Sample records for intractable disease state

  1. Thoracoscopic renal denervation for intractable autosomal dominant polycystic kidney disease-related pain

    Microsoft Academic Search

    Olivier Chapuis; Philippe Sockeel; Gilbert Pallas; François Pons; René Jancovici

    2004-01-01

    The authors report a case of intractable autosomal dominant polycystic kidney disease-related pain associated with normal renal function, treated with renal denervation. Renal denervation was performed via a thoracoscopic approach. The good medium-term result suggests that thoracoscopic sympatho-splanchnicectomy would be an attractive procedure for pain management in autosomal polycystic kidney disease.

  2. Thoracoscopic renal denervation for intractable autosomal dominant polycystic kidney disease-related pain.

    PubMed

    Chapuis, Olivier; Sockeel, Philippe; Pallas, Gilbert; Pons, François; Jancovici, René

    2004-01-01

    The authors report a case of intractable autosomal dominant polycystic kidney disease-related pain associated with normal renal function, treated with renal denervation. Renal denervation was performed via a thoracoscopic approach. The good medium-term result suggests that thoracoscopic sympatho-splanchnicectomy would be an attractive procedure for pain management in autosomal polycystic kidney disease. PMID:14712440

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

    SciTech Connect

    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

    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.

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

    PubMed

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

    2015-03-01

    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

  5. Intractable hiccups--an early feature of Addison's disease

    Microsoft Academic Search

    P. G. Hardo

    1989-01-01

    Hiccups has not been previously reported as a manifestation of Addison's disease. We report two cases where persistent hiccups was an early feature of Addison's disease. Steroid replacement cured the symptoms in both patients with no recurrence.

  6. Evaluation of retrosigmoid vestibular neurectomy for intractable vertigo in Ménière’s disease: an interdisciplinary review

    Microsoft Academic Search

    C.-S. Li; J.-T. Lai

    2008-01-01

    Summary  \\u000a Background. Retrosigmoid vestibular neurectomy is suggested to be the most effective and safe procedure to control intractable vertigo\\u000a associated with Ménière’s disease. The purpose of this study is to report the excellent efficacy of vertigo control, the good\\u000a preservation of hearing, the rare complications and the simplicity of retrosigmoid vestibular neurectomy performed by an interdisciplinary\\u000a team of neurosurgery and

  7. Von-Willebrand Disease Presenting as Intractable Epistaxis after Nasal Polypectomy

    PubMed Central

    Park, Jeong Jin; Kim, Chang-Hoon; Lee, Jeung-Gweon

    2014-01-01

    Von-Willebrand disease (VWD) is one of the platelet dysfunction disorders that results from a deficiency of Von-Willebrand factor, which is essential for hemostasis. VWD patients typically have normal laboratory results on screening for bleeding disorders. To suspect and diagnose VWD, a careful review of past medical history and laboratory tests is critical. A 59-year-old male patient presented with intractable nasal bleeding after nasal polypectomy. The bleeding was controlled by platelet transfusion, and he was later diagnosed with VWD. PMID:25243089

  8. Duodenal adenocarcinoma might be the cause of intractable nausea and vomiting in patient with coeliac disease

    PubMed Central

    Rajabalinia, Hassan; Dabiri, Reza; Shahbazi, Shahin; Ghobakhlou, Mehdi; Bahreiny, Rasoul; Molaei, Mahsa; Nejad, Mohammad Rostami

    2012-01-01

    Coeliac disease (CD) is an autoimmune disorder which leads to chronic inflammation of the gut. Untreated CD is associated with upper gastrointestinal malignancies, Small-bowel lymphoma and adenocarcinoma are recognized complications of untreated coeliac disease (CD). We report the case of a 43-year-old male suffering from CD who was treated with a gluten-free diet one year, presenting with complaints of intractable nausea and vomiting. After several studies, He underwent push enteroscopy, which identified one large mass lesion in the third part of duodenum. However, histopathological examination showed adenocarcinoma. Subsequently, a duodenal segment resection was performed. After surgery, the patient recovered well and left our hospital in good condition. Clinicians should take into small bowel adenocarcinoma is rare but associated with CD particularly in CD patients with worrying symptoms such as nausea and vomiting unresponsiveness to treatment and these patients should be screened for long term complications like malignancy. PMID:24834228

  9. Duodenal adenocarcinoma might be the cause of intractable nausea and vomiting in patient with coeliac disease.

    PubMed

    Rajabalinia, Hassan; Dabiri, Reza; Shahbazi, Shahin; Ghobakhlou, Mehdi; Bahreiny, Rasoul; Molaei, Mahsa; Rostami Nejad, Mohammad; Fatemi, Seyed Reza

    2012-01-01

    Coeliac disease (CD) is an autoimmune disorder which leads to chronic inflammation of the gut. Untreated CD is associated with upper gastrointestinal malignancies, Small-bowel lymphoma and adenocarcinoma are recognized complications of untreated coeliac disease (CD). We report the case of a 43-year-old male suffering from CD who was treated with a gluten-free diet one year, presenting with complaints of intractable nausea and vomiting. After several studies, He underwent push enteroscopy, which identified one large mass lesion in the third part of duodenum. However, histopathological examination showed adenocarcinoma. Subsequently, a duodenal segment resection was performed. After surgery, the patient recovered well and left our hospital in good condition. Clinicians should take into small bowel adenocarcinoma is rare but associated with CD particularly in CD patients with worrying symptoms such as nausea and vomiting unresponsiveness to treatment and these patients should be screened for long term complications like malignancy. PMID:24834228

  10. [My way to "Keep Pioneering": integrated neuroscience and immunology research produces a paradigm shift for intractable neurological disease].

    PubMed

    Kira, Jun-ichi

    2014-01-01

    The motto of Prof. Yoshigoro Kuroiwa, who established the first independent neurology department in Japan at Kyushu University, is "Keep Pioneering". His students have followed this motto in all fields. I hereby present my efforts to keep pioneering in the following fields: (1) multiple sclerosis (MS); (2) central nervous system (CNS) involvement associated with peripheral atopic inflammation; and (3) care network for patients with intractable neurological disease. In MS, I propose that Th1/Th17 cell-mediated connexin astrocytopathy may play a critical role in producing huge demyelinating lesions in MS, neuromyelitis optica (NMO), and Baló's concentric sclerosis. I discovered a peculiar myelitis that occurred in patients with atopic disorders, and designated it atopic myelitis. In this condition, allodynia and neuropathic pain are cardinal features, regardless of the presence or absence of spinal cord MRI lesions. We found that peripheral atopic inflammation in mice produces allodynia as well as activation of microglia and astroglia in the spinal cord. It is important to involve a variety of medical specialists and care coordinators for collaborative work on medical and social care issues for people with intractable disease. The motto of "Keep Pioneering" in neurology covers not only advanced research for the creation of new therapies for intractable neurological disease, but also caring for actual people with intractable disease, which I believe is the corporate social responsibility of our neurological society. I think that "Keep Pioneering" is a challenging process that never ends throughout one's life. PMID:25672676

  11. High-dose short-term chlorambucil for intractable sympathetic ophthalmia and Behçet's disease.

    PubMed Central

    Tessler, H H; Jennings, T

    1990-01-01

    We treated five patients with intractable sympathetic ophthalmia and six patients with severe Behçet's disease by high-dose, short-term chlorambucil therapy. We used a total dose ranging from 306 mg to 4.2 g and a duration of therapy no longer than 36 weeks and in most cases less than 24 weeks. After termination of therapy all 11 patients had a sustained remission of their eye disease. Unless subretinal neovascularisation was present, all had a final visual acuity of 20/50 or better. Malignancy has not developed in any of our cases, with a follow-up ranging from 6 months to 12 years (mean, 4.5 years). Although 30- and 40-year follow-ups and larger numbers of patients may be necessary fully to realise the risks of chlorambucil, we believe that our high-dose, short-term regimen (Behçet's disease: average duration, 23 weeks; average total dose 2.2 g; sympathetic ophthalmia: average duration, 11 weeks; total average dose, 0.9 g) may be safer than previously reported chlorambucil regimens of one to two years or longer. In addition we fulfilled our aim of discontinuing all concomitant systemic corticosteroids within a relatively short time (usually six to eight weeks). PMID:2378842

  12. Deep Anterior Lamellar Keratoplasty Using Irradiated Acellular Cornea with Amniotic Membrane Transplantation for Intractable Ocular Surface Diseases

    PubMed Central

    Wee, Sung Wook; Choi, Sang Uk

    2015-01-01

    Purpose To report the clinical outcomes of deep anterior lamellar keratoplasty (DALK) when sterile gamma-irradiated acellular corneal tissues (VisionGraft) are used in combination with amniotic membrane transplantation (AMT) for intractable ocular surface diseases. Methods The medical records of fifteen patients who had DALK with AMT were retrospectively reviewed. Indications for surgery included ocular burn, bacterial keratitis, herpes simplex virus keratitis, corneal opacity with Stevens-Johnson syndrome, Mooren's ulcer, idiopathic myxoid degeneration of corneal stroma, and recurrent band keratopathy. DALK was performed using partial-thickness acellular corneal tissue and a temporary amniotic membrane patch was added at the end of the operation. Results All cases that underwent DALK with AMT became epithelialized within 2 postoperative weeks. Twelve patients showed favorable outcomes without graft rejection, corneal opacification, or neovascularization. The other three grafts developed corneal opacification and neovascularization, and required additional penetrating keratoplasty (PK). Unlike the results of previous PKs, there were no graft rejections and the graft clarity was well-maintained in these three cases for at least 8 months after PK. Conclusions DALK using sterile acellular corneal tissues in combination with AMT may be a good therapeutic strategy for treating intractable ocular surface diseases because of lowered immune rejection, fibroblast activation, and facilitation of epithelialization. Furthermore, DALK can help stabilize the ocular surface, prolong graft survival, and may allow better outcomes when combined with subsequent PK.

  13. An intractable case of suspected psoriatic arthritis combined with Dupuytren’s disease

    PubMed Central

    Ding, Wen Quan; Gu, Jian Hui

    2015-01-01

    Some cases of psoriatic arthritis (PsA) cannot be explicitly diagnosed, especially when the skin and nail lesions present years after the joint disease or are absent. Autoimmunity may also play a role in the development of Dupuytren's disease. However, the simultaneous presence of PsA and Dupuytren’s disease is very rare. We present a patient displaying arthritis in multiple small joints, with bone erosions and bony fusions in all four extremities, combined with Dupuytren’s disease. Because of the atypical clinical manifestation, the diagnosis perplexed doctors for decades. Without formal treatment, the disease followed a natural course over time. Reviewing the patient’s data, a potential diagnosis of PsA, combined with Dupuytren’s disease, was eventually made. After surgery, contractures of palmar and plantar fascia as well the thumb web were released, and the hallux valgus was corrected.

  14. A 44 year-old lady with chronic renal disease and intractable ulcers: a case report

    PubMed Central

    Pujar, Thejeswi; Spinello, Irene M

    2009-01-01

    Calciphylaxis is a rare but potentially fatal condition occurring in patients with end stage renal disease on dialysis. Due to interplay of various factors, disturbances occur in the metabolism of calcium and phosphate leading to calcification within the vessel walls. The net result is tissue ischemia and necrosis. Clinically this presents as painful non-healing skin ulcers, which contribute to significant morbidity and mortality due to septic progression of the lesion. In this case report, we highlight the rapidly progressive nature of this disease, its etiopathogenesis and the role of early diagnosis in preventing life-threatening complications. PMID:19646226

  15. Sac-vein decompression for intractable Meniere's disease: Two-year treatment results

    Microsoft Academic Search

    Gerard J. Gianoli; Michael J. LaRouere; Jack M. Kartush; John Wayman

    1998-01-01

    Surgical intervention has been offered to patients with Meniere's disease who have failed medical treatment and have disabling symptoms. Surgical options have included labyrinthectomy (mechanical and chemical), vestibular neurectomy, and endolymphatic sac surgery with or without shunting. We present a modification of endolymphatic sac decompression surgery that includes wide decompression of the sigmoid sinus, posterior cranial fossa dura, and endolymphatic

  16. Eosinophilic Jejunitis Presenting as Intractable Abdominal Pain

    PubMed Central

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

    2014-01-01

    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

  17. Predictors of intractable childhood epilepsy.

    PubMed

    Seker Yilmaz, Berna; Okuyaz, Cetin; Komur, Mustafa

    2013-01-01

    Our study sought to identify early predictive factors of medically intractable childhood epilepsy. A cohort of epileptic children from the city of Mersin was retrospectively investigated. All patients received care from the same Department of Pediatric Neurology. The epileptic cohort was divided into a drug-responsive epilepsy group and an intractable epilepsy group. Intractable epilepsy is defined as continued seizures in children despite adequate therapy with two or more antiepileptic drugs for more than 18 months. Strong univariate association was observed between intractability and several factors: age of onset, high initial seizure frequency, symptomatic etiology, mixed seizure types, previous history of status epilepticus, febrile and neonatal seizures, mental and motor developmental delay, multiple seizures in 1 day, electroencephalogram abnormalities, magnetic resonance imaging findings, and specific epileptic syndromes. Logistic regression analysis revealed that a previous history of epilepticus status, abnormal electroencephalogram results, and multiple seizures in 1 day comprise independent predictors of medically intractable childhood epilepsy. We suggest that medical intractability in childhood epilepsy can be predicted by monitoring these factors. Along with early prediction, alternative therapies may be designed to provide patients better seizure control and quality of life. PMID:23290021

  18. Forehead carbuncle with intractable headache

    PubMed Central

    Chou, Ping-yin; Chen, Yin-Chun; Huang, Poyin

    2015-01-01

    Although carbuncles are commonly seen and may heal on their own or respond well to treatment, in rare conditions, bacteria from carbuncles can spread into the bloodstream and migrate to other areas of the body. Herein, we report on an elderly female who suffered from forehead carbuncle with intractable headache, later confirmed as having subgaleal abscess. Physicians should pay special attention to elderly and immune-compromised patients with carbuncles located on the middle of the face, especially when accompanied by intractable headache, to avoid poor outcome.

  19. Management of intractable spontaneous epistaxis

    PubMed Central

    Rudmik, Luke

    2012-01-01

    Background: Epistaxis is a common otolaryngology emergency and is often controlled with first-line interventions such as cautery, hemostatic agents, or anterior nasal packing. A subset of patients will continue to bleed and require more aggressive therapy. Methods: Intractable spontaneous epistaxis was traditionally managed with posterior nasal packing and prolonged hospital admission. In an effort to reduce patient morbidity and shorten hospital stay, surgical and endovascular techniques have gained popularity. A literature review was conducted. Results: Transnasal endoscopic sphenopalatine artery ligation and arterial embolization provide excellent control rates but the decision to choose one over the other can be challenging. The role of transnasal endoscopic anterior ethmoid artery ligation is unclear but may be considered in certain cases when bleeding localizes to the ethmoid region. Conclusion: This article will focus on the management of intractable spontaneous epistaxis and discuss the role of endoscopic arterial ligation and embolization as it pertains to this challenging clinical scenario. PMID:22391084

  20. Kidney Disease Statistics for the United States

    MedlinePLUS

    ... Info Statistics Research Resources About Us Español National Kidney and Urologic Diseases Information Clearinghouse Publications Tools and ... Titles : Kidney Disease Statistics for the United States Kidney Disease Statistics for the United States On this ...

  1. Oral bismuth for chronic intractable diarrheal conditions?

    PubMed Central

    Thazhath, Sony S; Haque, Mazhar; Florin, Timothy H

    2013-01-01

    Objective Bismuth has antidiarrheal, antibacterial, and anti-inflammatory properties. We report our single-center experience with oral colloidal bismuth subcitrate (CBS) treatment for patients with chronic intractable diarrhea. Method We interrogated our web-based Inflammatory Bowel Disease Clinical and Research database to ascertain clinical details on all patients in our tertiary hospital gastroenterology service treated with CBS between 2000 and 2010. Treatment responses were based on prospective scoring of daily number of liquid stools. Responses were recorded prior to commencement of CBS and at follow-up visits over 12 months. Results Thirty-one patients, mean age 47 years (range 17–79 years) and a mean duration of diarrhea of 22 weeks (range 6–104 weeks), were prescribed CBS at doses ranging from 120 mg to 480 mg/day for ?1 month. Of these, 23 patients (74%) had an initial clinical response and 12 (39%) who continued with this treatment had a sustained clinical response at 1 year. Twelve patients with pouchitis and four patients with indeterminate colitis had initial responses of 92% and 75%, respectively, and sustained responses of 50% and 75%, respectively. Ulcerative colitis patients (n = 5) responded poorly with respect to both initial and sustained responses. Three patients with microscopic colitis showed encouraging initial response of 100% but did not have any sustained benefit. Three of four patients with diarrhea-predominant irritable bowel syndrome (dIBS) had an initial response and two (50%) had good sustained responses. There were no serious adverse events. One patient stopped therapy because of nausea. Conclusion This is the largest report of oral bismuth treatment in chronic intractable diarrhea. CBS is cheap and appears to have the potential to be effective for ameliorating diarrheal symptoms in indeterminate colitis, pouchitis, and dIBS. An appropriately powered, blinded, randomized, controlled study appears warranted to establish the position of oral bismuth in routine practice. PMID:23515887

  2. A Team Approach to the Management of Intractable Leg Ulcers

    PubMed Central

    Kiyokawa, Kensuke; Akaiwa, Keiichi; Ishida, Masaru; Furuyama, Tadashi; Onohara, Toshihiro

    2013-01-01

    Objectives: The management of intractable leg ulcers requires a team approach which includes vascular surgeons and plastic surgeons. We retrospectively reviewed the results of the management of intractable leg ulcers by plastic surgeons. Patients and Methods: A total of 73 patients with intractable leg ulcers, (79 limbs) were treated at the Department of Plastic Surgery at our institution. Skin perfusion pressure (SPP) around the ulcer on the limb was measured before and after arterial reconstructive procedures. Local ulcer management involved intra-wound continuous negative pressure and irrigation therapy or negative pressure wound therapy. We examined the rates of wound healing and associated prognostic factors. Results: There were 21 limbs without ischemia (non-peripheral arterial disease [Non-PAD] group) and 58 limbs with ischemia (PAD group). The healing rates were 66% in the PAD group and 81% in the Non-PAD group, but the difference between the groups was not significant. A total of 41 limbs in the PAD group underwent revascularization, which involved bypass surgery in 18 limbs and endovascular therapy in 23 limbs. The salvage rate of the revascularized limbs was 83% at 1 year. The primary patency rates at 1 year were 87% for bypass surgery and 58% for endovascular therapy. The healing rate of the revascularized limbs was 66%, and the presence of concomitant hemodialysis, infected ulcers, and limbs without improved SPP were shown to be poor prognostic factors. Limbs treated with bypass surgery had a better healing rate than limbs treated with endovascular therapy, but the difference was not significant. Conclusion: Good ulcer-healing rates were achieved by effective revascularization and aggressive local management. These results suggest that a team approach is useful for the management of intractable leg ulcers. (English translation of Jpn J Vasc Surg 2011; 20: 913-920) PMID:23641282

  3. Sequencing Intractable DNA to Close Microbial Genomes

    SciTech Connect

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

    2012-01-01

    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.

  4. The intractable cigarette ‘filter problem’

    PubMed Central

    2011-01-01

    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

  5. Intractable verrucous hyperplasia: a surgically corrected case.

    PubMed

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

    2015-03-01

    Skin problems commonly occur after lower limb amputation. One such skin anomaly that develops on the residual limb is wart-like lesions of verrucous hyperplasia. The process is reversible if external compression is applied in combination with adequate control of bacterial infection and edema. Prosthetic adjustments usually help with this condition. We report an intractable verrucous hyperplasia in a 66-year-old female patient. She complained of a painful, oozing, verrucous papule at the amputation site. Despite management with typical treatment procedures, the lesion worsened; therefore, surgery was performed. Our case demonstrates that an intractable case is possible despite appropriate management and that sometimes surgical correction is necessary. PMID:25479281

  6. Noninvasive treatment alternative for intractable startle epilepsy

    PubMed Central

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

    2014-01-01

    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. PMID:25667869

  7. Bayesian model comparison with intractable likelihoods

    E-print Network

    Everitt, Richard G; Rowing, Ellen; Evdemon-Hogan, Melina

    2015-01-01

    Markov random field models are used widely in computer science, statistical physics and spatial statistics and network analysis. However, Bayesian analysis of these models using standard Monte Carlo methods is not possible due to their intractable likelihood functions. Several methods have been developed that permit exact, or close to exact, simulation from the posterior distribution. However, estimating the evidence and Bayes' factors (BFs) for these models remains challenging in general. This paper describes new random weight importance sampling and sequential Monte Carlo methods for estimating BFs that use simulation to circumvent the evaluation of the intractable likelihood, and compares them to existing methods. In some cases we observe an advantage in the use of biased weight estimates; an initial investigation into the theoretical and empirical properties of this class of methods is presented.

  8. Epilepsy surgery: perioperative investigations of intractable epilepsy

    Microsoft Academic Search

    A. Gorji; H. Straub; E.-J. Speckmann

    2005-01-01

    Recent advances in our understanding of the basic mechanisms of epilepsy have derived, to a large extent, from increasing\\u000a ability to carry out detailed studies on patients surgically treated for intractable epilepsy. Clinical and experimental perioperative\\u000a studies divide into three different phases: before the surgical intervention (preoperative studies), on the intervention itself\\u000a (intraoperative studies), and on the period when the

  9. Gastric Electrical Stimulation in Intractable Symptomatic Gastroparesis

    Microsoft Academic Search

    Thomas L. Abell; Eric Van Cutsem; Hasse Abrahamsson; Jan D. Huizinga; J. W. Konturek; Jean Paul Galmiche; Guy VoelIer; Ludo Filez; Bernt Everts; William E. Waterfall; W. Domschke; Stanislas Bruley des Varannes; Babajide O. Familoni; Ivan M. Bourgeois; Jozef Janssens; Gervais Tougas

    2002-01-01

    Background: The treatment of gastroparesis remains unsatisfactory despite prokinetic and anti-emetic drugs. Gastric electrical stimulation has been proposed as a therapeutic option. We have assessed the effect of gastric electrical stimulation on symptoms, medical treatment, body weight and gastric emptying in patients with intractable symptomatic gastroparesis in a non-placebo-controlled study. Methods: In this multicenter study, 38 highly symptomatic patients with

  10. Penn State: Plant Disease Fact Sheets

    NSDL National Science Digital Library

    This selection of online fact sheets concerned with plant diseases was compiled by Professor Gary W. Moorman, a Professor of Plant Pathology at Penn State. The concise fact sheets address "common diseases of plants frequently grown in greenhouses, interiorscapes, and in outdoor landscapes and nurseries in the northeastern U.S." The sheets are organized under categories for Woody Ornamental, and Floral and Foliage Plants, as well as a General Information category. Factsheets address such diseases as Bacterial Leaf Scorch, Pythium Root Rot, Botrytis Blight, Rhizoctonia, and more. There are sheets for a wide variety of plants and trees including Iris, Tulip, Maple, and Oak, to name a few.

  11. Study on expression of laminin in patients with intractable epilepsy.

    PubMed

    Wu, Yuan; Feng, Yun; Pang, Jia-Rong; Tang, Mei; Liu, Xiu-Ying; Li, Jia-Quan; Wang, Xue-Feng

    2009-01-01

    In this study, we examined differences in serum laminin expression in patients with intractable epilepsy. Our results suggest that elevated laminin may contribute to the pathogenesis of intractable epilepsy. ELISA and western blots were used to measure laminin in the serum of 30 intractable epilepsy patients, 46 nonintractable epilepsy patients, and 20 normal subjects. By ELISA, serum laminin levels were greater in intractable epilepsy patients (177.396 +/- 30.602) and nonintractable epilepsy patients (121.915 +/- 35.215) than in normal control subjects (67.474 +/- 7.197); laminin was significantly greater in the intractable epilepsy group than in the nonintractable epilepsy group. In western blots, the optical density ratio of laminin to ss-actin was 0.871 +/- 0.032 for the intractable epilepsy group, 0.686 +/- 0.017 for the nonintractable epilepsy group, and 0.385 +/- 0.024 for the normal control group. The optical density ratios of the intractable and nonintractable epilepsy groups were higher than those for the normal control group, and the intractable epilepsy group was even greater than the nonintractable epilepsy group. Thus, laminin is significantly increased in epilepsy patients, and this increase is more profound in intractable epilepsy patients. PMID:19916850

  12. Insulinoma Presenting as Medically Intractable Temporal Lobe Epilepsy

    PubMed Central

    Park, So-Hee; Kim, Dong Wook

    2014-01-01

    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

  13. The Gandhi Technique: A New Procedure for Intractable Problems.

    ERIC Educational Resources Information Center

    Schiff, Neil P.; Belson, Richard

    1988-01-01

    Notes problem of treating clients with intractable difficulties. Presents Gandhi Technique as simple, dramatic and seemingly effective procedure to resolve intractable difficulties. Describes technique and its application in different cases. Discusses several theories which may account for the efficacy of the technique. Proposes that Gandhi…

  14. Sustained improvement of intractable rheumatoid arthritis after total lymphoid irradiation

    SciTech Connect

    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

    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.

  15. Deep brain stimulation for intractable psychiatric disorders.

    PubMed

    Goodman, Wayne K; Alterman, Ron L

    2012-01-01

    Deep brain stimulation (DBS) has virtually replaced ablative neurosurgery for use in medication-refractory movement disorders. DBS is now being studied in severe psychiatric conditions, such as treatment-resistant depression (TRD) and intractable obsessive-compulsive disorder (OCD). Effects of DBS have been reported in ?100 cases of OCD and ?50 cases of TRD for seven (five common) anatomic targets. Although these published reports differ with respect to study design and methodology, the overall response rate appears to exceed 50% in OCD for some DBS targets. In TRD, >50% of patients responded during acute and long-term bilateral electrical stimulation in a different target. DBS was generally well tolerated in both OCD and TRD, but some unique, target- and stimulation-specific adverse effects were observed (e.g., hypomania). Further research is needed to test the efficacy and safety of DBS in psychiatric disorders, compare targets, and identify predictors of response. PMID:22034866

  16. Microcatheter Embolization of Intractable Idiopathic Epistaxis

    SciTech Connect

    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

    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.

  17. Clinical experiences with topiramate in children with intractable epilepsy.

    PubMed

    Uldall, P; Buchholt, J M

    1999-01-01

    At a tertial referral epilepsy centre 39 children were consecutively enrolled in an open add-on study with topiramate (TPM). All children had intractable epilepsy; the mean seizure frequency was 36 per month, and 31 children were treated with polypharmacy. All but five children were mentally retarded. The initial dose of TPM was 0.5-1 mg/kg daily, slowly titrated with 1-3 mg/kg daily every second week with an estimated target dose of 10 mg/kg daily. At latest follow-up 19 children continued on TPM, three (8%) were seizure-free, eight (21%) had a seizure reduction of more than 50% and eight (21%) improved their general condition. Mean follow-up was 13 months (range 9-36 months). Seizure reduction was seen in focal as well as generalized epilepsies. Adverse effects were reported in 21 cases (54%), weight loss and sedation being most frequent. The mean steady state dose in the children continuing on TPM was at latest follow-up: 14 mg/kg daily (< 5 years), 10 mg/kg daily (5-7 years), 5.8 mg/kg daily (8-17 years). The corresponding plasma level varied from 3 to 45 mumol/litre, and a significant correlation between the daily dose in mg/kg and the plasma level was found. Two patients with progressive myoclonus epilepsy are described separately; one had a dramatic general improvement. It is concluded that TPM seems to be a promising new broad-spectrum anti-epileptic drug, which is efficacious even in epilepsy syndromes, intractable to other new anti-epileptic drugs such as vigabatrin and lamotrigine. PMID:10461565

  18. Potential Use and Challenges of Functional Connectivity Mapping in Intractable Epilepsy

    PubMed Central

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

    2013-01-01

    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

  19. Cell mechanics and human disease states

    NASA Astrophysics Data System (ADS)

    Suresh, Subra

    2006-03-01

    This presentation will provide summary of our very recent studies exploring the effects of biochemical factors, influenced by foreign organisms or in vivo processes, on intracellular structural reorganization, single-cell mechanical response and motility of a population of cells in the context of two human diseases: malaria induced by Plasmodium falciparum merozoites that invade red blood cells, and gastrointestinal cancer metastasis involving epithelial cells. In both cases, particular attention will be devoted to systematic changes induced in specific molecular species in response to controlled alterations in disease state. The role of critical proteins in influencing the mechanical response of human red bloods during the intra-erythrocytic development of P. falciparum merozoites has also been assessed quantitatively using specific protein knock-out experiments by recourse to gene inactivation methods. Single-cell mechanical response characterization entails such tools as optical tweezers and mechanical plate stretchers whereas cell motility assays and cell-population biorheology characterization involves microfluidic channels. The experimental studies are accompanied by three-dimensional computational simulations at the continuum and mesoscopic scales of cell deformation. An outcome of such combined experimental and computational biophysical studies is the realization of how chemical factors influence single-cell mechanical response, cytoadherence, the biorheology of a large population of cells through microchannels representative of in vivo conditions, and the onset and progression of disease states.

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

    PubMed Central

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

    2015-01-01

    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

  1. Selective microsurgical vestibular neurectomy: an option in the treatment of intractable vertigo and related microsurgical landmarks.

    PubMed

    Bademci, G; Batay, F; Yorulmaz, I; Küçük, B; Ca?lar, S

    2004-02-01

    Selective microsurgical vestibular neurectomy (SMVN) is an accepted and effective means of treating patients with intractable vertigo, a resistant component of Meniere's syndrome. Meniere's syndrome is a condition characterized by fluctuating hearing loss, tinnitus and serious vertigo attacks. Vertigo is the most disabling symptom of the disease. There may be permanent hearing loss in untreated cases and vertigo may continue after deafness. Selective microsurgical vestibular neurectomy is an elite surgical procedure providing exact relief from vertigo while protecting the preoperative hearing level. In this report, clinical results of nine patients with intractable vertigo operated in the University of Ankara Medical Faculty, Department of Neurosurgery between 1999 and 2001 are discussed. Accordingly, we aimed to represent the landmarks often required for microsurgical exposure. From this study we conclude that SMVN is an effective neurosurgical procedure for those patients who are resistant for medical treatment and require hearing preservation. PMID:15100934

  2. Epigenome mapping in normal and disease States.

    PubMed

    Maunakea, Alika K; Chepelev, Iouri; Zhao, Keji

    2010-08-01

    Epigenomes are comprised, in part, of all genome-wide chromatin modifications, including DNA methylation and histone modifications. Unlike the genome, epigenomes are dynamic during development and differentiation to establish and maintain cell type-specific gene expression states that underlie cellular identity and function. Chromatin modifications are particularly labile, providing a mechanism for organisms to respond and adapt to environmental cues. Results from studies in animal models clearly demonstrate that epigenomic variability leads to phenotypic variability, including susceptibility to disease that is not recognized at the DNA sequence level. Thus, capturing epigenomic information is invaluable for comprehensively understanding development, differentiation, and disease. Herein, we provide a brief overview of epigenetic processes, how they are relevant to human health, and review studies using technologies that enable epigenome mapping. We conclude by describing feasible applications of epigenome mapping, focusing on epigenome-wide association studies (eGWAS), which have the potential to revolutionize current studies of human diseases and will likely promote the discovery of novel diagnostic, preventative, and treatment strategies. PMID:20689072

  3. Intractable itch relieved by 4-phenylbutyrate therapy in patients with progressive familial intrahepatic cholestasis type 1

    PubMed Central

    2014-01-01

    Background Progressive familial intrahepatic cholestasis type 1 (PFIC1), an inherited liver disease caused by mutations in ATP8B1, progresses to severe cholestasis with a sustained intractable itch. Currently, no effective therapy has been established for PFIC1. Decreased function of the bile salt export pump (BSEP) in hepatocytes is suggested to be responsible for the severe cholestasis observed in PFIC1. We found a previously unidentified pharmacological effect of 4-phenylbutyrate (4PB) that increases the expression and function of BSEP. Here, we tested 4PB therapy in three patients with PFIC1. Methods The therapeutic potency of 4PB in these patients was tested by oral administration of this drug with gradually increasing dosage (200, 350, and 500 mg/kg/day) for 6 months. Biochemical, histological, and clinical data were collected. Results 4PB therapy had no beneficial effect on the patients’ liver functions, as assessed by biochemical and histological analyses, despite an increase in hepatic BSEP expression. However, therapy with 4PB at a dosage of 350 or 500 mg/kg/day significantly relieved the intractable itch. Serum levels of potential pruritogens in cholestasis were much higher than the reference ranges during the 4PB therapy. Conclusions 4PB therapy may be a new medication for patients with intractable cholestatic pruritus and may improve quality of life for patients and their families. PMID:25022842

  4. Infectious Disease Hospitalizations Among Infants in the United States

    Microsoft Academic Search

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

    2010-01-01

    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

  5. Human Prion Diseases in the United States

    Microsoft Academic Search

    Robert C. Holman; Ermias D. Belay; Krista Y. Christensen; Ryan A. Maddox; Arialdi M. Minino; Arianne M. Folkema; Dana L. Haberling; Teresa A. Hammett; Kenneth D. Kochanek; James J. Sejvar; Lawrence B. Schonberger

    2010-01-01

    Background: Prion diseases are a family of rare, progressive, neurodegenerative disorders that affect humans and animals. The most common form of human prion disease, Creutzfeldt-Jakob disease (CJD), occurs worldwide. Variant CJD (vCJD), a recently emerged human prion disease, is a zoonotic foodborne disorder that occurs almost exclusively in countries with outbreaks of bovine spongiform encephalopathy. This study describes the occurrence

  6. West Nile Virus Neuroinvasive Disease Incidence by State - United States, 2014 (as of August 12, 2014)

    MedlinePLUS

    ... gov . West Nile Virus Share Compartir West Nile Virus Neuroinvasive Disease Incidence by State – United States, 2014 ( ... map shows the incidence of human West Nile virus neuroinvasive disease (e.g., meningitis, encephalitis, or acute ...

  7. Expression of laminin ?1 and integrin ?2 in the anterior temporal neocortex tissue of patients with intractable epilepsy.

    PubMed

    Wu, Yuan; Wang, Xue-feng; Mo, Xue-an; Li, Jing-mei; Yuan, Jie; Zheng, Jin-ou; Feng, Yun; Tang, Mei

    2011-06-01

    We investigated the expression of laminin ?1 and integrin ?2 in the anterior temporal neocortex tissue of patients with intractable epilepsy and explored the role of these molecules in the pathogenesis of this disease. Immunohistochemistry and immunofluorescence were used to test the expression of laminin ?1 and integrin ?2 in samples (from the brain bank of our department, n=32) of surgically removed anterior temporal neocortex tissues from intractable epilepsy patients, and the results were compared with those of controls (n=10). We found that laminin ?1 and integrin ?2 protein expression was significantly increased in the anterior temporal neocortex as compared with controls (immunohistochemistry optical density: laminin ?1 = 0.36 ± 0.01 vs. 0.10 ± 0.03 for control; integrin ?2=0.42 ± 0.02 vs. 0.04 ± 0.01 for control; p<.05). Immunofluorescence staining indicated that laminin ?1 and integrin ?2 accumulated in the plasma membrane and cytoplasm, with strong fluorescence intensity in the anterior temporal neocortex tissue of patients with intractable epilepsy. Thus, our work demonstrates that laminin ?1 and integrin ?2 expression is elevated in the anterior temporal neocortex tissue from patients with intractable epilepsy. PMID:21370991

  8. A Case of Intractable Psychogenic Essential Palatal Tremor

    PubMed Central

    Chung, Eun Joo; Jung, Hyun; Kim, Sang Jin

    2012-01-01

    Essential palatal tremor (EPT) is a rare disorder which shows rhythmic involuntary movement of the muscles of soft palate, especially tensor veli palatini muscle. EPT is classified by two subtypes, which is primary and secondary EPT. Secondary EPT includes psychogenic type. We describe a case of intractable psychogenic EPT. PMID:24868416

  9. Hydrophilic treatment of porous PTFE for intractable glaucoma implant devices

    NASA Astrophysics Data System (ADS)

    Murahara, Masataka M.; Sato, Yuji; Fernandez, Viviana; Fantes, Francisco; Nose, Izuru; Lee, William E.; Milne, Peter J.; Parel, Jean-Marie A.

    2001-06-01

    Intractable glaucoma results from hindrances in the eyeball aqueous humor pathways that increase the intraocular pressure above normal physiological levels (over 20 mmHg). In this study porous PTFE membranes were made hydrophilic with a photochemical method that use ethyl alcohol and water for the chemical solution.

  10. Successful monotherapy of severe and intractable atopic dermatitis by photopheresis

    Microsoft Academic Search

    Heike I. Richter; Claudia Billmann-Eberwein; Markus Grewe; Helger Stege; Mark Berneburg; Thomas Ruzicka; Jean Krutmann

    1998-01-01

    Background: Patients with chronic atopic dermatitis can become unresponsive to standard immunosuppressive therapy and thus pose a serious therapeutic problem. Objective: Our purpose was to evaluate the therapeutic effectiveness of photopheresis in the management of patients with severe and intractable atopic dermatitis. Methods: Photopheresis was used as monotherapy in patients (n = 3) who previously did not respond to treatment

  11. [Surgical therapy in Menière's disease. Historical development and today's state of the art].

    PubMed

    Baier, G; Ott, I

    2008-05-01

    After P. Menière's first description of the typical symptoms in 1861 it took more than 40 years before the first otosurgical procedures were performed to cure Menière's disease. Various surgical methods were established during the twentieth century, which still are employed in the treatment of intractable Menière's disease, especially saccotomy and vestibular neurectomy but also intoxication of the labyrinth by intratympanic application of gentamicin. Despite the good results of such therapeutic regimens the basic pathological mechanism is still not fully understood. Since the description of an endolymphatic hydrops by Hallpike und Cairns in 1938 as a typical feature, there have been some observations of a possible infectious, allergic and autoimmunological (co)pathogenesis without enough proof to explain the disease in every case. This article aims to present the current scientific data, diagnostics and therapy of Menière's disease with special emphasis on surgical treatment options. PMID:18418565

  12. The geographic distribution of Lyme disease in the United States.

    PubMed

    Ciesielski, C A; Markowitz, L E; Horsley, R; Hightower, A W; Russell, H; Broome, C V

    1988-01-01

    In 1982, national surveillance for Lyme disease was established by the Centers for Disease Control to monitor trends and determine endemic geographic areas. Initially, the endemic areas corresponded to the known distribution of Ixodes dammini, a five-state area of the northeastern seaboard (New York, New Jersey, Connecticut, Rhode Island, and Massachusetts) and Wisconsin and Minnesota. Increasing numbers of cases have been reported outside these areas, however, 86% of the provisional 5731 cases reported to CDC were acquired in these seven states. The number of reported cases increased from 491 in 1982 to approximately 1500 per year in 1984-1986, making Lyme disease the most commonly reported tick-borne illness in the United States. The apparently widening distribution of Lyme disease indicates that physicians in all regions of the country should be familiar with its signs and symptoms. Investigations of the vector in areas endemic for Lyme disease where Ixodes ticks are not found are warranted. PMID:3190099

  13. Aspects of early arthritis. Definition of disease states in early arthritis: remission versus minimal disease activity

    PubMed Central

    van der Helm-van Mil, Annette HM; Breedveld, Ferdinand C; Huizinga, Tom WJ

    2006-01-01

    With regard to rheumatoid arthritis, remission as currently used in the literature can have two meanings: either a state with persistent absence of clinical and radiological signs of disease activity without being treated for a specific time period, or it may point to a disease state with minimal disease activity during antirheumatic treatment. A risk factor for the first is absence of autoantibodies, with the anti-CCP-antibodies as best predictors, whereas risk factors for achieving a drug-induced state of minimal disease activity are not well defined. These definitions of remission refer to different disease states; therefore, we propose that the term remission is reserved for patients that are not treated with antirheumatic drugs. PMID:16879719

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

    PubMed

    Tominaga, Kazunari; Arakawa, Tetsuo

    2015-01-01

    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

  15. Treatment of intractable skin ulcers caused by vascular insufficiency with allogeneic cultured dermal substitute: a report of eight cases.

    PubMed

    Taniguchi, Tomonori; Amoh, Yasuyuki; Tanabe, Kenichi; Katsuoka, Kensei; Kuroyanagi, Yoshimitsu

    2012-03-01

    Chronic leg ulcers have various causes and can be difficult to treat, although topical treatments, including basic fibroblast growth factor and PGE1, have been used. We applied an allogeneic cultured dermal substitute (CDS) to eight patients with intractable ulcers. The patients had various underlying diseases, including diabetes mellitus, systemic lupus erythematosus, antiphospholipid syndrome, necrobiosis lipoidica, stasis dermatitis, livedo vasculopathy, and rheumatoid arthritis. The CDS was prepared by seeding cultured human fibroblasts on a spongy matrix consisting of hyaluronic acid and atelocollagen. Good clinical results were achieved, as demonstrated by reepithelization, healthy granulation tissue formation, and a subsequent decrease in wound size. Daily dressing changes became unnecessary when the allogeneic CDS was used. Based on these results, we suggest that CDS may be useful for the treatment of intractable skin ulcers. PMID:21861088

  16. 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 ...

  17. Infectious Diseases Treated in Emergency Departments: United States, 2001

    Microsoft Academic Search

    Nelson Adekoya

    2005-01-01

    Emergency departments (EDs) are an important source of medical care in the United States. Information is limited concerning epidemiologic patterns of ED visits for infectious diseases. Data for 2001 from the National Hospital Ambulatory Medical Care Survey (NHAMCS) were analyzed for infectious disease visits. The NHAMCS is a national probability sample survey of visits to hospital EDs and outpatient departments

  18. MULTI-STATE BLUETONGUE DISEASE SURVEILLANCE PROJECT: VECTOR STUDY

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The distribution of the biting midge, Culicoides sonorensis, the major vector (carrier) of bluetongue viruses, was determined across the multi-state region of Nebraska, South, and North Dakota. This study was part of a larger study of bluetongue disease in cattle. Bluetongue disease is important b...

  19. 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...

  20. Indicators for chronic disease surveillance - United States, 2013.

    PubMed

    Holt, James B; Huston, Sara L; Heidari, Khosrow; Schwartz, Randy; Gollmar, Charles W; Tran, Annie; Bryan, Leah; Liu, Yong; Croft, Janet B

    2015-01-01

    Chronic diseases are an important public health problem, which can result in morbidity, mortality, disability, and decreased quality of life. Chronic diseases represented seven of the top 10 causes of death in the United States in 2010 (Murphy SL, Xu J, Kochanek KD. Deaths: final data for 2010. Natl Vital Stat Rep 2013;6. Available at http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_04.pdf Adobe PDF file). Chronic diseases and risk factors vary by geographic area such as state and county, where essential public health interventions are implemented. The chronic disease indicators (CDIs) were established in the late 1990s through collaboration among CDC, the Council of State and Territorial Epidemiologists, and the Association of State and Territorial Chronic Disease Program Directors (now the National Association of Chronic Disease Directors) to enable public health professionals and policymakers to retrieve data for chronic diseases and risk factors that have a substantial impact on public health. This report describes the latest revisions to the CDIs, which were developed on the basis of a comprehensive review during 2011-2013. The number of indicators is increasing from 97 to 124, with major additions in systems and environmental indicators and additional emphasis on high-impact diseases and conditions as well as emerging topics. PMID:25578080

  1. Neuraxial (epidural and intrathecal) opioids for intractable pain

    Microsoft Academic Search

    Paul Farquhar-Smith; Suzanne Chapman

    2012-01-01

    1. Neuraxial opioids are considered for use in patients who have resistant intractable pain that fails to respond to other treatment options or pain that responds to analgesia but for which the doses required result in unacceptable side-effects.2. Neuraxial opiods can be considered for both chronic non-malignant pain and chronic cancer-related pain.3. Effectiveness in chronic non-malignant pain and cancer pain

  2. Neglected parasitic infections in the United States: Chagas disease.

    PubMed

    Montgomery, Susan P; Starr, Michelle C; Cantey, Paul T; Edwards, Morven S; Meymandi, Sheba K

    2014-05-01

    Chagas disease, which is caused by the protozoan parasite Trypanosoma cruzi, can lead to severe cardiac and gastrointestinal disease. Most persons acquire this infection through contact with vector bugs carrying T. cruzi in endemic areas of Latin America. Infection can also be acquired by congenital, transfusion, transplantation, and foodborne transmission. Although an estimated 300,000 persons with Chagas disease live in the United States, little is known about the burden of chagasic heart disease. It is not known how often congenital or vector-borne transmission of T. cruzi occurs in the United States, although it is known that infected mothers and infected vector bugs are found in this country. Better diagnostic tests and treatment drugs are needed to improve patient care, and research is needed to define transmission risks and develop strategies to prevent new infections and reduce the burden of disease. PMID:24808250

  3. Trypanosoma cruzi and Chagas' Disease in the United States

    PubMed Central

    Bern, Caryn; Kjos, Sonia; Yabsley, Michael J.; Montgomery, Susan P.

    2011-01-01

    Summary: Chagas' disease is caused by the protozoan parasite Trypanosoma cruzi and causes potentially life-threatening disease of the heart and gastrointestinal tract. The southern half of the United States contains enzootic cycles of T. cruzi, involving 11 recognized triatomine vector species. The greatest vector diversity and density occur in the western United States, where woodrats are the most common reservoir; other rodents, raccoons, skunks, and coyotes are also infected with T. cruzi. In the eastern United States, the prevalence of T. cruzi is highest in raccoons, opossums, armadillos, and skunks. A total of 7 autochthonous vector-borne human infections have been reported in Texas, California, Tennessee, and Louisiana; many others are thought to go unrecognized. Nevertheless, most T. cruzi-infected individuals in the United States are immigrants from areas of endemicity in Latin America. Seven transfusion-associated and 6 organ donor-derived T. cruzi infections have been documented in the United States and Canada. As improved control of vector- and blood-borne T. cruzi transmission decreases the burden in countries where the disease is historically endemic and imported Chagas' disease is increasingly recognized outside Latin America, the United States can play an important role in addressing the altered epidemiology of Chagas' disease in the 21st century. PMID:21976603

  4. The Epidemiology of Meningococcal Disease in the United States

    PubMed Central

    Harrison, Lee H.

    2009-01-01

    Neisseria meningitidis is a leading cause of bacterial meningitis and other serious infections worldwide. The epidemiology of N. meningitidis is highly changeable, with major changes in disease incidence and serogroup distribution. Six serogroups are responsible for most meningococcal disease worldwide, namely serogroups, A, B, C, W-135, X, and Y; the epidemiology of disease caused by each serogroup is unique. No vaccine is available for endemic disease caused by serogroup B strains. Two tetravalent (A/C/Y/W-135) meningococcal vaccines are licensed in the United States, a purified polysaccharide product and a polysaccharide–protein conjugate vaccine. The conjugate vaccine is recommended for all adolescents, although vaccine coverage remains low, and other high risk groups. A comprehensive program to prevent invasive meningococcal disease in the US will require immunization of infants; several conjugate vaccines for infants may become available in the near future. Broadly protective vaccines for endemic serogroup B disease are also needed. PMID:20144015

  5. Nuclear magnetic resonance of iron and copper disease states

    SciTech Connect

    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

    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.

  6. Intractable pneumothorax managed by talc pleurodesis and bronchial occlusion with spigots

    PubMed Central

    Ishida, Atsuko; Kida, Hirotaka; Muraoka, Hiromi; Nishine, Hiroki; Mineshita, Masamichi; Miyazawa, Teruomi

    2015-01-01

    Three cases of inoperable secondary spontaneous pneumothorax were diagnosed in patients with chronic obstructive pulmonary disease. Two cases initially underwent bronchial occlusion with endobronchial Watanabe spigot (EWS), while one underwent talc poudrage with pleuroscopy. As air leaks were not stopped completely in all cases with the initial procedures, we performed additional interventional treatments: pleuroscopic talc poudrage in cases when bronchial occlusion was performed first; and bronchial occlusion with EWS for a case that initially underwent talc pleurodesis. The air leaks ceased in all cases without complication. We successfully removed chest tubes 2–10 days after secondary procedure, which was 10–23 days after the first procedure. The combination of talc pleurodesis and bronchial occlusion with EWS, when a single, initial interventional treatment fails, can be considered in cases of intractable, inoperable secondary pneumothorax. PMID:25802742

  7. A rare case intractable diarrhea secondary to Clostridium difficile and cytomegalovirus coinfection

    PubMed Central

    John, Santhosh Gheevarghese; Dominguez, Cristian; Chandiramani, Vijay; Vemulappalli, Tejo

    2013-01-01

    Patient: Male, 63 Final Diagnosis: Cytomegalo virus (CMV) infection Symptoms: Diarrhea Medication:— Clinical Procedure:— Specialty: Infectious Diseases Objective: Unusual clinical course Background: Coinfection with cytomegalovirus in a patient with Clostridium difficile persistent diarrhea and colitis can lead to a delay in diagnosis and treatment. Case Report: A 63-year-old man with squamous cell carcinoma of the lower lip, status post surgical resection and currently on chemoradiation presented with intractable diarrhea and abdominal pain. Initial workup showed Clostridium difficile diarrhea with pancolitis. Diarrhea persisted despite being on antibiotics and bacteriological cure for C. difficile. Further noninvasive work up revealed associated cytomegalovirus infection, and patient had a dramatic response to ganciclovir without any relapse. Conclusions: Physicians should be cognizant about other causes of diarrhea and colitis in immunocompromised patient when treatment for primary diagnosis fails to resolve their symptoms. PMID:24298304

  8. Roux-en-Y gastric bypass for intractable biliary reflux in an individual with incomplete tetraplegia.

    PubMed

    Caruso, Deborah; Tower, Donald; Goetz, Lance

    2014-09-22

    Context Gastroesophageal reflux disease (GERD) is a common complication in the spinal cord injury (SCI) population. Surgical treatment of GERD has a unique risk/benefit profile in this population. Findings This 68-year-old male with chronic incomplete tetraplegia, dyslipidemia, and well-controlled diabetes mellitus underwent Roux-en-Y gastric bypass surgery (RYGBP) for intractable biliary reflux. Postoperatively, the patient had resolution of his symptoms but he also presented with significant weight loss and dumping syndrome. While he did have improvement in his dyslipidemia there was no change in his functional status. Conclusions RYGBP is an option for refractory GERD treatment in the SCI population but preoperative risk assessment and close monitoring postoperatively is essential. PMID:25243335

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

    PubMed

    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

    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

  10. Intractable pain due to rectus abdominis intramuscular haemangioma.

    PubMed

    Scozzari, G; Reddavid, R; Conti, L; Trombetta, F; Toppino, M; Sandrucci, S

    2014-08-01

    Haemangiomas are tumours of vascular origin accounting for approximately 7 % of all benign tumours. Three types of haemangioma have been described according to the vessel type involved: capillary, cavernous and mixed. Intramuscular haemangiomas (IMHs) are infrequent, accounting for less than 1 % of all haemangiomas and are mostly located in the extremities and the trunk. Intramuscular haemangiomas of the rectus abdominis muscle are extremely rare, with only one previous case reported in the literature to the best of our knowledge. In this report, we present the case of a patient with intractable pain related to IMHs of the rectus abdominis and we analyse diagnostic assessment and surgical management of the condition. PMID:23263560

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

    PubMed

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

    2014-10-31

    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

  12. [Chronic intrathecal drug administration for the control of intractable pain].

    PubMed

    Taira, Takaomi

    2008-05-01

    Intrathecal drug administration for the control of intractable pain has been practiced over many years in various countries; however, because of government regulation, no drugs except baclofen are approved for chronic intrathecal use in Japan. In this review, I have summarized the current international situation regarding the chronic intrathecal administration of various types of drugs for the control of intractable cancer and non-cancer pain. Morphine is the gold standard for this purpose, but its combination with local anesthetics or clonidine may be essential. Although this combination has presented strong evidence of cancer pain control, it shows weak evidence of non-malignant chronic pain control, probably because of the complex pathophysiology of the latter condition. A few new drugs such as ziconotide and gabapentin have been investigated, but the effective control of neuropathic pain, including complex regional pain syndrome, still appears difficult. Contrary to the general belief, intrathecal drug administration via an implantable pump is cost-effective, and I believe that this intrathecal drug delivery system should be used more extensively used for pain management in Japan. PMID:18516973

  13. Motive attribution asymmetry for love vs. hate drives intractable conflict.

    PubMed

    Waytz, Adam; Young, Liane L; Ginges, Jeremy

    2014-11-01

    Five studies across cultures involving 661 American Democrats and Republicans, 995 Israelis, and 1,266 Palestinians provide previously unidentified evidence of a fundamental bias, what we term the "motive attribution asymmetry," driving seemingly intractable human conflict. These studies show that in political and ethnoreligious intergroup conflict, adversaries tend to attribute their own group's aggression to ingroup love more than outgroup hate and to attribute their outgroup's aggression to outgroup hate more than ingroup love. Study 1 demonstrates that American Democrats and Republicans attribute their own party's involvement in conflict to ingroup love more than outgroup hate but attribute the opposing party's involvement to outgroup hate more than ingroup love. Studies 2 and 3 demonstrate this biased attributional pattern for Israelis and Palestinians evaluating their own group and the opposing group's involvement in the current regional conflict. Study 4 demonstrates in an Israeli population that this bias increases beliefs and intentions associated with conflict intractability toward Palestinians. Finally, study 5 demonstrates, in the context of American political conflict, that offering Democrats and Republicans financial incentives for accuracy in evaluating the opposing party can mitigate this bias and its consequences. Although people find it difficult to explain their adversaries' actions in terms of love and affiliation, we suggest that recognizing this attributional bias and how to reduce it can contribute to reducing human conflict on a global scale. PMID:25331879

  14. End State Renal Disease among Native Americans, 1983-86.

    ERIC Educational Resources Information Center

    Newman, Jeffrey M.; And Others

    1990-01-01

    Determines the incidence of end-stage renal disease (ESRD) among Native Americans and Whites in the United States from 1983-86. Findings indicate 1,075 Native American cases represented an annual incidence 2.8 times the rate for Whites. Fifty-six percent of Native American cases and 27 percent of White cases were attributed to diabetes. (JS)

  15. Resting state brain networks and their implications in neurodegenerative disease

    NASA Astrophysics Data System (ADS)

    Sohn, William S.; Yoo, Kwangsun; Kim, Jinho; Jeong, Yong

    2012-10-01

    Neurons are the basic units of the brain, and form network by connecting via synapses. So far, there have been limited ways to measure the brain networks. Recently, various imaging modalities are widely used for this purpose. In this paper, brain network mapping using resting state fMRI will be introduced with several applications including neurodegenerative disease such as Alzheimer's disease, frontotemporal lobar degeneration and Parkinson's disease. The resting functional connectivity using intrinsic functional connectivity in mouse is useful since we can take advantage of perturbation or stimulation of certain nodes of the network. The study of brain connectivity will open a new era in understanding of brain and diseases thus will be an essential foundation for future research.

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

    PubMed

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

    2014-05-01

    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

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

    PubMed Central

    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

    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

  18. Surveillance of Lyme disease in the United States, 1982.

    PubMed

    Schmid, G P; Horsley, R; Steere, A C; Hanrahan, J P; Davis, J P; Bowen, G S; Osterholm, M T; Weisfeld, J S; Hightower, A W; Broome, C V

    1985-06-01

    Lyme disease is a tick-borne illness that has been reported from three regions in the United States--the Northeast, Midwest, and West--which correspond to the distribution of the recognized vectors of the disease, Ixodes dammini and Ixodes pacificus. In 1982, a surveillance system designed to define the morbidity and geographic distribution for Lyme disease by using a clinical case definition received information on 491 definite cases and 38 probable cases. Of the definite cases, 489 were acquired in endemic areas of the Northeast or Midwest; one case was acquired in Utah and one in western Pennsylvania, two areas where the illness had not been previously reported. Three states that previously had not reported cases of Lyme disease (Kentucky, Indiana, Montana) reported probable cases. In 37% of the definite cases, the patients had neurological symptoms (most commonly reported was headache with stiff neck, suggestive of meningitis), 10% cardiac symptoms (most commonly reported was palpitations), and 54% arthritic symptoms (most commonly reported in large joints). The occurrence of Lyme disease in areas outside the currently recognized endemic regions, as well as the recent description of Amblyomma americanum as a probable vector, suggest that additional vectors may be described in the future. PMID:3998509

  19. [Diagnostic and therapeutic devices for patients with chronic intractable pain: preface and comments].

    PubMed

    Hanaoka, Kazuo

    2014-07-01

    New diagnostic and therapeutic devices for patients with chronic intractable pain are used in Japan. The following articles describe topics of new diagnostic and therapeutic devices for patients with chronic intractable pain including thermography, functional MRI, device for the quantitative analysis of perception and pain sensation, epiduroscopy, device for phototherapy, Racz catheter and device for spinal cord stimulation (SCS). PMID:25098129

  20. Various indications for a modified Atkins diet in intractable childhood epilepsy

    Microsoft Academic Search

    Yoon Mi Kim; Varsha Viranchi Vaidya; Timur Khusainov; Heung Dong Kim; Shin-Hye Kim; Eun Joo Lee; Young Mock Lee; Joon Soo Lee; Hoon-Chul Kang

    Purpose: We reviewed retrospectively our experiences with children with intractable epilepsy who were indicated for a modified Atkins diet (MAD). Methods: Twenty children (8 female, 12 male) who were aged 2–17years with intractable epilepsy and tried the MAD between September 2008 and December 2010 were enrolled. Outcome measures included seizure frequency, adverse reactions and tolerability of the diet. Results: Finally

  1. Management in intractable obstetric haemorrhage: an audit study on 61 cases

    Microsoft Academic Search

    Nathalie Lédée; Yves Ville; Dominique Musset; Frédéric Mercier; René Frydman; Hervé Fernandez

    2001-01-01

    Objective: To refine the indications of bilateral hypogastric artery ligation (BHAL) and angiographic selective embolisation (ASE) in intractable obstetric haemorrhage. Design: an audit study. Setting: Tertiary care university hospital. Population and methods: Retrospective analysis of 61 cases of obstetric intractable post partum haemorrhage (PPH) initially managed either by hysterectomy or a conservative approach in a tertiary referral centre between 1983

  2. Neural Synchrony-Monitoring Wireless Brain Implant for Intractable Epilepsy Neuromodulation

    E-print Network

    Genov, Roman

    Neural Synchrony-Monitoring Wireless Brain Implant for Intractable Epilepsy Neuromodulation Karim Abstract-- A validation of a closed-loop system-on-chip (SoC) for epilepsy treatment is presented. A 12mm2 in vivo experiment validates the SoC in early seizure detection and as a closed-loop intractable epilepsy

  3. Patient satisfaction with spinal cord stimulation for predominant complaints of chronic, intractable low back pain

    Microsoft Academic Search

    Donna D Ohnmeiss; Ralph F Rashbaum

    2001-01-01

    Background context: Results of subsequent surgical intervention in patients with intractable pain after lumbar spine surgery are typically worse than for initial surgery, particularly in those with predominant complaints of back pain rather than lower extremity pain. Spinal cord stimulation (SCS) has been found to yield good results in patients with primary complaints of intractable lower extremity pain. Technological advances

  4. Pars plana vitrectomy with pars plana tube implantation in eyes with intractable glaucoma

    Microsoft Academic Search

    Suleyman Kaynak; Nalan Fatma Tekin; Ismet Durak; Ayse Tulin Berk; Ali Osman Saatci; Meltem Fatma Soylev

    1998-01-01

    AIMSIntractable glaucoma is glaucoma resistant to medical therapy and conventional surgical procedures. In this study, a planned surgical technique is discussed for controlling the increased intraocular pressure in selected cases with intractable glaucoma.METHODSTotal pars plana vitrectomy with pars plana tube implantation was performed in 17 eyes of 17 cases with intractable glaucoma. Patients with neovascular glaucoma were not included in

  5. Bayesian experimental design for models with intractable likelihoods.

    PubMed

    Drovandi, Christopher C; Pettitt, Anthony N

    2013-12-01

    In this paper we present a methodology for designing experiments for efficiently estimating the parameters of models with computationally intractable likelihoods. The approach combines a commonly used methodology for robust experimental design, based on Markov chain Monte Carlo sampling, with approximate Bayesian computation (ABC) to ensure that no likelihood evaluations are required. The utility function considered for precise parameter estimation is based upon the precision of the ABC posterior distribution, which we form efficiently via the ABC rejection algorithm based on pre-computed model simulations. Our focus is on stochastic models and, in particular, we investigate the methodology for Markov process models of epidemics and macroparasite population evolution. The macroparasite example involves a multivariate process and we assess the loss of information from not observing all variables. PMID:24131221

  6. A Case of Intractable Suspected Perilymph Fistula with Severe Depression

    PubMed Central

    Oishi, Naoki; Tsutsumi, Tomoko; Ogawa, Kaoru

    2014-01-01

    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

  7. Successful hemostasis of intractable rectal variceal bleeding using variceal embolization.

    PubMed

    Ahn, Sung Soo; Kim, Eun Hye; Kim, Man Deuk; Lee, Won Jae; Kim, Seung Up

    2015-02-28

    Portal hypertension causes portosystemic shunting along the gastrointestinal tract, resulting in gastrointestinal varices. Rectal varices and their bleeding is a rare complication, but it can be fatal without appropriate treatment. However, because of its rarity, no established treatment strategy is yet available. In the setting of intractable rectal variceal bleeding, a transjugular intravenous portosystemic shunt can be a treatment of choice to enable portal decompression and thus achieve hemostasis. However, in the case of recurrent rectal variceal bleeding despite successful transjugular intravenous portosystemic shunt, alternative measures to control bleeding are required. Here, we report on a patient with liver cirrhosis who experienced recurrent rectal variceal bleeding even after successful transjugular intravenous portosystemic shunt and was successfully treated with variceal embolization. PMID:25741168

  8. Successful hemostasis of intractable rectal variceal bleeding using variceal embolization

    PubMed Central

    Ahn, Sung Soo; Kim, Eun Hye; Kim, Man Deuk; Lee, Won Jae; Kim, Seung Up

    2015-01-01

    Portal hypertension causes portosystemic shunting along the gastrointestinal tract, resulting in gastrointestinal varices. Rectal varices and their bleeding is a rare complication, but it can be fatal without appropriate treatment. However, because of its rarity, no established treatment strategy is yet available. In the setting of intractable rectal variceal bleeding, a transjugular intravenous portosystemic shunt can be a treatment of choice to enable portal decompression and thus achieve hemostasis. However, in the case of recurrent rectal variceal bleeding despite successful transjugular intravenous portosystemic shunt, alternative measures to control bleeding are required. Here, we report on a patient with liver cirrhosis who experienced recurrent rectal variceal bleeding even after successful transjugular intravenous portosystemic shunt and was successfully treated with variceal embolization. PMID:25741168

  9. A case of intractable suspected perilymph fistula with severe depression.

    PubMed

    Goto, Fumiyuki; Oishi, Naoki; Tsutsumi, Tomoko; Ogawa, Kaoru

    2014-10-01

    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

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

    NSDL National Science Digital Library

    2007-12-12

    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.

  11. 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.

  12. The intrinsic resting state voice network in Parkinson's disease.

    PubMed

    New, Anneliese B; Robin, Donald A; Parkinson, Amy L; Eickhoff, Claudia R; Reetz, Kathrin; Hoffstaedter, Felix; Mathys, Christian; Sudmeyer, Martin; Grefkes, Christian; Larson, Charles R; Ramig, Loraine O; Fox, Peter T; Eickhoff, Simon B

    2015-05-01

    Over 90 percent of patients with Parkinson's disease experience speech-motor impairment, namely, hypokinetic dysarthria characterized by reduced pitch and loudness. Resting-state functional connectivity analysis of blood oxygen level-dependent functional magnetic resonance imaging is a useful measure of intrinsic neural functioning. We utilized resting-state functional connectivity modeling to analyze the intrinsic connectivity in patients with Parkinson's disease within a vocalization network defined by a previous meta-analysis of speech (Brown et al., 2009). Functional connectivity of this network was assessed in 56 patients with Parkinson's disease and 56 gender-, age-, and movement-matched healthy controls. We also had item 5 and 18 of the UPDRS, and the PDQ-39 Communication subscale available for correlation with the voice network connectivity strength in patients. The within-group analyses of connectivity patterns demonstrated a lack of subcortical-cortical connectivity in patients with Parkinson's disease. At the cortical level, we found robust (homotopic) interhemispheric connectivity but only inconsistent evidence for many intrahemispheric connections. When directly contrasted to the control group, we found a significant reduction of connections between the left thalamus and putamen, and cortical motor areas, as well as reduced right superior temporal gyrus connectivity. Furthermore, most symptom measures correlated with right putamen, left cerebellum, left superior temporal gyrus, right premotor, and left Rolandic operculum connectivity in the voice network. The results reflect the importance of (right) subcortical nodes and the superior temporal gyrus in Parkinson's disease, enhancing our understanding of the neurobiological underpinnings of vocalization impairment in Parkinson's disease. Hum Brain Mapp 36:1951-1962, 2015. © 2015 Wiley Periodicals, Inc. PMID:25627959

  13. Quality of life and emotional state in chronic skin disease.

    PubMed

    Pärna, Ene; Aluoja, Anu; Kingo, Külli

    2015-03-01

    The aim of this study was to evaluate the associations between chronic inflammatory skin conditions and patients' emotional state and quality of life. The following self-rated questionnaires were used: Emotional State Questionnaire, a self-report scale assessing depression and anxiety symptoms; Dermatology Life Quality Index (DLQI); and RAND-36, a measure of health-related quality of life. The study group comprised 40 patients with psoriasis, 40 with eczema, 40 with acne, 15 with seborrhoeic dermatitis and 40 healthy controls. Patients with chronic skin diseases had lower DLQI and lower RAND-36 physical functioning scores, more perceived physical limitations and pain, and lower emotional well-being and general health ratings compared with the control group. In conclusion, chronic skin diseases are associated with symptoms of emotional distress, in particular insomnia and general anxiety. PMID:24978135

  14. The effect of leucotomy in intractable adolescent weight phobia (primary anorexia nervosa)

    PubMed Central

    Crisp, A. H.; Kalucy, R. S.

    1973-01-01

    Anorexia nervosa is best construed as a phobic avoidance response to the psychosocial maturational implications of adolescent weight. Within this state, surrender to the impulse to eat and consequent weight gain is associated with panic, depression and sometimes specific intense fear of loss of control. So long as the avoidance posture can be maintained the experience of such turmoil is largely avoided. Complicated ritualistic behaviour may arise to promote and secure the posture. However, its unrewarding and lonely nature still increasingly leaves the individual liable to the experience of depression. Established treatment procedures often assist recovery from the illness but intractable cases arise and it is amongst these that the majority of deaths occur either from inanition or suicide. The basis for the changes characteristically induced by leucotomy is complex. The procedure often leads to reduced tension and release of appetitive behaviour. This is taken to be due to some direct effect of the cerebral lesion and possibly the intervention may also be construed by some patients as a licence to behave differently. In patients with anorexia nervosa such appetitive release can be expected to promote considerable weight gain. However, the adverse psychological implications of such weight gain for the patient do not appear always to be so immediately or easily relieved. They may still experience panic, shame or depression and new patterns of social avoidance, or vomiting behaviour may develop. Intensive help of a psychotherapeutic and rehabilitative kind is then still required if the patient is to have the best chance of adjusting healthily to her newly found potential for a more normal nutritional status. Four patients who have undergone such treatment are described in this paper. It is concluded that leucotomy has a small but definite place in the treatment of patients with intractable anorexia nervosa. ImagesFig. 2 PMID:4806268

  15. Emergence of hantaviral disease in the southwestern United States.

    PubMed Central

    Hjelle, B; Jenison, S; Mertz, G; Koster, F; Foucar, K

    1994-01-01

    Hantaviruses are parasites of small mammals, predominantly peridomestic and commensal rodents. They have a worldwide distribution. Hantavirus-related illness occurs in rural areas where humans come into contact with rodents. In most cases human infection is manifested by one of a variety of acute illnesses involving hemorrhagic fever and renal disease. In May 1993, a cluster of patients with an acute pulmonary disease with high mortality was noted in the Four Corners region of the southwestern United States. Serologic and genetic studies indicated that the etiologic agent was a novel hantavirus. The uncertainty engendered by the emergence of a new disease with high mortality forced a rapid response by state and federal agencies and by the University of New Mexico Medical Center, Albuquerque, where most patients from this region were referred. Considerable progress has been made in identifying infected cases on clinical and laboratory grounds and in ensuring that appropriate supportive care is made available to patients as soon as they are suspected of having hantaviral infection. Cases of hantavirus pulmonary syndrome--both new and retrospectively diagnosed--are still being recognized throughout the western United States. Many important questions remain unanswered. Images PMID:7810123

  16. EDICALLY intractable epilepsy develops in approx-imately 15,000 to 30,000 people each year in the

    E-print Network

    Hampton, Robert

    EDICALLY intractable epilepsy develops in approx- imately 15,000 to 30,000 people each year in the US. Epilepsy is considered intractable when it significantly reduces the quality of a person's life.34 In most cases of surgically remediable medically intractable epilepsy, the pathological disorder

  17. Atypical language laterality is associated with large-scale disruption of network integration in children with intractable focal epilepsy.

    PubMed

    Ibrahim, George M; Morgan, Benjamin R; Doesburg, Sam M; Taylor, Margot J; Pang, Elizabeth W; Donner, Elizabeth; Go, Cristina Y; Rutka, James T; Snead, O Carter

    2015-04-01

    Epilepsy is associated with disruption of integration in distributed networks, together with altered localization for functions such as expressive language. The relation between atypical network connectivity and altered localization is unknown. In the current study we tested whether atypical expressive language laterality was associated with the alteration of large-scale network integration in children with medically-intractable localization-related epilepsy (LRE). Twenty-three right-handed children (age range 8-17) with medically-intractable LRE performed a verb generation task in fMRI. Language network activation was identified and the Laterality index (LI) was calculated within the pars triangularis and pars opercularis. Resting-state data from the same cohort were subjected to independent component analysis. Dual regression was used to identify associations between resting-state integration and LI values. Higher positive values of the LI, indicating typical language localization were associated with stronger functional integration of various networks including the default mode network (DMN). The normally symmetric resting-state networks showed a pattern of lateralized connectivity mirroring that of language function. The association between atypical language localization and network integration implies a widespread disruption of neural network development. These findings may inform the interpretation of localization studies by providing novel insights into reorganization of neural networks in epilepsy. PMID:25681650

  18. On the Computational Intractability of Exact and Approximate Dictionary Learning

    NASA Astrophysics Data System (ADS)

    Tillmann, Andreas M.

    2015-01-01

    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.

  19. Stimulation of primary motor cortex for intractable deafferentation pain.

    PubMed

    Saitoh, Y; Yoshimine, T

    2007-01-01

    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

  20. Endovascular Treatment of Traumatic Pseudoaneurysm Presenting as Intractable Epistaxis

    PubMed Central

    Zhang, Chang wei; You, Chao; Mao, Bo yong; Wang, Chao hua; He, Min; Sun, Hong

    2010-01-01

    Objective To investigate the clinical efficacy of individual endovascular management for the treatment of different traumatic pseudoaneurysms presenting as intractable epistaxis. Materials and Methods For 14 consecutive patients with traumatic pseudoaneurysm presenting as refractory epistaxes, 15 endovascular procedures were performed. Digital subtraction angiography revealed that the pseudoaneurysms originated from the internal maxillary artery in eight patients; and all were treated with occlusion of the feeding artery. In six cases, they originated from the internal carotid artery (ICA); out of which, two were managed with detachable balloons, two with covered stents, one by means of cavity embolization, and the remaining one with parent artery occlusion. All of these cases were followed up clinically from six to 18 months, with a mean follow up time of ten months; moreover, three cases were also followed with angiography. Results Complete cessation of bleeding was achieved in all the 15 instances (100%) immediately after the endovascular therapies. Of the six patients who suffered from ICA pseudoaneurysms, one presented with a permanent stroke and one had an episode of rebleeding requiring intervention. Conclusion In patients presenting with a history of craniocerebral trauma, traumatic pseudoaneurysm must be considered as a differential diagnosis. Individual endovascular treatment is a relatively safe, plausible, and reliable means of managing traumatic pseudoaneurysms. PMID:21076585

  1. Novel interventional treatment technique for intractable pancreatic fistula due to dehiscence of pancreatico-jejunal anastomosis following pancreaticoduodenectomy.

    PubMed

    Komatsu, Shuhei; Sonoyama, Teruhisa; Ochiai, Toshiya; Ichikawa, Daisuke; Ikoma, Hisashi; Okamura, Hiroko; Yamagishi, Hisakazu; Otsuji, Eigo

    2008-01-01

    Despite recent technological advances in the treatment of hepatobiliary pancreatic disease, intractable external pancreatic fistula is still a major critical complication after pancreaticoduodenectomy, and the treatment strategy is not well defined. We report here a case that was successfully treated by our novel interventional internal drainage technique. A 62-year-old woman underwent pylorus-preserving pancreaticoduodenectomy for carcinoma of the papilla of Vater, with reconstruction by a modified Child's procedure. One year later, she was readmitted to our hospital because of external pancreatic fistula. Both computed tomography and fistulography demonstrated a pancreatic fistula derived from dehiscence of the pancreatico-jejunal anastomosis. The pancreatic fistula persisted for 1 week with conservative management. Therefore, we performed repeated fistulography and cannulation, using two comparatively stiff guidewires introduced into the main pancreatic duct and stenotic anastomosed jejunal lumen, respectively, and we placed an endoprosthesis, using bilateral guidewires to connect the two lumens. Consequently, the pancreatic fistula was successfully closed within a few days. Our novel technique is simple, rapid, and not costly. Therefore, it should be considered an effective treatment strategy for persistent pancreatic fistula following pancreaticoduodenectomy that fails to respond to initial conservative management and an endoscopic approach. Also, this technique is applicable to other intractable fistulous situations. PMID:18670851

  2. [Treatment of intractable tuberculous meningitis using intrathecal isoniazid administration and steroid pulse therapy; a report of two cases].

    PubMed

    Takahashi, Ikuko; Yamada, Moemi; Matsushima, Masaaki; Sato, Kazunori; Kano, Takahiro; Yabe, Ichiro; Sasaki, Hidenao

    2012-01-01

    Tuberculous meningitis (TbM) is a neurological emergency condition that requires prompt initiation of treatment. The standard initial treatment for TbM is often insufficient for producing remission because the anti-tuberculosis agent may cause severe side effects, or vasculitis and hydrocephalus may induce an intractable state. Moreover, it is difficult to distinguish paradoxical expansion from its own deterioration. We treated 2 cases of adult TbM by using multidisciplinary therapy, including methyl prednisolone pulse and intrathecal isoniazid administration. Both cases had not been diagnosed as pulmonary or other tuberculosis, and cerebrospinal fluid (CSF) culture and polymerase chain reaction at approximately 1 week after hospitalization identified the cases as TbM. We administered the standard initial treatment recommended by the British Infection Society guidelines for adults, but both cases deteriorated and showed elevation of intracranial pressure. We indwelled a lumbar drainage for Case 1 and an Ommaya reservoir for Case 2. We removed CSF and administrated isoniazid regularly using each of the drainage devices, added streptomycin, and increased the steroid dose including addition of steroid pulse therapy. Both cases improved, and their neurological dysfunction did not persist. After the induction of an intractable state occurs due to TbM, we are likely to assume poor prognosis and neurological sequelae. However, our experience in these cases showed amelioration of the symptoms leading to the rehabilitation of these patients in society. PMID:22975852

  3. Use of an Oral Elemental Diet in Infants with Severe Intractable Diarrhea

    ERIC Educational Resources Information Center

    Sherman, Joseph O.; And Others

    1975-01-01

    Evaluated was the use of an oral elemental diet consisting of crystalline amino acids, glucose, electrolytes, and vitamins to control severe intractable diarrhea in 27 infants (1-day to 9-months of age). (DB)

  4. Intractable Headache - The Pain in Your Head that Just Won't Quit

    MedlinePLUS

    ... Print Email Intractable Headache – The pain in Your Head that Just Won’t Quit ACHE Newsletter Sign ... untreatable headache. What is going on in your head when the pain is so resistant to treatment? ...

  5. Efficacy of total lymphoid irradiation in intractable rheumatoid arthritis. A double-blind, randomized trial

    SciTech Connect

    Strober, S.; Tanay, A.; Field, E.; Hoppe, R.T.; Calin, A.; Engleman, E.G.; Kotzin, B.; Brown, B.W.; Kaplan, H.S.

    1985-04-01

    Twenty-six patients participated in a randomized, double-blind study of the efficacy of total lymphoid irradiation in the treatment of intractable rheumatoid arthritis. All 26 patients, for whom therapy with gold compounds and penicillamine had failed, would ordinarily have been considered candidates for cytotoxic or antimetabolite drug therapy. Thirteen patients randomly assigned to receive full-dose total lymphoid irradiation (2000 rad) and 11 patients assigned to receive control low-dose total lymphoid irradiation (200 rad) completed radiotherapy. Alleviation of joint disease activity was significantly greater in the high-dose group as judged by morning stiffness, joint tenderness, and functional assessment (global composite score) at 3 and 6 months after radiotherapy. The high-dose group had a marked reduction in both T-lymphocyte function and numbers, but this finding was not observed in the low-dose group. Complications seen in the high-dose but not low-dose group included transient neutropenia, thrombocytopenia, pericarditis, and pleurisy.

  6. Melatonin and sleep-related problems in children with intractable epilepsy.

    PubMed

    Elkhayat, Hamed A; Hassanein, Sahar M; Tomoum, Hoda Y; Abd-Elhamid, Iman A; Asaad, Tarek; Elwakkad, Amany S

    2010-04-01

    Children with epilepsy have high rates of sleep problems. Melatonin has been advocated in treatment of sleep disorders, and its beneficial effect has been confirmed in insomnia. The aim of this study was to assess melatonin levels in children with intractable epilepsy and its relation to pattern of sleep and characteristics of seizure disorder, as well as the effect of melatonin therapy on those parameters. The study was conducted on 23 children with intractable epilepsy and 14 children with controlled seizures. Patients were evaluated by psychometric sleep assessment and assay of diurnal and nocturnal melatonin levels. Children with intractable epilepsy received oral melatonin before bedtime. They were reassessed after 3 months. Children with intractable epilepsy had higher scores for each category of sleep walking, forcible teeth grinding, and sleep apnea. At the end of therapeutic trial, patients with intractable epilepsy exhibited significant improvement in bedtime resistance, sleep duration, sleep latency, frequent nocturnal arousals, sleep walking, excessive daytime sleepiness, nocturnal enuresis, forcible teeth grinding, sleep apnea, and Epworth sleepiness scores. There was also significant reduction in seizure severity. Thus, use of melatonin in patients with intractable seizures was associated with improvement of both many sleep-related phenomena and the severity of seizures. PMID:20304327

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

    PubMed

    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

    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

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

    Microsoft Academic Search

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

    1997-01-01

    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

  9. Predicting progression from cognitive impairment to Alzheimer's disease with the Disease State Index.

    PubMed

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

    2015-01-01

    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

  10. New York State Department of Health Meningococcal Disease

    E-print Network

    is meningococcal disease? Meningococcal disease is a severe bacterial infection of the bloodstream or meninges (a meningococcal disease? Anyone can get meningococcal disease, but it is more common in infants and children meningitis is prevalent. How is the meningococcus germ spread? The meningococcus germ is spread by direct

  11. 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...

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

    USGS Publications Warehouse

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

    2004-01-01

    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.

  13. The changing state of surgery for adult congenital heart disease

    Microsoft Academic Search

    J Monro

    2005-01-01

    The number of patients with adult congenital heart disease is expected to increase by 25% during this decade, so that by 2010 there will be more patients undergoing surgery for congenital heart disease over 16 years of age than under

  14. Children and End-State Renal Disease (ERSD)

    MedlinePLUS

    ... outside the U.S. I'm a caregiver Children & End-Stage Renal Disease (ESRD) How to tell if ... card Your Social Security card CMS Form 2728 ("End-Stage Renal Disease Medical Evidence Report Medicare Entitlement ...

  15. United States medical students’ knowledge of Alzheimer disease

    PubMed Central

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

    2013-01-01

    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

  16. Expression of laminin beta1 in hippocampi of patients with intractable epilepsy.

    PubMed

    Wu, Yuan; Wang, Xue-feng; Mo, Xue-an; Sun, Hong-bin; Li, Jin-mei; Zeng, Yan; Lin, Tao; Yuan, Jie; Xi, Zhi-qin; Zhu, Xi; Zheng, Jin-ou

    2008-10-10

    We investigated laminin beta1 expression in the hippocampi of patients with intractable epilepsy and explored the role of laminin beta1 in the pathogenesis of this condition. Fluorescence quantitative PCR, immunofluorescence, immunohistochemistry and Western blotting were used to measure laminin beta1 expression in surgically removed hippocampi of patients with intractable epilepsy, and the results were compared with control hippocampi. Fluorescence quantitative PCR showed increased expression of laminin beta1 mRNA in patient hippocampi compared with control tissues. Immunohistochemical staining demonstrated that laminin beta1 protein expression was significantly increased in patient hippocampi, and immunofluorescence microscopy showed accumulation of laminin beta1 in the cell membrane and cytoplasm of patient hippocampi. These findings were confirmed by Western blotting of protein preparations from patient hippocampi. Elevated expression of laminin beta1 mRNA and protein in the hippocampus suggests that laminin beta1 may play a role in the development of epileptic seizures in patients with intractable epilepsy. PMID:18691630

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

    PubMed

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

    2013-06-01

    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

  18. Intractable epilepsy due to angiocentric glioma: A case report and minireview

    PubMed Central

    CHEN, GUOQIANG; WANG, LIN; WU, JINTING; JIN, YONGJIAN; WANG, XIAOSONG; JIN, YULAN

    2014-01-01

    The aim of this case report and minireview was to investigate the diagnosis of and therapeutic approaches for angiocentric glioma (AG) and to summarize the clinical manifestations and the pathological and imaging characteristics of the disease. Intraoperative cortical electroencephalogram (ECoG) monitoring was performed to locate the epileptic foci in a child with AG who presented with intractable epilepsy, prior to the total resection of the tumor being performed under the microscope. The clinical features, imaging characteristics, intraoperative conditions, surgical methods and pathological results were analyzed and compared with the literature. The review revealed that to date, the clinical features of the 52 reported cases of AG (including this case) have been mainly characterized by epilepsy. High T2-weighted image (WI) and fluid-attenuated inversion recovery (FLAIR) signals may be detected with magnetic resonance imaging (MRI) scanning of the cranium; however, no enhancement signals are detected by enhanced scanning. The prognosis following surgical resection is favorable. The lesions in the present case demonstrated clear boundaries with a central cystic affection accompanied by an arachnoid cyst on the left temporal pole. Pathological examination revealed that the lesion was positive for glial fibrillary acidic protein (GFAP), S-100 protein, vimentin, epithelial membrane antigen (EMA), cluster of differentiation 99 (CD99) and D2-40. The Ki-67/MIBk-1 labeling index was ~1%. In conclusion, AG exhibits characteristic features in imaging; however, its diagnosis depends on histopathological examination. The prognosis of total surgical resection is good and intraoperative ECoG may be used to assist positioning. PMID:24348765

  19. State of progress in treating cystic fibrosis respiratory disease

    PubMed Central

    2012-01-01

    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

  20. A sterile-female technique proposed for control of Striga hermonthica and other intractable weeds: Advantages, shortcomings, and risk management

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Weeds have posed intractable challenges to farmers since the dawn of agriculture. This article describes in detail a proposed control strategy based on the introduction of genes conferring female-sterility into the genomes of intractable target weeds. Spread of these genes through target populations...

  1. Tolerance of benznidazole in a United States chagas disease clinic.

    PubMed

    Miller, David A; Hernandez, Salvador; Rodriguez De Armas, Lissette; Eells, Samantha J; Traina, Mahmoud M; Miller, Loren G; Meymandi, Sheba K

    2015-04-15

    The US-based Center of Excellence for Chagas Disease performed an observational study on the safety and tolerance of benznidazole 5 mg/kg/day for 60 days in 30 adults with chronic Chagas disease. The side-effect profile was suboptimal, including 5 cases of debilitating neuropathy and an unusually high angioedema rate. PMID:25601454

  2. An Analysis of Intractable Nightmares in a Two-Year Old Boy.

    ERIC Educational Resources Information Center

    Feinberg, Daniel

    This paper discusses a case study of therapeutic intervention with a 2-year-old boy. The child's major presenting symptom is intractable insomnia caused by nightmares, but his problems are linked to general patterns resulting from early paternal loss. The report analyzes the first 30 sessions of treatment. Discussion focuses on the unusual…

  3. A Hybrid Public Key Encryption in Standard Model and A New Intractibility Assumption

    E-print Network

    Bandyopadhyay, Antar

    A Hybrid Public Key Encryption in Standard Model and A New Intractibility Assumption Mahabir Prasad a hybrid public-key encryption scheme which is provably secure against adaptive cho- sen ciphertext attack-Hellman(DDH) assumption. Keywords: IND-CCA2(adaptive chosen ciphertext security), public-key encryption, DDH- As- sumption

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

    ERIC Educational Resources Information Center

    Plonski, Sharri

    2005-01-01

    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…

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

    SciTech Connect

    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

    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.

  6. Ethical issues in surgical decision making concerning children with medically intractable epilepsy

    Microsoft Academic Search

    George M. Ibrahim; Aria Fallah; O. Carter Snead; Irene Elliott; James M. Drake; Mark Bernstein; James T. Rutka

    2011-01-01

    The widespread inclusion of surgical strategies in the treatment of medically intractable epilepsy is largely justified by the medical and psychosocial burden of the illness. Performing these procedures in pediatric populations is associated with distinct challenges ranging from unique seizure etiologies to issues surrounding brain development and functional plasticity. As the trend toward more aggressive surgical intervention continues, the ethical

  7. Modified Atkins diet to children and adolescents with medical intractable epilepsy

    Microsoft Academic Search

    Susanne Weber; Christian Mølgaard; KarenTaudorf; Peter Uldall

    2009-01-01

    The aim of the present study was to evaluate the tolerability and efficacy of the modified Atkins diet given to children and adolescents with antiepileptic drug (AED) treatment resistant epilepsy.15 children with medically intractable epilepsy were enrolled in the study. Inclusion criteria were at least one seizure a week and a trial of at least two AEDs without obtaining seizure

  8. A Modified Atkins Diet Is Effective for the Treatment of Intractable Pediatric Epilepsy

    Microsoft Academic Search

    Eric H. Kossoff; Jane R. McGrogan; Renee M. Bluml; Diana J. Pillas; James E. Rubenstein; Eileen P. Vining

    2006-01-01

    Summary: Purpose: The Atkins diet may induce ketosis as does the ketogenic diet, without restrictions on calories, fluids, protein, or need for an inpatient fast and admission. Our objective was to evaluate the efficacy and tolerability of a modified Atkins diet for intractable childhood epilepsy. Methods: Twenty children were treated prospectively in a hospital-based ambulatory clinic from September 2003 to

  9. The Linked Importance Sampler Auxiliary Variable Metropolis Hastings Algorithm for Distributions with Intractable Normalising Constants

    Microsoft Academic Search

    Johan H. Koskinen

    Abstract We consider parameter inference for the class of models where the likelihood function is analytically intractable as a result of a complicated normalising con- stant. This means that an MCMC algorithm for drawing from the posterior of the parameters of the model would involve evaluating an acceptance ratio con- taining a ratio of unknown,normalising constants. We propose to improve

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

    ERIC Educational Resources Information Center

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

    2008-01-01

    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…

  11. Evaluation and treatment of chronic intractable rectal pain—A frustrating endeavor

    Microsoft Academic Search

    Gow Ching Ger; Steven D. Wexner; J. Marcio N. Jorge; Eleanor Lee; L. Amar Amaranath; Steve Heymen; Juan J. Nogueras; David G. Jagelman

    1993-01-01

    A study was undertaken to assess the evaluation and treatment of chronic intractable rectal pain. Sixty consecutive patients, 23 males and 37 females with a mean age of 69 (range, 29–87) years and a mean length of symptoms of 4.5 years, were evaluated by questionnaire, office examination, anal manometry, electromyography, cinedefecography, and pudendal nerve study. In all cases, organic abdominopelvic

  12. Mechanisms of dopamine transporter regulation in normal and disease states

    PubMed Central

    Vaughan, Roxanne A.; Foster, James D.

    2013-01-01

    The dopamine transporter (DAT) controls the spatial and temporal dynamics of dopamine (DA) neurotransmission by driving reuptake of extracellular transmitter into presynaptic neurons. Many diseases such as depression, bipolar disorder, Parkinson’s disease, and attention deficit hyperactivity disorder are associated with abnormal DA levels, implicating DAT as a factor in their etiology. Medications used to treat these disorders and many addictive drugs target DAT and enhance dopaminergic signaling by suppressing transmitter reuptake. We now understand that transport and binding properties of DAT are regulated by complex and overlapping mechanisms that provide neurons the ability to modulate DA clearance in response to physiological demands. These processes are controlled by endogenous signaling pathways and affected by exogenous transporter ligands, demonstrating their importance for normal neurotransmission, drug abuse, and disease treatments. Increasing evidence supports the disruption of these mechanisms in DA disorders, implicating dysregulation of transport in disease etiologies and suggesting these processes as potential points for therapeutic manipulation of DA availability. PMID:23968642

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

    E-print Network

    Varela, Carlos

    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

  14. Pathophysiology and evaluation of iron overload in various disease states

    Microsoft Academic Search

    John B. Porter

    Iron overload can result from increased iron absorption or from repeated blood transfusions. Primary iron overload is associated with genetic factors that boost iron absorption, such as hereditary haemochromatosis, while secondary iron overload results from chronic blood transfusions that are used to treat anaemia in conditions such as thalassaemia, sickle cell disease (SCD), and myelodysplastic syndromes (MDS). The consequences of

  15. Challenges in designing a national surveillance program for inflammatory bowel disease in the United States.

    PubMed

    Long, Millie D; Hutfless, Susan; Kappelman, Michael D; Khalili, Hamed; Kaplan, Gilaad G; Bernstein, Charles N; Colombel, Jean Frederic; Gower-Rousseau, Corinne; Herrinton, Lisa; Velayos, Fernando; Loftus, Edward V; Nguyen, Geoffrey C; Ananthakrishnan, Ashwin N; Sonnenberg, Amnon; Chan, Andrew; Sandler, Robert S; Atreja, Ashish; Shah, Samir A; Rothman, Kenneth J; Leleiko, Neal S; Bright, Renee; Boffetta, Paolo; Myers, Kelly D; Sands, Bruce E

    2014-02-01

    This review describes the history of U.S. government funding for surveillance programs in inflammatory bowel diseases (IBD), provides current estimates of the incidence and prevalence of IBD in the United States, and enumerates a number of challenges faced by current and future IBD surveillance programs. A rationale for expanding the focus of IBD surveillance beyond counts of incidence and prevalence, to provide a greater understanding of the burden of IBD, disease etiology, and pathogenesis, is provided. Lessons learned from other countries are summarized, in addition to potential resources that may be used to optimize a new form of IBD surveillance in the United States. A consensus recommendation on the goals and available resources for a new model for disease surveillance are provided. This new model should focus on "surveillance of the burden of disease," including (1) natural history of disease and (2) outcomes and complications of the disease and/or treatments. PMID:24280882

  16. A State-Wide Research Network for Alzheimer's Disease

    SciTech Connect

    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

    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.

  17. Nonalcoholic fatty liver disease and vascular disease: State-of-the-art

    PubMed Central

    Fargion, Silvia; Porzio, Marianna; Fracanzani, Anna Ludovica

    2014-01-01

    Nonalcoholic fatty liver disease (NAFLD), the most common of chronic liver disease in Western Country, is closely related to insulin resistance and oxidative stress and includes a wide spectrum of liver diseases ranging from steatosis alone, usually a benign and non-progressive condition, to nonalcoholic steatohepatitis (NASH), which may progress to liver fibrosis and cirrhosis. NAFLD is considered the hepatic manifestation of the metabolic syndrome with which shares several characteristics, however recent data suggest that NAFLD is linked to increased cardiovascular risk independently of the broad spectrum of risk factors of metabolic syndrome. Accumulating evidence suggests that the clinical burden of NAFLD is not restricted to liver-related morbidity and mortality, with the majority of deaths in NAFLD patients related to cardiovascular disease and cancer and not to the progression of liver disease. Retrospective and prospective studies provide evidence of a strong association between NAFLD and subclinical manifestation of atherosclerosis (increased intima-media thickness, endothelial dysfunction, arterial stiffness, impaired left ventricular function and coronary calcification). A general agreement emerging from these studies indicates that patients with NASH are at higher risk of cardiovascular diseases than those with simple steatosis, emphasizing the role of chronic inflammation in the pathogenesis of atherosclerosis of these patients. It is very likely that the different mechanisms involved in the pathogenesis of atherosclerosis in patients with NAFLD have a different relevance in the patients according to individual genetic background. In conclusion, in the presence of NAFLD patients should undergo a complete cardiovascular evaluation to prevent future atherosclerotic complications. Specific life-style modification and aggressive pharmaceutical modification will not only reduce the progression of liver disease, but also reduce morbidity for cardiovascular disease improving overall prognosis and survival. PMID:25309067

  18. GENOMIC AND PROTEOMIC ANALYSIS OF SURROGATE TISSUES FOR ASSESSING TOXIC EXPOSURES AND DISEASE STATES

    EPA Science Inventory

    Genomic and Proteomic Analysis of Surrogate Tissues for Assessing Toxic Exposures and Disease States David J. Dix and John C. Rockett Reproductive Toxicology Division, National Health and Environmental Effects Research Laboratory, Office of Research and Development, USEPA, ...

  19. SURVEILLANCE FOR WATERBORNE DISEASE AND OUTBREAK ASSOCIATED WITH RECREATIONAL WATER - UNITED STATES 2003-2004

    EPA Science Inventory

    Problem/Condition: Since 1971, the Centers for Disease Control and Prevention (CDC), the U.S. Environmental Protection Agency, and the Council of State and Territorial Epidemiologists have maintained a collaborative surveillance system for collecting and periodically reporting da...

  20. The potential for emergence of Chagas disease in the United States

    E-print Network

    Rebecca Click Lambert; Korine N. Kolivras; Lynn M. Resler; Carlyle C. Brewster; L. Paulson

    Abstract. To determine the risk for Chagas disease (American trypanosomiasis) in the United States, the characteristics that make the triatomine vector effective and the areas most at risk for transmission were delineated. In addition, the status of Chagas disease awareness among physicians in

  1. ASSESSMENT OF COCOA FARMERS CHEMICAL USAGE PATTERN IN PEST AND DISEASE MANAGEMENT IN ONDO STATE

    Microsoft Academic Search

    STEPHEN OLUSEUN ADEOGUN; ANTHONY EGHE AGBONGIARHUOYI

    Adeogun S. O. and Agbongiarhuoyi A. E. 2009. Assessment of Cocoa Farmers Chemical Usage Pattern in Pest and Disease Management in Ondo State. J. Innov. Dev. Strategy. 3(2):27-34 Cocoa farmers use a wide range of chemicals to limit losses from pests and diseases in cocoa production. This study was carried out between January and April 2006 in two local government

  2. Norovirus and Foodborne Disease, United States, 1991-2000

    Microsoft Academic Search

    Marc-Alain Widdowson; Alana Sulka; Sandra N. Bulens; R. Suzanne Beard; Sandra S. Chaves; Roberta Hammond; Ellen D. P. Salehi; Ellen Swanson; Jessica Totaro; Ray Woron; Paul S. Mead; Joseph S. Bresee; Stephan S. Monroe; Roger I. Glass

    2005-01-01

    Efforts to prevent foodborne illness target bacterial pathogens, yet noroviruses (NoV) are suspected to be the most common cause of gastroenteritis. New molecular assays allow for better estimation of the role of NoV in food- borne illness. We analyzed 8,271 foodborne outbreaks reported to the Centers for Disease Control and Prevention from 1991 to 2000 and additional data from 6

  3. 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 ...

  4. Botanical medicines used for kidney disease in the United States.

    PubMed

    Yarnell, Eric L

    2012-11-01

    Herbal medicines are being used with greater frequency by practitioners of natural medicine in the United States. Many categories of herbs are used, primarily angiotensin antagonists, nonspecific nephroprotective, and immunomodulating/adaptogenic herbs. The most common herbs in each category are discussed both from a historical and scientific perspective. For the first time, a case series of the use of the proposed herbal angiotensin antagonist herb indigenous to the United States, Lespedeza capitata, is reported based on the author's clinical practice. PMID:23146977

  5. Ultrasound-guided Pulsed Radiofrequency Lesioning of the Phrenic Nerve in a Patient with Intractable Hiccup

    PubMed Central

    Kang, Keum Nae; Park, In Kyung; Suh, Jeong Hun; Leem, Jeong Gill

    2010-01-01

    Persistent and intractable hiccups (with respective durations of more than 48 hours and 1 month) can result in depression, fatigue, impaired sleep, dehydration, weight loss, malnutrition, and aspiration syndromes. The conventional treatments for hiccups are either non-pharmacological, pharmacological or a nerve block treatment. Pulsed radiofrequency lesioning (PRFL) has been proposed for the modulation of the excited nervous system pathway of pain as a safe and nondestructive treatment method. As placement of the electrode in close proximity to the targeted nerve is very important for the success of PRFL, ultrasound appears to be well suited for this technique. A 74-year-old man suffering from intractable hiccups that had developed after a coronary artery bypass graft and had continued for 7 years was referred to our pain clinic. He had not been treated with conventional methods or medications. We performed PRFL of the phrenic nerve guided by ultrasound and the hiccups disappeared. PMID:20830266

  6. Intravenous lidocaine and magnesium for management of intractable trigeminal neuralgia: a case series of nine patients.

    PubMed

    Arai, Young-Chang P; Hatakeyama, Noboru; Nishihara, Makoto; Ikeuchi, Masahiko; Kurisuno, Makoto; Ikemoto, Tatsunori

    2013-12-01

    Most patients suffering from trigeminal neuralgia (TN) benefit from medical therapy, for example carbamazepin, gabapentin, and pregabalin, individually or in combination. Nonetheless, some patients experience severe and intractable pain despite such medication, or the medication eliminates their pain but they experience intolerable side effects sufficient to warrant discontinuation. Intravenous magnesium and lidocaine have been used for management of intractable neuropathic pain. We treated nine patients with TN by using an intravenous infusion of a combination of 1.2 g magnesium and 100 mg lidocaine for 1 hour, once a week for 3 weeks. All patients experienced sound pain relief after the combined intravenous infusion therapy. Two patients experienced short and mild dizziness after the therapy, but no severe side effects were reported. PMID:23712613

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

    PubMed Central

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

    2014-01-01

    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

  8. Botulinum toxin-type A: could it be an effective treatment option in intractable trigeminal neuralgia?

    PubMed Central

    2013-01-01

    Background Botulinum toxin type A (BTX-A) has been reported to have analgesic effects independent of its action on muscle tone, mostly by acting on neurogenic inflammatory mediators and controlling the neurotransmitter release of sensory and autonomic nerve terminals that are involved in many chronic painful conditions as chronic intractable trigeminal neuralgia (TN). The aim of our work was evaluating the efficacy, safety, and tolerability of BTX-A for the treatment of intractable idiopathic TN. Methods This was a randomized, single-blinded, placebo-control study carried out on 20 Egyptian patients with intractable TN. Patients received a one-time subcutaneous administration of BTX-A using “follow the pain” method. The primary efficacy measure was reduction in pain severity on the 10-cm VAS score as well as in paroxysms frequency from the baseline to week 12 (endpoint last observation carried forward [LOCF]). Secondary efficacy measures included QoL assessment and number of acute medications received from baseline to the endpoint. Results Pain reduction at the 12-week endpoint was significant in BTX-A group (p<0.0001); VAS scores at endpoint LOCF relative to baseline for BTX-A group showed a decrease of 6.5 compared with a decrease of 0.3 for placebo, also there was a significant decrease in the number of acute medications and an increase in QoL functioning scale. Conclusion These results indicate that BTX-A has a direct analgesic effect in patients with TN and can represent a therapeutic option for intractable cases. PMID:24251833

  9. A case of intractable facial pain secondary to metastatic lung cancer

    Microsoft Academic Search

    Silvia Ruffatti; Giorgio Zanchin; Ferdinando Maggioni

    2008-01-01

    Persistent idiopathic facial pain, once called atypical facial pain, rarely anticipates the detection of a lung carcinoma.\\u000a Thirty-six cases of intractable facial pain secondary to lung neoplasm are described in the literature. The onset of facial\\u000a pain usually precedes the onset of symptoms and signs due to lung cancer by several months and therefore it should be considered,\\u000a when present,

  10. Clinical trial of allogeneic cultured dermal substitutes for intractable skin ulcers of the lower leg

    Microsoft Academic Search

    Naoto Yamada; Eiju Uchinuma; Yoshimitsu Kuroyanagi

    2008-01-01

    The efficacy of allogeneic cultured dermal substitute (CDS) on wound healing was evaluated in six patients with intractable\\u000a skin ulcers on the lower extremities. Allogeneic CDS was repeatedly applied to wounds at intervals of 4–7 days to prepare\\u000a a wound bed acceptable for skin grafting or to induce resurfacing through the granulation tissue formation associated with\\u000a epithelialization. In one patient

  11. Free deepithelialized anterolateral thigh myocutaneous flaps for chronic intractable empyema with bronchopleural fistula

    Microsoft Academic Search

    Feng-chou Tsai; Hung-chi Chen; Samuel Huan-tang Chen; Bruno Coessens; Hui-ping Liu; Yi-cheng Wu; Ping-chang Lin

    2002-01-01

    Background. Free deepithelialized anterolateral thigh (DALT) flaps have been used for treatment of chronic intractable empyema with bronchopleural fistula at Chang Gung Memorial Hospital since 1997.Methods. Twelve patients with chronic empyema were treated at Chang Gung Memorial Hospital from January 1997 to January 2001. Their age ranged from 31 to 70 years (mean age 48.6 years). Left-sided involvement was predominant

  12. Spinal Cord Stimulation for Intractable Visceral Pain due to Chronic Pancreatitis

    PubMed Central

    Kim, Jin Kyung; Hong, Seok Ho; Kim, Myung-Hwan

    2009-01-01

    Pain caused by chronic pancreatitis is medically intractable and resistant to conventional interventional or surgical treatment. We report a case of spinal cord stimulation (SCS) for intractable pain due to chronic pancreatitis. The patient had a history of nonalcoholic chronic pancreatitis and multiple emergency room visits as well as repeated hospitalization including multiple nerve block and morphine injection for 3 years. We implanted surgical lead at T6-8 level on this patient after successful trial of percutaneous electrode. The patient experienced a decreased visual analog scale (VAS) scores for pain intensity and amount of opioid intake. The patient was followed for more than 14 months with good outcome and no further hospitalization. From our clinical case, spinal cord stimulation on intractable pain due to chronic pancreatitis revealed moderate pain control outcome. We suggest that SCS is an effective, noninvasive treatment option for abdominal visceral pain. Further studies and long term follow-up are needed to fully understand the effect of SCS on abdominal visceral pain. PMID:19763221

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

    PubMed Central

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

    2013-01-01

    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

  14. Lumbosacral reconstruction for intractable pyogenic spondylitis using a total leg flap with a vascularized tibia graft.

    PubMed

    Iwakiri, Kentaro; Miyauchi, Akira; Okuda, Shinya; Matsuda, Ken; Yamamoto, Tomio; Iwasaki, Motoki

    2008-05-01

    This report describes an effective technique of using a total leg flap for treating a 57-year-old male paraplegic patient with intractable sacral pyogenic spondylitis caused by methicillin-resistant Staphylococcus aureus. Spondylitis was accompanied by severe instability of the lumbosacral area, a large lumbosacral ulcer, and a large bone and muscle defect, which made it difficult for the patient to maintain a sitting position. A total leg flap procedure, a modification of the total thigh flap procedure, was performed as a 1-stage salvage surgery. The vascularized tibia and fibula were grafted between the lumbar and sacral vertebrae, and a musculocutaneous flap was used to cover the extensive ulceration in the lumbosacral skin defect. The intractable lesion of the lumbosacral spine, which had not been cured for more than 2 years despite repeated debridement, intravenous antibiotic injections, sugar treatment, pyoktanin treatment, and hyperbaric O(2) treatment, subsided and stabilized within 1 year of surgery. The patient returned to activities of daily living using a wheelchair, and was very satisfied with the results. Use of a total leg flap with a vascularized tibia graft is an effective treatment for intractable pyogenic spondylitis accompanied by a large bone defect and large lumbosacral ulcers. PMID:18447694

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

    PubMed Central

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

    2014-01-01

    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

  16. Mutation screening of the CDKL5 gene in cryptogenic infantile intractable epilepsy and review of clinical sensitivity

    Microsoft Academic Search

    Utcharee Intusoma; Fadell Hayeeduereh; Thanya Sripo; Punnee Vasiknanonte; Supachai Janjindamai; Apasri Lusawat; Sasipa Thammongkol; Anannit Visudtibhan; Pornprot Limprasert

    2011-01-01

    PurposesTo perform CDKL5 mutation screening in Thai children with cryptogenic infantile intractable epilepsy and to determine the clinical sensitivity of CDKL5 screening when different inclusion criteria were applied.

  17. Coral transcriptome and bacterial community profiles reveal distinct Yellow Band Disease states in Orbicella faveolata.

    PubMed

    Closek, Collin J; Sunagawa, Shinichi; DeSalvo, Michael K; Piceno, Yvette M; DeSantis, Todd Z; Brodie, Eoin L; Weber, Michele X; Voolstra, Christian R; Andersen, Gary L; Medina, Mónica

    2014-12-01

    Coral diseases impact reefs globally. Although we continue to describe diseases, little is known about the etiology or progression of even the most common cases. To examine a spectrum of coral health and determine factors of disease progression we examined Orbicella faveolata exhibiting signs of Yellow Band Disease (YBD), a widespread condition in the Caribbean. We used a novel combined approach to assess three members of the coral holobiont: the coral-host, associated Symbiodinium algae, and bacteria. We profiled three conditions: (1) healthy-appearing colonies (HH), (2) healthy-appearing tissue on diseased colonies (HD), and (3) diseased lesion (DD). Restriction fragment length polymorphism analysis revealed health state-specific diversity in Symbiodinium clade associations. 16S ribosomal RNA gene microarrays (PhyloChips) and O. faveolata complimentary DNA microarrays revealed the bacterial community structure and host transcriptional response, respectively. A distinct bacterial community structure marked each health state. Diseased samples were associated with two to three times more bacterial diversity. HD samples had the highest bacterial richness, which included components associated with HH and DD, as well as additional unique families. The host transcriptome under YBD revealed a reduced cellular expression of defense- and metabolism-related processes, while the neighboring HD condition exhibited an intermediate expression profile. Although HD tissue appeared visibly healthy, the microbial communities and gene expression profiles were distinct. HD should be regarded as an additional (intermediate) state of disease, which is important for understanding the progression of YBD. PMID:24950107

  18. Chagas disease: a proposal for testing policy for solid-organ transplant in the United States.

    PubMed

    Wallace, James A; Miller, Linda; Beavis, Andrew; Baptista, Carlos A C

    2013-09-01

    Chagas disease is caused by the parasite Trypanosoma cruzi. The disease is difficult to detect because of the asymptomatic pathogenesis after infection. Chagas disease is endemic throughout much of Mexico, Central America, and South America, but human migration patterns are bringing the pathogen to the United States. The disease currently affects 16 to 18 million people with approximately 50 000 deaths annually in these countries. In the United States, national screening of the blood supply was instituted in early 2007, and more than 1000 donors with T cruzi infection have been identified within the past 3 years of testing. It was observed that out of the 58 organ procurement organizations in the United States, only 4 required mandatory testing of every donor for Chagas disease. It was estimated that as of 2009, approximately 409 000 residents are living with Chagas disease, and in a 22-year span, approximately 300 patients may have contracted Chagas disease through transplant. Proposed solutions to the current testing method include automatic testing based on the medical social history questionnaire, testing of all recipients for Chagas disease, testing all persons of Latin descent, or testing of all organ donors. PMID:23996948

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

    PubMed

    Gorman, Linda S

    2013-01-01

    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

  20. Assessment of Climate-sensitive Infectious Diseases in the Federated States of Micronesia

    PubMed Central

    McIver, Lachlan; Hashizume, Masahiro; Kim, Ho; Honda, Yasushi; Pretrick, Moses; Iddings, Steven; Pavlin, Boris

    2015-01-01

    Background: The health impacts of climate change are an issue of growing concern in the Pacific region. Prior to 2010, no formal, structured, evidence-based approach had been used to identify the most significant health risks posed by climate change in Pacific island countries. During 2010 and 2011, the World Health Organization supported the Federated States of Micronesia (FSM) in performing a climate change and health vulnerability and adaptation assessment. This paper summarizes the priority climate-sensitive health risks in FSM, with a focus on diarrheal disease, its link with climatic variables and the implications of climate change. Methods: The vulnerability and adaptation assessment process included a review of the literature, extensive stakeholder consultations, ranking of climate-sensitive health risks, and analysis of the available long-term data on climate and climate-sensitive infectious diseases in FSM, which involved examination of health information data from the four state hospitals in FSM between 2000 and 2010; along with each state’s rainfall, temperature and El Niño-Southern Oscillation data. Generalized linear Poisson regression models were used to demonstrate associations between monthly climate variables and cases of climate-sensitive diseases at differing temporal lags. Results: Infectious diseases were among the highest priority climate-sensitive health risks identified in FSM, particularly diarrheal diseases, vector-borne diseases and leptospirosis. Correlation with climate data demonstrated significant associations between monthly maximum temperature and monthly outpatient cases of diarrheal disease in Pohnpei and Kosrae at a lag of one month and 0 to 3 months, respectively; no such associations were observed in Chuuk or Yap. Significant correlations between disease incidence and El Niño-Southern Oscillation cycles were demonstrated in Kosrae state. Conclusions: Analysis of the available data demonstrated significant associations between climate variables and climate-sensitive infectious diseases. This information should prove useful in implementing health system and community adaptation strategies to avoid the most serious impacts of climate change on health in FSM.

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

    ERIC Educational Resources Information Center

    Moak, Gary S.; Fisher, William H.

    1990-01-01

    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…

  2. Environmental and Policy Approaches to Cardiovascular Disease Prevention Through Nutrition: Opportunities for State and Local Action

    Microsoft Academic Search

    Karen Glanz; Becky Lankenau; Susan Foerster; Sally Temple; Rebecca Mullis; Thomas Schmid

    1995-01-01

    This article reviews environmental and policy intervention approaches to cardiovascular disease prevention through nutrition and recommends opportunities for state and local health departments to initiate and participate in environmental and nutrition policy initiatives. By addressing these complementary aims, the authors hope to stimulate further efforts to achieve progress in nutrition promotion among state and local health-related organizations. Key categories of

  3. Parameterizing State-space Models for Infectious Disease Dynamics by Generalized Profiling: Measles in Ontario

    E-print Network

    Keinan, Alon

    Parameterizing State-space Models for Infectious Disease Dynamics by Generalized Profiling: Measles and for statistical inference in this framework. The methods are applied to a model for pre-vaccination measles. Keywords: differential equation model, generalized profiling, state-space model, measles 1 Introduction

  4. A Qualitative Study of State-level Zoonotic disease surveillance in New England

    PubMed Central

    Scotch, Matthew; Mattocks, Kristin; Rabinowitz, Peter; Brandt, Cynthia

    2013-01-01

    Summary Zoonotic diseases are infectious diseases transmittable between animals and humans and outbreaks of these diseases in animals can signify that humans are also infected (or vice-versa). Thus, communication between animal and human health agencies is critical for surveillance. Understanding how these agencies conduct surveillance and share information is important for development of successful automated zoonotic monitoring systems. Individual interviews were conducted with 13 professionals who perform animal or human zoonotic disease surveillance in one of the New England states. Questions centered on existing surveillance methods, collaborations between animal and human health agencies, and technological and data needs. The results showed that agencies routinely communicate over suspected zoonotic disease cases yet there are barriers preventing automated electronic linking of health data of animals and humans. These include technological barriers and barriers due sensitivity and confidentiality of information. Addressing these will facilitate development of electronic systems for integrating animal and human zoonotic disease surveillance data. PMID:20163575

  5. Altered Resting State Brain Networks in Parkinson’s Disease

    PubMed Central

    Göttlich, Martin; Münte, Thomas F.; Heldmann, Marcus; Kasten, Meike; Hagenah, Johann; Krämer, Ulrike M.

    2013-01-01

    Parkinson’s disease (PD) is a neurodegenerative disorder affecting dopaminergic neurons in the substantia nigra leading to dysfunctional cortico-striato-thalamic-cortical loops. In addition to the characteristic motor symptoms, PD patients often show cognitive impairments, affective changes and other non-motor symptoms, suggesting system-wide effects on brain function. Here, we used functional magnetic resonance imaging and graph-theory based analysis methods to investigate altered whole-brain intrinsic functional connectivity in PD patients (n?=?37) compared to healthy controls (n?=?20). Global network properties indicated less efficient processing in PD. Analysis of brain network modules pointed to increased connectivity within the sensorimotor network, but decreased interaction of the visual network with other brain modules. We found lower connectivity mainly between the cuneus and the ventral caudate, medial orbitofrontal cortex and the temporal lobe. To identify regions of altered connectivity, we mapped the degree of intrinsic functional connectivity both on ROI- and on voxel-level across the brain. Compared to healthy controls, PD patients showed lower connectedness in the medial and middle orbitofrontal cortex. The degree of connectivity was also decreased in the occipital lobe (cuneus and calcarine), but increased in the superior parietal cortex, posterior cingulate gyrus, supramarginal gyrus and supplementary motor area. Our results on global network and module properties indicated that PD manifests as a disconnection syndrome. This was most apparent in the visual network module. The higher connectedness within the sensorimotor module in PD patients may be related to compensation mechanism in order to overcome the functional deficit of the striato-cortical motor loops or to loss of mutual inhibition between brain networks. Abnormal connectivity in the visual network may be related to adaptation and compensation processes as a consequence of altered motor function. Our analysis approach proved sensitive for detecting disease-related localized effects as well as changes in network functions on intermediate and global scale. PMID:24204812

  6. Resting-state networks link invasive and noninvasive brain stimulation across diverse psychiatric and neurological diseases.

    PubMed

    Fox, Michael D; Buckner, Randy L; Liu, Hesheng; Chakravarty, M Mallar; Lozano, Andres M; Pascual-Leone, Alvaro

    2014-10-14

    Brain stimulation, a therapy increasingly used for neurological and psychiatric disease, traditionally is divided into invasive approaches, such as deep brain stimulation (DBS), and noninvasive approaches, such as transcranial magnetic stimulation. The relationship between these approaches is unknown, therapeutic mechanisms remain unclear, and the ideal stimulation site for a given technique is often ambiguous, limiting optimization of the stimulation and its application in further disorders. In this article, we identify diseases treated with both types of stimulation, list the stimulation sites thought to be most effective in each disease, and test the hypothesis that these sites are different nodes within the same brain network as defined by resting-state functional-connectivity MRI. Sites where DBS was effective were functionally connected to sites where noninvasive brain stimulation was effective across diseases including depression, Parkinson's disease, obsessive-compulsive disorder, essential tremor, addiction, pain, minimally conscious states, and Alzheimer's disease. A lack of functional connectivity identified sites where stimulation was ineffective, and the sign of the correlation related to whether excitatory or inhibitory noninvasive stimulation was found clinically effective. These results suggest that resting-state functional connectivity may be useful for translating therapy between stimulation modalities, optimizing treatment, and identifying new stimulation targets. More broadly, this work supports a network perspective toward understanding and treating neuropsychiatric disease, highlighting the therapeutic potential of targeted brain network modulation. PMID:25267639

  7. Resting-state networks link invasive and noninvasive brain stimulation across diverse psychiatric and neurological diseases

    PubMed Central

    Fox, Michael D.; Buckner, Randy L.; Liu, Hesheng; Chakravarty, M. Mallar; Lozano, Andres M.; Pascual-Leone, Alvaro

    2014-01-01

    Brain stimulation, a therapy increasingly used for neurological and psychiatric disease, traditionally is divided into invasive approaches, such as deep brain stimulation (DBS), and noninvasive approaches, such as transcranial magnetic stimulation. The relationship between these approaches is unknown, therapeutic mechanisms remain unclear, and the ideal stimulation site for a given technique is often ambiguous, limiting optimization of the stimulation and its application in further disorders. In this article, we identify diseases treated with both types of stimulation, list the stimulation sites thought to be most effective in each disease, and test the hypothesis that these sites are different nodes within the same brain network as defined by resting-state functional-connectivity MRI. Sites where DBS was effective were functionally connected to sites where noninvasive brain stimulation was effective across diseases including depression, Parkinson's disease, obsessive-compulsive disorder, essential tremor, addiction, pain, minimally conscious states, and Alzheimer’s disease. A lack of functional connectivity identified sites where stimulation was ineffective, and the sign of the correlation related to whether excitatory or inhibitory noninvasive stimulation was found clinically effective. These results suggest that resting-state functional connectivity may be useful for translating therapy between stimulation modalities, optimizing treatment, and identifying new stimulation targets. More broadly, this work supports a network perspective toward understanding and treating neuropsychiatric disease, highlighting the therapeutic potential of targeted brain network modulation. PMID:25267639

  8. Estimates of Disease Effects on Soybean Yields in the United States 2003 to 2005

    PubMed Central

    Wrather, J. Allen; Koenning, Steve R.

    2006-01-01

    Research must focus on management of diseases that cause extensive losses, especially when funds for research are limited. Knowledge of the losses caused by various soybean diseases is essential when prioritizing research budgets. The objective of this project was to compile estimates of soybean yields suppressed due to diseases for each soybean-producing state in the US from 2003 to 2005. The goal was to provide this information to help funding agencies and scientists prioritize research objectives and budgets. Yield suppression due to individual diseases varied among regions in the US, and the total of soybean yields suppressed due to diseases in the US varied among years. Soybean cyst nematode suppressed US soybean yield more during 2003 to 2005 than any other disease. Phytophthora root and stem rot, sudden death syndrome, and seedling diseases ranked in the top four on the list of diseases that suppressed soybean yield during these years. This is the first report of soybean yield suppression due to Asian soybean rust in the United States. PMID:19259444

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

    PubMed

    Pemán, Javier; Quindós, Guillermo

    2014-01-01

    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 vary depending on the group 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. The treatment of mucormycoses, Lomentospora prolificans infections or mycoses by dematiaceous fungi are more complicated. Amphotericin B is active against many mucoralean fungi, 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

  10. Diversification of importin-? isoforms in cellular trafficking and disease states

    PubMed Central

    Pumroy, Ruth A.; Cingolani, Gino

    2015-01-01

    The human genome encodes seven isoforms of importin ? which are grouped into three subfamilies known as ?1, ?2 and ?3. All isoforms share a fundamentally conserved architecture that consists of an N-terminal, autoinhibitory, importin-?-binding (IBB) domain and a C-terminal Arm (Armadillo)-core that associates with nuclear localization signal (NLS) cargoes. Despite striking similarity in amino acid sequence and 3D structure, importin-? isoforms display remarkable substrate specificity in vivo. In the present review, we look at key differences among importin-? isoforms and provide a comprehensive inventory of known viral and cellular cargoes that have been shown to associate preferentially with specific isoforms. We illustrate how the diversification of the adaptor importin ? into seven isoforms expands the dynamic range and regulatory control of nucleocytoplasmic transport, offering unexpected opportunities for pharmacological intervention. The emerging view of importin ? is that of a key signalling molecule, with isoforms that confer preferential nuclear entry and spatiotemporal specificity on viral and cellular cargoes directly linked to human diseases. PMID:25656054

  11. Diversification of importin-? isoforms in cellular trafficking and disease states.

    PubMed

    Pumroy, Ruth A; Cingolani, Gino

    2015-02-15

    The human genome encodes seven isoforms of importin ? which are grouped into three subfamilies known as ?1, ?2 and ?3. All isoforms share a fundamentally conserved architecture that consists of an N-terminal, autoinhibitory, importin-?-binding (IBB) domain and a C-terminal Arm (Armadillo)-core that associates with nuclear localization signal (NLS) cargoes. Despite striking similarity in amino acid sequence and 3D structure, importin-? isoforms display remarkable substrate specificity in vivo. In the present review, we look at key differences among importin-? isoforms and provide a comprehensive inventory of known viral and cellular cargoes that have been shown to associate preferentially with specific isoforms. We illustrate how the diversification of the adaptor importin ? into seven isoforms expands the dynamic range and regulatory control of nucleocytoplasmic transport, offering unexpected opportunities for pharmacological intervention. The emerging view of importin ? is that of a key signalling molecule, with isoforms that confer preferential nuclear entry and spatiotemporal specificity on viral and cellular cargoes directly linked to human diseases. PMID:25656054

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

    E-print Network

    Maniatty, William A.

    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

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

    PubMed Central

    Kim, Hyun Kyung; La, Tae Yoon

    2013-01-01

    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

  14. The Association of Meningococcal Disease with Influenza in the United States, 1989–2009

    PubMed Central

    Jacobs, Jessica Hartman; Viboud, Cécile; Tchetgen, Eric Tchetgen; Schwartz, Joel; Steiner, Claudia; Simonsen, Lone; Lipsitch, Marc

    2014-01-01

    Importance and Objective Prior influenza infection is a risk factor for invasive meningococcal disease. Quantifying the fraction of meningococcal disease attributable to influenza could improve understanding of viral-bacterial interaction and indicate additional health benefits to influenza immunization. Design, Setting and Participants A time series analysis of the association of influenza and meningococcal disease using hospitalizations in 9 states from 1989–2009 included in the State Inpatient Databases from the Agency for Healthcare Research and Quality and the proportion of positive influenza tests by subtype reported to the Centers for Disease Control. The model accounts for the autocorrelation of meningococcal disease and influenza between weeks, temporal trends, co-circulating respiratory syncytial virus, and seasonality. The influenza-subtype-attributable fraction was estimated using the model coefficients. We analyzed the synchrony of seasonal peaks in hospitalizations for influenza, respiratory syncytial virus, and meningococcal disease. Results and Conclusions In 19 of 20 seasons, influenza peaked?2 weeks before meningococcal disease, and peaks were highly correlated in time (??=?0.95; P <.001). H3N2 and H1N1 peaks were highly synchronized with meningococcal disease while pandemic H1N1, B, and respiratory syncytial virus were not. Over 20 years, 12.8% (95% CI, 9.1–15.0) of meningococcal disease can be attributable to influenza in the preceding weeks with H3N2 accounting for 5.2% (95% CI, 3.0–6.5), H1N1 4.3% (95% CI, 2.6–5.6), B 3.0% (95% CI, 0.8–4.9) and pH1N1 0.2% (95% CI, 0–0.4). During the height of influenza season, weekly attributable fractions reach 59%. While vaccination against meningococcal disease is the most important prevention strategy, influenza vaccination could provide further protection, particularly in young children where the meningococcal disease vaccine is not recommended or protective against the most common serogroup. PMID:25265409

  15. The thalamostriatal system in normal and diseased states

    PubMed Central

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

    2014-01-01

    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

  16. Arginine de novo and nitric oxide production in disease states

    PubMed Central

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

    2012-01-01

    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

  17. Incidence of notifiable diseases among American Indians/Alaska Natives - United States, 2007-2011.

    PubMed

    Adekoya, Nelson; Truman, Benedict; Landen, Michael

    2015-01-16

    American Indian/Alaska Native (AI/AN) populations experience substantial disparities in the incidence of multiple diseases compared with other racial/ethnic groups in the United States. A major goal of Healthy People 2020 is to eliminate health disparities, monitor disease trends, and identify population groups and diseases for targeted interventions. High rates of certain infectious diseases continue to be a major problem facing AI/AN populations. During 1990-2011, incidence rates for some infectious diseases declined among AI/AN populations, but disparities remain and AI/AN populations are still disproportionately affected. To describe disparities in selected notifiable diseases among AI/ANs, CDC analyzed data from the National Notifiable Diseases Surveillance System (NNDSS) for 2007-2011, the most recent 5 years for which data are available. The results of this analysis of 26 infectious diseases indicate that incidence rates of 14 diseases were higher for AI/ANs than for whites. Interventions are needed to address and reduce disparities in chlamydia, gonorrhea, West Nile virus, spotted fever rickettsiosis, and other infections among AI/ANs. PMID:25590681

  18. DNA Modifications: Function and Applications in Normal and Disease States

    PubMed Central

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

    2014-01-01

    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

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

    PubMed

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

    2014-01-01

    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

  20. Endemic, Notifiable Bioterrorism-Related Diseases, United States, 1992–1999

    PubMed Central

    Glynn, M. Kathleen; Groseclose, Samuel L.

    2003-01-01

    Little information is available in the United States regarding the incidence and distribution of diseases caused by critical microbiologic agents with the potential for use in acts of terrorism. We describe disease-specific, demographic, geographic, and seasonal distribution of selected bioterrorism-related conditions (anthrax, botulism, brucellosis, cholera, plague, tularemia, and viral encephalitides) reported to the National Notifiable Diseases Surveillance System in 1992–1999. Tularemia and brucellosis were the most frequently reported diseases. Anthrax, plague, western equine encephalitis, and eastern equine encephalitis were rare. Higher incidence rates for cholera and plague were noted in the western United States and for tularemia in the central United States. Overall, the incidence of conditions caused by these critical agents in the United States is low. Individual case reports should be considered sentinel events. For potential bioterrorism-related conditions that are endemic and have low incidence, the use of nontraditional surveillance methods and complementary data sources may enhance our ability to rapidly detect changes in disease incidence. PMID:12737739

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

    EPA Science Inventory

    Background: Since 1978, CDC, EPA, and the Council of State and Territorial Epidemiologists have collaborated on the Waterborne Disease and Outbreak Surveillance System (WBDOSS) to capture data on waterborne disease outbreaks associated with recreational water. WBDOSS is the prima...

  2. Outcome of medical and surgical management in intractable idiopathic trigeminal neuralgia

    PubMed Central

    Salama, Hassan; Ben-Khayal, Hesham; Mohamed, Mohamed Abdel Salam; El-Mitwalli, Ashraf; Zaher, Ashraf Ahmed; EzzEldin, Ashraf; Badr, Hatem; Vorkapic, Peter

    2009-01-01

    Background: The neurovascular conflict in trigeminal neuralgia is an intractable condition; medical treatment is usually of long duration and can be annoying for both patients and clinicians. Aim: This prospective study was designed to assess the outcome of microvascular decompression (MVD) in patients with more than 3 years' history of intractable idiopathic trigeminal neuralgia (TN) and poor response to drugs. Materials and Methods: Twenty-one patients (8 females and 13 males) with intractable idiopathic TN (group 1) underwent MVD and were followed up for 2 years. Group 2 (n = 15), which included 6 females and 9 males, received pharmacotherapy. The outcome responses of pain relief were evaluated using a 10-cm visual analog scale (VAS) and the Barrow Neurological Institute (BNI) scoring system. The patients' morbidity was recorded as well. Results: All patients fulfilling the inclusion criteria were offered MVD surgery. Freedom from pain was achieved immediately after surgery in 95.2% (n = 20) of patients in group 1, and 90.5% (n = 19) had sustained relief over the follow-up period. There were no statistical significance recurrences or surgical complications in group 1 (P>0.5), while 53.3% (n = 8) of the subjects in group 2 showed poor response with pharmacotherapy over the same period of time and many patients experienced drug intolerance that had statistical significance (P<0.01). Conclusion: Early MVD in TN can help patients avoid the side effects of drugs and the adverse psychological effects of long-term pharmacotherapy and prolonged morbidity. PMID:20174498

  3. Chemotactic and mitogenic stimuli of neuronal apoptosis in patients with medically intractable temporal lobe epilepsy

    PubMed Central

    Fiala, Milan; Avagyan, Hripsime; Merino, Jose Joaquin; Bernas, Michael; Valdivia, Juan; Espinosa-Jeffrey, Araceli; Witte, Marlys; Weinand, Martin

    2012-01-01

    To identify the upstream signals of neuronal apoptosis in patients with medically intractable temporal lobe epilepsy (TLE), we evaluated by immunohistochemistry and confocal microscopy brain tissues of 13 TLE patients and 5 control patients regarding expression of chemokines and cell-cycle proteins. The chemokine RANTES (CCR5) and other CC-chemokines and apoptotic markers (caspase-3, -8, -9) were expressed in lateral temporal cortical and hippocampal neurons of TLE patients, but not in neurons of control cases. The chemokine RANTES is usually found in cytoplasmic and extracellular locations. However, in TLE neurons, RANTES was displayed in an unusual location, the neuronal nuclei. In addition, the cell-cycle regulatory transcription factor E2F1 was found in an abnormal location in neuronal cytoplasm. The pro-inflammatory enzyme cyclooxygenase-2 and cytokine interleukin-1? were expressed both in neurons of patients suffering from temporal lobe epilepsy and from cerebral trauma. The vessels showed fibrin leakage, perivascular macrophages and expression of IL-6 on endothelial cells. In conclusion, the cytoplasmic effects of E2F1 and nuclear effects of RANTES might have novel roles in neuronal apoptosis of TLE neurons and indicate a need to develop new medical and/or surgical neuroprotective strategies against apoptotic signaling by these molecules. Both RANTES and E2F1 signaling are upstream from caspase activation, thus the antagonists of RANTES and/or E2F1 blockade might be neuroprotective for patients with medically intractable temporal lobe epilepsy. The results have implications for the development of new medical and surgical therapies based on inhibition of chemotactic and mitogenic stimuli of neuronal apoptosis in patients with medically intractable temporal lobe epilepsy. PMID:22444245

  4. TIPS Versus Peritoneovenous Shunt in the Treatment of Medically Intractable Ascites

    PubMed Central

    Rosemurgy, Alexander S.; Zervos, Emmanuel E.; Clark, Whalen C.; Thometz, Donald P.; Black, Thomas J.; Zwiebel, Bruce R.; Kudryk, Bruce T.; Grundy, L Shane; Carey, Larry C.

    2004-01-01

    Objective: We undertook a prospective randomized clinical trial comparing TIPS to peritoneovenous (PV) shunts in the treatment of medically intractable ascites to establish relative efficacy and morbidity, and thereby superiority, between these shunts. Methods: Thirty-two patients were prospectively randomized to undergo TIPS or peritoneovenous (Denver) shunts. All patients had failed medical therapy. Results: After TIPS versus peritoneovenous shunts, median (mean ± SD) duration of shunt patency was similar: 4.4 months (6 ± 6.6 months) versus 4.0 months (5 ± 4.6 months). Assisted shunt patency was longer after TIPS: 31.1 months (41 ± 25.9 months) versus 13.1 months (19 ± 17.3 months) (P < 0.01, Wilcoxon test). Ultimately, after TIPS 19% of patients had irreversible shunt occlusion versus 38% of patients after peritoneovenous shunts. Survival after TIPS was 28.7 months (41 ± 28.7 months) versus 16.1 months (28 ± 29.7 months) after peritoneovenous shunts. Control of ascites was achieved sooner after peritoneovenous shunts than after TIPS (73% vs. 46% after 1 month), but longer-term efficacy favored TIPS (eg, 85% vs. 40% at 3 years). Conclusion: TIPS and peritoneovenous shunts treat medically intractable ascites. Absence of ascites after either is uncommon. PV shunts control ascites sooner, although TIPS provides better long-term efficacy. After either shunt, numerous interventions are required to assist patency. Assisted shunt patency is better after TIPS. Treating medically refractory ascites with TIPS risks early shunt-related mortality for prospects of longer survival with ascites control. This study promotes the application of TIPS for medically intractable ascites if patients undergoing TIPS have prospects beyond short-term survival. PMID:15166968

  5. Does laparoscopy used in open exploration alleviate pain associated with chronic intractable abdominal wall neuralgia?

    Microsoft Academic Search

    H. Paajanen

    2006-01-01

    Background  This study aimed to assess the efficacy of diagnostic laparoscopy and open exploration of trigger points (scar revision and\\u000a neurectomy) in the treatment of intractable chronic abdominal wall pain.\\u000a \\u000a \\u000a \\u000a Methods  This prospective nonrandomized study enrolled 24 patients (21 women) with an average age of 59 ± 11 years. Abdominal wall\\u000a pain was diagnosed by excluding other causes of pain and using

  6. Hot water irrigation as treatment for intractable posterior epistaxis in an out-patient setting.

    PubMed

    Novoa, E; Schlegel-Wagner, C

    2012-01-01

    The management of intractable posterior epistaxis is challenging for any physician. Nasal packing, often combined with use of an endonasal balloon system, is painful for the patient, and torturous to maintain for two to three days. If conservative treatment fails, the most commonly used treatment options are currently invasive procedures such as endoscopic coagulation of bleeding arteries, external ligation and, rarely, embolisation. This paper describes a simple, non-invasive technique of treating posterior epistaxis with hot water irrigation. Technical information is presented, and the benefits of the method are discussed. PMID:21888749

  7. Hyperbaric oxygen therapy for control of intractable cyclophosphamide-induced hemorrhagic cystitis.

    PubMed

    Shameem, I A; Shimabukuro, T; Shirataki, S; Yamamoto, N; Maekawa, T; Naito, K

    1992-01-01

    We report a case of intractable hemorrhagic cystitis due to cyclophosphamide therapy for Wegener's granulomatosis. Conservative treatment, including bladder irrigation with physiological saline and instillation of prostaglandin F2 alpha, failed to totally control hemorrhage. We then used hyperbaric oxygen at an absolute pressure of 2 atm, 5 days a week for 8 consecutive weeks. The bleeding ceased completely by the end of treatment and the patient remained free of hematuria thereafter. No side effect was noted during the course of therapy. In future, this form of therapy can offer a safe alternative in the treatment of cyclophosphamide-induced hemorrhagic cystitis. PMID:1468485

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

    PubMed

    Skeik, N; Kia, F; Klosterman, D

    2014-10-01

    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

  9. Successful treatment of intractable hiccup with methylphenidate in a lung cancer patient.

    PubMed

    Maréchal, R; Berghmans, T; Sculier, P

    2003-02-01

    In a 56-year-old man with metastatic small-cell lung cancer, a persistent hiccup was refractory to classic treatments. Hyponatremia, neoplasic mediastinal involvement and liver metastases were though to be potential causative factors. Methylphenidate (MTP), a mild central nervous system (CNS) stimulant that is most commonly used for the treatment of attention deficit hyperactivity disorder, was started at a daily dose of 10 mg. It was rapidly efficient and well tolerated. This report suggests a potential advantage of MTP in the treatment of intractable hiccup in cancer patients. PMID:12560943

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

    PubMed Central

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

    2014-01-01

    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

  11. Wetland cover dynamics drive hemorrhagic disease patterns in white-tailed deer in the United States.

    PubMed

    Berry, Brett S; Magori, Krisztian; Perofsky, Amanda C; Stallknecht, David E; Park, Andrew W

    2013-07-01

    While vector-borne diseases are known to be particularly influenced by environmental factors, the impact of land-cover change on vector-borne wildlife disease patterns is poorly understood, largely due to the paucity of data on disease occurrence at extensive spatial and temporal scales. Widespread and rapid anthropogenic land-cover change, especially urbanization, has transformed the US landscape during the last century. Epizootic hemorrhagic disease virus and blue tongue virus, vectored by Culicoides biting midges, are two RNA viruses in the Orbivirus genus that cause severe hemorrhagic disease (HD) in white-tailed deer (Odocoileus virginianus). We examine the spatial dynamics of HD affecting white-tailed deer in the contiguous United States in two periods covering 1980 to 2007 in connection with land-cover change over the same time. Using spatial statistical modeling, wetland cover emerges as a critical driver of HD morbidity, whereas the drivers of mortality patterns are more complex. Increasing wetland cover is positively associated with HD morbidity, which is consistent with the ecologic requirements of the Culicoides vector. Wetland cover is inherently dynamic due to its importance to biodiversity and water quality as well as its utility for other purposes when drained. Accordingly this analysis helps in understanding the consequences of changing wetlands on vector-borne disease patterns, to identify disease hotspots in a large landscape, and to forecast the spatial spread of HD and related diseases. PMID:23778598

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

    PubMed Central

    2014-01-01

    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

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

    PubMed

    Garcia, Melissa N; Hotez, Peter J; Murray, Kristy O

    2014-01-01

    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

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

    Microsoft Academic Search

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

    2004-01-01

    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

  15. Behçet’s disease: new insight into the relationship between procoagulant state, endothelial activation/damage and disease activity

    PubMed Central

    2013-01-01

    Background Behçet disease (BD) is associated with a prothrombotic state of unknown origin that may lead to life-threatening events. Calibrated Automated Thrombogram (CAT) and Rotational Thromboelastometry (ROTEM) are two global haemostasis assays that may reveal new insights into the physiopathological mechanisms of the disease and its procoagulant condition. Methods 23 BD patients who had no signs or symptoms of current thrombosis and 33 age- and sex-matched controls were included in the study. We performed ROTEM and CAT tests and assessed erythrocyte count, platelet count, platelet contribution to clot formation and plasma levels of tissue-type plasminogen activator, plasminogen activator inhibitor type 1 (PAI-1), fibrinogen, C-reactive protein (CRP), thrombin-antithrombin III complex (TAT), D-dimer and E-selectin (ES). Results Both ROTEM and CAT tests showed a hypercoagulable state in the BD patients. Plasma levels of PAI-1, fibrinogen, TAT, CRP and ES were significantly increased in this group compared to controls. The disease activity (DA) was significantly correlated with levels of ES and the maximum clot firmness, and this last one, in turn, correlated with rising levels of ES, PAI-1, CRP and fibrinogen. CAT parameters did not correlate with DA or ES. Conclusions Both ROTEM and CAT tests reveal that patients with BD have a procoagulant state even in the absence of thrombosis. ROTEM test indicates that increased levels of fibrinogen and PAI-1 may be involved in the prothrombotic state of this pathology, while platelets do not significantly contribute. Moreover, CAT assay demonstrate that plasma from BD patients is able to generate more thrombin than controls in response to the same stimulus and that this effect is independent of the DA and the endothelial impairment suggesting the involvement of another factor in the hypercoagulable state observed in BD patients. This study also shows that endothelium activation/damage may be a contributing factor in both the procoagulant and clinical conditions of BD, as shown by the direct correlation between ES levels, ROTEM parameters and DA. PMID:23711081

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

    PubMed Central

    2008-01-01

    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

  17. Meteorological Influences on the Seasonality of Lyme Disease in the United States

    PubMed Central

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

    2014-01-01

    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

  18. 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...

  19. GENOMIC ANALYSIS OF SURROGATE TISSUES FOR ASSESSING ENVIRONMENTAL EXPOSURES AND FUTURE DISEASE STATES

    EPA Science Inventory

    Genomic Analysis of Surrogate Tissues for Assessing Environmental Exposures and Future Disease States John C. Rockett, Chad R. Blystone, Amber K. Goetz, Rachel N. Murrell, Hongzu Ren, Judith E. Schmid, Jessica Stapelfeldt, Lillian F. Strader, Kary E. Thompson, Douglas B. T...

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

    E-print Network

    Ferrara, Katherine W.

    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

  1. Patients' willingness to pay for diabetes disease state management services in Australian community pharmacies

    Microsoft Academic Search

    Andrew Hanna; Lesley White; Venkata Yanamandram

    2010-01-01

    Purpose – The purpose of this paper is to determine whether and how much patients would be willing to pay for diabetes disease state management (DSM) services in community pharmacies, and also to determine the relationships between willingness to pay (WTP) and different clinical\\/socio\\/demographic characteristics of patients. Design\\/methodology\\/approach – A sample of 130 diabetic patients recruited from 14 pharmacies across

  2. SURVEILLANCE FOR WATERBORNE-DISEASE OUTBREAKS - UNITED STATES, 1999-2000

    EPA Science Inventory

    PROBLEM/CONDITION: Since 1971, CDC, the U.S. Environmental Protection Agency (EPA), and the Council of State and Territorial Epidemiologists (CSTE) have maintained a collaborative surveillance system for the occurrences and causes of waterborne-disease outbreaks (WBDOs).This surv...

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

    PubMed

    Liang, Faming; Jin, Ick-Hoon

    2013-08-01

    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

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

    PubMed Central

    Saito, Kazuya; Doi, Katsumi

    2015-01-01

    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. PMID:25685577

  5. Protein expression of phospho-lim kinase-1 in patients and an experimental rat model with intractable temporal lobe epilepsy

    PubMed Central

    Huang, Hao; Wang, Heng; Yuan, Jinxian; Wu, Xuling; Huang, Yunyi; Zhou, Xin; Chen, Yangmei

    2015-01-01

    Lim kinase-1 (LIMK1) plays a critical role in dendritic spine morphogenesis and brain function. The protein expression pattern of phospho-LIMK1 (p-LIMK1), the active form of LIMK1, in intractable temporal lobe epilepsy (TLE), however, is unknown. Here we measured p-LIMK1 protein expression in thirty temporal neocortex tissue samples from intractable TLE patients, fifteen histologically normal temporal neocortex tissue samples from trauma patients without epilepsy, in the hippocampi of lithium chloride/pilocarpine-induced TLE rats, and in controls. We found that p-LIMK1 was expressed mainly in the cytoplasm of neurons. The protein expression of p-LIMK1 was significantly higher in the TLE patients and rats than in the control groups. Our results suggest that p-LIMK1 might be involved in the pathogenesis of intractable TLE. PMID:25785037

  6. A change in the management of intractable obstetrical hemorrhage over 15 years in a tertiary care center

    PubMed Central

    Juneja, Sunil K; Tandon, Pooja; Mohan, Bishav; Kaushal, Sandeep

    2014-01-01

    Context: Peripartum hysterectomy was the gold standard to save a woman with persistent obstetrical bleeding, but compromised the menstrual and reproductive functions. Bilateral internal iliac artery ligation (BIAL) is a potentially effective, fertility preserving means of controlling pelvic hemorrhage, but with surgical and anesthetic risks and low success. Angiographic embolization has the potential to arrest severe pelvic hemorrhage without removing the uterus and without hazarding general anesthesia in a hemodynamically unstable patient. Aims: The aim of this study is to discuss change in the management of intractable obstetrical hemorrhage from removing to conserving the uterus over 15 years. Settings and Design: A retrospective analysis of 122 cases of intractable obstetrical hemorrhage over a period of 15 years (January 1997 to December 2011) was done. We started uterine artery embolization (UAE) in 2007 for obstetrical hemorrhage. The patients were analyzed for maternal characteristics, indications, treatment modality, maternal morbidity, and mortality. Statistical Analysis Used: Descriptive. Results: We analyzed 12,055 deliveries, (6029 cesarean sections; 6026 vaginal deliveries). One hundred and twenty-two cases of intractable obstetrical hemorrhage were managed with obstetrical hysterectomies in 63, UAE in 53 cases and BIAL in six cases. During the period between 1997 and 2006 intractable obstetrical hemorrhage was managed by hysterectomy/internal iliac artery ligation. The last 5 years of the study period had 80 patients with intractable obstetrical hemorrhage, 53 patients underwent arterial embolization and 35 had a hysterectomy and two had internal artery ligation. There was no mortality and significantly less morbidity in embolization group in our study. Conclusions: Embolization should be tried in patients with intractable obstetrical hemorrhage before proceeding for surgical intervention. PMID:25298935

  7. Necrotic arachnidism and intractable pain from recluse spider bites treated with lumbar sympathetic block: a case report and review of literature.

    PubMed

    Yi, Xiaobin; AuBuchon, Jacob; Zeltwanger, Shawn; Kirby, John P

    2011-06-01

    Brown recluse (Loxosceles reclusa) spider bites mainly occur in the southern and Midwestern United States. The clinical manifestation of brown recluse spider bites varies from skin irritation, a small area of tissue damage to neuropathic pain, necrotic arachnidism and severe systemic reactions such as acute renal failure and even death. Treatment is controversial and nonspecific. We describe a case of extensive right lower extremity tissue necrosis and intractable neuropathic pain treated with lumbar sympathetic block in a patient with a documented brown recluse spider bite. Both his pain and tissue necrosis improved significantly with lumbar sympathetic block with local anesthetic. After a series of lumbar sympathetic blocks, his symptoms resolved and lower extremity wound healed rapidly. We discuss the benefit of sympathetic blockade not only for neuropathic pain but also possibly as a treatment for necrotic arachnidism from a brown recluse spider bite. PMID:21317774

  8. Geographical distribution of milky disease bacteria in the eastern United States based on phylogeny.

    PubMed

    Dingman, Douglas W

    2008-02-01

    A phylogenetic grouping of 48 different isolates of milky disease bacteria isolated in the United States was determined using genomic RFLP analysis and 16S rDNA sequence comparison. A clear distinction between Paenibacillus popilliae isolates and Paenibacillus lentimorbus isolates was evident from the results of each procedure. The P. popilliae isolates segregated into two phylogenetic groups and the P. lentimorbus isolates segregated into three phylogenetic groups. In the United States, P. popilliae group 1 was generally isolated from insects collected west of the Appalachian Mountains. P. popilliae group 2 was only isolated from insects collected east of the Appalachian Mountains. P. lentimorbus groups 1 and 2 were obtained from insects collected west and south of the Appalachians. P. lentimorbus group 3 was identified in insects collected east of the mountains. From five different locations in Connecticut, 12 milky disease bacterial isolates were classified as P. popilliae and three were classified as P. lentimorbus. Except for one isolate, all P. popilliae isolates were of phylogenetic group 2. The three P. lentimorbus strains were isolated from diseased insects that had been collected from a localized area in the state. These three strains formed a separate phylogenetic grouping (i.e., group 3) of P. lentimorbus and, based on 16S rDNA sequence comparisons, were most similar to the newly identified P. lentimorbus Semadara strain recently isolated in Japan. All milky disease bacteria that had been isolated from commercially available insecticide preparations were identified as P. popilliae group 1. PMID:17959195

  9. Fully human anti-interleukin-8 monoclonal antibodies: potential therapeutics for the treatment of inflammatory disease states

    Microsoft Academic Search

    Xiao-Dong Yang; Jose R. F. Corvalan; Ping Wang; Catherine M.-N. Roy; C. Geoffrey Davis

    1999-01-01

    Interleukin-8 (IL-8) is a potent chemo- tactic cytokine implicated in the pathogenesis of a number of inflammatory disease states. Agents that block the binding of IL-8 to its receptor have been shown to block inflammation in animal models of disease. This suggests that drugs specifically target- ing IL-8 may prove efficacious in treating multiple human diseases. To this end, we

  10. The Disease Burden Attributable to Smoking in the State Of Rio De Janeiro, Brazil in 2000

    PubMed Central

    Oliveira, Andreia Ferreira; Valente, Joaquim Gonçalves; Leite, Iuri Costa

    2008-01-01

    INTRODUCTION Smoking is one of the main risk factors for morbidity and mortality. An estimated 59 million (4.4%) disability-adjusted life years were lost due to smoking throughout the world in 2000. OBJECTIVE To estimate the disease burden attributable to smoking in the State of Rio de Janeiro, Brazil, for the year 2000. METHODS Based on estimates of smoking prevalence and relative death risks, the smoking-attributable fraction was calculated for each selected cause, by age and gender. The disease burden attributable to smoking was estimated by multiplying the fractions by the corresponding disability-adjusted life years. RESULTS In the State of Rio de Janeiro, 7% of all disability-adjusted life years were due to smoking. For individuals 30 or more years old, the fraction increased to 10.6% (13.6% in males and 7.5% in females). Chronic obstructive pulmonary disease, ischemic heart disease, cerebrovascular disease, and tracheal, bronchial, and lung cancer accounted for 32.2%, 15.7%, 13.2%, and 11.1% of the estimated total DALYs, respectively, amounting to 72.2% of the smoking-attributable disease burden. DISCUSSION Limitations related to parameter estimates were not unique to this study, and therefore should not compromise the comparability of our results. Outcomes were similar to those obtained in other countries, despite methodological differences. CONCLUSION Smoking is an important risk factor and places a significant disease burden on Rio de Janeiro, Brazil, showing a pattern similar to that observed in high income countries. PMID:18438576

  11. Impact of heart disease and quality of care on minority populations in the United States.

    PubMed Central

    Graham, Garth N.; Guendelman, Mayadallia; Leong, Benjamin S.; Hogan, Sara; Dennison, Adrienne

    2006-01-01

    Heart disease is a leading cause of death across all populations in the United States. In 1985, the Secretary's Task Force on Black and Minority Health recognized the existence of widespread health disparities for heart disease and related risk factors among minorities in America. Inequalities in heart health and healthcare continue to exist. This review compares measures of heart disease and healthcare for white, African-American, Asian/Pacific Islander, American-Indian/Alaska-Native and Hispanic/Latino populations. Lack of healthcare data for minorities continues to be a barrier to understanding the nature and extent of heart disease and related risk factors for these groups. In combination with programs that address preventive measures to reduce risk factors for heart disease, the integration of quality improvement measures has developed as an important strategy for reducing cardiovascular health disparities. Improved data collection and reporting, enhanced use of information technology, and promotion of cultural competency hold potential for improving the quality of cardiac care and reducing health disease for all Americans. PMID:17052047

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

    PubMed Central

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

    2014-01-01

    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

  13. A case study examination of structure and function in a state health department chronic disease unit.

    PubMed

    Alongi, Jeanne

    2015-04-01

    Objectives. I explored the structural and operational practices of the chronic disease prevention and control unit of a state health department and proposed a conceptual model of structure, function, and effectiveness for future study. Methods. My exploratory case study examined 7 elements of organizational structure and practice. My interviews with staff and external stakeholders of a single chronic disease unit yielded quantitative and qualitative data that I coded by perspective, process, relationship, and activity. I analyzed these for patterns and emerging themes. Results. Chi-square analysis revealed significant correlations among collaboration with goal ambiguity, political support, and responsiveness, and evidence-based decisions with goal ambiguity and responsiveness. Conclusions. Although my study design did not permit conclusions about causality, my findings suggested that some elements of the model might facilitate effectiveness for chronic disease units and should be studied further. My findings might have important implications for identifying levers around which capacity can be built that may strengthen effectiveness. PMID:25689211

  14. Human Risk of Infection with Borrelia burgdorferi, the Lyme Disease Agent, in Eastern United States

    PubMed Central

    Diuk-Wasser, Maria A.; Hoen, Anne Gatewood; Cislo, Paul; Brinkerhoff, Robert; Hamer, Sarah A.; Rowland, Michelle; Cortinas, Roberto; Vourc'h, Gwenaël; Melton, Forrest; Hickling, Graham J.; Tsao, Jean I.; Bunikis, Jonas; Barbour, Alan G.; Kitron, Uriel; Piesman, Joseph; Fish, Durland

    2012-01-01

    The geographic pattern of human risk for infection with Borrelia burgdorferi sensu stricto, the tick-borne pathogen that causes Lyme disease, was mapped for the eastern United States. The map is based on standardized field sampling in 304 sites of the density of Ixodes scapularis host-seeking nymphs infected with B. burgdorferi, which is closely associated with human infection risk. Risk factors for the presence and density of infected nymphs were used to model a continuous 8 km×8 km resolution predictive surface of human risk, including confidence intervals for each pixel. Discontinuous Lyme disease risk foci were identified in the Northeast and upper Midwest, with a transitional zone including sites with uninfected I. scapularis populations. Given frequent under- and over-diagnoses of Lyme disease, this map could act as a tool to guide surveillance, control, and prevention efforts and act as a baseline for studies tracking the spread of infection. PMID:22302869

  15. A Case Study Examination of Structure and Function in a State Health Department Chronic Disease Unit

    PubMed Central

    2015-01-01

    Objectives. I explored the structural and operational practices of the chronic disease prevention and control unit of a state health department and proposed a conceptual model of structure, function, and effectiveness for future study. Methods. My exploratory case study examined 7 elements of organizational structure and practice. My interviews with staff and external stakeholders of a single chronic disease unit yielded quantitative and qualitative data that I coded by perspective, process, relationship, and activity. I analyzed these for patterns and emerging themes. Results. Chi-square analysis revealed significant correlations among collaboration with goal ambiguity, political support, and responsiveness, and evidence-based decisions with goal ambiguity and responsiveness. Conclusions. Although my study design did not permit conclusions about causality, my findings suggested that some elements of the model might facilitate effectiveness for chronic disease units and should be studied further. My findings might have important implications for identifying levers around which capacity can be built that may strengthen effectiveness. PMID:25689211

  16. The relationship between coagulation state and inflammatory bowel disease: current understanding and clinical implications.

    PubMed

    Koutroubakis, Ioannis E

    2015-04-01

    Inflammatory bowel disease (IBD) is associated with a hypercoagulable state and subsequently with an increased risk for venous thromboembolism (VTE). VTE in IBD is characterized by a high recurrence rate and is associated with the disease activity. Acquired endothelial dysfunction, abnormalities of platelets, activation of coagulation system and impaired fibrinolysis are the main changes in the coagulation state in IBD. The development of VTE in IBD has been considered to be the result of multiple interactions between acquired and inherited risk factors. The treatment of VTE in IBD patients is recommended to be similar and to follow the same protocols as for non-IBD patients. In the clinical practice, the management of IBD patients and especially the hospitalized patients should include thromboprophylaxis. PMID:25719625

  17. Perceptions of a changing world induce hope and promote peace in intractable conflicts.

    PubMed

    Cohen-Chen, Smadar; Crisp, Richard J; Halperin, Eran

    2015-04-01

    The importance of hope in promoting conciliatory attitudes has been asserted in the field of conflict resolution. However, little is known about conditions inducing hope, especially in intractable conflicts, where reference to the outgroup may backfire. In the current research, five studies yielded convergent support for the hypothesis that hope for peace stems from a general perception of the world as changing. In Study 1, coders observed associations between belief in a changing world, hope regarding peace, and support for concessions. Study 2 revealed the hypothesized relations using self-reported measures. Studies 3 and 4 established causality by instilling a perception of the world as changing (vs. unchanging) using narrative and drawing manipulations. Study 5 compared the changing world message with a control condition during conflict escalation. Across studies, although the specific context was not referred to, the belief in a changing world increased support for concessions through hope for peace. PMID:25713171

  18. Intractable Abdominal Pain in a Patient With Spinal Cord Injury: A Case Report

    PubMed Central

    Park, Hye Kyung; Song, Dae Heon; Kim, Young Moon; Kim, Hong Geum; Kim, Soo Yeon

    2013-01-01

    Patients with spinal cord injury (SCI) may experience several types of chronic pains. Abdominal pain in patients with SCI has gained limited attention and little is yet known about its characteristics and mechanisms. It often has been regarded as visceral pain associated with constipation and distention. Neuropathic pains localized in the abdomen have rarely been reported. We experience a case of intractable abdominal pain in a patient with SCI, neither of visceral pathology nor of musculoskeletal origin. The nature of pain fulfilled the diagnostic criteria for neuropathic pains. The pain was therefore regarded as neuropathic and managed accordingly. The first- and second-line oral drugs available were being performed, unfortunately, adequate pain control was not achieved. We tried an intrathecal lidocaine injection as another treatment option, and the injection had considerable effects. PMID:24236262

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

    SciTech Connect

    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

    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.

  20. Melanosomal sequestration of cytotoxic drugs contributes to the intractability of malignant melanomas

    NASA Astrophysics Data System (ADS)

    Chen, Kevin G.; Valencia, Julio C.; Lai, Barry; Zhang, Guofeng; Paterson, Jill K.; Rouzaud, François; Berens, Werner; Wincovitch, Stephen M.; Garfield, Susan H.; Leapman, Richard D.; Hearing, Vincent J.; Gottesman, Michael M.

    2006-06-01

    Multidrug resistance mechanisms underlying the intractability of malignant melanomas remain largely unknown. In this study, we demonstrate that the development of multidrug resistance in melanomas involves subcellular sequestration of intracellular cytotoxic drugs such as cis-diaminedichloroplatinum II (cisplatin; CDDP). CDDP is initially sequestered in subcellular organelles such as melanosomes, which significantly reduces its nuclear localization when compared with nonmelanoma/KB-3-1 epidermoid carcinoma cells. The melanosomal accumulation of CDDP remarkably modulates melanogenesis through a pronounced increase in tyrosinase activity. The altered melanogenesis manifested an 8-fold increase in both intracellular pigmentation and extracellular transport of melanosomes containing CDDP. Thus, our experiments provide evidence that melanosomes contribute to the refractory properties of melanoma cells by sequestering cytotoxic drugs and increasing melanosome-mediated drug export. Preventing melanosomal sequestration of cytotoxic drugs by inhibiting the functions of melanosomes may have great potential as an approach to improving the chemosensitivity of melanoma cells. cancer | melanosomes | skin | tumor therapy | multidrug resistance

  1. The prevalence of celiac disease in at-risk groups of children in the United States

    Microsoft Academic Search

    Ivor Hill; Alessio Fasano; Robert Schwartz; Debra Counts; Michael Glock; Karoly Horvath

    2000-01-01

    Objective: In contrast to its prevalence in Europe, celiac disease (CD) is considered rare in the United States. We aimed to determine the prevalence of CD in children presenting with symptoms or conditions associated with CD.Study design: Individuals aged 6 months to 20 years were screened for IgG and IgA antigliadin (AGA-IgG and AGA-IgA) and antiendomysium (EMA) antibodies. Those with

  2. Epidemiological studies on tick-borne diseases of cattle in Central Equatoria State, Southern Sudan

    Microsoft Academic Search

    D. A. Salih; A. M. El Hussein; U. Seitzer; J. S. Ahmed

    2007-01-01

    A herd-based study was carried out in Central Equatoria State, Southern Sudan, to study epidemiological aspects of tick-borne\\u000a diseases. Six herds of cattle situated in three different locations were selected and investigated every 3 months during the\\u000a year 2005. Blood smears for Giemsa staining and blood spots on filter paper for deoxyribonucleic acid extraction were collected\\u000a from 600 apparently healthy indigenous

  3. Altered functional connectivity in early Alzheimer's disease: A resting-state fMRI study

    Microsoft Academic Search

    Kun Wang; Meng Liang; Liang Wang; Lixia Tian; Xinqing Zhang; Kuncheng Li; Tianzi Jiang

    2007-01-01

    Previous studies have led to the proposal that patients with Alzheimer's disease (AD) may have disturbed functional connectivity between different brain regions. Furthermore, recent resting-state func- tional magnetic resonance imaging (fMRI) studies have also shown that low-frequency (<0.08 Hz) fluctua- tions (LFF) of the blood oxygenation level-dependent signals were abnormal in several brain areas of AD patients. However, few studies

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

    PubMed Central

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

    2014-01-01

    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

  5. Why Does Fear Override Hope in Societies Engulfed by Intractable Conflict, as It Does in the Israeli Society?

    Microsoft Academic Search

    Daniel Bar-Tal

    2001-01-01

    The question of why fear overrides hope in societies embarked on the road of peacemaking after years of intractable conflict is answered on the basis of accumulated knowledge in the psychology and sociology of emotions. This knowledge suggests that fear is an automatic emotion, grounded in the perceived present and often based on the memorized past (also processed unconsciously), that

  6. Historic Evolution of Open Cingulectomy and Stereotactic Cingulotomy in the Management of Medically Intractable Psychiatric Disorders, Pain and Drug Addiction

    Microsoft Academic Search

    Alexandros G. Brotis; Eftychia Z. Kapsalaki; Konstantinos Paterakis; Joseph R. Smith; Kostas N. Fountas

    2009-01-01

    Stereotactic cingulotomy constitutes a psychosurgical procedure nowadays advocated in the treatment of medically intractable obsessive-compulsive disorder, chronic pain and drug addiction. From its theoretical conception to the first cingulectomies performed and modern stereotactic-guided cingulotomies, various target localization methods, different surgical techniques, and numerous lesioning devices have been utilized. In the current article, the authors performed a literature review related to

  7. Disease properties, geography, and mitigation strategies in a simulation spread of rinderpest across the United States

    PubMed Central

    2011-01-01

    For the past decade, the Food and Agriculture Organization of the United Nations has been working toward eradicating rinderpest through vaccination and intense surveillance by 2012. Because of the potential severity of a rinderpest epidemic, it is prudent to prepare for an unexpected outbreak in animal populations. There is no immunity to the disease among the livestock or wildlife in the United States (US). If rinderpest were to emerge in the US, the loss in livestock could be devastating. We predict the potential spread of rinderpest using a two-stage model for the spread of a multi-host infectious disease among agricultural animals in the US. The model incorporates large-scale interactions among US counties and the small-scale dynamics of disease spread within a county. The model epidemic was seeded in 16 locations and there was a strong dependence of the overall epidemic size on the starting location. The epidemics were classified according to overall size into small epidemics of 100 to 300 animals (failed epidemics), epidemics infecting 3 000 to 30 000 animals (medium epidemics), and the large epidemics infecting around one million beef cattle. The size of the rinderpest epidemics were directly related to the origin of the disease and whether or not the disease moved into certain key counties in high-livestock-density areas of the US. The epidemic size also depended upon response time and effectiveness of movement controls. PMID:21435236

  8. Comparative incidence rates of end-stage renal disease treatment by state.

    PubMed

    Rosansky, S J; Huntsberger, T L; Jackson, K; Eggers, P

    1990-01-01

    End-stage renal disease (ESRD) treatment rates vary significantly between states in the United States. Much of this variation relates to the much higher rate of ESRD in blacks and the differences in race, age, and sex composition of various states. Even after adjusting for race, age, and sex differences utilizing data from new patients reported to Medicare with ESRD between 1980 and 1983, marked variation in treatment incidence rates per million population were still present. Overall rates varied from 45 in North Dakota to 99 in New Jersey. Regional rate patterns were demonstrated with very high rates in southwestern states (Texas, New Mexico, Arizona, and California: 87-91/million). In contrast, several south-central states had lower rates (Arkansas, Louisiana, Mississippi, Alabama, and Tennessee: 66-75/million). By state the rates for blacks were consistently higher than for whites. After adjustment for sex and age differences, the rates for blacks varied from 125 in Arkansas to 242 in New Jersey. Several north-eastern states (Massachusetts, Connecticut, Rhode Island, New Jersey) had higher rates of ESRD in blacks (197-242 million) as compared with several south-central states (Arkansas, Louisiana, Mississippi, Tennessee, Alabama) where rates varied from 125 to 180 million. ESRD rates by primary etiologies by state showed marked variation of the major primary etiologies of ESRD: diabetic nephropathy rates were most predictive of overall ESRD rates, with much higher rates in the southwestern states (28.1-33.2) as compared with the south-central states (12.8-16.3).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2382681

  9. Addition of Multimodal Therapy to Standard Management of Steady State Sickle Cell Disease

    PubMed Central

    Ikefuna, Anthony; Duru, Augustine; Chukwu, Barth; Madu, Anazoeze; Nwagha, Theresa; Ocheni, Sunday; Ibegbulam, Obike; Emodi, Ifeoma; Anike, Uche; Nonyelu, Charles; Anigbo, Chukwudi; Agu, Kingsley; Ajuba, Ifeoma; Chukwura, Awele; Ugwu, Ogechukwu; Ololo, Uche

    2013-01-01

    Most people on folic acid to boost erythropoiesis and prophylactic antimicrobials, the standard management of steady state sickle cell disease (SCD), have unacceptable numbers of crises. The objective of this study was to evaluate the effects of adding multimodal therapy with potassium thiocyanate and omega-3 fatty acids to the standard management of steady state SCD. Pre- and post-treatment numbers of crises and other disease indices were compared in 16 HbSS individuals on folic acid and paludrine after 12 months of adding eicosapentaenoic acid 15?mg/kg/day, docosahexaenoic acid 10?mg/kg/day, and potassium thiocyanate 1-2?mL/day, each milliliter of which contained 250?mg of thiocyanate and 100 micrograms of iodine to prevent hypothyroidism: a possible side-effect due to competitive inhibition of the transport of iodide into the thyroid gland by thiocyanate. Median number of crises reduced from 3/yr to 1/yr (P < 0.0001). There was no evidence of impaired thyroid function. Plasma level of tri-iodothyronine improved (P < 0.0001). Steady state full blood count and bilirubin level did not change significantly. The findings suggest that addition of potassium thiocyanate and eicosapentaenoic and docosahexaenoic acids to standard management of steady state SCD reduces the number of crises. This observation needs to be evaluated in larger studies. PMID:24386573

  10. End-Stage Renal Disease From Autosomal Dominant Polycystic Kidney Disease in the United States, 2001-2010

    PubMed Central

    Reule, Scott; Sexton, Donal J.; Solid, Craig A.; Chen, Shu-Cheng; Collins, Allan J.; Foley, Robert N.

    2015-01-01

    Background Autosomal dominant polycystic kidney disease (ADPKD) is amenable to early detection and specialty care. Thus, while important to patients with the condition, end-stage renal disease (ESRD) from ADPKD may also be an indicator of the overall state of nephrology care. Study Design Retrospective cohort study of temporal trends in renal replacement therapy (RRT)-requiring ESRD from ADPKD and pre-RRT nephrologist care, 2001-2010 (n = 23,772). Setting & Participants US patients who initiated maintenance RRT between 2001 and 2010 (n = 1,069,343), from United States Renal Data System data. Predictor RRT-requiring ESRD from ADPKD. Outcomes Death, wait-listing for renal transplant, renal transplant. Measurements US census data were used as population denominators. The Poisson distribution was used to compute incidence rates. Incidence ratios were standardized to rates in 2001-2002 for age, sex, and race/ethnicity. Patients with and without ADPKD were matched to compare clinical outcomes. Poisson regression was used to calculate incidence rates and adjusted hazards ratios for clinical events after inception of RRT. Results General population incidence ratios in 2009-2010 were unchanged from 2001-2002 (incidence ratio 1.02). Of patients with ADPKD, 48.1% received > 12 months of nephrology care before RRT; preemptive transplant was the initial RRT in 14.3% and fistula the initial hemodialysis access in 35.8%. Over 4.9 years of follow-up, patients with ADPKD were more likely to be listed for transplant (11.7 [95% CI 11.5-12.0] per 100 person-years vs. 8.4 [8.2-8.7]) and to undergo transplant (9.8 [9.5-10.0] vs. 4.8 [4.7-5.0]), and less likely to die (5.6 [5.4-5.7] vs. 15.5 [15.3-15.8]) than matched controls without ADPKD. Limitations Retrospective, nonexperimental, registry-based study of associations; cause-and-effect relationships cannot be determined. Conclusions While outcomes on dialysis are better for ADPKD than for non-ADPKD patients, access to predialysis nephrology care and non-declining ESRD rates may be a cause for concern. PMID:25134777

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

    PubMed Central

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

    2014-01-01

    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

  12. Characterization of the Hypercoagulable State in Patients with Sickle Cell Disease

    PubMed Central

    Shah, Nirmish; Thornburg, Courtney; Telen, Marilyn J.; Ortel, Thomas L.

    2012-01-01

    SUMMARY Background The pathophysiology of sickle cell disease (SCD) is complex, with increasing evidence of a pronounced prothrombotic state. Objective We investigated thrombin generation in SCD utilizing calibrated automated thrombography (CAT) and Ddimer, with subsequent correlation to clinical disease. Patient/Methods The study included 51 patients homozygous for hemoglobin S, either admitted for vaso-occlusive crisis (VOC) (n=34) or while in steady state and being seen in outpatient clinic (n=37). Twenty patients had blood drawn during both VOC and steady state. Mean values for CAT and D-dimer were compared between groups. Mean values for patients with and without clinical complications such as avascular necrosis and stroke were also compared. Linear regression was used to evaluate correlation to number of hospitalizations and for all pediatric patients, transcranial doppler (TCD) velocities. Results The mean D-dimer during VOC (2743 ± 3118 ng/ml) was significantly higher than during steady state (1151 ± 802, p<0.0001). Comparison of crisis and steady state by CAT also revealed a significant difference in all phases of thrombin generation, including mean endogenous thrombin potential (1381 ± 295 nM vs 923 ± 316, p<0.0001) and peak thrombin generated (284 ± 9 vs 223 ± 18, p=0.0002). There were no significant differences in mean values for the clinical outcomes examined in adults. In pediatric patients, however, increased TCD velocities correlated with steady state Ddimer (r2=0.32, p=0.02) and thrombin-antithrombin complex (r2=0.28, p=0.04. Conclusion Hypercoagulable markers distinguish between patients with SCD during and between VOC, but do not correlate with specific clinical phenotypes. PMID:22959127

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

    NASA Astrophysics Data System (ADS)

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

    2000-03-01

    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.

  14. Systemic complement profiling in multiple sclerosis as a biomarker of disease state

    PubMed Central

    Ingram, G; Hakobyan, S; Hirst, CL; Harris, CL; Loveless, S; Mitchell, JP; Pickersgill, TP; Robertson, NP

    2012-01-01

    Background: There is increasing evidence of significant and dynamic systemic activation and upregulation of complement in multiple sclerosis (MS), which may contribute to disease pathogenesis. Objective: We aimed to investigate the pathological role of complement in MS and the potential role for complement profiling as a biomarker of MS disease state. Methods: Key components of the classical, alternative and terminal pathways of complement were measured in plasma and cerebrospinal fluid (CSF) of patients with MS in different clinical phases of disease and in matched controls. Results: Increased plasma levels of C3 (p<0.003), C4 (p<0.001), C4a (p<0.001), C1 inhibitor (p<0.001), and factor H (p<0.001), and reduced levels of C9 (p<0.001) were observed in MS patients compared with controls. Combined profiling of these analytes produced a statistical model with a predictive value of 97% for MS and 73% for clinical relapse when combined with selected demographic data. CSF-plasma correlations suggested that source of synthesis of these components was both systemic and central. Conclusion: These data provide further evidence of alterations in both local and systemic expression and activation of complement in MS and suggest that complement profiling may be informative as a biomarker of MS disease, although further work is needed to determine its use in distinguishing MS from its differential. PMID:22354735

  15. Experimental and imaging techniques for examining fibrin clot structures in normal and diseased States.

    PubMed

    Fan, Natalie K; Keegan, Philip M; Platt, Manu O; Averett, Rodney D

    2015-01-01

    Fibrin is an extracellular matrix protein that is responsible for maintaining the structural integrity of blood clots. Much research has been done on fibrin in the past years to include the investigation of synthesis, structure-function, and lysis of clots. However, there is still much unknown about the morphological and structural features of clots that ensue from patients with disease. In this research study, experimental techniques are presented that allow for the examination of morphological differences of abnormal clot structures due to diseased states such as diabetes and sickle cell anemia. Our study focuses on the preparation and evaluation of fibrin clots in order to assess morphological differences using various experimental assays and confocal microscopy. In addition, a method is also described that allows for continuous, real-time calculation of lysis rates in fibrin clots. The techniques described herein are important for researchers and clinicians seeking to elucidate comorbid thrombotic pathologies such as myocardial infarctions, ischemic heart disease, and strokes in patients with diabetes or sickle cell disease. PMID:25867016

  16. The burden of disease due to tuberculosis in the state of Santa Catarina, Brazil*, **

    PubMed Central

    Ferrer, Glênio César Nunes; da Silva, Rosemeri Maurici; Ferrer, Kelian Tenfen; Traebert, Jefferson

    2014-01-01

    OBJECTIVE: To estimate the burden of disease due to tuberculosis in the state of Santa Catarina, Brazil, in 2009. METHODS: This was an epidemiological study with an ecological design. Data on tuberculosis incidence and mortality were collected from specific Brazilian National Ministry of Health databases. The burden of disease due to tuberculosis was based on the calculation of disability-adjusted life years (DALYs). The DALYs were estimated by adding the years of life lost (YLLs) and years lived with disability (YLDs). Absolute values were transformed into rates per 100,000 population. The rates were calculated by gender, age group, and health care macroregion. RESULTS: The burden of disease due to tuberculosis was 5,644.27 DALYs (92.25 DALYs/100,000 population), YLLs and YLDs respectively accounting for 78.77% and 21.23% of that total. The highest rates were found in males in the 30-44 and 45-59 year age brackets, although that was not true in every health care macroregion. Overall, the highest estimated burden was in the Planalto Norte macroregion (179.56 DALYs/100,000 population), followed by the Nordeste macroregion (167.07 DALYs/100,000 population). CONCLUSIONS: In the majority of the health care macroregions of Santa Catarina, the burden of disease due to tuberculosis was concentrated in adult males, the level of that concentration varying among the various macroregions. PMID:24626271

  17. Feral swine brucellosis in the United States and prospective genomic techniques for disease epidemiology.

    PubMed

    Leiser, Owen P; Corn, Joseph L; Schmit, Brandon S; Keim, Paul S; Foster, Jeffrey T

    2013-09-27

    Brucellosis is a common infection of feral swine throughout the United States. With the recent expansion of feral swine populations across the country, this disease poses an increasing threat to agriculture and hunters. The standard approach to Brucella surveillance in feral swine has been serological testing, which gives an indication of past exposure and is a rapid method of determining populations where Brucella is present. More in-depth analyses require bacterial isolation to determine the Brucella species and biovar involved. Ultimately, for a comprehensive understanding of Brucella epizootiology in feral swine, incorporation of genotyping assays has become essential. Fortunately, the past decade has given rise to an array of genetic tools for assessing Brucella transmission and dispersal. This review aims to synthesize what is known about brucellosis in feral swine and will cover prospective genomic techniques that may be utilized to develop more complete understanding of the disease and its transmission history. PMID:23548760

  18. Can male vaccination reduce the burden of human papillomavirus-related disease in the United States?

    PubMed

    Low, Garren M I; Attiga, Yasser S; Garg, Gaurav; Schlegal, Richard; Gallicano, G Ian

    2012-06-01

    Human papillomavirus (HPV) can cause cervical cancer, as well as a number of other diseases in both men and women. Both sexes play a role in transmission of the disease, but the cost-effectiveness of HPV vaccination differs between them. It is necessary to determine the best allocation of limited resources between these two populations to produce the most effective strategy for reducing the burden from HPV-related disease. This literature review intends to elucidate the economic and social considerations that will lead to maximum utilization of vaccination programs, which in turn will reduce the burden of HPV-related disease. Current outreach in the United States is based on vaccination against HPV as a means for combating cervical cancer in women. If we are to include males, however, new marketing strategies must focus on educating patients about the full range of the vaccine's benefits. Men who have sex with men (MSM) are also unprotected against HPV in the current system. Social considerations alone may not be enough, however, as economic prediction models suggest that the associated costs outweigh the benefits in most circumstances. Taking this into account, our review also considers alternate methods of maximizing prevention of HPV-associated disease. The most prudent programs will include physician involvement in patient education and the implementation of structured vaccination and screening programs. Unfortunately, many countries do not have the necessary resources to undertake national vaccination programs. HPV testing and cytology screening for women and MSM may be the most financially reasonable option for many countries. PMID:22691099

  19. Pathogens and diseases of freshwater mussels in the United States: studies on bacterial transmission and depuration

    USGS Publications Warehouse

    Starliper, Clifford E.

    2011-01-01

    Unionid mussels are recognized as important contributors to healthy aquatic ecosystems, as well as bioindicators of environmental perturbations. Because they are sedentary, filter feeding animals and require hosts (i.e., fishes) to transform embryonic glochidia, mussels are susceptible to direct adverse environmental parameters, and indirect parameters that restrict the timely presence of the host(s). Their numbers have declined in recent decades to a point that this fauna is regarded as one of the most imperiled in North America. The most significant threat to populations of native unionids in recent years has been the introduction and spread of zebra mussels Dreissena polymorpha. Many federal and state agencies, and private interests are now engaged in mussel conservation efforts, including collecting selected imperiled species from impacted rivers and lakes and propagating them at refuges for future population augmentations. One essential consideration with mussel propagation and their intensive culture at refugia is the prevention of pathogen introductions and control of diseases. Currently, there are few reports of etiological agents causing diseases among freshwater mussels; however, because of increased observations of mussel die-offs in conjunction with transfers of live animals between natural waters and refugia, disease problems can be anticipated to emerge. This review summarizes research to develop bacterial isolation techniques, study pathogen transmission between fish and mussels, identify causes of seasonal mussel die-offs, and develop non-destructive methods for pathogen detection. These efforts were done to develop disease preventative techniques for use by resource managers to avoid potential large-scale disease problems in restoration and population augmentation efforts among imperiled populations.

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

    PubMed

    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

    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

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

    PubMed Central

    Tuite, Ashleigh R.; Greer, Amy L.

    2013-01-01

    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

  2. SIR model on a small-world network and the endemic state of an infectious disease

    E-print Network

    Dottori, Martin

    2014-01-01

    In this work we performed a numerical study of an epidemic model that mimics the endemic state of whooping cough in the pre-vaccine era. We considered a stochastic SIR model on two-dimensional Watts-Strogatz-type networks and analyzed the influence of the network properties on the characterization of the quasi-stationary state. We computed probability density functions (PDF) for infected fraction of individuals and found that they are well fitted by gamma functions, excepted the tails of the distributions that are q-exponentials. We also computed the fluctuation power spectra of infective time series for different networks. We found that network effects can be partially absorbed by rescaling the rate of infective contacts of the model. An explicit relation between the effective transmission rate of the disease and the correlation of susceptible individuals with their infective nearest neighbours was obtained. This relation quantifies the known screening of infective individuals observed in these networks. We ...

  3. Geographic patterns of industry in the United States. An aid to the study of occupational disease.

    PubMed

    Stone, B J; Blot, W J; Fraumeni, J F

    1978-07-01

    The geographic location of 18 major manufacturing industries within the United States is illustrated by a series of computer-generated county maps. The metal and machinery industries, the two largest employers, an the transportation and rubber industries are concentrated in the northeastern quadrant of the United States, while most counties with textile, apparel, tobacco, and furniture manufacturing are in the South. Other industries had different patterns. The counties where industry was concentrated tended to be more urban and to have higher levels of income and education. The maps and associated demographic data on industrial counties may prove a useful adjunct to county maps illustrating mortality patterns for cancer and other diseases. Despite obvious limitations, the visual patterns and correlation analyses may help to generate and formulate hypothese concerning occupationally induced diease. PMID:671124

  4. Systems for rapidly detecting and treating persons with ebola virus disease - United States.

    PubMed

    Koonin, Lisa M; Jamieson, Denise J; Jernigan, John A; Van Beneden, Chris A; Kosmos, Christine; Harvey, Melissa Cole; Pietz, Harald; Bertolli, Jeanne; Perz, Joseph F; Whitney, Cynthia G; Halpin, Alison Sheehan-Laufer; Daley, W Randolph; Pesik, Nicki; Margolis, Gregg S; Tumpey, Abbigail; Tappero, Jordan; Damon, Inger

    2015-03-01

    The U.S. Department of Health and Human Services (HHS), CDC, other U.S. government agencies, the World Health Organization (WHO), and international partners are taking multiple steps to respond to the current Ebola virus disease (Ebola) outbreak in West Africa to reduce its toll there and to reduce the chances of international spread. At the same time, CDC and HHS are working to ensure that persons who have a risk factor for exposure to Ebola and who develop symptoms while in the United States are rapidly identified and isolated, and safely receive treatment. HHS and CDC have actively worked with state and local public health authorities and other partners to accelerate health care preparedness to care for persons under investigation (PUI) for Ebola or with confirmed Ebola. This report describes some of these efforts and their impact. PMID:25742383

  5. The roles of vitamin B12 and vitamin D in children with intractable epilepsy

    PubMed Central

    Li, Xiao-Hong; Hou, Xiao-Yan; Chen, Rong

    2015-01-01

    Epilepsy is a chronic neurological disorder. Antiepileptic drugs (AEDs) can cause vitamin B12 or D deficiency in children with intractable epilepsy. In this study, we measured salivary superoxide dismutase (SOD) and metalloproteinsases (MMP) levels in the patients with vitamin B12 and vitamin D treatment. Cytokines and chemokines were measured using ELISA. The mean salivary value of SOD activity in the control group was 1.75 ± 0.21 U/ml. In the treatment group, the value was 1.33 ± 0.18 U/ml. The salivary MMP 2, MMP 3, and MMP 9 levels of the patients with vitamin D and vitamin B12 treatment were lower than that in the patients without vitamin D and vitamin B12 treatment. Interleukin 1? (IL-1?), IL-6, IL-8, macrophage inflammatory protein 1? (MIP-1?), monocyte chemoattractant protein-1 (MCP-1) and IFN-inducible protein 10 (IP-10) were significantly decreased in the cortex of our patients with vitamin D and vitamin B12 treatment. In this study, a clear association between vitamin D and vitamin B12 treatment and epilepsy was identified. We now plan to investigate the genetic factors that underlie vitamin D and vitamin B12 treatment in patients treated with AEDs.

  6. Outcome of Gamma Knife Thalamotomy in Patients with an Intractable Tremor

    PubMed Central

    Cho, Kyung Rae; Kim, Hong Rye; Im, Yong Seok; Youn, Jinyoung; Cho, Jin Whan

    2015-01-01

    Objective Tremor is a common movement disorder that interferes with daily living. Since the medication for tremor has some limitations, surgical intervention is needed in many patients. In certain patients who cannot undergo aggressive surgical intervention, Gamma Knife thalamotomy (GKT) is a safe and effective alternative. Methods From June 2012 to August 2013, 7 patients with an intractable tremor underwent GKT. Four of these 7 patients had medical comorbidities, and 3 patients refused to undergo traditional surgery. Each patient was evaluated with the modified Fahn-Tolosa-Marin tremor rating scale (TRS) along with analysis of handwriting samples. All of the patients underwent GKT with a maximal dose of 130 Gy to the left ventralis intermedius (VIM) nucleus of the thalamus. Follow-up brain MRI was performed after 3 to 8 months of GKT, and evaluation with the TRS was also performed. Results Six patients showed objective improvement in the TRS score. Excluding one patient who demonstrated tremor progression, there was 28.9% improvement in the TRS score. However, five patients showed subjective improvement in their symptoms. On comparing the TRS scores between follow-up periods of more and less than 4 months, the follow-up TRS score at more than 4 months of GKT was significantly improved compared to that at less than 4 months of GKT. Follow-up MRI showed radiosurgical changes in 5 patients. Conclusion GKT with a maximal dose of 130 Gy to the VIM is a safe procedure that can replace other surgical procedures. PMID:25810859

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

    PubMed

    Bloch, Yuval; Arad, Shira; Levkovitz, Yechiel

    2014-10-24

    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

  8. Combining stereo-electroencephalography and subdural electrodes in the diagnosis and treatment of medically intractable epilepsy.

    PubMed

    Enatsu, Rei; Bulacio, Juan; Najm, Imad; Wyllie, Elaine; So, Norman K; Nair, Dileep R; Foldvary-Schaefer, Nancy; Bingaman, William; Gonzalez-Martinez, Jorge

    2014-08-01

    Stereo-electroencephalography (SEEG) has advantages for exploring deeper epileptic foci. Nevertheless, SEEG can only sample isolated cortical areas and its spatial limitation, with the inability to record contiguous cortical regions, may cause difficulties in interpretation. In light of these limitations, the authors describe the hybrid technique of SEEG and subdural strip electrode placement. The hybrid technique was used for a presurgical evaluation in four patients with intractable epilepsy. Initially, the depth electrodes were inserted with a robotic stereotactic system. Thereafter, a skin incision and a small craniectomy were performed at the entry point of the strip electrode trajectory. The dura was opened and, under live fluoroscopic guidance, strip electrodes were slid into the subdural space. In these patients, the additional subdural strip electrodes provided (1) information regarding the precise description of seizure spread in the cortical surface adjacent to the subdural space, (2) identification of epileptogenic zones located near the crown, (3) more precise definition of functional cortex and (4) a better delineation of the interface between epileptogenic zones and functional cortex. This hybrid technique provides additional data compared to either technique alone, offering superior understanding of the dynamics of the epileptic activity and its interaction with functional cortical areas. PMID:24650680

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

    PubMed Central

    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

    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

  10. [Patients with intractable epilepsy who achieved good seizure control after craniotomy instead of vagal nerve stimulation].

    PubMed

    Morioka, Takato; Shimogawa, Takashi; Sayama, Tetsuro; Hashiguchi, Kimiaki; Murakami, Nobuya; Shigeto, Hiroshi; Suzuki, Satoshi O; Sakata, Ayumi; Makihara, Kosuke; Iihara, Koji

    2014-12-01

    Vagal nerve stimulation(VNS)is an effective adjunctive therapy for medically intractable epilepsy. However, VNS is a palliative therapy, and craniotomy should preferably be performed when complete seizure remission can be expected after craniotomy. We report here three patients who were referred for VNS therapy, but underwent craniotomy instead of VNS based on the results of a comprehensive preoperative evaluation, and achieved good seizure control. Case 1 was a 48-year-old woman with left temporal lobe epilepsy and amygdalar enlargement. Even though no left hippocampal sclerosis was observed on magnetic resonance imaging, she underwent left anterior temporal lobectomy and hippocampectomy. Case 2 was a 36-year-old woman with multiple bilateral subependymal nodular heterotopias, who underwent resection of the left medial temporal lobe including subependymal nodular heterotopias adjacent to the left inferior horn. Case 3 was a 25-year-old man with posttraumatic epilepsy. As the right hemisphere was most affected, multiple subpial transections were performed on the left frontal convexity. These three patients were referred to us for VNS therapy because there was a dissociation between the interictal electroencephalogram and magnetic resonance imaging findings, or because they had multiple or extensive epileptogenic lesions. Comprehensive preoperative evaluation including ictal electroencephalography can help to identify patients who are suitable candidates for craniotomy. PMID:25433062

  11. Plasma and urinary serotonin and 5-HIAA in children treated with lamotrigine for intractable epilepsy.

    PubMed

    Jovi?, N J; Mirkovi?, D; Majki?-Singh, N; Milovanovi?, D D

    1999-01-01

    Alteration of monoamine levels by some antiepileptic drugs (AEDs) was elucidated in this study. Lamotrigine (LTG) is a new AED, acting the sodium-channels. LTG was given as add-on therapy to 16 patients aged 4.5-18 yrs with intractable epilepsy and comedicated with carbamazepine or valproate. An equal group of epileptics with comparable clinical characteristics and treatment served as control. Plasma and urinary (24 h-samples) serotonin and 5-HIAA were determined before onset of LTG therapy and after 2-3 months. HPLC and electrochemical detection was used for the determination of serotonin (5-HT) and 5-hydroxy indoleacetic acid (5-HIAA). No significant effect of LTG on both urinary 5-HT and 5-HIAA levels was found, whereas plasma 5-HT concentrations significantly decreased in comparison with levels before LTG starting and relevant values in controls. This findings was noted in 7/16 children with favourable response to LTG. Increased serotonin catabolism may be result of LTG action. PMID:10721069

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

    PubMed

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

    2013-06-18

    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

  13. Intractable Facial Pain and Numb Chin due to Metastatic Esophageal Adenocarcinoma

    PubMed Central

    Elahi, Foad; Luke, Whitney; Elahi, Fazel

    2014-01-01

    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

  14. The use of ketogenic diet in special situations: expanding use in intractable epilepsy and other neurologic disorders

    PubMed Central

    2012-01-01

    The ketogenic diet has been widely used and proved to be effective for intractable epilepsy. Although the mechanisms underlying its anti-epileptic effects remain to be proven, there are increasing experimental evidences for its neuroprotective effects along with many researches about expanding use of the diet in other neurologic disorders. The first success was reported in glucose transporter type 1 deficiency syndrome, in which the diet served as an alternative metabolic source. Many neurologic disorders share some of the common pathologic mechanisms such as mitochondrial dysfunction, altered neurotransmitter function and synaptic transmission, or abnormal regulation of reactive oxygen species, and the role of the ketogenic diet has been postulated in these mechanisms. In this article, we introduce an overview about the expanding use and emerging trials of the ketogenic diet in various neurologic disorders excluding intractable epilepsy and provide explanations of the mechanisms in that usage. PMID:23049588

  15. A sterile-female technique proposed for control of Striga hermonthica and other intractable weeds: advantages, shortcomings and risk management.

    PubMed

    Rector, Brian G

    2009-05-01

    Weeds have posed intractable challenges to farmers since the dawn of agriculture. This article describes in detail a proposed control strategy based on the introduction of genes conferring female sterility into the genome of an intractable target weed. Spread of these genes through target populations via pollen would be facilitated by their incorporation within active transposable elements. Advantages (e.g. self-dissemination, self-proliferation, target specificity) and shortcomings (e.g. high cost, long project incubation period, limited range of possible targets) of this strategy are discussed in depth, as are assessment and management of its attendant biological and ecological risks, such as the risk of introduced genes spreading to non-target species. The parasitic weed Striga hermonthica (Del.) Benth. is examined as a potential target. PMID:19288471

  16. Trends in mortality due to invasive mycotic diseases in the United States, 1980-1997.

    PubMed

    McNeil, M M; Nash, S L; Hajjeh, R A; Phelan, M A; Conn, L A; Plikaytis, B D; Warnock, D W

    2001-09-01

    To determine national trends in mortality due to invasive mycoses, we analyzed National Center for Health Statistics multiple-cause-of-death record tapes for the years 1980 through 1997, with use of their specific codes in the International Classification of Diseases, Ninth Revision (ICD-9 codes 112.4-118 and 136.3). In the United States, of deaths in which an infectious disease was the underlying cause, those due to mycoses increased from the tenth most common in 1980 to the seventh most common in 1997. From 1980 through 1997, the annual number of deaths in which an invasive mycosis was listed on the death certificate (multiple-cause [MC] mortality) increased from 1557 to 6534. In addition, rates of MC mortality for the different mycoses varied markedly according to human immunodeficiency virus (HIV) status but were consistently higher among males, blacks, and persons > or =65 years of age. These data highlight the public health importance of mycotic diseases and emphasize the need for continuing surveillance. PMID:11486286

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

    PubMed

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

    2014-12-01

    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

  18. Drosophila as a model for intractable epilepsy: gilgamesh suppresses seizures in para(bss1) heterozygote flies.

    PubMed

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

    2013-08-01

    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 para(bss1) that resembles Dravet syndrome in some aspects (parker et al. 2011a). In particular, we identify second-site mutations that interact with para(bss1), 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 para(bss1)/+ 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

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

    PubMed Central

    Hijikata, Yasuyo; Kano, Takashi; Xi, Lu

    2009-01-01

    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

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

    PubMed Central

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

    2015-01-01

    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

  1. P-glycoprotein alters blood–brain barrier penetration of antiepileptic drugs in rats with medically intractable epilepsy

    PubMed Central

    Ma, Aimei; Wang, Cuicui; Chen, Yinghui; Yuan, Weien

    2013-01-01

    P-glycoprotein is one of the earliest known multidrug transporters and plays an important role in resistance to chemotherapeutic drugs. In this study, we detected levels of P-glycoprotein and its mRNA expression in a rat brain model of medically intractable epilepsy established by amygdala kindling and drug selection. We investigated whether inhibition of P-glycoprotein affects the concentration of antiepileptic drugs in cortical extracellular fluid. We found that levels of P-glycoprotein and its mRNA expression were upregulated in epileptic cerebral tissue compared with cerebral tissue from normal rats. The concentrations of two antiepileptic drugs, carbamazepine and phenytoin, were very low in the cortical extracellular fluid of rats with medically intractable epilepsy, and were restored after blockade of P-glycoprotein by verapamil. These results show that increased P-glycoprotein levels alter the ability of carbamazepine and phenytoin to penetrate the blood–brain barrier and reduce the concentrations of these agents in extracellular cortical fluid. High P-glycoprotein levels may be involved in resistance to antiepileptic drugs in medically intractable epilepsy. PMID:24348021

  2. Autoimmune disease and hair loss.

    PubMed

    Moghadam-Kia, Siamak; Franks, Andrew G

    2013-01-01

    Once systemic disease is in remission, it is prudent to recognize the importance of alopecia in the patient's overall sense of well-being and quality-of-life clinical outcome. Scarring alopecia (scalp discoid lupus erythematosus) can be the presenting manifestation of lupus in more than half of affected individuals. Diffuse nonscarring alopecia in lupus is usually responsive to treatment of the systemic disease. Severe, often intractable burning pruritus of the scalp is a frequent complaint in dermatomyositis. Lichen planopilaris may mimic other autoimmune forms of scarring alopecia. Alopecia can also be caused by medications used to treat systemic autoimmune disease and fibromyalgia. PMID:23159178

  3. The modified Atkins diet for intractable epilepsy may be associated with late-onset egg-induced anaphylactic reaction: A case report

    Microsoft Academic Search

    Yael Levy; Lilach Peleg-Weiss; Hadassa Goldberg-Stern

    2011-01-01

    The modified Atkins diet is a therapeutic option for children with intractable epilepsy. It is less restrictive than the traditional ketogenic diet, with ?60% of calories from fat sources. We describe a 6-y-old boy with intractable epilepsy treated with the modified Atkins diet who presented to the emergency department with first-time anaphylactic reaction to egg. Symptoms of urticaria and angioedema,

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

    PubMed Central

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

    2014-01-01

    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

  5. Alzheimer disease in the United States (2010–2050) estimated using the 2010 census

    PubMed Central

    Weuve, Jennifer; Scherr, Paul A.; Evans, Denis A.

    2013-01-01

    Objectives: To provide updated estimates of Alzheimer disease (AD) dementia prevalence in the United States from 2010 through 2050. Methods: Probabilities of AD dementia incidence were calculated from a longitudinal, population-based study including substantial numbers of both black and white participants. Incidence probabilities for single year of age, race, and level of education were calculated using weighted logistic regression and AD dementia diagnosis from 2,577 detailed clinical evaluations of 1,913 people obtained from stratified random samples of previously disease-free individuals in a population of 10,800. These were combined with US mortality, education, and new US Census Bureau estimates of current and future population to estimate current and future numbers of people with AD dementia in the United States. Results: We estimated that in 2010, there were 4.7 million individuals aged 65 years or older with AD dementia (95% confidence interval [CI] = 4.0–5.5). Of these, 0.7 million (95% CI = 0.4–0.9) were between 65 and 74 years, 2.3 million were between 75 and 84 years (95% CI = 1.7–2.9), and 1.8 million were 85 years or older (95% CI = 1.4–2.2). The total number of people with AD dementia in 2050 is projected to be 13.8 million, with 7.0 million aged 85 years or older. Conclusion: The number of people in the United States with AD dementia will increase dramatically in the next 40 years unless preventive measures are developed. PMID:23390181

  6. Employment and activity limitations among adults with chronic obstructive pulmonary disease - United States, 2013.

    PubMed

    Wheaton, Anne G; Cunningham, Timothy J; Ford, Earl S; Croft, Janet B

    2015-03-27

    Chronic obstructive pulmonary disease (COPD) is a group of progressive respiratory conditions, including emphysema and chronic bronchitis, characterized by airflow obstruction and symptoms such as shortness of breath, chronic cough, and sputum production. COPD is an important contributor to mortality and disability in the United States. Healthy People 2020 has several COPD-related objectives,* including to reduce activity limitations among adults with COPD. To assess the state-level prevalence of COPD and the association of COPD with various activity limitations among U.S. adults, CDC analyzed data from the 2013 Behavioral Risk Factor Surveillance System (BRFSS). Among U.S. adults in all 50 states, the District of Columbia (DC), and two U.S. territories, 6.4% (an estimated 15.7 million adults) had been told by a physician or other health professional that they have COPD. Adults who reported having COPD were more likely to report being unable to work (24.3% versus 5.3%), having an activity limitation caused by health problems (49.6% versus 16.9%), having difficulty walking or climbing stairs (38.4% versus 11.3%), or using special equipment to manage health problems (22.1% versus 6.7%), compared with adults without COPD. Smokers who have been diagnosed with COPD are encouraged to quit smoking, which can slow the progression of the disease and reduce mobility impairment. In addition, COPD patients should consider participation in a pulmonary rehabilitation program that combines patient education and exercise training to address barriers to physical activity, such as respiratory symptoms and muscle wasting. PMID:25811677

  7. Impact of the Metabolic Syndrome on Mortality From Coronary Heart Disease, Cardiovascular Disease, and All Causes in United States Adults

    Microsoft Academic Search

    Shaista Malik; Nathan D. Wong; Stanley S. Franklin; Tripthi V. Kamath; Gilbert J. L'Italien; Jose R. Pio; G. Rhys Williams

    2010-01-01

    Background—Mortality resulting from coronary heart disease (CHD), cardiovascular disease (CVD), and all causes in persons with diabetes and pre-existing CVD is high; however, these risks compared with those with metabolic syndrome (MetS) are unclear. We examined the impact of MetS on CHD, CVD, and overall mortality among US adults. Methods and Results—In a prospective cohort study, 6255 subjects 30 to

  8. Altered functional connectivity in early Alzheimer's disease: a resting-state fMRI study.

    PubMed

    Wang, Kun; Liang, Meng; Wang, Liang; Tian, Lixia; Zhang, Xinqing; Li, Kuncheng; Jiang, Tianzi

    2007-10-01

    Previous studies have led to the proposal that patients with Alzheimer's disease (AD) may have disturbed functional connectivity between different brain regions. Furthermore, recent resting-state functional magnetic resonance imaging (fMRI) studies have also shown that low-frequency (<0.08 Hz) fluctuations (LFF) of the blood oxygenation level-dependent signals were abnormal in several brain areas of AD patients. However, few studies have investigated disturbed LFF connectivity in AD patients. By using resting-state fMRI, this study sought to investigate the abnormal functional connectivities throughout the entire brain of early AD patients, and analyze the global distribution of these abnormalities. For this purpose, the authors divided the whole brain into 116 regions and identified abnormal connectivities by comparing the correlation coefficients of each pair. Compared with healthy controls, AD patients had decreased positive correlations between the prefrontal and parietal lobes, but increased positive correlations within the prefrontal lobe, parietal lobe, and occipital lobe. The AD patients also had decreased negative correlations (closer to zero) between two intrinsically anti-correlated networks that had previously been found in the resting brain. By using resting-state fMRI, our results supported previous studies that have reported an anterior-posterior disconnection phenomenon and increased within-lobe functional connectivity in AD patients. In addition, the results also suggest that AD may disturb the correlation/anti-correlation effect in the two intrinsically anti-correlated networks. PMID:17133390

  9. Pediatric Invasive Pneumococcal Disease in the United States in the Era of Pneumococcal Conjugate Vaccines

    PubMed Central

    2012-01-01

    Summary: Invasive infections caused by Streptococcus pneumoniae continue to be a major cause of morbidity and mortality worldwide, especially in children under 5 years of age. In the United States, 90% of invasive pneumococcal infections in children are caused by 13 serotypes of S. pneumoniae. The licensure (in 2000) and subsequent widespread use of a heptavalent pneumococcal conjugate vaccine (PCV7) have had a significant impact on decreasing the incidence of serious invasive pneumococcal disease (IPD) in all age groups, especially in children under 2 years of age. However, the emergence of replacement non-PCV7 serotypes, especially serotype 19A, has resulted in an increase in the incidence of serious and invasive infections. In 2010, a 13-valent PCV was licensed in the United States. However, the impact that this vaccine will have on IPD remains to be seen. The objectives of this review are to discuss the epidemiology of serious and invasive pneumococcal infections in the United States in the PCV era and to review some of the pneumococcal vaccines that are in development. PMID:22763632

  10. 9 CFR 53.2 - Determination of existence of disease; agreements with States.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE COOPERATIVE CONTROL AND ERADICATION OF LIVESTOCK OR POULTRY DISEASES FOOT-AND-MOUTH DISEASE, PLEUROPNEUMONIA, RINDERPEST, AND CERTAIN OTHER COMMUNICABLE DISEASES OF LIVESTOCK OR POULTRY §...

  11. [Treatment of intractable postherpetic neuralgia and blepharospasm: intraneural injection of adriamycin].

    PubMed

    Saiki, M; Kondo, A; Kinuta, Y; Iwasaki, K; Kobata, H; Hasegawa, K; Chin, M; Nakano, I; Yamamoto, T

    1995-02-01

    Adriamycin, an anthracycline antineoplastic agent, can swiftly be transported to the sensory or somatic motor neurons by way of axoplasmic transport when injected into the subepineurium of the trigeminal nerve or sciatic nerve in experimental animals, and is consequently able to induce degeneration of the neurons without any systemic side effects. Intraneural injection of this agent was carried out for the treatment of a total of 22 patients presenting with intractable neural dysfunction (12 with neuralgia, including 7 with post-herpetic neuralgia and 10 with facial dystonia). The nerve which innervated the affected site was exposed under local anesthesia and approximately 10-60 microliters of 1-20% adriamycin was injected into the subepineurium. Results of the treatment after average follow-up periods of 21.5 months were as follows: Out of 12 patients with neuralgia, good results were obtained in 2 cases (16.7%), fair results in 6 cases (50.0%) (overall effective rate 67.7%). There were no changes in symptoms in 4 cases (33.3%). Out of 10 patients with facial dystonia, good results were obtained in 2 cases (20.0%), fair in 2 cases (20.0%) (overall effective rate 40.0%), and no changes in symptoms in 6 cases (60.0%). No major complications were encountered during these procedures and, once symptoms had disappeared after the treatment, no recurrence of symptoms was experienced. This method clearly differs from other various kinds of simple peripheral neurotomy, since transection of the peripheral nerve does not cause any, destructive changes in the sensory ganglion or motor nucleus and, hence, symptoms may recur.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7877732

  12. Stem cell transplantation improves aging-related diseases.

    PubMed

    Ikehara, Susumu; Li, Ming

    2014-01-01

    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

  13. Stem cell transplantation improves aging-related diseases

    PubMed Central

    Ikehara, Susumu; Li, Ming

    2014-01-01

    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

  14. Plasma levels of some coagulation parameters in Steady State HBSC disease patients

    PubMed Central

    Ajuwon, Mauryne Debola; Olayemi, Edeghonghon; Benneh, Amma Anima

    2014-01-01

    Introduction Sickle cell disease is a collection of autosomal recessive genetic disorders. It includes homozygous HbSS and double heterozygote combinations such as HbSC. Central and West Africa bears a significant burden of HbSC disease. Methods Prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen concentration (FC) and platelet count (PC) were determined in 41HbSC and HbSS patients in steady state along with 40 apparently healthy HbAA controls. One way ANOVA test was used to compare means; p values< 0.05 were considered statistically significant. Results There was no significant difference in mean PT for the study groups (p = 0.192). Mean PC was highest in HbSS patients: 445.7 +/- 128.3 X 10 9/ L compared to HbSC: 330.0 +/- 97.7 X 10 9/ L andHbAA:245 +/- 77.7 X 10 9/ L (p= 0.000). Mean APTT was 28.1 +/- 3.8 seconds in controls,24.1 + /- 66 seconds in HbSS patients and 21.8 +/- 3.8 seconds in HbSC patients (p = 0.000). Mean FC in HbSS was 1.6 +/- 0.7 g/L, 3.2 +/- 0.6 g/L in HbSC and 2.9 +/- 0.4 g/L in HbAA (p =0.000). Conclusion A significant difference exists in PC, APTT and FC in HbSC patients compared to HbSS patients and HbAA controls. Elevated FC and shortened APTT may play a role in complications more characteristic of HbSC such as retinopathy and osteonecrosis. These suggestHbSC is not merely a milder form of HbSS; both diseases should be seen as different entities with regards to approaches for management.

  15. [Triatoma infestans in area under entomological surveillance for Chagas' disease in São Paulo State, Brazil].

    PubMed

    Leite, O F; Alves, M J; Souza, S S; Mayo, R C; Andrade, V R; Souza, C E; Rangel, O; Oliveira, S S; Lima, V L; Rodrigues, V L; Carvalho, M E; Casanova, C; Wanderley, D M

    2001-01-01

    In response to notification of the capture of a winged triatomine bug by local inhabitants, an epidemiological investigation was investigated in the rural area of the Municipality of Paulínia, São Paulo State (Brazil). This led to the collection of 109 specimens of Triatoma infestans from peridomiciliary breeding sites. Local conditions favored colonization by triatomine bugs: many abandoned outbuildings were inhabited by pigeons and sparrows, which meant abundant feed for these bugs. Thus, surveillance is mandatory as long as conditions for triatomine breeding persist. Nevertheless, entomological and serological indicators ruled out immediate concern over vectorial transmission of Chagas' disease in this municipality. All domiciliary units of the region were sprayed with residual-effect insecticides and the triatomine breeding sites were destroyed by the use of mechanical control of bird nests. The importance of reporting the occurrence of triatomine bugs, particularly Triatoma infestans, in this region, is emphasized. PMID:11600909

  16. State of the Art: Medical treatment of aspirin exacerbated respiratory disease (AERD).

    PubMed

    Ta, Von; Simon, Ronald

    2015-01-01

    Aspirin exacerbated respiratory disease (AERD) is characterized as adult onset asthma, nasal polyps, chronic rhinosinusitis, and hypersensitivity to a cyclooxygenase-1 (COX-1) inhibitor, viz aspirin or nonsteroidal antiinflammatory drugs (NSAIDs). The method for diagnosing AERD is with aspirin challenge, and treatment includes aspirin desensitization followed by continued daily aspirin. Although oral challenge has been the mainstay in the United States, lysyl-aspirin has been validated as a diagnostic tool for aspirin-sensitive asthma and will be discussed further in this article. The challenges with aspirin therapy surrounding endoscopy and perioperative aspirin therapy will be discussed. Additionally, daily aspirin therapy is not for everyone. Aspirin is relatively contraindicated in those with a history of gastrointestinal bleed and an absolute contraindication in pregnancy. Aspirin desensitization and subsequent treatment has been shown to be highly effective for AERD. PMID:25590318

  17. Cushing's disease, pseudo-Cushing states and the dexamethasone test: a historical and critical review.

    PubMed

    Lindholm, J

    2014-08-01

    The dexamethasone (DXM) test has been widely used for diagnosing Cushing's disease (CD). The purpose of this paper is to review its diagnostic merit based on calculation of data extracted from earlier publications. Studies presenting individual values for patients with CD and normal subjects were identified through PubMed searches and references in pertinent studies. Calculation of the retrieved data demonstrated huge variation in the relative suppressibility, negative suppression being common. Furthermore, in almost each study retrieved, the pre and post DXM values were closely correlated. Finally, the generally accepted view that DXM causes less suppression in Cushing's disease than in euadrenal controls appears unfounded. A central issue in the definition of so-called "pseudo-Cushing's states" is failure to suppress cortisol secretion with DXM. From analysis of the literature it appears quite possible that this does not reflect a specific endocrine deficit, but a physiological "stress" reaction. The above issues question the diagnostic value of the test, in particular in clinically and biochemically borderline cases. PMID:23979450

  18. Mediators of the association between low socioeconomic status and chronic kidney disease in the United States.

    PubMed

    Vart, Priya; Gansevoort, Ron T; Crews, Deidra C; Reijneveld, Sijmen A; Bültmann, Ute

    2015-03-15

    Using data collected from 9,823 participants in the 2007-2008 and 2009-2010 cycles of the National Health and Nutrition Examination Survey, we formally investigated potentially modifiable factors linking low socioeconomic status (SES) to chronic kidney disease (CKD) for their presence and magnitude of mediation. SES was defined using the poverty income ratio. The main outcome was CKD, defined as estimated glomerular filtration rate <60 mL/minute/1.73 m(2) (using the Chronic Kidney Disease Epidemiology Collaboration equation) and/or urinary albumin:creatinine ratio ?30 mg/g. In mediation analyses, we tested the contributions of health-related behaviors (smoking, alcohol intake, diet, physical activity, and sedentary time), comorbid conditions (diabetes, hypertension, obesity, abdominal obesity, and hypercholesterolemia), and access to health care (health insurance and routine health-care visits) to this association. Except for sedentary time and diet, all examined health-related behaviors, comorbid conditions, and factors related to health-care access mediated the low SES-CKD association and contributed 20%, 32%, and 11%, respectively, to this association. In race/ethnicity-specific analyses, identified mediators tended to explain more of the association between low SES and CKD in non-Hispanic blacks than in other racial/ethnic groups. In conclusion, potentially modifiable factors like health-related behaviors, comorbid conditions, and health-care access contribute substantially to the association between low SES and CKD in the United States, especially among non-Hispanic blacks. PMID:25731886

  19. Widespread increase of functional connectivity in Parkinson's disease with tremor: a resting-state FMRI study.

    PubMed

    Zhang, Delong; Liu, Xian; Chen, Jun; Liu, Bo; Wang, Jinhui

    2015-01-01

    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. PMID:25691867

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

    PubMed Central

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

    2013-01-01

    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

  1. Bluetongue disease and seroprevalence in South American camelids from the northwestern region of the United States.

    PubMed

    Allen, Andrew J; Stanton, James B; Evermann, James F; Fry, Lindsay M; Ackerman, Melissa G; Barrington, George M

    2015-03-01

    In late summer/early fall of 2013, 2 South American camelids from central Washington were diagnosed with fatal bluetongue viral disease, an event which is rarely reported. A 9-year-old intact male llama (Lama glama), with a 1-day history of anorexia, recumbency, and dyspnea before death. Abundant foam discharged from the mouth and nostrils, and the lungs were severely edematous on postmortem examination. Histologically, there was abundant intra-alveolar edema with fibrin. Hemorrhage and edema disrupted several other organs. Bluetongue viral RNA was detected by reverse transcription polymerase chain reaction (RT-PCR), and serotype 11 was identified by sequencing a segment of the VP2 outer capsid gene. Approximately 1 month later, at a site 150 miles north of the index case, a 2-year-old female alpaca with similar, acutely progressive clinical signs was reported. A postmortem examination was performed, and histologic lesions from the alpaca were similar to those of the llama, and again serotype 11 was detected by PCR. The occurrence of bluetongue viral infection and disease is described in the context of seasonal Bluetongue virus activity within the northwestern United States and southwestern Canada. PMID:25680921

  2. Procoagulatory State in Inflammatory Bowel Diseases Is Promoted by Impaired Intestinal Barrier Function

    PubMed Central

    Dozio, Elena; Boscolo-Anzoletti, Massimo; Vianello, Elena; Munizio, Nadia; Spina, Luisa; Tontini, Gian Eugenio; Corsi Romanelli, Massimiliano Marco; Vecchi, Maurizio

    2015-01-01

    Inflammatory and immune mediated disorders are risk factors for arterial and venous thromboembolism. Inflammatory bowel diseases (IBD) confer an even greater risk of thromboembolic events than other inflammatory conditions. It has been shown that IBD patients display defective intestinal barrier functions. Thus, pathogen-associated molecular patterns (PAMPs) coming from the intestinal bacterial burden might reach systemic circulation and activate innate immunity receptors on endothelial cells and platelets, promoting a procoagulative state. Aim of the study was to test this hypothesis, correlating the presence of circulating PAMPs with the activation of innate immune system and the activation of the coagulatory cascade in IBD patients. Specifically, we studied lipopolysaccharide (LPS), Toll-like receptor (TLR) 2, TLR4, and markers of activated coagulation (i.e., D-Dimer and prothrombin fragment F1+2) in the serum and plasma of IBD patients. We found that LPS levels are increased in IBD and correlate with TLR4 concentrations; although a mild correlation between LPS and CRP levels was detected, clinical disease activity does not appear to influence circulating LPS. Instead, serum LPS correlates with both D-Dimer and F1+2 measurements. Taken together, our data support the role of an impairment of intestinal barrier in triggering the activation of the coagulatory cascade in IBD.

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

    PubMed Central

    Wechalekar, Mihir D; Smith, Malcolm D

    2014-01-01

    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

  4. Retrosigmoid approach for vestibular neurectomy in Meniere’s disease

    Microsoft Academic Search

    R. Perez; A. Ducati; D. Garbossa; F. Benech; M. M. Fontanella; A. Canale; R. Albera

    2005-01-01

    Summary Background. Vestibular nerve section is considered to be the most effective surgical procedure to control intractable symptoms secondary to Menière’s disease (MD). This study was developed to analyze the adequacy of retrosigmoid vestibular neurectomy in terms of vertigo control, hearing preservation and clinical complications of this procedure.

  5. Progressive Neuronal Degeneration of Childhood (PNDC) with Liver Disease

    Microsoft Academic Search

    J. Egger; B. N. Harding; S. G. Boyd; J. Wilson; M. Erdohazi

    1987-01-01

    Thirteen children with progressive neuronal degeneration and liver disease are reported. Clinical features included developmental delay after a normal initial period with later onset of intractable epilepsy. The EEG showed an unusual but characteristic pattern, and visual evoked responses (VER) were abnormal. Rapidly progressive cerebral atrophy was seen on computerized axial tomography (CAT). Inheritance was consistent with an autosomal recessive

  6. Mortality impact of thoracic aortic disease in São Paulo state from 1998 to 2007

    PubMed Central

    Dias, Ricardo Ribeiro; Mejia, Omar Asdrubal Vilca; Fernandes, Fábio; Ramires, Félix José Alvarez; Mady, Charles; Stolf, Noedir Antonio Groppo; Jatene, Fabio Biscegli

    2013-01-01

    Background The epidemiological characteristics of thoracic aortic diseases (TAD) in the State of São Paulo and in Brazil, as well as their impact on the survival of these patients have yet to be analyzed. Objectives To evaluate the mortality impact of TAD and characterize it epidemiologically. Methods Retrospective analysis of data from the public health system for the TAD registry codes of hospitalizations, procedures and deaths, from the International Code of Diseases (ICD-10), registered at the Ministry of Health of São Paulo State from January 1998 to December 2007. Results They were 9.465 TAD deaths, 5.500 men (58.1%) and 3.965 women (41.9%); 6.721 dissections (71%) and 2.744. aneurysms. In 86.3% of cases the diagnosis was attained during autopsy. There were 6.109 hospitalizations, of which 67.9% were males; 21.2% of them died (69% men), with similar proportions of dissection and aneurysm between sexes, respectively 54% and 46%, but with different mortality. Men with TAD die more often than women (OR = 1.5). The age distribution for deaths and hospitalizations was similar with predominance in the 6th decade. They were 3.572 surgeries (58% of hospitalizations) with 20.3% mortality (patients kept in clinical treatment showed 22.6% mortality; p = 0.047). The number of hospitalizations, surgeries, deaths of in-patients and general deaths by TAD were progressively greater than the increase in population over time. Conclusions Specific actions for the early identification of these patients, as well as the viability of their care should be implemented to reduce the apparent progressive mortality from TAD seen among our population. PMID:24100695

  7. Evolutionary dynamics and spatial genetic structure of epizootic hemorrhagic disease virus in the eastern United States.

    PubMed

    Biek, Roman

    2007-09-01

    Epizootic hemorrhagic disease virus (EHDV) is a significant pathogen of wild and domestic ungulates worldwide. In North America, serotype EHDV-2 is responsible for the majority of outbreaks, which are most commonly observed in white-tailed deer. A recent study by Murphy et al. [Murphy, M.D., Howerth, E.W., MacLachlan, N.J., Stallknecht, D.E., 2005. Genetic variation among epizootic hemorrhagic disease viruses in the southeastern United States: 1978-2001. Infect. Genet. Evol. 5, 157-165] examined the genetic relationships of EHDV-2 sequences from outbreaks across the eastern United States for evidence of temporal and spatial structure but found no evidence for either. Here, I present results of further examination of the same data using additional types of analysis. Contrary to the earlier assessment, I find that for outbreaks observed within the same year, genetic and spatial distances are in fact positively correlated and that the virus is evolving at a rate similar to that seen in other vector-born RNA viruses. Estimates of demographic history further revealed that population sizes of the virus had remained relatively stable over most of its history. A noticeable exception to this trend was a recent demographic bottleneck, possibly associated with a selective sweep, that affected one of the two viral genes examined. These results demonstrate that genetic variation accumulating at selectively neutral and measurably evolving sites in the EHDV-2 genome can be employed to gain insights into the spatial and temporal dynamics of this viral pathogen. PMID:17543590

  8. Stem cell therapy for inflammatory bowel disease.

    PubMed

    Nagaishi, Kanna; Arimura, Yoshiaki; Fujimiya, Mineko

    2015-03-01

    Inflammatory bowel disease (IBD) could be curable by "immune rest" and correction of the genetic predisposition inherent in allogeneic hematopoietic stem cell transplantation. However, balancing risks against benefits remains challenging. The application of mesenchymal stem cells (MSCs) serving as a site-regulated "drugstore" is a recent concept, which suggests the possibility of an alternative treatment for many intractable diseases such as IBD. Depending on the required function of MSC, such as a cell provider, immune moderator, and/or trophic resource, MSC therapy should be optimized to maximize its therapeutic benefit. Therapeutic effects do not always require full engraftment of MSCs. Therefore, optimization of pleiotropic gut trophic factors produced by MSCs, which favoring not only regulating immune responses but also promoting tissue repair, must directly enhance new drug discoveries for treatment of IBD. Stem cell biology holds great promise for a new era of cell-based therapy, sparking considerable interest among scientists, clinicians, and patients. However, the translational arm of stem cell science remains in a relatively primitive state. Although several clinical studies using MSCs have been initiated, early results suggest several inherent problems. In each study, optimization of MSC therapy appears to be the most urgent problem, and can be resolved only by scientifically unveiling the mechanisms of therapeutic action. In the present review, the authors outline how such information would facilitate the critical steps in the paradigm shift from basic research on stem cell biology to clinical practice of regenerative medicine for conquering IBD in the near future. PMID:25618180

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

    PubMed Central

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

    2001-01-01

    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

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

    PubMed Central

    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

    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

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

    PubMed Central

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

    2003-01-01

    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

  12. Mad cow disease in the United States: an update on bovine spongiform encephalopathy and variant Creutzfeldt-Jakob disease

    Microsoft Academic Search

    Karin E Finberg

    2004-01-01

    Classified among the transmissible spongiform encephalopathies, bovine spongiform encephalopathy (BSE) and variant Creutzfeldt-Jakob disease (vCJD), are neurodegenerative conditions associated with the accumulation of an abnormal protein called PrP. Both conditions are thought to result from a novel type of infection that is mediated by a protein agent rather than a nucleic acid-containing particle. Amplified by the practice of feeding infected

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

    NASA Astrophysics Data System (ADS)

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

    2011-08-01

    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.

  14. Estimating Influenza Disease Burden from Population-Based Surveillance Data in the United States

    PubMed Central

    Reed, Carrie; Chaves, Sandra S.; Daily Kirley, Pam; Emerson, Ruth; Aragon, Deborah; Hancock, Emily B.; Butler, Lisa; Baumbach, Joan; Hollick, Gary; Bennett, Nancy M.; Laidler, Matthew R.; Thomas, Ann; Meltzer, Martin I.; Finelli, Lyn

    2015-01-01

    Annual estimates of the influenza disease burden provide information to evaluate programs and allocate resources. We used a multiplier method with routine population-based surveillance data on influenza hospitalization in the United States to correct for under-reporting and estimate the burden of influenza for seasons after the 2009 pandemic. Five sites of the Influenza Hospitalization Surveillance Network (FluSurv-NET) collected data on the frequency and sensitivity of influenza testing during two seasons to estimate under-detection. Population-based rates of influenza-associated hospitalization and Intensive Care Unit admission from 2010–2013 were extrapolated to the U.S. population from FluSurv-NET and corrected for under-detection. Influenza deaths were calculated using a ratio of deaths to hospitalizations. We estimated that influenza-related hospitalizations were under-detected during 2010-11 by a factor of 2.1 (95%CI 1.7–2.9) for age < 18 years, 3.1 (2.4–4.5) for ages 18-64 years, and 5.2 (95%CI 3.8–8.3) for age 65+. Results were similar in 2011-12. Extrapolated estimates for 3 seasons from 2010–2013 included: 114,192–624,435 hospitalizations, 18,491–95,390 ICU admissions, and 4,915–27,174 deaths per year; 54–70% of hospitalizations and 71–85% of deaths occurred among adults aged 65+. Influenza causes a substantial disease burden in the U.S. that varies by age and season. Periodic estimation of multipliers across multiple sites and age groups improves our understanding of influenza detection in sentinel surveillance systems. Adjusting surveillance data using a multiplier method is a relatively simple means to estimate the impact of influenza and the subsequent value of interventions to prevent influenza. PMID:25738736

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

    PubMed Central

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

    2014-01-01

    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

  16. Verbal Mistreatment in Older Adults: A Look at Persons with Alzheimer's Disease and Their Caregivers in the State of Florida

    Microsoft Academic Search

    Carla Vande Weerd; Gregory J. Paveza

    2006-01-01

    Purpose. This study examined verbal aggression in a sample of community dwelling older adults with Alzheimer's Disease (AD) using the Risk and Vulnerability model as a means for identifying factors associated with verbal mistreatment in caregiver\\/patient dyads.Design and Methods. Subjects were recruited in the State of Florida through their association with state-funded memory disorder clinics or with local chapters of

  17. Effects of alcohol taxes on alcohol-related disease mortality in New York State from 1969 to 2006

    PubMed Central

    Delcher, Chris; Maldonado-Molina, Mildred M.; Wagenaar, Alexander C.

    2013-01-01

    Objective The relationship of increased alcohol taxes to reductions in alcohol-related harm is well established. Few studies, however, have examined the effects of sudden decreases in alcohol tax rates or effects of narrow tax changes limited to specific beverage types. In the current study, we: (1) examine whether tax increases on spirits have similar effects in reducing alcohol-related disease mortality as increasing taxes on all types of alcoholic beverages simultaneously, and (2) evaluate effects of beer-specific tax decreases in New York State on mortality. Method We used a time-series, quasi-experimental research design, including non-alcohol deaths within New York State and other states’ rates of alcohol-related disease mortality for comparison. The dataset included 456 monthly observations of mortality in New York State over a 38-year period (1969–2006). We used a random-effects approach and included several other important covariates. Results Alcohol-related disease mortality declined by 7.0% after a 1990 tax increase for spirits and beer. A spirits-only tax increase (in 1972) was not significantly associated with mortality but a data anomaly increased error in this effect estimate. Small tax decreases on beer between 1996 and 2006 had no measurable effect on mortality. Doubling the beer tax from $0.11 to $0.22 per gallon, a return to New York State’s 1990 levels, would decrease deaths by an estimated 250 deaths per year. Conclusions Excise tax increases on beer and spirits were associated with reductions in alcohol-related disease mortality. Modifying tax rates on a single beverage type does not appear to be as effective as doing so on multiple alcoholic beverages simultaneously. In New York, small decreases in beer taxes were not significantly associated with alcohol-related disease mortality. PMID:22436591

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

    PubMed Central

    Price, James H.; Braun, Robert

    2013-01-01

    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

  19. 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

    2013-01-01

    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

  20. 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...

  1. Essays on Modeling the Economic Impacts of a Foreign Animal Disease on the United States Agricultural Sector

    E-print Network

    Hagerman, Amy Deann

    2011-02-22

    to 2001 (NAO) ............................ 10 Figure 3: FMD Events Reported in 2001 (WAHID, 2008) ........................................... 10 Figure 4: Illustration Depicting the Model States and Pathways for Progression of FMD... Page Figure 19: Basic FASOM Modeling Structure and Disease Shock Imposition .............. 58 Figure 20: International Market Regions in ASM .......................................................... 59 Figure 21: ASM Beef Cattle Flow Chart...

  2. 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...

  3. Changes in hippocampal connectivity in the early stages of Alzheimer's disease: Evidence from resting state fMRI

    Microsoft Academic Search

    Liang Wang; Yufeng Zang; Yong He; Meng Liang; Xinqing Zhang; Lixia Tian; Tao Wu; Tianzi Jiang; Kuncheng Li

    2006-01-01

    A selective distribution of Alzheimer's disease (AD) pathological lesions in specific cortical layers isolates the hippocampus from the rest of the brain. However, functional connectivity between the hippocampus and other brain regions remains unclear in AD. Here, we employ a resting state functional MRI (fMRI) to examine changes in hippocampal connectivity comparing 13 patients with mild AD versus 13 healthy

  4. 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...

  5. First report of zebra chip disease and Candidatus Liberibacter solanacearum on potatoes in Oregon and Washington State

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In August of 2011, potato (Solanum tuberosum) tubers grown in the lower Columbia Basin of southern Washington State and northern Oregon were observed with internal discolorations suggestive of the zebra chip disease (ZC). Symptoms included brown spots, streaks, and stripes in and near the vascular ...

  6. HIV association with conventional STDS (sexual transmitted diseases) in Lagos State, Nigeria.

    PubMed

    Otuonye, N M; Olukoya, D K; Odunukwe, N N; Idigbe, E O; Udeaja, M N; Bamidele, M; Onyewuchie, J I; Oparaugu, C T; Ayelari, O S; Oyekunle, B

    2002-01-01

    The study examined a possible association between HIV infection and conventional sexually transmitted diseases (STDS) in a population of 700 patients seen in some hospitals and clinics in Lagos State between November 1997 and December 1999. The patients were drawn mainly from LUTH and Jolad hospitals in Lagos State. In these hospitals, patients who presented with symptoms of STDS were screened clinically and microbiologically for agents of STDS and HIV antibodies. Screening was carried out using conventional methods. A total of 150 (21.5%) were found positive for various STDS while 550 (78.5%) were negative Also, 109 (15.8%) were sero-positive for HIV while 591 (84.4%) were sero-negative. The frequency of STDS diagnosed were, Treponema pallidum, 38(25.3%), Neisseria gonorrhoea 3(2.0%), Chlamydia trachomatis 26(17.3), Hepatitis B virus 60(40.0%) Staphylococcus aureaus, 20 (13.3%) and Candida albicans 3(2.0%). Data showed that Syphillis was the most prevalent STDS diagnosed while Calbicans and N. gonorrhoea are the least. Amongst the 150 (21.5%) patients positive with STDS, 82(54.65%) were found to be positive for HIV antibodies. The remaining 68(45.3%) patients were negative for HIV. The difference in sero-prevalence on the true group of patients rates was significant. The higher rate in the STDS patients strongly suggest some association between HIV infections andSTDS amongst the patients studied p = 0.05. It was also recorded that HIV-1 infection is four times more prevalent than HIV-2 in these patients. PMID:12403041

  7. NEW YORK STATE DEPARTMENT OF HEALTH Bureau of Communicable Disease Control

    E-print Network

    Suzuki, Masatsugu

    or meninges (a thin lining covering the brain and spinal cord) caused by the meningococcus germ. Who gets meningococcal disease? Anyone can get meningococcal disease, but it is more common in infants and children disease. Should people who have been in contact with a diagnosed case of meningococcal meningitis

  8. Parameterizing state–space models for infectious disease dynamics by generalized profiling: measles in Ontario

    PubMed Central

    Hooker, Giles; Ellner, Stephen P.; Roditi, Laura De Vargas; Earn, David J. D.

    2011-01-01

    Parameter estimation for infectious disease models is important for basic understanding (e.g. to identify major transmission pathways), for forecasting emerging epidemics, and for designing control measures. Differential equation models are often used, but statistical inference for differential equations suffers from numerical challenges and poor agreement between observational data and deterministic models. Accounting for these departures via stochastic model terms requires full specification of the probabilistic dynamics, and computationally demanding estimation methods. Here, we demonstrate the utility of an alternative approach, generalized profiling, which provides robustness to violations of a deterministic model without needing to specify a complete probabilistic model. We introduce novel means for estimating the robustness parameters and for statistical inference in this framework. The methods are applied to a model for pre-vaccination measles incidence in Ontario, and we demonstrate the statistical validity of our inference through extensive simulation. The results confirm that school term versus summer drives seasonality of transmission, but we find no effects of short school breaks and the estimated basic reproductive ratio ?0 greatly exceeds previous estimates. The approach applies naturally to any system for which candidate differential equations are available, and avoids many challenges that have limited Monte Carlo inference for state–space models. PMID:21084339

  9. Oral immunotherapy for allergic diseases using transgenic rice seeds: current state and future prospects.

    PubMed

    Saeki, Mayumi; Nishimura, Tomoe; Kaminuma, Osamu; Mori, Akio; Hiroi, Takachika

    2013-01-01

    Allergen-specific immunotherapy (IT) has been shown to provide clinical benefit for patients with allergic diseases. At present, subcutaneous and sublingual ITs are mainly authorized for clinical treatment. Oral administration of allergens seems to be the easiest way to achieve IT, though it has yet to be translated to the clinical setting, mainly due to the requirement of a large amount of allergens. Plants, especially rice seeds, have recently been recognized as superior allergen carriers for oral administration, because of their high productivity, stability and safety. Therefore, in order to establish clinically applicable oral IT, we have been developing transgenic rice seeds (Tg rice), in which major epitopes of cedar pollen allergens or house-dust mites (HDM) are expressed. The efficacy of this orally administered Tg rice was confirmed in murine models of allergic rhinitis and bronchial asthma. In the safety study of the Tg rice, no adverse effects on cynomolgus macaques were observed. In this review, we summarized the current state and future prospects of allergen-specific IT, focusing particularly on oral IT with allergen-expressing Tg rice. PMID:23711869

  10. Total antioxidants status and some hematological values in sickle cell disease patients in steady state.

    PubMed Central

    Fasola, Foluke; Adedapo, Kayode; Anetor, John; Kuti, Modupe

    2007-01-01

    Congenital hemoglobin mutations may alter the delicate balance of free-radical generation and antioxidant defense systems in the red cell. Oxidative stress may thus play a role in the pathophysiology of the clinical manifestations of the disease. We assessed the total antioxidant status in steady-state sickle cell anemia (SCA) patients and related it to certain hematological parameters and their recent clinical history. Forty (25 males/15 females) adult SCA patients and 30 age-matched controls were studied. All patients and control subjects had total antioxidant status (TAS), hematocrit, white blood cells, platelets and reticulocyte count done. The results showed that TAS levels were about 50% lower in the SCA patients compared with the controls. Among the SCA patients, 57.1% of those with TAS levels <1.00 mmol/L had bone pain crisis >3 times in the past year, compared with 16% in those with TAS levels >1.00 mmol/L. Total leukocyte count and platelets were also significantly higher in the SCA patients than controls. Our data support the growing evidence that oxidative stress has a role to play in the pathophysiology of SCA and intervention aimed at increasing the antioxidant capacity of these patients may be beneficial. PMID:17722666

  11. Molecular characterization of penicillin-resistant Streptococcus pneumoniae isolates causing respiratory disease in the United States.

    PubMed

    Corso, A; Severina, E P; Petruk, V F; Mauriz, Y R; Tomasz, A

    1998-01-01

    Three hundred twenty-eight (328) penicillin-resistant Streptococcus pneumoniae isolates collected in 39 states of the United States between October, 1996, and March, 1997, from (mostly adult) patients with respiratory disease were characterized by microbiological, serological, and molecular fingerprinting techniques, including determination of chromosomal macrorestriction pattern with pulsed-field gel electrophoresis (PFGE) and hybridization with DNA probes specific for various antibiotic resistance genes. The overwhelming majority of the isolates were in five serogroups (23, 6, 19, 9, 14). All isolates had penicillin MIC values of at least 2 microg/ml, but the collection also included isolates with MIC values as high as 16 microg/ml. Virtually all isolates (96.6%) were resistant to trimethoprim/sulfamethoxazole (SXT) and many isolates were also resistant to chloramphenicol (43%), tetracycline (55%), and erythromycin (65%). Resistance to levofloxacin was extremely rare. The molecular fingerprinting methods showed that a surprisingly large proportion (167 out of 328, or 50.9%) of the isolates belonged to two international epidemic clones of S. pneumoniae: clone A (127, or 38.7%) with properties indistinguishable from that of the 23F multiresistant "Spanish/USA" clone widely spread in Europe, Asia, Latin America, and South Africa, and clone B (40, or 12.2%) belonging to the "French" serogroup 9/14 clone widely spread in Europe and South America. Virtually all members of clone A were also resistant to chloramphenicol (cat+), tetracycline (tetM+), and SXT, and about 75% were also resistant to erythromycin (mefE+ or ermB+). Close to 30% (39 out of 127) of the clone A isolates expressed anomalous serotypes (primarily serotypes 19 and 14, and nontypable) and most likely represented spontaneous capsular transformants. Most of the 40 isolates (35/40) belonging to clone B expressed serotype 9, with five of the isolates expressing serotypes 14 or 19, or were nontypable. All members of this clone were resistant to penicillin and SXT with only occasional isolates showing resistance to macrolides, tetracycline, and chloramphenicol. The combination of microbiological tests and DNA hybridizations also allowed the identification of unusual strains, for instance, isolates that reacted with the tetM or mefE DNA probes without showing phenotypic antibiotic resistance, an isolate showing phenotypic macrolide resistance without hybridizing with either the ermB or mefE DNA probes, or isolates that hybridized with both of these DNA probes. In addition to clones A and B, another large portion of the S. pneumoniae isolates (112 of 328, or 34.1%) was represented by eight clusters, each with a unique PFGE type. These clusters, together with the clone A and clone B isolates, made up 85% of all the penicillin-resistant isolates identified in this survey in the United States. Both international clones and the unique clusters showed wide geographic dispersal: Clone A was present in 30 of the 39 states and clone B in 18. The data suggest that the major mode of spread of penicillin-resistant pneumococci in the United States is by clonal expansion and that the most significant components (clones A and B) have been imported into the United States from abroad. PMID:9988052

  12. Herpes Virus and Ménière’s Disease

    Microsoft Academic Search

    M. Gärtner; W. Bossart; T. Linder

    2008-01-01

    Objective: The main goal of this study was to examine the vestibular ganglia from patients with intractable classic Ménière’s disease (MD) for the presence or absence of DNA from three neurotropic viruses herpes simplex virus 1 and 2 (HSV1, HSV2) and varicella zoster virus (VZV) and to investigate the hypothesis that MD is associated with virus reactivation within Scarpa’s ganglion.

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

    PubMed Central

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

    2015-01-01

    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

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

    PubMed

    Stone, Jonathan; Matchett, Gerald

    2014-01-01

    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

  15. Neuroimaging and electroencephalographic changes after vagus nerve stimulation in a boy with medically intractable myoclonic astatic epilepsy.

    PubMed

    Fan, Pi-Chuan; Peng, Steven Shinn-Forng; Yen, Ruoh-Fang; Shieh, Jeng-Yi; Kuo, Meng-Fai

    2014-04-01

    Myoclonic astatic epilepsy (MAE) is characterized by multiple seizure types, which are often refractory. Although vagus nerve stimulation (VNS) is an alternative treatment for medically intractable seizures, its exact mechanism of action remains unclear. Herein, we report the case of a 4-year-old boy with intractable MAE who has been in a seizure-free status for 2 years and 3 months since 6 months after the implantation of a vagus nerve stimulator (Model 103, Cyberonics, Inc., Houston, TX). Various test results 6 months after VNS were compared with those before VNS. Results of an electroencephalograph revealed disappearance of epileptiform discharges and an increased beta-gamma spectrum rhythm. The brain diffusion-tensor imaging showed an increased ratio of fraction anisotropy in the right fimbria-fornix, indicating improved diffusion of the white matter tract, and (18)F-fluorodeoxyglucose positron emission tomography revealed globally improved cerebral glucose metabolism. His cognitive and social-emotional performances also improved at 2 years after VNS. To the best of our knowledge, this is the first report to describe the effects of VNS on fimbria-fornix and glucose metabolism in MAE. PMID:23643463

  16. Percutaneous endoscopic gastrojejunostomy for a patient with an intractable small bowel injury after repeat surgeries: a case report

    PubMed Central

    2011-01-01

    Introduction The management of intestinal injury can be challenging, because of the intractable nature of the condition. Surgical treatment for patients with severe adhesions sometimes results in further intestinal injury. We report a conservative management strategy using percutaneous endoscopic gastrojejunostomy for an intractable small bowel surgical injury after repeated surgeries. Case presentation A 78-year-old Japanese woman had undergone several abdominal surgeries including urinary cystectomy for bladder cancer. After this operation, she developed peritonitis as a result of a small bowel perforation thought to be due to an injury sustained during the operation, with signs consistent with systemic inflammatory response syndrome: body temperature 38.5°C, heart rate 92 beats/minute, respiratory rate 23 breaths/minute, white blood cell count 11.7 × 109/L (normal range 4-11 × 109/?L). Two further surgical interventions failed to control the leak, and our patient's clinical condition and nutritional status continued to deteriorate. We then performed percutaneous endoscopic gastrojejunostomy, and continuous suction was applied as an alternative to a third surgical intervention. With this endoscopic intervention, the intestinal leak gradually closed and oral feeding became possible. Conclusion We suggest that the technique of percutaneous endoscopic gastrojejunostomy combined with a somatostatin analog is a feasible alternative to surgical treatment for small bowel leakage, and is less invasive than a nasojejunal tube. PMID:21310033

  17. A simplified approach for evaluating multiple test outcomes and multiple disease states in relation to the exercise thallium-201 stress test in suspected coronary artery disease

    SciTech Connect

    Pollock, S.G.; Watson, D.D.; Gibson, R.S.; Beller, G.A.; Kaul, S. (Univ. of Virginia School of Medicine, Charlottesville (USA))

    1989-09-01

    This study describes a simplified approach for the interpretation of electrocardiographic and thallium-201 imaging data derived from the same patient during exercise. The 383 patients in this study had also undergone selective coronary arteriography within 3 months of the exercise test. This matrix approach allows for multiple test outcomes (both tests positive, both negative, 1 test positive and 1 negative) and multiple disease states (no coronary artery disease vs 1-vessel vs multivessel coronary artery disease). Because this approach analyzes the results of 2 test outcomes simultaneously rather than serially, it also negates the lack of test independence, if such an effect is present. It is also demonstrated that ST-segment depression on the electrocardiogram and defects on initial thallium-201 images provide conditionally independent information regarding the presence of coronary artery disease in patients without prior myocardial infarction. In contrast, ST-segment depression on the electrocardiogram and redistribution on the delayed thallium-201 images may not provide totally independent information regarding the presence of exercise-induced ischemia in patients with or without myocardial infarction.

  18. Exploring Very Large State Spaces Using Genetic Algorithms

    E-print Network

    Khurshid, Sarfraz

    Exploring Very Large State Spaces Using Genetic Algorithms Patrice Godefroid1 and Sarfraz Khurshid2 this frame- work in conjunction with VeriSoft, a tool for exploring the state spaces of software applications, thereby mak- ing exhaustive state-space exploration intractable. Several approaches have been proposed

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

    E-print Network

    Keil, David M.

    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

  20. Will our final years be golden? Mortality by Alzheimer's disease in the United States

    E-print Network

    Davis, Mary Ann

    2007-09-17

    mortality by AD. Many demographers (Rogers et al.1987, Rogers et al. 1996, Rogers et al. 2000, Rogers et al. 2005 and Schoenborn, 1986) have addressed the effects of social demographic factors such as education, income, ethnicity, social class, medical... to 1930. During the third stage mortality declined due to medical advances in the prevention and treatment of infectious diseases. The remaining causes of mortality are the chronic degenerative diseases, heart disease, cancer and stroke. During...

  1. 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

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

    2013-01-01

    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

  2. Quantitative Network Measures as Biomarkers for Classifying Prostate Cancer Disease States: A Systems Approach to Diagnostic Biomarkers

    PubMed Central

    Dehmer, Matthias; Mueller, Laurin A. J.; Emmert-Streib, Frank

    2013-01-01

    Identifying diagnostic biomarkers based on genomic features for an accurate disease classification is a problem of great importance for both, basic medical research and clinical practice. In this paper, we introduce quantitative network measures as structural biomarkers and investigate their ability for classifying disease states inferred from gene expression data from prostate cancer. We demonstrate the utility of our approach by using eigenvalue and entropy-based graph invariants and compare the results with a conventional biomarker analysis of the underlying gene expression data. PMID:24236006

  3. Utility of infectious disease coding sheets for surveillance in a state medical examiner's office.

    PubMed

    Lathrop, Sarah L; Paul, Ian D; Schwartz, Michael H; Nolte, Kurt B

    2008-07-01

    Medical examiners are often first to recognize unusual occurrences of fatal infectious diseases. Recognition of these deaths allows public health officials to institute appropriate public health measures. Therefore, we developed a simple method of identifying and tracking infectious disease deaths in a statewide medical examiner's office. One-page infectious disease forms were completed for 1566/1949 autopsies (80%) performed at the New Mexico Office of the Medical Investigator in 2004. In 241 cases one infectious disease was identified at autopsy and 58 cases had two infectious diseases. Fourteen of the infectious-diseases caused deaths involved diseases that are notifiable conditions in New Mexico. Pneumonia was the most commonly reported infectious process (47 deaths) followed by sepsis (25 deaths). Tracking infectious disease deaths highlighted the importance of recognizing these deaths, although hand-written entries were unstandardized. Preferably, a tracking system would be built into electronic databases at medical examiner and coroner's offices, expediting the identification of these diseases and contact of public health agencies. PMID:18544116

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

    PubMed

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

    2015-01-01

    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. PMID:25164875

  5. 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

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

    2013-01-01

    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

  6. Veterans and Risk of Heart Disease in the United States: A Cohort with 20 Years of Follow Up

    PubMed Central

    Assari, Shervin

    2014-01-01

    Background: The aim of the current study was twofold: To investigate the effect of veteran status on risk of developing heart disease over a period of 20 years in the United States and to test if socio-economic characteristics, chronic conditions, health behaviors, body mass index (BMI) and depressive symptoms explain the association between veteran status and risk of heart disease. Methods: Data came from the Health and Retirement Study, a 20 year national cohort from 1992 to 2012. The study enrolled a representative sample of Americans over the age of 50. We included 8,375 individuals who were older than 50 years at entry, did not have heart disease at baseline and provided data on heart disease over the next 20 years. Veteran status was considered to be the independent variable. Self-reported data on physician diagnosis of heart disease, which was measured on a biannual basis, was the outcome. Baseline socio-economic data (i.e. age, gender, race, marital status and education), chronic conditions (diabetes and hypertension), health behaviors (i.e. drinking, smoking, and exercise), BMI and depressive symptoms (modified Center for Epidemiologic Studies Depression Scale) were entered into logistic regressions. Logistic regression was used for data analysis. Results: Veterans were at higher risk of having a new onset of heart disease (unadjusted relative risk [RR] = 1.996, 95% confidence interval [CI] =1.694-2.351), compared with non-veterans. Logistic regression confirmed the association between veteran status and heart disease (adjusted RR = 1.483, 95% CI = 1.176-1.871) after controlling for all covariates. Conclusions: Veterans may be at higher risk for heart disease over time and this link may be independent of baseline socio-economic characteristics, chronic medical conditions, health behaviors, BMI and depressive symptoms. Veterans may require more rigorous cardiovascular prevention programs. PMID:25013689

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

    PubMed Central

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

    2012-01-01

    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

  8. 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...

  9. Phytoplasmas Diseases and Insect Vectors in Potatoes of the Pacific Northwest of the United States

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Potato growers in the Columbia Basin of Washington and Oregon experienced an outbreak of the potato purple top disease in the 2002 growing season. This outbreak caused significant yield losses and reduced tuber quality. The disease was also observed during ensuing years, especially in potato fields ...

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

    PubMed

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

    2010-02-01

    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

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

    Microsoft Academic Search

    HB el-Serag; A Sonnenberg

    1997-01-01

    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

  12. Prevention of autoimmune rheumatic disease: state of the art and future perspectives

    Microsoft Academic Search

    Lars Klareskog; Peter K Gregersen; Tom W J Huizinga

    2010-01-01

    Prevention of disease can in principle be accomplished by identification of environmental and\\/or lifestyle risk and protective factors followed by public health measures (such as for smoking and lung cancer), or by modification of the individual's reactions to disease-inducing factors (such as in vaccinations against microbes). This review discusses both options based on emerging understanding of aetiologies in inflammatory rheumatic

  13. Coronary heart disease

    MedlinePLUS

    Heart disease, Coronary heart disease, Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD ... Coronary heart disease (CHD) is the leading cause of death in the United States for men and women. Coronary ...

  14. Complement regulator factor H as a serum biomarker of multiple sclerosis disease state.

    PubMed

    Ingram, Gillian; Hakobyan, Svetlana; Hirst, Claire L; Harris, Claire L; Pickersgill, Trevor P; Cossburn, Mark D; Loveless, Sam; Robertson, Neil P; Morgan, Bryan Paul

    2010-06-01

    Multiple sclerosis has a variable phenotypic presentation and subsequent disease course that, although unpredictable at disease onset, is of crucial importance in guiding interventions. Effective and accessible biomarkers are required in order to stratify patients and inform treatment. We examined whether the complement regulator factor H and its Tyr402His polymorphism, recently implicated as biomarkers in other chronic inflammatory central nervous system conditions, might identify or predict specific pathological processes and outcomes in multiple sclerosis. Employing novel assays, we measured factor H and its His402 variant in serum from 350 patients with multiple sclerosis classified according to disease course and relapse status. Serum factor H levels were significantly higher in progressive disease (P < 0.001) compared to controls and relapsing patients, after controlling for variables including disease duration, age, gender, disability and treatment. Serum factor H levels were capable of distinguishing secondary progressive from relapsing remitting disease (excluding patients in clinical relapse) with a sensitivity of 89.41%, specificity of 69.47% and a positive predictive value of 72.38%. Acute relapse was also associated with transiently increased factor H levels (P = 0.009) compared to stable relapsing disease. In clinically stable patients, factor H levels remained constant over 1 year (coefficient of variation percentage = 6.8), however, in patients in transition from relapsing to progressive disease, factor H levels significantly increased over a period of 2 years (P = 0.007). Concentration of the His402 variant in heterozytgotes was significantly higher in secondary progressive (P < 0.01) and primary progressive (P < 0.05) disease, suggesting altered expression or consumption of variants when factor H is upregulated. Serum factor H may be an effective indicator of progression and a practical and accessible biomarker and stratifying tool in determining disease course, providing objective evidence to help guide therapeutic decisions. PMID:20421219

  15. Bacterial inclusion bodies of Alzheimer's disease ?-amyloid peptides can be employed to study native-like aggregation intermediate states.

    PubMed

    Dasari, Muralidhar; Espargaro, Alba; Sabate, Raimon; Lopez del Amo, Juan Miguel; Fink, Uwe; Grelle, Gerlinde; Bieschke, Jan; Ventura, Salvador; Reif, Bernd

    2011-02-11

    The structures of oligomeric intermediate states in the aggregation process of Alzheimer's disease ?-amyloid peptides have been the subject of debate for many years. Bacterial inclusion bodies contain large amounts of small heat shock proteins (sHSPs), which are highly homologous to those found in the plaques of the brains of Alzheimer's disease patients. sHSPs break down amyloid fibril structure in vitro and induce oligomeric assemblies. Prokaryotic protein overexpression thus mimics the conditions encountered in the cell under stress and allows the structures of A? aggregation intermediate states to be investigated under native-like conditions, which is not otherwise technically possible. We show that IB40/IB42 fulfil all the requirements to be classified as amyloids: they seed fibril growth, are Congo red positive and show characteristic ?-sheet-rich CD spectra. However, IB40 and IB42 are much less stable than fibrils formed in vitro and contain significant amounts of non-?-sheet regions, as seen from FTIR studies. Quantitative analyses of solution-state NMR H/D exchange rates show that the hydrophobic cores involving residues V18-F19-F20 adopt ?-sheet conformations, whereas the C termini adopt ?-helical coiled-coil structures. In the past, an ?-helical intermediate-state structure has been postulated, but could not be verified experimentally. In agreement with the current literature, in which A? oligomers are described as the most toxic state of the peptides, we find that IB42 contains SDS-resistant oligomers that are more neurotoxic than A?42 fibrils. E. coli inclusion bodies formed by the Alzheimer's disease ?-amyloid peptides A?40 and A?42 thus behave structurally like amyloid aggregation intermediate states and open the possibility of studying amyloids in a native-like, cellular environment. PMID:21290543

  16. Socioeconomic determinants of health: community marginalisation and the diffusion of disease and disorder in the United States.

    PubMed Central

    Wallace, R.; Wallace, D.

    1997-01-01

    This article describes the cascading diffusion of "inner city problems" of disease and disorder in the United States--from the huge marginalised inner city communities of the largest municipalities, first along national travel routes to smaller cities, and then from central cities into surrounding more affluent suburbs-following the pattern of the daily journey to work. Public policies and economic practices which increase marginalisation act to damage the "weak ties" of the community social networks which bind central city neighbourhoods into functioning units. Spreading disease and disorder can be interpreted as indices of the resulting social disintegration, which is driven by policy. This "failure of containment" in the United States should serve as a warning for cities in Europe against reducing the municipal and other services that they provide to "unpopular" subpopulations. PMID:9158474

  17. A pilot psychometric study of aberrant salience state in patients with Parkinson's disease and its association with dopamine replacement therapy.

    PubMed

    Poletti, Michele; Frosini, Daniela; Pagni, Cristina; Baldacci, Filippo; Lucetti, Claudio; Del Dotto, Paolo; Ceravolo, Roberto; Bonuccelli, Ubaldo

    2014-10-01

    An overactive striatal dopaminergic neurotransmission is described in psychosis and may be associated with a state of aberrant salience attribution. This pilot psychometric study investigated if features suggestive of an aberrant salience state, a condition of psychosis proneness, are associated with dopamine replacement therapy in patients with early Parkinson's disease (PD). 77 participants (50 medicated PD patients, 12 newly diagnosed drug-naive PD patients and 15 healthy controls) were enrolled and assessed with the Aberrant Salience Inventory (ASI). Differences between groups were found for ASI scores, and ASI scores correlated with the dopaminergic therapy, in particular levodopa. These findings preliminary suggested that the presence and the degree of an aberrant salience state may be associated with features of the dopaminergic therapy; further studies are needed to investigate which neuropsychiatric complications more common in PD patients may be characterized by an underlying aberrant salience state. PMID:25012755

  18. Bilirubin conjugates in bile of man and rat in the normal state and in liver disease.

    PubMed

    Fevery, J; Van Damme, B; Michiels, R; De Groote, J; Heirwegh, K P

    1972-09-01

    Conjugates of bilirubin were studied in normal bile of man and rat, and in bile of liver patients. In general human bile was obtained by duodenal intubation. In addition T-tube bile was examined in patients operated on for mechanical obstruction. The bile pigment compositions of duodenal and T-tube bile were similar in two patients where comparison was possible. Obstruction of the bile duct in rats was used as an animal model for obstructive jaundice. Diazotized ethyl anthranilate was used for determination of total conjugated bile pigment and for thin-layer chromatography (t.l.c.) analysis of the derived azopigments. The available t.l.c. procedures are versatile and allow rapid and quantitative analysis. A variety of conjugated azopigments can be distinguished. With chloroform, negligible amounts of unconjugated bilirubin are extracted from bile of man. Therefore, the percentage of monoconjugated bile pigments present in the initial bile sample can be calculated from the percentage of azodipyrrole found after diazotization. Normal bile from man and rat yields similar azopigment patterns. The dominant component is azopigment-delta (azodipyrrole beta-D-monoglucuronoside). Small amounts of azopigments with complex conjugating structures (gamma-azopigments) are present in both cases. Human bile further yields small amounts of azopigments containing xylose or glucose (called azopigments-alpha(2) and -alpha(3), respectively). Monoconjugated bilirubin (estimated from the percentage of azodipyrrole) amounts of 22% of total bile pigments in human bile and to 39% in murine bile. In both, the bulk of bile pigment is bilirubin diglucuronoside. From bile of patients with acquired liver diseases a new azopigment group (beta-azopigment) was derived. The gamma-azopigment group was increased; the delta-azopigment group (containing azodipyrrole beta-D-monoglucuronoside) was decreased. No differentiation was possible between intra- and extrahepatic cholestasis. The percentage of beta-azopigment showed a positive correlation with serum bilirubin concentration (r = 0.6). Recovery of the diseases was accompanied by normalization of the azopigment patterns. In rats, hydrostatic or mechanical obstruction induced increases in beta- and gamma-azopigments and a decrease in delta-azopigment similar to the changes observed in bile of liver patients. Complete normalization was obtained 6 hr after relieving the hydrostatic obstruction (duration 15-21 hr). In contrast, with man after surgery for extrahepatic obstruction, T-tube bile was not normalized when the T-tube was withdrawn (10 days after operation). Hydrostatic obstruction in rats provides an easy model when postobstructive bile pigment composition and parameters have to be investigated. The present investigations stress the importance of the physiopathological state when studying bilirubin conjugation. Hindrance to bile secretion induced heterogeneity of bilirubin conjugates and stimulated the formation of complex structures. PMID:4639028

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

    PubMed

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

    2013-01-01

    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

  20. Spinal cord stimulation for intractable chronic upper abdominal pain: a case report of the first patient in New Zealand.

    PubMed

    Al-Mahrouqi, Haitham; Munro, Zea; Acland, Richard H; MacFarlane, Martin R

    2012-12-14

    We present the first patient in New Zealand to undergo Spinal Cord Stimulation (SCS) for intractable upper abdominal pain. The patient was a 53-year-old man with a 20-year history of debilitating upper abdominal pain associated with chronic pancreatitis secondary to pancreatic divisum. Prior to the SCS, he was prescribed 680 mg of morphine sulphate equi-analgesia a day. Despite the intense analgesia, he still suffered monthly attacks of upper abdominal pain requiring hospitalisation. Nine months after implanting a Spinal Cord Stimulator, the monthly attacks ceased, his background pain was effectively controlled and the need for opioids decreased to 510 mg of morphine sulphate equi-analgesia a day. PMID:23321890

  1. Successful treatment of drug-resistant atrial tachycardia and intractable congestive heart failure with permanent coupled atrial pacing.

    PubMed

    Arbel, E R; Cohen, H C; Langendorf, R; Glick, G

    1978-02-01

    Temporary coupled atrial stimulation slowed the ventricular rate by nearly 50% in an adolescent patient with intractable congestive heart failure and focal repetitive atrial tachycardia that was resistant to drug treatment. Because of the success with the temporary pacemaker, a specially designed permanent pacemaker was implanted to provide coupled atrial stimulation. The necessary electrophysiologic conditions for ventricular slowing by coupled atrial pacing are: (1) an atrial effective refractory period shorter than that of the atrioventricular junction, and (2) depolarization of the ectopic atrial pacemaker by the responses to coupled atrial stimulation. During a 4 year follow-up period the treatment resulted in elimination of the tachycardia, followed by return of the heart size to normal and complete clinical recovery. Coupled atrial stimulation can provide effective treatment in selected patients with disabling drug-resistant atrial tachycardia in whom this mode of therapy is shown to be effective by careful electrophysiologic studies. PMID:623025

  2. Botulinum toxin type-A injection to treat patients with intractable anismus unresponsive to simple biofeedback training

    PubMed Central

    Zhang, Yong; Wang, Zhen-Ning; He, Lei; Gao, Ge; Zhai, Qing; Yin, Zhi-Tao; Zeng, Xian-Dong

    2014-01-01

    AIM: To evaluate the efficacy of botulinum toxin type A injection to the puborectalis and external sphincter muscle in the treatment of patients with anismus unresponsive to simple biofeedback training. METHODS: This retrospective study included 31 patients suffering from anismus who were unresponsive to simple biofeedback training. Diagnosis was made by anorectal manometry, balloon expulsion test, surface electromyography of the pelvic floor muscle, and defecography. Patients were given botulinum toxin type A (BTX-A) injection and pelvic floor biofeedback training. Follow-up was conducted before the paper was written. Improvement was evaluated using the chronic constipation scoring system. RESULTS: BTX-A injection combined with pelvic floor biofeedback training achieved success in 24 patients, with 23 maintaining persistent satisfaction during a mean period of 8.4 mo. CONCLUSION: BTX-A injection combined with pelvic floor biofeedback training seems to be successful for intractable anismus. PMID:25253964

  3. The Role of Resting State Networks in Focal Neocortical Seizures

    PubMed Central

    Bandt, S. Kathleen; Bundy, David T.; Hawasli, Ammar H.; Ayoub, Kareem W.; Sharma, Mohit; Hacker, Carl D.; Pahwa, Mrinal; Leuthardt, Eric C.

    2014-01-01

    Objective The role of resting state functional networks in epilepsy is incompletely understood. While some pathologic diagnoses have been shown to have maintained but altered resting state connectivity, others have implicated resting state connectivity in disease progression. However little is known about how these resting state networks influence the behavior of a focal neocortical seizure. Methods Using data taken from invasively monitored patients with intractable focal neocortical epilepsy, we evaluated network connectivity (as determined by oscillatory covariance of the slow cortical potential (<0.5 Hz)) as it relates to neocortical seizure foci both in the interictal and ictal states. Results Similar to what has been shown in the past for sleep and anesthesia, electophysiologic resting state networks that are defined by this slow cortical potential covariance maintain their topographic correlation structure throughout an ictal event. Moreover, in the context of focal epilepsy in which the seizure has a specific site of onset, seizure propagation is not chaotic or random. Rather, the seizure (reflected by an elevation of high frequency power) preferentially propagates along the network that contains the seizure onset zone. Significance Taken together, these findings further undergird the fundamental role of resting state networks, provide novel insights into the network-influenced behavior of seizures, and potentially identify additional targets for surgical disconnection including informing the location for the completion of multiple subpial transections (MSPTs). PMID:25247680

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

    SciTech Connect

    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

    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.

  5. CAN RELIGION HELP? USING JOHN HOWARD YODER AND MOHANDAS GANDHI TO CONCEPTUALIZE NEW APPROACHES TO INTRACTABLE SOCIAL AND POLITICAL PROBLEMS SUCH AS VIOLENCE AND WAR

    Microsoft Academic Search

    GREGORY TODD KEETER

    Religious Studies is making possible a scholarly study of many aspects of human religious traditions and practices, but the field has yet to articulate fully the ability of such study to affect the creation of new approaches to intractable social and political problems. Many of these problems have as their basis religious justifications, yet the rigor of academic thought has

  6. 9 CFR 53.2 - Determination of existence of disease; agreements with States.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Section 53.2 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ...animals and materials required to be destroyed because of being contaminated by or exposed to such disease: Provided, however,...

  7. 9 CFR 53.2 - Determination of existence of disease; agreements with States.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Section 53.2 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ...animals and materials required to be destroyed because of being contaminated by or exposed to such disease: Provided, however,...

  8. 9 CFR 53.2 - Determination of existence of disease; agreements with States.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Section 53.2 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ...animals and materials required to be destroyed because of being contaminated by or exposed to such disease: Provided, however,...

  9. 9 CFR 53.2 - Determination of existence of disease; agreements with States.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Section 53.2 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ...animals and materials required to be destroyed because of being contaminated by or exposed to such disease: Provided, however,...

  10. PopMod: a longitudinal population model with two interacting disease states

    Microsoft Academic Search

    Jeremy A Lauer; Klaus Röhrich; Harald Wirth; Claude Charette; Steve Gribble; Christopher JL Murray

    2003-01-01

    This article provides a description of the population model PopMod, which is designed to simulate the health and mortality experience of an arbitrary population subjected to two interacting disease conditions as well as all other \\

  11. Evolutionary dynamics and spatial genetic structure of epizootic hemorrhagic disease virus in the eastern United States

    Microsoft Academic Search

    Roman Biek

    2007-01-01

    Epizootic hemorrhagic disease virus (EHDV) is a significant pathogen of wild and domestic ungulates worldwide. In North America, serotype EHDV-2 is responsible for the majority of outbreaks, which are most commonly observed in white-tailed deer. A recent study by Murphy et al. [Murphy, M.D., Howerth, E.W., MacLachlan, N.J., Stallknecht, D.E., 2005. Genetic variation among epizootic hemorrhagic disease viruses in the

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

    Microsoft Academic Search

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

    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

  13. Parasitic Diseases

    MedlinePLUS

    ... a bug bite, or sexual contact. Some parasitic diseases are easily treated and some are not. Parasites ... be seen with the naked eye. Some parasitic diseases occur in the United States. Contaminated water supplies ...

  14. Chagas Disease

    MedlinePLUS

    Chagas disease is caused by a parasite. It is common in Latin America but not in the United States. ... nose, the bite wound or a cut. The disease can also spread through contaminated food, a blood ...

  15. An Asian Origin of Virulent Aeromonas hydrophila Responsible for Disease Epidemics in United States-Farmed Catfish

    PubMed Central

    Hossain, Mohammad J.; Sun, Dawei; McGarey, Donald J.; Wrenn, Shannon; Alexander, Laura M.; Martino, Maria Elena; Xing, Ye; Terhune, Jeffery S.

    2014-01-01

    ABSTRACT Since 2009, catfish farming in the southeastern United States has been severely impacted by a highly virulent and clonal population of Aeromonas hydrophila causing motile Aeromonas septicemia (MAS) in catfish. The possible origin of this newly emerged highly virulent A. hydrophila strain is unknown. In this study, we show using whole-genome sequencing and comparative genomics that A. hydrophila isolates from diseased grass carp in China and catfish in the United States have highly similar genomes. Our phylogenomic analyses suggest that U.S. catfish isolates emerged from A. hydrophila populations of Asian origin. Furthermore, we identified an A. hydrophila strain isolated in 2004 from a diseased catfish in Mississippi, prior to the onset of the major epidemic outbreaks in Alabama starting in 2009, with genomic characteristics that are intermediate between those of the Asian and Alabama fish isolates. Investigation of A. hydrophila strain virulence demonstrated that the isolate from the U.S. catfish epidemic is significantly more virulent to both channel catfish and grass carp than is the Chinese carp isolate. This study implicates the importation of fish or fishery products into the United States as the source of highly virulent A. hydrophila that has caused severe epidemic outbreaks in United States-farmed catfish and further demonstrates the potential for invasive animal species to disseminate bacterial pathogens worldwide. PMID:24895303

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

    PubMed Central

    Yurow, Julie; Lippwe, Kipier; Aitaoto, Nia

    2013-01-01

    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

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

    PubMed

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

    2013-05-01

    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

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

    PubMed Central

    Anson, Robina; Keller, Elizabeth; Lippwe, Kipier; Aitaoto, Nia

    2013-01-01

    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

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

    PubMed Central

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

    2015-01-01

    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

  20. Differential diagnosis in inflammatory bowel disease colitis: state of the art and future perspectives.

    PubMed

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

    2015-01-01

    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

  1. Simulants, stimulants and diseases: the evolution of the United States biological warfare programme, 1945-60.

    PubMed

    Hay, A

    1999-01-01

    Details about the US biological programme have largely been based on information in the open literature. More revealing aspects of the programme are now available through documents released under the Freedom of Information Act. Annual reports of the activities of the US Army Chemical Corps from 1945 to 1959 have revealed significant increases in activity in biological warfare research. The Corps research activity progressed from work on anthrax in 1941, through anti-crop agents in the mid-1940s, to a wider range of animal, plant and human diseases by 1960. A number of disease organisms were investigated sufficiently to permit some standardisation and manufacture of munitions. PMID:10472189

  2. Assessment of 6-sulfatoxymelatonin rhythms and melatonin response to light in disease states: Lessons from cirrhosis.

    PubMed

    Montagnese, Sara; Middleton, Benita; Corrias, Michela; Mani, Ali Reza; Skene, Debra J; Morgan, Marsha Y

    2015-03-01

    Circadian rhythmicity and non-visual sensitivity to light can be assessed, in healthy subjects, by measuring the rhythm of the urinary melatonin metabolite 6-sulphatoxymelatonin (aMT6s) and by determining the response of plasma melatonin to nocturnal retinal light exposure, respectively. However, the validity of these techniques has not been assessed in disease states in which disruption of the circadian rhythm is known or suspected to occur. Thus, the aims of this study were as follows: (i) to assess the reliability of circadian aMT6s profile estimates derived from 36?h versus 56?h urine collections and (ii) to test different models for calculating melatonin suppression in response to light in healthy volunteers and patients with cirrhosis. Twenty patients with biopsy-proven cirrhosis and 10 matched healthy volunteers undertook: (i) separate 36?- and 56-h urine collections, under controlled conditions, for cosinor analysis of the urinary aMT6s profile; (ii) a melatonin suppression test, comprising of a baseline night, during which subjects were woken and asked to sit in front of a switched off light sphere, and an experimental night, identically executed, except that the light sphere was switched on and the subjects were exposed to white light (4.1?×?10(14) photons/cm(2)/s) for 30?min. Alternative approaches to the calculation of melatonin suppression were taken, with/without inclusion of the baseline night. Eighteen patients and eight healthy volunteers had matched analysable 36?- and 56-h urinary samples. Cosinor analysis showed a significant fit in 88% of the remaining 56?h collections, and 48% of the remaining 36-h collections. Thus, eight patients and five healthy volunteers had matched analysable samples for cosinor analysis. In the healthy volunteers, aMT6s profile indices obtained using the 36?- and the 56-h collections did not differ significantly. In contrast, considerably more variability was observed in patients [i.e. the difference in the aMT6s peak time was 0.5?±?1.7?h (limits of agreement: -3.9; +2.9?h)]. No difficulties were encountered in obtaining suppression estimates by use of the experimental night only. In contrast, suppression estimates obtained by use of both nights were considered inaccurate in one (11%) healthy volunteer and in 5 (28%) patients, primarily because: (i) melatonin concentrations at the beginning of light administration were significantly different on baseline and experimental night; (ii) the rise in melatonin was inconsistent on baseline night; and (iii) the shape of the rising phase of melatonin was different on baseline and experimental night. In conclusion, shorter urine collections lead to a higher number of profiles with no significant cosinor fit, and differences in cosinor indices obtained from the 36?- and 56-h collections were considerable, especially in patients. Thus, 56-h collections are probably advisable. Use of both baseline and experimental nights to calculate melatonin suppression often resulted in increased variation and confounding, due to point oscillations in melatonin concentration and lack of repeatability of the melatonin profiles on the two nights. Thus, use of the experimental night only is probably advisable. PMID:25264562

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

    Microsoft Academic Search

    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

    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

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

    E-print Network

    Dao, Ming

    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

  5. Chronic Cardiovascular Disease Mortality in Mountaintop Mining Areas of Central Appalachian States

    ERIC Educational Resources Information Center

    Esch, Laura; Hendryx, Michael

    2011-01-01

    Purpose: To determine if chronic cardiovascular disease (CVD) mortality rates are higher among residents of mountaintop mining (MTM) areas compared to mining and nonmining areas, and to examine the association between greater levels of MTM surface mining and CVD mortality. Methods: Age-adjusted chronic CVD mortality rates from 1999 to 2006 for…

  6. National Surveillance of Dialysis Associated Diseases in the United States, 1995

    Microsoft Academic Search

    Jerome I. Tokars; Elaine R. Miller; Matthew J. Arduino

    1998-01-01

    In December 2001, all U.S. chronic hemodialysis (HD) centers were surveyed regarding selected patient care practices and dialysis-associated diseases. The results were compared with similar surveys conducted in previous years. During 1997- 2001, the percentage of patients vaccinated against hepatitis B virus (HBV) infection increased from 47% to 60% and the percentage of staff vaccinated increased from 87% to 89%.

  7. 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...

  8. SURVEILLANCE FOR WATERBORNE-DISEASE OUTBREAKS-UNITED STATES, 1997-1998

    EPA Science Inventory

    PROBLEM/CONDITION: Since 1971, CDC and the U.S. Environmental Protection Agency (EPA) have maintained a collaborative surveillance system for collecting and periodically reporting data relating to occurrences and causes of waterborne-disease outbreaks (WBDOs). REPORTING PERIOD CO...

  9. 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...

  10. NEW YORK STATE DEPARTMENT OF HEALTH Bureau of Communicable Disease Control

    E-print Network

    Mahon, Bradford Z.

    is a severe bacterial infection of the bloodstream or meninges (a thin lining covering the brain and spinal in infants and children. College students as a group are at lower risk of Meningococcal infection than young this disease, and people traveling to parts of the world where meningitis is prevalent. How

  11. A New Animal Model for Studying Lyme Disease Spirochetes in a Mammalian Host-adapted State

    Microsoft Academic Search

    Darrin R. Akins; Kenneth W. Bourell; Melissa J. Caimano; Michael V. Norgard; Justin D. Radolf

    There is now substantial evidence that Borrelia burgdorferi , the Lyme disease spirochete, undergoes major alterations in antigenic composition as it cycles between its arthropod and mammalian hosts. In this report, we cultivated B. burgdor- feri 297 within dialysis membrane chambers implanted into the peritoneal cavities of rats to induce antigenic changes similar to those which occur during mammalian infection.

  12. Hematopoietic Cell Transplantation for Autoimmune Disease: Updates from Europe and the United States

    Microsoft Academic Search

    Keith M. Sullivan; Paolo Muraro; Alan Tyndall

    2010-01-01

    Considerable advances have been made in our understanding of the immunobiology of autoimmune disease and its treatment with hematopoietic cell transplantation (HCT). In autoimmune disorders, the reconsti- tuted immune system following lymphoablation and autologous HCTyields qualitative changes in immune defects and modifications in adaptive immune responses. Seminal experiments in animals demonstrated that allogeneic or autologous HCT could prevent progression or

  13. Constitution for the Colorado State University Student Chapter of the Wildlife Disease Association

    E-print Network

    and opportunities in the field of wildlife health and disease ecology through education, communication, and collaboration with local and global research and education communities. Article III ­ MEMBERSHIP Section 1, disability, sexual orientation, veteran status, or disability. To remove a member, a 2/3 majority

  14. The intractable intra-abdominal hemorrhage with unknown etiology in a patient with severe hemophilia A.

    PubMed

    Morichika, Kazuho; Tomoyose, Takeaki; Nishi, Yukiko; Nakachi, Sawako; Fukushima, Takuya; Masuzaki, Hiroaki

    2015-01-01

    Severe hemophilia patients are more likely to be complicated by intra-articular hemorrhage, subcutaneous hemorrhage, and intra-mascular hemorrhage. Spontaneous intra-abdominal hemorrhage is a rare fatal disease, which is an arterial bleeding of uncertain causes from vessel feeding arteries. In case the spontaneous intra-abdominal hemorrhage is complicated to severe hemophilia patients, the mortality rate increases considerably. We experienced a patient with severe hemophilia A, who made a full recovery from spontaneous intra-abdominal hemorrhagic shock by replacement therapy of coagulation factor VII, a noninvasive procedure. PMID:25088441

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

    PubMed Central

    Graham, Garth

    2014-01-01

    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

  16. Population Structure of Geosmithia morbida, the Causal Agent of Thousand Cankers Disease of Walnut Trees in the United States

    PubMed Central

    Graves, Andrew D.; Hartel, Colleen; Pscheidt, Jay W.; Tonos, Jadelys; Broders, Kirk; Cranshaw, Whitney; Seybold, Steven J.; Tisserat, Ned

    2014-01-01

    The ascomycete Geosmithia morbida and the walnut twig beetle Pityophthorus juglandis are associated with thousand cankers disease of Juglans (walnut) and Pterocarya (wingnut). The disease was first reported in the western United States (USA) on several Juglans species, but has been found more recently in the eastern USA in the native range of the highly susceptible Juglans nigra. We performed a comprehensive population genetic study of 209 G. morbida isolates collected from Juglans and Pterocarya from 17 geographic regions distributed across 12 U.S. states. The study was based on sequence typing of 27 single nucleotide polymorphisms from three genomic regions and genotyping with ten microsatellite primer pairs. Using multilocus sequence-typing data, 197 G. morbida isolates were placed into one of 57 haplotypes. In some instances, multiple haplotypes were recovered from isolates collected on the same tree. Twenty-four of the haplotypes (42%) were recovered from more than one isolate; the two most frequently occurring haplotypes (H02 and H03) represented 36% of all isolates. These two haplotypes were abundant in California, but were not recovered from Arizona or New Mexico. G. morbida population structure was best explained by four genetically distinct groups that clustered into three geographic regions. Most of the haplotypes isolated from the native range of J. major (Arizona and New Mexico) were found in those states only or present in distinct genetic clusters. There was no evidence of sexual reproduction or genetic recombination in any population. The scattered distribution of the genetic clusters indicated that G. morbida was likely disseminated to different regions at several times and from several sources. The large number of haplotypes observed and the genetic complexity of G. morbida indicate that it evolved in association with at least one Juglans spp. and the walnut twig beetle long before the first reports of the disease. PMID:25393300

  17. Population structure of Geosmithia morbida, the causal agent of thousand cankers disease of walnut trees in the United States.

    PubMed

    Zerillo, Marcelo M; Ibarra Caballero, Jorge; Woeste, Keith; Graves, Andrew D; Hartel, Colleen; Pscheidt, Jay W; Tonos, Jadelys; Broders, Kirk; Cranshaw, Whitney; Seybold, Steven J; Tisserat, Ned

    2014-01-01

    The ascomycete Geosmithia morbida and the walnut twig beetle Pityophthorus juglandis are associated with thousand cankers disease of Juglans (walnut) and Pterocarya (wingnut). The disease was first reported in the western United States (USA) on several Juglans species, but has been found more recently in the eastern USA in the native range of the highly susceptible Juglans nigra. We performed a comprehensive population genetic study of 209 G. morbida isolates collected from Juglans and Pterocarya from 17 geographic regions distributed across 12 U.S. states. The study was based on sequence typing of 27 single nucleotide polymorphisms from three genomic regions and genotyping with ten microsatellite primer pairs. Using multilocus sequence-typing data, 197 G. morbida isolates were placed into one of 57 haplotypes. In some instances, multiple haplotypes were recovered from isolates collected on the same tree. Twenty-four of the haplotypes (42%) were recovered from more than one isolate; the two most frequently occurring haplotypes (H02 and H03) represented 36% of all isolates. These two haplotypes were abundant in California, but were not recovered from Arizona or New Mexico. G. morbida population structure was best explained by four genetically distinct groups that clustered into three geographic regions. Most of the haplotypes isolated from the native range of J. major (Arizona and New Mexico) were found in those states only or present in distinct genetic clusters. There was no evidence of sexual reproduction or genetic recombination in any population. The scattered distribution of the genetic clusters indicated that G. morbida was likely disseminated to different regions at several times and from several sources. The large number of haplotypes observed and the genetic complexity of G. morbida indicate that it evolved in association with at least one Juglans spp. and the walnut twig beetle long before the first reports of the disease. PMID:25393300

  18. 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

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

    2009-01-01

    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…

  19. Did you know heart disease is the leading cause of death in the United States? Contributing factors include smoking, obesity, diabetes, high blood pressure,

    E-print Network

    the risk of stroke or heart attack. · Weight loss will improve heart health and heart function. · Reduced6:00 AM Wake up Did you know heart disease is the leading cause of death in the United States history of heart disease. 7:30 AM Breakfast: Whole grain cereal, 1 medium orange and 1 cup fat-free milk

  20. PHARMACOTHERAPY IN SICKLE CELL DISEASESTATE OF THE ART AND FUTURE PROSPECTS

    PubMed Central

    Hankins, Jane; Aygun, Banu

    2011-01-01

    In the last decade, the care of patients with sickle cell disease (SCD) has undergone important advances with better understanding of disease pathophysiology and improvement in standards of care, especially among paediatric patients. Although many new drugs are currently being investigated and are at different stages of development, the pace of drug discovery and utilization has been slow and suboptimal. Hydroxycarbamide (hydroxyurea) has been investigated and utilized for at least two decades. Hydroxycarbamide’s efficacy has been demonstrated, albeit with different levels of evidence, in paediatric and adult populations, and yet clinician and patient acceptance and use have been far from ideal. In this review we discuss the current usage of hydroxycarbamide and its possible future indications in SCD, as well as the use of new compounds that have very different mechanisms of action, which may prove safe and efficacious when used alone or in combination in patients with SCD. PMID:19222472

  1. The National Kidney Disease Education Program and other related efforts in the United States.

    PubMed

    Narva, Andrew S

    2008-01-01

    The National Kidney Disease Education Program (NKDEP) works to reduce the morbidity and mortality caused by chronic kidney disease (CKD) and its complications through educational efforts targeted towards at-risk communities, patients and health-care professionals. NKDEP aims to improve early detection of CKD, facilitate identification of patients at greatest risk for progression to kidney failure and promote evidence-based interventions. Barriers to achieving these goals include confusion and misunderstanding of the laboratory tests used to identify and monitor patients with CKD. Through the Laboratory Working Group, NKDEP has collaborated with the clinical chemistry community to standardize creatinine measurements, promote the routine reporting of eGFR and standardize the measurement and reporting of urine albumin. It is hoped that these efforts will improve screening, clinical care and research in CKD and facilitate the implementation of evidence-based care recommended by the National Kidney Foundation and others. PMID:18569959

  2. Disease properties, geography, and mitigation strategies in a simulation spread of rinderpest across the United States

    Microsoft Academic Search

    Carrie Manore; Benjamin McMahon; Jeanne Fair; James M Hyman; Mac Brown; Montiago LaBute

    2011-01-01

    For the past decade, the Food and Agriculture Organization of the United Nations has been working toward eradicating rinderpest\\u000a through vaccination and intense surveillance by 2012. Because of the potential severity of a rinderpest epidemic, it is prudent\\u000a to prepare for an unexpected outbreak in animal populations. There is no immunity to the disease among the livestock or wildlife\\u000a in

  3. A cross-species analysis method to analyze animal models' similarity to human's disease state

    PubMed Central

    2012-01-01

    Background Animal models are indispensable tools in studying the cause of human diseases and searching for the treatments. The scientific value of an animal model depends on the accurate mimicry of human diseases. The primary goal of the current study was to develop a cross-species method by using the animal models' expression data to evaluate the similarity to human diseases' and assess drug molecules' efficiency in drug research. Therefore, we hoped to reveal that it is feasible and useful to compare gene expression profiles across species in the studies of pathology, toxicology, drug repositioning, and drug action mechanism. Results We developed a cross-species analysis method to analyze animal models' similarity to human diseases and effectiveness in drug research by utilizing the existing animal gene expression data in the public database, and mined some meaningful information to help drug research, such as potential drug candidates, possible drug repositioning, side effects and analysis in pharmacology. New animal models could be evaluated by our method before they are used in drug discovery. We applied the method to several cases of known animal model expression profiles and obtained some useful information to help drug research. We found that trichostatin A and some other HDACs could have very similar response across cell lines and species at gene expression level. Mouse hypoxia model could accurately mimic the human hypoxia, while mouse diabetes drug model might have some limitation. The transgenic mouse of Alzheimer was a useful model and we deeply analyzed the biological mechanisms of some drugs in this case. In addition, all the cases could provide some ideas for drug discovery and drug repositioning. Conclusions We developed a new cross-species gene expression module comparison method to use animal models' expression data to analyse the effectiveness of animal models in drug research. Moreover, through data integration, our method could be applied for drug research, such as potential drug candidates, possible drug repositioning, side effects and information about pharmacology. PMID:23282076

  4. Suppression of the Immune Response: Reversal of the Disease State with Antigen in Allergic Encephalomyelitis

    Microsoft Academic Search

    E. H. Eylar; J. Jackson; B. Rothenberg; S. W. Brostoff

    1972-01-01

    EXPERIMENTAL allergic encephalomyelitis (EAE) is an autoimmune disease which is characterized1,2 primarily by lymphocytic inflammation and demyelination of the white matter of the central nervous system (CNS); clinical signs generally include lower limb paralysis, ataxia, tremors and death3,4. Of numerous factors proposed for EAE induction, it is now established that the A1 protein, the basic protein of CNS myelin (molecular

  5. 75 years of breeding pinto bean for resistance to diseases in the United States

    Microsoft Academic Search

    Henry Terán; Margarita Lema; David Webster; Shree P. Singh

    2009-01-01

    Diseases are major production constraints of pinto bean despite 75 years of breeding. The objectives were to (1) assess progress\\u000a made and (2) discuss future breeding strategies. Bean common mosaic virus (BCMV), anthracnose, rust, white mold, common blight,\\u000a and halo blight and growth habit, seed weight, and seed coat darkening were evaluated for 52 cultivars released between 1944\\u000a and 2001. Sixteen

  6. Protein Sets Define Disease States and Predict In Vivo Effects of Drug Treatment*

    PubMed Central

    Meierhofer, David; Weidner, Christopher; Hartmann, Ludger; Mayr, Johannes A.; Han, Chung-Ting; Schroeder, Frank C.; Sauer, Sascha

    2013-01-01

    Gaining understanding of common complex diseases and their treatments are the main drivers for life sciences. As we show here, comprehensive protein set analyses offer new opportunities to decipher functional molecular networks of diseases and assess the efficacy and side-effects of treatments in vivo. Using mass spectrometry, we quantitatively detected several thousands of proteins and observed significant changes in protein pathways that were (dys-) regulated in diet-induced obesity mice. Analysis of the expression and post-translational modifications of proteins in various peripheral metabolic target tissues including adipose, heart, and liver tissue generated functional insights in the regulation of cell and tissue homeostasis during high-fat diet feeding and medication with two antidiabetic compounds. Protein set analyses singled out pathways for functional characterization, and indicated, for example, early-on potential cardiovascular complication of the diabetes drug rosiglitazone. In vivo protein set detection can provide new avenues for monitoring complex disease processes, and for evaluating preclinical drug candidates. PMID:23579186

  7. Primary Immunodeficiency Diseases at Reference and High-Specialty Hospitals in the State of Guanajuato, Mexico

    PubMed Central

    Guaní-Guerra, Eduardo; García-Ramírez, Ulises Noel; Jiménez-Romero, Ana Isabel; Velázquez-Ávalos, José Manuel; Gallardo-Martínez, Gabriela; Mendoza-Espinoza, Francisco-Javier

    2013-01-01

    Background. In general, primary immunodeficiency diseases (PIDs) are underdiagnosed in most countries. The objective of this study was to describe the frequency and clinical spectrum of PID in the most important tertiary hospitals in our region. Methods. An observational, cross-sectional, with retrospective chart, review study was conducted. A total of 26 patients were included and grouped according to the updated classification of PIDs. Results. PIDs spectra were as follows: predominantly antibody deficiency diseases were the most common category (65.38%), followed by other well-defined immunodeficiency syndromes (11.55%), congenital defects of phagocyte number and/or function (7.69%), complement deficiencies (3.85%), combined T- and B-cell immunodeficiencies (3.85%), and defects in innate immunity (3.85%). The mean time elapsed from the onset of symptoms to the reference and diagnosis by a tertiary hospital was of 4.65 ± 6.95 years. Conclusions. Predominant antibody deficiency disease was the most common group of PIDs, agreeing with international reports. Awareness of underdiagnosis by physicians is crucial for a prompt diagnosis and treatment, which in turn should improve the quality of life among patients with PIDs. PMID:24073395

  8. Regulation of Translocator Protein 18 kDa (TSPO) Expression in Health and Disease States

    PubMed Central

    Batarseh, Amani; Papadopoulos, Vassilios

    2010-01-01

    Translocator protein (TSPO) is an 18-kDa high affinity cholesterol- and drug-binding protein found primarily in the outer mitochondrial membrane. Although TSPO is found in many tissue types, it is expressed at the highest levels under normal conditions in tissues that synthesize steroids. TSPO has been associated with cholesterol import into mitochondria, a key function in steroidogenesis, and directly or indirectly with multiple other cellular functions including apoptosis, cell proliferation, differentiation, anion transport, porphyrin transport, heme synthesis, and regulation of mitochondrial function. Aberrant expression of TSPO has been linked to multiple diseases, including cancer, brain injury, neurodegeneration, and ischemia reperfusion injury. There has been an effort during the last decade to understand the mechanisms regulating tissue- and disease-specific TSPO expression and to identify pharmacological means to control its expression. This review focuses on the current knowledge regarding the chemicals, hormones, and molecular mechanisms regulating Tspo gene expression under physiological conditions in a tissue- and disease-specific manner. The results described here provide evidence that the PKC?-ERK1/2-AP1/Stat3 signal transduction pathway is the primary regulator of Tspo gene expression in normal and pathological tissues expressing high levels of TSPO. PMID:20600583

  9. Fasting therapy for treating and preventing disease - current state of evidence.

    PubMed

    Michalsen, Andreas; Li, Chenying

    2013-01-01

    Periods of deliberate fasting with restriction of solid food intake are practiced worldwide, mostly based on traditional, cultural or religious reasons. There is large empirical and observational evidence that medically supervised modified fasting (fasting cure, 200-500 kcal nutritional intake per day) with periods of 7-21 days is efficacious in the treatment of rheumatic diseases, chronic pain syndromes, hypertension, and metabolic syndrome. The beneficial effects of fasting followed by vegetarian diet in rheumatoid arthritis are confirmed by randomized controlled trials. Further beneficial effects of fasting are supported by observational data and abundant evidence from experimental research which found caloric restriction and intermittent fasting being associated with deceleration or prevention of most chronic degenerative and chronic inflammatory diseases. Intermittent fasting may also be useful as an accompanying treatment during chemotherapy of cancer. A further beneficial effect of fasting relates to improvements in sustainable lifestyle modification and adoption of a healthy diet, possibly mediated by fasting-induced mood enhancement. Various identified mechanisms of fasting point to its potential health-promoting effects, e.g., fasting-induced neuroendocrine activation and hormetic stress response, increased production of neurotrophic factors, reduced mitochondrial oxidative stress, general decrease of signals associated with aging, and promotion of autophagy. Fasting therapy might contribute to the prevention and treatment of chronic diseases and should be further evaluated in controlled clinical trials and observational studies. PMID:24434759

  10. 76 FR 31499 - Lists of Regions Classified With Respect to Certain Animal Diseases and States Approved To...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-01

    ...PART 94--RINDERPEST, FOOT-AND-MOUTH DISEASE, EXOTIC NEWCASTLE DISEASE...1 Regions where rinderpest or foot-and-mouth disease exists; importations...APHIS considers rinderpest or foot-and-mouth disease to exist in all...

  11. 77 FR 1388 - Lists of Regions Classified With Respect to Certain Animal Diseases and States Approved To...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-10

    ...PART 94--RINDERPEST, FOOT-AND-MOUTH DISEASE, EXOTIC NEWCASTLE DISEASE...1 Regions where rinderpest or foot-and-mouth disease exists; importations...APHIS considers rinderpest or foot-and-mouth disease to exist in all...

  12. Increasing habitat suitability in the United States for the tick that transmits Lyme disease: a remote sensing approach.

    PubMed Central

    Estrada-Peña, Agustín

    2002-01-01

    The warnings about the spread of (italic)Ixodes scapularis(/italic), one of the vectors of Lyme disease, into the United States are based on reports about regional distribution and increasing local abundance. In a modeling approach, I used the recorded, current distribution of this tick and remotely sensed bioclimatic factors over the United States to establish the changes of habitat for this tick since 1982 and to detect the areas with factors adequate to support tick colonization. Results indicate the geographic expansion of areas with adequate habitat suitability in the period 1982-2000. A discriminant analysis of counties with different degrees of habitat suitability shows that the increase in winter temperatures and in vegetation vitality (as a direct consequence of higher rainfall) is key to habitat switch from unsuitable to suitable. PMID:12117639

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

    PubMed Central

    2011-01-01

    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

  14. Use of dietary supplements among United States adults with coronary artery disease and atherosclerotic risks.

    PubMed

    Buettner, Catherine; Phillips, Russell S; Davis, Roger B; Gardiner, Paula; Mittleman, Murray A

    2007-03-01

    The study seeks to describe the use of dietary supplements promoted for cardiovascular health and the relation between supplement use and coronary artery disease (CAD) and the presence of major CAD risk factors. The aim is also to explore whether use of medications for the treatment of cardiovascular disease or diabetes mellitus (DM) is associated with supplement use. We performed a cross-sectional analysis of the 1999 to 2002 National Health and Nutrition Examination Survey (NHANES) of 6,671 adults (representing 119.3 million US adults) aged > or =40 years. We categorized adults into 4 nonoverlapping groups as (1) having reported CAD or stroke (CAD/stroke), (2) DM without CAD/stroke, (3) hypertension (HTN) or hypercholesterolemia (HC) without CAD/stroke or DM (HTN/HC), or (4) none of these conditions (no reported CAD/CAD risk) and performed weighted (NHANES) multiple logistic regression to determine the odds of using supplements (reference group, no reported CAD/CAD risk). After controlling for sociodemographics, health, and lifestyle factors, we found that persons with CAD/Stroke used more supplements (any), vitamin E, folic acid, and niacin, and less fish oil. Those with DM used less coenzyme Q10, and adults with HTN/HC used more supplements (any), herbs (any), and ginseng. Adults with CAD/stroke who used medications for the treatment of cardiovascular disease or DM were more likely to use folic acid compared with those who did not use medications for these conditions. In adults with CAD/stroke, DM, or HTN/HC, those who did not use medications for these conditions were more likely to use herbs and other select supplements. In conclusion, use of dietary supplements is common in those with CAD or CAD risks. PMID:17317368

  15. The Epidemiology of Weil's Disease: (Section of Epidemiology and State Medicine).

    PubMed

    Alston, J M; Brown, H C

    1937-04-01

    Adolf Weil defined the disease as a clinical entity in 1886, and Leptospira ictero-haemorrhagiae was found to be the causative organism in 1915 by Inada et al. in Japan, and confirmed by Hübener and Reiter in Germany. The infection has been found in most countries, and recently there has been a great increase in the number of instances reported.In most parts of the world rats and other small rodents harbour the organism and excrete it in the urine. This is almost always the direct or indirect source of infection of man, but natural infection of dogs and foxes takes place, and is at least a potential danger to human beings. Infection is usually related to occupation in coal-mines, field work of all sorts, sewers, fish-cleaning, and to bathing in fresh water.The organism quickly dies in an acid medium, in strong sunlight and in salt water. These facts accord with the presence of the disease in certain situations.The route of infection of man is usually by contact of the abraded or sodden skin with infected mud or water, but it may be by inhalation of water and by bites of rats, dogs, and ferrets.Men are much more exposed to infection than women, but in fish-cleaners the incidence is equal in the sexes. Children are sometimes infected by bathing and in houses.The incubation time may be four to nineteen days, and is usually seven to thirteen days.By serological methods many unjaundiced and subclinical infections can be detected among people who are often at risk, and these correct the rather high fatality rates which are derived from jaundiced cases only.During the last three and a half years 142 authenticated instances of the disease in an obvious clinical form have been reported in the British Isles. Twenty-one occupations or circumstances were involved, and the case fatality rate was 15 per cent. PMID:19991094

  16. Upregulation of D site of albumin promoter binding protein in the brain of patients with intractable epilepsy

    PubMed Central

    YUAN, JINXIAN; GUO, JING; ZHANG, MELIN; WANG, QIAN; HUANG, HAO; CHEN, YANGMEI

    2015-01-01

    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

  17. [Thalamic relay nucleus stimulation for relief of intractable pain. Clinical results and beta-endorphin immunoreactivity in cerebrospinal fluid].

    PubMed

    Tsubokawa, T; Yamamoto, T; Katayama, Y; Nishimoto, H; Hirayama, A; Shibuya, H

    1984-03-01

    Chronic implantation of a stimulating electrode in the thalamic relay nucleus (11 cases), in the periaqueductal gray (1 case) and in the internal capsule (2 cases) was performed in fourteen cases which suffered from intractable pain. All these cases could get pain relief at least initial two months. Ventricular fluids were collected before and after stimulation with optimal combination of parameters, and measurements of beta-endorphin were performed by radio-immunoassay. Intrathecal morphine (1mg) injection was performed in eight cases. Cerebrospinal fluids were collected by lumbar tap before and 24 hours after morphine injection. beta-endorphin immunoreactivity was measured by the same method. Pain relief was judged to be excellent if the patient so claimed, and if he discontinued analgesics. Pain relief was thought to be good when it was not completely controllable by stimulation but was sufficiently improved that the patient could do without analgesics. It was thought to be fair when patient could not discontinue analgesics, and poor when patient could not get pain relief. We usually attempt to prevent the stimulation-tolerance by administration of the monoamine precursors , i.e., 1-dopa and 1-tryptophan, on the basis of the experimental observation reported previously. In somatogenic pain patients, the thalamic relay nucleus stimulation was performed in 7 cases (excellent; 3, good; 1, fair; 3) and the periaqueductal gray stimulation in one case (good).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6330600

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

    PubMed

    Chung, Eric; Brock, Gerald

    2013-02-01

    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

  19. Clinical effects of surgical and Gamma Knife treatments on hippocampal sclerosis-induced intractable epilepsy of children below age 10 years

    PubMed Central

    Xiao, Aiju; Wang, Tuanjie; Tian, Yunjiao; Xu, Li; Li, Shujun; Zhu, Fenglian

    2013-01-01

    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

  20. Estimating the United States demand for influenza antivirals and the effect on severe influenza disease during a potential pandemic.

    PubMed

    O'Hagan, Justin J; Wong, Karen K; Campbell, Angela P; Patel, Anita; Swerdlow, David L; Fry, Alicia M; Koonin, Lisa M; Meltzer, Martin I

    2015-05-01

    Following the detection of a novel influenza strain A(H7N9), we modeled the use of antiviral treatment in the United States to mitigate severe disease across a range of hypothetical pandemic scenarios. Our outcomes were total demand for antiviral (neuraminidase inhibitor) treatment and the number of hospitalizations and deaths averted. The model included estimates of attack rate, healthcare-seeking behavior, prescription rates, adherence, disease severity, and the potential effect of antivirals on the risks of hospitalization and death. Based on these inputs, the total antiviral regimens estimated to be available in the United States (as of April 2013) were sufficient to meet treatment needs for the scenarios considered. However, distribution logistics were not examined and should be addressed in future work. Treatment was estimated to avert many severe outcomes (5200-248 000 deaths; 4800-504 000 hospitalizations); however, large numbers remained (25 000-425 000 deaths; 580 000-3 700 000 hospitalizations), suggesting that the impact of combinations of interventions should be examined. PMID:25878299

  1. Reduced Topological Efficiency in Cortical-Basal Ganglia Motor Network of Parkinson's Disease: A Resting State fMRI Study

    PubMed Central

    Long, Zhiliang; Wu, Guo-Rong; Hu, Xiaofei; Zhang, Yanling; Wang, Jian

    2014-01-01

    Parkinson's disease (PD) is mainly characterized by dopamine depletion of the cortico-basal ganglia (CBG) motor circuit. Given that dopamine dysfunction could affect functional brain network efficiency, the present study utilized resting-state fMRI (rs-fMRI) and graph theoretical approach to investigate the topological efficiency changes of the CBG motor network in patients with PD during a relatively hypodopaminergic state (12 hours after a last dose of dopamimetic treatment). We found that PD compared with controls had remarkable decreased efficiency in the CBG motor network, with the most pronounced changes observed in rostral supplementary motor area (pre-SMA), caudal SMA (SMA-proper), primary motor cortex (M1), primary somatosensory cortex (S1), thalamus (THA), globus pallidus (GP), and putamen (PUT). Furthermore, reduced efficiency in pre-SMA, M1, THA and GP was significantly correlated with Unified Parkinson's Disease Rating Scale (UPDRS) motor scores in PD patients. Together, our results demonstrate that individuals with PD appear to be less effective at information transfer within the CBG motor pathway, which provides a novel perspective on neurobiological explanation for the motor symptoms in patients. These findings are in line with the pathophysiology of PD, suggesting that network efficiency metrics may be used to identify and track the pathology of PD. PMID:25279557

  2. Spatial clustering by disease severity among reported Rocky Mountain spotted fever cases in the United States, 2001-2005.

    PubMed

    Adjemian, Jennifer Zipser; Krebs, John; Mandel, Eric; McQuiston, Jennifer

    2009-01-01

    Rocky Mountain spotted fever (RMSF) occurs throughout much of the United States, ranging in clinical severity from moderate to fatal infection. Yet, little is known about possible differences among severity levels across geographic locations. To identify significant spatial clusters of severe and non-severe disease, RMSF cases reported to Centers for Disease Control and Prevention (CDC) were geocoded by county and classified by severity level. The statistical software program SaTScan was used to detect significant spatial clusters. Of 4,533 RMSF cases reported, 1,089 hospitalizations (168 with complications) and 23 deaths occurred. Significant clusters of 6 deaths (P = 0.05, RR = 11.4) and 19 hospitalizations with complications (P = 0.02, RR = 3.45) were detected in southwestern Tennessee. Two geographic areas were identified in north-central North Carolina with unusually low rates of severity (P = 0.001, RR = 0.62 and P = 0.001, RR = 0.45, respectively). Of all hospitalizations, 20% were clustered in central Oklahoma (P = 0.02, RR = 1.43). Significant geographic differences in severity were observed, suggesting that biologic and/or anthropogenic factors may be impacting RMSF epidemiology in the United States. PMID:19141843

  3. Unilaterally and rapidly progressing white matter lesion and elevated cytokines in a patient with Tay–Sachs disease

    Microsoft Academic Search

    Tomomi Hayase; Jun Shimizu; Tamako Goto; Yasuyuki Nozaki; Masato Mori; Naoto Takahashi; Eiji Namba; Takanori Yamagata; Mariko Y. Momoi

    2010-01-01

    We report the case of a girl with Tay–Sachs disease who had convulsions and deteriorated rapidly after an upper respiratory infection at the age of 11 months. At the age of 16 months, her seizures became intractable and magnetic resonance imaging of the brain showed high signal intensity on T2-weighted images and marked swelling in the white matter and basal

  4. Towards evidence-based emergency medicine: Best BETs from the Manchester Royal Infirmary. BET 2: Steroid therapy in the treatment of intractable hyperemesis gravidarum.

    PubMed

    Poon, Siu Ling

    2011-10-01

    A short-cut review was performed to evaluate whether steroids could be an effective therapy in hyper-emesis gravidarum. A database search revealed 9 papers relevant to this question and the details of each study methods and results were displayed in a table. The quality of these studies was generally low. There is only weak evidence that steroids could be an effective treatment for intractable hyper-emesis gravidarum. PMID:21918097

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

    PubMed Central

    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

    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

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

    PubMed Central

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

    2009-01-01

    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

  7. Design and operation of state and local infectious disease surveillance systems.

    PubMed

    Hopkins, Richard S

    2005-01-01

    Since 2001, increased attention has been focused on improving acute infectious disease surveillance systems. This article describes options for their design and operation. Systems designed primarily to detect individual cases of reportable diseases may differ from those designed to detect outbreaks or support design or evaluation of control programs. Timeliness, sensitivity, and predictive value of surveillance systems cannot all be maximized at the same time. Core activities of surveillance systems include collection, analysis, and dissemination of information about health events under surveillance. Doing these well requires attention to the mechanics of surveillance, such as making the health department accessible at all times to receive reports and provide consultation, and maintaining current directories of persons for dissemination of surveillance data, alerts, and recommendations. Rapid access to electronic representations of health events (eg, laboratory reports, patient records, or health care claims) provides great opportunities for more timely and complete surveillance. Some important information (eg, exposures, contacts) will still need to be collected directly from affected persons. One productive strategy is to collect core demographic and onset data on all cases and detailed clinical, exposure, and outcome data on a subset. PMID:15829830

  8. Obesity as a disease state: a new paradigm for diagnosis and treatment.

    PubMed

    Aronne, Louis J; Nelinson, Donald S; Lillo, Joseph L

    2009-01-01

    While global prevalence of obesity continues to increase dramatically, treatment options remain less than optimal. The etiology of obesity is multifactorial, ranging from lifestyle choices such as excess food intake and insufficient physical activity, to use of medications that have weight gain as an undesirable side effect. Economic and political determinants of available foodstuffs and even social networks may also contribute to obesity. Successful management of obesity requires the understanding and acceptance of a new paradigm that identifies obesity as a disease--one defined by waist circumference--that requires treatment. Obesity meets all accepted criteria of a medical disease, including a known etiology, recognized signs and symptoms, and a range of structural and functional changes that culminate in pathologic consequences. Excess adipose tissue acts as an endocrine organ to produce excess free fatty acids, as well as tumor necrosis factor-alpha, interleukin-6, leptin, and plasminogen activator inhibitor-1. These bioactive molecules are associated with hyperinsulinemia, hyperglycemia, insulin resistance, development of diabetes, endothelial damage, and the onset and progression of atherosclerotic lesions. Options for treating obesity include lifestyle modifications (dietary changes, increased physical activity, behavior modification) and, for the morbidly obese, surgery. Lifestyle modification is rarely successful over the long term; therefore, addition of pharmacotherapy should be considered for obese individuals who have difficulty achieving and maintaining weight goals with lifestyle modifications alone. Several weight loss drugs are available for long-term use, with others in various stages of clinical development. PMID:19789061

  9. Differential Epidemiology: IQ, Neuroticism, and Chronic Disease by the 50 U.S. States

    ERIC Educational Resources Information Center

    Pesta, Bryan J.; Bertsch, Sharon; McDaniel, Michael A.; Mahoney, Christine B.; Poznanski, Peter J.

    2012-01-01

    Current research shows that geo-political units (e.g., the 50 U.S. states) vary meaningfully on psychological dimensions like intelligence (IQ) and neuroticism (N). A new scientific discipline has also emerged, differential epidemiology, focused on how psychological variables affect health. We integrate these areas by reporting large correlations…

  10. DISEASES DIAGNOSED IN WILD TURKEYS (MELEAGRIS GALLOPAVO) OF THE SOUTHEASTERN UNITED STATES

    Microsoft Academic Search

    William R. Davidson; Victor F. Nettles; C. Edward Couvillion; Elizabeth W. Howerth

    Diagnostic findings are presented on 139 sick or dead wild turkeys examined during the period 1972 through 1984. Turkeys originated from eight southeastern states (Alabama, Ar- kansas, Florida, Georgia, South Carolina, Tennessee, Virginia, West Virginia) and included 31 turkeys categorized as capture-related mortalities and 108 turkeys categorized as natural mortal- ities. Frequent diagnoses (? 10% of case accessions) in the

  11. Lumbar paravertebral blockade as intractable pain management method in palliative care

    PubMed Central

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

    2013-01-01

    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

  12. Promoting state health department evidence-based cancer and chronic disease prevention: a multi-phase dissemination study with a cluster randomized trial component

    PubMed Central

    2013-01-01

    Background Cancer and other chronic diseases reduce quality and length of life and productivity, and represent a significant financial burden to society. Evidence-based public health approaches to prevent cancer and other chronic diseases have been identified in recent decades and have the potential for high impact. Yet, barriers to implement prevention approaches persist as a result of multiple factors including lack of organizational support, limited resources, competing emerging priorities and crises, and limited skill among the public health workforce. The purpose of this study is to learn how best to promote the adoption of evidence based public health practice related to chronic disease prevention. Methods/design This paper describes the methods for a multi-phase dissemination study with a cluster randomized trial component that will evaluate the dissemination of public health knowledge about evidence-based prevention of cancer and other chronic diseases. Phase one involves development of measures of practitioner views on and organizational supports for evidence-based public health and data collection using a national online survey involving state health department chronic disease practitioners. In phase two, a cluster randomized trial design will be conducted to test receptivity and usefulness of dissemination strategies directed toward state health department chronic disease practitioners to enhance capacity and organizational support for evidence-based chronic disease prevention. Twelve state health department chronic disease units will be randomly selected and assigned to intervention or control. State health department staff and the university-based study team will jointly identify, refine, and select dissemination strategies within intervention units. Intervention (dissemination) strategies may include multi-day in-person training workshops, electronic information exchange modalities, and remote technical assistance. Evaluation methods include pre-post surveys, structured qualitative phone interviews, and abstraction of state-level chronic disease prevention program plans and progress reports. Trial registration clinicaltrials.gov: NCT01978054. PMID:24330729

  13. 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

    Baylor, Carolyn; McAuliffe, Megan J.; Hughes, Louise E.; Yorkston, Kathryn; Anderson, Tim; Jiseon, Kim; Amtmann, Dagmar

    2014-01-01

    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…

  14. Endothelial dysfunction and coronary artery disease: a state of the art review.

    PubMed

    Veerasamy, Murugapathy; Bagnall, Alan; Neely, Dermot; Allen, John; Sinclair, Hannah; Kunadian, Vijay

    2015-01-01

    Atherosclerotic coronary artery disease (CAD) is a major cause of morbidity and mortality in the developed world. Endothelial dysfunction plays an important role in the development of atherosclerosis and predicts cardiovascular (CV) outcomes independent of conventional CV risk factors. In recent years, there have been tremendous improvements in the pharmacological prevention and management of CAD. In this review, the pathophysiology of endothelial dysfunction in relation to CAD is discussed and various techniques of invasive and noninvasive assessments of peripheral and coronary endothelial function described. In addition, evidence for the association of endothelial dysfunction and CV outcomes has been examined and finally the role of therapeutic interventions in endothelial dysfunction has been discussed. PMID:25420051

  15. FastStats: Kidney Disease

    MedlinePLUS

    ... Diseases and Conditions Anemia or Iron Deficiency Cancer Cancer Prostate Disease Cardiovascular Cerebrovascular Disease or Stroke Cholesterol Heart ... States, 2013, table 97 [PDF - 9.8 MB] > Incidence and prevalence of end-stage renal disease Health, United States, ...

  16. Fingolimod for the treatment of neurological diseases—state of play and future perspectives

    PubMed Central

    Brunkhorst, Robert; Vutukuri, Rajkumar; Pfeilschifter, Waltraud

    2014-01-01

    Sphingolipids are a fascinating class of signaling molecules derived from the membrane lipid sphingomyelin. They show abundant expression in the brain. Complex sphingolipids such as glycosphingolipids (gangliosides and cerebrosides) regulate vesicular transport and lysosomal degradation and their dysregulation can lead to storage diseases with a neurological phenotype. More recently, simple sphingolipids such ceramide, sphingosine and sphingosine 1-phosphate (S1P) were discovered to signal in response to many extracellular stimuli. Forming an intricate signaling network, the balance of these readily interchangeable mediators is decisive for cell fate under stressful conditions. The immunomodulator fingolimod is the prodrug of an S1P receptor agonist. Following receptor activation, the drug leads to downregulation of the S1P1 receptor inducing functional antagonism. As the first drug to modulate the sphingolipid signaling pathway, it was marketed in 2010 for the treatment of multiple sclerosis (MS). At that time, immunomodulation was widely accepted as the key mechanism of fingolimod’s efficacy in MS. But given the excellent passage of this lipophilic compound into the brain and its massive brain accumulation as well as the abundant expression of S1P receptors on brain cells, it is conceivable that fingolimod also affects brain cells directly. Indeed, a seminal study showed that the protective effect of fingolimod in experimental autoimmune encephalitis (EAE), a murine MS model, is lost in mice lacking the S1P1 receptor on astrocytes, arguing for a specific role of astrocytic S1P signaling in MS. In this review, we discuss the role of sphingolipid mediators and their metabolizing enzymes in neurologic diseases and putative therapeutic strategies arising thereof. PMID:25309325

  17. Oncohematological diseases in the Vale do Paraíba, State of São Paulo: demographic aspects, prevalences and incidences

    PubMed Central

    Callera, Fernando; Brasil, Alvaro Azevedo Vital; Casali, Anna Raquel de Lima; Mulin, Carla Cecília; Rosa, Evandro Secchi; Barbosa, Maira de Assis; Vieira, Thais Domitila Freire

    2011-01-01

    Background Based on the necessity of detailed information that supports effective strategies to improve cancer outcomes in the different regions of Brazil, the aims of this study were to report demographic aspects and to calculate the prevalence and incidence rates of oncohematological diseases in the region of Vale do Paraíba. Methods This is a multicentric prospective study carried out from October 2009 to March 2010. A total of 500 over 19-year-old patients were enrolled. Data such as type of healthcare insurance, gender, age, ethnic classification, place of residence, schooling, income, body mass index, new cases and the period between the first symptoms and a definite diagnosis were collected. The prevalence and incidence rates were calculated according to an estimated number of 1,319,800 inhabitants. Results The prevalence and incidence rates per 100,000 inhabitants in the period of six months were, respectively: acute myeloid leukemia 1.5 and 0.7; acute lymphoblastic leukemia 0.5 and 0.1; chronic lymphocytic leukemia 2.4 and 0.4; chronic myeloid leukemia 6.2 and 0.8; Hodgkin's lymphoma 2.9 and 0.9; non-Hodgkin lymphoma 9.8 and 4.3; multiple myeloma 5.7 and 0.7; myelodysplastic syndromes 2.1 and 0.2 and myeloproliferative syndromes 5.1 and 0.3. Conclusion Giving the paucity of data in this field of investigation, our data may be useful for comparisons with those of other regions of Brazil and will assist in the implementation of treatment programs of oncohematological diseases in this region. PMID:23284259

  18. Prevalence of chronic disease and insurance coverage among refugees in the United States.

    PubMed

    Yun, Katherine; Fuentes-Afflick, Elena; Desai, Mayur M

    2012-12-01

    Little is known about the health status of refugees beyond the immediate post-arrival period in the US. Using data from the 2003 New Immigrant Survey, a nationally representative survey of immigrants who had recently become legal permanent residents, we determined the prevalence of chronic conditions and health insurance coverage among adult refugees who had lived in the US for at least 1 year (n = 490). We compared their health status with that of other immigrants (n = 3,715) using multivariable logistic regression. The median duration of US residency was 5.6 and 8.0 years among refugees and other immigrants, respectively. Refugees were more likely than other immigrants to report at least one chronic condition (24.7 vs. 15.6 %, P < 0.001). After adjusting for sociodemographic differences, the odds of the following conditions remained significantly higher among refugees: arthritis (adjusted odds ratio [AOR] = 1.67, 95 % confidence interval [CI] = 1.07, 2.61), heart disease (AOR = 2.49, 95 % CI = 1.30, 4.74), stroke (AOR = 5.87, 95 % CI = 1.27, 27.25), activity-limitation due to pain (AOR = 1.96, 95 % CI = 1.31, 2.93), and any chronic condition (AOR = 1.37, 95 % CI = 1.03, 1.81). Although similar percentages of refugees (49.0 %) and other immigrants (47.4 %) were uninsured, 46.5 % of refugees with chronic conditions lacked health insurance. Refugees have a high burden of chronic disease and would benefit from expanded insurance coverage for adults with preexisting conditions. PMID:22527741

  19. Regression methods for investigating risk factors of chronic kidney disease outcomes: the state of the art

    PubMed Central

    2014-01-01

    Background Chronic kidney disease (CKD) is a progressive and usually irreversible disease. Different types of outcomes are of interest in the course of CKD such as time-to-dialysis, transplantation or decline of the glomerular filtration rate (GFR). Statistical analyses aiming at investigating the association between these outcomes and risk factors raise a number of methodological issues. The objective of this study was to give an overview of these issues and to highlight some statistical methods that can address these topics. Methods A literature review of statistical methods published between 2002 and 2012 to investigate risk factors of CKD outcomes was conducted within the Scopus database. The results of the review were used to identify important methodological issues as well as to discuss solutions for each type of CKD outcome. Results Three hundred and four papers were selected. Time-to-event outcomes were more often investigated than quantitative outcome variables measuring kidney function over time. The most frequently investigated events in survival analyses were all-cause death, initiation of kidney replacement therapy, and progression to a specific value of GFR. While competing risks were commonly accounted for, interval censoring was rarely acknowledged when appropriate despite existing methods. When the outcome of interest was the quantitative decline of kidney function over time, standard linear models focussing on the slope of GFR over time were almost as often used as linear mixed models which allow various numbers of repeated measurements of kidney function per patient. Informative dropout was accounted for in some of these longitudinal analyses. Conclusions This study provides a broad overview of the statistical methods used in the last ten years for investigating risk factors of CKD progression, as well as a discussion of their limitations. Some existing potential alternatives that have been proposed in the context of CKD or in other contexts are also highlighted. PMID:24628838

  20. Impaired development of intrinsic connectivity networks in children with medically intractable localization-related epilepsy.

    PubMed

    Ibrahim, George M; Morgan, Benjamin R; Lee, Wayne; Smith, Mary Lou; Donner, Elizabeth J; Wang, Frank; Beers, Craig A; Federico, Paolo; Taylor, Margot J; Doesburg, Sam M; Rutka, James T; Snead, O Carter

    2014-11-01

    Typical childhood development is characterized by the emergence of intrinsic connectivity networks (ICNs) by way of internetwork segregation and intranetwork integration. The impact of childhood epilepsy on the maturation of ICNs is, however, poorly understood. The developmental trajectory of ICNs in 26 children (8-17 years) with localization-related epilepsy and 28 propensity-score matched controls was evaluated using graph theoretical analysis of whole brain connectomes from resting-state functional magnetic resonance imaging (fMRI) data. Children with epilepsy demonstrated impaired development of regional hubs in nodes of the salience and default mode networks (DMN). Seed-based connectivity and hierarchical clustering analysis revealed significantly decreased intranetwork connections, and greater internetwork connectivity in children with epilepsy compared to controls. Significant interactions were identified between epilepsy duration and the expected developmental trajectory of ICNs, indicating that prolonged epilepsy may cause progressive alternations in large-scale networks throughout childhood. DMN integration was also associated with better working memory, whereas internetwork segregation was associated with higher full-scale intelligence quotient scores. Furthermore, subgroup analyses revealed the thalamus, hippocampus, and caudate were weaker hubs in children with secondarily generalized seizures, relative to other patient subgroups. Our findings underscore that epilepsy interferes with the developmental trajectory of brain networks underlying cognition, providing evidence supporting the early treatment of affected children. PMID:24976288

  1. Clobazam: a newly approved but well-established drug for the treatment of intractable epilepsy syndromes.

    PubMed

    Wheless, James W; Phelps, Stephanie J

    2013-02-01

    Clobazam, a 1,5-benzodiazepine, was introduced in the 1970s as an anxiolytic and antiepileptic drug. Despite worldwide usage, it was only recently approved in the United States (seizures associated with Lennox-Gastaut syndrome). This article reviews historical and recent data to help practitioners better understand clobazam's clinical properties and usage. In many clinical trials, open-label studies, and retrospective reviews, clobazam was generally associated with ?50% seizure reduction for more than half of Lennox-Gastaut syndrome patients, with approximately 10% achieving freedom from drop attacks. Efficacy is persistent, with little evidence for development of tolerance. Clobazam's safety profile appears to be similar to that of other benzodiazepines, but with substantially decreased sedation and increased psychomotor performance. Studies suggest clobazam acts through potentiation of gamma-aminobutyric acid type A receptors in a manner similar to other benzodiazepines. However, clobazam appears to display greater selectivity for receptors responsible for anticonvulsant activity than for those involved in sedation. PMID:23112237

  2. Comparison of the effect of decompressive craniectomy on different neurosurgical diseases

    Microsoft Academic Search

    Ki-Tae Kim; Jin-Kyu Park; Seok-Gu Kang; Kyung-Suck Cho; Do-Sung Yoo; Dong-Kyu Jang; Pil-Woo Huh; Dal-Soo Kim

    2009-01-01

    Background  Many previous studies have reported that decompressive craniectomy has improved clinical outcomes in patients with intractable\\u000a increased intracranial pressure (ICP) caused by various neurosurgical diseases. However there is no report that compares the\\u000a effectiveness of the procedure in the different conditions. The authors performed decompressive craniectomy following a constant\\u000a surgical indication and compared the clinical outcomes in different neurosurgical diseases.

  3. Coverage of the Ebola Virus Disease Epidemic in Three Widely Circulated United States Newspapers: Implications for Preparedness and Prevention

    PubMed Central

    Basch, Corey H; Basch, Charles E; Redlener, Irwin

    2014-01-01

    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

  4. Trends in the prevalence of hospitalization attributable to hypertensive diseases among United States adults aged 35 and older from 1980 to 2007.

    PubMed

    Liu, Longjian; An, Yuan; Chen, Ming; Liu, Zuolu; Hu, Xiaohua; Chou, Edgar; Eisen, Howard J

    2013-09-01

    We aimed to examine the trend in the prevalence of hospitalization attributable to hypertensive disease and its subtypes among United States adults aged ?35 years from 1980 to 2007. Data (n = 4,598,488,000 hospitalized cases) from the National Hospital Discharge Surveys were used to examine the trends of hospitalized patients with first (the reason for admission) and patients with any second to seventh (a co-morbid condition when admission) diagnosis of hypertensive disease (International Classification of Disease, 9th Revision, Clinical Modification: 401 to 405) by gender and geographic region. Age-adjusted rates of disease were calculated using the United States 2000 standard population. The results show that age-adjusted hospitalization rates due to first diagnosis of hypertensive disease increased from 1.74% to 2.06% in men (p <0.01), and from 2.0% to 2.09% in women (p = 0.06) from 1980 to 1981 to 2006 to 2007. Age-adjusted rates due to any second to seventh diagnosis of hypertensive disease significantly increased from 7.06% to 35.09% in men (p <0.001), and from 7.88% to 31.98% (p <0.001) in women from 1980 to 1981 to 2006 to 2007. Patients with second to seventh diagnosis of essential hypertension and hypertensive chronic kidney disease had the highest and the second highest annual percent increases. Subjects living in the Southern region of the United States had the highest prevalence of hospitalization due to any second to seventh diagnosis of hypertensive disease compared with all other regions in 2006 to 2007. In conclusion, the prevalence of hospitalization due to hypertensive disease significantly increased in the United States from 1980 to 2007. PMID:23726180

  5. Treatment patterns of chronic obstructive pulmonary disease in employed adults in the United States

    PubMed Central

    Diette, Gregory B; Dalal, Anand A; D’Souza, Anna O; Lunacsek, Orsolya E; Nagar, Saurabh P

    2015-01-01

    Background This study evaluated patterns of pharmacotherapy in chronic obstructive pulmonary disease (COPD) as they relate to recommended guidelines in a prevalent COPD patient population with employer-sponsored health insurance in the US. Methods Health care claims data from 2007 and 2008 were retrospectively analyzed for the study population defined as patients aged 40 years and older, continuously enrolled during the study period, and having at least one inpatient or one emergency department (ED) visit, or at least two outpatient claims coded with COPD (International Classification of Diseases, 9th Revision, Clinical Modification code 491.xx, 492.xx, 496.xx). Rates of any pharmacotherapy (both maintenance and reliever), long-acting maintenance pharmacotherapy in patients with an exacerbation history, and short-term treatment of acute exacerbations of COPD were evaluated in the overall population, newly diagnosed, and previously diagnosed patients (including maintenance-naïve and maintenance-experienced). Stratified analyses were also conducted by age group (40–64 years, ?65 years) and physician specialty. Results A total of 55,361 patients met study criteria of whom 39% were newly diagnosed. The mean age was 66 years, and 46% were male. Three-fourths (74%) of all COPD patients had some pharmacotherapy (maintenance or reliever) with less than half (45%) being treated with maintenance medications. The combination of an inhaled corticosteroid and a long-acting beta-agonist was the most prevalent drug class for maintenance treatment followed by tiotropium. Only 64% of patients with an exacerbation history had a prescription for a long-acting maintenance medication, and short-term treatment with oral corticosteroids or antibiotics was higher for hospitalization exacerbations compared to ED visit exacerbations (68% vs 44%). In general, the rates of pharmacotherapy were highest in patients who were maintenance-experienced followed by newly diagnosed and maintenance-naïve. Conclusion The majority of COPD patients received maintenance or reliever COPD medications, but less than half received guideline-recommended care, especially those with an exacerbation history or receiving short-term treatment for acute exacerbations. PMID:25759574

  6. Etiology of three recent diseases of citrus in São Paulo State: sudden death, variegated chlorosis and huanglongbing.

    PubMed

    Bové, Joseph Marie; Ayres, Antonio Juliano

    2007-01-01

    The state of São Paulo (SSP) is the first sweet orange growing region in the world. Yet, the SSP citrus industry has been, and still is, under constant attack from various diseases. In the 1940s, tristeza-quick decline (T-QD) was responsible for the death of 9 million trees in SSP. The causal agent was a new virus, citrus tristeza virus (CTV). The virus was efficiently spread by aphid vectors, and killed most of the trees grafted on sour orange rootstock. Control of the disease resided in replacing sour orange by alternative rootstocks giving tolerant combinations with scions such as sweet orange. Because of its drought resistance, Rangpur lime became the favourite alternative rootstock, and, by 1995, 85% of the SSP sweet orange trees were grafted on this rootstock. Therefore, when in 1999, many trees grafted on Rangpur lime started to decline and suddenly died, the spectre of T-QD seemed to hang over SSP again. By 2003, the total number of dead or affected trees was estimated to be over one million. The new disease, citrus sudden death (CSD), resembles T-QD in several aspects. The two diseases have almost the same symptoms, they spread in time and space in a manner strikingly similar, and the pathological anatomy of the bark at the bud union is alike. Transmission of the CSD agent by graft-inoculation has been obtained with budwood inoculum taken not only on CSD-affected trees (grafted on Rangpur lime), but also on symptomless trees (grafted on Cleopatra mandarin) from the same citrus block. This result shows that symptomless trees on Cleopatra mandarin are tolerant to the CSD agent. Trees on rootstocks such as Sunki mandarin or Swingle citrumelo are also tolerant. Thus, in the CSD-affected region, control consists in replacing Rangpur lime with compatible rootstocks, or in approach-grafting compatible rootstock seedlings to the scions of trees on Rangpur lime (inarching). More than 5 million trees have been inarched in this way. A new disease of sweet orange, citrus variegated chlorosis (CVC), was observed in 1987 in the Triangulo Mineiro of Minas Gerais State and the northern and north-eastern parts of SSP. By 2000, the disease affected already 34% of the 200 million sweet orange trees in SSP. By 2005, the percentage had increased to 43%, and CVC was present in all citrus growing regions of Brazil. Electron microscopy showed that xylem-limited bacteria were present in all symptomatic sweet orange leaves and fruit tissues tested, but not in similar materials from healthy, symptomless trees. Bacteria were consistently cultured from twigs of CVC-affected sweet orange trees but not from twigs of healthy trees. Serological analyses showed the CVC bacterium to be a strain of Xylella fastidiosa. The disease could be reproduced and Koch's postulates fulfilled, by mechanically inoculating a pure culture of X. fastidiosa isolate 8.1.b into sweet orange seedlings. The genome of a CVC strain of X. fastidiosa was sequenced in SSP in the frame of a project supported by FAPESP and Fundecitrus. X. fastidiosa is the first plant pathogenic bacterium, the genome of which has been sequenced. Until recently, America was free of huanglongbing (HLB), but in March 2004 and August 2005, symptoms of the disease were recognized, respectively in the State of São Paulo (SSP) and in Florida, USA. HLB was known in China since 1870 and in South Africa since 1928. Because of its destructiveness and its rapid spread by efficient psyllid insect-vectors, HLB is probably the most serious citrus disease. HLB is caused by a phloem sieve tube-restricted Gram negative bacterium, not yet available in culture. In the 1990s, the bacterium was characterized by molecular techniques as a member of the alpha proteobacteria designated Candidatus Liberibacter africanus for the disease in Africa, and Candidatus Liberibacter asiaticus for HLB in Asia. In SSP, Ca. L. asiaticus is also present, but most of the trees are infected with a new species, Candidatus Liberibacter americanus. PMID:17505974

  7. Disparities in Injury Mortality Between Uganda and the United States: Comparative Analysis of a Neglected Disease

    Microsoft Academic Search

    Sudha Jayaraman; Doruk Ozgediz; Justin Miyamoto; Nolan Caldwell; Michael S. Lipnick; Cephas Mijumbi; Jacqueline Mabweijano; Renee Hsia; Rochelle Dicker

    2011-01-01

    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

  8. 76 FR 15211 - Changes in Disease Status of the Brazilian State of Santa Catarina With Regard to Certain...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-21

    ...as free of foot-and-mouth disease (FMD), rinderpest, swine vesicular disease...trading relationships with rinderpest- or FMD-affected countries. In the final rule...rinderpest, foot-and-mouth disease (FMD), African swine fever (ASF),...

  9. Root Diseases: Primary Agents and Secondary Consequences of Disturbance

    SciTech Connect

    Otrosina, W.J.; Ferrell, G.T.

    1995-01-01

    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.

  10. Building a roadmap for developing combination therapies for Alzheimer's disease.

    PubMed

    Perry, Daniel; Sperling, Reisa; Katz, Russell; Berry, Donald; Dilts, David; Hanna, Debra; Salloway, Stephen; Trojanowski, John Q; Bountra, Chas; Krams, Michael; Luthman, Johan; Potkin, Steven; Gribkoff, Val; Temple, Robert; Wang, Yaning; Carrillo, Maria C; Stephenson, Diane; Snyder, Heather; Liu, Enchi; Ware, Tony; McKew, John; Fields, F Owen; Bain, Lisa J; Bens, Cynthia

    2015-03-01

    Combination therapy has proven to be an effective strategy for treating many of the world's most intractable diseases. A growing number of investigators in academia, industry, regulatory agencies, foundations and advocacy organizations are interested in pursuing a combination approach to treating Alzheimer's disease. A meeting co-hosted by the Accelerate Cure/Treatments for Alzheimer's Disease Coalition, the Critical Path Institute and the Alzheimer's Association addressed challenges in designing clinical trials to test multiple treatments in combination and outlined a roadmap for making such trials a reality. PMID:25708309

  11. Sexually transmitted diseases in the history of Uganda.

    PubMed Central

    Lyons, M

    1994-01-01

    First noticed in Uganda in 1863 by a European explorer, sexually transmitted diseases (STDs) were cited as a major cause of morbidity and mortality throughout this century. In 1908 the venereal diseases campaign was launched marking the real introduction of western medicine. By the mid-1920s, the campaign was combined with the medical service but throughout the colonial period (1901-1962) venereal diseases were considered intractable. A 1991 survey revealed alarming incidence rates and in light of the importance of STDs as a co-factor in the transmission of HIV, it is of paramount importance to implement more effective control measures. PMID:8206475

  12. Chlamydia pneumoniae and Oxidative Stress in Cardiovascular Disease: State of the Art and Prevention Strategies

    PubMed Central

    Di Pietro, Marisa; Filardo, Simone; De Santis, Fiorenzo; Mastromarino, Paola; Sessa, Rosa

    2014-01-01

    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

  13. Hematopoietic stem cell transplantation for sickle cell disease: state of the science.

    PubMed

    Talano, Julie-An; Cairo, Mitchell S

    2015-05-01

    Sickle cell disease (SCD) is an inherited disorder secondary to a point mutation at the sixth position of the beta chain of human hemoglobin resulting in the replacement of valine for glutamic acid. This recessive genetic abnormality precipitates the polymerization of the deoxygenated form of hemoglobin S inducing a major distortion of red blood cells (S-RBC), which decreases S-RBC deformability leading to chronic hemolysis and vaso-occlusion. These processes can result in severe complications including chronic pain, end-organ dysfunction, stroke, and early mortality. The only proven curative therapy for patients with SCD is myeloablative conditioning and allogeneic stem cell transplantation from HLA-matched sibling donors. In this review, we discuss the most recent advances in allogeneic stem cell transplantation in patients with SCD including more novel approaches such as reduced toxicity conditioning and the use of alternative allogeneic donors, including matched unrelated donors (MUDs), unrelated cord blood donors (UCBT), and familial haploidentical (FHI) donors. The results to date are very encouraging regarding allogeneic stem cell transplantation for patients with SCD including high survival rates and enabling a greater number of patients suffering from this chronic and debilitating condition to receive curative allogeneic stem cell therapies. However, we still have several areas to investigate and barriers to overcome to successfully cure the majority of patients with severe SCD through allogeneic stem cell therapies. PMID:25200500

  14. In-Vivo Animation of Auditory-Language-Induced Gamma-Oscillations in Children with Intractable Focal Epilepsy

    PubMed Central

    Brown, Erik C.; Rothermel, Robert; Nishida, Masaaki; Juhász, Csaba; Muzik, Otto; Hoechstetter, Karsten; Sood, Sandeep; Chugani, Harry T.; Asano, Eishi

    2008-01-01

    We determined if high-frequency gamma-oscillations (50- to 150-Hz) were induced by simple auditory communication over the language network areas in children with focal epilepsy. Four children (ages: 7, 9, 10 and 16 years) with intractable left-hemispheric focal epilepsy underwent extraoperative electrocorticography (ECoG) as well as language mapping using neurostimulation and auditory-language-induced gamma-oscillations on ECoG. The audible communication was recorded concurrently and integrated with ECoG recording to allow for accurate time-lock upon ECoG analysis. In three children, who successfully completed the auditory-language task, high-frequency gamma-augmentation sequentially involved: i) the posterior superior temporal gyrus when listening to the question, ii) the posterior lateral temporal region and the posterior frontal region in the time interval between question completion and the patient’s vocalization, and iii) the pre- and post-central gyri immediately preceding and during the patient’s vocalization. The youngest child, with attention deficits, failed to cooperate during the auditory-language task, and high-frequency gamma-augmentation was noted only in the posterior superior temporal gyrus when audible questions were given. The size of language areas suggested by statistically-significant high-frequency gamma-augmentation was larger than that defined by neurostimulation. The present method can provide in-vivo imaging of electrophysiological activities over the language network areas during language processes. Further studies are warranted to determine whether recording of language-induced gamma-oscillations can supplement language mapping using neurostimulation in presurgical evaluation of children with focal epilepsy. PMID:18455440

  15. Upregulation of RBFOX1 in the malformed cortex of patients with intractable epilepsy and in cultured rat neurons

    PubMed Central

    WEN, MING; YAN, YONG; YAN, NING; CHEN, XIAO SHAN; LIU, SHI YONG; FENG, ZHAN HUI

    2015-01-01

    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

  16. Upregulation of RBFOX1 in the malformed cortex of patients with intractable epilepsy and in cultured rat neurons.

    PubMed

    Wen, Ming; Yan, Yong; Yan, Ning; Chen, Xiao Shan; Liu, Shi Yong; Feng, Zhan Hui

    2015-03-01

    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

  17. The many roles of the conserved eukaryotic Paf1 complex in regulating transcription, histone modifications, and disease states.

    PubMed

    Tomson, Brett N; Arndt, Karen M

    2013-01-01

    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. This article is part of a Special Issue entitled: RNA polymerase II Transcript Elongation. PMID:22982193

  18. Characterization and treatment of chronic active Epstein-Barr virus disease: a 28-year experience in the United States

    PubMed Central

    Jaffe, Elaine S.; Dale, Janet K.; Pittaluga, Stefania; Heslop, Helen E.; Rooney, Cliona M.; Gottschalk, Stephen; Bollard, Catherine M.; Rao, V. Koneti; Marques, Adriana; Burbelo, Peter D.; Turk, Siu-Ping; Fulton, Rachael; Wayne, Alan S.; Little, Richard F.; Cairo, Mitchell S.; El-Mallawany, Nader K.; Fowler, Daniel; Sportes, Claude; Bishop, Michael R.; Wilson, Wyndham; Straus, Stephen E.

    2011-01-01

    Chronic active EBV disease (CAEBV) is a lymphoproliferative disorder characterized by markedly elevated levels of antibody to EBV or EBV DNA in the blood and EBV RNA or protein in lymphocytes in tissues. We present our experience with CAEBV during the last 28 years, including the first 8 cases treated with hematopoietic stem cell transplantation in the United States. Most cases of CAEBV have been reported from Japan. Unlike CAEBV in Japan, where EBV is nearly always found in T or natural killer (NK) cells in tissues, EBV was usually detected in B cells in tissues from our patients. Most patients presented with lymphadenopathy and splenomegaly; fever, hepatitis, and pancytopenia were common. Most patients died of infection or progressive lymphoproliferation. Unlike cases reported from Japan, our patients often showed a progressive loss of B cells and hypogammaglobulinemia. Although patients with CAEBV from Japan have normal or increased numbers of NK cells, many of our patients had reduced NK-cell numbers. Although immunosuppressive agents, rituximab, autologous cytotoxic T cells, or cytotoxic chemotherapy often resulted in short-term remissions, they were not curative. Hematopoietic stem cell transplantation was often curative for CAEBV, even in patients with active lymphoproliferative disease that was unresponsive to chemotherapy. These studies are registered at http://www.clinicaltrials.gov as NCT00032513 for CAEBV, NCT00062868 and NCT00058812 for EBV-specific T-cell studies, and NCT00578539 for the hematopoietic stem cell transplantation protocol. PMID:21454450

  19. Hurling Alone? How Social Capital Failed to Save the Irish From Cardiovascular Disease in the United States

    PubMed Central

    Kelleher, C. Cecily; Lynch, John; Harper, Sam; Tay, Joseph B.; Nolan, Geraldine

    2004-01-01

    Objectives. We performed a historical review of cardiovascular risk profiles of Irish immigrants to the United States, 1850–1970, in regard to lifestyle, socio-economic circumstances, and social capital. Methods. We analyzed US Census data from 1850–1970, area-based social and epidemiological data from Boston, data from Ireland’s National Nutrition Surveillance Centre, and literature on Irish migration. Results. The Irish were consistently at increased risk of cardiovascular diseases, a risk that related initially to material deprivation, across the life course of at least 2 generations. Conclusions. The principal difference between the Irish and other disadvantaged immigrant groups, such as the Italians, was dietary habits influenced by experiences during the Irish famine. Although there was a psychosocial component to the disadvantage and discrimination they experienced as an ethnic group, the Irish also exhibited strong community networks and support structures that might have been expected to counteract discrimination’s negative effects. However, the Irish’s high levels of social capital were not protective for cardiovascular disease. PMID:15569969

  20. Widespread Increase of Functional Connectivity in Parkinson’s Disease with Tremor: A Resting-State fMRI Study

    PubMed Central

    Zhang, Delong; Liu, Xian; Chen, Jun; Liu, Bo; Wang, Jinhui

    2015-01-01

    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. PMID:25691867

  1. FXR acetylation is normally dynamically regulated by p300 and SIRT1 but constitutively elevated in metabolic disease states

    PubMed Central

    Kemper, Jongsook Kim; Xiao, Zhen; Ponugoti, Bhaskar; Miao, Ji; Fang, Sungsoon; Kanamaluru, Deepthi; Tsang, Stephanie; Wu, Shwu-Yuan; Chiang, Cheng-Ming; Veenstra, Timothy D.

    2009-01-01

    Summary The nuclear bile acid receptor FXR is critical for regulation of lipid and glucose metabolism. Here we report that FXR is a target of SIRT1, a deacetylase that mediates nutritional and hormonal modulation of hepatic metabolism. Lysine 217 of FXR is the major acetylation site targeted by p300 and SIRT1. Acetylation of FXR increases its stability but inhibits heterodimerization with RXR?, DNA binding, and transactivation activity. Down-regulation of hepatic SIRT1 increased FXR acetylation with deleterious metabolic outcomes. Surprisingly, in mouse models of metabolic disease, FXR interaction with SIRT1 and p300 was dramatically altered, FXR acetylation levels were elevated, and overexpression of SIRT1 or resveratrol treatment reduced acetylated FXR levels. Our data demonstrate that FXR acetylation is normally dynamically regulated by p300 and SIRT1 but is constitutively elevated in metabolic disease states. Small molecules that inhibit FXR acetylation by targeting SIRT1 or p300 may be promising therapeutic agents for metabolic disorders. PMID:19883617

  2. Parkinson disease-associated mutation R1441H in LRRK2 prolongs the "active state" of its GTPase domain.

    PubMed

    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

    2014-03-18

    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

  3. Dietary acid load and chronic kidney disease among adults in the United States

    PubMed Central

    2014-01-01

    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

  4. Geologic occurrences of erionite in the United States: an emerging national public health concern for respiratory disease

    USGS Publications Warehouse

    Van Gosen, Bradley S.; Blitz, Thomas A.; Plumlee, Geoffrey S.; Meeker, Gregory P.; Pierson, M. Patrick

    2013-01-01

    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.

  5. Resting state cortical electroencephalographic rhythms and white matter vascular lesions in subjects with Alzheimer's disease: an Italian multicenter study.

    PubMed

    Babiloni, Claudio; Lizio, Roberta; Carducci, Filippo; Vecchio, Fabrizio; Redolfi, Alberto; Marino, Silvia; Tedeschi, Gioacchino; Montella, Patrizia; Guizzaro, Antonio; Esposito, Fabrizio; Bozzao, Alessandro; Giubilei, Franco; Orzi, Francesco; Quattrocchi, Carlo C; Soricelli, Andrea; Salvatore, Elena; Baglieri, Annalisa; Bramanti, Placido; Cavedo, Enrica; Ferri, Raffaele; Cosentino, Filomena; Ferrara, Michelangelo; Mundi, Ciro; Grilli, Gianpaolo; Pugliese, Silvia; Gerardi, Gianluca; Parisi, Laura; Vernieri, Fabrizio; Triggiani, Antonio I; Pedersen, Jan T; Hårdemark, Hans-Göran; Rossini, Paolo M; Frisoni, Giovanni B

    2011-01-01

    Resting state electroencephalographic (EEG) rhythms do not deteriorate with the increase of white matter vascular lesion in amnesic mild cognitive impairment (MCI) subjects [1], although white matter is impaired along Alzheimer's disease (AD). Here we tested whether this is true even in AD subjects. Closed-eye resting state EEG data were recorded in 40 healthy elderly (Nold), 96 amnesic MCI, and 83 AD subjects. White matter vascular lesions were indexed by magnetic resonance imaging recorded in the MCI and AD subjects (about 42% of cases following ADNI standards). The MCI subjects were divided into two sub-groups based on the median of the white matter lesion, namely MCI+ (people with highest vascular load; n = 48) and MCI- (people with lowest vascular load; n = 48). The same was true for the AD subjects (AD+, n = 42; AD-, n = 41). EEG rhythms of interest were delta (2-4 Hz), theta (4-8 Hz), alpha1 (8-10.5 Hz), alpha2 (10.5-13 Hz), beta1 (13-20 Hz), beta2 (20-30 Hz), and gamma (30-40 Hz). LORETA software estimated cortical EEG sources. When compared to Nold group, MCI and AD groups showed well known abnormalities of delta and alpha sources. Furthermore, amplitude of occipital, temporal, and limbic alpha 1 sources were higher in MCI+ than MCI- group. As a novelty, amplitude of occipital delta sources was lower in AD+ than AD- group. Furthermore, central, parietal, occipital, temporal, and limbic alpha sources were higher in amplitude in AD+ than AD- group. Amplitude of these sources was correlated to global cognitive status (i.e., Mini Mental State Evaluation score). These results suggest that in amnesic MCI and AD subjects, resting state posterior delta and alpha EEG rhythms do not deteriorate with the increase of white-matter vascular lesion. These rhythms might be more sensitive to AD neurodegenerative processes and cognitive status rather than to concomitant lesions to white matter. PMID:21673406

  6. Clinical inquiries regarding Ebola virus disease received by CDC--United States, July 9-November 15, 2014.

    PubMed

    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

    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

  7. Solid-state laser source of narrowband ultraviolet B light for skin disease care

    NASA Astrophysics Data System (ADS)

    Tarasov, Aleksandr A.; Chu, Hong

    2013-03-01

    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.

  8. Prospective spatial prediction of infectious disease: experience of New York State (USA) with West Nile Virus and proposed directions for improved surveillance

    Microsoft Academic Search

    Glen D. Johnson

    2008-01-01

    Infectious disease surveillance has become an international top priority due to the perceived risk of bioterrorism. This is\\u000a driving the improvement of real-time geo-spatial surveillance systems for monitoring disease indicators, which is expected\\u000a to have many benefits beyond detecting a bioterror event. West Nile Virus surveillance in New York State (USA) is highlighted\\u000a as a working system that uses dead

  9. Selected Bibliographies and State-of-the-Art Review for Communicable Diseases Control. Volume 1: Communicable Diseases and Health Planning References. International Health Planning and Reference Series.

    ERIC Educational Resources Information Center

    White (E.H.) Co., San Francisco, CA.

    Intended as a companion piece to volume 1 in the Methods Series, Communicable Disease Control Planing (CE 024 229), this first of six volumes in the International Health Planning Reference Series is a combined literature review and annotated bibliography dealing with communicable disease control in developing countries. The review identifies…

  10. Similarities in mortality patterns from influenza in the first half of the 20th century and the rise and fall of ischemic heart disease in the United States: a new hypothesis concerning the coronary heart disease epidemic

    Microsoft Academic Search

    Maria Inês Reinert Azambuja; Bruce B. Duncan

    2002-01-01

    The classic risk factors for developing coronary heart disease (CHD) explain less than 50% of the decrease in mortality observed since 1950. The transition currently under way, from the degenerative to the infectious-inflammatory paradigm, requires a new causal interpretation of temporal trends. The following is an ecological study based on data from the United States showing that in men and

  11. Process Evaluation of a Regional Public Health Model to Reduce Chronic Disease Through Policy and Systems Changes, Washington State, 2010–2014

    PubMed Central

    Walkinshaw, Lina P.; Allen, Claire L.; Vu, Thuy; Nandi, Paj; Santiago, Patti Migliore; Hannon, Peggy A.

    2015-01-01

    Introduction Although the regionalization of public health systems has been well documented in the case of emergency preparedness, there is little literature on the application of regional approaches to other aspects of public health. From 2011 through 2014 the Washington State Department of Health implemented a Community Transformation Grant to support community-level policy and systems changes to decrease chronic disease risk factors and increase access to clinical preventive services. The Department of Health implemented the grant through a regional model, grouping 32 of the state’s 35 local health jurisdictions into 5 regions. Our process evaluation identifies the challenges and facilitators to Community Transformation Grant planning and implementation. Methods We conducted 34 key informant interviews with people directly involved in the implementation of the Community Transformation Grant. We interviewed state and local partners, including representatives from each region, the Department of Health, external consultants, and regional partners. We collected data from October 2013 through July 2014. Results Challenges for planning, building, and implementing a regional model for chronic disease prevention included stakeholder buy-in, regional geography, and communication; facilitators included shared regional history and infrastructure, strong leadership, collaborative relationships, shared vision and goals, sufficient funding, and direct technical assistance and training. Conclusion Lessons learned in Washington State provide a foundation for other states interested in using a regional approach to reduce chronic disease risk. Policy and systems changes require adequate time, funding, and staffing. States and funders should work closely with local leaders to address these challenges and facilitators. PMID:25789498

  12. Management of intractable hiccup.

    PubMed Central

    Williamson, B W; MacIntyre, I M

    1977-01-01

    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. PMID:890370

  13. 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

    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

    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

  14. Impact of NO(x) emissions reduction policy on hospitalizations for respiratory disease in New York State.

    PubMed

    Lin, Shao; Jones, Rena; Pantea, Cristian; Özkaynak, Halûk; Rao, S Trivikrama; Hwang, Syni-An; Garcia, Valerie C

    2013-01-01

    To date, only a limited number of studies have examined the impact of ambient pollutant policy on respiratory morbidities. This accountability study examined the effect of a regional pollution control policy, namely, the US Environmental Protection Agency's (EPA) nitrogen oxides (NO(x)) Budget Trading Program (NBP), on respiratory health in New York State (NYS). Time-series analysis using generalized additive models was applied to assess changes in daily hospitalizations for respiratory diseases in NYS after the implementation of the NBP policy. Respiratory end points in the summers during the baseline period (1997-2000) were compared with those during the post-intervention period (2004-2006). Stratified analyses were also conducted to examine whether health impacts of the NBP differed by socio-demographic, regional, or clinical characteristics. Following the implementation of EPA's NBP policy, there were significant reductions in mean ozone levels (-2% to -9%) throughout NYS. After adjusting for time-varying variables, PM(2.5) concentration, and meteorological factors, significant post-intervention declines in respiratory admissions were observed in the Central (-10.18, 95% confidence interval (CI): -14.18, -6.01), Lower Hudson (-11.05, 95% CI: -16.54, -5.19), and New York City Metro regions (-5.71, 95% CI: -7.39, -4.00), consistent with wind trajectory patterns. Stratified analyses suggest that admissions for asthma, chronic airway obstruction, among those 5-17 years old, self-payers, Medicaid-covered, and rural residents declined the most post-NBP. This study suggests that the NO(x) control policy may have had a positive impact on both air pollution levels statewide and respiratory health in some NYS regions. However, the effect varied by disease subgroups, region, and socio-demographic characteristics. PMID:22829050

  15. Modeling the impact of vaccination control strategies on a foot and mouth disease outbreak in the Central United States.

    PubMed

    McReynolds, Sara W; Sanderson, Michael W; Reeves, Aaron; Hill, Ashley E

    2014-12-01

    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 10 km or 50 km 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

  16. Heart Disease in Women

    MedlinePLUS

    ... page from the NHLBI on Twitter. How Does Heart Disease Affect Women? Español In the United States, ... about coronary MVD and broken heart syndrome. Coronary Heart Disease CHD is a disease in which plaque ( ...

  17. Chagas disease

    MedlinePLUS

    ... help control the spread of the disease. Blood banks in Central and South America screen donors for ... discarded if the donor tests positive. Most blood banks in the United States began screening for Chagas ...

  18. The financial impact of a state adopting a personal/philosophical belief exemption policy: modeling the cost of pertussis disease in infants, children and adolescents.

    PubMed

    Wells, Katelyn B; Omer, Saad B

    2012-09-01

    State school immunization exemption policies help reduce the risk of individual and community disease. Assessing the costs of vaccine preventable disease associated with a state adding a philosophical/personal belief school exemption policy is useful for making future policy decisions. Two formulas were developed to estimate the infant, child and adolescent hospitalization and non-medical costs of pertussis disease that are associated with adding a philosophical/personal belief school exemption policy. The parameter estimates were obtained from peer reviewed literature and the Centers for Disease Control and Prevention. The state of Iowa was used as an example in order to demonstrate how the formulas can be applied. The annual projected impact of pertussis disease in Iowa is $273,365 without a philosophical/personal belief exemption policy and an average of $410,047 (range of $281,566-$582,267) with adding a personal belief exemption policy. We project that adding a philosophical/personal belief exemption will cost 50% more dollars annually. PMID:22863661

  19. Current situation and perspectives regarding human Chagas disease in midwestern of the state of Minas Gerais, Brazil

    PubMed Central

    Matos, Christiane Santos; dos Santos, José Eloy; Medeiros, Fernanda Alvarenga Cardoso; Furtado, Eliana; Dias, João Carlos Pinto

    2014-01-01

    Recognising the importance of Chagas disease in Brazil, Bambuí set up epidemiological surveillance for Chagas disease in 1974 and was the first municipality to do so. To ascertain the current epidemiology of Chagas disease in this municipality, 1.782 blood samples from the general population were analysed; 7.7% of samples were found to be seropositive for Chagas disease. A strong positive correlation between increasing age and Chagas disease was evident in both genders, with the highest prevalence in individuals aged over 60 years. Clinically, the cardiodigestive form of Chagas disease was the most common in these samples. These data confirm the interruption of Trypanosoma cruzi transmission, in parallel with a still important residual morbidity of Chagas disease in the county, thus supporting political decisions that will prioritise epidemiological surveillance and medical treatment of Chagas disease in the coming years. PMID:24831551

  20. 75 FR 69851 - Changes in Disease Status of the Brazilian State of Santa Catarina With Regard to Certain...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-16

    ...as free of foot-and- mouth disease (FMD), rinderpest, swine vesicular disease...trading relationships with rinderpest- or FMD-affected countries. These actions will...status of Santa Catarina with regard to FMD, rinderpest, swine vesicular...

  1. Oxidative stress in the molecular mechanism of pathogenesis at different diseased states of organism in clinics and experiment.

    PubMed

    Karageuzyan, Konstantin G

    2005-02-01

    According to modern images and results of our observations the oxidative stress (OS) is a non-specific though certain component of pathogenesis at numerous diseased states of organism having in the basis the thoroughness of pathogenic disturbances of phospholipids (PL) metabolism and processes of their free radical oxidation (FRO), which takes place in the membrane formations of as the whole cell, as well as the mitochondrial and microsomal fractions (MCF and MSF) of the white rat brain, liver mitochondria, lung shadows, at the same time erythrocyte and lymphocyte shadows at brain acute edema, ischemia, reperfusion and desympathization, infarction of myocardium, tuberculosis of lungs, diabetes, Familial Mediterranean Fever (FMF), intoxications under halothane anaesthesia (HA) and with micotoxin zearalenon. The regularities observed promote to understand from the point of view of modern approaches the molecular mechanisms of initiation, development and generalization of factors for OS formation under pathologic conditions. It is more obvious at zearalenon intoxication with intensification of lipids FRO processes and failures in PL-PL ratio phenomena. The lymphocytes membranes of the white rats spleen subjected OS induced by zearalenon intoxication permit us conclude that the general immune status of the organism decreases. It is generally peculiar to the states under conditions of generalized intoxication. The observed increase of phospholipase A(2) activity induces the release of high concentrations of lysophosphatidylcholines (LPC) and non-etherified fatty acids (NEFA) of polyenic range with prevail of arachidonic acid as a pathogenic factor, namely, at modelling brain acute edema by tetraethylolovo to white rats. Formation of the above mentioned disturbances to some extent depends on hydrophobic properties of toxins, particularly, zearalenon. The latter gives certain tropism to dopamine-beta-monooxygenase (DBM), and ability to stimulate functional activity of the enzyme. Striking haemolytic properties of phospholipase A(2) induced by existence of LPC and NEFA high concentrations, and products of their peroxidation, promote elimination of separate protein fractions of erythrocyte membranes (EM) responsible for OS formation and decrease of erythrocytes resistance to peroxide hemolysis. Increase of DBM activity under the effect of relatively moderate doses of zearalenon (1-15 microg/ml) is accompanied with extra intensification of catecholamine synthesizing function of the organism with lethal result. Data of publications represented testify exceptional efficiency of sodium thiosulfate (STS) as a powerful synergist for endogenous factors of antioxidant effect, particularly alpha-tocopherol (alpha-T), which is the main component for the system of cell antiradical defence. Detoxicating effect of STS can be demonstrated indeed on the example of zearalenon intoxication during the first two hours with the reduction of metabolism disturbances of PL and products of its peroxidation. Comparative evaluation of molecular mechanisms of STS normalizing effect as a supplier for hydrogen and sulphur ions, as well as an effective synergist for alpha-T on the level of various formations of the live cell in compare with the effects of alpha-T and ubiquinone, allowed to make a special accent on the role of STS in interaction with energy-dependent enzymatic systems of cell antiradical defence, as well as accumulation and transformation of energy on the level of mitochondrial membranes. The results obtained by us confirm a number of clinical experimental observations, which demonstrate treatment and prophylactic role of STS at different pathologic states of the organism. STS protectory role at toxic injuries of the organism is higher at its preliminary introduction to the organism before modelling of the studied diseased states, especially at zearalenon and halothane (H) intoxication (in the last case before HA). These data serve a sound affirmation for protectory function of STS, detailed revelation of molecular properties of pathogenesis o

  2. Appropriating Risk Factors: The Reception of an American Approach to Chronic Disease in the two German States, c. 1950–1990

    PubMed Central

    Timmermann, Carsten

    2012-01-01

    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.

  3. 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

  4. Surveillance for waterborne disease and outbreaks associated with recreational water use and other aquatic facility-associated health events-United States, 2005-2006

    EPA Science Inventory

    PROBLEM/CONDITION: Since 1971, CDC, the U.S. Environmental Protection Agency, and the Council of State and Territorial Epidemiologists have collaboratively maintained the Waterborne Disease and Outbreak Surveillance System for collecting and reporting data related to waterborne-d...

  5. 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

    H. G. Balla; A. S. Tahir; C. Haskainu

    2008-01-01

    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

  6. Surveillance for waterborne disease and outbreaks associated with drinking water and water not intended for drinking-United States, 2005-2006

    EPA Science Inventory

    PROBLEM/CONDITION: Since 1971, 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 (WBDOSS) for collecting and reporting data related to o...

  7. 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

    Sherry D. Broadwell; Peikang Yao; Deborah Hasin

    2006-01-01

    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

  8. Olfactory performance and resting state functional connectivity in non-demented drug naïve patients with Parkinson's disease.

    PubMed

    Sunwoo, Mun Kyung; Cha, Jungho; Ham, Jee Hyun; Song, Sook K; Hong, Jin Yong; Lee, Jong-Min; Sohn, Young H; Lee, Phil Hyu

    2015-05-01

    Olfactory performance in Parkinson's disease (PD) is closely associated with subsequent cognitive decline. In the present study, we analyzed the olfaction-dependent functional connectivity with a hypothesis that olfactory performance would influence functional connectivity within key brain areas of PD. A total of 110 nondemented drug-naïve patients with PD were subdivided into three groups of high score (PD-H, n?=?23), middle score (PD-M, n?=?64), and low score (PD-L, n?=?23) based on olfactory performance. We performed the resting-state functional connectivity with seed region of interest in the posterior cingulate cortex (PCC) and caudate. An analysis of functional connectivity revealed that PD-L patients exhibited a significant attenuation of cortical functional connectivity with the PCC in the bilateral primary sensory areas, right frontal areas, and right parietal areas compared to PD-H or PD-M patients. Meanwhile, PD-L patients exhibited a significant enhancement of striatocortical functional connectivity in the bilateral occipital areas and right frontal areas compared to PD-H or PD-M patients. In the voxel-wise correlation analysis, olfactory performance was positively associated with cortical functional connectivity with the PCC in similar areas of attenuated cortical connectivity in PD-L patients relative to PD-H patients. On the other hand, the cortical functional connectivity with the caudate was negatively correlated with olfactory performance in similar areas of increased connectivity in PD-L patients relative to PD-H patients. The present study demonstrated that resting state functional connectivity exhibits a distinctive pattern depending on olfactory performance, which might shed light on a meaningful relationship between olfactory impairment and cognitive dysfunction in PD. Hum Brain Mapp 36:1716-1727, 2015. © 2014 Wiley Periodicals, Inc. PMID:25640661

  9. HLA similarities indicate shared genetic risk in 21-hydroxylase autoantibody positive South African and United States Addison's disease.

    PubMed

    Ross, I L; Babu, S; Armstrong, T; Zhang, L; Schatz, D; Pugliese, A; Eisenbarth, G; Baker Ii, P

    2014-10-01

    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

  10. Conformational energetics of stable and metastable states formed by DNA triplet repeat oligonucleotides: Implications for triplet expansion diseases

    PubMed Central

    Völker, J.; Makube, N.; Plum, G. E.; Klump, H. H.; Breslauer, K. J.

    2002-01-01

    We have embedded the hexameric triplet repeats (CAG)6 and (CTG)6 between two (GC)3 domains to produce two 30-mer hairpins with the sequences d[(GC)3(CAG)6(GC)3] and d[(GC)3(CTG)6(GC)3]. This construct reduces the conformational space available to these repetitive DNA sequences. We find that the (CAG)6 and (CTG)6 repeats form stable, ordered, single-stranded structures. These structures are stabilized at 62°C by an average enthalpy per base of 1.38 kcal·mol?1 for the CAG triplet and 2.87 kcal·mol?1 for the CTG triplet, while being entropically destabilized by 3.50 cal·K?1·mol?1 for the CAG triplet and 7.6 cal·K?1·mol?1 for the CTG triplet. Remarkably, these values correspond, respectively, to 1/3 (for CAG) and 2/3 (for CTG) of the enthalpy and entropy per base values associated with Watson–Crick base pairs. We show that the presence of the loop structure kinetically inhibits duplex formation from the two complementary 30-mer hairpins, even though the duplex is the thermodynamically more stable state. Duplex formation, however, does occur at elevated temperatures. We propose that this thermally induced formation of a more stable duplex results from thermal disruption of the single-stranded order, thereby allowing the complementary domains to associate (perhaps via “kissing hairpins”). Our melting profiles show that, once duplex formation has occurred, the hairpin intermediate state cannot be reformed, consistent with our interpretation of kinetically trapped hairpin structures. The duplex formed by the two complementary oligonucleotides does not have any unusual optical or thermodynamic properties. By contrast, the very stable structures formed by the individual single-stranded triplet repeat sequences are thermally and thermodynamically unusual. We discuss this stable, triplet repeat, single-stranded structure and its interconversion with duplex in terms of triplet expansion diseases. PMID:12417759

  11. An outbreak of pertussis in rural Texas: an example of the resurgence of the disease in the United States.

    PubMed

    Eshofonie, Anthony O; Lin, Huai; Valcin, Randy P; Martin, LaTasha R; Grunenwald, Paul E

    2015-02-01

    During 2012, an increase in the number of pertussis cases or outbreaks was reported among most states within the United States. The majority of these cases included previously vaccinated children between the ages of 7-10 years. This underscores the growing concern regarding current immunization practices and vaccine efficacy, especially as it pertains to pertussis prevention within this age group. In the fall of 2012, an outbreak of pertussis occurred within a school district in a rural Texas county that was reflective of this national pattern. Our objective is to describe this outbreak, highlight the similarities with the national trend, and identify strategies for better disease prevention. The cases in this outbreak were interviewed and laboratory testing done. Information regarding exposure and immunization history among cases was obtained. Immunization audits of the affected institutions were also conducted. We performed a descriptive analysis of the collected data using EPI-INFO software v.3.5.3. A total of 34 cases were identified in this outbreak, of which 23 were PCR confirmed and 11 were epidemiologically linked. Ages ranged from 5 months to 12 years, and 62 % were among children aged 7-10 years. All cases were up-to-date on their pertussis vaccinations. Immunization coverage rate was over 90 % within each of the affected institutions. The characteristics of this outbreak bear striking similarities to the current national trend in terms of age groups and immunization status of the affected cases. Increased focus on this vulnerable target group, including heightened scrutiny of vaccine efficacy and delivery, is indicated. PMID:24927977

  12. 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...

  13. Comparing Bacterial Community Composition between Healthy and White Plague-Like Disease States in Orbicella annularis Using PhyloChip™ G3 Microarrays

    PubMed Central

    Kellogg, Christina A.; Piceno, Yvette M.; Tom, Lauren M.; DeSantis, Todd Z.; Gray, Michael A.; Zawada, David G.; Andersen, Gary L.

    2013-01-01

    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

  14. Comparing bacterial community composition between healthy and white plague-like disease states in Orbicella annularis using PhyloChip™ G3 microarrays

    USGS Publications Warehouse

    Kellogg, Christina A.; Piceno, Yvette M.; Tom, Lauren M.; DeSantis, Todd Z.; Gray, Michael A.; Zawada, David G.; Andersen, Gary L.

    2013-01-01

    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.

  15. Hantavirus pulmonary syndrome in the United States: a pathological description of a disease caused by a new agent.

    PubMed

    Nolte, K B; Feddersen, R M; Foucar, K; Zaki, S R; Koster, F T; Madar, D; Merlin, T L; McFeeley, P J; Umland, E T; Zumwalt, R E

    1995-01-01

    An outbreak of an acute respiratory disease in the southwestern United States has led to the recognition of a new hantaviral illness. This report describes a unique spectrum of antemortem and postmortem pathological findings seen in a case series of nine surviving patients and 13 who died. Clinical, laboratory, and autopsy findings were derived from a consecutive series of individuals confirmed to have hantavirus pulmonary syndrome. Laboratory studies included chemical, hematological, and bone marrow analyses as well as flow cytometric and immunohistochemical phenotyping. Autopsy tissues were examined by routine histological stains, immunohistochemical methods, and transmission electron microscopy. The lung is the primary target organ in this illness. Pulmonary abnormalities include pleural effusions, alveolar edema and fibrin, and an interstitial mononuclear cell infiltrate. Large immunoblast type cells are seen in the lungs, blood, bone marrow, lymph nodes, liver, and spleen. A tetrad of hematological findings includes left-shifted neutrophilic leukocytosis, thrombocytopenia, hemoconcentration in severe cases, and circulating immunoblasts. In contrast to previously described nephropathic hantaviral syndromes, hantavirus pulmonary syndrome is characterized by a unique constellation of pulmonary, hematological, and reticuloendothelial pathological findings. The pulmonary findings are distinguishable from fatal adult respiratory distress syndrome. The data suggest a capillary leak syndrome restricted to the pulmonary circulation. Likewise, the hematological picture is unique and may be valuable in the rapid identification of cases for further diagnostic studies. PMID:7821907

  16. Menstrual Cycle Changes in Women with Inflammatory Bowel Disease: A Study from the Ocean State Crohn's and Colitis Area Registry

    PubMed Central

    Saha, Sumona; Zhao, Yingqi; Shah, Samir A.; Esposti, Silvia Degli; Lidofsky, Sheldon; Salih, Sana; Bright, Renee; Law, Meaghan; Moniz, Heather; Flowers, Nicole; Merrick, Marjorie; Sands, Bruce E.

    2014-01-01

    Background and Aims The effect of the inflammatory bowel diseases (IBD) on menstrual function is largely unknown. The aims of this study were to determine whether changes in menstrual function occur in the year prior to IBD diagnosis or in the initial years after diagnosis. Methods Women aged 18 and above in the Ocean State Crohn's and Colitis Area Registry with at least 2 years of follow-up were eligible for this study. All subjects were enrolled within 6 months of IBD diagnosis and followed prospectively. Menstrual cycle characteristics were retrospectively assessed. To assess for changes over time, general linear models for correlated data were used for continuous outcomes and generalized estimating equations were used for discrete outcomes. Results 121 subjects were studied. Twenty-five percent of subjects experienced a change in cycle interval in the year prior to IBD diagnosis and 21% experienced a change in duration of flow. Among women with dysmenorrhea, 40% experienced a change in the intensity of their menstrual pain and 31% experienced a change in its duration. Overall cycle regularity increased over time.. Quality of life (QOL) was significantly lower in women without regular cycles across all time points. Conclusions Changes in menstrual function occur frequently in the year prior to IBD diagnosis; therefore screening for menstrual irregularities should be considered in women with newly diagnosed IBD. Patients can be reassured that cycles typically become more regular over time. PMID:24451220

  17. Mortality Caused by Chronic Liver Disease Among American Indians and Alaska Natives in the United States, 1999–2009

    PubMed Central

    Suryaprasad, Anil; Byrd, Kathy K.; Redd, John T.; Perdue, David G.; Manos, M. Michele; McMahon, Brian J.

    2014-01-01

    Objectives. We compared chronic liver disease (CLD) mortality from 1999 to 2009 between American Indians and Alaska Natives (AI/ANs) and Whites in the United States after improving CLD case ascertainment and AI/AN race classification. Methods. We defined CLD deaths and causes by comprehensive death certificate-based diagnostic codes. To improve race classification, we linked US mortality data to Indian Health Service enrollment records, and we restricted analyses to Contract Health Service Delivery Areas and to non-Hispanic populations. We calculated CLD death rates (per 100?000) in 6 geographic regions. We then described trends using linear modeling. Results. CLD mortality increased from 1999 to 2009 in AI/AN persons and Whites. Overall, the CLD death rate ratio (RR) of AI/AN individuals to Whites was 3.7 and varied by region. The RR was higher in women (4.7), those aged 25 to 44 years (7.4), persons residing in the Northern Plains (6.4), and persons dying of cirrhosis (4.0) versus hepatocellular carcinoma (2.5), particularly those aged 25 to 44 years (7.7). Conclusions. AI/AN persons had greater CLD mortality, particularly from premature cirrhosis, than Whites, with variable mortality by region. Comprehensive prevention and care strategies are urgently needed to stem the CLD epidemic among AI/AN individuals. PMID:24754616

  18. The Importance of Diabetes Mellitus in the Global Epidemic of Cardiovascular Disease: The Case of the State of Qatar

    PubMed Central

    Mushlin, Alvin I.; Christos, Paul J.; Abu-Raddad, Laith; Chemaitelly, Hiam; Deleu, Dirk; Gehani, Abdul Razak

    2012-01-01

    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

  19. Caregiver's burden and quality of life in mitochondrial disease.

    PubMed

    Kim, Kyung Ran; Lee, Eun; Namkoong, Kee; Lee, Young Mock; Lee, Joon Soo; Kim, Heung Dong

    2010-04-01

    A child's health inevitably affects the parents' psychologic health and quality of life, especially for mothers of disabled children. Caregiver burden and health-related quality of life were investigated in mothers of children with mitochondrial disease, compared with mothers of children with intractable epilepsy. Mothers of children with mitochondrial disease (n = 33) and intractable epilepsy (n = 32) were recruited. The Zarit Burden Inventory, the Medical Outcomes Short Form 36, short version of the World Health Organization Quality of Life, Beck Depression Inventory, and Beck Anxiety Inventory were administered to all participants. Except for duration of illness and number of previous hospitalizations, there was no significant difference in recorded variables between the two groups. Mothers of children with mitochondrial disease had significantly higher caregiver burden and poorer health-related quality of life, particularly related to role limitations, vitality, and mental health. They also had greater levels of depression and anxiety. After adjustment for all covariates, caregiver anxiety was the most important factor affecting overall caregiver burden. With mitochondrial disease, the possibility of maternal inheritance and scarcity of information about the disease might increase anxiety and thus eventually also the caregiver burden. Accurate information about rare diseases provided to caregivers could be helpful in reducing their anxiety. PMID:20304331

  20. Geographic variation in the relationship between human Lyme disease incidence and density of infected host-seeking Ixodes scapularis nymphs in the Eastern United States.

    PubMed

    Pepin, Kim M; Eisen, Rebecca J; Mead, Paul S; Piesman, Joseph; Fish, Durland; Hoen, Anne G; Barbour, Alan G; Hamer, Sarah; Diuk-Wasser, Maria A

    2012-06-01

    Prevention and control of Lyme disease is difficult because of the complex biology of the pathogen's (Borrelia burgdorferi) vector (Ixodes scapularis) and multiple reservoir hosts with varying degrees of competence. Cost-effective implementation of tick- and host-targeted control methods requires an understanding of the relationship between pathogen prevalence in nymphs, nymph abundance, and incidence of human cases of Lyme disease. We quantified the relationship between estimated acarological risk and human incidence using county-level human case data and nymphal prevalence data from field-derived estimates in 36 eastern states. The estimated density of infected nymphs (mDIN) was significantly correlated with human incidence (r = 0.69). The relationship was strongest in high-prevalence areas, but it varied by region and state, partly because of the distribution of B. burgdorferi genotypes. More information is needed in several high-prevalence states before DIN can be used for cost-effectiveness analyses. PMID:22665620

  1. RARE DISEASES LIST

    EPA Science Inventory

    The rare disease list includes rare diseases and conditions for which information requests have been made to the Office of Rare Diseases. A rare disease is defined as a disease or condition for which there are fewer than 200,000 affected persons alive in the United States. The Of...

  2. Gaussian process classification of Alzheimer's disease and mild cognitive impairment from resting-state fMRI.

    PubMed

    Challis, Edward; Hurley, Peter; Serra, Laura; Bozzali, Marco; Oliver, Seb; Cercignani, Mara

    2015-05-15

    Multivariate pattern analysis and statistical machine learning techniques are attracting increasing interest from the neuroimaging community. Researchers and clinicians are also increasingly interested in the study of functional-connectivity patterns of brains at rest and how these relations might change in conditions like Alzheimer's disease or clinical depression. In this study we investigate the efficacy of a specific multivariate statistical machine learning technique to perform patient stratification from functional-connectivity patterns of brains at rest. Whilst the majority of previous approaches to this problem have employed support vector machines (SVMs) we investigate the performance of Bayesian Gaussian process logistic regression (GP-LR) models with linear and non-linear covariance functions. GP-LR models can be interpreted as a Bayesian probabilistic analogue to kernel SVM classifiers. However, GP-LR methods confer a number of benefits over kernel SVMs. Whilst SVMs only return a binary class label prediction, GP-LR, being a probabilistic model, provides a principled estimate of the probability of class membership. Class probability estimates are a measure of the confidence the model has in its predictions, such a confidence score may be extremely useful in the clinical setting. Additionally, if miss-classification costs are not symmetric, thresholds can be set to achieve either strong specificity or sensitivity scores. Since GP-LR models are Bayesian, computationally expensive cross-validation hyper-parameter grid-search methods can be avoided. We apply these methods to a sample of 77 subjects; 27 with a diagnosis of probable AD, 50 with a diagnosis of a-MCI and a control sample of 39. All subjects underwent a MRI examination at 3T to obtain a 7minute and 20second resting state scan. Our results support the hypothesis that GP-LR models can be effective at performing patient stratification: the implemented model achieves 75% accuracy disambiguating healthy subjects from subjects with amnesic mild cognitive impairment and 97% accuracy disambiguating amnesic mild cognitive impairment subjects from those with Alzheimer's disease, accuracies are estimated using a held-out test set. Both results are significant at the 1% level. PMID:25731993

  3. The use of the United States FDA programs as a strategy to advance the development of drug products for neglected tropical diseases.

    PubMed

    Sachs-Barrable, Kristina; Conway, Jocelyn; Gershkovich, Pavel; Ibrahim, Fady; Wasan, Kishor M

    2014-11-01

    Neglected tropical diseases (NTDs) are infections which are endemic in poor populations in lower- and middle-income countries (LMIC). Approximately one billion people have now or are at risk of getting an NTD and yet less than 5% of research dollars are focused on providing treatments and prevention of these highly debilitating and deadly conditions. The United States Food and Drug Administration (FDA) Orphan Drug Designation program (ODDP) provides orphan status to drugs and biologics, defined as those intended for the safe and effective treatment, diagnosis or prevention of rare diseases and/or disorders that affect fewer than 200 000 people in the United States, or that affect more than 200 000 persons but are not expected to recover the costs of developing and marketing a treatment drug. These regulations have led to the translation of rare disease knowledge into innovative rare disease therapies. The FDA Guidance for Industry on developing drugs for the treatment and prevention of NTDs describes the following regulatory strategies: Orphan Product Designation, Fast Track Designation, Priority Review Designation, Accelerated Approval and Tropical Disease Priority Review Voucher. This paper will discuss how these regulations and especially the ODDP can improve the clinical development and accessibility of drug products for NTDs. PMID:24512098

  4. State Synergies and Disease Surveillance: Creating an Electronic Health Data Communication Model for Cancer Reporting and Comparative Effectiveness Research in Kentucky

    PubMed Central

    Reams, Christopher; Powell, Mallory; Edwards, Rob

    2014-01-01

    Purpose: This case study describes the collaboration between a state public health department, a major research university, and a health extension service funded as part of the Health Information Technology for Economic and Clinical Health (HITECH) Act to establish an interoperable health information system for disease surveillance through electronic reporting of systemic therapy data from numerous oncology practices in Kentucky. The experience of the Kentucky cancer surveillance system can help local and state entities achieve greater effectiveness in designing communication efforts to increase usage of electronic health records (EHRs) and health information exchanges (HIEs), help eligible clinicians meet these new standards in patient care, and conduct disease surveillance in a learning health system. Innovation: We document and assess the statewide efforts of early health information technology (HIT) adopters in Kentucky to facilitate the nation’s first electronic transmission of a clinical document architecture (CDA) from a physician office to a state cancer surveillance registry in November 2012. Successful transmission of the CDA not only represented a landmark for technology innovators, informaticists, and clinicians, but it also set in motion a new communication mechanism by which state and federal agencies can capture and trade vital cancer statistics in a way that is safe, secure, and timely. The corresponding impact this has on cancer surveillance and comparative effective research is immense. With guidance from the Centers for Disease Control and Prevention (CDC), the Kentucky Cancer Registry (KCR), the Kentucky Health Information Exchange (KHIE), and the Kentucky Regional Extension Center (KREC) have moved one step further in transforming the interoperable health environment for improved disease surveillance. Credibility: This case study describes the efforts of established and reputable agencies, including the KCR, the state department of health, state and federal governmental agencies, and a major research university in leveraging existing networks, infrastructure, and federally awarded funding to implement interoperable health information systems for disease surveillance. Project assessment through quasi-qualitative interviews with key stakeholders facilitated evaluation of attitudes and beliefs for continued use of the cancer surveillance model. Conclusion and Discussion: In Kentucky, the cancer reporting initiative leveraged and enhanced a solid foundation for statewide collaboration to achieve better health and improved disease surveillance through a learning health system. Leveraging the Meaningful Use (MU) program as an overarching policy and structural driver is imperative. The cancer reporting initiative in Kentucky suggests that future surveillance and reporting initiatives will require locally adaptable solutions and that there is a need for increased technical assistance in rural settings. Kentucky’s experience also indicates that stakeholders should be diligent in identifying state-level criteria that align with MU for vetting EHR vendors.

  5. A brief review of infectious and parasitic diseases of wapiti, with emphasis on western Canada and the northwestern United States

    PubMed Central

    Smits, Judit E.G.

    1991-01-01

    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

  6. Improvement of Freezing of Gait in Patients with Parkinson's Disease by Imagining Bicycling

    PubMed Central

    Kikuchi, Akio; Baba, Toru; Hasegawa, Takafumi; Sugeno, Naoto; Konno, Masatoshi; Miura, Emiko; Oshima, Ryuji; Aoki, Masashi; Takeda, Atsushi

    2014-01-01

    Freezing of gait (FOG) is one of the factors that reduce the quality of life in patients with Parkinson's disease (PD). Imagining bicycling before gait start provided improvement in FOG in 2 PD patients. Imagining and mimicking bicycling after the initiation of gait allowed the rhythmic gait to continue without interruption. We suggest that imagining and mimicking bicycling, which are nonexternal cues, could serve as a helpful therapeutic approach for the intractable freezing and interruption of gait of PD patients. PMID:24761145

  7. Lyme Disease

    PubMed Central

    Murray, Thomas S.; Shapiro, Eugene D.

    2013-01-01

    Synopsis Lyme disease, caused by spirochete Borrelia burgdorferi, is the most common vector-borne disease in the United States. The clinical presentation varies depending on the stage of the illness: early disease includes erthyma migrans, early disseminated disease includes multiple erythema migrans, meningitis, cranial nerve palsies and carditis; late disease is primarily arthritis. The symptoms and signs of infection resolve in the vast majority of patients after appropriate treatment with antimicrobials for from 2-4 weeks. Serologic testing should be used judiciously as it often results in misdiagnosis when performed on blood from patients with a low prior probability of disease and those with non-specific symptoms such as fatigue or arthralgia without signs of infection. PMID:20513553

  8. Climate variability and change in the United States: potential impacts on water- and foodborne diseases caused by microbiologic agents.

    PubMed Central

    Rose, J B; Epstein, P R; Lipp, E K; Sherman, B H; Bernard, S M; Patz, J A

    2001-01-01

    Exposure to waterborne and foodborne pathogens can occur via drinking water (associated with fecal contamination), seafood (due to natural microbial hazards, toxins, or wastewater disposal) or fresh produce (irrigated or processed with contaminated water). Weather influences the transport and dissemination of these microbial agents via rainfall and runoff and the survival and/or growth through such factors as temperature. Federal and state laws and regulatory programs protect much of the U.S. population from waterborne disease; however, if climate variability increases, current and future deficiencies in areas such as watershed protection, infrastructure, and storm drainage systems will probably increase the risk of contamination events. Knowledge about transport processes and the fate of microbial pollutants associated with rainfall and snowmelt is key to predicting risks from a change in weather variability. Although recent studies identified links between climate variability and occurrence of microbial agents in water, the relationships need further quantification in the context of other stresses. In the marine environment as well, there are few studies that adequately address the potential health effects of climate variability in combination with other stresses such as overfishing, introduced species, and rise in sea level. Advances in monitoring are necessary to enhance early-warning and prevention capabilities. Application of existing technologies, such as molecular fingerprinting to track contaminant sources or satellite remote sensing to detect coastal algal blooms, could be expanded. This assessment recommends incorporating a range of future scenarios of improvement plans for current deficiencies in the public health infrastructure to achieve more realistic risk assessments. PMID:11359688

  9. Resting state in Alzheimer's disease: a concurrent analysis of Flash-Visual Evoked Potentials and quantitative EEG

    PubMed Central

    2012-01-01

    Background To investigate to what extent Alzheimer's Disease (AD) affects Resting State activity, the possible impairment of independent electrophysiological parameters was determined in Eye-open and Eye-closed Conditions. Specifically, Flash-Visual Evoked Potential (F-VEP) and quantitative EEG (q-EEG) were examined to establish whether abnormalities of the former were systematically associated with changes of the latter. Methods Concurrently recorded F-VEP and q-EEG were comparatively analysed under Eye-open and Eye-closed Conditions in 11 Controls and 19 AD patients presenting a normal Pattern-Visual Evoked Potential (P-VEP). Between Condition differences in latencies of P2 component were matched to variations in spectral components of q-EEG. Results P2 latency increased in 10 AD patients with Abnormal Latency (AD-AL) under Eye-closed Condition. In these patients reduction of alpha activity joined an increased delta power so that their spectral profile equated that recorded under Eye-open Condition. On the opposite, in Controls as well as in AD patients with Normal P2 Latency (AD-NL) spectral profiles recorded under Eye-open and Eye-closed Conditions significantly differed from each other. At the baseline, under Eye-open Condition, the spectra overlapped each other in the three Groups. Conclusion Under Eye-closed Condition AD patients may present a significant change in both F-VEP latency and EEG rhythm modulation. The presence of concurrent changes of independent parameters suggests that the neurodegenerative process can impair a control system active in Eye-closed Condition which the electrophysiological parameters depend upon. F-VEP can be viewed as a reliable marker of such impairment. PMID:23190493

  10. Forecast of the number of patients with end-stage renal disease in the United States to the year 2010.

    PubMed

    Xue, J L; Ma, J Z; Louis, T A; Collins, A J

    2001-12-01

    As the United States end-stage renal disease (ESRD) program enters the new millennium, the continued growth of the ESRD population poses a challenge for policy makers, health care providers, and financial planners. To assist in future planning for the ESRD program, the growth of patient numbers and Medicare costs was forecasted to the year 2010 by modeling of historical data from 1982 through 1997. A stepwise autoregressive method and exponential smoothing models were used. The forecasting models for ESRD patient numbers demonstrated mean errors of -0.03 to 1.03%, relative to the observed values. The model for Medicare payments demonstrated -0.12% mean error. The R(2) values for the forecasting models ranged from 99.09 to 99.98%. On the basis of trends in patient numbers, this forecast projects average annual growth of the ESRD populations of approximately 4.1% for new patients, 6.4% for long-term ESRD patients, 7.1% for dialysis patients, 6.1% for patients with functioning transplants, and 8.2% for patients on waiting lists for transplants, as well as 7.7% for Medicare expenditures. The numbers of patients with ESRD in 2010 are forecasted to be 129,200 +/- 7742 (95% confidence limits) new patients, 651,330 +/- 15,874 long-term ESRD patients, 520,240 +/- 25,609 dialysis patients, 178,806 +/- 4349 patients with functioning transplants, and 95,550 +/- 5478 patients on waiting lists. The forecasted Medicare expenditures are projected to increase to $28.3 +/- 1.7 billion by 2010. These projections are subject to many factors that may alter the actual growth, compared with the historical patterns. They do, however, provide a basis for discussing the future growth of the ESRD program and how the ESRD community can meet the challenges ahead. PMID:11729245

  11. 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'

  12. Research into the (Cost-) effectiveness of the ketogenic diet among children and adolescents with intractable epilepsy: design of a randomized controlled trial

    PubMed Central

    2011-01-01

    Background Epilepsy is a neurological disorder, characterized by recurrent unprovoked seizures which have a high impact on the individual as well as on society as a whole. In addition to the economic burden, epilepsy imposes a substantial burden on the patients and their surroundings. Patients with uncontrolled epilepsy depend heavily on informal care and on health care professionals. About 30% of patients suffer from drug-resistant epilepsy. The ketogenic diet can be a treatment of last resort, especially for children. The beneficial effect of the ketogenic diet has been proven, but information is lacking about its cost-effectiveness. In the current study we will evaluate the (cost-) effectiveness of the ketogenic diet in children and adolescents with intractable epilepsy. Methods/Design In a RCT we will compare the ketogenic diet with usual care. Embedded in this RCT will be a trial-based and model-based economic evaluation, looking from a societal perspective at the cost-effectiveness and cost-utility of the ketogenic diet versus usual care. Fifty children and adolescents (aged 1-18) with intractable epilepsy will be screened for eligibility before randomization into the intervention or the usual care group. The primary outcome measure is the proportion of children with a 50% or more reduction in seizure frequency. Secondary outcomes include seizure severity, side effects/complaints, neurocognitive, socio-emotional functioning, and quality of life. Costs and productivity losses will be assessed continuously by a prospective diary and a retrospective questionnaire. Measurements will take place during consults at baseline, at 6 weeks and at 4 months after the baseline period, and 3, 6, 9 and 12 months follow-up after the 4 months consult. Discussion The proposed research project will be the first study to provide data about the cost-effectiveness of the ketogenic diet for children and adolescents with intractable epilepsy, in comparison with usual care. It is anticipated that positive results in (cost-) effectiveness of the proposed intervention will contribute to the improvement of treatment for epilepsy in children and adolescents and will lead to a smaller burden to society. Trial registration The study has been registered with the Netherlands Trial Registry (NTR2498). PMID:21262002

  13. The Contributions of Selected Diseases to Disparities in Death Rates and Years of Life Lost for Racial/Ethnic Minorities in the United States, 1999–2010

    PubMed Central

    Peace, Frederick; Howard, Virginia J.

    2014-01-01

    Introduction Differences in risk for death from diseases and other causes among racial/ethnic groups likely contributed to the limited improvement in the state of health in the United States in the last few decades. The objective of this study was to identify causes of death that are the largest contributors to health disparities among racial/ethnic groups. Methods Using data from WONDER system, we measured the relative (age-adjusted mortality ratio [AAMR]) and absolute (difference in years of life lost [dYLL]) differences in mortality risk between the non-Hispanic white population and the black, Hispanic, American Indian/Alaska Native, and Asian/Pacific Islander populations for the 25 leading causes of death. Results Many causes contributed to disparities between non-Hispanic whites and blacks, led by assault (AAMR, 7.56; dYLL, 4.5 million). Malignant neoplasms were the second largest absolute contributor (dYLL, 3.8 million) to black–white disparities; we also found substantial relative and absolute differences for several cardiovascular diseases. Only assault, diabetes, and diseases of the liver contributed substantially to disparities between non-Hispanic whites and Hispanics (AAMR ? 1.65; dYLL ? 325,000). Many causes of death, led by assault (AAMR, 3.25; dYLL, 98,000), contributed to disparities between non-Hispanic whites and American Indians/Alaska Natives; Asian/Pacific Islanders did not have a higher risk than non-Hispanic whites for death from any disease. Conclusion Assault was a substantial contributor to disparities in mortality among non-Asian racial/ethnic minority populations. Research and intervention resources need to target diseases (such as diabetes and diseases of the liver) that affect certain racial/ethnic populations. PMID:25078566

  14. [Chagas disease epidemiological surveillance in a decentralized program: evaluation of practice and knowledge among municipal health agents in an endemic region of Minas Gerais State, Brazil].

    PubMed

    Villela, Marcos Marreiro; Souza, Janice Maria Borba de; Melo, Vicente de Paula; Dias, João Carlos Pinto

    2007-10-01

    This study aimed to evaluate the epidemiological surveillance of Chagas disease in the central-western region of Minas Gerais State, Brazil, based on knowledge and practice among municipal health agents working in the Chagas Disease Control Program. Thirty-five municipalities (counties) were visited, with meetings and application of a questionnaire on knowledge, practice, and difficulties in conducting the surveillance work. Twenty-six agents were on temporary (annual) contracts, and only two had job stability. 77.1% of the agents commented that the local population had difficulty identifying the vector insects (triatomines). Twenty-three employees stated that the municipal governments provided adequate conditions for conducting the surveillance program, although 27 made suggestions, particularly requesting more educational materials, better wages, and greater appreciation of their work by the municipal governments. Such suggestions are crucial to the consolidation of the program's results. PMID:17891303

  15. Atypical and Classical Forms of the Disease-Associated State of the Prion Protein Exhibit Distinct Neuronal Tropism, Deposition Patterns, and Lesion Profiles

    PubMed Central

    Kovacs, Gabor G.; Makarava, Natallia; Savtchenko, Regina; Baskakov, Ilia V.

    2014-01-01

    A number of disease-associated PrP forms characterized by abnormally short proteinase K–resistant fragments (atypical PrPres) were recently described in prion diseases. The relationship between atypical PrPres and PrPSc, and their role in etiology of prion diseases, remains unknown. We examined the relationship between PrPSc and atypical PrPres, a form characterized by short C-terminal proteinase K–resistant fragments, in a prion strain of synthetic origin. We found that the two forms exhibit distinct neuronal tropism, deposition patterns, and degree of pathological lesions. Immunostaining of brain regions demonstrated a partial overlap in anatomic involvement of the two forms and revealed the sites of their selective deposition. The experiments on amplification in vitro suggested that distinct neuronal tropism is attributed to differences in replication requirements, such as preferences for different cellular cofactors and PrPC glycoforms. Remarkably, deposition of atypical PrPres alone was not associated with notable pathological lesions, suggesting that it was not neurotoxic, but yet transmissible. Unlike PrPSc, atypical PrPres did not show significant perineuronal, vascular, or perivascular immunoreactivity. However, both forms showed substantial synaptic immunoreactivity. Considering that atypical PrPres is not associated with substantial lesions, this result suggests that not all synaptic disease–related PrP states are neurotoxic. The current work provides important new insight into our understanding of the structure–pathogenicity relationships of transmissible PrP states. PMID:24012784

  16. Comparing clinical attachment level and pocket depth for predicting periodontal disease progression in healthy sites of patients with chronic periodontitis using multi-state Markov models

    PubMed Central

    Mdala, Ibrahimu; Olsen, Ingar; Haffajee, Anne D; Socransky, Sigmund S; Thoresen, Magne; de Blasio, Birgitte Freiesleben

    2014-01-01

    Aim To understand degeneration of healthy sites and identify factors associated with disease progression in patients with chronic periodontitis. Material and Methods Data on healthy sites from 163 American and Swedish subjects were analysed using two-three-state (health, gingivitis, chronic periodontitis) Markov models based on bleeding on probing (BOP), and either clinical attachment level (CAL) + BOP or pocket depth (PD) + BOP. Results In 2 years, 10% (CAL + BOP) and 3% (PD + BOP) of healthy sites developed chronic periodontitis. On average, healthy sites remained healthy for 32 months before transiting in both models. Most transitions (87–97%) from health were to the gingivitis state. The expected duration of the gingivitis lesion was 4–5 months and sites recovered with a high probability (96–98%). Disease severity as measured by number of sites with CAL/PD > 4 mm at baseline and smoking, were associated with fast progression from health to chronic periodontitis within 6 months as were gingival redness in the PD + BOP model only. With age, the rate of disease progression to gingivitis decreased. Conclusion Transition probabilities for gingivitis and chronic periodontitis were higher with CAL + BOP than with PD + BOP. Smoking and disease severity were significant predictors for fast progression. PMID:24888705

  17. Steady-state pharmacokinetic properties of a 24-hour prolonged-release formulation of ropinirole: Results of two randomized studies in patients with Parkinson's disease

    Microsoft Academic Search

    Debra J. Tompson; Deborah Vearer

    2007-01-01

    Background: Ropinirole 24-hour prolonged release is a new once-daily formulation of ropinirole that provides continuous delivery of ropinirole over 24 hours.Objective: The studies described here were conducted to characterize the steady-state pharmacokinetics of ropinirole 24-hour prolonged release in patients with Parkinson's disease.Methods: Study 164 was a 2-part study; Part A employed a crossover design to assess the relative bioavailability of

  18. Compendium of measures to prevent disease associated with animals in public settings, 2011: National Association of State Public Health Veterinarians, Inc.

    PubMed

    2011-05-01

    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 in day camp settings, as well as the protective role of zoonotic disease education. PMID:21546893

  19. Intractable intraoperative bleeding requiring platelet transfusion during emergent cholecystectomy in a patient with dual antiplatelet therapy after drug-eluting coronary stent implantation (with video)

    PubMed Central

    Fujikawa, Takahisa; Noda, Tomohiro; Tada, Seiichiro; Tanaka, Akira

    2013-01-01

    We report a case of a 76-year-old man, receiving dual antiplatelet therapy (DAPT) with aspirin and ticlopidine for the past 6?years after implantation of drug-eluting coronary stent, developed a severe hypochondriac pain. After diagnosing severe acute cholecystitis by an enhanced CT, emergent laparotomy under continuation of DAPT was attempted. During the operation, intractable bleeding from the adhesiolysed liver surface was encountered, which required platelet transfusion. Subtotal cholecystectomy with abdominal drainage was performed, and the patient recovered without any postoperative bleeding or thromboembolic complications. Like the present case, the final decision should be made to perform platelet transfusion when life-threatening DAPT-induced intraoperative bleeding occurs during an emergent surgery, despite the elevated risk of stent thrombosis. PMID:23536626

  20. 75 FR 3243 - NIH State-of-the-Science Conference: Preventing Alzheimer's Disease and Cognitive Decline; Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-20

    ...cognitive impairment or into various forms of dementia, including Alzheimer's disease. Such...decades before cognitive decline and dementia symptoms appear, they also hope to discover...Alzheimer's, the most common form of dementia, and those numbers are expected to...