to study viral quasispecies complexity. Several parameters are available to quantify the complexity of mutant spectra, but they have limitations. Here we critically evaluate the information provided by several population diversity indices, and we propose the introduction of some new ones used in ecology. In particular we make a distinction between incidence, abundance and function measures of viral quasispecies composition. We suggest a multidimensional approach (complementary information contributed by adequately chosen indices), propose some guidelines, and illustrate the use of indices with a simple example. We apply the indices to three clinical samples of hepatitis C virus that display different population heterogeneity. Areas of virus biology in which population complexity plays a role are discussed. PMID:27060566

  12. Alanine water complexes.

    PubMed

    Vaquero, Vanesa; Sanz, M Eugenia; Peña, Isabel; Mata, Santiago; Cabezas, Carlos; López, Juan C; Alonso, José L

    2014-04-10

    Two complexes of alanine with water, alanine-(H2O)n (n = 1,2), have been generated by laser ablation of the amino acid in a supersonic jet containing water vapor and characterized using Fourier transform microwave spectroscopy. In the observed complexes, water molecules bind to the carboxylic group of alanine acting as both proton donors and acceptors. In alanine-H2O, the water molecule establishes two intermolecular hydrogen bonds forming a six-membered cycle, while in alanine-(H2O)2 the two water molecules establish three hydrogen bonds forming an eight-membered ring. In both complexes, the amino acid moiety is in its neutral form and shows the conformation observed to be the most stable for the bare molecule. The microsolvation study of alanine-(H2O)n (n = 1,2) can be taken as a first step toward understanding bulk properties at a microscopic level. PMID:24617287

  13. Synchronization in complex networks

    SciTech Connect

    Arenas, A.; Diaz-Guilera, A.; Moreno, Y.; Zhou, C.; Kurths, J.

    2007-12-12

    Synchronization processes in populations of locally interacting elements are in the focus of intense research in physical, biological, chemical, technological and social systems. The many efforts devoted to understand synchronization phenomena in natural systems take now advantage of the recent theory of complex networks. In this review, we report the advances in the comprehension of synchronization phenomena when oscillating elements are constrained to interact in a complex network topology. We also overview the new emergent features coming out from the interplay between the structure and the function of the underlying pattern of connections. Extensive numerical work as well as analytical approaches to the problem are presented. Finally, we review several applications of synchronization in complex networks to different disciplines: biological systems and neuroscience, engineering and computer science, and economy and social sciences.

  14. Aminophosphonate metal complexes of biomedical potential.

    PubMed

    Tušek-Božić, L J

    2013-01-01

    Metals and their complexes with organic ligands have an important role in biochemical systems such as enzymatic catalysis, metal ion transfer across the cell membranes, treatment of malignancy, rheumatoid arthritis, ulcer and other types of diseases. Special attention is directed to metal complexes with ligands which are important in biological systems, as their incorporation into metallo-organic compounds offers much scope for design of potential metal-based agents that provide new opportunities in the medicinal chemistry. In view of this, derivatives of aminophosphonic acids, owing to their broad spectrum of biological activities and wide range of applications in the medicinal and agrochemical fields, are very attractive metal-ligand agents that might form biomedical important metal complexes. Thus, a number of aminophosphonate complexes of platinum group metals have been found to possess remarkable antitumor activity while complexes of some other transition and rare-earth metals like technetium, rhenium, samarium and gadolinium have been used either as therapeutic and diagnostic radiopharmaceuticals or as magnetic resonance imaging (MRI) contrast agents. In addition, the high phosphonate affinity towards bone and other calcified tissues may be utilized for the drug targeting based on synthesis of metal complexes linked to bioactive carrier systems, affording better modalities of attack to the site of pathology. In this review article, aminophosphonate metal-based compounds with potential biomedical applications are described. PMID:23432587

  15. Antibiotic treatment for nontuberculous mycobacterial lung disease.

    PubMed

    Kang, Young Ae; Koh, Won-Jung

    2016-05-01

    Pulmonary infections are the most frequent diseases caused by nontuberculous mycobacteria (NTM). Common causative organisms of pulmonary infection are slowly growing mycobacteria including Mycobacterium avium complex and Mycobacterium kansasii, and rapidly growing mycobacteria including Mycobacterium abscessus complex. Clinical concern has been raised over the increasing incidence of NTM lung disease combined with the poor treatment outcomes of these chronic infectious diseases. Since treatment guidelines of the American Thoracic Society/Infectious Disease Society of America were published in 2007 there have been continuous efforts to improve the outcomes of NTM lung disease, albeit slowly and with limitations. Here, we focus on recent advances in the antibiotic treatment of NTM lung disease. PMID:26967761

  16. The ESCRT Complexes

    PubMed Central

    Hurley, James H.

    2010-01-01

    The ESCRT machinery consists of the peripheral membrane protein complexes, ESCRT-0, -I, -II, -III, and Vps4-Vta1, and the ALIX homodimer. The ESCRT system is required for degradation of unneeded or dangerous plasma membrane proteins; biogenesis of the lysosome and the yeast vacuole; the budding of most membrane enveloped viruses; the membrane abscission step in cytokinesis; macroautophagy; and several other processes. From their initial discovery in 2001-2002, the literature on ESCRTs has grown exponentially. This review will describe the structure and function of the six complexes noted above and summarizes current knowledge of their mechanistic roles in cellular pathways and in disease. PMID:20653365

  17. Complex Gaussian Multiplicative Chaos

    NASA Astrophysics Data System (ADS)

    Lacoin, Hubert; Rhodes, Rémi; Vargas, Vincent

    2015-07-01

    In this article, we study complex Gaussian multiplicative chaos. More precisely, we study the renormalization theory and the limit of the exponential of a complex log-correlated Gaussian field in all dimensions (including Gaussian Free Fields in dimension 2). Our main working assumption is that the real part and the imaginary part are independent. We also discuss applications in 2 D string theory; in particular we give a rigorous mathematical definition of the so-called Tachyon fields, the conformally invariant operators in critical Liouville Quantum Gravity with a c = 1 central charge, and derive the original KPZ formula for these fields.

  18. Complexity and Fly Swarms

    NASA Astrophysics Data System (ADS)

    Cates, Grant; Murray, Joelle

    Complexity is the study of phenomena that emerge from a collection of interacting objects and arises in many systems throughout physics, biology, finance, economics and more. Certain kinds of complex systems can be described by self-organized criticality (SOC). An SOC system is one that is internally driven towards some critical state. Recent experimental work suggests scaling behavior of fly swarms-one of the hallmarks of an SOC system. Our goal is to look for SOC behavior in computational models of fly swarms.

  19. Complex matrix model duality

    SciTech Connect

    Brown, T. W.

    2011-04-15

    The same complex matrix model calculates both tachyon scattering for the c=1 noncritical string at the self-dual radius and certain correlation functions of operators which preserve half the supersymmetry in N=4 super-Yang-Mills theory. It is dual to another complex matrix model where the couplings of the first model are encoded in the Kontsevich-like variables of the second. The duality between the theories is mirrored by the duality of their Feynman diagrams. Analogously to the Hermitian Kontsevich-Penner model, the correlation functions of the second model can be written as sums over discrete points in subspaces of the moduli space of punctured Riemann surfaces.

  20. Luminescent macrocyclic lanthanide complexes

    DOEpatents

    Raymond, Kenneth N; Corneillie, Todd M; Xu, Jide

    2014-05-20

    The present invention provides a novel class of macrocyclic compounds as well as complexes formed between a metal (e.g., lanthanide) ion and the compounds of the invention. Preferred complexes exhibit high stability as well as high quantum yields of lanthanide ion luminescence in aqueous media without the need for secondary activating agents. Preferred compounds incorporate hydroxy-isophthalamide moieties within their macrocyclic structure and are characterized by surprisingly low, non-specific binding to a variety of polypeptides such as antibodies and proteins as well as high kinetic stability. These characteristics distinguish them from known, open-structured ligands.

  1. Luminescent macrocyclic lanthanide complexes

    DOEpatents

    Raymond, Kenneth N.; Corneillie, Todd M.; Xu, Jide

    2012-05-08

    The present invention provides a novel class of macrocyclic compounds as well as complexes formed between a metal (e.g., lanthanide) ion and the compounds of the invention. Preferred complexes exhibit high stability as well as high quantum yields of lanthanide ion luminescence in aqueous media without the need for secondary activating agents. Preferred compounds incorporate hydroxy-isophthalamide moieties within their macrocyclic structure and are characterized by surprisingly low, non-specific binding to a variety of polypeptides such as antibodies and proteins as well as high kinetic stability. These characteristics distinguish them from known, open-structured ligands.

  2. Planning Complex Projects Automatically

    NASA Technical Reports Server (NTRS)

    Henke, Andrea L.; Stottler, Richard H.; Maher, Timothy P.

    1995-01-01

    Automated Manifest Planner (AMP) computer program applies combination of artificial-intelligence techniques to assist both expert and novice planners, reducing planning time by orders of magnitude. Gives planners flexibility to modify plans and constraints easily, without need for programming expertise. Developed specifically for planning space shuttle missions 5 to 10 years ahead, with modifications, applicable in general to planning other complex projects requiring scheduling of activities depending on other activities and/or timely allocation of resources. Adaptable to variety of complex scheduling problems in manufacturing, transportation, business, architecture, and construction.

  3. Nonsurgical treatment of recurrent glioblastoma

    PubMed Central

    Gallego, O.

    2015-01-01

    Standard treatment for glioblastoma multiforme is surgery followed by radiotherapy and chemotherapy, generally with temozolomide. However, disease recurs in almost all patients. Diagnosis of progression is complex given the possibility of pseudoprogression. The Response Assessment in Neuro-Oncology criteria increase the sensitivity for detecting progression. Most patients will not be candidates for new surgery or re-irradiation, and anticancer drugs are the most common approach for second-line treatment, if the patient’s condition allows. Antiangiogenics, inhibitors of the epidermal growth factor receptor, nitrosoureas, and re-treatment with temozolomide have been studied in the second line, but a standard therapy has not yet been established. This review considers currently available medical treatment options for patients with glioblastoma recurrence. PMID:26300678

  4. [Extensive conservative treatment of obesity].

    PubMed

    Buri, Caroline; Laederach, Kurt

    2013-02-01

    The treatment of obesity is complex due to the multifactorial etiology. A modern therapy concept must therefore be tailored to the individual needs and problems and depends on various factors such as degree of obesity, the presence of physical complications, psychological co-morbidities, any treatment measures the patient underwent up to now as well as on motivational factors. Before deciding on a therapeutic measure a structured multidisciplinary cooperation is essential including psychosomatic medicine/psychiatry/psychotherapy, endocrinology, sports medicine, nutritional medicine and surgery as well. The treatment must be carried out in a multidisciplinary team and includes an adequate therapy of comorbidities and sometimes a psychopharmacological support. The success of a conservative treatment of obesity is remarkable and long-lasting and can be straightforwardly compared to bariatric surgery in financial as well as ethical terms, although for patients and their physicians the latter often carries the allure of quick success. PMID:23385187

  5. Multiple sclerosis - New treatment modalities

    PubMed Central

    Totaro, Rocco; Di Carmine, Caterina; Marini, Carmine; Carolei, Antonio

    2015-01-01

    Ever since the introduction of the first disease modifying therapies, the concept of multiple sclerosis treatment algorithms developed ceaselessly. The increasing number of available drugs is paralleled by impelling issue of ensuring the most appropriate treatment to the right patient at the right time. The purpose of this review is to describe novel agents recently approved for multiple sclerosis treatment, namely teriflunomide, alemtuzumab and dimethylfumarate, focusing on mechanism of action, efficacy data in experimental setting, safety and tolerability. The place in therapy of newer treatment implies careful balancing of risk-benefit profile as well as accurate patient selection. Hence the widening of therapeutic arsenal provides greater opportunity for personalized therapy but also entails a complex trade-off between efficacy, tolerability, safety and eventually patient preference. PMID:26831413

  6. Multiple sclerosis - New treatment modalities.

    PubMed

    Totaro, Rocco; Di Carmine, Caterina; Marini, Carmine; Carolei, Antonio

    2015-12-01

    Ever since the introduction of the first disease modifying therapies, the concept of multiple sclerosis treatment algorithms developed ceaselessly. The increasing number of available drugs is paralleled by impelling issue of ensuring the most appropriate treatment to the right patient at the right time. The purpose of this review is to describe novel agents recently approved for multiple sclerosis treatment, namely teriflunomide, alemtuzumab and dimethylfumarate, focusing on mechanism of action, efficacy data in experimental setting, safety and tolerability. The place in therapy of newer treatment implies careful balancing of risk-benefit profile as well as accurate patient selection. Hence the widening of therapeutic arsenal provides greater opportunity for personalized therapy but also entails a complex trade-off between efficacy, tolerability, safety and eventually patient preference. PMID:26831413

  7. Genetics Home Reference: Carney complex

    MedlinePlus

    ... Understand Genetics Home Health Conditions Carney complex Carney complex Enable Javascript to view the expand/collapse boxes. Print All Open All Close All Description Carney complex is a disorder characterized by an increased risk ...

  8. Six Questions on Complex Systems

    NASA Astrophysics Data System (ADS)

    Symons, John F.; Sanayei, Ali

    2011-09-01

    This paper includes an interview with John F. Symons regarding some important questions in "complex systems" and "complexity". In addition, he has stated some important open problems concerning complex systems in his research area from a philosophical point of view.

  9. Treatment of Cachexia in Oncology

    PubMed Central

    Tazi, EM; Errihani, H

    2010-01-01

    Cachexia is a complex metabolic syndrome associated with many chronic or end-stage diseases, especially cancer, and is characterized by loss of muscle with or without loss of fat mass. The management of cachexia is a complex challenge that should address the different causes underlying this clinical event with an integrated or multimodal treatment approach targeting the different factors involved in its pathophysiology. The purpose of this article was to review the current medical treatment of cancer-related cachexia, in particular focusing on combination therapy and ongoing research. Among the treatments proposed in the literature for cancer-related cachexia, some proved to be ineffective, namely, cyproheptadine, hydrazine, metoclopramide, and pentoxifylline. Among effective treatments, progestagens are currently considered the best available treatment option for cancer-related cachexia, and they are the only drugs approved in Europe. Drugs with a strong rationale that have failed or have not shown univocal results in clinical trials so far include eicosapentaenoic acid, cannabinoids, bortezomib, and anti-TNF-alpha MoAb. Several emerging drugs have shown promising results but are still under clinical investigation (thalidomide, selective cox-2 inhibitors, ghrelin mimetics, insulin, oxandrolone, and olanzapine). To date, despite several years of coordinated efforts in basic and clinical research, practice guidelines for the prevention and treatment of cancer-related muscle wasting are lacking, mainly because of the multifactorial pathogenesis of the syndrome. From all the data presented, one can speculate that one single therapy may not be completely successful in the treatment of cachexia. From this point of view, treatments involving different combinations are more likely to be successful. PMID:21218002

  10. Functional role of Chaperonin protein complexes

    NASA Astrophysics Data System (ADS)

    Briganti, Giuseppe; Giordano, Rita; Londei, Paola; Valle, Francesco

    2000-03-01

    The chaperonins are high-molecular weight protein complexes present in all living cells; they are thought to participate in the folding or refolding of cellular proteins and may also have a function in RNA metabolism. Recently, it has been reported that the chaperonin of thermophilic archeon Sulfolobus solfataricus interacts with the 16S ribosomal RNA and participates in the early stages of its maturation. By means of contrast variation SANS we demonstrate that the native S. solfataricus chaperonin is complexed with a nucleic acid molecule of about 1600 nucleotides, which becomes detached from the protein mojety in the presence of ATP. Treatment with ATP also provokes a conformational change in the protein complex, compacting its structure and closing its central hole. The result lends support to the hypothesis that Sulfolobus chaperonin participates in ribosomal RNA maturation and ribosome assembly.

  11. [Prophylaxis and treatment of periimpalntitis].

    PubMed

    Mandzhavidze, N; Vadachkoriia, N; Gumberidze, N

    2013-09-01

    Ultrasonic Vector System (Dürr Dental, Germany) is the best means for complex treatment of peri-implantitis. The therapeutic effect of the system proved anti-inflammatory and regenerative impact of calcium hydroxyapatite on the soft tissue around the implant. The effectiveness of the result provided full, persistent and safe removal of bacteria, dental plaque, infected granulation tissue; the possibility of regular monitoring, prevention of re-infection of pathological pockets, without damaging the hard and soft tissues around the implant, the implant itself and artificial fragile crown, securing superb cleaning and polishing of the implant surface, which is an important condition for the further reduction and inactivation of pathogenic bacteria population. Healing peri-implantitis pockets at the expense of using conventional oral hygiene is not possible. Tools of carbon fiber in combination with a suspension Vector Fluid Polish and the Vector machine successfully accomplish the function of disinfection and polishing. The aim of the research was to present the results of peri-implantitis treatment with a new ultrasonic device Ultrasonic Vector System. Surgical treatment (21% of patients) was atraumatic. The risk of infection was decreased and necessary conditions were created for a significant acceleration of the tissue healing process. Relying on the successful results we recommend Vector- therapy before surgical procedures. Complex treatment was repeated depending on the clinical manifestations of inflammation around the implant. To prevent peri-implantitis, and get timely diagnosis of unwanted changes, and to maintain implants and the soft tissues around them in a healthy condition, the patients were strongly recommended to visit the dentist 3-4 times a year. They were offered professional oral hygiene and accessible parts of the implants with the help of a Vector machine. Relying on the results of the research we conducted during the treatment of peri-implantitis, we have seen the "magic" efficiency and the need to apply the «Vector» system into the complex treatment of this disease. PMID:24099810

  12. Late transition metal. mu. -oxo and. mu. -imido complexes

    SciTech Connect

    Sharp, P.R.

    1990-01-01

    The synthesis and reactions of late-transition-metal oxo and imido complexes was explored. The deprotonation of platinum(II) hydroxo complexes yielded new oxo complexes. Attempted deprotonation of Cp*Rh(III) hydroxo complexes did not give oxo complexes but complex mixtures probably resulting from reduction of the Rh(III) center. The reaction of Na/Hg with (Cp*RhCl{sub 2}){sub 2} gave the very reactive Rh(II) dimer, (Cp*RhCl){sub 2}. Rhodium(I) imido complexes with the bis(dimethylphosphino)methane ligand were prepared and found to be similar to the previously prepared bis(diphenylphosphino)methane complexes. Attempts to prepare bis(diphenylphosphino)methylamine, bis(diphenylphosphino)phenylamine, PMe{sub e} and NO{sup +} analogues were not successful. Attempts to prepare Cp*Rh(III) imido complexes resulted in amido complexes and reduction. Rhodium (III) tris(3.5-dimethylpyrazoyl)borate analogues are reduction resistant but have not yet yielded imido complexes. The first imido complexes of Au were prepared by treating a Au oxo complex with amines or isocyanates. Dimeric Cp*Rh dioxygen and nitrosobenzene complexes were prepared by insertion into the Rh-Rh bond of (Cp*RhCl){sub 2}. The dioxygen complex activates a C-H bond of the Cp* ligand on treatment with PMe{sub 3}. Imido and oxo complexes nitrene and oxygen atom transfer product in reactions with CO. A novel electrophilic ring addition was observed with sterically protected aryl imido complexes. 15 refs.

  13. Complex Event Recognition Architecture

    NASA Technical Reports Server (NTRS)

    Fitzgerald, William A.; Firby, R. James

    2009-01-01

    Complex Event Recognition Architecture (CERA) is the name of a computational architecture, and software that implements the architecture, for recognizing complex event patterns that may be spread across multiple streams of input data. One of the main components of CERA is an intuitive event pattern language that simplifies what would otherwise be the complex, difficult tasks of creating logical descriptions of combinations of temporal events and defining rules for combining information from different sources over time. In this language, recognition patterns are defined in simple, declarative statements that combine point events from given input streams with those from other streams, using conjunction, disjunction, and negation. Patterns can be built on one another recursively to describe very rich, temporally extended combinations of events. Thereafter, a run-time matching algorithm in CERA efficiently matches these patterns against input data and signals when patterns are recognized. CERA can be used to monitor complex systems and to signal operators or initiate corrective actions when anomalous conditions are recognized. CERA can be run as a stand-alone monitoring system, or it can be integrated into a larger system to automatically trigger responses to changing environments or problematic situations.

  14. Complex Digital Visual Systems

    ERIC Educational Resources Information Center

    Sweeny, Robert W.

    2013-01-01

    This article identifies possibilities for data visualization as art educational research practice. The author presents an analysis of the relationship between works of art and digital visual culture, employing aspects of network analysis drawn from the work of Barabási, Newman, and Watts (2006) and Castells (1994). Describing complex network…

  15. Launching Complex Tasks

    ERIC Educational Resources Information Center

    Jackson, Kara J.; Shahan, Emily C.; Gibbons, Lynsey K.; Cobb, Paul A.

    2012-01-01

    Mathematics lessons can take a variety of formats. In this article, the authors discuss lessons organized around complex mathematical tasks. These lessons usually unfold in three phases. First, the task is introduced to students. Second, students work on solving the task. Third, the teacher "orchestrates" a concluding whole-class discussion in…

  16. Managing Complex Dynamical Systems

    ERIC Educational Resources Information Center

    Cox, John C.; Webster, Robert L.; Curry, Jeanie A.; Hammond, Kevin L.

    2011-01-01

    Management commonly engages in a variety of research designed to provide insight into the motivation and relationships of individuals, departments, organizations, etc. This paper demonstrates how the application of concepts associated with the analysis of complex systems applied to such data sets can yield enhanced insights for managerial action.

  17. Surface complexation modeling

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Adsorption-desorption reactions are important processes that affect the transport of contaminants in the environment. Surface complexation models are chemical models that can account for the effects of variable chemical conditions, such as pH, on adsorption reactions. These models define specific ...

  18. Complexity in Cultural Identity

    ERIC Educational Resources Information Center

    Holliday, Adrian

    2010-01-01

    Despite their diverse national backgrounds, 28 interviewees speak similarly about the complexity of the cultural realities with which they live, and refuse to be pinned down to specific cultural types. While nation is of great importance, unless personally inspiring, it tends to be an external force which is in conflict with a wide variety of…

  19. Complex Characters Made Simple

    ERIC Educational Resources Information Center

    Kettle, Sidney F. A.

    2009-01-01

    The physical significance of complex characters is explored with particular reference to the C[subscript 4] point group. While a diagrammatic representation of these characters in this group is possible, the extension to higher groups C[subscript n], n greater than 4 is left as a problem for discussion. (Contains 3 tables, 8 figures, and 1 note.)

  20. Lanthanide porphyrin complexes

    NASA Astrophysics Data System (ADS)

    Mironov, A. F.

    2013-01-01

    The review summarizes literature data and results of the author's research on the synthesis, properties and possible fields of practical application of lanthanide porphyrin complexes. Emphasis is given to the application of luminescence properties of lanthanide derivatives in medicine. The bibliography includes 108 references

  1. The Complexity of Care

    ERIC Educational Resources Information Center

    Collins, Steve; Ting, Hermia

    2014-01-01

    The profession of teaching is unique because of the extent to which a teacher becomes involved in the lives of their "clients". The level of care required to support students well can be intense, confusing, and overwhelming. Relationships co-evolve within an ever-changing process and care is considered an essential aspect of complex relationships…

  2. E Complex groundbreaking

    NASA Technical Reports Server (NTRS)

    2009-01-01

    Representatives from NASA, Orbital Sciences Corp. and Aerojet participate in a ribbon-cutting ceremony for construction of a flame deflector trench at Stennis Space Center's E Test Complex. Participants included Orbital CEO J.R. Thompson (center, left) and Stennis Space Center Director Gene Goldman (center, right).

  3. Unifying Complexity and Information

    NASA Astrophysics Data System (ADS)

    Ke, Da-Guan

    2013-04-01

    Complex systems, arising in many contexts in the computer, life, social, and physical sciences, have not shared a generally-accepted complexity measure playing a fundamental role as the Shannon entropy H in statistical mechanics. Superficially-conflicting criteria of complexity measurement, i.e. complexity-randomness (C-R) relations, have given rise to a special measure intrinsically adaptable to more than one criterion. However, deep causes of the conflict and the adaptability are not much clear. Here I trace the root of each representative or adaptable measure to its particular universal data-generating or -regenerating model (UDGM or UDRM). A representative measure for deterministic dynamical systems is found as a counterpart of the H for random process, clearly redefining the boundary of different criteria. And a specific UDRM achieving the intrinsic adaptability enables a general information measure that ultimately solves all major disputes. This work encourages a single framework coving deterministic systems, statistical mechanics and real-world living organisms.

  4. Analyzing Complex Survey Data.

    ERIC Educational Resources Information Center

    Rodgers-Farmer, Antoinette Y.; Davis, Diane

    2001-01-01

    Uses data from the 1994 AIDS Knowledge and Attitudes Supplement to the National Health Interview Survey (NHIS) to illustrate that biased point estimates, inappropriate standard errors, and misleading tests of significance can result from using traditional software packages, such as SPSS or SAS, for complex survey analysis. (BF)

  5. Restricting Grammatical Complexity

    ERIC Educational Resources Information Center

    Frank, Robert

    2004-01-01

    Theories of natural language syntax often characterize grammatical knowledge as a form of abstract computation. This paper argues that such a characterization is correct, and that fundamental properties of grammar can and should be understood in terms of restrictions on the complexity of possible grammatical computation, when defined in terms of…

  6. Coordination Complexes of Cobalt.

    ERIC Educational Resources Information Center

    Williams, Gregory M.; And Others

    1989-01-01

    Described is an experiment involving the synthesis and spectral studies of cobalt complexes that not only give general chemistry students an introduction to inorganic synthesis but allows them to conduct a systematic study on the effect of different ligands on absorption spectra. Background information, procedures, and experimental results are…

  7. METAL COMPLEXING SILOXANE POLYMERS

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Novel silicone polymers containing pendant phosphonate groups have been synthesized. A new silicone monomer, (CH3O)2CH3Si(CH2)3P=O(OCH2CH3)2 has been copolymerized with dimethyldimethoxysilane to form polymers capable of binding metal salts. The viscous liquids can complex a variety of metals, inc...

  8. Complex lymphatic anomalies.

    PubMed

    Trenor, Cameron C; Chaudry, Gulraiz

    2014-08-01

    Complex lymphatic anomalies include several diagnoses with overlapping patterns of clinical symptoms, anatomic location, imaging features, hematologic alterations, and complications. Lymphatic malformations likely arise through anomalous embryogenesis of the lymphatic system. Analysis of clinical, imaging, histologic, and hematologic features is often needed to reach a diagnosis. Aspiration of fluid collections can readily define fluid as chylous or not. The presence of chyle indicates dysfunction at the mesenteric or retroperitoneal level or above the cisterna chyli due to reflux. The imaging patterns of generalized lymphatic anomaly (GLA) and Gorham-Stout disease have been segregated with distinctive bone lesions and peri-osseous features. More aggressive histology (spindled lymphatic endothelial cells), clinical progression, hemorrhage, or moderate hematologic changes should raise suspicion for kaposiform lymphangiomatosis. Biopsy may be needed for diagnosis, though avoidance of rib biopsy is advised to prevent iatrogenic chronic pleural effusion. Lymphangiography can visualize the anatomy and function of the lymphatic system and may identify dysfunction of the thoracic duct in central conducting lymphatic anomalies. Local control and symptom relief are targeted by resection, laser therapy, and sclerotherapy. Emerging data suggest a role for medical therapies for complications of complex lymphatic anomalies. Outcomes include recurrent effusion, infection, pain, fracture, mortality, and rarely, malignancy. Complex lymphatic anomalies present significant diagnostic and therapeutic challenges. Results from a phase 2 study of sirolimus in these and other conditions are expected in 2014. Improved characterization of natural history, predictors of poor outcomes, responses to therapy, and further clinical trials are needed for complex lymphatic anomalies. PMID:25241096

  9. Stabilized therapeutic radiopharmaceutical complexes

    SciTech Connect

    Wolfangel, R.G.

    1993-06-15

    A method of preparing a stable radioactive therapeutic radiopharmaceutical composition is described which comprises providing a therapeutic amount of an alpha- or beta-emitting radionuclide forming a complex between said therapeutic amount of said radionuclide and a ligand in an aqueous medium, and then lyophilizing the medium so as to form a stable radioactive therapeutic radiopharmaceutical composition.

  10. Marijuana. Health and treatment issues.

    PubMed

    Jones, R T

    1984-12-01

    Intermittent use of low-potency cannabis is not generally associated with obvious toxicity. In recent years, some cannabis users have been using high doses more frequently and seeking treatment. A large but incomplete literature indicates that cannabis can be harmful to health, and that virtually every system in the body is affected by cannabis. Cannabis pharmacology is complex; all recent scientific groups reviewing cannabis conclude it is clearly capable of causing adverse effects to health. Specific treatment procedures have not been developed for managing cannabis related problems. Strategies useful in treating other drug dependence problems are useful in treating dependence. PMID:6097886

  11. Rhabdomyolysis: Pathogenesis, Diagnosis, and Treatment

    PubMed Central

    Torres, Patrick A.; Helmstetter, John A.; Kaye, Adam M.; Kaye, Alan David

    2015-01-01

    Background Rhabdomyolysis is a complex medical condition involving the rapid dissolution of damaged or injured skeletal muscle. Methods This review focuses on the epidemiology, pathophysiology, causes, presentation, diagnosis, complications, management, and anesthetic considerations related to rhabdomyolysis. Results Any form of muscle damage––and by extension any entity that causes muscle damage––can initiate rhabdomyolysis. One of the most important treatment goals when rhabdomyolysis is suspected is avoiding acute kidney injury. Conclusion All clinicians should be aware of common causes, diagnosis, and treatment options. PMID:25829882

  12. [Novel drugs for COPD treatment].

    PubMed

    Gillissen, A

    2014-09-01

    Currently, numerous new compounds and inhaler types are reaching the market for the treatment of chronic obstructive pulmonary disease (COPD). They comprise new long-acting beta-2 agonists, muscarinic antagonists and inhaled corticosteroids. Most of them are for combination treatment in new fixed-dose inhalers. Even the combination of three components in one inhaler is under development. Thus, management of COPD are getting more differentiated but also much more complex. This review gives an overview of the state of art of pharmaceutical research in this area and offers a glimpse into the proximate future. PMID:25003907

  13. Diagnosis and Treatment of Delirium

    PubMed Central

    Henry, W. Desmond; Mann, Alan M.

    1965-01-01

    Delirium is not a clinical entity but a symptom-complex of manifold etiology. Its presence signifies acute cerebral insufficiency and often represents a medical and/or psychiatric emergency. Though some forms of delirium have distinctive features, the fundamental phenomena are common to all, with clouding of consciousness the sine qua non. The condition has two major components: (1) the basic “acute brain syndrome” and (2) associated release phenomena. Clinicians must first make the vital differentiation between delirium and “functional” mental disorder, then proceed with the elucidation of the underlying diagnosis and the concurrent organization of symptomatic and etiologic treatment. Proper treatment combines management of the acute brain syndrome with general and specific procedures for control of the underlying condition. Dealing with the symptom-complex itself involves the principles and practice of sedation, hydration, and nutrition, nursing care and supportive measures. Provided the basic organic condition is treatable, the prognosis today is usually good. PMID:5844423

  14. Osteopathic Manipulative Treatment

    PubMed Central

    Campbell, Shannon M.; Walkowski, Stevan

    2012-01-01

    Dermatological diseases, such as dysesthesia syndromes, stasis dermatoses, and hyperhidrosis are difficult to treat due to their complex etiologies. Current theories suggest these diseases are caused by physiological imbalances, such as nerve impingement, localized tissue congestion, and impaired autonomic regulation. Osteopathic manipulative therapy targets these physiological dysfunctions and may serve as a beneficial therapeutic option. Osteopathic manipulative therapy techniques include high velocity low amplitude, muscle energy, counterstrain, myofascial release, craniosacral, and lymphatic drainage. An osteopathic manipulative therapy technique is chosen based on its physiological target for a particular disease. Osteopathic manipulative therapy may be useful alone or in combination with standard therapeutic options. However, due to the lack of standardized trials supporting the efficacy of osteopathic manipulative therapy treatment for dermatological disease, randomized, well-controlled studies are necessary to confirm its therapeutic value. PMID:23125887

  15. Group 4 Metalloporphyrin diolato Complexes and Catalytic Application of Metalloporphyrins and Related Transition Metal Complexes

    SciTech Connect

    Guodong Du

    2004-12-19

    In this work, the first examples of group 4 metalloporphyrin 1,2-diolato complexes were synthesized through a number of strategies. In general, treatment of imido metalloporphyrin complexes, (TTP)M=NR, (M = Ti, Zr, Hf), with vicinal diols led to the formation of a series of diolato complexes. Alternatively, the chelating pinacolate complexes could be prepared by metathesis of (TTP)MCl{sub 2} (M = Ti, Hf) with disodium pinacolate. These complexes were found to undergo C-C cleavage reactions to produce organic carbonyl compounds. For titanium porphyrins, treatment of a titanium(II) alkyne adduct, (TTP)Ti({eta}{sup 2}-PhC{triple_bond}CPh), with aromatic aldehydes or aryl ketones resulted in reductive coupling of the carbonyl groups to produce the corresponding diolato complexes. Aliphatic aldehydes or ketones were not reactive towards (TTP)Ti({eta}{sup 2}-PhC{triple_bond}CPh). However, these carbonyl compounds could be incorporated into a diolato complex on reaction with a reactive precursor, (TTP)Ti[O(Ph){sub 2}C(Ph){sub 2}O] to provide unsymmetrical diolato complexes via cross coupling reactions. In addition, an enediolato complex (TTP)Ti(OCPhCPhO) was obtained from the reaction of (TTP)Ti({eta}{sup 2}-PhC{triple_bond}CPh) with benzoin. Titanium porphyrin diolato complexes were found to be intermediates in the (TTP)Ti=O-catalyzed cleavage reactions of vicinal diols, in which atmospheric oxygen was the oxidant. Furthermore, (TTP)Ti=O was capable of catalyzing the oxidation of benzyl alcohol and {alpha}-hydroxy ketones to benzaldehyde and {alpha}-diketones, respectively. Other high valent metalloporphyrin complexes also can catalyze the oxidative diol cleavage and the benzyl alcohol oxidation reactions with dioxygen. A comparison of Ti(IV) and Sn(IV) porphyrin chemistry was undertaken. While chelated diolato complexes were invariably obtained for titanium porphyrins on treatment with 1,2-diols, the reaction of vicinal diols with tin porphyrins gave a number of products, including mono-, bis-alkoxo, and chelating diolato complexes, depending on the identity of diols and the stoichiometry employed. It was also found that tin porphyrin complexes promoted the oxidative cleavage of vicinal diols and the oxidation of {alpha}-ketols to {alpha}-diketones with dioxygen. In extending the chemistry of metalloporphyrins and analogous complexes, a series of chiral tetraaza macrocyclic ligands and metal complexes were designed and synthesized. Examination of iron(II) complexes showed that they were efficient catalysts for the cyclopropanation of styrene by diazo reagents. Good yields and high diastereoselectivity were obtained with modest enantioselectivity. A rationalization of the stereoselectivity was presented on the basis of structural factors in a carbene intermediate.

  16. Review of social cognitive treatments for psychosis.

    PubMed

    Fiszdon, Joanna M; Reddy, L Felice

    2012-12-01

    Social cognitive treatments for schizophrenia are a rapidly expanding area of research. In this comprehensive review of the treatment literature, we provide information on nearly 50 studies evaluating a range of social cognitive interventions, including broad-based, targeted, and comprehensive approaches. Research to date has established that some social cognitive domains are responsive to structured training, though much work still remains to be done in further refining these treatments, improving their effects on more complex social cognitive domains, and demonstrating both the durability of the training effects as well as their generalization to important social functioning outcomes. We end our review by offering hypotheses for why existing treatments may have had limited success in improving more complex social cognitive processes, and summarize ongoing issues and future directions in social cognitive treatment research. PMID:23059624

  17. Debating complexity in modeling

    USGS Publications Warehouse

    Hunt, Randall J.; Zheng, Chunmiao

    1999-01-01

    As scientists trying to understand the natural world, how should our effort be apportioned? We know that the natural world is characterized by complex and interrelated processes. Yet do we need to explicitly incorporate these intricacies to perform the tasks we are charged with? In this era of expanding computer power and development of sophisticated preprocessors and postprocessors, are bigger machines making better models? Put another way, do we understand the natural world better now with all these advancements in our simulation ability? Today the public's patience for long-term projects producing indeterminate results is wearing thin. This increases pressure on the investigator to use the appropriate technology efficiently. On the other hand, bringing scientific results into the legal arena opens up a new dimension to the issue: to the layperson, a tool that includes more of the complexity known to exist in the real world is expected to provide the more scientifically valid answer.

  18. Compressively sensed complex networks.

    SciTech Connect

    Dunlavy, Daniel M.; Ray, Jaideep; Pinar, Ali

    2010-07-01

    The aim of this project is to develop low dimension parametric (deterministic) models of complex networks, to use compressive sensing (CS) and multiscale analysis to do so and to exploit the structure of complex networks (some are self-similar under coarsening). CS provides a new way of sampling and reconstructing networks. The approach is based on multiresolution decomposition of the adjacency matrix and its efficient sampling. It requires preprocessing of the adjacency matrix to make it 'blocky' which is the biggest (combinatorial) algorithm challenge. Current CS reconstruction algorithm makes no use of the structure of a graph, its very general (and so not very efficient/customized). Other model-based CS techniques exist, but not yet adapted to networks. Obvious starting point for future work is to increase the efficiency of reconstruction.

  19. Reducing GWAS Complexity.

    PubMed

    Hazelett, Dennis J; Conti, David V; Han, Ying; Al Olama, Ali Amin; Easton, Doug; Eeles, Rosalind A; Kote-Jarai, Zsofia; Haiman, Christopher A; Coetzee, Gerhard A

    2016-01-01

    Genome-wide association studies (GWAS) have revealed numerous genomic 'hits' associated with complex phenotypes. In most cases these hits, along with surrogate genetic variation as measure by numerous single nucleotide polymorphisms (SNPs) that are in linkage disequilibrium, are not in coding genes making assignment of functionality or causality intractable. Here we propose that fine-mapping along with the matching of risk SNPs at chromatin biofeatures lessen this complexity by reducing the number of candidate functional/causal SNPs. For example, we show here that only on average 2 SNPs per prostate cancer risk locus are likely candidates for functionality/causality; we further propose that this manageable number should be taken forward in mechanistic studies. The candidate SNPs can be looked up for each prostate cancer risk region in 2 recent publications in 2015 (1,2) from our groups. PMID:26771711

  20. Immunization of complex networks

    NASA Astrophysics Data System (ADS)

    Pastor-Satorras, Romualdo; Vespignani, Alessandro

    2002-03-01

    Complex networks such as the sexual partnership web or the Internet often show a high degree of redundancy and heterogeneity in their connectivity properties. This peculiar connectivity provides an ideal environment for the spreading of infective agents. Here we show that the random uniform immunization of individuals does not lead to the eradication of infections in all complex networks. Namely, networks with scale-free properties do not acquire global immunity from major epidemic outbreaks even in the presence of unrealistically high densities of randomly immunized individuals. The absence of any critical immunization threshold is due to the unbounded connectivity fluctuations of scale-free networks. Successful immunization strategies can be developed only by taking into account the inhomogeneous connectivity properties of scale-free networks. In particular, targeted immunization schemes, based on the nodes' connectivity hierarchy, sharply lower the network's vulnerability to epidemic attacks.