Note: This page contains sample records for the topic complex tfcc treatment from Science.gov.
While these samples are representative of the content of Science.gov,
they are not comprehensive nor are they the most current set.
We encourage you to perform a real-time search of Science.gov
to obtain the most current and comprehensive results.
Last update: August 15, 2014.
1

Arthroscopic reconstruction of triangular fibrocartilage complex (TFCC) with tendon graft for chronic DRUJ instability.  

PubMed

PURPOSE: To report the 10-years' experience of a novel arthroscopic assisted anatomical TFCC reconstruction in treatment of chronic DRUJ instability resulting from irreparable TFCC injuries. MATERIALS AND METHODS: 15 patients (7 males, 8 females) with mean age of 37 (17-49) suffering from irreparable TFCC injuries received arthroscopic assisted reconstruction using palmaris longus graft. Three skin incisions were made with creation of one radial and one ulna tunnel for passage of graft following the path of dorsal and palmar radio-ulnar ligaments under fluoroscopic and arthroscopic guidance. The joint capsule was kept intact. Early mid-range forearm rotation was started since 4th week postoperatively. RESULTS: The mean follow-up was 85.53months (32-138). Mayo wrist score improved from 62.5 to 88(p<0.05). Comparing contralateral side, total prono-supination range increased from 76.6% to 92.1% and grip strength increased from 56.1% to 76.9%. Twelve patients resumed previous jobs. No evidence of DRUJ arthritis was noticed. Complications included 2 late graft ruptures and one unexplained dystonia. CONCLUSIONS: Our arthroscopic assisted approach on TFCC reconstruction is safe, produces comparable results as the standard technique and may achieve better range of motion with less soft tissue dissection and earlier mobilization. PMID:23337702

Tse, Wing-Lim; Lau, Sun-Wing; Wong, Wing Yee; Cheng, Hi-Shan; Chow, Ching-Shan; Ho, Pak-Cheong; Hung, Leung-Kim

2013-01-18

2

TILT Following a TFCC Tear: A Case Report  

PubMed Central

We describe the case of a dorsal proximal triquetral impingement caused by a torn triangular fibrocartilage complex (TFCC) amassed on the repair site at the ulnar styloid. The impinging tissue was removed by simple burring with resultant relief of symptoms. This case illustrates painful impingement of soft tissue on the triquetrum. Possibly, the source of tissue impingement may include different extra-articular or torn intra-articular structures. Soft tissue impingement on the triquetrum may be a cause of ulnar-sided wrist pain following failed TFCC repair.

Wollstein, Ronit; Unadkat, Jignesh; Grand, Aaron

2012-01-01

3

Anatomic foveal reconstruction of the triangular fibrocartilage complex with a tendon graft.  

PubMed

An acute injury to the triangular fibrocartilage complex (TFCC) with avulsion of the foveal attachment can produce distal radioulnar joint (DRUJ) instability. The avulsed TFCC is translated distally so the footprint will be bathed in synovial fluid from the DRUJ and will become covered in synovitis. If the TFCC fails to heal to the footprint, then persistent instability can occur. The authors describe a surgical technique indicated for the treatment of persistent instability of the DRUJ due to foveal detachment of the TFCC. The procedure utilizes a loop of palmaris longus tendon graft passed through the ulnar aspect of the TFCC and into an osseous tunnel in the distal ulna to reconstruct the foveal attachment. This technique provides stability of the distal ulna to the radius and carpus. We recommend this procedure for chronic instability of the DRUJ due to TFCC avulsion, but recommend that suture repair remain the treatment of choice for acute instability. An arthroscopic assessment includes the trampoline test, hook test, and reverse hook test. DRUJ ballottement under arthroscopic vision details the direction of instability, the functional tear pattern, and unmasks concealed tears. If the reverse hook test demonstrates a functional instability between the TFCC and the radius, then a foveal reconstruction is contraindicated, and a reconstruction that stabilizes the radial and ulnar aspects of the TFCC is required. The foveal reconstruction technique has the advantage of providing a robust anatomically based reconstruction of the TFCC to the fovea, which stabilizes the DRUJ and the ulnocarpal sag. PMID:24694387

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

2014-06-01

4

Computational Identification of Transcription Factor Binding Sites via a Transcription-factor-centric Clustering (TFCC) Algorithm  

Microsoft Academic Search

While microarray-based expression profiling has facilitated the use of computational methods to find potential cis-regulatory promoter elements, few current in silico approaches explicitly link regulatory motifs with the transcription factors that bind them. We have thus developed a TF-centric clustering (TFCC) algorithm that may provide such missing information through incorporation of biological knowledge about TFs. TFCC is a semi-supervised clustering

Zhou Zhu; Yitzhak Pilpel; George M. Church

2002-01-01

5

A Newer Technique of Distal Ulna Reconstruction Using Proximal Fibula and TFCC Reconstruction Using Palmaris Longus Tendon following Wide Resection of Giant Cell Tumour of Distal Ulna  

PubMed Central

Giant cell tumour of the bone (GCT) is a rare locally aggressive primary bone tumour with an incidence of 3% to 5% of all primary bone tumours. The most common location for this tumour is the long bone metaepiphysis especially of the distal femur, proximal tibia, distal radius, and the proximal humerus. Involvement of distal ulna is rare accounting for 0.45% to 3.2%. Considering local aggressive nature and high recurrence, wide resection is the treatment recommended. Instability of ulnar stump and ulnar translation of the carpals are known complications following resection of distal ulna. To overcome these problems, we attempted a newer technique of distal ulna reconstruction using proximal fibula and TFCC reconstruction using palmaris longus tendon following wide resection of giant cell tumour of distal ulna in a 44-year-old male. This technique of distal radioulnar joint reconstruction has excellent functional results with no evidence of recurrence after one-year followup.

Mariappan, Elango; Mohanen, Pragash; Moses, Justin

2013-01-01

6

The Role of Wrist Magnetic Resonance Arthrography in Diagnosing Triangular Fibrocartilage Complex Tears  

PubMed Central

Objectives: The aims of the study were to evaluate the role of magnetic resonance arthrography (MRA) of the wrist in detecting full-thickness tears of the triangular fibrocartilage complex (TFCC) and to compare the results of the magnetic resonance arthrography (MRA) with the gold standard arthroscopic findings. Methods: The study was performed at King Hussein Medical Center, Amman, Jordan, between January 2008 and December 2011. A total of 42 patients (35 males and 7 females) who had ulnar-sided wrist pain and clinical suspicions of TFCC tears were included in the study. All patients underwent wrist magnetic resonance arthrography (MRA) and then a wrist arthroscopy. The results of MRA were compared with the arthroscopic findings. Results: After comparison with the arthroscopic findings, the MRA had three false-negative results (sensitivity = 93%) and no false-positive results. A total of 39 patients were able to return to work. Satisfaction was high in 38 of the patients and 33 had satisfactory pain relief. The sensitivity of the wrist MRA in detecting TFCC full-thickness tears was 93% (39), and specificity was 80% (16/20). The overall accuracy of wrist arthroscopy in detecting a full-thickness tear of the TFCC in our study was 85% (29/34). Conclusion: These results illustrate the role of wrist MRA in assessing the TFCC pathology and suggest its use as the first imaging technique, following a plain X-ray, in evaluating patients with chronic ulnar side wrist pain with suspected TFCC injuries.

Al-Hiari, Asem A.

2013-01-01

7

COMPLEX TRAUMA, COMPLEX REACTIONS: ASSESSMENT AND TREATMENT  

Microsoft Academic Search

Complex trauma occurs repeatedly and escalates over its duration. In families, it is exemplified by domestic violence and child abuse and in other situations by war, prisoner of war or refugee status, and human trafficking. Complex trauma also refers to situations such as acute\\/chronic illness that requires intensive medical intervention or a single traumatic event that is calamitous. Complex trauma

Christine A. Courtois

2004-01-01

8

Complexity in Treatment of Syntactic Deficits  

Microsoft Academic Search

Purpose: This article addresses complexity in the context of treatment for sentence structural impairments in agrammatic aphasia, with em- phasis on noncanonical sentences involving linguistic movement and their related counter- parts. Extensions of the complexity effect to recovery of canonical sentences also are dis- cussed, stressing the linguistic properties of verbs as well as grammatical morphology in building complexity hierarchies.

Cynthia K. Thompson; Lewis P. Shapiro

2007-01-01

9

Complexity in Language Learning and Treatment  

PubMed Central

Purpose To introduce a Clinical Forum focused on the Complexity Account of Treatment Efficacy (C. K. Thompson, L. P. Shapiro, S. Kiran, & J. Sobecks, 2003), a counterintuitive but effective approach for treating language disorders. This approach espouses training complex structures to promote generalized improvement of simpler, linguistically related structures. Three articles are included, addressing complexity in treatment of phonology, lexical-semantics, and syntax. Method Complexity hierarchies based on models of normal language representation and processing are discussed in each language domain. In addition, each article presents single-subject controlled experimental studies examining the complexity effect. By counterbalancing treatment of complex and simple structures across participants, acquisition and generalization patterns are examined as they emerge. Results In all language domains, cascading generalization occurs from more to less complex structures; however, the opposite pattern is rarely seen. The results are robust, with replication within and across participants. Conclusions The construct of complexity appears to be a general principle that is relevant to treating a range of language disorders in both children and adults. While challenging the longstanding clinical notion that treatment should begin with simple structures, mounting evidence points toward the facilitative effects of using more complex structures as a starting point for treatment.

Thompson, Cynthia K.

2011-01-01

10

Complexity in the Treatment of Naming Deficits  

PubMed Central

Purpose This paper discusses a novel approach for treatment of lexical retrieval deficits in aphasia in which treatment begins with complex, rather than simple, lexical stimuli. This treatment considers the semantic complexity of items within semantic categories, with a focus on their featural detail. Methods and Results Previous work on training items within animate categories (Kiran & Thompson, 2003a) and preliminary work aimed at items within inanimate categories are discussed in this paper. Both these studies indicate that training atypical category items that entail features inherent in the category prototype as well as distinctive features that are not characteristic of the category prototype results in generalization to untrained typical examples which entail only features consistent with the category prototype. Conversely, training typical examples does not result in generalization to untrained atypical examples. In this paper, it is argued that atypical items are more complex than typical items within a category and a theoretical framework for this dimension of semantic complexity is discussed. Then, evidence from treatment studies that support this complexity hierarchy is presented. Potential patient- and stimulus- specific factors that may influence the success of this treatment approach are also discussed. Conclusions The applications of semantic complexity to treatment of additional semantic categories and functional applications of this approach are proposed.

Kiran, Swathi

2009-01-01

11

Complexity in Language Learning and Treatment  

ERIC Educational Resources Information Center

Purpose: To introduce a Clinical Forum focused on the Complexity Account of Treatment Efficacy (C. K. Thompson, L. P. Shapiro, S. Kiran, & J. Sobecks, 2003), a counterintuitive but effective approach for treating language disorders. This approach espouses training "complex" structures to promote generalized improvement of simpler, linguistically…

Thompson, Cynthia K.

2007-01-01

12

Hanford Waste Treatment Complex Foundation for Success  

Microsoft Academic Search

The mission of the U.S. Department of Energy (DOE) Office of River Protection (ORP) River Protection Project (RPP) is to build and operate a Waste Treatment Complex to complete the cleanup of the Hanford Site's highly radioactive tank waste. As directed by Congress in Section 3139 of the Strom Thurmond National Defense Authorization Act for Fiscal Year 1999, DOE established

2001-01-01

13

Treatment of the complex idiopathic clubfoot.  

PubMed

Treatment with the Ponseti method corrects congenital idiopathic clubfeet in the majority of patients. However, some feet do not respond to the standard treatment protocol. We describe the characteristics and treatment results of these complex idiopathic clubfeet. We identified 50 patients (75 clubfeet) from 762 consecutive patients treated at five institutions. Clinically, complex clubfeet were defined as having rigid equinus, severe plantar flexion of all metatarsals, a deep crease above the heel, a transverse crease in the sole of the foot, and a short and hyperextended first toe. The Achilles' tendon was exceptionally tight and fibrotic up to the middle of the calf. Correction was achieved in all patients by modifying the Ponseti manipulation and casting technique. Correction required an average of five casts (range, 1-10 casts). Two patients (4%) not initially recognized as having complex clubfeet had a posterior release with tendo Achillis lengthening. There were seven relapses that responded to casting. Three patients had a second tenotomy. Modifying the treatment protocol for complex clubfeet successfully corrected the deformity without the need for extensive corrective surgery. PMID:16788408

Ponseti, Ignacio V; Zhivkov, Miroslav; Davis, Naomi; Sinclair, Marc; Dobbs, Matthew B; Morcuende, Jose A

2006-10-01

14

Hanford Waste Treatment Complex Foundation for Success  

SciTech Connect

The mission of the U.S. Department of Energy (DOE) Office of River Protection (ORP) River Protection Project (RPP) is to build and operate a Waste Treatment Complex to complete the cleanup of the Hanford Site's highly radioactive tank waste. As directed by Congress in Section 3139 of the Strom Thurmond National Defense Authorization Act for Fiscal Year 1999, DOE established ORP at the Hanford Site in eastern Washington State to manage RPP (formerly the Tank Waste Remediation System). This is DOE's largest and most complex environmental cleanup project. ORP is responsible for safe storage, retrieval, treatment, and disposal of 53 million gallons of highly toxic, high-level radioactive waste stored in 177 underground tanks located within seven miles of the Columbia River. One hundred forty-nine of these tanks have a single steel liner inside the concrete tanks and are decades beyond their design life. Sixty-seven have leaked an estimated one million gallons of waste into the soil. Some of this waste has reached the groundwater, threatening the Columbia River. It is urgent that this waste be vitrified (turned to glass) and stored or disposed of in a more secure location before more leaks occur and before tanks and infrastructure deteriorate to the point where the cost and schedule for cleanup becomes prohibitive. This cleanup must occur in an environmentally sound, safe, and cost-efficient manner. The cleanup also must comply with the comprehensive cleanup and compliance agreement among DOE, the U.S. Environmental Protection Agency, and the Washington State Department of Ecology, signed on May 15, 1989. The Hanford Federal Facility Agreement and Consent Order, or Tri-Party Agreement, is an agreement for achieving compliance with the Comprehensive Environmental Response Compensation and Liability Act of 1980 remedial action provisions and with the Resource Conservation and Recover Act of 1976 treatment, storage, and disposal unit regulations and corrective action provisions. The RPP is managed as a single, integrated Waste Treatment Complex. A RPP management team consisting of ORP, Tank Farm Contractor (CH2M HILL Hanford Group, Inc.), and the Waste Treatment and Immobilization Plant (WTP) Contractor (Bechtel Washington) execute the mission. The role each organization plays in laying out the foundations for success of the Waste Treatment Complex will be further identified in the paper.

BOSTON, H.L.

2001-02-01

15

Neurosurgical treatment of tuberous sclerosis complex lesions  

Microsoft Academic Search

Background  Tuberous sclerosis complex (TSC) is an autosomal dominantly inherited syndrome. Renal disease is the main cause of death.\\u000a Brain disorders are the origin of more frequent and severe problems, such as tumors, epilepsy, and mental retardation. Participation\\u000a of neurosurgeons in the study and especially in the treatment of TSC patients is often required.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methods  Two types of pathological conditions

Ignacio Pascual-Castroviejo

2011-01-01

16

Results of repair of peripheral tears in the triangular fibrocartilage complex using an arthroscopic suture technique.  

PubMed

We present the results of an arthroscopic suture technique for repairing peripheral tears (Palmer type 1 b) of the triangular fibrocartilage complex (TFCC). The 20 patients included in this study were 15-59 years of age; the most common mechanism of injury was a fall on a hyperextended wrist. After diagnosis of the tear in the TFCC we debrided the synovitis and repaired the tears by an arthroscopic suture technique. At follow up 23-59 months postoperatively, range of movement (sum of flexion-extension) was 90% (range 53%-108%) and grip strength was 83% (range 18%-122%) when compared with the uninjured side. All patients returned to work, though three changed occupations. The arthroscopic suture technique of peripheral TFCC repair produced seven excellent, seven good, four fair, and two poor results (grading based on a Mayo modification of the Green and O'Brien wrist score). As our results are comparable to others, we think that the technique described could be used in the repair of peripheral tears of the TFCC. PMID:10614755

Haugstvedt, J R; Husby, T

1999-12-01

17

Surgical Treatment and Rehabilitation of Combined Complex Ligament Injuries  

PubMed Central

This article is a description of the surgical treatment and rehabilitation of combined complex ligament injuries. A background will be provided, and information on the combined complex knee injuries, selected aspects of surgical treatments, and rehabilitation strategies will be presented. Combined complex ligament injuries are devastating injuries and are not very common compared to other knee injuries. No meta-analysis or systematic review studies exist regarding the best treatments for these patients. This article's emphasis is on the stages in the rehabilitation program with documentation of the scientific and clinical rationale for the treatment techniques in each stage. Treatment interventions are described and documented with the limited evidence available in treating these patients. Guidelines for treatment, surgery, and a clinical protocol for treating patients with combined complex ligament injuries are provided for the practicing clinician to use as a template for treating these complicated patients.

Romeyn, Richard L.; Jennings, Jason

2008-01-01

18

The challenge of treatment in bipolar depression: evidence from clinical guidelines, treatment recommendations and complex treatment situations.  

PubMed

Bipolar depression and its clinical presentation is a frequent but complex psychiatric disease. Despite the high prevalence and the clinical and economic relevance of bipolar depression, few treatments are proven to be highly and consistently effective. In practice, the treatment of bipolar depression typically includes complex treatment decision-making. The best evidence for a pharmacological treatment exists for quetiapine. Alternatives with limitations are lamotrigine (also in the combination with lithium), carbamazepine and olanzapine. The effectiveness and recommendation of antidepressants in the treatment of bipolar depression remains controversial. Initially, depressive episodes should been treated with one of the named substances with antidepressant properties. In non-responders, a combination of lithium and lamotrigine, or antidepressants in combination with either lithium, an antiepileptic drug or atypical antipsychotics, may be necessary. If a depressive episode occurs under ongoing mood-stabilizing treatment, combination treatments of different substances, even with antidepressants, can be necessary. In the case of treatment-resistant depressive episodes, complex treatment strategies (combination therapies, MAO inhibitors) should be considered. This review describes the treatment recommendations of different guidelines for bipolar depression and emphasizes their differences. Furthermore, alternative pharmacological treatment strategies and complex treatment situations are discussed. PMID:24549861

Köhler, S; Gaus, S; Bschor, T

2014-03-01

19

[Cell technologies in complex treatment of venous trophic ulcers].  

PubMed

Live skin equivalent and fibroblasts in gel were used in complex treatment of venous trophic ulcers to evaluate efficacy of cell transplants. Their efficacy depended on extent of trophic ulcer and time of their existence. Cell culture method is minimally traumatic, can be used in elder patients and seniors and gives positive results in 85% of cases. PMID:21350400

Gavrilenko, A V; Pavlova, O V; Ivanov, A A; Vakhrat'ian, P E; Dashinimaev, É B; Li, R A

2011-01-01

20

Operative versus nonoperative treatment in complex proximal humeral fractures.  

PubMed

This updated meta-analysis investigated whether operative treatment is superior to nonoperative treatment in complex proximal humeral fractures. The authors searched the Cochrane Central Register of Controlled Trials, PubMed, and EMBASE. Randomized controlled trials that evaluated operative vs nonoperative treatment for exclusively 3- or 4-part proximal humeral fractures were considered. Six studies with a total of 287 patients who had proximal humeral fractures were included. According to the meta-analysis, no statistically significant differences were found between operative and nonoperative treatment in Constant-Murley shoulder scores (Constant scores); Disabilities of the Arm, Shoulder, and Hand scores; total complication events; mortality; infection; nonunion; avascular necrosis; osteoarthritis; redisplacement of fractures; or dislocation or resorption of tuberosity. For health-related quality of life, EuroQol-5D (EQ-5D) favored operative treatment, but 15D scores showed no significant difference. Compared with nonoperative treatment, open reduction and internal fixation required significantly more additional surgeries (risk ratio, 6.50; 95% confidence interval, 1.54-27.50; P=.01), and more penetrations into joint space occurred (risk ratio, 9.56; 95% confidence interval, 2.27-40.13; P=.002). The limited evidence suggests that no convincing findings support the use of either open reduction and internal fixation or hemiarthroplasty for the treatment of complex proximal humeral fractures. The findings of the current study should be interpreted cautiously because of the modest sample size and the short follow-up period. PMID:24810816

Mao, Zhi; Zhang, Lihai; Zhang, Licheng; Zeng, Xiantao; Chen, Shuo; Liu, Daohong; Zhou, Zhirui; Tang, Peifu

2014-05-01

21

Treatment of bipolar disorder: a complex treatment for a multi-faceted disorder  

Microsoft Academic Search

BACKGROUND: Manic-depression or bipolar disorder (BD) is a multi-faceted illness with an inevitably complex treatment. METHODS: This article summarizes the current status of our knowledge and practice of its treatment. RESULTS: It is widely accepted that lithium is moderately useful during all phases of bipolar illness and it might possess a specific effectiveness on suicidal prevention. Both first and second

Konstantinos N Fountoulakis; Eduard Vieta; Melina Siamouli; Marc Valenti; Stamatia Magiria; Timucin Oral; David Fresno; Panteleimon Giannakopoulos; George S Kaprinis

2007-01-01

22

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

PubMed Central

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.

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

2011-01-01

23

[Pantogam active in the complex treatment of dystonic hyperkineses].  

PubMed

Efficacy of pantogam active in the complex treatment of facial and cervical dystonic hyperkineses was studied in 37 patients (25 women, 12 men) with dystonic torticollis, blepharospasm, oromandibular dystonia with illness duration more than 6 months. In these patients, the previous treatment had no positive effect. Pantogam active was prescribed in dose 900-1800 mg/day during 12 weeks. Efficacy was assessed with the TWSTRS, the HADS and the CGI-I. Pantogam active as add-on to basic treatment led to the reduction of severity in dystonic hyperkineses on the average 2-2,5 months from baseline. The best effect was seen in patients with short disease duration. The prescription of this drug allowed to increase the dose of drugs traditionally used in treatment of dystonia (clonazepam, cyclodole, tiapridal, baclofen) due to the decrease of their side-effects. PMID:21389940

Katunina, E A; Malykhina, E A; Avanesova, O V; Makarova, A A; Abdurakhmanova, E K; Gridiakin, V I

2010-01-01

24

Low glycemic index treatment for epilepsy in tuberous sclerosis complex.  

PubMed

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

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

2012-03-01

25

Complexity of Nursing in Patients Undergoing Treatment for CNS Tumors  

Microsoft Academic Search

\\u000a Patients with tumors of the central nervous system (CNS) present an array of complex clinical issues for the neuroscience\\u000a nurse. Nurses play a critical role during the treatment and long-term care of these patients. Dealing with patients harboring\\u000a CNS tumors requires a high level of nursing expertise and a great deal of compassion and understanding. Patients with these\\u000a diagnoses are

Evangeline M. Thomson

26

Treatment of refractory complex partial seizures: role of vigabatrin.  

PubMed

Vigabatrin (VGB) is an antiepileptic drug that was designed to inhibit GABA-transaminase, and increase levels of gamma-amino-butyric acid (GABA), a major inhibitory neurotransmitter in the brain. VGB has demonstrated efficacy as an adjunctive antiepileptic drug for refractory complex partial seizures (CPS) and for infantile spasms (IS). This review focuses on its use for complex partial seizures. Although VGB is well tolerated, there have been significant safety concerns about intramyelinic edema and visual field defects. VGB is associated with a risk of developing bilateral concentric visual field defects. Therefore, the use of VGB for complex partial seizures should be limited to those patients with seizures refractory to other treatments. Patients must have baseline and follow-up monitoring of visual fields, early assessment of its efficacy, and ongoing evaluation of the benefits and risks of VGB therapy. PMID:19851518

Waterhouse, Elizabeth J; Mims, Kimberly N; Gowda, Soundarya N

2009-01-01

27

Maggot Debridement Therapy in the Treatment of Complex Diabetic Wounds  

PubMed Central

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.

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

2011-01-01

28

Multimodal Treatment for Complex Intracranial Aneurysms: Clinical Research  

PubMed Central

Objective For patients with giant or dissecting aneurysm, multimodal treatment consisting extracranial-intracranial bypass surgery plus clip or coil for parent artery occlusion may be necessary. In this study, the safety and efficacy of multimodal treatment in 15 patients with complex aneurysms were evaluated retrospectively. Methods From January 1995 to June 2007, the authors treated 15 complex aneurysms that were unable to be clipped or coiled. Among them, nine patitents had unruptured aneurysms and 6 had ruptured aneurysms. Aneurysms were located in the internal cerebral artery (ICA) in 11 patients (4 in the dorsal wall, 4 in the terminal ICA, 1 in the paraclinoid, and 2 in the cavernous ICA), in the middle cerebral artery (MCA) in 2, and in the posterior circulation in two patients Results Fifteen patients with complex aneurysms were treated with bypass surgery previously. Thirteen patients were treated with external carotid middle cerebral artery (ECA-MCA) anastomosis, and one patient with superficial temporal to posterior cerebral artery (STA-PCA) and another patient with occipital artery to posterior inferior cerebellar artery (OA-PICA) anastomosis. Parent artery occlusion was then performed with a clip in 9 patients, with a coil in 4, with balloon plus coil in one patient. All 15 aneurysms were successfully treated with clip or coil combined with bypass surgery. Follow-up angiograms showed good patency of anastomotic site in 10 out of 11 patients, and perfusion study showed sufficient perfusion in 6 out of 9 patients. Conclusion These findings indicate that for patients with complex aneurysms, clip or coil for parent vessel occlusion with additive bypass surgery can successfully exclude the aneurysm from the neurovascular circulatory system.

Jin, Sung-Chul; Song, Young; Kim, Hyun Jung; Ahn, Jae Seung; Kwun, Byung-Duk

2008-01-01

29

Treatment of bipolar disorder: a complex treatment for a multi-faceted disorder  

PubMed Central

Background Manic-depression or bipolar disorder (BD) is a multi-faceted illness with an inevitably complex treatment. Methods This article summarizes the current status of our knowledge and practice of its treatment. Results It is widely accepted that lithium is moderately useful during all phases of bipolar illness and it might possess a specific effectiveness on suicidal prevention. Both first and second generation antipsychotics are widely used and the FDA has approved olanzapine, risperidone, quetiapine, ziprasidone and aripiprazole for the treatment of acute mania. These could also be useful in the treatment of bipolar depression, but only limited data exists so far to support the use of quetiapine monotherapy or the olanzapine-fluoxetine combination. Some, but not all, anticonvulsants possess a broad spectrum of effectiveness, including mixed dysphoric and rapid-cycling forms. Lamotrigine may be effective in the treatment of depression but not mania. Antidepressant use is controversial. Guidelines suggest their cautious use in combination with an antimanic agent, because they are supposed to induce switching to mania or hypomania, mixed episodes and rapid cycling. Conclusion The first-line psychosocial intervention in BD is psychoeducation, followed by cognitive-behavioral therapy. Other treatment options include Electroconvulsive therapy and transcranial magnetic stimulation. There is a gap between the evidence base, which comes mostly from monotherapy trials, and clinical practice, where complex treatment regimens are the rule.

Fountoulakis, Konstantinos N; Vieta, Eduard; Siamouli, Melina; Valenti, Marc; Magiria, Stamatia; Oral, Timucin; Fresno, David; Giannakopoulos, Panteleimon; Kaprinis, George S

2007-01-01

30

Treatment of experimental immune complex glomerulonephritis by sodium alginate.  

PubMed

We have studied the therapeutic efficacy of the sodium alginate in experimental immune complex glomerulonephritis. Bovine serum albumin (BSA) nephritis was induced in rats by a subcutaneous immunization and daily intravenous administration of BSA. Sodium alginate at two different doses (25 and 50 mg/kg) was administered intraperitoneally at regular 72-h intervals for 6 weeks. Onset of treatment was day 42. Urinary protein was measured weekly and serum anti-BSA antibody was assessed by ELISA method at different intervals. Animals were euthanized at the 12th experimental week and blood samples and kidney specimens were obtained. BUN, serum creatinine and serum cholesterol and triglyceride were measured at the time of sacrifice. Kidney specimens were processed for light and immunofluorescent microscopic examination. The tolerability and inhibitory effect of LVA on matrix metalloproteinase 2 (MMP-2) were tested using WEHI-164 cell line and zymography method. Results of this experiment showed that treatment with sodium alginate could significantly reduce the urinary protein excretion and serum creatinine in treated rats vs. nontreated controls. Anti-BSA antibody titers were lower in treated rats than in controls at the 12th week post-immunization. There was no significant difference in the level of BUN and serum lipids between two groups. Whereas, glomerular hypercellularity, PMN infiltration and glomerular deposition of BSA were less intense in treated rats vs. controls. Moreover, in vitro examinations revealed that treatment with LVA, as a very safe agent could diminish MMP-2 activity. These results suggest that treatment with sodium alginate as a new immunosuppressive agent can reduce proteinuria, inhibit MMP-2 activity and suppress the antibody production as well as the development of glomerular lesions in a rat model of immune complex glomerulonephritis. PMID:15893960

Mirshafiey, Abbas; Borzooy, Zohreh; Abhari, Reza Safari; Razavi, Alireza; Tavangar, Mohammad; Rehm, Bernd H A

2005-06-01

31

Surgical treatment of complex fracture of the proximal humerus.  

PubMed

Sixteen patients aged 19 to 63 years (average, 52 years) were observed from 1.8 to 5.6 years (average, 3.8 years) after open reduction and internal fixation with or without external fixation of 3- and 4-part displaced fractures of the proximal humerus. There were 12, 3-part displaced greater tuberosity and surgical neck fractures with 6 concomitant dislocations. Four cases were 4-part fractures with 3 concomitant dislocations. Fixation was achieved with heavy sutures or wire that incorporated the rotator cuff tendon, tuberosities, and shaft combined with threaded pins or Hoffmann external fixation to enhanced stability for early rehabilitation. According to Neer's criteria, 14 (87%) of the 16 patients had satisfactory or excellent results. Two (13%) of the 16 had unsatisfactory results. The use of a technique of limited soft tissue dissection and internal fixation with or without external fixation achieved good fracture stability and a high percentage of satisfactory results. The limitations of the procedure include (1) patients who could not tolerate anesthesia, (2) complex displaced fractures in older patients with osteoporotic bone that cannot hold pins or external fixation, (3) older patients with 4-part fracture dislocations in which avascular necrosis of the humeral head occurs frequently and in which a subsequent endoprosthesis insertion is inappropriate if osteosynthesis fails, and (4) head splitting fractures. The described approach provides an alternative method for the treatment of complex displaced fractures of the proximal humerus. PMID:8641068

Ko, J Y; Yamamoto, R

1996-06-01

32

Optimal treatment of multivessel complex coronary artery disease  

PubMed Central

The aim of the present study was to investigate major cardiac events and the similarities and differences of medical costs among patients with multivessel complex coronary artery disease (MCCAD) during the three-year follow-up. The MCCAD patients had undergone single complete revascularization (CR), fractionated revascularization (FR) or partial revascularization (PR) and the present study aimed to screen the optimal treatment program. A total of 2,309 MCCAD patients who had been treated at a single center in the last decade, among which 1,020 cases underwent single CR, 856 cases successively underwent FR and 433 cases only underwent PR, were followed-up for three years. Major cardiac events, including all-cause mortality, myocardial infarction, severe heart failure, rehospitalization and revascularization (coronary artery bypass grafting and coronary stent reimplantation), were set as the end points. In addition, the three-year medical costs associated with heart disease were analyzed. The three-year cardiac event rate in the CR group (17%) was significantly lower compared with the other two groups and the average three-year medical costs in the CR group (62,100 RMB) were significantly lower than those in the other two groups. Therefore, under permissive conditions, single CR is the optimal and most economical treatment strategy for patients with MCCAD.

SUN, HAIHUI; CUI, LIANQUN

2014-01-01

33

[Sanation of biliary system using antiseptic decasan in complex treatment of cholangitis].  

PubMed

Experience of treatment of 17 patients, suffering cholangitis of various genesis, using antiseptic Decasan, is presented. Clinical efficacy of the preparation in complex treatment of cholangitis, confirmed by results of the bile bacteriological investigation, was noted. PMID:24923115

Aripova, N U; Magzumov, I Kh

2014-02-01

34

Complex regional pain syndrome: a report of two cases recalcitrant to usual treatment protocols.  

PubMed

In this report the authors present a review of complex regional pain syndrome and two case reports of complex regional pain syndrome that were recalcitrant to the usual treatments. The first case presented is a middle-aged female who developed signs and symptoms of post-traumatic complex regional pain syndrome. The second case is a woman with a pre-existing history of complex regional pain syndrome whose condition worsened after surgery despite appropriate perioperative precautions. These cases are unique because in both cases an early diagnosis of complex regional pain syndrome was established, yet they were both resistant to the usual treatment protocols. PMID:11924684

Fox, I M; Domsky, R; Frank, M J

2001-01-01

35

Assessing vestibular dysfunction. Exploring treatments of a complex condition.  

PubMed

In summary, patients with BPPV can be treated with the canalith repositioning maneuver. Patients with unilateral vestibular hypofunction can be treated using adaptation, substitution, and/or habituation exercises. Patients with motion sensitivity can demonstrate improved tolerance to motion after performing habituation exercises. Patients with bilateral vestibular loss will benefit from substitution and adaptation exercises. Each patient requires a treatment regime that is individualized and appropriate to address their impairments. Often the treatment is determined through the evaluation process. The task that causes the patient's complaints, whether it be dizziness, imbalance, and/or issues with eye-head coordination, often becomes the treatment of choice, gradually increasing difficulty as appropriate and safe. Patients with TBI who have concomitant vestibular dysfunction are a challenging population to treat. One has to be cognizant of cognitive deficits that may interfere with or prolong treatment as well as the many other neurological deficits that may be present because of the brain injury. For example, attempting to perform the canalith repositioning maneuver on a patient status post TBI when they are not able to comprehend the reasoning behind the treatment can lead to agitation or behavioral issues. Communication with the patient's primary doctor is a necessity so that the team is always on the same page about the approach to treatment. Vestibular evaluation and rehabilitation are a necessity for patients who have experienced a TBI. The sooner the problems are identified, the sooner treatment can be initiated with the goal of helping patients recover their maximal functional level of independence and safety. Also, treating patients with TBI and vestibular impairments can require increased treatment time in comparison to treatment of a patient with only vestibular dysfunction, so the sooner the treatment for vestibular dysfunction can be started, the better for the patient with TBI. PMID:20614769

Childs, Lisa A

2010-07-01

36

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

SciTech Connect

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.

D'Souza, Neil, E-mail: neil.dsouza@sunnybrook.ca [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada) [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Holden, Lori [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada) [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Robson, Sheila [Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada)] [Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Mah, Kathy; Di Prospero, Lisa; Wong, C. Shun; Chow, Edward; Spayne, Jacqueline [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada) [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada)

2012-09-01

37

Treatment of Complex Anal Fistulas with the Collagen Fistula Plug  

Microsoft Academic Search

Purpose  Anal fistulas that involve a significant amount of sphincter may be difficult to treat without compromising continence function.\\u000a In this study, we evaluated our experience with the Surgisis® anal fistula plug, which was recently reported to be successful\\u000a in >80 percent of patients with complex fistulas.\\u000a \\u000a \\u000a \\u000a Methods  We retrospectively collected patient and fistula characteristics, procedure details, and follow-up information for all

Dimitrios Christoforidis; David A. Etzioni; Stanley M. Goldberg; Robert D. Madoff; Anders Mellgren

2008-01-01

38

Tables for Calculation of Nominal Standard Dose for Complex Treatment Schedules.  

National Technical Information Service (NTIS)

Tables with instructions and examples are presented which allow calculation of Nominal standard dose (NSD) values for complex treatment schedules with gaps or changes in fractionation pattern. These are based on a previously derived formula and eliminate ...

H. M. Phelps C. E. Phelps

1974-01-01

39

Sodium hydroxide treatment of field water in a biopolymer complex  

SciTech Connect

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.

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

1990-12-18

40

Comorbidity, Case Complexity, and Effects of Evidence-Based Treatment for Children Referred for Disruptive Behavior  

ERIC Educational Resources Information Center

Comorbidity and complexity of cases seen in clinical work form a basis for discounting the applicability and generality of evidence-based treatments (EBTs). The authors evaluated treatment outcomes in 2 samples of clinically referred children who met criteria for oppositional defiant disorder (n = 183; 42 girls, 141 boys; ages 3-14) or conduct…

Kazdin, Alan E.; Whitley, Moira K.

2006-01-01

41

Effective Treatment of Complex Post Traumatic Stress Disorder and Early Attachment Trauma  

Microsoft Academic Search

Research on and disagreements regarding the appropriate treatments for various types of traumas have existed throughout the history of psychotherapy. While approaches have differed over the years, current research suggests that prolonged exposure therapy, long considered the most efficacious treatment for single incident trauma, may be at best ineffectual for treating the condition known as Complex Post Traumatic Stress Disorder,

Emily R Murphrey

2011-01-01

42

Long-term results after arthroscopic resection of lesions of the triangular fibrocartilage complex.  

PubMed

Thirty-five patients with central and radial lesions of the triangular fibrocartilage complex (TFCC) were treated by arthroscopic resection and debridement. Their median age was 36 years (range 11-52), and preoperative duration of symptoms 18 months (range 4-132). Fall on a hyperextended wrist was the most common injury (n = 15), and nine patients had had a previous fracture of the radius. Eighteen patients had an additional arthroscopic debridement of coexisting chondral lesions. There were no complications. At a median follow up time of 39 months (range 18-58), grip strength was recorded as a median of 94% (range 4-164), flexion-extension sector as 94% (range 50-107), and pronation and supination sector as 100% (range 50-112) of the uninjured side. At follow up eight patients were free of pain, 14 much better, eight somewhat better, five unchanged, and no patient had got worse. The Mayo Modified Wrist Score assessed 13 patients as excellent, 14 good, four fair, and one poor. Thirty-one patients returned to full-time work, and four were unemployed (partly because of reasons not relevant to the operation). Thirty-three patients reported they would have had the same procedure if they had known the outcome of the surgery. We find arthroscopic debridement of central or radial lesions of the TFCC to be safe and reliable with good pain relief. PMID:11291355

Husby, T; Haugstvedt, J R

2001-03-01

43

[Renal function and size after complex treatment of Wilms' tumour].  

PubMed

The aim of our study was to measure renal function and growth in survivors of unilateral Wilms' tumour in 21 children and young adults (7 female). The mean age was 12.6 +/- 4.8 years, mean follow-up time was 7.01 +/- 4.25 years: seven of the group received irradiation (35 Gy). Blood pressure was normal in all patients. Three of them had elevated cystatin C and clearance of cystatin C below referenced normal value. The others had normal renal function tests (cystatin C, creatinine and cystatin clearance, B2 microglobulin, microalbuminuria, osmolality). Compared to the control we found higher cystatin C values in children treated before the age 3 years old (p=0.03) and in children treated more than 5 years before (p=0.03), and lower cystatin clearance in group treated before the age 3 years old (p=0,03). No difference between the irradiated and non-irradiated group was found. We observed a greater increase in volume (155.9% +/- 33.4) than in length (127.9% +/- 6.3). The highest rise of renal volume was in children treated more than 5 years before (174.6% +/- 22.3). In conclusion, our data suggest that after combined treatment for Wilms' tumour compensatory renal hypertrophy and a tendency progressive renal dysfunction takes place. PMID:14963343

Krawczuk-Rybak, Maryna; Ku?micz, Marta; Kitszel, Anna; Wysocka, Jolanta; Zalewska, Beata; Olszewska, Magdalena

2003-01-01

44

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

PubMed

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

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

2011-12-01

45

Increasing model complexity in simulating phosphorus dynamics in a large treatment wetland: does it matter?  

NASA Astrophysics Data System (ADS)

As the structure of ecological models grows more complex, it becomes increasingly important to identify the appropriate level of complexity for reliable process description and prediction. Here, a suite of mechanistic biogeochemical models with increasing level of complexity for representing phosphorus cycling processes was developed and tested against observations from a large treatment wetland. The study site was the 147-ha Cell 4 of Stormwater Treatment Area 1 West, which was designed to help protect the greater Everglades, FL, USA from nutrient over-enrichment. The biogeochemical models were coupled with a pre-calibrated two-dimensional hydrodynamic model of Cell 4. We provide guidance for evaluating a set of models with varying level of process complexity using key model attributes that influence the suitability of a model or a set of models. Considerations of model accuracy, complexity, and explanatory depth are combined into a single indicator of model effectiveness. Results revealed that the most complex model structure may not necessarily the most effective in simulating the dynamics of total phosphorus concentrations in the wetland. The rate of improvement in the model performance decreased as model complexity increased. Although the most complex model reproduced the field observations best, the marginal improvement in model performance compared to simpler models was outweighed by the higher costs of increased complexity. Highly detailed representations of system structures may not be useful to simulate total phosphorus dynamics in treatment wetlands if comprehensive data sets are not available to constrain each pathway in the model. It is crucial for model developers and users to evaluate model structures of differing complexity to identify the optimal level of model complexity for given data and questions of interest.

Paudel, R.; Jawitz, J. W.

2011-12-01

46

Amphotericin B lipid complex for the treatment of patients with acute leukemia and hepatosplenic candidiasis.  

PubMed

Hepatosplenic candidiasis (HSC) is an emerging complication of the treatment of patients with acute leukemia. Treatment of this infection can be very difficult and data on the duration of antifungal therapy are not available. We evaluated the efficacy of amphotericin B lipid complex (ABLC) for the treatment of five patients with acute leukemia and HSC. The dose of the administered ABLC ranged between 5 and 11 mg/kg per day and the median duration of therapy was 4.3 months. Four patients had complete response to the above treatment with resolution of fever and improvement in the radiologic findings. One patient refused to continue treatment and subsequently died with relapsed leukemia and disseminated Candida infection. Preliminary data suggest that ABLC is a well-tolerated and effective treatment for HSC and should be considered for phase II trials as front line treatment for this type of deep seated fungal infections. PMID:10576503

Sallah, S; Semelka, R C; Sallah, W; Vainright, J R; Philips, D L

1999-11-01

47

Treating complex trauma among veterans: three stage-based treatment models.  

PubMed

This article addresses the issue of complex trauma in veterans and treatments for symptom presentations resulting from complex trauma exposure. While various definitions have been proposed for complex trauma, the clinical issues related to it are relevant for veterans as they are at risk for cumulative trauma exposures such as multiple combat deployments and military sexual trauma. Several treatments were either developed to address and/or implemented with complex trauma. This article discusses three of these treatments that share a stage-based approach, focusing on the present (e.g., skills training and psychoeducation), which can then be followed, if needed, with a past-focused (e.g., exposure-based) treatment: Dialectical Behavior Therapy (Linehan, 1993), Seeking Safety (Najavits, 2002), Skills Training in Affective and Interpersonal Regulation (STAIR) Narrative Therapy (Cloitre, Cohen, & Koenen, 2006). This article also discusses what is currently being done to address symptom presentations resulting from complex trauma exposure and challenges and possible solutions to implementing this care. PMID:23529776

Landes, Sara J; Garovoy, Natara D; Burkman, Kristine M

2013-05-01

48

Orthopaedic reconstruction of complex pelvic bone defects. Evaluation of various treatment methods.  

PubMed

Despite major developments in the field of revision surgery in recent decades, the management of severe acetabular deficiency at revision arthroplasty, complex primary total hip replacement or after pelvic tumour resection remains a complex problem. The options available for the management of severe bone loss include the use of uncemented press-fit cups with or without metal augments, impaction allografts, allograft-prosthesis composites, custom-made triflange cups, hip transposition, reconstruction prostheses or various combinations of these. This paper describes defect classification, various treatment options, clinical outcomes, survival of reconstruction, and typical complications in relation to treatment. PMID:23628635

Nieminen, J; Pakarinen, T-K; Laitinen, M

2013-01-01

49

Combined electron-beam and biological treatment of dyeing complex wastewater. Pilot plant experiments  

NASA Astrophysics Data System (ADS)

Pilot plant (output 1000 m 3 day -1) with ELV electron accelerator (energy 1 MeV, beam power 40 kW) is in operation from October 1998. Combined electron-beam and biological treatment was used for purification of dyeing complex wastewater under continuous flow conditions. The main results of pilot-scale experiments consisted in the fact that decrease in total content of pollutants after biological treatment was substantially influenced by preliminary electron-beam treatment (mainly, because of radiolytic conversions of terephthalic acid being a main pollutant of the wastewater). Equal purification degree corresponded to 17 h of bio-treatment without preliminary irradiation and about 8 h of bio-treatment with preliminary electron-beam treatment at absorbed dose 1-2 kGy.

Han, Bumsoo; Ko, Jaein; Kim, Jinkyu; Kim, Yuri; Chung, Wooho; Makarov, I. E.; Ponomarev, A. V.; Pikaev, A. K.

2002-04-01

50

Bioadhesive tablets containing cyclodextrin complex of itraconazole for the treatment of vaginal candidiasis.  

PubMed

Itraconazole (ITR) is commonly used in the treatment of Candida infections. It has a nephrotoxic effect and low bioavailability in patients who suffer from renal insufficiency, and its poor solubility in water makes ITR largely unavailable. Cyclodextrins (CyDs) are used to form inclusion complexes with drugs to improve their aqueous solubility and to reduce their side effects. In this study, ITR was complexed with ?-cyclodextrin (?-CyD), hydroxypropyl-?-cyclodextrin (HP-?-CyD), methyl-?-cyclodextrin (Met-?-CyD) and sulphobutyl ether-?-cyclodextrin (SBE7-?-CyD) to increase its water solubility and to reduce the side effects of the drug without decreasing antifungal activity. Complex formation between ITR and CyDs was evaluated using SEM, (1)H NMR and XRD studies. The antifungal activity of the complexes was analyzed on Candida albicans strains, and the susceptibility of the strains was found to be higher for the ITR-SBE7-?-CyD complex than for the complexes that were prepared with other CyDs. Vaginal bioadhesive sustained release tablet formulations were developed using the ITR-SBE7-?-CyD inclusion complex to increase the residence time of ITR in the vagina, thereby boosting the efficacy of the treatment. The swelling, matrix erosion and bioadhesion properties of formulations and the drug release rate of these tablets were analyzed, and the most therapeutically effective vaginal formulation was determined. PMID:24857873

Cevher, Erdal; Açma, Ay?e; Sinani, Genada; Aksu, Buket; Zloh, Mire; Mülaz?mo?lu, Lütfiye

2014-08-01

51

Two cases of axenfeld-rieger syndrome, report of the complex pathology and treatment.  

PubMed

The purpose of this case report is to report the orthodontic surgical treatment and subsequent dental rehabilitation in two patients with Axenfeld-Rieger syndrome. Axenfeld-Rieger syndrome is a rare autosomal dominant condition characterized by ocular, dental, craniofacial, and periumbilical abnormalities. The treatment of two patients with various anomalies in Axenfeld-Rieger syndrome is described and discussed. Early recognition of the syndrome and referral during childhood to a specialized oral and maxillofacial surgery, special dental care, and orthodontic unit provide the optimal starting point for this complex treatment. PMID:23886080

Bender, Céline A; Koudstaal, Maarten J; van Elswijk, Josephine F A; Prahl, Charlotte; Wolvius, Eppo B

2014-05-01

52

Complex treatment of trophic affections with vascular patients using monochromatic red light and hyperbaric oxygenation  

NASA Astrophysics Data System (ADS)

Monochromatic red light irradiation therapy of trophic skin affections with vascular patients permits to receive positive results with small wounds. A combination of monochromatic red light and hyperbaric oxygenation is most perspective when conducting a complex therapy of trophic wounds not more than 40 mm2 and allows to diminish time of treatment almost two times.

Babkina, Zinaida M.; Vasilyev, Mikhail V.; Zakharov, Vyacheslav P.; Nikolayev, Viktor V.; Babkin, Vasily I.; Samoday, Valery G.; Zon, Boris A.; Pakhomov, Gennady V.; Naskidashvili, Vasily I.; Kumin, Anatoly A.

1996-11-01

53

Anaerobic filter reactor performance for the treatment of complex dairy wastewater at industrial scale  

Microsoft Academic Search

The wastewaters discharged by raw milk quality control laboratories are more complex than the ones commonly generated by dairy factories because of the presence of certain chemicals such as sodium azide or chloramphenicol, which are used for preserving milk before analysis. The treatment of these effluents has been carried out in a full-scale plant comprising a 12m3 anaerobic filter (AF)

Francisco Omil; Juan M Garrido; Belén Arrojo; Ramón Méndez

2003-01-01

54

Identifying Novel Drug Targets for the Treatment of Tuberous Sclerosis Complex Using High Throughput Technologies.  

National Technical Information Service (NTIS)

In a patient with Tuberous Sclerosis Complex (TSC), the problematic cells that initiate and constitute tumors have lost TSC1 or TSC2 function. A promising approach for treatment would be to target members of the pathway with which TSC1/2 proteins interact...

D. Sabatini

2006-01-01

55

Identifying Novel Drug Targets for the Treatment of Tuberous Sclerosis Complex Using High Throughput Technologies. Addendum.  

National Technical Information Service (NTIS)

In a patient with Tuberous Sclerosis Complex (TSC), the problematic cells that initiate and constitute tumors have lost TSC1 or TSC2 function. A promising approach for treatment would be to target members of the pathway with which TSC1/2 proteins interact...

D. Sabatini

2007-01-01

56

Tracing copper-thiomolybdate complexes in a prospective treatment for Wilson's disease.  

PubMed

Wilson's disease is a human genetic disorder which results in copper accumulation in liver and brain. Treatments such as copper chelation therapy or dietary supplementation with zinc can ameliorate the effects of the disease, but if left untreated, it results in hepatitis, neurological complications, and death. Tetrathiomolybdate (TTM) is a promising new treatment for Wilson's disease which has been demonstrated both in an animal model and in clinical trials. X-ray absorption spectroscopy suggests that TTM acts as a novel copper chelator, forming a complex with accumulated copper in liver. We have used X-ray absorption spectroscopy and X-ray fluorescence imaging to trace the molecular form and distribution of the complex in liver and kidney of an animal model of human Wilson's disease. Our work allows new insights into metabolism of the metal complex in the diseased state. PMID:19146437

Zhang, Limei; Lichtmannegger, Josef; Summer, Karl H; Webb, Samuel; Pickering, Ingrid J; George, Graham N

2009-02-10

57

Complex vulnerabilities as barriers to treatment for illicit drug users with high prevalence mental health co-morbidities  

Microsoft Academic Search

Background: Drug treatment clients are significantly more likely to remain in treatment if ancillary life issues and complex needs are addressed.Aim: to document and analyse the complex needs (‘complex vulnerabilities’) of people experiencing both problems with drug dependence and common mental health problems, with a particular focus on barriers and incentives to drug treatment.Method: A qualitative interview-based study of 77

Carla Treloar; Martin Holt

2008-01-01

58

[Application of nootropic agents in complex treatment of patients with concussion of the brain].  

PubMed

65 patients with a mild craniocereberal trauma have been observed. Medical examination included among general clinical methods the following methods: KT (MRT) of the brain, oculist examination including the observation of eye fundus. For objectification of a patient' complaints the authors used orientation and Galvestona's amnesia tests, feeling scale (psychological test), the table to determine the level of memory. Tests have been carried out on the first, tenth and thirty day of the treatment. Patients of the first group received in a complex treatment -pramistar, patients of the second group - piracetam. Patients of both groups noted considerable improvement during a complex treatment (disappearance of headache, dizziness and nausea) and at the same time patients receiving pramistar had better restoration of orientation and feeling. Pramistar was also more effective in patients with amnesia. PMID:18418926

Tkachev, A V

2007-01-01

59

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

PubMed

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

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

2005-04-01

60

Orthodontic Treatment Need and Complexity among Nigerian Adolescents in Rivers State, Nigeria.  

PubMed

Introduction. The assessment of orthodontic treatment need and complexity are necessary for informed planning of orthodontic services. The aim of this cross-sectional study was to assess these parameters using the Index of Complexity, Outcome, and Need (ICON) in a Nigerian adolescent population in a region where orthodontic services are just being established. Methods. Six hundred and twelve randomly selected Nigerian adolescents aged 12 to 18 years were examined using the ICON in their school compounds. Descriptive statistics were employed in the data analysis. Results. Out of a total of 38.1% of the population found to need orthodontic treatment, there were more males and older adolescents. The overall mean ICON score for the population was 39.7 ± 25.3 SD with males having statistically higher mean ICON score. The grades of complexity of the population were 21.6% for very difficult and difficult, 7.5% moderate, and 70.9% mild/easy. Conclusions. Although just over a third of the adolescents were found to have a need for treatment, about a quarter of them were found to have difficult and very difficult complexity grades indicating a need for specialist care. The authors recommend the training of more specialist orthodontists in this region. PMID:22121361

Aikins, Elfleda Angelina; Dacosta, Oluranti Olatokunbo; Onyeaso, Chukwudi Ochi; Isiekwe, Michael Chukwudi

2011-01-01

61

[Neurosurgical aspects in the treatment of children with tuberous sclerosis complex].  

PubMed

Tuberous sclerosis complex (TSC) is a genetic syndrome, characterized by seizures, mental retardation, and a typical facial rash. Many patients have early onset seizures (usually during infancy) which are refractory to medical treatment. It has been shown that the neurocognitive decline in TSC patients is associated with the severity of seizures. The cerebral pathologies in TSC include - tubers (associated with seizures), benign tumors (subependymal giant cell astrocytomas - SEGAs), and intraventricular subependymal nodules (SENs). Until recent years, TSC patients with refractory seizures were only rarely considered to be suitable for epilepsy surgery. Over the past few years, several pre-surgical and surgical techniques have enabled patients to undergo epilepsy surgery with a high rate of seizure control. These techniques include invasive monitoring, mapping and resection of epileptogenic foci. The overall seizure outcome is around 75% seizure freedom. Additionally, benign brain tumors unique for TSC (SEGAs) present a treatment challenge. These tumors are typically located adjacent to the foramen of Monro. Without treatment the tumors may obstruct the CSF pathways leading to hydrocephalus. Current treatment options include surgical approaches, as well as medical treatment with mTOR inhibitors. The combination of medical and surgical treatments may decrease morbidity especially in partially resected tumors, multifocal tumors, or as neoadjuvant treatment in selected cases. In the current paper we review the neurosurgical aspects in the treatment of patients with TSC. PMID:24605407

Roth, Jonathan; Fried, Itzhak; Constantini, Shlomi

2014-01-01

62

Variables related to surgical and nonsurgical treatment of zygomatic complex fracture.  

PubMed

The aim of this retrospective research was to establish the association between variables for the surgical treatment of zygomatic complex (ZC) fractures. In a 10-year period, 532 patients were examined for ZC fractures. The medical records of patients were analyzed to obtain information related to sociodemographic characteristics, trauma etiology, sign and symptoms of patients, and surgical or nonsurgical treatment. Statistical analysis was performed using ? test with statistical significance of P < 0.05. Most fractures were sustained by subjects between 21 and 40 years of age (55.8%), being principally men (80.1%), and 153 patients underwent surgery (28.8%). Surgical treatment of ZC fractures was statistically associated to the presence of other facial fractures (P = 0.004), alteration of occlusion (P = 0.0001; probably due to jaw fractures), presence of the comminuted fractures (P = 0.0002), and infraorbital nerve sensory disturbances (P = 0.003). A mixture of complex variables can be associated to surgical treatment; however, variables as comminuted fracture and alteration of occlusion were associated to surgical treatment indications. PMID:21772219

Olate, Sergio; Lima, Sergio Monteiro; Sawazaki, Renato; Moreira, Roger William Fernandez; de Moraes, Márcio

2011-07-01

63

Treatment Complexities of a Young Woman Suffering Psychosis and Pituitary Adenoma  

PubMed Central

This paper is a clinical description of the presentation, therapy, and pharmacological management of a 28-year-old woman who had nine admissions to a psychiatry ward, the last four within one year. It became clear that the treatments, which the patient had received concurrently for ten years for a pituitary adenoma and for psychotic symptoms, were counteractive. The case highlights the importance of the role of prolactin in psychosis and of an interdisciplinary team approach when patients present with complex symptoms.

Sigman, Maxine; Drury, Kate

2011-01-01

64

The operative treatment of complex pilon fractures: A strategy of soft tissue control  

PubMed Central

Background: Pilon fractures are challenging to manage because of the complexity of the injury pattern and the risk of significant complications. The soft tissue injury and handling of the soft tissue envelope are crucial in pilon fracture outcomes. The purpose of this study was to evaluate the early rate of complications using the strategy of “soft tissue control” for operative treatment of complex pilon fractures. Materials and Methods: 36 complex pilon fractures were treated with the “soft tissue control” strategy. Patients followed the standard staged protocol, anterolateral approach to the distal tibia, the “no-touch” technique and incisional negative pressure wound therapy for pilon fractures. Patients were examined clinically at 2-3 weeks and then 8 weeks for complications associated with the surgical technique. Results: All fractures were AO/OTA (Orthopaedic Trauma Association) type C fractures (61% C3, 22% C2 and 16% C1). Only one patient developed superficial infection and resolved with antibiotics and local wound care. None developed deep infection. Conclusions: The strategy of soft tissue control for treatment of pilon fractures resulted in relatively low incidence of early wound complications in patients with complex pilon fractures.

He, Xianfeng; Hu, Yong; Ye, Penghan; Huang, Lei; Zhang, Feng; Ruan, Yongping

2013-01-01

65

Application of ferrate(VI) in the treatment of industrial wastes containing metal-complexed cyanides : a green treatment.  

PubMed

Ferrate(VI) was employed for the oxidation of cyanide (CN) and simultaneous removal of copper or nickel in the mixed/complexed systems of CN-Cu, CN-Ni, or CN-Cu-Ni. The degradation of CN (1.00 mmol/L) and removal of Cu (0.095 mmol/L) were investigated as a function of Fe(VI) doses from 0.3-2.00 mmol/L at pH 10.0. It was found that Fe(VI) could readily oxidize CN and the reduction of Fe(VI) into Fe(III) might serve efficiently for the removal of free copper ions. The increase in Fe(VI) dose apparently favoured the CN oxidation as well as Cu removal. Moreover, the pH dependence study (pH 10.0-13.0) revealed that the oxidation of CN was almost unaffected in the studied pH range (10.0-13.0), however, the maximum removal efficiency of Cu was obtained at pH 13.0. Similarly, treatment was carried out for CN-Ni system having the initial Ni concentration of 0.170 mmol/L and CN concentration of 1.00 mmol with Fe(VI) dose 2.00 mmol at various pH values (10.0-12.0). Results showed a partial oxidation of CN and partial removal of Ni. It can be observed that Fe(VI) can partially degrade the CN-Ni complex in this pH range. Further, Fe(VI) was applied for the treatment of simulated industrial waste/effluent waters treatment containing CN, Cu, and Ni. PMID:19999988

Lee, Seung-Mok; Tiwari, Diwakar

2009-01-01

66

Treatment of Refractory Mycobacterium avium Complex Lung Disease with a Moxifloxacin-Containing Regimen  

PubMed Central

Moxifloxacin (MXF) has in vitro and in vivo activity against Mycobacterium avium complex (MAC) in experimental models. However, no data are available concerning its treatment effect in patients with MAC lung disease. The aim of this study was to evaluate the clinical efficacy of an MXF-containing regimen for the treatment of refractory MAC lung disease. Patients with MAC lung disease who were diagnosed between January 2002 and December 2011 were identified from our hospital database. We identified 41 patients who received MXF for ?4 weeks for the treatment of refractory MAC lung disease. A total of 41 patients were treated with an MXF-containing regimen because of a persistent positive culture after at least 6 months of clarithromycin-based standardized antibiotic therapy. The median duration of antibiotic therapy before MXF administration was 410 days (interquartile range [IQR], 324 to 683 days). All patients had culture-positive sputum when MXF treatment was initiated. The median duration of MXF administration was 332 days (IQR, 146 to 547 days). The overall treatment success rate was 29% (12/41), and the median time to sputum conversion was 91 days (IQR, 45 to 190 days). A positive sputum acid-fast-bacillus smear at the start of treatment with MXF-containing regimens was an independent predictor of an unfavorable microbiological response. Our results indicate that MXF may improve treatment outcomes in about one-third of patients with persistently culture-positive MAC lung disease who fail to respond to clarithromycin-based standardized antibiotic treatment. Prospective studies are required to assess the clinical efficacy of MXF treatment for refractory MAC lung disease.

Hong, Goohyeon; Kim, Su-Young; Jeong, Byeong-Ho; Park, Hye Yun; Jeon, Kyeongman; Kwon, O Jung; Lee, Seung-Heon; Kim, Chang Ki; Shin, Sung Jae

2013-01-01

67

[Reflexotherapy combined with cortexin in the complex treatment of speech disorders in patients with cerebral palsy].  

PubMed

Authors studied 78 outpatients with children cerebral palsy, aged from 2 to 7 years, in the children department of neurology and reflexotherapy. All children had speech disorders of different severity: from a severe mental-speech deficit to muscle asinergia of the speech apparatus. Combined microcurrent reflexotherapy (MCRT) in the author's technique and the neuroprotector cortexin were used for treatment. The main group included 40 patients who received the treatment of MCRT in the combination with cortexin, the comparison group consisted of 38 patients who received only MCRT. MCRT consisted of 15 sessions with one month interval after the first treatment and two months after the second one. The treatment with cortexin included sessions of 10 injections each after the end of the first and the third MCRT sessions. Patient state was measured at baseline and at the end of 6 month treatment program. An analysis of results of the complex treatment demonstrated its high efficacy in the recovery of speech functions in children with cerebral palsy compared to patients of the comparison group. PMID:21946134

Ukhanova, T A; Gorbunov, F E; Ivanova, V V

2011-01-01

68

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

PubMed

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

Maiese, Kenneth

2014-05-01

69

Cutting through the Complexities of mTOR for the Treatment of Stroke  

PubMed Central

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.

Maiese, Kenneth

2014-01-01

70

Vigabatrin for partial-onset seizure treatment in patients with tuberous sclerosis complex.  

PubMed

Vigabatrin (VGB) has been shown to be particularly effective in the treatment of infantile spasms for those with tuberous sclerosis complex (TSC). However, many patients with TSC continue to have treatment-resistant seizures. For many patients with TSC, partial-onset seizures are prominent. Therefore, we examined the efficacy and tolerability of VGB for treatment of refractory partial-onset seizures. We performed a retrospective cohort study on 49 TSC patients with treatment-resistant seen at our center from 1997 to 2010, examined seizure outcomes, and reported adverse effects. We found that 13 (24.5%) patients became seizure-free or experienced a >90% decrease in seizure episode frequency with the addition of VGB to their regimens. Only one patient stopped VGB use because of excess sedation. The remaining 21 patients discontinued VGB use because of lack of efficacy. We conclude that VGB may be a safe and effective treatment in TSC patients with refractory partial-onset seizures. PMID:23399947

Friedman, Daniel; Bogner, Miles; Parker-Menzer, Kimberly; Devinsky, Orrin

2013-04-01

71

Ammonium chloride complex formation during downstream microwave ammonia plasma treatment of parylene-C  

NASA Astrophysics Data System (ADS)

In this work, parylene-C is exposed to the effluent from a microwave ammonia plasma with a goal of producing primary amine groups on the parylene-C. These amine groups are desired as sites for the attachment of various biomolecules that will influence the biocompatibility of the parylene-C. Ammonia plasma treatment is an effective approach for creating amine species on polymers. In this work, attenuated total reflectance infrared spectroscopy studies showed that no primary amine groups resulted from this treatment of parylene-C. Instead, reactive nitrogen-bearing radicals from the plasma appear to have been complexed by chlorine in the polymer. The formation of these complexes scavenged nitrogen-bearing radicals from the plasma and prevented the formation of nitrogenous species, such as the desired primary amines, on the parylene-C. These results are consistent with results of ammonia plasma treatment of other chlorinated polymers and suggest that alternative approaches are required to create nitrogen-bearing species on parylene-C.

Pruden, K. G.; Beaudoin, S. P.

2005-11-01

72

Treatment decisions for complex patients: differences between primary care physicians and mid-level providers  

PubMed Central

Background Few studies have examined differences in decision making for complex patients with multiple chronic conditions between physicians and mid-level providers. Objective To examine whether treatment change for diabetic patients presenting with an elevated blood pressure (BP) differed between physicians and mid-level providers [nurse practitioners (NPs) and physician assistants (PAs)] and, to determine reasons for any observed differences. Methods Analyses were part of a prospective cohort study of 1169 diabetic patients with scheduled visits to 92 primary care providers (PCPs) in nine Midwest VA facilities presenting with a triage BP of >=140/90. We analyzed probabilities of treatment change by provider type. Results Among the PCPs, 64 were physicians, 21 were NPs, and 7 were PAs. Patients cared for by physicians and mid-level providers did not differ in their mean visit BP, number of chronic conditions, age or number of BP medications. Controlling for current and past BPs and patient characteristics, physicians were significantly more likely than mid-level providers to initiate a treatment change at a visit for an elevated BP (53.8% vs. 36.4%; p=0.001). After controlling for additional visit specific factors, provider practice style, measurement and organizational factors, physicians were still more likely to initiate a treatment change for elevated BP at a visit (52.5% vs. 37.5%; p=0.02). Conclusions Mid-level providers were significantly less likely than physicians to change BP treatment for diabetic patients with multiple chronic conditions presenting with elevated BP at a single visit. We could not find good explanations for this difference despite examining a broad array of potential explanatory variables: factors relating to the complexity of the patient, the time available for visits, or attitudes about BP targets and prioritization of BP. Given the expanding role of mid-level providers in delivering primary care to complex patients, we need to understand whether these treatment change differences lead to long term differences in BP control.

Subramanian, Usha; Kerr, Eve A; Klamerus, Mandi; Zikmund-Fisher, Brian J.; Holleman, Robert; Hofer, Timothy P.

2013-01-01

73

Comparison of daunorubicin and daunorubicin-DNA complex in the treatment of acute nonlymphoblastic leukemia  

Microsoft Academic Search

Sixty consecutive patients, 15–60 years old, with ANLL were divided randomly into three groups for induction treatment with one of the following regimens: R1, daunorubicin (DNR) 1.5 mg\\/kg on day 1+ARA-C 2 mg\\/kg body weight on days 1–5; R2, DNR 1.5 mg\\/kg on days 1 and 2+ARA-C 2 mg\\/kg on days 4–8; R3, DNR-DNA complex 1.5 mg\\/kg on days 1

Christer Paul; Magnus Björkholm; Inga Christenson; Lars Engstedt; Gösta Gahrton; Robert Hast; Göran Holm; Andreas Iillander; Bo Lantz; Dieter Lockner; Berit Lönnqvist; Håkan Mellstedt; Jan Palmblad; Curt Peterson; Bengt Simonsson; Ann-Marie Stalfelt; Ann-Mari Udén; Bengt Wadman; Gunnar Öberg

1981-01-01

74

Treatment of the Atrophic Upper Jaw: Rehabilitation of Two Complex Cases  

PubMed Central

In reconstructive surgery, the fresh frozen homologous bone (FFB) represents a valid alternative to the autologous bone, because FFB allows bone regeneration thanks to its osteoinductive and osteoconductive properties. The purpose of this work is to describe the surgical-implant-prosthetic treatment of two complex cases using FFB. In particular, fresh frozen homologous bone grafts were used to correct the severe atrophy of the maxilla, and, then, once the graft integration was obtained, implant therapy was performed and implants placed in native bone were immediately loaded.

Borgonovo, Andrea Enrico; Marchetti, Andrea; Vavassori, Virna; Censi, Rachele; Boninsegna, Ramon

2013-01-01

75

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

PubMed Central

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.

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

2011-01-01

76

Melarsoprol Cyclodextrin Inclusion Complexes as Promising Oral Candidates for the Treatment of Human African Trypanosomiasis  

PubMed Central

Human African trypanosomiasis (HAT), or sleeping sickness, results from infection with the protozoan parasites Trypanosoma brucei (T.b.) gambiense or T.b.rhodesiense and is invariably fatal if untreated. There are 60 million people at risk from the disease throughout sub-Saharan Africa. The infection progresses from the haemolymphatic stage where parasites invade the blood, lymphatics and peripheral organs, to the late encephalitic stage where they enter the central nervous system (CNS) to cause serious neurological disease. The trivalent arsenical drug melarsoprol (Arsobal) is the only currently available treatment for CNS-stage T.b.rhodesiense infection. However, it must be administered intravenously due to the presence of propylene glycol solvent and is associated with numerous adverse reactions. A severe post-treatment reactive encephalopathy occurs in about 10% of treated patients, half of whom die. Thus melarsoprol kills 5% of all patients receiving it. Cyclodextrins have been used to improve the solubility and reduce the toxicity of a wide variety of drugs. We therefore investigated two melarsoprol cyclodextrin inclusion complexes; melarsoprol hydroxypropyl-?-cyclodextrin and melarsoprol randomly-methylated-?-cyclodextrin. We found that these compounds retain trypanocidal properties in vitro and cure CNS-stage murine infections when delivered orally, once per day for 7-days, at a dosage of 0.05 mmol/kg. No overt signs of toxicity were detected. Parasite load within the brain was rapidly reduced following treatment onset and magnetic resonance imaging showed restoration of normal blood-brain barrier integrity on completion of chemotherapy. These findings strongly suggest that complexed melarsoprol could be employed as an oral treatment for CNS-stage HAT, delivering considerable improvements over current parenteral chemotherapy.

Gibaud, Stephane; Bradley, Barbara; McCabe, Christopher; Barrett, Michael P.; Gettinby, George; Kennedy, Peter G. E.

2011-01-01

77

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

PubMed Central

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.

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

2014-01-01

78

Modeling the complexity of post-treatment drinking: it's a rocky road to relapse.  

PubMed

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

Witkiewitz, Katie; Marlatt, G Alan

2007-07-01

79

[Complex treatment of a large radicular cyst due to traumatic dental injury--a case report].  

PubMed

A 28-year-old male came to the clinic for control visit and scaling. Panoramic radiograph was taken before any treatment. The radiograph revealed a large size periapical lesion extending from the lower right first premolar to the lower left canine. History of dental trauma in childhood was recorded. The asymptomatic, injured teeth were not treated by dentist. Upon clinical examination a discolored lower right central incisor and more teeth with pulpal necrosis were found. After the endodontic treatments a cystostomy was performed. Obturator was used by the patient in the healing period. The success of complex treatment is proven by the highly recovered bone forming shown during the regular recalls. For the correct diagnosis and planning of the complete treatment dentist should be careful on general- and dental anamnesis and complete clinical and radiographic examination. Small clinical signs and pathoses should alert the dentist. This case is a reminder that the careful anamnesis, clinical examination and early diagnosis of any pathosis are very important. PMID:24812750

Demeter, Andrea; Bogdán, Sándor; Tóth, Zsuzsanna; Nemes, Júlia

2014-03-01

80

Esthetic orthodontic treatment using the invisalign appliance for moderate to complex malocclusions.  

PubMed

In this report, three patients were treated with a new treatment protocol for Invisalign to demonstrate that a variety of complex malocclusions can be successfully treated using this protocol, including correction of moderate crowding, correction of moderate Class II division 1, and deep overbite. Previous studies of Invisalign showed significant limitations for more complex orthodontic treatment, although a few recent case reports have shown successfully completed moderate to difficult orthodontic malocclusions. One reason for the discrepancy is that the earlier studies were done during the first four years of the appliance development (now ten years of clinical use), when significant problems existed with accomplishing bodily movement, torquing of roots, extrusions, and rotations of premolars and canines. The new protocol included new methods for anterior/posterior corrections, showing on the computer the effect of elastics for Class II treatment simulated as a one-stage anterior/posterior movement at the end of treatment. Staging for interproximal reduction (IPR) is now automatically staged when there is better access to interproximal contacts to avoid IPR where significant overlap between teeth is present to avoid performing IPR on surfaces that may be damaged by instruments such as burs, strips, and disks when cut on a sharp angle. Staging for tooth movements is now also done to enable combination movements to occur simultaneously for each tooth with the tooth that needs to move the most (the lead tooth) determining the minimum number of stages required. All other teeth move at a slower rate than the lead tooth throughout the duration of treatment. Attachments are now placed in the middle of the crown automatically for rotation and automatically sized in proportion to the clinical crown. Use of 1 mm thick (buccal-lingual dimension) horizontal beveled rectangular attachments is standard on premolars for retention of aligners during intrusive movements, such as leveling the lower curve of Spee in deep overbite for extrusions and for control of the tooth long axis during torquing movements. Staging of tooth movements now track linear and rotational velocities of teeth separately with the number of treatment stages determined by the lead tooth based on its rotational or linear maximum velocities at no more than two degrees of rotation per stage. Simultaneous movements are done for all teeth providing visible space (approximately 0.05 mm) between teeth during movements past other teeth using expansion instead of IPR as a primary way to increase space available for correction of crowding. PMID:18676803

Boyd, Robert L

2008-08-01

81

Clinical decision making in the treatment of complex PTSD and substance misuse.  

PubMed

Treating clients with complex posttraumatic stress disorder (PTSD) who also misuse substances presents a number of clinical challenges. The nature of complex PTSD is that we are faced with the far-reaching consequences of early and prolonged trauma on clients' lives, typically interfering with a host of emotional, relational, and functional capacities. Often substance misuse has become an offshoot of this experience, initially an "adaptive" response to unbearable circumstances, but over time exacerbating client dysfunction, at times leading to revictimization, and frequently culminating in a substance use disorder. Many clinicians feel overwhelmed in the face of this myriad of problems. This article provides an overview of some of the clinical choice points facing clinicians in this work: Where do we start? How do we proceed? What do we treat first? How do we handle a dysregulated client? The article attempts to provide some guidance about how to approach these multifaceted decisions, with an emphasis on attending to comorbidity, to assist clinicians in providing symptom-focused treatment for this complex population. PMID:23533007

Litt, Lisa

2013-05-01

82

Hyaluronate-gold nanoparticle/tocilizumab complex for the treatment of rheumatoid arthritis.  

PubMed

Rheumatoid arthritis (RA) is a chronic inflammatory immune disease causing the inflammation of synovial membrane and the articular cartilage destruction. In this work, hyaluronate-gold nanoparticle/Tocilizumab (HA-AuNP/TCZ) complex was prepared for the treatment of RA. AuNP was used as a drug carrier with antiangiogenic effect. TCZ is a humanized monoclonal antibody against the interleukin-6 (IL-6) receptor and used as an immunosuppressive drug by interfering IL-6 in the pathogenesis of RA. HA is known to have cartilage-protective and lubricant effects. HA was modified with cystamine via reductive amination, which was reduced with dithiothreitol (DTT) to prepare end-group thiolated HA (HA-SH). AuNP was chemically modified with HA-SH and physically modified with TCZ. The formation of HA-AuNP/TCZ complex was corroborated by UV-vis spectroscopy, dynamic light scattering (DLS), and transmission electron microscopy (TEM). The therapeutic effect of HA-AuNP/TCZ complex on RA was confirmed in collagen-induced arthritis (CIA) model mice by ELISA, histological, and Western blot analyses. PMID:24730974

Lee, Hwiwon; Lee, Min-Young; Bhang, Suk Ho; Kim, Byung-Soo; Kim, Yun Seop; Ju, Ji Hyeon; Kim, Ki Su; Hahn, Sei Kwang

2014-05-27

83

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

ERIC Educational Resources Information Center

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…

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

2005-01-01

84

Relationship between clinical efficacy of treatment of pulmonary Mycobacterium avium complex disease and drug-sensitivity testing of Mycobacterium avium complex isolates  

Microsoft Academic Search

We prospectively investigated the relationship between the clinical efficacy of treatment of pulmonary Mycobacterium avium complex (MAC) disease and drug-sensitivity testing of MAC isolates for antituberculous drugs, new quinolone antibiotics,\\u000a and clarithromycin (CAM). Fifty-two patients who satisfied the diagnostic criteria of the American Thoracic Society (ATS)\\u000a and who received treatment between April 1998 and December 2005, using combined therapy of

Yoshihiro Kobashi; Kouichiro Yoshida; Naoyuki Miyashita; Yoshihito Niki; Mikio Oka

2006-01-01

85

"Adiabatic-hindered-rotor" treatment of the parahydrogen-water complex.  

PubMed

Inspired by a recent successful adiabatic-hindered-rotor treatment for parahydrogen pH(2) in CO(2)-H(2) complexes [H. Li, P.-N. Roy, and R. J. Le Roy, J. Chem. Phys. 133, 104305 (2010); H. Li, R. J. Le Roy, P.-N. Roy, and A. R. W. McKellar, Phys. Rev. Lett. 105, 133401 (2010)], we apply the same approximation to the more challenging H(2)O-H(2) system. This approximation reduces the dimension of the H(2)O-H(2) potential from 5D to 3D and greatly enhances the computational efficiency. The global minimum of the original 5D potential is missing from the adiabatic 3D potential for reasons based on solution of the hindered-rotor Schro?dinger equation of the pH(2). Energies and wave functions of the discrete rovibrational levels of H(2)O-pH(2) complexes obtained from the adiabatic 3D potential are in good agreement with the results from calculations with the full 5D potential. This comparison validates our approximation, although it is a relatively cruder treatment for pH(2)-H(2)O than it is for pH(2)-CO(2). This adiabatic approximation makes large-scale simulations of H(2)O-pH(2) systems possible via a pairwise additive interaction model in which pH(2) is treated as a point-like particle. The poor performance of the diabatically spherical treatment of pH(2) rotation excludes the possibility of approximating pH(2) as a simple sphere in its interaction with H(2)O. PMID:21913760

Zeng, Tao; Li, Hui; Le Roy, Robert J; Roy, Pierre-Nicholas

2011-09-01

86

``Adiabatic-hindered-rotor'' treatment of the parahydrogen-water complex  

NASA Astrophysics Data System (ADS)

Inspired by a recent successful adiabatic-hindered-rotor treatment for parahydrogen pH2 in CO2-H2 complexes [H. Li, P.-N. Roy, and R. J. Le Roy, J. Chem. Phys. 133, 104305 (2010); H. Li, R. J. Le Roy, P.-N. Roy, and A. R. W. McKellar, Phys. Rev. Lett. 105, 133401 (2010)], we apply the same approximation to the more challenging H2O-H2 system. This approximation reduces the dimension of the H2O-H2 potential from 5D to 3D and greatly enhances the computational efficiency. The global minimum of the original 5D potential is missing from the adiabatic 3D potential for reasons based on solution of the hindered-rotor Schrödinger equation of the pH2. Energies and wave functions of the discrete rovibrational levels of H2O-pH2 complexes obtained from the adiabatic 3D potential are in good agreement with the results from calculations with the full 5D potential. This comparison validates our approximation, although it is a relatively cruder treatment for pH2-H2O than it is for pH2-CO2. This adiabatic approximation makes large-scale simulations of H2O-pH2 systems possible via a pairwise additive interaction model in which pH2 is treated as a point-like particle. The poor performance of the diabatically spherical treatment of pH2 rotation excludes the possibility of approximating pH2 as a simple sphere in its interaction with H2O.

Zeng, Tao; Li, Hui; Le Roy, Robert J.; Roy, Pierre-Nicholas

2011-09-01

87

Formation of hydrogel particles by thermal treatment of beta-lactoglobulin-chitosan complexes.  

PubMed

Molecular complexes based on proteins and ionic polysaccharides have considerable potential for encapsulation of functional food components, but their widespread utilization is limited because their structure is highly sensitive to pH and ionic strength. We have investigated the possibility of creating stable hydrogel particles by thermal treatment of protein (beta-lactoglobulin) and cationic polysaccharide (chitosan) mixtures. Mixed solutions of beta-lactoglobulin (0.5 wt %) and chitosan (0.1 wt %) were prepared at various pH's (3-8) and were heated (80 degrees C for 20 min). Prior to heating, the biopolymer mixtures formed molecular complexes at pH values where there was an electrostatic attraction between the protein and the polysaccharide: soluble complexes at pH 4.5; complex coacervates at pH 5.0 and 5.5; precipitates at pH>5.5. After heating, relatively small (d approximately 140 nm) and cationic (zeta>+20 mV) hydrogel particles were formed at pH 4.5, but much larger aggregates were formed at pH 5.0 and higher (d>1000 nm). The thermally treated hydrogel particles formed at pH 4.5 maintained their initial particle size when the pH was subsequently adjusted within the range pH 3-5, but they aggregated when the pH was adjusted to >pH 5 because of a reduction in the magnitude of their electrical charge. This study suggests that hydrogel particles can be formed by heating mixed protein-polysaccharide systems under controlled conditions. These hydrogel particles may be useful for encapsulation of functional food components. PMID:17567036

Hong, Youn-Ho; McClements, David Julian

2007-07-11

88

[Clinical effectiveness of probiotics in complex treatment of infants with cow's milk allergy].  

PubMed

6-8% of infants have food hypersensitivity or allergy that often manifest as atopic dermatitis. Formation of intestinal microbiocenosis is occurring during the same age range. There are some research data about the influence of probiotic on clinical course of atopic dermatitis. The aim of this study was to estimate the effect of Bifidobacterium lactis BB-12 (1 ? 10(9 0 CFU) and Streptococcus thermophilus TH-4 (1 ? 10(8) CFU) administration to infants with atopic dermatitis and cow's milk allergy. We conducted an open randomized prospective clinical study. 60 infants aged of 3-12 months with the diagnosis of atopic dermatitis and allergy to cow's milk protein were enrolled. Children were divided into 2 groups, one of that received probiotic during 4 weeks. Results were estimated with SCORAD scoring after 4 and 8 weeks of treatment. The difference in SCORAD scores between a visit 1 and a visit 3 in infants who in complex treatment received the probiotic strains was 44,05 (3,97) as compared with 38,94 (5,65) in the control group (?<0,05). As a result of our study it is possible to draw a conclusion that administration of probiotics to infants with atopic dermatitis and cow's milk allergy in addition to elimination diet and base treatment improves clinical symptoms of the disease. PMID:23567307

Ivakhnenko, O; Niankovskyy, S

2013-03-01

89

Complex Diagnostic and Treatment Issues in Psychotic Symptoms Associated with Narcolepsy  

PubMed Central

Narcolepsy is an uncommon chronic, neurological disorder characterized by abnormal manifestations of rapid eye movement sleep and perturbations in the sleep-wake cycle. Accurate diagnosis of psychotic symptoms in a person with narcolepsy could be difficult due to side effects of stimulant treatment (e.g., hallucinations) as well as primary symptoms of narcolepsy (e.g., sleep paralysis and hypnagogic and/or hypnapompic hallucinations). Pertinent articles from peer-reviewed journals were identified to help understand the complex phenomenology of psychotic symptoms in patients with narcolepsy. In this ensuing review and discussion, we present an overview of narcolepsy and outline diagnostic and management approaches for psychotic symptoms in patients with narcolepsy.

Ivanenko, Anna

2009-01-01

90

Treatment of complex infantile haemangioma in a resource-poor setting.  

PubMed

Infantile haemangiomas affect approximately 5% of the population and usually do not require treatment. However, complex cutaneous haemangiomas can cause disabling disfigurement, while haemangiomas in the brain, airway or gastrointestinal tract can cause life-threatening complications. Although children with infantile haemangiomas are often first brought to general practitioners and paediatricians by parents for care, they are thought of as a surgical problem and usually referred to specialty care. We present a case of an infant from a resource-poor setting in rural Indonesia with disfiguring facial haemangiomas, as well as a probable airway haemangioma causing stridor at rest. The infant was treated with oral propranolol with marked involution of the cutaneous haemangioma, resolution of stridor and increase in weight. PMID:25053694

Natawidjaja, Ronald; Wang, Ewen

2014-01-01

91

The use of TPA in combination with alcohol in the treatment of the recurrent complex hydrocele  

PubMed Central

A hydrocele is an abnormal collection of serous fluid in the space between the parietal and visceral layers of the tunica vaginalis. Hydrocele is the most common cause of painless scrotal swelling which affects about 1% of men. Generally, adult hydroceles are idiopathic in origin; however, inguinal surgery, varicocelectomy, infection, trauma and a patent processus vaginalis are each associated with the subsequent development of a hydrocele. Surgical removal of hydroceles is the gold standard of care. However, multiple cases have reported high success rates (ranging from 85% to 96%) using a combination of aspiration and sclerotherapy. We present a case of a patient with recurring complex hydrocele and effective treatment utilizing a combination of thrombolytic therapy, catheter drainage and subsequent alcohol ablation.

Metcalfe, Michael J.; Spouge, Rebecca J.; Spouge, David J.; Hoag, Chris C.

2014-01-01

92

[Vitamin B complex (milgamma) in the treatment of vertebrogenic lumbosacral radiculopathy].  

PubMed

An open controlled study of efficacy of the vitamin B complex (milgamma) has been performed in 38 patients with vertebrogenic lumbosacral radiculopathy suffered from moderate or severe pain during 1 month or longer. Patients have been randomized into 2 equal groups: in the main group milgamma has been prescribed in the combination with diclofenac; patients of the control group have received diclofenac only. Treatment efficacy has been assessed by clinical scales in the 10th and 24th days, and by the results of telephone interview after 3 and 6 months. A trend to higher efficacy of the treatment of the main group compared to that of the control group assessed with the Visual Analogue Scale was observed during all the study but the difference reached the level of statistical significance only to the 24th day. The assessment of qualitative characteristics of pain with the Neuropathic Pain Scale revealed decreasing of intensive, acute and sensitive pain only in patients of the main group. The moderate or substantial improvement was noted in 66% patients received the combination therapy and only in 34% patients received diclofenac. At the 3rd months, between-group differences were still significant (the pain was absent or minimal in 63% patients of the main group and 34% of the control one). The results revealed the potentiation of analgesic effect of diclofenac by the vitamin B complex. Using of milgamma in combination with NSAIDS leads to the rapid and long-standing regress of pain syndrome in patients with lumbosacral radiculopathy. PMID:20037567

Levin, O S; Mose?kin, I A

2009-01-01

93

Complex dural arteriovenous fistulas. Results of combined endovascular and neurosurgical treatment in 16 patients.  

PubMed

Of the 88 patients evaluated for symptomatic dural arteriovenous (AV) fistula over the past 8 years, 16 had large or complicated lesions that could not be treated with standard transvascular approaches or in which such treatment had been unsuccessful. Eleven fistulas were located in the transverse sinus, two in the cavernous sinus, two in the straight sinus, and one in the falx-tentorial region near the vein of Galen. The patients were treated with a combination of endovascular and neurosurgical techniques. Fourteen patients underwent preoperative transarterial embolization; this procedure closed the fistula in one patient. In the remaining 15 patients, surgery was performed to provide access to the fistula for embolization from either the venous or the arterial side, or for excision of the fistula. Transvenous embolization completely obliterated the fistula in seven of nine patients; the fistulas were embolized incompletely through the feeding arteries in two patients; and complete surgical resection of the lesion was accomplished in four patients. Complications related to venous occlusion occurred in two patients and one patient suffered communicating hydrocephalus that was effectively treated by shunting. There were no deaths. The results suggest that combined endovascular and neurosurgical techniques are a safe and effective means for the treatment of selected complex dural AV fistulas. PMID:2769386

Barnwell, S L; Halbach, V V; Higashida, R T; Hieshima, G; Wilson, C B

1989-09-01

94

Anaerobic filter reactor performance for the treatment of complex dairy wastewater at industrial scale.  

PubMed

The wastewaters discharged by raw milk quality control laboratories are more complex than the ones commonly generated by dairy factories because of the presence of certain chemicals such as sodium azide or chloramphenicol, which are used for preserving milk before analysis. The treatment of these effluents has been carried out in a full-scale plant comprising a 12 m(3) anaerobic filter (AF) reactor and a 28 m(3) sequential batch reactor (SBR). After more than 2 years of operation, a successful anaerobic treatment of these effluents was achieved, without fat removal prior to the anaerobic reactor. The organic loading rates maintained in the AF reactor were 5-6 kg COD/m(3) d, with COD removal being higher than 90%. No biomass washout was observed, and most of the fat contained in the wastewaters was successfully degraded. The addition of alkalinity is crucial for the maintenance of a proper buffer medium to ensure pH stability. The effluent of the AF reactor was successfully treated in the SBR reactor, and a final effluent with a COD content below 200 mg/l and total nitrogen below 10mg N/l was obtained. PMID:12946891

Omil, Francisco; Garrido, Juan M; Arrojo, Belén; Méndez, Ramón

2003-10-01

95

A new concept: the use of vanadium complexes in the treatment of diabetes mellitus.  

PubMed

In the 21st century, patients suffering from diabetes mellitus (DM), a lifestyle-related disease, will increase more than in the 20th century. DM is threatening because of the development of many severe secondary complications, including atherosclerosis, microangiopathy, renal dysfunction and failure, cardiac abnormalities, diabetic retinopathy, and ocular disorders. Generally, DM is classified as either insulin-dependent type 1 or noninsulin-dependent type 2 DM. Type 1 DM is treated only by daily insulin injections; type 2 DM is treated by several types of synthetic therapeutic substances together with a controlled diet and physical exercise. Even with these measures, the daily necessity for several insulin injections can be painful both physically and mentally, whereas the synthetic therapeutic substances used over the long term often have side effects. For those reasons, the creation and development of a new class of pharmaceuticals for treatment of DM in the 21st century would be extremely desirable. In the last half of the 20th century, investigations of the relationships among diseases and micronutrients, such as iron, copper, zinc, and selenium, have been numerous. Research into the development of metallopharmaceuticals involving the platinum-containing anticancer drug, cisplatin, and the gold-containing rheumatoid arthritis drug, auranofin, has also been widespread. Such important findings prompted us to develop therapeutic reagents based on a new concept to replace either insulin injections or the use of synthetic drugs. After many trials, we noticed that vanadium might be very useful in the treatment of DM. Before the discovery of insulin by Banting and Best in 1921 and its clinical trial for treating DM, the findings in 1899, in which orally administered sodium vanadate (NaVO(3)) was reported to improve human DM, gave us the idea to use vanadium to treat DM. However, it has taken a long time to obtain a scientific explanation as to why the metal ion exhibits insulin-mimetic or blood-glucose lowering effects in in vitro and in vivo experiments. After investigations from many perspectives involving biochemistry and bioinorganic chemistry, vanadyl sulfate (VOSO(4)) and its complexes with several types of ligands have been proposed as useful for treating DM in experimental diabetic animals. On the basis of a mechanistic study, this article reports on recent progress regarding the development of antidiabetic vanadyl complexes, emphasizing that the vanadyl ion and its complexes are effective not only in treating or relieving both types of DM but also in preventing the onset of DM. PMID:12203906

Sakurai, Hiromu

2002-01-01

96

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

Federal Register 2010, 2011, 2012, 2013

...Certain Complex Diagnostic Laboratory Tests Demonstration AGENCY: Centers for Medicare & Medicaid Services...Certain Complex Diagnostic Laboratory Tests Demonstration. The Demonstration is mandated by section 3113 of the...

2011-07-05

97

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

PubMed Central

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.

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

2011-01-01

98

Treatment of Atopic Dermatitis with a Combination of Allergen-Specific Immunotherapy and a Histamine-Immunoglobulin Complex  

Microsoft Academic Search

Background: Allergic responses to common environmental agents are believed to be involved in the development of atopic dermatitis, but clinical usefulness of allergen-specific immunotherapy in the treatment of atopic dermatitis is controversial. We performed a pilot study to evaluate the clinical usefulness of combined treatment with allergen-specific immunotherapy and a histamine-immunoglobulin complex in patients with atopic dermatitis. Methods: Twenty patients

Dong-Ho Nahm; Eun So Lee; Han-Jung Park; Hyoun-Ah Kim; Gil-Soon Choi; Sook-Yeong Jeon

2008-01-01

99

A Novel Technique for Detecting Instability of the Distal Radioulnar Joint in Complete Triangular Fibrocartilage Complex Lesions  

PubMed Central

We performed this study to investigate whether discrepancy of bilateral dorsovolar shift of the distal radioulnar joint (DRUJ) is decisive for the diagnosis of DRUJ instability. Although several cadaver studies have quantified the amount of physiological dorsovolar shift, so far, there is no reliable method of quantification of DRUJ mobility in daily practice. The aim was to describe a novel sonographic method of quantifying DRUJ instability and evaluate its reliability and validity. In this study, 40 healthy volunteers and 17 patients with complete rupture of the triangular fibrocartilage complex (TFCC) underwent sonographic quantification of the grade of instability of their DRUJ bilaterally. Dorsovolar ulnar head translation relative to the distal radius was quantified by means of ultrasonography performed in a transversal plane through the ulnar head and Lister tubercle. Measurements were done while actively pressing the volar surface of the hand onto a brick 30 degrees pronated, and after lifting the hand. A quotient Q of the radioulnar distance (distance between the dorsal radius surface and the ulnar head) between the unloaded and loaded wrist was calculated for differentiation of a normal and unstable DRUJ. The Q ratio of the 17 patients with unilateral TFCC lesion was significantly different between the pathologic side and the contralateral wrist (1.19 vs. 0.54, p??0.8 was found to be a reasonable cut-off for pathologic laxity of the DRUJ with a sensitivity of 88% and a specificity of 81%. A quotient Q >?0.8 determines instability of the DRUJ reliably. This was a level II diagnostic study.

Hess, Florian; Farshad, Mazda; Sutter, Reto; Nagy, Ladislav; Schweizer, Andreas

2012-01-01

100

A novel technique for detecting instability of the distal radioulnar joint in complete triangular fibrocartilage complex lesions.  

PubMed

We performed this study to investigate whether discrepancy of bilateral dorsovolar shift of the distal radioulnar joint (DRUJ) is decisive for the diagnosis of DRUJ instability. Although several cadaver studies have quantified the amount of physiological dorsovolar shift, so far, there is no reliable method of quantification of DRUJ mobility in daily practice. The aim was to describe a novel sonographic method of quantifying DRUJ instability and evaluate its reliability and validity. In this study, 40 healthy volunteers and 17 patients with complete rupture of the triangular fibrocartilage complex (TFCC) underwent sonographic quantification of the grade of instability of their DRUJ bilaterally. Dorsovolar ulnar head translation relative to the distal radius was quantified by means of ultrasonography performed in a transversal plane through the ulnar head and Lister tubercle. Measurements were done while actively pressing the volar surface of the hand onto a brick 30 degrees pronated, and after lifting the hand. A quotient Q of the radioulnar distance (distance between the dorsal radius surface and the ulnar head) between the unloaded and loaded wrist was calculated for differentiation of a normal and unstable DRUJ. The Q ratio of the 17 patients with unilateral TFCC lesion was significantly different between the pathologic side and the contralateral wrist (1.19 vs. 0.54, p??0.8 was found to be a reasonable cut-off for pathologic laxity of the DRUJ with a sensitivity of 88% and a specificity of 81%. A quotient Q >?0.8 determines instability of the DRUJ reliably. This was a level II diagnostic study. PMID:24179720

Hess, Florian; Farshad, Mazda; Sutter, Reto; Nagy, Ladislav; Schweizer, Andreas

2012-11-01

101

Performance of anaerobic hybrid reactors for the treatment of complex phenolic wastewaters with biogas recirculation.  

PubMed

This study investigates the application of a novel anaerobic hybrid reactor (AHR) configuration, incorporating support media for biomass immobilisation and biogas recirculation for improved mixing towards the anaerobic treatment of complex phenolic wastewater. Synthetic coal wastewater with an average phenolics and COD concentration of 752 and 2240 mg L(-1) was used as substrate. Biogas recirculation was employed at four different rates of 11.25, 16.87, 25.30 and 37.95 L d(-1) for 100 days. Phenolics and COD removal improved with increase in biogas recirculation. After 120 days of continuous operation, the results revealed that a high amount (14.0 g VSS) of biomass was able to attach itself to the support medium. The investigated AHR configuration achieved phenolics and COD removal efficiencies of 95% and 92% respectively at a hydraulic retention time (HRT) of 0.33 d. The corresponding average methane production obtained in this study was 0.02 mol methane g(-1) COD. PMID:23232220

Ramakrishnan, Anushuya; Surampalli, Rao Y

2013-02-01

102

Azithromycin as Treatment for Disseminated Mycobacterium avium Complex in AIDS Patients  

PubMed Central

This multicenter, randomized, dose-ranging study was performed to determine the safety and efficacy of two different doses of azithromycin for treating disseminated Mycobacterium avium complex (MAC) in patients with AIDS. Eighty-eight AIDS patients with symptoms and blood cultures consistent with disseminated MAC were treated with 600 or 1,200 mg of azithromycin daily for 6 weeks; 62 patients completed the entire 6 weeks of study. Of note, this study was done prior to the time when combination antiretroviral or anti-MAC regimens were the standard of care. Over the 6-week study period, symptomatic improvement was noted in both dose groups. Microbiological responses were comparable, with mean decreases of 1.5 and 2.0 log CFU/ml in the high- and low-dose groups, respectively. Sterilization of blood cultures occurred in 54% of samples; patients with lower baseline colony counts were more likely to achieve culture negativity. Resistance developed in one patient. Gastrointestinal symptoms were the most common side effects and were more frequent in patients receiving 1,200 mg. Azithromycin is a useful alternative treatment for disseminated MAC infection in AIDS patients. Symptomatic improvement correlates with measurable decreases in mycobacterial load.

Koletar, Susan L.; Berry, Alison J.; Cynamon, Michael H.; Jacobson, Jeffrey; Currier, Judith S.; MacGregor, Rob Roy; Dunne, Michael W.; Williams, Debra J.

1999-01-01

103

76 FR 49491 - Medicare Program; Section 3113: The Treatment of Certain Complex Diagnostic Laboratory Tests...  

Federal Register 2010, 2011, 2012, 2013

...Complex Diagnostic Laboratory Tests Demonstration; Extension of the Deadline for Submission...Complex Diagnostic Laboratory Tests Demonstration. The deadline for submitting supporting...request a temporary code under the Demonstration, which ended on August 1,...

2011-08-10

104

Determination of Stability Constants of Cadmium-Glycine Complexes by a Unified Treatment for Potentiometric and Polarographic Data  

NASA Astrophysics Data System (ADS)

The cadmium(II)-glycine system was studied by the two experimental techniques, ion sensitive electrode (ISE) and differential pulse polarography (DPP), and the experimental data obtained were used by a unified mathematical treatment to calculate the complex stability constants. The combination of the two techniques is of many advantages as ISE can be performed at low [LT]:[MT] ratios and significantly higher [MT], whereas DPP could be used well at large [LT]:[MT] ratios and much smaller [MT]. This makes it possible to study a metal-ligand system in a relatively broader range of experimental conditions that, in turn, provides more information about the metal-ligand system of interest. Applying the unified mathematical treatment to the cadmium-glycine system, two new complexes MHL and ML2(OH) as well as three complexes ML, ML2 and ML3, reported in literatures, could be modeled and all their stability constants have been refined.

Zhang, Jian-min; Shi, Qiu-zhi

2006-04-01

105

Six-month outcomes of an integrated assertive community treatment team serving adults with complex behavioral health and housing needs.  

PubMed

Assertive community treatment (ACT) and integrated dual disorders treatment (IDDT) have individually proven effective for treatment of adults with complex behavioral health and housing needs. This study evaluated the effectiveness of an ACT team that delivered integrated care consistent with IDDT principles. Participants included 60 adults with a history of chronic homelessness and co-occurring mental health and substance use disorders. Measures assessing mental health, substance use, and residential stability were completed at intake to the program and then 6 months later. Participants reported statistically significant improvements in mental health symptomatology and residential stability over time, although there were no changes in substance use. Findings support the effectiveness of the intervention for improving mental health and housing stability among adults with complex behavioral health and housing needs. Fidelity data support the notion that multiple evidence-based interventions can be integrated while still maintaining adequate fidelity to individual components. PMID:24346225

Young, M Scott; Barrett, Blake; Engelhardt, Mark A; Moore, Kathleen A

2014-05-01

106

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

PubMed Central

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.

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

2012-01-01

107

Transdermal delivery of the in situ hydrogels of curcumin and its inclusion complexes of hydroxypropyl-?-cyclodextrin for melanoma treatment.  

PubMed

Curcumin (Cur) is a hydrophobic polyphenol with diverse pharmacological effects, especially for cancer treatment. However, its weak water solubility and stability was the major obstacle for the formulation research of Cur. The complexation of Cur and hydroxypropyl-?-cyclodextrin (HP-?-CD) was done by grinding. The increasing solubility of Cur was achieved due to complexation and the photochemical stability of Cur was improved. The inclusion of Cur could happen when two ends of Cur were embedded into the cavity of the HP-?-CD rings. The in situ hydrogels (ISGs) of Cur and its inclusion complexes were prepared using poloxamers 407 and 188 as the matrix. The extent of drug's in vitro release from the ISGs depended on the dissolution of drugs. Both of the ISGs had transdermal effect and cytotoxicity on B16-F10 cells. However, the effects of the ISGs containing Cur inclusion complexes were much higher than those of Cur ISGs because of the improved Cur solubility in the former. The cytotoxicity of Cur on melanoma cells was related to blocking of cellular proliferation in the G2/M stage followed by cellular apoptosis. The ISGs of Cur inclusion complexes are a promising formulation for melanoma treatment. PMID:24746691

Sun, Yunbo; Du, Lina; Liu, Yangpu; Li, Xin; Li, Miao; Jin, Yiguang; Qian, Xiaohong

2014-07-20

108

Wherefore the Oedipus Complex in Adolescence? Its Relevance, Evolution, and Appearance in Treatment  

Microsoft Academic Search

This article is a critique of the frequent and reflexive use of the Oedipus complex in clinical discussions as a constellation that refers specifically to experiences of young children. A more fluid concept of the Oedipus complex is described in which it is seen as a constellation of issues that derives from early childhood and recurs throughout development. The adolescent

Marsha H. Levy-Warren

2008-01-01

109

Use of inclusion complex of cyclodextrin with ambenonium to improve the treatment of anticholinesterase poisoning.  

PubMed

The complex of ambenonium with methyl-?-cyclodextrin injected intramuscularly to rats caused more pronounced inhibition of acetylcholinesterase in erythrocyte and brain than free drug. The use of this complex as part of combined therapy significantly reduces mortality in animals during experimental anticholinesterase poisoning in comparison with the controls. PMID:24130994

Yudin, M A; Ivanov, I M; Nikiforov, A S; Kornyukhina, T M; Tyunin, M A

2013-06-01

110

Topical Review: Intractable Seizures in Tuberous Sclerosis Complex: From Molecular Pathogenesis to the Rationale for Treatment  

Microsoft Academic Search

Tuberous sclerosis complex is a multisystem autosomal dominant genetic disorder resulting from mutations in one of two genes, TSC1 and TSC2. Pathologically, tuberous sclerosis complex is characterized by abnormal cellular differentiation and proliferation, as well as abnormal neuronal migration. Epilepsy occurs in about 90% of patients, with onset frequently in the first year of life. In a sizable proportion of

Paolo Curatolo; Roberta Bombardieri; Magda Verdecchia; Stefano Seri

2005-01-01

111

ENDOSCOPIC TREATMENT WITH DEXTRANOMER\\/HYALURONIC ACID FOR COMPLEX CASES OF VESICOURETERAL REFLUX  

Microsoft Academic Search

Purpose:The surgical correction of primary vesicoureteral reflux (VUR) is highly successful. This success decreases in more complex cases and often involves reoperation and increased morbidity. We present our experience with the use of subureteral injection of dextranomer\\/hyaluronic acid (Dx\\/HA) in complex cases of vesicoureteral reflux in which open surgery would have been indicated.

MARCOS PEREZ-BRAYFIELD; ANDREW J. KIRSCH; TERRY W. HENSLE; MARTIN A. KOYLE; PETER FURNESS; HAL C. SCHERZ

2004-01-01

112

Autologous fibrin glue in the treatment of rectovaginal and complex fistulas  

Microsoft Academic Search

This nonrandomized series reports the use of autologous fibrin glue to treat complex rectovaginal and anorectal fistulas. The use of an autologous source to prepare fibrin glue eliminates the risk of disease transmission. Ten patients, six women and four men, with complex fistulas were treated with autologous fibrin glue application. Five patients had rectovaginal fistulas; one of them had Crohn's

Michael E. Abel; Yanek S. Y. Chiu; Thomas R. Russell; Peter A. Volpe

1993-01-01

113

Application of ferrate(VI) in the treatment of industrial wastes containing metal-complexed cyanides: A green treatment  

Microsoft Academic Search

Ferrate(VI) was employed for the oxidation of cyanide (CN) and simultaneous removal of copper or nickel in the mixed\\/complexed systems of CN-Cu, CN-Ni, or CN-Cu-Ni. The degradation of CN (1.00 mmol\\/L) and removal of Cu (0.095 mmol\\/L) were investigated as a function of Fe(VI) doses from 0.3–2.00 mmol\\/L at pH 10.0. It was found that Fe(VI) could readily oxidize CN

Lee SEUNG-MOK; Tiwari DIWAKAR

2009-01-01

114

Treatment of vertigo with a homeopathic complex remedy compared with usual treatments: a meta-analysis of clinical trials.  

PubMed

The increasing interest in alternative medical practices has led to a number of controlled studies on herbal and homeopathic agents. This paper presents the results of a meta-analysis of four recent clinical trials evaluating the homeopathic preparation Vertigoheel (VH) compared with usual therapies (betahistine, Ginkgo biloba extract, dimenhydrinate) for vertigo in a total of 1388 patients. Two trials were observational studies and the other two were randomised double-blind controlled trials. The duration of treatment (6-8 weeks) and dosage were comparable in all studies. Treatments were evaluated for the variables "number of vertigo episodes", "intensity of episodes" and "duration of episodes". As the studies differed in the age of patients and in the baseline values of vertigo, the individual reductions of number, intensity and duration of episodes were adjusted on equal age and baseline values (total means). An analysis of variance (with studies as random effects) showed no relevant influence of studies on the adjusted reductions and no relevant interaction between studies and treatment effects. The meta-analysis of all four trials showed equivalent reductions with VH and with control treatment: mean reduction of the number of daily episodes 4.0 for VH and 3.9 for control (standard error 0.11 for both groups); mean reduction of the duration (on a scale 0-4) for VH 1.1 and for the control 1.0 (standard error 0.03 for both groups); mean reduction of the intensity (on a scale 0-4) for VH 1.18 and for the control 1.8 (standard error 0.03 for both groups). In the non-inferiority analysis from all trials, VH was non-inferior in all variables. The results show the applicability of meta-analyses on the data from studies with homeopathicdrugs and support the results from the individual studies indicating good efficacy and tolerability of VH in patients with vertigo. PMID:15727161

Schneider, Berthold; Klein, Peter; Weiser, Michael

2005-01-01

115

Predicting stabilizing treatment outcomes for complex posttraumatic stress disorder and dissociative identity disorder: an expertise-based prognostic model.  

PubMed

The purpose of this study was to develop an expertise-based prognostic model for the treatment of complex posttraumatic stress disorder (PTSD) and dissociative identity disorder (DID). We developed a survey in 2 rounds: In the first round we surveyed 42 experienced therapists (22 DID and 20 complex PTSD therapists), and in the second round we surveyed a subset of 22 of the 42 therapists (13 DID and 9 complex PTSD therapists). First, we drew on therapists' knowledge of prognostic factors for stabilization-oriented treatment of complex PTSD and DID. Second, therapists prioritized a list of prognostic factors by estimating the size of each variable's prognostic effect; we clustered these factors according to content and named the clusters. Next, concept mapping methodology and statistical analyses (including principal components analyses) were used to transform individual judgments into weighted group judgments for clusters of items. A prognostic model, based on consensually determined estimates of effect sizes, of 8 clusters containing 51 factors for both complex PTSD and DID was formed. It includes the clusters lack of motivation, lack of healthy relationships, lack of healthy therapeutic relationships, lack of other internal and external resources, serious Axis I comorbidity, serious Axis II comorbidity, poor attachment, and self-destruction. In addition, a set of 5 DID-specific items was constructed. The model is supportive of the current phase-oriented treatment model, emphasizing the strengthening of the therapeutic relationship and the patient's resources in the initial stabilization phase. Further research is needed to test the model's statistical and clinical validity. PMID:21240739

Baars, Erik W; van der Hart, Onno; Nijenhuis, Ellert R S; Chu, James A; Glas, Gerrit; Draijer, Nel

2011-01-01

116

Determination of Stability Constants of Cadmium-Glycine Complexes by a Unified Treatment for Potentiometric and Polarographic Data  

Microsoft Academic Search

The cadmium(II)-glycine system was studied by the two experimental techniques, ion sensitive electrode (ISE) and differential pulse polarography (DPP), and the experimental data obtained were used by a unified mathematical treatment to calculate the complex stability constants. The combination of the two techniques is of many advantages as ISE can be performed at low [LT]:[MT] ratios and significantly higher [MT],

Jian-min Zhang; Qiu-zhi Shi

2006-01-01

117

Modifying effect of organocobalt complexes on the tumour response to anticancer treatments.  

PubMed

A new type of agents are proposed for combined cancer therapy. They are organocobalt (III) chelates containing a sigma-bounded organyl group and a mixed tridentate ligand derived from a Schiff base. These complexes generate free radicals due to the action of protons in physiological ranges of pH and temperature, and hence are conceivably capable of selectively attacking a malignant neoplasm that is slightly acidic and can be made even more so by introducing some means intensifying glycolysis. An in vivo examination was performed using transplanted rat tumours (Guerin and Walker 256 carcinomas, Sarcoma 45). The modifying effect of one of these complexes on the tumour response to cis-DDP, radiation and/or local hyperthermia was tested by means of tumour growth delay assay and local tumour control. The potentiating effect of the complex was maximal when it was administered 60-90 minutes prior to other agents (cisDDP, X-irradiation heat). The enhancement ratio was found to be ca. 2.0-4.0 for cisDDP and 2.0 for radiation. In conclusion, in our tumour models, an increase of the antitumour effect was obtained for conventional antitumour agents when they were supplemented with organocobalt complex. It can be hypothesised that DNA in tumour cells may be considered to be the main target for organocobalt complexes. PMID:9413187

Osinsky, S P; Levitin, I Y; Bubnovskaya, L N; Ganusevich, I I; Tsikalova, M V; Istomin, Y P; Zhavrid, E A; Volpin, M E

1997-01-01

118

Single Transconjunctival Incision and Two-point Fixation for the Treatment of Noncomminuted Zygomatic Complex Fracture  

PubMed Central

The ultimate goal in treating zygomatic complex fracture is to obtain an accurate, stable reduction while minimizing external scars and functional deformity. The present authors present our experiences with a single transconjunctival incision and two-point (inferior orbital rim and frontozygomatic suture) fixation in 53 patients with zygomatic complex fracture which were not comminuted. All patients had transconjunctival approaches with lateral canthal extensions, and six out of 53 patients also had an additional small (about less than 2 cm) gingivobuccal incision to achieve an accurate reduction. There were 3 minor complications, and the overall esthetics and functional results were satisfactory with a long term follow-up. Our method has the following advantages in the reduction of zygomatic complex fracture; It leaves only an inconspicuous lateral canthal scar. In addition, it provides excellent simultaneous visualization of the inferior orbital rim and frontozygomatic suture area. Hence, two-point fixation through a single incision can be performed with a satisfactory stability.

Lee, Jung-Ho; Choi, Yoon-Seok; Oh, Deuk-Young; Rhie, Jong-Won; Han, Ki-Taik; Ahn, Sang-Tae

2006-01-01

119

Tuberous sclerosis complex, implication from a rare genetic disease to common cancer treatment  

PubMed Central

Tuberous sclerosis complex (TSC) is a relatively rare autosomal dominant disorder characterized by widespread benign tumor formation in a variety of organs. Mutations in either TSC1 or TSC2 tumor suppressor gene are responsible for TSC. The gene products of TSC1 and TSC2, also known as hamartin and tuberin, respectively, form a physical and functional complex and inhibit the mammalian target of rapamycin complex 1 (mTORC1) signaling. The mTORC1 pathway is an evolutionarily conserved growth promoting pathway. mTORC1 plays an essential role in a wide array of cellular processes including translation, transcription, trafficking and autophagy. In this review, we will discuss recent progresses in the TSC-mTOR field and their physiological functions and alterations of this pathway in pathophysiology.

Inoki, Ken; Guan, Kun-Liang

2009-01-01

120

I Kappa B Kinase Complex as a Target for the Treatment of Huntington's Disease.  

National Technical Information Service (NTIS)

The present invention provides methods and compositions for protecting cells from the toxicity of mutant huntingtin (Htt) protein and for treatment of Huntington's disease (HD). The methods generally involve administering to cells or a patient an effectiv...

A. Khoshnan P. H. Patterson

2005-01-01

121

3-D dose distributions for optimum radiation treatment planning of complex foods  

Microsoft Academic Search

To obtain satisfactory e-beam irradiation of fresh products a strict process control is required to ensure that the dose delivered to all parts of the treated product falls within some specified range. As a basis of a dosimetry technique, assessment of the exact geometry of fresh products in a 3-D configuration is needed. Obtaining a uniform dose in inherently complex

J. Kim; R. G. Moreira; Y. Huang; M. E. Castell-Perez

2007-01-01

122

Felodipine ?-cyclodextrin complex as an active core for time delayed chronotherapeutic treatment of hypertension.  

PubMed

The present research work deals with the development of a time delayed chronotherapeutic formulation of felodipine (FD) aimed at rapid drug release after a desired lag time in the management of hypertension. The developed system comprises a drug core embedded within a swellable layer and coated with an insoluble, water permeable polymeric system. FD cyclodextrin complex was used as an active core while ethyl cellulose was used as an effective coating layer. Dissolution studies of the complex revealed that there was a 3-fold increase in dissolution of the complex compared to plain FD. This dissolution enhancement and rapid drug release resulted from FD amorphisation, as confirmed by XRD, DSC and SEM studies. FTIR and ¹H NMR studies confirmed the complex formation between FD and cyclodextrin based on the observed hydrogen bond interactions. FD release was adequately adjusted by using a pH independent polymer, i.e., ethyl cellulose, along with dibutyl phthalate as plasticizer. Influence of formulation variables like polymer viscosity, plasticizer concentration, super disintegrant concentration in the swellable layer and percent coating weight gain was investigated to characterize the lag time. Upon permeation of water, the core tablet swelled, resulting in the rupture of the coating layer, followed by rapid drug release. The developed formulation of FD showed a lag time of 5-7 h, which is desirable for chronotherapeutic application. PMID:23470351

Pagar, Kunal P; Vavia, Pradeep R

2012-11-01

123

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

Microsoft Academic Search

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

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

2003-01-01

124

Efficient Treatment of Complex Geometries and Moving Bodies using Overlapping Grids  

Microsoft Academic Search

The overlapping grids method, also known as the Chimera method, is reviewed and discussed in the context of a methodology for the solution and analysis of flows around complex geometries and moving bodies. The overlapping grids method is a way of assembling multiple overlapping grids and treating them as a single grid that periodically update and exchange boundary information through

Joel Guerrero

125

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

ERIC Educational Resources Information Center

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…

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

1998-01-01

126

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

ERIC Educational Resources Information Center

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,…

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

2010-01-01

127

Geometric morphometric assessment of treatment effects of maxillary protraction combined with chin cup appliance on the maxillofacial complex.  

PubMed

The aim of this study was to investigate the treatment effects on the maxillofacial complex by maxillary protraction combined with chin cup therapy among growing children. An effective geometric morphometric assessment of cephalometric radiographs, using Procrustes analysis and thin-plate spline analysis, was applied to evaluate shape change in the craniofacial and midfacial configurations of a treated sample of 20 children with skeletal Class III malocclusion. This was compared with matched untreated skeletal Class III controls. Marked treatment induced change involved the maxilla and the mandible. Major deformation consisted of forward advancement of the maxillary complex with negligible rotation of the palatal plane and a forward direction of growth of the mandibular condyle associated with a restriction in sagittal advancement of the chin. Considerable dentoalveolar components contributed to the correction of anterior crossbite. Further detailed study of skeletofacial remodelling in response to maxillary protraction in other skeletal components, including the cranial base and the mandibular complex that contribute to Class III skeletal discrepancies, is warranted. PMID:16159349

Chang, H P; Lin, H C; Liu, P H; Chang, C H

2005-10-01

128

Time-dependent reduction of structural complexity of the buccal epithelial cell nuclei after treatment with silver nanoparticles.  

PubMed

Recent studies have suggested that silver nanoparticles (AgNPs) may affect cell DNA structure in in vitro conditions. In this paper, we present the results indicating that AgNPs change nuclear complexity properties in isolated human epithelial buccal cells in a time-dependent manner. Epithelial buccal cells were plated in special tissue culture chamber / slides and were kept at 37°C in an RPMI 1640 cell culture medium supplemented with L-glutamine. The cells were treated with colloidal silver nanoparticles suspended in RPMI 1640 medium at the concentration 15 mg L?¹. Digital micrographs of the cell nuclei in a sample of 30 cells were created at five different time steps: before the treatment (controls), immediately after the treatment, as well as 15 , 30 and 60 min after the treatment with AgNPs. For each nuclear structure, values of fractal dimension, lacunarity, circularity, as well as parameters of grey level co-occurrence matrix (GLCM) texture, were determined. The results indicate time-dependent reduction of structural complexity in the cell nuclei after the contact with AgNPs. These findings further suggest that AgNPs, at concentrations present in today's over-the-counter drug products, might have significant effects on the cell genetic material. PMID:24118045

Pantic, I; Paunovic, J; Perovic, M; Cattani, C; Pantic, S; Suzic, S; Nesic, D; Basta-Jovanovic, G

2013-12-01

129

Terminal ventriculostomy as an adjuvant treatment of complex syringomyelia: a case report and review of the literature.  

PubMed

Complex syringomyelia is multifactorial, and treatment strategies are highly individualized. In refractory cases, sectioning of the filum terminale, also known as terminal ventriculostomy, has been described as a potential adjuvant treatment to alleviate syrinx progression. A 10-year-old boy with a history of arachnoiditis presented with complex syringomyelia, progressive lower extremity motor weakness, and spasticity. Previously, he had failed spinal cord detethering and direct syrinx shunting. Imaging studies demonstrated a holocord syrinx extending to the level of his conus medullaris and into the filum terminale. The patient underwent an uncomplicated lumbar laminectomy and transection of the filum terminale. Operative pathologic specimens demonstrated a dilated central canal within the filum. Postoperative imaging demonstrated significant reduction in the diameter of the syrinx. At follow-up, the patient's motor symptoms had improved. Terminal ventriculostomy may be a useful adjuvant in treating caudally placed syringes refractory to other treatments. This procedure carries low neurological risk and involves no hardware implantation. In select cases, terminal ventriculostomy may help preserve neurological function in the face of otherwise progressive syringomyelia. PMID:21523358

Wilson, David A; Fusco, David J; Rekate, Harold L

2011-07-01

130

The complexity of ADHD: diagnosis and treatment of the adult patient with comorbidities.  

PubMed

Attention-deficit/hyperactivity disorder (ADHD) is an impairing but usually treatable condition. Popular culture propagates the myth that ADHD recedes with age; this is not the case. Although it is common, <20% of adults with ADHD are diagnosed or treated. Adults with ADHD show significant comorbidities with depressive disorders, anxiety disorders, substance use, oppositional defiant disorder, personality disorders, sleep problems, and learning disabilities. However, symptoms that result from ADHD, such as mood symptoms or lability, are often mistaken for comorbid disorders. Comorbidity with ADHD impacts treatment compliance, treatment response, and patient insight. Insufficient data on the interaction between ADHD and comorbidities impedes proper diagnosis and treatment. Better clinical tools for assessing these conditions are needed. Food and Drug Administration-approved pharmacologic treatments for adult ADHD include stimulants, dexmethylphenidate, and the nonstimulant atomoxetine. Effect sizes of approved medicines at approved doses are half those seen in children. Adults may also need longer duration of medication effects than children. Short-acting stimulants are likely to result in poorer adherence and have a higher risk for diversion or abuse. Risk of abuse is a major concern; stimulant treatments are controlled substances, and children with ADHD show increased risk of substance abuse. Psychosocial interventions may be beneficial in treating both ADHD and comorbidities.In this expert roundtable supplement, Margaret Weiss, MD, PhD, presents a comprehensive overview of complications surrounding differential diagnosis in adults with ADHD. Next, Mark A. Stein, PhD, reviews evaluation, comorbidity, and development of a treatment plan in this population. Finally, Jeffrey H. Newcorn, MD, provides a discussion on the pharmacologic options available for adults with ADHD, considering dosages specific to adults and common comorbidities. PMID:17667893

Newcorn, Jeffrey H; Weiss, Margaret; Stein, Mark A

2007-08-01

131

[Mexidol in the complex treatment of patients in the acute period of tick borne encephalitis].  

PubMed

Therapeutical action of mexidol as compared to piracetam was evaluated in groups of patients with tick borne encephalitis in the acute period of disease. Mexidol was administered as add-on to antiviral treatment in 72 patients while 89 patients received piracetam. The drugs were introduced intravenously during the first 10 days and then were given as tablets during 2 months. Based on these results, we can recommend the inclusion of mexidol in the pathogenetic treatment (fever symptoms) of tick born encephalitis. The use of mexidol as compared to piracetam led to more pronounced positive changes, higher percentage of favorable outcomes and lower frequency of residual signs. PMID:23096037

Udintseva, I N; Bartfel't, N N; Zhukova, N G; Poponina, A M

2012-01-01

132

Target specific systemic delivery of TGF-? siRNA/(PEI-SS)-g-HA complex for the treatment of liver cirrhosis.  

PubMed

A target specific systemic delivery system of siRNA therapeutics was successfully developed using reducible polyethyleneimine grafted hyaluronic acid [(PEI-SS)-g-HA] conjugates. The PEI-SS was synthesized by Michael addition of low molecular weight PEI (MW = 2000) with cystaminebisacrylamide (CBA), and grafted to carboxyl groups of HA via amide bond formation after activation with 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide (EDC) and 1-hydroxybenzotriazole monohydrate (HOBt). The confocal microscopic and fluorometric analyses confirmed the effective cellular uptake of siRNA/(PEI-SS)-g-HA complex by HA receptor mediated endocytosis. In vitro gene silencing efficiency was ca. 80% in the presence of 10 vol% serum and ca. 50% in the presence of 50 vol% serum in B16F1 melanoma cells and activated hepatic stellate cells (HSCs). Furthermore, target specific systemic delivery of apolipoprotein B (ApoB) siRNA/(PEI-SS)-g-HA complex resulted in a drastically reduced ApoB mRNA level down to ca. 20% in a dose-dependent manner. Finally, TGF-? siRNA/(PEI-SS)-g-HA complex showed a feasible therapeutic effect on liver cirrhosis with a significantly reduced nodule formation, collagen content, and HSC number. The siRNA/(PEI-SS)-g-HA complex can be exploited for the target specific systemic treatment of various liver diseases. PMID:21481451

Park, Kitae; Hong, Sung Woo; Hur, Wonhee; Lee, Min-Young; Yang, Jeong-A; Kim, Sung Woo; Yoon, Seung Kew; Hahn, Sei Kwang

2011-07-01

133

Surgical treatment of a dislocated intraocular lens-capsular bag-capsular tension ring complex.  

PubMed

We describe a surgical technique for managing late dislocation of an intraocular lens-capsular bag-capsular tension ring (IOL-CB-CTR) complex. Two 10-0 polypropylene sutures are placed transsclerally over and under the CTR through the anterior and posterior capsules to capture the CTR, which then is retracted and sutured through the sclera. The same maneuver is performed 180 degrees away. This simple, easy, effective procedure can be performed with a small corneal incision and does not require extraction of the IOL-CB complex. Although the CTR does not completely prevent IOL-CB dislocation, it provides the possibility of suturing the IOL-CB to the sulcus without replacing the IOL. PMID:15767145

Moreno-Montañés, Javier; Heras, Henar; Fernández-Hortelano, Ana

2005-02-01

134

Complex-basis-function treatment of photoionization in the random-phase approximation  

SciTech Connect

Complex-basis-function techniques are used to implement the equations of the random-phase approximation (RPA) in matrix form. This approach allows the direct extraction of total photoionization cross sections from a finite series of (complex) transition energies and oscillator strengths. The RPA is an effective means for including electron correlation effects on the photoionization of closed-shell atoms and molecules. The procedure demonstrated here provides a rigorous way of solving the RPA equations for continuum photoabsorption without resorting to numerical integration. The results of calculations on He and N/sub 2/ are presented. Correlation effects are found to significantly influence the threshold behavior of the N/sub 2/ photoionization cross sections.

Yabushita, S.; McCurdy, C.W.; Rescigno, T.N.

1987-10-01

135

Respirometric Evaluation of Strong Wastewater Activated Sludge Treatment for a Complex Chemical Industry  

Microsoft Academic Search

\\u000a This study deals with respirometric modeling of biodegradation of complex organic matter generated from a chemical industry.\\u000a Evaluation with a multi-degradation model indicated that organic matter in raw wastewater has four types of biodegradable\\u000a components having different biodegradation characteristics. The model evaluation of batch respirogram indicated that the acclimated\\u000a biomass exhibited a delayed response after the addition of raw wastewater

E. Ubay Cokgor; G. Insel; E. Aydin; S. Ozdemir; D. Orhon

136

Targeted treatments for cognitive and neurodevelopmental disorders in tuberous sclerosis complex  

Microsoft Academic Search

Summary  Until recently, the neuropsychiatric phenotype of tuberous sclerosis complex (TSC) was presumed to be caused by the structural\\u000a brain abnormalities and\\/or seizures seen in the disorder. However, advances in the molecular biology of the disorder have\\u000a shown that TSC is a mammalian target of rapamycin (mTOR) overactivation syndrome, and that direct molecular pathways exist\\u000a between gene mutation and cognitive\\/neurodevelopmental phenotype.

Petrus J. de Vries

2010-01-01

137

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

SciTech Connect

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.

Abashkin, Y.; Mele, F.; Russo, N.; Toscano, M. [Universita della Calabria, Arcavacata di Rende (Italy)

1994-12-31

138

Fibrin glue treatment of complex anal fistulas has low success rate  

Microsoft Academic Search

Purpose: Fibrin glue has been used to treat anal fistulas in an attempt to avoid more radical surgical intervention. Reported\\u000a success rates vary widely. The purpose of this study was to review the use of fibrin glue in the management of complex anal\\u000a fistulas at a tertiary referral center. Methods: This study was designed as a retrospective review of all

Rasmy Loungnarath; David W. Dietz; Matthew G. Mutch; Elisa H. Birnbaum; Ira J. Kodner; James W. Fleshman

2004-01-01

139

Relationship between clinical efficacy of treatment of pulmonary Mycobacterium avium complex disease and drug-sensitivity testing of Mycobacterium avium complex isolates.  

PubMed

We prospectively investigated the relationship between the clinical efficacy of treatment of pulmonary Mycobacterium avium complex (MAC) disease and drug-sensitivity testing of MAC isolates for antituberculous drugs, new quinolone antibiotics, and clarithromycin (CAM). Fifty-two patients who satisfied the diagnostic criteria of the American Thoracic Society (ATS) and who received treatment between April 1998 and December 2005, using combined therapy of rifampicin (RFP), ethambutol (EB), streptomycin (SM), and CAM, were enrolled in this study. The causative microorganisms isolated were Mycobacterium avium in 30 patients and M. intracellulare in 22 patients. Although separation of the two strains showed drug sensitivity testing to have slightly better minimal inhibitory concentrations (MIC) for M. intracellulare than for M. avium, there were no significant differences in the sputum eradication rate or clinical improvement between the two strains. The MICs of various antibiotics for the isolated MAC strains were as follows: RFP, 0.125-8 microg/ml; CAM, 0.25-16 microg/ml; SM, 2-128< or =microg/ml; EB, 128< or = microg/ml; levofloxacin (LVFX), 1-32 microg/ml; sparfloxacin (SPFX), 0.5-16 microg/ml; and gatifloxacin (GFLX), 0.25-8 microg/ml. The isolated MAC strains showed the same excellent drug sensitivity test results for RFP, new quinolones, and CAM, but they showed resistant drug-sensitivity results for EB and SM. Regarding the relationship between clinical efficacy and the MICs of RFP, EB, CAM, and SM, there was a good relationship only for CAM. Although the ATS has not yet recommended routine drug susceptibility testing of CAM, we believe that drug susceptibility testing of CAM should be performed before the initial treatment is undertaken for pulmonary MAC disease. PMID:16944258

Kobashi, Yoshihiro; Yoshida, Kouichiro; Miyashita, Naoyuki; Niki, Yoshihito; Oka, Mikio

2006-08-01

140

Quasi-analytical treatment of spatially averaged radiation transfer in complex terrain  

NASA Astrophysics Data System (ADS)

We provide a new quasi-analytical method to compute the subgrid topographic influences on the shortwave radiation fluxes and the effective albedo in complex terrain as required for large-scale meteorological, land surface, or climate models. We investigate radiative transfer in complex terrain via the radiosity equation on isotropic Gaussian random fields. Under controlled approximations we derive expressions for domain-averaged fluxes of direct, diffuse, and terrain radiation and the sky view factor. Domain-averaged quantities can be related to a type of level-crossing probability of the random field, which is approximated by long-standing results developed for acoustic scattering at ocean boundaries. This allows us to express all nonlocal horizon effects in terms of a local terrain parameter, namely, the mean-square slope. Emerging integrals are computed numerically, and fit formulas are given for practical purposes. As an implication of our approach, we provide an expression for the effective albedo of complex terrain in terms of the Sun elevation angle, mean-square slope, the area-averaged surface albedo, and the ratio of atmospheric direct beam to diffuse radiation. For demonstration we compute the decrease of the effective albedo relative to the area-averaged albedo in Switzerland for idealized snow-covered and clear-sky conditions at noon in winter. We find an average decrease of 5.8% and spatial patterns which originate from characteristics of the underlying relief. Limitations and possible generalizations of the method are discussed.

LöWe, H.; Helbig, N.

2012-10-01

141

Quasi-analytical treatment of spatially averaged radiation transfer in complex terrain  

NASA Astrophysics Data System (ADS)

We provide a new quasi-analytical method to compute the topographic influence on the effective albedo of complex topography as required for meteorological, land-surface or climate models. We investigate radiative transfer in complex terrain via the radiosity equation on isotropic Gaussian random fields. Under controlled approximations we derive expressions for domain averages of direct, diffuse and terrain radiation and the sky view factor. Domain averaged quantities are related to a type of level-crossing probability of the random field which is approximated by longstanding results developed for acoustic scattering at ocean boundaries. This allows us to express all non-local horizon effects in terms of a local terrain parameter, namely the mean squared slope. Emerging integrals are computed numerically and fit formulas are given for practical purposes. As an implication of our approach we provide an expression for the effective albedo of complex terrain in terms of the sun elevation angle, mean squared slope, the area averaged surface albedo, and the direct-to-diffuse ratio of solar radiation. As an application, we compute the effective albedo for the Swiss Alps and discuss possible generalizations of the method.

Löwe, H.; Helbig, N.

2012-04-01

142

Anoxic bio-electrochemical system for treatment of complex chemical wastewater with simultaneous bioelectricity generation.  

PubMed

Bioelectrochemical treatment system (BET) with anoxic anodic microenvironment was studied with chemical wastewater (CW) in comparison with anoxic treatment (AxT, sequencing batch reactor (SBR)) with same parent anaerobic consortia. BET system documented relatively higher treatment efficiency at higher organic load (5.0 kg COD/m(3)) accounting for COD removal efficiency of (90%) along with nitrate (48%), phosphate (51%), sulphates (68%), colour (63%) and turbidity (90%) removal, compared to AxT operation (COD, 47%; nitrate, 36%; phosphate, 32%; sulphate, 35%; colour, 45% and turbidity, 54%). The self-induced bio-potential developed due to the electrode assembly in BET resulted in effective treatment with simultaneous bioelectricity generation (631 mA/m(2)). AxT operation showed persistent reduction behaviour, while simultaneous redox behaviour was observed with BET indicating balanced electron transfer. BET operation illustrated higher wastewater toxicity reduction compared to the AxT system which documents the variation in bio-electrocatalytic behaviour of same consortia under different microenvironment. PMID:24240180

Velvizhi, G; Goud, R Kannaiah; Venkata Mohan, S

2014-01-01

143

Sodium ferric gluconate complex in the treatment ofiron deficiency for patients on dialysis  

Microsoft Academic Search

Intravenous iron has been found to be an important adjunctive therapy in the treatment of anemia for patients ondialysis. In the United States, iron dextran had been the only form available for parenteral use until 1999. This agent has been associated with a concerning number of severe adverse reactions, in some cases resulting In patients' deaths. Recently, a form of

Steven Fishbane; John Wagner

2001-01-01

144

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

ERIC Educational Resources Information Center

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…

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

145

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

PubMed Central

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.

Kiran, Swathi; Johnson, Lauren

2009-01-01

146

Ultrasonic bone surgery in the treatment of impacted lower third molar associated to a complex odontoma: a case report  

PubMed Central

Summary The removal of impacted mandibular third molar is a common surgical procedure entailing some risk of complications, especially when the tooth and the inferior alveolar nerve and/or lingual cortical plate are in close proximity. A technique that can reduce the possibility of damage is the Ultra Sonic Bone Surgery. The aim of this report is to present a paradigmatic case of an impacted mandibular third molar closely associated with a complex odontoma, which was treated with the Ultrasonic Bone Surgery (UBS) device. This technique appeared to be a valid alternative to manual or mechanical treatment, strongly minimizing trauma to the inferior alveolar nerve, vascular tissues, or surrounding dental tissues.

Cristalli, Maria Paola; La Monaca, Gerardo; Sgaramella, Nicola; Vozza, Iole

2012-01-01

147

[Our experience with the complex treatment of phlegmon of the lacrimal sac].  

PubMed

Eighty-nine patients with lacrimal sac phlegmons, 76 women and 13 men, aged 16 to 78, were administered multiple-modality treatment, consisting in Group 1 (43 patients) of traditional methods, such as UHF therapy, antibiotics, sulfonamides, symptomatic therapy, dacryocystorhinostomy after complete cessation of inflammation, and in group 2 (46 patients) including sessions of intermittent magnetic field (IMF) exposure, antibiotics, and early dacryocystorhinostomy. Sparing technique was used in all operations, carried out under local anesthesia with 2% procaine or trimecaine. IMF exposure was found to be an effective therapeutic means characterized by antiinflammatory, resolving, and analgesic effects. IMF sessions and early dacryocystorhinostomy enhance cessation of inflammation and improve the treatment efficacy: remote results of surgery were excellent in 80% of Group 1 patients and in 90.9% of Group 2 patients; As a results of IMF exposure, the terms of medical and social rehabilitation of patients with the lacrimal sac phlegmons were reduced twofold. PMID:1481321

Sultanov, M Iu; Iskenderov, G F; Tagi-zade, N S; Seidbekov, O S

1992-01-01

148

Metal complexes as photochemical nitric oxide precursors: potential applications in the treatment of tumors.  

PubMed

The bioregulatory molecule NO plays key roles in cancer biology and has been implicated in both tumor growth and suppression. Furthermore, it is a gamma-radiation sensitizer that may enhance selective killing of neoplastic tissues. For these reasons, there is considerable interest in developing methods for NO delivery to specific physiological targets. In this Perspective, we describe ongoing investigations focused on photochemical methodologies to deliver therapeutic doses of NO to such targets utilizing transition metal complexes that are nitric oxide precursors. The photochemical strategy has the advantages that it allows for precise control of the timing, location, and dosage for the targeted delivery of a bioactive agent. PMID:20023893

Ostrowski, Alexis D; Ford, Peter C

2009-12-28

149

[Effectiveness of complex containing antrale and tymohexine in the treatment of patients with chronic hepatitis].  

PubMed

The effectiveness of the combination of immunologically active tymohexine and antioxidant antrale was studied on 89 patients aged from 26 to 58 years with chronic viral or alcoholic hepatitis. The combination was found to have positive effect on the course of chronic hepatitis, immunological and biochemical indices. The following positive tendencies were observed: the rise in T-cell level, normalization of immunoregulatory index, decrease in activity of autoimmune, immune complex reactions, and lipid peroxidation, increase in activity of enzymes antioxidant system. PMID:16158720

Pinski?, L L; Belianski?, I I

2005-06-01

150

Ammonium chloride complex formation during downstream microwave ammonia plasma treatment of parylene-C  

Microsoft Academic Search

In this work, parylene-C is exposed to the effluent from a microwave ammonia plasma with a goal of producing primary amine groups on the parylene-C. These amine groups are desired as sites for the attachment of various biomolecules that will influence the biocompatibility of the parylene-C. Ammonia plasma treatment is an effective approach for creating amine species on polymers. In

S. P. Beaudoin; K. G. Pruden

2005-01-01

151

TREATMENT OF ALCOHOLIC POLYNEUROPATHY WITH VITAMIN B COMPLEX: A RANDOMISED CONTROLLED TRIAL  

Microsoft Academic Search

Aims: To evaluate the therapeutic efficacy and safety of BEFACTForte 'new formulation' and BEFACTForte 'old formulation' in the treatment of sensory symptoms of alcoholic polyneuropathy. Methods: A multi-centre, randomised, double- blind, placebo-controlled study was conducted on 325 patients with sensory symptoms and signs of alcoholic polyneuropathy. Patients were randomised to the 'old formulation' (i.e. vitamins B1 ,B 2 ,B 6,

T. J. PETERS; J. KOTOWICZ; W. NYKA; W. KOZUBSKI; V. KUZNETSOV; F. VANDERBIST; S. DE NIET; D. MARCEREUIL; M. COFFINER

2006-01-01

152

Treatment of complex regional pain syndrome type 1 in a pediatric patient using the lidocaine patch 5%: a case report?  

PubMed Central

Background Successful treatment of complex regional pain syndrome type 1 (CRPS-1) requires a coordinated, multidisciplinary approach. Physical rehabilitation is an important component of long-term treatment. Unfortunately, patients with significant allodynia or hyperalgesia characteristic of CRPS-1 often have difficulty progressing through a physical therapy (PT) regimen. In most adults with CRPS-1, the treatment of choice is PO opioids. Objective This article presents a case report of the use of the lidocaine patch 5%, a targeted peripheral analgesic, in a pediatric patient and its effects on reducing pain, improving the patient's overall attitude, and facilitating compliance with ongoing PT. Results A 10-year-old girl developed CRPS-1 after arthroscopic surgery for a sprained ankle. Attempts at PT were unsuccessful due to inadequate pain relief from various treatment modalities. Therapy with the lidocaine patch 5% was initiated and resulted in significant pain relief, improvements in the patient's attitude, and progress with PT. Conclusion This case report of a child with CRPS-1 showed that therapy with lidocaine patch 5% may be efficacious in treating children with pain resulting from CRPS-1, thereby increasing the success of PT.

Frost, Steven G

2003-01-01

153

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

PubMed Central

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).

Kiran, Swathi

2009-01-01

154

Combination treatment with atorvastatin plus niacin provides effective control of complex dyslipidemias: a literature review.  

PubMed

Patients with dyslipidemia receive a cardiovascular benefit from lowering low-density lipoprotein cholesterol (LDL-C). Atorvastatin is currently one of the most effective approved medications for lowering LDL-C, and has been shown to significantly reduce cardiovascular risk in many patient groups. However, even with substantial lowering of LDL-C with atorvastatin, patients still have a residual risk for coronary heart disease. Elevated triglyceride levels and low high-density lipoprotein cholesterol (HDL-C) levels may contribute to this risk. Approved medications targeting these secondary lipid parameters include fibrates, omega-3 fatty acids, and niacin. Among these medications, niacin provides the optimal increase in HDL-C levels and has efficacy similar to the other medications in lowering triglyceride levels. However, there are challenges to adherence with niacin treatment. The most common challenge during niacin treatment is flushing, although it typically decreases with ongoing use and can be ameliorated by pretreatment with aspirin and counseling by the prescriber. A combination of atorvastatin and niacin may provide more complete normalization of the lipid profile and increased cardiovascular benefits. A literature review of the PubMed and Embase databases was conducted for clinical studies that reported on the lipid-modifying efficacy of the atorvastatin plus niacin combination. Identified studies involved patients at risk for coronary heart disease and patients with established coronary heart disease. Overall, the studies were small but indicated that atorvastatin in combination with niacin was efficacious in normalizing lipid parameters. Larger lipid studies as well as studies evaluating cardiovascular outcomes during atorvastatin plus niacin treatment are warranted. PMID:22314110

McKenney, James M

2012-01-01

155

[Using cycloferon in the complex treatment of herpetic infection in patients with atopic dermatitis].  

PubMed

Clinical efficacy of including cycloferon liniment in combined treatment of herpetic infection in a group of 40 patients with atopic dermatitis has been analyzed. It is concluded that the administration of cycloferon favors dynamic disappearance of general infectious syndrome, reduces timeline of rash as well as length of local inflammation, accelerates epithelization of erosions (on the average 1.2 - 1.4 times, p < 0.05), decreases frequency of recurrent infections, and reduces the level of pro-inflammatory cytokines in the blood of patients. PMID:24800525

Barkhatova, T S; Shul'diakov, A A; Gavrilova, I B; Sretenskaia, D A

2014-01-01

156

[Metabolic effects of mexidol in complex treatment of chronic brain ischemia].  

PubMed

Patients with a chronic brain ischemia of stages I-II on the background of hypertension and/or cerebral atherosclerosis are characterized by energy insufficiency of the metabolism, as estimated by the activity of succinate dehydrogenase in peripheral blood lymphocytes. Within the framework of randomized comparative investigation of the efficiency of actovegin and mexidol in the complex therapy of a chronic brain ischemia, positive dynamics in reduction of the clinical semiology, restoration of cognitive processes in the brain, and reduction of the expression of subjective manifestations of the disease is established. On this background, the administration of mexidol led to restoration of the energy exchange due to substrate effects of the Krebs cycle intermediates present in its structure. PMID:19140508

Demchenko, E Iu; Kulakova, N V; Semiglazova, T A; Golovacheva, A B; Borodulina, E V; Udut, V V

2008-01-01

157

Molecular pathways: the complex roles of inflammation pathways in the development and treatment of liver cancer.  

PubMed

Inflammatory signals from the surrounding microenvironment play important roles in tumor promotion. Key inflammatory mediators and pathways that induce and sustain tumorigenesis have recently been identified in many different cancers. Hepatocellular carcinoma is a paradigm for inflammation-induced cancer, as it most frequently develops in the setting of chronic hepatitis, consecutive cellular damage, and compensatory regeneration. Recent studies revealed that liver damage-mediated inflammation and carcinogenesis are triggered by a complex cross-talk between NF-?B, c-jun-NH2-kinase, and STAT3 signaling pathways. Molecular dissection of the mechanisms involved in the interplay between these pathways identified promising new targets for therapeutic intervention. Targeting different components of the signaling cascades may provide efficient means for blocking the apparently irreversible sequence of events initiated by chronic liver inflammation and culminating in liver cancer. PMID:23549874

Nikolaou, Kostas; Sarris, Michalis; Talianidis, Iannis

2013-06-01

158

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

SciTech Connect

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.

Gandini, Roberto [IRCCS Policlinico di Tor Vergata, Department of Diagnostic Imaging, Interventional Radiology, Radiotherapy, and Nuclear Medicine (Italy)] [IRCCS Policlinico di Tor Vergata, Department of Diagnostic Imaging, Interventional Radiology, Radiotherapy, and Nuclear Medicine (Italy); Uccioli, Luigi [IRCCS Policlinico di Tor Vergata, Department of Internal Medicine (Italy)] [IRCCS Policlinico di Tor Vergata, Department of Internal Medicine (Italy); Spinelli, Alessio; Del Giudice, Costantino, E-mail: costantino.delgiudice@yahoo.it; Ros, Valerio Da; Volpi, Tommaso [IRCCS Policlinico di Tor Vergata, Department of Diagnostic Imaging, Interventional Radiology, Radiotherapy, and Nuclear Medicine (Italy)] [IRCCS Policlinico di Tor Vergata, Department of Diagnostic Imaging, Interventional Radiology, Radiotherapy, and Nuclear Medicine (Italy); Meloni, Marco [IRCCS Policlinico di Tor Vergata, Department of Internal Medicine (Italy)] [IRCCS Policlinico di Tor Vergata, Department of Internal Medicine (Italy); Simonetti, Giovanni [IRCCS Policlinico di Tor Vergata, Department of Diagnostic Imaging, Interventional Radiology, Radiotherapy, and Nuclear Medicine (Italy)] [IRCCS Policlinico di Tor Vergata, Department of Diagnostic Imaging, Interventional Radiology, Radiotherapy, and Nuclear Medicine (Italy)

2013-02-15

159

[Certain principles for differential utilization of metabolic treatment preparations in the complex therapy of mental disorders].  

PubMed

A study of 246 patients (with schizophrenia, manic depressive psychoses and psychoorganic syndrome) treated by some drugs of a metabolic action (encephalotropic", "nootropic" drugs, piracetam, piriditol and pantogam) permitted one to determine the place of these preparations in a comprehensive treatment of mental disorders. On the basis of clinical studies of the above-mentioned preparations, the conclusion is made about desirability (and in some cases about necessity) of including them into pharmacotherapy. During such studies certain traits of the clinical effect in each of these drugs was examined, permitting the comparative spectra of the pharmacological activity of piracetam, piriditol and pantogam to be determined. The clinical studies of these patients indicate the necessity of a differentiated use of the mentioned drugs having in view the state of the patient and detected clinical profile of the drugs. PMID:484144

Avrutski?, G Ia; Laskova, N B

1979-01-01

160

Successful short-term suppression of clarithromycin-resistant Mycobacterium avium complex bacteremia in AIDS. California Collaborative Treatment Group.  

PubMed

During a randomized study of clarithromycin plus clofazimine with or without ethambutol in patients with AIDS and Mycobacterium avium complex (MAC) bacteremia, eight participants received additional antimycobacterial drugs following the detection of a clarithromycin-resistant isolate (MIC, > 8 micrograms/mL). A macrolide (seven received clarithromycin, one azithromycin) and clofazimine were continued; additional treatment included various combinations of ethambutol, ciprofloxacin, amikacin, and rifabutin. After the detection of a resistant isolate and before receipt of additional antimycobacterials, the median peak MAC colony count in blood was 105 cfu/mL (range, 8-81,500 cfu/mL). After additional antimycobacterials, the median nadir MAC colony count was 5 cfu/mL (range, 0-110 cfu/mL). Five (63%) of eight patients had a > or = 1 log10 decrease, including two who achieved negative blood cultures; all of these responses occurred in patients originally assigned to clarithromycin plus clofazimine. Treatment of clarithromycin-resistant MAC bacteremia that emerges during clarithromycin-based treatment can decrease levels of bacteremia and transiently sterilize blood cultures. PMID:10028084

Dubé, M P; Torriani, F J; See, D; Havlir, D V; Kemper, C A; Leedom, J M; Tilles, J G; McCutchan, J A; Sattler, F R

1999-01-01

161

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

PubMed

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

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

2014-01-01

162

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

PubMed

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

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

2013-01-01

163

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

PubMed

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

Arslan-Alaton, I; Kabda?li, I; Teksoy, S

2007-01-01

164

Novel dual drug-loaded block ionomer complex micelles for enhancing the efficacy of chemotherapy treatments.  

PubMed

Combination of two or more drugs has emerged as a promising strategy to elicit synergistic therapeutic responses that can overcome multidrug resistance of cancer cells at various stages of the growth cycle. In the current study, we investigated the efficacy of two drugs, mitoxantrone (MTX) and doxorubicin (DOX), co-encapsulated in a polyethylene oxide-b-polyacrylic acid polymer. The resulting block ionomer complex (BIC)-based combination chemotherapy provides a novel method for enhancing the therapeutic efficacy of chemotherapies. The BIC micelles were very stable at physiological pH, and showed a temporally sequenced release profile for the co-encapsulated drugs at tumor pH. This suggests that the micelles can deliver chemotherapeutic agents at the appropriate cellular stage. At a predetermined and carefully controlled ratio (MTX:DOX = 2:1), the two drugs worked synergistically within A549 small lung cancer cells. Taken together, these findings suggest that the synergistic activity of ratiometrically controlled drug combinations can enhance their chemotherapeutic action and overall therapeutic index. PMID:24804551

Ramasamy, Thiruganesh; Kim, Jeonghwan; Choi, Han-Gon; Yong, Chul Soon; Kim, Jong Oh

2014-07-01

165

[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

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

Israfilova, S B; Gasymov, É M

2013-09-01

166

Platinum complexes inhibit repair of potentially lethal damage following bleomycin treatment.  

PubMed

The SCC-25 cell line is a well-established line derived from a human squamous carcinoma of the head and neck. The capacity of this cell line for recovery from potentially lethal damage following X-ray treatment has been documented. The survival curve of stationary phase SCC-25 cells exposed to various concentrations of bleomycin is biphasic with an initial sensitive phase and a less sensitive second phase as is common for many cell lines. Stationary phase SCC-25 cells were exposed to 100 mU ml-1 of bleomycin for 1 h. The drug was removed and the cells were allowed various periods to recover from potentially lethal damage. After 24 h, the SCC-25 cells showed a recovery ratio (R/R0) of 7.0 which corresponded to an immediate survival at a drug level of 27 mU ml-1, a dose 3.7-fold less than the exposure concentration of 100 mU ml-1. Over the course of the first 4 h following bleomycin exposure, 0.5 microM CDDP was a very effective inhibitor of potentially lethal damage repair, giving a R/R0 of 1.1 or nearly complete inhibition of recovery. Between 2 and 4 h the R/R0 was 1.6-1.8 with CDDP and 4.1-5.3 without CDDP indicating appreciable inhibition of recovery. Plant (10 microM) and Plato (10 microM) produced potentially lethal damage recovery inhibition patterns very similar to that of CDDP. After 1 h the recovery ratios in the presence of Plant and Plato were 1.1-1.3. Between 2 and 4 h, Plato and Plant gave recovery ratios of 1.8-2.3 and 1.6-1.9, respectively. NIPt and Pt(terpy) were examined at both 10 microM and 25 microM for their ability to inhibit potentially lethal damage recovery after bleomycin treatment. After 1 h, NIPt gave a recovery ratio of 1.3-1.4, and after 2-4 h the recovery ratio was 1.7-2.6. Pt(terpy) gave recovery ratios of 1.3-1.6 after 1 h and 1.5-1.8 after 24 h. PMID:2436643

Holden, S A; Teicher, B A; Boeheim, K; Weichselbaum, R R; Ervin, T J

1987-03-01

167

Platinum complexes inhibit repair of potentially lethal damage following bleomycin treatment.  

PubMed Central

The SCC-25 cell line is a well-established line derived from a human squamous carcinoma of the head and neck. The capacity of this cell line for recovery from potentially lethal damage following X-ray treatment has been documented. The survival curve of stationary phase SCC-25 cells exposed to various concentrations of bleomycin is biphasic with an initial sensitive phase and a less sensitive second phase as is common for many cell lines. Stationary phase SCC-25 cells were exposed to 100 mU ml-1 of bleomycin for 1 h. The drug was removed and the cells were allowed various periods to recover from potentially lethal damage. After 24 h, the SCC-25 cells showed a recovery ratio (R/R0) of 7.0 which corresponded to an immediate survival at a drug level of 27 mU ml-1, a dose 3.7-fold less than the exposure concentration of 100 mU ml-1. Over the course of the first 4 h following bleomycin exposure, 0.5 microM CDDP was a very effective inhibitor of potentially lethal damage repair, giving a R/R0 of 1.1 or nearly complete inhibition of recovery. Between 2 and 4 h the R/R0 was 1.6-1.8 with CDDP and 4.1-5.3 without CDDP indicating appreciable inhibition of recovery. Plant (10 microM) and Plato (10 microM) produced potentially lethal damage recovery inhibition patterns very similar to that of CDDP. After 1 h the recovery ratios in the presence of Plant and Plato were 1.1-1.3. Between 2 and 4 h, Plato and Plant gave recovery ratios of 1.8-2.3 and 1.6-1.9, respectively. NIPt and Pt(terpy) were examined at both 10 microM and 25 microM for their ability to inhibit potentially lethal damage recovery after bleomycin treatment. After 1 h, NIPt gave a recovery ratio of 1.3-1.4, and after 2-4 h the recovery ratio was 1.7-2.6. Pt(terpy) gave recovery ratios of 1.3-1.6 after 1 h and 1.5-1.8 after 24 h.

Holden, S. A.; Teicher, B. A.; Boeheim, K.; Weichselbaum, R. R.; Ervin, T. J.

1987-01-01

168

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

PubMed Central

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 ?-CD based drug complex might be promising as an anti-tumor treatment for FR(+) cancer.

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

169

[Oncoplastic technics with nipple-areolar complex resection for the treatment of central breast cancers].  

PubMed

Central breast cancer has long been an indication for mastectomy. Plastic surgical techniques adapted to cancer (oncoplastic surgery) have made it possible to offer breast cancer patients conservative surgery with resection of the nipple-areolar complex (NAC). We evaluated carcinologic results and cosmetic outcomes as a function of the oncoplastic technique used. We performed a retrospective study in 47 patients with central breast cancers undergoing breast-conserving with NAC resection. Carcinologic results were assessed by calculating local and metastatic recurrences rates. Cosmetic results were evaluated on four criteria assessed by the patient then by two surgeons. The mean age of the patients was 59.8 (44-84) years. The mean tumour diameter was 17.4 (6-39)mm. Histological involvement of the nipple is present in 53% of the cases. No local recurrence, neither death was observed at 4.5 years median follow-up. One patient had liver metastatic recurrence at 83 months. Cosmetic results were assessed in 33 patients. Round-block provided better aesthetic results: the shape of the breast was considered very good or satisfactory for 90% of the surgeons with the round-block technique and for 46% with transverse incision (P=0.02). Breast-conserving surgery is feasible in selected patients with T1 or T2 central breast cancers, with no impact on the risk of local recurrence. NAC resection is essential especially when the patients have clinical signs of nipple involvement. It provides satisfactory cosmetic results, especially with the round-block technique, possibly associated with nipple reconstruction using the "cat-design" technique developed by our team. PMID:18372086

Faure, C; Escalon, J; Brémond, A; Mignotte, H; Pérol, D; Delay, E

2008-04-01

170

Arthroscopic repair of peripheral avulsions of the triangular fibrocartilage complex of the wrist: a multicenter study.  

PubMed

A multicenter study to assess arthroscopic reconstruction of the peripheral attachment of the triangular fibrocartilage complex was undertaken. A total of 44 patients (45 wrists) from three institutions were reviewed. Twenty-seven of the 45 wrists had associated injuries, including distal radius fracture (4), partial or complete rupture of the scapholunate (7), lunotriquetral (9), ulnocarpal (2), or radiocarpal (2) ligaments. There were two fractured ulnar styloids and one scapholunate accelerated collapse (SLAC) wrist deformity. The peripheral tears were repaired using a zone-specific repair kit. The patients were immobilized in a munster cast, allowing elbow flexion and extension, but no pronation or supination for 4 weeks, followed by 2 to 4 weeks in a short arm cast or VersaWrist splint. All patients were reexamined independently 1 to 3 years postoperatively by a physician, therapist, and registered nurse. The results were graded according to the Mayo modified wrist score. Twenty-nine of the 45 wrists were rated excellent. 12 good, 1 fair, and 3 poor. Overall, 42 of the 45 patients (93%) rated as satisfactory and returned to sports or work activities. One patient had chronic pain, and two patients had ulnar nerve symptoms, although motion was normal in all, and their grip strength was at least 75% of the opposite hand. Arthroscopic repair of peripheral tears of the triangular fibrocartilage complex (TFCC) is a satisfactory method of repairing these injuries. PMID:9043608

Corso, S J; Savoie, F H; Geissler, W B; Whipple, T L; Jiminez, W; Jenkins, N

1997-02-01

171

Affects, agency, and self-regulation: complexity theory in the treatment of children with anxiety and disruptive behavior disorders.  

PubMed

In an increasingly unsettled and violent world, with swelling numbers of children who are abused, abandoned, or neglected, emotionally if not physically, and an increasing population of aggressive preschool children with anxiety and disruptive behavior disorders who cannot be contained in ordinary settings, psychoanalysts can make a contribution. Early intervention is essential. In very early childhood, new procedural memories for interacting with others and for regulating affects can be formed more easily than they can ever be again. Intervention should aim toward helping the child develop a sense of agency, establish moral standards, assume self-responsibility, and attain the capacity for emotional regulation. The principles of complex dynamic systems can inform psychoanalytic treatment strategies, as demonstrated with five children whose cases are presented. PMID:15822427

Tyson, Phyllis

2005-01-01

172

Everolimus in the treatment of subependymal giant cell astrocytomas, angiomyolipomas, and pulmonary and skin lesions associated with tuberous sclerosis complex  

PubMed Central

Tuberous sclerosis complex (TSC) is an autosomal dominant genetic disorder caused by inactivating mutations in either the TSC1 or TSC2 genes. It is characterized by the development of multiple, benign tumors in several organs throughout the body. Lesions occur in the brain, kidneys, heart, liver, lungs, and skin and result in seizures and epilepsy, mental retardation, autism, and renal and pulmonary organ system dysfunction, as well as other complications. Elucidation of the molecular pathways and etiological factors responsible for causing TSC has led to a paradigm shift in the management and treatment of the disease. TSC1 or TSC2 mutations lead to constitutive upregulation of the mammalian target of rapamycin pathway, which affects many cellular processes involved in tumor growth. By targeting mammalian target of rapamycin with everolimus, an orally active rapamycin derivative, clinically meaningful and statistically significant reductions in tumor burden have been achieved for the main brain (subependymal giant cell astrocytoma) and renal manifestations (angiomyolipoma) associated with TSC. This review provides an overview of TSC, everolimus, and the clinical trials that led to its approval for the treatment of TSC-associated subependymal giant cell astrocytoma and renal angiomyolipoma.

Franz, David Neal

2013-01-01

173

Negative pressure wound therapy with Bio-Dome dressing technology in the treatment of complex wounds: A case series.  

PubMed

The treatment of complex wounds is difficult and not always effective. Various treatment options are used with varying degrees of success. Negative pressure wound therapy (NPWT) is a cost-efficient and effective way to help treat these wounds. The use of a vacuum device applies the negative pressure to the site of the wound and promotes waste removal and increases circulation and tissue formation. While various NPWT systems are currently on the market, we utilised the ConvaTec Engenex® system with Bio-DomeTM technology; however, our case study is not intended to advocate the specific use of this system, but instead focusses on the use of NPWT as a viable option for wound healing. Each of the following case study patients presented with difficult-to-heal wounds that failed traditional therapeutic approaches. Through the use of NPWT, our patients saw major wound size reductions. Each patient exhibited at least a 94% reduction in wound area, wound volume or both. PMID:24762555

L Penny, H; Spinazzola, J; Green, A; Rifkah, M; Faretta, M; Youshaw, D; Weaver, A; Zaki, P

2014-04-17

174

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

PubMed

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

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

2013-12-28

175

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

SciTech Connect

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.

Rivard, Mark J.; Melhus, Christopher S.; Granero, Domingo; Perez-Calatayud, Jose; Ballester, Facundo [Department of Radiation Oncology, Tufts University School of Medicine, Boston, Massachusetts 02111 (United States); Radiation Oncology Department, Physics Section, ''La Fe'' University Hospital, Avenida Campanar 21, E-46009 Valencia (Spain); Department of Atomic, Molecular, and Nuclear Physics, University of Valencia, C/Dr. Moliner 50, E-46100 Burjassot, Spain and IFIC (University of Valencia-CSIC), C/Dr. Moliner 50, E-46100 Burjassot (Spain)

2009-06-15

176

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

PubMed Central

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-NF?B and TGF-?1, 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 ?- and ?-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.

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

2013-01-01

177

Oral treatment of pressure ulcers with polaprezinc (zinc L-carnosine complex): 8-week open-label trial.  

PubMed

Polaprezinc (zinc L-carnosine complex) is a tablet commonly prescribed for gastric ulcers in Japan. Recently, we reported the effects of polaprezinc on pressure ulcer healing at 4-week follow-up. We aimed to further evaluate the efficacy and safety of polaprezinc in 8-week treatment for chronic pressure ulcers. Patients with stage II-IV pressure ulcers for ? 8 weeks received 150 mg/day polaprezinc (containing 116 mg L-carnosine and 34 mg zinc) per os for a maximum of 8 weeks. We measured the severity of pressure ulcers weekly using the Pressure Ulcer Scale for Healing (PUSH) score and monitored blood biochemistry. Fourteen patients (nine men; 68.4?±?11.8 years) were enrolled. Pressure ulcer stages were II (one patient; 7 %), III (nine; 64 %), and IV (four; 29 %). The PUSH score improved significantly from 8.1 [95 % CI, 6.0-10.3] at baseline to -1.4 [-4.0 to 1.1] after 8 weeks (P?treatment of pressure ulcers and could be a candidate for their oral treatment. PMID:24691900

Sakae, Kensaku; Yanagisawa, Hiroyuki

2014-06-01

178

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

PubMed Central

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 ?katA and ?katB 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.

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

179

Methods and Compositions for the Treatment of Cancer and Infectious Disease Using Alpha (2) Macroglobulin-Antigenic Molecule Complexes.  

National Technical Information Service (NTIS)

The present invention relates to the use of alpha (2) macroglobulin complexes isolated from the serum of a mammal. The invention also relates to methods for making such complexes and compositions comprising alpha (2) macroglobulin complexes, isolated from...

P. K. Srivastava R. J. Binder

2004-01-01

180

An investigation of multidisciplinary complex health care interventions - steps towards an integrative treatment model in the rehabilitation of People with Multiple Sclerosis  

PubMed Central

Background The Danish Multiple Sclerosis Society initiated a large-scale bridge building and integrative treatment project to take place from 2004–2010 at a specialized Multiple Sclerosis (MS) hospital. In this project, a team of five conventional health care practitioners and five alternative practitioners was set up to work together in developing and offering individualized treatments to 200 people with MS. The purpose of this paper is to present results from the six year treatment collaboration process regarding the development of an integrative treatment model. Discussion The collaborative work towards an integrative treatment model for people with MS, involved six steps: 1) Working with an initial model 2) Unfolding the different treatment philosophies 3) Discussing the elements of the Intervention-Mechanism-Context-Outcome-scheme (the IMCO-scheme) 4) Phrasing the common assumptions for an integrative MS program theory 5) Developing the integrative MS program theory 6) Building the integrative MS treatment model. The model includes important elements of the different treatment philosophies represented in the team and thereby describes a common understanding of the complexity of the courses of treatment. Summary An integrative team of practitioners has developed an integrative model for combined treatments of People with Multiple Sclerosis. The model unites different treatment philosophies and focuses on process-oriented factors and the strengthening of the patients’ resources and competences on a physical, an emotional and a cognitive level.

2012-01-01

181

Genes of major histocompatibility complex class II influence chronic C hepatitis treatment with interferon in hemodialysis patients.  

PubMed

The prevalence of anti-HCV among patients on hemodialysis is consistently higher than in the general population, indicating that patients on hemodialysis programs are at risk of acquiring HCV infection. The response to interferon alpha 2b (IFN -alpha 2b) therapy in chronic C hepatitis depends on viral and host factors. We treated 22 chronic C hepatitis uremic patients with IFN -alpha 2b (3 MU three times a week) and compared interferon responsive and unresponsive patients with regard to HLA II genes. HLA II genes were investigated by PCR-SSP low resolution, anti-HCV with ELISA II and HCV-RNA with reverse transcriptase "nested" PCR. Findings: HLA DRB1*13 is 50% positive in the non-responder group (four women, four men, mean age; 28.8+/-11.9 years) and 7% in the responder group (five women, nine men, mean age; 32.2+/-7.8 years) (p<0.05). There was no difference with respect to HLA genes between controls (six women, eight men, mean age; 29.5+/-12.8 years) and patients (nine women, 13 men, mean age; 31.0+/-9.3 years) (HLA DRB1*13 is 28% and 22% positive, respectively). We conclude that major histocompatibility complex class II genes influence the outcome of chronic C hepatitis treatment with IFN -alpha 2b. PMID:11394702

Dinçer, D; Besisik, F; O?uz, F; Sever, M S; Kaymakoglu, S; Cakaloglu, Y; Demir, K; Türkoglu, S; Carin, M; Okten, A

2001-04-01

182

Antiproliferative and Proapoptotic Activities of Methanolic Extracts from Ligustrum vulgare L. as an Individual Treatment and in Combination with Palladium Complex  

PubMed Central

The aim of this study is to examine the growth inhibitory effects of methanolic leaf and fruit extracts of L. vulgare on HCT-116 cells over different time periods and their synergistic effect with a Pd(apox) complex. The antiproliferative activity of plant extracts alone or in combination with the Pd(apox) complex was determined using MTT cell viability assay, where the IC50 value was used as a parameter of cytotoxicity. Results show that antiproliferative effects of L. vulgare extracts increase with extension of exposure time, with decreasing IC50 values, except for 72 h where the IC50 values for methanolic leaf extract were lower than for the fruit extract. The Pd(apox) complex alone had a weak antiproliferative effect, but combination with L. vulgare extracts caused stronger effects with lower IC50 values than with L. vulgare extracts alone. The type of cell death was explored by fluorescence microscopy using the acridin orange/ethidium bromide method. Treatments with plant extracts caused typical apoptotic morphological changes in HCT-116 cells and co-treatments with Pd(apox) complex caused higher levels of apoptotic cells than treatment with plant extracts alone. The results indicate that L. vulgare is a considerable source of natural bioactive substances with antiproliferative activity on HCT-116 cells and which have a substantial synergistic effect with the Pd(apox) complex.

Curcic, Milena G.; Stankovic, Milan S.; Mrkalic, Emina M.; Matovic, Zoran D.; Bankovic, Dragic D.; Cvetkovic, Danijela M.; ?acic, Dragana S.; Markovic, Snezana D.

2012-01-01

183

Comparing Two Service Delivery Models for Homeless Individuals With Complex Behavioral Health Needs: Preliminary Data From Two SAMHSA Treatment for Homeless Studies  

Microsoft Academic Search

Assertive Community Treatment (ACT) and the Comprehensive, Continuous, Integrated System of Care (CCISC) are two models for delivering services to homeless persons with complex behavioral health needs. This quasi-experimental study presents preliminary data comparing these two programs. The first program was based out of a community mental health center and utilized the ACT model of care with supported housing (ACT-SH),

M. Scott Young; Colleen Clark; Kathleen Moore; Blake Barrett

2009-01-01

184

Inhibition of mitochondrial complex IV leads to secondary loss complex II-III activity: implications for the pathogenesis and treatment of mitochondrial encephalomyopathies.  

PubMed

Mitochondrial encephalomyopathies, arising from deficiencies of the electron transport chain (ETC) give rise to a wide clinical spectrum of presentation and are often progressive in nature. The aetiology of mitochondrial encephalomyopathies have yet to be fully elucidated, however, a successive loss of ETC function may contribute to the progressive nature of these disorders. The possibility arises that as a consequence of a primary impairment of ETC activity, secondary damage to the ETC may occur. In order to investigate this hypothesis, we established a model of cytochrome oxidase (Complex IV) deficiency in cultured human astrocytoma 1321N cells. Potassium cyanide (KCN, 1mM) resulted in a sustained 50% (p<0.01) loss of complex IV. At 24h activities of the other ETC complexes were unaffected. However, at 72h significant loss of succinate-cytochrome c reductase (complex II-III) activity expressed as a ratio to the mitochondrial marker, citrate synthase was observed. (KCN treated; 0.065+/-0.011 vs controls; 0.118+/-0.017 mean+/-SEM, n=8, p<0.05). These results provide a possible mechanism for the progressive nature of ETC defects and why in some patients multiple patterns of ETC deficiencies can be demonstrated. PMID:17395552

Hargreaves, I P; Duncan, A J; Wu, L; Agrawal, A; Land, J M; Heales, S J R

2007-07-01

185

TEST: A Z, A&Z, A  

PubMed Central

Background Soft tissue injuries associated with distal radius fractures have been reported by some authors. Arthroscopy can be used to evaluate the condition of the articular surface and intracarpal soft tissues and as an aid to treatment. There are three intracarpal soft tissues of particular importance: the triangular fibrocartilage complex (TFCC), the scapholunate interosseous ligament (SLIL), and the lunotriquetral interosseous ligament (LTIL). The purpose of this study was to evaluate intracarpal soft tissue injuries and their relationships with fracture types during arthroscopic surgical treatment of distal radius fractures. Methods Eighty-nine patients in our hospital underwent surgical treatment by arthroscopy for a fracture of the distal end of the radius. They ranged in age from 17 to 92 years (mean, 62.2 years), and comprised 20 men (mean age, 45.6 years) and 69 women (mean age, 66.5 years). The AO classification data on plain radiographs indicated A2 fracture in four patients, A3 fracture in 10 patients, C1 fracture in two patients, C2 fracture in 24 patients, and C3 fracture in 49 patients. Wrist arthroscopy was performed with vertical traction, and intracarpal soft tissues were examined. For assessment of the TFCC in the radiocarpal space, the Palmar classification was used. For assessment of the SLIL and LTIL in the midcarpal space, the Geissler classification was used. Results TFCC injury was present in 59% of cases, SLIL injury in 54.5% of cases, and LTIL injury in 34.5% of cases. Only 17.1% of patients (14/82 patients) were negative for all three types of injury. In 81% of cases (72/89 patients), some intracarpal soft tissue injury was present in association with the fracture. Conclusions The fracture was complicated by TFCC injury in 59% of patients, SLIL injury in 54.5% of patients, and LTIL injury in 34.5% of patients, irrespective of the fracture type.

2013-01-01

186

Serum COMP-C3b complexes in rheumatic diseases and relation to anti-TNF-? treatment  

PubMed Central

Introduction Cartilage oligomeric matrix protein (COMP) is found at elevated concentrations in sera of patients with joint diseases such as rheumatoid arthritis (RA) and osteoarthritis (OA). We recently showed that COMP activates complement via the alternative pathway and that COMP-C3b complexes are present in sera of RA patients, but not in healthy controls. We now set out to elaborate on the information provided by this marker in a variety of diseases and larger patient cohorts. Methods COMP-C3b levels in sera were measured by using an enzyme-linked immunosorbent assay (ELISA) capturing COMP and detecting C3b. Serum COMP was measured by using ELISA. Results COMP-C3b levels were significantly elevated in patients with RA as well as in systemic lupus erythematosus (SLE), compared with healthy controls. SLE patients with arthritis had significantly higher COMP-C3b levels than did those without. COMP-C3b was furthermore elevated in patients with ankylosing spondylitis (AS), psoriatic arthritis (PsA), reactive arthritis, systemic sclerosis, and OA. COMP-C3b did not correlate with COMP in any of the patient groups. COMP-C3b correlated with disease activity in RA, but not in other diseases. COMP-C3b levels in RA patients decreased on treatment with tumor necrosis factor (TNF)-? inhibitors, whereas the levels increased in patients with AS or PsA. The changes of COMP-C3b did not parallel the changes of C-reactive protein (CRP). Conclusions COMP-C3b levels are elevated in several rheumatologic diseases and correlate with inflammatory measures in RA. COMP-C3b levels in RA decrease during TNF-? inhibition differently from those of CRP, suggesting that formation of COMP-C3b relates to disease features not reflected by general inflammation measures.

2012-01-01

187

P147Protective effect of ubiquinone-10 and complex of precursors and modulator of its biosynthesis on heart under doxorubicin treatment.  

PubMed

Doxorubicin is a potent anticarcinogenic drug that is widely used in practical oncology. Its use is accompanied by cardiotoxicity and toxicity to other tissues. Ubiquinone (CoQ) is an important electron and proton carrier, antioxidant, regulator of genes expression. Its biosynthesis may be inhibited under number of pathologies. The aim was to study the state of mitochondrial electron transport chain (ETC) components, CoQ content and redox state, superoxide anion radicals and NO production rates, and matrix metalloproteinase-2 and -9 activities in rat heart tissues under treatment with doxorubicin, CoQ10 medical, and complex preparation of precursors and modulator of CoQ biosynthesis. Doxorubicin was administrated intraperitoneally in dose of 2.2 mg/kg daily for 8 days. Experimental rats in addition to doxorubicin received per os ?-tocopherol acetate, 4-hydroxybenzoic acid, and methionine (EPM complex) and CoQ10. Under doxorubicin treatment heart weight to body weight ratio decreased. Treatment with EPM complex and CoQ10 in addition to doxorubicin administration exerts a protective effect on heart cells' mitochondria, evidenced by restoration of electron transport in electron transport chain, which is expressed as decreased nitrile complexes formation with Fe-S-proteins and increased ubisemiquinone content. It should be stressed that the protective effects of EPM complex on mitochondrial electron transport chain under doxorubicin administration is on par with those of CoQ10. EPM complex and CoQ10 administration leads to normalization of NO content, superoxide-anion radicals generation, free radical lipid (conjugated dienes, TBA-reactive products) and protein peroxidation and activity of antioxidant enzyme systems (catalase, superoxidedismutase) under doxorubicin treatment. Concurrently, matrix metalloproteinase-2 and -9 activities are decreased, which gives evidence of lessened extracellular matrix destruction. CoQ10 appeared to be more efficient at this if compared to EPM complex. The expiremental data obtained may become the basis of development of approaches to correction of adverse effects of doxorubicin. These data may be used to substantiate the application of these biologically active substances within frameworks of complex treatment of oncological and cardiovascular pathologies. PMID:25020566

Kuchmenko, O; Burlaka, A; Ganusevich, I

2014-07-15

188

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

PubMed

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

Abdellatif, Ady; Gaede, Stewart

2014-01-01

189

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

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.

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

190

A phase I\\/IIa study on intra-articular injection of holmium-166-chitosan complex for the treatment of knee synovitis of rheumatoid arthritis  

Microsoft Academic Search

Previous animal studies have established that the intra-articular injection of holmium-166-chitosan complex (DW-166HC) causes effective necrosis of the inflamed synovium with little leakage of radioactivity from the injected joint. Based on these findings, we conducted a phase I\\/IIa study to examine the biodistribution of DW-166HC and to assess the safety of DW-166HC for the treatment of knee synovitis in patients

Jungsik Song; Chang Hee Suh; Yong Beom Park; Seung Hoon Lee; Nae Chun Yoo; Jong Doo Lee; Kyoung Hwan Kim; Soo Kon Lee

2001-01-01

191

Functional outcome of arthroscopic assisted fixation of distal radius fractures  

PubMed Central

Background: Many studies in literature have supported the role of wrist arthroscopy as an adjunct to the stable fixation of unstable intraarticular distal radial fractures. This article focuses on the surgical technique, indications, advantages, and results using wrist arthroscopy to assess articular reduction and evaluates the treatment of carpal ligament injuries and triangular fibrocartilage complex (TFCC) injuries in conjunction with the stable fixation of distal radial fractures. Materials and Methods: We retrospectively evaluated 27 patients (16 males and 11 females), who underwent stable fixation of intraarticular distal radial fractures with arthroscopic evaluation of the articular reduction and repair of associated carpal injuries. As per the AO classification, they were 9 C 1, 12 C2, 2 C3, 3 B 1, and 1 B2 fractures. The final results were evaluated by modified Mayo wrist scoring system. The average age was 41 years (range: 18-68 years). The average followup was of 26 months (range 24-52 months). Results: Five patients needed modification of the reduction and fixation after arthroscopic joint evaluation. Associated ligament lesions found during the wrist arthroscopy were TFCC tears (n=17), scapholunate ligament injury (n=8), and luno-triquetral ligament injury (n=1). Five patients had combined injuries i.e. included TFCC tear, scapholunate and/or lunotriquetral ligament tear. There were 20 excellent, 3 good, and 4 fair results using this score. Conclusion: The radiocarpal and mid carpal arthroscopy is a useful adjunct to stable fixation of distal radial fractures.

Khanchandani, Prakash; Badia, Alejandro

2013-01-01

192

Hydration of cis- and trans-platin: A pseudopotential treatment in the frame of a G3-type theory for platinum complexes  

NASA Astrophysics Data System (ADS)

Hydration of selected platinum complexes [PtCl42-, Pt(NH3)42+, and cis- and trans-platin-PtCl2(NH3)2] have been studied. Up to two solvent molecules have been considered to replace the ligands. In order to be able to draw conclusions about pH changes in the course of the hydration process, both H2O and OH- species were considered in the solvating process. The modified Gaussian 3 theory was adapted for the pseudopotential treatment of platinum complexes. Since a heavy element was present in the complexes, an additional stabilization due to the spin-orbit coupling and core-polarization potentials have been evaluated above the scheme of a G3 treatment. This spin-orbit coupling stabilization amounts to 2-5 kcal/mol but does not qualitatively change the hydration preferences. In accord with the experiment, neutral Pt(NH3)2(OH)2 was found to be the most stable complex for hydration of both cis- and trans-platin.

Burda, J. V.; Zeizinger, M.; Šponer, J.; Leszczynski, J.

2000-08-01

193

Theoretical treatment of double photoionization of helium using a B-spline implementation of exterior complex scaling  

SciTech Connect

Calculations of absolute triple differential and single differential cross sections for helium double photoionization are performed using an implementation of exterior complex scaling in B-splines. Results for cross sections, well-converged in partial waves, are presented and compared with both experiment and earlier theoretical calculations. These calculations establish the practicality and effectiveness of the complex B-spline approach to calculations of double ionization of atomic and molecular systems.

McCurdy, C. William; Horner, Daniel A.; Rescigno, Thomas N.; Martin, Fernando

2004-02-19

194

The effect of multileaf collimator leaf width on the radiosurgery planning for spine lesion treatment in terms of the modulated techniques and target complexity  

PubMed Central

Purpose We aim to evaluate the effects of multileaf collimator (MLC) leaf width (5 mm vs. 2.5 mm) on the radiosurgery planning for the treatment of spine lesions according to the modulated techniques (intensity-modulated radiotherapy [IMRT] vs. volumetric-modulated arc therapy [VMAT]) and the complexity of the target shape. Methods For this study, artificial spinal lesions were contoured and used for treatment plans. Three spinal levels (C5, T5, and L2 spines) were selected, and four types of target shapes reflecting the complexity of lesions were contoured. The treatment plans were performed using 2.5-mm and 5-mm MLCs, and also using both static IMRT and VMAT. In total, 48 treatment plans were established. The efficacy of each treatment plan was compared using target volume coverage (TVC), conformity index (CI), dose gradient index (GI), and V30%. Results When the 5-mm MLC was replaced by the 2.5-mm MLC, TVC and GI improved significantly by 5.68% and 6.25%, respectively, while CI did not improve. With a smaller MLC leaf width, the improvement ratios of the TVC were larger in IMRT than VMAT (8.38% vs. 2.97%). In addition, the TVC was improved by 14.42-16.74% in target type 4 compared to the other target types. These improvements were larger in IMRT than in VMAT (27.99% vs. 6.34%). The V30% was not statistically different between IMRT and VMAT according to the MLC leaf widths and the types of target. Conclusion The smaller MLC leaf width provided improved target coverage in both IMRT and VMAT, and its improvement was larger in IMRT than in VMAT. In addition, the smaller MLC leaf width was more effective for complex-shaped targets.

2014-01-01

195

Primary mucosal sinonasal melanoma--Case report and review of the literature. The role of complex treatment-surgery and adjuvant radiotherapy  

PubMed Central

Aim The place of adjuvant radiotherapy in the treatment of sinonasal melanoma. Background Sinonasal mucosal melanoma is a rare disease with poor prognosis and requires a complex treatment. Elective neck dissection in patients with N0 and adjuvant radiotherapy has been a source of controversy. High late regional recurrence rates rise questions about elective irradiation of the neck nodes in patients with N0 stage disease. Methods We present our two years’ follow up in a case of locally advanced sinonasal melanoma and literature review of the treatment options for mucosal melanoma. Results In locally advanced sinonasal melanoma treated with surgical resection, postoperative radiotherapy and chemotherapy we had local tumor control. Two years later, a regional contralateral recurrence without distant metastasis occurred. Conclusions Literature data for frequent neck lymph nodes recurrences justify elective neck dissection. Postoperative elective neck radiotherapy for patients with locally advanced sinonasal melanoma and clinically N0 appears to decrease the rate of late regional recurrences.

Marinova, Lena; Yordanov, Kaloyan; Sapundgiev, Nikolay

2010-01-01

196

Comparative study of the effects of treatment with diethyleneiminebenzoquinone and its polymer complex with polyvinylpyrrolidone on the primary response of mice to sheep red blood cells.  

PubMed

The primary response of BALB/c mice to sheep red blood cells was used to study comparatively the time-dependent effects of a 5-day course of treatment with equivalent doses (0.8 mg/kg of body weight every day) of the cytotoxic agent diethyleneiminebenzoquinone (DEiBq) and its polymer complex with polyvinylpyrrolidone (DEiBqPVP). The experimental results show that in contrast to treatment with DEiBq, the ability of treated mice to establish a specific immune response was not markedly impaired during the treatment with DEiBqPVP. The possible significance of these results is considered with reference to the use of the synthetic polymer PVP as a carrier of cytotoxic groups in experimental cancer chemotherapy. PMID:556384

Kostadinov, D A; Popov, D V

1978-05-01

197

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

PubMed

Xylan-lignin (XL), glucomannan-lignin (GML) and glucan-lignin (GL) complexes were isolated from spruce wood, hydrolyzed with xylanase or endoglucanase/?-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 ?-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 % ?-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

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

198

Treatment of complex intercondylar humeral fractures in adolescents by open reduction and internal fixation through the transolecranon approach.  

PubMed

This is a review of six cases of complex intercondylar fractures of the humerus in adolescents, treated operatively through a transolecranon approach. Outcome was assessed by means of the Mayo Elbow score, the Disability of the Arm, Shoulder and Hand score, and the Oxford Elbow score. All patients reported 'good' to 'excellent' results. One patient required revision surgery because of fracture nonunion, and all patients underwent removal of hardware from the olecranon after osteotomy union. The transolecranon approach is effective in visualization of complex intercondylar fractures, and good outcomes are expected following stable surgical fixation in adolescents. PMID:24667148

Dreyfuss, Daniel; Eidelman, Mark

2014-07-01

199

A new treatment for focal dystonias: incobotulinumtoxinA (Xeomin(R)), a botulinum neurotoxin type A free from complexing proteins  

PubMed Central

Dystonia is a movement disorder of uncertain pathogenesis that is characterized by involuntary and inappropriate muscle contractions which cause sustained abnormal postures and movements of multiple or single (focal) body regions. The most common focal dystonias are cervical dystonia (CD) and blepharospasm (BSP). The first-line recommended treatment for CD and BSP is injection with botulinum toxin (BoNT), of which two serotypes are available: BoNT type A (BoNT/A) and BoNT type B (BoNT/B). Conventional BoNT formulations include inactive complexing proteins, which may increase the risk for antigenicity, possibly leading to treatment failure. IncobotulinumtoxinA (Xeomin®; Merz Pharmaceuticals GmbH, Frankfurt, Germany) is a BoNT/A agent that has been recently Food and Drug Administration-approved for the treatment of adults with CD and adults with BSP previously treated with onabotulinumtoxinA (Botox®; Allergen, Inc, Irvine, CA) – a conventional BoNT/A. IncobotulinumtoxinA is the only BoNT product that is free of complexing proteins. The necessity of complexing proteins for the effectiveness of botulinum toxin treatment has been challenged by preclinical and clinical studies with incobotulinumtoxinA. These studies have also suggested that incobotulinumtoxinA is associated with a lower risk for stimulating antibody formation than onabotulinumtoxinA. In phase 3 noninferiority trials, incobotulinumtoxinA demonstrated significant improvements in CD and BSP symptoms in both primary and secondary measures, compared with baseline, and met criteria for noninferiority versus onabotulinumtoxinA. In placebo-controlled trials, incobotulinumtoxinA also significantly improved the symptoms of CD and BSP, with robust outcomes in both primary and secondary measures. The use of incobotulinumtoxinA has been well tolerated in all trials, with an adverse event profile similar to that of onabotulinumtoxinA. Based on these data, incobotulinumtoxinA is a safe and effective BoNT/A for the treatment of CD and BSP, and may pose a lower risk for immunogenicity leading to treatment failure compared with other available BoNT agents. This paper reviews the treatment of focal dystonias with BoNTs, in particular, incobotulinumtoxinA. Controlled trials from the existing incobotulinumtoxinA literature are summarized.

Jimenez-Shahed, Joohi

2012-01-01

200

Successful treatment of chylous ascites secondary to Mycobacterium avium complex in a patient with the acquired immune deficiency syndrome  

Microsoft Academic Search

Chylous ascites is a rare form of ascites, the presence of which generally denotes a very poor long term prognosis. We report the case of a patient with acquired immune deficiency syndrome (AIDS) and massive chylous ascites secondary to Mycobacterium avium complex (MAC) infection, identified in the ascitic fluid by a DNA probe assay. With multidrug anti-MAC therapy the ascites

Andrew P Keaveny; Michael S Karasik; Harrison W Farber

1999-01-01

201

Treatment with cationic liposome–DNA complexes (CLDCs) protects mice from lethal Western equine encephalitis virus (WEEV) challenge  

Microsoft Academic Search

Having recently characterized a CD-1 outbred mouse model of pathogenesis for Western equine encephalitis virus, we examined the possible protective effects of cationic liposome–DNA complexes (CLDCs) 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

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

2010-01-01

202

Transcutaneous electroporation mediated delivery of doxepin-HPCD complex: A sustained release approach for treatment of postherpetic neuralgia  

PubMed Central

The electroporation mediated transdermal delivery (Protocol - 120V, 10ms, 30pulses at 1Hz with post pulse waiting period of 20min) of doxepin using pure drug solution (PDS) and doxepin-hydroxypropyl-?-cyclodextrin (HPCD) complex solution (CDS) was studied using porcine epidermis model. The stoichiometry of drug-HPCD inclusion complex was determined by differential scanning calorimetry (DSC). The amount of doxepin retained in the epidermis following electroporation did not differ significantly between PDS and CDS. When the drug loaded epidermis was subjected to “Release studies”, doxepin release attained a plateau within ~2.5 days in case of PDS, whereas in case of CDS, doxepin release was prolonged up to 5 days. Mechanistic studies across the nonbiological barriers demonstrated that the slow dissociation of complex was responsible for sustained release of drug from the epidermis. Pharmacodynamic studies were carried out by electroporation mediated delivery of CDS and PDS in hairless rats. The analgesic effect of doxepin was prolonged in case of CDS as compared to PDS.

Sammeta, Srinivasa M.; Vaka, Siva Ram K.; Murthy, S. Narasimha

2009-01-01

203

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

National Technical Information Service (NTIS)

According to the Record of Decision for Phase I Interim Source Control Actions in the Upper East Fork Poplar Creek Characterization Area, Oak Ridge, Tennessee, issued in May 2002, a new 300 gpm water treatment system is to be constructed and operated to r...

M. W. Davis

2002-01-01

204

Delamination technique together with longitudinal incisions for treatment of Chiari I\\/syringomyelia complex: a prospective clinical study  

Microsoft Academic Search

BACKGROUND: Treatment modalities in Chiari malformation type 1(CMI) accompanied by syringomyelia have not yet been standardized. Pathologies such as a small posterior fossa and thickened dura mater have been discussed previously. Various techniques have been explored to enlarge the foramen magnum and to expand the dura. The aim of this clinical study was to explore a new technique of excision

Kadir Kotil; Tu?rul Ton; Rabia Tari; Yildiray Savas

2009-01-01

205

A double-blind placebo-controlled study of 5-fluorouracil:cyclodextrin complex loaded thermosensitive gel for the treatment of HPV induced condyloma  

Microsoft Academic Search

Objective of this double-blind placebo-controlled study was to determine the efficacy of thermosensitive mucoadhesive gel\\u000a loaded with 5-fluorouracil (5-FU):hydroxypropyl-ß-cyclodextrin (HP-ß-CD) complex via topical administration or intralesional\\u000a injection for the treatment of human papilloma virus induced condyloma in 44 women. The diagnosis of human papilloma virus\\u000a was established with clinical, histopathological and polymerase chain reaction techniques. Subjects were randomized into four

Erem Bilensoy; Perran Moroy; Yasemin Ç?rpanl?; Tamer Bilensoy; Sema Çal??; Leyla Mollamahmutoglu

2011-01-01

206

Two-phase orthodontic treatment of a complex malocclusion: giving up efficiency in favor of effectiveness, quality of life, and functional rehabilitation?  

PubMed

The interceptive orthodontic treatment of patients with complex dentofacial abnormalities is frequently inefficient and produces less than ideal outcomes. Therefore, postponing therapy to a single-phase surgical-orthodontic approach might be considered a reasonable option. However, other relevant aspects of the patient's quality of life, such as possible psychosocial problems and functional impairments, should also be considered before deciding whether to intercept a severe dentofacial malocclusion while the patient is still growing, or wait and treat later. This case report describes the nonsurgical treatment of a young patient with a severe Class III open-bite malocclusion associated with a cervical cystic lymphangioma. Despite the poor interceptive therapy prognosis, a 2-phase approach was effective. A reflection about giving up efficiency in favor of effectiveness, functional rehabilitation, and the patient's quality of life is included. PMID:23561417

Souki, Bernardo Quiroga; Figueiredo, Daniel Santos Fonseca; Lima, Izabella Lucas de Abreu; Oliveira, Dauro Douglas; Miguel, José Augusto Mendes

2013-04-01

207

Fertility-sparing treatment in young women with endometrial cancer or atypical complex hyperplasia: a prospective single-institution experience of 21 cases.  

PubMed

We conducted a prospective study of conservative treatment in 21 young nulliparous women with grade (G)1 endometrial cancer stage IA (11) or atypical complex hyperplasia (10). All were treated with a low-dose cyclic natural progestin therapy (200 mg/day from day 14-25) and encouraged to attempt pregnancy immediately. No adverse therapy-related effects were recorded. Overall response rate to progestin therapy was 57%. Nine women conceived (43%). There were 13 pregnancies, of which 13 were spontaneous and 8 were in women with persistent disease or partial response to hormonal treatment. Three additional complete responses were observed after delivery. Only women with known primary infertility or severe polycystic ovary syndrome showed inadequate pregnancy rate. Fifteen women underwent definitive surgery after enrolment (median 27 months, range 3-56 months). All 21 women are alive and disease free after a median follow up of 98 months. PMID:19087082

Signorelli, M; Caspani, G; Bonazzi, C; Chiappa, V; Perego, P; Mangioni, C

2009-01-01

208

Waffle-cone technique with Solitaire™ AB Remodeling Device: endovascular treatment of highly selected complex cerebral aneurysms  

Microsoft Academic Search

Introduction  To evaluate patients with complex aneurysms who underwent waffle-cone stent-assisted coil embolization.\\u000a \\u000a \\u000a \\u000a Methods  From February 2008 to February 2010, consecutive data were collected from 80 patients with aneurysms treated with the Solitaire™\\u000a AB Remodeling Device followed by a standard coiling procedure using bare or\\/and bioactive coils. Six of these patients were\\u000a treated using the “waffle-cone-technique” placing the distal end of a

Vojtech Sychra; Joachim Klisch; Maren Werner; Christian Dettenborn; Alexander Petrovitch; Christoph Strasilla; Rüdiger Gerlach; Steffen Rosahl; Markus Holtmannspötter

209

Application of the upflow anaerobic sludge bed (UASB) process for treatment of complex wastewaters at low temperatures  

Microsoft Academic Search

The feasibility of the upflow anaerobic sludge bed (UASB) process for the treatment of potato starch wastewater at low ambient temperatures was demonstrated by operating two 5.65 l reactors at 14 degrees C and 20 degrees C, respectively. The organic space loading rates achieved in these laboratory-scale reactors were 3 kg COD\\/cubic m\\/day at 14 degrees C and 4-5 kg

I. W. Koster; G. Lettinga

1985-01-01

210

Application of the upflow anaerobic sludge bed (UASB) process for treatment of complex wastewaters at low temperatures  

SciTech Connect

The feasibility of the upflow anaerobic sludge bed (UASB) process for the treatment of potato starch wastewater at low ambient temperatures was demonstrated by operating two 5.65 l reactors at 14 degrees C and 20 degrees C, respectively. The organic space loading rates achieved in these laboratory-scale reactors were 3 kg COD/cubic m/day at 14 degrees C and 4-5 kg COD/cubic m/day at 20 degrees C. The corresponding sludge loading rates were 0.12 kg COD/kg VSS/day at 14 degrees C and 0.16-0.18 kg COD/kg VSS/day at 20 degrees C. These findings are of considerable practical importance because application of anaerobic treatment at low ambient temperatures will lead to considerable savings in energy needed for operating the process. As compared with various other anaerobic wastewater treatment processes, a granular sludge upflow process represents one of the best options developed so far. Although the overall sludge yield under psychrophilic conditions is slightly higher than under optimal mesophilic conditions, this doesn't seriously hamper the operation of the process. The extra sludge yield, due to accumulation of slowly hydrolyzing substrate ingredients, was 4.75% of the COD input at 14 degrees C and 1.22% of the COD input at 20 degrees C. 26 references.

Koster, I.W.; Lettinga, G.

1985-10-01

211

[Efficacy of vascular therapy in complex of treatment of purulent necrotic foot ulcers in patients with diabetes mellitus].  

PubMed

The result of treatment of purulent-necrotic affection of foot (PNAF) in 151 patients with diabetes mellitus (DM) was estimated. The conduction of preoperative medicinal therapy is mandatory for the general status of patient stabilization only. After prescribing of heparin, no-spa, papaverin, rheopolyglucinum, solcoseryl, aspirin the foot tissues blood supply is changing nonvitally, the foot tissues blood supply while the alprostan intravenous infusion improves significantly. The alprostan prescription during performance of operative intervention on foot in patients with PNAF, caused by DM, and in the collateral blood flow decompensation of the leg and foot arteries is mandatory. PMID:11482020

Podpriatov, S Ie; Lisovets', V V; Huch, A O; Tovkun, V K; Slobodeniuk, I M; Hupalo, Iu M

2001-02-01

212

Radial side (1D) tears.  

PubMed

The triangular fibrocartilage complex (TFCC) is the key structure at the wrist that facilitates the rotation of the radius and the carpus on the distal ulnar. The radial or type 1D tears of the TFCC are uncommon, but they pose a major disruption of the articular contact between the carpus and the distal ulna. The tears can heal by arthroscopically repairing the TFCC back to the radius using sutures through bone tunnels. This procedure allows patients to return to their work and sports activities with significant recovery of strength and range of motion. PMID:21871347

Trumble, Thomas

2011-08-01

213

Complex karyotype in mantle cell lymphoma is a strong prognostic factor for the time to treatment and overall survival, independent of the MCL international prognostic index.  

PubMed

Mantle cell lymphoma (MCL) is usually an aggressive disease. However, a few patients do have an "indolent" evolution (iMCL) defined by a long survival time without intensive therapy. Many studies highlight the prognostic role of additional genetic abnormalities, but these abnormalities are not routinely tested for and do not yet influence the treatment decision. We aimed to evaluate the prognostic impact of these additional abnormalities detected by conventional cytogenetic testing, as well as their relationships with the clinical characteristics and their value in identifying iMCL. All consecutive MCL cases diagnosed between 1995 and 2011 at four institutions were retrospectively selected on the basis of an informative karyotype with a t(11;14) translocation at the time of diagnosis. A total of 125 patients were included and followed for an actual median time of 35 months. The median overall survival (OS) and survival without treatment (TFS) were 73.7 and 1.3 months, respectively. In multivariable Cox models, a high mantle cell lymphoma international prognostic index score, a complex karyotype, and blastoid morphology were independently associated with a shortened OS. Spleen enlargement, nodal presentation, extra-hematological involvement, and complex karyotypes were associated with shorter TFS. A score based on these factors allowed for the identification of "indolent" patients (median TFS 107 months) from other patients (median TFS: 1 month). In conclusion, in this multicentric cohort of MCL patients, a complex karyotype was associated with a shorter survival time and allowed for the identification of iMCL at the time of diagnosis. PMID:24249260

Sarkozy, Clémentine; Terré, Christine; Jardin, Fabrice; Radford, Isabelle; Roche-Lestienne, Catherine; Penther, Dominique; Bastard, Christian; Rigaudeau, Sophie; Pilorge, Sylvain; Morschhauser, Franck; Bouscary, Didier; Delarue, Richard; Farhat, Hassan; Rousselot, Philippe; Hermine, Olivier; Tilly, Hervé; Chevret, Sylvie; Castaigne, Sylvie

2014-01-01

214

Efficacy of a short course of complex lymphedema therapy or graduated compression stocking therapy in the treatment of post-thrombotic syndrome.  

PubMed

Treatment options for established post-thrombotic syndrome (PTS) are limited. Complex lymphedema therapy (CLT), a non-invasive treatment that improves lymphatic flow, may have the potential to improve PTS. We conducted a single-center, investigator-blind, randomized controlled trial of 31 patients with a clinically established diagnosis of PTS and compared the efficacy of graduated compression stockings alone (30-40 mmHg) with CLT, a treatment that includes compression stockings, exercise, patient education, skin care and lymphatic drainage. Primary outcomes were the 1- and 3-month changes in PTS severity by the Villalta score and disease-specific quality of life using the VEINES-QOL (Venous Insufficiency Epidemiological and Economic Study Quality of Life) questionnaire. Analysis was by intent-to-treat. We found from a baseline average score of 9.9 points, CLT reduced mean PTS severity scores by -2.4 points (p=0.02) at the 1-month and -2.3 points (p=0.05) at the 3-month follow-up. Score reductions with stockings only were similar at -2.1 (p=0.03) and -3.3 points (p=0.03) at 1 and 3 months. The differences in score between treatments were not significant. Neither treatment significantly changed the VEINES-QOL score except in patients with severe disease. Patients with moderate to severe PTS derived the greatest benefit from either therapy and the two therapies differentially impacted PTS signs and symptoms. We found a short course of lymphedema therapy and compression stockings offer similar benefit in patients with PTS; however, larger studies are needed to further explore the potential use of CLT in PTS, particularly in patients with more severe disease. ClinicalTrials.gov Identifier: NCT00633971. PMID:24558028

Holmes, Chris E; Bambace, Nadia M; Lewis, Patricia; Callas, Peter W; Cushman, Mary

2014-02-01

215

[Comparative estimation of efficacy of the immunecorrecting combined three- level cytokino- and ozonotherapy in complex treatment of extended peritonitis].  

PubMed

The results of surgical treatment of 211 patients, suffering extended peritonitis (EP) of various etiology, were analyzed. The peritonitis severity was graded in accordance to Mannheim's index of peritonitis (MIP). The patients were divided on two groups. In 60 patients (group of comparison) the basic treatment was conducted, without immunocorrection. The patients of the main group were divided on three subgroups. To the patients of the first subgroup (43) 400 ml of ozonated isotonic solution (OIS) of sodium chloride was infused intravenously additionally in the contents of basic therapy, as well as peritoneal-enteral detoxication using OIS was conducted. In a second subgroup a regional intraabdominal endolymphatic ozonotherapy (OTH) was conducted to 57 patients with OIS and peritoneal-enteral sanation using medical ozone. In the 3d subgroup in 51 patients additionally were applied intravenous infusion of OIS and peritoneal-enteral sanation with medical ozone. To these patients cytokinotherapy was conducted, when splenopid was applied intravenously, intraperitoneally and enterally simultaneously. The indices of the T- and B-immunity links, phagocytic activity of neutrophils, including phagocytic index, phagocytic number, the completeness of phagocytosis index, as well as the content of the tumor necrosis factor alpha (TNF-alpha), gamma-interferon (IFN-gamma) and interleukins (IL) - IL-1, IL-2, IL-4, IL-6, IL-10 were estimated in the blood serum in dynamics. The combined staged three-level (systemic, intraperitoneal and enteral) application of natural cytokins and medical ozone have promoted mutual potentiating of their action, significant efficacy of the immunemodulating therapy in comparison with such systemic and local OTH. PMID:23888800

Gadzhiev, N D; Sushkov, S V; Klimova, E M; Kordon, T I

2013-05-01

216

Rapamycin as an alternative to surgical treatment of subependymal giant cell astrocytomas in a patient with tuberous sclerosis complex.  

PubMed

Tuberous sclerosis complex (TSC) is associated with the potential development of benign hamartomas, including subependymal giant cell astrocytomas (SEGAs). Intracranial hypertension can be caused by SEGAs due to their propensity to block the foramen of Monro. The traditional management approach is to monitor SEGAs with periodic neuroimaging and to resect those that exhibit serial growth and/or cause clinical signs of intracranial hypertension. Recent observations suggest that rapamycin therapy may induce partial regression of SEGAs, therefore providing a potential alternative to resection. The authors present the case of an 8-year-old girl with bilateral SEGAs that led to progressive hydrocephaly and incipient signs of papilledema. Three months after initiating rapamycin therapy, the SEGAs exhibited significant reduction in size (82.6% on the left and 46.7% on the right), and the lesions remained stable 5 months later. Compared with previous case reports, similar or even greater antitumor efficacy was achieved with much lower trough levels of rapamycin (10–15 compared with 3.3–4.5 ng/ml, respectively). The authors discuss various aspects of rapamycin therapy and address unresolved issues that highlight the need for further prospective clinical trials. PMID:20887114

Birca, Ala; Mercier, Claude; Major, Philippe

2010-10-01

217

Efficacy of gemcitabine conjugated and miRNA-205 complexed micelles for treatment of advanced pancreatic cancer.  

PubMed

Clinical effectiveness of gemcitabine in pancreatic cancer is hindered due to its rapid plasma metabolism and development of chemo-resistance. We have previously delineated the significant role of miRNAs in mediating the growth and proliferation of cancer stem cells (CSCs) which in turn result in chemo-resistance, invasion and metastasis. Here, we designed self-assembling, gemcitabine conjugated cationic copolymers for co-delivery of a tumor suppressor miRNA-205 (miR-205) and evaluated their in vivo efficacy in a pancreatic cancer ectopic tumor model developed using gemcitabine resistant MIA PaCa-2(R) cells. Combination formulations showed mean a particle size of <100 nm and gemcitabine payload of >10% w/w, exhibited miRNA complexation at N/P ratio of 4/1, sustained release of gemcitabine for >10 days, transfection efficiency of >90%, extended miRNA and drug stability in serum. Functional assays in gemcitabine resistant MIA PaCa-2(R) and CAPAN-1(R) pancreatic cancer cells revealed that the combination formulations effectively reversed chemo-resistance, invasion and migration. In pancreatic tumor model, the combination formulation treated group showed significant inhibition of tumor growth. Immuno-hiostochemical analysis revealed decreased tumor cell proliferation with increased apoptosis in the animals treated with miR-205 and gemcitabine combination. PMID:24836307

Mittal, Anupama; Chitkara, Deepak; Behrman, Stephan W; Mahato, Ram I

2014-08-01

218

Emerging complexities of APOBEC3G action on immunity and viral fitness during HIV infection and treatment  

PubMed Central

The enzyme APOBEC3G (A3G) mutates the human immunodeficiency virus (HIV) genome by converting deoxycytidine (dC) to deoxyuridine (dU) on minus strand viral DNA during reverse transcription. A3G restricts viral propagation by degrading or incapacitating the coding ability of the HIV genome. Thus, this enzyme has been perceived as an innate immune barrier to viral replication whilst adaptive immunity responses escalate to effective levels. The discovery of A3G less than a decade ago led to the promise of new anti-viral therapies based on manipulation of its cellular expression and/or activity. The rationale for therapeutic approaches has been solidified by demonstration of the effectiveness of A3G in diminishing viral replication in cell culture systems of HIV infection, reports of its mutational footprint in virions from patients, and recognition of its unusually robust enzymatic potential in biochemical studies in vitro. Despite its effectiveness in various experimental systems, numerous recent studies have shown that the ability of A3G to combat HIV in the physiological setting is severely limited. In fact, it has become apparent that its mutational activity may actually enhance viral fitness by accelerating HIV evolution towards the evasion of both anti-viral drugs and the immune system. This body of work suggests that the role of A3G in HIV infection is more complex than heretofore appreciated and supports the hypothesis that HIV has evolved to exploit the action of this host factor. Here we present an overview of recent data that bring to light historical overestimation of A3G’s standing as a strictly anti-viral agent. We discuss the limitations of experimental systems used to assess its activities as well as caveats in data interpretation.

2012-01-01

219

Vincristine Lipid Complex Injection  

MedlinePLUS

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

220

Delamination technique together with longitudinal incisions for treatment of Chiari I/syringomyelia complex: a prospective clinical study  

PubMed Central

Background Treatment modalities in Chiari malformation type 1(CMI) accompanied by syringomyelia have not yet been standardized. Pathologies such as a small posterior fossa and thickened dura mater have been discussed previously. Various techniques have been explored to enlarge the foramen magnum and to expand the dura. The aim of this clinical study was to explore a new technique of excision of the external dura accompanied by widening the cisterna magna and making longitudinal incisions in the internal dura, without disturbing the arachnoid. Methods Ten patients with CMI and syringomyelia, operated between 2004 and 2006, formed this prospective series. All cases underwent foramen magnum decompression of 3 × 3 cm area with C1–C2 (partial) laminectomy, resection of foramen magnum fibrous band, excision of external dura, delamination and widening of internal dura with longitudinal incisions. Results Patients were aged between 25 and 58 years and occipital headache was the most common complaint. The mean duration of preoperative symptoms was 4 years and the follow-up time was 25 months. Clinical progression was halted for all patients; eight patients completely recovered and two reported no change. In one patient, there was a transient cerebrospinal fluid (CSF) fistula that was treated with tissue adhesive. While syringomyelia persisted radiologically with radiological stability in five patients; for three patients the syringomyelic cavity decreased in size, and for the remaining two it regressed completely. Conclusion Removal of the fibrous band and the outer dural layer, at level of foramen magnum, together with the incision of inner dural layer appears to be good technique in adult CMI patients. The advantages are short operation time, no need for duraplasty, sufficient posterior fossa decompression, absence of CSF fistulas as a result of extra arachnoidal surgery, and short duration of hospitalization. Hence this surgical technique has advantages compared to other techniques.

Kotil, Kadir; Ton, Tugrul; Tari, Rabia; Savas, Yildiray

2009-01-01

221

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

PubMed

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

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

2014-04-01

222

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

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

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

1994-01-01

223

A multiscale approach to assess the complex surface of polyurethane catheters and the effects of a new plasma decontamination treatment on the surface properties.  

PubMed

Polyurethane catheters made of Pellethane 2363-80AE® were treated with a low temperature plasma developed for the decontamination of reusable polymer devices in hospitals. We investigated the modifications of the polymer surface by studying the topographic modifications, the chemical modifications, and their consequences on the wettability and bacterial adhesion. This study showed that plasma treatment modified the topography and grafted oxygen and nitrogen species onto the surface, resulting in an increase in the surface polarity. This effect could be correlated to the number of nitrogen atoms interacting with the surface. Moreover, this study demonstrated the significance of multiscale heterogeneities, and the complexity of industrial medical devices made from polymers. Their surface can be heterogeneous, and they contain additives that can migrate and change the surface composition. PMID:20920389

Mrad, Omar; Saunier, Johanna; Aymes-Chodur, Caroline; Rosilio, Véronique; Bouttier, Sylvie; Agnely, Florence; Aubert, Pascal; Vigneron, Jacky; Etcheberry, Arnaud; Yagoubi, Najet

2010-12-01

224

Development of pyrrole-imidazole polyamide targeting fc receptor common gamma chain for the treatment of immune-complex related renal disease.  

PubMed

Fc? receptors I and III are thought to be involved in the development of lupus nephritis. Expression of Fc receptor common gamma chain (FcR?) is necessary for the stable expression of Fc? receptors I and III. The aim of this study was to develop a novel agent for the treatment of immune complex related renal disease using a gene regulator, pyrrole(Py)-imidazole(Im) (PI) polyamide, targeting the mouse FcR? gene promoter. Two PI polyamides targeting FcR? promoters were designed and synthesized. The effect of the PI polyamides on FcR? mRNA expression was evaluated in J774.A cells by real-time polymerase chain reaction (PCR), and CD16/32 protein expression was determined by immunocytochemical analysis and flow cytometry. The effects of these polyamides on FcR? gene expression and CD16/32 protein expression were evaluated in mouse peripheral blood mononuclear cells (PBMCs). One milligram per kilogram body weight of PI polyamide was injected via the tail vein every 2 d for 1 week and PBMCs were collected and analyzed. PI polyamide showed a specific binding to the target DNA in a gel mobility shift assay. Treatment of J774.A cells with 1.0 µM PI polyamide 1 significantly reduced FcR? mRNA expression and CD16/32 surface protein expression in J774.A cells. Similarly, PI polyamide significantly decreased expression of FcR? mRNA and CD16/32 in the PBMCs of C57B6 mice. PI polyamide designed to bind the FcR? promoter decreased FcR? gene and CD16/32 protein expression. PI polyamide targeting the FcR? gene may be a novel gene regulator for the prevention of lupus nephritis or other immune complex-related disease. PMID:22971693

Kajiwara, Mamiko; Ueno, Takahiro; Fukuda, Noboru; Matsuda, Hiroyuki; Shimokawa, Toshibumi; Kitai, Maki; Tsunemi, Akiko; Fuke, Yoshinobu; Fujita, Takayuki; Matsumoto, Koichi; Matsumoto, Yoshiaki; Ra, Chisei; Soma, Masayoshi

2012-01-01

225

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

SciTech Connect

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.

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

1997-12-31

226

Ulnar shortening after TFCC suture repair of Palmer type 1B lesions  

Microsoft Academic Search

Purpose  The objective of this study was to determine functional and subjective outcomes of an ulnar shortening procedure elected by\\u000a patients who experienced persistent ulno-carpal symptoms following arthroscopic suture repair of a Palmer type 1B lesion.\\u000a All patients had a dynamic ulna positive variance.\\u000a \\u000a \\u000a \\u000a Methods  Five patients (3 males and 2 females) with arthroscopic repair of Palmer type 1B tears who subsequently

Maya B. Wolf; Markus W. Kroeber; Andreas Reiter; Susanne B. Thomas; Peter Hahn; Raymund E. Horch; Frank Unglaub

2010-01-01

227

"Waffle Cone" Technique for Intra/Extra-Aneurysmal Stent Placement for the Treatment of Complex and Wide-Necked Bifurcation Aneurysm  

PubMed Central

Summary Endovascular treatment of intracranial aneurysms by coiling has become an accepted alternative to surgical clipping1. In cases of wide-necked and sidewall aneurysms, selective embolization is difficult because of the risk of coil protrusion into the parent vessel. The use of three-dimensional coils, stents2, and balloon remodeling have all aided the attempt to adequately manage such lesions. However, compared with sidewall aneurysms, bifurcation aneurysms are more challenging from an endovascular standpoint. Because of their specific anatomy and hemodynamics, the tendency to recur and rerupture is higher. Several authors have reported successful treatment of these complex and wide-necked bifurcation aneurysms by using Y-configured dual stent-assisted coil embolization3,4, the double microcatheter technique5, a more compliant balloon remodeling technique6, the TriSpan neck-bridge device7, or the waffle cone technique8. We describe two cases of wide-necked bifurcation aneurysms in which the waffle cone technique was used for coil embolization. The waffle cone technique was first described in 2006; however, the small number of published cases and the lack of follow-up prevent one from assessing this technique's durability and the probability of recanalization. We report the cases of two patients harboring unruptured wide-necked bifurcation aneurysms that were treated and followed-up for six months.

Yang, Tzu-Hsien; Wong, Ho-Fai; Yang, Ming-Shiang; Ou, Chang-Hsien; Ho, Tzu-Lung

2008-01-01

228

"Waffle cone"technique for intra/extra-aneurysmal stent placement for the treatment of complex and wide-necked bifurcation aneurysm.  

PubMed

Summary: Endovascular treatment of intracranial aneurysms by coiling has become an accepted alternative to surgical clipping (1). In cases of wide-necked and sidewall aneurysms, selective embolization is difficult because of the risk of coil protrusion into the parent vessel. The use of three-dimensional coils, stents (2), and balloon remodeling have all aided the attempt to adequately manage such lesions. However, compared with sidewall aneurysms, bifurcation aneurysms are more challenging from an endovascular standpoint. Because of their specific anatomy and hemodynamics, the tendency to recur and rerupture is higher. Several authors have reported successful treatment of these complex and wide-necked bifurcation aneurysms by using Yconfigured dual stent-assisted coil embolization (3,4), the double microcatheter technique (5), a more compliant balloon remodeling technique (6), the TriSpan neck-bridge device (7), or the waffle cone technique (8).We describe two cases of widenecked bifurcation aneurysms in which the waffle cone technique was used for coil embolization. The waffle cone technique was first described in 2006; however, the small number of published cases and the lack of follow-up prevent one from assessing this technique's durability and the probability of recanalization.We report the cases of two patients harboring unruptured wide-necked bifurcation aneurysms that were treated and followed-up for six months. PMID:20557801

Yang, Tzu Hsien; Wong, Ho Fai; Yang, Ming Shiang; Ou, Chang Hsien; Ho, Tzu Lung

2008-11-11

229

Delta III reverse shoulder arthroplasty in the treatment of complex 3- and 4-part fractures of the proximal humerus: 6 to 42 months of follow up  

PubMed Central

Background There is a growing tendency for complex proximal humerus fractures (PHF) in osteoporotic patients to be treated with reverse shoulder arthroplasty (RSA). It has been proposed that RSA has more benefits than other treatment options. The aim of our study was to investigate preoperative characteristics as well as clinical and radiological outcomes in patients with complex 3- or 4-part PHF who had undergone primary RSA. Methods Patients with a minimum follow-up of 6 months who had undergone a primary RSA after 3- or 4-part PHF in the period between 2008 and 2011 were eligible for the study. Clinical records, X-rays and CT-scans were investigated and a clinical examination was performed. Disabilities of the Arm, Shoulder and Hand (DASH) score and Constant-Murley score (CMS) were calculated. Sixteen patients were examined as part of the study. The mean follow-up was 20 months (range 6-42 months). According to Codman-Hertel classification we encountered 15 Hertel “12” and 1 Hertel “8” type fractures. Results Thirty-two patients (27 female – 84.4%) with a mean age of 72 years underwent operations to treat complex 3- and 4-part fractures of the proximal humerus. Sixteen patients were reexamined. In 14 cases the dominant upper extremity was on the right, in 2 cases it was on the left, in 6 cases the right side was affected and in 10 cases the left side was affected. The mean CMS was 54.8 (range 18-95) and the mean DASH was 37.5 (range 2.9-81). A trend was established between the CMS and dominance of the affected shoulder. The CMS was better if the affected shoulder was on the non-dominant side (p-value 0.051). No statistical difference was noted between age and clinical outcome. Conclusions Our mid-term follow-up shows satisfying results in terms of the treatment of severe displaced fractures in elderly patients with RSA. RSA can provide immediate relief and good shoulder function in elderly patients. Nevertheless, the question of longevity of these implants remains to be observed.

2013-01-01

230

Comparison of Efficacy, Tolerability, and Cost of Iron Polymaltose Complex With Ferrous Sulphate in the Treatment of Iron Deficiency Anemia in Pregnant Women  

PubMed Central

Background The efficacy of iron polymaltose complex (IPC) in the treatment of iron deficiency anemia (IDA) during pregnancy has not been well established, and the evidence is inconclusive. Aims The aim of the study was to compare efficacy, safety, compliance, and cost-effectiveness of IPC with ferrous sulphate (FS) in pregnant patients. Settings and Designs The randomized, double-blind, parallel-group study was conducted in the Department of Pharmacology in collaboration with the Department of Obstetrics and Gynaecology Postgraduate Institute of Medical Education and Research, Chandigarh, India. Methods One hundred pregnant women aged 20–40 years at14 to 27 weeks' gestation, with hemoglobin (Hb) < 9 g/dL, and serum ferritin < 12 mcg/L, were classified into 2 groups. One group received IPC (100 mg elemental iron), and the other group received FS (120 mg elemental iron) daily for 8 weeks. At Week 0 and Week 8, Hb, packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), serum iron, and serum ferritin were measured. Compliance with study medication was determined by pill counting at each visit. Cost minimization analysis was done to compare the costs of the 2 treatments. Statistical Analysis Data are expressed as mean ± SD. Paired and unpaired ‘t’ test were used to analyze differences within groups and between groups. Chi-square (x2) test was used to analyze primary efficacy parameters and adverse drug reactions (ADR). Results Statistically significant increases in Hb, PCV, MCV, MCH, MCHC, serum iron, and serum ferritin levels were seen at the end of 8 weeks of treatment in both groups. The overall adverse effects were more common in the FS group compared with the IPC group [41 (78%) vs 15 (31%), P < .001]. The compliance rate was significantly (P < .05) higher for the IPC (91%) group than for the FS (87%) group. The average total cost (direct + indirect) of treatment of anemia was comparable between the 2 groups. Conclusion The results of the present study suggest that IPC can be considered as a useful alternative formulation for the treatment of IDA during pregnancy for those patients who cannot tolerate other iron preparations (ferrous form); this is an important finding, as compliance is a significant concern during pregnancy.

Saha, Lekha; Pandhi, Promila; Gopalan, Sarala; Malhotra, Samir; Saha, Pradip kumar

2007-01-01

231

Constructing a Theory- and Evidence-Based Treatment Rationale for Complex eHealth Interventions: Development of an Online Alcohol Intervention Using an Intervention Mapping Approach  

PubMed Central

Background Due to limited reporting of intervention rationale, little is known about what distinguishes a good intervention from a poor one. To support improved design, there is a need for comprehensive reports on novel and complex theory-based interventions. Specifically, the emerging trend of just-in-time tailoring of content in response to change in target behavior or emotional state is promising. Objective The objective of this study was to give a systematic and comprehensive description of the treatment rationale of an online alcohol intervention called Balance. Methods We used the intervention mapping protocol to describe the treatment rationale of Balance. The intervention targets at-risk drinking, and it is delivered by email, mobile phone text messaging, and tailored interactive webpages combining text, pictures, and prerecorded audio. Results The rationale of the current treatment was derived from a self-regulation perspective, and the overarching idea was to support continued self-regulation throughout the behavior change process. Maintaining the change efforts over time and coping adaptively during critical moments (eg, immediately before and after a lapse) are key factors to successful behavior change. Important elements of the treatment rationale to achieving these elements were: (1) emotion regulation as an inoculation strategy against self-regulation failure, (2) avoiding lapses by adaptive coping, and (3) avoiding relapse by resuming the change efforts after a lapse. Two distinct and complementary delivery strategies were used, including a day-to-day tunnel approach in combination with just-in-time therapy. The tunnel strategy was in accordance with the need for continuous self-regulation and it functions as a platform from which just-in-time therapy was launched. Just-in-time therapy was used to support coping during critical moments, and started when the client reports either low self-efficacy or that they were drinking above target levels. Conclusions The descriptions of the treatment rationale for Balance, the alcohol intervention reported herein, provides an intervention blueprint that will aid in interpreting the results from future program evaluations. It will ease comparisons of program rationales across interventions, and may assist intervention development. By putting just-in-time therapy within a complete theoretical and practical context, including the tunnel delivery strategy and the self-regulation perspective, we have contributed to an understanding of how multiple delivery strategies in eHealth interventions can be combined. Additionally, this is a call for action to improve the reporting practices within eHealth research. Possible ways to achieve such improvement include using a systematic and structured approach, and for intervention reports to be published after peer-review and separately from evaluation reports.

Johansen, Ayna; Nesvag, Sverre; Kok, Gerjo; Duckert, Fanny

2013-01-01

232

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

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.

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

2014-01-01

233

Anti-TNF-? (Infliximab) Used as Induction Treatment in Case of Active Proctitis in a Multistep Strategy Followed by Definitive Surgery of Complex Anal Fistulas in Crohn’s Disease: A Preliminary Report  

Microsoft Academic Search

PURPOSE  This study was designed to assess the healing rate of complex perianal fistulas in Crohns disease after a multistep strategy, including induction treatment with In-fliximab in case of active proctitis, followed by definitive surgery.METHODS  From 2000 to 2003, all consecutive patients with complex fistulas and Crohns disease underwent pretreatment with noncutting setons and, in case of severe recurrent fistulas or abscesses,

Stephan J. van der Hagen; Cor G. Baeten; Peter B. Soeters; Maurice G. V. M. Russel; Regina G. Beets-Tan; Wim G. van Gemert

2005-01-01

234

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

PubMed Central

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.

2010-01-01

235

Efficacy and toxicity of intermediate-dose amphotericin B lipid complex as a primary or salvage treatment of fungal infections in patients with hematological malignancies.  

PubMed

We treated 74 adults with a hematological malignancy and documented or suspected invasive fungal infection (IFI) with amphotericin B lipid complex (ABLC) at 3 mg/kg/day. Forty-five patients (61%) received upfront therapy and 29 patients (39%) received salvage therapy for their IFI. Forty-eight of 71 evaluable patients responded [complete responses in 40 (56%) and partial responses in 8 (11%)] and 15 (21%) died as a consequence of the IFI. Response rates in invasive aspergillosis were 33 out of 49 (67%) for probable/definite cases and 6 out of 11 (55%) for invasive candidiasis. In 40 patients with neutropenia-associated IFI, rapid neutropenic recovery ( < 10 days from study entry) was essential for response to therapy (90% vs. 32%, P < 0.01). Treatment was well tolerated, with 15% infusions followed by infusion-related adverse events, nephrotoxicity in 7% of patients and 11% of withdrawals due to toxicity. These data suggest that intermediate-doses of ABLC may be of similar efficacy than higher doses with less toxicity, making it a cost-effective alternative worthy of study in future trials. PMID:16194888

Martino, Rodrigo; Cortés, Montserrat; Subirá, Maricel; Parody, Rocio; Moreno, Estela; Sierra, Jorge

2005-10-01

236

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

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.

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

2013-01-01

237

Randomized, Double-Blind, Placebo-Controlled Study of the Safety and Efficacy of Vitamin B Complex in the Treatment of Nocturnal Leg Cramps in Elderly Patients with Hypertension  

Microsoft Academic Search

Nocturnal leg cramps is a common and troublesome problem in elderly individuals, and their etiology is unknown. Treatment with quinine is a common practice, but the effectiveness of the drug is doubtful and adverse drug effects are common. This randomized, double-blind, placebo-controlled study was conducted to evaluate the safety and efficacy of vitamin B complex capsules (fursulthiamine 50 mg, hydroxocobalamin

Paul Chan; Tsuei-Yuen Huang; Yi-Jen Chen; Wen-Pin Huang; Yu-Chi Liu

1998-01-01

238

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

PubMed Central

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.

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

239

Aortic arch/elephant trunk procedure with SiennaTM graft and endovascular stenting of thoraco-abdominal aorta for treatment of complex chronic dissection  

PubMed Central

Aneurismal dilatation of the remaining thoracic aorta after ascending aortic interposition grafting for type ‘A’ aortic dissection is not uncommon. For such complex cases, one treatment option is total arch replacement and elephant trunk procedure with the SiennaTM collared graft (Vascutek, Inchinnan, UK) technique followed by a staged thoracic endovascular aortic repair (TEVAR). The video illustrates our technique in a 56-year-old man with an extensive aortic arch and descending thoracic aortic dissecting aneurysm. For the ‘open’ procedure femoral arterial and venous cannulation was used along with systemic cooling and circulatory arrest at 22 °C. Upon circulatory arrest, the aortic arch was incised and antegrade cerebral perfusion achieved via selective cannulation to the right brachiocephalic and left common carotid artery, keeping flow rates at 10-15 mL/kg/min and perfusion pressure at 50-60 mmHg. Arch replacement with an elephant trunk component was then performed and after completion of the distal aortic anastomosis antegrade perfusion via a side-arm in the graft was started and the operation completed using a variation of the ‘sequential’ clamping technique to maximize cerebral perfusion. The second endovascular stage was performed two weeks after discharge. Two covered stents were landing from the elephant trunk to the distal descending thoracic aorta, to secure the distal landing a bare stent of was placed to cover the aorta just distal to the origin of the celiac axis. The left subclavian artery was embolised with fibre coils. Post TEVAR angiogram showed no endoleak Although re-operative total arch replacement and elephant trunk procedure and subsequent TEVAR remained a challenging procedure, we believe excellent surgical outcome can be achieved with carefully planned operative strategy.

Wong, Randolph H.L.; Baghai, Max; Yu, Simon C.H.

2013-01-01

240

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

The systemic administration of nitroglycerine induces attacks in migraineurs and is able to activate and sensitize the trigeminal system in animals involving glutamate and ?7-nicotinic acetylcholine receptors, among others. Kynurenic acid is one of the endogenous glutamate receptor antagonists, and exerts inhibitory action on the ?7-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 ?7-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

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

2014-07-01

241

Guideline-concordant administration of prothrombin complex concentrate and vitamin K is associated with decreased mortality in patients with severe bleeding under vitamin K antagonist treatment (EPAHK study)  

PubMed Central

Introduction In vitamin K antagonist (VKA)-treated patients with severe hemorrhage, guidelines recommend prompt VKA reversal with prothrombin complex concentrate (PCC) and vitamin K. The aim of this observational cohort study was to evaluate the impact of guideline concordant administration of PCC and vitamin K on seven-day mortality. Methods Data from consecutive patients treated with PCC were prospectively collected in 44 emergency departments. Type of hemorrhage, coagulation parameters, type of treatment and seven-day mortality mortality were recorded. Guideline-concordant administration of PCC and vitamin K (GC-PCC-K) were defined by at least 20 IU/kg factor IX equivalent PCC and at least 5 mg of vitamin K performed within a predefined time frame of eight hours after admission. Multivariate analysis was used to assess the effect of appropriate reversal on seven-day mortality in all patients and in those with intracranial hemorrhage (ICH). Results Data from 822 VKA-treated patients with severe hemorrhage were collected over 14 months. Bleeding was gastrointestinal (32%), intracranial (32%), muscular (13%), and “other” (23%). In the whole cohort, seven-day mortality was 13% and 33% in patients with ICH. GC-PCC-K was performed in 38% of all patients and 44% of ICH patients. Multivariate analysis showed a two-fold decrease in seven-day mortality in patients with GC-PCC-K (odds ratio (OR)?=?2.15 (1.20 to 3.88); P?=?0.011); this mortality reduction was also observed when only ICH was considered (OR?=?3.23 (1.53 to 6.79); P?=?0.002). Conclusions Guideline-concordant VKA reversal with PCC and vitamin K within eight hours after admission was associated with a significant decrease in seven-day mortality.

2014-01-01

242

Estrus synchronization and ovarian hyper-stimulation treatments have negligible effects on cumulus oocyte complex gene expression whereas induction of ovulation causes major expression changes.  

PubMed

The effects of exogenous hormones, used for estrus synchronization and ovarian hyper stimulation, on cumulus oocyte complexes (COCs) gene expression in sexually mature rats were determined using microarrays. Gene expression in COCs collected from GnRH (G(trt)), GnRH + eCG (G + E(trt)), and GnRH + eCG + hCG (G + E + H(trt)) treatments were compared to COCs from naturally cycling (NC) rats before the preovulatory luteninizing hormone surge. There was no significant difference in gene expression among NC, G(trt), and G + E(trt); however, over 2,600 genes were significantly different between NC and G + E + H(trt) (P < 0.05). Genes upregulated in G + E + H(trt) encode for: proteins that are involved in prostaglandin synthesis (Ptgs2, Pla2g4a, and Runx1) and cholesterol biosynthesis (Hmgcr, Sc4mol, and Dhcr24); receptors that allow cholesterol uptake (Ldlr and Scarb1), regulate progesterone synthesis (Star), and inactivate estrogen (Sult1e1); and downstream effectors of LH signal (Pgr, Cebpb, Creb3l1, Areg, Ereg, and Adamts1). Conversely, G + E + H(trt) downregulated genes encoding proteins involved in: DNA replication and cell cycle progression (Ccne2, Orc5l, Rad50, and Mcm6); reproductive developmental process; and granulosa cell expansion (Gdf9, Bmp15, Amh, Amhr2, Bmpr1b, Tgfb2, Foxl2, Pde3a, Esr2, Fshr, Ybx2, Ccnd2, Ccnb1ip1, and Zp3); maternal effect genes required for embryo development (Zar1, Npm2, Nlrp5, Dnmt1, H1foo, and Zfp57); amino acid degradation; and ketogenesis (Hmgcs2, and Cpt1b). These results from the rat show that hormones used for estrus synchronization (G(trt)) and ovarian hyper stimulation (G + E(trt)) had minimal effects on gene expression, whereas induction of ovulation (G + E + H(trt)) caused major changes in gene expression of rat COCs. This study provides comprehensive information about regulated genes during late follicle development and ovulation induction. PMID:23239112

Agca, Cansu; Yakan, Akin; Agca, Yuksel

2013-02-01

243

Shape complexity  

Microsoft Academic Search

The complexity of 3D shapes that are represented in digital form and processed in CAD\\/CAM\\/CAE, entertainment, biomedical, and other applications has increased considerably. Much research was focused on coping with or on reducing shape complexity. But, what exactly is shape complexity? We discuss several complexity measures and the corresponding complexity reduction techniques. Algebraic complexity measures the degree of polynomials needed

Jarek Rossignac

2005-01-01

244

A new promising application for highly cytotoxic metal compounds: ?6-areneruthenium(II) phosphite complexes for the treatment of alveolar echinococcosis.  

PubMed

Two series of ?(6)-areneruthenium(II) phosphite complexes were prepared, characterized, and evaluated in vitro for their toxic potential against Echinococcus multilocularis metacestodes. Neutral complexes of general formula [(?(6)-p-cymene)RuCl(2){P(OR)(3)}] (R = Et, (i)Pr, Ph) with two easily exchangable chloride ligands showed only minor toxicity, whereas the substitution of these moieties against a ?-diketonate (2,2,6,6-tetramethylheptanedionate) ligand led to hydrolytically stable complex salts of type [(?(6)-p-cymene)Ru(?-diketonate){P(OR)(3)}][BF(4)] (R = Et, (i)Pr, Ph) with comparable in vitro toxicity (50% PGI release at c = 1.4 - 4.7 ?M) to the reference drug nitazoxanide (50% PGI release at c = 1.2 ?M). In addition, the latter complexes were highly toxic against rat hepatoma cells (IC(50) = 0.40-2.0 ?M) and less toxic against human foreskin fibroblasts (IC(50) = 1.1-2.9 ?M) and Vero cells (IC(50) = 1.2-8.9 ?M). The measured cytotoxicities against mammalian cells are, to the best of our knowledge, among the highest ever observed for ruthenium-based complexes. In conclusion, complex salts of type [(?(6)-p-cymene)Ru(?-diketonate){P(OR)(3)}][BF(4)] might be interesting candidates for further development toward anthelmintic drugs and/or highly cytotoxic metal compounds. PMID:22489925

Küster, Tatiana; Lense, Nadine; Barna, Fabienne; Hemphill, Andrew; Kindermann, Markus K; Heinicke, Joachim W; Vock, Carsten A

2012-05-10

245

Efficacy of 5 day radical treatment of primaquine in Plasmodium vivax cases at the BHEL industrial complex, Hardwar (U.P.).  

PubMed

Studies on 725 P. vivax infected patients at the Bharat Heavy Electricals Ltd. produced 6.9 per cent relapse rate after administration of radical treatment of primaquine / 15 mg daily for 5 days as followed under the National Malaria Eradication Programme. Maximum relapses were recorded in a female patient in spite of repeated radical treatment. PMID:2676618

Sinha, S; Dua, V K; Sharma, V P

1989-06-01

246

EBT2 radiochromic film for quality assurance of complex IMRT treatments of the prostate: micro-collimated IMRT, RapidArc, and TomoTherapy.  

PubMed

In response to the clinical need for a dosimetry system with both high resolution and minimal angular dependence, this study demonstrates the utility of Gafchromic EBT2 radiochromic dosimetry film for the quality assurance of micro-collimated IMRT, RapidArc and TomoTherapy treatments. Firstly, preliminary measurements indicated that the dose response of EBT2 film does not appreciably vary with either the angle of incidence of the radiation beam or the depth in water at which the film is placed. Secondly, prostate treatment plans designed for delivery using static-beam IMRT (collimated using the BrainLab m3 microMLC), RapidArc and TomoTherapy were investigated by comparing dose planes obtained from treatment planning calculations with EBT2 film measurements. For all treatment plans, the proportion of dose points agreeing with the film measurements to within ? (3%,3 mm) was found to be above 95%, with all points agreeing within 5%. The film images provided sufficient information to verify that the treatments could be delivered with an acceptable level of accuracy, while also providing additional information on low-level dose variations that were not predicted by the treatment planning systems. This information included: the location and extent of dose from inter-leaf leakage (in the RapidArc plan) and helical field junctioning (in the TomoTherapy plan), as well as the existence of small regions where the treatment planning system under-predicted the dose from very small treatment segments (in the micro-collimated IMRT plan). PMID:21748444

Kairn, T; Hardcastle, N; Kenny, J; Meldrum, R; Tomé, W A; Aland, T

2011-09-01

247

Impact of Three-Phase Bone Scintigraphy on the Diagnosis and Treatment of Complex Regional Pain Syndrome Type I or Reflex Sympathetic Dystrophy  

Microsoft Academic Search

Objective: To determine the impact of three-phase bone scintigraphy (TPBS) on the diagnosis and management of complex regional pain syndrome type I (CRPSI) or reflex sympathetic dystrophy (RSD). Subjects and Methods: Twentyconsecutive patients with a recent clinical evidence of CRPSI were referred for TPBS as part of their routine management plan. All patients underwent neurological examinations with special attention to

Dia Shehab; Abdelhamid Elgazzar; B. David Collier; Sleiman Naddaf; Khalid Al-Jarallah; Abdelmoneim Omar; Moudi Al-Mutairy

2006-01-01

248

Treatment and Recovery  

MedlinePLUS

... Shopping cart Contact Us DVBIC Defense and Veterans Brain Injury Center Main menu Service Members & Veterans Family & Friends ... Materials Research DVBIC Locations Press Treatment and Recovery Brain injury treatment is a complex field of medical rehabilitation. ...

249

Routine depression screening in an HIV clinic cohort identifies patients with complex psychiatric co-morbidities who show significant response to treatment.  

PubMed

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

Schumacher, Joseph E; 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

2013-10-01

250

Current use of intrapleural tissue plasminogen activator in the treatment of complex pleural processes: a review of the literature and report of 9 cases.  

PubMed

Intrapleural tissue plasminogen activator is increasingly being utilized to treat complex pleural processes, such as complicated pleural effusions and empyemas, without surgical intervention. This technique is especially useful for patients with numerous co-morbidities or who are poor surgical candidates. We present our experience in treating nine adult patients with intrapleural tissue plasminogen activator for complex pleural processes. Patients were treated with one to eight doses until their condition resolved or surgical intervention was necessary. Seven patients had complete resolution, two patients required surgical intervention, and there were no complications from therapy. A review of all available literature on the use of intrapleural tissue plasminogen activator in adults is presented, comparing the various methods and techniques used by others. PMID:23066590

Dulaney, Caleb R; Merrill, Walter H; Tesseneer, Stephanie; Jenkins-Lonidier, Lora; Tribble, Curtis G

2012-07-01

251

Low-Dose Amphotericin B Lipid Complex for the Treatment of Persistent Fever of Unknown Origin in Patients with Hematologic Malignancies and Prolonged Neutropenia  

Microsoft Academic Search

We studied the safety of low-dose amphotericin B lipid complex (ABLC, at 1 mg\\/kg\\/day) in 30 persistently febrile (>38°C for at least 5 days or with recurrent fever after 3 days of apyrexia) and neutropenic (<0.5 × 109\\/l) adult patients with hematologic malignancies. The median age was 45 years (range 18–67), most (60%) had an acute leukemia and all had

Rodrigo Martino; Maricel Subirá; Andreu Domingo-Albós; Anna Sureda; Salut Brunet; Jordi Sierra

1999-01-01

252

Fuel Treatments, Fire Suppression, and Their Interactions With Wildfire and Its Effects: The Warm Lake Experience During the Cascade Complex of Wilfires in Central Idaho, 2007.  

National Technical Information Service (NTIS)

Wildfires during the summer of 2007 burned over 500,000 acres within central Idaho. These fires burned around and through over 8,0000 acres of fuel treatments designed to offer protection from wildfire to over 70 summer homes and other buildings located n...

M. Loseke R. T. Graham T. B. Jain

2009-01-01

253

Localization of Activator Protein1 Complex with DNA Binding Activity in Mitochondria of Murine Brain after In Vivo Treatment with Kainate  

Microsoft Academic Search

To elucidate mechanisms underlying mitochondrial dysfunc- tions induced by glutamate, we have examined the effects of in vivo treatment with the ionotropic glutamate receptor agonist kainate on localization of the transcription factor activator protein-1 (AP-1) in mitochondria as well as nuclei of murine brain. A systemic administration of kainate dramatically en- hanced AP-1 DNA binding in both mitochondrial and nuclear

Kiyokazu Ogita; Hiroaki Okuda; Masahiro Kitano; Yoshiaki Fujinami; Kiyokazu Ozaki; Yukio Yoneda

2002-01-01

254

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

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.

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

2012-01-01

255

Treatment of ovarian cancer cell lines with 5-aza-2?-deoxycytidine upregulates the expression of cancer-testis antigens and class I major histocompatibility complex-encoded molecules  

Microsoft Academic Search

Purpose  To test the hypothesis that decrease in DNA methylation will increase the expression of cancer-testis antigens (CTA) and class\\u000a I major histocompatibility complex (MHC)-encoded molecules by ovarian cancer cells, and thus increase the ability of these\\u000a cells to be recognized by antigen-reactive CD8+ T cells.\\u000a \\u000a \\u000a \\u000a Methods  Human ovarian cancer cell lines were cultured in the presence or absence of varying concentrations

Sara J. Adair; Kevin T. Hogan

2009-01-01

256

Formation of Edible Soybean and Soybean-Complex Protein Films by a Cross-Linking Treatment with a New Streptomyces Transglutaminase  

Microsoft Academic Search

Summary Soybean protein isolate (SPI) was used in the investigation of the formation of edible protein films through an enzymatic cross-linking method with a purified microbial trans- glutaminase (MTG) produced from a new effective strain Streptomyces sp. WZFF.L-M1 pre- served in our laboratory, followed by the addition of glycerol and suitable heating and drying treatments. Cheaper partially-purified skimmed soybean protein

Guocheng Su; Huinong Cai; Changyi Zhou; Zhang Wang

2007-01-01

257

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

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 1.0?L 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 0.0024?g/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

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

2014-01-17

258

Propranolol in Use for Treatment of Complex Infant Hemangiomas: Literature Review Regarding Current Guidelines for Preassessment and Standards of Care before Initiation of Therapy  

PubMed Central

In 2008, the positive effects of propranolol on infantile hemangiomas (IH) have been discovered serendipitously by Léauté-Labrèze and her coworkers. Since then, propranolol has been in use in allday clinical practice worldwide for treatment of IH. It even caused some kind of paradigm shift in the overall management of these lesions, though propranolol is still not FDA approved, respectively, in “off-label” use for this indication in the majority of institutions. Thus, the aim of this communication is to evaluate the literature for current evidence regarding guidelines for preassessment and standards of care before initiation of therapy.

Fette, Andreas

2013-01-01

259

Efficacy of adjunctive ablation of complex fractionated atrial electrograms and pulmonary vein isolation for the treatment of atrial fibrillation: a meta-analysis of randomized controlled trials  

PubMed Central

Aims Although useful, percutaneous left atrial ablation for pulmonary vein isolation (PVI) does not eliminate atrial fibrillation (AF) in all patients. The ablation of complex fractionated atrial electrograms (CFAEs) has been proposed as an adjunctive strategy to improve the maintenance of sinus rhythm after PVI. Our objective was to analyse the efficacy of adjunctive CFAE ablation. Methods and results We meta-analysed six randomized controlled trials (total, n= 538) using random-effects modelling to compare PVI (n= 291) with PVI plus CFAE ablation (PVI + CFAE) (n= 237). The primary outcome was freedom from AF or other atrial tachyarrhythmias (ATs) after a single ablation with or without antiarrhythmic drugs. Following a single ablation, PVI + CFAE improved the odds of freedom from any AF/AT compared with PVI alone (odds ratio 2.0, 95% confidence interval 1.04–3.8, P = 0.04) at ?3-month follow-up. There was moderate heterogeneity among trials (I2= 63.0%). Complex fractionated atrial electrogram ablation significantly increased mean procedural (178.5 ± 66.9 vs. 331.5 ± 92.6 min, P< 0.001), mean fluoroscopy (59.5 ± 22.2 vs. 115.5 ± 35.3 min, P< 0.001), and mean radiofrequency (RF) energy application times (46.9 ± 36.6 vs. 74.4 ± 43.0 min, P< 0.001). Conclusions Pulmonary vein isolation followed by adjunctive CFAE ablation is associated with increased freedom from AF after a single procedure. Adjunctive CFAE ablation increased procedural, fluoroscopy, and RF application times, and the risk/benefit profile of adjunctive CFAE ablation deserves further evaluation with additional studies and longer-term follow-up.

Kong, Melissa H.; Piccini, Jonathan P.; Bahnson, Tristram D.

2011-01-01

260

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 ...

261

Treatment of a complex posterior fossa aneurysm in a child using side-to-side posterior inferior cerebellar artery-posterior inferior cerebellar artery bypass.  

PubMed

Endovascular and cerebral bypass therapies are rarely used in children. The authors describe the treatment of a partially coiled giant distal vertebral artery (VA)-posterior inferior cerebellar artery (PICA) aneurysm in a child. They performed a side-to-side PICA-PICA anastomosis followed by endovascular VA aneurysm deconstruction with PICA preservation. A healthy 11-year-old boy developed progressive holocephalic headaches over the course of 2 months. Magnetic resonance imaging and magnetic resonance angiography revealed a large right PICA aneurysm causing brainstem compression. In November 2005, 2 Neuroform stents and Guglielmi detachable coils and Matrix were placed in the aneurysm at an outside institution. In 2006, angiography demonstrated aneurysm enlargement from which the PICA originated, coil compaction, and increased mass effect. The patient underwent a PICA-PICA bypass with intraoperative flow measurements followed by endovascular embolization of the aneurysm and parent VA. An angiogram obtained after the procedure demonstrated filling of the right PICA medullary branch through the bypass and obliteration of the aneurysm. The patient remained neurologically intact. Giant aneurysms of the posterior circulation are rare but do occur in children. With the aid of combined surgical and endovascular strategies the authors were able to safely eliminate the aneurysm from circulation with good outcome. Cerebral bypass and endovascular deconstructive therapies can be used safely in children but should be reserved for cases in which direct treatment carries significant risk. Careful surgical and endovascular planning with intraoperative flow assessment is essential for good outcome. PMID:18352808

Chandela, Sid; Alzate, Juan; Sen, Chandranath; Song, Joon; Nimi, Yasunari; Berenstein, Alejandro; Langer, David

2008-01-01

262

Polyelectrolyte Complexes  

Microsoft Academic Search

This chapter presents selected ideas concerning complexes that are formed either by oppositely charged polyelectrolytes or by polyelectrolytes and surfactants of opposite charge. The polyelectrolyte complexes polyelectrolyte complexe (PECs PEC ), which are surfactant-free, form typical structures of a low degree of order such as the ladder ladder-egg structure - and scrambled-egg structures scrambled-egg structure . In contrast, polyelectrolyte-surfactant complexes

Andreas F. Thünemann; Martin Müller; Herbert Dautzenberg; Jean-François Joanny; Hartmut Löwen

263

Thermodynamics of complexity  

NASA Astrophysics Data System (ADS)

The definition of complexity, simultaneously introduced by Kolmogorov and Chaitin, has given a numerical measure to what was previously defined only at an intuitive level. This measure, useful as it is, becomes hard to utilise when one deals with the complexity of most real systems, and biological objects in particular. We try to overcome this difficulty by discussing a possible thermodynamic definition of complexity based on energy balance. The Kolmogorov-Chaitin definition of complexity thus relates to our thermodynamic definition in a similar way as the probabilistic definition of entropy relates to the thermodynamic one. In the framework of this intuitive treatment it is discussed how the complexity of a biological system may depend on the variability of the environmental conditions. A specific illustration of this approach is given using some numerical modeling examples.

Rojdestvenski, I.; Cottam, M. G.; Oquist, G.; Huner, N.

2003-03-01

264

The timing of onset of mechanical systole and diastole in reference to the QRS-T complex: a study to determine performance criteria for a non-invasive diastolic timed vibration massage system in treatment of potentially unstable cardiac disorders.  

PubMed

Our institution is in development of a low frequency, non-invasive Diastolic Timed Vibrator (DTV) for use in emergency treatment of ST Elevation Myocardial Infarction (STEMI). It is preferable to avoid vibration emissions during the IsoVolumetric Contraction Period (IVCP) and at least the majority of mechanical systole thereafter, as systolic vibration may cause a negative inotropic effect in the ischemic heart. Furthermore diastolic vibration should preferably include the IsoVolumetric Relaxation Period (IVRP) which has been shown in clinical studies to improve cardiac performance and enhance coronary flow. Electrocardiographic (ECG) monitoring can be used to enable diastolic tracking, however, the timing of the phases of the cardiac cycle in relation to the ECG waveform must first be verified. The objective of this study was therefore to determine timing of onset of mechanical systole and diastole in reference to the QRS-T Complex. One hundred and twenty-three adult echocardiographic studies were assessed for the point of mitral and aortic valve closure in relation to the QRS complex and T wave in a representative population. We found that onset of mechanical systole occurred on and usually shortly after the peak of a first dominant QRS complex deflection, and onset of diastole occurred at the earliest on and most commonly beyond the peak or midpoint of the T wave. A DTV should ideally be able to stop vibrating on or before the peak of the first dominant deflection of a QRS complex, and begin vibrating near the peak of the T wave. Given early detection of ventricular depolarization can occur 10-20 ms prior to R wave peak, it is proposed that a DTV should preferably be able to stop vibrating within 10 ms of a triggered stop command. Onset of vibration during peak of T wave could be approximated by a rate adapted Q-T interval regression equation, and then fine tuned by manual adjustment during therapy. PMID:21113800

Gill, Harjit; Hoffmann, Andrew

2010-12-01

265

Complexity Survey.  

ERIC Educational Resources Information Center

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,…

Gordon, Sandra L.; Anderson, Beth C.

266

Cyclotomic complexes  

NASA Astrophysics Data System (ADS)

We construct a triangulated category of cyclotomic complexes (homological analogues of the cyclotomic spectra of Bökstedt and Madsen) along with a version of the topological cyclic homology functor TC for cyclotomic complexes and an equivariant homology functor (commuting with TC) from cyclotomic spectra to cyclotomic complexes. We also prove that the category of cyclotomic complexes essentially coincides with the twisted 2-periodic derived category of the category of filtered Dieudonné modules, which were introduced by Fontaine and Lafaille. Under certain conditions we show that the functor TC on cyclotomic complexes is the syntomic cohomology functor.

Kaledin, D.

2013-10-01

267

Production of reactive oxygen and nitrogen species by light irradiation of a nitrosyl phthalocyanine ruthenium complex as a strategy for cancer treatment.  

PubMed

Production of reactive oxygen species has been used in clinical therapy for cancer treatment in a technique known as Photodynamic Therapy (PDT). The success of this therapy depends on oxygen concentration since hypoxia limits the formation of reactive oxygen species with consequent clinical failure of PDT. Herein, a possible synergistic effect between singlet oxygen and nitric oxide (NO) is examined since this scenario may display increased tumoricidal activity. To this end, the trinuclear species [Ru(pc)(pz)2{Ru(bpy)2(NO)}2](PF6)6 (pc = phthalocyanine; pz = pyrazine; bpy = bipyridine) was synthesized to be a combined NO and singlet oxygen photogenerator. Photobiological assays using at 4 × 10(-6) M in the B16F10 cell line result in the decrease of cell viability to 21.78 ± 0.29% of normal under light irradiation at 660 nm. However, in the dark and at the same concentration of compound , viability was 91.82 ± 0.37% of normal. The potential application of a system like in clinical therapy against cancer may be as an upgrade to normal photodynamic therapy. PMID:24452093

Heinrich, Tassiele A; Tedesco, Antonio Claudio; Fukuto, Jon M; da Silva, Roberto Santana

2014-03-14

268

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

SciTech Connect

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.

Kruzins, A.; Klincare, I.; Nikolayeva, O.; Tamanis, M.; Ferber, R.; Pazyuk, E. A.; Stolyarov, A. V. [Laser Center, University of Latvia, Rainis Boulevard 19, LV-1586 Riga (Latvia); Department of Chemistry, Moscow State University, GSP-2 Leninskie gory 1/3, Moscow RU-119992 (Russian Federation)

2010-04-15

269

[Clinical guidelines as part of total quality management. Analysis of heterogenous treatment concepts of sepsis in various clinics with computer assisted generation, logical testing and complexity assessment of clinical algorithms].  

PubMed

Generation, local tailoring, implementation and evaluation of clinical guidelines is an integral part of quality management. Clinical guidelines are intimately related to the independency of physicians' decisions. By this the physicians should be responsible for guideline development and guarantee the use of adequate methods of total quality management and outcome assessment. Formal consensus finding and transparency of evidence are necessary to guarantee the use of guidelines. Clinical algorithms are highly formalized and they are well suited for generation and analysis by the software ALGO. Determination of complexity and comparison of the clinical contents of algorithms is done by the scores CASA (Clinical Algorithm Structural Analysis) and CAPA (Clinical Algorithm Patient Abstraction). In a study of 22 clinical departments on treatment management concepts in sepsis following anastomotic insufFiciency in colorectal carcinoma a considerable heterogeneity was shown using this program. PMID:10355087

Sitter, H; Dietz, W; Stinner, B; Geks, J; Bauhofer, A; Celik, I; Prünte, H; Lorenz, W

1999-01-01

270

Designing Complexity  

ERIC Educational Resources Information Center

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…

Glanville, Ranulph

2007-01-01

271

Land Treatment Digital Library  

USGS Publications Warehouse

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.

Pilliod, David;Welty, Justin L.

2013-01-01

272

Packaged Waste Treatment  

NASA Technical Reports Server (NTRS)

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.

1977-01-01

273

Complex Numbers  

NSDL National Science Digital Library

Written by Tony R. Kuphaldt and Jason Starck, this chapter of All About Circuit's second volume on Alternating Current describes complex numbers: "In order to successfully analyze AC circuits, we need to work with mathematical objects and techniques capable of representing these multi-dimensional quantities. Here is where we need to abandon scalar numbers for something better suited: complex numbers." In addition to the introduction and credits to contributors, the chapter has seven sections: Vectors and AC waveforms, Simple vector addition, Complex vector addition, Polar and rectangular notation, Complex number arithmetic, More on AC "polarity," and Some examples with AC circuits. Each section has clear illustrations and a concise, bulleted review of what was covered at the end.

Kuphaldt, Tony R.

2008-07-15

274

Complex Clouds  

article title:  Multi-layer Clouds Over the South Indian Ocean     ... Larger Image The complex structure and beauty of polar clouds are highlighted by these images acquired by the Multi-angle Imaging ...

2013-04-16

275

Softball Complex  

ERIC Educational Resources Information Center

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)

Ellis, Jim

1977-01-01

276

Complex Rays.  

National Technical Information Service (NTIS)

Methods for tracking local plane-wave fields with complex phase have recently received attention. In the time-harmonic regime and in lossless media, such fields are frequently referred to as evanescent; they arise exterior to surfacewave guiding structure...

L. B. Felsen

1974-01-01

277

Complex trauma.  

PubMed

Complex trauma refers to traumatic events that are chronic, interpersonal, and occur within the context of caregiving relationships; the term also describes the pattern of symptoms associated with such experiences. This article explores the prevalence, causes, and phenomenology of complex trauma in children and adolescents. The investigators also describe family-related and system-related issues, assessment strategies, diagnostic challenges, and clinical intervention options. PMID:24656584

Kliethermes, Matthew; Schacht, Megan; Drewry, Kate

2014-04-01

278

Feline respiratory disease complex.  

PubMed

Feline respiratory disease complex (FRDC) refers to the characteristic acute presentation of a contagious respiratory or ocular disease caused by one or multiple pathogens. Environmental and host factors impact the transmission, clinical presentation, preventive strategy, and treatment of affected cats. The FRDC is especially problematic in settings where large numbers of cats cohabit, including animal shelters, catteries, and semi-feral colonies. Although elimination of FRDC is an unrealistic goal, improved understanding can lead to strategies to minimize disease impact. PMID:22041216

Cohn, Leah A

2011-11-01

279

New aryloxo allylpalladium complexes  

Microsoft Academic Search

Treatment of the di-?-chloride allyl palladium complex [(?3-C4H7)Pd(?-Cl)2Pd(?3-C4H7)] with [NBu4]OH (1:2 molar ratio) in methanol, followed by addition of phenol or para-substituted phenol ArOH (1:2 molar ratio), allows the preparation of dimeric aryloxo complexes of the type [(?3-C4H7)Pd(?-OAr)2Pd(?3-C4H7)] (Ar=Ph 1, C6H4Me-p2, C6H4Cl-p3, C6H4Br-p4). The addition of p-nitrophenol or pentafluorophenol to complex 1 results in quantitative substitution of the phenoxide anion

José Ruiz; José M Mart??; Félix Florenciano; Gregorio López

1999-01-01

280

[Complex therapy of schizophrenia].  

PubMed

Schizoprenia is not a consistent illness, but the symptoms free state do may achive with different methods. During the last fifty years the clinical psychopharmacology improved very quickly, but the psychotherapy and sociotherapy as well. The complex therapy of schizophrenia is a new method: the psychopharmacons together with psychotherapy (first of all with cognitive one), sociotherapy and psychiatric rehabilitation. During the acute or chronic phase of schizophrenia the psychopharmacons are the first line treatment, but the complex therapy is better. In the last forty years we tested this new therapy, finally conducted a clinical trial: with one psychopharmacon (monotherapy), with two or three psychopharmacons (combination) and with the complex therapy (one psychopharmacon together with psychotherapy, sociotherapy and psychiatric rehabilitation). The antipsychotics, first of all the second generations have a very good efficacy. Risperidone is proven to be an efficient product. Fields of indication: first psychotic episode, acut schizophrenic exacerbation, chronic schizophrenia, the treatment of behavior disorder in dementia, maniac phase of bipolar disorder, treatment of behavioral disorders. PMID:19731818

Gaszner, Péter

2009-03-01

281

Does in vitro susceptibility to rifabutin and ethambutol predict the response to treatment of Mycobacterium avium complex bacteremia with rifabutin, ethambutol, and clarithromycin? Canadian HIV Trials Network Protocol 010 Study Group.  

PubMed

The in vitro susceptibilities of baseline Mycobacterium avium complex (MAC) blood isolates from 86 patients with AIDS who were treated with clarithromycin, ethambutol, and rifabutin were determined to examine whether these results predict bacteriologic response to treatment. No patient received prior prophylaxis with clarithromycin or azithromycin. Minimum inhibitory concentrations (MICs) of clarithromycin for all isolates were < or = 2 micrograms/mL. The median MIC of rifabutin was between 0.25 and 0.5 microgram/mL, and all isolates were susceptible to < or = 2 micrograms of rifabutin/mL. The median MIC of ethambutol was 4 micrograms/mL, and the MIC90 was 8 micrograms/mL. There was no correlation between ethambutol susceptibility and subsequent bacteriologic clearance. At all time points through week 12, bacteriologic clearance occurred more frequently in patients with isolates for which MICs of rifabutin were lower, but this difference was statistically significant only at week 2. Susceptibility testing for baseline MAC isolates from AIDS patients not previously treated with clarithromycin or azithromycin does not appear to be useful in guiding therapy. PMID:9868650

Shafran, S D; Talbot, J A; Chomyc, S; Davison, E; Singer, J; Phillips, P; Salit, I; Walmsley, S L; Fong, I W; Gill, M J; Rachlis, A R; Lalonde, R G

1998-12-01

282

Optimising waste treatment systems  

Microsoft Academic Search

The treatment and utilisation of biomass residues and waste for energy and recycling can contribute significantly to greenhouse gas emission reduction. Therefore, a waste treatment structure should be designed for an efficient saving of fossil primary energy in terms of maximal primary energy savings or minimal costs per unit of primary energy savings. However, this is a complex task, given

Veronika Dornburg; Berry Meuleman

2006-01-01

283

Complex Systems  

NASA Astrophysics Data System (ADS)

This book explores the exciting new field of complexity. It features in-depth coverage of important theoretical areas, including fractals, chaos, nonlinear dynamics, artificial life, and self organization. It also provides overviews of complexity in several applied areas, including parallel computation, control systems, neural systems, and ecosystems. Contributors examine some of the properties that best characterize complex systems, including algorithmic richness, nonlinearity, and abundant interactions between components. In this way the book draws themes, especially the ideas of connectivity and natural computation, that reveal deep, underlying similarities among phenomena that have formerly been treated as completely distinct. Researchers in a wide array of fields, including ecology, neuroscience, computer science, and mathematics, will find this volume to be a fascinating collection of ideas.

Bossomaier, Terry R. J.; Green, David G.

2000-07-01

284

Complex chimerism  

PubMed Central

Thousands of women with organ transplantation have undergone successful pregnancies, however little is known about how the profound immunologic changes associated with pregnancy might influence tolerance or rejection of the allograft. Pregnant women with a solid organ transplant are complex chimeras with multiple foreign cell populations from the donor organ, fetus, and mother of the pregnant woman. We consider the impact of complex chimerism and pregnancy-associated immunologic changes on tolerance of the allograft both during pregnancy and the postpartum period. Mechanisms of allograft tolerance are likely dynamic during pregnancy and affected by the influx of fetal microchimeric cells, HLA relationships (between the fetus, pregnant woman and/or donor), peripheral T cell tolerance to fetal cells, and fetal minor histocompatibility antigens. Further research is necessary to understand the complex immunology during pregnancy and the postpartum period of women with a solid organ transplant.

Ma, Kimberly K.; Petroff, Margaret G.; Coscia, Lisa A.; Armenti, Vincent T.; Adams Waldorf, Kristina M.

2013-01-01

285

Researching Complexity.  

ERIC Educational Resources Information Center

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…

Sumara, Dennis J.

2000-01-01

286

Diversity as a determinant of system complexity  

Microsoft Academic Search

Diversity of viewpoint is discussed as a major determinant of system complexity - in particular as affecting project complexity during design, development, manufacture and roll-out. The viewpoints of particular interest are those arising from diversity of implementation technology, and from multiple specialist engineering disciplines. The paper discusses the historical treatment of complexity in design offices, the challenge of diversity to

Brian Sherwood Jones; Paul Anderson

287

Subluxation of the Palmar Radioulnar Ligament As a Cause of Blocked Forearm Supination: A Case of DRUJ Locking  

PubMed Central

We report a case of locking of the distal radioulnar joint (DRUJ) due to interposition of a flap of the palmar radioulnar ligament (RUL) torn from the triangular fibrocartilage complex (TFCC). We released the blockage by elevating the flap and partially resecting a portion of the triangular fibrocartilage (TFC) arthroscopically.

Takahashi, Yuichiro; Nakamura, Toshiyasu; Sato, Kazuki; Toyama, Yoshiaki

2013-01-01

288

Intelligent Track Analysis on Navy Platforms Using Soft Computing  

Microsoft Academic Search

We have developed and continue to enhance automated intelligent software that performs the tasks and decision making which now occurs by the personnel manning watch stations in the Combat Direction Center (CDC) and Task Force Combat Center (TFCC), on-board aircraft carriers and other Navy ships. Integrating information from various sources in a combat station is a complex task; disparate sources

Robert Richards; Richard Stottler; Ben Ball; Coskun Tasoluk

2005-01-01

289

Complex Systems  

PubMed Central

Physiologic systems in health and disease display an extraordinary range of temporal behaviors and structural patterns that defy understanding based on linear constructs, reductionist strategies, and classical homeostasis. Application of concepts and computational tools derived from the contemporary study of complex systems, including nonlinear dynamics, fractals and “chaos theory,” is having an increasing impact on biology and medicine. This presentation provides a brief overview of an emerging area of biomedical research, including recent applications to cardiopulmonary medicine and chronic obstructive lung disease.

Goldberger, Ary L.

2006-01-01

290

Complex regional pain syndrome  

PubMed Central

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.

Sebastin, Sandeep J

2011-01-01

291

Cosmic Complexity  

NASA Technical Reports Server (NTRS)

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

Mather, John C.

2012-01-01

292

Hyperbaric treatment  

NASA Technical Reports Server (NTRS)

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.

Amoroso, Michael T.

1990-01-01

293

[Complex injuries associated with somnambulism].  

PubMed

Up to 3% of adults walk in their sleep and some perform complex behaviours. Treatment recommendations for sleepwalking are inconsistent. This case report describes a 64-year-old man who climbed out of a 2nd floor toilet window during somnambulism. He fell 6-8 meters and fractured the tibia, fibula, cervical columna, lumbal columna, calcaneus, costae and suffered a pneumothorax. Evidence to support sleepwalking treatment is lacking and besides benzodiazepines, prevention is the preferred treatment choice according to the literature. PMID:21156113

Sillesen, Nanna Hylleholt; Nielsen, Lisa Toft; Bonde, Christian

2010-12-13

294

Treatment of unwanted pigment.  

PubMed

Disorders of skin pigmentation pose significant challenges to both patients and physicians, as they have the unfortunate duality of being both common and difficult to treat conditions. This article reviews the etiology, pathophysiology, clinical presentation, and treatment options for melasma and postinflammatory hyperpigmentation. A thorough understanding of the disease process itself, expected agent efficacy, risks, and benefits of various treatments is crucial while treating these complex conditions. PMID:24488633

Chance, Elizabeth W

2014-02-01

295

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 ...

296

Group 4 Metalloporphyrin diolato Complexes and Catalytic Application of Metalloporphyrins and Related Transition Metal Complexes  

Microsoft Academic Search

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)MClâ (M = Ti,

Guodong Du

2004-01-01

297

Dorsal Capsuloplasty for Dorsal Instability of the Distal Ulna  

PubMed Central

Background?Dorsal instability of the distal ulna can lead to chronic wrist pain and loss of function. Structural changes to the dorsal radioulnar ligaments (DRUL) of the triangular fibrocartilage complex (TFCC) and the dorsal capsule around the ulnar head with or without foveal detachment can lead to volar subluxation of the distal radius e.g., dorsal instability of the distal ulna. Purpose?Is to evaluate the post-operative results of reinstituting distal radioulnar joint (DRUJ) stability through reefing of the dorsal capsule and dorsal radioulnar ligaments, with and without a foveal reattachment of the TFCC. Methods?A total of 37 patients were included in this retrospective study. Diagnosis and treatment was based strictly on dry wrist arthroscopy. In 17 patients isolated reefing of the DRUL and their collateral tissue extension was performed. In 20 patients an additional foveal reinsertion was performed. Postoperative results were evaluated with the DASH questionnaire, VAS scores, grip strength and range of motion. These findings were extrapolated in the Mayo wrist score. The two subgroups were compared. Results?Mayo wrist scores of the whole population had a mean of 73. There was no difference between the group that was treated with reefing of the DRUL only and the group that was treated with a combined foveal reinsertion. Conclusion?This relatively simple 'dorsal reefing' procedure, with foveal reinsertion when indicated, is a reliable method to restore volar-dorsal DRUJ stability with a significant decrease in pain sensation, good DASH scores and restoration of functional grip strength and ROM. Type of Study/Level of Evidence?Therapeutic, Level IV.

Kouwenhoven, S.T.P.; de Jong, T.; Koch, A.R.

2013-01-01

298

Complex sleep apnea syndrome.  

PubMed

Complex sleep apnea syndrome (CompSAS) is a distinct form of sleep-disordered breathing characterized as central sleep apnea (CSA), and presents in obstructive sleep apnea (OSA) patients during initial treatment with a continuous positive airway pressure (CPAP) device. The mechanisms of why CompSAS occurs are not well understood, though we have a high loop gain theory that may help to explain it. It is still controversial regarding the prevalence and the clinical significance of CompSAS. Patients with CompSAS have clinical features similar to OSA, but they do exhibit breathing patterns like CSA. In most CompSAS cases, CSA events during initial CPAP titration are transient and they may disappear after continued CPAP use for 4~8 weeks or even longer. However, the poor initial experience of CompSAS patients with CPAP may not be avoided, and nonadherence with continued therapy may often result. Treatment options like adaptive servo-ventilation are available now that may rapidly resolve the disorder and relieve the symptoms of this disease with the potential of increasing early adherence to therapy. But these approaches are associated with more expensive and complicated devices. In this review, the definition, potential plausible mechanisms, clinical characteristics, and treatment approaches of CompSAS will be summarized. PMID:23861580

Wang, Juan; Wang, Yan; Feng, Jing; Chen, Bao-Yuan; Cao, Jie

2013-01-01

299

Glaucoma Treatments  

MedlinePLUS

... for Change Get Involved Research Grants Special Events Glaucoma Treatments In this section you will find information on current treatments for glaucoma, including drugs and laser and conventional surgery… Treatments ...

300

Managing Complex Knowledge in Natural Sciences  

Microsoft Academic Search

In many fields dependant upon complex observation, the structuring, depiction and treatment of knowledge can be of great complexity. For example in Systematics, the scientific discipline that investigates bio-diversity, the descriptions of specimens are often highly structured (composite objects, taxonomic attributes), noisy (erroneous or unknown data), and polymorphous (variable or imprecise data). In this paper, we present IKBS, an Iterative

Noël Conruyt; David Grosser

1999-01-01

301

ICD Complex Operations and Maintenance Plan  

SciTech Connect

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.

Gibson, P. L.

2007-06-25

302

HIFU: Local Treatment of Prostate Cancer  

Microsoft Academic Search

ObjectiveTreatment of carcinoma of the prostate (CaP) begs some complex questions. Different disease stages call for different treatment modalities and no universally ‘gold standard’ treatment has yet been agreed upon. In the present work we will present the results, indications and limitations of HIFU in the treatment of CaP.

H. Azzouz; J. J. M. C. H. de la Rosette

2006-01-01

303

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

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.

Gumilar, Fernanda; Boeris, Monica; Toso, Ricardo; Minetti, Alejandra

2014-01-01

304

[Enduring pain II. Treatment].  

PubMed

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

Baldessarini, Ross; Selle, Valerio; Vigo, Daniel V

2013-01-01

305

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

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.

Hazen, Terry

2002-08-26

306

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

307

Circulating Immune Complexes (IC) and IC-Induced Levels of GM-CSF Are Increased in Sudanese Patients with Acute Visceral Leishmania donovani Infection Undergoing Sodium Stibogluconate Treatment: Implications for Disease Pathogenesis1  

Microsoft Academic Search

Infection with Leishmania donovani is associated with IL-10 as well as with GM-CSF. Immune complexes (IC) exert important functions by stimulation of monocytes\\/macrophage-mediated production of pro- and anti-inflammatory cytokines in rheumatic diseases. In this investigation, we have explored IC-induced cytokine production during Leishmania infection. Sera from 43 patients with visceral leishmaniasis (VL), 17 patients with post-kala-azar dermal leishmaniasis, and 20

Amir Ibrahim Elshafie; Erik Åhlin; Linda Mathsson; Gehad ElGhazali; Johan Ronnelid

308

Satisfaction with orthodontic treatment outcome.  

PubMed

ABSTRACT Objectives: To examine factors associated with treatment outcome satisfaction in a group of adolescent patients. Materials and Methods: One hundred and twenty patients (60 girls and 60 boys; mean age, 14.3 years; standard deviation [SD], 1.73 years) were consecutively recruited. The inclusion criteria for all patients were as follows: adolescents with a permanent dentition in need of orthodontic treatment and a treatment plan involving extractions (two or four premolars) followed by fixed appliances in both jaws. Questionnaire 1, concerning treatment motivation and expectations, was assessed prior to treatment start. Questionnaire 2 was assessed after active treatment and included questions about satisfaction with treatment outcome, quality of care and attention, and perceived pain and discomfort during active treatment. Results: One hundred and ten patients completed the trial (54 boys and 56 girls; mean age, 16.9 years; SD, 1.78 years). Median values for satisfaction with treatment outcome were generally high. There was a clear correlation (P ? .001) between satisfaction with treatment outcome and patients' perception of how well they had been informed and cared for during treatment. Pain and discomfort during treatment also strongly affected treatment satisfaction. Sex, treatment time, and Peer Assessment Rating index pre- and posttreatment as well as expectations for future treatment showed no correlation with treatment satisfaction. Conclusions: Care and attention was the variable showing the highest correlation with satisfaction with treatment outcome. Patients' perceptions of pain and discomfort during treatment had an overall negative correlation with treatment satisfaction. Satisfaction with treatment outcome is a complex issue and requires further exploration in future research. PMID:24423202

Feldmann, Ingalill

2014-07-01

309

Therapeutic Doll Making in Art Psychotherapy for Complex Trauma  

ERIC Educational Resources Information Center

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,…

Stace, Sonia M.

2014-01-01

310

[A 2-month-old child with complex tracheal hypoplasia].  

PubMed

We describe the case of a 2-month-old child with complex tracheal hypoplasia with bilateral bronchial hypoplasia and left pulmonary hypoplasia. Tracheal hypoplasia is complex when it is associated with critical stenosis, cricoid stenosis, bronchial hypoplasia, tracheal bronchus, or esophageal atresia with severe tracheomalacia. Slide tracheoplasty is the gold standard treatment for the complex tracheal hypoplasia. PMID:24183835

De Cloedt, L; Papadopoulos, J; Corouge, P; Khalil, T; Van Laer, P

2013-12-01

311

Evolution of Biological Complexity  

Microsoft Academic Search

In order to make a case for or against a trend in the evolution of complexity in biological evolution, complexity needs to be both rigorously defined and measurable. A recent information-theoretic (but intuitively evident) definition identifies genomic complexity with the amount of information a sequence stores about its envi- ronment. We investigate the evolution of genomic complexity in populations of

Christoph Adami; Charles Ofria; Travis C. Collier

2000-01-01

312

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)

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.

Oláh, Csaba; Oláh, Mihály; Demeter, Béla; Jancsó, Zoltán; Páll, Valéria; Bender, Tamás

2010-02-01

313

Treatment goals: response and nonresponse  

PubMed Central

Psychiatric symptomatology is often subjective, but it can be partly made more objective for the purposes of evaluation. Esquirol was the first modern psychiatrist to stress the need for a scientific approach to treatment evaluation. The kinetics of treatment is complex because different components of the clinical picture improve at a different pace. Assessment of treatment requires prior definition of end point, response, and nonresponse. Response is influenced by several factors, such as placebo effect, diagnostic category and subtypes, and patient heterogeneity. Treatment response may be predicted from clinical and biological parameters. This article lists the main causes of nonresponse, and suggests how to remedy them.

Macher, Jean-Paul; Crocq, Marc-Antoine

2004-01-01

314

Window treatments  

SciTech Connect

This book includes basic material as well as information the professional needs for designing appropriate window treatments for residential and nonresidential buildings: site, orientation, climate, energy efficiency, sound-proofing, privacy, protection, view, ventilation and interior and exterior aesthetics. Also includes a guide to the window treatment industry, a list of manufacturers, distributors, and retailers, information on window treatment fibers and fabrics, three glossaries, an extensive bibliography, and over 800 illustrations.

Nielson, K.J.

1990-01-01

315

The Treatment of Melioidosis  

PubMed Central

Melioidosis is a complex bacterial infection, treatment of which combines the urgency of treating rapidly fatal Gram negative septicaemia with the need for eradication of long-term persistent disease in pulmonary, soft tissue, skeletal and other organ systems. Incremental improvements in treatment have been made as a result of multicentre collaboration across the main endemic region of Southeast Asia and northern Australia. There is an emerging consensus on the three main patterns of antimicrobial chemotherapy; initial (Phase 1) treatment, subsequent eradication (Phase 2) therapy and most recently post-exposure (Phase 0) prophylaxis. The combination of agents used, duration of therapy and need for adjunct modalities depends on the type, severity and antimicrobial susceptibility of infection. New antibiotic and adjunct therapies are at an investigational stage but on currently available data are unlikely to make a significant impact on this potentially fatal infection.

Inglis, Timothy J.J.

2010-01-01

316

Wastewater Treatment  

NSDL National Science Digital Library

This lesson introduces students to the basics of wastewater treatment. Topics include the variety of materials that enter the wastewater system, septic tanks, and municpal treatment systems. Students can review online resources that describe the processes of wastewater treatment and septic tank operation in detail, and listen to a National Publc Radio (NPR) show that discusses the use of treated wastewater to make snow at a ski resort in Maine. The lesson includes an activity in which students participate in virtual tours of wastewater treatment facilities and answer questions about what they see.

Laposata, Mark

317

Development and psychometric validation of the HIV Treatment Knowledge Scale  

Microsoft Academic Search

Accurate treatment knowledge is required for patients to successfully manage complex medical conditions. Existing HIV knowledge scales focus on disease transmission and risk factors. This is the first study to develop and validate a scale to measure HIV treatment knowledge about complex treatment issues such as adherence, side-effects and drug resistance. A total of 346 participants were recruited into this

L. Balfour; J. Kowal; G. A. Tasca; C. L. Cooper; J. B. Angel; P. A. MacPherson; G. Garber; L. Béïque; D. W. Cameron

2007-01-01

318

Biomechanical analysis of the acetabular buttress-plate: are complex acetabular fractures in the quadrilateral area stable after treatment with anterior construct plate-1/3 tube buttress plate fixation?  

PubMed Central

OBJECTIVE: The acetabular buttress-plate has been widely used in treating difficult cases with satisfying clinical results. However, the biomechanical properties of a postoperative acetabular fracture fixed by the buttress-plate are not clear. The purpose of this study was to evaluate the biomechanical properties of stability after the anterior tube buttress-plate fixation of complex acetabular fractures in the quadrilateral area. METHODS: A construct was proposed based on anterior construct plate - 1/3 tube buttress plate fixation for acetabular both-column fractures. Two groups of six formalin-preserved cadaveric pelvises were analyzed: (1) group A, the normal pelvis and (2) group B, anterior construct plate-1/3 tube buttress plate with quadrilateral area fixation. The displacements were measured, and cyclical loads were applied in both standing and sitting simulations. RESULTS: As the load was added, the displacements were A

Wu, Yong-De; Cai, Xian-Hua; Liu, Xi-Ming; Zhang, Hong-Xi

2013-01-01

319

Complex Sleep Apnea Syndrome  

PubMed Central

Complex sleep apnea is the term used to describe a form of sleep disordered breathing in which repeated central apneas (>5/hour) persist or emerge when obstructive events are extinguished with positive airway pressure (PAP) and for which there is not a clear cause for the central apneas such as narcotics or systolic heart failure. The driving forces in the pathophysiology are felt to be ventilator instability associated oscillation in PaCO2 arterial partial pressure of Carbon Dioxide, continuous cositive airway pressure (CPAP) related increased CO2 carbon dioxide elimination, and activation of airway and pulmonary stretch receptors triggering these central apneas. The prevalence ranges from 0.56% to 18% with no clear predictive characteristics as compared to simple obstructive sleep apnea. Prognosis is similar to obstructive sleep apnea. The central apnea component in most patients on followup using CPAP therap, has resolved. For those with continued central apneas on simple CPAP therapy, other treatment options include bilevel PAP, adaptive servoventilation, permissive flow limitation and/or drugs.

Khan, Muhammad Talha; Franco, Rose Amy

2014-01-01

320

Evolution of biological complexity  

PubMed Central

To make a case for or against a trend in the evolution of complexity in biological evolution, complexity needs to be both rigorously defined and measurable. A recent information-theoretic (but intuitively evident) definition identifies genomic complexity with the amount of information a sequence stores about its environment. We investigate the evolution of genomic complexity in populations of digital organisms and monitor in detail the evolutionary transitions that increase complexity. We show that, because natural selection forces genomes to behave as a natural “Maxwell Demon,” within a fixed environment, genomic complexity is forced to increase.

Adami, Christoph; Ofria, Charles; Collier, Travis C.

2000-01-01

321

Complex networks analysis of language complexity  

NASA Astrophysics Data System (ADS)

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.

Amancio, Diego R.; Aluisio, Sandra M.; Oliveira, Osvaldo N., Jr.; Costa, Luciano da F.

2012-12-01

322

Crotoxin complex as cytotoxic agent  

US Patent & Trademark Office Database

The present invention provides a stable composition of matter based on the cytotoxic activity of a basic phospholipase A.sub.2 of molecular weight 14,500 and isoelectric point 9.6-9.7 (crotoxin B) isolated from the venom of Crotalus durissus terrificus which in complex with a specific, non-enzymatic, peptide of molecular weight 9,500 and isoelectric point 3.5-3.7 (crotoxin A) displays a preferential cytotoxic activity against various types of tumor cells. When administered parenterally in an acceptable vehicle and in pharmacologically efficient amounts to animals and humans the complex is useful in the treatment of malignant tumors in advanced stages. The method for purification of the active components, the preparation in a pharmacologically acceptable form, and the method of therapeutic use of the present composition of matter are also disclosed.

1992-11-17

323

Epispadias-Exstrophy Complex  

Microsoft Academic Search

The exstrophy-epispadias complex represents a spectrum of malformations ranging from epispadias to cloacal exstrophy (Wood 1990). The most common entities of this complex and their frequencies are listed in Table 9.1 (Duckett and Cladamone 1985).

Erich Sorantin

324

Security of Complex Networks.  

National Technical Information Service (NTIS)

The main goal of the project was to conduct a comprehensive study of complex networks from the perspectives of security and information protection using an interdisciplinary approach. Specific Objectives were: (1) cascading breakdown of complex networks t...

Y. Lai

2010-01-01

325

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 ... body) related to acquired immunodeficiency syndrome (AIDS). Daunorubicin lipid complex is in a class of medications called ...

326

Cognitive Complexity and Persuasion.  

National Technical Information Service (NTIS)

A number of approaches to complexity, both from the stimulus and the personality vantage point as they affect attitudes, and specifically influence and persuasion are reviewed. The paper discusses the specific predictions that can be made with complexity ...

S. Streufert H. L. Fromkin

1970-01-01

327

Complex Object Hashing.  

National Technical Information Service (NTIS)

An important characteristic of many new data models is the capability of constructing complex data objects. These complex data objects usually include set valued attributes. The efficiency of the implementation of sets heavily depends on the efficiency of...

H. Duchene V. Turau

1990-01-01

328

Complex partial status epilepticus in a child.  

PubMed

Complex partial status epilepticus (SE) has been reported rarely in children. We describe the clinical case of a 14 year-old girl with complex partial seizures (CPS) since age 10 who developed a complex partial SE probably because she was not adherent to treatment. The neurologic examination and computed tomography scan were normal. During the SE she received diazepam and phenytoin and became free of the seizures after 5 minutes. The ictal EEG showed spikes and slow waves over the right temporal region. PMID:7487537

Silva, D F; Zanoteli, E; Lima, M M; Anghinah, R; Lima, J G

1995-06-01

329

[Folic acid treatment of epileptics].  

PubMed

The author describes the regimen of treatment with folic acid employed in 137 patients with epilepsy. The drug was given to 81 patients to control a complex of disturbances (psychic, neurologic, somatic) caused by folic acid hypovitaminosis secondary to a prolonged use of diphenin, phenobarbital and hexamidine and to another 56 patients to prevent its depletion and to improve the psychic condition. The author considers the questions of the theoretical justification of the pathogenetic treatment with folic acid of epileptic patients. PMID:3630498

Vaintrub, M Ia

1987-01-01

330

Dimensions of Stimulus Complexity  

Microsoft Academic Search

Animal learning research has increasingly used complex stimuli that approximate natural objects, events, and locations, a trend that has accompanied a resurgence of interest in the role of cognitive factors in learning. Accounts of complex stimulus control have focused mainly on cognitive mechanisms and largely ignored the contribution of stimulus information to perception and memory for complex events. It is

J. Gregor Fetterman

1996-01-01

331

Complex BIFORE transform†  

Microsoft Academic Search

Complex BIFORE (Binary FOurior REpresentation) transform belongs to the family of discrete orthogonal transformations and is analogous to discrete Fourier transform (DFT) when dealing with complex inputs. For real inputs, complex BIFORE transform (CBT) reduces to BIFORE or Hadamard transform (BT or HT) whose bases are Walsh functions. BT has been applied in several phases of information processing and sequency

K. R. RAO; N. AHMED

1971-01-01

332

Complexity and fisher information  

PubMed

The connection between an observer-based theory of measurement and a hierarchical classification of complex systems in terms of topological exponents is discussed. This leads to generalized definitions of complexity that capture different aspects of the structure of the trajectory space of complex systems. PMID:11088185

Binder

2000-04-01

333

Simply Complex by Design  

ERIC Educational Resources Information Center

Reality--real life--is complex, more complex than can be imagined. The majority of our most pressing issues confronted in the management of organizations are overwhelmingly complex. I make the case for a systems design approach as a remedy. Examples introduced in this paper illuminate conceptual tools that advance how people transform their…

Nelson, Harold G.

2007-01-01

334

The Language Complexity Game  

Microsoft Academic Search

roundvarious aspects of the problem of determining which anaphoric elements in a givensentence can refer to which potential antecedents. Ristad takes the reader through fiverounds of what he calls a "complexity game," which is a contest between a maximizer,who tries to make natural languages as complex as possible, and a minimizer, whoseeks to reduce the complexity to a bare minimum.In

Eric Sven Ristad Princeton

1993-01-01

335

Sewage Treatment  

NASA Technical Reports Server (NTRS)

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.

1976-01-01

336

[Immunodepressive properties of diethyleneimine benzoquinone-containing polyvinylpyrrolidone complexes].  

PubMed

The authors examined the changes, which occurred in the weight of lymphoid organs (thymus, spleen, and lymph nodes) and titre of serum hemagglutinines against sheep erythrocytes in mice BAIB/c under the influence of treatment with diethyleniminbenzochinon and some of its complexes with polyvinylpirolidon (PVP). The ratio of the substances composing the complexes (in mg per 1000 mg of complex) was as followed: DEiBx- PVP complex NoI-340:660; DEiBx-PVP complex No2-200:800; DEiBx-PVP-Uracyl complex No3-250:500:250. There was a sharp reduction of the weight of lymphoid organs in mice, treated with DEiBx, singly or in the form of complexes NoI and No2 in comparison with the control nontreated mice or treated with complex No3. This effect was more manifested after treatment with DEiBx during the same regimen (0.8 mg/kg of body weight daily for 5 days). The ability of the treated animals to react to immunization with sheep erythrocytes practicaly was not impaired during the treatment with complexes No2 and No3 or the damage was slight (complex NoI) in contrast to the treatment with DEiBx. PMID:658000

Kostadinov, D; Popov, D

1978-01-01

337

Complex Correspondence Principle  

NASA Astrophysics Data System (ADS)

Quantum mechanics and classical mechanics are distinctly different theories, but the correspondence principle states that quantum particles behave classically in the limit of high quantum number. In recent years much research has been done on extending both quantum and classical mechanics into the complex domain. These complex extensions continue to exhibit a correspondence, and this correspondence becomes more pronounced in the complex domain. The association between complex quantum mechanics and complex classical mechanics is subtle and demonstrating this relationship requires the use of asymptotics beyond all orders.

Bender, Carl M.; Hook, Daniel W.; Meisinger, Peter N.; Wang, Qing-Hai

2010-02-01

338

Complexity systems management method  

US Patent & Trademark Office Database

The Complexity Systems Management (CSM) Method is a scientifically derived business process method for managing complex events and situations. The CSM Method.TM. is based on new scientific evidence that explains the behaviors of complex adaptive systems. This same scientific evidence gives rise to a new method of science, known as a priori optionality. A priori optionality is based on six scientifically derived tenets that are systematically applied using the CSM Method.TM. to more accurately characterize the behaviors of complex adaptive systems and manage complex events and situations. Applications of the CSM Method are integrally tied to specialized knowledgebases and a plurality of automated software applications.

2012-01-24

339

Cryptosporidium: Treatment  

MedlinePLUS

... should be consulted before such medicine is taken. Nitazoxanide has been FDA-approved for treatment of diarrhea ... is available by prescription. However, the effectiveness of nitazoxanide in immunosuppressed individuals is unclear. HIV-positive individuals ...

340

Vitiligo Treatments  

MedlinePLUS

... for the treatment of vitiligo: sunscreens; cover-up; restoration of normal skin color; and bleaching of normal ... helpful for some patients. Restoring Normal Skin Color Restoration of normal skin color can take the form ...

341

Anthrax: Treatment  

MedlinePLUS

... Confirming Anthrax Through the Laboratory Response Network Laboratory Testing - FAQs Collecting Specimens Recommended Specimens Information for Specific Groups Laboratory Professionals People Who Work with Animal Products Exposure to Hides/Drums Treatment of Products ...

342

Salmonellosis Treatment  

MedlinePLUS

... Treatment If you are like most people with salmonella, the disease will clear up within five to ... with antibiotics such as ampicillin. Some strains of Salmonella have become resistant to several antibiotics normally used ...

343

Wastewater Treatment.  

ERIC Educational Resources Information Center

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)

Zoltek, J., Jr.; Melear, E. L.

1978-01-01

344

Wastewater Treatment  

NSDL National Science Digital Library

Before this activity the students will have heard about groundwater and water resources through lecture to give them a background on where our drinking water comes from. The activity involves a tour of the local wastewater treatment plant where the students told about the treatment processes and shown the treatment facility. They are also introduced to the water quality testing done at the plans and they learn about the energy usage/management at the plant. As part of the activity they write up a paper on the processes in the treatment process from the time water enters the plant until it exits. The students are encouraged before hand to ask questions to ensure that they gather the needed information. This always means that each tour has a slightly different content based on these questions.

Pedersen, Bianca

345

Coccygodynia: treatment.  

PubMed

This article presents a retrospective review of the treatment of coccygodynia. The past 5 years of conservative treatment for coccygodynia were reviewed, including local injection. The results were evaluated. Retrospectively, the past 20 years of surgical treatment for coccygodynia were reviewed and the clinical results were evaluated. Twenty-four patients were treated with local injection and 15 patients were treated with coccygectomy. Local injection was successful in 78% of patients. Coccygectomy was successful in 87% of patients. The results of conservative treatment with local injection for coccygodynia appear to be successful. However, no other historical literature exists to compare these results. The results of coccygectomy for coccygodynia were also highly successful, and the success rate compares favorably to previous historical data in the literature. PMID:12722911

Ramsey, Michael L; Toohey, John S; Neidre, Arvo; Stromberg, Lynn J; Roberts, David A

2003-04-01

346

Root resorption following treatment with aligners.  

PubMed

Can orthodontically induced inflammatory root resorption (OIIRR) be the result of Invisalign treatment? Since OIIRR was first described in the literature, orthodontists have been looking for a treatment procedure where no root shortening will occur. In the past decade, Invisalign orthodontic treatment has become very popular, and there is no description of OIIRR after this treatment. Therefore, it might be incorrectly concluded that the body is immune to this type of orthodontic treatment modality and no OIIRR appears as a result of this treatment. The following case report demonstrates an aspect of the complexity of OIIRR. PMID:18947291

Brezniak, Naphtali; Wasserstein, Atalia

2008-11-01

347

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...

348

School Phobia: Understanding a Complex Behavioural Response  

ERIC Educational Resources Information Center

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…

Chitiyo, Morgan; Wheeler, John J.

2006-01-01

349

ELECTROCOAGULATION AS A WASTEWATER TREATMENT  

Microsoft Academic Search

Coagulation and flocculation are traditional methods for the treatment of polluted water. Electrocoagulation presents a robust novel and innovative alternative in which a sacrificial metal anode doses water electrochemically. This has the major advantage of providing active cations required for coagulation, without increasing the salinity of the water. Electrocoagulation is a complex process with a multitude of mechanisms operating synergistically

Peter Holt; Geoffrey Barton; Cynthia Mitchell

350

Antitumor effects of electrochemical treatment  

PubMed Central

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.

Gonzalez, Maraelys Morales; Zamora, Lisset Ortiz; Cabrales, Luis Enrique Bergues; Sierra Gonzalez, 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; Tello, Marcos; Holandino, Carla

2013-01-01

351

Phosphinomethyl complexes of zirconium  

SciTech Connect

The synthesis, structure, and reactivity of a new class of early transition metal complexes containing a phosphinomethyl ligand are described. These complexes possess two different sites of reactivity: the zirconium metal center and the remote phosphine moiety. Phosphinomethyl complexes of zirconium are the first examples of such complexes containing either a group IV or V metal displaying exclusively monohapto bonding between ligand and metal. Zirconcene halides can be selectively mono- or bis-substituted with the appropriate dialkylphosphinomethylithium reagent. The steric and electronic properties of these complexes can be altered by modifying several moieties in the molecule. The intramolecular disposition of the remote functionality can be exploited to stabilize the unusual +3 oxidation state of zirconium. The isolation and characterization of a monomeric paramagnetic phosphinomethyl zirconocene(III) complex has opened the way for a systematic study of the heretofore inaccessible zirconium(III) system. The remote phosphine moiety can also be exploited in an intermolecular manner to construct novel heterobimetallic compounds. These include simple acyclic bridged species as well as a remarkably hindered cyclic complex. Phosphinomethyl complexes of zirconium are unique because they have a remote phosphine moiety which is free to interact in either an inter- or intramolecular fashion. The most important ramifications of this for organic synthesis or catalysis are the stabilization of an unusual monomeric zirconium(III) oxidation state, and the ability to complex a second transition metal to form heterobimetallic complexes.

Young, S.J.

1985-01-01

352

Disruption of protein complexes.  

PubMed

Protein complexes are a cornerstone of many biological processes and, together, they form various types of molecular machinery that perform a vast array of biological functions. Different complexes perform different functions and, the same complex can perform very different functions that depend on a variety of factors. Thus disruption of protein complexes can be lethal to an organism. It is interesting to identify a minimal set of proteins whose removal would lead to a massive disruption of protein complexes and, to understand the biological properties of these proteins. A method is presented for identifying a minimum number of proteins from a given set of complexes so that a maximum number of these complexes are disrupted when these proteins are removed. The method is based on spectral bipartitioning. This method is applied to yeast protein complexes. The identified proteins participate in a large number of biological processes and functional modules. A large proportion of them are essential proteins. Moreover, removing these identified proteins causes a large number of the yeast protein complexes to break into two fragments of nearly equal size, which minimizes the chance of either fragment being functional. The method is also superior in these aspects to alternative methods based on proteins with high connection degree, proteins whose neighbors have high average degree, and proteins that connect to lots of proteins of high connection degree. Our spectral bipartitioning method is able to efficiently identify a biologically meaningful minimal set of proteins whose removal causes a massive disruption of protein complexes in an organism. PMID:23796185

Taheri, Golnaz; Habibi, Mahnaz; Wong, Limsoon; Eslahchi, Changiz

2013-06-01

353

How evolution guides complexity  

PubMed Central

Long-standing debates about the role of natural selection in the growth of biological complexity over geological time scales are difficult to resolve from the paleobiological record. Using an evolutionary model—a computational ecosystem subjected to natural selection—we investigate evolutionary trends in an information-theoretic measure of the complexity of the neural dynamics of artificial agents inhabiting the model. Our results suggest that evolution always guides complexity change, just not in a single direction. We also demonstrate that neural complexity correlates well with behavioral adaptation but only when complexity increases are achieved through natural selection (as opposed to increases generated randomly or optimized via a genetic algorithm). We conclude with a suggested research direction that might be able to use the artificial neural data generated in these experiments to determine which aspects of network structure give rise to evolutionarily meaningful neural complexity.

Yaeger, Larry S.

2009-01-01

354

Complex Function Plot Program  

NSDL National Science Digital Library

The Complex Function Plot program displays a user-defined complex function of position and time using representations that map phase into color. The default complex function is a time-dependent complex Gaussian and the representation can be changed by selecting a radio button. Additional parameters can be specified using the Display | Switch GUI menu item. Complex Function Plot is an Open Source Physics program written for the teaching of mathematical methods in the sciences. It is distributed as a ready-to-run (compiled) Java archive. Double clicking the math_complex_function_plot.jar file will run the program if Java is installed. Other mathematical methods programs are also available. They can be found by searching ComPADRE for Open Source Physics, OSP, or Math.

Christian, Wolfgang

2008-05-14

355

Artistic forms and complexity.  

PubMed

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

Boon, J-P; Casti, J; Taylor, R P

2011-04-01

356

Child health in complex emergencies.  

PubMed Central

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.

Moss, William J.; Ramakrishnan, Meenakshi; Storms, Dory; Henderson Siegle, Anne; Weiss, William M.; Lejnev, Ivan; Muhe, Lulu

2006-01-01

357

[Sarcoidosis treatment].  

PubMed

Sarcoidosis treatment suppresses the granulomatous process and its clinical, functional and radiographic consequences but it is not etiological. Only a minority of patients necessitate systemic therapy. This is definitely required in severe extra-respiratory sarcoidosis including cardiac, neurological, renal, ocular involvement not responding to topical therapy and malignant hypercalcemia. Respiratory indications for therapy include symptomatic stage II/III showing significant physiologic impairment or progressive disease, and stage IV with persistent signs of activity. As a general rule, systemic corticosteroids are the first-line treatment, given for at least 12 months. One of the following sparing agents can be associated with steroids when the threshold level to control the disease is high: hydroxychloroquine, methotrexate or azathioprine. An alternative option to corticosteroids is proposed in case of contra-indication or cortico-resistant sarcoidosis; methotrexate is then the treatment of choice. Although other drugs are only occasionnally needed, the available therapeutical range is wide (thalidomide, infliximab, cyclophosphamide, leflunomide...). PMID:18652410

Nunes, Hilario; Uzunhan, Yurdagul; Bonnet, Daniel; Valeyre, Dominique

2008-05-31

358

Complex optical holograms  

NASA Astrophysics Data System (ADS)

This paper discusses three forms of complex holograms, described by means of complex Fourier, Fresnel, and Hartley transformations. Digital models of these holograms and algorithms for modelling them digitally are presented. It is shown that the reflectance and the phase variation upon reflection from the surface of an object can be determined not only from the reconstructed image but also by analyzing the structure of the recorded pair of quadrature components of a complex hologram.© 2004

Bogdanova, T. V.; Titar, V. P.

2004-05-01

359

From Complex Environments to Complex Behaviors  

Microsoft Academic Search

Adaptation of ecological systems to their environments is commonly viewed through some explicit fitness function defined a priori by the experimenter or measured a posteriori by estimations based on population size or reproductive rates. These methods do not capture the role of environmental complexity in shaping the selective pressures that control the adaptive process. Ecological simulations enabled by computational tools

Filippo Menczer; Richard K. Belew

1996-01-01

360

Sewage Treatment  

NASA Technical Reports Server (NTRS)

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.

1991-01-01

361

Complexity and Space Plasmas  

NASA Astrophysics Data System (ADS)

In this study the general theoretical framework of Complexity theory is presented, viewed through non-extensive statistical theory introduced by Constantino Tsallis in 1988. Nonlinear dynamics, fractional dynamics, thermodynamics and statistical physics constitute the basic elements of Complexity theory which can be applied to processes near, as well as, far from equilibrium. Moreover, the nonextensive statistics can be the fundamental linchpin of Complexity theory from microscopical to macroscopical level. Finally, a brief review of results concerning nonlinear analysis of space plasma time series corresponding to different complex systems is given.

Pavlos, G.; Iliopoulos, A.; Karakatsanis, L.; Xenakis, M.; Pavlos, E.

2013-09-01

362

Treatment of Idiopathic Clubfoot  

PubMed Central

Idiopathic clubfoot, one of the most common problems in pediatric orthopaedics, is characterized by a complex three-dimensional deformity of the foot. The treatment of clubfoot is controversial and continues to be one of the biggest challenges in pediatric orthopaedics. This controversy is due in part to the difficulty in measuring and evaluating the effectiveness of different treatment methods. We believe the heart of the debate is a lack of understanding of the functional anatomy of the deformity, the biological response of young connective tissue to injury and repair, and their combined effect on the long-term treatment outcomes. The aim of this review is not only to assess the different methods of clubfoot treatment used over the years in light of an evolving understanding of the pathoanatomy of the deformity, but to also clarify factors that allow a safe, logical approach to clubfoot management. Further research will be needed to fully understand the pathogenesis of clubfoot, as well as the long-term results and quality of life for the treated foot.

Dobbs, Matthew B; Morcuende, Jose A; Gurnett, Christina A; Ponseti, Ignacio V

2000-01-01

363

Surface Treatment  

Microsoft Academic Search

\\u000a Laser beam hardening produces hard, wear-resistant surface layers on tools and components made from steel and cast iron. Laser\\u000a beam hardening offers technically rewarding solutions especially for small and\\/or complex-shaped components where conventional\\u000a methods of hardening cause problems in regard to distortion or make compliance with preset geometries of the hardness penetration\\u000a layer difficult.

Konrad Wissenbach

364

Silicone oil in the repair of pediatric complex retinal detachments  

Microsoft Academic Search

ObjectiveTo report anatomic and visual acuity outcomes, as well as complications, after using 1000-centistoke silicone oil as a retinal tamponade for the treatment of complex retinal detachments in a pediatric population.

Ingrid U Scott; Harry W Flynn; Mei-Ying Lai; Steven Schwartz; Michael T Trese

1999-01-01

365

Silicone oil in the repair of complex retinal detachments  

Microsoft Academic Search

ObjectiveThis study aimed to report anatomic and visual acuity outcomes and complications after 1000centistoke silicone oil was used as a retinal tamponade for the treatment of complex retinal detachments.

Ingrid U Scott; Harry W Flynn; Mei-Ying Lai; Trexler M Topping; Lisa Benati; Douglas K Trask; Lee Ann Rogus

1998-01-01

366

Labile sulfide and sulfite in phytochelatin complexes  

SciTech Connect

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.

Eannetta, N.T.; Steffens, J.C. (Cornell Univ., Ithaca, NY (USA))

1989-04-01

367

Wastewater Treatment  

NSDL National Science Digital Library

Water-technology.net web site for the water industry contains links to many sites for detailed information on industrial and municipal wastewater treatment plants as well as water supply and transmission. Also find information on current news releases, expos, conferences and much more.

2008-10-13

368

Alkene to carbyne: tandem Lewis acid activation and dehydrogenation of a molybdenum ethylene complex.  

PubMed

Carbyne formation: Treatment of a molybdenum ethylene complex with B(C6 F5 )3 induces ditopic activation of an ethylene ligand and acceptor-assisted ethane elimination to generate a novel type of zwitterionic carbyne complex. PMID:24038792

Stennett, Tom E; Haddow, Mairi F; Wass, Duncan F

2013-10-18

369

[Ulna impaction syndrome therapy: decompressive surgical procedures of the head of the ulna].  

PubMed

The ulnar impaction syndrome can be defined as the impaction of the ulnar head against the triangular fibrocartilage complex and ulnar carpus. As a result of this pattern, painful degeneration of the TFCC occurs. Wrist arthroscopy offers a certain diagnostic tool. In addition, arthroscopic debridement of the TFCC shows a high success rate of 70 to 80 percent. After failed arthroscopic debridement, ulnar shortening osteotomy reduces ulnar load significantly. Malunion of the radius resulting in posttraumatic ulna-plus variance should be treated by correction osteotomy with lengthening of the radius. If arthrosis of the distal radioulnar joint is combined with ulnar impaction syndrome, the hemiresection procedure of Bowers or the method of Kapandji-Sauvé are the methods of choice. PMID:9888007

Krimmer, H; Tränkle, M; Schober, F; van Schoonhoven, J

1998-11-01

370

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...

371

Complex systems and valuation  

Microsoft Academic Search

Ecological and economic systems are undeniably complex. Whereas a goal of delineating ‘ecosystem services’ is to make readily apparent some of the important ways in which ecosystems underpin human welfare, insights are also gained by appreciating the nonlinear dynamic properties of ecosystems. In this paper, we review some of the relevant characteristics of complex systems. Ecosystems and economic systems share

Karin E. Limburg; Robert V. O'neill; Robert Costanza; Stephen Farber

2002-01-01

372

Complexity and Relations  

ERIC Educational Resources Information Center

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…

Lancaster, Jeanette Elizabeth

2013-01-01

373

Immunization of complex networks  

Microsoft Academic Search

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,

Romualdo Pastor-Satorras; Alessandro Vespignani

2002-01-01

374

Complex oxide interface studies  

Microsoft Academic Search

As the proximity and complexity increase for modern device structures, it becomes increasingly important to be able to understand film growth and interface properties of the new classes of complex (stoichiometry and structure) thin films in heterostructures. Non-destructive in situ real-time surface analytical techniques with monolayer surface specificity and ability to provide information for complete characterization would be ideal for

Ying Gao

2000-01-01

375

Minimum complexity density estimation  

Microsoft Academic Search

The authors introduce an index of resolvability that is proved to bound the rate of convergence of minimum complexity density estimators as well as the information-theoretic redundancy of the corresponding total description length. The results on the index of resolvability demonstrate the statistical effectiveness of the minimum description-length principle as a method of inference. The minimum complexity estimator converges to

Andrew R. Barron; Thomas M. Cover

1991-01-01

376

Complex systems: Network thinking  

Microsoft Academic Search

Like arti?cial intelligence in its earlier years, the ?eld of complex systems has received a lot of press in the last two decades, both positive and negative, breezily hyped and unjustly derogatory. As in the early years of AI, complex systems scientists have at times made promises and set up expectations that are hard for any young science to ful?ll.

Melanie Mitchell

2006-01-01

377

Complex optical holograms  

Microsoft Academic Search

This paper discusses three forms of complex holograms, described by means of complex Fourier, Fresnel, and Hartley transformations. Digital models of these holograms and algorithms for modelling them digitally are presented. It is shown that the reflectance and the phase variation upon reflection from the surface of an object can be determined not only from the reconstructed image but also

T. V. Bogdanova; V. P. Titar

2004-01-01

378

Managing complex team interventions  

Microsoft Academic Search

Purpose – To provide readers with a better understanding of the organizational conditions that lead to complexity in team structure, operation, and dynamics, and introduce guidelines for facilitating complex team interventions. Design\\/methodology\\/approach – This article is based on the author's 20 years' experience as an internal OD executive, external consultant, and associate professor in the areas of organizational change and

Robert Barner

2006-01-01

379

TELLURITO COMPLEXES: BASIC METAL PYROTELLURITO COMPLEXES  

Microsoft Academic Search

The reaction between metal salts and K2TeO2·xH2O in aqueous ethanol yielded basic metal pyrotellurito complexes, nMTe2O5·mM(OH)2·xH2O (M = Ni(II), Co(II), Cu(II), Zn(lI), Cd(II) and UO2(VI); n, m and x are whole numbers) and M2(Te2O5)3·mM(OH)3·xH2O (M = Cr(III) and Fe(III)). As the reaction medium was slightly alkaline basic pyrotellurites are formed instead of normal tellurites. The complexes are micro-crystalline, stable compounds

Faten S. M. Abd El-Hameed

1996-01-01

380

Bimacrocyclic NHC transition metal complexes  

Microsoft Academic Search

The preparation of seven concave NHC metal complexes derived from bimacrocyclic imidazolinium salt 1 is reported. The silver complex 2, obtained in 86% yield by reacting 1 with silver(I) oxide, was used to give copper complex 3, rhodium complex 5 and iridium complex 6 by transmetalation in good yields. Palladium complex 4 was obtained by reaction of the azolium salt

Ole Winkelmann; Christian Näther; Ulrich Lüning

2008-01-01

381

Cyclodextrin complexes: chiral recognition and complexation behaviour.  

PubMed

Cyclodextrins are well known in supramolecular chemistry as host molecules capable of engulfing molecules in their hydrophobic cavity via noncovalent interactions. Although cyclodextrins are frequently used for chiral separation of racemates, the mechanism of chiral recognition has not yet been fully characterised. The current investigation was aimed at examining chiral recognition mechanism in order to construct an in silico method for prediction of chiral recognition. Amino acids were selected as model guest, whereas alphaCD was used as model host. The results of molecular docking and molecular dynamic calculations were compared to results of stability constant determination and capillary electrophoresis measurements of enantioseparations. Positive correlation between binding strength and chiral separation ability was found. However, the small energy differences between interaction energy of each enantiomer with alphaCD fell into the range of standard error of molecular docking calculations limiting its applicability for in silico prediction. Examining the stability of complex geometry during molecular dynamics simulation revealed that stable complex geometry is likely to be a prerequisite for chiral recognition. This hypothesis was tested on methylderivatized tryptophan. Indeed, chiral separation of beta-methyl-tryptophans by alphaCD could be successfully predicted by examining the complex geometries during molecular dynamic simulation. PMID:18045090

Bikádi, Zsolt; Iványi, Róbert; Szente, Lajos; Ilisz, István; Hazai, Eszter

2007-12-01

382

Trauma-focused CBT for youth with complex trauma  

PubMed Central

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.

Mannarino, Anthony P.; Kliethermes, Matthew; Murray, Laura A.

2013-01-01

383

Some experiments on the toxicity of complex cyanides to fish  

Microsoft Academic Search

The toxicity to minnows, Pimephales promelas, of mixed solutions of sodium cyanide and sulfates of heavy metals, diluted with synthetic soft water, was evaluated in order to learn the degree of toxicity, to fish, of complex cyanides found in industrial wastes. The potentials of complex formation as a waste treatment method thus were explored also. The zinc cyanide and cadmium

Doudoroff

1956-01-01

384

Comparison of simple and complex liver intensity modulated radiotherapy  

Microsoft Academic Search

BACKGROUND: Intensity-modulated radiotherapy (IMRT) may allow improvement in plan quality for treatment of liver cancer, however increasing radiation modulation complexity can lead to increased uncertainties and requirements for quality assurance. This study assesses whether target coverage and normal tissue avoidance can be maintained in liver cancer intensity-modulated radiotherapy (IMRT) plans by systematically reducing the complexity of the delivered fluence. METHODS:

Mark T Lee; Thomas G Purdie; Cynthia L Eccles; Michael B Sharpe; Laura A Dawson

2010-01-01

385

B Plant complex treatment, storage, and disposal units inspection plan  

SciTech Connect

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.

Beam, T.G.

1994-10-01

386

Evolution of Endovascular Treatment for Complex Thoracic Aortic Disease  

PubMed Central

In a relatively short period of time, transcatheter and endovascular approaches to treat thoracic aortic and structural heart disease have exploded onto the scene. New device frontiers already being forged in the experimental stages include expanded indications and variations of fenestrated and branch stentgrafting to treat thoracoabdominal and arch disease, endovascular ascending and aortic root repair, and all of the cardiac valves. A fundamental concept to optimize durability of endovascular repair is the need for fixation and seal in healthy tissue. Before long, the entire vascular and cardiovascular system will be within the reach of endovascular interventions. Ultimately, achieving success in this endeavor will require a combination of skill sets including familiarity with high definition imaging, surgical access, and the mastery of interventional techniques, as well as the development of better anatomy-specific and disease-specific devices.

2008-01-01

387

Sodium hydroxide treatment of field water in a biopolymer complex  

Microsoft Academic Search

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

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

1990-01-01

388

The Evolution of Privatization at Hanford Tank Waste Treatment Complex  

SciTech Connect

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.

BROWN, N.R.

2001-02-01

389

[Omaron in the complex treatment of patients with multiple sclerosis].  

PubMed

We studied efficacy and tolerability of the combined drug omaron (25 mg of cinnarizine and 400 mg of piracetam in one tablet) in patients with multiple sclerosis. The dosage of the drug was 1 tablet 3 times a day during 12 weeks in 33 patients (mean age 35.3±4.2 years) of the index group. A comparison group consisted of 27 patients matched for demographic and clinical characteristics who did not receive nootropics during the study. None of patients included in the study received disease modifying drugs. The significant (p<0.05) decrease in the severity of chronic fatigue syndrome (by 28.6% compared to baseline), improvement (p<0.05) of cognitive functions (increase of MMSE scores by 9.4%) were found in the index group compared to the comparison one. The statistically significant changes in the severity of disability assessed by EDSS were not observed. Omaron was well-tolerated with no serious adverse-effects. PMID:21183917

Popova, N F; Kamchatnov, P R; Riabukhina, O V; Batysheva, T T; Za?tsev, K A; Bo?ko, A N

2010-01-01

390

New homoleptic carbene transfer ligands and related coinage metal complexes  

Microsoft Academic Search

The synthesis, spectroscopic and structural characterization of the carbene ligand precursor bis(4-benzyl-1,2,4-triazol-4-ium-1-yl)dihydroborate has been described. Treatment with Ag2O leads to the silver(I) complex of the new monoanionic bis(4-benzyl-1,2,4-triazol-5-ylidene-1-yl)dihydroborate dicarbene ligand. The resulting dimetallacycle carbene complex has been used to synthesize the homoleptic gold(I) complex by transmetallation reaction.

Grazia Papini; Giuliano Bandoli; Alessandro Dolmella; Giancarlo Gioia Lobbia; Maura Pellei; Carlo Santini

2008-01-01

391

Biocompatibility and degradability of sepiolite-collagen complex.  

PubMed

Sepiolite, a magnesium silicate, binds collagen resulting in a complex which has a gel-like structure when hydrated. The binding of the protein to the clay decreases its degradability by collagenase, and no degradation was observed after treatment of the complex with glutaraldehyde. Extracts of both the untreated and the glutaraldehyde-treated complex are biocompatible for fibroblast growth. Based on its properties, this material should be considered in the design of biomaterials. PMID:3030456

Olmo, N; Lizarbe, M A; Gavilanes, J G

1987-01-01

392

Antimicrobials Treatment  

NASA Astrophysics Data System (ADS)

The use of antimicrobials is a common practice for preservation of foods. Incorporation, in a food recipe, of chemical antimicrobials towards inhibition of spoilage and pathogenic micro-organisms results in the compositional modification of food. This treatment is nowadays undesirable for the consumer, who likes natural products. Scientific community reflecting consumers demand for natural antimicrobials has made efforts to investigate the possibility to use natural antimicrobials such us bacteriocins and essential oils of plant origin to inhibit microbial growth.

Drosinos, Eleftherios H.; Skandamis, Panagiotis N.; Mataragas, Marios

393

Selenophene transition metal complexes  

SciTech Connect

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.

White, C.J.

1994-07-27

394

Complexity and robustness  

PubMed Central

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.

Carlson, J. M.; Doyle, John

2002-01-01

395

Mobile multiwave lidar complexes  

SciTech Connect

Multiwave mobile lidar complexes (MLCs) are designed and developed. A number of vehicle-based MLCs are built. The set of complex lidar probing data obtained with the help of MLCs is synchronised in space and time, covers a large area (the operation range of an MLC is 15 km), and is based on a unified methodological approach. The results of probing contain information on the concentration and physical nature of atmospheric aerosol, chemical composition of the gaseous phase of the atmosphere, wind and turbulence. The obtained data form the basis for a complex analysis of the ecological situation and prognosis of its development. (laser applications and other topics in quantum electronics)

Boreysho, A S; Konyaev, M A; Morozov, A V; Pikulik, A V; Savin, A V; Trilis, A V; Chakchir, S Ya [Institute of Laser Instruments and Technologies, D F Ustinov 'VOENMEKh' Baltic State Technical University, St Petersburg (Russian Federation); Boiko, N I; Vlasov, Yu N; Nikitaev, S P; Rozhnov, A V [Administration of the Commander of Radiation, Chemical and Biological Defence Corps of the Armed Forces of the Russian Federation (Russian Federation)

2005-12-31

396

Complex intuitionistic fuzzy sets  

NASA Astrophysics Data System (ADS)

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.

Alkouri, Abdulazeez (Moh'd. Jumah) S.; Salleh, Abdul Razak

2012-09-01

397

Finding the missing heritability of complex diseases  

PubMed Central

Genome-wide association studies have identified hundreds of genetic variants associated with complex human diseases and traits, and have provided valuable insights into their genetic architecture. Most variants identified so far confer relatively small increments in risk, and explain only a small proportion of familial clustering, leading many to question how the remaining, ‘missing’ heritability can be explained. Here we examine potential sources of missing heritability and propose research strategies, including and extending beyond current genome-wide association approaches, to illuminate the genetics of complex diseases and enhance its potential to enable effective disease prevention or treatment.

Manolio, Teri A.; Collins, Francis S.; Cox, Nancy J.; Goldstein, David B.; Hindorff, Lucia A.; Hunter, David J.; McCarthy, Mark I.; Ramos, Erin M.; Cardon, Lon R.; Chakravarti, Aravinda; Cho, Judy H.; Guttmacher, Alan E.; Kong, Augustine; Kruglyak, Leonid; Mardis, Elaine; Rotimi, Charles N.; Slatkin, Montgomery; Valle, David; Whittemore, Alice S.; Boehnke, Michael; Clark, Andrew G.; Eichler, Evan E.; Gibson, Greg; Haines, Jonathan L.; Mackay, Trudy F. C.; McCarroll, Steven A.; Visscher, Peter M.

2010-01-01

398

A golden ring: molecular gold carbido complexes.  

PubMed

Stannylcarbynes [M(?CSnMe3)(CO)2(Tp*)] [M = Mo, W; Tp* = hydrotris(dimethylpyrazol-1-yl)borate], which are readily obtained via the successive treatment of [M(?CBr)(CO)2(Tp*)] with (n)BuLi and ClSnMe3, serve as effective carbyne transmetalation agents for the preparation of heteronuclear molecular gold carbido complexes such as [M(?CAuPPh3)(CO)2(Tp*)] and the tetrameric golden ring complex [W(?CAu)(CO)2(Tp*)]4, which are in turn able to transfer the carbido unit to palladium. PMID:23485021

Borren, Elliot S; Hill, Anthony F; Shang, Rong; Sharma, Manab; Willis, Anthony C

2013-04-01

399

[Patient adherence in antihypertensive treatment].  

PubMed

Hypertension is one of the most frequent chronic diseases as well as most important cardiovascular risk factors in developed countries. Blood pressure control to target levels can significantly decrease the risk for development of coronary artery disease, stroke, chronic renal disease and mortality. Adequately maintained blood pressure is very important in high risk patients. In the treatment of hypertension, life style therapy and drug treatment have essential roles. Further, patient adherence plays a significant part of the treatment, too. Importantly, about half of the patients only become adherent to antihypertensive therapy by the end of the first year treatment. Hence, non-adherence of patients is an important cause for resistant hypertension. Adherence is influenced by the complexity of drug regimen and characteristic of drug class, as well as age and gender of patients. PMID:24077162

Simonyi, Gábor

2013-10-01

400

Neuropathic pain after dental treatment.  

PubMed

The head and neck regions are the most common sites of the human body to be involved in chronic pain conditions. Neuropathic pain is a chronic pain condition, and refers to all pain initiated or caused by a primary lesion or dysfunction or transitory perturbation in the peripheral or central nervous system (CNS). Trigeminal neuralgia, atypical odontalgia (phantom tooth pain), burning mouth syndrome, traumatic neuropathies, postherpetic neuralgias and complex regional pain syndrome are neuropathic pain conditions in the orofacial region that can be encountered in pain and dental clinics. The majority of the time this problem is misdiagnosed by the dentist, which can lead to unnecessary treatments. These treatments may include endodontic treatment and extraction of the tooth or teeth in the region. In this review, only post-traumatic peripheral pain neuropathies seen after dental treatments will be discussed. PMID:23588863

T?nastepe, Neslihan; Oral, Koray

2013-01-01

401

Pharmacological treatment of fibromyalgia.  

PubMed

Fibromyalgia (FM) is a common syndrome characterised by widespread pain and at least 11/18 painful tender points that requires multimodal pharmacological treatment also combined with non-pharmacological therapy. Various drugs currently are available to control the complex and different symptoms reported by patients. Only three drugs (duloxetine, milnacipram, pregabalin) are approved by the American Food and Drug Administration (FDA) and none by the European Medicines Agency (EMEA), consequently, off-label use is habitual in Europe. Most of the drugs improve only one or two symptoms; no drug capable of overall symptom control is yet available. Furthermore, different classes of drugs with different mechanisms of action are used off-label, including tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), opioids, non-steroidal anti-inflammatory drugs (NSAIDs), growth hormone, corticosteroids and sedative hypnotics. As no single drug fully manages FM symptoms, multicomponent therapy should be used from the beginning. Various pharmacological treatments have been used to treat FM with inconclusive results, and gradually increasing low doses is suggested in order to maximise efficacy. The best treatment should be individualised and combined with patient education and non-pharmacological therapy. PMID:21176430

Di Franco, M; Iannuccelli, C; Atzeni, F; Cazzola, M; Salaffi, F; Valesini, G; Sarzi-Puttini, P

2010-01-01

402

STRUCTURAL BIOLOGY: Complex II Is Complex Too  

NSDL National Science Digital Library

Access to the article is free, however registration and sign-in are required. In aerobic eukaryotic cells, the respiratory chain of enzymes in the inner mitochondrial membrane transfers electrons from NADH and succinate to molecular oxygen, in the process producing the energy-rich molecule ATP. Hederstedt explains in his Perspective that the crystal structure of bacterial SQR (equivalent to mitochondrial complex II) reveals how the arrangement of redox centers in this enzyme enables electrons to be transferred to ubiquinone while minimizing production of reactive oxygen species that could damage tissues (Yankovskaya et al.).

Lars Hederstedt (Lund University;Department of Cell and Organism Biology)

2003-01-31

403

Reconstruction Using Witness Complexes  

PubMed Central

We present a novel reconstruction algorithm that, given an input point set sampled from an object S, builds a one-parameter family of complexes that approximate S at different scales. At a high level, our method is very similar in spirit to Chew’s surface meshing algorithm, with one notable difference though: the restricted Delaunay triangulation is replaced by the witness complex, which makes our algorithm applicable in any metric space. To prove its correctness on curves and surfaces, we highlight the relationship between the witness complex and the restricted Delaunay triangulation in 2d and in 3d. Specifically, we prove that both complexes are equal in 2d and closely related in 3d, under some mild sampling assumptions.

Oudot, Steve Y.

2010-01-01

404

Analysis of Complex Genomes.  

National Technical Information Service (NTIS)

Dr. Brenner discusses the techniques of cloning and sequencing DNA which enables large-scale analysis of complex genomes. The opportunities and challenges of the human genome project are reviewed. Primary audience: health professionals and researchers.

1994-01-01

405

Berberine: Complex with Dna.  

National Technical Information Service (NTIS)

A complex of calf-thymus DNA with berberine sediments in the analytical ultracentrifuge. The DNA produced systematic changes in the absorption spectrum of berberine which suggest that single alkaloid molecules bind to DNA. Flow dichroism of purines and py...

A. E. Krey F. E. Hahn

1969-01-01

406

Complex Line Integrals I  

NSDL National Science Digital Library

Created by Lang More of the Connected Curriculum Project, the purpose of this module is to investigate the behavior of complex line integrals. This is one lesson within a much larger set of learning modules hosted by Duke University.

Moore, Lang

2010-06-21

407

Automata and Computational Complexity.  

National Technical Information Service (NTIS)

The report summarizes the results obtained in research supported by the National Science Foundation Grant AUTOMATA AND COMPUTATIONAL COMPLEXITY. The report lists the problem areas considered, the publications resulting from this work and gives an outline ...

J. Hartmanis

1972-01-01

408

Sewage Treatment  

NASA Technical Reports Server (NTRS)

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.

1984-01-01

409

Alternative treatment.  

PubMed

Alternatives to endometrial ablation include re-education of the 20% or more women complaining of menorrhagia whose blood loss is normal, less than 35 ml, and the use of an increasing variety of drugs to find an effective regime with minimal side effects. Endometrial resection is an effective treatment, particularly in the short term. Laparoscopic and vaginal hysterectomy have advantages over endometrial resection in the long term, avoiding failure and retreatment for menorrhagia. Hysteroscopic, laparoscopic and open myomectomy are more suitable in treating fibroids of significant size, although these techniques may be used with endometrial resection to avoid hysterectomy. Myoma reduction may become a less morbid alternative to myomectomy. PMID:7554619

Wood, C

1995-06-01

410

Complex Networks and Graphs  

NSDL National Science Digital Library

Students learn about complex networks and how to represent them using graphs. They also learn that graph theory is a useful mathematical tool for studying complex networks in diverse applications of science and engineering, such as neural networks in the brain, biochemical reaction networks in cells, communication networks, such as the internet, and social networks. Topics covered include set theory, defining a graph, as well as defining the degree of a node and the degree distribution of a graph.

Complex Systems Science Laboratory

411

Systems Engineering and Complexity  

Microsoft Academic Search

The interaction between the fields of systems engineering and complexity theory is only beginning. This paper quickly explores the two fields to seek the relationship between them. Systems engineering is usually defined in terms of the activities that are used in the field: mission\\/purpose definition, requirements engineering, system architecting, system implementation, technical analysis, technical management\\/leadership, scope management, and verification\\/validation. Complexity

Eric Honour

412

[Prophylaxis and treatment of periimpalntitis].  

PubMed

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

Manjavidze, N; Vadachkoria, N; Gumberidze, N

2013-09-01

413

Complex organics in meteorites.  

PubMed

Complex macromolecular organic matter is present in carbonaceous chondrites as the most abundant organic matter and may be present in interstellar dusts and comets. With this view, our studies of the complex organic matter isolated from six CM2 chondrites, namely Yamato-74662, Yamato-791198, Yamato-793321, Yamato-86720, Belgica-7904, and Murchison are introduced and discussed in the text. The complex organic matter is acid-insoluble and organic solvent-insoluble, and therefore, it was examined by heating experiments to obtain information on its chemical constituents and characteristics. Three chondrites, Yamato-74662, Yamato-791198, and Murchison which have solvent-extractable organic compounds, such as amino acids, carboxylic acid, hydrocarbons, etc. possess thermally labile organic fraction in the complex organic matter. Organic compounds detected in the pyrolyzate of the complex organic matter number over 130 of which aromatic hydrocarbons are dominant. They appeared around 300 degrees C, and disappeared at about 600 degrees C with a maximum at 400-500 degrees C during the heating. On the other hand, the other three chondrites do not have the extractable organic compounds nor a thermally labile organic fraction. The presence or absence of the fraction in the complex organic matter likely indicates the presence or absence of the solvent-extractable organic compounds and relates to thermal history of the chondrite. PMID:11541331

Shimoyama, A

1997-01-01

414

Lymphedema in tuberous sclerosis complex.  

PubMed

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

Geffrey, Alexandra L; Shinnick, Julianna E; Staley, Brigid A; Boronat, Susana; Thiele, Elizabeth A

2014-06-01

415

Aminophosphonate metal complexes of biomedical potential.  

PubMed

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

Tušek-Boži?, L J

2013-01-01

416

Late transition metal. mu. -oxo and. mu. -imido complexes  

SciTech Connect

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.

Sharp, P.R.

1990-01-01

417

Clubfoot Treatment -- Ponseti Method  

MedlinePLUS

... Treatment Treatment for clubfoot is usually started in infancy. The Ponseti method is the most common treatment ... birth. Treatment for clubfoot is usually started in infancy. The Ponseti method is the most common treatment ...

418

Combination syndrome symptomatology and treatment.  

PubMed

Combination syndrome (CS) is one of the most fascinating oral conditions yet is poorly understood and underappreciated in the literature and clinical practice. This article reviews the most important literature on this subject and analyzes the etiology, symptomatology, diagnosis, and current therapeutic modalities for treatment in an attempt to better understand CS. The syndrome represents an example ofa complex pathologic condition of the entire stomatognathic system with a multitude of hard-tissue, soft-tissue, and occlusal changes. These changes, initiated by a certain sequence of events, beginning with a prolonged period of tooth loss, can lead to severe bone atrophy in different regions of the jaws, loss of masticatory function, and the need for complex treatment. Implant rehabilitation of these patients in a preventative approach with cooperation of the entire dental team is emphasized. PMID:21560744

Tolstunov, Len

2011-04-01

419

Diagnosis and Treatment of Delirium  

PubMed Central

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.

Henry, W. Desmond; Mann, Alan M.

1965-01-01

420

Tuberous Sclerosis Complex: Perioperative Considerations  

PubMed Central

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.

Rabito, Matthew J.; Kaye, Alan David

2014-01-01

421

Pulling complexes out of complex diseases  

PubMed Central

Spinocerebellar ataxia 7 (SCA7) is an incurable disease caused by expansion of CAG trinucleotide sequences within the Ataxin-7 gene. This elongated CAG tract results in an Ataxin-7 protein bearing an expanded polyglutamine (PolyQ) repeat. SCA7 disease is characterized by progressive neural and retinal degeneration leading to ataxia and blindness. Evidence gathered from investigating SCA7 and other PolyQ diseases strongly suggest that misregulation of gene expression contributes to neurodegeneration. In fact, Ataxin-7 is a subunit of the essential Spt-Ada-Gcn5-Acetltransferase (SAGA) chromatin modifying complex that regulates expression of a large number of genes. Here we discuss recent insights into Ataxin-7 function and, considering these findings, propose a model for how polyglutamine expansion of Ataxin-7 may affect Ataxin-7 function to alter chromatin modifications and gene expression.

Mohan, Ryan D; Abmayr, Susan M; Workman, Jerry L

2014-01-01

422

Evaluation of treatments for myofascial pain syndrome and fibromyalgia  

Microsoft Academic Search

Myofascial pain syndrome (MPS) and fibromyalgia (FM) are complex conditions and pose significant challenges to clinicians\\u000a and patients. This chapter explores available treatments for MPS and FM in the context of pathophysiology, clinical evidence,\\u000a and experimental support. This information may prove to be helpful in designing individualized treatment for patients with\\u000a these complex syndromes. New treatments should be critically and

Nathan J. Rudin

2003-01-01

423

[Oxygen therapy in wound treatment].  

PubMed

The observation of a device delivering oxygen locally on twelve patients with chronic wounds for which conventional treatments have had little or no effect, aims to assess the benefit of the local use of oxygen on complex wounds. The main benefits observed are the obtaining of high quality tissue formation and a notable reduction in pain. These encouraging initial results merit being backed up by a comparative clinical study. PMID:24839677

Baffie, Aurélie; Gérard, Maud; Varlin, Valérie; Fromantin, Isabelle; Perceau, Géraldine

2014-04-01

424

Ecology, Complexity, and Metaphor  

NSDL National Science Digital Library

This peer-reviewed article from Bioscience is about Ecology, Complexity and Metaphor.Complexity has recently risen to prominence in ecology as part of a broader interest that suggests its status is something more than just a scientific theory or property of reality. It may be helpful to consider complexity, and related terms such as "self-organization," as recent metaphors deployed to advance knowledge on fundamental questions in ecology, including the relationship between parts and wholes, and between order and disorder. Though not commonly viewed as such, metaphors are an indispensable component of science, and should not be appraised as true or false, but rather in terms of how they help or hinder knowledge. By understanding metaphor as a necessary ally and not a threat to ecological knowledge, we may enrich our contextual understanding of complexity while continuing to invoke it in useful ways. The special section introduced by this article features essays by two prominent experts in ecology, complexity, and metaphor: science studies scholar Evelyn Fox Keller and theoretical ecologist Simon Levin

JAMES D. PROCTOR and BRENDON M. H. LARSON (;)

2005-12-01

425

The ULK1 complex  

PubMed Central

The Atg1/ULK1 complex plays a central role in starvation-induced autophagy, integrating signals from upstream sensors such as MTOR and AMPK and transducing them to the downstream autophagy pathway. Much progress has been made in the last few years in understanding the mechanisms by which the complex is regulated through protein-protein interactions and post-translational modifications, providing insights into how the cell modulates autophagy, particularly in response to nutrient status. However, how the ULK1 complex transduces upstream signals to the downstream central autophagy pathway is still unclear. Although the protein kinase activity of ULK1 is required for its autophagic function, its protein substrate(s) responsible for autophagy activation has not been identified. Furthermore, examples of potential ULK1-independent autophagy have emerged, indicating that under certain specific contexts, the ULK1 complex might be dispensable for autophagy activation. This raises the question of how the autophagic machinery is activated independent of the ULK1 complex and what are the biological functions of such noncanonical autophagy pathways.

Wong, Pui-Mun; Puente, Cindy; Ganley, Ian G.; Jiang, Xuejun

2013-01-01

426

Hydridomethyl iridium complex  

DOEpatents

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.

Bergman, Robert G. (P.O. Box 7141, San Francisco, CA 94120-7141); Buchanan, J. Michael (P.O. Box 7141, San Francisco, CA 94120-7141); Stryker, Jeffrey M. (P.O. Box 7141, San Francisco, CA 94120-7141); Wax, Michael J. (P.O. Box 7141, San Francisco, CA 94120-7141)

1989-01-01

427

Controllability of Complex Networks  

NASA Astrophysics Data System (ADS)

The ultimate proof of our understanding of natural or technological systems is reflected in our ability to control them. While control theory offers mathematical tools to steer engineered systems towards a desired state, we lack a general framework to control complex self-organized systems, like the regulatory netwo