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1

Primary sclerosing cholangitis as an intractable disease  

PubMed Central

Summary Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease of unknown origin which eventually results in liver cirrhosis. The disease is reported to be more common among the Western population than in the Asian population. Asian experience remains limited. Diagnosis and treatment standards in the Far East have largely followed those in the West, including liver transplantation. Unlike in the West, however, recent reports from Japan have presented with a higher recurrence rate of PSC after liver transplantation, suggesting the intractable nature of the disease even after the replacement of the entire affected organ. PMID:25343066

Tamura, Sumihito; Sugawara, Yasuhiko; Kokudo, Norihiro

2012-01-01

2

Intractable hiccup caused by spinal cord lesions in demyelination disease  

PubMed Central

Objective This study aimed to summarize the clinical features of patients who presented intractable hiccup (IH) without brain and medulla oblongata (MO) lesions. Method This study included six patients who were diagnosed with inflammatory demyelinating myelitis, categorized as neuromyelitis optica (NMO), multiple sclerosis (MS), and myelitis. Patients who presented IH with cervical lesions but without MO lesions were also included. Clinical profiles, laboratory data, and magnetic resonance imaging findings were analyzed. Results Three out of six patients were diagnosed with NMO, whereas the remaining three were diagnosed with acute myelitis, recurrent myelities, and MS, respectively. The duration of hiccup was from 2 to 23 days (average = 9.33 ± 8.64 days). Five patients (83.33%, patients 1–5) had long segmental lesions and one had a patchy lesion. None of these patients had any MO lesions. Half of them were successfully treated with high-dose methylprednisolone combined with gamma-aminobutyric acid (GABA) inhibitor. Conclusion IH occurred in patients without MO lesion. However, the mechanism remained unclear. Immune factors of demyelinating neuropathy stimulated the hiccup reflex arch. Cervical cord lesions may activate the hiccup center. In general, IH can be controlled by IVMP combined with GABA inhibitor. Unilateral phrenic nerve block may elicit no effect. PMID:24090474

Hao, Xiao-ting; Wang, Lu; Yan, Bo; Zhou, Hong-yu

2013-01-01

3

Renal Artery Embolization Controls Intractable Pain in a Patient with Polycystic Kidney Disease  

SciTech Connect

A 65-year-old man with adult polycystic kidney disease (APKD) and chronic renal failure suffered from intractable abdominal pain and distension for 2 weeks. Meperidine infusion did not alleviate his pain. However, pain and abdominal distension were successfully controlled by embolization of both renal arteries.

Hahn, Seong Tai; Park, Seog Hee; Lee, Jae Mun; Kim, Choon-Yul [Department of Radiology, St. Mary's Hospital, Catholic Medical Center, Catholic University of Korea, 62, Youido-dong, Yongdungpo-gu, Seoul, 150-010 (Korea, Republic of); Chang, Yoon Sik [Department of Internal Medicine, St. Mary's Hospital, Catholic Medical Center, Catholic University of Korea, 62, Youido-dong, Yongdungpo-gu, Seoul, 150-010, Korea (Korea, Republic of)

1999-09-15

4

Comparative Study of Endolymphatic Sac Decompression and Vestibular Neurectomy in Intractable Meniere's Disease.  

PubMed

To comparative study the clinical effect of endolymphatic sac decompression (ELSD) and vestibular neurectomy (VN) in intractable Meniere's disease (MD). The study included 30 MD intractable patients, 21 of which underwent ELSD and nine of which were treated by VN via retrosigmoid approach. Follow-up period ranged from 3 to 6 years. In 21 patients by ELSD, excellent vertigo control and good control were noted in 11 patients (52.4 %) and 4 patients (19.0 %), partial control in 4 and no control in 2 patients. All the 9 patients by VN, vertigo was excellent control. ELSD can improve hearing and tinnitus, but VN not. VN can achieve much better effect in improving vertigo in intractable MD patients. But relative to ELSD, it has much more disadvantages. PMID:25621233

Liu, Yiqing; Han, Jie; Zhou, Xuanchen; Luan, Deheng; Xie, Fengyang; Gao, Kun

2015-03-01

5

Interleukin-10 receptor mutations in children with neonatal-onset Crohn's disease and intractable ulcerating enterocolitis.  

PubMed

Neonatal-onset inflammatory bowel disease (IBD) accounts for only 0.25% of pediatric IBD cases. The molecular pathogenesis of IBD remains unclear. Recently, rare Mendelian mutations have been identified in children with very early-onset Crohn's disease and ulcerative colitis. In this study, we report compound heterozygous mutations in the interleukin-10 receptor A (IL-10RA) gene in children with severe neonatal-onset IBD. Patient 1 had chronic diarrhea within the first month of life and had perianal fistulae. She was diagnosed with 'intractable ulcerating enterocolitis in infancy' and underwent subtotal colectomy at the age of 24 months because of poor response to immunosuppressant therapy. Compound heterozygous mutations, c.[301C>T];[350G>A](p.[R101W];[R117H]), were discovered in IL-10RA for this patient. Patient 2 presented symptoms within the first month of life and was diagnosed with Crohn's disease. Severe colitis and perianal and enteroenteric fistulae occurred repeatedly, and he underwent surgical management involving colectomy, colostomy, and ileostomy. We identified mutations in IL-10RA, c.[272A>G];[784C>T] (p.[Y91C];[R262C]). Patient 3 had chronic diarrhea and a rectovaginal fistula at 3 days of life and was diagnosed with Crohn's disease. She underwent fistulectomy and ileostomy, but experienced frequent relapses. Mutations, c.[272A>G];[301C>T] (p.[Y91C];[R101W]), were found in IL-10RA. This report confirms the genetic defect of IL-10RA in neonatal-onset IBD including 'intractable ulcerating enterocolitis in infancy'. PMID:23839161

Shim, Jung Ok; Hwang, Solha; Yang, Hye Ran; Moon, Jin Soo; Chang, Ju Young; Ko, Jae Sung; Park, Sung Sup; Kang, Gyeong-Hoon; Kim, Woo Sun; Seo, Jeong Kee

2013-10-01

6

Case report: a case of intractable Meniere's disease treated with autogenic training  

PubMed Central

Background Psychological stress plays an important role in the onset and course of Meniere's disease. Surgical therapy and intratympanic gentamicin treatment are options for cases that are intractable to conventional medical therapy. Psychotherapy, however, including autogenic training (AT), which can be used for general relaxation, is not widely accepted. This paper describes the successful administration of AT in a subject suffering from intractable Meniere's disease. Case presentation A 51-year-old male patient has suffered from fluctuating right sensorineural hearing loss with vertigo since 1994. In May 2002, he was first admitted to our hospital due to a severe vertigo attack accompanied by right sensorineural hearing loss. Spontaneous nystagmus toward the right side was observed. Since April 2004, he has experienced vertigo spells with right-sided tinnitus a few times per month that are intractable to conventional medical therapy. After four months, tympanic tube insertion was preformed in the right tympanic membrane. Intratympanic injection of dexamethasone was ineffective. He refused Meniett therapy and intratympanic gentamicin injection. In addition to his vertigo spells, he suffered from insomnia, tinnitus, and anxiety. Tranquilizers such as benzodiazepines and antidepressants such as serotonin selective re-uptake inhibitors (SSRIs) failed to stop the vertigo and only slightly improved his insomnia. In December 2006, the patient began psychological counseling with a psychotherapist. After brief psychological counseling along with cognitive behavior therapy (CBT), he began AT. He diligently and regularly continued his AT training in his home according to a written timetable. His insomnia, tinnitus, and vertigo spells disappeared within a few weeks after only four psychotherapy sessions. In order to master the six standard formulas of AT, he underwent two more sessions. Thereafter, he underwent follow-up for 9 months with no additional treatment. He is now free from drugs, including tranquilizers, and has continued AT. No additional treatment was performed. When we examined him six and nine months later for follow-up, he was free of vertigo and insomnia. Conclusion AT together with CBT can be a viable and palatable treatment option for Meniere's disease patients who are not responsive to other therapies. PMID:18221543

Goto, Fumiyuki; Nakai, Kimiko; Kunihiro, Takanobu; Ogawa, Kaoru

2008-01-01

7

Pseudomyxoma peritonei as an intractable disease and its preoperative assessment to help improve prognosis after surgery: A review of the literature  

PubMed Central

Summary Pseudomyxoma peritonei (PMP) is a rare and intractable disease with an estimated incidence of one per million population per year. Many aspects of PMP need to be fully and precisely understood; these include its preoperative assessment, i.e. diagnosis, early diagnosis, pathologic classification, and staging according to the peritoneal cancer index, and its surgical treatment. This review focuses on elements of preoperative assessment and surgery using the Sugarbaker procedure to help improve the prognosis for patients with PMP. Accurate data on the incidence of PMP must be based on large populations rather than estimates, and much work needs to be done especially in China. Special attention should be paid to its preoperative assessment. Also proposed here are steps to manage PMP with an emphasis on preoperative assessment. PMID:25343082

Zhong, Yuesi; Deng, Meihai; Xu, Ruiyun; Kokudo, Norihiro; Tang, Wei

2012-01-01

8

Neuromodulation for intractable headaches.  

PubMed

Intractable chronic headaches are a major challenge for both patients and healthcare professionals. Over the last two decades, implantable electrical neuromodulators, previously established to manage other forms of chronic pain, have been used increasingly for intractable primary and secondary headache disorders. We review the current approaches to the management of refractory headaches using neuromodulation. Indications, operative considerations and complications are discussed based on our experience and a review of the literature. The field of neuromodulation has been rapidly advancing, with many new targets being discovered and novel devices being developed for treating craniofacial pain. We discuss some of these targets, detailing the latest advances in the area of neuromodulation for intractable headaches. PMID:24488653

Hassanzadeh, Roya; Jones, Jeremy C; Ross, Edgar L

2014-02-01

9

Midazolam for intractable hiccup  

Microsoft Academic Search

We describe two terminally ill cancer patients severely distressed by intractable hiccup. Commonly recommended treatments were ineffective. Intravenous midazolam 5–10 mg rapidly relieved the hiccup. Maintenance treatment comprised midazolam 40–120 mg\\/24 hr by continuous subcutaneous infusion.

Andrew Wilcock; Robert Twycross

1996-01-01

10

Eosinophilic jejunitis presenting as intractable abdominal pain.  

PubMed

Eosinophilic gastroenteritis is an uncommon disease characterized by eosinophilic infiltration of the gastrointestinal tract. The clinical manifestations are related to the layer(s) and extent of the bowel involved. In this paper, we present a case of intractable abdominal pain caused by jejunal submucosal eosinophilic infiltration without mucosal involvement, diagnosed by deep endoscopic biopsies. The patient was successfully treated with steroids without need for surgery for diagnosis or therapy. PMID:25565932

Mungan, Zeynel; Attila, Tan; Kapran, Yersu; Tokatli, Ilyas Pinar; Unal, Zeynep

2014-09-01

11

Eosinophilic Jejunitis Presenting as Intractable Abdominal Pain  

PubMed Central

Eosinophilic gastroenteritis is an uncommon disease characterized by eosinophilic infiltration of the gastrointestinal tract. The clinical manifestations are related to the layer(s) and extent of the bowel involved. In this paper, we present a case of intractable abdominal pain caused by jejunal submucosal eosinophilic infiltration without mucosal involvement, diagnosed by deep endoscopic biopsies. The patient was successfully treated with steroids without need for surgery for diagnosis or therapy. PMID:25565932

Mungan, Zeynel; Attila, Tan; Kapran, Yersu; Tokatli, Ilyas Pinar; Unal, Zeynep

2014-01-01

12

Prospective study of POLG mutations presenting in children with intractable epilepsy: Prevalence and clinical features  

PubMed Central

Purpose To assess the frequency and clinical features of childhood-onset intractable epilepsy caused by the most common mutations in the POLG gene, which encodes the catalytic subunit of mitochondrial DNA polymerase gamma. Methods Children presenting with nonsyndromic intractable epilepsy of unknown etiology but without documented liver dysfunction at presentation were eligible for this prospective, population-based study. Blood samples were analyzed for the three most common POLG mutations. If any of the three tested mutations were found, all the exons and the exon–intron boundaries of the POLG gene were sequenced. In addition, we retrospectively reviewed the notes of patients presenting with intractable epilepsy in which we had found POLG mutations. All available clinical data were collected by questionnaire and by reviewing the medical records. Key Findings We analyzed 213 blood DNA samples from patients fulfilling the inclusion criteria of the prospective study. Among these, five patients (2.3%) were found with one of the three common POLG mutations as homozygous or compound heterozygous states. In addition, three patients were retrospectively identified. Seven of the eight patients had either raised cerebrospinal fluid (CSF) lactate (n = 3) or brain magnetic resonance imaging (MRI) changes (n = 4) at presentation with intractable epilepsy. Three patients later developed liver dysfunction, progressing to fatal liver failure in two without previous treatment with sodium valproate (VPA). Furthermore, it is worth mentioning that one patient presented first with an autism spectrum disorder before seizures emerged. Significance Mutations in POLG are an important cause of early and juvenile onset nonsyndromic intractable epilepsy with highly variable associated manifestations including autistic features. This study emphasizes that genetic testing for POLG mutations in patients with nonsyndromic intractable epilepsies is very important for clinical diagnostics, genetic counseling, and treatment decisions because of the increased risk for VPA-induced liver failure in patients with POLG mutations. We recommend POLG gene testing for patients with intractable seizures and at least one elevated CSF lactate or suggestive brain MRI changes (predominantly abnormal T2-weighted thalamic signal) with or without status epilepticus, epilepsia partialis continua, or liver manifestations typical for Alpers disease, especially when the disease course is progressive. PMID:23448099

Uusimaa, Johanna; Gowda, Vasantha; McShane, Anthony; Smith, Conrad; Evans, Julie; Shrier, Annie; Narasimhan, Manisha; O'Rourke, Anthony; Rajabally, Yusuf; Hedderly, Tammy; Cowan, Frances; Fratter, Carl; Poulton, Joanna

2013-01-01

13

Kidney Disease Statistics for the United States  

MedlinePLUS

... Disease Statistics for the United States Kidney Disease Statistics for the United States On this page: The ... The Growing Burden of Kidney Disease Kidney disease statistics for the United States convey the burden of ...

14

Intractable hiccups during stroke rehabilitation  

Microsoft Academic Search

Objective: To study the frequency of intractable hiccups during stroke rehabilitation and the impact on rehabilitation management.Design: Case series, retrospective chart review.Setting: Inpatient stroke rehabilitation floor within a tertiary care teaching hospital.Patients: Three patients admitted for stroke rehabilitation with hiccups of at least 48 hours out of 270 consecutive cases.Interventions: None.Main Outcome Measure: Response to pharmacologic treatment.Results: All three subjects

Ashok Kumar; Alexander W. Dromerick

1998-01-01

15

Amygdalar neuromelanosis intractable epilepsy without leptomeningeal involvement.  

PubMed

Neurocutaneous melanosis (NCM) is a rare, congenital neuroectodermal dysplasia generally resulting in early death from neurological decline due to leptomeningeal involvement. Nonmeningeal CNS epileptogenic lesions presenting in later childhood in the absence of leptomeningeal disease are rare. This report summarizes a rare presentation and curative epilepsy surgery. The authors discuss the case of a 14-year-old girl with NCM who originally presented with intractable partial-onset seizures. The MRI, PET, and SPECT studies subsequently revealed a focal epileptogenic source in the right temporal lobe. Results of video-electroencephalography monitoring concurred with the imaging findings, and a right temporal lobectomy was performed including the medial structures. Following surgery, histopathological features of the lesion included multiple scattered mononuclear cells with brown pigmentation in the amygdala specimen. The patient remains seizure free 2 years postresection, and no longer needs medication for seizure management. This patient presented with an atypical CNS manifestation of NCM that is curable by epilepsy surgery. Her intractable epilepsy developed secondary to amygdalar neuromelanosis, which had no associated leptomeningeal melanosis, an uncommon occurrence. As evidenced by the lack of seizure activity following resection, the patient's quality of life greatly improved after neurological surgery. PMID:23641959

Taylor, Douglas R; Wait, Scott D; Wheless, James W; Boop, Frederick A

2013-07-01

16

Giant PICA aneurysm presenting as intractable hiccups  

Microsoft Academic Search

We report a 23-year-old female with rare intractable hiccups caused by a giant posterior inferior cerebellar artery (PICA) aneurysm compressing the medulla oblongata, which resolved after surgical resection of the aneurysm and decompression of the medulla oblongata. We review the literature on lesions in the posterior fossa presenting as intractable hiccups.

Shanu Gambhir; Amardeep Singh; Bhavna Maindiratta; Matthias Jaeger; Balsam Darwish; Mark Sheridan

2010-01-01

17

Gabapentin for Intractable Hiccups in Palliative Care  

Microsoft Academic Search

Intractable hiccups are not common in the general population or in the palliative care population but can adversely impact quality of life and cause other complications such as weight loss and sleep disturbance. Many treatments have been proposed for intractable hiccups, but there is little consensus regarding treatment in the medical literature. This is partly because hiccups are relatively uncommon

Monica L. Tegeler; Steven J. Baumrucker

2008-01-01

18

The intractable cigarette ‘filter problem’  

PubMed Central

Background When lung cancer fears emerged in the 1950s, cigarette companies initiated a shift in cigarette design from unfiltered to filtered cigarettes. Both the ineffectiveness of cigarette filters and the tobacco industry's misleading marketing of the benefits of filtered cigarettes have been well documented. However, during the 1950s and 1960s, American cigarette companies spent millions of dollars to solve what the industry identified as the ‘filter problem’. These extensive filter research and development efforts suggest a phase of genuine optimism among cigarette designers that cigarette filters could be engineered to mitigate the health hazards of smoking. Objective This paper explores the early history of cigarette filter research and development in order to elucidate why and when seemingly sincere filter engineering efforts devolved into manipulations in cigarette design to sustain cigarette marketing and mitigate consumers' concerns about the health consequences of smoking. Methods Relevant word and phrase searches were conducted in the Legacy Tobacco Documents Library online database, Google Patents, and media and medical databases including ProQuest, JSTOR, Medline and PubMed. Results 13 tobacco industry documents were identified that track prominent developments involved in what the industry referred to as the ‘filter problem’. These reveal a period of intense focus on the ‘filter problem’ that persisted from the mid-1950s to the mid-1960s, featuring collaborations between cigarette producers and large American chemical and textile companies to develop effective filters. In addition, the documents reveal how cigarette filter researchers' growing scientific knowledge of smoke chemistry led to increasing recognition that filters were unlikely to offer significant health protection. One of the primary concerns of cigarette producers was to design cigarette filters that could be economically incorporated into the massive scale of cigarette production. The synthetic plastic cellulose acetate became the fundamental cigarette filter material. By the mid-1960s, the meaning of the phrase ‘filter problem’ changed, such that the effort to develop effective filters became a campaign to market cigarette designs that would sustain the myth of cigarette filter efficacy. Conclusions This study indicates that cigarette designers at Philip Morris, British-American Tobacco, Lorillard and other companies believed for a time that they might be able to reduce some of the most dangerous substances in mainstream smoke through advanced engineering of filter tips. In their attempts to accomplish this, they developed the now ubiquitous cellulose acetate cigarette filter. By the mid-1960s cigarette designers realised that the intractability of the ‘filter problem’ derived from a simple fact: that which is harmful in mainstream smoke and that which provides the smoker with ‘satisfaction’ are essentially one and the same. Only in the wake of this realisation did the agenda of cigarette designers appear to transition away from mitigating the health hazards of smoking and towards the perpetuation of the notion that cigarette filters are effective in reducing these hazards. Filters became a marketing tool, designed to keep and recruit smokers as consumers of these hazardous products. PMID:21504917

2011-01-01

19

Sequencing Intractable DNA to Close Microbial Genomes  

SciTech Connect

Advancement in high throughput DNA sequencing technologies has supported a rapid proliferation of microbial genome sequencing projects, providing the genetic blueprint for for in-depth studies. Oftentimes, difficult to sequence regions in microbial genomes are ruled intractable resulting in a growing number of genomes with sequence gaps deposited in databases. A procedure was developed to sequence such difficult regions in the non-contiguous finished Desulfovibrio desulfuricans ND132 genome (6 intractable gaps) and the Desulfovibrio africanus genome (1 intractable gap). The polynucleotides surrounding each gap formed GC rich secondary structures making the regions refractory to amplification and sequencing. Strand-displacing DNA polymerases used in concert with a novel ramped PCR extension cycle supported amplification and closure of all gap regions in both genomes. These developed procedures support accurate gene annotation, and provide a step-wise method that reduces the effort required for genome finishing.

Hurt, Jr., Richard Ashley [ORNL; Brown, Steven D [ORNL; Podar, Mircea [ORNL; Palumbo, Anthony Vito [ORNL; Elias, Dwayne A [ORNL

2012-01-01

20

The Intractability of Computing the Hamming Distance  

E-print Network

The Intractability of Computing the Hamming Distance Bodo Manthey 1,, R¨udiger Reischuk Universit Abstract Given a string x and a language L, the Hamming distance of x to L is the minimum Hamming distance prove that there is a language in AC0 such that both Hamming and edit distance to this language are hard

Al Hanbali, Ahmad

21

Progesterone therapy in women with intractable catamenial epilepsy  

PubMed Central

Background: Catamenial epilepsy is a kind of epilepsy, known in this name, when the periodicity of the exacerbation of the seizure is in association with menstural cycle. The present study examined the progesterone effectiveness as a complementary treatment in women with intractable catamenial epilepsy. Materials and Methods: The present study was conducted as a double-blind randomized controlled trial on 38 women with intractable catamenial epilepsy. Patients were assessed in two groups: The case group received in addition to AEDs, two (Mejestrol) 40 mg progesterone tablets in the second half of the cycle from 15th to 25th day. And the control group received in addition to AEDs, two placebo tablets daily. Age, BMI, epilepsy duration, types of the drugs used, progesterone level, and the number of the seizures in 3 months before and after the study were compared. Results: Based on the results of which there was no statistically significant difference in regard to age, BMI, epilepsy duration, types of the drugs used, progesterone level between the case and the control groups (P-value > 0.05). The number of the seizures after treatment has significantly decreased compared to before-treatment state. The degree of decreasing in the case group receiving the progesterone was higher than in the control group receiving the placebo. The difference, thus, is significant, based on statistical tests (P-value = 0.024). Conclusion: Based on the findings of this study using progesterone in women with intractable catamenial epilepsy has a significant effect on the degree of decreasing in the number of the seizures. PMID:23930253

Najafi, Mohammadreza; Sadeghi, Maedeh Mirmohamad; Mehvari, Jafar; Zare, Mohammad; Akbari, Mojtaba

2013-01-01

22

Noninvasive treatment alternative for intractable startle epilepsy  

PubMed Central

We describe a treatment alternative for intractable, startle-provoked, epileptic seizures in four children aged between 8 and 14. Three of the four children had symptomatic localization-related epilepsy. They all suffered from intractable epilepsy precipitated by sudden sounds. The fact that seizures tended to occur with high frequency – more than one seizure a day – had a clear impact on daily life. Clinical seizure pattern demonstrated asymmetric tonic posturing in all four children. Three children experienced several seizure types including focal seizure onset. All children had focal neurological signs or learning disabilities or a combination of both. Our noninvasive treatment method using psychoeducational counseling and sound generators was applied in four children, resulting in a seizure frequency reduction of ? 50% in two of them.

Klinkenberg, Sylvia; Ubbink, Sander; Vles, Johannes; de Louw, Anton; van Hall, Mariette Debeij; Scheijen, Dyon; Brokx, Jan

2014-01-01

23

Intractable verrucous hyperplasia: a surgically corrected case.  

PubMed

Skin problems commonly occur after lower limb amputation. Wart-like lesions of verrucous hyperplasia is one such skin anomaly that develops on the residual-limb. The process is reversible if external compression in combination with adequate control of bacterial infection and edema is applied. Prosthetic adjustments usually help with this condition. However, we experienced an intractable verrucous hyperplasia case in a 65-year-old female. She complained of a painful, oozing, verrucous papule at the amputation site. Despite management with typical treatment procedures, the lesion worsened. Surgical treatment was therefore carried out. This case demonstrated that an intractable case is possible despite appropriate management and sometimes surgical correction is necessary. PMID:25479281

Chang, Ji Hea; Moon, Hee Bong; Kim, Chang Jae; Nam, Kiyeun; Lee, Ho Jun; Kwon, Bum Sun; Park, Jin-Woo

2014-12-01

24

Insulinoma presenting as medically intractable temporal lobe epilepsy.  

PubMed

We describe a female insulinoma patient who presented with recurrent attacks of abnormal behavior, confusion, and seizure. Her interictal EEG showed epileptiform discharges on the left temporal area, therefore she was initially misdiagnosed as temporal lobe epilepsy. In the video-EEG monitoring, hypoglycemic state was detected during the seizure attack, so the right diagnosis was made after the endocrinologic investigations. After surgical removal of the tumor, the patient became seizure-free, and no abnormality was found in the follow-up EEG after six months. Since insulinoma shares some common clinical and EEG features with complex partial seizure of temporal lobe origin, insulioma should be included in the differential diagnosis for medically intractable temporal lobe epilepsy. PMID:24977127

Park, So-Hee; Kim, Dong Wook

2014-06-01

25

Insulinoma Presenting as Medically Intractable Temporal Lobe Epilepsy  

PubMed Central

We describe a female insulinoma patient who presented with recurrent attacks of abnormal behavior, confusion, and seizure. Her interictal EEG showed epileptiform discharges on the left temporal area, therefore she was initially misdiagnosed as temporal lobe epilepsy. In the video-EEG monitoring, hypoglycemic state was detected during the seizure attack, so the right diagnosis was made after the endocrinologic investigations. After surgical removal of the tumor, the patient became seizure-free, and no abnormality was found in the follow-up EEG after six months. Since insulinoma shares some common clinical and EEG features with complex partial seizure of temporal lobe origin, insulioma should be included in the differential diagnosis for medically intractable temporal lobe epilepsy. PMID:24977127

Park, So-Hee; Kim, Dong Wook

2014-01-01

26

Nurse management of intractable functional constipation: a randomised controlled trial  

PubMed Central

Aims: To evaluate the effectiveness of a nurse led clinic (NLC) compared with a consultant led paediatric gastroenterology clinic (PGC) in the management of chronic constipation. Methods: Children (age 1–15 years) with functional constipation were randomised following a detailed medical assessment to follow up in either the NLC or PGC. An escalating algorithm of treatment was used as the basis of management in both the NLC and PGC. Main outcome measures were: time to cure at last visit or later confirmed by telephone; time to cure at last visit; and time to prematurely leaving the study. Results: A total of 102 children were recruited, of whom 52 were randomly assigned to NLC and 50 to PGC. Outcome assessment showed that 34 children in the NLC and 25 children in the PGC were confirmed cured at their last visit or later confirmed by telephone. The median time to cure was 18.0 months in the NLC and 23.2 months in the PGC. The probability of being cured was estimated as 33% higher in the NLC compared to PGC (hazard ratio 1.33). Attending the NLC hastened time to cure by an estimated 18.4%. Conclusion: Children who attend an NLC are equally as, if not more likely to be cured of intractable constipation, than those attending a PGC and on average their cure will occur sooner. Results suggest that an NLC can significantly improve follow up for children with intractable constipation and highlight the important role for clinic nurse specialists in management of children with gastrointestinal disease. PMID:15269068

Burnett, C; Juszczak, E; Sullivan, P

2004-01-01

27

Sustained improvement of intractable rheumatoid arthritis after total lymphoid irradiation  

SciTech Connect

Total lymphoid irradiation (TLI) was administered to 11 patients who had intractable rheumatoid arthritis that was unresponsive to conventional medical therapy, including aspirin, multiple nonsteroidal antiinflammatory drugs, gold salts, and D-penicillamine. Total lymphoid irradiation was given as an alternative to cytotoxic drugs such as azathioprine and cyclophosphamide. After radiotherapy, 9 of the 11 patients showed a marked improvement in clinical disease activity as measured by morning stiffness, joint tenderness, joint swelling, and overall functional abilities. The mean improvement of disease activity in all patients ranged from 40-70 percent and has persisted throughout a 13-28 month followup period. This improvement permitted the mean daily steroid dose to be reduced by 54%. Complications included severe fatigue and other constitutional symptoms during radiotherapy, development of Felty's syndrome in 1 patient, and an exacerbation of rheumatoid lung disease in another. After therapy, all patients exhibited a profound T lymphocytopenia, and a reversal in their T suppressor/cytotoxic cell to helper cell ratio. The proliferative responses of peripheral blood mononuclear cells to phytohemagglutinin, concanavalin A, and allogeneic leukocytes (mixed leukocyte reaction) were markedly reduced, as was in vitro immunoglobulin synthesis after stimulation with pokeweed mitogen. Alterations in T cell numbers and function persisted during the entire followup period, except that the mixed leukocyte reaction showed a tendency to return to normal values.

Field, E.H.; Strober, S.; Hoppe, R.T.; Calin, A.; Engleman, E.G.; Kotzin, B.L.; Tanay, A.S.; Calin, H.J.; Terrell, C.P.; Kaplan, H.S.

1983-08-01

28

Oral Azithromycin for Treatment of Intractable Rosacea  

PubMed Central

Rosacea is a common chronic cutaneous disorder that primarily occurs on the convex surfaces of the central face and is often characterized by exacerbations and remissions. A case of a 52-yr-old woman visited our clinic in February 2008 complaining typical features of rosacea including multiple pinhead to rice-sized erythematous papules. We applied various conventional treatments including topical benzoyl peroxide and metronidazole as well as oral metronidazole, isotretinoin, and doxycycline. The lesions were not controlled but were rather aggravated by complications from these treatments. Therefore, we prescribed oral azithromycin, which has anti-inflammatory effects and reduces reactive oxygen species. Ten weeks after the administration of oral azithromycin, 500 mg per day for 2 weeks, the lesions had mostly disappeared and no specific side effects related to the azithromycin were noted. Oral azithromycin dosing 500 mg/day for 2 weeks is effective for treatment of intractable rosacea. PMID:21532865

Kim, Jae-Hong; Oh, Yoon Seok

2011-01-01

29

Medullary neurosarcoidosis presenting with intractable hiccoughs.  

PubMed

Hiccoughs (singultus) are a complex physiological process characterized by sudden brief involuntary contractions of the diaphragm. They most commonly occur from peripheral mechanisms that result in diaphragmatic irritation, but also occur from brain stem lesions such as that seen in Wallenberg's syndrome. They are uncommon in sarcoidosis and it is remarkably rare when hiccoughs are the presenting symptom of neurosarcoidosis. We report a patient with sarcoidosis who presented with intractable hiccoughs due to an inflammatory medullary lesion. Evaluation revealed an enhancing lesion in the dorsomedial medulla that resolved after aggressive immune-modulating therapy. In the absence of a clear peripheral lesion that would potentially affect the diaphragm, the diagnosis of neurosarcoidosis involving the brainstem should be considered in patients with sarcoidosis. PMID:22613488

John, Seby; Parambil, Joseph; Culver, Daniel; Tavee, Jinny

2012-08-01

30

Microcatheter Embolization of Intractable Idiopathic Epistaxis  

SciTech Connect

Purpose: To assess the efficacy and safety of microcatheter embolization in the treatment of intractable idiopathic epistaxis. Methods: Thirty-seven patients underwent microcatheter embolization in 1991-1998. We evaluated retrospectively the technical and clinical outcome, the number of complications, the duration of embolization in each case, and the number of blood transfusions needed. All embolizations were done with biplane digital subtraction angiography (DSA) equipment. The procedure was carried out under local anesthesia using transfemoral catheterization, except in one case where the translumbar route was used. Tracker 18 or 10 microcatheters were advanced as far as possible to the distal branches of the sphenopalatine artery. Polyvinyl alcohol (PVA) particles were used for embolization in most cases, while platinum coils or a combination of these two materials were occasionally used. The primary outcome was always assessed immediately by angiography. Follow-up data were obtained from patient records, by interviewing patients on the telephone or by postal questionnaires when necessary. The mean follow-up time was 21 months. Results: The embolization was technically successful in all 37 cases. A curative outcome was achieved in 33 cases (89%). The mean duration of the procedure was 110 min. Four patients (8%) had mild transient complications, but no severe or persistent complications were encountered. Twenty-three patients needed a blood transfusion. Slight rebleeding occurred in three patients during the follow-up; all responded to conservative treatment. One patient suffered two episodes of rebleeding within 2 months after primary embolization. Re-embolizations successfully stopped the bleeding. Conclusion: Embolization is the primary invasive modality for treating intractable idiopathic epistaxis. It proved both safe and effective over a relatively long follow-up.

Leppaenen, Martti; Seppaenen, Seppo [Department of Radiology, Tampere University Hospital, P.O. Box 2000, FIN-33521 Tampere (Finland); Laranne, Jussi [Department of Otolaryngology, Tampere University Hospital, P.O. Box 2000, FIN-33521 Tampere (Finland); Kuoppala, Katriina [Department of Neurology, Seinaejoki Central Hospital, Hanneksenrinne 7, FIN-60220 Seinaejoki (Finland)

1999-11-15

31

Potential Use and Challenges of Functional Connectivity Mapping in Intractable Epilepsy  

PubMed Central

This review focuses on the use of resting-state functional magnetic resonance imaging data to assess functional connectivity in the human brain and its application in intractable epilepsy. This approach has the potential to predict outcomes for a given surgical procedure based on the pre-surgical functional organization of the brain. Functional connectivity can also identify cortical regions that are organized differently in epilepsy patients either as a direct function of the disease or through indirect compensatory responses. Functional connectivity mapping may help identify epileptogenic tissue, whether this is a single focal location or a network of seizure-generating tissues. This review covers the basics of connectivity analysis and discusses particular issues associated with analyzing such data. These issues include how to define nodes, as well as differences between connectivity analyses of individual nodes, groups of nodes, and whole-brain assessment at the voxel level. The need for arbitrary thresholds in some connectivity analyses is discussed and a solution to this problem is reviewed. Overall, functional connectivity analysis is becoming an important tool for assessing functional brain organization in epilepsy. PMID:23734143

Constable, Robert Todd; Scheinost, Dustin; Finn, Emily S.; Shen, Xilin; Hampson, Michelle; Winstanley, F. Scott; Spencer, Dennis D.; Papademetris, Xenophon

2013-01-01

32

The effect of stellate ganglion block on intractable lymphedema after breast cancer surgery.  

PubMed

Lymphedema of the upper limb after breast cancer surgery is a disease that carries a life-long risk and is difficult to cure once it occurs despite the various treatments which have been developed. Two patients were referred from general surgery department for intractable lymphedema. They were treated with stellate ganglion blocks (SGBs), and the circumferences of the mid-point of their each upper and lower arms were measured on every visit to the pain clinic. A decrease of the circumference in each patient was observed starting after the second injection. A series of blocks were established to maintain a prolonged effect. Both patients were satisfied with less swelling and pain. This case demonstrates the benefits of an SGB for intractable upper limb lymphedema. PMID:25589949

Kim, Jin; Park, Hahck Soo; Cho, Soo Young; Baik, Hee Jung; Kim, Jong Hak

2015-01-01

33

The Effect of Stellate Ganglion Block on Intractable Lymphedema after Breast Cancer Surgery  

PubMed Central

Lymphedema of the upper limb after breast cancer surgery is a disease that carries a life-long risk and is difficult to cure once it occurs despite the various treatments which have been developed. Two patients were referred from general surgery department for intractable lymphedema. They were treated with stellate ganglion blocks (SGBs), and the circumferences of the mid-point of their each upper and lower arms were measured on every visit to the pain clinic. A decrease of the circumference in each patient was observed starting after the second injection. A series of blocks were established to maintain a prolonged effect. Both patients were satisfied with less swelling and pain. This case demonstrates the benefits of an SGB for intractable upper limb lymphedema. PMID:25589949

Kim, Jin; Cho, Soo Young; Baik, Hee Jung; Kim, Jong Hak

2015-01-01

34

Intractable pain--the present position.  

PubMed Central

The broad changes that have occurred in the treatment of intractable pain are considered. There is a new understanding of the anatomy and physiology of pain pathways and pain appreciation. Thus gate control theory, the spinal laminae, and the descending inhibitory pain pathway through the raphe nuclei are discussed in relation to the recent discovery of the opioid (enkephalin) systems. Out of this arises the stimulation methods of pain relief--transcutaneous neural stimulation, periaqueductal stimulation, and acupuncture. These are valuable in patients with a normal expectation of life. For patients with a shortened expectation of life other methods, especially destructive ones, are valuable (though in all types of chronic pain drug therapy is still the most used method). Basic changes in techniques and the equipment used to bring this about are detailed broadly. In particular, the use of the image intensifier X-ray machine and the stimulation and destruction available from the modern lesion generator when used in combination provide accuracy and safety. Techniques and methods are constantly altering and examples of this are given. All this costs money in time, personnel, and equipment; the costings of the Liverpool Centre for Pain Relief are given. Finally, the Pain Relief Foundation is in being in Liverpool in the grounds of Walton Hospital. This has been made possible by a large 'seed' donation by the Wolfson Foundation. Images Fig. 1 Fig. 2 PMID:6894676

Lipton, S.

1981-01-01

35

Infectious Disease Hospitalizations Among Infants in the United States  

Microsoft Academic Search

OBJECTIVE. This study describes the burden and epidemiologic features of infectious disease hospitalizations among infants in the United States. METHODS. Hospitalizations with an infectious disease listed as a primary diagnosis for infants (1 year of age) in the United States during 2003 were examined by using the Kids' Inpatient Database. National estimates of infectious disease hospitalizations, hospitalization rates, and various

Krista L. Yorita; Robert C. Holman; James J. Sejvar; Claudia A. Steiner; Lawrence B. Schonberger

2010-01-01

36

Vagus Nerve Stimulation for Control of Intractable Seizures in Childhood  

Microsoft Academic Search

Vagus nerve stimulation (VNS) is gaining increasing popularity and credibility as a treatment option for children with intractable epilepsy. VNS offers several advantages over extant treatments. Its efficacy is maintained during prolonged stimulation, and seizure control actually improves with time. There is no associated cognitive impairment and no adverse drug interactions. Unlike cerebral surgery, VNS is a potentially reversible form

Arun Paul Amar; Michael L. Levy; J. Gordon McComb; Michael L. J. Apuzzo

2001-01-01

37

Intractable hiccup and nausea with periaqueductal lesions in neuromyelitis optica  

Microsoft Academic Search

Intractable hiccup and nausea (IHN) was found in eight of 47 cases of relapsing neuromyelitis optica (NMO) (17%) but in none of 130 cases of multiple sclerosis (MS). IHN resolved with methylprednisolone. In six cases, MRI detected linear medullary lesions involving the pericanal region, the area postrema, and the nucleus tractus solitarius. Like long and centrally located myelitis, a linear

T. Misu; K. Fujihara; I. Nakashima; S. Sato; Y. Itoyama

2005-01-01

38

Intractable Hiccups as Presenting Symptom of Brainstem Tumor in Children  

Microsoft Academic Search

Hiccups are an unusual presenting symptom of brainstem tumors in children. An 8-year-old boy is described who presented with hiccups 2½ years prior to any major neurological manifestation. Central nervous system etiologies of hiccups are discussed. Intractable hiccups have seldom been described as a presenting symptom of brainstem tumors. We present a patient who presented to us with this symptom

Asma Q. Fischer

1982-01-01

39

Grapevine Fanleaf Disease in Washington State Vineyards  

Technology Transfer Automated Retrieval System (TEKTRAN)

Wine grapes (Vitis vinifera L.) are susceptible to a wide range of viruses. Among them, grapevine degeneration caused by Grapevine fanleaf virus (GFLV) is considered as one of the most economically important virus diseases affecting grapevines worldwide. Infected grapevines show a range of foliar sy...

40

Lymphoproliferative disease virus in wild turkeys in southeast United States  

Technology Transfer Automated Retrieval System (TEKTRAN)

Previously, retroviral neoplasms reported in wild upland game birds in the United States of America have typically been associated with reticuloendotheliosis virus (REV) infection. The information presented herein described the first reports of lymphoproliferative disease virus (LPDV) infection in ...

41

OBSERVATIONS ON THE STATE OF MARINE DISEASE STUDIES  

EPA Science Inventory

State of marine disease studies is described. erhaps the greatest area of success in the last 20 years has been in the identification and characterization of viruses, bacteria, fungi, protozoan and metazoan disease agents. pening of new areas of investigation such as that of inte...

42

Clinical application of kampo medicine (rikkunshito) for common and/or intractable symptoms of the gastrointestinal tract  

PubMed Central

Gastroenterological reflux disease and functional dyspepsia are usually treatable using Western medical practices. Nonetheless, some cases present with intractable symptoms that are not amenable to these therapies. Treatment with kampo, a traditional Japanese medicine, recently has been proposed as an alternative therapy for use in combination with the Western practices. In general, traditional Japanese medicines have been used empirically for intractable symptoms correctively designated as “general malaises.” Accumulating lines of evidence, including basic and clinical researches, have demonstrate detailed mechanisms where traditional Japanese medicines exert pharmacological action to improve symptoms. Therefore, traditional Japanese medicines have been gaining use by various medical doctors as the specific modes of pharmacological action are recognized. This review covers both the pharmacological functions and the clinical efficacies of rikkunshito for use in treating disorders of the gastrointestinal tract. PMID:25688209

Tominaga, Kazunari; Arakawa, Tetsuo

2015-01-01

43

Cinacalcet Reduces Serum Calcium Concentrations in Patients with Intractable Primary Hyperparathyroidism  

PubMed Central

Context: Patients with persistent primary hyperparathyroidism (PHPT) after parathyroidectomy or with contraindications to parathyroidectomy often require chronic treatment for hypercalcemia. Objective: The objective of the study was to assess the ability of the calcimimetic, cinacalcet, to reduce serum calcium in patients with intractable PHPT. Design: This was an open-label, single-arm study comprising a titration phase of variable duration (2–16 wk) and a maintenance phase of up to 136 wk. Setting: The study was conducted at 23 centers in Europe, the United States, and Canada. Patients: The study included 17 patients with intractable PHPT and serum calcium greater than 12.5 mg/dl (3.1 mmol/liter). Intervention: During the titration phase, cinacalcet dosages were titrated every 2 wk (30 mg twice daily to 90 mg four times daily) for 16 wk until serum calcium was 10 mg/dl or less (2.5 mmol/liter). If serum calcium increased during the maintenance phase, additional increases in the cinacalcet dose were permitted. Main Outcome Measure: The primary end point was the proportion of patients experiencing a reduction in serum calcium of 1 mg/dl or greater (0.25 mmol/liter) at the end of the titration phase. Results: Mean ± sd baseline serum calcium was 12.7 ± 0.8 mg/dl (3.2 ± 0.2 mmol/liter). At the end of titration, a 1 mg/dl or greater reduction in serum calcium was achieved in 15 patients (88%). Fifteen patients (88%) experienced treatment-related adverse events, none of which were serious. The most common adverse events were nausea, vomiting, and paresthesias. Conclusions: In patients with intractable PHPT, cinacalcet reduces serum calcium, is generally well tolerated, and has the potential to fulfill an unmet medical need. PMID:19470620

Marcocci, Claudio; Chanson, Philippe; Shoback, Dolores; Bilezikian, John; Fernandez-Cruz, Laureano; Orgiazzi, Jacques; Henzen, Christoph; Cheng, Sunfa; Sterling, Lulu Ren; Lu, John; Peacock, Munro

2009-01-01

44

Laser Light Scattering Characterization of Special Intractable Macromolecules in Solution  

Microsoft Academic Search

This review summerizes the recent advances in characterization of some special intractable macromolecules in solution by laser\\u000a light scattering. Since both static and dynamic laser light scattering (LLS) are theoretically well established, we focus\\u000a the discussion on experimental details, such as the design of a high-temperature LLS spectrometer, the sample clarification,\\u000a a novel differential refractometer, and some newly developed methods

Chi Wu

45

Olanzapine and baclofen for the treatment of intractable hiccups.  

PubMed

Intractable hiccups are a relatively uncommon condition characterized by involuntary, spasmodic contractions of the diaphragm. This type of hiccups generally has a duration of more than 1 month. We describe a 59-year-old kidney transplant recipient with a complicated medical history (atrial fibrillation, chronic renal failure, type 2 diabetes mellitus, gastroesophageal reflux, gout, hypertension, hyperlipidemia, and obstructive sleep apnea) who developed intractable hiccups that significantly affected his quality of life. Despite an extensive gastrointestinal and pulmonary evaluation, and treatment failures with several different drug regimens--metoclopramide, desipramine, amantadine, cyclobenzaprine, phenytoin, and lorazepam--his hiccups were eventually controlled with a combination of baclofen and low-dose olanzapine therapy. Baclofen is a c-aminobutyric acid (GABA) analog that contains a phenylethylamine moiety. It is hypothesized that having both GABA and phenylethylamine properties activates inhibitory neurotransmitters, most notably GABA, which may in turn block the hiccup stimulus. The exact mechanism through which olanzapine is effective in patients with hiccups is not fully understood. It is thought that the effect is, in part, due to serotonin augmenting phrenic motoneuronal activity on the reflex arcs involved in the generation of hiccups within the spinal cord. In addition, since olanazapine is a dopamine antagonist, particularly a dopamine D?-receptor antagonist, this could also have played a role in its effectiveness in treating our patient. Strong evidence for a specific treatment regimen for intractable hiccups is lacking in the primary literature. Our case report adds to the available literature, as there are currently no published data on the use of combination therapy for the treatment of intractable hiccups, and the combination of baclofen and olanzapine significantly improved our patient's quality of life. PMID:24551889

Thompson, Amy N; Ehret Leal, Julie; Brzezinski, Walter A

2014-01-01

46

Multimodal imaging in nonlesional medically intractable focal epilepsy.  

PubMed

Identification and localization of epileptogenic zone (EZ) is vital in patients with medically-intractable focal epilepsy, who may be candidates for potentially curative resective epilepsy surgery. Presence of a lesion on magnetic resonance imaging (MRI) influences both diagnostic classification and selection for surgery. However, the implications for MRI-negative cases are not well-defined for such patients. Most of these patients undergo invasive long-term Electroencephalography recordings before a final decision regarding resection is possible. Recent developments in structural and functional neuroimaging which include quali-quantitative MRI, Positron Emission Tomography, Single Photon Emission Computed Tomography, and functional MRI have significantly changed presurgical epilepsy evaluation. Source analysis based on electrophysiological information, using either EEG or magnetoencephalography are also promising in order to noninvasively localize the EZ and to guide surgery in medically-intractable focal epilepsy patients that exhibit nonlesional MRI. This chapter aims to review the value of the combined use of structural and functional imaging techniques, and how this multimodal approach improves both selection of surgical candidates and post-operative outcomes in medically-intractable nonlesional focal epilepsy. PMID:25553362

Morales-Chacon, Lilia Maria; Alfredo Sanchez Catasus, Carlos; Minou Baez Martin, Margarita; Rodriguez Rojas, Rafael; Lorigados Pedre, Lourdes; Estupiñan Diaz, Barbara

2015-01-01

47

The Efficacy and Tolerability of Rufinamide in Intractable Pediatric Epilepsy  

PubMed Central

Background and Purpose: Rufinamide (RUF) is a novel antiepileptic drug (AED) and its efficacy has been proven in Lennox-Gastaut syndrome (LGS). However, there is a lack of data regarding the efficacy in pediatric intractable epilepsies other than LGS. The purpose of the study was to explore the efficacy and tolerability of RUF in pediatric patients with intractable epilepsies as well as LGS. Methods: This retrospective observation study was conducted in Samsung medical center from August 2010 to September 2011. Thirty seven patients (27 males, 10 females, aged between 1.8 and 18.4 years), with refractory epilepsies or LGS were treated with RUF as an adjunctive drug. Efficacy was represented by the response rate and retention rate over the study period. Tolerability was measured as the number of patients who showed adverse effects. Results: The overall response rate was 21.6% during the 12 months of the study period with 5.4% of seizure-free patients. The retention rate was 54% and ineffectiveness was the most common reason for discontinuation of RUF. The most common adverse effects were insomnia and somnolence. Conclusions: RUF may be considered to be an efficacious and safe AED for pediatric patients with intractable epilepsies as well as LGS. PMID:24649460

Kim, Jae Yeon; Lee, Cha Gon; Yu, Hee Joon; Nam, Sook Hyun; Lee, Jeehun; Lee, Munhyang

2012-01-01

48

Chronic spinal cord stimulation in medically intractable orthostatic tremor  

PubMed Central

Background Orthostatic tremor with its sense of unsteadiness when standing may have a devastating effect on affected persons. Currently, there are no other treatment options in those who do not respond or who do not tolerate medical treatment. Objectives To report on a pilot study on spinal cord stimulation in medically intractable orthostatic tremor. Methods Chronic spinal cord stimulation (SCS) was performed in two patients with medically?intractable orthostatic tremor via quadripolar plate electrodes implanted at the lower thoracic spine. The electrodes were connected to implantable pulse generators. Results Subjective and objective improvement of unsteadiness was achieved within a frequency range of 50 to 150?Hz, and occurred in the presence of stimulation?induced paraesthesia. With optimized stimulation settings polygraphic electromyelogram (EMG) recordings continued to show the typical 14–16?Hz EMG activity. The beneficial effect of SCS was maintained at long?term follow?up. Conclusions The results of this pilot study indicate that SCS may be an option in patients with otherwise intractable orthostatic tremor. PMID:16735398

Krauss, J K; Weigel, R; Blahak, C; Bäzner, H; Capelle, H?H; Grips, E; Rittmann, M; Wöhrle, J C

2006-01-01

49

Nuclear magnetic resonance of iron and copper disease states  

SciTech Connect

The tissue levels of paramagnetic ions are an important factor in the determination of T/sub 1/ values as observed by nuclear magnetic resonance (NMR) imaging. The increased levels of iron present in human disease states such as hemochromatosis lead to decreased T/sub 1/ values. The mean liver T/sub 1/ of three patients with iron storage disease was determined to be 130 msec, significantly different from the value of 154 msec, the mean for 14 normal controls. Whether NMR will be able to detect the increased copper levels in liver and brain in Wilson disease remains for further clinical trials to evaluate. NMR imaging, however, does serve as a noninvasive method for the diagnosis of states of iron overload and as a technique to follow progression of disease or response to medical therapy.

Runge, V.M. (Vanderbilt Univ., Nashville, TN); Clanton, J.A.; Smith, F.W.; Hutchison, J.; Mallard, J.; Partain, C.L.; James, A.E. Jr.

1983-11-01

50

Incidence of Hansen's Disease--United States, 1994-2011.  

PubMed

Hansen's disease (HD), or leprosy, is caused by the bacterium Mycobacterium leprae and is reportable in many states. It is a chronic disease affecting the skin and nerves, commonly presenting as pale or reddish skin patches with diminished sensation. Without treatment, it can progress to a severely debilitating disease with nerve damage, tissue destruction, and functional loss. An important factor in limiting HD morbidity is early diagnosis and prompt initiation of therapy. Because HD is rare, clinicians in the United States are often unfamiliar with it; however, HD continues to cause morbidity in the United States. To better characterize at-risk U.S. populations, HD trends during 1994-2011 were evaluated by reviewing records from the National Hansen's Disease Program (NHDP). When the periods 1994-1996 and 2009-2011 were compared, a decline in the rate for new diagnoses from 0.52 to 0.43 per million was observed. The rate among foreign-born persons decreased from 3.66 to 2.29, whereas the rate among U.S.-born persons was 0.16 in both 1994-1996 and 2009-2011. Delayed diagnosis was more common among foreign-born persons. Clinicians throughout the United States should familiarize themselves with the signs and symptoms of HD and understand that HD can occur in the United States. PMID:25356604

Nolen, Leisha; Haberling, Dana; Scollard, David; Truman, Richard; Rodriguez-Lainz, Alfonso; Blum, Laura; Blaney, David

2014-10-31

51

Homozygous nonsense mutation in SYNJ1 associated with intractable epilepsy and tau pathology.  

PubMed

The tauopathies are a heterogeneous group of neurodegenerative disorders characterized by the shared presence of tau aggregates and neurofibrillary tangles within the central nervous system. Here, we present a child with a severe neurodegenerative disorder characterized by intractable seizures and significant tau-immunoreactive neurofibrillary degeneration localized predominantly to the substantia nigra on neuropathology with absence of beta-amyloid plaques and Lewy or Pick bodies. Whole-exome sequencing identified a homozygous truncating mutation in Synaptojanin 1 (SYNJ1). Quantitative polymerase chain reaction and Western blot experiments demonstrated diminished SYNJ1 messenger RNA and protein. Knockout Synj1(-/-) mice have convulsions and die early in life. More recently, homozygous missense mutations have been reported in 2 families with early-onset parkinsonism and seizures. Our findings broaden the spectrum of disease associated with alteration of SYNJ1 and further implicate defects in synaptic vesicle recycling in the tauopathies. PMID:25316601

Dyment, David A; Smith, Amanda C; Humphreys, Peter; Schwartzentruber, Jeremy; Beaulieu, Chandree L; Bulman, Dennis E; Majewski, Jacek; Woulfe, John; Michaud, Jean; Boycott, Kym M

2015-02-01

52

Efficacy of long term weekly ACTH therapy for intractable epilepsy.  

PubMed

Background: Adrenocorticotropic hormone (ACTH) therapy is the first-line therapy for infantile spasms, and is effective for many other intractable epilepsies. While spasms may respond to ACTH for weeks, a substantial proportion of patients develop recurrent seizures over a yearly period. To maintain efficacy, we treated two children with intractable epilepsy with weekly ACTH therapy for 1year and described the changes in clinical seizures, electroencephalograms, developmental assessments and side effects. Subjects and methods: A girl with infantile spasms due to lissencephaly and a boy with atypical absence seizures were studied. In both cases, seizures were frequent and resistant to antiepileptic drugs; electroencephalograms showed continuous epileptiform activities, and the patients' development was delayed and stagnant prior to ACTH treatment. The initial ACTH therapy (daily 0.015mg/kg for 2weeks, 0.015mg/kg every 2days for 1week, 0.0075mg/kg every 2days for 1week), was transiently effective in both cases. The second-round ACTH therapy consisted of the initial ACTH therapy protocol followed by weekly ACTH injections (0.015mg/kg or 0.0075mg/kg) for 1year. Both cases were followed for at least 1year after therapy. Results: In both patients, clinical seizures were completely controlled during and 1year after the second-round AHCH therapy. Continuous epileptiform discharges disappeared, while intermittent interictal epileptiform discharges remained. Both patients showed some developmental gains after achieving seizure control. No serious side effects were recorded. Conclusion: Further studies are warranted to determine if a long-term weekly ACTH is a safe and effective treatment for intractable epilepsy. PMID:25149137

Inui, Takehiko; Kobayashi, Tomoko; Kobayashi, Satoru; Sato, Ryo; Endo, Wakaba; Kikuchi, Atsuo; Nakayama, Tojo; Uematsu, Mitsugu; Takayanagi, Masaru; Kato, Mitsuhiro; Saitsu, Hirotomo; Matsumoto, Naomichi; Kure, Shigeo; Haginoya, Kazuhiro

2014-08-19

53

West nile virus disease and other arboviral diseases - United States, 2011.  

PubMed

Arthropodborne viruses (arboviruses) are transmitted to humans primarily through the bites of infected mosquitoes and ticks. Symptomatic infections most often manifest as a systemic febrile illness and, less commonly, as neuroinvasive disease (e.g., meningitis, encephalitis, or acute flaccid paralysis). West Nile virus (WNV) is the leading cause of domestically acquired arboviral disease in the United States. However, several other arboviruses also cause seasonal outbreaks and sporadic cases. In 2011, CDC received reports of 871 cases of nationally notifiable arboviral diseases (excluding dengue); etiological agents included WNV (712 cases), La Crosse virus (LACV) (130), Powassan virus (POWV) (16), St. Louis encephalitis virus (SLEV) (six), Eastern equine encephalitis virus (EEEV) (four), and Jamestown Canyon virus (JCV) (three). Of these, 624 (72%) were classified as neuroinvasive disease, for a national incidence of 0.20 per 100,000 population. WNV and other arboviruses continue to cause focal outbreaks and severe illness in substantial numbers of persons in the United States. PMID:22785342

2012-07-13

54

[Insular psammomatous meningioma presenting intractable complex partial seizures].  

PubMed

We describe a 30-year-old female with intractable symptomatic epilepsy caused by an insular calcified mass, which was histologically proved as psammomatous meningioma. Seizures were described as consciousness impairment, motionless stare and automatism. After total removal of the tumor with a neuronavigation system and motor evoked potential (MEP) monitoring, seizures completely disappeared without neurological deficit. We emphasize that insular meningioma presents complex partial seizures which mimic medial temporal lobe epilepsy and seizures are controlled by total resection of the tumor. PMID:22915702

Imoto, Hirochika; Fujii, Masami; Maruta, Yuichi; Sadahiro, Hirokazu; Ideguchi, Makoto; Ishihara, Hideyuki; Nomura, Sadahiro; Suzuki, Michiyasu

2012-09-01

55

Adult rumination syndrome: Differentiation from psychogenic intractable vomiting.  

PubMed

Rumination syndrome is known to exist in infants and mentally retarded adults since long time. In past few years, some reports appeared that showed its existence in adult patients also. It is frequently confused with the intractable vomiting in adults and misdiagnosis leads to delay in appropriate management. We are here describing the case of a female patient with rumination syndrome where specific points in the history delineated the presence of this illness and helped in appropriate management. The patient became symptom free soon after the diagnosis was reached. PMID:23226859

Gupta, Ravi; Kalla, Mukesh; Gupta, Jugal Behari

2012-07-01

56

The importance of occupational skin diseases in the United States  

Microsoft Academic Search

Occupational skin diseases and disorders (OSDs) are the most commonly reported non-trauma-related (acute or cumulative) category of occupational illnesses in the United States. This factor, along with their potential chronicity, their effect on an individual's vocational and avocational activities, and the fact that they are preventable, point out the public health importance of OSDs. It can be difficult to obtain

Boris D. Lushniak

2003-01-01

57

THREE-STATE STUDY OF WATERBORNE DISEASE SURVEILLANCE TECHNIQUES  

EPA Science Inventory

For a two-year period, the states of Colorado, Vermont and Washington tested the effectiveness of seven surveillance methods for identifying waterborne disease outbreaks. Six of the methods were termed active and utilized procedures soliciting reports of illness. The seventh meth...

58

Periodontal Disease and Oral Hygiene Among Children. United States.  

ERIC Educational Resources Information Center

Statistical data presented on periodontal disease and oral hygiene among noninstitutionalized children, aged 6-11, in the United States are based on a probability sample of approximately 7,400 children involved in a national health survey during 1963-65. The report contains estimates of the Periodontal Index (PI) and the Simplified Oral Hygiene…

National Center for Health Statistics (DHEW/PHS), Hyattsville, MD.

59

[Elderly depression and depressive state with Alzheimer's disease].  

PubMed

Depression and dementia, particularly Alzheimer's disease, are frequently observed in the elderly, and their diagnosis and treatment require complex knowledge of gerontology and psychiatry. Gerontologically, these diseases should be considered as geriatric syndrome. For the differentiation between depression and that associated with Alzheimer's disease, radiological examinations such as single photon emission CT and psychological examinations using the Geriatric Depression Scale (GDS) and Vitality Index are useful. Against depressive state with Alzheimer's disease, in addition to donepezil hydrochloride, selective serotonin reuptake inhibitors (SSRI) and serotonin-noradrenaline reuptake inhibitors (SNRI) are effective, and a small dose of sulpiride is also expected to be effective. In the treatment of elderly depression, its stage should be classified as acute or chronic. Treatment in the acute stage is similar to that in other age groups. In the chronic stage, activation treatment focusing on the prevention of functional decreases is necessary. For both depression and dementia, care and support for daily life are indispensable. PMID:19348250

Hattori, Hideyuki

2009-04-01

60

Characterizing disease states from topological properties of transcriptional regulatory networks  

PubMed Central

Background High throughput gene expression experiments yield large amounts of data that can augment our understanding of disease processes, in addition to classifying samples. Here we present new paradigms of data Separation based on construction of transcriptional regulatory networks for normal and abnormal cells using sequence predictions, literature based data and gene expression studies. We analyzed expression datasets from a number of diseased and normal cells, including different types of acute leukemia, and breast cancer with variable clinical outcome. Results We constructed sample-specific regulatory networks to identify links between transcription factors (TFs) and regulated genes that differentiate between healthy and diseased states. This approach carries the advantage of identifying key transcription factor-gene pairs with differential activity between healthy and diseased states rather than merely using gene expression profiles, thus alluding to processes that may be involved in gene deregulation. We then generalized this approach by studying simultaneous changes in functionality of multiple regulatory links pointing to a regulated gene or emanating from one TF (or changes in gene centrality defined by its in-degree or out-degree measures, respectively). We found that samples can often be separated based on these measures of gene centrality more robustly than using individual links. We examined distributions of distances (the number of links needed to traverse the path between each pair of genes) in the transcriptional networks for gene subsets whose collective expression profiles could best separate each dataset into predefined groups. We found that genes that optimally classify samples are concentrated in neighborhoods in the gene regulatory networks. This suggests that genes that are deregulated in diseased states exhibit a remarkable degree of connectivity. Conclusion Transcription factor-regulated gene links and centrality of genes on transcriptional networks can be used to differentiate between cell types. Transcriptional network blueprints can be used as a basis for further research into gene deregulation in diseased states. PMID:16670008

Tuck, David P; Kluger, Harriet M; Kluger, Yuval

2006-01-01

61

Duodenal switch for intractable reflux gastroesophagitis after proximal gastrectomy.  

PubMed

Reflux gastroesophagitis is a common postgastrectomy complication after proximal gastrectomy, and conservative treatments including protease inhibitors and proton pump inhibitors are effective in most patients. Here we report a patient with severe reflux gastroesophagitis after proximal gastrectomy, in whom surgical treatment of duodenal switch was effective. An 80-year-old man complained of intractable heartburn, anorexia, and body weight loss after having undergone proximal gastrectomy, with reconstruction by esophagogastrostomy with valvuloplasty and pyloroplasty, for early gastric cancer 14 months before referral to our department. Oral administration of protease inhibitors and proton pump inhibitors was ineffective. Laboratory evaluation showed poor nutritional status. On endoscopic examination, we noted the redness, bleeding, and multiple erosions in the esophagus and the gastric remnant. He was diagnosed to have severe gastroesophagitis due to reflux of duodenal juice into the gastric remnant and esophagus. We performed duodenal switch to divert duodenal juice from the gastric remnant and esophagus; the duodenum was transected 2 cm distal to the pylorus, the duodenal distal end was closed, and a 50-cm Roux limb from the proximal jejunum was anastomosed to the proximal end of the duodenum. The heartburn disappeared postoperatively, and endoscopic examination revealed marked improvement of the reflux gastroesophagitis. One year postoperatively, the patient is free from symptoms including heartburn. His body weight increased, and laboratory data showed improvement in nutritional status. In conclusion, the duodenal switch may be surgical treatment of choice for intractable reflux gastroesophagitis after proximal gastrectomy. PMID:23803250

Someya, Soutoku; Shibata, Chikashi; Tanaka, Naoki; Kudoh, Katsuyoshi; Naitoh, Takeshi; Miura, Koh; Unno, Michiaki

2013-01-01

62

Therapeutic options for intractable hematuria in advanced bladder cancer.  

PubMed

Intractable hematuria is a common and severe complication in patients with inoperable bladder carcinoma. The aim was to provide an overview of therapeutic options for such cases, and analyze their effectiveness and risk profile, so a systematic literature search of peer-reviewed papers published up to September 2012 was carried out. Various options are available to treat hematuria in patients with inoperable bladder cancer; these include orally administered epsilon-aminocaproic acid, intravesical formalin, alum or prostaglandin irrigation, hydrostatic pressure, urinary diversion, radiotherapy, embolization and intraarterial mitoxantrone perfusion. These treatment options are associated with different prospects of success, risks and side-effects. Well-designed and large studies comparing options are completely lacking. Despite various treatment options, management of intractable hematuria in patients with inoperable bladder cancer remains a challenge, and most of the reported methods should be seen as experimental. Interventional radiology and alum instillation seem to be suitable alternative options for patients who, after critical consideration, cannot be treated by irrigation, transurethral resection or palliative cystectomy. PMID:23387805

Abt, Dominik; Bywater, Mirjam; Engeler, Daniel Stephan; Schmid, Hans-Peter

2013-07-01

63

[Repeated syncope episodes caused by intractable hiccups; a case report].  

PubMed

A 66-year-old man visited our hospital with a chief complaint of a sore throat. On examination, the pharyngeal and laryngeal mucosa was reddish and localized mucosal erosion was present on the left side. Based on an initial diagnosis of acute pharyngitis caused by bacteriological infection or mycotic infection, treatment with antibacterial and antimycotic agents was initiated. However, the patient's sore throat gradually worsened and he developed intractable hiccups. Intravenous steroids were given for the treatment of the severe sore throat, and this symptom was gradually alleviated. However, the intractable hiccups persisted. In addition, the patient began to have convulsive syncope episodes and was subsequently admitted to our hospital. Further examination revealed that the syncope episodes were linked to the hiccups. To treat the hiccups, baclofen and Chinese medicine were prescribed, and the convulsive syncope episodes disappeared immediately. The patient's hiccups also improved and disappeared six days thereafter. Based on this clinical evidence, we concluded that the hiccups were caused by pharyngitis, resulting in the stimulation of the glossopharyngeal nerve, while the convulsive syncope episodes were a type of situational syncope related to hiccups. PMID:24313063

Sueyoshi, Shintaro; Shin, Buichiro; Nakashima, Tadashi

2013-10-01

64

West nile virus and other arboviral diseases - United States, 2013.  

PubMed

Arthropod-borne viruses (arboviruses) are transmitted to humans primarily through the bites of infected mosquitoes and ticks. West Nile virus (WNV) is the leading cause of domestically acquired arboviral disease in the United States. However, several other arboviruses also cause sporadic cases and seasonal outbreaks of neuroinvasive disease (i.e., meningitis, encephalitis, and acute flaccid paralysis). This report summarizes surveillance data reported to CDC in 2013 for WNV and other nationally notifiable arboviruses, excluding dengue. Forty-seven states and the District of Columbia reported 2,469 cases of WNV disease. Of these, 1,267 (51%) were classified as WNV neuroinvasive disease, for a national incidence of 0.40 per 100,000 population. After WNV, the next most commonly reported cause of arboviral disease was La Crosse virus (LACV) (85 cases), followed by Jamestown Canyon virus (JCV), Powassan virus (POWV), and eastern equine encephalitis virus (EEEV) (eight). WNV and other arboviruses continue to cause serious illness in substantial numbers of persons annually. Maintaining surveillance remains important to help direct and promote prevention activities. PMID:24941331

Lindsey, Nicole P; Lehman, Jennifer A; Staples, J Erin; Fischer, Marc

2014-06-20

65

Deletions of recessive disease genes: CNV contribution to carrier states and disease-causing alleles  

PubMed Central

Over 1200 recessive disease genes have been described in humans. The prevalence, allelic architecture, and per-genome load of pathogenic alleles in these genes remain to be fully elucidated, as does the contribution of DNA copy-number variants (CNVs) to carrier status and recessive disease. We mined CNV data from 21,470 individuals obtained by array-comparative genomic hybridization in a clinical diagnostic setting to identify deletions encompassing or disrupting recessive disease genes. We identified 3212 heterozygous potential carrier deletions affecting 419 unique recessive disease genes. Deletion frequency of these genes ranged from one occurrence to 1.5%. When compared with recessive disease genes never deleted in our cohort, the 419 recessive disease genes affected by at least one carrier deletion were longer and located farther from known dominant disease genes, suggesting that the formation and/or prevalence of carrier CNVs may be affected by both local and adjacent genomic features and by selection. Some subjects had multiple carrier CNVs (307 subjects) and/or carrier deletions encompassing more than one recessive disease gene (206 deletions). Heterozygous deletions spanning multiple recessive disease genes may confer carrier status for multiple single-gene disorders, for complex syndromes resulting from the combination of two or more recessive conditions, or may potentially cause clinical phenotypes due to a multiply heterozygous state. In addition to carrier mutations, we identified homozygous and hemizygous deletions potentially causative for recessive disease. We provide further evidence that CNVs contribute to the allelic architecture of both carrier and recessive disease-causing mutations. Thus, a complete recessive carrier screening method or diagnostic test should detect CNV alleles. PMID:23685542

Boone, Philip M.; Campbell, Ian M.; Baggett, Brett C.; Soens, Zachry T.; Rao, Mitchell M.; Hixson, Patricia M.; Patel, Ankita; Bi, Weimin; Cheung, Sau Wai; Lalani, Seema R.; Beaudet, Arthur L.; Stankiewicz, Pawel; Shaw, Chad A.; Lupski, James R.

2013-01-01

66

Identity and psychological ownership in chronic illness and disease state  

PubMed Central

Psychological ownership is rarely considered in health discourse related to chronic illness or disease state. Construction of identity is an important consideration within this framework. This autoethnographic study explores psychological ownership and identity related to prostate cancer and chronic illness. Conclusions about the nature of psychological ownership and identity were gathered from the relevant literature and personal experience. Themes include the patient–healthcare professional relationship and that psychological ownership is personal and grounded in an individual's sense of identity, control and perceived capacity to control illness or disease. Personal reflection through autoethnography guides discussion of psychological ownership and identity. PMID:20738388

Karnilowicz, W

2011-01-01

67

Therapeutic efficacy of the Qing Dai in patients with intractable ulcerative colitis  

PubMed Central

Ulcerative colitis (UC) is a chronic inflammatory bowel disease that may become intractable when treated with conventional medications such as aminosalicylates, corticosteroids, and azathioprine. The herbal medicine Qing Dai has traditionally been used in Chinese medicine to treat UC patients, but there is a lack of published data on the efficacy of Qing Dai in UC treatment. We report several cases of patients with intractable UC who take Qing Dai in a retrospective observational study. Furthermore, we explore the mechanisms of action of Qing Dai. Nine patients with active UC who received conventional medications but wished to receive Qing Dai as an alternative medication were included in our analysis. The UC severity level was determined based on the clinical activity index (CAI). Additionally, 5 of the 9 patients were endoscopically evaluated according to the Matts grading system. Each patient received 2 g/d of Qing Dai orally and continued taking other medications for UC as prescribed. Electron spin resonance was applied to explore the mechanisms of action of Qing Dai. After 4 mo of treatment with Qing Dai, the CAI score decreased from 8.3 ± 2.4 to 2.4 ± 3.4 (mean ± SD; P < 0.001). Similarly, the endoscopic Matts grade decreased from 3.4 ± 0.5 to 2.2 ± 0.8 (P = 0.02). Six of 7 patients who were on prednisolone upon enrollment in the study were able to discontinue this corticosteroid. Electron spin resonance revealed that Qing Dai possesses strong hydroxyl radical scavenging activity. Qing Dai showed significant clinical and endoscopic efficacy in patients who failed to respond to conventional medications. Scavenging of hydroxyl radicals appears to be a potential mechanism through which Qing Dai acts, but the significance of the scavenging ability of Qing Dai with respect to the anti-inflammatory effect in UC patients warrants further investigation. PMID:23674882

Suzuki, Hideo; Kaneko, Tsuyoshi; Mizokami, Yuji; Narasaka, Toshiaki; Endo, Shinji; Matsui, Hirofumi; Yanaka, Akinori; Hirayama, Aki; Hyodo, Ichinosuke

2013-01-01

68

Therapeutic efficacy of the Qing Dai in patients with intractable ulcerative colitis.  

PubMed

Ulcerative colitis (UC) is a chronic inflammatory bowel disease that may become intractable when treated with conventional medications such as aminosalicylates, corticosteroids, and azathioprine. The herbal medicine Qing Dai has traditionally been used in Chinese medicine to treat UC patients, but there is a lack of published data on the efficacy of Qing Dai in UC treatment. We report several cases of patients with intractable UC who take Qing Dai in a retrospective observational study. Furthermore, we explore the mechanisms of action of Qing Dai. Nine patients with active UC who received conventional medications but wished to receive Qing Dai as an alternative medication were included in our analysis. The UC severity level was determined based on the clinical activity index (CAI). Additionally, 5 of the 9 patients were endoscopically evaluated according to the Matts grading system. Each patient received 2 g/d of Qing Dai orally and continued taking other medications for UC as prescribed. Electron spin resonance was applied to explore the mechanisms of action of Qing Dai. After 4 mo of treatment with Qing Dai, the CAI score decreased from 8.3 ± 2.4 to 2.4 ± 3.4 (mean ± SD; P < 0.001). Similarly, the endoscopic Matts grade decreased from 3.4 ± 0.5 to 2.2 ± 0.8 (P = 0.02). Six of 7 patients who were on prednisolone upon enrollment in the study were able to discontinue this corticosteroid. Electron spin resonance revealed that Qing Dai possesses strong hydroxyl radical scavenging activity. Qing Dai showed significant clinical and endoscopic efficacy in patients who failed to respond to conventional medications. Scavenging of hydroxyl radicals appears to be a potential mechanism through which Qing Dai acts, but the significance of the scavenging ability of Qing Dai with respect to the anti-inflammatory effect in UC patients warrants further investigation. PMID:23674882

Suzuki, Hideo; Kaneko, Tsuyoshi; Mizokami, Yuji; Narasaka, Toshiaki; Endo, Shinji; Matsui, Hirofumi; Yanaka, Akinori; Hirayama, Aki; Hyodo, Ichinosuke

2013-05-01

69

Lamotrigine for intractable migraine-like headaches in Sturge-Weber syndrome.  

PubMed

We herein report that naratriptan remarkably improved intractable migraine-like headaches in a patient with Sturge-Weber syndrome (SWS) despite his past history of cerebral infarction. In addition, lamotrigine had a prophylactic effect on his visual aura and headaches. An 18-year-old male patient with SWS had intractable migraine-like headaches every several months from the age of 3years. His migraine-like headaches were characterized by pulsating attacks preceded by left homonymous hemianopsia, which persisted after headache disappearance. In addition, after 14years of age, the pulsating headaches were preceded by photophobia without homonymous hemianopsia and occurred almost daily. Headache pains were not improved by acetaminophen or loxoprofen sodium hydrate. Furthermore, various prophylactic drugs were ineffective. After obtaining informed consent, naratriptan was administered. The pain severity was reduced and the duration of headache with homonymous hemianopsia was shortened from several days to several hours. Interestingly, naratriptan also shortened the duration of homonymous hemianopsia to several hours. We confirmed that his headache attacks were not epileptic seizures by ictal electroencephalography. However, 25mg/day of lamotrigine had a prophylactic effect on the frequency of headache. Moreover, lamotrigine led to complete remission of his headache without homonymous hemianopsia. Lamotrigine may have an advantage in terms of reducing the risk of cerebrovascular disease caused by migraine-like headaches and the use of triptans. The most effective management for migraine-like headaches in patients with SWS has not been established. Lamotrigine is a potentially effective option for patients with SWS with migraine-like headaches. PMID:23877022

Nomura, Shohei; Shimakawa, Shuichi; Fukui, Miho; Tanabe, Takuya; Tamai, Hiroshi

2014-05-01

70

Montana State University-Bozeman: Insects, Disease, and History  

NSDL National Science Digital Library

As carriers of many serious diseases throughout time, insects have certainly played a significant role in shaping world history. Edited by Drs. Gary Miller and Robert Peterson, this website from Montana State University devotes itself to understanding the impact of insect-borne diseases on world history. The site contains several feature articles including: The Role of Insects as Biological Weapons; Historical Natural History: Insects and the Civil War; and Yellow Fever and the Strategy of the Mexican-American War. The website also contains A Primer to Medical Entomology, suggested readings, and a brief section on Disease, Epidemics, and Historical Periods. Related links and a glossary -- including terms such as anaphylaxis, anthropophilic, delusory parasitosis, and Hymenoptera -- are included as well.

2007-12-12

71

Montana State University-Bozeman: Insects, Disease, and History  

NSDL National Science Digital Library

As carriers of many serious diseases throughout time, insects have certainly played a significant role in shaping world history. Edited by Drs. Gary Miller and Robert Peterson, this website from Montana State University devotes itself to understanding the impact of insect-borne diseases on world history. The site contains several feature articles including: The Role of Insects as Biological Weapons; Historical Natural History: Insects and the Civil War; and Yellow Fever and the Strategy of the Mexican-American War. The website also contains A Primer to Medical Entomology, suggested readings, and a brief section on Disease, Epidemics, and Historical Periods. Related links and a glossary -- including terms such as anaphylaxis, anthropophilic, delusory parasitosis, and Hymenoptera -- are included as well.

72

Long-term outcome in children with intractable epilepsy showing bilateral diffuse cortical glucose hypometabolism pattern on positron emission tomography.  

PubMed

The objective of this study is to determine the long-term outcome of children with intractable epilepsy who have diffuse cortical hypometabolism on 2-deoxy-2-((18)F)fluoro-D-glucose positron emission tomography (FDG-PET) scans. Seventeen children with intractable epilepsy showing bilateral, diffuse cortical hypometabolism on FDG-PET were followed up through telephone interview from 1 year 4 months to 11 years 4 months (mean: 5 years 7 months ± 2 years 1 month) after their PET scans. One child succumbed to Sanfilippo disease at age 20 years. Only 2 children were seizure free. Fifty percent had walking difficulties, 56.25% were not toilet trained, all had speech difficulties, 43.75% had behavioral problems, 37.5% had poor eye contact, 75% had socialization difficulties, and 87.5% attended special schools. Three children were found to have genetic causes, including a 4-MB deletion of the mitochondrial genome, MECP2 duplication, and Lafora disease. In conclusion, the long-term outcome in this patient population is poor, and they tend to suffer from genetic/neurodegenerative diseases. PMID:21940690

Shandal, Varun; Veenstra, Amy L; Behen, Michael; Sundaram, Senthil; Chugani, Harry

2012-01-01

73

Adenosine Signaling During Acute and Chronic Disease States  

PubMed Central

Adenosine is a signaling nucleoside that is produced following tissue injury, particularly injury involving ischemia and hypoxia. The production of extracellular adenosine and its subsequent signaling through adenosine receptors plays an important role in orchestrating injury responses in multiple organs. There are four adenosine receptors that are widely distributed on immune, epithelial, endothelial, neuronal and stromal cells throughout the body. Interestingly, these receptors are subject to altered regulation following injury. Studies in mouse models and human cells and tissues have identified that the production of adenosine and its subsequent signaling through its receptors plays largely beneficial roles in acute disease states, with the exception of brain injury. In contrast, if elevated adenosine levels are sustained beyond the acute injury phase, adenosine responses can become detrimental by activating pathways that promote tissue injury and fibrosis. Understanding when during the course of disease adenosine signaling is beneficial as opposed to detrimental and defining the mechanisms involved will be critical for the advancement of adenosine based therapies for acute and chronic diseases. The purpose of this review is to discuss key observations that define the beneficial and detrimental aspects of adenosine signaling during acute and chronic disease states with an emphasis on cellular processes such as inflammatory cell regulation, vascular barrier function and tissue fibrosis. PMID:23340998

Karmouty-Quintana, Harry; Xia, Yang; Blackburn, Michael R.

2013-01-01

74

Coronary heart disease and stroke deaths - United States, 2009.  

PubMed

Heart disease and stroke are the first and fourth leading causes of death, respectively in the United States. In 2008, heart disease and stroke were responsible for nearly a third of all deaths in the United States (30.4%), killing more than three-quarters of a million people that year. Coronary heart disease (CHD) is the cause of more than two-thirds of all heart disease-related deaths. One of the Healthy People 2020 objectives includes reducing the rate of CHD deaths by 20% from the baseline rate of 126 deaths per 100,000 population per year, to a goal of 100.8 deaths per 100,000 (objective HDS-2). The objectives also include reducing the rate of stroke deaths by 20% over the baseline of 42.2 deaths per 100,000, to a goal of 33.8 deaths per 100,000 population. Although the rates of death from both CHD and stroke have declined continuously in recent decades and the Healthy People 2010 goals for these two objectives were met among the overall U.S. population in 2004, the death rates remain high, particularly among men and blacks. PMID:24264507

Gillespie, Cathleen D; Wigington, Charles; Hong, Yuling

2013-11-22

75

Chronic obstructive pulmonary disease among adults--United States, 2011.  

PubMed

Chronic obstructive pulmonary disease (COPD) is a group of progressive, debilitating respiratory conditions, including emphysema and chronic bronchitis, characterized by difficulty breathing, lung airflow limitations, cough, and other symptoms. COPD often is associated with a history of cigarette smoking and is the primary contributor to mortality caused by chronic lower respiratory diseases, which became the third leading cause of death in the United States in 2008. Despite this substantial disease burden, state-level data on the prevalence of COPD and associated health-care resource use in the United States have not been available for all states. To assess the state-level prevalence of COPD among adults, the impact of COPD on their quality of life, and the use of health-care resources by those with COPD, CDC analyzed data from the 2011 Behavioral Risk Factor Surveillance System (BRFSS). Among BRFSS respondents in all 50 states, the District of Columbia (DC), and Puerto Rico, 6.3% reported having been told by a physician or other health professional that they had COPD. In addition to the screening question asked of all respondents, 21 states, DC, and Puerto Rico elected to include an optional COPD module. Among persons who reported having COPD and completed the optional module, 76.0% reported that they had been given a diagnostic breathing test, 64.2% felt that shortness of breath impaired their quality of life, and 55.6% were taking at least one daily medication for their COPD. Approximately 43.2% of them reported visiting a physician for COPD-related symptoms in the previous 12 months, and 17.7% had either visited an emergency department or been admitted to a hospital for their COPD in the previous 12 months. Continued surveillance for COPD, particularly at state and local levels, is critical to 1) identify communities that likely will benefit most from awareness and outreach campaigns and 2) evaluate the effectiveness of public health efforts related to the prevention, treatment, and control of the disease. PMID:23169314

2012-11-23

76

A Case of Intractable Suspected Perilymph Fistula with Severe Depression  

PubMed Central

A 68-year-old woman presented dizziness whenever she put her finger into the right ear and also complained of water-streaming tinnitus, which indicated she would have been suffering from perilymph fistula. An exploratory tympanotomy was conducted. Leakage of perilymph from the round window was suspected, although the cochlin-tomoprotein (CTP) results were negative. After the procedure, the patient's finger-induced dizziness, tinnitus, and vertigo spells disappeared completely. However, her dizzy symptom did not improve. The patient also complained of general fatigue, weight loss, and insomnia, which led us to suspect comorbid depression. Antidepressants and vestibular rehabilitation treatment resulted in a significant improvement in her dizziness. Although it is not apparent whether the patient had a perilymph fistula, this case demonstrates the importance of evaluating not only physical symptoms but also psychological comorbidity, especially when the physical symptoms are intractable despite treatment. PMID:25395985

Oishi, Naoki; Tsutsumi, Tomoko; Ogawa, Kaoru

2014-01-01

77

[Transdermal fentanyl patch for the treatment of chronic intractable pain].  

PubMed

The purpose of the treatment of chronic non-cancer pain is the improvement of the patient's quality of life, not the complete alleviation of pain. In Japan transdermal fentanyl patch can be used for the treatment of chronic intractable pain including cancer pain and chronic non-cancer pain. In prescribing transdermal fentanyl patch for patients with chronic non-cancer pain, cares should be focused on the selection of the patients and the periodic and continuous observation of analgesic effect and side effects. Patients with mental disorders need the consultation with specialists. In most cases side effects such as nausea, vomiting, constipation and sedation can be well tolerated. However, respiratory suppression or over sedation would also occur and such side effects can sometimes be fatal. Furthermore, long term effects on endocrine and immune systems have not been clarified yet. Proper prescription of opioids during a limited period of time is definitely the primary concern of medical professionals. PMID:23905400

Ibuki, Takae

2013-07-01

78

Topiramate-induced intractable cough during migraine prophylaxis.  

PubMed

Topiramate is a highly effective drug in migraine prophylaxis and is considered a first-line treatment. The evidence for the efficacy of topiramate is based upon the results of several large, randomized, double-blind, placebo-controlled trials. Adverse events (AEs) are common and require discontinuation of the treatment in about 20-25% of patients, but they are rarely severe. There are reviews regarding topiramate-related AEs representing a large number of patients treated in controlled trials. The most common AEs are weight loss, dizziness, somnolence, abnormal thinking, fatigue, ataxia, confusion, paresthesias, impaired concentration, nervousness, amnesia, and language difficulties. The development of cough has never been reported as an AE during topiramate prophylaxis for migraine. We present 3 cases in which the prophylactic treatment for migraine with topiramate was discontinued due to the onset of primary intractable coughing. PMID:19751366

Maggioni, Ferdinando; Mampreso, Edoardo; Mainardi, Federico; Lisotto, Carlo; Malvindi, Maria Lucia; Zanchin, Giorgio

2010-02-01

79

“On” state freezing of gait in Parkinson disease  

PubMed Central

Objective: To describe the phenotype of levodopa-induced “on” freezing of gait (FOG) in Parkinson disease (PD). Methods: We present a diagnostic approach to separate “on” FOG (deterioration during the “on state”) from other FOG forms. Four patients with PD with suspected “on” FOG were examined in the “off state” (>12 hours after last medication intake), “on state” (peak effect of usual medication), and “supra-on” state (after intake of at least twice the usual dose). Results: Patients showed clear “on” FOG, which worsened in a dose-dependent fashion from the “on” to the “supra-on” state. Two patients also demonstrated FOG during the “off state,” of lesser magnitude than during “on.” In addition, levodopa produced motor blocks in hand and feet movements, while other parkinsonian features improved. None of the patients had cognitive impairment or a predating “off” FOG. Conclusions: True “on” FOG exists as a rare phenotype in PD, unassociated with cognitive impairment or a predating “off” FOG. Distinguishing the different FOG subtypes requires a comprehensive motor assessment in at least 3 medication states. PMID:22262741

Fasano, A.; van Nuenen, B.F.L.; Payne, M.M.; Snijders, A.H.; Bloem, B.R.

2012-01-01

80

Diagnostic reframing of intractable environmental problems: case of a contested multiparty public land-use conflict.  

PubMed

Intractable conflicts are omnipresent in environmental management. These conflicts do not necessarily resist resolution but need to be fundamentally transformed in order to reach agreement. Reframing, a process that allows disputants to create new alternative understandings of the problem, is one way of transforming these conflicts. Cognitive and interactional reframing are the two major approaches to conflict transformation. These approaches have some drawbacks. Cognitive reframing does not guarantee commensurate consideration of all disputants' views about the problem. Interactional reframing is prone to inter-disputant influences that interfere with presenting the problems as accurately as they exist in disputants' minds. Inadequate consideration of other disputants' views and inter-disputant influences often lead to inaccurate problem identification and definition. This in turn leads to solving the wrong problem, enabling intractability to persist. Proper problem identification and definition requires commensurate consideration of all sides of the conflict while minimizing inter-disputant influences. From a problem diagnosis perspective, we show how Q methodology is used to reframe environmental problems, rendering them more tractable to analysis while minimizing the influence of who disputants are talking with, and without ignoring the perspectives of other disputants. Using a case of contentious All-Terrain Vehicle (ATV) use in a state-administered public land, conflicting parties reframed the problem by prioritizing issues, outlining areas and levels of consensus and disagreement, and revealing inherent unrecognized and/or unspoken agendas. The reframing process surprisingly revealed several areas of common ground in disputants' diagnosis of the problem, including lack of emphasis on environmental protection and uncoordinated management factions. Emergent frames were misaligned on some issues, such as the behaviors of ATV riders and the role of management, including political and economic influences on decision making. We discuss how the reframing process enhances tractability of multiparty environmental problems. We point to some limitations of Q methodology as a tool for the diagnostic reframing of such problems. PMID:22705762

Asah, Stanley T; Bengston, David N; Wendt, Keith; Nelson, Kristen C

2012-10-15

81

Seasonality and Coronary Heart Disease Deaths in United States Firefighters  

PubMed Central

United States firefighters have a high on-duty fatality rate and coronary heart disease is the leading cause. Seasonality affects the incidence of cardiovascular events in the general population, but its effects on firefighters are unknown. We statistically examined the seasonal and annual variation of all on-duty coronary heart disease deaths among US firefighters between 1994 and 2004 using the chi-square distribution and Poisson regression model of the monthly fatality counts. We also examined the effect of ambient temperature (apparent as well as wind chill temperature) on coronary heart disease fatalities during the study span using a time-stratified, case-crossover study design. When grouped by season, we observed the distribution of the 449 coronary heart disease fatalities to show a relative peak in winter (32%) and relative nadir in spring (21%). This pattern was significantly different (p=0.005) from the expected distribution under the null hypothesis where season has no effect. The pattern persisted in additional analyses, stratifying the deaths by the type of duty in which the firefighters were engaged at the time of their deaths. In the Poisson regression model of the monthly fatality counts, the overall goodness-of-fit between the actual and predicted case counts was excellent ( ?42 = 16.63; p = 0.002). Two distinct peaks were detected, one in January-February and the other in August-September. Overall, temperature was not associated with increased risk of on-duty death. After allowing for different effects of temperature in mild/hot versus cold periods, a 1°C increase was not protective in cold weather, nor did it increase the risk of death in warmer weather. The findings of this study reveal statistical evidence for excess coronary heart disease deaths among firefighters during winter; however, the temporal pattern coronary heart disease deaths was not linked to temperature variation. We also found the seasonal pattern to be independent of duty-related risks. PMID:17701682

Mbanu, Ibeawuchi; Wellenius, Gregory A.; Mittleman, Murray A.; Peeples, Lynne; Stallings, Leonard A.; Kales, Stefanos N.

2013-01-01

82

Differential Expression of MicroRNAs in Different Disease States  

PubMed Central

Disturbances in gene expression as a result of perturbed transcription or posttranscriptional regulation is one of the main causes of cellular dysfunction that underlies different disease states. About a decade ago, the discovery of microRNAs (miRNAs) in mammalian cells has renewed our focus on posttranscriptional regulatory mechanisms during pathogenesis. These tiny posttranscriptional regulators are differentially expressed in almost every disease that has been studied-to-date and can modulate a gene’s expression via specifically binding to its messenger RNA. Due to their capacity to simultaneously target multiple, functionally-related, genes, they are proving to be potentially powerful therapeutic agents/targets. In this review we will focus on the miRNAs that are differentially regulated in the more common cardiovascular pathologies, their targets, and potential function. PMID:22343558

Abdellatif, Maha

2012-01-01

83

Subcellular compartmentation of ascorbate and its variation in disease states.  

PubMed

Beyond its general role as antioxidant, specific functions of ascorbate are compartmentalized within the eukaryotic cell. The list of organelle-specific functions of ascorbate has been recently expanded with the epigenetic role exerted as a cofactor for DNA and histone demethylases in the nucleus. Compartmentation necessitates the transport through intracellular membranes; members of the GLUT family and sodium-vitamin C cotransporters mediate the permeation of dehydroascorbic acid and ascorbate, respectively. Recent observations show that increased consumption and/or hindered entrance of ascorbate in/to a compartment results in pathological alterations partially resembling to scurvy, thus diseases of ascorbate compartmentation can exist. The review focuses on the reactions and transporters that can modulate ascorbate concentration and redox state in three compartments: endoplasmic reticulum, mitochondria and nucleus. By introducing the relevant experimental and clinical findings we make an attempt to coin the term of ascorbate compartmentation disease. PMID:24907663

Bánhegyi, Gábor; Benedetti, Angelo; Margittai, Eva; Marcolongo, Paola; Fulceri, Rosella; Németh, Csilla E; Szarka, András

2014-09-01

84

Lymphoid irradiation in intractable rheumatoid arthritis. A double-blind, randomized study comparing 750-rad treatment with 2,000-rad treatment  

SciTech Connect

Twenty patients with intractable rheumatoid arthritis were treated with 750-rad or 2,000-rad lymphoid irradiation in a randomized double-blind comparative study. Over a 12-month followup period, there was a significant improvement in 4 of 7 and 6 of 7 standard parameters of disease activity following treatment with 750 rads and 2,000 rads, respectively. Transient, short-term toxicity was less frequent with the lower dose. In both groups, there was a sustained peripheral blood lymphopenia, a selective depletion of T helper (Leu-3a+) lymphocytes, and reduced in vitro mitogen responses. These changes did not occur, however, in synovial fluid. These results suggest that 750-rad lymphoid irradiation is as effective as, but less toxic than, that with 2,000 rads in the management of patients with intractable rheumatoid arthritis.

Hanly, J.G.; Hassan, J.; Moriarty, M.; Barry, C.; Molony, J.; Casey, E.; Whelan, A.; Feighery, C.; Bresnihan, B.

1986-01-01

85

Stimulation of primary motor cortex for intractable deafferentation pain.  

PubMed

The stimulation of the primary motor cortex (M1) has proved to be an effective treatment for intractable deafferentation pain. This treatment started in 1990, and twenty-eight studies involving 271 patients have been reported so far. The patients who have been operated on were suffering from post-stroke pain (59%), trigeminal neuropathic pain, brachial plexus injury, spinal cord injury, peripheral nerve injury and phantom-limb pain. The method of stimulation was: a) epidural, b) subdural, and c) within the central sulcus. Overall, considering the difficulty in treating central neuropathic pain, trigeminal neuropathic pain and certain types of refractory peripheral pain, the electrical stimulation of M1 is a very promising technique; nearly 60% of the treated patients improved with a higher than 50% pain relief after several months of follow-up and sometimes of a few years in most reports. The mechanism of pain relief by the electrical stimulation of M1 has been under investigation. Recently, repetitive transcranial magnetic stimulation (rTMS) of M1 has been reported to be effective on deafferentation pain. In the future, rTMS may take over from electrical stimulation as a treatment for deafferentation pain. PMID:17691289

Saitoh, Y; Yoshimine, T

2007-01-01

86

Responsive neurostimulation for the treatment of medically intractable epilepsy.  

PubMed

With an annual incidence of 50/100,000 people, nearly 1% of the population suffers from epilepsy. Treatment with antiepileptic medication fails to achieve seizure remission in 20-30% of patients. One treatment option for refractory epilepsy patients who would not otherwise be surgical candidates is electrical stimulation of the brain, which is a rapidly evolving and reversible adjunctive therapy. Therapeutic stimulation can involve direct stimulation of the brain nuclei or indirect stimulation of peripheral nerves. There are three stimulation modalities that have class I evidence supporting their uses: vagus nerve stimulation (VNS), stimulation of the anterior nuclei of the thalamus (ANT), and, the most recently developed, responsive neurostimulation (RNS). While the other treatment modalities outlined deliver stimulation regardless of neuronal activity, the RNS administers stimulation only if triggered by seizure activity. The lower doses of stimulation provided by such responsive devices can not only reduce power consumption, but also prevent adverse reactions caused by continuous stimulation, which include the possibility of habituation to long-term stimulation. RNS, as an investigational treatment for medically refractory epilepsy, is currently under review by the FDA. Eventually systems may be developed to enable activation by neurochemical triggers or to wirelessly transmit any information gathered. We review the mechanisms, the current status, the target options, and the prospects of RNS for the treatment of medically intractable epilepsy. PMID:23735806

Liu, Chong; Wen, Xiong-Wei; Ge, Yan; Chen, Ning; Hu, Wen-Han; Zhang, Tan; Zhang, Jian-Guo; Meng, Fan-Gang

2013-08-01

87

On the Computational Intractability of Exact and Approximate Dictionary Learning  

NASA Astrophysics Data System (ADS)

The efficient sparse coding and reconstruction of signal vectors via linear observations has received a tremendous amount of attention over the last decade. In this context, the automated learning of a suitable basis or overcomplete dictionary from training data sets of certain signal classes for use in sparse representations has turned out to be of particular importance regarding practical signal processing applications. Most popular dictionary learning algorithms involve NP-hard sparse recovery problems in each iteration, which may give some indication about the complexity of dictionary learning but does not constitute an actual proof of computational intractability. In this technical note, we show that learning a dictionary with which a given set of training signals can be represented as sparsely as possible is indeed NP-hard. Moreover, we also establish hardness of approximating the solution to within large factors of the optimal sparsity level. Furthermore, we give NP-hardness and non-approximability results for a recent dictionary learning variation called the sensor permutation problem. Along the way, we also obtain a new non-approximability result for the classical sparse recovery problem from compressed sensing.

Tillmann, Andreas M.

2015-01-01

88

Epilepsy Surgery in Pediatric Intractable Epilepsy with Destructive Encephalopathy  

PubMed Central

Background and Purpose: The aim of the current study is to review the clinical features, surgery outcomes and parental satisfaction of children with destructive encephalopathy who underwent epilepsy surgery due to medically intractable seizures. Methods: 48 patients who underwent epilepsy surgery from October 2003 to August 2011 at Severance Children’s Hospital have been reviewed. The survey was conducted for functional outcomes and parental satisfaction at least 1 year after the surgery. Results: Epileptic encephalopathy including Lennox-Gastaut syndrome and infantile spasms was more prevalent than symptomatic focal epilepsy. Hypoxic ischemic injury accounted for most of the underlying etiology of the destructive encephalpathy, followed by central nervous system infection and head trauma. 27 patients (56.3%) underwent resective surgery and 21 patients (43.7%) underwent palliative surgery. 16 patients (33.3%) achieved seizure free and 27 parents (87.5%) reported satisfaction with the outcome of their children’s epilepsy surgery. In addition, 14 parents (77.8 %) whose children were not seizure free reported satisfaction with their children’s improvement in cognitive and behavior issues. Conclusions: Epilepsy surgery in destructive encephalopathy was effective for controlling seizures. Parents reported satisfaction not only with the surgical outcomes, but also with improvement of cognitive and behavior issues. PMID:24649473

Park, So Young; Kwon, Hye Eun; Kang, Hoon-Chul; Lee, Joon Soo; Kim, Dong Seok; Kim, Heung Dong

2013-01-01

89

Characteristics and safety assessment of intractable proteins in genetically modified crops.  

PubMed

Genetically modified (GM) crops may contain newly expressed proteins that are described as "intractable". Safety assessment of these proteins may require some adaptations to the current assessment procedures. Intractable proteins are defined here as those proteins with properties that make it extremely difficult or impossible with current methods to express in heterologous systems; isolate, purify, or concentrate; quantify (due to low levels); demonstrate biological activity; or prove equivalency with plant proteins. Five classes of intractable proteins are discussed here: (1) membrane proteins, (2) signaling proteins, (3) transcription factors, (4) N-glycosylated proteins, and (5) resistance proteins (R-proteins, plant pathogen recognition proteins that activate innate immune responses). While the basic tiered weight-of-evidence approach for assessing the safety of GM crops proposed by the International Life Sciences Institute (ILSI) in 2008 is applicable to intractable proteins, new or modified methods may be required. For example, the first two steps in Tier I (hazard identification) analysis, gathering of applicable history of safe use (HOSU) information and bioinformatics analysis, do not require protein isolation. The extremely low level of expression of most intractable proteins should be taken into account while assessing safety of the intractable protein in GM crops. If Tier II (hazard characterization) analyses requiring animal feeding are judged to be necessary, alternatives to feeding high doses of pure protein may be needed. These alternatives are discussed here. PMID:24662477

Bushey, Dean F; Bannon, Gary A; Delaney, Bryan F; Graser, Gerson; Hefford, Mary; Jiang, Xiaoxu; Lee, Thomas C; Madduri, Krishna M; Pariza, Michael; Privalle, Laura S; Ranjan, Rakesh; Saab-Rincon, Gloria; Schafer, Barry W; Thelen, Jay J; Zhang, John X Q; Harper, Marc S

2014-07-01

90

Risk of Importing Zoonotic Diseases through Wildlife Trade, United States  

PubMed Central

The United States is the world’s largest wildlife importer, and imported wild animals represent a potential source of zoonotic pathogens. Using data on mammals imported during 2000–2005, we assessed their potential to host 27 selected risk zoonoses and created a risk assessment that could inform policy making for wildlife importation and zoonotic disease surveillance. A total of 246,772 mammals in 190 genera (68 families) were imported. The most widespread agents of risk zoonoses were rabies virus (in 78 genera of mammals), Bacillus anthracis (57), Mycobacterium tuberculosis complex (48), Echinococcus spp. (41), and Leptospira spp. (35). Genera capable of harboring the greatest number of risk zoonoses were Canis and Felis (14 each), Rattus (13), Equus (11), and Macaca and Lepus (10 each). These findings demonstrate the myriad opportunities for zoonotic pathogens to be imported and suggest that, to ensure public safety, immediate proactive changes are needed at multiple levels. PMID:19891857

Schloegel, Lisa M.; Daszak, Peter

2009-01-01

91

Automated mechanical ventilation: adapting decision making to different disease states.  

PubMed

The purpose of the present study is to introduce a novel methodology for adapting and upgrading decision-making strategies concerning mechanical ventilation with respect to different disease states into our fuzzy-based expert system, AUTOPILOT-BT. The special features are: (1) Extraction of clinical knowledge in analogy to the daily routine. (2) An automated process to obtain the required information and to create fuzzy sets. (3) The controller employs the derived fuzzy rules to achieve the desired ventilation status. For demonstration this study focuses exclusively on the control of arterial CO(2) partial pressure (p(a)CO(2)). Clinical knowledge from 61 anesthesiologists was acquired using a questionnaire from which different disease-specific fuzzy sets were generated to control p(a)CO(2). For both, patients with healthy lung and with acute respiratory distress syndrome (ARDS) the fuzzy sets show different shapes. The fuzzy set "normal", i.e., "target p(a)CO(2) area", ranges from 35 to 39 mmHg for healthy lungs and from 39 to 43 mmHg for ARDS lungs. With the new fuzzy sets our AUTOPILOT-BT reaches the target p(a)CO(2) within maximal three consecutive changes of ventilator settings. Thus, clinical knowledge can be extended, updated, and the resulting mechanical ventilation therapies can be individually adapted, analyzed, and evaluated. PMID:21069471

Lozano-Zahonero, S; Gottlieb, D; Haberthür, C; Guttmann, J; Möller, K

2011-03-01

92

Predicting progression from cognitive impairment to Alzheimer's disease with the disease state index.  

PubMed

We evaluated the performance of the Disease State Index (DSI) method when predicting progression to Alzheimer's disease (AD) in patients with subjective cognitive impairment (SCI), amnestic or non-amnestic mild cognitive impairment (aMCI, naMCI). The DSI model measures patients' similarity to diagnosed cases based on available data, such as cognitive tests, the APOE genotype, CSF biomarkers and MRI. We applied the DSI model to data from the DESCRIPA cohort, where non-demented patients (N=775) with different subtypes of cognitive impairment were followed for 1 to 5 years. Classification accuracies for the subgroups were calculated with the DSI using leave-one-out crossvalidation. The DSI's classification accuracy in predicting progression to AD was 0.75 (AUC=0.83) in the total population, 0.70 (AUC=0.77) for aMCI and 0.71 (AUC=0.76) for naMCI. For a subset of approximately half of the patients with high or low DSI values, accuracy reached 0.86 (all), 0.78 (aMCI), and 0.85 (naMCI). For patients with MRI or CSF biomarker data available, theywere 0.78 (all), 0.76 (aMCI) and 0.76 (naMCI), while for clear cases the accuracies rose to 0.90 (all), 0.83 (aMCI) and 0.91 (naMCI). The results show that the DSI model can distinguish between clear and ambiguous cases, assess the severity of the disease and also provide information on the effectiveness of different biomarkers. While a specific test or biomarker may confound analysis for an individual patient, combining several different types of tests and biomarkers could be able to reveal the trajectory of the disease and improve the prediction of AD progression. PMID:25523428

Hall, Anette; Mattila, Jussi; Koikkalainen, Juha; Lotjonen, Jyrki; Wolz, Robin; Scheltens, Philip; Frisoni, Giovanni; Tsolaki, Magdalini; Nobili, Flavio; Freund-Levi, Yvonne; Minthon, Lennart; Frolich, Lutz; Hampel, Harald; Visser, Pieter Jelle; Soininen, Hilkka

2015-01-01

93

Epidemiology and Estimated Population Burden of Selected Autoimmune Diseases in the United States  

Microsoft Academic Search

Autoimmune diseases cause significant and chronic morbidity and disability. The actual number of persons in the United States that are affected by autoimmune diseases and the resultant magnitude of their impact on the public's health are limited to a few specific diseases. In order to understand the clinical, public health and economic importance of these diseases it is necessary to

Denise L. Jacobson; Stephen J. Gange; Noel R. Rose; Neil M. H. Graham

1997-01-01

94

Is Intraoperative Electrocorticography Reliable in Children with Intractable Neocortical Epilepsy?  

PubMed Central

Summary Purpose To study the relation between the spike frequency during intraoperative electrocorticography (ECoG) under general anesthesia with isoflurane and that during extraoperative ECoG monitoring in children with intractable neocortical epilepsy. Methods Twenty-one children (age, 1–16 years; 15 boys and six girls) who underwent intraoperative and extraoperative ECoG monitoring with subdural electrode arrays were studied. The spike frequency and the spatial pattern of spike frequency were compared between intraoperative and extraoperative ECoGs for each patient (by using Wilcoxon signed-ranks and Spearman’s rank correlation, respectively). Results In 15 of 21 patients, the spike frequency was significantly lower during intraoperative than during extraoperative ECoG (mean z = ?6.3; p < 0.001). In four of 21 patients, no significant difference was found in the spike frequency between intraoperative and extraoperative recordings. In two of 21 patients, spike frequency reached one spike/min neither during intraoperative nor extraoperative recording; therefore appropriate comparison of spike frequency was not possible. A significant positive correlation in the spike-frequency pattern was seen between intraoperative and extraoperative recordings in nine of nine cases who had ?10 spikes/min during intraoperative ECoG (mean rho =0.62; p < 0.01), in five of six cases with one to nine spikes/min (mean rho =0.50; p < 0.01), and in none of five cases with less than one spike/min (mean rho =0.13). Conclusions General anesthesia often decreases the spike frequency in children with neocortical epilepsy, yet intraoperative ECoG can reliably reflect the awake interictal spiking pattern when spike frequency exceeds one spike/min during intraoperative ECoG recording. PMID:15329074

Asano, Eishi; Benedek, Krisztina; Shah, Aashit; Juhász, Csaba; Shah, Jagdish; Chugani, Diane C.; Muzik, Otto; Sood, Sandeep; Chugani, Harry T.

2007-01-01

95

Surveillance for Waterborne Disease Outbreaks Associated with Drinking Water United States, 2007-2008  

EPA Science Inventory

Problem/Condition: Since 1971, the Centers for Disease Control and Prevention (CDC), the U.S. Environmental Protection Agency (EPA), and the Council of State and Territorial Epidemiologists have maintained a collaborative Waterborne Disease and Outbreak Surveillance System (WBDOS...

96

Precipitation and the occurrence of lyme disease in the Northeastern United States  

USGS Publications Warehouse

The occurrence of Lyme disease is a growing concern in the United States, and various studies have been performed to understand the factors related to Lyme disease occurrence. In the United States, Lyme disease has occurred most frequently in the northeastern United States. Positive correlations between the number of cases of Lyme disease reported in the northeastern United States during the 1992-2002 period indicate that late spring/early summer precipitation was a significant climate factor affecting the occurrence of Lyme disease. When late spring/early summer precipitation was greater than average, the occurrence of Lyme disease was above average, possibly due to increased tick activity and survival rate during wet conditions. Temperature did not seem to explain the variability in Lyme disease reports for the northeastern United States. ?? Mary Ann Liebert, Inc.

McCabe, G.J.; Bunnell, J.E.

2004-01-01

97

Ankylosing Spondylitis Disease Activity Score (ASDAS): defining cut-off values for disease activity states and improvement scores  

Microsoft Academic Search

BackgroundThe Ankylosing Spondylitis Disease Activity Score (ASDAS) is a new composite index to assess disease activity in ankylosing spondylitis (AS). It fulfils important aspects of truth, feasibility and discrimination. Criteria for disease activity states and improvement scores are important for use in clinical practice, observational studies and clinical trials and so far have not been developed for the ASDAS.ObjectiveTo determine

Pedro Machado; Robert Landewé; Elisabeth Lie; Tore K Kvien; Jürgen Braun; Daniel Baker; Désirée van der Heijde

2011-01-01

98

Intractable chest pain in cardiomyopathy: treatment by a novel technique of cardiac cryodenervation with quantitative immunohistochemical assessment of success.  

PubMed

A novel method of cardiac denervation by cryoablation has been developed experimentally. The technique uses liquid nitrogen delivered under pressure to ablate the principal sources of cardiac innervation--namely, the adventitia surrounding the aorta, pulmonary arteries, and veins. The technique has been verified experimentally both in vivo by physiological means and in vitro by quantitative immunohistochemistry and the measurement of myocardial noradrenaline concentrations. A 35 year old woman presented with intractable precordial pain, normal epicardial coronary arteries, and hypertrophic cardiomyopathy. Her symptoms were refractory to maximal medical treatment and she was thought to be unsuitable for either conventional myocardial revascularisation, autotransplantation, or allografting with the concomitant risk of transplant coronary artery disease. She therefore underwent cardiac denervation by the method developed in the laboratory. There was quantitative immunohistochemical evidence of extrinsic cardiac denervation associated with a considerable improvement in her symptoms. This improvement persisted during a follow up period of over 16 months. PMID:8280529

Gaer, J A; Gordon, L; Wharton, J; Polak, J M; Taylor, K M; McKenna, W; Parker, D J

1993-12-01

99

Influence of disease state on oxygen transport in newborn piglets.  

PubMed

Optimally, oxygen delivery (DO2) should be sufficient to provide for adequate oxygen consumption (VO2) while avoiding O2 toxicity. Physiologically a critical level of DO2 has been described, below which decreases in oxygen supply begin to impair VO2, leading to venous hypercarbia and tissue acidosis. We predicted that this critical level would be influenced by factors such as underlying disease state and oxygen needs. Newborn piglets were exposed either to hypoxia (n = 6) or to group-B beta-hemolytic streptococcal sepsis (n = 6). Hemodynamic parameters were measured; DO2 and VO2 were calculated and compared within and between the groups. 'Critical DO2' was defined as the point at which decreases in DO2 began to produce concomitant decreases in VO2. This was observed at 9 ml/kg/min in hypoxic vs. 21 ml/kg/min in septic piglets. The 'critical Vsat' was defined as the venous O2 saturation beyond which tissue acidosis, as defined by base excess, developed. 'Critical VsatS' were 17% for hypoxic vs. 21% for septic animals. In summary, septic newborn piglets had higher critical DO2 and critical Vsat than hypoxic piglets, implying that they became oxygen supply dependent and developed tissue acidosis at higher levels of DO2 and Vsat, respectively. PMID:7993946

Hammerman, C

1994-01-01

100

United States medical students’ knowledge of Alzheimer disease  

PubMed Central

Purpose: A knowledge gap exists between general physicians and specialists in diagnosing and managing Alzheimer disease (AD). This gap is concerning due to the estimated rise in prevalence of AD and cost to the health care system. Medical school is a viable avenue to decrease the gap, educating future physicians before they specialize. The purpose of this study was to assess the knowledge level of students in their first and final years of medical school. Methods: Fourteen participating United States medical schools used e-mail student rosters to distribute an online survey of a quantitative cross-sectional assessment of knowledge about AD; 343 students participated. Knowledge was measured using the 12-item University of Alabama at Birmingham AD Knowledge Test for Health Professionals. General linear models were used to examine the effect of demographic variables and previous experience with AD on knowledge scores. Results: Only 2.5% of first year and 68.0% of final year students correctly scored ten or more items on the knowledge scale. Personal experience with AD predicted higher knowledge scores in final year students (P= 0.027). Conclusion: Knowledge deficiencies were common in final year medical students. Future studies to identify and evaluate the efficacy of AD education programs in medical schools are warranted. Identifying and disseminating effective programs may help close the knowledge gap. PMID:23750313

Nagle, Brian J.; Usita, Paula M.; Edland, Steven D.

2013-01-01

101

Projections of Alzheimer's disease in the United States and the public health impact of delaying disease onset.  

PubMed Central

OBJECTIVES: The goal of this study was to project the future prevalence and incidence of Alzheimer's disease in the United States and the potential impact of interventions to delay disease onset. METHODS: The numbers of individuals in the United States with Alzheimer's disease and the numbers of newly diagnosed cases that can be expected over the next 50 years were estimated from a model that used age-specific incidence rates summarized from several epidemiological studies, US mortality rates, and US Bureau of the Census projections. RESULTS: in 1997, the prevalence of Alzheimer's disease in the United States was 2.32 million (range: 1.09 to 4.58 million); of these individuals, 68% were female. It is projected that the prevalence will nearly quadruple in the next 50 years, by which time approximately 1 in 45 Americans will be afflicted with the disease. Currently, the annual number of new incident cases in 360,000. If interventions could delay onset of the disease by 2 years, after 50 years there would be nearly 2 million fewer cases than projected; if onset could be delayed by 1 year, there would be nearly 800,000 fewer prevalent cases. CONCLUSIONS: As the US population ages, Alzheimer's disease will become an enormous public health problem. interventions that could delay disease onset even modestly would have a major public health impact. PMID:9736873

Brookmeyer, R; Gray, S; Kawas, C

1998-01-01

102

Monte Carlo Simulation of Alzheimer's Disease in the United States: 2010-2060  

E-print Network

that accurately predict the long-term prevalence of the disease. In 2007, Brookmeyer et al. used Monte CarloMonte Carlo Simulation of Alzheimer's Disease in the United States: 2010-2060 Michael Blech Professor Renato Feres MATH 350 #12;Introduction Alzheimer's disease is one of the major public health

Feres, Renato

103

State of progress in treating cystic fibrosis respiratory disease  

PubMed Central

Since the discovery of the gene associated with cystic fibrosis (CF), there has been tremendous progress in the care of patients with this disease. New therapies have entered the market and are part of the standard treatment of patients with CF, and have been associated with marked improvement in survival. Now there are even more promising therapies directed at different components of the pathophysiology of this disease. In this review, our current knowledge of the pathophysiology of lung disease in patients with CF is described, along with the current treatment of CF lung disease, and the therapies in development that offer great promise to our patients. PMID:22883684

2012-01-01

104

Use of paced respiration to alleviate intractable hiccups (Singultus): a case report.  

PubMed

Heart rate variability (HRV) biofeedback is an emerging treatment for many health conditions involving dysregulation of the autonomic nervous system including hypertension, gastric pain, anxiety, and depression. Hiccups are frequently considered an annoyance. However, when intractable (lasting over 1 month), they can become debilitating, with some patients resorting to invasive treatments that often involve the phrenic nerve. Theoretically, HRV biofeedback should also provide a means to stimulate the phrenic nerve and could be an alternative option. We report the successful treatment of a 5 year-long case of intractable hiccups with one session of HRV biofeedback training. These results suggest that biofeedback may be a useful, non-invasive means of relieving intractable hiccups. No clear causality can be inferred from a single case, and further study is needed to determine if this finding has wider applicability. PMID:23568280

Hurst, Duane F; Purdom, Catherine L; Hogan, Michael J

2013-06-01

105

State Quitlines and Cessation Patterns Among Adults With Selected Chronic Diseases in 15 States, 2005–2008  

PubMed Central

Introduction The death rate of people who have a chronic disease is lower among former smokers than current smokers. State tobacco cessation quitlines are available for free in every state. The objective of our study was to compare demographic characteristics, use of quitline services, and quit rates among a sample of quitline callers. Methods We used data from 15 states on tobacco users aged 18 or older who enrolled with a quitline between October 1, 2005, and May 31, 2008; 9 states also provided data from 7-month follow-up surveys. We used descriptive statistics and logistic regression to compare callers by disease status. Results Among 195,057 callers, 32.3% reported having 1 or more of the following chronic diseases: 17.7%, asthma; 5.9%, coronary artery disease; 11.1%, chronic obstructive pulmonary disease; and 9.3%, diabetes; 9.0% had 2 or more chronic diseases. Callers who had a chronic disease were older and better educated; more likely to be female, have Medicaid or other health insurance, and have used tobacco for 20 years or more; and less likely to quit smoking (22.3%) at 7 months than callers who had none of these chronic diseases (29.7%). Conclusion About one-third of tobacco users who call state quitlines have a chronic disease, and those who have a chronic disease are less likely to quit using tobacco. Continued efforts are needed to ensure cessation treatments are reaching tobacco users who have a chronic disease and to develop and test ways to increase quit rates among them. PMID:23137862

Zbikowski, Susan M.; Mahoney, Lisa; Deprey, Mona; Mowery, Paul; Cerutti, Barbara

2012-01-01

106

Intractable hiccup accompanying pleural effusion: reversible clipping of an intrathoracic phrenic nerve.  

PubMed

Hiccup is usually a self-limiting condition, and can be treated with medications and physical maneuvers. However, hiccup episodes continuing for days or weeks can be incapacitating, and disturb work, sleep, and eating. Therefore, timely therapeutic intervention is needed to achieve early resolution of this treatable condition. We report on a successful phrenic nerve block for intractable hiccups, which consisted of thoracoscopic nerve clipping under general anesthesia and reversal under local anesthesia. This method has the advantage of assured diaphragmatic functional recovery while controlling intractable hiccups. PMID:23752012

Kim, Jae Jun; Sa, Young Jo; Cho, Deog Gon; Kim, Young Du; Kim, Chi Kyung; Moon, Seok Whan

2013-06-01

107

[Alcoholic liver disease: current state of the problem].  

PubMed

The literature review gives the present views of the diagnosis and treatment of alcoholic liver disease (ALD) and data on the genetic markers associated with the development of ALD and alcohol addiction. It discusses in detail the mechanisms of liver damage within the disease in question and substantiates indications for the use of prednisolone and pentoxifylline in alcoholic hepatitis. Therapeutic approaches to treating different forms of ALD are considered. PMID:24864478

Maev, I V; Abdurakhmanov, D T; Andreev, D N; Dicheva, D T

2014-01-01

108

Biomarkers of Chronic Inflammatory State in Uremia and Cardiovascular Disease  

PubMed Central

Cardiovascular disease is the leading cause of death in the general population; traditional risk factors seem inadequate to explain completely the remarkable prevalence of cardiovascular mortality and morbidity observed in the uremic population. A role for chronic inflammation has been well established in the development of atherosclerotic disease, and, on the basis of these observations, atherosclerosis might be considered an inflammatory disease. Inflammation has been implicated in the etiology of coronary artery disease in the general population, and traditional inflammatory biomarkers such as C-reactive protein (CRP) and interleukin-6 (IL-6) have been shown to predict cardiovascular events in both symptomatic and asymptomatic individuals as well as those in the uremic population. Later on, new nontraditional markers were related to the risk of cardiovascular morbidity and mortality in general and in uremic population. As a consequence of the expanding research base and availability of assays, the number of inflammatory marker tests ordered by clinicians for cardiovascular disease (CVD) risk prediction has grown rapidly and several commercial assays have become available. So, up to now we can consider that several new nontraditional markers as CD40-CD40 ligand system and pentraxin-3 seem to be significant features of cardiovascular disease in general and in ESRD population. PMID:22701810

Panichi, Vincenzo; Scatena, Alessia; Migliori, Massimiliano; Marchetti, Valentina; Paoletti, Sabrina; Beati, Sara

2012-01-01

109

T helper cell subclasses and clinical disease states.  

PubMed

The functionally different CD4 T helper cell subsets known as T helper 1 (Th1) and T helper 2 (Th2) display a unique and different cytokine profile. Abnormal skewing toward Th1 or Th2 cells has been suggested to play an important role in the pathogenesis of autoimmune disorders and in inflammatory and allergic diseases. The Th1/Th2 paradigm continues to serve as a model to understand the pathogenesis of several pathologic conditions and provides the rationale for the development of new strategies for treating and preventing these diseases. Over the past year, efforts have continued to increase our understanding of the mechanisms underlying the development and regulation of Th cells and their pathogenic role and therapeutic potential in the induction and treatment of clinic diseases. Several teams of researchers have further examined the association of Th1/Th2 inducing factors and allergic disease and intestinal inflammatory diseases. The protective effect of helminth infection on allergy and the role of regulatory T cells in both Th1- and Th2-mediated diseases have been further examined. PMID:17033353

Shi, Hai Ning; Walker, W Allan

2002-11-01

110

Proposing a Master One-Way Function Polynomial Morphology * Intractability Metric  

E-print Network

Proposing a Master One-Way Function Polynomial Morphology * Intractability Metric Gideon Samid, for that ciphersystem will be the result of hashing of p. We can write therefore: c=p2 crypto. And conversely: p = c operation of an arbitrary string using a given cipher system may be regarded as a "sterile" metrics

111

The Intractability of Computing the Hamming Bodo Manthey and Rudiger Reischuk  

E-print Network

The Intractability of Computing the Hamming Distance Bodo Manthey and R¨udiger Reischuk Universit/reischuk@tcs.uni-luebeck.de Abstract. Given a string x and a language L, the Hamming distance of x to L is the minimum Hamming distance prove that there is a language in AC0 such that both Hamming and edit distance to this language are hard

Al Hanbali, Ahmad

112

Developing Agency through Peacebuilding in the Midst of Intractable Conflict: The Case of Israel and Palestine  

ERIC Educational Resources Information Center

This paper discusses the presence of "peacebuilding islands" within civil society as potential agents of transformation in the midst of intractable conflict. Focusing on the particular case of the Israeli-Palestinian conflict, the argument stems from a deconstruction of the legacy of national myopia perpetuated through social and political…

Plonski, Sharri

2005-01-01

113

Intractable Hiccups: The Role of Cerebral MR in Cases without Systemic Cause  

Microsoft Academic Search

PURPOSE: To look for central nervous system abnormalities as possible causes of intractable hiccups. METHODS: Of a series of 50 patients with chronic (ie, lasting more than 48 hours) hiccups, a prospective study identified a subgroup of 9 patients with no clinical or gastroesopha- geal abnormalities (according to endoscopy, pH monitoring, and manometry). We performed in all 9 patients brain

K. Marsot-Dupuch; V. Bousson; J. Cabane; J. M. Tubiana

114

The perceived characteristics of irresolvable, resolvable and resolved intimate conflicts : Is there evidence of intractability?  

Microsoft Academic Search

Purpose – The paper seeks to investigate the characteristics of irresolvable interpersonal conflicts by comparing irresolvable conflicts to resolvable and resolved conflicts on each of Coleman's common social psychological factors associated with intractable conflicts. Design\\/methodology\\/approach – Undergraduate students were randomly assigned to complete questionnaires about an irresolvable conflict, a resolvable conflict, or a resolved conflict. Participants reported on conflicts in

Courtney Waite Miller; Michael E. Roloff

2006-01-01

115

Growth Failure in Children with Intractable Epilepsy Is Not Due to Increased Resting Energy Expenditure  

ERIC Educational Resources Information Center

The aim of this study was to evaluate the resting energy expenditure (REE) of children with intractable epilepsy (IE) compared with healthy children, and to determine factors that contribute to the pattern of REE. REE, growth status, and body composition were assessed in 25 prepubertal children with IE (15 males, 10 females; mean age 5y 5mo [SD 2y…

Bergqvist, A. G. Christina; Trabulsi, Jillian; Schall, Joan I.; Stallings, Virginia A.

2008-01-01

116

Intractable Postpartum Hemorrhage Resulting from Uterine Artery Pseudoaneurysm: Superselective Arteriographic Embolization via the Collateral Route  

SciTech Connect

We present a patient with intractable postpartum hemorrhage resulting from uterine artery pseudoaneurysm despite bilateral hypogastric artery ligation who was successfully treated by an endovascular approach via the collateral route. Although there is a good argument for postponing surgery until transcatheter embolization has been attempted, this case shows that embolization can still be successful even if the iliac vessels have been ligated.

Doenmez, Halil, E-mail: hdonmez68@yahoo.com; Oztuerk, M. Halil; Guergen, Fatma; Soylu, Serra O.; Hekimoglu, Baki [S.B. Diskapi Yildirim Beyazit Egitim ve Arastirma Hastanesi, Department of Radiology (Turkey)

2007-04-15

117

New York State Department of Health Meningococcal Disease  

E-print Network

of meningococcal disease. Is the vaccine safe? Are there adverse side effects to the vaccine? Both vaccines are currently available and both are safe and effective vaccines. However, both vaccines may cause mild and infrequent side effects, such as redness and pain at the injection site lasting up to two days. Who should

118

State of non-communicable diseases in Nepal  

PubMed Central

Background The prevalence of Non Communicable Diseases (NCDs) is still unknown in Nepal. The Ministry of Health and Population, Government of Nepal has not yet formulated policy regarding NCDs in the absence of evidence based finding. The study aims to find out the hospital based prevalence of NCDs in Nepal, thus directing the concerned authorities at policy level. Methods A cross sectional study was conducted to identify the hospital based prevalence of 4 NCDs (cancer, cardiovascular disease, diabetes mellitus and chronic obstructive pulmonary disease), wherein 400 indoor patients admitted during 2009 were randomly selected from each of the 31 selected health institutions which included all non-specialist tertiary level hospitals outside the Kathmandu valley (n?=?25), all specialist tertiary level hospitals in the country (n?=?3) and 3 non-specialist tertiary level hospitals inside the Kathmandu valley. In case of Kathmandu valley, 3 non-specialist health institutions- one central hospital, one medical college and one private hospital were randomly selected. The main analyses are based on the 28 non-specialist hospitals. Univariate (frequency and percentage) and bivariate (cross-tabulation) analysis were used. Results In non-specialist institutions, the hospital based NCD prevalence was 31%. Chronic obstructive pulmonary disease (43%) was the most common NCD followed by cardiovascular disease (40%), diabetes mellitus (12%) and cancer (5%). Ovarian (14%), stomach (14%) and lung cancer (10%) were the main cancers accounting for 38% of distribution. Majority of CVD cases were hypertension (47%) followed by cerebrovascular accident (16%), congestive cardiac failure (11%), ischemic heart disease (7%), rheumatic heart disease (5%) and myocardial infarction (2%). CVD was common in younger age groups while COPD in older age groups. Majority among males (42%) and females (45%) were suffering from COPD. Conclusions The study was able to reveal that Nepal is also facing the surging burden of NCDs similar to other developing nations in South East Asia. Furthermore, the study has provided a background data on NCDs in Nepal which should prove useful for the concerned organizations to focus and contribute towards the prevention, control and reduction of NCD burden and its risk factors. PMID:24405646

2014-01-01

119

A State-Wide Research Network for Alzheimer's Disease  

SciTech Connect

The Specific Aim of the proposal was to develop an administrative structure that will facilitate the development of AD research across the state of SC by providing key services such as (but not limited to) seeking funding research opportunities, financial tracking, regulatory management, central recruitment, training for investigators and coordinators, data collection, data storing, and data processing to researchers across the state.

Mintzer, Jacobo E.; Bachman, D. L.; Stuckey, M.; Ebeling, M.; Wagner, M. T.; Evans, W. J.; Hirth, V.; Walker, A.; Joglekar, R.; Faison, W.

2014-03-13

120

AJTMH manuscript number 00-231 Title: LYME DISEASE IN NEW YORK STATE: SPATIAL PATTERN AT A REGIONAL  

E-print Network

1 COVER PAGE AJTMH manuscript number 00-231 Title: LYME DISEASE IN NEW YORK STATE: SPATIAL PATTERN-442-4343; FAX: 518-442-4767 Key Words: correlation distance, Lyme disease, New York State, spatial 2001, pp. 538-555. #12;2 LRH: GLAVANAKOV AND OTHERS RRH: SPATIAL PATTERN IN LYME DISEASE LYME DISEASE

Varela, Carlos

121

Platelet function rather than plasmatic coagulation explains hypercoagulable state in cholestatic liver disease  

Microsoft Academic Search

Background\\/Aims: As compared to other chronic liver diseases, cholestatic disorders are associated with a better outcome of variceal bleeding and less blood loss at transplantation, suggesting the presence of a hypercoagulable state. We have assessed plasmatic coagulation and platelet function in patients with cholestatic and non-cholestatic liver disease.Methods: Thirty-seven patients with chronic cholestatic liver disease (primary biliary cirrhosis (PBC)\\/primary sclerosing

Rudolf Pihusch; Andreas Rank; Peter Göhring; Markus Pihusch; Erhard Hiller; Ulrich Beuers

2002-01-01

122

Intractable desquamative interstitial pneumonia in a tattooed man.  

PubMed

A 20-year-old man with a 15 pack-year history of cigarette smoking had a tattoo outlined on his back with blue pigment. He noticed a dry cough and shortness of breath on exertion when the pigment of other colors was added at the age of 27. He visited our hospital two years later because of severe dyspnea. He was diagnosed with desquamative interstitial pneumonia by surgical lung biopsy. Steroid therapy with cessation of smoking was partially effective, however his disease worsened again and he died three and a half years after the diagnosis because of respiratory failure. PMID:17043377

Arai, Toru; Inoue, Yoshikazu; Hayashi, Seiji; Akira, Masanori; Yamamoto, Satoru; Travis, William D; Sakatani, Mitsunori

2006-01-01

123

Effects of Climate on Variability in Lyme Disease Incidence in the Northeastern United States  

Microsoft Academic Search

Numbers of reported Lyme disease cases have increased dramatically over the past decade in the northeastern United States, but the year-to-year variability is sizable (average standard deviation ~30% of the mean). An improved understanding of the causes of such variability would aid in prevention and control of the disease, which is transmitted by a spirochete carried in the \\

Susan Subak

124

The burden of disease and injury in the United States 1996  

Microsoft Academic Search

BACKGROUND: Burden of disease studies have been implemented in many countries using the Disability-Adjusted Life Year (DALY) to assess major health problems. Important objectives of the study were to quantify intra-country differentials in health outcomes and to place the United States situation in the international context. METHODS: We applied methods developed for the Global Burden of Disease (GBD) to data

Catherine M Michaud; Matthew T McKenna; Stephen Begg; Niels Tomijima; Meghna Majmudar; Maria T Bulzacchelli; Shahul Ebrahim; Majid Ezzati; Joshua A Salomon; Jessica Gaber Kreiser; Mollie Hogan; Christopher JL Murray

2006-01-01

125

Therapeutic neovascularization for coronary disease: current state and future prospects  

Microsoft Academic Search

Despite advances in surgical and percutaneous revascularization techniques, nearly one-third of patients with ischemic coronary\\u000a artery disease are not candidates for revascularization due to suboptimal anatomy or receive suboptimal revascularization\\u000a from these standard procedures. Neovascularization of the myocardium is not only a physiologic response to ischemia, but also\\u000a potentially the target of new therapeutic strategies. Induced angiogenesis via protein, gene,

Antonio D. Lassaletta; Louis M. Chu; Frank W. Sellke

126

Crohn’s Disease: an Immune Deficiency State  

Microsoft Academic Search

Crohn’s disease is a chronic inflammatory disorder primarily affecting the gastrointestinal tract. Its clinical manifestations\\u000a arise from a substantial infiltration of the intestinal mucosa by activated leukocytes and the downstream consequences of\\u000a chronic inflammation. The underlying cause driving this immunological reaction remains poorly understood. A number of hypotheses\\u000a have been proposed, most of which postulate a primary over-activation of the

Daniel J. B. Marks; Farooq Z. Rahman; Gavin W. Sewell; Anthony W. Segal

2010-01-01

127

Most States Not Ready to Handle Infectious Disease Outbreaks  

MedlinePLUS

... control at medical centers, attempts to prepare for climate change, and surveillance efforts to track cases of HIV ... strike the United States as a result of climate change. These include mosquito-borne illnesses like chikungunya, West ...

128

Cervical Endometriosis, a Case Presenting With Intractable Spotting  

PubMed Central

Abstract and Introduction Abstract Cervix uteri is regarded as an infrequent localization for endometriosis. With widespread use of invasive cervical procedures, however, an increased incidence can be expected. Limited awareness of the clinical appearance of the disease may account for its apparent rarity. This presentation aims to refocus attention to the disease by reviewing the case of a woman who presented to us with minimal metrorrhagia, which is a rare symptom of cervical endometriosis. Introduction Although reports of cervical endometriosis were relatively frequent in the 1950s and 1960s, one finds few recent reports of cervical endometriosis; this may account for the common idea that cervix uteri is a rare localization for endometriosis. In a colposcopic examination series published in 1987,[1] the incidence of cervical endometriosis was reported to be between 0.11% and 2.4%. Procedures traumatizing the cervix increase the likelihood of development of cervical endometriosis.[2] As biopsy, loop excision procedures, and laser treatments are more commonly performed than they were at the time of these earlier reports, an increase in the prevalence of cervical endometriosis can be expected. The purpose of this report is 2-fold: to remind clinicians of the neglected topic of endometriosis of the uterine cervix and to show that cervical endometriosis can be encountered in different clinical presentations. PMID:16369442

Ata, Baris; Ates, Ugur; Usta, Taner; Attar, Erkut

2005-01-01

129

Putting Chronic Disease on the Map: Building GIS Capacity in State and Local Health Departments  

PubMed Central

Techniques based on geographic information systems (GIS) have been widely adopted and applied in the fields of infectious disease and environmental epidemiology; their use in chronic disease programs is relatively new. The Centers for Disease Control and Prevention’s Division for Heart Disease and Stroke Prevention is collaborating with the National Association of Chronic Disease Directors and the University of Michigan to provide health departments with capacity to integrate GIS into daily operations, which support priorities for surveillance and prevention of chronic diseases. So far, 19 state and 7 local health departments participated in this project. On the basis of these participants’ experiences, we describe our training strategy and identify high-impact GIS skills that can be mastered and applied over a short time in support of chronic disease surveillance. We also describe the web-based resources in the Chronic Disease GIS Exchange that were produced on the basis of this training and are available to anyone interested in GIS and chronic disease (www.cdc.gov/DHDSP/maps/GISX). GIS offers diverse sets of tools that promise increased productivity for chronic disease staff of state and local health departments. PMID:23786907

Casper, Michele; Tootoo, Joshua; Schieb, Linda

2013-01-01

130

Kissing Bugs in the United States: Risk for Vector-Borne Disease in Humans  

PubMed Central

Eleven species of kissing bugs are found in the United States. Their home ranges may be expanding northward, perhaps as a consequence of climate change. At least eight of the species, perhaps all, are reported to harbor Trypanosoma cruzi, the parasite that causes Chagas disease. Because humans are encroaching on kissing bug habitat, there is concern for vector-transmitted Chagas disease in the United States. To date, documented autochthonous cases of Chagas in humans in the United States are rare. Kissing bugs are capable of adapting to new habitats such as human domiciles; however, they do not colonize homes in the United States as in Central and South America. We review the biology, behavior, and medical importance of kissing bugs and the risk they pose for transmission of Chagas disease in the United States. Where possible, descriptions of US species are compared to the epidemiologically important Latin American species. PMID:25574143

Klotz, Stephen A; Dorn, Patricia L; Mosbacher, Mark; Schmidt, Justin O

2014-01-01

131

Paediatric intractable epilepsy syndromes: changing concepts in diagnosis and management.  

PubMed

Epilepsy surgery for drug-resistant childhood epilepsy is not new. However, brain imaging, surgical and anaesthetic techniques have improved to the extent that they are now as much safer and realistic option than they were in the past. Further, the range of surgical candidates is wide, and previous concepts about likely surgical candidates are now challenged as children with previously thought widespread or apparent multifocal disease are evaluated. Outcomes for seizure freedom range from 40 to 80 % depending on the underlying aetiology and the extent of resection. However, the aims of surgery may include seizure reduction in some and improvement in neurodevelopment and behaviour in others, which are less -predictable. Epilepsy surgery in children is no longer a last resort. Children thought to be likely candidates should be evaluated early in their natural history to optimise outcomes in the long term. PMID:23250836

Follett, Pamela L; Vora, Nitishkumar; Cross, J Helen

2012-01-01

132

The adrenal gland: common disease states and suspected new applications.  

PubMed

The adrenal gland, while small in size, provides a major punch to human metabolism. The interplay between the adrenal cortex hormones aldosterone and cortisol provides needed regulation to human metabolism. Aldosterone regulates the body sodium content affecting blood pressure thru fluid-volume regulation by the kidney. Cortisol, also from the adrenal cortex, contributes to regulation of glucose and protein metabolism. Diseases like addison's disease and Cushing's syndrome that affect the normal levels of these hormones can lead to serious pathologies that need to be detected thru clinical laboratory testing. The inner core of the adrenal gland, called the medulla, houses the catecholamine epinephrine, a fast acting neuropeptide hormone that can influence body action and energy levels quickly. The pheochromocytomas pathology of the adrenal medulla adversely affects the medulla hormones and needs to be recognized by clinical laboratory testing. The overview of the adrenal gland and its potential pathologies needs to be looked at anew in relation to post-traumatic stress disorder to find any linkage that may aid in the treatment and cure of our affected military soldiers. This interrelationship between cortisol and epinephrine in PTSD should be closely evaluated to determine if the suspected linkages are significant. PMID:23772480

Gorman, Linda S

2013-01-01

133

Hansen disease among Micronesian and Marshallese persons living in the United States.  

PubMed

An increasing proportion of Hansen disease cases in the United States occurs among migrants from the Micronesian region, where leprosy prevalence is high. We abstracted surveillance and clinical records of the National Hansen's Disease Program to determine geographic, demographic, and clinical patterns. Since 2004, 13% of US cases have occurred in this migrant population. Although Hawaii reported the most cases, reports have increased in the central and southern states. Multibacillary disease in men predominates on the US mainland. Of 49 patients for whom clinical data were available, 37 (75%) had leprosy reaction, neuropathy, or other complications; 17 (37%) of 46 completed treatment. Comparison of data from the US mainland with Hawaii and country-of-origin suggests under-detection of cases in pediatric and female patients and with paucibacillary disease in the United States. Increased case finding and management, and avoidance of leprosy-labeled stigma, is needed for this population. PMID:21762573

Woodall, Patricia; Scollard, David; Rajan, Latha

2011-07-01

134

Hansen Disease among Micronesian and Marshallese Persons Living in the United States  

PubMed Central

An increasing proportion of Hansen disease cases in the United States occurs among migrants from the Micronesian region, where leprosy prevalence is high. We abstracted surveillance and clinical records of the National Hansen’s Disease Program to determine geographic, demographic, and clinical patterns. Since 2004, 13% of US cases have occurred in this migrant population. Although Hawaii reported the most cases, reports have increased in the central and southern states. Multibacillary disease in men predominates on the US mainland. Of 49 patients for whom clinical data were available, 37 (75%) had leprosy reaction, neuropathy, or other complications; 17 (37%) of 46 completed treatment. Comparison of data from the US mainland with Hawaii and country-of-origin suggests under-detection of cases in pediatric and female patients and with paucibacillary disease in the United States. Increased case finding and management, and avoidance of leprosy-labeled stigma, is needed for this population. PMID:21762573

Woodall, Patricia; Rajan, Latha

2011-01-01

135

Pulsed radiofrequency treatment within brachial plexus for the management of intractable neoplastic plexopathic pain.  

PubMed

We report on the use of pulsed radiofrequency (RF) within the plexus for the management of intractable pain in three patients with metastatic or invasive plexopathy. The patients were a 38-year-old woman with a history of breast cancer 6 years earlier whose computed tomography (CT) scans revealed a mass lesion at the infraclavicular part of the right brachial plexus, a 68-year-old man diagnosed with advanced lung cancer whose CT scans revealed a bone metastasis in the right humerus invading the axillary region of the right brachial plexus, and a 67-year-old woman diagnosed with advanced lung cancer whose CT scans revealed a bone metastasis in the left humerus invading the axillary region of the left brachial plexus. Ultrasound-guided pulsed RF was performed within the interscalene brachial plexus. During the follow-up period, their intractable pain was moderately controlled. PMID:23070568

Arai, Young-Chang P; Nishihara, Makoto; Aono, Shuichi; Ikemoto, Tatsunori; Suzuki, Chiharu; Kinoshita, Akiko; Ushida, Takahiro

2013-04-01

136

Alzheimer's Disease and Related Disorders in State Mental Hospitals: Data from a Nationwide Survey.  

ERIC Educational Resources Information Center

Reports data from nationwide survey of state mental hospitals, providing exploratory look at patients with Alzheimer's disease and related disorders currently residing in state hospitals. Describes admissions trends, reasons for admission, and sources of referral. Discusses civil commitment of nursing home patients with dementing illnesses and…

Moak, Gary S.; Fisher, William H.

1990-01-01

137

Embolization—An optional treatment for intractable hemorrhage from a malignant rectovaginal fistula  

Microsoft Academic Search

PURPOSE: Patients rarely have intractable hemorrhage from rectovaginal fistulas, which usually require surgical intervention. This report presents our experience with nonsurgical treatment of a high-risk patient with uncontrolled hemorrhage originating from a malignant rectovaginal fistula. METHODS: A 74-year-old female developed uncontrolled hemorrhage from a malignant rectovaginal fistula. Because of her poor physical condition, an embolization with metal clips of the

T. Dushnitsky; Y. Ziv; A. Peer; A. Halevy

1999-01-01

138

Percutaneous Cyanoacrylate Glue Injection into the Renal Pseudoaneurysm to Control Intractable Hematuria After Percutaneous Nephrolithotomy  

SciTech Connect

We report a case of a 43-year-old man who developed intractable hematuria after percutaneous nephrolithotomy. Angiography detected a pseudoaneurysm arising from the lower polar artery; however, embolization could not be performed because of unfavorable vascular anatomy. A percutaneous thrombin injection under ultrasound guidance initially controlled the bleeding, but hematuria subsequently recurred as a result of recanalization of the aneurysm. The case was successfully managed with ultrasound- and fluoroscopic-guided direct injection of cyanoacrylate glue into the pseudoaneurysm.

Lal, Anupam, E-mail: dralal@rediffmail.com; Kumar, Ajay; Prakash, Mahesh; Singhal, Manphool [Post Graduate Institute of Medical Education and Research (PGIMER), Department of Radiodiagnosis and Imaging (India); Agarwal, Mayank Mohan; Sarkar, Debansu [Post Graduate Institute of Medical Education and Research (PGIMER), Department of Urology (India); Khandelwal, Niranjan [Post Graduate Institute of Medical Education and Research (PGIMER), Department of Radiodiagnosis and Imaging (India)

2009-07-15

139

X-linked immune dysregulation, neonatal insulin dependent diabetes, and intractable diarrhoea.  

PubMed Central

Four related male infants presented with neonatal diabetes mellitus, immune dysregulation with extremely high concentrations of immunoglobulin E, and intractable diarrhoea. They were all from one family, and all of them died. As far as is known this X-linked recessive disorder has not been described before. It is suggested that this is a new immunodeficiency in which type 2 T helper responses predominate. PMID:8777684

Peake, J. E.; McCrossin, R. B.; Byrne, G.; Shepherd, R.

1996-01-01

140

Discovery and use of efficient biomarkers for objective disease state assessment in Alzheimer's disease.  

PubMed

Objective and early detection of Alzheimer's disease (AD) is a demanding problem requiring consideration of manymodal observations. Potentially, many features could be used to discern between people without AD and those at different stages of the disease. Such features include results from cognitive and memory tests, imaging (MRI, PET) results, cerebral spine fluid data, blood markers etc. However, in order to define an efficient and limited set of features that can be employed in classifiers requires mining of data from many patient cases. In this study we used two databases, ADNI and Kuopio LMCI, to investigate the relative importance of features and their combinations. Optimal feature combinations are to be used in a Clinical Decision Support System that is to be used in clinical AD diagnosis practice. PMID:21095977

van Gils, Mark; Koikkalainen, Juha; Mattila, Jussi; Herukka, Sannakaisa; Lotjonen, Jyrki; Soininen, Hilkka

2010-01-01

141

Drosophila as a Model for Intractable Epilepsy: Gilgamesh Suppresses Seizures in parabss1 Heterozygote Flies  

PubMed Central

Intractable epilepsies, that is, seizure disorders that do not respond to currently available therapies, are difficult, often tragic, neurological disorders. Na+ channelopathies have been implicated in some intractable epilepsies, including Dravet syndrome (Dravet 1978), but little progress has been forthcoming in therapeutics. Here we examine a Drosophila model for intractable epilepsy, the Na+ channel gain-of-function mutant parabss1 that resembles Dravet syndrome in some aspects (parker et al. 2011a). In particular, we identify second-site mutations that interact with parabss1, seizure enhancers, and seizure suppressors. We describe one seizure-enhancer mutation named charlatan (chn). The chn gene normally encodes an Neuron-Restrictive Silencer Factor/RE1-Silencing Transcription factor transcriptional repressor of neuronal-specific genes. We identify a second-site seizure-suppressor mutation, gilgamesh (gish), that reduces the severity of several seizure-like phenotypes of parabss1/+ heterozygotes. The gish gene normally encodes the Drosophila ortholog of casein kinase CK1g3, a member of the CK1 family of serine-threonine kinases. We suggest that CK1g3 is an unexpected but promising new target for seizure therapeutics. PMID:23797108

Howlett, Iris C.; Rusan, Zeid M.; Parker, Louise; Tanouye, Mark A.

2013-01-01

142

Magnetoencephalography-guided epilepsy surgery for children with intractable focal epilepsy: SickKids experience.  

PubMed

We introduced magnetoencephalography (MEG)-guided epilepsy surgery for children with intractable focal epilepsy at The Hospital for Sick Children (SickKids) in Toronto, Canada. Surgical candidacy and decisions on surgical procedure for children with intractable focal epilepsy are based on long-term scalp video EEG (VEEG) results, magnetic resonance imaging (MRI) findings, and the distribution of MEG spike sources. After multidisciplinary discussion at the seizure conference, for the patients requiring intracranial VEEG, custom-made subdural electrode grids are designed using three-dimensional MRI superimposed with MEG spike sources to cover the area of clustered MEG spike sources. At the first surgery, neurosurgeons use the intraoperative neuronavigation system to visualize the area of clustered spike dipoles and somatosensory evoked fields on MEG to place the subdural grid and depth electrodes. At the second surgery, the area of seizure onset and active interictal spike discharges on the intracranial VEEG recording, which usually correlates with the zone of clustered MEG spike sources, is resected. This combination leads to successful surgical outcome to control seizures in these challenging paediatric patients. MEG is a useful tool in children with intractable focal epilepsy to determine the surgical candidacy and focal cortical resection to stop seizures. PMID:18313780

Ochi, Ayako; Otsubo, Hiroshi

2008-05-01

143

The Ketogenic and Atkins Diets Effect on Intractable Epilepsy: A Comparison  

PubMed Central

Objective Intractable epilepsy is a major difficulty in child neurology, because the numbers of drugs that are available for treatment are limited and new treatments such as diets must be tried. Now there are some diets available for treating patients with intractable epilepsy. The oldest diet is the classic ketogenic diet and one of the newest diets is the modified Atkins diet. Patients have a harder time accepting the classic ketogenic diet than the Atkins diet, which is easier to accept because the food tastes better. This study compares the efficacy of the ketogenic diet and the Atkins diet for intractable epilepsy in children. Materials & Methods This study is a clinical trial survey with sample size of 40 children with refractory epilepsy who were patients at Mofid hospital in Tehran, Iran. Initially, from Jan 2005–Oct 2007, 20 children were treated with the Atkins diet, and then from Oct 2007–March 2010, the other group was treated with the classic ketogenic diet and the results were compared. Results In this study, response to treatment was greater than a 50% reduction in seizures and at the end of first, second, and third months for the ketogenic diet were 55%, 30%, and 70% and for the Atkins diet were 50%, 65%, and 70%, respectively. Conclusion The results of this study show that there is no significant difference between the classic Ketogenic diet and the Atkins diet at the end of first, second, and third months and both had similar responses to the treatments. PMID:25143768

GHAZAVI, Ahad; TONEKABONI, Seyed Hassan; KARIMZADEH, Parvaneh; NIKIBAKHSH, Ahmad Ali; KHAJEH, Ali; FAYYAZI, Afshin

2014-01-01

144

Intractable hiccup as the presenting symptom of cavernous hemangioma in the medulla oblongata: a case report and literature review.  

PubMed

A case of intractable hiccup developed by cavernous hemangioma in the medulla oblongata is reported. There have been only five previously reported cases of medullary cavernoma that triggered intractable hiccup. The patient was a 28-year-old man who was presented with intractable hiccup for 15 days. It developed suddenly, then aggravated progressively and did not respond to any types of medication. On magnetic resonance images, a well-demarcated and non-enhancing mass with hemorrhagic changes was noted in the left medulla oblongata. Intraoperative findings showed that the lesion was fully embedded within the brain stem and pathology confirmed the diagnosis of cavernous hemangioma. The hiccup resolved completely after the operation. Based on the presumption that the medullary cavernoma may trigger intractable hiccup by displacing or compression the hiccup arc of the dorsolateral medulla, surgical excision can eliminate the symptoms, even in the case totally buried in brainstem. PMID:25237438

Lee, Kyung-Hwa; Moon, Kyung-Sub; Jung, Min-Young; Jung, Shin

2014-06-01

145

Intractable Hiccup as the Presenting Symptom of Cavernous Hemangioma in the Medulla Oblongata: A Case Report and Literature Review  

PubMed Central

A case of intractable hiccup developed by cavernous hemangioma in the medulla oblongata is reported. There have been only five previously reported cases of medullary cavernoma that triggered intractable hiccup. The patient was a 28-year-old man who was presented with intractable hiccup for 15 days. It developed suddenly, then aggravated progressively and did not respond to any types of medication. On magnetic resonance images, a well-demarcated and non-enhancing mass with hemorrhagic changes was noted in the left medulla oblongata. Intraoperative findings showed that the lesion was fully embedded within the brain stem and pathology confirmed the diagnosis of cavernous hemangioma. The hiccup resolved completely after the operation. Based on the presumption that the medullary cavernoma may trigger intractable hiccup by displacing or compression the hiccup arc of the dorsolateral medulla, surgical excision can eliminate the symptoms, even in the case totally buried in brainstem. PMID:25237438

Lee, Kyung-Hwa; Jung, Min-Young; Jung, Shin

2014-01-01

146

ER Calcium and Alzheimer's Disease: In a State of Flux  

NSDL National Science Digital Library

The calcium ion (Ca2+) plays fundamental roles in orchestrating dynamic changes in the function and structure of nerve cell circuits in the brain. The endoplasmic reticulum (ER), an organelle that actively removes Ca2+ from the cytoplasm, can release stored Ca2+ through ER membrane receptor channels responsive either to the lipid messenger inositol trisphosphate(IP3) or to cytosolic Ca2+. Emerging findings suggest that perturbed ER Ca2+ homeostasis contributes to the dysfunction and degeneration of neurons that occurs in Alzheimer’s disease (AD). Presenilin-1 (PS1) is an integral membrane protein in the ER; mutations in PS1 that cause early-onset inherited AD increase the pool of ER Ca2+ available for release and also enhance Ca2+ release through ER IP3- and ryanodine-sensitive channels. By enhancing Ca2+ flux across the ER membrane, PS1 mutations may exaggerate Ca2+ signaling in synaptic terminals and thereby render them vulnerable to dysfunction and degeneration in the settings of aging and amyloid accumulation in AD.

Mark P. Mattson (Baltimore; National Institute on Aging Intramural Research Program REV)

2010-03-23

147

[State of the art in invasive diseases by filamentous fungi.  

PubMed

Invasive fungal infections have become a major cause of morbimortality in intensive care patients, persons suffering from cancer or immune deficiencies, and other diseases with impaired immunity. Candida albicans remains the most frequent fungal pathogen, but advances in the diagnosis, prevention and treatment of invasive candidiasis are leading to important etiological changes. Among the emerging invasive mycoses, are those caused by filamentous fungi, such as Aspergillus, Lomentospora/Scedosporium, Fusarium or the mucorales. Invasive aspergillosis is difficult to diagnose, and although there are diagnostic tools available, their use is not widespread, and their effectiveness varies depending on the specific groups of patients. Clinical suspicion in high-risk patients, radiological diagnosis and the use of biomarkers, such as 1,3-?-D-glucan and galactomannan can be of great help. However, diagnostic resources are limited in other mycoses, but radiology, pathological studies and the microbiological diagnosis can be useful. The high mortality of these mycoses requires early empirical antifungal treatment in many cases. Voriconazole is the first choice for treatment of the majority of aspergillosis, scedosporiasis, fusariosis and other hyalohyphomycoses. Treatments of the mucormycoses, Lomentospora prolificans infections or mycoses by dematiaceous fungi are more complicated. Amphotericin B is active against many mucorales, but the combination of two or more antifungal agents could be a therapeutic alternative in many amphotericin B-refractory mycoses. Current clinical challenges include improving the diagnosis and the treatment of these mycoses, along with improving the adequate prevention in patients at high risk of suffering from them. PMID:25449676

Pemán, Javier; Quindós, Guillermo

2014-09-30

148

Effects of climate on variability in Lyme disease incidence in the northeastern United States.  

PubMed

Numbers of reported Lyme disease cases have increased dramatically over the past decade in the northeastern United States, but the year-to-year variability is sizable (average standard deviation approximately 30% of the mean). An improved understanding of the causes of such variability would aid in prevention and control of the disease, which is transmitted by a spirochete carried in the "black-legged" tick, Ixodes scapularis. In this study, the variability in reported Lyme disease incidence between 1993 and 2001 in seven northeastern US states was analyzed as an outcome of weather variability. For all seven states analyzed, significant (p < 0.05) positive relations were found for the correlation of early summer disease incidence with the June moisture index (Palmer Hydrological Drought Index) in the region 2 years previously. The correlations may reflect enhanced nymph tick survival in wetter conditions. Few significant relations were found with same-year moisture index, which suggests that moisture has a greater effect on nymph tick survival following the insect's blood meal than before. In some states, significant correlations were observed related to warmer winter weather a year and a half prior to disease incidence, which may have been due to higher survival and activity levels of the white-footed mouse, the main host for Lyme disease-infected ticks. PMID:12631543

Subak, Susan

2003-03-15

149

Nonalcoholic Wernicke's Encephalopathy Associated with Unintentional Weight Loss, Cholecystectomy, and Intractable Vomiting: The Role of Dual Thiamine and Corticosteroid Therapy  

PubMed Central

A 23-year-old male with one month of intractable vomiting, subsequent cholecystitis status post cholecystectomy, and overall 40-pound weight loss over the last few months presented with altered mental status and seizures. MRI showed signal abnormalities involving the hypothalamus, periaqueductal gray matter, 4th ventricle, and bilateral thalami, indicative of Wernicke's encephalopathy. The patient was started on empiric IV thiamine and methylprednisolone; thiamine levels were subsequently found to be low. Infectious disease workup was negative. Within a few days of this therapy, the patient's neurological status steadily improved with increased responsiveness and communication. Repeat MRI 7 days after admission showed significant resolution of the signal abnormalities. Over the next several weeks the patient became fully conversational, cognitively intact, and increasingly ambulatory. Nonalcoholic Wernicke's encephalopathy is rare; there have been reports relating it separately to vomiting and invasive surgery. In this case report, we associate it with both recurrent vomiting and minimally invasive cholecystectomy. We also discuss combinatorial therapy of thiamine and corticosteroids, which is poorly defined in the literature. Though there is no consensus-based optimal treatment of Wernicke's encephalopathy, this adds to the discussion of using dual therapy and supports that the use of empiric corticosteroids does not harm the patient. PMID:24716018

Donadee, Chenell; Gomez, Leslie; Zaretskaya, Marina

2014-01-01

150

Nonalcoholic Wernicke's Encephalopathy Associated with Unintentional Weight Loss, Cholecystectomy, and Intractable Vomiting: The Role of Dual Thiamine and Corticosteroid Therapy.  

PubMed

A 23-year-old male with one month of intractable vomiting, subsequent cholecystitis status post cholecystectomy, and overall 40-pound weight loss over the last few months presented with altered mental status and seizures. MRI showed signal abnormalities involving the hypothalamus, periaqueductal gray matter, 4th ventricle, and bilateral thalami, indicative of Wernicke's encephalopathy. The patient was started on empiric IV thiamine and methylprednisolone; thiamine levels were subsequently found to be low. Infectious disease workup was negative. Within a few days of this therapy, the patient's neurological status steadily improved with increased responsiveness and communication. Repeat MRI 7 days after admission showed significant resolution of the signal abnormalities. Over the next several weeks the patient became fully conversational, cognitively intact, and increasingly ambulatory. Nonalcoholic Wernicke's encephalopathy is rare; there have been reports relating it separately to vomiting and invasive surgery. In this case report, we associate it with both recurrent vomiting and minimally invasive cholecystectomy. We also discuss combinatorial therapy of thiamine and corticosteroids, which is poorly defined in the literature. Though there is no consensus-based optimal treatment of Wernicke's encephalopathy, this adds to the discussion of using dual therapy and supports that the use of empiric corticosteroids does not harm the patient. PMID:24716018

Verma, Vivek; Donadee, Chenell; Gomez, Leslie; Zaretskaya, Marina

2014-01-01

151

The thalamostriatal system in normal and diseased states  

PubMed Central

Because of our limited knowledge of the functional role of the thalamostriatal system, this massive network is often ignored in models of the pathophysiology of brain disorders of basal ganglia origin, such as Parkinson’s disease (PD). However, over the past decade, significant advances have led to a deeper understanding of the anatomical, electrophysiological, behavioral and pathological aspects of the thalamostriatal system. The cloning of the vesicular glutamate transporters 1 and 2 (vGluT1 and vGluT2) has provided powerful tools to differentiate thalamostriatal from corticostriatal glutamatergic terminals, allowing us to carry out comparative studies of the synaptology and plasticity of these two systems in normal and pathological conditions. Findings from these studies have led to the recognition of two thalamostriatal systems, based on their differential origin from the caudal intralaminar nuclear group, the center median/parafascicular (CM/Pf) complex, or other thalamic nuclei. The recent use of optogenetic methods supports this model of the organization of the thalamostriatal systems, showing differences in functionality and glutamate receptor localization at thalamostriatal synapses from Pf and other thalamic nuclei. At the functional level, evidence largely gathered from thalamic recordings in awake monkeys strongly suggests that the thalamostriatal system from the CM/Pf is involved in regulating alertness and switching behaviors. Importantly, there is evidence that the caudal intralaminar nuclei and their axonal projections to the striatum partly degenerate in PD and that CM/Pf deep brain stimulation (DBS) may be therapeutically useful in several movement disorders. PMID:24523677

Smith, Yoland; Galvan, Adriana; Ellender, Tommas J.; Doig, Natalie; Villalba, Rosa M.; Huerta-Ocampo, Icnelia; Wichmann, Thomas; Bolam, J. Paul

2014-01-01

152

Arginine de novo and nitric oxide production in disease states  

PubMed Central

Arginine is derived from dietary protein intake, body protein breakdown, or endogenous de novo arginine production. The latter may be linked to the availability of citrulline, which is the immediate precursor of arginine and limiting factor for de novo arginine production. Arginine metabolism is highly compartmentalized due to the expression of the enzymes involved in arginine metabolism in various organs. A small fraction of arginine enters the NO synthase (NOS) pathway. Tetrahydrobiopterin (BH4) is an essential and rate-limiting cofactor for the production of NO. Depletion of BH4 in oxidative-stressed endothelial cells can result in so-called NOS3 “uncoupling,” resulting in production of superoxide instead of NO. Moreover, distribution of arginine between intracellular transporters and arginine-converting enzymes, as well as between the arginine-converting and arginine-synthesizing enzymes, determines the metabolic fate of arginine. Alternatively, NO can be derived from conversion of nitrite. Reduced arginine availability stemming from reduced de novo production and elevated arginase activity have been reported in various conditions of acute and chronic stress, which are often characterized by increased NOS2 and reduced NOS3 activity. Cardiovascular and pulmonary disorders such as atherosclerosis, diabetes, hypercholesterolemia, ischemic heart disease, and hypertension are characterized by NOS3 uncoupling. Therapeutic applications to influence (de novo) arginine and NO metabolism aim at increasing substrate availability or at influencing the metabolic fate of specific pathways related to NO bioavailability and prevention of NOS3 uncoupling. These include supplementation of arginine or citrulline, provision of NO donors including inhaled NO and nitrite (sources), NOS3 modulating agents, or the targeting of endogenous NOS inhibitors like asymmetric dimethylarginine. PMID:23011059

Luiking, Yvette C.; Ten Have, Gabriella A. M.; Wolfe, Robert R.

2012-01-01

153

AJTMH manuscript number 00-231 Title: LYME DISEASE IN NEW YORK STATE: SPATIAL PATTERN AT A REGIONAL  

E-print Network

1 COVER PAGE AJTMH manuscript number 00-231 Title: LYME DISEASE IN NEW YORK STATE: SPATIAL PATTERN-442-4343; FAX: 518-442-4767 Key Words: correlation distance, Lyme disease, New York State, spatial in Microsoft Word 2000 (9.0.2831 SR-1) #12;2 LRH: GLAVANAKOV AND OTHERS RRH: SPATIAL PATTERN IN LYME DISEASE

Maniatty, William A.

154

West Nile virus and other arboviral diseases--United States, 2012.  

PubMed

Arthropod-borne viruses (arboviruses) are transmitted to humans primarily through the bites of infected mosquitoes and ticks. West Nile virus (WNV) is the leading cause of domestically acquired arboviral disease in the United States. However, several other arboviruses also cause sporadic cases and seasonal outbreaks of neuroinvasive disease (e.g., meningitis, encephalitis, and acute flaccid paralysis). In 2012, CDC received reports of 5,780 nationally notifiable arboviral disease cases (excluding dengue). A large multistate outbreak of WNV disease accounted for 5,674 (98%) of reported cases, the highest number reported since 2003. Other reported etiologies included Eastern equine encephalitis virus (EEEV), Powassan virus (POWV), St. Louis encephalitis virus (SLEV), and California serogroup viruses such as La Crosse virus (LACV) and Jamestown Canyon virus (JCV). Arboviruses continue to cause serious illness in substantial numbers of persons in the United States. Maintaining surveillance remains important to identify outbreaks and guide prevention efforts. PMID:23803959

2013-06-28

155

Fine-scale predictions of distributions of Chagas disease vectors in the state of Guanajuato, Mexico  

E-print Network

MODELING/GIS, RISK ASSESSMENT,ECONOMIC IMPACT Fine-Scale Predictions of Distributions of Chagas Disease Vectors in the State of Guanajuato, Mexico JORGE LO ´ PEZ-CA ´ RDENAS, 1 FRANCISCO ERNESTO GONZALEZ BRAVO, 2 PAZ MARIA SALAZAR SCHETTINO, 3 JUAN..., in the last decade, “additional” operative vector control activities have focused pri- marily in urban environments owing to increases in classical and hemorrhagic dengue transmission. (To date, vector-borne disease control activities are bud- geted only...

Ló pez-Cá tdenas, Jorge; Gonzalez-Bravo, Francisco Ernesto; Salazar-Schettino, Paz Maria; Gallaga-Solorzano, Juan Carlos; Ramí rez-Barba, Ector; Martinez-Mendez, Joel; Sá nchez-Cordero, Ví ctor; Peterson, A. Townsend; Ramsey, J. M.

2005-11-01

156

DNA Modifications: Function and Applications in Normal and Disease States  

PubMed Central

Epigenetics refers to a variety of processes that have heritable effects on gene expression programs without changes in DNA sequence. Key players in epigenetic control are chemical modifications to DNA, histone, and non-histone chromosomal proteins, which establish a complex regulatory network that controls genome function. Methylation of DNA at the fifth position of cytosine in CpG dinucleotides (5-methylcytosine, 5mC), which is carried out by DNA methyltransferases, is commonly associated with gene silencing. However, high resolution mapping of DNA methylation has revealed that 5mC is enriched in exonic nucleosomes and at intron-exon junctions, suggesting a role of DNA methylation in the relationship between elongation and RNA splicing. Recent studies have increased our knowledge of another modification of DNA, 5-hydroxymethylcytosine (5hmC), which is a product of the ten-eleven translocation (TET) proteins converting 5mC to 5hmC. In this review, we will highlight current studies on the role of 5mC and 5hmC in regulating gene expression (using some aspects of brain development as examples). Further the roles of these modifications in detection of pathological states (type 2 diabetes, Rett syndrome, fetal alcohol spectrum disorders and teratogen exposure) will be discussed. PMID:25340699

Liyanage, Vichithra R. B.; Jarmasz, Jessica S.; Murugeshan, Nanditha; Del Bigio, Marc R.; Rastegar, Mojgan; Davie, James R.

2014-01-01

157

DNA modifications: function and applications in normal and disease States.  

PubMed

Epigenetics refers to a variety of processes that have heritable effects on gene expression programs without changes in DNA sequence. Key players in epigenetic control are chemical modifications to DNA, histone, and non-histone chromosomal proteins, which establish a complex regulatory network that controls genome function. Methylation of DNA at the fifth position of cytosine in CpG dinucleotides (5-methylcytosine, 5mC), which is carried out by DNA methyltransferases, is commonly associated with gene silencing. However, high resolution mapping of DNA methylation has revealed that 5mC is enriched in exonic nucleosomes and at intron-exon junctions, suggesting a role of DNA methylation in the relationship between elongation and RNA splicing. Recent studies have increased our knowledge of another modification of DNA, 5-hydroxymethylcytosine (5hmC), which is a product of the ten-eleven translocation (TET) proteins converting 5mC to 5hmC. In this review, we will highlight current studies on the role of 5mC and 5hmC in regulating gene expression (using some aspects of brain development as examples). Further the roles of these modifications in detection of pathological states (type 2 diabetes, Rett syndrome, fetal alcohol spectrum disorders and teratogen exposure) will be discussed. PMID:25340699

Liyanage, Vichithra R B; Jarmasz, Jessica S; Murugeshan, Nanditha; Del Bigio, Marc R; Rastegar, Mojgan; Davie, James R

2014-01-01

158

Treatment of intractable orbital implant exposure with a large conjunctival defect by secondary insertion of the implant after preceding dermis fat graft  

PubMed Central

AIM To report a procedure and results of a two-stage operation to manage intractable extensive orbital implant exposure with a large conjunctival defect which was difficult to treat with dermis fat grafts due to repeated graft necrosis. METHODS A retrospective chart review of four patients who had extensive orbital implant exposures with large conjunctival defects and had past histories of repeated autologous or preserved dermis graft failures was done. As a first-stage operation, the problematic pre-existing orbital implants were removed and autologous dermis fat grafts alone were performed on the defect area. Four months later, new orbital implants were secondarily inserted after confirmation of graft survival. The size of the conjunctival defects and state of the extraocular muscles were checked preoperatively. Success of the operations and complications were investigated. RESULTS The mean size of the conjuctival defects was 17.3mm×16.0mm, and the mean time from the initial diagnosis of orbital implant exposure to implant removal and autologous dermis fat graft was 20.8 months. After implant removal and autologous dermis fat graft, no graft necrosis was observed in any patients. Also, implant exposure or fornix shortening was not observed in any patients after new orbital implant insertion. CONCLUSION The secondary insertion of a new orbital implant after pre-existing implant removal and preceding dermis fat graft is thought to be an another selective management of intractable orbital implant exposure in which dermis fat grafts persistently fail. PMID:23638423

Kim, Hyun Kyung; La, Tae Yoon

2013-01-01

159

Transitions between epithelial and mesenchymal states in development and disease.  

PubMed

The ancestors of modern Metazoa were constructed in large part by the foldings and distortions of two-dimensional sheets of epithelial cells. This changed approximately 600 million years ago with the evolution of mesenchymal cells. These cells arise as the result of epithelial cell delamination through a reprogramming process called an epithelial to mesenchymal transition (EMT) [Shook D, Keller R. Mechanisms, mechanics and function of epithelial-mesenchymal transitions in early development. Mech Dev 2003;120:1351-83; Thiery JP, Sleeman JP. Complex networks orchestrate epithelial-mesenchymal transitions. Nat Rev Mol Cell Biol 2006;7:131-42]. Because mesenchymal cells are free to migrate through the body cavity, the evolution of the mesenchyme opened up new avenues for morphological plasticity, as cells evolved the ability to take up new positions within the embryo and to participate in novel cell-cell interactions; forming new types of internal tissues and organs such as muscle and bone [Thiery JP, Sleeman, JP. Complex networks orchestrate epithelial-mesenchymal transitions. Nat Rev Mol Cell Biol 2006;7:131-42; Hay ED, Zuk A. Transformations between epithelium and mesenchyme: normal, pathological, and experimentally induced. Am J Kidney Dis 1995;26:678-90]. After migrating to a suitable site, mesenchymal cells coalesce and re-polarize to form secondary epithelia, in a so-called mesenchymal-epithelial transition (MET). Such switches between mesenchymal and epithelial states are a frequent feature of Metazoan gastrulation [Hay ED, Zuk A. Transformations between epithelium and mesenchyme: normal, pathological, and experimentally induced. Am J Kidney Dis 1995;26:678-90] and the neural crest lineage [Duband JL, Monier F, Delannet M, Newgreen D. Epitheliu-mmesenchyme transition during neural crest development. Acta Anat 1995;154:63-78]. Significantly, however, when hijacked during the development of cancer, the ability of cells to undergo EMT, to leave the primary tumor and to undergo MET at secondary sites can have devastating consequences on the organism, allowing tumor cells derived from epithelia to invade surrounding tissues and spread through the host [Thiery JP, Sleeman JP. Complex networks orchestrate epithelial-mesenchymal transitions. Nat Rev Mol Cell Biol 2006;7:131-42; Hay ED, Zuk A. Transformations between epithelium and mesenchyme: normal, pathological, and experimentally induced. Am J Kidney Dis 1995;26:678-90]. Thus, the molecular and cellular mechanisms underpinning EMT are both an essential feature of Metazoan development and an important area of biomedical research. In this review, we discuss the common molecular and cellular mechanisms involved in EMT in both cases. PMID:18343170

Baum, Buzz; Settleman, Jeffrey; Quinlan, Margaret P

2008-06-01

160

Perceived Benefits and Challenges of Coordinated Approaches to Chronic Disease Prevention in State Health Departments  

PubMed Central

Introduction Chronic disease prevention efforts have historically been funded categorically according to disease or risk factor. Federal agencies are now progressively starting to fund combined programs to address common risk. The purpose of this study was to inform transitions to coordinated chronic disease prevention by learning views on perceived benefits and challenges of a coordinated approach to funding. Methods A national survey on evidence-based public health was conducted from March through May 2013 among state health department employees working in chronic disease prevention (N = 865). Participants were asked to rank the top 3 benefits and top 3 challenges in coordinating chronic disease approaches from provided lists and could provide additional responses. Descriptive analyses, ?2 tests, and analysis of variance were conducted. Results The most common perceived benefits of coordinated approaches to chronic disease prevention were improved health outcomes, common risk factors better addressed, and reduced duplication of program efforts. The most common perceived challenges were funding restrictions, such as disease-specific performance measures; competing priorities; lack of communication across programs; funding might be reduced; agency not structured for program coordination; and loss of disease-specific partner support. Rankings of benefits and challenges were similar across states and participant roles; the perceived challenges “lack of communication across programs” (P = .02) and “funding might be reduced” differed by program area (P < .001). Conclusion Findings can be used by funding agencies and state health departments for planning, training, and technical assistance. The information on perceived challenges demonstrates the need to improve communication across programs, enhance organizational support for coordinated approaches, and create benefits for organizational partners. PMID:24809362

Sequeira, Sonia; Best, Leslie; Jones, Ellen; Baker, Elizabeth A.; Brownson, Ross C.

2014-01-01

161

Maternal, Perinatal, and Postneonatal Outcomes in Women With Chronic Heart Disease in Washington State  

PubMed Central

Objective To explore the association between the presence of maternal heart disease and maternal, perinatal, and infant outcomes. Methods We conducted a population-based retrospective cohort study using Washington State birth certificates linked with hospital discharge records of mothers noted to have maternal congenital heart disease, ischemic heart disease, heart failure or pulmonary hypertension. Women who gave birth between 1987 and 2009 (n=2,171) were compared to a sample of mothers without these conditions (n=21,710). We described characteristics of pregnant women with heart disease over time. Logistic regression estimated the association between reported chronic maternal heart disease and small for gestational age (SGA) birth, as well as perinatal, post-neonatal and maternal death. Results The proportion of births to women with reported heart disease increased 224% between the 1987-1994 and 2002-2009 calendar periods. Chronic maternal heart disease was associated with increased risk of SGA birth (62 additional SGA infants per 1,000 births, 95% CI 46-78, p <0.001), perinatal death (14 additional deaths per 1,000 births, 95% CI 8-20, p <0.001), postneonatal death (five additional deaths per 1,000 births, 95% CI 2-9, p<0.001) and maternal death (five additional deaths per 1,000 births, 95% CI 2-9, p<0.001). Conclusion The presence of chronic maternal heart disease is associated with elevated risk for poor maternal, perinatal, and postneonatal outcomes. PMID:23168751

Leary, Peter J; Leary, Sarah ES; Stout, Karen K; Schwartz, Stephen M; Easterling, Thomas R

2014-01-01

162

HIV-associated nephropathy and end-stage renal disease in children in the United States  

Microsoft Academic Search

Single-center studies have reported that HIV-associated nephropathy (HIVAN) can occur in children and may have a clinical course and prognosis similar to that of adults. However, the prevalence and survival has not been reported for a national sample of children with HIVAN and end-stage renal disease (ESRD) on dialysis in the United States. We utilized the United States Renal Data

Tejinder S. Ahuja; Kevin C. Abbott; Laura Pack; Yong-Fang Kuo

2004-01-01

163

Potential novel risk factors for autochthonous and sylvatic transmission of human Chagas disease in the United States  

PubMed Central

Chagas disease is an emerging vector-borne disease in the United States that causes progressive dilated cardiomyopathy in a third of infected humans. While transmission studies have been performed in Latin America, little is known about the source of infection in locally acquired cases in the United States. This letter describes the underlying factors possibly leading to an increased risk of disease transmission among high-risk groups in the United States. PMID:24996479

2014-01-01

164

The Association Between Extreme Precipitation and Waterborne Disease Outbreaks in the United States, 1948–1994  

PubMed Central

Objectives. Rainfall and runoff have been implicated in site-specific waterborne disease outbreaks. Because upward trends in heavy precipitation in the United States are projected to increase with climate change, this study sought to quantify the relationship between precipitation and disease outbreaks. Methods. The US Environmental Protection Agency waterborne disease database, totaling 548 reported outbreaks from 1948 through 1994, and precipitation data of the National Climatic Data Center were used to analyze the relationship between precipitation and waterborne diseases. Analyses were at the watershed level, stratified by groundwater and surface water contamination and controlled for effects due to season and hydrologic region. A Monte Carlo version of the Fisher exact test was used to test for statistical significance. Results. Fifty-one percent of waterborne disease outbreaks were preceded by precipitation events above the 90th percentile (P = .002), and 68% by events above the 80th percentile (P = .001). Outbreaks due to surface water contamination showed the strongest association with extreme precipitation during the month of the outbreak; a 2-month lag applied to groundwater contamination events. Conclusions. The statistically significant association found between rainfall and disease in the United States is important for water managers, public health officials, and risk assessors of future climate change. PMID:11499103

Curriero, Frank C.; Patz, Jonathan A.; Rose, Joan B.; Lele, Subhash

2001-01-01

165

Meteorological influences on the seasonality of Lyme disease in the United States.  

PubMed

Lyme disease (Borrelia burgdorferi infection) is the most common vector-transmitted disease in the United States. The majority of human Lyme disease (LD) cases occur in the summer months, but the timing of the peak occurrence varies geographically and from year to year. We calculated the beginning, peak, end, and duration of the main LD season in 12 highly endemic states from 1992 to 2007 and then examined the association between the timing of these seasonal variables and several meteorological variables. An earlier beginning to the LD season was positively associated with higher cumulative growing degree days through Week 20, lower cumulative precipitation, a lower saturation deficit, and proximity to the Atlantic coast. The timing of the peak and duration of the LD season were also associated with cumulative growing degree days, saturation deficit, and cumulative precipitation, but no meteorological predictors adequately explained the timing of the end of the LD season. PMID:24470565

Moore, Sean M; Eisen, Rebecca J; Monaghan, Andrew; Mead, Paul

2014-03-01

166

State of World Allergy Report 2008: Allergy and Chronic Respiratory Diseases  

PubMed Central

It is widely recognized that the incidence of allergies and allergic diseases is on the rise globally. As an international umbrella organization for regional and national allergy and clinical immunology societies, the World Allergy Organization is at the forefront of a combined united effort across nations and organizations to address this global concern by promoting the science of allergy and clinical immunology, and advancing exchange of information. The World Allergy Organization's State of World Allergy Reports will provide a biennial review of allergic diseases worldwide, consider their medical and socioeconomic contexts, and propose effective approaches to addressing these problems. In this first State of World Allergy Report 2008, experts from different regions of the world have attempted to define the extent of the global allergy problem, examine recent trends, and provide a framework for the collaboration among world medicine, science, and government agencies that is needed to address the rapidly developing issues associated with allergy and allergic diseases. PMID:23282447

2008-01-01

167

An expenditure analysis of high-cost Medicaid recipients with HIV disease in New York State.  

PubMed

A retrospective analysis was conducted of federal fiscal year (FFY) 2007 New York State Medicaid claims and expenditure data to examine variation in expenditures among New York State Medicaid recipients with HIV disease and the extent to which this variation could be attributed to the prevalence of comorbidities and other chronic conditions unrelated to HIV disease. Median expenditures per person for the period for a high-cost group (those for whom expenditures exceeded $100,000 for the period) were over $157,000, with 40% of total expenditures for this group for treatment unrelated to their HIV disease. The prevalence of comorbidities in the high-cost population is very high, the most common being substance abuse and mental illness. PMID:21317526

Chesnut, Thomas J; Laufer, Franklin N; Carrascal, Alvaro F; Feldman, Ira S

2011-02-01

168

Flu is a serious contagious disease. Each year in the United States, on average, more  

E-print Network

Flu is a serious contagious disease. Each year in the United States, on average, more than 200,000 people are hospitalized and 36,000 people die from seasonal flu complications. This flu season could be worse. There is a new and very different flu virus spreading worldwide among people called novel or new

Ferrara, Katherine W.

169

GEOGRAPHIC VARIATION IN THE ONSET OF DECLINE OF ISCHEMIC HEART DISEASE MORTALITY IN THE UNITED STATES  

EPA Science Inventory

The report examines geographic variation in the onset of the decline of ischemic heart disease (IHD) mortality in white males aged 35-74 during the period 1968-78. Using a quadratic regression model, State Economic Areas (SEAs) were classified as experiencing onset of the decline...

170

Economic Costs of Childhood Diseases and Disabilities Attributable to Environmental Contaminants in Washington State, USA  

Microsoft Academic Search

This study estimates the economic costs associated with childhood diseases and disabilities attributable to environmental contaminants in Washington State, USA, including asthma, cancer, lead exposure, birth defects, and neurobehavioral disorders. The estimates are based on “cost of illness” models that include direct healthcare costs and indirect costs. The estimates are also based on an “environmentally attributable fraction” model which quantifies

Kate Davies

2006-01-01

171

NEW YORK STATE DEPARTMENT OF HEALTH Bureau of Communicable Disease Control  

E-print Network

to prevent Meningococcal meningitis? YES, a safe and effective vaccine is available. The vaccine is 85) that cause about 70% of the disease in the United States. The vaccine is safe, with mild and infrequent side effects, such as redness and pain at the injection site lasting up to 2 days. After vaccination, immunity

Mahon, Bradford Z.

172

FACTS ON THE MAJOR KILLING AND CRIPPLING DISEASES IN THE UNITED STATES TODAY.  

ERIC Educational Resources Information Center

MAJOR CAUSES OF DEATH AND DISABILITY, RESULTS OF MEDICAL RESEARCH, LIFE EXPECTANCY FIGURES, COST OF ILLNESS TO THE UNITED STATES, AND GOVERNMENT EXPENDITURES IN MEDICINE AND HEALTH ARE PRESENTED TABULARLY AND GRAPHICALLY IN QUESTION AND ANSWER FORM. FOR EACH OF 14 MAJOR DISEASES, PERTINENT FACTS ARE LISTED ABOUT INCIDENCE, COST, DEATH RATE,…

National Health Education Committee, Inc., New York, NY.

173

Role of hyperbaric medicine for intractable leg ulcers: a case report.  

PubMed

We present a case report of intractable multifactorial leg ulcer that was treated successfully with multiple approaches including hyperbaric oxygen treatment (HBOT) to prepare for skin grafting. A 66-year-old female with a history of rheumatoid arthritis and Felty's syndrome presented with a non-healing ulcer on her left leg that was caused by a trauma. She failed multiple treatment options including debridement, different wound dressings, antibiotics, anti-inflammatories and vein closure procedure. She finally healed with skin graft following HBOT that prepared the wound bed before the procedure. PMID:25289650

Skeik, N; Kia, F; Klosterman, D

2014-10-01

174

Noninfectious disease among the Bhutanese refugee population at a United States urban clinic.  

PubMed

A large number of Bhutanese are currently being resettled to the United States. A high prevalence of noninfectious diseases has been noted in some refugee groups, but data on the Bhutanese refugee population are lacking. A retrospective, chart review study was conducted to determine proportion of noninfectious disease among ethnically Nepali Bhutanese refugees (n = 66) seen at the Grady Refugee Clinic (GRC). GRC disease proportions included the following: 52 % of the patients were overweight/obese (n = 34), 23 % were hypertensive (n = 15), 12 % had vitamin B(12) deficiency (n = 8), 15 % had depression (n = 10), and 14 % had diabetes (n = 9). Nine (90 %) patients with depression had chronic disease compared to 30 (54 %) of the patients without depression. The study found a substantial burden of chronic disease, micronutrient deficiency, and depression in the GRC. Further research is needed to accurately describe the disease burden in refugee populations and to evaluate pre-resettlement disease prevention strategies to provide a framework for future public health interventions. PMID:23456726

Kumar, Gayathri S; Varma, Selina; Saenger, Michael S; Burleson, Molly; Kohrt, Brandon A; Cantey, Paul

2014-10-01

175

Distinct Stability States of Disease-Associated Human Prion Protein Identified by Conformation-Dependent Immunoassay?  

PubMed Central

The phenotypic and strain-related properties of human prion diseases are, according to the prion hypothesis, proposed to reside in the physicochemical properties of the conformationally altered, disease-associated isoform of the prion protein (PrPSc), which accumulates in the brains of patients suffering from Creutzfeldt-Jakob disease and related conditions, such as Gerstmann-Straussler-Scheinker disease. Molecular strain typing of human prion diseases has focused extensively on differences in the fragment size and glycosylation site occupancy of the protease-resistant prion protein (PrPres) in conjunction with the presence of mutations and polymorphisms in the prion protein gene (PRNP). Here we report the results of employing an alternative strategy that specifically addresses the conformational stability of PrPSc and that has been used previously to characterize animal prion strains transmitted to rodents. The results show that there are at least two distinct conformation stability states in human prion diseases, neither of which appears to correlate fully with the PrPres type, as judged by fragment size or glycosylation, the PRNP codon 129 status, or the presence or absence of mutations in PRNP. These results suggest that conformational stability represents a further dimension to a complete description of potentially phenotype-related properties of PrPSc in human prion diseases. PMID:20844046

Choi, Young Pyo; Peden, Alexander H.; Gröner, Albrecht; Ironside, James W.; Head, Mark W.

2010-01-01

176

Intractable Persistent Direction-Changing Geotropic Nystagmus Improved by Lateral Semicircular Canal Plugging  

PubMed Central

Antigravitational deviation of the cupula of the lateral semicircular canal, which is also called light cupula, evokes persistent direction-changing geotropic nystagmus with a neutral point. No intractable cases of this condition have been reported. In our case, a 67-year-old man complained of positional vertigo 3 months after developing idiopathic sudden hearing loss in the right ear with vertigo. He showed a persistent direction-changing geotropic nystagmus with a leftward beating nystagmus in the supine position. The nystagmus resolved when his head was turned approximately 30° to the right. He was diagnosed with light cupula of the right lateral semicircular canal and was subsequently treated with an antivertiginous agent. However, his symptoms and positional nystagmus did not improve, so the right lateral semicircular canal was plugged by surgery. One month after surgery, his positional vertigo and nystagmus were completely resolved. We speculated that the cause of the patient's intractable light cupula was an enlarged cupula caused by his idiopathic sudden hearing loss.

Saito, Kazuya; Doi, Katsumi

2015-01-01

177

A Monte Carlo Metropolis-Hastings algorithm for sampling from distributions with intractable normalizing constants.  

PubMed

Simulating from distributions with intractable normalizing constants has been a long-standing problem in machine learning. In this letter, we propose a new algorithm, the Monte Carlo Metropolis-Hastings (MCMH) algorithm, for tackling this problem. The MCMH algorithm is a Monte Carlo version of the Metropolis-Hastings algorithm. It replaces the unknown normalizing constant ratio by a Monte Carlo estimate in simulations, while still converges, as shown in the letter, to the desired target distribution under mild conditions. The MCMH algorithm is illustrated with spatial autologistic models and exponential random graph models. Unlike other auxiliary variable Markov chain Monte Carlo (MCMC) algorithms, such as the Møller and exchange algorithms, the MCMH algorithm avoids the requirement for perfect sampling, and thus can be applied to many statistical models for which perfect sampling is not available or very expensive. The MCMH algorithm can also be applied to Bayesian inference for random effect models and missing data problems that involve simulations from a distribution with intractable integrals. PMID:23607562

Liang, Faming; Jin, Ick-Hoon

2013-08-01

178

Benzodiazepine sensitivity testing in the management of intractable seizure disorders in childhood.  

PubMed

The use of benzodiazepine sensitivity testing in the management of 40 children with intractable seizure disorders was studied. The aetiology and clinical syndromes varied widely with myoclonic, atonic and complex absence seizures predominating. Twenty-five cases had mixed seizure disorders. There was, likewise, a wide range of EEG abnormalities. Seven cases were in non-convulsive status at the time of testing. Diazepam (0.2 mg/kg) was given slowly intravenously and its effect on the EEG was observed. In 21 cases epileptiform activity was abolished. No change was seen in 13 cases and an unusual result was seen in 3. There was a paradoxical response in 3 cases, two of these associated with clinical seizures. Only 1 child in non-convulsive status had a positive result. Following testing, 32 patients went on to long-term oral benzodiazepine treatment. Twenty-one of these patients showed subsequent clinical improvement and 16/21 (76%) had had a positive sensitivity test previously. Eleven of these patients did not improve on long-term treatment. Seven out of the 11 (64%) had had a negative sensitivity test. These results suggest that the benzodiazepine sensitivity test is of value in the long-term management of intractable seizure disorders in childhood, but also emphasise the variability and unpredictability of response to benzodiazepine treatment. PMID:2441952

Livingston, J H; Anderson, A; Brown, J K; McInnes, A

1987-09-01

179

Treatment of intractable arterial hemorrhage during stereotactic brain biopsy with thrombin. Report of three patients.  

PubMed

Of 165 consecutive patients undergoing computerized tomography- or magnetic resonance imaging-guided stereotactic brain biopsies at the Cleveland Clinic between June, 1987, and November, 1989, four patients (2.4%) developed arterial hemorrhage refractory to conventional efforts to secure hemostasis. Craniotomy was performed in one of these patients to control the hemorrhage; in the other three, 0.5 to 2 cc of thrombin (5000 U/cc) was slowly injected via the biopsy cannula, resulting in immediate control of bleeding in all three cases. Postoperatively, the first two patients treated with 1 to 2 cc of thrombin were slow to awaken; one had evidence of vasospasm by transcranial Doppler ultrasound studies and multiple infarcts on cranial computerized tomography, while the other had a moderate-sized frontal hematoma with intracranial hypertension. After prolonged recovery periods, only mild neurological deficits persisted in both patients. The third patient, treated with 0.5 cc of thrombin, had an uneventful postoperative course. Thrombin is highly effective for stopping intractable arterial hemorrhage during stereotactic brain biopsy; however, it is a vasospastic agent and may have been responsible for the cerebral infarctions in one patient. Therefore, thrombin should be used only as a last resort, short of craniotomy, to control intractable arterial hemorrhage during stereotactic brain biopsy. PMID:1988604

Chimowitz, M I; Barnett, G H; Palmer, J

1991-02-01

180

Tackling learning intractability through topological organization and regulation of cortical networks.  

PubMed

A key challenge in evolving control systems for robots using neural networks is training tractability. Evolving monolithic fixed topology neural networks is shown to be intractable with limited supervision in high dimensional search spaces. Common strategies to overcome this limitation are to provide more supervision by encouraging particular solution strategies, manually decomposing the task and segmenting the search space and network. These strategies require a supervisor with domain knowledge and may not be feasible for difficult tasks where novel concepts are required. The alternate strategy is to use self-organized task decomposition to solve difficult tasks with limited supervision. The artificial neural tissue (ANT) approach presented here uses self-organized task decomposition to solve tasks. ANT inspired by neurobiology combines standard neural networks with a novel wireless signaling scheme modeling chemical diffusion of neurotransmitters. These chemicals are used to dynamically activate and inhibit wired network of neurons using a coarse-coding framework. Using only a global fitness function that does not encourage a predefined solution, modular networks of neurons are shown to self-organize and perform task decomposition. This approach solves the sign-following task found to be intractable with conventional fixed and variable topology networks. In this paper, key attributes of the ANT architecture that perform self-organized task decomposition are shown. The architecture is robust and scalable to number of neurons, synaptic connections, and initialization parameters. PMID:24805039

Thangavelautham, Jekanthan; D'Eleuterio, Gabriele M T

2012-04-01

181

Colorado State University, Office of the Vice President for Research Building Operations Manager, Infectious Disease Research Center  

E-print Network

Manager, Infectious Disease Research Center Colorado State University has a dynamic opportunity for a seasoned Building Operations Manager to join its Infectious Disease Research Center (IDRC). The optimal the University with hitech facilities and equipment for researching emerging infectious diseases and methods

Rutledge, Steven

182

Haff disease associated with eating buffalo fish--United States, 1997.  

PubMed

Haff disease is a syndrome of unexplained rhabdomyolysis following consumption of certain types of fish; it is caused by an unidentified toxin. Rhabdomyolysis is a clinical syndrome caused by injury to skeletal muscle that results in release of muscle cell contents into the circulation. In 1997, six cases of Haff disease were identified in the United States (four in California and two in Missouri) among persons who ate buffalo fish (Ictiobus cyprinellus), a bottom-feeding species found mostly in the Mississippi River or its tributaries. This report summarizes the investigation of these cases. PMID:9883771

1998-12-25

183

The rise and fall of celiac disease in the United States.  

PubMed

Because celiac disease is greatly under-diagnosed in the United States, a common assumption is that U.S. doctors and researchers always have considered the condition extremely rare. However, the disorder captured widespread medical attention at the beginning of the twentieth century. Luther Emmett Holt, a leading pediatrician, encouraged three other doctors to investigate the condition. Two helped to associate celiac disease with elite medical institutions. The third linked it to the marketing efforts of the United Fruit Company. Interest in celiac declined after 1965, partly as a result of the decreased concern with nutrition and nutritional disorders. PMID:19553256

Abel, Emily K

2010-01-01

184

Landscape, demographic, entomological, and climatic associations with human disease incidence of West Nile virus in the state of Iowa, USA  

Microsoft Academic Search

BACKGROUND: West Nile virus (WNV) emerged as a threat to public and veterinary health in the Midwest United States in 2001 and continues to cause significant morbidity and mortality annually. To investigate biotic and abiotic factors associated with disease incidence, cases of reported human disease caused by West Nile virus (WNV) in the state of Iowa were aggregated by census

John P DeGroote; Ramanathan Sugumaran; Sarah M Brend; Brad J Tucker; Lyric C Bartholomay

2008-01-01

185

Early Recognition and Disease Prediction in the At-Risk Mental States for Psychosis Using Neurocognitive Pattern Classification  

E-print Network

Early Recognition and Disease Prediction in the At-Risk Mental States for Psychosis Using could facilitate the diagnostic identification of different at-risk mental states (ARMS) for psychosis in different at-risk mental states (ARMS) for the illness. In this context, the state of ultrahigh risk (UHR

Gaser, Christian

186

Generalizability of the Disease State Index Prediction Model for Identifying Patients Progressing from Mild Cognitive Impairment to Alzheimer's Disease.  

PubMed

Background: The Disease State Index (DSI) prediction model measures the similarity of patient data to diagnosed stable and progressive mild cognitive impairment (MCI) cases to identify patients who are progressing to Alzheimer's disease. Objectives: We evaluated how well the DSI generalizes across four different cohorts: DESCRIPA, ADNI, AddNeuroMed, and the Kuopio MCI study. Methods: The accuracy of the DSI in predicting progression was examined for each cohort separately using 10 × 10-fold cross-validation and for inter-cohort validation using each cohort as a test set for the model built from the other independent cohorts using bootstrapping with 10 repetitions. Altogether 875 subjects were included in the analysis. The analyzed data included a comprehensive set of age and gender corrected magnetic resonance imaging (MRI) features from hippocampal volumetry, multi-template tensor-based morphometry, and voxel-based morphometry as well as Mini-Mental State Examination (MMSE), APOE genotype, and additional cohort specific data from neuropsychological tests and cerebrospinal fluid measurements (CSF). Results: The DSI model was used to classify the patients into stable and progressive MCI cases. AddNeuroMed had the highest classification results of the cohorts, while ADNI and Kuopio MCI exhibited the lowest values. The MRI features alone achieved a good classification performance for all cohorts. For ADNI and DESCRIPA, adding MMSE, APOE genotype, CSF, and neuropsychological data improved the results. Conclusions: The results reveal that the prediction performance of the combined cohort is close to the average of the individual cohorts. It is feasible to use different cohorts as training sets for the DSI, if they are sufficiently similar. PMID:25201784

Hall, Anette; Muñoz-Ruiz, Miguel; Mattila, Jussi; Koikkalainen, Juha; Tsolaki, Magda; Mecocci, Patrizia; Kloszewska, Iwona; Vellas, Bruno; Lovestone, Simon; Visser, Pieter Jelle; Lötjonen, Jyrki; Soininen, Hilkka

2014-09-01

187

Bupivacaine administered intrathecally versus rectally in the management of intractable rectal cancer pain in palliative care  

PubMed Central

Background Unacceptable adverse effects, contraindications to and/or ineffectiveness of World Health Organization step III “pain ladder” drugs causes needless suffering among a population of cancer patients. Successful management of severe cancer pain may require invasive treatment. However, a patient’s refusal of an invasive procedure necessitates that clinicians consider alternative options. Objective Intrathecal bupivacaine delivery as a viable treatment of intractable pain is well documented. There are no data on rectal bupivacaine use in cancer patients or in the treatment of cancer tenesmoid pain. This study aims to demonstrate that bupivacaine administered rectally could be a step in between the current treatment options for intractable cancer pain (conventional/conservative analgesia or invasive procedures), and to evaluate the effect of the mode of administration (intrathecal versus rectal) on the bupivacaine plasma concentration. Cases We present two Caucasian, elderly inpatients admitted to hospice due to intractable rectal/tenesmoid pain. The first case is a female with vulvar cancer, and malignant infiltration of the rectum/vagina. Bupivacaine was used intrathecally (0.25–0.5%, 1–2 mL every 6 hours). The second case is a female with ovarian cancer and malignant rectal infiltration. Bupivacaine was adminstered rectally (0.05–0.1%, 100 mL every 4.5–11 hours). Methods Total bupivacaine plasma concentrations were determined using the high-performance liquid chromatography-ultraviolet method. Results Effective pain control was achieved with intrathecal bupivacaine (0.077–0.154 mg·kg?1) and bupivacaine in enema (1.820 mg·kg?1). Intrathecal bupivacaine (0.5%, 2 mL) caused a drop in blood pressure; other side effects were absent in both cases. Total plasma bupivacaine concentrations following intrathecal and rectal bupivacaine application did not exceed 317.2 ng·mL?1 and 235.7 ng·mL?1, respectively. Bupivacaine elimination was slower after rectal than after intrathecal administration (t½= 5.50 versus 2.02 hours, respectively). Limitations This study reports two cases only, and there could be inter-patient variation. Conclusion Bupivacaine in boluses administered intrathecally (0.25%, 2 mL) provided effective, safe analgesia in advanced cancer patients. Bupivacaine enema (100 mg·100 mL?1) was shown to be a valuable option for control of end-of-life tenesmoid cancer pain. PMID:25336967

Zaporowska-Stachowiak, Iwona; Kowalski, Grzegorz; ?uczak, Jacek; Kosicka, Katarzyna; Kotlinska-Lemieszek, Aleksandra; Sopata, Maciej; G?ówka, Franciszek

2014-01-01

188

Deep Brain Stimulation for Advanced Parkinson's Disease  

Microsoft Academic Search

Deep brain stimulation (DBS) is a new and promising technique for the treatment of movement disorders. Medically intractable Parkinson's disease (PD) is one of the most common indications for DBS. There are three possible subcortical targets for PD, depending on the symptomatology (ie, the motor subdivision of the thalamus, the globus pallidus internus, the subthalamic nucleus [STN]). Thalamic stimulation has

Debra L. Byrd; William J. Marks; Philip A. Starr

2000-01-01

189

A 24-year-old woman with intractable seizures: review of surgery for epilepsy.  

PubMed

Epilepsy, a recurrent seizure disorder affecting 1% of the population, can be genetic in origin and thereby affect multiple members in a family, or it can be sporadic. Many sporadic seizures come from a specific "focus" in the cortex. Focal-onset seizures account for 60% of all cases of epilepsy. Among patients with partial seizures, 35% respond poorly to available medication and may benefit from neurosurgical excisional surgery. In cases in which epilepsy is localized through different modes (electroencephalogram, magnetic resonance imaging, etc) to a specific area of the brain where there is an associated lesion, more than half of patients can expect a successful surgical outcome. In patients with consistent seizure-associated behavior but without a lesion, surgical treatment is less successful. Ms H, a young woman with a history of medically intractable partial epilepsy, does not have an anatomical lesion but wants to know if a surgical approach is a good option for her. PMID:18984876

Schomer, Donald L; Black, Peter M

2008-12-01

190

Pseudohypoparathyroidism type Ia manifesting as intractable epilepsy in a 23-year-old female  

PubMed Central

Pseudohypoparathyroidism is a rare disorder of calcium metabolism that involves target organ resistance to the action of the parathyroid hormone. As a result, calcium levels may become dangerously low, sometimes leading to seizures and other symptoms. We present a case of a 23-year-old Somalian female on antiepileptic therapy presenting with intractable epilepsy. She was subsequently found to have pseudohypoparathyroidism type Ia. She had multiple reasons accounting for loss of seizure control, including worsening hypocalcemia from resistance to the parathyroid hormone; vitamin D deficiency, which could have resulted from lack of exposure to direct sunlight and her antiepileptic medication; and extensive calcium deposition in the brain due to pseudohypoparathyroidism. The patient was stabilized with intravenous therapy and oral calcium, vitamin D, and calcitriol. Her antiepileptic therapy was changed to a medication that did not interfere with vitamin D metabolism or contribute to worsening hypocalcemia. PMID:23754923

Raghavan, Pooja; Katz, Charles M

2012-01-01

191

HIPDM-SPECT in patients with medically intractable complex partial seizures. Ictal study  

SciTech Connect

Both interictal and ictal N,N,N'-trimethyl-N'-(2-hydroxy-3-methyl-5-iodobenzyl)-1,3,propanediamine -single photon emission computed tomography (HIPDM-SPECT) were performed in 16 patients with medically intractable complex partial seizures. Ictal HIPDM-SPECT localized epileptic foci in 13 of 14 patients with unilateral temporal focus and provided confirmative evidence of epileptic focus in 11 patients by demonstrating maximally increased regional cerebral perfusion (rCP) in epileptic foci that had shown decreased rCP in a previous interictal study. Ictal HIPDM-SPECT in two patients with bitemporal foci showed more complicated patterns consisting of slightly increased rCP in bilateral multifocal regions. Ictal HIPDM-SPECT was particularly useful for investigating epileptic foci, and correlation with simultaneously recorded ictal electroencephalograms provided further insight for localizing epileptic foci.

Lee, B.I.; Markand, O.N.; Wellman, H.N.; Siddiqui, A.R.; Park, H.M.; Mock, B.; Worth, R.M.; Edwards, M.K.; Krepshaw, J.

1988-04-01

192

Successful treatment of massive intractable pericardial effusion in a patient with systemic lupus erythematosus with tocilizumab.  

PubMed

A 51-year-old Japanese woman developed systemic lupus erythematosus (SLE) in 1995. In August 2005, she had massive pericardial effusion due to lupus pericarditis, which was compromising her circulation. Methylprednisolone pulse, intravenous cyclophosphamide pulse and pericardiocentesis were all ineffective. The pericardium was cut surgically to create a passage to drain the liquid into the pleural cavity. The procedure was temporarily effective; however, massive liquid accumulated in the pleural cavity within 1 year. Oral tacrolimus and topical betamethasone injection were ineffective. Since the interleukin-6 (IL-6) level in the effusion was markedly increased (1160 pg/ml), tocilizumab was administered intravenously at a dose of 8 mg/kg every 4 weeks. The effect was astonishing and only a residual amount of pericardial effusion remained. Prednisolone was tapered successfully from 15 to 5 mg daily. Tocilizumab is a treatment of choice when we confront an intractable serositis with massive effusion in SLE, if the IL-6 level is high. PMID:23264273

Kamata, Yasuyuki; Minota, Seiji

2012-01-01

193

Long-Term Outcomes of Hemispheric Disconnection in Pediatric Patients with Intractable Epilepsy  

PubMed Central

Background and Purpose Hemispherectomy reportedly produces remarkable results in terms of seizure outcome and quality of life for medically intractable hemispheric epilepsy in children. We reviewed the neuroradiologic findings, pathologic findings, epilepsy characteristics, and clinical long-term outcomes in pediatric patients following a hemispheric disconnection. Methods We retrospectively studied 12 children (8 males) who underwent a hemispherectomy at Asan Medical Center between 1997 and 2005. Clinical, EEG, neuroradiological, and surgical data were collected. Long-term outcomes for seizure, motor functions, and cognitive functions were evaluated at a mean follow-up of 12.7 years (range, 7.6-16.2 years) after surgery. Results The mean age at epilepsy onset was 3.0 years (range, 0-7.6 years). The following epilepsy syndromes were identified in our cohort: focal symptomatic epilepsy (n=8), West syndrome (n=3), and Rasmussen's syndrome (n=1). Postoperative histopathology of our study patients revealed malformation of cortical development (n=7), encephalomalacia as a sequela of infarction or trauma (n=3), Sturge-Weber syndrome (n=1), and Rasmussen's encephalitis (n=1). The mean age at surgery was 6.5 years (range, 0.8-12.3 years). Anatomical or functional hemispherectomy was performed in 8 patients, and hemispherotomy was performed in 4 patients. Eight of our 12 children (66.7%) were seizure-free, but 3 patients with perioperative complications showed persistent seizure. Although all patients had preoperative hemiparesis and developmental delay, none had additional motor or cognitive deficits after surgery, and most achieved independent walking and improvement in daily activities. Conclusions The long-term clinical outcomes of hemispherectomy in children with intractable hemispheric epilepsy are good when careful patient selection and skilled surgical approaches are applied. PMID:24829595

Lee, Yun-Jeong; Kim, Eun-Hee; Yum, Mi-Sun; Lee, Jung Kyo; Hong, Seokho

2014-01-01

194

Immediate and long term outcome after infrathalamic and thalamic lesioning for intractable Tourette's syndrome  

PubMed Central

OBJECTIVE—The surgical treatment of intractable Tourette's syndrome is controversial. Experience with 17 consecutive patients treated between 1970 and 1998 is reviewed and the efficacy and safety of surgical treatment is assessed.?METHODS—These patients were retrospectively reclassified into subtypes according to the protocol of the Tourette's Syndrome Study Group. One patient was excluded from the study. Ventriculography based stereotactic zona incerta (ZI) and ventrolateral/ lamella medialis thalamotomy (VL/LM) were performed on all patients. The preoperative, postoperative, and late tic severities were assessed by the tic severity rating scale. The median follow up of 11 patients (65%) was 7 years (range 3.5-17 years) and six patients were lost to long term follow up.?RESULTS—Median age was 23 years (range 11-40) at the time of surgery. Median duration of illness was 14 years (range 3-33). The mean preoperative motor and vocal tic severities were estimated to be 4.44 (SD 0.63) and 3.81 (SD 0.66), respectively. Unilateral ZI lesioning and VL/LM lesioning selected by asymmetry of symptoms provide an effective control of tic severity (p motor and vocal<0.001). In attenuation of contralateral symptoms, a second surgical intervention in the relevant side could reduce tic severity sufficiently (p motor<0.01; p vocal<0.005). Transient complications occurred in 68% of patients. Only one permanent complication was registered in six patients followed up after unilateral surgery. Two out of five patients followed up after bilateral surgery had disabling side effects of surgery.?CONCLUSIONS—ZI and VL/LM lesioning provide a significant long term reduction of tic severity in intractable Tourette's syndrome. Adequate selection of the side of first intervention might prevent the patient from increased risk of bilateral surgery.?? PMID:11309463

Babel, T; Warnke, P; Ostertag, C

2001-01-01

195

Successful use of tetrabenazine in a patient with intractable hiccups after stroke.  

PubMed

A hiccup is a myoclonic jerk of the diaphragm, and cases of hiccups may last for more than 48 hours (persistent hiccups) or even more than 2 months (intractable hiccups). Current pharmacologic treatment of persistent or intractable hiccups mainly includes antidopaminergic drugs. We describe the case of a 60-year-old man with a recent diagnosis of right insular ischemic stroke who presented with frequent, intense, and disabling hiccups for more than 1 month. As diagnosis of poststroke hiccups was assumed, the patient was treated over the next 6 months with adequate doses of various antipsychotic drugs commonly used for the treatment of hiccups; however, all were discontinued because of adverse effects. Indeed, dyskinesia after chlorpromazine (up to 75 mg/day for 4 wks), as well as somnolence and dyskinesia after haloperidol (up to 6 mg/day for 6 wks), somnolence after gabapentin (up to 1800 mg/day for 8 wks), and severe somnolence and hypotension after baclofen (up to 50 mg/day for 6 wks) were reported. The patient was then prescribed tetrabenazine at a starting dose of 12.5 mg twice/day (25 mg/day), with a nearly complete remission of the hiccup symptomatology after ~6 weeks, when a daily dose of 150 mg was reached. We therefore hypothesize that a supratentorial lesion may disrupt the modulation of dopaminergic pathways involved in the regulation of medullar centers responsible for the hiccup reflex. To our knowledge, this is the first case report of poststroke hiccups responding to tetrabenazine. The dramatic response of our patient to tetrabenazine monotherapy suggests that this drug may be a valuable pharmacologic alternative for patients with hiccups after stroke who are intolerant or unresponsive to classic antipsychotic agents. PMID:25471210

Naro, Antonino; Bramanti, Placido; Calabrò, Rocco Salvatore

2014-12-01

196

Screening for Common Occupational Health Diseases Among Long Distance Professional Drivers in Sagamu, Ogun State, Nigeria  

PubMed Central

Background: Long term exposure to hazards at the work place is injurious to health and usually leads to diseased conditions. The objective of this study was to determine the occupational health problems associated with driving among the professional drivers in Sagamu, Ogun state, Nigeria. Methods: This study is a cross-sectional study. Total sample of all the consenting professional drivers in the five interstate motor parks, including the cement factory [WAPCO] in the local government area, were recruited into the study. An interviewer administered structured questionnaire was administered by trained health workers and respondents were screen for common occupational health problems. Results: A total of 400 professional drivers were interviewed, all [100%] of them were males with age range from 21 to 59 yrs and nearly half [42%] were non indigenes. Only half, 208 [52%] of them were married with majority, 232 [58.0%] working for about 12 hrs daily and 46% of them had been working for 5 yrs or more. Most, 382 [95.5%] had been educated on HIV/AIDS before and 313 [78.3%] of them had multiple sexual partners. Only 241 [60.3%] used condom at the last sexual act and 55 [13.5%] had ever been tested for HIV/AIDS. Common occupational health diseases were renal tubular acidosis (RTA) 52 [13%] in the last one year and most of them currently have myalgia 352 [88.0%], upper respiratory tract infections (URTI) 20 [5.0%], sexually transmitted diseases (STD) 15 [3.8%], short sightedness 41 [10.3%], and Hypertension 90 [22.5%]. Conclusions: The study shows that common occupational diseases among long distance professional drivers in Western Nigeria were myalgia, upper respiratory tract infection, hypertension, short sightedness, sexually transmitted diseases, and RTA. Prevention and control of these common diseases among the drivers will lead to reduction of road traffic accidents in Western Nigeria and other low income countries. PMID:24829742

Amoran, Olorunfemi Emmanuel; Salako, Albert Adekunle; Jeminusi, Olubunmi

2014-01-01

197

Effects of noise on a computational model for disease states of mood disorders  

NASA Astrophysics Data System (ADS)

Nonlinear dynamics are currently proposed to explain the progressive course of recurrent mood disorders starting with isolated episodes and ending with accelerated irregular (``chaotic") mood fluctuations. Such a low-dimensional disease model is attractive because of its principal accordance with biological disease models, i.e. the kindling and biological rhythms model. However, most natural systems are nonlinear and noisy and several studies in the neuro- and physical sciences have demonstrated interesting cooperative behaviors arising from interacting random and deterministic dynamics. Here, we consider the effects of noise on a recent neurodynamical model for the timecourse of affective disorders (Huber et al.: Biological Psychiatry 1999;46:256-262). We describe noise effects on temporal patterns and mean episode frequencies of various in computo disease states. Our simulations demonstrate that noise can cause unstructured randomness or can maximize periodic order. The frequency of episode occurence can increase with noise but it can also remain unaffected or even can decrease. We show further that noise can make visible bifurcations before they would normally occur under deterministic conditions and we quantify this behavior with a recently developed statistical method. All these effects depend critically on both, the dynamic state and the noise intensity. Implications for neurobiology and course of mood disorders are discussed.

Tobias Huber, Martin; Krieg, Jürgen-Christian; Braun, Hans Albert; Moss, Frank

2000-03-01

198

Enhanced proinflammatory state and autoimmune activation: a breakthrough to understanding chronic diseases.  

PubMed

Insight is provided herein into the novel mechanisms of cardiometabolic risk. Previous reports, including the epidemiological work of the Turkish Adult Risk Factor study, indicated that proinflammatory state and oxidative stress are crucial for evaluating cardiometabolic risk. Autoimmune pathways in the course of oxidative stress are major determinants of cardiorenal and metabolic risk. The latter encompasses metabolic syndrome, type 2 diabetes, coronary heart disease, and chronic kidney disease (CKD). Along with platelet-activating factor acetylhydrolase, creatinine, thyroid stimulating hormone, acylation-stimulating protein, asymmetric dimethylarginine, and serum lipoprotein[Lp](a) are triggers of systemic low-grade inflammation and enhanced autoimmune reactions. Related studies are analyzed in the current review. Lp(a) plays a crucial role by taking part in the immune activation, thereby accelerating the course of diabetes, CKD, and other chronic disorders. Populations prone to impaired glucose tolerance, and particularly peri- and postmenopausal women, are at high risk of developing related vascular complications. PMID:23565630

Onat, Altan; Can, Günay

2014-01-01

199

Anemia and left ventricular hypertrophy in chronic kidney disease populations: A review of the current state of knowledge  

Microsoft Academic Search

Anemia and left ventricular hypertrophy in chronic kidney disease populations: A review of the current state of knowledge. The increasing awareness of the high prevalence of cardiovascular disease (CVD) in the dialysis population has led clinical nephrologists and researchers to focus their attention on processes and factors that are present in patients prior to dialysis. It is clear that many

Adeera Levin

2002-01-01

200

Clinical care of two patients with Ebola virus disease in the United States.  

PubMed

West Africa is currently experiencing the largest outbreak of Ebola virus disease (EVD) in history. Two patients with EVD were transferred from Liberia to our hospital in the United States for ongoing care. Malaria had also been diagnosed in one patient, who was treated for it early in the course of EVD. The two patients had substantial intravascular volume depletion and marked electrolyte abnormalities. We undertook aggressive supportive measures of hydration (typically, 3 to 5 liters of intravenous fluids per day early in the course of care) and electrolyte correction. As the patients' condition improved clinically, there was a concomitant decline in the amount of virus detected in plasma. PMID:25390460

Lyon, G Marshall; Mehta, Aneesh K; Varkey, Jay B; Brantly, Kent; Plyler, Lance; McElroy, Anita K; Kraft, Colleen S; Towner, Jonathan S; Spiropoulou, Christina; Ströher, Ute; Uyeki, Timothy M; Ribner, Bruce S

2014-12-18

201

Effect of latitude on the rate of change in incidence of Lyme disease in the United States  

PubMed Central

Background Tick-borne illnesses represent an important class of emerging zoonoses, with climate change projected to increase the geographic range within which tick-borne zoonoses might become endemic. We evaluated the impact of latitude on the rate of change in the incidence of Lyme disease in the United States, using publicly available data. Methods We estimated state-level year-on-year incidence rate ratios (IRRs) for Lyme disease for the period 1993 to 2007 using Poisson regression methods. We evaluated between-state heterogeneity in IRRs using a random-effects meta-analytic approach. We identified state-level characteristics associated with increasing incidence using random-effects meta-regression. Results The incidence of Lyme disease in the US increased by about 80% between 1993 and 2007 (IRR per year 1.049, 95% CI [confidence interval] 1.048 to 1.050). There was marked between-state heterogeneity in the average incidence of Lyme disease, ranging from 0.008 per 100 000 person-years in Colorado to 75 per 100 000 in Connecticut, and significant between-state heterogeneity in temporal trends (p < 0.001). In multivariable meta-regression models, increasing incidence showed a linear association with state latitude and population density. These 2 factors explained 27% of the between-state variation in IRRs. No independent association was identified for other state-level characteristics. Interpretation Lyme disease incidence increased in the US as a whole during the study period, but the changes were not uniform. Marked increases were identified in northern-most states, whereas southern states experienced stable or declining rates of Lyme disease. PMID:25077101

Tuite, Ashleigh R.; Greer, Amy L.

2013-01-01

202

Alveolar hydatid disease in Minnesota. First human case acquired in the contiguous United States.  

PubMed

A 56-year-old woman from southwestern Minnesota underwent an extended left hepatic lobectomy to remove a large multinodular mass with a necrotic central cavity. The clinical, serological, and pathological findings led to the diagnosis of alveolar hydatid disease, and specific identification of Echinococcus multilocularis was achieved by growing mature larvas in voles inoculated intraperitoneally with tissue from the hepatic lesions. The patient probably acquired her infection some years previously from pet cats or dogs that had become infected by ingesting infected rodents. In North America E multilocularis is enzootic in the northern tundra zone of Alaska and Canada. Since 1964 the cestode has been recognized with increasing frequency in several north-central states, including Minnesota. The parasite may extend its range farther south, since suitable animal hosts occur throughout the United States. PMID:762867

Gamble, W G; Segal, M; Schantz, P M; Rausch, R L

1979-03-01

203

Non-Erosive Reflux Disease Manifested Exclusively by Protracted Hiccups  

PubMed Central

Hiccups are a benign physiological feature affecting almost everyone at one time or another. They tend to be short-lived and do not affect quality of life; however, there are various pathologies that may present with long-lasting hiccups. These are grouped into 3 categories according to their duration: acute, persistent and intractable or protracted hiccups. Intractable hiccups last longer than 2 months and are usually associated with more severe conditions. The association between intractable hiccups and reflux disease has not been previously documented by objective methods. This report describes the case of a 23-year-old female who presented with protracted hiccups; all other organic pathologies were ruled out, and endoscopy and conventional pH-metry confirmed a diagnosis of non-erosive reflux disease as the unique cause. PMID:21103425

Esparza, Edgar A; Cervantes-Sodi, María

2010-01-01

204

An entomoepidemiological investigation of Chagas disease in the state of Ceará, Northeast Region of Brazil.  

PubMed

The seroprevalence of Chagas disease in humans and the presence of triatomines were investigated in a rural locality in the State of Ceará, Brazil, an historically endemic region. Approximately 80% of the surveyed residents agreed to undergo serological tests. Intradomestic and peridomestic environments were searched for triatomines in both the dry and rainy seasons. The prevalence rate of Chagas disease was 1.2% and the majority of individuals confirmed with the disease over 50 years of age. A total of 761 specimens of triatomines were captured, most of which were from colonies composed of nymphs and adult bugs, and the majority of specimens were obtained in the dry season. Triatoma brasiliensis was the predominant species. Analysis using light microscopy revealed that 28.6% of the insects were Trypanosoma cruzi positive. Results suggest that peridomestic man-made structures, such as animal shelters, improper storage of timber and uninhabited dwellings contribute to the high rate of triatomine infestation in the area. PMID:24896053

Coutinho, Carolina Fausto de Souza; Souza-Santos, Reinaldo; Teixeira, Natalia Faria Daflon; Georg, Ingebourg; Gomes, Taís Ferreira; Boia, Marcio Neves; dos Reis, Neilane Bertoni; Maia, Alexander de Oliveira; Lima, Marli Maria

2014-04-01

205

Phosphoprotein enriched in astrocytes (PEA)-15: A potential therapeutic target in multiple disease states  

PubMed Central

Phosphoprotein enriched in astrocytes-15 (PEA-15) is a cytoplasmic protein that sits at an important junction in intracellular signalling and can regulate diverse cellular processes, such as proliferation and apoptosis, dependent upon stimulation. Regulation of these processes occurs by virtue of the unique interaction of PEA-15 with other signalling proteins. PEA-15 acts as a cytoplasmic tether for the mitogen-activated protein kinases, extracellular signal-regulated kinase 1/2 (ERK1/2) preventing nuclear localisation. In order to release ERK1/2, PEA-15 requires to be phosphorylated via several potential pathways. PEA-15 (and its phosphorylation state) therefore regulates many ERK1/2-dependent processes, including proliferation, via regulating ERK1/2 nuclear translocation. In addition, PEA-15 contains a death effector domain (DED) which allows interaction with other DED-containing proteins. PEA-15 can bind the DED-containing apoptotic adaptor molecule, Fas-associated death domain protein (FADD) which is also dependent on the phosphorylation status of PEA-15. PEA-15 binding of FADD can inhibit apoptosis as bound FADD cannot participate in the assembly of apoptotic signalling complexes. Through these protein–protein interactions, PEA-15-regulated cellular effects have now been investigated in a number of disease-related studies. Changes in PEA-15 expression and regulation have been observed in diabetes mellitus, cancer, neurological disorders and the cardiovascular system. These changes have been suggested to contribute to the pathology related to each of these disease states. As such, new therapeutic targets based around PEA-15 and its associated interactions are now being uncovered and could provide novel avenues for treatment strategies in multiple diseases. PMID:24657708

Greig, Fiona H.; Nixon, Graeme F.

2014-01-01

206

Optimal set of EEG features for emotional state classification and trajectory visualization in Parkinson's disease.  

PubMed

In addition to classic motor signs and symptoms, individuals with Parkinson's disease (PD) are characterized by emotional deficits. Ongoing brain activity can be recorded by electroencephalograph (EEG) to discover the links between emotional states and brain activity. This study utilized machine-learning algorithms to categorize emotional states in PD patients compared with healthy controls (HC) using EEG. Twenty non-demented PD patients and 20 healthy age-, gender-, and education level-matched controls viewed happiness, sadness, fear, anger, surprise, and disgust emotional stimuli while fourteen-channel EEG was being recorded. Multimodal stimulus (combination of audio and visual) was used to evoke the emotions. To classify the EEG-based emotional states and visualize the changes of emotional states over time, this paper compares four kinds of EEG features for emotional state classification and proposes an approach to track the trajectory of emotion changes with manifold learning. From the experimental results using our EEG data set, we found that (a) bispectrum feature is superior to other three kinds of features, namely power spectrum, wavelet packet and nonlinear dynamical analysis; (b) higher frequency bands (alpha, beta and gamma) play a more important role in emotion activities than lower frequency bands (delta and theta) in both groups and; (c) the trajectory of emotion changes can be visualized by reducing subject-independent features with manifold learning. This provides a promising way of implementing visualization of patient's emotional state in real time and leads to a practical system for noninvasive assessment of the emotional impairments associated with neurological disorders. PMID:25109433

Yuvaraj, R; Murugappan, M; Ibrahim, Norlinah Mohamed; Sundaraj, Kenneth; Omar, Mohd Iqbal; Mohamad, Khairiyah; Palaniappan, R

2014-12-01

207

Amoeba-inspired nanoarchitectonic computing: solving intractable computational problems using nanoscale photoexcitation transfer dynamics.  

PubMed

Biologically inspired computing devices and architectures are expected to overcome the limitations of conventional technologies in terms of solving computationally demanding problems, adapting to complex environments, reducing energy consumption, and so on. We previously demonstrated that a primitive single-celled amoeba (a plasmodial slime mold), which exhibits complex spatiotemporal oscillatory dynamics and sophisticated computing capabilities, can be used to search for a solution to a very hard combinatorial optimization problem. We successfully extracted the essential spatiotemporal dynamics by which the amoeba solves the problem. This amoeba-inspired computing paradigm can be implemented by various physical systems that exhibit suitable spatiotemporal dynamics resembling the amoeba's problem-solving process. In this Article, we demonstrate that photoexcitation transfer phenomena in certain quantum nanostructures mediated by optical near-field interactions generate the amoebalike spatiotemporal dynamics and can be used to solve the satisfiability problem (SAT), which is the problem of judging whether a given logical proposition (a Boolean formula) is self-consistent. SAT is related to diverse application problems in artificial intelligence, information security, and bioinformatics and is a crucially important nondeterministic polynomial time (NP)-complete problem, which is believed to become intractable for conventional digital computers when the problem size increases. We show that our amoeba-inspired computing paradigm dramatically outperforms a conventional stochastic search method. These results indicate the potential for developing highly versatile nanoarchitectonic computers that realize powerful solution searching with low energy consumption. PMID:23565603

Aono, Masashi; Naruse, Makoto; Kim, Song-Ju; Wakabayashi, Masamitsu; Hori, Hirokazu; Ohtsu, Motoichi; Hara, Masahiko

2013-06-18

208

Surgical Outcomes after Total Colectomy with Ileorectal Anastomosis in Patients with Medically Intractable Slow Transit Constipation  

PubMed Central

Purpose The aim of this study was to evaluate outcomes of a total colectomy with ileorectal anastomosis in patients with slow transit constipation. Methods A retrospective review of 37 consecutive patients with slow transit constipation who underwent a total colectomy between 1994 and 2008 was undertaken. Preoperative and postoperative Wexner's constipation scores were collected and used to evaluate the outcomes after surgical treatment. Also patients' postoperative satisfaction scores were collected using a 4-point scale. Results The 37 patients consisted of 31 women and 6 men, with a median age of 41 years (range, 17 to 71 years). Pre- and post-operative Wexner's scores were collected from 33 patients (89.1%), and the mean preoperative Wexner's score was 19.3 (range, 11 to 24), which decreased to an average post-operative score of 2.3 (range, 0 to 8). Neither intraoperative complications nor postoperative mortalities were noted. Five patients (13.5%) had early postoperative complications, and the most common complication was postoperative ileus (10.8%). Seven patients (18.9%) had late postoperative complications, and postoperative ileus (10.8%) was also the most common. Twenty seven of 33 patients were satisfied with their surgical outcome (81.8%). Conclusion A total colectomy with ileorectal anastomosis might be an effective surgical procedure with acceptable morbidity to treat medically intractable slow transit constipation. PMID:21980588

Sohn, Guiyun; Kim, Chan Wook; Kwak, Jae Young; Jang, Tae Young; Kim, Kyung Ho; Yang, Song Soo; Yoon, Yong Sik; Lim, Seok-Byung; Kim, Jin Cheon

2011-01-01

209

Deep TMS add-on treatment for intractable Tourette syndrome: A feasibility study.  

PubMed

Objectives. In a considerable minority of patients who suffer from Tourette syndrome (TS) the disorder persists into adulthood and is associated with severe symptoms and limited therapeutic options. Repetitive transcranial magnetic stimulation (rTMS) to the supplementary motor area (SMA) has shown promising therapeutic results. Deep rTMS is a novel technology that enables deeper non-invasive cortical stimulation. This open-label pilot study is the first to examine the possible role of deep rTMS as add-on treatment for intractable TS. Methods. Twelve patients were recruited in order to examine bilateral SMA inhibition via deep TMS using the HBDL coil, as a possible treatment for adult TS treatment-resistant patients. Two patients did not complete the 20-day study protocol. Results. There were no significant side effects. While tics did not improve among the group as a whole, the subgroup of six patients with combined TS and OCD (obsessive compulsive syndrome) showed significant improvement in tic severity (P = 0.037). Conclusions. These findings support the safety of deep rTMS for treating TS. The results also highlight the importance of studying the different TS syndromes separately (e.g., with or without OCD comorbidity) when evaluating deep rTMS protocols for TS patients. PMID:25342253

Bloch, Yuval; Arad, Shira; Levkovitz, Yechiel

2014-10-24

210

Spinal Cord Stimulation for Intractable Visceral Pain Due to Sphincter of Oddi Dysfunction  

PubMed Central

Sphincter of Oddi dysfunction (SOD) is a syndrome of chronic biliary pain or recurrent pancreatitis due to the functional obstruction of the pancreaticobiliary flow. We report a case of spinal cord stimulation (SCS) for chronic abdominal pain due to SOD. The patient had a history of cholecystectomy and had suffered from chronic right upper quadrant abdominal pain. The patient had been diagnosed as having SOD. The patient was treated with opioid analgesics and nerve blocks, including a splanchnic nerve block. However, two years later, the pain became intractable. We implanted percutaneous SCS at the T5-7 level for this patient. Visual analog scale (VAS) scores for pain and the amount of opioid intake decreased. The patient was tracked for more than six months without significant complications. From our clinical case, SCS is an effective and alternative treatment option for SOD. Further studies and long-term follow-up are necessary to understand the effectiveness and the limitations of SCS on SOD. PMID:25589948

Lee, Kang Hun; Lee, Sang Eun; Jung, Jae Wook

2015-01-01

211

Adjuvant single-fraction radiotherapy is safe and effective for intractable keloids  

PubMed Central

The aim of this study was to assess the feasibility and efficacy of high-dose, single-fraction electron beam radiotherapy for therapy-resistant keloids. Before 2010, intractable keloids were treated at our institution with post-operative irradiation of 6–15 Gy in 3–5 fractionations. For convenience and cost effectiveness, we have changed our treatment protocol to high-dose single-fraction radiotherapy. A total of 12 patients with 16 keloid lesions were treated from January 2010 to January 2013 in our department. A 10-Gy dose of electron irradiation was given within 72 h of the surgical excision. The mean follow-up period was 20 months. Treatments were well tolerated, and there was no recurrence in any of the patients. Severe adverse effects were not observed. Surgical excision of the keloid, followed by immediate, single-fraction, high-dose radiotherapy, is both safe and effective in preventing recurrence of therapy-resistant keloids. PMID:24801475

Song, Changhoon; Wu, Hong-Gyun; Chang, Hak; Kim, Il Han; Ha, Sung W.

2014-01-01

212

Intractable Facial Pain and Numb Chin due to Metastatic Esophageal Adenocarcinoma  

PubMed Central

The etiologies of facial pain are innumerable, thus facial pain misdiagnosis and resultant mismanagement is common. Numb chin syndrome presents with hypoesthesia and/or anesthesia in the dermatomal distribution of the inferior alveolar or the mental nerve. In this case report, we will discuss a case of intractable facial pain in a 57-year-old male with a history of esophageal adenocarcinoma who was initially misdiagnosed and treated as trigeminal neuralgia. During clinical examination, the loss of sensation in the inferior alveolar nerve distribution was identified and led to the diagnosis of mandibular metastasis. The details of the clinical presentation will be discussed in the context of accurate identification and diagnosis. Focal radiation to the metastatic location along with sphenopalatine ganglion radiofrequency ablation and medication management provided significant pain relief. This case report provides additional information to the current medical knowledge and it enhances the clinical vigilance of the clinicians when they encounter similar cases. We concluded that patients with a history of neoplasms who present with atypical symptoms of facial pain should undergo further investigation with advanced imaging. Targeted treatment based on an accurate diagnosis is the foundation of pain management. PMID:25606033

Elahi, Foad; Luke, Whitney; Elahi, Fazel

2014-01-01

213

Occipital nerve stimulation for the treatment of intractable chronic migraine headache: ONSTIM feasibility study  

PubMed Central

Background: Medically intractable chronic migraine (CM) is a disabling illness characterized by headache ?15 days per month. Methods: A multicenter, randomized, blinded, controlled feasibility study was conducted to obtain preliminary safety and efficacy data on occipital nerve stimulation (ONS) in CM. Eligible subjects received an occipital nerve block, and responders were randomized to adjustable stimulation (AS), preset stimulation (PS) or medical management (MM) groups. Results: Seventy-five of 110 subjects were assigned to a treatment group; complete diary data were available for 66. A responder was defined as a subject who achieved a 50% or greater reduction in number of headache days per month or a three-point or greater reduction in average overall pain intensity compared with baseline. Three-month responder rates were 39% for AS, 6% for PS and 0% for MM. No unanticipated adverse device events occurred. Lead migration occurred in 12 of 51 (24%) subjects. Conclusion: The results of this feasibility study offer promise and should prompt further controlled studies of ONS in CM. PMID:20861241

Saper, Joel R; Dodick, David W; Silberstein, Stephen D; McCarville, Sally; Sun, Mark; Goadsby, Peter J

2011-01-01

214

Health Care System Collaboration to Address Chronic Diseases: A Nationwide Snapshot From State Public Health Practitioners  

PubMed Central

Introduction Until recently, health care systems in the United States often lacked a unified approach to prevent and manage chronic disease. Recent efforts have been made to close this gap through various calls for increased collaboration between public health and health care systems to better coordinate provision of services and programs. Currently, the extent to which the public health workforce has responded is relatively unknown. The objective of this study is to explore health care system collaboration efforts and activities among a population-based sample of state public health practitioners. Methods During spring 2013, a national survey was administered to state-level chronic disease public health practitioners. Respondents were asked to indicate whether or not they collaborate with health care systems. Those who reported “yes” were asked to indicate all topic areas in which they collaborate and provide qualitative examples of their collaborative work. Results A total of 759 respondents (84%) reported collaboration. Common topics of collaboration activities were tobacco, cardiovascular health, and cancer screening. More client-oriented interventions than system-wide interventions were found in the qualitative examples provided. Respondents who collaborated were also more likely to use the Community Guide, use evidence-based decision making, and work in program areas that involved secondary, rather than primary, prevention. Conclusion The study findings indicate a need for greater guidance on collaboration efforts that involve system-wide and cross-system interventions. Tools such as the Community Guide and evidence-based training courses may be useful in providing such guidance. PMID:25188277

McBride, Timothy D.; Allen, Peg; Jacob, Rebekah R.; Jones, Ellen; Kerner, Jon; Brownson, Ross C.

2014-01-01

215

Intractable Chronic Low-Back Pain Caused by Ligamentopathia Treated Using a Spinous Process Plate (S-plate)  

PubMed Central

We report a case of intractable chronic low-back pain in a gymnast that was caused by ligamentopathia in the interspinous region of the lumbar vertebrae. Sprained interspinous ligaments are a common mechanical cause of acute low-back pain in athletes. Although conservative therapy is generally effective in such cases, in this case it was not. The patient experienced severe low-back pain during lumbar flexion with tension between the L5/S interspinous ligaments. We performed interspinous fixation by using a spinous process plate system, which has been developed for short in situ fusions, and following which the low-back pain resolved. Conservative therapy for low-back pain caused by ligamentopathia is first-line choice, but interspinous fixation with instrumentation might be recommended in intractable cases with conservative therapy. PMID:21124690

Iwatsuki, Koichi; Yoshimine, Toshiki; Yoshimura, Kazuhiro; Ishihara, Masahiro; Ohnishi, Yu-ichiro; Goto, Yuko

2010-01-01

216

[Strontium-89 therapy and subarachnoid phenol block successfully eliminated intractable pain of metastasis in the patient with advanced urachal carcinoma].  

PubMed

We report a case of a 39-year-old man with intractable multifocal pain caused by metastatic urachal carcinoma to the bone. The patient underwent a partial cystectomy in May 2008, and lung metastasis occurred 9 months after the surgery. He then received salvage chemotherapy, but developed metastasis to the liver, brain, and bone. He was hospitalized due to a shoulder pain, a lower back pain, buttocks pain, numbness in both legs, and drop foot in right leg. MRI revealed metastases to the spine, and lumbar spinal canal stenosis with cauda equina compression. Even a combination of fentanyl-patch, oral acetaminophen, gabapentin and paroxetine was not effective for pain control. Strontium-89 therapy and subarachnoid phenol block successfully eliminated intractable pain. The patient could be discharged from hospital and received a palliative care at home for a short period of time. PMID:22189321

Arakawa, Yasuhiro; Inoue, Daisuke; Sakuyama, Toshikazu; Nagasaki, Eijiro; Aiba, Keisuke

2011-12-01

217

A pilot study of the effect of Direct Instruction programming on the academic performance of students with intractable epilepsy  

Microsoft Academic Search

Fifty-five students with intractable epilepsy and learning difficulties, aged 6.5 to 14.1 years with a mean IQ of 71.25 (SD=13.56), attended a hospital-based classroom of no more than eight students where they received Direct Instruction programming for 3 to 4.5 days a week, typically for up to 16 weeks. Pretest–posttest academic gains were evaluated in comparison to normative test performance.

Tom Humphries; Michelle Neufeld; Christine Johnson; Katie Engels; Roseanne McKay

2005-01-01

218

Intractable hiccup and nausea in neuromyelitis optica with anti-aquaporin-4 antibody: a herald of acute exacerbations  

Microsoft Academic Search

BACKGROUND: Intractable hiccup and nausea (IHN) are unique symptoms in neuromyelitis optica (NMO). Recent studies have strongly suggested that the pathogenesis of NMO is closely associated with anti-aquaporin-4 (AQP4) antibody. However, clinical implications of IHN and the relationship with anti-AQP4 antibody remain unknown. METHODS: The past medical records of 35 patients with seropositivity for anti-AQP4 antibody were reviewed. We also

T. Takahashi; I. Miyazawa; T. Misu; R. Takano; I. Nakashima; K. Fujihara; M. Tobita; Y. Itoyama

2008-01-01

219

Identification of resting and active state EEG features of Alzheimer's disease using discrete wavelet transform.  

PubMed

Alzheimer's disease (AD) is associated with deficits in a number of cognitive processes and executive functions. Moreover, abnormalities in the electroencephalogram (EEG) power spectrum develop with the progression of AD. These features have been traditionally characterized with montage recordings and conventional spectral analysis during resting eyes-closed and resting eyes-open (EO) conditions. In this study, we introduce a single lead dry electrode EEG device which was employed on AD and control subjects during resting and activated battery of cognitive and sensory tasks such as Paced Auditory Serial Addition Test (PASAT) and auditory stimulations. EEG signals were recorded over the left prefrontal cortex (Fp1) from each subject. EEG signals were decomposed into sub-bands approximately corresponding to the major brain frequency bands using several different discrete wavelet transforms and developed statistical features for each band. Decision tree algorithms along with univariate and multivariate statistical analysis were used to identify the most predictive features across resting and active states, separately and collectively. During resting state recordings, we found that the AD patients exhibited elevated D4 (~4-8 Hz) mean power in EO state as their most distinctive feature. During the active states, however, the majority of AD patients exhibited larger minimum D3 (~8-12 Hz) values during auditory stimulation (18 Hz) combined with increased kurtosis of D5 (~2-4 Hz) during PASAT with 2 s interval. When analyzed using EEG recording data across all tasks, the most predictive AD patient features were a combination of the first two feature sets. However, the dominant discriminating feature for the majority of AD patients were still the same features as the active state analysis. The results from this small sample size pilot study indicate that although EEG recordings during resting conditions are able to differentiate AD from control subjects, EEG activity recorded during active engagement in cognitive and auditory tasks provide important distinct features, some of which may be among the most predictive discriminating features. PMID:23536113

Ghorbanian, Parham; Devilbiss, David M; Verma, Ajay; Bernstein, Allan; Hess, Terry; Simon, Adam J; Ashrafiuon, Hashem

2013-06-01

220

Treatment for intractable anemia with the traditional Chinese medicines Hominis Placenta and Cervi Cornus Colla (deer antler glue)  

PubMed Central

Objective Intractable anemia, such as aplastic anemia or that presumably associated with chronic herpes virus infections, sometimes require bone marrow transplant. We investigated the use of traditional Chinese medicine (TCM) for the treatment of intractable anemia. Method Placenta Hominis (PH), steam boiled and roasted, and Cervi Cornus Colla (deer antler glue) has been used in China for hundreds of years to treat anemia. After consent was obtained, we prescribed these two materials for a 74-year-old female with aplastic anemia and a 26-year-old male with presumably a virus-induced anemia. Concomitant conventional therapy was continued in both patients as prescribed by their respective attending physicians. Conclusion Conventional therapy with steroid hormones, immunosuppressive drugs, platelet and erythrocyte transfusions were not effective in these patients. In addition, both patients suffered from serious side effects. In two patients, ingestion of Placenta Hominis and Cervi Cornus Colla with TCM prescriptions increased the platelet and enhanced the hemoglobin concentration in several months of therapy accompanied by a dramatic improvement in quality of life. The addition to conventional therapy of PH and Cervi Cornus Colla, the latter of which is very easy to obtain, may be one of the potentially advantageous choices in case of otherwise intractable anemia. PMID:20360892

Hijikata, Yasuyo; Kano, Takashi; Xi, Lu

2009-01-01

221

Efficacy of and Patient Compliance with a Ketogenic Diet in Adults with Intractable Epilepsy: A Meta-Analysis  

PubMed Central

Background and Purpose Despite the successful use of a ketogenic diet in pediatric epilepsy, its application in adults has been limited. The aim of this meta-analysis was to summarize the findings of relevant published studies in order to identify the efficacy of and compliance with a ketogenic diet and its main subtypes (i.e., classic ketogenic diet and modified Atkins diet) in adults with intractable epilepsy, and to provide useful information for clinical practice. Methods Electronic searches of PubMed, EMBASE, Google Scholar, and the ISI Web of Science were conducted to identify studies of the efficacy of and patient compliance with a ketogenic diet in adults with intractable epilepsy; the included studies were reviewed. Meta-analyses were performed using STATA to determine combined efficacy rates and combined rates of compliance with the ketogenic diet and its main subtypes. Results In total, 12 studies qualified for inclusion, and data from 270 patients were evaluated.The results of the meta-analysis revealed combined efficacy rates of all types of ketogenic diet, a classical ketogenic diet, and a modified Atkins diet were 42%, 52%, and 34%, respectively; the corresponding combined compliance rates were 45%, 38%, and 56%. Conclusions The results indicate that a ketogenic diet is a promising complementary therapy in adult intractable epilepsy, and that while a classical ketogenic diet may be more effective, adult patients are likely to be less compliant with it than with a modified Atkins diet. PMID:25628734

Ye, Fang; Li, Xiao-Jia; Jiang, Wan-Lin

2015-01-01

222

Oxidative stress markers in hypertensive states of pregnancy: preterm and term disease  

PubMed Central

Discussion continues as to whether de novo hypertension in pregnancy with significant proteinuria (pre-eclampsia; PE) and non-proteinuric new hypertension (gestational hypertension; GH) are parts of the same disease spectrum or represent different conditions. Non-pregnant hypertension, pregnancy and PE are all associated with oxidative stress. We have established a 6 weeks postpartum clinic for women who experienced a hypertensive pregnancy. We hypothesized that PE and GH could be distinguished by markers of oxidative stress; thiobarbituric acid reactive substances (TBARS) and antioxidants (ferric ion reducing ability of plasma; FRAP). Since the severity of PE and GH is greater pre-term, we also compared pre-term and term disease. Fifty-eight women had term PE, 23 pre-term PE, 60 had term GH and 6 pre-term GH, 11 pre-existing (essential) hypertension (EH) without PE. Limited data were available from normotensive pregnancies (n = 7) and non-pregnant controls (n = 14). There were no differences in postpartum TBARS or FRAP between hypertensive states; TBARS (P = 0.001) and FRAP (P = 0.009) were lower in plasma of non-pregnant controls compared to recently-pregnant women. Interestingly FRAP was higher in preterm than term GH (P = 0.013). In PE and GH, TBARS correlated with low density lipoprotein (LDL)-cholesterol (P = 0.036); this association strengthened with inclusion of EH (P = 0.011). The 10 year Framingham index for cardiovascular risk was positively associated with TBARS (P = 0.003). Oxidative stress profiles do not differ between hypertensive states but appear to distinguish between recently-pregnant and non-pregnant states. This suggests that pregnancy may alter vascular integrity with changes remaining 6 weeks postpartum. LDL-cholesterol is a known determinant of oxidative stress in cardiovascular disease and we have shown this association to be present in hypertensive pregnancy further emphasizing that such a pregnancy may be revealing a pre-existing cardiovascular risk. PMID:25202276

Kurlak, Lesia O.; Green, Amanda; Loughna, Pamela; Broughton Pipkin, Fiona

2014-01-01

223

Infectious disease surveillance in the United States and the United Kingdom: from public goods to the challenges of new technologies.  

PubMed

Infectious diseases are a long-standing and continuing threat to health and welfare, with their containment dependent on national disease surveillance and response capacities. This article discusses infectious disease surveillance in the United States and the United Kingdom, examining historical national traditions for identifying and controlling infectious disease risks and how globalization and technical advances have influenced the evolution of their respective approaches. The two systems developed in different but parallel ways. In the United States, surveillance remained quite localized at the state level until the early twentieth century and still retains many of those features. The U.K. approach became centralized from the latter part of the nineteenth century and has principally remained so. In both cases, disease surveillance was traditionally conceived as a public good, where national or local authorities held sovereign rights and power to protect public health. With the increasing globalized nature of infectious disease, such notions shifted toward surveillance as a global public good, with countries responding in turn by creating new global health governance arrangements and regulations. However, the limitations of current surveillance systems and the strong hold of national interests place into question the provision of surveillance as a global public good. These issues are further highlighted with the introduction of new surveillance technologies, which offer opportunities for improved disease detection and identification but also create potential tensions between individual rights, corporate profit, equitable access to technology, and national and global public goods. PMID:21498799

Barnett, Tony; Sorenson, Corinna

2011-02-01

224

Predictors and Course of Medically Intractable Epilepsy in Young Children Presenting Before 36 Months of Age: A Retrospective, Population-Based Study  

PubMed Central

Purpose To determine the prevalence and identify predictors of medical intractability in children presenting with epilepsy prior to 36 months of age, and to assess the impact of medical intractability on long-term mortality and intellectual function. Methods Children with newly-diagnosed epilepsy prior to 36 months between 1980–2009 while resident in Olmsted County, MN were identified. Medical records were reviewed to collect epilepsy specific variables and long-term outcome data. Medically intractable epilepsy was defined as either (1) seizures greater than every 6 months at final follow-up and failure of two or more antiepileptic drugs for lack of efficacy, or (2) having undergone epilepsy surgery after failure of two or more antiepileptic drugs. Key Findings One hundred and twenty seven children with new-onset epilepsy were identified and followed for a median of 78 months. Medically intractable seizures occurred in 35%, and significant predictors on multivariate analysis were age ?12 months at diagnosis (odds ratio [OR] 6.76, 95% confidence interval [CI] 2.00, 22.84, p=0.002), developmental delay at initial diagnosis of epilepsy (OR 20.03, 95% CI 3.49, 114.83, p=0.0008 ), neuroimaging abnormality (OR 6.48, 95% CI 1.96, 21.40, p=0.002) and focal slowing on initial EEG (OR 5.33, 95% CI 1.14, 24.88, p=0.03). Medical intractability occurred early in the course in most children, being seen in 61% by one year, and 93% by five years after initial diagnosis. Mortality was higher (20% vs 0%, p<0.001) and intellectual outcome poorer (p<0.001) if epilepsy was medically intractable. Significance One third of children presenting with epilepsy before 36 months will be medically intractable and significant predictors are identified. Medically intractable epilepsy is associated with increased mortality risk and significant intellectual disability. PMID:22738069

Wirrell, Elaine; Wong-Kisiel, Lily; Mandrekar, Jay; Nickels, Katherine

2012-01-01

225

Advanced Practice Internship: Experiential Learning in a Drug Use and Disease State Management Program  

PubMed Central

Objective Establish a 3-year hospital internship within a drug use and disease state management program that would provide doctor of pharmacy students with experiential learning while still completing their classroom studies. Design As paid interns, students engaged in group and individual activities that assessed clinical practice guidelines. Patient monitoring and clinical intervention techniques were learned through prospective evaluation of drug therapy. Students designed evidence-based treatment guidelines and participated in all phases of development, including multidisciplinary approval, implementation, and evaluation stages. Assessment Student competency was continually monitored through direct observation by a preceptor and written examinations. Patient case studies, group discussions, and poster presentations allowed assessment of student growth in knowledge and communication skills. Conclusion The comprehensive structure of this internship provides a broad perspective for understanding the role of the hospital pharmacist in providing pharmaceutical care. Close supervision maximizes student learning potential and fosters a mentoring relationship for both personal and professional growth. PMID:17136188

Skledar, Susan J.; McKaveney, Teresa P.; Ward, Charles O.; Culley, Colleen M.; Ervin, Kelly C.; Weber, Robert J.

2006-01-01

226

The TAR model: use of therapeutic state transitions for quality assurance reporting in chronic disease management.  

PubMed

Chronic disease management represents one of the challenges for health informatics and demands the appropriate application of information technology for improved patient care. This paper presents an approach to quality assurance reporting wherein the recommendations of evidence-based clinical practice guidelines are considered in the context of empirical therapeutic state-transitions (in terms of changes in individual patient prescriptions over time). We apply a Transition-based Audit Report (TAR) model to antihypertensive prescribing and related data as stored in a New Zealand General Practice Management System database. The results provide a set of quality indicators and specific patient cohorts for potential practice quality improvement with strong linkage to the selected guidelines and observed practice patterns. We see the TAR model primarily as a tool to enable internal quality improvement efforts, but also to be of relevance for focusing pay-for-performance programs. PMID:17911839

Gaikwad, R; Warren, J; Kenealy, T

2007-01-01

227

Modular reorganization of brain resting state networks and its independent validation in Alzheimer's disease patients.  

PubMed

Previous studies have demonstrated disruption in structural and functional connectivity occurring in the Alzheimer's Disease (AD). However, it is not known how these disruptions alter brain network reorganization. With the modular analysis method of graph theory, and datasets acquired by the resting-state functional connectivity MRI (R-fMRI) method, we investigated and compared the brain organization patterns between the AD group and the cognitively normal control (CN) group. Our main finding is that the largest homotopic module (defined as the insula module) in the CN group was broken down to the pieces in the AD group. Specifically, it was discovered that the eight pairs of the bilateral regions (the opercular part of inferior frontal gyrus, area triangularis, insula, putamen, globus pallidus, transverse temporal gyri, superior temporal gyrus, and superior temporal pole) of the insula module had lost symmetric functional connection properties, and the corresponding gray matter concentration (GMC) was significant lower in AD group. We further quantified the functional connectivity changes with an index (index A) and structural changes with the GMC index in the insula module to demonstrate their great potential as AD biomarkers. We further validated these results with six additional independent datasets (271 subjects in six groups). Our results demonstrated specific underlying structural and functional reorganization from young to old, and for diseased subjects. Further, it is suggested that by combining the structural GMC analysis and functional modular analysis in the insula module, a new biomarker can be developed at the single-subject level. PMID:23950743

Chen, Guangyu; Zhang, Hong-Ying; Xie, Chunming; Chen, Gang; Zhang, Zhi-Jun; Teng, Gao-Jun; Li, Shi-Jiang

2013-01-01

228

Current status of Marek's disease in the United States and worldwide based on a questionnaire survey.  

PubMed

A questionnaire was widely distributed in 2011 to estimate the global prevalence of Marek's disease (MD) and gain a better understanding of current control strategies and future concerns. A total of 112 questionnaires were returned representing 116 countries from sources including national branch secretaries of the World Veterinary Poultry Association, vaccine, breeder, and production companies, as well as MD researchers from various backgrounds. Each country listed on a questionnaire was recorded as an individual entry, and on average there were 2.0 entries per country (median 1; range 1-13). All flock types were listed as having increased MD incidence during the last 10 yr in close to 50% of countries by at least one respondent, with the majority of these countries located within French-speaking Africa, Eastern Europe, East Asia, and South America. Only 18 countries (16%) indicated increasing MD incidence was likely due to higher virulent strains, while the presence of other immunosuppressive diseases was a more common explanation. Increased use of CVI988/Rispens was cited as the most likely reason for decreasing MD incidence in 49 countries (42%). In the United States, MD incidence has continued to decrease during the last 10 yr, reaching a record low in 2007 (0.0008%) as measured by leukosis condemnation rates in broilers at slaughter. However, a recent increase of leukosis condemnations in North Carolina and Pennsylvania needs to be closely monitored. PMID:23901765

Dunn, John R; Gimeno, Isabel M

2013-06-01

229

Utility of arthroscopic guided synovial biopsy in understanding synovial tissue pathology in health and disease states  

PubMed Central

The synovium is the soft tissue lining diarthrodial joints, tendon sheaths and bursae and is composed of intimal and subintimal layers. The intimal layer is composed of type A cells (macrophages) and type B cells (fibroblasts); in health, the subintima has few inflammatory cells. The synovium performs several homeostatic functions and is the primary target in several inflammatory arthritides. Inflammatory states are characterised by thickening of the synovial lining, macrophage recruitment and fibroblast proliferation, and an influx of inflammatory cells including lymphocytes, monocytes and plasma cells. Of the various methods employed to perform synovial biopsies arthroscopic techniques are considered the “gold standard”, and have an established safety record. Synovial biopsy has been of critical importance in understanding disease pathogenesis and has provided insight into mechanisms of action of targeted therapies by way of direct evidence about events in the synovial tissue in various arthritides. It has been very useful as a research tool for proof of concept studies to assess efficacy and mechanisms of new therapies, provide tissue for in vitro studies, proteomics and microarrays and allow evaluation for biomarkers that may help predict response to therapy and identify new targets for drug development. It also has diagnostic value in the evaluation of neoplastic or granulomatous disease or infection when synovial fluid analysis is non-contributory. PMID:25405084

Wechalekar, Mihir D; Smith, Malcolm D

2014-01-01

230

Bacterial Infection in Chronic Obstructive Pulmonary Disease in 2000: a State-of-the-Art Review  

PubMed Central

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States. The precise role of bacterial infection in the course and pathogenesis of COPD has been a source of controversy for decades. Chronic bacterial colonization of the lower airways contributes to airway inflammation; more research is needed to test the hypothesis that this bacterial colonization accelerates the progressive decline in lung function seen in COPD (the vicious circle hypothesis). The course of COPD is characterized by intermittent exacerbations of the disease. Studies of samples obtained by bronchoscopy with the protected specimen brush, analysis of the human immune response with appropriate immunoassays, and antibiotic trials reveal that approximately half of exacerbations are caused by bacteria. Nontypeable Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae are the most common causes of exacerbations, while Chlamydia pneumoniae causes a small proportion. The role of Haemophilus parainfluenzae and gram-negative bacilli remains to be established. Recent progress in studies of the molecular mechanisms of pathogenesis of infection in the human respiratory tract and in vaccine development guided by such studies promises to lead to novel ways to treat and prevent bacterial infections in COPD. PMID:11292642

Sethi, Sanjay; Murphy, Timothy F.

2001-01-01

231

Resting-State Network Disruption and APOE Genotype in Alzheimer's Disease: A lagged Functional Connectivity Study  

PubMed Central

Background The apolipoprotein E epsilon 4 (APOE-4) is associated with a genetic vulnerability to Alzheimer's disease (AD) and with AD-related abnormalities in cortical rhythms. However, it is unclear whether APOE-4 is linked to a specific pattern of intrinsic functional disintegration of the brain after the development of the disease or during its different stages. This study aimed at identifying spatial patterns and effects of APOE genotype on resting-state oscillations and functional connectivity in patients with AD, using a physiological connectivity index called “lagged phase synchronization”. Methodology/Principal Findings Resting EEG was recorded during awake, eyes-closed state in 125 patients with AD and 60 elderly controls. Source current density and functional connectivity were determined using eLORETA. Patients with AD exhibited reduced parieto-occipital alpha oscillations compared with controls, and those carrying the APOE-4 allele had reduced alpha activity in the left inferior parietal and temporo-occipital cortex relative to noncarriers. There was a decreased alpha2 connectivity pattern in AD, involving the left temporal and bilateral parietal cortex. Several brain regions exhibited increased lagged phase synchronization in low frequencies, specifically in the theta band, across and within hemispheres, where temporal lobe connections were particularly compromised. Areas with abnormal theta connectivity correlated with cognitive scores. In patients with early AD, we found an APOE-4-related decrease in interhemispheric alpha connectivity in frontal and parieto-temporal regions. Conclusions/Significance In addition to regional cortical dysfunction, as indicated by abnormal alpha oscillations, there are patterns of functional network disruption affecting theta and alpha bands in AD that associate with the level of cognitive disturbance or with the APOE genotype. These functional patterns of nonlinear connectivity may potentially represent neurophysiological or phenotypic markers of AD, and aid in early detection of the disorder. PMID:23050006

Canuet, Leonides; Tellado, Ivan; Couceiro, Veronica; Fraile, Carmen; Fernandez-Novoa, Lucia; Ishii, Ryouhei; Takeda, Masatoshi; Cacabelos, Ramon

2012-01-01

232

A group-theoretical notation for disease states: an example using the psychiatric rating scale  

PubMed Central

Background While many branches of natural science have embraced group theory reaping enormous advantages for their respective fields, clinical medicine lacks to date such applications. Here we intend to explain a prototypal model based on the postulates of groups that could have potential in categorizing clinical states. Method As an example, we begin by modifying the original ‘Brief Psychiatric Rating Scale’ (BPRS), the most frequently used standards for evaluating the psychopathology of patients with schizophrenia. We consider a presumptively idealized (virtually standardized) BPRS (denoted BPRS-I) with assessments ranging from ‘0’ to ‘6’ to simplify our discussion. Next, we introduce the modulo group Z7 containing elements {0,1,2,…,6} defined by composition rule, ‘modulo 7 addition’, denoted by *. Each element corresponds to a score resulting from grading a symptom under the BPRS-I assessment. By grading all symptoms associated with the illness, a Cartesian product, denoted Aj, constitutes a summary of a patient assessment. By considering operations denoted A(j?k) that change state Aj into state Ak, a group M (that itself contains Aj and Ak as elements) is also considered. Furthermore, composition of these operations obey modulo 7 arithmetic (i.e., addition, multiplication, and division). We demonstrate the application with a simple example in the form of a series of states (A4?=?A1*A(1?2)*A(2?3)*A(3?4)) to illustrate this result. Results The psychiatric disease states are defined as 18-fold Cartesian products of Z7, i.e., Z7×18?=?Z7×…×Z7 (18 times). We can construct set G???{a(m)i| m?=?1,2,3,…(the patient’s history of the i-th symptom)} and M???{Am | Am ? Z7×18 (the set of all possible assessments of a patient)} simplistically, at least, in terms of modulo 7 addition that satisfies the group postulates. Conclusions Despite the large limitations of our methodology, there are grounds not only within psychiatry but also within other medical fields to consider more generalized notions based on groups (if not rings and fields). These might enable through some graduated expression a systematization of medical states and of medical procedures in a manner more aligned with other branches of natural science. PMID:22776348

2012-01-01

233

Predictive Value of Rapid Decline in Mini Mental State Examination in Clinical Practice for Prognosis in Alzheimer’s Disease  

Microsoft Academic Search

Background: Given the poorer prognosis of Alzheimer’s disease (AD) patients with rapid cognitive decline (RCD), there is a need for a clinical assessment tool to detect these patients. Objective: To investigate if there is a Mini Mental State Examination (MMSE) threshold of decline during 6 months of follow-up which predicts a worse disease progression at the 2-year follow-up. Then, to

Maria E. Soto; Sandrine Andrieu; Christelle Cantet; Emma Reynish; Pierre-Jean Ousset; Christophe Arbus; Sophie Gillette-Guyonnet; Fati Nourhashémi; Bruno Vellas

2008-01-01

234

Functional Connectivity Estimated from Intracranial EEG Predicts Surgical Outcome in Intractable Temporal Lobe Epilepsy  

PubMed Central

This project aimed to determine if a correlation-based measure of functional connectivity can identify epileptogenic zones from intracranial EEG signals, as well as to investigate the prognostic significance of such a measure on seizure outcome following temporal lobe lobectomy. To this end, we retrospectively analyzed 23 adult patients with intractable temporal lobe epilepsy (TLE) who underwent an invasive stereo-EEG (SEEG) evaluation between January 2009 year and January 2012. A follow-up of at least one year was required. The primary outcome measure was complete seizure-freedom at last follow-up. Functional connectivity between two areas in the temporal lobe that were sampled by two SEEG electrode contacts was defined as Pearson’s correlation coefficient of interictal activity between those areas. SEEG signals were filtered between 5 and 50 Hz prior to computing this correlation. The mean and standard deviation of the off diagonal elements in the connectivity matrix were also calculated. Analysis of the mean and standard deviation of the functional connections for each patient reveals that 90% of the patients who had weak and homogenous connections were seizure free one year after temporal lobectomy, whereas 85% of the patients who had stronger and more heterogeneous connections within the temporal lobe had recurrence of seizures. This suggests that temporal lobectomy is ineffective in preventing seizure recurrence for patients in whom the temporal lobe is characterized by weakly connected, homogenous networks. This pilot study shows promising potential of a simple measure of functional brain connectivity to identify epileptogenicity and predict the outcome of epilepsy surgery. PMID:24205027

Antony, Arun R.; Alexopoulos, Andreas V.; González-Martínez, Jorge A.; Mosher, John C.; Jehi, Lara; Burgess, Richard C.; So, Norman K.; Galán, Roberto F.

2013-01-01

235

A versatile cryo-focussing flow switching gas chromatography inlet for trace analysis of intractable compounds.  

PubMed

A wide variety of samples that can be analysed by gas chromatography do not lend themselves to the usual preparation of solvent extracts for split-splitless injections, and are best handled by purge and trap or equilibrium headspace sampling. A cryo-focussing, flow switching gas chromatography inlet system that handles different types of sample without the need for hardware changes has been prototyped. It provides excellent repeatability and linearity with liquid injections, purge and trap, and equilibrium headspace samples, in both split and splitless modes. The performance of the system was tested with sub-nanogram quantities of challenging analytes such as free carboxylic acids, alcohols, diols, phenols and aldehydes, and volatiles purged from contaminated soil, mammal faeces, a pesticide formulation, and a spice. Repeatability RSDs for peak areas were consistently below 11% and repeatabilities of retention times below 0.05%, independently of sample type (liquid or gas phase) and nature or quantity of compound. Regression coefficients of peak areas vs. quantity were typically ? 0.999 over two orders of magnitude ranges extending down to below 0.01 ng, also independently of sample and analyte. Limits of quantitation were robustly below 0.1-0.2 ng. Peak shapes and resolution are the same with use of the cryo-trap and flow switch as they are with conventional injections. Performance is robust to flow rate and, for most compounds, to trapping and desorption temperature. The cryo-trapping flow switching inlet's performance parameters match those of other sample introduction systems, and are achieved with sub-nanogram quantities of intractable analytes. PMID:22920301

Apps, Peter; Mmualefe, Lesego

2012-09-28

236

Stem cell transplantation improves aging-related diseases  

PubMed Central

Aging is a complex process of damage accumulation, and has been viewed as experimentally and medically intractable. The number of patients with age-associated diseases such as type 2 diabetes mellitus (T2DM), osteoporosis, Alzheimer's disease (AD), Parkinson's disease, atherosclerosis, and cancer has increased recently. Aging-related diseases are related to a deficiency of the immune system, which results from an aged thymus and bone marrow cells. Intra bone marrow-bone marrow transplantation (IBM-BMT) is a useful method to treat intractable diseases. This review summarizes findings that IBM-BMT can improve and treat aging-related diseases, including T2DM, osteoporosis and AD, in animal models. PMID:25364723

Ikehara, Susumu; Li, Ming

2014-01-01

237

Adult Moyamoya Disease in an Urban Center in the United States Is Associated With a High Burden of Watershed Ischemia  

PubMed Central

Background Adult moyamoya disease is rare in the United States, and patients mostly present with cerebral ischemia. However, clinical and neurodiagnostic correlates of ischemia are not well known in this population. We sought to characterize the clinical and radiographic features of moyamoya disease in a large urban center in the United States, with a focus on angiographic and neuroimaging patterns of ischemia. Methods and Results We retrospectively reviewed charts of consecutive adult moyamoya disease patients evaluated at 2 centers in Houston, Texas from January 2002 to December 2011. We reviewed all available cerebral angiograms and neuroimaging studies to evaluate the Suzuki grades, presence of intracranial hemorrhage or ischemia, infarct patterns, and vascular territory distribution. Our analysis was mainly descriptive. We identified 31 adults with moyamoya disease who met our inclusion criteria. The female?to?male ratio was 2.4:1. The majority of patients were white, followed by Hispanic, black, and Asian. Most presented with ischemia (61%), followed by headaches, and intracranial hemorrhage. Of the 22 patients with available neuroimaging, 72.7% had ischemic findings, with the vast majority having a watershed pattern (81.3%). Conclusions We observed a high burden of ischemia, mostly watershed pattern on neuroimaging in our adult moyamoya disease patients. Long?term monitoring of adult moyamoya disease patients in the United States would be useful to better understand the natural history of this condition. PMID:25037198

Zafar, Sahar F.; Bershad, Eric M.; Gildersleeve, Kasey L.; Newmark, Michael E.; Calvillo, Eusebia; Suarez, Jose I.; Venkatasubba Rao, Chethan P.

2014-01-01

238

Resting-state fMRI changes in Alzheimer's disease and mild cognitive impairment.  

PubMed

Regional functional connectivity (FC) of 39 patients with Alzheimer's disease (AD), 23 patients with mild cognitive impairment (MCI), and 43 healthy elderly controls was studied using resting-state functional magnetic resonance imaging (rs-fMRI). After a mean follow-up of 2.8 ± 1.9 years, 7 MCI patients converted to AD, while 14 patients remained cognitively stable. Resting-state functional magnetic resonance imaging scans were analyzed using independent component analysis (ICA), followed by a "dual-regression" technique to create and compare subject-specific maps of each independent spatiotemporal component, correcting for age, sex, and gray matter atrophy. AD patients displayed lower FC within the default-mode network (DMN) in the precuneus and posterior cingulate cortex compared with controls, independent of cortical atrophy. Regional FC values of MCI patients were numerically in between AD patients and controls, but only the difference between AD and stable MCI patients was statistically significant. Correlation with cognitive dysfunction demonstrated the clinical relevance of FC changes within the DMN. In conclusion, clinically relevant decreased FC within the DMN was observed in AD. PMID:21862179

Binnewijzend, Maja A A; Schoonheim, Menno M; Sanz-Arigita, Ernesto; Wink, Alle Meije; van der Flier, Wiesje M; Tolboom, Nelleke; Adriaanse, Sofie M; Damoiseaux, Jessica S; Scheltens, Philip; van Berckel, Bart N M; Barkhof, Frederik

2012-09-01

239

Altered Resting State Cortico-Striatal Connectivity in Mild to Moderate Stage Parkinson's Disease  

PubMed Central

Parkinson's disease (PD) is a progressive neurodegenerative disorder that is characterized by dopamine depletion in the striatum. One consistent pathophysiological hallmark of PD is an increase in spontaneous oscillatory activity in the basal ganglia thalamocortical networks. We evaluated these effects using resting state functional connectivity MRI in mild to moderate stage Parkinson's patients on and off l-DOPA and age-matched controls using six different striatal seed regions. We observed an overall increase in the strength of cortico-striatal functional connectivity in PD patients off l-DOPA compared to controls. This enhanced connectivity was down-regulated by l-DOPA as shown by an overall decrease in connectivity strength, particularly within motor cortical regions. We also performed a frequency content analysis of the BOLD signal time course extracted from the six striatal seed regions. PD off l-DOPA exhibited increased power in the frequency band 0.02–0.05?Hz compared to controls and to PD on l-DOPA. The l-DOPA associated decrease in the power of this frequency range modulated the l-DOPA associated decrease in connectivity strength between striatal seeds and the thalamus. In addition, the l-DOPA associated decrease in power in this frequency band correlated with the l-DOPA associated improvement in cognitive performance. Our results demonstrate that PD and l-DOPA modulate striatal resting state BOLD signal oscillations and cortico-striatal network coherence. PMID:21206528

Kwak, Youngbin; Peltier, Scott; Bohnen, Nicolaas I.; Müller, Martijn L. T. M.; Dayalu, Praveen; Seidler, Rachael D.

2010-01-01

240

Seroprevalence of infectious bursal disease virus in local chickens in Udu Local Government Area of Delta State, South East Nigeria.  

PubMed

Infectious Bursal Disease Virus (IBDV) poses a great global threat to the poultry industry. Knowledge of the occurrence of the disease is important in the design and implementation of a control program, therefore this study determines the seroprevalence of IBDV in local chickens in Udu Local Government Area of Delta State. 250 chickens were bled by exsanguination and sera obtained were screened using Agar Gel Immunodiffusion (AGID) test. The seropositivity was 51.6%, which is indicates endemicity of the disease. Biosecurity and good sanitary measures are recommended. Molecular characterization of the strains should be carried out for inclusion in generic vaccines. PMID:25331185

Abraham-Oyiguh, J; Adewumi, M O; Onoja, A B; Suleiman, I; Sulaiman, L K; Ahmed, S J; Jagboro, S T

2015-01-01

241

Climate variability and change in the United States: potential impacts on vector- and rodent-borne diseases.  

PubMed Central

Diseases such as plague, typhus, malaria, yellow fever, and dengue fever, transmitted between humans by blood-feeding arthropods, were once common in the United States. Many of these diseases are no longer present, mainly because of changes in land use, agricultural methods, residential patterns, human behavior, and vector control. However, diseases that may be transmitted to humans from wild birds or mammals (zoonoses) continue to circulate in nature in many parts of the country. Most vector-borne diseases exhibit a distinct seasonal pattern, which clearly suggests that they are weather sensitive. Rainfall, temperature, and other weather variables affect in many ways both the vectors and the pathogens they transmit. For example, high temperatures can increase or reduce survival rate, depending on the vector, its behavior, ecology, and many other factors. Thus, the probability of transmission may or may not be increased by higher temperatures. The tremendous growth in international travel increases the risk of importation of vector-borne diseases, some of which can be transmitted locally under suitable circumstances at the right time of the year. But demographic and sociologic factors also play a critical role in determining disease incidence, and it is unlikely that these diseases will cause major epidemics in the United States if the public health infrastructure is maintained and improved. PMID:11359689

Gubler, D J; Reiter, P; Ebi, K L; Yap, W; Nasci, R; Patz, J A

2001-01-01

242

The Impact of Movements and Animal Density on Continental Scale Cattle Disease Outbreaks in the United States  

PubMed Central

Globalization has increased the potential for the introduction and spread of novel pathogens over large spatial scales necessitating continental-scale disease models to guide emergency preparedness. Livestock disease spread models, such as those for the 2001 foot-and-mouth disease (FMD) epidemic in the United Kingdom, represent some of the best case studies of large-scale disease spread. However, generalization of these models to explore disease outcomes in other systems, such as the United States’s cattle industry, has been hampered by differences in system size and complexity and the absence of suitable livestock movement data. Here, a unique database of US cattle shipments allows estimation of synthetic movement networks that inform a near-continental scale disease model of a potential FMD-like (i.e., rapidly spreading) epidemic in US cattle. The largest epidemics may affect over one-third of the US and 120,000 cattle premises, but cattle movement restrictions from infected counties, as opposed to national movement moratoriums, are found to effectively contain outbreaks. Slow detection or weak compliance may necessitate more severe state-level bans for similar control. Such results highlight the role of large-scale disease models in emergency preparedness, particularly for systems lacking comprehensive movement and outbreak data, and the need to rapidly implement multi-scale contingency plans during a potential US outbreak. PMID:24670977

Buhnerkempe, Michael G.; Tildesley, Michael J.; Lindström, Tom; Grear, Daniel A.; Portacci, Katie; Miller, Ryan S.; Lombard, Jason E.; Werkman, Marleen; Keeling, Matt J.; Wennergren, Uno; Webb, Colleen T.

2014-01-01

243

Effects of acetylcholinesterase inhibitors and memantine on resting-state electroencephalographic rhythms in Alzheimer's disease patients.  

PubMed

Acetylcholinesterase inhibitors (AChEIs) are the most widely used symptomatic treatment for mild to severe Alzheimer's disease (AD) patients, while N-methyl-d-aspartic acid (NMDA) receptor antagonist memantine is licensed for use in moderate to severe AD patients. In this article, the effect of these compounds on resting state eyes-closed electroencephalographic (EEG) rhythms in AD patients is reviewed to form a knowledge platform for the European Innovative Medicine Initiative project "PharmaCog" (IMI Grant Agreement No. 115009) aimed at developing innovative translational models for drug testing in AD. Indeed, quite similar EEG experiments and the same kind of spectral data analysis can be performed in animal models of AD and in elderly individuals with prodromal or manifest AD. Several studies have shown that AChEIs affect both resting state EEG rhythms and cognitive functions in AD patients. After few weeks of successful treatment, delta (0-3 Hz) or theta (4-7 Hz) rhythms decrease, dominant alpha rhythms (8-10 Hz) increase, and cognitive functions slightly improve. Beneficial effects of these rhythms and cognitive functions were also found in AD responders to the long-term successful treatment (i.e. 6-12 months). In contrast, only one study has explored the long-term effects of memantine on EEG rhythms in AD patients, showing reduced theta rhythms. The present review enlightens the expected effects of AChEIs on resting state EEG rhythms in AD patients as promising EEG markers for the development of translational protocols both within the PharmaCog project and for wider use. PMID:23098644

Babiloni, Claudio; Del Percio, Claudio; Bordet, Regis; Bourriez, Jean-Luis; Bentivoglio, Marina; Payoux, Pierre; Derambure, Philippe; Dix, Sophie; Infarinato, Francesco; Lizio, Roberta; Triggiani, Antonio Ivano; Richardson, Jill C; Rossini, Paolo M

2013-05-01

244

Occupational silica exposure and risk of various diseases: an analysis using death certificates from 27 states of the United States  

PubMed Central

Background: Although crystalline silica exposure is associated with silicosis, lung cancer, pulmonary tuberculosis, and chronic obstructive pulmonary disease (COPD), there is less support for an association with autoimmune disease, and renal disease. Methods: Using data from the US National Occupational Mortality Surveillance (NOMS) system, a matched case-control design was employed to examine each of several diseases (including silicosis, lung cancer, stomach cancer, oesophageal cancer, COPD, pulmonary tuberculosis, sarcoidosis, systemic lupus erythematosus, systemic sclerosis, rheumatoid arthritis, and various types of renal disease). Cases were subjects whose death certificate mentioned the disease of interest. A separate control group for each of the diseases of interest was selected from among subjects whose death certificate did not mention the disease of interest or any of several diseases reported to be associated with crystalline silica exposure. Subjects were assigned into a qualitative crystalline silica exposure category based on the industry/occupation pairing found on their death certificate. We also investigated whether silicotics had a higher risk of disease compared to those without silicosis. Results: Those postulated to have had detectable crystalline silica exposure had a significantly increased risk for silicosis, COPD, pulmonary tuberculosis, and rheumatoid arthritis. In addition, a significant trend of increasing risk with increasing silica exposure was observed for these same conditions and for lung cancer. Those postulated to have had the greatest crystalline silica exposure had a significantly increased risk for silicosis, lung cancer, COPD, and pulmonary tuberculosis only. Finally, those with silicosis had a significantly increased risk for COPD, pulmonary tuberculosis, and rheumatoid arthritis. Conclusions: This study corroborates the association between crystalline silica exposure and silicosis, lung cancer, COPD, and pulmonary tuberculosis. In addition, support is provided for an association between crystalline silica exposure and rheumatoid arthritis. PMID:12554840

Calvert, G; Rice, F; Boiano, J; Sheehy, J; Sanderson, W

2003-01-01

245

Sex-specific relationships between adverse childhood experiences and chronic obstructive pulmonary disease in five states  

PubMed Central

Purpose Adverse childhood experiences (ACEs) before age 18 have been repeatedly associated with several chronic diseases in adulthood such as depression, heart disease, cancer, diabetes, and stroke. We examined sex-specific relationships between individual ACEs and the number of ACEs with chronic obstructive pulmonary disease (COPD) in the general population. Materials and methods Data from 26,546 women and 19,015 men aged ?18 years in five states of the 2011 Behavioral Risk Factor Surveillance System were analyzed. We used log-linear regression to estimate prevalence ratios (PRs) and their corresponding 95% confidence intervals (CIs) for the relationship of eight ACEs with COPD after adjustment for age group, race/ethnicity, marital status, educational attainment, employment, asthma history, health insurance coverage, and smoking status. Results Some 63.8% of women and 62.2% of men reported ?1 ACE. COPD was reported by 4.9% of women and 4.0% of men. In women, but not in men, there was a higher likelihood of COPD associated with verbal abuse (PR =1.30, 95% CI: 1.05, 1.61), sexual abuse (PR =1.69, 95% CI: 1.36, 2.10), living with a substance abusing household member (PR =1.49, 95% CI: 1.23, 1.81), witnessing domestic violence (PR =1.40, 95% CI: 1.14, 1.72), and parental separation/divorce (PR =1.47, 95% CI: 1.21, 1.80) during childhood compared to those with no individual ACEs. Reporting ?5 ACEs (PR =2.08, 95% CI: 1.55, 2.80) compared to none was associated with a higher likelihood of COPD among women only. Conclusion ACEs are related to COPD, especially among women. These findings underscore the need for further research that examines sex-specific differences and the possible mechanisms linking ACEs and COPD. This work adds to a growing body of research suggesting that ACEs may contribute to health problems later in life and suggesting a need for program and policy solutions. PMID:25298732

Cunningham, Timothy J; Ford, Earl S; Croft, Janet B; Merrick, Melissa T; Rolle, Italia V; Giles, Wayne H

2014-01-01

246

Seven Strains of Enterovirus D68 Detected in the United States during the 2014 Severe Respiratory Disease Outbreak  

PubMed Central

Clusters of severe respiratory disease in the United States were reported to the CDC beginning in August 2014. Enterovirus D68 (EV-D68) was identified from 83% (30/36) of initial severe cases. Investigations in August and September found severe EV-D68 cases to be widespread across the United States. We report seven EV-D68 genomes from the outbreak. PMID:25414503

Brown, B. A.; Nix, W. A.; Sheth, M.; Frace, M.

2014-01-01

247

Identification of lymphoproliferative disease virus in wild turkeys (Meleagris gallopavo) in the United States  

Technology Transfer Automated Retrieval System (TEKTRAN)

Viral-associated lymphoproliferative neoplasia in domestic poultry is caused by infection with a herpesvirus (Marek’s disease virus) or three species of retroviruses [Reticuloendotheliosis virus (REV), Avian leukosis/sarcoma virus, lymphoproliferative disease virus (LPDV)]. Previously, retroviral n...

248

Racial/Ethnic Disparities in Chronic Diseases of Youths and Access to Health Care in the United States  

PubMed Central

Racial/ethnic minorities are 1.5 to 2.0 times more likely than whites to have most of the major chronic diseases. Chronic diseases are also more common in the poor than the nonpoor and this association is frequently mediated by race/ethnicity. Specifically, children are disproportionately affected by racial/ethnic health disparities. Between 1960 and 2005 the percentage of children with a chronic disease in the United States almost quadrupled with racial/ethnic minority youth having higher likelihood for these diseases. The most common major chronic diseases of youth in the United States are asthma, diabetes mellitus, obesity, hypertension, dental disease, attention-deficit/hyperactivity disorder, mental illness, cancers, sickle-cell anemia, cystic fibrosis, and a variety of genetic and other birth defects. This review will focus on the psychosocial rather than biological factors that play important roles in the etiology and subsequent solutions to these health disparities because they should be avoidable and they are inherently unjust. Finally, this review examines access to health services by focusing on health insurance and dental insurance coverage and access to school health services. PMID:24175301

Price, James H.; Braun, Robert

2013-01-01

249

Hemodynamic Energy Dissipation in the Cardiovascular System: Generalized Theoretical Analysis on Disease States  

Microsoft Academic Search

Background We present a fundamental theoretical framework for analysis of energy dissipation in any component of the circulatory system\\u000a and formulate the full energy budget for both venous and arterial circulations. New indices allowing disease-specific subject-to-subject\\u000a comparisons and disease-to-disease hemodynamic evaluation (quantifying the hemodynamic severity of one vascular disease type\\u000a to the other) are presented based on this formalism. Methods

Lakshmi P. Dasi; Kerem Pekkan; Diane de Zelicourt; Kartik S. Sundareswaran; Resmi Krishnankutty; Pedro J. Delnido; Ajit P. Yoganathan

2009-01-01

250

Parent satisfaction in a nurse led clinic compared with a paediatric gastroenterology clinic for the management of intractable, functional constipation  

PubMed Central

Aims To assess parent satisfaction with a nurse led clinic for children with intractable, functional constipation compared with a paediatric gastroenterology outpatient clinic. Methods A validated questionnaire covering six separate domains in 48 statements (provision of information, empathy with the patient, technical quality and competence, attitude towards the patient, access to and continuity with the caregiver, and overall satisfaction) was employed. For all outcomes, the data were analysed on an intention?to?treat basis. Results 90/107 (84%) questionnaires were returned: 40/51 (78%) from the paediatric gastroenterology clinic and 50/56 (89%) from the nurse led clinic. Results indicated a high “total” satisfaction with the clinical care, but these were statistically significantly higher in the nurse led clinic compared with the paediatric gastroenterology clinic (median score 8.7 and 7.3 respectively, out of a maximum score of 10). This difference was consistent across all domains when the scores from those attending the nurse led clinic were compared with those attending the paediatric gastroenterology clinic (information median score 8.7 v 7.5; empathy 9.0 v 7.3; competence 9.1 v 8.0; attitude 8.7 v 7.3; access 8.2 v 6.7). All comparisons were highly statistically significant. Conclusion These results provide firm evidence that parents of children with intractable constipation are satisfied with the care they receive in both the paediatric and nursing clinic setting. Parent satisfaction, however, was significantly higher in those attending the nurse led clinic. This study adds further support to the development of a nurse led service to manage intractable, functional constipation in children. PMID:16531455

Sullivan, P B; Burnett, C A; Juszczak, E

2006-01-01

251

Physician preferences in the diagnosis and treatment of Lyme disease in the United States  

Microsoft Academic Search

Summary To assess physician preferences in the diagnosis and treatment of Lyme disease, questionnaires were sent to physicians in various Lyme disease endemic areas in the U. S. Seventy-eight responses were analyzed. Both ELISA and Western blot were ordered by 86% of responders. Fifty percent of responders believed that 25% or more of patients who have Lyme disease were seronegative.

Martina H. Ziska; S. T. Donta; F. C. Demarest

1996-01-01

252

Surveillance for Waterborne Disease Outbreaks and Other Health Events Associated with Recreational Water -United States, 2007-2008*  

EPA Science Inventory

Problem/Condition: Since 1978, CDC, the U.S. Environmental Protection Agency, and the Council of State and Territorial Epidemiologists have collaborated on the Waterborne Disease and Outbreak Surveillance System (WBDOSS) for collecting and reporting data on occurrences and causes...

253

THE PEARLY FRESH-WATER MUSSELS OF THE UNITED STATES; THEIR HABITS, ENEMIES, AND DISEASES, WITH SUGGESTIONS FOR THEIR  

E-print Network

THE PEARLY FRESH-WATER MUSSELS OF THE UNITED STATES; THEIR HABITS, ENEMIES, AND DISEASES, WITH SUGGESTIONS FOR THEIR PROTECTION. By CHARLES T. SIMPSON. The Naiades, or pearly fresh-water mussels, have and accurate information. In the present paper the subject of the pearly mussels will be treated more from

254

Virulent Newcastle disease viruses isolated from cormorant and gull species in the states of the Atlantic Flyway in 2010  

Technology Transfer Automated Retrieval System (TEKTRAN)

Newcastle disease viruses (NDV) have been the causative agent for die-offs of juvenile double-crested cormorants (Phalacrocorax auritus) in the northern border-states focused around the Great Lakes of the U.S. in years past. However, the most recent die-off has included not only great cormorants (P...

255

Whole Genome Sequencing to Investigate the Emergence of Clonal Complex 23 Neisseria meningitidis Serogroup Y Disease in the United States  

Microsoft Academic Search

In the United States, serogroup Y, ST-23 clonal complex Neisseria meningitidis was responsible for an increase in meningococcal disease incidence during the 1990s. This increase was accompanied by antigenic shift of three outer membrane proteins, with a decrease in the population that predominated in the early 1990s as a different population emerged later in that decade. To understand factors that

Mary G. Krauland; Julie C. Dunning Hotopp; David R. Riley; Sean C. Daugherty; Jane W. Marsh; Nancy E. Messonnier; Leonard W. Mayer; Hervé Tettelin; Lee H. Harrison

2012-01-01

256

Infectious disease and dermatologic conditions in evacuees and rescue workers after Hurricane Katrina--multiple states, August-September, 2005.  

PubMed

On August 29, 2005, Hurricane Katrina struck states along the Gulf Coast of the United States. In the days after the hurricane struck, approximately 750 evacuation centers were established in at least 18 states to accommodate more than 200,000 evacuees. State and local health departments, with assistance from CDC, initiated enhanced infectious disease surveillance and outbreak response activities, implemented by teams of public health and rescue workers, including military personnel. Outbreak monitoring included direct reporting of conditions of public health significance to public health agencies; daily contact between CDC and local public health officials; canvassing of reports from CDC, public health departments, and news media for potential infectious disease outbreaks; and investigation of reports of infectious disease with outbreak potential. This report summarizes infectious disease and dermatologic conditions reported during the first 3 weeks after the hurricane, before effective local surveillance was fully implemented. One outbreak of norovirus was reported among evacuees in Texas; no other outbreaks requiring unusual mobilization of public health resources were reported among evacuees or rescue workers. PMID:16195696

2005-09-30

257

Multimodal Stepped Care Approach Involving Topical Analgesics for Severe Intractable Neuropathic Pain in CRPS Type 1: A Case Report  

PubMed Central

A multimodal stepped care approach has been successfully applied to a patient with complex regional pain syndrome type 1 and severe intractable pain, not responding to regular neuropathic pain medication. The choice to administer drugs in creams was made because of the intolerable adverse effects to oral medication. With this method, peak-dose adverse effects did not occur. The multimodal stepped care approach resulted in considerable and clinically relevant decrease in pain after every step, using topical amitriptyline, ketamine, and dimethylsulphoxide. PMID:22028723

Kopsky, David J.; Keppel Hesselink, Jan M.

2011-01-01

258

Multimodal Stepped Care Approach Involving Topical Analgesics for Severe Intractable Neuropathic Pain in CRPS Type 1: A Case Report.  

PubMed

A multimodal stepped care approach has been successfully applied to a patient with complex regional pain syndrome type 1 and severe intractable pain, not responding to regular neuropathic pain medication. The choice to administer drugs in creams was made because of the intolerable adverse effects to oral medication. With this method, peak-dose adverse effects did not occur. The multimodal stepped care approach resulted in considerable and clinically relevant decrease in pain after every step, using topical amitriptyline, ketamine, and dimethylsulphoxide. PMID:22028723

Kopsky, David J; Keppel Hesselink, Jan M

2011-01-01

259

Intradural approach to selective stimulation in the spinal cord for treatment of intractable pain: design principles and wireless protocol  

NASA Astrophysics Data System (ADS)

We introduce an intradural approach to spinal cord stimulation for the relief of intractable pain, and describe the biophysical rationale that underlies its design and performance requirements. The proposed device relies on wireless, inductive coupling between a pial surface implant and its epidural controller, and we present the results of benchtop experiments that demonstrate the ability to transmit and receive a frequency-modulated 1.6 MHz carrier signal between micro-coil antennae scaled to the ? 1 cm dimensions of the implant, at power levels of about 5 mW. Plans for materials selection, microfabrication, and other aspects of future development are presented and discussed.

Howard, M. A.; Utz, M.; Brennan, T. J.; Dalm, B. D.; Viljoen, S.; Jeffery, N. D.; Gillies, G. T.

2011-08-01

260

The Mitochondrial Proteome: A Dynamic Functional Program in Tissues and Disease States  

PubMed Central

The nuclear DNA transcriptional programming of the mitochondria proteome varies dramatically between tissues depending on its functional requirements. This programming generally regulates all of the proteins associated with a metabolic or biosynthetic pathway associated with a given function, essentially regulating the maximum rate of the pathway while keeping the enzymes at the same molar ratio. This may permit the same regulatory mechanisms to function at low and high flux capacity situations. This alteration in total protein content results in rather dramatic changes in the mitochondria proteome between tissues. A tissues mitochondria proteome also changes with disease state, in Type 1 diabetes the liver mitochondrial proteome shifts to support ATP production, urea synthesis and fatty acid oxidation. Acute flux regulation is modulated by numerous post-translational events that also are highly variable between tissues. The most studied post-translational modification is protein phosphorylation which is found all of the Complexes of oxidative phosphorylation and most of the major metabolic pathways. The functional significance of these modifications is currently a major area of research along with the kinase and phosphatase regulatory network. This near ubiquitous presence of protein phosphorylations, and other post-translational events, in the matrix suggest that not all post-translational events have functional significance. Screening methods are being introduced to detect the active or dynamic post-translational sites to focus attention on sites that might provide insight into regulatory mechanisms. PMID:20544878

Balaban, Robert S.

2011-01-01

261

Role of cilia in normal pancreas function and in diseased states.  

PubMed

Primary cilia play an essential role in modulating signaling cascades that shape cellular responses to environmental cues to maintain proper tissue development. Mutations in primary cilium proteins have been linked to several rare developmental disorders, collectively known as ciliopathies. Together with other disorders associated with dysfunctional cilia/centrosomes, affected individuals have increased risk of developing metabolic syndrome, neurologic disorders, and diabetes. In pancreatic tissues, cilia are found exclusively in islet and ductal cells where they play an essential role in pancreatic tissue organization. Their absence or disorganization leads to pancreatic duct abnormalities, acinar cell loss, polarity defects, and dysregulated insulin secretion. Cilia in pancreatic tissues are hubs for cellular signaling. Many signaling components, such as Hh, Notch, and Wnt, localize to pancreatic primary cilia and are necessary for proper development of pancreatic epithelium and ?-cell morphogenesis. Receptors for neuroendocrine hormones, such as Somatostatin Receptor 3, also localize to the cilium and may play a more direct role in controlling insulin secretion due to somatostatin's inhibitory function. Finally, unique calcium signaling, which is at the heart of ?-cell function, also occurs in primary cilia. Whereas voltage-gated calcium channels trigger insulin secretion and serve a variety of homeostatic functions in ?-cells, transient receptor potential channels regulate calcium levels within the cilium that may serve as a feedback mechanism, regulating insulin secretion. This review article summarizes our current understanding of the role of primary cilia in normal pancreas function and in the diseased state. PMID:24861006

diIorio, Philip; Rittenhouse, Ann R; Bortell, Rita; Jurczyk, Agata

2014-06-01

262

Diseases diagnosed in gray foxes (Urocyon cinereoargenteus) from the southeastern United States.  

PubMed

Diagnostic findings were reviewed on 157 sick or dead gray foxes (Urocyon cinereoargenteus) from the southeastern United States examined during the period 1972 through 1989. Most foxes (n = 118) originated from Georgia; fewer animals were from Florida, Kentucky, Maryland, Mississippi, North Carolina, South Carolina, Tennessee, Virginia and West Virginia. Etiologic diagnoses included canine distemper (n = 125), congenital absence of guard hairs (n = 7), traumatic injuries (n = 7), rabies (n = 3), suspected toxicoses (n = 3), verminous pneumonia due to Paragonimus kellicotti (n = 1), bacterial septicemia secondary to Dracunculus insignis (n = 1), and tick paralysis (n = 1). Concurrent toxoplasmosis or toxoplasmosis or cryptosporidiosis was noted in six and three foxes with canine distemper, respectively. Only lesion diagnoses were attainable for three foxes, and six cases were classified as undetermined. Canine distemper was diagnosed in 78% of the foxes, was geographically widespread, was detected in 16 of 18 yr, and exhibited a seasonal pattern of occurrence. These facts indicate that canine distemper is more significant as a mortality factor for gray foxes than all other infectious and noninfectious diseases combined. PMID:1548799

Davidson, W R; Nettles, V F; Hayes, L E; Howerth, E W; Couvillion, C E

1992-01-01

263

Prethrombotic state and cardiac events in patients with coronary heart disease during noncardiac surgery.  

PubMed

This study aimed to investigate the significance of the prethrombotic state (PTS) and 4 plasma markers in predicting perisurgical adverse cardiac events in patients with coronary heart disease (CHD) undergoing abdominal surgery. Perioperative adverse effects were recorded in 128 consecutive patients with CHD undergoing elective abdominal surgery. Plasma d-dimer, P-selectin, von Willebrand factor (VWF), and thrombus precursor protein were measured before and after the surgery. Patients with abnormal values in one or more of the 4 PTS markers were identified as having PTS, and data were analyzed by univariate and multivariate logistic regression. Abnormal presurgery levels of the 4 markers were found more frequently in those with adverse perioperative cardiac events than in those without. Multivariate analysis showed the odds ratios for adverse cardiac events to be 64.3 (PTS, P < .001), 25.7 (VWF, P = .003), and 23.5 (P-selectin, P = .04). Preoperative PTS is an independent risk factor for perioperative events in patients with CHD undergoing noncardiac surgery. PMID:23262969

Zheng, Hong; Ma, Hai-Ping; Chen, Lin; Zhan, Hai-Ting; Guo, Hai

2014-01-01

264

Emotional state affects gait initiation in individuals with Parkinson’s disease  

PubMed Central

The purpose of the present study was to determine the impact of manipulating emotional state on gait initiation in persons with Parkinson’s disease (PD) and healthy older adults. Following the presentation of pictures that are known to elicit specific emotional responses, participants initiated gait and continued to walk for several steps at their normal pace. Reaction time, the displacement and velocity of the center of pressure (COP) trajectory during the preparatory postural adjustments, and length and velocity of the first two steps were measured. Analysis of the gait initiation measures revealed that exposure to (1) threatening pictures, relative to all other pictures, speeded the initiation of gait for PD patients and healthy older adults; (2) approach-oriented emotional pictures (erotic and happy people), relative to withdrawal-oriented pictures, facilitated the anticipatory postural adjustments of gait initiation for PD patients and healthy older adults, as evidenced by greater displacement and velocity of the COP movement; and (3) emotional pictures modulated gait initiation parameters in PD patients to the same degree as in healthy older adults. Collectively, these findings hold significant implications for understanding the circuitry underlying the manner by which emotions modulate movement and for the development of emotion-based interventions designed to maximize improvements in gait initiation for individuals with PD. PMID:22194236

Hass, Chris J.; Bowers, Dawn; Janelle, Christopher M.

2013-01-01

265

Metabolic States Following Accumulation of Intracellular Aggregates: Implications for Neurodegenerative Diseases  

PubMed Central

The formation of intracellular aggregates is a common etiology of several neurodegenerative diseases. Mitochondrial defects and oxidative stress has been pointed as the major mechanistic links between the accumulation of intracellular aggregates and cell death. In this work we propose a “metabolic cell death by overcrowding” as an alternative hypothesis. Using a model of neuron metabolism, we predict that as the concentration of protein aggregates increases the neurons transit through three different metabolic phases. The first phase (0–6 mM) corresponds with the normal neuron state, where the neuronal activity is sustained by the oxidative phosphorylation of lactate. The second phase (6–8.6 mM) is characterized by a mixed utilization of lactate and glucose as energy substrates and a switch from ammonia uptake to ammonia release by neurons. In the third phase (8.6–9.3 mM) neurons are predicted to support their energy demands from glycolysis and an alternative pathway for energy generation, involving reactions from serine synthesis, one carbon metabolism and the glycine cleavage system. The model also predicts a decrease in the maximum neuronal capacity for energy generation with increasing the concentration of protein aggregates. Ultimately this maximum capacity becomes zero when the protein aggregates reach a concentration of about 9.3 mM, predicting the cessation of neuronal activity. PMID:23667676

Vazquez, Alexei

2013-01-01

266

The adjuvant use of lansoprazole, clonazepam and dimenhydrinate for treating intractable hiccups in a patient with gastritis and reflux esophagitis complicated with myocardial infarction: a case report  

PubMed Central

Background Hiccup (Singultus) is a sudden and involuntary contraction of the diaphragm followed by a sharp closure of the epiglottis which results in the production of a specific “hic” sound. Normally, hiccups are treated without intervention. Intractable hiccups occur rarely but are a disturbing symptom underlying other health related disorders. Case presentation We report the clinical case of a 67-year-old male patient with myocardial infarction accompanied by intractable hiccups during the course of 8 months, and who was non-responsive to chlorpromazine or metoclopramide, and baclofen; drugs routinely used to treat this condition. This sustained hiccup had severely restricted the patient's ability to intake food and sleep. To explore alternative treatments, we investigated the adjuvant administration of lansoprazole, dimenhydrinate and clonazepam in this patient. We discovered that this drug combination was capable of successfully terminating his intractable hiccups, with no further evidence of recurrence. No similar treatment is previously reported for intractable hiccups. We further suggest a hypothesis concerning a potential mechanism on the anti-hiccup effect of dimenhydrinate. Conclusion We identified that the adjuvant use of lansoprazole, clonazepam and dimenhydrinate was capable of attenuating the symptoms of our patient with intractable hiccups. PMID:23954069

2013-01-01

267

Ketamine treatment for intractable pain in a patient with severe refractory complex regional pain syndrome: a case report.  

PubMed

In this case report, we describe the effect of ketamine infusion in a case of severe refractory complex regional pain syndrome I (CRPS I). The patient was initially diagnosed with CRPS I in her right upper extremity. Over the next 6 years, CRPS was consecutively diagnosed in her thoracic region, left upper extremity, and both lower extremities. The severity of her pain, combined with the extensive areas afflicted by CRPS, caused traumatic emotional problems for this patient. Conventional treatments, including anticonvulsants, bisphosphonates, oral steroids and opioids, topical creams, dorsal column spinal cord stimulation, spinal morphine infusion, sympathetic ganglion block, and sympathectomy, failed to provide long-term relief from pain. An N-methyl-d-aspartate (NMDA) antagonist inhibitor, ketamine, was recently suggested to be effective at resolving intractable pain. The patient was then given several infusions of intravenous ketamine. After the third infusion, the edema, discoloration, and temperature of the affected areas normalized. The patient became completely pain-free. At one-year of follow-up, the patient reported that she has not experienced any pain since the last ketamine infusion. Treatment with intravenous ketamine appeared to be effective in completely resolving intractable pain caused by severe refractory CRPS I. Future research on this treatment is needed. PMID:18523505

Shirani, Peyman; Salamone, Alicia R; Schulz, Paul E; Edmondson, Everton A

2008-01-01

268

Primary non-Hodgkin’s lymphoma of the prostate with intractable hematuria: A case report and review of the literature  

PubMed Central

Cases of primary non-Hodgkin’s lymphoma of the prostate are globally rare. The present study reports a case of prostatic diffuse large B-cell lymphoma (DLBCL) with intractable hematuria in a 75-year-old male. The patient presented with difficulties in urination and gross hematuria. A prostate biopsy was performed immediately, followed by conservative treatment for bleeding. A bilateral iliac arteriography and chemoembolization were then performed as emergency procedures under local anesthesia due to significant bleeding and a sharply decreased blood pressure, indicating the failure of the conservative treatment. Consequently, the bleeding was effectively controlled. Pathological examination of the prostate biopsy confirmed the presence of a DLBCL of non-germinal center B-cell origin. Immunohistochemical examination demonstrated cluster of differentiation (CD)20(++), CD3(+), leukocyte common antigen(+++), B-cell lymphoma-2(+) and prostate-specific antigen(?) results. Due to the poor general condition and low hemoglobin levels of the patient, a low-dose Rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) chemotherapy regimen was administered. Subsequent to three courses of chemotherapy, the patient achieved complete remission. In conclusion, combining R-CHOP and bilateral selective iliac arterial chemoembolization could be a safe and effective way to treat patients with non-Hodgkin’s lymphoma of the prostate and intractable hematuria. PMID:25663879

HU, SHANBIAO; WANG, YINHUAI; YANG, LUOYAN; YI, LU; NIAN, YEQI

2015-01-01

269

Spectrum disorder of neuromyelitis optica in a patient presenting with intractable vomiting and hiccups, transverse myelitis and acute encephalopathy.  

PubMed

Optic neuropathy and transverse myelitis (TM) are common symptoms of multiple sclerosis (MS) but may also be seen in association with the antibody-mediated autoimmune disorder, neuromyelitis optica (NMO). We report a female patient presenting with intractable vomiting and hiccups and TM shortly followed by an acute encephalopathy, most likely due to NMO spectrum disorder. Serum and cerebrospinal fluid NMO antibodies were negative. Serial MRI abnormalities included longitudinally extensive TM of the cervical cord, focal T2-weighted hyperintensity of the area postrema and lesions in both thalami and the hypothalamus. Clinical and MRI involvement of these brain regions, which have high aquaporin expression, in conjunction with a spinal lesion extending over three vertebral segments strongly favoured a diagnosis of NMO. She required several courses of intravenous methylprednisolone and plasmapheresis before receiving intravenous rituximab therapy. NMO spectrum disorder should be considered in the differential diagnosis of atypical central nervous system presentations such as intractable vomiting and hiccups and acute encephalopathy. Recognition of this syndrome has significant implications as its treatment and prognosis differs from MS. PMID:22925418

Patel, Vishal; Griffith, Neil C; Blackwood, Emma; Dias, Manu; Cordato, Dennis J

2012-11-01

270

Central-part laryngectomy is a useful and less invasive surgical procedure for resolution of intractable aspiration.  

PubMed

A novel narrow-field laryngectomy procedure known as central-part laryngectomy (CPL) for less invasive laryngeal diversion in patients with intractable aspiration is introduced. We conducted retrospective case reviews of 15 patients who underwent CPL. In this procedure, an area of the glottis including the mid-part of the thyroid cartilage and cricoid cartilage is removed to separate the digestive tract from the air way. The lateral part of the thyroid cartilage, the entire hypopharyngeal mucosa and epiglottis are preserved. The superior laryngeal vessels and nerve are not invaded. All fifteen patients were relieved of aspiration without major complications. In good accordance with cutting of the cricopharyngeal muscles and removal of the cricoid cartilage, postoperative videofluoroscopy demonstrated smooth passages of barium. Ten of 12 patients who had hoped to resume oral food intake became able to do so after CPL and two others also achieved partial oral deglutition. CPL is a useful procedure for treatment of intractable aspiration and offers considerable advantages over other laryngotracheal diversion procedures from the view point of oral food intake. PMID:24136476

Kawamoto, Ai; Katori, Yukio; Honkura, Yohei; Kakuta, Risako; Higashi, Kenjiro; Ogura, Masaki; Miyazaki, Makiko; Arakawa, Kazuya; Kashima, Kazutaka; Asada, Yukinori; Matsuura, Kazuto

2014-05-01

271

Combined ultrasound and fluoroscopic guidance for radiofrequency ablation of the obturator nerve for intractable cancer-associated hip pain.  

PubMed

Management of pain from skeletal metastases is notoriously difficult. Case reports and case series have described radiofrequency ablation of the obturator nerve branches to the femoral head for treatment of intractable hip pain. Ablation of the obturator branches to the femoral head is technically difficult because of bony and vascular anatomy, including close proximity of the femoral vessels. Here we present the case of a 79-year-old woman with intractable right hip pain and inability to ambulate secondary to metastatic non-small cell lung cancer in the femoral head and acetabulum, treated with thermal radiofrequency ablation of the obturator and femoral nerve branches to the femoral head. Ablation of the obturator nerve was done via anterior placement of the radiofrequency needle under combined ultrasound and fluoroscopic guidance, passing the radiofrequency needle between the femoral artery and femoral vein. Real-time ultrasound guidance was used to avoid vascular puncture. Thermal radiofrequency ablation resulted in sustained pain relief, and resumption in the ability of the patient to ambulate. From this case we suggest that an anterior approach to the obturator nerve branches to the femoral head may be technically feasible using combined ultrasound and fluoroscopic guidance to avoid vascular puncture. PMID:24452660

Stone, Jonathan; Matchett, Gerald

2014-01-01

272

Motor cortex stimulation: functional magnetic resonance imaging-localized treatment for three sources of intractable facial pain.  

PubMed

Neuropathic facial pain can be a debilitating condition characterized by stabbing, burning, dysesthetic sensation. With a large range of causes and types, including deafferentation, postherpetic, atypical, and idiopathic, both medicine and neurosurgery have struggled to find effective treatments that address this broad spectrum of facial pain. The authors report the use of motor cortex stimulation to alleviate 3 distinct conditions associated with intractable facial pain: trigeminal deafferentation pain following rhizotomy, deafferentation pain secondary to meningioma, and postherpetic neuralgia. Functional MR imaging was used to localize facial areas on the precentral gyrus prior to surgery. All 3 patients experienced long-lasting complete or near-complete resolution of pain following electrode implantation. Efficacy in pain reduction was achieved through variation of stimulation settings over the course of treatment, and it was assessed using the visual analog scale and narrative report. Surgical complications included moderate postsurgical incisional pain, transient cerebral edema, and intraoperative seizure. The authors' results affirm the efficacy and broaden the application of motor cortex stimulation to several forms of intractable facial pain. PMID:20509733

Esfahani, Darian R; Pisansky, Marc T; Dafer, Rima M; Anderson, Douglas E

2011-01-01

273

An Assessment of Non-Communicable Diseases, Diabetes, and Related Risk Factors in the Federated States of Micronesia, State of Chuuk: A Systems Perspective  

PubMed Central

Non-communicable diseases (NCD) have been identified as a health emergency in the US-affiliated Pacific Islands (USAPI).1 This assessment, funded by the National Institutes of Health, was conducted in the Federated States of Micronesia, State of Chuuk and describes the burdens due to selected NCDs (diabetes, heart disease, hypertension, stroke, chronic kidney disease); and assesses the system of service capacity and current activities for service delivery, data collection and reporting as well as identifying the issues that need to be addressed. There has been a 9.2% decline in the total population between 2000 and 2010. Findings of medical and health data reveal that diabetes, myocardial infarction, and septicemia are the leading causes of death and lower limb surgical procedures and amputations was a major problem that was addressed with a foot care education program to prevent amputations. No data were available on the prevalence of diabetes among the population of Chuuk. Other findings show significant gaps in the system of administrative, clinical, data, and support services to address these NCDs. There is a lack of policy and procedure manuals, coordination among providers, and common standards of care. There is no functional data system to identify and track patients with diabetes and other chronic diseases. Priority issues and problems were identified for the clinical, administrative, and data systems. PMID:23901365

Shomour, Moria; Marar, Julio; Lippwe, Kipier; Aitaoto, Nia

2013-01-01

274

2. State-space search D. Keil Artificial Intelligence 6/13 David Keil, Framingham State University  

E-print Network

2. State-space search D. Keil Artificial Intelligence 6/13 David Keil, Framingham State University CSCI 300 Artificial Intelligence 2. State-space search 1. Constraint and optimization problems 2. Goal-driven search 3. Exhaustive search and intractability 4. Heuristics 1D. Keil CSCI 300 Artificial Intelligence 2

Keil, David M.

275

Regional Disparities in Mortality after Ischemic Heart Disease in a Brazilian State from 2006 to 2010  

PubMed Central

Background High technology in the field of interventional cardiology applied in tertiary hospitals has brought enormous benefits in the treatment of ischemic heart disease (IHD). However, IHD mortality rates remain high. We analyzed the relationship between IHD mortality rate and the socioeconomic, demographic, and geographic conditions in 399 cities in Parana state, Brazil, from 2006 to 2010. Methods and Results Data were obtained from the Mortality Information System and the Brazilian Institute of Geography and Statistics and evaluated through Exploratory Spatial Data Analysis. GeoDa™ was used to analyze 29.351 deaths across 399 cities. We found a positive spatial autocorrelation regarding IHD mortality (I?=?0.5913, p?=?0.001). There was a significant positive association between each of three socioeconomic and demographic indicators and IHD mortality rate: Population Elderly Index (I?=?0.3436), Illiteracy Rate (I?=?0.1873) and City Development Index (I?=?0.0900). In addition, two indicators presented significant negative association with IHD mortality rate: Adjusted Population Size (I?=??0.1216) and Gross Domestic Product (I?=??0.0864). We also found a positive association between IHD mortality rates and the geographic distances between patients’ city of residence and their corresponding regional referral centers in interventional cardiology (I?=?0.3368). Cities located within Regional Health Units with Reference Interventional Cardiology Center presented a significantly lower average specific mortality rate by IHD. The high mortality rate by IHD within the Regional Health Units was not restricted to socioeconomic and demographic variables, but dependent on the distance between each city and their reference interventional cardiology center. Conclusions We conclude that geographic factors play a significant role in IHD mortality within cities. These findings have important policy implications regarding the geographic distribution of cardiac health care networks in Latin America and in other emerging countries. PMID:23527174

de Andrade, Luciano; Zanini, Vanessa; Batilana, Adelia Portero; de Carvalho, Elias Cesar Araujo; Pietrobon, Ricardo; Nihei, Oscar Kenji; de Barros Carvalho, Maria Dalva

2013-01-01

276

Cognitive impairment and resting-state network connectivity in Parkinson's disease.  

PubMed

The purpose of this work was to evaluate changes in the connectivity patterns of a set of cognitively relevant, dynamically interrelated brain networks in association with cognitive deficits in Parkinson's disease (PD) using resting-state functional MRI. Sixty-five nondemented PD patients and 36 matched healthy controls were included. Thirty-four percent of PD patients were classified as having mild cognitive impairment (MCI) based on performance in attention/executive, visuospatial/visuoperceptual (VS/VP) and memory functions. A data-driven approach using independent component analysis (ICA) was used to identify the default-mode network (DMN), the dorsal attention network (DAN) and the bilateral frontoparietal networks (FPN), which were compared between groups using a dual-regression approach controlling for gray matter atrophy. Additional seed-based analyses using a priori defined regions of interest were used to characterize local changes in intranetwork and internetwork connectivity. Structural group comparisons through voxel-based morphometry and cortical thickness were additionally performed to assess associated gray matter atrophy. ICA results revealed reduced connectivity between the DAN and right frontoinsular regions in MCI patients, associated with worse performance in attention/executive functions. The DMN displayed increased connectivity with medial and lateral occipito-parietal regions in MCI patients, associated with worse VS/VP performance, and with occipital reductions in cortical thickness. In line with data-driven results, seed-based analyses mainly revealed reduced within-DAN, within-DMN and DAN-FPN connectivity, as well as loss of normal DAN-DMN anticorrelation in MCI patients. Our findings demonstrate differential connectivity changes affecting the networks evaluated, which we hypothesize to be related to the pathophysiological bases of different types of cognitive impairment in PD. Hum Brain Mapp, 36:199-212, 2015. © 2014 Wiley Periodicals, Inc. PMID:25164875

Baggio, Hugo-Cesar; Segura, Bàrbara; Sala-Llonch, Roser; Marti, Maria-José; Valldeoriola, Francesc; Compta, Yaroslau; Tolosa, Eduardo; Junqué, Carme

2015-01-01

277

An Assessment of Non-Communicable Diseases, Diabetes, and Related Risk Factors in the Federated States of Micronesia, State of Kosrae: A Systems Perspective  

PubMed Central

Non-communicable diseases (NCD) have been identified as a health emergency in the US-affiliated Pacific Islands (USAPI).1 This assessment, funded by the National Institutes of Health, was conducted in the Federated States of Micronesia, State of Kosrae and describes the burdens due to NCDs, including diabetes, and assesses the system of service capacity and current activities for service delivery, data collection and reporting as well as identifying the issues that need to be addressed. There has been a 13.9% decline in the population between 2000 and 2010. Findings reveal that the risk factors of poor diet, lack of physical activity, and lifestyle behaviors lead to overweight and obesity and subsequent NCD that are a significant factor in the morbidity and mortality of the population. Leading causes of death were due to nutrition and metabolic diseases followed by diseases of the circulatory system. Data from selected community programs show that the prevalence of overweight and obese participants ranged between 82% and 95% and the rate of reported diabetes ranged from 13% to 14%. Other findings show significant gaps in the system of administrative, clinical, data, and support services to address these NCD. There is no functional data system that is able to identify, register, or track patients with diabetes. Priority administrative and clinical issues were identified that need to be addressed to begin to mitigate the burdens of NCDs among the residents of Kosrae State. PMID:23900387

Tolenoa, Nena; Taulung, Livinson; Mongkeya, Maria; Lippwe, Kipier; Aitaoto, Nia

2013-01-01

278

An assessment of non-communicable diseases, diabetes, and related risk factors in the Federated States of Micronesia, State of Kosrae: a systems perspective.  

PubMed

Non-communicable diseases (NCD) have been identified as a health emergency in the US-affiliated Pacific Islands (USAPI). This assessment, funded by the National Institutes of Health, was conducted in the Federated States of Micronesia, State of Kosrae and describes the burdens due to NCDs, including diabetes, and assesses the system of service capacity and current activities for service delivery, data collection and reporting as well as identifying the issues that need to be addressed. There has been a 13.9% decline in the population between 2000 and 2010. Findings reveal that the risk factors of poor diet, lack of physical activity, and lifestyle behaviors lead to overweight and obesity and subsequent NCD that are a significant factor in the morbidity and mortality of the population. Leading causes of death were due to nutrition and metabolic diseases followed by diseases of the circulatory system. Data from selected community programs show that the prevalence of overweight and obese participants ranged between 82% and 95% and the rate of reported diabetes ranged from 13% to 14%. Other findings show significant gaps in the system of administrative, clinical, data, and support services to address these NCD. There is no functional data system that is able to identify, register, or track patients with diabetes. Priority administrative and clinical issues were identified that need to be addressed to begin to mitigate the burdens of NCDs among the residents of Kosrae State. PMID:23900387

Ichiho, Henry M; Tolenoa, Nena; Taulung, Livinson; Mongkeya, Maria; Lippwe, Kipier; Aitaoto, Nia

2013-05-01

279

Genome Sequence of Fusarium oxysporum f. sp. melonis Strain NRRL 26406, a Fungus Causing Wilt Disease on Melon  

PubMed Central

Horizontal chromosome transfer introduces host-specific pathogenicity among members of the Fusarium oxysporum species complex and is responsible for some of the most destructive and intractable plant diseases. This paper reports the genome sequence of F. oxysporum f. sp. melonis (NRRL 26406), a causal agent of Fusarium wilt disease on melon. PMID:25081257

Shea, Terrance; Young, Sarah; Zeng, Qiandong; Kistler, H. Corby

2014-01-01

280

Comorbid occurrence of laryngeal or pulmonary disease with esophagitis in United States military veterans  

Microsoft Academic Search

BACKGROUND & AIMS: It has been speculated that gastroesophageal reflux disease (GERD) represents a risk factor for the occurrence of extraesophageal complications. The aim of this study was to compare the comorbid occurrence of sinus, laryngeal, and pulmonary diseases in case subjects with and control subjects without reflux esophagitis. METHODS: The case population consisted of all patients with erosive esophagitis

HB el-Serag; A Sonnenberg

1997-01-01

281

Software for generating liability distributions for pedigrees conditional on their observed disease states and covariates.  

PubMed

For many multifactorial diseases, aetiology is poorly understood. A major research aim is the identification of disease predictors (environmental, biological, and genetic markers). In order to achieve this, a two-stage approach is proposed. The initial or synthesis stage combines observed pedigree data with previous genetic epidemiological research findings, to produce estimates of pedigree members' disease risk and predictions of their disease liability. A further analysis stage uses the latter as inputs to look for associations with potential disease markers. The incorporation of previous research findings into an analysis should lead to power gains. It also allows separate predictions for environmental and genetic liabilities to be generated. This should increase power for detecting disease predictors that are environmental or genetic in nature. Finally, the approach brings pragmatic benefits in terms of data reduction and synthesis, improving comprehensibility, and facilitating the use of existing statistical genetics tools. In this article we present a statistical model and Gibbs sampling approach to generate liability predictions for multifactorial disease for the synthesis stage. We have implemented the approach in a software program. We apply this program to a specimen disease pedigree, and discuss the results produced, comparing its results with those generated under a more naïve model. We also detail simulation studies that validate the software's operation. PMID:19771574

Campbell, Desmond D; Sham, Pak C; Knight, Jo; Wickham, Harvey; Landau, Sabine

2010-02-01

282

Identification of lymphoproliferative disease virus in wild turkeys (Meleagris gallopavo) in the southeastern United States  

Technology Transfer Automated Retrieval System (TEKTRAN)

The eight cases described herein represent the first reports of lymphoproliferative disease virus (LPDV) infection in wild turkeys and the first identification of LPDV in North America. Systemic lymphoproliferative disease was presumably the cause of morbidity and mortality in five of the eight turk...

283

Disease State Differentiation and Identification of Tuberculosis Biomarkers via Native Antigen Array Profiling  

Microsoft Academic Search

A critical element of tuberculosis control is early and sensitive diagnosis of infection and disease. Our labora- tories recently showed that different stages of disease were distinguishable via two-dimensional Western blot analyses of Mycobacterium tuberculosis culture filtrate proteins. However, this methodology is not suitable for high throughput testing. Advances in protein microarray technology provide a realistic mechanism to screen a

Mark J. Sartain; Richard A. Slayden; Krishna K. Singh; Suman Laal; John T. Belisle

2006-01-01

284

Correlation between “ABO” blood group phenotypes and periodontal disease: Prevalence in south Kanara district, Karnataka state, India  

PubMed Central

Background: The correlation between certain systemic diseases and ABO blood group is a well-documented fact. The association between periodontal disease and ABO blood group is not studied in relation to a specific geographic location. Here is a study conducted on a group of patients belonging to South Kanara district of Karnataka state. Materials and Methods: A total of 750 subjects aged between 30and 38 years belonging to South Kanara district were selected on random basis. The study subjects were segregated into healthy/mild gingivitis, moderate/severe gingivitis, and periodontitis group, based on Loe and Silness index and clinical attachment loss as criteria. The study group was further categorized and graded using Ramfjord's periodontal disease index. Blood samples were collected to identify ABO blood group. Results: Prevalence of blood group O was more in South Kanara district, followed by blood groups B and A, and the least prevalent was AB. The percentage distribution of subjects with blood groups O and AB was more in healthy/mild gingivitis group (group I) and moderate/severe gingivitis group (group II), while subjects with blood groups B and A were more in periodontitis group III. There was increased prevalence of subjects with blood groups O and AB with healthy periodontium, while subjects with blood groups B and A showed inclination toward diseased periodontium. Conclusion: There is a correlation existing between periodontal disease and ABO blood group in this geographic location. This association can be due to various blood group antigens acting as receptors for infectious agents associated with periodontal disease. This broad correlation between periodontal disease and ABO blood group also points toward susceptibility ofthe subjects with certain blood groups to periodontal disease. PMID:23493096

Pai, Gurpur Prakash; Dayakar, Mundoor Manjunath; Shaila, Mulki; Dayakar, Anitha

2012-01-01

285

Finding Homes for Orphan Cytochrome P450s: CYP4V2 and CYP4F22 in Disease States  

PubMed Central

Genetic analyses have identified a wide spectrum of mutations in the CYP4V2 gene from patients suffering from Bietti’s crystalline corneoretinal dystrophy, and mutations in the CYP4F22 gene have been linked to lamellar ichthyosis. These strong gene–disease associations will be better understood if we can elucidate the substrate specificity of the heretofore “orphan” P450s and unravel the biochemical pathways that go awry in disease states. The complex biotransformations that underlie eicosanoid signaling, however, pose great challenges for the enzymologist seeking to assign specific metabolic roles to these members of the CYP4 family. Inductive reasoning and modeling are crucial tools for designing the experiments that will define disease progression in terms of CYP function. PMID:21540472

Kelly, Edward J.; Nakano, Mariko; Rohatgi, Priyanka; Yarov-Yarovoy, Vladimir; Rettie, Allan E.

2011-01-01

286

A climate-based model predicts the spatial distribution of the Lyme disease vector Ixodes scapularis in the United States.  

PubMed Central

An understanding of the spatial distribution of the black-legged tick, Ixodes scapularis, is a fundamental component in assessing human risk for Lyme disease in much of the United States. Although a county-level vector distribution map exists for the United States, its accuracy is limited by arbitrary categories of its reported presence. It is unknown whether reported positive areas can support established populations and whether negative areas are suitable for established populations. The steadily increasing range of I. scapularis in the United States suggests that all suitable habitats are not currently occupied. Therefore, we developed a spatially predictive logistic model for I. scapularis in the 48 conterminous states to improve the previous vector distribution map. We used ground-observed environmental data to predict the probability of established I. scapularis populations. The autologistic analysis showed that maximum, minimum, and mean temperatures as well as vapor pressure significantly contribute to population maintenance with an accuracy of 95% (p < 0.0001). A cutoff probability for habitat suitability was assessed by sensitivity analysis and was used to reclassify the previous distribution map. The spatially modeled relationship between I. scapularis presence and large-scale environmental data provides a robust suitability model that reveals essential environmental determinants of habitat suitability, predicts emerging areas of Lyme disease risk, and generates the future pattern of I. scapularis across the United States. PMID:12842766

Brownstein, John S; Holford, Theodore R; Fish, Durland

2003-01-01

287

Multiple risk factors and population attributable risk for ischemic heart disease mortality in the United States, 1971–1992  

Microsoft Academic Search

The objective of this study was to assess the associations and population attributable risks (PAR) of risk factor combinations and ischemic heart disease (IHD) mortality in the United States. We used logistic regression models to assess the association of risk factors with IHD in the First National Health and Nutrition Examination Survey (1971–1974) and Epidemiologic Follow-up Study (1982–1992) among white

Man-huei Chang; Robert A Hahn; Steven M Teutsch; Lori C Hutwagner

2001-01-01

288

Impact of metabolic syndrome on the risk of cardiovascular disease mortality in the United States and in Japan.  

PubMed

The United States has a higher prevalence of metabolic syndrome (MS) and cardiovascular disease (CVD) mortality than Japan, but it is unknown how much of the difference in MS accounts for the mortality difference. The aim of this study was to examine the impact of MS on the excess CVD mortality in the United States compared with that in Japan. Data from the United States Third National Health and Nutrition Examination Survey (NHANES III; n = 12,561) and the Japanese National Integrated Project for Prospective Observation of Noncommunicable Disease and Its Trends in Aged (NIPPON DATA; n = 7,453) were analyzed. MS was defined as ?3 of 5 risk factors (obesity, high blood pressure, decreased high-density lipoprotein cholesterol, elevated glycosylated hemoglobin, and elevated triglycerides). The results show that after a median of 13.8 years of follow-up in the United States, 1,683 patients died from CVD (11.75 per 1,000 person-years), and after a median of 15 years of follow-up in Japan, 369 patients died from CVD (3.56 per 1,000 person-years). The age-adjusted prevalence of MS was 26.7% in the United States and 19.3% in Japan. Of 5 MS factors, obesity, high blood pressure, elevated triglycerides, and glycosylated hemoglobin in the United States, and high blood pressure and elevated glycosylated hemoglobin in Japan were significant risk factors for CVD mortality. Estimates of 13.3% and 44% of the excess CVD mortality for the United States could be explained by the higher prevalence of MS and MS plus baseline CVD history than in Japan. In conclusion, the present study is the first to quantitatively demonstrate that MS and MS plus baseline CVD history may significantly contribute to the explanation of excess CVD mortality in the United States compared with Japan. PMID:24169008

Liu, Longjian; Miura, Katsuyuki; Fujiyoshi, Akira; Kadota, Aya; Miyagawa, Naoko; Nakamura, Yasuyuki; Ohkubo, Takayoshi; Okayama, Akira; Okamura, Tomonori; Ueshima, Hirotsugu

2014-01-01

289

Chemotherapy of East Coast fever: the long term weight changes, carrier state and disease manifestations of parvaquone treated cattle.  

PubMed

The weight changes, carrier state and nature of chronic disease in cattle following infection with five isolates of Theileria parva and treatment with parvaquone were studied over an 18 month period while the cattle were maintained on normal management under strict tick control. Cattle infected with the T.p. parva Pugu II isolate gained weight similarly to uninfected control cattle and did not develop a detectable carrier state or show chronic disease. The cattle in the 4 other isolate groups regained the weight lost during the initial infection more slowly, then gained weight in parallel to the control cattle. Transmission of infection through ticks was achieved consistently from the T.p. parva Mbita I and Entebbe II isolate infections and intermittently from the T.p. lawrencei Mara II and Manyara infections. Infections were transmitted from cattle which had neither a detectable parasitaemia nor an antitheilerial antibody titre. Persistent macroschizont parasitoses were detected with the T.p. parva Entebbe II and the two T.p. lawrencei infections. The histopathology of the chronic disease lesions is described and the importance of the carrier state discussed. PMID:3084600

Dolan, T T

1986-03-01

290

A cost-effectiveness study of the management of intractable urinary incontinence by urinary catheterisation or incontinence pads.  

PubMed Central

STUDY OBJECTIVE--The aim was to compare the costs and effects of management of intractable urinary incontinence by urinary catheterisation or incontinence pads. DESIGN--This was a prospective, randomised study comparing catheterisation with pads, supplemented by additional data collected from patients with chronic indwelling catheters. Main outcome measures were costs of equipment, nursing time, patient preference, nursing preference, and clinical and bacteriological assessment of urinary infection. SUBJECTS--78 intractably incontinent elderly female patients were randomly allocated to management by urinary catheter or pads and toileting. Supplementary data on equipment costs and nursing time were collected from 27 patients, of whom 22 were already catheterised at the time of the randomisation and five were catheterised by the nursing staff after the last date for entry into the randomisation. MAIN RESULTS--Of the 38 patients randomised to catheterisation, 14 refused consent so only 24 were catheterised on day 1 of the study. There was a rapid removal of catheters, especially in the first six weeks of the study and only four of the randomised catheter patients completed the full 26 weeks of the study. However, eight of the pads patients were catheterised between the 7th and 22nd week because of deteriorating general condition and all retained their catheters for the remainder of the study period. Of 35 patients who had experienced catheters and pads, 12 expressed a clear preference for catheters, 12 for pads, and 11 were undecided. Nurses were in favour of the use of pads, mainly because of concerns about urinary infection with catheters. Comparing costs for patients managed with catheters (532 patient weeks) or pads (903 patient weeks), catheter patients required less nursing time (15.4 v 29.0 h per patient per week) but equipment costs were higher (19.20-24.65 pounds v 8.79-11.35 pounds per patient per week), mainly because of the cost of catheter care (12.75 pounds per patient per week). Asymptomatic bacteriuria was prevalent in both groups but 73% of catheterised patients received treatment for clinical signs of infection compared with 40% of pads patients. Only 30% of patients who were treated had any generalised symptoms of infection. CONCLUSIONS--Use of catheters reduces nursing time but may increase weekly equipment costs depending on the cost of laundry. Despite the high dropout rate among patients randomised to catheters a minority of patients (12/35) expressed a clear preference for catheters and we believe that more patients with intractable incontinence should be given a trial of catheterisation to assess acceptability. Bacteriuria was prevalent in pads or catheter patients but no major episodes of invasive infection were noted in either group. PMID:1645076

McMurdo, M E; Davey, P G; Elder, M A; Miller, R M; Old, D C; Malek, M

1992-01-01

291

Mortality from Diseases of the Circulatory System in Radiologic Technologists in the United States  

Microsoft Academic Search

Although increased mortality from diseases of the circulatory system has been observed in patients treated with radiotherapy, the effects of chronic low-dose radiation exposure are not clear. Among 90,284 US radiologic technologists who responded to a mailed questionnaire during 1983-1989, the authors evaluated mortality from circulatory system diseases through 1997 in relation to job history and work procedures as surrogates

Michael Hauptmann; Aparna K. Mohan; Michele M. Doody; Martha S. Linet; Kiyohiko Mabuchi

292

Legal Authority for Infectious Disease Reporting in the United States: Case Study of the 2009 H1N1 Influenza Pandemic.  

PubMed

Tracking of infectious diseases is a public health core function essential to disease prevention and control. Each state mandates reporting of certain infectious diseases to public health authorities. These laws vary by state, and the variation could affect the ability to collect critical information. The 2009 H1N1 influenza pandemic served as a case study to examine the legal authority in the 50 states; Washington, DC; and New York City for mandatory infectious disease reporting, particularly for influenza and new or emerging infectious diseases. Our study showed reporting laws to be generally present and functioning well; nevertheless, jurisdictions should be mindful of their mandated parameters and review the robustness of their laws before they face a new or emerging disease outbreak. PMID:25393187

Danila, Richard N; Laine, Ellen S; Livingston, Franci; Como-Sabetti, Kathryn; Lamers, Lauren; Johnson, Kelli; Barry, Anne M

2015-01-01

293

Lyme disease risk influences human settlement in the wildland-urban interface: evidence from a longitudinal analysis of counties in the northeastern United States.  

PubMed

The expansion of human settlement into wildland areas, including forests in the eastern United States, has resulted in fragmented forest habitat that has been shown to drive higher entomological risk for Lyme disease. We investigated an alternative pathway between fragmentation and Lyme disease, namely whether increased risk of Lyme disease results in a reduced propensity to settle in high-risk areas at the interface of developed and undeveloped lands. We used longitudinal data analyses at the county level to determine whether Lyme disease incidence (LDI) influences the proportion of the population residing in the wildland-urban interface in 12 high LDI states in the eastern United States. We found robust evidence that a higher LDI reduces the proportion of a county's population residing in the wildland-urban interface in high-LDI states. This study provides some of the first evidence of human behavioral responses to Lyme disease risk via settlement decisions. PMID:25048372

Larsen, Ashley E; MacDonald, Andrew J; Plantinga, Andrew J

2014-10-01

294

Effective management of intractable neuropathic pain using an intrathecal morphine pump in a patient with acute transverse myelitis  

PubMed Central

Transverse myelitis is a rare inflammatory myelopathy characterized by loss of motor and sensory function below the affected level of the spinal cord, and causes neurogenic bowel and bladder. Occasionally, it also causes neuropathic pain with spasticity. Traditional therapies for neuropathic pain are multiple, including multimodal analgesic regimens, antiepileptic or antidepressant medications, opioids, sympathetic blocks, and spinal cord stimulation. Persistent neuropathic pain can cause emotional distress by affecting sleep, work, recreation, and emotional well-being. Here we report the case of a patient suffering from intractable neuropathic pain following acute transverse myelitis that was not relieved by combinations of nonsteroidal anti-inflammatory, anti-epileptic, antidepressant, and opioid medications, or by acupuncture. Implantation of an intrathecal morphine pump controlled the pain successfully without side effects, and enabled the patient to embark on intensive rehabilitation. The patient’s muscle strength has improved significantly and the patient may soon be able to use a walker with minimal assistance. PMID:23935366

Wu, Wei-Ting; Huang, Yu-Hui; Chen, Der-Cherng; Huang, Yu-Hsuan; Chou, Li-Wei

2013-01-01

295

Identifying the primary epileptogenic hemisphere from electroencephalographic (EEG) and magnetoencephalographic dipole lateralizations in children with intractable epilepsy.  

PubMed

We used electroencephalographic (EEG) and magnetoencephalographic dipole lateralizations to identify the primary epileptogenic hemisphere in 41 children with intractable localization-related epilepsy. We compared EEG and magnetoencephalographic dipole lateralizations, EEG ictal onsets, and magnetic resonance images (MRIs). Concordant lateralization of EEG and magnetoencephalographic dipoles (> 50% of each lateralizing to the same hemisphere) occurred in 34 patients, with EEG ictal onsets in the same hemisphere in 23 (68%) and concordant MRI lesions in 23 (68%). Focal resection in 16 of 20 patients resulted in a good surgical outcome. Of the seven children with nonconcordant magnetoencephalographic and EEG lateralizations, one (14%) had EEG ictal onset and one (14%) had MRI lesions that lateralized; none had surgery. The relationship between lateralized EEG and magnetoencephalographic dipoles forecasts surgical candidacy. Concordant lateralizations predict good seizure control after surgery by identifying the primary epileptogenic hemisphere. Discordant lateralizations signify an undetermined epileptogenic hemisphere and contraindicate surgery without further testing. PMID:16417858

Ochi, Ayako; Otsubo, Hiroshi; Iida, Koji; Oishi, Makoto; Elliott, Irene; Weiss, Shelly K; Kutomi, Tomoko; Nakayama, Tojo; Sharma, Roy; Chuang, Sylvester H; Rutka, James T; Snead, O Carter

2005-11-01

296

Laparoscopic management of sacral nerve root schwannoma with intractable vulvococcygodynia: report of three cases and review of literature.  

PubMed

Herein we report the feasibility of laparoscopic resection of schwannomas of the sacral nerves roots in 3 women with intractable vulvodynia and coccygodynia. Laparoscopic en bloc resection of the sacral schwannomas was performed, with primary control of the tumor blood supply and with exposure and sparing of the sacral nerve roots. In all 3 patients, laparoscopy was successful, with minimal blood loss and without complications. Histologic examination confirmed the diagnosis of schwannoma without malignant transformation in all 3 women. At mean follow-up of 27.66 months, no patient reported recurrence or worsening of symptoms. All patients are able to walk normally without gait aids. Primary control of the tumor blood supply during laparoscopic surgery to resect deep sacral masses reduces considerably the risk of operative hemorrhage. Compared with classic neurosurgical approaches, laparoscopic exposure of the rectum, ureters, and sacral nerve roots renders the procedure safer and easier, with less risk of postoperative functional morbidity. PMID:23522662

Possover, Marc; Kostov, Plamen

2013-01-01

297

The Long-Term Safety and Efficacy of Intrathecal Therapy Using Sufentanil in Chronic Intractable Non-Malignant Pain  

PubMed Central

This report describes the long term safety and efficacy of intrathecal therapy using Sufentanil for the management of chronic intractable neuropathic pain in 12 chronic pain patients. Standardized psychological screening was used to determine treatment suitability. Evaluation data included the Visual Analog Scale (VAS), Wong-Baker Faces Scale, Brief Pain Inventory (BPI), Disability of Arm, Shoulder, and Hand (DASH), McGill Quality of Life Questionnaire, and complications (granulomas, toxicity, withdrawal, or deaths). SPSS version 18 was used for data analysis. Pre- and post- treatment BPI measures and pain scale scores showed a statistically significant difference. There were no complications directly related to drug toxicity, nor drug withdrawals, granulomas, or deaths. Intrathecal therapy with Sufentanil therapy offers a good treatment alternative for those cases that have failed both surgery and standard pain treatment. Strict patient selection based on psychological screening, control of co-morbidities, a proper pain management may contribute to successful outcome. PMID:25031819

Monsivais, Diane Burn

2014-01-01

298

An assessment of non-communicable diseases, diabetes, and related risk factors in the Federated States of Micronesia, State of Pohnpei: a systems perspective.  

PubMed

Non-communicable diseases (NCD) have been identified as a health emergency in the US-affiliated Pacific Islands (USAPI).1 This assessment, funded by the National Institutes of Health, was conducted in the Federated States of Micronesia, State of Pohnpei and describes the burden due to selected NCD (diabetes, heart disease, hypertension, stroke, chronic kidney disease); and assesses the system of service capacity and current activities for service delivery, data collection and reporting as well as identifies the issues that need to be addressed. Findings reveal that the risk factors of poor diet, lack of physical activity, and lifestyle behaviors lead to overweight and obesity and subsequent NCD that are significant factors in the morbidity and mortality of the population. Leading causes of death were due to heart disease, diabetes, cancer, and hypertension. Population survey data show that 32.1% of the adult population had diabetes with a higher rate among women (37.1%) when compared to men (26.4%). The data also showed that 73.1% of the adult population was overweight or obese. Other findings show significant gaps in the system of administrative, clinical, data, and support services to address these NCD. There is no overall planning document for the prevention and control of NCDs or diabetes. There is evidence of little communication among the medical and health care providers which leads to fragmentation of care and loss of continuity of care. Based on some of the findings, priority issues and problems that need to be addressed for the administrative and clinical systems are identified. PMID:23900565

Ichiho, Henry M; Anson, Robina; Keller, Elizabeth; Lippwe, Kipier; Aitaoto, Nia

2013-05-01

299

An assessment of non-communicable diseases, diabetes, and related risk factors in the Federated States of Micronesia, State of Yap: a systems perspective.  

PubMed

Non-communicable diseases (NCD) have been identified as a health emergency in the US-affiliated Pacific Islands (USAPI).1 This assessment, funded by the National Institutes of Health, was conducted in the Federated States of Micronesia, State of Yap, and describes the burdens due to diabetes and other NCDs (heart disease, hypertension, stroke, chronic renal disease), and assesses the system of service capacity and current activities for service delivery, data collection and reporting as well as identifying the issues that need to be addressed. There has been a 1.2% increase in the population between 2000 and 2010; however, there was a significant increase in the 45-64 year old age group. Findings reveal that the risk factors of poor diet, lack of physical activity, and lifestyle behaviors lead to overweight and obesity and subsequent NCD that are a significant factor in the morbidity and mortality of the population. The leading causes of death include cancer, heart disease, and diabetes. Local household surveys show that 63% to 80% of the adults and 20.5% to 33.8% of the children were overweight or obese. The surveys also showed that 23% of the adult population had diabetes and 35% were hypertensive. Other findings show significant gaps in the system of administrative, clinical, data, and support services to address these NCD. There is a policy and procedure manual that guides the NCD staff. There is no functional data system that is able to identify, register, or track patients with diabetes and other NCDs. Priority administrative and clinical issues were identified. PMID:23900490

Ichiho, Henry M; Yurow, Julie; Lippwe, Kipier; Aitaoto, Nia

2013-05-01

300

Argon Plasma Coagulation Therapy Versus Topical Formalin for Intractable Rectal Bleeding and Anorectal Dysfunction After Radiation Therapy for Prostate Carcinoma  

SciTech Connect

Purpose: To evaluate and compare the effect of argon plasma coagulation (APC) and topical formalin for intractable rectal bleeding and anorectal dysfunction associated with chronic radiation proctitis. Methods and Materials: Thirty men (median age, 72 years; range, 49-87 years) with intractable rectal bleeding (defined as ?1× per week and/or requiring blood transfusions) after radiation therapy for prostate carcinoma were randomized to treatment with APC (n=17) or topical formalin (n=13). Each patient underwent evaluations of (1) anorectal symptoms (validated questionnaires, including modified Late Effects in Normal Tissues–Subjective, Objective, Management, and Analytic and visual analogue scales for rectal bleeding); (2) anorectal motor and sensory function (manometry and graded rectal balloon distension); and (3) anal sphincteric morphology (endoanal ultrasound) before and after the treatment endpoint (defined as reduction in rectal bleeding to 1× per month or better, reduction in visual analogue scales to ?25 mm, and no longer needing blood transfusions). Results: The treatment endpoint was achieved in 94% of the APC group and 100% of the topical formalin group after a median (range) of 2 (1-5) sessions of either treatment. After a follow-up duration of 111 (29-170) months, only 1 patient in each group needed further treatment. Reductions in rectal compliance and volumes of sensory perception occurred after APC, but no effect on anorectal symptoms other than rectal bleeding was observed. There were no differences between APC and topical formalin for anorectal symptoms and function, nor for anal sphincteric morphology. Conclusions: Argon plasma coagulation and topical formalin had comparable efficacy in the durable control of rectal bleeding associated with chronic radiation proctitis but had no beneficial effect on anorectal dysfunction.

Yeoh, Eric, E-mail: eric.yeoh@health.sa.gov.au [Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide (Australia); School of Medicine, University of Adelaide, Adelaide (Australia); Tam, William; Schoeman, Mark [School of Medicine, University of Adelaide, Adelaide (Australia); Department of Gastroenterology, Royal Adelaide Hospital, Adelaide (Australia); Moore, James; Thomas, Michelle [School of Medicine, University of Adelaide, Adelaide (Australia); Department of Colorectal Surgery, Royal Adelaide Hospital, Adelaide (Australia); Botten, Rochelle; Di Matteo, Addolorata [Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide (Australia)

2013-12-01

301

Predictors of outcome and pathological considerations in the surgical treatment of intractable epilepsy associated with temporal lobe lesions  

PubMed Central

OBJECTIVES—To evaluate the influence of clinical, investigative, and pathological factors on seizure remission after temporal lobectomy for medically intractable epilepsy associated with focal lesions other than hippocampal sclerosis.?METHODS—From a series of 234 consecutive "en bloc" temporal resections for medically intractable epilepsy performed between 1976 and 1995, neuropathological examination disclosed a focal lesion in 80. The preoperative clinical, neuropsychological, interictal EEG, and neuroimaging characteristics of these patients were assembled in a computerised database. The original neuropathological material was re-examined for lesion classification and completeness of removal. The presence of additional cortical dysplasia and mesial temporal sclerosis was also noted. Survival analysis was performed using Kaplein-Meier curves and actuarial statistics. Logistic regression analysis was used to establish the independent significance of the clinical variables.?RESULTS—The probability of achieving a 1 year seizure remission was 71% by 5 years of follow up. Factors predicting a poor outcome on multivariate analysis included the need for special schooling and a long duration of epilepsy. Generalised tonic-clonic seizures, interictal EEG discharges confined to the resected lobe, demonstration of the lesion preoperatively on CT, and complete histological resection of the lesion were not predictive of outcome. Neuropsychological tests correctly predicted outcome in left sided cases but apparently congruent findings in right sided resections were associated with a poor outcome. Pathological reclassification established the dysembryoplastic neuroepithelial tumour as the commonest neoplasm (87%) in this series, with a significantly better seizure outcome than for developmental lesions, such as focal cortical dysplasia.?CONCLUSIONS—The findings highlight the importance of dysembryoplastic neuroepithelial tumour in the pathogenesis of medically refractory lesional temporal lobe epilepsy and the prognostic significance of preoperative duration of epilepsy emphasises the need for early recognition and surgical treatment. Cognitive and behavioural dysfunction, however, is associated with a lower seizure remission rate, independent of duration of epilepsy.?? PMID:11254766

Hennessy, M; Elwes, R; Honavar, M; Rabe-Hesketh, S; Binnie, C; Polkey, C

2001-01-01

302

Differential diagnosis in inflammatory bowel disease colitis: State of the art and future perspectives  

PubMed Central

Distinction between Crohn’s disease of the colon-rectum and ulcerative colitis or inflammatory bowel disease (IBD) type unclassified can be of pivotal importance for a tailored clinical management, as each entity often involves specific therapeutic strategies and prognosis. Nonetheless, no gold standard is available and the uncertainty of diagnosis may frequently lead to misclassification or repeated examinations. Hence, we have performed a literature search to address the problem of differential diagnosis in IBD colitis, revised current and emerging diagnostic tools and refined disease classification strategies. Nowadays, the differential diagnosis is an untangled issue, and the proper diagnosis cannot be reached in up to 10% of patients presenting with IBD colitis. This topic is receiving emerging attention, as medical therapies, surgical approaches and leading prognostic outcomes require more and more disease-specific strategies in IBD patients. The optimization of standard diagnostic approaches based on clinical features, biomarkers, radiology, endoscopy and histopathology appears to provide only marginal benefits. Conversely, emerging diagnostic techniques in the field of gastrointestinal endoscopy, molecular pathology, genetics, epigenetics, metabolomics and proteomics have already shown promising results. Novel advanced endoscopic imaging techniques and biomarkers can shed new light for the differential diagnosis of IBD, better reflecting diverse disease behaviors based on specific pathogenic pathways. PMID:25574078

Tontini, Gian Eugenio; Vecchi, Maurizio; Pastorelli, Luca; Neurath, Markus F; Neumann, Helmut

2015-01-01

303

B. Appendix C. Modem Data Carrier Detector Signal One of the most intractable algorithms is one that reliably discriminates FSK signals from noise in  

E-print Network

B. Appendix C. Modem Data Carrier Detector Signal One of the most intractable algorithms is one with no signal present is nearly the same as the amplitude of the signal, when present. In typical modems the signal/noise ratio. When the DCD signal exceeds some threshold, the DCD lead is raised at the modem

Mills, David L.

304

Attempted Gene Therapy for Intractable Pain: Dexamethasone-Mediated Exogenous Control of ?-Endorphin Secretion in Genetically Modified Cells and Intrathecal Transplantation  

Microsoft Academic Search

For optimal neural transplantation using gene engineering, it might be important to control the expression of the transfected gene extrinsically as required. This strategy could be very useful for the treatment of intractable pain that responds to opioids. For this purpose, we established a genetically modified embryonal carcinoma cell line (P19) in which the expression of ?-endorphin (?-EP) could be

Keisuke Ishii; Mitsuo Isono; Ryo Inoue; Shigeaki Hori

2000-01-01

305

Intractable nausea and vomiting due to gastrointestinal mucosal metastases relieved by tetrahydrocannabinol (Dronabinol)  

Microsoft Academic Search

Four years following resection of a Clark's level IV malignant melanoma, a 50-year-old man developed widespread metastatic disease involving the liver, bones, brain, gastrointestinal mucosa, and lungs. One week after whole brain radiation therapy, he was admitted to the hospital for nausea, vomiting, and pain. He was treated with several antiemetic drugs, but it was not until dronabinol was added

Francisco Gonzalez-Rosales; Declan Walsh

1997-01-01

306

Crowdfunding drug development: the state of play in oncology and rare diseases.  

PubMed

In this article, we present descriptive data on 125 crowdfunding campaigns aimed at financing research in oncology (including basic research, drug discovery, and clinical trials). We also describe five campaigns that have succeeded in raising substantial funds to support the development of treatments for ultrarare diseases. The data suggest that crowdfunding is a viable approach to supporting early proof-of-concept research that could allow researchers in oncology and rare diseases to succeed in traditional grant competitions or to attract private investment. The data also suggest that such an approach could become a valuable additional source of funding for early-stage innovators in the drug development arena. PMID:24973645

Dragojlovic, Nick; Lynd, Larry D

2014-11-01

307

Gene therapy with vascular endothelial growth factor for inoperable coronary artery disease  

Microsoft Academic Search

Background. Patients presenting with medically intractable angina who have undergone previous coronary bypass (CABG) and\\/or percutaneous revascularization procedures are frequently deemed “inoperable” based on angiographic findings of diffuse distal disease or a lack of available conduits. We initiated a phase I clinical trial to assess the safety and bioactivity of intramyocardial transfection of plasmid DNA encoding for the angiogenic mitogen

James F Symes; Douglas W Losordo; Peter R Vale; Kishor G Lathi; Darryl D Esakof; Michael Mayskiy; Jeffrey M Isner

1999-01-01

308

Behçet's disease  

Microsoft Academic Search

Background: Behçet's disease is a multisystem disease that is rare in the United States.Objective: The purpose of our study was to assess the characteristics and treatment of a series of patients with Behçet's disease in the United States.Methods: A retrospective clinical review of 25 patients with Behçet's disease was performed, and histopathologic findings and therapeutic modalities were reviewed.Results: All patients

Heidi C. Mangelsdorf; Wain L. White; Joseph L. Jorizzo

1996-01-01

309

Whole genome sequencing to investigate the emergence of clonal complex 23 Neisseria meningitidis serogroup Y disease in the United States.  

PubMed

In the United States, serogroup Y, ST-23 clonal complex Neisseria meningitidis was responsible for an increase in meningococcal disease incidence during the 1990s. This increase was accompanied by antigenic shift of three outer membrane proteins, with a decrease in the population that predominated in the early 1990s as a different population emerged later in that decade. To understand factors that may have been responsible for the emergence of serogroup Y disease, we used whole genome pyrosequencing to investigate genetic differences between isolates from early and late N. meningitidis populations, obtained from meningococcal disease cases in Maryland in the 1990s. The genomes of isolates from the early and late populations were highly similar, with 1231 of 1776 shared genes exhibiting 100% amino acid identity and an average ?(N) ?=? 0.0033 and average ?(S) ?=? 0.0216. However, differences were found in predicted proteins that affect pilin structure and antigen profile and in predicted proteins involved in iron acquisition and uptake. The observed changes are consistent with acquisition of new alleles through horizontal gene transfer. Changes in antigen profile due to the genetic differences found in this study likely allowed the late population to emerge due to escape from population immunity. These findings may predict which antigenic factors are important in the cyclic epidemiology of meningococcal disease. PMID:22558202

Krauland, Mary G; Dunning Hotopp, Julie C; Riley, David R; Daugherty, Sean C; Marsh, Jane W; Messonnier, Nancy E; Mayer, Leonard W; Tettelin, Hervé; Harrison, Lee H

2012-01-01

310

Amyloid disease prevention by transthyretin native state complexation with carborane derivatives lacking cyclooxygenase inhibition.  

PubMed

Misfolding and subsequent aggregation of any of a number of proteins leads to the accumulation of amyloid fibrils, which have been associated with a variety of diseases. One such amyloidogenic protein is transthyretin (TTR), a 55-kDa homotetrameric protein found in the blood plasma and cerebrospinal fluid where it binds and transports thyroxine. In humans, the T119M-TTR variant has been shown to be protective against familial amyloid polyneuropathy, a TTR amyloid disease, through kinetic stabilization of the unliganded tetrameric structure. Studies have indicated that a diverse range of small molecules may also bind TTR in the thyroxine-binding pocket and subsequently kinetically stabilize the protein's native conformation in vitro, preventing the misfolding that has been implicated in the progression of several diseases. However, cyclooxygenase inhibition is a common unwanted side effect among such small-molecule kinetic stabilizers. The recent development of transthyretin stabilizers not subject to cyclooxygenase inhibition may prove attractive for the long-term treatment of TTR misfolding diseases in humans. Such compounds are attained by incorporating aromatic carborane icosahedra at strategic points in their structures. PMID:18596990

Julius, Richard L; Hawthorne, M Frederick

2008-06-01

311

GEOGRAPHIC VARIATION IN DECLINING ISCHEMIC HEART DISEASE MORTALITY IN THE UNITED STATES, 1968-1978  

EPA Science Inventory

Despite the well-known geographic pattern for ischemic heart disease (IHD) mortality, studies of the decline in IHD have not provided a comprehensive examination of its spatial component. In the study, the authors computed and mapped mean rates and percent change in IHD mortality...

312

Connections between single-cell biomechanics and human disease states: gastrointestinal cancer and malaria  

E-print Network

and malaria S. Suresh a,b,*, J. Spatz c , J.P. Mills a , A. Micoulet c , M. Dao a , C.T. Lim d , M. Beil e , T in the context of two distinctly different human diseases: gastrointestinal tumor and malaria. Although the cell (RBC) infected with the malaria parasite Plasmodium falciparum. We present, for the first time

Dao, Ming

313

Chronic kidney disease, hypovitaminosis D, and mortality in the United States  

Microsoft Academic Search

Low serum 25-hydroxy vitamin D (25OHD) predicts a higher cardiovascular risk in the general population. Because patients with chronic kidney disease are more likely to have low serum 25OHD, we determined the relationship between hypovitaminosis D and death in this group. Analysis was done using a cohort composed of 3011 patients from the Third National Health and Nutrition Examination Survey

Rajnish Mehrotra; Dulcie A Kermah; Isidro B Salusky; Myles S Wolf; Ravi I Thadhani; Yi-Wen Chiu; David Martins; Sharon G Adler; Keith C Norris

2009-01-01

314

TRENDS IN THE GEOGRAPHIC INEQUALITY OF CARDIOVASCULAR DISEASE MORTALITY IN THE UNITED STATES, 1962-1982  

EPA Science Inventory

Substantial geographic variation of cardiovascular disease (CVD) mortality within the U.S. has been recognized for decades. nalyses reported here address the question of whether relative geographic inequality has increased or decreased during the period of rapidly declining CVD m...

315

Decision analytic models for Alzheimer's disease: State of the art and future directions  

Microsoft Academic Search

Decision analytic policy models for Alzheimer's disease (AD) enable researchers and policy makers to investigate questions about the costs and benefits of a wide range of existing and potential screening, testing, and treatment strategies. Such models permit analysts to compare existing alternatives, explore hypothetical scenarios, and test the strength of underlying assumptions in an explicit, quantitative, and systematic way. Decision

Joshua T. Cohen; Peter J. Neumann

2008-01-01

316

Magnetic resonance imaging of peripheral vascular disease. The state of the artery.  

PubMed

Peripheral vascular disease is a term often used to describe the manifestation of atherosclerosis below the bifurcation of the abdominal aorta. Peripheral atherosclerosis is a major cause of morbidity in the developed countries and 2% of adults in late middle age have intermittent claudication, which is severe enough in some patients to warrant hospital admission. The disease produces problems either by reducing blood flow or by the release of emboli from ulcerated plaques. The morphology and composition of arterial segments containing atheroma is of considerable importance. Plaques of different morphology have different effects on the arterial wall, such as the potential for thrombosis and the effect of arterial spasm. The lipid content may also affect the propensity for fissuring, ulceration, and thrombosis. In addition to discrete atherotic lesions, a localized and generalized sclerosis occurs. Sclerosis, or stiffness, can be demonstrated in experimental disease in animals and in man, and regression leads to reduced stiffness. Magnetic resonance imaging promises a comprehensive assessment of peripheral atherosclerosis noninvasively and without the use of ionizing radiation. Atheroma can be imaged directly, its size can be measured, its shape can be described, its lipid content can be assessed, and its effects upon vascular hemodynamics can be studied. In addition, arterial compliance, pulse wave velocity, and the pattern of flow within the vessel can be studied. It is thus a potential tool not only for the detection of disease but also for studying its natural history, risk factors, and the effects of pharmacological or surgical interventions. PMID:10147795

Mohiaddin, R H

1992-09-01

317

Intractable vomiting and hiccups as the presenting symptom of neuromyelitis optica  

PubMed Central

Vomiting and hiccups can be due to peripheral or central causes. Neurological diseases causing vomiting and hiccups are due to lesions of medulla involving area postrema and nucleus tractus solitarius. Neuromyelitis optica (NMO) is one such disease which involves these structures. However refractory vomiting and hiccups as the presenting symptom of NMO is unusual. Here we report a patient with NMO in whom refractory vomiting and hiccups were the sole manifestation of the first attack. Diagnosis can be missed at this stage leading to delay in treatment and further complications. This case demonstrates the importance of considering NMO in any patient presenting with refractory vomiting and hiccups and with local and metabolic causes ruled out and linear medullary lesion on magnetic resonance imaging may indicate the diagnosis even when the classical clinical criteria are not met. Anti NMO antibody testing should be done and if positive appropriate treatment should be initiated to prevent further neurological damage. PMID:24753677

Kulkarni, Girish Baburao; Kallollimath, Pradeep; Subasree, R.; Veerendrakumar, M.

2014-01-01

318

Population-based approaches to understanding disparities in cardiovascular disease risk in the United States  

PubMed Central

This is a comprehensive narrative review of the literature on the current science and evidence of population-level differences in risk factors for heart disease among different racial and ethnic population in the US. It begins by discussing the importance of population-level risk assessment of heart disease in light of the growth rate of specific minority populations in the US. It describes the population-level dynamics for racial and ethnic minorities: a higher overall prevalence of risk factors for coronary artery disease that are unrecognized and therefore not treated, which increases their likelihood of experiencing adverse outcomes and, therefore, potentially higher morbidity and mortality. It discusses the rate of acute coronary syndrome (ACS) in minority communities. Minority patients with ACS are at greater risk of myocardial infarction, rehospitalization, and death from ACS. They also are less likely than nonminority patients to receive potentially beneficial treatments such as angiography or percutaneous coronary intervention. This paper looks at the data surrounding the increased rate of congestive heart failure in racial and ethnic minorities, where the risk is related to the prevalence of comorbidities with hypertension or diabetes mellitus, which, in combination with environmental factors, may largely explain congestive heart failure disparity. The conclusion is it is essential that health care providers understand these various communities, including nuances in disease presentation, risk factors, and treatment among different racial and ethnic groups. Awareness of these communities’ attributes as well as differences in incidence, risk factor burdens, prognosis, and treatment are necessary to mitigate racial and ethnic disparities in heart disease. PMID:25143752

Graham, Garth

2014-01-01

319

ASSESSMENT OF TRAINING ON MEASLES CASE-BASED SURVEILLANCE FOR DISEASE SURVEILLANCE AND NOTIFICATION OFFICERS (DSNOs) IN OSUN STATE  

PubMed Central

Background: Poor knowledge among Disease Surveillance and Notification Officers (DSNOs) as a result of high staff turnover has been identified as a major reason for sub-optimal surveillance performance in Osun State. Training aimed at strengthening the measles surveillance sub-system of the Integrated Disease Surveillance and Response (IDSR) was thus conducted for DSNOs in the state in May, 2006. Objectives: The immediate impact of the training on participants’ knowledge and their role in the measles surveillance process was assessed as well as demographic factors associated with participants’ knowledge. Methods: Participants were DSNOs from the 30 Local Government Areas of the State and the Ife East Area office. Training materials were received from the WHO country office and adapted for use. Assessment of training was conducted by statistical evaluation of the pre- and post-tests results. Results: Thirty-one DSNOs with a mean age of 36.2 (± 3.5) years participated. There were 14 (45.2%) males and 17 (54.8%) females and they had been employed for an average of 13.7 (± 2.2) years. Mean pre- and post-test scores were 31 and 61, respectively, and showed a significant statistical difference (paired t-test = 12.665, p=0.000). Conclusion: Training achieved its short-term objective. However, a correlation between knowledge and practice will be based on the subsequent surveillance performance. PMID:25161463

Fatiregun, A.A; Sangowawa, A.O; Abubakar, A.A

2009-01-01

320

N-Glycan Profiling by Microchip Electrophoresis to Differentiate Disease-States Related to Esophageal Adenocarcinoma  

PubMed Central

We report analysis of N-glycans derived from disease-free individuals and patients with Barrett's esophagus, high-grade dysplasia, and esophageal adenocarcinoma by microchip electrophoresis with laser-induced fluorescence detection. Serum samples in 10-?L aliquots are enzymatically treated to cleave the N-glycans that are subsequently reacted with 8-aminopyrene-1,3,6-trisulfonic acid to add charge and a fluorescent label. Separations at 1250 V/cm and over 22 cm yielded efficiencies up to 700,000 plates for the N-glycans and analysis times under 100 s. Principal component analysis (PCA) and analysis of variance (ANOVA) tests of the peak areas and migration times are used to evaluate N-glycan profiles from native and desialylated samples and to determine differences among the four sample groups. With microchip electrophoresis, we are able to distinguish the three patient groups from each other and from disease-free individuals. PMID:22397697

Mitra, Indranil; Zhuang, Zexi; Zhang, Yuening; Yu, Chuan-Yih; Hammoud, Zane T.; Tang, Haixu; Mechref, Yehia; Jacobson, Stephen C.

2012-01-01

321

The Effects of a Disease Management Program on Self-Reported Health Behaviors and Health Outcomes: Evidence from the "Florida--A Healthy State (FAHS)" Medicaid Program  

ERIC Educational Resources Information Center

Premature morbidity and mortality from chronic diseases account for a major proportion of expenditures for health care cost in the United States. The purpose of this study was to measure the effects of a disease management program on physiological and behavioral health indicators for Medicaid patients in Florida. A two-year prospective study of…

Morisky, Donald E.; Kominski, Gerald F.; Afifi, Abdelmonem A.; Kotlerman, Jenny B.

2009-01-01

322

Interlaboratory Comparison of Test Results for Detection of Lyme Disease by 516 Participants in the Wisconsin State Laboratory of Hygiene\\/College of American Pathologists Proficiency Testing Program  

Microsoft Academic Search

In 1991, we reported that 55% of laboratories participating in the Wisconsin Proficiency Testing Program could not accurately identify serum samples from Lyme disease patients containing antibody againstBorrelia burgdorferi. The purpose of this study was to determine whether the accuracy of Lyme disease test results reported by approximately 500 participants in the Wisconsin State Laboratory of Hygiene\\/College of American Pathologists

LORI L. BAKKEN; STEVEN M. CALLISTER; PHILIP J. WAND; ANDRONALD F. SCHELL

323

Alterations in cognitive performance and affect-arousal state during fluctuations in motor function in Parkinson's disease.  

PubMed Central

Sixteen patients with idiopathic Parkinson's disease were selected who were all showing severe fluctuations in motor function ("on-off" phenomenon). Measures of cognitive function and of subjective affect/arousal state were taken on two occasions, once when "on" and once when "off". Twenty-five matched normal controls were also assessed on the same measures. Results revealed, on the average, a drop in cognitive function plus an adverse swing in affect/arousal state, in the patient group in the "off" condition, compared to the levels when "on". Analysis of the data suggested that the main factor associated with cognitive function when "off" was not the severity of disability but the level of affect/arousal. The fluctuations in cognitive function found tended to be mild relative to the severe changes in motor ability, and were present in only a proportion of patients. PMID:6736975

Brown, R G; Marsden, C D; Quinn, N; Wyke, M A

1984-01-01

324

Detection of infectious disease outbreaks in twenty-two fragile states, 2000-2010: a systematic review  

PubMed Central

Fragile states are home to a sixth of the world's population, and their populations are particularly vulnerable to infectious disease outbreaks. Timely surveillance and control are essential to minimise the impact of these outbreaks, but little evidence is published about the effectiveness of existing surveillance systems. We did a systematic review of the circumstances (mode) of detection of outbreaks occurring in 22 fragile states in the decade 2000-2010 (i.e. all states consistently meeting fragility criteria during the timeframe of the review), as well as time lags from onset to detection of these outbreaks, and from detection to further events in their timeline. The aim of this review was to enhance the evidence base for implementing infectious disease surveillance in these complex, resource-constrained settings, and to assess the relative importance of different routes whereby outbreak detection occurs. We identified 61 reports concerning 38 outbreaks. Twenty of these were detected by existing surveillance systems, but 10 detections occurred following formal notifications by participating health facilities rather than data analysis. A further 15 outbreaks were detected by informal notifications, including rumours. There were long delays from onset to detection (median 29 days) and from detection to further events (investigation, confirmation, declaration, control). Existing surveillance systems yielded the shortest detection delays when linked to reduced barriers to health care and frequent analysis and reporting of incidence data. Epidemic surveillance and control appear to be insufficiently timely in fragile states, and need to be strengthened. Greater reliance on formal and informal notifications is warranted. Outbreak reports should be more standardised and enable monitoring of surveillance systems' effectiveness. PMID:21861869

2011-01-01

325

Chronic Hepatitis C Virus (HCV) Disease Burden and Cost in the United States  

PubMed Central

Hepatitis C virus (HCV) infection is a leading cause of cirrhosis, hepatocellular carcinoma, and liver transplantation. A better understanding of HCV disease progression and the associated cost can help the medical community manage HCV and develop treatment strategies in light of the emergence of several potent anti-HCV therapies. A system dynamic model with 36 cohorts was used to provide maximum flexibility and improved forecasting. New infections incidence of 16,020 (95% confidence interval, 13,510-19,510) was estimated in 2010. HCV viremic prevalence peaked in 1994 at 3.3 (2.8-4.0) million, but it is expected to decline by two-thirds by 2030. The prevalence of more advanced liver disease, however, is expected to increase, as well as the total cost associated with chronic HCV infection. Today, the total cost is estimated at $6.5 ($4.3-$8.4) billion and it will peak in 2024 at $9.1 ($6.4-$13.3) billion. The lifetime cost of an individual infected with HCV in 2011 was estimated at $64,490. However, this cost is significantly higher among individuals with a longer life expectancy. Conclusion This analysis demonstrates that US HCV prevalence is in decline due to a lower incidence of infections. However, the prevalence of advanced liver disease will continue to increase as well as the corresponding healthcare costs. Lifetime healthcare costs for an HCV-infected person are significantly higher than for noninfected persons. In addition, it is possible to substantially reduce HCV infection through active management. PMID:23280550

Razavi, Homie; ElKhoury, Antoine C; Elbasha, Elamin; Estes, Chris; Pasini, Ken; Poynard, Thierry; Kumar, Ritesh

2013-01-01

326

Analysis of bile in various hepatobiliary disease states: A pilot study  

PubMed Central

Aim: Our study aims to find various enzymatic and biochemical components of bile and their clinical or prognostic correlation with regard to progression and severity of hepatobiliary diseases. Materials and Methods: It was a cross-sectional study where all the patients suffering from choledochal cyst (CDC), extrahepatic portal venous obstruction (EHPVO), and infantile obstructive cholangiopathy undergoing diagnostic preoperative cholangiogram; and patients with history of total parenteral nutrition (TPN) undergoing surgery for some other condition were included in the study. Intraoperatively, bile was collected from the gallbladder and sent for estimation of amylase, lipase, sodium, potassium, calcium, chloride, bicarbonate, total bilirubin, pH, cholesterol, triglycerides, and total bile acid. Results: A total of 80 patients were included in the study (20 in each of the four disease-based groups). Amylase, lipase, and pH were significantly different among the patients of CDC when compared with the presence or absence of dilated intrahepatic biliary radicals. Similarly, amylase, lipase, and pH were also significantly different among the patients of EHPVO when compared with presence or absence of biliopathy. Levels of cholesterol and bile acid were significantly higher in patients who were evaluated after 1 year following TPN than those who were evaluated before 1 year. The patients of infantile cholangiopathy, who had history of fever, had significantly higher level of calcium. Conclusion: The components of bile show close correlation with various clinical and prognostic markers, there is a very close correlation between these parameters and the clinical severity, disease progression, and final outcome. PMID:25197193

Verma, Ajay; Bhatnagar, Veereshwar; Prakash, Shyam; Srivastava, Abhay Kumar

2014-01-01

327

Study exploring depression and cardiovascular diseases amongst Arabic speaking patients living in the State of Qatar: Rationale and methodology  

PubMed Central

Abstract: In Qatar, cardiovascular diseases are the leading cause of death. Studies show that depression is associated with an increased morbidity and mortality among cardiovascular patients. Thus, early detection of, and intervention for, depression among cardiovascular patients can reduce cardiovascular morbidity and mortality, and save health care costs. To date there is no study in the Gulf region exploring depression among cardiovascular patients. The goals of our three-phase research program are to (1) understand the mental health issues, specifically depression, as experienced by cardiovascular patients living in the State of Qatar; (2) identify and implement strategies that would prevent depression and assist patients to deal with depression; and (3) evaluate, facilitate, and sustain strategies that are effective at reducing depression and foster its treatment among cardiovascular patients. This paper describe phase I of the research program. Using both quantitative and qualitative research methodologies, we will investigate (1) the prevalence and severity of depression among patients who have confirmed diagnosis of cardiovascular diseases (2) how contextual factors such as social, cultural, and economic factors contribute to the risk of depression and its management among cardiovascular patients, and (3) formulate effective intervention strategies that are expected to increase awareness, prevention of and treatment for depression among cardiovascular patients, thus reducing cardiovascular diseases morbidity and mortality in Qatar. PMID:24688991

Donnelly, Tam Truong; Al Suwaidi, Jassim M; Alqahtani, Awad; Assad, Nidal; Qader, Najla Abdul; Byrne, Carolyn; Singh, Rajvir; Fung, Tak Shing

2012-01-01

328

Chronic or intractable medical problems associated with prolonged exposure to unsuspected harmful environmental electric, magnetic or electro-magnetic fields radiating in the bedroom or workplace and their exacerbation by intake of harmful light and heavy metals from common sources.  

PubMed

Unsuspected prolonged exposure to abnormal environmental (very high frequency) electro-magnetic fields (EMF), electric fields (EF) or magnetic fields (MF) at 60 Hz or 16K Hz in the bedroom or workplace may contribute to the development of various intractable medical problems. Most of the clinical symptoms appear when the individuals are exposed to EMF for many hours a day for at least several months to 1-year for relatively benign diseases or symptoms (such as intractable pain or medical problems), or several to over 10 years for more serious diseases (such as cancers of the digestive system or other organs), all of which seem to appear with the additional co-existence of micro-circulatory disturbances with Thromboxane B2 (TXB2), bacterial or viral infections and decrease or absence of acetylcholine, and lead, mercury, or aluminum deposits, with or without asbestos. These abnormal environmental EMF's or EF's can be detected by the Bi-Digital O-Ring Test, which has good correlation with standard laboratory measurement, especially with EF measurement, and the distribution of EMF often includes a linear band-like appearance on the abnormal part of the patient's body, as well as on the patient's corresponding area of the bed, or at the workplace. These EMF's can be eliminated either by a metal sheet, acting as a reflector, which redirects the harmful EMF or eliminates it completely by grounding the metal sheet at high frequency range, while extremely low frequency (ELF) magnetic fields at the near field are more difficult to eliminate. Several examples of medical problems that appear to be associated with repeated and prolonged exposure to abnormal environmental EMF, EF or MF are summarized in this article. EF or MF-induced abnormalities were artificially and reversibly created in humans by exposing the extremities or head to a 10Volt/Meter (V/M) EF at 60 Hz about 33 (evening) to 50 cm (daytime or after midnight) from a pair of rubber insulated wires connected to an AC source, but where no current is passed, so that no extra MF exists. After exposing normal parts of the extremities and head to a 10 V/M EF for 5 minutes, abnormal increase of TXB2 and disappearance or significant reduction of acetylcholine was observed for 5 minutes, and slightly longer abnormal time duration was observed in those who have aluminum, lead, or mercury deposits. This indicates that the upper limit of relatively safe EF should be around 10V/M at 60 Hz rather than 25V/M at ELF by Swedish Government recommendation, which is now widely accepted.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:1685623

Omura, Y; Losco, M; Omura, A K; Yamamoto, S; Ishikawa, H; Takeshige, C; Shimotsuura, Y; Muteki, T

1991-01-01

329

Gene expression in normal and disease states--identification of therapeutic targets.  

PubMed

Analysis of gene-expression patterns derived from large expressed sequence tag (EST) databases has become a valuable tool in the discovery of therapeutic targets and diagnostic markers. Sequence data derived from a wide variety of cDNA libraries offer a wealth of information for identifying genes for pharmaceutical product development. Collecting, storing, organizing, analyzing and presenting cDNA expression data requires advanced bioinformatics methods and high-performance computational equipment. Comparison of expression patterns from normal and disease tissues enables inferences about gene function to be made, and medically relevant genes as candidates for therapeutics research and development programs to be identified. PMID:8987461

Fannon, M R

1996-08-01

330

Penile traction therapy and Peyronie's disease: a state of art review of the current literature.  

PubMed

In recent years, penile traction therapy (PTT) has gained considerable interest as a novel nonsurgical treatment option for men with Peyronie's disease (PD) and short penises. The current published literature suggests that selected cases of PD may benefit from a conservative approach with PTT, resulting in increased penile length and reduction of penile deformity. It appears to be safe and well tolerated but requires a great deal of patient compliance and determination. This article reviews the current literature pertaining to the use of PTT in men with PD, short penises and in the setting of pre- and postprosthesis corporal fibrosis. PMID:23372611

Chung, Eric; Brock, Gerald

2013-02-01

331

[Clinico-radiographic evaluation of the state of the spine in stomach and duodenal diseases].  

PubMed

Data are given on the condition of the thoracic spine of 465 patients with certain gastric and duodenal diseases. Degenerative-dystrophic lesions (spondylosis deformans and intervertebral osteochondrosis) of the thoracic spine together with osteoarthritis deformans of the costovertebral and costotransverse articulations lead to neurodystrophy of the gastric and duodenal mucosa through chronic stimulation by osteophytes of the thoracic sympathetic ganglia. Disorders of gastric and duodenal motor activity are also important. The attendant reflux gastritis is stipulated by reflux of the intestinal contents into the gastric lumen. Condition of the stomach and duodenum can be improved by relieving changes in the spine. PMID:2716242

Dmitriev, A E; Arapov, N A

1989-01-01

332

[Current state of knowledge about the application of cryotherapy for treatment of musculoskeletal diseases].  

PubMed

On the basis of literature data and his own investigations, the author discusses differential reactions of the human organism to cooling, the varieties of cryotherapeutic procedures, their therapeutic efficacy and current views on their mechanisms of action, and contraindications to their application. The present data indicate that the reflexotherapeutic mechanism plays a fundamental role in the analgetic action of cryotherapeutic procedures. The transient antiinflammatory influence of a single cryotherapeutic procedure does not undergo any additive effect during repetitive application of cooling. Regarding the facilitation of the kinesitherapy, cryotherapy appears a valuable means in the symptomatic management of inflammatory and noninflammatory diseases of the locomotor system. PMID:1369920

Jonderko, G

1990-01-01

333

Current patterns of acute respiratory disease in the United States Navy and Marine Corps.  

PubMed Central

During 1974 there was an apparent decrease in the reported amount of acute respiratory illness in the Navy and Marine Corps. Streptococcal infections continued to be controlled by the selective use of prophylactic benzathine penicillin in recruit training centers. Influenza immunization limited the impact of that illness, and serogroup C polysaccharide vaccine reduced the amount of meningococcal disease among recruits. Although some of the data are contradictory there are indications that fully potent live adenovirus vaccines lessen the frequency and severity of respiratory illness in recruit populations. Continued epidemiologic study will be required to fill the gaps in our knowledge. PMID:808911

Hoeffler, D. F.

1975-01-01

334

Chronic Kidney Disease (CKD)  

MedlinePLUS

... www.kidneyfund.org > Kidney Disease > Chronic Kidney Disease Chronic Kidney Disease (CKD) An estimated 31 million people in the United States are living with chronic kidney disease (CKD). What is CKD? The term “chronic kidney ...

335

Drug Delivery for Treatment of Inner Ear Disease: Current State of Knowledge  

PubMed Central

Delivery of medications to the inner ear has been an area of considerable growth in both the research and clinical realms over the past several decades. Systemic delivery of medication destined for treatment of the inner ear is the foundation upon which newer delivery techniques have been developed. Due to systemic side effects, investigators and clinicians have begun developing and utilizing techniques to deliver therapeutic agents locally. Alongside the now commonplace use of intratympanic gentamicin for Meniere's disease and the emerging use of intratympanic steroids for sudden sensorineural hearing loss, novel technologies, such as hydrogels and nanoparticles, are being explored. At the horizon of inner ear drug delivery techniques, intracochlear devices that leverage recent advances in microsystems technology are being developed to apply medications directly into the inner ear. Potential uses for such devices include neurotrophic factor and steroid delivery with cochlear implantation, RNA interference technologies, and stem cell therapy. The historical, current, and future delivery techniques and uses of drug delivery for treatment of inner ear disease serve as the basis for this review. PMID:19952751

McCall, Andrew A.; Leary Swan, Erin E.; Borenstein, Jeffrey T.; Sewell, William F.; Kujawa, Sharon G.; McKenna, Michael J.

2009-01-01

336

Chromatin stretch enhancer states drive cell-specific gene regulation and harbor human disease risk variants.  

PubMed

Chromatin-based functional genomic analyses and genomewide association studies (GWASs) together implicate enhancers as critical elements influencing gene expression and risk for common diseases. Here, we performed systematic chromatin and transcriptome profiling in human pancreatic islets. Integrated analysis of islet data with those from nine cell types identified specific and significant enrichment of type 2 diabetes and related quantitative trait GWAS variants in islet enhancers. Our integrated chromatin maps reveal that most enhancers are short (median = 0.8 kb). Each cell type also contains a substantial number of more extended (? 3 kb) enhancers. Interestingly, these stretch enhancers are often tissue-specific and overlap locus control regions, suggesting that they are important chromatin regulatory beacons. Indeed, we show that (i) tissue specificity of enhancers and nearby gene expression increase with enhancer length; (ii) neighborhoods containing stretch enhancers are enriched for important cell type-specific genes; and (iii) GWAS variants associated with traits relevant to a particular cell type are more enriched in stretch enhancers compared with short enhancers. Reporter constructs containing stretch enhancer sequences exhibited tissue-specific activity in cell culture experiments and in transgenic mice. These results suggest that stretch enhancers are critical chromatin elements for coordinating cell type-specific regulatory programs and that sequence variation in stretch enhancers affects risk of major common human diseases. PMID:24127591

Parker, Stephen C J; Stitzel, Michael L; Taylor, D Leland; Orozco, Jose Miguel; Erdos, Michael R; Akiyama, Jennifer A; van Bueren, Kelly Lammerts; Chines, Peter S; Narisu, Narisu; Black, Brian L; Visel, Axel; Pennacchio, Len A; Collins, Francis S

2013-10-29

337

Chromatin stretch enhancer states drive cell-specific gene regulation and harbor human disease risk variants  

PubMed Central

Chromatin-based functional genomic analyses and genomewide association studies (GWASs) together implicate enhancers as critical elements influencing gene expression and risk for common diseases. Here, we performed systematic chromatin and transcriptome profiling in human pancreatic islets. Integrated analysis of islet data with those from nine cell types identified specific and significant enrichment of type 2 diabetes and related quantitative trait GWAS variants in islet enhancers. Our integrated chromatin maps reveal that most enhancers are short (median = 0.8 kb). Each cell type also contains a substantial number of more extended (?3 kb) enhancers. Interestingly, these stretch enhancers are often tissue-specific and overlap locus control regions, suggesting that they are important chromatin regulatory beacons. Indeed, we show that (i) tissue specificity of enhancers and nearby gene expression increase with enhancer length; (ii) neighborhoods containing stretch enhancers are enriched for important cell type–specific genes; and (iii) GWAS variants associated with traits relevant to a particular cell type are more enriched in stretch enhancers compared with short enhancers. Reporter constructs containing stretch enhancer sequences exhibited tissue-specific activity in cell culture experiments and in transgenic mice. These results suggest that stretch enhancers are critical chromatin elements for coordinating cell type–specific regulatory programs and that sequence variation in stretch enhancers affects risk of major common human diseases. PMID:24127591

Parker, Stephen C. J.; Stitzel, Michael L.; Taylor, D. Leland; Orozco, Jose Miguel; Erdos, Michael R.; Akiyama, Jennifer A.; van Bueren, Kelly Lammerts; Chines, Peter S.; Narisu, Narisu; Black, Brian L.; Visel, Axel; Pennacchio, Len A.; Collins, Francis S.; Becker, Jesse; Benjamin, Betty; Blakesley, Robert; Bouffard, Gerry; Brooks, Shelise; Coleman, Holly; Dekhtyar, Mila; Gregory, Michael; Guan, Xiaobin; Gupta, Jyoti; Han, Joel; Hargrove, April; Johnson, Taccara; Legaspi, Richelle; Lovett, Sean; Maduro, Quino; Masiello, Cathy; Maskeri, Baishali; McDowell, Jenny; Montemayor, Casandra; Mullikin, James; Park, Morgan; Riebow, Nancy; Schandler, Karen; Schmidt, Brian; Sison, Christina; Stantripop, Mal; Thomas, James; Thomas, Pam; Vemulapalli, Meg; Young, Alice

2013-01-01

338

Haematological values in homozygous sickle cell disease in steady state and haemoglobin phenotypes AA controls in Lagos, Nigeria  

PubMed Central

Background Sickle cell disease is a genetic abnormality involving the haemoglobin. Although, it is primarily a red cell disorders, the white blood cells and platelets are also affected by the mutation. The consequent haemoglobin S causes polymerization of haemoglobin resulting in haemolysis and anaemia. This study aims to provide baseline haematological values in sickle cell disease patients in steady state and compare the deviation from haemoglobin phenotype AA control values. Methods A case–control study was conducted amongst homozygous sickle cell patients attending the sickle cell clinics of Lagos State University Teaching Hospital Ikeja and haemoglobin phenotype AA controls. About 4.5mls of blood sample was collected from each participant for full blood count analysis. All blood samples were screened for HIV and haemoglobin phenotypes confirmed using cellulose acetate haemoglobin electrophoresis at pH 8.6. Results A total of 103 cases and 98 controls were enrolled. The overall mean haemoglobin concentration for cases was 7.93?±?1.47?g/dl, packed cell volume 24.44?±?4.68%, mean cell volume 81.52?±?7.89?fl, and mean cell haemoglobin 26.50?±?3.20?pg. While for controls, mean haemoglobin concentration was 13.83?±?1.32?g/dl, packed cell volume 43.07?±?3.95%, mean cell volume 86.90?±?4.69?fl, and mean cell haemoglobin 28.50?±?1.34?pg. The overall mean white blood cell counts for the cases was 10.27?±?3.94 *103/?l and platelet counts of 412.71?±?145.09*103/?l. While white blood cell count for the controls was 5.67?±?1.59*103/?l and platelet counts of 222.82?±?57.62*103/?l. Conclusion Homozygous sickle cell disease patients have lower values of red cell parameters, but higher values of white cell and platelets counts compared to haemoglobin phenotype AA controls. PMID:22849350

2012-01-01

339

Abnormal synchrony of resting state networks in premanifest and symptomatic Huntington disease: the IMAGE-HD study  

PubMed Central

Background Functional neural impairments have been documented in people with symptomatic Huntington disease (symp-HD) and in premanifest gene carriers (pre-HD). This study aimed to characterize synchrony in resting state cerebral networks in both pre-HD and symp-HD populations and to determine its association with disease burden and neurocognitive functions. Methods We acquired functional magnetic resonance imaging (fMRI) data from pre-HD, symp-HD and healthy control participants. The fMRI data were analyzed using multisubject independent component analysis and dual regression. We compared networks of interest among the groups using a nonparametric permutation method and correcting for multiple comparisons. Results Our study included 25 people in the pre-HD, 23 in the symp-HD and 18 in the healthy control groups. Compared with the control group, the pre-HD group showed decreased synchrony in the sensorimotor and dorsal attention networks; decreased level of synchrony in the sensorimotor network was associated with poorer motor performance. Compared with the control group, the symp-HD group showed widespread reduction in synchrony in the dorsal attention network, which was associated with poorer cognitive performance. The posterior putamen and superior parietal cortex were functionally disconnected from the frontal executive network in the symp-HD compared with control and pre-HD groups. Furthermore, the left frontoparietal network showed areas of increased synchrony in the symp-HD compared with the pre-HD group. Limitations We could not directly correct for influence of autonomic changes (e.g., heart rate) and respiration on resting state synchronization. Conclusion Our findings suggest that aberrant synchrony in the sensorimotor and dorsal attention networks may serve as an early signature of neural change in pre-HD individuals. The altered synchrony in dorsal attention, frontoparietal and corticostriatal networks may contribute to the development of clinical symptoms in people with Huntington disease. PMID:24083458

Poudel, Govinda R.; Egan, Gary F.; Churchyard, Andrew; Chua, Phyllis; Stout, Julie C.; Georgiou-Karistianis, Nellie

2014-01-01

340

Plant Disease -92(2):318 -Abstract Welcome Washington State Univ Sign in | Register  

E-print Network

virus on Onion in Canada C. A. Hoepting, Cornell Cooperative Extension Vegetable Program, 12690 Route 31 pathogen of onion vectored by onion thrips (Thrips tabaci Lindeman). Rapid spread of IYSV has occurred States (1). In June and mid-July of 2007, symptomatic plants were found in Ontario, Canada in onions

Pappu, Hanu R.

341

The Role of Surgery in Global Health: Analysis of United States Inpatient Procedure Frequency by Condition Using the Global Burden of Disease 2010 Framework  

PubMed Central

Background The role of surgical care in promoting global health is the subject of much debate. The Global Burden of Disease 2010 study (GBD 2010) offers a new opportunity to consider where surgery fits amongst global health priorities. The GBD 2010 reinforces the DALY as the preferred methodology for determining the relative contribution of disease categories to overall global burden of disease without reference to the likelihood of each category requiring surgery. As such, we hypothesize that the GBD framework underestimates the role of surgery in addressing the global burden of disease. Methods and Findings We compiled International Classification of Diseases, Version 9, codes from the United States Nationwide Inpatient Sample from 2010. Using the primary diagnosis code for each hospital admission, we aggregated admissions into GBD 2010 disease sub-categories. We queried each hospitalization for a major operation to determine the frequency of admitted patients whose care required surgery. Major operation was defined according to the Agency for Healthcare Research and Quality (AHRQ). In 2010, 10 million major inpatient operations were performed in the United States, associated with 28.6% of all admissions. Major operations were performed in every GBD disease subcategory (range 0.2%–84.0%). The highest frequencies of operation were in the subcategories of Musculoskeletal (84.0%), Neoplasm (61.4%), and Transport Injuries (43.2%). There was no disease subcategory that always required an operation; nor was there any disease subcategory that never required an operation. Conclusions Surgical care cuts across the entire spectrum of GBD disease categories, challenging dichotomous traditional classifications of ‘surgical’ versus ‘nonsurgical’ diseases. Current methods of measuring global burden of disease do not reflect the fundamental role operative intervention plays in the delivery of healthcare services. Novel methodologies should be aimed at understanding the integration of surgical services into health systems to address the global burden of disease. PMID:24586967

2014-01-01

342

Alzheimer's Disease  

MedlinePLUS

... years of age and the sixth leading cause of death for all people in the United States. Most people live 4 to 8 years after being diagnosed with Alzheimer’s disease. Some live with the disease for up ... of Alzheimer’s disease? The Alzheimer’s Association has identified 10 ...

343

Current and future disease progression of the chronic HCV population in the United States.  

PubMed

Chronic hepatitis C virus (HCV) infection can lead to advanced liver disease (AdvLD), including cirrhosis, decompensated cirrhosis, and liver cancer. The aim of this study was to determine recent historical rates of HCV patient progression to AdvLD and to project AdvLD prevalence through 2015. We first determined total 2008 US chronic HCV prevalence from the National Health and Nutrition Evaluation Surveys. Next, we examined disease progression and associated non-pharmacological costs of diagnosed chronic HCV-infected patients between 2007-2009 in the IMS LifeLink and CMS Medicare claims databases. A projection model was developed to estimate AdvLD population growth through 2015 in patients diagnosed and undiagnosed as of 2008, using the 2007-2009 progression rates to generate a "worst case" projection of the HCV-related AdvLD population (i.e., scenario where HCV treatment is the same in the forecasted period as it was before 2009). We found that the total diagnosed chronic HCV population grew from 983,000 to 1.19 million in 2007-2009, with patients born from 1945-1964 accounting for 75.0% of all patients, 83.7% of AdvLD patients, and 79.2% of costs in 2009, indicating that HCV is primarily a disease of the "baby boomer" population. Non-pharmacological costs grew from $7.22 billion to $8.63 billion, with the majority of growth derived from the 60,000 new patients that developed AdvLD in 2007-2009, 91.5% of whom were born between 1945 and 1964. The projection model estimated the total AdvLD population would grow from 195,000 in 2008 to 601,000 in 2015, with 73.5% of new AdvLD cases from patients undiagnosed as of 2008. AdvLD prevalence in patients diagnosed as of 2008 was projected to grow 6.5% annually to 303,000 patients in 2015. These findings suggest that strategies to diagnose and treat HCV-infected patients are urgently needed to increase the likelihood that progression is interrupted, particularly for patients born from 1945-1964. PMID:23704962

Zalesak, Martin; Francis, Kevin; Gedeon, Alex; Gillis, John; Hvidsten, Kyle; Kidder, Phyllis; Li, Hong; Martyn, Derek; Orne, Leslie; Smith, Amanda; Kwong, Ann

2013-01-01

344

Campylobacter hyointestinalis associated with human gastrointestinal disease in the United States.  

PubMed Central

Campylobacter hyointestinalis was isolated from stool specimens of four persons, all of whom were experiencing nonbloody, watery diarrhea. The youngest (8 months of age) and the oldest (79 years of age) individuals were females, and the other two were homosexual men. C. hyointestinalis was the only clinically significant pathogen isolated from stool specimens for three of the individuals. In case 3 (involving a 37-year-old homosexual man), Entamoeba histolytica and Shigella sonnei were also present in the stool. The identification of all C. hyointestinalis strains was made biochemically and confirmed by DNA hybridization. This study documented the isolation of C. hyointestinalis from four patients with diarrhea, and our findings suggest that the clinical significance of Campylobacter species must be expanded to include C. hyointestinalis as a potential cause of human gastrointestinal disease. PMID:3571477

Edmonds, P; Patton, C M; Griffin, P M; Barrett, T J; Schmid, G P; Baker, C N; Lambert, M A; Brenner, D J

1987-01-01

345

Specificity of rheumatoid factors in relation to the disease state in rheumatoid arthritis.  

PubMed Central

Rheumatoid factors found in patients with rheumatoid arthritis react with human IgG and with IgG from some other species. The levels of rheumatoid factor give some indication of prognosis, albeit a rather poor one in this highly variable disease. The high degree of variability may, in part, be due to differences in the fine specificity of the rheumatoid factor in each individual patient, leading to differences in the types of immune complex formed. To study this hypothesis the fine specificity of rheumatoid factors of the IgM, IgA, and IgG classes for IgG from human, baboon, orangutan, macaque, owl monkey, gorilla, marmoset, cow, pig, sheep, goat, horse, mouse, and chicken was examined. Differential reactivity for these species was found and associations between the presence of rheumatoid factor and the development of moderate or severe erosions. PMID:2241264

Jones, M G; Shipley, M E; Hearn, J P; Hay, F C

1990-01-01

346

Regadenoson use in patients with chronic obstructive pulmonary disease: the state of current knowledge.  

PubMed

Stress testing is challenging in patients with chronic obstructive pulmonary disease (COPD). Functional capacity is generally decreased in this patient population, limiting patients' ability to achieve physiologic stress through exercise. Additionally, due to emphysematous changes, COPD patients tend to have poor acoustic windows that impair the quality and therefore diagnostic accuracy of stress echocardiography techniques. Pharmacologic stress myocardial perfusion imaging (MPI) testing is also problematic, particularly due to the concern for adenosine-induced bronchoconstriction with conventional vasodilator stress agents. Regadenoson, a selective A2A adenosine receptor agonist, has gained popularity due to its ease of administration and improved patient experience in the general population. The literature describing the experience with regadenoson in COPD patients, though limited, is rapidly growing and reassuring. This review summarizes the pharmacology and clinical application of this novel stress agent and presents the available data on the safety and tolerability of its use in COPD patients. PMID:24489466

Golzar, Yasmeen; Doukky, Rami

2014-01-01

347

A Differential Item Functioning (DIF) Analysis of the Communicative Participation Item Bank (CPIB): Comparing Individuals with Parkinson's Disease from the United States and New Zealand  

ERIC Educational Resources Information Center

Purpose: To examine the cross-cultural applicability of the Communicative Participation Item Bank (CPIB) through a comparison of respondents with Parkinson's disease (PD) from the United States and New Zealand. Method: A total of 428 respondents--218 from the United States and 210 from New Zealand-completed the self-report CPIB and a series…

Baylor, Carolyn; McAuliffe, Megan J.; Hughes, Louise E.; Yorkston, Kathryn; Anderson, Tim; Jiseon, Kim; Amtmann, Dagmar

2014-01-01

348

Quantitative second harmonic generation imaging of the diseased state osteogenesis imperfecta: experiment and simulation.  

PubMed

We report the integrated use of 3D second harmonic generation (SHG) imaging microscopy and Monte Carlo simulation as a combined metric to quantifiably differentiate normal and diseased tissues based on the physical properties of the respective extracellular matrix. To achieve this, we have identified a set of parameters comprised of the SHG creation attributes and the bulk optical parameters, which are used collectively via comparative analysis. Monte Carlo simulations of the SHG axial directional and attenuation responses allow their decomposition into the underlying factors that are not readily obtainable through experimental techniques. Specifically, this approach allows for estimation of the SHG creation attributes (directionality and relative conversion efficiency) and separation of primary and secondary filter effects, collectively that form the observed SHG contrast. The quantitative metric is shown for the connective tissue disorder Osteogenesis Imperfecta (characterized by abnormal assembly of type I collagen) using a murine model that expresses the disease in the dermis layer of skin. Structural dissimilarities between the osteogenesis imperfecta mouse and wild-type tissues lead to significant differences in the SHG depth-dependent directionality and signal attenuation. The Monte Carlo simulations of these responses using measured bulk optical parameters reproduce the experimental data trends, and the extracted emission directionality and conversion efficiencies are consistent with independent determinations. The simulations also illustrate the dominance of primary filter affects on overall SHG generation and attenuation. Thus, the combined method of 3D SHG imaging and modeling forms an essential foundation for parametric description of the matrix properties that are not distinguishable by sole consideration of either bulk optical parameters or SHG alone. Moreover, due to the quasi-coherence of the SHG process in tissues, we submit that this approach contains unique information not possible by purely scattering based methods and that these methods will be applicable in the general case where the complex fibrillar structure is difficult to fully quantify via morphological analysis. PMID:18281387

Lacomb, Ronald; Nadiarnykh, Oleg; Campagnola, Paul J

2008-06-01

349

Emerging Roles for Retinoids in Regeneration and Differentiation in Normal and Disease States  

PubMed Central

The vitamin A (retinol) metabolite, all-trans retinoic acid (RA), is a signaling molecule that plays key roles in the development of the body plan and induces the differentiation of many types of cells. In this review the physiological and pathophysiological roles of retinoids (retinol and related metabolites) in mature animals are discussed. Both in the developing embryo and in the adult, RA signaling via combinatorial Hox gene expression is important for cell positional memory. The genes that require RA for the maturation/differentiation of T cells are only beginning to be catalogued, but it is clear that retinoids play a major role in expression of key genes in the immune system. An exciting, recent publication in regeneration research shows that ALDH1a2 (RALDH2), which is the rate-limiting enzyme in the production of RA from retinaldehyde, is highly induced shortly after amputation in the regenerating heart, adult fin, and larval fin in zebrafish. Thus, local generation of RA presumably plays a key role in fin formation during both embryogenesis and in fin regeneration. HIV transgenic mice and human patients with HIV-associated kidney disease exhibit a profound reduction in the level of RAR? protein in the glomeruli, and HIV transgenic mice show reduced retinol dehydrogenase levels, concomitant with a greater than 3-fold reduction in endogenous RA levels in the glomeruli. Levels of endogenous retinoids (those synthesized from retinol within cells) are altered in many different diseases in the lung, kidney, and central nervous system, contributing to pathophysiology. PMID:21855651

Gudas, Lorraine J.

2011-01-01

350

Emerging roles for retinoids in regeneration and differentiation in normal and disease states.  

PubMed

The vitamin A (retinol) metabolite, all-trans retinoic acid (RA), is a signaling molecule that plays key roles in the development of the body plan and induces the differentiation of many types of cells. In this review the physiological and pathophysiological roles of retinoids (retinol and related metabolites) in mature animals are discussed. Both in the developing embryo and in the adult, RA signaling via combinatorial Hox gene expression is important for cell positional memory. The genes that require RA for the maturation/differentiation of T cells are only beginning to be cataloged, but it is clear that retinoids play a major role in expression of key genes in the immune system. An exciting, recent publication in regeneration research shows that ALDH1a2 (RALDH2), which is the rate-limiting enzyme in the production of RA from retinaldehyde, is highly induced shortly after amputation in the regenerating heart, adult fin, and larval fin in zebrafish. Thus, local generation of RA presumably plays a key role in fin formation during both embryogenesis and in fin regeneration. HIV transgenic mice and human patients with HIV-associated kidney disease exhibit a profound reduction in the level of RAR? protein in the glomeruli, and HIV transgenic mice show reduced retinol dehydrogenase levels, concomitant with a greater than 3-fold reduction in endogenous RA levels in the glomeruli. Levels of endogenous retinoids (those synthesized from retinol within cells) are altered in many different diseases in the lung, kidney, and central nervous system, contributing to pathophysiology. This article is part of a Special Issue entitled Retinoid and Lipid Metabolism. PMID:21855651

Gudas, Lorraine J

2012-01-01

351

Standard dose valproic acid does not cause additional cognitive impact in a rodent model of intractable epilepsy.  

PubMed

Children with epilepsy face significant cognitive and behavioral impairments. These impairments are due to a poorly characterized interaction between the underlying etiology, the effect of seizures and the effect of medication. The large variation in these factors make understanding the main drivers of cognitive impairment in humans extremely difficult. Therefore, we investigated the cognitive effect of seizures and the antiepileptic drug valproic acid in a rodent model of cortical dysplasia. Rats were divided into seizure-receiving and non-receiving groups. Rats experienced frequent early life seizures using the flurothyl inhalation method: 50 seizures between postnatal day 5 and 15 and then one seizure a day following that. Rats were further divided into drug-treated and vehicle treated groups. Valproic acid treated animals were treated from 5 days preceding behavioral testing in the Morris water maze at a clinically relevant concentration. We show here that the main driver of cognitive impairments are the brain malformations, and that persistent seizures in animals with brain malformations and valproic acid caused no additional impact. These findings suggest that neither an appropriate dose of a standard antiepileptic drug or intractable seizures worsen cognition associated with a malformation of cortical development and that alternative treatment strategies to improve cognition are required. PMID:25616460

Jellett, Adam P; Jenks, Kyle; Lucas, Marcella; Scott, Rod C

2015-02-01

352

Cutaneous nerve transection for the management of intractable upper extremity pain caused by invasive squamous cell carcinoma.  

PubMed

A recurrent clinical dilemma in the management of patients with painful metastatic lesions is achieving a balance between effective analgesic therapies versus intolerable side effects, in particular altered mental status. We present the case of an immunosuppressed patient post-lung transplant who was suffering from intractable pain caused by widely metastatic squamous cell carcinoma. The patient's progressive, excruciating neuropathic pain was localized to the area of the left wrist and forearm. Additionally, the patient complained of moderate pain at sites of tumor involvement on her right arm and scalp. Attempts to adequately manage her left upper extremity pain included a combination of pharmacologic treatments intended to treat neuropathic pain (gabapentin, SNRI, ketamine, opioids) and focused regional analgesia (infraclavicular infusion of local anesthetic). However, the patient developed intolerable side effects including altered mental status and delirium associated with the systemic agents and suboptimal control with the infraclavicular infusion. Given that the most severe pain was well localized, we undertook a diagnostic block of the cutaneous nerves of the left forearm. As this intervention significantly reduced her pain, we subsequently performed neurectomies to the left superficial radial nerve, lateral cutaneous nerve of the forearm and the posterior cutaneous nerve of the forearm. This resulted in immediate and continued relief of her left upper extremity pain without an altered mental status. Residual focal pain from lesions over her right arm and scalp was successfully managed with daily topical applications of lidocaine and capsaicin cream. Successful pain control continued until the patient's death five months later. PMID:21306862

Turnbull, John H; Gebauer, Sara L; Miller, Bruce L; Barbaro, Nicholas M; Blanc, Paul D; Schumacher, Mark A

2011-07-01

353

Upregulation of D site of albumin promoter binding protein in the brain of patients with intractable epilepsy.  

PubMed

The mechanisms that underlie the pathogenesis of intractable epilepsy (IE) remain to be elucidated. The present study aimed to investigate the expression of D site of albumin promoter binding protein (DBP) and mitogen?activated protein kinases (MAPKs) in the temporal lobes of patients with IE, in order to examine the possible roles of DBP in the pathogenesis of IE. The expression of DBP and MAPK was detected by immunohistochemistry and double?label immunofluorescence staining against DBP/MAPK in 35 patients with IE, and the data were compared with those of the 15 controls. The results demonstrated that DBP expression in IE group (0.31±0.03) was significantly higher compared with that in the controls (0.18±0.02; P<0.05) and MAPK expression in the IE group (0.19±0.03) was also higher compared with that in the controls (0.12±0.02; P<0.05). DBP and MAPK were mainly expressed in the cytoplasm of neurons and the double?label immunofluorescence staining demonstrated that DBP and MAPK expression occurred in the same neurons. Therefore, the expression of DBP and MAPK in epilepsy patients was upregulated, suggesting a possible pathogenetic role in IE. PMID:25503293

Yuan, Jinxian; Guo, Jing; Zhang, Melin; Wang, Qian; Huang, Hao; Chen, Yangmei

2015-04-01

354

A novel SCN1A mutation in a cytoplasmic loop in intractable juvenile myoclonic epilepsy without febrile seizures.  

PubMed

Generalised (genetic) epilepsy with febrile seizures plus (GEFS+) is a familial epilepsy syndrome with various phenotypes. The majority of individuals with GEFS+ have generalised seizure types, in addition to febrile seizures (FS) or febrile seizures plus (FS+), defined as either continued FS after 6 years of age or afebrile seizures following FS. A 27-year-old man with no history of FS/FS+ experienced intractable generalised convulsive seizures. The patient's father had a history of similar seizures during puberty and the patient's siblings had only FS. No individual in the family had both generalised seizures and FS/FS+, although GEFS+ might be considered to be present in the family. Analysis of SCN1A, a sodium channel gene, revealed a novel mutation (c.3250A>T [S1084C]) in the cytoplasmic loop 2 of SCN1A in both the patient and his father. Most previously reported SCN1A mutations in GEFS+ patients are located in the conserved homologous domains of SCN1A, whereas mutations in the cytoplasmic loops are very rare. SCN1A gene analysis is not commonly performed in subjects with generalised seizures without FS. SCN1A mutation may be a clinically-useful genetic marker in order to distinguish GEFS+ patients from those with classic idiopathic generalised epilepsy, even if they present an atypical clinical picture. PMID:24842605

Jingami, Naoto; Matsumoto, Riki; Ito, Hirotaka; Ishii, Atsushi; Ihara, Yukiko; Hirose, Shinichi; Ikeda, Akio; Takahashi, Ryosuke

2014-06-01

355

Primary pulmonary tuberculosis in infancy: a resurgent disease in the urban United States  

Microsoft Academic Search

Primary pulmonary tuberculosis in infancy still exists in the urban United States, reflecting new immigrations from less developed\\u000a areas. The clinical diagnosis may be difficult and routine chest radiographs may be confusing. We found magnification high\\u000a KV filtered radiography to be very useful in delineating lineating the primary complex and its effect on the tracheobronchial\\u000a tree. Twelve infants and small

J. Amodio; S. Abramson; W. Berdon

1986-01-01

356

Clinical effects of surgical and Gamma Knife treatments on hippocampal sclerosis-induced intractable epilepsy of children below age 10 years  

PubMed Central

Objective: To discuss the treatment effects and costs of surgery and Gamma Knife on hippocampal sclerosis (HS)-induced intractable epilepsy of children below age 10 years. Methods: The children below age 10 years who suffered from HS-induced intractable epilepsy from June 2010 to June 2012 were subjected to surgical and Gamma Knife treatments respectively according to their preference. Results: The short-term curative rates of the surgical group and the Gamma Knife group were 93.51% and 54.87%, respectively. The average expenses of the two groups were 10,000 CNY (Chinese Yuan) and 22,000 CNY, respectively. Conclusion: The two groups were treated safely and effectively, but the surgical treatment led to better results at a reduced cost. PMID:24353664

Xiao, Aiju; Wang, Tuanjie; Tian, Yunjiao; Xu, Li; Li, Shujun; Zhu, Fenglian

2013-01-01

357

Lumbar paravertebral blockade as intractable pain management method in palliative care  

PubMed Central

Optimal symptoms control in advanced cancer disease, with refractory to conventional pain treatment, needs an interventional procedure. This paper presents coadministration of local anesthetic (LA) via paravertebral blockade (PVB) as the alternative to an unsuccessful subcutaneous fentanyl pain control in a 71-year old cancer patient with pathological fracture of femoral neck, bone metastases, and contraindications to morphine. Bupivacaine in continuous infusion (0.25%, 5 mL · hour?1) or in boluses (10 mL of 0.125%–0.5% solution), used for lumbar PVB, resulted in pain relief, decreased demand for opioids, and led to better social interactions. The factors contributing to an increased risk of systemic toxicity from LA in the patient were: renal impairment; heart failure; hypoalbuminemia; hypocalcemia; and a complex therapy with possible drug-drug interactions. These factors were taken into consideration during treatment. Bupivacaine’s side effects were absent. Coadministered drugs could mask LA’s toxicity. Elevated plasma ?1-acid glycoprotein levels were a protective factor. To evaluate the benefit-risk ratio of the PVB treatment in boluses and in constant infusion, bupivacaine serum levels were determined and the drug plasma half-lives were calculated. Bupivacaine’s elimination was slower when administered in constant infusion than in boluses (t½ = 7.80 hours versus 2.64 hours). Total drug serum concentrations remained within the safe ranges during the whole treatment course (22.9–927.4 ng mL?1). In the case presented, lumbar PVB with bupivacaine in boluses (? 137.5 mg · 24 hours?1) was an easy to perform, safe, effective method for pain control. Bupivacaine in continuous infusion (?150 mg · 12 hours?1) had an acceptable risk-benefits ratio, but was ineffective. PMID:24043944

Zaporowska-Stachowiak, Iwona; Kotlinska-Lemieszek, Aleksandra; Kowalski, Grzegorz; Kosicka, Katarzyna; Hoffmann, Karolina; G?ówka, Franciszek; ?uczak, Jacek

2013-01-01

358

Coverage of the Ebola Virus Disease Epidemic in Three Widely Circulated United States Newspapers: Implications for Preparedness and Prevention  

PubMed Central

Background:Widespread media attention about Ebola influences public awareness and interest, yet there is limited research on what aspects of Ebola have and have not been communicated through the media. Methods:We examined the nature and extent of coverage about Ebola in the three most widely circulated United States (U.S.) daily newspapers. Between September 17, 2014 and October 17, 2014, 301 articles about Ebola in The New York Times, USA Today, and The Wall Street Journal were identified and coded. Results:The most common topic was coverage of cases in the United States (39%), followed by the outbreak in Africa (33.6%). Conclusion:This is the first study to describe coverage of the Ebola epidemic in widely circulated U.S. newspapers. A substantial portion of the American public is concerned about being infected with Ebola virus disease (EVD). In this study, a large emphasis was placed on death tolls and the cases in the United States. Much more can be done to educate readers about relevant aspects of the Ebola epidemic, including how Ebola is and is not transmitted. PMID:25649411

Basch, Corey H; Basch, Charles E; Redlener, Irwin

2014-01-01

359

Red blood cell alloimmunization is influenced by recipient inflammatory state at time of transfusion in patients with sickle cell disease.  

PubMed

Sickle cell disease (SCD) patients are at increased risk of red blood cell (RBC) alloimmunization. Recipient inflammatory state at time of transfusion has been shown to regulate alloimmunization in murine models, but evidence is lacking in SCD patients. We retrospectively studied a cohort of alloimmunized SCD patients to determine the influence of pro-inflammatory SCD-related complications at time of transfusion on alloimmunization. For each transfusion, the presence of pro-inflammatory state, degree of RBC antigen matching, unit age, storage solution and alloantibody detection date were ascertained. Transfusion-associated pro-inflammatory events were compared between transfusions resulting and not resulting in new alloantibodies. Univariate analysis and multivariate logistic regression were performed. Fifty-two patients received 3166 pre-storage leuco-reduced transfusions of which 128 resulted in alloantibodies. Transfusions during inflammatory events were associated with increased alloantibody risk on univariate and multivariate analysis; acute chest syndrome and vaso-occlusive crisis showed strongest associations with alloimmunization. Increased antigen matching demonstrated a protective effect on alloimmunization (univariate and multivariate analysis). Although an association was seen between citrate-phosphate-dextrose (adenine) stored units and alloimmunization on univariate analysis, no effect was found on multivariate analysis. Identifying recipient pro-inflammatory states at time of transfusion that promote alloimmunization can impact RBC unit selection decisions for SCD patients at risk for alloimmunization. PMID:25256676

Fasano, Ross M; Booth, Garrett S; Miles, Megan; Du, Liping; Koyama, Tatsuki; Meier, Emily Riehm; Luban, Naomi L C

2015-01-01

360

Disparities in Injury Mortality Between Uganda and the United States: Comparative Analysis of a Neglected Disease  

Microsoft Academic Search

Background  The burden of global injury-related deaths predominantly affects developing countries, which have little infrastructure to\\u000a evaluate these disparities. We describe injury-related mortality patterns in Kampala, Uganda and compare them with data from\\u000a the United States and San Francisco (SF), California.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We created a database in Kampala of deaths recorded by the City Mortuary, the Mulago Hospital Mortuary, and the Uganda

Sudha Jayaraman; Doruk Ozgediz; Justin Miyamoto; Nolan Caldwell; Michael S. Lipnick; Cephas Mijumbi; Jacqueline Mabweijano; Renee Hsia; Rochelle Dicker

2011-01-01

361

Chlamydia pneumoniae and Oxidative Stress in Cardiovascular Disease: State of the Art and Prevention Strategies  

PubMed Central

Chlamydia pneumoniae, a pathogenic bacteria responsible for respiratory tract infections, is known as the most implicated infectious agent in atherosclerotic cardiovascular diseases (CVDs). Accumulating evidence suggests that C. pneumoniae-induced oxidative stress may play a critical role in the pathogenesis of CVDs. Indeed, the overproduction of reactive oxygen species (ROS) within macrophages, endothelial cells, platelets and vascular smooth muscle cells (VSMCs) after C. pneumoniae exposure, has been shown to cause low density lipoprotein oxidation, foam cell formation, endothelial dysfunction, platelet adhesion and aggregation, and VSMC proliferation and migration, all responsible for the typical pathological changes of atherosclerotic plaque. The aim of this review is to improve our insight into C. pneumoniae-induced oxidative stress in order to suggest potential strategies for CVD prevention. Several antioxidants, acting on multi-enzymatic targets related to ROS production induced by C. pneumoniae, have been discussed. A future strategy for the prevention of C. pneumoniae-associated CVDs will be to target chlamydial HSP60, involved in oxidative stress. PMID:25561227

Di Pietro, Marisa; Filardo, Simone; De Santis, Fiorenzo; Mastromarino, Paola; Sessa, Rosa

2014-01-01

362

Hodgkin's disease incidence in the United States by age, sex, geographic region and rye histologic subtype  

SciTech Connect

Hodgkin's disease (HD) incidence in whites is described by age, sex, Rye histologic subtype and time period for ten US locations, using recently available data with Rye histologic diagnoses for most cases. Some distinctive features of incidence in young persons - stable childhood rates, and high and increasing rates in young adults, particularly women - resulted from the elevated rates of the Nodular Sclerosis (NS) subtype. NS was the only histologic form with a rising incidence. Unexpectedly, among middle-aged and older persons rates of all subtypes declined during the 1970s. HD incidence varied little across study regions and became more geographically homogeneous with time, notably among women. HD rates were positively correlated with regional socio-economic levels. In areas with the highest young adult incidence, higher risk also affected a broader age range, including older children. Rates for young adults were positively associated with community socioeconomic status but did not covary with older adult rates. Rates for the NS and Lymphocyte Predominance subtypes were inversely correlated across areas. NS incidence increased with community economic levels. These features suggest the incidence of HD in a well-developed country is not static but evolves, characterized by higher rates of NS in an increasingly broad age range of young, particularly female, adults, rising with small increments in socioeconomic status, and occurring over the relatively short study interval. 27 figures, 50 tables.

Glaser, S.L.

1984-11-01

363

ABO (H) secretor status of sickle cell disease patients in Zaria, Kaduna State, Nigeria.  

PubMed

Certain individuals secrete ABO blood group antigens in body fluids and secretions while others do not. In this study, the presence of water soluble agglutinogens in body fluids such as blood, saliva and urine of 64 sickle cell disease patients and 75 AA genotype subjects who served as control were taken and tested by hem-agglutination inhibition method. Data obtained was expressed in percentages. Results revealed that 84.4% sickle cell patients were secretors while 15.6% were non secretors. Amongst the control, 97.3% were secretors while 3.1% were non secretors. 81.2% SS and 3.2% SS+F patients were secretors while 15.6% SS were non secretors, 68% AA were secretors and 29.3% AS were secretors while 2.7% AA were non secretors. The result showed that a non secretor is more likely to be an SS than a secretor and Secretor status is influenced by hemoglobin genotype. PMID:23955403

Olorunshola, K V; Audu, L

2013-01-01

364

Biomarker analysis of Morquio syndrome: identification of disease state and drug responsive markers  

PubMed Central

Background This study was conducted to identify potential biomarkers that could be used to evaluate disease progression and monitor responses to enzyme replacement therapy (ERT) in patients with mucopolysaccharidosis (MPS) IVA. Methods Levels of 88 candidate biomarkers were compared in plasma samples from 50 healthy controls and 78 MPSIVA patients not receiving ERT to test for significant correlations to the presence of MPSIVA. MPSIVA samples were also tested for correlations between candidate biomarkers and age, endurance, or urinary keratin sulfate (KS) levels. Then, levels of the same 88 analytes were followed over 36 weeks in 20 MPSIVA patients receiving ERT to test for significant correlations related to ERT, age, or endurance. Results Nineteen candidate biomarkers were significantly different between MPSIVA and unaffected individuals. Of these, five also changed significantly in response to ERT: alpha-1-antitrypsin, eotaxin, lipoprotein(a), matrix metalloprotein (MMP)-2, and serum amyloid P. Three of these were significantly lower in MPSIVA individuals versus unaffected controls and were increased during ERT: alpha-1-antitrypsin, lipoprotein(a), and serum amyloid P. Conclusions Candidate biomarkers alpha-1-antitrypsin, lipoprotein(a), and serum amyloid P may be suitable markers, in addition to urinary KS, to follow the response to ERT in MPSIVA patients. PMID:22176730

2011-01-01

365

Visuomotor adaptation in Parkinson's disease: effects of perturbation type and medication state.  

PubMed

To perform simple everyday tasks, we use visual feedback from our external environment to generate and guide movements. However, tasks like reaching for a cup may become extremely difficult in movement disorders such as Parkinson's disease (PD), and it is unknown whether PD patients use visual information to compensate for motor deficiencies. We tested adaptation to changes in visual feedback of the hand in three subject groups, PD patients on daily levodopa (l-dopa) therapy (PD ON), PD patients off l-dopa (PD OFF), and age-matched control subjects, to determine the effects of PD on the visual control of movement. Subjects were tested on two classes of visual perturbations, one that altered visual direction of movement and one that altered visual extent of movement, allowing us to test adaptive sensitivity to changes in both movement direction (visual rotations) and extent (visual gain). The PD OFF group displayed more complete adaptation to visuomotor rotations compared with control subjects but initial, transient difficulty with adaptation to visual gain perturbations. The PD ON group displayed feedback control more sensitive to visual error compared with control subjects but compared with the PD OFF group had mild impairments during adaptation to changes in visual extent. We conclude that PD subjects can adapt to changes in visual information but that l-dopa may impair visual-based motor adaptation. PMID:24694937

Semrau, Jennifer A; Perlmutter, Joel S; Thoroughman, Kurt A

2014-06-15

366

Neuropeptide research discloses part of the secrets of Alzheimer's disease neuropathogenesis: state of the art 2004.  

PubMed

Molecular misreading, a process discovered in the late 1990s, entails the formation of aberrant transcripts due to the inaccurate conversion of genomic information, and results in an accumulation of aberrant proteins. The aberrant transcripts are formed as a result of a dinucleotide deletion (e.g. DeltaGA, DeltaGU) during or after transcription. Either the RNA polymerase starts to make mistakes (e.g. stuttering) in simple sequence repeats, such as GAGAG, or erroneous editing of transcripts occurs. If these aberrant transcripts are not detected and degraded efficiently, they can be translated from the deletion onwards into the +1 reading frame. The resulting proteins are therefore called +1 proteins. If functional domains are located downstream of the frameshift site, the result will be a protein with a potential loss or gain of function. It has been hypothesized that quality control mechanisms for both transcripts and proteins work less efficiently during aging, which is why +1 proteins may become manifest and contribute to age-related diseases in neuronal and non-neuronal cells. PMID:15135909

van Leeuwen, F W

2004-05-01

367

Resting state cortical rhythms in mild cognitive impairment and Alzheimer's disease: electroencephalographic evidence.  

PubMed

Physiological brain aging is characterized by a combination of synaptic pruning, loss of cortico-cortical connections and neuronal apoptosis that provoke age-dependent decline of cognitive functions. Neural/synaptic redundancy and plastic remodeling of brain networking, also secondary to mental and physical training, promotes maintenance of brain activity in healthy elderly for everyday life and fully productive affective and intellectual capabilities. Unfortunately, in pathological situations, aging triggers neurodegenerative processes that impact on cognition, like Alzheimer's disease (AD). Oscillatory electromagnetic brain activity is a hallmark of neuronal network function in various brain regions. Modern neurophysiological techniques including digital electroencephalography (EEG) allow non-invasive analysis of cortico-cortical connectivity and neuronal synchronization of firing, and coherence of brain rhythmic oscillations at various frequencies. The present review of field EEG literature suggests that discrimination between physiological and pathological brain aging clearly emerges at the group level, with some promising result on the informative value of EEG markers at the individual level. Integrated approaches utilizing neurophysiological techniques together with biological markers and structural and functional imaging are promising for large-scale, low-cost, widely available on the territory and non-invasive screening of at-risk populations. PMID:21971461

Babiloni, Claudio; Vecchio, Fabrizio; Lizio, Roberta; Ferri, Raffaele; Rodriguez, Guido; Marzano, Nicola; Frisoni, Giovanni B; Rossini, Paolo M

2011-01-01

368

Postdoctoral Research Fellow: Prion/Chronic Wasting Disease Research The MIP Department at Colorado State University is seeking  

E-print Network

Postdoctoral Research Fellow: Prion/Chronic Wasting Disease Research ­ Open Pool The MIP Department of infection and transmission of chronic wasting disease (CWD), a prion disease of deer and elk. Expertise

Stephens, Graeme L.

369

The many roles of the conserved eukaryotic Paf1 complex in regulating transcription, histone modifications, and disease states  

PubMed Central

The Paf1 complex was originally identified over fifteen years ago in budding yeast through its physical association with RNA polymerase II. The Paf1 complex is now known to be conserved throughout eukaryotes and is well studied for promoting RNA polymerase II transcription elongation and transcription-coupled histone modifications. Through these critical regulatory functions, the Paf1 complex participates in numerous cellular processes such as gene expression and silencing, RNA maturation, DNA repair, cell cycle progression and prevention of disease states in higher eukaryotes. In this review, we describe the historic and current research involving the eukaryotic Paf1 complex to explain the cellular roles that underlie its conservation and functional importance. PMID:22982193

Tomson, Brett N.; Arndt, Karen M.

2012-01-01

370

Parkinson disease-associated mutation R1441H in LRRK2 prolongs the “active state” of its GTPase domain  

PubMed Central

Mutation in leucine-rich-repeat kinase 2 (LRRK2) is a common cause of Parkinson disease (PD). A disease-causing point mutation R1441H/G/C in the GTPase domain of LRRK2 leads to overactivation of its kinase domain. However, the mechanism by which this mutation alters the normal function of its GTPase domain [Ras of complex proteins (Roc)] remains unclear. Here, we report the effects of R1441H mutation (RocR1441H) on the structure and activity of Roc. We show that Roc forms a stable monomeric conformation in solution that is catalytically active, thus demonstrating that LRRK2 is a bona fide self-contained GTPase. We further show that the R1441H mutation causes a twofold reduction in GTPase activity without affecting the structure, thermal stability, and GDP-binding affinity of Roc. However, the mutation causes a twofold increase in GTP-binding affinity of Roc, thus suggesting that the PD-causing mutation R1441H traps Roc in a more persistently activated state by increasing its affinity for GTP and, at the same time, compromising its GTP hydrolysis. PMID:24591621

Liao, Jingling; Wu, Chun-Xiang; Burlak, Christopher; Zhang, Sheng; Sahm, Heather; Wang, Mu; Zhang, Zhong-Yin; Vogel, Kurt W.; Federici, Mark; Riddle, Steve M.; Nichols, R. Jeremy; Liu, Dali; Cookson, Mark R.; Stone, Todd A.; Hoang, Quyen Q.

2014-01-01

371

Widespread Increase of Functional Connectivity in Parkinson’s Disease with Tremor: A Resting-State fMRI Study  

PubMed Central

Parkinson’s disease (PD) is a clinically heterogeneous disease in the symptomatology dominated by tremor, akinesia, or rigidity. Focusing on PD patients with tremor, this study investigated their discoordination patterns of spontaneous brain activity by combining voxel-wise centrality, seed-based functional connectivity, and network efficiency methods. Sixteen patients and 20 matched healthy controls (HCs) were recruited and underwent structural and resting-state functional MRI scan. Compared with the HCs, the patients exhibited increased centrality in the frontal, parietal, and occipital regions while decreased centrality in the cerebellum anterior lobe and thalamus. Seeded at these regions, a distributed network was further identified that encompassed cortical (default mode network, sensorimotor cortex, prefrontal and occipital areas) and subcortical (thalamus and basal ganglia) regions and the cerebellum and brainstem. Graph-based analyses of this network revealed increased information transformation efficiency in the patients. Moreover, the identified network correlated with clinical manifestations in the patients and could distinguish the patients from HCs. Morphometric analyses revealed decreased gray matter volume in multiple regions that largely accounted for the observed functional abnormalities. Together, these findings provide a comprehensive view of network disorganization in PD with tremor and have important implications for understanding neural substrates underlying this specific type of PD.

Zhang, Delong; Liu, Xian; Chen, Jun; Liu, Bo; Wang, Jinhui

2015-01-01

372

Dietary acid load and chronic kidney disease among adults in the United States  

PubMed Central

Background Diet can markedly affect acid-base status and it significantly influences chronic kidney disease (CKD) and its progression. The relationship of dietary acid load (DAL) and CKD has not been assessed on a population level. We examined the association of estimated net acid excretion (NAEes) with CKD; and socio-demographic and clinical correlates of NAEes. Methods Among 12,293 U.S. adult participants aged >20 years in the National Health and Nutrition Examination Survey 1999–2004, we assessed dietary acid by estimating NAEes from nutrient intake and body surface area; kidney damage by albuminuria; and kidney dysfunction by eGFR < 60 ml/min/1.73m2 using the MDRD equation. We tested the association of NAEes with participant characteristics using median regression; while for albuminuria, eGFR, and stages of CKD we used logistic regression. Results Median regression results (? per quintile) indicated that adults aged 40–60 years (? [95% CI] = 3.1 [0.3–5.8]), poverty (? [95% CI] = 7.1 [4.01–10.22]), black race (? [95% CI] = 13.8 [10.8–16.8]), and male sex (? [95% CI] = 3.0 [0.7- 5.2]) were significantly associated with an increasing level of NAEes. Higher levels of NAEes compared with lower levels were associated with greater odds of albuminuria (OR [95% CI] = 1.57 [1.20–2.05]). We observed a trend toward greater NAEes being associated with higher risk of low eGFR, which persisted after adjustment for confounders. Conclusion Higher NAEes is associated with albuminuria and low eGFR, and socio-demographic risk factors for CKD are associated with higher levels of NAEes. DAL may be an important target for future interventions in populations at high risk for CKD. PMID:25151260

2014-01-01

373

The pathogenic activation of calpain: a marker and mediator of cellular toxicity and disease states  

PubMed Central

Over-activation of calpain, a ubiquitous calcium-sensitive protease, has been linked to a variety of degenerative conditions in the brain and several other tissues. Dozens of substrates for calpain have been identified and several of these have been used to measure activation of the protease in the context of experimentally induced and naturally occurring pathologies. Calpain-mediated cleavage of the cytoskeletal protein spectrin, in particular, results in a set of large breakdown products (BDPs) that are unique in that they are unusually stable. Over the last 15 years, measurements of BDPs in experimental models of stroke-type excitotoxicity, hypoxia/ischemia, vasospasm, epilepsy, toxin exposure, brain injury, kidney malfunction, and genetic defects, have established that calpain activation is an early and causal event in the degeneration that ensues from acute, definable insults. The BDPs also have been found to increase with normal ageing and in patients with Alzheimer's disease, and the calpain activity may be involved in related apoptotic processes in conjunction with the caspase family of proteases. Thus, it has become increasingly clear that regardless of the mode of disturbance in calcium homeostasis or the cell type involved, calpain is critical to the development of pathology and therefore a distinct and powerful therapeutic target. The recent development of antibodies that recognize the site at which spectrin is cleaved has greatly facilitated the temporal and spatial resolution of calpain activation in situ. Accordingly, sensitive spectrin breakdown assays now are utilized to identify potential toxic side-effects of compounds and to develop calpain inhibitors for a wide range of indications including stroke, cerebral vasospasm, and kidney failure. PMID:11168679

Vanderklish, Peter W; Bahr, Ben A

2000-01-01

374

Neuronal and physiological correlation to hemodynamic resting-state fluctuations in health and disease.  

PubMed

Low-frequency, spatially coherent fluctuations present in functional magnetic resonance imaging time series have had a tremendous impact on brain connectomics. This work aims to explore the degree with which hemodynamic connectivity is associated with neuronal, metabolic, and vascular connectivity measures. For this purpose, GCaMP and nontransgenic mice were used to image neuronal activity and oxidative metabolism activity, respectively, along with blood-oxygenation- and cerebral blood volume (CBV)-sensitive hemodynamic changes from the same animals. Although network clusters calculated using either GCaMP (neuronal activity) or optical imaging of intrinsic signal (OIS)-BOLD (blood oxygenation) data did not exhibit strong spatial similarity, the strengths of node-to-node connectivity measured with these modalities were strongly correlated with one another. This finding suggests that hemodynamic connectivity as measured by blood oxygenation measurements, such as functional connectivity magnetic resonance imaging, is a valuable surrogate for the underlying neuronal connectivity. In nontransgenic animals, greater connectivity correlation was observed between tissue oxidative metabolism (flavoprotein autofluorescence imaging [FAI]) and blood oxygenation measurements, suggesting that metabolic contributions to hemodynamic signals are likely responsible for its significant correlation with neuronal connectivity. Lastly, a mouse model of Alzheimer's disease was used to explore the source of decreases in connectivity reported in these mice, a finding that is thought to be associated with amyloid load-driven metabolic decline. The intercluster connectivity measured by metabolic-sensitive measurements (FAI and OIS-BOLD) was maintained while vascular-only signals (OIS-CBV) provided negligible correlation. Therefore, metabolism-sensitive measurements as used in this work are better positioned to capture changes in neuronal connectivity, such that decreases in hemodynamic connectivity likely reflect decreases in oxidative metabolic function. PMID:25300278

Vazquez, Alberto L; Murphy, Matthew C; Kim, Seong-Gi

2014-11-01

375

The State of Infectious Diseases Clinical Trials: A Systematic Review of ClinicalTrials.gov  

PubMed Central

Background There is a paucity of clinical trials informing specific questions faced by infectious diseases (ID) specialists. The ClinicalTrials.gov registry offers an opportunity to evaluate the ID clinical trials portfolio. Methods We examined 40,970 interventional trials registered with ClinicalTrials.gov from 2007–2010, focusing on study conditions and interventions to identify ID-related trials. Relevance to ID was manually confirmed for each programmatically identified trial, yielding 3570 ID trials and 37,400 non-ID trials for analysis. Results The number of ID trials was similar to the number of trials identified as belonging to cardiovascular medicine (n?=?3437) or mental health (n?=?3695) specialties. Slightly over half of ID trials were treatment-oriented trials (53%, vs. 77% for non-ID trials) followed by prevention (38%, vs. 8% in non-ID trials). ID trials tended to be larger than those of other specialties, with a median enrollment of 125 subjects (interquartile range [IQR], 45–400) vs. 60 (IQR, 30–160) for non-ID trials. Most ID studies are randomized (73%) but nonblinded (56%). Industry was the funding source in 51% of ID trials vs. 10% that were primarily NIH-funded. HIV-AIDS trials constitute the largest subset of ID trials (n?=?815 [23%]), followed by influenza vaccine (n?=?375 [11%]), and hepatitis C (n?=?339 [9%]) trials. Relative to U.S. and global mortality rates, HIV-AIDS and hepatitis C virus trials are over-represented, whereas lower respiratory tract infection trials are under-represented in this large sample of ID clinical trials. Conclusions This work is the first to characterize ID clinical trials registered in ClinicalTrials.gov, providing a framework to discuss prioritization, methodology, and policy. PMID:24146958

Horton, John R.; Chiswell, Karen; Tasneem, Asba; Tsalik, Ephraim L.

2013-01-01

376

Solid-state laser source of narrowband ultraviolet B light for skin disease care  

NASA Astrophysics Data System (ADS)

We report about the development of all-solid-state laser source of narrowband UV-B light for medical applications. The device is based on a gain-switched Ti: Sapphire laser with volume Bragg grating, pumped at 532 nm and operating at 931.8 nm, followed by a third harmonic generator and a fiber optic beam homogenizer. The maximum available pulse energy exceeded 5 mJ at 310.6 nm, with a pulse repetition rates of 50 Hz. The output characteristics satisfy the medical requirements for psoriasis and vitiligo treatment. A new optical scheme for third harmonic generation enhancement at moderate levels of input intensities is proposed and investigated. As a result, 40% harmonic efficiency was obtained, when input pulse power was only 300 kW.

Tarasov, Aleksandr A.; Chu, Hong

2013-03-01

377

Geologic occurrences of erionite in the United States: an emerging national public health concern for respiratory disease  

USGS Publications Warehouse

Erionite, a mineral series within the zeolite group, is classified as a Group 1 known respiratory carcinogen. This designation resulted from extremely high incidences of mesothelioma discovered in three small villages from the Cappadocia region of Turkey, where the disease was linked to environmental exposures to fibrous forms of erionite. Natural deposits of erionite, including fibrous forms, have been identified in the past in the western United States. Until recently, these occurrences have generally been overlooked as a potential hazard. In the last several years, concerns have emerged regarding the potential for environmental and occupational exposures to erionite in the United States, such as erionite-bearing gravels in western North Dakota mined and used to surface unpaved roads. As a result, there has been much interest in identifying locations and geologic environments across the United States where erionite occurs naturally. A 1996 U.S. Geological Survey report describing erionite occurrences in the United States has been widely cited as a compilation of all US erionite deposits; however, this compilation only focused on one of several geologic environments in which erionite can form. Also, new occurrences of erionite have been identified in recent years. Using a detailed literature survey, this paper updates and expands the erionite occurrences database, provided in a supplemental file (US_erionite.xls). Epidemiology, public health, and natural hazard studies can incorporate this information on known erionite occurrences and their characteristics. By recognizing that only specific geologic settings and formations are hosts to erionite, this knowledge can be used in developing management plans designed to protect the public.

Van Gosen, Bradley S.; Blitz, Thomas A.; Plumlee, Geoffrey S.; Meeker, Gregory P.; Pierson, M. Patrick

2013-01-01

378

Clinical inquiries regarding Ebola virus disease received by CDC--United States, July 9-November 15, 2014.  

PubMed

Since early 2014, there have been more than 6,000 reported deaths from Ebola virus disease (Ebola), mostly in Guinea, Liberia, and Sierra Leone. On July 9, 2014, CDC activated its Emergency Operations Center for the Ebola outbreak response and formalized the consultation service it had been providing to assist state and local public health officials and health care providers evaluate persons in the United States thought to be at risk for Ebola. During July 9-November 15, CDC responded to clinical inquiries from public health officials and health care providers from 49 states and the District of Columbia regarding 650 persons thought to be at risk. Among these, 118 (18%) had initial signs or symptoms consistent with Ebola and epidemiologic risk factors placing them at risk for infection, thereby meeting the definition of persons under investigation (PUIs). Testing was not always performed for PUIs because alternative diagnoses were made or symptoms resolved. In total, 61 (9%) persons were tested for Ebola virus, and four, all of whom met PUI criteria, had laboratory-confirmed Ebola. Overall, 490 (75%) inquiries concerned persons who had neither traveled to an Ebola-affected country nor had contact with an Ebola patient. Appropriate medical evaluation and treatment for other conditions were noted in some instances to have been delayed while a person was undergoing evaluation for Ebola. Evaluating and managing persons who might have Ebola is one component of the overall approach to domestic surveillance, the goal of which is to rapidly identify and isolate Ebola patients so that they receive appropriate medical care and secondary transmission is prevented. Health care providers should remain vigilant and consult their local and state health departments and CDC when assessing ill travelers from Ebola-affected countries. Most of these persons do not have Ebola; prompt diagnostic assessments, laboratory testing, and provision of appropriate care for other conditions are essential for appropriate patient care and reflect hospital preparedness. PMID:25503923

Karwowski, Mateusz P; Meites, Elissa; Fullerton, Kathleen E; Ströher, Ute; Lowe, Luis; Rayfield, Mark; Blau, Dianna M; Knust, Barbara; Gindler, Jacqueline; Van Beneden, Chris; Bialek, Stephanie R; Mead, Paul; Oster, Alexandra M

2014-12-12

379

Root Diseases: Primary Agents and Secondary Consequences of Disturbance  

SciTech Connect

A pathogen such as the P-group of Heterobasidion annosum has become an intractable problem in many Sienna east side pine stands in California because the fungus is adapted to colonization of freshly cut stump surfaces. Other diseases such as blackstain root disease are associated with certain root feeding bark beetles that are attracted to tree roots after site disturbances such as thinning. Fire may also affect various root disease fungi and their pathological behavior in longleaf pine through interactions with various soil factors as a consequence of various land use.

Otrosina, W.J.; Ferrell, G.T.

1995-01-01

380

Upregulation of RBFOX1 in the malformed cortex of patients with intractable epilepsy and in cultured rat neurons  

PubMed Central

Mutations in RNA-binding Fox 1 (RBFOX1) are known to be associated with neurodevelopmental disorders including epilepsy, mental retardation and autism spectrum disorder. The deletion of the Rbfox1 gene in mice has been shown to result in heightened susceptibility to seizures. However, other studies have revealed mutations or the downregulation of RBFOX1 in specimens obtained from patients with epilepsy or malformations of cortical development (MCD). Generally, the expression of RBFOX1 varies according to tissue type. In this study, we demonstrated the upregulation of RBFOX1 protein in the cortex of patients with MCD and intractable epilepsy. Electrophysiological recordings of cultured rat cortical neurons with increased Rbfox1 expression also revealed a significantly increased amplitude of action potential (AP) and Na+ current density. Some of these neurons (26.32%) even displayed spontaneous, recurrent, epileptiform discharges (SREDs). Additionally, certain Rbfox1 target transcripts associated with epilepsy, including glutamate receptor, ionotropic, N-methyl D-aspartate 1 [Grin1, also known as N-methyl-D-aspartate receptor subunit NR1 (NMDAR1)], synaptosomal-associated protein, 25 kDa (SNAP-25 or Snap25) and sodium channel, voltage gated, type VIII, alpha subunit (Scn8a, also known as Nav1.6) were identified to be upregulated in these cultured cortical neurons with an upregulated Rbfox1 expression. These data suggest that the upregulation of RBFOX1 contributes to neuronal hyperexcitation and seizures. The upregulation of NMDAR1 (Grin1), SNAP-25 (Snap25) and Scn8a may thus be involved in Rbfox1-related neuronal hyperexcitation. PMID:25571999

WEN, MING; YAN, YONG; YAN, NING; CHEN, XIAO SHAN; LIU, SHI YONG; FENG, ZHAN HUI

2015-01-01

381

The long-term safety and efficacy of opioids: A survey of 84 selected patients with intractable chronic noncancer pain  

PubMed Central

BACKGROUND: The use of opioids for chronic noncancer pain (CNCP) remains controversial. Despite a number of randomized controlled trials showing efficacy and safety in the short term, long-term data are limited. OBJECTIVE: To survey a selected cohort of patients with intractable CNCP with regard to long-term efficacy and safety of opioids. METHODS: The present study reports long-term results from a survey of 84 patients with CNCP. The majority of patients had neuropathic pain, were treated with opioids and were followed every three months for a median of 8.4 years. Outcomes examined were pain severity, adverse effects, pain relief, satisfaction, mood, problematic opioid use, tolerance, physical dependency, functional status, health-related quality of life, immune status, sexual function, morbidity and mortality. Measures included a numerical rating scale, the Hospital Anxiety and Depression Scale, Brief Pain Inventory interference scale, Pain Disability Index and Short-Form Health Survey 12, version 2. RESULTS AND CONCLUSIONS: Both long- and short-acting opioids were reported to be effective, with few significant long-term adverse effects in many subjects in the present selected cohort. The majority of patients reported at least 50% or greater pain relief and a moderate improvement in disability. Functional status and health-related quality of life scores were not severely affected. Problematic opioid use, tolerance and serious adverse effects, including constipation, were not major issues. The authors emphasize that the results obtained in the present selected group may not be generalizable to all CNCP patients in whom opioids are being initiated. PMID:20808965

Watson, C Peter N; Watt-Watson, Judy; Chipman, Mary

2010-01-01

382

Upregulation of RBFOX1 in the malformed cortex of patients with intractable epilepsy and in cultured rat neurons.  

PubMed

Mutations in RNA?binding Fox 1 (RBFOX1) are known to be associated with neurodevelopmental disorders including epilepsy, mental retardation and autism spectrum disorder. The deletion of the Rbfox1 gene in mice has been shown to result in heightened susceptibility to seizures. However, other studies have revealed mutations or the downregulation of RBFOX1 in specimens obtained from patients with epilepsy or malformations of cortical development (MCD). Generally, the expression of RBFOX1 varies according to tissue type. In this study, we demonstrated the upregulation of RBFOX1 protein in the cortex of patients with MCD and intractable epilepsy. Electrophysiological recordings of cultured rat cortical neurons with increased Rbfox1 expression also revealed a significantly increased amplitude of action potential (AP) and Na+ current density. Some of these neurons (26.32%) even displayed spontaneous, recurrent, epileptiform discharges (SREDs). Additionally, certain Rbfox1 target transcripts associated with epilepsy, including glutamate receptor, ionotropic, N-methyl D-aspartate 1 [Grin1, also known as N-methyl-D-aspartate receptor subunit NR1 (NMDAR1)], synaptosomal-associated protein, 25 kDa (SNAP?25 or Snap25) and sodium channel, voltage gated, type VIII, alpha subunit (Scn8a, also known as Nav1.6) were identified to be upregulated in these cultured cortical neurons with an upregulated Rbfox1 expression. These data suggest that the upregulation of RBFOX1 contributes to neuronal hyperexcitation and seizures. The upregulation of NMDAR1 (Grin1), SNAP?25 (Snap25) and Scn8a may thus be involved in Rbfox1?related neuronal hyperexcitation. PMID:25571999

Wen, Ming; Yan, Yong; Yan, Ning; Chen, Xiao Shan; Liu, Shi Yong; Feng, Zhan Hui

2015-03-01

383

Presurgical language lateralization assessment by fMRI and dichotic listening of pediatric patients with intractable epilepsy  

PubMed Central

Objective The aim of this study was to evaluate the clinical use of a method to assess hemispheric language dominance in pediatric candidates for epilepsy surgery. The method is designed for patients but has previously been evaluated with healthy children. Methods Nineteen patients, 8–18 years old, with intractable epilepsy and candidates for epilepsy surgery were assessed. The assessment consisted of two functional MRI protocols (fMRI) intended to target frontal and posterior language networks respectively, and a behavioral dichotic listening task (DL). Regional left/right indices for each fMRI task from the frontal, temporal and parietal lobe were calculated, and left/right indices of the DL task were calculated from responses of consonants and vowels, separately. A quantitative analysis of each patient's data set was done in two steps based on clearly specified criteria. First, fMRI data and DL data were analyzed separately to determine whether the result from each of these assessments were conclusive or not. Thereafter, the results from the individual assessments were combined to reach a final conclusion regarding hemispheric language dominance. Results For 14 of the 19 subjects (74%) a conclusion was reached about their hemispheric language dominance. Nine subjects had a left-sided and five subjects had a right-sided hemispheric dominance. In three cases (16%) DL provided critical data to reach a conclusive result. Conclusions The success rate of conclusive language lateralization assessments in this study is comparable to reported rates on similar challenged pediatric populations. The results are promising but data from more patients than in the present study will be required to conclude on the clinical applicability of the method. PMID:25610785

Norrelgen, Fritjof; Lilja, Anders; Ingvar, Martin; Åmark, Per; Fransson, Peter

2014-01-01

384

Complications of Therapy in Parkinson's Disease  

PubMed Central

Despite several more effective combinations, the incidence of disability and intractable complications from levodopa therapy for Parkinson's disease is unchanged. Many of these appear to be related to the development of denervation hypersensitivity as well as to drug tolerance and loss of effect. They include dyskinesia, `wearing off' phenomenon, `on-off' phenomenon, and various psychic changes. More current forms of therapy with bromocriptine and drug holidays are described, emphasizing methods of preventing and controlling the incapacitating complications associated with long term drug therapy. Some future therapeutic considerations are also described. PMID:21286582

Kofman, Oscar S.

1983-01-01

385

Modeling the impact of vaccination control strategies on a foot and mouth disease outbreak in the Central United States.  

PubMed

The central United States (U.S.) has a large livestock population including cattle, swine, sheep and goats. Simulation models were developed to assess the impact of livestock herd types and vaccination on foot and mouth disease (FMD) outbreaks using the North American Animal Disease Spread Model. In this study, potential FMD virus outbreaks in the central region of the U.S. were simulated to compare different vaccination strategies to a depopulation only scenario. Based on data from the U.S. Department of Agriculture National Agricultural Statistics Service, a simulated population of 151,620 livestock operations characterized by latitude and longitude, production type, and herd size was generated. For the simulations, a single 17,000 head feedlot was selected as the initial latently infected herd in an otherwise susceptible population. Direct and indirect contact rates between herds were based on survey data of livestock producers in Kansas and Colorado. Control methods included ring vaccination around infected herds. Feedlots ?3000 head were either the only production type that was vaccinated or were assigned the highest vaccination priority. Simulated vaccination scenarios included low and high vaccine capacity, vaccination zones of 10km or 50km around detected infected premises, and vaccination trigger of 10 or 100 detected infected herds. Probability of transmission following indirect contact, movement controls and contact rate parameters were considered uncertain and so were the subjects of sensitivity analysis. All vaccination scenarios decreased number of herds depopulated but not all decreased outbreak duration. Increased size of the vaccination zone during an outbreak decreased the length of the outbreak and number of herds destroyed. Increased size of the vaccination zone primarily resulted in vaccinating feedlots ?3000 head across a larger area. Increasing the vaccination capacity had a smaller impact on the outbreak and may not be feasible if vaccine production and delivery is limited. The ability to vaccinate all the production types surrounding an infected herd did not appear as beneficial as priority vaccination of feedlot production types that have high numbers of indirect contacts. Outbreak duration, number of herds depopulated and the effectiveness of vaccination were sensitive to indirect contact transmission probability and movement restrictions. The results of this study will provide information about the impacts of disease control protocols which may be useful in choosing the optimal control methods to meet the goals of rapid effective control and eradication. PMID:25457133

McReynolds, Sara W; Sanderson, Michael W; Reeves, Aaron; Hill, Ashley E

2014-12-01

386

Epidemic of end-stage renal disease in people with diabetes in the United States population: Do we know the cause?  

Microsoft Academic Search

Epidemic of end-stage renal disease in people with diabetes in the United States population: Do we know the cause?BackgroundThe number of individuals initiating renal replacement therapy in the United States population grew exponentially over the past two decades. Cases of end-stage renal diseae (ESRD) attributed to diabetes accounted for most of this increase. In this report we examined factors that

Camille A. Jones; Andrzej S. Krolewski; JOHN ROGUS; Jay L. Xue; ALLAN COLLINS; James H. Warram

2005-01-01

387

Management of intractable hiccup  

Microsoft Academic Search

A patient who developed hiccups after laparotomy was treated with numerous drugs with limited success. A left phrenic nerve crush was eventually successful. A review of published work showed that the drugs most likely to succeed were chlorpromazine and metoclopramide, and that phrenic nerve injection and crush should be considered if these failed.

B W Williamson; I M MacIntyre

1977-01-01

388

HLA similarities indicate shared genetic risk in 21-hydroxylase autoantibody positive South African and United States Addison's disease.  

PubMed

Genetic similarities between patients from the United States and South African (SA) Addison's Disease (AD) strengthen evidence for genetic association. SA-AD (n?=?73), SA healthy controls (N?=?78), and US-AD patients (N?=?83) were genotyped for DQA1, DQB1, DRB1, and HLA-B alleles. Serum was tested for the quantity of 21OH-AA and IFN?-AA at the Barbara Davis Center. Although not as profound as in US-AD, in SA-AD 21OH-AA?+?subjects the predominantly associated risk haplotypes were DRB1*0301-DQB1*0201 (DR3), DRB1*04xx-DQB1*0302 (DR4), and the combined DR3/4 genotype. DQB1*0302 associated DRB1*04xx haplotypes conferred higher risk than those DRB1*04xx haplotypes associated with other DQB1 alleles. We found negative association in 21OH-AA?+?SA-AD for DQA1*0201-DQB1*0202 and DQA1*0101-DQB1*0501 vs SA controls, and positive association for DQA1*0401-DQB1*0402 vs US-AD. Apart from the class II DR3 haplotype, HLA-B8 did not have an independent effect; however together DR3 and HLA-B8 conferred the highest risk vs 21OH-AA negative SA-AD and SA-controls. HLA-B7 (often with DR4) conferred novel risk in 21OH-AA?+?SA-AD vs controls. This study represents the first comparison between South African and United States AD populations utilizing genotyping and serology performed at the same center. SA-AD and US-AD 21OH-AA?+?patients share common HLA risk haplotypes including DR4 (with HLA-B7) and DR3 (with HLA-B8), strengthening previously described HLA associations and implicating similar genetic etiology. PMID:25040682

Ross, I L; Babu, S; Armstrong, T; Zhang, L; Schatz, D; Pugliese, A; Eisenbarth, G; Baker Ii, P

2014-10-01

389

Characterization of Newcastle disease virus isolated from cormorant and gull species in the United States in 2010  

Technology Transfer Automated Retrieval System (TEKTRAN)

Newcastle disease virus (NDV), a member of the genus Avulavirus of the family Paramyxoviridae, is the causative agent of Newcastle disease (ND) a highly contagious disease that affects many species of birds and which frequently causes significant economic losses to the poultry industry worldwide. V...

390

Legionnaires' Disease  

MedlinePLUS

... with major differences in "attack rate" (the fraction of exposed persons who become infected) and severity are not known. In the United States, Legionnaires' disease is fairly common and serious. LDB ...

391

Appropriating Risk Factors: The Reception of an American Approach to Chronic Disease in the two German States, c. 1950–1990  

PubMed Central

Summary Risk factors have become a dominant approach to the aetiology of chronic disease worldwide. The concept emerged in the new field of chronic disease epidemiology in the United States in the 1950s, around near-iconic projects such as the Framingham Heart Study. In this article I examine how chronic disease epidemiology and the risk factor concept were adopted and adapted in the two German states. I draw on case studies that illuminate the characteristics of the different contexts and different take on traditions in social hygiene, social medicine and epidemiology. I also look at critics of the risk factor approach in East and West Germany, who viewed risk factors as intellectually dishonest and a new surveillance tool.

Timmermann, Carsten

2012-01-01

392

Two-year seizure reduction in adults with medically intractable partial onset epilepsy treated with responsive neurostimulation: Final results of the RNS System Pivotal trial  

PubMed Central

Objective To demonstrate the safety and effectiveness of responsive stimulation at the seizure focus as an adjunctive therapy to reduce the frequency of seizures in adults with medically intractable partial onset seizures arising from one or two seizure foci. Methods Randomized multicenter double-blinded controlled trial of responsive focal cortical stimulation (RNS System). Subjects with medically intractable partial onset seizures from one or two foci were implanted, and 1 month postimplant were randomized 1:1 to active or sham stimulation. After the fifth postimplant month, all subjects received responsive stimulation in an open label period (OLP) to complete 2 years of postimplant follow-up. Results All 191 subjects were randomized. The percent change in seizures at the end of the blinded period was ?37.9% in the active and ?17.3% in the sham stimulation group (p = 0.012, Generalized Estimating Equations). The median percent reduction in seizures in the OLP was 44% at 1 year and 53% at 2 years, which represents a progressive and significant improvement with time (p < 0.0001). The serious adverse event rate was not different between subjects receiving active and sham stimulation. Adverse events were consistent with the known risks of an implanted medical device, seizures, and of other epilepsy treatments. There were no adverse effects on neuropsychological function or mood. Significance Responsive stimulation to the seizure focus reduced the frequency of partial-onset seizures acutely, showed improving seizure reduction over time, was well tolerated, and was acceptably safe. The RNS System provides an additional treatment option for patients with medically intractable partial-onset seizures. PMID:24621228

Heck, Christianne N; King-Stephens, David; Massey, Andrew D; Nair, Dileep R; Jobst, Barbara C; Barkley, Gregory L; Salanova, Vicenta; Cole, Andrew J; Smith, Michael C; Gwinn, Ryder P; Skidmore, Christopher; Van Ness, Paul C; Bergey, Gregory K; Park, Yong D; Miller, Ian; Geller, Eric; Rutecki, Paul A; Zimmerman, Richard; Spencer, David C; Goldman, Alica; Edwards, Jonathan C; Leiphart, James W; Wharen, Robert E; Fessler, James; Fountain, Nathan B; Worrell, Gregory A; Gross, Robert E; Eisenschenk, Stephan; Duckrow, Robert B; Hirsch, Lawrence J; Bazil, Carl; O'Donovan, Cormac A; Sun, Felice T; Courtney, Tracy A; Seale, Cairn G; Morrell, Martha J

2014-01-01

393

Heart Disease in Women  

MedlinePLUS

... page from the NHLBI on Twitter. How Does Heart Disease Affect Women? Español In the United States, 1 ... about coronary MVD and broken heart syndrome. Coronary Heart Disease CHD is a disease in which plaque (plak) ...

394

Incidence of Avian Influenza in Adamawa State, Nigeria: The Epidemiology, Economic Losses and the Possible Role of Wild Birds in the Transmission of the Disease  

Microsoft Academic Search

Reducing the huge economic losses due to diseases in poultry as the second largest industry in Nigeria after oil means improving the protein intake of the majority. Similarly, this will also promotes a steady income for the teeming farmers. This study investigated the incidence of the lethal avian influenza in Adamawa State, Nigeria, with particular emphasis on the socio-economic and

H. G. Balla; A. S. Tahir; C. Haskainu

2008-01-01

395

Major Depression, Alcohol and Drug Use Disorders Do Not Appear to Account for the Sexually Transmitted Disease and HIV Epidemics in the Southern United States  

Microsoft Academic Search

Objective: Sexually transmitted disease (STD) and HIV infection are occurring at epidemic rates in the southern region of the United States. Depression and substance use disorders are associated with sexual risk behavior, so we investigated whether regionwide societal rates of major depression or substance use disorders could explain the higher southern rates. Methods: Data came from two surveys, the National

Sherry D. Broadwell; Peikang Yao; Deborah Hasin

2006-01-01

396

Asthma in New York State Asthma is a chronic lung disease that affects an estimated 16.4 million adults (aged 18 years)1  

E-print Network

Asthma in New York State Asthma is a chronic lung disease that affects an estimated 16.4 million.S.), regardless of age, sex, race, or ethnicity. Although the exact cause of asthma is unknown and it cannot exposure to environmental triggers. The following data provide an overview of the burden of asthma in New

397

Comparing bacterial community composition between healthy and white plague-like disease states in Orbicella annularis using PhyloChip™ G3 microarrays  

USGS Publications Warehouse

Coral disease is a global problem. Diseases are typically named or described based on macroscopic changes, but broad signs of coral distress such as tissue loss or discoloration are unlikely to be specific to a particular pathogen. For example, there appear to be multiple diseases that manifest the rapid tissue loss that characterizes ‘white plague.’ PhyloChip™ G3 microarrays were used to compare the bacterial community composition of both healthy and white plague-like diseased corals. Samples of lobed star coral (Orbicella annularis, formerly of the genus Montastraea [1]) were collected from two geographically distinct areas, Dry Tortugas National Park and Virgin Islands National Park, to determine if there were biogeographic differences between the diseases. In fact, all diseased samples clustered together, however there was no consistent link to Aurantimonas coralicida, which has been described as the causative agent of white plague type II. The microarrays revealed a large amount of bacterial heterogeneity within the healthy corals and less diversity in the diseased corals. Gram-positive bacterial groups (Actinobacteria, Firmicutes) comprised a greater proportion of the operational taxonomic units (OTUs) unique to healthy samples. Diseased samples were enriched in OTUs from the families Corynebacteriaceae, Lachnospiraceae, Rhodobacteraceae, and Streptococcaceae. Much previous coral disease work has used clone libraries, which seem to be methodologically biased toward recovery of Gram-negative bacterial sequences and may therefore have missed the importance of Gram-positive groups. The PhyloChip™data presented here provide a broader characterization of the bacterial community changes that occur within Orbicella annularis during the shift from a healthy to diseased state.

Kellogg, Christina A.; Piceno, Yvette M.; Tom, Lauren M.; DeSantis, Todd Z.; Gray, Michael A.; Zawada, David G.; Andersen, Gary L.

2013-01-01

398

Comparing Bacterial Community Composition between Healthy and White Plague-Like Disease States in Orbicella annularis Using PhyloChip™ G3 Microarrays  

PubMed Central

Coral disease is a global problem. Diseases are typically named or described based on macroscopic changes, but broad signs of coral distress such as tissue loss or discoloration are unlikely to be specific to a particular pathogen. For example, there appear to be multiple diseases that manifest the rapid tissue loss that characterizes ‘white plague.’ PhyloChip™ G3 microarrays were used to compare the bacterial community composition of both healthy and white plague-like diseased corals. Samples of lobed star coral (Orbicella annularis, formerly of the genus Montastraea [1]) were collected from two geographically distinct areas, Dry Tortugas National Park and Virgin Islands National Park, to determine if there were biogeographic differences between the diseases. In fact, all diseased samples clustered together, however there was no consistent link to Aurantimonas coralicida, which has been described as the causative agent of white plague type II. The microarrays revealed a large amount of bacterial heterogeneity within the healthy corals and less diversity in the diseased corals. Gram-positive bacterial groups (Actinobacteria, Firmicutes) comprised a greater proportion of the operational taxonomic units (OTUs) unique to healthy samples. Diseased samples were enriched in OTUs from the families Corynebacteriaceae, Lachnospiraceae, Rhodobacteraceae, and Streptococcaceae. Much previous coral disease work has used clone libraries, which seem to be methodologically biased toward recovery of Gram-negative bacterial sequences and may therefore have missed the importance of Gram-positive groups. The PhyloChip™data presented here provide a broader characterization of the bacterial community changes that occur within Orbicella annularis during the shift from a healthy to diseased state. PMID:24278181

Kellogg, Christina A.; Piceno, Yvette M.; Tom, Lauren M.; DeSantis, Todd Z.; Gray, Michael A.; Zawada, David G.; Andersen, Gary L.

2013-01-01

399

The Importance of Diabetes Mellitus in the Global Epidemic of Cardiovascular Disease: The Case of the State of Qatar  

PubMed Central

As a manifestation of the epidemiologic transition being experienced throughout the developing world, the prevalence of diabetes mellitus (DM) is increasing. However, whether an individual's risk of cardiovascular diseases as a consequence of DM is also higher in these countries is unknown. We conducted a case-control study at the medical center in the state of Qatar comparing the prevalence of DM in 512 patients who were admitted with acute myocardial infarctions (MI) and 262 cases of cerebrovascular accidents (CVA) to 382 hospital and outpatient controls to calculate the odds ratios (OR) associated with DM for MI and CVA. The OR for MI was estimated to be 4.01 compared to 2.92 for other countries in the Middle East and 1.75 for North America. The OR was even higher for Qatari natives. Understanding the reasons for this increase, including genetic differences, lifestyle, and medical management issues, is critical for the design and prioritization of effective interventions. PMID:23303985

Mushlin, Alvin I.; Christos, Paul J.; Abu-Raddad, Laith; Chemaitelly, Hiam; Deleu, Dirk; Gehani, Abdul Razak

2012-01-01

400

Multilocus sequence typing of Xylella fastidiosa causing Pierce's disease and oleander leaf scorch in the United States.  

PubMed

Using a modified multilocus sequence typing (MLST) scheme for the bacterial plant pathogen Xylella fastidiosa based on the same seven housekeeping genes employed in a previously published MLST, we studied the genetic diversity of two subspecies, X. fastidiosa subsp. fastidiosa and X. fastidiosa subsp. sandyi, which cause Pierce's disease and oleander leaf scorch, respectively. Typing of 85 U.S. isolates (plus one from northern Mexico) of X. fastidiosa subsp. fastidiosa from 15 different plant hosts and 21 isolates of X. fastidiosa subsp. sandyi from 4 different hosts in California and Texas supported their subspecific status. Analysis using the MLST genes plus one cell-surface gene showed no significant genetic differentiation based on geography or host plant within either subspecies. Two cases of homologous recombination (with X. fastidiosa subsp. multiplex, the third U.S. subspecies) were detected in X. fastidiosa subsp. fastidiosa. Excluding recombination, MLST site polymorphism in X. fastidiosa subsp. fastidiosa (0.048%) and X. fastidiosa subsp. sandyi (0.000%) was substantially lower than in X. fastidiosa subsp. multiplex (0.240%), consistent with the hypothesis that X. fastidiosa subspp. fastidiosa and sandyi were introduced into the United States (probably just prior to 1880 and 1980, respectively). Using whole-genome analysis, we showed that MLST is more effective at genetic discrimination at the specific and subspecific level than other typing methods applied to X. fastidiosa. Moreover, MLST is the only technique effective in detecting recombination. PMID:20465416

Yuan, Xiaoli; Morano, Lisa; Bromley, Robin; Spring-Pearson, Senanu; Stouthamer, Richard; Nunney, Leonard

2010-06-01

401

Exome sequencing identifies compound heterozygous mutations in C12orf57 in two siblings with severe intellectual disability, hypoplasia of the corpus callosum, chorioretinal coloboma, and intractable seizures.  

PubMed

In patients with genetically heterogeneous disorders such as intellectual disability or epilepsy, exome sequencing is a powerful tool to elucidate the underlying genetic cause. Homozygous and compound heterozygous mutations in C12orf57 have recently been described to cause an autosomal recessive syndromic form of intellectual disability, including agenesis/hypoplasia of the corpus callosum, optic coloboma, and intractable seizures. Here, we report on two siblings from nonconsanguineous parents harboring two compound heterozygous loss-of-function mutations in C12orf57 identified by exome sequencing, including a novel nonsense mutation, and review the patients described in the literature. PMID:24798461

Platzer, Konrad; Hüning, Irina; Obieglo, Carolin; Schwarzmayr, Thomas; Gabriel, Rainer; Strom, Tim M; Gillessen-Kaesbach, Gabriele; Kaiser, Frank J

2014-08-01

402

A brief review of infectious and parasitic diseases of wapiti, with emphasis on western Canada and the northwestern United States  

PubMed Central

In this paper I review diseases reported in both captive and free-ranging wapiti in western North America, with some reference to diseases in captive red deer in Great Britain, Europe, New Zealand, and eastern North America. With the exception of coronavirus in neonates, few viral agents are reported to cause serious disease losses in wapiti in North America at this time. Bacterial diseases of current significance include brucellosis (focus in Wyoming), clostridial diseases, coliform enteritis of neonates, pasteurellosis, and necrobacillosis. The endoparasites most likely to be seen causing lesions in wapiti of western North America are lungworm (Dictyocaulus viviparus), arterial worm (Elaeophora schneideri), and, possibly, liver fluke (Fascioloides magna). Ectoparasites of importance to wapiti are Psoroptes cervinus and Dermacentor albipictus. Nutritional diseases are not covered in this review. ImagesFigure 1. PMID:17423839

Smits, Judit E.G.

1991-01-01

403

Correcting human heart 31P NMR spectra for partial saturation. Evidence that saturation factors for PCr/ATP are homogeneous in normal and disease states  

NASA Astrophysics Data System (ADS)

Heart PCr/ATP ratios measured from spatially localized 31P NMR spectra can be corrected for partial saturation effects using saturation factors derived from unlocalized chest surface-coil spectra acquired at the heart rate and approximate Ernst angle for phosphor creatine (PCr) and again under fully relaxed conditions during each 31P exam. To validate this approach in studies of normal and disease states where the possibility of heterogeneity in metabolite T1 values between both chest muscle and heart and normal and disease states exists, the properties of saturation factors for metabolite ratios were investigated theoretically under conditions applicable in typical cardiac spectroscopy exams and empirically using data from 82 cardiac 31P exams in six study groups comprising normal controls ( n = 19) and patients with dilated ( n = 20) and hypertrophic ( n = 5) cardiomyopathy, coronary artery disease ( n = 16), heart transplants ( n = 19), and valvular heart disease ( n = 3). When TR ? T1,(PCr), with T1(PCr) ? T1(ATP), the saturation factor for PCr/ATP lies in the range 1.5 ± 0.5, regardless of the T1 values. The precise value depends on the ratio of metabolite T1 values rather than their absolute values and is insensitive to modest changes in TR. Published data suggest that the metabolite T1 ratio is the same in heart and muscle. Our empirical data reveal that the saturation factors do not vary significantly with disease state, nor with the relative fractions of muscle and heart contributing to the chest surface-coil spectra. Also, the corrected myocardial PCr/ATP ratios in each normal or disease state bear no correlation with the corresponding saturation factors nor the fraction of muscle in the unlocalized chest spectra. However, application of the saturation correction (mean value, 1.36 ± 0.03 SE) significantly reduced scatter in myocardial PCr/ATP data by 14 ± 11% (SD) ( p ? 0.05). The findings suggest that the relative T1 values of PCr and ATP are substantially the same in chest and heart muscle and are unchanged in these disease states. The mean value for T1 (PCr)/ T1(ATP) is 2.16 ± 0.29 SE.

Bottomley, Paul A.; Hardy, Christopher J.; Weiss, Robert G.

404

Paradata for 'University of California-Davis-Department of Entomology: Background Information on the Biology of TicksIowa State University: Iowa State's Deer Tick Home PageUniversity of Florida Institute of Food and Agricultural Sciences-Featured Creatures: Blacklegged Tick or Deer TickCornell University-Cooperative Extension: Tick Biology for the HomeownerAmerican Lyme Disease Foundation, Inc.U.S. Centers for Disease Control and Prevention: A Focus of Deer Tick Virus Transmission in the Northcentral United StatesMaine Medical Center Research Institute: Lyme Disease Research Laboratory'  

NSDL National Science Digital Library

This record contains paradata for the resource 'University of California-Davis-Department of Entomology: Background Information on the Biology of TicksIowa State University: Iowa State's Deer Tick Home PageUniversity of Florida Institute of Food and Agricultural Sciences-Featured Creatures: Blacklegged Tick or Deer TickCornell University-Cooperative Extension: Tick Biology for the HomeownerAmerican Lyme Disease Foundation, Inc.U.S. Centers for Disease Control and Prevention: A Focus of Deer Tick Virus Transmission in the Northcentral United StatesMaine Medical Center Research Institute: Lyme Disease Research Laboratory'

405

Temporal Trends in Population-Based Death Rates Associated With Chronic Liver Disease and Liver Cancer in the United States Over the Last 30 Years  

PubMed Central

BACKGROUND The health and economic burden from liver disease in the United States is substantial and rising. The objective of this study was to characterize temporal trends in mortality from chronic liver disease and liver cancer and the incidence of associated risk factors using population-based data over the past 30 years. METHODS Population-based mortality data were obtained from the National Vital Statistics System, and population estimates were derived from the national census for US adults (aged >45 years). Crude death rates (CDRs), age-adjusted death rates (ADRs), and average annual percentage change (AAPC) statistics were calculated. RESULTS In total, 690,414 deaths (1.1%) were attributable to chronic liver disease, whereas 331,393 deaths (0.5%) were attributable to liver cancer between 1981 and 2010. The incidence of liver cancer was estimated at 7.1 cases per 100,000 population. Mortality rates from chronic liver disease and liver cancer increased substantially over the past 3 decades, with ADRs of 23.7 and 16.6 per 100,000 population in 2010, respectively. The AAPC from 2006 to 2010 demonstrated an increased ADR for chronic liver disease (AAPC, 1.5%; 95% confidence interval, 0.3%–2.8%) and liver cancer (AAPC, 2.6%; 95% confidence interval, 2.4%–2.7%). CONCLUSIONS A comprehensive approach that involves primary and secondary prevention, increased access to treatment, and more funding for liver-related research is needed to address the high death rates associated with chronic liver disease and liver cancer in the United States. PMID:24917245

Kim, Yuhree; Ejaz, Aslam; Tayal, Amit; Spolverato, Gaya; Bridges, John F. P.; Anders, Robert A.; Pawlik, Timothy M.

2015-01-01

406

Self-report of cognitive impairment and mini-mental state examination performance in PRKN, LRRK2, and GBA carriers with early onset Parkinson's disease  

Microsoft Academic Search

While little is known about risk factors for cognitive impairment in early onset Parkinson disease (EOPD), postmortem studies have shown an association between dementia with Lewy bodies (DLB) and glucocerebrosidase (GBA) mutation. We compared Mini-Mental State Examination (MMSE) performance and self-reported cognitive impairment in 699 EOPD participants genotyped for mutations in parkin (PRKN), leucine-rich repeat kinase-2 (LRRK2), and GBA. Logistic

Roy N. Alcalay; Helen Mejia-Santana; Ming X. Tang; Brian Rakitin; Llency Rosado; Barbara Ross; Miguel Verbitsky; Sergey Kisselev; Elan D. Louis; Cynthia L. Comella; Amy Colcher; Danna Jennings; Martha A. Nance; Susan Bressman; William K. Scott; Caroline Tanner; Susan F. Mickel; Howard F. Andrews; Cheryl H. Waters; Stanley Fahn; Lucien J. Cote; Steven J. Frucht; Blair Ford; Michael Rezak; Kevin Novak; Joseph H. Friedman; Ronald Pfeiffer; Laura Marsh; Bradley Hiner; Andrew Siderowf; Ruth Ottman; Lorraine N. Clark; Karen S. Marder; Elise Caccappolo

2010-01-01

407

Postural instability and fall risk in Parkinson’s disease: impaired dual tasking, pacing, and bilateral coordination of gait during the “ON” medication state  

Microsoft Academic Search

The interplay between gait and specific cognitive faculties, in particular executive function (EF) and dual tasking abilities,\\u000a has been described in healthy adults and in patients with Parkinson’s disease (PD). There is, however, little direct evidence\\u000a on the relationship between cognitive function, gait, and fall risk in PD, especially in the “ON” state (i.e., under the influence\\u000a of the anti-parkinsonian

Meir Plotnik; Nir Giladi; Yaacov Dagan; Jeffery M. Hausdorff

2011-01-01

408

Integrated Mapping of Neglected Tropical Diseases: Epidemiological Findings and Control Implications for Northern Bahr-el-Ghazal State, Southern Sudan  

PubMed Central

Background There are few detailed data on the geographic distribution of most neglected tropical diseases (NTDs) in post-conflict Southern Sudan. To guide intervention by the recently established national programme for integrated NTD control, we conducted an integrated prevalence survey for schistosomiasis, soil-transmitted helminth (STH) infection, lymphatic filariasis (LF), and loiasis in Northern Bahr-el-Ghazal State. Our aim was to establish which communities require mass drug administration (MDA) with preventive chemotherapy (PCT), rather than to provide precise estimates of infection prevalence. Methods and Findings The integrated survey design used anecdotal reports of LF and proximity to water bodies (for schistosomiasis) to guide selection of survey sites. In total, 86 communities were surveyed for schistosomiasis and STH; 43 of these were also surveyed for LF and loiasis. From these, 4834 urine samples were tested for blood in urine using Hemastix reagent strips, 4438 stool samples were analyzed using the Kato-Katz technique, and 5254 blood samples were tested for circulating Wuchereria bancrofti antigen using immunochromatographic card tests (ICT). 4461 individuals were interviewed regarding a history of ‘eye worm’ (a proxy measure for loiasis) and 31 village chiefs were interviewed regarding the presence of clinical manifestations of LF in their community. At the village level, prevalence of Schistosoma haematobium and S. mansoni ranged from 0 to 65.6% and from 0 to 9.3%, respectively. The main STH species was hookworm, ranging from 0 to 70% by village. Infection with LF and loiasis was extremely rare, with only four individuals testing positive or reporting symptoms, respectively. Questionnaire data on clinical signs of LF did not provide a reliable indication of endemicity. MDA intervention thresholds recommended by the World Health Organization were only exceeded for urinary schistosomiasis and hookworm in a few, yet distinct, communities. Conclusion This was the first attempt to use an integrated survey design for this group of infections and to generate detailed results to guide their control over a large area of Southern Sudan. The approach proved practical, but could be further simplified to reduce field work and costs. The results show that only a few areas need to be targeted with MDA of PCT, thus confirming the importance of detailed mapping for cost-effective control. PMID:19859537

Sturrock, Hugh J. W.; Picon, Diana; Sabasio, Anthony; Oguttu, David; Robinson, Emily; Lado, Mounir; Rumunu, John; Brooker, Simon; Kolaczinski, Jan H.

2009-01-01

409

Compendium of measures to prevent disease associated with animals in public settings, 2011: National Association of State Public Health Veterinarians, Inc.  

PubMed

Certain venues encourage or permit the public to be in contact with animals, resulting in millions of human-animal interactions each year. These settings include county or state fairs, petting zoos, animal swap meets, pet stores, feed stores, zoologic institutions, circuses, carnivals, educational farms, livestock-birthing exhibits, educational exhibits at schools and child-care facilities, and wildlife photo opportunities. Although human-animal contact has many benefits, human health problems are associated with these settings, including infectious diseases, exposure to rabies, and injuries. Infectious disease outbreaks have been caused by Escherichia coli O157:H7, Salmonella species, Cryptosporidium species, Coxiella burnetii, Mycobacterium tuberculosis, ringworm, and other pathogens. Such outbreaks have substantial medical, public health, legal, and economic effects. This report provides recommendations for public health officials, veterinarians, animal venue staff members, animal exhibitors, visitors to animal venues, physicians, and others concerned with minimizing risks associated with animals in public settings. The recommendation to wash hands is the most important for reducing the risk for disease transmission associated with animals in public settings. Other important recommendations are that venues prohibit food in animal areas and include transition areas between animal areas and nonanimal areas, visitors receive information about disease risk and prevention procedures, and animals be properly cared for and managed. These updated 2011 guidelines provide new information on the risks associated with amphibians and with animals